New Biomarkers of Inflammation Identified as Risk of Polyneuropathy
Polyneuropathy is one of the most common complications in people with diabetes. However, it can also occur with certain risk factors or diseases before the onset of diabetes. First symptoms are often pins-and-needles sensations in the feet. Although polyneuropathy is present in about 30% of people with diabetes, it often remains undiagnosed. Scientists from the German Diabetes Center (DDZ) in Düsseldorf, in cooperation with colleagues from Helmholtz Zentrum München, both partners in the German Center for Diabetes Research, have now been able to show for the first time that six biomarkers of inflammation indicate the risk of polyneuropathy. The results were published in the journal Diabetes.
Although many patients suffer from polyneuropathy, relatively little is currently known about its development, which also limits the therapeutic options. It is known that inflammatory processes contribute to other diabetic complications such as heart attack or stroke. The aim of this new study was therefore the extensive analysis of biomarkers that characterize inflammatory processes as a risk factor for distal sensory polyneuropathy (DSPN). Both people with type 2 diabetes and people in the elderly general population were examined.
"In our study, we identified novel biomarkers that indicate the risk of polyneuropathy. For the first time, we were also able to find indications that in addition to the innate immune system, the adaptive immune system could be involved in the development of the disease," says Professor Christian Herder, MD, head of the study at the DDZ.
"These findings could open new therapeutic perspectives. The goal could be to influence the immune system accordingly and thus ultimately prevent the development or progression of neuropathy," adds Professor Dan Ziegler, MD, who is a neuro-diabetologist and deputy director of the Institute for Clinical Diabetology at the DDZ.
Study — Procedure and Design
The chemokines showed neurotoxic effects in a cell culture model, which indicates their involvement in the development of neuropathy. When the data for these six biomarkers were added to a clinical risk model, the predictive quality of the model improved significantly. Further pathway analyses indicated that different cell types of innate and adaptive immunity are likely to be involved in the development of DSPN. Overall, this study has therefore been able to reveal novel associations between biomarkers of inflammation and the risk of polyneuropathy and to provide evidence suggesting a complex interaction of innate and adaptive immunity in the development of this complication.
Source: German Center for Diabetes Research