Can VEGF Reverse Diabetic Neuropathy In Human Subjects?

A nonviral gene therapy may relieve symptoms of painful diabetic neuropathy. Painful peripheral neuropathy may also occur along with damage to motor nerves, or to autonomic nerves that govern basic physiological states, such as blood pressure - both of which cause non-sensory symptoms, such as muscle weakness or lightheadedness.
Degenerative changes in the cervical vertebrae and surrounding soft tissues (ligaments, intervertebral discs, joint capsules) cause narrowing of the spinal canal where the spinal cord itself passes, as well as the openings that allow passage of nerve roots as they exit the spinal cord and travel to other parts of the body.



Duloxetine has been shown to reduce pain by 8% on the 11-point Liker scale 42 , Class I and by 13% on the visual analog scale (compared with placebo) in patients with painful diabetic neuropathy 43 , 44 , Class II. There was also a high completion rate of approximately 75% 43 , 44 , and quality of life measures were improved 44 , Class II.
Results of the Diabetic Neuropathy Nerve Decompression (DNNP) randomized controlled double-blinded prospective study were presented at the American Diabetes Association (ADA) 2017 Scientific Sessions by Shai Michael Rozen, MD, associate professor of plastic surgery at the University of Texas Southwestern Medical Center, Dallas.

The release of neurotransmitters and neuropeptides from peripheral nerve terminals (black box affects a variety of cell types such as vascular cells (endothelial cells, red), mast cells (purple), macrophages (green), T-cells (orange), and dendritic cells (red).
Vitamin D deficiency: Those with vitamin D deficiency had more than twice the risk of having neuropathy compared to those with healthy levels of vitamin D. It was therefore concluded vitamin D deficiency was associated with symptoms of diabetic neuropathy.
Of the 12 subjects who were screen positive on the validated TNS sensory component, 5 had evidence of a length‐dependent axonal peripheral neuropathy on NCS (Figure 1 ). Seven subjects had symptoms, but had a borderline NCS (mean ± SD sural amplitude of 5.6 ± 0.61 μV).

Laser Doppler flowmetry measurements in the sciatic nerve of streptozotocin-induced diabetic rats and spontaneously diabetic BB rats have yielded similar Reverse Neuropathy Pain results ( 10 ). Nerve blood flow is therefore routinely used as an end point in assessing new possible therapeutic agents in diabetic animals.
SAN DIEGO — Among patients with diabetic peripheral neuropathy who also had a compressed nerve behind the knee and were in pain despite medical therapies, those who had nerve-decompression surgery had less pain 1 year and 4.5 years later than patients who did not receive surgery.