In the repair of damaged nerves due to diabetic neuropathy, blood vessels and supporting cells may be the real target for treatment to help regrow damaged nerves.
Twenty percent of diabetics experience neuropathy and current treatments for this focus on relieving symptoms but don’t address the nerve damage itself. A Johns Hopkins study recruited 10 patients with diabetic neuropathy and 10 healthy patients of similar ages. The researchers took 3 millimeter “punch” biopsies from the skin of each participant’s thigh. Several months later, a 4mm biopsy was taken from the same site to see how the nerves, blood vessels and nerve-supporting cells, called Schwann cells, were growing back.
In both groups, the first to grow in the healing site were blood vessels, then Schwann cells and then axons, which used the blood vessels as support to grow on. The process was delayed for the neuropathy patients. Axon regeneration was slower compared to the healthy patients, blood vessel growth was slower, and fewer Schwann cells accompanied the growth of the axons in the skin.
“Our results suggest that regenerative abnormalities associated with diabetes are widespread,” Michael Polydefkis, M.D., M.H.S., stated in a press release, “They’re not just affecting nerves – they’re also affecting blood vessel growth and Schwann cell proliferation.” He also says that slowed regeneration of damaged blood vessels could contribute to heart attacks and strokes, which often accompany diabetes. Researchers may be able to speed up axon regeneration and repair nerves by promoting blood vessel and Schwann cell growth that could lead to combating diabetic neuropathy and vascular complications.