Peripheral Neuropathy in Rat Models of T2DM

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Questions and Answers

What is the primary measurement focus of nerve conduction studies according to the Neurodiab guidelines?

  • Small fiber function
  • Peripheral nerve structure
  • Autonomic nerve function
  • Large fiber function (correct)

Which aspect is emphasized in the assessment of nerve conduction velocity (NCV)?

  • All nerve types regardless of temperature
  • Blinding researchers during analysis (correct)
  • Using only sensory nerves
  • Ignoring core temperature changes

Why is assessing nerve conduction velocity in the caudal nerve not strongly recommended?

  • It does not represent small fiber function
  • It yields highly variable results
  • It is not part of standard nerve conduction studies
  • It lacks sufficient anatomical relevance in rodents (correct)

What is a critical factor for accurate nerve conduction velocity assessment?

<p>Measuring under controlled core and near-nerve temperatures (C)</p> Signup and view all the answers

The Neurodiab guidelines suggest which of the following as endpoints for phenotyping?

<p>Peripheral nerve structure and function (C)</p> Signup and view all the answers

What is the role of reporting both positive and negative results in research according to the guidelines?

<p>To improve data transparency and validity (B)</p> Signup and view all the answers

What is a reliable and sensitive marker of small sensory nerve fiber loss in diabetic rodents?

<p>Quantifying intraepidermal nerve fiber density (D)</p> Signup and view all the answers

Which of these criteria is necessary for defining diabetic peripheral neuropathy (DPN) in rodent models?

<p>Reporting differences in at least two of three measures: behaviour, nerve conduction, and nerve structure (A)</p> Signup and view all the answers

What is a commonly utilized behavioral test for assessing small fiber neuropathy in rodent models?

<p>Hargreaves test (A)</p> Signup and view all the answers

How have T2DM and T1DM demonstrated differences in DPN treatment effectiveness according to research?

<p>T2DM patients exhibit lesser treatment effectiveness for DPN symptoms. (A)</p> Signup and view all the answers

Which factor is NOT typically assessed when evaluating DPN in relation to the Neurodiab guidelines?

<p>Autonomic neuropathy measures (D)</p> Signup and view all the answers

What recent advancements have been made in T2DM rat models for studying DPN?

<p>Increased consistency in protocols for measuring DPN (A)</p> Signup and view all the answers

Which behavioral test primarily assesses large fiber dysfunction in neuropathy evaluation?

<p>Von Frey monofilament test (B)</p> Signup and view all the answers

What primary metabolic comorbidity associated with T2DM is focused on in preclinical models of DPN?

<p>Hypertension (D)</p> Signup and view all the answers

Which method has been criticized for having variability when assessing DPN in rodent models?

<p>Streptozotocin (STZ) method (D)</p> Signup and view all the answers

Which type of neuropathy assessment was excluded from the focus of the review on DPN?

<p>Autonomic neuropathy measures (B)</p> Signup and view all the answers

What is the predominant model used in studies of diet and chemically induced T2DM in rats?

<p>Sprague-Dawley (SD) rats (C)</p> Signup and view all the answers

Which criteria were used to exclude studies from the review?

<p>Non-rat models (B), Clinical studies and reviews (D)</p> Signup and view all the answers

Which T2DM model was most frequently studied among the transgenic models?

<p>Zucker diabetic fatty (ZDF) rats (A)</p> Signup and view all the answers

Which of the following DPN endpoints was assessed most frequently by diet and chemically induced T2DM models?

<p>All three key DPN endpoints (A)</p> Signup and view all the answers

How many articles were ultimately included in the review after screening?

<p>125 articles (C)</p> Signup and view all the answers

What percentage of diet and chemically induced T2DM studies assessed all three DPN endpoints?

<p>30% (C)</p> Signup and view all the answers

What was the primary focus of the scoping review conducted up to 3rd November 2020?

<p>Rat models of T2DM and diabetic polyneuropathies (B)</p> Signup and view all the answers

Which of the following terms was NOT part of the search terms used in the literature search?

<p>Type 1 diabetes mellitus (A)</p> Signup and view all the answers

Flashcards

DPN Phenotyping

Using multiple methods (behaviour, nerve conduction, and nerve structure) to identify and characterize diabetic peripheral neuropathy in rodent models.

Neurodiab Guidelines

A set of consensus criteria for phenotyping diabetic peripheral neuropathy (DPN) in rodent models, aiming for standardized data reporting and collaboration.

Nerve Conduction Studies (NCS)

Gold standard clinical tests for assessing large fiber function in rodent models of DPN.

Nerve Conduction Velocity (NCV)

A measure of how fast electrical signals travel along nerves, used in assessing nerve function.

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Intraepidermal Nerve Fiber Density (IENFD)

A measure of the number of small sensory nerve fibers, used to assess small fiber damage in DPN.

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Peripheral Nerve Structure

Quantified aspects of nerve trunks (large and small fibers), used to evaluate the physical condition of peripheral nerves.

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Experimental Design

Systematic approach to research with randomization, blinding, and detailed reporting of all parameters (e.g., blood glucose, weight).

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Rodent Models

Animal models like rats used to study (diabetic) diseases, including DPN

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Scoping Review

A review that evaluates the range of existing research related to a specific topic to understand the current knowledge and identify gaps.

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T2DM

Type 2 Diabetes Mellitus, a metabolic disorder characterized by high blood sugar levels.

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DPN

Diabetic Peripheral Neuropathy, nerve damage caused by high blood sugar.

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Rat Models

Animal models used to study diseases, in this case, T2DM and DPN, using rats.

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PubMed, Web of Science, Scopus

Databases for finding scientific literature, used to search for articles on T2DM and DPN in rat models.

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High-Fat Diet (HFD)

A diet rich in fat, frequently used as one part of the protocol to induce T2DM in rats.

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Study Selection Criteria

Specifically for this review, criteria determined which articles got included or excluded (rat models of T2DM & DPN endpoints).

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Transgenic/Spontaneous Models

Models of T2DM involving genetic modification (transgenic) or naturally occurring traits (spontaneous) in rats.

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Distinct Pathophysiological Mechanisms of DPN in T1DM and T2DM

Type 1 and Type 2 diabetes mellitus (T1DM and T2DM) have different underlying causes for Diabetic Peripheral Neuropathy (DPN), impacting treatment effectiveness.

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Glycemic Control's Limited Effect on T2DM DPN

In individuals with Type 2 diabetes, glycemic control, despite being the primary treatment, often has less impact on Diabetic Peripheral Neuropathy symptoms compared to Type 1 diabetes.

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T2DM Preclinical Models

Models used to study Type 2 diabetes, encompassing various related health issues, like obesity, high blood pressure, unhealthy cholesterol levels, inflammation, and insulin resistance.

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Hargreaves Test

A test for small fiber neuropathy in animal models, using escalating heat to measure hindpaw withdrawal latency.

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Von Frey Monofilaments

Instruments used to assess tactile allodynia (pain from touch), often employed in animal models of large fiber neuropathy.

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DPN Phenotyping in Rodent Models

The process of evaluating and characterizing Diabetic Peripheral Neuropathy in animal models, focusing on consistency of measurement and reporting.

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Study Notes

Peripheral Neuropathy in Rat Models of T2DM

  • Diabetic peripheral neuropathy (DPN) affects over half of type 2 diabetes mellitus (T2DM) patients.
  • Effective pharmacotherapies are urgently needed.
  • Phenotyping DPN in rodent models has been challenging due to inconsistencies across laboratories.
  • A consensus guideline ("Neurodiab") was published in 2014 to standardize preclinical DPN phenotyping.
  • This review examines rat T2DM models' DPN phenotyping, evaluating guideline uptake and identifying future directions.
  • 125 studies (diet/chemically induced & transgenic/spontaneous T2DM models) were reviewed, focusing mainly on diet-induced models (predominantly high-fat diet (HFD) + low-dose streptozotocin (STZ) in Sprague-Dawley (SD) rats).
  • The use of HFD and chemically induced T2DM models surpassed transgenic models. The Neurodiab guidelines' introduction hasn't appreciably increased studies assessing all DPN endpoints.

Neurodiab Criteria for Rodent Models

  • DPN is defined as statistically significant differences in at least two of three measures: behavioral assessment, nerve conduction, and peripheral nerve structure, between diabetic and age-matched control animals.
  • Key behavioral tests include Hargreaves (for small fiber neuropathy), von Frey monofilaments (for large fiber dysfunction), and others.
  • Nerve conduction studies (NCS) measure large-fiber function (motor and sensory nerve conduction velocity, NCV).
  • Peripheral nerve structure is assessed by intraepidermal nerve fiber density (IENFD) in footpads, nerve trunk morphometry, and corneal nerve fiber analysis.

Study Methods and Results

  • A literature search (PubMed, Scopus, Web of Science) identified 1,625 articles. 125 articles met inclusion criteria (rat T2DM model & assessment of at least one DPN endpoint).
  • Studies using diet-induced T2DM models more frequently assessed all three DPN endpoints than transgenic models, although this difference wasn't statistically significant.
  • Most commonly used diet+chemical model is HFD + low-dose STZ in SD rats, often with varied duration of HFD feeding and STZ doses.
  • Many studies showed significant impairment in at least two DPN endpoints irrespective of whether the duration of diabetes was short (0-6 weeks) or long (> 6 weeks).

Influence of Sex and Duration of Diabetes

  • Sex differences in DPN phenotypes are a limited area of research, with few studies using female rats and inconsistencies in results for differences in pain-related behaviors between genders.
  • Diabetes duration affects DPN phenotypes in a dynamic manner. Hyperalgesia is more common in the initial phases, giving way to hypoalgesia in later stages of diabetes.

Discussion and Future Directions

  • The review highlights the limitations of current rat models for DPN, emphasizing the need to better characterize models like HFHS/STZ and STZ/NA.
  • Further studies need to incorporate more female rat models, explore DPN phenotypes across multiple time points, and systematically assess the relationship between metabolic measures and DPN severity.
  • The development of more standardized and spontaneous T2DM models is essential to accelerate the development of effective treatments.

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