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Future treatments for diabetic neuropathy may focus on supporting cell regeneration

A recent John Hopkins study indicating new potential treatments for diabetic neuropathy is encouraging given that neuropathy can be treated by measures as extreme as amputation of affected areas.

Hopkins researchers found that, rather than trying to treat damaged nerve cells directly, it may be more efficient to treat supporting cells in the surrounding area (including blood vessel cells), a technique that also would have the positive effect of treating vascular complications associated with diabetes. 

Experimental treatments for neuropathy, a nerve degeneration condition whose symptoms range from physical discomfort to dangerous infections, have traditionally focused on ways to directly repair nerve cells by helping their axons (the spindly cell extensions that sprout from nerve cells) regenerate. While studying axon regeneration in patients with diabetic neuropathy, Hopkins researchers noticed something interesting: As patients' nerve cells regenerated, so did blood vessels and nerve-supporting Schwann cells in the area surrounding the damaged nerves (though much more slowly than in healthy people).

The order in which these cells regenerated (first blood vessels, then Schwann cells, then finally neurons) suggests that axon regeneration hinges on support from surrounding cells - and that may hint at future treatments that would focus on blood vessel and Schwann cells to indirectly speed up axon regeneration.

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