Peripheral Nerve Repair Following ARI Treatment

  • Anders A. F. Sima
  • Virgil Nathaniel
  • Douglas A. Greene
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 291)


Distal symmetric polyneuropathy accompanying diabetes mellitus is a major contributor to the morbidity associated with diabetes. Its pathogenesis remains controversial, although hyperglycemia induced metabolic abnormalities as well as microangiopathic changes are believed to be important 1,2.


Diabetic Neuropathy Aldose Reductase Sural Nerve Myelinated Fiber Wallerian Degeneration 
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  1. 1.
    Greene, D.A., Lattimer, S.A., Sima, A.A.F., 1987, Sorbitol, phosphoinositides, and sodium-potassium-ATPase in the pathogenesis of diabetic complications. N. Engl. J. Med., 316:599.PubMedCrossRefGoogle Scholar
  2. 2.
    Dyck, P.J., Karnes, J.L, O’Brien P., Okazaki, H., Lais, A., Engelstad, J., 1986, The spatial distribution of fiber loss in diabetic polyneuropathy suggests ischemia. Ann. Neurol., 19:440.PubMedCrossRefGoogle Scholar
  3. 3.
    Sima, A.A.F., 1985, Can the BB-rat help to unravel diabetic neuropathy? Neuropath. Appl. Neurobiol., 11:253.CrossRefGoogle Scholar
  4. 4.
    Gabbay, K.H., Merola, L.O., Field, R.A., 1966, Sorbitol pathway: presence in nerve and cord with substrate accumulation in diabetes. Science, 151:209.PubMedCrossRefGoogle Scholar
  5. 5.
    Sima, A.A.F., Lattimer, S.A., Yagihashi, S., Greene, D.A., 1986, Axo-glial dysjunction: A novel structural lesion that accounts for poorly reversible slowing of nerve conduction in the spontaneously diabetic Bio-Breeding rat. J. Clin. Invest., 77:474.PubMedCrossRefGoogle Scholar
  6. 6.
    Sima, A.A.F., Bouchier, M, Christensen, H., 1983, Axonal atrophy in sensory nerves of the diabetic BB-Wistar rat: a possible early correlate of human diabetic neuropathy. Ann. Neurol., 13:262.CrossRefGoogle Scholar
  7. 7.
    Sima, A.A.F., Nathaniel, V., Bril, V., McEwen, T.A.J., Greene, D.A., 1988, Histopathological heterogeneity of neuropathy in insulin-dependent and non-insulin-dependent diabetes, and demonstration of axo-glial dysjunction in human diabetic neuropathy. J. Clin. Invest., 81:349.PubMedCrossRefGoogle Scholar
  8. 8.
    Greene, D.A., Chakrabarti, S., Lattimer, S.A., Sima, A.A.F., 1987, Role of sorbitol accumulation and myo-inositol depletion in paranodal swelling of large myelinated nerve fibers in the insulin-deficient spontaneously diabetic Bio-Breeding rat. Reversal by insulin replacement, an aldose reductase inhibitor and myo-inositol. J. Clin. Invest., 79:1479.PubMedCrossRefGoogle Scholar
  9. 9.
    Mayer, J.H., Tomlinson, D.R., 1983, Prevention of defects of axonal transport and nerve conduction velocity by oral administration of myo-inositol or an aldose reductase inhibitor in streptozotocin-diabetic rats. Diabetologia, 25:433.PubMedCrossRefGoogle Scholar
  10. 10.
    Sima, A.A.F., Prashar, A., Zhang, W-X, Chakrabarti, S., Greene, D.A., 1990, The preventive effect of long term aldose reductase inhibition (Ponalrestat) on nerve conduction and sural nerve structure in the spontaneously diabetic BB-rat. J. Clin. Invest., 85:1410.PubMedCrossRefGoogle Scholar
  11. 11.
    Sima, A.A.F., Bril, V., Nathaniel, V., McEwen, T.A.J., Brown, M.B., Lattimer, S.A., Greene, D.A., 1988, Regeneration and repair of myelinated fibers in sural nerve specimens from patients with diabetic neuropathy treated with sorbinil. N. Engl. J. Med., 319:548.PubMedCrossRefGoogle Scholar
  12. 12.
    Sima, A.A.F., Brismar, T., 1985, Reversible diabetic nerve dysfunction: structural correlates to electrophysiological abnormalities. Ann. Neurol., 18:21.PubMedCrossRefGoogle Scholar
  13. 13.
    Brismar, T., Sima, A.A.F., Greene, D.A., 1987, Reversible and irreversible nodal dysfunction in diabetic neuropathy. Ann. Neurol., 21:504.PubMedCrossRefGoogle Scholar
  14. 14.
    Greene, D.A., Sima, A.A.F., Albers, J., Pfeifer, M., Diabetic neuropathy in“Ellenberg and Rifkin Diabetes Mellitus”, H. Rifkin and D. Porte, eds., Elseviers Publishing Company, New York, (1989).Google Scholar
  15. 15.
    Yagihashi, S., Kamijo, M., Ido, Y., Mirrlees, D.J., 1990, Effects of long-term aldose reductase inhibition on development of experimental diabetic neuropathy: ultrastructural and morphometric studies of sural nerve in streptozocin-induced diabetic rats. Diabetes, 39:690.PubMedCrossRefGoogle Scholar

Copyright information

© Plenum Press, New York 1991

Authors and Affiliations

  • Anders A. F. Sima
    • 1
  • Virgil Nathaniel
    • 1
  • Douglas A. Greene
    • 2
  1. 1.Neuropathology Research LaboratoriesUniversity of ManitobaWinnipegCanada
  2. 2.Michigan Diabetes Research and Training CenterUniversity of MichiganAnn ArborUSA

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