Antioxidant strategies in the management of diabetic neuropathy

Ayodeji Babatunde Oyenihi, Ademola Olabode Ayeleso, Emmanuel Mukwevho, Bubuya Masola, Ayodeji Babatunde Oyenihi, Ademola Olabode Ayeleso, Emmanuel Mukwevho, Bubuya Masola

Abstract

Chronic hyperglycaemia (an abnormally high glucose concentration in the blood) resulting from defects in insulin secretion/action, or both, is the major hallmark of diabetes in which it is known to be involved in the progression of the condition to different complications that include diabetic neuropathy. Diabetic neuropathy (diabetes-induced nerve damage) is the most common diabetic complication and can be devastating because it can lead to disability. There is an increasing body of evidence associating diabetic neuropathy with oxidative stress. Oxidative stress results from the production of oxygen free radicals in the body in excess of its ability to eliminate them by antioxidant activity. Antioxidants have different mechanisms and sites of actions by which they exert their biochemical effects and ameliorate nerve dysfunction in diabetes by acting directly against oxidative damage. This review will examine different strategies for managing diabetic neuropathy which rely on exogenous antioxidants.

Figures

Figure 1
Figure 1
A simplified scheme showing the roles of reactive species and antioxidants in the progression of diabetic neuropathy. AGEs: advanced glucose end-products; PKC: protein kinase C; PARP: poly-ADP ribose polymerase; ARIs: aldose reductase inhibitors; ROS: reactive oxygen species; RNS: reactive nitrogen species; •O2 −: superoxide radical; •HO: hydroxyl radical; •RO2 −: peroxyl radical; •HRO2 −: hydroperoxyl radical; H2O2: hydrogen peroxide; HOCl: hydrochlorous acid; •NO−: nitric oxide radical; •NO2 −: nitrogen dioxide radical; ONOO: peroxynitrite; HNO2: nitrous oxide; RONOO: alkyl peroxynitrates.
Figure 2
Figure 2
Polyol pathway of hyperglycaemia-induced neuropathy.
Figure 3
Figure 3
Hyperglycaemia-induced overactivation of protein kinase c leads to nerve dysfunction.

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