title: Effect of sorbitol dehydrogenase inhibition on experimental diabetic autonomic neuropathy.
abstract: The polyol pathway and its dependent biochemical pathways are thought to play a role in the pathogenesis of diabetic neuropathy. We have developed an animal model of diabetic autonomic neuropathy characterized by neuroaxonal dystrophy involving ileal mesenteric nerves and prevertebral sympathetic superior mesenteric ganglia (SMG) in chronic streptozocin-diabetic rats. Our previous studies have shown a salutary effect of aldose reductase inhibitors on experimental autonomic neuropathy, suggesting a role for the polyol pathway in its pathogenesis. In the current studies we have examined the effect of the sorbitol dehydrogenase inhibitor (SDI) CP-166,572, which interrupts the conversion of sorbitol to fructose (and reactions dependent on the second step of the polyol pathway) resulting in markedly increased levels of sorbitol in peripheral nerve. Fourteen weeks of treatment with CP-166,572 resulted in a dramatically increased frequency of neuroaxonal dystrophy in ileal mesenteric nerves and SMG. Although lesions developed prematurely and in greater numbers in SDI-treated diabetics than untreated diabetics did, their anatomic distribution and ultrastructural appearance were identical to that previously reported in long-term untreated diabetics. CP-166,572 treatment did not produce neuroaxonal dystrophy in control animals despite the fact that sciatic nerve sorbitol levels were markedly increased, reaching the same levels as untreated diabetic animals. Treatment of diabetic rats for 14 weeks with the aldose reductase inhibitor zopolrestat resulted in a significant decrease in the frequency of neuroaxonal dystrophy compared with untreated diabetics.
authors.affiliation: Department of Pathology, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
authors.forename: R E
authors.initials: RE
authors.lastname: Schmidt
authors.forename: D A
authors.initials: DA
authors.lastname: Dorsey
authors.forename: L N
authors.initials: LN
authors.lastname: Beaudet
authors.forename: S B
authors.initials: SB
authors.lastname: Plurad
authors.forename: J R
authors.initials: JR
authors.lastname: Williamson
authors.forename: Y
authors.initials: Y
authors.lastname: Ido
mesh_terms: D000818:Animals; D001342:Autonomic Nervous System Diseases / Q000188:drug therapy*; D052160:Benzothiazoles; D003929:Diabetic Neuropathies / Q000188:drug therapy*; D004353:Drug Evaluation, Preclinical; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D005728:Ganglia, Sympathetic / Q000187:drug effects; D007064:L-Iditol 2-Dehydrogenase / Q000037:antagonists & inhibitors*; D008297:Male; D008643:Mesentery / Q000294:innervation; D019150:Neuroaxonal Dystrophies / Q000188:drug therapy; D010793:Phthalazines / Q000627:therapeutic use; D010879:Piperazines / Q000627:therapeutic use*; D011743:Pyrimidines / Q000627:therapeutic use*; D051381:Rats; D017207:Rats, Sprague-Dawley; D013844:Thiazoles / Q000627:therapeutic use
chemical_list: D052160:Benzothiazoles; D004791:Enzyme Inhibitors; D010793:Phthalazines; D010879:Piperazines; D011743:Pyrimidines; D013844:Thiazoles; C106112:2-hydroxymethyl-4-(4-(N,N-dimethylaminosulfonyl)-1-piperazino)pyrimidine; C067172:zopolrestat; D007064:L-Iditol 2-Dehydrogenase