Prostaglandin E1 in lipid microspheres ameliorates diabetic peripheral neuropathy: clinical usefulness of Semmes-Weinstein monofilaments for evaluating diabetic sensory abnormality.
We investigated the effect of Prostaglandin E1 in lipid microspheres (Lipo-PGE1) on diabetic peripheral neuropathy from view of symptoms, neurological examinations including sensory threshold evaluated with Semmes-Weinstein monofilaments (SWM). Type 2 diabetic patients with diabetic peripheral neuropathy were participated in this study. The patients were randomly assigned to two groups, 11 Lipo-PGE1-treated patients and 16 control patients. Lipo-PGE1 at a dose of 10mg in 20ml of saline was injected intravenously as a bolus once daily for 2 weeks. Before and, 1, 2 and 4 weeks after the start of treatment with Lipo-PGE1, sensory threshold was evaluated with Semmes-Weinstein monofilaments at total 18 touch sites on the feet. Administration of Lipo-PGE1 improved subjective symptoms especially in items of numbness and imperception. Such improvement in subjective symptoms correlated well with the improvement in Semmes-Weinstein monofilaments examination, whereas the improvement was not recognized in motor nerve conduction velocity (MCV), sensory nerve conduction velocity (SCV) and coefficient variation of R-R interval on ECG (CVR-R). The improvement lasted for at least 6 months. This study demonstrated that Lipo-PGE1 has long term amelioration effects on diabetic neuropathy especially in symptoms and sensory threshold, and that Semmes-Weinstein monofilaments examination is a simpler, more valid and quantitative tool for assessing the clinical effect of Lipo-PGE1 on diabetic peripheral neuropathy.
Akahori
Hiroshi
H
Department of Endocrinology and Metabolism, Kanazawa University Graduate School of Medical Science, Takara-machi 13-1, Kanazawa, Ishikawa, Japan.
Takamura
Toshinari
T
Hayakawa
Tetsuo
T
Ando
Hitoshi
H
Yamashita
Haruhisa
H
Kobayashi
Ken-ichi
K
D000527:Alprostadil / Q000008:administration & dosage* / Q000737:chemistry / Q000627:therapeutic use*; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis; D003929:Diabetic Neuropathies / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D004334:Drug Administration Schedule; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007564:Japan; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D009460:Neurologic Examination / Q000379:methods; D009475:Neurons, Afferent / Q000187:drug effects / Q000473:pathology; D012678:Sensation Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D020886:Somatosensory Disorders / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D013997:Time Factors
D000527:Alprostadil