title: Elevated basal cytosolic calcium of endothelial cells influences the post-surgical outcome in diabetic CTS.
abstract: Background Type 2 diabetes mellitus (T2DM)-induced neuropathy and ischemia-reperfusion post-surgery prolong carpal tunnel syndrome (CTS) pathology, but the effect of T2DM on the prognostic outcome of carpal tunnel (CT) release surgery needs to be investigated. Materials and methods A total of 64 individuals with CTS underwent CT release surgery. HbA1c levels identified their diabetic status. The individual prognostic outcomes were measured by nerve conduction velocity (NCV), amplitude, and latency. Measurement of [Ca2+]cand reactive oxygen species (ROS) from isolated endothelial cells (ECs) revealed the oxidative burden of the normal and diabetic CTS phenotypes. Results CTS individuals with HbA1c > 7 showed decreased NCV (≈22 m/s) and amplitude (≈4.2 mV) with increased latency (≈6 ms), compared to groups with HbA1c ≤ 7. Further to CT release surgery, the reversal of the nerve conduction to normalcy was greatly influenced by the diabetic profile of the individuals. Our results showed elevated basal [Ca2+]cand corresponding high cytosolic ROS in the ECs isolated from individuals with HbA1c > 7 compared to the diabetic and healthy control groups. Conclusion The individuals with diabetic index showed suboptimal neuronal performance pre- and post-CT release surgery. Oxidative stress mediated by high [Ca2+]cand ROS of ECs dissipates to adjoining cells worsening the pathology of the untreated CTS.
authors.affiliation: 1 Department of Physiology, College of Medicine, King Khalid University , Abha, Saudi Arabia.
authors.forename: I M
authors.initials: IM
authors.lastname: Bin-Jaliah
authors.affiliation: 1 Department of Physiology, College of Medicine, King Khalid University , Abha, Saudi Arabia.|2 Department of Orthopedics, Jubilee Mission Medical College , Thrissur, Kerala, India.
authors.forename: Mea
authors.initials: M
authors.lastname: Shariff
authors.affiliation: 2 Department of Orthopedics, Jubilee Mission Medical College , Thrissur, Kerala, India.
authors.forename: P S
authors.initials: PS
authors.lastname: Nayar
authors.affiliation: 3 Department of Microbiology and Parasitology, College of Medicine, King Khalid University , Abha, Saudi Arabia.
authors.forename: H C
authors.initials: HC
authors.lastname: Chandramoorthy
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002118:Calcium / Q000378:metabolism*; D002349:Carpal Tunnel Syndrome / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery*; D002478:Cells, Cultured; D003600:Cytosol / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000628:therapy; D003929:Diabetic Neuropathies / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery*; D042783:Endothelial Cells / Q000378:metabolism*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction; D019637:Orthopedic Procedures / Q000009:adverse effects; D018384:Oxidative Stress; D011183:Postoperative Complications / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology; D011930:Reaction Time; D017382:Reactive Oxygen Species / Q000378:metabolism; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D002118:Calcium; D006442:Glycated Hemoglobin; D017382:Reactive Oxygen Species; C517652:hemoglobin A1c protein, human
keywords: T2DM complications; carpal tunnel syndrome; diabetic CTS; endothelial ROS; endothelial calcium; oxidative stress; post surgery prolonged CTS