Aims/hypothesis. Increased oxidative stress has been causally linked to diabetic neurovascular complications, which are attenuated by antioxidants.
There are several possible sources of reactive oxygen species in diabetes. Our aim was to assess the contribution of free
radicals, produced by transition metal catalysed reactions, to early neuropathic changes. To this end, we examined, firstly,
the effects of an extracellular high molecular weight chelator, hydroxyethyl starch-deferoxamine, which is expected to be
confined to vascular space, on nerve perfusion and conduction deficits in diabetic rats and, secondly, the action of a single
chelator dose.
Methods. Diabetes was induced by streptozotocin. In vivo measurements comprised sciatic nerve motor conduction velocity and endoneurial
perfusion, monitored by hydrogen clearance microelectrode polarography.
Results. We found that 8 weeks of diabetes reduced sciatic blood flow and conduction velocity by 48.3 % and 19.9 % respectively. Two
weeks of intravenous treatment corrected these deficits. Starch vehicle was ineffective. The time-course of action of a single
hydroxyethyl starch-deferoxamine injection was examined in diabetic rats. There was a rapid increase in nerve blood flow on
day 1, which remained within the non-diabetic range for 9 days before declining to the diabetic level at day 27. In contrast,
conduction velocity changes were slower, reaching the non-diabetic range at day 6 and declining to the diabetic level at day
27.
Conclusion/interpretation. Extracellular transition metal catalysed reactions play a major role in the neurovascular deficits of experimental diabetes.
Given the long-lasting effect of a single treatment, extracellular metal chelator therapy could be suitable for further assessment
in clinical trials. [Diabetologia (2001) 44: 621–628]
Keywords Neuropathy - nerve conduction - blood flow - oxidative stress - iron - copper - chelator - deferoxamine - diabetic rat.
Received: 30 October 2000 and in revised form: 12 January 2001