Diabetes, Vol 47, Issue 10 1637-1642, Copyright © 1998 by American Diabetes Association
Peripheral neuropathy in transgenic diabetic mice: restoration of C-fiber function with human recombinant nerve growth factor
KA Elias, MJ Cronin, TA Stewart and RC Carlsen
Genentech, San Francisco, California 94080, USA. kelias@gene.com
Mice (Ins.Dd1) with hypoinsulinemic diabetes were created by increased
expression of syngeneic major histocompatibility complex (MHC) class I
protein in pancreatic beta-cells. The diabetic state was characterized in
these mice by high glucose concentrations and islet pathology. To determine
whether a neuropathy would develop, motor and sensory conduction velocities
(CV) were determined in the sciatic nerves of 2-, 4-, and 7-month-old
control and diabetic littermate male mice. Recording bipolar electrodes
were placed in the plantar muscles of the hind foot of anesthetized
(ketamine/xylazine) mice. Bipolar stimulating electrodes were positioned
near the sciatic nerve at the sciatic notch or near the tibial nerve at the
ankle. Motor CV from alpha-motor fibers and sensory CV from proprioceptive
Aalpha nerves were measured and expressed as meters per second (m/s). Group
data are reported as mean +/- SE and compared by analysis of variance. The
CVs from nondiabetic mice (controls) were not different across the three
ages and averaged 41.3 +/- 1.7 m/s for motor and 38.7 +/- 1.7 m/s for
sensory. The motor CVs from diabetic mice at 2 and 4 months were similar to
controls. Sensory CVs were unchanged at 2 months but were lower at 4 months
(18.9 +/- 2.4 m/s). Both sensory (23.9 +/- 2.1 m/s) and motor (18.9 +/- 1.8
m/s) CVs were significantly reduced at 7 months, which is indicative of a
polyneuropathy. NGF has well-known trophic effects on sympathetic and small
sensory neurons. To determine whether NGF could influence this neuropathy,
6-month-old control and diabetic mice were divided into the following
groups: 1) control + vehicle, 2) diabetic + vehicle, and 3) diabetic + NGF
(1 mg/kg, 3x week, s.c.). After 1 month of treatment, motor and sensory CVs
were determined. In some mice, the branches of the sciatic nerve were
exposed and in situ recordings from the sural nerve were performed to
determine compound C-fiber CV, integral, and amplitude. Sensory CV,
determined via Hoffmann's reflex (H-reflex) (A-fiber), was decreased in
diabetic compared with control animals as expected (P < 0.05), and NGF
did not alter this parameter. Continuing diabetes reduced the amplitude
(0.9 +/- 0.2 vs. 3.2 +/- 0.7 mV x 10(-2); P < 0.05) and integral (6.9
+/- 1.9 mV/ms vs. 18.8 +/- 4.4 mV/ms; P < 0.05) of the C-fiber response
versus control, suggesting fiber loss. NGF treatment normalized C-fiber
amplitude (2.9 +/- 0.8 mV x 10(-2)) and integral (21.2 +/- 6.5 mV/ms) in
animals with established diabetes, with no effect on blood glucose. The
C-fiber CV was similar in all groups, indicating that the animals had some
normally conducting small fiber sensory nerves. These studies characterized
a motor and sensory polyneuropathy in transgenic diabetic mice and are the
first to demonstrate directly that NGF treatment can protect or restore
abnormal sensory C-fiber function.