Advanced search
Start date
Betweenand

"neuropathic pain prevalence in diabetic patients, validation of pain screening instruments, correlation with cutaneous neuropathology, TNF alpha-gene polymorphism, tissular cicatricial process and effect of photobiomodulation therapy"

Grant number: 18/14560-1
Support type:Regular Research Grants
Duration: November 01, 2018 - October 31, 2020
Field of knowledge:Biological Sciences - Physiology - Physiology of Organs and Systems
Principal Investigator:Camila Squarzoni Dale
Grantee:Camila Squarzoni Dale
Home Institution: Instituto de Ciências Biomédicas (ICB). Universidade de São Paulo (USP). São Paulo , SP, Brazil
Assoc. researchers:Daniel Ciampi Araujo de Andrade ; José Pinhata Otoch ; Manoel Jacobsen Teixeira

Abstract

Diabetic neuropathy (DN) is one of the most common complications of diabetes, affecting about 50% of diabetic patients. Among the various symptoms of DN, the development of chronic pain, which mainly affects the extremities, is manifested as exacerbated responses to noxious stimuli (hyperalgesia) and pain in response to mild or non-painful stimuli (allodynia). Conventional treatments available for general neuropathy, including associated pain, are still unsatisfactory and benefit only a small portion of patients. Thus, it is necessary to know if there are typical epidemiological and clinical data, as well as sets of sensorial symptoms, which are characteristic for each modality of the disease. This knowledge is important for designing future clinical trials and for developing more effective medications for these patients who do not yet find adequate relief from currently available drugs. In the clinic, the use of photobiomodulation therapy (PBM) has increasingly attention, since, by promoting early nervous regeneration, results in a significant improvement of the motor and sensory disabilities generated by several types of lesions in peripheral nerves. However, although the results are satisfactory, the mechanisms by which these beneficial effects occur are still unknown. Data obtained by our group demonstrate that the experimental treatment with FBM reverses mechanical hypersensitivity, induces increase of NGF levels and restores the myelin of the peripheral nerves of mice with diabetic neuropathy in a process involving the central release of opioids. The present project aims to: a) determine the different sensorial profiles in diabetic patients creating a phenotype / genotype of signs and symptoms capable of differentiating different populations of patients with the same initial diagnosis. For this, the profile of symptoms, exteroceptive sensitivity, intraepidermal nerve fiber density, association with gene polymorphism for TNF alpha and evaluation of the wound healing profile in diabetic patients of the Hospital Universitário of USP will be compared, and b) to evaluate the therapeutic effect of FBM in the adjuvant treatment of diabetic neuropathy, wound healing and associated pain. (AU)