Mem Inst Oswaldo Cruz, Rio de Janeiro, VOLUME 118 | 2023
Perspective
Impact of gut-peripheral nervous system axis on the development of diabetic neuropathy
1Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo cruz, Rio de Janeiro, RJ, Brasil
2Cedars-Sinai Medical Center, Medicine Department, Los Angeles, CA, United States of America
3Instituto Nacional de Ciência e Tecnologia em Neuroimunomodulação, Rio de Janeiro, RJ, Brasil
DOI: 10.1590/0074-02760220197
ABSTRACT
Diabetes is a chronic metabolic disease caused by a reduction in the production and/or action of insulin, with consequent development of hyperglycemia. Diabetic patients, especially those who develop neuropathy, presented dysbiosis, with an increase in the proportion of pathogenic bacteria and a decrease in the butyrate-producing bacteria. Due to this dysbiosis, diabetic patients presented a weakness of the intestinal permeability barrier and high bacterial product translocation to the bloodstream, in parallel to a high circulating levels of pro-inflammatory cytokines such as TNF-?. In this context, we propose here that dysbiosis-induced increased systemic levels of bacterial products, like lipopolysaccharide (LPS), leads to an increase in the production of pro-inflammatory cytokines, including TNF-?, by Schwann cells and spinal cord of diabetics, being crucial for the development of neuropathy.
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+ Corresponding author: vfrias@ioc.fiocruz.br 
https://orcid.org/0000-0003-2136-8958
Received 26 August 2022
Accepted 14 February 2023
HOW TO CITE
Mázala-de-Oliveira T, Jannini de Sá YAP, Carvalho VF. Impact of gut-peripheral nervous system axis on the development of diabetic neuropathy. Mem Inst Oswaldo Cruz. 2023; 118: e220197.
