The Effect Of Autologous Bone Marrow Transplantation Combined With SDF-1Alpha Local Injection On Diabetic Peripheral Neuropathy

Aim: This study was designed to research the therapeutic effect of autologous bonemarrow transplantation combined with stromal cell-derived factor-1α（SDF-1α）injected locally on diabetic peripheral neuropathy and its possible mechanism.Methods:48male SPF SD rats (6weeks old, average body weight180-200g), fedfreely for one week adaptation period, were randomly divided into normal group (NC,n=8) and type1diabetes model group (n=38). Rats were fasted overnight beforeexperiment was performed. The rat models of type1diabetes were induced by asingle intraperitoneal injection of streptozotocin (STZ,60mg/kg), while the controlrats were given the same dose of citric acid-sodium citrate buffer injectedintraperitoneally. Fasting blood glucose (6h,9AM-3PM) after72hours and a weekwere measured, rats with which exceeded16.7mmol/L were considered diabeticmodel. A total of27rats could be used to our research. Then, these diabetic rats wererandomly divided into three groups: a diabetes group (MD, n=10), a diabeticautologous bone marrow transplantation group (DB, n=10), and a diabetic autologousbone marrow transplantation combined with SDF-1α treatment group (DBS, n=7).After4-week bone marrow transplantation, the rat’s behavioral index (algesia andthermesthesia), sensory nerve conduction velocity, and motor nerve conductionvelocity were measured. Sciatic nerve morphology was also observed by light andelectron microscopy. The mRNA lever of bFGF and Gli were assayed by real-timePCR.Results: Serious peripheral neuropathy was occurred in type1diabetic rats. Theirnerve conduction velocity was significantly lower than normal ones. The painthreshold was reduced. What’s more, Sciatic nerve was presented serious damages by light and electron microscopy: the nerve fibers myelin lamellar was sparse andisolated, showed segmental demyelination sugar; axonal neurofilaments werederanged; and Schwann cells displayed the character of swelling and apomorphosis.In parallel with this, the level of the neurotrophic factor secreted by sciatic nerve isrelatively insufficient. After receiving autologous bonemarrow transplantationtreatment, neuropathy in DB and DBS both showed a significant improvement, butneuropathy in DBS showed more improvement than in DB, which may be ascribed tothe increase of neurotrophic factor synthesized by sciatic nerve itself.Conclusion: Autologous bone marrow transplantation can improve diabeticperipheral neuropathy, the effect of which can be increased by SDF-1αaMDinistratedlocally to some extent. It may be largely due to the elevation of neurotrophic factorsynthesized by sciatic nerve itself. Autologous bone marrow transplantation combinedwith chemokines such as SDF-1αlocal intervention is expected to become a newmethod for the treatment of diabetic peripheral neuropathy.