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Science  09 Sep 2005:
Vol. 309, Issue 5741, pp. 1651
DOI: 10.1126/science.309.5741.1651c

Many people living with diabetes for an extended time eventually develop a complication called diabetic neuropathy, a form of nerve damage that affects the extremities with symptoms that range from tingling and numbness to severe pain. Although many hypotheses have been proposed to explain how this nerve damage arises, the underlying mechanisms remain poorly understood.

A new study identifies an unexpected cellular culprit. From an analysis of rodent models, Terashima et al. find that diabetic neuropathy is accompanied by an aberrant fusion of bone marrow-derived (BMD) cells to neurons in the sciatic nerve and dorsal root ganglion. The fusion, which appears to involve a distinct subset of BMD cells that are marked by inappropriate expression of proinsulin, disrupts calcium handling in the neurons and triggers their premature death. The authors speculate that the diabetic state likely induces inappropriate gene expression in the BMD cells, producing molecules (such as tumor necrosis factor- α) that may be toxic to neurons and to the hybrid cells. Although BMD cells are often viewed in a favorable light for their potential therapeutic applications in repairing tissue damage, this study suggests that in certain contexts these cells may in fact be harmful. — PAK

Proc. Natl. Acad. Sci. U.S.A. 102, 12525 (2005).

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