The Relationship between Serum Calprotectin and Peripheral Neuropathy in a Sample of Egyptian type 2 Diabetic Patients

Abstract

Diabetic neuropathy is a common clinical condition that is observed by primary care physicians in the out-patient department. Its early diagnosis can help in reducing the morbidity among patients. Diabetic neuropathy is primarily diagnosed on the basis of neurologic symptoms and signs along with a nerve conduction study (NCS). PDN has a substantial effect on the diabetic patients’ life. It interferes with the patient’s self-management through decreased activity and loss of motivation with increased risk of fall down and fractures due to movement incoordination and weakness. Clinical manifestations of diabetic peripheral neuropathy vary widely from being asymptomatic to painful neuropathic symptoms, loss of sensation, and diabetic foot ulcers. Many pathophysiologic mechanisms have been proposed for the development of diabetic peripheral neuropathy (DPN). A pro-inflammatory state in diabetic patients causes microvascular inflammation and damage to peripheral nerves. This is one of the widely accepted mechanisms for peripheral neuropathy in diabetic patients. Neuro-inflammatory serum biomarkers may have a role in the early diagnosis of DPN. Calprotectin is a heterodimer belonging to the S100 protein family. It is found in the cytoplasm of neutrophils and monocyte membranes and gets released in acute and chronic inflammatory states. Elevated plasma levels of calprotectin have been reported in a variety of chronic inflammatory conditions, including rheumatoid arthritis, allograft rejection, inflammatory bowel disease, and cancer and lung disease. It is excreted during phagocytic stress.