Skin Cream Could Treat Peripheral Neuropathy

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One of the most debilitating risks of diabetes is peripheral neuropathy, which can impact millions of people each year and often leads to amputation.

It’s difficult to treat, but researchers at Boston Children’s Hospital are working to develop a skin cream that may relieve it.

The cream, which has been tested on mice in two trials, is designed to enhance GDNF (Glial cell-derived neurotrophic factor), a protein that plays a role in stimulating nerve growth. For those with small-fiber neuropathy–which reveals itself through pain and tingling in the extremities, usually the feet–the cells are lost through the degeneration of nerve endings.

While the cream does not replenish GDNF, it does help enhance the effects of the cells, so losses are less apparent.

“When you use an enhancer, you need less GDNF to activate receptors on the sensory neuron,” said Gabriel Corfas, PhD, of the F.M. Kirby Neurobiology Center at Boston Children’s. “The receptors are activated for longer, and GDNF’s effects are stronger.”

The study is potentially great news for those with peripheral neuropathy, since it could erase the need for medication and other invasive treatments, which are traditionally used to treat the disorder but are not without certain side effects.

“People have been able to treat pain in small-fiber neuropathy, but the treatments cause side effects, and there’s nothing that can help the loss of sensation, which can contribute to people losing limbs,” Corfas said.

Previously, GDNF has been used to treat neuropathy through spinal cord injections, which allows the body to use the large molecules. Instead, the cream uses a small-molecule compound called XIB4035.

Mice with small-fiber neuropathy that were given the cream showed improvements not only in nerve structure, but also in regained sensitivity compared to those that were provided with an inactive cream.

Researchers are now looking at whether the cream has any impact on large-fiber neuropathy, often the result of injury.

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