Abstract
Prostaglandin E1 (PGE1) is a potent vasodilator and au efficient iiihibitor of platelet aggregation. The clinical use of PGE1 Ibr peripheral artery disease has become established, especially for severe resting pain. It is said that peripheral vascular complications and/or metabolic disarrangement clue to hyperglycemia may play an important role in the pathogmesis of diabetic neuropathy, and there is no standardized treatment for symptoms of this disorder. We observed a striking effect of PGE1 on diabetic neuropathy with pain and dysesthesia of distal extremities.
Two types of PGE1 were used; one was stabilized with cyclodextrin (PGE1-CD) and the other was dissolved in a lipid emulsion (Lipo-PGE1). PGE1-CD (20-80μg/day) was administered intravenously for 14 days in three patients, and improvements in subjective symptoms and vibration senses were observed. However, there were no significant changes in tendon reflexes, R-R intervals, or nerve conduction velocities. Lipo-PGE1 (5μg/day) was used for 14 days in four patients, and a remarkable improvement in subjective symptoms and vibration senses was observed in all four cases. In two of the four cases, motor nerve conduction velocities and/or R-R intervals were also restored toward normal. There were no significant changes in blood glucose levels or retinal findings before and after the treatment. PGE1 therapy is effective for diabetic neuropathy; Lipo-PGE1 especially seems to be useful, even in a small dose.
