Exciting Developments in the Treatment of Peripheral Neuropathy | Dr. Fernyhough & Dr. Calcutt

As many of you are aware, much of our information that we present deals with problems of the brain and spinal cord. These have been described as being parts of the central nervous system. However, there is another part of the nervous system called the peripheral nervous system that is basically made up of the peripheral nerves.

Peripheral neuropathy is a term that describes an abnormality with peripheral nerves. This can cause loss of sensation, pain, or even loss of autonomic function. Here in America some 20 million people suffer from peripheral neuropathy. In fact more than half of the people with diabetes will develop prayerful neuropathy at some point in their lifetimes. We are at increased risk for peripheral neuropathy not only as a consequence of diabetes but also as we age. Pray for neuropathy can be caused by chemotherapy and fully 1/4 of all peripheral neuropathy patients do not have an identifiable cost.

There aren't really any FDA approved treatments to actually treat purple neuropathy in terms of the underlying cause of the nerve damage. While we do have drugs that treat, pain for example, again we need to find a way of treating the fire, not just focusing on the smoke. Having said that, there is an exciting new development in this field using drugs that are already available and are called muscarinic antagonists. Basically, they block the transmission of acetylcholine.

In today's podcast, we are going to explore deeply, the mechanisms whereby this approach, using these muscarinic antagonists seems to be incredibly effective in growing new nerve fibers as well as increasing metabolism in the nerve itself leading to improvement ultimately in the manifestation of peripheral neuropathy.

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0:00 Intro
5:35 The Scope of the Problem
8:09 Diabetic Neuropathy
11:49 Neuropathy Following Chemotherapy
14:21 Viral Infections: HIV Treatment & Covid
16:56 Why Mitochondria are Essential in This
19:44 Pharmaceutical Study of Neuropathy
24:57 Aldose reductase inhibitor
29:31 Why This Approach is Different
37:44 How Antimuscarinics Work
48:10 Metrics for Getting FDA Approval
58:42 Funding the Research
1:01:53 Conclusion
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Nigel A. Calcutt, Ph.D. ook both his B.Sc. in Zoology and Ph.D. Physiology and Pharmacology at Nottingham University, England. Following post-doctoral research in the Department of Pharmacology at St. Bartholomew’s Hospital, London and in the Department of Anesthesiology at the University of California San Diego, he was appointed to the faculty of the Department of Pathology at UC San Diego in 1993. Dr. Calcutt first began studying nerve damage caused by diabetes as an undergraduate, with a largely unsuccessful but nevertheless entertaining and informative attempt to generate diabetic chickens in the laboratory of the esteemed ornithologist Professor David Tomlinson. Undeterred by the pitiful paucity of pre-diabetic poultry, he has continued to investigate mechanisms of diabetic neuropathy and neuropathic pain throughout his academic career, with a particular interest in translational studies. Dr. Calcutt is also a co-founder of the biotechnology company WinSanTor Inc. and the non-profit organization Diabetes Research Connection.

Paul Fernyhough PhD received his PhD in biochemistry from the department of Biochemistry at University of Sheffield. He then carried out postdoctoral research at Colorado State University, Kings College London and as a Wellcome Trust Postdoctoral Fellow at St Bartholomew’s Medical College. He subsequently worked as a tenured lecturer in the School of Biological Sciences at the University of Manchester. Dr. Fernyhough moved to Winnipeg in 2004 and set up a neuroscience research group at St Boniface Hospital Albrechtsen Research Centre and holds a tenured professorship in the Department of Pharmacology & Therapeutics at University of Manitoba. Dr. Fernyhough’s research interest is in the cell biology underlying neurodegenerative disorders of the peripheral nervous system with a focus on the impact of diabetes. A biotech start-up, WinSanTor Inc, has been established and is directing phase 2 clinical trials in diabetic neuropathy and chemotherapy-induced peripheral neuropathy.

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[RichardWagenknecht]

Thanks so much for having these fine gentleman on. They’ve been quietly working on this for many years and they need some exposure to secure their next funding.

[wendybrooks]

My oncologist had me ice my hands and feet during chemo infusion. It was uncomfortable, but I did sooo much better than anyone I know who had same chemo. I do have some neuropathy but very little comparatively. I was so grateful!

[katiequ]

If I get windfall will send chunk of change your way! Thanks Dr P for not interrupting the guests w/ constant requests for further explanation for lay persons. We have google and makes interview flow

[rickcinway]

I have Type 2 diabetes. And had two severe bouts of neuropathy on my left leg and feet. So severe that the pain caused me to stop walking and I had to take painkillers to be able to sleep. I was taking Rosuvastatin drug or other statin drugs on and off for about four years. So, I heard that statin drugs can cause or make worse neuropathy. So, I stopped taking the Rosuvastatin pill and the agonizing neuropathy pain on my left leg subsided after about 13 days. And I was able to walk unhindered by pain. Although, I still have residual numbness on my left foot and a tiny amount of numbness on my right foot. Now, I am able to go for long walks and climb stairs at the park which has 85 steps.

[Suzitao]

I think I will stick to natural methods of improving mitochondrial function. (My partner and I both have peripheral neuropathy since getting covid..neither is diabetic). Fasting exercise lower carb diet acv sunshine heat and cold therapy lymph drainage omega 3 rich small fish. Supplementation such as turmeric magnesium NAC ALA etc. In my experience side effects seem to usually outweigh the benefits of prescription drugs. Interesting talk though. Thank you all.

[adorableadornments]

My sister has idiopathic neuropathy. She was told by her doctor that it was caused by her taking vitamin b6 over many years. So far after getting off the B6, she is not getting better. She also has essential tremor, but tested for adrenal tumors, none found. She is 79 and lives in Assisted Living, and her pain and imbalance makes her reliant on a walker. She doesn't have type two diabetes.

[geegev.]

Loved the talk, very scientific but understandable. I do not have diabetes, but a recent diagnosis of PAD. A little more about what causes foot pain in the absence of diabetes would have been helpful. I do have autoimmune thyroid and a build up of heat in my back L4-L5 which might be flaring up the neuropathy in feet? It's all a science project. Thank you

[davidnorman]

Blood flow, nitric oxide, increasing VO2 Max seems like all would help, beyond the blood sugar issues.

[PattiHill-gt]

Covid left me with neuropathy in my hand. I still can't believe it's not discussed more! Soooo many people like myself. I hold onto hope for healing, but it's been 4 years. We need more funding and research, and we desperately need something to come out in the next five years or so. I really hope they are able to push something through.

[davidnorman]

You gentlemen are doing great, inquisitive work. I am hearing several clear examples of the FDA steering what they care symptom treatment with pain drugs and away from root cause analysis altogether. They do this by only asking or allowing certain questions to be asked and explored. I think it is obvious that non-pharma medicine is simply not allowed a seat at the table.

[Kathleenschweiker]

Peripheral neuropathy, is often experienced in patients with autoimmune illnesses, - Sjogrens, Mast Cell activation, autoimmune dysautonomia POTS, Lyme disease.

[aslamw]

Ask the public for funding, GoFundMe or anything similar. The world will donate like never before.

[pacificislandgirl]

My neuropathy is caused by spinal stenosis at L4/L5. My diabetes is considered under control / normal at an A1C of 5.6 and achieving this has not affected my neuropathy - it is still the same with dropfoot. The neuropathy started after a very serious bout of pneumonia and coughing which aggravated my stenosis that my doc did not take seriously and that caused a month in the hospital. Uric Acid is 391 umol/L.

[BillEarl]

Fascinating discussion. The takeaway for me is....stay healthy, look after your diet and avoid diabetes ect. as one illness leads to another.

[wisdomrules]

I looked up the negative side affects of muscarinic antagonists and they seem concerning, particularly in the elderly.

[Jack-rusr]

While diabetic, I never had issues of leg neuropathy until I had an adverse reaction to Leviquin in 2016. My reaction was bad enough that despite walking 4 miles per day prior, within two days, I had to crawl down our stairs. The leg cramps that I never had before were intense and still plague me to some extent, even with taking 600mg of magnesium malate. Still have tingling on occasion, often leg cramps during the night.

If you don't want to get medical help, tell a doctor that you had a reaction to Leviquin.

[swamiman]

This sounds like an exciting prospect and they can make this treatment available to others in 2026-27.

[lindalembeck]

Really interesting. I wonder if this drug could work for shingles or traumatic injury to nerves from say a car accident.

[johnschlesinger]

Re diabetic neuropathy: if tight glycaemic control is put into place early, neuropathy shouldn't occur. And, with normoglycaemia, neuropathy is reversible. And access to things like insulin pumps is a nonsense. I have had type one diabetes for 59 years, and have no complications. My HbA1c is 4.5%.

[jedadruled]

Fat is bad.
The political correct food advice to reduce eating fats has been a disaster for health.