ABSTRACT

Introduction

With a complex and often misunderstood etiology, acute Charcot neuroarthropathy (ACN) is a devastating complication of peripheral neuropathy. In patients with diabetes, timely diagnosis of ACN in the foot and ankle is essential to prevent loss of both limb and life.

Areas covered

Herein, the authors evaluate the growing body of evidence in identifying targeted pathways for future therapeutic interventions. A literature search was conducted through the PubMed research database. Searched terms included ‘Charcot,’ ‘foot and ankle,’ ‘neuroarthropathy,’ ‘pathophysiology,’ ‘arthropathy,’ ‘diabetic foot,’ and ‘Charcot foot.’

Expert opinion

The interplay between the acute inflammatory response, cytokine signaling, and bone metabolism equilibrium can now be better understood with the aid of several novel immunobiologic mechanisms. The more recently elucidated roles of advanced glycation end-products, neuropeptides, monocyte differentiation, and genomics combine with classical Charcot pathophysiology to aid researchers and clinicians alike in combatting this often puzzling consequence of peripheral neuropathy.

中文翻译：

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糖尿病足和踝关节急性夏科神经关节病病理生理学的当前概念。

摘要

介绍

急性夏科神经关节病 (ACN) 具有复杂且经常被误解的病因，是周围神经病变的破坏性并发症。在糖尿病患者中，及时诊断足部和踝部的 ACN 对于防止肢体和生命的丧失至关重要。

覆盖区域

在此，作者评估了在确定未来治疗干预的靶向途径方面越来越多的证据。通过 PubMed 研究数据库进行了文献检索。搜索词包括“Charcot”、“脚和脚踝”、“神经关节病”、“病理生理学”、“关节病”、“糖尿病足”和“Charcot 足”。

专家意见

借助几种新的免疫生物学机制，现在可以更好地理解急性炎症反应、细胞因子信号传导和骨代谢平衡之间的相互作用。最近阐明的晚期糖基化终产物、神经肽、单核细胞分化和基因组学的作用与经典的夏科病理生理学相结合，可帮助研究人员和临床医生应对周围神经病变这一经常令人费解的后果。