Exciting Developments in the Treatment of Peripheral Neuropathy - with Dr. Fernyhough & Dr. Calcutt | EP 179

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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. 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. 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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