In addition to the mechanisms related to the hyperglycemic state, studies also suggest a mechanism of neuronal damage that occurs folowing STZ that is unrelated to the hyperglycemic state. The studies suggest that there is direct damage to the nerves via ROS-mediated elevation of TRPVI in the neurons. Some in vitro studies also suggest that DRG is exposed to the STZ. This suggests that this model involves direct changes in the nerves that are not related to the inflammatory process.
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