Sciatic Nerve Structural and Functional Recovery with Extract of Phyllanthus amarus and Esculetin in STZ-Induced Hyperglycemic Rats

Background: Diabetes-instigated nerve damage is a chronic complication including impaired peripheral nerve function with lowered nerve conduction velocity (NCV), demyelination of nerve fibres and alterations in the behaviour. Many clinical and experimental studies have proved that Phyllanthus amarus and esculetin have potential effects against various diseases. Purpose: The aim of this study is to assess the neuroprotective role of hydro-ethanolic extract of Phyllanthus amaras (PAE) and esculetin (ESC) on NCV, metabolism, behavioural and structural changes in diabetic rats. Methods: The extent of protection using PAE and ESC in diabetic rats was determined by checking the HbA(1)c, NO, myeloperoxidase (MPO), total calcium, protein content, Na+-K+ ATPase activity, acetylcholine content and behavioural alterations using rotarod and maze learning tests on 7, 14 and 21 days. NCV was measured on the 21st day. Results: The diabetic rats showed increased HbA1c, nitrite, MPO, calcium and decreased protein, Na+-K+ ATPase activity, NCV, acetylcholine, behavioural alterations and morphological changes of sciatic nerve so that diabetic peripheral neuropathy (DPN) is manifested. Continuous treatment for three weeks with Phyllanthus amarus and esculetin significantly minimized the damage to axons and myelin sheath and enhanced the sciatic NCV by reversing all the mentioned parameters. Conclusion: Phyllanthus amarus and esculetin showed the anti-diabetic as well as anti-inflammatory characteristics by prevention of initiation of adverse processes of the sciatic nerve morphology, internal cell functions leading to improved coordination, behavioural and physiological functions in STZ-induced diabetic rats. PAE has shown similar effects with the ESC. However, further studies are essential to confirm their detailed therapeutic effects.