Gynostemma pentaphyllum (Thunb.) Makino Affects Autophagy and Improves Diabetic Peripheral Neuropathy Through TXNIP-Mediated PI3K/AKT/mTOR Signaling Pathway

TXNIP is closely associated with diabetic peripheral neuropathy (DPN). Gynostemma pentaphyllum (Thunb.) Makino (GP), a perennial herb with five leaves, is considered to have medicinal values. However, it is unknown whether GP alleviates DPN by modulating TXNIP-mediated autophagy. The aim of this study was to evaluate the effect of GP on Schwann cell injury during DPN and to investigate the mechanism of GP in DPN for the first time. High-fat diet-fed GK rats and high-glucose-cultured RSC96 cells were used to establish DPN models. The effects of GP on DPN were investigated by blood glucose assay, neurological function assay, pathology assay, and immunohistochemistry. To investigate the effect of GP on autophagy and upstream PI3K/AKT/mTOR signaling pathway in Schwann cells, Western blot and immunofluorescence assay were performed on RSC96 cells to detect the expression of beclin-1 and LC3. Western blot method was used to detect the expression of PI3K, p-Akt/Akt, p-mTOR/mTOR, and RT-qPCR method and was used to detect the expression of PI3K. Apoptosis was detected by flow cytometry. The effects of TXNIP on the above indicators were also detected in RSC96 cells. Finally, the mechanism of GP regulation of autophagy and apoptosis in RSC96 cells was verified. GP reduced blood glucose level, attenuated peripheral nerve myelin damage, and improved nerve function in DPN rats. In addition, GP enhanced autophagy activity and reduced apoptosis in RSC96 cells. GP promoted autophagy by regulating TXNIP-mediated PI3K/AKT/mTOR signaling pathway, and GP reduced apoptosis in RSC96 cells by promoting cellular autophagy. GP attenuates DPN myelin damage in RSC96 cells by enhancing autophagy, and its mechanism may be related to the inhibition of PI3K/AKT/mTOR signaling pathway by up-regulating the expression of TXNIP.