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PLOS One logoLink to PLOS One
. 2025 Oct 27;20(10):e0334245. doi: 10.1371/journal.pone.0334245

Novel insights into neuropathy: The impact of prolonged hyperglycemia on long non-coding RNA expression

Kamila Zglejc-Waszak 1,*,#, Jan Paweł Jastrzebski 2,3,#, Joanna Wojtkiewicz 4, Zenon Pidsudko 1, Judyta Karolina Juranek 4
Editor: Li Shen5
PMCID: PMC12558608  PMID: 41144575

Abstract

Multiple evidence suggests that type 1 diabetes triggers perturbations in the nervous system both in human patients as well as in animal models of the disease. These perturbations are likely controlled by the expression of long non-coding RNAs (lncRNAs) and are present both in peripheral and central nervous system. To dissect the role of lncRNAs in diabetes-affected nervous system malfunctions, we conducted a comparative analysis of spinal cord transcriptome profiles between long-term (six months of duration) diabetic versus non-diabetic mice. The analysis of RNA sequencing data revealed that of 277 unique differentially expressed transcripts, 201 were up-regulated and 76 were down-regulated in the diabetic lumbar spinal cord. We also observed elevated expression of Snhg15 lncRNA in diabetic spinal cord. The in-depth data analysis revealed differential expression of lncRNAs involved in the PI3K-Akt signaling pathway (KEGG: mmu04151) as well as substantial differences in several biological processes such as developmental process, cell communication, anatomical structure development and multicellular organismal process. Our analysis verified the role of lncRNAs in mouse spinal cord during the progression of type 1 diabetes and confirmed molecular alternations in the spinal cord occurring in the course of diabetic neuropathy.

Introduction

Numerous studies have shown that type 1 diabetes (T1D) is the main cause of peripheral nervous system perturbations [16]. Studies indicated that patients with diabetes have also malfunctions in the central nervous system [711]. Our previous RNA-seq studies indicated that long-term T1D may alter the expression of genes in the mouse spinal cord [2]. We observed that the expression of 248 differential genes increased and 137 decreased in lumbar spinal cord harvested six months after T1D induction in mice [2]. Moreover, our data demonstrated that changes in the spinal cord occur simultaneously with molecular changes in the sciatic nerve during T1D [2]. However, the cause of molecular changes in the nervous system during T1D is still unknown.

Nevertheless, studies indicated that long non-coding RNAs (lncRNAs) may play a key role in neurological complications of diabetes [12], likely affecting the receptor for advance glycation end products-diaphanous related fromins 1 (RAGE-Diaph1) signaling pathways in T1D nervous system. Our previous studies have shown that the interaction between RAGE and Diaph1 is essential in neurological complications [2,6,13,14].

Results suggest that lncRNAs may influence gene expression in the mouse lumbar spinal cord during long-term T1D [2,3,1517]. Therefore, the aim of the present study was to investigate the expression of lncRNAs and the relationships between target genes in the lumbar spinal cord harvested from mice with T1D. We observed that lncRNAs may have an impact on the PI3K-Akt signaling pathway in the lumbar spinal cord and thus contribute to the progression of T1D.

Materials and methods

Animals and tissues

The study was approved by the Local Ethics Committee of Experiments on Animals in Olsztyn (Poland; decision no. 57/2019).

Male mice (C57BL/6) that had T1D for 6 months were obtained as previously described [3] and the presence of peripheral neuropathy was confirmed [3]. Briefly, at eight weeks of age mice were randomly divided into two experimental groups (n = 5 per group) and treated with: streptozotocin (STZ) or vehicle (PBS, phosphate buffer saline). T1D was induced by intraperitoneal injection of 50 mg/kg STZ diluted in PBS for five consecutive days. Simultaneously, our control group received the same volume of PBS throughout treatment period [2]. Among T1D mice, animals with a glucose concentration of 13 mmol/L (260 mg/dL) were selected for further experiments. Blood glucose measurements as well as the confirmation of diabetic neuropathy were previously described [2]. Diabetic peripheral neuropathy was confirmed by measuring nerve conduction and determining the ultrastructure of the sciatic nerve (data included in the previous manuscript [2]). As described previously [2], all mice were anesthetized using ketamine (300 mg/kg) and xylazine (30 mg/kg) mixture to minimize mouse suffering. Mice were humanely euthanized by cervical dislocation. Following collection, lumbar spinal cords were collected on ice, immediately frozen in liquid nitrogen and stored at −80 °C until further analyses. All tissues were sampled during our previous study [3], therefore we limited the number of animals used in accordance with the 3R principle [18].

RNA isolation

Total RNA was isolated the use of a RNeasy Plus Mini Kit (Qiagen, Hilden, Germany). Genomic DNA (gDNA) contamination was effectively removed using a special gDNA eliminator spin column. The purified RNA was ready to use for further analyses, such as: Next Generation Sequencing and quantitative PCR (qPCR).

Next generation sequencing

The sequencing reactions were performed as described in Zglejc-Waszak and co-workers [2]. Briefly, we have used the NovaSeq 6000 platform (IlluminaR, USA) to generate 2 × 150 bp reads. We have obtained 40 million readings per sample. Next, sequencing data was converted into raw data for the in-silico analysis of lncRNAs [1819].

Bioinformatic analysis of lncRNAs

We performed in silico preprocessing including both quality control using FastQC software version 0.11.7 (Bioinformatics Group at the Babraham Institute, Cambridge, UK; www.bioinformatics.babraham.ac.uk) and trimming of low quality reads (Phred cut score ≤ 20; reads length = 90 nucleotides, default Illumina adapters removing) using Trimmomatic version 0.39 [20]. Mapping process was performed using STAR, v. 2.7.10a and StringTie, v. 2.1.7. based on the reference mouse genome GRCm39 (Genome Reference Consortium Mouse Reference 39), INSDC Assembly GCA_000001635.9 (ENSEMBL release 102) and annotation version 107 [2122].

The lncRNA identification process followed the previously described procedure [19] applying the lncRna library [23] for the validation and the setting of a customized set of procedures with the most optimal configuration for these studies. We implemented the following methods to identify coding potential: “CPC2”, “PLEK”, “FEELnc”, “CPAT”, “CNCI”, “LncFinder” [2426]. Finally (using the lncRna library), we selected two tools for the combination of coding potential analysis methods: CPAT and CNCI as the most optimal solution for this particular study (Fig 1).

Fig 1. FourPlot.

Fig 1

The plot of confusion matrix (A) generated for the combination of the coding potential prediction results of the two selected tools: CPAT and CNCI. Green fields represent truly and red – falsely predicted features. Statistics confirming the quality of the prediction by the selected combination of methods (such as accuracy, P-Value or precision) are shown in part (B) of the figure.

Thanks to the very favorable ratio between correct predictions and incorrect ones, and to the high-quality annotation of the reference genome, 1-exon transcripts were not filtered out Therefore, the final pool of predicted new lncRNAs also includes 1-exon transcripts.

The STRING v. 12 database was used to created interaction networks (https://string-db.org/). REVIGO server was used to summarize and visualize lists of Gene Ontology (GO) terms [2526]. David KEGG database was used to visualize biological pathways [26].

qPCR analysis of lncRNA

RNA was transcribed (QuantiNova Reverse Transcription Kit (Qiagen, Hilden, Germany) to cDNA according to the manufacturer’s instructions [14]. Snhg15 expression was tested in duplicates using a qPCR with SYBR® Green PCR Master Mix (Qiagen, Hilden, Germany; [14]). Fold change was calculated using ΔΔCt method and normalized using reference gene (Table 1; [28]). The specificity of qPCR was confirmed by agarose gel electrophoresis.

Table 1. Primers used for qPCR.

Symbol (official) Transcript Primers sequences Accession number Amplicon length Reference
Snhg15 Snhg15–201 F: TAGCACTTCAGAGACCATCAG
R: TGTCTTCAGACACACCAGAG
NR_045893 214 nt
18S rRNA F: GGGAGCCTGAGAAACGGC
R: GGGTCGGGAGTGGGTAATTT
NR_003278.3 68 nt [27]

Statistical analysis

Results of qPCR were presented as the mean ± SEM. Analyses with P-values ≤ 0.05 were considered statistically significant. Statistical analyses were performed using Statistica 13.3 (StatSoft Inc., Tulsa, OK, USA). Statistical graphs were performed using GraphPad Prism 9.1.0. (CA, USA) as well as Office package.

Results

Description of lncRNAs

We obtained 277 differentially expressed transcripts; 201 were up-regulated and 76 were down-regulated in the T1D lumbar spinal cord (Fig 2).

Fig 2. Volcano plot showing log2fold change plotted against normalized p-values. Each point (dot, circle and triangle) represent gene expression value. Gray triangle – no significance. Green triangle – Log2FC. Blue circles are genes that meet the significance threshold, but the expression difference is less than 2 (2 x fold change = 1 log2 fold change). Red circles indicate genes that meet both conditions, so they are classified as genes with significantly variable expressions, while circles with large diameters indicate lncRNAs with significantly different expressions (DELs). Logarithm of fold change on the X-axis and statistical significance of the measurement (negative logarithm of p-adjusted on the Y-axis.

Fig 2

Of these, 181 transcripts were products of lncRNA biotype genes, 78 protein coding and 18 as pseudogenes (Fig 3A). We identified 277 such transcripts, which are lncRNAs, but at the gene level it is as in Fig 3A, and at the transcript level it is as in Fig 3B). A table containing a complete list of lncRNAs that were differentially expressed in the T1D lumbar spinal cord in relation to control is presented in the supplementary data (S1 Table).

Fig 3. Description of differentially regulated lncRNAs.

Fig 3

Overall, 277 transcripts were expressed in mouse lumbar spinal cord, while 201 were up-regulated and 76 were down-regulated in T1D mice. Transcripts were divided into five categories based on biotype: protein coding (66 were up- and 13 were down-regulated in T1D mice), lncRNA (117 were up- and 63 were down-regulated), transcribed unprocessed pseudogene (seven were up-regulated in T1D mice), transcribed processed pseudogene (nine were up-regulated in T1D mice) and transcribed unitary pseudogene (two were down-regulated in T1D mice).

Interaction of lncRNAs with protein

Analysis of direct lncRNA-protein interactions revealed strong associations with three proteins, A disintegrin-like and metallopeptidase (reprolysin type) with thrombospondin type 1 motifs 3 (Adamts3), A disintegrin and metalloproteinase with thrombospondin motif 18 (Adamts18), SCO-spondin (Sspo). Sspo is involved in the modulation of neuronal aggregation. It may be involved in developmental events during the formation of the central nervous system. Moreover, Sspo protein belongs to the thrombospondin family. In silico analysis revealed that these proteins participate in Gene Ontology-term (GO-term) associated with Cellular Component – Extracellular matrix (GO:0031012); limited to Mus musculus (Fig 4). The most enriched biological pathway was O-glycosylation of TSR domain-containing proteins (MMU-5173214). The mentioned proteins do not form direct interactions, but they create a network of interactions with other proteins (Fig 4). We observed that in the O-glycosylation of TSR domain-containing proteins pathway, Adamts3, Adamts18, Sspo interact with Beta-1,3-glucosyltransferase (B3glct) and GDP-fucose protein O-fucosyltransferase 2 (Pofut2; Fig 5).

Fig 4. Functional analysis of Adamts3, Adamts18 and Sspo proteins.

Fig 4

Colors indicate the type of function performed in the network. Created in STRING v. 12. Adamts3 – A disintegrin-like and metallopeptidase (reprolysin type) with thrombospondin type 1 motif, 3: Adamts 18 – A disintegrin and metalloproteinase with thrombospondin motifs 18, Sspo – SCO-spondin. Colors indicate the process related to the GO-term and biological pathways.

Fig 5. Proteins involved in extracellular matrix and o-glycosylation of TSR domain-containing proteins.

Fig 5

Protein-protein network was created in STRING v. 12 database. Limited to Mus Musculus. Network nodes represent proteins. Edges represent protein-protein associations. Created in STRING v. 12. Gp1ba - Platelet glycoprotein Ib alpha chain, Krba1 – Protein KRBA1, Tmeme86a - Lysoplasmalogenase-like protein TMEM86A, Ccdc51- Mitochondrial potassium channel; Mitochondrial potassium channel located in the mitochondrial inner membrane, Fam131a - Protein FAM131A, Ccdc172 – Coiled-coil domain-containing protein 172, Tpgs1 – Tubulin polyglutamylase complex subunit 1, Ccbe1 – Collagen and calcium-binding EGF domain-containing protein 1, Pofut2 – GDP-fucose protein O-fucosyltransferase 2, B3gltc - Beta-1,3-glucosyltransferase, Adamts3 – A disintegrin-like and metallopeptidase (reprolysin type) with thrombospondin type 1 motif, 3; Adamts 18 – A disintegrin and metalloproteinase with thrombospondin motifs 18, Sspo – SCO-spondin. The color indicates the process related to the GO-term and biological pathways.

Direct interaction with RNA

We found that RNA-RNA interactions are associated with GO-terms involved in biological process (BP), cellular component (CC) and molecular function (MF, Fig 6; S2 Table). In BP term we observed GO associated with anatomical structure development (GO:0048856), developmental process (GO:0032502), multicellular organismal process (GO:0032501), multicellular organism development (GO:0007275), cell differentiation (GO:0030154), cellular developmental process (GO:0048869), response to stress (GO:0006950), cellular response to chemical stimulus (GO:0070887), positive regulation of cellular process (GO:0048522), regulation of developmental process (GO:0050793), organonitrogen compound metabolic process (GO:1901564) and cell communication (GO:0007154; Figs 6 and 7). The largest number of genes that showed RNA-RNA interactions and associated with the BP term were involved in the multicellular organismal process (GO:0032501) and the PI3K-Akt signaling pathway (KEGG: mmu04151; Table 2, S1 Fig.).

Fig 6. Summary visualization of GO terms associated with RNA-RNA interactions.

Fig 6

GO terms under MF (purple), CC (dark blue) and BP (green). Cellular anatomical entity was the most enriched GO term. The X-axis indicates the number of genes involved in GO-term.

Fig 7. GO-BP term enrichment analysis associated with RNA-RNA interactions.

Fig 7

Top GO terms under BP are developmental process, cell communication, anatomical structure development and multicellular organismal process. Colors indicate processes related to the GO-term.

Table 2. The most enriched biological pathway. Genes that showed RNA-RNA interactions.

PI3K-Akt signaling pathway (KEGG: mmu04151)
Ensembl ID Official Symbol Description
ENSMUST00000177197 Chrm1 cholinergic receptor, muscarinic 1
ENSMUST00000125346 Pkn3 protein kinase N3
ENSMUST00000107571 Lpar1 lysophosphatidic acid receptor 1
ENSMUST00000124203 Sgk1 serum/glucocorticoid regulated kinase 1
ENSMUST00000020308 Ddit4 DNA-damage-inducible transcript 4
ENSMUST00000171265 Sgk3 serum/glucocorticoid regulated kinase 3
ENSMUST00000023829 Cdkn1a cyclin dependent kinase inhibitor 1A
ENSMUST00000199615 Egf epidermal growth factor
ENSMUST00000039164 Lpar3 lysophosphatidic acid receptor 3
ENSMUST00000029547 Creb3l4 cAMP responsive element binding protein 3-like 4

Trans-acting

Trans-correlations were associated with five BP and two MF terms (Table 3). Among BP we distinguish anatomical structure development (GO:0048856), developmental process (GO:0032502), multicellular organism development (GO:0007275), multicellular organismal process (GO:0032501), organonitrogen compound metabolic process (GO:1901564). Moreover, we observed trans-correlations in MF associated with binding (GO:0005488) and protein binding (GO:0005515). All trans interactions are listed in S3 Table.

Table 3. Differentially expressed genes associated with BP and MF terms. Trans-acting genes.

Category name,
* Subcategory name
Genes, Official symbol Number
Biological process
GO:0032501
multicellular organismal process
Rab7b, Myoc, Sgk1, Enpp1, Ddit4, Aire, Icos, Myola, Pla2g3, Ddc, Gjc2, Per1, Tbx2, Mfsd2b, Nfkbia, Nkx2–9, Ucn3, Akr1c14, Serpinb1a, Shld3, Setdb2, Maff, Acr, Serpind1, Dusp1, Spdef, Cdkn1a, Nrtn, Cabyr, Il33, Nrap, Fut7, Ptgds, Ada, Dcst2, Creb3l4, Oaz3, Ctsk, Ugt8a, Egf, Rrh, Slc9b2, Ccn1, Lpar3, Gabrr2, Lpar1, Mfsd2a, Crybg2, Asic3, Adamts3, Sh2b2, Clcn1, Sspo, Nat8f6, Hif3a, Nanos2, Meiosin, Klc3, Zfp36, Alpk3, Insc, Trim72, Itgad, Mki67, Ascl2, Hmgb2, Il12rb1, Asf1b, Adamts18, Or8b53 70
GO:0032502
developmental process
Rab7b, Myoc, Sgk1, Enpp1, Ddit4, Aire, Icos. Pla2g3, Ddc, Gjc2, Tbx2, Nfkbia, Nkx2–9, Akr1c14, Shld3, Setdb2, Maff, Ankrd33, Dusp1, Spdef, Cdkn1a, Nrtn, Cabyr, Cdc42ep2, Il33, Nrap, Fut7, Spdef, Ada, Creb3l4, Oaz3, Ctsk, Ugt8a, Egf, Slc9b2, Ccn1, Lpar3, Lpar1, Mfsd2a, Crybg2, Adamts3, Sh2b2, Sspo, Nat8f6, Ninj2, Hif3a, Nanos2, Meiosin, Klc3, Zfp36, Alpk3, Imsc, Trim72, Mki67, Ascl2, Tgfbr3l, Hmgb2, Asf1b, Ccl17, Adamts18 60
GO:0048856
anatomical structure development
* GO:0007275
multicellular organism development
Rab7b, Myoc, Sgk1, Ddit4, Aire, Icos, Pla2g3, Ddc, Gjc2, Tbx2, Nfkbia, Nkx2–9, Shld3, Akr1c14, Setdb2, Maff, Ankrd33, Dusp1, Spdef, Cdkn1a, Nrtn, Cabyr, Cdc42ep2, Il33, Nrap, Fut7, Ctsk, Lpar1, Lpar3, Slc9b2, Ccn1, Ada, Ugt8a, Egf 57
Rab7b, Myoc, Sgk1, Ddit4, Aire, Pla2g3, Ddc, Gjc2, Tbx2, Nfkbia, Nkx2–9, Akr1c14, Shld3, Setdb2, Maff, Dusp1, Spdef, Cdkn1a, Nrtn, Il33, Nrap, Fut7, Ada, Ctsk, Ugt8a, Egf, Slc9b2, Ccn1, Lpar3, Lpar1, Mfsd2a, Crybg2, Adamts3, Sh2b2, Sspo, Nat8f6, Hif3a, Zfp36, Alpk3, Imsc, Mki67, Ascl2, Hmgb2, Asf1b, Adamts18 46
GO:1901564
organonitrogen compound metabolic process
Sgk1, Enpp1, Ddit4, Aire, Pla2g3, Ddc, Gjc2, Per1, Nfkbia, Serpinb1a, Cdc14b, Galnt15, Cideb, Setdb2, Hr, Acr, Serpind1, Dusp1, Fkbp5, Cdkn1a, Gnmt, Spink10, Il33, Fut7, Pla2g4e, Trib3, Ada, Oaz3, Ctsk, Ovgp1, Ugt8a, Egf, Ccn1, Mob3b, Mfsd2a, Map3k6, Adamats3, Tfr2, Nat8f7, Nat8f6, Asprv1, Gxylt2, Nanos2, Hipk4, Zfp36, Ttll13, Alpk3, Kctd21, Acsm3, Trim72, Il12rb1, Fbxl9, Adamts18, mt-Ti 54
Molecular function
GO:0005488
binding
Rab7b, Myoc, Dnah14, Sgk1, Enpp1, Ddit4, Aire, Icosl, Myo1a, Castor1, Ddc, Per1, Tbx2, Arl4d, 1810010H24Rik, Nfkbia, Nkx2–9, Ucn3, Akr1c14, Pla2g3, Serpinb1a, Galnt15, Cideb, Setdb2, Hr, Maff, Acr, Ankrd33, Serpind1, Dynlt2a3, Dusp1, Spdef, Fkbp5, Cdkn1a, Myo1f, Ly6g6e, Ly6g5b, Gnmt, Plin5, Nrtn, Slc3a1, Cabyr, Spin10, Cdc42ep2, Il33, Nrap, Mcm10, Yme1, Ptgds, Phyhd1, Pla2g4e, Trib3, Ada, Phactr3, Fcrl, Creb3l4, Oaz3, Ctsk, Inka2, Ovgp1, Egf, Etnppl, Slc9b2, Ccn1, Lpar3, Gabrr2, Mob3b, Lpar1, Map3k6, Crybg2, 1700109H08Rik, Adamts3, Sh2b2, Tfr2, Rasl11a, Clcn1, Sspo, Zfand4, Hifa3, Nanos2, Meiosin, Klc3, Hipk4, Zfp36, Ttll13, Alpk3, Kctd21, Insc, Acsm3, Trim72, Itgad, Mki67, Pnpla2, Tspan4, Ascl2, Tgfbr3l, Hmgb2, Tma16, Il12rb1, Asf1b, Mt2, Mt1, Ccl17, Fbxl9, Adamats18, Or8b53, mt-Ti, Hsf3, Pla2g3 109
GO:0005515
protein binding
Myoc, Dnah14, Sgk1, Enpp1, Ddit4, Aire, Icosl, Myo1a, Castor1, Ddc, Per1, Tbx2, 1810010H24Rik, Nfkbia, Ucn3, Pla2g3, Serpinb1a, Cideb, Setdb2, Hr, Acr, Ankrd33, Dynlt2a3, Dusp1, Fkbp5, Cdkn1a, Myo1f, Ly6g6e, Ly6g5b, Gnmt, Plin5, Nrtn, Slc3a1, Cabyr, Spin10, Cdc42ep2, Il33, Nrap, Mcm10, Yme1, Trib3, Phactr3, Fcrl, Oaz3, Ctsk, Inka2, Egf, Slc9b2, Ccn1, Lpar3, Gabrr2, Lpar1, Sh2b2, Tfr2, Rasl11a, Clcn1, Zfand4, Sspo, Hifa3, Nanos2, Meiosin, Klc3, Zfp36, Ttll13, Kctd21, Insc, Trim72, Itgad, Mki67, Pnpla2, Tspan4, Ascl2, Tgfbr3l, Hmgb2, Il12rb1, Asf1b, Ccl17, Fbxl9 78

Expression of Snhg15 lncRNA in the lumbar spinal cord

An elevated expression of Snhg15 was detected in T1D spinal cord P ≤ 0.01 (Fig 8A). The expression of Snhg15 lncRNA confirmed the results obtained from Next generation sequencing (Fig 8B). Negative controls confirmed the specificity of the primers and the carefully selected primer annealing conditions. We chose this lncRNA because of its function and interaction with other genes involved in diabetic neuropathy [3].

Fig 8. Results of Next Generation Sequencing validation with qPCR.

Fig 8

A. Expression of Snhg15 lncRNA in the lumbar spinal cord. B. Fold change of Snhg15 determined by Next Generation Sequencing was confirmed by qPCR. T1D – type 1 diabetes, CTRL – control.

Discussion

We identified 277 differentially expressed transcripts in the T1D spinal cord. The novel aspect of our study is that the two transcriptomes (i.e., determined in T1D and non-diabetic) were compared to identify the known lncRNAs that are uniquely expressed in the mouse spinal cord. Among the differentially expressed lncRNAs in the mouse spinal cord, transcripts engaging in kinase regulator activity, enterobactin binding, binding, macrolide binding, extracellular region, cellular anatomical entity, cell communication, organonitrogen compound metabolic process, regulation of developmental process, positive regulation of cellular process, cellular response to chemical stimulus, response to stress, cellular developmental process, cell differentiation, multicellular organismal process, anatomical structure development as well as developmental process were found. Nevertheless, our results revealed that lncRNAs are involved in PI3K-Akt signaling pathway. Therefore, our findings confirm the crucial role that the spinal cord may play in the progression of peripheral neuropathy in T1D mice. We revealed that not only peripheral nervous system, but also central nervous system may be affected in the progression of diabetic peripheral neuropathy [23].

Spinal cord role in the progression of diabetic peripheral neuropathy has been overlooked for many decades [3,7]. The first indications of pathological change in the spinal cord during diabetic neuropathy were reported in 1960s [1011]. Our previous results revealed that cathepsin E (CTSE) is expressed in the spinal cord and sciatic nerve in both T1D and T2D [2] and itis up regulated in a damaged spinal cord [2]. Therefore, it is plausible to speculate that the onset of neurodegenerative diseases may have its origin in the spinal cord. Our results confirm that spinal cord plays a role in the progression of diabetic peripheral neuropathy in mice.

LncRNAs may regulate expression of genes through epigenetic mechanisms [29]. The epigenome is sensitive to microenvironmental changes. Long-term hyperglycemia induces alternations in tissues and cells [3031]. Hence, T1D may contribute to alternations in the expression of lncRNAs. Malfunctions in the expression of lncRNAs and thus in the epigenetic factors may induce diabetic perturbations [32]. Studies indicated that lncRNAs are present in central nervous system during the course of neurodegenerative diseases, suggesting that malfunctions in the expression of these molecules may cause perturbations in neuronal cells [3334].

We found that in prolonged hyperglycemia the expression of Snhg15 lncRNA was elevated in the spinal cord of T1D mice. The analysis indicated that Snhg15 belongs to the group of lncRNAs which participate in the modulation of vascular endothelial cell function. Previous studies have shown that the expression of Snhg15 decreases in the hind limbs of mice with diabetes [35]. Nevertheless, we observed that the expression of Snhg15 was elevated in the spinal cord of T1D mice.

Numerous studies indicated that long-term diabetes leads to disturbances in the vascular system [3637]. This phenomenon may suggest that Snhg15 may promote angiogenesis in the spinal cord harvested from T1D mice. Angiogenesis has pathogenic importance during progression of retinopathy [38]. Retinopathy is a common pathology in diabetic patients [39]. Spinal cord injury may initiate the process of angiogenesis [40]. However, angiogenic processes may not be sufficient for the regeneration of axons in the spinal cord during diabetes [4143]. Our previous studies showed the elevated expression of thioredoxin-interacting protein (TXNIP) in the T1D spinal cord of mouse [2,3]. Increased TXNIP expression in mouse spinal cord may induce endothelial cell dysfunction in the case of long-term hyperglycemia [42]. Nevertheless, studies indicated molecular crosstalk between TXNIP and Snhg15 during diabetes [3637]. Overall, Snhg15 overexpression may improve endothelial function during diabetes and thus erase the negative effect of TXNIP in the spinal cord of mice.

However, during long-term diabetes, the amount of advanced glycation end-products (AGEs) increased [1,42]. AGEs accumulation may trigger endothelial dysfunction in spinal cord by enhancing the production of proinflammatory cytokines and perturbations in actin cytoskeleton dynamics of nervous cells and vessels in the spinal cord [2]. In serum, plasma and tissues of patients with diabetes we observe elevated level of AGEs [1]. Moreover, AGEs are the best-known ligand for RAGE [1,6]. RAGE signaling pathways are active during renal microvascular complications in diabetic patients [42]. The authors speculated that AGEs may trigger the overexpression of Snhg15 lncRNA in the spinal cord of T1D mice. Our findings showed that Snhg15 may be a novel biomarker of spinal cord dysfunctions during diabetes. Moreover, our data suggests that Snhg15 may be involved in RAGE signaling pathways underlying the endothelial dysfunction in the spinal cord of T1D mice.

Evidence indicated that in endothelial cells PI3K-Akt signaling pathway plays a role in angiogenesis [44]. However, the molecular relationship between Snhg15 and PI3K-Akt signaling pathway is still unknown. The PI3K-Akt signaling pathway plays an essential role in diabetes [3,12]. This pathway is responsible for insulin signaling and regulation of glucose metabolism [45]. However, it should be noted that the PI3K-Akt signaling pathway plays also a significant role in another process related to diabetes disorders [12,46,47]. Evidence suggests that the PI3K-Akt signaling pathway participates in central nervous system perturbations [45]. This pathway regulates neuron growth, survival, differentiation as well as regeneration [4647]. Evidence indicated that nerve growth factors and some neurotrophic factors are transported in neurons via the PI3K-Akt signaling pathway [48]. Moreover, investigations have shown that the PI3K-Akt signaling pathway may be regulated by lncRNAs [45,48]. However, further studies are needed to clarify this phenomenon.

Our results confirm that lncRNAs play a crucial role in diabetes. Nevertheless, we indicated that Snhg15 lncRNA may be essential in spinal cord dysfunction in T1D [49]. Our in-silico findings also revealed that the PI3K-Akt signaling pathway may be regulated by lncRNAs. The cause of changes in the spinal cord during diabetes may be due to disruptions of endothelial cells.

We confirmed that a long-term T1D may alter the expression of lncRNAs in mouse spinal cord. Nevertheless, the role of lncRNAs as biomarkers of T1D perturbations is not established [50]. The lncRNAs may be involved in spinal cord dysfunctions during T1D. Our data indicated that lncRNas may be responsible for dysfunctions in endothelial cells of mouse spinal cord. Therefore, damage to the vascular epithelium in the spinal cord may cause damage to neurons and, consequently, lead to diabetic neuropathy. We assume that lncRNAs may be responsible for malfunctions in nervous system during T1D. However, a better understanding of the molecular mechanisms of lncRNAs interactions with processes occurring in the nervous and vessel systems is needed [51]. Treatment of diabetic neuropathy should be directed at processes that are often not directly related to glucose regulation, such as lncRNAs control [5255].

Conclusion

Our data demonstrated that lncRNAs are expressed in the spinal cord harvested from T1D mice. We observed alternations in molecular pattern of spinal cord during prolonged hyperglycemia in mice. We confirmed the T1D may affect lncRNA expression in the lumbar spinal cord. Moreover, T1D elevated the expression of Snhg15 in T1D spinal cord as well as the PI3K-Akt signaling pathway. Our research confirmed that the neglected lncRNA, Snhg15 may be an important marker in the progression of T1D. The presented results are a continuation of previous studies on the role of the spinal cord in diabetic neuropathy. However, our results need further study and validation.

Supporting information

S1 Table. A table containing a complete list of lncRNAs that were differentially expressed in the T1D lumbar spinal cord in relation to control.

(DOCX)

pone.0334245.s001.docx (72.4KB, docx)
S2 Table. We found that RNA-RNA interactions are associated with GO-terms involved in biological process (BP), cellular component (CC) and molecular function (MF).

(DOCX)

pone.0334245.s002.docx (33.2KB, docx)
S3 Table. Trans-acting.

(DOCX)

pone.0334245.s003.docx (22.5KB, docx)
S1 Fig. The most enriched biological pathway.

PI3K-Akt signaling pathway (KEGG: mmu04151). Blue rectangles without background indicate the site of lncRNA interaction.

(TIF)

pone.0334245.s004.tif (2.2MB, tif)

Acknowledgments

Authors would like to thank Staff at the Regenerative Medicine Laboratory and Laboratory of Stem Cells Research, University of Warmia and Mazury in Olsztyn, Warszawska 30, 10–082 Olsztyn for letting us use the laboratory space and equipment.

Data Availability

All relevant data are within the manuscript and supporting information. RNA-seq data have been deposited in the ArrayExpress database at EMBL-EBI (www.ebi.ac.uk/arrayexpress) under accession number E-MTAB 12252.

Funding Statement

This work was supported by the National Science Centre, Poland; Grant no. UMO-2018/30/E/NZ5/00458. The publication fee was funded by the School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Poland; Grant no. 61.610.100-110. The funders were not involved in the design or analysis of this research, the preparation of the manuscript, or the decision to publish.

References

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Decision Letter 0

Li Shen

5 Aug 2025

Dear Dr. Zglejc-Waszak,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

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Additional Editor Comments:

The manuscript presents a relevant and timely investigation into the role of long non-coding RNAs (lncRNAs) in diabetic neuropathy, focusing on spinal cord changes in a mouse model of type 1 diabetes. The study addresses an underexplored area and includes both bioinformatics analysis and experimental validation. However, all reviewers identified several critical issues that must be addressed before the manuscript can be considered for publication. These include insufficient contextualization of the findings within existing literature, limited validation of identified lncRNAs (with only Snhg15 experimentally confirmed), and a lack of mechanistic support for key biological claims. Moreover, the diabetic neuropathy model is not adequately described, and essential information regarding disease onset, neuropathy development, and animal selection for transcriptomic profiling is missing. Reviewers also noted concerns with figure clarity, incomplete supplementary materials, and overinterpretation of results in the Discussion. Substantial revisions are required to improve the manuscript's clarity, experimental justification, and scientific rigor.

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Partly

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2. Has the statistical analysis been performed appropriately and rigorously? -->?>

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available??>

The PLOS Data policy

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English??>

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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Reviewer #1: Some remarks to authors:

General Assessment: This manuscript investigates the impact of prolonged hyperglycemia on long non-coding RNA expression in the spinal cord of diabetic mice. The study addresses an underexplored aspect of diabetic neuropathy, particularly focusing on central nervous system involvement. The bioinformatics pipeline and experimental validation of Snhg15 expression are strengths. However, several issues should be addressed before the manuscript is considered for publication.

Major Comments:

Novelty and Contextualization: The manuscript provides new data on lncRNAs in the diabetic spinal cord. However, further contextualization with recent high-throughput studies on lncRNAs in neurodegeneration and diabetes would strengthen the Introduction and Discussion.

Validation: Only Snhg15 was validated by qPCR. Please justify why no additional lncRNAs were selected for validation. Were any protein-level experiments (e.g., Western blot, immunohistochemistry) considered to confirm PI3K-Akt pathway activation?

Mechanistic Insight: The link between Snhg15 and endothelial dysfunction or RAGE signaling is hypothesized but not mechanistically demonstrated. Authors should moderate the claims or provide additional experimental support.

Figure Quality and Supplementary Data: Some figures (e.g., interaction networks) lack clarity and resolution. The supplementary tables referenced in the text (e.g., S1 Table, S2 Table) are not included in this file. These should be provided for review.

Minor Comments:

Please revise the text for grammatical accuracy and clarity. There are frequent awkward phrasings (e.g., "We confirmed pathological effect of T1D in lumbar spinal cord of the expression of lncRNAs").

Consider removing repetitive statements, especially in the Discussion.

Ensure that all GO terms and KEGG pathways are described with their biological significance.

Best regards

Reviewer #2: First of all, I would like to thank Plos One for inviting me to review the article Novel insights into neuropathy: the impact of prolonged hyperglycemia on long non-coding RNA expression.

After reading it, I can confirm that the article is pertinent and has logical conclusions.

I believe that the article is ready for release.

Thank you,

Dr João Paulo Barile

Neurologist at the Department of Neuromuscular Diseases at the Federal University of São Paulo (UNIFESP)

Reviewer #3: The analysis of long non coding RNAs is not so deeply studied as other non conding RNAs, so a study focused on lncRNAs in neuropathy is interesting. Major points should be implemented:

- the model of diabetic neuropathy is not described, information is demanded to references 2 and 18. Ref 2 is a review, ref 18 does not seem related to diabetes model. Please clarify and clear detail the model used.

- Please report data regarding the development of diabetes and neuropathy in the animals used for transcriptomic analysis; at least at the time point considered for sacrifice (6 months)

- Depending on the model, not all the animals with diabetes develop neuropathy, please report here the percentage. Were the non neuropathic animals excluded by the omic analysis?

- Snhg15 lncRNA expression was validated by RT-PCR. Why the attention was focused on this particular target? Since among several others one only was verified, the choice must be well supported.

- The discussion is mainly based on the description of Snhg15 and its relationship with PI3K (not measured here); the authors state "We assume that Snhg15 lncRNA may be responsible for malfunctions in nervous system during T1D", the authors should better analyze this hypothesis or strongly revise the discussion reducing the impact of only probabilistic suggestions

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Reviewer #1: No

Reviewer #2: Yes:  João Paulo Barile

Reviewer #3: No

**********

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PLoS One. 2025 Oct 27;20(10):e0334245. doi: 10.1371/journal.pone.0334245.r002

Author response to Decision Letter 1


3 Sep 2025

Additional Editor Comments:

The manuscript presents a relevant and timely investigation into the role of long non-coding RNAs (lncRNAs) in diabetic neuropathy, focusing on spinal cord changes in a mouse model of type 1 diabetes. The study addresses an underexplored area and includes both bioinformatics analysis and experimental validation. However, all reviewers identified several critical issues that must be addressed before the manuscript can be considered for publication. These include insufficient contextualization of the findings within existing literature, limited validation of identified lncRNAs (with only Snhg15 experimentally confirmed), and a lack of mechanistic support for key biological claims. Moreover, the diabetic neuropathy model is not adequately described, and essential information regarding disease onset, neuropathy development, and animal selection for transcriptomic profiling is missing. Reviewers also noted concerns with figure clarity, incomplete supplementary materials, and overinterpretation of results in the Discussion. Substantial revisions are required to improve the manuscript's clarity, experimental justification, and scientific rigor.

Response: We would like to thank you for the very thorough reading of our manuscript.

Diabetic neuropathy is a vast topic with new information coming out almost every week. In depth coverage of this topic may be voluminous. We have tried here to limit the scope of our MS to aberrant lncRNAs mediated signaling in diabetic neuropathy/axonopathy and how new high throughput data may help us formulate new hypothesis. We believe that understanding this pathway may uncover targets for safe and efficacious therapeutic intervention for diabetic symmetrical axonal neuropathy treatment. We believe that the scope limitation has allowed us to better focus on how interaction between lncRNAs may play a pivotal role in diabetic neurological complications in animal models and thus human patients and, whether, the understanding of this pathway can uncover targets for safe and efficacious therapeutic intervention for diabetic symmetrical axonal neuropathy. We also do not delve into the topic of lncRNAs pathway outside the context of diabetic symmetrical axonal neuropathy and spinal cord. Neuronal injury in diabetic peripheral neuropathy has been well recognized within the peripheral nervous system for over a century. Studies in the 1960’s identified pathological alterations in spinal cord and brain structures in patients with diabetes. However, for many years after these findings, the involvement of central nervous system in diabetic peripheral neuropathy was largely overlooked until the advent of advanced neuroimaging techniques in the latter part of the 20th century. To date however no study has used high throughput RNA sequencing experiments on spinal cord in animal models of diabetic peripheral neuropathy. Thus, we aimed to find out whether there was an altered expression of lncRNAs as well as biological pathways in type 1 diabetic mice with long-term diabetic peripheral neuropathy (6 months duration of the disease).

All tissues were sampled during our previous study, therefore we limited the number of animals used in accordance with the 3R principle. Thanks to this approach, we have minimized animal suffering and the number of animals.

We have made every effort to improve our manuscript according to your suggestions and those of the reviewers.

Reviewer #1: Some remarks to authors:

General Assessment: This manuscript investigates the impact of prolonged hyperglycemia on long non-coding RNA expression in the spinal cord of diabetic mice. The study addresses an underexplored aspect of diabetic neuropathy, particularly focusing on central nervous system involvement. The bioinformatics pipeline and experimental validation of Snhg15 expression are strengths. However, several issues should be addressed before the manuscript is considered for publication.

Response: We would like to thank you for the very thorough reading of our manuscript. We are very excited by the positive critiques of our manuscript. Please find our point-by-point response below.

Major Comments:

Reviewer #1: Novelty and Contextualization: The manuscript provides new data on lncRNAs in the diabetic spinal cord. However, further contextualization with recent high-throughput studies on lncRNAs in neurodegeneration and diabetes would strengthen the Introduction and Discussion.

Response: Diabetic neuropathy is a vast topic with new information coming out almost every week. In depth coverage of this topic may be voluminous. We have tried here to limit the scope of our MS to aberrant lncRNAs mediated signaling in diabetic neuropathy/axonopathy and how new high throughput data may help us formulate new hypothesis. We believe that understanding this pathway may uncover targets for safe and efficacious therapeutic intervention for diabetic symmetrical axonal neuropathy treatment. We believe that the scope limitation has allowed us to better focus on how interaction between lncRNAs may play a pivotal role in diabetic neurological complications in animal models and thus human patients and, whether the understanding of this pathway can uncover targets for safe and efficacious therapeutic intervention for diabetic symmetrical axonal neuropathy. We also do not delve into the topic of lncRNAs pathway outside the context of diabetic symmetrical axonal neuropathy and spinal cord. Neuronal injury in diabetic peripheral neuropathy has been well recognized within the peripheral nervous system for over a century. Studies in the 1960’s identified pathological alterations in spinal cord and brain structures in patients with diabetes. However, for many years after these findings, the involvement of central nervous system in diabetic peripheral neuropathy was largely overlooked until the advent of advanced neuroimaging techniques in the latter part of the 20th century. To date however, no study has used high throughput RNA sequencing experiments on spinal cord in animal models of diabetic peripheral neuropathy. Thus, we aimed to find out whether there was an altered expression of lncRNAs as well as biological pathways in type 1 diabetic mice with long-term diabetic peripheral neuropathy (6 months duration of the disease).

However, we have added new references.

Reviewer #1: Validation: Only Snhg15 was validated by qPCR. Please justify why no additional lncRNAs were selected for validation. Were any protein-level experiments (e.g., Western blot, immunohistochemistry) considered to confirm PI3K-Akt pathway activation?

Response: Our current results are a continuation of our previous studies (Zglejc-Waszak et al. 2023).

Our current results suggest that the expression of SNHG15 lncRNAs was up-regulated in spinal cord of diabetic mice. SNHG15 lncRNA alters the expression level of target proteins like TXNIP. Increase in expression of TXNIP was reported in the plasma of diabetic patients. Dunn and co-workers (2014) showed that elevated expression of TXNIP protein may trigger endothelial dysfunctions by inhibiting synthesis of vascular endothelial growth factor (VEGF). Our study demonstrates simultaneous overexpression of SNHG15 as well as TXNIP in lumbar spinal cord of type 1 diabetic mice. We speculate that elevated expression of SNHG15 may be compensatory to overexpression of TXNIP in lumbar spinal cord in hyperglycemia. However, further studies are needed to elucidate SNHG15 lncRNA effect on the TXNIP expression pattern in diabetes.

Our previous sequencing analysis demonstrated that the most enriched categories were those related to signal transduction, with PI3K-Akt signaling pathway (mmu04151) being the most enriched pathway (Zglejc-Waszak et al. 2023). PI3K-Akt signaling pathway is engaged in multiple functions in cells, such as metabolism, cell survival, proliferation and angiogenesis in response to extracellular factors. It is also involved in the regulation of glucose level in cells and regeneration of peripheral nervous system as well as nerves growth in central nervous system. Moreover, AGE-RAGE interaction activates the PI3K-Akt pathway. Our data confirmed elevated level of RAGE protein and mRNA during type 1 diabetes in nervous system (spinal cord as well as sciatic nerve).

Fig. The expression of AGER (gene encoding RAGE) – B in the type 1 diabetic spinal cord.

Fig. The amount of RAGE protein in type 1 diabetic sciatic nerve.

Reviewer #1: Mechanistic Insight: The link between Snhg15 and endothelial dysfunction or RAGE signaling is hypothesized but not mechanistically demonstrated. Authors should moderate the claims or provide additional experimental support.

Response: We responded to this comment above. Moreover, Juranek et al. revealed that RAGE may play a key biological role in diabetic microvascular complications. Our conclusions are based on our extensive research. I have added a new reference to the current text to ensure that these conclusions are supported by scientific evidence. Nevertheless, we agree that further studies are needed to elucidate SNHG15 lncRNA role in endothelial dysfunction during type 1 diabetes. Moreover, our previous data suggests that molecular changes in spinal cord may act synergistically with RAGE signaling pathway in the peripheral nerve. In the reviewed version of the manuscript, we will try to provide arguments to support our claims.

Reviewer #1: Figure Quality and Supplementary Data: Some figures (e.g., interaction networks) lack clarity and resolution. The supplementary tables referenced in the text (e.g., S1 Table, S2 Table) are not included in this file. These should be provided for review.

Response: Thank you for your comments. We have provided for review as per suggestion. Supplementary files have been added. We have noticed that in the pdf file the figures have low resolution, but after downloading the figures (tiff) they are of very good quality.

Minor Comments:

Reviewer #1: Please revise the text for grammatical accuracy and clarity. There are frequent awkward phrasings (e.g., "We confirmed pathological effect of T1D in lumbar spinal cord of the expression of lncRNAs").

Response: Thank you for your comments. We have revised the text for grammatical accuracy and clarity. We hope that that the revised version reads clearly and accurately as per the commentary

Reviewer #1: Consider removing repetitive statements, especially in the Discussion.

Response: Thanks for your comment. We have re-edited the Discussion section.

Reviewer #1: Ensure that all GO terms and KEGG pathways are described with their biological significance.

Response: We have followed your suggestion. We hope the text of our MS is now clear.

Reviewer #2: First of all, I would like to thank Plos One for inviting me to review the article Novel insights into neuropathy: the impact of prolonged hyperglycemia on long non-coding RNA expression.

After reading it, I can confirm that the article is pertinent and has logical conclusions.

I believe that the article is ready for release.

Response: We would like to thank you for the very thorough reading of our manuscript. We are very excited by the positive critiques of our manuscript.

Reviewer #3: The analysis of long non coding RNAs is not so deeply studied as other non conding RNAs, so a study focused on lncRNAs in neuropathy is interesting. Major points should be implemented:

Response: We would like to thank you for the very thorough reading of our manuscript. We are very excited by the positive critiques of our manuscript. Please find our point-by-point response below.

Reviewer #3:

- the model of diabetic neuropathy is not described, information is demanded to references 2 and 18. Ref 2 is a review, ref 18 does not seem related to diabetes model. Please clarify and clear detail the model used.

Response: Thank you for your suggestion. We have clarified this issue in the text of our revised MS (lines:58-64). We apologize for the inaccuracies.

Reviewer #3:

- Please report data regarding the development of diabetes and neuropathy in the animals used for transcriptomic analysis; at least at the time point considered for sacrifice (6 months)

Response: We have clarified the issue in the text of our revised MS (lines:64-66). We apologize for the inaccuracies.

Reviewer #3:

- Depending on the model, not all the animals with diabetes develop neuropathy, please report here the percentage. Were the non neuropathic animals excluded by the omic analysis?

Response: We have clarified this information in our revised MS (lines:64-66). We apologize for the inaccuracies. Briefly, we monitored blood glucose levels after five days after the last dose of STZ injection and for the following weeks to confirm diabetes. Nevertheless, we have many years of experience in inducing type 1 diabetes in a mouse model of the disease. Our experience has been supported by numerous scientific publications since 2013. Laboratorymouse is an excellent model for the induction of type 1 diabetes. Evidence supporting our thesis is provided by numerous publications using a mouse model in studies on the type 1 diabetes [dodać piśmiennictwo na potwierdzenie tej tezy]

We have put a lot of effort into the presented analyses and studies in our MS. Moreover, mouse experiments were performed in accordance with the Local Ethical Committee of Experiments on Animals in Olsztyn (Poland; decision no. 57/2019) and the studies were reported in accordance with ARRIVE guidelines (https://arriveguidelines.org) and the three Rs principle. The 3 Rs stand for Replacement, Reduction and Refinement. Additionally, we report annually on the number of animals used in studies. We cannot exceed the number of animals used in study that is permitted by the Local Animal Ethics Committee. Hence, the number of animals that will not develop diabetes is less than 1%.

Reviewer #3:

- Snhg15 lncRNA expression was validated by RT-PCR. Why the attention was focused on this particular target? Since among several others one only was verified, the choice must be well supported.

Response: Our previous studies showed that the elevated expression of thioredoxin-interacting protein (TXNIP) in the T1D spinal cord of mouse (Zglejc-Waszak et al. 2023). Increased TXNIP expression in mouse spinal cord may induce endothelial cell dysfunction in the case of long-term hyperglycemia. Nevertheless, studies indicated molecular crosstalk between TXNIP and Snhg15 during diabetes. Overall, Snhg15 overexpression may improve endothelial function during diabetes and thus erase the negative effect of TXNIP in the spinal cord of mice. The analysis of Sngh15 was well-thought-out and results from the analysis of our previous research data.

In our previous work we validated data obtained from diabetic lumbar spinal cord samples. Our current results are a continuation of our previous studies (Zglejc-Waszak et al. 2023).

Reviewer #3:

- The discussion is mainly based on the description of Snhg15 and its relationship with PI3K (not measured here); the authors state "We assume that Snhg15 lncRNA may be responsible for malfunctions in nervous system during T1D", the authors should better analyze this hypothesis or strongly revise the discussion reducing the impact of only probabilistic suggestions.

Response: Thank you for your comment. We have slightly edited the Discussion section to soften its tone. However, our current results are a continuation of our previous studies (Zglejc-Waszak et al. 2023). Thus, we have well-established evidence that the spinal cord plays a key role in diabetic neuropathy in a mouse model of the disease. Identifying molecular changes occurring in the spinal cord during diabetes may be a milestone in inhibiting the development of peripheral neuropathy.

Attachment

Submitted filename: Reviewer 3rev.docx

pone.0334245.s006.docx (17.2KB, docx)

Decision Letter 1

Li Shen

24 Sep 2025

Novel insights into neuropathy: the impact of prolonged hyperglycemia on long non-coding RNA expression

PONE-D-25-24198R1

Dear Dr. Zglejc-Waszak,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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PLOS ONE

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Reviewer #2: All comments have been addressed

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Reviewer #3: Yes

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Reviewer #3: Yes

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Reviewer #2: First, I would like to thank PLOS ONE for the opportunity to review the manuscript "New Insights into Neuropathy: The Impact of Prolonged Hyperglycemia on Long Noncoding RNA Expression."

The article is coherently written, with pertinent conclusions. I confirm that I accept the publication of this article.

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Dr. João Paulo Barile, Neurologist

Reviewer #3: The authors improved the manuscript according to suggestions, in my opinion it can be accepted by the journal

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Acceptance letter

Li Shen

PONE-D-25-24198R1

PLOS ONE

Dear Dr. Zglejc-Waszak,

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Associated Data

    This section collects any data citations, data availability statements, or supplementary materials included in this article.

    Supplementary Materials

    S1 Table. A table containing a complete list of lncRNAs that were differentially expressed in the T1D lumbar spinal cord in relation to control.

    (DOCX)

    pone.0334245.s001.docx (72.4KB, docx)
    S2 Table. We found that RNA-RNA interactions are associated with GO-terms involved in biological process (BP), cellular component (CC) and molecular function (MF).

    (DOCX)

    pone.0334245.s002.docx (33.2KB, docx)
    S3 Table. Trans-acting.

    (DOCX)

    pone.0334245.s003.docx (22.5KB, docx)
    S1 Fig. The most enriched biological pathway.

    PI3K-Akt signaling pathway (KEGG: mmu04151). Blue rectangles without background indicate the site of lncRNA interaction.

    (TIF)

    pone.0334245.s004.tif (2.2MB, tif)
    Attachment

    Submitted filename: Reviewer 3rev.docx

    pone.0334245.s006.docx (17.2KB, docx)

    Data Availability Statement

    All relevant data are within the manuscript and supporting information. RNA-seq data have been deposited in the ArrayExpress database at EMBL-EBI (www.ebi.ac.uk/arrayexpress) under accession number E-MTAB 12252.


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