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麻风病患者的皮肤损伤、感觉障碍恢复和神经再生。

Cutaneous lesions sensory impairment recovery and nerve regeneration in leprosy patients.

机构信息

Laboratório de Hanseníase, Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro, RJ, Brasil.

出版信息

Mem Inst Oswaldo Cruz. 2012 Dec;107 Suppl 1:68-73. doi: 10.1590/s0074-02762012000900012.

Abstract

It is important to understand the mechanisms that enable peripheral neurons to regenerate after nerve injury in order to identify methods of improving this regeneration. Therefore, we studied nerve regeneration and sensory impairment recovery in the cutaneous lesions of leprosy patients (LPs) before and after treatment with multidrug therapy (MDT). The skin lesion sensory test results were compared to the histopathological and immunohistochemical protein gene product (PGP) 9.5 and the p75 nerve growth factor receptors (NGFr) findings. The cutaneous neural occupation ratio (CNOR) was evaluated for both neural markers. Thermal and pain sensations were the most frequently affected functions at the first visit and the most frequently recovered functions after MDT. The presence of a high cutaneous nerve damage index did not prevent the recovery of any type of sensory function. The CNOR was calculated for each biopsy, according to the presence of PGP and NGFr-immunostained fibres and it was not significantly different before or after the MDT. We observed a variable influence of MDT in the recovery from sensory impairment in the cutaneous lesions of LPs. Nociception and cold thermosensation were the most recovered sensations. The recovery of sensation in the skin lesions appeared to be associated with subsiding inflammation rather than with the regenerative activity of nerve fibres.

摘要

为了明确改善外周神经再生的方法,理解周围神经在损伤后再生的机制非常重要。因此,我们研究了麻风病患者(麻风患者)在多药治疗(MDT)前后皮肤损伤处的神经再生和感觉障碍恢复情况。将皮肤损伤感觉测试结果与组织病理学和免疫组织化学蛋白基因产物(PGP)9.5 和 p75 神经生长因子受体(NGFr)结果进行比较。对两种神经标记物均评估了皮肤神经占有率(CNOR)。在初次就诊时,热觉和痛觉是最常受影响的功能,而在 MDT 后,这些功能是最常恢复的。高皮肤神经损伤指数的存在并不能阻止任何类型的感觉功能恢复。根据 PGP 和 NGFr 免疫染色纤维的存在,对每个活检进行了 CNOR 计算,MDT 前后均无显著差异。我们观察到 MDT 对麻风病患者皮肤损伤感觉障碍恢复的影响具有可变性。痛觉和冷温觉是恢复最明显的感觉。皮肤损伤感觉的恢复似乎与炎症消退有关,而与神经纤维的再生活动无关。

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