Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.
J Peripher Nerv Syst. 2013 Jun;18(2):162-7. doi: 10.1111/jns5.12027.
Skin biopsies have primarily been used to study the non-myelinated nerve fibers of the epidermis in a variety of neuropathies. In this study, we have expanded the skin biopsy technique to glabrous, non-hairy skin to evaluate myelinated nerve fibers in the most highly prevalent peripheral nerve disease, diabetic polyneuropathy (DPN). Twenty patients with DPN (Type I, n = 9; Type II, n = 11) and 16 age-matched healthy controls (age 29-73) underwent skin biopsy of the index finger, nerve conduction studies (NCS), and composite neuropathy scoring. In patients with DPN, we found a statistically significant reduction of both mechanoreceptive Meissner corpuscles (MCs) and their afferent myelinated nerve fibers (p = 0.01). This myelinated nerve fiber loss was correlated with the decreased amplitudes of sensory/motor responses in NCS. This study supports the utilization of skin biopsy to quantitatively evaluate axonal loss of myelinated nerve fibers in patients with DPN.
皮肤活检主要用于研究各种神经病变中表皮的无髓神经纤维。在这项研究中，我们将皮肤活检技术扩展到无毛的光滑皮肤上，以评估最常见的周围神经疾病——糖尿病多发性神经病（DPN）中的有髓神经纤维。20 名 DPN 患者（I 型，n = 9；II 型，n = 11）和 16 名年龄匹配的健康对照者（年龄 29-73 岁）接受了食指皮肤活检、神经传导研究（NCS）和综合神经病变评分。我们发现 DPN 患者的机械感觉 Meissner 小体（MC）及其传入有髓神经纤维均有统计学显著减少（p = 0.01）。这种有髓神经纤维的丢失与 NCS 中感觉/运动反应幅度的降低相关。这项研究支持利用皮肤活检定量评估 DPN 患者有髓神经纤维轴突的丢失。
