Levy D M, Karanth S S, Springall D R, Polak J M
Department of Diabetes and Endocrinology, Central Middlesex Hospital, London, UK.
Diabetologia. 1989 Jul;32(7):427-33. doi: 10.1007/BF00271262.
Immunocytochemistry for the general neuronal marker protein gene product 9.5 and four neuropeptides (calcitonin gene-related peptide, substance P, vasoactive intestinal polypeptide and neuropeptide Y) was performed on 20 skin biopsy specimens from 19 diabetic patients, age range 20-75 years, 17 Type 2 (non-insulin-dependent) and 3 Type 1 (insulin-dependent). Fifteen specimens were from the lower limb, 3 from the upper limb and 2 from the abdominal wall. Seven subjects had lower limb neurophysiological tests. All but one specimen showed reduced protein gene product 9.5 and neuropeptide immunoreactivity. Reduced protein gene product 9.5 and neuropeptide immunoreactivity was found in specimens taken from the abdominal wall and hand as well as those from the leg, and also in specimens from patients undergoing amputation for peripheral vascular disease. In general, the greater the number of abnormal neurophysiological tests, the greater the extent of neuronal abnormalities. Three patients with normal tests had abnormalities of dermal innervation. While these changes are also found in other axonal neuropathies, in the absence of other causes of peripheral nerve disease and of macrovascular disease, immunocytochemistry of skin biopsies may have a role in the assessment of diabetic neuropathy and its response to treatment.
对19例糖尿病患者（年龄范围20 - 75岁，其中17例为2型（非胰岛素依赖型），3例为1型（胰岛素依赖型））的20份皮肤活检标本进行了一般神经元标志物蛋白基因产物9.5和四种神经肽（降钙素基因相关肽、P物质、血管活性肠肽和神经肽Y）的免疫细胞化学检测。15份标本取自下肢，3份取自上肢，2份取自腹壁。7名受试者进行了下肢神经生理学测试。除一份标本外，所有标本均显示蛋白基因产物9.5和神经肽免疫反应性降低。在取自腹壁和手部以及腿部的标本中，以及在因外周血管疾病接受截肢手术患者的标本中，均发现蛋白基因产物9.5和神经肽免疫反应性降低。一般来说，神经生理学测试异常的数量越多，神经元异常的程度就越大。3名测试正常的患者存在皮肤神经支配异常。虽然这些变化在其他轴索性神经病中也有发现，但在没有外周神经疾病和大血管疾病的其他病因的情况下，皮肤活检的免疫细胞化学可能在评估糖尿病性神经病变及其对治疗的反应中发挥作用。
