Ravara Barbara, Hofer Christian, Kern Helmut, Guidolin Diego, Porzionato Andrea, De Caro Raffaele, Albertin Giovanna
Interdepartmental Research Center of Myology, Department of Biomedical Science, University of Padova, Italy.
A&C M-C Foundation for Translational Myology, Padova, Italy.
Eur J Transl Myol. 2018 Dec 13;28(4):7914. doi: 10.4081/ejtm.2018.7914. eCollection 2018 Nov 2.
Our previous studies have shown that severely atrophic Quadriceps muscles of spinal cord injury (SCI) persons suffering with complete and syndrome, and thus with permanent denervation-induced atrophy and degeneration of muscle, were almost completely rescued to normal size after two years of home based Functional Electrical Stimulation (hbFES). Since large surface electrodes were used to stimulate the denervated thigh muscles, we wanted to know if the skin was affected by this peculiar long-term treatment. Indeed, we demonstrated by two approaches that the epidermis decreases in thickness in the long term denervated persons, while it increased to almost pre-SCI values in hbFES compliant SCI persons. Here we report data of morphometry of skin biopsies from both legs of 18 SCI persons, harvested at enrolment in the Project RISE, to test if the Interdigitation Index, a simple measurement of the epidermal-dermal junction, may provide a further precise quantitative evidence of the flattening of the skin in those SCI persons. The Interdigitation Index of the 36 skin biopsies shows a higly significant linear correlation with the years of SCI (p < 0.001). Furthermore, when the 18 SCI persons are divided in two groups (1 to 3.9 versus 4.1 to 8.0 years from SCI, respectively) and the data are compared, the later Group presents a statistically significant -22% decrease (p, 0.029) of the Interdigitation Index. On the other hand counting the papille do not provide the same strong evidence. In conclusion, the Interdigitation Index is an additional sound quantitative structural biomarker of skin atrophy and flattening occurring in SCI. The result correlates with the much severe extent of atrophy of the permanently denervated thigh muscles, as determined at both macro and microscopic levels.We are confident that the Interdigitation Index will provide sound evidence that the effects of hbFES, we previously reported on skeletal muscle and epidermis thickness, will be extended to the dermal layer of the skin, suggesting a coordinated negative effects of SCI on skeletal muscle and skin, and an improvement of both tissues after hbFES. Incoming analyses will be extended to basal lamina, collagene types, elastic fibers and skin annexes in the subcutaneous layer.
我们之前的研究表明，患有完全性损伤综合征的脊髓损伤（SCI）患者的股四头肌严重萎缩，肌肉因永久性去神经支配而萎缩和退化，经过两年的家庭功能性电刺激（hbFES）后，几乎完全恢复到正常大小。由于使用大表面电极刺激失神经支配的大腿肌肉，我们想知道皮肤是否会受到这种特殊的长期治疗的影响。事实上，我们通过两种方法证明，长期去神经支配的患者表皮厚度会变薄，而在接受hbFES治疗的SCI患者中，表皮厚度增加到几乎接近SCI前的值。在此，我们报告了18名SCI患者双腿皮肤活检的形态学数据，这些数据是在“RISE项目”入组时采集的，以测试指状交叉指数（一种简单的表皮-真皮交界处测量方法）是否能为这些SCI患者皮肤扁平化提供进一步精确的定量证据。36份皮肤活检样本的指状交叉指数与SCI年限呈高度显著的线性相关（p < 0.001）。此外，当将18名SCI患者分为两组（分别为SCI后1至3.9年和4.1至8.0年）并比较数据时，后一组的指状交叉指数在统计学上显著下降了22%（p, 0.029）。另一方面，计算乳头数量并不能提供同样有力的证据。总之，指状交叉指数是SCI患者皮肤萎缩和扁平化的另一个可靠的定量结构生物标志物。该结果与在宏观和微观层面确定的永久性去神经支配大腿肌肉更严重的萎缩程度相关。我们相信，指状交叉指数将提供有力证据，证明我们之前报道的hbFES对骨骼肌和表皮厚度的影响将扩展到皮肤的真皮层，表明SCI对骨骼肌和皮肤有协同的负面影响，以及hbFES后两种组织的改善。后续分析将扩展到基膜、胶原类型、弹性纤维和皮下层的皮肤附属器。
