健康个体和掌腱膜纤维瘤病患者的人手掌腱膜感觉神经支配。

Sensory innervation of the human palmar aponeurosis in healthy individuals and patients with palmar fibromatosis.

机构信息

Servicio de Cirugía Plástica y Reparadora, Fundación Hospital de Jove, Gijón, Spain.

Departamento de Morfología y Biología Celular, Grupo SINPOS, Universidad de Oviedo, Oviedo, Spain.

出版信息

J Anat. 2022 May;240(5):972-984. doi: 10.1111/joa.13609. Epub 2021 Dec 8.

Abstract

The human palmar aponeurosis is involved in hand proprioception, and it contains different sensory corpuscle morphotypes that serve this role. In palmar fibromatosis (classically referred to as Dupuytren's disease), the palmar aponeurosis undergoes fibrous structural changes that, presumably, also affect the nervous system, causing altered perception. We analysed the various sensory nerve formation morphotypes in the palmar aponeuroses of healthy subjects and patients with palmar fibromatosis. To do this, we used immunohistochemistry for corpuscular constituents and the putative mechanoproteins PIEZO2 and acid-sensing ion channel 2. Free nerve endings and Golgi-Mazzoni, Ruffini, paciniform and Pacinian corpuscles were identified in both the healthy and the pathological conditions. The densities of the free nerve endings and Golgi-Mazzoni corpuscles were slightly increased in the pathological tissues. Furthermore, the Pacinian corpuscles were enlarged and displayed an altered shape. Finally, there was also morphological and immunohistochemical evidence of occasional denervation of the Pacinian corpuscles, although no increase in their number was observed. Both PIEZO2 and acid-sensing ion channel 2 were absent from the altered corpuscles. These results indicate that the human palmar aponeurosis is richly innervated, and the free nerve endings and sensory corpuscles within the palmar aponeurosis undergo quantitative and qualitative changes in patients with palmar fibromatosis, which may explain the sensory alterations occasionally reported for this pathology.

摘要

人类手掌腱膜参与手部本体感觉,其中包含不同的感觉小体形态类型,起到这种作用。在掌纤维瘤病(经典地称为Dupuytren 病)中,手掌腱膜发生纤维结构改变,这些改变可能也会影响神经系统,导致感觉改变。我们分析了健康受试者和掌纤维瘤病患者手掌腱膜中的各种感觉神经形成形态类型。为此,我们使用了针对颗粒成分以及假定的机械敏感蛋白 PIEZO2 和酸敏感离子通道 2 的免疫组织化学方法。在健康和病理条件下都可以识别游离神经末梢、高尔基-马佐尼小体、鲁菲尼小体、棒状小体和Pacinian 小体。在病理组织中,游离神经末梢和高尔基-马佐尼小体的密度略有增加。此外,Pacinian 小体增大并呈现出改变的形状。最后,还存在 Pacinian 小体偶尔失神经支配的形态学和免疫组织化学证据,尽管没有观察到它们数量的增加。改变的小体中均不存在 PIEZO2 和酸敏感离子通道 2。这些结果表明,人类手掌腱膜富含神经支配,在掌纤维瘤病患者的手掌腱膜中,游离神经末梢和感觉小体发生了定量和定性的变化,这可能解释了这种病理偶尔报告的感觉改变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5584/9005682/e6294b96991c/JOA-240-972-g005.jpg

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