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Evaluation Of Diabetic Neuropathy Through The Quantitation Of Cutaneous Nerves
Author(s) -
Hirai A.,
Yasuda H.,
Joko M.,
Maeda T.,
Kikkawa R.
Publication year - 2000
Publication title -
journal of the peripheral nervous system
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1
H-Index - 67
eISSN - 1529-8027
pISSN - 1085-9489
DOI - 10.1046/j.1529-8027.2000.005002122.x
Subject(s) - dermis , medicine , epidermis (zoology) , diabetic neuropathy , nerve fiber , papillary dermis , cutaneous nerve , diabetes mellitus , sensory nerve , sural nerve , pathophysiology , immunohistochemistry , pathology , endocrinology , anatomy , sensory system , biology , neuroscience
The significance and usefulness of immunohistochemically quantitated cutaneous nerves in the evaluation of diabetic neuropathy was examined in biopsied skins of the calf from healthy subjects (n = 12) and non‐insulin dependent diabetic patients (n = 32) with diabetic sensory neuropathy. Skin samples were immunostained with antibodies against protein gene product (PGP) 9.5, a pan‐axonal marker. A quantitative analysis to determine nerve fiber (NF) number and nerve lengths (NLs) was performed on nerve fibers of the epidermis and the dermis and on nerves surrounding sweat glands. Nerve function tests were performed on the biopsied sites and erythrocyte aldose reductase level was determined by enzyme‐linked immunosorbent assay. Numbers of epidermal NFs, NLs of epidermis and dermis and NL around sweat glands were significantly decreased in diabetic patients compared with control subjects (P<0.001, P<0.001, P < 0.01, P < 0.01, respectively). NL of epidermis showed a significant correlation with NL of dermis (P < 0.01). Sural nerve conduction velocity was significantly correlated with NL of dermis (P < 0.05). Patients with higher AR level (> 10.8 (average in 555 diabetic patients) ng/mgHb) possessed a shorter NL of dermis NFs than those with lower AR level (> 10.8) (P < 0.05). These findings suggest that the quantitation of cutaneous nerves in biopsied skin samples provides important information about diabetic neuropathy and may improve the understanding of the pathophysiology of sensory nerve terminals in diabetic neuropathy.