Quantification of myelinated endings and mechanoreceptors in human digital skin
We used immunohistochemistry and confocal microscopy applied to fingertip punch biopsy to study glabrous skin innervation in 14 healthy subjects. In addition to epidermal nerve fibers, we quantified mechanoreceptors and their myelinated afferents. Using digital images and dedicated software, we calc...
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Published in | Annals of neurology Vol. 54; no. 2; pp. 197 - 205 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
Hoboken
Wiley Subscription Services, Inc., A Wiley Company
01.08.2003
Willey-Liss |
Subjects | |
Online Access | Get full text |
ISSN | 0364-5134 1531-8249 |
DOI | 10.1002/ana.10615 |
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Abstract | We used immunohistochemistry and confocal microscopy applied to fingertip punch biopsy to study glabrous skin innervation in 14 healthy subjects. In addition to epidermal nerve fibers, we quantified mechanoreceptors and their myelinated afferents. Using digital images and dedicated software, we calculated caliber, internodal and nodal length, and G‐ratio of the last four internodes of the myelinated endings. In our skin samples, we found a mean density of 59.0 ± 29.3 myelinated endings per square millimeter with a mean diameter of 3.3 ± 0.5μm and an internodal length of 79.1 ± 13.8μm. These findings indicate that Aβ fibers undergo drastic changes in their course from the nerve trunk to the target organ, with repeated branching and consequent tapering and shortening of internodal length. Our work demonstrates that skin biopsy can give information on the status of large myelinated endings as well as unmyelinated sensory and autonomic nerves. Since distal endings are primarily involved in distal axonopathy, skin biopsy can be more suitable than sural nerve biopsy to detect early abnormalities. In addition to diagnostic applications, this technique allows clarification of the mode of termination of Aβ fibers and their relationship with mechanoreceptors, leading to relevant electrophysiological speculations. Ann Neurol 2003 |
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AbstractList | We used immunohistochemistry and confocal microscopy applied to fingertip punch biopsy to study glabrous skin innervation in 14 healthy subjects. In addition to epidermal nerve fibers, we quantified mechanoreceptors and their myelinated afferents. Using digital images and dedicated software, we calculated caliber, internodal and nodal length, and G-ratio of the last four internodes of the myelinated endings. In our skin samples, we found a mean density of 59.0 +/- 29.3 myelinated endings per square millimeter with a mean diameter of 3.3 +/- 0.5 microm and an internodal length of 79.1 +/- 13.8 microm. These findings indicate that Abeta fibers undergo drastic changes in their course from the nerve trunk to the target organ, with repeated branching and consequent tapering and shortening of internodal length. Our work demonstrates that skin biopsy can give information on the status of large myelinated endings as well as unmyelinated sensory and autonomic nerves. Since distal endings are primarily involved in distal axonopathy, skin biopsy can be more suitable than sural nerve biopsy to detect early abnormalities. In addition to diagnostic applications, this technique allows clarification of the mode of termination of Abeta fibers and their relationship with mechanoreceptors, leading to relevant electrophysiological speculations. We used immunohistochemistry and confocal microscopy applied to fingertip punch biopsy to study glabrous skin innervation in 14 healthy subjects. In addition to epidermal nerve fibers, we quantified mechanoreceptors and their myelinated afferents. Using digital images and dedicated software, we calculated caliber, internodal and nodal length, and G‐ratio of the last four internodes of the myelinated endings. In our skin samples, we found a mean density of 59.0 ± 29.3 myelinated endings per square millimeter with a mean diameter of 3.3 ± 0.5μm and an internodal length of 79.1 ± 13.8μm. These findings indicate that Aβ fibers undergo drastic changes in their course from the nerve trunk to the target organ, with repeated branching and consequent tapering and shortening of internodal length. Our work demonstrates that skin biopsy can give information on the status of large myelinated endings as well as unmyelinated sensory and autonomic nerves. Since distal endings are primarily involved in distal axonopathy, skin biopsy can be more suitable than sural nerve biopsy to detect early abnormalities. In addition to diagnostic applications, this technique allows clarification of the mode of termination of Aβ fibers and their relationship with mechanoreceptors, leading to relevant electrophysiological speculations. Ann Neurol 2003 We used immunohistochemistry and confocal microscopy applied to fingertip punch biopsy to study glabrous skin innervation in 14 healthy subjects. In addition to epidermal nerve fibers, we quantified mechanoreceptors and their myelinated afferents. Using digital images and dedicated software, we calculated caliber, internodal and nodal length, and G-ratio of the last four internodes of the myelinated endings. In our skin samples, we found a mean density of 59.0 +/- 29.3 myelinated endings per square millimeter with a mean diameter of 3.3 +/- 0.5 microm and an internodal length of 79.1 +/- 13.8 microm. These findings indicate that Abeta fibers undergo drastic changes in their course from the nerve trunk to the target organ, with repeated branching and consequent tapering and shortening of internodal length. Our work demonstrates that skin biopsy can give information on the status of large myelinated endings as well as unmyelinated sensory and autonomic nerves. Since distal endings are primarily involved in distal axonopathy, skin biopsy can be more suitable than sural nerve biopsy to detect early abnormalities. In addition to diagnostic applications, this technique allows clarification of the mode of termination of Abeta fibers and their relationship with mechanoreceptors, leading to relevant electrophysiological speculations.We used immunohistochemistry and confocal microscopy applied to fingertip punch biopsy to study glabrous skin innervation in 14 healthy subjects. In addition to epidermal nerve fibers, we quantified mechanoreceptors and their myelinated afferents. Using digital images and dedicated software, we calculated caliber, internodal and nodal length, and G-ratio of the last four internodes of the myelinated endings. In our skin samples, we found a mean density of 59.0 +/- 29.3 myelinated endings per square millimeter with a mean diameter of 3.3 +/- 0.5 microm and an internodal length of 79.1 +/- 13.8 microm. These findings indicate that Abeta fibers undergo drastic changes in their course from the nerve trunk to the target organ, with repeated branching and consequent tapering and shortening of internodal length. Our work demonstrates that skin biopsy can give information on the status of large myelinated endings as well as unmyelinated sensory and autonomic nerves. Since distal endings are primarily involved in distal axonopathy, skin biopsy can be more suitable than sural nerve biopsy to detect early abnormalities. In addition to diagnostic applications, this technique allows clarification of the mode of termination of Abeta fibers and their relationship with mechanoreceptors, leading to relevant electrophysiological speculations. |
Author | Kennedy, William Robert Stancanelli, Annamaria Crisci, Claudio Wendelschafer-Crabb, Gwen Provitera, Vincenzo Santoro, Lucio Nolano, Maria |
Author_xml | – sequence: 1 givenname: Maria surname: Nolano fullname: Nolano, Maria email: mnolano@fsm.it organization: Salvatore Maugeri Foundation, IRCCS, Center of Telese Terme, Italy – sequence: 2 givenname: Vincenzo surname: Provitera fullname: Provitera, Vincenzo organization: Salvatore Maugeri Foundation, IRCCS, Center of Telese Terme, Italy – sequence: 3 givenname: Claudio surname: Crisci fullname: Crisci, Claudio organization: Salvatore Maugeri Foundation, IRCCS, Center of Telese Terme, Italy – sequence: 4 givenname: Annamaria surname: Stancanelli fullname: Stancanelli, Annamaria organization: Salvatore Maugeri Foundation, IRCCS, Center of Telese Terme, Italy – sequence: 5 givenname: Gwen surname: Wendelschafer-Crabb fullname: Wendelschafer-Crabb, Gwen organization: Department of Neurology University of Minnesota, Minneapolis, MN – sequence: 6 givenname: William Robert surname: Kennedy fullname: Kennedy, William Robert organization: Department of Neurology University of Minnesota, Minneapolis, MN – sequence: 7 givenname: Lucio surname: Santoro fullname: Santoro, Lucio organization: Department of Neurological Sciences, University of Naples, Federico II, Naples, Italy |
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Keywords | Human Immunohistochemistry Nervous system diseases Biopsy Mechanoreceptor Myelinated nerve fiber Neuropathy |
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Neurology 1999; 52: 1249-1254. Faden A, Mendoza E, Flynn F. Subclinical neuropathy associated with chronic obstructive pulmonary disease: possible pathophysiologic role of smoking. Arch Neurol 1981; 38: 639-642. Dyck PJ, Winkelmann RK, Bolton CF. Quantitation of Meissner corpuscles in hereditary neurologic disorders. Neurology 1966; 16: 10-17. Cauna N. The mode of termination of the sensory nerves and its significance. 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Ultrastructure and numbers of fibres and cells publication-title: Acta Neuropathol (Berlin) – volume: 38 start-page: 639 year: 1981 end-page: 642 article-title: Subclinical neuropathy associated with chronic obstructive pulmonary disease: possible pathophysiologic role of smoking publication-title: Arch Neurol – volume: 186 start-page: 261 year: 1995 end-page: 270 article-title: Three‐dimensional reconstruction of the Meissner's corpuscles of man after silver impregnation and immunofluorescence with PGP 9.5 antibodies using confocal scanning laser microscopy publication-title: J Anat – volume: 2 start-page: 209 year: 1988 end-page: 228 – volume: 44 start-page: 47 year: 1998 end-page: 59 article-title: Small‐fiber sensory neuropathies: clinical course and neuropathology of idiopathic cases publication-title: Ann Neurol – start-page: 28 year: 1993 end-page: 91 – volume: 22 start-page: S31 year: 2001 end-page: S36 article-title: Tactile stimulation and mechanoreceptors in sensory neuropathies publication-title: Neurol Sci – volume: 53 start-page: 1641 year: 1999 end-page: 1647 article-title: Painful sensory neuropathy: prospective evaluation using skin biopsy publication-title: Neurology – volume: 52 start-page: 1249 year: 1999 end-page: 1254 article-title: Quantitative analysis of epidermal innervation in Fabry disease publication-title: Neurology – volume: 99 start-page: 315 year: 1956 article-title: Nerve supply and nerve endings in Meissner corpuscles publication-title: Am J Anat – volume: 16 start-page: 10 year: 1966 end-page: 17 article-title: Quantitation of Meissner corpuscles in hereditary neurologic disorders publication-title: Neurology – volume: 17 start-page: 211 year: 1894 end-page: 258 article-title: On the anatomical constitution of nerves of skeletal muscles; with remarks on recurrent fibers in the ventral spinal root publication-title: J Physiol (Lond) – volume: 45 start-page: 1848 year: 1995 end-page: 1855 article-title: Cutaneous innervation in sensory neuropathies: evaluation by skin biopsy publication-title: Neurology – volume: 48 start-page: 708 year: 1997 end-page: 711 article-title: Intraepidermal nerve fiber density in patients with painful sensory neuropathy publication-title: Neurology – volume: 16 start-page: 1 year: 1966 end-page: 9 article-title: A quantitative study of Meissner's corpuscles in man publication-title: Neurology – volume: 13 start-page: 91 year: 1962 end-page: 100 article-title: Cholinesterase demonstration of dermal nerve endings in patients with impaired sensation publication-title: Neurology – volume: 6 start-page: 165 year: 2001 article-title: Meissner corpuscles and myelinated nerve fibers in human digital skin: a correlation with electrophysiological findings publication-title: J Peripher Nerv Syst – volume: 291 start-page: 419 year: 1999 end-page: 424 article-title: Neuronal structural proteins, transmitters, transmitter enzymes and neuropeptides in human Meissner's corpuscles: a reappraisal using immunohistochemistry publication-title: Arch Dermatol Res – volume: 115 start-page: 1925 year: 1992 end-page: 1945 article-title: The relationship between electrophysiological findings, upper limb growth and histological features of median and ulnar nerves in man publication-title: Brain – volume: 5 start-page: 373 year: 1980 end-page: 381 article-title: Diagnostic significance of pacinian corpuscle degeneration in Friedreich's ataxia publication-title: Acta Neurol – volume: 115 start-page: 184 year: 1993 end-page: 190 article-title: The innervation of human epidermis publication-title: J Neurol Sci – volume: 6 start-page: 165 year: 2001 ident: e_1_2_6_21_2 article-title: Meissner corpuscles and myelinated nerve fibers in human digital skin: a correlation with electrophysiological findings publication-title: J Peripher Nerv Syst – ident: e_1_2_6_34_2 doi: 10.1007/BF00690642 – ident: e_1_2_6_18_2 doi: 10.1212/WNL.16.1.1 – ident: e_1_2_6_28_2 doi: 10.1177/002215540004800215 – ident: e_1_2_6_12_2 doi: 10.1024/0300-9831.70.3.126 – ident: e_1_2_6_14_2 doi: 10.1002/ana.1283 – ident: e_1_2_6_11_2 doi: 10.1001/archneur.1981.00510100067011 – ident: e_1_2_6_8_2 doi: 10.1212/WNL.48.3.708 – ident: e_1_2_6_22_2 doi: 10.1007/s100720170007 – ident: e_1_2_6_29_2 doi: 10.1007/s004030050432 – ident: e_1_2_6_32_2 doi: 10.1113/jphysiol.1894.sp000528 – ident: e_1_2_6_3_2 doi: 10.1212/WNL.47.4.1042 – ident: e_1_2_6_30_2 doi: 10.1523/JNEUROSCI.21-18-07236.2001 – ident: e_1_2_6_4_2 doi: 10.1007/BF00329435 – ident: e_1_2_6_20_2 doi: 10.1016/B978-0-12-470348-3.50013-6 – ident: e_1_2_6_33_2 doi: 10.1002/cne.900910105 – volume: 54 start-page: 167 year: 1943 ident: e_1_2_6_23_2 article-title: Alterveränderungen der Meissnerschen körperchen in der fingerhaut publication-title: Z Mikrosk Anat Forsch – volume: 7 start-page: 236 year: 1988 ident: e_1_2_6_26_2 article-title: Cutaneous sensory nerves publication-title: Semin Dermatol – ident: e_1_2_6_10_2 doi: 10.1212/WNL.52.6.1249 – ident: e_1_2_6_5_2 doi: 10.1212/WNL.45.10.1848 – ident: e_1_2_6_24_2 doi: 10.1002/aja.1000990206 – ident: e_1_2_6_9_2 doi: 10.1212/WNL.58.1.115 – ident: e_1_2_6_17_2 doi: 10.1212/WNL.16.1.10 – start-page: 28 volume-title: Peripheral neuropathy year: 1993 ident: e_1_2_6_15_2 – volume: 5 start-page: 373 year: 1980 ident: e_1_2_6_16_2 article-title: Diagnostic significance of pacinian corpuscle degeneration in Friedreich's ataxia publication-title: Acta Neurol – ident: e_1_2_6_25_2 doi: 10.1002/cne.901130202 – ident: e_1_2_6_36_2 doi: 10.1016/0006-8993(85)90909-6 – ident: e_1_2_6_37_2 doi: 10.1016/0168-5597(93)90112-3 – ident: e_1_2_6_38_2 doi: 10.1002/mus.880170303 – ident: e_1_2_6_7_2 doi: 10.1212/WNL.53.8.1641 – ident: e_1_2_6_2_2 doi: 10.1016/0022-510X(93)90223-L – ident: e_1_2_6_6_2 doi: 10.1002/ana.410440111 – ident: e_1_2_6_35_2 doi: 10.1093/brain/115.6.1925 – volume: 186 start-page: 261 year: 1995 ident: e_1_2_6_27_2 article-title: Three‐dimensional reconstruction of the Meissner's corpuscles of man after silver impregnation and immunofluorescence with PGP 9.5 antibodies using confocal scanning laser microscopy publication-title: J Anat – ident: e_1_2_6_19_2 doi: 10.1212/WNL.13.2.91 – ident: e_1_2_6_13_2 doi: 10.1093/alcalc/36.5.393 – volume: 82 start-page: 1 year: 1990 ident: e_1_2_6_31_2 article-title: Morphometric studies on the human sural nerve publication-title: Acta Neurol Scand |
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Snippet | We used immunohistochemistry and confocal microscopy applied to fingertip punch biopsy to study glabrous skin innervation in 14 healthy subjects. In addition... |
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SubjectTerms | Adult Amyloid beta-Peptides - metabolism Autonomic Nervous System - cytology Autonomic Nervous System - physiology Biological and medical sciences Cell Count Female Fingers - innervation Humans Immunohistochemistry Male Mechanoreceptors - physiology Medical sciences Microscopy, Confocal Middle Aged Myelin Basic Protein - metabolism Myelin Sheath - physiology Nerve Endings - physiology Nerve Fibers - physiology Nervous system involvement in other diseases. Miscellaneous Neurology Reference Values Skin - innervation |
Title | Quantification of myelinated endings and mechanoreceptors in human digital skin |
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