Differential myelinated and unmyelinated sensory and autonomic skin nerve fiber involvement in patients with ophthalmic postherpetic neuralgia
Postherpetic neuralgia (PHN) is a common and exceptionally drug-resistant neuropathic pain condition. In this cross-sectional skin biopsy study, seeking information on the responsible pathophysiological mechanisms we assessed how ophthalmic PHN affects sensory and autonomic skin innervation. We took...
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| Published in | Frontiers in neuroanatomy Vol. 9; p. 105 |
|---|---|
| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Switzerland
Frontiers Research Foundation
04.08.2015
Frontiers Media S.A |
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| Online Access | Get full text |
| ISSN | 1662-5129 1662-5129 |
| DOI | 10.3389/fnana.2015.00105 |
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| Abstract | Postherpetic neuralgia (PHN) is a common and exceptionally drug-resistant neuropathic pain condition. In this cross-sectional skin biopsy study, seeking information on the responsible pathophysiological mechanisms we assessed how ophthalmic PHN affects sensory and autonomic skin innervation. We took 2-mm supraorbital punch skin biopsies from the affected and unaffected sides in 10 patients with ophthalmic PHN. Using indirect immunofluorescence and a large panel of antibodies including protein gene product (PGP) 9.5 we quantified epidermal unmyelinated, dermal myelinated and autonomic nerve fibers. Although skin biopsy showed reduced epidermal and dermal myelinated fiber density in specimens from the affected side, the epidermal/dermal myelinated nerve fiber ratio was lower in the affected than in the unaffected side (p < 0.001), thus suggesting a predominant epidermal unmyelinated nerve fiber loss. Conversely, autonomic skin innervation was spared. Our study showing that ophthalmic PHN predominantly affects unmyelinated nerve fiber and spares autonomic nerve fiber might help to understand the pathophysiological mechanisms underlying this difficult-to-treat condition. |
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| AbstractList | Postherpetic neuralgia is a common and exceptionally drug-resistant neuropathic pain condition. In this cross-sectional skin biopsy study, seeking information on the responsible pathophysiological mechanisms we assessed how ophthalmic postherpetic neuralgia affects sensory and autonomic skin innervation. We took 2-mm supraorbital punch skin biopsies from the affected and unaffected sides in 10 patients with ophthalmic postherpetic neuralgia. Using indirect immunofluorescence and a large panel of antibodies including PGP 9.5 we quantified epidermal unmyelinated, dermal myelinated and autonomic nerve fibers. Although skin biopsy showed reduced epidermal and dermal myelinated fiber density in specimens from the affected side, the epidermal/dermal myelinated nerve fiber ratio was lower in the affected than in the unaffected side (p< 0.001), thus suggesting a predominant epidermal unmyelinated nerve fiber loss. Conversely, autonomic skin innervation was spared. Our study showing that ophthalmic postherpetic neuralgia predominantly affects unmyelinated nerve fiber and spares autonomic nerve fiber might help to understand the pathophysiological mechanisms underlying this difficult-to-treat condition. Postherpetic neuralgia (PHN) is a common and exceptionally drug-resistant neuropathic pain condition. In this cross-sectional skin biopsy study, seeking information on the responsible pathophysiological mechanisms we assessed how ophthalmic PHN affects sensory and autonomic skin innervation. We took 2-mm supraorbital punch skin biopsies from the affected and unaffected sides in 10 patients with ophthalmic PHN. Using indirect immunofluorescence and a large panel of antibodies including protein gene product (PGP) 9.5 we quantified epidermal unmyelinated, dermal myelinated and autonomic nerve fibers. Although skin biopsy showed reduced epidermal and dermal myelinated fiber density in specimens from the affected side, the epidermal/dermal myelinated nerve fiber ratio was lower in the affected than in the unaffected side (p < 0.001), thus suggesting a predominant epidermal unmyelinated nerve fiber loss. Conversely, autonomic skin innervation was spared. Our study showing that ophthalmic PHN predominantly affects unmyelinated nerve fiber and spares autonomic nerve fiber might help to understand the pathophysiological mechanisms underlying this difficult-to-treat condition. Postherpetic neuralgia (PHN) is a common and exceptionally drug-resistant neuropathic pain condition. In this cross-sectional skin biopsy study, seeking information on the responsible pathophysiological mechanisms we assessed how ophthalmic PHN affects sensory and autonomic skin innervation. We took 2-mm supraorbital punch skin biopsies from the affected and unaffected sides in 10 patients with ophthalmic PHN. Using indirect immunofluorescence and a large panel of antibodies including protein gene product (PGP) 9.5 we quantified epidermal unmyelinated, dermal myelinated and autonomic nerve fibers. Although skin biopsy showed reduced epidermal and dermal myelinated fiber density in specimens from the affected side, the epidermal/dermal myelinated nerve fiber ratio was lower in the affected than in the unaffected side ( p < 0.001), thus suggesting a predominant epidermal unmyelinated nerve fiber loss. Conversely, autonomic skin innervation was spared. Our study showing that ophthalmic PHN predominantly affects unmyelinated nerve fiber and spares autonomic nerve fiber might help to understand the pathophysiological mechanisms underlying this difficult-to-treat condition. |
| Author | Stancanelli, Annamaria Biasiotta, Antonella Caporaso, Giuseppe Truini, Andrea Haanpaa, Maija Cruccu, Giorgio Provitera, Vincenzo Santoro, Lucio Nolano, Maria |
| AuthorAffiliation | 4 Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples Naples, Italy 1 Department of Neurology and Psychiatry, Sapienza University of Rome Rome, Italy 2 Department of Neurosurgery, Helsinki University Central Hospital Helsinki, Finland 3 Neurology Division “Salvatore Maugeri” Foundation—Institute of Telese Terme (BN) Italy Telese Terme, Italy |
| AuthorAffiliation_xml | – name: 1 Department of Neurology and Psychiatry, Sapienza University of Rome Rome, Italy – name: 3 Neurology Division “Salvatore Maugeri” Foundation—Institute of Telese Terme (BN) Italy Telese Terme, Italy – name: 4 Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples Naples, Italy – name: 2 Department of Neurosurgery, Helsinki University Central Hospital Helsinki, Finland |
| Author_xml | – sequence: 1 givenname: Andrea surname: Truini fullname: Truini, Andrea – sequence: 2 givenname: Maija surname: Haanpaa fullname: Haanpaa, Maija – sequence: 3 givenname: Vincenzo surname: Provitera fullname: Provitera, Vincenzo – sequence: 4 givenname: Antonella surname: Biasiotta fullname: Biasiotta, Antonella – sequence: 5 givenname: Annamaria surname: Stancanelli fullname: Stancanelli, Annamaria – sequence: 6 givenname: Giuseppe surname: Caporaso fullname: Caporaso, Giuseppe – sequence: 7 givenname: Lucio surname: Santoro fullname: Santoro, Lucio – sequence: 8 givenname: Giorgio surname: Cruccu fullname: Cruccu, Giorgio – sequence: 9 givenname: Maria surname: Nolano fullname: Nolano, Maria |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/26300742$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_1016_j_ejphar_2023_175665 crossref_primary_10_1097_j_pain_0000000000001584 crossref_primary_10_1097_PR9_0000000000000941 crossref_primary_10_1177_0300060520929582 crossref_primary_10_1126_sciadv_adh3273 crossref_primary_10_1177_0333102417689995 crossref_primary_10_1111_ene_13950 crossref_primary_10_3389_fnmol_2024_1400118 crossref_primary_10_1152_physrev_00045_2019 crossref_primary_10_3389_fneur_2020_00661 |
| Cites_doi | 10.1016/j.pain.2010.04.002 10.1006/nbdi.1998.0204 10.1002/ana.410440513 10.1016/s0163-7258(98)00040-0 10.1016/j.jpain.2013.10.010 10.1002/ana.10615 10.1212/WNL.0000000000000518 10.1111/joa.12001 10.1016/s0304-3959(00)00481-4 10.1016/j.pain.2008.08.018 10.1038/nrneurol.2013.180 10.1016/S1474-4422(07)70172-2 10.1002/(sici)1097-4598(199711)20:111433::aid-mus113.0.co;2-2 10.1016/j.pain.2014.01.022 10.1007/s00415-012-6432-7 10.1016/0306-3623(94)00155-g 10.1016/j.pain.2013.04.015 |
| ContentType | Journal Article |
| Copyright | 2015. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. Copyright © 2015 Truini, Haanpaa, Provitera, Biasiotta, Stancanelli, Caporaso, Santoro, Cruccu and Nolano. 2015 Truini, Haanpaa, Provitera, Biasiotta, Stancanelli, Caporaso, Santoro, Cruccu and Nolano |
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| Keywords | postherpetic neuralgia trigeminal nerve neuropathic pain intraepidermal nerve fiber skin biopsy |
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| Snippet | Postherpetic neuralgia (PHN) is a common and exceptionally drug-resistant neuropathic pain condition. In this cross-sectional skin biopsy study, seeking... Postherpetic neuralgia is a common and exceptionally drug-resistant neuropathic pain condition. In this cross-sectional skin biopsy study, seeking information... |
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| SubjectTerms | Autonomic nervous system Biopsy Classification Drug resistance Headaches Immunofluorescence Immunoglobulins Innervation Intraepidermal nerve fiber Microscopy Neuralgia Neurology neuropathic pain Neuroscience Pain Patients Peptides postherpetic neuralgia Proteins Skin Skin biopsy Studies Trigeminal Nerve |
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| Title | Differential myelinated and unmyelinated sensory and autonomic skin nerve fiber involvement in patients with ophthalmic postherpetic neuralgia |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/26300742 https://www.proquest.com/docview/2295572644 https://www.proquest.com/docview/1706575674 https://pubmed.ncbi.nlm.nih.gov/PMC4523825 https://doaj.org/article/f17669ab71dd492e91bc7b18237ad62d |
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