The expression of NGFr and PGP 9.5 in leprosy reactional cutaneous lesions: an assessment of the nerve fiber status using immunostaining

Antunes, Sérgio Luiz Gomes; Liang, Yong; Neri, José Augusto da Costa; Haak‐Frendscho, Mary; Johansson, Ӧlle

doi:10.1590/s0004-282x2003000300005

Cited by 14 publications

(17 citation statements)

References 25 publications

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“…Antunes et al (28) also raised this last hypothesis when they found no significant quantitative difference between the number of fibers in biopsies taken during or after reactional episodes. It is worth noting that the lack of immunoreactivity of a neural marker in the endoneurium does not necessarily mean the absence of fibers.…”

Section: Discussionmentioning

confidence: 93%

An immunohistochemical, clinical and electroneuromyographic correlative study of the neural markers in the neuritic form of leprosy

Antunes

Chimelli

Rabello

et al. 2006

Braz J Med Biol Res

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The nerve biopsies of 11 patients with pure neuritic leprosy were submitted to routine diagnostic procedures and immunoperoxidase staining with antibodies against axonal (neurofilament, nerve growth factor receptor (NGFr), and protein gene product (PGP) 9.5) and Schwann cell (myelin basic protein, S-100 protein, and NGFr) markers. Two pairs of non-adjacent histological cross-sections of the peripheral nerve were removed for quantification. All the fascicles of the nerve were examined with a 10X-ocular and 40X-objective lens. The immunohistochemistry results were compared to the results of semithin section analysis and clinical and electroneuromyographic data. Neurofilament staining was reduced in 100% of the neuritic biopsies. NGFr positivity was also reduced in 81.8%, PGP staining in 100% of the affected nerves, S100 positivity in 90.9%, and myelin basic protein immunoreactivity in 90.9%. Hypoesthesia was associated with decreased NGFr (81.8%) and PGP staining (90.9%). Reduced potential amplitudes (electroneuromyographic data) were found to be associated with reduced PGP 9.5 (63.6%) and nerve fiber neurofilament staining (45.4%) by immunohistochemistry and with loss of myelinated fibers (100%) by semithin section analysis. On the other hand, the small fibers (immunoreactive dots) seen amid inflammatory cells continued to be present even after 40% of the larger myelinated fibers had disappeared. The present study shows an indepth view of the destructive effects of leprosy upon the expression of neural markers and the integrity of nerve fiber. The association of these structural changes with the clinical and electroneuromyographic manifestations of leprosy peripheral neuropathy was also discussed. Correspondence

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Section: Discussionmentioning

confidence: 93%

An immunohistochemical, clinical and electroneuromyographic correlative study of the neural markers in the neuritic form of leprosy

Antunes

Chimelli

Rabello

et al. 2006

Braz J Med Biol Res

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“…In our study, we used p75 predominantly as a neuronal marker. A previous study using simultaneous costaining of p75 with axonal marker protein gene product (PGP) 9.5 showed no significant difference in nerve fiber density between both staining in humans, 19 suggesting that p75 is a reasonable pan‐neuronal marker. A distinct advantage of p75 over PGP 9.5 is higher contrast of stained fibers 19 .…”

Section: Discussionmentioning

confidence: 97%

“…A previous study using simultaneous costaining of p75 with axonal marker protein gene product (PGP) 9.5 showed no significant difference in nerve fiber density between both staining in humans, 19 suggesting that p75 is a reasonable pan‐neuronal marker. A distinct advantage of p75 over PGP 9.5 is higher contrast of stained fibers 19 . However, because p75 stains predominantly Schwann cells, the loss of p75 IR is because of either axonal neuropathy with the secondary Schwann cell degeneration or primary degeneration of Schwann cells.…”

Section: Discussionmentioning

confidence: 97%

Dermal sheet preparations in the evaluation of dermal innervation in Parkinson’s disease and multiple system atrophy

Novák¹,

Marya

Whren

et al. 2009

J Cutan Pathol

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“…However, such studies have used non-systematic semi-quantitative methods to evaluate the nerve density and the thermal thresholds, and did not exclude treated patients [20], [21], [22], [23], [24].…”

Section: Introductionmentioning

confidence: 99%

Degree of Skin Denervation and Its Correlation to Objective Thermal Sensory Test in Leprosy Patients

et al. 2012

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BackgroundLeprosy is an infectious disease affecting skin and peripheral nerves resulting in increased morbidity and physical deformities. Early diagnosis provides opportune treatment and reduces its complications, relying fundamentally on the demonstration of impaired sensation in suggestive cutaneous lesions. The loss of tactile sensitivity in the lesions is preceded by the loss of thermal sensitivity, stressing the importance of the thermal test in the suspicious lesions approach. The gold-standard method for the assessment of thermal sensitivity is the quantitative sensory test (QST). Morphological study may be an alternative approach to access the thin nerve fibers responsible for thermal sensitivity transduction. The few studies reported in leprosy patients pointed out a rarefaction of thin dermo-epidermal fibers in lesions, but used semi-quantitative evaluation methods.Methodology/Principal FindingsThis work aimed to study the correlation between the degree of thermal sensitivity impairment measured by QST and the degree of denervation in leprosy skin lesions, evaluated by immunohistochemistry anti-PGP 9.5 and morphometry. Twenty-two patients were included. There were significant differences in skin thermal thresholds among lesions and contralateral skin (cold, warm, cold induced pain and heat induced pain). The mean reduction in the density of intraepidermal and subepidermal fibers in lesions was 79.5% (SD = 19.6) and 80.8% (SD = 24.9), respectively.Conclusions/SignificanceWe observed a good correlation between intraepidermal and subepidermal fibers deficit, but no correlation between these variables and those accounting for the degree of impairment in thermal thresholds, since the thin fibers rarefaction was homogeneously intense in all patients, regardless of the degree of sensory deficit. We believe that the homogeneously intense denervation in leprosy lesions should be objective of further investigations focused on its diagnostic applicability, particularly in selected cases with only discrete sensory impairment, patients unable to perform the sensory test and especially those with nonspecific histopathological finds.

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The expression of NGFr and PGP 9.5 in leprosy reactional cutaneous lesions: an assessment of the nerve fiber status using immunostaining

Cited by 14 publications

References 25 publications

An immunohistochemical, clinical and electroneuromyographic correlative study of the neural markers in the neuritic form of leprosy

An immunohistochemical, clinical and electroneuromyographic correlative study of the neural markers in the neuritic form of leprosy

Dermal sheet preparations in the evaluation of dermal innervation in Parkinson’s disease and multiple system atrophy

Degree of Skin Denervation and Its Correlation to Objective Thermal Sensory Test in Leprosy Patients

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