Comparison of a simple method for quantitation of intraepidermal nerve fibres with a standard image analysis method using hypothenar skin

Wilder-Smith, Einar; Chow, Adeline

doi:10.1007/s00415-006-0147-6

Cited by 11 publications

(10 citation statements)

References 21 publications

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“…In a prospective study, hypothenar intraepidermal nerve fibre density (IENFD) from healthy subjects and from subjects referred for investigation of neuropathy was assessed. 12 In the subgroup reported here, the distribution of TPVR1 in the epidermis of the human skin is described. We studied the different epidermal TPVR1 staining intensity and distribution of patients with length-dependant DN and distal idiopathic small nerve fibre neuropathy (DSFN) and compared these with healthy subjects.…”

Section: Methodsmentioning

confidence: 96%

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Epidermal transient receptor potential vanilloid 1 in idiopathic small nerve fibre disease, diabetic neuropathy and healthy human subjects

Wilder-Smith

Guo

et al. 2007

Histopathology

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Epidermal transient receptor potential vanilloid 1 in idiopathic small nerve fibre disease, diabetic neuropathy and healthy human subjects Aims: The transient receptor potential vanilloid 1 (TRPV1) plays an important role in mediating pain and heat. In painful neuropathies, intraepidermal TRPV1 nerve fibre expression is low or absent, suggesting that pain generated is not directly related to sensory nerve fibres. Recent evidence suggests that keratinocytes may act as thermal receptors via TRPV1. The aim was to investigate epidermal TRPV1 expression in patients with neuropathic conditions associated with pain. Methods and results: In a prospective study of distal small nerve fibre neuropathy (DISN; n = 13) and diabetic neuropathy (DN; n = 12) intraepidermal nerve fibre density was assessed using the pan axonal marker PGP 9.5 and epidermal TPVR1 immunoreactivity compared with controls (n = 9). Intraepidermal nerve fibres failed to show TRPV1 immunoreactivity across all groups. There was moderate and strong TRPV1 reactivity of epidermal keratinocytes in 41.8% and 6% for DISN, 32.9% and 2.9% for DN and 25.4% and 5.1% for controls, respectively. Moderate keratinocyte TRPV1 expression was significantly increased in DISN compared with controls (P = 0.01). Conclusion: Our study suggests that in human painful neuropathies, epidermal TRPV1 expression is mainly in keratinocytes.

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Section: Methodsmentioning

confidence: 96%

“…IENFD assessment was achieved by staining skin obtained from the hypothenar region with PGP 9.5, as previously described. 12 …”

Section: Methodsmentioning

confidence: 99%

Epidermal transient receptor potential vanilloid 1 in idiopathic small nerve fibre disease, diabetic neuropathy and healthy human subjects

Wilder-Smith

Guo

et al. 2007

Histopathology

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“…Bilateral median, ulnar, peroneal, tibial sensory, and motor and sural nerve study results were normal. In all 3, hypothenar skin biopsy was performed, showing an absence of intraepidermal nerve fibers . The 3 patients received treatment 42, 6, and 11 days, respectively, after symptom onset.…”

Section: Clinical Features Of Patients With Acute Painful Autoimmune mentioning

confidence: 99%

“…In all 3, hypothenar skin biopsy was performed, showing an absence of intraepidermal nerve fibers. 3 The 3 patients received treatment 42, 6, and 11 days, respectively, after symptom onset. Within days to 1 week of treatment with intravenous immunoglobulin (IVIG), pain symptoms in patients 1 and 2 improved from visual analogue score (VAS) 8/10 and 7/10, respectively, at the onset of the illness to 1/10.…”

Section: Introductionmentioning

confidence: 99%

Acute painful autoimmune neuropathy: A variant of Guillain‐Barré syndrome

et al. 2017

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“…Skin biopsy from the left forearm did not reveal any abnormality on hematoxylin and eosin staining. Ten‐micrometer sections of the specimen were subjected to immunohistochemistry with anti‐protein gene product 9.5 antibody, with protocol adapted from that described by Wilder‐Smith . The average number of intra‐epidermal nerve fiber counted (IENFc) over 6 mm was 3.67/mm (FIG.…”

Section: Investigations Into the Pathologymentioning

confidence: 99%

Idiopathic aquagenic pruritus: pathogenesis and effective treatment with atenolol

et al. 2015

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Aquagenic pruritus (AP) is a rare condition with unknown pathogenesis. We explored its pathogenesis through investigations of a patient and report the first case to be effectively treated with atenolol. A 36-year-old Indian female presented with idiopathic AP. Small-fiber neuropathy involving itch/pain-transmitting C-fibers appears to be pathogenetically important: compared with matched controls, our patient had increased intra-epidermal nerve fibers, raised warmth detection threshold, and marked hyperknesis to electrical stimulation. Autonomic nerve function tests and fingertips vasoconstriction response were normal, indicating integrity of other small (Aδ and C) nerve fibers. She was initially treated with propranolol with good response, but was subsequently switched to atenolol for convenient once-a-day dosing. Symptoms were well controlled long term with no side effect experienced. Atenolol may exert its effect in AP through blockage of over-activated neuronal sodium channels. Through the investigations, we propose that the pathogenesis of idiopathic AP may involve the following: upon contact of the skin with water, yet-unknown mediator/s released stimulate dysfunctional and hyper-innervated C-nerve fibers, which may have resulted from a sodium channel defect. Atenolol may be a preferred therapeutic option compared with propanolol, in view of its convenient once-a-day dosing and better side effect profile.

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Comparison of a simple method for quantitation of intraepidermal nerve fibres with a standard image analysis method using hypothenar skin

Abstract: A simple method for counting intraepidermal nerve fibres produces results similar to those using standard software image analysis. This should help the implementation of this technique for wider use.

Cited by 11 publications

References 21 publications

Epidermal transient receptor potential vanilloid 1 in idiopathic small nerve fibre disease, diabetic neuropathy and healthy human subjects

Epidermal transient receptor potential vanilloid 1 in idiopathic small nerve fibre disease, diabetic neuropathy and healthy human subjects

Acute painful autoimmune neuropathy: A variant of Guillain‐Barré syndrome

Idiopathic aquagenic pruritus: pathogenesis and effective treatment with atenolol

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