Quantitation of epidermal nerves in diabetic neuropathy

TLDR

The study develops methods to quantify epidermal nerve fibers in skin biopsies from diabetic pancreas transplant candidates and controls. ENFs and the dermal‑epidermal basement membrane were stained, imaged with confocal microscopy, and quantified using a neuron tracing system. Diabetic subjects showed reduced ENF number and total length per epidermal area, while branch point density was unchanged, establishing a baseline for future studies of pancreatic transplantation and neuropathy therapies.

Abstract

We describe methods to quantify epidermal nerve fibers (ENFs) in skin biopsy specimens from diabetic candidates for pancreas transplantation and control subjects. ENFs and the dermal-epidermal basement membrane were stained by immunohistochemical methods, imaged with a confocal microscope, and quantified using a neuron tracing system. The number of ENFs per surface of epidermis was diminished in diabetic subjects. ENF number and summed length of all ENFs per volume of epidermis examined were also decreased. Length and number of branch points of single surviving ENFs were similar in skin of control and diabetic subjects. The methods and results constitute a basis for continued study of the effects of the euglycemia that attends successful pancreas transplantation and the effects of therapy in patients with various types of polyneuropathy.