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NEUROLOGY 1996;47:1042-1048
© 1996 American Academy of Neurology

Quantitation of epidermal nerves in diabetic neuropathy

William R. Kennedy, MD, Gwen Wendelschafer-Crabb, MS and Timothy Johnson, MS

From the Department of Neurology, University of Minnesota, Minneapolis, MN.
Supported by U.S. National Institutes of Health (NS 26348, NS 31397), National Resources Center Grant M01-RR00400, and Toray Industries Inc. (Japan).
Received December 6, 1995. Accepted in final form January 17, 1996.
Address correspondence and reprint requests to William R. Kennedy, MD, Box 187 UMHC, 420 Delaware St. SE, Minneapolis, MN 55455.

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.

NEUROLOGY 1996;47: 1042-1048




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