Abstract：
Schwann cell clusters have been described at the murine dermis-epidermis border. We quantified dermal Schwann cells in the skin of patients with small-fiber neuropathy (SFN) compared with healthy controls to correlate with the clinical phenotype.
Skin punch biopsies from the lower legs of 28 patients with SFN (11 men, 17 women; median age, 54 [range, 19-73] years) and 9 healthy controls (five men, four women, median age, 34 [range, 25-69] years) were immunoreacted for S100 calcium-binding protein B as a Schwann cell marker, protein-gene product 9.5 as a pan-neuronal marker, and CD207 as a Langerhans cell marker. Intraepidermal nerve fiber density (IENFD) and subepidermal Schwann cell counts were determined.
Skin samples of patients with SFN showed lower IENFD (P < .05), fewer Schwann cells per millimeter (P < .01), and fewer Schwann cell clusters per millimeter (P < .05) than controls. When comparing SFN patients with reduced (n = 13; median age, 53 [range, 19-73] years) and normal distal (n = 15, median age, 54 [range, 43-68] years) IENFD, the number of solitary Schwann cells per millimeter (p < .01) and subepidermal nerve fibers associated with Schwann cell branches (P < .05) were lower in patients with reduced IENFD. All three parameters correlated positively with distal IENFD (P < .05 to P < .01), whereas no correlation was found between Schwann cell counts and clinical pain characteristics.
Our data raise questions about the mechanisms underlying the interdependence of dermal Schwann cells and skin innervation in SFN. The temporal course and functional impact of Schwann cell presence and kinetics need further investigation.
Skin punch biopsies from the lower legs of 28 patients with SFN (11 men, 17 women; median age, 54 [range, 19-73] years) and 9 healthy controls (five men, four women, median age, 34 [range, 25-69] years) were immunoreacted for S100 calcium-binding protein B as a Schwann cell marker, protein-gene product 9.5 as a pan-neuronal marker, and CD207 as a Langerhans cell marker. Intraepidermal nerve fiber density (IENFD) and subepidermal Schwann cell counts were determined.
Skin samples of patients with SFN showed lower IENFD (P < .05), fewer Schwann cells per millimeter (P < .01), and fewer Schwann cell clusters per millimeter (P < .05) than controls. When comparing SFN patients with reduced (n = 13; median age, 53 [range, 19-73] years) and normal distal (n = 15, median age, 54 [range, 43-68] years) IENFD, the number of solitary Schwann cells per millimeter (p < .01) and subepidermal nerve fibers associated with Schwann cell branches (P < .05) were lower in patients with reduced IENFD. All three parameters correlated positively with distal IENFD (P < .05 to P < .01), whereas no correlation was found between Schwann cell counts and clinical pain characteristics.
Our data raise questions about the mechanisms underlying the interdependence of dermal Schwann cells and skin innervation in SFN. The temporal course and functional impact of Schwann cell presence and kinetics need further investigation.
摘要：
已经在鼠真皮-表皮边界处描述了雪旺氏细胞簇。我们定量了小纤维神经病（SFN）患者皮肤中的真皮雪旺氏细胞，与健康对照组相比，与临床表型相关。
对28名SFN患者的小腿进行皮肤穿刺活检（11名男性，17名妇女；平均年龄，54[范围，19-73]岁）和9名健康对照（5名男性，四个女人,中位年龄,34[范围，25-69]年）对S100钙结合蛋白B作为雪旺氏细胞标志物进行免疫反应，蛋白质基因产物9.5作为泛神经元标记，和CD207作为朗格汉斯细胞标记。确定表皮内神经纤维密度（IENFD）和表皮下雪旺氏细胞计数。
SFN患者的皮肤样本显示较低的IENFD（P<0.05），每毫米雪旺氏细胞较少（P<0.01），和较少的施万细胞簇每毫米（P<0.05）比对照组。当比较SFN患者与降低时(n=13；中位年龄，53[范围，19-73]岁)和正常远端(n=15，中位年龄，54[范围，43-68]年)IENFD，在IENFD减少的患者中，每毫米孤立雪旺氏细胞的数量（p<.01）和与雪旺氏细胞分支相关的表皮下神经纤维的数量（P<.05）较低。所有三个参数均与远端IENFD呈正相关（P<0.05至P<0.01），而施万细胞计数与临床疼痛特征之间没有相关性。
我们的数据提出了关于SFN中真皮雪旺氏细胞和皮肤神经支配相互依存的机制的问题。雪旺氏细胞存在和动力学的时间过程和功能影响需要进一步研究。
对28名SFN患者的小腿进行皮肤穿刺活检（11名男性，17名妇女；平均年龄，54[范围，19-73]岁）和9名健康对照（5名男性，四个女人,中位年龄,34[范围，25-69]年）对S100钙结合蛋白B作为雪旺氏细胞标志物进行免疫反应，蛋白质基因产物9.5作为泛神经元标记，和CD207作为朗格汉斯细胞标记。确定表皮内神经纤维密度（IENFD）和表皮下雪旺氏细胞计数。
SFN患者的皮肤样本显示较低的IENFD（P<0.05），每毫米雪旺氏细胞较少（P<0.01），和较少的施万细胞簇每毫米（P<0.05）比对照组。当比较SFN患者与降低时(n=13；中位年龄，53[范围，19-73]岁)和正常远端(n=15，中位年龄，54[范围，43-68]年)IENFD，在IENFD减少的患者中，每毫米孤立雪旺氏细胞的数量（p<.01）和与雪旺氏细胞分支相关的表皮下神经纤维的数量（P<.05）较低。所有三个参数均与远端IENFD呈正相关（P<0.05至P<0.01），而施万细胞计数与临床疼痛特征之间没有相关性。
我们的数据提出了关于SFN中真皮雪旺氏细胞和皮肤神经支配相互依存的机制的问题。雪旺氏细胞存在和动力学的时间过程和功能影响需要进一步研究。
