title: Innervation of the skin of the forearm in diabetic patients: relation to nerve function.
abstract: Complications of diabetes include sensory and autonomic neuropathy. The aim of the present paper was to study the degree of sensory and autonomic neuropathy and correlate these findings with the distribution and density of neuropeptidergic nerve fibers in the skin of the forearm of diabetic patients and healthy controls. We investigated 30 diabetics (24 type 1 and 6 type 2) and compared them with 13 healthy controls. There were no differences between the groups with respect to density and distribution of nerve fibers displaying immunoreactivity to the pan-neuronal marker PGP 9.5 and sensory and parasympathetic neuropeptides (substance P, calcitonin gene-related peptide and vasoactive intestinal peptide). By contrast, nerve fibers containing neuropeptide Y, a marker of sympathetic neurons, were reduced in number in the diabetic patients. C-fiber function (measured as the axon-reflex-evoked flare response) became impaired with increasing age in all subjects. The diabetic patients, however, showed a reduced flare compared to age-matched healthy controls. The reduction was particularly prominent in the younger patients (20-50 years). There was a greater reduction of the flare in neuropathic patients than in non-neuropathic patients, but there was no correlation between the degree of functional impairment and the duration of the disease.
authors.affiliation: Department of Occupational Dermatology, Lund University.
authors.forename: J
authors.initials: J
authors.lastname: Wallengren
authors.forename: K
authors.initials: K
authors.lastname: Badendick
authors.forename: F
authors.initials: F
authors.lastname: Sundler
authors.forename: R
authors.initials: R
authors.lastname: Håkanson
authors.forename: E
authors.initials: E
authors.lastname: Zander
mesh_terms: D000328:Adult; D000368:Aged; D001341:Autonomic Nervous System / Q000503:physiopathology; D001369:Axons / Q000502:physiology; D015740:Calcitonin Gene-Related Peptide / Q000032:analysis; D016022:Case-Control Studies; D003920:Diabetes Mellitus / Q000473:pathology* / Q000503:physiopathology; D003929:Diabetic Neuropathies / Q000503:physiopathology*; D005260:Female; D005542:Forearm / Q000294:innervation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000502:physiology*; D009475:Neurons, Afferent / Q000502:physiology; D009478:Neuropeptide Y / Q000032:analysis; D010275:Parasympathetic Nervous System / Q000503:physiopathology; D012867:Skin / Q000294:innervation*; D013373:Substance P / Q000032:analysis; D013564:Sympathetic Nervous System / Q000503:physiopathology; D013869:Thiolester Hydrolases / Q000032:analysis; D043222:Ubiquitin Thiolesterase; D014660:Vasoactive Intestinal Peptide / Q000032:analysis
chemical_list: D009478:Neuropeptide Y; D013373:Substance P; D014660:Vasoactive Intestinal Peptide; D013869:Thiolester Hydrolases; D043222:Ubiquitin Thiolesterase; D015740:Calcitonin Gene-Related Peptide