Rarefaction of the peripheral nerve network in diabetic patients is associated with a pronounced reduction of terminal Schwann cells.
OBJECTIVE
Peripheral neuropathy is the most frequent neurological complication in diabetic patients. The diagnosis is established by both clinical neurological examination and demonstration of reduced epidermal nerve fibers in skin biopsies (1). Whereas the decrease of free nerve endings has been extensively studied in diabetic patients (2,3), no data are available on possible changes of terminal Schwann cells. Besides their role as scaffold for peripheral nerves, they also play an important role in supporting survival and function of peripheral nerves (4).


METHODS
We analyzed the subepidermal nerve plexus in dermal sheet preparations of deceased diabetic and nondiabetic patients by immunostaining for detection of the neural cell adhesion molecule and quantification of the subepidermal nerve plexus.


CONCLUSIONS
The subepidermal nerve plexus, comprising nerve fibers and ensheathing Schwann cells, was significantly reduced in diabetic patients. Whether the reduction in terminal Schwann cells is cause or consequence of the loss of peripheral nerve fibers remains to be investigated.
Reinisch
Christina M
CM
Department of Dermatology, Medical University of Vienna, Vienna, Austria.
Traxler
Hannes
H
Piringer
Stefanie
S
Tangl
Stefan
S
Nader
Alexander
A
Tschachler
Erwin
E
D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D019002:CD56 Antigen / Q000032:analysis; D003929:Diabetic Neuropathies / Q000473:pathology / Q000503:physiopathology*; D004817:Epidermis / Q000294:innervation; D006801:Humans; D008875:Middle Aged; D009411:Nerve Endings / Q000473:pathology / Q000502:physiology; D009412:Nerve Fibers / Q000502:physiology; D009415:Nerve Net; D010525:Peripheral Nerves / Q000473:pathology / Q000503:physiopathology*; D012016:Reference Values; D012583:Schwann Cells / Q000473:pathology / Q000502:physiology*; D012867:Skin / Q000294:innervation
D019002:CD56 Antigen