Skin biopsy for assessment of autonomic denervation in Parkinson's disease
Skin biopsy for assessment of autonomic denervation in Parkinson's disease
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DOI：
10.1007/s00702-005-0431-0
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发表时间：
2006-09-01
影响因子：
3.3
通讯作者：
Avinoach, I.
中科院分区：
文献类型：
--
作者：
Dabby, R.;Djaldetti, R.;Avinoach, I.
帕金森氏病(PD)的自主神经功能障碍被认为是该疾病的晚期并发症或抗帕金森病药物的不良反应。只有通过尸检才能证明形态变化。该研究的目的是通过穿孔皮肤活检来评估帕金森病患者周围自主神经的受累情况。研究样本包括22名患者(平均年龄50±7.7岁，平均病程5.3±3.8年)和19名对照组。4 mm皮肤活检标本用抗PGP9.5抗体进行免疫组织化学染色。血管、汗腺和竖毛肌的自主神经支配被评估为0(正常)到2(严重)。与对照组相比，患者的皮肤自主神经支配减少。半定量分析显示，对照组血管(1.0+/-0.8vs.0.42+/-0.8vs.p<；0.02)、汗腺(0.95+/-0.67vs.0.47+/-0.61；p<；0.02)和竖毛肌(1.06+/-0.55vs.0.21+/-0.42；p<；0.001)的自主神经支配减少。这一方法表明，帕金森病患者的外周自主神经系统在疾病的早期阶段受到影响，而且帕金森病患者的自主神经受累可能比之前认为的更普遍。
Autonomic dysfunction in Parkinson's disease (PD) is considered a late complication of the disease or an adverse effect of anti-parkinsonian medications. Morphological changes are demonstrated only by postmortem examination. The study objective was to evaluate peripheral autonomic neural involvement in PD using punch skin biopsy. The study sample included 22 patients (mean age 50 +/- 7.7 years, mean disease duration 5.3 +/- 3.8 years) and 19 controls. Four-millimeter skin biopsies were immunohistochemically stained with anti-PGP 9.5 antibody. Autonomic innervation of the blood vessels, sweat glands, and erector pili muscles was assessed and rated from 0 (normal) to 2 (severe). Cutaneous autonomic innervation was decreased in patients compared to controls. Semi quantitative analysis demonstrated reduced autonomic innervation of the blood vessels (1.0 +/- 0.8 vs. 0.42 +/- 0.8 in controls; p < 0.02), of sweat glands (0.95 +/- 0.67 vs. 0.47 +/- 0.61; p < 0.02) and of the erector pili muscles (1.06 +/- 0.55 vs 0.21 +/- 0.42; p < 0.001). This method demonstrates that the peripheral autonomic system is affected in PD at early stage of the disease and that autonomic involvement in PD may be more prevalent than previously thought.