The density of remaining nerve endings in human skin with and without postherpetic neuralgia after shingles
The density of remaining nerve endings in human skin with and without postherpetic neuralgia after shingles
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DOI：
10.1016/s0304-3959(00)00481-4
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发表时间：
2001-05-01
期刊：
影响因子：
7.4
通讯作者：
Oaklander, AL
中科院分区：
文献类型：
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作者：
Oaklander, AL
慢性神经病理性疼痛的机制还不清楚。带状疱疹后神经痛（PHN），发生在一些患者带状疱疹后（疱疹测试仪），被用来调查慢性疼痛的神经决定因素。在躯干带状疱疹愈合后至少3个月，从38名患有或不患有PHN的成人中获得皮肤活检。垂直切片进行免疫标记对PGP9.5，一个泛轴突标记，以测量密度的皮肤中剩余的神经末梢以前受到带状疱疹。所有终止于表皮的轴突都是伤害感受器，即传递疼痛信息的神经元。神经突起密度范围在2 - 3976个/mm（2）皮肤表面之间，但受试者和无PHN者之间的重叠很小。在19名没有PHN的受试者中，17名的皮肤表面积超过670个神经突/mm 2（平均值+/- SEM = 1569 +/- 230），19名PHN受试者中有18名的神经突/mm 2或更少（平均值+/- SEM = 367 +/- 92）。PHN可能是一种与伤害性感受器丧失相关的“幻皮肤”疼痛。在先前使用汇总统计的研究中未检测到约650个神经突/mm（2）皮肤表面的阈值。这意味着带状疱疹后疼痛的消失可能需要保留最小密度的初级伤害性神经元。并且表皮神经支配的密度可以提供PHN疼痛存在或不存在的客观相关性。(C)2001年国际疼痛研究协会。由Elsevier Science B. V.出版，版权所有。
The mechanisms of chronic neuropathic pain are not well understood. Postherpetic neuralgia (PHN), which occurs in some patients after shingles (herpes tester), was used to investigate the neural determinants of chronic pain. Skin biopsies were obtained from 38 adults with or without PHN at least 3 months after healing of shingles on the torso. Vertical sections were immunolabeled against PGP9.5, a pan-axonal marker, to measure the density of remaining nerve endings in skin previously affected by shingles. All axons that end in the epidermis are nociceptors, neurons that transmit pain messages. The densities ranged between 2 and 3976 neurites/mm(2) skin surface, but the overlap between subjects and without PHN was small. Of 19 subjects without PHN, 17 had more than 670 neurites/mm(2) skin surface area (mean +/- SEM = 1569 +/- 230), and 18 of 19 subjects with PHN had 640 or fewer neurites/mm(2) (mean +/- SEM = 367 +/- 92). PHN may be a 'phantom-skin' pain associated with loss of nociceptors. This threshold of approximately 650 neurites/mm(2) skin surface was not detected in previous studies that used summary statistics. It implies that the absence of pain after shingles may require the preservation of a minimum density of primary nociceptive neurons. and that the density of epidermal innervation may provide an objective correlate for the presence or absence of PHN pain. (C) 2001 International Association for the Study of Pain. Published by Elsevier Science B.V. All rights reserved.