HIV neuropathy: an in vivo confocal microscopic study.
HIV neuropathy: an in vivo confocal microscopic study.
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DOI：
10.1007/s13365-012-0130-1
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发表时间：
2012-12
影响因子：
3.2
通讯作者：
Herrmann, David N.
中科院分区：
文献类型：
--
作者：
Almodovar, Jorge L.;Schifitto, Giovanni;McDermott, Michael P.;Ferguson, Michele;Herrmann, David N.
关键词：
有几种方法可用于定量评估人类免疫缺陷病毒(HIV)相关的远端感觉性多发性神经病(DSP)。虽然很有用，但每种方法都有一些限制。这项研究评估了无创性的体内反射共聚焦显微镜(RCM)作为HIV-DSP的一种测量方法。对48例成人(29例HIV感染者，19例对照)的足弓、指尖和大鱼际隆起(TE)进行MC密度(Mcs/mm2)的RCM检查、踝部皮肤活检以测量表皮神经纤维密度(ENFD)、电生理检查、触觉、振动和热阈值测试。HIV阳性的受试者在临床上分为有DSP体征和无体征两组。有数字信号的HIV+受试者MC密度低于对照组(ARCH，p=0.0003；指尖，p<；0.0001；TE，p=0.0002)。HIV-DSP组的TE和足部的触觉阈值比对照组差，但在这个轻度的DSP队列中，腓肠肌振幅、ENFD以及振动和温度阈值与对照组没有显著差异。没有DSP征象的HIV+受试者的指尖MC密度和足部触觉阈值也低于对照组。没有DSP体征的HIV+受试者的其他感觉指标与对照组没有显著差异。MC密度与每个成像位置的触觉阈值呈负相关。结果表明，MC密度的RCM补充了现有的感觉DSP测量，并在腓肠肌振幅不能区分轻度HIV-DSP和对照的阶段。需要进一步的研究来确定MC密度的RCM是否可以建立DSP的量化变化，以响应治疗或疾病进展。
Several approaches exist for quantitative assessment of human immunodeficiency virus (HIV) associated distal sensory polyneuropathy (DSP). While useful, each has some limitations. This study evaluated non-invasive, in vivo reflectance confocal microscopy (RCM) of Meissner Corpuscles (MCs) as a measure of HIV-DSP. Forty-eight adults (29 HIV-infected, 19 controls) underwent RCM of MC density (MCs/mm2) at the arch, fingertip and thenar eminence (TE), ankle skin biopsy to measure epidermal nerve fiber density (ENFD), electrophysiologic studies, and tactile, vibration and thermal threshold testing. HIV+ subjects were clinically categorized as having DSP signs or no signs. MC densities were lower in HIV+ subjects with DSP signs than in controls (arch, p = 0.0003; fingertip, p < 0.0001; TE, p = 0.0002). Tactile thresholds in the TE and foot were worse in HIV-DSP than in controls, but in this mild DSP cohort, sural amplitudes, ENFD and vibration and thermal thresholds didn't differ significantly from controls. Fingertip MC densities and tactile thresholds at the foot were also lower in HIV+ subjects without DSP signs than in controls. Other sensory measures were not significantly different in HIV+ subjects without DSP signs than in controls. MC density correlated inversely with tactile thresholds at each imaging location. The results suggest that RCM of MC density complements existing sensory DSP measures and discriminates mild HIV-DSP from controls at a stage when sural amplitudes do not. Further studies are required to determine whether RCM of MC density can establish quantitative changes in DSP, in response to treatment or disease progression.
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影响因子：
3.8
作者：
Almodovar, Jorge L.;Ferguson, Michele;Herrmann, David N.
通讯作者：
Herrmann, David N.
影响因子：
--
作者：
SO, YT;HOLTZMAN, DM;OLNEY, RK
通讯作者：
OLNEY, RK
影响因子：
9.9
作者：
DYCK, PJ;ZIMMERMAN, I;OBRIEN, PC
通讯作者：
OBRIEN, PC
影响因子：
9.9
作者：
Simpson, D. M.;Kitch, D.;Clifford, D. B.
通讯作者：
Clifford, D. B.
影响因子：
9.9
作者：
Shy, ME;Frohman, EM;Weimer, LH
通讯作者：
Weimer, LH