The effect of age and gender on epidermal nerve fiber density
The effect of age and gender on epidermal nerve fiber density
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DOI：
10.1212/01.wnl.0000113732.41127.8f
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发表时间：
2004-03-09
期刊：
影响因子：
9.9
通讯作者：
Omdal, R
中科院分区：
文献类型：
--
作者：
Goransson, LG;Mellgren, SI;Omdal, R
目的：感觉神经病变常累及小直径有髓鞘和无髓鞘神经纤维，除非累及较大的神经纤维，否则神经学和电生理表现可能正常。使用panaxonal标记抗蛋白基因产物9.5 (PGP 9.5)，免疫组织化学技术可以可视化小的表皮神经纤维（ENFs）。利用这项技术，作者建立了一个健康白人ENF的参考范围，并评估了该方法的可靠性。方法：对106例健康志愿者（平均年龄49.0±19.6岁）的小腿远端进行了两次直径为3mm的穿刺活检。冰冻50微米厚的切片用兔抗人PGP 9.5的多克隆抗体孵育。ENF/mm数作为6个切片（两次活检各取3个切片）计数的平均值。结果：ENFs平均数目为12.4±4.6 mm。在多元回归模型中，ENF的密度与年龄和性别有关（Y = 13.92 + 2.25（性别）- 0.06 x年龄）。观察者内分析的ENF平均差异为0.2 +/- 1.2 ENF/mm，观察者间分析的ENF平均差异为0.4 +/- 1.5纤维/mm。结论：建立了参考人群表皮神经纤维密度的正常均值和范围。表皮神经纤维的密度随着年龄的增长而下降，男性比女性低。观察者内部和观察者之间的分析证明了该方法的可靠性。
Objective: Sensory neuropathies often involve small-diameter myelinated and unmyelinated nerve fibers, and neurologic and electrophysiologic findings may be normal unless larger nerve fibers are involved. The small ( intra) epidermal nerve fibers (ENFs) now can be visualized with immunohistochemical techniques using the panaxonal marker anti-protein gene product 9.5 (PGP 9.5). Using this technique, the authors have established a reference range for ENF in a healthy white population and evaluated the reliability of the method. Methods: Two punch biopsies, 3 mm in diameter, were taken from the distal part of the leg in 106 healthy volunteers ( mean age, 49.0 +/- 19.6 years). Fifty-micrometer frozen thick sections were incubated with rabbit polyclonal antibodies to human PGP 9.5. The number of ENF/mm then was reported as the mean of counts in six sections ( three sections from each of the two biopsies). Results: The mean number of ENFs was 12.4 +/- 4.6 mm. In a multiple regression model, the density of ENF depended on age and gender (Y = 13.92 + 2.25 ( gender) - 0.06 x age). The mean difference in ENF by intraobserver analysis was 0.2 +/- 1.2 ENF/mm, and by interobserver analysis, it was 0.4 +/- 1.5 fibers/mm. Conclusion: Normal means and ranges for the density of epidermal nerve fibers in a reference population have been established. The density of epidermal nerve fibers decreases with age and is lower in men compared with women. Intraobserver and interobserver analysis proves the reliability of the method.