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Published online March 10, 2008
Diabetes Care 31:1219-1221, 2008
DOI: 10.2337/dc07-1832
© 2008 by the American Diabetes Association
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Pathophysiology/Complications
Original Research

Rarefaction of the Peripheral Nerve Network in Diabetic Patients Is Associated With a Pronounced Reduction of Terminal Schwann Cells

Christina M. Reinisch, MD1, Hannes Traxler, MD2, Stefanie Piringer2, Stefan Tangl, MS3,4, Alexander Nader, MD5 and Erwin Tschachler, MD1,6

1 Department of Dermatology, Medical University of Vienna, Vienna, Austria
2 Center of Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
3 Department of Oral Surgery, Bernhard Gottlieb University Dental Clinic, Medical University of Vienna, Vienna, Austria
4 Austrian Cluster for Tissue Regeneration, Vienna, Austria
5 Institute of Pathology, Hanuschkrankenhaus, Vienna, Austria
6 Centre de Recherches et d'Investigations Épidermiques et Sensorielles (CE.R.I.E.S.), Neuilly, France

Corresponding author: Erwin Tschachler, MD, Department of Dermatology, University of Vienna Medical School, Waehringer Gürtel 18-20, A-1090 Vienna, Austria. E-mail: tschachler{at}meduniwien.ac.at

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).

RESEARCH DESIGN AND 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.

RESULTS AND 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.


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