Nευροανοσολογική και ιολογική μελέτη ασθενών με αυτοάνοσες συστηματικές και πρωτογενείς παθήσεις του νευρικού συστήματος σε βιοψίες δέρματος και μορφομετρία των νευρικών απολήξεων

Doctoral Dissertation uoadl:1305576 733 Read counter

Unit:
Τομέας Κλινικοεργαστηριακός
Library of the School of Health Sciences
Deposit date:
2015-06-12
Year:
2015
Author:
Κοσμίδης Μιχάλης
Dissertation committee:
Mαρίνος Δαλάκας, Αθανάσιος Τζιούφας, Παναγιώτης Βλαχογιαννόπουλος
Original Title:
Nευροανοσολογική και ιολογική μελέτη ασθενών με αυτοάνοσες συστηματικές και πρωτογενείς παθήσεις του νευρικού συστήματος σε βιοψίες δέρματος και μορφομετρία των νευρικών απολήξεων
Languages:
Greek
Summary:
Our initial aim was to find a possible relevance of a highly neurotropic virus
such asJC in the pathogenesis of primary central nervous system (CNS)
autoimmune disorders and systemic autoimmune disorders that affect the
CNS.Because the results were negative we were prompted to pay attention to the
skin as a source for JCV and examine nerve fiber density. Because pain can be
associated with viral infections, and the skin is an immunologically active
organ, with antigen-presenting cells, our attention was shifted to Fibromyalgia
(FM) a common problem of unknown origin, possibly implicated to viral
infections. Accordingly the Intraepidermal Nerve Fiber density (IENFD) in FM
was explored as well as possible relevant immunological pathomechanisms.
FMisoneofthemostcommonchronicpainsyndromes.Variouspathogeneticmechanismshavebeen
implicatedbutnoneisproven.OurscopewastodetermineifIntraepidermalNerveFiberDensit
y(IENFD)isreducedin theskinofFMpatients, asobservedinpatientswithpainful
smallbersensoryneuropathy(SFSN).

Design,settingandparticipants:Weprospectively studied
46FM patients(5menand 41
women)aged29to76(mean:52.5)years,diagnosedaccordingtotheACR2010criteria,and34con
trols(18womenand16men)aged19to84(mean:31.7)years.IENFDwasmeasuredusingpublishedg
uidelinesandimmunemarkersweresoughtimmunocytochemically.
In30FMpatients,painintensitywasassessedwiththeNeuropathicPainSymptomInventory(NP
SI),a scale validatedfor neuropathicpain.

Results:15of46(32.6%)FMpatientshadreducedIENFD[range:0.6–12.5bers/mm(mean:
4.83SD:2.5)],compared to healthy controls[2.8–11.5bers/mm(mean:7.35, SD:1.85)]
(p<0.0001). NosignicantcorrelationwasnoticedbetweenNPSIscoresandIENFD.
NodifferenceintheLangerhanscells,themajorAntigenPresentingCells(APCs)intheepider
mis,orinIL6staining,wasnotedbetweenFMandcontrols.IENFDwasequallyreducedina
subsetofFMpatientswhoalsohad anotherautoimmunedisease.
Keywords:
Fibromyalgia, Pain, Neuropathy, Skin, Mechanisms
Index:
No
Number of index pages:
0
Contains images:
Yes
Number of references:
260
Number of pages:
127

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