Abnormal intraepidermal nerve fiber density in disease: A scoping review

BackgroundIntraepidermal nerve fiber density (IENFD) has become an important biomarker for neuropathy diagnosis and research. The consequences of reduced IENFD can include sensory dysfunction, pain, and a significant decrease in quality of life. We examined the extent to which IENFD is being used as...

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Main Authors: Sarah Thomas, Jonathan Enders, Andrew Kaiser, Luke Rovenstine, Lana Heslop, Will Hauser, Andrea Chadwick, Douglas Wright
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-04-01
Series:Frontiers in Neurology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2023.1161077/full
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author Sarah Thomas
Jonathan Enders
Andrew Kaiser
Luke Rovenstine
Lana Heslop
Will Hauser
Andrea Chadwick
Douglas Wright
author_facet Sarah Thomas
Jonathan Enders
Andrew Kaiser
Luke Rovenstine
Lana Heslop
Will Hauser
Andrea Chadwick
Douglas Wright
author_sort Sarah Thomas
collection DOAJ
description BackgroundIntraepidermal nerve fiber density (IENFD) has become an important biomarker for neuropathy diagnosis and research. The consequences of reduced IENFD can include sensory dysfunction, pain, and a significant decrease in quality of life. We examined the extent to which IENFD is being used as a tool in human and mouse models and compared the degree of fiber loss between diseases to gain a broader understanding of the existing data collected using this common technique.MethodsWe conducted a scoping review of publications that used IENFD as a biomarker in human and non-human research. PubMed was used to identify 1,004 initial articles that were then screened to select articles that met the criteria for inclusion. Criteria were chosen to standardize publications so they could be compared rigorously and included having a control group, measuring IENFD in a distal limb, and using protein gene product 9.5 (PGP9.5).ResultsWe analyzed 397 articles and collected information related to publication year, the condition studied, and the percent IENFD loss. The analysis revealed that the use of IENFD as a tool has been increasing in both human and non-human research. We found that IENFD loss is prevalent in many diseases, and metabolic or diabetes-related diseases were the most studied conditions in humans and rodents. Our analysis identified 73 human diseases in which IENFD was affected, with 71 reporting IENFD loss and an overall average IENFD change of −47%. We identified 28 mouse and 21 rat conditions, with average IENFD changes of −31.6% and −34.7%, respectively. Additionally, we present data describing sub-analyses of IENFD loss according to disease characteristics in diabetes and chemotherapy treatments in humans and rodents.InterpretationReduced IENFD occurs in a surprising number of human disease conditions. Abnormal IENFD contributes to important complications, including poor cutaneous vascularization, sensory dysfunction, and pain. Our analysis informs future rodent studies so they may better mirror human diseases impacted by reduced IENFD, highlights the breadth of diseases impacted by IENFD loss, and urges exploration of common mechanisms that lead to substantial IENFD loss as a complication in disease.
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spelling doaj.art-3336c914bfb14e969efde89362c065f42023-04-20T06:00:23ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-04-011410.3389/fneur.2023.11610771161077Abnormal intraepidermal nerve fiber density in disease: A scoping reviewSarah ThomasJonathan EndersAndrew KaiserLuke RovenstineLana HeslopWill HauserAndrea ChadwickDouglas WrightBackgroundIntraepidermal nerve fiber density (IENFD) has become an important biomarker for neuropathy diagnosis and research. The consequences of reduced IENFD can include sensory dysfunction, pain, and a significant decrease in quality of life. We examined the extent to which IENFD is being used as a tool in human and mouse models and compared the degree of fiber loss between diseases to gain a broader understanding of the existing data collected using this common technique.MethodsWe conducted a scoping review of publications that used IENFD as a biomarker in human and non-human research. PubMed was used to identify 1,004 initial articles that were then screened to select articles that met the criteria for inclusion. Criteria were chosen to standardize publications so they could be compared rigorously and included having a control group, measuring IENFD in a distal limb, and using protein gene product 9.5 (PGP9.5).ResultsWe analyzed 397 articles and collected information related to publication year, the condition studied, and the percent IENFD loss. The analysis revealed that the use of IENFD as a tool has been increasing in both human and non-human research. We found that IENFD loss is prevalent in many diseases, and metabolic or diabetes-related diseases were the most studied conditions in humans and rodents. Our analysis identified 73 human diseases in which IENFD was affected, with 71 reporting IENFD loss and an overall average IENFD change of −47%. We identified 28 mouse and 21 rat conditions, with average IENFD changes of −31.6% and −34.7%, respectively. Additionally, we present data describing sub-analyses of IENFD loss according to disease characteristics in diabetes and chemotherapy treatments in humans and rodents.InterpretationReduced IENFD occurs in a surprising number of human disease conditions. Abnormal IENFD contributes to important complications, including poor cutaneous vascularization, sensory dysfunction, and pain. Our analysis informs future rodent studies so they may better mirror human diseases impacted by reduced IENFD, highlights the breadth of diseases impacted by IENFD loss, and urges exploration of common mechanisms that lead to substantial IENFD loss as a complication in disease.https://www.frontiersin.org/articles/10.3389/fneur.2023.1161077/fullepidermisaxonsensationpaindegenerationinnervation
spellingShingle Sarah Thomas
Jonathan Enders
Andrew Kaiser
Luke Rovenstine
Lana Heslop
Will Hauser
Andrea Chadwick
Douglas Wright
Abnormal intraepidermal nerve fiber density in disease: A scoping review
Frontiers in Neurology
epidermis
axon
sensation
pain
degeneration
innervation
title Abnormal intraepidermal nerve fiber density in disease: A scoping review
title_full Abnormal intraepidermal nerve fiber density in disease: A scoping review
title_fullStr Abnormal intraepidermal nerve fiber density in disease: A scoping review
title_full_unstemmed Abnormal intraepidermal nerve fiber density in disease: A scoping review
title_short Abnormal intraepidermal nerve fiber density in disease: A scoping review
title_sort abnormal intraepidermal nerve fiber density in disease a scoping review
topic epidermis
axon
sensation
pain
degeneration
innervation
url https://www.frontiersin.org/articles/10.3389/fneur.2023.1161077/full
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