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Skin Biopsy Findings in Patients With CMT1A: Baseline Data From the CLN-PXT3003-01 Study Provide New Insights Into the Pathophysiology of the Disorder
Abstract Charcot-Marie-Tooth disease type 1A (CMT1A), the most common form of Charcot-Marie-Tooth diseases, is a demyelinating neuropathy caused by a deletion encompassing the gene coding for PMP22, a myelin protein of the peripheral nervous system. Although myelinated fibers are mostly involved in...
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Published in: | Journal of neuropathology and experimental neurology 2018-04, Vol.77 (4), p.274-281 |
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creator | Duchesne, Mathilde Danigo, Aurore Richard, Laurence Vallat, Jean-Michel Attarian, Shahram Gonnaud, Pierre-Marie Lacour, Arnaud Péréon, Yann Stojkovic, Tania Nave, Klaus-Armin Bertrand, Viviane Nabirotchkin, Serguei Cohen, Daniel Demiot, Claire Magy, Laurent |
description | Abstract
Charcot-Marie-Tooth disease type 1A (CMT1A), the most common form of Charcot-Marie-Tooth diseases, is a demyelinating neuropathy caused by a deletion encompassing the gene coding for PMP22, a myelin protein of the peripheral nervous system. Although myelinated fibers are mostly involved in CMT1A, some patients experience neuropathic pain. We thus investigated whether unmyelinated fibers are lost in CMT1A. Skin biopsies were taken from the distal portion of the leg of 80 patients with CMT1A as part of the PXT30003-01 study and processed for quantification of intraepidermal nerve fiber density (IENFD). Mean IENFD was significantly lower in CMT1A patients than in healthy controls. Although the data were highly dispersed, IENFD tended to decrease with age and was higher overall in female patients and controls than male patients and controls. This study shows that small nerve fibers are affected in CMT1A and that this correlates with pin sensitivity. The density of epidermal Langerhans cells (LCs) was also significantly reduced in CMT1A patients, suggesting the involvement of LCs in neuropathic pain processes. These findings raise several questions concerning the interactions of Schwann cells and LCs with unmyelinated fibers in CMT1A. Moreover, they suggest that factors other than PMP22 gene dosage are involved in small fiber pathology in CMT1A. |
doi_str_mv | 10.1093/jnen/nly001 |
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Charcot-Marie-Tooth disease type 1A (CMT1A), the most common form of Charcot-Marie-Tooth diseases, is a demyelinating neuropathy caused by a deletion encompassing the gene coding for PMP22, a myelin protein of the peripheral nervous system. Although myelinated fibers are mostly involved in CMT1A, some patients experience neuropathic pain. We thus investigated whether unmyelinated fibers are lost in CMT1A. Skin biopsies were taken from the distal portion of the leg of 80 patients with CMT1A as part of the PXT30003-01 study and processed for quantification of intraepidermal nerve fiber density (IENFD). Mean IENFD was significantly lower in CMT1A patients than in healthy controls. Although the data were highly dispersed, IENFD tended to decrease with age and was higher overall in female patients and controls than male patients and controls. This study shows that small nerve fibers are affected in CMT1A and that this correlates with pin sensitivity. The density of epidermal Langerhans cells (LCs) was also significantly reduced in CMT1A patients, suggesting the involvement of LCs in neuropathic pain processes. These findings raise several questions concerning the interactions of Schwann cells and LCs with unmyelinated fibers in CMT1A. Moreover, they suggest that factors other than PMP22 gene dosage are involved in small fiber pathology in CMT1A.</description><identifier>ISSN: 0022-3069</identifier><identifier>EISSN: 1554-6578</identifier><identifier>DOI: 10.1093/jnen/nly001</identifier><identifier>PMID: 29408953</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Adult ; Anopheles ; Biopsy ; Charcot-Marie-Tooth disease ; Charcot-Marie-Tooth Disease - genetics ; Charcot-Marie-Tooth Disease - pathology ; Charcot-Marie-Tooth Disease - physiopathology ; Epstein-Barr virus ; Female ; Genes ; Humans ; Male ; Medical research ; Middle Aged ; Myelin Proteins - genetics ; Myelin Proteins - metabolism ; Myelin Sheath - metabolism ; Myelin Sheath - pathology ; Nerve Fibers - pathology ; Nerve Fibers - physiology ; Neural Conduction - physiology ; Severity of Illness Index ; Skin ; Skin - pathology ; Visual Analog Scale</subject><ispartof>Journal of neuropathology and experimental neurology, 2018-04, Vol.77 (4), p.274-281</ispartof><rights>2018 American Association of Neuropathologists, Inc. All rights reserved. 2018</rights><rights>2018 by American Association of Neuropathologists, Inc.</rights><rights>COPYRIGHT 2018 Oxford University Press</rights><rights>Copyright © 2018 American Association of Neuropathologists</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5371-f7a668effc094c0f5c8a1a960814f4f75baade869b83bac990f5de2f755d0df73</citedby><cites>FETCH-LOGICAL-c5371-f7a668effc094c0f5c8a1a960814f4f75baade869b83bac990f5de2f755d0df73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29408953$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Duchesne, Mathilde</creatorcontrib><creatorcontrib>Danigo, Aurore</creatorcontrib><creatorcontrib>Richard, Laurence</creatorcontrib><creatorcontrib>Vallat, Jean-Michel</creatorcontrib><creatorcontrib>Attarian, Shahram</creatorcontrib><creatorcontrib>Gonnaud, Pierre-Marie</creatorcontrib><creatorcontrib>Lacour, Arnaud</creatorcontrib><creatorcontrib>Péréon, Yann</creatorcontrib><creatorcontrib>Stojkovic, Tania</creatorcontrib><creatorcontrib>Nave, Klaus-Armin</creatorcontrib><creatorcontrib>Bertrand, Viviane</creatorcontrib><creatorcontrib>Nabirotchkin, Serguei</creatorcontrib><creatorcontrib>Cohen, Daniel</creatorcontrib><creatorcontrib>Demiot, Claire</creatorcontrib><creatorcontrib>Magy, Laurent</creatorcontrib><title>Skin Biopsy Findings in Patients With CMT1A: Baseline Data From the CLN-PXT3003-01 Study Provide New Insights Into the Pathophysiology of the Disorder</title><title>Journal of neuropathology and experimental neurology</title><addtitle>J Neuropathol Exp Neurol</addtitle><description>Abstract
Charcot-Marie-Tooth disease type 1A (CMT1A), the most common form of Charcot-Marie-Tooth diseases, is a demyelinating neuropathy caused by a deletion encompassing the gene coding for PMP22, a myelin protein of the peripheral nervous system. Although myelinated fibers are mostly involved in CMT1A, some patients experience neuropathic pain. We thus investigated whether unmyelinated fibers are lost in CMT1A. Skin biopsies were taken from the distal portion of the leg of 80 patients with CMT1A as part of the PXT30003-01 study and processed for quantification of intraepidermal nerve fiber density (IENFD). Mean IENFD was significantly lower in CMT1A patients than in healthy controls. Although the data were highly dispersed, IENFD tended to decrease with age and was higher overall in female patients and controls than male patients and controls. This study shows that small nerve fibers are affected in CMT1A and that this correlates with pin sensitivity. The density of epidermal Langerhans cells (LCs) was also significantly reduced in CMT1A patients, suggesting the involvement of LCs in neuropathic pain processes. These findings raise several questions concerning the interactions of Schwann cells and LCs with unmyelinated fibers in CMT1A. Moreover, they suggest that factors other than PMP22 gene dosage are involved in small fiber pathology in CMT1A.</description><subject>Adult</subject><subject>Anopheles</subject><subject>Biopsy</subject><subject>Charcot-Marie-Tooth disease</subject><subject>Charcot-Marie-Tooth Disease - genetics</subject><subject>Charcot-Marie-Tooth Disease - pathology</subject><subject>Charcot-Marie-Tooth Disease - physiopathology</subject><subject>Epstein-Barr virus</subject><subject>Female</subject><subject>Genes</subject><subject>Humans</subject><subject>Male</subject><subject>Medical research</subject><subject>Middle Aged</subject><subject>Myelin Proteins - genetics</subject><subject>Myelin Proteins - metabolism</subject><subject>Myelin Sheath - metabolism</subject><subject>Myelin Sheath - pathology</subject><subject>Nerve Fibers - pathology</subject><subject>Nerve Fibers - physiology</subject><subject>Neural Conduction - physiology</subject><subject>Severity of Illness Index</subject><subject>Skin</subject><subject>Skin - pathology</subject><subject>Visual Analog Scale</subject><issn>0022-3069</issn><issn>1554-6578</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp9klFv0zAUhSMEYmXwxDuyhISQUNbrJE7ivXUdhUplVFoRvEVuct24S-1iJ1T5I_xenHWAQDD5wfLxd869lm8QPKdwRoHH461GPdZND0AfBCPKWBKmLMsfBiOAKApjSPlJ8MS5LQBw4Mnj4CTiCeScxaPg-_WN0uRCmb3ryUzpSumNI15ailahbh35rNqaTD-s6OScXAiHjdJILkUryMyaHWlrJNPFVbj8sooB4hAouW67qidLa76pCskVHshcO7Wpfdhct-bW4uNrs697p0xjNj0x8la-VM7YCu3T4JEUjcNnd_tp8Gn2djV9Hy4-vptPJ4uwZHFGQ5mJNM1RytK_qwTJylxQwVPIaSITmbG1EBXmKV_n8VqUnHukwshfsAoqmcWnwetj7t6arx26ttgpV2LTCI2mcwXlnFOeMkg9-vIvdGs6q313RQQRzVgcMfab2ogGC6Wlaa0oh9BiwvIUohSSoezZPyi_Ktyp0miUyut_GN4cDaU1zlmUxd6qnbB9QaEYpqAYpqA4ToGnX9y12q13WP1if367B8ZH4GCaFq27aboD2qJG0bT1fyKTexx-soBBFoUR0BwSfwoHaSj06mgz3f7eln8AGRHZLw</recordid><startdate>201804</startdate><enddate>201804</enddate><creator>Duchesne, Mathilde</creator><creator>Danigo, Aurore</creator><creator>Richard, Laurence</creator><creator>Vallat, Jean-Michel</creator><creator>Attarian, Shahram</creator><creator>Gonnaud, Pierre-Marie</creator><creator>Lacour, Arnaud</creator><creator>Péréon, Yann</creator><creator>Stojkovic, Tania</creator><creator>Nave, Klaus-Armin</creator><creator>Bertrand, Viviane</creator><creator>Nabirotchkin, Serguei</creator><creator>Cohen, Daniel</creator><creator>Demiot, Claire</creator><creator>Magy, Laurent</creator><general>Oxford University Press</general><general>by American Association of Neuropathologists, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>201804</creationdate><title>Skin Biopsy Findings in Patients With CMT1A: Baseline Data From the CLN-PXT3003-01 Study Provide New Insights Into the Pathophysiology of the Disorder</title><author>Duchesne, Mathilde ; Danigo, Aurore ; Richard, Laurence ; Vallat, Jean-Michel ; Attarian, Shahram ; Gonnaud, Pierre-Marie ; Lacour, Arnaud ; Péréon, Yann ; Stojkovic, Tania ; Nave, Klaus-Armin ; Bertrand, Viviane ; Nabirotchkin, Serguei ; Cohen, Daniel ; Demiot, Claire ; Magy, Laurent</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5371-f7a668effc094c0f5c8a1a960814f4f75baade869b83bac990f5de2f755d0df73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Anopheles</topic><topic>Biopsy</topic><topic>Charcot-Marie-Tooth disease</topic><topic>Charcot-Marie-Tooth Disease - genetics</topic><topic>Charcot-Marie-Tooth Disease - pathology</topic><topic>Charcot-Marie-Tooth Disease - physiopathology</topic><topic>Epstein-Barr virus</topic><topic>Female</topic><topic>Genes</topic><topic>Humans</topic><topic>Male</topic><topic>Medical research</topic><topic>Middle Aged</topic><topic>Myelin Proteins - genetics</topic><topic>Myelin Proteins - metabolism</topic><topic>Myelin Sheath - metabolism</topic><topic>Myelin Sheath - pathology</topic><topic>Nerve Fibers - pathology</topic><topic>Nerve Fibers - physiology</topic><topic>Neural Conduction - physiology</topic><topic>Severity of Illness Index</topic><topic>Skin</topic><topic>Skin - pathology</topic><topic>Visual Analog Scale</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Duchesne, Mathilde</creatorcontrib><creatorcontrib>Danigo, Aurore</creatorcontrib><creatorcontrib>Richard, Laurence</creatorcontrib><creatorcontrib>Vallat, Jean-Michel</creatorcontrib><creatorcontrib>Attarian, Shahram</creatorcontrib><creatorcontrib>Gonnaud, Pierre-Marie</creatorcontrib><creatorcontrib>Lacour, Arnaud</creatorcontrib><creatorcontrib>Péréon, Yann</creatorcontrib><creatorcontrib>Stojkovic, Tania</creatorcontrib><creatorcontrib>Nave, Klaus-Armin</creatorcontrib><creatorcontrib>Bertrand, Viviane</creatorcontrib><creatorcontrib>Nabirotchkin, Serguei</creatorcontrib><creatorcontrib>Cohen, Daniel</creatorcontrib><creatorcontrib>Demiot, Claire</creatorcontrib><creatorcontrib>Magy, Laurent</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest_Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest Science Journals</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of neuropathology and experimental neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Duchesne, Mathilde</au><au>Danigo, Aurore</au><au>Richard, Laurence</au><au>Vallat, Jean-Michel</au><au>Attarian, Shahram</au><au>Gonnaud, Pierre-Marie</au><au>Lacour, Arnaud</au><au>Péréon, Yann</au><au>Stojkovic, Tania</au><au>Nave, Klaus-Armin</au><au>Bertrand, Viviane</au><au>Nabirotchkin, Serguei</au><au>Cohen, Daniel</au><au>Demiot, Claire</au><au>Magy, Laurent</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Skin Biopsy Findings in Patients With CMT1A: Baseline Data From the CLN-PXT3003-01 Study Provide New Insights Into the Pathophysiology of the Disorder</atitle><jtitle>Journal of neuropathology and experimental neurology</jtitle><addtitle>J Neuropathol Exp Neurol</addtitle><date>2018-04</date><risdate>2018</risdate><volume>77</volume><issue>4</issue><spage>274</spage><epage>281</epage><pages>274-281</pages><issn>0022-3069</issn><eissn>1554-6578</eissn><abstract>Abstract
Charcot-Marie-Tooth disease type 1A (CMT1A), the most common form of Charcot-Marie-Tooth diseases, is a demyelinating neuropathy caused by a deletion encompassing the gene coding for PMP22, a myelin protein of the peripheral nervous system. Although myelinated fibers are mostly involved in CMT1A, some patients experience neuropathic pain. We thus investigated whether unmyelinated fibers are lost in CMT1A. Skin biopsies were taken from the distal portion of the leg of 80 patients with CMT1A as part of the PXT30003-01 study and processed for quantification of intraepidermal nerve fiber density (IENFD). Mean IENFD was significantly lower in CMT1A patients than in healthy controls. Although the data were highly dispersed, IENFD tended to decrease with age and was higher overall in female patients and controls than male patients and controls. This study shows that small nerve fibers are affected in CMT1A and that this correlates with pin sensitivity. The density of epidermal Langerhans cells (LCs) was also significantly reduced in CMT1A patients, suggesting the involvement of LCs in neuropathic pain processes. These findings raise several questions concerning the interactions of Schwann cells and LCs with unmyelinated fibers in CMT1A. Moreover, they suggest that factors other than PMP22 gene dosage are involved in small fiber pathology in CMT1A.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>29408953</pmid><doi>10.1093/jnen/nly001</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Adult Anopheles Biopsy Charcot-Marie-Tooth disease Charcot-Marie-Tooth Disease - genetics Charcot-Marie-Tooth Disease - pathology Charcot-Marie-Tooth Disease - physiopathology Epstein-Barr virus Female Genes Humans Male Medical research Middle Aged Myelin Proteins - genetics Myelin Proteins - metabolism Myelin Sheath - metabolism Myelin Sheath - pathology Nerve Fibers - pathology Nerve Fibers - physiology Neural Conduction - physiology Severity of Illness Index Skin Skin - pathology Visual Analog Scale |
title | Skin Biopsy Findings in Patients With CMT1A: Baseline Data From the CLN-PXT3003-01 Study Provide New Insights Into the Pathophysiology of the Disorder |
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