Assessing corneal dendritic cells in glucose dysregulation small‐fibre neuropathy

• Published in: Journal of the peripheral nervous system 2024-12, Vol.29 (4), p.400-405
• Main Authors: Idiaquez, Juan Francisco, Barnett‐Tapia, Carolina, Perkins, Bruce A., Bril, Vera
• Format: Article
• Language: English
• Subjects: Adult; Aged; Cell density; Confocal microscopy; Cornea; Cornea - diagnostic imaging; Cornea - innervation; Cornea - pathology; corneal confocal microscopy; corneal dendritic cells; Dendritic Cells; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - complications; Diabetic Neuropathies - diagnosis; Diabetic Neuropathies - metabolism; Diabetic Neuropathies - pathology; Diabetic Neuropathies - physiopathology; Diabetic neuropathy; Female; Glucose Intolerance - metabolism; Glucose tolerance; Humans; Immunological tolerance; impaired glucose tolerance; Male; Microscopy, Confocal; Middle Aged; Neuropathy; Research Report; Small Fiber Neuropathy - diagnosis; Small Fiber Neuropathy - pathology; Small Fiber Neuropathy - physiopathology; small‐fibre neuropathy
• ISSN: 1085-9489; 1529-8027; 1529-8027
• DOI: 10.1111/jns.12671

Background and Aims Small‐fibre neuropathy (SFN) is associated with glucose dysregulation, including impaired glucose tolerance (IGT) and type 2 diabetes (T2D). Corneal confocal microscopy (CCM) offers a non‐invasive tool to assess corneal nerve damage and dendritic cell density (DCD). In this study, we investigated corneal DCD in patients with SFN and glucose dysregulation, defined as IGT or T2D. Methods We enrolled 38 patients with SFN + glucose dysregulation, 51 with SFN + non‐glucose dysregulation and 20 healthy controls. All participants underwent neurological examination, neurophysiology and CCM. Results Individuals with SFN and glucose dysregulation had higher DCD compared with healthy controls (p = .01), and mature DCD was higher in IGT SFN patients than in T2D patients. Interpretation Higher DCD in IGT compared with controls and patients with established T2D may suggest that DCD is a biomarker of early neuropathy.