| Increased Langerhan cell density and corneal nerve damage in diabetic patients: role of immune mechanisms in human diabetic neuropathy. | |
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MedLine Citation:
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PMID: 20851037 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIM/HYPOTHESIS: Immune mechanisms have been proposed to play a role in the development of diabetic neuropathy. We employed in vivo corneal confocal microscopy (CCM) to quantify the presence and density of Langerhans cells (LCs) in relation to the extent of corneal nerve damage in Bowman's layer of the cornea in diabetic patients. METHODS: 128 diabetic patients aged 58 ± 1 yrs with a differing severity of neuropathy based on Neuropathy Deficit Score (NDS-4.7 ± 0.28) and 26 control subjects aged 53 ± 3 yrs were examined. Subjects underwent a full neurological evaluation, evaluation of corneal sensation with non-contact corneal aesthesiometry (NCCA) and corneal nerve morphology using corneal confocal microscopy (CCM). RESULTS: The proportion of individuals with LCs was significantly increased in diabetic patients (73.8%) compared to control subjects (46.1%), P = 0.001. Furthermore, LC density (no/mm(2)) was significantly increased in diabetic patients (17.73 ± 1.45) compared to control subjects (6.94 ± 1.58), P = 0.001 and there was a significant correlation with age (r = 0.162, P = 0.047) and severity of neuropathy (r = -0.202, P = 0.02). There was a progressive decrease in corneal sensation with increasing severity of neuropathy assessed using NDS in the diabetic patients (r = 0.414, P = 0.000). Corneal nerve fibre density (P < 0.001), branch density (P < 0.001) and length (P < 0.001) were significantly decreased whilst tortuosity (P < 0.01) was increased in diabetic patients with increasing severity of diabetic neuropathy. CONCLUSION: Utilising in vivo corneal confocal microscopy we have demonstrated increased LCs in diabetic patients particularly in the earlier phases of corneal nerve damage suggestive of an immune mediated contribution to corneal nerve damage in diabetes. |
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Authors:
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M Tavakoli; A J M Boulton; N Efron; R A Malik |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2010-09-20 |
Journal Detail:
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Title: Contact lens & anterior eye : the journal of the British Contact Lens Association Volume: 34 ISSN: 1476-5411 ISO Abbreviation: Cont Lens Anterior Eye Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-01-18 Completed Date: 2011-05-17 Revised Date: 2012-02-02 |
Medline Journal Info:
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Nlm Unique ID: 9712714 Medline TA: Cont Lens Anterior Eye Country: England |
Other Details:
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Languages: eng Pagination: 7-11 Citation Subset: IM |
Copyright Information:
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Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved. |
Affiliation:
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Division of Cardiovascular Medicine, University of Manchester and Manchester Royal Infirmary, Manchester, M13 9NT, UK. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cell Count Cornea / immunology*, innervation*, pathology Diabetic Neuropathies / immunology*, pathology* Female Humans Langerhans Cells / immunology*, pathology* Male Middle Aged |
| Grant Support | |
ID/Acronym/Agency:
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1 R01 NS46259-01/NS/NINDS NIH HHS; R01 NS046259-01/NS/NINDS NIH HHS |
| Comments/Corrections | |
Comment In:
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Cont Lens Anterior Eye. 2011 Apr;34(2):98; author reply 99
[PMID:
21215678
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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