Characterization of dermal skin innervation in fibromyalgia syndrome.

Dimitar Evdokimov,Johanna Frank,Nurcan Üçeyler,Claudia Sommer,Philine Dinkel

doi:10.1371/journal.pone.0227674

Dimitar Evdokimov, Johanna Frank + Show 3 more

Open Access

https://doi.org/10.1371/journal.pone.0227674

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Journal: PloS one	Publication Date: Jan 13, 2020
Citations: 13	License type: CC BY 4.0

Affiliation: University of Würzburg

Abstract

IntroductionWe characterized dermal innervation in patients with fibromyalgia syndrome (FMS) as potential contribution to small fiber pathology.MethodsSkin biopsies of the calf were collected (86 FMS patients, 35 healthy controls). Skin was immunoreacted with antibodies against protein gene product 9.5, calcitonine gene-related peptide, substance P, CD31, and neurofilament 200 for small fiber subtypes. We assessed two skin sections per patient; on each skin section, two dermal areas (150 x 700 μm each) were investigated for dermal nerve fiber length (DNFL).ResultsIn FMS patients we found reduced DNFL of fibers with vessel contact compared to healthy controls (p<0.05). There were no differences for the other nerve fiber subtypes.DiscussionWe found less dermal nerve fibers in contact with blood vessels in FMS patients than in controls. The pathophysiological relevance of this finding is unclear, but we suggest the possibility of a relationship with impaired thermal tolerance commonly reported by FMS patients.

Highlights

We characterized dermal innervation in patients with fibromyalgia syndrome (FMS) as potential contribution to small fiber pathology
The overall dermal nerve fiber length (DNFL) immunoreacted with PGP9.5 did not differ between patients with FMS and healthy controls, and not between FMS patients with normal and reduced distal intraepidermal nerve fiber density (IENFD)
Total length of dermal nerve fibers with contact to blood vessels was lower in skin of patients with FMS compared to healthy controls

Summary

Introduction

We characterized dermal innervation in patients with fibromyalgia syndrome (FMS) as potential contribution to small fiber pathology. A reduction of the intraepidermal nerve fiber density (IENFD) is one of the commonly reported findings [1,2,3,4], while dermal innervation apparently does not differ from healthy controls [4]. We investigated dermal nerve fiber composition of patients with fibromyalgia compared to healthy controls as potential contributor to small fiber pathology in FMS.

Results

Conclusion