Tissue-Clearing Technique and Cutaneous Nerve Biopsies: Quantification of the Intraepidermal Nerve-Fiber Density Using Active Clarity Technique-Pressure Related Efficient and Stable Transfer of Macromolecules Into Organs
Journal of Clinical Neurology
;
: 537-544, 2019.
Article
in English
| WPRIM
| ID: wpr-764362
ABSTRACT
BACKGROUND AND PURPOSE:
Cutaneous nerve biopsies based on two-dimensional analysis have been regarded as a creditable assessment tool for diagnosing peripheral neuropathies. However, advancements in methodological imaging are required for the analysis of intact structures of peripheral nerve fibers. A tissue-clearing and labeling technique facilitates three-dimensional imaging of internal structures in unsectioned, whole biological tissues without excessive time or labor costs. We sought to establish whether a tissue-clearing and labeling technique could be used for the diagnostic evaluation of peripheral neuropathies.METHODS:
Five healthy individuals and four patients with small-fiber neuropathy (SFN) and postherpetic neuralgia (PHN) were prospectively enrolled. The conventional methods of indirect immunofluorescence (IF) and bright-field immunohistochemistry (IHC) were adopted in addition to the tissue-clearing and labeling method called active clarity technique-pressure related efficient and stable transfer of macromolecules into organs (ACT-PRESTO) to quantify the intraepidermal nerve-fiber density (IENFD).RESULTS:
The mean IENFD values obtained by IF, bright-field IHC, and ACT-PRESTO in the healthy control group were 6.54, 6.44, and 90.19 fibers/mm², respectively; the corresponding values in the patients with SFN were 1.99, 2.32, and 48.12 fibers/mm², respectively, and 3.06, 2.87, and 47.21 fibers/mm², respectively, in the patients with PHN.CONCLUSIONS:
This study has shown that a tissue-clearing method provided not only rapid and highly reproducible three-dimensional images of cutaneous nerve fibers but also yielded reliable quantitative IENFD data. Quantification of the IENFD using a tissue-clearing and labeling technique is a promising way to improve conventional cutaneous nerve biopsies.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Peripheral Nerves
/
Biopsy
/
Immunohistochemistry
/
Prospective Studies
/
Peripheral Nervous System Diseases
/
Fluorescent Antibody Technique, Indirect
/
Imaging, Three-Dimensional
/
Neuralgia, Postherpetic
/
Methods
/
Nerve Fibers
Type of study:
Observational study
Limits:
Humans
Language:
English
Journal:
Journal of Clinical Neurology
Year:
2019
Type:
Article
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