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PubMed2004

Pathologic prion protein spreading in the peripheral nervous system of a patient with sporadic Creutzfeldt-Jakob disease.

BACKGROUND: Involvement of the peripheral nervous system in the pathogenesis of prion diseases is becoming increasingly evident. However, pathologic protease-resistant prion protein deposition in the peripheral nerves of patients with Creutzfeldt-Jakob disease has never been demonstrated, to our knowledge. OBJECTIVE: To determine whether mutated prion protein accumulation could be shown in the peripheral nervous system of patients with sporadic Creutzfeldt-Jakob disease. DESIGN: Autopsy study. PATIENTS: Three patients with sporadic Creutzfeldt-Jakob disease. INTERVENTIONS: Study of the brain, spinal cord, and sciatic and superficial peroneal nerves by immunohistochemistry and Western blot analysis. MAIN OUTCOME MEASURE: Demonstration of protease-resistant prion protein accumulation. RESULTS: In all cases, protease-resistant prion protein accumulation was found in the brain and posterior horns of the spinal cord. In 1 case, protease-resistant prion protein deposits were also evidenced in the dorsal root ganglia and the superficial peroneal nerve. CONCLUSIONS: Protease-resistant prion protein may be found in the peripheral nervous system of some patients with sporadic Creutzfeldt-Jakob disease. However, a larger series is required to assess the incidence of peripheral nervous system involvement and to discuss the diagnostic usefulness of peripheral nerve biopsy in sporadic Creutzfeldt-Jakob disease.

Aged↗
PubMed1990

Microenvironment of the peripheral nervous system under normal and pathological conditions.

The peripheral nervous system (PNS) is composed of neurons and their processes which are located in a special fluid microenvironment. As is well known, complex biological functions such as those going on in peripheral nerves are best carried out when there is homeostasis, i.e., in a constant internal milieu. This paper is concerned with the maintenance of the homeostasis in the PNS under normal and pathological conditions. Diffusion barriers located in the intrinsic vessels of the PNS and the perineurium have the capacity to regulate the environment around the nerve fibers and to keep it away from the blood and the extracellular fluid outside the PNS. Endoneurial vascular permeability has similarities to that in the central nervous system, but compared with the blood-brain barrier the blood-nerve barrier is less efficient. This implies that toxic and infectious agents as well as some drugs have easier access to the parenchyma in nerves than to the brain parenchyma. However, ganglionic vessels lack an efficient vascular barrier to many substances which is important in intoxications caused by, e.g., doxorubicin, lead, mercury, and cadmium. It has also a significance in herpes zoster infection and presumably in Guillain-Barré syndrome. The diffusion barriers may themselves be influenced by pathologic processes and can then respond with an increased permeability. This may lead to the formation of edema in the PNS, i.e., one of the cardinal features of many diseases in nerves of traumatic, toxic, and inflammatory nature. Such a response had negative as well as positive implications. Severe edema may disturb the normal microcirculation in the endoneurial vessels and stimulate collagen production and fibrosis. However, the presence of a protein-rich endoneurial edema may well be important in repair processes such as reduplication of Schwann cells and growth of axons.

Animals↗
PubMed1991

Homologous patterns in the embryonic development of the peripheral nervous system in the grasshopper Schistocerca gregaria and the fly Drosophila melanogaster.

To determine the generality of developmental mechanisms involved in the construction of the insect nervous system, the embryonic development of the peripheral nervous system in the grasshopper Schistocerca gregaria was characterized at the level of identified neurons and nerve branches and then compared to that previously described from the fly Drosophila melanogaster. For this, immunocytochemistry using a neuron-specific antibody was carried out on staged grasshopper embryos. Our results show that initially a simple peripheral nerve scaffolding is established in each segment of the animal. This scaffolding consists of a pair of intersegmental nerves that are formed by identified afferent and efferent pioneer neurons and a pair of segmental nerves that are formed by afferent pioneers situated in limb buds. Subsequently, identified sets of sensory neurons differentiate in a stereotyped spatiotemporal pattern in dorsal, lateral and ventral clusters in each segment and project their axons onto these nerves. Although segment-specific differences exist, serial homologs of the developing nerves and sensory neurons can be identified. A comparison of these results with those obtained from Drosophila shows that virtually the same pattern of peripheral nerves and sensory structures is formed in both species. This indicates that the construction of the peripheral nervous system in extremely divergent modern insects relies on conserved developmental mechanisms that evolved in ancestral insects over 300 million years ago.

Animals↗
PubMed1993

Infantile neuroaxonal dystrophy--immunohistochemical and ultrastructural studies on the central and peripheral nervous systems in infantile neuroaxonal dystrophy.

We performed pathological studies on the central and peripheral nervous systems of cases with infantile neuroaxonal dystrophy (INAD). Numerous spheroid bodies in the central and peripheral nervous systems, were seen and divided into large spheroid bodies (LSB) and small spheroid bodies (SSB) photo-microscopically. LSB had a relation to some specific neurons with weak expression of neuron specific enolase, neurofilament and chromogranin using PAP method. SSB showed a relation to the axon without immunohistochemical expression of neuron specific enolase, neurofilament, glial fibrillary acidic protein, myelin basic protein, chromogranin, S 100 protein or antitrypsin. LSB were prominent in the posterior column, gracile nucleus, cuneate nucleus, and the tegmentum of the midbrain and the pons associated with neuronal loss and gliosis. SSB were observed in the thalamus, basal ganglia and the cerebral cortex. The cerebellum was sclerotic with few microtubule-like structures disposed in a dense network in association with degenerated mitochondria. Similar changes were observed in the sural nerves, autonomic nerve endings in the skin, and the nerve plexus of the digestive tract. Although INAD is a generalized neurodegenerative disease, it is suggested that the primary disorder might occur in the neurons and axons of the sensory tracts.

Axons↗
PubMed2006

Expression of capsaicin receptor immunoreactivity in human peripheral nervous system and in painful neuropathies.

We describe the expression of the capsaicin receptor (TRPV1) in human peripheral nervous system (PNS) and its changes in sural nerve and skin nerve fibers of patients with painful neuropathy. Dorsal root ganglion (DRG), root, and spinal cord autopsy specimens from subjects without PNS diseases were immunoassayed with anti-TRPV1 antibodies. Bright-field and confocal microscope studies using anti-TRPV1, protein gene product 9.5 (PGP 9.5), and unique-beta-tubulin (TuJ1) antibodies were performed in skin biopsies from 15 healthy subjects and 10 painful neuropathies. The density of intraepidermal nerve fiber (IENF) labeled by each antibody was quantified. Sural nerve biopsies from three patients with painful, one patient with nonpainful diabetic neuropathy, and two patients with multifocal motor neuropathy used as controls were immunoassayed with anti-TRPV1 antibodies and investigated by immunoelectron microscopy. TRPV1 strongly labeled laminae I and II of dorsal horns, most small-size and some medium-size DRG neurons, and small-diameter axons of dorsal roots. In sural nerve, TRPV1 was expressed within the cytoplasm of most unmyelinated and some small myelinated axons, in the muscular lamina of epineural vessels, and in the endothelium of endoneurial vessels. The density of IENF labeled by TRPV1, PGP 9.5, and TuJ1 did not differ. TRPV1 colocalized with TuJ1 in all IENF and dermal nerve bundles. Painful neuropathies showed a diffuse loss of TRPV1-positive axons both in the sural nerve and in the skin. Our findings demonstrated that TRPV1 is normally expressed throughout the nociceptive pathway of PNS and that TRPV1-positive peripheral nerve fibers degenerate in painful neuropathies.

Adult↗
PubMed1988

The use of somatosensory evoked potentials for the evaluation of the peripheral nervous system.

Use of the somatosensory evoked potential (SEP) in the evaluation of the peripheral nervous system is described. When using SEPs to evaluate peripheral nervous system disease, it is assumed that the central nervous system is intact. SEPs can be used to measure conduction through nerves that, by nature of their anatomic site, are difficult to assess. By reason of central amplification they can indicate return of nerve continuity following trauma before peripheral sensory action potentials are recordable. For the same reason, it is possible to use them to measure peripheral sensory conduction velocity when conventional methods cannot be applied. They are helpful in the localization of plexopathies. Considerable effort has been devoted to their use in radiculopathies, but, for the most part, their role here is limited.

Diagnosis, Differential↗
PubMed2003

Mu-opioid receptor mRNA regulation during morphine tolerance in the rat peripheral nervous system.

UNLABELLED: In vivo data on opioid receptor mRNA regulation after agonist exposure in the peripheral nervous system are lacking. Therefore, we studied the impact of morphine treatment on the regulation of mu-opioid receptor mRNA during behavioral signs of tolerance in rat peripheral sensory ganglia. Nineteen rats were treated in 2 groups with either morphine (10 mg/kg subcutaneously) or saline over 4 days, and a subset of rats received naloxone on the fifth day followed by either morphine injection on the sixth day or death to obtain dorsal root ganglia for mRNA analysis. Animals were tested on the hot plate during treatment days. To assess the levels of mu-opioid receptor mRNA, quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) was used with the co-amplification of the "housekeeping" gene cyclophilin as internal control. Morphine treatment over 4 days induced tolerance as reflected on the hot-plate test by a significant reduction of paw-withdrawal latency from 242% to 99% above baseline. Using RT-PCR we demonstrated a down-regulation of mu-opioid receptor mRNA by 62% after morphine exposure (P < 0.05). After acute withdrawal of morphine from the mu-receptor by naloxone, the mu-opioid receptor mRNA levels in the dorsal root ganglia were restored to control levels within 24 h and the paw-withdrawal latency also returned to 280% above control. These data suggest that the peripheral nervous system may be an important site of opioid tolerance development. IMPLICATIONS: The peripheral nervous system is a possible site of opioid receptor tolerance. We show the development of behavioral tolerance and mu-opioid receptor mRNA down-regulation in the dorsal root ganglia in rats after chronic morphine treatment. Both this mRNA down-regulation and behavioral tolerance reverse after 24 h of naloxone treatment.

Analgesics, Opioid↗
PubMed2005

Human multidrug resistance protein 8 (MRP8/ABCC11), an apical efflux pump for steroid sulfates, is an axonal protein of the CNS and peripheral nervous system.

Dehydroepiandrosterone 3-sulfate and other neurosteroids are synthesized in the CNS and peripheral nervous system where they may modulate neuronal excitability by interacting with ligand-gated ion channels. For this modulatory activity, neurosteroids have to be locally released from either neurons or glial cells. We here identify the integral membrane protein ABCC11 (multidrug resistance protein 8) as an ATP-dependent efflux pump for steroid sulfates, including dehydroepiandrosterone 3-sulfate, and localize it to axons of the human CNS and peripheral nervous system. ABCC11 mRNA was detected in human brain by real-time polymerase chain reaction. Antibodies raised against ABCC11 served to detect the protein in brain by immunoblotting and immunofluorescence microscopy. ABCC11 was preferentially found in the white matter of the brain and co-localized with neurofilaments indicating that it is an axonal protein. Additionally, ABCC11 was localized to axons of the peripheral nervous system. For functional studies, ABCC11 was expressed in polarized Madin-Darby canine kidney cells where it was sorted to the apical membrane. This apical sorting is in accordance with the localization of ABCC11 to the axonal membrane of neurons. Inside-out plasma membrane vesicles containing recombinant ABCC11 mediated ATP-dependent transport of dehydroepiandrosterone 3-sulfate with a Km value of 21 microM. This transport function together with the localization of the ABCC11 protein in vicinity to GABAA receptors is consistent with a role of ABCC11 in dehydroepiandrosterone 3-sulfate release from neurons to sites of dehydroepiandrosterone 3-sulfate-mediated receptor modulation. Our findings may provide a basis for the characterization of mutations in the human ABCC11 gene and their linkage with neurological disorders.

ATP-Binding Cassette Transporters↗
PubMed1994

Synaptotagmin I is present mainly in autonomic and sensory neurons of the rat peripheral nervous system.

The distribution of synaptotagmin I in the peripheral nervous system of the rat was investigated by immunofluorescence and confocal laser scanning microscopy. After crushing of the sciatic nerve, synaptotagmin I-like immunoreactivity accumulated proximally as well as distally to the crushes in thin and medium-sized axons. Double labelling studies revealed that synaptotagmin I co-localized with tyrosine hydroxylase, a marker of sympathetic adrenergic neurons, and with substance P, a marker for sensory neurons. No synaptotagmin I-like immunoreactivity was found in large axons, while accumulations of the synaptic vesicle proteins synaptophysin and synapsin I were found in all types of axons. Furthermore, no synaptotagmin I-like immunoreactivity was detected in motor endplates. In contrast, the protein was found in muscle spindles of young rats and in perivascular terminals, where it co-localized with synaptophysin and synapsin I. Lumbar sympathectomy resulted in a marked reduction of the amount and intensity of synaptotagmin I-like immunoreactivity in sciatic nerve. High magnification revealed that synaptotagmin I-like immunoreactivity was mainly distributed in a fine granular pattern, but large, brightly fluorescent granules which were not labelled by anti-synaptophysin or anti-synapsin I were occasionally observed. We conclude that synaptotagmin I is mainly expressed in adrenergic and sensory neurons and is absent from, or below detection levels, in motoneurons.

Animals↗
PubMed1988

Humoral factors in inflammatory disorders of the central and peripheral nervous system.

The immune-mediated disorders of the central and peripheral nervous systems all involve humoral mechanisms in which immunoglobulin, complement and/or other mediators are implicated. The disorders can be characterized by pattern of disease activity, site of immunoglobulin synthesis, humoral mechanism of injury, and presence of one or more concurrent cellular mechanisms of injury. Control of the humoral responses is presumably T-cell dependent. While these disorders should be viewed as having both humoral and cellular components, the specific components of each disorder might predict the response to specific therapeutic approaches.

Animals↗
PubMed2002

[Vasculitis confined to the peripheral nervous system: atypical clinical presentation].

INTRODUCTION: Peripheral neuropathy is a common feature of many vasculitic syndromes. In some patients, the neuropathy may be the sole manifestation of vasculitis. EXEGESIS: A 74-year-old lady complained of pain and weakness of the lower limbs. In her history, we noted right optic neuritis, monoclonal gammopathy and dyslipidemia treated by fenofibrate. Clinical examination showed proximal muscle strength deficit of lower limbs, with quadriceps femoral muscles atrophy. Muscle stretch reflexes were absent. There was no deficit in light touch and pain sensation, but proprioception was impaired. There was electromyographic evidence of myopathic impairment with abnormal spontaneous activity. Amplitude of the sensory action potentials was mildly reduced. Laboratory tests were normal. Fenofibrate was stopped, but the clinical symptoms increased. Four months later, another electrophysiological study showed a very reduced amplitude of sensory action potentials. Myopathic impairment was less severe. Nerve biopsy showed inflammation and necrosis of nerve arteries, which lead to the diagnosis of necrotizing vasculitis. A corticosteroid treatment was done. Six months later, clinical and electrophysiological improvement clearly appeared. CONCLUSION: Histological lesions of vasculitis confined to the peripheral nervous system are those of classic polyarteritis nodosas. There is no systemic involvement nor biological abnormalities, which strengthens the role of nerve and muscle biopsy. The prognosis is good after corticosteroid treatment, which is not the case with systemic vasculitis.

Action Potentials↗
PubMed1995

P-element mutations affecting embryonic peripheral nervous system development in Drosophila melanogaster.

The Drosophila embryonic peripheral nervous system (PNS) is an excellent model system to study the molecular mechanisms governing neural development. To identify genes controlling PNS development, we screened 2000 lethal P-element insertion strains. The PNS of mutant embryos was examined using the neural specific marker MAb 22C10, and 92 mutant strains were retained for further analysis. Genetic and cytological analysis of these strains shows that 42 mutations affect previously isolated genes that are known to be required for PNS development: longitudinals lacking (19), mastermind (15), numb (4), big brain (2), and spitz (2). The remaining 50 mutations were classified into 29 complementation groups and the P-element insertions were cytologically mapped. The mutants were classified in five major classes on the basis of their phenotype: gain of neurons, loss of neurons, organizational defects, pathfinding defects and morphological defects. Herein we report the preliminary phenotypic characterization of each of these complementation groups as well as the embryonic lacZ expression pattern of each P-element strain. Our analysis indicates that in most of the P-element insertion strains, the lacZ reporter gene is not expressed in the developing PNS.

Animals↗
PubMed2006

An electrodiagnostic evaluation of the effect of pre-existing peripheral nervous system disorders in patients treated with the novel proteasome inhibitor bortezomib.

AIMS: Bortezomib (Velcade), a novel proteasome inhibitor, has shown promise in the treatment of malignancies, including multiple myeloma and non-Hodgkin's lymphoma. Several studies have identified neuropathy as a potentially dose-limiting side effect of treatment with bortezomib. We report the clinical and electrodiagnostic data from four patients who developed signs and symptoms of peripheral neuropathy from treatment with bortezomib. MATERIALS AND METHODS: Patients were included if they were enrolled in active phase 2 trials of bortezomib for non-Hodgkin's lymphoma or prostate cancer, developed signs and symptoms of peripheral neuropathy, and were referred for electrodiagnostic evaluation. RESULTS: Four patients, including two with non-Hodgkin's lymphoma and two with prostate cancer, underwent electrodiagnostic testing. Electrodiagnostic evaluation showed pre-existing peripheral nervous system disorders in three out of four patients. Multiple peripheral nervous system disorders were present in two out of four patients. CONCLUSIONS: Bortezomib can cause a predominately sensory axonal polyneuropathy. Pre-existing peripheral nervous system disorders, such as neuropathy and radiculopathy, are common in patients with cancer, and may pre-dispose to the development of symptomatic neuronal toxicity when treated with bortezomib. Baseline electrodiagnostic evaluation may identify patients with pre-existing peripheral nervous system disorders at risk for additive neuronal toxicity from neurotoxic chemotherapeutic agents.

Aged↗
PubMed1995

Immunolocalization of vgr (BMP-6, DVR-6), a TGF-beta related cytokine, to Schwann cells of the rat peripheral nervous system: expression patterns are not modulated by autoimmune disease.

The transforming growth factors type beta (TGF-beta) have been implicated in regulation of peripheral nervous system inflammation and regeneration. Here we demonstrate expression of a TGF-beta-related bone morphogenetic protein, the vgr (BMP-6, DVR-6) in Schwann cells of the rat peripheral nervous system. The expression of vgr in the peripheral nervous system suggests that this factor and probably other TGF-beta-related bone morphogenetic proteins might participate in Schwann cell function during aspects of peripheral nervous system physiology and pathology. However, we did not observe changes in expression patterns in response to autoimmune inflammation (experimental autoimmune neuritis) of the peripheral nervous system.

Amino Acid Sequence↗
PubMedDate not supplied

[Subclinical lesions of peripheral nervous system in multiple sclerosis patients].

BACKGROUND AND PURPOSE: In the last years the presence of peripheral nervous system (PNS) lesions has been noted in patients with multiple sclerosis (MS). The frequency and degree of PNS damage reported by many authors differ among publications, so does the type of PNS lesions. The aim of our study was to perform an electrophysiological evaluation of the peripheral nervous system in patients with a definite diagnosis of multiple sclerosis and without any clinical signs of peripheral neuropathy. MATERIAL AND METHODS: 110 patients were included in the study, comprising 70 people with a definite diagnosis of multiple sclerosis and 40 people without any symptoms of organic nervous system lesion serving as a control group. During neurologic examination of MS patients the degree of disability measured by EDSS scale, the duration of the disease as well as number of relapses were assessed. A "disease progression factor" was calculated by dividing a number of relapses by disease duration in years. Patients with common etiologies for peripheral neuropathy such as diabetes, renal insufficiency, thyroid gland dysfunction, proliferative disorders etc. were excluded from the study. Orthodromic motor conduction and late responses (F wave) in median, ulnar, peroneal and tibial nerves as well as sensory conduction in median, ulnar (orthodromic) and sural (antidromic) nerves were evaluated. RESULTS: There was electrophysiological evidence of peripheral nervous system lesions in at least one nerve in 52 (74.2%) MS patients. In 30 patients (42.8%) more than one peripheral nerve was lesioned. There were more significant differences noted during the examination of sensory nerves. Sensory amplitudes in all of the sensory nerves examined were significantly lower than in control group. Furthermore we observed slow sensory conduction velocities and prolonged sensory latencies in ulnar and sural nerves. There were significant differences between the two groups of patients concerning motor conduction too: prolonged distal latency in tibial and sural nerves, prolonged F wave latency in median, peroneal and tibial nerves, low motor amplitude in ulnar and peroneal nerves, low motor conduction velocity in ulnar nerve -- all noted in MS patients. We found no correlation between conduction parameters and the patients' age, disease duration, number of relapses and disease progression degree. CONCLUSIONS: We found out that subclinical peripheral nervous system abnormalities are very frequent in MS patients. We noted both sensory and motor nerve lesions of a demyelinating-axonal character. Sensory abnormalities were more pronounced than motor ones. There was no correlation between the degree of PNS lesions and the patients' age and/or progression of multiple sclerosis.

Adult↗