Neurotrophins and peripheral neuropathy.

Endogenous nerve growth factor (NGF) levels were studied in patients with nerve trauma, diabetes mellitus and leprosy, the most common causes of human peripheral neuropathy. In diabetics, there was an early length-dependent dysfunction of small-diameter sensory fibres, with depletion of skin NGF and the sensory neuropeptide substance P. The NGF depletion correlated significantly with decreased skin axon-reflex vasodilatation, which is mediated by small sensory fibres at least partly via substance P release. Immunostaining showed depletion of NGF in keratinocytes in diabetic skin. In injured nerves, NGF levels were reduced when compared to intact nerve, except acutely distal to injury; NGF-immunostaining was seen in Schwann cells in distal segments, including neuromas. NGF levels were decreased in leprosy-affected skin and nerve. The role of neurotrophins in the rational treatment of human neuropathies is discussed e.g. loss of nociception and axon-reflex vasodilatation contribute to skin ulceration, a major and serious complication, for which NGF may provide prophylaxis.

Neuroartropatía. Reporte de 10 casos / Neuroarthropathy. Report of 10 patients

Se presentan 10 pacientes con neuroartropatía que afecta sus articulaciones de carga, principalente rodilla, tobillo y pie, en quiens el diagnóstico de origen, que dió lugar a la artropatía fue sífilis tardía, diabetes mellitus, lepra y mielomeningocele. Se hace énfasis en la importancia del diagnóstico de neuroartropatía, ya que en un alto porentaje de los enfermos este cuedro pasa inadvertido puesto que se trata de un proceso no doloroso.