In our study, we aimed at investigating corneal langerhans cells (LC) in patients with fibromyalgia syndrome (FMS) and small fiber neuropathy (SFN) as potential contributors to corneal small fiber pathology. We enrolled women with FMS (n = 134) and SFN (n = 41) who underwent neurological examination, neurophysiology, prostaglandin analysis in tear fluid, and corneal confocal microscopy (CCM). Data were compared with those of 60 age‐matched female controls. After screening for dry eye disease, corneal LC were counted and sub‐classified as dendritic (dLC) and non‐dendritic (ndLC) cells with or without nerve fiber association. We further analyzed corneal nerve fiber density (CNFD), length (CNFL), and branch density (CNBD). Neurological examination indicated deficits of small fiber function in patients with SFN. Nerve conduction studies were normal in all participants. Dry eye disease was more prevalent in FMS (17%) and SFN (28%) patients than in controls (5%). Tear fluid prostaglandin levels did not differ between FMS patients and controls. While corneal LC density in FMS and SFN patients was not different from controls, there were fewer dLC in association with nerve fibers in FMS and SFN patients than in controls (P < .01 each). Compared to controls, CNFL was lower in FMS and SFN patients (P < .05 each), CNFD was lower only in FMS patients (P < .05), and CNBD was lower only in SFN patients (P < .001). There was no difference in any CCM parameter between patients with and without dry eyes. Our data indicate changes in corneal innervation and LC distribution in FMS and SFN, potentially based on altered LC signaling.

中文翻译：

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纤维肌痛综合征患者的树突状细胞与角膜下基底神经纤维之间的结合减少。

在我们的研究中，我们旨在研究患有纤维肌痛综合征（FMS）和小纤维神经病变（SFN）的患者的角膜Langerhans细胞（LC），它们可能是导致角膜小纤维病理的潜在因素。我们招募了接受过FMS（n = 134）和SFN（n = 41）治疗的妇女，这些妇女接受了神经系统检查，神经生理学，泪液中的前列腺素分析和角膜共聚焦显微镜（CCM）。将数据与60位年龄相匹配的女性对照者进行比较。筛查干眼病后，对角膜LC进行计数，并将其分为具有或不具有神经纤维缔合的树突（dLC）和非树突（ndLC）细胞。我们进一步分析了角膜神经纤维密度（CNFD），长度（CNFL）和分支密度（CNBD）。神经系统检查表明SFN患者小纤维功能受损。所有参与者的神经传导研究均正常。FMS（17％）和SFN（28％）患者的干眼病比对照组（5％）更为普遍。FMS患者和对照组之间的泪液前列腺素水平没有差异。尽管FMS和SFN患者的角膜LC密度与对照组无差异，但FMS和SFN患者的与神经纤维相关的dLC较对照组少（P <0.01）。与对照组相比，FMS和SFN患者的CNFL较低（每个P <.05），仅FMS患者的CNFD较低（P <.05），而SFN患者的CNBD较低（P <.001）。在有和没有干眼的患者之间，任何CCM参数都没有差异。我们的数据表明FMS和SFN中角膜神经支配和LC分布的变化，可能是基于LC信号的改变。