The evaluation of human epidermal innervation and its impact by disease has largely focused on rigorous immunohistochemical counts of PGP 9.5 labelled axons. In this brief and preliminary report, we expand the repertoire of epidermal axon markers to include those with an influence on their regenerative plasticity. We studied human lower limb punch skin samples with tandem analyses of their mRNA content using qRT-PCR. Normal human subjects (n = 11) and two patients with newly diagnosed CIDP were sampled with the latter undergoing serial tandem biopsies before and after 3 months of immunotherapy. Controls expressed regeneration proteins within dermal and epidermal axons: GAP43 (growth associated protein 43), Shh (sonic hedgehog) and SCG (superior cervical ganglion-10; stathmin 2). Moreover, this expression accompanied intraepidermal nerve fiber density (IENF) within normal established values. CIDP patients had lower IENF but also expressed GAP43, Shh, and SCG. Tandem qRT-PCR identified confirmed the presence not only of these plasticity markers but of additional regeneration related mRNAs. CIDP patients had marked elevation of several mRNAs, with improvement following treatment. The findings support the concept of dynamic skin axon plasticity in humans is relevant toward consideration of newer therapeutic approaches.

中文翻译：

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完整人体皮肤轴突的再生可塑性

对人类表皮神经支配及其对疾病影响的评估主要集中在 PGP 9.5 标记轴突的严格免疫组织化学计数上。在这份简短的初步报告中，我们扩展了表皮轴突标记的库，包括那些对其再生可塑性有影响的标记。我们研究了人类下肢打孔皮肤样本，并使用 qRT-PCR 对其 mRNA 含量进行了串联分析。对正常人类受试者（n = 11）和两名新诊断的 CIDP 患者进行采样，后者在免疫治疗 3 个月之前和之后接受连续串联活检。对照在真皮和表皮轴突内表达再生蛋白：GAP43（生长相关蛋白 43）、Shh（音速刺猬）和 SCG（颈上神经节 10；stathmin 2）。而且，这种表达伴随着正常确定值内的表皮内神经纤维密度（IENF）。CIDP 患者的 IENF 较低，但也表达 GAP43、Shh 和 SCG。经鉴定的串联 qRT-PCR 不仅证实了这些可塑性标记的存在，而且证实了其他再生相关 mRNA 的存在。CIDP 患者的几种 mRNA 显着升高，治疗后有所改善。这些发现支持人类动态皮肤轴突可塑性的概念与考虑更新的治疗方法有关。治疗后好转。这些发现支持人类动态皮肤轴突可塑性的概念与考虑更新的治疗方法有关。治疗后好转。这些发现支持人类动态皮肤轴突可塑性的概念与考虑更新的治疗方法有关。