Reduced association between dendritic cells and corneal sub-basal nerve fibers in patients with fibromyalgia syndrome

Alexander Klitsch, Dimitar Evdokimov, Johanna Frank, Dominique Thomas, Nadine Saffer, Caren Meyer zu Altenschildesche, Marco Sisignano, Daniel Kampik, Rayaz A. Malik, Claudia Sommer, Nurcan Üçeyler

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
JournalJournal of the Peripheral Nervous System
DOIs
Publication statusAccepted/In press - 1 Jan 2019

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Fibromyalgia
Nerve Fibers
Dendritic Cells
Langerhans Cells
Eye Diseases
Neurologic Examination
Tears
Confocal Microscopy
Prostaglandins
Small Fiber Neuropathy
Neurophysiology
Neural Conduction
Cell Count
Pathology

Keywords

  • corneal confocal microscopy
  • fibromyalgia syndrome
  • Langerhans cells
  • pain
  • small fiber neuropathy

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology

Cite this

Klitsch, A., Evdokimov, D., Frank, J., Thomas, D., Saffer, N., Meyer zu Altenschildesche, C., ... Üçeyler, N. (Accepted/In press). Reduced association between dendritic cells and corneal sub-basal nerve fibers in patients with fibromyalgia syndrome. Journal of the Peripheral Nervous System. https://doi.org/10.1111/jns.12360

Reduced association between dendritic cells and corneal sub-basal nerve fibers in patients with fibromyalgia syndrome. / Klitsch, Alexander; Evdokimov, Dimitar; Frank, Johanna; Thomas, Dominique; Saffer, Nadine; Meyer zu Altenschildesche, Caren; Sisignano, Marco; Kampik, Daniel; Malik, Rayaz A.; Sommer, Claudia; Üçeyler, Nurcan.

In: Journal of the Peripheral Nervous System, 01.01.2019.

Research output: Contribution to journalArticle

Klitsch, A, Evdokimov, D, Frank, J, Thomas, D, Saffer, N, Meyer zu Altenschildesche, C, Sisignano, M, Kampik, D, Malik, RA, Sommer, C & Üçeyler, N 2019, 'Reduced association between dendritic cells and corneal sub-basal nerve fibers in patients with fibromyalgia syndrome', Journal of the Peripheral Nervous System. https://doi.org/10.1111/jns.12360
Klitsch, Alexander ; Evdokimov, Dimitar ; Frank, Johanna ; Thomas, Dominique ; Saffer, Nadine ; Meyer zu Altenschildesche, Caren ; Sisignano, Marco ; Kampik, Daniel ; Malik, Rayaz A. ; Sommer, Claudia ; Üçeyler, Nurcan. / Reduced association between dendritic cells and corneal sub-basal nerve fibers in patients with fibromyalgia syndrome. In: Journal of the Peripheral Nervous System. 2019.
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abstract = "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.",
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AU - Saffer, Nadine

AU - Meyer zu Altenschildesche, Caren

AU - Sisignano, Marco

AU - Kampik, Daniel

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AU - Sommer, Claudia

AU - Üçeyler, Nurcan

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AB - 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.

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