Nerve, Skin and Pain Overview
The skin is an extremely complex and constantly remodeling organ that is not only a physical protective barrier but also an integration of the nervous system, vascular system, immune system and endocrine system.
Given its complexity, over 150 diseases have been identified that affect the skin, its innervation and blood supply. Many of these afflictions manifest with severe intractable numbness, chronic pain and/or itch, which respond poorly to existing therapeutics.
|Current Disease Investigations|
|Physical Injury (trauma)||Systemic Diseases||Infections and Autoimmune Disorders||Inherited Diseases|
|Normal||Postherpetic Neuralgia||Normal||Complex Regional Pain Syndrome||Normal||Complex Regional Pain Syndrome|
|Increased TrpV1 on sensory endings (red arrows) and keratinocytes in the epidermis of humans with postherpetic neuralgia.
Petersen KL, Rice FL, Suess F, Berro M, Rowbotham MC (2002) Pain 98: 119.
|Increased NaV1.6 on keratinocytes in the epidermis of humans with complex regional pain syndrome and postherpetic neuralgia.
Zhao P, Barr TP, Hou Q, Dib-Hajj SD, Black JA, Albrecht PJ, Petersen KL, Eisenberg E, Rice FL, Waxman SG (2008) Pain 139:90.
|Disrupted sensory endings on hair follicles are in humans with complex regional pain syndrome.
Albrecht PJ, Hines S, Eisenberg E, Pud D, Finlay DR, Connolly MK, Paré M, Davar G, Rice FL (2005) Pain 120:244.
|Normal||Type 2 Diabetes||26 yr Control||24 yr Fibromyalgia|
Selective loss of CGRP containing sensory endings on arteries as early as metabolic syndrome phase in aged monkeys with naturally occurring Type 2 diabetes.
Paré M, Albrecht PJ, Bodkin NL, Pittenger GL, Noto CJ, Schreyer DJ , Tigno XT, Hansen BC, Rice FL (2007) J Comp Neurol 501:543 .
Excessive sensory innervation on arteriole-venule shunts as seen in a 3mm skin punch biopsy from the palm of the hand in a 24 year old female fibromyalgia patient as compared to a 26 year old female normal control.
Albrecht PJ, Hou Q, Argoff CE, Storey JR, Wymer JP, Rice FL (2013). Pain Medicine, May 20. doi: 10.1111/pme.12139 [Epub ahead of print].
Existing research, much of it conducted by the co-founders of Intidyn, have shown that microscopic immunochemical assessments of skin sections cut from 3mm punch biopsies are an invaluable means:
- For elucidating the nature and potential basis of skin and nerve pathologies.
- For assessing the efficacy of therapeutics and providing insights for potential future therapeutic strategies.
- Diagnosing existing and impending disease - such as diabetes - before the overt manifestation of the disease, thereby providing the potential for appropriate intervention before a more intractable problem occurs.
- Detecting potential detrimental side effects associated with drug development for other diseases such as arthritis and hypertension. This is due to the fact that the skin is a constantly remodeling structure that integrates multiple systems.
- Evaluating the specificity of novel reagents, such as antibodies, that are designed to detect the location of specific functional molecules.
Thus, skin biopsies provide an important diagnostic tool for impending or existing disease, and for developing therapeutics.