Dermal nerves in human diabetic subjects.

The lack of a nerve tissue source that is easily, safely, and repeatedly available has been a major impediment to the study of human diabetic neuropathy. In this study dermal nerves from skin, obtained at biopsy and autopsy from the lower leg and at autopsy from the mid-abdomen, were subjected to quantitative electron microscopy to assess for diabetic perineurial cell basement membrane thickening, a change previously reported in sural nerve. A highly significant degree of perineurial cell basement membrane thickening was found in the diabetic subjects. Other structures in dermal nerves, such as axons, myelin, Schwann cells, and their organelles are also amenable to quantitative ultrastructural study. Skin biopsy is a way to obtain samples of peripheral nervous system tissue safely and repeatedly for the study of diabetic neuropathy.