Pub Date : 2024-03-01DOI: 10.17650/2222-8721-2024-14-1-34-41
T. Safonova, Z. Surnina, E. S. Medvedeva
Background. Excessive evaporation of the tear film can lead to damage to the corneal nerve fibers and cause the occurrence of chronic neuropathic pain that mimics dryness. Laser confocal microscopy of the cornea allows you to record morphological changes in the nerve fibers of the cornea and can be a diagnostic tool for finding the substrate of neuropathic pain.Aim. To study and compare the structural changes of corneal nerve fibers in patients with burning eye syndrome and dry eye disease.Materials and methods. 54 patients (108 eyes) aged 20–35 years were examined: 17 patients (34 eyes) with a verified diagnosis of mild and moderate dry eye disease were the first group, 17 patients (34 eyes) with burning eye syndrome were the second group. The third group (control) consisted of 20 volunteers (40 eyes) of the same age, who did not have any somatic and eye diseases. The criterion for exclusion from the study was the presence of clinical signs of blepharitis and dysfunction of the meibomian glands in patients and individuals of the control group. In all patients, the number of blinking movements and the completeness of eyelid closure were determined, the Norn test and the Schirmer I test were performed. For an objective assessment of corneal nerve fibers, laser confocal microscopy of the cornea was used on a Heidelberg Retina Tomograph III device with a rostock corneal module.Results. The lowest values of the anisotropy coefficient of the corneal nerve fibers directivity were recorded in the group of patients with burning eye syndrome (2.605), which indicates the greatest changes in the structure of the nerve fiber in this group. There was no significant negative correlation between the value of the Norn sample, the number of blinking movements, and the value of the anisotropy coefficient of the corneal nerve fibers orientation in the group of patients with burning eye syndrome (r = –0.45, p = 0.07 and r = –0.45, p = 0.07). There was a statistically significant (p >0.05) increase in the number of inflammatory Langerhans cells, the length and density of their processes in the groups of burning eye syndrome and dry eye disease compared with the group of healthy volunteers.Conclusion. The method of laser confocal microscopy of the cornea can be used to detect changes in corneal nerve fibers associated with the occurrence of neuropathic pain syndrome.
{"title":"Laser confocal microscopy of corneal nerve fibers in patients with burning eye syndrome and dry eye disease","authors":"T. Safonova, Z. Surnina, E. S. Medvedeva","doi":"10.17650/2222-8721-2024-14-1-34-41","DOIUrl":"https://doi.org/10.17650/2222-8721-2024-14-1-34-41","url":null,"abstract":"Background. Excessive evaporation of the tear film can lead to damage to the corneal nerve fibers and cause the occurrence of chronic neuropathic pain that mimics dryness. Laser confocal microscopy of the cornea allows you to record morphological changes in the nerve fibers of the cornea and can be a diagnostic tool for finding the substrate of neuropathic pain.Aim. To study and compare the structural changes of corneal nerve fibers in patients with burning eye syndrome and dry eye disease.Materials and methods. 54 patients (108 eyes) aged 20–35 years were examined: 17 patients (34 eyes) with a verified diagnosis of mild and moderate dry eye disease were the first group, 17 patients (34 eyes) with burning eye syndrome were the second group. The third group (control) consisted of 20 volunteers (40 eyes) of the same age, who did not have any somatic and eye diseases. The criterion for exclusion from the study was the presence of clinical signs of blepharitis and dysfunction of the meibomian glands in patients and individuals of the control group. In all patients, the number of blinking movements and the completeness of eyelid closure were determined, the Norn test and the Schirmer I test were performed. For an objective assessment of corneal nerve fibers, laser confocal microscopy of the cornea was used on a Heidelberg Retina Tomograph III device with a rostock corneal module.Results. The lowest values of the anisotropy coefficient of the corneal nerve fibers directivity were recorded in the group of patients with burning eye syndrome (2.605), which indicates the greatest changes in the structure of the nerve fiber in this group. There was no significant negative correlation between the value of the Norn sample, the number of blinking movements, and the value of the anisotropy coefficient of the corneal nerve fibers orientation in the group of patients with burning eye syndrome (r = –0.45, p = 0.07 and r = –0.45, p = 0.07). There was a statistically significant (p >0.05) increase in the number of inflammatory Langerhans cells, the length and density of their processes in the groups of burning eye syndrome and dry eye disease compared with the group of healthy volunteers.Conclusion. The method of laser confocal microscopy of the cornea can be used to detect changes in corneal nerve fibers associated with the occurrence of neuropathic pain syndrome.","PeriodicalId":516233,"journal":{"name":"Neuromuscular Diseases","volume":"178 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140276744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.17650/2222-8721-2024-14-1-51-62
K. S. Kochergin-Nikitskiy, S. Smirnikhina, A. Lavrov
Duchenne muscular dystrophy is one of the most common inherited muscular dystrophies. The cause of this disease with an X‑linked recessive type of inheritance is mutations of the DMD gene, leading to the absence of the dystrophin protein this gene encodes or its impaired function. Loss of dystrophin leads to severe degenerative processes in patients, especially in muscle tissue, with impaired muscle function, loss of ability to move independently, respiratory failure, cardiomyopathies, etc.More than 160 years have passed since the work of Guillaume‑Benjamin‑Armand Duchenne in the 19th century. Despite the efforts of many researchers who have developed various therapeutic approaches designed to alleviate the condition of patients if not cure it, few of them have significantly changed the course of the disease. Different approaches related to specific therapy of ischemia and fibrosis in affected muscles, correction of hormonal regulation of muscle tissue growth, therapeutic methods aimed at preventing damaged myocytes from excessive accumulation of calcium ions, which enhance proteolytic processes, suppression of oxidative stress in muscles, etc. have not yet shown high effectiveness both independently and in combination with glucocorticoids. The introduction of corticosteroid drugs made it possible to slow down disease development, but the average survival still does not exceed 30–40 years and patients spend many of them in a wheelchair. At the same time, the patients’ quality of life can be additionally diminished due to the common corticosteroids’ side effects.
杜兴氏肌肉萎缩症是最常见的遗传性肌肉萎缩症之一。这种疾病为 X 连锁隐性遗传，病因是 DMD 基因突变，导致该基因编码的肌营养蛋白缺失或功能受损。肌营养不良蛋白的缺失会导致患者出现严重的退行性病变，尤其是肌肉组织退行性病变，表现为肌肉功能受损、丧失独立活动能力、呼吸衰竭、心肌病等。尽管许多研究人员都在努力开发各种治疗方法，以减轻患者的病情，即使不能根治，也能显著改变疾病的进程。与受影响肌肉缺血和纤维化的特殊治疗、肌肉组织生长的激素调节矫正、旨在防止受损肌细胞过度积聚钙离子的治疗方法（钙离子会增强蛋白水解过程）、抑制肌肉氧化应激等有关的不同方法，无论是单独使用还是与糖皮质激素联合使用，都尚未显示出很高的疗效。皮质类固醇药物的引入使疾病的发展得以减缓，但平均存活期仍不超过 30-40 年，而且许多患者要在轮椅上度过。同时，由于常见的皮质类固醇药物的副作用，患者的生活质量会进一步下降。
{"title":"Stages of research and development of therapeutic approaches for Duchenne myodystrophy. Part I: the period before etiotropic approaches introduction","authors":"K. S. Kochergin-Nikitskiy, S. Smirnikhina, A. Lavrov","doi":"10.17650/2222-8721-2024-14-1-51-62","DOIUrl":"https://doi.org/10.17650/2222-8721-2024-14-1-51-62","url":null,"abstract":"Duchenne muscular dystrophy is one of the most common inherited muscular dystrophies. The cause of this disease with an X‑linked recessive type of inheritance is mutations of the DMD gene, leading to the absence of the dystrophin protein this gene encodes or its impaired function. Loss of dystrophin leads to severe degenerative processes in patients, especially in muscle tissue, with impaired muscle function, loss of ability to move independently, respiratory failure, cardiomyopathies, etc.More than 160 years have passed since the work of Guillaume‑Benjamin‑Armand Duchenne in the 19th century. Despite the efforts of many researchers who have developed various therapeutic approaches designed to alleviate the condition of patients if not cure it, few of them have significantly changed the course of the disease. Different approaches related to specific therapy of ischemia and fibrosis in affected muscles, correction of hormonal regulation of muscle tissue growth, therapeutic methods aimed at preventing damaged myocytes from excessive accumulation of calcium ions, which enhance proteolytic processes, suppression of oxidative stress in muscles, etc. have not yet shown high effectiveness both independently and in combination with glucocorticoids. The introduction of corticosteroid drugs made it possible to slow down disease development, but the average survival still does not exceed 30–40 years and patients spend many of them in a wheelchair. At the same time, the patients’ quality of life can be additionally diminished due to the common corticosteroids’ side effects.","PeriodicalId":516233,"journal":{"name":"Neuromuscular Diseases","volume":"32 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140280224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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