The ultrastructure of cutaneous type I mechanoreceptors (Haarscheiben) in cats following denervation

Epigenetic regulation and signalling pathways in Merkel cell development

Merkel cells are specialized epithelial cells connected to afferent nerve endings responsible for light-touch sensations, formed at specific locations in touch-sensitive regions of the mammalian skin. Although Merkel cells are descendants of the epidermal lineage, little is known about the mechanisms responsible for the development of these unique mechanosensory cells. Recent studies have highlighted that the Polycomb group (PcG) of proteins play a significant role in spatiotemporal regulation of Merkel cell formation. In addition, several of the major signalling pathways involved in skin development have been shown to regulate Merkel cell development as well. Here, we summarize the current understandings of the role of developmental regulators in Merkel cell formation, including the interplay between the epigenetic machinery and key signalling pathways, and the lineage-specific transcription factors involved in the regulation of Merkel cell development.

Merkel Cells: A Collective Review of Current Concepts

Merkel cells (MCs) constitute a very unique population of postmitotic cells scattered along the dermo-epidermal junction. These cells that have synaptic contacts with somatosensory afferents are regarded to have a pivotal role in sensory discernment. Several concerns exist till date as to their origin, multiplication, and relevance in skin biology. The article, a collective review of literature extracted from PubMed search and dermatology books, provides novel insights into the physiology of MCs and their recent advances.

Primary neuroendocrine (merkel cell) carcinoma of the anterior skull base

A case of a primary neuroendocrine (Merkel cell) carcinoma arising in the anterior skull base involving the dura, both frontal lobes, and the paranasal sinuses is presented. The tumor was completely removed by an enlarged bifrontal transbasal approach. The neuropathological, immunohistological, and electron microscopical investigation revealed all characteristics of a Merkel cell carcinoma, normally presenting as a skin carcinoma of the head and neck. The history, treatment, neuropathology, and possible explanation for this rare manifestation are discussed.

Solitary chemoreceptor cell survival is independent of intact trigeminal innervation

Nasal solitary chemoreceptor cells (SCCs) are a population of specialized chemosensory epithelial cells presumed to broaden trigeminal chemoreceptivity in mammals (Finger et al. [2003] Proc Natl Acad Sci USA 100:8981-8986). SCCs are innervated by peptidergic trigeminal nerve fibers (Finger et al. [2003]) but it is currently unknown if intact innervation is necessary for SCC development or survival. We tested the dependence of SCCs on innervation by eliminating trigeminal nerve fibers during development with neurogenin-1 knockout mice, during early postnatal development with capsaicin desensitization, and during adulthood with trigeminal lesioning. Our results demonstrate that elimination of innervation at any of these times does not result in decreased SCC numbers. In conclusion, neither SCC development nor mature cell maintenance is dependent on intact trigeminal innervation.

Apoptosis of Merkel cells in neurotrophin-3 null mice

Postnatal mice lacking neurotrophin-3 (NT3) are deficient in Merkel cells of touch domes and whisker follicles. We examined the mechanism of Merkel cell loss by immunocytochemistry and electron microscopy. Merkel cell of whisker follicles of NT3 null newborns exhibited decreased immunoreactivity for cytokeratin 8 and contained apoptotic bodies that were positive for cleaved caspase-3, a marker of active apoptosis. By electron microscopy, the Merkel cells displayed aggregation of chromatin along the nuclear membrane, with the marginated chromatin forming caps at the periphery of the nucleus. Ribosomes aggregated in the cytoplasm, while dense core granules characteristic of Merkel cells were still discernible. Finally, the Merkel cells and their nuclei fragmented into apoptotic bodies. None of the apoptotic Merkel cells were contacted by nerve fibers, and their desmosomal contacts with surrounding keratinocytes disappeared. After postnatal day 6 apoptotic Merkel cells were no longer observed, and the number of surviving Merkel cells was severely reduced. They were flat and contained few osmiophilic granules. We conclude that perinatal apoptosis is responsible for the loss of Merkel cells lacking innervation in NT3 null mice.

C-fiber modulation of the rat type I slowly adapting mechanoreceptor

Effects of C-fiber activation on type I slowly adapting mechanoreceptor responses were investigated in a rat in vitro nerve-skin preparation using controlled mechanical stimuli. Two changes in behavior were evoked by antidromic C-fiber stimulation: (1). The type I response to mechanical stimuli was modulated in a graded fashion by antidromic C-fiber activation. The average decrease in mechanoresponse from baseline discharge was 53% at 20-Hz, 51% at 5-Hz, and 30% at 1-Hz stimulation rate. The type I response recovered to baseline levels following termination of antidromic electrical stimulation. (2). Antidromic C-fiber activation generated a spontaneous ongoing activity in many skin units; this was independent of mechanical stimulation and outlasted electrical stimulation. The fact that neither antidromic electrical stimulation of the crushed nerve trunk nor selective A-fiber activation elicited these reactions suggests that they were mediated via action potentials of slowly conducting (C-fiber) axons. Immunohistochemical staining revealed both substance P- and calcitonin gene-related peptide-like immunoreactivity in small unmyelinated nerve fibers entering the touch dome. These results support the concepts that (1). the type I slowly adapting mechanoreceptor in rat receives input from nociceptive terminals within the touch dome. (2). The function of type I slowly adapting mechanoreceptors is modulated by axon reflex activation of nociceptor terminals, which may play a role in altering the type I response during states of mechanical allodynia and have paracrine and autocrine influences on maintenance of touch dome structure.

Influence of cutaneous nerves on keratinocyte proliferation and epidermal thickness in mice

We evaluated the influence of skin innervation on the epidermis in mice. The rich innervation of skin was demonstrated by immunocytochemistry with protein gene product 9.5, a ubiquitin carboxy hydrolase. Protein gene product-immunoreactive nerve fibers were in the epidermis, subepidermal plexus, dermal nerve trunks, and nerve terminals around sweat glands. Effects of denervation on the plantar surface of the hind foot was assessed by comparing the thickness of the epidermis, which was innervated by the sciatic nerve. Within 48 h after sectioning of the sciatic nerve, protein gene product (+)-nerves in the territory of the sciatic nerve were completely degenerated. There was a significant thinning of the denervated epidermis 72 h post-transection (30.5+/-1.1 vs 41.4+/-2.9 microm, 74+/-4% of the control side). The reduction in epidermal thickness persisted when skin remained denervated (69-75% of the control side). Incorporation of bromodeoxyuridine was reduced 24 h after denervation (71+/-6% of the control side). Reduction in bromodeoxyuridine-incorporation was most pronounced within 48 h after denervation (19+/-6% of the control side). Therefore, the reduction in bromodeoxyuridine-labeling followed a similar temporal course as the thinning of the epidermis (25-50%). Both epidermal thinning and reduced bromodeoxyuridine-labeling were reversed by epidermal reinnervation three months after denervation. Patterns of keratinocyte differentiation and programmed cell death were unaffected by skin denervation. These findings are consistent with the notion that skin innervation exerts influence on the proliferation of keratinocytes and the thickness of the epidermis, and offers a new look at the interaction between nociceptive nerves and their innervated targets.

Postnatal loss of Merkel cells, but not of slowly adapting mechanoreceptors in mice lacking the neurotrophin receptor p75

Merkel cells are specialized epidermal cells which are abundantly found in touch-sensitive areas and which are innervated by slowly adapting mechanosensitive afferent fibres with large myelinated (Abeta) axons. The role of Merkel cells in mechanosensation, their developmental regulation and their influence on sensory neuron function are, however, incompletely understood. Here, we used mice lacking the neurotrophin receptor p75 which is expressed on Merkel cells to investigate their postnatal development and that of their innervating sensory neurons. Using morphological studies we now show that Merkel cells develop normally in both hairy and glabrous skin in these animals until 2 weeks old, but are progressively lost thereafter and have almost completely disappeared 2 months after birth. Using standard extracellular electrophysiological recording techniques we find that despite the profound loss of Merkel cells there is no corresponding reduction in the number of myelinated slowly adapting afferent fibres. Moreover, the mean mechanical threshold of these neurons and their average stimulus response function to suprathreshold mechanical stimuli does not change during the time period when more than 99% of Merkel cells are lost. We conclude that Merkel cells require p75 during the late postnatal development. However, neither the survival nor the mechanical sensitivity of slowly adapting mechanoreceptive Abeta-fibres depends on the presence of Merkel cells.

Modulation of keratinocyte proliferation by skin innervation

Several lines of evidence suggest that sensory nerves ending at the skin have profound influences on their target, the epidermis. To test the hypothesis, we examined the consequences of denervation on the paw skin of rats by eliminating its innervation. We investigated temporal changes of nerve degeneration, keratinocyte proliferation and differentiation, gene expression, and epidermal thickness. Nerve terminals in the epidermis began to degenerate within 24 h after denervation. All epidermal nerves were completely degenerated by 2 d. During the interval of nerve degeneration, there was a significant reduction of bromodeoxyuridine incorporation from 24 h of nerve injury (39 +/- 7% of the control side, p 0.01). By 2 d, there was a further reduction of bromodeoxyuridine labeling (11 +/- 8%, p < 0. 0001). The incorporation of bromodeoxyuridine remained depressed when the skin was denervated (35 +/- 11%, p < 0.01). Four days after eliminating skin innervation, the denervated epidermis became thinner than the control epidermis (70 +/- 8% of the control, p < 0. 01). Epidermal thinning was associated with a significant decrease in expression of glyceraldehyde-3-phosphate dehydrogenase and beta-actin transcripts (33 +/- 8% of the control epidermis from postoperative day 4, p < 0.001). Other aspects of keratinocyte differentiation, including the patterns of keratin expression, and programmed cell death, were unaltered by skin denervation. These data indicate that skin denervation is sufficient to influence keratinocyte proliferation and therefore epidermal thickness.

Sensory and motor denervation influence epidermal thickness in rat foot glabrous skin

Denervation in man often results in shiny, dry, thin skin. A previous study has shown that the epidermis of glabrous skin in the rat becomes approximately 40% thinner within 1 week following sciatic nerve transection, but which nerve fiber type or types influence epidermal thickness is unknown. In this study, we compared the effects on the epidermis of selective sensory, motor, and sympathetic denervation. Protein gene product 9.5 and calcitonin gene-related peptide immunocytochemical staining were used to determine the extent of denervation of epidermis, dermis, and sweat glands in the footpads. Epidermal thickness of the glabrous plantar skin of the foot was measured. To verify the specificity and reliability of each animal model, the relevant regions of the peripheral nervous system were examined by light or electron microscopy or both. Epidermal thickness decreased significantly following sciatic nerve transection (58% of control, P < 0.05) and dorsal root ganglionectomy (59%; P < 0.05). The thickness also decreased following lumbar ventral rhizotomy (61%; P < 0.01), destruction of lumbar spinal motor neurons (66%; P < 0.05), and botulinum toxin-induced paralysis of the tibialis anterior and gastrocnemius muscles (70%; P < 0.05). A slight decrease followed dorsal rhizotomy (84%; P < 0.01). In contrast, no significant alterations in epidermal thickness were detected following sham operation and sympathectomy. Epidermal thinning was paralleled by reductions in the amounts of transcripts for glyceraldehyde-3-phosphate dehydrogenase and beta-actin. These results suggest that selective loss of both sensory and motor fibers to the hind limb can contribute to reducing epidermal thickness in rat foot glabrous skin.

Epidermal denervation and its effects on keratinocytes and Langerhans cells

Skin innervation has been considered to subserve sensory perception only, but several lines of evidence suggest that there are "effector' influences of skin innervation on the immune system and keratotinocytes. In this study, we transected the sciatic nerves of rats and examined the effects of denervation on the epidermis. In normal skin, the epidermis was densely innervated by fine axons that were immunostained with several axonal markers, including neuronal ubiquitin carboxyl terminal hydrolase (protein gene product 9.5). All of the epidermal axons in the regions innervated by sciatic nerve disappeared within 24-48 h after transection of sciatic nerve, and remained absent as long as subsequent reinnervation by regenerating axonal sprouts was prevented. Denervation produced changes in both the keratinocytes and the Langerhans cells, the bone marrow-derived antigen-presenting cells of the epidermis. The thickness of epidermis decreased within 7 days. By 48 h after transection, the Langerhans cells and their dendritic processes became intensely immunoreactive for protein gene product. Protein gene product 9.5 expression on Langerhans cells remained prominent as long as skin was denervated, but disappeared with reinnervation. By reverse transcription-polymerase chain reaction, we demonstrated the presence of the transcripts for protein gene product 9.5 in epidermis, consistent with the synthesis of the protein by the Langerhans cells. We conclude that epidermal sensory fibres have novel influences on both keratinocytes and Langerhans cells of the epidermis.

Protein gene product 9.5-immunoreactive nerves and cells in human oral mucosa

BACKGROUND

Current conflicting information on the innervation of the human oral cavity indicates technical problems such as different detectability of the neural structures according to the various staining methods used and difficulties in reproducibility. The possibility of intraoral regional differences has not been properly considered.

METHODS

Human biopsies of mucosa from different intraoral regions were prepared for immunohistochemistry using protein gene product 9.5 (PGP 9.5; a marker for neuronal structures).

RESULTS

Nerves were found consistently in all the biopsies. The neural pattern showed clear regional differences. Intraepithelial nerve fibers were found in the gingiva, labia, palate, within certain fungiform papillae, and in some salivary excretory ducts. Organized nerve endings were found in varying frequencies in all but one (sublingual) region, appearing as lamellar (Meissner-like), coiled or glomerular neural structures. Merkel cell-neurite complexes were observed in the buccal, gingival, and palatal epithelia. Immunoreactive cells with many similarities to Merkel cells but without a neural connection were also encountered.

CONCLUSIONS

Conflicting results from earlier innervation studies of the oral cavity could be attributed to regional innervation differences. The distribution of the nerves also casts doubt on some of the present theories concerning the function(s) of intraoral nerves, such as the free nerve endings and the Merkel cell-neurite complexes.

Merkel cells in mouse skin: intermediate filament pattern, localization, and hair cycle-dependent density

The distribution and antigen expression of Merkel cells in mouse skin is as yet ill defined. Since the mouse offers an excellent model for studying the origin and functions of Merkel cells, the Merkel cell distribution as well as the expression of intermediate filament proteins and neuronal markers was characterized in C57 BL/6 mouse skin by immunohistochemistry and electron microscopy. Merkel cells in whisker pads, back, and foot pad skin as identified by staining for neuron-specific enolase-an established neuroendocrine marker--expressed cytokeratins (CK) 8,18, and 20 (i.e., simple-epithelial CKs), but not CKs 4 and 13. Sequential double staining for neuron-specific enolase and CK 20 showed consistent co-expression in Merkel cells, establishing CK 20 as a specific immunocytochemical marker for mouse Merkel cells. The Merkel cells also were immunoreactive for synaptophysin but not for neurofilament proteins, peripherin, S-100 protein, and neural cell adhesion molecule. Using CK 8, 18, and 20 as markers, we detected many Merkel cells in the outer roots sheath of vibrissae hair follicles and in foot pad skin. However, only few Merkel cells were found in back skin. These were restricted to small clusters, localized basally within the Haarscheiben epidermis of tylotrich hair follicles, and formed close contacts to prominent nerve fiber terminals as shown by electron microscopy. In striking contrast to human skin, Merkel cells were never found in the epithelium of pelage hair follicles. Even more strikingly, the density of Haarscheiben-associated Merkel cells changed substantially during the highly synchronized, depilation-induced C 57 BL/6 hair cycle, with a minimum in back skin with all hair follicles in telogen or catagen, and a maximum in back skin with all hair follicles in anagen IV-VI. These observations on the Merkel cell hair cycle-dependent distribution in murine skin point to important differences in Merkel cell functions between humans and mice, and raise intriguing questions as to the role of Merkel cells in hair biology.

Mitochondrial distribution within the terminal neurite of the pacinian corpuscle

Electron-microscopic analyses of the mitochondrial organization within the neurite innervating the Pacinian corpuscle (PC) were performed to test the hypothesis that the sites of mechanotransduction are the filopodia projecting from the neurite's surface. Since high concentrations of mitochondria imply the need for metabolic energy, and since transduction mechanisms are heavily dependent on such energy, it was reasoned that the greatest concentration of mitochondria should occur near the filopodia if they are involved in mechanotransduction. The analysis that the mitochondria lie close to the terminal neurite's membrane, on average within 0.4 microns, and thus are ideally located for supplying energy for membrane mechanisms. Although they can be found in a ring-like array, as seen in cross-sections of the terminal neurite, their greatest concentration occurs where the filopodia project from the terminal neurite. A linear algebraic analysis of the data set confirmed a high probability of the joint occurrence of a filopodial base and an increased frequency (number) of mitochondria. Thus the results provide further circumstantial support for the hypothesis that transduction within the PC mechanoreceptors takes place at or near the filopodia.

Merkel cells are not the mechanosensory transducers in the touch dome of the rat

The identity of the mechanosensory transducing elements in the vertebrate touch receptors that contain Merkel cell-neurite complexes is unknown. The Merkel cells, however, have long been the favoured candidates. We have now selectively eliminated the Merkel cells from rat touch domes by first loading them with quinacrine, and then irradiating the domes with near-UV light. Mechanical stimulation of these domes revealed a range of mechanosensory function, evaluated qualitatively, that varied from non-responsive to normal. Since irradiation eliminated the quinacrine fluorescence, the status of the Merkel cells was evaluated by EM. In both responsive and unresponsive domes fixed for EM immediately following irradiation, the Merkel cells and associated nerve endings appeared to be normal. After 2 or more days, even in domes that continued to be normally responsive, there was a striking reduction in the normal complement of about 90 Merkel cells, and most of the remaining Merkel cells appeared to be degenerating. However, numerous 'isolated' (Merkel cell-free) nerve endings remained in the basal epidermis. A few of these nerve endings showed signs of damage, but in the non-responsive domes abnormal nerve endings were routinely observed. The EM studies did not exclude the possibility that a few surviving innervated Merkel cells, or even one such, had escaped detection and were responsible for a persisting mechanosensitivity. To resolve this issue a mechanical stimulating technique with a spatial resolution of 55 microns was used to map the mechanosensory profile of a single responsive dome irradiated 2.75 days earlier. This dome was then serially sectioned for EM study. Only seven Merkel cells had survived which appeared to be both viable and innervated, but almost all of the tested sites were normally responsive. When the correlation was made, seven of these sites were located 55-100 microns away from the nearest surviving Merkel cell, four were 110-165 microns away, and three were more than 165 microns away. Even when allowance is made for errors in the positioning of the stimulus, the responses at the last seven sites cannot be attributed to the presence of underlying Merkel cells. We conclude that mechanosensory transduction within touch domes is not a function of the Merkel cells, but must reside in the associated nerve endings.

The cat pudendal nerve: afferent fibers responding to mechanical stimulation of the perineal skin, the vagina or the uterine cervix

Some afferent fibers from the pudendal nerve of the female cat were stimulated by pressing on the perineal skin, the vagina or the uterine cervix. Three different types of skin mechanoreceptors were found: (1) with low threshold (< 20 mg) and slow-adapting discharges; (2) with high threshold (0.1-0.5 g) and slow-adapting discharges; and (3) with low threshold and fast-adapting discharges. Most of these receptors increased their firing frequency as the velocity of skin indentation was increased (velocity detectors). The average conduction velocity of the skin afferents was 29 +/- 9 m/s. The receptors located at the vagina showed a fast-adapting response to probing and were sensitive to the velocity of the probe movement. Most of these receptors, however, showed a slow adaptation when the vaginal wall was distended with a balloon. The conduction velocity in vaginal afferents was 37 +/- 16 m/s. Those receptors responding to pressure on the uterine cervix adapted slowly to constant pressure but were sensitive to the velocity of the pressure pulses. The conduction velocity in the afferents from the uterine cervix was 31 +/- 9 m/s.

Special program of differentiation expressed in keratinocytes of human haarscheiben: an analysis of individual cytokeratin polypeptides

Human haarscheiben, epidermal Merkel cell-rich sensory organs of hairy skin, were studied for the expression of various cytokeratin (CK) polypeptides and other epithelial and neuronal differentiation markers by applying immunoperoxidase and immunofluorescence microscopy to frozen sections and by two-dimensional gel electrophoresis. The basal clusters of Merkel cells were specifically detected by antibodies against CK 20. Haarscheiben keratinocytes were unique mainly by the prominent expression of CK 17 in the lower and middle layers. Further differences as compared to keratinocytes of usual epidermis included the enlargement of the basal compartment, characterized by the expression of CK 5 and the absence of the maturation-associated CKs 1/10/11, and the reduction of CK 15, which is a constituent of normal basal cells. Using CK 17 as a highly sensitive Haarscheibe marker in skin tissue sections, variabilities in the spatial relationship of the haarscheibe and the corresponding hair follicle were recorded. The results show that haarscheibe keratinocytes express a special program of differentiation that may be important for optimal stimulus perception. Immunohistochemical stainings for CK 17 will facilitate further studies on the distribution and biology of haarscheibe.

Functional innervation of cultured skin grafts

The aims of the present study were to determine 1) if grafts of cultured skin become innervated; and 2) whether tactile function of these grafts could be improved by implanting target tissue into them. Autologous skin equivalents were generated in vitro (30 d) for individual adult Sprague-Dawley rats. Some animals received pure skin equivalent grafts; others had target tissue consisting of 2-mm punch biopsies (normal skin or touch domes) inserted into their skin equivalents at the time of grafting. After 83 d, physiologic recordings were obtained from afferent nerves innervating the grafts. Tissue was processed for histology at various intervals. Silver staining of the tissues demonstrated many isolated nerve fibers in the dermis of cultured areas of skin as well as in implant zones. When grafts were rubbed with a glass rod or pinched with watchmaker forceps, impulses were evoked in nerves innervating both implant and cultured regions. In contrast, the afferent response to gently stroking grafts with a camel hair brush was severely reduced in cultured areas but was vigorous in implanted skin. Neuronal activity characteristic of type I neurons innervating touch domes was only found in cutaneous nerves innervating implants originally possessing domal tissue. Furthermore, grafts with good takes had better return of sensory function than grafts undergoing episodes of crusting. These results suggest that structural components or trophic factors present in implants enhanced the return of neural function related to the sensory modality of light touch; and this was also affected by the engraftment quality.

The differentiation of the skin and its appendages. I. Normal development of papillary ridges

In the present study, the normal development of papillary ridges was studied in the volar pads of both fore and hindpaws of the opossum, Monodelphis domesticus. At birth, the developmental state of the opossum's paws is equivalent to that of a six-week human embryo. The development of papillary ridges in the opossum occurs entirely postnatally and the hindpaw lags behind the forepaw by at least four days in most developmental parameters. Papillary ridge formation is preceded by four events: skin innervation, Merkel cell differentiation, mesenchymal condensation, and epidermal proliferation. The apical pads at the tips of the digits and the interdigital pads between the heads of the metacarpals (or metatarsals) have a unique pattern of innervation and mesenchymal content as compared to the non-pad skin. Each pad is innervated by a prominent nerve trunk and axons ascend towards the epidermis providing a density of innervation that exceeds that in the non-pad epidermis. Merkel cells are absent in non-pad epidermis but present in the pads prior to the onset of formation of papillary ridges. A loose aggregation of mesenchyme forms the core of the pads and the superficial dermis is more cellular in the pads as compared to the equivalent dermis in surrounding non-pad skin. Developing papillary ridges always contained Merkel cell-axon complexes. Merkel cell axon complexes serve as the anatomical substrate of slowly adapting (SA) mechanoreceptors. The presence of these complexes during early skin differentiation is consistent with the use of the opossum's forepaw in climbing to the nipple, but also suggests other possible functions. We hypothesize that the nervous system might play a role in the timing or patterning of the formation of papillary ridges.

The differentiation of the skin and its appendages. II. Altered development of papillary ridges following neuralectomy

In order to test the hypothesis that the nervous system is an important determinant of skin differentiation, deletions of the left lumbosacral dorsal root ganglia (DRGs), the sources of cutaneous afferents to the left hindpaw, were performed on opossum pups at day 1 when hindpaws have just begun to be innervated. At birth, each lumbosacral DRG measures about 200 microns rostrocaudally and a deletion measuring 1 mm would span 4-5 DRGs. Following survival periods of 5-24 days, serial sections through the trunk documented partial left lumbosacral DRG deletion and a variable degree of spinal cord destruction. The blood supply to the trunk and hindpaws was preserved. Bilateral enlargement of residual DRGs was observed and regenerating skin at the site of the deletion was hyperplastic and hyperinnervated. The skin of the plantar pads of the hindpaws was studied following the neuralectomies. Statistically significant differences were observed between the left (experimental) and right (control) hindpaws. The density of innervation of the left hindpaw was reduced compared to the right hindpaw, development of papillary ridges was retarded by 3-4 days, and non-innervated Merkel cells were hypogranulated. This period of delay in ridge development is probably a reflection of the expansion of residual DRGs into the peripheral domains of deleted DRGs. The present study confirms a role for afferent nerves in the timing of cutaneous differentiation and a mutual trophic dependence between cutaneous nerves and Merkel cells in the epidermis.

The neural dependency of Merkel cell development in the rat: the touch domes and foot pads contrasted

We have used the quinacrine labeling technique and electron microscopy to study the development of the Merkel cell population in the skin of the rat and how this is affected by denervation produced at birth and at various times thereafter. An unexpected difference was found between the Merkel cells of glabrous and hairy skin. In the paw pads of rats aged 1 day or older the Merkel cells differentiated normally and survived quantitatively in the absence of their nerves. In the touch domes however, denervation at 1-4 days prevented the differentiation of the normal Merkel cell population and led to the disappearance of all or most of the Merkel cells that were already present. The Merkel cells in touch domes of the lower leg were affected by denervation like those of the back skin, differing strikingly from the Merkel cells of the footpads, even though the hairy skin of the leg and the glabrous skin of the foot are innervated by the same anatomical nerve. In adult rats, axons regenerating to denervated paws reinnervated epidermal Merkel cells of the pads and restored essentially normal mechanosensitivity to them; thus the Merkel cells of mammalian glabrous skin, like their counterparts in the wholly glabrous skin of lower vertebrates (S. A. Scott, E. Cooper, and J. Diamond, 1981, Proc. R. Soc. London B211, 455-470; K. M. Mearow and J. Diamond, 1988, Neuroscience 26, 695-708), can act as targets for ingrowing nerves. However, even though the differentiation of Merkel cells in hairy skin is nerve dependent, they probably have in common with the Merkel cells of glabrous skin the role of acting as final targets for nerves during development and regeneration.

Axonal domains within shared touch domes in the rat: a comparison of their fate during conditions favoring collateral sprouting and following axonal regeneration

Low-threshold mechanosensory nerves in the adult rat differ both from their counterparts in lower vertebrates and from high-threshold nociceptive nerves in mammals in that they appear not to undergo collateral sprouting into adjacent denervated skin, although they will clearly regenerate into it after they are damaged. We have now studied the growth capabilities of the low-threshold nerves supplying touch domes, the visible mechanosensory structures scattered throughout the hairy skin. Touch domes in the rat are often multiply innervated. A serendipitous observation on such domes allowed us to investigate the possibility that a functional collateral sprouting of their nerves can indeed occur, but only to a spatially very restricted extent, e.g., within the confines of a partially denervated dome. We used a "prodder" with a tip diameter of 16 micron to examine the mechanosensory profile across single domes that were preselected as being supplied by only two axons, one running in each of two adjacent dorsal cutaneous nerves (DCNs). Simultaneous recordings were made of the afferent discharges evoked in these nerves when the prodder was applied at about 17 or more locations on a selected dome; the spatial resolution was better than 55 micron. We found that within such a shared dome, one axon can supply a discrete territory (its "domain"), which may or may not overlap with the corresponding domain of the other axon. In a preliminary electron microscopic study, we found no evidence for a sharing of single Merkel cells, which are the specialized sensory cells in touch domes, even in the regions of a shared dome where two domains overlapped; each innervated Merkel cell appeared to be contacted by a single nerve ending, implying that in a shared dome each axon probably supplies an exclusive subpopulation of the Merkel cells. We tested for functional collateral sprouting by eliminating one nerve to a shared dome, and at a selected time thereafter mapping the domain of the remaining axon to see whether it had enlarged. The result was the same whether the two domains initially had a region of overlap or not; no expansion of the surviving domain occurred over postoperative periods up to 4 months (an expansion of the domain by 55 micron would have been detected). Thus functional collateral sprouting had failed to occur.(ABSTRACT TRUNCATED AT 400 WORDS)

Development of Merkel cell populations with contrasting sensitivities to neonatal deafferentation in the rat whisker pad

In this study, we used the quinacrine fluorescence technique to investigate the embryonic and early postnatal development of two distinct populations of Merkel cells in the rat whisker pad and the consequences of neonatal deafferentation on their subsequent development. Annular clusters of Merkel cells first appear in the epidermis near the caudal margin of the mystacial region between embryonic days E14 and E15 at dome sites located on horizontal ridges where the primordial vibrissal follicles develop. The development of these cells progresses in a caudorostral sequence across the whisker pad as does the development of the vibrissal follicles. Each cluster eventually forms a conical ridge or collar of about 130 Merkel cells that surrounds the vibrissal hair shaft as it penetrates the overlying pad epidermis. In the vibrissae, which develop as downgrowths from the horizontal ridges at the dome sites, Merkel cells first appear (caudally) between E16 and E17 and form a cylindrical cuff within the outer root sheath; cells are added progressively until about the end of the first postnatal week when a plateau level of about 750-800 cells is reached. Following unilateral transection of the infraorbital nerve at 24-36 hr after birth, these vibrissal Merkel cells continued to develop along a time course that was indistinguishable from normal, at least over the first 2 weeks of postnatal life. In contrast, all or most of the Merkel cells that normally develop within collars or annular clusters in the pad epidermis (around both the vibrissal and intervibrissal or pelage hairs) either disappeared within a few days or failed to develop. Other light and electron microscopic procedures supported the main findings and confirmed that the denervation was successful. Thus, the vibrissal Merkel cells, like those in the glabrous hindpaw, behaved as a distinct class which develops postnatally and is maintained (at least over a 2-week period) without the presence of sensory nerves. Since both the mystacial vibrissae and glabrous hindpaw have specialized cortical representations, a possible relationship between these findings and the organization of the somatosensory cortex during development is discussed.

The early embryogenesis of papillary (sweat duct) ridges in primate glabrous skin: the dermatotopic map of cutaneous mechanoreceptors and dermatoglyphics

The present study documents the early innervation of the epidermis prior to the onset of differentiation of the papillary (sweat duct) ridge in glabrous digital skin of rhesus monkey embryos measuring 45, 50 and 55 mm (crown-rump) length. We observed small papillary ridges, spaced at a distance of approximately 40 microns, projecting into the dermis in the center of the distal glabrous digital pad of digits 2-5 in the 55-mm embryo. The other digital pads lacked any sign of ridge formation. A two-dimensional, approximately hexagonal grid of afferent nerves was present in the superficial dermis of all digital and palmar pads. At regular intervals of approximately 40 microns, afferent nerves ascended from the superficial dermal nerve plexus and innervated the overlying epidermis. By electron microscopy, axonal growth cones were identified contacting Merkel cells that projected several microns down into the superficial dermis in the digital pad of digit 3. Thus, the earliest wave of differentiated dorsal root ganglion neuroblasts innervates Merkel cells. Schwann cells partially encircled these growing axon tips and could be identified by the presence of rough endoplasmic reticulum and free ribosomes. The youngest embryo studied had no sign of ridge formation; however, axons ascended from the superficial dermal nerve net at 30-40-microns intervals to innervate the epidermis. We conclude that afferent nerve fibers provide a two-dimensional grid that could modulate the spacing and arrangement of the papillary or sweat duct ridges of successive digits. Such an interaction is possible between digits based on the overlapping dermatotopic maps of each rete ridge. An abnormal fingerprint could thus reflect abnormal dorsal root ganglion neuroblasts expressed through mesenchyme and epidermis.

Intermediate filaments in Merkel cell tumors

A series of ten Merkel cell tumors is described, with special emphasis on intermediate filament expression. The presence of cytoskeletal proteins was studied with a polyclonal antiserum directed against cytokeratin and with monoclonal antibodies against cytokeratin, neurofilament, and vimentin by the immunoperoxidase technique. Cytokeratin was demonstrated in nine of ten tumors. Neurofilament was observed in the two snap-frozen tissues tested and in three of the eight formalin-fixed, paraffin-embedded tissues. No reactivity for vimentin was found. By electron microscopy desmosomes were found to be present in all cases, while tonofilaments were found in only a few cases. neurosecretory granules, although seen in all tumors, were generally present in low numbers. The results of this study indicate that the Merkel cell tumor is a poorly differentiated small cell carcinoma that has the ability to express some neuroendocrine features.

Properties of cutaneous mechanosensitive afferents during the early stages of regeneration in man

The technique of percutaneous microneurography was used to record single unit activity from 75 regenerated primary afferents innervating the glabrous skin of the human hand. Thirteen patients were studied, who had suffered complete transection, with subsequent suture or graft, of the median or ulnar nerves. The recordings were obtained from 7 to 23 months postoperatively (early regeneration). Three types of mechanoreceptive afferents (RA, SAI, SAII) and many deep units of unknown origin were found. No regenerated PC units could be identified. The reinnervated receptors were predominantly located in the palm and proximal fingers, comparable to those found 3 years or more postoperatively (late regeneration). Response thresholds and in general, discharge and receptive field characteristics of the majority of afferents were largely comparable to late regeneration and normal. The properties of SAII units were like normal in all respects. However, several distinct abnormalities were encountered early during regeneration: multiple receptive fields innervated by a single afferent (2/9 RA and 2/9 SAI), unusually small or large receptive fields (RA and SAI), pronounced fatigue on repetitive stimulation (7/15 SAI, 4/6 deep). Responses of reinnervated skin to sustained and repeated indentations were found to be similar to those of normal skin, and therefore, could not account for the abnormal discharge behavior. It is suggested that the transitional properties of regenerating afferents reflect unstable axon-end organ connections and immature axonal properties. Both factors would contribute to the slow course of sensory recovery, making prognosis on tactile recovery unpredictable.

Reinnervation of the rat touch dome restores the Merkel cell population reduced after denervation

By using the fluorescent dye quinacrine as a marker for the Merkel cells in the rat touch dome, we previously showed that a sustained denervation of the dome causes a rapid and persistent loss of about 60% of its Merkel cells [Nurse, Macintyre and Diamond (1984) Neuroscience 11, 521-533]. We now show that if the sensory nerves to the skin are crushed (or cut) in 2-week old pups and allowed to regenerate, the Merkel cell population within touch domes shows a biphasic response; there is an initial loss of Merkel cells associated with the early phase of denervation, followed by an increase, associated with the phase of reinnervation. Physiological tests revealed that many (though not all) domes within initially deafferented skin had become functionally reinnervated and had their Merkel cell numbers either wholly or partially restored some 40-100 days post operatively. In one case an adult reinnervated dome, that appeared normal physiologically and by its complement of quinacrine fluorescent (Merkel) cells, also had normal histological features in toluidine blue sections and normally innervated Merkel cells in the electron microscope. These results, based on the use of quinacrine to visualize the Merkel cell population in the touch dome, suggest that sensory nerves may induce the differentiation of new Merkel cells in domes where these cells have become reduced after denervation.

A quantitative study of the time course of the reduction in Merkel cell number within denervated rat touch domes

By using the fluorescent dye quinacrine as a marker for the Merkel cells in rat touch domes we have shown that denervation results in a progressive reduction in the number of these cells to a level that remains relatively constant at about 40% of that present at the time of denervation. The time-course of quinacrine fluorescent cell changes after denervation could be described by assuming that (i) there are two populations of quinacrine fluorescent cells, one labile and the other stable, and (ii) the labile population is the one most sensitive to denervation and disappears exponentially with a half-time of ca 10 days. It appeared that this time-course of decay of the labile quinacrine fluorescent cells was the same whether the denervation was performed during the period of postnatal development studied (at 7 and 14 days), when normally Merkel cells are rapidly added to the dome, or later (at 35 and 60 days) when the adult population is virtually established. Correlative electron microscopic studies confirmed that quinacrine fluorescent cell counts reflect fairly accurately the Merkel cell population in denervated domes. These quantitative findings based on the use of quinacrine to visualize the entire Merkel cell population of touch domes show that the normal development and maintenance of these cells are trophically dependent on sensory nerves, although a subpopulation may persist even in long-term denervated domes. In addition, the similarity of the first order rate constant for the decay of quinacrine fluorescent cells after denervation and for the normal generation of quinacrine fluorescent cells suggests that the labile Merkel cell population is one that turns over continuously in the normally innervated touch dome.

Denervation reduces extractable Met-enkephalin-like immunoreactivity in guinea-pig lips

Skin extracts of the upper lip of 18 guinea pigs were made and subjected to a Met-enkephalin radioimmunoassay 3-4 weeks, 8 weeks, and 12 weeks after transection of one infraorbital nerve. There was a significant reduction in the concentration of extractable Met-enkephalin-like immunoreactivity in the denervated half of the lip as compared to the innervated side. The reduction increased with time. These results show that the enkephalin content of the guinea pig upper lip depends on an intact innervation by the infraorbital nerve.

Effects of chronic denervation in type I cutaneous mechanoreceptors (Haarscheiben)

Cutaneous type I receptor sites (Haarscheiben or tactile domes) were examined at intervals of 4 to 275 days after chronic denervation of the skin. The number of domes decreased with denervation time, and only about one-third of the domes originally present were still visible at 275 days. Most but not all of the Merkel cells from these domes were absent by 48 days, and the epithelium was significantly thinner than in nondenervated domes. Only a few of the examined domes appeared to be completely devoid of Merkel cells. It is concluded that after nerve transection, domes degenerate but do not always disappear entirely. The remnants may thus act as target sites which either attract regenerating type I nerve fibers or facilitate the formation of new dome structures after nerve regeneration.

Merkel cells and Merkel cell tumors. Ultrastructure, immunocytochemistry and review of the literature

Certain monomorphic cellular tumors that occur in the dermis have been called trabecular carcinomas or Merkel cell tumors. Forty-six cases have been reported to date and the literature on these is reviewed here, with six additional cases reported. Cytologic features include sparse cytoplasm, dispersed chromatin with inconspicuous nucleoli in round nuclei and many mitoses. Trabeculae and pseudorosettes may be identified. Electron microscopy is required for definitive diagnosis. Like normal Merkel cells, tumor cells contain electron-dense granules (80-200 nm), 10 mm filaments and desmosomes. Filament-rich cytoplasmic spikes were found in four tumors. These resemble corresponding protrusions of normal Merkel cells and have not been described in other APUDomas.

Reinnervation of mechanoreceptors in the human glabrous skin following peripheral nerve repair

The technique of percutaneous microneurography was used to record single unit activity from 65 reinnervated and 24 normally innervated mechanoreceptors in the glabrous skin of the human hand. The results were obtained from 20 patients and 5 control subjects. The patients had suffered complete traumatic transsection, with subsequent repair, of the median or ulnar nerves. Three types of mechanoreceptors (RA, SAI, SAII) and many unidentified units located in deep tissues were found to become reinnervated. No reinnervated PC units could be identified. Response thresholds, discharge characteristics and receptive field properties of reinnervated receptors were comparable to normal, with the exception that reinnervated SA I units had slower static discharge rates and smaller receptive fields. No evidence was found for multiple peripheral innervation by a single afferent fiber. The reinnervated mechanoreceptors were predominantly located in the palm and the proximal fingers with few in the finger tips, contrary to normal. The locations and frequency of occurrence of the different types of receptors could be correlated with the goodness of sensory recovery. It is suggested that these differences result from misguidance of regenerating fibers and from poor reinnervation, and that they account for reduced sensitivity and poor tactile discrimination in patients with peripheral nerve injuries.

Sensory electroneurographic parameters and clinical recovery of sensibility in sutured human nerves

A total of 37 patients with traumatic transection of median or ulnar nerves at the wrist (total 41 nerves) were examined clinically and electrophysiologically 4-59 months after primary or secondary suture or grafting. There was a significant increase of cumulative amplitude with the time after suture, whereas maximum sensory nerve conduction velocity and maximum amplitude of nerve action potentials did not reveal such a correlation. The recovery of two-point discrimination, vibration threshold and sensibility scored according to the scale of Nicholson and Seddon were also not related to the passage of time after operation. Though there were significant correlations between cumulative amplitude and both two-point discrimination and recovery of sensibility, electrophysiological parameters were shown to be inadequate predictors of clinical recovery.

Degeneration of mouse digital corpuscles

The sequential changes of the morphology and the histochemically demonstrated, nonspecific cholinesterase (ChE) activity of the denervated digital corpuscle (Meissner corpuscle) of the mouse were observed by light and electron microscopy for 6 months after transection of the sciatic nerve. A fragment of the sciatic nerve, approximately 1 cm long, was removed from the distal stump to prevent reinnervation. Within one day following nerve division, the axon terminals began to manifest degenerative changes: the axoplasm became electron-opaque and some mitochondria became disorganized. The lamellar cell processes (lamellar) also exhibited atrophic changes: they became thinner and more electron opaque. The lamellar cell body became smaller due to a decreased amount of cytoplasm and contained few organelles except for some free ribosomes. These changes advance with time. Around 4-6 months after denervation, the corpuscle was small, consisting of a few thin, shrunken, atrophic lamellar cells. The ChE activity persisted and could be demonstrated in the interlamellar spaces, but its intensity decreased with time so that the corpuscle was hardly identifiable by light microscope histochemistry around 4-6 months after denervation. During this time, the precipitates of the reaction product were scattered as small particles throughout the interlamellar spaces. The enzyme activity in the cisternae of the rough endoplasmic reticulum and the nuclear envelope of the lamellar cell body was no longer demonstrable 5 days or less after denervation. These findings indicate that the lamellar cell is dependent on the axon terminal to maintain its normal morphology and the function of ChE synthesis.

Fine structural and morphometric studies of the Merkel cell during fetal and postnatal development

The morphological and morphometric changes of the Merkel cells during fetal and postnatal development were studied in the glabrous digital pads of rats. In 20-day-old fetus rats, the Merkel cells we observed were present in the lower spinous and basal layers, and not associated with axon terminals. The Merkel cell granules were few and sparse. The Merkel cell had clumps of fibrils and formed many desmosomes with surrounding keratinocytes. In postnatal rats, innervation was followed by an increase in the number of Merkel cell granules, and their specific accumulation. The fibrils of the Merkel cells were not prominent. It was found by t-test that the numerical density of the Merkel cell granules significantly increased from the fetal stage to 4-day-old postnatal rats. These results suggest that the Merkel cells are present in the epidermis without nerve contact in 20-day-old fetus rats, and that innervation is necessary for the increase of cellular activity in Merkel cells.

Reconstruction of congenital aplasia of digits

Reconstruction of partial digital aplasia with one border digit is attainable in young patients. It requires construction or transplantation of a stable part with functional sensibility to permit pinch and grasp. Toe transplants provide these functions relatively rapidly but carry a certain risk of failure and add a new deformity to the foot. The construction of a skin mitten by unfolding of the dorsal flap in the affected limb requires additional skin cover from a distance. Stabilization with a bone graft is done at a later stage. If the border digit is hypoplastic, staged autogenous bone grafts permits attainment of greater length. Using bone with epiphyseal plate from the toes of young children does not always result in growth. The assessment of regained sensibility in our patients was done with two-point discrimination but was not reliable in children under age seven. Sensibility in the unfolded flap was regained gradually over a long period of time. The longest follow up in this group was 11 years: the patient attained two-point discrimination of 7 mm. Published experiments with the denervated skin of laboratory animals demonstrated some return of sensibility through nerve sprouting. The pathway of sensibility in the denervated unfolded dorsal flap is continuity with volar intact skin is not known but is presumed to require some form of nerve sprouting. The advantages of using the unfolded dorsal flap are that in lengthens palmar skin without an intervening scar or unpleasant paresthesia and does not produce a defect in the foot.

Development of rat Merkel cells

The ultrastructure of Merkel cells and cutaneous nerves was examined in fetal, newborn, and 7-day-old rats. The earliest observation of cells having some, but not all, of the features of mature Merkel cells was at 16 days gestation in snout skin. These early presumptive Merkel cells resembled the neighboring keratocytes, except that they contained dense-cored vesicles scattered in the cytoplasm. Presumptive Merkel cells were seen only in the epidermis, although a careful search was made of the dermis. Developing neurons were not observed to penetrate the epidermal basal lamina when presumptive Merkel cells were first seen. The earliest observation of identifiable nerve axons in the snout epidermis was at 17-171/2 days gestation. Study of the presumptive Merkel cells through successively older gestational stages showed that the cells became innervated and progressively developed the characteristics of adult Merkel cells. We suggest that Merkel cells arise from keratocyte-like precursors in rat epidermis, at a time when skin nerves may still be several micrometers away.