Skip to main content
SpringerLink
Log in

Ultrastructural changes in blood vessels of peripheral nerves in leprosy neuropathy

I. Tuberculoid and borderline-tuberculoid leprosy patients

  • Original Investigations
  • Published:
Acta Neuropathologica Aims and scope Submit manuscript

Summary

Radial or superficial peroneal nerve biopsies of 6 patients with tuberculoid or borderline-tuberculoid leprosy and 6 control nerve biopsies were examined by electron microscopy.

Endoneurial blood vessels showed histopathology in all the leprosy patients. Changes, in particular, involved the basement membrane in postcapillary venules and venules. Multilayered parellel basement membranes, with collagen and ground substance, formed a thick coat (“hyaline zone”) around the vessels. It is suggested that the zone inhibits passage of nutrients and metabolites and, thus, contributes to or is the main cause of the local destruction of (unmyelinated) nerve fibres and the lack of nerve fibre regeneration observed in this type of leprosy. The perivascular zone, presumably, is produced by pericytes in response to defects in the “blood-nerve barrier” of endoneurial vessels. In granulomata of leprosy skin lesions, a perivascular zone was not present.

The endothelium of endoneurial vessels, in affected nerves, generallywas normal. Occasionally, however, gaps and fenestrations were seen and there were histological indications that leakage of blood plasma had occurred through the gaps and through the basement membrane of the endothelium.

Occlusion of endoneurial vessels was found only in the oldest patient and the degeneration of nerve fibres generally observed thus is considered not to be caused by ischaemia.

Histopathology in epi-and perineurial vessels was definitely less pronounced than in endoneurial vessels.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Adams, W. E.: The blood supply of nerves. I. Historical review. J. anat. (Lond.)76, 323–341 (1942)

    Google Scholar 

  • Adams, W. E.: The blood supply of nerves. II. The effects of exclusion of its regional sources of supply on the sciatic nerve of the rabbit. J. Anat. (Lond.)77, 243–250 (1943)

    Google Scholar 

  • Anapolle, S. E., Albright, J. T., Craft, F. O.: Continued study of the ultrastructure of the gingiva in the diabetic mouse. Microvasc. Res.6, 44–50 (1973)

    Google Scholar 

  • Ashton, N.: Oxygen and the growth and development of retinal vessels. In vivo and in vitro studies. In: Vascular complications of diabetes mellitus with special emphasis on microangiopathy of the eye (eds. S. J. Kimura and W. M. Caygill), St. Louis: C. V. Mosby Co 1967

    Google Scholar 

  • Bischoff, A.: Die diabetische Neuropathie. Praxis24, 723–729 (1965)

    Google Scholar 

  • Bloodworth, J. M. B.: see Discussion following Farquhar (1967)

  • Boddingius, J.: The occurrence ofMycobacterium leprae within axons of peripheral nerves. Acta neuropath. (Berl.)27, 257–270 (1974)

    Google Scholar 

  • Boddingius, J.: Ultrastructural changes in blood vessels of peripheral nerves in leprosy neuropathy. II. Borderline-lepromatous and lepromatous leprosy patients. (In preparation)

  • Boddingius, J., Rees, R. J. W., Weddell, A. G. M.: Defects in the blood-nerve barrier in mice with leprosy neuropathy. Nature New Biol.237, 190–191 (1972)

    Google Scholar 

  • Boddingius, J., Fallaux, E. M.: Argyrophil adenohypophysial cells in the rainbow trout (Salmo irideus), demonstrated simultaneously with chromophil cells and with intracellular argyrophil fibrils by a new technique. Neth. J. Zool.20, 291–297 (1970)

    Google Scholar 

  • Brand, P. W.: Deformity in leprosy. Orthopaedic principles and practical methods of relief. In: Leprosy in theory and practice (eds. R. G. Cochrane and T. F. Davey), Bristol: J. Wright & Sons Ltd. 1964

    Google Scholar 

  • Cervos-Navarro, J.: Elektronenmikroskopie der Hämangioblastome des ZNS und der angioblastischen Meningiome. Acta neuropath. (Berl.)19, 184–207 (1971)

    Google Scholar 

  • Cottrell, L.: Histologic variations with age in apparently normal peripheral nerve trunks. Arch. Neurol. Psychiat. (Chic.)43, 1138–1150 (1940)

    Google Scholar 

  • Dastur, D. K., Pandya, S. S., Antia, N. H.: Nerves in the arm in leprosy. 2. Pathology, pathogenesis and clinical correlations. Int. J. Leprosy38, 30–48 (1970)

    Google Scholar 

  • Dastur, D. K., Ramamohan, Y., Shah, J. S.: Ultrastructure of lepromatous nerves. Neural pathogenesis in leprosy. Int. J. Leprosy41, 47–80 (1973)

    Google Scholar 

  • Eames, R. A., Lange, L. S.: Clinical and pathological study of ischaemic neuropathy. J. Neurol. Neurosurg. Psychiat.30, 215–226 (1967)

    Google Scholar 

  • Edwards, R. P.: Fine structure of normal and diabetic glomerular capillaries. In: Vascular complications of diabetes mellitus with special emphasis on microangiopathy of the eye (eds. S. J. Kimura and W. M. Caygill.) St. Louis: C. V. Mosby Co 1967

    Google Scholar 

  • Gärtner, J.: Extracellular fibril formation by neuroglial cells in cystoid degenerations of the peripheral retina of the human eye. Acta neuropath. (Berl.)26, 45–57 (1973)

    Google Scholar 

  • Hammersen, F.: Anatomie der terminalen Strombahn. München-Berlin-Wien: Urban & Schwarzenberg 1971

    Google Scholar 

  • Harkin, J. C., Reed, R. J.: Tumors of the peripheral nervous system. Atlas of tumor pathology. 2nd. series, Fasc. 3. Armed Forces Institute of Pathol., Washington, D. C. 1969

    Google Scholar 

  • Hirano, A., Ghatek, N. R., Zimmerman, H. M.: Fenestrated blood vessels in craniopharyngioma. Acta neuropath. (Berl.)26, 171–177 (1973)

    Google Scholar 

  • Job, C. K.:Mycobacterium leprae in nerve lesions in lepromatous leprosy. An electron microscopic study. Arch. Path.89, 195–207 (1970)

    Google Scholar 

  • Job, C. K.: Pathology of peripheral nerve lesions in lepromatous leprosy — a light and electron microscopic study. Int. J. Leprosy39, 251–268 (1971)

    Google Scholar 

  • Kniker, W. T.: Immunogenic vasculitis: is it part of diabetes mellitus? In: Vascular complications of diabetes mellitus with special emphasis on microangiopathy of the eye (eds. S. J. Kimura and W. M. Caygill), St. Louis: C. V. Mosby Co 1967

    Google Scholar 

  • Lacy, P. E., Kissane, J. M.: Pancreas and diabetes mellitus. In: Pathology, 6th edit. (ed. W. A. D. Anderson), St. Louis: C. V. Mosby Co 1971

    Google Scholar 

  • Lundborg, G.: Ischemic nerve injury. Experimental studies on intraneural microvascular pathophysiology and nerve function in a limb subjected to temporary circulatory arrest. Scand. J. Plast. reconstr. Surg., Suppl.6, 1–113 (1970)

    Google Scholar 

  • Luse, S. A.: Electron microscopic studies of brain tumors. Neurology (Minneap.)10, 881–905 (1960)

    Google Scholar 

  • Morris, J. H., Hudson, A. R., Weddell, G.: A study of degeneration and regeneration in the divided rat sciatic nerve based on elecron microscopy. Z. Zellforsch.124, 76–203 (1972)

    Google Scholar 

  • Nyström, S.: Pathological changes in blood vessels of human glioblastoma multiforme. Acta path. microbiol. scand., Suppl.137, 1–83 (1960)

    Google Scholar 

  • Olsson, Y., Reese, T. S.: Permeability of vasa nervorum and perineurium in mouse sciatic nerve studied by fluorescence and electron microscopy. J. Neuropath. exp. Neurol.30, 105–119 (1971)

    Google Scholar 

  • Olsson, Y.: The involvement of vasa nervorum in diseases of peripheral nerves. In: Handbook of clinical neurology. Vol. 12 (eds. P. J. Vinken and G. W. Bruyn) Vascular diseases of the nervous system. Part II. Amsterdam: North Holland Publ. Co. New York: American Elsevier Publ. Co. Inc. 1972

    Google Scholar 

  • Ramsey, H. J.: Fine structure of hemangiopericytoma and hemangio-endothelioma. Cancer (Philad.)19, 2005–2018 (1966)

    Google Scholar 

  • Rhodin, J. A. G.: Ultrastructure of mammalian venous capillaries, venules and small collecting veins. J. Ultrastruct. Res.25, 452–500 (1968)

    Google Scholar 

  • Ridley, D. S., Jopling, W. H.: Classification of leprosy according to immunity. A five-group system. Int. J. Leprosy34, 255–273 (1966)

    Google Scholar 

  • Ridley, D. S., Waters, M. R. F.: Significance of variations within the lepromatous group. Leprosy Rev.40, 143–152 (1969)

    Google Scholar 

  • Romeis, B.: Mikroskopische Technik, 16 Aufl. München-Wien: R. Oldenbourg 1968

    Google Scholar 

  • Sunderland, S.: Nerves and nerve injuries. Edinburgh: Livingstone 1968

    Google Scholar 

  • Vick, N. A., Bigner, D. D.: Microvascular abnormalities in virally-induced canine brain tumors. Structural bases for altered blood-brain barrier function. J. neurol. Sci.17, 29–39 (1972)

    Google Scholar 

  • Vital, C., LeBlanc, M., Vallat, J. M., Coquet, M., Vallat, M., Roques, J. C.: Etude ultrastructurale du nerf périphérique chez 16 diabétiques sans neuropathie clinique. Comparaisons avec 16 neuropathies diabétiques et 16 neuropathies non diabétiques. Acta neuropath. (Berl.)30, 63–72 (1974)

    Google Scholar 

  • Waksman, B. H.: Experimental study of diphtheric polyneuritis in the rabbit and guinea pig. III. The blood-nerve barrier in the rabbit. J. Neuropath. exp. Neurol.20, 35–77 (1961)

    Google Scholar 

  • Wheeler, E. A., Hamilton, E. G., Harman, D. J.: An improved technique for the histopathological diagnosis and classification of leprosy. Leprosy Rev.36, 37–39 (1965)

    Google Scholar 

  • White, J. G., Clawson, C. C.: Blood cells and blood vessels. In: Ultrastructure of normal and abnormal skin (ed. A. S. Zelickson), Philadelphia: Lea & Febiger 1967

    Google Scholar 

  • Zacks, S. I., Pegues, J. J., Elliott, F. A.: Interstitial muscle capillaries in patients with diabetes mellitus: a light and electron microscopic study. Metab. Clin. exp.11, 381–393 (1962)

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Human Anatomy, University of Oxford, South Parks Road, OX1 3QX, Oxford, UK

    J. Boddingius

Authors
  1. J. Boddingius
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Boddingius, J. Ultrastructural changes in blood vessels of peripheral nerves in leprosy neuropathy. Acta Neuropathol 35, 159–181 (1976). https://doi.org/10.1007/BF00690562

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00690562

Key words

Search

Navigation