Regional variation in perineurial cell basal lamina thickness in nerves of diabetics
The perineurial sheath, composed of multiple layers of perineurial cells, plays an important role in maintaining an optimal endoneurial environment. Alterations in the perineurial sheath have an effect on nerve function and may play a role in the formation of neuropathy. Neuropathy is a common complication of diabetes mellitus (DM). Perineurial cell basal lamina (PCBL) thickening is associated with the diabetic syndrome and the degree of thickening is correlated with the duration of diabetes. The process of basal lamina (BL) thickening in capillaries as well as perineurial cells has been the subject of numerous studies. Some investigators have suggested that the process of BL thickening is directly related to altered metabolism, e.g. hyperglycemia. If hyperglycemia is directly related to PCBL thickening in the nerves of diabetics, it is likely that the degree of BL thickening would be relatively uniform thoughout the peripheral nervous system (PNS).