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Expression of GAP-43 has mostly been investigated in skin biopsies from patients with peripheral neuropathies in humans, with several studies reporting a decrease in GAP-43 immunoreactive cutaneous nerve fibres in humans. However, it is also unknown if cutaneous GAP-43 is a reliable indicator of human nerve regeneration. We present a cohort of 22 patients with electrodiagnostically confirmed carpal tunnel syndrome, which is used as a model system for focal nerve injury and neural regeneration after decompression surgery. We examine GAP-43 immunoreactivity and RNA expression in finger skin biopsy biopsies obtained before and six months after surgery, relative to healthy controls. Patients with CTS have lower GAP-43 positive intra-epidermal nerve fiber densification before surgery than healthy controls, according to Weta. These results indicate that cutaneous GAP-43 may not be a reliable indicator of nerve regeneration in humans.
Carpal tunnel syndrome is the most common entrapment neuropathy and has a relatively unknown origins. According to multiple functional tests, we find that at least 22 genes contribute to CTS risk and highlight the presence of 19 CTS variants in the extracellular matrix's biology. We find that the genetic component to the risk is higher in bilateral/recurrent/persistent cases than in nonrecurrent/nonpersistent cases. Our results show that the extracellular matrix elements of the extracellular matrix play a key role in CTS pathogenesis.
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