Axon Guidance Cues That May Play a Role in the Development of Small Fiber Pathology

Neuropathic pain may be caused by diverse etiologies and that the same etiology may lead to a painful condition or remain painless. Skin punch biopsy is increasingly used to determine intraepidermal nerve fiber density (IENFD). Although not specific, a reduction of IENFD is a frequent finding in conditions with small fiber pathology. The question is, how intraepidermal nerve fibers may be directed in growth and if peripheral mechanisms may play a role that could be used as surrogates or even future preventive and therapeutic targets. Axon guides are cues that have been hardly investigated in the peripheral nervous system, but that bear the potential to attract and/or repel peripheral axons. Here, the audience will learn about selected axon guides that may play a role in the development of small fiber pathology. Current knowledge will be summarized focusing on patient-derived biomaterial and in vitro model systems to better understand this exciting research field.