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Reduced skin elasticity a potential biomarker of ALS

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – Quantitative measurements of skin elasticity is a “highly promising” non-invasive biomechanical biomarker for detecting amyotrophic lateral sclerosis (ALS) and predicting disease progression, according to research reported at the American Academy of Neurology’s annual scientific meeting in Seattle.

“CNS and skin share the same embryonic origin and many diseases affect both systems,” the researchers explain in a meeting abstract.

“There has always been a suggestion that the skin of patients with ALS is different from the skin of healthy people,” Dr. Hiroshi Mitsumoto of New York Presbyterian Hospital/Columbia University Medical Center, added in a telephone interview with Reuters Health.

For example, the literature notes that decubitus ulcers are uncommon in immobile bedridden ALS patients, the skin is supple and has reduced elasticity, and on biopsy there are quantitative structural and biochemical abnormalities which appear to correlate with disease duration.

Using a cutometer, Dr. Mitsumoto and colleagues measured skin elasticity — how fast the skin returns from negative pressure — in 40 ALS patients and 30 healthy family members at baseline and 3 months later.

The team found “significant differences” between patients and controls at baseline, with skin elasticity significantly reduced in the arm of patients with ALS compared with healthy controls (p < 0.001).

In addition, changes in skin elasticity at 3 months correlated significantly with changes in the ALS Functional Rating Scale (p < 0.01). "Change of elasticity corresponded with disease worsening, and also loosely with decline in breathing capacity over time (p < 0.05), which was very interesting," Dr. Mitsumoto said.

“Further studies are needed to elucidate the relationship of this biomarker to specific biochemical changes related to the pathogenesis of ALS,” the researchers conclude.