Homogeneity of active demyelinating lesions in established multiple sclerosis

摘要: Objective: Four different patterns of demyelination have been described in active demyelinating lesions multiple sclerosis (MS) patients that were biopsied shortly after disease onset. These suggested to represent heterogeneity the underlying pathogenesis. The aim this study was determine whether lesion also exists an unselected collection autopsy material from with established MS. Methods: All MS brain tissue available VU Medical Center assessed for presence using magnetic resonance imaging-guided sampling and immunohistochemistry. Tissue blocks containing evaluated complement antibody deposition, oligodendrocyte apoptosis, differential loss myelin proteins, hypoxia-like damage histology, immunohistochemistry, confocal microscopy. Blocks compared (nondemyelinating) inactive lesions. Results: Complement antibodies consistently associated macrophages areas demyelination. Preferential extensive damage, apoptosis absent or rare. This pattern observed all lesions; between not found. Interpretation: immunopathological appearance is uniform. Initial earliest phase formation may disappear over time as pathways converge one general mechanism Consistent complement, antibodies, Fcγ receptors phagocytic suggests antibody- complement-mediated phagocytosis dominant © 2008 American Neurological Association.