MULTIPLE-SCLEROSIS - REMYELINATION OF NASCENT LESIONS
MULTIPLE-SCLEROSIS - REMYELINATION OF NASCENT LESIONS
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DOI：
10.1002/ana.410330203
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发表时间：
1993-02-01
影响因子：
11.2
通讯作者：
CHO, ES
中科院分区：
文献类型：
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作者：
PRINEAS, JW;BARNARD, RO;CHO, ES
对15例早期死亡的多发性硬化症患者的斑块病理与病程的关系进行了研究。髓鞘染色切片显示，在疾病第一个月死亡的患者中，大多数斑块检查显示有证据表明髓鞘正在破坏，并伴有少突胶质细胞的丢失。在这些患者中没有观察到含有大量少突胶质细胞的斑块，但在临床发病后1个月以上死亡的患者中相对常见。发病10周内死亡的5例患者82个斑块中有3个斑块再髓鞘形成，发病3~10个月死亡的5例患者105个斑块中有38个斑块再髓鞘形成，发病18个月或以上死亡的5例患者92个斑块中有19个斑块再髓鞘形成。这项研究提供了新的证据，表明在新的皮损中少突胶质细胞和髓鞘都被破坏，这种活性在许多皮损中在几周内完全停止，并且在少突胶质细胞重新填充斑块后经常发生重新髓鞘形成。这些发现表明，除非被反复的活动中断，否则新的病变通常会重新髓鞘，而重新髓鞘阴影斑块是先前单次局灶性脱髓鞘的结果。
The relationship between plaque pathology and disease duration was examined in 15 patients with multiple sclerosis who died early in the course of their illness. Myelin-stained sections revealed that most plaques examined in patients who died during the first month of their illness showed evidence of ongoing myelin destruction accompanied by a loss of oligodendrocytes. Plaques containing large numbers of oligodendrocytes were not observed in these patients, but were relatively common in patients who died more than 1 month after clinical onset. Remyelination affecting more than 10% of the plaque area was observed in 3 of 82 plaques in 5 patients who died within 10 weeks of clinical onset, in 38 of 105 plaques in 5 patients who died 3 to 10 months after clinical onset, and in 19 of 92 plaques in 5 patients who died 18 months or longer after clinical onset. The study provides new evidence that both oligodendrocytes and myelin are destroyed in new lesions, that this activity ceases completely in many lesions within a few weeks, and that remyelination frequently ensues following repopulation of the plaque by oligodendrocytes. The findings suggest that new lesions normally remyelinate unless interrupted by recurrent activity and that remyelinated shadow plaques are the outcome of a single previous episode of focal demyelination.