Grey matter damage in multiple sclerosis A pathology perspective
Grey matter damage in multiple sclerosis A pathology perspective
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DOI：
10.4161/pri.23499
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发表时间：
2013-01-01
期刊：
影响因子：
2.3
通讯作者：
Geurts, Jeroen J. G.
中科院分区：
文献类型：
--
作者：
Klaver, Roel;De Vries, Helga E.;Geurts, Jeroen J. G.
在过去的十年中，免疫组织化学研究提供了令人信服的证据，证明多发性硬化症(MS)的灰质(GM)病理是广泛的。直到最近，这种GM病理很难使用标准的磁共振成像(MRI)技术进行可视化。然而，随着新开发的MRI序列的出现，已经清楚地表明，GM损伤从疾病的最早阶段就存在，并随着疾病的进展而增加。GM病理在临床上是相关的，因为GM损害和/或GM萎缩被证明与MS运动缺陷和认知障碍有关。最近的尸检研究显示明显的GM脱髓鞘和小胶质细胞激活。然而，就像在西医病理中一样，广泛的免疫细胞内流、补体激活和血脑屏障渗漏在GM中远没有那么突出。因此，到目前为止，多发性硬化症中GM损伤的原因仍然不清楚，尽管已经提出了几种看似合理的潜在致病机制。本文对多发性硬化症的GM损伤进行了综述，重点介绍了它的拓扑结构和组织病理学。
Over the past decade, immunohistochemical studies have provided compelling evidence that gray matter (GM) pathology in multiple sclerosis (MS) is extensive. Until recently, this GM pathology was difficult to visualize using standard magnetic resonance imaging (MRI) techniques. However, with newly developed MRI sequences, it has become clear that GM damage is present from the earliest stages of the disease and accrues with disease progression. GM pathology is clinically relevant, as GM lesions and/or GM atrophy were shown to be associated with MS motor deficits and cognitive impairment. Recent autopsy studies demonstrated significant GM demyelination and microglia activation. However, extensive immune cell influx, complement activation and blood-brain barrier leakage, like in WM pathology, are far less prominent in the GM. Hence, so far, the cause of GM damage in MS remains unknown, although several plausible underlying pathogenic mechanisms have been proposed. This paper provides an overview of GM damage in MS with a focus on its topology and histopathology.