Extensive subpial cortical demyelination is specific to multiple sclerosis.
Extensive subpial cortical demyelination is specific to multiple sclerosis.
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DOI：
10.1111/bpa.12813
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发表时间：
2020-05
期刊：
影响因子：
--
通讯作者：
Stadelmann C
中科院分区：
文献类型：
--
作者：
Junker A;Wozniak J;Voigt D;Scheidt U;Antel J;Wegner C;Brück W;Stadelmann C
皮质脱髓鞘病变在慢性多发性硬化（MS）患者中常见且广泛，并可能导致疾病进展。炎症和相关的氧化应激已被认为是皮质损伤的中心介质，但脑膜和皮质炎症并不是MS所特有的，也发生在其他疾病中。本研究的第一个目的是测试皮质脱髓鞘是否特异性脱髓鞘CNS疾病相比，其他中枢神经系统疾病突出的脑膜和皮质炎症。第二个目的是评估氧化性组织损伤是否与神经轴突损伤的程度相关。我们研究了一个大型队列的患者诊断为脱髓鞘CNS疾病和非脱髓鞘疾病的自身免疫性，感染性，肿瘤性或代谢性疾病影响脑膜和皮质。包括MS、急性播散性脑脊髓炎（ADEM）、视神经肌萎缩症（NMO）、病毒性和细菌性脑膜脑炎、进行性多灶性白质脑病（PML）、亚急性硬化性全脑炎（SSPE）、癌性和淋巴瘤性脑膜炎以及代谢性疾病（如脑桥外髓鞘溶解）患者，因此涵盖了广泛的适应性和先天性细胞因子特征。使用髓鞘蛋白免疫组织化学，我们发现MS、ADEM、PML和桥脑外髓鞘溶解症中存在皮质脱髓鞘，因此每种疾病均显示出疾病特异性组织病理学模式。值得注意的是，仅在MS中观察到广泛的带状软膜下脱髓鞘，从而提供了重要的发病和诊断线索。在脱髓鞘和非脱髓鞘CNS疾病中均检测到皮质氧化损伤。我们的数据表明，单独的脑膜和皮质炎症伴氧化应激不足以产生MS中发现的广泛软膜下皮质脱髓鞘，但需要其他MS特异性因素。
Cortical demyelinated lesions are frequent and widespread in chronic multiple sclerosis (MS) patients, and may contribute to disease progression. Inflammation and related oxidative stress have been proposed as central mediators of cortical damage, yet meningeal and cortical inflammation is not specific to MS, but also occurs in other diseases. The first aim of this study was to test whether cortical demyelination was specific for demyelinating CNS diseases compared to other CNS disorders with prominent meningeal and cortical inflammation. The second aim was to assess whether oxidative tissue damage was associated with the extent of neuroaxonal damage. We studied a large cohort of patients diagnosed with demyelinating CNS diseases and non‐demyelinating diseases of autoimmune, infectious, neoplastic or metabolic origin affecting the meninges and the cortex. Included were patients with MS, acute disseminated encephalomyelitis (ADEM), neuromyelitis optica (NMO), viral and bacterial meningoencephalitis, progressive multifocal leukoencephalopathy (PML), subacute sclerosing panencephalitis (SSPE), carcinomatous and lymphomatous meningitis and metabolic disorders such as extrapontine myelinolysis, thus encompassing a wide range of adaptive and innate cytokine signatures. Using myelin protein immunohistochemistry, we found cortical demyelination in MS, ADEM, PML and extrapontine myelinolysis, whereby each condition showed a disease‐specific histopathological pattern. Remarkably, extensive ribbon‐like subpial demyelination was only observed in MS, thus providing an important pathogenetic and diagnostic cue. Cortical oxidative injury was detected in both demyelinating and non‐demyelinating CNS disorders. Our data demonstrate that meningeal and cortical inflammation alone accompanied by oxidative stress are not sufficient to generate the extensive subpial cortical demyelination found in MS, but require other MS‐specific factors.
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DOI：
10.1093/brain/aws012
发表时间：
2012-03
期刊：
Brain : a journal of neurology
影响因子：
--
作者：
Fischer MT;Sharma R;Lim JL;Haider L;Frischer JM;Drexhage J;Mahad D;Bradl M;van Horssen J;Lassmann H
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14.5
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影响因子：
6.4
作者：
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通讯作者：
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DOI：
10.1093/jnen/62.7.723
发表时间：
2003-07-01
影响因子：
3.2
作者：
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Mork, SJ
多发性硬化症中区域灰质萎缩的进展。
DOI：
10.1093/brain/awy088
发表时间：
2018-06-01
期刊：
Brain : a journal of neurology
影响因子：
--
作者：
Eshaghi A;Marinescu RV;Young AL;Firth NC;Prados F;Jorge Cardoso M;Tur C;De Angelis F;Cawley N;Brownlee WJ;De Stefano N;Laura Stromillo M;Battaglini M;Ruggieri S;Gasperini C;Filippi M;Rocca MA;Rovira A;Sastre-Garriga J;Geurts JJG;Vrenken H;Wottschel V;Leurs CE;Uitdehaag B;Pirpamer L;Enzinger C;Ourselin S;Gandini Wheeler-Kingshott CA;Chard D;Thompson AJ;Barkhof F;Alexander DC;Ciccarelli O
通讯作者：
Ciccarelli O