MOLECULAR AND PATHOLOGICAL ANALYSIS OF SPINAL CORD EOSINOPHILIC LESIONS IN ATOPIC MYELITIS

1)特应性脊髓炎与特应性疾病共存的临床研究我们在日本对特应性脊髓炎进行了全国范围的调查，收集了85例特应性脊髓炎病例。特应性脊髓炎伴发特应性皮炎与不伴特应性皮炎的临床表现比较，提示特应性脊髓炎具有以下特点：(1)特应性皮炎以女性为主，(2)发病年龄较小，(3)优先累及颈髓，(4)括约肌功能障碍发生率低于非特应性皮炎。所有活检标本的免疫组织化学染色显示，血管周围淋巴细胞主要由T细胞组成。在进一步检查T细胞亚群的三个病例中，CD8T细胞在血管周围a…占优势。更多的理由。此外，在所有病例的脊髓组织中都发现有大量的嗜酸性阳离子蛋白沉积。3)特应性脊髓病中的II类MHC基因。DPB1*0501和DRB1*1501分别与视神经-脊髓硬化症和传统形式的多发性硬化症有关。4)特应性脊髓炎的治疗虽然皮质类固醇类药物的治疗被证明可以缩短多发性硬化症引起的急性事件的持续时间，但这种治疗在大约三分之二的特应性脊髓炎患者中并不有效。大约80%的这种脊髓炎患者通过血浆置换治疗成功。静脉注射免疫球蛋白结合血浆置换也是有效的。这项研究的结果揭示了日本特应性相关脊髓炎的存在，其中嗜酸性粒细胞被认为像其他特应性疾病一样在组织破坏中发挥关键作用，但包括脊髓炎症在内的确切机制仍有待阐明。较少

1) Clinicolaboratory findings of atopic myelitis with regard to the coexistence of atopic disordersWe conducted a nation-wide survey of atopic myelitis in Japan and then collected 85 cases of this myelitis. Comparison of clinicolaboratory findings between atopic myelitis with and without atopic dermatitis revealed the characteristics of this myelitis as follows ; myelitic patients with atopic dermatitis showed (1)female predominance, (2)younger age of onset, (3)preferential involvement of the cervical cord and (4)less frequent occurrences of sphincter disturbance as comopared to those without atopic dermatitis.2) Immunopathological findings of eosinophilic myelitisFive biopsid cases of eosinophilic myelitis with atopy was collected from all over the country. Immunohistological staining of all biopsied specimens revealed the perivascular lymphocyte cuffings mainly consisted of T cells. In three cases further examined for T cell subsets, CD8 T cells were predominant in the perivascular a … More reas. Moreover, large amounts of eosinophilic cationic protein was found to be deposited in the spinal cord tissues in all cases examined.3) Class II MHC genotypes in atopic myelitisThe associations with DPB1*0501 and DRB1*1501 have been demonstrated in optico-spinal and conventional form of multiple sclerosis, respectively. However, we could not demonstrate either DPB1*0501 or DRB1*1501 association with topic myelitis.4) Treatment of atopic myelitisAlthough a treatment with corticosterods was shown to shorten the duration of acute events due to multiple sclerosis, this treatment was not effective in about two thirds of patients with atopic myelitis. About eighty percentages of patients with this myelitis were successfully treated with plasma exchange. Intravenous immunoglobulin therapy combined with plasma exchange was also useful.The results of this study revealed the presence of atopy-related myeltis in Japanese, in which eosinophils were considered to play a critical role for tissue destruction like other atopic disorders, yet the precise mechanism including the spinal cord inflammation remains to be elucidated. Less