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| Tissue preconditioning may explain concentric lesions in Balo's type of multiple sclerosis |
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| Author(s): Stadelmann C, Ludwin S, Tabira T, Guseo A, Lucchinetti CF, Leel-Ossy L, Ordinario AT, Bruck W, Lassmann H |
| Source: BRAIN Volume: 128 Pages: 979-987 Part: Part 5 Published: MAY 2005 |
| Times Cited: 57 References: 54 |
| Abstract: Lesions of Balo's concentric sclerosis are characterized by alternating layers of myelinated and demyelinated tissue. The reason for concentric demyelination in this variant of multiple sclerosis is unclear. In the present study we investigated the immunopathology in autopsy tissue of 14 patients with acute multiple sclerosis or fulminant exacerbations of chronic multiple sclerosis with Balo-type lesions in the CNS, focusing on the patterns of tissue injury in actively demyelinating lesions. We found that all active concentric lesions followed a pattern of demyelination that bears resemblances to hypoxia-like tissue injury. This was associated with high expression of inducible nitric oxide synthase in macrophages and microglia. At the edge of active lesions and, less consistently, in the outermost layer of preserved myelin, proteins involved in tissue preconditioning, such as hypoxia-inducible factor 1 alpha and heat-shock protein 70, were expressed mainly in oligodendrocytes and to a lesser degree also in astrocytes and macrophages. Due to their neuroprotective effects, the rim of periplaque tissue, where these proteins are expressed, may be resistant to further damage in an expanding lesion and may therefore remain as a layer of preserved myelinated tissue. |
| Document Type: Article |
| Language: English |
| Reprint Address: Lassmann, H (reprint author), Med Univ Vienna, Brain Res Ctr, Spitalgasse 4, A-1090 Vienna, Austria |
Addresses:
1. Med Univ Vienna, Brain Res Ctr, A-1090 Vienna, Austria
2. Univ Goettingen, Dept Neuropathol, Gottingen, Germany
3. Queens Univ, Dept Neuropathol, Kingston, ON Canada
4. NCGG, Natl Inst Longev Sci, Aichi, Japan
5. Municipal Hosp, Dept Neurol, Szekesfehervar, Hungary
6. Municipal Hosp, Dept Neuropathol, Esztergom, Hungary
7. Mayo Clin, Dept Neurol, Rochester, MN USA
8. Santo Tomas Univ, Dept Neuropsychiat, Manila, Philippines |
| Publisher: OXFORD UNIV PRESS, GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND |
| Subject Category: Clinical Neurology; Neurosciences |
| IDS Number: 919RM |
| ISSN: 0006-8950 |
| DOI: 10.1093/brain/awh457 |
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