Journal Article

Tissue preconditioning may explain concentric lesions in Baló's type of multiple sclerosis

Christine Stadelmann, Sam Ludwin, Takeshi Tabira, Andras Guseo, Claudia F. Lucchinetti, Lorant Leel-Össy, Artemio T. Ordinario, Wolfgang Brück and Hans Lassmann

in Brain

Published on behalf of The Guarantors of Brain

Volume 128, issue 5, pages 979-987
Published in print May 2005 | ISSN: 0006-8950
Published online March 2005 | e-ISSN: 1460-2156 | DOI: http://dx.doi.org/10.1093/brain/awh457
Tissue preconditioning may explain concentric lesions in Baló's type of multiple sclerosis

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Lesions of Baló'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 Baló-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 1α 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.

Keywords: multiple sclerosis, Baló; HIF-1α; hsp70; CNPase = cyclic nucleotide phosphodiesterase; MAG = myelin associated glycoprotein; MOG = myelin oligodendrocyte glycoprotein; PLP = proteolipid protein

Journal Article.  5783 words.  Illustrated.

Subjects: Neurology ; Neuroscience

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