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Mult Scler. 2010 Oct;16(10):1156-72. doi: 10.1177/1352458510382324. Epub 2010 Sep 7.

Neuromyelitis optica: a demyelinating disease characterized by acute destruction and regeneration of perivascular astrocytes.

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  • 1The Institute of Clinical Neurosciences, Department of Medicine, The University of Sydney, NSW, Australia.

Abstract

BACKGROUND:

A serum antibody directed against astrocytes is present in a high proportion of patients with neuromyelitis optica (NMO). The pathogenicity of the antibody is uncertain because no consistent astrocyte lesion is known to occur in NMO.

OBJECTIVE:

To determine whether there is an astrocyte lesion in NMO and if this differs from astrocyte changes in multiple sclerosis (MS).

METHODS:

Astrocyte pathology in early (still-myelinated) lesions and subacute NMO and MS lesions was examined immunohistochemically and in sections stained for astrocytes using routine histological techniques.

RESULTS:

Demyelination in early NMO lesions is accompanied by oligodendrocyte apoptosis in a pattern identical to that seen in MS and this is preceded by an abrupt destruction of perivascular astrocytes. Reparative astrogliosis is effected by a population of unipolar, new astrocytes. Evidence of a different type of astrocyte lesion was found in MS.

DISCUSSION:

The findings add to experimental evidence that the antibody is pathogenic. They also raise the possibility that demyelination in MS may be a bystander effect of an astrocyte lesion, i.e. that MS is not a disease primarily of myelin and oligodendrocytes.

PMID:
20823059
[PubMed - indexed for MEDLINE]
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