TY - JOUR
T1 - Multiple sclerosis
T2 - Lessons from neuropathology
AU - Lucchinetti, Claudia F.
AU - Brueck, W.
AU - Rodriguez, M.
AU - Lassmann, H.
PY - 1998
Y1 - 1998
N2 - The focus of multiple sclerosis (MS) research has been on attempts to identify the specific pathogenic mechanism responsible for producing the multifocal central nervous system inflammatory demyelinating lesions. However, extensive in vitro and in vivo evidence suggests that multiple different immunological mechanisms may produce the typical demyelinated plaque. A detailed examination of actively demyelinating MS lesions reveals a profound heterogeneity in the structural and immunopathological patterns of demyelination and oligodendrocyte pathology between different MS patients, suggesting multiple pathogenic mechanisms may contribute to oligodendrocyte and myelin injury in MS. These observations raise the question whether MS may be a neurological syndrome with different immunopathological mechanisms triggering a common pathway rather than a single disease with a uniform mechanism of myelin destruction. With the advent of new tools for neurobiological and immunological research applied to actively demyelinated MS lesions, an opportunity exists to reevaluate MS neuropathology. This review highlights the spectrum of the inflammatory demyelinating diseases, the multitude of effector mechanisms that may produce myelin destruction, and the pathologic heterogeneity observed in MS lesions. A careful evaluation of MS neuropathology should provide important clues regarding the induction, target, evolution, and pathogenesis of this complex disease.
AB - The focus of multiple sclerosis (MS) research has been on attempts to identify the specific pathogenic mechanism responsible for producing the multifocal central nervous system inflammatory demyelinating lesions. However, extensive in vitro and in vivo evidence suggests that multiple different immunological mechanisms may produce the typical demyelinated plaque. A detailed examination of actively demyelinating MS lesions reveals a profound heterogeneity in the structural and immunopathological patterns of demyelination and oligodendrocyte pathology between different MS patients, suggesting multiple pathogenic mechanisms may contribute to oligodendrocyte and myelin injury in MS. These observations raise the question whether MS may be a neurological syndrome with different immunopathological mechanisms triggering a common pathway rather than a single disease with a uniform mechanism of myelin destruction. With the advent of new tools for neurobiological and immunological research applied to actively demyelinated MS lesions, an opportunity exists to reevaluate MS neuropathology. This review highlights the spectrum of the inflammatory demyelinating diseases, the multitude of effector mechanisms that may produce myelin destruction, and the pathologic heterogeneity observed in MS lesions. A careful evaluation of MS neuropathology should provide important clues regarding the induction, target, evolution, and pathogenesis of this complex disease.
KW - Demyelination
KW - Immunopathology
KW - Oligodendrocyte
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U2 - 10.1055/s-2008-1040885
DO - 10.1055/s-2008-1040885
M3 - Review article
C2 - 9817538
AN - SCOPUS:0031770075
SN - 0271-8235
VL - 18
SP - 337
EP - 349
JO - Seminars in Neurology
JF - Seminars in Neurology
IS - 3
ER -