Patrikios Peter, Stadelmann Christine, Kutzelnigg Alexandra, Rauschka Helmut, Schmidbauer Manfred, Laursen Henning, Sorensen Per Soelberg, Brück Wolfgang, Lucchinetti Claudia, Lassmann Hans
Center for Brain Research, Medical University of Vienna, Vienna, Austria.
Brain. 2006 Dec;129(Pt 12):3165-72. doi: 10.1093/brain/awl217. Epub 2006 Aug 18.
Although spontaneous remyelination does occur in multiple sclerosis lesions, its extent within the global population with this disease is presently unknown. We have systematically analysed the incidence and distribution of completely remyelinated lesions (so-called shadow plaques) or partially remyelinated lesions (shadow plaque areas) in 51 autopsies of patients with different clinical courses and disease durations. The extent of remyelination was variable between cases. In 20% of the patients, the extent of remyelination was extensive with 60-96% of the global lesion area remyelinated. Extensive remyelination was found not only in patients with relapsing multiple sclerosis, but also in a subset of patients with progressive disease. Older age at death and longer disease duration were associated with significantly more remyelinated lesions or lesion areas. No correlation was found between the extent of remyelination and either gender or age at disease onset. These results suggest that the variable and patient-dependent extent of remyelination must be considered in the design of future clinical trials aimed at promoting CNS repair.
尽管在多发性硬化症病变中确实会发生自发髓鞘再生，但其在全球该疾病患者群体中的程度目前尚不清楚。我们系统分析了51例具有不同临床病程和疾病持续时间的患者尸检中完全髓鞘再生病变（所谓的阴影斑块）或部分髓鞘再生病变（阴影斑块区域）的发生率和分布。病例之间髓鞘再生的程度各不相同。在20%的患者中，髓鞘再生程度广泛，全球病变区域的60% - 96%实现了髓鞘再生。广泛的髓鞘再生不仅在复发缓解型多发性硬化症患者中发现，也在一部分进展型疾病患者中发现。较高的死亡年龄和较长的疾病持续时间与明显更多的髓鞘再生病变或病变区域相关。未发现髓鞘再生程度与性别或发病年龄之间存在相关性。这些结果表明，在设计旨在促进中枢神经系统修复的未来临床试验时，必须考虑髓鞘再生程度的变异性和患者依赖性。
