Goldschmidt T, Antel J, König F B, Brück W, Kuhlmann T
Department of Neuropathology, University Medical Center, Göttingen, Germany.
Neurology. 2009 Jun 2;72(22):1914-21. doi: 10.1212/WNL.0b013e3181a8260a.
To analyze and compare the extent of remyelination in lesions from patients with multiple sclerosis (MS) who have a short (early MS lesions) or a long (chronic MS lesions) disease duration and to determine the influence of anatomic localization on the extent of remyelination. In early MS lesions, remyelination has been described as a relatively frequent event, in contrast to chronic MS lesions, where remyelination is absent or limited to the lesion border in the majority of lesions. However, no studies have been published that have quantified and compared the extent of remyelination in early and chronic MS lesions.
We analyzed the occurrence of remyelination in 52 biopsies from 51 patients (early MS) and in 174 lesions from 36 autopsy cases (chronic MS) by immunohistochemistry for myelin proteins, and correlated our findings with anatomic localization, sex, age, and disease duration.
Significantly more lesions were remyelinated in early than in chronic MS (80.7% vs 60%). In chronic MS, subcortical lesions showed more extensive remyelination than periventricular lesions. The majority of cerebellar lesions were completely demyelinated.
In summary, our data demonstrate that remyelination is a frequent event in early multiple sclerosis lesions. Furthermore, the anatomic localization of a lesion might influence the extent of remyelination.
分析和比较疾病病程较短（早期多发性硬化症病变）或较长（慢性多发性硬化症病变）的多发性硬化症（MS）患者病变中的髓鞘再生程度，并确定解剖定位对髓鞘再生程度的影响。在早期MS病变中，髓鞘再生被描述为相对常见的事件，而在慢性MS病变中，大多数病变的髓鞘再生不存在或仅限于病变边界。然而，尚未发表过量化和比较早期和慢性MS病变中髓鞘再生程度的研究。
我们通过对髓鞘蛋白进行免疫组织化学分析，研究了51例患者的52份活检标本（早期MS）和36例尸检病例的174个病变（慢性MS）中的髓鞘再生情况，并将我们的研究结果与解剖定位、性别、年龄和病程进行了关联分析。
早期MS中髓鞘再生的病变明显多于慢性MS（80.7%对vs 60%）。在慢性MS中，皮质下病变的髓鞘再生比脑室周围病变更广泛。大多数小脑病变完全脱髓鞘。
总之，我们的数据表明，髓鞘再生在早期多发性硬化症病变中是常见事件。此外，病变的解剖定位可能会影响髓鞘再生的程度。
