Masaki Katsuhisa
Nihon Rinsho. 2014 Nov;72(11):1909-17.
Multiple sclerosis (MS) and neuromyelitis optica (NMO) are inflammatory demyelinating diseases of the central nervous system (CNS). The pathological hallmark of MS is sharply demarcated demyelinating plaques with the relative preservation of axons, suggesting autoimmune responses target CNS myelin. In contrast, NMO shows selective and severe attacks of both axons and myelin of the optic nerves and spinal cord, resulting in necrotic cavitation. Neuropathological studies have demonstrated extensive loss of aquaporin-4 (AQP4) and glial fibrillary acidic protein (GFAP) in NMO lesions, especially in perivascular areas of acute inflammatory lesions where immunoglobulins and activated complements are deposited. We recently demonstrated the extensive loss of connexins(Cxs) in active lesions of Baló's disease, MS and NMO. Early disruption of Cx gap junction among glial cells may be a common denominator in heterogeneous human demyelinating conditions. This review aims to discuss the molecular pathology of MS and NMO that have attracted the most attention in the recent years.
多发性硬化症(MS)和视神经脊髓炎(NMO)是中枢神经系统(CNS)的炎性脱髓鞘疾病。MS的病理特征是界限分明的脱髓鞘斑块,轴突相对保留,提示自身免疫反应靶向CNS髓鞘。相比之下,NMO表现为视神经和脊髓的轴突和髓鞘均受到选择性且严重的攻击,导致坏死性空洞形成。神经病理学研究表明,NMO病变中,尤其是免疫球蛋白和活化补体沉积的急性炎性病变的血管周围区域,水通道蛋白4(AQP4)和胶质纤维酸性蛋白(GFAP)大量缺失。我们最近证明,巴洛病、MS和NMO的活动性病变中连接蛋白(Cxs)大量缺失。胶质细胞间Cx间隙连接的早期破坏可能是人类异质性脱髓鞘疾病的一个共同特征。本综述旨在探讨近年来最受关注的MS和NMO的分子病理学。