Herndon R M, Kasckow J
Ann Neurol. 1978 Dec;4(6):515-23. doi: 10.1002/ana.410040607.
Cerebrospinal fluid specimens from 31 patients with multiple sclerosis (MS) and 2 with progressive multifocal leukoencephalopathy (PML) were subjected to ultracentrifugation, and the resulting pellets were examined in an electron microscope. Cell types seen in the pellets included lymphocytes, occasional plasma cells, polymorphonuclear leukocytes, monocytes, eosinophils, lipid-laden macrophages, and fibroblasts. The most interesting noncellular elements were extracellular myelin fragments, recognizable by their characteristic alternation of major dense lines and intraperiod lines. Myelin fragments were seen in the CSF from 7 of 9 patients with MS in exacerbation involving areas other than the optic nerve. These fragments were not observed in 4 specimens from patients with acute attacks manifested by optic neuritis. Myelin fragments were present in 1 of the 2 patients with PML. These observations indicate that a portion of the myelin destruction seen in MS and PML occurs extracellularly, with release of myelin fragments and degradation products into the CSF.
对31例多发性硬化症（MS）患者和2例进行性多灶性白质脑病（PML）患者的脑脊液样本进行超速离心，对所得沉淀进行电子显微镜检查。沉淀中可见的细胞类型包括淋巴细胞、偶尔的浆细胞、多形核白细胞、单核细胞、嗜酸性粒细胞、脂质负载巨噬细胞和成纤维细胞。最有趣的非细胞成分是细胞外髓鞘碎片，可通过其主要致密线和周期内线的特征性交替来识别。在9例病情加重且累及视神经以外区域的MS患者中，有7例的脑脊液中可见髓鞘碎片。在4例以视神经炎为表现的急性发作患者的样本中未观察到这些碎片。2例PML患者中有1例存在髓鞘碎片。这些观察结果表明，在MS和PML中所见的部分髓鞘破坏发生在细胞外，髓鞘碎片和降解产物释放到脑脊液中。
