Lassmann H
Klinisches Institut für Neurologie, Universität Wien, Austria.
Verh Dtsch Ges Pathol. 1996;80:109-15.
Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system. Its pathological hallmark is the demyelinated plaque with reactive glial scarring. Recent neuropathological and immunopathological data suggest a pronounced pathologic heterogeneity of MS plaques. Although demyelination is present in all lesions, the extent of oligodendroglia loss, remyelination and axonal pathology is highly variable. In the present review, data are discussed on the fate of myelin forming cells in MS lesions, which suggest that fundamentally different immunological mechanisms may be involved in the formation of the lesions in different MS patients. Possible immunopathogenetic mechanisms are discussed by comparing the different types of MS lesions with those described in different experimental models of inflammatory demyelinating disease.
多发性硬化症(MS)是一种中枢神经系统的炎性脱髓鞘疾病。其病理标志是伴有反应性胶质瘢痕形成的脱髓鞘斑块。最近的神经病理学和免疫病理学数据表明,MS斑块存在明显的病理异质性。尽管所有病变中均存在脱髓鞘,但少突胶质细胞丢失、髓鞘再生和轴索病理的程度差异很大。在本综述中,讨论了MS病变中髓鞘形成细胞命运的数据,这表明不同MS患者病变形成可能涉及根本不同的免疫机制。通过将不同类型的MS病变与炎性脱髓鞘疾病不同实验模型中描述的病变进行比较,讨论了可能的免疫发病机制。