Schmitt A B, Brook G A, Buss A, Nacimiento W, Noth J, Kreutzberg G W
Department of Neurology, Technical University, School of Medicine, Aachen, Germany.
Neuropathol Appl Neurobiol. 1998 Jun;24(3):167-76. doi: 10.1046/j.1365-2990.1998.00103.x.
Microglial reactivity associated with induction of MHC class II (HLA-DR) antigen is a sensitive indicator for pathological events in the CNS. To assess the response of glial cells after lesions of supraspinal descending tracts, HLA-DR, CD68 and GFAP were studied immunohistochemically on spinal cord tissue of 5 patients who died after unilateral infarction of the middle cerebral artery territory, and 5 control cases. In patients who died shortly after a stroke (4-14 days) increased HLA-DR-immunoreactivity (HLA-DR-IR) could be observed in the intermediate grey matter and in the ventral horn. The CD68-IR was much less intense. After longer survival times (5 weeks to 4 months). HLA-DR-IR in the grey matter was clearly lower than that observed in the spinal cord of short survival times, but very abundant in the dorsolateral funiculus, specifically within the corticospinal tract. In white matter areas, CD68-IR was almost identical to the HLA-DR-IR. Within the grey matter, CD68-IR was similar to the control tissue. A moderate increase of GFAP-positive astrocytes could be seen only in the grey matter after longer survival times. It seems probable, that the dynamics of HLA-DR-positive microglia reflect the early phagocytosis of presynaptic terminals by microglia in target regions of descending fibre tracts. In the white matter, the removal of degenerating axons by phagocytosing microglia expressing HLA-DR and CD68 antigens is a slower process which occurs over a period of months.
与MHC II类（HLA - DR）抗原诱导相关的小胶质细胞反应性是中枢神经系统病理事件的敏感指标。为了评估脊髓上降束损伤后胶质细胞的反应，对5例大脑中动脉区域单侧梗死死亡患者和5例对照病例的脊髓组织进行了免疫组织化学研究，检测了HLA - DR、CD68和GFAP。在中风后不久死亡的患者（4 - 14天）中，可观察到中间灰质和腹角中HLA - DR免疫反应性（HLA - DR - IR）增加。CD68免疫反应性强度则低得多。在较长存活时间（5周 - 4个月）后，灰质中的HLA - DR - IR明显低于存活时间短的脊髓，但在背外侧索，特别是皮质脊髓束内非常丰富。在白质区域，CD68免疫反应性与HLA - DR免疫反应性几乎相同。在灰质内，CD68免疫反应性与对照组织相似。仅在较长存活时间后，灰质中可见GFAP阳性星形胶质细胞有中度增加。HLA - DR阳性小胶质细胞的动态变化似乎反映了小胶质细胞对下行纤维束靶区域突触前终末的早期吞噬作用。在白质中，表达HLA - DR和CD68抗原的吞噬性小胶质细胞清除变性轴突是一个较慢的过程，发生在数月时间内。
