Circulating myelinotoxic factors in human and experimental demyelinative disease

Pathophysiological aspects of acute experimental allergic encephalomyelitis

Traditionally, research in experimental allergic encephalomyelitis (EAE) has focussed on immunological and histopathological aspects. The present review introduces a physiological approach to EAE. As EAE is characterized by many small, focal lesions in the central nervous system (CNS), methods with a high spatial resolution should be used to conduct studies on regional pathophysiology in the condition. Quantitative autoradiography seems an ideal method as it offers, 1) high regional resolution (approximately 50 um), 2) precise quantitation and, 3) a direct correlation between regional histopathology and pathophysiology. By the use of this method, the author has performed studies on 1) regional blood-brain barrier (BBB) permeability, and 2) regional metabolism of energy substrate and related subjects, (i.e. regional cerebral blood flow, regional cerebral glucose metabolic rate and regional pH). Corresponding to the EAE lesions (lymphocytic accumulations), there is a considerable increase in BBB permeability. Metabolism of energy substrate at the lesion sites is severely deranged, which is expressed in a CBF/CMR ratio of 3 ml/mumol compared to the normal 1.5 ml/mumol. No changes in regional pH are seen in the lesions. Unrelated to the lesion sites there is a 50% decrease in blood flow in cerebral cortex. This observation probably reflects a functional decrease in cortical flow due to sensory motor impairment.

Peripheral nervous system lesions in experimental allergic encephalomyelitis. Ultrastructural distribution of T cells and Ia-antigen

The distribution of T cells and Ia-antigen in peripheral nervous system (PNS) lesions of experimental allergic encephalomyelitis was studied by light- and electron-microscopic immunocytochemical techniques. Sprague Dawley rats, sensitized with guinea pig spinal cord tissue, developed a biphasic disease with acute inflammatory and chronic inflammatory demyelinating lesions in the PNS. In both the acute non-demyelinating and the chronic demyelinating disease inflammatory infiltrates were composed of T cells and Ia-positive monocytes/macrophages. Dependent upon the stage of the disease a variable percentage of T-lymphocytes carried the Ox 8 antigen (suppressor/cytotoxic cells). In demyelinating lesions no evidence for an interaction of T cells with myelin or Schwann cells was observed, thus arguing against a direct T-cell cytotoxicity in demyelination. The whole sequence of myelin destruction and digestion was performed by W3/13-, Ia+ mononuclear cells with ultrastructural features of monocytes/macrophages. In contrast to the acute inflammatory stage of the disease, high titers of anti-myelin antibodies were present in sera of affected animals sampled during the chronic inflammatory demyelinating stage. The sera from the latter animals also showed pronounced in vivo demyelinating activity when transferred into the cerebrospinal fluid (CSF) of normal recipient rats. It is thus suggested that demyelination in this model is induced by a co-operation of cell-mediated and humoral immune mechanisms. We did not find evidence for Ia-antigen expression on local elements of the PNS (Schwann cells, axons, or endothelial cells).