Effects of acute percutaneous transluminal recanalization on cerebral embolism

Structure and Biology of Self Lipid Antigens

Self lipid antigens induce selection and expansion of autoreactive T cells which have a role in immunoregulation and disease pathogenesis. Here we review the important biological rules which determine lipid immunogenicity. The impact of lipid structure, synthesis, traffic, membrane distribution and CD1 loading are discussed.

Emergence of antibodies as biomarkers in multiple sclerosis

Rather than being a homogenous disease entity, multiple sclerosis (MS) represents a family of heterogenous inflammatory-demyelinating CNS diseases. The heterogeneity is demonstrated by various well known clinical disease courses and, more importantly, by inhomogenous and unpredictable therapeutic effects. Recent neuropathological evidence has initiated a process of re-evaluation of the immunopathogenetic concepts in MS. The heterogeneity of MS claims to subtype our patients more distinctively in the future by genetic, clinical, neuroradiological and neuroimmunological parameters. Therefore, the importance of identifiying biological markers in MS has evolved over the past few years. This review discusses the current status and potential applicability of antibodies as biological markers for the diagnosis, classification, disease activity and prediction of clinical courses in MS. Antibodies serving as biomarkers will create the future path for establishing a differential therapeutic concept in MS, which will allow the treatment of individuals selectively, according to their pathogenetic subtype and disease status.

Structural basis for CD1d presentation of a sulfatide derived from myelin and its implications for autoimmunity

Sulfatide derived from the myelin stimulates a distinct population of CD1d-restricted natural killer T (NKT) cells. Cis-tetracosenoyl sulfatide is one of the immunodominant species in myelin as identified by proliferation, cytokine secretion, and CD1d tetramer staining. The crystal structure of mouse CD1d in complex with cis-tetracosenoyl sulfatide at 1.9 Å resolution reveals that the longer cis-tetracosenoyl fatty acid chain fully occupies the A′ pocket of the CD1d binding groove, whereas the sphingosine chain fills up the F′ pocket. A precise hydrogen bond network in the center of the binding groove orients and positions the ceramide backbone for insertion of the lipid tails in their respective pockets. The 3′-sulfated galactose headgroup is highly exposed for presentation to the T cell receptor and projects up and away from the binding pocket due to its β linkage, compared with the more intimate binding of the α-glactosyl ceramide headgroup to CD1d. These structure and binding data on sulfatide presentation by CD1d have important implications for the design of therapeutics that target T cells reactive for myelin glycolipids in autoimmune diseases of the central nervous system.

The pathology of primary progressive multiple sclerosis

The pathological hallmark of chronic multiple sclerosis includes focal demyelination, gliosis, inflammation and axonal injury. There is limited information on whether these pathological features differ across the clinical phenotypes of the disease (relapsing-remitting, secondary progressive, and primary progressive). This review will focus on the pathological aspects of PPMS and pathogenic implications. A better understanding of the differences in PPMS pathology and pathogenesis will lead to more effective treatment strategies.