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Meningeal inflammation and cortical demyelination in acute multiple sclerosis

Ryan J. Bevan, Rhian Evans, Lauren Griffiths, Lewis M. Watkins, Mark Rees, Roberta Magliozzi, Ingrid Allen, Gavin McDonnell, Rachel Kee, Michelle Naughton, Denise C. Fitzgerald, Richard Reynolds, James W. Neal, Owain Howell Orcid Logo

Annals of Neurology

Swansea University Authors: Mark Rees, Owain Howell Orcid Logo

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DOI (Published version): 10.1002/ana.25365

Abstract

Cortical grey matter (GM) pathology, involving demyelination and neurodegeneration, associated with meningeal inflammation, could be important in determining disability progression in multiple sclerosis (MS). However, we need to know more about how cortical demyelination, neurodegeneration and menin...

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Published in: Annals of Neurology
ISSN: 03645134
Published: 2018
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URI: https://cronfa.swan.ac.uk/Record/cronfa45060
first_indexed 2018-10-23T13:23:42Z
last_indexed 2020-07-01T19:00:23Z
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2020-07-01T16:16:05.3549426</datestamp><bib-version>v2</bib-version><id>45060</id><entry>2018-10-23</entry><title>Meningeal inflammation and cortical demyelination in acute multiple sclerosis</title><swanseaauthors><author><sid>10f39a4e9c2ee00d453cd84c10667ac8</sid><firstname>Mark</firstname><surname>Rees</surname><name>Mark Rees</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>58c995486fc93a242b987640b692db8c</sid><ORCID>0000-0003-2157-9157</ORCID><firstname>Owain</firstname><surname>Howell</surname><name>Owain Howell</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2018-10-23</date><abstract>Cortical grey matter (GM) pathology, involving demyelination and neurodegeneration, associated with meningeal inflammation, could be important in determining disability progression in multiple sclerosis (MS). However, we need to know more about how cortical demyelination, neurodegeneration and meningeal inflammation contribute to pathology in early stages of MS to better predict long-term outcome. Tissue blocks from short disease duration MS (n=12, median disease duration 2 years), progressive MS (n=21, disease duration 25 years), non-diseased controls (n=11) and other neurological inflammatory disease controls (n=6), were quantitatively analysed by immunohistochemistry, immunofluorescence and in situ hybridisation.Cortical GM demyelination was extensive in some cases of acute MS (range 1&#x2013; 48% of total cortical GM) and subpial lesions were the most common type (62%). The numbers of activated (CD68+) microglia/ macrophages were increased in cases with subpial lesions and the density of neurons was significantly reduced in acute MS normal appearing and lesion GM, compared to controls (p&lt;0.005). Significant meningeal inflammation and lymphoid-like structures were seen in 4 of 12 acute MS cases. The extent of meningeal inflammation correlated with microglial/ macrophage activation (p&lt;0.05), but not the area of cortical demyelination, reflecting the finding that lymphoid-like structures were seen adjacent to GM lesions as well as areas of partially demyelinated/remyelinated, cortical GM. Our findings demonstrate that cortical demyelination, neuronal loss and meningeal inflammation are notable pathological hallmarks of acute MS and support the need to identify early biomarkers of this pathology to better predict outcome.</abstract><type>Journal Article</type><journal>Annals of Neurology</journal><publisher/><issnPrint>03645134</issnPrint><keywords>B-cells; follicles; pathology</keywords><publishedDay>25</publishedDay><publishedMonth>10</publishedMonth><publishedYear>2018</publishedYear><publishedDate>2018-10-25</publishedDate><doi>10.1002/ana.25365</doi><url/><notes/><college>COLLEGE NANME</college><CollegeCode>COLLEGE CODE</CollegeCode><institution>Swansea University</institution><apcterm/><lastEdited>2020-07-01T16:16:05.3549426</lastEdited><Created>2018-10-23T09:19:58.9280862</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Ryan J.</firstname><surname>Bevan</surname><order>1</order></author><author><firstname>Rhian</firstname><surname>Evans</surname><order>2</order></author><author><firstname>Lauren</firstname><surname>Griffiths</surname><order>3</order></author><author><firstname>Lewis M.</firstname><surname>Watkins</surname><order>4</order></author><author><firstname>Mark</firstname><surname>Rees</surname><order>5</order></author><author><firstname>Roberta</firstname><surname>Magliozzi</surname><order>6</order></author><author><firstname>Ingrid</firstname><surname>Allen</surname><order>7</order></author><author><firstname>Gavin</firstname><surname>McDonnell</surname><order>8</order></author><author><firstname>Rachel</firstname><surname>Kee</surname><order>9</order></author><author><firstname>Michelle</firstname><surname>Naughton</surname><order>10</order></author><author><firstname>Denise C.</firstname><surname>Fitzgerald</surname><order>11</order></author><author><firstname>Richard</firstname><surname>Reynolds</surname><order>12</order></author><author><firstname>James W.</firstname><surname>Neal</surname><order>13</order></author><author><firstname>Owain</firstname><surname>Howell</surname><orcid>0000-0003-2157-9157</orcid><order>14</order></author></authors><documents><document><filename>0045060-27112018141220.pdf</filename><originalFilename>45060.pdf</originalFilename><uploaded>2018-11-27T14:12:20.2500000</uploaded><type>Output</type><contentLength>1521873</contentLength><contentType>application/pdf</contentType><version>Accepted Manuscript</version><cronfaStatus>true</cronfaStatus><embargoDate>2019-10-25T00:00:00.0000000</embargoDate><copyrightCorrect>true</copyrightCorrect><language>eng</language></document></documents><OutputDurs/></rfc1807>
spelling 2020-07-01T16:16:05.3549426 v2 45060 2018-10-23 Meningeal inflammation and cortical demyelination in acute multiple sclerosis 10f39a4e9c2ee00d453cd84c10667ac8 Mark Rees Mark Rees true false 58c995486fc93a242b987640b692db8c 0000-0003-2157-9157 Owain Howell Owain Howell true false 2018-10-23 Cortical grey matter (GM) pathology, involving demyelination and neurodegeneration, associated with meningeal inflammation, could be important in determining disability progression in multiple sclerosis (MS). However, we need to know more about how cortical demyelination, neurodegeneration and meningeal inflammation contribute to pathology in early stages of MS to better predict long-term outcome. Tissue blocks from short disease duration MS (n=12, median disease duration 2 years), progressive MS (n=21, disease duration 25 years), non-diseased controls (n=11) and other neurological inflammatory disease controls (n=6), were quantitatively analysed by immunohistochemistry, immunofluorescence and in situ hybridisation.Cortical GM demyelination was extensive in some cases of acute MS (range 1– 48% of total cortical GM) and subpial lesions were the most common type (62%). The numbers of activated (CD68+) microglia/ macrophages were increased in cases with subpial lesions and the density of neurons was significantly reduced in acute MS normal appearing and lesion GM, compared to controls (p<0.005). Significant meningeal inflammation and lymphoid-like structures were seen in 4 of 12 acute MS cases. The extent of meningeal inflammation correlated with microglial/ macrophage activation (p<0.05), but not the area of cortical demyelination, reflecting the finding that lymphoid-like structures were seen adjacent to GM lesions as well as areas of partially demyelinated/remyelinated, cortical GM. Our findings demonstrate that cortical demyelination, neuronal loss and meningeal inflammation are notable pathological hallmarks of acute MS and support the need to identify early biomarkers of this pathology to better predict outcome. Journal Article Annals of Neurology 03645134 B-cells; follicles; pathology 25 10 2018 2018-10-25 10.1002/ana.25365 COLLEGE NANME COLLEGE CODE Swansea University 2020-07-01T16:16:05.3549426 2018-10-23T09:19:58.9280862 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Ryan J. Bevan 1 Rhian Evans 2 Lauren Griffiths 3 Lewis M. Watkins 4 Mark Rees 5 Roberta Magliozzi 6 Ingrid Allen 7 Gavin McDonnell 8 Rachel Kee 9 Michelle Naughton 10 Denise C. Fitzgerald 11 Richard Reynolds 12 James W. Neal 13 Owain Howell 0000-0003-2157-9157 14 0045060-27112018141220.pdf 45060.pdf 2018-11-27T14:12:20.2500000 Output 1521873 application/pdf Accepted Manuscript true 2019-10-25T00:00:00.0000000 true eng
title Meningeal inflammation and cortical demyelination in acute multiple sclerosis
spellingShingle Meningeal inflammation and cortical demyelination in acute multiple sclerosis
Mark Rees
Owain Howell
title_short Meningeal inflammation and cortical demyelination in acute multiple sclerosis
title_full Meningeal inflammation and cortical demyelination in acute multiple sclerosis
title_fullStr Meningeal inflammation and cortical demyelination in acute multiple sclerosis
title_full_unstemmed Meningeal inflammation and cortical demyelination in acute multiple sclerosis
title_sort Meningeal inflammation and cortical demyelination in acute multiple sclerosis
author_id_str_mv 10f39a4e9c2ee00d453cd84c10667ac8
58c995486fc93a242b987640b692db8c
author_id_fullname_str_mv 10f39a4e9c2ee00d453cd84c10667ac8_***_Mark Rees
58c995486fc93a242b987640b692db8c_***_Owain Howell
author Mark Rees
Owain Howell
author2 Ryan J. Bevan
Rhian Evans
Lauren Griffiths
Lewis M. Watkins
Mark Rees
Roberta Magliozzi
Ingrid Allen
Gavin McDonnell
Rachel Kee
Michelle Naughton
Denise C. Fitzgerald
Richard Reynolds
James W. Neal
Owain Howell
format Journal article
container_title Annals of Neurology
publishDate 2018
institution Swansea University
issn 03645134
doi_str_mv 10.1002/ana.25365
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
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description Cortical grey matter (GM) pathology, involving demyelination and neurodegeneration, associated with meningeal inflammation, could be important in determining disability progression in multiple sclerosis (MS). However, we need to know more about how cortical demyelination, neurodegeneration and meningeal inflammation contribute to pathology in early stages of MS to better predict long-term outcome. Tissue blocks from short disease duration MS (n=12, median disease duration 2 years), progressive MS (n=21, disease duration 25 years), non-diseased controls (n=11) and other neurological inflammatory disease controls (n=6), were quantitatively analysed by immunohistochemistry, immunofluorescence and in situ hybridisation.Cortical GM demyelination was extensive in some cases of acute MS (range 1– 48% of total cortical GM) and subpial lesions were the most common type (62%). The numbers of activated (CD68+) microglia/ macrophages were increased in cases with subpial lesions and the density of neurons was significantly reduced in acute MS normal appearing and lesion GM, compared to controls (p<0.005). Significant meningeal inflammation and lymphoid-like structures were seen in 4 of 12 acute MS cases. The extent of meningeal inflammation correlated with microglial/ macrophage activation (p<0.05), but not the area of cortical demyelination, reflecting the finding that lymphoid-like structures were seen adjacent to GM lesions as well as areas of partially demyelinated/remyelinated, cortical GM. Our findings demonstrate that cortical demyelination, neuronal loss and meningeal inflammation are notable pathological hallmarks of acute MS and support the need to identify early biomarkers of this pathology to better predict outcome.
published_date 2018-10-25T07:36:20Z
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