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首页> 外文期刊>Neuropathology: official journal of the Japanese Society of Neuropathology >Significance of gray matter brain lesions in multiple sclerosis and neuromyelitis optica
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Significance of gray matter brain lesions in multiple sclerosis and neuromyelitis optica

机译：灰质脑病变在多发性硬化症和视神经脊髓炎中的意义

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摘要

Multiple sclerosis (MS) and neuromyelitis optica (NMO) are the two main autoimmune diseases of the CNS. In patients with NMO, the target antigen is aquaporin-4 (AQP4), the most abundant water channel protein in the CNS. AQP4 is mainly expressed on astrocytic endfoot processes at the blood-brain barrier and in subpial and subendymal regions. MS and NMO are distinct diseases, but they have some common clinical features: both have long been considered autoimmune diseases that primarily affect the white matter (WM). However, because WM demyelination by itself cannot explain the full extent of the clinical disabilities, including cognitive decline in patients with MS and NMO, renewed interest in gray matter (GM) pathology in MS and NMO is emerging. Important hallmarks of WM and GM lesions in MS and NMO may differentially influence neuronal degeneration and demyelination in the brain and spinal cord, given different detrimental effects, including cytokine diffusion, disruption of water homeostasis associated with or without AQP4 (the target antigen in NMO) dynamics, or other unidentified mechanisms. An increase in knowledge of the structure of GM and WM lesions in MS and NMO will result in more targeted therapeutic approaches to these two diseases.
机译：多发性硬化症（MS）和视神经脊髓炎（NMO）是中枢神经系统的两种主要自身免疫性疾病。在NMO患者中，目标抗原是Aquaporin-4（AQP4），这是CNS中最丰富的水通道蛋白。 AQP4主要表达在血脑屏障以及椎旁和内皮下区域的星形胶质尾足过程中。 MS和NMO是截然不同的疾病，但它们具有一些共同的临床特征：长期以来，它们都被视为主要影响白质（WM）的自身免疫疾病。然而，由于WM脱髓鞘作用本身不能解释包括MS和NMO患者认知能力下降在内的全部临床残疾，因此，人们对MS和NMO的灰质（GM）病理学重新产生了兴趣。 WM和GM病变在MS和NMO中的重要标志可能会不同地影响大脑和脊髓的神经元变性和脱髓鞘作用，给与不同的不利影响，包括细胞因子扩散，与或不与AQP4（NMO中的目标抗原）相关的水稳态破坏动态或其他未知机制。对MS和NMO中GM和WM病变结构的了解的增加将导致针对这两种疾病的针对性更强的治疗方法。

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