title: [Astrocytopathy in neuromyelitis optica, multiple sclerosis and Baló's disease].
abstract: Multiple sclerosis (MS) is a demyelinating disease of the central nervous system (CNS) while neuromyelitis optica (NMO) is an inflammatory disease of the CNS that selectively affects the optic nerves and spinal cord. An antibody for aquaporin-4 (AQP4), which is a water channel located in astrocyte foot process, is specifically positive for NMO and antibody and complement dependent astrocytic damage is thought to be a main cause of NMO. Baló's disease is characterized by alternating rings of demyelination and preserved myelin. We pathologically compared the astrocytic changes among autopsied cases with these CNS demyelinating diseases. NMO, MS and Baló's disease shared with reduced AQP4 immunoreactivity independent of antibodies and complements. The pathological finding was accompanied with a reduced immunoreactivity of connexin 43 and perivascular lymphocytic cuffing predominantly composed by T cells. The loss of astrocytic proteins such as AQP4 and connexin 43 preceded the loss of myelin proteins in some lesions. These features suggest astrocyte damages resulting in the loss of connexin 43 cause demyelination through the impairment of interaction between astrocytes and oligodendrocytes and the pathomechanism involves a T cell reaction.
authors.affiliation: Department of Neurommunology, Graduate School of Medical Sciences, Kyushu University.
authors.forename: Takuya
authors.initials: T
authors.lastname: Matsushita
authors.forename: Katsuhisa
authors.initials: K
authors.lastname: Masaki
authors.forename: Satoru
authors.initials: S
authors.lastname: Suzuki
authors.forename: Takeshi
authors.initials: T
authors.lastname: Matsuoka
authors.forename: Tomomi
authors.initials: T
authors.lastname: Yonekawa
authors.forename: Xiao-Mu
authors.initials: XM
authors.lastname: Wu
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tabira
authors.forename: Toru
authors.initials: T
authors.lastname: Iwaki
authors.forename: Jun-Ichi
authors.initials: J
authors.lastname: Kira
mesh_terms: D051401:Aquaporin 4 / Q000276:immunology; D001253:Astrocytes / Q000473:pathology*; D002549:Diffuse Cerebral Sclerosis of Schilder / Q000473:pathology*; D006801:Humans; D009103:Multiple Sclerosis / Q000473:pathology*; D009471:Neuromyelitis Optica / Q000473:pathology*
chemical_list: D051401:Aquaporin 4