Höftberger R, Leisser M, Bauer J, Lassmann H.Autoimmune encephalitis in humans: how closely does it reflect multiple sclerosis ? Acta Neuropathol Commun. 2015;3(1):80. doi: 10.1186/s40478-015-0260-9.
Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system. Immunological studies suggest that it is a T-cell mediated autoimmune disease, although an MS-specific target antigen for autoimmunity has so far not been identified. Models of experimental autoimmune encephalomyelitis in part reproduce features of MS, but none of the models so far covers the entire spectrum of pathology and immunology. Autoimmune disease of the nervous system has occasionally been observed in humans after active sensitization with brain tissue or brain cells, giving rise to acute demyelinating polyradiculoneuritis, acute disseminated encephalomyelitis and in rare cases reflecting an inflammatory demyelinating condition similar to acute multiple sclerosis. In this study we analyzed in detail the immunopathology in archival autopsy tissue of a patient who died with an MS like disease after repeated exposure to subcutaneous injections of lyophilized brain cells.
RESULTS: The pathology of this patient fulfilled all pathological diagnostic criteria of MS. Demyelination and tissue injury was associated with antibody (IgM) deposition at active lesion sites and complement activation. Major differences to classical EAE models were seen in the composition of inflammatory infiltrates, being dominated by B-cells, infiltration of IgM positive plasma cells, profound infiltration of the tissue by CD8(+) T-lymphocytes and a nearly complete absence of CD4(+) T-cells.
CONCLUSIONS: Our study shows that auto-sensitization of humans with brain tissue can induce a disease, which closely reflects the pathology of MS, but that the mechanisms leading to demyelination and tissue injury differ from those, generally implicated in the pathophysiology of MS through studies in experimental autoimmune encephalomyelitis
So human EAE is like MS, so all the more reason to study animal EAE....... yeah. There are B cell infiltrates and CD8 cells and near absence of CD4.
You can get this in EAE but you start with a CD4 rich infiltrate and with time the T cell infiltrates burn away. You can get B cell rich cuffs etc full of CD8 too, we showed this when we transplanted IL-10 producing cells into the brains of mice with EAE. However this report highlights the differences of mouse EAE and human MS.
However, are the pathologists comparing apples and pears, EAE taking a copy to a few weeks verses this patient that had been developing neurological symptoms for 4 years. This case was apparently reported in 1958 and they were treated with brain cells and placental cells for a year and half....and after the seventh injection they got signs. I guess the first question is what were they thinking when giving brain and placenta..may be DrK can read the original text (in German) to give us some logic. However some people are currently injecting myelin proteins into the skin of people with MS. Will disaster occur too?
Of course there are differences between EAE in animals and that in humans but the point is that sensitization to brain material can induce a condition that has similarities with MS, therefore maybe MS has an autoimmune cause.