Imperial College London
Alternate

ProfessorRichardNicholas

Faculty of Medicine, Department of Brain Sciences

Professor of Practice (Neurology)
 
 
 
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Contact

 

r.nicholas

 
 
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Location

 

12L12CLab BlockCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Reali:2020:10.1111/bpa.12841,
author = {Reali, C and Magliozzi, R and Roncaroli, F and Nicholas, R and Howell, OW and Reynolds, R},
doi = {10.1111/bpa.12841},
journal = {Brain Pathology},
pages = {779--793},
title = {B cell rich meningeal inflammation associates with increased spinal cord pathology in multiple sclerosis},
url = {http://dx.doi.org/10.1111/bpa.12841},
volume = {30},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Increased inflammation in the cerebral meninges is associated with extensive subpial cortical grey matter pathology in the forebrain and a more severe disease course in a substantial proportion of secondary progressive multiple sclerosis (SPMS) cases. It is not known whether this relationship extends to spinal cord pathology. We assessed the contribution of meningeal and parenchymal immune infiltrates to spinal cord pathology in SPMS cases characterised by the presence (F+) or absence (F) of lymphoidlike structures in the forebrain meninges. Transverse cryosections of cervical, thoracic and lumbar cord of 22 SPMS and 5 control cases were analysed for CD20+ B cells, CD4+ and CD8+ T cells, microglia/macrophages (IBA1+), demyelination (myelin oligodendrocyte glycoprotein+) and axon density (neurofilamentH+). Lymphoidlike structures containing follicular dendritic cell networks and dividing B cells were seen in the spinal meninges of three out of 11 F+SPMS cases. CD4+ and CD20+ cell counts were increased in F+SPMS compared to FSPMS and controls, whilst axon loss was greatest in motor and sensory tracts of the F+SPMS cases (p<0.01). The density of CD20+ B cells of the spinal leptomeninges correlated with: CD4+ T cells and total B and T cells of the meninges; with the density of white matter perivascular CD20+ and CD4+ lymphocytes (p<0.05); with white matter lesion area (p<0.05); and the extent of axon loss (p<0.05) in F+SPMS cases only. We show that the presence of lymphoidlike structures in the forebrain is associated with a profound spinal cord pathology, and local B cell rich meningeal inflammation associates with the extent of cord pathology. Our work supports a principal role for B cells in sustaining inflammation and tissue injury throughout the CNS in the progressive disease stage.
AU  - Reali,C
AU  - Magliozzi,R
AU  - Roncaroli,F
AU  - Nicholas,R
AU  - Howell,OW
AU  - Reynolds,R
DO  - 10.1111/bpa.12841
EP  - 793
PY  - 2020///
SN  - 1015-6305
SP  - 779
TI  - B cell rich meningeal inflammation associates with increased spinal cord pathology in multiple sclerosis
T2  - Brain Pathology
UR  - http://dx.doi.org/10.1111/bpa.12841
UR  - https://onlinelibrary.wiley.com/doi/abs/10.1111/bpa.12841
UR  - http://hdl.handle.net/10044/1/77840
VL  - 30
ER  -
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