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Expression of HLA-DR in pheripheral nerve of amyotrophic lateral sclerosis

Expressão de HLA-DR em nervo periférico de esclerose lateral amiotrófica

Abstracts

To investigate the possibility of local antigen presentation within the peripheral nerve in amyotrophic lateral sclerosis (ALS), cryostat sections of 83 peripheral nerve biopsies were stained for the demonstration of HLA-DR using a monoclonal antibody. Forty samples showed increased expression of HLA-DR in endoneurium. The phenotypic characteristics of the HLA-DR positive cells are chiefly Schwann cells, using S-100 protein as a marker. We did not detect any co-expression between HLA-DR and NF (axons) and HLA-DR and myelin marker. We also detected co-expression between HLA-DR and NGFr in a majority of HLA-DR positive cells. Inflammatory cells were infrequent, being detected only in 11 cases, predominantly around epineurial blood vessels. Motor and sensory nerve biopsies performed simultaneously showed higher expression of HLA-DR in motor nerves in 2 out of 4 patients. The significance of these findings is not clear. The presence of endoneurial cells expressing HLA-DR suggests that an autoimmune mechanism may be involved in ALS having Schwann as the main target.

amyotrophic lateral sclerosis; peripheral nerve; histocompatibity antigen


Para investigar a possibilidade de comprometimento auto imune no nervo periférico de pacientes com esclerose lateral amiotrófica (ELA) 83 biópsias do nervo periférico de 79 pacientes (51 sexo masculino, 28 sexo feminino) com média de idade de 62 anos (variação de 19 a 82) foram congeladas e coradas para demonstração de HLA-DR usando anticorpo monoclonal. Quarenta amostras (48%) mostraram expressão nitidamente aumentada de HLA-DR na região endoneural. Usando proteína S-100 como marcador, demonstramos que HLA-DR se expressava principalmente nas células de Schwann. Não encontramos co-expressão com HLA-DR usando anticorpos antineurofilamento ou antimielina, mas detectamos co-expressão de HLA-DR e anti-receptor de fator de crescimento nervoso na maioria das células HLA-DR positivas. Células inflamatórias foram encontradas ocasionalmente, sendo detectadas em somente 11 casos, predominantemente ao redor de vasos sanguíneos epineurais. Biópsias de nervo sensitivo e motor feitas simultaneamente mostraram maior expressão de HLA-DR em nervos motores de 2 dos 4 pacientes. A significância desses achados ainda não é clara. A presença de células endoneurais expressando HLA-DR sugere que mecanismos auto imunes podem estar envolvidos na ELA tendo a célula de Schwann como um dos principais alvos.

esclerose lateral amiotrófica; nervo periférico; antígeno de histocompatibilidade


Expression of HLA-DR in pheripheral nerve of amyotrophic lateral sclerosis

Expressão de HLA-DR em nervo periférico de esclerose lateral amiotrófica

A.S.B. OliveiraI; E. IsozakiII; D. YoungerII; A.A. GabbaiI; A.P. HaysII

IDisciplina de Neurologia da Escola Paulista de Medicina

IIDivision of Neuropathology, College of Physicians and Surgeons, Columbia University, New York, NY

SUMMARY

To investigate the possibility of local antigen presentation within the peripheral nerve in amyotrophic lateral sclerosis (ALS), cryostat sections of 83 peripheral nerve biopsies were stained for the demonstration of HLA-DR using a monoclonal antibody. Forty samples showed increased expression of HLA-DR in endoneurium. The phenotypic characteristics of the HLA-DR positive cells are chiefly Schwann cells, using S-100 protein as a marker. We did not detect any co-expression between HLA-DR and NF (axons) and HLA-DR and myelin marker. We also detected co-expression between HLA-DR and NGFr in a majority of HLA-DR positive cells. Inflammatory cells were infrequent, being detected only in 11 cases, predominantly around epineurial blood vessels. Motor and sensory nerve biopsies performed simultaneously showed higher expression of HLA-DR in motor nerves in 2 out of 4 patients. The significance of these findings is not clear. The presence of endoneurial cells expressing HLA-DR suggests that an autoimmune mechanism may be involved in ALS having Schwann as the main target.

Key words: amyotrophic lateral sclerosis, peripheral nerve, histocompatibity antigen.

RESUMO

Para investigar a possibilidade de comprometimento auto imune no nervo periférico de pacientes com esclerose lateral amiotrófica (ELA) 83 biópsias do nervo periférico de 79 pacientes (51 sexo masculino, 28 sexo feminino) com média de idade de 62 anos (variação de 19 a 82) foram congeladas e coradas para demonstração de HLA-DR usando anticorpo monoclonal. Quarenta amostras (48%) mostraram expressão nitidamente aumentada de HLA-DR na região endoneural. Usando proteína S-100 como marcador, demonstramos que HLA-DR se expressava principalmente nas células de Schwann. Não encontramos co-expressão com HLA-DR usando anticorpos antineurofilamento ou antimielina, mas detectamos co-expressão de HLA-DR e anti-receptor de fator de crescimento nervoso na maioria das células HLA-DR positivas. Células inflamatórias foram encontradas ocasionalmente, sendo detectadas em somente 11 casos, predominantemente ao redor de vasos sanguíneos epineurais. Biópsias de nervo sensitivo e motor feitas simultaneamente mostraram maior expressão de HLA-DR em nervos motores de 2 dos 4 pacientes. A significância desses achados ainda não é clara. A presença de células endoneurais expressando HLA-DR sugere que mecanismos auto imunes podem estar envolvidos na ELA tendo a célula de Schwann como um dos principais alvos.

Palavras-chave: esclerose lateral amiotrófica, nervo periférico, antígeno de histocompatibilidade.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Aceite: 12-abril-1994.

Dr. Aracy Oliveira was supported by postodoctoral fellowship from the Brazilian Research Council (CNPq).

Dr. Acary S.B. Oliveira - Disciplina de Neurologia, Escola Paulista de Medicina - Rua Botucatu 740 - 04023-900 São Paulo SP - Brasil.

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Publication Dates

  • Publication in this collection
    19 Jan 2011
  • Date of issue
    Dec 1994
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