Zusammenfassung
Die Multiple Sklerose (MS) ist die häufigste entzündliche demyelinisierende Erkrankung des zentralen Nervensystems (ZNS). Der entmarkte Plaque ist das Hauptcharakteristikum dieser Erkrankung. Die demyelinisierten Herde sind bevorzugt im Bereich der Kleinhirnstiele, der Nervi optici, der periventrikulären weißen Substanz und im Rückenmark lokalisiert, seltener finden sie sich in den Kerngebieten des Hirnstamms oder in der Großhirnrinde.Innerhalb der Plaques kommt es zu einer Zerstörung des Myelins und/oder der Oligodendrozyten, begleitet von einer Entzündungsreaktion (Lassmann 1998; Prineas 1985). Das entzündliche Infiltrat setzt sich hauptsächlich aus Lymphozyten und Makrophagen zusammen. Trotz dieser grundsätzlichen Gemeinsamkeiten gibt es jedoch Kriterien, anhand derer unterschiedlichehistologische Subtypen definiert werden können (Lucchinetti et al. 1996). In MS-Läsionen finden sich ganz unterschiedliche Veränderungen hinsichtlich der Myelin- und Oligodendrozytenschädigung. Einige Patienten weisen einen fast vollständigen Verlust an Oligodendrozyten in den Plaques auf, bei anderen ist lediglich das Myelin zerstört. Gelegentlich kommt es auch zu einer Rekrutierung von Oligodendrozytenvorläuferzellen (Lucchinetti et al. 1999). Mit einem einheitlichen Schädigungsmechanismus lassen sich diese unterschiedlichen histopathologischen Befunde nur schwer erklären. Vielmehr ist anzunehmen, dass verschiedene immunologische und toxische Mechanismen für diese unterschiedlichen histologischen Muster verantwortlich sind.
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Kuhlmann, T., Brück, W. (2001). Immunpathologie der Multiplen Sklerose. In: Zettl, U.K., Mix, E. (eds) Multiple Sklerose. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-59453-3_2
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DOI: https://doi.org/10.1007/978-3-642-59453-3_2
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