Overexpression of sphingosine-1-phosphate receptors on reactive astrocytes drives neuropathology of multiple sclerosis rebound after fingolimod discontinuation

被引：27

作者：

Giordana, Maria Teresa ^{[1
]}

Cavalla, Paola ^{[1
]}

Uccelli, Antonio ^{[2
]}

Laroni, Alice ^{[2
]}

Bandini, Fabio ^{[3
]}

Vercellino, Marco ^{[1
]}

Mancardi, Gianluigi ^{[2
]}

机构：

[1] Torino Univ Hosp, Dept Neurosci, Citta Salute & Sci, Via Cherasco 15, I-10126 Turin, Italy

[2] Univ Genoa, Dept Neurosci Ophthalmol & Genet, Genoa, Italy

[3] San Paolo Hosp, Dept Neurol, Savona, Italy

来源：

MULTIPLE SCLEROSIS JOURNAL | 2018年 / 24卷 / 08期

关键词：

Fingolimod; multiple sclerosis; histopathology; glia; post mortem; demyelination; WITHDRAWAL; CESSATION;

D O I：

10.1177/1352458518763095

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

We present the neuropathological description of an autoptic case of fatal rebound of disease activity after fingolimod discontinuation in a multiple sclerosis patient. MRI prior to the fatal outcome showed several large tumefactive demyelinating lesions. These lesions were characterized by prominent astrocytic gliosis, with a remarkable preponderance of large hypertrophic reactive astrocytes showing intense expression of sphingosine-1-phosphate receptor 1. Prominent astrocytic gliosis was also diffusely observed in the normal-appearing white matter. Dysregulated sphingosine-1-phosphate signaling on astrocytes following fingolimod withdrawal might represent a possible contributing mechanism to disease rebound and might account for the unusual radiological and neuropathological features observed in the present case.

引用

页码：1133 / 1137

页数：5

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