Studies on acute disseminated encephalomyelitis produced experimentally in rhesus monkeys

A MURINE VIRUS (JHM) CAUSING DISSEMINATED ENCEPHALOMYELITIS WITH EXTENSIVE DESTRUCTION OF MYELIN : II. PATHOLOGY

A description has been given of the pathologic changes produced experimentally in animals by the inoculation of a virus material obtained from a mouse with spontaneous encephalomyelitis. The most distinctive feature of the lesions in the central nervous system is the widespread destruction of myelin. Giant cells derived from a variety of tissue elements characterize the early lesions. The liver in the majority of cases is the seat of focal necrosis. In some mice, infected with large doses by the intravenous route, there is produced massive necrosis of the liver, with fat infiltration and calcification. Giant cells are occasionally found in lymphatic tissue, but no significant changes were noted in other organs. Inclusions or elementary bodies were not demonstrated in the lesions. Similar lesions were produced by the inoculation of mouse virus into hamsters. In rats, the lesions were of a more chronic character. The relation of this disease to other demyelinating diseases of man and animals is discussed.

Acute disseminated encephalomyelitis following immunization with homologous brain extracts; studies on the role of a circulating antibody in the production of the condition in dogs

1. A severe demyelinating condition characterized by ataxia and paralysis, in some instances leading to death, was produced in thirty-five of a total of fifty-five dogs following immunization with homologous brain tissue combined with Freund's adjuvants. In more than 30 per cent of instances paralysis did not occur until immunization was continued for 6 or more months. Only eight dogs became paralyzed after a single injection of antigen. The condition appeared between 6 and 15 days after the last injection in all animals, irrespective of the total number of injections or the duration of immunization. 2. An antibody which reacted in complement fixation tests with aqueous and alcoholic extracts of homologous brain tissue was demonstrable in the majority of immunized dogs, whether or not the animals became paralyzed. It appeared during or after the 3rd week of immunization, and its occurrence or titer could not be correlated with the incidence of the encephalomyelitis. In general, there were fewer dogs with demonstrable antibody in the paralyzed group than in the non-paralyzed group. 3. A flocculation reaction with alcohol extracts of homologous brain was demonstrated in the serum of immunized dogs. The antigen and antibody involved were apparently identical with those responsible for the complement fixation reactions. 4. The brain tissue component which reacted as antigen in the complement fixation test was present in adult brain from several mammalian species, and peripheral nerve. It was not present in the brain of newborn dogs nor in other unrelated organs. It was demonstrable in brain tissue which had been allowed to autolyze, or treated with 10 per cent formalin. It was not impaired by boiling, or by acid hydrolysis, and was contained in the unsaponifiable fraction of brain lipids. It was separable from cholesterol by digitonin precipitation of the latter. 5. Immunization of dogs with the unsaponifiable fraction of homologous brain, in adjuvants, caused the appearance of antibrain antibody similar to that in animals injected with whole brain. Encephalomyelitis was not observed during a 2 month period of immunization with this fraction. 6. In guinea pigs, an injection of the unsaponifiable fraction of brain, in adjuvants, was followed by fatal meningoencephalitis, but the identity of the state with that caused by whole brain antigens was not established.

Studies on acute disseminated encephalomyelitis produced experimentally in Rhesus monkeys; complement-fixing antibodies

1. Animals injected with emulsions of monkey brain with adjuvants show a complex pattern of antibody response as determined by complement fixation tests. 2. Organ-specific complement-fixing antibodies to constituents of brain tissue may be formed which fix complement with brain tissues of various animal species but fail to react with other organs or with rabbit placenta. 3. Antibodies may be formed to some constituent of brain other than nervous tissue. It would seem that these can be detected by the strong complement fixation given with rabbit placenta. 4. Sera from individual animals may contain antibodies to the brain or placenta constituents, to both, or to neither. Occasional individual sera show unique patterns of antibody response as determined with various additional antigens such as fetal brain, posterior pituitary, or peripheral nerves. 5. No evidence of any etiological relationship between the development of encephalomyelitis and the complement-fixing antibodies to brain demonstrable in the sera could be found. The complement-fixing antibody to the placental constituent was unrelated to the encephalomyelitis.

A lipolytic enzyme in reactive histiocytes of guinea pigs with experimental encephalomyelitis

A lipolytic enzyme has been demonstrated by means of a cytochemical technique and by direct chemical assay in granulomatous tissues of guinea pigs with encephalomyelitis and demyelinization resulting from the injection of an emulsion comprised of brain tissue and adjuvants, including Mycobacterium butyricum. Combined histologic and cytochemical studies showed that the lipolytic enzyme was present in the cytoplasm of a large proportion of the reactive histiocytes in the granulomatous tissue around the site of injection in the diseased animals, and that the enzyme-containing histiocytes were even more numerous in the inflamed regional lymph nodes. In control experiments, when emulsions lacking either brain tissue or M. butyricum were injected in previously normal guinea pigs, the experimental condition did not develop; under these circumstances the lipolytic enzyme was found in only a small proportion of the cells of the granulomatous tissue around the injection sites, and it was almost negligible in the regional lymph nodes of these animals. It was absent from the cells of the lymph nodes of normal animals, and from the cells of talcum and aluminum hydroxide granulomas produced experimentally in guinea pigs. The lipolytic enzyme may be a factor in the pathogenesis of the experimental encephalomyelitis and demyelinization.

Transfer of allergic encephalomyelitis in rats by means of lymph node cells

Transfer of allergic encephalomyelitis has been accomplished by injection of lymph node cells, obtained from donor rats sensitized to spinal cord, into recipient rats pretreated neonatally with normal rat spleen cells. Transfer of the disease may be achieved most frequently when the recipients are pretreated with spleen cells of the prospective lymph node cell donors. These transfers are attributed to the use of recipients which have acquired immunological tolerance to donor lymph node cells, as a result of the spleen cell pretreatment, and in which, therefore, the donor cells can survive and function longer after transfer.

Cellular events in the induction of experimental allergic encephalomyelitis in rats

Although both the T and B cells of the Lewis rat have immunoglobulin receptors for basic protein (BP) of myelin, and both cell types are required for antibody production to BP, the present results demonstrate that the T cells are the only cells required for the induction of experimental allergic encephalomyelitis (EAE). Both EAE and anti-BP were readily induced in thymectomized, irradiated Lewis rats reconstituted with normal thymus and bone marrow cells and challenged with BP in complete Freund's adjuvant. If the thymus cells were first treated with BP heavily labeled with 125I so as to eliminate (sucide) specific T cells, the recipients neither develop EAE nor produce antibody to BP. On the other hand, if the thymus cells were untreated and the specific B cells of bone marrow were eliminated by treatment with 125I-BP, EAE was not inhibited, although no antibody was produced. These results strongly suggest that the T cell is responsible for the induction of EAE although both the T and B cells are competent to respond to BP. Evidence was presented which suggests that neither suppressor T cells nor circulating antibody are involved in the inhibition of EAE by injection of Lewis rats with nonencephalitogenic preparations of BP. The immune status of T and B cells of the Lewis rat to BP was compared with the immune status of these cells in other species to thyroglobulin, where only the B cells appear to be competent. In this context, Brown Norway rats, which are resistant to the induction of EAE, also appear to lack T cells reactive to BP, although competent B cells are present.

Experimental allergic encephalitis. Dissociation of cellular immunity to brain protein and disease production

The encephalitogenic determinant of brain protein, a nonapeptide having the amino acid sequence Phe-Ser-Trp-Gly-Ala-Glu-Gly-Gln-Lys, has been characterized and synthesized. In a previous study, analogues of this encephalitogenic peptide were synthesized and some were shown to be encephalitogenic while others were not. Guinea pigs were immunized with encephalitogenic peptides having amino acid sequences different from that in the native protein. These guinea pigs did not show cellular immunity in vivo (skin reactivity) or in vitro (lymphocyte stimulation or macrophage migration inhibition) to the encephalitogenic brain protein (EP) although they did show cellular immunity to the immunizing antigenic peptide. Guinea pigs immunized with an encephalitogenic peptide having the same amino acid sequence as the brain protein, or with a nonencephalitogenic peptide having the same amino acid sequence as the native protein but lacking the terminal lysine, did develop cellular immunity to the EP. Animals immunized with EP showed cellular immunity to this protein, but not to the encephalitogenic peptides. Animals immunized with nonencephalitogenic protein (NEP), prepared by altering the tryptophan residue of EP, did not develop disease but did show cellular immunity in vitro and in vivo to the EP. Animals protected from disease by immunization with NEP similarly showed cellular immunity to EP. Thus, the results suggest a dissociation between cellular immunity to EP and the production of experimental allergic encephalitis (EAE). Animals immunized with the encephalitogenic peptides develop EAE, but do not show cellular immunity to EP, and animals immunized with NEP show cellular immunity to EP but do not develop EAE. A fresh approach to the examination of the pathogenesis of EAE is now possible through the use of these well-characterized antigens.

Acute hemorrhagic leucoencephalitis. Treatment with corticosteroids and dehydrating agents

✓ In a case of acute hemorrhagic leucoencephalitis, proven by biopsy, a steroid preparation and dehydrating agents used in unusual amounts resulted in almost complete recovery. The characteristic features and related studies of this disease are reviewed and the policy of conservative therapy emphasized.

An allergen-free antirabies vaccine

Studies on the development of encephalitogenic activity in the cerebral tissue of various animals (rabbits, rats, mice and sheep) showed that the brains of albino rats did not become encephalitogenic until after the 18th day of life, which is later than in any of the other animals studied. On the basis of this finding, a method was developed for the preparation of an entirely allergen-free, non-encephalitogenic antirabies vaccine using the brains of suckling rats. The phenolized vaccine, both in liquid and in lyophilized form, consistently gave high antigenic titres when tested in animals and produced a good increase in virus-neutralizing antibodies in man. It also showed a low thromboplastic activity. More than 1500 litres of this vaccine have since been manufactured on an industrial scale and more than 9500 persons vaccinated. General reactions have been far less frequent than with the conventional Fermi vaccine and no neuroparalytic accidents or shock reactions have been reported. Vaccination with the allergen-free vaccine has proceeded smoothly even in persons considered to be especially at risk owing to previous vaccination with antirabies vaccine or a history of trauma or disease of the central nervous system.

ANTIRABIES ANTIBODY RESPONSE IN MAN TO VACCINE MADE FROM INFECTED SUCKLING-MOUSE BRAINS

Antirabies vaccines produced from infected brains of adult mammals have always had the potentiality of causing post-vaccinal paralysis or allergic encephalitis in man. Attempts in recent years either to remove the paralytic factor from brain-tissue vaccines or to use as the virus source infected tissue other than nervous tissue (e.g., chick embryos) have usually resulted in a substantial reduction of the specific antirabies potency.The authors' laboratory had previously developed a vaccine made from infected suckling-mouse brains in which the virus was inactivated by ultraviolet irradiation. This vaccine was found highly potent in animal tests and low in organ-specific antigens. Others have found the brains of newborn mammals to be free of the allergic encephalitic factor. The studies reported in this paper show that the antirabies antibody responses to a 14-dose course of this suckling-mouse-brain vaccine in children are at a high level even when the vaccine is used at a 1% tissue concentration. There was no evidence of deleterious reactions to this treatment in 31 children.It is concluded that these results justify a long-term trial of this vaccine for antirabies prophylaxis in man.

The pathological effects produced by sera of animals immunized with foreign nervous or splenic tissue. I. Intracisternal injection of serum

Images

Allergic neuritis: an experimental disease of rabbits induced by the injection of peripheral nervous tissue and adjuvants

In experimental allergic encephalomyelitis (EAE), produced by injecting rabbits with whole rabbit spinal cord together with tubercle bacilli and mineral oil, lesions comparable to those seen in the central nervous system are found in the nerve roots, spinal ganglia, and peripheral nerves. When special fractions of bovine white matter are used as antigen in rabbits, the same distribution of lesions is seen but peripheral nerve involvement is relatively less frequent. When rabbit sciatic nerve or spinal ganglia are used as antigen in rabbits, lesions occur only in the roots, ganglia, and peripheral nerves. Lesions are not produced in the central nervous system, nor is there a meningitis. This disease picture has been called experimental allergic neuritis (EAN). The antigenicity of rabbit nerve is not impaired by autoclaving. Sciatic nerve of other mammalian species produces the same disease in rabbits as does rabbit nerve. Optic nerve, used as antigen, produces the typical picture of EAE, not EAN. The optic nerves are not affected in EAN, whereas they commonly contain lesions in EAE. There are differences of symptomatology, referable to the difference in distribution of lesions, between EAE and EAN. The spinal fluid of EAE shows an increase both in the number of cells and in the total protein content. In EAN, the same changes in protein are observed, but usually the cell count remains normal. The cell count appears to be related to the involvement of cerebral and spinal meninges, which is an almost invariable accompaniment of EAE. The skin tests and serologic studies made with homologous and heterologous antigens were essentially non-contributory, apparently as a consequence of the diversity of antigens present in the inoculated materials. The similarity between EAN and certain of the human polyneuritides is indicated and discussed.

A study of the chemical nature of components of bovine white matter effective in producing allergic encephalomyelitis in the rabbit

Fractions of bovine white matter, prepared by the methods of Folch and Lees, were studied for chemical composition and for their ability to produce experimental allergic encephalomyelitis in rabbits. Evaluation of the disease and of the lesions in animals injected with the more active fractions at several dose levels permitted comparison of the antigenic activity of these materials. When tissue was fractionated by the methods of Folch and Lees, antigenic activity was found in the chloroform-methanol extract but not in the denatured tissue residue. This activity was traced to proteolipides A and B and to the lower phase, more specifically the ether-soluble fraction of the lower phase. Proteolipide C was inactive. Correlation of the chemistry of fractions with their antigenic activity suggested two possibilities: (a) that there might be two antigens, one proteolipide and the other non-proteolipide; or (b) that a small specific proteolipide is responsible for all the observed activity. The high concentration of acetal phosphatide in the ether-soluble lower phase suggested that compounds of this type might be the hypothetical non-proteolipide antigen, but this hypothesis was disproved by analytic study of active and inactive materials. The possibility that proteolipide might account for all the antigenic activity was strongly supported by the experimental finding that total lipide and proteolipide progressively lost activity as proteolipide was degraded by adequate processing. The use of an entirely different method for preparing total lipides free of proteolipide (the colloidal iron technique) indicated that this loss of activity did not result from incidental removal of some non-proteolipide antigen. These tentative conclusions are in agreement with those of Tal and Olitsky and provide a satisfactory interpretation of the findings of Goldstein et al. The very fact, however, that the suggested proteolipide antigen would amount to no more than 1 per cent of the total chloroform-methanol extractives leaves open the possibility that some unrecognized trace substance may be the antigen. Skin tests with the various fractions indicated some cross-reactivity between proteolipides A and B and the ether-soluble lower phase fraction and a fair correlation of positive skin reactions with disease. This finding is compatible with the suggestion that the same antigen is present in both of these types of material. When the disease produced by whole tissue or fractions was evaluated by the use of the proportion of animals developing disease, the day of onset, and the severity of the histologic lesions, it was found that fractions produced milder disease of later onset than intact tissue at all dose levels. The disease-producing activity was not enhanced by increasing the dose; i.e., it appeared to reach an asymptotic maximum below that obtainable with whole fresh tissue. This finding suggests both a quantitative loss of activity and a qualitative change during the initial chloroform-methanol extraction, a procedure which denatures all proteins in the tissue residue. A comparable change appeared to occur in whole white matter stored at -15 degrees C. for 15 months and thawed and refrozen several times during this period. The later fractionation steps resulted in no apparent loss of antigenic activity. A scoring method employing the same type of data to estimate the actual relative antigen contents of different preparations is presented in the Appendix.