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Vercellino M, Costantini G, Cogoni M, Lequio L, Sciortino P, De Negri F, Marasciulo S, Valentini C, Bosa C, Garelli P, Rolando A, Calvo A, Morana G, Cavalla P. Association of MRI leptomeningeal enhancement with disability worsening in progressive multiple sclerosis: A clinical and post-mortem study. Mult Scler 2023; 29:1526-1539. [PMID: 37740714 DOI: 10.1177/13524585231199031] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/25/2023]
Abstract
BACKGROUND Leptomeningeal enhancement (LME) has been described as a biomarker of meningeal inflammation in multiple sclerosis (MS). OBJECTIVE The aim of this study was to (1) assess if LME is predictive of disability worsening in progressive MS (pMS) patients and (2) investigate the pathological substrates of LME in an independent post-mortem MS series. METHODS In total, 115 pMS patients were imaged yearly with 1.5T MRI, using post-contrast CUBE 3D FLAIR for LME detection. Endpoint: to identify the baseline variables predictive of confirmed disability worsening (CDW) at 24 months follow-up. Post-mortem, inflammation, and structural changes of the leptomeninges were assessed in 12 MS/8 control brains. RESULTS LME (27% of patients at baseline) was associated with higher EDSS and lower brain volume (nBV). LME was unchanged in most patients over follow-up. LME at baseline MRI was independently associated with higher risk of 24 months CDW (HR 3.05, 95% CI 1.36-6.84, p = 0.007) in a Cox regression, including age, nBV, T2 lesion volume, high-efficacy treatments, and MRI disease activity. Post-mortem, focal structural changes (fibrosis) of the leptomeninges were observed in MS, usually associated with inflammation (Kendall's Tau 0.315, p < 0.0001). CONCLUSIONS LME is frequently detected in pMS patients using 1.5T MRI and is independently predictive of disability progression. LME could result from both focal leptomeningeal post-inflammatory fibrosis and inflammation.
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Affiliation(s)
- Marco Vercellino
- MS Center and Neurologia I U, Dipartimento di Neuroscienze e Salute Mentale, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy
- MS Center and Neurologia I U, Dipartimento di Neuroscienze e Salute Mentale, A.O.U. Città della Salute e della Scienza di Torino, Torino 10126, Italy
| | | | - Maurizio Cogoni
- SC Neuroradiologia, Dipartimento di Diagnostica per Immagini e Radiologia Interventistica, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Laura Lequio
- SC Neuroradiologia, Dipartimento di Diagnostica per Immagini e Radiologia Interventistica, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Paola Sciortino
- SC Neuroradiologia, Dipartimento di Diagnostica per Immagini e Radiologia Interventistica, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Federica De Negri
- SC Neuroradiologia, Dipartimento di Diagnostica per Immagini e Radiologia Interventistica, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Stella Marasciulo
- MS Center and Neurologia I U, Dipartimento di Neuroscienze e Salute Mentale, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy/Dipartimento di Neuroscienze "Rita Levi Montalcini," Università di Torino, Torino, Italy
| | - Consuelo Valentini
- SC Neuroradiologia, Dipartimento di Diagnostica per Immagini e Radiologia Interventistica, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Chiara Bosa
- MS Center and Neurologia I U, Dipartimento di Neuroscienze e Salute Mentale, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy/Dipartimento di Neuroscienze "Rita Levi Montalcini," Università di Torino, Torino, Italy
| | - Paola Garelli
- MS Center and Neurologia I U, Dipartimento di Neuroscienze e Salute Mentale, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy/Dipartimento di Neuroscienze "Rita Levi Montalcini," Università di Torino, Torino, Italy
| | - Anna Rolando
- MS Center and Neurologia I U, Dipartimento di Neuroscienze e Salute Mentale, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy/Dipartimento di Neuroscienze "Rita Levi Montalcini," Università di Torino, Torino, Italy
| | - Andrea Calvo
- MS Center and Neurologia I U, Dipartimento di Neuroscienze e Salute Mentale, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy/Dipartimento di Neuroscienze "Rita Levi Montalcini," Università di Torino, Torino, Italy
| | - Giovanni Morana
- Dipartimento di Neuroscienze "Rita Levi Montalcini," Università di Torino, Torino, Italy
| | - Paola Cavalla
- MS Center and Neurologia I U, Dipartimento di Neuroscienze e Salute Mentale, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy
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Wachowiak IJ, Patterson JS, Winger KM, Smiler KL, Cole R, Moon R, Kluz M, Bartner LR. Thoracolumbar myelopathies in pug dogs. J Vet Intern Med 2023; 37:618-625. [PMID: 36744714 DOI: 10.1111/jvim.16639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 01/19/2023] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Constrictive myelopathy (CM) involving a fibrous band around the spinal cord is a newly recognized disease in pug dogs. OBJECTIVES To identify the frequency of CM based on diagnostic imaging supplemented with necropsy; to determine whether a relationship exists between the sites of CM and other described T3-L3 myelopathies; and to determine the frequency of caudal articular process dysplasia (CAPD). ANIMALS Thirty-two client-owned pug dogs diagnosed with a chronic, progressive T3-L3 myelopathy based on neurological examination performed by a board-certified neurologist. METHODS This is a prospective study. All dogs underwent computed tomography (CT) and magnetic resonance imaging (MRI) reviewed by a board-certified radiologist. Magnetic resonance imaging abnormalities were categorized into diseases; CM only, CM plus other non-CM condition(s), or non-CM condition. Sites of CAPD were reported on CT. Nineteen dogs underwent necropsy. RESULTS Magnetic resonance imaging revealed 3 dogs with CM only, 17 with CM plus at least 1 other myelopathy, 11 dogs with non-CM myelopathies only, and 1 with no MRI abnormalities. Nineteen of 32 dogs had >1 myelopathy diagnosis on MRI whereas 15/32 had >1 site of spinal cord compression. All dogs had CAPD at >1 site in the T3-L3 vertebral column on CT. CONCLUSIONS AND CLINICAL IMPORTANCE Constrictive myelopathy affected more than half of pug dogs presenting with chronic thoracolumbar myelopathies. Most had multilevel disease, concurrent myelopathies, or both. There was no apparent relationship between anatomic locations of CAPD and most severe myelopathy or myelopathy type.
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Affiliation(s)
- Ian J Wachowiak
- Department of Small Animal Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Jon S Patterson
- Department of Pathobiology and Diagnostic Investigation, Michigan State University, East Lansing, Michigan, USA
| | - Kathryn M Winger
- Department of Small Animal Clinical Sciences, Michigan State University, East Lansing, Michigan, USA
| | - Kathleen L Smiler
- ACLAM, Michigan State University College of Veterinary Medicine, East Lansing, Michigan, USA
| | - Robert Cole
- Department of Small Animal Clinical Sciences, Auburn University, Auburn, Alabama, USA
| | - Rachel Moon
- Department of Small Animal Clinical Sciences, Auburn University, Auburn, Alabama, USA
| | - Michael Kluz
- VCA Jackson, Michigan Animal Hospital, Jackson, Michigan, USA
| | - Lisa R Bartner
- Department of Small Animal Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA
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Enos N, Takenaka H, Scott S, Salfity HVN, Kirk M, Egar MW, Sarria DA, Slayback-Barry D, Belecky-Adams T, Chernoff EAG. Meningeal Foam Cells and Ependymal Cells in Axolotl Spinal Cord Regeneration. Front Immunol 2019; 10:2558. [PMID: 31736973 PMCID: PMC6838144 DOI: 10.3389/fimmu.2019.02558] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 10/15/2019] [Indexed: 12/01/2022] Open
Abstract
A previously unreported population of foam cells (foamy macrophages) accumulates in the invasive fibrotic meninges during gap regeneration of transected adult Axolotl spinal cord (salamander Ambystoma mexicanum) and may act beneficially. Multinucleated giant cells (MNGCs) also occurred in the fibrotic meninges. Actin-label localization and transmission electron microscopy showed characteristic foam cell and MNGC podosome and ruffled border-containing sealing ring structures involved in substratum attachment, with characteristic intermediate filament accumulations surrounding nuclei. These cells co-localized with regenerating cord ependymal cell (ependymoglial) outgrowth. Phase contrast-bright droplets labeled with Oil Red O, DiI, and DyRect polar lipid live cell label showed accumulated foamy macrophages to be heavily lipid-laden, while reactive ependymoglia contained smaller lipid droplets. Both cell types contained both neutral and polar lipids in lipid droplets. Foamy macrophages and ependymoglia expressed the lipid scavenger receptor CD36 (fatty acid translocase) and the co-transporter toll-like receptor-4 (TLR4). Competitive inhibitor treatment using the modified fatty acid Sulfo-N-succinimidyl Oleate verified the role of the lipid scavenger receptor CD36 in lipid uptake studies in vitro. Fluoromyelin staining showed both cell types took up myelin fragments in situ during the regeneration process. Foam cells took up DiI-Ox-LDL and DiI-myelin fragments in vitro while ependymoglia took up only DiI-myelin in vitro. Both cell types expressed the cysteine proteinase cathepsin K, with foam cells sequestering cathepsin K within the sealing ring adjacent to the culture substratum. The two cell types act as sinks for Ox-LDL and myelin fragments within the lesion site, with foamy macrophages showing more Ox-LDL uptake activity. Cathepsin K activity and cellular localization suggested that foamy macrophages digest ECM within reactive meninges, while ependymal cells act from within the spinal cord tissue during outgrowth into the lesion site, acting in complementary fashion. Small MNGCs also expressed lipid transporters and showed cathepsin K activity. Comparison of 3H-glucosamine uptake in ependymal cells and foam cells showed that only ependymal cells produce glycosaminoglycan and proteoglycan-containing ECM, while the cathepsin studies showed both cell types remove ECM. Interaction of foam cells and ependymoglia in vitro supported the dispersion of ependymal outgrowth associated with tissue reconstruction in Axolotl spinal cord regeneration.
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Affiliation(s)
- Nathaniel Enos
- Department of Biology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Hidehito Takenaka
- Department of Biology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Sarah Scott
- Department of Biology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Hai V N Salfity
- Department of Biology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Maia Kirk
- Department of Biology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Margaret W Egar
- Department of Biology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Deborah A Sarria
- Department of Biology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Denise Slayback-Barry
- Department of Biology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Teri Belecky-Adams
- Department of Biology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Ellen A G Chernoff
- Department of Biology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
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