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Immunologic factors in primary progressive multiple sclerosis

Reinhard Hohlfeld1

  • 1Institute for Clinical Neuroimmunology, University of Munich, Klinikum Grosshadern, Marchioninistr. 15, D-81366, Munich, Germany. hohlfeld@neuro.mpg.de

Multiple Sclerosis (Houndmills, Basingstoke, England)
|June 29, 2004
PubMed

Insights

Primary progressive multiple sclerosis (PPMS) shows distinct immunological profiles compared to relapsing MS. Brain-derived neurotrophic factor (BDNF) may play a protective role in multiple sclerosis (MS) lesions, potentially explaining glatiramer acetate (GA) therapy effects.

Area of Science:

  • Neuroimmunology
  • Clinical Neurology

Background:

  • Primary progressive multiple sclerosis (PPMS) is clinically and pathologically distinct from relapsing forms of multiple sclerosis (MS).
  • Existing research suggests PPMS patients may exhibit unique immunologic profiles, differing from both healthy controls and relapsing MS patients.
  • The role of neuroprotective factors like brain-derived neurotrophic factor (BDNF) in MS pathogenesis and treatment is an emerging area of investigation.

Purpose of the Study:

  • To investigate potential immunologic distinctions between PPMS and relapsing MS.
  • To explore the presence and significance of brain-derived neurotrophic factor (BDNF) in MS lesions and its potential role in glatiramer acetate (GA) therapy.

Main Methods:

  • Comparative analysis of cytokine, chemokine receptor, and adhesion molecule expression profiles in PPMS versus relapsing MS patients and healthy controls.
  • Investigation of BDNF production by activated immune cells in MS lesions.
  • Assessment of BDNF receptor presence in MS tissue.
  • Evaluation of BDNF production by glatiramer acetate (GA)-specific T cells.

Main Results:

  • Immunologic profiles in PPMS patients showed similarities to healthy controls, contrasting with relapsing MS patients, particularly regarding cytokine and adhesion molecule expression.
  • Activated immune cells in MS lesions produce the neuroprotective factor BDNF.
  • BDNF receptors are present in MS tissue.
  • Glatiramer acetate (GA)-specific T cells produce BDNF, independent of T helper cell phenotype (Th1 or Th2).

Conclusions:

  • The findings suggest potential immunologic differences between PPMS and relapsing MS.
  • The production of BDNF in MS lesions and by GA-specific T cells supports a concept of 'protective inflammation' and suggests a novel mechanism for GA therapy's efficacy.
  • Further research is needed to clarify the extent to which this BDNF-mediated mechanism is present across different forms of MS.

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