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Updated: Mar 20, 2026
Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Multiple sclerosis: The resolving lesion revealed
1Department of Pathology (Neuropathology), Albert Einstein College of Medicine, Bronx, New York City, NY, USA; Department of Neurology, Albert Einstein College of Medicine, Bronx, New York City, NY, USA; Department of Neuroscience, Albert Einstein College of Medicine, Bronx, New York City, NY, USA.
Abstract:
A little studied lesion, the resolving lesion, is described in multiple sclerosis (MS). Unusual features of early resolving lesions comprised a fibrous astrogliotic parenchyma replete with lipid-laden (foamy) microglia/macrophages widely scattered throughout and lined up at the edge, separating demyelinated plaque from myelinated white matter. Ongoing myelin breakdown was absent, as was remyelination. Later resolving lesions displayed the unusual coexistence of macrophages and remyelination within the gliotic parenchyma. Collectively, these observations may provide for the first time evidence for a role in MS for mitigating factors like alternatively-activated (M2) microglia/macrophages, known to have an anti-inflammatory phenotype and to be associated with wound-healing and repair.
Insights
This study describes resolving lesions in multiple sclerosis (MS), revealing foamy microglia/macrophages and later stages with remyelination. These findings suggest a role for anti-inflammatory M2 cells in MS repair.
Area of Science:
- Neuroscience
- Immunology
- Pathology
Background:
- Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system.
- The pathology of resolving lesions in MS remains poorly understood.
- Identifying reparative mechanisms in MS is crucial for developing effective therapies.
Purpose of the Study:
- To characterize the cellular and histological features of resolving lesions in multiple sclerosis.
- To investigate the potential role of microglia/macrophages in lesion resolution and repair.
- To explore the presence and significance of alternatively-activated (M2) microglia/macrophages in MS lesions.
Main Methods:
- Histological examination of brain tissue from MS patients.
- Immunohistochemistry to identify cell types, including microglia/macrophages.
- Assessment of myelin integrity and astrogliosis.
Main Results:
- Early resolving lesions showed fibrous astrogliosis and abundant lipid-laden microglia/macrophages at plaque edges.
- No ongoing myelin breakdown or remyelination was observed in early lesions.
- Later resolving lesions exhibited macrophages alongside evidence of remyelination within the gliotic parenchyma.
Conclusions:
- Resolving lesions in MS possess distinct histological characteristics.
- The presence of M2 microglia/macrophages suggests a potential role in modulating inflammation and promoting repair.
- These findings offer novel insights into endogenous repair mechanisms in multiple sclerosis.
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