HLA-DR-expressing cells and T-lymphocytes in sural nerve biopsies

Thirty-five sural nerve biopsies were stained immunohistochemically for HLA-DR antigen. HLA-DR was expressed on nonmyelinating Schwann cells, macrophages, vascular endothelium, and perineurium. By means of double immunofluorescence staining the identity of the HLA-DR presenting structures was confirmed. HLA-DR expression was found in all biopsies and thus was not restricted to any particular type of neuropathy. The HLA-DR expression appeared to correlate with severity and activity of the neuropathy. HLA-DR-expressing macrophages wrapping myelinated fibers were prominent in primary demyelinating neuropathies. T-cells were found in 6 out of 15 nerves examined. Their presence correlated with moderate to strong HLA-DR expression of nonmyelinating Schwann cells, and they occurred during active disease.