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HLA-DR antigen expression on T cells from cerebrospinal fluid in multiple sclerosis and aseptic meningo-encephalitis
S Fredrikson1, A Karlsson-Parra, T Olsson
1Department of Neurology, Karolinska Institutet, Huddinge University Hospital, Stockholm, Sweden.
Abstract:
HLA-DR expression on T lymphocytes in cerebrospinal fluid (CSF) from patients with multiple sclerosis (MS) and acute aseptic meningo-encephalitis (AM), and from blood only from healthy controls was examined by a new double-immunofluorescence labelling assay using species-specific second layers on prefixed cell samples. Thirteen of 16 patients with AM (81%) had an elevated percentage of DR positive T cells in CSF against only two of 20 patients with MS (10%). Our data indicate that AM, an acute infection of the central nervous system (CNS), is accompanied by accumulation in CSF of activated, DR positive T cells as a reflection of actively involved cellular immunity within the CNS, while this accumulation of DR positive T cells is not seen in MS, a chronic inflammatory CNS disease, despite some of the patients being examined during clinical exacerbations.
Insights
Acute aseptic meningo-encephalitis (AM) shows elevated T cells in cerebrospinal fluid (CSF), indicating active CNS immunity. Multiple sclerosis (MS) patients do not exhibit this accumulation of DR positive T cells in CSF.
Area of Science:
- Neuroimmunology
- Cellular Immunology
- Central Nervous System (CNS) Disorders
Background:
- Multiple sclerosis (MS) is a chronic inflammatory disease of the CNS.
- Acute aseptic meningo-encephalitis (AM) is an acute CNS infection.
- T lymphocytes play a role in CNS inflammation.
Purpose of the Study:
- To investigate Human Leukocyte Antigen - antigen D Related (HLA-DR) expression on T lymphocytes in CSF.
- To differentiate between MS and AM based on T cell activation markers in CSF.
- To assess the role of activated T cells in acute versus chronic CNS inflammatory conditions.
Main Methods:
- A novel double-immunofluorescence labeling assay was employed.
- Prefixed cell samples from CSF and blood were analyzed.
- T lymphocytes expressing HLA-DR in CSF from MS and AM patients, and in blood from healthy controls, were quantified.
Main Results:
- 81% of AM patients showed elevated DR positive T cells in CSF.
- Only 10% of MS patients exhibited elevated DR positive T cells in CSF.
- Accumulation of DR positive T cells in CSF was observed in AM but not in MS.
Conclusions:
- AM is characterized by the accumulation of activated, DR positive T cells in CSF, reflecting active CNS cellular immunity.
- This accumulation of DR positive T cells is not a feature of MS, a chronic inflammatory CNS disease.
- CSF T cell analysis may help distinguish between acute CNS infections and chronic inflammatory conditions like MS.