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Demyelinating diseases are traditionally classified into two types: demyelinating myelinoclastic diseases and demyelinating leukodystrophic diseases. In the first group, a healthy and normal myelin is destroyed by toxic substances, chemicals, or autoimmune reactions.
CD68 immunostaining demonstrating macrophages and giant cells in a case of xanthogranulomatous pyelonephritis CD68 ( C luster of D ifferentiation 68) is a protein highly expressed by cells in the monocyte lineage (e.g., monocytic phagocytes , osteoclasts ), by circulating macrophages , and by tissue macrophages (e.g., Kupffer cells , microglia ).
Demyelinating diseases of the CNS can be classified according to their pathogenesis into five non-exclusing categories: demyelination due to inflammatory processes, viral demyelination, demyelination caused by acquired metabolic derangements, hypoxic–ischaemic forms of demyelination and demyelination caused by focal compression. [3]
As a demyelinating disease, MS disrupts the nervous system's ability to transmit signals, resulting in a range of signs and symptoms, including physical, mental, and sometimes psychiatric problems. [ 1 ] [ 8 ] [ 9 ] Symptoms include double vision , vision loss, eye pain, muscle weakness, and loss of sensation or coordination.
The CD68 colored tissue shows several Macrophages in the area of the lesion. Original scale 1:100. A combination of histologic and/or immunohistochemical stains can be used to visualize post-mortem MS characteristic lesions and to diagnose post-mortem "inflammatory demyelinating lesions consistent with MS": [12]
Inflammatory demyelinating diseases (IDDs), sometimes called Idiopathic (IIDDs) due to the unknown etiology of some of them, are a heterogenous group of demyelinating diseases - conditions that cause damage to myelin, the protective sheath of nerve fibers - that occur against the background of an acute or chronic inflammatory process.
Immunohistochemical stains for microglia (CD68 or HLA-DR) and astrocytes (GFAP) are also helpful techniques to characterize white matter pathology. [6] With a similar pathology to POLD, HDLS is commonly grouped as adult-onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP) so as to give these individually under-recognized ...
Another criticism of the McDonald criteria is that the definition of "lesions typical of MS" is unclear; a 2013 review identified the following characteristics: specific cell morphology shown by hematoxylin, demyelination shown by Luxol fast blue, macrophage appearance by KiM1P or CD68, damage to the axons shown by Bielschowsky stain ...