Lymphocytic infiltrates in the spinal cord in amyotrophic lateral sclerosis
J. I. Engelhardt, J. Tajti and S. H. Appel
Department of Neurology, Baylor College of Medicine, Houston, Tex 77030.
OBJECTIVE--Immunohistochemical examination was undertaken to assess the
presence of lymphocytes and lymphocyte subsets in the spinal cord in
amyotrophic lateral sclerosis (ALS). DESIGN--Twenty-seven consecutive ALS
autopsy cases and 11 consecutive disease--control autopsy cases were
examined. Tissue sections were reacted with mouse monoclonal antibody to
human leukocyte common antigen, or monoclonal antibody to human B-cell L26
antigen, and detected with immunoperoxidase techniques. Unfixed sections
were reacted with antihuman Leu-3a and Leu-3b/CD4 or antihuman Leu-2a/CD8
mouse monoclonal antibody and then detected with peroxidase techniques.
SETTING--Tertiary care hospital. CASES--Amyotrophic lateral sclerosis and
non-ALS control autopsy specimens. MAIN OUTCOME MEASURE--Detection of
lymphocytes by histological and immunohistochemical reactivity.
RESULTS--Perivascular and intraparenchymal lymphocytic infiltrates were
found in the spinal cord of 18 of 27 consecutive ALS autopsy cases. The
lymphocytes possessed only T-cell markers; no B-cell markers could be
demonstrated. T-helper cells were found in proximity to degenerating
corticospinal tracts, while T-helper and T-suppressor/cytotoxic cells were
demonstrated in ventral horns. Lymphocytes were present in the spinal cord
of only one control specimen (multiple sclerosis) and in none of the
remaining 10 control specimens. In ALS tissue, the lymphocytic infiltrates
did not correlate with the rate of progression or stage of the disease or
with the presence or absence of terminal infections. CONCLUSIONS--T-cell
lymphocytes are present in the spinal cord of patients with ALS. T-helper
cells are found in proximity to corticospinal tract degeneration, while
T-helper and T-suppressor/cytotoxic cells are present in ventral horns. The
role of these lymphocytes remains to be elucidated.
