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Characterizing the Mechanisms and Progression in Multiple Sclerosis: Evidence and New Hypotheses for Future Directions
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Although Frohman et al1 claim that B cells and plasma cells are present in the brain parenchyma in patients with multiple sclerosis (MS), Serafini et al2 found that both these cells were confined to the perivascular spaces. In only 1 area in a single patient were plasma cells detected in the brain parenchyma, and these were very sparse.
Despite this virtual failure to demonstrate plasma cells within the brain parenchyma using the specific marker CD138, Esiri3 and Prineas4 found large numbers of cells that they described as plasma cells within the brain. However, these cells were frequently binucleate and contained subplasmalemmal linear densities,5 features not observed in plasma cells. Moreover, immunoglobulin has not been demonstrated by immunoelectron microscopy. For these reasons, we have suggested that these cells are plasmacytoid dendritic cells,6 which secrete interferon and are present in the cerebrospinal fluid of patients with MS.7 By using the specific marker . . . [Full Text of this Article] AUTHOR INFORMATION
Colin L. Crawford, MRCP;
Peter M. D. Hardwicke, PhD
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