Multiple sclerosis: chronic inflammation of neurons causing degeneration
An autoimmune disease of the central nervous system, multiple sclerosis is caused by an imbalance in the immune system: the latter attacks the brain and nerve fibers by destroying the myelin sheaths responsible for protecting neurons.
Gradually, patients then lose the use of their limbs, present with impaired vision, motor skills and sensitivity.
About ten years ago, research carried out on patients who had developed a severe form of multiple sclerosis revealed severe chronic inflammation of the plaques. Observed using a high-sensitivity magnetic resonance imaging (MRI) technique, this inflammation results in the appearance of black rings around the periphery of the plaques.
A new international study, led by Dr. Pietro Maggi and in which the universities and university hospitals of Lausanne and Basel (Switzerland) took part, as well as UCLouvain and the Saint-Luc university clinics (Belgium), shows that these Black rings are made up of inflammatory cells, including phagocytes, which attack neurons. It has just been published in the journal Neurology.
technique to the point
The researchers followed 118 patients with multiple sclerosis. Among them, some presented with these chronic inflammatory lesions with black rings and others with lesions without rings, that is, lesions which are not yet in the stage of active chronic inflammation. All study participants had their disease status checked with an MRI scan. They also had a blood test to detect the level of neurofilaments, proteins normally present inside neurons. This technique, which requires the use of an analyzer running a SIMOA (Single Molecule Array) assay, uses a well plate that can only accommodate a single molecule. Only two machines exist in the French community, including that of the Saint-Luc university clinics, where the work was carried out. "This technique has been used in neurological diseases to demonstrate neuronal loss, as in degenerative Alzheimer's disease," explains Dr. Pietro Maggi, deputy head of the neurology department at Saint-Luc university clinics. For sclerosis in plaques, it has already been used to show that patients with severe forms had a higher level of neurofilaments in the blood, but this is the first time that it has been linked to chronic inflammation in the brain . "
Advanced degeneration of neurons
Research has shown a correlation between the presence of lesions with chronic inflammatory ring on MRI and a significant increase in the level of neurofilaments in the blood, which indicates advanced degeneration of the neurons. The presence of lesions with chronic inflammatory ring on MRI is further associated with more severe clinical disability in patients. "This is the strongest association ever found at the statistical level, when we look at the variables measured in relation to the increase of neurofilaments in the blood, which means that these active chronic lesions have a primordial role in neurodegeneration. ", emphasizes Dr Maggi. The results of this study constitute an important advance in understanding the pathophysiological mechanisms of multiple sclerosis, says the researcher. It shows for the first time that the presence of chronic inflammation on MRI is associated with increased neuronal degeneration and a more severe clinical course in patients with multiple sclerosis. Finally, it shows the possibility of detecting both the presence of chronic brain inflammation and its neurodegenerative effect through the combined use of radiological and blood markers.
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