Summary
Human sural nerve biopsies of eight cases with acute, subacute and chronic polyradiculoneuritis were studied by means of immunohistochemistry to characterize the inflammatory infiltrates. In addition, the structural changes of the endoneurial blood vessels were examined by electron microscopy, since both factors are likely to contribute to disturbances of the blood-nerve barrier. By use of six monoclonal antibodies, it was shown that the inflammatory infiltrates in cases with more acute polyradiculoneuritis are predominantly recruited by Leu 3a- and Leu 4-positive T lymphocytes. In more chronic polyradiculoneuritis beside of few Leu 3a-positive and Leu 4-positive T lymphocytes also B cells occurred. Leu M3-positive macrophages were detected in all cases with floride myelin degeneration. Since immunoreactivity for antigens of the HLA-D-locus (Leu-HAL-DR and Leu 10) were present on the infiltrating mononuclear cells, it can be postulated that they represent active and immunocompetent cells. Ultrastructurally, the amount of pinocytotic vesicles in the endothelial cells of the endoneurial blood vessels was increased. Moreover, a prominent folding of the luminal and abluminal surface of vascular endothelial cells and diminution of the intercellular tight junctions were observed. These findings appear suitable to explain the increased leakage of serum proteins across the blood-nerve barrier in polyradiculoneuritis sharing general features of cell-mediated immunity.
Similar content being viewed by others
References
Aoki Y, Miyatake T, Shimizu N, Yoshida M (1984) Medullasin activity in granulocytes of patients with multiple sclerosis. Ann Neurol 15:245–249
Arnason B (1984) Acute demyelinating polyradiculoneuropathies. In: Dyck PJ, Thomas PK, Lambert EH, Bunge R (eds) Peripheral neuropathies, 2nd edn. Saunders, Philadelphia, pp 2050–2100
Asbury AK (1981) Diagnostic considerations in Guillain-Barré syndrome. Ann Neurol [Suppl] 9:1–5
Asbury AK, Arnason BG, Adams RD (1969) The inflammatory lesion in idiopathic polyneuritis. Its role in pathogenesis. Medicine 48:173–215
Bernard GCA (1977) Suppressor T cells prevent experimental autoimmune encephalomyelitis in mice. Clin Exp Immunol 29:100–109
Beutler B, Cerami A (1987) Cachectin: more than a tumor necrosis factor. N Engl J Med 316:379–385
Boddingius J (1976) Ultrastructural changes in blood vessels of peripheral nerves in leprosy neuropathy. I. Tuberculoid and borderline-tuberculoid leprosy patients. Acta Neuropathol (Berl) 35:159–181
Boddingius J (1977) Ultrastructural changes in blood vessels of peripheral nerves in leprosy neuropathy. II. Borderline, borderline-lepromatous and lepromatous leprosy patients. Acta Neuropathol (Berl) 40:21–39
Boddingius J (1984) Ultrastructural and histophysiological studies on the blood-nerve barrier and perineurial barrier in leprosy neuropathy. Acta Neuropathol (Berl) 64:282–296
Bottazzo GF, Dean BM, McNally JM, MacKay EH, Swift PGF, Gamble DR (1985) In situ characterization of autoimmune phenomena and expression of HLA molecules in the pancreas in diabetic insulitis. N Engl J Med 313:353–360
Brodsky FM (1984) A matrix approach to class II histocompatibility antigens: reactions of four monoclonal antibodies with the products of nine haplotypes. Immunogenetics 19:179–194
Chen YX, Evans RL, Pollack MS, Lanier LL, Phillips JH, Rousso C, Warner NL, Brodsky FM (1984) Characterization and expression of the HLA-DC antigens defined by anti-Leu 10. Hum Immunol 10:221–235
Craggs RI, Webster HdeF (1985) Ia antigens in the normal rat nervous system and in lesions of experimental allergic encephalomyelitis. Acta Neuropathol (Berl) 68:263–272
Dvorak HF, Galli SJ, Dvorak AM (1986) Cellular and vascular manifestations of cell-mediated immunity. Hum Pathol 17:122–137
Dyck PJ, Arnason B (1984) Chronic inflammatory demyelinating polyradiculoneuropathy. In: Dyck PJ, Thomas PK, Lambert EH, Bunge R (eds) Peripheral neuropathies, 2nd edn. Saunders, Philadelphia, pp 2101–2114
Dyck PJ, Lais AC, Ohta M, Bastron JA, Okazaki H, Groover RV (1975) Chronic inflammatory polyradiculoneuropathy. Mayo Clin Proc 50:621–637
Dyck PJ, Daube J, O'Brien P, Pineda A, Low PA, Windebank AJ, Swanson C (1986) Plasmaexchange in chronic inflammatory demyelinating polyradiculoneuropathy. N Engl J Med 314:461–465
Engel AG, Arahata K (1984) Monoconal antibody analysis of mononuclear cells in myopathies. II. Phenotypes of autoinvasive cells in polymyositis and inclusion body myositis. Ann neurol 16:209–215
Feasby TE, Gilbert JJ, Brown WF, Bolton CF, Hahn AF, Koopman WF, Zochodne DW (1986) An acute axonal form of Guillain-Barré polyneuropathy. Brain 109:1115–1126
Goust JM, Chenais F, Carnes JE, Hames CG, Fudenberg HH, Hogan EL (1978) Abnormal T cell subpopulations and circulating immune complexes in the Guillain-Barré syndrome and multiple sclerosis. Neurology 28:421–425
Hahn AF, Feasby TE, Gilbert JJ (1985) Blood-nerve barrier studies in experimental allergic neuritis. Acta Neuropathol (Berl) 68:101–109
Haymaker W, Kernohan JW (1949) The Landry-Guillain-Barré syndrome: a clinicopathologic report of fifty fatal cases and a critique of the literature. Medicine 28:59–99
Izumo S, Linington C, Wekerle H, Meyermann R (1985) Morphological study on experimental allergic neuritis mediated by T cell line specific for bovine P2 protein in Lewis rats. Lab Invest 53:209–218
Langenbach M, Plewig G, Wechsler W (1986) Peripheral nerve involvement in a case of dimorphous leprosy: immunocytochemical, ultrastructural and morphometric analysis. Clin Neuropathol 5:117
Liebert UG, Seitz RJ, Weber T, Wechsler W (1985) Immunocytochemical studies of serum proteins and immunoglobulins in human sural nerve biopsies. Acta Neuropathol (Berl) 68:39–47
Lin JT, Rowe V, Brostoff SW, Abdou NI (1982) Lymphocyte studies in a patient with chronic polyradiculoneuropathy. Neurology 32:1127–1132
McLeod JG (1981) Electrophysiological studies in the Guillain-Barré syndrome. Ann Neurol [Suppl] 9:20–27
McMichael AJ (ed) (1988) Leukocyte typing III. Oxford University Press, London (in press)
Meuer SC, Schlossman SF, Reinherz EL (1982) Clonal analysis of human cytotoxic T lymphocytes: T4+ and T8+ effector T cells recognize products of different major histocompatibility complex regions. Proc Natl Acad Sci USA 79:4395–4399
Neuen E, Seitz RJ, Langenbach M, Wechsler W (1987) The blood-nerve barrier in hereditary and inflammatory neuropathies. A morphometric and immunohistochemical study. Acta Neuropathol (Berl) 73:53–61
Olsson Y (1968) Mast cells in the nervous system. Int Rev Cytol 24:27–35
Olsson Y (1984) Vascular permeability in the peripheral nervous system. In: Dyck PJ, Thomas PK, Lambert EH, Bunge R (eds) Peripheral neuropathies, 2nd edn. Saunders, Philadelphia, pp 579–597
Pollard JD (1987) A critical review of therapies in acute and chronic inflammatory demyelinating polyneuropathies. Muscle Nerve 10:214–221
Pollard JD, McCombe PA, Baverstock J, Gatenby PA, McLeod JG (1986) Class II antigen expression and T lymphocyte subsets in chronic inflammatory demyelinating polyneuropathy. J Neuroimmunol 13:123–134
Pollard JD, Baverstock J, McLeod JG (1987) Class II antigen expression and inflammatory cells in the Guillain-Barré syndrome. Ann Neurol 21:337–341
Powell HC, Braheny SL, Myers RR, Rodriguez M, Lampert PW (1983) Early changes in experimental allergic neuritis. Lab Invest 48:332–338
Prineas JW (1972) Acute idiopathic polyneuritis. An electron microscopic study. Lab Invest 26:133–147
Prineas JW, McLeod JG (1976) Chronic relapsing polyneuritis. J Neurol Sci 27:427–458
Prineas JW (1981) Pathology of the Guillain-Barré syndrome. Ann Neurol [Suppl] 9:6–19
Rienherz EL, Kung PC, Goldstein G, Schlossmann SF (1979) Separation of functional subsets of human T cells by a monoclonal antibody. Proc Natl Acad Sci USA 76:4061–4065
Seitz RJ, Neuen E, Wechsler W (1985) The blood-nerve barrier in polyneuritis: immunocytochemical and electron microscopical studies on the human sural nerve. J Neurol [Suppl] 232:244
Seitz RJ, Reiners K, Himmelmann F, Heininger K, Hartung HP, Toyka KV (1989) The blood-nerve barrier in Wallerian degeneration: a sequential long-term study with biotinylated serum protein tracers. Muscle Nerve (in press)
Sobel RA, Blanchette BW, Bhan AK, Colvin RB (1984) The immunopathology of experimental allergic encephalomyelitis. II. Endothelial cell Ia increases prior to inflammatory cell infiltration. J Immunol 132:2402–2407
Steinman L, Solomon D, Lim M, Zamvil S, Sriram S (1983) Prevention of experimental allergic encephalomyelitis with in vivo administration of anti I-A antibody-decreased accumulation of radiolabelled lymph node cells in the central nervous system. J Neuroimmunol 5:91–97
Vass K, Lassmann H, Wekerle H, Wisniewski HM (1986) The distribution of Ia antigen in the lesions of rat acute experimental allergic encephalomyelitis. Acta Neuropathol (Berl) 70:149–160
Wekerle H, Vass K, Kitz K, Lassmann H (1985) The bloodbrain barrier in T lymphocyte-mediated experimental autoimmune encephalomyelitis: bypass of the blood-brain barrier precludes development of clinical disease. In: Wekerle H, Meyermann R (eds) Max-Planck-Society clinical research unit for multiple sclerosis. Annu Rep 3:91–95
Wekerle H, Linington C, Lassmann H, Meyermann R (1986) Cellular immune reactivity within the CNS. Trends Neurosci 9:271–277
Whitaker JN (1981) The protein antigens of peripheral nerve myelin. Ann Neurol [Suppl] 9:56–64
Author information
Authors and Affiliations
Additional information
Dedicated to Professor Dr. Dieter Seitz on the occasion of his 65th birthday
Rights and permissions
About this article
Cite this article
Seitz, R.J., Neuen-Jacob, E. & Wechsler, W. Significance of lymphocytes and blood vessel changes for edema formation in polyradiculoneuritis. Acta Neuropathol 76, 564–573 (1988). https://doi.org/10.1007/BF00689594
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00689594