PhD thesis about patterns and plasmapheresis

[frodo]

Apheresis therapy in immunopathologically classified multiple sclerosis patients

https://d-nb.info/1204636001/34

Conclusion

Our results show that the response to apheresis treatment could be predicted by immunopathological patterns as well as involvement of the cognitive and brainstem systems. Potentially, IA is more effective than PLEX, but this has to be clarified in further studies. Different pathological subtypes of early active multiple sclerosis lesions suggests different pathophysiological mechanism of lesion development and thus may explain the varying therapy responses. Pattern I and II lesions show sharp lesion edges and an infiltration with T-cells and macrophages. Additionally, an antibody and complement-mediated mechanism of demyelination is suggested in pattern II. These patients also showed the most success from the apheresis treatment. In contrast, in pattern III lesions a primary oligodendrocytic damage may play an important role in lesion pathogenesis; patients showing this pattern are not amenable to apheresis treatments.