Evidence of axonal damage in human acute demyelinating diseases


      Substantial axon damage, detected by immunostaining for β amyloid precursor protein (βAPP) has been demonstrated in acute demyelinating lesions in multiple sclerosis. Aims: The present study aimed to determine if this was also the case in the other human acute demyelinating diseases, acute hemorrhagic leucoencephalitis (AHLE), acute disseminated encephalomyelitis (ADEM) and central pontine myelinolysis (CPM). Methods: βAPP immunostaining was used as a marker of axonal damage in autopsy material from these conditions. Results: Axonal damage was detected in all these conditions. Its extent varied within and between them. Axonal damage was largely confined to tissue adjacent to veins and venules in AHLE and ADEM but was unrelated to proximity to these vessels in CPM. Conclusion: Substantial axon damage occurs in fatal cases of AHLE, ADEM and CPM.


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