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- Title
Overexpression of sphingosine-1-phosphate receptors on reactive astrocytes drives neuropathology of multiple sclerosis rebound after fingolimod discontinuation.
- Authors
Giordana, Maria Teresa; Cavalla, Paola; Uccelli, Antonio; Laroni, Alice; Bandini, Fabio; Vercellino, Marco; Mancardi, Gianluigi
- Abstract
We present the neuropathological description of an autoptic case of fatal rebound of disease activity after fingolimod discontinuation in a multiple sclerosis patient. MRI prior to the fatal outcome showed several large tumefactive demyelinating lesions. These lesions were characterized by prominent astrocytic gliosis, with a remarkable preponderance of large hypertrophic reactive astrocytes showing intense expression of sphingosine-1-phosphate receptor 1. Prominent astrocytic gliosis was also diffusely observed in the normal-appearing white matter. Dysregulated sphingosine-1-phosphate signaling on astrocytes following fingolimod withdrawal might represent a possible contributing mechanism to disease rebound and might account for the unusual radiological and neuropathological features observed in the present case.
- Subjects
GLIOSIS; FINGOLIMOD; MULTIPLE sclerosis; DEMYELINATION; NEUROLOGICAL disorders; PATIENTS
- Publication
Multiple Sclerosis Journal, 2018, Vol 24, Issue 8, p1133
- ISSN
1352-4585
- Publication type
Case Study
- DOI
10.1177/1352458518763095