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  1. Article ; Online: Neuroinflammation: 2022 update.

    Lassmann, Hans

    Free neuropathology

    2022  Volume 3

    Abstract: Besides important progress in the understanding of the pathological substrate of COVID-19-associated brain disease, major insights into mechanisms of neurodegeneration in human disease have been provided in neuropathological studies published in 2021. ... ...

    Abstract Besides important progress in the understanding of the pathological substrate of COVID-19-associated brain disease, major insights into mechanisms of neurodegeneration in human disease have been provided in neuropathological studies published in 2021. Recently developed techniques, which allow the simultaneous detection of a large battery of different molecules within single cells, have proven useful in the analysis of disease mechanisms in experimental and human neuroinflammatory conditions. They have elucidated protective and detrimental effects of activated microglia, which act in a stage and context-dependent manner in the induction and propagation of neurodegeneration. In addition, they emphasize the importance of synaptic damage and of selective neuronal vulnerability in the respective diseases. The results provide important new insights with high clinical relevance.
    Language English
    Publishing date 2022-02-10
    Publishing country Germany
    Document type Journal Article
    ISSN 2699-4445
    ISSN (online) 2699-4445
    DOI 10.17879/freeneuropathology-2022-3790
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: The contribution of neuropathology to multiple sclerosis research.

    Lassmann, Hans

    European journal of neurology

    2022  Volume 29, Issue 9, Page(s) 2869–2877

    Abstract: Background and purpose: Neuropathology plays a major role in deciphering disease mechanisms in multiple sclerosis (MS). This review article describes recent advances in neuropathological research related to inflammatory demyelinating diseases.: ... ...

    Abstract Background and purpose: Neuropathology plays a major role in deciphering disease mechanisms in multiple sclerosis (MS). This review article describes recent advances in neuropathological research related to inflammatory demyelinating diseases.
    Methods: A retrospective review of neuropathological studies published during the last two decades was conducted.
    Results: The importance of neuropathology is generally seen in its contribution to the diagnosis of diseases of the nervous system and, in particular, in neuro-oncology. However, when it also includes analysis of the global three-dimensional extension of brain damage and the temporal sequence of lesion evolution and relates this to molecular changes in the lesions, it offers the potential to decipher disease pathogenesis and to contribute to the development of effective and causative treatments. In MS research, neuropathology has been essential in discriminating the disease from other inflammatory autoimmune or demyelinating diseases, such as neuromyelitis optica spectrum disorders (NMOSD) or myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). It defined the hallmark of chronic progressive disease in MS patients as slowly expanding tissue damage, which occurs not only within and around lesions but also in the normal appearing white and gray matter. It showed that these changes occur in the course of a tissue-resident immune response within the central nervous system, involving tissue-resident effector memory cells and plasma cells. Molecular studies in neuropathologically defined micro-dissected MS lesions identified a cascade of oxidative injury, mitochondrial damage and subsequent virtual hypoxia as a major pathway of tissue injury in MS.
    Conclusions: The results of these studies were highly relevant for the identification of potential therapeutic targets in MS patients and the design of pivotal clinical trials.
    MeSH term(s) Aquaporin 4 ; Autoantibodies ; Central Nervous System ; Humans ; Multiple Sclerosis/pathology ; Myelin-Oligodendrocyte Glycoprotein ; Neuromyelitis Optica/pathology
    Chemical Substances Aquaporin 4 ; Autoantibodies ; Myelin-Oligodendrocyte Glycoprotein
    Language English
    Publishing date 2022-06-23
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1280785-0
    ISSN 1468-1331 ; 1351-5101 ; 1471-0552
    ISSN (online) 1468-1331
    ISSN 1351-5101 ; 1471-0552
    DOI 10.1111/ene.15360
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Tumefactive multiple sclerosis or inflammatory demyelinating disease with large lesions?

    Lassmann, Hans

    European journal of neurology

    2021  Volume 29, Issue 3, Page(s) 687–688

    MeSH term(s) Brain/pathology ; Demyelinating Diseases/pathology ; Humans ; Multiple Sclerosis/pathology
    Language English
    Publishing date 2021-12-22
    Publishing country England
    Document type Journal Article ; Comment
    ZDB-ID 1280785-0
    ISSN 1468-1331 ; 1351-5101 ; 1471-0552
    ISSN (online) 1468-1331
    ISSN 1351-5101 ; 1471-0552
    DOI 10.1111/ene.15210
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Neuroinflammation: 2021 update.

    Lassmann, Hans

    Free neuropathology

    2021  Volume 2

    Abstract: Key requirements for the validity of a neuropathological study are the inclusion of large numbers of biopsy or autopsy cases and proper controls, the rigorous classification of the basic neuropathology and the selection of the most suitable technologies ... ...

    Abstract Key requirements for the validity of a neuropathological study are the inclusion of large numbers of biopsy or autopsy cases and proper controls, the rigorous classification of the basic neuropathology and the selection of the most suitable technologies for investigation. Whether the studies are performed with the fanciest, new, and state of the art technology or with rather conventional methodology is of minor importance. Following these criteria, a spectrum of neuropathological studies has been published in 2020, which provides new insights on important questions related to neurological disease. They include the pathological substrate of brain disease in COVID-19 infected patients, the nature of the adaptive and innate inflammatory response, or the type and mechanisms of tissue injury and repair in multiple sclerosis, and diagnostically relevant or mechanistic new insights into antibody-mediated diseases of the central nervous system. Other studies describe in detail the dynamic changes of brain inflammation in patients with trisomy 21 as a disease model for Alzheimer's disease, or the presence and consequences of vascular comorbidities in a chronic inflammatory disease, such as multiple sclerosis. All these contributions have provided important, highly relevant clues for basic and translational neuroscience.
    Language English
    Publishing date 2021-01-12
    Publishing country Germany
    Document type Journal Article
    ISSN 2699-4445
    ISSN (online) 2699-4445
    DOI 10.17879/freeneuropathology-2021-3166
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Top ten discoveries of the year: Neuroinflammation.

    Lassmann, Hans

    Free neuropathology

    2020  Volume 1

    Abstract: Ten neuropathological studies, published in 2019, are discussed, which address important aspects of neuroimmunology and inflammatory brain disease. They include topics related to new mechanisms of inflammation and immune mediated neurodegeneration, which ...

    Abstract Ten neuropathological studies, published in 2019, are discussed, which address important aspects of neuroimmunology and inflammatory brain disease. They include topics related to new mechanisms of inflammation and immune mediated neurodegeneration, which are relevant for multiple sclerosis (publications 1 to 4) and discuss the role of specific autoantibodies against myelin oligodendrocyte glycoprotein or aquaporin 4 in neuromyelitis optica spectrum disorders (publications 5 and 6). Other studies highlight the discovery of new virus induced diseases of the nervous system and their relevance for clinical neurology and diagnostic neuropathology (publications 7 and 8). Finally, very interesting studies are discussed dealing with microglia and immune mechanisms in neurodegeneration (publication 9) and the neuropathological long-term outcome of Aß vaccination in Alzheimer's disease (publication 10). All these studies highlight the central role of neuropathology in neurological disease research.
    Language English
    Publishing date 2020-01-11
    Publishing country Germany
    Document type Journal Article
    ISSN 2699-4445
    ISSN (online) 2699-4445
    DOI 10.17879/fnp-2020-2612
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: The changing concepts in the neuropathology of acquired demyelinating central nervous system disorders.

    Lassmann, Hans

    Current opinion in neurology

    2019  Volume 32, Issue 3, Page(s) 313–319

    Abstract: Purpose of review: Research on multiple sclerosis (MS) pathogenesis and therapy is to a large extent driven by results obtained in experimental autoimmune encephalomyelitis (EAE). This approach provided deep insights into the mechanism of brain ... ...

    Abstract Purpose of review: Research on multiple sclerosis (MS) pathogenesis and therapy is to a large extent driven by results obtained in experimental autoimmune encephalomyelitis (EAE). This approach provided deep insights into the mechanism of brain inflammation and immune mediated tissue injury and, thus, most of our currently established therapies for MS patients have been developed with profound contributions of experimental autoimmune research. Recent data, which are summarized in this review article, however, show important differences between EAE and MS.
    Recent findings: EAE models perfectly reproduce a disease, now called myelin oligodendrocyte glycoprotein (MOG) antibody-associated inflammatory demyelinating disease, which, however, is different from classical MS. In MS, the inflammatory reaction in the brain is dominated by CD8 T-lymphocyte and CD20 B cells. Demyelination in MS appears to be triggered by soluble factors, produced by T cells and/or B cells, which are different from anti-MOG antibodies seen in EAE, and induce widespread MS like primary demyelination and tissue damage associated with oxidative injury, mitochondrial damage and subsequent 'virtual' hypoxia.
    Summary: To define the antigenic target of the inflammatory reaction, the nature of the inflammatory response and the mechanisms of tissue injury are key topics of ongoing MS research.
    MeSH term(s) Animals ; Autoantibodies/immunology ; Brain/immunology ; Brain/metabolism ; Brain/pathology ; Encephalomyelitis, Autoimmune, Experimental/immunology ; Encephalomyelitis, Autoimmune, Experimental/metabolism ; Encephalomyelitis, Autoimmune, Experimental/pathology ; Humans ; Multiple Sclerosis/immunology ; Multiple Sclerosis/metabolism ; Multiple Sclerosis/pathology ; Myelin-Associated Glycoprotein/immunology ; Myelin-Associated Glycoprotein/metabolism ; Myelin-Oligodendrocyte Glycoprotein/immunology ; Myelin-Oligodendrocyte Glycoprotein/metabolism ; T-Lymphocytes/immunology
    Chemical Substances Autoantibodies ; Myelin-Associated Glycoprotein ; Myelin-Oligodendrocyte Glycoprotein
    Language English
    Publishing date 2019-03-20
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 1182686-1
    ISSN 1473-6551 ; 1350-7540
    ISSN (online) 1473-6551
    ISSN 1350-7540
    DOI 10.1097/WCO.0000000000000685
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Pathology of inflammatory diseases of the nervous system: Human disease versus animal models.

    Lassmann, Hans

    Glia

    2019  Volume 68, Issue 4, Page(s) 830–844

    Abstract: Numerous recent studies have been performed to elucidate the function of microglia, macrophages, and astrocytes in inflammatory diseases of the central nervous system. Regarding myeloid cells a core pattern of activation has been identified, starting ... ...

    Abstract Numerous recent studies have been performed to elucidate the function of microglia, macrophages, and astrocytes in inflammatory diseases of the central nervous system. Regarding myeloid cells a core pattern of activation has been identified, starting with the activation of resident homeostatic microglia followed by recruitment of blood borne myeloid cells. An initial state of proinflammatory activation is at later stages followed by a shift toward an-anti-inflammatory and repair promoting phenotype. Although this core pattern is similar between experimental models and inflammatory conditions in the human brain, there are important differences. Even in the normal human brain a preactivated microglia phenotype is evident, and there are disease specific and lesion stage specific differences in the contribution between resident and recruited myeloid cells and their lesion state specific activation profiles. Reasons for these findings reside in species related differences and in differential exposure to different environmental cues. Most importantly, however, experimental rodent studies on brain inflammation are mainly focused on autoimmune encephalomyelitis, while there is a very broad spectrum of human inflammatory diseases of the central nervous system, triggered and propagated by a variety of different immune mechanisms.
    MeSH term(s) Animals ; Brain/pathology ; Central Nervous System/pathology ; Disease Models, Animal ; Humans ; Inflammation/pathology ; Microglia/pathology ; Multiple Sclerosis/pathology
    Language English
    Publishing date 2019-10-12
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 639414-0
    ISSN 1098-1136 ; 0894-1491
    ISSN (online) 1098-1136
    ISSN 0894-1491
    DOI 10.1002/glia.23726
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Pathogenic Mechanisms Associated With Different Clinical Courses of Multiple Sclerosis.

    Lassmann, Hans

    Frontiers in immunology

    2019  Volume 9, Page(s) 3116

    Abstract: In the majority of patients multiple sclerosis starts with a relapsing remitting course (RRMS), which may at later times transform into secondary progressive disease (SPMS). In a minority of patients the relapsing remitting disease is skipped and the ... ...

    Abstract In the majority of patients multiple sclerosis starts with a relapsing remitting course (RRMS), which may at later times transform into secondary progressive disease (SPMS). In a minority of patients the relapsing remitting disease is skipped and the patients show progression from the onset (primary progressive MS, PPMS). Evidence obtained so far indicate major differences between RRMS and progressive MS, but no essential differences between SPMS and PPMS, with the exception of a lower incidence in the global load of focal white matter lesions and in particular in the presence of classical active plaques in PPMS. We suggest that in MS patients two types of inflammation occur, which develop in parallel but partially independent from each other. The first is the focal bulk invasion of T- and B-lymphocytes with profound blood brain barrier leakage, which predominately affects the white matter, and which gives rise to classical active demyelinated plaques. The other type of inflammation is a slow accumulation of T-cells and B-cells in the absence of major blood brain barrier damage in the connective tissue spaces of the brain, such as the meninges and the large perivascular Virchow Robin spaces, where they may form aggregates or in most severe cases structures in part resembling tertiary lymph follicles. This type of inflammation is associated with the formation of subpial demyelinated lesions in the cerebral and cerebellar cortex, with slow expansion of pre-existing lesions in the white matter and with diffuse neurodegeneration in the normal appearing white or gray matter. The first type of inflammation dominates in acute and relapsing MS. The second type of inflammation is already present in early stages of MS, but gradually increases with disease duration and patient age. It is suggested that CD8
    MeSH term(s) B-Lymphocytes/immunology ; Blood-Brain Barrier/immunology ; Blood-Brain Barrier/pathology ; Disease Progression ; Glymphatic System/immunology ; Glymphatic System/pathology ; Humans ; Multiple Sclerosis, Chronic Progressive/immunology ; Multiple Sclerosis, Chronic Progressive/pathology ; Multiple Sclerosis, Relapsing-Remitting/immunology ; Multiple Sclerosis, Relapsing-Remitting/pathology ; Spinal Cord/immunology ; Spinal Cord/pathology ; T-Lymphocytes/immunology ; White Matter/cytology ; White Matter/immunology ; White Matter/pathology
    Language English
    Publishing date 2019-01-10
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2606827-8
    ISSN 1664-3224 ; 1664-3224
    ISSN (online) 1664-3224
    ISSN 1664-3224
    DOI 10.3389/fimmu.2018.03116
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Multiple Sclerosis Pathology and its Reflection by Imaging Technologies: Introduction.

    Lassmann, Hans

    Brain pathology (Zurich, Switzerland)

    2018  Volume 28, Issue 5, Page(s) 721–722

    MeSH term(s) Humans ; Magnetic Resonance Imaging ; Multiple Sclerosis/diagnostic imaging ; Multiple Sclerosis/metabolism ; Multiple Sclerosis/pathology ; Positron-Emission Tomography
    Language English
    Publishing date 2018-10-10
    Publishing country Switzerland
    Document type Introductory Journal Article
    ZDB-ID 1051484-3
    ISSN 1750-3639 ; 1015-6305
    ISSN (online) 1750-3639
    ISSN 1015-6305
    DOI 10.1111/bpa.12649
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Multiple Sclerosis Pathology.

    Lassmann, Hans

    Cold Spring Harbor perspectives in medicine

    2018  Volume 8, Issue 3

    Abstract: Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system (CNS), which gives rise to focal lesions in the gray and white matter and to diffuse neurodegeneration in the entire brain. In this review, the spectrum ...

    Abstract Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system (CNS), which gives rise to focal lesions in the gray and white matter and to diffuse neurodegeneration in the entire brain. In this review, the spectrum of MS lesions and their relation to the inflammatory process is described. Pathology suggests that inflammation drives tissue injury at all stages of the disease. Focal inflammatory infiltrates in the meninges and the perivascular spaces appear to produce soluble factors, which induce demyelination or neurodegeneration either directly or indirectly through microglia activation. The nature of these soluble factors, which are responsible for demyelinating activity in sera and cerebrospinal fluid of the patients, is currently undefined. Demyelination and neurodegeneration is finally accomplished by oxidative injury and mitochondrial damage leading to a state of "virtual hypoxia."
    MeSH term(s) Brain/pathology ; Demyelinating Diseases/complications ; Demyelinating Diseases/pathology ; Disease Progression ; Humans ; Inflammation/pathology ; Multiple Sclerosis/metabolism ; Multiple Sclerosis/pathology ; Nerve Degeneration/complications ; Nerve Degeneration/pathology
    Language English
    Publishing date 2018-03-01
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 2157-1422
    ISSN (online) 2157-1422
    DOI 10.1101/cshperspect.a028936
    Database MEDical Literature Analysis and Retrieval System OnLINE

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