Open Access Research

Clusters of activated microglia in normal-appearing white matter show signs of innate immune activation

Jack van Horssen1*, Shailender Singh2,3, Susanne van der Pol1, Markus Kipp3,4, Jamie L Lim1, Laura Peferoen2, Wouter Gerritsen2, Evert-Jan Kooi2, Maarten E Witte2, Jeroen JG Geurts5, Helga E de Vries1, Regina Peferoen-Baert2, Peter J van den Elsen2,6, Paul van der Valk2 and Sandra Amor2,7

Author Affiliations

1 Department of Molecular Cell Biology and Immunology/Neuropathology, VU University Medical Center, Van der Boechorststraat 7, 1081, BT, Amsterdam, The Netherlands

2 Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands

3 Department of Neuropathology, University Medical Center, Georg-August University Göttingen, Göttingen, Germany

4 Institute of Neuroanatomy, Faculty of Medicine, RWTH Aachen University, Wendlingweg 2, D-52074, Aachen, Germany

5 Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, The Netherlands

6 Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands

7 Neuroscience and Trauma Centre, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom

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Journal of Neuroinflammation 2012, 9:156 doi:10.1186/1742-2094-9-156

Published: 2 July 2012

Abstract

Background

In brain tissues from multiple sclerosis (MS) patients, clusters of activated HLA-DR-expressing microglia, also referred to as preactive lesions, are located throughout the normal-appearing white matter. The aim of this study was to gain more insight into the frequency, distribution and cellular architecture of preactive lesions using a large cohort of well-characterized MS brain samples.

Methods

Here, we document the frequency of preactive lesions and their association with distinct white matter lesions in a cohort of 21 MS patients. Immunohistochemistry was used to gain further insight into the cellular and molecular composition of preactive lesions.

Results

Preactive lesions were observed in a majority of MS patients (67%) irrespective of disease duration, gender or subtype of disease. Microglial clusters were predominantly observed in the vicinity of active demyelinating lesions and are not associated with T cell infiltrates, axonal alterations, activated astrocytes or blood–brain barrier disruption. Microglia in preactive lesions consistently express interleukin-10 and TNF-α, but not interleukin-4, whereas matrix metalloproteases-2 and −9 are virtually absent in microglial nodules. Interestingly, key subunits of the free-radical-generating enzyme NADPH oxidase-2 were abundantly expressed in microglial clusters.

Conclusions

The high frequency of preactive lesions suggests that it is unlikely that most of them will progress into full-blown demyelinating lesions. Preactive lesions are not associated with blood–brain barrier disruption, suggesting that an intrinsic trigger of innate immune activation, rather than extrinsic factors crossing a damaged blood–brain barrier, induces the formation of clusters of activated microglia.

Keywords:
Multiple sclerosis; Microglial cells; Preactive lesion; Immune activation; Lesion development