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Destruction of neurons by cytotoxic T cells: A new pathogenic mechanism in rasmussen's encephalitis
Author(s) -
Bien Christian G.,
Bauer Jan,
Deckwerth Thomas L.,
Wiendl Heinz,
Deckert Martina,
Wiestler Otmar D.,
Schramm Johannes,
Elger Christian E.,
Lassmann Hans
Publication year - 2002
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.10100
Subject(s) - cytotoxic t cell , cd8 , granzyme b , apposition , biology , confocal microscopy , pathology , immunology , microbiology and biotechnology , immune system , medicine , anatomy , biochemistry , in vitro
Rasmussen's encephalitis is a progressive epileptic disorder characterized by unihemispheric lymphocytic infiltrates, microglial nodules, and neuronal loss leading to the destruction of the affected hemisphere. In this study, immunohistochemical evaluation of specimens from 11 patients revealed lymphocytic infiltrates that consisted mainly of CD3 + CD8 + T cells. Of these cells, 7.0% lay in direct apposition to MHC class I + neurons. Confocal laser microscopy revealed that these lymphocytes contained granzyme B in a polar orientation toward these perikarya. Single neurons underwent apoptosis. These findings indicate that a T‐cell–mediated cytotoxic reaction induces neuronal death in Rasmussen's encephalitis. This study directly shows, for what we believe is the first time, that a cytotoxic T‐cell mechanism contributes to loss of neurons in human brain disease.