Editorial
J Asthma Downloaded from informahealthcare.com by University of North Carolina on 11/21/14 For personal use only.
Chronic Experimental Allergic Encephalomyelitis Raine and Stone‘ have reported in some detail the pertinent highlights of the present status of chronic experimental allergic encephalomyelitis (chronic EAE) in inbred guinea pigs (strain 13). They correctly distinguish between the acute EAE and the chronic form. In man, multiple sclerosis (MS) is usually a chronic, long-drawn-out progressive illness with gross lesions, microscopic gliosis and a few inflammatory cuffs. Raine and Stone emphasize that the experimental immunological model for MS should more appropriately provide a chronic clinical course. Chronic EAE was developed in juvenile guinea pigs by giving them a single intracutaneous injection in the nuchal area of 0.5 ml suspension of isologous spinal cord in a complete Freund‘s adjuvant containing killed Myocobacterium tuberculosis. After an asymptomatic period of approximately two months, the injected animals developed incontinence, weakness, paraparesis and often quadriparesis. Partial remission of these signs occasionally occurred. Animals with this chronic EAE have been observed for as long as three years with relapses not uncommon. In the presence of clinical disease in guinea pigs (chronic EAE) the central nervous system shows not only recent lesions but also old lesions comparable to M S plaques in man. Raine and Stone believe that their chronic EAE experimental model “probably approximates more closely the human disease than any other model currently available.” It had been proposed in another article by Field, Joyce and Smith2 that the electric mobility of red blood cells is decreased in MS. This offers the possibility of an early diagnosis. They summarize their results as follows: “Erythrocytes from patients with multiple sclerosis (MS) show a highly significant reduction in their absolut,e electrophoretic mobility in the presence of linoleic and arachidonic acids (LA; AA). Patients with other (destructive) neurological disease (OND) and normal subjects show an increased absolute mobility of their erythrocytes in the presence of LA and AA. About 40% of blood relatives of MS patients show an intermediate type of reaction-being slowed by LA and speeded up by AA. Administration of LA (or gamma linolenate) to an MS patient for some months leads to change in the mobilities from the MS to normal type, the AA result altering first. The effect of LA and AA on the absolute mobility of RBC may thus be used as a simple laboratory test involving a long-established technique and eliminating the animal and other needs of the macrophage electrophoretic mobility (MEM) test. T h e implications of these findings for our understanding and handling of M S are briefly discussed.”
The work of Raine and Stone and possibly that of Fields et al. provide us with new approaches to the study of clinical pathological, biochemical, immunologic and therapeutic processes in multiple sclerosis. If the diagnosis of MS in its earliest stages were possible, the experiments of Levine and Sowinski3might lead to possible therapy. They found a synergistic
EDITORIAL
delaying effect between single doses of antilymphocyte serum, cyclophosphamide, cycloleucine and tilorone in acute EAE. All physicians have observed the tragic events in the families of MS patients. It is to be hoped that trivial scientific controversies will be replaced by more concerted efforts to solve the riddle confronting the physician in prevention and treatment of multiple sclerosis. Harold A. Abramson
J Asthma Downloaded from informahealthcare.com by University of North Carolina on 11/21/14 For personal use only.
References 1. RAINE,C. S.A N D STONE, S.H. N . Y. State J. Med. Sept.:1693, 1977. 2 . FIELD,E. J., JOYCE,G . AND SMITH, B. M. J . Neurol. 224:113, 1977. 3. LEVINE,S. A N D SOWINSKI, R. Proc. SOC.Biol. Med. 256:57, 1977.
J Asthma Downloaded from informahealthcare.com by University of North Carolina on 11/21/14 For personal use only.
Chronic Experimental Allergic Encephalomyelitis Raine and Stone‘ have reported in some detail the pertinent highlights of the present status of chronic experimental allergic encephalomyelitis (chronic EAE) in inbred guinea pigs (strain 13). They correctly distinguish between the acute EAE and the chronic form. In man, multiple sclerosis (MS) is usually a chronic, long-drawn-out progressive illness with gross lesions, microscopic gliosis and a few inflammatory cuffs. Raine and Stone emphasize that the experimental immunological model for MS should more appropriately provide a chronic clinical course. Chronic EAE was developed in juvenile guinea pigs by giving them a single intracutaneous injection in the nuchal area of 0.5 ml suspension of isologous spinal cord in a complete Freund‘s adjuvant containing killed Myocobacterium tuberculosis. After an asymptomatic period of approximately two months, the injected animals developed incontinence, weakness, paraparesis and often quadriparesis. Partial remission of these signs occasionally occurred. Animals with this chronic EAE have been observed for as long as three years with relapses not uncommon. In the presence of clinical disease in guinea pigs (chronic EAE) the central nervous system shows not only recent lesions but also old lesions comparable to M S plaques in man. Raine and Stone believe that their chronic EAE experimental model “probably approximates more closely the human disease than any other model currently available.” It had been proposed in another article by Field, Joyce and Smith2 that the electric mobility of red blood cells is decreased in MS. This offers the possibility of an early diagnosis. They summarize their results as follows: “Erythrocytes from patients with multiple sclerosis (MS) show a highly significant reduction in their absolut,e electrophoretic mobility in the presence of linoleic and arachidonic acids (LA; AA). Patients with other (destructive) neurological disease (OND) and normal subjects show an increased absolute mobility of their erythrocytes in the presence of LA and AA. About 40% of blood relatives of MS patients show an intermediate type of reaction-being slowed by LA and speeded up by AA. Administration of LA (or gamma linolenate) to an MS patient for some months leads to change in the mobilities from the MS to normal type, the AA result altering first. The effect of LA and AA on the absolute mobility of RBC may thus be used as a simple laboratory test involving a long-established technique and eliminating the animal and other needs of the macrophage electrophoretic mobility (MEM) test. T h e implications of these findings for our understanding and handling of M S are briefly discussed.”
The work of Raine and Stone and possibly that of Fields et al. provide us with new approaches to the study of clinical pathological, biochemical, immunologic and therapeutic processes in multiple sclerosis. If the diagnosis of MS in its earliest stages were possible, the experiments of Levine and Sowinski3might lead to possible therapy. They found a synergistic
EDITORIAL
delaying effect between single doses of antilymphocyte serum, cyclophosphamide, cycloleucine and tilorone in acute EAE. All physicians have observed the tragic events in the families of MS patients. It is to be hoped that trivial scientific controversies will be replaced by more concerted efforts to solve the riddle confronting the physician in prevention and treatment of multiple sclerosis. Harold A. Abramson
J Asthma Downloaded from informahealthcare.com by University of North Carolina on 11/21/14 For personal use only.
References 1. RAINE,C. S.A N D STONE, S.H. N . Y. State J. Med. Sept.:1693, 1977. 2 . FIELD,E. J., JOYCE,G . AND SMITH, B. M. J . Neurol. 224:113, 1977. 3. LEVINE,S. A N D SOWINSKI, R. Proc. SOC.Biol. Med. 256:57, 1977.
