1. Volume 18, Issue 1, Pages 69-79 (February 2011)
Neuromyelitis optica and opticospinal multiple sclerosis: Mechanisms and pathogenesis 
Jun-ichi Kira 
Pathophysiology 
Volume 18, Issue 1, Pages (February 2011)
DOI: /j.pathophys
Copyright © 2010 Elsevier Ireland Ltd Terms and Conditions

2. Fig. 1
Destruction of an astrocyte foot process by complement-activating anti-aquaporin-4 (AQP4) antibody. Once the anti-AQP4 IgG1 antibody crosses the blood–brain barrier, it binds to AQP4 on the astrocyte foot process, and fixes and activates complements. Activated complements mobilize neutrophils and eosinophils, which then produce severe tissue damage, and cause secondary demyelination. Disruption of the astrocyte foot process prolongs resolution from vasogenic edema caused by inflammation.
Pathophysiology  , 69-79DOI: ( /j.pathophys )
Copyright © 2010 Elsevier Ireland Ltd Terms and Conditions

3. Fig. 2
Two subtypes of NMO/OSMS with LESCLs in Asians. There are NMO-IgG-seropositive and -seronegative cases with NMO/OSMS, which show some difference in clinical features. Pathologically, there are also two subtypes of NMO: one presenting with preferential AQP4 loss and one that does not. Even in MS plaques, AQP4 loss is occasionally seen. Some cases show both features in different lesions. Ab: antibody; AQP4: aquaporin-4; LESCLs: longitudinally extensive spinal cord lesions; MS: multiple sclerosis; NMO: neuromyelitis optica; OSMS: opticospinal multiple sclerosis.
Pathophysiology  , 69-79DOI: ( /j.pathophys )
Copyright © 2010 Elsevier Ireland Ltd Terms and Conditions

4. Fig. 3
Two hypothetical mechanisms of MS and NMO. In (A), myelin is a primary target of T cells and antibodies in MS, whereas in NMO, astrocytes are a primary target of anti-AQP4 antibody. In (B), myelin-specific T cells initiate CNS inflammation and antibodies recognizing various components of CNS antigens modify the clinicopathological features. Ab: antibody; AQP4: aquaporin-4; CPMS: chronic progressive multiple sclerosis; MOG: myelin-oligodendrocyte glycoprotein; MS: multiple sclerosis; NMO: neuromyelitis optica; OSMS: opticospinal multiple sclerosis.
Pathophysiology  , 69-79DOI: ( /j.pathophys )
Copyright © 2010 Elsevier Ireland Ltd Terms and Conditions