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Figure Nuclear Nrf2 expression after fumarate therapy A new left occipital fluid-attenuated inversion recovery hyperintense (A), T1 hypointense (B), and.

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Presentation on theme: "Figure Nuclear Nrf2 expression after fumarate therapy A new left occipital fluid-attenuated inversion recovery hyperintense (A), T1 hypointense (B), and."— Presentation transcript:

1 Figure Nuclear Nrf2 expression after fumarate therapy A new left occipital fluid-attenuated inversion recovery hyperintense (A), T1 hypointense (B), and gadolinium- enhancing lesion (C, T1 + gadolinium) under fumarate therapy for relapsing-remitting multiple sclerosis (MS) led to biopsy. Nuclear Nrf2 expression after fumarate therapy A new left occipital fluid-attenuated inversion recovery hyperintense (A), T1 hypointense (B), and gadolinium- enhancing lesion (C, T1 + gadolinium) under fumarate therapy for relapsing-remitting multiple sclerosis (MS) led to biopsy. The biopsy specimen shows an inactive demyelinated white matter lesion with macrophages and reactive astrocytes (D, hematoxylin & eosin). The lesion is demyelinated (E, Luxol fast blue/periodic acid-Schiff staining) without any signs of active myelin degradation. Only scant lymphocytic infiltrate is present (F, anti-CD3 staining, lymphocytes indicated by arrows). Numerous cells show nuclear factor (erythroid-derived 2)-related factor 2 (Nrf2) expression (G, anti-Nrf2 staining, Nrf2+ astrocytes indicated by arrows). Within this inflammatory demyelinated MS lesion, the Nrf2-positive nuclei were determined. Six-fold higher numbers of Nrf2-positive nuclei were found compared to MS controls (H). The strongest nuclear Nrf2 signals were present in astrocytes (I), whereas oligodendrocytes showed mostly a cytoplasmic Nrf2 staining (J). Furthermore, patients with psoriasis treated with fumarates showed higher numbers of Nrf2-positive nuclei than progressive multifocal leukoencephalopathy (PML) controls (H). Scale bars: D–G: 100 µm, I and J: 50 µm. Imke Metz et al. Neurol Neuroimmunol Neuroinflamm 2015;2:e99 © 2015 American Academy of Neurology

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