Tissue donations for multiple sclerosis research: current state and suggestions for improvement

Abstract

Although major progress in multiple sclerosis research has been made during the last decades, key questions related to the cause and the mechanisms of brain and spinal cord pathology remain unresolved. These cover a broad range of topics, including disease etiology, antigenic triggers of the immune response inside and/or outside the CNS and mechanisms of inflammation, demyelination neurodegeneration and tissue repair. Most of these questions can be addressed with novel molecular technologies in the injured CNS. Access to brain and spinal cord tissue from multiple sclerosis patients is therefore of critical importance. High quality tissue is provided in part by the existing brain banks. However, material from early and highly active disease stages is limited. An initiative, realized under the patronage of the European Charcot Foundation, gathered together experts from different disciplines to analyze the current state of multiple sclerosis tissues collected post-mortem or as biopsies. Here, we present an account of what material is currently available and where it can be accessed. We also provide recommendations on how tissue donation from patients in early disease stages could be potentially increased, and for procedures of tissue sampling and preservation. We also suggest to create a registry of the available tissues that, depending on the source (autopsy vs biopsy), could be made accessible to clinicians and researchers.

Research Attitude and Interest among Cancer Survivors with or without Cognitive Impairment

“…Considering the scarcity of literature regarding interest in autopsy studies among cancer survivors with cognitive issues, our results bring light to the prospective creation of brain banks for facilitating CRCI neuropathological research as a feasible method to enhance understanding of CRCI. Past neuropathological studies in neurodegenerative diseases have helped the respective fields to progress by validating clinical phenotypes with post-mortem brain tissue analyses, enhancing evaluations of genetic mutations’ pathogenesis associated with the diseases (in comparison to animal models), as well as determining the measurement accuracy (sensitivity and specificity) of candidate biomarkers [ 35 , 36 , 37 ]. Few have utilized neuropathological approaches to investigate CRCI mechanisms, save for two retrospective studies [ 38 , 39 ].…”

Update on pathology of central nervous system inflammatory demyelinating diseases

“…Research in immunobiology and neuropathology of CNS--IDD is facilitated by the meticulous documentation of clinical records, biological samples and pathological data obtained from patients with atypical demyelinating syndromes. Careful analysis of this data, especially when long-term follow-ups are available, and adhering to the recommended procedures for tissue sampling and preservation [1] is likely to unravel and define further CNS-IDDs that have been previously categorised as multiple sclerosis.…”

“…Although rarely required in multiple sclerosis (MS) patients, neuropathological studies have been crucial in progressing the understanding, differentiation, and therapy of central nervous system inflammatory demyelinating diseases (CNS-IDDs) [1]. MS is an umbrella diagnosis applied to patients with clinical symptoms suggestive of inflammatory demyelinating disease AND typical magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) findings, all of which allow it to be established that the pathological process is indeed disseminated in time and space [2,3].…”

Attitudes of people with multiple sclerosis toward brain donation

“…Such research relies heavily on donations of post-mortem brain tissue because autopsy rates continue to decline and typical post-mortem intervals for autopsy are too long for most research techniques ( 1 ). A recent initiative of the European Charcot Foundation highlighted the importance of tissue donations including post-mortem brain tissue, for MS research and the need to increase the availability of brain tissue, particularly from patients with early MS or cause of death unrelated to MS ( 2 ). Specifically, the initiative pointed to unresolved questions regarding the mechanisms underlying brain and spinal cord injury, such as the initial trigger of inflammation, or whether infectious agents play a mechanistic role in the disease process.…”