Bcl-2 expressing T lymphocytes in multiple sclerosis lesions

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system. T lymphocytes play a major role in the pathogenesis of the disease. The exact mechanisms by which the inflammation is regulated in MS have not yet been defined. Studies in animal models of MS suggest that apoptosis of T  cells is the main factor terminating inflammation. The process of apoptosis itself is regulated by a range of pro- and anti-apoptotic proteins. The bcl-2 gene family is an important member of these proteins. The present study investigated the expression of the anti-apoptotic protein bcl-2 in 11 chronic MS cases including five relapsing-remitting and six chronic progressive MS patients. A total of 35 lesions containing all stages of demyelinating activity were studied. The number of CD3-positive T  cells and the absolute and relative numbers of T  cells expressing bcl-2 were determined by double immunocytochemistry. Bcl-2 is expressed by T lymphocytes in MS plaques. Patients with chronic progressive MS have a higher proportion of bcl-2 expressing T  cells than patients with relapsing remitting disease. Highest numbers of bcl-2-positive T lymphocytes were found in remyelinating and demyelinated lesions, whereas active demyelinating lesions revealed lower numbers. These data indicate that cell-death-related proteins such as the anti-apoptotic protein bcl-2 are expressed in MS lesions and that they might have important effects on the regulation of elimination or persistence of inflammatory cells in the central nervous system.