Neuroimmunological studies in steroid-responsive meningitis-arteritis in dogs

Abstract

The clinical and pathological expression of steroid-responsive meningitis-arteritis (SRMA) is predominantly neurological and the present study was therefore mostly concerned with the intrathecal humoral immune reponses of 13 dogs suffering from the disease. All the dogs synthesised IgG intrathecally, indicating that the immune response in SRMA is in part specifically directed towards the central nervous system (CNS). Half of the dogs also had high levels of IgM only in the cerebrospinal fluid (CSF) and nearly all of them had high levels of IgA in the CSF as well as in the serum. Six of the dogs had circulating immune complexes in the serum, but not in the CSF. Neither IgM nor IgA rheumatoid factors were found. A chemotaxis assay revealed enhanced migration of neutrophils into the CSF in three cases. All the dogs had marked meningeal inflammation and arterial lesions of the meaingeal blood vessels. Only one dog had arterial involvement outside the CNS. The acute vascular lesions consisted mostly of degenerative changes of the media and periarterial inflammation, and there was no evidence of immune complex deposition. Chronic lesions were mostly characterised by stenosis, adventitial thickening and periarteritis. Focal deposits of IgA were found in the vascular wall of one chronic case. It was concluded that the meningeal lesions in SRMA are a primary event, rather than the result of a generalised immune complex disease. These lesions are associated with an intrathecal Immoral immune response, in which IgA appears to play a central role. It is possible, that the uncontrolled IgA synthesis is induced by an infectious agent, but the localisation of the lesions in the CNS remains unexplained.