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. 2021 Jan 15;11:1552. doi: 10.1038/s41598-021-81282-9

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© The Author(s) 2021

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Immunohistochemical staining for HA (panels A,B,C,D), HAS2 (panels E,F,G,H), and COX2 (panels I,J,K,L). There was strong staining for HA in the thickened intima of the middle cerebral artery from the patient with MMD (A,C). Specimens from Control 1 (B) and Control 2 (D) exhibited HA staining on vascular endothelium, which was not stained in the MMD sample (arrows). There was weak staining for HA in the thickened intima of the carotid artery from Control 2 (D). There was strong HAS2 staining in the VSMCs in the MMD sample (E,G) and both Control 1 (F) and Control 2 (H), as well as in the infiltrating cells within the thickened intima of the MMD specimen (E,G). VSMCs stained weakly for COX2 in specimens from the patient with MMD (I,K), Control 1 (J), and Control 2 (L). In addition, infiltrating cells within the thickened intima of the MMD specimen (I,K) stained positive for COX2. Scale bar: 500 μm for (A,B,E,F,I,J); 100 μm for (C,D,G,H,K,L).