Immunocytochemical detection of iNOS protein (a and c), GFAP (b), and nitrotyrosine (d) in active, confluent demyelinating lesions consistent with diffuse sclerosis (Schilder type). (a) Extensive, confluent demyelinating lesions involving cerebral white matter. Scattered iNOS-positive reactive or hypertrophic astrocytes are visible amidst heavy accumulations of iNOS-negative foamy macrophages. Original magnification, ×100. (b) Subserial section relative to that of panel a. Accumulations of GFAP-positive hypertrophic astrocytes intermingled with GFAP-negative foamy macrophages are visible. Original magnification, ×100. (c) Higher magnification of the microscopic field depicted in panel a. There is distinctive iNOS immunoreactivity in large astrocytic cell bodies; however, some degree of staining variability among morphologically identical hypertrophic astrocytes is visible. The inset shows discrete iNOS localization in hypertrophic astrocytes and its processes encroaching on the adventitia of a parenchymal blood vessel. Original magnification, ×400. (d) Robust nitrotyrosine-like staining in hypertrophic astrocytes surrounding a white matter blood vessel. Also, linear-type staining in the luminal endothelial surface, as well as lack of immunoreactivity in foamy macrophages (inset), is visible. Original magnification, ×400. (e to h) Immunocytochemical profile of HAM-56 (e), GFAP (f), iNOS (g), and nitrotyrosine (h) in subserial sections from a chronic-MS plaque. (e) Perivascular aggregates of HAM-56-positive monocytes/macrophages surrounding a sclerotic vessel within a chronic-MS plaque. Original magnification, ×400. (f) GFAP staining highlights fibrous gliosis surrounding an intralesional blood vessel. GFAP-negative mononuclear cells are visible in the perivascular space. Original magnification, ×400. (g) Lack of iNOS staining in perivascular mononuclear cells and in fibrous astrocytes. Original magnification, ×400. (h) Lack of nitrotyrosine-like staining in perivascular mononuclear cells and in fibrous astrocytes mirroring the profile of iNOS. Original magnification, ×400.