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Ectopic Lymphoid Follicle Development in MS

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Association of Medical Illustrators Award of Merit in the Didactic/Instructional
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Development of intrathecal ectopic lymphoid follicles in secondary progressive multiple sclerosis. 

Graphite, Adobe Photoshop and Illustrator CS6

University level immunology students

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Prof. L. Wilson-Pauwels, M. Corrin, Content expert: Dr. J. Gommerman

This purpose of this illustration is to demonstrate the hypothesized process of how intrathecal lymphoid follicles develop in secondary progressive multiple sclerosis. 

This piece won an Award of Merit in the Didactic/Instructional – Molecular/Biological/Life Sciences category at the 2014 AMI conference. 


PROCESS WORK

These were a series of initial sketches I did. The content of the illustration was set but the focus of the process of the development of the follicles to be shown in the illustration was still being worked out. Many versions of layout were experimented with. The most challenging part of this piece was figuring out how to demonstrate all the molecular and cellular interactions that were occurring in the very small, tight subarachnoid space without losing the audience as to the anatomical orientation and location of the piece. 
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Once I decided the 3 main processes of the development of the intrathecal follicles and found a layout that worked, I worked up the color sketch of the piece. At this stage, I was figuring out the style of the piece, the lighting and rendering challenges, and ensuring that every detail of the content was correct. 
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The final piece was pathed and rendered completely in illustrator. 
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References

Aguzzi, Adriano. “Origin of Follicular Dendritic Cells.” Youtube. June 18, 2012.
Aloisi, Francesca, and Ricardo Pujol-Borrell. "Lymphoid Neogenesis in Chronic Inflammatory Diseases." Nature Reviews.Immunology 6.3 (2006): 205-17.
Boulianne, Bryant, et al. “Lymphotoxin-sensitive microenvironments in homeostasis and inflammation.” Frontiers in Immunology 3 (2012): 243
Gommerman, Jennifer L., and Jeffrey L. Browning. "Lymphotoxin/LIGHT, Lymphoid Microenvironments and Autoimmune Disease." NatureReviews.Immunology 3.8 (2003): 642-55.
Greter, Melanie, et al. "Dendritic Cells Permit Immune Invasion of the CNS in an Animal Model of Multiple Sclerosis." Nature medicine 11.3 (2005): 328-34. 
Magliozzi, Roberta, et al. "Meningeal B-Cell Follicles in Secondary Progressive Multiple Sclerosis Associate with Early Onset of Disease and Severe Cortical Pathology." Brain 130.4 (2007): 1089-104.
Pikor, Natalia, and Jennifer L. Gommerman. "B Cells in MS: Why, Where and how?" Multiple Sclerosis and Related Disorders 1.3 (2012): 123-30.
Serafini, Barbara, et al. "Detection of Ectopic B‐cell Follicles with Germinal Centers in the Meninges of Patients with Secondary Progressive Multiple Sclerosis." Brain Pathology 14.2 (2004): 164-74.

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