Histochemical characteristics of the striated inclusions of adrenoleukodystrophy

The striated accumulations in adrenal cortical cells and brain macrophages that are characteristic of adrenoleukodystrophy were studied histochemically in cryostat sections to seek leads for the biochemical identification of the striated material. It stained pale pink with oil red O and did not stain with the Schultz cholesterol procedure or periodic acid Schiff technique. By utilizing the birefringence of the accumulations as a marker, it was determined that, unlike natural cholesterol and cholesterol esters, the striated material was resistant to acetone and ethanol extraction. It was readily soluble, however, in nonpolar solvents such as n hexane and chloroform. These findings indicated that the material was most probably a lipid, and suggested that sequential extraction of adrenoleukodystrophy adrenal and brain with acetone and then n hexane could be used to isolate this material in relatively pure form. Based on this lead, biochemical studies have just revealed a fatty acid abnormality in adrenoleukodystrophy which appears to be unique to this genetic disease.