NCOA4 and secondary progressive multiple sclerosis: In addition, histological analysis of CNS lesions in SPMS autopsy material revealed: (1) increased ferritin labeling (a surrogate marker of iron) in macrophages and oligodendrocytes along the rim of SPMS lesions (MAIAD and MAIAPD); (2) increased expression of NCOA4 (required for ferritinophagy and release of redox active iron), and (3) increased lipid peroxidation, in these cells, that suggest increased likelihood for ferroptosis that can contribute to progressive pathology in SPMS.