101
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Lai W, Kinoshita M, Peng A, Li W, Qiu X, Zhu X, He S, Zhang L, Chen L. Does pregnancy affect women with multiple sclerosis? A prospective study in Western China. J Neuroimmunol 2018; 321:24-28. [DOI: 10.1016/j.jneuroim.2018.05.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 05/11/2018] [Accepted: 05/22/2018] [Indexed: 10/16/2022]
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102
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Voskuhl R. It is time to conduct phase 3 clinical trials of sex hormones in MS - Yes. Mult Scler 2018; 24:1413-1415. [PMID: 30058469 DOI: 10.1177/1352458518768764] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Rhonda Voskuhl
- Multiple Sclerosis Program, Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
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103
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Morris G, Maes M, Murdjeva M, Puri BK. Do Human Endogenous Retroviruses Contribute to Multiple Sclerosis, and if So, How? Mol Neurobiol 2018; 56:2590-2605. [PMID: 30047100 PMCID: PMC6459794 DOI: 10.1007/s12035-018-1255-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 07/17/2018] [Indexed: 12/24/2022]
Abstract
The gammaretroviral human endogenous retrovirus (HERV) families MRSV/HERV-W and HERV-H (including the closely related HERV-Fc1) are associated with an increased risk of multiple sclerosis (MS). Complete HERV sequences betray their endogenous retroviral origin, with open reading frames in gag, pro, pol and env being flanked by two long terminal repeats containing promoter and enhancer sequences with the capacity to regulate HERV transactivation and the activity of host genes in spite of endogenous epigenetic repression mechanisms. HERV virions, RNA, cDNA, Gag and Env, and antibodies to HERV transcriptional products, have variously been found in the blood and/or brain and/or cerebrospinal fluid of MS patients, with the HERV expression level being associated with disease status. Furthermore, some HERV-associated single nucleotide polymorphisms (SNPs), such as rs662139 T/C in a 3-kb region of Xq22.3 containing a HERV-W env locus, and rs391745, upstream of the HERV-Fc1 locus on the X chromosome, are associated with MS susceptibility, while a negative association has been reported with SNPs in the tripartite motif-containing (TRIM) protein-encoding genes TRIM5 and TRIM22. Factors affecting HERV transcription include immune activation and inflammation, since HERV promoter regions possess binding sites for related transcription factors; oxidative stress, with oxidation of guanine to 8-oxoguanine and conversion of cytosine to 5-hydroxymethylcytosine preventing binding of methyl groups transferred by DNA methyltransferases; oxidative stress also inhibits the activity of deacetylases, thereby favouring the acetylation of histone lysine residues favouring gene expression; interferon beta; natalizumab treatment; impaired epigenetic regulation; and the sex of patients.
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Affiliation(s)
- Gerwyn Morris
- IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Michael Maes
- IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Marianna Murdjeva
- Department of Microbiology and Immunology, Medical University, Plovdiv, Bulgaria
| | - Basant K Puri
- Department of Medicine, Hammersmith Hospital, Imperial College London, London, UK.
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104
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Hyarat S, Al-Gamal E, Dela Rama E. Depression and perceived social support among Saudi patients with multiple sclerosis. Perspect Psychiatr Care 2018; 54:428-435. [PMID: 29774946 DOI: 10.1111/ppc.12293] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 04/03/2018] [Accepted: 04/27/2018] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To examine the association between depression level and perceived social support among patients with multiple sclerosis (MS) in Saudi Arabia. DESIGN AND METHODS A cross-sectional, descriptive, correlational design was used with 140 patients. A self-reporting questionnaires were used. FINDINGS The age range of the participants was 18-59 years (mean 34.3 years, SD 7.69). The mean score for reported depression was 27.5 which is considered as moderate level of depression. The mean score of the Multidimensional Scale of Perceived Social Support (MSPSS) was 45.3 (SD = 16.2). Patients with MS who received higher level of social support exhibits lower level of depression. PRACTICE IMPLICATIONS Aside from addressing physiological needs, healthcare providers must ensure that patients with MS receive positive social support to decrease level of depression.
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Affiliation(s)
- Saba Hyarat
- College of Nursing, King Saud Bin Abd AlAziz University for Health sciences
| | - Ekhlas Al-Gamal
- College of Nursing, King Saud Bin Abd AlAziz University for Health sciences.,School of Nursing, The University of Jordan
| | - Ellaine Dela Rama
- College of Nursing, King Saud Bin Abd AlAziz University for Health sciences
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105
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Social influences on microglial reactivity and neuronal damage after cardiac arrest/cardiopulmonary resuscitation. Physiol Behav 2018; 194:437-449. [PMID: 29933031 DOI: 10.1016/j.physbeh.2018.06.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 05/15/2018] [Accepted: 06/11/2018] [Indexed: 12/20/2022]
Abstract
Social isolation presents a risk factor and worsens outcome to cerebrovascular diseases; however, the underlying mechanisms remain underspecified. This study examines the effect of social environment on microglial reactivity after global cerebral ischemia, to test the hypothesis that social isolation leads to greater microglial responses. Adult female and male mice were pair-housed or socially isolated for one week prior to cardiac arrest/cardiopulmonary resuscitation (CA/CPR) or the sham procedure, and following either 2 or 24 h of reperfusion, microglia samples were enriched and analyzed for gene expression. At the 2-hour time point, microglia from both females and males exhibited ischemia-induced inflammation, characterized by the gene expression increase of tumor necrosis factor alpha (TNF-α), interleukin 1 beta (IL-1β) and interleukin 6 (IL-6), regardless of the housing conditions. However, at 24 h post-ischemia, social housing attenuated microglial pro-inflammatory gene expression in a sex-specific manner. At this time point, the ischemia-induced increased expression of IL-1β and IL-6 was attenuated by social interaction in microglia from male mice, while among female mice social attenuation of the inflammatory response was observed in the microglial expression of cell surface protein major histocompatibility complex II (MHC II). A second study examined behavioral and physiological measures 96 h after ischemic injury. At this time point, female and male mice displayed increased locomotion and exploratory behavior following CA/CPR relative to controls. Regardless of sex, ischemia also elicited neuroinflammation and neurodegeneration, both of which were modulated by the social environment. Hippocampal nitric oxide (iNOS), cortical TNF-α, and counts of Fluoro-Jade C positive stained cells in the CA1 region of the hippocampus, were increased in the isolated CA/CPR group relative to sham controls and the pair-housed CA/CPR groups. Together, these data indicate that female and male mice exhibit similar outcome measures and social modulation at 96 h post-ischemic injury, nonetheless, that social environment influences microglial reactivity to global cerebral ischemia in a sex-specific manner.
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106
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Stoessel D, Stellmann JP, Willing A, Behrens B, Rosenkranz SC, Hodecker SC, Stürner KH, Reinhardt S, Fleischer S, Deuschle C, Maetzler W, Berg D, Heesen C, Walther D, Schauer N, Friese MA, Pless O. Metabolomic Profiles for Primary Progressive Multiple Sclerosis Stratification and Disease Course Monitoring. Front Hum Neurosci 2018; 12:226. [PMID: 29915533 PMCID: PMC5994544 DOI: 10.3389/fnhum.2018.00226] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 05/15/2018] [Indexed: 01/28/2023] Open
Abstract
Primary progressive multiple sclerosis (PPMS) shows a highly variable disease progression with poor prognosis and a characteristic accumulation of disabilities in patients. These hallmarks of PPMS make it difficult to diagnose and currently impossible to efficiently treat. This study aimed to identify plasma metabolite profiles that allow diagnosis of PPMS and its differentiation from the relapsing-remitting subtype (RRMS), primary neurodegenerative disease (Parkinson’s disease, PD), and healthy controls (HCs) and that significantly change during the disease course and could serve as surrogate markers of multiple sclerosis (MS)-associated neurodegeneration over time. We applied untargeted high-resolution metabolomics to plasma samples to identify PPMS-specific signatures, validated our findings in independent sex- and age-matched PPMS and HC cohorts and built discriminatory models by partial least square discriminant analysis (PLS-DA). This signature was compared to sex- and age-matched RRMS patients, to patients with PD and HC. Finally, we investigated these metabolites in a longitudinal cohort of PPMS patients over a 24-month period. PLS-DA yielded predictive models for classification along with a set of 20 PPMS-specific informative metabolite markers. These metabolites suggest disease-specific alterations in glycerophospholipid and linoleic acid pathways. Notably, the glycerophospholipid LysoPC(20:0) significantly decreased during the observation period. These findings show potential for diagnosis and disease course monitoring, and might serve as biomarkers to assess treatment efficacy in future clinical trials for neuroprotective MS therapies.
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Affiliation(s)
- Daniel Stoessel
- Metabolomic Discoveries GmbH, Potsdam, Germany.,Institut für Biochemie und Biologie, Universität Potsdam, Potsdam, Germany.,Bioinformatik, Max-Planck-Institut für Molekulare Pflanzenphysiologie, Potsdam, Germany
| | - Jan-Patrick Stellmann
- Zentrum für Molekulare Neurobiologie Hamburg, Institut für Neuroimmunologie und Multiple Sklerose, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.,Klinik und Poliklinik für Neurologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Anne Willing
- Zentrum für Molekulare Neurobiologie Hamburg, Institut für Neuroimmunologie und Multiple Sklerose, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Birte Behrens
- Neurodegenerative Erkrankungen, Hertie-Institut für klinische Hirnforschung, Eberhardt-Karls-Universität Tübingen, Tübingen, Germany
| | - Sina C Rosenkranz
- Zentrum für Molekulare Neurobiologie Hamburg, Institut für Neuroimmunologie und Multiple Sklerose, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.,Klinik und Poliklinik für Neurologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Sibylle C Hodecker
- Zentrum für Molekulare Neurobiologie Hamburg, Institut für Neuroimmunologie und Multiple Sklerose, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.,Klinik und Poliklinik für Neurologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Klarissa H Stürner
- Zentrum für Molekulare Neurobiologie Hamburg, Institut für Neuroimmunologie und Multiple Sklerose, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.,Klinik und Poliklinik für Neurologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Stefanie Reinhardt
- Zentrum für Molekulare Neurobiologie Hamburg, Institut für Neuroimmunologie und Multiple Sklerose, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Sabine Fleischer
- Zentrum für Molekulare Neurobiologie Hamburg, Institut für Neuroimmunologie und Multiple Sklerose, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Deuschle
- Neurodegenerative Erkrankungen, Hertie-Institut für klinische Hirnforschung, Eberhardt-Karls-Universität Tübingen, Tübingen, Germany
| | - Walter Maetzler
- Neurodegenerative Erkrankungen, Hertie-Institut für klinische Hirnforschung, Eberhardt-Karls-Universität Tübingen, Tübingen, Germany.,Department of Neurology, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Daniela Berg
- Neurodegenerative Erkrankungen, Hertie-Institut für klinische Hirnforschung, Eberhardt-Karls-Universität Tübingen, Tübingen, Germany.,Department of Neurology, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Christoph Heesen
- Zentrum für Molekulare Neurobiologie Hamburg, Institut für Neuroimmunologie und Multiple Sklerose, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.,Klinik und Poliklinik für Neurologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Dirk Walther
- Institut für Biochemie und Biologie, Universität Potsdam, Potsdam, Germany.,Bioinformatik, Max-Planck-Institut für Molekulare Pflanzenphysiologie, Potsdam, Germany
| | | | - Manuel A Friese
- Zentrum für Molekulare Neurobiologie Hamburg, Institut für Neuroimmunologie und Multiple Sklerose, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Ole Pless
- Fraunhofer IME ScreeningPort, Hamburg, Germany
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107
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Guerrero-García JDJ, Godínez-Rubí M, Ortuño-Sahagún D. Multiple Sclerosis in Search for Biomarkers: Gender as a Variable in the Equation. ACTA ACUST UNITED AC 2018. [DOI: 10.3233/nib-170126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
| | - Marisol Godínez-Rubí
- Laboratorio de Investigación en Patología, Departamento de Microbiología y Patología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - Daniel Ortuño-Sahagún
- Laboratorio de Neuroinmunobiología Molecular, Instituto de Investigación en Ciencias Biomédicas (IICB), C.U.C.S., Universidad de Guadalajara, Guadalajara, Jalisco, México
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108
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Brown MA, Weinberg RB. Mast Cells and Innate Lymphoid Cells: Underappreciated Players in CNS Autoimmune Demyelinating Disease. Front Immunol 2018; 9:514. [PMID: 29619025 PMCID: PMC5871669 DOI: 10.3389/fimmu.2018.00514] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 02/27/2018] [Indexed: 12/29/2022] Open
Abstract
Multiple sclerosis (MS) and its mouse model, experimental autoimmune encephalomyelitis, are autoimmune CNS inflammatory diseases. As a result of a breakdown in the relatively impermeable blood–brain barrier (BBB) in affected individuals, myelin-specific CD4+ and CD8+ T cells gain entry into the immune privileged CNS and initiate myelin, oligodendrocyte, and nerve axon destruction. However, despite the absolute requirement for T cells, there is increasing evidence that innate immune cells also play critical amplifying roles in disease pathogenesis. By modulating the character and magnitude of the myelin-reactive T cell response and regulating BBB integrity, innate cells affect both disease initiation and progression. Two classes of innate cells, mast cells and innate lymphoid cells (ILCs), have been best studied in models of allergic and gastrointestinal inflammatory diseases. Yet, there is emerging evidence that these cell types also exert a profound influence in CNS inflammatory disease. Both cell types are residents within the meninges and can be activated early in disease to express a wide variety of disease-modifying cytokines and chemokines. In this review, we discuss how mast cells and ILCs can have either disease-promoting or -protecting effects on MS and other CNS inflammatory diseases and how sex hormones may influence this outcome. These observations suggest that targeting these cells and their unique mediators can be exploited therapeutically.
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Affiliation(s)
- Melissa A Brown
- Department of Microbiology and Immunology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Rebecca B Weinberg
- Department of Microbiology and Immunology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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109
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Brown MA. Studies of Mast Cells: Adventures in Serendipity. Front Immunol 2018; 9:520. [PMID: 29593744 PMCID: PMC5859373 DOI: 10.3389/fimmu.2018.00520] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 02/28/2018] [Indexed: 01/14/2023] Open
Abstract
Like many of us who had the great fortune to work with Bill Paul, my science life was immeasurably altered by my interactions with him. Although intimidating at first because of his stature in the immunology world, it was soon clear that he not only truly cared about the specific research we were doing together, but he wished to convey to his trainees an approach to science that was open, always questioning, and infinitely fun. His enthusiasm was infectious and after my training with him, despite stresses due to funding and publishing hurdles, I never regretted the path I took. My research took a sharp turn from the studies of adaptive immunity I had planned on pursuing after my fellowship with Bill to a life long quest to understand the wonders of the mast cell, a relatively rare innate immune cell. This came about because Bill’s curiosity and expectation of the unexpected allowed him to view, in retrospect, a rather mundane observation we made together involving a non-physiological transformed mast cell line as something that might be really interesting. I have never forgotten that lesson: Look at the data with an eye on the big picture. Sometimes the unexpected is more interesting than predicted results. His example in this regard was incredibly important when as an independent investigator a mistake in mouse sex determination led to unexpected and very confusing data. Yet, these data ultimately revealed a role for mast cells in male-specific protection in experimental autoimmune encephalomyelitis, the mouse model of multiple sclerosis. Bill’s influence in immunology is far-reaching and will continue to be felt as those of us who train our own students and post-doctoral fellows pass on his wisdom and approach to scientific research.
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Affiliation(s)
- Melissa A Brown
- Department of Microbiology and Immunology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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110
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Ćuruvija I, Stanojević S, Arsenović-Ranin N, Blagojević V, Dimitrijević M, Vidić-Danković B, Vujić V. Sex Differences in Macrophage Functions in Middle-Aged Rats: Relevance of Estradiol Level and Macrophage Estrogen Receptor Expression. Inflammation 2018; 40:1087-1101. [PMID: 28353029 DOI: 10.1007/s10753-017-0551-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The aim of this study was to examine the influence of sex on age-related changes in phenotype and functional capacity of rat macrophages. The potential role of estradiol as a contributing factor to a sex difference in macrophage function with age was also examined. Thioglycollate-elicited peritoneal macrophages derived from the young (2 months old) and the naturally senescent intact middle-aged (16 months old) male and female rats were tested for cytokine secretion and antimicrobial activity (NO and H2O2 production and myeloperoxidase activity). Serum concentration of estradiol and the expression of estrogen receptor (ER)α and ERβ on freshly isolated peritoneal macrophages were also examined. Decreased secretion of IL-1β and IL-6 by macrophages from middle-aged compared to the young females was accompanied with the lesser density of macrophage ERα expression and the lower systemic level of estradiol, whereas the opposite was true for middle-aged male rats. Macrophages in the middle-aged females, even with the diminished circulating estradiol levels, produce increased amount of IL-6, and comparable amounts of IL-1β, TNF-α, and NO to that measured in macrophages from the middle-aged males. Age-related changes in macrophage phenotype and the antimicrobial activity were independent of macrophage ERα/ERβ expression and estradiol level in both male and female rats. Although our study suggests that the sex difference in the level of circulating estradiol may to some extent contribute to sex difference in macrophage function of middle-aged rats, it also points to more complex hormonal regulation of peritoneal macrophage activity in females.
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Affiliation(s)
- Ivana Ćuruvija
- Immunology Research Centre "Branislav Janković", Institute of Virology, Vaccines and Sera "Torlak", Vojvode Stepe 458, Belgrade, 11221, Serbia
| | - Stanislava Stanojević
- Immunology Research Centre "Branislav Janković", Institute of Virology, Vaccines and Sera "Torlak", Vojvode Stepe 458, Belgrade, 11221, Serbia.
| | - Nevena Arsenović-Ranin
- Department of Microbiology and Immunology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
| | - Veljko Blagojević
- Immunology Research Centre "Branislav Janković", Institute of Virology, Vaccines and Sera "Torlak", Vojvode Stepe 458, Belgrade, 11221, Serbia
| | - Mirjana Dimitrijević
- Department of Immunology, Institute for Biological Research "Siniša Stanković", University of Belgrade, Belgrade, Serbia
| | - Biljana Vidić-Danković
- Immunology Research Centre "Branislav Janković", Institute of Virology, Vaccines and Sera "Torlak", Vojvode Stepe 458, Belgrade, 11221, Serbia
| | - Vesna Vujić
- Department of Chemistry, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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111
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Huitema MJD, Schenk GJ. Insights into the Mechanisms That May Clarify Obesity as a Risk Factor for Multiple Sclerosis. Curr Neurol Neurosci Rep 2018; 18:18. [PMID: 29525910 PMCID: PMC5845596 DOI: 10.1007/s11910-018-0827-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE OF REVIEW The proportion to which genetic and environmental factors contribute to the etiology of multiple sclerosis (MS) is still incompletely understood. An interesting association between MS etiology and obesity has recently been shown although the mechanisms underlying this association are still unknown. We propose deregulated gut microbiota and increased leptin levels as possible mechanisms underlying MS etiology in obese individuals. RECENT FINDINGS Alterations in the human gut microbiota and leptin levels have recently been established as immune modulators in both MS patients and obese individuals. A resemblance between pro-inflammatory bacterial profiles in MS and obese individuals was observed. Furthermore, elevated leptin levels push the immune system towards a more pro-inflammatory state and inhibit the regulatory immune response. Deregulated gut microbiota and elevated leptin levels may explain the increased risk of developing MS in obese individuals. Further research to confirm causality is warranted.
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Affiliation(s)
- Marije J D Huitema
- Faculty of medicine, VU University, Van der Boechorststraat 7, 1081 BT, Amsterdam, Netherlands
| | - Geert J Schenk
- Department of Anatomy and Neurosciences, Neuroscience Amsterdam, VUmc MS Center Amsterdam, VU University Medical Center, De Boelelaan 1108, 1081 HV, Amsterdam, Netherlands.
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112
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Male-specific IL-33 expression regulates sex-dimorphic EAE susceptibility. Proc Natl Acad Sci U S A 2018; 115:E1520-E1529. [PMID: 29378942 DOI: 10.1073/pnas.1710401115] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The cellular and molecular basis of sex-dimorphic autoimmune diseases, such as the CNS demyelinating disease multiple sclerosis (MS), remains unclear. Our studies in the SJL mouse model of MS, experimental autoimmune encephalomyelitis (EAE), reveal that sex-determined differences in Il33 expression by innate immune cells in response to myelin peptide immunization regulate EAE susceptibility. IL-33 is selectively induced in PLP139-151-immunized males and activates type 2 innate lymphoid cells (ILC2s), cells that promote and sustain a nonpathogenic Th2 myelin-specific response. Without this attenuating IL-33 response, females generate an encephalitogenic Th17-dominant response, which can be reversed by IL-33 treatment. Mast cells are one source of IL-33 and we provide evidence that testosterone directly induces Il33 gene expression and also exerts effects on the potential for Il33 gene expression during mast cell development. Thus, in contrast to their pathogenic role in allergy, we propose a sex-specific role for both mast cells and ILC2s as attenuators of the pathogenic Th response in CNS inflammatory disease.
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113
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Iparraguirre L, Muñoz-Culla M, Prada-Luengo I, Castillo-Triviño T, Olascoaga J, Otaegui D. Circular RNA profiling reveals that circular RNAs from ANXA2 can be used as new biomarkers for multiple sclerosis. Hum Mol Genet 2018. [PMID: 28651352 DOI: 10.1093/hmg/ddx243] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Multiple sclerosis is an autoimmune disease, with higher prevalence in women, in whom the immune system is dysregulated. This dysregulation has been shown to correlate with changes in transcriptome expression as well as in gene-expression regulators, such as non-coding RNAs (e.g. microRNAs). Indeed, some of these have been suggested as biomarkers for multiple sclerosis even though few biomarkers have reached the clinical practice. Recently, a novel family of non-coding RNAs, circular RNAs, has emerged as a new player in the complex network of gene-expression regulation. MicroRNA regulation function through a 'sponge system' and a RNA splicing regulation function have been proposed for the circular RNAs. This regulating role together with their high stability in biofluids makes them seemingly good candidates as biomarkers. Given the dysregulation of both protein-coding and non-coding transcriptome that have been reported in multiple sclerosis patients, we hypothesised that circular RNA expression may also be altered. Therefore, we carried out expression profiling of 13.617 circular RNAs in peripheral blood leucocytes from multiple sclerosis patients and healthy controls finding 406 differentially expressed (P-value < 0.05, Fold change > 1.5) and demonstrate after validation that, circ_0005402 and circ_0035560 are underexpressed in multiple sclerosis patients and could be used as biomarkers of the disease.
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Affiliation(s)
- Leire Iparraguirre
- Multiple Sclerosis Unit, Neurosciences Area, Biodonostia Health Research Institute, 20014, San Sebastián, Spain
| | - Maider Muñoz-Culla
- Multiple Sclerosis Unit, Neurosciences Area, Biodonostia Health Research Institute, 20014, San Sebastián, Spain.,Spanish Network of Multiple Sclerosis, 08028, Barcelona, Spain
| | - Iñigo Prada-Luengo
- Multiple Sclerosis Unit, Neurosciences Area, Biodonostia Health Research Institute, 20014, San Sebastián, Spain
| | - Tamara Castillo-Triviño
- Multiple Sclerosis Unit, Neurosciences Area, Biodonostia Health Research Institute, 20014, San Sebastián, Spain.,Spanish Network of Multiple Sclerosis, 08028, Barcelona, Spain.,Neurology Department, Donostia University Hospital, 20014, San Sebastián, Spain
| | - Javier Olascoaga
- Multiple Sclerosis Unit, Neurosciences Area, Biodonostia Health Research Institute, 20014, San Sebastián, Spain.,Spanish Network of Multiple Sclerosis, 08028, Barcelona, Spain.,Neurology Department, Donostia University Hospital, 20014, San Sebastián, Spain
| | - David Otaegui
- Multiple Sclerosis Unit, Neurosciences Area, Biodonostia Health Research Institute, 20014, San Sebastián, Spain.,Spanish Network of Multiple Sclerosis, 08028, Barcelona, Spain
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114
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Abstract
PURPOSE OF REVIEW This article provides a review of the available data on reproductive issues that arise in patients with multiple sclerosis (MS). RECENT FINDINGS Recent findings have replicated earlier findings that pregnancy and possibly breast-feeding bring about a favorable immunomodulatory effect in patients with MS. Use of disease-modifying therapies prior to pregnancy may further decrease a patient's risk for postpartum disease activity. SUMMARY The annualized relapse rate in MS decreases during pregnancy, with a nadir in the third trimester, and rebounds significantly in the 3-month postpartum period. Exclusive breast-feeding may exert a beneficial effect in decreasing the postpartum risk for relapse. Certain assisted reproductive technology methods are thought to increase the risk for relapse. Disease-modifying therapies are generally discontinued during pregnancy and lactation with a few exceptions. The pregnancy course is usually routine without significant obstetric complications, and babies, although slightly smaller, are typically healthy.
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115
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Cell-specific and region-specific transcriptomics in the multiple sclerosis model: Focus on astrocytes. Proc Natl Acad Sci U S A 2018; 115:E302-E309. [PMID: 29279367 PMCID: PMC5777065 DOI: 10.1073/pnas.1716032115] [Citation(s) in RCA: 168] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Changes in gene expression that occur across the central nervous system (CNS) during neurological diseases do not address the heterogeneity of cell types from one CNS region to another and are complicated by alterations in cellular composition during disease. Multiple sclerosis (MS) is multifocal by definition. Here, a cell-specific and region-specific transcriptomics approach was used to determine gene expression changes in astrocytes in the most widely used MS model, experimental autoimmune encephalomyelitis (EAE). Astrocyte-specific RNAs from various neuroanatomic regions were attained using RiboTag technology. Sequencing and bioinformatics analyses showed that EAE-induced gene expression changes differed between neuroanatomic regions when comparing astrocytes from spinal cord, cerebellum, cerebral cortex, and hippocampus. The top gene pathways that were changed in astrocytes from spinal cord during chronic EAE involved decreases in expression of cholesterol synthesis genes while immune pathway gene expression in astrocytes was increased. Optic nerve from EAE and optic chiasm from MS also showed decreased cholesterol synthesis gene expression. The potential role of cholesterol synthesized by astrocytes during EAE and MS is discussed. Together, this provides proof-of-concept that a cell-specific and region-specific gene expression approach can provide potential treatment targets in distinct neuroanatomic regions during multifocal neurological diseases.
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Abstract
Sex differences in epidemiological, clinical, and pathological features of multiple sclerosis (MS) have been observed for decades, establishing a foundation for more recent progress in our understanding of their overall impact on the disease. In the ACTRIMS session on Hormones, Sex Chromosomes, and MS: Risk Factors, Biomarkers, and Therapeutic Targets, this progress was summarized in three presentations by pioneers in the field, revealing evidence that sex chromosomes, epigenetic factors, and sex hormones function as interactive determinants of disease risk and phenotype in a fashion dependent upon life stage, from prenatal development, childhood, and adolescence to adulthood and aging. Implications for the effects of puberty, pregnancy, menopause, and andropause on autoimmune and neurodegenerative mechanisms were discussed, along with potential applications of exogenous hormones. Although several limitations in current approaches and concepts were noted, current insights pave the way for future progress in our understanding of this enigmatic disease
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Affiliation(s)
- Riley Bove
- Department of Neurology and Weill Institute for Neurosciences, University of California–San Francisco, San Francisco, CA, USA
| | - Wendy Gilmore
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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117
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Voskuhl RR, Sawalha AH, Itoh Y. Sex chromosome contributions to sex differences in multiple sclerosis susceptibility and progression. Mult Scler 2018; 24:22-31. [PMID: 29307297 PMCID: PMC5823689 DOI: 10.1177/1352458517737394] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Why are women more susceptible to multiple sclerosis, but men have worse disability progression? Sex differences in disease may be due to sex hormones, sex chromosomes, or both. OBJECTIVE Determine whether differences in sex chromosomes can contribute to sex differences in multiple sclerosis using experimental autoimmune encephalomyelitis. METHODS Sex chromosome transgenic mice, which permit the study of sex chromosomes not confounded by differences in sex hormones, were used to examine an effect of sex chromosomes on autoimmunity and neurodegeneration, focusing on X chromosome genes. RESULTS T-lymphocyte DNA methylation studies of the X chromosome gene Foxp3 suggested that maternal versus paternal imprinting of X chromosome genes may underlie sex differences in autoimmunity. Bone marrow chimeras with the same immune system but different sex chromosomes in the central nervous system suggested that differential expression of the X chromosome gene Toll-like receptor 7 in neurons may contribute to sex differences in neurodegeneration. CONCLUSION Mapping the transcriptome and methylome in T lymphocytes and neurons in females versus males could reveal mechanisms underlying sex differences in autoimmunity and neurodegeneration.
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Affiliation(s)
- Rhonda R. Voskuhl
- Department of Neurology, 635 Charles E. Young Drive South, University of California, Los Angeles, Multiple Sclerosis Program, Los Angeles, California 90095
| | - Amr H. Sawalha
- Departments of Internal Medicine & Center for Computational Medicine and Bioinformatics, 1150 W. Medical Center Drive, University of Michigan, Ann Arbor, Michigan, 48109-5680
| | - Yuichiro Itoh
- Department of Neurology, 635 Charles E. Young Drive South, University of California, Los Angeles, Multiple Sclerosis Program, Los Angeles, California 90095
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118
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Brooks CE, Clayton JA. Sex/gender influences on the nervous system: Basic steps toward clinical progress. J Neurosci Res 2017; 95:14-16. [PMID: 27870446 DOI: 10.1002/jnr.23902] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 08/02/2016] [Accepted: 08/05/2016] [Indexed: 12/24/2022]
Abstract
A Commentary highlighting the progress that sex-based data and research have made in neuroscience and the complexities that research has revealed thus far. Basic and preclinical neuroscientific research that considers sex as a biological variable will continue to build on the foundation of knowledge that has been started by multiple predecessors. The expansion of knowledge in preclinical neuroscience that integrates the study of both sexes will have a significant role in informing clinical trial design. We applaud the efforts of the editors and authors who have contributed to this issue. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.
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Affiliation(s)
- Claudette Elise Brooks
- Office of Research on Women's Health (ORWH), Office of the Director, National Institutes of Health, Bethesda, Maryland
| | - Janine Austin Clayton
- Office of Research on Women's Health (ORWH), Office of the Director, National Institutes of Health, Bethesda, Maryland
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119
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Lioudyno V, Abdurasulova I, Bisaga G, Skulyabin D, Klimenko V. Single-nucleotide polymorphism rs948854 in human galanin gene and multiple sclerosis: a gender-specific risk factor. J Neurosci Res 2017; 95:644-651. [PMID: 27870457 DOI: 10.1002/jnr.23887] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 07/14/2016] [Accepted: 07/25/2016] [Indexed: 01/15/2023]
Abstract
We performed comparative analyses of the genotype distribution and allelic frequencies of the rs948854 polymorphism (G/A) in the galanin gene's promoter in patients with multiple sclerosis (MS) and in healthy matched controls. In total 111 patients and 115 control subjects were included. The analyses revealed that the presence of the minor allele (G) increased susceptibility to MS in men (OR = 2.49, P = 0.008) but not in women. The presence of the G allele in men was also significantly associated with the late onset of MS. Furthermore, rs948854 polymorphism affected the rate of MS progression depending on the sex of the patients. In woman (typically slowly progressing), the percentage of patients with the slow (<0.5 EDSS score per year) progression rate was significantly reduced (χ2 = 5.7, P = 0.017) in the minor allele carriers group (52.6%), in comparison with the wild-type carriers (83.9%). In men (typically quickly progressing), the number of patients with fast progression rate (≥0.75 EDSS score per year) tended to increase in the minor allele carriers group (50%) compared with number of patients with the wild-type carriers (31.3%). These data demonstrate for the first time an association between rs948854 polymorphism and multiple sclerosis and, further, that this association is sex specific. They also point to diagnostic and prognostic benefits of genetic screening of patients with multiple sclerosis. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Victoria Lioudyno
- Pavlov Department of Physiology, Federal State Budgetary Scientific Institution "Institute of Experimental Medicine,", St. Petersburg, Russia
| | - Irina Abdurasulova
- Pavlov Department of Physiology, Federal State Budgetary Scientific Institution "Institute of Experimental Medicine,", St. Petersburg, Russia
| | - Gennady Bisaga
- Department of Neurology, S.M. Kirov Military Medical Academy, St. Petersburg, Russia
| | - Dmitry Skulyabin
- Department of Neurology, S.M. Kirov Military Medical Academy, St. Petersburg, Russia
| | - Victor Klimenko
- Pavlov Department of Physiology, Federal State Budgetary Scientific Institution "Institute of Experimental Medicine,", St. Petersburg, Russia
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120
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Golden LC, Voskuhl R. The importance of studying sex differences in disease: The example of multiple sclerosis. J Neurosci Res 2017; 95:633-643. [PMID: 27870415 DOI: 10.1002/jnr.23955] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 08/19/2016] [Accepted: 09/06/2016] [Indexed: 12/20/2022]
Abstract
To date, scientific research has often focused on one sex, with assumptions that study of the other sex would yield similar results. However, many diseases affect males and females differently. The sex of a patient can affect the risk for both disease susceptibility and progression. Such differences can be brought to the laboratory bench to be investigated, potentially bringing new treatments back to the clinic. This method of research, known as a "bedside to bench to bedside" approach, has been applied to studying sex differences in multiple sclerosis (MS). Females have greater susceptibly to MS, while males have worse disease progression. These two characteristics of the disease are influenced by the immune system and the nervous system, respectively. Thus, sex differences in each system must be studied. Personalized medicine has been at the forefront of research recently, and studying sex differences in disease fits with this initiative. This review will discuss the known sex differences in MS and highlight how investigating them can lead to new insights and potential treatments for both men and women. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Lisa C Golden
- Department of Neurology, University of California Los Angeles, Los Angeles, California.,Molecular Biology IDP, University of California Los Angeles, Los Angeles, California
| | - Rhonda Voskuhl
- Department of Neurology, University of California Los Angeles, Los Angeles, California
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121
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Abi Ghanem C, Degerny C, Hussain R, Liere P, Pianos A, Tourpin S, Habert R, Macklin WB, Schumacher M, Ghoumari AM. Long-lasting masculinizing effects of postnatal androgens on myelin governed by the brain androgen receptor. PLoS Genet 2017; 13:e1007049. [PMID: 29107990 PMCID: PMC5690690 DOI: 10.1371/journal.pgen.1007049] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 11/16/2017] [Accepted: 09/28/2017] [Indexed: 12/17/2022] Open
Abstract
The oligodendrocyte density is greater and myelin sheaths are thicker in the adult male mouse brain when compared with females. Here, we show that these sex differences emerge during the first 10 postnatal days, precisely at a stage when a late wave of oligodendrocyte progenitor cells arises and starts differentiating. Androgen levels, analyzed by gas chromatography/tandem-mass spectrometry, were higher in males than in females during this period. Treating male pups with flutamide, an androgen receptor (AR) antagonist, or female pups with 5α-dihydrotestosterone (5α-DHT), revealed the importance of postnatal androgens in masculinizing myelin and their persistent effect into adulthood. A key role of the brain AR in establishing the sexual phenotype of myelin was demonstrated by its conditional deletion. Our results uncover a new persistent effect of postnatal AR signaling, with implications for neurodevelopmental disorders and sex differences in multiple sclerosis. Sex differences in brain structure are of great scientific and medical interest because the incidence and progress of many neurological and psychiatric disorders differ between males and females. They affect neural networks and also the myelin sheaths that insulate and protect axons and thus allow the rapid conduction of electrical impulses. In the central nervous system, myelin is formed by a particular type of cells named oligodendrocytes. In the male mouse brain, the density of oligodendrocytes is greater and myelin sheaths are thicker when compared with females. We show that these sex differences in myelin result from the long-lasting actions of androgens in males during their first 10 postnatal days. Importantly, the postnatal masculinizing effects of androgens involve brain androgen receptors as shown by the use of pharmacological and genetic tools. These findings are important for understanding sex-related differences in the susceptibility and progression of demyelinating diseases such as multiple sclerosis. They also reveal a so far unknown role of androgen receptor signaling in sexual differentiation of the brain.
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Affiliation(s)
- Charly Abi Ghanem
- U1195 Inserm and Universities Paris-Sud and Paris-Saclay, 80 rue du Général Leclerc, Kremlin-Bicêtre, France
| | - Cindy Degerny
- U1195 Inserm and Universities Paris-Sud and Paris-Saclay, 80 rue du Général Leclerc, Kremlin-Bicêtre, France
| | - Rashad Hussain
- U1195 Inserm and Universities Paris-Sud and Paris-Saclay, 80 rue du Général Leclerc, Kremlin-Bicêtre, France
- Department of Neurosurgery, Institute for Translational Neuromedicine, University of Rochester, Rochester, NY, United States of America
| | - Philippe Liere
- U1195 Inserm and Universities Paris-Sud and Paris-Saclay, 80 rue du Général Leclerc, Kremlin-Bicêtre, France
| | - Antoine Pianos
- U1195 Inserm and Universities Paris-Sud and Paris-Saclay, 80 rue du Général Leclerc, Kremlin-Bicêtre, France
| | - Sophie Tourpin
- U566 Inserm, CEA, Universities Paris-Diderot and Paris-Sud, Fontenay aux Roses, France
| | - René Habert
- U566 Inserm, CEA, Universities Paris-Diderot and Paris-Sud, Fontenay aux Roses, France
| | - Wendy B. Macklin
- Department of Cell and Developmental Biology, University of Colorado, Aurora, CO, United States of America
| | - Michael Schumacher
- U1195 Inserm and Universities Paris-Sud and Paris-Saclay, 80 rue du Général Leclerc, Kremlin-Bicêtre, France
- * E-mail: (AMG); (MS)
| | - Abdel M. Ghoumari
- U1195 Inserm and Universities Paris-Sud and Paris-Saclay, 80 rue du Général Leclerc, Kremlin-Bicêtre, France
- * E-mail: (AMG); (MS)
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122
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Massa MG, David C, Jörg S, Berg J, Gisevius B, Hirschberg S, Linker RA, Gold R, Haghikia A. Testosterone Differentially Affects T Cells and Neurons in Murine and Human Models of Neuroinflammation and Neurodegeneration. THE AMERICAN JOURNAL OF PATHOLOGY 2017. [PMID: 28634006 DOI: 10.1016/j.ajpath.2017.03.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The high female-to-male sex ratio of multiple sclerosis (MS) prevalence has continuously confounded researchers, especially in light of male patients' accelerated disease course at later stages of MS. Although multiple studies have concentrated on estrogenic mechanisms of disease modulation, fairly little attention has been paid to androgenic effects in a female system, and even fewer studies have attempted to dissociate hormonal effects on the neurodegenerative and neuroinflammatory processes of MS. Herein, we demonstrate the differential effects of hormone treatment on the acute inflammatory and chronic neurodegenerative phases of murine experimental autoimmune encephalomyelitis. Although s.c. treatment with testosterone and aromatase inhibitor applied beginning on the day of immunization ameliorated initial course of disease, similar treatment administered therapeutically exacerbated chronic disease course. Spinal cord analyses of axonal densities reflected the clinical scores of the chronic phase. In vitro, testosterone treatment not only decreased Th1 and Th17 differentiation in an aromatase-independent fashion, but also exacerbated cell death in induced pluripotent stem cell-derived primary human neurons under oxidative stress conditions in an aromatase inhibitor-dependent manner. Thus, through the alleviation of inflammatory processes and the exacerbation of neurodegenerative processes, androgens may contribute to the epidemiologic sex differentials observed in MS prevalence and course.
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Affiliation(s)
- Megan G Massa
- Department of Neurology, Ruhr University-Bochum, Bochum, Germany
| | - Christina David
- Department of Neurology, Ruhr University-Bochum, Bochum, Germany
| | - Stefanie Jörg
- Department of Neurology, Friedrich-Alexander University-Erlangen-Nuremberg, Erlangen, Germany
| | - Johannes Berg
- Department of Neurology, Ruhr University-Bochum, Bochum, Germany
| | - Barbara Gisevius
- Department of Neurology, Ruhr University-Bochum, Bochum, Germany
| | - Sarah Hirschberg
- Department of Neurology, Ruhr University-Bochum, Bochum, Germany
| | - Ralf A Linker
- Department of Neurology, Friedrich-Alexander University-Erlangen-Nuremberg, Erlangen, Germany
| | - Ralf Gold
- Department of Neurology, Ruhr University-Bochum, Bochum, Germany
| | - Aiden Haghikia
- Department of Neurology, Ruhr University-Bochum, Bochum, Germany.
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123
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Voskuhl R, Momtazee C. Pregnancy: Effect on Multiple Sclerosis, Treatment Considerations, and Breastfeeding. Neurotherapeutics 2017; 14:974-984. [PMID: 28766273 PMCID: PMC5722767 DOI: 10.1007/s13311-017-0562-7] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Multiple sclerosis (MS) commonly affects women in childbearing years making pregnancy issues important for patients with MS and their families. Pregnancy is a naturally occurring disease modifier of MS associated with a 70% reduction in relapse rates in the third trimester. This relapse rate reduction during the last trimester is roughly equal to the most effective disease-modifying treatments for MS. Given this efficacy, various pregnancy factors have been tested to determine which play a part in pregnancy's protection, and some have been translated to completed and ongoing phase II clinical trials. In contrast to protective effects during pregnancy, the postpartum period entails increased relapse risk, which may be due to either abrupt removal of protective pregnancy factors after delivery or to unique deleterious factors inherent to the postpartum period. The effect of breastfeeding on MS remains unclear. The best predictor for whether a patient will have a postpartum relapse is the incidence of her having active relapsing MS prior to pregnancy. The medical management of MS during pregnancy and the postpartum period is challenging given the risks of medication exposure to the fetus in utero and to the infant through breast milk. This review will focus on clinical aspects of pregnancy, including the effects of pregnancy on MS disease activity, as well as the medical management of MS during pregnancy and postpartum.
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Affiliation(s)
- Rhonda Voskuhl
- Multiple Sclerosis Program, UCLA Department of Neurology, David Geffen School of Medicine, University of Los Angeles, Los Angeles, CA, 90095, USA.
| | - Callene Momtazee
- Multiple Sclerosis Program, UCLA Department of Neurology, David Geffen School of Medicine, University of Los Angeles, Los Angeles, CA, 90095, USA
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124
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Nacka-Aleksić M, Stojić-Vukanić Z, Pilipović I, Vujnović I, Bufan B, Dimitrijević M, Leposavić G. Strain specificities in cellular and molecular immunopathogenic mechanisms underlying development of experimental autoimmune encephalomyelitis in aged rats. Mech Ageing Dev 2017; 164:146-163. [DOI: 10.1016/j.mad.2017.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 02/21/2017] [Accepted: 03/03/2017] [Indexed: 11/29/2022]
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126
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Najafi P, Moghadasi M. The effect of yoga training on enhancement of Adrenocorticotropic hormone (ACTH) and cortisol levels in female patients with multiple sclerosis. Complement Ther Clin Pract 2016; 26:21-25. [PMID: 28107844 DOI: 10.1016/j.ctcp.2016.11.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 11/08/2016] [Accepted: 11/11/2016] [Indexed: 11/16/2022]
Abstract
The effect of 8 weeks yoga training on cortisol and Adrenocorticotropic hormone (ACTH) levels in female patients with Multiple Sclerosis (MS) is examined. Twenty four MS female patients with Expanded Disability Status Scale (EDSS) 1 to 5.5 participated in this study as the subject. The participants were divided into control (n = 10) or training group (n = 14) randomly. Training group performed 90 min yoga training per session, 3 days a week for 8 weeks. Assessments include body composition measurement and blood sampling 48 h before first session and 48 h after the intervention. The results demonstrated that ACTH increased and cortisol decreased compared to the control group (P < 0.05); In conclusion, it seems that yoga training modulates ACTH level in concomitant with reduction in cortisol level in female patients with MS.
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Affiliation(s)
- Parisa Najafi
- Department of Exercise Physiology, Marvdasht Branch, Islamic Azad University, Marvdasht, Iran
| | - Mehrzad Moghadasi
- Department of Exercise Physiology, Shiraz Branch, Islamic Azad University, Shiraz, Iran.
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127
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Sex Difference in Oxidative Stress Parameters in Spinal Cord of Rats with Experimental Autoimmune Encephalomyelitis: Relation to Neurological Deficit. Neurochem Res 2016; 42:481-492. [PMID: 27812760 DOI: 10.1007/s11064-016-2094-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 09/26/2016] [Accepted: 10/27/2016] [Indexed: 01/02/2023]
Abstract
The study examined (a) whether there is sex difference in spinal cord and plasma oxidative stress profiles in Dark Agouti rats immunised for experimental autoimmune encephalomyelitis (EAE), the principal experimental model of multiple sclerosis, and (b) whether there is correlation between the oxidative stress in spinal cord and neurological deficit. Regardless of rat sex, with the disease development xanthine oxidase (XO) activity and inducible nitric oxide synthase (iNOS) mRNA expression increased in spinal cord, whereas glutathione levels decreased. This was accompanied by the rise in spinal cord malondialdehyde level. On the other hand, with EAE development superoxide dismutase (SOD) activity decreased, while O2- concentration increased only in spinal cord of male rats. Consequently, SOD activity was lower, whereas O2- concentration was higher in spinal cord of male rats with clinically manifested EAE. XO activity and iNOS mRNA expression were also elevated in their spinal cord. Consistently, in the effector phase of EAE the concentration of advanced oxidation protein product (AOPP) was higher in spinal cord of male rats, which exhibit more severe neurological deficit than their female counterparts. In as much as data obtained in the experimental models could be translated to humans, the findings may be relevant for designing sex-specific antioxidant therapeutic strategies. Furthermore, the study indicated that the increased pro-oxidant-antioxidant balance in plasma may be an early indicator of EAE development. Moreover, it showed that plasma AOPP level may indicate not only actual activity of the disease, but also serve to predict severity of its course.
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128
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Borisow N, Kleiter I, Gahlen A, Fischer K, Wernecke KD, Pache F, Ruprecht K, Havla J, Krumbholz M, Kümpfel T, Aktas O, Ringelstein M, Geis C, Kleinschnitz C, Berthele A, Hemmer B, Angstwurm K, Weissert R, Stellmann JP, Schuster S, Stangel M, Lauda F, Tumani H, Mayer C, Zeltner L, Ziemann U, Linker RA, Schwab M, Marziniak M, Then Bergh F, Hofstadt-van Oy U, Neuhaus O, Winkelmann A, Marouf W, Rückriem L, Faiss J, Wildemann B, Paul F, Jarius S, Trebst C, Hellwig K. Influence of female sex and fertile age on neuromyelitis optica spectrum disorders. Mult Scler 2016; 23:1092-1103. [PMID: 27758954 DOI: 10.1177/1352458516671203] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Gender and age at onset are important epidemiological factors influencing prevalence, clinical presentation, and treatment response in autoimmune diseases. OBJECTIVE To evaluate the impact of female sex and fertile age on aquaporin-4-antibody (AQP4-ab) status, attack localization, and response to attack treatment in patients with neuromyelitis optica (NMO) and its spectrum disorders (neuromyelitis optica spectrum disorder (NMOSD)). METHODS Female-to-male ratios, diagnosis at last visit (NMO vs NMOSD), attack localization, attack treatment, and outcome were compared according to sex and age at disease or attack onset. RESULTS A total of 186 NMO/SD patients (82% female) were included. In AQP4-ab-positive patients, female predominance was most pronounced during fertile age (female-to-male ratio 23:1). Female patients were more likely to be positive for AQP4-abs (92% vs 55%; p < 0.001). Interval between onset and diagnosis of NMO/SD was longer in women than in men (mean 54 vs 27 months; p = 0.023). In women, attacks occurring ⩽40 years of age were more likely to show complete remission ( p = 0.003) and better response to high-dose intravenous steroids ( p = 0.005) compared to woman at >40 years. CONCLUSION Our data suggest an influence of sex and age on susceptibility to AQP4-ab-positive NMO/SD. Genetic and hormonal factors might contribute to pathophysiology of NMO/SD.
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Affiliation(s)
- Nadja Borisow
- NeuroCure Clinical Research Center and Clinical and Experimental Multiple Sclerosis Research Center, Department of Neurology, Charité University Medicine Berlin, Berlin, Germany
| | - Ingo Kleiter
- Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Anna Gahlen
- Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Katrin Fischer
- Department of Neurology, Asklepios Fachklinikum Teupitz, Teupitz, Germany
| | | | - Florence Pache
- NeuroCure Clinical Research Center and Clinical and Experimental Multiple Sclerosis Research Center, Department of Neurology, Charité University Medicine Berlin, Berlin, Germany
| | - Klemens Ruprecht
- Department of Neurology and Clinical and Experimental Multiple Sclerosis Research Center, Charité University Medicine Berlin, Berlin, Germany
| | - Joachim Havla
- Institute of Clinical Neuroimmunology, Medical Campus Grosshadern, Ludwig Maximilians University of Munich, Munich, Germany
| | - Markus Krumbholz
- Institute of Clinical Neuroimmunology, Medical Campus Grosshadern, Ludwig Maximilians University of Munich, Munich, Germany
| | - Tania Kümpfel
- Institute of Clinical Neuroimmunology, Medical Campus Grosshadern, Ludwig Maximilians University of Munich, Munich, Germany
| | - Orhan Aktas
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Marius Ringelstein
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Christian Geis
- Department of Neurology, University Hospital of Würzburg, Würzburg, Germany/Hans-Berger Department of Neurology and Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
| | | | - Achim Berthele
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Bernhard Hemmer
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany/Munich Cluster for Systems Neurology (SyNergy), Technische Universität München, Munich, Germany
| | - Klemens Angstwurm
- Department of Neurology, University Hospital Regensburg, Regensburg, Germany
| | - Robert Weissert
- Department of Neurology, University Hospital Regensburg, Regensburg, Germany
| | - Jan-Patrick Stellmann
- Institute of Neuroimmunology and MS (INIMS), University Medical Center Hamburg-Eppendorf, Hamburg, Germany/Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Simon Schuster
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Stangel
- Department of Clinical Neuroimmunology and Neurochemistry and Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Florian Lauda
- Department of Neurology, University of Ulm, Ulm, Germany
| | - Hayrettin Tumani
- Department of Neurology at RKU and Specialty Clinic of Neurology Dietenbronn, University of Ulm, Ulm, Germany
| | - Christoph Mayer
- Department of Neurology, Goethe University Frankfurt, Frankfurt, Germany
| | - Lena Zeltner
- Department of Neurology and Stroke and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Ulf Ziemann
- Department of Neurology and Stroke and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Ralf A Linker
- Department of Neurology, Friedrich-Alexander University Erlangen-Nüremberg, Erlangen, Germany
| | - Matthias Schwab
- Hans-Berger Department of Neurology, Jena University Hospital, Jena, Germany
| | - Martin Marziniak
- Department of Neurology, University of Münster, Münster, Germany/Department of Neurology and Neurological Intensive Care, Isar-Amper-Clinic, Munich-East, Haar, Germany
| | | | - Ulrich Hofstadt-van Oy
- Department of Neurology, Klinikum Bayreuth, Bayreuth, Germany/Department of Neurology, Klinikum Westfalen, Dortmund, Germany
| | - Oliver Neuhaus
- Department of Neurology, SRH Krankenhaus Sigmaringen, Sigmaringen, Germany
| | | | - Wael Marouf
- Department of Neurology, HELIOS Hanseklinikum Stralsund, Stralsund, Germany
| | - Lioba Rückriem
- Department of Neurology, MediClin Hedon Klinik, Lingen, Germany
| | - Jürgen Faiss
- Department of Neurology, Asklepios Fachklinikum Teupitz, Teupitz, Germany
| | | | - Friedemann Paul
- NeuroCure Clinical Research Center and Clinical and Experimental Multiple Sclerosis Research Center, Department of Neurology, Charité University Medicine Berlin, Berlin, Germany/Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité University Medicine Berlin, Berlin, Germany
| | - Sven Jarius
- Department of Neurology, Heidelberg University, Heidelberg, Germany
| | - Corinna Trebst
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Kerstin Hellwig
- Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
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Itoh N, Kim R, Peng M, DiFilippo E, Johnsonbaugh H, MacKenzie-Graham A, Voskuhl RR. Bedside to bench to bedside research: Estrogen receptor beta ligand as a candidate neuroprotective treatment for multiple sclerosis. J Neuroimmunol 2016; 304:63-71. [PMID: 27771018 DOI: 10.1016/j.jneuroim.2016.09.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 09/28/2016] [Indexed: 12/16/2022]
Abstract
Protective effects of pregnancy during MS have led to clinical trials of estriol, the pregnancy estrogen, in MS. Since estriol binds to estrogen receptor (ER) beta, ER beta ligand could represent a "next generation estriol" treatment. Here, ER beta ligand treatment was protective in EAE in both sexes and across genetic backgrounds. Neuroprotection was shown in spinal cord, sparing myelin and axons, and in brain, sparing neurons and synapses. Longitudinal in vivo MRIs showed decreased brain atrophy in cerebral cortex gray matter and cerebellum during EAE. Investigation of ER beta ligand as a neuroprotective treatment for MS is warranted.
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Affiliation(s)
- Noriko Itoh
- Department of Neurology, University of California, Los Angeles, David Geffen School of Medicine, USA
| | - Roy Kim
- Department of Neurology, University of California, Los Angeles, David Geffen School of Medicine, USA
| | - Mavis Peng
- Department of Neurology, University of California, Los Angeles, David Geffen School of Medicine, USA
| | - Emma DiFilippo
- Department of Neurology, University of California, Los Angeles, David Geffen School of Medicine, USA
| | - Hadley Johnsonbaugh
- Department of Neurology, University of California, Los Angeles, David Geffen School of Medicine, USA
| | - Allan MacKenzie-Graham
- Department of Neurology, University of California, Los Angeles, David Geffen School of Medicine, USA
| | - Rhonda R Voskuhl
- Department of Neurology, University of California, Los Angeles, David Geffen School of Medicine, USA.
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130
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Rojas JI, Sánchez F, Patrucco L, Miguez J, Funes J, Cristiano E. Structural sex differences at disease onset in multiple sclerosis patients. Neuroradiol J 2016; 29:368-71. [PMID: 27562581 DOI: 10.1177/1971400916666560] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Male sex is associated with worsening disability and a more rapid progression of multiple sclerosis (MS). This study analysed structural sex differences in magnetic resonance images of the brain, comparing women whose disease started before and after the menopause with a control group of men. METHODS This was a case control study in which female patients whose MS started before (Group 1) and after (Group 2) the menopause were included. The control group was matched by age, disease duration, Expanded Disability Status Scale and disease-modifying treatment. Patients were analysed according to demographic and clinical variables, as well as in terms of radiological measurements at disease onset and during the first 12 months of follow-up. These measurements included normalised total brain volume (NTBV), normalised cortical volume (NCV), normalised white matter volume, left and right hippocampus, the thalamus, brain stem volume, lesion load and percentage brain volume change. A linear regression model was used to analyse the data. RESULTS A total of 97 patients were included: 53 in Group 1 (27 females) and 44 in Group 2 (22 females). In Group 1, we observed a reduction in brain volume in males compared with females at disease onset in NTBV (p = 0.01), NCV (p = 0.001) and brain stem volume (p = 0.01). We did not observe differences in Group 2 at disease onset in the brain volumes analysed. CONCLUSION We observed structural sex differences in brain volume at disease onset in the pre-menopausal group. However, no structural differences were observed at disease onset between the sexes after the menopause had started.
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Affiliation(s)
| | - Francisco Sánchez
- MS Center of Buenos Aires, Italian Hospital of Buenos Aires, Argentina
| | - Liliana Patrucco
- MS Center of Buenos Aires, Italian Hospital of Buenos Aires, Argentina
| | - Jimena Miguez
- MS Center of Buenos Aires, Italian Hospital of Buenos Aires, Argentina
| | - Jorge Funes
- Neuroradiology Department, Italian Hospital of Buenos Aires, Argentina
| | - Edgardo Cristiano
- MS Center of Buenos Aires, Italian Hospital of Buenos Aires, Argentina
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131
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The choroid plexus in health and in disease: dialogues into and out of the brain. Neurobiol Dis 2016; 107:32-40. [PMID: 27546055 DOI: 10.1016/j.nbd.2016.08.011] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 07/20/2016] [Accepted: 08/17/2016] [Indexed: 12/31/2022] Open
Abstract
This article brings the choroid plexus into the context of health and disease. It is remarkable that the choroid plexus, composed by a monolayer of epithelial cells that lie in a highly vascularized stroma, floating within the brain ventricles, gets so little attention in major physiology and medicine text books and in the scientific literature in general. Consider that it is responsible for producing most of the about 150mL of cerebrospinal fluid that fills the brain ventricles and the subarachnoid space and surrounds the spinal cord in the adult human central nervous system, which is renewed approximately 2-3 times daily. As such, its activity influences brain metabolism and function, which will be addressed. Reflect that it contains an impressive number of receptors and transporters, both in the apical and basolateral sides of the epithelial cells, and as such is a key structure for the communication between the brain and the periphery. This will be highlighted in the context of neonatal jaundice, multiple sclerosis and Alzheimer's disease. Realize that the capillaries that irrigate the choroid plexus stroma do not possess tight junctions and that the blood flow to the choroid plexus is five times higher than that in the brain parenchyma, allowing for a rapid sensing system and delivery of molecules such as nutrients and metals as will be revised. Recognize that certain drugs reach the brain parenchyma solely through the choroid plexus epithelia, which has potential to be manipulated in diseases such as neonatal jaundice and Alzheimer's disease as will be discussed. Without further notice, it must be now clear that understanding the choroid plexus is necessary for comprehending the brain and how the brain is modulated and modulates all other systems, in health and in disease. This review article intends to address current knowledge on the choroid plexus, and to motivate the scientific community to consider it when studying normal brain physiology and diseases of the central nervous system. It will guide the reader through several aspects of the choroid plexus in normal physiology, in diseases characteristic of various periods of life (newborns-kernicterus, young adults-multiple sclerosis and the elder-Alzheimer's disease), and how sex-differences may relate to disease susceptibility.
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132
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Mendibe Bilbao M, Boyero Durán S, Bárcena Llona J, Rodriguez-Antigüedad A. Multiple sclerosis: Pregnancy and women's health issues. Neurologia 2016; 34:259-269. [PMID: 27546613 DOI: 10.1016/j.nrl.2016.06.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 06/06/2016] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The course of multiple sclerosis (MS) is influenced by sex, pregnancy and hormonal factors. AIMS To analyse the influence of the above factors in order to clarify the aetiopathogenic mechanisms involved in the disease. METHODS We conducted a comprehensive review of scientific publications in the PubMed database using a keyword search for 'multiple sclerosis', 'MS', 'EAE', 'pregnancy', 'hormonal factors', 'treatment', and related terms. We reviewed the advances presented at the meeting held by the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) in March 2013 in London, as well as recommendations by international experts. RESULTS AND CONCLUSIONS We provide recommendations for counselling and treating women with MS prior to and during pregnancy and after delivery. Current findings on the effects of treatment on the mother, fetus, and newborn are also presented. We issue recommendations for future research in order to address knowledge gaps and clarify any inconsistencies in currently available data.
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Affiliation(s)
- M Mendibe Bilbao
- Departamento de Neurología, Hospital Universitario Cruces, Baracaldo, España.
| | - S Boyero Durán
- Departamento de Neurología, Hospital Universitario Cruces, Baracaldo, España
| | - J Bárcena Llona
- Departamento de Neurología, Hospital Universitario Cruces, Baracaldo, España
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133
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Pregnancy and multiple sclerosis: from molecular mechanisms to clinical application. Semin Immunopathol 2016; 38:709-718. [PMID: 27501960 DOI: 10.1007/s00281-016-0584-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 07/19/2016] [Indexed: 12/14/2022]
Abstract
Translational research generally refers to a "bench to bedside" approach where basic science discoveries in models move to clinical trials in humans. However, a "bedside to bench to bedside" approach may be more promising with respect to clinical relevance, since it starts with a clinical observation that can serve as a research paradigm to elucidate mechanisms and translate them back into novel therapeutic approaches. The effect of pregnancy on human autoimmune disorders in general, and multiple sclerosis (MS) in particular, serves as an intriguing example of how this can be used to understand disease pathobiology and discover new therapeutic targets. Disease activity in MS undergoes pronounced shifts in the time before, during, and after pregnancy. The most well-known and established example is a reduction in relapse rates in the last trimester by 70-80 %. However, disease activity reappears in the first few months after delivery, temporarily overshooting pre-pregnancy levels. This phenomenon has since its first description served as a model for investigating novel treatment options in animal models and has cumulated in successful phase 2a and 2b trials in female MS patients. However, recently, a number of other clinical observations have been made that might be similarly suitable to offer additional insights into pathobiological mechanisms of MS activity, progression, and possibly even incidence. Here, we outline the various changes in the clinical course of MS that have been described in relation to pregnancy, both short term and long term, and discuss how these may inform the development of novel treatments for autoimmune diseases.
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134
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Saigoh K, Yoshimura S, Izumikawa T, Miyata S, Tabara Y, Matsushita T, Miki T, Miyamoto K, Hirano M, Kitagawa H, Kira JI, Kusunoki S. Chondroitin sulfate β-1,4-N-acetylgalactosaminyltransferase-1 (ChGn-1) polymorphism: Association with progression of multiple sclerosis. Neurosci Res 2016; 108:55-9. [DOI: 10.1016/j.neures.2016.01.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 12/28/2015] [Accepted: 01/12/2016] [Indexed: 11/28/2022]
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135
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Hanamsagar R, Bilbo SD. Sex differences in neurodevelopmental and neurodegenerative disorders: Focus on microglial function and neuroinflammation during development. J Steroid Biochem Mol Biol 2016; 160:127-33. [PMID: 26435451 PMCID: PMC4829467 DOI: 10.1016/j.jsbmb.2015.09.039] [Citation(s) in RCA: 234] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 09/25/2015] [Accepted: 09/28/2015] [Indexed: 12/12/2022]
Abstract
Several neurological conditions are associated with sex differences in prevalence or outcome. For example, autism predominantly affects boys, depression is more common in women, Parkinson's disease more common in men, and multiple sclerosis in women. In the case of stroke, women have a less favorable outcome and suffer from a more precipitous drop in health status compared to men. As a result, treatment of such diseases is difficult and yields variable results. Despite this, sex is rarely considered when making treatment decisions. The mechanisms underlying sex differences in disease progression are not well understood, however a strong link exists between different inflammation states of men and women and their propensity to develop certain diseases. As neuroinflammation is an important component of pathophysiology in many neurological conditions, it can be speculated that any changes in the state of inflammation in the brain during normal development can potentially lead to an increase in susceptibility to neurological and neurodegenerative diseases. Microglia play a crucial role in onset and modulation of inflammation and thus sex differences in microglial function could explain, at least in part, differences observed in susceptibilities and outcomes of neurological disorders in men and women. Understanding the mechanisms behind sex differences could help develop more targeted therapy with higher success rate, especially in diseases where sex differences are most prominent.
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Affiliation(s)
- Richa Hanamsagar
- Duke University, Department of Psychology & Neuroscience, Durham NC 27708, USA.
| | - Staci D Bilbo
- Duke University, Department of Psychology & Neuroscience, Durham NC 27708, USA.
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136
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Reactive gliosis in the pathogenesis of CNS diseases. Biochim Biophys Acta Mol Basis Dis 2016; 1862:483-91. [DOI: 10.1016/j.bbadis.2015.11.014] [Citation(s) in RCA: 157] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 11/19/2015] [Accepted: 11/30/2015] [Indexed: 01/11/2023]
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137
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SncRNA (microRNA &snoRNA) opposite expression pattern found in multiple sclerosis relapse and remission is sex dependent. Sci Rep 2016; 6:20126. [PMID: 26831009 PMCID: PMC4735588 DOI: 10.1038/srep20126] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 12/21/2015] [Indexed: 11/08/2022] Open
Abstract
Multiple sclerosis (MS) is a common inflammatory and degenerative disease that causes neurological disability. It affects young adults and its prevalence is higher in women. The most common form is manifested as a series of acute episodes of neurological disability (relapses) followed by a recovery phase (remission). Recently, non-coding RNAs have emerged as new players in transcriptome regulation, and in turn, they could have a significant role in MS pathogenesis. In this context, our aim was to investigate the involvement of microRNAs and snoRNAs in the relapse-remission dynamics of MS in peripheral blood leucocytes, to shed light on the molecular and regulatory mechanisms that underlie this complex process. With this approach, we found that a subset of small non-coding RNAs (sncRNA) is altered in relapse and remission, revealing unexpected opposite changes that are sex dependent. Furthermore, we found that a relapse-related miRNA signature regulated general metabolism processes in leucocytes, and miRNA altered in remission are involved in the regulation of innate immunity. We observed that sncRNA dysregulation is different in relapse and remission leading to differences in transcriptome regulation, and that this process is sex dependent. In conclusion, relapse and remission have a different molecular background in men and women.
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139
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Voskuhl R. Preclinical studies of sex differences: a clinical perspective. Biol Sex Differ 2016; 7:7. [PMID: 26807212 PMCID: PMC4722789 DOI: 10.1186/s13293-016-0061-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 01/18/2016] [Indexed: 11/23/2022] Open
Abstract
The new policy from the National Institutes of Health to encourage grant applicants to consider studying both females and males in preclinical biological experiments has been met with support and opposition. Here, we will discuss implications of preclinical studies of sex differences on clinical research.
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Affiliation(s)
- Rhonda Voskuhl
- Jack H. Skirball Chair in MS Research, Multiple Sclerosis Program, Department of Neurology, UCLA School of Medicine, Neuroscience Research Building 1, Room 475, 635 Charles E. Young Drive South, Los Angeles, CA 90024 USA
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140
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Kallaur AP, Reiche EMV, Oliveira SR, Simão ANC, Pereira WLDCJ, Alfieri DF, Flauzino T, Proença CDM, Lozovoy MAB, Kaimen-Maciel DR, Maes M. Genetic, Immune-Inflammatory, and Oxidative Stress Biomarkers as Predictors for Disability and Disease Progression in Multiple Sclerosis. Mol Neurobiol 2016; 54:31-44. [PMID: 26732588 DOI: 10.1007/s12035-015-9648-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 12/17/2015] [Indexed: 12/17/2022]
Abstract
The aim of this study was to evaluate the TNFβ NcoI polymorphism (rs909253) and immune-inflammatory, oxidative, and nitrosative stress (IO&NS) biomarkers as predictors of disease progression in multiple sclerosis (MS). We included 212 MS patients (150 female, 62 male, mean (±standard deviation (SD)) age = 42.7 ± 13.8 years) and 249 healthy controls (177 female, 72 male, 36.8 ± 11 years). The disability was measured the Expanded Disability Status Scale (EDSS) in 2006 and 2011. We determined the TNFβ NcoI polymorphism and serum levels of interleukin (IL)-6, tumor necrosis factor (TNF)-α, interferon (IFN)-γ, IL-4, IL-10, and IL-17, albumin, ferritin, and plasma levels of lipid hydroperoxides (CL-LOOH), carbonyl protein, advanced oxidation protein products (AOPPs), nitric oxide metabolites (NOx), and total radical-trapping antioxidant parameter (TRAP). The mean EDSS (±SD) in 2006 was 1.62 ± 2.01 and in 2011 3.16 ± 2.29, and disease duration was 7.34 ± 7.0 years. IL-10, TNF-α, IFN-γ, AOPP, and NOx levels were significantly higher and IL-4 lower in MS patients with a higher 2011 EDSS scores (≥3) as compared with those with EDSS < 3. The actual increases in EDSS from 2006 to 2011 were positively associated with TNF-α and IFN-γ. Increased IFN-γ values were associated with higher pyramidal symptoms and increased IL-6 with sensitive symptoms. Increased carbonyl protein and IL-10 but lowered albumin levels predicted cerebellar symptoms. The TNFB1/B2 genotype decreased risk towards progression of pyramidal symptoms. Treatments with IFN-β and glatiramer acetate significantly reduced TNF-α but did not affect the other IO&NS biomarkers or disease progression. Taken together, IO&NS biomarkers and NcoI TNFβ genotypes predict high disability in MS and are associated with different aspects of disease progression. New drugs to treat MS should also target oxidative stress pathways.
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Affiliation(s)
- Ana Paula Kallaur
- Health Sciences Postgraduate Program, Health Sciences Center, State University of Londrina, Londrina, Paraná, 86.038-440, Brazil
| | - Edna Maria Vissoci Reiche
- Department of Pathology, Clinical Analysis and Toxicology, Health Sciences Center, State University of Londrina, Av. Robert Koch, 60, Londrina, Paraná, CEP 86.038-440, Brazil.
| | - Sayonara Rangel Oliveira
- Health Sciences Postgraduate Program, Health Sciences Center, State University of Londrina, Londrina, Paraná, 86.038-440, Brazil
| | - Andrea Name Colado Simão
- Department of Pathology, Clinical Analysis and Toxicology, Health Sciences Center, State University of Londrina, Av. Robert Koch, 60, Londrina, Paraná, CEP 86.038-440, Brazil
| | - Wildea Lice de Carvalho Jennings Pereira
- Health Sciences Postgraduate Program, Health Sciences Center, State University of Londrina, Londrina, Paraná, 86.038-440, Brazil.,Outpatient Clinic for Demyelinating Diseases, University Hospital, State University of Londrina, Londrina, Paraná, 86061-335, Brazil
| | - Daniela Frizon Alfieri
- Health Sciences Postgraduate Program, Health Sciences Center, State University of Londrina, Londrina, Paraná, 86.038-440, Brazil
| | - Tamires Flauzino
- Health Sciences Postgraduate Program, Health Sciences Center, State University of Londrina, Londrina, Paraná, 86.038-440, Brazil
| | - Caio de Meleck Proença
- Outpatient Clinic for Demyelinating Diseases, University Hospital, State University of Londrina, Londrina, Paraná, 86061-335, Brazil
| | - Marcell Alysson Batisti Lozovoy
- Department of Pathology, Clinical Analysis and Toxicology, Health Sciences Center, State University of Londrina, Av. Robert Koch, 60, Londrina, Paraná, CEP 86.038-440, Brazil
| | - Damacio Ramón Kaimen-Maciel
- Outpatient Clinic for Demyelinating Diseases, University Hospital, State University of Londrina, Londrina, Paraná, 86061-335, Brazil.,Department of Clinical Medicine, Health Sciences Center, State University of Londrina, Londrina, Paraná, 86.038-440, Brazil
| | - Michael Maes
- Impact Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria, Australia.,Department of Psychiatry, King Chulalongkorn Memorial Hospital, Chulalongkorn, Bangkok, Thailand
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141
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Stelzer IA, Arck PC. Immunity and the Endocrine System. ENCYCLOPEDIA OF IMMUNOBIOLOGY 2016. [PMCID: PMC7151910 DOI: 10.1016/b978-0-12-374279-7.19001-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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142
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Forger NG, Strahan JA, Castillo-Ruiz A. Cellular and molecular mechanisms of sexual differentiation in the mammalian nervous system. Front Neuroendocrinol 2016; 40:67-86. [PMID: 26790970 PMCID: PMC4897775 DOI: 10.1016/j.yfrne.2016.01.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 12/31/2015] [Accepted: 01/09/2016] [Indexed: 01/16/2023]
Abstract
Neuroscientists are likely to discover new sex differences in the coming years, spurred by the National Institutes of Health initiative to include both sexes in preclinical studies. This review summarizes the current state of knowledge of the cellular and molecular mechanisms underlying sex differences in the mammalian nervous system, based primarily on work in rodents. Cellular mechanisms examined include neurogenesis, migration, the differentiation of neurochemical and morphological cell phenotype, and cell death. At the molecular level we discuss evolving roles for epigenetics, sex chromosome complement, the immune system, and newly identified cell signaling pathways. We review recent findings on the role of the environment, as well as genome-wide studies with some surprising results, causing us to re-think often-used models of sexual differentiation. We end by pointing to future directions, including an increased awareness of the important contributions of tissues outside of the nervous system to sexual differentiation of the brain.
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Affiliation(s)
- Nancy G Forger
- Neuroscience Institute, Georgia State University, Atlanta, GA 30303, United States.
| | - J Alex Strahan
- Neuroscience Institute, Georgia State University, Atlanta, GA 30303, United States.
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143
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Langer-Gould A. Sex hormones and multiple sclerosis: another informative failure. Lancet Neurol 2015; 15:22-3. [PMID: 26621681 DOI: 10.1016/s1474-4422(15)00348-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 11/18/2015] [Indexed: 10/22/2022]
Affiliation(s)
- Annette Langer-Gould
- Kaiser Permanente, Research & Evaluation, 100 S Los Robles Avenue, Pasadena, California 91101, USA.
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144
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Spanier JA, Nashold FE, Mayne CG, Nelson CD, Hayes CE. Vitamin D and estrogen synergy in Vdr-expressing CD4+ T cells is essential to induce Helios+FoxP3+ T cells and prevent autoimmune demyelinating disease. J Neuroimmunol 2015; 286:48-58. [DOI: 10.1016/j.jneuroim.2015.06.015] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 06/16/2015] [Accepted: 06/19/2015] [Indexed: 01/08/2023]
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145
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Frischer JM, Weigand SD, Guo Y, Kale N, Parisi JE, Pirko I, Mandrekar J, Bramow S, Metz I, Brück W, Lassmann H, Lucchinetti CF. Clinical and pathological insights into the dynamic nature of the white matter multiple sclerosis plaque. Ann Neurol 2015; 78:710-21. [PMID: 26239536 DOI: 10.1002/ana.24497] [Citation(s) in RCA: 454] [Impact Index Per Article: 50.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 07/27/2015] [Accepted: 07/29/2015] [Indexed: 11/07/2022]
Abstract
OBJECTIVE An extensive analysis of white matter plaques in a large sample of multiple sclerosis (MS) autopsies provides insights into the dynamic nature of MS pathology. METHODS One hundred twenty MS cases (1,220 tissue blocks) were included. Plaque types were classified according to demyelinating activity based on stringent criteria. Early active, late active, smoldering, inactive, and shadow plaques were distinguished. A total of 2,476 MS white matter plaques were identified. Plaque type distribution was analyzed in relation to clinical data. RESULTS Active plaques were most often found in early disease, whereas at later stages, smoldering, inactive, and shadow plaques predominated. The presence of early active plaques rapidly declined with disease duration. Plaque type distribution differed significantly by clinical course. The majority of plaques in acute monophasic and relapsing-remitting MS (RRMS) were active. Among secondary progressive MS (SPMS) cases with attacks, all plaque types could be distinguished including active plaques, in contrast to SPMS without attacks, in which inactive plaques predominated. Smoldering plaques were frequently and almost exclusively found in progressive MS. At 47 years of age, an equilibrium was observed between active and inactive plaques, whereas smoldering plaques began to peak. Men displayed a higher proportion of smoldering plaques. INTERPRETATION Disease duration, clinical course, age, and gender contribute to the dynamic nature of white matter MS pathology. Active MS plaques predominate in acute and early RRMS and are the likely substrate of clinical attacks. Progressive MS transitions to an accumulation of smoldering plaques characterized by microglial activation and slow expansion of pre-existing plaques. Whether current MS therapeutics impact this pathological driver of disease progression remains uncertain.
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Affiliation(s)
- Josa M Frischer
- Department of Neurosurgery, Medical University Vienna, Vienna, Austria
| | - Stephen D Weigand
- Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN
| | - Yong Guo
- Department of Neurology, College of Medicine, Mayo Clinic, Rochester, MN
| | - Nilufer Kale
- Department of Neurology, College of Medicine, Mayo Clinic, Rochester, MN
| | - Joseph E Parisi
- Department of Neurology, College of Medicine, Mayo Clinic, Rochester, MN
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - Istvan Pirko
- Department of Neurology, College of Medicine, Mayo Clinic, Rochester, MN
| | - Jay Mandrekar
- Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN
| | - Stephan Bramow
- Department of Neurology, Copenhagen University Hospital, Bispebjerg, Denmark
- Department of Pathology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Imke Metz
- Department of Neuropathology, University of Göttingen, Göttingen, Germany
| | - Wolfgang Brück
- Department of Neuropathology, University of Göttingen, Göttingen, Germany
| | - Hans Lassmann
- Department of Neuroimmunology, Center for Brain Research, Medical University of Vienna, Vienna, Austria
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146
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de Vries GJ, Forger NG. Sex differences in the brain: a whole body perspective. Biol Sex Differ 2015; 6:15. [PMID: 26279833 PMCID: PMC4536872 DOI: 10.1186/s13293-015-0032-z] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 07/28/2015] [Indexed: 12/29/2022] Open
Abstract
Most writing on sexual differentiation of the mammalian brain (including our own) considers just two organs: the gonads and the brain. This perspective, which leaves out all other body parts, misleads us in several ways. First, there is accumulating evidence that all organs are sexually differentiated, and that sex differences in peripheral organs affect the brain. We demonstrate this by reviewing examples involving sex differences in muscles, adipose tissue, the liver, immune system, gut, kidneys, bladder, and placenta that affect the nervous system and behavior. The second consequence of ignoring other organs when considering neural sex differences is that we are likely to miss the fact that some brain sex differences develop to compensate for differences in the internal environment (i.e., because male and female brains operate in different bodies, sex differences are required to make output/function more similar in the two sexes). We also consider evidence that sex differences in sensory systems cause male and female brains to perceive different information about the world; the two sexes are also perceived by the world differently and therefore exposed to differences in experience via treatment by others. Although the topic of sex differences in the brain is often seen as much more emotionally charged than studies of sex differences in other organs, the dichotomy is largely false. By putting the brain firmly back in the body, sex differences in the brain are predictable and can be more completely understood.
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Affiliation(s)
- Geert J. de Vries
- Neuroscience Institute, Georgia State University, P.O. Box 5030, Atlanta, GA 30302-5030 USA
| | - Nancy G. Forger
- Neuroscience Institute, Georgia State University, P.O. Box 5030, Atlanta, GA 30302-5030 USA
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147
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Esposito F, Guaschino C, Sorosina M, Clarelli F, Ferre' L, Mascia E, Santoro S, Pagnesi M, Radaelli M, Colombo B, Moiola L, Rodegher M, Stupka E, Martinelli V, Comi G, Martinelli Boneschi F. Impact of MS genetic loci on familial aggregation, clinical phenotype, and disease prediction. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2015; 2:e129. [PMID: 26185776 PMCID: PMC4503410 DOI: 10.1212/nxi.0000000000000129] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 05/25/2015] [Indexed: 11/15/2022]
Abstract
Objective: To investigate the role of known multiple sclerosis (MS)-associated genetic variants in MS familial aggregation, clinical expression, and accuracy of disease prediction in sporadic and familial cases. Methods: A total of 1,443 consecutive patients were screened for MS and familial autoimmune history in a hospital-based Italian cohort. Among them, 461 sporadic and 93 familial probands were genotyped for 107 MS-associated polymorphisms. Their effect sizes were combined to calculate the weighted genetic risk score (wGRS). Results: Family history of MS was reported by 17.2% of probands, and 33.8% reported a familial autoimmune disorder, with autoimmune thyroiditis and psoriasis being the most frequent. No difference in wGRS was observed between sporadic and familial MS cases. In contrast, a lower wGRS was observed in probands with greater familial aggregation (>1 first-degree relative or >2 relatives with MS) (p = 0.03). Also, female probands of familial cases with greater familial aggregation had a lower wGRS than sporadic cases (p = 0.0009) and male probands of familial cases (p = 0.04). An inverse correlation between wGRS and age at onset was observed (p = 0.05). The predictive performance of the genetic model including all known MS variants was modest but greater in sporadic vs familial cases (area under the curve = 0.63 and 0.57). Conclusions: Additional variants outside the known MS-associated loci, rare variants, and/or environmental factors may explain disease occurrence within families; in females, hormonal and epigenetic factors probably have a predominant role in explaining familial aggregation. The inclusion of these additional factors in future versions of aggregated genetic measures could improve their predictive ability.
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Affiliation(s)
- Federica Esposito
- Department of Neurology (F.E., C.G., L.F., M.P., M. Radaelli, B.C., L.M., M. Rodegher, V.M., G.C., F.M.B.) and Laboratory of Genetics of Neurological Complex Disorders (F.E., C.G., M.S., F.C., L.F., E.M., S.S., M.P., G.C., F.M.B.), Institute of Experimental Neurology, Division of Neuroscience, and Center for Translational Genomics and Bioinformatics (E.S.), San Raffaele Scientific Institute, Milan, Italy
| | - Clara Guaschino
- Department of Neurology (F.E., C.G., L.F., M.P., M. Radaelli, B.C., L.M., M. Rodegher, V.M., G.C., F.M.B.) and Laboratory of Genetics of Neurological Complex Disorders (F.E., C.G., M.S., F.C., L.F., E.M., S.S., M.P., G.C., F.M.B.), Institute of Experimental Neurology, Division of Neuroscience, and Center for Translational Genomics and Bioinformatics (E.S.), San Raffaele Scientific Institute, Milan, Italy
| | - Melissa Sorosina
- Department of Neurology (F.E., C.G., L.F., M.P., M. Radaelli, B.C., L.M., M. Rodegher, V.M., G.C., F.M.B.) and Laboratory of Genetics of Neurological Complex Disorders (F.E., C.G., M.S., F.C., L.F., E.M., S.S., M.P., G.C., F.M.B.), Institute of Experimental Neurology, Division of Neuroscience, and Center for Translational Genomics and Bioinformatics (E.S.), San Raffaele Scientific Institute, Milan, Italy
| | - Ferdinando Clarelli
- Department of Neurology (F.E., C.G., L.F., M.P., M. Radaelli, B.C., L.M., M. Rodegher, V.M., G.C., F.M.B.) and Laboratory of Genetics of Neurological Complex Disorders (F.E., C.G., M.S., F.C., L.F., E.M., S.S., M.P., G.C., F.M.B.), Institute of Experimental Neurology, Division of Neuroscience, and Center for Translational Genomics and Bioinformatics (E.S.), San Raffaele Scientific Institute, Milan, Italy
| | - Laura Ferre'
- Department of Neurology (F.E., C.G., L.F., M.P., M. Radaelli, B.C., L.M., M. Rodegher, V.M., G.C., F.M.B.) and Laboratory of Genetics of Neurological Complex Disorders (F.E., C.G., M.S., F.C., L.F., E.M., S.S., M.P., G.C., F.M.B.), Institute of Experimental Neurology, Division of Neuroscience, and Center for Translational Genomics and Bioinformatics (E.S.), San Raffaele Scientific Institute, Milan, Italy
| | - Elisabetta Mascia
- Department of Neurology (F.E., C.G., L.F., M.P., M. Radaelli, B.C., L.M., M. Rodegher, V.M., G.C., F.M.B.) and Laboratory of Genetics of Neurological Complex Disorders (F.E., C.G., M.S., F.C., L.F., E.M., S.S., M.P., G.C., F.M.B.), Institute of Experimental Neurology, Division of Neuroscience, and Center for Translational Genomics and Bioinformatics (E.S.), San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Santoro
- Department of Neurology (F.E., C.G., L.F., M.P., M. Radaelli, B.C., L.M., M. Rodegher, V.M., G.C., F.M.B.) and Laboratory of Genetics of Neurological Complex Disorders (F.E., C.G., M.S., F.C., L.F., E.M., S.S., M.P., G.C., F.M.B.), Institute of Experimental Neurology, Division of Neuroscience, and Center for Translational Genomics and Bioinformatics (E.S.), San Raffaele Scientific Institute, Milan, Italy
| | - Matteo Pagnesi
- Department of Neurology (F.E., C.G., L.F., M.P., M. Radaelli, B.C., L.M., M. Rodegher, V.M., G.C., F.M.B.) and Laboratory of Genetics of Neurological Complex Disorders (F.E., C.G., M.S., F.C., L.F., E.M., S.S., M.P., G.C., F.M.B.), Institute of Experimental Neurology, Division of Neuroscience, and Center for Translational Genomics and Bioinformatics (E.S.), San Raffaele Scientific Institute, Milan, Italy
| | - Marta Radaelli
- Department of Neurology (F.E., C.G., L.F., M.P., M. Radaelli, B.C., L.M., M. Rodegher, V.M., G.C., F.M.B.) and Laboratory of Genetics of Neurological Complex Disorders (F.E., C.G., M.S., F.C., L.F., E.M., S.S., M.P., G.C., F.M.B.), Institute of Experimental Neurology, Division of Neuroscience, and Center for Translational Genomics and Bioinformatics (E.S.), San Raffaele Scientific Institute, Milan, Italy
| | - Bruno Colombo
- Department of Neurology (F.E., C.G., L.F., M.P., M. Radaelli, B.C., L.M., M. Rodegher, V.M., G.C., F.M.B.) and Laboratory of Genetics of Neurological Complex Disorders (F.E., C.G., M.S., F.C., L.F., E.M., S.S., M.P., G.C., F.M.B.), Institute of Experimental Neurology, Division of Neuroscience, and Center for Translational Genomics and Bioinformatics (E.S.), San Raffaele Scientific Institute, Milan, Italy
| | - Lucia Moiola
- Department of Neurology (F.E., C.G., L.F., M.P., M. Radaelli, B.C., L.M., M. Rodegher, V.M., G.C., F.M.B.) and Laboratory of Genetics of Neurological Complex Disorders (F.E., C.G., M.S., F.C., L.F., E.M., S.S., M.P., G.C., F.M.B.), Institute of Experimental Neurology, Division of Neuroscience, and Center for Translational Genomics and Bioinformatics (E.S.), San Raffaele Scientific Institute, Milan, Italy
| | - Mariaemma Rodegher
- Department of Neurology (F.E., C.G., L.F., M.P., M. Radaelli, B.C., L.M., M. Rodegher, V.M., G.C., F.M.B.) and Laboratory of Genetics of Neurological Complex Disorders (F.E., C.G., M.S., F.C., L.F., E.M., S.S., M.P., G.C., F.M.B.), Institute of Experimental Neurology, Division of Neuroscience, and Center for Translational Genomics and Bioinformatics (E.S.), San Raffaele Scientific Institute, Milan, Italy
| | - Elia Stupka
- Department of Neurology (F.E., C.G., L.F., M.P., M. Radaelli, B.C., L.M., M. Rodegher, V.M., G.C., F.M.B.) and Laboratory of Genetics of Neurological Complex Disorders (F.E., C.G., M.S., F.C., L.F., E.M., S.S., M.P., G.C., F.M.B.), Institute of Experimental Neurology, Division of Neuroscience, and Center for Translational Genomics and Bioinformatics (E.S.), San Raffaele Scientific Institute, Milan, Italy
| | - Vittorio Martinelli
- Department of Neurology (F.E., C.G., L.F., M.P., M. Radaelli, B.C., L.M., M. Rodegher, V.M., G.C., F.M.B.) and Laboratory of Genetics of Neurological Complex Disorders (F.E., C.G., M.S., F.C., L.F., E.M., S.S., M.P., G.C., F.M.B.), Institute of Experimental Neurology, Division of Neuroscience, and Center for Translational Genomics and Bioinformatics (E.S.), San Raffaele Scientific Institute, Milan, Italy
| | - Giancarlo Comi
- Department of Neurology (F.E., C.G., L.F., M.P., M. Radaelli, B.C., L.M., M. Rodegher, V.M., G.C., F.M.B.) and Laboratory of Genetics of Neurological Complex Disorders (F.E., C.G., M.S., F.C., L.F., E.M., S.S., M.P., G.C., F.M.B.), Institute of Experimental Neurology, Division of Neuroscience, and Center for Translational Genomics and Bioinformatics (E.S.), San Raffaele Scientific Institute, Milan, Italy
| | - Filippo Martinelli Boneschi
- Department of Neurology (F.E., C.G., L.F., M.P., M. Radaelli, B.C., L.M., M. Rodegher, V.M., G.C., F.M.B.) and Laboratory of Genetics of Neurological Complex Disorders (F.E., C.G., M.S., F.C., L.F., E.M., S.S., M.P., G.C., F.M.B.), Institute of Experimental Neurology, Division of Neuroscience, and Center for Translational Genomics and Bioinformatics (E.S.), San Raffaele Scientific Institute, Milan, Italy
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148
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Mottron L, Duret P, Mueller S, Moore RD, Forgeot d'Arc B, Jacquemont S, Xiong L. Sex differences in brain plasticity: a new hypothesis for sex ratio bias in autism. Mol Autism 2015; 6:33. [PMID: 26052415 PMCID: PMC4456778 DOI: 10.1186/s13229-015-0024-1] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Accepted: 04/27/2015] [Indexed: 01/13/2023] Open
Abstract
Several observations support the hypothesis that differences in synaptic and regional cerebral plasticity between the sexes account for the high ratio of males to females in autism. First, males are more susceptible than females to perturbations in genes involved in synaptic plasticity. Second, sex-related differences in non-autistic brain structure and function are observed in highly variable regions, namely, the heteromodal associative cortices, and overlap with structural particularities and enhanced activity of perceptual associative regions in autistic individuals. Finally, functional cortical reallocations following brain lesions in non-autistic adults (for example, traumatic brain injury, multiple sclerosis) are sex-dependent. Interactions between genetic sex and hormones may therefore result in higher synaptic and consecutively regional plasticity in perceptual brain areas in males than in females. The onset of autism may largely involve mutations altering synaptic plasticity that create a plastic reaction affecting the most variable and sexually dimorphic brain regions. The sex ratio bias in autism may arise because males have a lower threshold than females for the development of this plastic reaction following a genetic or environmental event.
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Affiliation(s)
- Laurent Mottron
- Centre d'excellence en Troubles envahissants du dévelopement de l'Université de Montréal (CETEDUM), Montréal, Canada.,Hôpital Rivière-des-Prairies, Département de Psychiatrie, Montréal, Canada.,Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Québec, Canada.,Department of Psychiatry, University of Montreal, Québec, Canada
| | - Pauline Duret
- Centre d'excellence en Troubles envahissants du dévelopement de l'Université de Montréal (CETEDUM), Montréal, Canada.,Hôpital Rivière-des-Prairies, Département de Psychiatrie, Montréal, Canada.,Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Québec, Canada.,Department of Psychiatry, University of Montreal, Québec, Canada.,Département de Biologie, École Normale Supérieure de Lyon, Lyon, CEDEX 07 France
| | - Sophia Mueller
- Institute of Clinical Radiology, University Hospitals, Munich, Germany.,Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA 02129 USA.,Harvard University, Center for Brain Science, Cambridge, MA 02138 USA
| | - Robert D Moore
- Department of Psychiatry, University of Montreal, Québec, Canada.,Department of Health Sciences, University of Montreal, Montreal, Canada.,College of Applied Health Sciences, University of Illinois, Urbana-Champaign, USA
| | - Baudouin Forgeot d'Arc
- Centre d'excellence en Troubles envahissants du dévelopement de l'Université de Montréal (CETEDUM), Montréal, Canada.,Hôpital Rivière-des-Prairies, Département de Psychiatrie, Montréal, Canada.,Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Québec, Canada.,Department of Psychiatry, University of Montreal, Québec, Canada
| | - Sebastien Jacquemont
- Department of Psychiatry, University of Montreal, Québec, Canada.,Centre de recherche, Centre Hospitalier Universitaire Sainte Justine, Montréal, Canada.,Service of Medical Genetics, University Hospital of Lausanne, University of Lausanne, Lausanne, 1011 Switzerland
| | - Lan Xiong
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Québec, Canada.,Department of Psychiatry, University of Montreal, Québec, Canada
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149
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Airas L. Hormonal and gender-related immune changes in multiple sclerosis. Acta Neurol Scand 2015; 132:62-70. [PMID: 26046561 DOI: 10.1111/ane.12433] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2015] [Indexed: 01/10/2023]
Abstract
Similarly to many other autoimmune diseases, multiple sclerosis (MS) is more common among women than men, and its incidence among women is rising. There are also qualitative differences in the disease course between men and women, with male patients experiencing increased disease progression, brain atrophy, and cognitive impairment. During pregnancy, women with MS typically have a greatly reduced relapse rate, whereas very soon after the delivery, the disease activity returns, often even at a higher level than seen in the prepregnancy year. The reasons for the increased postpartum activity are not entirely clear, but factors such as the abrupt decrease in estrogen levels immediately after the delivery and the loss of the immunosuppressive state of pregnancy are likely of importance. There is compelling evidence that estrogen, progesterone, and testosterone control MS pathology by influencing immune responses and by contributing to repair mechanisms in the nervous system. Hormones may thus offer important insights into MS disease prevention and treatment. In this review, the possible reasons for the sex bias in autoimmune diseases will be discussed. The pregnancy-related alterations in MS, including the effect of pregnancy on disease activity, long-term disability accumulation, and prevalence will be reviewed, as well as the hormonal and immunological mechanisms potentially underlying these changes. Finally, the present thinking on the effect of hormones on the changing incidence of MS will be elucidated.
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Affiliation(s)
- L. Airas
- Division of Clinical Neurosciences; Turku University Hospital; Turku Finland
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150
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Sex-specific prediction of interferon beta therapy response in relapsing-remitting multiple sclerosis. J Clin Neurosci 2015; 22:986-9. [DOI: 10.1016/j.jocn.2014.11.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Accepted: 11/08/2014] [Indexed: 01/19/2023]
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