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Morris G, Reiche EMV, Murru A, Carvalho AF, Maes M, Berk M, Puri BK. Multiple Immune-Inflammatory and Oxidative and Nitrosative Stress Pathways Explain the Frequent Presence of Depression in Multiple Sclerosis. Mol Neurobiol 2018; 55:6282-6306. [PMID: 29294244 PMCID: PMC6061180 DOI: 10.1007/s12035-017-0843-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 12/14/2017] [Indexed: 12/21/2022]
Abstract
Patients with a diagnosis of multiple sclerosis (MS) or major depressive disorder (MDD) share a wide array of biological abnormalities which are increasingly considered to play a contributory role in the pathogenesis and pathophysiology of both illnesses. Shared abnormalities include peripheral inflammation, neuroinflammation, chronic oxidative and nitrosative stress, mitochondrial dysfunction, gut dysbiosis, increased intestinal barrier permeability with bacterial translocation into the systemic circulation, neuroendocrine abnormalities and microglial pathology. Patients with MS and MDD also display a wide range of neuroimaging abnormalities and patients with MS who display symptoms of depression present with different neuroimaging profiles compared with MS patients who are depression-free. The precise details of such pathology are markedly different however. The recruitment of activated encephalitogenic Th17 T cells and subsequent bidirectional interaction leading to classically activated microglia is now considered to lie at the core of MS-specific pathology. The presence of activated microglia is common to both illnesses although the pattern of such action throughout the brain appears to be different. Upregulation of miRNAs also appears to be involved in microglial neurotoxicity and indeed T cell pathology in MS but does not appear to play a major role in MDD. It is suggested that the antidepressant lofepramine, and in particular its active metabolite desipramine, may be beneficial not only for depressive symptomatology but also for the neurological symptoms of MS. One clinical trial has been carried out thus far with, in particular, promising MRI findings.
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Affiliation(s)
- Gerwyn Morris
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Barwon Health, Geelong, Australia
| | - Edna Maria Vissoci Reiche
- Department of Pathology, Clinical Analysis, and Toxicology, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
| | - Andrea Murru
- Bipolar Disorders Program, Hospital Clínic Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - André F Carvalho
- Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Michael Berk
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Barwon Health, Geelong, Australia
- Department of Psychiatry, Medical University Plovdiv, Plovdiv, Bulgaria
- Department of Psychiatry, Faculty of Medicine, State University of Londrina, Londrina, Brazil
- Revitalis, Waalre, The Netherlands
- Orygen - The National Centre of Excellence in Youth Mental Health, The Department of Psychiatry and the Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Parkville, Australia
| | - Basant K Puri
- Department of Medicine, Imperial College London, Hammersmith Hospital, London, UK.
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102
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Fominykh V, Vorobyeva A, Onufriev MV, Brylev L, Zakharova MN, Gulyaeva NV. Interleukin-6, S-Nitrosothiols, and Neurodegeneration in Different Central Nervous System Demyelinating Disorders: Is There a Relationship? J Clin Neurol 2018; 14:327-332. [PMID: 29856157 PMCID: PMC6031979 DOI: 10.3988/jcn.2018.14.3.327] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 02/10/2018] [Accepted: 02/13/2018] [Indexed: 12/22/2022] Open
Abstract
Background and Purpose A few groups have suggested that activated cytokines and nitrosative stress are closely involved in the pathogenesis of different demyelinating disorders induced by the neuroinflammatory destruction of neurons. The purpose of this study was to elucidate the associations of cytokines and S-nitrosothiols (RSNO) with the severity of neurodegeneration during relapse in demyelinating disorders of the central nervous system. Methods We measured levels of interleukin-6 (IL-6), erythropoietin, RSNO, and phosphorylated neurofilament heavy chain (pNfh) in cerebrospinal fluid (CSF) samples obtained from patients with different demyelinating disorders: multiple sclerosis (MS, n=52), acute disseminated encephalomyelitis (ADEM, n=9), and neuromyelitis optica spectrum disorders (NMOSD) with aquaporin-4 immunoglobulin G (AQP4-IgG, n=12). We compared these levels with those measured in a control group (n=24). Results We found that IL-6 in CSF was elevated in NMOSD with AQP4-IgG and ADEM patients as well as in MS patients after the destruction of soluble IL-6. Erythropoietin levels were lower in MS, while RSNO levels were higher in NMOSD with AQP4-IgG and MS patients than in the control group. CSF pNfh levels were elevated in MS and ADEM patients. Conclusions These results confirm that IL-6 is activated in different demyelinating disorders, with this elevation being more prominent in the CSF of NMOSD with AQP4-IgG and ADEM patients. Moreover, S-nitrosylation is activated in demyelinating disorders with spinal-cord injury and neurodegeneration in these patients. However, we found no correlation between these biochemical markers, and so we could not confirm whether IL-6-mediated nitric oxide production is involved in spinal-cord lesions.
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Affiliation(s)
- Vera Fominykh
- Institute of Higher Nervous Activity and Neurophysiology Russian Academy of Sciences, Department of Functional Biochemistry of the Nervous System, Moscow, Russia.,Bujanov Moscow City Clinical Hospital, Moscow, Russia.
| | - Anna Vorobyeva
- Research Center of Neurology, Volokolamskoe shosse, Moscow, Russia
| | - Mikhail V Onufriev
- Institute of Higher Nervous Activity and Neurophysiology Russian Academy of Sciences, Department of Functional Biochemistry of the Nervous System, Moscow, Russia
| | - Lev Brylev
- Institute of Higher Nervous Activity and Neurophysiology Russian Academy of Sciences, Department of Functional Biochemistry of the Nervous System, Moscow, Russia.,Bujanov Moscow City Clinical Hospital, Moscow, Russia
| | | | - Natalia V Gulyaeva
- Institute of Higher Nervous Activity and Neurophysiology Russian Academy of Sciences, Department of Functional Biochemistry of the Nervous System, Moscow, Russia
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103
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Brenner P, Granqvist M, Königsson J, Al Nimer F, Piehl F, Jokinen J. Depression and fatigue in multiple sclerosis: Relation to exposure to violence and cerebrospinal fluid immunomarkers. Psychoneuroendocrinology 2018; 89:53-58. [PMID: 29324301 DOI: 10.1016/j.psyneuen.2018.01.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 01/02/2018] [Accepted: 01/03/2018] [Indexed: 12/19/2022]
Abstract
Multiple sclerosis (MS) is a neuroinflammatory condition characterized by chronic dysregulation of immune responses leading to repeated episodes of inflammation in the central nervous system. Depression and fatigue are common among MS patients, even in early disease phases, and the disease course can be negatively affected by stressful events. IL-6 and IL-8 have been associated with depression and stressful life events in non-MS patients. The aim of this study was to examine the relationships between depression, fatigue, and exposure to violence, with IL-6 and IL-8 levels in the cerebrospinal fluid (CSF) of MS patients. Levels of IL-6 and -8 were analyzed in the CSF of 47 patients with relapsing-remitting MS. Correlations between IL-6 and IL-8 levels and self-rated depression and fatigue symptoms, as well as clinician-rated history of being exposed to interpersonal violence, were analyzed with correction for age, sex and MS disability status. IL-6 correlated significantly (p < 0.05) with depressive symptoms (adjusted Spearman's ρ = 0.39), fatigue (ρ = 0.39), and exposure to violence in adult life (ρ = 0.35). Depression correlated with both fatigue and being exposed to violence. Associations were not present among patients exposed to disease modifying drugs. In exploratory analyses, the relationship between exposure to violence and IL-6 was non-significant when controlled for depression. Further research should focus on replication of these results, as well as exploring the impact of stressful life events on immune regulation and the clinical characteristics and prognosis of MS patients.
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Affiliation(s)
- Philip Brenner
- Division of Psychiatry, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden.
| | - Mathias Granqvist
- Division of Neurology, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Johan Königsson
- Department of Clinical Sciences, Umeå University, SE-901 87, Umeå, Sweden
| | - Faiez Al Nimer
- Division of Neurology, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Fredrik Piehl
- Division of Neurology, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Jussi Jokinen
- Division of Psychiatry, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden; Department of Clinical Sciences, Umeå University, SE-901 87, Umeå, Sweden
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Kira JI. Reply to letter to the editor: Dimethyl fumarate for patients with neuromyelitis optica spectrum disorder by Pitarokoili and Gold. Mult Scler 2018; 24:366-367. [DOI: 10.1177/1352458517721978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Jun-ichi Kira
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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105
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Tong Y, Yang T, Wang J, Zhao T, Wang L, Kang Y, Cheng C, Fan Y. Elevated Plasma Chemokines for Eosinophils in Neuromyelitis Optica Spectrum Disorders during Remission. Front Neurol 2018; 9:44. [PMID: 29497397 PMCID: PMC5819570 DOI: 10.3389/fneur.2018.00044] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 01/18/2018] [Indexed: 01/13/2023] Open
Abstract
Background A prominent pathological feature of neuromyelitis optica spectrum disorders (NMOSD) is markedly greater eosinophilic infiltration than that seen in other demyelinating diseases, like multiple sclerosis (MS). Eosinophils express the chemokine receptor CCR3, which is activated by eotaxins (CCL11/eotaxin-1, CCL24/eotaxin-2, CCL26/eotaxin-3) and CCL13 [monocyte chemoattractant protein (MCP)-4]. Moreover, CCL13 is part of the chemokine set that activates CCR2. The present study aimed to evaluate plasma levels of eotaxins (CCL11, CCL24, and CCL26) and MCPs (CCL13, CCL2, CCL8, and CCL7) in patients with NMOSD during remission. Methods Healthy controls (HC; n = 30) and patients with MS (n = 47) and NMOSD (n = 58) in remission were consecutively enrolled in this study between January 2016 and August 2017. Plasma CCL11, CCL24, CCL26, CCL2, CCL8, CCL7, CCL13, tumor necrosis factor (TNF)-α, and interleukin (IL)-1β levels were detected using the human cytokine multiplex assay. Results Plasma CCL13, CCL11, and CCL26 levels were all significantly higher in patients with NMOSD than in HC and patients with MS. No significant differences were found in the CCL13, CCL11, or CCL26 levels between patients with NMOSD receiving and not receiving immunosuppressive therapy. The plasma levels of TNF-α and IL-1β, which stimulate the above chemokines, were higher in patients with NMOSD than in HC. There was no difference in CCL24 levels among the three groups. In most cases, the CCL7 levels were below the threshold value of the human cytokine multiplex assay, which is in line with other studies. Adjusted multiple regression analyses showed a positive association of CCL13 levels with the number of relapses after controlling gender, age, body mass index, and disease duration in patients with NMOSD. Conclusion The study indicates that in NMOSD, the overproduction of cytokines such as IL-1β and TNF-α during remission stimulates eosinophilic chemoattractants such as CCL13, CCL11, and CCL26, which in turn bind to their receptor (CCR3); this could lead to eosinophil hypersensitivity. These findings suggest that the elevated secretion of CCL13, CCL11, and CCL26 may be a critical step in eosinophil recruitment during NMOSD remission.
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Affiliation(s)
- Yanping Tong
- Department of Traditional Chinese Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,TCM Brain Research Institution, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Tao Yang
- Department of Traditional Chinese Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,TCM Brain Research Institution, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jingwen Wang
- First Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Tianyou Zhao
- Department of Traditional Chinese Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Lei Wang
- School of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Yuezhi Kang
- Department of Traditional Chinese Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Cuicui Cheng
- First Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Yongping Fan
- Department of Traditional Chinese Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,TCM Brain Research Institution, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Cerebrospinal fluid pentraxin 3 and CD40 ligand in anti- N -menthyl- d -aspartate receptor encephalitis. J Neuroimmunol 2018; 315:40-44. [DOI: 10.1016/j.jneuroim.2017.11.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 11/17/2017] [Accepted: 11/27/2017] [Indexed: 12/15/2022]
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107
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Hiltensperger M, Korn T. The Interleukin (IL)-23/T helper (Th)17 Axis in Experimental Autoimmune Encephalomyelitis and Multiple Sclerosis. Cold Spring Harb Perspect Med 2018; 8:cshperspect.a029637. [PMID: 29101111 DOI: 10.1101/cshperspect.a029637] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
T helper (Th)17 cells are responsible for host defense against fungi and certain extracellular bacteria but have also been reported to play a role in a variety of autoimmune diseases. Th17 cells respond to environmental cues, are very plastic, and might also be involved in tissue homeostasis and regeneration. The imprinting of pathogenic properties in Th17 cells in autoimmunity seems highly dependent on interleukin (IL)-23. Since Th17 cells were first described in experimental autoimmune encephalomyelitis, they have been suggested to also promote tissue damage in multiple sclerosis (MS). Indeed, some studies linked Th17 cells to disease severity in MS, and the efficacy of anti-IL-17A therapy in MS supported this idea. In this review, we will summarize molecular features of Th17 cells and discuss the evidence for their function in experimental models of autoimmune diseases and MS.
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Affiliation(s)
- Michael Hiltensperger
- Klinikum rechts der Isar, Department of Neurology, Technische Universität München, 81675 Munich, Germany
| | - Thomas Korn
- Klinikum rechts der Isar, Department of Neurology, Technische Universität München, 81675 Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), 81377 Munich, Germany
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108
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Abstract
Neuromyelitis optica (NMO) is a rare, disabling, sometimes fatal central nervous system inflammatory demyelinating disease that is associated with antibodies ("NMO IgG") that target the water channel protein aquaporin-4 (AQP4) expressed on astrocytes. There is considerable interest in identifying environmental triggers that may elicit production of NMO IgG by AQP4-reactive B cells. Although NMO is considered principally a humoral autoimmune disease, antibodies of NMO IgG are IgG1, a T-cell-dependent immunoglobulin subclass, indicating that AQP4-reactive T cells have a pivotal role in NMO pathogenesis. When AQP4-specific proliferative T cells were first identified in patients with NMO it was discovered that T cells recognizing the dominant AQP4 T-cell epitope exhibited a T helper 17 (Th17) phenotype and displayed cross-reactivity to a homologous peptide sequence within a protein of Clostridium perfringens, a commensal bacterium found in human gut flora. The initial analysis of gut microbiota in NMO demonstrated that, in comparison to healthy controls (HC) and patients with multiple sclerosis, the microbiome of NMO is distinct. Remarkably, C. perfringens was the second most significantly enriched taxon in NMO, and among bacteria identified at the species level, C. perfringens was the one most highly associated with NMO. Those discoveries, along with evidence that certain Clostridia in the gut can regulate the balance between regulatory T cells and Th17 cells, indicate that gut microbiota, and possibly C. perfringens itself, could participate in NMO pathogenesis. Collectively, the evidence linking microbiota to humoral and cellular immunity in NMO underscores the importance for further investigating this relationship.
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Affiliation(s)
- Scott S Zamvil
- Department of Neurology, University of California, San Francisco, CA, USA.
- Program in Immunology, University of California, San Francisco, CA, USA.
| | - Collin M Spencer
- Department of Neurology, University of California, San Francisco, CA, USA
| | - Sergio E Baranzini
- Department of Neurology, University of California, San Francisco, CA, USA
| | - Bruce A C Cree
- Department of Neurology, University of California, San Francisco, CA, USA
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109
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Kaskow BJ, Buttrick TS, Klein HU, White C, Bourgeois JR, Ferland RJ, Patsopoulos N, Bradshaw EM, De Jager PL, Elyaman W. MS AHI1 genetic risk promotes IFNγ + CD4 + T cells. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2017; 5:e414. [PMID: 29379820 PMCID: PMC5778810 DOI: 10.1212/nxi.0000000000000414] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 09/18/2017] [Indexed: 01/30/2023]
Abstract
Objective To study the influence of the Abelson helper integration site 1 (AHI1) locus associated with MS susceptibility on CD4+ T cell function. Methods We characterized the chromatin state of T cells in the MS-associated AHI1 linkage disequilibrium (LD) block. The expression and the role of the AHI1 variant were examined in T cells from genotyped healthy subjects who were recruited from the PhenoGenetic Project, and the function of AHI1 was explored using T cells from Ahi1 knockout mice. Results Chromatin state analysis reveals that the LD block containing rs4896153, which is robustly associated with MS susceptibility (odds ratio 1.15, p = 1.65 × 10-13), overlaps with strong enhancer regions that are present in human naive and memory CD4+ T cells. Relative to the rs4896153A protective allele, the rs4896153T susceptibility allele is associated with decreased AHI1 mRNA expression, specifically in naive CD4+ T cells (p = 1.73 × 10-74, n = 213), and we replicate this effect in an independent set of subjects (p = 2.5 × 10-9, n = 32). Functional studies then showed that the rs4896153T risk variant and the subsequent decreased AHI1 expression were associated with reduced CD4+ T cell proliferation and a specific differentiation into interferon gamma (IFNγ)-positive T cells when compared with the protective rs4896153A allele. This T cell phenotype was also observed in murine CD4+ T cells with genetic deletion of Ahi1. Conclusions Our findings suggest that the effect of the AHI1 genetic risk for MS is mediated, in part, by enhancing the development of proinflammatory IFNγ+ T cells that have previously been implicated in MS and its mouse models.
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Affiliation(s)
- Belinda J Kaskow
- Ann Romney Center for Neurologic Diseases (B.J.K., T.S.B., N.P.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Translational and Computational Neuroimmunology (H.-U.K., E.M.B., P.L.D.J., W.E.), Department of Neurology, Columbia University Medical Center, New York, NY; Program in Medical and Population Genetics (H.-U.K., C.W., E.M.B., P.L.D.J., W.E.), Broad Institute, Cambridge, MA; and Departments of Neuroscience and Experimental Therapeutics, and Neurology (J.R.B., R.J.F.), Albany Medical College, Albany, NY
| | - Thomas S Buttrick
- Ann Romney Center for Neurologic Diseases (B.J.K., T.S.B., N.P.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Translational and Computational Neuroimmunology (H.-U.K., E.M.B., P.L.D.J., W.E.), Department of Neurology, Columbia University Medical Center, New York, NY; Program in Medical and Population Genetics (H.-U.K., C.W., E.M.B., P.L.D.J., W.E.), Broad Institute, Cambridge, MA; and Departments of Neuroscience and Experimental Therapeutics, and Neurology (J.R.B., R.J.F.), Albany Medical College, Albany, NY
| | - Hans-Ulrich Klein
- Ann Romney Center for Neurologic Diseases (B.J.K., T.S.B., N.P.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Translational and Computational Neuroimmunology (H.-U.K., E.M.B., P.L.D.J., W.E.), Department of Neurology, Columbia University Medical Center, New York, NY; Program in Medical and Population Genetics (H.-U.K., C.W., E.M.B., P.L.D.J., W.E.), Broad Institute, Cambridge, MA; and Departments of Neuroscience and Experimental Therapeutics, and Neurology (J.R.B., R.J.F.), Albany Medical College, Albany, NY
| | - Charles White
- Ann Romney Center for Neurologic Diseases (B.J.K., T.S.B., N.P.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Translational and Computational Neuroimmunology (H.-U.K., E.M.B., P.L.D.J., W.E.), Department of Neurology, Columbia University Medical Center, New York, NY; Program in Medical and Population Genetics (H.-U.K., C.W., E.M.B., P.L.D.J., W.E.), Broad Institute, Cambridge, MA; and Departments of Neuroscience and Experimental Therapeutics, and Neurology (J.R.B., R.J.F.), Albany Medical College, Albany, NY
| | - Justin R Bourgeois
- Ann Romney Center for Neurologic Diseases (B.J.K., T.S.B., N.P.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Translational and Computational Neuroimmunology (H.-U.K., E.M.B., P.L.D.J., W.E.), Department of Neurology, Columbia University Medical Center, New York, NY; Program in Medical and Population Genetics (H.-U.K., C.W., E.M.B., P.L.D.J., W.E.), Broad Institute, Cambridge, MA; and Departments of Neuroscience and Experimental Therapeutics, and Neurology (J.R.B., R.J.F.), Albany Medical College, Albany, NY
| | - Russell J Ferland
- Ann Romney Center for Neurologic Diseases (B.J.K., T.S.B., N.P.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Translational and Computational Neuroimmunology (H.-U.K., E.M.B., P.L.D.J., W.E.), Department of Neurology, Columbia University Medical Center, New York, NY; Program in Medical and Population Genetics (H.-U.K., C.W., E.M.B., P.L.D.J., W.E.), Broad Institute, Cambridge, MA; and Departments of Neuroscience and Experimental Therapeutics, and Neurology (J.R.B., R.J.F.), Albany Medical College, Albany, NY
| | - Nikolaos Patsopoulos
- Ann Romney Center for Neurologic Diseases (B.J.K., T.S.B., N.P.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Translational and Computational Neuroimmunology (H.-U.K., E.M.B., P.L.D.J., W.E.), Department of Neurology, Columbia University Medical Center, New York, NY; Program in Medical and Population Genetics (H.-U.K., C.W., E.M.B., P.L.D.J., W.E.), Broad Institute, Cambridge, MA; and Departments of Neuroscience and Experimental Therapeutics, and Neurology (J.R.B., R.J.F.), Albany Medical College, Albany, NY
| | - Elizabeth M Bradshaw
- Ann Romney Center for Neurologic Diseases (B.J.K., T.S.B., N.P.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Translational and Computational Neuroimmunology (H.-U.K., E.M.B., P.L.D.J., W.E.), Department of Neurology, Columbia University Medical Center, New York, NY; Program in Medical and Population Genetics (H.-U.K., C.W., E.M.B., P.L.D.J., W.E.), Broad Institute, Cambridge, MA; and Departments of Neuroscience and Experimental Therapeutics, and Neurology (J.R.B., R.J.F.), Albany Medical College, Albany, NY
| | - Philip L De Jager
- Ann Romney Center for Neurologic Diseases (B.J.K., T.S.B., N.P.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Translational and Computational Neuroimmunology (H.-U.K., E.M.B., P.L.D.J., W.E.), Department of Neurology, Columbia University Medical Center, New York, NY; Program in Medical and Population Genetics (H.-U.K., C.W., E.M.B., P.L.D.J., W.E.), Broad Institute, Cambridge, MA; and Departments of Neuroscience and Experimental Therapeutics, and Neurology (J.R.B., R.J.F.), Albany Medical College, Albany, NY
| | - Wassim Elyaman
- Ann Romney Center for Neurologic Diseases (B.J.K., T.S.B., N.P.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Translational and Computational Neuroimmunology (H.-U.K., E.M.B., P.L.D.J., W.E.), Department of Neurology, Columbia University Medical Center, New York, NY; Program in Medical and Population Genetics (H.-U.K., C.W., E.M.B., P.L.D.J., W.E.), Broad Institute, Cambridge, MA; and Departments of Neuroscience and Experimental Therapeutics, and Neurology (J.R.B., R.J.F.), Albany Medical College, Albany, NY
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Kong BS, Kim Y, Kim GY, Hyun JW, Kim SH, Jeong A, Kim HJ. Increased frequency of IL-6-producing non-classical monocytes in neuromyelitis optica spectrum disorder. J Neuroinflammation 2017; 14:191. [PMID: 28946890 PMCID: PMC5613387 DOI: 10.1186/s12974-017-0961-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 09/06/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune inflammatory disease of the central nervous system that preferentially affects the optic nerves, spinal cord, and area postrema. A series of evidence suggested that B cells play a fundamental role in the pathogenesis of NMOSD. However, there are still gaps left to be answered in NMOSD pathogenesis suggesting the roles of other immune cells. This study aimed to investigate the monocyte inflammatory characteristics, monocyte subset frequency and cytokine production, and cell-surface molecule expression in NMOSD, multiple sclerosis (MS), and healthy controls (HC). METHODS Peripheral blood mononuclear cells of 20 aquaporin 4IgG-positive NMOSD patients, 20 MS patients, and 20 healthy controls were collected to analyze the monocyte subsets and to purify monocytes. To mimic the adaptive immunity, we have activated the monocytes using CD40L and IFN-γ to observe the production of cytokines and expression of cell-surface molecules. RESULTS NMOSD monocytes showed a remarkable increase in the production of pro-inflammatory cytokines (IL-6, IL-1β) and increased expression of cell-surface molecules (CD80, HLA, ICAM-1, CD16), as well as a decrease in the levels of anti-inflammatory cytokine IL-10, compared to healthy control (HC) monocytes. As expected, MS monocytes also exhibit increased inflammatory cytokine production and increased cell-surface molecule expression compared to HC monocytes. Further analysis of monocyte subsets revealed that NMOSD monocytes have an increased frequency of the non-classical monocyte subset (CD14+CD16++) and a decreased frequency of the classical monocyte subset (CD14++CD16+) compared to HC monocytes. This finding was distinctly different from that of MS monocytes, which had an increased intermediate monocyte (CD14+CD16+) subset. In addition, these NMOSD non-classical monocyte subsets were highly dedicated, IL-6-producing monocytes. CONCLUSIONS Increased expression of cell-surface molecules and a reciprocal dysregulation of inflammatory and anti-inflammatory cytokines in NMOSD monocytes suggest an altered monocyte inflammatory response. CD14+CD16++ non-classical monocyte subset was more abundant in NMOSD monocytes than in HC or MS monocytes, and NMOSD non-classical monocyte subset had dysregulated IL-6 production, a phenotype which has been reported to be highly associated with NMOSD pathogenesis.
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Affiliation(s)
- Byung Soo Kong
- Division of Clinical Research, Research Institute and Hospital of the National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, 10408, South Korea
| | - Yeseul Kim
- Division of Clinical Research, Research Institute and Hospital of the National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, 10408, South Korea
| | - Ga Young Kim
- Division of Clinical Research, Research Institute and Hospital of the National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, 10408, South Korea
| | - Jae-Won Hyun
- Department of Neurology, Research Institute and Hospital of the National Cancer Center, Goyang, South Korea
| | - Su-Hyun Kim
- Department of Neurology, Research Institute and Hospital of the National Cancer Center, Goyang, South Korea
| | - Aeran Jeong
- Department of Neurology, Research Institute and Hospital of the National Cancer Center, Goyang, South Korea
| | - Ho Jin Kim
- Division of Clinical Research, Research Institute and Hospital of the National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, 10408, South Korea. .,Department of Neurology, Research Institute and Hospital of the National Cancer Center, Goyang, South Korea.
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Domingues RB, Fernandes GBP, Leite FBVDM, Tilbery CP, Thomaz RB, Silva GS, Mangueira CLP, Soares CAS. The cerebrospinal fluid in multiple sclerosis: far beyond the bands. EINSTEIN-SAO PAULO 2017; 15:100-104. [PMID: 28444098 PMCID: PMC5433316 DOI: 10.1590/s1679-45082017rw3706] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 08/18/2016] [Indexed: 11/21/2022] Open
Abstract
The cerebrospinal fluid analysis has been employed for supporting multiple sclerosis diagnosis and ruling out the differential diagnoses. The most classical findings reflect the inflammatory nature of the disease, including mild pleocytosis, mild protein increase, intrathecal synthesis of immunoglobulin G, and, most typically, the presence of oligoclonal bands. In recent years, new biomarkers have emerged in the context of multiple sclerosis. The search for new biomarkers reflect the need of a better evaluation of disease activity, disease progression, and treatment efficiency. A more refined evaluation of disease and therapy status can contribute to better therapeutic choices, particularly in escalation of therapies. This is very relevant taking into account the availability of a greater number of drugs for multiple sclerosis treatment in recent years. In this review, we critically evaluate the current literature regarding the most important cerebrospinal fluid biomarkers in multiple sclerosis. The determination of biomarkers levels, such as chemokine ligand 13, fetuin A, and mainly light neurofilament has shown promising results in the evaluation of this disease, providing information that along with clinical and neuroimaging data may contribute to better therapeutic decisions.
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Ikeguchi R, Shimizu Y, Shimizu S, Kitagawa K. CSF and clinical data are useful in differentiating CNS inflammatory demyelinating disease from CNS lymphoma. Mult Scler 2017; 24:1212-1223. [DOI: 10.1177/1352458517717804] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: It is often difficult to diagnose central nervous system (CNS) inflammatory demyelinating diseases (IDDs) because they are similar to CNS lymphoma and glioma. Objective: To evaluate whether cerebrospinal fluid (CSF) analysis can differentiate CNS IDDs from CNS lymphoma and glioma. Methods: We measured CSF cell counts; concentrations of proteins, glucose, interleukin (IL)-6, IL-10, soluble IL-2 receptor (sIL-2R), and myelin basic protein; and IgG index in patients with multiple sclerosis (MS, n = 64), neuromyelitis optica spectrum disorder (NMOSD, n = 35), tumefactive demyelinating lesion (TDL, n = 17), CNS lymphoma ( n = 12), or glioma ( n = 10). We detected diagnostic markers using logistic regression and receiver operating characteristic (ROC) analyses. Results: Median CSF IL-10 and sIL-2R levels were higher in CNS lymphoma patients than in MS, NMOSD, or TDL patients. Logistic regression revealed that CSF sIL-2R levels predicted CNS lymphoma. In the ROC analysis of CSF sIL-2R levels, the area under the curve was 0.867, and the sensitivity and specificity were 83.3% and 90.0%, respectively. Conclusion: CSF sIL-2R levels can be used to differentiate CNS lymphoma from CNS IDDs. Further studies may identify other applications of CSF as a diagnostic biomarker.
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Affiliation(s)
- Ryotaro Ikeguchi
- Department of Neurology, School of Medicine, Tokyo Women’s Medical University, Tokyo, Japan
| | - Yuko Shimizu
- Department of Neurology, School of Medicine, Tokyo Women’s Medical University, Tokyo, Japan
| | - Satoru Shimizu
- Medical Research Institute, Tokyo Women’s Medical University, Tokyo, Japan
| | - Kazuo Kitagawa
- Department of Neurology, School of Medicine, Tokyo Women’s Medical University, Tokyo, Japan
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Gahlen A, Trampe AK, Haupeltshofer S, Ringelstein M, Aktas O, Berthele A, Wildemann B, Gold R, Jarius S, Kleiter I. Aquaporin-4 antibodies in patients treated with natalizumab for suspected MS. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2017. [PMID: 28642888 PMCID: PMC5473957 DOI: 10.1212/nxi.0000000000000363] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Objective: To evaluate (1) the frequency of aquaporin-4 antibody (AQP4-ab)-seropositive cases among patients treated with natalizumab (NAT) and previously diagnosed with MS (MSNAT) in a nationwide cohort, (2) the clinical course of NAT-treated AQP4-ab–seropositive neuromyelitis optica spectrum disorder (NMOSD) patients (NMONAT), (3) AQP4-ab titers in NMONAT and AQP4-ab–seropositive NMOSD treated with other immunotherapies (NMOIT), and (4) immune mechanisms influencing disease activity in NMONAT. Methods: MSNAT serum samples were retrospectively screened with a cell-based assay for AQP4-IgG and titers determined by ELISA. The annualized relapse rate (ARR) and disability progression were assessed. Serum levels of proinflammatory cytokines (interleukin [IL]-1β, IL-4, IL-6, IL-8, IL-10, IL-17, IL-21, and interferon [IFN]-γ) and the chemokine CXCL-10 of NMONAT patients identified in this (n = 4) and a previous study (n = 5) were measured by cytometric bead array and ELISA. Results: Of the 1,183 MSNAT patients (851 female, median 9 NAT infusions), only 4 (0.33%; 3 female, 1 male) had AQP4-IgG. Of these, 2 fulfilled the 2006 NMO criteria and all met the 2015 NMOSD criteria. The ARR was higher in NMONAT vs MSNAT (p = 0.0182). All 4 NMONAT patients had relapses and 2 had an increase of disability. AQP4-ab titers were higher in NMONAT (n = 9) vs NMOIT (n = 13; p = 0.0059). IL-8, IL-1β, and IFN-γ serum levels were significantly higher, and CXCL-10 was significantly lower in NMONAT vs NMOIT. Conclusions: Misdiagnosis of NMOSD with MS is rare. NAT was not able to control disease activity in NMONAT patients, who had higher serum levels of AQP4-IgG and proinflammatory cytokines than patients with NMOSD treated with other immunotherapies.
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Affiliation(s)
- Anna Gahlen
- Department of Neurology (A.G., A.-K.T., S.H., R.G., I.K.), St. Josef-Hospital, Ruhr-University Bochum; Department of Neurology (M.R., O.A.), Medical Faculty, Heinrich-Heine-University Düsseldorf; Department of Neurology (A.B.), Klinikum Rechts der Isar, Technische Universität München; and Molecular Neuroimmunology Group (B.W., S.J.), Department of Neurology, University of Heidelberg, Germany
| | - Anne-Kathrin Trampe
- Department of Neurology (A.G., A.-K.T., S.H., R.G., I.K.), St. Josef-Hospital, Ruhr-University Bochum; Department of Neurology (M.R., O.A.), Medical Faculty, Heinrich-Heine-University Düsseldorf; Department of Neurology (A.B.), Klinikum Rechts der Isar, Technische Universität München; and Molecular Neuroimmunology Group (B.W., S.J.), Department of Neurology, University of Heidelberg, Germany
| | - Steffen Haupeltshofer
- Department of Neurology (A.G., A.-K.T., S.H., R.G., I.K.), St. Josef-Hospital, Ruhr-University Bochum; Department of Neurology (M.R., O.A.), Medical Faculty, Heinrich-Heine-University Düsseldorf; Department of Neurology (A.B.), Klinikum Rechts der Isar, Technische Universität München; and Molecular Neuroimmunology Group (B.W., S.J.), Department of Neurology, University of Heidelberg, Germany
| | - Marius Ringelstein
- Department of Neurology (A.G., A.-K.T., S.H., R.G., I.K.), St. Josef-Hospital, Ruhr-University Bochum; Department of Neurology (M.R., O.A.), Medical Faculty, Heinrich-Heine-University Düsseldorf; Department of Neurology (A.B.), Klinikum Rechts der Isar, Technische Universität München; and Molecular Neuroimmunology Group (B.W., S.J.), Department of Neurology, University of Heidelberg, Germany
| | - Orhan Aktas
- Department of Neurology (A.G., A.-K.T., S.H., R.G., I.K.), St. Josef-Hospital, Ruhr-University Bochum; Department of Neurology (M.R., O.A.), Medical Faculty, Heinrich-Heine-University Düsseldorf; Department of Neurology (A.B.), Klinikum Rechts der Isar, Technische Universität München; and Molecular Neuroimmunology Group (B.W., S.J.), Department of Neurology, University of Heidelberg, Germany
| | - Achim Berthele
- Department of Neurology (A.G., A.-K.T., S.H., R.G., I.K.), St. Josef-Hospital, Ruhr-University Bochum; Department of Neurology (M.R., O.A.), Medical Faculty, Heinrich-Heine-University Düsseldorf; Department of Neurology (A.B.), Klinikum Rechts der Isar, Technische Universität München; and Molecular Neuroimmunology Group (B.W., S.J.), Department of Neurology, University of Heidelberg, Germany
| | - Brigitte Wildemann
- Department of Neurology (A.G., A.-K.T., S.H., R.G., I.K.), St. Josef-Hospital, Ruhr-University Bochum; Department of Neurology (M.R., O.A.), Medical Faculty, Heinrich-Heine-University Düsseldorf; Department of Neurology (A.B.), Klinikum Rechts der Isar, Technische Universität München; and Molecular Neuroimmunology Group (B.W., S.J.), Department of Neurology, University of Heidelberg, Germany
| | - Ralf Gold
- Department of Neurology (A.G., A.-K.T., S.H., R.G., I.K.), St. Josef-Hospital, Ruhr-University Bochum; Department of Neurology (M.R., O.A.), Medical Faculty, Heinrich-Heine-University Düsseldorf; Department of Neurology (A.B.), Klinikum Rechts der Isar, Technische Universität München; and Molecular Neuroimmunology Group (B.W., S.J.), Department of Neurology, University of Heidelberg, Germany
| | - Sven Jarius
- Department of Neurology (A.G., A.-K.T., S.H., R.G., I.K.), St. Josef-Hospital, Ruhr-University Bochum; Department of Neurology (M.R., O.A.), Medical Faculty, Heinrich-Heine-University Düsseldorf; Department of Neurology (A.B.), Klinikum Rechts der Isar, Technische Universität München; and Molecular Neuroimmunology Group (B.W., S.J.), Department of Neurology, University of Heidelberg, Germany
| | - Ingo Kleiter
- Department of Neurology (A.G., A.-K.T., S.H., R.G., I.K.), St. Josef-Hospital, Ruhr-University Bochum; Department of Neurology (M.R., O.A.), Medical Faculty, Heinrich-Heine-University Düsseldorf; Department of Neurology (A.B.), Klinikum Rechts der Isar, Technische Universität München; and Molecular Neuroimmunology Group (B.W., S.J.), Department of Neurology, University of Heidelberg, Germany
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Yamasaki R, Yamaguchi H, Matsushita T, Fujii T, Hiwatashi A, Kira JI. Early strong intrathecal inflammation in cerebellar type multiple system atrophy by cerebrospinal fluid cytokine/chemokine profiles: a case control study. J Neuroinflammation 2017; 14:89. [PMID: 28438224 PMCID: PMC5404297 DOI: 10.1186/s12974-017-0863-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 04/14/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The pathology of multiple system atrophy cerebellar-type (MSA-C) includes glial inflammation; however, cerebrospinal fluid (CSF) inflammatory cytokine profiles have not been investigated. In this study, we determined CSF cytokine/chemokine/growth factor profiles in MSA-C and compared them with those in hereditary spinocerebellar ataxia (SCA). METHODS We collected clinical data and CSF from 20 MSA-C patients, 12 hereditary SCA patients, and 15 patients with other non-inflammatory neurological diseases (OND), and measured 27 cytokines/chemokines/growth factors using a multiplexed fluorescent bead-based immunoassay. The size of each part of the hindbrain and hot cross bun sign (HCBS) in the pons was studied by magnetic resonance imaging. RESULTS Granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin (IL)-6, IL-7, IL-12, and IL-13 levels were significantly higher in MSA-C and SCA compared with OND. In MSA-C, IL-5, IL-6, IL-9, IL-12, IL-13, platelet-derived growth factor-bb, macrophage inflammatory protein (MIP)-1α, and GM-CSF levels positively correlated with anteroposterior diameters of the pontine base, vermis, or medulla oblongata. By contrast, in SCA patients, IL-12 and MIP-1α showed significant negative correlations with anteroposterior diameters of the pontine base, and unlike MSA-C, there was no cytokine with a positive correlation in SCA. IL-6 was significantly higher in MSA-C patients with the lowest grade of HCBS compared with those with the highest grade. Macrophage chemoattractant protein-1 (MCP-1) had a significant negative correlation with disease duration only in MSA-C patients. Tumor necrosis factor-alpha, IL-2, IL-15, IL-4, IL-5, IL-10, and IL-8 were all significantly lower in MSA-C and SCA compared with OND, while IL-1ra, an anti-inflammatory cytokine, was elevated only in MSA-C. IL-1β and IL-8 had positive correlations with Unified Multiple System Atrophy Rating Scale part 1 and 2, respectively, in MSA-C. CONCLUSIONS Although CSF cytokine/chemokine/growth factor profiles were similar between MSA-C and SCA, pro-inflammatory cytokines, such as IL-6, GM-CSF, and MCP-1, correlated with the disease stage in a way higher at the beginning only in MSA-C, reflecting early stronger intrathecal inflammation.
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Affiliation(s)
- Ryo Yamasaki
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan.
| | - Hiroo Yamaguchi
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Takuya Matsushita
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Takayuki Fujii
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Akio Hiwatashi
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Jun-Ichi Kira
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
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Kimura A, Takemura M, Saito K, Serrero G, Yoshikura N, Hayashi Y, Inuzuka T. Increased cerebrospinal fluid progranulin correlates with interleukin-6 in the acute phase of neuromyelitis optica spectrum disorder. J Neuroimmunol 2017; 305:175-181. [DOI: 10.1016/j.jneuroim.2017.01.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Revised: 12/26/2016] [Accepted: 01/11/2017] [Indexed: 01/16/2023]
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Casserly CS, Nantes JC, Whittaker Hawkins RF, Vallières L. Neutrophil perversion in demyelinating autoimmune diseases: Mechanisms to medicine. Autoimmun Rev 2017; 16:294-307. [DOI: 10.1016/j.autrev.2017.01.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 11/29/2016] [Indexed: 12/12/2022]
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117
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Modulation of Neuroinflammation in the Central Nervous System: Role of Chemokines and Sphingolipids. Adv Ther 2017; 34:396-420. [PMID: 28054310 DOI: 10.1007/s12325-016-0474-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Indexed: 12/16/2022]
Abstract
Neuroinflammation is a process involved in the pathogenesis of different disorders, both autoimmune, such as neuropsychiatric systemic lupus erythematosus, and degenerative, such as Alzheimer's and Parkinson's disease. In the central nervous system, the local milieu is tightly regulated by different mediators, among which are chemoattractant cytokines, also known as chemokines. These small molecules are able to modulate trafficking of immune cells in the course of nervous system development or in response to tissue damage, and different patterns of chemokine molecule and receptor expression have been described in several neuroinflammatory disorders. In recent years, a number of studies have highlighted a pivotal role of sphingolipids in regulating neuroinflammation. Sphingolipids have different functions, among which are the control of leukocyte egress from lymphonodes into inflamed tissues, the expression of various mediators of inflammation and a direct effect on the cells of the central nervous system as regulators of neuroinflammation. In the future, a better knowledge of these two groups of mediators could provide insight into the pathogenesis of neuroinflammatory disorders and could help develop novel diagnostic tools and therapeutic strategies.
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Ghaffari SA, Nemati M, Hajghani H, Ebrahimi H, Sheikhi A, Jafarzadeh A. Circulating concentrations of interleukin (IL)-17 in patients with multiple sclerosis: Evaluation of the effects of gender, treatment, disease patterns and IL-23 receptor gene polymorphisms. IRANIAN JOURNAL OF NEUROLOGY 2017; 16:15-25. [PMID: 28717429 PMCID: PMC5506751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background: Interleukin (IL)-17/IL-23 axis performs a prominent role in the pathogenesis of several autoimmune disorders. This study aimed to investigate the concentrations of IL-17 in patients with multiple sclerosis (MS) and its relationship with gender, medication, disease forms and single nucleotide polymorphisms (SNP) in IL-23R gene, including rs11209026 and rs1004819. Methods: The blood specimens were obtained from 135 healthy individuals and 135 MS patients. The patients exhibited relapsing-remitting (RRMS; n = 65), primary progressive (PPMS; n = 19), secondary progressive (SPMS; n = 35) or progressive relapsing (PRMS; n = 14) MS. The DNA was analyzed for SNPs using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and IL-17 concentrations were measured by enzyme-linked immunosorbent assay (ELISA). Results: We have observed elevated serum IL-17 concentrations in MS patients compared with healthy individuals (P < 0.001). The men with MS had higher IL-17 concentrations than women patients (P < 0.050). Untreated patients had significantly higher IL-17 concentrations than healthy individuals and treated patients (P < 0.001 and P < 0.010, respectively). The IL-17 concentrations were significantly decreased in patients treated with interferon-β (IFN-β), methylprednisolone or both drugs as compared with untreated MS patients (P < 0.050, P < 0.020 and P < 0.050, respectively). The IL-17 concentrations were also significantly higher in patients with RRMS and PRMS compared with healthy individuals (P < 0.005 and P < 0.010, respectively). The genetic variations at SNPs rs11209026 and rs1004819 were not significantly different between healthy individuals and patients. The IL-17 concentrations were not influenced by genetic variations at investigated SNPs. Conclusion: These results indicated higher levels of IL-17 in MS patients that may be influenced by disease patterns, medication and gender. No association was observed between investigated SNPs and MS.
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Affiliation(s)
- Seyed Ali Ghaffari
- Neurology Research Center, Department of Neurology, Kerman University of Medical Sciences, Kerman, Iran ,Department of Laboratory Sciences, School of Paramedicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Nemati
- Neurology Research Center, Department of Neurology, Kerman University of Medical Sciences, Kerman, Iran
| | - Hossain Hajghani
- Neurology Research Center, Department of Neurology, Kerman University of Medical Sciences, Kerman, Iran
| | - Hossainali Ebrahimi
- Neurology Research Center, Department of Neurology, Kerman University of Medical Sciences, Kerman, Iran
| | - Abdolkarim Sheikhi
- Department of Immunology, School of Medicine, Dezful University of Medical Sciences, Dezful, Iran
| | - Abdollah Jafarzadeh
- Molecular Medicine Research Center, Department of Immunology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran,Department of Immunology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
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Tolerance checkpoint bypass permits emergence of pathogenic T cells to neuromyelitis optica autoantigen aquaporin-4. Proc Natl Acad Sci U S A 2016; 113:14781-14786. [PMID: 27940915 DOI: 10.1073/pnas.1617859114] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Aquaporin-4 (AQP4)-specific T cells are expanded in neuromyelitis optica (NMO) patients and exhibit Th17 polarization. However, their pathogenic role in CNS autoimmune inflammatory disease is unclear. Although multiple AQP4 T-cell epitopes have been identified in WT C57BL/6 mice, we observed that neither immunization with those determinants nor transfer of donor T cells targeting them caused CNS autoimmune disease in recipient mice. In contrast, robust proliferation was observed following immunization of AQP4-deficient (AQP4-/-) mice with AQP4 peptide (p) 135-153 or p201-220, peptides predicted to contain I-Ab-restricted T-cell epitopes but not identified in WT mice. In comparison with WT mice, AQP4-/- mice used unique T-cell receptor repertoires for recognition of these two AQP4 epitopes. Donor T cells specific for either determinant from AQP4-/-, but not WT, mice induced paralysis in recipient WT and B-cell-deficient mice. AQP4-specific Th17-polarized cells induced more severe disease than Th1-polarized cells. Clinical signs were associated with opticospinal infiltrates of T cells and monocytes. Fluorescent-labeled donor T cells were detected in CNS lesions. Visual system involvement was evident by changes in optical coherence tomography. Fine mapping of AQP4 p201-220 and p135-153 epitopes identified peptides within p201-220 but not p135-153, which induced clinical disease in 40% of WT mice by direct immunization. Our results provide a foundation to evaluate how AQP4-specific T cells contribute to AQP4-targeted CNS autoimmunity (ATCA) and suggest that pathogenic AQP4-specific T-cell responses are normally restrained by central tolerance, which may be relevant to understanding development of AQP4-reactive T cells in NMO.
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Th9 cells in the pathogenesis of EAE and multiple sclerosis. Semin Immunopathol 2016; 39:79-87. [DOI: 10.1007/s00281-016-0604-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 11/01/2016] [Indexed: 01/06/2023]
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121
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Gerwien H, Hermann S, Zhang X, Korpos E, Song J, Kopka K, Faust A, Wenning C, Gross CC, Honold L, Melzer N, Opdenakker G, Wiendl H, Schafers M, Sorokin L. Imaging matrix metalloproteinase activity in multiple sclerosis as a specific marker of leukocyte penetration of the blood-brain barrier. Sci Transl Med 2016; 8:364ra152. [DOI: 10.1126/scitranslmed.aaf8020] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 10/03/2016] [Indexed: 12/19/2022]
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Utility of CSF Cytokine/Chemokines as Markers of Active Intrathecal Inflammation: Comparison of Demyelinating, Anti-NMDAR and Enteroviral Encephalitis. PLoS One 2016; 11:e0161656. [PMID: 27575749 PMCID: PMC5004915 DOI: 10.1371/journal.pone.0161656] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 08/09/2016] [Indexed: 12/11/2022] Open
Abstract
Background Despite the discovery of CSF and serum diagnostic autoantibodies in autoimmune encephalitis, there are still very limited CSF biomarkers for diagnostic and monitoring purposes in children with inflammatory or autoimmune brain disease. The cause of encephalitis is unknown in up to a third of encephalitis cohorts, and it is important to differentiate infective from autoimmune encephalitis given the therapeutic implications. Aim To study CSF cytokines and chemokines as diagnostic biomarkers of active neuroinflammation, and assess their role in differentiating demyelinating, autoimmune, and viral encephalitis. Methods We measured and compared 32 cytokine/chemokines using multiplex immunoassay and APRIL and BAFF using ELISA in CSF collected prior to commencing treatment from paediatric patients with confirmed acute disseminated encephalomyelitis (ADEM, n = 16), anti-NMDAR encephalitis (anti-NMDAR E, n = 11), and enteroviral encephalitis (EVE, n = 16). We generated normative data using CSF from 20 non-inflammatory neurological controls. The sensitivity of CSF cytokine/chemokines to diagnose encephalitis cases was calculated using 95th centile of control values as cut off. We correlated CSF cytokine/chemokines with disease severity and follow up outcome based on modified Rankin scale. One-way hierarchical correlational cluster analysis of molecules was performed in different encephalitis and outcome groups. Results In descending order, CSF TNF-α, IL-10, IFN-α, IL-6, CXCL13 and CXCL10 had the best sensitivity (>79.1%) when all encephalitis patients were included. The combination of IL-6 and IFN-α was most predictive of inflammation on multiple logistic regression with area under the ROC curve 0.99 (CI 0.97–1.00). There were no differences in CSF cytokine concentrations between EVE and anti-NMDAR E, whereas ADEM showed more pronounced elevation of Th17 related (IL-17, IL-21) and Th2 (IL-4, CCL17) related cytokine/chemokines. Unlike EVE, heat map analysis showed similar clustering of cytokine/chemokine molecules in immune mediated encephalitis (ADEM and anti-NMDAR E). Th1 and B cell (CXCL13 and CXCL10) molecules clustered together in patients with severe encephalopathy at admission and worse disability at follow up in all encephalitis. There was no correlation between CSF neopterin and IFN-γ or IFN-α. Conclusion A combination panel of cytokine/chemokines consisting of CSF TNF-α, IL-10, IFN-α, IL-6, CXCL13 and CXCL10 measured using multiplex immunoassay may be used to diagnose and monitor intrathecal inflammation in the brain. Given their association with worse outcome, certain key chemokines (CXCL13, CXCL10) could represent potential therapeutic targets in encephalitis.
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Byun JI, Lee ST, Moon J, Jung KH, Sunwoo JS, Lim JA, Kim TJ, Shin YW, Lee KJ, Jun JS, Lee HS, Lee WJ, Kim YS, Kim S, Jeon D, Park KI, Jung KY, Kim M, Chu K, Lee SK. Distinct intrathecal interleukin-17/interleukin-6 activation in anti-N-methyl-d-aspartate receptor encephalitis. J Neuroimmunol 2016; 297:141-7. [DOI: 10.1016/j.jneuroim.2016.05.023] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 05/28/2016] [Accepted: 05/31/2016] [Indexed: 12/12/2022]
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Puthenparampil M, Miante S, Federle L, Zanetta C, Toffanin E, Ruggero S, Rinaldi F, Gallo P. BAFF is decreased in the cerebrospinal fluid of multiple sclerosis at clinical onset. J Neuroimmunol 2016; 297:63-7. [DOI: 10.1016/j.jneuroim.2016.05.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 05/06/2016] [Accepted: 05/11/2016] [Indexed: 12/24/2022]
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Lévesque SA, Paré A, Mailhot B, Bellver-Landete V, Kébir H, Lécuyer MA, Alvarez JI, Prat A, de Rivero Vaccari JP, Keane RW, Lacroix S. Myeloid cell transmigration across the CNS vasculature triggers IL-1β-driven neuroinflammation during autoimmune encephalomyelitis in mice. J Exp Med 2016; 213:929-49. [PMID: 27139491 PMCID: PMC4886360 DOI: 10.1084/jem.20151437] [Citation(s) in RCA: 120] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 03/21/2016] [Indexed: 12/11/2022] Open
Abstract
Growing evidence supports a role for IL-1 in multiple sclerosis and experimental autoimmune encephalomyelitis (EAE), but how it impacts neuroinflammation is poorly understood. We show that susceptibility to EAE requires activation of IL-1R1 on radiation-resistant cells via IL-1β secreted by bone marrow-derived cells. Neutrophils and monocyte-derived macrophages (MDMs) are the main source of IL-1β and produce this cytokine as a result of their transmigration across the inflamed blood-spinal cord barrier. IL-1R1 expression in the spinal cord is found in endothelial cells (ECs) of the pial venous plexus. Accordingly, leukocyte infiltration at EAE onset is restricted to IL-1R1(+) subpial and subarachnoid vessels. In response to IL-1β, primary cultures of central nervous system ECs produce GM-CSF, G-CSF, IL-6, Cxcl1, and Cxcl2. Initiation of EAE or subdural injection of IL-1β induces a similar cytokine/chemokine signature in spinal cord vessels. Furthermore, the transfer of Gr1(+) cells on the spinal cord is sufficient to induce illness in EAE-resistant IL-1β knockout (KO) mice. Notably, transfer of Gr1(+) cells isolated from C57BL/6 mice induce massive recruitment of recipient myeloid cells compared with cells from IL-1β KO donors, and this recruitment translates into more severe paralysis. These findings suggest that an IL-1β-dependent paracrine loop between infiltrated neutrophils/MDMs and ECs drives neuroinflammation.
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Affiliation(s)
- Sébastien A Lévesque
- Centre de Recherche du Centre Hospitalier Universitaire (CHU) de Québec-Université Laval, Département de Médecine Moléculaire, Faculté de Médecine, Université Laval, Québec, QC G1V 4G2, Canada
| | - Alexandre Paré
- Centre de Recherche du Centre Hospitalier Universitaire (CHU) de Québec-Université Laval, Département de Médecine Moléculaire, Faculté de Médecine, Université Laval, Québec, QC G1V 4G2, Canada
| | - Benoit Mailhot
- Centre de Recherche du Centre Hospitalier Universitaire (CHU) de Québec-Université Laval, Département de Médecine Moléculaire, Faculté de Médecine, Université Laval, Québec, QC G1V 4G2, Canada
| | - Victor Bellver-Landete
- Centre de Recherche du Centre Hospitalier Universitaire (CHU) de Québec-Université Laval, Département de Médecine Moléculaire, Faculté de Médecine, Université Laval, Québec, QC G1V 4G2, Canada
| | - Hania Kébir
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Département de Neurosciences, Faculté de Médecine, Université de Montréal, Montréal, QC H2X 0A9, Canada
| | - Marc-André Lécuyer
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Département de Neurosciences, Faculté de Médecine, Université de Montréal, Montréal, QC H2X 0A9, Canada
| | - Jorge Ivan Alvarez
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Département de Neurosciences, Faculté de Médecine, Université de Montréal, Montréal, QC H2X 0A9, Canada Department of Pathobiology, University of Pennsylvania, Philadelphia, PA 19104
| | - Alexandre Prat
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Département de Neurosciences, Faculté de Médecine, Université de Montréal, Montréal, QC H2X 0A9, Canada
| | - Juan Pablo de Rivero Vaccari
- Department of Neurological Surgery, The Miami Project to Cure Paralysis, Miller School of Medicine, University of Miami, Miami, FL 33136
| | - Robert W Keane
- Department of Physiology and Biophysics, Miller School of Medicine, University of Miami, Miami, FL 33136
| | - Steve Lacroix
- Centre de Recherche du Centre Hospitalier Universitaire (CHU) de Québec-Université Laval, Département de Médecine Moléculaire, Faculté de Médecine, Université Laval, Québec, QC G1V 4G2, Canada
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Tavakolpour S. Interleukin 7 receptor polymorphisms and the risk of multiple sclerosis: A meta-analysis. Mult Scler Relat Disord 2016; 8:66-73. [PMID: 27456877 DOI: 10.1016/j.msard.2016.05.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 04/17/2016] [Accepted: 05/01/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) is considered as the most common chronic inflammatory neurologic disorder diagnosed in young adults. Both environmental and genetic factors may influence risk of MS development. Interleukin 7 receptor (IL7R) is one of the most studied gene polymorphism on MS that may play a possible role in MS development. The most studied polymorphism of IL7R gene is "rs6897932" polymorphism on IL7Rα gene (IL7RA). METHODS PubMed, Scopus, and Google scholar databases were searched for all of related studies on the association of IL7RA polymorphism with single nucleotide polymorphism (SNP) ID of "rs6897932" and the risk of MS through August 07, 2015. After exclusion of irrelevant articles, 11 eligible studies were selected, which were analyzed to determine an association between the MS and IL7R T244I polymorphism (rs6897932). For identification of this association, odds ratios (ORs) and 95% confidence interval (95% CI) were calculated. Four models of allelic (T vs. C), co-dominant genotype (TT vs. CC), dominant (TT+CT vs. CC), and recessive genotypes (TT vs. CT+CC) were considered to check the possible role of rs6897932 polymorphism in MS. A sensitivity analysis was conducted to find the reliability of this study. Furthermore, funnel plots were used to evaluate publication bias. RESULTS A total of 11 case-control studies were identified through this meta-analysis, which containing 6752 cases and 7349 controls. In overall, the frequency of the C allele was found to be higher in patients with MS compared to healthy controls (75.66% vs. 72.19%). T allele was significantly associated with the decreased risk of MS in a random effect model (T vs. C: OR=0.84, 95% CI=0.77-0.92, P-value <0.001). In the co-dominant, dominant, and recessive genotypes models, a significant association between the IL7R T244I polymorphism and MS risk was demonstrated (TT vs. CC: OR=0.70, 95% CI=0.61-0.80, P-value <0.001; TT+CT vs. CC: OR=0.82, 95% CI=0.73-0.92, P-value <0.001; TT vs. CT+CC: OR=0.76, 95% CI=0.66-0.87, P-value <0.001). Sensitivity analysis revealed that this study is reliable. There was no evidence of publication bias. CONCLUSION It was demonstrated that the IL7R T244I polymorphism was associated with susceptibility to MS. However, more well-designed studies with large sample size are needed to validate this association between this single nucleotide polymorphism and MS.
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Affiliation(s)
- Soheil Tavakolpour
- Iran University of Medical Sciences, Tehran, Iran; Neuroscience Research center, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Neurology, Tehran University of Medical Sciences, Tehran, Iran.
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Administration of Myelin Basic Protein Peptides Encapsulated in Mannosylated Liposomes Normalizes Level of Serum TNF-α and IL-2 and Chemoattractants CCL2 and CCL4 in Multiple Sclerosis Patients. Mediators Inflamm 2016; 2016:2847232. [PMID: 27239100 PMCID: PMC4864531 DOI: 10.1155/2016/2847232] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 04/06/2016] [Indexed: 11/17/2022] Open
Abstract
We have previously shown that immunodominant MBP peptides encapsulated in mannosylated liposomes (Xemys) effectively suppressed experimental allergic encephalomyelitis (EAE). Within the frames of the successfully completed phase I clinical trial, we investigated changes in the serum cytokine profile after Xemys administration in MS patients. We observed a statistically significant decrease of MCP-1/CCL2, MIP-1β/CCL4, IL-7, and IL-2 at the time of study completion. In contrast, the serum levels of TNF-α were remarkably elevated. Our data suggest that the administration of Xemys leads to a normalization of cytokine status in MS patients to values commonly reported for healthy subjects. These data are an important contribution for the upcoming Xemys clinical trials.
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128
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Myelin-specific Th17 cells induce severe relapsing optic neuritis with irreversible loss of retinal ganglion cells in C57BL/6 mice. Mol Vis 2016; 22:332-41. [PMID: 27122964 PMCID: PMC4830397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 04/08/2016] [Indexed: 10/31/2022] Open
Abstract
PURPOSE Optic neuritis affects most patients with multiple sclerosis (MS), and current treatments are unreliable. The purpose of this study was to characterize the contribution of Th1 and Th17 cells to the development of optic neuritis. METHODS Mice were passively transferred myelin-specific Th1 or Th17 cells to induce experimental autoimmune encephalomyelitis (EAE), a model of neuroautoimmunity. Visual acuity was assessed daily with optokinetic tracking, and 1, 2, and 3 weeks post-induction, optic nerves and retinas were harvested for immunohistochemical analyses. RESULTS Passive transfer experimental autoimmune encephalomyelitis elicits acute episodes of asymmetric visual deficits and is exacerbated in Th17-EAE relative to Th1-EAE. The Th17-EAE optic nerves contained more inflammatory infiltrates and an increased neutrophil to macrophage ratio. Significant geographic degeneration of the retinal ganglion cells accompanied Th17-EAE but not Th1. CONCLUSIONS Th17-induced transfer EAE recapitulates pathologies observed in MS-associated optic neuritis, namely, monocular episodes of vision loss, optic nerve inflammation, and geographic retinal ganglion cell (RGC) degeneration.
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129
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Lin J, Li X, Xia J. Th17 cells in neuromyelitis optica spectrum disorder: a review. Int J Neurosci 2016; 126:1051-60. [DOI: 10.3109/00207454.2016.1163550] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Decreased serum IL-27 and IL-35 levels are associated with disease severity in neuromyelitis optica spectrum disorders. J Neuroimmunol 2016; 293:100-104. [DOI: 10.1016/j.jneuroim.2016.03.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 02/08/2016] [Accepted: 03/04/2016] [Indexed: 01/01/2023]
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Albumin and Protein Oxidation are Predictors that Differentiate Relapsing-Remitting from Progressive Clinical Forms of Multiple Sclerosis. Mol Neurobiol 2016; 54:2961-2968. [PMID: 27026183 DOI: 10.1007/s12035-016-9860-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 03/17/2016] [Indexed: 10/22/2022]
Abstract
The aim of the present study was to evaluate inflammatory, oxidative, and nitrosative stress (IO&NS) blood markers as possible predictors of multiple sclerosis (MS) and its clinical forms. This study included 258 MS patients (175 with relapsing-remitting MS (RRMS) and 83 with progressive MS clinical forms) and 249 healthy individuals. Peripheral blood samples were obtained to determine serum levels of albumin, ferritin, C-reactive protein (CRP), total protein, lipid hydroperoxide by tert-butyl hydroperoxide-initiated chemiluminescence (CL-LOOH), carbonyl protein content, advanced oxidation protein products (AOPP), nitric oxide metabolites (NOx), and total radical-trapping antioxidant parameter (TRAP). MS patients showed higher ferritin (p < 0.001) and CL-LOOH (p < 0.001) and lower albumin (p = 0.001), TRAP (p < 0.001), AOPP (p = 0.013), and NOx values (p < 0.001) than controls. Difference was not observed in CRP, total protein, and carbonyl proteins between patients and controls. In the logistic regression age-adjusted, ferritin and CL-LOOH showed positive association with MS and were predictors of MS development (OR: 1.006, 95 % CI: 1.003-1.009, p < 0.001 and OR: 1.029, 95 % CI: 1.007-1.052, p = 0.009, respectively). Albumin, TRAP, AOPP, and NOx were negatively associated with MS (p = 0.019, p = 0.003, p = 0.001, and p = 0.003, respectively). Moreover, other logistic regression age-adjusted showed that MS patients with progressive clinical forms had lower albumin and higher AOPP than those with RRMS (p = 0.037). In conclusion, ferritin, albumin, and biomarkers of IO&NS, such as CL-LOOH, AOPP, TRAP, and NOx were predictors of MS diagnosis, whereas albumin and AOPP were predictors that differentiated RRMS from the progressive clinical forms of MS.
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132
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Predictors of clinical outcomes in patients with neuropsychiatric systemic lupus erythematosus. Cytokine 2016; 79:31-7. [DOI: 10.1016/j.cyto.2015.12.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 09/29/2015] [Accepted: 12/11/2015] [Indexed: 12/29/2022]
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Yoshio T, Okamoto H, Kurasawa K, Dei Y, Hirohata S, Minota S. IL-6, IL-8, IP-10, MCP-1 and G-CSF are significantly increased in cerebrospinal fluid but not in sera of patients with central neuropsychiatric lupus erythematosus. Lupus 2016; 25:997-1003. [DOI: 10.1177/0961203316629556] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2015] [Accepted: 01/07/2016] [Indexed: 12/11/2022]
Abstract
Objective To determine whether the intrathecal concentrations of cytokines/chemokines are associated with, or influenced by, serum concentrations in patients with central neuropsychiatric systemic lupus erythematosus (NPSLE), and to ascertain whether the increased production of cytokines/chemokines intrathecally relative to serum levels is associated with the presence of central NPSLE. Methods 52 SLE patients (30 with central NPSLE and 22 with non-NPSLE), for whom the CSF and serum samples were obtained at the same time, were enrolled. 27 kinds of cytokine/chemokine concentrations other than IFN-α in the cerebrospinal fluid (CSF) and serum samples were measured by Bio-Plex Pro Assays. IFN-α concentration and anti-ribosomal P protein antibody (anti-P) titres in CSF and serum samples were measured by ELISA. Results The mean concentrations of IL-6, IL-8, IP-10, MCP-1, G-CSF and GM-CSF were higher in the CSF than in the sera, respectively, while the mean concentrations of other 22 cytokines/chemokines, including RANTES and IFN-α, in the CSF were much lower than those in the sera, respectively. Furthermore, the concentrations of IL-6, IL-8, IP-10, MCP-1 and G-CSF in the CSF of the 30 patients with NPSLE were significantly higher than in the 22 patients with non-NPSLE ( p = 6.82 × 10−5, p = 0.00037, p = 0.0028, p = 0.00065, and p = 0.0001, respectively), while the concentration of GM-CSF in the CSF of the 30 patients with NPSLE was not significantly higher than in the 22 patients with non-NPSLE. Most importantly, the largest difference occurred in CSF IL-6 concentrations. A significant positive correlation between CSF anti-P titres and serum anti-P titres in 52 patients with SLE ( r = 0.6316, p = 6.44 × 10−6) was found, while no significant positive correlation was observed between CSF levels and serum levels of each cytokine/chemokine in the 52 SLE patients. Conclusion In central NPSLE the production of IL-6, IL-8, IP-10, MCP-1 and G-CSF might take place in the central nervous system (CNS). These increased CSF cytokines/chemokines along with anti-P might have a prerequisite role in the pathogenesis of central NPSLE.
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Affiliation(s)
- T Yoshio
- Division of Rheumatology and Clinical Immunology, Jichi Medical University, Tochigi, Japan
| | - H Okamoto
- Minami-Otsuka Institute of Technology, Minami-Otsuka Clinic, Tokyo, Japan
| | - K Kurasawa
- Department of Clinical Immunology, Dokkyo Medical University, Tochigi, Japan
| | - Y Dei
- Dei Clinic, Tochigi, Japan
| | - S Hirohata
- Department of Rheumatology and Infectious Disease, Kitasato University School of Medicine, Kanagawa, Japan
| | - S Minota
- Division of Rheumatology and Clinical Immunology, Jichi Medical University, Tochigi, Japan
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Th17 Cells Pathways in Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorders: Pathophysiological and Therapeutic Implications. Mediators Inflamm 2016; 2016:5314541. [PMID: 26941483 PMCID: PMC4749822 DOI: 10.1155/2016/5314541] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 12/22/2015] [Accepted: 12/24/2015] [Indexed: 12/23/2022] Open
Abstract
Several animal and human studies have implicated CD4+ T helper 17 (Th17) cells and their downstream pathways in the pathogenesis of central nervous system (CNS) autoimmunity in multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD), challenging the traditional Th1-Th2 paradigm. Th17 cells can efficiently cross the blood-brain barrier using alternate ways from Th1 cells, promote its disruption, and induce the activation of other inflammatory cells in the CNS. A number of environmental factors modulate the activity of Th17 pathways, so changes in the diet, exposure to infections, and other environmental factors can potentially change the risk of development of autoimmunity. Currently, new drugs targeting specific points of the Th17 pathways are already being tested in clinical trials and provide basis for the development of biomarkers to monitor disease activity. Herein, we review the key findings supporting the relevance of the Th17 pathways in the pathogenesis of MS and NMOSD, as well as their potential role as therapeutic targets in the treatment of immune-mediated CNS disorders.
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Hegen H, Adrianto I, Lessard CJ, Millonig A, Bertolotto A, Comabella M, Giovannoni G, Guger M, Hoelzl M, Khalil M, Fazekas F, Killestein J, Lindberg RLP, Malucchi S, Mehling M, Montalban X, Rudzki D, Schautzer F, Sellebjerg F, Sorensen PS, Deisenhammer F, Steinman L, Axtell RC. Cytokine profiles show heterogeneity of interferon-β response in multiple sclerosis patients. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2016; 3:e202. [PMID: 26894205 PMCID: PMC4747480 DOI: 10.1212/nxi.0000000000000202] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 12/16/2015] [Indexed: 11/15/2022]
Abstract
Objective: To evaluate serum cytokine profiles for their utility to determine the heterogeneous responses to interferon (IFN)–β treatment in patients with multiple sclerosis (MS). Methods: Patients with relapsing-remitting MS (RRMS) or clinically isolated syndrome receiving de novo IFN-β treatment were included in this prospective, observational study. Number of relapses and changes in disability were assessed 2 years prior to and 2 years after initiation of treatment. Sera were collected at baseline and after 3 months on therapy. Cytokine levels in sera were assessed by Luminex multiplex assays. Baseline cytokine profiles were grouped by hierarchical clustering analysis. Demographic features, changes in cytokines, and clinical outcome were then assessed in the clustered patient groups. Results: A total of 157 patients were included in the study and clustered into 6 distinct subsets by baseline cytokine profiles. These subsets differed significantly in their clinical and biological response to IFN-β therapy. Two subsets were associated with patients who responded poorly to therapy. Two other subsets, associated with a good response to therapy, showed a significant reduction in relapse rates and no worsening of disability. Each subset also had differential changes in cytokine levels after 3 months of IFN-β treatment. Conclusions: There is heterogeneity in the immunologic pathways of the RRMS population, which correlates with IFN-β response.
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Affiliation(s)
- Harald Hegen
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Indra Adrianto
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Christopher J Lessard
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Alban Millonig
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Antonio Bertolotto
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Manuel Comabella
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Gavin Giovannoni
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Michael Guger
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Martina Hoelzl
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Michael Khalil
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Franz Fazekas
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Joep Killestein
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Raija L P Lindberg
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Simona Malucchi
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Matthias Mehling
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Xavier Montalban
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Dagmar Rudzki
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Franz Schautzer
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Finn Sellebjerg
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Per Soelberg Sorensen
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Florian Deisenhammer
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Lawrence Steinman
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
| | - Robert C Axtell
- Department of Neurology (H.H., A.M., M.H., D.R., F.D.), Medical University of Innsbruck, Austria; Department of Arthritis and Clinical Immunology (I.A., C.J.L., R.C.A.), Oklahoma Medical Research Foundation, Oklahoma City; Centro di Riferimento Regionale Sclerosi Multipla (A.B., S.N.), Neurologia 2, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano, Turin, Italy; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (M.C., X.M.), Unitat de Neuroimmunologia Clínica, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Queen Mary University London (G.G.), Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK; Clinical Department of Neurology (M.G.), Allgemeines Krankenhaus Linz, Austria; Department of Neurology (M.K., F.F.), Medical University of Graz, Austria; Department of Neurology (J.K.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Biomedicines and Neurology (R.L.P.L., M.M.), Clinical Neuroimmunology, University of Basel, University Hospital Basel, Switzerland; Clinical Department of Neurology (F. Schautzer), Landeskrankenhaus Villach, Austria; Danish Multiple Sclerosis Center (F. Sellebjerg, P.S.S.), Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark; and Department of Neurology and Neurological Sciences (L.S.), Stanford University School of Medicine, CA
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Michael BD, Griffiths MJ, Granerod J, Brown D, Davies NWS, Borrow R, Solomon T. Characteristic Cytokine and Chemokine Profiles in Encephalitis of Infectious, Immune-Mediated, and Unknown Aetiology. PLoS One 2016; 11:e0146288. [PMID: 26808276 PMCID: PMC4726626 DOI: 10.1371/journal.pone.0146288] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 12/15/2015] [Indexed: 01/20/2023] Open
Abstract
Background Encephalitis is parenchymal brain inflammation due to infectious or immune-mediated processes. However, in 15–60% the cause remains unknown. This study aimed to determine if the cytokine/chemokine-mediated host response can distinguish infectious from immune-mediated cases, and whether this may give a clue to aetiology in those of unknown cause. Methods We measured 38 mediators in serum and cerebrospinal fluid (CSF) of patients from the Health Protection Agency Encephalitis Study. Of serum from 78 patients, 38 had infectious, 20 immune-mediated, and 20 unknown aetiology. Of CSF from 37 patients, 20 had infectious, nine immune-mediated and eight unknown aetiology. Results Heat-map analysis of CSF mediator interactions was different for infectious and immune-mediated cases, and that of the unknown aetiology group was similar to the infectious pattern. Higher myeloperoxidase (MPO) concentrations were found in infectious than immune-mediated cases, in serum and CSF (p = 0.01 and p = 0.006). Serum MPO was also higher in unknown than immune-mediated cases (p = 0.03). Multivariate analysis selected serum MPO; classifying 31 (91%) as infectious (p = 0.008) and 17 (85%) as unknown (p = 0.009) as opposed to immune-mediated. CSF data also selected MPO classifying 11 (85%) as infectious as opposed to immune-mediated (p = 0.036). CSF neutrophils were detected in eight (62%) infective and one (14%) immune-mediated cases (p = 0.004); CSF MPO correlated with neutrophils (p<0.0001). Conclusions Mediator profiles of infectious aetiology differed from immune-mediated encephalitis; and those of unknown cause were similar to infectious cases, raising the hypothesis of a possible undiagnosed infectious cause. Particularly, neutrophils and MPO merit further investigation.
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MESH Headings
- Adult
- Bacterial Infections/blood
- Bacterial Infections/cerebrospinal fluid
- Biomarkers
- Cell Adhesion Molecules/blood
- Cell Adhesion Molecules/cerebrospinal fluid
- Chemokines/cerebrospinal fluid
- Chemokines/classification
- Cytokines/blood
- Cytokines/cerebrospinal fluid
- Diagnosis, Differential
- Encephalitis/blood
- Encephalitis/cerebrospinal fluid
- Encephalitis/etiology
- Encephalitis/immunology
- Encephalitis, Viral/blood
- Encephalitis, Viral/cerebrospinal fluid
- Encephalitis, Viral/diagnosis
- England/epidemiology
- Female
- Humans
- Infectious Encephalitis/blood
- Infectious Encephalitis/cerebrospinal fluid
- Infectious Encephalitis/diagnosis
- Leukocyte Count
- Male
- Multicenter Studies as Topic
- Mycoses/blood
- Mycoses/cerebrospinal fluid
- Mycoses/diagnosis
- Paraneoplastic Syndromes, Nervous System/blood
- Paraneoplastic Syndromes, Nervous System/cerebrospinal fluid
- Paraneoplastic Syndromes, Nervous System/diagnosis
- Peroxidase/blood
- Peroxidase/cerebrospinal fluid
- Retrospective Studies
- Toxoplasmosis, Cerebral/blood
- Toxoplasmosis, Cerebral/cerebrospinal fluid
- Toxoplasmosis, Cerebral/diagnosis
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Affiliation(s)
- Benedict D. Michael
- The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
- The Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, United Kingdom
- * E-mail:
| | - Michael J. Griffiths
- The Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, United Kingdom
- Alder Hey Children’s NHS Foundation Trust, Liverpool, United Kingdom
| | | | - David Brown
- Public Health England, London, United Kingdom
- Influenza and measles laboratory, IOC, Fiocruz, Rio de Janeiro, Brazil
| | | | - Ray Borrow
- Vaccine Evaluation Unit, Public Health England, Manchester, United Kingdom
| | - Tom Solomon
- The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
- The Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, United Kingdom
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137
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Kothur K, Wienholt L, Brilot F, Dale RC. CSF cytokines/chemokines as biomarkers in neuroinflammatory CNS disorders: A systematic review. Cytokine 2016; 77:227-37. [DOI: 10.1016/j.cyto.2015.10.001] [Citation(s) in RCA: 163] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 08/19/2015] [Accepted: 10/01/2015] [Indexed: 11/25/2022]
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138
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Kessler RA, Mealy MA, Levy M. Treatment of Neuromyelitis Optica Spectrum Disorder: Acute, Preventive, and Symptomatic. Curr Treat Options Neurol 2015; 18:2. [PMID: 26705758 DOI: 10.1007/s11940-015-0387-9] [Citation(s) in RCA: 100] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OPINION STATEMENT Neuromyelitis optica spectrum disorder (NMOSD) is a rare, autoimmune disease of the central nervous system that primarily attacks the optic nerves and spinal cord leading to blindness and paralysis. The spectrum of the disease has expanded based on the specificity of the autoimmune response to the aquaporin-4 water channel on astrocytes. With wider recognition of NMOSD, a standard of care for treatment of this condition has condition based on a growing series of retrospective and prospective studies. This review covers the present state of the field in the treatment of acute relapses, preventive approaches, and therapies for symptoms of NMOSD.
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Affiliation(s)
- Remi A Kessler
- Department of Neurology, Johns Hopkins University School of Medicine, 600 N. Wolfe St., Baltimore, MD, 21287, USA
| | - Maureen A Mealy
- Department of Neurology, Johns Hopkins University School of Medicine, 600 N. Wolfe St., Baltimore, MD, 21287, USA
| | - Michael Levy
- Department of Neurology, Johns Hopkins University School of Medicine, 600 N. Wolfe St., Baltimore, MD, 21287, USA.
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139
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Kira JI. [My way to "Keep Pioneering": integrated neuroscience and immunology research produces a paradigm shift for intractable neurological disease]. Rinsho Shinkeigaku 2015; 54:939-46. [PMID: 25672676 DOI: 10.5692/clinicalneurol.54.939] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The motto of Prof. Yoshigoro Kuroiwa, who established the first independent neurology department in Japan at Kyushu University, is "Keep Pioneering". His students have followed this motto in all fields. I hereby present my efforts to keep pioneering in the following fields: (1) multiple sclerosis (MS); (2) central nervous system (CNS) involvement associated with peripheral atopic inflammation; and (3) care network for patients with intractable neurological disease. In MS, I propose that Th1/Th17 cell-mediated connexin astrocytopathy may play a critical role in producing huge demyelinating lesions in MS, neuromyelitis optica (NMO), and Baló's concentric sclerosis. I discovered a peculiar myelitis that occurred in patients with atopic disorders, and designated it atopic myelitis. In this condition, allodynia and neuropathic pain are cardinal features, regardless of the presence or absence of spinal cord MRI lesions. We found that peripheral atopic inflammation in mice produces allodynia as well as activation of microglia and astroglia in the spinal cord. It is important to involve a variety of medical specialists and care coordinators for collaborative work on medical and social care issues for people with intractable disease. The motto of "Keep Pioneering" in neurology covers not only advanced research for the creation of new therapies for intractable neurological disease, but also caring for actual people with intractable disease, which I believe is the corporate social responsibility of our neurological society. I think that "Keep Pioneering" is a challenging process that never ends throughout one's life.
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Affiliation(s)
- Jun-ichi Kira
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University
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140
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Milosevic E, Dujmovic I, Markovic M, Mesaros S, Rakocevic G, Drulovic J, Mostarica Stojkovic M, Popadic D. Higher expression of IL-12Rβ2 is associated with lower risk of relapse in relapsing-remitting multiple sclerosis patients on interferon-β1b therapy during 3-year follow-up. J Neuroimmunol 2015; 287:64-70. [PMID: 26439963 DOI: 10.1016/j.jneuroim.2015.07.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 07/16/2015] [Accepted: 07/20/2015] [Indexed: 11/17/2022]
Abstract
Cytokines produced by helper T (Th)1 cells, Th17 and regulatory T cells (Treg) are involved in multiple sclerosis (MS) immunopathogenesis. Interferon (IFN)-β alters the numerous genes' expression, but how this alteration affects the treatment response is still elusive. We assessed relative gene expression of nineteen Th1/Th17/Treg-associated mediators in peripheral blood mononuclear cells and plasma levels of GM-CSF, IL-17A and IL-17F, in relapsing-remitting MS (RRMS) patients before IFN-β1b treatment initiation and at 6, 12, 24 and 36 months of therapy. All mRNA levels changed significantly during the IFN-β1b therapy. Higher IL-12Rβ2 mRNA levels were associated with lower risk of relapse. Despite recent reports regarding role of GM-CSF in MS, our study failed to demonstrate its significance as therapy response biomarker, both on the mRNA and protein level.
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Affiliation(s)
- Emina Milosevic
- Institute of Microbiology and Immunology, School of Medicine, University of Belgrade, Dr Subotica 1, 11000 Belgrade, Serbia.
| | - Irena Dujmovic
- Neurology Clinic, Clinical Centre of Serbia, School of Medicine, University of Belgrade, Dr Subotica 6, 11000 Belgrade, Serbia.
| | - Milos Markovic
- Institute of Microbiology and Immunology, School of Medicine, University of Belgrade, Dr Subotica 1, 11000 Belgrade, Serbia.
| | - Sarlota Mesaros
- Neurology Clinic, Clinical Centre of Serbia, School of Medicine, University of Belgrade, Dr Subotica 6, 11000 Belgrade, Serbia.
| | - Goran Rakocevic
- School of Electrical Engineering, University of Belgrade, Bulevar kralja Aleksandra 73, 11000 Belgrade, Serbia.
| | - Jelena Drulovic
- Neurology Clinic, Clinical Centre of Serbia, School of Medicine, University of Belgrade, Dr Subotica 6, 11000 Belgrade, Serbia.
| | - Marija Mostarica Stojkovic
- Institute of Microbiology and Immunology, School of Medicine, University of Belgrade, Dr Subotica 1, 11000 Belgrade, Serbia.
| | - Dusan Popadic
- Institute of Microbiology and Immunology, School of Medicine, University of Belgrade, Dr Subotica 1, 11000 Belgrade, Serbia.
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141
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Khorooshi R, Asgari N, Mørch MT, Berg CT, Owens T. Hypersensitivity Responses in the Central Nervous System. Front Immunol 2015; 6:517. [PMID: 26500654 PMCID: PMC4595775 DOI: 10.3389/fimmu.2015.00517] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 09/22/2015] [Indexed: 12/29/2022] Open
Abstract
Immune-mediated tissue damage or hypersensitivity can be mediated by autospecific IgG antibodies. Pathology results from activation of complement, and antibody-dependent cellular cytotoxicity, mediated by inflammatory effector leukocytes include macrophages, natural killer cells, and granulocytes. Antibodies and complement have been associated to demyelinating pathology in multiple sclerosis (MS) lesions, where macrophages predominate among infiltrating myeloid cells. Serum-derived autoantibodies with predominant specificity for the astrocyte water channel aquaporin-4 (AQP4) are implicated as inducers of pathology in neuromyelitis optica (NMO), a central nervous system (CNS) demyelinating disease where activated neutrophils infiltrate, unlike in MS. The most widely used model for MS, experimental autoimmune encephalomyelitis, is an autoantigen-immunized disease that can be transferred to naive animals with CD4+ T cells, but not with antibodies. By contrast, NMO-like astrocyte and myelin pathology can be transferred to mice with AQP4–IgG from NMO patients. This is dependent on complement, and does not require T cells. Consistent with clinical observations that interferon-beta is ineffective as a therapy for NMO, NMO-like pathology is significantly reduced in mice lacking the Type I IFN receptor. In MS, there is evidence for intrathecal synthesis of antibodies as well as blood–brain barrier (BBB) breakdown, whereas in NMO, IgG accesses the CNS from blood. Transfer models involve either direct injection of antibody and complement to the CNS, or experimental manipulations to induce BBB breakdown. We here review studies in MS and NMO that elucidate roles for IgG and complement in the induction of BBB breakdown, astrocytopathy, and demyelinating pathology. These studies point to significance of T-independent effector mechanisms in neuroinflammation.
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Affiliation(s)
- Reza Khorooshi
- Department of Neurobiology Research, Institute for Molecular Medicine, University of Southern Denmark , Odense , Denmark
| | - Nasrin Asgari
- Department of Neurobiology Research, Institute for Molecular Medicine, University of Southern Denmark , Odense , Denmark ; Department of Neurology, Vejle Hospital , Vejle , Denmark
| | - Marlene Thorsen Mørch
- Department of Neurobiology Research, Institute for Molecular Medicine, University of Southern Denmark , Odense , Denmark
| | - Carsten Tue Berg
- Department of Neurobiology Research, Institute for Molecular Medicine, University of Southern Denmark , Odense , Denmark
| | - Trevor Owens
- Department of Neurobiology Research, Institute for Molecular Medicine, University of Southern Denmark , Odense , Denmark
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142
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Kornum BR, Pizza F, Knudsen S, Plazzi G, Jennum P, Mignot E. Cerebrospinal fluid cytokine levels in type 1 narcolepsy patients very close to onset. Brain Behav Immun 2015; 49:54-8. [PMID: 25771509 PMCID: PMC4567452 DOI: 10.1016/j.bbi.2015.03.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 03/02/2015] [Accepted: 03/05/2015] [Indexed: 11/17/2022] Open
Abstract
Type 1 narcolepsy is caused by a loss of hypocretin (orexin) signaling in the brain. Genetic data suggests the disorder is caused by an autoimmune attack on hypocretin producing neurons in hypothalamus. This hypothesis has however not yet been confirmed by consistent findings of autoreactive antibodies or T-cells in patient samples. One explanation for these negative results may be that the autoimmune process is no longer active when patients present to the clinic. With increasing awareness in recent years, more and more patients have been diagnosed closer and closer to disease onset. In this study, we tested whether an active immune process in the brain could be detected in these patients, as reflected by increased cytokine levels in the cerebrospinal fluid (CSF). Using multiplex analysis, we measured the levels of 51 cytokines and chemokines in the CSF of 40 type 1 narcolepsy patients having varying disease duration. For comparison, we used samples from 9 healthy controls and 9 patients with other central hypersomnia. Cytokine levels did not differ significantly between controls and patients, even in 5 patients with disease onset less than a month prior to CSF sampling.
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Affiliation(s)
- Birgitte Rahbek Kornum
- Center for Sleep Sciences and Medicine, Department of Psychiatry, Stanford University School of Medicine, Palo Alto, CA, USA; Molecular Sleep Laboratory, Department of Diagnostics, Rigshospitalet, Glostrup, Denmark; Danish Center for Sleep Medicine, Department of Neurophysiology, University of Copenhagen, Rigshospitalet, Glostrup, Denmark.
| | - Fabio Pizza
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, AUSL di Bologna, Bologna, Italy
| | - Stine Knudsen
- Danish Center for Sleep Medicine, Department of Neurophysiology, University of Copenhagen, Rigshospitalet, Glostrup, Denmark; Norwegian Centre of Expertise for Neurodevelopmental Disorders and Hypersomnias, Oslo University Hospital, Ullevål, Norway
| | - Giuseppe Plazzi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, AUSL di Bologna, Bologna, Italy
| | - Poul Jennum
- Danish Center for Sleep Medicine, Department of Neurophysiology, University of Copenhagen, Rigshospitalet, Glostrup, Denmark
| | - Emmanuel Mignot
- Center for Sleep Sciences and Medicine, Department of Psychiatry, Stanford University School of Medicine, Palo Alto, CA, USA
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143
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NFκB signaling drives pro-granulocytic astroglial responses to neuromyelitis optica patient IgG. J Neuroinflammation 2015; 12:185. [PMID: 26423139 PMCID: PMC4590277 DOI: 10.1186/s12974-015-0403-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 09/22/2015] [Indexed: 01/21/2023] Open
Abstract
Background Astrocytes expressing the aquaporin-4 water channel are a primary target of pathogenic, disease-specific immunoglobulins (IgG) found in patients with neuromyelitis optica (NMO). Immunopathological analyses of active NMO lesions highlight a unique inflammatory phenotype marked by infiltration of granulocytes. Previous studies characterized this granulocytic infiltrate as a response to vasculocentric complement activation and localized tissue destruction. In contrast, we observe that granulocytic infiltration in NMO lesions occurs independently of complement-mediated tissue destruction or active demyelination. These immunopathological findings led to the hypothesis that NMO IgG stimulates astrocyte signaling that is responsible for granulocytic recruitment in NMO. Methods Histopathology was performed on archival formalin-fixed paraffin-embedded autopsy-derived CNS tissue from 23 patients clinically and pathologically diagnosed with NMO or NMO spectrum disorder. Primary murine astroglial cultures were stimulated with IgG isolated from NMO patients or control IgG from healthy donors. Transcriptional responses were assessed by microarray, and translational responses were measured by ELISA. Signaling through the NFκB pathway was measured by western blotting and immunostaining. Results Stimulation of primary murine astroglial cultures with NMO IgG elicited a reactive and inflammatory transcriptional response that involved signaling through the canonical NFκB pathway. This signaling resulted in the release of pro-granulocytic chemokines and was inhibited by the clinically relevant proteasome inhibitors bortezomib and PR-957. Conclusions We propose that the astrocytic NFκB-dependent inflammatory response to stimulation by NMO IgG represents one of the earliest events in NMO pathogenesis, providing a target for therapeutic intervention upstream of irreversible cell death and tissue damage. Electronic supplementary material The online version of this article (doi:10.1186/s12974-015-0403-8) contains supplementary material, which is available to authorized users.
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144
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Sato S, Yamamoto K, Matsushita T, Isobe N, Kawano Y, Iinuma K, Niino M, Fukazawa T, Nakamura Y, Watanabe M, Yonekawa T, Masaki K, Yoshimura S, Murai H, Yamasaki R, Kira JI. Copy number variations in multiple sclerosis and neuromyelitis optica. Ann Neurol 2015; 78:762-74. [PMID: 26296936 DOI: 10.1002/ana.24511] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 08/19/2015] [Accepted: 08/19/2015] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To clarify the potential association of copy number variations (CNVs) with multiple sclerosis (MS) and neuromyelitis optica (NMO) in Japanese cases. METHODS Genome-wide association analyses of CNVs among 277 MS patients, 135 NMO/NMO spectrum disorder (NMOSD) patients, and 288 healthy individuals as a discovery cohort, and among 296 MS patients, 76 NMO/NMOSD patients, and 790 healthy individuals as a replication cohort were performed using high-density single nucleotide polymorphism microarrays. RESULTS A series of discovery and replication studies revealed that most identified CNVs were 5 to 50kb deletions at particular T cell receptor (TCR) gamma and alpha loci regions. Among these CNVs, a TCR gamma locus deletion was found in 16.40% of MS patients (p = 2.44E-40, odds ratio [OR] = 52.6), and deletion at the TCR alpha locus was found in 17.28% of MS patients (p = 1.70E-31, OR = 13.0) and 13.27% of NMO/NMOSD patients (p = 5.79E-20, OR = 54.6). These CNVs were observed in peripheral blood T-cell subsets only, suggesting the CNVs were somatically acquired. NMO/NMOSD patients carrying the CNV tended to be seronegative for anti-aquaporin-4 antibody or had significantly lower titers than those without CNV. INTERPRETATION Deletion-type CNVs at specific TCR loci regions contribute to MS and NMO susceptibility.
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Affiliation(s)
- Shinya Sato
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | - Ken Yamamoto
- Department of Medical Chemistry, Kurume University School of Medicine, Kurume
| | - Takuya Matsushita
- Department of Neurological Therapeutics, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | - Noriko Isobe
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | - Yuji Kawano
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | - Kyoko Iinuma
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | - Masaaki Niino
- Department of Clinical Research, Hokkaido Medical Center, Hokkaido
| | | | - Yuri Nakamura
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | - Mitsuru Watanabe
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | - Tomomi Yonekawa
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | - Katsuhisa Masaki
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | - Satoshi Yoshimura
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | - Hiroyuki Murai
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | - Ryo Yamasaki
- Department of Neurological Therapeutics, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | - Jun-Ichi Kira
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka
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145
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Pittock SJ, Lucchinetti CF. Neuromyelitis optica and the evolving spectrum of autoimmune aquaporin-4 channelopathies: a decade later. Ann N Y Acad Sci 2015. [PMID: 26096370 DOI: 10.1111/nyas.12794.] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The discovery of AQP4-IgG (a pathogenic antibody that targets the astrocytic water channel aquaporin-4), as the first sensitive and specific biomarker for any inflammatory central nervous system demyelinating disease (IDD), has shifted emphasis from the oligodendrocyte and myelin to the astrocyte as a central immunopathogenic player. Neuromyelitis optica (NMO) spectrum disorders (SDs) represent an evolving spectrum of IDDs extending beyond the optic nerves and spinal cord to include the brain (especially in children) and, rarely, muscle. NMOSD typical brain lesions are located in areas that highly express the target antigen, AQP4, including the circumventricular organs (accounting for intractable nausea and vomiting) and the diencephalon (accounting for sleep disorders, endocrinopathies, and syndrome of inappropriate antidiuresis). Magnetic resonance imaging brain abnormalities fulfill Barkoff criteria for multiple sclerosis in up to 10% of patients. As the spectrum broadens, the importance of highly specific assays that detect pathogenic AQP4-IgG targeting extracellular epitopes of AQP4 cannot be overemphasized. The rapid evolution of our understanding of the immunobiology of AQP4 autoimmunity necessitates continuing revision of NMOSD diagnostic criteria. Here, we describe scientific advances that have occurred since the discovery of NMO-IgG in 2004 and review novel targeted immunotherapies. We also suggest that NMOSDs should now be considered under the umbrella term autoimmune aquaporin-4 channelopathy.
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Affiliation(s)
- Sean J Pittock
- Department of Laboratory Medicine/Pathology, Rochester, Minnesota.,Department of Neurology, Mayo Clinic, College of Medicine, Rochester, Minnesota
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146
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Pittock SJ, Lucchinetti CF. Neuromyelitis optica and the evolving spectrum of autoimmune aquaporin-4 channelopathies: a decade later. Ann N Y Acad Sci 2015; 1366:20-39. [PMID: 26096370 DOI: 10.1111/nyas.12794] [Citation(s) in RCA: 144] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The discovery of AQP4-IgG (a pathogenic antibody that targets the astrocytic water channel aquaporin-4), as the first sensitive and specific biomarker for any inflammatory central nervous system demyelinating disease (IDD), has shifted emphasis from the oligodendrocyte and myelin to the astrocyte as a central immunopathogenic player. Neuromyelitis optica (NMO) spectrum disorders (SDs) represent an evolving spectrum of IDDs extending beyond the optic nerves and spinal cord to include the brain (especially in children) and, rarely, muscle. NMOSD typical brain lesions are located in areas that highly express the target antigen, AQP4, including the circumventricular organs (accounting for intractable nausea and vomiting) and the diencephalon (accounting for sleep disorders, endocrinopathies, and syndrome of inappropriate antidiuresis). Magnetic resonance imaging brain abnormalities fulfill Barkoff criteria for multiple sclerosis in up to 10% of patients. As the spectrum broadens, the importance of highly specific assays that detect pathogenic AQP4-IgG targeting extracellular epitopes of AQP4 cannot be overemphasized. The rapid evolution of our understanding of the immunobiology of AQP4 autoimmunity necessitates continuing revision of NMOSD diagnostic criteria. Here, we describe scientific advances that have occurred since the discovery of NMO-IgG in 2004 and review novel targeted immunotherapies. We also suggest that NMOSDs should now be considered under the umbrella term autoimmune aquaporin-4 channelopathy.
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Affiliation(s)
- Sean J Pittock
- Department of Laboratory Medicine/Pathology, Rochester, Minnesota.,Department of Neurology, Mayo Clinic, College of Medicine, Rochester, Minnesota
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147
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Kira JI. Helicobacter pylori infection might prove the hygiene hypothesis in multiple sclerosis. J Neurol Neurosurg Psychiatry 2015; 86:591-2. [PMID: 25602010 DOI: 10.1136/jnnp-2014-309759] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 11/30/2014] [Indexed: 01/28/2023]
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148
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T helper 9 cells induced by plasmacytoid dendritic cells regulate interleukin-17 in multiple sclerosis. Clin Sci (Lond) 2015; 129:291-303. [DOI: 10.1042/cs20140608] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We have established a novel role in multiple sclerosis for a molecule, called IL-9, produced by immune cells. IL-9 reduces inflammation, and its expression in the cerebrospinal fluid of patients inversely correlates with the severity of multiple sclerosis.
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149
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Song ZY, Yamasaki R, Kawano Y, Sato S, Masaki K, Yoshimura S, Matsuse D, Murai H, Matsushita T, Kira JI. Peripheral blood T cell dynamics predict relapse in multiple sclerosis patients on fingolimod. PLoS One 2015; 10:e0124923. [PMID: 25919001 PMCID: PMC4412716 DOI: 10.1371/journal.pone.0124923] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 03/10/2015] [Indexed: 12/27/2022] Open
Abstract
Background Fingolimod efficiently reduces multiple sclerosis (MS) relapse by inhibiting lymphocyte egress from lymph nodes through down-modulation of sphingosine 1-phosphate (S1P) receptors. We aimed to clarify the alterations in peripheral blood T cell subsets associated with MS relapse on fingolimod. Methods/Principal Findings Blood samples successively collected from 23 relapsing-remitting MS patients before and during fingolimod therapy (0.5 mg/day) for 12 months and 18 healthy controls (HCs) were analysed for T cell subsets by flow cytometry. In MS patients, the percentages of central memory T (CCR7+CD45RO+) cells (TCM) and naïve T (CCR7+CD45RO-) cells decreased significantly, while those of effector memory T (CCR7-CD45RA-) and suppressor precursor T (CD28-) cells increased in both CD4+T and CD8+T cells from 2 weeks to 12 months during fingolimod therapy. The percentages of regulatory T (CD4+CD25highCD127low) cells in CD4+T cells and CCR7-CD45RA+T cells in CD8+T cells also increased significantly. Eight relapsed patients demonstrated greater percentages of CD4+TCM than 15 non-relapsed patients at 3 and 6 months (p=0.0051 and p=0.0088, respectively). The IL17-, IL9-, and IL4-producing CD4+T cell percentages were significantly higher at pre-treatment in MS patients compared with HCs (p<0.01 for all), while the IL17-producing CD4+T cell percentages tended to show a transient increase at 2 weeks of fingolimod therapy (pcorr=0.0834). Conclusions The CD4+TCM percentages at 2 weeks to 12 months during fingolimod therapy are related to relapse.
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Affiliation(s)
- Zi-Ye Song
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ryo Yamasaki
- Department of Neurological Therapeutics, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yuji Kawano
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shinya Sato
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Katsuhisa Masaki
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Satoshi Yoshimura
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Dai Matsuse
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroyuki Murai
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takuya Matsushita
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Jun-ichi Kira
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- * E-mail:
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Distinguishing the cerebrospinal fluid cytokine profile in neuropsychiatric systemic lupus erythematosus from other autoimmune neurological diseases. Clin Immunol 2015; 157:114-20. [DOI: 10.1016/j.clim.2015.01.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 01/22/2015] [Accepted: 01/24/2015] [Indexed: 11/24/2022]
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