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Magliozzi R, Hametner S, Facchiano F, Marastoni D, Rossi S, Castellaro M, Poli A, Lattanzi F, Visconti A, Nicholas R, Reynolds R, Monaco S, Lassmann H, Calabrese M. Iron homeostasis, complement, and coagulation cascade as CSF signature of cortical lesions in early multiple sclerosis. Ann Clin Transl Neurol 2019; 6:2150-2163. [PMID: 31675181 PMCID: PMC6856609 DOI: 10.1002/acn3.50893] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 08/07/2019] [Accepted: 08/12/2019] [Indexed: 12/30/2022] Open
Abstract
Objective Intrathecal inflammation, compartmentalized in cerebrospinal fluid (CSF) and in meningeal infiltrates, has fundamental role in inflammation, demyelination, and neuronal injury in cerebral cortex in multiple sclerosis (MS). Since the exact link between intrathecal inflammation and mechanisms of cortical pathology remains unknown, we aimed to investigate a detailed proteomic CSF profiling which is able to reflect cortical damage in early MS. Methods We combined new proteomic method, TRIDENT, CSF analysis, and advanced 3T magnetic resonance imaging (MRI), in 64 MS patients at the time of diagnosis and 26 controls with other neurological disorders. MS patients were stratified according to cortical lesion (CL) load. Results We identified 227 proteins differently expressed between the patients with high and low CL load. These were mainly related to complement and coagulation cascade as well as to iron homeostasis pathway (30 and 6% of all identified proteins, respectively). Accordingly, in the CSF of MS patients with high CL load at diagnosis, significantly higher levels of sCD163 (P < 0.0001), free hemoglobin (Hb) (P < 0.05), haptoglobin (P < 0.0001), and fibrinogen (P < 0.01) were detected. By contrast, CSF levels of sCD14 were significantly (P < 0.05) higher in MS patients with low CL load. Furthermore, CSF levels of sCD163 positively correlated (P < 0.01) with CSF levels of neurofilament, fibrinogen, and B cell‐related molecules, such as CXCL13, CXCL12, IL10, and BAFF. Interpretation Intrathecal dysregulation of iron homeostasis and coagulation pathway as well as B‐cell and monocyte activity are strictly correlated with cortical damage at early disease stages.
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Affiliation(s)
- Roberta Magliozzi
- Neurology B, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.,Division of Brain Sciences, Department of Medicine, Imperial College London, London, United Kingdom
| | - Simon Hametner
- Neuroimmunology Department, Center for Brain Research, Medical University of Vienna, Wien, Austria
| | - Francesco Facchiano
- Department of Oncology and Molecular Oncology, Istituto Superiore di Sanità, Rome, Italy
| | - Damiano Marastoni
- Neurology B, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Stefania Rossi
- Neurology B, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.,Department of Oncology and Molecular Oncology, Istituto Superiore di Sanità, Rome, Italy
| | - Marco Castellaro
- Neurology B, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Alberto Poli
- Neurology B, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Federico Lattanzi
- Neurology B, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | | - Richard Nicholas
- Division of Brain Sciences, Department of Medicine, Imperial College London, London, United Kingdom
| | - Richard Reynolds
- Division of Brain Sciences, Department of Medicine, Imperial College London, London, United Kingdom
| | - Salvatore Monaco
- Neurology B, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Hans Lassmann
- Neuroimmunology Department, Center for Brain Research, Medical University of Vienna, Wien, Austria
| | - Massimiliano Calabrese
- Neurology B, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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Gjelstrup MC, Stilund M, Petersen T, Møller HJ, Petersen EL, Christensen T. Subsets of activated monocytes and markers of inflammation in incipient and progressed multiple sclerosis. Immunol Cell Biol 2017; 96:160-174. [PMID: 29363161 PMCID: PMC5836924 DOI: 10.1111/imcb.1025] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 09/14/2017] [Accepted: 10/10/2017] [Indexed: 12/26/2022]
Abstract
Multiple sclerosis (MS) is an immune mediated, inflammatory and demyelinating disease of the central nervous system (CNS). Substantial evidence points toward monocytes and macrophages playing prominent roles early in disease, mediating both pro- and anti-inflammatory responses. Monocytes are subdivided into three subsets depending on the expression of CD14 and CD16, representing different stages of inflammatory activation. To investigate their involvement in MS, peripheral blood mononuclear cells from 40 patients with incipient or progressed MS and 20 healthy controls were characterized ex vivo. In MS samples, we demonstrate a highly significant increase in nonclassical monocytes (CD14+CD16++), with a concomitant significant reduction in classical monocytes (CD14++CD16-) compared with healthy controls. Also, a significant reduction in the surface expression of CD40, CD163, and CD192 was found, attributable to the upregulation of the nonclassical monocytes. In addition, significantly increased levels of human endogenous retrovirus (HERV) envelope (Env) epitopes, encoded by both HERV-H/F and HERV-W, were specifically found on nonclassical monocytes from patients with MS; emphasizing their involvement in MS disease. In parallel, serum and cerebrospinal fluid (CSF) samples were analyzed for soluble biomarkers of inflammation and neurodegeneration. For sCD163 versus CD163, no significant correlations were found, whereas highly significant correlations between levels of soluble neopterine and the intermediate monocyte (CD14++CD16+) population was found, as were correlations between levels of soluble osteopontin and the HERV Env expression on nonclassical monocytes. The results from this study emphasize the relevance of further focus on monocyte subsets, particularly the nonclassical monocytes in monitoring of inflammatory diseases.
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Affiliation(s)
- Mikkel Carstensen Gjelstrup
- Department of Biomedicine, Aarhus University, Bartholin Building, Wilhelm Meyers Allé 4, DK-8000, Aarhus C, Denmark
| | - Morten Stilund
- Department of Biomedicine, Aarhus University, Bartholin Building, Wilhelm Meyers Allé 4, DK-8000, Aarhus C, Denmark.,Department of Neurology, Aarhus University Hospital, Nørrebrogade 44, DK-8000, Aarhus C, Denmark
| | - Thor Petersen
- Department of Neurology, Aarhus University Hospital, Nørrebrogade 44, DK-8000, Aarhus C, Denmark
| | - Holger Jon Møller
- Department of Clinical Biochemistry, Aarhus University Hospital, Palle Juul Jensens Boulevard 99, DK-8200, Aarhus N, Denmark
| | - Eva Lykke Petersen
- Department of Biomedicine, Aarhus University, Bartholin Building, Wilhelm Meyers Allé 4, DK-8000, Aarhus C, Denmark
| | - Tove Christensen
- Department of Biomedicine, Aarhus University, Bartholin Building, Wilhelm Meyers Allé 4, DK-8000, Aarhus C, Denmark
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Stilund M, Gjelstrup MC, Christensen T, Møller HJ, Petersen T. A multi-biomarker follow-up study of patients with multiple sclerosis. Brain Behav 2016; 6:e00509. [PMID: 27688939 PMCID: PMC5036432 DOI: 10.1002/brb3.509] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 04/06/2016] [Accepted: 04/29/2016] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES This study aimed to examine the levels of the macrophage marker sCD163 and other biomarkers at the time of diagnosis of patients with either clinically isolated syndrome (CIS) or relapsing-remitting multiple sclerosis (RRMS), and assess relation to clinical indicators of prognosis, disease activity (DA), and changes in the levels of these biomarkers at follow-up. MATERIALS AND METHODS The clinical status and MRI were reevaluated in 56 patients more than 1 year after diagnosis with a median follow-up time of 2 years. Levels of biomarkers in serum and cerebrospinal fluid (CSF) samples were evaluated by enzyme-linked immunosorbent assays. RESULTS There was no significant difference in time to DA between patients with CIS and RRMS. A high sCD163 ratio (>0.07) was significantly (P = 0.04) associated with time to DA in the untreated patient group. In 21 patients reevaluated with serum and CSF samples, the sCD163 ratio levels decreased from 0.068 to 0.054 (P = 0.026) in the CIS/RRMS-treated group. The CSF CXCL13, CXCL13 ratio, CSF neurofilament light polypeptide and osteopontin levels also decreased significantly in the CIS/RRMS-treated group. CONCLUSIONS The levels of all biomarkers changed concurrently with MS treatment. The sCD163 ratio was identified as a potential novel marker for time to DA.
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Affiliation(s)
- Morten Stilund
- Department of Neurology Aarhus University Hospital Nørrebrogade 44 DK-8000 Aarhus C Denmark; Department of Biomedicine Aarhus University Bartholin Building, Wilhelm Meyers Allé 4 DK-8000 Aarhus C Denmark
| | - Mikkel Carstensen Gjelstrup
- Department of Biomedicine Aarhus University Bartholin Building, Wilhelm Meyers Allé 4 DK-8000 Aarhus C Denmark
| | - Tove Christensen
- Department of Biomedicine Aarhus University Bartholin Building, Wilhelm Meyers Allé 4 DK-8000 Aarhus C Denmark
| | - Holger Jon Møller
- Department of Clinical Biochemistry Aarhus University Hospital Nørrebrogade 44 DK-8000 Aarhus C Denmark
| | - Thor Petersen
- Department of Neurology Aarhus University Hospital Nørrebrogade 44 DK-8000 Aarhus C Denmark
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