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Cruciani C, Puthenparampil M, Tomas-Ojer P, Jelcic I, Docampo MJ, Planas R, Manogaran P, Opfer R, Wicki C, Reindl M, Jelcic I, Lutterotti A, Martin R, Sospedra M. T-Cell Specificity Influences Disease Heterogeneity in Multiple Sclerosis. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2021; 8:8/6/e1075. [PMID: 34535569 PMCID: PMC8453544 DOI: 10.1212/nxi.0000000000001075] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 07/15/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVES Encouraged by the enormous progress that the identification of specific autoantigens added to the understanding of neurologic autoimmune diseases, we undertook here an in-depth study of T-cell specificities in the autoimmune disease multiple sclerosis (MS), for which the spectrum of responsible autoantigens is not fully defined yet. The identification of target antigens in MS is crucial for therapeutic strategies aimed to induce antigen-specific tolerance. In addition, knowledge of relevant T-cell targets can improve our understanding of disease heterogeneity, a hallmark of MS that complicates clinical management. METHODS The proliferative response and interferon gamma (IFN-γ) release of CSF-infiltrating CD4+ T cells from patients with MS against several autoantigens was used to identify patients with different intrathecal T-cell specificities. Fresh CSF-infiltrating and paired circulating lymphocytes in these patients were characterized in depth by ex vivo immunophenotyping and transcriptome analysis of relevant T-cell subsets. Further examination of these patients included CSF markers of inflammation and neurodegeneration and a detailed characterization with respect to demographic, clinical, and MRI features. RESULTS By testing CSF-infiltrating CD4+ T cells from 105 patients with MS against seven long-known myelin and five recently described GDP-l-fucose synthase peptides, we identified GDP-l-fucose synthase and myelin oligodendrocyte glycoprotein (35-55) responder patients. Immunophenotyping of CSF and paired blood samples in these patients revealed a significant expansion of an effector memory (CCR7- CD45RA-) CD27- Th1 CD4+ cell subset in GDP-l-fucose synthase responders. Subsequent transcriptome analysis of this subset demonstrated expression of Th1 and cytotoxicity-associated genes. Patients with different intrathecal T-cell specificities also differ regarding inflammation- and neurodegeneration-associated biomarkers, imaging findings, expression of HLA class II alleles, and seasonal distribution of the time of the lumbar puncture. DISCUSSION Our observations reveal an association between autoantigen reactivity and features of disease heterogeneity that strongly supports an important role of T-cell specificity in MS pathogenesis. These data have the potential to improve patient classification in clinical practice and to guide the development of antigen-specific tolerization strategies.
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Affiliation(s)
- Carolina Cruciani
- From the Neuroimmunology and MS Research (NIMS) (C.C., M.P., P.T.O., I.J., M.J.D., R.P., P.M., C.W., I.J., A.L., R.M., M.S.), Department of Neurology, University Hospital and University Zurich, Switzerland; Department of Neuroscience DNS (M.P.), University-Hospital of Padova, Italy; Jung Diagnostics GmbH (R.O.), HIP - Health Innovation Port, Germany; Department of Health Sciences and Technology (C.W.), ETH Zurich, Switzerland; and Clinical Department of Neurology (M.R.), Medical University of Innsbruck, Austria
| | - Marco Puthenparampil
- From the Neuroimmunology and MS Research (NIMS) (C.C., M.P., P.T.O., I.J., M.J.D., R.P., P.M., C.W., I.J., A.L., R.M., M.S.), Department of Neurology, University Hospital and University Zurich, Switzerland; Department of Neuroscience DNS (M.P.), University-Hospital of Padova, Italy; Jung Diagnostics GmbH (R.O.), HIP - Health Innovation Port, Germany; Department of Health Sciences and Technology (C.W.), ETH Zurich, Switzerland; and Clinical Department of Neurology (M.R.), Medical University of Innsbruck, Austria
| | - Paula Tomas-Ojer
- From the Neuroimmunology and MS Research (NIMS) (C.C., M.P., P.T.O., I.J., M.J.D., R.P., P.M., C.W., I.J., A.L., R.M., M.S.), Department of Neurology, University Hospital and University Zurich, Switzerland; Department of Neuroscience DNS (M.P.), University-Hospital of Padova, Italy; Jung Diagnostics GmbH (R.O.), HIP - Health Innovation Port, Germany; Department of Health Sciences and Technology (C.W.), ETH Zurich, Switzerland; and Clinical Department of Neurology (M.R.), Medical University of Innsbruck, Austria
| | - Ivan Jelcic
- From the Neuroimmunology and MS Research (NIMS) (C.C., M.P., P.T.O., I.J., M.J.D., R.P., P.M., C.W., I.J., A.L., R.M., M.S.), Department of Neurology, University Hospital and University Zurich, Switzerland; Department of Neuroscience DNS (M.P.), University-Hospital of Padova, Italy; Jung Diagnostics GmbH (R.O.), HIP - Health Innovation Port, Germany; Department of Health Sciences and Technology (C.W.), ETH Zurich, Switzerland; and Clinical Department of Neurology (M.R.), Medical University of Innsbruck, Austria
| | - Maria Jose Docampo
- From the Neuroimmunology and MS Research (NIMS) (C.C., M.P., P.T.O., I.J., M.J.D., R.P., P.M., C.W., I.J., A.L., R.M., M.S.), Department of Neurology, University Hospital and University Zurich, Switzerland; Department of Neuroscience DNS (M.P.), University-Hospital of Padova, Italy; Jung Diagnostics GmbH (R.O.), HIP - Health Innovation Port, Germany; Department of Health Sciences and Technology (C.W.), ETH Zurich, Switzerland; and Clinical Department of Neurology (M.R.), Medical University of Innsbruck, Austria
| | - Raquel Planas
- From the Neuroimmunology and MS Research (NIMS) (C.C., M.P., P.T.O., I.J., M.J.D., R.P., P.M., C.W., I.J., A.L., R.M., M.S.), Department of Neurology, University Hospital and University Zurich, Switzerland; Department of Neuroscience DNS (M.P.), University-Hospital of Padova, Italy; Jung Diagnostics GmbH (R.O.), HIP - Health Innovation Port, Germany; Department of Health Sciences and Technology (C.W.), ETH Zurich, Switzerland; and Clinical Department of Neurology (M.R.), Medical University of Innsbruck, Austria
| | - Praveena Manogaran
- From the Neuroimmunology and MS Research (NIMS) (C.C., M.P., P.T.O., I.J., M.J.D., R.P., P.M., C.W., I.J., A.L., R.M., M.S.), Department of Neurology, University Hospital and University Zurich, Switzerland; Department of Neuroscience DNS (M.P.), University-Hospital of Padova, Italy; Jung Diagnostics GmbH (R.O.), HIP - Health Innovation Port, Germany; Department of Health Sciences and Technology (C.W.), ETH Zurich, Switzerland; and Clinical Department of Neurology (M.R.), Medical University of Innsbruck, Austria
| | - Roland Opfer
- From the Neuroimmunology and MS Research (NIMS) (C.C., M.P., P.T.O., I.J., M.J.D., R.P., P.M., C.W., I.J., A.L., R.M., M.S.), Department of Neurology, University Hospital and University Zurich, Switzerland; Department of Neuroscience DNS (M.P.), University-Hospital of Padova, Italy; Jung Diagnostics GmbH (R.O.), HIP - Health Innovation Port, Germany; Department of Health Sciences and Technology (C.W.), ETH Zurich, Switzerland; and Clinical Department of Neurology (M.R.), Medical University of Innsbruck, Austria
| | - Carla Wicki
- From the Neuroimmunology and MS Research (NIMS) (C.C., M.P., P.T.O., I.J., M.J.D., R.P., P.M., C.W., I.J., A.L., R.M., M.S.), Department of Neurology, University Hospital and University Zurich, Switzerland; Department of Neuroscience DNS (M.P.), University-Hospital of Padova, Italy; Jung Diagnostics GmbH (R.O.), HIP - Health Innovation Port, Germany; Department of Health Sciences and Technology (C.W.), ETH Zurich, Switzerland; and Clinical Department of Neurology (M.R.), Medical University of Innsbruck, Austria
| | - Markus Reindl
- From the Neuroimmunology and MS Research (NIMS) (C.C., M.P., P.T.O., I.J., M.J.D., R.P., P.M., C.W., I.J., A.L., R.M., M.S.), Department of Neurology, University Hospital and University Zurich, Switzerland; Department of Neuroscience DNS (M.P.), University-Hospital of Padova, Italy; Jung Diagnostics GmbH (R.O.), HIP - Health Innovation Port, Germany; Department of Health Sciences and Technology (C.W.), ETH Zurich, Switzerland; and Clinical Department of Neurology (M.R.), Medical University of Innsbruck, Austria
| | - Ilijas Jelcic
- From the Neuroimmunology and MS Research (NIMS) (C.C., M.P., P.T.O., I.J., M.J.D., R.P., P.M., C.W., I.J., A.L., R.M., M.S.), Department of Neurology, University Hospital and University Zurich, Switzerland; Department of Neuroscience DNS (M.P.), University-Hospital of Padova, Italy; Jung Diagnostics GmbH (R.O.), HIP - Health Innovation Port, Germany; Department of Health Sciences and Technology (C.W.), ETH Zurich, Switzerland; and Clinical Department of Neurology (M.R.), Medical University of Innsbruck, Austria
| | - Andreas Lutterotti
- From the Neuroimmunology and MS Research (NIMS) (C.C., M.P., P.T.O., I.J., M.J.D., R.P., P.M., C.W., I.J., A.L., R.M., M.S.), Department of Neurology, University Hospital and University Zurich, Switzerland; Department of Neuroscience DNS (M.P.), University-Hospital of Padova, Italy; Jung Diagnostics GmbH (R.O.), HIP - Health Innovation Port, Germany; Department of Health Sciences and Technology (C.W.), ETH Zurich, Switzerland; and Clinical Department of Neurology (M.R.), Medical University of Innsbruck, Austria
| | - Roland Martin
- From the Neuroimmunology and MS Research (NIMS) (C.C., M.P., P.T.O., I.J., M.J.D., R.P., P.M., C.W., I.J., A.L., R.M., M.S.), Department of Neurology, University Hospital and University Zurich, Switzerland; Department of Neuroscience DNS (M.P.), University-Hospital of Padova, Italy; Jung Diagnostics GmbH (R.O.), HIP - Health Innovation Port, Germany; Department of Health Sciences and Technology (C.W.), ETH Zurich, Switzerland; and Clinical Department of Neurology (M.R.), Medical University of Innsbruck, Austria
| | - Mireia Sospedra
- From the Neuroimmunology and MS Research (NIMS) (C.C., M.P., P.T.O., I.J., M.J.D., R.P., P.M., C.W., I.J., A.L., R.M., M.S.), Department of Neurology, University Hospital and University Zurich, Switzerland; Department of Neuroscience DNS (M.P.), University-Hospital of Padova, Italy; Jung Diagnostics GmbH (R.O.), HIP - Health Innovation Port, Germany; Department of Health Sciences and Technology (C.W.), ETH Zurich, Switzerland; and Clinical Department of Neurology (M.R.), Medical University of Innsbruck, Austria.
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Mørkholt AS, Oklinski MK, Larsen A, Bockermann R, Issazadeh-Navikas S, Nieland JGK, Kwon TH, Corthals A, Nielsen S, Nieland JDV. Pharmacological inhibition of carnitine palmitoyl transferase 1 inhibits and reverses experimental autoimmune encephalitis in rodents. PLoS One 2020; 15:e0234493. [PMID: 32520953 PMCID: PMC7286491 DOI: 10.1371/journal.pone.0234493] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 05/26/2020] [Indexed: 02/01/2023] Open
Abstract
Multiple sclerosis (MS) is a neurodegenerative disease characterized by demyelination and inflammation. Dysregulated lipid metabolism and mitochondrial dysfunction are hypothesized to play a key role in MS. Carnitine Palmitoyl Transferase 1 (CPT1) is a rate-limiting enzyme for beta-oxidation of fatty acids in mitochondria. The therapeutic effect of pharmacological CPT1 inhibition with etomoxir was investigated in rodent models of myelin oligodendrocyte glycoprotein- and myelin basic protein-induced experimental autoimmune encephalitis (EAE). Mice receiving etomoxir showed lower clinical score compared to placebo, however this was not significant. Rats receiving etomoxir revealed significantly lower clinical score and lower body weight compared to placebo group. When comparing etomoxir with interferon-β (IFN-β), IFN-β had no significant therapeutic effects, whereas etomoxir treatment starting at day 1 and 5 significantly improved the clinical scores compared to the IFN-β and the placebo group. Immunohistochemistry and image assessments of brain sections from rats with EAE showed higher myelination intensity and decreased expression of CPT1A in etomoxir-treated rats compared to placebo group. Moreover, etomoxir mediated increased interleukin-4 production and decreased interleukin-17α production in activated T cells. In conclusion, CPT1 is a key protein in the pathogenesis of EAE and MS and a crucial therapeutic target for the treatment.
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Affiliation(s)
| | | | - Agnete Larsen
- Department of Biomedicine, Aarhus University, Aarhus C, Denmark
| | - Robert Bockermann
- Biotech Research and Innovation Centre, Copenhagen University, Copenhagen N, Denmark
| | | | | | - Tae-Hwan Kwon
- Department of Biochemistry and Cell Biology, School of Medicine, Kyungpook National University, Taegu, Korea
| | - Angelique Corthals
- Department of Science, John Jay College of Criminal Justice, City University of New York, New York, New York, United States of America
| | - Søren Nielsen
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.,Meta-IQ, ApS, Aarhus C, Denmark
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Chu F, Shi M, Zheng C, Shen D, Zhu J, Zheng X, Cui L. The roles of macrophages and microglia in multiple sclerosis and experimental autoimmune encephalomyelitis. J Neuroimmunol 2018; 318:1-7. [PMID: 29606295 DOI: 10.1016/j.jneuroim.2018.02.015] [Citation(s) in RCA: 220] [Impact Index Per Article: 31.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 02/10/2018] [Accepted: 02/26/2018] [Indexed: 12/13/2022]
Abstract
Multiple sclerosis (MS) is an autoimmune and neurodegenerative disorder characterized by chronic inflammation, demyelination, as well as axonal and neuronal loss in the central nervous system (CNS). Macrophages and microglia are important components of the innate immune system. They participate in the primary response to microorganisms and play a role in inflammatory responses, homeostasis, and tissue regeneration. In the initial phase of MS and experimental autoimmune encephalomyelitis (EAE), an animal model of MS, macrophages from peripheral tissues infiltrate into the CNS and, together with residential microglia, contribute to the pathogenesis of MS. In the early stages, microglia and macrophages are expressed as the M1 phenotype, which can release proinflammatory cytokines, leading to tissue damage in the CNS. However, in the later stage, the M2 phenotype, which is the phenotype that is associated with resolving inflammation and tissue repair, becomes predominant in the CNS. Therefore, it is hypothesized that the M1/M2 phenotype balance plays an important role in disease progression and that the transition from the proinflammatory M1 phenotype to the regulatory or anti-inflammatory M2 phenotype can lead to restoration of homeostasis and improved functional outcomes. This review of recent literature focuses on the discussion of the M1/M2 phenotypes of microglia and macrophages as well as their relevance in the pathophysiology and treatment of MS and EAE. Furthermore, the possibility of directing the polarization of microglia and macrophages toward the M2 phenotype as a therapeutic and preventative strategy for MS is discussed.
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Affiliation(s)
- Fengna Chu
- Department of Neurology and Neuroscience Center, First Hospital of Jilin University, Changchun, Jilin Province, China
| | - Mingchao Shi
- Department of Neurology and Neuroscience Center, First Hospital of Jilin University, Changchun, Jilin Province, China
| | - Chao Zheng
- Department of Neurology and Neuroscience Center, First Hospital of Jilin University, Changchun, Jilin Province, China
| | - Donghui Shen
- Department of Neurology and Neuroscience Center, First Hospital of Jilin University, Changchun, Jilin Province, China
| | - Jie Zhu
- Department of Neurology and Neuroscience Center, First Hospital of Jilin University, Changchun, Jilin Province, China; Department of Neurobiology, Care Sciences & Society, Karolinska Institute, Karolinska University Hospital Huddinge, SE-14157 Huddinge, Stockholm, Sweden.
| | - Xiangyu Zheng
- Department of Neurology and Neuroscience Center, First Hospital of Jilin University, Changchun, Jilin Province, China.
| | - Li Cui
- Department of Neurology and Neuroscience Center, First Hospital of Jilin University, Changchun, Jilin Province, China.
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