Pathogenetic aspects of demyelinating lesions in chronic relapsing experimental allergic encephalomyelitis: possible interaction of cellular and humoral immune mechanisms

Neuroprotection by ulinastatin in experimental autoimmune encephalomyelitis

Ulinastatin has previously been used as a drug for patients with acute inflammatory disorders. The goal of the present study was to investigate the protective effects of ulinastatin on myelin sheaths and oligodendrocytes in experimental autoimmune encephalomyelitis (EAE), and to explore the possible underlying mechanism. Mice were divided into an ulinastatin treatment group, a normal saline treatment group, and a normal control group. EAE was induced in the mice with and without ulinastatin treatment. Demyelination was evaluated, as was the number of oligodendrocytes. The ulinastatin treatment group had a significantly lower clinical score, demyelinating score, and large numbers of oligodendrocytes compared with the group without ulinastatin treatment. Furthermore, ulinastatin treatment increased the expression of nerve growth factor and brain-derived neurotrophic factor, and protected against oligodendrocyte apoptosis. Thus, ulinastatin is shown to have a protective effect against EAE.

Berberine attenuates experimental autoimmune encephalomyelitis in C57 BL/6 mice

Background

Berberine, an isoquinoline derivative alkaloid, has a wide range of pharmacological properties and is considered to have anti-inflammatory and neuroprotective effects. However, there are no reports about the effects and mechanisms of berberine in experimental autoimmune encephalomyelitis (EAE), an established model of multiple sclerosis (MS).

Methodology/Principal Findings

Female C57 BL/6 mice immunized with myelin oligodendrocyte glycoprotein 35–55 amino acid peptide were treated with berberine at the day of disease onset and medication was administered daily until mice were sacrificed. Blood–brain barrier (BBB) permeability and the alteration of matrix metalloproteinase-2 (MMP-2, 72 kDa) and matrix metalloproteinase-9 (MMP-9, 92 kDa) in the brain and cerebrospinal fluid (CSF) of EAE mice were detected by quantitative measurement for Evan's blue (EB) content, Western blot and gelatin zymography respectively. The results showed that berberine attenuated clinical and pathological parameters of EAE, reduced the permeability of BBB, inhibited the activity and expression of MMP-9 but not MMP-2 in the CSF and brain of EAE mice.

Conclusions/Significance

These findings suggest that berberine is effective to attenuate the clinical severity of EAE in C57 BL/6 mice by reducing the permeability of BBB, decreasing the expression and activity of MMP-9, and decreasing the inflammatory infiltration. We think that berberine might be a potential therapeutic agent for MS.

Importance of oligodendrocyte protection, BBB breakdown and inflammation for remyelination

Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the CNS. A better understanding of why remyelination fails in MS is necessary to improve remyelination strategies. Remyelination is mediated by oligodendrocyte precursor cells (OPCs), which are widely distributed throughout the adult CNS. However, it is still unclear whether OPCs detectable in MS lesions survive the inflammatory response but are unable to myelinate or whether OPC and oligodendrocyte death is primarily responsible for remyelination failure and detectable OPCs enter demyelinated areas from adjacent tissue as the lesion evolves. Remyelination strategies should, therefore, focus on stimulation of differentiation or prevention of apoptosis, as well as establishment of a supportive environment for OPC-mediated remyelination, which may be especially important in chronically demyelinated lesions.

[Implication of the blood-brain barrier in neurological diseases: part II]

The main characteristic of the blood-brain-barrier (BBB) is its extremely low permeability, due to tight intercellular endothelial junctions and a variety of transporters, which provides the brain with a unique protection against the potential toxicity of several xenobiotics, but also constitutes a major limitation to drug delivery to the central nervous system. Several dysfunctions of the BBB have been recently implicated in the pathophysiology of neurological diseases: inflammatory, vascular, tumoral, infectious and neurodegenerative diseases. Based on a better knowledge of the BBB biology, new therapeutic strategies are emerging, which by-pass the BBB or take advantage of the selective expression of membrane proteins by brain endothelial cells or circulating leucocytes to target new drugs, such as the anti-VLA4 antibody recently approved for multiple sclerosis treatment. This review will focus on the recently described BBB dysfunctions presumably involved in various neurological diseases.

The blood-brain barrier in brain homeostasis and neurological diseases

Brain endothelial cells are unique among endothelial cells in that they express apical junctional complexes, including tight junctions, which quite resemble epithelial tight junctions both structurally and functionally. They form the blood-brain-barrier (BBB) which strictly controls the exchanges between the blood and the brain compartments by limiting passive diffusion of blood-borne solutes while actively transporting nutrients to the brain. Accumulating experimental and clinical evidence indicate that BBB dysfunctions are associated with a number of serious CNS diseases with important social impacts, such as multiple sclerosis, stroke, brain tumors, epilepsy or Alzheimer's disease. This review will focus on the implication of brain endothelial tight junctions in BBB architecture and physiology, will discuss the consequences of BBB dysfunction in these CNS diseases and will present some therapeutic strategies for drug delivery to the brain across the BBB.

Autoimmunity in demyelinating diseases

Demyelinative diseases of the CNS and peripheral nervous system can be distinguished on the basis of primary mediation by antibody or T lymphocytes (or failure of the T-cell-mediated response) and on the basis of chronicity. The principal mechanisms are autoimmunization to myelin antigens after actual immunization with tissue or infection with cross-reactive viruses or, alternatively, persistent infection of the nervous system (viral or spirochetal) with an associated immune response to the pathogen.

Plasma immunoglobulin responses and disease severity in chronic relapsing experimental allergic encephalomyelitis

Plasma IgG, IgA and IgM responses in various stages of chronic relapsing experimental allergic encephalomyelitis (CR-EAE) were investigated by ELISA and rocket immunoelectrophoresis. Autoantibody levels were elevated in acute EAE but immunoglobulin responses were maximal in chronic disease. Plasma IgG and IgA specific for the whole cord, myelin and MBP correlated closely with the clinical signs of post-acute disease; in age-matched groups, levels were lower in animals in remission or with no further disease than in those in relapse or with a stable chronic disease course. Sequential sampling revealed a significant increase in neuroantigen-specific IgG (with MBP as the dominant autoantigen) during the onset of a relapse. Lipid-specific antibody levels were raised throughout CR-EAE but constituted only a small proportion of the total response against neural antigens. Determination of total immunoglobulin concentrations suggested a general suppression of IgG responses in guinea pigs in remission. The strong correlations found between antibody levels and the severity of chronic disease provide further evidence that antibody-mediated mechanisms can play a major role in the pathogenesis of CR-EAE.

Herpes simplex virus-enhanced production of autoantibodies against myelin basic protein in mice

In 5 per cent of untreated and apparently healthy Swiss albino mice antibodies were demonstrable against myelin basic protein (MBP) prepared from human brain tissue. Associated with infection with herpes simplex virus (HSV) type 1, enhancement of the antibody formation against MBP was encountered. Thus of infected but symptom-free animals 15-25 per cent revealed anti-MBP antibodies. The latter type of antibodies appeared later than antibodies against HSV and were found predominantly in animals inoculated via the intraperitoneal route. No signs of demyelination in spinal cords or spinal nerve roots were observed in MBP antibody-positive HSV-immunized animals. Results reported may indicate triggering of an autoantibody formation against MBP and are discussed in relation to demyelinating disease.

The role of myelin lipids in experimental allergic encephalomyelitis. Part 2. Influence on disease production by encephalitogenic doses of myelin basic protein

Hartley guinea pig CNS myelin lipids (TL) were combined with an encephalitogenic dose (50 micrograms) of myelin basic protein (MBP) and injected together with complete Freund's adjuvant (CFA) into juvenile strain 13 guinea pigs. All the animals developed acute EAE and recovered, but only 50% had a single mild relapse during an observation period of 12 months. To determine the effect of individual myelin lipids on EAE, purified fractions comprising the galactocerebrosides (GC) or gangliosides (GANG) were combined with 50 micrograms MBP together with phosphatidyl choline (PC) and cholesterol (CHOL) and injected with CFA into juvenile Hartley guinea pigs. Control animals received MBP mixed with PC and CHOL or MBP alone, in CFA. The incidence of acute EAE was similar in all groups, but the highest percent recovery (69%) was seen in animals immunized with the MBP-GC combination. All animals that developed acute EAE in the control groups died. Histologically, CNS myelin breakdown was present during the acute attack except in the MBP control group. Parameters of cell-mediated immunity (CMI) showed good correlation with the clinicopathological findings in animals that received MBP-GC or MBP alone. In most animals, serum anti-MBP antibodies were detected as early as 10 days post-immunization (p.i.) whereas anti-lipid antibodies were found at 90 days p.i. Animals that received MBP-PC did not show any positive CMI or serum antibodies although they developed severe disease. The results indicate that myelin lipids, especially the galactocerebrosides, contribute to the development of chronic EAE; however, the mechanism by which this occurs is still obscure.

Chronic relapsing experimental allergic encephalomyelitis: its value as an experimental model for multiple sclerosis

Comparison of the pathohistology of chronic relapsing experimental allergic encephalomyelitis (CR-EAE) and multiple sclerosis (MS) reveals a close similarity. Thus, CR-EAE appears to be a valuable model for the study of pathogenetic factors leading to the formation of MS lesions, although the induction of the disease may be different (active sensitization with CNS antigens and adjuvant in CR-EAE versus unknown etiology in MS). CR-EAE furthermore mimicks the pathohistological patterns of other related human inflammatory demyelinating diseases (i.e., acute perivenous leukoencephalomyelitis and acute hemorrhagic leukoencephalomyelitis). The expression of an acute, predominantly inflammatory versus chronic inflammatory demyelinating disease in this model depends upon the time interval between sensitization and sampling of the animals. Recent evidence is discussed that a cooperation between cellular and humoral immune mechanisms, directed against multiple CNS antigens, is responsible for the formation of large demyelinated plaques in EAE and MS.