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Wu X, Wang S, Xue T, Tan X, Li J, Chen Z, Wang Z. Disease-modifying therapy in progressive multiple sclerosis: a systematic review and network meta-analysis of randomized controlled trials. Front Neurol 2024; 15:1295770. [PMID: 38529035 PMCID: PMC10962394 DOI: 10.3389/fneur.2024.1295770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 02/06/2024] [Indexed: 03/27/2024] Open
Abstract
Background Currently, disease-modifying therapies (DMTs) for progressive multiple sclerosis (PMS) are widely used in clinical practice. At the same time, there are a variety of drug options for DMTs, but the effect of the drugs that can better relieve symptoms and improve the prognosis are still inconclusive. Objectives This systematic review aimed to evaluate the efficacy and safety of DMTs for PMS and to identify the best among these drugs. Methods MEDLINE, EMBASE, the Cochrane Library, and clinicaltrials.gov were systematically searched to identify relevant studies published before 30 January, 2023. We assessed the certainty of the evidence using the confidence in the network meta-analysis (CINeMA) framework. We estimated the summary risk ratio (RR) for dichotomous outcomes and mean differences (MD) for continuous outcomes with 95% credible intervals (CrIs). Results We included 18 randomized controlled trials (RCTs) involving 9,234 patients in the study. DMT can effectively control the disease progression of MS. Among them, mitoxantrone, siponimod, and ocrelizumab are superior to other drug options in delaying disease progression (high certainty). Mitoxantrone was the best (with high certainty) for mitigating deterioration (progression of disability). Ocrelizumab performed best on the pre- and post-treatment Timed 25-Foot Walk test (T25FW; low certainty), as did all other agents (RR range: 1.12-1.05). In the 9-Hole Peg Test (9HPT), natalizumab performed the best (high certainty), as did all other agents (RR range: 1.59-1.09). In terms of imaging, IFN-beta-1b performed better on the new T2 hypointense lesion on contrast, before and after treatment (high certainty), while siponimod performed best on the change from baseline in the total volume of lesions on T2-weighted image contrast before and after treatment (high certainty), and sWASO had the highest area under the curve (SUCRA) value (100%). In terms of adverse events (AEs), rituximab (RR 1.01), and laquinimod (RR 1.02) were more effective than the placebo (high certainty). In terms of serious adverse events (SAEs), natalizumab (RR 1.09), and ocrelizumab (RR 1.07) were safer than placebo (high certainty). Conclusion DMTs can effectively control disease progression and reduce disease deterioration during the treatment of PMS. Systematic review registration https://inplasy.com/?s=202320071, identifier: 202320071.
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Affiliation(s)
- Xin Wu
- Department of Neurosurgery and Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Shixin Wang
- Department of Neurosurgery and Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Tao Xue
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xin Tan
- Department of Neurology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu, China
| | - Jiaxuan Li
- Department of Neurosurgery and Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Zhouqing Chen
- Department of Neurosurgery and Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Zhong Wang
- Department of Neurosurgery and Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
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Wang PF, Jiang F, Zeng QM, Yin WF, Hu YZ, Li Q, Hu ZL. Mitochondrial and metabolic dysfunction of peripheral immune cells in multiple sclerosis. J Neuroinflammation 2024; 21:28. [PMID: 38243312 PMCID: PMC10799425 DOI: 10.1186/s12974-024-03016-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 01/08/2024] [Indexed: 01/21/2024] Open
Abstract
Multiple sclerosis (MS) is a chronic autoimmune disorder characterized by the infiltration of inflammatory cells and demyelination of nerves. Mitochondrial dysfunction has been implicated in the pathogenesis of MS, as studies have shown abnormalities in mitochondrial activities, metabolism, mitochondrial DNA (mtDNA) levels, and mitochondrial morphology in immune cells of individuals with MS. The presence of mitochondrial dysfunctions in immune cells contributes to immunological dysregulation and neurodegeneration in MS. This review provided a comprehensive overview of mitochondrial dysfunction in immune cells associated with MS, focusing on the potential consequences of mitochondrial metabolic reprogramming on immune function. Current challenges and future directions in the field of immune-metabolic MS and its potential as a therapeutic target were also discussed.
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Affiliation(s)
- Peng-Fei Wang
- Department of Anesthesiology, The Second Xiangya Hospital, Central South University, 139 Ren-Min Central Road, Changsha City, 410011, Hunan, China
| | - Fei Jiang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha City, 410011, Hunan, China
| | - Qiu-Ming Zeng
- Department of Neurology, Xiangya Hospital, Central South University, Changsha City, 410011, Hunan, China
| | - Wei-Fan Yin
- Department of Neurology, The Second Xiangya Hospital, Central South University, 139 Ren-Min Central Road, Changsha City, 410011, Hunan, China
| | - Yue-Zi Hu
- Clinical Laboratory, The Second Hospital of Hunan University of Chinese Medicine, 233 Cai' e North Road, Changsha City, 410005, Hunan, China
| | - Qiao Li
- Department of Anesthesiology, The Second Xiangya Hospital, Central South University, 139 Ren-Min Central Road, Changsha City, 410011, Hunan, China
| | - Zhao-Lan Hu
- Department of Anesthesiology, The Second Xiangya Hospital, Central South University, 139 Ren-Min Central Road, Changsha City, 410011, Hunan, China.
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Eva L, Pleș H, Covache-Busuioc RA, Glavan LA, Bratu BG, Bordeianu A, Dumitrascu DI, Corlatescu AD, Ciurea AV. A Comprehensive Review on Neuroimmunology: Insights from Multiple Sclerosis to Future Therapeutic Developments. Biomedicines 2023; 11:2489. [PMID: 37760930 PMCID: PMC10526343 DOI: 10.3390/biomedicines11092489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/02/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
This review delves into neuroimmunology, focusing on its relevance to multiple sclerosis (MS) and potential treatment advancements. Neuroimmunology explores the intricate relationship between the immune system and the central nervous system (CNS). Understanding these mechanisms is vital for grasping the pathophysiology of diseases like MS and for devising innovative treatments. This review introduces foundational neuroimmunology concepts, emphasizing the role of immune cells, cytokines, and blood-brain barrier in CNS stability. It highlights how their dysregulation can contribute to MS and discusses genetic and environmental factors influencing MS susceptibility. Cutting-edge research methods, from omics techniques to advanced imaging, have revolutionized our understanding of MS, offering valuable diagnostic and prognostic tools. This review also touches on the intriguing gut-brain axis, examining how gut microbiota impacts neuroimmunological processes and its potential therapeutic implications. Current MS treatments, from immunomodulatory drugs to disease-modifying therapies, are discussed alongside promising experimental approaches. The potential of personalized medicine, cell-based treatments, and gene therapy in MS management is also explored. In conclusion, this review underscores neuroimmunology's significance in MS research, suggesting that a deeper understanding could pave the way for more tailored and effective treatments for MS and similar conditions. Continued research and collaboration in neuroimmunology are essential for enhancing patient outcomes.
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Affiliation(s)
- Lucian Eva
- Clinical Emergency Hospital “Prof. Dr. Nicolae Oblu”, 700309 Iasi, Romania;
| | - Horia Pleș
- Department of Neurosurgery, Centre for Cognitive Research in Neuropsychiatric Pathology (NeuroPsy-Cog), “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Razvan-Adrian Covache-Busuioc
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 București, Romania; (L.A.G.); (B.-G.B.); (A.B.); (D.-I.D.); (A.D.C.); (A.V.C.)
| | - Luca Andrei Glavan
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 București, Romania; (L.A.G.); (B.-G.B.); (A.B.); (D.-I.D.); (A.D.C.); (A.V.C.)
| | - Bogdan-Gabriel Bratu
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 București, Romania; (L.A.G.); (B.-G.B.); (A.B.); (D.-I.D.); (A.D.C.); (A.V.C.)
| | - Andrei Bordeianu
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 București, Romania; (L.A.G.); (B.-G.B.); (A.B.); (D.-I.D.); (A.D.C.); (A.V.C.)
| | - David-Ioan Dumitrascu
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 București, Romania; (L.A.G.); (B.-G.B.); (A.B.); (D.-I.D.); (A.D.C.); (A.V.C.)
| | - Antonio Daniel Corlatescu
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 București, Romania; (L.A.G.); (B.-G.B.); (A.B.); (D.-I.D.); (A.D.C.); (A.V.C.)
| | - Alexandru Vlad Ciurea
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 București, Romania; (L.A.G.); (B.-G.B.); (A.B.); (D.-I.D.); (A.D.C.); (A.V.C.)
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Olmez O, Baba C, Abasiyanik Z, Ozakbas S. Epstein-Barr virus antibody in newly diagnosed multiple sclerosis patients and its association with relapse severity and lesion location. Mult Scler Relat Disord 2022; 68:104149. [PMID: 36096010 DOI: 10.1016/j.msard.2022.104149] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 08/24/2022] [Accepted: 08/25/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Epstein-Barr virus is considered a risk factor for the development of multiple sclerosis, and recent findings reveal infected plasma -cells in meningeal ectopic lymphoid deposits. Activation of the dormant virus could be responsible for the multiple sclerosis exacerbation AIMS: To compare Epstein-Barr nuclear IgG (EBNA IgG) titer in newly diagnosed treatment-naive multiple sclerosis patients regarding the diagnoses date, clinical and radiological activity. METHODS Treatment-naive multiple sclerosis patients were divided into two groups according to Poser (late group) and McDonald2017(early group) diagnostic criteria. EBNA IgG, EDSS, physical (Timed 25 Foot Walk test, Nine-hole Peg test), and cognitive tests (Brief International Cognitive Assessment for Multiple Sclerosis) were done before the methylprednisolone infusion. The lesion location was evaluated by an MRI. Myelitis was considered a severe attack, and optic neuritis a mild relapse. RESULTS In total, 69 patients were enrolled. 44 (63.8%) of them were diagnosed by McDonald2017, and 25 (36.2%) were diagnosed with Poser criteria. There was a significant difference (p = 0.049) between the EBNA IgG titer of the late (median:238 U/ml, IQR: 154-362) and early (median: 154 U/ml, IQR:100.25-293.25). Severe relapse, having a spinal cord lesion, and not being treated with methylprednisolone was associated with higher EBNA IgG titer. CONCLUSION Study results show that EBNA IgG was significantly associated with disease activity regarding relapse severity and lesion location and could be a potential biomarker for predicting disease exacerbation.
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Affiliation(s)
- Onder Olmez
- Department of Neurology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Cavid Baba
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Zuhal Abasiyanik
- Physical Therapy and Rehabilitation, Graduate School of Health Sciences, Dokuz Eylül University, Inciraltı mah. Mithatpaşa cad., Izmir 35340, Turkey; Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey.
| | - Serkan Ozakbas
- Department of Neurology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
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van Schaik PEM, Zuhorn IS, Baron W. Targeting Fibronectin to Overcome Remyelination Failure in Multiple Sclerosis: The Need for Brain- and Lesion-Targeted Drug Delivery. Int J Mol Sci 2022; 23:ijms23158418. [PMID: 35955549 PMCID: PMC9368816 DOI: 10.3390/ijms23158418] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 07/22/2022] [Accepted: 07/23/2022] [Indexed: 11/16/2022] Open
Abstract
Multiple sclerosis (MS) is a neuroinflammatory and neurodegenerative disease with unknown etiology that can be characterized by the presence of demyelinated lesions. Prevailing treatment protocols in MS rely on the modulation of the inflammatory process but do not impact disease progression. Remyelination is an essential factor for both axonal survival and functional neurological recovery but is often insufficient. The extracellular matrix protein fibronectin contributes to the inhibitory environment created in MS lesions and likely plays a causative role in remyelination failure. The presence of the blood–brain barrier (BBB) hinders the delivery of remyelination therapeutics to lesions. Therefore, therapeutic interventions to normalize the pathogenic MS lesion environment need to be able to cross the BBB. In this review, we outline the multifaceted roles of fibronectin in MS pathogenesis and discuss promising therapeutic targets and agents to overcome fibronectin-mediated inhibition of remyelination. In addition, to pave the way for clinical use, we reflect on opportunities to deliver MS therapeutics to lesions through the utilization of nanomedicine and discuss strategies to deliver fibronectin-directed therapeutics across the BBB. The use of well-designed nanocarriers with appropriate surface functionalization to cross the BBB and target the lesion sites is recommended.
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Affiliation(s)
- Pauline E. M. van Schaik
- Section Molecular Neurobiology, Department of Biomedical Sciences of Cells & Systems, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands;
| | - Inge S. Zuhorn
- Department of Biomedical Engineering, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
- Correspondence: (I.S.Z.); (W.B.); Tel.: +31-50-3616178 (I.S.Z.); +31-503611652 (W.B.); Fax: +31-503616190 (W.B.)
| | - Wia Baron
- Section Molecular Neurobiology, Department of Biomedical Sciences of Cells & Systems, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands;
- Correspondence: (I.S.Z.); (W.B.); Tel.: +31-50-3616178 (I.S.Z.); +31-503611652 (W.B.); Fax: +31-503616190 (W.B.)
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Rayatpour A, Farhangi S, Verdaguer E, Olloquequi J, Ureña J, Auladell C, Javan M. The Cross Talk between Underlying Mechanisms of Multiple Sclerosis and Epilepsy May Provide New Insights for More Efficient Therapies. Pharmaceuticals (Basel) 2021; 14:ph14101031. [PMID: 34681255 PMCID: PMC8541630 DOI: 10.3390/ph14101031] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/30/2021] [Accepted: 10/02/2021] [Indexed: 12/17/2022] Open
Abstract
Despite the significant differences in pathological background of neurodegenerative diseases, epileptic seizures are a comorbidity in many disorders such as Huntington disease (HD), Alzheimer's disease (AD), and multiple sclerosis (MS). Regarding the last one, specifically, it has been shown that the risk of developing epilepsy is three to six times higher in patients with MS compared to the general population. In this context, understanding the pathological processes underlying this connection will allow for the targeting of the common and shared pathological pathways involved in both conditions, which may provide a new avenue in the management of neurological disorders. This review provides an outlook of what is known so far about the bidirectional association between epilepsy and MS.
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Affiliation(s)
- Atefeh Rayatpour
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran 14117-13116, Iran; (A.R.); (S.F.)
- Institute for Brain and Cognition, Tarbiat Modares University, Tehran 14117-13116, Iran
| | - Sahar Farhangi
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran 14117-13116, Iran; (A.R.); (S.F.)
- Institute for Brain and Cognition, Tarbiat Modares University, Tehran 14117-13116, Iran
| | - Ester Verdaguer
- Department of Cell Biology, Physiology and Immunology, Biology Faculty, Universitat de Barcelona, 08028 Barcelona, Spain; (E.V.); (J.U.)
- Centre for Biomedical Research of Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Institute of Neuroscience, Universitat de Barcelona, 08035 Barcelona, Spain
| | - Jordi Olloquequi
- Laboratory of Cellular and Molecular Pathology, Biomedical Sciences Institute, Health Sciences Faculty, Universidad Autónoma de Chile, Talca 3460000, Chile;
| | - Jesus Ureña
- Department of Cell Biology, Physiology and Immunology, Biology Faculty, Universitat de Barcelona, 08028 Barcelona, Spain; (E.V.); (J.U.)
- Centre for Biomedical Research of Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Institute of Neuroscience, Universitat de Barcelona, 08035 Barcelona, Spain
| | - Carme Auladell
- Department of Cell Biology, Physiology and Immunology, Biology Faculty, Universitat de Barcelona, 08028 Barcelona, Spain; (E.V.); (J.U.)
- Centre for Biomedical Research of Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Institute of Neuroscience, Universitat de Barcelona, 08035 Barcelona, Spain
- Correspondence: (C.A.); (M.J.)
| | - Mohammad Javan
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran 14117-13116, Iran; (A.R.); (S.F.)
- Institute for Brain and Cognition, Tarbiat Modares University, Tehran 14117-13116, Iran
- Cell Science Research Center, Department of Brain and Cognitive Sciences, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran 14117-13116, Iran
- Correspondence: (C.A.); (M.J.)
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Ravi AK, Muthukrishnan SK. Combination of Probiotics and Natural Compounds to Treat Multiple Sclerosis via Warburg Effect. Adv Pharm Bull 2021; 12:515-523. [PMID: 35935051 PMCID: PMC9348531 DOI: 10.34172/apb.2022.057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 09/13/2021] [Accepted: 09/27/2021] [Indexed: 11/26/2022] Open
Abstract
Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system (CNS). It is an auto-immune disorder. Its usual symptoms are unique to each person. In MS lesions vast fractions of pyruvate molecules are instantly transformed into lactate. This reprogramming mechanism of glycolysis is known as the Warburg effect. MS has no efficient treatment yet. Hence, there is a requirement for profitable immunomodulatory agents in MS. Probiotics perform as an immunomodulator because they regulate the host’s immune responses. Its efficacy gets enhanced for an extended period when it combines with prebiotics. In this review, we focus on the metabolic alterations behind the MS lesions via the Warburg effect, and also suggesting, the combined efficacy of prebiotics and probiotics for the effective treatment of MS without side effects. The Warburg effect mechanism intensifies the infiltration of activated T-cells and B-cells into the CNS. It provokes the inflammation process on the myelin sheath. The infiltration of immune cells can be inhibited by the combination therapy of probiotics and prebiotics. By this review, we can recommend that the idea of this combinational therapy can do miracles in the treatment of MS in the future.
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Astrocytes in Multiple Sclerosis-Essential Constituents with Diverse Multifaceted Functions. Int J Mol Sci 2021; 22:ijms22115904. [PMID: 34072790 PMCID: PMC8198285 DOI: 10.3390/ijms22115904] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 11/19/2022] Open
Abstract
In multiple sclerosis (MS), astrocytes respond to the inflammatory stimulation with an early robust process of morphological, transcriptional, biochemical, and functional remodeling. Recent studies utilizing novel technologies in samples from MS patients, and in an animal model of MS, experimental autoimmune encephalomyelitis (EAE), exposed the detrimental and the beneficial, in part contradictory, functions of this heterogeneous cell population. In this review, we summarize the various roles of astrocytes in recruiting immune cells to lesion sites, engendering the inflammatory loop, and inflicting tissue damage. The roles of astrocytes in suppressing excessive inflammation and promoting neuroprotection and repair processes is also discussed. The pivotal roles played by astrocytes make them an attractive therapeutic target. Improved understanding of astrocyte function and diversity, and the mechanisms by which they are regulated may lead to the development of novel approaches to selectively block astrocytic detrimental responses and/or enhance their protective properties.
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Is There Justification to Treat Neurodegenerative Disorders by Repurposing Drugs? The Case of Alzheimer's Disease, Lithium, and Autophagy. Int J Mol Sci 2020; 22:ijms22010189. [PMID: 33375448 PMCID: PMC7795249 DOI: 10.3390/ijms22010189] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 12/16/2020] [Accepted: 12/23/2020] [Indexed: 12/11/2022] Open
Abstract
Lithium is the prototype mood-stabilizer used for acute and long-term treatment of bipolar disorder. Cumulated translational research of lithium indicated the drug's neuroprotective characteristics and, thereby, has raised the option of repurposing it as a drug for neurodegenerative diseases. Lithium's neuroprotective properties rely on its modulation of homeostatic mechanisms such as inflammation, mitochondrial function, oxidative stress, autophagy, and apoptosis. This myriad of intracellular responses are, possibly, consequences of the drug's inhibition of the enzymes inositol-monophosphatase (IMPase) and glycogen-synthase-kinase (GSK)-3. Here we review lithium's neurobiological properties as evidenced by its neurotrophic and neuroprotective properties, as well as translational studies in cells in culture, in animal models of Alzheimer's disease (AD) and in patients, discussing the rationale for the drug's use in the treatment of AD.
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Metaxakis A, Petratou D, Tavernarakis N. Molecular Interventions towards Multiple Sclerosis Treatment. Brain Sci 2020; 10:brainsci10050299. [PMID: 32429225 PMCID: PMC7287961 DOI: 10.3390/brainsci10050299] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/11/2020] [Accepted: 05/12/2020] [Indexed: 12/24/2022] Open
Abstract
Multiple sclerosis (MS) is an autoimmune life-threatening disease, afflicting millions of people worldwide. Although the disease is non-curable, considerable therapeutic advances have been achieved through molecular immunotherapeutic approaches, such as peptides vaccination, administration of monoclonal antibodies, and immunogenic copolymers. The main aims of these therapeutic strategies are to shift the MS-related autoimmune response towards a non-inflammatory T helper 2 (Th2) cells response, inactivate or ameliorate cytotoxic autoreactive T cells, induce secretion of anti-inflammatory cytokines, and inhibit recruitment of autoreactive lymphocytes to the central nervous system (CNS). These approaches can efficiently treat autoimmune encephalomyelitis (EAE), an essential system to study MS in animals, but they can only partially inhibit disease progress in humans. Nevertheless, modern immunotherapeutic techniques remain the most promising tools for the development of safe MS treatments, specifically targeting the cellular factors that trigger the initiation of the disease.
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Affiliation(s)
- Athanasios Metaxakis
- Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology Hellas, Nikolaou Plastira 100, 70013 Heraklion, Greece; (A.M.); (D.P.)
| | - Dionysia Petratou
- Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology Hellas, Nikolaou Plastira 100, 70013 Heraklion, Greece; (A.M.); (D.P.)
| | - Nektarios Tavernarakis
- Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology Hellas, Nikolaou Plastira 100, 70013 Heraklion, Greece; (A.M.); (D.P.)
- Department of Basic Sciences, Faculty of Medicine, University of Crete, 71110 Heraklion, Greece
- Correspondence: ; Tel.: +30-2810-391066
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Kaushansky N, Bakos E, Becker-Herman S, Shachar I, Ben-Nun A. Circulating Picomolar Levels of CCL2 Downregulate Ongoing Chronic Experimental Autoimmune Encephalomyelitis by Induction of Regulatory Mechanisms. THE JOURNAL OF IMMUNOLOGY 2019; 203:1857-1866. [PMID: 31484731 DOI: 10.4049/jimmunol.1900424] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 07/29/2019] [Indexed: 12/27/2022]
Abstract
Multiple sclerosis is an inflammatory disease of the CNS characterized by neurologic impairment resulting from primary demyelination and axonal damage. The pathogenic mechanisms of disease development include Ag-specific T cell activation and Th1 differentiation, followed by T cell and macrophage migration into the CNS. CCL2 is a chemokine that induces migration of monocytes, memory T cells, and dendritic cells. We previously demonstrated that picomolar levels of CCL2 strongly restrict the development of inflammation in models of inflammatory bowel disease. Moreover, CCR2 deficiency in T cells promotes a program inducing the accumulation of Foxp3+ regulatory T cells while decreasing the levels of Th17 cells in vivo. In the current study, the effect of picomolar levels of CCL2 on the autoimmune inflammatory response associated with a multiple sclerosis-like disease in mice was analyzed. We found that low dosages of CCL2 were effective in suppressing MOG-induced experimental autoimmune encephalomyelitis (EAE), and they downregulated chronic EAE. The modulation of EAE by CCL2 was associated with downregulation of Th1/Th17 cells and upregulation of TGF-β and induction of regulatory CD4+Foxp3 T cells. Most strikingly, these low levels of CCL2 induced formation of highly functional regulatory T cells. Thus, this study strongly supports the potential use of CCL2 as a regulatory mediator for treating inflammatory autoimmune diseases.
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Affiliation(s)
- Nathali Kaushansky
- Department of Immunology, The Weizmann Institute of Science, Rehovot 76100, Israel
| | - Eszter Bakos
- Department of Immunology, The Weizmann Institute of Science, Rehovot 76100, Israel
| | - Shirly Becker-Herman
- Department of Immunology, The Weizmann Institute of Science, Rehovot 76100, Israel
| | - Idit Shachar
- Department of Immunology, The Weizmann Institute of Science, Rehovot 76100, Israel
| | - Avraham Ben-Nun
- Department of Immunology, The Weizmann Institute of Science, Rehovot 76100, Israel
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't Hart BA. Experimental autoimmune encephalomyelitis in the common marmoset: a translationally relevant model for the cause and course of multiple sclerosis. Primate Biol 2019; 6:17-58. [PMID: 32110715 PMCID: PMC7041540 DOI: 10.5194/pb-6-17-2019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 03/26/2019] [Indexed: 02/07/2023] Open
Abstract
Aging Western societies are facing an increasing prevalence of chronic
autoimmune-mediated inflammatory disorders (AIMIDs) for which treatments that are safe and effective are scarce. One of the
main reasons for this situation is the lack of animal models, which accurately replicate
clinical and pathological aspects of the human diseases. One important AIMID is the
neuroinflammatory disease multiple sclerosis (MS), for which the mouse experimental
autoimmune encephalomyelitis (EAE) model has been frequently used in preclinical
research. Despite some successes, there is a long list of experimental treatments that
have failed to reproduce promising effects observed in murine EAE models when they were
tested in the clinic. This frustrating situation indicates a wide validity gap between
mouse EAE and MS. This monography describes the development of an EAE model in nonhuman
primates, which may help to bridge the gap.
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Affiliation(s)
- Bert A 't Hart
- Department of Immunobiology, Biomedical Primate Research Centre, Rijswijk, the Netherlands.,Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, the Netherlands
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13
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Pappalardo F, Rajput AM, Motta S. Computational modeling of brain pathologies: the case of multiple sclerosis. Brief Bioinform 2019; 19:318-324. [PMID: 28011755 DOI: 10.1093/bib/bbw123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Indexed: 01/09/2023] Open
Abstract
The central nervous system is the most complex network of the human body. The existence and functionality of a large number of molecular species in human brain are still ambiguous and mostly unknown, thus posing a challenge to Science and Medicine. Neurological diseases inherit the same level of complexity, making effective treatments difficult to be found. Multiple sclerosis (MS) is a major neurological disease that causes severe inabilities and also a significant social burden on health care system: between 2 and 2.5 million people are affected by it, and the cost associated with it is significantly higher as compared with other neurological diseases because of the chronic nature of the disease and to the partial efficacy of current therapies. Despite difficulties in understanding and treating MS, many computational models have been developed to help neurologists. In the present work, we briefly review the main characteristics of MS and present a selection criteria of modeling approaches.
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Affiliation(s)
| | | | - Santo Motta
- Istitute for Applied Calculus (IAC) "M. Picone", National Research Council of Italy (CNR), Italy
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14
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Hussain R, Zubair H, Pursell S, Shahab M. Neurodegenerative Diseases: Regenerative Mechanisms and Novel Therapeutic Approaches. Brain Sci 2018; 8:E177. [PMID: 30223579 PMCID: PMC6162719 DOI: 10.3390/brainsci8090177] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 09/03/2018] [Accepted: 09/12/2018] [Indexed: 12/12/2022] Open
Abstract
Regeneration refers to regrowth of tissue in the central nervous system. It includes generation of new neurons, glia, myelin, and synapses, as well as the regaining of essential functions: sensory, motor, emotional and cognitive abilities. Unfortunately, regeneration within the nervous system is very slow compared to other body systems. This relative slowness is attributed to increased vulnerability to irreversible cellular insults and the loss of function due to the very long lifespan of neurons, the stretch of cells and cytoplasm over several dozens of inches throughout the body, insufficiency of the tissue-level waste removal system, and minimal neural cell proliferation/self-renewal capacity. In this context, the current review summarized the most common features of major neurodegenerative disorders; their causes and consequences and proposed novel therapeutic approaches.
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Affiliation(s)
- Rashad Hussain
- Center for Translational Neuromedicine, University of Rochester, NY 14642, USA.
| | - Hira Zubair
- Department of Animal Sciences, Quaid-i-Azam University, Islamabad 45320, Pakistan.
| | - Sarah Pursell
- Center for Translational Neuromedicine, University of Rochester, NY 14642, USA.
| | - Muhammad Shahab
- Department of Animal Sciences, Quaid-i-Azam University, Islamabad 45320, Pakistan.
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15
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Keane RW, Dietrich WD, de Rivero Vaccari JP. Inflammasome Proteins As Biomarkers of Multiple Sclerosis. Front Neurol 2018; 9:135. [PMID: 29615953 PMCID: PMC5868457 DOI: 10.3389/fneur.2018.00135] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 02/23/2018] [Indexed: 12/19/2022] Open
Abstract
Multiple sclerosis (MS) is an autoimmune disease that affects the brain and spinal cord. The inflammasome is a multiprotein complex that contributes to the innate immune response in animal models of MS as well as in patients with the disease. Important to the care of patients with MS is the need for biomarkers that can predict disease onset, disease exacerbation, as well as response to treatment. In this study, we analyzed serum samples from 32 patients with MS and 120 age-matched controls, and provide receiver operator characteristic (ROC) curves with associated confidence intervals following analyses of serum samples from patients with MS, most of which had the relapsing-remitting form of the disease, and from healthy unaffected donors, and determine the sensitivity and specificity of inflammasome proteins as biomarkers of MS. We report that caspase-1 (1.662 ± 0.6024 difference between means), apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC) (407.5 ± 35.79), and interleukin (IL)-18 (78.53 + 17.86) were elevated in the serum of MS patients when compared to controls. Interestingly, the levels of IL-1β (−0.5961 ± 0.265) were lower in the MS cohort. Importantly, the area under the curve (AUC) for ASC and caspase-1 were 0.9448 and 0.848, respectively. Taken together, these data suggest that ASC and caspase-1 could be potential candidate biomarkers for MS onset.
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Affiliation(s)
- Robert W Keane
- Department of Physiology and Biophysics, Miller School of Medicine, University of Miami, Miami, FL, United States.,InflamaCORE, LLC, Miami, FL, United States
| | - W Dalton Dietrich
- InflamaCORE, LLC, Miami, FL, United States.,Department of Neurological Surgery, The Miami Project to Cure Paralysis, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Juan Pablo de Rivero Vaccari
- InflamaCORE, LLC, Miami, FL, United States.,Department of Neurological Surgery, The Miami Project to Cure Paralysis, Miller School of Medicine, University of Miami, Miami, FL, United States
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16
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Lepka K, Volbracht K, Bill E, Schneider R, Rios N, Hildebrandt T, Ingwersen J, Prozorovski T, Lillig CH, van Horssen J, Steinman L, Hartung HP, Radi R, Holmgren A, Aktas O, Berndt C. Iron-sulfur glutaredoxin 2 protects oligodendrocytes against damage induced by nitric oxide release from activated microglia. Glia 2017; 65:1521-1534. [PMID: 28618115 DOI: 10.1002/glia.23178] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 05/15/2017] [Accepted: 05/24/2017] [Indexed: 02/06/2023]
Abstract
Demyelinated brain lesions, a hallmark of autoimmune neuroinflammatory diseases like multiple sclerosis, result from oligodendroglial cell damage. Activated microglia are considered a major source of nitric oxide and subsequent peroxynitrite-mediated damage of myelin. Here, we provide biochemical and biophysical evidence that the oxidoreductase glutaredoxin 2 inhibits peroxynitrite formation by transforming nitric oxide into dinitrosyl-diglutathionyl-iron-complexes. Glutaredoxin 2 levels influence both survival rates of primary oligodendrocyte progenitor cells and preservation of myelin structure in cerebellar organotypic slice cultures challenged with activated microglia or nitric oxide donors. Of note, glutaredoxin 2-mediated protection is not linked to its enzymatic activity as oxidoreductase, but to the disassembly of its uniquely coordinated iron-sulfur cluster using glutathione as non-protein ligand. The protective effect of glutaredoxin 2 is connected to decreased protein carbonylation and nitration. In line, brain lesions of mice suffering from experimental autoimmune encephalomyelitis, an animal model of multiple sclerosis, show decreased glutaredoxin 2 expression and increased nitrotyrosine formation indicating that this type of protection is missing in the inflamed central nervous system. Our findings link inorganic biochemistry to neuroinflammation and identify glutaredoxin 2 as a protective factor against neuroinflammation-mediated myelin damage. Thus, improved availability of glutathione-coordinated iron-sulfur clusters emerges as a potential therapeutic approach in inflammatory demyelination.
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Affiliation(s)
- Klaudia Lepka
- Department of Neurology, Medical Faculty, Heinrich-Heine Universität, Düsseldorf, 40225, Germany
| | - Katrin Volbracht
- Department of Neurology, Medical Faculty, Heinrich-Heine Universität, Düsseldorf, 40225, Germany
| | - Eckhard Bill
- Max-Planck-Institut für Chemische Energiekonversion, Mülheim/Ruhr, 45470, Germany
| | - Reiner Schneider
- Department of Neurology, Medical Faculty, Heinrich-Heine Universität, Düsseldorf, 40225, Germany
| | - Natalia Rios
- Departmento de Bioquímica and Center for Free Radical and Biomedical Research, Facultad de Medicina, Universidad de la República, Montevideo, CP 11800, Uruguay
| | - Thomas Hildebrandt
- Department of Neurology, Medical Faculty, Heinrich-Heine Universität, Düsseldorf, 40225, Germany
| | - Jens Ingwersen
- Department of Neurology, Medical Faculty, Heinrich-Heine Universität, Düsseldorf, 40225, Germany
| | - Timur Prozorovski
- Department of Neurology, Medical Faculty, Heinrich-Heine Universität, Düsseldorf, 40225, Germany
| | - Christopher Horst Lillig
- Universitätsmedizin Greifswald, Institute for Medical Biochemistry and Molecular Biology, Greifswald, 17475, Germany
| | - Jack van Horssen
- Department of Molecular Cell Biology and Immunology, VU University Medical Center, Amsterdam, MB, 1007, The Netherlands
| | - Lawrence Steinman
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, 94305-5316, USA
| | - Hans-Peter Hartung
- Department of Neurology, Medical Faculty, Heinrich-Heine Universität, Düsseldorf, 40225, Germany
| | - Rafael Radi
- Departmento de Bioquímica and Center for Free Radical and Biomedical Research, Facultad de Medicina, Universidad de la República, Montevideo, CP 11800, Uruguay
| | - Arne Holmgren
- Department for Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, 17177, Sweden
| | - Orhan Aktas
- Department of Neurology, Medical Faculty, Heinrich-Heine Universität, Düsseldorf, 40225, Germany
| | - Carsten Berndt
- Department of Neurology, Medical Faculty, Heinrich-Heine Universität, Düsseldorf, 40225, Germany
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17
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Lombardo MC, Barresi R, Bilotta E, Gargano F, Pantano P, Sammartino M. Demyelination patterns in a mathematical model of multiple sclerosis. J Math Biol 2016; 75:373-417. [DOI: 10.1007/s00285-016-1087-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 11/25/2016] [Indexed: 11/29/2022]
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18
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Yokoyama K, Hattori N. Immunomodulatory effects of glatiramer acetate as they relate to stage-specific immune dysregulation in multiple sclerosis. Nihon Yakurigaku Zasshi 2016; 148:105-20. [PMID: 27478050 DOI: 10.1254/fpj.148.105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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19
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Bhise V, Dhib-Jalbut S. Further understanding of the immunopathology of multiple sclerosis: impact on future treatments. Expert Rev Clin Immunol 2016; 12:1069-89. [PMID: 27191526 DOI: 10.1080/1744666x.2016.1191351] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION The understanding of the immunopathogenesis of multiple sclerosis (MS) has expanded with more research into T-cell subtypes, cytokine contributors, B-cell participation, mitochondrial dysfunction, and more. Treatment options have rapidly expanded with three relatively recent oral therapy alternatives entering the arena. AREAS COVERED In the following review, we discuss current mechanisms of immune dysregulation in MS, how they relate to current treatments, and the impact these findings will have on the future of therapy. Expert commentary: The efficacy of these medications and understanding their mechanisms of actions validates the immunopathogenic mechanisms thought to underlie MS. Further research has exposed new targets, while new promising therapies have shed light on new aspects into the pathophysiology of MS.
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Affiliation(s)
- Vikram Bhise
- a Rutgers Biomedical and Health Sciences - Departments of Pediatrics , Robert Wood Johnson Medical School , New Brunswick , NJ , USA
| | - Suhayl Dhib-Jalbut
- b Rutgers Biomedical and Health Sciences - Departments of Neurology , Robert Wood Johnson Medical School , New Brunswick , NJ , USA
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20
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Hassan D, Provansal M, Lehmann S, Rizk M, Moez P, Vialaret J, Hirtz C, Essa A, Agamia H. Proteomic profile of cerebrospinal fluid in patients with multiple sclerosis using two dimensional gel electrophoresis. Br J Biomed Sci 2016; 73:143-146. [PMID: 27254308 DOI: 10.1080/09674845.2016.1186310] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Dina Hassan
- a Faculty of Medicine, Department of Clinical Pathology , Alexandria University , Alexandria , Egypt
| | - Monique Provansal
- b CHRU de Montpellier and Université de Montpellier, IRMB, Laboratoire de Biochimie Protéomique Clinique , Montpellier , France
| | - Sylvain Lehmann
- b CHRU de Montpellier and Université de Montpellier, IRMB, Laboratoire de Biochimie Protéomique Clinique , Montpellier , France
| | - Moustafa Rizk
- a Faculty of Medicine, Department of Clinical Pathology , Alexandria University , Alexandria , Egypt
| | - Pacint Moez
- a Faculty of Medicine, Department of Clinical Pathology , Alexandria University , Alexandria , Egypt
| | - Jerome Vialaret
- b CHRU de Montpellier and Université de Montpellier, IRMB, Laboratoire de Biochimie Protéomique Clinique , Montpellier , France
| | - Christophe Hirtz
- b CHRU de Montpellier and Université de Montpellier, IRMB, Laboratoire de Biochimie Protéomique Clinique , Montpellier , France
| | - Ayman Essa
- c Faculty of Medicine, Department of Neuropsychiatry , Alexandria University , Alexandria , Egypt
| | - Hussein Agamia
- d Faculty of Medicine, Department of Anesthesia and Surgical Care , Alexandria University , Alexandria , Egypt
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21
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Bittner S, Wiendl H. Neuroimmunotherapies Targeting T Cells: From Pathophysiology to Therapeutic Applications. Neurotherapeutics 2016; 13:4-19. [PMID: 26563391 PMCID: PMC4720668 DOI: 10.1007/s13311-015-0405-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Therapeutic options for multiple sclerosis (MS) have significantly increased over the last few years. T lymphocytes are considered to play a central role in initiating and perpetuating the pathological immune response. Currently approved therapies for MS target T lymphocytes, either in an unspecific manner or directly by interference with specific T-cell pathways. While the concept of "T-cell-specific therapy" implies specificity and selectivity, currently approved approaches come from a general shaping of the immune system towards anti-inflammatory immune responses by non-T-cell-selective immune suppression or immune modulation (e.g., interferons-immune modulation approach) to a depletion of immune cell populations involving T cells (e.g., anti-CD52, alemtuzumab-immune selective depletion approach), or a selective inhibition of distinct molecular pathways in order to sequester leucocytes (e.g., natalizumab-leukocyte sequestration approach). This review will highlight the rationale and results of different T-cell-directed therapeutic approaches coming from basic animal experiments to clinical trials. We will first discuss the pathophysiological rationale for targeting T lymphocytes in MS leading to currently approved treatments acting on T lymphocytes. Furthermore, we will disuss previous promising concepts that have failed to show efficacy in clinical trials or were halted as a result of unexpected adverse events. Learning from the discrepancies between expectations and failures in practical outcomes helps to optimize future research approaches and clinical study designs. As our current view of MS pathogenesis and patient needs is rapidly evolving, novel therapeutic approaches targeting T lymphocytes will also be discussed, including specific molecular interventions such as cytokine-directed treatments or strategies enhancing immunoregulatory mechanisms. Based on clinical experience and novel pathophysiological approaches, T-cell-based strategies will remain a pillarstone of MS therapy.
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Affiliation(s)
- Stefan Bittner
- Department of Neurology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Department of Neurology, University of Münster, Münster, Germany
| | - Heinz Wiendl
- Department of Neurology, University of Münster, Münster, Germany.
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22
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The search for the target antigens of multiple sclerosis, part 1: autoreactive CD4+ T lymphocytes as pathogenic effectors and therapeutic targets. Lancet Neurol 2015; 15:198-209. [PMID: 26724103 DOI: 10.1016/s1474-4422(15)00334-8] [Citation(s) in RCA: 135] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Identification of the target antigens of pathogenic antibodies and T cells is of fundamental importance for understanding the pathogenesis of multiple sclerosis, and for the development of personalised treatments for the disease. Myelin-specific CD4+ T cells emerged long ago as a key player in animal models of multiple sclerosis. Taking a forward-translational approach, autoreactive CD4+ T cells have been studied extensively in patients with multiple sclerosis, and there is evidence, but as yet no direct proof, that autoreactive CD4+ T cells are a key player in the pathogenesis of the disorder. Several therapies that selectively target myelin-specific CD4+ T cells have been investigated in clinical trials up to phase 3. So far, however, none of these (mostly underpowered) therapeutic trials have provided definitive evidence of clinical efficacy. One major obstacle to personalised, highly selective immunotherapy is the absence of standardised and reliable assays to assess antigen-specific human T-cell responses. Such assays would be essential for stratification of patients with multiple sclerosis according to their individual target antigens.
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23
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Pacini G, Ieronymaki M, Nuti F, Sabatino G, Larregola M, Aharoni R, Papini AM, Rovero P. Epitope mapping of anti-myelin oligodendrocyte glycoprotein (MOG) antibodies in a mouse model of multiple sclerosis: microwave-assisted synthesis of the peptide antigens and ELISA screening. J Pept Sci 2015; 22:52-8. [PMID: 26663200 DOI: 10.1002/psc.2839] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 10/28/2015] [Accepted: 10/28/2015] [Indexed: 01/06/2023]
Abstract
The role of pathologic auto-antibodies against myelin oligodendrocyte glycoprotein (MOG) in multiple sclerosis is a highly controversial matter. As the use of animal models may enable to unravel the molecular mechanisms of the human disorder, numerous studies on multiple sclerosis are carried out using experimental autoimmune encephalomyelitis (EAE). In particular, the most extensively used EAE model is obtained by immunizing C57BL/6 mice with the immunodominant peptide MOG(35-55). In this scenario, we analyzed the anti-MOG antibody response in this model using the recombinant refolded extracellular domain of the protein, MOG(1-117). To assess the presence of a B-cell intramolecular epitope spreading mechanism, we tested also five synthetic peptides mapping the 1-117 sequence of MOG, including MOG(35-55). For this purpose, we cloned, expressed in Escherichia coli and on-column refolded MOG(1-117), and we applied an optimized microwave-assisted solid-phase synthetic strategy to obtain the designed peptide sequences. Subsequently, we set up a solid-phase immunoenzymatic assay testing both naïve and EAE mice sera and using MOG protein and peptides as antigenic probes. The results obtained disclose an intense IgG antibody response against both the recombinant protein and the immunizing peptide, while no response was observed against the other synthetic fragments, thus excluding the presence of an intramolecular epitope spreading mechanism. Furthermore, as the properly refolded recombinant probe is able to bind antibodies with greater efficiency compared with MOG(35-55), we hypothesize the presence of both linear and conformational epitopes on MOG(35-55) sequence.
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Affiliation(s)
- Giulia Pacini
- French-Italian Interdepartmental Laboratory of Peptide and Protein Chemistry and Biology - PeptLab, Florence, Italy and Cergy-Pontoise, France.,Department NeuroFarBa, Section of Pharmaceutical and Nutraceutical Sciences, University of Florence, Via Ugo Schiff 6, Sesto Fiorentino, Florence, I-50019, Italy
| | - Matthaia Ieronymaki
- French-Italian Interdepartmental Laboratory of Peptide and Protein Chemistry and Biology - PeptLab, Florence, Italy and Cergy-Pontoise, France.,Department NeuroFarBa, Section of Pharmaceutical and Nutraceutical Sciences, University of Florence, Via Ugo Schiff 6, Sesto Fiorentino, Florence, I-50019, Italy.,Laboratoire de Chimie Biologique EA4505, University of Cergy-Pontoise, 5 mail Gay-Lussac Neuville-sur-Oise, Cergy-Pontoise, 95000, France
| | - Francesca Nuti
- French-Italian Interdepartmental Laboratory of Peptide and Protein Chemistry and Biology - PeptLab, Florence, Italy and Cergy-Pontoise, France.,Department of Chemistry "Ugo Schiff", University of Florence, Via della Lastruccia 3/13, Sesto Fiorentino, Florence, I-50019, Italy
| | - Giuseppina Sabatino
- French-Italian Interdepartmental Laboratory of Peptide and Protein Chemistry and Biology - PeptLab, Florence, Italy and Cergy-Pontoise, France.,Department of Chemistry "Ugo Schiff", University of Florence, Via della Lastruccia 3/13, Sesto Fiorentino, Florence, I-50019, Italy
| | - Maud Larregola
- French-Italian Interdepartmental Laboratory of Peptide and Protein Chemistry and Biology - PeptLab, Florence, Italy and Cergy-Pontoise, France.,Laboratoire de Chimie Biologique EA4505, University of Cergy-Pontoise, 5 mail Gay-Lussac Neuville-sur-Oise, Cergy-Pontoise, 95000, France
| | - Rina Aharoni
- Department of Immunology, The Weizmann Institute of Science, Rehovot, 76100, Israel
| | - Anna Maria Papini
- French-Italian Interdepartmental Laboratory of Peptide and Protein Chemistry and Biology - PeptLab, Florence, Italy and Cergy-Pontoise, France.,Department of Chemistry "Ugo Schiff", University of Florence, Via della Lastruccia 3/13, Sesto Fiorentino, Florence, I-50019, Italy.,Laboratoire de Chimie Biologique EA4505, University of Cergy-Pontoise, 5 mail Gay-Lussac Neuville-sur-Oise, Cergy-Pontoise, 95000, France
| | - Paolo Rovero
- French-Italian Interdepartmental Laboratory of Peptide and Protein Chemistry and Biology - PeptLab, Florence, Italy and Cergy-Pontoise, France.,Department NeuroFarBa, Section of Pharmaceutical and Nutraceutical Sciences, University of Florence, Via Ugo Schiff 6, Sesto Fiorentino, Florence, I-50019, Italy
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24
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Höftberger R, Leisser M, Bauer J, Lassmann H. Autoimmune encephalitis in humans: how closely does it reflect multiple sclerosis ? Acta Neuropathol Commun 2015; 3:80. [PMID: 26637427 PMCID: PMC4670499 DOI: 10.1186/s40478-015-0260-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 11/20/2015] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system. Immunological studies suggest that it is a T-cell mediated autoimmune disease, although an MS-specific target antigen for autoimmunity has so far not been identified. Models of experimental autoimmune encephalomyelitis in part reproduce features of MS, but none of the models so far covers the entire spectrum of pathology and immunology. Autoimmune disease of the nervous system has occasionally been observed in humans after active sensitization with brain tissue or brain cells, giving rise to acute demyelinating polyradiculoneuritis, acute disseminated encephalomyelitis and in rare cases reflecting an inflammatory demyelinating condition similar to acute multiple sclerosis. In this study we analyzed in detail the immunopathology in archival autopsy tissue of a patient who died with an MS like disease after repeated exposure to subcutaneous injections of lyophilized brain cells. RESULTS The pathology of this patient fulfilled all pathological diagnostic criteria of MS. Demyelination and tissue injury was associated with antibody (IgM) deposition at active lesion sites and complement activation. Major differences to classical EAE models were seen in the composition of inflammatory infiltrates, being dominated by B-cells, infiltration of IgM positive plasma cells, profound infiltration of the tissue by CD8(+) T-lymphocytes and a nearly complete absence of CD4(+) T-cells. CONCLUSIONS Our study shows that auto-sensitization of humans with brain tissue can induce a disease, which closely reflects the pathology of MS, but that the mechanisms leading to demyelination and tissue injury differ from those, generally implicated in the pathophysiology of MS through studies in experimental autoimmune encephalomyelitis.
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Affiliation(s)
- Romana Höftberger
- Institute of Neurology, Medical University of Vienna, Vienna, Austria
| | - Marianne Leisser
- Center for Brain Research, Medical University of Vienna, Vienna, Austria
| | - Jan Bauer
- Center for Brain Research, Medical University of Vienna, Vienna, Austria
| | - Hans Lassmann
- Center for Brain Research, Medical University of Vienna, Vienna, Austria.
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25
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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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Zavalishin IA, Belogurov AA, Lomakin YA, Ponomarenko NA, Morozova SN, Suslina ZA, Piradov MA, Illarioshkin SN, Gabibov AG. Clinical and experimental studies of multiple sclerosis in Russia: experience of the leading national research centers. Degener Neurol Neuromuscul Dis 2015; 5:83-90. [PMID: 32669915 PMCID: PMC7337142 DOI: 10.2147/dnnd.s46023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 04/23/2015] [Indexed: 12/04/2022] Open
Abstract
Mechanisms of axonal damage and adaptive capacity in multiple sclerosis (MS), including cortical reorganization, have been actively studied in recent years. The lack of regenerative capabilities and the irreversibility of neurodegeneration in MS are critical factors for the optimization of MS treatment. In this study, we present the results of clinical and basic studies in the field of MS by two leading Russian centers. Clinical and neuroimaging correlations show that spinal damage in MS is accompanied by functional reorganization of the cerebral cortex, which is determined not only by the efferent component but also by the afferent component. Comparative analysis of MS treatment with both interferon β1b (IFN-β1b) and IFN-β1a at a dosage of 22 µg for 3 years through subcutaneous administration and glatiramer acetate showed equally high efficiency in reducing the number of exacerbations in relapsing-remitting MS and secondary-progressive MS. We demonstrate a reduced risk of disability in relapsing-remitting MS and secondary-progressive MS patients in all groups treated with IFN-β1 and glatiramer acetate. MS appears to be a disease that would greatly benefit from the development of personalized therapy; thus, adequate molecular predictors of myelin degradation are greatly needed. Therefore, novel ideas related to the viral hypothesis of the etiology of MS and new targets for therapeutic intervention are currently being developed. In this manuscript, we discuss findings of both clinical practice and fundamental research reflecting challenges and future directions of MS treatment in the Russian Federation.
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Affiliation(s)
| | - Alexey A Belogurov
- Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow.,Institute of Gene Biology, RAS
| | - Yakov A Lomakin
- Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow
| | | | | | | | | | | | - Alexander G Gabibov
- Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow.,Chemistry Department, Moscow State University, Moscow, Russia
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Tomankova T, Petrek M, Gallo J, Kriegova E. MicroRNAs: Emerging Regulators of Immune-Mediated Diseases. Scand J Immunol 2015; 75:129-41. [PMID: 21988491 DOI: 10.1111/j.1365-3083.2011.02650.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
MicroRNAs (miRNAs) represent the most abundant class of regulators of gene expression in humans: they regulate one-third of human protein-coding genes. These small noncoding ∼22-nucleotides (nt)-long RNAs originate by multistep process from miRNA genes localized in the genomic DNA. To date, more than 1420 miRNAs have been identified in humans (miRBase v17). The main mechanism of miRNA action is the posttranscriptional regulation via RNA interference with their target mRNAs. The majority of target mRNAs (more than 80%) undergo degradation after recognition by complementary miRNA; the translational inhibition with little or no influence on mRNA levels has been also reported. Each miRNA may suppress multiple mRNA targets (average ∼200), and at the same time, one mRNA can be targeted by many miRNAs enabling to control a spectrum wide range of cellular processes. Recently, the role of miRNAs in the development of immune cells and the maintenance of immune system homeostasis gained attention, and the involvement of miRNAs in the pathogenesis of several immune system diseases has emerged. This review focuses on the role of miRNAs in autoimmune disorders (systemic lupus erythematosus, rheumatoid arthritis, multiple sclerosis, inflammatory bowel disease and psoriasis), inflammatory pathologies of distinct organ (atherosclerosis, osteoarthritis and atopic eczema) and/or systemic locations such as allergy. The role of miRNAs, their predicted and known mRNA targets and description of their actions in physiological immune reactions and in the pathological processes ongoing in immune-mediated human disorders will be discussed. Finally, miRNA-based diagnostics and therapeutic potentials will be highlighted.
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Affiliation(s)
- T Tomankova
- Laboratory of Immunogenomics and Immunoproteomics, Faculty of Medicine and Dentistry, Institute of Molecular and Translational Medicine, Palacky University, Olomouc, Czech RepublicDepartment of Orthopaedics, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - M Petrek
- Laboratory of Immunogenomics and Immunoproteomics, Faculty of Medicine and Dentistry, Institute of Molecular and Translational Medicine, Palacky University, Olomouc, Czech RepublicDepartment of Orthopaedics, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - J Gallo
- Laboratory of Immunogenomics and Immunoproteomics, Faculty of Medicine and Dentistry, Institute of Molecular and Translational Medicine, Palacky University, Olomouc, Czech RepublicDepartment of Orthopaedics, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - E Kriegova
- Laboratory of Immunogenomics and Immunoproteomics, Faculty of Medicine and Dentistry, Institute of Molecular and Translational Medicine, Palacky University, Olomouc, Czech RepublicDepartment of Orthopaedics, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
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׳t Hart BA. Reverse translation of failed treatments can help improving the validity of preclinical animal models. Eur J Pharmacol 2015; 759:14-8. [DOI: 10.1016/j.ejphar.2015.03.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 01/16/2015] [Accepted: 03/12/2015] [Indexed: 10/23/2022]
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Held K, Bhonsle-Deeng L, Siewert K, Sato W, Beltrán E, Schmidt S, Rühl G, Ng JKM, Engerer P, Moser M, Klinkert WEF, Babbe H, Misgeld T, Wekerle H, Laplaud DA, Hohlfeld R, Dornmair K. αβ T-cell receptors from multiple sclerosis brain lesions show MAIT cell-related features. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2015; 2:e107. [PMID: 25977934 PMCID: PMC4426681 DOI: 10.1212/nxi.0000000000000107] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 03/23/2015] [Indexed: 12/26/2022]
Abstract
Objectives: To characterize phenotypes of T cells that accumulated in multiple sclerosis (MS) lesions, to compare the lesional T-cell receptor (TCR) repertoire of T-cell subsets to peripheral blood, and to identify paired α and β chains from single CD8+ T cells from an index patient who we followed for 18 years. Methods: We combined immunohistochemistry, laser microdissection, and single-cell multiplex PCR to characterize T-cell subtypes and identify paired TCRα and TCRβ chains from individual brain-infiltrating T cells in frozen brain sections. The lesional and peripheral TCR repertoires were analyzed by pyrosequencing. Results: We found that a TCR Vβ1+ T-cell population that was strikingly expanded in active brain lesions at clinical onset comprises several subclones expressing distinct yet closely related Vα7.2+ α chains, including a canonical Vα7.2-Jα33 chain of mucosal-associated invariant T (MAIT) cells. Three other α chains bear striking similarities in their antigen-recognizing, hypervariable complementarity determining region 3. Longitudinal repertoire studies revealed that the TCR chains that were massively expanded in brain at onset persisted for several years in blood or CSF but subsequently disappeared except for the canonical Vα7.2+ MAIT cell and a few other TCR sequences that were still detectable in blood after 18 years. Conclusions: Our observation that a massively expanded TCR Vβ1-Jβ2.3 chain paired with distinct yet closely related canonical or atypical MAIT cell–related α chains strongly points to an antigen-driven process in early active MS brain lesions.
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Affiliation(s)
- Kathrin Held
- Institute of Clinical Neuroimmunology (K.H., L.B.-D., K.S., W.S., E.B., G.R., J.K.M.N., R.H., K.D.), Ludwig-Maximilians University, Munich, Germany; Neurologische Gemeinschaftspraxis (S.S.), Gesundheitszentrum St. Johannes Hospital, Bonn, Germany; Institute of Neuronal Cell Biology (P.E., T.M.), TU Munich, Munich, Germany; Department for Molecular Medicine (M.M.), Max-Planck-Institute of Biochemistry, Martinsried, Germany; Department for Neuroimmunology (W.E.F.K., H.W.), Max-Planck-Institute of Neurobiology, Martinsried, Germany; Department of Genetics (H.B.), Harvard Medical School, Boston, MA; Munich Cluster for Systems Neurology (SyNergy) (T.M., H.W., R.H., K.D.), Munich, Germany; German Center for Neurodegenerative Diseases (DZNE) and Center for Integrated Protein Science (CIPSM) (T.M.), Munich, Germany; and INSERM, UMR 1064 (D.A.L.), Nantes, France
| | - Latika Bhonsle-Deeng
- Institute of Clinical Neuroimmunology (K.H., L.B.-D., K.S., W.S., E.B., G.R., J.K.M.N., R.H., K.D.), Ludwig-Maximilians University, Munich, Germany; Neurologische Gemeinschaftspraxis (S.S.), Gesundheitszentrum St. Johannes Hospital, Bonn, Germany; Institute of Neuronal Cell Biology (P.E., T.M.), TU Munich, Munich, Germany; Department for Molecular Medicine (M.M.), Max-Planck-Institute of Biochemistry, Martinsried, Germany; Department for Neuroimmunology (W.E.F.K., H.W.), Max-Planck-Institute of Neurobiology, Martinsried, Germany; Department of Genetics (H.B.), Harvard Medical School, Boston, MA; Munich Cluster for Systems Neurology (SyNergy) (T.M., H.W., R.H., K.D.), Munich, Germany; German Center for Neurodegenerative Diseases (DZNE) and Center for Integrated Protein Science (CIPSM) (T.M.), Munich, Germany; and INSERM, UMR 1064 (D.A.L.), Nantes, France
| | - Katherina Siewert
- Institute of Clinical Neuroimmunology (K.H., L.B.-D., K.S., W.S., E.B., G.R., J.K.M.N., R.H., K.D.), Ludwig-Maximilians University, Munich, Germany; Neurologische Gemeinschaftspraxis (S.S.), Gesundheitszentrum St. Johannes Hospital, Bonn, Germany; Institute of Neuronal Cell Biology (P.E., T.M.), TU Munich, Munich, Germany; Department for Molecular Medicine (M.M.), Max-Planck-Institute of Biochemistry, Martinsried, Germany; Department for Neuroimmunology (W.E.F.K., H.W.), Max-Planck-Institute of Neurobiology, Martinsried, Germany; Department of Genetics (H.B.), Harvard Medical School, Boston, MA; Munich Cluster for Systems Neurology (SyNergy) (T.M., H.W., R.H., K.D.), Munich, Germany; German Center for Neurodegenerative Diseases (DZNE) and Center for Integrated Protein Science (CIPSM) (T.M.), Munich, Germany; and INSERM, UMR 1064 (D.A.L.), Nantes, France
| | - Wakiro Sato
- Institute of Clinical Neuroimmunology (K.H., L.B.-D., K.S., W.S., E.B., G.R., J.K.M.N., R.H., K.D.), Ludwig-Maximilians University, Munich, Germany; Neurologische Gemeinschaftspraxis (S.S.), Gesundheitszentrum St. Johannes Hospital, Bonn, Germany; Institute of Neuronal Cell Biology (P.E., T.M.), TU Munich, Munich, Germany; Department for Molecular Medicine (M.M.), Max-Planck-Institute of Biochemistry, Martinsried, Germany; Department for Neuroimmunology (W.E.F.K., H.W.), Max-Planck-Institute of Neurobiology, Martinsried, Germany; Department of Genetics (H.B.), Harvard Medical School, Boston, MA; Munich Cluster for Systems Neurology (SyNergy) (T.M., H.W., R.H., K.D.), Munich, Germany; German Center for Neurodegenerative Diseases (DZNE) and Center for Integrated Protein Science (CIPSM) (T.M.), Munich, Germany; and INSERM, UMR 1064 (D.A.L.), Nantes, France
| | - Eduardo Beltrán
- Institute of Clinical Neuroimmunology (K.H., L.B.-D., K.S., W.S., E.B., G.R., J.K.M.N., R.H., K.D.), Ludwig-Maximilians University, Munich, Germany; Neurologische Gemeinschaftspraxis (S.S.), Gesundheitszentrum St. Johannes Hospital, Bonn, Germany; Institute of Neuronal Cell Biology (P.E., T.M.), TU Munich, Munich, Germany; Department for Molecular Medicine (M.M.), Max-Planck-Institute of Biochemistry, Martinsried, Germany; Department for Neuroimmunology (W.E.F.K., H.W.), Max-Planck-Institute of Neurobiology, Martinsried, Germany; Department of Genetics (H.B.), Harvard Medical School, Boston, MA; Munich Cluster for Systems Neurology (SyNergy) (T.M., H.W., R.H., K.D.), Munich, Germany; German Center for Neurodegenerative Diseases (DZNE) and Center for Integrated Protein Science (CIPSM) (T.M.), Munich, Germany; and INSERM, UMR 1064 (D.A.L.), Nantes, France
| | - Stephan Schmidt
- Institute of Clinical Neuroimmunology (K.H., L.B.-D., K.S., W.S., E.B., G.R., J.K.M.N., R.H., K.D.), Ludwig-Maximilians University, Munich, Germany; Neurologische Gemeinschaftspraxis (S.S.), Gesundheitszentrum St. Johannes Hospital, Bonn, Germany; Institute of Neuronal Cell Biology (P.E., T.M.), TU Munich, Munich, Germany; Department for Molecular Medicine (M.M.), Max-Planck-Institute of Biochemistry, Martinsried, Germany; Department for Neuroimmunology (W.E.F.K., H.W.), Max-Planck-Institute of Neurobiology, Martinsried, Germany; Department of Genetics (H.B.), Harvard Medical School, Boston, MA; Munich Cluster for Systems Neurology (SyNergy) (T.M., H.W., R.H., K.D.), Munich, Germany; German Center for Neurodegenerative Diseases (DZNE) and Center for Integrated Protein Science (CIPSM) (T.M.), Munich, Germany; and INSERM, UMR 1064 (D.A.L.), Nantes, France
| | - Geraldine Rühl
- Institute of Clinical Neuroimmunology (K.H., L.B.-D., K.S., W.S., E.B., G.R., J.K.M.N., R.H., K.D.), Ludwig-Maximilians University, Munich, Germany; Neurologische Gemeinschaftspraxis (S.S.), Gesundheitszentrum St. Johannes Hospital, Bonn, Germany; Institute of Neuronal Cell Biology (P.E., T.M.), TU Munich, Munich, Germany; Department for Molecular Medicine (M.M.), Max-Planck-Institute of Biochemistry, Martinsried, Germany; Department for Neuroimmunology (W.E.F.K., H.W.), Max-Planck-Institute of Neurobiology, Martinsried, Germany; Department of Genetics (H.B.), Harvard Medical School, Boston, MA; Munich Cluster for Systems Neurology (SyNergy) (T.M., H.W., R.H., K.D.), Munich, Germany; German Center for Neurodegenerative Diseases (DZNE) and Center for Integrated Protein Science (CIPSM) (T.M.), Munich, Germany; and INSERM, UMR 1064 (D.A.L.), Nantes, France
| | - Judy K M Ng
- Institute of Clinical Neuroimmunology (K.H., L.B.-D., K.S., W.S., E.B., G.R., J.K.M.N., R.H., K.D.), Ludwig-Maximilians University, Munich, Germany; Neurologische Gemeinschaftspraxis (S.S.), Gesundheitszentrum St. Johannes Hospital, Bonn, Germany; Institute of Neuronal Cell Biology (P.E., T.M.), TU Munich, Munich, Germany; Department for Molecular Medicine (M.M.), Max-Planck-Institute of Biochemistry, Martinsried, Germany; Department for Neuroimmunology (W.E.F.K., H.W.), Max-Planck-Institute of Neurobiology, Martinsried, Germany; Department of Genetics (H.B.), Harvard Medical School, Boston, MA; Munich Cluster for Systems Neurology (SyNergy) (T.M., H.W., R.H., K.D.), Munich, Germany; German Center for Neurodegenerative Diseases (DZNE) and Center for Integrated Protein Science (CIPSM) (T.M.), Munich, Germany; and INSERM, UMR 1064 (D.A.L.), Nantes, France
| | - Peter Engerer
- Institute of Clinical Neuroimmunology (K.H., L.B.-D., K.S., W.S., E.B., G.R., J.K.M.N., R.H., K.D.), Ludwig-Maximilians University, Munich, Germany; Neurologische Gemeinschaftspraxis (S.S.), Gesundheitszentrum St. Johannes Hospital, Bonn, Germany; Institute of Neuronal Cell Biology (P.E., T.M.), TU Munich, Munich, Germany; Department for Molecular Medicine (M.M.), Max-Planck-Institute of Biochemistry, Martinsried, Germany; Department for Neuroimmunology (W.E.F.K., H.W.), Max-Planck-Institute of Neurobiology, Martinsried, Germany; Department of Genetics (H.B.), Harvard Medical School, Boston, MA; Munich Cluster for Systems Neurology (SyNergy) (T.M., H.W., R.H., K.D.), Munich, Germany; German Center for Neurodegenerative Diseases (DZNE) and Center for Integrated Protein Science (CIPSM) (T.M.), Munich, Germany; and INSERM, UMR 1064 (D.A.L.), Nantes, France
| | - Markus Moser
- Institute of Clinical Neuroimmunology (K.H., L.B.-D., K.S., W.S., E.B., G.R., J.K.M.N., R.H., K.D.), Ludwig-Maximilians University, Munich, Germany; Neurologische Gemeinschaftspraxis (S.S.), Gesundheitszentrum St. Johannes Hospital, Bonn, Germany; Institute of Neuronal Cell Biology (P.E., T.M.), TU Munich, Munich, Germany; Department for Molecular Medicine (M.M.), Max-Planck-Institute of Biochemistry, Martinsried, Germany; Department for Neuroimmunology (W.E.F.K., H.W.), Max-Planck-Institute of Neurobiology, Martinsried, Germany; Department of Genetics (H.B.), Harvard Medical School, Boston, MA; Munich Cluster for Systems Neurology (SyNergy) (T.M., H.W., R.H., K.D.), Munich, Germany; German Center for Neurodegenerative Diseases (DZNE) and Center for Integrated Protein Science (CIPSM) (T.M.), Munich, Germany; and INSERM, UMR 1064 (D.A.L.), Nantes, France
| | - Wolfgang E F Klinkert
- Institute of Clinical Neuroimmunology (K.H., L.B.-D., K.S., W.S., E.B., G.R., J.K.M.N., R.H., K.D.), Ludwig-Maximilians University, Munich, Germany; Neurologische Gemeinschaftspraxis (S.S.), Gesundheitszentrum St. Johannes Hospital, Bonn, Germany; Institute of Neuronal Cell Biology (P.E., T.M.), TU Munich, Munich, Germany; Department for Molecular Medicine (M.M.), Max-Planck-Institute of Biochemistry, Martinsried, Germany; Department for Neuroimmunology (W.E.F.K., H.W.), Max-Planck-Institute of Neurobiology, Martinsried, Germany; Department of Genetics (H.B.), Harvard Medical School, Boston, MA; Munich Cluster for Systems Neurology (SyNergy) (T.M., H.W., R.H., K.D.), Munich, Germany; German Center for Neurodegenerative Diseases (DZNE) and Center for Integrated Protein Science (CIPSM) (T.M.), Munich, Germany; and INSERM, UMR 1064 (D.A.L.), Nantes, France
| | - Holger Babbe
- Institute of Clinical Neuroimmunology (K.H., L.B.-D., K.S., W.S., E.B., G.R., J.K.M.N., R.H., K.D.), Ludwig-Maximilians University, Munich, Germany; Neurologische Gemeinschaftspraxis (S.S.), Gesundheitszentrum St. Johannes Hospital, Bonn, Germany; Institute of Neuronal Cell Biology (P.E., T.M.), TU Munich, Munich, Germany; Department for Molecular Medicine (M.M.), Max-Planck-Institute of Biochemistry, Martinsried, Germany; Department for Neuroimmunology (W.E.F.K., H.W.), Max-Planck-Institute of Neurobiology, Martinsried, Germany; Department of Genetics (H.B.), Harvard Medical School, Boston, MA; Munich Cluster for Systems Neurology (SyNergy) (T.M., H.W., R.H., K.D.), Munich, Germany; German Center for Neurodegenerative Diseases (DZNE) and Center for Integrated Protein Science (CIPSM) (T.M.), Munich, Germany; and INSERM, UMR 1064 (D.A.L.), Nantes, France
| | - Thomas Misgeld
- Institute of Clinical Neuroimmunology (K.H., L.B.-D., K.S., W.S., E.B., G.R., J.K.M.N., R.H., K.D.), Ludwig-Maximilians University, Munich, Germany; Neurologische Gemeinschaftspraxis (S.S.), Gesundheitszentrum St. Johannes Hospital, Bonn, Germany; Institute of Neuronal Cell Biology (P.E., T.M.), TU Munich, Munich, Germany; Department for Molecular Medicine (M.M.), Max-Planck-Institute of Biochemistry, Martinsried, Germany; Department for Neuroimmunology (W.E.F.K., H.W.), Max-Planck-Institute of Neurobiology, Martinsried, Germany; Department of Genetics (H.B.), Harvard Medical School, Boston, MA; Munich Cluster for Systems Neurology (SyNergy) (T.M., H.W., R.H., K.D.), Munich, Germany; German Center for Neurodegenerative Diseases (DZNE) and Center for Integrated Protein Science (CIPSM) (T.M.), Munich, Germany; and INSERM, UMR 1064 (D.A.L.), Nantes, France
| | - Hartmut Wekerle
- Institute of Clinical Neuroimmunology (K.H., L.B.-D., K.S., W.S., E.B., G.R., J.K.M.N., R.H., K.D.), Ludwig-Maximilians University, Munich, Germany; Neurologische Gemeinschaftspraxis (S.S.), Gesundheitszentrum St. Johannes Hospital, Bonn, Germany; Institute of Neuronal Cell Biology (P.E., T.M.), TU Munich, Munich, Germany; Department for Molecular Medicine (M.M.), Max-Planck-Institute of Biochemistry, Martinsried, Germany; Department for Neuroimmunology (W.E.F.K., H.W.), Max-Planck-Institute of Neurobiology, Martinsried, Germany; Department of Genetics (H.B.), Harvard Medical School, Boston, MA; Munich Cluster for Systems Neurology (SyNergy) (T.M., H.W., R.H., K.D.), Munich, Germany; German Center for Neurodegenerative Diseases (DZNE) and Center for Integrated Protein Science (CIPSM) (T.M.), Munich, Germany; and INSERM, UMR 1064 (D.A.L.), Nantes, France
| | - David-Axel Laplaud
- Institute of Clinical Neuroimmunology (K.H., L.B.-D., K.S., W.S., E.B., G.R., J.K.M.N., R.H., K.D.), Ludwig-Maximilians University, Munich, Germany; Neurologische Gemeinschaftspraxis (S.S.), Gesundheitszentrum St. Johannes Hospital, Bonn, Germany; Institute of Neuronal Cell Biology (P.E., T.M.), TU Munich, Munich, Germany; Department for Molecular Medicine (M.M.), Max-Planck-Institute of Biochemistry, Martinsried, Germany; Department for Neuroimmunology (W.E.F.K., H.W.), Max-Planck-Institute of Neurobiology, Martinsried, Germany; Department of Genetics (H.B.), Harvard Medical School, Boston, MA; Munich Cluster for Systems Neurology (SyNergy) (T.M., H.W., R.H., K.D.), Munich, Germany; German Center for Neurodegenerative Diseases (DZNE) and Center for Integrated Protein Science (CIPSM) (T.M.), Munich, Germany; and INSERM, UMR 1064 (D.A.L.), Nantes, France
| | - Reinhard Hohlfeld
- Institute of Clinical Neuroimmunology (K.H., L.B.-D., K.S., W.S., E.B., G.R., J.K.M.N., R.H., K.D.), Ludwig-Maximilians University, Munich, Germany; Neurologische Gemeinschaftspraxis (S.S.), Gesundheitszentrum St. Johannes Hospital, Bonn, Germany; Institute of Neuronal Cell Biology (P.E., T.M.), TU Munich, Munich, Germany; Department for Molecular Medicine (M.M.), Max-Planck-Institute of Biochemistry, Martinsried, Germany; Department for Neuroimmunology (W.E.F.K., H.W.), Max-Planck-Institute of Neurobiology, Martinsried, Germany; Department of Genetics (H.B.), Harvard Medical School, Boston, MA; Munich Cluster for Systems Neurology (SyNergy) (T.M., H.W., R.H., K.D.), Munich, Germany; German Center for Neurodegenerative Diseases (DZNE) and Center for Integrated Protein Science (CIPSM) (T.M.), Munich, Germany; and INSERM, UMR 1064 (D.A.L.), Nantes, France
| | - Klaus Dornmair
- Institute of Clinical Neuroimmunology (K.H., L.B.-D., K.S., W.S., E.B., G.R., J.K.M.N., R.H., K.D.), Ludwig-Maximilians University, Munich, Germany; Neurologische Gemeinschaftspraxis (S.S.), Gesundheitszentrum St. Johannes Hospital, Bonn, Germany; Institute of Neuronal Cell Biology (P.E., T.M.), TU Munich, Munich, Germany; Department for Molecular Medicine (M.M.), Max-Planck-Institute of Biochemistry, Martinsried, Germany; Department for Neuroimmunology (W.E.F.K., H.W.), Max-Planck-Institute of Neurobiology, Martinsried, Germany; Department of Genetics (H.B.), Harvard Medical School, Boston, MA; Munich Cluster for Systems Neurology (SyNergy) (T.M., H.W., R.H., K.D.), Munich, Germany; German Center for Neurodegenerative Diseases (DZNE) and Center for Integrated Protein Science (CIPSM) (T.M.), Munich, Germany; and INSERM, UMR 1064 (D.A.L.), Nantes, France
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Kaushansky N, Eisenstein M, Boura-Halfon S, Hansen BE, Nielsen CH, Milo R, Zeilig G, Lassmann H, Altmann DM, Ben-Nun A. Role of a Novel Human Leukocyte Antigen-DQA1*01:02;DRB1*15:01 Mixed Isotype Heterodimer in the Pathogenesis of "Humanized" Multiple Sclerosis-like Disease. J Biol Chem 2015; 290:15260-78. [PMID: 25911099 DOI: 10.1074/jbc.m115.641209] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Indexed: 11/06/2022] Open
Abstract
Gene-wide association and candidate gene studies indicate that the greatest effect on multiple sclerosis (MS) risk is driven by the HLA-DRB1*15:01 allele within the HLA-DR15 haplotype (HLA-DRB1*15:01-DQA1*01:02-DQB1*0602-DRB5*01:01). Nevertheless, linkage disequilibrium makes it difficult to define, without functional studies, whether the functionally relevant effect derives from DRB1*15:01 only, from its neighboring DQA1*01:02-DQB1*06:02 or DRB5*01:01 genes of HLA-DR15 haplotype, or from their combinations or epistatic interactions. Here, we analyzed the impact of the different HLA-DR15 haplotype alleles on disease susceptibility in a new "humanized" model of MS induced in HLA-transgenic (Tg) mice by human oligodendrocyte-specific protein (OSP)/claudin-11 (hOSP), one of the bona fide potential primary target antigens in MS. We show that the hOSP-associated MS-like disease is dominated by the DRB1*15:01 allele not only as the DRA1*01:01;DRB1*15:01 isotypic heterodimer but also, unexpectedly, as a functional DQA1*01:02;DRB1*15:01 mixed isotype heterodimer. The contribution of HLA-DQA1/DRB1 mixed isotype heterodimer to OSP pathogenesis was revealed in (DRB1*1501xDQB1*0602)F1 double-Tg mice immunized with hOSP(142-161) peptide, where the encephalitogenic potential of prevalent DRB1*1501/hOSP(142-161)-reactive Th1/Th17 cells is hindered due to a single amino acid difference in the OSP(142-161) region between humans and mice; this impedes binding of DRB1*1501 to the mouse OSP(142-161) epitope in the mouse CNS while exposing functional binding of mouse OSP(142-161) to DQA1*01:02;DRB1*15:01 mixed isotype heterodimer. This study, which shows for the first time a functional HLA-DQA1/DRB1 mixed isotype heterodimer and its potential association with disease susceptibility, provides a rationale for a potential effect on MS risk from DQA1*01:02 through functional DQA1*01:02;DRB1*15:01 antigen presentation. Furthermore, it highlights a potential contribution to MS risk also from interisotypic combination between products of neighboring HLA-DR15 haplotype alleles, in this case the DQA1/DRB1 combination.
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Affiliation(s)
| | - Miriam Eisenstein
- Chemical Research Support, Weizmann Institute of Science, Rehovot 76100, Israel
| | | | - Bjarke Endel Hansen
- the Institute for Inflammation Research, Department of Infectious Diseases and Rheumatology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
| | - Claus Henrik Nielsen
- the Institute for Inflammation Research, Department of Infectious Diseases and Rheumatology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
| | - Ron Milo
- the Department of Neurology, Barzilai Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Ashkelon 78278, Israel
| | - Gabriel Zeilig
- the Department of Neurological Rehabilitation, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel, the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel
| | - Hans Lassmann
- the Center for Brain Research, Department of Neuroimmunology, Medical University of Vienna, 1090 Vienna, Austria, and
| | - Daniel M Altmann
- the Department of Medicine, Imperial College, Hammersmith Hospital, London W12 0HS, United Kingdom
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De Oliveira GLV, De Lima KWA, Colombini AM, Pinheiro DG, Panepucci RA, Palma PVB, Brum DG, Covas DT, Simões BP, De Oliveira MC, Donadi EA, Malmegrim KCR. Bone Marrow Mesenchymal Stromal Cells Isolated from Multiple Sclerosis Patients have Distinct Gene Expression Profile and Decreased Suppressive Function Compared with Healthy Counterparts. Cell Transplant 2015; 24:151-65. [DOI: 10.3727/096368913x675142] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease of the central nervous system, due to an immune reaction against myelin proteins. Multipotent mesenchymal stromal cells (MSCs) present immunosuppressive effects and have been used for the treatment of autoimmune diseases. In our study, gene expression profile and in vitro immunomodulatory function tests were used to compare bone marrow-derived MSCs obtained from MS patients, at pre- and postautologous hematopoietic stem cell transplantation (AHSCT) with those from healthy donors. Patient MSCs comparatively exhibited i) senescence in culture; ii) similar osteogenic and adipogenic differentiation potential; iii) decreased expression of CD105, CD73, CD44, and HLA-A/B/C molecules; iv) distinct transcription at pre-AHSCT compared with control MSCs, yielding 618 differentially expressed genes, including the downregulation of TGFB1 and HGF genes and modulation of the FGF and HGF signaling pathways; v) reduced antiproliferative effects when pre-AHSCT MSCs were cocultured with allogeneic T-lymphocytes; vi) decreased secretion of IL-10 and TGF-β in supernatants of both cocultures (pre- and post-AHSCT MSCs); and vii) similar percentages of regulatory cells recovered after MSC cocultures. The transcriptional profile of patient MSCs isolated 6 months posttransplantation was closer to pre-AHSCT samples than from healthy MSCs. Considering that patient MSCs exhibited phenotypic changes, distinct transcriptional profile and functional defects implicated in MSC immunomodulatory and immunosuppressive activity, we suggest that further MS clinical studies should be conducted using allogeneic bone marrow MSCs derived from healthy donors. We also demonstrated that treatment of MS patients with AHSCT does not reverse the transcriptional and functional alterations observed in patient MSCs.
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Affiliation(s)
- Gislane L. V. De Oliveira
- Center for Cell-Based Research, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
- Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Kalil W. A. De Lima
- Center for Cell-Based Research, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
- Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Amanda M. Colombini
- Center for Cell-Based Research, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Daniel G. Pinheiro
- Center for Cell-Based Research, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Rodrigo A. Panepucci
- Center for Cell-Based Research, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Patrícia V. B. Palma
- Center for Cell-Based Research, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Doralina G. Brum
- Department of Neurology, Psychology and Psychiatry, School of Medicine of Botucatu, University of State of São Paulo (UNESP), Botucatu, São Paulo, Brazil
| | - Dimas T. Covas
- Center for Cell-Based Research, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
- Department of Clinical Medicine, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Belinda P. Simões
- Center for Cell-Based Research, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
- Department of Clinical Medicine, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Maria C. De Oliveira
- Center for Cell-Based Research, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
- Department of Clinical Medicine, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Eduardo A. Donadi
- Department of Clinical Medicine, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Kelen C. R. Malmegrim
- Center for Cell-Based Research, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
- Department of Clinical, Toxicological and Bromatological Analysis, Faculty of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
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Abstract
A better understanding of the pathological mechanisms that drive neurodegeneration in individuals with multiple sclerosis is needed to develop therapies that will effectively treat patients in the primary and secondary progressive stages of the disease. We propose that the inflammatory demyelinating disease process in early multiple sclerosis triggers a cascade of events that lead to neurodegeneration and are amplified by pathogenic mechanisms related to brain ageing and accumulated disease burden. Key elements driving neurodegeneration include microglia activation, chronic oxidative injury, accumulation of mitochondrial damage in axons, and age-related iron accumulation in the human brain. Altered mitochondrial function in axons might be of particular importance. This process leads to chronic cell stress and imbalance of ionic homoeostasis, resulting in axonal and neuronal death. The evidence suggests that treatment of progressive multiple sclerosis should be based on a combination of anti-inflammatory, regenerative, and neuroprotective strategies.
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Affiliation(s)
- Don H Mahad
- Centre for Neuroregeneration, University of Edinburgh, Edinburgh, UK
| | - Bruce D Trapp
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Hans Lassmann
- Center for Brain Research, Medical University of Vienna, Austria.
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Pieragostino D, D'Alessandro M, di Ioia M, Rossi C, Zucchelli M, Urbani A, Di Ilio C, Lugaresi A, Sacchetta P, Del Boccio P. An integrated metabolomics approach for the research of new cerebrospinal fluid biomarkers of multiple sclerosis. MOLECULAR BIOSYSTEMS 2015; 11:1563-72. [DOI: 10.1039/c4mb00700j] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
(1) Lipid profiling in MuS and OND patients. (2) Search of alterations associated with MuS. (3) Characterization of differences.
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Sriramoju B, Kanwar RK, Kanwar JR. Neurobehavioral burden of multiple sclerosis with nanotheranostics. Neuropsychiatr Dis Treat 2015; 11:2675-89. [PMID: 26508863 PMCID: PMC4610886 DOI: 10.2147/ndt.s82768] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Multiple sclerosis (MS) is a chronic demyelinating neurological disorder affecting people worldwide; women are affected more than men. MS results in serious neurological deficits along with behavioral compromise, the mechanisms of which still remain unclear. Behavioral disturbances such as depression, anxiety, cognitive impairment, psychosis, euphoria, sleep disturbances, and fatigue affect the quality of life in MS patients. Among these, depression and psychosis are more common than any other neurological disorders. In addition, depression is associated with other comorbidities. Although anxiety is often misdiagnosed in MS patients, it can induce suicidal ideation if it coexists with depression. An interrelation between sleep abnormalities and fatigue is also reported among MS patients. In addition, therapeutics for MS is always a challenge because of the presence of the blood-brain barrier, adding to the lack of detailed understanding of the disease pathology. In this review, we tried to summarize various behavioral pathologies and their association with MS, followed by its conventional treatment and nanotheranostics.
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Affiliation(s)
- Bhasker Sriramoju
- Nanomedicine-Laboratory of Immunology and Molecular Biomedical Research (NLIMBR), School of Medicine, Molecular and Medical Research, Faculty of Health, Deakin University, VIC, Australia
| | - Rupinder K Kanwar
- Nanomedicine-Laboratory of Immunology and Molecular Biomedical Research (NLIMBR), School of Medicine, Molecular and Medical Research, Faculty of Health, Deakin University, VIC, Australia
| | - Jagat R Kanwar
- Nanomedicine-Laboratory of Immunology and Molecular Biomedical Research (NLIMBR), School of Medicine, Molecular and Medical Research, Faculty of Health, Deakin University, VIC, Australia
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35
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Ochi H. Mechanism of multiple sclerosis based on the clinical trial results of molecular targeted therapy. ACTA ACUST UNITED AC 2014. [DOI: 10.1111/cen3.12159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Hirofumi Ochi
- Department of Neurology; Ehime University Graduate School of Medicine; Toon Ehime Japan
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36
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Abstract
Autoimmune diseases are common chronic disorders that not only have a major impact on the quality of life but are also potentially life-threatening. Treatment modalities that are currently favored have conferred significant clinical benefits, but they may have considerable side effects. An optimal treatment strategy for autoimmune disease would specifically target disease-associated antigens and limit systemic side effects. Similar to allergen-specific immunotherapy for allergic rhinitis, antigen-specific immunotherapy for autoimmune disease aims to induce immune deviation and promote tolerance to specific antigens. In this review, we present the current status of studies and clinical trials in both human and animal hosts that use antigen-based immunotherapy for autoimmune disease.
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Affiliation(s)
- Darren Lowell Hirsch
- Division of Allergy and Immunology, North Shore-Long Island Jewish Health System/Hofstra North Shore-LIJ School of Medicine, New Hyde Park, NY, USA
| | - Punita Ponda
- Division of Allergy and Immunology, North Shore-Long Island Jewish Health System/Hofstra North Shore-LIJ School of Medicine, New Hyde Park, NY, USA
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37
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Ingwersen J, Menge T, Wingerath B, Kaya D, Graf J, Prozorovski T, Keller A, Backes C, Beier M, Scheffler M, Dehmel T, Kieseier BC, Hartung HP, Küry P, Aktas O. Natalizumab restores aberrant miRNA expression profile in multiple sclerosis and reveals a critical role for miR-20b. Ann Clin Transl Neurol 2014; 2:43-55. [PMID: 25642434 PMCID: PMC4301674 DOI: 10.1002/acn3.152] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 10/03/2014] [Accepted: 10/24/2014] [Indexed: 12/20/2022] Open
Abstract
Objective To identify microRNAs (miRNAs) regulated by anti-α4 integrin monoclonal antibody therapy (natalizumab) in the peripheral blood of patients with relapsing-remitting (RR) multiple sclerosis (MS) and to confirm their role in experimental settings in vivo. Methods In a longitudinal study of 17 RR-MS patients, we investigated blood miRNA expression profiles at baseline and after 1 year of natalizumab therapy by microarray technique and quantitative PCR validation. We compared the baseline expression profiles of these patients to those of 18 age- and sex-matched healthy controls. We confirmed the contribution of resulting candidate miRNAs in an animal model of MS, experimental autoimmune encephalomyelitis (EAE) induced by adoptive transfer of proteolipid protein (PLP)139–151-activated lymphocytes in SJL/J mice or by active immunization of miR-106a∼363-deficient C57BL/6 mice (or wildtype litter mates) with myelin oligodendrocyte glycoprotein (MOG)35–55. Results Our longitudinal analysis revealed that miR-18a, miR-20b, miR-29a, and miR-103 were upregulated and predominantly expressed by CD4+ T cells, whereas miR-326 was downregulated upon natalizumab treatment. A comparison of untreated RR-MS patients at baseline with healthy controls revealed that the four natalizumab-upregulated targets were initially downregulated in MS. All confirmed targets showed disease-dependent expression in splenocytes of mice suffering from EAE. Genetic deletion of the miRNA cluster miR-106a∼363 (containing natalizumab-regulated miR-20b) resulted in a more severe EAE course and an in vivo upregulation of the miR-20b target genes rorgt, stat3, and vegfa. Interpretation Our study indicates that natalizumab restores dysregulated miRNA patterns in MS and reveals the contribution of miR-20b in autoimmune demyelination in vivo.
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Affiliation(s)
- Jens Ingwersen
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Düsseldorf Düsseldorf, Germany
| | - Til Menge
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Düsseldorf Düsseldorf, Germany
| | - Britta Wingerath
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Düsseldorf Düsseldorf, Germany
| | - Derya Kaya
- Department of Neurology, Medical School, Dokuz Eylül University Izmir, Turkey
| | - Jonas Graf
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Düsseldorf Düsseldorf, Germany
| | - Tim Prozorovski
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Düsseldorf Düsseldorf, Germany
| | - Andreas Keller
- CBC Comprehensive Biomarker Center GmbH Heidelberg, Germany ; Clinical Bioinformatics, Saarland University Saarbrücken, Germany
| | - Christina Backes
- Clinical Bioinformatics, Saarland University Saarbrücken, Germany
| | - Markus Beier
- CBC Comprehensive Biomarker Center GmbH Heidelberg, Germany
| | | | - Thomas Dehmel
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Düsseldorf Düsseldorf, Germany
| | - Bernd C Kieseier
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Düsseldorf Düsseldorf, Germany
| | - Hans-Peter Hartung
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Düsseldorf Düsseldorf, Germany
| | - Patrick Küry
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Düsseldorf Düsseldorf, Germany
| | - Orhan Aktas
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Düsseldorf Düsseldorf, Germany
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38
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Increasing Incidence in Relapsing-Remitting MS and High Rates among Young Women in Finland: A Thirty-Year Follow-Up. Mult Scler Int 2014; 2014:186950. [PMID: 25431672 PMCID: PMC4241579 DOI: 10.1155/2014/186950] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 09/23/2014] [Accepted: 10/09/2014] [Indexed: 12/27/2022] Open
Abstract
Object. Gender and disease course specific incidences were studied in high- and medium-risk regions of MS in Finland. Methods. Age- and gender-specific incidences with 95% CIs were calculated in 10-year periods from 1981 to 2010. Poser diagnostic criteria were used and compared with the McDonald criteria from 2001 to 2010. Association between age and diagnostic delay over time was assessed by using the Kruskal-Wallis test. Results. 1419 (89%) RRMS and 198 (11%) PPMS cases were included. RRMS incidence increased with the female to male ratio (F/M) from 4,2/105 (F/M 1.9) to 9,7 (2.3), while that of PPMS decreased from 1,2 (1.6) to 0,7 (1.2). The use of McDonald criteria did not change the conclusion. The decreasing diagnostic delay and age at diagnosis in RRMS were associated within the 10-year periods and contrasted those in PPMS. Increasing female risk in RRMS was observed in the high-risk region. Conclusion. Increasing RRMS incidence and high female ratios shown in each age group indicate gender-specific influences acting already from childhood. A more precise definition of the risk factors and their action in MS is needed to provide a better understanding of underlying pathological processes and a rationale for the development of new preventive and treatment strategies.
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39
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Unaltered regulatory B-cell frequency and function in patients with multiple sclerosis. Clin Immunol 2014; 155:198-208. [PMID: 25267439 DOI: 10.1016/j.clim.2014.09.011] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 09/15/2014] [Accepted: 09/16/2014] [Indexed: 11/20/2022]
Abstract
Multiple sclerosis (MS) is a chronic disease of the central nervous system (CNS) typically characterized by the recruitment of T cells into the CNS. However, certain subsets of B cells have been shown to negatively regulate autoimmune diseases and some data support a prominent role for B cells in MS physiopathology. For B cells in MS patients we analyzed subset frequency, cytokine secretion ability and suppressive properties. No differences in the frequencies of the B-cell subsets or in their ability to secrete cytokines were observed between MS and healthy volunteers (HV). Prestimulated B cells from MS patients also inhibited CD4(+)CD25(-) T cell proliferation with a similar efficiency as B cells from HV. Altogether, our data show that, in our MS patient cohort, regulatory B cells have conserved frequency and function.
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40
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Dimou L, Götz M. Glial cells as progenitors and stem cells: new roles in the healthy and diseased brain. Physiol Rev 2014; 94:709-37. [PMID: 24987003 DOI: 10.1152/physrev.00036.2013] [Citation(s) in RCA: 175] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The diverse functions of glial cells prompt the question to which extent specific subtypes may be devoted to a specific function. We discuss this by reviewing one of the most recently discovered roles of glial cells, their function as neural stem cells (NSCs) and progenitor cells. First we give an overview of glial stem and progenitor cells during development; these are the radial glial cells that act as NSCs and other glial progenitors, highlighting the distinction between the lineage of cells in vivo and their potential when exposed to a different environment, e.g., in vitro. We then proceed to the adult stage and discuss the glial cells that continue to act as NSCs across vertebrates and others that are more lineage-restricted, such as the adult NG2-glia, the most frequent progenitor type in the adult mammalian brain, that remain within the oligodendrocyte lineage. Upon certain injury conditions, a distinct subset of quiescent astrocytes reactivates proliferation and a larger potential, clearly demonstrating the concept of heterogeneity with distinct subtypes of, e.g., astrocytes or NG2-glia performing rather different roles after brain injury. These new insights not only highlight the importance of glial cells for brain repair but also their great potential in various aspects of regeneration.
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Affiliation(s)
- Leda Dimou
- Physiological Genomics, Institute of Physiology, Ludwig-Maximilians University, Munich, Germany; Institute for Stem Cell Research, HelmholtzZentrum, Neuherberg, Germany; and Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Magdalena Götz
- Physiological Genomics, Institute of Physiology, Ludwig-Maximilians University, Munich, Germany; Institute for Stem Cell Research, HelmholtzZentrum, Neuherberg, Germany; and Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
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41
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Emmer A, Staege MS, Kornhuber ME. The retrovirus/superantigen hypothesis of multiple sclerosis. Cell Mol Neurobiol 2014; 34:1087-96. [PMID: 25138639 DOI: 10.1007/s10571-014-0100-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 08/09/2014] [Indexed: 12/21/2022]
Abstract
The pathogenesis of multiple sclerosis (MS) is as yet unknown. Commonly, MS is assumed to be due to an autoimmune inflammation of the central nervous system (CNS). Neurodegeneration is regarded to be a secondary reaction. This concept is increasingly being challenged. Human endogenous retroviruses (HERV) that could be locally activated in the CNS have been proposed as an alternative concept. HERV-encoded envelope proteins (env) can act as strong immune stimulators (superantigens). Thus, slow disease progression following neurodegeneration might be induced by re-activation of HERV expression directly, while relapses in parallel to inflammation might be secondary to the expression of HERV-encoded superantigens. It has been shown previously that T-cell superantigens are capable to induce a cellular inflammatory reaction in the CNS of experimental animals similar to that in MS. Furthermore, B-cell superantigens have been shown to activate blood leucocytes in vitro to produce immunoglobulin in an oligoclonal manner. It remains to be established, whether the outlined hypothesis accords with all known features of MS. Furthermore, anti-HERV agents may be taken into consideration to enrich and improve MS therapy.
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Affiliation(s)
- Alexander Emmer
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany,
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42
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Aharoni R. Immunomodulation neuroprotection and remyelination - the fundamental therapeutic effects of glatiramer acetate: a critical review. J Autoimmun 2014; 54:81-92. [PMID: 24934599 DOI: 10.1016/j.jaut.2014.05.005] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 05/23/2014] [Indexed: 01/04/2023]
Abstract
Multiple sclerosis (MS) is a multifaceted heterogeneous disease with various patterns of tissue damage. In addition to inflammation and demyelination, widespread axonal and neuronal pathologies are central components of this disease. MS therapies aim to restrain the pathological processes, enhance protective mechanisms, and prevent disease progression. The amino acid copolymer, glatiramer acetate (GA, Copaxone), an approved treatment for MS, has a unique mode of action. Evidence from the animal model experimental autoimmune encephalomyelitis (EAE) and from MS patients indicates that GA affects various levels of the innate and the adaptive immune response, inducing deviation from the pro-inflammatory to the anti-inflammatory pathways. This includes competition for the binding of antigen presenting cells, driving dendritic cells, monocytes, and B-cells towards anti-inflammatory responses, induction of Th2/3 and T-regulatory cells, and downregulating of both Th1 and Th-17 cells. The immune cells induced by GA reach the inflamed disease organ and secrete in situ anti-inflammatory cytokines alleviating the pathological processes. Furthermore, cumulative findings have revealed that in addition to its immunomodulatory activities GA promotes neuroprotective repair processes such as neurotrophic factors secretion and remyelination. This review aims to provide a comprehensive overview on the diverse mechanism of action of GA in EAE/MS, in particular on the in situ effect of GA and its ability to generate neuroprotection and repair in the CNS. In view of its immunomodulatory activity, the beneficial effects of GA in various models of additional autoimmune related pathologies, such as immune rejection and inflammatory bowel disease (IBD), are also presented.
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Affiliation(s)
- Rina Aharoni
- Department of Immunology, The Weizmann Institute of Science, Rehovot 76100, Israel.
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43
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Ben Fredj N, Rizzo R, Bortolotti D, Nefzi F, Chebel S, Rotola A, Frih-Ayed M, Di Luca D, Aouni M. Evaluation of the implication of KIR2DL2 receptor in multiple sclerosis and herpesvirus susceptibility. J Neuroimmunol 2014; 271:30-5. [DOI: 10.1016/j.jneuroim.2014.03.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 02/10/2014] [Accepted: 03/24/2014] [Indexed: 01/23/2023]
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44
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Kooij G, Kroon J, Paul D, Reijerkerk A, Geerts D, van der Pol SMA, van Het Hof B, Drexhage JA, van Vliet SJ, Hekking LHP, van Buul JD, Pachter JS, de Vries HE. P-glycoprotein regulates trafficking of CD8(+) T cells to the brain parenchyma. Acta Neuropathol 2014; 127:699-711. [PMID: 24429546 DOI: 10.1007/s00401-014-1244-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 01/02/2014] [Indexed: 01/13/2023]
Abstract
The trafficking of cytotoxic CD8(+) T lymphocytes across the lining of the cerebral vasculature is key to the onset of the chronic neuro-inflammatory disorder multiple sclerosis. However, the mechanisms controlling their final transmigration across the brain endothelium remain unknown. Here, we describe that CD8(+) T lymphocyte trafficking into the brain is dependent on the activity of the brain endothelial adenosine triphosphate-binding cassette transporter P-glycoprotein. Silencing P-glycoprotein activity selectively reduced the trafficking of CD8(+) T cells across the brain endothelium in vitro as well as in vivo. In response to formation of the T cell-endothelial synapse, P-glycoprotein was found to regulate secretion of endothelial (C-C motif) ligand 2 (CCL2), a chemokine that mediates CD8(+) T cell migration in vitro. Notably, CCL2 levels were significantly enhanced in microvessels isolated from human multiple sclerosis lesions in comparison with non-neurological controls. Endothelial cell-specific elimination of CCL2 in mice subjected to experimental autoimmune encephalomyelitis also significantly diminished the accumulation of CD8(+) T cells compared to wild-type animals. Collectively, these results highlight a novel (patho)physiological role for P-glycoprotein in CD8(+) T cell trafficking into the central nervous system during neuro-inflammation and illustrate CCL2 secretion as a potential link in this mechanism.
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Affiliation(s)
- Gijs Kooij
- Blood-Brain Barrier Research Group, Department of Molecular Cell Biology and Immunology, Neuroscience Campus Amsterdam, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands,
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Bar-Or A, Pachner A, Menguy-Vacheron F, Kaplan J, Wiendl H. Teriflunomide and its mechanism of action in multiple sclerosis. Drugs 2014; 74:659-74. [PMID: 24740824 PMCID: PMC4003395 DOI: 10.1007/s40265-014-0212-x] [Citation(s) in RCA: 228] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Treatment of multiple sclerosis (MS) is challenging: disease-modifying treatments (DMTs) must both limit unwanted immune responses associated with disease initiation and propagation (as T and B lymphocytes are critical cellular mediators in the pathophysiology of relapsing MS), and also have minimal adverse impact on normal protective immune responses. In this review, we summarize key preclinical and clinical data relating to the proposed mechanism of action of the recently approved DMT teriflunomide in MS. Teriflunomide selectively and reversibly inhibits dihydro-orotate dehydrogenase, a key mitochondrial enzyme in the de novo pyrimidine synthesis pathway, leading to a reduction in proliferation of activated T and B lymphocytes without causing cell death. Results from animal experiments modelling the immune activation implicated in MS demonstrate reductions in disease symptoms with teriflunomide treatment, accompanied by reduced central nervous system lymphocyte infiltration, reduced axonal loss, and preserved neurological functioning. In agreement with the results obtained in these model systems, phase 3 clinical trials of teriflunomide in patients with MS have consistently shown that teriflunomide provides a therapeutic benefit, and importantly, does not cause clinical immune suppression. Taken together, these data demonstrate how teriflunomide acts as a selective immune therapy for patients with MS.
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Affiliation(s)
- Amit Bar-Or
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Andrew Pachner
- Geisel School of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | | | | | - Heinz Wiendl
- Department of Neurology, University of Münster, Albert-Schweitzer-Campus 1, Building A10 (previously Domagkstr. 13), 48149 Münster, Germany
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46
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Salmen A, Gold R. Mode of action and clinical studies with fumarates in multiple sclerosis. Exp Neurol 2014; 262 Pt A:52-6. [PMID: 24568735 DOI: 10.1016/j.expneurol.2014.02.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 02/10/2014] [Accepted: 02/11/2014] [Indexed: 12/21/2022]
Abstract
Multiple sclerosis (MS) as a chronic neuro-inflammatory and neurodegenerative disease of the central nervous system is frequently associated with severe disability and impairment in quality of life. Early disease-modifying treatment options have mainly focused on inflammatory aspects of the disease. Recently, the neurodegenerative features have received more attention in experimental models, paraclinical assessments and the evaluation of drug effects. Fumaric acid esters (FAEs) as orally available immunomodulatory and neuroprotective compounds have thus advanced to a highly interesting MS treatment option. Here, we will review the pharmaceutical history of FAEs, their immunomodulatory and putative neuroprotective mechanisms of action and clinical trial data in relapsing MS.
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Affiliation(s)
- Anke Salmen
- Department of Neurology, St. Josef-Hospital, Ruhr-University, Bochum, Germany
| | - Ralf Gold
- Department of Neurology, St. Josef-Hospital, Ruhr-University, Bochum, Germany.
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Vaughan K, Peters B, O'Connor KC, Martin R, Sette A. A molecular view of multiple sclerosis and experimental autoimmune encephalitis: what can we learn from the epitope data? J Neuroimmunol 2014; 267:73-85. [PMID: 24365494 PMCID: PMC4784960 DOI: 10.1016/j.jneuroim.2013.12.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 12/03/2013] [Accepted: 12/06/2013] [Indexed: 02/04/2023]
Abstract
An analysis to inventory all immune epitope data related to multiple sclerosis (MS) was performed using the Immune Epitope Database (IEDB). The analysis revealed that MS related data represent >20% of all autoimmune data, and that studies of EAE predominate; only 22% of the references describe human data. To date, >5800 unique peptides, analogs, mimotopes, and/or non-protein epitopes have been reported from 861 references, including data describing myelin-containing, as well as non-myelin antigens. This work provides a reference point for the scientific community of the universe of available data for MS-related adaptive immunity in the context of EAE and human disease.
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Affiliation(s)
- Kerrie Vaughan
- La Jolla Institute for Allergy and Immunology, 9420 Athena Circle, La Jolla, CA, USA.
| | - Bjoern Peters
- La Jolla Institute for Allergy and Immunology, 9420 Athena Circle, La Jolla, CA, USA
| | - Kevin C O'Connor
- Department of Neurology, Yale School of Medicine, 300 George Street, New Haven, CT 06511, USA; Human and Translational Immunology Program, Yale School of Medicine, 300 George Street, New Haven, CT 06511, USA
| | - Roland Martin
- Neuroimmunology and MS Research, Department of Neurology, University Hospital Zurich, 8091 Zurich, Switzerland
| | - Alessandro Sette
- La Jolla Institute for Allergy and Immunology, 9420 Athena Circle, La Jolla, CA, USA
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Lutterotti A, Yousef S, Sputtek A, Stürner KH, Stellmann JP, Breiden P, Reinhardt S, Schulze C, Bester M, Heesen C, Schippling S, Miller SD, Sospedra M, Martin R. Antigen-specific tolerance by autologous myelin peptide-coupled cells: a phase 1 trial in multiple sclerosis. Sci Transl Med 2014; 5:188ra75. [PMID: 23740901 DOI: 10.1126/scitranslmed.3006168] [Citation(s) in RCA: 221] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Multiple sclerosis (MS) is a devastating inflammatory disease of the brain and spinal cord that is thought to result from an autoimmune attack directed against antigens in the central nervous system. The aim of this first-in-man trial was to assess the feasibility, safety, and tolerability of a tolerization regimen in MS patients that uses a single infusion of autologous peripheral blood mononuclear cells chemically coupled with seven myelin peptides (MOG1-20, MOG35-55, MBP13-32, MBP83-99, MBP111-129, MBP146-170, and PLP139-154). An open-label, single-center, dose-escalation study was performed in seven relapsing-remitting and two secondary progressive MS patients who were off-treatment for standard therapies. All patients had to show T cell reactivity against at least one of the myelin peptides used in the trial. Neurological, magnetic resonance imaging, laboratory, and immunological examinations were performed to assess the safety, tolerability, and in vivo mechanisms of action of this regimen. Administration of antigen-coupled cells was feasible, had a favorable safety profile, and was well tolerated in MS patients. Patients receiving the higher doses (>1 × 10(9)) of peptide-coupled cells had a decrease in antigen-specific T cell responses after peptide-coupled cell therapy. In summary, this first-in-man clinical trial of autologous peptide-coupled cells in MS patients establishes the feasibility and indicates good tolerability and safety of this therapeutic approach.
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Affiliation(s)
- Andreas Lutterotti
- Institute for Neuroimmunology and Clinical MS Research, Center for Molecular Neurobiology, 20251 Hamburg, Germany
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Schreiner B, Bailey SL, Miller SD. T-cell response dynamics in animal models of multiple sclerosis: implications for immunotherapies. Expert Rev Clin Immunol 2014; 3:57-72. [DOI: 10.1586/1744666x.3.1.57] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Lolli F, Rovero P, Chelli M, Papini AM. Toward biomarkers in multiple sclerosis: new advances. Expert Rev Neurother 2014; 6:781-94. [PMID: 16734525 DOI: 10.1586/14737175.6.5.781] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Multiple sclerosis is an autoimmune disease that commonly affects young adults. If initially characterized by acute relapses, it is later followed by only incomplete remission. Over years, progressive disability and irreversible deficit lead to chronic neurological deficits in the majority of patients. The clinical course is protracted and unpredictable, and no biological marker is useful in predicting the evolution of autoaggression and disability. It is difficult to diagnose and to monitor disease progression after the initial symptoms or even during the major clinical manifestations, and it is difficult to treat. In this review, the authors report recent advances in the field, focusing on the search of new antigens as a marker of the disease, in their relevance to the pathophysiology and diagnosis of the disease.
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Affiliation(s)
- Francesco Lolli
- Laboratorio Interdipartimentale di Chimica & Biologia dei Peptidi & Proteine, Polo Scientifico e Tecnologico, Università degli Studi di Firenze, via Ugo Schiff 6, I-50019 Sesto Fiorentino, Italy.
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