The Multiple Factors of Multiple Sclerosis: A Darwinian Perspective

Pathological transitions in myelin membranes driven by environmental and multiple sclerosis conditions

In demyelination diseases, such as multiple sclerosis, the structure of the axons’ protective sheaths is disrupted. Due to the proximity of cytoplasmic myelin membrane to structural phase transition, minor alterations in the local environmental conditions can have devastating results. Using small-angle X-ray scattering and cryogenic transmission electron microscopy, we show that drastic structural reorganization and instabilities of myelin membrane are linked to specific environmental conditions and molecular composition in healthy and diseased states. These instabilities involve phase transition from the healthy lamellar membranes to pathological inverted hexagonal phase. These results highlight that local environmental conditions are critical for myelin function and should be considered as alternative routes for early pathology and as a means to avoid the initiation of demyelination.

Multiple sclerosis (MS) is an autoimmune disease, leading to the destruction of the myelin sheaths, the protective layers surrounding the axons. The etiology of the disease is unknown, although there are several postulated environmental factors that may contribute to it. Recently, myelin damage was correlated to structural phase transition from a healthy stack of lamellas to a diseased inverted hexagonal phase as a result of the altered lipid stoichiometry and low myelin basic protein (MBP) content. In this work, we show that environmental conditions, such as buffer salinity and temperature, induce the same pathological phase transition as in the case of the lipid composition in the absence of MBP. These phase transitions have different transition points, which depend on the lipid’s compositions, and are ion specific. In extreme environmental conditions, we find an additional dense lamellar phase and that the native lipid composition results in similar pathology as the diseased composition. These findings demonstrate that several local environmental changes can trigger pathological structural changes. We postulate that these structural modifications result in myelin membrane vulnerability to the immune system attacks and thus can help explain MS etiology.

Viral Infection of the Central Nervous System Exacerbates Interleukin-10 Receptor Deficiency-Mediated Colitis in SJL Mice

Theiler´s murine encephalomyelitis virus (TMEV)-infection is a widely used animal model for studying demyelinating disorders, including multiple sclerosis (MS). The immunosuppressive cytokine Interleukin (IL)-10 counteracts hyperactive immune responses and critically controls immune homeostasis in infectious and autoimmune disorders. In order to investigate the effect of signaling via Interleukin-10 receptor (IL-10R) in infectious neurological diseases, TMEV-infected SJL mice were treated with IL-10R blocking antibody (Ab) in the acute and chronic phase of the disease. The findings demonstrate that (i) Ab-mediated IL-10 neutralization leads to progressive colitis with a reduction in Foxp3+ regulatory T cells and increased numbers of CD8+CD44+ memory T cells as well as activated CD4+CD69+ and CD8+CD69+ T cells in uninfected mice. (ii) Concurrent acute TMEV-infection worsened enteric disease-mediated by IL-10R neutralization. Virus-triggered effects were associated with an enhanced activation of CD4+ T helper cells and CD8+ cytotoxic T lymphocytes and augmented cytokine expression. By contrast, (iii) IL-10R neutralization during chronic TMEV-infection was not associated with enhanced peripheral immunopathology but an increased CD3+ T cell influx in the spinal cord. IL-10R neutralization causes a breakdown in peripheral immune tolerance in genetically predisposed mice, which leads to immune-mediated colitis, resembling inflammatory bowel disease. Hyperactive immune state following IL-10R blockade is enhanced by central nervous system-restricted viral infection in a disease phase-dependent manner.

Can an engineer fix an immune system?--Rethinking theoretical biology

In an instant classic paper (Lazebnik, in Cancer Cell 2(3); 2002: 179-182) biologist Yuri Lazebnik deplores the poor effectiveness of the approach adopted by biologists to understand and "fix" biological systems. Lazebnik suggests that to remedy this state of things biologist should take inspiration from the approach used by engineers to design, understand, and troubleshoot technological systems. In the present paper I substantiate Lazebnik's analysis by concretely showing how to apply the engineering approach to biological problems. I use an actual example of electronic circuit troubleshooting to ground the thesis that, in engineering, the crucial phases of any non-trivial troubleshooting process are aimed at generating a mechanistic explanation of the functioning of the system, which makes extensive recourse to problem-driven qualitative reasoning possibly based on cognitive artifacts applied to systems that are known to have been designed for function. To show how to translate these findings into biological practice I consider a concrete example of biological model building and "troubleshooting", aimed at the identification of a "fix" for the human immune system in presence of progressing cancer, autoimmune disease, and transplant rejection. The result is a novel immune system model--the danger model with regulatory cells--and new, original hypotheses concerning the development, prophylaxis, and therapy of these unwanted biological processes. Based on the manifest efficacy of the proposed approach, I suggest a refocusing of the activity of theoretical biologists along the engineering-inspired lines illustrated in the paper.

Multiple sclerosis and inflammatory bowel diseases: what we know and what we would need to know!

Multiple sclerosis (MS) is a demyelinating disorder of the central nervous system (CNS) but the causes have not been defined. The disease process appears to involve interplay between environmental factors and certain susceptibility genes. It is likely that the identification of the exact etiological mechanisms will permit the development of preventive and curative treatments. Evaluation of several diseases found to be more often associated than by chance alone may reveal clues to the etiology of those disorders. An association between MS and inflammatory bowel diseases (IBD) was suggested by the observation of an increased incidence of IBD among MS patients. A problem in the interpretation of the data rests, in part, with the observation that abnormal findings in brain magnetic resonance imaging (MRI) may be reported as MS in IBD patients. Defining the limits between incidental MRI findings and findings compatible with MS has resulted in further exploration of this possible association.

Adolescents and inhalant abuse: how huffing affects the myelin sheath

As concern grows over the impact that accidental chemical exposures may have on the long term health of individuals, our young people are deliberately exposing themselves to the effect of neurotoxic chemicals with the intent of feeling high. Over time the result of inhaling these chemicals is often the development of symptoms and behavior that may suggest serious physiological damage. Research is being conducted to examine what the exact nature of the damage might be, especially the impact of inhaled lipophilic chemicals on structures in the brain and other parts of the nervous system. Healthcare professionals responsible for assessing adolescents in all settings need to be aware of the prevalence of inhalant abuse, as well as the chemicals, terminology, and potential symptomatology in order to intervene in the behavior and provide diagnosis and treatment as indicated. Some implications for nursing are included.