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Maxwell DL, Orian JM. Cerebellar pathology in multiple sclerosis and experimental autoimmune encephalomyelitis: current status and future directions. J Cent Nerv Syst Dis 2023; 15:11795735231211508. [PMID: 37942276 PMCID: PMC10629308 DOI: 10.1177/11795735231211508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 10/15/2023] [Indexed: 11/10/2023] Open
Abstract
Recent decades have witnessed significant progress in understanding mechanisms driving neurodegeneration and disease progression in multiple sclerosis (MS), but with a focus on the cerebrum. In contrast, there have been limited studies of cerebellar disease, despite the common occurrence of cerebellar symptoms in this disorder. These rare studies, however, highlight the early cerebellar involvement in disease development and an association between the early occurrence of cerebellar lesions and risk of worse prognosis. In parallel developments, it has become evident that far from being a region specialized in movement control, the cerebellum plays a crucial role in cognitive function, via circuitry connecting the cerebellum to association areas of the cerebrum. This complexity, coupled with challenges in imaging of the cerebellum have been major obstacles in the appreciation of the spatio-temporal evolution of cerebellar damage in MS and correlation with disability and progression. MS studies based on animal models have relied on an induced neuroinflammatory disease known as experimental autoimmune encephalomyelitis (EAE), in rodents and non-human primates (NHP). EAE has played a critical role in elucidating mechanisms underpinning tissue damage and been validated for the generation of proof-of-concept for cerebellar pathological processes relevant to MS. Additionally, rodent and NHP studies have formed the cornerstone of current knowledge of functional anatomy and cognitive processes. Here, we propose that improved insight into consequences of cerebellar damage in MS at the functional, cellular and molecular levels would be gained by more extensive characterization of EAE cerebellar pathology combined with the power of experimental paradigms in the field of cognition. Such combinatorial approaches would lead to improved potential for the development of MS sensitive markers and evaluation of candidate therapeutics.
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Affiliation(s)
- Dain L. Maxwell
- Department of Biochemistry and Chemistry, La Trobe Institute for Molecular Science, School of Agriculture, Biomedicine and Environment, La Trobe University, Bundoora, VIC, Australia
- Department of Anatomy and Neuroscience, The University of Melbourne, Parkville, VIC, Australia
| | - Jacqueline M. Orian
- Department of Biochemistry and Chemistry, La Trobe Institute for Molecular Science, School of Agriculture, Biomedicine and Environment, La Trobe University, Bundoora, VIC, Australia
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Aigrot MS, Barthelemy C, Moyon S, Dufayet-Chaffaud G, Izagirre-Urizar L, Gillet-Legrand B, Tada S, Bayón-Cordero L, Chara JC, Matute C, Cartier N, Lubetzki C, Tepavčević V. Genetically modified macrophages accelerate myelin repair. EMBO Mol Med 2022; 14:e14759. [PMID: 35822550 PMCID: PMC9358396 DOI: 10.15252/emmm.202114759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 06/01/2022] [Accepted: 06/02/2022] [Indexed: 11/09/2022] Open
Abstract
Preventing neurodegeneration‐associated disability progression in patients with multiple sclerosis (MS) remains an unmet therapeutic need. As remyelination prevents axonal degeneration, promoting this process in patients might enhance neuroprotection. In demyelinating mouse lesions, local overexpression of semaphorin 3F (Sema3F), an oligodendrocyte progenitor cell (OPC) attractant, increases remyelination. However, molecular targeting to MS lesions is a challenge. A clinically relevant paradigm for delivering Sema3F to demyelinating lesions could be to use blood‐derived macrophages as vehicles. Thus, we chose transplantation of genetically modified hematopoietic stem cells (HSCs) as means of obtaining chimeric mice with circulating Sema3F‐overexpressing monocytes. We demonstrated that Sema3F‐transduced HSCs stimulate OPC migration in a neuropilin 2 (Nrp2, Sema3F receptor)‐dependent fashion, which was conserved in middle‐aged OPCs. While demyelinating lesions induced in mice with Sema3F‐expressing blood cells showed no changes in inflammation and OPC survival, OPC recruitment was enhanced which accelerated the onset of remyelination. Our results provide a proof of concept that blood cells, particularly monocytes/macrophages, can be used to deliver pro‐remyelinating agents “at the right time and place,” suggesting novel means for remyelination‐promoting strategies in MS.
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Affiliation(s)
| | - Clara Barthelemy
- INSERM UMR1127 Sorbonne Université, Paris Brain Institute (ICM), Paris, France
| | - Sarah Moyon
- NYU Langone Health, Neuroscience Institute, New York City, NY, USA
| | | | - Leire Izagirre-Urizar
- Achucarro Basque Center for Neuroscience/Department of Neuroscience, School of Medicine University of the Basque Country, Leioa, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | | | - Satoru Tada
- INSERM UMR1127 Sorbonne Université, Paris Brain Institute (ICM), Paris, France
| | - Laura Bayón-Cordero
- Achucarro Basque Center for Neuroscience/Department of Neuroscience, School of Medicine University of the Basque Country, Leioa, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Juan-Carlos Chara
- Achucarro Basque Center for Neuroscience/Department of Neuroscience, School of Medicine University of the Basque Country, Leioa, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Carlos Matute
- Achucarro Basque Center for Neuroscience/Department of Neuroscience, School of Medicine University of the Basque Country, Leioa, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Nathalie Cartier
- Asklepios Biopharmaceutical, Inc., Institut du Cerveau (ICM), Paris, France
| | - Catherine Lubetzki
- INSERM UMR1127 Sorbonne Université, Paris Brain Institute (ICM), Paris, France.,AP-HP, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - Vanja Tepavčević
- Achucarro Basque Center for Neuroscience/Department of Neuroscience, School of Medicine University of the Basque Country, Leioa, Spain
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Bhargava P, Hartung HP, Calabresi PA. Contribution of B cells to cortical damage in multiple sclerosis. Brain 2022; 145:3363-3373. [PMID: 35775595 DOI: 10.1093/brain/awac233] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 05/06/2022] [Accepted: 06/17/2022] [Indexed: 11/14/2022] Open
Abstract
Multiple sclerosis is associated with lesions not just in the white matter, but also involving the cortex. Cortical involvement has been linked to greater disease severity and hence understanding the factor underlying cortical pathology could help identify new therapeutic strategies for multiple sclerosis. The critical role of B cells in multiple sclerosis has been clarified by multiple pivotal trials of B cell depletion in people with multiple sclerosis. The presence of B cell rich areas of meningeal inflammation in multiple sclerosis has been identified at all stages of multiple sclerosis. Leptomeningeal inflammation is associated with greater extent of cortical demyelination and neuronal loss and with greater disease severity. Recent studies have identified several potential mechanisms by which B cells may mediate cortical injury including antibody production, extracellular vesicles containing neurotoxic substances and production of pro-inflammatory cytokines. Additionally, B cells may indirectly mediate cortical damage through effects on T cells, macrophages or microglia. Several animal models replicate the meningeal inflammation and cortical injury noted in people with multiple sclerosis. Studies in these models have identified BTK inhibition and type II anti-CD20 antibodies as potential agents that can impact meningeal inflammation. Trials of anti-CD20 monoclonal antibodies in people with multiple sclerosis have unsuccessfully attempted to eliminate B cells in the leptomeninges. New strategies to target B cells in multiple sclerosis include BTK inhibition and cell-based therapies aimed at B cells infected with Epstein Barr virus. Future studies will clarify the mechanisms by which B cells mediate cortical injury and treatment strategies that can target B cells in the leptomeninges and CNS parenchyma.
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Affiliation(s)
- Pavan Bhargava
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Hans Peter Hartung
- Department of Neurology, Heinrich-Heine University, Dusseldorf, Germany.,Brain and Mind Center, University of Sydney, Sydney, Australia.,Department of Neurology, Medical University of Vienna, Vienna, Austria.,Department of Neurology, Palacky University Olomouc, Olomouc, Czech Republic
| | - Peter A Calabresi
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Shin T, Ahn M, Kim J, Jung K, Moon C, Kim MD. Visual Dysfunction in Multiple Sclerosis and its Animal Model, Experimental Autoimmune Encephalomyelitis: a Review. Mol Neurobiol 2021; 58:3484-3493. [PMID: 33745114 DOI: 10.1007/s12035-021-02355-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 03/09/2021] [Indexed: 01/09/2023]
Abstract
Visual disabilities in central nervous system autoimmune diseases such as multiple sclerosis (MS) and its animal model, experimental autoimmune encephalomyelitis (EAE), are important symptoms. Past studies have focused on neuro-inflammatory changes and demyelination in the white matter of the brain and spinal cord. In MS, neuro-inflammatory lesions have been diagnosed in the visual pathway; the lesions may perturb visual function. Similarly, neuropathological changes in the retina and optic nerves have been found in animals with chronic EAE. Although the retina and optic nerves are immunologically privileged sites via the blood-retina barrier and blood-brain barrier, respectively, inflammation can occur via other routes, such as the uvea (e.g., iris and choroid) and cerebrospinal fluid in the meninges. This review primarily addresses the direct involvement of the blood-retina barrier and the blood-brain barrier in the development of retinitis and optic neuritis in EAE models. Additional routes, including pro-inflammatory mediator-filled choroidal and subarachnoid spaces, are also discussed with respect to their roles in EAE-induced visual disability and as analogues of MS in humans.
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Affiliation(s)
- Taekyun Shin
- College of Veterinary Medicine and Veterinary Medical Research Institute, Jeju National University, Jeju, 63243, Republic of Korea.
| | - Meejung Ahn
- Department of Animal Science, College of Life Science, Sangji University, Wonju, 26339, Republic of Korea
| | - Jeongtae Kim
- Department of Anatomy, Kosin University College of Medicine, Busan, 43267, Republic of Korea
| | - Kyungsook Jung
- Functional Biomaterials Research Center, Korea Research Institute of Bioscience and Biotechnology, 181 Ipsin-gil, Jeongeup-si, Jeonbuk, 56212, Republic of Korea
| | - Changjong Moon
- Department of Veterinary Anatomy, College of Veterinary Medicine and BK21 Plus Project Team, Chonnam National University, Gwangju, 61186, Republic of Korea
| | - Moon-Doo Kim
- Department of Psychiatry, School of Medicine, Jeju National University, Jeju, 63241, Republic of Korea
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Herrmann CJJ, Els A, Boehmert L, Periquito J, Eigentler TW, Millward JM, Waiczies S, Kuchling J, Paul F, Niendorf T. Simultaneous T 2 and T 2 ∗ mapping of multiple sclerosis lesions with radial RARE-EPI. Magn Reson Med 2021; 86:1383-1402. [PMID: 33951214 DOI: 10.1002/mrm.28811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 03/26/2021] [Accepted: 03/26/2021] [Indexed: 12/26/2022]
Abstract
PURPOSE The characteristic MRI features of multiple sclerosis (MS) lesions make it conceptually appealing to pursue parametric mapping techniques that support simultaneous generation of quantitative maps of 2 or more MR contrast mechanisms. We present a modular rapid acquisition with relaxation enhancement (RARE)-EPI hybrid that facilitates simultaneous T2 and T 2 ∗ mapping (2in1-RARE-EPI). METHODS In 2in1-RARE-EPI the first echoes in the echo train are acquired with a RARE module, later echoes are acquired with an EPI module. To define the fraction of echoes covered by the RARE and EPI module, an error analysis of T2 and T 2 ∗ was conducted with Monte Carlo simulations. Radial k-space (under)sampling was implemented for acceleration (R = 2). The feasibility of 2in1-RARE-EPI for simultaneous T2 and T 2 ∗ mapping was examined in a phantom study mimicking T2 and T 2 ∗ relaxation times of the brain. For validation, 2in1-RARE-EPI was benchmarked versus multi spin-echo (MSE) and multi gradient-echo (MGRE) techniques. The clinical applicability of 2in1-RARE-EPI was demonstrated in healthy subjects and MS patients. RESULTS There was a good agreement between T2 / T 2 ∗ values derived from 2in1-RARE-EPI and T2 / T 2 ∗ reference values obtained from MSE and MGRE in both phantoms and healthy subjects. In patients, MS lesions in T2 and T 2 ∗ maps deduced from 2in1-RARE-EPI could be just as clearly delineated as in reference maps calculated from MSE/MGRE. CONCLUSION This work demonstrates the feasibility of radially (under)sampled 2in1-RARE-EPI for simultaneous T2 and T 2 ∗ mapping in MS patients.
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Affiliation(s)
- Carl J J Herrmann
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany.,Department of Physics, Humboldt University of Berlin, Berlin, Germany
| | - Antje Els
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Laura Boehmert
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Joao Periquito
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Thomas Wilhelm Eigentler
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany.,Chair of Medical Engineering, Technical University of Berlin, Berlin, Germany
| | - Jason M Millward
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Sonia Waiczies
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Joseph Kuchling
- Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max Delbrück Center for Molecular Medicine, Berlin, Germany.,NeuroCure Clinical Research Center, Charité-Universitätsmedizin, Berlin, Germany.,Department of Neurology, Charité-Universitätsmedizin, Berlin, Germany
| | - Friedemann Paul
- Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max Delbrück Center for Molecular Medicine, Berlin, Germany.,NeuroCure Clinical Research Center, Charité-Universitätsmedizin, Berlin, Germany.,Department of Neurology, Charité-Universitätsmedizin, Berlin, Germany
| | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany.,Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max Delbrück Center for Molecular Medicine, Berlin, Germany
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Beutel T, Dzimiera J, Kapell H, Engelhardt M, Gass A, Schirmer L. Cortical projection neurons as a therapeutic target in multiple sclerosis. Expert Opin Ther Targets 2020; 24:1211-1224. [PMID: 33103501 DOI: 10.1080/14728222.2020.1842358] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Multiple sclerosis (MS) is a chronic inflammatory-demyelinating disease of the central nervous system associated with lesions of the cortical gray matter and subcortical white matter. Recently, cortical lesions have become a major focus of research because cortical pathology and neuronal damage are critical determinants of irreversible clinical progression. Recent transcriptomic studies point toward cell type-specific changes in cortical neurons in MS with a selective vulnerability of excitatory projection neuron subtypes. AREAS COVERED We discuss the cortical mapping and the molecular properties of excitatory projection neurons and their role in MS lesion pathology while placing an emphasis on their subtype-specific transcriptomic changes and levels of vulnerability. We also examine the latest magnetic resonance imaging techniques to study cortical MS pathology as a key tool for monitoring disease progression and treatment efficacy. Finally, we consider possible therapeutic avenues and novel strategies to protect excitatory cortical projection neurons. Literature search methodology: PubMed articles from 2000-2020. EXPERT OPINION Excitatory cortical projection neurons are an emerging therapeutic target in the treatment of progressive MS. Understanding neuron subtype-specific molecular pathologies and their exact spatial mapping will help establish starting points for the development of novel cell type-specific therapies and biomarkers in MS.
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Affiliation(s)
- Tatjana Beutel
- Department of Neurology, Medical Faculty Mannheim, MCTN, Heidelberg University , Mannheim, Germany
| | - Julia Dzimiera
- Department of Neurology, Medical Faculty Mannheim, MCTN, Heidelberg University , Mannheim, Germany
| | - Hannah Kapell
- Department of Neurology, Medical Faculty Mannheim, MCTN, Heidelberg University , Mannheim, Germany
| | - Maren Engelhardt
- Institute of Neuroanatomy, Medical Faculty Mannheim, MCTN, Heidelberg University , Mannheim, Germany.,Interdisciplinary Center for Neurosciences, Heidelberg University , Heidelberg, Germany
| | - Achim Gass
- Department of Neurology, Medical Faculty Mannheim, MCTN, Heidelberg University , Mannheim, Germany
| | - Lucas Schirmer
- Department of Neurology, Medical Faculty Mannheim, MCTN, Heidelberg University , Mannheim, Germany.,Interdisciplinary Center for Neurosciences, Heidelberg University , Heidelberg, Germany
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