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Shadab A, Abbasi-Kolli M, Yazdanpanah E, Esmaeili SA, Baharlou R, Yousefi B, Haghmorad D. Exploring the immune-modulating properties of boswellic acid in experimental autoimmune encephalomyelitis. APMIS 2024; 132:452-464. [PMID: 38563150 DOI: 10.1111/apm.13406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/08/2024] [Indexed: 04/04/2024]
Abstract
Multiple sclerosis (MS) is a condition where the central nervous system loses its myelin coating due to autoimmune inflammation. The experimental autoimmune encephalomyelitis (EAE) simulates some aspects of human MS. Boswellic acids are natural compounds derived from frankincense extract, known for their anti-inflammatory properties. The purpose of this research was to investigate therapeutic potential of boswellic acids. Mice were divided into three groups: low-dose (LD), high-dose (HD), and control groups (CTRL). Following EAE induction, the mice received daily doses of boswellic acid for 25 days. Brain tissue damage, clinical symptoms, and levels of TGF-β, IFN-γ, and IL-17 cytokines in cell cultured supernatant of lymphocytes were assessed. Gene expression of transcription factors in brain was measured using real-time PCR. The levels of brain demyelination were significantly lower in the treatment groups compared to the CTRL group. Boswellic acid reduced the severity and duration of EAE symptoms. Furthermore, boswellic acid decreased the amounts of IFN-γ and IL-17, also the expression of T-bet and ROR-γt in brain. On the contrary, it increased the levels of TGF-β and the expression FoxP3 and GATA3. Our findings suggest that boswellic acids possess therapeutic potential for EAE by modulating the immune response and reducing inflammation.
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MESH Headings
- Animals
- Encephalomyelitis, Autoimmune, Experimental/drug therapy
- Encephalomyelitis, Autoimmune, Experimental/immunology
- Encephalomyelitis, Autoimmune, Experimental/pathology
- Triterpenes/pharmacology
- Triterpenes/therapeutic use
- Mice
- Female
- Mice, Inbred C57BL
- Brain/drug effects
- Brain/pathology
- Brain/metabolism
- Brain/immunology
- Cytokines/metabolism
- Transforming Growth Factor beta/metabolism
- Transforming Growth Factor beta/genetics
- Immunomodulating Agents/pharmacology
- Immunomodulating Agents/therapeutic use
- Interleukin-17/metabolism
- Nuclear Receptor Subfamily 1, Group F, Member 3/metabolism
- Nuclear Receptor Subfamily 1, Group F, Member 3/genetics
- Anti-Inflammatory Agents/pharmacology
- Anti-Inflammatory Agents/therapeutic use
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Affiliation(s)
- Alireza Shadab
- Department of Immunology, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
- Deputy of Health, Iran University of Medical Sciences, Tehran, Iran
| | | | - Esmaeil Yazdanpanah
- Immunology Research Center, and Department of Immunology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed-Alireza Esmaeili
- Immunology Research Center, and Department of Immunology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Rasoul Baharlou
- Department of Immunology, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
- Cancer Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Bahman Yousefi
- Department of Immunology, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
- Cancer Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Dariush Haghmorad
- Department of Immunology, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
- Cancer Research Center, Semnan University of Medical Sciences, Semnan, Iran
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2
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Yska HAF, Engelen M, Bugiani M. The pathology of X-linked adrenoleukodystrophy: tissue specific changes as a clue to pathophysiology. Orphanet J Rare Dis 2024; 19:138. [PMID: 38549180 PMCID: PMC10976706 DOI: 10.1186/s13023-024-03105-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 02/23/2024] [Indexed: 04/02/2024] Open
Abstract
Although the pathology of X-linked adrenoleukodystrophy (ALD) is well described, it represents the end-stage of neurodegeneration. It is still unclear what cell types are initially involved and what their role is in the disease process. Revisiting the seminal post-mortem studies from the 1970s can generate new hypotheses on pathophysiology. This review describes (histo)pathological changes of the brain and spinal cord in ALD. It aims at integrating older works with current insights and at providing an overarching theory on the pathophysiology of ALD. The data point to an important role for axons and glia in the pathology of both the myelopathy and leukodystrophy of ALD. In-depth pathological analyses with new techniques could help further unravel the sequence of events behind the pathology of ALD.
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Affiliation(s)
- Hemmo A F Yska
- Department of Child Neurology, Amsterdam Leukodystrophy Center, Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands.
| | - Marc Engelen
- Department of Child Neurology, Amsterdam Leukodystrophy Center, Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Marianna Bugiani
- Department of Pediatrics/Child Neurology, VU University Medical Centre, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Department of Pathology, VU University Medical Centre, Amsterdam Neuroscience, Amsterdam, The Netherlands
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3
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Atkinson KC, Osunde M, Tiwari-Woodruff SK. The complexities of investigating mitochondria dynamics in multiple sclerosis and mouse models of MS. Front Neurosci 2023; 17:1144896. [PMID: 37559701 PMCID: PMC10409489 DOI: 10.3389/fnins.2023.1144896] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 06/23/2023] [Indexed: 08/11/2023] Open
Abstract
Multiple sclerosis (MS) is a demyelinating, degenerating disorder of the central nervous system (CNS) that is accompanied by mitochondria energy production failure. A loss of myelin paired with a deficit in energy production can contribute to further neurodegeneration and disability in patients in MS. Mitochondria are essential organelles that produce adenosine triphosphate (ATP) via oxidative phosphorylation in all cells in the CNS, including neurons, oligodendrocytes, astrocytes, and immune cells. In the context of demyelinating diseases, mitochondria have been shown to alter their morphology and undergo an initial increase in metabolic demand. This is followed by mitochondrial respiratory chain deficiency and abnormalities in mitochondrial transport that contribute to progressive neurodegeneration and irreversible disability. The current methodologies to study mitochondria are limiting and are capable of providing only a partial snapshot of the true mitochondria activity at a particular timepoint during disease. Mitochondrial functional studies are mostly performed in cell culture or whole brain tissue, which prevents understanding of mitochondrial pathology in distinct cell types in vivo. A true understanding of cell-specific mitochondrial pathophysiology of MS in mouse models is required. Cell-specific mitochondria morphology, mitochondria motility, and ATP production studies in animal models of MS will help us understand the role of mitochondria in the normal and diseased CNS. In this review, we present currently used methods to investigate mitochondria function in MS mouse models and discuss the current advantages and caveats with using each technique. In addition, we present recently developed mitochondria transgenic mouse lines expressing Cre under the control of CNS specific promoters to relate mitochondria to disease in vivo.
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Affiliation(s)
| | | | - Seema K. Tiwari-Woodruff
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, United States
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4
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Corneal nerve fiber involvement in chronic inflammatory demyelinating polyneuropathy. Neurol Sci 2023:10.1007/s10072-023-06711-1. [PMID: 36856905 DOI: 10.1007/s10072-023-06711-1] [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: 12/21/2022] [Accepted: 02/20/2023] [Indexed: 03/02/2023]
Abstract
BACKGROUND Despite the primary myelin-related pathophysiology, small fiber neuropathy (SFN) and axonal degeneration are also considered to be involved and associated with disabling symptoms and impaired quality of life in chronic inflammatory demyelinating polyneuropathy (CIDP). Demonstration of SFN usually requires complex or invasive investigations. OBJECTS In vivo corneal confocal microscopy (IVCCM) has evolved as a non-invasive, easily applied method for quantification of small fiber involvement in peripheral nerve disorders. We aimed to investigate the potential role of IVCCM in CIDP. METHODS In this cross-sectional study, 15 patients with CIDP underwent assessment with clinical disability scales, neuropathic pain (NP) and autonomic symptom questionnaires, nerve conduction studies, and IVCCM. IVCCM parameters were analyzed and compared to those from 32 healthy controls. RESULTS Corneal nerve fiber density (CNFD) and corneal nerve fiber length (CNFL) were significantly decreased in the CIDP group, compared to those in controls (p = 0.03 and p = 0.024, respectively). Langerhans cells and fiber tortuosity were increased in CIDP patients (p = 0.005 and p = 0.001, respectively). IVCCM parameters were significantly lower in patients with NP compared to those in patients without NP. CONCLUSION IVCCM shows promise as a non-invasive complementary biomarker in the assessment of demyelinating polyneuropathies, providing insights into the potential pathophysiology of these non-length-dependent neuropathies.
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5
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Tonietto M, Poirion E, Lazzarotto A, Ricigliano V, Papeix C, Bottlaender M, Bodini B, Stankoff B. Periventricular remyelination failure in multiple sclerosis: a substrate for neurodegeneration. Brain 2023; 146:182-194. [PMID: 36097347 DOI: 10.1093/brain/awac334] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 07/26/2022] [Accepted: 08/18/2022] [Indexed: 01/11/2023] Open
Abstract
In multiple sclerosis, spontaneous remyelination is generally incomplete and heterogeneous across patients. A high heterogeneity in remyelination may also exist across lesions within the same individual, suggesting the presence of local factors interfering with myelin regeneration. In this study we explored in vivo the regional distribution of myelin repair and investigated its relationship with neurodegeneration. We first took advantage of the myelin binding property of the amyloid radiotracer 11C-PiB to conduct a longitudinal 11C-PiB PET study in an original cohort of 19 participants with a relapsing-remitting form of multiple sclerosis, followed-up over a period of 1-4 months. We then replicated our results on an independent cohort of 40 people with multiple sclerosis followed-up over 1 year with magnetization transfer imaging, an MRI metrics sensitive to myelin content. For each imaging method, voxel-wise maps of myelin content changes were generated according to modality-specific thresholds. We demonstrated a selective failure of remyelination in periventricular white matter lesions of people with multiple sclerosis in both cohorts. In both the original and the replication cohort, we estimated that the probability of demyelinated voxels to remyelinate over the follow-up increased significantly as a function of the distance from ventricular CSF. Enlarged choroid plexus, a recently discovered biomarker linked to neuroinflammation, was found to be associated with the periventricular failure of remyelination in the two cohorts (r = -0.79, P = 0.0018; r = -0.40, P = 0.045, respectively), suggesting a role of the brain-CSF barrier in affecting myelin repair in surrounding tissues. In both cohorts, the failure of remyelination in periventricular white matter lesions was associated with lower thalamic volume (r = 0.86, P < 0.0001; r = 0.33; P = 0.069, respectively), an imaging marker of neurodegeneration. Interestingly, we also showed an association between the periventricular failure of remyelination and regional cortical atrophy that was mediated by the number of cortex-derived tracts passing through periventricular white matter lesions, especially in patients at the relapsing-remitting stage. Our findings demonstrate that lesion proximity to ventricles is associated with a failure of myelin repair and support the hypothesis that a selective periventricular remyelination failure in combination with the large number of tracts connecting periventricular lesions with cortical areas is a key mechanism contributing to cortical damage in multiple sclerosis.
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Affiliation(s)
- Matteo Tonietto
- Paris Brain Institute, Sorbonne Université, ICM, CNRS, Inserm, Paris, France.,Service Hospitalier Frédéric Joliot, Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, France
| | - Emilie Poirion
- Paris Brain Institute, Sorbonne Université, ICM, CNRS, Inserm, Paris, France
| | - Andrea Lazzarotto
- Paris Brain Institute, Sorbonne Université, ICM, CNRS, Inserm, Paris, France.,Neurology Department, St Antoine Hospital, APHP, Paris, France
| | - Vito Ricigliano
- Paris Brain Institute, Sorbonne Université, ICM, CNRS, Inserm, Paris, France.,Neurology Department, St Antoine Hospital, APHP, Paris, France
| | - Caroline Papeix
- Paris Brain Institute, Sorbonne Université, ICM, CNRS, Inserm, Paris, France.,Neurology Department, Pitié-Salpêtrière Hospital, APHP, Paris, France
| | - Michel Bottlaender
- Service Hospitalier Frédéric Joliot, Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, France
| | - Benedetta Bodini
- Paris Brain Institute, Sorbonne Université, ICM, CNRS, Inserm, Paris, France.,Neurology Department, St Antoine Hospital, APHP, Paris, France
| | - Bruno Stankoff
- Paris Brain Institute, Sorbonne Université, ICM, CNRS, Inserm, Paris, France.,Neurology Department, St Antoine Hospital, APHP, Paris, France
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6
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Al‐Zuhairy A, Jakobsen J, Moldovan M, Krarup C. Axonal loss at time of diagnosis as biomarker for long-term disability in chronic inflammatory demyelinating polyneuropathy. Muscle Nerve 2022; 66:715-722. [PMID: 36217677 PMCID: PMC9828077 DOI: 10.1002/mus.27722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 08/16/2022] [Accepted: 08/27/2022] [Indexed: 01/12/2023]
Abstract
INTRODUCTION/AIMS We hypothesized that early, pretreatment axonal loss would predict long-term disability, supported by a pilot study of selected patients with chronic inflammatory demyelinating polyneuropathy (CIDP). To further test this hypothesis, we examined a larger consecutive group of CIDP patients. METHODS Needle electromyography and motor and sensory nerve conduction studies were carried out in 30 CIDP patients at pretreatment and follow-up 5 to 28 years later. Changes in amplitudes were expressed as axonal Z scores and changes in conduction as demyelination Z scores and correlated with findings of the Inflammatory Rasch-built Overall Disability Scale (I-RODS), the Neuropathy Impairment Score (NIS), and isokinetic dynamometry (IKS). RESULTS At follow-up, the median I-RODS score was 73, the NIS was 23, and the IKS was 56%. The median axonal Z score was unchanged at follow-up. Conversely, the corresponding demyelination Z scores improved. The initial axonal loss was correlated with the clinical outcome and was an independent predictor of outcome by multivariate regression analysis. Axonal loss at follow-up was also correlated with the clinical outcome. Only the follow-up demyelination Z score was correlated with the clinical outcomes. Furthermore, the latency until treatment initiation was predictive of all three clinical outcome scores at follow-up, and of axonal loss and demyelination at follow-up. DISCUSSION The present study findings indicate that pretreatment axonal loss at diagnosis in CIDP is predictive of long-term disability, neurological impairment, and strength. A delay in treatment is associated with more pronounced axonal loss and a worse clinical outcome.
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Affiliation(s)
- Ali Al‐Zuhairy
- Department of NeurologyCopenhagen University Hospital, RigshospitaletCopenhagenDenmark
| | - Johannes Jakobsen
- Department of NeurologyCopenhagen University Hospital, RigshospitaletCopenhagenDenmark
| | - Mihai Moldovan
- Department of Clinical NeurophysiologyRigshospitalet and Department of Neuroscience, University of CopenhagenCopenhagenDenmark
| | - Christian Krarup
- Department of Clinical NeurophysiologyRigshospitalet and Department of Neuroscience, University of CopenhagenCopenhagenDenmark
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7
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Kapoor M, Carr A, Foiani M, Heslegrave A, Zetterberg H, Malaspina A, Compton L, Hutton E, Rossor A, Reilly MM, Lunn MP. Association of plasma neurofilament light chain with disease activity in chronic inflammatory demyelinating polyradiculoneuropathy. Eur J Neurol 2022; 29:3347-3357. [PMID: 35837802 PMCID: PMC9796374 DOI: 10.1111/ene.15496] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/06/2022] [Accepted: 06/25/2022] [Indexed: 01/02/2023]
Abstract
BACKGROUND AND PURPOSE This study was undertaken to explore associations between plasma neurofilament light chain (pNfL) concentration (pg/ml) and disease activity in patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and examine the usefulness of pNfL concentrations in determining disease remission. METHODS We examined pNfL concentrations in treatment-naïve CIDP patients (n = 10) before and after intravenous immunoglobulin (IVIg) induction treatment, in pNfL concentrations in patients on maintenance IVIg treatment who had stable (n = 15) versus unstable disease (n = 9), and in clinically stable IVIg-treated patients (n = 10) in whom we suspended IVIg to determine disease activity and ongoing need for maintenance IVIg. pNfL concentrations in an age-matched healthy control group were measured for comparison. RESULTS Among treatment-naïve patients, pNfL concentration was higher in patients before IVIg treatment than healthy controls and subsequently reduced to be comparable to control group values after IVIg induction. Among CIDP patients on IVIg treatment, pNfL concentration was significantly higher in unstable patients than stable patients. A pNFL concentration > 16.6 pg/ml distinguished unstable treated CIDP from stable treated CIDP (sensitivity = 86.7%, specificity = 66.7%, area under receiver operating characteristic curve = 0.73). Among the treatment withdrawal group, there was a statistically significant correlation between pNfL concentration at time of IVIg withdrawal and the likelihood of relapse (r = 0.72, p < 0.05), suggesting an association of higher pNfL concentration with active disease. CONCLUSIONS pNfL concentrations may be a sensitive, clinically useful biomarker in assessing subclinical disease activity.
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Affiliation(s)
- Mahima Kapoor
- Department of Neuromuscular DiseasesUniversity College London Queen Square Institute of NeurologyLondonUK
- Department of NeurosciencesCentral Clinical School, Monash University, Alfred CentreMelbourneVictoriaAustralia
| | - Aisling Carr
- Department of Neuromuscular DiseasesUniversity College London Queen Square Institute of NeurologyLondonUK
- Centre for Neuromuscular diseasesNational Hospital for Neurology and NeurosurgeryLondonUK
| | - Martha Foiani
- Department of Neurodegenerative DiseaseUniversity College London Queen Square Institute of NeurologyLondonUK
- UK Dementia Research Institute at University College LondonLondonUK
| | - Amanda Heslegrave
- Department of Neurodegenerative DiseaseUniversity College London Queen Square Institute of NeurologyLondonUK
- UK Dementia Research Institute at University College LondonLondonUK
| | - Henrik Zetterberg
- Department of Neurodegenerative DiseaseUniversity College London Queen Square Institute of NeurologyLondonUK
- UK Dementia Research Institute at University College LondonLondonUK
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and Physiology, Sahlgrenska Academy at University of GothenburgMölndalSweden
- Hong Kong Center for Neurodegenerative DiseasesHong KongChina
| | - Andrea Malaspina
- Department of Neuromuscular DiseasesUniversity College London Queen Square Institute of NeurologyLondonUK
- University College London Queen Square Motor Neuron Disease Centre, Queen Square Institute of NeurologyLondonUK
- Centre for Neuroscience and TraumaBlizard Institute, Barts and London School of Medicine and Dentistry, Queen Mary University of LondonLondonUK
- ALS Biomarkers StudyUniversity College LondonLondonUK
| | - Laura Compton
- Centre for Neuromuscular diseasesNational Hospital for Neurology and NeurosurgeryLondonUK
| | - Elspeth Hutton
- Department of NeurosciencesCentral Clinical School, Monash University, Alfred CentreMelbourneVictoriaAustralia
| | - Alexander Rossor
- Department of Neuromuscular DiseasesUniversity College London Queen Square Institute of NeurologyLondonUK
- Centre for Neuromuscular diseasesNational Hospital for Neurology and NeurosurgeryLondonUK
| | - Mary M. Reilly
- Department of Neuromuscular DiseasesUniversity College London Queen Square Institute of NeurologyLondonUK
- Centre for Neuromuscular diseasesNational Hospital for Neurology and NeurosurgeryLondonUK
| | - Michael P. Lunn
- Department of Neuromuscular DiseasesUniversity College London Queen Square Institute of NeurologyLondonUK
- Centre for Neuromuscular diseasesNational Hospital for Neurology and NeurosurgeryLondonUK
- Neuroimmunology and CSF LaboratoryUniversity College London Queen Square Institute of NeurologyLondonUK
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8
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The Brave New World of Early Treatment of Multiple Sclerosis: Using the Molecular Biomarkers CXCL13 and Neurofilament Light to Optimize Immunotherapy. Biomedicines 2022; 10:biomedicines10092099. [PMID: 36140203 PMCID: PMC9495360 DOI: 10.3390/biomedicines10092099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 11/17/2022] Open
Abstract
Multiple sclerosis (MS) is a highly heterogeneous disease involving a combination of inflammation, demyelination, and CNS injury. It is the leading cause of non-traumatic neurological disability in younger people. There is no cure, but treatments in the form of immunomodulatory drugs (IMDs) are available. Experience over the last 30 years has shown that IMDs, also sometimes called disease-modifying therapies, are effective in downregulating neuroinflammatory activity. However, there are a number of negatives in IMD therapy, including potential for significant side-effects and adverse events, uncertainty about long-term benefits regarding disability outcomes, and very high and increasing financial costs. The two dozen currently available FDA-approved IMDs also are heterogeneous with respect to efficacy and safety, especially long-term safety, and determining an IMD treatment strategy is therefore challenging for the clinician. Decisions about optimal therapy have been particularly difficult in early MS, at the time of the initial clinical demyelinating event (ICDE), at a time when early, aggressive treatment would best be initiated on patients destined to have a highly inflammatory course. However, given the fact that the majority of ICDE patients have a more benign course, aggressive immunosuppression, with its attendant risks, should not be administered to this group, and should only be reserved for patients with a more neuroinflammatory course, a decision that can only be made in retrospect, months to years after the ICDE. This quandary of moderate vs. aggressive therapy facing clinicians would best be resolved by the use of biomarkers that are predictive of future neuroinflammation. Unfortunately, biomarkers, especially molecular biomarkers, have not thus far been particularly useful in assisting clinicians in predicting the likelihood of future neuroinflammation, and thus guiding therapy. However, the last decade has seen the emergence of two highly promising molecular biomarkers to guide therapy in early MS: the CXCL13 index and neurofilament light. This paper will review the immunological and neuroscientific underpinnings of these biomarkers and the data supporting their use in early MS and will propose how they will likely be used to maximize benefit and minimize risk of IMDs in MS patients.
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9
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D'Souza A, Wang C, Tu S, Soligo DJ, Kiernan MC, Barnett M, Calamante F. A robust framework for characterising diffusion metrics of the median and ulnar nerves: Exploiting state-of-the-art tracking methods. J Peripher Nerv Syst 2021; 27:67-83. [PMID: 34908209 DOI: 10.1111/jns.12478] [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: 02/05/2021] [Revised: 11/10/2021] [Accepted: 12/11/2021] [Indexed: 11/26/2022]
Abstract
Diffusion-weighted imaging has been used to quantify peripheral nerve properties; however, traditional post-processing techniques have several limitations. Advanced neuroimaging techniques, which overcome many of these limitations, have not been applied to peripheral nerves. Here, we use state-of-the-art diffusion analysis tools to reconstruct the median and ulnar nerves and quantify their diffusion properties. Diffusion-weighted MRI scans were obtained from eight healthy adult subjects. Constrained spherical deconvolution was combined with probabilistic fibre tracking to compute track-weighted fibre orientation distribution (TW-FOD). The tensor was computed and used along with the tracks to estimate TW apparent diffusion coefficient (TW-ADC), TW fractional anisotropy (TW-FA), TW axial diffusivity (TW-AD), and TW radial diffusivity (TW-RD). Variability of TW measurements was used to estimate power size information. The population intersession mean (± SD) measurements for the median nerve were TW-FOD 1.30 (±0.17), TW-ADC 1.16 (±0.13) × 10-3 mm2 /s, TW-FA 0.60 (±0.05), TW-AD 2.05 (±0.16) × 10-3 mm2 /s, and TW-RD 0.72 (±0.12) × 10-3 mm2 /s. The corresponding measurements for the ulnar nerve were TW-FOD 1.25 (±0.14), TW-ADC 1.13 (±0.10) × 10-3 mm2 /s, TW-FA 0.56 (±0.06), TW-AD 1.93 (±0.01) × 10-3 mm2 /s, and TW-RD 0.74 (±0.12) × 10-3 mm2 /s. Based on these measurements, a sample size of 37 would be sufficient to detect a 10% difference in any of the measured TW metrics. A sample size of 20 would be large enough to detect within-subject differences as small as 2.9% (TW-AD, ulnar nerve) and between-subject differences as small as 3.8% (TW-AD, ulnar nerve).
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Affiliation(s)
- Arkiev D'Souza
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia.,Sydney Imaging, The University of Sydney, Sydney, New South Wales, Australia
| | - Chenyu Wang
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia.,Sydney Neuroimaging Analysis Centre, Camperdown, New South Wales, Australia
| | - Sicong Tu
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia.,Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Matthew C Kiernan
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia.,Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia.,Department of Neurology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Michael Barnett
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia.,Sydney Neuroimaging Analysis Centre, Camperdown, New South Wales, Australia.,Department of Neurology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Fernando Calamante
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia.,Sydney Imaging, The University of Sydney, Sydney, New South Wales, Australia.,School of Biomedical Engineering, The University of Sydney, Sydney, New South Wales, Australia
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10
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Wang C, Barton J, Kyle K, Ly L, Barnett Y, Hartung HP, Reddel SW, Beadnall H, Taha M, Klistorner A, Barnett MH. Multiple sclerosis: structural and functional integrity of the visual system following alemtuzumab therapy. J Neurol Neurosurg Psychiatry 2021; 92:1319-1324. [PMID: 34187865 DOI: 10.1136/jnnp-2021-326164] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 06/02/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To investigate potential neuroprotective and pro-remyelinating effects of alemtuzumab in multiple sclerosis (MS), using the visual pathway as a model. METHODS We monitored clinical, multifocal visual evoked potential (mfVEP) and MRI outcomes in 30 patients commencing alemtuzumab for relapsing MS, and a reference group of 20 healthy controls (HCs), over 24 months. Change in mfVEP latency was the primary endpoint; change in optic radiation (OR) lesion diffusion metrics and Mars letter contrast sensitivity over the course of the study were secondary endpoints. RESULTS In patients, we observed a mean shortening of mfVEP latency of 1.21 ms over the course of the study (95% CI 0.21 to 2.21, p=0.013), not altered by correction for age, gender, disease duration or change in OR T2 lesion volume. Mean mfVEP latency in the HC group increased over the course of the study by 0.72 ms (not significant). Analysis of chronic OR T2 lesions (patients) showed an increase in normalised fractional anisotropy and axial diffusivity between baseline and 24 months (both p<0.01). Mean Mars letter contrast sensitivity was improved at 24 months vs baseline (p<0.001), and driven by an early improvement, in both patients and HC. CONCLUSION We found evidence of partial lesion remyelination after alemtuzumab therapy, indicating either natural restoration in the context of a 'permissive' local milieu; or potentially an independent, pro-reparative mechanism of action. The visual system presents a unique opportunity to study function-structure specific effects of therapy and inform the design of future phase 2 MS remyelination trials.
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Affiliation(s)
- Chenyu Wang
- Sydney Neuroimaging Analysis Centre, Camperdown, New South Wales, Australia.,Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Joshua Barton
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Kain Kyle
- Sydney Neuroimaging Analysis Centre, Camperdown, New South Wales, Australia.,Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Linda Ly
- Sydney Neuroimaging Analysis Centre, Camperdown, New South Wales, Australia
| | - Yael Barnett
- Sydney Neuroimaging Analysis Centre, Camperdown, New South Wales, Australia.,Radiology Department, St Vincent's Hospital Sydney, Darlinghurst, New South Wales, Australia
| | - Hans-Peter Hartung
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia.,Clinic for Neurology, Heinrich Heine University Düsseldorf, Dusseldorf, Germany
| | - Stephen W Reddel
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Heidi Beadnall
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia.,Neurology Department, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Marinda Taha
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Alexander Klistorner
- Sydney Neuroimaging Analysis Centre, Camperdown, New South Wales, Australia.,Save Sight Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Michael Harry Barnett
- Sydney Neuroimaging Analysis Centre, Camperdown, New South Wales, Australia .,Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia.,Neurology Department, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
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11
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Wang Y, Xie C, Song Y, Xiang W, Peng J, Han L, Ding J, Guan Y. miR-20a suppresses Treg differentiation by targeting Map3k9 in experimental autoimmune encephalomyelitis. J Transl Med 2021; 19:223. [PMID: 34039371 PMCID: PMC8157414 DOI: 10.1186/s12967-021-02893-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 05/17/2021] [Indexed: 12/18/2022] Open
Abstract
Background Experimental autoimmune encephalomyelitis (EAE) is a model for inflammatory demyelinating diseases of the central nervous system (CNS), a group of autoimmune diseases characterized by inflammatory infiltration, demyelination, and axonal damage. miR-20a is dysregulated in patients with CNS inflammatory demyelinating diseases; however, the function of miR-20a remains unclear. In this study, we intended to explore the role of miR-20a in EAE. Methods The expression of miR-20a was detected by quantitative real-time PCR (qRT-PCR) in EAE mice and patients with MOG antibody-associated demyelinating diseases. CD4+ T cells of EAE mice were sorted, stimulated, and polarized with miR-20a knockdown. Activation and differentiation of CD4+ T cells were analyzed by flow cytometry. The expression of target gene Map3k9 was detected by qRT-PCR and western blot experiments. The binding of miR-20a to the 3’ UTR of Map3k9 was tested by luciferase assays. The feasibility of miR-20a as a therapeutic target to alleviate the severity of EAE was explored by intravenous administration of miR-20a antagomirs to EAE mice. Results miR-20a was upregulated in splenocytes and lymph node cells, CD4+ T cells, and spinal cords of EAE mice. Moreover, miR-20a knockdown did not influence the activation of antigen-specific CD4+ T cells but promoted their differentiation into Treg cells. Map3k9 was predicted to be a target gene of miR-20a. The expressions of Map3k9 and miR-20a were negatively correlated, and miR-20a knockdown increased the expression of Map3k9. In addition, miR-20a binded to the 3’ UTR of Map3k9, and simultaneous knockdown of miR-20a and Map3k9 counteracted the enhanced differentiation of Tregs observed when miR-20a was knocked down alone. Furthermore, injection of miR-20a antagomirs to EAE mice reduced the severity of the disease and increased the proportion of Treg cells in peripheral immune organs. Conclusions miR-20a suppresses the differentiation of antigen-specific CD4+ T cells into Tregs in EAE by decreasing the expression of Map3k9. miR-20a antagomirs alleviate EAE, suggesting a new therapy for EAE and CNS inflammatory demyelinating diseases. Supplementary Information The online version contains supplementary material available at 10.1186/s12967-021-02893-4.
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Affiliation(s)
- Yishu Wang
- Department of Neurology, Renji Hospital, Shanghai Jiaotong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China
| | - Chong Xie
- Department of Neurology, Renji Hospital, Shanghai Jiaotong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China
| | - Yaying Song
- Department of Neurology, Renji Hospital, Shanghai Jiaotong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China
| | - Weiwei Xiang
- Department of Neurology, Renji Hospital, Shanghai Jiaotong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China
| | - Jing Peng
- Department of Neurology, Renji Hospital, Shanghai Jiaotong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China
| | - Lu Han
- Department of Neurology, Renji Hospital, Shanghai Jiaotong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China
| | - Jie Ding
- Department of Neurology, Renji Hospital, Shanghai Jiaotong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China
| | - Yangtai Guan
- Department of Neurology, Renji Hospital, Shanghai Jiaotong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China.
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12
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Early axonal loss predicts long-term disability in chronic inflammatory demyelinating polyneuropathy. Clin Neurophysiol 2021; 132:1000-1007. [DOI: 10.1016/j.clinph.2020.12.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 11/30/2020] [Accepted: 12/23/2020] [Indexed: 12/13/2022]
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13
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Dworkin JD, Linn KA, Solomon AJ, Satterthwaite TD, Raznahan A, Bakshi R, Shinohara RT. A local group differences test for subject-level multivariate density neuroimaging outcomes. Biostatistics 2019; 22:646-661. [PMID: 31875881 DOI: 10.1093/biostatistics/kxz058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 11/24/2019] [Accepted: 11/29/2019] [Indexed: 11/14/2022] Open
Abstract
A great deal of neuroimaging research focuses on voxel-wise analysis or segmentation of damaged tissue, yet many diseases are characterized by diffuse or non-regional neuropathology. In simple cases, these processes can be quantified using summary statistics of voxel intensities. However, the manifestation of a disease process in imaging data is often unknown, or appears as a complex and nonlinear relationship between the voxel intensities on various modalities. When the relevant pattern is unknown, summary statistics are often unable to capture differences between disease groups, and their use may encourage post hoc searches for the optimal summary measure. In this study, we introduce the multi-modal density testing (MMDT) framework for the naive discovery of group differences in voxel intensity profiles. MMDT operationalizes multi-modal magnetic resonance imaging (MRI) data as multivariate subject-level densities of voxel intensities and utilizes kernel density estimation to develop a local two-sample test for individual points within the density space. Through simulations, we show that this method controls type I error and recovers relevant differences when applied to a specified point. Additionally, we demonstrate the ability to maintain power while controlling the family-wise error rate and false discovery rate when applying the test over a grid of points within the density space. Finally, we apply this method to a study of subjects with either multiple sclerosis (MS) or conditions that tend to mimic MS on MRI, and find significant differences between the two groups in their voxel intensity profiles within the thalamus.
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Affiliation(s)
- Jordan D Dworkin
- Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Drive, Philadelphia, PA 19104, USA
| | - Kristin A Linn
- Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Drive, Philadelphia, PA 19104, USA
| | - Andrew J Solomon
- Department of Neurological Sciences, Larner College of Medicine at The University of Vermont, 149 Beaumont Avenue, Burlington, VT 05405, USA
| | - Theodore D Satterthwaite
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Armin Raznahan
- Developmental Neurogenomics Unit, National Institute of Mental Health, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA
| | - Rohit Bakshi
- Departments of Neurology and Radiology, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Boston, MA 02115, USA
| | - Russell T Shinohara
- Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Drive, Philadelphia, PA 19104, USA
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14
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van Lieverloo GGA, Wieske L, Verhamme C, Vrancken AFJ, van Doorn PA, Michalak Z, Barro C, van Schaik IN, Kuhle J, Eftimov F. Serum neurofilament light chain in chronic inflammatory demyelinating polyneuropathy. J Peripher Nerv Syst 2019; 24:187-194. [PMID: 30973667 DOI: 10.1111/jns.12319] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 04/05/2019] [Accepted: 04/06/2019] [Indexed: 12/12/2022]
Abstract
Axonal damage in chronic inflammatory demyelinating polyneuropathy (CIDP) is the main predictor of poor outcome. We hypothesized that serum neurofilament light chain (sNfL) reflects disease activity by detecting ongoing neuro-axonal damage in CIDP. Three prospective cohorts of CIDP patients were studied: (a) patients starting induction treatment (IT cohort, N = 29) measured at baseline and 6 months after starting treatment; (b) patients on maintenance treatment (MT) starting intravenous immunoglobuline (IVIg) withdrawal (MT cohort, N = 24) measured at baseline and 6 months after IVIg withdrawal or at time of relapse; and (c) patients in long-term remission without treatment (N = 27). A single molecule array assay was used to measure sNfL. Age-matched healthy controls (N = 30) and age-specific reference values were used for comparison. At baseline, sNfL was higher in patients starting IT compared to healthy controls. Ten out of 29 IT (34%) patients have sNfL levels above the 95th percentile of age-specific cut-off values. In the MT and remission cohort, elevated sNfL levels were infrequent and not different from healthy controls. sNfL levels were correlated with electrophysiological markers of axonal damage. At follow-up assessment, patients with active disease (non-responders and patients who relapsed after IVIg withdrawal) had higher sNfL levels compared with patients with stable disease (responders and patients who were successfully withdrawn from IVIg treatment). sNfL levels were increased in a third of CIDP patients starting IT and reflected axonal damage. sNfL levels might be usable as biomarker of disease activity in a subset of CIDP patients.
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Affiliation(s)
- Gwen G A van Lieverloo
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Luuk Wieske
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Camiel Verhamme
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Alexander F J Vrancken
- Brain Centre Rudolf Magnus, Department of Neurology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Pieter A van Doorn
- Department of Neurology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Zuzanna Michalak
- Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine, and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Christian Barro
- Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine, and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Ivo N van Schaik
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Jens Kuhle
- Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine, and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Filip Eftimov
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
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15
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Vural A, Doppler K, Meinl E. Autoantibodies Against the Node of Ranvier in Seropositive Chronic Inflammatory Demyelinating Polyneuropathy: Diagnostic, Pathogenic, and Therapeutic Relevance. Front Immunol 2018; 9:1029. [PMID: 29867996 PMCID: PMC5960694 DOI: 10.3389/fimmu.2018.01029] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 04/24/2018] [Indexed: 11/13/2022] Open
Abstract
Discovery of disease-associated autoantibodies has transformed the clinical management of a variety of neurological disorders. Detection of autoantibodies aids diagnosis and allows patient stratification resulting in treatment optimization. In the last years, a set of autoantibodies against proteins located at the node of Ranvier has been identified in patients with chronic inflammatory demyelinating polyneuropathy (CIDP). These antibodies target neurofascin, contactin1, or contactin-associated protein 1, and we propose to name CIDP patients with these antibodies collectively as seropositive. They have unique clinical characteristics that differ from seronegative CIDP. Moreover, there is compelling evidence that autoantibodies are relevant for the pathogenesis. In this article, we review the current knowledge on the characteristics of autoantibodies against the node of Ranvier proteins and their clinical relevance in CIDP. We start with a description of the structure of the node of Ranvier followed by a summary of assays used to identify seropositive patients; and then, we describe clinical features and characteristics linked to seropositivity. We review knowledge on the role of these autoantibodies for the pathogenesis with relevance for the emerging concept of nodopathy/paranodopathy and summarize the treatment implications.
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Affiliation(s)
- Atay Vural
- Institute of Clinical Neuroimmunology, Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried, Germany.,Research Center for Translational Medicine, Koç University, Istanbul, Turkey
| | - Kathrin Doppler
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | - Edgar Meinl
- Institute of Clinical Neuroimmunology, Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried, Germany
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16
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Garber JY, Barnett MH. We should focus more on finding therapeutic targets for the non-inflammatory damage in MS - Yes. Mult Scler 2018; 24:1272-1274. [PMID: 29656673 DOI: 10.1177/1352458518770970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Justin Y Garber
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | - Michael H Barnett
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia/Sydney Neuroimaging Analysis Centre, Sydney, NSW, Australia
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17
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Quercetin treatment regulates the Na +,K +-ATPase activity, peripheral cholinergic enzymes, and oxidative stress in a rat model of demyelination. Nutr Res 2018; 55:45-56. [PMID: 29914627 DOI: 10.1016/j.nutres.2018.04.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 03/30/2018] [Accepted: 04/08/2018] [Indexed: 01/13/2023]
Abstract
Quercetin is reported to exert a plethora of health benefits through many different mechanisms of action. This versatility and presence in the human diet has attracted the attention of the scientific community, resulting in a huge output of in vitro and in vivo (preclinical) studies. Therefore, we hypothesized that quercetin can protect Na+,K+-ATPase activity in the central nervous system, reestablish the peripheral cholinesterases activities, and reduce oxidative stress during demyelination events in rats. In line with this expectation, our study aims to find out how quercetin acts on the Na+,K+-ATPase activity in the central nervous system, peripheral cholinesterases, and stress oxidative markers in an experimental model of demyelinating disease. Wistar rats were divided into 4 groups: vehicle, quercetin, ethidium bromide (EB), and EB plus quercetin groups. The animals were treated once a day with vehicle (ethanol 20%) or quercetin 50 mg/kg for 7 (demyelination phase, by gavage) or 21 days (remyelination phase) after EB (0.1%, 10 μL) injection (intrapontine).The encephalon was removed, and the pons, hypothalamus, cerebral cortex, hippocampus, striatum, and cerebellum were dissected to verify the Na+,K+-ATPase activity. Our results showed that quercetin protected against reduction in Na+,K+-ATPase in the pons and cerebellum in the demyelination phase, and it increased the activity of this enzyme in the remyelination phase. During the demyelination, quercetin promoted the increase in acetylcholinesterase activity in whole blood and lymphocytes induced by EB, and it reduced the increase in acetylcholinesterase activity in lymphocytes in the remyelination phase. On day 7, EB increased the superoxide dismutase and decreased catalase activities, as well as increased the thiobarbituric acid-reactive substance levels. Taken together, these results indicated that quercetin regulates the Na+,K+-ATPase activity, affects the alterations of redox state, and participates in the reestablishment of peripheral cholinergic activity during demyelinating and remyelination events.
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18
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Clarkson BDS, Patel MS, LaFrance-Corey RG, Howe CL. Retrograde interferon-gamma signaling induces major histocompatibility class I expression in human-induced pluripotent stem cell-derived neurons. Ann Clin Transl Neurol 2017; 5:172-185. [PMID: 29468178 PMCID: PMC5817842 DOI: 10.1002/acn3.516] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 11/28/2017] [Accepted: 11/30/2017] [Indexed: 02/06/2023] Open
Abstract
Objective Injury-associated axon-intrinsic signals are thought to underlie pathogenesis and progression in many neuroinflammatory and neurodegenerative diseases, including multiple sclerosis (MS). Retrograde interferon gamma (IFN γ) signals are known to induce expression of major histocompatibility class I (MHC I) genes in murine axons, thereby increasing the susceptibility of these axons to attack by antigen-specific CD8+ T cells. We sought to determine whether the same is true in human neurons. Methods A novel microisolation chamber design was used to physically isolate and manipulate axons from human skin fibroblast-derived induced pluripotent stem cell (iPSC)-derived neuron-enriched neural aggregates. Fluorescent retrobeads were used to assess the fraction of neurons with projections to the distal chamber. Axons were treated with IFN γ for 72 h and expression of MHC class I and antigen presentation genes were evaluated by RT-PCR and immunofluorescence. Results Human iPSC-derived neural stem cells maintained as 3D aggregate cultures in the cell body chamber of polymer microisolation chambers extended dense axonal projections into the fluidically isolated distal chamber. Treatment of these axons with IFN γ resulted in upregulation of MHC class I and antigen processing genes in the neuron cell bodies. IFN γ-induced MHC class I molecules were also anterogradely transported into the distal axon. Interpretation These results provide conclusive evidence that human axons are competent to express MHC class I molecules, suggesting that inflammatory factors enriched in demyelinated lesions may render axons vulnerable to attack by autoreactive CD8+ T cells in patients with MS. Future work will be aimed at identifying pathogenic anti-axonal T cells in these patients.
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Affiliation(s)
| | - Misha S Patel
- Department of Neurology Mayo Clinic Rochester Minnesota
| | | | - Charles L Howe
- Department of Neurology Mayo Clinic Rochester Minnesota.,Department of Neuroscience Mayo Clinic Rochester Minnesota.,Department of Immunology Mayo Clinic Rochester Minnesota.,Center for Multiple Sclerosis and Autoimmune Neurology Mayo Clinic Rochester Minnesota
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19
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Marshall KL, Clary RC, Baba Y, Orlowsky RL, Gerling GJ, Lumpkin EA. Touch Receptors Undergo Rapid Remodeling in Healthy Skin. Cell Rep 2017; 17:1719-1727. [PMID: 27829143 DOI: 10.1016/j.celrep.2016.10.034] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 09/21/2016] [Accepted: 10/12/2016] [Indexed: 11/24/2022] Open
Abstract
Sensory tissues exposed to the environment, such as skin, olfactory epithelia, and taste buds, continuously renew; therefore, peripheral neurons must have mechanisms to maintain appropriate innervation patterns. Although somatosensory neurons regenerate after injury, little is known about how these neurons cope with normal target organ changes. To elucidate neuronal plasticity in healthy skin, we analyzed the structure of Merkel-cell afferents, which are gentle touch receptors, during skin remodeling that accompanies mouse hair-follicle regeneration. The number of Merkel cells is reduced by 90% and axonal arbors are simplified during active hair growth. These structures rebound within just days. Computational modeling predicts that Merkel-cell changes are probabilistic, but myelinated branch stability depends on Merkel-cell inputs. Electrophysiology and behavior demonstrate that tactile responsiveness is less reliable during active growth than in resting skin. These results reveal that somatosensory neurons display structural plasticity at the cost of impairment in the reliability of encoding gentle touch.
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Affiliation(s)
- Kara L Marshall
- Department of Physiology and Cellular Biophysics, Columbia University, New York, NY 10032, USA; Integrated Training Program in Cellular, Molecular and Biomedical Sciences, Columbia University, New York, NY 10032, USA
| | - Rachel C Clary
- Department of Physiology and Cellular Biophysics, Columbia University, New York, NY 10032, USA; Neurobiology and Behavior Training Program, Columbia University, New York, NY 10032, USA
| | - Yoshichika Baba
- Department of Physiology and Cellular Biophysics, Columbia University, New York, NY 10032, USA
| | - Rachel L Orlowsky
- Department of Systems and Information Engineering, University of Virginia, Charlottesville, VA 22904, USA; Department of Biomedical Engineering, University of Virginia, Charlottesville, VA 22904, USA
| | - Gregory J Gerling
- Department of Systems and Information Engineering, University of Virginia, Charlottesville, VA 22904, USA; Department of Biomedical Engineering, University of Virginia, Charlottesville, VA 22904, USA
| | - Ellen A Lumpkin
- Department of Physiology and Cellular Biophysics, Columbia University, New York, NY 10032, USA; Integrated Training Program in Cellular, Molecular and Biomedical Sciences, Columbia University, New York, NY 10032, USA; Neurobiology and Behavior Training Program, Columbia University, New York, NY 10032, USA; Department of Dermatology, Columbia University, New York, NY 10032, USA.
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20
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Garg N, Howells J, Yiannikas C, Vucic S, Krishnan AV, Spies J, Bostock H, Mathey EK, Pollard JD, Park SB, Kiernan MC. Motor unit remodelling in multifocal motor neuropathy: The importance of axonal loss. Clin Neurophysiol 2017; 128:2022-2028. [DOI: 10.1016/j.clinph.2017.07.414] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 06/27/2017] [Accepted: 07/18/2017] [Indexed: 12/13/2022]
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21
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Autoantibody responses to nodal and paranodal antigens in chronic inflammatory neuropathies. J Neuroimmunol 2017; 309:41-46. [PMID: 28601286 DOI: 10.1016/j.jneuroim.2017.05.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 05/09/2017] [Accepted: 05/10/2017] [Indexed: 12/11/2022]
Abstract
Autoantibodies to nodal/paranodal proteins have been reported in patients with chronic inflammatory demyelinating polyneuropathy (CIDP) and multifocal motor neuropathy (MMN). To determine the frequency of anti-paranodal antibodies in our cohort of CIDP patients and to validate the presence anti-nodal antibodies in MMN, sera were screened for IgG against human neurofascin 155, contactin-1, neurofascin 186 and gliomedin using ELISA. In CIDP patients, 7% were anti-NF155 IgG4 positive and 7% were anti-CNTN1 IgG4 positive. Positive results were confirmed using cell based assays and indirect immunofluorescence on teased nerve fibres. We did not detect IgG autoantibodies against these nodal/paranodal antigens in MMN patients.
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