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Moraes AS, Boldrini VO, Dionete AC, Andrade MD, Longhini ALF, Santos I, Lima ADR, Silva VAPG, Dias Carneiro RPC, Quintiliano RPS, Ferrari BB, Damasceno A, Pradella F, Farias AS, Tilbery CP, Domingues RB, Senne C, Fernandes GBP, von Glehn F, Brandão CO, Stella CRAV, Santos LMB. Decreased Neurofilament L Chain Levels in Cerebrospinal Fluid and Tolerogenic Plasmacytoid Dendritic Cells in Natalizumab-Treated Multiple Sclerosis Patients - Brief Research Report. Front Cell Neurosci 2021; 15:705618. [PMID: 34381335 PMCID: PMC8350727 DOI: 10.3389/fncel.2021.705618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 06/23/2021] [Indexed: 11/25/2022] Open
Abstract
Background Neurofilament Light (NfL) chain levels in both cerebrospinal fluid (CSF) and serum have been correlated with the reduction of axonal damage in multiple sclerosis (MS) patients treated with Natalizumab (NTZ). However, little is known about the function of plasmacytoid cells in NTZ-treated MS patients. Objective To evaluate CSF NfL, serum levels of soluble-HLA-G (sHLA-G), and eventual tolerogenic behavior of plasmacytoid dendritic cells (pDCs) in MS patients during NTZ treatment. Methods CSF NfL and serum sHLA-G levels were measured using an ELISA assay, while pDCs (BDCA-2+) were accessed through flow cytometry analyses. Results CSF levels of NfL were significantly reduced during NTZ treatment, while the serum levels of sHLA-G were increased. Moreover, NTZ treatment enhanced tolerogenic (HLA-G+, CD274+, and HLA-DR+) molecules and migratory (CCR7+) functions of pDCs in the peripheral blood. Conclusion These findings suggest that NTZ stimulates the production of molecules with immunoregulatory function such as HLA-G and CD274 programmed death-ligand 1 (PD-L1) which may contribute to the reduction of axonal damage represented by the decrease of NfL levels in patients with MS.
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Affiliation(s)
- Adriel S Moraes
- Neuroimmunology Unit, Department of Genetics, Evolution, Microbiology, and Immunology, University of Campinas (UNICAMP), Campinas, Brazil
| | - Vinicius O Boldrini
- Neuroimmunology Unit, Department of Genetics, Evolution, Microbiology, and Immunology, University of Campinas (UNICAMP), Campinas, Brazil
| | - Alliny C Dionete
- Neuroimmunology Unit, Department of Genetics, Evolution, Microbiology, and Immunology, University of Campinas (UNICAMP), Campinas, Brazil
| | - Marilia D Andrade
- Neuroimmunology Unit, Department of Genetics, Evolution, Microbiology, and Immunology, University of Campinas (UNICAMP), Campinas, Brazil
| | - Ana Leda F Longhini
- Neuroimmunology Unit, Department of Genetics, Evolution, Microbiology, and Immunology, University of Campinas (UNICAMP), Campinas, Brazil.,Department of Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Irene Santos
- Neuroimmunology Unit, Department of Genetics, Evolution, Microbiology, and Immunology, University of Campinas (UNICAMP), Campinas, Brazil
| | - Amanda D R Lima
- Neuroimmunology Unit, Department of Genetics, Evolution, Microbiology, and Immunology, University of Campinas (UNICAMP), Campinas, Brazil
| | - Veronica A P G Silva
- Neuroimmunology Unit, Department of Genetics, Evolution, Microbiology, and Immunology, University of Campinas (UNICAMP), Campinas, Brazil
| | - Rafael P C Dias Carneiro
- Neuroimmunology Unit, Department of Genetics, Evolution, Microbiology, and Immunology, University of Campinas (UNICAMP), Campinas, Brazil.,Department of Neurology, University of Campinas, Campinas, Brazil.,MS Clinic of Santa Casa de São Paulo (CATEM), São Paulo, Brazil
| | - Raphael P S Quintiliano
- Neuroimmunology Unit, Department of Genetics, Evolution, Microbiology, and Immunology, University of Campinas (UNICAMP), Campinas, Brazil
| | - Breno B Ferrari
- Neuroimmunology Unit, Department of Genetics, Evolution, Microbiology, and Immunology, University of Campinas (UNICAMP), Campinas, Brazil
| | | | - Fernando Pradella
- Neuroimmunology Unit, Department of Genetics, Evolution, Microbiology, and Immunology, University of Campinas (UNICAMP), Campinas, Brazil
| | - Alessandro S Farias
- Neuroimmunology Unit, Department of Genetics, Evolution, Microbiology, and Immunology, University of Campinas (UNICAMP), Campinas, Brazil.,National Institute of Science and Technology on Neuroimmunomodulation (INCT-NIM), Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Renan B Domingues
- MS Clinic of Santa Casa de São Paulo (CATEM), São Paulo, Brazil.,Senne Liquor Diagnóstico, São Paulo, Brazil
| | - Carlos Senne
- Senne Liquor Diagnóstico, São Paulo, Brazil.,Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Gustavo B P Fernandes
- Senne Liquor Diagnóstico, São Paulo, Brazil.,Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Felipe von Glehn
- Neuroimmunology Unit, Department of Genetics, Evolution, Microbiology, and Immunology, University of Campinas (UNICAMP), Campinas, Brazil
| | - Carlos Otavio Brandão
- Neuroimmunology Unit, Department of Genetics, Evolution, Microbiology, and Immunology, University of Campinas (UNICAMP), Campinas, Brazil.,Department of Neurology, University of Campinas, Campinas, Brazil
| | | | - Leonilda M B Santos
- Neuroimmunology Unit, Department of Genetics, Evolution, Microbiology, and Immunology, University of Campinas (UNICAMP), Campinas, Brazil.,National Institute of Science and Technology on Neuroimmunomodulation (INCT-NIM), Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Preziosa P, Pagani E, Moiola L, Rodegher M, Filippi M, Rocca MA. Occurrence and microstructural features of slowly expanding lesions on fingolimod or natalizumab treatment in multiple sclerosis. Mult Scler 2020; 27:1520-1532. [DOI: 10.1177/1352458520969105] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background: In multiple sclerosis (MS), up to 57% of white matter lesions are chronically active. These slowly expanding lesions (SELs) contribute to disability progression. Objective: The aim of this study is to compare fingolimod and natalizumab effects on progressive linearly enlarging lesions (i.e. SELs), a putative biomarker of smouldering inflammation. Methods: Relapsing-remitting MS patients starting fingolimod ( n = 24) or natalizumab ( n = 28) underwent 3T brain magnetic resonance imaging (MRI) at baseline, months 6, 12 and 24. SELs were identified among baseline-visible lesions showing ⩾ 12.5% of annual increase, calculated by linearly fitting the Jacobian of the nonlinear deformation field between timepoints obtained combining T1- and T2-weighted scans. SEL burden, magnetization transfer ratio (MTR) and T1 signal intensity were compared using linear models. Results: The prevalences of fingolimod (75%) and natalizumab patients (46%) with ⩾ 1 SEL were not significantly different (adjusted- p = 0.08). Fingolimod group had higher SEL number and volume (adjusted- p ⩽ 0.047, not false discovery rate (FDR) survived). In both groups, SELs versus non-SELs showed lower MTR and T1 signal intensity (adjusted- p ⩽ 0.01, FDR-survived). Longitudinally, non-SEL MTR increased in both treatment groups (adjusted- p ⩽ 0.005, FDR-survived). T1 signal intensity decreased in SELs with both treatments (adjusted- p ⩽ 0.049, FDR-survived in fingolimod group) and increased in natalizumab non-SELs (adjusted- p = 0.03, FDR-survived). Conclusion: The effects of natalizumab and fingolimod on SEL occurrence seem modest, with natalizumab being slightly more effective. Both treatments may promote reparative mechanisms in stable or chronic inactive lesions.
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Affiliation(s)
- Paolo Preziosa
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy/Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Elisabetta Pagani
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Lucia Moiola
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy/Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy/Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Maria A Rocca
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy/Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy/Vita-Salute San Raffaele University, Milan, Italy
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De Laere M, Berneman ZN, Cools N. To the Brain and Back: Migratory Paths of Dendritic Cells in Multiple Sclerosis. J Neuropathol Exp Neurol 2019; 77:178-192. [PMID: 29342287 PMCID: PMC5901086 DOI: 10.1093/jnen/nlx114] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Migration of dendritic cells (DC) to the central nervous system (CNS) is a critical event in the pathogenesis of multiple sclerosis (MS). While up until now, research has mainly focused on the transmigration of DC through the blood-brain barrier, experimental evidence points out that also the choroid plexus and meningeal vessels represent important gateways to the CNS, especially in early disease stages. On the other hand, DC can exit the CNS to maintain immunological tolerance to patterns expressed in the CNS, a process that is perturbed in MS. Targeting trafficking of immune cells, including DC, to the CNS has demonstrated to be a successful strategy to treat MS. However, this approach is known to compromise protective immune surveillance of the brain. Unravelling the migratory paths of regulatory and pathogenic DC within the CNS may ultimately lead to the design of new therapeutic strategies able to selectively interfere with the recruitment of pathogenic DC to the CNS, while leaving host protective mechanisms intact.
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Affiliation(s)
- Maxime De Laere
- Laboratory of Experimental Hematology, Vaccine & Infectious Disease Institute (VAXINFECTIO), Faculty of Medicine and Health Sciences, University of Antwerp
| | - Zwi N Berneman
- Laboratory of Experimental Hematology, Vaccine & Infectious Disease Institute (VAXINFECTIO), Faculty of Medicine and Health Sciences, University of Antwerp.,Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Nathalie Cools
- Laboratory of Experimental Hematology, Vaccine & Infectious Disease Institute (VAXINFECTIO), Faculty of Medicine and Health Sciences, University of Antwerp
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Kolasa M, Hagman S, Verkkoniemi-Ahola A, Airas L, Koivisto K, Elovaara I. Anti-JC virus seroprevalence in a Finnish MS cohort. Acta Neurol Scand 2016; 133:391-7. [PMID: 26347001 DOI: 10.1111/ane.12475] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2015] [Indexed: 12/15/2022]
Abstract
BACKGROUND The risk of progressive multifocal leukoencephalopathy (PML) caused by the JC virus (JCV) is increased in patients with multiple sclerosis receiving biological therapies. OBJECTIVES To determine the seroprevalence of anti-JCV antibodies in Finnish patients with multiple sclerosis (MS) and clinically isolated syndrome and to assess the clinical risk factors for JCV seropositivity. METHODS The JCV seroprevalence was analyzed in 503 patients using a second-generation two-step ELISA. Sixty-seven patients underwent longitudinal serological evaluation over 4.5 years. RESULTS The overall seroprevalence of JCV was 57.4%. The seropositivity was higher in men than in women, tended to increase with age, and was not affected by different immunomodulatory therapies. However, in patients with ongoing natalizumab treatment (n = 72), the anti-JCV antibody screening index was lower than in patients without such therapy [median 0.3 (range 0.1-3.1) vs 0.6 (0.1-3.1), respectively, P = 0.01]. Over 4.5 years, 4/19 (21%) initially seronegative patients converted to seropositivity, whereas 4/48 (8.3%) initially seropositive patients reverted to seronegativity. Fluctuations in serostatus were observed in 3/67 patients. CONCLUSION The study confirmed a high anti-JCV antibody prevalence in patients with MS and its association with age and male gender but not with disease-modifying therapies. Our data suggest that therapy with natalizumab may cause a decrease in anti-JCV antibody levels, suggesting an immunosuppressive effect of natalizumab without an impact on JCV seroprevalence. The results of studies performed until now confirm the predictive value of anti-JCV antibody measurement in the assessment of PML risk; however, changes in serostatus need to be considered.
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Affiliation(s)
- M. Kolasa
- Neuroimmunology Unit; Medical School; University of Tampere; Tampere Finland
| | - S. Hagman
- Neuroimmunology Unit; Medical School; University of Tampere; Tampere Finland
| | - A. Verkkoniemi-Ahola
- Department of Clinical Neurosciences; Helsinki University Central Hospital; Helsinki Finland
| | - L. Airas
- Department of Clinical Neurosciences; Turku University Hospital; Turku Finland
| | - K. Koivisto
- Department of Neurology; Seinäjoki Central Hospital; Seinäjoki Finland
| | - I. Elovaara
- Neuroimmunology Unit; Medical School; University of Tampere; Tampere Finland
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Spadaro M, Caldano M, Marnetto F, Lugaresi A, Bertolotto A. Natalizumab treatment reduces L-selectin (CD62L) in CD4+ T cells. J Neuroinflammation 2015; 12:146. [PMID: 26259673 PMCID: PMC4532246 DOI: 10.1186/s12974-015-0365-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 07/21/2015] [Indexed: 11/10/2022] Open
Abstract
Background The purpose of this research was to validate the low expression of L-selectin (CD62L) in natalizumab (NTZ)-treated patients. CD62L is involved in rolling and transmigration of leukocyte cells. A correlation between CD62LCD4+ T cells low expression and progressive multifocal leukoencephalopathy (PML) development has been suggested in multiple sclerosis (MS) patients treated with NTZ. Methods We performed a flow cytometric analysis on peripheral blood mononuclear cells (PBMC); we collected from 23 healthy donors and 225 MS patients: untreated (n = 19) or treated with NTZ (n = 113), interferon-beta (n = 26), glatiramer acetate (n = 26), fingolimod (n = 23) and rituximab (n = 18). We have also analysed two PML/IRIS (immune reconstitution inflammatory syndrome) patients and four longitudinal samples of a NTZ-treated patients before and during the development of a clinical asymptomatic magnetic resonance imaging (MRI) lesion confirmed as PML by cerebrospinal fluid (CSF) examination. Thirty-five NTZ-treated patients were studied longitudinally with three samples taken 4 months apart. Results The NTZ-treated patients showed a lower percentage of CD62L (33.68 %, n = 113) than first-line treated patients (44.24 %, n = 52, p = 0.0004). NTZ effect was already clear during the first year of treatment (34.68 %; p = 0.0184); it persisted in the following years and disappeared after drug withdrawal (44.08 %). Three percent of longitudinally analysed patients showed a percentage of CD62LCD4+ T cells under a hypothetical threshold and one patient with asymptomatic PML belongs to a group which expressed low percentage of CD62LCD4+ T cells. Conclusions Our research confirms that NTZ has a specific effect on CD62LCD4+ T cells consisting in decreasing of the number of positive cells. The low level of CD62L found in a clinically asymptomatic PML patient strengthens its potential usefulness as a biomarker of high PML risk in NTZ-treated patients. A larger study is required to better confirm the data. Electronic supplementary material The online version of this article (doi:10.1186/s12974-015-0365-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Michela Spadaro
- Clinical Neurobiology Unit Neuroscience Institute Cavalieri Ottolenghi (NICO), Regione Gonzole 10, 10043, Orbassano, Turin, Italy. .,AOU S. Luigi Gonzaga, Neurologia 2 - CRESM (Centro Riferimento Regionale Sclerosi Multipla), Regione Gonzole 10, 10043, Orbassano, Turin, Italy.
| | - Marzia Caldano
- Clinical Neurobiology Unit Neuroscience Institute Cavalieri Ottolenghi (NICO), Regione Gonzole 10, 10043, Orbassano, Turin, Italy. .,AOU S. Luigi Gonzaga, Neurologia 2 - CRESM (Centro Riferimento Regionale Sclerosi Multipla), Regione Gonzole 10, 10043, Orbassano, Turin, Italy.
| | - Fabiana Marnetto
- Clinical Neurobiology Unit Neuroscience Institute Cavalieri Ottolenghi (NICO), Regione Gonzole 10, 10043, Orbassano, Turin, Italy. .,AOU S. Luigi Gonzaga, Neurologia 2 - CRESM (Centro Riferimento Regionale Sclerosi Multipla), Regione Gonzole 10, 10043, Orbassano, Turin, Italy.
| | - Alessandra Lugaresi
- Department Neuroscience, Imaging and Clinical Sciences, University 'G. d'Annunzio', Chieti, Italy.
| | - Antonio Bertolotto
- Clinical Neurobiology Unit Neuroscience Institute Cavalieri Ottolenghi (NICO), Regione Gonzole 10, 10043, Orbassano, Turin, Italy. .,AOU S. Luigi Gonzaga, Neurologia 2 - CRESM (Centro Riferimento Regionale Sclerosi Multipla), Regione Gonzole 10, 10043, Orbassano, Turin, Italy.
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