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Ahmadi A, Fallah Vastani Z, Abounoori M, Azizi M, Labani‐Motlagh A, Mami S, Mami S. The role of
NK
and
NKT
cells in the pathogenesis and improvement of multiple sclerosis following
disease‐modifying
therapies. Health Sci Rep 2022; 5:e489. [PMID: 35229046 PMCID: PMC8865072 DOI: 10.1002/hsr2.489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 11/09/2021] [Accepted: 12/07/2021] [Indexed: 11/07/2022] Open
Abstract
Background Multiple sclerosis (MS) is an autoimmune inflammatory disease of the central nervous system (CNS) that T cells become autoreactive by recognizing CNS antigens. Both innate and adaptive immune systems are involved in the pathogenesis of MS. In recent years, the impact of innate immune cells on MS pathogenesis has received more attention. CD56bright NK cells, as an immunoregulatory subset of NK cells, can increase the production of cytokines that modulate adaptive immune responses, whereas CD56dim NK cells are more active in cytolysis functions. These two main subsets of NK cells may have different effects on the onset or progression of MS. Invariant NKT (iNKT) cells are other immune cells involved in the control of autoimmune diseases; however, variant NKT (vNKT) cells, despite limited information, could play a role in MS remission via an immunoregulatory pathway. Aim We aimed to evaluate the influence of MS therapeutic agents on NK and NKT cells and NK cell subtypes. Materials and Methods The possible mechanism of each MS therapeutic agent has been presented here, focusing on the effects of different disease‐modifying therapies on the number of NK and NKT subtypes. Results Expansion of CD56bright NK cells, reduction in the CD56dim cells, and enhancement in NKT cells are the more important innate immune cells alterations following the disease‐modifying therapies. Conclusion Expansion of CD56bright NK cells or reduction in the CD56dim cells has been associated with a successful response to different treatments in MS. iNKT and vNKT cells could have beneficial effects on MS improving. It seems that they are enhanced due to some of MS drugs, leading to disease improvement. However, a reduction in the number of NKT cells could be due to the adverse effects of some of MS drugs on the bone marrow.
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Affiliation(s)
- Alireza Ahmadi
- Student Research Committee, Department of Laboratory Sciences, Faculty of Allied Medical Sciences Ilam University of Medical Sciences Ilam Iran
| | - Zahra Fallah Vastani
- Student Research Committee, Department of Laboratory Sciences, Faculty of Allied Medical Sciences Ilam University of Medical Sciences Ilam Iran
| | - Mahdi Abounoori
- Student Research Committee, School of Medicine Mazandaran University of Medical Sciences Sari Iran
| | - Mahdieh Azizi
- Department of Immunology, School of Medicine Isfahan University of Medical Sciences Isfahan Iran
| | - Alireza Labani‐Motlagh
- Department of Pulmonary Immunology The University of Texas Health Science Center at Tyler Texas USA
| | - Sajad Mami
- Department of laboratory and clinical science, faculty of veterinary medicine Ilam University Ilam Iran
| | - Sanaz Mami
- Department of Immunology, School of Medicine Ilam University of Medical Sciences Ilam Iran
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IL-2 and Mycobacterial Lipoarabinomannan as Targets of Immune Responses in Multiple Sclerosis Patients. Microorganisms 2020; 8:microorganisms8040500. [PMID: 32244639 PMCID: PMC7232413 DOI: 10.3390/microorganisms8040500] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/27/2020] [Accepted: 03/27/2020] [Indexed: 12/11/2022] Open
Abstract
Interleukin 2 (IL-2) is considered a key player in exacerbating multiple sclerosis (MS). Therapies targeting its receptor have been developed; however, a resolution of the disease and side effects are still an issue of concern. The involvement of other factors, such as Mycobacterium avium subspecies paratuberculosis (MAP) and envelope protein derived from human endogenous retrovirus type W (HERV-Wenv), in MS pathogenesis has been recently suggested. Here, we investigated the levels of antibodies (Abs) directed against IL-2 and HERV-Wenv in 108 MS patients, 34 patients affected by neuromyelitis optica spectrum disorder (NMOSD), and 137 healthy controls (HCs). Our results show increased levels of Abs specific to IL-2 and HERV-Wenv-su antigens in MS vs. HCs (p < 0.0001 for IL-2, p = 0.0004 for HERV-Wenv) and significantly decreased levels in NMOSD vs. MS. The assessment of different 12-month-long therapies on Abs against IL-2, HERV-Wenv, and MAP lipoarabinomannan (LAM) demonstrated the strongest effect on anti-LAM Abs (p = 0.018), a slight reduction of anti-IL-2 Abs, and small variations for anti-HERV-Wenv Abs. These results highlight the conclusion that the impact of therapy is more correlated with selected epitopes than with the therapeutic agent. Screening for anti-IL-2 and anti-HERV-Wenv Abs has a potential as additional future practice to distinguish between symptomatically similar MS and NMOSD.
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Baldassari LE, Rose JW. Daclizumab: Development, Clinical Trials, and Practical Aspects of Use in Multiple Sclerosis. Neurotherapeutics 2017; 14:842-858. [PMID: 28707278 PMCID: PMC5722760 DOI: 10.1007/s13311-017-0553-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Daclizumab is a humanized monoclonal antibody directed towards CD25, the alpha subunit of the high-affinity interleukin (IL)-2 receptor. Daclizumab exerts its effects via multiple mechanisms, including reduction of IL-2-mediated lymphocyte activation and upregulation of CD56-bright natural killer cells. Intravenous daclizumab (Zenapax™) was initially approved for prevention of rejection in renal transplant. In subsequent early testing, followed by larger-scale phase II and phase III trials, both intravenous and subcutaneous daclizumab have demonstrated clinical efficacy in the treatment of multiple sclerosis. The subcutaneous daclizumab prepared by high-yield process was utilized in the advanced phase II and phase III trials (SELECT and DECIDE). High-yield process daclizumab is now approved by the US Food and Drug Administration for relapsing-remitting multiple sclerosis, and is now formally termed daclizumab beta (DAC-beta; Zinbryta™). In this review, the early development of anti-IL-2 receptor alpha monoclonal antibodies and the properties of IL-2 and its receptor are discussed, and diverse mechanisms of action for daclizumab are presented. Results of the CHOICE, SELECT, and DECIDE clinical trials are discussed in detail. Adverse events observed in clinical trials included cutaneous reactions, liver enzyme elevations, infections, and autoimmune phenomena. DAC-beta is a monthly, patient-administered subcutaneous injection that requires enrollment in a safety monitoring (REMS) program for monthly liver function testing. Prescribers should be aware of the potential adverse events, as early recognition and management is important, particularly in cutaneous and hepatic reactions. Continued clinical experience with DAC-beta, including observations from the REMS program, will define its place in the armamentarium of immunotherapeutics for relapsing-remitting multiple sclerosis.
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Affiliation(s)
- Laura E Baldassari
- Division of Neuroimmunology, Department of Neurology, University of Utah, Imaging and Neurosciences Center, 729 Arapeen Drive, Salt Lake City, UT, 84108, USA
| | - John W Rose
- Division of Neuroimmunology, Department of Neurology, University of Utah, Imaging and Neurosciences Center, 729 Arapeen Drive, Salt Lake City, UT, 84108, USA.
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Acetylcholine-producing NK cells attenuate CNS inflammation via modulation of infiltrating monocytes/macrophages. Proc Natl Acad Sci U S A 2017; 114:E6202-E6211. [PMID: 28696300 DOI: 10.1073/pnas.1705491114] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The nonneural cholinergic system of immune cells is pivotal for the maintenance of immunological homeostasis. Here we demonstrate the expression of choline acetyltransferase (ChAT) and cholinergic enzymes in murine natural killer (NK) cells. The capacity for acetylcholine synthesis by NK cells increased markedly under inflammatory conditions such as experimental autoimmune encephalomyelitis (EAE), in which ChAT expression escalated along with the maturation of NK cells. ChAT+ and ChAT- NK cells displayed distinctive features in terms of cytotoxicity and chemokine/cytokine production. Transfer of ChAT+ NK cells into the cerebral ventricles of CX3CR1-/- mice reduced brain and spinal cord damage after EAE induction, and decreased the numbers of CNS-infiltrating CCR2+Ly6Chi monocytes. ChAT+ NK cells killed CCR2+Ly6Chi monocytes directly via the disruption of tolerance and inhibited the production of proinflammatory cytokines. Interestingly, ChAT+ NK cells and CCR2+Ly6Chi monocytes formed immune synapses; moreover, the impact of ChAT+ NK cells was mediated by α7-nicotinic acetylcholine receptors. Finally, the NK cell cholinergic system up-regulated in response to autoimmune activation in multiple sclerosis, perhaps reflecting the severity of disease. Therefore, this study extends our understanding of the nonneural cholinergic system and the protective immune effect of acetylcholine-producing NK cells in autoimmune diseases.
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Ganguly B, Balasa B, Efros L, Hinton PR, Hartman S, Thakur A, Xiong JM, Schmidt B, Robinson RR, Sornasse T, Vexler V, Sheridan JP. The CD25-binding antibody Daclizumab High-Yield Process has a distinct glycosylation pattern and reduced antibody-dependent cell-mediated cytotoxicity in comparison to Zenapax®. MAbs 2016; 8:1417-1424. [PMID: 27367933 PMCID: PMC5058627 DOI: 10.1080/19420862.2016.1207031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
The CD25-binding antibody daclizumab high-yield process (DAC HYP) is an interleukin (IL)-2 signal modulating antibody that shares primary amino acid sequence and CD25 binding affinity with Zenapax®, a distinct form of daclizumab, which was approved for the prevention of acute organ rejection in patients receiving renal transplants as part of an immunosuppressive regimen that includes cyclosporine and corticosteroids. Comparison of the physicochemical properties of the two antibody forms revealed the glycosylation profile of DAC HYP differs from Zenapax in both glycan distribution and the types of oligosaccharides, most notably high-mannose, galactosylated and galactose-α-1,3-galactose (α-Gal) oligosaccharides, resulting in a DAC HYP antibody material that is structurally distinct from Zenapax. Although neither antibody elicited complement-dependent cytotoxicity in vitro, DAC HYP antibody had significantly reduced levels of antibody-dependent cell-mediated cytotoxicity (ADCC). The ADCC activity required natural killer (NK) cells, but not monocytes, suggesting the effects were mediated through binding to Fc-gamma RIII (CD16). Incubation of each antibody with peripheral blood mononuclear cells also caused the down-modulation of CD16 expression on NK cells and the CD16 down-modulation was greater for Zenapax in comparison to that observed for DAC HYP. The substantive glycosylation differences between the two antibody forms and corresponding greater Fc-mediated effector activities by Zenapax, including cell killing activity, manifest as a difference in the biological function and pharmacology between DAC HYP and Zenapax.
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Affiliation(s)
- Bishu Ganguly
- a Department Translational Medicine , AbbVie Biotherapeutics , Redwood City , CA , USA
| | - Balaji Balasa
- a Department Translational Medicine , AbbVie Biotherapeutics , Redwood City , CA , USA
| | - Lyubov Efros
- a Department Translational Medicine , AbbVie Biotherapeutics , Redwood City , CA , USA
| | - Paul R Hinton
- b Department Discovery Sciences , AbbVie Biotherapeutics , Redwood City , CA , USA
| | - Stephen Hartman
- c Department Analytical Development & QC , AbbVie Biotherapeutics , Redwood City , CA , USA
| | - Archana Thakur
- b Department Discovery Sciences , AbbVie Biotherapeutics , Redwood City , CA , USA
| | - Joanna M Xiong
- b Department Discovery Sciences , AbbVie Biotherapeutics , Redwood City , CA , USA
| | - Brian Schmidt
- c Department Analytical Development & QC , AbbVie Biotherapeutics , Redwood City , CA , USA
| | - Randy R Robinson
- d Department of Neuroscience Development , AbbVie Biotherapeutics , Redwood City , CA , USA
| | - Thierry Sornasse
- a Department Translational Medicine , AbbVie Biotherapeutics , Redwood City , CA , USA
| | - Vladimir Vexler
- a Department Translational Medicine , AbbVie Biotherapeutics , Redwood City , CA , USA
| | - James P Sheridan
- a Department Translational Medicine , AbbVie Biotherapeutics , Redwood City , CA , USA
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Ottenlinger F, Schwiebs A, Pfarr K, Wagner A, Grüner S, Mayer CA, Pfeilschifter JM, Radeke HH. Fingolimod targeting protein phosphatase 2A differently affects IL-33 induced IL-2 and IFN-γ production in CD8(+) lymphocytes. Eur J Immunol 2016; 46:941-51. [PMID: 26683421 DOI: 10.1002/eji.201545805] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 11/02/2015] [Accepted: 12/10/2015] [Indexed: 01/05/2023]
Abstract
Multiple sclerosis patients are treated with fingolimod (FTY720), a prodrug that acts as an immune modulator. FTY720 is first phosphorylated to FTY720-P and then internalizes sphingosine-1-phosphate receptors, preventing lymphocyte sequestration. IL-33 is released from necrotic endothelial cells and contributes to MS severity by coactivating T cells. Herein we analyzed the influence of FTY720, FTY720-P, and S1P on IL-33 induced formation of IL-2 and IFN-γ, by using IL-33 receptor overexpressing EL4 cells, primary CD8(+) T cells, and splenocytes. EL4-ST2 cells released IL-2 after IL-33 stimulation that was inhibited dose-dependently by FTY720-P but not FTY720. In this system, S1P increased IL-2, and accordingly, inhibition of S1P producing sphingosine kinases diminished IL-2 release. In primary CD8(+) T cells and splenocytes IL-33/IL-12 stimulation induced IFN-γ, which was prevented by FTY720 but not FTY720-P, independently from intracellular phosphorylation. The inhibition of IFN-γ by nonphosphorylated FTY720 was mediated via the SET/protein phosphatase 2A (PP2A) pathway, since a SET peptide antagonist also prevented IFN-γ formation and the inhibition of IFN-γ by FTY720 was reversible by a PP2A inhibitor. While our findings directly improve the understanding of FTY720 therapy in MS, they could also contribute to side effects of FTY720 treatment, like progressive multifocal leukoencephalopathy, caused by an insufficient immune response to a viral infection.
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Affiliation(s)
- Florian Ottenlinger
- pharmazentrum frankfurt/ZAFES, Hospital of the Goethe University, Frankfurt am Main, Germany
| | - Anja Schwiebs
- pharmazentrum frankfurt/ZAFES, Hospital of the Goethe University, Frankfurt am Main, Germany
| | - Kathrin Pfarr
- pharmazentrum frankfurt/ZAFES, Hospital of the Goethe University, Frankfurt am Main, Germany
| | - Annika Wagner
- pharmazentrum frankfurt/ZAFES, Hospital of the Goethe University, Frankfurt am Main, Germany
| | - Sophia Grüner
- pharmazentrum frankfurt/ZAFES, Hospital of the Goethe University, Frankfurt am Main, Germany
| | - Christoph A Mayer
- Center for Neurology and Neurosurgery, Hospital of the Goethe University, Frankfurt am Main, Germany
| | - Josef M Pfeilschifter
- pharmazentrum frankfurt/ZAFES, Hospital of the Goethe University, Frankfurt am Main, Germany
| | - Heinfried H Radeke
- pharmazentrum frankfurt/ZAFES, Hospital of the Goethe University, Frankfurt am Main, Germany
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