1
|
Kwiatkowski AJ, Stewart JM, Cho JJ, Avram D, Keselowsky BG. Nano and Microparticle Emerging Strategies for Treatment of Autoimmune Diseases: Multiple Sclerosis and Type 1 Diabetes. Adv Healthc Mater 2020; 9:e2000164. [PMID: 32519501 DOI: 10.1002/adhm.202000164] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 03/12/2020] [Indexed: 02/06/2023]
Abstract
Autoimmune diseases affect 10% of the world's population, and 1 in 200 people worldwide suffer from either multiple sclerosis (MS) or type 1 diabetes (T1D). While the targeted organ systems are different, MS and T1D share similarities in terms of autoreactive immune cells playing a critical role in pathogenesis. Both diseases can be managed only symptomatically without curative remission, and treatment options are limited and non-specific. Most current therapies cause some degree of systemic immune suppression, leaving the patients susceptible to opportunistic infections and other complications. Thus, there is considerable interest in the development of immunotherapies not associated with generalized immune suppression for these diseases. This review presents current and preclinical strategies for MS and T1D treatment, emphasizing those aimed to modulate the immune response, including the most recent strategies for tolerance induction. A central focus is on the emerging approaches using nano- and microparticle platforms, their evolution as immunotherapeutic carriers, including those incorporating specific antigens to induce tolerance and reduce unwanted generalized immune suppression.
Collapse
Affiliation(s)
- Alexander J Kwiatkowski
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, 32611, USA
| | - Joshua M Stewart
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, 32611, USA
| | - Jonathan J Cho
- Department of Anatomy and Cell Biology, College of Medicine, University of Florida, Gainesville, FL, 32610, USA
| | - Dorina Avram
- Department of Anatomy and Cell Biology, College of Medicine, University of Florida, Gainesville, FL, 32610, USA
- UF Health Cancer Center, University of Florida, Gainesville, FL, 32610, USA
| | - Benjamin G Keselowsky
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, 32611, USA
| |
Collapse
|
3
|
Cho JJ, Stewart JM, Drashansky TT, Brusko MA, Zuniga AN, Lorentsen KJ, Keselowsky BG, Avram D. An antigen-specific semi-therapeutic treatment with local delivery of tolerogenic factors through a dual-sized microparticle system blocks experimental autoimmune encephalomyelitis. Biomaterials 2017; 143:79-92. [PMID: 28772190 DOI: 10.1016/j.biomaterials.2017.07.029] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 07/11/2017] [Accepted: 07/21/2017] [Indexed: 01/07/2023]
Abstract
Antigen-specific treatments are highly desirable for autoimmune diseases in contrast to treatments which induce systemic immunosuppression. A novel antigen-specific therapy has been developed which, when administered semi-therapeutically, is highly efficacious in the treatment of the mouse model for multiple sclerosis, experimental autoimmune encephalomyelitis (EAE). The treatment uses dual-sized, polymeric microparticles (dMPs) loaded with specific antigen and tolerizing factors for intra- and extra-cellular delivery, designed to recruit and modulate dendritic cells toward a tolerogenic phenotype without systemic release. This approach demonstrated robust efficacy and provided complete protection against disease. Therapeutic efficacy required encapsulation of the factors in controlled-release microparticles and was antigen-specific. Disease blocking was associated with a reduction of infiltrating CD4+ T cells, inflammatory cytokine-producing pathogenic CD4+ T cells, and activated macrophages and microglia in the central nervous system. Furthermore, CD4+ T cells isolated from dMP-treated mice were anergic in response to disease-specific, antigen-loaded splenocytes. Additionally, the frequency of CD86hiMHCIIhi dendritic cells in draining lymph nodes of EAE mice treated with Ag-specific dMPs was reduced. Our findings highlight the efficacy of microparticle-based drug delivery platform to mediate antigen-specific tolerance, and suggest that such a multi-factor combinatorial approach can act to block autoimmunity.
Collapse
Affiliation(s)
- Jonathan J Cho
- Division of Pulmonary Medicine, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Joshua M Stewart
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611, USA
| | - Theodore T Drashansky
- Division of Pulmonary Medicine, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Maigan A Brusko
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611, USA
| | - Ashley N Zuniga
- Division of Pulmonary Medicine, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Kyle J Lorentsen
- Division of Pulmonary Medicine, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Benjamin G Keselowsky
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611, USA.
| | - Dorina Avram
- Division of Pulmonary Medicine, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL 32610, USA.
| |
Collapse
|
4
|
Fujita Y, Yamashita T. Axon growth inhibition by RhoA/ROCK in the central nervous system. Front Neurosci 2014; 8:338. [PMID: 25374504 PMCID: PMC4205828 DOI: 10.3389/fnins.2014.00338] [Citation(s) in RCA: 174] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 10/06/2014] [Indexed: 12/31/2022] Open
Abstract
Rho kinase (ROCK) is a serine/threonine kinase and a downstream target of the small GTPase Rho. The RhoA/ROCK pathway is associated with various neuronal functions such as migration, dendrite development, and axonal extension. Evidence from animal studies reveals that RhoA/ROCK signaling is involved in various central nervous system (CNS) diseases, including optic nerve and spinal cord injuries, stroke, and neurodegenerative diseases. Given that RhoA/ROCK plays a critical role in the pathophysiology of CNS diseases, the development of therapeutic agents targeting this pathway is expected to contribute to the treatment of CNS diseases. The RhoA/ROCK pathway mediates the effects of myelin-associated axon growth inhibitors—Nogo, myelin-associated glycoprotein (MAG), oligodendrocyte-myelin glycoprotein (OMgp), and repulsive guidance molecule (RGM). Blocking RhoA/ROCK signaling can reverse the inhibitory effects of these molecules on axon outgrowth, and promotes axonal sprouting and functional recovery in animal models of CNS injury. To date, several RhoA/ROCK inhibitors have been under development or in clinical trials as therapeutic agents for neurological disorders. In this review, we focus on the RhoA/ROCK signaling pathway in neurological disorders. We also discuss the potential therapeutic approaches of RhoA/ROCK inhibitors for various neurological disorders.
Collapse
Affiliation(s)
- Yuki Fujita
- Department of Molecular Neuroscience, Graduate School of Medicine, Osaka University Osaka, Japan ; Japan Science and Technology Agency, Core Research for Evolutional Science and Technology Tokyo, Japan
| | - Toshihide Yamashita
- Department of Molecular Neuroscience, Graduate School of Medicine, Osaka University Osaka, Japan ; Japan Science and Technology Agency, Core Research for Evolutional Science and Technology Tokyo, Japan
| |
Collapse
|
5
|
Ding Z, Mathur V, Ho PP, James ML, Lucin KM, Hoehne A, Alabsi H, Gambhir SS, Steinman L, Luo J, Wyss-Coray T. Antiviral drug ganciclovir is a potent inhibitor of microglial proliferation and neuroinflammation. ACTA ACUST UNITED AC 2014; 211:189-98. [PMID: 24493798 PMCID: PMC3920559 DOI: 10.1084/jem.20120696] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Aberrant microglial responses contribute to neuroinflammation in many neurodegenerative diseases, but no current therapies target pathogenic microglia. We discovered unexpectedly that the antiviral drug ganciclovir (GCV) inhibits the proliferation of microglia in experimental autoimmune encephalomyelitis (EAE), a mouse model for multiple sclerosis (MS), as well as in kainic acid-induced excitotoxicity. In EAE, GCV largely prevented infiltration of T lymphocytes into the central nervous system (CNS) and drastically reduced disease incidence and severity when delivered before the onset of disease. In contrast, GCV treatment had minimal effects on peripheral leukocyte distribution in EAE and did not inhibit generation of antibodies after immunization with ovalbumin. Additionally, a radiolabeled analogue of penciclovir, [(18)F]FHBG, which is similar in structure to GCV, was retained in areas of CNS inflammation in EAE, but not in naive control mice, consistent with the observed therapeutic effects. Our experiments suggest GCV may have beneficial effects in the CNS beyond its antiviral properties.
Collapse
Affiliation(s)
- Zhaoqing Ding
- Stanford, Department of Radiology; Stanford University School of Medicine, Stanford, CA 94305
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
6
|
Fox RJ, Salter AR, Tyry T, Sun J, You X, Laforet G, Campagnolo D. Treatment discontinuation and disease progression with injectable disease-modifying therapies: findings from the north american research committee on multiple sclerosis database. Int J MS Care 2014; 15:194-201. [PMID: 24453783 DOI: 10.7224/1537-2073.2012-034] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Injectable first-line disease-modifying therapies (DMTs) for multiple sclerosis (MS) are generally prescribed for continuous use. Accordingly, the various factors that influence patient persistence with treatment and that can lead some patients to switch medications or discontinue treatment may affect clinical outcomes. Using data from the North American Research Committee on Multiple Sclerosis (NARCOMS) database, this study evaluated participants' reasons for discontinuation of injectable DMTs as well as the relationship between staying on therapy and sustained patient-reported disease progression and annualized relapse rates. Participants selected their reason(s) for discontinuation from among 16 possible options covering the categories of efficacy, safety, tolerability, and burden, with multiple responses permitted. Both unadjusted data and data adjusted for baseline age, disease duration, disability, and sex were evaluated. Discontinuation profiles varied among DMTs. Participants on intramuscular interferon beta-1a (IM IFNβ-1a) and glatiramer acetate (GA) reported the fewest discontinuations based on safety concerns, although GA was associated with reports of higher burden and lower efficacy than other therapies. Difficulties with tolerability were more often reported as a reason for discontinuing subcutaneous (SC) IFNβ-1a than as a reason for discontinuing IM IFNβ-1a, GA, or SC IFNβ-1b. In the persistent therapy cohort, less patient-reported disability progression was reported with IM IFNβ-1a treatment than with SC IFNβ-1a, IFNβ-1b, or GA. These findings have relevance to clinical decision making and medication compliance in MS patient care.
Collapse
Affiliation(s)
- Robert J Fox
- Mellen Center for Multiple Sclerosis, Neurological Institute, and the Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, OH, USA (RJF); the University of Alabama at Birmingham, Birmingham, AL, USA (ARS); Barrow Neurological Institute of St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA (TT); Biogen Idec Inc, Weston, MA, USA (JS, XY, GL, DC); the University of Massachusetts Medical School, Worcester, MA, USA (GL); and the University of Arizona College of Medicine, Phoenix, AZ, USA (DC)
| | - Amber R Salter
- Mellen Center for Multiple Sclerosis, Neurological Institute, and the Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, OH, USA (RJF); the University of Alabama at Birmingham, Birmingham, AL, USA (ARS); Barrow Neurological Institute of St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA (TT); Biogen Idec Inc, Weston, MA, USA (JS, XY, GL, DC); the University of Massachusetts Medical School, Worcester, MA, USA (GL); and the University of Arizona College of Medicine, Phoenix, AZ, USA (DC)
| | - Tuula Tyry
- Mellen Center for Multiple Sclerosis, Neurological Institute, and the Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, OH, USA (RJF); the University of Alabama at Birmingham, Birmingham, AL, USA (ARS); Barrow Neurological Institute of St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA (TT); Biogen Idec Inc, Weston, MA, USA (JS, XY, GL, DC); the University of Massachusetts Medical School, Worcester, MA, USA (GL); and the University of Arizona College of Medicine, Phoenix, AZ, USA (DC)
| | - Jennifer Sun
- Mellen Center for Multiple Sclerosis, Neurological Institute, and the Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, OH, USA (RJF); the University of Alabama at Birmingham, Birmingham, AL, USA (ARS); Barrow Neurological Institute of St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA (TT); Biogen Idec Inc, Weston, MA, USA (JS, XY, GL, DC); the University of Massachusetts Medical School, Worcester, MA, USA (GL); and the University of Arizona College of Medicine, Phoenix, AZ, USA (DC)
| | - Xiaojun You
- Mellen Center for Multiple Sclerosis, Neurological Institute, and the Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, OH, USA (RJF); the University of Alabama at Birmingham, Birmingham, AL, USA (ARS); Barrow Neurological Institute of St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA (TT); Biogen Idec Inc, Weston, MA, USA (JS, XY, GL, DC); the University of Massachusetts Medical School, Worcester, MA, USA (GL); and the University of Arizona College of Medicine, Phoenix, AZ, USA (DC)
| | - Genevieve Laforet
- Mellen Center for Multiple Sclerosis, Neurological Institute, and the Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, OH, USA (RJF); the University of Alabama at Birmingham, Birmingham, AL, USA (ARS); Barrow Neurological Institute of St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA (TT); Biogen Idec Inc, Weston, MA, USA (JS, XY, GL, DC); the University of Massachusetts Medical School, Worcester, MA, USA (GL); and the University of Arizona College of Medicine, Phoenix, AZ, USA (DC)
| | - Denise Campagnolo
- Mellen Center for Multiple Sclerosis, Neurological Institute, and the Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, OH, USA (RJF); the University of Alabama at Birmingham, Birmingham, AL, USA (ARS); Barrow Neurological Institute of St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA (TT); Biogen Idec Inc, Weston, MA, USA (JS, XY, GL, DC); the University of Massachusetts Medical School, Worcester, MA, USA (GL); and the University of Arizona College of Medicine, Phoenix, AZ, USA (DC)
| |
Collapse
|