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Ding J, Yan X, Zhao C, Zhao D, Jia Y, Ren K, Wang Y, Lu J, Sun T, Zhao S, Li H, Guo J. The ratio of circulating CD56 dim NK cells to follicular T helper cells as a promising predictor for disease activity of relapsing-remitting multiple sclerosis. Heliyon 2024; 10:e31533. [PMID: 38803865 PMCID: PMC11128518 DOI: 10.1016/j.heliyon.2024.e31533] [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: 01/23/2024] [Revised: 05/17/2024] [Accepted: 05/17/2024] [Indexed: 05/29/2024] Open
Abstract
Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system primarily mediated by CD4+ T helper cells. This study investigated the dynamic changes of natural killer (NK) cells and follicular T helper (Tfh) cells and their associations in relapsing-remitting MS patients. The findings revealed inverse relationships between NK cells and CD4+ T cells or Tfh cells. Specifically, CD56dim NK cells, not CD56bright NK cells, were negatively correlated with CD4+ T cells and Tfh cells. However, no significant correlations were found between NK cells and sNfL levels or EDSS scores. The ratio of CD56dim NK cells to circulating Tfh (cTfh) cells demonstrated superior discriminatory ability in distinguishing relapsing MS patients from healthy controls (HCs) and remitting patients, as determined by receiver operating characteristic (ROC) analysis. Following treatment with immunosuppressants or disease-modifying therapies (DMTs), a significant increase in the CD56dim NK/cTfh ratio was observed. These findings suggest that the CD56dim NK/cTfh ratio holds promise as a prognostic indicator for clinical relapse and treatment response in MS.
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Affiliation(s)
- Jiaqi Ding
- Department of Neurology, Tangdu Hospital, Air Force Medical University, Xi'an, 710038, China
| | - Xu Yan
- Department of Neurology, Tangdu Hospital, Air Force Medical University, Xi'an, 710038, China
| | - Cong Zhao
- Department of Neurology, Air Force Medical Center of PLA, Beijing, 100142, China
| | - Daidi Zhao
- Department of Neurology, Tangdu Hospital, Air Force Medical University, Xi'an, 710038, China
| | - Yan Jia
- Department of Neurology, Tangdu Hospital, Air Force Medical University, Xi'an, 710038, China
| | - Kaixi Ren
- Department of Neurology, Tangdu Hospital, Air Force Medical University, Xi'an, 710038, China
| | - Yao Wang
- Department of Neurology, Tangdu Hospital, Air Force Medical University, Xi'an, 710038, China
| | - Jiarui Lu
- Department of Neurology, Tangdu Hospital, Air Force Medical University, Xi'an, 710038, China
| | - Tangna Sun
- Department of Neurology, Tangdu Hospital, Air Force Medical University, Xi'an, 710038, China
| | - Sijia Zhao
- Department of Neurology, Tangdu Hospital, Air Force Medical University, Xi'an, 710038, China
| | - Hongzeng Li
- Department of Neurology, Tangdu Hospital, Air Force Medical University, Xi'an, 710038, China
| | - Jun Guo
- Department of Neurology, Tangdu Hospital, Air Force Medical University, Xi'an, 710038, China
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Miedema J, Cinetto F, Smed-Sörensen A, Spagnolo P. The immunopathogenesis of sarcoidosis. J Autoimmun 2024:103247. [PMID: 38734536 DOI: 10.1016/j.jaut.2024.103247] [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: 02/27/2024] [Revised: 04/30/2024] [Accepted: 05/06/2024] [Indexed: 05/13/2024]
Abstract
Sarcoidosis is a granulomatous multiorgan disease, thought to result from exposure to yet unidentified antigens in genetically susceptible individuals. The exaggerated inflammatory response that leads to granuloma formation is highly complex and involves the innate and adaptive immune system. Consecutive immunological studies using advanced technology have increased our understanding of aberrantly activated immune cells, mediators and pathways that influence the formation, maintenance and resolution of granulomas. Over the years, it has become increasingly clear that disease immunopathogenesis can only be understood if the clinical heterogeneity of sarcoidosis is taken into consideration, along with the distribution of immune cells in peripheral blood and involved organs. Most studies offer an immunological snapshot during disease course, while the cellular composition of both the circulation and tissue microenvironment may change over time. Despite these challenges, novel insights on the role of the immune system are continuously published, thus bringing the field forward. This review highlights current knowledge on the innate and adaptive immune responses involved in sarcoidosis pathogenesis, as well as the pathways involved in non-resolving disease and fibrosis development. Additionally, we describe proposed immunological mechanisms responsible for drug-induced sarcoid like reactions. Although many aspects of disease immunopathogenesis remain to be unraveled, the identification of crucial immune reactions in sarcoidosis may help identify new treatment targets. We therefore also discuss potential therapies and future strategies based on the latest immunological findings.
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Affiliation(s)
- Jelle Miedema
- Department of Pulmonary Medicine, Center of Expertise for Interstitial Lung Disease, Erasmus University Medical Center, Rotterdam, the Netherlands.
| | - Francesco Cinetto
- Rare Diseases Referral Center, Internal Medicine 1, Ca' Foncello Hospital, AULSS2 Marca Trevigiana, Italy; Department of Medicine - DIMED, University of Padova, Padova, Italy.
| | - Anna Smed-Sörensen
- Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden.
| | - Paolo Spagnolo
- Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy.
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Pelletier J, Sugar D, Koyfman A, Long B. Multiple Sclerosis: An Emergency Medicine-Focused Narrative Review. J Emerg Med 2024; 66:e441-e456. [PMID: 38472027 DOI: 10.1016/j.jemermed.2023.12.003] [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: 07/25/2023] [Revised: 11/15/2023] [Accepted: 12/11/2023] [Indexed: 03/14/2024]
Abstract
BACKGROUND Multiple sclerosis (MS) is a rare but serious condition associated with significant morbidity. OBJECTIVE This review provides a focused assessment of MS for emergency clinicians, including the presentation, evaluation, and emergency department (ED) management based on current evidence. DISCUSSION MS is an autoimmune disorder targeting the central nervous system (CNS), characterized by clinical relapses and radiological lesions disseminated in time and location. Patients with MS most commonly present with long tract signs (e.g., myelopathy, asymmetric spastic paraplegia, urinary dysfunction, Lhermitte's sign), optic neuritis, or brainstem syndromes (bilateral internuclear ophthalmoplegia). Cortical syndromes or multifocal presentations are less common. Radiologically isolated syndrome and clinically isolated syndrome (CIS) may or may not progress to chronic forms of MS, including relapsing remitting MS, primary progressive MS, and secondary progressive MS. The foundation of outpatient management involves disease-modifying therapy, which is typically initiated with the first signs of disease onset. Management of CIS and acute flares of MS in the ED includes corticosteroid therapy, ideally after diagnostic testing with imaging and lumbar puncture for cerebrospinal fluid analysis. Emergency clinicians should evaluate whether patients with MS are presenting with new-onset debilitating neurological symptoms to avoid unnecessary testing and admissions, but failure to appropriately diagnose CIS or MS flare is associated with increased morbidity. CONCLUSIONS An understanding of MS can assist emergency clinicians in better diagnosing and managing this neurologically devastating disease.
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Affiliation(s)
- Jessica Pelletier
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Davis Sugar
- Department of Neurology, Virginia Tech Carilion, Roanoke, Virginia
| | - Alex Koyfman
- Department of Emergency Medicine, University of Texas Southwestern, Dallas, Texas
| | - Brit Long
- SAUSHEC (San Antonio Uniformed Services Health Education Consortium), Department of Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, Texas
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Seyedmirzaei H, Salabat D, KamaliZonouzi S, Teixeira AL, Rezaei N. Risk of MS relapse and deterioration after COVID-19: A systematic review and meta-analysis. Mult Scler Relat Disord 2024; 83:105472. [PMID: 38316078 DOI: 10.1016/j.msard.2024.105472] [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: 12/11/2023] [Revised: 01/19/2024] [Accepted: 01/23/2024] [Indexed: 02/07/2024]
Abstract
BACKGROUND Upper respiratory viral infections have long been considered triggers for multiple sclerosis (MS) relapse and exacerbation. The possible effects of SARS-CoV-2 infection on MS relapse and deterioration remain controversial. METHODS We systematically searched PubMed, Scopus, Embase, Cochrane, and Web of Science databases to find relevant studies assessing changes in relapse rates or Expanded Disability Status Scale (EDSS) following COVID-19 in people with MS. Meta-analyses were performed, and to investigate sources of heterogeneity, subgroup analysis, meta-regression, and sensitivity analysis were conducted. RESULTS We included 14 studies in our systematic review and meta-analysis. The meta-analysis demonstrated that COVID-19 was not associated with a rise in relapse rate (risk ratio (RR): 0.97, 95 % confidence interval (CI): 0.67, 1.41, p-value: 0.87) or a rise in EDSS (standardized mean difference (SMD): -0.09, 95 % CI: -0.22, 0.03, p-value: 0.13). The analysis of EDSS changes indicated a significant heterogeneity (I2: 55 %, p-value: 0.01). Other analyses were not statistically significant. CONCLUSIONS COVID-19 infection was not associated with an increased risk of relapse and clinical deterioration in people with MS.
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Affiliation(s)
- Homa Seyedmirzaei
- Universal Scientific Education and Research Network (USERN), Tehran, Iran; Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran; Interdisciplinary Neuroscience Research Program (INRP), Tehran University of Medical Sciences, Tehran, Iran
| | - Dorsa Salabat
- Universal Scientific Education and Research Network (USERN), Tehran, Iran; School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sara KamaliZonouzi
- Universal Scientific Education and Research Network (USERN), Tehran, Iran; School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Antônio L Teixeira
- Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Nima Rezaei
- Universal Scientific Education and Research Network (USERN), Tehran, Iran; Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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Hajizadeh M, Jabbari A, Spotin A, Hejazian SS, Mikaeili Galeh T, Hassannia H, Sahlolbei M, Pagheh AS, Ahmadpour E. Modulatory Effects of Hydatid Cyst Fluid on a Mouse Model of Experimental Autoimmune Encephalomyelitis. Vet Sci 2024; 11:34. [PMID: 38250940 PMCID: PMC10819194 DOI: 10.3390/vetsci11010034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 01/10/2024] [Accepted: 01/10/2024] [Indexed: 01/23/2024] Open
Abstract
The reduced burden of helminth parasites in industrialized countries is probably one of the reasons for the increased prevalence of autoimmune disorders such as multiple sclerosis (MS). The current study aimed to evaluate the potential preventive effects of hydatid cyst fluid (HCF) on the disease severity in an EAE mouse model of MS. EAE-induced mice were treated with HCF before and after EAE induction. An RT-PCR-based evaluation of IFN-γ, IL-1β, TNF, T-bet, IL-4, GATA3, IL-17, RoRγ, TGF-β, and FOXP3 expression levels in splenocytes and an ELISA-based analysis of IFN-γ and IL-4 levels in cell culture supernatant of splenocytes were performed. Histopathological examinations of mice during the study were also conducted. The expression levels of T-bet, IL-4, GATA3, TGF-β, and FOXP3 in EAE + HCF mice were significantly higher compared to EAE + PBS mice. In the EAE + HCF group, the expression levels of IFN-γ, IL-1β, and TNF were significantly lower than in the EAE + PBS group. The histopathological results showed significantly reduced inflammation and demyelination in EAE + HCF mice compared to EAE + PBS mice. Our study provides proof-of-concept in the EAE mouse model of MS that helminth-derived products such as HCF have a potential prophylactic effect on MS development and present a novel potential therapeutic strategy.
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Affiliation(s)
- Maryam Hajizadeh
- Infectious and Tropical Disease Research Center, Tabriz University of Medical Sciences, Tabriz 51656-65811, Iran
| | - Aynaz Jabbari
- Infectious and Tropical Disease Research Center, Tabriz University of Medical Sciences, Tabriz 51656-65811, Iran
| | - Adel Spotin
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz 51656-65811, Iran (S.S.H.)
| | - Seyyed Sina Hejazian
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz 51656-65811, Iran (S.S.H.)
- Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz 51656-65811, Iran
| | - Tahereh Mikaeili Galeh
- Department of Basic Medical Sciences, Khoy University of Medical Sciences, Khoy 53464-58167, Iran
| | - Hadi Hassannia
- Immunogenetic Research Center, Faculty of Medicine and Amol Faculty of Paramedical Sciences, Mazandaran, University of Medical Sciences, Sari 48175-866, Iran
| | - Maryam Sahlolbei
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz 51656-65811, Iran (S.S.H.)
| | - Abdol Sattar Pagheh
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand 14619-65381, Iran
| | - Ehsan Ahmadpour
- Infectious and Tropical Disease Research Center, Tabriz University of Medical Sciences, Tabriz 51656-65811, Iran
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz 51656-65811, Iran (S.S.H.)
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Mauro D, Manou-Stathopoulou S, Rivellese F, Sciacca E, Goldmann K, Tsang V, Lucey-Clayton I, Pagani S, Alam F, Pyne D, Rajakariar R, Gordon PA, Whiteford J, Bombardieri M, Pitzalis C, Lewis MJ. UBE2L3 regulates TLR7-induced B cell autoreactivity in Systemic Lupus Erythematosus. J Autoimmun 2023; 136:103023. [PMID: 37001433 DOI: 10.1016/j.jaut.2023.103023] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 02/28/2023] [Indexed: 03/31/2023]
Abstract
Both TLR7 and NF-κB hyperactivity are known to contribute to pathogenesis in Systemic Lupus Erythematosus (SLE), driving a pro-interferon response, autoreactive B cell expansion and autoantibody production. UBE2L3 is an SLE susceptibility gene which drives plasmablast/plasma cell expansion in SLE, but its role in TLR7 signalling has not been elucidated. We aimed to investigate the role of UBE2L3 in TLR7-mediated NF-κB activation, and the effect of UBE2L3 inhibition by Dimethyl Fumarate (DMF) on SLE B cell differentiation in vitro. Our data demonstrate that UBE2L3 is critical for activation of NF-κB downstream of TLR7 stimulation, via interaction with LUBAC. DMF, which directly inhibits UBE2L3, significantly inhibited TLR7-induced NF-κB activation, differentiation of memory B cells and plasmablasts, and autoantibody secretion in SLE. DMF also downregulated interferon signature genes and plasma cell transcriptional programmes. These results demonstrate that UBE2L3 inhibition could potentially be used as a therapy in SLE through repurposing of DMF, thus preventing TLR7-driven autoreactive B cell maturation.
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Qi J, Liu C, Bai Z, Li X, Yao G. T follicular helper cells and T follicular regulatory cells in autoimmune diseases. Front Immunol 2023; 14:1178792. [PMID: 37187757 PMCID: PMC10175690 DOI: 10.3389/fimmu.2023.1178792] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 04/13/2023] [Indexed: 05/17/2023] Open
Abstract
T follicular helper (Tfh) cells are heterogeneous and mainly characterized by expressing surface markers CXCR5, ICOS, and PD-1; cytokine IL-21; and transcription factor Bcl6. They are crucial for B-cell differentiation into long-lived plasma cells and high-affinity antibody production. T follicular regulatory (Tfr) cells were described to express markers of conventional T regulatory (Treg) cells and Tfh cells and were able to suppress Tfh-cell and B-cell responses. Evidence has revealed that the dysregulation of Tfh and Tfr cells is positively associated with the pathogenic processes of autoimmune diseases. Herein, we briefly introduce the phenotype, differentiation, and function of Tfh and Tfr cells, and review their potential roles in autoimmune diseases. In addition, we discuss perspectives to develop novel therapies targeting Tfh/Tfr balance.
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Affiliation(s)
- Jingjing Qi
- Department of Immunology, College of Basic Medical Science, Dalian Medical University, Dalian, Liaoning, China
- *Correspondence: Genhong Yao, ; Jingjing Qi,
| | - Chang Liu
- Department of Rheumatology and Immunology, Dalian Municipal Central Hospital, Dalian, Liaoning, China
| | - Ziran Bai
- Department of Immunology, College of Basic Medical Science, Dalian Medical University, Dalian, Liaoning, China
| | - Xia Li
- Department of Immunology, College of Basic Medical Science, Dalian Medical University, Dalian, Liaoning, China
| | - Genhong Yao
- Department of Rheumatology and Immunology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
- *Correspondence: Genhong Yao, ; Jingjing Qi,
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Morille J, Mandon M, Rodriguez S, Roulois D, Leonard S, Garcia A, Wiertlewski S, Le Page E, Berthelot L, Nicot A, Mathé C, Lejeune F, Tarte K, Delaloy C, Amé P, Laplaud D, Michel L. Multiple Sclerosis CSF Is Enriched With Follicular T Cells Displaying a Th1/Eomes Signature. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2022; 9:9/6/e200033. [PMID: 36266053 PMCID: PMC9585484 DOI: 10.1212/nxi.0000000000200033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/05/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVES Tertiary lymphoid structures and aggregates are reported in the meninges of patients with multiple sclerosis (MS), especially at the progressive stage, and are strongly associated with cortical lesions and disability. Besides B cells, these structures comprise follicular helper T (Tfh) cells that are crucial to support B-cell differentiation. Tfh cells play a pivotal role in amplifying autoreactive B cells and promoting autoantibody production in several autoimmune diseases, but very few are known in MS. In this study, we examined the phenotype, frequency, and transcriptome of circulating cTfh cells in the blood and CSF of patients with relapsing-remitting MS (RRMS). METHODS The phenotype and frequency of cTfh cells were analyzed in the blood of 39 healthy controls and 41 untreated patients with RRMS and in the CSF and paired blood of 10 patients with drug-naive RRMS at diagnosis by flow cytometry. Using an in vitro model of blood-brain barrier, we assessed the transendothelial migratory abilities of the different cTfh-cell subsets. Finally, we performed an RNA sequencing analysis of paired CSF cTfh cells and blood cTfh cells in 8 patients sampled at their first demyelinating event. RESULTS The blood phenotype and frequency of cTfh cells were not significantly modified in patients with RRMS. In the CSF, we found an important infiltration of Tfh1 cells, with a high proportion of activated PD1+ cells. We demonstrated that the specific subset of Tfh1 cells presents increased migration abilities to cross an in vitro model of blood-brain barrier. Of interest, even at the first demyelinating event, cTfh cells in the CSF display specific characteristics with upregulation of EOMES gene and proinflammatory/cytotoxic transcriptomic signature able to efficiently distinguish cTfh cells from the CSF and blood. Finally, interactome analysis revealed potential strong cross talk between pathogenic B cells and CSF cTfh cells, pointing out the CSF as opportune supportive compartment and highlighting the very early implication of B-cell helper T cells in MS pathogenesis. DISCUSSION Overall, CSF enrichment in activated Tfh1 as soon as disease diagnosis, associated with high expression of EOMES, and a predicted high propensity to interact with CSF B cells suggest that these cells probably contribute to disease onset and/or activity.
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Affiliation(s)
- Jérémy Morille
- From the Université de Nantes (J.M., A.G., L.B., A.N., C.M., F.L., D.L.), INSERM, CR2TI, UMR1064, Nantes; Pôle Biologie (M.M., K.T., P.A., L.M.), Laboratoire SITI, University Hospital; INSERM UMR1236 MicrOenvironment and B-Cell: Immunopathology Cell Differentiation and Cancer (M.M., S.R., D.R., S.L., K.T., C.D., P.A., L.M.), Univ Rennes, Etablissement Français du Sang Bretagne, Rennes; LabEx IGO "Immunotherapy (S.L.), Graft, Oncology", Nantes; Service de neurologie (S.W., F.L., D.L.), CRC-SEP Pays de La Loire and CIC 1314, CHU Nantes; Neurology Department (E.L.P., L.M.), Rennes University Hospital; and Clinical Neuroscience Centre (E.L.P., L.M.), CIC_P1414 INSERM, Rennes, University Hospital, Rennes University
| | - Marion Mandon
- From the Université de Nantes (J.M., A.G., L.B., A.N., C.M., F.L., D.L.), INSERM, CR2TI, UMR1064, Nantes; Pôle Biologie (M.M., K.T., P.A., L.M.), Laboratoire SITI, University Hospital; INSERM UMR1236 MicrOenvironment and B-Cell: Immunopathology Cell Differentiation and Cancer (M.M., S.R., D.R., S.L., K.T., C.D., P.A., L.M.), Univ Rennes, Etablissement Français du Sang Bretagne, Rennes; LabEx IGO "Immunotherapy (S.L.), Graft, Oncology", Nantes; Service de neurologie (S.W., F.L., D.L.), CRC-SEP Pays de La Loire and CIC 1314, CHU Nantes; Neurology Department (E.L.P., L.M.), Rennes University Hospital; and Clinical Neuroscience Centre (E.L.P., L.M.), CIC_P1414 INSERM, Rennes, University Hospital, Rennes University
| | - Stéphane Rodriguez
- From the Université de Nantes (J.M., A.G., L.B., A.N., C.M., F.L., D.L.), INSERM, CR2TI, UMR1064, Nantes; Pôle Biologie (M.M., K.T., P.A., L.M.), Laboratoire SITI, University Hospital; INSERM UMR1236 MicrOenvironment and B-Cell: Immunopathology Cell Differentiation and Cancer (M.M., S.R., D.R., S.L., K.T., C.D., P.A., L.M.), Univ Rennes, Etablissement Français du Sang Bretagne, Rennes; LabEx IGO "Immunotherapy (S.L.), Graft, Oncology", Nantes; Service de neurologie (S.W., F.L., D.L.), CRC-SEP Pays de La Loire and CIC 1314, CHU Nantes; Neurology Department (E.L.P., L.M.), Rennes University Hospital; and Clinical Neuroscience Centre (E.L.P., L.M.), CIC_P1414 INSERM, Rennes, University Hospital, Rennes University
| | - David Roulois
- From the Université de Nantes (J.M., A.G., L.B., A.N., C.M., F.L., D.L.), INSERM, CR2TI, UMR1064, Nantes; Pôle Biologie (M.M., K.T., P.A., L.M.), Laboratoire SITI, University Hospital; INSERM UMR1236 MicrOenvironment and B-Cell: Immunopathology Cell Differentiation and Cancer (M.M., S.R., D.R., S.L., K.T., C.D., P.A., L.M.), Univ Rennes, Etablissement Français du Sang Bretagne, Rennes; LabEx IGO "Immunotherapy (S.L.), Graft, Oncology", Nantes; Service de neurologie (S.W., F.L., D.L.), CRC-SEP Pays de La Loire and CIC 1314, CHU Nantes; Neurology Department (E.L.P., L.M.), Rennes University Hospital; and Clinical Neuroscience Centre (E.L.P., L.M.), CIC_P1414 INSERM, Rennes, University Hospital, Rennes University
| | - Simon Leonard
- From the Université de Nantes (J.M., A.G., L.B., A.N., C.M., F.L., D.L.), INSERM, CR2TI, UMR1064, Nantes; Pôle Biologie (M.M., K.T., P.A., L.M.), Laboratoire SITI, University Hospital; INSERM UMR1236 MicrOenvironment and B-Cell: Immunopathology Cell Differentiation and Cancer (M.M., S.R., D.R., S.L., K.T., C.D., P.A., L.M.), Univ Rennes, Etablissement Français du Sang Bretagne, Rennes; LabEx IGO "Immunotherapy (S.L.), Graft, Oncology", Nantes; Service de neurologie (S.W., F.L., D.L.), CRC-SEP Pays de La Loire and CIC 1314, CHU Nantes; Neurology Department (E.L.P., L.M.), Rennes University Hospital; and Clinical Neuroscience Centre (E.L.P., L.M.), CIC_P1414 INSERM, Rennes, University Hospital, Rennes University
| | - Alexandra Garcia
- From the Université de Nantes (J.M., A.G., L.B., A.N., C.M., F.L., D.L.), INSERM, CR2TI, UMR1064, Nantes; Pôle Biologie (M.M., K.T., P.A., L.M.), Laboratoire SITI, University Hospital; INSERM UMR1236 MicrOenvironment and B-Cell: Immunopathology Cell Differentiation and Cancer (M.M., S.R., D.R., S.L., K.T., C.D., P.A., L.M.), Univ Rennes, Etablissement Français du Sang Bretagne, Rennes; LabEx IGO "Immunotherapy (S.L.), Graft, Oncology", Nantes; Service de neurologie (S.W., F.L., D.L.), CRC-SEP Pays de La Loire and CIC 1314, CHU Nantes; Neurology Department (E.L.P., L.M.), Rennes University Hospital; and Clinical Neuroscience Centre (E.L.P., L.M.), CIC_P1414 INSERM, Rennes, University Hospital, Rennes University
| | - Sandrine Wiertlewski
- From the Université de Nantes (J.M., A.G., L.B., A.N., C.M., F.L., D.L.), INSERM, CR2TI, UMR1064, Nantes; Pôle Biologie (M.M., K.T., P.A., L.M.), Laboratoire SITI, University Hospital; INSERM UMR1236 MicrOenvironment and B-Cell: Immunopathology Cell Differentiation and Cancer (M.M., S.R., D.R., S.L., K.T., C.D., P.A., L.M.), Univ Rennes, Etablissement Français du Sang Bretagne, Rennes; LabEx IGO "Immunotherapy (S.L.), Graft, Oncology", Nantes; Service de neurologie (S.W., F.L., D.L.), CRC-SEP Pays de La Loire and CIC 1314, CHU Nantes; Neurology Department (E.L.P., L.M.), Rennes University Hospital; and Clinical Neuroscience Centre (E.L.P., L.M.), CIC_P1414 INSERM, Rennes, University Hospital, Rennes University
| | - Emmanuelle Le Page
- From the Université de Nantes (J.M., A.G., L.B., A.N., C.M., F.L., D.L.), INSERM, CR2TI, UMR1064, Nantes; Pôle Biologie (M.M., K.T., P.A., L.M.), Laboratoire SITI, University Hospital; INSERM UMR1236 MicrOenvironment and B-Cell: Immunopathology Cell Differentiation and Cancer (M.M., S.R., D.R., S.L., K.T., C.D., P.A., L.M.), Univ Rennes, Etablissement Français du Sang Bretagne, Rennes; LabEx IGO "Immunotherapy (S.L.), Graft, Oncology", Nantes; Service de neurologie (S.W., F.L., D.L.), CRC-SEP Pays de La Loire and CIC 1314, CHU Nantes; Neurology Department (E.L.P., L.M.), Rennes University Hospital; and Clinical Neuroscience Centre (E.L.P., L.M.), CIC_P1414 INSERM, Rennes, University Hospital, Rennes University
| | - Laureline Berthelot
- From the Université de Nantes (J.M., A.G., L.B., A.N., C.M., F.L., D.L.), INSERM, CR2TI, UMR1064, Nantes; Pôle Biologie (M.M., K.T., P.A., L.M.), Laboratoire SITI, University Hospital; INSERM UMR1236 MicrOenvironment and B-Cell: Immunopathology Cell Differentiation and Cancer (M.M., S.R., D.R., S.L., K.T., C.D., P.A., L.M.), Univ Rennes, Etablissement Français du Sang Bretagne, Rennes; LabEx IGO "Immunotherapy (S.L.), Graft, Oncology", Nantes; Service de neurologie (S.W., F.L., D.L.), CRC-SEP Pays de La Loire and CIC 1314, CHU Nantes; Neurology Department (E.L.P., L.M.), Rennes University Hospital; and Clinical Neuroscience Centre (E.L.P., L.M.), CIC_P1414 INSERM, Rennes, University Hospital, Rennes University
| | - Arnaud Nicot
- From the Université de Nantes (J.M., A.G., L.B., A.N., C.M., F.L., D.L.), INSERM, CR2TI, UMR1064, Nantes; Pôle Biologie (M.M., K.T., P.A., L.M.), Laboratoire SITI, University Hospital; INSERM UMR1236 MicrOenvironment and B-Cell: Immunopathology Cell Differentiation and Cancer (M.M., S.R., D.R., S.L., K.T., C.D., P.A., L.M.), Univ Rennes, Etablissement Français du Sang Bretagne, Rennes; LabEx IGO "Immunotherapy (S.L.), Graft, Oncology", Nantes; Service de neurologie (S.W., F.L., D.L.), CRC-SEP Pays de La Loire and CIC 1314, CHU Nantes; Neurology Department (E.L.P., L.M.), Rennes University Hospital; and Clinical Neuroscience Centre (E.L.P., L.M.), CIC_P1414 INSERM, Rennes, University Hospital, Rennes University
| | - Camille Mathé
- From the Université de Nantes (J.M., A.G., L.B., A.N., C.M., F.L., D.L.), INSERM, CR2TI, UMR1064, Nantes; Pôle Biologie (M.M., K.T., P.A., L.M.), Laboratoire SITI, University Hospital; INSERM UMR1236 MicrOenvironment and B-Cell: Immunopathology Cell Differentiation and Cancer (M.M., S.R., D.R., S.L., K.T., C.D., P.A., L.M.), Univ Rennes, Etablissement Français du Sang Bretagne, Rennes; LabEx IGO "Immunotherapy (S.L.), Graft, Oncology", Nantes; Service de neurologie (S.W., F.L., D.L.), CRC-SEP Pays de La Loire and CIC 1314, CHU Nantes; Neurology Department (E.L.P., L.M.), Rennes University Hospital; and Clinical Neuroscience Centre (E.L.P., L.M.), CIC_P1414 INSERM, Rennes, University Hospital, Rennes University
| | - Flora Lejeune
- From the Université de Nantes (J.M., A.G., L.B., A.N., C.M., F.L., D.L.), INSERM, CR2TI, UMR1064, Nantes; Pôle Biologie (M.M., K.T., P.A., L.M.), Laboratoire SITI, University Hospital; INSERM UMR1236 MicrOenvironment and B-Cell: Immunopathology Cell Differentiation and Cancer (M.M., S.R., D.R., S.L., K.T., C.D., P.A., L.M.), Univ Rennes, Etablissement Français du Sang Bretagne, Rennes; LabEx IGO "Immunotherapy (S.L.), Graft, Oncology", Nantes; Service de neurologie (S.W., F.L., D.L.), CRC-SEP Pays de La Loire and CIC 1314, CHU Nantes; Neurology Department (E.L.P., L.M.), Rennes University Hospital; and Clinical Neuroscience Centre (E.L.P., L.M.), CIC_P1414 INSERM, Rennes, University Hospital, Rennes University
| | - Karin Tarte
- From the Université de Nantes (J.M., A.G., L.B., A.N., C.M., F.L., D.L.), INSERM, CR2TI, UMR1064, Nantes; Pôle Biologie (M.M., K.T., P.A., L.M.), Laboratoire SITI, University Hospital; INSERM UMR1236 MicrOenvironment and B-Cell: Immunopathology Cell Differentiation and Cancer (M.M., S.R., D.R., S.L., K.T., C.D., P.A., L.M.), Univ Rennes, Etablissement Français du Sang Bretagne, Rennes; LabEx IGO "Immunotherapy (S.L.), Graft, Oncology", Nantes; Service de neurologie (S.W., F.L., D.L.), CRC-SEP Pays de La Loire and CIC 1314, CHU Nantes; Neurology Department (E.L.P., L.M.), Rennes University Hospital; and Clinical Neuroscience Centre (E.L.P., L.M.), CIC_P1414 INSERM, Rennes, University Hospital, Rennes University
| | - Céline Delaloy
- From the Université de Nantes (J.M., A.G., L.B., A.N., C.M., F.L., D.L.), INSERM, CR2TI, UMR1064, Nantes; Pôle Biologie (M.M., K.T., P.A., L.M.), Laboratoire SITI, University Hospital; INSERM UMR1236 MicrOenvironment and B-Cell: Immunopathology Cell Differentiation and Cancer (M.M., S.R., D.R., S.L., K.T., C.D., P.A., L.M.), Univ Rennes, Etablissement Français du Sang Bretagne, Rennes; LabEx IGO "Immunotherapy (S.L.), Graft, Oncology", Nantes; Service de neurologie (S.W., F.L., D.L.), CRC-SEP Pays de La Loire and CIC 1314, CHU Nantes; Neurology Department (E.L.P., L.M.), Rennes University Hospital; and Clinical Neuroscience Centre (E.L.P., L.M.), CIC_P1414 INSERM, Rennes, University Hospital, Rennes University
| | - Patricia Amé
- From the Université de Nantes (J.M., A.G., L.B., A.N., C.M., F.L., D.L.), INSERM, CR2TI, UMR1064, Nantes; Pôle Biologie (M.M., K.T., P.A., L.M.), Laboratoire SITI, University Hospital; INSERM UMR1236 MicrOenvironment and B-Cell: Immunopathology Cell Differentiation and Cancer (M.M., S.R., D.R., S.L., K.T., C.D., P.A., L.M.), Univ Rennes, Etablissement Français du Sang Bretagne, Rennes; LabEx IGO "Immunotherapy (S.L.), Graft, Oncology", Nantes; Service de neurologie (S.W., F.L., D.L.), CRC-SEP Pays de La Loire and CIC 1314, CHU Nantes; Neurology Department (E.L.P., L.M.), Rennes University Hospital; and Clinical Neuroscience Centre (E.L.P., L.M.), CIC_P1414 INSERM, Rennes, University Hospital, Rennes University
| | - David Laplaud
- From the Université de Nantes (J.M., A.G., L.B., A.N., C.M., F.L., D.L.), INSERM, CR2TI, UMR1064, Nantes; Pôle Biologie (M.M., K.T., P.A., L.M.), Laboratoire SITI, University Hospital; INSERM UMR1236 MicrOenvironment and B-Cell: Immunopathology Cell Differentiation and Cancer (M.M., S.R., D.R., S.L., K.T., C.D., P.A., L.M.), Univ Rennes, Etablissement Français du Sang Bretagne, Rennes; LabEx IGO "Immunotherapy (S.L.), Graft, Oncology", Nantes; Service de neurologie (S.W., F.L., D.L.), CRC-SEP Pays de La Loire and CIC 1314, CHU Nantes; Neurology Department (E.L.P., L.M.), Rennes University Hospital; and Clinical Neuroscience Centre (E.L.P., L.M.), CIC_P1414 INSERM, Rennes, University Hospital, Rennes University
| | - Laure Michel
- From the Université de Nantes (J.M., A.G., L.B., A.N., C.M., F.L., D.L.), INSERM, CR2TI, UMR1064, Nantes; Pôle Biologie (M.M., K.T., P.A., L.M.), Laboratoire SITI, University Hospital; INSERM UMR1236 MicrOenvironment and B-Cell: Immunopathology Cell Differentiation and Cancer (M.M., S.R., D.R., S.L., K.T., C.D., P.A., L.M.), Univ Rennes, Etablissement Français du Sang Bretagne, Rennes; LabEx IGO "Immunotherapy (S.L.), Graft, Oncology", Nantes; Service de neurologie (S.W., F.L., D.L.), CRC-SEP Pays de La Loire and CIC 1314, CHU Nantes; Neurology Department (E.L.P., L.M.), Rennes University Hospital; and Clinical Neuroscience Centre (E.L.P., L.M.), CIC_P1414 INSERM, Rennes, University Hospital, Rennes University.
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9
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Holm Hansen R, Talbot J, Højsgaard Chow H, Bredahl Hansen M, Buhelt S, Herich S, Schwab N, Hellem MNN, Nielsen JE, Sellebjerg F, von Essen MR. Increased Intrathecal Activity of Follicular Helper T Cells in Patients With Relapsing-Remitting Multiple Sclerosis. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2022; 9:9/5/e200009. [PMID: 35835563 PMCID: PMC9621607 DOI: 10.1212/nxi.0000000000200009] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/06/2022] [Indexed: 04/29/2023]
Abstract
BACKGROUND AND OBJECTIVES Follicular helper T (Tfh) cells play a critical role in protective immunity helping B cells produce antibodies against foreign pathogens and are likely implicated in the pathogenesis of various autoimmune diseases. The purpose of this study was to investigate the role of Tfh cells in the pathogenesis of multiple sclerosis (MS). METHODS Using flow cytometry, we investigated phenotype, prevalence, and function of Tfh cells in blood and CSF from controls and patients with relapsing-remitting MS (RRMS) and primary progressive MS (PPMS). In addition, an in vitro blood-brain barrier coculture assay of primary human astrocytes and brain microvascular endothelial cells grown in a Boyden chamber was used to assess the migratory capacity of peripheral Tfh cells. RESULTS This study identified 2 phenotypically and functionally distinct Tfh cell populations: CD25- Tfh cells (Tfh1-like) and CD25int Tfh cells (Tfh17-like). Whereas minor differences in Tfh cell populations were found in blood between patients with MS and controls, we observed an increased frequency of CD25- Tfh cells in CSF of patients with RRMS and PPMS and CD25int Tfh cells in patients with RRMS, compared with controls. Increasing frequencies of CSF CD25- Tfh cells and the CD25- Tfh/Tfr ratio scaled with increasing IgG index in patients with RRMS. Despite an increased prevalence of intrathecal Tfh cells in patients with MS, no difference in the migratory capacity of circulating Tfh cells was observed between controls and patients with MS. Instead, CSF concentrations of CXCL13 scaled with total counts of Tfh and Tfr cell subsets in the CSF. DISCUSSION Our study indicates substantial changes in intrathecal Tfh dynamics, particularly in patients with RRMS, and suggests that the intrathecal inflammatory environment in patients with RRMS promotes recruitment of peripheral Tfh cells rather than the Tfh cells having an increased capacity to migrate to CNS.
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10
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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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11
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Ma Q, Caillier SJ, Muzic S, Wilson MR, Henry RG, Cree BAC, Hauser SL, Didonna A, Oksenberg JR. Specific hypomethylation programs underpin B cell activation in early multiple sclerosis. Proc Natl Acad Sci U S A 2021; 118:e2111920118. [PMID: 34911760 PMCID: PMC8713784 DOI: 10.1073/pnas.2111920118] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2021] [Indexed: 12/12/2022] Open
Abstract
Epigenetic changes have been consistently detected in different cell types in multiple sclerosis (MS). However, their contribution to MS pathogenesis remains poorly understood partly because of sample heterogeneity and limited coverage of array-based methods. To fill this gap, we conducted a comprehensive analysis of genome-wide DNA methylation patterns in four peripheral immune cell populations isolated from 29 MS patients at clinical disease onset and 24 healthy controls. We show that B cells from new-onset untreated MS cases display more significant methylation changes than other disease-implicated immune cell types, consisting of a global DNA hypomethylation signature. Importantly, 4,933 MS-associated differentially methylated regions in B cells were identified, and this epigenetic signature underlies specific genetic programs involved in B cell differentiation and activation. Integration of the methylome to changes in gene expression and susceptibility-associated regions further indicates that hypomethylated regions are significantly associated with the up-regulation of cell activation transcriptional programs. Altogether, these findings implicate aberrant B cell function in MS etiology.
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Affiliation(s)
- Qin Ma
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA 94158
| | - Stacy J Caillier
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA 94158
| | - Shaun Muzic
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA 94158
| | - Michael R Wilson
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA 94158
| | - Roland G Henry
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA 94158
| | - Bruce A C Cree
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA 94158
| | - Stephen L Hauser
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA 94158
| | - Alessandro Didonna
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA 94158
| | - Jorge R Oksenberg
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA 94158
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12
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Follicular Helper CD4 + T Cells, Follicular Regulatory CD4 + T Cells, and Inducible Costimulator and Their Roles in Multiple Sclerosis and Experimental Autoimmune Encephalomyelitis. Mediators Inflamm 2021; 2021:2058964. [PMID: 34552387 PMCID: PMC8452443 DOI: 10.1155/2021/2058964] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 08/12/2021] [Accepted: 08/26/2021] [Indexed: 12/13/2022] Open
Abstract
Follicular helper CD4+ T (TFH) cells are a specialized subset of effector T cells that play a central role in orchestrating adaptive immunity. TFH cells mainly promote germinal center (GC) formation, provide help to B cells for immunoglobulin affinity maturation and class-switch recombination of B cells, and facilitate production of long-lived plasma cells and memory B cells. TFH cells express the nuclear transcriptional repressor B cell lymphoma 6 (Bcl-6), the chemokine (C-X-C motif) receptor 5 (CXCR5), the CD28 family members programmed cell death protein-1 (PD-1) and inducible costimulator (ICOS) and are also responsible for the secretion of interleukin-21 (IL-21) and IL-4. Follicular regulatory CD4+ T (TFR) cells, as a regulatory counterpart of TFH cells, participate in the regulation of GC reactions. TFR cells not only express markers of TFH cells but also express markers of regulatory T (Treg) cells containing FOXP3, glucocorticoid-induced tumor necrosis factor receptor (GITR), cytotoxic T lymphocyte antigen 4 (CTLA-4), and IL-10, hence owing to the dual characteristic of TFH cells and Treg cells. ICOS, expressed on activated CD4+ effector T cells, participates in T cell activation, differentiation, and effector process. The expression of ICOS is highest on TFH and TFR cells, indicating it as a key regulator of humoral immunity. Multiple sclerosis (MS) is a severe autoimmune disease that affects the central nervous system and results in disability, mediated by autoreactive T cells with evolving evidence of a remarkable contribution from humoral responses. This review summarizes recent advances regarding TFH cells, TFR cells, and ICOS, as well as their functional characteristics in relation to MS.
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13
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Haque R, Kim Y, Park K, Jang H, Kim SY, Lee H, Kim HJ. Altered distributions in circulating follicular helper and follicular regulatory T cells accountable for imbalanced cytokine production in multiple sclerosis. Clin Exp Immunol 2021; 205:75-88. [PMID: 33759187 PMCID: PMC8209573 DOI: 10.1111/cei.13596] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 03/11/2021] [Accepted: 03/16/2021] [Indexed: 12/15/2022] Open
Abstract
Follicular T helper (Tfh) and regulatory (Tfr) cells are distinct subsets of CD4+ T lymphocytes, regulating humoral immune responses in the germinal center. It is widely accepted that dysregulated Tfh and Tfr cells are associated with autoimmunity. In this study, we evaluated the frequencies of circulating chemokine receptor (CXCR)5+ programmed cell death 1 (PD-1+ ) Tfh (cTfh) and CXCR5+ PD-1+ forkhead box protein 3 (FoxP3+ ) CD25+ Tfr (cTfr) cells, and their corresponding cytokines from the peripheral blood mononuclear cells of 28 patients with relapsing-remitting multiple sclerosis (MS) and 16 age- and sex-matched healthy controls (HC). Subsets of cTfh cells by Th1- and Th17-related surface markers (CXCR3 and CCR6) were also evaluated. We found that the frequency of cTfh cells was significantly higher in MS patients compared to that of HC. Conversely, the frequency of cTfr cells was lower in MS patients than that of HC. Interleukin (IL)-21-producing cTfh cells were significantly increased in MS patients, while IL-10-secreting cTfr cells were lower in MS patients compared to levels in HC. Among cTfh cells, cTfh17.1 cells were the major subtypes that were significantly increased in MS patients compared to HC, with the frequency of IL-21-secreting cells being the highest. These results suggest that an imbalanced distribution of cTfh and cTfr exist in MS patients, which contributes to the reciprocally altered IL-21 and IL-10 production.
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Affiliation(s)
- R. Haque
- Department of Cancer Biomedical ScienceGraduate School of Cancer Science and PolicyNational Cancer CenterGoyangSouth Korea
- Department of NeurologyNational Cancer CenterGoyangSouth Korea
- Division of Clinical ResearchNational Cancer CenterGoyangSouth Korea
| | - Y. Kim
- Department of NeurologyNational Cancer CenterGoyangSouth Korea
- Division of Clinical ResearchNational Cancer CenterGoyangSouth Korea
| | - K. Park
- Division of Clinical ResearchNational Cancer CenterGoyangSouth Korea
| | - H. Jang
- Department of NeurologyNational Cancer CenterGoyangSouth Korea
| | - S. Y. Kim
- Department of NeurologyNational Cancer CenterGoyangSouth Korea
- Division of Clinical ResearchNational Cancer CenterGoyangSouth Korea
| | - H. Lee
- Department of Cancer Biomedical ScienceGraduate School of Cancer Science and PolicyNational Cancer CenterGoyangSouth Korea
| | - H. J. Kim
- Department of Cancer Biomedical ScienceGraduate School of Cancer Science and PolicyNational Cancer CenterGoyangSouth Korea
- Department of NeurologyNational Cancer CenterGoyangSouth Korea
- Division of Clinical ResearchNational Cancer CenterGoyangSouth Korea
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14
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Calis Z, Mogulkoc R, Baltaci AK. The Roles of Flavonols/Flavonoids in Neurodegeneration and Neuroinflammation. Mini Rev Med Chem 2021; 20:1475-1488. [PMID: 31288717 DOI: 10.2174/1389557519666190617150051] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 03/05/2019] [Accepted: 05/25/2019] [Indexed: 12/27/2022]
Abstract
The inflammatory process in the human body is a physiological response involving many cellular types and mediators. It results in scar formation to separate the damaged area from the surrounding healthy tissue. Because of increased blood-brain barrier permeability following inflammation, leukocytes infiltrate the CNS and are also supplemented by proinflammatory mediators. However, an acute inflammatory process after cerebral trauma or stroke may also result in a prolonged lesion formation, leading to a severe neuronal loss. The prolonged inflammatory process in the CNS may cause serious damage to the neuronal system. It may lead to CNS damage in such a way that endangers functional integration and proinflammatory system balance. Effects of different flavonoid species on ischemia-reperfusion injury and cognition and function have also been shown in experimental studies. Flavonoids are presented broadly in plants and diets. They are believed to have various bioactive effects including anti-viral, anti-inflammatory, cardioprotective, anti-diabetic, anti-cancer, anti-aging, etc. Quercetine is the predominant dietary flavonoid. Main sources are tea, onion, and apple. It is demonstrated that the frequently consumed food like soybean, peanut, mustard, rice, sesame, olive, potatoes, onion, and oats contain flavonoids. Catechin and its derivates which are isolated from tea leaves have antioxidant activity but in low doses, their prooxidant effects are also reported. Ipriflavone which is a synthetic flavonoid may increase total calcium in bone. In this review, the effects of flavonoids species on the inflammatory process in the neurodegenerative process were examined as general.
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Affiliation(s)
- Zehra Calis
- Department of Physiology, Medical Faculty, Selcuk University, Konya, Turkey
| | - Rasim Mogulkoc
- Department of Physiology, Medical Faculty, Selcuk University, Konya, Turkey
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15
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DiSano KD, Gilli F, Pachner AR. Intrathecally produced CXCL13: A predictive biomarker in multiple sclerosis. Mult Scler J Exp Transl Clin 2020; 6:2055217320981396. [PMID: 33403120 PMCID: PMC7747124 DOI: 10.1177/2055217320981396] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 11/25/2020] [Indexed: 01/27/2023] Open
Abstract
Background Clinicians caring for patients with Multiple Sclerosis (MS) need improved biomarkers to aid them in disease management. Objective We assessed the predictive value of the candidate biomarker CXCL13 index in comparison to oligoclonal bands (OCBs) and CSF neurofilament light (NfL) concentration, examining the ability of each biomarker to predict future disease activity in clinically and radiologically isolated syndromes, relapsing-remitting MS, and progressive MS. Methods Matched serum and CSF samples were obtained from 67 non-inflammatory neurologic disease patients and 67 MS patients. CSF and serum CXCL13 and CSF NfL were analyzed by Luminex and ELISA, respectively. CXCL13 data were also analyzed as CSF/serum ratios and indices. Electronic medical records were accessed to determine diagnosis, CSF profiles, and disease activity after the lumbar puncture. Results Among CXCL13 measures, CXCL13 index was the best predictor of future disease activity in MS patients (AUC = 0.82; CI = 0.69–0.95; p = 0.0002). CXCL13 index values were significantly elevated in activity-positive MS patients compared to activity-negative patients (p < 0.0001). As a single predictor, CXCL13 index outperformed both OCBs and CSF NfL in sensitivity, specificity, and positive and negative predictive value, for future disease activity in MS patients. Moreover, combining CXCL13 index and CSF NfL status improved sensitivity and predictive values for disease activity in MS patients. Conclusions The CXCL13 index is an excellent candidate prognostic biomarker for disease activity in patients with MS.
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Affiliation(s)
- Krista D DiSano
- Department of Neurology, Geisel School of Medicine & Dartmouth-Hitchcock Medical Center, Lebanon, USA
| | - Francesca Gilli
- Department of Neurology, Geisel School of Medicine & Dartmouth-Hitchcock Medical Center, Lebanon, USA
| | - Andrew R Pachner
- Department of Neurology, Geisel School of Medicine & Dartmouth-Hitchcock Medical Center, Lebanon, USA
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16
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Huber JE, Chang Y, Meinl I, Kümpfel T, Meinl E, Baumjohann D. Fingolimod Profoundly Reduces Frequencies and Alters Subset Composition of Circulating T Follicular Helper Cells in Multiple Sclerosis Patients. THE JOURNAL OF IMMUNOLOGY 2020; 204:1101-1110. [PMID: 32034063 DOI: 10.4049/jimmunol.1900955] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 12/12/2019] [Indexed: 12/22/2022]
Abstract
Fingolimod is an effective treatment for relapsing-remitting multiple sclerosis. It is well established that fingolimod, a modulator of the sphingosine-1-phosphate pathway, restrains the egress of CCR7+ lymphocytes from lymphatic tissues into the blood, thus resulting in reduced lymphocyte counts in peripheral blood. CXCR5+ T follicular helper (Tfh) cells provide help to B cells, are essential for the generation of potent Ab responses, and have been shown to be critically involved in the pathogenesis of several autoimmune diseases. Besides lymphoid tissue-resident Tfh cells, CXCR5+ circulating Tfh (cTfh) cells have been described in the blood, their numbers correlating with the magnitude of Tfh cells in lymphoid tissues. Although the effect of fingolimod on circulating lymphocyte subsets has been established, its effect on cTfh cells remains poorly understood. In this study, we found that although fingolimod strongly and disproportionally reduced cTfh cell frequencies, frequencies of activated cTfh cells were increased, and the composition of the cTfh cell pool was skewed toward a cTfh1 cell phenotype. The circulating T follicular regulatory cell subset and CXCR5+ CD8+ T cell frequencies were also strongly and disproportionally decreased after fingolimod treatment. In contrast, relative frequencies of CXCR5- memory Th cells as well as regulatory T and B cells were increased. In summary, these data provide new insights into fingolimod-induced compositional changes of lymphocyte populations in the blood, in particular cTfh cells, and thus contribute to a better understanding of the mechanism of action of fingolimod in multiple sclerosis patients.
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Affiliation(s)
- Johanna E Huber
- Institute for Immunology, Biomedical Center, Faculty of Medicine, LMU Munich, Planegg-Martinsried 82152, Germany; and
| | - Yinshui Chang
- Institute for Immunology, Biomedical Center, Faculty of Medicine, LMU Munich, Planegg-Martinsried 82152, Germany; and
| | - Ingrid Meinl
- Institute of Clinical Neuroimmunology, University Hospital and Biomedical Center, LMU Munich, Planegg-Martinsried 82152, Germany
| | - Tania Kümpfel
- Institute of Clinical Neuroimmunology, University Hospital and Biomedical Center, LMU Munich, Planegg-Martinsried 82152, Germany
| | - Edgar Meinl
- Institute of Clinical Neuroimmunology, University Hospital and Biomedical Center, LMU Munich, Planegg-Martinsried 82152, Germany
| | - Dirk Baumjohann
- Institute for Immunology, Biomedical Center, Faculty of Medicine, LMU Munich, Planegg-Martinsried 82152, Germany; and
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17
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Ma Q, Ran H, Li Y, Lu Y, Liu X, Huang H, Yang W, Yu L, Chen P, Huang X, Qiu L, Lin Z, Ou C, Liu W. Circulating Th1/17 cells serve as a biomarker of disease severity and a target for early intervention in AChR-MG patients. Clin Immunol 2020; 218:108492. [DOI: 10.1016/j.clim.2020.108492] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 04/15/2020] [Accepted: 06/03/2020] [Indexed: 02/01/2023]
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18
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Moser T, Akgün K, Proschmann U, Sellner J, Ziemssen T. The role of TH17 cells in multiple sclerosis: Therapeutic implications. Autoimmun Rev 2020; 19:102647. [PMID: 32801039 DOI: 10.1016/j.autrev.2020.102647] [Citation(s) in RCA: 136] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 03/08/2020] [Indexed: 12/13/2022]
Abstract
Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system (CNS) where immunopathology is thought to be mediated by myelin-reactive CD4+ T helper (TH) cells. The TH cells most commonly implicated in the pathogenesis of the disease are of TH1 and TH17 lineage, which are defined by the production of interferon-γ and interleukin-17, respectively. Moreover, there is emerging evidence for the involvement of TH17.1 cells, which share the hallmarks of TH1 and TH17 subsets. In this review, we summarise current knowledge about the potential role of TH17 subsets in the initiation and progression of the disease and put a focus on their response to approved immunomodulatory MS drugs. In this regard, TH17 cells are abundant in peripheral blood, cerebrospinal fluid and brain lesions of MS patients, and their counts and inflammatory mediators are further increased during relapses. Fingolimod and alemtuzumab induce a paramount decrease in central memory T cells, which harbour the majority of peripheral TH17 cells, while the efficacy of natalizumab, dimethyl fumarate and importantly hematopoietic stem cell therapy correlates with TH17.1 cell inhibition. Interestingly, also CD20 antibodies target highly inflammatory TH cells and hamper TH17 differentiation by IL-6 reductions. Moreover, recovery rates of TH cells best correlate with long-term efficacy after therapeutical immunodepletion. We conclude that central memory TH17.1 cells play a pivotal role in MS pathogenesis and they represent a major target of MS therapeutics.
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Affiliation(s)
- Tobias Moser
- Center of Clinical Neuroscience, University Hospital Carl Gustav Carus, Dresden University of Technical, Fetscherstrasse 74, 01307 Dresden, Germany; Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Ignaz-Harrer-Straße 79, 5020 Salzburg, Austria
| | - Katja Akgün
- Center of Clinical Neuroscience, University Hospital Carl Gustav Carus, Dresden University of Technical, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Undine Proschmann
- Center of Clinical Neuroscience, University Hospital Carl Gustav Carus, Dresden University of Technical, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Johann Sellner
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Ignaz-Harrer-Straße 79, 5020 Salzburg, Austria; Department of Neurology, Landesklinikum Mistelbach-Gänserndorf, Liechtensteinstrasse 67, 3120 Mistelbach, Austria; Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Strasse 22, 81675 München, Germany
| | - Tjalf Ziemssen
- Center of Clinical Neuroscience, University Hospital Carl Gustav Carus, Dresden University of Technical, Fetscherstrasse 74, 01307 Dresden, Germany.
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19
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Differential Effects of MS Therapeutics on B Cells-Implications for Their Use and Failure in AQP4-Positive NMOSD Patients. Int J Mol Sci 2020; 21:ijms21145021. [PMID: 32708663 PMCID: PMC7404039 DOI: 10.3390/ijms21145021] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/11/2020] [Accepted: 07/13/2020] [Indexed: 12/25/2022] Open
Abstract
B cells are considered major contributors to multiple sclerosis (MS) pathophysiology. While lately approved disease-modifying drugs like ocrelizumab deplete B cells directly, most MS medications were not primarily designed to target B cells. Here, we review the current understanding how approved MS medications affect peripheral B lymphocytes in humans. These highly contrasting effects are of substantial importance when considering these drugs as therapy for neuromyelitis optica spectrum disorders (NMOSD), a frequent differential diagnosis to MS, which is considered being a primarily B cell- and antibody-driven diseases. Data indicates that MS medications, which deplete B cells or induce an anti-inflammatory phenotype of the remaining ones, were effective and safe in aquaporin-4 antibody positive NMOSD. In contrast, drugs such as natalizumab and interferon-β, which lead to activation and accumulation of B cells in the peripheral blood, lack efficacy or even induce catastrophic disease activity in NMOSD. Hence, we conclude that the differential effect of MS drugs on B cells is one potential parameter determining the therapeutic efficacy or failure in antibody-dependent diseases like seropositive NMOSD.
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20
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Imbalance in B cell and T Follicular Helper Cell Subsets in Pulmonary Sarcoidosis. Sci Rep 2020; 10:1059. [PMID: 31974463 PMCID: PMC6978348 DOI: 10.1038/s41598-020-57741-0] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 01/07/2020] [Indexed: 12/12/2022] Open
Abstract
Sarcoidosis is a systemic granulomatous disease that develops due to the Th1, Th17 and Treg lymphocytes disturbance. There is an assumption, that B cells and follicular T-helper (Tfh) cells may play an important role in this disorder, as well as in several other autoimmune diseases. The aim of this study was to determine CD19+ B cells subset distribution in the peripheral blood and to define disturbance in the circulating Tfh cells subsets in patients with sarcoidosis. The prospective comparative study was performed in 2016-2018, where peripheral blood B cell subsets and circulating Tfh cell subsets were analyzed in 37 patients with primarily diagnosed sarcoidosis and 35 healthy donors using multicolor flow cytometry. In the results of our study we found the altered distribution of peripheral B cell subsets with a predominance of "naïve" (IgD + CD27-) and activated B cell (Bm2 and Bm2') subsets and a decreased frequency of memory cell (IgD+ CD27+ and IgD- CD27+) in peripheral blood of sarcoidosis patients was demonstrated. Moreover, we found that in sarcoidosis patients there are increased levels of B cell subsets, which were previously shown to display regulatory capacities (CD24+++ CD38+++ and CD5 + CD27-). Next, a significantly higher proportion of CXCR5-expressing CD45RA - CCR7+ Th cells in patients with sarcoidosis in comparison to the healthy controls was revealed, that represents the expansion of this memory Th cell subset in the disease. This is the first study to demonstrate the association between the development of sarcoidosis and imbalance of circulating Tfh cells, especially CCR4- and CXCR3-expressing Tfh subsets. Finally, based on our data we can assume that B cells and Tfh2- and Tfh17-like cells - most effective cell type in supporting B-cell activity, particularly in antibody production - may be involved in the occurrence and development of sarcoidosis and in several other autoimmune conditions. Therefore, we can consider these results as a new evidence of the autoimmune mechanisms in the sarcoidosis development.
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21
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Choileáin SN, Kleinewietfeld M, Raddassi K, Hafler DA, Ruff WE, Longbrake EE. CXCR3+ T cells in multiple sclerosis correlate with reduced diversity of the gut microbiome. J Transl Autoimmun 2019; 3:100032. [PMID: 32743517 PMCID: PMC7388357 DOI: 10.1016/j.jtauto.2019.100032] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 12/11/2019] [Accepted: 12/13/2019] [Indexed: 12/25/2022] Open
Abstract
Multiple sclerosis (MS) is a genetically mediated autoimmune disease characterized by inflammation in the central nervous system (CNS). Disease onset is thought to occur when autoreactive T cells orchestrate a cascade of events in the CNS resulting in white and grey matter inflammation and axonal degeneration. It is unclear what triggers the activation of CNS-reactive T cells and their polarization into inflammatory subsets. Mounting evidence from animal and human studies supports the hypothesis that the gut microbiome affects MS pathogenesis. We investigated the association between the gut microbiome and inflammatory T cell subsets in relapsing-remitting MS patients and healthy controls. Gut microbiome composition was characterized by sequencing the V4 region of the 16S rRNA gene from fecal DNA, and inflammatory T cell subsets were characterized by flow cytometry. We identified an altered gut microbiome in MS patients, including decreased abundance of Coprococcus, Clostridium, and an unidentified Ruminococcaceae genus. Among circulating immune cells, patients had increased expression of CXCR3 in both CD4 and CD8 T cells, and both CD4+CXCR3+ and CD8+CXCR3+ populations expressing the gut-homing α4β7 integrin receptor were increased. Finally, we show that alpha diversity inversely correlated with a CXCR3+ Th1 phenotype in MS. These findings indicate the presence of an aberrant gut-immune axis in patients with MS.
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Affiliation(s)
- Siobhán Ní Choileáin
- Department of Neurology, Yale University School of Medicine, New Haven, CT, 06511, USA
| | - Markus Kleinewietfeld
- Department of Neurology, Yale University School of Medicine, New Haven, CT, 06511, USA
- VIB Laboratory of Translational Immunomodulation, VIB Center for Inflammation Research (IRC), UHasselt, Campus Diepenbeek, Hasselt, Belgium
| | - Khadir Raddassi
- Department of Neurology, Yale University School of Medicine, New Haven, CT, 06511, USA
| | - David A. Hafler
- Department of Neurology, Yale University School of Medicine, New Haven, CT, 06511, USA
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, 06511, USA
| | - William E. Ruff
- Department of Neurology, Yale University School of Medicine, New Haven, CT, 06511, USA
| | - Erin E. Longbrake
- Department of Neurology, Yale University School of Medicine, New Haven, CT, 06511, USA
- Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, Yale University, New Haven, CT, USA
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22
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Shao F, Zheng P, Yu D, Zhou Z, Jia L. Follicular helper T cells in type 1 diabetes. FASEB J 2019; 34:30-40. [PMID: 31914661 DOI: 10.1096/fj.201901637r] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 11/09/2019] [Accepted: 11/25/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Feng Shao
- Department of Metabolism & Endocrinology The Second Xiangya HospitalCentral South University Changsha China
- Key Laboratory of Diabetes Immunology Central South University, Ministry of Education, National Clinical Research Center for Metabolic Diseases Changsha China
| | - Peilin Zheng
- Department of Endocrinology, Shenzhen People’s Hospital The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology Shenzhen China
| | - Di Yu
- The University of Queensland Diamantina Institute, Translational Research Institute Brisbane Queensland Australia
- Shandong Analysis and Test Center Shandong Academy of Sciences Jinan China
- China‐Australia Centre for Personalised Immunology Shanghai Renji Hospital Shanghai Jiaotong University School of Medicine Shanghai China
| | - Zhiguang Zhou
- Department of Metabolism & Endocrinology The Second Xiangya HospitalCentral South University Changsha China
- Key Laboratory of Diabetes Immunology Central South University, Ministry of Education, National Clinical Research Center for Metabolic Diseases Changsha China
| | - Lijing Jia
- Department of Endocrinology, Shenzhen People’s Hospital The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology Shenzhen China
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23
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Seth A, Craft J. Spatial and functional heterogeneity of follicular helper T cells in autoimmunity. Curr Opin Immunol 2019; 61:1-9. [PMID: 31374450 DOI: 10.1016/j.coi.2019.06.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 06/21/2019] [Accepted: 06/25/2019] [Indexed: 12/16/2022]
Abstract
Follicular helper T cells provide signals that promote B cell development, proliferation, and production of affinity matured and appropriately isotype switched antibodies. In addition to their classical locations within B cell follicles and germinal centers therein, B cell helper T cells are also found in extrafollicular spaces - either in secondary lymphoid or non-lymphoid tissues. Both follicular and extrafollicular T helper cells drive autoantibody-mediated autoimmunity. Interfering with B cell help provided by T cells can ameliorate autoimmune disease in animal models and human patients. The next frontier in Tfh cell biology will be identification of Tfh cell-specific pathogenic changes in autoimmunity and exploiting them for therapeutic purposes.
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Affiliation(s)
- Abhinav Seth
- Department of Internal Medicine, Section of Rheumatology, New Haven, CT, United States
| | - Joe Craft
- Department of Internal Medicine, Section of Rheumatology, New Haven, CT, United States; Department of Immunobiology, Yale University School of Medicine, New Haven, CT, United States.
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24
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Rommer PS, Milo R, Han MH, Satyanarayan S, Sellner J, Hauer L, Illes Z, Warnke C, Laurent S, Weber MS, Zhang Y, Stuve O. Immunological Aspects of Approved MS Therapeutics. Front Immunol 2019; 10:1564. [PMID: 31354720 PMCID: PMC6637731 DOI: 10.3389/fimmu.2019.01564] [Citation(s) in RCA: 104] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Accepted: 06/24/2019] [Indexed: 12/21/2022] Open
Abstract
Multiple sclerosis (MS) is the most common neurological immune-mediated disease leading to disability in young adults. The outcome of the disease is unpredictable, and over time, neurological disabilities accumulate. Interferon beta-1b was the first drug to be approved in the 1990s for relapsing-remitting MS to modulate the course of the disease. Over the past two decades, the treatment landscape has changed tremendously. Currently, more than a dozen drugs representing 1 substances with different mechanisms of action have been approved (interferon beta preparations, glatiramer acetate, fingolimod, siponimod, mitoxantrone, teriflunomide, dimethyl fumarate, cladribine, alemtuzumab, ocrelizumab, and natalizumab). Ocrelizumab was the first medication to be approved for primary progressive MS. The objective of this review is to present the modes of action of these drugs and their effects on the immunopathogenesis of MS. Each agent's clinical development and potential side effects are discussed.
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Affiliation(s)
- Paulus S. Rommer
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Ron Milo
- Department of Neurology, Barzilai University Medical Center, Ashkelon, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - May H. Han
- Neuroimmunology Division, Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, United States
| | - Sammita Satyanarayan
- Neuroimmunology Division, Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, United States
| | - Johann Sellner
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria
- Department of Neurology, Klinikum Rechts der Isar, Technische Universität, Munich, Germany
| | - Larissa Hauer
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria
| | - Zsolt Illes
- Department of Neurology, Odense University Hospital, Odense, Denmark
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Clemens Warnke
- Department of Neurology, Medical Faculty, University of Köln, Cologne, Germany
| | - Sarah Laurent
- Department of Neurology, Medical Faculty, University of Köln, Cologne, Germany
| | - Martin S. Weber
- Institute of Neuropathology, University Medical Center, Göttingen, Germany
- Department of Neurology, University Medical Center, Göttingen, Germany
| | - Yinan Zhang
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Olaf Stuve
- Department of Neurology, Klinikum Rechts der Isar, Technische Universität, Munich, Germany
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, United States
- Neurology Section, VA North Texas Health Care System, Medical Service Dallas, VA Medical Center, Dallas, TX, United States
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25
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Perfluorinated substances, risk factors for multiple sclerosis and cellular immune activation. J Neuroimmunol 2019; 330:90-95. [PMID: 30852181 DOI: 10.1016/j.jneuroim.2019.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 02/28/2019] [Accepted: 03/01/2019] [Indexed: 01/05/2023]
Abstract
Perfluorinated alkylated substances (PFASs) have immunomodulatory effects but the impact on multiple sclerosis (MS) and cellular immune functions is only sparsely described. In the present study, we found lower concentrations of the long chain PFAS perfluorooctane sulfonic acid (PFOS) in MS than in healthy controls (HC). In HC, we did not detect associations between PFOS concentrations and immune phenotypes. Analyzing the impact of known MS risk factors on cellular immune functions, we found that smoking and Epstein-Barr nuclear antigen 1 antibodies were associated with distinct circulating immune cell changes. In summary, current background PFAS exposure is not an important risk factor for MS.
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26
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Verhagen FH, Hiddingh S, Rijken R, Pandit A, Leijten E, Olde Nordkamp M, Ten Dam-van Loon NH, Nierkens S, Imhof SM, de Boer JH, Radstake TRDJ, Kuiper JJW. High-Dimensional Profiling Reveals Heterogeneity of the Th17 Subset and Its Association With Systemic Immunomodulatory Treatment in Non-infectious Uveitis. Front Immunol 2018; 9:2519. [PMID: 30429855 PMCID: PMC6220365 DOI: 10.3389/fimmu.2018.02519] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 10/12/2018] [Indexed: 12/19/2022] Open
Abstract
Background: Non-infectious uveitis (NIU) is a severe intra ocular inflammation, which frequently requires prompt systemic immunosuppressive therapy (IMT) to halt the development of vision-threatening complications. IMT is considered when NIU cannot be treated with corticosteroids alone, which is unpredictable in advance. Previous studies have linked blood cell subsets to glucocorticoid sensitivity, which suggests that the composition of blood leukocytes may early identify patients that will require IMT. Objective: To map the blood leukocyte composition of NIU and identify cell subsets that stratify patients that required IMT during follow-up. Methods: We performed controlled flow cytometry experiments measuring a total of 37 protein markers in the blood of 30 IMT free patients with active non-infectious anterior, intermediate, and posterior uveitis, and compared these to 15 age and sex matched healthy controls. Results from manual gating were validated by automatic unsupervised gating using FlowSOM. Results: Patients with uveitis displayed lower relative frequencies of Natural Killer cells and higher relative frequencies of memory T cells, in particular the CCR6+ lineages. These results were confirmed by automatic gating by unsupervised clustering using FlowSOM. We observed considerable heterogeneity in memory T cell subsets and abundance of CXCR3-CCR6+ (Th17) cells between the uveitis subtypes. Importantly, regardless of the uveitis subtype, patients that eventually required IMT in the course of the study follow-up exhibited increased CCR6+ T cell abundance before commencing therapy. Conclusion: High-dimensional immunoprofiling in NIU patients shows that clinically distinct forms of human NIU exhibit shared as well as unique immune cell perturbations in the peripheral blood and link CCR6+ T cell abundance to systemic immunomodulatory treatment.
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Affiliation(s)
- Fleurieke H Verhagen
- Ophthalmo-Immunology Unit, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.,Department of Ophthalmology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.,Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Sanne Hiddingh
- Ophthalmo-Immunology Unit, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.,Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Rianne Rijken
- Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Aridaman Pandit
- Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.,Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Emmerik Leijten
- Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.,Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Michel Olde Nordkamp
- Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Ninette H Ten Dam-van Loon
- Department of Ophthalmology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Stefan Nierkens
- Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Saskia M Imhof
- Department of Ophthalmology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Joke H de Boer
- Ophthalmo-Immunology Unit, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.,Department of Ophthalmology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Timothy R D J Radstake
- Ophthalmo-Immunology Unit, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.,Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.,Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Jonas J W Kuiper
- Ophthalmo-Immunology Unit, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.,Department of Ophthalmology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.,Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
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27
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Quinn JL, Axtell RC. Emerging Role of Follicular T Helper Cells in Multiple Sclerosis and Experimental Autoimmune Encephalomyelitis. Int J Mol Sci 2018; 19:ijms19103233. [PMID: 30347676 PMCID: PMC6214126 DOI: 10.3390/ijms19103233] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 10/18/2018] [Accepted: 10/18/2018] [Indexed: 12/21/2022] Open
Abstract
Multiple sclerosis (MS) is an autoimmune disorder where both T cells and B cells are implicated in pathology. However, it remains unclear how these two distinct populations cooperate to drive disease. There is ample evidence from studies in both MS patients and mouse models that Th17, B cells, and follicular T helper (TFH) cells contribute to disease. This review article describes the literature that identifies mechanisms by which Th17, TFH, and B cells cooperatively drive disease activity in MS and experimental autoimmune encephalomyelitis (EAE). The curation of this literature has identified that central nervous system (CNS) infiltrating TFH cells act with TH17 cell to contribute to an inflammatory B cell response in neuroinflammation. This demonstrates that TFH cells and their products are promising targets for therapies in MS.
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Affiliation(s)
- James L Quinn
- Department of Microbiology and Immunology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA.
- Arthritis and Clinical Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA.
| | - Robert C Axtell
- Arthritis and Clinical Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA.
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