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van den Bosch A, Fransen N, Mason M, Rozemuller AJ, Teunissen C, Smolders J, Huitinga I. Neurofilament Light Chain Levels in Multiple Sclerosis Correlate With Lesions Containing Foamy Macrophages and With Acute Axonal Damage. Neurol Neuroimmunol Neuroinflamm 2022; 9:9/3/e1154. [PMID: 35241571 PMCID: PMC8893592 DOI: 10.1212/nxi.0000000000001154] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/03/2022] [Indexed: 12/18/2022]
Abstract
Background and Objectives To investigate whether white matter lesion activity, acute axonal damage, and axonal density in MS associate with CSF neurofilament light chain (NfL) levels. Methods Of 101 brain donors with MS (n = 92 progressive MS, n = 9 relapsing-remitting MS), ventricular CSF was collected, and NfL levels were measured. White matter lesions were classified as active, mixed, inactive, or remyelinated, and microglia/macrophage morphology in active and mixed lesions was classified as ramified, ameboid, or foamy. In addition, axonal density and acute axonal damage were assessed using Bielschowsky and amyloid precursor protein (APP) (immune)histochemistry. Results CSF NfL measurements of donors with recent (<1 year) or clinically silent stroke were excluded. CSF NfL levels correlated negatively with disease duration (p = 6.9e-3, r = 0.31). In donors without atrophy, CSF NfL levels correlated positively with the proportion of active and mixed lesions containing foamy microglia/macrophages (p = 9.85e-10 and p = 1.75e-3, respectively), but not with those containing ramified microglia. CSF NfL correlated negatively with proportions of inactive (p = 5.66e-3) and remyelinated lesions (p = 0.03). In the normal appearing pyramid tract, axonal density negatively correlated with CSF NfL levels (Bielschowsky, p = 0.02, r = −0.31), and the presence of acute axonal damage in lesions was related to higher NfL levels (APP, p = 1.17e-6). The amount of acute axonal damage was higher in active lesions with foamy microglia/macrophages and in the rim of mixed lesions with foamy microglia/macrophages when compared with active lesions containing ramified microglia/macrophages (p = 4.6e-3 and p = 0.02, respectively), the center and border of mixed lesions containing ramified microglia/macrophages (center: p = 4.6e-3, border, p = 4.6e-3, and n.s., p = 4.6e-3, respectively), the center of mixed lesions containing foamy microglia/macrophages (p = 4.6e-3 and p = 0.02, respectively), inactive lesions (p = 4.6e-3 and p = 4.6e-3, respectively), and remyelinated lesions (p = 0.03 and p = 0.04, respectively). Discussion Our results demonstrated that active and mixed white matter MS lesions with foamy microglia show high acute axonal damage and correlate with elevated CSF NfL levels. Our data support the use of this biomarker to monitor inflammatory demyelinating lesion activity with axonal damage in MS.
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Affiliation(s)
- Aletta van den Bosch
- From the Neuroimmunology Research Group (A.B., N.F., M.M., J.S., I.H.), Netherlands Institute for Neuroscience; Department Pathology (A.J.R.), Amsterdam UMC; Neurochemistry Lab (C.T.), Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit; Department of Neurology and Immunology (J.S.), MS Center ErasMS, ErasmusMC, Rotterdam; and Swammerdam Institute for Life Sciences (I.H.), University of Amsterdam, the Netherlands.
| | - Nina Fransen
- From the Neuroimmunology Research Group (A.B., N.F., M.M., J.S., I.H.), Netherlands Institute for Neuroscience; Department Pathology (A.J.R.), Amsterdam UMC; Neurochemistry Lab (C.T.), Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit; Department of Neurology and Immunology (J.S.), MS Center ErasMS, ErasmusMC, Rotterdam; and Swammerdam Institute for Life Sciences (I.H.), University of Amsterdam, the Netherlands
| | - Matthew Mason
- From the Neuroimmunology Research Group (A.B., N.F., M.M., J.S., I.H.), Netherlands Institute for Neuroscience; Department Pathology (A.J.R.), Amsterdam UMC; Neurochemistry Lab (C.T.), Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit; Department of Neurology and Immunology (J.S.), MS Center ErasMS, ErasmusMC, Rotterdam; and Swammerdam Institute for Life Sciences (I.H.), University of Amsterdam, the Netherlands
| | - Annemieke Johanna Rozemuller
- From the Neuroimmunology Research Group (A.B., N.F., M.M., J.S., I.H.), Netherlands Institute for Neuroscience; Department Pathology (A.J.R.), Amsterdam UMC; Neurochemistry Lab (C.T.), Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit; Department of Neurology and Immunology (J.S.), MS Center ErasMS, ErasmusMC, Rotterdam; and Swammerdam Institute for Life Sciences (I.H.), University of Amsterdam, the Netherlands
| | - Charlotte Teunissen
- From the Neuroimmunology Research Group (A.B., N.F., M.M., J.S., I.H.), Netherlands Institute for Neuroscience; Department Pathology (A.J.R.), Amsterdam UMC; Neurochemistry Lab (C.T.), Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit; Department of Neurology and Immunology (J.S.), MS Center ErasMS, ErasmusMC, Rotterdam; and Swammerdam Institute for Life Sciences (I.H.), University of Amsterdam, the Netherlands
| | - Joost Smolders
- From the Neuroimmunology Research Group (A.B., N.F., M.M., J.S., I.H.), Netherlands Institute for Neuroscience; Department Pathology (A.J.R.), Amsterdam UMC; Neurochemistry Lab (C.T.), Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit; Department of Neurology and Immunology (J.S.), MS Center ErasMS, ErasmusMC, Rotterdam; and Swammerdam Institute for Life Sciences (I.H.), University of Amsterdam, the Netherlands
| | - Inge Huitinga
- From the Neuroimmunology Research Group (A.B., N.F., M.M., J.S., I.H.), Netherlands Institute for Neuroscience; Department Pathology (A.J.R.), Amsterdam UMC; Neurochemistry Lab (C.T.), Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit; Department of Neurology and Immunology (J.S.), MS Center ErasMS, ErasmusMC, Rotterdam; and Swammerdam Institute for Life Sciences (I.H.), University of Amsterdam, the Netherlands
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Peruzzotti-Jametti L, Bernstock JD, Willis CM, Manferrari G, Rogall R, Fernandez-Vizarra E, Williamson JC, Braga A, van den Bosch A, Leonardi T, Krzak G, Kittel Á, Benincá C, Vicario N, Tan S, Bastos C, Bicci I, Iraci N, Smith JA, Peacock B, Muller KH, Lehner PJ, Buzas EI, Faria N, Zeviani M, Frezza C, Brisson A, Matheson NJ, Viscomi C, Pluchino S. Neural stem cells traffic functional mitochondria via extracellular vesicles. PLoS Biol 2021; 19:e3001166. [PMID: 33826607 PMCID: PMC8055036 DOI: 10.1371/journal.pbio.3001166] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 04/19/2021] [Accepted: 03/02/2021] [Indexed: 12/20/2022] Open
Abstract
Neural stem cell (NSC) transplantation induces recovery in animal models of central nervous system (CNS) diseases. Although the replacement of lost endogenous cells was originally proposed as the primary healing mechanism of NSC grafts, it is now clear that transplanted NSCs operate via multiple mechanisms, including the horizontal exchange of therapeutic cargoes to host cells via extracellular vesicles (EVs). EVs are membrane particles trafficking nucleic acids, proteins, metabolites and metabolic enzymes, lipids, and entire organelles. However, the function and the contribution of these cargoes to the broad therapeutic effects of NSCs are yet to be fully understood. Mitochondrial dysfunction is an established feature of several inflammatory and degenerative CNS disorders, most of which are potentially treatable with exogenous stem cell therapeutics. Herein, we investigated the hypothesis that NSCs release and traffic functional mitochondria via EVs to restore mitochondrial function in target cells. Untargeted proteomics revealed a significant enrichment of mitochondrial proteins spontaneously released by NSCs in EVs. Morphological and functional analyses confirmed the presence of ultrastructurally intact mitochondria within EVs with conserved membrane potential and respiration. We found that the transfer of these mitochondria from EVs to mtDNA-deficient L929 Rho0 cells rescued mitochondrial function and increased Rho0 cell survival. Furthermore, the incorporation of mitochondria from EVs into inflammatory mononuclear phagocytes restored normal mitochondrial dynamics and cellular metabolism and reduced the expression of pro-inflammatory markers in target cells. When transplanted in an animal model of multiple sclerosis, exogenous NSCs actively transferred mitochondria to mononuclear phagocytes and induced a significant amelioration of clinical deficits. Our data provide the first evidence that NSCs deliver functional mitochondria to target cells via EVs, paving the way for the development of novel (a)cellular approaches aimed at restoring mitochondrial dysfunction not only in multiple sclerosis, but also in degenerative neurological diseases.
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Affiliation(s)
- Luca Peruzzotti-Jametti
- Department of Clinical Neurosciences and NIHR Biomedical Research Centre, University of Cambridge, United Kingdom
| | - Joshua D. Bernstock
- Department of Clinical Neurosciences and NIHR Biomedical Research Centre, University of Cambridge, United Kingdom
- National Institutes of Health (NINDS/NIH), Bethesda, Maryland, United States of America
| | - Cory M. Willis
- Department of Clinical Neurosciences and NIHR Biomedical Research Centre, University of Cambridge, United Kingdom
| | - Giulia Manferrari
- Department of Clinical Neurosciences and NIHR Biomedical Research Centre, University of Cambridge, United Kingdom
| | - Rebecca Rogall
- Department of Clinical Neurosciences and NIHR Biomedical Research Centre, University of Cambridge, United Kingdom
| | | | - James C. Williamson
- Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID), University of Cambridge, Cambridge, United Kingdom
- NHS Blood and Transplant, Cambridge, United Kingdom
| | - Alice Braga
- Department of Clinical Neurosciences and NIHR Biomedical Research Centre, University of Cambridge, United Kingdom
| | - Aletta van den Bosch
- Department of Clinical Neurosciences and NIHR Biomedical Research Centre, University of Cambridge, United Kingdom
| | - Tommaso Leonardi
- Department of Clinical Neurosciences and NIHR Biomedical Research Centre, University of Cambridge, United Kingdom
- Center for Genomic Science of IIT@SEMM, Istituto Italiano di Tecnologia (IIT), Milan, Italy
| | - Grzegorz Krzak
- Department of Clinical Neurosciences and NIHR Biomedical Research Centre, University of Cambridge, United Kingdom
| | - Ágnes Kittel
- Institute of Experimental Medicine, Eötvös Lorand Research Network, Budapest, Hungary
| | - Cristiane Benincá
- MRC Mitochondrial Biology Unit, University of Cambridge, United Kingdom
| | - Nunzio Vicario
- Department of Clinical Neurosciences and NIHR Biomedical Research Centre, University of Cambridge, United Kingdom
- Department of Biomedical and Biotechnological Sciences (BIOMETEC), University of Catania, Italy
| | | | - Carlos Bastos
- Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Iacopo Bicci
- Department of Clinical Neurosciences and NIHR Biomedical Research Centre, University of Cambridge, United Kingdom
| | - Nunzio Iraci
- Department of Clinical Neurosciences and NIHR Biomedical Research Centre, University of Cambridge, United Kingdom
- Department of Biomedical and Biotechnological Sciences (BIOMETEC), University of Catania, Italy
| | - Jayden A. Smith
- Cambridge Innovation Technologies Consulting (CITC) Limited, United Kingdom
| | - Ben Peacock
- NanoFCM Co., Ltd, Nottingham, United Kingdom
| | | | - Paul J. Lehner
- Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID), University of Cambridge, Cambridge, United Kingdom
- NHS Blood and Transplant, Cambridge, United Kingdom
| | - Edit Iren Buzas
- Semmelweis University, Budapest, Hungary
- HCEMM Kft HU, Budapest, Hungary
- ELKH-SE, Budapest, Hungary
| | - Nuno Faria
- Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Massimo Zeviani
- MRC Mitochondrial Biology Unit, University of Cambridge, United Kingdom
| | - Christian Frezza
- MRC Cancer Unit, Hutchison/MRC Research Centre, University of Cambridge, Cambridge United Kingdom
| | | | - Nicholas J. Matheson
- Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID), University of Cambridge, Cambridge, United Kingdom
- NHS Blood and Transplant, Cambridge, United Kingdom
- Department of Medicine, University of Cambridge, United Kingdom
| | - Carlo Viscomi
- MRC Mitochondrial Biology Unit, University of Cambridge, United Kingdom
| | - Stefano Pluchino
- Department of Clinical Neurosciences and NIHR Biomedical Research Centre, University of Cambridge, United Kingdom
- Cambridge Innovation Technologies Consulting (CITC) Limited, United Kingdom
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