Increased frequency of CD4+CD25high CD127low/ - regulatory T cells in patients with multiple sclerosis

Regulatory T Cells in Multiple Sclerosis Diagnostics-What Do We Know So Far?

BACKGROUND

Multiple sclerosis (MS) is an autoimmune disorder that affects the central nervous system (CNS) through inflammation. MS symptoms become acute if the disease progresses to the relapsing phase.

AIM

This review aimed to evaluate the role played by regulatory T cells (Tregs) in the pathogenesis of MS.

METHODS

This review used scholarly journal articles obtained from PubMed, PsycINFO, and CINAHL with different search parameters such as 'regulatory T cells', 'multiple sclerosis', and 'current knowledge'. The process of searching for articles was limited to those that had publication dates falling between 2010 and 2020.

RESULTS

Tregs play a role in the pathogenesis of MS. This conclusion is supported by animal disease models and environmental factors that can underlie Treg alterations in MS. Despite the knowledge of the role played by Tregs in MS pathogenesis, the specific subsets of Tregs involved in MS development remain incompletely understood.

DISCUSSION

This review provides an essential link between Tregs and MS activity. Targeting Tregs could be an efficient way to establish new treatment methods for MS management.

CONCLUSION

MS is a complex condition affecting many people worldwide. Research has shown that Tregs can influence MS development and progression. More investigations are needed to understand how Tregs affect the pathogenesis of MS.

Autoreactive lymphocytes in multiple sclerosis: Pathogenesis and treatment target

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS) characterized by destruction of the myelin sheath structure. The loss of myelin leads to damage of a neuron’s axon and cell body, which is identified as brain lesions on magnetic resonance image (MRI). The pathogenesis of MS remains largely unknown. However, immune mechanisms, especially those linked to the aberrant lymphocyte activity, are mainly responsible for neuronal damage. Th1 and Th17 populations of lymphocytes were primarily associated with MS pathogenesis. These lymphocytes are essential for differentiation of encephalitogenic CD8⁺ T cell and Th17 lymphocyte crossing the blood brain barrier and targeting myelin sheath in the CNS. B-lymphocytes could also contribute to MS pathogenesis by producing anti-myelin basic protein antibodies. In later studies, aberrant function of Treg and Th9 cells was identified as contributing to MS. This review summarizes the aberrant function and count of lymphocyte, and the contributions of these cell to the mechanisms of MS. Additionally, we have outlined the novel MS therapeutics aimed to amend the aberrant function or counts of these lymphocytes.

Mechanistic and Biomarker Studies to Demonstrate Immune Tolerance in Multiple Sclerosis

The induction of specific immunological tolerance represents an important therapeutic goal for multiple sclerosis and other autoimmune diseases. Sound knowledge of the target antigens, the underlying pathomechanisms of the disease and the presumed mechanisms of action of the respective tolerance-inducing approach are essential for successful translation. Furthermore, suitable tools and assays to evaluate the induction of immune tolerance are key aspects for the development of such treatments. However, investigation of the mechanisms of action underlying tolerance induction poses several challenges. The optimization of sensitive, robust methods which allow the assessment of low frequency autoreactive T cells and the long-term reduction or change of their responses, the detection of regulatory cell populations and their immune mediators, as well as the validation of specific biomarkers indicating reduction of inflammation and damage, are needed to develop tolerance-inducing approaches successfully to patients. This short review focuses on how to demonstrate mechanistic proof-of-concept in antigen-specific tolerance-inducing therapies in MS.

Multiple sclerosis patients have reduced resting and increased activated CD4+CD25+FOXP3+T regulatory cells

Resting and activated subpopulations of CD4⁺CD25⁺CD127^loT regulatory cells (Treg) and CD4⁺CD25⁺CD127⁺ effector T cells in MS patients and in healthy individuals were compared. Peripheral blood mononuclear cells isolated using Ficoll Hypaque were stained with monoclonal antibodies and analysed by flow cytometer. CD45RA and Foxp3 expression within CD4⁺ cells and in CD4⁺CD25⁺CD127^loT cells identified Population I; CD45RA⁺Foxp3⁺, Population II; CD45RA⁻Foxp3^hi and Population III; CD45RA⁻Foxp3⁺ cells. Effector CD4⁺CD127⁺ T cells were subdivided into Population IV; memory /effector CD45RA⁻ CD25⁻Foxp3⁻ and Population V; effector naïve CD45RA⁺CD25⁻Foxp3⁻CCR7⁺ and terminally differentiated RA⁺ (TEMRA) effector memory cells. Chemokine receptor staining identified CXCR3⁺Th1-like Treg, CCR6⁺Th17-like Treg and CCR7⁺ resting Treg. Resting Treg (Population I) were reduced in MS patients, both in untreated and treated MS compared to healthy donors. Activated/memory Treg (Population II) were significantly increased in MS patients compared to healthy donors. Activated effector CD4⁺ (Population IV) were increased and the naïve/ TEMRA CD4⁺ (Population V) were decreased in MS compared to HD. Expression of CCR7 was mainly in Population I, whereas expression of CCR6 and CXCR3 was greatest in Populations II and intermediate in Population III. In MS, CCR6⁺Treg were lower in Population III. This study found MS is associated with significant shifts in CD4⁺T cells subpopulations. MS patients had lower resting CD4⁺CD25⁺CD45RA⁺CCR7⁺ Treg than healthy donors while activated CD4⁺CD25^hiCD45RA⁻Foxp3^hiTreg were increased in MS patients even before treatment. Some MS patients had reduced CCR6⁺Th17-like Treg, which may contribute to the activity of MS.