Serological reactions against glycolipid-sensitised liposomes in multiple sclerosis

Characterization of novel glycolipid antigens with an α-galactose epitope in lactobacilli detected with rabbit anti-Lactobacillus antisera and occurrence of antibodies against them in human sera

Anti-Lactobacillus johnsonii (LJ) antisera generated by immunization of rabbits with LJ reacted with glyceroglycolipids in LJ, i.e. dihexaosyl diacylglycerol (DH-DG), trihexaosyl DG (TH-DG) and tetrahexaosyl DG (TetH-DG), whose reactivities with antisera increased proportionally with longer carbohydrate chains of glycolipids. Structural analyses of glycolipids from LJ revealed that DH-DG was Galα1-2Glcα1-3'DG, and TH-DG and TetH-DG were novel derivatives of it with α-Gal at the non-reducing terminal, i.e. Galα1-6Galα1-2Glcα1-3'DG and Galα1-6Galα1-6Galα1-2Glcα1-3'DG, respectively. DH-DG was commonly present in several lactobacilli examined, but TetH-DG was restricted to LJ, L. intestinalis and L. reuteri, while the TH-DGs from L. casei were Glc1-6Galα1-2Glcα1-3'DG and an esterified derivative of it, Glc1-6Galα1-2Glc(6-fatty acid)α1-3'DG, as reported in the literature. Anti-LJ antisera reacted with TH-DG and esterified TH-DG from L. casei to lesser extents, but not at all with gentibiosyl DG from Staphylococcus epidermidis or kojibiosyl DG from Streptococcus salivalis or sphingoglycolipids containing α-Gal residues. The major molecular species of glycolipids obtained from lactobacilli were 11-octadecenoic and 11,12-methylene-octadecanoic acids-containing ones. Also, human IgM antibodies against TH-DG and TetH-DG from LJ were detected in human sera, with various antibody titres, indicating that an immune reaction to symbiotic lactobacilli occurs against their glycolipid antigens, TH-DG and TetH-DG.

Excretion into feces of asialo GM1 in the murine digestive tract and Lactobacillus johnsonii exhibiting binding ability toward asialo GM1. A possible role of epithelial glycolipids in the discharge of intestinal bacteria

In the digestive tract of mice (HR-1, 5 months old, ♀), asialo GM1 (GA1) exhibiting receptor activity toward several intestinal bacteria was preferentially expressed in the small intestine. Also, less than 10% of GA1 in the small intestine was converted into fucosylated and sulfated derivatives, but it was completely converted to fucosyl GA1 (FGA1) in the stomach, cecum and colon. Among the lipid components in these tissues, glycolipids other than Forssman antigen and cholesterol sulfate (CS) were present in the digestive tract contents. However, sulfated GA1, sulfatide and fucosyl GM1 in the gastro-intestinal contents were not present in the cecal and colonic contents, in which the major glycolipids were ceramide monohexoside (CMH), GA1 and FGA1. The total amount of GA1 in the whole contents was 20% of that in the tissues. Thus, glycolipids were stable during the process of digestion, and excreted from the body together with cholesterol and CS. On the other hand, Lactobacillus johnsonii (LJ), whose receptor is GA1, was detected in the cecal and colonic contents on sequential analysis of 16S-ribosomal RNA and TLC-immunostaining of antigenic glycolipids with anti-LJ antiserum. LJ was found to comprise 20% of the total bacteria cultured in the lactobacillus medium under aerobic conditions, and to be present in the cecal and colonic contents, 9.8 × 10(7) cells versus 37 μg GA1 and 1.4 × 10(8) cells versus 49 μg GA1, respectively. Thus, GA1 in the contents might facilitate the discharge of intestinal bacteria by becoming attached them to prevent their irregular diffusion.

Distribution of receptor glycolipids for Lactobacilli in murine digestive tract and production of antibodies cross-reactive with them by immunization of rabbits with Lactobacilli

In the digestive tract of mice (HR-1 strain), glycolipids belonging to the ganglio-series were revealed to be expressed in region-specific manners, i.e. FGA1 and FGM1 in the stomach, GA1 in the small intestine, and FGA1 and sulphatides in the cecum. The amount of GA1 as a receptor glycolipid for Lactobacilli was especially higher in the small intestine than in the other regions, it comprising 1.6-2.8 microg/mg dry weight. On immunization of rabbits with Lactobacillus johnsonii and Lactobacillus intestinalis, both of which are murine intestinal bacteria, antibodies toward bacterial glycolipids, i.e. Galalpha1-2Glcalpha1-3DG, and tri- and tetrahexaosyl DGs, were effectively generated and, in addition, they were found to cross-react with GA1 and GalCer, but not with structurally related glycolipids such as Lc(4)Cer, nLc(4)Cer and IV(3)Galalpha-nLc(4)Cer, indicating that GA1 is a preferable antigen for anti-lactobacillus antisera and suggesting the presence of epitopes common to both Lactobacilli and the host. In fact, molecules reacting with anti-GA1 antibodies were detected among bacterial proteins on Western blotting, indicating a possible occurrence of the carbohydrate structure mimicking GA1 in bacterial proteins.

The involvement of specific anti myelin basic protein antibody-forming cells in multiple sclerosis immunopathology

Irrespective of the large body of literature on the putative role of antibodies in the development of multiple sclerosis (MS), the detection of specific antibody-forming B cells (AFCs) in the central nervous system (CNS) tissues has not been described. In this study we show that autoantigen-specific AFCs can be found in CSN tissue sections of MS patients. Applying a newly developed myelin basic protein (MBP)-enzyme conjugate technique, we have detected MBP-specific AFCs in autopsy periventricular white matter and cerebellum tissue sections of MS patients. We demonstrated the presence of MBP-specific AFCs in CNS tissue sections in five out of 12 MS patients. No MBP-specific AFCs were detected in CNS tissue sections of 11 patients with other neurological diseases, such as Parkinson's and Alzheimer's disease, or in brain tissue sections of eight deceased persons without neurological diseases. In MS patients, anti-MBP AFCs were present in brain tissue sections both with and without plaques. The proportion of MBP-specific AFCs in some of the MS patient brain tissues reached over 50% of all AFCs. The high relative frequency of the anti-MBP AFCs and their localization in periventricular white matter and cerebellum of MS patients only, suggests that anti-MBP AFCs represent a cell population, which could play an important role in MS immunopathology.

Complement-dependent phagocytosis of liposomes

In this article we describe an in vitro model for complement-dependent phagocytosis of liposomes. We have previously reported that complement-opsonized liposomes are avidly ingested by murine peritoneal or bone marrow-derived cultured macrophages. However, when the liposomes contained certain lipids, including phosphatidylinositol, ganglioside GM1, and sulfogalactosyl ceramide, that have been identified as causing prolonged circulation time in vivo, complement-dependent phagocytosis of the liposomes was greatly suppressed. We identify certain additional factors associated with suppressed complement-dependent phagocytosis, including, liposomal negative charge and liposomal prostaglandin E2 or thromboxane B2. Possible mechanisms responsible for suppression of complement dependent phagocytosis are suggested. We propose that suppression of complement-dependent phagocytosis could be a contributing factor in the promotion of increased circulation time of 'stealth' liposomes and that complement opsonization probably plays a role in vivo in removing liposomes from the circulation.

Neuropsychiatric manifestations of systemic lupus erythematosus: the value of anticardiolipin, antigangliosides and antigalactocerebrosides antibodies

In an attempt to find a serological marker for neuropsychiatric manifestations (NPM) of SLE, sera from 66 patients (classified in three groups, according to their NPM-defined, probable and without NPM) were analysed by ELISA for IgG and IgM anticardiolipin, antigangliosides and antigalactocerebrosides antibodies. A strong correlation was found between IgM antigangliosides and antigalactocerebrosides antibodies and NPM, but not with IgG class. IgM and IgG antibodies anticardiolipin were not correlated with NPM in this study. Both IgM antigangliosides and antigalactocerebrosides antibodies disappeared in seven patients with definite but clinically inactive NPM. The analysis of these autoantibodies showed an important role predictive for NPM in SLE; the negative test decreases the chance of the NPM.

Functions of sphingolipids and sphingolipid breakdown products in cellular regulation

The discovery that breakdown products of cellular sphingolipids are biologically active has generated interest in the role of these molecules in cell physiology and pathology. Sphingolipid breakdown products, sphingosine and lysosphingolipids, inhibit protein kinase C, a pivotal enzyme in cell regulation and signal transduction. Sphingolipids and lysosphingolipids affect significant cellular responses and exhibit antitumor promoter activities in various mammalian cells. These molecules may function as endogenous modulators of cell function and possibly as second messengers.

Monoclonal autoantibodies derived from multiple sclerosis patients and control persons and their reactivities with antigens of the central nervous system

Peripheral blood B lymphocytes of multiple sclerosis (MS) patients and control persons were transformed with Epstein-Barr virus. Antibody production of transformed cells against isolated human myelin was investigated by enzyme-linked immunosorbent assay (ELISA). Cells producing reactive antibodies were cloned and propagated to produce monoclonal antibodies (mAbs). These mAbs did also react with acetone fixed frozen sections of normal human white matter, as determined by indirect immunofluorescence staining. Some of the mAbs derived from MS patients and a control person with a central nervous system cyst agglutinated liposomes made from lipids of a chloroform/methanol extract of human myelin, whereas mAbs derived from four glioma patients were negative in these tests. The reactive antibodies were investigated further using agglutination tests with liposomes made from pure auxiliary lipids (cholesterol and lecithin) or containing in addition either galactocerebroside, sulfatide or a mixture of bovine brain gangliosides. The great majority of myelin liposome agglutinating antibodies reacted with all types of liposomes, including those made from pure auxiliary lipids. Investigations by ELISA suggest that phospholipids are the reactive components, at least for some of these mAbs. Some antibodies reacted with liposomes containing galactocerebroside or sulfatide, others only with sulfatide containing liposomes. Antibodies showing these specificities were only obtained from MS patients.

Antiglycolipid antibodies in normal and pathologic human sera and synovial fluids

Antiglycolipid antibodies were measured in normal and pathologic sera and synovial fluids by means of a modified microplate method of complement-mediated immune lysis of fluorescent dye-trapped liposomes. All sera of normal subjects had antibodies against globopentaosylceramide (IV3 GalNAcGbOse4Cer), ganglioside GM1, gangliotriaosylceramide, gangliotetraosylceramide, and galactosylneolactotetraosylceramide antigens. Most sera of normal subjects had antibodies against lactotriaosylceramide, N-glycolylneuraminosyl-neolactotetraosylceramide (NeuGcnLcOse4Cer), GM3 ganglioside with N-glycolylneuraminic acid (NeuGcGM3) and GD1a antigens. Differences of titers against IV3GalNAcGbOse4Cer, neolactotetraosylceramide, NeuGcGM3 and NeuGcnLcOse4Cer antigens were observed between sera of normal subjects and pathologic sera from cases of leukemias, lymphomas, several autoimmune diseases and liver diseases.

Immune responses to myelin antigens in multiple sclerosis

Multiple sclerosis is considered to be a putative immunopathologic disease and there has been considerable effort over the years to prove an autoimmune etiology for it. To date, the evidence is all indirect and there is no proof of either antibody and/or cell-mediated hypersensitivity to any single identifiable CNS constituent whether a constituent of normal CNS or specific to the CNS of MS patients.

Antibodies to glycosphingolipids in patients with multiple sclerosis

Antibodies to one or more glycosphingolipids were detected by means of a liposome lysis assay in the sera of 60/81 patients with multiple sclerosis, 24/42 patients with systemic lupus erythematosus and in the majority of patients with cranial trauma or cerebrovascular accidents. Antibodies against ganglioside GM1 and asialo GM1 were found most commonly and they were frequently present in the same sera. Among patients whose sera contained antibodies to glycolipids, anti-GM1 alone occurred more frequently in patients with multiple sclerosis (14/59) than in systemic lupus erythematosus (1/22; p = 0.045) and antiasialo GM1 alone was more common in patients with lupus (9/22) than in patients with multiple sclerosis (8/59, p = 0.007). In 10 sera analyzed, all of the antibodies against these two glycolipids were of the IgM class, and some fluctuation in antibody titers was noted over a three-month period. The role of these antibodies in the initiation or perpetuation of inflammatory diseases of the central nervous system remains to be determined.

Immune lysis of lipid vesicles containing myelin basic protein or glycolipid antigens by multiple sclerosis and normal sera

We have compared the reactivity of sera from 34 multiple sclerosis (MS) patients and 32 normal (N) individuals with lipid vesicles containing myelin basic protein (BP) and several glycolipids reconstituted into a membrane environment. The ability of the sera to cause complement-mediated lysis of lipid vesicles containing these antigens was determined by measuring the release of a water-soluble spin label, tempocholine chloride, from the height of its electron spin resonance spectrum. Only 4 MS sera caused lysis of BP-containing vesicles which was comparable to that produced by specific antibody to BP. A number of both MS and N sera caused significant lysis of vesicles containing GM1 ganglioside or digalactosyldiglyceride. A few MS and N sera also caused significant lysis of vesicles containing GM2, GT1 and GD1a gangliosides. However, in no case was there a statistically significant difference between the mean lysis produced by MS and N sera. There was some overlap between the specific MS and N sera reactive to vesicles containing BP, GM1, GM2, and DGDG while a completely different group of MS and N sera were reactive to GT1 and GD1a gangliosides. This suggested that there was either antigenic cross reactivity between the two groups of glycolipids or two different origins of the immune response to the two groups of antigens. It was concluded that antibody-dependent complement fixation by these particular antigens, in the kind of lipid environment used, is not characteristic of or specific to MS.

A review of the immunogenic and immuno-modulatory properties of glycosphingolipids

This review summarizes recent data concerning the immunogenicity and immunomodulatory properties of glycosphingolipids. Many murine monoclonal antibodies that react with glycosphingolipids have been described recently. Most of these antibodies have been elicited by immunization with tumor cells and they may also bind to glycoproteins that contain similar carbohydrate sequences. Immunization with a variety of tissues, murine teratocarcinomas, myeloid leukemia, and carcinomas of the human lung, colon and stomach, has elicited antibodies that react with the sugar sequence Gal beta 1-4[Fuc alpha 1-3]GlcNAc beta 1-3Gal----. The suppression of lymphocyte responses to mitogens and antigens by gangliosides in vitro has led to suggestions that these glycolipids possess immunodulatory properties in vivo. The in vitro studies were performed by incubating mononuclear cells with either dispersions of pure gangliosides or ganglioside-containing liposomes. In vivo gangliosides are found only in cell membranes or in lipoproteins, where they represent a small mole percent of total lipids, and there is little information about the transfer of gangliosides from lipoproteins to cells in vivo. A role for gangliosides as modulators of the immune response is an interesting possibility that is not supported by physiologically relevant data at present.

Immunological expression of gangliosides in multiple sclerosis and in a demyelinating model disease in rabbits

Accumulating evidence suggests that the process of demyelination in MS might involve an autoimmune response to one or more myelin components. A combination of myelin basic protein and myelin haptens was considered as possibly enhancing a cellular or humoral autoimmune reaction in MS. In line with this motion we have used an in-vitro E-rosette assay that correlates with in-vivo delayed hypersensitivity to demonstrate specific immunologic sensitivity of lymphocytes from MS patients to polysialogangliosides. A recent report that only lymphocytes from patients in relapse, but not in remission, are primed by gangliosides, underscores the relevance of the antigenic expression of gangliosides during the active pathological phase of the disease. The antigenic capacity of gangliosides to induce upon immunization a neurological disorder featured by demyelination in the CNS was demonstrated in rabbits. This and previous reports on the induction of peripheral demyelination in rabbits immunized with gangliosides will be further analyzed to gain insight on the possible role of these myelin lipid components as targets for an autoimmune mechanism in MS.

Immune reactivity against membranes containing ganglioside GM1 in chronic-progressive multiple sclerosis: observation by spin-membrane immunoassay

A spin-membrane immunoassay has been employed to examine the immune reactivity of whole serum from patients with chronic-progressive multiple sclerosis (CPMS) against liposomes containing ganglioside GM1. Exposure to serum resulted in complement-mediated lysis of the GM1-liposomes. No lysis occurred with liposomes devoid of ganglioside. The mean (+/- S.E.M.) lysis values were 52.6 (+/- 9.8)% for fifteen CPMS patients and 32.9 (+/- 7.2)% for nine controls. The difference between the means was highly significant (student's t-test, P less than 0.0001), indicating increased anti-ganglioside immunity in patients with CPMS.

Preparation of anti-GM4 antiserum and its assay by a solid-phase radioimmunoassay

Anti-GM4 antiserum was prepared from rabbits by immunization with pure human brain GM4 ganglioside in complete Freund's adjuvant and methylated bovine serum albumin. None of the immunized animals developed any clinically apparent neurological dysfunction. The antiserum titer and specificity were analyzed by double immunodiffusion and a novel solid-phase radioimmunoassay (RIA). In the latter procedure, microtiter plate wells were coated first with the glycolipid antigen, followed by sequential application of antiserum and [125I]-Staphylococcal Protein A. The absorbed radioactivity in the well was then counted. Employing the RIA procedure, anti-GM4 antibody achieved a titer of 1:1600. The antiserum also exhibited a high degree of specificity to GM4; cross-reactivity with glycolipids of similar structure was negligible. The production of highly specific antiserum to GM4 and the feasibility of detecting antibodies to glycolipid antigens by a convenient solid-phase RIA should be useful to further study the biological and immunological roles of GM4 and other glycolipids in the central nervous system.

Multi-sialo brain gangliosides are powerful stimulators of active E-rosetting lymphocytes from multiple sclerosis patients

Peripheral blood T lymphocytes from all of 14 patients with clinically definite multiple sclerosis (MS) were significantly stimulated by MS brain gangliosides in the active rosetting of sheep erythrocytes. Fractionated mono- and disialogangliosides were devoid of any stimulating effect on MS lymphocytes whereas the trisialoganglioside GT1 and to a greater extent the tetrasialoganglioside GQ1b were fully effective at a dose as low as 2 x 10(-18) moles. Gangliosides extracted from MS brains or from MS brain myelin were far more effective than gangliosides derived from control human brains or from bovine and mouse brains, suggesting the importance of highly sialylated gangliosides occurring to a greater extent in MS brain as previously reported. Lymphocytes from only 3 out of 24 other neurological patients were stimulated by the slow migrating gangliosides in the same way, but none of 32 healthy subjects responded to these gangliosides in the active E-rosette test. Lymphocytes from 5 to 8 patients with unilateral optic neuritis reacted positively to brain gangliosides by rosette formation, several weeks before a similar reaction to myelin basic protein was evident. Our data are compatible with a release of gangliosides during demyelination or other CNS degenerative processes occurring in multiple sclerosis.

Experimental allergic neuritis induced by galactocerebroside

Experimental allergic neuritis (EAN), an animal model of human demyelinative neuritis, was induced by sensitization with galactocerebroside, a glycolipid hapten common in central and peripheral nervous system myelin. Between two months and one year after the initial sensitization, 11 of 24 rabbits immunized repeatedly with bovine brain galactocerebroside (GC) in complete Freund's adjuvant developed a neurological disorder manifested by flaccid quadriparesis, limb hypesthesia, and respiratory paralysis. Seventeen of 20 autopsied rabbits, including all those with clinical illness, had small multiple perivascular foci of demyelinative lesions in roots, dorsal root ganglia, proximal peripheral nerves adjacent to ganglia, and, less frequently, in distal nerves. No change was found in the central nervous system. Demyelination started around venules, with splitting and vesiculation of the outer myelin sheaths of adjacent fibers, and later progressed to form confluent lesions. The lesions were associated with infiltration of phagocytic mononuclear cells, mostly macrophages, which insinuated themselves between myelin lamellae, phagocytized myelin, and subsequently denuded axons. Perivenular infiltration of small lymphocytes, comparable to that seen in whole nerve- induced EAN, was not encountered. The distribution of demyelinative lesions seems to correspond to areas known to have a defective blood-nerve barrier.

Interaction of multiple sclerosis serum with liposomes containing ganglioside GM1

Multiple sclerosis serum contains a factor or factors capable of releasing sequestered [14C]glucose from liposomes containing GM1, the major ganglioside present in human central nervous system myelin. Although some control sera can also release large quantities of liposomal glucose, multiple sclerosis and control sera differ in the mechanism of this release. Liposomal damage by multiple sclerosis serum does not appear to be complement mediated, but shares certain releasing characteristics of cholera toxin.

Anti-ganglioside antibodies in multiple sclerosis

Serological activity against several purified brain gangliosides has been demonstrated in sera of a proportion of multiple sclerosis patients, but not in normal individuals. The activity was determined by the capacity of the sera to bring about complement-dependent lysis of liposomes containing the respective ganglioside in their lipid bilayer. An apparent correlation is indicated between the severity of the disease and the extent of liposome lysis. Cerebrospinal fluid of the patients did not induce lysis, probably due to low antibody concentration.

Bilayer lipid membranes (BLM) study of antigen-antibody interactions

Previous work of del Castillo and co-workers has shown that bilayer lipid membranes (BLM) can be used as transducers for detection of antigen-antibody reactions. The present experiments extend the previous work by incorporating complement into the BLM system. The results indicate that the antigen-antibody complex or the complement has no ability to affect the BLM system separately, but when carefully combined they will destabilize the BLM as a tool for investigating immunological reactions is suggested.

Multiple specificities of antibrain antibodies in multiple sclerosis and chronic myelopathy

The presence of complement-fixing antibodies against brain antigens was tested in paired serum and cerebrospinal fluid (CSF) samples from 60 multiple sclerosis (MS) patients, 15 patients with chronic myelopathy of undetermined cause (CM) and 60 control patients. Six MS sera, 34 MS CSF, 4 CM sera, 3 CM CSF, 4 control sera and 1 control CSF gave positive reactions either with a lipid extract or a saline extract of normal human brain. The proportion of anticomplementary CSF was significantly higher in the MS group than in the control group (15% vs 0%, P less than 0.01). The reactivity of a large number of individual positive samples was further investigated. Seven antibody specificities were discerned in the MS samples. Most samples reacted with non-lipid antigens, the dominating being a heat-labile, nonlipid component associated with CNS myelin. Antibodies to cerebroside and sulfatide were detected in a few patients. A number of samples reacted with cholesterol in combination with a variety of lipids. Positive samples from the CM patients exhibited a similar heterogeneity. In the control group positive reactions were seen in one patient with systemic lupus erythematosus (SLE), two patients with rheumatoid arthritis (RA), and one with a spinal meningioma. The reaction patterns of these patients were different from those commonly seen in MS patients. The complement-fixing antibrain antibodies in MS CSF are usually of IgG class (Ryberg 1976). This applies also to the positive MS sera in this study. The distribution of the antibodies between serum and CSF indicated, in several cases, an intrathecal synthesis. All of a number of human brains, including one MS brain, contained all 6 antigens (haptens) reactive in saline extracts. Antibodies to tissues outside the CNS were rarely detected in MS patients. The varied humoral autoimmune response in MS might reflect a heterogeneity in the MS patients, the disease itself or its causative agent.