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Illes Z, Jørgensen MM, Bæk R, Bente LM, Lauridsen JT, Hyrlov KH, Aboo C, Baumbach J, Kacprowski T, Cotton F, Guttmann CRG, Stensballe A. New Enhancing MRI Lesions Associate with IL-17, Neutrophil Degranulation and Integrin Microparticles: Multi-Omics Combined with Frequent MRI in Multiple Sclerosis. Biomedicines 2023; 11:3170. [PMID: 38137391 PMCID: PMC10740934 DOI: 10.3390/biomedicines11123170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 11/16/2023] [Accepted: 11/24/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Blood-barrier (BBB) breakdown and active inflammation are hallmarks of relapsing multiple sclerosis (RMS), but the molecular events contributing to the development of new lesions are not well explored. Leaky endothelial junctions are associated with increased production of endothelial-derived extracellular microvesicles (EVs) and result in the entry of circulating immune cells into the brain. MRI with intravenous gadolinium (Gd) can visualize acute blood-barrier disruption as the initial event of the evolution of new lesions. METHODS Here, weekly MRI with Gd was combined with proteomics, multiplex immunoassay, and endothelial stress-optimized EV array to identify early markers related to BBB disruption. Five patients with RMS with no disease-modifying treatment were monitored weekly using high-resolution 3T MRI scanning with intravenous gadolinium (Gd) for 8 weeks. Patients were then divided into three groups (low, medium, or high MRI activity) defined by the number of new, total, and maximally enhancing Gd-enhancing lesions and the number of new FLAIR lesions. Plasma samples taken at each MRI were analyzed for protein biomarkers of inflammation by quantitative proteomics, and cytokines using multiplex immunoassays. EVs were characterized with an optimized endothelial stress EV array based on exosome surface protein markers for the detection of soluble secreted EVs. RESULTS Proteomics analysis of plasma yielded quantitative information on 208 proteins at each patient time point (n = 40). We observed the highest number of unique dysregulated proteins (DEPs) and the highest functional enrichment in the low vs. high MRI activity comparison. Complement activation and complement/coagulation cascade were also strongly overrepresented in the low vs. high MRI activity comparison. Activation of the alternative complement pathway, pathways of blood coagulation, extracellular matrix organization, and the regulation of TLR and IGF transport were unique for the low vs. high MRI activity comparison as well, with these pathways being overrepresented in the patient with high MRI activity. Principal component analysis indicated the individuality of plasma profiles in patients. IL-17 was upregulated at all time points during 8 weeks in patients with high vs. low MRI activity. Hierarchical clustering of soluble markers in the plasma indicated that all four MRI outcomes clustered together with IL-17, IL-12p70, and IL-1β. MRI outcomes also showed clustering with EV markers CD62E/P, MIC A/B, ICAM-1, and CD42A. The combined cluster of these cytokines, EV markers, and MRI outcomes clustered also with IL-12p40 and IL-7. All four MRI outcomes correlated positively with levels of IL-17 (p < 0.001, respectively), and EV-ICAM-1 (p < 0.0003, respectively). IL-1β levels positively correlated with the number of new Gd-enhancing lesions (p < 0.01), new FLAIR lesions (p < 0.001), and total number of Gd-enhancing lesions (p < 0.05). IL-6 levels positively correlated with the number of new FLAIR lesions (p < 0.05). Random Forests and linear mixed models identified IL-17, CCL17/TARC, CCL3/MIP-1α, and TNF-α as composite biomarkers predicting new lesion evolution. CONCLUSIONS Combination of serial frequent MRI with proteome, neuroinflammation markers, and protein array data of EVs enabled assessment of temporal changes in inflammation and endothelial dysfunction in RMS related to the evolution of new and enhancing lesions. Particularly, the Th17 pathway and IL-1β clustered and correlated with new lesions and Gd enhancement, indicating their importance in BBB disruption and initiating acute brain inflammation in MS. In addition to the Th17 pathway, abundant protein changes between MRI activity groups suggested the role of EVs and the coagulation system along with innate immune responses including acute phase proteins, complement components, and neutrophil degranulation.
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Affiliation(s)
- Zsolt Illes
- Department of Neurology, Odense University Hospital, 5000 Odense, Denmark
- Department of Clinical Medicine, University of Southern Denmark, 5230 Odense, Denmark
- Institute of Molecular Medicine, University of Southern Denmark, 5230 Odense, Denmark
- Brain Research—Inter Disciplinary Guided Excellence (BRIDGE), University of Southern Denmark, 5230 Odense, Denmark
| | - Malene Møller Jørgensen
- Department of Clinical Immunology, Aalborg University Hospital, 9220 Aalborg, Denmark; (M.M.J.); (R.B.)
| | - Rikke Bæk
- Department of Clinical Immunology, Aalborg University Hospital, 9220 Aalborg, Denmark; (M.M.J.); (R.B.)
| | - Lisa-Marie Bente
- Division Data Science in Biomedicine, Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, 38106 Braunschweig, Germany; (L.-M.B.); (T.K.)
- Braunschweig Integrated Centre for Systems Biology (BRICS), TU Braunschweig, 38106 Braunschweig, Germany
| | - Jørgen T. Lauridsen
- Department of Business and Economics, University of Southern Denmark, 5230 Odense, Denmark;
| | - Kirsten H. Hyrlov
- Department of Neurology, Odense University Hospital, 5000 Odense, Denmark
| | - Christopher Aboo
- Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark;
- Sino-Danish Center for Education and Research, University of Chinese Academy of Sciences, 101408 Beijing, China
| | - Jan Baumbach
- Department of Mathematics and Computer Science, University of Southern Denmark, 5230 Odense, Denmark;
- Institute for Computational Systems Biology, University of Hamburg, 20148 Hamburg, Germany
| | - Tim Kacprowski
- Division Data Science in Biomedicine, Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, 38106 Braunschweig, Germany; (L.-M.B.); (T.K.)
- Braunschweig Integrated Centre for Systems Biology (BRICS), TU Braunschweig, 38106 Braunschweig, Germany
| | - Francois Cotton
- Service de Radiologie, Centre Hospitalier Lyon-Sud, France/CREATIS, Université de Lyon, 69007 Lyon, France;
| | | | - Allan Stensballe
- Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark;
- Clinical Cancer Center, Aalborg University Hospital, 9220 Aalborg, Denmark
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Elkjaer ML, Simon L, Frisch T, Bente LM, Kacprowski T, Thomassen M, Reynolds R, Baumbach J, Röttger R, Illes Z. Hypothesis of a potential BrainBiota and its relation to CNS autoimmune inflammation. Front Immunol 2022; 13:1043579. [PMID: 36532064 PMCID: PMC9756883 DOI: 10.3389/fimmu.2022.1043579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/16/2022] [Indexed: 12/03/2022] Open
Abstract
Infectious agents have been long considered to play a role in the pathogenesis of neurological diseases as part of the interaction between genetic susceptibility and the environment. The role of bacteria in CNS autoimmunity has also been highlighted by changes in the diversity of gut microbiota in patients with neurological diseases such as Parkinson's disease, Alzheimer disease and multiple sclerosis, emphasizing the role of the gut-brain axis. We discuss the hypothesis of a brain microbiota, the BrainBiota: bacteria living in symbiosis with brain cells. Existence of various bacteria in the human brain is suggested by morphological evidence, presence of bacterial proteins, metabolites, transcripts and mucosal-associated invariant T cells. Based on our data, we discuss the hypothesis that these bacteria are an integral part of brain development and immune tolerance as well as directly linked to the gut microbiome. We further suggest that changes of the BrainBiota during brain diseases may be the consequence or cause of the chronic inflammation similarly to the gut microbiota.
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Affiliation(s)
- Maria L. Elkjaer
- Department of Neurology, Odense University Hospital, Odense, Denmark,BRIDGE, Department of Clinical Research, University of Southern Denmark, Odense, Denmark,Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark,*Correspondence: Maria L. Elkjaer, ; Zsolt Illes,
| | - Lukas Simon
- Center for Precision Health, School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Tobias Frisch
- Department of Mathematics and Computer Science, University of Southern Denmark, Odense, Denmark
| | - Lisa-Marie Bente
- Division Data Science in Biomedicine, Peter L. Reichertz Institute for Medical Informatics, Technische Universität Braunschweig and Hannover Medical School, Braunschweig, Germany,Braunschweig Integrated Centre of Systems Biology (BRICS), Technische Universität Braunschweig, Braunchweig, Germany
| | - Tim Kacprowski
- Division Data Science in Biomedicine, Peter L. Reichertz Institute for Medical Informatics, Technische Universität Braunschweig and Hannover Medical School, Braunschweig, Germany,Braunschweig Integrated Centre of Systems Biology (BRICS), Technische Universität Braunschweig, Braunchweig, Germany
| | - Mads Thomassen
- BRIDGE, Department of Clinical Research, University of Southern Denmark, Odense, Denmark,Research Unit of Human Genetics, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Richard Reynolds
- Department of Brain Sciences, Imperial College, London, United Kingdom,Centre for Molecular Neuropathology, LKC School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Jan Baumbach
- Chair of Computational Systems Biology, University of Hamburg, Hamburg, Germany
| | - Richard Röttger
- Department of Mathematics and Computer Science, University of Southern Denmark, Odense, Denmark
| | - Zsolt Illes
- Department of Neurology, Odense University Hospital, Odense, Denmark,BRIDGE, Department of Clinical Research, University of Southern Denmark, Odense, Denmark,Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark,*Correspondence: Maria L. Elkjaer, ; Zsolt Illes,
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