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Gupta K, Kesharwani A, Rua S, Singh SS, Siu C, Jank L, Smith MD, Calabresi PA, Bhargava P. BAFF blockade in experimental autoimmune encephalomyelitis reduces inflammation in the meninges and synaptic and neuronal loss in adjacent brain regions. J Neuroinflammation 2023; 20:229. [PMID: 37805549 PMCID: PMC10559498 DOI: 10.1186/s12974-023-02922-7] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 10/04/2023] [Indexed: 10/09/2023] Open
Abstract
Multiple sclerosis (MS) has traditionally been viewed as a chronic inflammatory disease affecting the white matter of the central nervous system. However, over the past two decades, increasing evidence has highlighted the role of gray matter pathology in MS-related disability. Numerous studies have linked the presence of leptomeningeal inflammation to a more severe disease course, underscoring its potential importance as a driver of gray matter pathology in MS. The major components of leptomeningeal inflammation include T cells, B cells, macrophages, follicular dendritic cells, and plasma cells. Since BAFF [B cell-activating factor of the tumor necrosis factor (TNF) family] promotes B cell survival and maturation and is a co-stimulator of T cells, we used anti-BAFF antibody 10F4 as a BAFF antagonist to study its effect on meningeal inflammation and adjacent brain regions in a relapsing-remitting PLP-EAE (rr-EAE) model of multiple sclerosis in SJL/J mice. rr-EAE mice were treated either with anti-BAFF antibody 10F4 or with IgG control antibody. We performed ultra-high field (11.7 T) MRI to identify areas of meningeal inflammation and track them over time in both treatment groups. We also performed histopathological analysis in brain sections of these mice to study the effects of the BAFF antagonist on leptomeningeal inflammation, and hippocampal and cortical neurons and synapses. We observed that BAFF antagonist treatment reduced B cells, T cells, and myeloid cells in regions of meningeal inflammation. Additionally, we noted that BAFF treatment protected against EAE-induced synaptic and neuronal loss in the adjacent cortex and in the CA1, CA3, and dentate gyrus regions of the hippocampus likely due to its effects on meningeal inflammation.
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Affiliation(s)
- Kanak Gupta
- Division of Neuroimmunology and Neurological Infections, Department of Neurology, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Pathology Building, 600 N. Wolfe St., Pathology 627, Baltimore, MD, 21287, USA
| | - Ajay Kesharwani
- Division of Neuroimmunology and Neurological Infections, Department of Neurology, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Pathology Building, 600 N. Wolfe St., Pathology 627, Baltimore, MD, 21287, USA
| | - Steven Rua
- Division of Neuroimmunology and Neurological Infections, Department of Neurology, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Pathology Building, 600 N. Wolfe St., Pathology 627, Baltimore, MD, 21287, USA
| | - Saumitra Sen Singh
- Division of Neuroimmunology and Neurological Infections, Department of Neurology, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Pathology Building, 600 N. Wolfe St., Pathology 627, Baltimore, MD, 21287, USA
| | - Catherine Siu
- Division of Neuroimmunology and Neurological Infections, Department of Neurology, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Pathology Building, 600 N. Wolfe St., Pathology 627, Baltimore, MD, 21287, USA
| | - Larissa Jank
- Division of Neuroimmunology and Neurological Infections, Department of Neurology, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Pathology Building, 600 N. Wolfe St., Pathology 627, Baltimore, MD, 21287, USA
| | - Matthew D Smith
- Division of Neuroimmunology and Neurological Infections, Department of Neurology, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Pathology Building, 600 N. Wolfe St., Pathology 627, Baltimore, MD, 21287, USA
| | - Peter A Calabresi
- Division of Neuroimmunology and Neurological Infections, Department of Neurology, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Pathology Building, 600 N. Wolfe St., Pathology 627, Baltimore, MD, 21287, USA
| | - Pavan Bhargava
- Division of Neuroimmunology and Neurological Infections, Department of Neurology, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Pathology Building, 600 N. Wolfe St., Pathology 627, Baltimore, MD, 21287, USA.
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Magliozzi R, Howell OW, Durrenberger P, Aricò E, James R, Cruciani C, Reeves C, Roncaroli F, Nicholas R, Reynolds R. Meningeal inflammation changes the balance of TNF signalling in cortical grey matter in multiple sclerosis. J Neuroinflammation 2019; 16:259. [PMID: 31810488 PMCID: PMC6898969 DOI: 10.1186/s12974-019-1650-x] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 11/19/2019] [Indexed: 12/18/2022] Open
Abstract
Background Recent studies of cortical pathology in secondary progressive multiple sclerosis have shown that a more severe clinical course and the presence of extended subpial grey matter lesions with significant neuronal/glial loss and microglial activation are associated with meningeal inflammation, including the presence of lymphoid-like structures in the subarachnoid space in a proportion of cases. Methods To investigate the molecular consequences of pro-inflammatory and cytotoxic molecules diffusing from the meninges into the underlying grey matter, we carried out gene expression profiling analysis of the motor cortex from 20 post-mortem multiple sclerosis brains with and without substantial meningeal inflammation and 10 non-neurological controls. Results Gene expression profiling of grey matter lesions and normal appearing grey matter not only confirmed the substantial pathological cell changes, which were greatest in multiple sclerosis cases with increased meningeal inflammation, but also demonstrated the upregulation of multiple genes/pathways associated with the inflammatory response. In particular, genes involved in tumour necrosis factor (TNF) signalling were significantly deregulated in MS cases compared with controls. Increased meningeal inflammation was found to be associated with a shift in the balance of TNF signalling away from TNFR1/TNFR2 and NFkB-mediated anti-apoptotic pathways towards TNFR1- and RIPK3-mediated pro-apoptotic/pro-necroptotic signalling in the grey matter, which was confirmed by RT-PCR analysis. TNFR1 was found expressed preferentially on neurons and oligodendrocytes in MS cortical grey matter, whereas TNFR2 was predominantly expressed by astrocytes and microglia. Conclusions We suggest that the inflammatory milieu generated in the subarachnoid space of the multiple sclerosis meninges by infiltrating immune cells leads to increased demyelinating and neurodegenerative pathology in the underlying grey matter due to changes in the balance of TNF signalling.
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Affiliation(s)
- Roberta Magliozzi
- Department of Brain Sciences, Department of Medicine, Imperial College Faculty of Medicine, Hammersmith Hospital Campus, Imperial College London, Burlington Danes Building, Du Cane Road, London, W12 0NN, UK. .,Neurology Unit, Department of Neuroscience, Biomedicine and Movement Science, University of Verona, Policlinico G.B. Rossi, P.le L.A. Scuro, 10, 37134, Verona, Italy.
| | - Owain William Howell
- Department of Brain Sciences, Department of Medicine, Imperial College Faculty of Medicine, Hammersmith Hospital Campus, Imperial College London, Burlington Danes Building, Du Cane Road, London, W12 0NN, UK.,Institute for Life Sciences, Swansea University, Swansea, Wales
| | - Pascal Durrenberger
- Department of Brain Sciences, Department of Medicine, Imperial College Faculty of Medicine, Hammersmith Hospital Campus, Imperial College London, Burlington Danes Building, Du Cane Road, London, W12 0NN, UK
| | - Eleonora Aricò
- FaBioCell, Core Facilities, Istituto Superiore di Sanità, Rome, Italy
| | - Rachel James
- Department of Brain Sciences, Department of Medicine, Imperial College Faculty of Medicine, Hammersmith Hospital Campus, Imperial College London, Burlington Danes Building, Du Cane Road, London, W12 0NN, UK
| | - Carolina Cruciani
- Department of Brain Sciences, Department of Medicine, Imperial College Faculty of Medicine, Hammersmith Hospital Campus, Imperial College London, Burlington Danes Building, Du Cane Road, London, W12 0NN, UK
| | | | - Federico Roncaroli
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Richard Nicholas
- Department of Brain Sciences, Department of Medicine, Imperial College Faculty of Medicine, Hammersmith Hospital Campus, Imperial College London, Burlington Danes Building, Du Cane Road, London, W12 0NN, UK
| | - Richard Reynolds
- Department of Brain Sciences, Department of Medicine, Imperial College Faculty of Medicine, Hammersmith Hospital Campus, Imperial College London, Burlington Danes Building, Du Cane Road, London, W12 0NN, UK.
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Hatfield JK, Brown MA. Group 3 innate lymphoid cells accumulate and exhibit disease-induced activation in the meninges in EAE. Cell Immunol 2015; 297:69-79. [PMID: 26163773 DOI: 10.1016/j.cellimm.2015.06.006] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 05/31/2015] [Accepted: 06/18/2015] [Indexed: 12/11/2022]
Abstract
Innate lymphoid cells are immune cells that reside in tissues that interface with the external environment and contribute to the first line defense against pathogens. However, they also have roles in promoting chronic inflammation. Here we demonstrate that group 3 ILCs, (ILC3s - CD45+Lin-IL-7Rα+RORγt+), are normal residents of the meninges and exhibit disease-induced accumulation and activation in EAE. In addition to production of the pro-inflammatory cytokines IL-17 and GM-CSF, ILC3s constitutively express CD30L and OX40L, molecules required for memory T cell survival. We show that disease-induced trafficking of transferred wild type T cells to the meninges is impaired in ILC3-deficient Rorc-/- mice. Furthermore, lymphoid tissue inducer cells, a c-kit+ ILC3 subset that promotes ectopic lymphoid follicle development, a hallmark of many autoimmune diseases, are reduced in the meninges of EAE-resistant c-kit mutant Kit(W/Wv) mice. We propose that ILC3s sustain neuroinflammation by supporting T cell survival and reactivation in the meninges.
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Koshihara H, Oguchi K, Takei YI, Kitazawa K, Higuchi K, Ohara S. Meningeal inflammation and demyelination in a patient clinically diagnosed with acute disseminated encephalomyelitis. J Neurol Sci 2014; 346:323-7. [PMID: 25216555 DOI: 10.1016/j.jns.2014.08.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 08/02/2014] [Accepted: 08/25/2014] [Indexed: 12/14/2022]
Abstract
Acute disseminated encephalomyelitis (ADEM) and multiple sclerosis (MS) are both CNS inflammatory demyelinating diseases with overlapping clinical features. A case is reported of a 51-year-old female who presented with headache, progressive aphasia and hemiparesis without preceding infection or vaccination. Brain MRI revealed multiple, often confluent, subcortical white matter lesions without enhancement, affecting predominantly the left cerebral hemisphere. CSF examination failed to reveal oligoclonal bands. Brain biopsy revealed both pathological features of ADEM and findings are consistent with the early stage of MS, including meningeal B and T lymphocytic infiltration, perivenular demyelination, subpial demyelination and discrete confluent plaque-like foci of demyelination. Steroid treatment resulted in remarkable clinical and radiological improvement and there has been no recurrence in six years of follow-up. This case highlights the difficulties in differentiating between ADEM and the first attack of MS and further suggests that ADEM and the early stage of MS, and its tumefactive variant, may have a common underlying pathologic mechanism, which may have a therapeutic implication in treating these diseases.
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Affiliation(s)
- Hiroshi Koshihara
- Department of Neurology, Matsumoto Medical Center, Chushin-Matsumoto Hospital, Matsumoto, Japan
| | - Kenya Oguchi
- Department of Neurology, Matsumoto Medical Center, Chushin-Matsumoto Hospital, Matsumoto, Japan
| | - Yo-ichi Takei
- Department of Neurology, Matsumoto Medical Center, Chushin-Matsumoto Hospital, Matsumoto, Japan
| | - Kazuo Kitazawa
- Department of Neurosurgery, Aizawa Hospital, Matsumoto, Japan
| | - Kayoko Higuchi
- Department of Pathology, Aizawa Hospital, Matsumoto, Japan
| | - Shinji Ohara
- Department of Neurology, Matsumoto Medical Center, Chushin-Matsumoto Hospital, Matsumoto, Japan.
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