1
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Jamann H, Desu HL, Cui QL, Halaweh A, Tastet O, Klement W, Zandee S, Pernin F, Mamane VH, Ouédraogo O, Daigneault A, Sidibé H, Millette F, Peelen E, Dhaeze T, Hoornaert C, Rébillard RM, Thai K, Grasmuck C, Vande Velde C, Prat A, Arbour N, Stratton JA, Antel J, Larochelle C. ALCAM on human oligodendrocytes mediates CD4 T cell adhesion. Brain 2024; 147:147-162. [PMID: 37640028 PMCID: PMC10766241 DOI: 10.1093/brain/awad286] [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: 03/17/2023] [Revised: 07/25/2023] [Accepted: 08/08/2023] [Indexed: 08/31/2023] Open
Abstract
Multiple sclerosis is a chronic neuroinflammatory disorder characterized by demyelination, oligodendrocyte damage/loss and neuroaxonal injury in the context of immune cell infiltration in the CNS. No neuroprotective therapy is available to promote the survival of oligodendrocytes and protect their myelin processes in immune-mediated demyelinating diseases. Pro-inflammatory CD4 Th17 cells can interact with oligodendrocytes in multiple sclerosis and its animal model, causing injury to myelinating processes and cell death through direct contact. However, the molecular mechanisms underlying the close contact and subsequent detrimental interaction of Th17 cells with oligodendrocytes remain unclear. In this study we used single cell RNA sequencing, flow cytometry and immunofluorescence studies on CNS tissue from multiple sclerosis subjects, its animal model and controls to characterize the expression of cell adhesion molecules by mature oligodendrocytes. We found that a significant proportion of human and murine mature oligodendrocytes express melanoma cell adhesion molecule (MCAM) and activated leukocyte cell adhesion molecule (ALCAM) in multiple sclerosis, in experimental autoimmune encephalomyelitis and in controls, although their regulation differs between human and mouse. We observed that exposure to pro-inflammatory cytokines or to human activated T cells are associated with a marked downregulation of the expression of MCAM but not of ALCAM at the surface of human primary oligodendrocytes. Furthermore, we used in vitro live imaging, immunofluorescence and flow cytometry to determine the contribution of these molecules to Th17-polarized cell adhesion and cytotoxicity towards human oligodendrocytes. Silencing and blocking ALCAM but not MCAM limited prolonged interactions between human primary oligodendrocytes and Th17-polarized cells, resulting in decreased adhesion of Th17-polarized cells to oligodendrocytes and conferring significant protection of oligodendrocytic processes. In conclusion, we showed that human oligodendrocytes express MCAM and ALCAM, which are differently modulated by inflammation and T cell contact. We found that ALCAM is a ligand for Th17-polarized cells, contributing to their capacity to adhere and induce damage to human oligodendrocytes, and therefore could represent a relevant target for neuroprotection in multiple sclerosis.
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Affiliation(s)
- Hélène Jamann
- Neuroimmunology unit, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, H2X 0A9, Canada
- Department of Neurosciences, Université de Montréal, Montreal, H3T 1J4, Canada
| | - Haritha L Desu
- Neuroimmunology unit, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, H2X 0A9, Canada
| | - Qiao-Ling Cui
- Neuroimmunology Unit, Montreal Neurological Institute and Department of Neurology and Neurosurgery, McGill University, Montreal, H3A 2B4, Canada
| | - Alexandre Halaweh
- Neuroimmunology unit, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, H2X 0A9, Canada
- Department of Microbiology, Immunology and Infectiology, Université de Montréal, Montreal, H2X 3E4, Canada
| | - Olivier Tastet
- Neuroimmunology unit, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, H2X 0A9, Canada
| | - Wendy Klement
- Neuroimmunology unit, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, H2X 0A9, Canada
| | - Stephanie Zandee
- Neuroimmunology unit, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, H2X 0A9, Canada
- Department of Neurosciences, Université de Montréal, Montreal, H3T 1J4, Canada
| | - Florian Pernin
- Neuroimmunology Unit, Montreal Neurological Institute and Department of Neurology and Neurosurgery, McGill University, Montreal, H3A 2B4, Canada
| | - Victoria H Mamane
- Neuroimmunology unit, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, H2X 0A9, Canada
- Department of Neurosciences, Université de Montréal, Montreal, H3T 1J4, Canada
| | - Oumarou Ouédraogo
- Neuroimmunology unit, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, H2X 0A9, Canada
- Department of Microbiology, Immunology and Infectiology, Université de Montréal, Montreal, H2X 3E4, Canada
| | - Audrey Daigneault
- Neuroimmunology unit, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, H2X 0A9, Canada
| | - Hadjara Sidibé
- Neuroimmunology unit, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, H2X 0A9, Canada
- Department of Neurosciences, Université de Montréal, Montreal, H3T 1J4, Canada
| | - Florence Millette
- Neuroimmunology unit, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, H2X 0A9, Canada
- Department of Neurosciences, Université de Montréal, Montreal, H3T 1J4, Canada
| | - Evelyn Peelen
- Neuroimmunology unit, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, H2X 0A9, Canada
- Department of Neurosciences, Université de Montréal, Montreal, H3T 1J4, Canada
| | - Tessa Dhaeze
- Neuroimmunology unit, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, H2X 0A9, Canada
- Department of Neurosciences, Université de Montréal, Montreal, H3T 1J4, Canada
| | - Chloé Hoornaert
- Neuroimmunology unit, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, H2X 0A9, Canada
- Department of Neurosciences, Université de Montréal, Montreal, H3T 1J4, Canada
| | - Rose-Marie Rébillard
- Neuroimmunology unit, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, H2X 0A9, Canada
- Department of Neurosciences, Université de Montréal, Montreal, H3T 1J4, Canada
| | - Karine Thai
- Neuroimmunology unit, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, H2X 0A9, Canada
- Department of Neurosciences, Université de Montréal, Montreal, H3T 1J4, Canada
| | - Camille Grasmuck
- Neuroimmunology unit, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, H2X 0A9, Canada
- Department of Neurosciences, Université de Montréal, Montreal, H3T 1J4, Canada
| | - Christine Vande Velde
- Neuroimmunology unit, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, H2X 0A9, Canada
- Department of Neurosciences, Université de Montréal, Montreal, H3T 1J4, Canada
| | - Alexandre Prat
- Neuroimmunology unit, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, H2X 0A9, Canada
- Department of Neurosciences, Université de Montréal, Montreal, H3T 1J4, Canada
| | - Nathalie Arbour
- Neuroimmunology unit, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, H2X 0A9, Canada
- Department of Neurosciences, Université de Montréal, Montreal, H3T 1J4, Canada
| | - Jo Anne Stratton
- Neuroimmunology Unit, Montreal Neurological Institute and Department of Neurology and Neurosurgery, McGill University, Montreal, H3A 2B4, Canada
| | - Jack Antel
- Neuroimmunology Unit, Montreal Neurological Institute and Department of Neurology and Neurosurgery, McGill University, Montreal, H3A 2B4, Canada
| | - Catherine Larochelle
- Neuroimmunology unit, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, H2X 0A9, Canada
- Department of Neurosciences, Université de Montréal, Montreal, H3T 1J4, Canada
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2
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Charabati M, Zandee S, Fournier AP, Tastet O, Thai K, Zaminpeyma R, Lécuyer MA, Bourbonnière L, Larouche S, Klement W, Grasmuck C, Tea F, Zierfuss B, Filali-Mouhim A, Moumdjian R, Bouthillier A, Cayrol R, Peelen E, Arbour N, Larochelle C, Prat A. MCAM+ brain endothelial cells contribute to neuroinflammation by recruiting pathogenic CD4+ T lymphocytes. Brain 2023; 146:1483-1495. [PMID: 36319587 PMCID: PMC10115172 DOI: 10.1093/brain/awac389] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 03/15/2022] [Revised: 09/12/2022] [Accepted: 10/01/2022] [Indexed: 01/13/2023] Open
Abstract
The trafficking of autoreactive leucocytes across the blood-brain barrier endothelium is a hallmark of multiple sclerosis pathogenesis. Although the blood-brain barrier endothelium represents one of the main CNS borders to interact with the infiltrating leucocytes, its exact contribution to neuroinflammation remains understudied. Here, we show that Mcam identifies inflammatory brain endothelial cells with pro-migratory transcriptomic signature during experimental autoimmune encephalomyelitis. In addition, MCAM was preferentially upregulated on blood-brain barrier endothelial cells in multiple sclerosis lesions in situ and at experimental autoimmune encephalomyelitis disease onset by molecular MRI. In vitro and in vivo, we demonstrate that MCAM on blood-brain barrier endothelial cells contributes to experimental autoimmune encephalomyelitis development by promoting the cellular trafficking of TH1 and TH17 lymphocytes across the blood-brain barrier. Last, we showcase ST14 as an immune ligand to brain endothelial MCAM, enriched on CD4+ T lymphocytes that cross the blood-brain barrier in vitro, in vivo and in multiple sclerosis lesions as detected by flow cytometry on rapid autopsy derived brain tissue from multiple sclerosis patients. Collectively, our findings reveal that MCAM is at the centre of a pathological pathway used by brain endothelial cells to recruit pathogenic CD4+ T lymphocyte from circulation early during neuroinflammation. The therapeutic targeting of this mechanism is a promising avenue to treat multiple sclerosis.
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Affiliation(s)
- Marc Charabati
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada
- Department of Neurosciences, Université de Montréal, Montreal, Quebec H3T 1J4, Canada
| | - Stephanie Zandee
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada
- Department of Neurosciences, Université de Montréal, Montreal, Quebec H3T 1J4, Canada
| | - Antoine P Fournier
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada
- Department of Neurosciences, Université de Montréal, Montreal, Quebec H3T 1J4, Canada
| | - Olivier Tastet
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada
| | - Karine Thai
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada
- Department of Neurosciences, Université de Montréal, Montreal, Quebec H3T 1J4, Canada
| | - Roxaneh Zaminpeyma
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada
| | - Marc-André Lécuyer
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada
- Department of Microbiology, Infectious Diseases and Immunology, Université de Montréal, Montreal, Quebec H3T 1J4, Canada
| | - Lyne Bourbonnière
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada
| | - Sandra Larouche
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada
| | - Wendy Klement
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada
| | - Camille Grasmuck
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada
- Department of Neurosciences, Université de Montréal, Montreal, Quebec H3T 1J4, Canada
| | - Fiona Tea
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada
- Department of Neurosciences, Université de Montréal, Montreal, Quebec H3T 1J4, Canada
| | - Bettina Zierfuss
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada
- Department of Neurosciences, Université de Montréal, Montreal, Quebec H3T 1J4, Canada
| | - Ali Filali-Mouhim
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada
| | - Robert Moumdjian
- Division of Neurosurgery, Centre Hospitalier de l’Université de Montréal (CHUM), Montreal, Quebec H2X 0C1, Canada
- Department of Surgery, Université de Montréal, Montreal, Quebec H3C 3J7, Canada
| | - Alain Bouthillier
- Division of Neurosurgery, Centre Hospitalier de l’Université de Montréal (CHUM), Montreal, Quebec H2X 0C1, Canada
- Department of Surgery, Université de Montréal, Montreal, Quebec H3C 3J7, Canada
| | - Romain Cayrol
- Clinical Department of Laboratory Medicine, CHUM, Montreal, Quebec H2X 0C1, Canada
- Department of Pathology and Cell Biology, Université de Montréal, Montreal, Quebec H3T 1J4, Canada
| | - Evelyn Peelen
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada
- Department of Neurosciences, Université de Montréal, Montreal, Quebec H3T 1J4, Canada
| | - Nathalie Arbour
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada
- Department of Neurosciences, Université de Montréal, Montreal, Quebec H3T 1J4, Canada
| | - Catherine Larochelle
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada
- Department of Neurosciences, Université de Montréal, Montreal, Quebec H3T 1J4, Canada
- Multiple Sclerosis Clinic, Division of Neurology, CHUM, Montreal, Quebec H2L 4M1, Canada
| | - Alexandre Prat
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada
- Department of Neurosciences, Université de Montréal, Montreal, Quebec H3T 1J4, Canada
- Multiple Sclerosis Clinic, Division of Neurology, CHUM, Montreal, Quebec H2L 4M1, Canada
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3
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Heering J, Jores N, Kilu W, Schallmayer E, Peelen E, Muehler A, Kohlhof H, Vitt D, Linhard V, Gande SL, Chaikuad A, Sreeramulu S, Schwalbe H, Merk D. Mechanistic Impact of Different Ligand Scaffolds on FXR Modulation Suggests Avenues to Selective Modulators. ACS Chem Biol 2022; 17:3159-3168. [PMID: 36318238 DOI: 10.1021/acschembio.2c00599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The bile-acid sensing nuclear farnesoid X receptor (FXR) is an attractive target for the treatment of hepatic and metabolic diseases, but application of this chemotherapeutic concept remains limited due to adverse effects of FXR activation observed in clinical trials. To elucidate the mechanistic basis of FXR activation at the molecular level, we have systematically studied FXR co-regulator interactions and dimerization in response to seven chemically diverse FXR ligands. Different molecular effects on FXR activation mediated by different scaffolds were evident and aligned with characteristic structural changes within the ligand binding domain of FXR. A partial FXR agonist acted mainly through co-repressor displacement from FXR and caused an FXR-regulated gene expression pattern markedly differing from FXR agonist effects. These results suggest selective modulation of FXR dimerization and co-regulator interactions for different ligands, offering a potential avenue for the design of gene- or tissue-selective FXR modulators.
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Affiliation(s)
- Jan Heering
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, and Fraunhofer Cluster of Excellence for Immune Mediated Diseases CIMD, 60596Frankfurt, Germany
| | - Nathalie Jores
- Institute for Organic Chemistry and Chemical Biology, Center for Biomolecular Magnetic Resonance (BMRZ), Goethe-University Frankfurt, 60438Frankfurt, Germany
| | - Whitney Kilu
- Institute of Pharmaceutical Chemistry, Goethe-University Frankfurt, 60438Frankfurt, Germany
| | - Espen Schallmayer
- Institute of Pharmaceutical Chemistry, Goethe-University Frankfurt, 60438Frankfurt, Germany
| | | | | | | | | | - Verena Linhard
- Institute for Organic Chemistry and Chemical Biology, Center for Biomolecular Magnetic Resonance (BMRZ), Goethe-University Frankfurt, 60438Frankfurt, Germany
| | - Santosh L Gande
- Institute for Organic Chemistry and Chemical Biology, Center for Biomolecular Magnetic Resonance (BMRZ), Goethe-University Frankfurt, 60438Frankfurt, Germany
| | - Apirat Chaikuad
- Institute of Pharmaceutical Chemistry, Goethe-University Frankfurt, 60438Frankfurt, Germany
| | - Sridhar Sreeramulu
- Institute for Organic Chemistry and Chemical Biology, Center for Biomolecular Magnetic Resonance (BMRZ), Goethe-University Frankfurt, 60438Frankfurt, Germany
| | - Harald Schwalbe
- Institute for Organic Chemistry and Chemical Biology, Center for Biomolecular Magnetic Resonance (BMRZ), Goethe-University Frankfurt, 60438Frankfurt, Germany
| | - Daniel Merk
- Institute of Pharmaceutical Chemistry, Goethe-University Frankfurt, 60438Frankfurt, Germany.,Department of Pharmacy, Ludwig-Maximilians-Universität München, 81377Munich, Germany
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4
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Fournier AP, Zandee S, Charabati M, Peelen E, Tastet O, Alvarez JI, Kebir H, Bourbonnière L, Larouche S, Lahav B, Klement W, Tea F, Bouthillier A, Moumdjian R, Cayrol R, Duquette P, Girard M, Larochelle C, Arbour N, Prat A. CLMP Promotes Leukocyte Migration Across Brain Barriers in Multiple Sclerosis. Neurol Neuroimmunol Neuroinflamm 2022; 9:9/6/e200022. [PMID: 36241608 PMCID: PMC9465835 DOI: 10.1212/nxi.0000000000200022] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 06/10/2022] [Indexed: 11/15/2022]
Abstract
Background and Objectives In multiple sclerosis (MS), peripheral immune cells use various cell trafficking molecules to infiltrate the CNS where they cause damage.The objective of this study was to investigate the involvement of coxsackie and adenovirus receptor–like membrane protein (CLMP) in the migration of immune cells into the CNS of patients with MS. Methods Expression of CLMP was measured in primary cultures of human brain endothelial cells (HBECs) and human meningeal endothelial cells (HMECs), postmortem brain samples, and peripheral blood mononuclear cells (PBMCs) from patients with MS and controls by RNA sequencing, quantitative PCR, immunohistochemistry, and flow cytometry. In vitro migration assays using HBECs and HMECs were performed to evaluate the function of CLMP. Results Using bulk RNA sequencing of primary cultures of human brain and meningeal endothelial cells (ECs), we have identified CLMP as a new potential cell trafficking molecule upregulated in inflammatory conditions. We first confirmed the upregulation of CLMP at the protein level on TNFα-activated and IFNγ-activated primary cultures of human brain and meningeal ECs. In autopsy brain specimens from patients with MS, we demonstrated an overexpression of endothelial CLMP in active MS lesions when compared with normal control brain tissue. Flow cytometry of human PBMCs demonstrated an increased frequency of CLMP+ B lymphocytes and monocytes in patients with MS, when compared with that in healthy controls. The use of a blocking antibody against CLMP reduced the migration of immune cells across the human brain and meningeal ECs in vitro. Finally, we found CLMP+ immune cell infiltrates in the perivascular area of parenchymal lesions and in the meninges of patients with MS. Discussion Collectively, our data demonstrate that CLMP is an adhesion molecule used by immune cells to access the CNS during neuroinflammatory disorders such as MS. CLMP could represent a target for a new treatment of neuroinflammatory conditions.
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Affiliation(s)
- Antoine Philippe Fournier
- From the Neuroimmunology Research Laboratory (A.P.F., S.Z., M.C., E.P., O.T., J.I.A., H.K., L.B., S.L., B., W.K., F.T., P.D., C.L., N.A., M.D.,P.D.A.P.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM); Department of Neurosciences (A.P.F., S.Z., M.C., E.P., F.T., C.L., N.A., M.D.,P.D.A.P.), Faculty of Medicine, Université de Montréal; Department of Microbiology (H.K.), Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal; Multiple Sclerosis Clinic (B., P.D., M.G., C.L., N.A., M.D.,P.D.A.P.), Division of Neurology, Centre Hospitalier de l'Université de Montréal (CHUM); Division of Neurosurgery (A.B., R.M.), Université de Montréal & CHUM; and Department of Pathology (R.C.), Université de Montréal & CHUM, Quebec, Canada
| | - Stephanie Zandee
- From the Neuroimmunology Research Laboratory (A.P.F., S.Z., M.C., E.P., O.T., J.I.A., H.K., L.B., S.L., B., W.K., F.T., P.D., C.L., N.A., M.D.,P.D.A.P.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM); Department of Neurosciences (A.P.F., S.Z., M.C., E.P., F.T., C.L., N.A., M.D.,P.D.A.P.), Faculty of Medicine, Université de Montréal; Department of Microbiology (H.K.), Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal; Multiple Sclerosis Clinic (B., P.D., M.G., C.L., N.A., M.D.,P.D.A.P.), Division of Neurology, Centre Hospitalier de l'Université de Montréal (CHUM); Division of Neurosurgery (A.B., R.M.), Université de Montréal & CHUM; and Department of Pathology (R.C.), Université de Montréal & CHUM, Quebec, Canada
| | - Marc Charabati
- From the Neuroimmunology Research Laboratory (A.P.F., S.Z., M.C., E.P., O.T., J.I.A., H.K., L.B., S.L., B., W.K., F.T., P.D., C.L., N.A., M.D.,P.D.A.P.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM); Department of Neurosciences (A.P.F., S.Z., M.C., E.P., F.T., C.L., N.A., M.D.,P.D.A.P.), Faculty of Medicine, Université de Montréal; Department of Microbiology (H.K.), Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal; Multiple Sclerosis Clinic (B., P.D., M.G., C.L., N.A., M.D.,P.D.A.P.), Division of Neurology, Centre Hospitalier de l'Université de Montréal (CHUM); Division of Neurosurgery (A.B., R.M.), Université de Montréal & CHUM; and Department of Pathology (R.C.), Université de Montréal & CHUM, Quebec, Canada
| | - Evelyn Peelen
- From the Neuroimmunology Research Laboratory (A.P.F., S.Z., M.C., E.P., O.T., J.I.A., H.K., L.B., S.L., B., W.K., F.T., P.D., C.L., N.A., M.D.,P.D.A.P.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM); Department of Neurosciences (A.P.F., S.Z., M.C., E.P., F.T., C.L., N.A., M.D.,P.D.A.P.), Faculty of Medicine, Université de Montréal; Department of Microbiology (H.K.), Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal; Multiple Sclerosis Clinic (B., P.D., M.G., C.L., N.A., M.D.,P.D.A.P.), Division of Neurology, Centre Hospitalier de l'Université de Montréal (CHUM); Division of Neurosurgery (A.B., R.M.), Université de Montréal & CHUM; and Department of Pathology (R.C.), Université de Montréal & CHUM, Quebec, Canada
| | - Olivier Tastet
- From the Neuroimmunology Research Laboratory (A.P.F., S.Z., M.C., E.P., O.T., J.I.A., H.K., L.B., S.L., B., W.K., F.T., P.D., C.L., N.A., M.D.,P.D.A.P.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM); Department of Neurosciences (A.P.F., S.Z., M.C., E.P., F.T., C.L., N.A., M.D.,P.D.A.P.), Faculty of Medicine, Université de Montréal; Department of Microbiology (H.K.), Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal; Multiple Sclerosis Clinic (B., P.D., M.G., C.L., N.A., M.D.,P.D.A.P.), Division of Neurology, Centre Hospitalier de l'Université de Montréal (CHUM); Division of Neurosurgery (A.B., R.M.), Université de Montréal & CHUM; and Department of Pathology (R.C.), Université de Montréal & CHUM, Quebec, Canada
| | - Jorge Ivan Alvarez
- From the Neuroimmunology Research Laboratory (A.P.F., S.Z., M.C., E.P., O.T., J.I.A., H.K., L.B., S.L., B., W.K., F.T., P.D., C.L., N.A., M.D.,P.D.A.P.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM); Department of Neurosciences (A.P.F., S.Z., M.C., E.P., F.T., C.L., N.A., M.D.,P.D.A.P.), Faculty of Medicine, Université de Montréal; Department of Microbiology (H.K.), Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal; Multiple Sclerosis Clinic (B., P.D., M.G., C.L., N.A., M.D.,P.D.A.P.), Division of Neurology, Centre Hospitalier de l'Université de Montréal (CHUM); Division of Neurosurgery (A.B., R.M.), Université de Montréal & CHUM; and Department of Pathology (R.C.), Université de Montréal & CHUM, Quebec, Canada
| | - Hania Kebir
- From the Neuroimmunology Research Laboratory (A.P.F., S.Z., M.C., E.P., O.T., J.I.A., H.K., L.B., S.L., B., W.K., F.T., P.D., C.L., N.A., M.D.,P.D.A.P.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM); Department of Neurosciences (A.P.F., S.Z., M.C., E.P., F.T., C.L., N.A., M.D.,P.D.A.P.), Faculty of Medicine, Université de Montréal; Department of Microbiology (H.K.), Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal; Multiple Sclerosis Clinic (B., P.D., M.G., C.L., N.A., M.D.,P.D.A.P.), Division of Neurology, Centre Hospitalier de l'Université de Montréal (CHUM); Division of Neurosurgery (A.B., R.M.), Université de Montréal & CHUM; and Department of Pathology (R.C.), Université de Montréal & CHUM, Quebec, Canada
| | - Lyne Bourbonnière
- From the Neuroimmunology Research Laboratory (A.P.F., S.Z., M.C., E.P., O.T., J.I.A., H.K., L.B., S.L., B., W.K., F.T., P.D., C.L., N.A., M.D.,P.D.A.P.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM); Department of Neurosciences (A.P.F., S.Z., M.C., E.P., F.T., C.L., N.A., M.D.,P.D.A.P.), Faculty of Medicine, Université de Montréal; Department of Microbiology (H.K.), Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal; Multiple Sclerosis Clinic (B., P.D., M.G., C.L., N.A., M.D.,P.D.A.P.), Division of Neurology, Centre Hospitalier de l'Université de Montréal (CHUM); Division of Neurosurgery (A.B., R.M.), Université de Montréal & CHUM; and Department of Pathology (R.C.), Université de Montréal & CHUM, Quebec, Canada
| | - Sandra Larouche
- From the Neuroimmunology Research Laboratory (A.P.F., S.Z., M.C., E.P., O.T., J.I.A., H.K., L.B., S.L., B., W.K., F.T., P.D., C.L., N.A., M.D.,P.D.A.P.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM); Department of Neurosciences (A.P.F., S.Z., M.C., E.P., F.T., C.L., N.A., M.D.,P.D.A.P.), Faculty of Medicine, Université de Montréal; Department of Microbiology (H.K.), Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal; Multiple Sclerosis Clinic (B., P.D., M.G., C.L., N.A., M.D.,P.D.A.P.), Division of Neurology, Centre Hospitalier de l'Université de Montréal (CHUM); Division of Neurosurgery (A.B., R.M.), Université de Montréal & CHUM; and Department of Pathology (R.C.), Université de Montréal & CHUM, Quebec, Canada
| | - Boaz Lahav
- From the Neuroimmunology Research Laboratory (A.P.F., S.Z., M.C., E.P., O.T., J.I.A., H.K., L.B., S.L., B., W.K., F.T., P.D., C.L., N.A., M.D.,P.D.A.P.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM); Department of Neurosciences (A.P.F., S.Z., M.C., E.P., F.T., C.L., N.A., M.D.,P.D.A.P.), Faculty of Medicine, Université de Montréal; Department of Microbiology (H.K.), Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal; Multiple Sclerosis Clinic (B., P.D., M.G., C.L., N.A., M.D.,P.D.A.P.), Division of Neurology, Centre Hospitalier de l'Université de Montréal (CHUM); Division of Neurosurgery (A.B., R.M.), Université de Montréal & CHUM; and Department of Pathology (R.C.), Université de Montréal & CHUM, Quebec, Canada
| | - Wendy Klement
- From the Neuroimmunology Research Laboratory (A.P.F., S.Z., M.C., E.P., O.T., J.I.A., H.K., L.B., S.L., B., W.K., F.T., P.D., C.L., N.A., M.D.,P.D.A.P.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM); Department of Neurosciences (A.P.F., S.Z., M.C., E.P., F.T., C.L., N.A., M.D.,P.D.A.P.), Faculty of Medicine, Université de Montréal; Department of Microbiology (H.K.), Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal; Multiple Sclerosis Clinic (B., P.D., M.G., C.L., N.A., M.D.,P.D.A.P.), Division of Neurology, Centre Hospitalier de l'Université de Montréal (CHUM); Division of Neurosurgery (A.B., R.M.), Université de Montréal & CHUM; and Department of Pathology (R.C.), Université de Montréal & CHUM, Quebec, Canada
| | - Fiona Tea
- From the Neuroimmunology Research Laboratory (A.P.F., S.Z., M.C., E.P., O.T., J.I.A., H.K., L.B., S.L., B., W.K., F.T., P.D., C.L., N.A., M.D.,P.D.A.P.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM); Department of Neurosciences (A.P.F., S.Z., M.C., E.P., F.T., C.L., N.A., M.D.,P.D.A.P.), Faculty of Medicine, Université de Montréal; Department of Microbiology (H.K.), Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal; Multiple Sclerosis Clinic (B., P.D., M.G., C.L., N.A., M.D.,P.D.A.P.), Division of Neurology, Centre Hospitalier de l'Université de Montréal (CHUM); Division of Neurosurgery (A.B., R.M.), Université de Montréal & CHUM; and Department of Pathology (R.C.), Université de Montréal & CHUM, Quebec, Canada
| | - Alain Bouthillier
- From the Neuroimmunology Research Laboratory (A.P.F., S.Z., M.C., E.P., O.T., J.I.A., H.K., L.B., S.L., B., W.K., F.T., P.D., C.L., N.A., M.D.,P.D.A.P.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM); Department of Neurosciences (A.P.F., S.Z., M.C., E.P., F.T., C.L., N.A., M.D.,P.D.A.P.), Faculty of Medicine, Université de Montréal; Department of Microbiology (H.K.), Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal; Multiple Sclerosis Clinic (B., P.D., M.G., C.L., N.A., M.D.,P.D.A.P.), Division of Neurology, Centre Hospitalier de l'Université de Montréal (CHUM); Division of Neurosurgery (A.B., R.M.), Université de Montréal & CHUM; and Department of Pathology (R.C.), Université de Montréal & CHUM, Quebec, Canada
| | - Robert Moumdjian
- From the Neuroimmunology Research Laboratory (A.P.F., S.Z., M.C., E.P., O.T., J.I.A., H.K., L.B., S.L., B., W.K., F.T., P.D., C.L., N.A., M.D.,P.D.A.P.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM); Department of Neurosciences (A.P.F., S.Z., M.C., E.P., F.T., C.L., N.A., M.D.,P.D.A.P.), Faculty of Medicine, Université de Montréal; Department of Microbiology (H.K.), Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal; Multiple Sclerosis Clinic (B., P.D., M.G., C.L., N.A., M.D.,P.D.A.P.), Division of Neurology, Centre Hospitalier de l'Université de Montréal (CHUM); Division of Neurosurgery (A.B., R.M.), Université de Montréal & CHUM; and Department of Pathology (R.C.), Université de Montréal & CHUM, Quebec, Canada
| | - Romain Cayrol
- From the Neuroimmunology Research Laboratory (A.P.F., S.Z., M.C., E.P., O.T., J.I.A., H.K., L.B., S.L., B., W.K., F.T., P.D., C.L., N.A., M.D.,P.D.A.P.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM); Department of Neurosciences (A.P.F., S.Z., M.C., E.P., F.T., C.L., N.A., M.D.,P.D.A.P.), Faculty of Medicine, Université de Montréal; Department of Microbiology (H.K.), Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal; Multiple Sclerosis Clinic (B., P.D., M.G., C.L., N.A., M.D.,P.D.A.P.), Division of Neurology, Centre Hospitalier de l'Université de Montréal (CHUM); Division of Neurosurgery (A.B., R.M.), Université de Montréal & CHUM; and Department of Pathology (R.C.), Université de Montréal & CHUM, Quebec, Canada
| | - Pierre Duquette
- From the Neuroimmunology Research Laboratory (A.P.F., S.Z., M.C., E.P., O.T., J.I.A., H.K., L.B., S.L., B., W.K., F.T., P.D., C.L., N.A., M.D.,P.D.A.P.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM); Department of Neurosciences (A.P.F., S.Z., M.C., E.P., F.T., C.L., N.A., M.D.,P.D.A.P.), Faculty of Medicine, Université de Montréal; Department of Microbiology (H.K.), Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal; Multiple Sclerosis Clinic (B., P.D., M.G., C.L., N.A., M.D.,P.D.A.P.), Division of Neurology, Centre Hospitalier de l'Université de Montréal (CHUM); Division of Neurosurgery (A.B., R.M.), Université de Montréal & CHUM; and Department of Pathology (R.C.), Université de Montréal & CHUM, Quebec, Canada
| | - Marc Girard
- From the Neuroimmunology Research Laboratory (A.P.F., S.Z., M.C., E.P., O.T., J.I.A., H.K., L.B., S.L., B., W.K., F.T., P.D., C.L., N.A., M.D.,P.D.A.P.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM); Department of Neurosciences (A.P.F., S.Z., M.C., E.P., F.T., C.L., N.A., M.D.,P.D.A.P.), Faculty of Medicine, Université de Montréal; Department of Microbiology (H.K.), Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal; Multiple Sclerosis Clinic (B., P.D., M.G., C.L., N.A., M.D.,P.D.A.P.), Division of Neurology, Centre Hospitalier de l'Université de Montréal (CHUM); Division of Neurosurgery (A.B., R.M.), Université de Montréal & CHUM; and Department of Pathology (R.C.), Université de Montréal & CHUM, Quebec, Canada
| | - Catherine Larochelle
- From the Neuroimmunology Research Laboratory (A.P.F., S.Z., M.C., E.P., O.T., J.I.A., H.K., L.B., S.L., B., W.K., F.T., P.D., C.L., N.A., M.D.,P.D.A.P.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM); Department of Neurosciences (A.P.F., S.Z., M.C., E.P., F.T., C.L., N.A., M.D.,P.D.A.P.), Faculty of Medicine, Université de Montréal; Department of Microbiology (H.K.), Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal; Multiple Sclerosis Clinic (B., P.D., M.G., C.L., N.A., M.D.,P.D.A.P.), Division of Neurology, Centre Hospitalier de l'Université de Montréal (CHUM); Division of Neurosurgery (A.B., R.M.), Université de Montréal & CHUM; and Department of Pathology (R.C.), Université de Montréal & CHUM, Quebec, Canada
| | - Nathalie Arbour
- From the Neuroimmunology Research Laboratory (A.P.F., S.Z., M.C., E.P., O.T., J.I.A., H.K., L.B., S.L., B., W.K., F.T., P.D., C.L., N.A., M.D.,P.D.A.P.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM); Department of Neurosciences (A.P.F., S.Z., M.C., E.P., F.T., C.L., N.A., M.D.,P.D.A.P.), Faculty of Medicine, Université de Montréal; Department of Microbiology (H.K.), Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal; Multiple Sclerosis Clinic (B., P.D., M.G., C.L., N.A., M.D.,P.D.A.P.), Division of Neurology, Centre Hospitalier de l'Université de Montréal (CHUM); Division of Neurosurgery (A.B., R.M.), Université de Montréal & CHUM; and Department of Pathology (R.C.), Université de Montréal & CHUM, Quebec, Canada
| | - Alexandre Prat
- From the Neuroimmunology Research Laboratory (A.P.F., S.Z., M.C., E.P., O.T., J.I.A., H.K., L.B., S.L., B., W.K., F.T., P.D., C.L., N.A., M.D.,P.D.A.P.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM); Department of Neurosciences (A.P.F., S.Z., M.C., E.P., F.T., C.L., N.A., M.D.,P.D.A.P.), Faculty of Medicine, Université de Montréal; Department of Microbiology (H.K.), Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal; Multiple Sclerosis Clinic (B., P.D., M.G., C.L., N.A., M.D.,P.D.A.P.), Division of Neurology, Centre Hospitalier de l'Université de Montréal (CHUM); Division of Neurosurgery (A.B., R.M.), Université de Montréal & CHUM; and Department of Pathology (R.C.), Université de Montréal & CHUM, Quebec, Canada.
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5
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Vehreschild MJGT, Atanasov P, Yurko K, Oancea C, Popov G, Smesnoi V, Placinta G, Kohlhof H, Vitt D, Peelen E, Mihajlović J, Muehler AR. Safety and Efficacy of Vidofludimus Calcium in Patients Hospitalized with COVID-19: A Double-Blind, Randomized, Placebo-Controlled, Phase 2 Trial. Infect Dis Ther 2022; 11:2159-2176. [PMID: 36242741 PMCID: PMC9568890 DOI: 10.1007/s40121-022-00690-0] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 08/17/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction Vidofludimus calcium has shown anti-inflammatory effects in clinical trials of autoimmune diseases and recently demonstrated antiviral activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We performed a double-blind, randomized, placebo-controlled, phase 2 trial to evaluate the safety and efficacy of vidofludimus calcium in patients hospitalized for coronavirus disease 2019 (COVID-19) in Europe and the USA. Methods Patients aged 18 years or older who positive for COVID-19 were randomized (1:1) to receive placebo or 45 mg vidofludimus calcium for 14 days with both groups receiving standard-of-care treatment. The primary endpoint was the need for invasive ventilation after 28 days (ClinicalTrials.gov NCT04379271; EudraCT 2020-001264-28). Results Between June 12, 2020 and December 10, 2020, a total of 223 were randomized to receive either placebo (n = 112) or vidofludimus calcium (n = 111); three patients withdrew consent and were not treated. Eight (9%) patients in the placebo group and 12 (11%) patients in the vidofludimus calcium group needed invasive ventilation during the 28-day study period, which was lower than the assumed rate of 40%. Time to clinical improvement was shorter by approximately 1 day in the vidofludimus calcium group (15.0 days [90% CI 14.8–15.9]) compared to the placebo group (15.9 days [90% CI 14.9–19.9]). This effect was greatest in patients who initiated therapy within 9 days of symptom onset (3.8 days shorter in the vidofludimus calcium group). Higher trough concentrations of vidofludimus calcium were associated with quicker time to clinical recovery. The rate and timing of appearance of anti-SARS-CoV-2 antibodies were not different between groups. Serious adverse events occurred in 4 (4%) patients in the placebo group and 2 (2%) patients in the vidofludimus calcium group; treatment-emergent adverse events of increased severity related to COVID-19 occurred in 13 (12%) patients in the placebo group and 8 (7%) patients in the vidofludimus calcium group. Overall mortality was low (2%). Conclusions These findings support vidofludimus calcium being safe and well tolerated in patients with COVID-19. Supplementary Information The online version contains supplementary material available at 10.1007/s40121-022-00690-0.
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Affiliation(s)
- Maria J G T Vehreschild
- Department of Internal Medicine, Infectious Diseases, Medizinische Klinik II, University Hospital Frankfurt, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
| | - Petar Atanasov
- Clinic of Internal Diseases, UMHATEM "N.I.Pirogov" EAD, 21 Gen. Totleben Blvd., 1606, Sofia, Bulgaria
| | - Kateryna Yurko
- Infectious Diseases, Kharkiv National Medical University, 4 Nauki Avenue, Kharkiv, 61022, Ukraine
| | - Cristian Oancea
- University of Medicine and Pharmacy "Victor Babeş" Timişoara, Gh. Adam Street No 13, 300173, Timişoara, Romania
| | - Georgi Popov
- Clinic of Infectious Disease, Military Medical Academy-Sofia, 3, "St. Georgi Sofiiski" Str., 1606, Sofia, Bulgaria
| | - Valentina Smesnoi
- PMSI Clinical Hospital of Infectious Diseases "Toma Ciorba", Section 3, Bulevardul Ştefan Cel Mare şi Sfânt, Nr 163, 2004, Chişinău, Moldova
| | - Gheorghe Placinta
- PMSI Clinical Hospital of Infectious Diseases "Toma Ciorba", Section 4, Bulevardul Ştefan Cel Mare şi Sfânt, nr 163, 2004, Chişinău, Moldova
| | - Hella Kohlhof
- Immunic AG, Lochhamer Schlag 21, 82166, Gräfelfing, Germany
| | - Daniel Vitt
- Immunic AG, Lochhamer Schlag 21, 82166, Gräfelfing, Germany
| | - Evelyn Peelen
- Immunic AG, Lochhamer Schlag 21, 82166, Gräfelfing, Germany
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6
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Stegmann KM, Dickmanns A, Heinen N, Blaurock C, Karrasch T, Breithaupt A, Klopfleisch R, Uhlig N, Eberlein V, Issmail L, Herrmann ST, Schreieck A, Peelen E, Kohlhof H, Sadeghi B, Riek A, Speakman JR, Groß U, Görlich D, Vitt D, Müller T, Grunwald T, Pfaender S, Balkema-Buschmann A, Dobbelstein M. Inhibitors of dihydroorotate dehydrogenase cooperate with Molnupiravir and N4-hydroxycytidine to suppress SARS-CoV-2 replication. iScience 2022; 25:104293. [PMID: 35492218 PMCID: PMC9035612 DOI: 10.1016/j.isci.2022.104293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 01/24/2022] [Revised: 03/29/2022] [Accepted: 04/20/2022] [Indexed: 12/15/2022] Open
Abstract
The nucleoside analog N4-hydroxycytidine (NHC) is the active metabolite of the prodrug molnupiravir, which has been approved for the treatment of COVID-19. SARS-CoV-2 incorporates NHC into its RNA, resulting in defective virus genomes. Likewise, inhibitors of dihydroorotate dehydrogenase (DHODH) reduce virus yield upon infection, by suppressing the cellular synthesis of pyrimidines. Here, we show that NHC and DHODH inhibitors strongly synergize in the inhibition of SARS-CoV-2 replication in vitro. We propose that the lack of available pyrimidine nucleotides upon DHODH inhibition increases the incorporation of NHC into nascent viral RNA. This concept is supported by the rescue of virus replication upon addition of pyrimidine nucleosides to the media. DHODH inhibitors increased the antiviral efficiency of molnupiravir not only in organoids of human lung, but also in Syrian Gold hamsters and in K18-hACE2 mice. Combining molnupiravir with DHODH inhibitors may thus improve available therapy options for COVID-19. Molnupiravir and DHODH inhibitors are approved drugs, facilitating clinical testing The combination may allow lower drug doses to decrease possible toxic effects Inhibitors of nucleotide biosynthesis may boost antiviral nucleoside analogs
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Affiliation(s)
- Kim M Stegmann
- Institute of Molecular Oncology, Göttingen Center of Molecular Biosciences (GZMB), University Medical Center Göttingen, Justus von Liebig Weg 11, 37077 Göttingen, Germany
| | - Antje Dickmanns
- Institute of Molecular Oncology, Göttingen Center of Molecular Biosciences (GZMB), University Medical Center Göttingen, Justus von Liebig Weg 11, 37077 Göttingen, Germany
| | - Natalie Heinen
- Department of Molecular and Medical Virology, Ruhr University Bochum, Germany
| | - Claudia Blaurock
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald - Insel Riems, Germany
| | - Tim Karrasch
- Institute of Molecular Oncology, Göttingen Center of Molecular Biosciences (GZMB), University Medical Center Göttingen, Justus von Liebig Weg 11, 37077 Göttingen, Germany
| | - Angele Breithaupt
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald - Insel Riems, Germany
| | | | - Nadja Uhlig
- Fraunhofer Institute for Cell Therapy and Immunology IZI, Leipzig, Germany
| | - Valentina Eberlein
- Fraunhofer Institute for Cell Therapy and Immunology IZI, Leipzig, Germany
| | - Leila Issmail
- Fraunhofer Institute for Cell Therapy and Immunology IZI, Leipzig, Germany
| | - Simon T Herrmann
- Department of Molecular Biochemistry, Ruhr University Bochum, Germany
| | | | | | | | - Balal Sadeghi
- Friedrich-Loeffler-Institut, Institute of Novel and Emerging Infectious Diseases, Greifswald - Insel Riems, Germany
| | - Alexander Riek
- Friedrich-Loeffler-Institut, Institute of Animal Welfare and Animal Husbandry, Celle, Germany
| | - John R Speakman
- Institute of Biological and Environmental Sciences, University of Aberdeen, UK
| | - Uwe Groß
- Institute of Medical Microbiology and Virology, Göttingen Center of Molecular Biosciences (GZMB), University Medical Center Göttingen, Germany
| | - Dirk Görlich
- Max Planck Institute for Biophysical Chemistry, Göttingen, Germany
| | | | - Thorsten Müller
- Department of Molecular Biochemistry, Ruhr University Bochum, Germany.,Institute of Psychiatric Phenomics and Genomics (IPPG), Organoid laboratory, University Hospital, LMU Munich, Germany
| | - Thomas Grunwald
- Fraunhofer Institute for Cell Therapy and Immunology IZI, Leipzig, Germany
| | - Stephanie Pfaender
- Department of Molecular and Medical Virology, Ruhr University Bochum, Germany
| | - Anne Balkema-Buschmann
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald - Insel Riems, Germany
| | - Matthias Dobbelstein
- Institute of Molecular Oncology, Göttingen Center of Molecular Biosciences (GZMB), University Medical Center Göttingen, Justus von Liebig Weg 11, 37077 Göttingen, Germany
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7
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Charabati M, Grasmuck C, Ghannam S, Bourbonnière L, Fournier AP, Lécuyer MA, Tastet O, Kebir H, Rébillard RM, Hoornaert C, Gowing E, Larouche S, Fortin O, Pittet C, Filali-Mouhim A, Lahav B, Moumdjian R, Bouthillier A, Girard M, Duquette P, Cayrol R, Peelen E, Quintana FJ, Antel JP, Flügel A, Larochelle C, Arbour N, Zandee S, Prat A. DICAM promotes T H17 lymphocyte trafficking across the blood-brain barrier during autoimmune neuroinflammation. Sci Transl Med 2022; 14:eabj0473. [PMID: 34985970 DOI: 10.1126/scitranslmed.abj0473] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Marc Charabati
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada.,Department of Neurosciences, Faculty of Medicine, Université de Montréal, Montreal, Quebec H3T 1J4, Canada
| | - Camille Grasmuck
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada.,Department of Neurosciences, Faculty of Medicine, Université de Montréal, Montreal, Quebec H3T 1J4, Canada
| | - Soufiane Ghannam
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada.,Department of Neurosciences, Faculty of Medicine, Université de Montréal, Montreal, Quebec H3T 1J4, Canada
| | - Lyne Bourbonnière
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada
| | - Antoine P Fournier
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada.,Department of Neurosciences, Faculty of Medicine, Université de Montréal, Montreal, Quebec H3T 1J4, Canada
| | - Marc-André Lécuyer
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada.,Department of Microbiology, Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal, Montreal, Quebec H3T 1J4, Canada.,Institute for Neuroimmunology and Multiple Sclerosis Research, University Medical Center Göttingen, Göttingen D-37073, Germany
| | - Olivier Tastet
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada
| | - Hania Kebir
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada.,Department of Microbiology, Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal, Montreal, Quebec H3T 1J4, Canada
| | - Rose-Marie Rébillard
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada.,Department of Neurosciences, Faculty of Medicine, Université de Montréal, Montreal, Quebec H3T 1J4, Canada
| | - Chloé Hoornaert
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada.,Department of Neurosciences, Faculty of Medicine, Université de Montréal, Montreal, Quebec H3T 1J4, Canada
| | - Elizabeth Gowing
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada.,Department of Neurosciences, Faculty of Medicine, Université de Montréal, Montreal, Quebec H3T 1J4, Canada
| | - Sandra Larouche
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada
| | - Olivier Fortin
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada
| | - Camille Pittet
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada
| | - Ali Filali-Mouhim
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada
| | - Boaz Lahav
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada.,Multiple Sclerosis Clinic, Division of Neurology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec H2L 4M1, Canada
| | - Robert Moumdjian
- Division of Neurosurgery, Université de Montréal and CHUM, Montreal, Quebec H2L 4M1, Canada
| | - Alain Bouthillier
- Division of Neurosurgery, Université de Montréal and CHUM, Montreal, Quebec H2L 4M1, Canada
| | - Marc Girard
- Multiple Sclerosis Clinic, Division of Neurology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec H2L 4M1, Canada
| | - Pierre Duquette
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada.,Multiple Sclerosis Clinic, Division of Neurology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec H2L 4M1, Canada
| | - Romain Cayrol
- Department of Pathology, Université de Montréal and CHUM, Montreal, Quebec H2L 4M1, Canada
| | - Evelyn Peelen
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada.,Department of Neurosciences, Faculty of Medicine, Université de Montréal, Montreal, Quebec H3T 1J4, Canada
| | - Francisco J Quintana
- Ann Romney Carter for Neurologic Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.,Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Jack P Antel
- Neuroimmunology Unit, Montreal Neurological Institute and Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec H3A 2B4, Canada
| | - Alexander Flügel
- Institute for Neuroimmunology and Multiple Sclerosis Research, University Medical Center Göttingen, Göttingen D-37073, Germany
| | - Catherine Larochelle
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada.,Department of Neurosciences, Faculty of Medicine, Université de Montréal, Montreal, Quebec H3T 1J4, Canada.,Multiple Sclerosis Clinic, Division of Neurology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec H2L 4M1, Canada
| | - Nathalie Arbour
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada.,Department of Neurosciences, Faculty of Medicine, Université de Montréal, Montreal, Quebec H3T 1J4, Canada
| | - Stephanie Zandee
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada.,Department of Neurosciences, Faculty of Medicine, Université de Montréal, Montreal, Quebec H3T 1J4, Canada
| | - Alexandre Prat
- Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec H2X 0A9, Canada.,Department of Neurosciences, Faculty of Medicine, Université de Montréal, Montreal, Quebec H3T 1J4, Canada.,Multiple Sclerosis Clinic, Division of Neurology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec H2L 4M1, Canada
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8
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Muehler A, Slizgi JR, Kohlhof H, Groeppel M, Peelen E, Vitt D. Clinical relevance of intestinal barrier dysfunction in common gastrointestinal diseases. World J Gastrointest Pathophysiol 2020; 11:114-130. [PMID: 33362939 PMCID: PMC7739114 DOI: 10.4291/wjgp.v11.i6.114] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 10/07/2020] [Accepted: 10/27/2020] [Indexed: 02/06/2023] Open
Abstract
The intestinal barrier is a complex and well-controlled physiological construct designed to separate luminal contents from the bowel wall. In this review, we focus on the intestinal barrier’s relationship with the host’s immune system interaction and the external environment, specifically the microbiome. The bowel allows the host to obtain nutrients vital to survival while protecting itself from harmful pathogens, luminal antigens, or other pro-inflammatory factors. Control over barrier function and the luminal milieu is maintained at the biochemical, cellular, and immunological level. However, disruption to this highly regulated environment can cause disease. Recent advances to the field have progressed the mechanistic understanding of compromised intestinal barrier function in the context of gastrointestinal pathology. There are numerous examples where bowel barrier dysfunction and the resulting interaction between the microbiome and the immune system has disease-triggering consequences. The purpose of this review is to summarize the clinical relevance of intestinal barrier dysfunction in common gastrointestinal and related diseases. This may help highlight the importance of restoring barrier function as a therapeutic mechanism of action in gastrointestinal pathology.
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9
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Michel L, Grasmuck C, Charabati M, Lécuyer MA, Zandee S, Dhaeze T, Alvarez JI, Li R, Larouche S, Bourbonnière L, Moumdjian R, Bouthillier A, Lahav B, Duquette P, Bar-Or A, Gommerman JL, Peelen E, Prat A. Activated leukocyte cell adhesion molecule regulates B lymphocyte migration across central nervous system barriers. Sci Transl Med 2020; 11:11/518/eaaw0475. [PMID: 31723036 DOI: 10.1126/scitranslmed.aaw0475] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 07/10/2019] [Accepted: 10/21/2019] [Indexed: 12/19/2022]
Abstract
The presence of B lymphocyte-associated oligoclonal immunoglobulins in the cerebrospinal fluid is a classic hallmark of multiple sclerosis (MS). The clinical efficacy of anti-CD20 therapies supports a major role for B lymphocytes in MS development. Although activated oligoclonal populations of pathogenic B lymphocytes are able to traffic between the peripheral circulation and the central nervous system (CNS) in patients with MS, molecular players involved in this migration have not yet been elucidated. In this study, we demonstrated that activated leukocyte cell adhesion molecule (ALCAM/CD166) identifies subsets of proinflammatory B lymphocytes and drives their transmigration across different CNS barriers in mouse and human. We also showcased that blocking ALCAM alleviated disease severity in animals affected by a B cell-dependent form of experimental autoimmune encephalomyelitis. Last, we determined that the proportion of ALCAM+ B lymphocytes was increased in the peripheral blood and within brain lesions of patients with MS. Our findings indicate that restricting access to the CNS by targeting ALCAM on pathogenic B lymphocytes might represent a promising strategy for the development of next-generation B lymphocyte-targeting therapies for the treatment of MS.
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Affiliation(s)
- Laure Michel
- Department of Neuroscience, Faculty of Medicine, Université de Montréal, Montréal, QC Canada.,Neuroimmunology Unit, Centre de recherche du CHUM (CRCHUM), Montréal, QC H2X 0A9, Canada
| | - Camille Grasmuck
- Department of Neuroscience, Faculty of Medicine, Université de Montréal, Montréal, QC Canada.,Neuroimmunology Unit, Centre de recherche du CHUM (CRCHUM), Montréal, QC H2X 0A9, Canada
| | - Marc Charabati
- Department of Neuroscience, Faculty of Medicine, Université de Montréal, Montréal, QC Canada.,Neuroimmunology Unit, Centre de recherche du CHUM (CRCHUM), Montréal, QC H2X 0A9, Canada
| | - Marc-André Lécuyer
- Department of Neuroscience, Faculty of Medicine, Université de Montréal, Montréal, QC Canada.,Neuroimmunology Unit, Centre de recherche du CHUM (CRCHUM), Montréal, QC H2X 0A9, Canada
| | - Stephanie Zandee
- Department of Neuroscience, Faculty of Medicine, Université de Montréal, Montréal, QC Canada.,Neuroimmunology Unit, Centre de recherche du CHUM (CRCHUM), Montréal, QC H2X 0A9, Canada
| | - Tessa Dhaeze
- Department of Neuroscience, Faculty of Medicine, Université de Montréal, Montréal, QC Canada.,Neuroimmunology Unit, Centre de recherche du CHUM (CRCHUM), Montréal, QC H2X 0A9, Canada
| | - Jorge I Alvarez
- Department of Neuroscience, Faculty of Medicine, Université de Montréal, Montréal, QC Canada.,Neuroimmunology Unit, Centre de recherche du CHUM (CRCHUM), Montréal, QC H2X 0A9, Canada
| | - Rui Li
- Center for Neuroinflammation and Experimental Therapeutics and Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Sandra Larouche
- Department of Neuroscience, Faculty of Medicine, Université de Montréal, Montréal, QC Canada.,Neuroimmunology Unit, Centre de recherche du CHUM (CRCHUM), Montréal, QC H2X 0A9, Canada
| | - Lyne Bourbonnière
- Department of Neuroscience, Faculty of Medicine, Université de Montréal, Montréal, QC Canada.,Neuroimmunology Unit, Centre de recherche du CHUM (CRCHUM), Montréal, QC H2X 0A9, Canada
| | | | | | - Boaz Lahav
- Department of Neuroscience, Faculty of Medicine, Université de Montréal, Montréal, QC Canada.,Neuroimmunology Unit, Centre de recherche du CHUM (CRCHUM), Montréal, QC H2X 0A9, Canada
| | - Pierre Duquette
- Department of Neuroscience, Faculty of Medicine, Université de Montréal, Montréal, QC Canada.,Neuroimmunology Unit, Centre de recherche du CHUM (CRCHUM), Montréal, QC H2X 0A9, Canada
| | - Amit Bar-Or
- Center for Neuroinflammation and Experimental Therapeutics and Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | | | - Evelyn Peelen
- Department of Neuroscience, Faculty of Medicine, Université de Montréal, Montréal, QC Canada.,Neuroimmunology Unit, Centre de recherche du CHUM (CRCHUM), Montréal, QC H2X 0A9, Canada
| | - Alexandre Prat
- Department of Neuroscience, Faculty of Medicine, Université de Montréal, Montréal, QC Canada. .,Neuroimmunology Unit, Centre de recherche du CHUM (CRCHUM), Montréal, QC H2X 0A9, Canada
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10
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Broux B, Zandee S, Gowing E, Charabati M, Lécuyer MA, Tastet O, Hachehouche L, Bourbonnière L, Ouimet JP, Lemaitre F, Larouche S, Cayrol R, Bouthillier A, Moumdjian R, Lahav B, Poirier J, Duquette P, Arbour N, Peelen E, Prat A. Interleukin-26, preferentially produced by T H17 lymphocytes, regulates CNS barrier function. Neurol Neuroimmunol Neuroinflamm 2020; 7:7/6/e870. [PMID: 32788322 PMCID: PMC7428369 DOI: 10.1212/nxi.0000000000000870] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 07/13/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To investigate the involvement of interleukin (IL)-26 in neuroinflammatory processes in multiple sclerosis (MS), in particular in blood-brain barrier (BBB) integrity. METHODS Expression of IL-26 was measured in serum, CSF, in vitro differentiated T helper (TH) cell subsets, and postmortem brain tissue of patients with MS and controls by ELISA, quantitative PCR, and immunohistochemistry. Primary human and mouse BBB endothelial cells (ECs) were treated with IL-26 in vitro and assessed for BBB integrity. RNA sequencing was performed on IL-26-treated human BBB ECs. Myelin oligodendrocyte glycoprotein35-55 experimental autoimmune encephalomyelitis (EAE) mice were injected IP with IL-26. BBB leakage and immune cell infiltration were assessed in the CNS of these mice using immunohistochemistry and flow cytometry. RESULTS IL-26 expression was induced in TH lymphocytes by TH17-inducing cytokines and was upregulated in the blood and CSF of patients with MS. CD4+IL-26+ T lymphocytes were found in perivascular infiltrates in MS brain lesions, and both receptor chains for IL-26 (IL-10R2 and IL-20R1) were detected on BBB ECs in vitro and in situ. In contrast to IL-17 and IL-22, IL-26 promoted integrity and reduced permeability of BBB ECs in vitro and in vivo. In EAE, IL-26 reduced disease severity and proinflammatory lymphocyte infiltration into the CNS, while increasing infiltration of Tregs. CONCLUSIONS Our study demonstrates that although IL-26 is preferentially expressed by TH17 lymphocytes, it promotes BBB integrity in vitro and in vivo and is protective in chronic EAE, highlighting the functional diversity of cytokines produced by TH17 lymphocytes.
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Affiliation(s)
- Bieke Broux
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Stephanie Zandee
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Elizabeth Gowing
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Marc Charabati
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Marc-André Lécuyer
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Olivier Tastet
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Lamia Hachehouche
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Lyne Bourbonnière
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Jean-Philippe Ouimet
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Florent Lemaitre
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Sandra Larouche
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Romain Cayrol
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Alain Bouthillier
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Robert Moumdjian
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Boaz Lahav
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Josée Poirier
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Pierre Duquette
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Nathalie Arbour
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Evelyn Peelen
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada
| | - Alexandre Prat
- From the Neuroimmunology Unit and Multiple Sclerosis Clinic (B.B., S.Z., E.G., M.C., M.-A.L., O.T., L.H., L.B., J.-P.O., F.L., S.L., R.C., B.L., J.P., P.D., N.A., E.P., A.P.), The Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Department of Neuroscience, Faculty of Medicine, Université de Montréal, Canada; Hasselt University (B.B.), Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium; and Division of Neurosurgery (A.B., R.M.), Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Canada.
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11
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Häusler D, Torke S, Peelen E, Bertsch T, Djukic M, Nau R, Larochelle C, Zamvil SS, Brück W, Weber MS. High dose vitamin D exacerbates central nervous system autoimmunity by raising T-cell excitatory calcium. Brain 2020; 142:2737-2755. [PMID: 31302671 DOI: 10.1093/brain/awz190] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [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: 06/11/2018] [Revised: 04/08/2019] [Accepted: 05/03/2019] [Indexed: 01/12/2023] Open
Abstract
Poor vitamin D status is associated with a higher relapse rate and earlier disability in multiple sclerosis. Based on these associations, patients with multiple sclerosis are frequently supplemented with the vitamin D precursor cholecalciferol, although it is unclear whether this regimen is of therapeutic benefit. To model consequences of this common practice, mice were fed for more than 3 months with a low, medium or high dose of cholecalciferol, representative of vitamin D deficiency, modest and disproportionally high supplementation, respectively, in patients with multiple sclerosis. Compared to vitamin D-deprived mice, its moderate supplementation reduced the severity of subsequent experimental autoimmune encephalomyelitis, which was associated with an expansion of regulatory T cells. Direct exposure of murine or human T cells to vitamin D metabolites inhibited their activation. In contrast, mice with 25-(OH) vitamin D levels above 200 nmol/l developed fulminant experimental autoimmune encephalomyelitis with massive CNS infiltration of activated myeloid cells, Th1 and Th17 cells. When dissecting this unexpected outcome, we observed that high, but not medium dose vitamin D had caused mild hypercalcaemia, which rendered T cells more prone to pro-inflammatory activation. Exposing murine or human T cells to equivalent calcium concentrations in vitro enhanced its influx, triggering activation, upregulation of pro-inflammatory gene products and enhanced transmigration across a blood-brain barrier model. These findings suggest that vitamin D at moderate levels may exert a direct regulatory effect, while continuous high dose vitamin D treatment could trigger multiple sclerosis disease activity by raising mean levels of T-cell excitatory calcium.
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Affiliation(s)
- Darius Häusler
- Institute of Neuropathology, University Medical Center, Göttingen, Germany
| | - Sebastian Torke
- Institute of Neuropathology, University Medical Center, Göttingen, Germany
| | - Evelyn Peelen
- Department of Neurosciences, Centre de recherche de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada
| | - Thomas Bertsch
- Institute of Clinical Chemistry, Laboratory Medicine and Transfusion Medicine, General Hospital Nuremberg, Paracelsus Medical University, Nuremberg, Germany
| | - Marija Djukic
- Institute of Neuropathology, University Medical Center, Göttingen, Germany.,Department of Geriatrics, Evangelisches Krankenhaus Göttingen-Weende, Göttingen, Germany
| | - Roland Nau
- Institute of Neuropathology, University Medical Center, Göttingen, Germany.,Department of Geriatrics, Evangelisches Krankenhaus Göttingen-Weende, Göttingen, Germany
| | - Catherine Larochelle
- Department of Neurosciences, Centre de recherche de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada
| | - Scott S Zamvil
- Department of Neurology, University of California, San Francisco, CA, USA
| | - Wolfgang Brück
- Institute of Neuropathology, University Medical Center, Göttingen, Germany
| | - Martin S Weber
- Institute of Neuropathology, University Medical Center, Göttingen, Germany.,Department of Neurology, University Medical Center, Göttingen, Germany
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12
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Muehler A, Peelen E, Kohlhof H, Gröppel M, Vitt D. Vidofludimus calcium, a next generation DHODH inhibitor for the Treatment of relapsing-remitting multiple sclerosis. Mult Scler Relat Disord 2020; 43:102129. [PMID: 32428844 DOI: 10.1016/j.msard.2020.102129] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [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: 12/27/2019] [Revised: 04/10/2020] [Accepted: 04/12/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND Inhibition of dihydroorotate dehydrogenase (DHODH) is an established mechanism for the treatment of relapsing-remitting multiple sclerosis (RRMS). Currently approved treatments have several shortcomings. Consequently, new and effective treatments with improved safety and convenience profiles are sought after by patients. OBJECTIVE To explore the overall profile of vidofludimus for the treatment of RRMS. METHODS Preclinical investigations were done exploring the species-dependency of DHODH inhibition of vidofludimus. In addition, the preclinical efficacy in a rat experimental autoimmune encephalomyelitis (EAE) model and the inhibition of cytokine release from activated PBMC were investigated. Pharmacokinetic data were also obtained in a Phase 1 multiple ascending dose trial of the formulation IMU-838 (vidofludimus calcium). RESULTS It was shown that vidofludimus is 2.6 times more potent in inhibiting DHO oxidation by human DHODH compared to teriflunomide. Although both compounds increased cell apoptosis, vidofludimus was more efficacious in the inhibition of T-lymphocyte proliferation compared to teriflunomide. The same was also observed for the secretion of IL-17 and IFN-γ. Interestingly, the potency or vidofludimus to inhibit rat or mouse DHODH is 7.5 and 64.4 time lower than the for the human DHODH, respectively. The rat EAE study clearly exhibited a dose-dependent inhibition of cumulative disease scores by vidofludimus. In the multiple ascending dose Phase 1 clinical trial, the serum half-life of about 30 h provides a favorable profile for once daily dosing of IMU-838, with quick dosing to steady state through levels within 5 days and the ability to wash out drug quickly, if required. CONCLUSIONS The investigations highlighted that the desired selective immunomodulatory properties can be separated from general antiproliferative effects seen and related adverse events in first-generation DHODH inhibitors. Based on data obtained from a series of pre-clinical as well as phase 1 and phase 2 studies, IMU-838 is a promising next-generation candidate for the oral treatment of RRMS. However, this will need to be confirmed in the currently ongoing Phase 2 study in RRMS patients.
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Affiliation(s)
- Andreas Muehler
- Immunic AG, Am Klopferspitz 19, 82152 Planegg-Martinsried, Germany.
| | - Evelyn Peelen
- Immunic AG, Am Klopferspitz 19, 82152 Planegg-Martinsried, Germany
| | - Hella Kohlhof
- Immunic AG, Am Klopferspitz 19, 82152 Planegg-Martinsried, Germany
| | - Manfred Gröppel
- Immunic AG, Am Klopferspitz 19, 82152 Planegg-Martinsried, Germany
| | - Daniel Vitt
- Immunic AG, Am Klopferspitz 19, 82152 Planegg-Martinsried, Germany
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13
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Häusler D, Torke S, Peelen E, Bertsch T, Weber M, Heilmann M, Djukic M, Nau R, Larochelle C, Zamvil SS, Brück W, Weber MS. Reply: Neither human nor mouse is hypercalcaemic with 250 nmol/l 25-hydroxyvitamin D. Brain 2020; 143:e10. [PMID: 31848576 PMCID: PMC7009594 DOI: 10.1093/brain/awz389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Darius Häusler
- Institute of Neuropathology, University Medical Center, Göttingen, Germany
| | - Sebastian Torke
- Institute of Neuropathology, University Medical Center, Göttingen, Germany
| | - Evelyn Peelen
- Department of Neurosciences, Centre de recherche de l’Université de Montréal (CRCHUM), Montréal, Québec, Canada
| | - Thomas Bertsch
- Institute of Clinical Chemistry, Laboratory Medicine and Transfusion Medicine, Nuremberg General Hospital, Paracelsus Medical University, Nuremberg, Germany
| | - Matthias Weber
- LaborDiagnostik-Karlsruhe GmbH, Clinical Mass Spectrometry, Karlsruhe, Germany
| | - Marcus Heilmann
- Institute of Clinical Chemistry, Laboratory Medicine and Transfusion Medicine, Nuremberg General Hospital, Paracelsus Medical University, Nuremberg, Germany
| | - Marija Djukic
- Institute of Neuropathology, University Medical Center, Göttingen, Germany
- Department of Geriatrics, Evangelisches Krankenhaus Göttingen-Weende, Göttingen, Germany
| | - Roland Nau
- Institute of Neuropathology, University Medical Center, Göttingen, Germany
- Department of Geriatrics, Evangelisches Krankenhaus Göttingen-Weende, Göttingen, Germany
| | - Catherine Larochelle
- Department of Neurosciences, Centre de recherche de l’Université de Montréal (CRCHUM), Montréal, Québec, Canada
| | - Scott S Zamvil
- Department of Neurology, University of California, San Francisco, CA, USA
| | - Wolfgang Brück
- Institute of Neuropathology, University Medical Center, Göttingen, Germany
| | - Martin S Weber
- Institute of Neuropathology, University Medical Center, Göttingen, Germany
- Department of Neurology, University Medical Center, Göttingen, Germany
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14
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Häusler D, Torke S, Peelen E, Bertsch T, Djukic M, Nau R, Larochelle C, Zamvil SS, Brück W, Weber MS. Reply: Hypercalcaemia rather than high dose vitamin D3 supplements could exacerbate multiple sclerosis. Brain 2019; 142:e72. [DOI: 10.1093/brain/awz341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Darius Häusler
- Institute of Neuropathology, University Medical Center, Göttingen, Germany
| | - Sebastian Torke
- Institute of Neuropathology, University Medical Center, Göttingen, Germany
| | - Evelyn Peelen
- Department of Neurosciences, Centre de recherche de l’Université de Montréal (CRCHUM), Montréal, Québec, Canada
| | - Thomas Bertsch
- Institute of Clinical Chemistry, Laboratory Medicine and Transfusion Medicine, General Hospital Nuremberg, Paracelsus Medical University, Nuremberg, Germany
| | - Marija Djukic
- Institute of Neuropathology, University Medical Center, Göttingen, Germany
- Department of Geriatrics, Evangelisches Krankenhaus Göttingen-Weende, Göttingen, Germany
| | - Roland Nau
- Institute of Neuropathology, University Medical Center, Göttingen, Germany
- Department of Geriatrics, Evangelisches Krankenhaus Göttingen-Weende, Göttingen, Germany
| | - Catherine Larochelle
- Department of Neurosciences, Centre de recherche de l’Université de Montréal (CRCHUM), Montréal, Québec, Canada
| | - Scott S Zamvil
- Department of Neurology, University of California, San Francisco, CA, USA
| | - Wolfgang Brück
- Institute of Neuropathology, University Medical Center, Göttingen, Germany
| | - Martin S Weber
- Institute of Neuropathology, University Medical Center, Göttingen, Germany
- Department of Neurology, University Medical Center, Göttingen, Germany
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15
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Dhaeze T, Tremblay L, Lachance C, Peelen E, Zandee S, Grasmuck C, Bourbonnière L, Larouche S, Ayrignac X, Rébillard RM, Poirier J, Lahav B, Duquette P, Girard M, Moumdjian R, Bouthillier A, Larochelle C, Prat A. CD70 defines a subset of proinflammatory and CNS-pathogenic T H1/T H17 lymphocytes and is overexpressed in multiple sclerosis. Cell Mol Immunol 2019; 16:652-665. [PMID: 30635649 DOI: 10.1038/s41423-018-0198-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [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: 10/21/2018] [Accepted: 12/16/2018] [Indexed: 12/12/2022] Open
Abstract
CD70 is the unique ligand of CD27 and is expressed on immune cells only upon activation. Therefore, engagement of the costimulatory CD27/CD70 pathway is solely dependent on upregulation of CD70. However, the T cell-intrinsic effect and function of human CD70 remain underexplored. Herein, we describe that CD70 expression distinguishes proinflammatory CD4+ T lymphocytes that display an increased potential to migrate into the central nervous system (CNS). Upregulation of CD70 on CD4+ T lymphocytes is induced by TGF-β1 and TGF-β3, which promote a pathogenic phenotype. In addition, CD70 is associated with a TH1 and TH17 profile of lymphocytes and is important for T-bet and IFN-γ expression by both T helper subtypes. Moreover, adoptive transfer of CD70-/-CD4+ T lymphocytes induced less severe experimental autoimmune encephalomyelitis (EAE) disease than transfer of WT CD4+ T lymphocytes. CD70+CD4+ T lymphocytes are found in the CNS during acute autoimmune inflammation in humans and mice, highlighting CD70 as both an immune marker and an important costimulator of highly pathogenic proinflammatory TH1/TH17 lymphocytes infiltrating the CNS.
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Affiliation(s)
- Tessa Dhaeze
- Department of Neuroscience, Faculty of Medicine, Université de Montréal, and Centre de Recherche du CHUM (CRCHUM), Montréal, QC, H2X0A9, Canada
| | - Laurence Tremblay
- Department of Neuroscience, Faculty of Medicine, Université de Montréal, and Centre de Recherche du CHUM (CRCHUM), Montréal, QC, H2X0A9, Canada
| | - Catherine Lachance
- Department of Neuroscience, Faculty of Medicine, Université de Montréal, and Centre de Recherche du CHUM (CRCHUM), Montréal, QC, H2X0A9, Canada
| | - Evelyn Peelen
- Department of Neuroscience, Faculty of Medicine, Université de Montréal, and Centre de Recherche du CHUM (CRCHUM), Montréal, QC, H2X0A9, Canada
| | - Stephanie Zandee
- Department of Neuroscience, Faculty of Medicine, Université de Montréal, and Centre de Recherche du CHUM (CRCHUM), Montréal, QC, H2X0A9, Canada
| | - Camille Grasmuck
- Department of Neuroscience, Faculty of Medicine, Université de Montréal, and Centre de Recherche du CHUM (CRCHUM), Montréal, QC, H2X0A9, Canada
| | - Lyne Bourbonnière
- Department of Neuroscience, Faculty of Medicine, Université de Montréal, and Centre de Recherche du CHUM (CRCHUM), Montréal, QC, H2X0A9, Canada
| | - Sandra Larouche
- Department of Neuroscience, Faculty of Medicine, Université de Montréal, and Centre de Recherche du CHUM (CRCHUM), Montréal, QC, H2X0A9, Canada
| | - Xavier Ayrignac
- Department of Neuroscience, Faculty of Medicine, Université de Montréal, and Centre de Recherche du CHUM (CRCHUM), Montréal, QC, H2X0A9, Canada.,Multiple Sclerosis Clinic, Division of Neurology, CHUM, Montréal, QC, H2X0A9, Canada
| | - Rose-Marie Rébillard
- Department of Neuroscience, Faculty of Medicine, Université de Montréal, and Centre de Recherche du CHUM (CRCHUM), Montréal, QC, H2X0A9, Canada
| | - Josée Poirier
- Multiple Sclerosis Clinic, Division of Neurology, CHUM, Montréal, QC, H2X0A9, Canada
| | - Boaz Lahav
- Multiple Sclerosis Clinic, Division of Neurology, CHUM, Montréal, QC, H2X0A9, Canada
| | - Pierre Duquette
- Department of Neuroscience, Faculty of Medicine, Université de Montréal, and Centre de Recherche du CHUM (CRCHUM), Montréal, QC, H2X0A9, Canada.,Multiple Sclerosis Clinic, Division of Neurology, CHUM, Montréal, QC, H2X0A9, Canada
| | - Marc Girard
- Department of Neuroscience, Faculty of Medicine, Université de Montréal, and Centre de Recherche du CHUM (CRCHUM), Montréal, QC, H2X0A9, Canada.,Multiple Sclerosis Clinic, Division of Neurology, CHUM, Montréal, QC, H2X0A9, Canada
| | | | | | - Catherine Larochelle
- Department of Neuroscience, Faculty of Medicine, Université de Montréal, and Centre de Recherche du CHUM (CRCHUM), Montréal, QC, H2X0A9, Canada.,Multiple Sclerosis Clinic, Division of Neurology, CHUM, Montréal, QC, H2X0A9, Canada
| | - Alexandre Prat
- Department of Neuroscience, Faculty of Medicine, Université de Montréal, and Centre de Recherche du CHUM (CRCHUM), Montréal, QC, H2X0A9, Canada. .,Multiple Sclerosis Clinic, Division of Neurology, CHUM, Montréal, QC, H2X0A9, Canada.
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16
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Dhaeze T, Peelen E, Hombrouck A, Peeters L, Van Wijmeersch B, Lemkens N, Lemkens P, Somers V, Lucas S, Broux B, Stinissen P, Hellings N. Circulating Follicular Regulatory T Cells Are Defective in Multiple Sclerosis. J I 2015; 195:832-40. [DOI: 10.4049/jimmunol.1500759] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 05/18/2015] [Indexed: 12/29/2022]
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17
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Peelen E, Damoiseaux J, Muris AH, Knippenberg S, Smolders J, Hupperts R, Thewissen M. Increased inflammasome related gene expression profile in PBMC may facilitate T helper 17 cell induction in multiple sclerosis. Mol Immunol 2015; 63:521-9. [PMID: 25458313 DOI: 10.1016/j.molimm.2014.10.008] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Revised: 10/01/2014] [Accepted: 10/11/2014] [Indexed: 01/12/2023]
Abstract
The NLRP3 inflammasome is a macromolecular complex importantly involved in IL-1β processing. A role for this has been described in multiple sclerosis (MS). One mechanism by which IL-1β might be involved in MS is by inducing pathogenic Th17 cells, i.e. GM-CSF+ Th17 cells. In the present study, we show that expression of the inflammasome related genes, NLRP3, caspase-1, IL-1β and the IL-1β/IL-1Ra ratio, was increased in PBMC from MS patients compared to healthy controls (HC). However, in an in vitro inflammasome activity assay with PBMC, IL-1β protein secretion and the IL-1β/IL-1Ra protein ratio were similar in MS patients and HC. Th cells cultured in the presence of supernatant derived from LPS/ATP inflammasome activated PBMC showed increased Th17 and GM-CSF+ Th17 cell frequencies in HC and MS patients and decreased anti-inflammatory IL-10+Th cell frequency in HC compared to Th cells cultured in the presence of control supernatant. Moreover, addition of the immune modulator calcitriol to the former condition resulted in reduced frequencies of Th17 and GM-CSF+Th17 cells, and also of IL-10+ Th cells. Evidently, our data indicate that inflammasome activity can skew the Th cell population toward a more pro-inflammatory composition, an effect that might be inhibited by vitamin D, and that might be importantly involved in inflammation within the central nervous system.
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Affiliation(s)
- E Peelen
- School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
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18
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Smolders J, Peelen E, Thewissen M, Menheere P, Damoiseaux J, Hupperts R. Circulating vitamin D binding protein levels are not associated with relapses or with vitamin D status in multiple sclerosis. Mult Scler 2013; 20:433-7. [DOI: 10.1177/1352458513500552] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: A low vitamin D status has been associated with multiple sclerosis (MS). Most circulating vitamin D metabolites are bound to vitamin D binding protein (DBP). Objectives: The purpose of this study was to explore whether there is an association between MS and DBP. Methods: We compared DBP concentrations in blood samples of controls ( n = 30) and subjects with relapsing–remitting MS (RRMS) during remission ( n = 29) and relapse ( n = 15). Furthermore, we explored correlations of DBP with 25- hydroxyvitamin D (25(OH)D) and 1,25-dihydroxyvitamin D levels (1,25(OH)2D), and the effect of high-dose vitamin D3 supplementation on DBP levels in RRMS patients ( n = 15). Results: DBP-concentration did not differ between the sub-groups measured, and there was no correlation between DBP and vitamin D metabolite concentration within the physiological range. Upon supplementation of high doses vitamin D3, DBP concentration remained unaltered. After supplementation, serum 1,25(OH)2D( R = 0.517, p = 0.049), but not 25(OH)D, correlated positively with DBP. Conclusions: We found no association between DBP, MS, and vitamin D status within the physiological range. After high - dose vitamin D supplementation, DBP concentrations may be relevant for vitamin D metabolism.
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Affiliation(s)
- Joost Smolders
- Neuroimmunology Research Group, Netherlands Institute for Neuroscience, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University Medical Center, The Netherlands
| | - Evelyn Peelen
- School for Mental Health and Neuroscience, Maastricht University Medical Center, The Netherlands
- Biomedical Research Institute and Transnationale Universiteit Limburg, Hasselt University, Belgium
| | - Mariëlle Thewissen
- Department of Internal Medicine, Maastricht University Medical Center, The Netherlands
| | - Paul Menheere
- Central Diagnostic Laboratory, Maastricht University Medical Center, The Netherlands
| | - Jan Damoiseaux
- Central Diagnostic Laboratory, Maastricht University Medical Center, The Netherlands
| | - Raymond Hupperts
- School for Mental Health and Neuroscience, Maastricht University Medical Center, The Netherlands
- Academic MS Center Limburg, Orbis Medical Center, The Netherlands
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19
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Peelen E, Thewissen M, Knippenberg S, Smolders J, Muris AH, Menheere P, Tervaert JWC, Hupperts R, Damoiseaux J. Fraction of IL-10+ and IL-17+ CD8 T cells is increased in MS patients in remission and during a relapse, but is not influenced by immune modulators. J Neuroimmunol 2013; 258:77-84. [PMID: 23517930 DOI: 10.1016/j.jneuroim.2013.02.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Revised: 01/31/2013] [Accepted: 02/19/2013] [Indexed: 12/22/2022]
Abstract
In the present study, circulating proportions of CD8(+) T (Tc) cell subsets, including IL-17 (Tc17) and IL-10 (Tc10) producing cells, were assessed in relapsing-remitting MS (RRMS) patients and a possible effect of beta interferon (IFN-β), glatiramer acetate (GA), and vitamin D (VitD) on these cell subsets was investigated. We show that both Tc17 and Tc10 cell fractions are elevated in the circulation of RRMS patients in remission compared to healthy subjects and that these Tc subsets remain unaffected by current immune modulating regimens.
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Affiliation(s)
- E Peelen
- School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.
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20
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Peelen E, Damoiseaux J, Smolders J, Knippenberg S, Menheere P, Tervaert JWC, Hupperts R, Thewissen M. Th17 expansion in MS patients is counterbalanced by an expanded CD39+ regulatory T cell population during remission but not during relapse. J Neuroimmunol 2011; 240-241:97-103. [DOI: 10.1016/j.jneuroim.2011.09.013] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Revised: 09/15/2011] [Accepted: 09/30/2011] [Indexed: 12/20/2022]
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21
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Knippenberg S, Peelen E, Smolders J, Thewissen M, Menheere P, Cohen Tervaert JW, Hupperts R, Damoiseaux J. Reduction in IL-10 producing B cells (Breg) in multiple sclerosis is accompanied by a reduced naïve/memory Breg ratio during a relapse but not in remission. J Neuroimmunol 2011; 239:80-6. [DOI: 10.1016/j.jneuroim.2011.08.019] [Citation(s) in RCA: 132] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2011] [Revised: 08/30/2011] [Accepted: 08/30/2011] [Indexed: 11/29/2022]
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22
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Knippenberg S, Smolders J, Thewissen M, Peelen E, Tervaert JWC, Hupperts R, Damoiseaux J. Effect of vitamin D(3) supplementation on peripheral B cell differentiation and isotype switching in patients with multiple sclerosis. Mult Scler 2011; 17:1418-23. [PMID: 21690147 DOI: 10.1177/1352458511412655] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Vitamin D has been proposed as a promoter of immune homeostasis in multiple sclerosis (MS). During the past decade, the focus of the effects of vitamin D has been on dendritic cells and on T cells. Since there is an increasing interest in the role of B cells in the pathophysiology of MS, we studied the role of vitamin D on B cells in vivo in patients with MS. OBJECTIVE We explored the effects of 12 weeks high-dose vitamin D(3) supplementation on peripheral B cell differentiation, immunoglobulin production and levels of B cell activating factor (BAFF) in 15 patients with MS. METHODS Circulating B cell subsets were characterized by flow cytometry. Plasma immunoglobulin levels were assessed by nephelometry. Plasma BAFF levels were assessed by enzyme-linked immunosorbent assay (ELISA). RESULTS Although a significant increase serum 25-hydroxyvitamin D was induced, we found no significant shift in B cell differentiation, isotype switching, or plasma BAFF levels. CONCLUSION In patients with MS, supplementation of high doses vitamin D(3) does not have substantial effects on phenotypic markers of B cell differentiation in circulating B cells. Future studies may unravel more subtle changes in the B cell compartment, either in the circulation or in the central nervous system.
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Affiliation(s)
- Stephanie Knippenberg
- School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.
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Peelen E, Knippenberg S, Muris AH, Thewissen M, Smolders J, Tervaert JWC, Hupperts R, Damoiseaux J. Effects of vitamin D on the peripheral adaptive immune system: a review. Autoimmun Rev 2011; 10:733-43. [PMID: 21621002 DOI: 10.1016/j.autrev.2011.05.002] [Citation(s) in RCA: 160] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Accepted: 05/05/2011] [Indexed: 12/20/2022]
Abstract
Epidemiological studies have shown that a poor vitamin D status is associated with an increased risk of several diseases, including autoimmune diseases. The immune regulatory function of vitamin D is thought to have an important role in these associations. Cells of the adaptive immune system have shown to be direct targets of the vitamin D metabolites. Besides being direct targets, cells of the adaptive immune system express the enzymes involved in the metabolism of vitamin D, enabling them to locally convert 25(OH)D into its active metabolite 1,25(OH)2D. In this review, the effects of vitamin D on cells of the adaptive immune system are described. Experimental data in vitro show that vitamin D skews cells of the adaptive immune system toward a more tolerogenic status which might be exploited in the treatment of autoimmune diseases. However, it should be noticed that in vivo effects may differ from in vitro effects due to the cross-talk between different vitamin D sensitive cells, but data support the view that vitamin D is positively involved in maintaining or restoring immune homeostasis. Upcoming vitamin D supplementation trials will further elucidate the in vivo effects of vitamin D on the immune system and its potency to serve as an immune regulating agent in autoimmune diseases.
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Affiliation(s)
- Evelyn Peelen
- School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.
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Smolders J, Peelen E, Thewissen M, Cohen Tervaert JW, Menheere P, Hupperts R, Damoiseaux J. Safety and T cell modulating effects of high dose vitamin D3 supplementation in multiple sclerosis. PLoS One 2010; 5:e15235. [PMID: 21179201 PMCID: PMC3001453 DOI: 10.1371/journal.pone.0015235] [Citation(s) in RCA: 127] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2010] [Accepted: 11/01/2010] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND A poor vitamin D status has been associated with a high disease activity of multiple sclerosis (MS). Recently, we described associations between vitamin D status and peripheral T cell characteristics in relapsing remitting MS (RRMS) patients. In the present study, we studied the effects of high dose vitamin D3 supplementation on safety and T cell related outcome measures. METHODOLOGY/PRINCIPAL FINDINGS Fifteen RRMS patients were supplemented with 20,000 IU/d vitamin D3 for 12 weeks. Vitamin D and calcium metabolism were carefully monitored, and T cell characteristics were studied by flowcytometry. All patients finished the protocol without side-effects, hypercalcaemia, or hypercalciuria. The median vitamin D status increased from 50 nmol/L (31-175) at week 0 to 380 nmol/L (151-535) at week 12 (P<0.001). During the study, 1 patient experienced an exacerbation of MS and was censored from the T cell analysis. The proportions of (naïve and memory) CD4+ Tregs remained unaffected. Although Treg suppressive function improved in several subjects, this effect was not significant in the total cohort (P=0.143). An increased proportion of IL-10+ CD4+ T cells was found after supplementation (P=0.021). Additionally, a decrease of the ratio between IFN-γ+ and IL-4+ CD4+ T cells was observed (P=0.035). CONCLUSION/SIGNIFICANCE Twelve week supplementation of high dose vitamin D3 in RRMS patients was well tolerated and did not induce decompensation of calcium metabolism. The skewing towards an anti-inflammatory cytokine profile supports the evidence on vitamin D as an immune-modulator, and may be used as outcome measure for upcoming randomized placebo-controlled trials. TRIAL REGISTRATION Clinicaltrials.gov NCT00940719.
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Affiliation(s)
- Joost Smolders
- School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.
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25
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Smolders J, Menheere P, Thewissen M, Peelen E, Tervaert JWC, Hupperts R, Damoiseaux J. Regulatory T cell function correlates with serum 25-hydroxyvitamin D, but not with 1,25-dihydroxyvitamin D, parathyroid hormone and calcium levels in patients with relapsing remitting multiple sclerosis. J Steroid Biochem Mol Biol 2010; 121:243-6. [PMID: 20211254 DOI: 10.1016/j.jsbmb.2010.03.001] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2009] [Revised: 02/02/2010] [Accepted: 03/01/2010] [Indexed: 11/21/2022]
Abstract
Vitamin D is a potent immune modulator in multiple sclerosis (MS), but was primarily identified for its effects on calcium homeostasis. It is uncertain whether these calcaemic functions of vitamin D are critically involved in its immune modulating potential. We earlier reported a correlation between serum 25-hydroxyvitamin D (25(OH)D) levels and regulatory T cell (Treg) function. In the present study, the correlation of serum levels of 1,25-dihydroxyvitamin D (1,25(OH)2D), intact parathyroid hormone (PTH), and total calcium with Treg number and functionality and the proportions of other T helper cell subsets was assessed in 29 relapsing remitting MS patients. In contrast to serum 25(OH)D levels, serum concentrations of neither 1,25(OH)2D, nor PTH and total calcium correlated significantly with Treg function or Th1/Th2 ratio. None of the parameters correlated with the relative and absolute number of Tregs. Interestingly, the serum levels of 1,25(OH)2D correlated positively with the proportion of T helper type 17 (Th17) cells. These results suggest that the serum levels of 1,25(OH)2D, PTH, and total calcium are not critically involved in the correlation between vitamin D status and T cell regulation.
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Affiliation(s)
- Joost Smolders
- School for Mental Health and Neuroscience, Maastricht University Medical Center, PO Box 616, 6200MD Maastricht, The Netherlands.
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Smolders J, Thewissen M, Peelen E, Menheere P, Tervaert JWC, Damoiseaux J, Hupperts R. Vitamin D status is positively correlated with regulatory T cell function in patients with multiple sclerosis. PLoS One 2009; 4:e6635. [PMID: 19675671 PMCID: PMC2721656 DOI: 10.1371/journal.pone.0006635] [Citation(s) in RCA: 216] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2009] [Accepted: 07/16/2009] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND In several autoimmune diseases, including multiple sclerosis (MS), a compromised regulatory T cell (Treg) function is believed to be critically involved in the disease process. In vitro, the biologically active metabolite of vitamin D has been shown to promote Treg development. A poor vitamin D status has been linked with MS incidence and MS disease activity. In the present study, we assess a potential in vivo correlation between vitamin D status and Treg function in relapsing remitting MS (RRMS) patients. METHODOLOGY/PRINCIPAL FINDINGS Serum levels of 25-hydroxyvitamin D (25(OH)D) were measured in 29 RRMS patients. The number of circulating Tregs was assessed by flow-cytometry, and their functionality was tested in vitro in a CFSE-based proliferation suppression assay. Additionally, the intracellular cytokine profile of T helper cells was determined directly ex-vivo by flow-cytometry. Serum levels of 25(OH)D correlated positively with the ability of Tregs to suppress T cell proliferation (R = 0.590, P = 0.002). No correlation between 25(OH)D levels and the number of Tregs was found. The IFN-gamma/IL-4 ratio (Th1/Th2-balance) was more directed towards IL-4 in patients with favourable 25(OH)D levels (R = -0.435, P = 0.023). CONCLUSIONS/SIGNIFICANCE These results show an association of high 25(OH)D levels with an improved Treg function, and with skewing of the Th1/Th2 balance towards Th2. These findings suggest that vitamin D is an important promoter of T cell regulation in vivo in MS patients. It is tempting to speculate that our results may not only hold for MS, but also for other autoimmune diseases. Future intervention studies will show whether modulation of vitamin D status results in modulation of the T cell response and subsequent amelioration of disease activity.
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Affiliation(s)
- Joost Smolders
- School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.
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Smolders J, Peelen E, Thewissen M, Menheere P, Tervaert JWC, Hupperts R, Damoiseaux J. The relevance of vitamin D receptor gene polymorphisms for vitamin D research in multiple sclerosis. Autoimmun Rev 2009; 8:621-6. [PMID: 19393206 DOI: 10.1016/j.autrev.2009.02.009] [Citation(s) in RCA: 110] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2009] [Accepted: 02/06/2009] [Indexed: 02/06/2023]
Abstract
A poor vitamin D status has been associated with several autoimmune diseases, including multiple sclerosis (MS). The receptor for the biologically active metabolite of vitamin D appears to be a key player in these associations, not only as a mediator of the biological effects of vitamin D, but also as a mediator of the regulation of vitamin D metabolism itself. In this concise review, we will discuss the mostly investigated genetic polymorphisms of the vitamin D receptor (VDR), and their consequences for VDR functionality and immune regulation. Next, we will discuss the association of these polymorphisms with MS, and their relation with vitamin D metabolism. We conclude that polymorphisms of the VDR have major effects on vitamin D function and metabolism, and should therefore be assessed in studies on vitamin D and MS.
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Affiliation(s)
- Joost Smolders
- School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands.
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