Granulocyte–Colony‐Stimulating Factor Treatment Enhances Foxp3+ T Lymphocytes and Modifies the Proinflammatory Response in Experimental Autoimmune Neuritis

Abstract

Despite the evolution of treatments in the past decade, acute inflammatory autoimmune diseases of the peripheral nervous system are still a concern due to their considerable morbidity and mortality [1]. Guillain-Barr e syndrome (GBS) is an acute inflammatory disorder. The study of experimental autoimmune neuritis (EAN), the experimental model of GBS, has provided most of the knowledge regarding GBS disease mechanisms. Inflammatory lesions are primarily located in the sciatic nerves and the cauda equina of EAN-affected Lewis rats [2]. Lesions are characterized by an accumulation of inflammatory cells, primarily T cells, and macrophages. The inflammatory response during EAN is characterized mainly by the migration of neuritogenic cells into the peripheral nerves and by the production and secretion of proinflammatory cytokines, such as IFNc, TNFa, IL-6, and IL-17 [3]. During the last years, hematopoietic factors, such as erythropoietin, granulocyte–macrophage colony-stimulating factor and granulocyte–colony-stimulating factor (G-CSF), have been successfully used to modify experimental autoimmune diseases [4,5]. Moreover, G-CSF has an important and strong tolerogenic function. This cytokine recruits immature dendritic cells (DCs), which induce tolerance through the enhancement of regulatory T cells [5]. In this study, we investigated the effects of short-term G-CSF treatment on the evolution of EAN. EAN was induced using the neuritogenic peptide P253-78 as previously described [6]. The clinical signs of EAN were significantly reduced by the in vivo administration of G-CSF in a short-term treatment regimen (Figure 1A). The development of EAN is characterized by the sensitization and activation of neuritogenic T cells in the peripheral immune organs. These cells migrate into peripheral nerves and release inflammatory mediators, which may contribute directly or indirectly to the destruction of the myelin sheath. We observed a significant reduction in the specific proliferative response of T cells from Lewis rats with EAN treated with G-CSF compared with the cells from the control animals (Figure 1B). Moreover, G-CSF treatment reduced the mononuclear cell infiltration into the sciatic nerve (Figure 1C). The EAN autoaggressive response is characterized by the expression and release of Th1 and/or Th17 cytokines. Therefore, we evaluated the expression, by real-time PCR (Figure S1), of Th1 and Th17 cytokines and transcription factors, in the lymph nodes 10 days after immunization, prior to the migration of the neuritogenic cells from the periphery to the target tissue. We observed a consistent downregulation in the expression of the Th1 (T-bet) and Th17 (RORa and RORct) transcription factors in the G-CSFtreated group compared with control group (Figure 1D). Corroborating the changes in the transcription factors expression profile, the expression of proinflammatory cytokines (IFNc, IL-17A, IL17E, and IL-6) was reduced in the G-CSF-treated group compared with the control group. G-CSF treatment also led to an increase in the expression of anti-inflammatory cytokines, such as IL-10 and