Abstract
Although activation of the innate and adaptive arms of the immune system are undoubtedly involved in the pathophysiology of neurodegenerative diseases, it is unclear whether immune system activation is a primary or secondary event. Increasingly, published studies link primary metabolic stress to secondary inflammatory responses inside and outside of the nervous system. In this study, we show that the metabolic stress pathway known as the unfolded protein response (UPR) leads to secondary activation of the immune system. First, we observe innate immune system activation in autopsy specimens from Pelizaeus-Merzbacher disease (PMD) patients and mouse models stemming from PLP1 gene mutations. Second, missense mutations in mildly- and severely-affected Plp1-mutant mice exhibit immune-associated expression profiles with greater disease severity causing an increasingly proinflammatory environment. Third, and unexpectedly, we find little evidence for dysregulated expression of major antioxidant pathways, suggesting that the unfolded protein and oxidative stress responses are separable. Together, these data show that UPR activation can precede innate and/or adaptive immune system activation and that neuroinflammation can be titrated by metabolic stress in oligodendrocytes. Whether or not such activation leads to autoimmune disease in humans is unclear, but the case report of steroid-mitigated symptoms in a PMD patient initially diagnosed with multiple sclerosis lends support.
Highlights
The immune system is an important player in the pathophysiology of a number of neurodegenerative diseases [1,2]
Because of the functional cross-talk between the unfolded protein response (UPR) and immune system that has been revealed in recent years, and the observation that immune signaling can activate the UPR in oligodendrocytes [33], it seems reasonable to postulate that activation of the UPR may lead to modulation of immune signaling in the local environment
Astrocytes are widely known to be activated in vivo by the pathophysiological processes stemming from mutant Plp1 expression in animals and Pelizaeus-Merzbacher disease (PMD) patients, but microglia/macrophages have been studied in less detail
Summary
The immune system is an important player in the pathophysiology of a number of neurodegenerative diseases [1,2]. These profiles suggest that greater disease severity is associated with a proinflammatory environment in msd but not rsh mice, which has been previously suggested for Plp overexpressor mice [22,32] Together, these data demonstrate a nonimmune-mediated mechanism of disease in the CNS, whereby genetic lesions in a myelin-specific structural protein activate the UPR and trigger an innate immune response that, in severe cases, could broaden to include inflammatory or autoimmune responses mediated by the adaptive immune system. These data are most significant in the context of diseases such as MS because they raise the possibility of an etiology by which neuroinflammation may evolve secondarily to an underlying metabolic pathophysiology
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