Treatment Of Experimental Autoimmune Neuritis Research Articles

FTY720 controls disease severity and attenuates sciatic nerve damage in chronic experimental autoimmune neuritis

BackgroundChronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an autoimmune-mediated inflammatory disease of the peripheral nervous system characterized by a response directed against certain myelin proteins and for which therapies are limited. Previous studies have suggested a beneficial role of FTY720, a sphingosine 1-phosphate (S1P) receptor agonist, known to deplete lymphocytes from the peripheral blood by sequestering them into lymph nodes, in the treatment of experimental autoimmune neuritis (EAN). Therefore, we investigated whether FTY720 is also beneficial in chronic experimental autoimmune neuritis (c-EAN), a recently developed rat model mimicking human CIDP.Methodsc-EAN was induced in Lewis rats by immunization with S-palm P0(180–199) peptide. Rats were treated with FTY720 (1 mg/kg) or vehicle intraperitoneally once daily from the onset of clinical signs for 18 days; clinical signs were assessed daily until 60 days post-immunization (dpi). Electrophysiological and histological features were examined at different time points. We also evaluated the serum levels of different pro- and anti-inflammatory cytokines by ELISA or flow cytometry at 18, 40, and 60 dpi.ResultsOur data demonstrate that FTY720 decreased the severity and abolished the chronicity of the disease in c-EAN rats. Therapeutic FTY720 treatment reversed electrophysiological and histological anomalies, suggesting that myelinated fibers were subsequently preserved, it inhibited macrophage and IL-17+ cell infiltration in PNS, and it significantly reduced circulating pro-inflammatory cytokines.ConclusionsFTY720 treatment has beneficial effects on c-EAN, a new animal model mimicking human CIDP. We have shown that FTY720 is an effective immunomodulatory agent, improving the disease course of c-EAN, preserving the myelinated fibers, attenuating the axonal degeneration, and decreasing the number of infiltrated inflammatory cells in peripheral nerves. These data confirm the interest of testing FTY720 or molecules targeting S1P in human peripheral neuropathies.

Costimulatory Molecule CD40 Is Essential for Myelin Protein 0 Peptide 106–125–Induced Experimental Autoimmune Neuritis in Mice

Myelin protein 0 peptide 106-125-induced murine experimental autoimmune neuritis (EAN) is a CD4-positive T cell-mediated monophasic axonal inflammatory neuropathy; interferon-γ is the key proinflammatory mediator. Experimental autoimmune neuritis is well suited for elucidating pathogenetic mechanisms underlying human acute axonal Guillain-Barré syndrome. Here, the functional role of the costimulatory molecule CD40 was defined by characterization of EAN in CD40-deficient mice. In contrast to immunized C57BL/6 mice, CD40-deficient mice were resistant to EAN owing to impaired priming of CD4-positive T-effector cells. To determine whether CD40 is a suitable candidate for the treatment of EAN, we administered monoclonal anti-CD40 antibody either before immunization or upon onset of neurologic signs. Prophylactic anti-CD40 treatment completely abolished CD4-positive T-cell priming. Therapeutic application of anti-CD40 prevented full activation of CD4-positive T cells that were in the process of priming and suppressed production of interferon-γ in peripheral lymph nodes, spleen, and serum, and of interleukin-6, interleukin-12p40, intercellular adhesion molecule-1, and vascular cell adhesion molecule-1, which are associated with activation of the nuclear factor-κB signaling pathway. This resulted in enhanced recovery by early generation of CD25-positive, Foxp3-positive, CD4-positive regulatory T cells. Thus, these experiments highlight the crucial role of CD40 as an important costimulatory molecule in EAN and suggest that it has potential as a therapeutic target in human neuritis.

Transplantation of Schwann cells co-cultured with brain-derived neurotrophic factor for the treatment of experimental autoimmune neuritis

The aim of this study was to investigate the effects of transplantation of Schwann cells (SCs) co-cultured with brain-derived neurotrophic factor (BDNF) for the treatment of experimental autoimmune neuritis (EAN). Primary SCs were co-cultured with various BDNF concentrations, and the optimum concentration was determined by cell proliferation, and NGF and FGF levels. A rat model of EAN was established by immunization with 400μg of P2 peptide dissolved in Freund's complete adjuvant. SCs were labeled with CFSE and injected into the cisterna magna 14days after immunization. We found proliferation of SCs, and NGF and FGF levels were highest at a BDNF concentration of 50ng/mL. Compared with EAN group, SCs+BDNF group showed the lower paralysis scores from day 34 to day 45, and in sciatic nerves showed a significant decrease in inflammatory cell infiltration (involved CD4-, CD8- and CD68-positive cells) at days 25 and 35, an alleviated demyelination at days 35 and 45, and an increase in S-100-positive cells and a decrease in NGF-positive cells at each time point (P<0.05). Compared with the EAN group, the SCs+BDNF group showed, in sciatic nerves, the mRNA level of NGF was significantly decreased but that of S-100 was increased at day 25, the mRNA level of CCL3 was also remarkably reduced at day 35, and the mRNA level of CD11a, CCL3 and NGF was reduced but that of S-100 was elevated at day 45 (P<0.05). There were no differences in results between the SCs group and EAN group. In the end, we draw the conclusions that the exogenous SCs injected through cisterna magna can migrate to the injured peripheral nerves, BDNF promotes the proliferation and secretory function of SCs in vitro, and BDNF-treated SCs in vivo can reduce paralysis, inflammation, and demyelination and improve the self-repair capability of body in EAN.

IL-5 promotes induction of antigen-specific CD4+CD25+ T regulatory cells that suppress autoimmunity

AbstractImmune responses to foreign and self-Ags can be controlled by regulatory T cells (Tregs) expressing CD4 and IL-2Rα chain (CD25). Defects in Tregs lead to autoimmunity, whereas induction of Ag-specific CD4+CD25+ Tregs restores tolerance. Ag-specific CD4+CD25+ FOXP3+Tregs activated by the T helper type 2 (Th2) cytokine, IL-4, and specific alloantigen promote allograft tolerance. These Tregs expressed the specific IL-5Rα and in the presence of IL-5 proliferate to specific but not third-party Ag. These findings suggest that recombinant IL-5 (rIL-5) therapy may promote Ag-specific Tregs to mediate tolerance. This study showed normal CD4+CD25+ Tregs cultured with IL-4 and an autoantigen expressed Il-5rα. Treatment of experimental autoimmune neuritis with rIL-5 markedly reduced clinical paralysis, weight loss, demyelination, and infiltration of CD4+ (Th1 and Th17) CD8+ T cells and macrophages in nerves. Clinical improvement was associated with expansion of CD4+CD25+FOXP3+ Tregs that expressed Il-5rα and proliferated only to specific autoantigen that was enhanced by rIL-5. Depletion of CD25+ Tregs or blocking of IL-4 abolished the benefits of rIL-5. Thus, rIL-5 promoted Ag-specific Tregs, activated by autoantigen and IL-4, to control autoimmunity. These findings may explain how Th2 responses, especially to parasitic infestation, induce immune tolerance. rIL-5 therapy may be able to induce Ag-specific tolerance in autoimmunity.

Mesenchymal stem cells lack efficacy in the treatment of experimental autoimmune neuritis despite in vitro inhibition of T-cell proliferation.

Mesenchymal stem cells have been demonstrated to ameliorate experimental autoimmune encephalomyelitis (EAE), a model of multiple sclerosis, prompting clinical trials in multiple sclerosis which are currently ongoing. An important question is whether this therapeutic effect generalises to other autoimmune neurological diseases. We performed two trials of efficacy of MSCs in experimental autoimmune neuritis (EAN) in Lewis (LEW/Han MHsd) rats, a model of human autoimmune inflammatory neuropathies. No differences between the groups were found in clinical, histological or electrophysiological outcome measures. This was despite the ability of mesenchymal stem cells to inhibit proliferation of CD4+ T-cells in vitro. Therefore the efficacy of MSCs observed in autoimmune CNS demyelination models do not necessarily generalise to the treatment of other forms of neurological autoimmunity.

Effective treatment of experimental autoimmune neuritis with Fc fragment of human immunoglobulin

IV immunoglobulin (IVIg) and its Fc fragment proved effective in preventing further progression of experimental autoimmune neuritis (EAN) in the rat induced by whole bovine peripheral nerve myelin and shortening disease duration. This effectiveness was associated with significant differences in electrophysiological parameters including less prolongation of somatosensory evoked potential (S wave) latencies, better maintained S wave amplitudes, less reduction of distal motor nerve conduction velocity, and better maintained amplitudes of compound muscle action potentials of dorsal foot muscles after stimulation at ankle and hip. Moreover, treatment with IVIg and Fc fragments resulted in less extensive inflammation and demyelination in nerve roots evidenced by significantly lower histological grades. The current study provides direct evidence for the first time that Fc fraction of IVIg is the effective component in the treatment of rat EAN.

Effective treatment of experimental autoimmune neuritis with human immunoglobulin

High-dose intravenous immunoglobulin (IVIg) is an effective treatment for inflammatory demyelinating neuropathies, although the mechanism(s) of action remain incompletely understood. Experimental autoimmune neuritis (EAN) is an animal model of inflammatory demyelinating neuropathies; however, there have been conflicting reports regarding the efficacy of human IVIg in EAN. To obtain a model suitable for the study of the mechanism(s) of action of IVIg in Guillain–Barré syndrome, we investigated the effect of IVIg in EAN in the rat using clinical, electrophysiological and morphological measures. Human IVIg administered at the onset of signs of disease proved effective in preventing further progression of disease and shortening disease duration. This effectiveness was associated with significant differences in electrophysiological parameters including less prolongation of somatosensory evoked potential (S wave) latencies, better maintained S wave amplitudes, less reduction of distal motor nerve conduction velocity, and better maintained amplitudes of compound muscle action potentials of the dorsal foot muscles after stimulation at ankle and hip. Moreover, treatment with IVIg resulted in significantly lower histological grades in rat EAN. The current study provides evidence that human IVIg is effective in the treatment of EAN in the rat, indicating that this model may facilitate further investigation of the mechanism(s) of action of IVIg in inflammatory demyelinating neuropathies.

0357 Effective prevention and treatment of experimental autoimmune neuritis with rapamycin

0357 Effective prevention and treatment of experimental autoimmune neuritis with rapamycin

New cyclooxygenase-2 inhibitors for treatment of experimental autoimmune neuritis

We analyzed two new cyclooxygenase-2 (COX-2) inhibitors, celecoxib (SC-58635) and meloxicam, for the treatment of experimental autoimmune neuritis (EAN) in rats. Celecoxib and meloxicam significantly reduced clinical EAN score and histopathological damage of the sciatic nerve. They induced no serious side effects, whereas indomethacin used as a control caused severe intestinal ulceration and dysfunction of liver and kidney. These findings suggest that the new COX-2 inhibitors may be useful as additional therapeutic agents for patients with Guillain–Barré syndrome and chronic inflammatory demyelinating polyneuropathy. © 2002 John Wiley & Sons, Inc. Muscle Nerve 25: 280–282, 2002 DOI 10.1002/mus.10019

New cyclooxygenase-2 inhibitors for treatment of experimental autoimmune neuritis.

We analyzed two new cyclooxygenase-2 (COX-2) inhibitors, celecoxib (SC-58635) and meloxicam, for the treatment of experimental autoimmune neuritis (EAN) in rats. Celecoxib and meloxicam significantly reduced clinical EAN score and histopathological damage of the sciatic nerve. They induced no serious side effects, whereas indomethacin used as a control caused severe intestinal ulceration and dysfunction of liver and kidney. These findings suggest that the new COX-2 inhibitors may be useful as additional therapeutic agents for patients with Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy.

Vaccination, prevention, and treatment of experimental autoimmune neuritis (EAN) by an oligomerized T cell epitope.

Using a polypeptide oligomer harboring 16 repeats of the neuritogenic epitope (aa 58-73) of myelin P2 protein separated by spacers, enhancement of the immune response to the P2 protein, an important neuritogenic autoantigen in experimental autoimmune neuritis (EAN), was attempted. In contrast to a previous study with PLP-16-mer antigen-specific response of T cells was attenuated at all doses examined to a variable degree. Treatment of Lewis rats with the P2-16-mer up to 2 months before immunization with P2(53-78) (vaccination) or after immunization but before appearance of disease (prevention) had a strong tolerizing effect against the induction of EAN on immunization with P2(53-78). Moreover, rats injected with 200 microg of the P2-16-mer i.v. on day 11 after disease induction, at which time the initial signs of disease had appeared, were almost completely protected against progression of clinical disease, whereas animals treated with the same amount of monomeric control peptide developed severe disease (treatment). Similar results were obtained by i.v. treatment of adoptive-transfer EAN with the P2-16-mer. The lack of clinical signs of disease after 16-mer therapy could be correlated with a reduced proliferative response of P2(53-78)-specific lymph node cells. The frequency of apoptotic T cells in sciatic nerve or in lymph node cells, however, was not increased by the 16-mer treatment, suggesting that induction of anergy or other forms of peripheral tolerance may be responsible for the effect. Thus, the oligomerized P2 peptide antigen was highly effective in all three treatment modalities examined in this specific autoreactive T cell-mediated immune response.

Antigen-specific immunosuppression: nasal tolerance to P0 protein peptides for the prevention and treatment of experimental autoimmune neuritis in Lewis rats

Experimental autoimmune neuritis (EAN) is an autoimmune inflammatory demyelinating disease of the peripheral nervous system (PNS), and represents an animal model of the human Guillain–Barré syndrome (GBS). In this study, we report that nasal administration of the neuritogenic peptide 180–199 and of the cryptic peptide 56–71 of the rat neuritogenic P0 protein of peripheral nerve myelin prevents EAN and attenuates ongoing EAN. Both peptides effectively decreased the severity and shortened clinical EAN. Both a prophylactic and a therapeutic approach proved to be beneficial. These effects were associated with T and B cells hyporesponsiveness to the peptide antigens, reflected by downregulated Th1 cell responses (interferon-γ secretion) and macrophage function, whereas Th2 cell responses (IL-4 secretion) and transforming growth factor-β mRNA expression were upregulated.

Antigen-specific immunosuppression: Nasal tolerance to PO protein peptides for the prevention and treatment of experimental autoimmune neuritis in Lewis rats

Antigen-specific immunosuppression: Nasal tolerance to PO protein peptides for the prevention and treatment of experimental autoimmune neuritis in Lewis rats

Antigen therapy eliminates T cell inflammation by apoptosis: effective treatment of experimental autoimmune neuritis with recombinant myelin protein P2.

Exposure of T cells to their specific antigen normally results in proliferation, but in the presence of high and repeatedly administered doses of antigen, T cells may undergo apoptosis. Here we demonstrate that i.v. administration of as little as 100 microg of recombinant P2 protein twice daily completely prevents experimental autoimmune neuritis induced by adoptive transfer of neuritogenic P2-specific T cells or by immunization with the neuritogenic P2-peptide-spanning amino acids 53-78. Antigen treatment started after disease onset markedly ameliorated experimental autoimmune neuritis. The mechanism of action may be through programmed T cell death; a profound increase of the rate of apoptosis was seen in inflammatory foci of peripheral nerves and in the spleen. There was no cytokine switch by our Th1 cells after exposure to their specific antigen, but increased secretion of interferon gamma and tumor necrosis factor alpha was demonstrated. High antigen dose therapy using recombinant, pathogen-free protein may prove useful for the treatment of autoimmune inflammatory disorders of the nervous system.