myelin-basic-protein and Multiple-Sclerosis

Myelin basic protein (MBP) is an abundant protein in central nervous system (CNS) myelin. MBP has long been studied as a factor in the pathogenesis of the autoimmune neurodegenerative disease multiple sclerosis (MS). MS is characterized by CNS inflammation, demyelination, and axonal loss. One of the main theories on the pathogenesis of MS suggests that exposure to foreign antigens causes the activation of cross-reactive T cells in genetically susceptible individuals, with MBP being a possible autoantigen. While a direct role for MBP as a primary antigen in human MS is unclear, it is clear that MBP and its functions in myelin formation and long-term maintenance are linked to MS. This review looks at some key molecular characteristics of MBP and its relevance to MS, as well as the mechanisms of possible molecular mimicry between MBP and some viral antigens. We also discuss the use of serum anti-myelin antibodies as biomarkers for disease. MBP is a prime example of an apparently simple, but in fact biochemically and structurally complex molecule, which is closely linked to both normal nervous system development and neurodegenerative disease.

Topics: Autoantigens; Humans; Multiple Sclerosis; Myelin Basic Protein; Neurodegenerative Diseases; T-Lymphocytes

Multiple sclerosis (MS) is a debilitating disease that arises from immune system attacks to the protective myelin sheath that covers nerve fibers and ensures optimal communication between brain and body. Although the cause of MS is unknown, a number of factors, which include viruses, have been identified as increasing the risk of displaying MS symptoms. Specifically, the ubiquitous and highly prevalent Epstein-Barr virus, human herpesvirus 6, cytomegalovirus, varicella-zoster virus, and other viruses have been identified as potential triggering agents. In this review, we examine the specific role of proline-rich proteins encoded by these viruses and their potential role in MS at a molecular level.

Topics: Herpesviridae; Humans; Molecular Mimicry; Multiple Sclerosis; Myelin Basic Protein; Oligodendroglia; Phosphorylation; Proline-Rich Protein Domains; Risk Factors; src Homology Domains; Ubiquitin-Protein Ligases; Viral Proteins; Virus Physiological Phenomena; WW Domains

Multiple sclerosis (MS) is an immune-mediated central nervous system (CNS) inflammatory demyelinating disease in which analysis of clinical presentation, imaging studies, and laboratory tests aid in diagnosis.. This review discusses laboratory tests ordered to rule out and rule in MS, such as the traditional measurement of cerebrospinal fluid (CSF) IgG index and oligoclonal bands. Biomarkers discovered in the past 2 decades, such as aquaporin-4 (AQP4) antibodies and myelin oligodendrocyte glycoprotein (MOG) antibodies, have been incorporated into clinical practice in the diagnosis of disorders referred to as MS mimics. The importance of test selection, assay methodology, optimal sample for testing, and diagnostic utility of these biomarkers is reviewed. Other laboratory testing that can aid in the differentiation between MS and these biomarker-defined CNS demyelinating diseases is described. There is a focus on emerging biomarkers such as the use of kappa immunoglobulin free light chain concentration in CSF and kappa CSF index measurement as an alternative to oligoclonal bands which has a potential for an improvement in laboratory workflows. Finally, the role of biomarkers of disease activity and prognosis are discussed, including neurofilament light chain, glial fibrillary acidic protein, and myelin basic protein. Future perspectives with improved laboratory testing tools and discovery of additional biomarkers are provided.. Laboratory testing for demyelinating disorders using CSF and serum are routine practices that can benefit from an update, as novel biomarker-defined entities have reduced the potential for MS misdiagnosis, and CSF/serum biomarkers reinstated in the diagnostic criteria of MS.

Topics: Aquaporins; Autoantibodies; Biomarkers; Glial Fibrillary Acidic Protein; Humans; Immunoglobulin G; Immunoglobulin kappa-Chains; Multiple Sclerosis; Myelin Basic Protein; Myelin-Oligodendrocyte Glycoprotein; Oligoclonal Bands

Multiple sclerosis (MS) is a multifocal demyelinating disease of the central nervous system (CNS) leading to the progressive destruction of the myelin sheath surrounding axons. It can present with variable clinical and pathological manifestations, which might reflect the involvement of distinct pathogenic processes. Although the mechanisms leading to the development of the disease are not fully understood, numerous evidences indicate that MS is an autoimmune disease, the initiation and progression of which are dependent on an autoimmune response against myelin antigens. In addition, genetic susceptibility and environmental triggers likely contribute to the initiation of the disease. At this time, there is no cure for MS, but several disease-modifying therapies (DMTs) are available to control and slow down disease progression. A good number of these DMTs were identified and tested using animal models of MS referred to as experimental autoimmune encephalomyelitis (EAE). In this review, we will recapitulate the characteristics of EAE models and discuss how they help shed light on MS pathogenesis and help test new treatments for MS patients.

Topics: Animals; Antigens; B-Lymphocytes; CD4-Positive T-Lymphocytes; CD8-Positive T-Lymphocytes; Encephalomyelitis, Autoimmune, Experimental; Humans; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Myelin-Oligodendrocyte Glycoprotein

Multiple sclerosis (MS) is a multifactorial demyelinating disease characterized by neurodegenerative events and autoimmune response against myelin component. Citrullination or deimination, a post-translational modification of protein-bound arginine into citrulline, catalyzed by Ca(2+) dependent peptidylarginine deiminase enzyme (PAD), plays an essential role in physiological processes include gene expression regulation, apoptosis and the plasticity of the central nervous system, while aberrant citrullination can generate new epitopes, thus involving in the initiation and/or progression of autoimmune disorder like MS. Myelin basic protein (MBP) is the major myelin protein and is generally considered to maintain the stability of the myelin sheath. This review describes the MBP citrullination and its consequence, as well as offering further support for the "inside-out" hypothesis that MS is primarily a neurodegenerative disease with secondary inflammatory demyelination. In addition, it discusses the role of MBP citrullination in the immune inflammation and explores the potential of inhibition of PAD enzymes as a therapeutic strategy for the disease.

Topics: Animals; Citrulline; Drug Delivery Systems; Humans; Hydrolases; Immunologic Factors; Multiple Sclerosis; Myelin Basic Protein; Neuroprotective Agents; Protein-Arginine Deiminases

The classic isoforms of myelin basic protein (MBP, 14-21.5 kDa) are essential to formation of the multilamellar myelin sheath of the mammalian central nervous system (CNS). The predominant 18.5-kDa isoform links together the cytosolic surfaces of oligodendrocytes, but additionally participates in cytoskeletal turnover and membrane extension, Fyn-mediated signalling pathways, sequestration of phosphoinositides and maintenance of calcium homoeostasis. All MBP isoforms are intrinsically disordered proteins (IDPs) that interact via molecular recognition fragments (MoRFs), which thereby undergo local disorder-to-order transitions. Their conformations and associations are modulated by environment and by a dynamic barcode of post-translational modifications, particularly phosphorylation by mitogen-activated and other protein kinases and deimination [a hallmark of demyelination in multiple sclerosis (MS)]. The MBPs are thus to myelin what basic histones are to chromatin. Originally thought to be merely structural proteins forming an inert spool, histones are now known to be dynamic entities involved in epigenetic regulation and diseases such as cancer. Analogously, the MBPs are not mere adhesives of compact myelin, but active participants in oligodendrocyte proliferation and in membrane process extension and stabilization during myelinogenesis. A central segment of these proteins is pivotal in membrane-anchoring and SH3 domain (Src homology 3) interaction. We discuss in the present review advances in our understanding of conformational conversions of this classic basic protein upon membrane association, including new thermodynamic analyses of transitions into different structural ensembles and how a shift in the pattern of its post-translational modifications is associated with the pathogenesis and potentially onset of demyelination in MS.

Topics: Humans; Intrinsically Disordered Proteins; Models, Molecular; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Oligodendroglia; Phosphorylation; Protein Isoforms; Protein Structure, Secondary

Autoimmune diseases (ADs) are a spectrum of diseases originating from loss of immunologic self-tolerance and T cell abnormal autoreactivity, causing organ damage and death. However, the pathogenic mechanism of ADs remains unclear. The current treatments of ADs include nonsteroidal anti-inflammatory drugs (NSAIDS), antimalarials, corticosteroids, immunosuppressive drugs, and biological therapies. With the need to prevent side effects resulting from current treatments and acquire better clinical remission, developing a novel pharmaceutical treatment is extremely urgent. The concept of T cell vaccination (TCV) has been raised as the finding that immunization with attenuated autoreactive T cells is capable of inducing T cell-dependent inhibition of autoimmune responses. TCV may act as an approach to control unwanted adaptive immune response through eliminating the autoreactive T cells. Over the past decades, the effect of TCV has been justified in several animal models of autoimmune diseases including experimental autoimmune encephalomyelitis (EAE), murine autoimmune diabetes in nonobese diabetic (NOD) mice, collagen-induced arthritis (CIA), and so on. Meanwhile, clinical trials of TCV have confirmed the safety and efficacy in corresponding autoimmune diseases ranging from multiple sclerosis (MS) to systemic lupus erythematosus (SLE). This review aims to summarize the ongoing experimental and clinical trials and elucidate possible molecule mechanisms of TCV.

Topics: Adaptive Immunity; Animals; Arthritis, Experimental; Clinical Trials as Topic; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Gene Expression; Humans; Lupus Erythematosus, Systemic; Mice; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell; T-Lymphocytes; Vaccination; Vaccines

Multiple sclerosis is believed to be mediated by T cells specific for myelin antigens that circulate harmlessly in the periphery of healthy individuals until they are erroneously activated by an environmental stimulus. Upon activation, the T cells enter the central nervous system and orchestrate an immune response against myelin. To understand the initial steps in the pathogenesis of multiple sclerosis, it is important to identify the mechanisms that maintain T-cell tolerance to myelin antigens and to understand how some myelin-specific T cells escape tolerance and what conditions lead to their activation. Central tolerance strongly shapes the peripheral repertoire of myelin-specific T cells, as most myelin-specific T cells are eliminated by clonal deletion in the thymus. Self-reactive T cells that escape central tolerance are generally capable only of low-avidity interactions with antigen-presenting cells. Despite the low avidity of these interactions, peripheral tolerance mechanisms are required to prevent spontaneous autoimmunity. Multiple peripheral tolerance mechanisms for myelin-specific T cells have been identified, the most important of which appears to be regulatory T cells. While most studies have focused on CD4(+) myelin-specific T cells, interesting differences in tolerance mechanisms and the conditions that abrogate these mechanisms have recently been described for CD8(+) myelin-specific T cells.

Topics: Animals; Autoantigens; CD4-Positive T-Lymphocytes; CD8-Positive T-Lymphocytes; Clonal Deletion; Humans; Immune Tolerance; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes, Regulatory

A potential therapeutic possibility for multiple sclerosis (MS) is provided by Tovaxin, a personalized autologous T-cell immunotherapy utilizing myelin-reactive lymphocytes from peripheral blood.. This review covers the production of the vaccine, which follows a series of steps after the acquisition of T-cells. This includes identification of the subsets that are myelin reactive, expansion ex vivo and, also extrinsically, inactivation of their replication capacity by cellular irradiation. Once attenuated, the modified cells are reintroduced into the donor. This process appears to induce a vigorous immune response towards specific populations of autoreactive T-cells determined to attack the myelin and its derivatives by trafficking from the vascular space into the CNS in MS. Historical aspects of the T-cell vaccination with Tovaxin, the process to obtain reactive T-cells and their attenuation techniques ex vivo are described. The clinical results obtained from clinical trials are also discussed.. The process of T-cell vaccination is complicated and presents some limitations. Further studies are required to provide scientific support and clinical evidence of the efficacy of Tovaxin in MS.

Topics: Animals; Humans; Lymphocyte Activation; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes; Treatment Outcome; Vaccines

Multiple sclerosis is the most frequent chronic inflammatory, demyelinating and neurodegenerative disease in young adults, but has no definitive pharmacological treatment. It is a heterogeneous disease from the immunological, neuropathological and clinical point of view, as well as in terms of its response to different therapies. Over the last two decades, pharmacology has focused on developing drugs that are capable of modifying the course of this disease, with the aim of reducing the frequency of the outbreaks and the speed at which the disability produced by the disease progresses. Nevertheless, today, there are no drugs that are capable of offering a curative effect that can fully stabilise the disease, and neuroprotective and neuroreparative strategies are still in their early stages. In this work we carry out a critical review of the different pathogenic paths involved in multiple sclerosis and we discuss the different pharmacological approaches that have been followed, based on the clinical trials that are currently being conducted. In the near future it is to be expected that, first, we will manage to stabilise the disease completely and, later, recover some of the functions altered by this disease. Research is being conducted at such a rate that we have to be optimistic and think that soon we will be able to improve the situation of those who suffer from the disease.

Topics: Adenosine Deaminase; Antigen-Presenting Cells; Antigens, CD; Cell Adhesion Molecules; Dihydroorotate Dehydrogenase; Humans; Lysophospholipids; Matrix Metalloproteinases; Multiple Sclerosis; Myelin Basic Protein; NF-kappa B; Oxidoreductases Acting on CH-CH Group Donors; Sphingosine; Transforming Growth Factor beta

CD4(+) T cells play a central role in the pathogenesis of multiple sclerosis (MS). Generation, activation and effector function of these cells crucially depends on their interaction with MHC II-peptide complexes displayed by antigen presenting cells (APC). Processing and presentation of self antigens by different APC therefore influences the disease course at all stages. Selection by thymic APC leads to the generation of autoreactive T cells, which can be activated by peripheral APC. Reactivation by central nervous system APC leads to the initiation of the inflammatory response resulting in demyelination. In this review we will focus on how MHC class II antigenic epitopes are created by different APC from the thymus, the periphery and from the brain, and will discuss the relevance of the balance between creation and destruction of such epitopes in the context of MS. A solid understanding of these processes offers the possibility for designing future therapeutic strategies.

Topics: Animals; Antigen Presentation; Autoantigens; Brain; Encephalomyelitis, Autoimmune, Experimental; Epitopes, T-Lymphocyte; Histocompatibility Antigens Class II; Humans; Mice; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Nerve Tissue Proteins; Protein Processing, Post-Translational; Thymus Gland; Transcription Factors

Multiple sclerosis (MS) is a disease of the human CNS, characterized by perivascular inflammation, demyelination and axonal damage. Although the etiology of MS is unknown, it is believed that the disease results from destructive autoimmune mechanisms, presumably initiated by abnormal activation of potentially pathogenic autoimmune T-cells recognizing CNS components. The myelin-associated oligodendrocyte basic protein (MOBP), a relatively abundant CNS-specific myelin protein, which plays a role in stabilizing the myelin sheath in the CNS, has recently been implicated in the pathogenesis of MS. Here we review studies showing that MOBP is as an important candidate target antigen in MS as the other widely studied target antigens, myelin basic protein (MBP), proteolipid protein (PLP), and myelin oligodendrocyte glycoprotein (MOG). The studies summarized below indicate that T-cell autoimmunity against MOBP can be detected in MS patients; T-cells reactive against MOBP can be pathogenic in several mouse strains as well as in the "humanized" HLA-DR15-Tg mice; and, that the HLA-DQ6-restricted, but not HLA-DR15-restricted, MOBP-reactive T-cells cause in HLA-DR15-Tg mice MS-like clinical disease associated with perivascular and parenchymal infiltration, demyelination, axonal loss, and optic neuritis. Accordingly, the MOBP should be considered a bona fide primary target antigen in MS, in addition to MBP, PLP, and MOG.

Topics: Animals; Autoantigens; Demyelinating Diseases; Disease Models, Animal; HLA-DR Antigens; HLA-DR Serological Subtypes; Lymphocyte Activation; Mice; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Optic Neuritis; T-Lymphocytes

To identify HLA-DRB1 alleles contributing to susceptibility to multiple sclerosis (MS) in a Colombian population and to estimate the common effect size of HLA class II on MS susceptibility in Latin American populations through a meta-analysis.. A total of 65 Colombian patients with MS and 184 matched controls were included. HLA-DRB1 typing was done using the sequence-specific oligonucleotide probe method. A bivariate and a multivariate logistic regression analyses were done. Case-control studies performed in Latin America were searched up to January 2009 through a systematic review of the literature. Effect summary odds ratios (ORs) and 95% confidence intervals (CIs) were obtained by means of the random effect model.. A total of 464 cases and 2581 controls from 7 studies and the results of the present study in Colombians were analyzed. HLA-DRB1*15 (OR: 2.3; 95% CI: 1.68-3.07; p<0.001) and HLA-DQB1*06 (OR: 2.2; 95% CI: 1.54-3.07; p<0.001) groups as well as DRB1*1501 (OR: 2.6; 95% CI: 1.67-4.02; p<0.001), DRB1*1503 (OR: 2.2; 95% CI: 1.39-3.62; p=0.001) and DQB1*0602 (OR: 2.5; 95% CI: 1.66-3.71; p<0.001) alleles were found to be risk factors for MS. The myelin basic protein immunodominant sequence (221)VHFFKNIVT(229) was predicted to strongly and simultaneously bind to HLA-DRB1*1501 and *1503.. The current study highlights the effect size of HLA class II in MS in Latin America and confirms similar allelic risk factors across diverse populations. Receptor-ligand interactions in the HLA-antigenic peptide complex could have potential predictive and therapeutical implications.

Topics: Autoantigens; Case-Control Studies; Colombia; Female; Gene Frequency; Genetic Association Studies; Genetic Predisposition to Disease; Histocompatibility Testing; HLA-DQ Antigens; HLA-DR Antigens; HLA-DRB1 Chains; Humans; Male; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Polymorphism, Genetic; Protein Binding; Risk Factors

Recent studies outline apoptosis of oligodendrocytes (OLDs) as an early event prior to the formation of the demyelinated plaque and post-translational modifications (PTMs) of myelin basic protein as characteristic processes of normal-appearing white matter in multiple sclerosis (MS). We reviewed reports using the following keywords: apoptosis, PTMs, autoimmunity and multiple sclerosis in all possible combinations. Introductory basic scientific information is included for the non-experts. Given the standard and ongoing studies, we raise the hypothesis that, at least in some cases, defective apoptosis of OLDs, early in the course of the disease, and post-translationally modified molecules lead to the activation of immune responses and eventually to autoimmunity. Autoimmune reactions and epitope spreading that take place in the course of the disease might obscure the initial events and leave most investigators blind to etiopathogenesis. Our paper outlines the need for studies at the very early stages of the disease, as well as sequential ones, in order to give us a valuable hint about the clarification of the cause(s) of the different clinical subtypes of MS.

Topics: Animals; Apoptosis; Humans; Multiple Sclerosis; Myelin Basic Protein; Oligodendroglia; Protein Processing, Post-Translational

Disseminated sclerosis is currently regarded as a CNS autoimmune disease. One of the mechanisms behind this pathology is antibody (AB) formation. In this context, recent data on AB with proteolytic activity are of importance because they participate in selective proteolysis of myelin proteins in patients with disseminated sclerosis. This paper focuses on AB-proteases associated with disseminated sclerosis and site-specificity of antibody-mediated proteolysis of myelin basic protein. Protocol of serodiagnostic algorithm to be used in clinical practice is described.

Topics: Amino Acid Sequence; Antibody Specificity; Antigen-Presenting Cells; Autoantibodies; Epitopes; Humans; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptide Hydrolases; Serologic Tests; Substrate Specificity

The current treatments for multiple sclerosis (MS) are, by many measures, not satisfactory. The original interferon-β therapies were not necessarily based on an extensive knowledge of the pathophysiological mechanisms of the disease. As more and more insight has been acquired about the autoimmune mechanisms of MS and, in particular, the molecular targets involved, several treatment approaches have emerged. In this chapter, we highlight both promising preclinical approaches and therapies in late stage clinical trials that have been developed as a result of the improved understanding of the molecular pathophysiology of MS. These clinical stage therapies include oral agents, monoclonal antibodies, and antigen-specific therapies. Particular emphasis is given to the molecular targets when known and any safety concerns that have arisen because, despite the need for improved efficacy, MS remains a disease in which the safety of any agent remains of paramount importance.

Topics: Alemtuzumab; Animals; Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Antibodies, Monoclonal, Murine-Derived; Antibodies, Neoplasm; Cladribine; Crotonates; Daclizumab; Dimethyl Fumarate; Encephalomyelitis, Autoimmune, Experimental; Fingolimod Hydrochloride; Fumarates; Humans; Hydroxybutyrates; Immunoglobulin G; Immunosuppressive Agents; Immunotherapy; Mice; Multiple Sclerosis; Myelin Basic Protein; Nitriles; Peptide Fragments; Propylene Glycols; Quinolones; Rituximab; Sphingosine; Toluidines; Vaccines, DNA

The last decade has seen numerous advances in the treatment of multiple sclerosis with six immunotherapeutic agents licensed for use. Although these therapeutic agents have powerful effects upon the inflammatory phase of disease, they have limitations in treating the progression of disability and in their safety profile. This review focuses on our current understanding of first- and second-line treatments for multiple sclerosis, including combination therapies, and also discusses the most promising novel therapeutic strategies on the horizon. Such agents include orally administered immunosuppressive drugs, monoclonal antibodies, antigen-specific tolerance, and neural protection and repair strategies. The challenge ahead lies in the delivery of potent drugs to inhibit inflammation and neurodegeneration while limiting side effects. Further elucidation of the pathophysiology of disease may provide new clinical targets and disease-relevant biomarkers that, in combination with proteomics, may help personalize treatment to individual patients.

Topics: Animals; Antibodies, Monoclonal; Clinical Trials as Topic; Cytokines; Drug Combinations; Humans; Immunosuppressive Agents; Immunotherapy; Inflammation; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments

Multiple sclerosis (MS) is an autoimmune disease. The etiology and pathogenesis of MS remain unclear. At present, there are substantial evidences to support the hypothesis that genetics plays a crucial role. The people who have genetic predisposing genes easily develop immune-mediated disorder, probably in conjunction with environmental factors. The aim of this review is to describe recent observations regarding the immunologic pathogenesis of MS.

Topics: Animals; Autoantibodies; Humans; Models, Biological; Multiple Sclerosis; Myelin Basic Protein

Although the treatment of multiple sclerosis has made significant strides in the last decade, the therapeutic enhancement of repair has yet to make the successful translation from laboratory to clinic. Nevertheless, advances in the biology of stem and precursor cells, particularly in relation to myelin damage, make this a realistic proposition during the next decade. Replacing lost myelin (remyelination) is currently thought to be an important clinical objective because of the role it might play in slowing or preventing axonal degeneration. Stem/precursor cell-based strategies for enhancing remyelination can be divided into those in which cells are transplanted into a patient (exogenous or cell therapies) and those in which the patient's own stem/precursor cells are mobilised to more efficiently engage in healing areas of demyelination (endogenous or pharmacological therapies). While the two approaches tend to be regarded separately they are not mutually exclusive. This article focuses on the endogenous approach and reviews the nature and nomenclature of the stem and precursor cells present within the adult CNS that engage in remyelination and that are therefore potential targets for pharmacological manipulation.

Topics: Adult Stem Cells; Animals; Cell Differentiation; Cell Proliferation; Humans; Multiple Sclerosis; Myelin Basic Protein; Nerve Regeneration

Multiple sclerosis (MS) is the most common human inflammatory, demyelinating and degenerative disorder of the CNS. Based mostly on work in experimental autoimmune encephalomyelitis, CD4(+) T cells were long thought to play the crucial role in MS pathogenesis. Only more recently has it been recognized that other effector cell types, including CD8(+) T cells, gammadelta-T cells and B lymphocytes may also have an important role in disease initiation and perpetuation. The expression of soluble inflammatory mediators, including cytokines and free radicals, may be one of the late pathways mediating CNS tissue damage. In addition, in virtually all patients with MS, an oligoclonal banding pattern of antibodies can be detected in the cerebrospinal fluid (CSF). However, the cause of MS still remains unknown. Specifically, no single foreign or self antigen has been identified to account for clinical disease activity or the presence of surrogate disease markers. All approved pharmacotherapies have anti-inflammatory or immunoregulatory properties and work in early stages of the disease. In a recent clinical trial, BHT-3009, a DNA vaccine encoding full-length human myelin basic protein, was tested in patient with MS. BHT-3009 was safe and well tolerated. In addition, immunization with BHT-3009 induced anti-inflammatory antigen-specific immune changes consisting of a marked decrease in T-cell proliferation of IFN gamma production and a reduction in titers of myelin-specific autoantibodies in the CSF. This review will discuss these intriguing observations and the overall potential of DNA vaccination in MS.

Topics: Autoantibodies; B-Lymphocytes; Brain; Forecasting; Humans; Immune Tolerance; Inflammation Mediators; Lymphocyte Activation; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes; Vaccines, DNA

Opexa Pharmaceuticals Inc is developing Tovaxin, a trivalent formulation of attenuated myelin-peptide-reactive T-cells, for the potential treatment of multiple sclerosis. Tovaxin is being evaluated in phase II clinical trials. Opexa was previously investigating Tovaxin for the potential treatment of rheumatoid arthritis; however, no development has been reported for this indication since December 2002.

Topics: Clinical Trials as Topic; Drug Evaluation, Preclinical; Humans; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; T-Lymphocytes; T-Lymphocytes, Regulatory; Vaccination; Vaccines

Myelin basic protein (MBP) binds to negatively charged lipids on the cytosolic surface of oligodendrocyte membranes and is responsible for adhesion of these surfaces in the multilayered myelin sheath. The pattern of extensive post-translational modifications of MBP is dynamic during normal central nervous system (CNS) development and during myelin degeneration in multiple sclerosis (MS), affecting its interactions with the myelin membranes and with other molecules. In particular, the degree of deimination (or citrullination) of MBP is correlated with the severity of MS, and may represent a primary defect that precedes neurodegeneration due to autoimmune attack. That the degree of MBP deimination is also high in early CNS development indicates that this modification plays major physiological roles in myelin assembly. In this review, we describe the structural and functional consequences of MBP deimination in healthy and diseased myelin.

Topics: Amino Acid Sequence; Animals; Arthritis, Rheumatoid; Citrulline; Humans; Hydrolases; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Protein Conformation; Protein Processing, Post-Translational; Protein-Arginine Deiminases

The pathogenesis of MS is unknown. In our studies, we have demonstrated an important role for citrullinated myelin basic protein (MBP). The accompanying loss of positive charge compromises the ability of MBP to interact with the lipid bilayer. The conversion of arginine to citrulline in brain is carried out by an enzyme peptidyl arginine deiminase (PAD) 2. The amount of PAD 2 in brain was increased in MS normal-appearing white matter. The mechanism responsible for this increase involved hypomethylation of the promoter region in the PAD 2 gene in MS, but no change (compared to normal) was found in thymus tissue DNA from the same MS patients. In addition, no change was observed in other neurological diseases, including Alzheimer's, Parkinson's, and Huntington's. We propose that citrullinated MBP, resulting from elevated levels of PAD 2 represents an important biochemical pathway in the pathogenesis of MS.

Topics: Apoptosis; Citrulline; Humans; Hydrolases; Methylation; Multiple Sclerosis; Myelin Basic Protein; Oligodendroglia; Protein Conformation; Protein Processing, Post-Translational; Protein-Arginine Deiminases

Myelin basic protein (MBP) binds to negatively charged lipids on the cytosolic surface of oligodendrocyte membranes and is responsible for adhesion of these surfaces in the multilayered myelin sheath. The pattern of extensive posttranslational modifications of MBP is dynamic during normal central nervous system development and during myelin degeneration in multiple sclerosis (MS), affecting its interactions with the myelin membranes and other proteins. In particular, the degree of deimination (or citrullination) of MBP is correlated with the severity of MS, and may represent a primary defect that precedes neurodegeneration due to autoimmune attack. That MBP deimination also affects topological accessibility of an otherwise partially buried immunodominant epitope of the protein indicates that this modification may play a major role in the autoimmune pathogenesis of the disease. In this chapter, we describe the structural and functional consequences of MBP deimination in healthy and diseased myelin.

Topics: Animals; Autoimmunity; Demyelinating Diseases; Humans; Immunodominant Epitopes; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Protein Conformation; Protein Processing, Post-Translational

The adaptive immune response in multiple sclerosis (MS) targets various myelin proteins and even some inducible heat shock proteins. A few attempts have been made to tolerize relapsing-remitting patients with MS to either full-length myelin basic protein or to a key peptide epitope between residues 83-99. These trials have demonstrated that this approach may potentially provide benefit to patients with relapsing- remitting MS. However, manipulation of responses to myelin proteins can have deleterious effects. The immune response to myelin components is positioned at a key tipping point in the pathophysiology of the disease. Clarification of the key target antigens in MS, and better understanding of practical methods to attain tolerance to a wide variety of myelin and neuronal molecules will provide the basis for the ultimately successful antigen specific therapy.

Topics: Antigens; Epitopes; Humans; Multiple Sclerosis; Myelin Basic Protein

Multiple Sclerosis (MS) is a chronic inflammatory autoimmune disease of the central nervous system (CNS) characterized by the presence of cellular infiltrates consisting primarily of lymphocytes and macrophages and localized areas of demyelination in the CNS. MS is thought to be initiated by self-reactive CD4(+) Th1 T cells. Thus far, treatment modalities for MS are limited, with the most common acting nonspecifically on the immune system, resulting in a general immunosuppression accompanied by severe side effects. There is a large demand for developing MS therapy that particularly targets pathogenic myelin-specific T cells. Experimental allergic encephalomyelitis (EAE) is a well-characterized animal model that mimics many of the disease symptoms of MS, including the presence of cellular infiltrates and demyelination. EAE can be actively induced in genetically susceptible strains of mice, rats, and monkeys and is mediated by activated autoreactive CD4(+) T cells that are specific to MBP (myelin basic protein). The knowledge acquired using EAE allows us to better understand the pathogenesis of MS and thus manipulate particular components of the immune response in order to develop an efficient therapy.

Topics: Animals; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Humans; Mice; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Receptors, Antigen, T-Cell; T-Lymphocytes; Th1 Cells

Cerebrospinal fluid (CSF) is the body fluid closest to the pathology of multiple sclerosis (MS). For many candidate biomarkers CSF is the only fluid that can be investigated. Several factors need to be standardized when sampling CSF for biomarker research: time/volume of CSF collection, sample processing/storage, and the temporal relationship of sampling to clinical or MRI markers of disease activity. Assays used for biomarker detection must be validated so as to optimize the power of the studies. A formal method for establishing whether or not a particular biomarker can be used as a surrogate end-point needs to be adopted. This process is similar to that used in clinical trials, where the reporting of studies has to be done in a standardized way with sufficient detail to permit a critical review of the study and to enable others to reproduce the study design. A commitment must be made to report negative studies so as to prevent publication bias. Pre-defined consensus criteria need to be developed for MS-related prognostic biomarkers. Currently no candidate biomarker is suitable as a surrogate end-point. Bulk biomarkers of the neurodegenerative process such as glial fibrillary acidic protein (GFAP) and neurofilaments (NF) have advantages over intermittent inflammatory markers.

Topics: Biomarkers; Follow-Up Studies; Glial Fibrillary Acidic Protein; Humans; Inflammation; Multiple Sclerosis; Myelin Basic Protein; Nerve Growth Factors; Neurofilament Proteins; S100 Calcium Binding Protein beta Subunit; S100 Proteins

This article is focusing on the etiology of the multiple sclerosis (MS). MS is the disease of autoimmune origin, concerning mainly young people with its complicated nature. The course of the degenerative and inflammatory process is variable and unexpected, from featureless to the vast and rapidly progressing nature, leading to the considerable disability. The etiological factors are not still well known. We can distinguish different agents: genetic, immunological and environmental, among them tobacco smoking also. Authors survey the etiopathological basis of the disease.

Topics: Adjuvants, Immunologic; Adult; Autoimmunity; Causality; Chronic Disease; Comorbidity; Cytokines; Female; Humans; Male; Multiple Sclerosis; Myelin Basic Protein; Smoking; T-Lymphocytes; Tobacco Use Disorder

In this Mini-Review we present a new hypothesis in support of the neurodegenerative theory as a mechanism for the pathogenesis of multiple sclerosis (MS). The pathogenesis of MS results from changes in two distinct CNS compartments. These are the "myelin" and "nonmyelin" compartments. The myelin compartment is where primary demyelination, amidst attempts at remyelination, is superseded in the CNS by ongoing disease. Recent evidence obtained via magnetic resonance imaging and spectroscopy techniques supports the view that the normal-appearing white matter (NAWM) in the MS brain is altered. Several biochemical changes in NAWM have been determined. These include the cationicity of myelin basic protein (MBP) as a result of the action of peptidyl argininedeiminase (PAD) activity converting arginyl residues to citrulline. The accompanying loss of positive charge makes myelin susceptible to vesiculation and MBP more susceptible to proteolytic activity. An increase of MBP autocatalysis in the MS brain might also contribute to the generation of immunodominant epitopes. Accompanying the destruction of myelin in the myelin compartment is the activation of astrocytes and microglia. These contribute to the inflammatory response and T-cell activation leading to autoimmunity. The complex environment that exists in the demyelinating brain also affects the "nonmyelin" compartment. The inappropriate up-regulation of molecules, including those of the Jagged-1-Notch-1 signal transduction pathway, affects oligodendrocyte precursor cell (OPC) differentiation. Other effectors of oligodendrocyte maturation include stathmin, a microtubule-destabilizing protein, which prevents healing in the demyelinating brain. The hypothesis we present suggests a therapeutic strategy that should 1) target the effectors within the myelin compartment and 2) enable resident OPC maturation in the nonmyelin compartment, allowing for effective repair of myelin loss. The net effect of this new therapeutic strategy is the modification of the disease environment and the stimulation of healing and repair.

Topics: Animals; Central Nervous System; Humans; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Sheath; Nerve Fibers, Myelinated; Oligodendroglia; Recovery of Function

Confronting Multiple Sclerosis requires as an underlying step the manipulation of immune response through modification of Myelin Basic Protein peptides. The aim is to design peptidic or nonpeptidic molecules that compete for recognition of self-antigens at the level of antigen presentation. The rational approach is to substitute residues that serve as anchors for the T-Cell Receptor with others that show no binding at all, and those that serve as Major Histocompatibility Complex II anchors with others that present increased binding affinity. The resulting structure, hence, retains normal or increased MHC II binding properties, but fails to activate disease-inducing T-cells. This rational design can only be achieved by identifying the structural requirements for binding of the natural peptide to MHC II, and the anchor residues with their corresponding specific pockets in the binding groove. The peptide-MHC II complex then interacts with the TCR; thus, an additional way to trigger the desired immune response is to alter secondary anchor residues as well as primary ones. In this review, the structural requirements for binding of MBP peptides to MHC II are presented, as are the mechanism and key features for TCR recognition of the peptide-MHC II complex.

Topics: Animals; Histocompatibility Antigens Class II; Models, Molecular; Multiple Sclerosis; Myelin Basic Protein; Peptides; Protein Binding; Receptors, Antigen, T-Cell; T-Lymphocytes

Neurocrine Biosciences is developing NBI-5788, an analog of an immunodominant epitope of myelin basic protein for the potential intravenous treatment of multiple sclerosis. By April 2005, enrollment for phase II trials was complete, with results expected early in 2006.

Topics: Animals; Clinical Trials, Phase I as Topic; Clinical Trials, Phase II as Topic; Humans; Multiple Sclerosis; Myelin Basic Protein; Neurotransmitter Agents; Peptide Fragments

Abnormal immunoglobulin synthesis within the central nervous system is a common finding in patients with multiple sclerosis (MS) that is often used for diagnosis. However, it is not clear whether antibodies, or the B-cells and plasma cells that make them, are critical to the pathogenesis of MS. Here we review the descriptive data that suggest a role for antibody in the pathogenesis of MS. The results of B-cell and antibody depletion studies in the animal model for MS, experimental autoimmune encephalomyelitis, are summarized, as well as early data using a chimeric monoclonal antibody to deplete B-cells in patients with MS.

Topics: Animals; Antibodies, Monoclonal; Antigen-Antibody Complex; Antilymphocyte Serum; Autoantibodies; B-Lymphocytes; Central Nervous System; Complement System Proteins; Encephalomyelitis, Autoimmune, Experimental; Humans; Lymphocyte Depletion; Mice; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Rats

Topics: Autoantibodies; Biomarkers; Demyelinating Autoimmune Diseases, CNS; Enzyme-Linked Immunosorbent Assay; Humans; Multiple Sclerosis; Myelin Basic Protein; Radioimmunoassay

Catalytic autoantibodies (abzymes) are autoantibodies that are potentially ready to realize certain effects in the organism, first of all antibody-mediated catalysis and cytotoxicity. Natural abzymes with protolytic (protabzymes) and DNA-hydrolyzing DNA-abzymes) activity are of the greatest interest. The most impressive example of the catalytic activity of protabzymes is hydrolysis of specific proteins, revealed in patients with autoimmune diseases, such as bronchial asthma (vasoactive intestinal neuropeptide), autoimmune thyroiditis (thyroglobulin), multiple sclerosis (myelin basic protein), and autoimmune myocarditis (cardiomyosin). The pathogenic role of DNA-abzymes is not quite clear yet. However, it has been proven that they present a powerful regulator of apoptosis and other cytotoxicity mechanisms in systemic autoimmune diseases and tumors. The most promising is use of abzymes as illness activity markers, and as therapeutic agents capable of catalyzing specific proteins or activating antitumoral chemotherapeutic preparations.

Topics: Animals; Antibodies, Catalytic; Apoptosis; Asthma; Autoantibodies; Autoimmune Diseases; Biomarkers; Cytotoxicity, Immunologic; DNA; Humans; Hydrolysis; Mice; Multiple Sclerosis; Myelin Basic Protein; Prodrugs; Thyroglobulin; Thyroiditis, Autoimmune; Vasoactive Intestinal Peptide

Molecular mimics of self-antigens can behave as altered peptide ligands and serve to ameliorate autoimmune disease. Analysis of experimental autoimmune encephalomyelitis with proteomic autoantibody microarrays reveals that there might exist a wide variety of microbes with features that mimic self-epitopes. Autoimmunity could therefore be modulated via microbial immunity, which may account for relapse and remission of ongoing disease.

Topics: Animals; Autoantigens; Autoimmunity; Encephalomyelitis, Autoimmune, Experimental; Epitopes; Humans; Ligands; Mice; Molecular Mimicry; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Peptide Fragments; Peptides; Self Tolerance

Multiple sclerosis (MS) is a common neurological disease, which affects young adults. Its course is unpredictable and runs over decades. It is considered as an autoimmune disease, and is neuropathologically characterized by demyelination, variable loss of oligodendroglial cells, and axonal degeneration. Demyelination provides a permitting condition for axonal degeneration, which seems to be causative of permanent neurological deficits. Hence, the current treatment, which works preferentially immunmodulatory, should be complemented by therapeutics, which improves remyelination not only for restoring conduction velocity but also for preventing an irreversible axonal damage. One strategy to achieve this aim would be to promote remyelination by stimulating oligodendroglial cells remaining in MS lesions. While central nervous system neurons were already known to respond to neurotrophins (NT), interactions with glial cells became apparent more recently. In vitro and in vivo studies have shown that NT influence proliferation, differentiation, survival, and regeneration of mature oligodendrocytes and oligodendroglial precursors in favor of a myelin repair. Two in vivo models provided direct evidence that NT can improve remyelination. In addition, their neuroprotective and anti-inflammatory role would support a repair. Hence, a wealth of data point to NT as promising therapeutical candidates.

Topics: Animals; Blotting, Western; Carrier Proteins; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Humans; Immunohistochemistry; In Vitro Techniques; Membrane Proteins; Microscopy, Electron; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Nerve Growth Factors; Nerve Regeneration; Neuroimmunomodulation; Oligodendroglia; Receptor, trkA; Receptors, Nerve Growth Factor

Multiple sclerosis (MS) is a complex human autoimmune-type disease with a predominantly unknown etiology. Immunologic destruction of myelin basic protein (MBP) throughout the nervous system is the major pathology of multiple sclerosis. This review will attempt to update new information about basic mechanisms and therapeutic management of the disease. The significance of the structure of MBP is discussed with respect to the contribution of such structures to the disease process. A number of MBP peptides that serve as the immunodominant antigens in MS patients have been identified. These peptides have been studied in animal models for their antigenic characteristics and ability to induce disease. Evidence for genetic contributions is reviewed with multigenerational twin studies providing the best evidence for susceptible haplotypes. The role of microorganisms/viruses and environmental agents are discussed as potential etiological factors but are now thought to be of minor importance to the primary causal development of the disease. Of major consideration are immunological mechanisms that contribute to the development of autoimmunity. In particular, antigen expression, cytokine and leukocyte interactions, and regulatory T-cells are discussed. Particular attention is given to regulatory T-cells (Treg), which help balance/modulate other T-cells such as Th1 and Th2 cells, and how such Treg regulate autoimmunity is addressed. The importance of the role of Tregs is exemplified by the demonstration that administration of oral antigens can induce specific Tregs that counteract experimental autoimmune encephalomyelitis in animal models. The significance of animal studies to human multiple sclerosis is discussed. A potential role for natural antibodies and innate immune mechanisms to help provide resistance to disease development is also reviewed. Finally, a variety of therapeutic agents that have been and continue to be utilized for multiple sclerosis is reviewed. Trials with oral antigens, such as glatirmer acetate (copolymer 1) especially in combination with interferon-beta, have shown promise. Antibody therapy and bone marrow transplantation are also briefly discussed.

Topics: Animals; Clinical Trials as Topic; Disease Models, Animal; Forecasting; Humans; Immunity, Innate; Multiple Sclerosis; Myelin Basic Protein

T cells that are autoreactive against myelin antigens play a pivotal role in the pathogenesis of multiple sclerosis (MS). The concept of T cell vaccination (TCV) has been developed to generate an immune response against these autoreactive pathogenic T cells. Immunologic data accumulated so far demonstrates depletion of T cells reactive against immunodominant myelin peptides after immunization in the animal model of experimental autoimmune encephalomyelitis, as well as in vaccinated MS patients. Clinical trials have confirmed the safety and efficacy of TCV in a small number of immunized MS patients. TCV resulted in reduced relapse rates and slowed the progression of neurological disability and MRI brain lesion load. Recently, there have been several double-blind, placebo-controlled studies initiated to evaluate the role of TCV in MS. Specifically, it is important to examine the effect of early TCV, given after the first episode suggestive of the disease, in order to prevent the process of epitope spreading.

Topics: Animals; Autoimmunity; Encephalomyelitis, Autoimmune, Experimental; Epitopes; Humans; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes; Vaccination

Early recognition of whether a product has potential as a new therapy for treating multiple sclerosis (MS) relies upon the quality of the animal models used in the preclinical trials. The promising effects of new treatments in rodent models of experimental autoimmune encephalomyelitis (EAE) have rarely been reproduced in patients suffering from MS. EAE in outbred marmoset monkeys, Callithrix jacchus, is a valid new model, and might provide an experimental link between EAE in rodent models and human MS. Using magnetic resonance imaging techniques similar to those used in patients suffering from MS pathological abnormalities in the brain, white matter of the animal can be visualized and quantified. Moreover, NMR spectroscopy, in combination with pattern recognition, offers an advanced uroscopic technique for the identification of biomarkers of inflammatory demyelination.

Topics: Animals; Animals, Outbred Strains; Antigens, CD; Biomarkers; Brain; Callithrix; CD4-Positive T-Lymphocytes; Chronic Disease; Demyelinating Diseases; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Genes, MHC Class II; Humans; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Mice; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Radiography; T-Lymphocytes, Cytotoxic; Th2 Cells

Topics: Antibodies, Anti-Idiotypic; Antigens, Surface; Apoptosis; Autoantigens; Biomarkers; Down-Regulation; Humans; Immunohistochemistry; Interferon-gamma; Interleukins; Matrix Metalloproteinases; Multiple Sclerosis; Myelin Basic Protein; Nitric Oxide; Reactive Oxygen Species; Tumor Necrosis Factor-alpha; Uric Acid

The 18.5 kDa isoform of myelin basic protein (MBP) is a major component of the myelin sheath in the central nervous system of higher vertebrates, and a member of a larger family of proteins with a multiplicity of forms and post-translational modifications (PTMs). The 18.5 kDa protein is the exemplar of the family, being most abundant in adult myelin, and thus the most-studied. It is peripherally membrane-associated, but has generally been investigated in isolated form. MBP is an 'intrinsically unstructured' protein with a high proportion (approximately 75%) of random coil, but postulated to have core elements of beta-sheet and alpha-helix. We review here the properties of the MBP family, especially of the 18.5 kDa isoform, and discuss how its three-dimensional (3D) structure may be resolved by direct techniques available to us, viz., X-ray and electron crystallography, and solution and solid-state NMR spectrometry. In particular, we emphasise that creating an appropriate environment in which the protein can adopt a physiologically relevant fold is crucial to such endeavours. By solving the 3D structure of 18.5 kDa MBP and the effects of PTMs, we will attain a better understanding of myelin architecture, and of the molecular mechanisms that transpire in demyelinating diseases such as multiple sclerosis.

Topics: Amino Acid Sequence; Animals; Crystallography, X-Ray; Humans; Magnetic Resonance Spectroscopy; Models, Molecular; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Protein Conformation; Structure-Activity Relationship

Autoimmune T and B cell responses to CNS antigen(s) are thought to drive the pathogenesis of multiple sclerosis (MS), and thus are logical targets for therapy. Indeed, several immunomodulatory agents, including IFN-beta 1b, IFN-beta 1a, glatiramer acetate, and mitoxantrone, have had beneficial clinical effects in different forms of MS. However, because the available treatments are only partially effective, MS therapy needs to be further improved. Selective (antigen-specific) immunotherapies are especially appealing because in theory they combine maximal efficacy with minimal side effects. Indeed, several innovative immunotherapies have been successfully applied in experimental autoimmune encephalomyelitis. For example, autoreactive T cells can be selectively targeted by means of antigen, T cell receptor, or activation markers. However, experimental autoimmune encephalomyelitis is far from being a perfect approximation of MS because MS is more heterogeneous and the target antigen(s) is (are) not known. Further advances in MS therapy will depend on our growing understanding of the pathogenesis of this still incurable disease.

Topics: Animals; Autoantigens; Autoimmunity; Genetic Engineering; Glatiramer Acetate; Humans; Immune Tolerance; Immunotherapy; Multiple Sclerosis; Myelin Basic Protein; Peptides; T-Lymphocytes; Vaccination

An autoimmune response to one or more myelin-protein components is thought to be part of the pathogenesis of multiple sclerosis (MS). The immunodominant-autoantibody epitope may be localized on a linear peptide segment, on a conformation-sensitive epitope, or on an epitope resulting from post-translational modifications. Primary, secondary, and tertiary structures of myelin proteins may determine the specific site for binding of autoantibodies. A myelin protein-specific autoantibody can bind to either a linear or conformational epitope, whereas all of the T cell epitopes are linear. At present, the conformational epitopes of myelin proteins have not been identified; most of the methods used to identify the myelin-protein epitopes corresponding to the pathogenesis of multiple sclerosis are involved in the linear epitope mapping. Polymorphism or mutations may cause inappropriate expression of the myelin proteins with alterations to their linear and/or conformational epitopes, and make them susceptible to autoantibody binding, especially if these changes occur at the surface of the protein. This review focuses on the specificity of autoantibodies to the epitopes of myelin proteins and correlates this to the structures of proteins. Factors that influence the expression of myelin-protein epitopes such as the alpha-helical or beta-sheet structure of the protein, the tri-proline site, and the post-translational modifications as well as physicochemical properties of amino acid changed are included.

Topics: Antibody Specificity; Autoantibodies; Epitopes; Humans; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Protein Conformation; Protein Structure, Secondary; Protein Structure, Tertiary

Topics: Animals; Antibodies; Humans; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Risk Factors

Topics: Adrenoleukodystrophy; Antidepressive Agents, Tricyclic; Antipsychotic Agents; Autoimmunity; Benzodiazepines; Diffuse Cerebral Sclerosis of Schilder; Encephalomyelitis, Acute Disseminated; Humans; Methylprednisolone; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Neuromyelitis Optica; Olanzapine; Pirenzepine; Pulse Therapy, Drug; Selective Serotonin Reuptake Inhibitors; T-Lymphocytes

Multiple sclerosis (MS) is a demyelinating disorder of the central nervous system. It is believed to be an autoimmune disease arising from a breakdown of immune tolerance in T cells specific for myelin antigens. The heterogeneity in clinical signs and pathology observed in MS patients suggests a complex pathogenesis in which the specificity of the pathogenic T cells and the tolerance mechanisms that are compromised vary among individual patients. In this review, we summarize some of the features of the diverse immune pathology observed in MS and the animal models used to study this disease. We then describe the current state of knowledge regarding the expression of the major myelin protein antigens believed to be targeted in MS and the mechanisms of immune tolerance that operate on T cells that recognize these antigens.

Topics: Animals; Antigen Presentation; Autoantigens; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Humans; Immune Tolerance; Mice; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; T-Lymphocytes

Topics: Animals; Autoimmunity; CD8-Positive T-Lymphocytes; Cross Reactions; Glatiramer Acetate; Humans; Immune Tolerance; Immunotherapy; Ligands; Multiple Sclerosis; Myelin Basic Protein; Peptides; Receptors, Antigen, T-Cell; T-Lymphocytes

The need to ensure an accurate diagnosis and proper treatment for multiple sclerosis patients, considering the various clinical and immunopathological subtypes of the disease, requires the identification of biomarkers that measure disease activity and predict the course of disease development in individual patients. Moreover, the identification of effective indicators will lead not only to optimized patient treatment but also to the development of better tools for evaluating clinical trials. Recent studies focusing on the identification of possible immunological markers in multiple sclerosis will be reviewed.

Topics: Antigens, Surface; Biomarkers; Cytokines; Humans; Immune System; Matrix Metalloproteinases; Multiple Sclerosis; Myelin Basic Protein; Predictive Value of Tests; Prognosis; Uric Acid

Topics: Autoantigens; Humans; Immunodominant Epitopes; Multiple Sclerosis; Myelin Basic Protein; Peptides; T-Lymphocytes

Infectious agents are thought to play an important role in the development of autoimmune diseases. Sequence similarity between infectious agents and self-proteins (molecular mimicry) has been proposed as a mechanism for the induction of autoimmunity [1]. However, it has been difficult to identify microbial peptides that activate autoreactive T cells using conventional sequence alignments. This chapter reviews progress made in the identification of such microbial peptides based on the analysis of structural features that are important for TCR recognition of MHC-bound peptides [2].

Topics: Amino Acid Sequence; Autoimmune Diseases; Autoimmunity; Cross Reactions; Crystallography, X-Ray; Histocompatibility Antigens Class II; HLA-DR2 Antigen; Humans; Lymphocyte Activation; Molecular Mimicry; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Receptors, Antigen, T-Cell; Structure-Activity Relationship; T-Lymphocytes; Viral Proteins

These results support a model of epitope spreading (Figure 4) wherein localized virus-specific T cell-mediated inflammatory processes lead to the recruitment/activation of CNS-resident APCs which can serve both as effector cells for myelin destruction and as APCs which efficiently process/present endogenous self epitopes to autoreactive T cells. Thus, inflammatory responses induced by viruses which trigger pro-inflammatory Th1 responses and have the ability to persist in genetically susceptible hosts, may lead to chronic organ-specific autoimmune disease via epitope spreading. Regardless of the specificity of the T cells (myelin peptides in R-EAE or TMEV epitopes in TMEV-IDD) responsible for initiating myelin destruction, epitope spreading plays an important contributory role in the chronic disease process in genetically susceptible SJL mice. Epitope spreading has obvious important implications to the design of antigen-specific therapies for the potential treatment of MS and other autoimmune diseases. This process indicates that autoimmune diseases are evolving pathologies and that the specificity of the effector autoantigen-specific T cells varies during the chronic disease process.

Topics: Animals; Autoimmune Diseases; Demyelinating Diseases; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Epitopes; Humans; Mice; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Theilovirus

Topics: Animals; CD8-Positive T-Lymphocytes; Encephalomyelitis, Autoimmune, Experimental; Humans; Multiple Sclerosis; Myelin Basic Protein; Nervous System Autoimmune Disease, Experimental; T-Lymphocytes

This review article summarises the initial preclinical studies as well as the different stages of clinical trials in multiple sclerosis (MS) with Copolymer 1 (Cop 1), recently denoted glatiramer acetate. Experimental studies on autoimmune encephalomyelitis (EAE), the animal model of MS, as well as studies on the mechanism of action in both animals and humans are discussed. The review describes the early clinical trials which were followed by Phase II and III trials, culminating in FDA approval in 1996 for the treatment of relapsing-remitting MS. The accumulated experience with glatiramer acetate indicates that its efficacy is apparently increased as a function of usage time while the favourable side effect profile is sustained. MRI studies revealed that treatment with glatiramer acetate resulted in a significant reduction of gadolinium (Gd)-enhancing lesions. Ongoing clinical trials which might extend its usage or change its mode of delivery are also described. Glatiramer acetate appears to be a treatment of choice for the relapsing-remitting type of MS.

Topics: Animals; Antibody Formation; Clinical Trials as Topic; Cross Reactions; Drug Approval; Encephalitis; Glatiramer Acetate; Guidelines as Topic; Histocompatibility Antigens Class II; Humans; Immunosuppressive Agents; Magnetic Resonance Imaging; Multicenter Studies as Topic; Multiple Sclerosis; Myelin Basic Protein; Patient Dropouts; Peptides; T-Lymphocytes; T-Lymphocytes, Regulatory; Th1 Cells

Vaccination with inactivated autoreactive T cells (T-cell vaccination) was originally developed to study immune regulation in experimental autoimmune conditions. During the last two decades, research in this area has led to the new understanding of cellular and molecular mechanisms whereby autoreactive T cells are regulated in vivo and the development of new therapeutic strategies using synthetic peptides and plasmid or viral DNA vectors. Recently T-cell vaccination has been advanced to human trials in patients with multiple sclerosis. These early clinical studies were designed to test the potential treatment efficacy of T-cell vaccination and have shown some promising results. In this article, new insights in the understanding of the regulatory mechanism induced by T-cell vaccination and the results of the clinical trials are reviewed. In particular, issues related to the improvement of the current T-cell vaccination protocol are discussed in relationship to the concept of immune regulation and clinical considerations.

Topics: Animals; Antibodies, Anti-Idiotypic; Autoantigens; Clinical Trials as Topic; Humans; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Receptors, Antigen, T-Cell; T-Lymphocytes; Th2 Cells; Vaccination

Models that adequately reflect the complexity of human multiple sclerosis (MS) are needed, especially for preclinical testing of immunomodulatory drugs. Our group has created a unique experimental system in a New World outbred primate, the common marmoset Callithrix jacchus (C. jacchus). Following immunization with myelin, these monkeys develop a chronic, relapsing-remitting form of experimental allergic encephalomyelitis (EAE), which pathologically recapitulates the hallmark features of lesions of human MS. The MS-like lesion in C. jacchus results from a complex immune response against myelin antigens and requires both T cells and pathogenic antibodies. Studies of C. jacchus EAE have permitted the identification of a major target for pathogenic autoantibodies in MS, the myelin/oligodendrocyte glycoprotein. Other advantages of the model include a natural bone-marrow chimerism, which permits T-cell adoptive transfers between siblings, and the possibility of using different antigens to produce either inflammatory or demyelinating phenotypes of EAE. Despite their small size, sequential in vivo imaging and immunological studies are possible in these monkeys, and have been used to monitor efficacy in preclinical trials. Due to close phylogeny and high homology of immune and nervous system genes with humans, this model should fast-track the development of novel therapeutics for MS.

Topics: Animals; Autoantibodies; Brain; Callithrix; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Epitopes, T-Lymphocyte; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; Myelin Sheath; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Peptide Fragments

In multiple sclerosis (MS), inflammatory demyelination in the central nervous system is thought to be initiated by T cells that recognize myelin antigens. T cells are the main regulators of acquired immunity and are involved in the pathogenesis of several organ-specific autoimmune diseases. This review provides an overview of recent studies on the role of T cells in autoimmune demyelination. Because autoreactive T cells are normally present in the mature repertoire of T cells in the blood and lymphoid organs of MS patients, but also in normal controls, particular attention is devoted to the mechanisms of activation and the functional phenotype of such T cells in patients with MS. The role of cytokines as effector molecules and the main candidate antigens are also discussed.

Topics: Amino Acid Substitution; Antigen Presentation; Autoantigens; Autoimmune Diseases; Blood-Brain Barrier; Chemokines; Clinical Trials, Phase II as Topic; Cytokines; Humans; Immunologic Memory; Ligands; Lymphocyte Activation; Magnetic Resonance Imaging; Molecular Mimicry; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Nerve Tissue Proteins; Peptide Fragments; T-Lymphocyte Subsets

Myelin basic protein (MBP) is a major component of the myelin sheath of both the central and peripheral nervous systems. A number of neurological diseases in humans are associated with demyelination of the central and/or peripheral nervous systems, including multiple sclerosis and its variants such as acute disseminated encephalomyelitis (AD), acute hemorrhagic leukoencephalopathy, and idiopathic polyneuritis (Guilliame-Barre syndrome), as well as tropical spastic paraparesis (TSP), and progressive multifocal leukoencephalopathy (PML). Multiple sclerosis (MS) is perhaps the most common demyelinating disease and is one of great importance to the clinical neurologist. The underlying cause of the demyelination seen in multiple sclerosis patients is unknown. However, patients frequently have unusually high antibody titers to a number of common viruses, leading to speculation that viral infections may participate in the pathogenesis of MS. On the other hand, studies on maternal and paternal twins have suggested the involvement of genetic factors in the predisposition of an individual toward developing MS. PML, once a rare demyelinating disease of elderly patients with lymphoproliferative disorders, is now a much more common disease affecting patients of all ages due to the increasingly widespread use of immunosuppressive chemotherapy and the prevalence of AIDS. PML is the result of productive infection of oligodendrocytes, the myelin producing cells of the CNS, with the human polyomavirus, JCV. In this article, we have focused our attention on PML, and the role of JCV in disrupting myelin sheaths by affecting myelin basic gene expression, ultimately leading to demyelination.

Topics: Genes, Viral; Humans; JC Virus; Leukoencephalopathy, Progressive Multifocal; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath

Multiple Sclerosis (MS) is considered a T cell-mediated autoimmune disease of central nervous system myelin. Based on elegant experiments in an animal model of MS, experimental allergic encephalomyelitis (EAE), a number of myelin proteins and peptides derived from these can induce inflammatory demyelinating lesions. Recent studies with transgenic mice expressing human HLA-DR molecules and a myelin basic protein (MBP)-specific T cell receptor as well as data from a phase II clinical trial with an altered peptide ligand based on MBP peptide (83-99) provide convincing evidence that the pathogenetic concepts which largely stem from the above EAE studies are valid in MS, too.

Topics: Animals; Autoantigens; Clinical Trials, Phase II as Topic; Humans; Ligands; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Peptide Fragments; Receptors, Antigen, T-Cell; T-Lymphocytes

The potential causes, immunopathology, and treatment of multiple sclerosis (MS) are summarized in this article. Findings from a well-examined animal model for MS, experimental allergic encephalomyelitis (EAE), are described and used to illustrate the paths of research in MS. Data from a recent clinical trial with a modified myelin peptide provide support for concepts deduced from EAE. The authors stress that the complexity of the disease requires new techniques to capture the influence of single or combined treatment approaches.

Topics: Animals; Antigen-Presenting Cells; Autoantigens; Blood-Brain Barrier; Brain; Encephalomyelitis, Autoimmune, Experimental; Humans; Immunosuppressive Agents; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Peptide Fragments; Recombinant Proteins; T-Lymphocytes

Topics: Animals; Antibodies; Arthritis, Rheumatoid; Autoimmune Diseases; Cytokines; Diabetes Mellitus, Experimental; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Humans; Mice; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Th1 Cells; Th2 Cells; Time Factors

Multiple sclerosis is a putative autoimmune disease in which limited numbers of autoimmune T cells reactive to myelin basic protein or proteolipid protein would play critical roles in initiation or augmentation of the inflammatory processes. Owing to the recent immunological studies, it is now possible to discuss the possible link between infectious agents and the development of MS on the molecular terms. This article deals with key issues in this subject such as molecular mimicry between autoantigen and viral peptide, autoimmune T cell stimulation by bacterial superantigens, and regulatory network in MS. In addition to reviewing the current activity in other laboratories, I point out that there might be much more broader range of peptide ligands for autodestructive T cells causing MS. This postulate is based on our recent discovery for the presence of degenerate autoimmune T cells in animal model of MS (EAE). I also indicate the possibility that immune regulatory system could be destroyed by some infectious agents. These informations should have significant implications for management of MS patients.

Topics: Autoimmunity; Humans; Lymphocyte Activation; Multiple Sclerosis; Myelin Basic Protein; Peptides; Receptors, Antigen, T-Cell; Superantigens; T-Lymphocytes

Multiple sclerosis is an inflammatory demyelinating CNS disease of putatively autoimmune origin. Novel models of experimental autoimmune encephalomyelitis (EAE) have demonstrated that T cells specific for various myelin and even nonmyelin proteins are potentially encephalitogenic. The encephalitogenic T cell response directed against different CNS antigens not only determines the lesional topography of CNS inflammation but also the composition of the inflammatory infiltrates. The heterogeneity of the lesional distribution seen in EAE might therefore be useful for the understanding of the various clinical subtypes seen in MS. In this review the possible candidate autoantigens in MS are discussed with special regard to the human T cell and B cell responses against various myelin and nonmyelin proteins.

Topics: 2',3'-Cyclic-Nucleotide Phosphodiesterases; Adult; Animals; Autoantigens; B-Lymphocytes; Callithrix; Clinical Trials as Topic; Crystallins; Disease Susceptibility; Encephalomyelitis, Autoimmune, Experimental; Female; Heat-Shock Proteins; Humans; Immunotherapy; Infant; Infant, Newborn; Male; Mice; Molecular Mimicry; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Myelin-Associated Glycoprotein; Protein Isoforms; Rats; Rats, Inbred Lew; S100 Proteins; T-Lymphocytes; Transaldolase; Vaccination

In this article, we will examine the roles of transgenic and knockout animals that aid us in understanding two autoimmune diseases-type 1 (insulin-dependent) diabetes and multiple sclerosis. The first sections will focus on studies in type 1 diabetes to show how genetically altered animals have given insight into the role of various immune cell types, autoantigens, co-stimulatory molecules, cytokines and, finally, the role of various effector pathways in the pathogenesis of diabetes. The second section concentrating on the animal model of multiple sclerosis, experimental autoimmune encephalomyelitis (EAE), will show how animals that express a T-cell receptor derived from a clone able to cause disease have given insight into the pathogenesis of EAE.

Topics: Animals; Antigen Presentation; Autoantigens; B-Lymphocytes; CD8-Positive T-Lymphocytes; Cytokines; Diabetes Mellitus, Type 1; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Humans; Islets of Langerhans; Mice; Mice, Inbred NOD; Mice, Knockout; Mice, Transgenic; Multiple Sclerosis; Mutation; Myelin Basic Protein

Studies of experimental autoimmune encephalomyelitis in conventional and transgenic mouse models have clarified mechanisms of central and peripheral tolerance to myelin antigens. It is now clear that myelin antigens are expressed in the thymus and their expression can influence generation of the potential autoimmune T-cell repertoire. How autoreactive T cells escape tolerance in the thymus is largely unclear. One mechanism has been revealed through the use of a transgenic mouse expressing a T-cell receptor specific for a myelin antigen. T cells specific for the N-terminal epitope of myelin basic protein escape tolerance through low avidity interaction. The affinity of antigen binding to MHC also proves to be important for induction of peripheral tolerance. Peptides may be administered in solution to adults in order to reinstate peripheral tolerance and suppress disease. Induction of antigen-specific suppression with synthetic peptides can result in either linked or bystander suppression and this appears to involve the generation of T cells secreting suppressive cytokines. The use of altered peptide ligands for induction of peripheral tolerance has been investigated. This can be achieved but the complexity of the approach argues against its use for treatment of human autoimmune diseases.

Topics: Amino Acid Sequence; Animals; Autoimmune Diseases; Cytokines; Disease Models, Animal; Humans; Immune Tolerance; Immunotherapy; Mice; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell; T-Lymphocytes

T-cell receptor (TCR) transgenic mice provide the ability to follow the maturation and fate of T cells specific for self-antigens in vivo. This technology represents a major breakthrough in the study of autoimmune diseases in which specific antigens have been implicated. Proteins expressed within the central nervous system are believed to be important autoantigens in multiple sclerosis. TCR transgenic models specific for myelin basic protein (MBP) allowed us to assess the role of tolerance in providing protection from T cells with this specificity. Our studies demonstrate that T cells specific for the immunodominant epitope of MBP do not undergo tolerance in vivo and that TCR transgenic mice are susceptible to spontaneous autoimmune disease. The susceptibility to spontaneous disease is dependent on exposure to microbial antigens. MBP TCR transgenic models expressing TCRs specific for the same epitope of MBP but utilizing different V alpha genes exhibit differing susceptibilities to spontaneous disease. These data support the idea that genetic and environmental differences play a role in susceptibility to autoimmunity. MBP TCR transgenic models are playing an important role in defining mechanisms by which infectious agents trigger autoimmune disease as well as defining mechanisms by which tolerance is induced to distinct epitopes within self-antigens.

Topics: Animals; Autoantigens; Autoimmunity; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Humans; Immune Tolerance; Mice; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell

It is probable that myelin-reactive T cells, including those specific for myelin basic protein (MBP) contribute to the pathogenesis of multiple sclerosis (MS). Although many studies have characterized the specificity, MHC restriction, and V gene use of MBP-specific T cells, there is little agreement as to whether there are differences between MS and controls, and how HLA-DR2, a risk factor for MS, might influence selection of MBP-specific T cells. We here discuss models in which MHC class II alleles could help shape the TCR repertoire, and then review more than 750 clones reported in the literature. The major finding from our analysis is that both TCRAV8 and BV5, but not BV6 were utilized more frequently in MS patients than non-MS patients in response to MBP, although no differences were found between DR2+ versus DR2- donors. These data indicate HLA-independent differences in the T cell repertoire between MS patients and controls that may be important for targeted TCR-based therapy. Moreover, we conclude that (1) HLA-DR alleles preferentially restrict MBP responses, although MS patients tend to use HLA-DQ and -DP alleles more often than control donors; (2) HLA-DR2 alleles are used to restrict only about half the MBP responses in MS patients, significantly less than in control patients; (3) the DRB1*1501 and DRB5*0101 subtypes within the Dw2 haplotype are used relatively equally to restrict MBP responses. In this context, we review the results of our previous clinical trials in progressive MS patients, demonstrating the ability of TCRBV5S2 peptides to induce clinically relevant regulatory responses that inhibit MBP-specific Th1 cells through a bystander suppression mechanism.

Topics: Antigen Presentation; Genes, Immunoglobulin; Histocompatibility Antigens Class II; Humans; Immunoglobulin Variable Region; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell, alpha-beta

Topics: Autoantibodies; Humans; Multiple Sclerosis; Myelin Basic Protein; Nervous System Diseases

Copolymer 1 (Cop 1, Copaxone) is a synthetic amino acid copolymer effective in suppression of experimental allergic encephalomyelitis (EAE). The suppressive effect of Cop 1 in EAE is not restricted to a certain species, disease type or encephalitogen used for EAE induction. In phase II and III clinical trials, Cop 1 was found to slow the progression of disability and reduce the relapse rate in exacerbating-remitting multiple sclerosis (MS) patients. In vivo and in vitro studies suggest that the mechanism for Cop 1 activity in EAE and MS involves, as an initial step, the binding of Cop 1 to MHC class II molecules. This binding results in competition with myelin antigens for T-cell activation, both at the MHC and T-cell receptor levels and in induction of specific suppressor cells of the Th2 type. As an antigen-specific intervention, Cop 1 has the advantage of reduced probability for long-term damage to the immune system, and is thus a safe and effective novel therapeutic approach to MS. It also serves to illustrate the new concept of a drug/vaccine specific for a single autoimmune disease. Indeed, we have used a similar approach for myasthenia gravis. Myasthenia gravis (MG) and its experimental animal model, experimental autoimmune MG (EAMG), are immune disorders characterized by circulating antibodies and lymphocyte autoreactivity to nicotinic acetylcholine receptor (AChR). We utilized peptides representing different sequences of the human acetylcholine receptor alpha-subunit to study the role of T cells in the initiation, development and immunomodulation of myasthenia gravis. Here we summarize our studies over the last decade on T cells specific to 'myasthenogenic' epitopes of the alpha-subunit of the human acetylcholine receptor and their relevance for myasthenia gravis.

Topics: Animals; Autoimmune Diseases; Encephalomyelitis, Autoimmune, Experimental; Glatiramer Acetate; Humans; Immunosuppressive Agents; Multiple Sclerosis; Myasthenia Gravis; Myelin Basic Protein; Peptides; Vaccines

Myelin basic protein (MBP) or a fragment thereof may enter cerebrospinal fluid (CSF) and other body fluids in an etiologically nonspecific fashion to provide information about the status of central nervous system (CNS) myelin damage. MBP immunochemically detected is referred to as MBP-like material (MBPLM). The clinical utility of the assay for MBPLM in CSF is to document the presence, continuation, or resolution of CNS myelin injury. The analysis of CSF for MBPLM is subject to many variables, among which are the antisera and the form of the assay utilized. The dominant epitope of CSF MBPLM is in the decapeptide of 80-89 from the intact MBP molecule of 170 residues. Normally, CSF has no detected MBPLM. Following an acute relapse of MS, MBPLM rises quickly in the range of ng/ml and rapidly declines and disappears. The presence of MBPLM in CSF in chronic and progressive phases of the disease is unusual, but it may sometimes be detected in low levels, depending on the assay used for detection. The level of CSF MBPLM is related to both the mass of CNS myelin damage and how recently it occurred. The level of CSF MBPLM rarely is elevated in optic neuritis. The level of CSF MBPLM is unrelated to CSF protein level, level of IgG, presence of oligoclonal bands or pleocytosis. CSF MBPLM has the potential of serving as a marker of therapeutic effectiveness in MS and does have predictive value for response to glucocorticoids given for worsening of disease. The detection of MBPLM in body fluids other than CSF would be of great value because of the resulting improved feasibility for objectively monitoring the natural history of MS and response to therapy. Studies on blood have yet to produce a valid assay of MBPLM. Urinary MBPLM, though different in its features from that in CSF, may provide a correlate, not with acute demyelination in MS as is the case for CSF, but with progression of disease.

Topics: Humans; Multiple Sclerosis; Myelin Basic Protein

Immunization of Lewis rats with guinea-pig myelin basic protein (Gp-MBP) induced T cell responses to primary and secondary encephalitogenic determinants, as well as to a third non-encephalitogenic epitope, residues 55-69. This sequence is of interest due to its protective activity against experimental autoimmune encephalomyelitis. Protection involved induction of MBP-55-69-specific T cells expressing cross-reactive TCR BV8S6 genes that activated regulatory T cells specific for TCR BV8S2 determinants expressed on encephalitogenic T cells. We here present and discuss new evidence suggesting a possible immunological cross-reactivity between the protective Gp-MBP-55-69 peptide and the regulatory BV8S2-39-59 peptide. This cross-reactivity, which may also occur between the human MBP-55-74 peptide and the BV12S2-38-58 sequence, has potentially important implications for human diseases such as multiple sclerosis.

Topics: Animals; Cross Reactions; Encephalomyelitis, Autoimmune, Experimental; Epitopes, T-Lymphocyte; Humans; Multiple Sclerosis; Myelin Basic Protein; Peptides; Rats; Receptors, Antigen, T-Cell, alpha-beta; T-Lymphocytes; Th2 Cells; Vaccination

I postulate that multiple sclerosis is an autoimmune disease that involves genetically determined failure of activation-induced apoptosis of autoreactive T cells in the central nervous system. Activation of central-nervous-system-reactive T cells in peripheral lymphoid organs by exposure to crossreacting antigens or superantigens derived from common infectious agents may trigger attacks of multiple sclerosis. In normal individuals these activated T cells are deleted by activation-induced apoptosis, but in individuals predisposed to multiple sclerosis they survive, proliferate, and damage the central nervous system. The clinical course of multiple sclerosis may vary according to the antigens in the central nervous system being targeted: targeting of myelin antigens leads to a relapsing-remitting course of clinical recovery due to remyelination or other mechanisms; targeting of axonal antigens leads to a progressive course from onset because axonal regeneration is limited in the central nervous system. This hypothesis can account for many characteristics of multiple sclerosis and has predictions that can be tested.

Topics: Animals; Apoptosis; Autoimmune Diseases; Down-Regulation; Encephalomyelitis, Autoimmune, Experimental; Humans; Lymphocyte Activation; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes

Urinary myelin basic protein-like material (MBPLM) represents material which is cross-reactive with a cryptic epitope in peptide 84-89 of human myelin basic protein. While normally present at moderate levels in the adult, these levels rise higher in patients who have secondary progressive multiple sclerosis (MS). The increase in urine MBPLM correlates with the burden of disease detected by T2-weighted cranial magnetic resonance imaging. There is no correlation between urinary MBPLM and acute disease activity in relapsing-remitting MS. The first major need for improving the clinical utility of measurements of MBPLM in urine in MS patients is to delineate its exact chemical features so that assays may be improved and a potential biological role of the MBPLM better understood. The second major task is to apply the group data accumulated and apply them to individual patients. This could prove to be means to individually direct treatment and determine its effectiveness.

Topics: Adult; Body Fluids; Cross Reactions; Epitopes; Humans; Magnetic Resonance Imaging; Multiple Sclerosis; Myelin Basic Protein

Accumulating evidence indicates that multiple sclerosis (MS) is an autoimmune disease mediated by autoreactive T lymphocytes with specificity for myelin antigens. Initially, the evidence to support this hypothesis was based mainly on experiments performed in experimental allergic encephalomyelitis (EAE), the animal model of MS. In this model it was demonstrated that T cells reactive to several myelin antigens are encephalitogenic. Many recent immunological and immunohistochemical studies in MS have yielded further data to support this view. For instance, it was demonstrated that activated myelin basic protein (MBP) and proteolipid protein (PLP)-specific T cells accumulate in the central nervous system (CNS), and that clonally expanded MBP-specific T cells persist for several years in the blood of patients with MS. Furthermore, T cells with specificity for MBP were identified in the brain lesions of the patients. It is not yet clear how these autoreactive T cells are activated in the periphery, but several studies have suggested that viral antigens mimicking the myelin epitopes, or superantigens may be involved. Furthermore, we and others have provided evidence showing that the regulatory mechanisms that control autoreactive T cells in healthy subjects are potentially defective in MS patients. In addition to myelin reactive T cells, B cells producing myelin-specific antibodies and gamma delta T cells may also play an important role in the autoimmune cascade. Based on the recent insights in the disease mechanisms, new experimental therapies were developed to target specifically the pathogenic lymphocytes in MS. Some therapies yielded encouraging data in pilot studies, whereas phase III trials of other drugs showed beneficial effects on the disease course. In this article, we overview the most recent data on the role of autoreactive lymphocytes in the pathogenesis of the disease, and discuss some of the recently developed immunotherapeutical strategies in MS.

Topics: Adoptive Transfer; Animals; Autoimmune Diseases; Autoimmunity; Central Nervous System; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Humans; Immunotherapy; Lymphocyte Activation; Mice; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Rats; Receptors, Antigen, T-Cell; T-Lymphocyte Subsets; T-Lymphocytes

Topics: Animals; Antigen-Presenting Cells; Autoantigens; Autoimmunity; CD4-Positive T-Lymphocytes; Demyelinating Diseases; Encephalomyelitis, Autoimmune, Experimental; Gene Rearrangement; Histocompatibility Antigens Class II; Humans; Lymphocyte Activation; Macrophage Activation; Mice; Microglia; Models, Biological; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell, alpha-beta; T-Lymphocytes

Although monogenic diseases often show extreme clinical phenotypes, the major burden of genetic ill health lies in the more prevalent polygenic disorders, such as diabetes, hypertension and multiple sclerosis. These conditions affect many thousands of individuals and their management consumes vast amounts of health care resources: in the UK some 80,000 people have multiple sclerosis; the estimated financial cost to society of introducing treatments, such as beta interferon, could be as high as 250 million pounds per year. Knowledge on the genetics of these common diseases is poor, but has potentially received a considerable boost with the arrival of whole genome screening. The genome screen in insulin-dependent diabetes mellitus (IDDM) reported in 1994 was the first in a human polygenic disease. Since this publication, whole genome screening has been performed in a variety of human polygenic diseases, including schizophrenia, bipolar affective disorder, non-insulin-dependent diabetes mellitus (NIDDM), inflammatory bowel disease, asthma and multiple sclerosis.

Topics: Americas; Canada; France; Genetic Linkage; Genome, Human; Humans; Immunoglobulins; Major Histocompatibility Complex; Mitochondria; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell; United Kingdom

Myelin is a membrane characteristic of the nervous tissue and functions as an insulator to increase the velocity of the stimuli being transmitted between a nerve cell body and its target. Myelin isolated from human and bovine nervous tissue is composed of approximately 80% lipid and 20% protein, and 30% of the protein fraction constitutes myelin basic protein (MBP). MBP has an unusual amino acid at Res-107 as a mixture of NG-monomethylarginine and NG, N'G-dimethylarginine. The formation of these methylarginine derivatives is catalysed by one of the subtypes of protein methylase I, which specifically methylates Res-107 of this protein. Evidence is presented to demonstrate an involvement of this biological methylation in the integrity and maintenance of myelin.

Topics: Animals; Brain; Humans; Methylation; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Protein-Arginine N-Methyltransferases

S100 beta protein is a calcium binding protein that is not only expressed by astrocytes in the CNS, but also in many other tissues including the eye, thymus, spleen and lymph nodes. Despite this tissue distribution, which was expected to induce a firm state of self-tolerance to S100 beta, the Lewis rat mounts a strong T cell response to this autoantigen. The pathogenicity of this T cell response was demonstrated by the adoptive transfer of S100 beta-specific T cells which induced an inflammatory response in the CNS and eye of naive syngeneic recipients. The distribution of lesions in this novel model of EAE resembles that seen in some patients with MS, suggesting that the initial autoimmune insult in MS may be directed against a non-myelin antigen co-expressed in the CNS and extra-neural tissues.

Topics: Adoptive Transfer; Animals; Astrocytes; Calcium-Binding Proteins; CD4-Positive T-Lymphocytes; Encephalomyelitis, Autoimmune, Experimental; Humans; Multiple Sclerosis; Myelin Basic Protein; Nerve Growth Factors; Rats; Rats, Inbred Lew; S100 Calcium Binding Protein beta Subunit; S100 Proteins

Copolymer 1 (Cop 1), a synthetic copolymer of amino acids, is very effective in suppression of experimental autoimmune encephalomyelitis (EAE), the animal model for multiple sclerosis (MS). Cop 1 was found incapable of inducing EAE, yet it suppressed EAE in a variety of animal species, including primates. The immunological cross-reaction between the myelin basic protein (MBP) and Cop 1 serves as the basis for the suppressive activity of Cop 1 in EAE, by the induction of antigen-specific suppressor cells and competition with MBP for binding to major histocompatibility complex (MHC) molecules. Clinical trials with Cop 1, both Phase II and Phase III, were performed in relapsing-remitting (E-R) patients. The latter, a two-year multicenter double blind trial with 251 participating patients was conducted at 11 leading medical centers in the USA. It demonstrated a significant beneficial effect of Cop 1 in both diminishing the rate of exacerbations and improving the clinical status. The side effects of Cop 1 were only minimal. The cumulative results indicate that Cop 1 is a promising candidate drug for multiple sclerosis.

Topics: Animals; Clinical Trials as Topic; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Humans; Immunosuppressive Agents; Multiple Sclerosis; Myelin Basic Protein; Peptides; Recurrence

Multiple sclerosis is a chronic demyelinating disease of the central nervous system in young adults. It is considered a T cell-mediated autoimmune disease which is probably triggered by exogenous events, e.g. infectious agents, in susceptible individuals. Population, family and twin studies indicate that genetic factors and most likely several genes are associated with disease, but it is clear from the concordance rates of identical twins (25-30%) that genetic background as well as exogenous or somatic events are required to develop disease. Among many candidate genes which have been analyzed during recent years, the strongest association was shown for genes of the HLA-class II complex, in particular HLA-DR15 Dw2 and -DQw6. At present, it is not clear how the expression of a particular HLA-class II gene translates into susceptibility to develop an organ-specific autoimmune disease. Potential explanations how this could occur will be discussed.

Topics: Adult; Amino Acid Sequence; Chromosome Mapping; Family; Genes, MHC Class II; HLA-DQ Antigens; HLA-DR Antigens; HLA-DR Serological Subtypes; Humans; Major Histocompatibility Complex; Multiple Sclerosis; Myelin Basic Protein; Protein Structure, Secondary; Twin Studies as Topic

Multiple sclerosis (MS) is a complex genetic trait. Analyses to identify genetic variants that increase susceptibility to MS have primarily focused on candidate genes, either in family linkage investigations or in association (linkage disequilibrium) studies in sporadic cases and control subjects. Most of the candidate genes considered to date either influence immune function or encode structural myelin proteins. Recently, three preliminary whole genomic surveys were completed, and they reveal multiple loci of possible genetic linkage that are worthy of further study. No convincing evidence for a single strong locus has emerged from analysis of the three studies. Linkage promises to focus the future choice of candidate genes for further investigation.

Topics: Complement System Proteins; Genetic Linkage; Genome; HLA Antigens; Humans; Immunoglobulins; Mitochondria; Multiple Sclerosis; Mutation; Myelin Basic Protein; Receptors, Antigen, T-Cell; Tumor Necrosis Factor-alpha

Our studies addressed the questions of how self-reactive T cells escape tolerance and what stimuli cause these T cells to initiate autoimmune responses. We employed experimental allergic encephalomyelitis (EAE) as an animal model of multiple sclerosis (MS). Endogenous expression of myelin basic protein (MBP) induces tolerance in T cells that recognize one region of MBP, whereas T cells specific for a different region escape tolerance. Triggers of disease induction were investigated in a T-cell receptor (TCR) transgenic model in which the majority of T cells recognize the MBP epitope that does not induce tolerance. EAE occurs spontaneously in this model and the incidence of disease depends on microbial exposure. EAE can also be actively induced by immunization with MBP peptide accompanied by injection of pertussis toxin as well as by administration of pertussis toxin alone. Immunization with MBP peptide without pertussis toxin, however, stimulates the transgenic T cells, but the activated T cells do not accumulate in the central nervous system (CNS) or induce EAE. Our studies suggest that initiation of autoimmune disease involves complex interactions between the neuroendocrine system as well as the innate and specific immune systems.

Topics: Animals; Antigens; Autoimmunity; Central Nervous System; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Humans; Immune Tolerance; Lymphocyte Activation; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes

T cell responses to myelin basic protein (MBP) are implicated to play an important role in the pathogenesis of multiple sclerosis (MS). These MBP autoreactive T cells are found to undergo in vivo activation and clonal expansion in patients with MS. They accumulate in the brain compartment and may reside in the brain lesions of patients with MS. As MBP-reactive T cells potentially hold a central position in initiation and perpetuation of the brain inflammation, specific immune therapies designed to deplete them may improve the clinical course of the disease. We review here the recent application of T cell vaccination in patients with MS to deplete circulating MBP-reactive T cells. The results of our phase I clinical trial indicate that T cell vaccination with inactivated MBP autoreactive T cells induces specific regulatory T cell network of the host immune system to deplete circulating MBP-reactive T cells in a clonotype-specific fashion. The immunity induced by T cell vaccination is clonotype specific and long-lasting. Our longitudinal clinical evaluation further suggests a moderately lower rate of clinical exacerbation, disability score, and brain lesions (measured by magnetic resonance imaging) in vaccinated patients than in matched controls. Our study should encourage further investigation on the treatment efficacy of T cell vaccination and further improvement for its clinical administration in other human autoimmune diseases. This review discusses the immune regulation and therapeutic administration of T cell vaccination in human autoimmune diseases, exemplified by our recent T cell vaccination trial in MS.

Topics: Autoimmune Diseases; Humans; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes; Vaccination; Vaccines

Topics: Humans; Immunization; Immunoglobulins, Intravenous; Immunosuppressive Agents; Immunotherapy; Interferons; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes

T cell responses to myelin basic protein (MBP) are implicated to play an important role in the pathogenesis of multiple sclerosis (MS). These MBP autoreactive T cells are found to undergo in vivo activation and clonal expansion in patients with MS. They accumulate in the brain compartment and may reside in the brain lesions of patients with MS. As MBP-reactive T cells potentially hold a central position in initiation and perpetuation of the brain inflammation, specific immune therapies designed to deplete them may improve the clinical course of the disease. In this paper, the therapeutic potential of T cell vaccination in the treatment of MS is discussed in context of its immunological and clinical effect. The results of our phase one clinical trial indicate that T cell vaccination with inactivated MBP autoreactive T cells induces specific regulatory T cell network of the host immune system to deplete circulating MBP-reactive T cells in a clonotype-specific fashion. The immunity induced by T cell vaccination is clonotype-specific and long-lasting. Our longitudinal clinical evaluation further suggests a moderate reduction of rate of clinical exacerbation, disability score and the brain lesions (measured by magnetic resonance imaging) in vaccinated patients, as compared to matched controls. Our study should encourage further investigation on the treatment efficacy of T cell vaccination and further improvement for its clinical application.

Topics: Autoantibodies; Humans; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes; Vaccination

Evidence is emerging that the major T- and B-cell response in multiple sclerosis (MS) is directed to a region of myelin basic protein (MBP) between residues 84 and 103. In rodent models of MS, immunization to this component of MBP evokes experimental autoimmune encephalomyelitis (EAE). T cells found in EAE lesions show similarities in the VJ and VDJ regions of their alpha and beta chains with T cells in MS lesions, and with T cells that are specific for MBPp84-103 isolated from patients with MS. If this region of MBP is critical in the pathogenesis of MS, then therapy aimed at controlling the immune response to this immunodominant region of MBP may be beneficial in treating MS.

Topics: Amino Acid Sequence; Animals; B-Lymphocytes; Epitopes; Humans; Models, Immunological; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes

Topics: Adolescent; Adult; Animals; Dose-Response Relationship, Drug; Female; Glatiramer Acetate; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Neurologic Examination; Peptides; Pilot Projects; Randomized Controlled Trials as Topic

Understanding the immune response to myelin antigens in regard to the peptide/MHC/TCR complex is important in defining pathogenesis of demyelinating autoimmune diseases and in developing antigen-specific therapies. We previously reported that individual multiple sclerosis patients may use certain dominant TCR V beta chains to recognize immunodominant MBP peptides. In examining the TCR beta chain usage, we observed repeated TCR VDJ sequences among different T-cell lines isolated from the same patient. This suggested that a few expanded T-cell clones may dominate the immune response to immunodominant MBP peptides. Here, we report experiments where TCR rearrangements were used as a probe for the clonal origin of MBP specific T-cells cultured from blood lymphocytes of MS patients and normal subjects. In two patients with the DR2 haplotype that were analyzed in detail, the T-cell response to MBP was focused on the MBP (84-102) peptide and in vivo expanded population(s) dominated the response to the MBP (84-102) peptide. Two MBP (84-102) specific T-cell clones from a normal subject with the DR2 haplotype were also found to have identical TCR sequences. Clonality was proven by demonstrating that independent clones had identical TCR alpha and beta chain sequences as well as identical sequences of a TCR gamma chain or of a second TCR alpha chain rearrangement. These data suggest that the response to human MBP is dominated in at least some subjects by expanded clones that may persist in vivo for relatively long periods of time.

Topics: Amino Acid Sequence; Base Sequence; Clone Cells; DNA Primers; Epitopes; Gene Rearrangement, T-Lymphocyte; HLA-D Antigens; Humans; Interleukin-2; Lymphocyte Activation; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptides; Receptors, Antigen, T-Cell, alpha-beta; T-Lymphocytes

Topics: Amino Acid Sequence; Animals; Base Sequence; Clone Cells; Encephalomyelitis, Autoimmune, Experimental; Gene Rearrangement, beta-Chain T-Cell Antigen Receptor; Humans; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; Receptors, Antigen, T-Cell, alpha-beta; T-Lymphocytes

Topics: Animals; Autoantigens; Autoimmune Diseases; Calcium-Binding Proteins; Cytokines; Disease Models, Animal; Diseases in Twins; Gene Rearrangement, T-Lymphocyte; Humans; Immunodominant Epitopes; Macaca mulatta; Mice; Multiple Sclerosis; Myelin Basic Protein; Nerve Growth Factors; S100 Calcium Binding Protein beta Subunit; S100 Proteins; T-Lymphocyte Subsets

In EAE/MS, effector molecules are produced as a result of the interaction between T lymphocytes and antigen-presenting cells and the spectrum of cytokines produced is likely to decisively influence the disease outcome. These events may be more important, or at least more easily accessible to therapeutic intervention, than particular autoantigen specificities. Data from EAE suggest that cytokines connected to the Th1 phenotype of lymphocytes, especially IFN-gamma but also TNF-beta, TNF-alpha and IL-12, may promote inflammation while cytokines connected to the Th2 subset, IL-4, IL-10 and TGF-beta, may potentially have a role in disease limitation. It will be important to accurately study cytokines during immunotherapeutic interventions and in relation to immunogenetic variables in order to aim at immunotherapeutically intervening in the Th1, Th2 balance as well as counteracting disease-promoting cytokines such as IFN-gamma and TNF-alpha or promoting the action of downregulatory cytokines such as IL-10 and TGF-beta.

Topics: Animals; Cytokines; Encephalomyelitis, Autoimmune, Experimental; Epitopes; Humans; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes

Multiple sclerosis (MS) is a demyelinating disease of the central nervous system (CNS) afflicting approximately 250,000 individuals in the United States. This inflammatory disease has variable clinical manifestations, ranging from a relapsing-remitting course to a chronic progressive disease. Approximately one third of MS patients have chronic progressive disease often leading to severe impairment of mobility, paralysis, poor vision, and disturbances of bladder and bowel function. Although the etiology and pathogenesis remain unknown, accumulating evidence supports the hypothesis that exposure to an as-yet-unidentified infectious agent(s) triggers an aberrant immune response against self nervous tissue in genetically susceptible individuals. The tenfold higher concordance rate for MS in monozygotic twins compared to dizygotic twins, the increased incidence of MS in women compared to men (2:1), and the familial and racial occurrence of MS provide strong evidence that genetic factors influence susceptibility to MS. The major predisposing genes in MS are the human leukocyte antigen (HLA) class II molecules, DR15 and DQw6, molecularly defined as HLA-DRB1, 1501-DQA1 0102-DQB1 0602. In certain ethnic groups, MS susceptibility is more strongly associated with other DR molecules. Environmental factors are also believed to play a role, as suggested by the unique worldwide prevalence, migration effects, and epidemiological studies. Increased serum and cerebrospinal fluid antibody titers to numerous viruses have been reported; however, there have been no confirmed studies detecting viral RNA or antigen in MS brain tissue. At the present time, no known treatment can significantly alter the progression of MS. Based on the postulate that MS is an autoimmune disease associated with abnormalities in immunoregulation, a number of different immunosuppressive and immunomodulating agents have been tested as therapeutic modalities. In this article, we review the circumstantial evidence suggesting that immune system abnormalities are associated with the disease process, and provide an update on current therapies used in MS.

Topics: Animals; Antibodies, Monoclonal; Autoantigens; Autoimmune Diseases; Brain; Clinical Trials as Topic; Epitopes; Female; Gene Rearrangement, T-Lymphocyte; HLA-DR Antigens; Humans; Immunoglobulins, Intravenous; Immunosuppression Therapy; Immunosuppressive Agents; Immunotherapy; Lymphatic Irradiation; Lymphocyte Subsets; Male; Mice; Mice, SCID; Molecular Mimicry; Multiple Sclerosis; Myelin Basic Protein; Virus Diseases

Different models of experimental autoimmune encephalomyelitis (EAE) have been successfully applied to investigate and manifold aspects of the autoimmune pathogenesis of multiple sclerosis. Studies using myelin-specific T-cell lines that transfer EAE to naive recipient animals established that only activated lymphocytes are able to cross the endothelial blood-brain barrier and cause autoimmune disease within the local parenchyma. All encephalitogenic T cells are CD4+ Th1-type lymphocytes that recognize autoantigenic peptides in the context of MHC class II molecules. In the case of myelin basic protein (MBP) specific EAE in the Lewis rat, the T-cell response is directed against one strongly dominant peptide epitope. The encephalitogenic T cells preferentially use one particular set of T-cell receptor genes. Although MBP is a strong encephalitogen in many species, a number of other brain protein are now known to induce EAE. These include mainly myelin components (PLP, MAG, and MOG), but also, the astroglial S-100 beta protein. Encephalitogenic T cells produce only inflammatory changes in the central nervous system, without extensive primary demyelination. Destruction of myelin and oligodendrocytes in these models requires additional effector mechanisms such as auto-antibodies binding to myelin surface antigens such as the myelin-oligodendrocyte glycoprotein.

Topics: Animals; CD4-Positive T-Lymphocytes; CD8 Antigens; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Humans; Multiple Sclerosis; Myelin Basic Protein; Neuroglia; Rats; S100 Proteins

Multiple sclerosis is a chronic inflammatory disease characterized by multifocal damage of the central nervous system myelin. Both humoral and cell-mediated immune abnormalities have been observed in patients with multiple sclerosis, but their relation to the demyelination process is not understood. The etiology of the disease is still unknown; however, evidence exists for an interplay between environmental and genetic factors. Several genes are involved in determining the disease susceptibility, at least one of them encoded within human leukocyte antigen gene complex. Other genomic regions coding for components of the immune system or myelin have also been suggested. Clinical, immunological and genetic data suggest that multiple sclerosis may turn out to be a heterogeneous disease. Therefore, molecular genetic dissection of this complex disease should provide important clues to its pathogenesis as well as unravel metabolic pathways for potential therapeutic or preventive strategies. This review will give an overview of recent progress and future challenges in identifying susceptibility genes for multiple sclerosis.

Topics: Adult; Animals; Demyelinating Diseases; Disease Models, Animal; Family Health; Female; Genes, Immunoglobulin; Genetic Linkage; Genetic Predisposition to Disease; HLA Antigens; Humans; Lod Score; Male; Multiple Sclerosis; Myelin Basic Protein; Polymorphism, Genetic; Receptors, Antigen, T-Cell

Human demyelinating disease, multiple sclerosis, is now though to be caused by autoreactive T cells against several antigens in central nervous system. In experimental allergic encephalomyelitis, animal model of the disease, successful treatment is reported using a monoclonal antibody to T-cell receptor (TCR) of encephalitogenic T cells. Analoging this model, researchers are now trying to intervene T cells suspected to elicit the disease. For this purpose, myelin basic protein, one of the candidate CNS antigens, reactive T cells and usage of TCR in those cells are extensively examined. Although no convincing result was obtained so far because of complexity of the disease and a genetic background of human beings, T cell intervention may be beneficial to some patients with this disease.

Topics: Humans; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell

Topics: Amino Acid Sequence; Base Sequence; Brain; HLA-D Antigens; Humans; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell, alpha-beta; Sequence Homology, Amino Acid; Sequence Homology, Nucleic Acid; T-Lymphocytes

Autoreactive T cells specific for myelin proteins, such as myelin basic protein (MBP), are thought to play an important role in the pathogenesis of multiple sclerosis (MS). In MS, these MBP-reactive T cells are activated and clonally expanded in vivo and found to accumulate in the brain compartment, suggesting their pathologic role in the disease. There is experimental evidence supporting the beliefs that MBP-reactive T cells are regulated in vivo by the clonotypic regulatory network. This concept has led to the paradigm of T cell vaccination where attenuated MBP-reactive T cells are used as vaccines to effectively prevent and treat experimental autoimmune encephalomyelitis, an animal model for MS. In this paper, the recent evidence regarding the pathologic relevance of MBP-reactive T cell in MS is reviewed. In particular, we discuss our recent clinical trial in which patients with MS were vaccinated with inactivated autologous MBP-reactive T cell clones to investigate the nature of clonotypic responses in vivo, and whether the responses are effective in depleting circulating MBP-reactive T cells in patients with MS. Our study presented in this paper demonstrated the successful depletion of MBP-reactive T cells by T cell vaccination and touched upon important issues related to the clinical application of T cell vaccination in humans. This review provides new insights into the current development in designing effective therapeutic strategies, such as T cell vaccination, to treat patients with MS and other autoimmune diseases.

Topics: Clinical Trials as Topic; Humans; Immunotherapy, Adoptive; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes

Experimental allergic encephalomyelitis, a cell-mediated autoimmune disease, continues to provide interesting data on the mechanisms subserving organ-specific autoimmunity. The elements of the trimolecular complex have been further defined and the conserved molecular basis of the interaction between the T-cell receptor and the major histocompatibility complex class II-peptide antigen complex is better understood. This model also provides new insights into the cellular interactions within the brain during the course of the autoimmune inflammatory response.

Topics: Animals; Autoimmune Diseases; Brain; Encephalomyelitis, Autoimmune, Experimental; Histocompatibility Antigens Class II; Humans; Multiple Sclerosis; Myelin Basic Protein; Neuroglia; Peptides; Receptors, Antigen, T-Cell; T-Lymphocytes

Experimental allergic encephalomyelitis (EAE) is considered the animal disease model for multiple sclerosis (MS) in humans. However, EAE is an acute disease whereas MS is a chronic disease. The on-off nature in both diseases of autoimmune reactivity suggests a regulatory response by the host, a response which can effect the autoreactive T cell by modulating-up or modulating-down. This review discusses various aspects of this regulation, seen after administration of autoantigen, of antibody directed at the T cell receptor (TcR), and of fragments of the TcR itself.

Topics: Amino Acid Sequence; Animals; Autoantibodies; Autoantigens; Down-Regulation; Encephalomyelitis, Autoimmune, Experimental; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell, alpha-beta; Up-Regulation

Topics: Amino Acid Sequence; Animals; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Epitopes; Humans; Immunotherapy; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptides; Receptors, Antigen, T-Cell, alpha-beta; T-Lymphocytes

Multiple sclerosis (MS) is characterized by the active degradation of central nervous system myelin, a multilamellar membrane system that insulates nerve axons. MS arises from complex interactions between genetic, immunological, infective, and biochemical mechanisms. Although the circumstances of MS etiology remain hypothetical, one persistent theme involves immune system recognition of myelin-specific antigens derived from myelin basic protein, the most abundant extrinsic myelin membrane protein, and/or another equally suitable myelin protein or lipid. Knowledge of the biochemical and physical-chemical properties of myelin proteins, and lipids, particularly their composition, organization, structure, and accessibility with respect to the compacted myelin multilayers, thus becomes central to understanding how and why these antigens become selected during the development of MS. This article focuses on the current understanding of the molecular basis of MS as it may relate to the protein and lipid components of myelin, which dictate myelin morphology on the basis of protein-lipid and lipid-lipid interactions, and the relationship, if any, between the protein/lipid components and the destruction of myelin in pathological situations.

Topics: Amino Acid Sequence; Animals; Central Nervous System; Humans; Lipid Metabolism; Lipids; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Proteolipids; Structure-Activity Relationship

Multiple sclerosis (MS) is acquired as a systemic "trait" by individuals who are genetically susceptible. This condition does not involve the central nervous system (CNS) and is characterized by a state of hyperactive immunocompetent responsiveness. It develops as the result of an antigenic challenge by a viral protein, either from a viral infection or a vaccination. In order for MS to become a disease affecting the CNS, it is necessary for the blood-brain barrier's (BBB) impermeability to be altered. This is now a fully recognized fact. As a result of this change, the MS lesion, which consists of edema and inflammation occurs. It may but need not lead to demyelination. Several mechanisms can cause this increased permeability of the BBB. The role of the immune system, and in particular of T lymphocytes in initiating and continuing the process of lesion formation remains extremely controversial. In fact, there are unanswered questions regarding the actual target of MS: is it the myelin sheath itself or its forming cell, the oligodendrocyte, or is it the BBB itself leading to bystander demyelination? The role of mild, concussional trauma to the CNS in producing the alteration of the BBB and therefore acting as a trigger or facilitator in the development or enlargement of MS lesions in the CNS, is based on considerable clinical, neuropathological and experimental evidence. Along with another viral infection, it must be one of the commonest causes of progression of MS, and quite often leads to the onset of the clinical manifestations of an hitherto asymptomatic condition.

Topics: Amino Acid Sequence; Animals; Blood-Brain Barrier; Craniocerebral Trauma; Genetic Predisposition to Disease; Humans; Immune System; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Sequence Homology, Amino Acid; Viral Proteins

Repertoire analyses of activated T-cell populations specific for myelin basic protein, peptides of which cause experimental allergic encephalomyelitis in rats and mice, indicate a very limited utilization of homologous V alpha and V beta genes in both species. However, the encephalitogenic peptide fragments of myelin basic protein represent different domains of the antigen molecule and the MHC restricting elements are different. This finding has lead to an interpretation, the 'V-region disease hypothesis', which suggests that some TCR molecules may have special effector functions in addition to peptide-MHC recognition. On the basis of recent findings with the rat experimental allergic encephalomyelitis model and preliminary studies in human multiple sclerosis, we present a more conservative and conventional interpretation of the association of certain TCR V-region elements with encephalitogenicity.

Topics: Amino Acid Sequence; Animals; Encephalomyelitis, Autoimmune, Experimental; Genes, Immunoglobulin; Humans; Immunoglobulin Variable Region; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Rats; Receptors, Antigen, T-Cell, alpha-beta; T-Lymphocytes

The etiology of multiple sclerosis is linked to a variety of genetic and environmental factors. Both cell-mediated and humoral immune responses, triggered by extraneous or autoantigens, are likely to contribute to the pathogenesis of this disease. A greater insight into the fundamental cause of multiple sclerosis has been provided by the recognition that certain immune response genes are associated with an increased susceptibility to the disease. Such knowledge should provide new opportunities for selective therapeutic interventions.

Topics: Animals; Autoantibodies; Brain; Cell Movement; Humans; Immunodominant Epitopes; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell, alpha-beta; T-Lymphocytes

Topics: Animals; Autoantigens; Autoimmunity; Encephalomyelitis, Autoimmune, Experimental; Humans; Lymphocyte Activation; Major Histocompatibility Complex; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell; T-Lymphocytes

Topics: Biomarkers; Cytokines; Evoked Potentials; Humans; Immunoglobulins; Magnetic Resonance Imaging; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocyte Subsets; Tomography, X-Ray Computed

Primary demyelination in the central nervous system results from damage to the myelin sheath or oligodendroglia and can be produced by a variety of mechanisms, including metabolic disturbances, toxicities, infection, and autoimmunity. The major human demyelinating disease affecting the central nervous system is multiple sclerosis (MS). Although the etiology of MS is not known, existing data indicate that both genetic and environmental factors contribute to pathogenesis. Experimental allergic encephalomyelitis (EAE) is induced by immunization of genetically susceptible animals with myelin proteins. This is mediated by autoimmune T cells. Characterization of MHC restriction, fine specificity of antigen recognition, and T cell receptor (TCR) usage by encephalitogenic T cells has resulted in highly specific immunotherapies. Both HLA and TCR genes have been linked to susceptibility for MS which is widely believed to be mediated by T cells that recognize an as yet unidentified autoantigen. Because of the advances in the understanding and treatment of EAE, recent research in MS has been focused on the characterization of cellular immune responses against myelin components. The results of these studies are reviewed and the potential implications of these findings for the pathogenesis and future therapy of MS are examined.

Topics: Animals; Autoantigens; Demyelinating Diseases; Encephalomyelitis, Autoimmune, Experimental; Humans; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes

The genomic organization of the T-cell receptor (TCR) gene complexes accounts for many central aspects of T-cell immunobiology, including specificity and diversity. Recent data indicate that polymorphism of TCR genes is present within a species and may influence the immune phenotype of an individual. Such polymorphism has been detected by RFLP, by the presence of large regions of insertion or deletion of germline DNA, and by allelic variability of individual gene segments that are expressed. In addition to allelic variation of TCR genes, immune responses may also be influenced by the repertoire of the TCR molecules that are expressed by responding T-cell populations. In some situations, pathogenic T-cell responses may involve expression of limited numbers of TCR gene families. This is true, for example, in experimental allergic encephalomyelitis, an autoimmune nervous system disease mediated by T-cells reactive to myelin basic protein. In the human disease counterpart, multiple sclerosis, a more complex pattern of T-cell recognition to the putative autoantigen is generally present, although in some individuals a restricted response may occur. Specific therapies targeted to certain TCR molecules represents a promising approach to chronic inflammatory diseases in humans. The efficacy of such therapies will be determined in part by the TCR repertoire expressed in individual disease situations and by the potential for plasticity in the pathogenic T-cell response that may exist.

Topics: Alleles; Animals; Autoimmune Diseases; Chromosomes, Human, Pair 14; Chromosomes, Human, Pair 7; Demyelinating Diseases; Encephalomyelitis, Autoimmune, Experimental; Gene Rearrangement, T-Lymphocyte; Humans; Mice; Multiple Sclerosis; Myelin Basic Protein; Polymorphism, Genetic; Polymorphism, Restriction Fragment Length; Prevalence; Receptors, Antigen, T-Cell

Topics: Amino Acid Sequence; Animals; Autoimmune Diseases; Cattle; Encephalomyelitis, Autoimmune, Experimental; Epitopes; Gene Rearrangement, T-Lymphocyte; HLA-DR Antigens; Humans; Mice; Mice, Inbred Strains; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Rats; Rats, Inbred Lew; Receptors, Antigen, T-Cell; Vaccination

Multiple sclerosis is a chronic inflammatory disease of the central nervous system which has been hypothesized to be autoimmune in nature. To test whether this is the case, Kai Wucherpfennig and colleagues have developed a set of criteria that must be met to satisfy the hypothesis. Here, they present these criteria and assess the extent to which studies to date satisfy them.

Topics: Autoantigens; Autoimmune Diseases; Humans; Lymphocyte Activation; Major Histocompatibility Complex; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell; T-Lymphocytes

Experimental allergic encephalomyelitis (EAE) is a T cell mediated model of demyelinating disease that develops as a result of an autoimmune response to the myelin structural antigen, myelin basic protein (MBP). Much information has accumulated on the nature of trimolecular interactions which lead to the activation of self-reactive T lymphocytes in this disorder. Many parallels exist in the etiopathogenesis of EAE and multiple sclerosis (MS). Based upon these similarities selective immunotherapy that targets either class II molecules of the major histocompatibility complex or T cell receptor variable region genes will be described for EAE with consideration given to application of these principles in MS.

Topics: Amino Acid Sequence; Animals; Encephalomyelitis, Autoimmune, Experimental; Epitopes; Humans; Immunotherapy; Mice; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell; T-Lymphocytes

Topics: Animals; Autoimmune Diseases; Central Nervous System; Encephalomyelitis, Autoimmune, Experimental; Humans; Immunity, Cellular; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath

Topics: Animals; Encephalomyelitis, Autoimmune, Experimental; Humans; Multiple Sclerosis; Myelin Basic Protein; Peripheral Nervous System Diseases

Topics: Animals; Arthritis; Autoimmune Diseases; Autoimmunity; B-Lymphocytes; Collagen; Encephalomyelitis, Autoimmune, Experimental; Humans; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes

Topics: Antigens, Viral; Autoantigens; Central Nervous System; Clone Cells; Humans; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes

The precise role of T cells in multiple sclerosis (MS) remains to be defined. No MS-specific antigen has been found. The autoimmune hypothesis for MS rests on immune changes seen in the spinal fluid and brain and on the demonstration, in an experimental animal model, that T cells raised to myelin basic protein transfer demyelination. In this review, Virginia Calder and colleagues focus on recent studies suggesting that in MS, the initial T-cell response occurs within the central nervous system and that the blood poorly reflects this immune activity. This contrasts with the animal model, experimental allergic encephalomyelitis, where the initial immune response is peripheral.

Topics: Central Nervous System; Demyelinating Diseases; Encephalomyelitis, Autoimmune, Experimental; Humans; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes

Topics: Autoantibodies; Autoimmune Diseases; Humans; Lymphopenia; Multiple Sclerosis; Myelin Basic Protein; Nervous System; T-Lymphocytes

Topics: Autoimmune Diseases; Humans; Multiple Sclerosis; Myelin Basic Protein; Slow Virus Diseases; Virus Diseases

Experimental allergic encephalomyelitis (EAE) is a prototypic neuroautoimmune disease involving sensitization to central nervous system myelin basic protein (MBP). Our studies of the clotting system and ensuing fibrinolysis implicate coagulation and cleavage of fibrin within or on the luminal surface of the cerebrovasculature as events initiating the inflammation characterizing EAE. Among recipient rats injected with MPB-primed, cultured-activated lymph node cells, opening of the blood-brain barrier (BBB) and deposition of perivascular fibrin within the spinal cord occur in parallel 1 day before onset of clinical signs of EAE. Daily treatment of recipient rats with trans-4-(aminomethyl)cyclohexanecarboxylic acid, a synthetic product that specifically inhibits plasminogen activator derived from endothelial cells, results in marked reduction of increased permeability of the BBB and suppression of clinical signs of EAE. We postulate that the critical event precipitating EAE is binding of circulating MBP-reactive immune effector cells to MBP immunodeterminants on the surface of cerebrovascular endothelial cells. Coagulation and ensuing fibrinolysis occur at sites of binding of effector cells to cerebrovascular endothelium. Release of biologically active peptides cleaved from fibrin open the BBB, thereby setting the stage for the cascade of inflammatory events culminating in clinical manifestations of EAE.

Topics: Animals; Blood Coagulation; Blood-Brain Barrier; Cerebrovascular Circulation; Encephalomyelitis, Autoimmune, Experimental; Fibrinolysis; Inflammation; Multiple Sclerosis; Myelin Basic Protein; Rats; Rats, Inbred Lew; T-Lymphocytes; Tranexamic Acid

Topics: Humans; Multiple Sclerosis; Myelin Basic Protein; Nervous System Diseases; Peptide Fragments

Topics: Antibodies; Dose-Response Relationship, Drug; Humans; Methylprednisolone; Methylprednisolone Hemisuccinate; Multiple Sclerosis; Myelin Basic Protein; Prednisone

Topics: Animals; Autoantigens; Demyelinating Diseases; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Humans; Immunity, Cellular; Multiple Sclerosis; Myelin Basic Protein

The major immune-mediated diseases affecting the nervous system are reviewed. The continued expansion of knowledge concerning the pathogenesis is leading to improved diagnosis and effective treatment regimens.

Topics: Adrenal Cortex Hormones; Antibodies, Monoclonal; Cholinesterase Inhibitors; Humans; Hypergammaglobulinemia; Immune System Diseases; Immunoglobulins; Immunosuppression Therapy; Multiple Sclerosis; Myasthenia Gravis; Myelin Basic Protein; Nervous System Diseases; Plasma Exchange; Plasmapheresis; Polyradiculoneuropathy; Receptors, Cholinergic

Defining the immunochemical basis for the detection of BP peptides in body fluids has led to an appreciation of the complexity of the number and location of epitopes in BP peptide 43-88. There appear to be roles for epitopes based on both sequence and conformation of these small peptides. Antisera to some of the fragments of BP peptide 43-88 may have restricted reactivity with BP peptide 43-88 and BP. The amount of BP-like material that enters CSF and cross-reacts with BP peptide 43-88 is related to the recognition of an epitope or epitopes in the C-terminal portion of this peptide. The immunochemical detection of BP peptides in body fluids is dependent on the precise identification of the BP peptides present.

Topics: Epitopes; Humans; Immunochemistry; Molecular Weight; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Peptide Fragments; Radioimmunoassay; Radioligand Assay

Multiple sclerosis is considered to be a putative immunopathologic disease and there has been considerable effort over the years to prove an autoimmune etiology for it. To date, the evidence is all indirect and there is no proof of either antibody and/or cell-mediated hypersensitivity to any single identifiable CNS constituent whether a constituent of normal CNS or specific to the CNS of MS patients.

Topics: Animals; Antibodies; Antibody-Dependent Cell Cytotoxicity; Antigens; Binding Sites, Antibody; Brain; Cerebrospinal Fluid; Epitopes; Fluorescent Antibody Technique; Galactosylceramides; Humans; Immunoenzyme Techniques; Killer Cells, Natural; Lymphocyte Culture Test, Mixed; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; T-Lymphocytes

Topics: Animals; Autoimmune Diseases; Demyelinating Diseases; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Galactosylceramides; Guinea Pigs; Humans; Mice; Microscopy, Electron; Multiple Sclerosis; Myelin Basic Protein; Rats

Myelin basic protein (BP) has the capacity to induce experimental allergic encephalomyelitis (EAE) in animals as well as to prevent and suppress EAE. Immunoreactive BP or BP fragments appear in cerebrospinal fluid (CSF) in persons with multiple sclerosis in acute disease periods and in individuals with acute damage to central nervous system myelin. Humoral and cellular immune responses, especially in the CSF, may occur but are of uncertain effect in the etiology and pathogenesis of MS. Attempts to use BP to suppress MS have disclosed no therapeutic benefit.

Topics: Animals; Antibodies; Antibody Formation; Encephalomyelitis, Autoimmune, Experimental; Guinea Pigs; Humans; Immunity, Cellular; Multiple Sclerosis; Myelin Basic Protein; Rats

Topics: Animals; Antibody-Producing Cells; Autoantibodies; B-Lymphocytes; Disease Models, Animal; Dogs; Encephalomyelitis, Autoimmune, Experimental; History, 20th Century; Humans; Immunity, Cellular; Immunization, Passive; Multiple Sclerosis; Myelin Basic Protein; Rats; Rats, Inbred Lew; Rats, Inbred Strains; United States

Cerebrospinal fluid (CSF) from 40 multiple sclerosis (MS) patients was tested by solid-phase radioimmunoassay (RIA) for ability to bind 2 common structural components of myelin and oligodendroglia, i.e., to bind myelin basic protein (MBP) and myelin-associated glycoprotein (MAG). To prevent the effect of differences in CSF IgG concentration on binding activity, the CSF samples were tested at equal IgG concentration 1 mg/ml. The mean binding activity to MBP and MAG was significantly higher than in control neurotics, respectively P less than or equal to 0.05 and P less than or equal to 0.001. In 33% of MS cases, CSF antibody against both antigens was found. Indirect data were obtained that autoantibodies whose antigens are associated with myelin-oligodendrocyte unit are produced locally within the central nervous system (CNS). Anti-MAG and anti-MBP CSF antibody activity was significantly higher, P less than or equal to 0.01 for both antibody specificity, in MS cases characterized by high IgG Index, greater than or equal to 0.70 = means + SD in the neurotic group, versus MS cases characterized by normal IgG Index (less than or equal to 0.70). Correlation coefficient between antibody activity and IgG Index values was 0.785 for anti-MBP antibody, and 0.400 for anti-MAG antibody. The importance of intrathecally produced antibody to MBP and MAG lies in the fact that it indicates an active humoral autoimmune process against a myelin-oligodendrocyte unit in which more than one autoantigen is involved.

Topics: Antibodies; Antibody Formation; Humans; Immunoglobulin G; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Radioimmunoassay; Tissue Distribution

Topics: Blood-Brain Barrier; Cell Count; Cerebrospinal Fluid; Cerebrospinal Fluid Proteins; Humans; Immunoglobulin G; Lymphocytes; Meningitis; Meningoencephalitis; Monocytes; Multiple Sclerosis; Myelin Basic Protein

Multiple sclerosis may ultimately be effectively treated using appropriate immunosuppressive regimens. Both cytotoxic drugs and therapeutic apheresis may constitute important therapeutic options. A number of studies are currently underway which will hopefully clarify the exact role of these treatment modalities in patients at different stages of disease.

Topics: Acute Disease; Adrenocorticotropic Hormone; Adult; Antilymphocyte Serum; Azathioprine; Cell Separation; Chronic Disease; Cyclophosphamide; Female; Humans; Immunosuppressive Agents; Lymphocyte Depletion; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Plasmapheresis; Prednisone; Recurrence

Topics: Animals; Antibodies, Anti-Idiotypic; Antibody Affinity; Autoantibodies; Autoantigens; B-Lymphocytes; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Humans; Multiple Sclerosis; Myelin Basic Protein; Nervous System; Rats; T-Lymphocytes

Topics: Adrenocorticotropic Hormone; Antilymphocyte Serum; Azathioprine; Desensitization, Immunologic; Dietary Fats; Glutens; Humans; Immunosuppressive Agents; Levamisole; Linoleic Acids; Methylprednisolone; Multiple Sclerosis; Myelin Basic Protein; Prednisolone; Transfer Factor

Although the ultimate diagnosis of multiple sclerosis (MS) still remains clinical, confirmatory laboratory aids can be of marked assistance, especially in early and atypical cases. Whereas numerous tests have been described, the only ones to withstand scrutiny in numerous laboratories have been various immunoglobulin assays and myelin basic protein measurements in the cerebrospinal fluid (CSF). Of the newer assays that are commercially available and readily adapted to routine clinical laboratory use, the most discriminating are the production of a CSF IgG:albumin ratio, using an electroimmunodiffusion method, and agarose electrophoresis of concentrated CSF to demonstrate oligoclonal IgG bands. Together, these assays can be performed on less than 3 ml of CSF, and will show relatively specific abnormalities in over 95% of clinically definite MS patients. They both detect abnormalities that frequently occur in the course of disease, and thus add considerable weight to the clinical impression of MS.

Topics: Albumins; Antibodies, Viral; Cerebrospinal Fluid; Electrophoresis, Agar Gel; Humans; Immunodiffusion; Immunoglobulin G; Isoelectric Focusing; Leukocyte Adherence Inhibition Test; Multiple Sclerosis; Myelin Basic Protein; Rosette Formation

In this brief overview, I have identified some of the cardinal facts involving neuroantigens and neuroautoimmunologic responses to them, briefly listed the clinical-immunohistopathologic features of EAE, discussed the presence of circulating MBP degradation fragments in the blood of rats and humans and the high probability of some of these fragments serving to act as immunomodulating factors with respect to maintaining immunologic silence of varying numbers of MBP-reactive lymphoid cells in the blood and peripheral lymphoid tissues of clinically well humans. Perhaps more important is the inhibitory effect which such factors might well exert on expanding MBP-reactive clones of lymphocytes should they escape from immunological silence and become activated for one reason or another. The degree of concordance of immunological events and responses characterizing animals with EAE and patients with MS serves to underline the usefulness and the validity of the EAE animal model system for probing fundamental mechanisms implicated in the tissue injury characterizing the MS process.

Topics: Animals; Cell Extracts; Encephalomyelitis, Autoimmune, Experimental; Freund's Adjuvant; Humans; Lymphoid Tissue; Multiple Sclerosis; Myelin Basic Protein; Radioimmunoassay; Rats; T-Lymphocytes

Autosensitization to some central nervous system antigen still remains one of the best hypotheses for the continuing pathogenesis of multiple sclerosis (MS). Enough is now known about the cause, pathogenesis, and treatment of experimental allergic encephalomyelitis (EAE) to test this hypothesis. Reports of therapeutic failure of the encephalitogen myelin basic protein (BP) in the treatment of MS have their counterparts in similar therapeutic failures in EAE. Only highly inbred strain 13 guinea pigs respond consistently to BP therapy, and this only when BP is administered in relatively high doses. Noninbred guinea pigs respond much less well to simple BP therapy, and monkeys hardly at all. In both strains of monkeys so far studied, a nonspecific adjunctive factor--an antibiotic in Macaca mulatta and a steroid in Macaca fascicularis--is also required. Accordingly, human trials of the therapeutic efficacy of BP in MS should include its administration in large concentrations together with an adjunctive agent.

Topics: Adjuvants, Immunologic; Animals; Central Nervous System; Encephalomyelitis, Autoimmune, Experimental; Guinea Pigs; Histocompatibility Testing; Humans; Inbreeding; Lymphocytes; Macaca fascicularis; Macaca mulatta; Macrophages; Mice; Multiple Sclerosis; Myelin Basic Protein; Plasma Cells; Rats; Species Specificity

Topics: Amino Acid Sequence; Animals; Encephalomyelitis, Autoimmune, Experimental; Epitopes; Guinea Pigs; Haplorhini; Humans; Hypersensitivity, Delayed; Immunity, Cellular; Immunization; Immunization, Passive; Immunosuppression Therapy; Mice; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Rabbits; Rats; Rosette Formation; T-Lymphocytes

Topics: Animals; Antibodies; Antibody Formation; Autoantibodies; Blood-Brain Barrier; Cerebrospinal Fluid; Encephalomyelitis, Autoimmune, Experimental; Humans; Immunity, Cellular; Immunization, Passive; Immunoglobulin G; Immunosuppression Therapy; Lymphocytes; Measles virus; Mice; Multiple Sclerosis; Myelin Basic Protein

Topics: Antigens; Brain; Encephalomyelitis, Autoimmune, Experimental; Lymphocyte Activation; Lysosomes; Molecular Conformation; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath

Topics: Amino Acid Sequence; Animals; Arginine; Cattle; Cerebrospinal Fluid; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Guinea Pigs; Haplorhini; Immunity, Maternally-Acquired; Methylation; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Peptides; Proteins; Rats; Species Specificity

Topics: Animals; Antibody Formation; Antigens; Autoimmune Diseases; Cell Migration Inhibition; Cyclophosphamide; Disease Models, Animal; Encephalomyelitis; Guinea Pigs; Haplorhini; Humans; Immunity, Cellular; Immunization; Immunoglobulin G; Lymphocyte Activation; Methotrexate; Multiple Sclerosis; Myelin Basic Protein; Nerve Tissue Proteins; Protein Binding; Rabbits; Rats; Skin Tests; Virus Diseases

Topics: Antibody-Producing Cells; Autoantibodies; Brain; Cross Reactions; Demyelinating Diseases; Hemolytic Plaque Technique; Humans; Hydrolases; Immunoglobulin G; Lipid Metabolism; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Neuroglia; Nucleotidases; Subacute Sclerosing Panencephalitis

We have previously shown that immunodominant MBP peptides encapsulated in mannosylated liposomes (Xemys) effectively suppressed experimental allergic encephalomyelitis (EAE). Within the frames of the successfully completed phase I clinical trial, we investigated changes in the serum cytokine profile after Xemys administration in MS patients. We observed a statistically significant decrease of MCP-1/CCL2, MIP-1β/CCL4, IL-7, and IL-2 at the time of study completion. In contrast, the serum levels of TNF-α were remarkably elevated. Our data suggest that the administration of Xemys leads to a normalization of cytokine status in MS patients to values commonly reported for healthy subjects. These data are an important contribution for the upcoming Xemys clinical trials.

Topics: Adult; Animals; Chemokine CCL2; Chemokine CCL4; Female; Humans; Interleukin-2; Interleukin-7; Liposomes; Male; Mice; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Tumor Necrosis Factor-alpha; Young Adult

Previously, we showed that CD206-targeted liposomal delivery of co-encapsulated immunodominant myelin basic protein (MBP) sequences MBP

Topics: Adult; Antigens, CD; Cytokines; Disability Evaluation; Dose-Response Relationship, Drug; Female; Follow-Up Studies; Humans; Lectins, C-Type; Magnetic Resonance Imaging; Male; Mannose-Binding Lectins; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Phospholipids; Statistics, Nonparametric; Treatment Outcome; Young Adult

Data from in vitro and animal studies support a neuroprotective role of glatiramer acetate (GA) in multiple sclerosis (MS). We investigated prospectively whether treatment with GA leads to clinical and paraclinical changes associated with neuroprotection in patients with relapsing-remitting (RR) MS. Primary aim of this clinical study was to determine serum BDNF levels in RR-MS patients who were started on GA as compared to patients who remained therapy-naive throughout 24 months. Secondary outcomes included relapses and EDSS, cognition, quality of life, fatigue and depression, BDNF expression levels on peripheral immune cells (FACS, RT-PCR), serum anti-myelin basic peptide (MBP) antibody status, evoked potential and cerebral MRI studies. While GA treatment did not alter serum levels or expression levels on peripheral immune cells of BDNF over time it resulted in a transient increase of serum IgG antibody response to MBP, mainly due to subtype IgG1 (p<0.05), after 3 months. However, no significant differences were found between GA treated and therapy-naive patients with regard to serum BDNF and intracellular BDNF expression levels, nerve conduction (including median and tibial nerve somatosensory, pattern-shift visual and upper and lower limb motor evoked potentials) or MRI (including volume of hyperintense lesions, volume of hypointense lesions after CE, mean diffusivity and fractional anisotropy) outcome parameters. In conclusion, our findings do not support a major impact of GA treatment on paraclinical markers of neuroprotection in human RR-MS.

Topics: Adjuvants, Immunologic; Antibodies; Brain-Derived Neurotrophic Factor; Cerebral Cortex; Disability Evaluation; Electroencephalography; Evoked Potentials; Female; Glatiramer Acetate; Humans; Longitudinal Studies; Magnetic Resonance Imaging; Male; Multiple Sclerosis; Myelin Basic Protein; Neuropsychological Tests; RNA, Messenger; Time Factors; Treatment Outcome

Demonstration of efficacious antigen-specific therapy in multiple sclerosis.. To assess the safety and efficacy of transdermally applied myelin peptides in patients with relapsing-remitting multiple sclerosis.. One-year double-blind, placebo-controlled cohort study.. Referral center.. Thirty outpatients aged 18 to 55 years with relapsing-remitting multiple sclerosis.. Skin patch with a mixture of 3 myelin peptides, MBP85-99, MOG35-55, and PLP139-155. MAIN OUTCOMES AND MEASURES Cumulative number of active gadolinium-enhanced (Gd+) lesions per patient per scan, mean volume of Gd+ lesions, cumulative number of new T2 lesions, and T2 lesion and T1 lesion volume change from baseline to the end of the study. Total number of relapses during the year of the study per patient (annual relapse rate), proportion of relapse-free patients, and proportion of patients with 3 months of confirmed disability worsening on the Expanded Disability Status Scale at month 12.. All patients completed the study. Compared with placebo, treatment with a myelin peptide skin patch (1 mg) showed a 66.5% reduction in the cumulative number of Gd+ lesions (P = .02) during the 12 months of the study. The annual relapse rate in patients treated with a mixture of myelin peptides (1 mg) was significantly lower compared with the placebo group (0.43 vs 1.4; P = .007). Treatment with a myelin peptide skin patch was well tolerated and no serious adverse events were reported.. In patients with relapsing-remitting multiple sclerosis, treatment with a myelin peptide skin patch significantly reduced both magnetic resonance imaging and clinically defined measures of disease activity and was safe and well tolerated.

Topics: Administration, Cutaneous; Adult; Cohort Studies; DNA-Binding Proteins; Double-Blind Method; Drug Therapy, Combination; Female; Gadolinium; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Myelin-Oligodendrocyte Glycoprotein; Peptide Fragments; Secondary Prevention; Transcription Factors

Persistent black holes (PBH) are associated with axonal loss and disability progression in multiple sclerosis (MS). The objective of this work was to determine if BHT-3009, a DNA plasmid-encoding myelin basic protein (MBP), reduces the risk of new lesions becoming PBH, compared to placebo, and to test if pre-treatment serum anti-MBP antibody levels impact on the effect of BHT-3009 treatment. In this retrospective, blinded MRI study, we reviewed MRI scans of 155 MS patients from a double-blind, randomized, phase II trial with three treatment arms (placebo, 0.5 and 1.5 mg BHT-3009). New lesions at weeks 8 and 16 were tracked at week 48 and those appearing as T1-hypointense were classified as PBH. A subset of 46 patients with available pre-treatment serum anti-MBP IgM levels were analyzed separately. Overall, there was no impact of treatment on the risk for PBH. However, there was a significant interaction between anti-MBP antibodies and treatment effect: patients receiving 0.5 mg BHT-3009 showed a reduced risk of PBH with higher antibody levels compared to placebo (p < 0.01). Although we found no overall reduction of the risk for PBH in treated patients, there may be an effect of low-dose BHT-3009, depending on the patients' pre-treatment immune responses.

Topics: Adolescent; Adult; Analysis of Variance; Dose-Response Relationship, Drug; Double-Blind Method; Female; Follow-Up Studies; Humans; Immunoglobulin M; Magnetic Resonance Imaging; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Odds Ratio; Time Factors; Vaccines, DNA; Young Adult

To evaluate the efficacy and safety of MBP8298 in subjects with secondary progressive multiple sclerosis (SPMS) who express human leukocyte antigen (HLA) haplotype DR2 or DR4 (DR2(+) or DR4(+)).. This multicenter randomized 2-year, double-blind, placebo-controlled study included 612 subjects with a diagnosis of SPMS and an Expanded Disability Status Scale (EDSS) score of 3.5-6.5, stratified according to baseline EDSS score (3.5-5.0, or 5.5-6.5) and HLA haplotype (DR2(+) or DR4(+), or DR2(-)/DR4(-)). Upon entry of 100 DR2(-)/DR4(-) subjects, further study enrollment was limited to DR2(+) or DR4(+) subjects. Subjects were randomly assigned to either 500 mg MBP8298 or placebo, given by IV injection once every 6 months for 2 years. The primary outcome measure was time to progression by ≥1.0 EDSS point (or 0.5 point if baseline EDSS was 5.5 or higher), confirmed 6 months later. Secondary outcomes included mean change in EDSS, mean change in Multiple Sclerosis Functional Composite, MRI changes, annualized relapse rate, and quality of life.. There were no significant differences between treatment groups in either the primary or secondary endpoints. MBP8298 was well tolerated in all treated subjects with no safety issues identified.. In the population studied, treatment with MBP8298 did not provide a clinical benefit compared to placebo.. This study provides Class 1 evidence that MBP8298 is not effective in patients with SPMS who are HLA DR2(+) or DR4(+).

Topics: Adult; Aged; Disability Evaluation; Disease Progression; Double-Blind Method; Female; Humans; Kaplan-Meier Estimate; Longitudinal Studies; Magnetic Resonance Imaging; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Quality of Life; Severity of Illness Index; Time Factors; Treatment Outcome

A retrospective phase IV study was designed to evaluate the anti-GA antibody subtypes, test their in vitro neutralizing activity and correlate these parameters with the clinical efficacy, in long-term GA treatment of MS patients. Serum samples from 153 MS patients, 126 treated with GA for 2 to 15 years (mean 6.6 years) and 27 treated for <2 years, were collected. Anti-myelin basic protein (MBP) and anti-GA antibodies were measured by specific ELISA. Neutralizing activity was determined by the capacity of the serum to inhibit the proliferation of GA-specific T-cells. Anti-GA antibodies were detected even after very long treatment periods, although at lower levels. Anti-MBP reactivity remained consistently negative. The IgG2 isotype of anti-GA antibodies and the multiple sclerosis severity scale (MSSS) was lower in the long-term treated patients P=0.0003 and 0.016 respectively. The neutralizing activity of anti-GA antibodies was insignificant. Our results indicate that the clinical efficacy of GA treatment could be associated with a decrease in anti-GA IgG2 isotype in long-term GA-treated patients.

Topics: Adult; Antibodies, Anti-Idiotypic; Antibodies, Neutralizing; Autoantibodies; Cell Proliferation; Cells, Cultured; Cross Reactions; Drug Administration Schedule; Drug Resistance; Female; Glatiramer Acetate; Humans; Immunoglobulin G; Immunoglobulin Isotypes; Immunosuppressive Agents; Israel; Lymphocyte Activation; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Peptides; Retrospective Studies; T-Lymphocytes; Time; Time Factors; Treatment Outcome

The efficacy of intravenous choline citrate infusions was investigated in 34 patients with multiple sclerosis (MS) by clinical evaluation and by monitoring of lymphocyte proliferation in vitro against fragments of myelin basic protein (MOG-35-55, MBP15-31, PLP 39-15) over a period of 12 weeks. Patients have been diagnosed with MS at least one year before entering the study and suffered from mild relapsing/remitting course to long-term chronic progressive disease. Twenty one patients exhibited positive lymphocyte proliferation to myelin fragments prior to treatment and were therefore selected for further studies. Choline citrate was administered with a dosage of 1200mg/ 2x week for a period of 3 months. This treatment resulted in a significant decrease of lymphocyte proliferation to neural fragments (MOG- 35-55, MBP15-31) in lymphocyte transformation test (LTT). There was no significant SI change of PLP Peptide (PLP 39-15) LTT found after treatment with choline citrate. During the 3 mo observation period, patients remained stable and no side-effects of the treatment were observed. In addition, some patients reported long-lasting improvement (less paresthesia and increase of muscle strength in lower extremities) which was demonstrated up to 3 years later. In one spectacular case a commercial pilot was able to return to duty again after treatment. This pilot was allowed back in to his position as a commercial flying cockpit member and is on duty for more than 4 yrs now.

Topics: Adult; Choline; Humans; Immunologic Factors; Lymphocyte Activation; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Severity of Illness Index; Treatment Outcome

To evaluate the efficacy and safety of BHT-3009 in relapsing-remitting multiple sclerosis (MS) and to confirm that BHT-3009 causes immune tolerance.. BHT-3009 is a tolerizing DNA vaccine for MS, encoding full-length human myelin basic protein. Relapsing-remitting MS patients were randomized 1:1:1 into three groups: placebo, 0.5 mg BHT-3009, or 1.5 mg BHT-3009, given intramuscularly at weeks 0, 2, 4, and every 4 weeks thereafter until week 44. The primary end point was the 4-week rate of occurrence of new gadolinium-enhancing lesions on brain magnetic resonance images from weeks 28 to 48. Protein microarrays were used to measure levels of anti-myelin autoantibodies.. Compared with placebo, in the 267 patient analysis population the median 4-week rate of new enhancing lesions during weeks 28 to 48 was 50% lower with 0.5 mg BHT-3009 (p = 0.07) and during weeks 8 to 48 was 61% lower with 0.5 mg BHT-3009 (p = 0.05). The mean volume of enhancing lesions at week 48 was 51% lower on 0.5 mg BHT-3009 compared with placebo (p = 0.02). No significant improvement in magnetic resonance imaging lesion parameters was observed with 1.5 mg BHT-3009. Dramatic reductions in 23 myelin-specific autoantibodies in the 0.5 mg BHT-3009 arm were observed, but not with placebo or 1.5 mg BHT-3009.. In relapsing-remitting MS patients, treatment with the lower dose (0.5 mg) of BHT-3009 for 44 weeks nearly attained the primary end point for reduction of the rate of new enhancing magnetic resonance imaging lesions (p = 0.07) and achieved several secondary end points including a reduction of the rate of enhancing magnetic resonance imaging lesions from weeks 8 to 48 (p = 0.05). Immunological data in a preselected subgroup of patients also indicated that treatment with 0.5 mg induced antigen-specific immune tolerance. The greater dose was ineffective.

Topics: Adolescent; Adult; Female; Humans; Male; Maximum Tolerated Dose; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Treatment Outcome; Vaccines, DNA

Patients with a single episode of neurologic dysfunction and brain magnetic resonance imaging (MRI) scans suggestive of multiple sclerosis are at high risk for clinically definite multiple sclerosis, but the outcome for individual patients is unpredictable. An increased risk of progression to clinically definite multiple sclerosis in patients with serum antibodies against myelin oligodendrocyte glycoprotein (MOG) and myelin basic protein (MBP) has been reported.. We measured serum anti-MOG and anti-MBP IgG and IgM antibodies in 462 patients with a first clinical event suggestive of multiple sclerosis and at least two clinically silent lesions on brain MRI. The patients were participating in a multicenter trial of treatment with interferon beta-1b. Antibodies were assessed by Western blot analysis at baseline, and the results compared with the time and rate of progression to clinically definite multiple sclerosis or a diagnosis of multiple sclerosis as defined by an international panel (the McDonald criteria). Regular visits were scheduled for the assessment of neurologic impairment and for MRI before treatment and at months 3, 6, 9, 12, 18, and 24.. No associations were found between the presence of anti-MOG and anti-MBP IgM and IgG antibodies and progression to clinically definite multiple sclerosis or a diagnosis of multiple sclerosis according to the McDonald criteria, either in the entire cohort or in any subgroups of the study population.. Serum antibodies against MOG and MBP, as detected by Western blot analysis, are not associated with an increased risk of progression to clinically definite multiple sclerosis in patients who have had a clinically isolated syndrome suggestive of multiple sclerosis.

Topics: Adjuvants, Immunologic; Adult; Autoantibodies; Brain; Disease Progression; Female; Humans; Immunoglobulin G; Immunoglobulin M; Interferon beta-1b; Interferon-beta; Kaplan-Meier Estimate; Magnetic Resonance Imaging; Male; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Proportional Hazards Models

To assess safety and immune modulation by BHT-3009, a tolerizing DNA vaccine encoding full-length human myelin basic protein, in patients with multiple sclerosis (MS).. The study was a randomized, double-blind, placebo-controlled trial. Subjects receiving placebo were crossed over into an active arm after treatment unblinding.. The trial was conducted at 4 academic institutions within North America. Patients Thirty patients with relapsing-remitting or secondary progressive MS who were not taking any other disease-modifying drugs were enrolled in the trial. Further, the patients were required to have either 1 to 5 gadolinium-enhancing lesions on screening brain magnetic resonance imaging (MRI), a relapse in the previous 2 years, or disease worsening in the previous 2 years.. BHT-3009 was administered as intramuscular injections at weeks 1, 3, 5, and 9 after randomization into the trial, with or without 80 mg of daily oral atorvastatin calcium in combination. Three dose levels of BHT-3009 were tested (0.5 mg, 1.5 mg, and 3 mg).. The primary outcome measures were safety and tolerability of BHT-3009. Secondary outcome measures included the number and volume of gadolinium-enhanced lesions on MRI, relapses, and analysis of antigen-specific immune responses.. BHT-3009 was safe and well tolerated, provided favorable trends on brain MRI, and produced beneficial antigen-specific immune changes. These immune changes consisted of a marked decrease in proliferation of interferon-gamma-producing, myelin-reactive CD4+ T cells from peripheral blood and a reduction in titers of myelin-specific autoantibodies from cerebral spinal fluid as assessed by protein microarrays. We did not observe a substantial benefit of the atorvastatin combination compared with BHT-3009 alone.. In patients with MS, BHT-3009 is safe and induces antigen-specific immune tolerance with concordant reduction of inflammatory lesions on brain MRI.

Topics: Adult; Atorvastatin; Disability Evaluation; Double-Blind Method; Endpoint Determination; Female; Heptanoic Acids; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Immune Tolerance; Immunization; Injections, Intramuscular; Lymphocyte Count; Magnetic Resonance Imaging; Male; Middle Aged; Multiple Sclerosis; Multiple Sclerosis, Relapsing-Remitting; Myelin Basic Protein; Oligonucleotide Array Sequence Analysis; Plasmids; Pyrroles; Recurrence; T-Lymphocytes; Vaccines, DNA

MBP8298 is a synthetic peptide with a sequence corresponding to amino acid residues 82-98 of human myelin basic protein (DENPVVHFFKNIVTPRT). It represents the immunodominant target for both B cells and T cells in multiple sclerosis (MS) patients with HLA haplotype DR2. Its administration in accordance with the principle of high dose tolerance results in long-term suppression of anti-myelin basic protein (MBP) autoantibody levels in the cerebrospinal fluid (CSF) of a large fraction of progressive MS patients. MBP8298 was evaluated in a 24-month placebo-controlled double-blinded Phase II clinical trial in 32 patients with progressive MS. The objective was to assess the clinical efficacy of 500 mg of MBP8298 administered intravenously every 6 months, as measured by changes in Expanded Disability Status Scale (EDSS) scores. Contingency analysis for all patients at 24 months showed no significant difference between MBP8298 and placebo-treatments (n = 32, P = 0.29). Contingency analysis in an HLA Class II defined subgroup showed a statistically significant benefit of MBP8298 treatment compared with placebo in patients with HLA haplotypes DR2 and/or DR4 (n = 20, P = 0.01). Long-term follow-up treatment and assessment of patients in this responder group showed a median time to progression of 78 months for MBP8298 treated patients compared with 18 months for placebo-treatment (Kaplan-Meier analysis, P = 0.004; relative rate of progression = 0.23). Anti-MBP autoantibody levels in the CSF of most MBP8298 treated patients were suppressed, but antibody suppression was not predictive of clinical benefit. Anti-MBP autoantibodies that reappeared in the CSF of one patient at 36 months, whilst under treatment with MBP8298, were not reactive with the MBP8298 peptide in vitro. The identification of a responder subgroup (62.5% of the patients in this study) enables a more efficient design of a large confirmatory clinical trial of MBP8298. The probability that patients with other less common HLA-DR haplotypes will respond to this treatment should not be ignored.

Topics: Adult; Antibodies; Disability Evaluation; Disease Progression; Double-Blind Method; Female; Follow-Up Studies; HLA-DR2 Antigen; Humans; In Vitro Techniques; Magnetic Resonance Imaging; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Psychomotor Performance; Severity of Illness Index; Time Factors; Treatment Outcome

CD4(+)CD25(high) T regulatory (Tr) cells, representing high IL-2 receptor alpha chain expressing cells, have been shown to inhibit proliferation and cytokine secretion by CD4(+) T cells that are assumed to represent important effector cells in auto-aggressive immunity. Tr cells may therefore be considered of importance in the pathogenesis of multiple sclerosis (MS). Glatiramer acetate (GA; Copaxone) is approved as a disease-modulating agent that ameliorates the course of MS. The goal of this study was to examine in vitro effects of GA on Tr cells from MS patients subgrouped according to treatment without or with disease-modulating drugs, and healthy controls (HC). Three-colour flow cytometry was used to investigate in vitro influence of GA, and of the encephalitogenic myelin basic protein (MBP) peptide 83-89 as control, on the blood Tr cell proportion and on their functionally important cell surface molecules CD45RO, CD69, CD95 and HLA-DR, and on intracellular CTLA-4 and IL-10. Irrespective of exposure to GA or MBP((83-99)), levels of blood Tr cells expressing HLA-DR remained low in untreated MS patients and HC compared to the three treated MS patient groups. In vitro exposure to GA resulted in elevated levels of IL-10 producing Tr cells in all MS patient groups irrespective of receiving treatment as well as in HC. Exposure to GA or MBP((83-99)) had no effects on levels of Tr cells expressing other above-mentioned molecules. We conclude that GA induces elevated IL-10 production by Tr cells that is uniform and independent of ongoing MS treatment with IFN-beta or GA or IFN-beta+GA.

Topics: Adjuvants, Immunologic; Adult; CD4 Lymphocyte Count; CD4-Positive T-Lymphocytes; Cells, Cultured; Female; Glatiramer Acetate; HLA-DR Antigens; Humans; Interleukin-10; Lymphocyte Activation; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Peptides; Receptors, Interleukin-2; T-Lymphocyte Subsets; Up-Regulation

We investigated the effects of interferon beta-1a (IFN beta-1a) on specific response towards two immunodominant MBP peptides and on global production of IgG. We evaluated 54 sera from multiple sclerosis (MS) patients at baseline and 1 year after treatment. We did not observe any modification of immune response to the MBP peptides but we noted a significant decrease in mean IgG concentrations in patients with progression of the disease but not in stable patients. These results suggest that IFN beta1a restores or maintains a beneficial immune response.

Topics: Adult; Autoantibodies; Disease Progression; Down-Regulation; Epitopes; Female; Humans; Immune System; Immunoglobulin G; Interferon beta-1a; Interferon-beta; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Treatment Outcome

The availability of a group of multiple sclerosis (MS) patients at the University of Maryland, who had participated in the pivotal Copaxone trial in the early 1990s, provided an opportunity to examine the long-term immunologic effects of Glatiramer acetate (GA) treatment in MS. Forty-eight GA-reactive T-cell lines (TCL) were generated from 10 MS patients who have been receiving GA treatment for 6-9 years. Proliferative responses, cytokine production, and cross-reactivity with myelin basic protein (MBP) and the MBP immunodominant peptide 83-99 were compared to responses obtained from 10 MS patients who were tested pretreatment and after a shorter period of treatment ranging from 1 to 10 months. The results indicate that while long-term treatment with GA results in a 2.9-fold decrease in the estimated precursor frequency of GA-reactive T-cells, the sustained response to GA remains Th2-biased and in part cross-reactive with MBP and MBP (83-99) as measured by proliferation and cytokine release assays. The results indicate that despite a drop in the precursor frequency of GA-reactive T-cells with long-term treatment, the sustained response remains predominantly Th2-biased and cross-reactive with MBP, which is consistent with the anti-inflammatory effects of the drug and bystander suppression.

Topics: Biomarkers; Cross Reactions; Glatiramer Acetate; Humans; Immunophenotyping; Immunosuppressive Agents; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Peptides; Th2 Cells

Altered peptide ligands (APLs) can modulate responses of T cells to native peptide antigens implicated in the pathogenesis of autoimmune diseases. An APL of the putative target antigen myelin basic protein (MBP) peptide 83-99 has been used in abbreviated clinical trials in patients with multiple sclerosis (MS). Our objective was to assess the long-term persistence, and characteristics, of the APL-induced immune response in such patients. We measured the ex vivo proliferative frequency to the APL and native MBP, the cross-reactivity, and the cytokine production by these lines. We found that a 4- to 16-week course of APL therapy could induce a persistent (2-4.5 year) increase in the frequency of T cells responsive to both the APL and the native MBP in a select number of patients. These T cells produced high levels of IL-5, contrasting with the pretreatment observation that the responses to either antigen were IFNgamma (Th1) dominant. Our results indicate that APL therapy can induce persistent Th2-directed immune deviation. Understanding the impact of such APL-induced immune responses on MS disease activity will require additional clinical trials that incorporate careful monitoring of both clinical and immunological parameters.

Topics: Adult; Cohort Studies; Cross Reactions; Humans; Immunity, Cellular; Interferon-alpha; Interleukin-5; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; T-Lymphocytes; Th1 Cells

The objective of this study was to evaluate the safety and efficacy of the humanized antibody ATM-027 in a baseline versus treatment magnetic resonance imaging-monitored study. Expansion of Vbeta5.2/5.3(+) T cells has been demonstrated in the peripheral blood, cerebrospinal fluid, and brain lesions of MS patients. In a phase I study, ATM-027 depleted these cells in peripheral blood and, in parallel, T-cell MBP reactivity and IFN-gamma expression were reduced. We studied 59 patients with relapsing-remitting MS (47 on ATM-027 and 12 on placebo) stratified for HLA-DR2 status. Monthly intravenous injections were given for 6 months. Individual dose titration was employed to obtain depletion of the target T-cell level and downregulation of antigen receptor density as monitored by flow cytometry. Five monthly magnetic resonance imaging scans were performed before treatment to establish baseline activity, six during treatment, and three during follow-up. Additional immunological assessments were performed to elucidate the mechanism of action of ATM-027. The treatment was safe and well tolerated, inducing consistent suppression of the target cell population. During run-in, active lesions were found in 78.7% (37/47) of patients treated with ATM-027. During treatment, the median number of lesions was reduced by 33% (p = 0.13) independent of DR2 status. The corresponding volume of enhancement was 221 mm(3) at baseline, with a reduction of 10% during treatment. Decreased numbers of cells expressing interferon-gamma messenger RNA, and decreased T-cell reactivity to several myelin antigens were found in ATM-027 treated patients. In conclusion, consistent suppression of Vbeta 5.2/5.3(+) T cells was achieved. However, the effect size on magnetic resonance imaging was considerably less than the targeted 60%.

Topics: Adult; Amino Acid Sequence; Autoantigens; Cytokines; Female; Follow-Up Studies; Haplotypes; HLA-DR2 Antigen; Humans; Immunoglobulin G; Immunosuppression Therapy; Magnetic Resonance Imaging; Male; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Receptors, Antigen, T-Cell, alpha-beta; Recombinant Proteins; RNA, Messenger; T-Lymphocytes

Myelin basic protein (MBP)-reactive T cells are potentially involved in the pathogenesis of multiple sclerosis (MS), and can be depleted by subcutaneous inoculations with irradiated autologous MBP-reactive T cells (T cell vaccination). This preliminary open label study was undertaken to evaluate whether depletion of MBP-reactive T cells would be clinically beneficial to patients with MS. Fifty-four patients with relapsing-remitting (RR) MS (n=28) or secondary progressive (SP) MS (n=26) were immunized with irradiated autologous MBP-reactive T cells and monitored for changes in rate of relapse, expanded disability scale score (EDSS) and MRI lesion activity over a period of 24 months. Depletion of MBP-reactive T cells correlated with a reduction (40%) in rate of relapse in RR-MS patients as compared with the pre-treatment rate in the same cohort. However, the reduction in EDSS was minimal in RR-MS patients while the EDSS was slightly increased in SP-MS patients over a period of 24 months. Serial semi-quantitative MRI examinations suggest stabilization in lesion activity as compared with baseline MRI. The findings suggest some potential clinical benefit of T cell vaccination in MS and encourage further investigations to evaluate the treatment efficacy of T cell vaccination in controlled trials.

Topics: Adoptive Transfer; Adult; Brain; Chemotaxis, Leukocyte; Disease Progression; Female; Humans; Lymphocyte Count; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Pilot Projects; Secondary Prevention; T-Lymphocytes; Treatment Outcome; Vaccination

Humoral and cellular immune responses were followed in multiple sclerosis patients treated with Copolymer 1 (Cop1, glatiramer acetate, Copaxone) who participated in three different clinical trials. All patients (130) developed Cop1 reactive antibodies, which peaked at 3 months after initiation of treatment, decreasing at 6 months and remaining low. IgG1 antibody levels were 2-3-fold higher than those of IgG2. The proliferative response of Peripheral Blood Mononuclear Cells (PBMC) to Cop1 was initially high and gradually decreased during treatment. Antibodies and T cell responses to MBP were low and did not change significantly during the treatment. The humoral and cellular immunological responses to Cop1 do not correlate with the side effects and do not affect its therapeutic activity. The preferential production of IgG1 over IgG2 antibodies may indicate that Th2 responses are involved in mediating the clinical effect of Cop1.

Topics: Adult; Antibody Affinity; Cell Division; Double-Blind Method; Female; Glatiramer Acetate; Humans; Immunoglobulin G; Leukocytes, Mononuclear; Male; Multiple Sclerosis; Myelin Basic Protein; Peptides; Recurrence; Severity of Illness Index; T-Lymphocytes; Treatment Outcome

Although multiple sclerosis (MS) is considered primarily as a demyelinating disease, neuronal damage is abundant and correlates with the neurological deficit. Therefore, we investigated the frequency and characteristics of human T cells specific for synapsin-a neuronal protein highly conserved among species. Synapsin specific T cell responses were detected at a frequency similar to that of MBP specific T cells in MS patients, one patient with acute demyelinating encephalomyelitis (ADEM) and controls. Long-term T cell lines specific for synapsin exhibited a CD3(+), CD4(+), CD8(-) phenotype and produced high amounts of tumor-necrosis-factor-alpha (TNF-alpha) and interferon-gamma (IFN-gamma) after antigen specific stimulation, whereas lymphotoxin (LT), interleukin-4 (IL-4) and interleukin-10 (IL-10) were detectable in smaller quantities.

Topics: Acute Disease; CD3 Complex; CD4 Antigens; Cell Line; Dose-Response Relationship, Immunologic; Encephalomyelitis, Acute Disseminated; Humans; Immunophenotyping; Interferon-gamma; Interleukin-10; Interleukin-4; Lymphotoxin-alpha; Multiple Sclerosis; Myelin Basic Protein; Synapsins; T-Lymphocytes; Tumor Necrosis Factor-alpha

Glatiromer acetate (GA) is an approved treatment for multiple sclerosis (MS). The proposed mechanism of action is the induction of GA-specific T cells characterized by protective anti-inflammatory Th2 response. We tested this hypothesis in 11 MS patients treated with GA from 1-19 months. Interferon-gamma and IL-5 (markers of Th1 and Th2 responses respectively) were assayed by ELISA in GA-specific T-cell lines (TCL) supernatants. Th1/Th2 bias was defined based on the ratio of IFN-gamma/IL-5 secretion. Fifty-eight pre-treatment and 75 on-treatment GA-specific TCL were generated. On-treatment mean IL-5 levels in GA-TCL increased significantly, whereas those for IFN-gamma were markedly reduced. Consequently, the ratio of IFN-gamma IL-5 also shifted in favor of a Th2 response. The percentage of GA-TCL classified as Th1 was decreased, whereas those classified as Th2 increased on-treatment as compared to pre-treatment. Some GA-specific TCL, (approximately 25%) generated during treatment secreted predominantly IL-5 in response to MBP and the immunodominant MBP peptide 83-99, indicating that these crossreactive antigens can act as partial agonists for GA-reactive TCL. These results strongly suggest that the mechanism of action of GA in MS involves the induction of crossreactive GA-specific T cells with a predominant Th2 cytokine profile.

Topics: Cell Line; Cross Reactions; Cytokines; Enzyme-Linked Immunosorbent Assay; Glatiramer Acetate; Humans; Immunosuppressive Agents; Interleukin-5; Multiple Sclerosis; Myelin Basic Protein; Peptides; Regression Analysis; T-Lymphocytes; Th2 Cells

Pathogenic autoreactive T cells can be targeted by T cell vaccination (TCV), a procedure in which patients are immunized with autologous attenuated pathogenic T cells. We reported previously that TCV with myelin basic protein (MBP) reactive T cell clones in multiple sclerosis (MS) patients induced T cell immune responses, resulting in a clonal depletion of MBP reactive T cells in all patients. Five years after TCV, MBP reactive T cells were observed in five out of nine MS patients. These clones had a different clonal origin from those isolated before vaccination. We have studied the cytokine profile, cytotoxicity and epitope specificity of these reappearing clones. Our data indicate that the clones express similar effector functions as those isolated before TCV, suggesting that they also could play a pathogenic role in the disease. We demonstrated that these clones can be depleted by an additional sequence of immunizations. These findings may be relevant to other T cell targeted immunotherapies for MS and other autoimmune diseases.

Topics: Clone Cells; Cytokines; Epitopes; Humans; Immunotherapy; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes; T-Lymphocytes, Cytotoxic; Time Factors; Vaccination

We examined the effect of glatiramer acetate, a random copolymer of alanine, lysine, glutamic acid, and tyrosine, on antigen-specific T-cell responses in patients with multiple sclerosis (MS). Glatiramer acetate (Copaxone) functioned as a universal antigen, inducing proliferation, independent of any prior exposure to the polymer, in T-cell lines prepared from MS or healthy subjects. However, for most patients, daily injections of glatiramer acetate abolished this T-cell response and promoted the secretion of IL-5 and IL-13, which are characteristic of Th2 cells. The surviving glatiramer acetate-reactive T cells exhibited a greater degree of degeneracy as measured by cross-reactive responses to combinatorial peptide libraries. Thus, it appears that, in some individuals, in vivo administration of glatiramer acetate induces highly cross-reactive T cells that secrete Th2 cytokines. To our knowledge, glatiramer acetate is the first agent that suppresses human autoimmune disease and alters immune function by engaging the T-cell receptor. This compound may be useful in a variety of autoimmune disorders in which immune deviation to a Th2 type of response is desirable.

Topics: Adult; Amino Acid Sequence; Cell Division; Cells, Cultured; Cross Reactions; Epitopes, T-Lymphocyte; Female; Glatiramer Acetate; Humans; Immunodominant Epitopes; Immunosuppressive Agents; Interferon-gamma; Interleukin-5; Leukocytes, Mononuclear; Ligands; Male; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Peptide Fragments; Peptides; Tetanus Toxoid; Th2 Cells

RIA of myelin basic protein (MBP) in cerebrospinal fluid (CSF) is commonly used as a biochemical marker of demyelination in patients with multiple sclerosis (MS). Our aim was to develop a sufficiently sensitive ELISA for MBP and evaluate it clinically in patients with MS.. The ELISA used anti-bovine MBP antibody coated on plates and biotinylated anti-MBP antibody. The bound antibody complex was quantified with streptavidin-horseradish peroxidase. MBP was determined in CSF from 84 MS patients and 55 patients with other neurological diseases.. The respective within- and between-assay CVs were 4.7% and 7.2% at 200 ng/L, and 6. 3% and 8.8% at 2000 ng/L. The detection limit was 30 ng/L. Most of the MS patients with acute exacerbations had markedly increased MBP in the CSF. Longitudinal studies of six MS patients with recurrent exacerbation confirmed this observation. MBP concentrations from 78 MS patients, as tested with our ELISA, correlated well with those obtained by RIA (r = 0.9; P: <0.01), but the detection limit of the ELISA was much lower than that of the RIA.. This convenient ELISA with higher sensitivity than the existing assays is a suitable routine assay that provides a diagnostic indicator of myelin breakdown in the central nervous system; moreover, it is an excellent indicator of MS disease activity.

Topics: Adolescent; Adult; Enzyme-Linked Immunosorbent Assay; Humans; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Radioimmunoassay; Sensitivity and Specificity

Myelin-specific T lymphocytes are considered essential in the pathogenesis of multiple sclerosis. The myelin basic protein peptide (a.a. 83-99) represents one candidate antigen; therefore, it was chosen to design an altered peptide ligand, CGP77116, for specific immunotherapy of multiple sclerosis. A magnetic resonance imaging-controlled phase II clinical trial with this altered peptide ligand documented that it was poorly tolerated at the dose tested, and the trial had therefore to be halted. Improvement or worsening of clinical or magnetic resonance imaging parameters could not be demonstrated in this small group of individuals because of the short treatment duration. Three patients developed exacerbations of multiple sclerosis, and in two this could be linked to altered peptide ligand treatment by immunological studies demonstrating the encephalitogenic potential of the myelin basic protein peptide (a.a. 83-99) in a subgroup of patients. These data raise important considerations for the use of specific immunotherapies in general.

Topics: Adolescent; Adult; Amino Acid Sequence; Case-Control Studies; Cross Reactions; Cytokines; Dose-Response Relationship, Drug; Humans; Ligands; Magnetic Resonance Imaging; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Peptides; T-Lymphocytes; Treatment Failure

In this 'double-blind', randomized, placebo-controlled phase II trial, we compared an altered peptide ligand of myelin basic protein with placebo, evaluating their safety and influence on magnetic resonance imaging in relapsing-remitting multiple sclerosis. A safety board suspended the trial because of hypersensitivity reactions in 9% of the patients. There were no increases in either clinical relapses or in new enhancing lesions in any patient, even those with hypersensitivity reactions. Secondary analysis of those patients completing the study showed that the volume and number of enhancing lesions were reduced at a dose of 5 mg. There was also a regulatory type 2 T helper-cell response to altered peptide ligand that cross-reacted with the native peptide.

Topics: Dose-Response Relationship, Drug; Drug Hypersensitivity; Humans; Incidence; Ligands; Magnetic Resonance Imaging; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Peptides; Th2 Cells

Multiple sclerosis [MS], a demyelinating disease of the central nervous system associated with inflammation and gliosis, may be an autoimmune disease with T lymphocytes and autoantibodies to myelin protein(s). This study deals exclusively with B cell autoimmunity to myelin basic protein (MBP). T lymphocytes and anti-MBP share a common MBP epitope located between P(85) and P(96) which contains the essential contact residues H(88)FFK(91) for the trimolecular complex. The purpose of this Phase I open label clinical study was to monitor CSF anti-MBP in patients with chronic progressive MS subsequent to IV administration of synthetic peptide (sp) MBP82-98 namely DEN(85)VVHFFKNIVTP(96)RT. Fifty-six patients who participated in this project were assigned to two groups: a 'control group' of 15 patients who received IV saline injections every 6 months for the first 2 years of the study and a 'peptide group' of 41 patients who received IV spMBP82-98 from the beginning of the study and then infrequently subsequent to a rise of their CSF anti-MBP. In the control group antibody levels remained persistently elevated during the 2 year period. Patients in the 'peptide group' segregated into four kinetic profiles: Cohort A (15 patients) illustrated prolonged anti-BMP suppression into the normal range. Cohort B (10 patients) illustrated significant anti-MBP suppression into the normal range for shorter durations. Cohort C (eight patients) showed significant CSF anti-MBP suppression after the initial injection but lost the ability to suppress the autoantibody titer following subsequent injections. Cohort D (eight patients) failed to show significant CSF anti-MBP suppression. In conclusion the B cell tolerizing effect of spMBP82-98 segregated into four kinetic profiles; this molecular variability should be considered in attempts to develop specific 'peptide therapies' for the broad range of clinical profiles currently diagnosed as 'multiple sclerosis'. Multiple Sclerosis (2000) 6 300 - 311

Topics: Amino Acid Sequence; Autoantibodies; Cohort Studies; Epitopes, B-Lymphocyte; Epitopes, T-Lymphocyte; Female; Humans; Immune Tolerance; Immunosuppression Therapy; Injections, Intravenous; Kinetics; Male; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments

To determine levels of urinary myelin basic protein-like material (MBPLM) in patients with multiple sclerosis (MS) openly treated with interferon beta-1b and to correlate these with clinical changes.. Levels of urinary MBPLM correlate with the presence of the progressive phase of MS and with the disease burden detected on T2-weighted, cranial magnetic resonance imaging. Measurement of urinary MBPLM level may be a feasible test for monitoring or predicting response to therapeutic measures.. In a prospective study at one site, 166 patients with MS (131 with relapsing-remitting [RR] and 35 with secondary progressive [SP] disease) were treated for a minimum of 1 year and up to 3 years with interferon beta-1b and underwent assessment for neurologic disability (Expanded Disability Status Scale and Scripps Neurological Rating Scale) and change in disease subtype. Urine samples were obtained at 1219 of 1378 clinic visits, and urinary MBPLM level was determined and related to creatinine level to adjust for renal function.. Statistical analysis using the general linear models procedure confirmed previous findings that the level of urinary MBPLM related to urinary creatinine level (MBPLM/creatinine) was higher (P<.001) in patients with SP than RR MS. Of the 131 patients with RR MS, SP disease developed in 13 during the observation period. Compared with those in the RR group, the RR to SP group had a higher level (P<.001) of urinary MBPLM and did not differ from the SP group.. The level of urinary MBPLM is higher in SP MS than RR MS but not in RR MS that converts to SP MS. Level of urinary MBPLM may permit the examination of treatment tested to prevent RR disease from becoming progressive.

Topics: Adjuvants, Immunologic; Adolescent; Adult; Creatinine; Disease Progression; Female; Humans; Interferon beta-1a; Interferon beta-1b; Interferon-beta; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Prospective Studies; Recombinant Proteins; Recurrence

In experimental animal models of multiple sclerosis demyelinating antibody responses are directed against the myelin oligodendrocyte glycoprotein (MOG). We have investigated whether a similar antibody response is also present in multiple sclerosis patients. Using the recombinant human extracellular immunoglobulin domain of MOG (MOG-Ig) we have screened the sera and CSFs of 130 multiple sclerosis patients, 32 patients with other inflammatory neurological diseases (OIND), 30 patients with other non-inflammatory neurological diseases (ONND) and 10 patients with rheumatoid arthritis. We report that 38% of multiple sclerosis patients are seropositive for IgG antibodies to MOG-Ig compared with 28% seropositive for anti-myelin basic protein (MBP). In contrast, OIND are characterized by similar frequencies of serum IgG antibody responses to MOG-Ig (53%) and MBP (47%), whereas serum IgG responses to MOG-Ig are rare in ONND (3%) and rheumatoid arthritis (10%). Anti-MBP IgG antibodies, however, are a frequent finding in ONND (23%) and rheumatoid arthritis (60%). Our results provide clear evidence that anti-MOG-Ig antibodies are common in CNS inflammation. However, in OIND these antibody responses are transient, whereas they persist in multiple sclerosis. We demonstrate that the serum anti-MOG-Ig response is already established in early multiple sclerosis (multiple sclerosis-R0; 36%). In later multiple sclerosis stages frequencies and titres are comparable with early multiple sclerosis. In contrast, the frequency of anti-MBP antibodies is low in multiple sclerosis-R0 (12%) and increases during disease progression in relapsing-remitting (32%) and chronic progressive multiple sclerosis (40%), thus suggesting that anti-MBP responses accumulate over time. Finally we provide evidence for intrathecal synthesis of IgG antibodies to MOG-Ig in multiple sclerosis.

Topics: Adult; Arthritis, Rheumatoid; Autoantibodies; Blotting, Western; Enzyme-Linked Immunosorbent Assay; Female; Humans; Immunoglobulins; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Nervous System Diseases; Neuritis; Recombinant Proteins; Retrospective Studies

There is an evident need for a quantitative laboratory marker for ascertaining disease activity and treatment effects in multiple sclerosis (MS) patients. Activity of the disease process in MS is accompanied by myelin breakdown and appearance of myelin basic protein (MBP) in cerebrospinal fluid (CSF). In this paper MBP in CSF of relapsing-remitting (RR) MS patients is reviewed. MBP in CSF is a fragment containing an epitope corresponding to amino acid residues 45-89 of the native molecule. From several relevant studies about CSF MBP in RR MS the following relations can be concluded: CSF MBP levels in active MS patients are frequently increased (45-100%), remain increased until 5 to 6 weeks after onset symptoms and are higher in polysymptomatic exacerbations and correlate with number of gadolinium-enhanced (Gd) lesions on MRI, severity of relapses, EDSS score and CSF intrathecal IgM synthesis. After an intravenous methylprednisolone treatment the increased CSF MBP levels return to normal values and reduction in CSF MBP is related to reduction in EDSS score, number of Gd lesions and CSF intrathecal IgM synthesis.

Topics: Epitopes; Humans; Methylprednisolone; Monitoring, Physiologic; Multiple Sclerosis; Myelin Basic Protein; Neuroprotective Agents; Recurrence; Remission Induction

Intrathecal immunoglobulin synthesis and activation of the complement cascade occurs in patients with multiple sclerosis (MS). The present study aimed at further studying the relation between intrathecal immunoglobulin synthesis and complement activation. We compared total intrathecal synthesis of IgA, IgG, and IgM, the number of cells secreting anti-myelin basic protein (MBP) and anti-proteolipid protein (PLP) antibodies of the IgG isotype and intrathecal activation of the complement cascade in patients with possible onset symptoms of MS (n = 18) or clinically definite MS (n = 30). Early activation of the complement cascade correlated with intrathecal synthesis of IgM. Intrathecal IgG, IgA and IgM synthesis also correlated weakly with the presence of cells secreting anti-MBP or anti-PLP autoantibodies. Full activation of the complement cascade did not correlate with any measures of intrathecal antibody synthesis. These findings suggest a complex relation between different immunoglobulin isotypes and complement activation which may have similarly complex roles in the pathogenesis of MS.

Topics: Acute Disease; Adult; Complement Activation; Female; Humans; Immunoglobulins; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Optic Neuritis

Acute relapses of multiple sclerosis (MS) are characterized by elevated Free (F)/Bound (B) anti-MBP ratios during the initial phase, followed by a steady decline of F antibody as the recovery/remission phase develops. The (human) MBP epitope for MS anti-MBP is: Pro85-Val-Val-His-Phe-Phe-Lys-Asn-Ile-Val-Thr-Pro96. In phase one clinical research, synthetic peptides (p) containing this epitope, namely pMBP86-95 and/or pMBP82-98, were intrathecally administered to MS patients with monosymptomatic or polysymptomatic relapses to determine the dosage, frequency and duration of administration which will immediately neutralize F circulating CSF anti-MBP. Patients with monosymptomatic relapses required 50 mg of peptide administered daily for 4-5 days. In patients with polysymptomatic relapses, F anti-MBP can be neutralized with dosages between 50 mg peptide daily for 4 days up to 100 mg twice a day for 2 days; however due to the prolonged nature of polysymptomatic relapses, antibody neutralization could not be maintained by these short courses of intrathecal peptide administration. Intravenous administration of these same peptides did not prevent occurrence of future relapses.

Topics: Acute Disease; Adult; Autoantibodies; Epitopes; Humans; Injections, Intravenous; Injections, Spinal; Male; Multiple Sclerosis; Myelin Basic Protein; Peptides; Protein Binding; Recurrence

Peptide-based tolerance induction may be useful for antigen-specific immunotherapy of human autoimmune diseases. Induction of tolerance to myelin basic protein (MBP) was examined in a Phase I clinical trial in multiple sclerosis (MS) patients with chronic progressive disease using a peptide that is immunodominant for MBP specific T cells and B cells. Tolerance induction was monitored by quantification of MBP specific autoantibodies in cerebrospinal fluid (CSF). The route of peptide administration was important since only intravenous but not intrathecal or subcutaneous injection induced tolerance to MBP. Following a single intravenous injection of a peptide containing epitope P85VVHFFKNIVTP96, MBP autoantibodies were undetectable for three to four months. Tolerance was more prolonged following a second injection since autoantibodies were low or undetectable after one year in the majority of patients. Duration of tolerance to MBP depended on MHC class II haplotypes of patients; tolerance was long-lived in all patients with disease associated HLA-DR2. No neurological or systemic side effects were observed, regardless of the route of peptide administration. These data demonstrate that intravenous administration of a soluble peptide can result in long-lasting tolerance to an autoantigen in humans.

Topics: Autoantibodies; Epitopes; Female; Haplotypes; HLA-DR2 Antigen; Humans; Immune Tolerance; Immunotherapy; Injections, Intravenous; Injections, Subcutaneous; Male; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Safety

Oral administration of antigen is a long-recognized method of inducing systemic immune tolerance. In animals with experimental autoimmune disease, a major mechanism of oral tolerance involves the induction of regulatory T cells that mediate active suppression by secreting the cytokine TGF-beta 1. Multiple sclerosis (MS) is a presumed T cell-mediated Th1 type autoimmune disease. In this paper we investigated, in patients with MS, whether oral myelin treatment (myelin containing both MBP and PLP) induced antigen-specific MBP- or PLP-reactive T cells that were either Th2-like (secreted IL-4 or TGF-beta 1), or alternatively whether Th1 type sensitization occurred as measured by IFN-gamma secretion. Specifically, 4,860 short-term T cell lines were generated to either MBP, PLP or TT from 34 relapsing-remitting patients with MS; 17 were orally treated with bovine myelin daily for a minimum of two years as compared to 17 non-treated patients. We found a marked increase in the relative frequencies of both MBP- and PLP-specific TGF-beta 1 secreting T cell lines in the myelin-treated MS patients as compared to non-treated MS patients (MBP, p < 0.001; PLP, p < 0.003). In contrast, no changes in the frequency of MBP- or PLP-specific IFN-gamma or TT-specific TGF-beta 1 secreting T cells were observed. These results suggest that the oral administration of antigens generates antigen-specific TGF-beta 1 secreting T cells of presumed mucosal origin that may represent a distinct cytokine-secreting lineage of T cells (Th3). Since, in animal models, antigen-specific TGF-beta 1 secreting cells localize to the target organ and then suppress inflammation in the local microenvironment, oral tolerization with self-antigens may provide a therapeutic approach for the treatment of cell-mediated autoimmune disease which does not depend upon knowledge of the antigen specificity of the original T cell clone triggering the autoimmune cascade.

Topics: Administration, Oral; Adult; Antigens; Female; Humans; Immune Tolerance; Interferon-gamma; Interleukin-4; Lymphocyte Activation; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; T-Lymphocytes; Transforming Growth Factor beta

Oral administration of antigen is a long recognized method of inducing systemic immune tolerance. In animals with experimental autoimmune disease, a major mechanism of oral tolerance triggered by oral administration of antigen involves the induction of regulatory T cells that mediate active suppression by secreting the cytokine TGF-beta 1. Multiple sclerosis (MS) is a presumed T cell-mediated Th1 type autoimmune disease. Here, we investigated whether in MS patients oral myelin treatment, containing both myelin basic protein (MBP) and proteolipid protein (PLP), induced antigen specific MBP or PLP reactive T cells that either secreted IL4, TGF-beta1, or alternatively did Th1 type sensitization occur as measured by IFN-gamma secretion. Specifically, 4,860 short-term T cell lines were generated to either MBP, PLP, or tetanus toxoid (TT) from 34 relapsing-remitting MS patients: 17 orally treated with bovine myelin daily for a minimum of 2 yr as compared to 17 nontreated patients. We found a marked increase in the relative frequencies of both MBP and PLP specific TGF-beta1-secreting T cell lines in the myelin treated MS patients as compared to non-treated MS patients (MBP P < 0.001, PLP P < 0.003). In contrast, no change in the frequency of MBP or PLP specific IFN-gamma or TT specific TGF-beta1 secreting T cells were observed. These results suggest that the oral administration of antigens generates antigen specific TGF-beta1 secreting Th3 cells of presumed mucosal origin that represent a distinct lineage of T cells. Since antigen-specific TGF-beta1 secreting cells localize to the target organ and then suppress inflammation in the local microenvironment, oral tolerization with self antigens may provide a therapeutic approach for the treatment of cell-mediated autoimmune disease which does not depend upon knowledge of the antigen specificity of the original T cell clone triggering the autoimmune cascade.

Topics: Administration, Oral; Autoantigens; Clinical Trials as Topic; Follow-Up Studies; Humans; Immune Tolerance; Interferon-gamma; Interleukin-4; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; Recurrence; T-Lymphocytes, Helper-Inducer; Transforming Growth Factor beta

A T-cell receptor (TCR) peptide vaccine from the V beta 5.2 sequence expressed in multiple sclerosis (MS) plaques and on myelin basic protein (MBP)-specific T cells boosted peptide-reactive T cells in patients with progressive MS. Vaccine responders had a reduced MBP response and remained clinically stable without side effects during one year of therapy, whereas nonresponders had an increased MBP response and progressed clinically. Peptide-specific T helper 2 cells directly inhibited MBP-specific T helper 1 cells in vitro through the release of interleukin-10, implicating a bystander suppression mechanism that holds promise for treatment of MS and other autoimmune diseases.

Topics: Adult; Autoimmune Diseases; Disease Progression; Double-Blind Method; Female; HLA-DR Antigens; HLA-DRB1 Chains; Humans; Immunotherapy, Active; Interleukin-10; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Pilot Projects; Receptors, Antigen, T-Cell, alpha-beta; T-Lymphocyte Subsets; Th2 Cells; Vaccines

T cell responses to myelin basic protein (MBP) are implicated to play an important role in the pathogenesis of multiple sclerosis (MS). These MBP autoreactive T cells are found to undergo in vivo activation and clonal expansion in patients with MS. They accumulate in the brain compartment and may reside in the brain lesions of patients with MS. As MBP-reactive T cells potentially hold a central position in initiation and perpetuation of the brain inflammation, specific immune therapies designed to deplete them may improve the clinical course of the disease. In this paper, the therapeutic potential of T cell vaccination in the treatment of MS is discussed in context of its immunological and clinical effect. The results of our phase one clinical trial indicate that T cell vaccination with inactivated MBP autoreactive T cells induces specific regulatory T cell network of the host immune system to deplete circulating MBP-reactive T cells in a clonotype-specific fashion. The immunity induced by T cell vaccination is clonotype-specific and long-lasting. Our longitudinal clinical evaluation further suggests a moderate reduction of rate of clinical exacerbation, disability score and the brain lesions (measured by magnetic resonance imaging) in vaccinated patients, as compared to matched controls. Our study should encourage further investigation on the treatment efficacy of T cell vaccination and further improvement for its clinical application.

Topics: Autoantibodies; Humans; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes; Vaccination

Topics: Cytotoxicity, Immunologic; Histocompatibility Antigens Class I; Humans; In Vitro Techniques; Lymphocyte Activation; Lymphocyte Depletion; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell, alpha-beta; T-Lymphocytes; Vaccination

In the multicenter, randomized, placebo-controlled trial of alternate-day injections of recombinant interferon beta-1b in relapsing-remitting multiple sclerosis (MS), urine specimens were collected periodically from all patients (n = 64) in two of the clinical test sites over the 2 years of the study. Urine specimens were also collected over two consecutive 24-hour periods from 43 patients from a third center. Urine samples were assayed for their content of myelin basic protein-like material (MBPLM), the level of which was correlated with clinical changes, cranial magnetic resonance imaging results, and the development of progressive disease. Concordant changes in creatinine values affected some of the relationships of MBPLM. The level of urinary MBPLM correlated with a chronic progressive course and with the number of lesions and the total lesion area on cranial magnetic resonance images. A rise in the level of urinary MBPLM appeared to antedate the clinical transition from a relapsing-remitting to a chronic progressive course. By chance, the randomized entry of patients led to significant differences in urinary MBPLM levels among the three treatment groups, thus precluding correlation studies of treatment effects. However, the patient group from which 24-hour specimens were collected showed that the patients with relapsing-remitting MS changing to a chronic progressive course, and more specifically, those patients with chronic progressive MS receiving placebo, had the highest values of urinary MBPLM. These findings indicate that urinary MBPLM may offer an objective test and possibly serve as a surrogate marker for detecting or predicting the failure of remission or the transition to a progressive phase of MS.

Topics: Analysis of Variance; Creatinine; Drug Administration Schedule; Humans; Interferon beta-1a; Interferon beta-1b; Interferon-beta; Multiple Sclerosis; Myelin Basic Protein

A double blind Phase 1 clinical research project was conducted in vivo in multiple sclerosis (MS) patients to determine the effect of myelin basic protein (MBP) synthetic peptides on free (F) and bound (B) titers of anti-MBP in cerebrospinal fluid (CSF). Intrathecal administration of peptide MBP75-95, either as a single dose, or as repeated injections for periods up to 10 weeks, produced complete binding-neutralization of F anti-MBP with no change in B levels. A control peptide MBP35-58 had no effect on F and B anti-MBP levels. Intravenous administration of MBP75-95 resulted in significant decline of F and B CSF anti-MBP levels over a period of one month. Administration of MBP synthetic peptides to MS patients either intrathecally or intravenously did not have any adverse neurological effects and systemic complications did not occur. The MBP epitope for MS anti-MBP was further localized to an area between Pro85 and Pro96.

Topics: Adult; Aged; Antigen-Antibody Reactions; Autoantibodies; Double-Blind Method; Drug Administration Schedule; Epitope Mapping; Female; Humans; Injections, Intravenous; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Peptides

Immunization with disease-associated TCR V region peptides is an effective treatment for experimental autoimmune encephalomyelitis. Myelin basic protein-specific T cells, which induce experimental autoimmune encephalomyelitis in many animal strains, may be important in the pathogenesis of multiple sclerosis. Myelin basic protein-specific T cell clones from some multiple sclerosis patients preferentially use TCR V genes from the V beta 5.2 and V beta 6.1 families. To assess the safety and immunogenicity of TCR V beta 5.2 and V beta 6.1 peptides, we injected 11 multiple sclerosis patients with varying doses of two synthetic peptides, TCR V beta 5.2(39-59) and V beta 6.1(39-59), encompassing the CDR2 region of these V gene families. Low doses (100 to 300 micrograms) of peptide induced T cell immunity in 7 of 11 patients to one or both peptides. Delayed type hypersensitivity skin responses to the peptides were observed in three of seven responders, and TCR peptide-specific Ab occurred in two of seven T cell responders. Low doses of TCR peptides produced no side effects and did not cause broad spectrum immunosuppression. Synthetic TCR V region peptides can induce T cell immunity safely in humans and may prove useful in treating human autoimmune diseases.

Topics: Adult; Aged; Amino Acid Sequence; Epitopes; Female; Humans; Hypersensitivity, Delayed; Immunization; Immunologic Techniques; Immunotherapy; Male; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Receptors, Antigen, T-Cell, alpha-beta; T-Lymphocytes

Immunoreactive material that appears to be a peptide encompassing all or a portion of residues 80 to 89 of myelin basic protein is present in normal unconcentrated urine and is increased in certain patients with multiple sclerosis (MS). Compared with normal controls, urines collected randomly from 158 MS patients or in a clinical research unit from 8 patients with MS had higher mean values of urinary MBP-like material (MBPLM). The level of MBPLM in urine showed no direct relationship to MBPLM in cerebrospinal fluid and did not correlate with clinical relapses of disease. In the other neurological disease control group (26 patients), some patients with other inflammatory diseases, but not stroke or early phase Guillain-Barré syndrome, also showed elevations. Among the subtypes of MS, those with secondary chronic progressive disease had the highest values. Urinary MBPLM showed no definite correlation with or effect of treatment with glucocorticoids and immunosuppressants except that a lower level of urinary MBPLM showed a weak relationship with improvement following treatment with methylprednisolone/prednisone. In a serial study of 8 patients with unenhanced cranial magnetic resonance imaging and 20 patients with gadolinium-enhanced cranial magnetic resonance imaging, urinary MBPLM did not show a direct correlation with new or enhancing lesions. Urinary MBPLM does not parallel acute myelin damage but appears to reflect an ongoing process, possibly linked to attempted efforts at remyelination.

Topics: Adult; Cyclosporine; Double-Blind Method; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Nervous System Diseases; Radioimmunoassay; Reference Values; Sensitivity and Specificity

Six MS-patients were inoculated three times with autologous attenuated MBP-specific T cell clones at two month intervals. No toxic effects were observed. After the third inoculation the precursor frequency of the MBP-specific T cells dropped to undetectable levels in all patients. Injection of attenuated MBP-specific T cells gave rise to a pronounced response of anti-clonotypic T cells and a limited anti-ergotypic response. The anti-clonotypic T cells proliferated in the presence of the vaccine clones and were inhibitory and cytotoxic for the same vaccine clones. This clinical trial shows for the first time that antigen specific T cell vaccination in humans is feasible. The results obtained are highly promising for future treatments of Multiple Sclerosis and other autoimmune diseases.

Topics: Humans; Immunotherapy; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes; Transplantation, Autologous; Vaccination

Multiple sclerosis (MS) is thought to be an autoimmune disease mediated by T lymphocytes that recognize myelin components of the central nervous system. In a 1-year double-blind study, 30 individuals with relapsing-remitting MS received daily capsules of bovine myelin or a control protein to determine the effect of oral tolerization to myelin antigens on the disease. Six of 15 individuals in the myelin-treated group had at least one major exacerbation; 12 or 15 had an attack in the control group. T cells reactive with myelin basic protein were reduced in the myelin-treated group. No toxicity or side effects were noted. Although conclusions about efficacy cannot be drawn from these data, they open an area of investigation for MS and other autoimmune diseases.

Topics: Adult; Antigens, Differentiation, T-Lymphocyte; Autoantigens; Double-Blind Method; Female; Haplotypes; HLA-DR2 Antigen; Humans; Immune Tolerance; Male; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Pilot Projects; T-Lymphocytes

Activated autoreactive T cells are potentially pathogenic and regulated by clonotypic networks. Experimental autoimmune diseases can be treated by inoculation with autoreactive T cells (T cell vaccination). In the present study, patients with multiple sclerosis were inoculated with irradiated myelin basic protein (MBP)-reactive T cells. T cell responses to the inoculates were induced to deplete circulating MBP-reactive T cells in the recipients. Regulatory T cell lines isolated from the recipients inhibited T cells used for vaccination. The cytotoxicity of the CD8+ T cell lines was restricted by major histocompatibility antigens. Thus, clonotypic interactions regulating autoreactive T cells in humans can be induced by T cell vaccination.

Topics: Adult; CD4 Antigens; CD8 Antigens; Cell Line; Epitopes; Female; Humans; Immunotherapy, Adoptive; Lymphocyte Activation; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell, alpha-beta; T-Lymphocytes; Vaccination

Sixteen patients with clinically definite MS admitted to a double blind randomised controlled trial of intrathecal natural beta-IFN were followed for a mean of 22 months including the six month treatment period. Clinical response, evaluated in terms of relapse frequency and of progression rate, showed an increase in relapse rate in treated patients during the six month treatment period and, overall, no benefit in treated versus placebo patients. Serial evaluations were made of cerebrospinal fluid (CSF) cells, IgG, myelin basic protein and CSF and blood T-cell subsets. A rise in CSF IgG Index, MBP and DR+ cells in IFN-treated patients suggested an activation of intrathecal immune response in treated patients.

Topics: Adolescent; Adult; Cerebrospinal Fluid; Disability Evaluation; Double-Blind Method; Female; Humans; Immunoglobulin G; Injections, Spinal; Interferon Type I; Leukocyte Count; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes

Topics: Adrenocorticotropic Hormone; Autoantigens; Autoimmune Diseases; Brain; Cells, Cultured; Humans; Immunity, Cellular; In Vitro Techniques; Lymphocyte Activation; Lymphocytes; Multiple Sclerosis; Myelin Basic Protein; Prednisone

Topics: Adult; Aged; Clinical Trials as Topic; Desensitization, Immunologic; Evaluation Studies as Topic; Female; Freund's Adjuvant; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Nerve Tissue Proteins; Placebos

Topics: Humans; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Remyelination

Topics: Animals; HLA-A Antigens; Humans; Immunodominant Epitopes; Ligands; Mammals; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Peptides; Proteasome Endopeptidase Complex

Multiple sclerosis (MS) is the chronic inflammatory demyelinating disease of the CNS. Relapsing-remitting MS (RRMS) is the most common type of MS. However, the mechanisms of relapse and remission in MS have not been fully understood. While SJL mice immunized with proteolipid protein (PLP) develop relapsing-remitting experimental autoimmune encephalomyelitis (RR-EAE), we have recently observed that some of these mice were resistant to the active induction of relapsing EAE after initial clinical and histological symptoms of EAE with a severity similar to the relapsing EAE mice. To clarify the mechanism of relapsing, we examined myelin morphology during PLP

Topics: Animals; Brain; Chronic Disease; Encephalomyelitis, Autoimmune, Experimental; Inflammation; Mice; Mice, Inbred Strains; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Neoplasm Recurrence, Local; Protein Isoforms; Spinal Cord

Despite accumulating evidence of intrathecal inflammation in patients with primary progressive multiple sclerosis (PPMS), immunomodulatory and suppressive treatment strategies have proven unsuccessful. With this study, we investigated the involvement of CD20. The main outcomes in this observational, case-control study were flow cytometry assessments of blood and CSF CD20. Assessing CD20. This study shows an association between intrathecal CD8

Topics: Case-Control Studies; CD8-Positive T-Lymphocytes; Dimethyl Fumarate; Humans; Multiple Sclerosis; Multiple Sclerosis, Chronic Progressive; Myelin Basic Protein; T-Lymphocytes

The post-translational modification citrullination has been proposed to play a role in the pathogenesis of multiple sclerosis (MS). Myelin basic protein (MBP) is a candidate autoantigen which is citrullinated to a minor extent under physiological conditions and hypercitrullinated in MS. We examined immune cell responses elicited by hypercitrullinated MBP (citMBP) in cultures of mononuclear cells from 18 patients with MS and 42 healthy donors (HDs). The immunodominant peptide of MBP, MBP85-99, containing citrulline in position 99, outcompeted the binding of native MBP85-99 to HLA-DR15, which is strongly linked to MS. Moreover, using the monoclonal antibody MK16 as probe, we observed that B cells and monocytes from HLA-DR15

Topics: Citrullination; Humans; Multiple Sclerosis; Myelin Basic Protein; Th17 Cells; Tumor Necrosis Factor-alpha

Validation of quantitative MR measures for myelin imaging in the postmortem multiple sclerosis spinal cord.. Four fixed spinal cord samples were imaged first with a 3T clinical MR scanner to identify areas of interest for scanning, and then with a 7T small bore scanner using a multicomponent-driven equilibrium single-pulse observation of T. Excellent correspondence was found between high-resolution MR parameter maps and histology, particularly for apparent proton density MRI and myelin basic protein staining.. High-resolution quantitative MRI of the spinal cord provides biologically meaningful measures, and could be beneficial to diagnose and track multiple sclerosis lesions in the spinal cord.

Topics: Humans; Magnetic Resonance Imaging; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Protons; Spinal Cord; Water

Morphea is an autoimmune, sclerosing skin disorder. Despite the recent emphasis on immune dysregulation in morphea, the role of autoantibodies in morphea pathogenesis or utility as biomarkers are poorly defined.. Autoantigen microarray was used to profile autoantibodies from the serum of participants from the Morphea in Adults and Children (MAC) cohort. Clinical and demographic features of morphea patients with myelin basic protein (MBP) autoantibodies were compared to those without. MBP immunohistochemistry staining was subsequently performed in morphea skin to assess for perineural inflammation in areas of staining. Immunofluorescence staining on mouse brain tissue was also performed using patient sera and mouse anti-myelin basic protein antibody to confirm the presence of MBP antibodies in patient sera.. Myelin basic protein autoantibodies were found in greater frequency in morphea (n = 50, 71.4%) compared to systemic sclerosis (n = 2, 6.7%) and healthy controls (n = 7, 20%). Patients with MBP antibodies reported pain at higher frequencies. Morphea skin biopsies, highlighted by immunohistochemistry, demonstrated increased perineural inflammation in areas of MBP expression. Immunofluorescence staining revealed an increased fluorescence signal in myelinated areas of mouse brain tissue (i.e. axons) when incubated with sera from MBP antibody-positive morphea patients compared to sera from MBP antibody-negative morphea patients. Epitope mapping revealed target epitopes for MBP autoantibodies in morphea are distinct from those reported in MS, and included fragments 11-30, 41-60, 51-70, and 91-110.. A molecular classification of morphea based on distinct autoantibody biosignatures may be used to differentially classify morphea. We have identified anti-MBP as a potential antibody associated with morphea due to its increased expression in morphea compared to healthy controls and systemic sclerosis patients.

Topics: Animals; Autoantibodies; Autoantigens; Humans; Mice; Multiple Sclerosis; Myelin Basic Protein; Scleroderma, Localized

This work reports an amperometric bioplatform for the determination of anti-myelin basic protein autoantibodies (anti-MBP), a relevant biomarker for multiple sclerosis (MS) autoimmune disease. The developed configuration involves the use of carboxylated magnetic microparticles (cMBs) where the protein for specific capture of the target autoantibodies was covalently attached. The immobilized anti-MBP were further conjugated with a secondary antibody labelled with horseradish peroxidase (HRP-anti-hIgG) and amperometric transduction was performed by adding hydrogen peroxide and using hydroquinone (HQ) as redox mediator. The cathodic current resulting from the reduction of the corresponding quinone was directly proportional to the logarithmic concentration of the target autoantibodies. The analytical performance of the developed method for the determination of anti-MBP is competitive in terms of sensitivity and range of linearity with that claimed for the only biosensor reported so far in the literature, as well as with commercially available ELISA kits showing a remarkably shorter assay time. The bioplatform was applied to the analysis of serum samples of healthy individuals and patients diagnosed with MS providing results in agreement with the ELISA methodology.

Topics: Autoantibodies; Biosensing Techniques; Electrodes; Enzyme-Linked Immunosorbent Assay; Humans; Multiple Sclerosis; Myelin Basic Protein

The naturally occurring imino acid azetidine-2-carboxylic acid (Aze) is consumed by humans and can be misincorporated in place of proline in myelin basic protein (MBP) in vitro. To determine Aze effects on the mammalian CNS in vivo, adult CD1 mice were given Aze orally or intraperitoneally. Clinical signs reminiscent of MBP-mutant mice occurred with 600 mg/kg Aze exposure. Aze induced oligodendrocyte (OL) nucleomegaly and nucleoplasm clearing, dilated endoplasmic reticulum, cytoplasmic vacuolation, abnormal mitochondria, and Aze dose-dependent apoptosis. Immunohistochemistry demonstrated myelin blistering and nuclear translocation of unfolded protein response (UPR)/proinflammatory molecules (ATF3, ATF4, ATF6, eIF2α, GADD153, NFκB, PERK, XBP1), MHC I expression, and MBP cytoplasmic aggregation in OL. There were scattered microglial nodules in CNS white matter (WM); other CNS cells appeared unaffected. Mice given Aze in utero and postnatally showed more marked effects than their dams. These OL, myelin, and microglial alterations are found in normal-appearing WM (NAWM) in multiple sclerosis (MS) patients. Thus, Aze induces a distinct oligodendrogliopathy in mice that recapitulates MS NAWM pathology without leukocyte infiltration. Because myelin proteins are relatively stable throughout life, we hypothesize that Aze misincorporation in myelin proteins during myelinogenesis in humans results in a progressive UPR that may be a primary process in MS pathogenesis.

Topics: Animals; Azetidinecarboxylic Acid; Humans; Mammals; Mice; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Oligodendroglia; Proline

Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system (CNS). Most exercise studies concentrate on the impact of exercise on cardiovascular system; this study aims to present the effects of exercise of varying intensity on the nervous system. Most recently in MS, positive outcomes were obtained with resistance and high-intensity exercises. This study also analyzes the effects of a prior conditioning program before the induction of demyelination and subsequent neuroprotective effects of such program.. To study and determine the neuroprotective and remyelinating effects of different intensity of aquatic exercise and a preconditioning exercise program on demyelination induced by oral administration of cuprizone (Cup).. Six groups of animals, each containing 6 rats, were used in the study. The groups were as follows: group I - control group; group II - Cup group; group III - treated with methylprednisolone (MP); group IV - treated with low-intensity exercise (LIE), free swimming for 40 min and high-intensity exercise (HIE); group V - treated with a resistance of 9% body weight and free swimming for 40 min; group VI - treated with preconditioning exercise (free swimming for 40 min for 3 weeks) before Cup administration followed by the same exercise protocol as for group V. All data were analyzed using one-way analysis of variance (ANOVA) with Tukey's test, by means of SigmaPlot v. 14.5 software.. Similarly to the MP group, group VI showed a positive outcome. A value of p < 0.001 was considered statistically significant. Also, group VI showed improved areas of remyelination in histopathology, an increased expression of myelin basic protein (MBP), reduced expression of glial fibrillary acidic protein (GFAP) in corpus callosum, and improved gene expression of brain-derived neurotrophic factor (BDNF) in the hippocampus region.. General fitness achieved through a preconditioning program combined with HIE showed neuroprotective effects, as evidenced by increased areas of remyelination and improved neuronal plasticity, observed mostly in group VI (conditioning+HIE).

Topics: Animals; Brain-Derived Neurotrophic Factor; Cuprizone; Demyelinating Diseases; Disease Models, Animal; Glial Fibrillary Acidic Protein; Male; Methylprednisolone; Mice; Mice, Inbred C57BL; Multiple Sclerosis; Myelin Basic Protein; Neuronal Plasticity; Neuroprotective Agents; Rats; Rats, Wistar; Remyelination

The pathogenesis of bipolar affective disorder is associated with immunological imbalances, a general pro-inflammatory status, neuroinflammation, and impaired white matter integrity. Myelin basic protein (MBP) is one of the major proteins in the myelin sheath of brain oligodendrocytes. For the first time, we have shown that IgGs isolated from sera of bipolar patients can effectively hydrolyze human myelin basic protein (MBP), unlike other test proteins. Several stringent criteria were applied to assign the studied activity to serum IgG. The level of MBP-hydrolyzing activity of IgG from patients with bipolar disorder was statistically significantly 1.6-folds higher than that of healthy individuals. This article presents a detailed characterization of the catalytic properties of MBP-hydrolyzing antibodies in bipolar disorder, including the substrate specificity, inhibitory analysis, pH dependence of hydrolysis, and kinetic parameters of IgG-dependent MBP hydrolysis, providing the heterogeneity of polyclonal MBP-hydrolyzing IgGs and their difference from canonical proteases. The ability of serum IgG to hydrolyze MBP in bipolar disorder may become an additional link between the processes of myelin damage and inflammation.

Topics: Antibodies, Catalytic; Bipolar Disorder; Humans; Immunoglobulin G; Multiple Sclerosis; Myelin Basic Protein

Multiple sclerosis (MS) is a chronic neurodegenerative disease marked by oligodendrocyte loss, which results in central neuronal demyelination. AC/cAMP/CREB signaling dysregulation is involved in the progression of MS, including mitochondrial dysfunctions, reduction in nerve growth factors, neuronal inflammation, apoptosis, and white matter degeneration. Our previous research has shown that Forskolin (FSK), a naturally occurring direct adenylyl cyclase (AC)/cAMP/CREB activator, has neuroprotective potential to alleviate pathogenic factors linked with numerous neurological abnormalities. The current study intends to explore the neuroprotective potential of FSK at doses of 40 mg/kg and 60 mg/kg alone, as well as in combination with conventional medicines, such as Fingolimod (FNG), Donepezil (DON), Memantine (MEM), and Simvastatin (SIM) in EB-induced demyelinated experimental MS rats. Adult Wistar rats were divided into nine groups, and EB was infused stereotaxically in the rat brain's intracerebropeduncle (ICP) area. Chronic gliotoxin EB treatment results in demyelination as well as motor and cognitive dysfunctions. FSK, combined with standard medications, improves behavioral dysfunctions, such as neuromuscular and motor deficits and memory and cognitive abnormalities. Following pharmacological treatments improved remyelination by enhancing myelin basic protein and increasing AC, cAMP, and CREB levels in brain homogenates. Furthermore, FSK therapy restored brain mitochondrial-ETC complex enzymes and neurotransmitter levels while decreasing inflammatory cytokines and oxidative stress markers. The Luxol fast blue (LFB) stain results further indicate FSK's neuroprotective potential in preventing oligodendrocyte death. Therefore, the results of these studies contribute to a better understanding of the possible role that natural phytochemicals FSK could have in preventing motor neuron diseases, such as multiple sclerosis.

Topics: Adenylyl Cyclases; Animals; Colforsin; Cytokines; Demyelinating Diseases; Donepezil; Ethidium; Fingolimod Hydrochloride; Gliotoxin; Memantine; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Nerve Growth Factors; Neurodegenerative Diseases; Oligodendroglia; Rats; Rats, Wistar; Simvastatin

To investigate whether antibody production against mycobacterium avium subsp. paratuberculosis (MAP) is related to clinical characteristics of multiple sclerosis (MS) and human leukocyte antigen (HLA) alleles, IgG antibody against three MAP peptides and two human peptides homologous to MAP were measured in sera from 103 MS patients and 50 healthy controls (HCs). MS patients had higher IgG levels against MAP2694

Topics: Adult; Aged; Antibodies, Bacterial; Antibody Specificity; Antigens, Bacterial; Bacterial Proteins; Dairy Products; Diet; Female; Genes, MHC Class II; HLA-DRB1 Chains; Humans; Immunodominant Epitopes; Immunoglobulin G; Interferon Regulatory Factors; Japan; Male; Membrane Proteins; Middle Aged; Molecular Mimicry; Multiple Sclerosis; Mycobacterium avium subsp. paratuberculosis; Myelin Basic Protein; Oligoclonal Bands; Peptide Fragments; Receptors, Antigen, T-Cell, alpha-beta; Sequence Alignment; Sequence Homology, Amino Acid; Severity of Illness Index

Topics: Alleles; Computer Simulation; DNA-Binding Proteins; Epitopes, T-Lymphocyte; HLA-A Antigens; Humans; Multiple Sclerosis; Myelin Basic Protein; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Transcription Factors

Humanized double transgenic mice express both HLA-DR15 (the MHC gene linked to MS) and TCR.Ob1A12 from a multiple sclerosis patient (that recognizes MBP85-99 presented by HLA-DR15), yet they fail to develop autoimmune encephalomyelitis quickly, although 5-10% develop disease at 12 months. These mice were found to express large numbers of IL-10-secreting splenocytes as early as 4 weeks of age. These regulatory T cells appeared spontaneously without prior immunization with the autoantigen MBP85-99. They were of murine origin and had a cytokine secretion profile and surface phenotype similar to that reported for Tr1 cells. Notably, the frequency of disease appeared to increase at 14 months. The diseased mice had small spleens which averaged 47 mg, while the remaining non-diseased mice in our colony killed at ages 14-15 months had splenocytes that averaged 80 mg (ranging from 47-130 mg). Thus, the appearance of disease was associated with diminution in numbers of IL-10-secreting regulatory T cells with age.

Topics: Animals; Cells, Cultured; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; HLA-DR Serological Subtypes; Humans; Interleukin-10; Mice; Mice, Inbred C57BL; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Receptors, Antigen, T-Cell, alpha-beta; Spleen; T-Lymphocytes, Regulatory

Multiple sclerosis (MS) has been considered to specifically affect the central nervous system (CNS) for a long time. As autonomic dysfunction including dysphagia can occur as accompanying phenomena in patients, the enteric nervous system has been attracting increasing attention over the past years. The aim of this study was to identify glial and myelin markers as potential target structures for autoimmune processes in the esophagus. RT-PCR analysis revealed glial fibrillary acidic protein (GFAP), proteolipid protein (PLP), and myelin basic protein (MBP) expression, but an absence of myelin oligodendrocyte glycoprotein (MOG) in the murine esophagus. Selected immunohistochemistry for GFAP, PLP, and MBP including transgenic mice with cell-type specific expression of PLP and GFAP supported these results by detection of (1) GFAP, PLP, and MBP in Schwann cells in skeletal muscle and esophagus; (2) GFAP, PLP, but no MBP in perisynaptic Schwann cells of skeletal and esophageal motor endplates; (3) GFAP and PLP, but no MBP in glial cells surrounding esophageal myenteric neurons; and (4) PLP, but no GFAP and MBP in enteric glial cells forming a network in the esophagus. Our results pave the way for further investigations regarding the involvement of esophageal glial cells in the pathogenesis of dysphagia in MS.

Topics: Animals; Biomarkers; Central Nervous System; Esophagus; Female; Fluorescent Antibody Technique; Gene Expression; Glial Fibrillary Acidic Protein; Immunohistochemistry; Male; Mice; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Neuroglia; RNA, Messenger

The aim: To study the peculiarities of demyelination by detection of changes in the levels of myelin basic protein (MBP) in CSF of patients with acute herpesviral meningitis (M) and meningoencephalitis (ME).. Materials and methods: A total of 136 CSF samples from 68 patients with herpesviral M and ME were collected. The control group consisted of patients with acute respiratory infection and meningismus. MBP level in CSF was identified at the admission and after 10-12 days of treatment. Analysis of MBP concentrations in CSF was performed using an enzyme immunoassay.. Results: Examination of patients on the first day of hospitalization showed the presence of a significant increase of MBP in the CSF in all patients with viral M/ME compared with the indicators of the comparison group (р<0.01). In all groups of patients with ME, the level of MBP in CSF was significantly higher than the indicators of comparison group and M groups of the suitable etiology of the disease (p<0.01). In patients with lethal outcome, the MBP level was significantly higher (p<0.01) than in all meningitis groups, but we did not find a significant difference with the patients with ME (p>0.05).. Conclusions: The increase of MBP level identified in patients with acute M/ME confirms the presence of the demyelinating process that occurs in all patients, but it is more pronounced in patients with ME.

Topics: Humans; Meningoencephalitis; Multiple Sclerosis; Myelin Basic Protein

Multiple sclerosis (MS) is a neuroinflammatory and neurodegenerative disease characterized by myelin damage followed by axonal and ultimately neuronal loss. The etiology and physiopathology of MS are still elusive, and no fully effective therapy is yet available. We investigated the role in MS of autophagy (physiologically, a controlled intracellular pathway regulating the degradation of cellular components) and of mitophagy (a specific form of autophagy that removes dysfunctional mitochondria). We found that the levels of autophagy and mitophagy markers are significantly increased in the biofluids of MS patients during the active phase of the disease, indicating activation of these processes. In keeping with this idea, in vitro and in vivo MS models (induced by proinflammatory cytokines, lysolecithin, and cuprizone) are associated with strongly impaired mitochondrial activity, inducing a lactic acid metabolism and prompting an increase in the autophagic flux and in mitophagy. Multiple structurally and mechanistically unrelated inhibitors of autophagy improved myelin production and normalized axonal myelination, and two such inhibitors, the widely used antipsychotic drugs haloperidol and clozapine, also significantly improved cuprizone-induced motor impairment. These data suggest that autophagy has a causal role in MS; its inhibition strongly attenuates behavioral signs in an experimental model of the disease. Therefore, haloperidol and clozapine may represent additional therapeutic tools against MS.

Topics: Animals; Antipsychotic Agents; Autophagy; Autophagy-Related Proteins; Axons; Biomarkers; Clozapine; Cytokines; Demyelinating Diseases; Disease Models, Animal; Glucose; Haloperidol; Inflammation; Interleukin-1beta; Mitochondria; Mitophagy; Models, Biological; Motor Activity; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Stress, Physiological; Tumor Necrosis Factor-alpha

Incomplete remyelination is frequent in multiple sclerosis (MS)-lesions, but there is no established marker for recent remyelination. We investigated the role of the oligodendrocyte/myelin protein ermin in de- and remyelination in the cuprizone (CPZ) mouse model, and in MS. The density of ermin+ oligodendrocytes in the brain was significantly decreased after one week of CPZ exposure (p < 0.02). The relative proportion of ermin+ cells compared to cells positive for the late-stage oligodendrocyte marker Nogo-A increased at the onset of remyelination in the corpus callosum (p < 0.02). The density of ermin-positive cells increased in the corpus callosum during the CPZ-phase of extensive remyelination (p < 0.0001). In MS, the density of ermin+ cells was higher in remyelinated lesion areas compared to non-remyelinated areas both in white- (p < 0.0001) and grey matter (p < 0.0001) and compared to normal-appearing white matter (p < 0.001). Ermin immunopositive cells in MS-lesions were not immunopositive for the early-stage oligodendrocyte markers O4 and O1, but a subpopulation was immunopositive for Nogo-A. The data suggest a relatively higher proportion of ermin immunopositivity in oligodendrocytes compared to Nogo-A indicates recent or ongoing remyelination.

Topics: Animals; Brain; Cerebral Cortex; Corpus Callosum; Cuprizone; Demyelinating Diseases; Disease Models, Animal; Female; Gray Matter; Mice; Mice, Inbred C57BL; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Sheath; Oligodendroglia; Remyelination; White Matter

Histones play a key role in chromatin remodeling and gene transcription. Further, free histones in the blood act as damage-associated molecules. Administration of histones to animals results in systemic inflammatory and toxic effects. Myelin basic protein is the principal constituent element of the myelin-proteolipid sheath of axons. Abzymes (antibodies with catalytic activities) are the original features of some autoimmune diseases. In this study, electrophoretically homogeneous IgGs against H1, H2A, H2B, H3, and H4 histones and myelin basic protein (MBP) were isolated from the blood sera of multiple sclerosis (MS) patients by several affinity chromatographies. Using MALDI mass spectrometry, the sites of H1 histone cleavage by IgGs against H1, H2A, H2B, H3, H4, and MBP were determined. It was shown that IgGs against H1 split H1 at 12 sites, while the number of cleavage sites by abzymes against other histones was lower: H2A (9), H2B (7), H3 (3), and H4 (3). The minimum rate of H1 hydrolysis was observed for antibodies against H3 and H4. A high rate of hydrolysis and the maximum number of H1 hydrolysis sites (17) were found for antibodies against MBP. Only a few sites of H1 hydrolysis by anti-H1 antibodies coincided with those for IgGs against H2A, H2B, H3, H4, and MBP. Thus, the polyreactivity of complexation and the enzymatic cross-activity of antibodies against H1, four other histones, and MBP have first been shown. Since histones act as damage molecules, abzymes against histones and MBP can play a negative role in the pathogenesis of MS and probably other different diseases as well.

Topics: Amino Acid Sequence; Antibodies, Catalytic; Autoantibodies; Binding Sites; Chromatography, Affinity; Histones; Humans; Hydrolysis; Immunoglobulin G; Multiple Sclerosis; Myelin Basic Protein; Protein Binding; Protein Isoforms; Proteolysis; Substrate Specificity

Multiple sclerosis (MS) is a chronic autoimmune demyelinating disease in the central nervous system. The myelin loss is mainly caused by dysfunction of oligodendrocytes and inflammatory responses of microglia and astrocytes further aggravate the demyelination. Current therapies for MS focus on suppressing the overactivated immune response but cannot halt the disease progress, so effective drugs are urgently needed. Compound 21 is a phloroglucinol derivative that has been proved to have an outstanding anti-inflammatory effect. The purpose of the present study is to investigate whether this novel compound is effective in MS. The cuprizone-induced model was used in this study to mimic the pathological progress of MS. The results showed that Compound 21 significantly improved the neurological dysfunction and motor coordination impairment. Luxol Fast Blue staining and myelin basic protein immunostaining demonstrated that Compound 21 remarkably promoted remyelination. In addition, Compound 21 significantly promoted oligodendrocytes differentiation. Furthermore, we found that Compound 21 decreased microglia and astrocytes activities and the subsequent neuroinflammatory response, indicating that the anti-inflammatory effect of Compound 21 was also involved in its neuro-protection. All the data prove that Compound 21 exerts protective effect on MS through promoting remyelination and suppressing neuroinflammation, indicating that Compound 21 might be a potential drug candidate for MS treatment.

Topics: Animals; Astrocytes; Brain; Cuprizone; Cytokines; Disease Models, Animal; Drug Discovery; Inflammation; Male; Mice; Mice, Inbred C57BL; Microglia; Multiple Sclerosis; Myelin Basic Protein; Oligodendroglia; Phloroglucinol; Remyelination; Treatment Outcome

The aetiology of multiple sclerosis (MS) is as yet poorly understood. Multiple mechanisms in different disease stages are responsible for immunopathology in MS. HLA Class II DR2b (DRB1*1501 β, DRA1*0101 α) is the strongest genetic risk factor for MS. Remnants of ancient retroviruses in the human genome, termed human endogenous retroviruses (HERV), and Epstein-Barr virus (EBV) infection are also associated with MS. In silico analyses of human endogenous retroviral envelope (HERV env) proteins and three myelin proteins that are principal targets of an autoimmune response in MS showed sequence similarities between potential T

Topics: Amino Acid Sequence; beta-Synuclein; Endogenous Retroviruses; Epitopes; Gene Products, env; Herpesvirus 4, Human; HLA-DR beta-Chains; Humans; Models, Molecular; Molecular Mimicry; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Myelin-Oligodendrocyte Glycoprotein; Protein Binding; Risk Factors; T-Lymphocytes

Our national reference laboratory sought to improve stewardship for multiple sclerosis (MS) testing, which included orders for myelin basic protein (MBP) and oligoclonal bands (OCB). From 2011 to 2012, we performed 2 interventions for MS testing: one gentle-strength intervention of a publication designed to educate others about the lack of utility for MBP results and a second medium-strength intervention that included removal of MBP from the panel of MS tests. The ordering trends and practice variation were examined for OCB and MBP to retrospectively observe the effect of the interventions.. Data from clients within academic and community hospitals were examined (n = 1710 clients). Ordering patterns for OCB and MBP were investigated from 2008 to 2018 by calculating the %OCB: %OCB = (OCB)/(OCB + MBP). Practice variation was examined by comparing the distribution of clients with different %OCB statistics before and after the interventions in 5-year blocks (2008-2012 vs 2014-2018).. From 2000 to 2011, the %OCB was approximately 50%, but gradually increased to 67% in 2018. For practice variation, analysis of the distribution of clients by %OCB also demonstrated a shift toward clients favoring OCB alone vs OCB + MBP for MS testing for the later time period of 2014-2018.. Our 2 interventions had a measurable, beneficial effect on ordering trends for MS testing over a 10-year period at a single reference laboratory. However, given that MBP has questionable clinical utility, stronger interventions are likely needed to bring about larger changes in ordering behavior.

Topics: Diagnostic Tests, Routine; Humans; Multiple Sclerosis; Myelin Basic Protein; Oligoclonal Bands; Practice Patterns, Physicians'; Procedures and Techniques Utilization; Quality Assurance, Health Care; Reproducibility of Results; United States

Multiple Sclerosis (MS) is a chronic inflammatory disorder in the central nervous system for which biomarkers for diagnosis still remain unknown. One potential biomarker is the myelin basic protein. Here, a nanoimmunosensor based on atomic force spectroscopy (AFS) successfully detected autoantibodies against the MBP

Topics: Autoantibodies; Biomarkers; Biosensing Techniques; Early Diagnosis; Female; Humans; Male; Microscopy, Atomic Force; Molecular Dynamics Simulation; Multiple Sclerosis; Multiple Sclerosis, Relapsing-Remitting; Myelin Basic Protein; Peptide Fragments; Sensitivity and Specificity

Adipose-derived stem cells (ASCs) have neuroprotective effects, and their repair ability has been approved in neurodegenerative studies. Pregnenolone as a neurosteroid plays significant roles in neurogenesis. We aimed to consider the effect of ADSCs and pregnenolone injection on the multiple sclerosis (MS) model created by cuprizone. Male Wistar rats (n = 36) were fed with an ordinary diet or a diet with cuprizone (0.6%) for 3 weeks. H-ADSCs were taken from patients with lipoaspirate surgery. The rats were divided into six groups (n = 6): healthy, MS, sham, pregnenolone injection, ADSCs injection, pregnenolone and ADSCs injection. Behavioral test, histological examination and TEM were conducted. The specific markers for myelin and cell differentiation were assessed using immunohistochemistry staining. Additionally, the measure of MBP and MOG gene expression and the amount of related proteins were determined using real-time RT-PCR and ELISA techniques, respectively. Histologic results showed that induced demyelination in corpus callosum fibers. TEM revealed an increased thickness of myelin in fibers in the treated groups (P < 0.05). Injection of hADSC and pregnenolone significantly increased the expression levels of MBP and MOG (P < 0.001). The mean percentage of MOG and MBP markers were significantly increased in the treated groups compared to MS and sham groups (P < 0.05). Moreover, the OD level of MBP and MOG proteins showed that their values in the ADSCs/pregnenolone group were close to those of the control group without a significant difference. Our data indicated the remyelination potency and cell differentiation can improve with ADSCs and pregnenolone treatments in the multiple sclerosis model which created by cuprizone in rats.

Topics: Adipose Tissue; Animals; Cell Differentiation; Cells, Cultured; Corpus Callosum; Cuprizone; Humans; Male; Mesenchymal Stem Cell Transplantation; Mesenchymal Stem Cells; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Myelin-Oligodendrocyte Glycoprotein; Pregnenolone; Rats; Rats, Wistar

It was recently shown that IgGs from sera of multiple sclerosis (MS) patients are active in the hydrolysis of DNA and myelin basic protein (MBP). We first analyzed the relative concentration of antibodies against five histones (H1, H2a, H2b, H3, and H4) in the cerebrospinal fluid (CSF) and serum of patients with MS. The relative concentrations of blood and CSF IgGs against histones and their activity in the hydrolysis of five histones varied greatly from patient to patient. However, all 28 IgG preparations were hydrolyzed from one to five histones. Relative activities and correlation coefficients among the activities of IgGs from serum and CSF in the hydrolysis of five histones (H1, H2a, H2b, H3, and H4), DNA, and MBP were calculated. It was shown that auto-IgGs from CSF and sera of MS patients are extremely heterogeneous in their affinity to histones, MBP, and DNA. The heterogeneity of IgG-abzymes hydrolyzing DNA, MBP, and histones from CSF and sera was also demonstrated using their isoelectrofocusing. The isofocusing profiles DNase, MBP-, and histone-hydrolyzing activities of IgGs may be very different for various individuals, but the total IgG subfractions with all their activities are distributed from pH 3 to 10.

Topics: Chromatography, Affinity; DNA; Histones; Humans; Hydrolysis; Immunoglobulin G; Multiple Sclerosis; Myelin Basic Protein

B cell-depleting therapies have recently proven to be clinically highly successful in the treatment of multiple sclerosis (MS). This study aimed to determine the effects of the novel type II anti-human CD20 (huCD20) monoclonal antibody (mAb) obinutuzumab (OBZ) on spinal cord degeneration in a B cell-dependent mouse model of MS. Double transgenic huCD20xHIGR3 (CD20dbtg) mice, which express human CD20, were immunised with the myelin fusion protein MP4 to induce experimental autoimmune encephalomyelitis (EAE). Both light and electron microscopy were used to assess myelination and axonal pathology in mice treated with OBZ during chronic EAE. Furthermore, the effects of the already established murine anti-CD20 antibody 18B12 were assessed in C57BL/6 wild-type (wt) mice. In both models (18B12/wt and OBZ/CD20dbtg) anti-CD20 treatment significantly diminished the extent of spinal cord pathology. While 18B12 treatment mainly reduced the extent of axonal pathology, a significant decrease in demyelination and increase in remyelination were additionally observed in OBZ-treated mice. Hence, the data suggest that OBZ could have neuroprotective effects on the CNS, setting the drug apart from the currently available type I anti-CD20 antibodies.

Topics: Animals; Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Antigens, CD20; Antineoplastic Agents, Immunological; Axons; B-Lymphocytes; Chronic Disease; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Mice; Mice, Inbred C57BL; Mice, Transgenic; Microscopy, Electron; Multiple Sclerosis; Multiple Sclerosis, Chronic Progressive; Myelin Basic Protein; Myelin Proteolipid Protein; Neurofilament Proteins; Recombinant Fusion Proteins; Spinal Cord

Myelin basic protein (MBP) and its interaction with lipids of the myelin sheath plays an important part in the pathology of multiple sclerosis (MS). Previous studies observed that changes in the myelin lipid composition lead to instabilities and enhanced local curvature of MBP-lipid multilayer structures. We investigated the molecular origin of the instability and found that the diseased lipid membrane has a 25% lower bending rigidity, thus destabilizing smooth [Formula: see text]µm curvature radius structures such as in giant unilamellar vesicles. MBP-mediated assembling of lipid bilayers proceeds in two steps, with a slow second step occurring over many days where native lipid membranes assemble into well-defined multilayer structures, whereas diseased lipid membranes form folded assemblies with high local curvature. For both native and diseased lipid mixtures we find that MBP forms dense liquid phases on top of the lipid membranes mediating attractive membrane interactions. Furthermore, we observe MBP to insert into its bilayer leaflet side in case of the diseased lipid mixture, whereas there is no insertion for the native mixture. Insertion increases the local membrane curvature, and could be caused by a decrease of the sphingomyelin content of the diseased lipid mixture. These findings can help to open a pathway to remyelination strategies.

Topics: Animals; Cell Membrane; Lipid Bilayers; Liposomes; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Sheep; Swine

The expansion of polyclonal T regulatory cells (Tregs) offers great promise for the treatment of immune-mediated diseases, such as multiple sclerosis (MS). However, polyclonal Tregs can be non-specifically immunosuppressive. Based on the advancements with chimeric antigen receptor (CAR) therapy in leukemia, we previously engineered Tregs to express a T-cell receptor (TCR) specific for a myelin basic protein (MBP) peptide. These TCR-engineered specific Tregs suppressed the proliferation of MBP-reactive T effector cells and ameliorated myelin oligodendrocyte glycoprotein (MOG)-induced experimental autoimmune encephalomyelitis (EAE). Herein, we extend this approach by creating human regulatory T cells expressing functional single-chain chimeric antigen receptors (scFv CAR), targeting either MBP or MOG. These scFv CAR-transduced Tregs retained FoxP3 and Helios, characteristic of Treg cells, after long-term expansion in vitro. Importantly, these engineered CNS targeting CAR-Tregs were able to suppress autoimmune pathology in EAE, demonstrating that these Tregs have the potential to be used as a cellular therapy for MS patients.

Topics: Animals; Encephalomyelitis, Autoimmune, Experimental; Female; Forkhead Transcription Factors; Humans; Immune Tolerance; Immunotherapy, Adoptive; Mice; Mice, Inbred C57BL; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Myelin-Oligodendrocyte Glycoprotein; Protein Engineering; Receptors, Antigen, T-Cell; Receptors, Chimeric Antigen; T-Lymphocytes, Regulatory

This article is about my amazing immunological journey for more than a decade with Eli Sercarz as an achaarya, which in Sanskrit means enlightened mentor. My training and routine interactions with colleagues not only at Eli's laboratory but at University of California at Los Angeles, La Jolla Institute for Immunology, Torrey Pines Institute for Molecular Studies, and University of California, San Diego School of Medicine were instrumental in my continued quest to understand how activation of autoimmune inflammatory cells results in pathology and how inflammatory responses are controlled to keep us healthy. I briefly outline different aspects of immune principles related to the immune response to a self-antigen myelin basic protein (MBP) that induces experimental autoimmune encephalomyelitis, a prototype for multiple sclerosis, and how a coordinated interactive network of regulatory T cells (Tregs) CD4+ (CD4 Tregs) and CD8+ (CD8 Tregs) control the anti-MBP response to maintain immune homeostasis. Eli was my mentor, collaborator, and friend, an incredible human being, and dear member of our extended family. This article is written in his memory with unconditional gratitude.

Topics: Allergy and Immunology; Animals; Autoantigens; Cell Communication; Encephalomyelitis, Autoimmune, Experimental; History, 20th Century; History, 21st Century; Humans; Lymphocyte Activation; Mentoring; Mice; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes, Cytotoxic; T-Lymphocytes, Regulatory

Human mutations in carnitine palmitoyl transferase 1A (CPT1A) are correlated with a remarkably low prevalence of multiple sclerosis (MS) in Inuits (P479L) and Hutterites (G710E). To elucidate the role of CPT1A, we established a Cpt1a P479L mouse strain and evaluated its sensitivity to experimental autoimmune encephalomyelitis (EAE) induction. Since CPT1a is a key molecule in lipid metabolism, we compared the effects of a high-fat diet (HFD) and normal diet (ND) on disease progression. The disease severity increased significantly in WT mice compared to that in Cpt1 P479L mice. In addition, WT mice receiving HFD showed markedly exacerbated disease course when compared either with Cpt1a P479L mice receiving HFD or WT control group receiving ND. Induction of EAE caused a significant decrease of myelin basic protein expression in the hindbrain of disease affected WT mice in comparison to Cpt1a P479L mice. Further, WT mice showed increased expression of oxidative stress markers like Nox2 and Ho-1, whereas expression of mitochondrial antioxidants regulator Pgc1α was increased in Cpt1a P479L mice. Our results suggest that, lipids metabolism play an important role in EAE, as shown by the higher severity of disease progression in both WT EAE and WT EAF HFD-fed mice in contrast to their counterpart Cpt1a P479L mutant mice. Interestingly, mice with downregulated lipid metabolism due to the Cpt1a P479L mutation showed resistance to EAE induction. These findings support a key role for CPT1A in the development of EAE and could be a promising target in MS treatment.

Topics: Animals; Carnitine O-Palmitoyltransferase; Diet, High-Fat; Encephalomyelitis, Autoimmune, Experimental; Female; Genetic Predisposition to Disease; Heme Oxygenase-1; Humans; Lipid Metabolism; Membrane Proteins; Mice; Mice, Inbred C57BL; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; NADPH Oxidase 2; Oxidative Stress; Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha; Rhombencephalon

Binding of small molecules in the human leukocyte antigen (HLA) peptide-binding groove may result in conformational changes of bound peptide and an altered immune response, but previous studies have not considered a potential role for endogenous metabolites. We performed virtual screening of the complete Human Metabolite Database (HMDB) for docking to the multiple sclerosis (MS) susceptible DRB1*15:01 allele and compared the results to the closely related yet non-susceptible DRB1*15:03 allele; and assessed the potential impact on binding of human myelin basic peptide (MBP). We observed higher energy scores for metabolite binding to DRB1*15:01 than DRB1*15:03. Structural comparison of docked metabolites with DRB1*15:01 and DRB1*15:03 complexed with MBP revealed that Phenylalanine

Topics: Alleles; Binding Sites; HLA-DRB1 Chains; Humans; Molecular Docking Simulation; Multiple Sclerosis; Myelin Basic Protein; Protein Binding

Several different theories of schizophrenia (SCZ) were discussed; the causes of this disease are not yet clear. Using ELISA, it was shown that titers of autoantibodies against myelin basic protein (MBP) in SCZ patients are ~1.8-fold higher than in healthy individuals but 5.0-fold lower than in patients with multiple sclerosis. Several rigid criteria were checked to show that the MBP-hydrolyzing activity is an intrinsic property of SCZ IgGs. Approximately 82% electrophoretically homogeneous SCZ IgGs purified using several affinity sorbents including Sepharose with immobilized MBP hydrolyze specifically only MBP but not many other tested proteins. The average relative activity of IgGs from patients with negative symptoms was 2.5-fold higher than that of patients with positive symptoms of SCZ, and it increases with the duration of this pathology. It was shown that abzymes are the earliest statistically significant markers of many autoimmune pathologies. Our findings surmise that the immune systems of individual SCZ patients can generate a variety of anti-MBP abzymes with different catalytic properties, which can attack MBP of the myelin-proteolipid shell of axons. Therefore, autoimmune processes together with other mechanisms can play an important role in SCZ pathogenesis. MBP-hydrolyzing antibodies were previously detected in the blood of 80% to 90% of patients with systemic lupus erythematosus (SLE) and multiple sclerosis (MS). In addition, some similar neuropsychiatric indicators of disease common to SLE, MS, and SCZ were described in the literature. Thus, the destruction of the myelin sheath and the production of MBP-hydrolyzing antibodies can be a common phenomenon for some different diseases.

Topics: Autoimmunity; Humans; Immunoglobulin G; Lupus Erythematosus, Systemic; Multiple Sclerosis; Myelin Basic Protein; Schizophrenia

T cell adaptation is an important peripheral tolerogenic process which ensures that the T cell population can respond effectively to pathogens but remains tolerant to self-antigens. We probed the mechanisms of T cell adaptation using an experimental autoimmune encephalomyelitis (EAE) model in which the fate of autopathogenic T cells could be followed. We demonstrated that immunisation with a high dose of myelin basic protein (MBP) peptide and complete Freund's adjuvant failed to effectively initiate EAE, in contrast to low dose MBP peptide immunisation which readily induced disease. The proportion of autopathogenic CD4

Topics: Adaptive Immunity; Animals; Autoantigens; Cells, Cultured; Central Nervous System; Clonal Anergy; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Humans; Immune Tolerance; Mice; Mice, Inbred C57BL; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Programmed Cell Death 1 Receptor; T-Lymphocytes; Up-Regulation

We describe a Luminex-coupled EliFACS assay that integrates multiplexing technology, enzyme-linked immunospot (ELISPOT), and intracellular cytokine FACS staining for the detection of multiple parameters of antigen-specific T-cell activation in human peripheral blood. Although our protocol is for measuring T-cell responses against cardiac myosin heavy chain and myelin basic protein, the major autoantigens in myocarditis and multiple sclerosis, respectively, these methods could be used for the detection of T-cell responses to other antigens, including foreign antigens.

Topics: Antigens; Autoantigens; Enzyme-Linked Immunospot Assay; Humans; Multiple Sclerosis; Myelin Basic Protein; Myocarditis; Myosin Heavy Chains; T-Lymphocytes

Multiple sclerosis (MS) is the first cause of acquired disability progression in the young adult. Pathology of MS associates inflammation, demyelination, and neurodegeneration. The development of immunotherapies, by reducing the relapse rate, has profoundly impacted short-term prognosis and patients' quality of life. These anti-inflammatory medications, however, have not proven to be sufficient to prevent long-term disability progression, resulting from axonal transection and neuronal damage, consequences of prolonged demyelination. Promoting remyelination is therefore a key therapeutic strategy to limit handicap progression, and represent the major therapeutic challenge in MS. Here we present a simple, rapid, and cost-effective experimental model developed in Xenopus laevis to screen in vivo molecules promoting remyelination.

Topics: Animals; Animals, Genetically Modified; Disease Models, Animal; Disease Progression; Drug Evaluation, Preclinical; Female; Male; Metronidazole; Multiple Sclerosis; Myelin Basic Protein; Nitroreductases; Promoter Regions, Genetic; Remyelination; Small Molecule Libraries; Xenopus laevis

Bioluminescent solid-phase sandwich-type microassay was developed to detect multiple sclerosis (MS)-associated autoantibodies in human sera. The assay is based on two different 2'-F-Py RNA aptamers against the target autoantibodies as biospecific elements, and Ca

Topics: Aptamers, Nucleotide; Autoantibodies; Enzyme-Linked Immunosorbent Assay; Humans; Luminescent Measurements; Multiple Sclerosis; Myelin Basic Protein; ROC Curve

Immune responses to citrullinated peptides have been described in autoimmune diseases like rheumatoid arthritis (RA) and multiple sclerosis (MS). We investigated the post-translational modification (PTM), arginine to citrulline, in brain tissue of MS patients and controls (C) by proteomics and subsequently the cellular immune response of cerebrospinal fluid (CSF)-infiltrating T cells to citrullinated and unmodified peptides of myelin basic protein (MBP). Using specifically adapted tissue extraction- and combined data interpretation protocols we could establish a map of citrullinated proteins by identifying more than 80 proteins with two or more citrullinated peptides in human brain tissue. We report many of them for the first time. For the already described citrullinated proteins MBP, GFAP, and vimentin, we could identify additional citrullinated sites. The number of modified proteins in MS white matter was higher than control tissue. Citrullinated peptides are considered neoepitopes that may trigger autoreactivity. We used newly identified epitopes and previously reported immunodominant myelin peptides in their citrullinated and non-citrullinated form to address the recognition of CSF-infiltrating CD4

Topics: Adolescent; Adult; Brain; Cerebrospinal Fluid; Citrullination; Female; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Peptides; T-Lymphocytes; Young Adult

Multiple sclerosis (MS) is a progressive demyelinating disease of the central nervous system that destroys oligodendrocytes. This work aims to evaluate the treatment of experimentally induced MS in dogs using laser activated non-expanded adipose derived stem cells. The results showed amelioration of the clinical signs over time confirmed by the resolution of the previous lesions on MRI. Positive migration of the injected cells to the site of lesion, increased remyelination detected by Myelin Basic Proteins, positive differentiation into Olig2 positive oligodendrocytes, prevented the glial scar formation and restored axonal architecture. The study concluded that treatment using laser activated stem cells holds a promising therapeutic option for treatment of MS in a canine model.

Topics: Adipocytes; Adipose Tissue; Animals; Cell Differentiation; Disease Models, Animal; Dogs; Immunohistochemistry; Lasers; Magnetic Resonance Imaging; Mesenchymal Stem Cells; Multiple Sclerosis; Myelin Basic Protein; Oligodendrocyte Transcription Factor 2; Oligodendroglia; Random Allocation; Spinal Cord

Genetic analysis of thousands of patients with multiple sclerosis (MS) and healthy Russian donors showed that the carriage of groups of HLA-DRB1*15 and HLA-DRB1*03 alleles is associated with the risk of MS, whereas the carriage of groups of HLA-DRB1*01 and HLA-DRB1*11 alleles is protective. Recombinant HLA-DRB1*01:01 with a high affinity can recognize the fragments of myelin basic protein (MBP), one of the autoantigens in MS. However, the comparison of the kinetic parameters of the load of MBP and viral HA peptides on HLA-DRB1*01:01, which is catalyzed by HLA-DM, showed a significantly lower rate of exchange of CLIP for MBP peptides. We assume that the observed protective properties of the group of HLA-DRB1*01 alleles may be directly associated with the ability of HLA-DRB1*01:01 to kinetically distinguish peptides of exogenous and endogenous nature.

Topics: Autoantigens; Female; HLA-DRB1 Chains; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Peptides

Previous data showed that myelin-reactive autoantibodies found in patients with multiple sclerosis and mice with experimental autoimmune encephalomyelitis recognize and hydrolyze various fragments of myelin basic protein (MBP). Moreover, antibody-mediated cleavage of the encephalithogenic fragment MBP

Topics: Adult; Aged; Autoantibodies; Biomarkers; Carbocyanines; Diagnosis, Differential; Energy Transfer; Female; Fluorescent Dyes; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Young Adult

Topics: Animals; Autoantibodies; Cognitive Dysfunction; Female; Humans; Immunoglobulin A; Immunotherapy; Mice; Mice, Knockout; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin-Oligodendrocyte Glycoprotein; Rats

Myelin abnormalities, oligodendrocyte damage, and concomitant glia activation are common in demyelinating diseases of the central nervous system (CNS). Increasing evidence has demonstrated that the inflammatory response triggers demyelination and gliosis in demyelinating disorders. Numerous clinical interventions, including those used to treat multiple sclerosis (MS), have confirmed prednisone (PDN) as a powerful anti-inflammatory drug that reduces the inflammatory response and promotes tissue repair in multiple inflammation sites. However, the underlying mechanism of PDN in ameliorating myelin damage is not well understood. In our study, a cuprizone (CPZ)-induced demyelinated mouse model was used to explore the mechanism of the protection provided by PDN. Open-field tests showed that CPZ-treated mice exhibited significantly increased anxiety and decreased exploration. However, PDN improved emotional behavior, as evidenced by an increase in the total distance traveled, and central distance traveled as well as the mean amount of time spent in the central area. CPZ-induced demyelination was observed to be alleviated in PDN-treated mice based on luxol fast blue (LFB) staining and myelin basic protein (MBP) expression analyses. In addition, PDN reduced astrocyte and microglia activation in the corpus callosum. Furthermore, we demonstrated that PDN inhibited the Nod-like receptor pyrin domain containing 3 (NLRP3) inflammasome signaling pathway and related inflammatory cytokines and chemokines, including TNF-α, CCL8, CXCL10 and CXCL16. PDN also reduced the serum corticosterone levels in the CPZ-treated mice. Taken together, these results suggest that inhibition of the NLRP3 signaling pathway may be a novel mechanism by which PDN exerts its protective actions in demyelinating diseases.

Topics: Animals; Astrocytes; Corpus Callosum; Cuprizone; Cytokines; Demyelinating Diseases; Disease Models, Animal; Inflammasomes; Male; Mice; Mice, Inbred C57BL; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; NLR Family, Pyrin Domain-Containing 3 Protein; Oligodendroglia; Prednisone; Signal Transduction

Citrullination of arginine residues is a post-translational modification (PTM) found on myelin basic protein (MBP), which neutralizes MBPs positive charge, and is implicated in myelin damage and multiple sclerosis (MS). Here we identify lysine acetylation as another neutralizing PTM to MBP that may be involved in myelin damage. We quantify changes in lysine and arginine PTMs on MBP derived from mice induced with an experimental autoimmune encephalomyelitis (EAE) model of MS using liquid chromatography tandem mass spectrometry. The changes in PTMs are correlated to changes in neurological disability scoring (NDS), as a marker of myelin damage. We found that lysine acetylation increased by 2-fold on MBP during peak NDS post-EAE induction. We also found that mono- and dimethyl-lysine, as well as asymmetric dimethyl-arginine residues on MBP were elevated at peak EAE disability. These findings suggest that the acetylation and methylation of lysine on MBP are PTMs associated with the neurological disability produced by EAE. Since histone deacetylase (HDAC) inhibitors have been previously shown to improve neurological disability, we also show that treatment with trichostatin A (a HDAC inhibitor) improves the NDS of EAE mice but does not change MBP acetylation.

Topics: Acetylation; Animals; Encephalomyelitis, Autoimmune, Experimental; Histone Deacetylase Inhibitors; Hydroxamic Acids; Lysine; Methylation; Mice; Multiple Sclerosis; Myelin Basic Protein; Nervous System Diseases; Protein Processing, Post-Translational

Scarce access to primary samples and lack of efficient protocols to generate oligodendrocytes (OLs) from human pluripotent stem cells (hPSCs) are hampering our understanding of OL biology and the development of novel therapies. Here, we demonstrate that overexpression of the transcription factor SOX10 is sufficient to generate surface antigen O4-positive (O4

Topics: Amyotrophic Lateral Sclerosis; Antigens, Surface; Cell Differentiation; Gene Expression Regulation, Developmental; Humans; Multiple Sclerosis; Myelin Basic Protein; Neurons; Oligodendroglia; Pluripotent Stem Cells; SOXE Transcription Factors; Transcriptome

Sciatic nerve chronic constriction injury (CCI) in rodents produces nerve demyelination via proteolysis of myelin basic protein (MBP), the major component of myelin sheath. Proteolysis releases the cryptic MBP epitope, a demyelination marker, which is hidden in the native MBP fold. It has never been established if the proteolytic release of this cryptic MBP autoantigen stimulates the post-injury increase in the respective circulating autoantibodies. To measure these autoantibodies, we developed the ELISA that employed the cryptic 84-104 MBP sequence (MBP84-104) as bait. This allowed us, for the first time, to quantify the circulating anti-MBP84-104 autoantibodies in rat serum post-CCI. The circulating IgM (but not IgG) autoantibodies were detectable as soon as day 7 post-CCI. The IgM autoantibody level continually increased between days 7 and 28 post-injury. Using the rat serum samples, we established that the ELISA intra-assay (precision) and inter-assay (repeatability) variability parameters were 2.87% and 4.58%, respectively. We also demonstrated the ELISA specificity by recording the autoantibodies to the liberated MBP84-104 epitope alone, but not to intact MBP in which the 84-104 region is hidden. Because the 84-104 sequence is conserved among mammals, we tested if the ELISA was applicable to detect demyelination and quantify the respective autoantibodies in humans. Our limited pilot study that involved 16 female multiple sclerosis and fibromyalgia syndrome patients demonstrated that the ELISA was efficient in measuring both the circulating IgG- and IgM-type autoantibodies in patients exhibiting demyelination. We believe that the ELISA measurements of the circulating autoantibodies against the pathogenic MBP84-104 peptide may facilitate the identification of demyelination in both experimental and clinical settings. In clinic, these measurements may assist neurologists to recognize patients with painful neuropathy and demyelinating diseases, and as a result, to personalize their treatment regimens.

Topics: Animals; Autoantibodies; Autoantigens; Biomarkers; Demyelinating Diseases; Disease Models, Animal; Enzyme-Linked Immunosorbent Assay; Epitopes; Female; Humans; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Polyradiculoneuropathy; Rats; Rats, Sprague-Dawley; Sciatic Nerve; Sensitivity and Specificity

Cuprizone (CZ) is a widely used copper chelating agent to develop non-autoimmune animal model of multiple sclerosis, characterized by demyelination of the corpus callosum (CC) and other brain regions. The exact mechanisms of CZ action are still arguable, but it seems that the only affected cells are the mature oligodendrocytes, possibly via metabolic disturbances caused by copper deficiency. During the pathogenesis of multiple sclerosis, high amount of deposited iron can be found throughout the demyelinated areas of the brain in the form of extracellular iron deposits and intracellularly accumulated iron in microglia. In the present study, we used the accepted experimental model of 0.2% CZ-containing diet with standard iron concentration to induce demyelination in the brain of C57BL/6 mice. Our aim was to examine the changes of iron homeostasis in the CC and as a part of the systemic iron regulation, in the liver. Our data showed that CZ treatment changed the iron metabolism of both tissues; however, it had more impact on the liver. Besides the alterations in the expressions of iron storage and import proteins, we detected reduced serum iron concentration and iron stores in the liver, together with elevated hepcidin levels and feasible disturbances in the Fe-S cluster biosynthesis. Our results revealed that the CZ-containing diet influences the systemic iron metabolism in mice, particularly the iron homeostasis of the liver. This inadequate systemic iron regulation may affect the iron homeostasis of the brain, eventually indicating a relationship among CZ treatment, iron metabolism, and neurodegeneration.

Topics: Animals; Axons; Cation Transport Proteins; Corpus Callosum; Cuprizone; Cytosol; Disease Models, Animal; Gene Expression Regulation; Hepcidins; Iron; Lipid Metabolism; Liver; Magnetic Resonance Imaging; Male; Mice, Inbred C57BL; Mitochondria; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Neuroglia; RNA, Messenger

Multiple sclerosis (MS) is a neuro-inflammatory and demyelinating disease. Downregulation of neuronal mitochondrial gene expression and activity have been reported in several studies of MS. We have previously shown that hemoglobin-β (Hbb) signals to the nucleus of neurons and upregulates H3K4me3, a histone mark involved in regulating cellular metabolism and differentiation. The present study was undertaken to evaluate the effect of erythropoietin (EPO) on the upregulation of hemoglobin and mitochondrial-associated neuroprotection. We found that administering EPO (5000 IU/kg intraperitoneally) to mice upregulated brain Hbb expression, levels of H3K4me3, expression of mitochondrial complex III, complex V, and mitochondrial respiration. We also found that the neuronal mitochondrial metabolite N-acetylaspartate (NAA), a marker of neuronal mitochondrial activity, was increased with EPO treatment. Further, we measured the effects of EPO on preventing mitochondrial deficits in the cuprizone toxic demyelinating mouse model of MS. We found that EPO prevented cuprizone-mediated decreases in Hbb, complex III, and NAA. Our data suggest that EPO mediated regulation of Hbb supports neuronal energetics and may provide neuroprotection in MS and other neurodegenerative diseases where a dysfunction of mitochondria contributes to disease.

Topics: Animals; Aspartic Acid; Brain; Cell Respiration; Cuprizone; Disease Models, Animal; Electron Transport Complex III; Erythropoietin; Hemoglobins; Histones; Lysine; Male; Methylation; Mice, Inbred C57BL; Mitochondria; Models, Biological; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Neurons; Up-Regulation

The pathological processes in the first weeks of multiple sclerosis (MS) lesion formation include myelin digestion that breaks chemical bonds in myelin lipid layers. This can increase lesion magnetic susceptibility, which is a potentially useful biomarker in MS patient management, but not yet investigated.. To understand and quantify the effects of myelin digestion on quantitative susceptibility mapping (QSM) of MS lesions.. Histological and QSM analyses on in vitro models of myelin breakdown and MS lesion formation in vivo.. Acutely demyelinating white matter lesions from MS autopsy tissue were stained with the lipid dye oil red O. Myelin basic protein (MBP), a major membrane protein of myelin, was digested with trypsin. Purified human myelin was denatured with sodium dodecyl sulfate (SDS). QSM was performed on phantoms containing digestion products and untreated controls. In vivo QSM was performed on five MS patients with newly enhancing lesions, and then repeated within 2 weeks.. 3D. Region of interest analyses were performed by a biochemist and a neuroradiologist to determine susceptibility changes on in vitro and in vivo QSM images.. Not applicable.. MBP degradation by trypsin increased the QSM measurement by an average of 112 ± 37 ppb, in excellent agreement with a theoretical estimate of 111 ppb. Degradation of human myelin by SDS increased the QSM measurement by 23 ppb. As MS lesions changed from gadolinium enhancing to nonenhancing over an average of 15.8 ± 3.7 days, their susceptibility increased by an average of 7.5 ± 6.3 ppb.. Myelin digestion in the early stages of MS lesion formation contributes to an increase in tissue susceptibility, detectable by QSM, as a lesion evolves from gadolinium enhancing to nonenhancing.. 1 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;47:1281-1287.

Topics: Algorithms; Animals; Autopsy; Biomarkers; Cattle; Humans; Magnetic Resonance Imaging; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Phantoms, Imaging; Trypsin; White Matter

Multiple sclerosis is an inflammatory demyelinating disorder of the central nervous system (CNS). Myelin basic protein (MBP), which is one of the main compounds of CNS myelin, appears to be hypercitrullinated in the brain of patients with MS. We hypothesized that MS is associated with an increased release of citrulline from the brain.. Twenty-five patients with MS, 25 controls without neurological disease (CwND) and 25 subjects with non-MS cerebral white matter lesions were included in this study. Groups were matched for age and gender. Clinical MS disability measures were recorded by means of Expanded Disability Status Scale (EDSS) scores and Multiple Sclerosis Severity Scores (MSSS). Citrulline was assessed in plasma obtained from an antecubital peripheral vein (PV) in all participants. Additional internal jugular vein (IJV) samples were examined in 10 patients with MS and 10 CwND. Twelve patients with MS underwent brain magnetic resonance imaging to determine total brain and T2 fluid-attenuated inversion recovery lesion volume.. Median [IQR] PV citrulline levels were increased in patients with MS (50.47 [86.61] μM), as compared to CwND (33.58 [43.65] μM, P = 0.042) and subjects with non-MS cerebral white matter lesions (32.41 [28.86] μM, P = 0.006). Citrulline IJV levels and IJV/PV ratios were comparable between patients with MS and CwND. No significant correlations were found between PV citrulline levels and any of the clinical, nor radiological, disease measures.. PV plasma levels of citrulline are elevated in patients with MS but this does not seem to result from an augmented release from the brain. Increased plasma citrulline may be a promising new biomarker in MS but the origin and significance need to be further elucidated.

Topics: Adult; Aged; Arginine; Citrulline; Disability Evaluation; Female; Glutamine; Humans; Immunologic Factors; Magnetic Resonance Imaging; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Nitric Oxide; Statistics, Nonparametric

Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system (CNS). There is still lack of commercially viable treatment currently. Pien Tze Huang (PZH), a traditional Chinese medicine, has been proved to have anti-inflammatory, neuroprotective, and immunoregulatory effects. This study investigated the possible therapeutic effects of PZH on experimental autoimmune encephalomyelitis (EAE) rats, a classic animal model of MS. Male Lewis rats were immunized with myelin basic protein (MBP) peptide to establish an EAE model and then treated with three doses of PZH. Clinical symptoms, organ coefficient, histopathological features, levels of proinflammatory cytokines, and chemokines as well as MBP and Olig2 were analyzed. The results indicated that PZH ameliorated the clinical severity of EAE rats. It also remarkably reduced inflammatory cell infiltration in the CNS of EAE rats. Furthermore, the levels of IL-17A, IL-23, CCL3, and CCL5 in serum and the CNS were significantly decreased; the p-P65 and p-STAT3 levels were also downregulated in the CNS, while MBP and Olig2 in the CNS of EAE rats had a distinct improvement after PZH treatment. In addition, PZH has no obvious toxicity at the concentration of 0.486 g/kg/d. This study demonstrated that PZH could be used to treat MS.

Topics: Animals; Anti-Inflammatory Agents; Brain; Cell Movement; Cytokines; Disease Models, Animal; Drugs, Chinese Herbal; Encephalomyelitis, Autoimmune, Experimental; Humans; Inflammation Mediators; Male; Medicine, Chinese Traditional; Multiple Sclerosis; Myelin Basic Protein; Neoplasm Proteins; Nucleocytoplasmic Transport Proteins; Rats; Rats, Inbred Lew; STAT3 Transcription Factor

Expanded polyclonal T regulatory cells (Tregs) offer great promise for the treatment of immune-mediated diseases. Inhibition by Tregs is under the control of the T-cell receptor (TCR). Therefore, we created Tregs with defined antigen specificity, using a recombinant T-cell receptor isolated from a myelin-basic protein specific T-cell clone of a multiple sclerosis (MS) patient (Ob2F3). We expressed this TCR using a retroviral expression vector in human Tregs from peripheral blood. We observed that transduced Tregs were activated in vitro in response to myelin basic protein (MBP) peptide on DR15 antigen-presenting cells (APC) and upregulated Treg markers, Foxp3, LAP and Helios. These engineered MBP-specific Tregs could suppress MBP-specific T effector cells, and were also able to suppress T cells with other specificities after Tregs had been activated through the TCR. Importantly, we showed that these engineered Tregs were able to function effectively in the presence of strong TLR-induced inflammatory signals, and that MBP-specific Tregs ameliorated EAE in myelin oligodendrocyte glycoprotein (MOG)-immunized DR15 transgenic mice. We further demonstrated in vitro that IL-2 produced by neighboring effector T cells activated MBP-specific Tregs, initiating contact-independent suppression to T effectors in local milieu. Mechanistic studies demonstrated that bystander suppression in vivo may involve transfer of soluble mediators, enhanced by cell contact between Tregs and effectors. Taken together, we show that engineered clonal MBP-specific Tregs are able to suppress autoimmune pathology in EAE. This approach may serve as a cellular therapy for MS patients with the common DR15 haplotype that is associated with disease susceptibility.

Topics: Animals; Autoimmunity; Bystander Effect; Cells, Cultured; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Forkhead Transcription Factors; Genetic Engineering; Genetic Predisposition to Disease; HLA-DR Serological Subtypes; Humans; Immunotherapy, Adoptive; Interleukin-2; Lymphocyte Activation; Mice; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Myelin-Oligodendrocyte Glycoprotein; Polymorphism, Genetic; Receptors, Antigen, T-Cell; T-Cell Antigen Receptor Specificity; T-Lymphocyte Subsets; T-Lymphocytes, Regulatory

We describe the cases of two sisters with spastic paraplegia 11 (SPG11). The younger sister developed relapsing lesions in the brain white matter with enhancement during the acute phase that mimicked multiple sclerosis (MS). The elevation of myelin basic protein in the cerebrospinal fluid (CSF) suggested demyelination, but a normal IgG index, the absence of oligoclonal bands, and the ineffectiveness of steroid treatment indicate that an autoimmune mechanism may not have been involved. In these affected sisters, we identified novel compound heterozygous mutations in the SPG11 gene. Our cases indicate the possible existence of a broader phenotypic spectrum of SPG11 mutations.

Topics: Adolescent; Adult; Diagnosis, Differential; Female; Humans; Magnetic Resonance Imaging; Multiple Sclerosis; Mutation; Myelin Basic Protein; Pedigree; Proteins; Siblings; Spastic Paraplegia, Hereditary; White Matter; Young Adult

Multiple sclerosis (MS) and neuromyelitis optica (NMO) are inflammatory demyelinating disorders of the central nervous system with evidence of antibody-mediated pathology. Using ex vivo organotypic mouse cerebellar slice cultures, we have demonstrated that recombinant antibodies (rAbs) cloned from cerebrospinal fluid plasmablasts of MS and NMO patients target myelin- and astrocyte-specific antigens to induce disease-specific oligodendrocyte loss and myelin degradation. In this study, we examined glial cell responses and myelin integrity during recovery from disease-specific antibody-mediated injury. Following exposure to MS rAb and human complement (HC) in cerebellar explants, myelinating oligodendrocytes repopulated the demyelinated tissue and formed new myelin sheaths along axons. Remyelination was accompanied by pronounced microglial activation. In contrast, following treatment with NMO rAb and HC, there was rapid regeneration of astrocytes and pre-myelinating oligodendrocytes but little formation of myelin sheaths on preserved axons. Deficient remyelination was associated with progressive axonal loss and the return of microglia to a resting state. Our results indicate that antibody-mediated demyelination in MS and NMO show distinct capacities for recovery associated with differential injury to adjacent axons and variable activation of microglia. Remyelination was rapid in MS rAb plus HC-induced demyelination. By contrast, oligodendrocyte maturation and remyelination failed following NMO rAb-mediated injury despite the rapid restoration of astrocytes and preservation of axons in early lesions.

Topics: Animals; Animals, Newborn; Aquaporin 4; Cerebellum; Glial Fibrillary Acidic Protein; Glutathione S-Transferase pi; Humans; Immunoglobulin G; Mice; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Myelin-Oligodendrocyte Glycoprotein; Neuroglia; Neuromyelitis Optica; Organ Culture Techniques; Remyelination; S100 Calcium Binding Protein beta Subunit; SOXB1 Transcription Factors

Multiple sclerosis is an immune-mediated autoimmune disease of the central nervous system that develops in genetically susceptible individuals and likely requires environmental triggers. The autoantigens and molecular mimics triggering the autoimmune response in multiple sclerosis remain incompletely understood. By using a brain-infiltrating CD4

Topics: Alleles; Amino Acid Sequence; Autoantigens; Brain; CD4-Positive T-Lymphocytes; Clone Cells; Fucose; Glucosyltransferases; HLA-DRB3 Chains; Humans; Multiple Sclerosis; Myelin Basic Protein; Peptides; RNA, Messenger

Multiple sclerosis (MS) is an autoimmune disease, leading to the destruction of the myelin sheaths, the protective layers surrounding the axons. The etiology of the disease is unknown, although there are several postulated environmental factors that may contribute to it. Recently, myelin damage was correlated to structural phase transition from a healthy stack of lamellas to a diseased inverted hexagonal phase as a result of the altered lipid stoichiometry and low myelin basic protein (MBP) content. In this work, we show that environmental conditions, such as buffer salinity and temperature, induce the same pathological phase transition as in the case of the lipid composition in the absence of MBP. These phase transitions have different transition points, which depend on the lipid's compositions, and are ion specific. In extreme environmental conditions, we find an additional dense lamellar phase and that the native lipid composition results in similar pathology as the diseased composition. These findings demonstrate that several local environmental changes can trigger pathological structural changes. We postulate that these structural modifications result in myelin membrane vulnerability to the immune system attacks and thus can help explain MS etiology.

Topics: Cell Membrane; Environment; Humans; Lipids; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath

Exosomes are small extracellular vesicles that provide cell-to-cell communication and are involved in immunoregulation.. To investigate serum exosomes for the presence of myelin proteins outside the central nervous system (CNS) and their role in multiple sclerosis (MS).. Serum, cerebrospinal fluid (CSF), and peripheral blood mononuclear cell (PBMC) samples were collected from 45 patients with relapsing-remitting MS (RRMS), 30 patients with secondary progressive MS (SPMS), and 45 healthy controls. Exosomes were isolated using a polymer formulation method, and their size, concentration, and CNS myelin protein contents were measured by a nanoparticle tracking analysis, enzyme-linked immunosorbent assays, and Western blot.. We found that exosomes expressed three major myelin proteins, myelin basic protein, proteolipid protein, and myelin oligodendrocyte glycoprotein (MOG). Exosomal content of MOG strongly correlated with disease activity and was highest in RRMS patients in relapse and in SPMS patients. Serum-derived exosomes induced proliferation of MOG-T cell receptor transgenic T cells confirming that serum exosomes maintained MOG immunogenicity.. Exosomes isolated outside CNS tissue expressed myelin proteins, and the presence of MOG correlated strongly with disease activity. We conclude that exosomes might enhance and/or perpetuate anti-myelin immune reactions in MS and may provide novel markers of disease activity.

Topics: Adult; Exosomes; Female; Humans; Leukocytes, Mononuclear; Male; Middle Aged; Multiple Sclerosis; Multiple Sclerosis, Relapsing-Remitting; Myelin Basic Protein; Myelin-Oligodendrocyte Glycoprotein

Prognosis following a first demyelinating event is difficult to predict, with no genetic markers of MS progression currently identified. Myelin basic protein (MBP) is a major component of the myelin sheath of CNS neurons and may play a central role in demyelinating diseases such as MS. However, genetic variation in. We found one variant, rs12959006, predicted worse clinical outcomes. The risk genotype (CT + TT) was significantly associated with hazard of relapse (HR = 1.74, 95% CI = 1.19-2.56,. Our results provide novel insights into the role of genetic variation within the

Topics: Case-Control Studies; Disease Progression; Genetic Predisposition to Disease; Genetic Variation; Genotyping Techniques; Herpesvirus 6, Human; Immunoglobulin G; Kaplan-Meier Estimate; Longitudinal Studies; Multiple Sclerosis; Myelin Basic Protein; Prognosis; Proportional Hazards Models; Prospective Studies; Risk; Severity of Illness Index

Multiple sclerosis (MS) as an autoimmune disorder is a common disease occurring in central nervous system (CNS) and the remyelination plays a pivotal role in the alleviating neurological impairment in the MS. Catalpol, an effective component extracted from the Chinese herb Radix Rehmanniae, which has been proved protective in cerebral diseases.. The results showed that Catalpol improved neurological function, reduced inflammatory cell infiltration and demyelination. It could decrease Th17 cells in the peripheral blood. It increased the protein expressions of NG2 and MBP in mice brains, up-regulated markedly protein and gene expressions of Olig1 and Olig2 in terms of timing, site and targets.. These data demonstrated that Catalpol had a strong neuroprotective effect on EAE mice. Catalpol also plays a role in remyelination by promoting the expressions of Olig1 and Olig2 transcription factors.

Topics: Animals; Basic Helix-Loop-Helix Transcription Factors; Central Nervous System; Drugs, Chinese Herbal; Encephalomyelitis, Autoimmune, Experimental; Female; Iridoid Glucosides; Mice, Inbred C57BL; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Myelin-Oligodendrocyte Glycoprotein; Nerve Tissue Proteins; Neuroprotective Agents; Oligodendrocyte Transcription Factor 2; Rehmannia

Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system (CNS) in young adults that has serious negative socioeconomic effects. In addition to symptoms caused by CNS pathology, the majority of MS patients frequently exhibit gastrointestinal dysfunction, which was previously either explained by the presence of spinal cord lesions or not directly linked to the autoimmune etiology of the disease. Here, we studied the enteric nervous system (ENS) in a B cell- and antibody-dependent mouse model of MS by immunohistochemistry and electron microscopy at different stages of the disease. ENS degeneration was evident prior to the development of CNS lesions and the onset of neurological deficits in mice. The pathology was antibody mediated and caused a significant decrease in gastrointestinal motility, which was associated with ENS gliosis and neuronal loss. We identified autoantibodies against four potential target antigens derived from enteric glia and/or neurons by immunoprecipitation and mass spectrometry. Antibodies against three of the target antigens were also present in the plasma of MS patients as confirmed by ELISA. The analysis of human colon resectates provided evidence of gliosis and ENS degeneration in MS patients compared to non-MS controls. For the first time, this study establishes a pathomechanistic link between the well-established autoimmune attack on the CNS and ENS pathology in MS, which might provide a paradigm shift in our current understanding of the immunopathogenesis of the disease with broad diagnostic and therapeutic implications.

Topics: Animals; Autoantibodies; Central Nervous System; Cytokines; Disease Models, Animal; Enteric Nervous System; Female; Freund's Adjuvant; Gastrointestinal Diseases; Humans; Male; Mice; Mice, Inbred C57BL; Multiple Sclerosis; Muscle, Smooth; Myelin Basic Protein; Myelin-Oligodendrocyte Glycoprotein; Myenteric Plexus; Recombinant Fusion Proteins; Tubulin

Multiple sclerosis (MS), as a multifactorial autoimmune disease with complex genetic basis, causes demyelination in the central nervous system via cytokine responses to myelin antigens. Myelin basic protein (MBP) is the main protein component of the myelin sheath. HLA-DRB (human leukocyte antigen-DR beta) alleles, particularly HLA-DRB1*1501, may be of significance in the pathogenesis of MS.. To examine the association of HLA-DRB1*1501 alleles and MBP VNTR (variable number tandem repeat) polymorphism with the MS susceptibility in Iranian population.. Genomic DNA was extracted from peripheral blood. The alleles were determined by the Polymerase Chain Reaction (PCR) method in 259 MS patients and 312 healthy control individuals and analyses were carried out using Fisher's exact test.. The frequencies of MBP VNTR genotypes (AA, AB and BB) were 47%, 42% and 11% among patients, and 45%, 43% and 12% in control subjects, respectively. HLA-DRB1*1501 allele was more frequent among patients than healthy individuals (OR=1.65, P=0.0045). The frequency of allele A and genotype A/A was significantly higher among HLA-DRB1*1501 positive patients (61% and 32%) than controls (46% and 19%) (OR=1.88, P=0.0013; A/A vs. B/B: OR=5.09, P=0.0004). The two-locus analysis of the interaction between the MBP VNTR polymorphism and the HLA-DRB1 allele showed that the HLADRB1* 1501/A haplotype was more frequent among MS patients than the healthy controls.. The interaction between the HLA-DRB1*1501 allele and MBP gene may be considered as a predisposing factor in the development and pathogenesis of MS in the case of gene-gene interaction.

Topics: Adolescent; Adult; Alleles; Child; Epistasis, Genetic; Female; Gene Frequency; Genetic Predisposition to Disease; Genotype; Haplotypes; HLA-DRB1 Chains; Humans; Iran; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Polymorphism, Genetic; Risk; Young Adult

In this unit, we describe in detail the most common methods used to break immunological tolerance for central myelin antigens and induce experimental autoimmune encephalomyelitis (EAE) in Lewis rats as an animal model of multiple sclerosis. The resulting disease course ranges from an acute monophasic disease to a chronic relapsing or chronic progressive course, which strongly resembles the human disease. These models enable the study of cellular and humoral autoimmunity against major antigenic epitopes of the myelin basic protein, myelin oligodendrocyte glycoprotein, or proteolipid protein. We provide an overview of common immunization protocols for induction of active and passive EAE, assessment and analysis of clinical score, preparation and purification of myelin basic protein, and derivation of neuroantigen-specific rat T cell lines. Finally, we describe the major clinical characteristics of these models. © 2017 by John Wiley & Sons, Inc.

Topics: Animals; Autoimmunity; CD4-Positive T-Lymphocytes; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Freund's Adjuvant; Guinea Pigs; Lipid Metabolism; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Myelin-Oligodendrocyte Glycoprotein; Neurologic Examination; Rats; Rats, Inbred Lew; Spinal Cord; T-Lymphocytes

This study was aimed at the development of an immunosensor for the simultaneous quantification of Myelin Basic Protein (MBP) and Tau proteins in cerebrospinal fluid (CSF) and serum, obtained from Multiple Sclerosis (MS) patients. The newly developed GO/pPG/anti-MBP/anti-Tau nanoimmunosensor has been established by immobilization of MBP and Tau antibodies. The newly developed nanoimmunosensor was tested, optimized and characterized using differential pulse voltammetry (DPV) and electrochemical impedance spectroscopy (EIS). The developed nanoimmunosensor was seen to have detection limits of 0.30nM for MBP and 0.15nM for Tau proteins which were sufficient for the levels to be analysed in neuro-clinic. The clinical study performed using CSF and serum of MS patients showed that the designed nanoimmunosensor was capable of detecting the proteins properly, that were essentially proven by ELISA.

Topics: Antibodies, Immobilized; Biosensing Techniques; Cadmium Compounds; Dendrimers; Dielectric Spectroscopy; Electrochemical Techniques; Graphite; Humans; Immunoassay; Lead; Limit of Detection; Multiple Sclerosis; Myelin Basic Protein; Nanoparticles; Oxides; Sulfides; tau Proteins

Microglia are resident immune cells in the central nervous system (CNS), which are essential for immune defence and critically contribute to neuronal functions during homeostasis. Until now, little is known about microglia biology in humans in part due to the lack of microglia-specific markers. We therefore investigated the expression of the purinergic receptor P2Y

Topics: Adolescent; Adult; Aged; Alzheimer Disease; Brain; Calbindins; Calcium-Binding Proteins; Cells, Cultured; Child, Preschool; Cytokines; DNA-Binding Proteins; Female; Fetus; Gene Expression Regulation, Developmental; Humans; Infant; Ki-67 Antigen; Microfilament Proteins; Microglia; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Receptors, Purinergic P2Y12; Young Adult

In multiple sclerosis (MS) T cells aberrantly recognize self-peptides of the myelin sheath and attack the central nervous system (CNS). Antigen-specific peptide immunotherapy, which aims to restore tolerance while avoiding the use of non-specific immunosuppressive drugs, is a promising approach to combat autoimmune disease, but the cellular mechanisms behind successful therapy remain poorly understood. Myeloid-derived suppressor cells (MDSCs) have been studied intensively in the field of cancer and to a lesser extent in autoimmunity. Because of their suppressive effect on the immune system in cancer, we hypothesized that the development of MDSCs and their interaction with CD4

Topics: Animals; Arginase; CD4-Positive T-Lymphocytes; Cell Differentiation; Cell Proliferation; Cells, Cultured; Encephalomyelitis, Autoimmune, Experimental; Humans; Immune Tolerance; Immunophenotyping; Immunotherapy; Lymphocyte Activation; Mice; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Myeloid-Derived Suppressor Cells; Peptide Fragments

Multiple sclerosis is an autoimmune disease caused by the destruction of the myelin sheath in the central nervous system. The major target molecules for the immune response are the myelin basic protein, myelin oligodendrocyte glycoprotein and proteolipid protein but the aetiology of the disease is as yet poorly understood. The HLA Class II allele DRB1*1501 in particular as well as DRB5*0101 and the expression of human endogenous retroviral envelope proteins have been linked to multiple sclerosis but the molecular mechanisms relating these remain to be elucidated. We hypothesised that cross-reactive peptide epitopes in retroviral envelope proteins and myelin proteins that can be presented by the two Class II DR molecules may play a role in initiating multiple sclerosis. Sequence homologies between retroviral envelope and myelin proteins and in silico predictions of peptides derived from them that are able to bind to the two Class II alleles were examined to test the hypothesis. The results support the hypothesis that molecular mimicry in peptide epitopes from envelope proteins of the HERV-W family of endogenous retroviruses and myelin proteins is possible and could potentially trigger multiple sclerosis. Mimicry between syncytin-1, a HERV-W envelope protein that is expressed during placentation, and myelin proteins may also explain the higher prevalence of multiple sclerosis in women. Experiments to test the ability of the identified peptide epitopes to activate T

Topics: Amino Acid Sequence; Computational Biology; Endogenous Retroviruses; Female; Gene Products, env; HLA-DR2 Antigen; Humans; Male; Molecular Mimicry; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Oligodendrocyte Glycoprotein; Peptide Fragments; Pregnancy Proteins; Protein Binding; Sequence Homology, Amino Acid; T-Lymphocytes; Viral Envelope Proteins

Topics: Aquaporin 4; Area Postrema; Child; Diplopia; Female; Humans; Immunoglobulin G; Magnetic Resonance Imaging; Multiple Sclerosis; Myelin Basic Protein

MicroRNAs have emerged as an important class of modulators of gene expression. These molecules influence protein synthesis through translational repression or degradation of mRNA transcripts. Herein, we investigated the potential role of miR-142a isoforms, miR-142a-3p and miR-142a-5p, in the context of autoimmune neuroinflammation.. Expression of miR-142-5p was significantly increased in the frontal white matter from MS patients compared with white matter from non-MS controls. Likewise, expression levels of miR-142a-5p and miR-142a-3p showed significant upregulation in the spinal cords of EAE mice at days 15 and 25 post disease induction. Splenocytes stimulated with myelin oligodendrocyte glycoprotein (MOG) peptide or anti-CD3/anti-CD28 antibodies showed upregulation of miR-142a-5p and miR-142a-3p isoforms, whereas stimulated bone marrow-derived macrophages and primary astrocytes did not show any significant changes in miRNA expression levels. miR-142a-5p overexpression in activated lymphocytes shifted the pattern of T cell differentiation towards Th1 cells. Luciferase assays revealed SOCS1 and TGFBR1 as direct targets of miR-142a-5p and miR-142a-3p, respectively, and overexpression of miRNA mimic sequences suppressed the expression of these target transcripts in lymphocytes. SOCS1 levels were also diminished in MS white matter and EAE spinal cords.. Our findings suggest that increased expression of miR-142 isoforms might be involved in the pathogenesis of autoimmune neuroinflammation by influencing T cell differentiation, and this effect could be mediated by interaction of miR-142 isoforms with SOCS1 and TGFBR-1 transcripts.

Topics: Aged; Animals; Antigens, CD; Astrocytes; Cell Differentiation; Cells, Cultured; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Female; Freund's Adjuvant; Humans; Macrophages; Male; Mice; Mice, Inbred C57BL; MicroRNAs; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin-Oligodendrocyte Glycoprotein; Peptide Fragments; Signal Transduction; T-Lymphocytes; Up-Regulation

Reactivity to myelin associated proteins is the hallmark of human multiple sclerosis (M.S) and its experimental counterparts. However, the nature of such reactivity has not been described fully. Herein, we report that myelin basic protein (MBP) reactivity accumulates in a rat model for M.S. over a period of time and sensitizes TRAIL mediated progressive oligodendrocyte apoptosis. We used active immunization by Myelin Oligodendrocyte Glycoprotein (MOG, 50 μg) to study chronic remitting relapsing encephalomyelitis in rats. A time point analysis of the progressive disease revealed cumulative accumulation of anti myelin basic protein antibodies during the disease progression with minimal change in the anti-MOG antibodies. Increased reactivity to MBP was studied to sensitize TNF related apoptosis-inducing ligand (TRAIL) and other proinflammatory cytokines in a cumulative fashion leading to the Caspase dependent apoptosis of oligodendrocytes and myelin loss. In a rescue experiment, we could limit the demyelination and prevent disease progression by neutralizing the effector, TRAIL in an early stage of the disease. This is the first study to identify the accumulation of MBP antibodies in MOG induced EAE which possibly leads to TRAIL sensitized oligodendrocyte apoptosis in the white mater of EAE rats. This finding stresses on the need to study MBP antibody titers in M.S. patients and therefore might serve as an alternate marker for progressive demyelination.

Topics: Animals; Apoptosis; Cytokines; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Male; Multiple Sclerosis; Myelin Basic Protein; Myelin-Oligodendrocyte Glycoprotein; Oligodendroglia; Rats, Wistar; Spinal Cord; White Matter

Scutellarin, a flavonoid extracted from an herbal medication (Erigeron breviscapus Hand-Mazz), has been shown to protect neurons against damage and to promote neurogenesis, and thus has therapeutic potential in the treatment of a variety of neurodegenerative diseases. Since neural stem cells (NSCs) could differentiate into myelin-producing oligodendrocytes, we speculate that scutellarin could also be used to treat multiple sclerosis (MS). In the current study, we examined potential effects of scutellarin using a mouse model of MS. Briefly, adult C57BL/6 mice exposed to cuprizone (8 mg/day through diet, for 6 consecutive weeks) randomly received scutellarin (50 mg/kg/day) or vehicle for 10 consecutive days. In the scutellarin-treated group, rotarod testing at the end of the treatment showed significant improvement of motor function (increased time to fall); myelin basic protein (MBP) staining of the corpus callosum revealed decreased demyelination; TUNEL staining followed by Nestin or Sox2 staining revealed increased number of NSCs and decreased rate of NSC apoptosis in the subventricular zone (SVZ) of the lateral ventricles (LV). In a series of experiments using cultured NSCs subjected to cuprizone injury, we confirmed the protective effects of scutellarin. At 30 μM, scutellarin increased the commitment of NSCs to the oligodendrocyte and neuronal lineages, as evidenced by NG2 chondroitin sulfate proteoglycan (NG2) and doublecortin (DCX) staining. Differentiation into astrocytes (as revealed by glial fibrillary acidic protein (GFAP) staining) was decreased. Maturation of the NSCs committed to the oligodendrocyte lineage, as evidenced by oligodendrocyte marker O4 antibody (O4) staining and MBP staining, was also promoted by scutellarin. Further analysis revealed that scutellarin might suppress the phosphorylation of p38 in cuprizone-induced NSCs. In summary, scutellarin could alleviate motor deficits in a mouse model for MS, possibly by inhibiting NSC apoptosis and promoting differentiation of NSCs to myelin-producing oligodendrocytes.

Topics: Animals; Apigenin; Apoptosis; Astrocytes; Cells, Cultured; Doublecortin Protein; Glucuronates; Locomotion; Male; Mice; Mice, Inbred C57BL; Multiple Sclerosis; Myelin Basic Protein; Nestin; Neural Stem Cells; Neurogenesis; Neurons; Neuroprotective Agents; SOXB1 Transcription Factors

Onset of multiple sclerosis (MS) in the very young (<10 years) is uncommon. We describe a 2 year old girl with MS, the youngest reported case in the USA. She presented to an outside hospital with acute onset of ataxia on three occasions before presenting to our institution, initially misdiagnosed as acute disseminated encephalomyelitis and treated with intravenous methylprednisolone. MRI of the brain during each presentation revealed new areas of demyelination. Initial cerebrospinal fluid (CSF) studies and MRI of the spine were normal. Repeat MRI of the brain at our institution, 7 months later, revealed new demyelinating lesions and CSF analysis revealed elevated myelin basic protein, negative oligoclonal band and neuromyelitis optica immunoglobulin and normal IgG synthesis. Her clinical presentation with multiple relapses and new MRI findings validated the diagnosis of MS.

Topics: Child, Preschool; Diagnostic Errors; Encephalomyelitis, Acute Disseminated; Female; Humans; Magnetic Resonance Imaging; Multiple Sclerosis; Myelin Basic Protein

Japanese macaque encephalomyelitis (JME) is an inflammatory demyelinating disease that occurs spontaneously in a colony of Japanese macaques (JM) at the Oregon National Primate Research Center. Animals with JME display clinical signs resembling multiple sclerosis (MS), and magnetic resonance imaging reveals multiple T2-weighted hyperintensities and gadolinium-enhancing lesions in the central nervous system (CNS). Here we undertook studies to determine if JME possesses features of an immune-mediated disease in the CNS. Comparable to MS, the CNS of animals with JME contain active lesions positive for IL-17, CD4+ T cells with Th1 and Th17 phenotypes, CD8+ T cells, and positive CSF findings.

Topics: Animals; Antigens, CD; B-Lymphocytes; Central Nervous System; Cytokines; Disease Models, Animal; Encephalomyelitis; Lymphocytes; Macaca; Macrophages; Magnetic Resonance Imaging; Microfilament Proteins; Microglia; Multiple Sclerosis; Myelin Basic Protein; Nerve Tissue Proteins

White matter abnormalities in the CNS have been reported recently in various neurological and psychiatric disorders. Quantitation of non-Gaussianity for water diffusion by q-space diffusional MRI (QSI) renders biological diffusion barriers such as myelin sheaths; however, the time-consuming nature of this method hinders its clinical application. In the current study, we aimed to refine QSI protocols to enable their clinical application and to visualize myelin signals in a clinical setting. For this purpose, animal studies were first performed to optimize the acquisition protocol of a non-Gaussian QSI metric. The heat map of standardized kurtosis values derived from optimal QSI (myelin map) was then created. Histological validation of the myelin map was performed in myelin-deficient mice and in a nonhuman primate by monitoring its variation during demyelination and remyelination after chemical spinal cord injury. The results demonstrated that it was sensitive enough to depict dysmyelination, demyelination, and remyelination in animal models. Finally, its utility in clinical practice was assessed by a pilot clinical study in a selected group of patients with multiple sclerosis (MS). The human myelin map could be obtained within 10 min with a 3 T MR scanner. Use of the myelin map was practical for visualizing white matter and it sensitively detected reappearance of myelin signals after demyelination, possibly reflecting remyelination in MS patients. Our results together suggest that the myelin map, a kurtosis-related heat map obtainable with time-saving QSI, may be a novel and clinically useful means of visualizing myelin in the human CNS.. Myelin abnormalities in the CNS have been gaining increasing attention in various neurological and psychiatric diseases. However, appropriate methods with which to monitor CNS myelin in daily clinical practice have been lacking. In the current study, we introduced a novel MRI modality that produces the "myelin map." The myelin map accurately depicted myelin status in mice and nonhuman primates and in a pilot clinical study of multiple sclerosis patients, suggesting that it is useful in detecting possibly remyelinated lesions. A myelin map of the human brain could be obtained in <10 min using a 3 T scanner and it therefore promises to be a powerful tool for researchers and clinicians examining myelin-related diseases.

Topics: Adult; Animals; Brain Mapping; Callithrix; Demyelinating Diseases; Diffusion Magnetic Resonance Imaging; Disease Models, Animal; Female; Humans; Image Processing, Computer-Assisted; Lysophosphatidylcholines; Male; Mice; Mice, Jimpy; Mice, Mutant Strains; Multiple Sclerosis; Mutation; Myelin Basic Protein; Myelin Sheath; Spinal Cord; White Matter

7,8-Dihydroxyflavone (DHF), is a recently described TrkB agonist that readily crosses the blood brain barrier. We treated C57Bl/6 mice with MOG--induced EAE daily with DHF starting on the day of disease induction. Clinical severity of impairment was reduced throughout the course of disease. Pathological examination of brains and spinal cords on day 28 showed that DHF treatment increased the phosphorylation of TrkB and activated downstream signaling pathways including AKT and STAT3 and reduced inflammation, demyelination and axonal loss compared to EAE controls. DHF treatment duplicated the central nervous system effects of brain derived neurotrophic factor in the EAE.

Topics: 2',3'-Cyclic-Nucleotide Phosphodiesterases; Animals; Apoptosis; bcl-2-Associated X Protein; Brain; Cytokines; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Female; Flavones; Humans; Mice; Mice, Inbred C57BL; Multiple Sclerosis; Myelin Basic Protein; Myelin-Oligodendrocyte Glycoprotein; Peptide Fragments; Severity of Illness Index; Signal Transduction; Spinal Cord; Time Factors

Mycobacterium avium subsp. paratuberculosis (MAP) and Epstein-Barr virus (EBV) epitopes elicit a consistent humoral response in serum of multiple sclerosis patients, but the cross reactivity against the homologous myelin basic protein (MBP) and human interferon regulatory factor 5 (IRF5) has not been searched within the Cerebral Spinal Fluid (CSF). We evaluated in sera and CSF of patients with MS and with other neurological diseases (OND) the humoral response against EBV/MAP peptides and the IRF5/MBP. Our data showed that EBV and MAP peptides are able to induce a specific humoral immune response in MS patients compared to OND controls both in serum and in CSF. An intrathecal specific synthesis of IgG against MBP and their EBV and MAP homologous as indicated by the antibody index was observed in MS patients. The humoral response against EBV, MAP, MBP and IRF5 was significantly higher in MS patients compared to OND both in serum and in CSF. The higher presence of antibodies against MBP and their MAP and EBV homologous in CSF during relapses suggests a possible role of the pathogens in enhancing inflammation.

Topics: Adult; Aged; Aged, 80 and over; Antibodies, Bacterial; Antibodies, Viral; Cerebrospinal Fluid; Cross Reactions; Female; Herpesvirus 4, Human; Humans; Interferon Regulatory Factors; Male; Middle Aged; Multiple Sclerosis; Mycobacterium avium subsp. paratuberculosis; Myelin Basic Protein; Serum; Young Adult

Cerebellar dysfunction is a significant contributor to disability in multiple sclerosis (MS). Both white matter (WM) and grey matter (GM) injury occurs within MS cerebellum and, within GM, demyelination, inflammatory cell infiltration and neuronal injury contribute to on-going pathology. The precise nature of cerebellar GM injury is, however, unknown. Oxidative stress pathways with ultimate lipid peroxidation and cell membrane injury occur extensively in MS and the purpose of this study was to investigate these processes in MS cerebellar GM. Post-mortem human cerebellar GM from MS and control subjects was analysed immunohistochemically, followed by semi-quantitative analysis of markers of cellular injury, lipid peroxidation and anti-oxidant enzyme expression. We have shown evidence for reduction in myelin and neuronal markers in MS GM, coupled to an increase in expression of a microglial marker. We also show that the lipid peroxidation product 4-hydroxynonenal co-localises with myelin and its levels negatively correlate to myelin basic protein levels. Furthermore, superoxide dismutase (SOD1 and 2) enzymes, localised within cerebellar neurons, are up-regulated, yet the activation of subsequent enzymes responsible for the detoxification of hydrogen peroxide, catalase and glutathione peroxidase are relatively deficient. These studies provide evidence for oxidative injury in MS cerebellar GM and further help define disease mechanisms within the MS brain.

Topics: Adult; Aged; Aged, 80 and over; Aldehydes; Cerebellum; Female; Gray Matter; Humans; Lipid Peroxidation; Male; Microglia; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Neurons; Oxidative Stress; RNA, Messenger; Superoxide Dismutase; Superoxide Dismutase-1; White Matter

We have recently shown that IgGs from serum and cerebrospinal fluid (CSF) of MS patients are active in hydrolysis of DNA and myelin basic protein. According to literature data, anti-DNA and anti-MBP abzymes may promote important neuropathologic mechanisms in this chronic inflammatory disorder and in MS pathogenesis development. At the same time, the involvement of antibodies with amylase activity in the pathogenesis of any autoimmune disease has not yet been identified. Electrophoretically and immunologically homogeneous IgGs were obtained by a sequential affinity chromatography of the CSF proteins on protein G-Sepharose and FPLC gel filtration. We are able to present the first unpredictable evidence showing that IgGs from CSF possess amylase activity and efficiently hydrolyze maltoheptaose; their average specific Ab activity is ~30-fold higher than that of antibodies from sera of the same MS patients. Specific average RA (SAA) for IgGs from healthy volunteers was approximately ~1000 lower than that for MS patients. In addition, it was shown that a relative SAA of total proteins of CSF (including Abs) ~15-fold lower than that for purified IgGs, while the relative SAA of the total sera protein is higher than that of sera IgGs by a factor of 1033. This result speaks in favor of the fact that amylolytic activity of CSF proteins is mainly caused by the activity of amylase abzymes. One cannot exclude, that amylase abzymes of CSF can play a, as yet unknown, role in the pathogenesis of MS. Some possible reasons of these findings are discussed.

Topics: Adult; Amylases; Antibodies, Antinuclear; Antibodies, Catalytic; Cerebrospinal Fluid Proteins; Chromatography, Affinity; Chromatography, Gel; Chromatography, High Pressure Liquid; DNA; Female; Humans; Hydrolysis; Immunoglobulin G; Isoelectric Focusing; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Retrospective Studies; Young Adult

Treatment of chronic neurodegenerative diseases such as multiple sclerosis (MS) remains a major challenge. Here we genetically engineer neural stem cells (NSCs) to produce a triply therapeutic cocktail comprising IL-10, NT-3, and LINGO-1-Fc, thus simultaneously targeting all mechanisms underlie chronicity of MS in the central nervous system (CNS): persistent inflammation, loss of trophic support for oligodendrocytes and neurons, and accumulation of neuroregeneration inhibitors. After transplantation, NSCs migrated into the CNS inflamed foci and delivered these therapeutic molecules in situ. NSCs transduced with one, two, or none of these molecules had no or limited effect when injected at the chronic stage of experimental autoimmune encephalomyelitis; cocktail-producing NSCs, in contrast, mediated the most effective recovery through inducing M2 macrophages/microglia, reducing astrogliosis, and promoting axonal integrity and endogenous oligodendrocyte/neuron differentiation. These engineered NSCs simultaneously target major mechanisms underlying chronicity of multiple sclerosis (MS) and encephalomyelitis (EAE), thus representing a novel and potentially effective therapy for the chronic stage of MS, for which there is currently no treatment available.

Topics: Animals; Autoimmunity; Cell Differentiation; Cell Engineering; Cell Proliferation; Disease Models, Animal; Disease Progression; Encephalomyelitis, Autoimmune, Experimental; Female; Gene Expression; Genetic Vectors; Interleukin-10; Lentivirus; Macrophages; Mice; Microglia; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Nerve Growth Factors; Neural Stem Cells; Neurons; Oligodendroglia; Stem Cell Transplantation; Transduction, Genetic; Transgenes

Antigen-specific T cell tolerance holds great promise for the treatment of autoimmune diseases. However, strategies to induce durable tolerance using high doses of soluble antigen have to date been unsuccessful, due to lack of efficacy and the risk of hypersensitivity. In the current study we have overcome these limitations by developing a platform for tolerance induction based on engineering the immunoglobulin Fc region to modulate the dynamic properties of low doses (1 μg/mouse; ∼50 μg/kg) of Fc-antigen fusions. Using this approach, we demonstrate that antigen persistence is a dominant factor governing the elicitation of tolerance in the model of multiple sclerosis (MS), experimental autoimmune encephalomyelitis (EAE), induced by immunizing B10.PL mice with the N-terminal epitope of myelin basic protein. Unexpectedly, our analyses reveal a stringent threshold of antigen persistence for both prophylactic and therapeutic treatments, although distinct mechanisms lead to tolerance in these two settings. Importantly, the delivery of tolerogenic Fc-antigen fusions during ongoing disease results in the downregulation of T-bet and CD40L combined with amplification of Foxp3(+) T cell numbers. The generation of effective, low dose tolerogens using Fc engineering has potential for the regulation of autoreactive T cells.

Topics: Animals; Antigens; Autoimmunity; CD4-Positive T-Lymphocytes; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Epitopes; Female; Flow Cytometry; Humans; Immune Tolerance; Immunization; Immunoglobulin Fc Fragments; Male; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Recombinant Fusion Proteins

Deimination of myelin basic protein (MBP) by peptidylarginine deiminase (PAD) prevents its binding to the proteasome and decelerates its degradation by the proteasome in mammalian cells. Potential anticancer drug tetrazole analogue of chloramidine 2, at concentrations greater than 1 µM inhibits the enzymatic activity of PAD in vitro. The observed acceleration of proteasome hydrolysis of MBP to antigenic peptides in the presence of PAD inhibitor may increase the efficiency of lesion of the central nervous system by cytotoxic lymphocytes in multiple sclerosis. We therefore suggest that clinical trials and the introduction of PAD inhibitors in clinical practice for the treatment of malignant neoplasms should be performed only after a careful analysis of their potential effect on the induction of autoimmune neurodegeneration processes.

Topics: Animals; Biphenyl Compounds; Bortezomib; Cattle; Dose-Response Relationship, Drug; Enzyme Inhibitors; HEK293 Cells; Humans; Hydrolases; Hydrolysis; Mice, Inbred C3H; Multiple Sclerosis; Muscle, Skeletal; Myelin Basic Protein; Neuroprotective Agents; Proteasome Endopeptidase Complex; Protein Binding; Protein-Arginine Deiminases; Proteolysis; Rabbits; Tetrazoles; Transfection

Multiple sclerosis (MS) is a neurodegenerative disease characterized by episodes of immune attacks and oligodendrocyte death leading to demyelination and progressive functional deficits. New therapeutic strategies are needed to stimulate the spontaneous regenerative process observed in some patients. Spontaneous myelin repair relies on the mobilization and differentiation of endogenous oligodendrocyte progenitors at the lesion site. Olesoxime, a cholesterol-like compound, has been shown to favor oligodendrocyte maturation in culture and promote myelin regeneration in rodents. Here, we study the mode of action of this compound and show that it binds to oligodendrocyte mitochondria, leading to their hyperfilamentation. This is accompanied by a reduction of basal superoxide levels, and accumulation of End Binding Protein 1 (EB1) at growing ends of microtubules. In parallel, we demonstrate that Reactive Oxygen Species (ROS) scavengers also promote oligodendrocyte differentiation, together with increasing mitochondrial filamentation and EB1-dependent microtubule polymerization. Altogether, our data uncover the mechanisms by which olesoxime promotes oligodendrocyte maturation. They also reveal that a bidirectional relationship between mitochondria hyperfilamentation and ROS level modulation controls oligodendrocyte maturation. This study identifies new cellular mechanisms to target for the development of regenerative treatments for MS.

Topics: Animals; Cell Differentiation; Cells, Cultured; Cholestenones; Microtubule-Associated Proteins; Microtubules; Mitochondria; Multiple Sclerosis; Myelin Basic Protein; Neocortex; Oligodendroglia; Rats; Rats, Sprague-Dawley; Reactive Oxygen Species; Superoxides

Topics: B-Lymphocytes; Canada; Environment; Epstein-Barr Virus Infections; Female; Genetic Predisposition to Disease; Geography, Medical; Herpesvirus 4, Human; HLA-DRB1 Chains; Humans; Male; Meta-Analysis as Topic; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Myeloid Cells; Risk Factors; T-Lymphocytes; Vitamin D Deficiency

Subpial cortical demyelination (SCD) accounts for the greatest proportion of demyelinated cortex in multiple sclerosis (MS). SCD is already found in biopsy cases with early MS and in marmosets with experimental autoimmune encephalomyelitis (EAE), but the pathogenesis of SCD is not well understood. The objective of this study was to investigate whether and, if so, which meningeal inflammatory cells were associated with early SCD in marmosets with EAE. Immunohistochemistry was performed to analyze brain samples from eight control animals and eight marmosets immunized with myelin oligodendrocyte glycoprotein. Meningeal T, B and plasma cells were quantified adjacent to SCD, normal-appearing EAE cortex (NAC) and control marmoset cortex. SCD areas appeared mostly hypocellular with low-grade microglial activation. In marmosets with EAE, meninges adjacent to SCD showed significantly increased T cells paralleled by elevated plasma cells, but unaltered B cell numbers compared with NAC. The elevation of meningeal T and plasma cells was a specific finding topographically associated with SCD, as the meninges overlying NAC displayed similarly low T, B and plasma cell numbers as control cortex. These findings suggest that local meningeal T and plasma cell infiltration contributes to the pathogenesis of SCD in marmosets with EAE.

Topics: Animals; Antigens, CD; Calgranulin B; Callithrix; Case-Control Studies; Cerebral Cortex; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Female; Male; Meninges; Multiple Sclerosis; Myelin Basic Protein; Plasma Cells; T-Lymphocytes; White Matter

Multiple Sclerosis affects mainly women and consists in intermittent or chronic damages to the myelin sheaths, focal inflammation, and axonal degeneration. Current therapies are limited to immunomodulators and antiinflammatory drugs, but there is no efficient treatment for stimulating the endogenous capacity of myelin repair. Progesterone and synthetic progestins have been shown in animal models of demyelination to attenuate myelin loss, reduce clinical symptoms severity, modulate inflammatory responses and partially reverse the age-dependent decline in remyelination. Moreover, progesterone has been demonstrated to promote myelin formation in organotypic cultures of cerebellar slices. In the present study, we show that progesterone and the synthetic 19-nor-progesterone derivative Nestorone® promote the repair of severe chronic demyelinating lesions induced by feeding cuprizone to female mice for up to 12 weeks. Progesterone and Nestorone increase the density of NG2(+) oligodendrocyte progenitor cells and CA II(+) mature oligodendrocytes and enhance the formation of myelin basic protein (MBP)- and proteolipid protein (PLP)-immunoreactive myelin. However, while demyelination in response to cuprizone was less marked in corpus callosum than in cerebral cortex, remyelination appeared earlier in the former. The remyelinating effect of progesterone was progesterone receptor (PR)-dependent, as it was absent in PR-knockout mice. Progesterone and Nestorone also decreased (but did not suppress) neuroinflammatory responses, specifically astrocyte and microglial cell activation. Therefore, some progestogens are promising therapeutic candidates for promoting the regeneration of myelin.

Topics: Animals; Cerebral Cortex; Corpus Callosum; Cuprizone; Demyelinating Diseases; Disease Models, Animal; Female; Mice, Inbred C57BL; Mice, Knockout; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Myelin Sheath; Oligodendroglia; Progesterone; Stem Cells

Citrullinated proteins have been suggested to play a critical role in the pathogenesis of multiple sclerosis (MS). Anticyclic citrullinated peptide (anti-CCP) antibody is used in the early diagnosis of rheumatoid arthritis (RA). The objective of this study was to investigate the presence of anti-CCP antibody in patients with MS compared to RA patients and healthy controls. Fifty patients with MS (38 females, 12 males; mean age 36.72 ± 8.82 years), 52 patients with RA (40 females, 12 males; mean age 40.87 ± 10.17 years), and 50 healthy controls (32 females, 18 males; mean age 38.22 ± 11.59 years) were included in this study. The levels of serum anti-CCP antibody were measured using an enzyme-linked immunosorbent assay (ELISA). The results of the study showed that anti-CCP antibody levels were significantly higher in RA patients versus MS or healthy controls (P < 0.001). Moreover, anti-CCP antibody was positive in 43 (83%) patients with RA, while it was negative in all MS patients as well as in all healthy controls. Also, no significant correlation was found between the anti-CCP levels and EDSS scores (r = -0.250). In conclusion, the results of this study did not support a positive association between serum anti-CCP antibody and MS.

Topics: Adult; Antibodies, Anti-Idiotypic; Arthritis, Rheumatoid; Central Nervous System; Citrulline; Early Diagnosis; Female; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Peptides

Autoreactive CD4+ T-cells are considered to play a major role in the pathogenesis of multiple sclerosis. In experimental autoimmune encephalomyelitis, an animal model of multiple sclerosis, exogenous and endogenous type I interferons restrict disease severity. Recombinant interferon-β is used for treatment of multiple sclerosis, and some untreated multiple sclerosis patients have increased expression levels of type I interferon-inducible genes in immune cells. The role of endogenous type I interferons in multiple sclerosis is controversial: some studies found an association of high expression levels of interferon-β-inducible genes with an increased expression of interleukin-10 and a milder disease course in untreated multiple sclerosis patients, whereas other studies reported an association with a poor response to treatment with interferon-β. In the present study, we found that untreated multiple sclerosis patients with an increased expression of interferon-β-inducible genes in peripheral blood mononuclear cells and interferon-β-treated multiple sclerosis patients had decreased CD4+ T-cell reactivity to the autoantigen myelin basic protein ex vivo. Interferon-β-treated multiple sclerosis patients had increased IL10 and IL27 gene expression levels in monocytes in vivo. In vitro, neutralization of interleukin-10 and monocyte depletion increased CD4+ T-cell reactivity to myelin basic protein while interleukin-10, in the presence or absence of monocytes, inhibited CD4+ T-cell reactivity to myelin basic protein. Our findings suggest that spontaneous expression of interferon-β-inducible genes in peripheral blood mononuclear cells from untreated multiple sclerosis patients and treatment with interferon-β are associated with reduced myelin basic protein-induced T-cell responses. Reduced myelin basic protein-induced CD4+ T-cell autoreactivity in interferon-β-treated multiple sclerosis patients may be mediated by monocyte-derived interleukin-10.

Topics: Adult; Biomarkers; CD4-Positive T-Lymphocytes; Cell Proliferation; Female; Gene Expression Regulation; Humans; Interferon Type I; Interferon-beta; Interleukin-10; Intracellular Space; Male; Monocytes; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocyte Subsets

In multiple sclerosis (MS) lymphoid follicle-like aggregates have been reported in the meninges of patients. Here we investigated the functional relevance of B cell infiltration into the central nervous system (CNS) in MP4-induced experimental autoimmune encephalomyelitis (EAE), a B cell-dependent mouse model of MS. In chronic EAE, B cell aggregates were characterized by the presence of CXCL13(+) and germinal center CD10(+) B cells. Germline transcripts were expressed in the CNS and particularly related to TH17-associated isotypes. We also observed B cells with restricted VH gene usage that differed from clones found in the spleen. Finally, we detected CNS-restricted spreading of the antigen-specific B cell response towards a myelin and a neuronal autoantigen. These data imply the development of autonomous B cell-mediated autoimmunity in the CNS in EAE - a concept that might also apply to MS itself.

Topics: Animals; Autoantigens; B-Lymphocytes; Central Nervous System; Cerebellum; Chemokine CXCL13; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Mice; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Myelin Sheath; Neprilysin; RNA, Messenger; Spleen

Multiple sclerosis is generally considered an autoimmune disease resulting from interaction between predisposing genes and environmental factors, together allowing immunological self-tolerance to be compromised. The precise nature of the environmental inputs has been elusive, infectious agents having received considerable attention. A recent study generated an algorithm predicting naturally occurring T cell receptor (TCR) ligands from the proteome database. Taking the example of a multiple sclerosis patient-derived anti-myelin TCR, the study identified a number of stimulatory, cross-reactive peptide sequences from environmental and human antigens. Having previously generated a spontaneous multiple sclerosis (MS) model through expression of this TCR, we asked whether any of these could indeed function in vivo to trigger CNS disease by cross-reactive activation.. A number of myelin epitope cross-reactive epitopes could stimulate T cell immunity in this MS anti-myelin TCR transgenic model. Two of the most stimulatory of these 'environmental' epitopes, from Dictyostyelium slime mold and from Emiliania huxleyi, were tested for the ability to induce MS-like disease in the transgenics. We found that immunization with cross-reactive peptide from Dictyostyelium slime mold (but not from E. huxleyi) induces severe disease.. These specific environmental epitopes are unlikely to be common triggers of MS, but this study suggests that our search for the cross-reactivity triggers of autoimmune activation leading to MS should encompass epitopes not just from the 'infectome' but also from the full environmental 'exposome.'

Topics: Animals; Autoantigens; Bacterial Infections; Disease Models, Animal; Environmental Microbiology; HLA-DR Serological Subtypes; Mice; Mice, Inbred C57BL; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Pertussis Toxin; Protozoan Infections; Receptors, Antigen, T-Cell; RNA, Messenger; T-Lymphocytes

Multiple sclerosis (MS) is an inflammatory, demyelinating disease of the central nervous system, and it has been established that autoreactive T helper (Th) cells play a crucial role in its pathogenesis. Myelin basic protein (MBP) epitopes are major autoantigens in MS, and the sequence MBP87-99 is an immunodominant epitope. We have previously reported that MBP87-99 peptides with modifications at principal T-cell receptor (TCR) contact sites suppressed the induction of EAE symptoms in rats and SJL/J mice, diverted the immune response from Th1 to Th2 and generated antibodies that did not cross react with the native MBP protein. In this study, the linear and cyclic analogs of the MBP87-99 epitope, namely linear (Ala91,Ala96)MBP87-99 (P2) and cyclo(87-99)(Ala91,Ala96)MBP87-99 (P3), were evaluated for their binding to HLA-DR4, stability to lysosomal enzymes, their effect on cytokine secretion by peripheral blood mononuclear cells (PBMC) derived from MS patients or healthy subjects (controls), and their effect in rat EAE. P1 peptide (wild-type, MBP87-99) was used as control. P2 and P3 did not alter significantly the cytokine secretion by control PBMC, in contrast to P1 that induced moderate IL-10 production. In MS PBMC, P2 and P3 induced the production of IL-2 and IFN-γ, with a simultaneous decrease of IL-10, whereas P1 caused a reduction of IL-10 secretion only. The cellular response to P3 indicated that cyclization did not affect the critical TCR contact sites in MS PBMC. Interestingly, the cyclic P3 analog was found to be a stronger binder to HLA-DR4 compared to linear P2. Moreover, cyclic P3 was more stable to proteolysis compared to linear P2. Finally, both P2 and P3 suppressed EAE induced by an encephalitogenic guinea pig MBP74-85 epitope in Lewis rats whereas P1 failed to do so. In conclusion, cyclization of myelin altered peptide ligand (Ala91,Ala96)MBP87-99 improved binding affinity to HLA-DR4, resistance to proteolysis and antigen-specific immunomodulation, rendering cyclo(87-99)(Ala91,Ala96)MBP87-99 an important candidate drug for MS immunotherapy.

Topics: Adolescent; Adult; Aged; Animals; Cell Proliferation; Encephalomyelitis, Autoimmune, Experimental; Female; Humans; Immunotherapy; Leukocytes, Mononuclear; Ligands; Male; Middle Aged; Molecular Structure; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Rats; Rats, Inbred Lew; Young Adult

NADPH oxidase (NOX)-dependent reactive oxygen species (ROS) production in inflammatory cells including microglia plays an important role in demyelination and free radical-mediated tissue injury in multiple sclerosis (MS). However, the mechanism underlying microglial ROS production and demyelination remains largely unknown. The voltage-gated proton channel, Hv1, is selectively expressed in microglia and is required for NOX-dependent ROS generation in the brain. In the present study, we sought to determine the role of microglial Hv1 proton channels in a mouse model of cuprizone-induced demyelination, a model for MS. Following cuprizone exposure, wild-type mice presented obvious demyelination, decreased myelin basic protein expression, loss of mature oligodendrocytes, and impaired motor coordination in comparison to mice on a normal chow diet. However, mice lacking Hv1 (Hv1(-/-) ) are partially protected from demyelination and motor deficits compared with those in wild-type mice. These rescued phenotypes in Hv1(-/-) mice in cuprizone-induced demyelination is accompanied by reduced ROS production, ameliorated microglial activation, increased oligodendrocyte progenitor cell (NG2) proliferation, and increased number of mature oligodendrocytes. These results demonstrate that the Hv1 proton channel is required for cuprizone-induced microglial oxidative damage and subsequent demyelination. Our study suggests that the microglial Hv1 proton channel is a unique target for controlling NOX-dependent ROS production in the pathogenesis of MS.

Topics: Animals; Chelating Agents; Cuprizone; Demyelinating Diseases; Ion Channels; Macrophage Activation; Mice; Mice, Inbred C57BL; Mice, Knockout; Microglia; Multiple Sclerosis; Myelin Basic Protein; NADPH Oxidases; Neural Stem Cells; Oxidative Stress; Postural Balance; Reactive Oxygen Species

Multiple Sclerosis (MS) is a heterogeneous disorder of the central nervous system (CNS) that begins as an inflammatory autoimmune disorder mediated by auto-reactive lymphocyte followed by microglial activation and chronic degeneration. The etiology of Multiple Sclerosis (MS) is unknown but several data support the hypothesis of possible infectious agents which may act as a trigger for the pathogenic cascade. Human endogenous retrovirus (HERV-W/MSRV), Epstein Barr Virus (EBV) and Mycobacterium avium ss. paratuberculosis (MAP) have been associated to Multiple Sclerosis. In this study, we evaluated the humoral response against different peptides: the human endogenous retrovirus HERV-Wenv73-88, MAP106c121-132 from MAP, EBNA1 400-413 from EBV and the homologous human peptide MBP85-98 in a cohort of MS patients treated with natalizumab. Results showed a statistically significant difference in the response against the HERV-W peptide in MS patients after two years of natalizumab treatment.

Topics: Adult; Antibodies; Case-Control Studies; Endogenous Retroviruses; Epstein-Barr Virus Nuclear Antigens; Female; Follow-Up Studies; Gene Products, env; Humans; Immunity, Humoral; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Natalizumab; Oligopeptides; Peptide Fragments; Pregnancy Proteins; Young Adult

Multiple sclerosis (MS) is believed to be initiated by myelin-reactive CD4(+) Th cells. IL-12-polarized Th1 cells, IL-23-polarized Th17 cells, and Th17 cells that acquire Th1 characteristics were each implicated in autoimmune pathogenesis. It is debated whether Th cells that can drive the development of demyelinating lesions are phenotypically diverse or arise from a single lineage. In the current study, we assessed the requirement of IL-12 or IL-23 stimulation, as well as Th plasticity, for the differentiation of T cells capable of inducing CNS axon damage. We found that stable murine Th1 and Th17 cells independently transfer experimental autoimmune encephalomyelitis (widely used as an animal model of MS) in the absence of IL-23 and IL-12, respectively. Plastic Th17 cells are particularly potent mediators of demyelination and axonopathy. In parallel studies, we identified MS patients who consistently mount either IFN-γ- or IL-17-skewed responses to myelin basic protein over the course of a year. Brain magnetic resonance imaging revealed that patients with mixed IFN-γ and IL-17 responses have relatively high T1 lesion burden, a measure of permanent axon damage. Our data challenge the dogma that IL-23 and Th17 plasticity are universally required for the development of experimental autoimmune encephalomyelitis. This study definitively demonstrates that autoimmune demyelinating disease can be driven by distinct Th-polarizing factors and effector subsets, underscoring the importance of a customized approach to the pharmaceutical management of MS.

Topics: Adoptive Transfer; Animals; Autoimmunity; Brain; Cell Differentiation; Demyelinating Diseases; Encephalomyelitis, Autoimmune, Experimental; Humans; Interferon-gamma; Interleukin-12; Interleukin-17; Interleukin-23; Magnetic Resonance Imaging; Mice; Mice, Inbred C57BL; Mice, Knockout; Multiple Sclerosis; Myelin Basic Protein; Optic Nerve; Radiography; Th1 Cells; Th17 Cells

Oligodendrocytes are the myelin-forming cells of the central nervous system (CNS). Failure of myelin development and oligodendrocyte loss results in serious human disorders, including multiple sclerosis. Here, we show that donepezil, an acetlycholinesterase inhibitor developed for the treatment of Alzheimer's disease, can stimulate oligodendrocyte differentiation and maturation of neural stem cell-derived oligodendrocyte progenitor cells without affecting proliferation or cell viability. Transcripts for essential myelin-associated genes, such as PLP, MAG, MBP, CNPase, and MOG, in addition to transcription factors that regulate oligodendrocyte differentiation and myelination, were rapidly increased after treatment with donepezil. Furthermore, luciferase assays confirmed that both MAG and MBP promoters display increased activity upon donepezil-induced oligodendrocytes differentiation, suggesting that donepezil increases myelin gene expression mainly through enhanced transcription. We also found that the increase in the number of oligodendrocytes observed following donepezil treatment was significantly inhibited by the nicotinic acetylcholine receptor (nAChR) antagonist mecamylamine, but not by the muscarinic acetylcholine receptor antagonist scopolamine. Moreover, donepezil-induced myelin-related gene expression was suppressed by mecamylamine at both the mRNA and protein level. These results suggest that donepezil stimulates oligodendrocyte differentiation and myelin-related gene expression via nAChRs in neural stem cell-derived oligodendrocyte progenitor cells. We show that donepezil, a drug for the treatment of Alzheimer disease, can stimulate oligodendrocyte differentiation and maturation of oligodendrocyte progenitor cells. Transcripts for essential myelin-associated genes, such as PLP, MAG, MBP, CNPase and MOG in addition to transcripton factors that regulate oligodendrocyte differentiation and myelination were rapidly increased after treatment with donepezil. These effects were partly dependent on nicotinic acetylcholine receptor (nAChR).

Topics: Animals; Cell Differentiation; Cells, Cultured; Central Nervous System; Donepezil; Female; Gene Expression; Indans; Mice; Multiple Sclerosis; Myelin Basic Protein; Neurogenesis; Oligodendroglia; Piperidines; Receptors, Nicotinic; Stem Cells

MicroRNAs (miR) are small non-coding RNAs involved in the immune response regulation. miR-155 has been attributed a major pro-inflammatory role in the pathogenesis of multiple sclerosis and its animal model experimental autoimmune encephalomyelitis (EAE). Here, a role of miR-155 in re-activation of encephalitogenic CD4(+) T cells was investigated. Dark Agouti rats were immunized with myelin basic protein (MBP) emulsified in complete Freund's adjuvant. CD4(+) T cells were purified from draining lymph node cells (DLNC) obtained in the inductive phase and from spinal cord immune cells (SCIC) isolated at the peak of EAE. CD4(+) T cells obtained from SCIC (i.e., in vivo re-activated cells) had markedly higher expression of miR-155 in comparison to those purified from DLNC (not re-activated). Likewise, in vitro re-activation of DLNC with MBP led to increase in miR-155 expression. Further, DLNC and DLNC CD4(+) T cells were transfected with an inhibitor of miR-155 during in vitro re-activation. As a result, expression of important CD4(+) T cell effector cytokines IFN-γ and IL-17, but not of regulatory cytokines IL-10 and TGF-β, was reduced. These results imply that miR-155 supports re-activation of encephalitogenic CD4(+) T cells. Our results contribute to a view that miR-155 might be a valuable target in multiple sclerosis therapy.

Topics: Animals; CD4-Positive T-Lymphocytes; Cytokines; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Female; Gene Expression Regulation; MicroRNAs; Multiple Sclerosis; Myelin Basic Protein; Rats; Spinal Cord

Multiple sclerosis is the most common autoimmune disorder affecting the central nervous system. In this study, whole blood samples were analyzed for activation capacity and the activatability of CD4+ and CD8+ T-lymphocytes by human total myelin basic protein (MBP), human MBP 104-118 fragment, and guinea pig MBP 68-82 fragment.. Whole blood samples from healthy human subjects were compared with samples from patients with multiple sclerosis (MS). In particular, the expression of CD69, a surface marker of T-lymphocyte activity, was measured via flow cytometry before and after 14 h of incubation with human total MBP, MBP 104-118 fragment and/or guinea pig MBP 68-82 fragment. The results were compared between 15 patients with MS and 15 healthy subjects.. In response to all three MBP forms, CD4+ and CD8+ T-lymphocytes from patients with MS demonstrated greater activatability than those from healthy subjects. These results indicate that in patients with MS, latent pre-activation to MBP epitopes results in an increased activation capacity of T-lymphocytes.. This effect may occur because immunization against MBP (at least in a subset of patients) plays a pathophysiological role in MS pathogenesis. Alternatively, this result may represent a non-specific, bystander autoimmune phenomenon.

Topics: Adult; Animals; Antigens, CD; Antigens, Differentiation, T-Lymphocyte; Case-Control Studies; CD4-Positive T-Lymphocytes; CD8-Positive T-Lymphocytes; Cell Separation; Epitopes; Erythrocytes; Female; Flow Cytometry; Guinea Pigs; Humans; Lectins, C-Type; Lymphocyte Activation; Male; Multiple Sclerosis; Myelin Basic Protein

Multiple sclerosis (MS) is an autoimmune disease of the central nervous system (CNS) characterized by inflammation, demyelination and axonal pathology. Myelin basic protein/proteolipid protein (MBP-PLP) fusion protein MP4 is capable of inducing chronic experimental autoimmune encephalomyelitis (EAE) in susceptible mouse strains mirroring diverse histopathological and immunological hallmarks of MS. Lack of human tissue underscores the importance of animal models to study the pathology of MS.. Twenty-two female C57BL/6 (B6) mice were immunized with MP4 and the clinical development of experimental autoimmune encephalomyelitis (EAE) was observed. Methylene blue-stained semi-thin and ultra-thin sections of the lumbar spinal cord were assessed at the peak of acute EAE, three months (chronic EAE) and six months after onset of EAE (long-term EAE). The extent of lesional area and inflammation were analyzed in semi-thin sections on a light microscopic level. The magnitude of demyelination and axonal damage were determined using electron microscopy. Emphasis was put on the ventrolateral tract (VLT) of the spinal cord.. B6 mice demonstrated increasing demyelination and severe axonal pathology in the course of MP4-induced EAE. Additionally, mitochondrial swelling and a decrease in the nearest neighbor neurofilament distance (NNND) as early signs of axonal damage were evident with the onset of EAE. In semi-thin sections we observed the maximum of lesional area in the chronic state of EAE while inflammation was found to a similar extent in acute and chronic EAE. In contrast to the well-established myelin oligodendrocyte glycoprotein (MOG) model, disease stages of MP4-induced EAE could not be distinguished by assessing the extent of parenchymal edema or the grade of inflammation.. Our results complement our previous ultrastructural studies of B6 EAE models and suggest that B6 mice immunized with different antigens constitute useful instruments to study the diverse histopathological aspects of MS.

Topics: Animals; Axons; Demyelinating Diseases; Disease Models, Animal; Disease Progression; Encephalomyelitis, Autoimmune, Experimental; Female; Humans; Immunization; Lumbar Vertebrae; Mice; Mice, Inbred C57BL; Microtomy; Mitochondria; Mitochondrial Swelling; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Myelin Sheath; Recombinant Fusion Proteins; Severity of Illness Index; Time Factors

The mechanisms triggering most of autoimmune diseases are still obscure. Autoreactive B cells play a crucial role in the development of such pathologies and, in particular, production of autoantibodies of different specificities. The combination of deep-sequencing technology with functional studies of antibodies selected from highly representative immunoglobulin combinatorial libraries may provide unique information on specific features in the repertoires of autoreactive B cells. Here, we have analyzed cross-combinations of the variable regions of human immunoglobulins against the myelin basic protein (MBP) previously selected from a multiple sclerosis (MS)-related scFv phage-display library. On the other hand, we have performed deep sequencing of the sublibraries of scFvs against MBP, Epstein-Barr virus (EBV) latent membrane protein 1 (LMP1), and myelin oligodendrocyte glycoprotein (MOG). Bioinformatics analysis of sequencing data and surface plasmon resonance (SPR) studies have shown that it is the variable fragments of antibody heavy chains that mainly determine both the affinity of antibodies to the parent autoantigen and their cross-reactivity. It is suggested that LMP1-cross-reactive anti-myelin autoantibodies contain heavy chains encoded by certain germline gene segments, which may be a hallmark of the EBV-specific B cell subpopulation involved in MS triggering.

Topics: Autoantibodies; Autoimmune Diseases; Cross Reactions; High-Throughput Nucleotide Sequencing; Humans; Immunoglobulin Heavy Chains; Immunoglobulins; Multiple Sclerosis; Myelin Basic Protein; Myelin-Oligodendrocyte Glycoprotein; Viral Matrix Proteins

Magnetic resonance imaging (MRI) of the brain and spinal cord is the gold standard for assessing disease activity in multiple sclerosis (MS). MRI is an excellent instrument for determination of accumulated damage to the brain and spinal cord, but tells us little about ongoing tissue damage. In this study, biomarkers of oligodendrocyte, axonal and astrocyte injury were related to MRI and clinical findings and used to assess tissue damage in MS.. Cerebrospinal fluid from 44 patients with relapsing-remitting MS, 20 with secondary progressive MS and 15 controls were investigated with ELISA to determine levels of myelin basic protein (MBP), neurofilament light (NFL) and glial fibrillary acidic protein (GFAp). Patients underwent MRI of the brain and spinal cord, and gadolinium enhancing lesions, T1 lesions and T2 lesions were counted.. Patients in clinical relapse and patients with nonsymptomatic gadolinium enhancing lesions had high levels of MBP and NFL, indicating ongoing damage to oligodendrocytes and axons. The level of MBP dropped quickly within a week from the onset of a relapse, whereas NFL remained elevated for several weeks and GFAp slowly rose during the course of a relapse. Relapsing-remitting MS patients without gadolinium enhancing lesions had values of MBP, NFL and GFAp similar to controls, while patients with secondary progressive disease had moderately increased values of all biomarkers.. Analysis of MBP, NFL and GFAp provides direct means to measure tissue damage and is a useful addition to our methods for evaluation of MS.

Topics: Adult; Astrocytes; Biomarkers; Brain; Case-Control Studies; Enzyme-Linked Immunosorbent Assay; Female; Glial Fibrillary Acidic Protein; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Neurofilament Proteins; Oligodendroglia; Spinal Cord

We provide evidence of cortical neuronopathy in myelin oligodendrocyte glycoprotein peptide-induced experimental autoimmune encephalomyelitis, an established model of chronic multiple sclerosis. To investigate phenotypic perturbations in neurons in this model, we used apoptotic markers and immunohistochemistry with antibodies to NeuN and other surrogate markers known to be expressed by adult pyramidal Layer V somas, including annexin V, encephalopsin, and Emx1. We found no consistent evidence of chronic loss of Layer V neurons but detected both reversible and chronic decreases in the expression of these markers in conjunction with evidence of cortical demyelination and presynaptic loss. These phenotypic perturbations were present in, but not restricted to, the neocortical Layer V. We also investigated inflammatory responses in the cortex and subcortical white matter of the corpus callosum and spinal dorsal funiculus and found that those in the cortex and corpus callosum were delayed compared with those in the spinal cord. Inflammatory infiltrates initially included T cells, neutrophils, and Iba1-positive microglia/macrophages in the corpus callosum, whereas only Iba1-positive cells were present in the cortex. These data indicate that we have identified a new temporal pattern of subtle phenotypic perturbations in neocortical neurons in this chronic multiple sclerosis model.

Topics: Animals; Caspase 3; Cell Death; Disease Models, Animal; Encephalitis; Freund's Adjuvant; Humans; In Situ Nick-End Labeling; Male; Mice; Mice, Inbred C57BL; Motor Neurons; Multiple Sclerosis; Myelin Basic Protein; Myelin-Oligodendrocyte Glycoprotein; Neocortex; Peptide Fragments; Phosphopyruvate Hydratase; Synaptophysin; Time Factors

Epstein-Barr virus and Mycobacterium avium subsp. paratuberculosis (MAP) have been associated to multiple sclerosis (MS). We searched for antibodies against the homologous peptides Epstein-Barr virus nuclear antigen 1 (EBNA1)400-413, MAP_0106c protein (MAP)121-132, and myelin basic protein (MBP)85-98 on a MS Sardinian cohort, showing that these antibodies are highly prevalent among MS patients compared to healthy controls. Competitive assay demonstrated that antibodies recognizing EBNA1400-413 and MAP121-132 cross-react with MBP85-98, possibly through a molecular mimicry mechanism. Indeed, the fact that peptides from different pathogens can be cross-recognized by antibodies targeting self-epitopes supports the hypothesis that EBV and MAP might trigger autoimmunity through a common target.

Topics: Adult; Antigens, Viral; Autoantibodies; Autoantigens; Cross Reactions; Enzyme-Linked Immunosorbent Assay; Female; Herpesvirus 4, Human; Humans; Male; Multiple Sclerosis; Mycobacterium avium subsp. paratuberculosis; Myelin Basic Protein; Peptide Fragments

The vast majority of cellular proteins are degraded by the 26S proteasome after their ubiquitination. Here, we report that the major component of the myelin multilayered membrane sheath, myelin basic protein (MBP), is hydrolyzed by the 26S proteasome in a ubiquitin-independent manner both in vitro and in mammalian cells. As a proteasomal substrate, MBP reveals a distinct and physiologically relevant concentration range for ubiquitin-independent proteolysis. Enzymatic deimination prevents hydrolysis of MBP by the proteasome, suggesting that an abnormally basic charge contributes to its susceptibility toward proteasome-mediated degradation. To our knowledge, our data reveal the first case of a pathophysiologically important autoantigen as a ubiquitin-independent substrate of the 26S proteasome.

Topics: Animals; Autoantigens; HEK293 Cells; HeLa Cells; Humans; Mice; Mice, Inbred BALB C; Multiple Sclerosis; Myelin Basic Protein; Proteasome Endopeptidase Complex; Proteolysis; Ubiquitination

Multiple sclerosis (MS) is a chronic inflammatory neurodegenerative disease, considered to be autoimmune in origin. Post-translational modification of central nervous system proteins, including glial fibrillary acidic protein (GFAP) and myelin basic protein (MBP), through citrullination of arginine residues, may lead to exposure of neoepitopes, triggering autoimmunity. Here we investigated the expression of citrullinated proteins in active MS lesions, MS normal appearing white matter and control brain white matter. We demonstrate increased citrullinated GFAP and MBP by immunohistochemistry and western blotting in areas of ongoing demyelination, suggesting a pivotal role for deimination of GFAP and MBP in MS pathogenesis MS.

Topics: Adult; Aged; Aged, 80 and over; Arginine; Astrocytes; Cells, Cultured; Central Nervous System; Endothelial Cells; Female; Glial Fibrillary Acidic Protein; HLA-DR Antigens; Humans; Hydrolases; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin-Oligodendrocyte Glycoprotein; Nerve Fibers, Myelinated; Protein-Arginine Deiminases

To study cerebrospinal fluid and protein indices characterizing the permeability of the hematoencephalitic barrier and intrathecal immunoglobulin synthesis in children with different course and outcome of demyelinating diseases of the central nervous system.. We examined 72 children with demyelinating diseases of the central nervous system and 16 children of a control group (without neuroinfections).. Differences in the concentration of myelin basic protein, immunoglobulin G, albumin and immunoglobulin indices in the cerebrospinal fluid were determined depending on acute, prolonged, chronic course of disseminated encephalitis and multiple sclerosis in children. The maximum value of the immunoglobulin index and the intrathecal immunoglobulin synthesis index was identified in multiple sclerosis. The correlations of cerebrospinal fluid indicators and protein factors in the acute period of demyelinating diseases and the formation of neurologic deficiency in the disease outcome were determined that can be used for prognostic purpose.. The alterations in the indices obtained in this study can be included in the algorithm of laboratory examination. The results prove the involvement of various mechanisms in the pathogenesis of demyelinating diseases of the central nervous system in children.

Topics: Adolescent; Blood-Brain Barrier; Child; Child, Preschool; Encephalomyelitis, Acute Disseminated; Humans; Immunoglobulin G; Infant; Male; Multiple Sclerosis; Myelin Basic Protein

A remarkable pathological difference between grey matter lesions (GML) and white matter lesions (WML) in Multiple Sclerosis (MS) patients is the paucity of infiltrating leukocytes in GML. To better understand these pathological differences, we hypothesize that the chemokine monocyte chemotactic protein-1 (MCP-1 or CCL2), of importance for leukocyte migration, and its receptor CCR2 are more abundantly expressed in WML than in GML of MS patients. To this end, we analyzed CCL2 and CCR2 expression in the hippocampus, comprising WML and GML,of post-mortem MS patients, and of control subjects. CCL2 and CCR2 mRNA were significantly increased in demyelinated MS hippocampus. Semi-quantification of CCL2 and CCR2 immunoreactivity showed that CCL2 is present in astrocytes only in active WML. CCR2 is upregulated in monocytes/macrophages or amoeboid microglia in active WML, and in ramified microglia in active GML, although to a lesser extent. As a follow-up, we observed a significantly increased CCL2 production by WM-, but not GM-derived astrocytes upon stimulation with bz-ATP in vitro. Finally, upon CCL2 stimulation, GM-derived microglia significantly increased their proliferation rate. We conclude that within hippocampal lesions, CCL2 expression is mainly restricted to WML, whereas the receptor CCR2 is upregulated in both WML and GML. The relative absence of CCL2 in GML may explain the lack of infiltrating immune cells in this type of lesions. We propose that the divergent expression of CCL2 and CCR2 in WML and GML explains or contributes to the differences in WML and GML formation in MS.

Topics: Adenosine Triphosphate; Adult; Aged; Animals; Animals, Newborn; Bromodeoxyuridine; Cell Proliferation; Cells, Cultured; Chemokine CCL2; Female; Gene Expression; Gray Matter; Hippocampus; Histocompatibility Antigens Class II; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Neuroglia; Platelet Aggregation Inhibitors; Rats; Rats, Wistar; Receptors, CCR2; White Matter

It was found that antibodies (Abs) against myelin basic protein (MBP) are the major components of the antibody response in multiple sclerosis (MS) patients. We have recently shown that IgGs from sera of MS patients are active in the hydrolysis of MBP. However, in literature there are no available data concerning possible MBP-hydrolyzing Abs in cerebrospinal fluid (CSF) of MS patients. We have shown that the average content of IgGs in their sera is about 195-fold higher than that in their CSF. Here we have compared, for the first time, the average content of lambda- and kappa-IgGs as well as IgGs of four different subclasses (IgG1-IgG4) in CSF and sera of MS patients. The average relative content of lambda-IgGs and kappa -IgGs in the case of CSFs (8.0 and 92.0%) and sera (12.3 and 87.7%) are comparable, while IgG1, IgG2, IgG3, and IgG4: CSF - 40.4, 49.0, 8.2, and 2.5% of total IgGs, respectively and the sera - 53.6, 36.0, 5.6, and 4.8%, decreased in different order. Electrophoretically and immunologically homogeneous IgGs were obtained by sequential affinity chromatography of the CSF proteins on protein G-Sepharose and FPLC gel filtration. We present first evidence showing that IgGs from CSF efficiently hydrolyze MBP and that their average specific catalytic activity is unpredictably ∼54-fold higher than that of Abs from sera of the same MS patients. Some possible reasons of these findings are discussed. We suggest that anti-MBP abzymes of CSF may promote important neuropathologic mechanisms in this chronic inflammatory disorder and in MS pathogenesis development.

Topics: Adult; Autoantibodies; Female; Humans; Hydrolysis; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Young Adult

We recently showed that myelin basic protein (MBP) is hydrolyzed by 26S proteasome without ubiquitination. The previously suggested concept of charge-mediated interaction between MBP and the proteasome led us to attempt to compensate or mimic its positive charge to inhibit proteasomal degradation. We demonstrated that negatively charged actin and calmodulin (CaM), as well as basic histone H1.3, inhibit MBP hydrolysis by competing with the proteasome and MBP, respectively, for binding their counterpart. Interestingly, glatiramer acetate (GA), which is used to treat multiple sclerosis (MS) and is structurally similar to MBP, inhibits intracellular and in vitro proteasome-mediated MBP degradation. Therefore, the data reported in this study may be important for myelin biogenesis in both the normal state and pathophysiological conditions.

Topics: Animals; Autoantigens; Blotting, Western; Cattle; Chickens; Glatiramer Acetate; HEK293 Cells; Humans; Hydrolysis; Mice, Inbred BALB C; Multiple Sclerosis; Myelin Basic Protein; Peptides; Proteasome Endopeptidase Complex; Proteolysis; Sus scrofa; Transfection

B cells may play both pathogenic and protective roles in T-cell mediated autoimmune diseases such as multiple sclerosis (MS). These functions relate to the ability of B cells to bind and present antigens. Under serum-free conditions we observed that 3-4% of circulating B cells from healthy donors were capable of binding the MS-associated self-antigen myelin basic protein (MBP) and of presenting the immunodominant peptide MBP85-99, as determined by staining with the mAb MK16 recognising the peptide presented by HLA-DR15-positive cells. In the presence of serum, however, the majority of B cells bound MBP in a complement-dependent manner, and almost half of the B cells became engaged in presentation of MBP85-99. Even though complement receptor 1 (CR1, CD35) and CR2 (CD21) both contributed to binding of MBP to B cells, only CR2 was important for the subsequent presentation of MBP85-99. A high proportion of MBP85-99 presenting B cells expressed CD27, and showed increased expression of CD86 compared to non-presenting B cells. MBP-pulsed B cells induced a low frequency of IL-10-producing CD4+ T cells in 3 out of 6 donors, indicating an immunoregulatory role of B cells presenting MBP-derived peptides. The mechanisms described here refute the general assumption that B-cell presentation of self-antigens requires uptake via specific B-cell receptors, and may be important for maintenance of tolerance as well as for driving T-cell responses in autoimmune diseases.

Topics: B-Lymphocytes; Cell Proliferation; Cells, Cultured; Humans; Immunodominant Epitopes; Interleukin-10; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; T-Lymphocytes

To define changes in phenotype and functional responses of reconstituting T cells in patients with aggressive multiple sclerosis (MS) treated with ablative chemotherapy and autologous hematopoietic stem cell transplantation (HSCT).. Clinical and brain magnetic resonance imaging measures of disease activity were monitored serially in patients participating in the Canadian MS HSCT Study. Reconstitution kinetics of immune-cell subsets were determined by flow cytometry, whereas thymic function was assessed using T-cell receptor excision circle analyses as well as flow cytometry measurements of CD31+ recent thymic emigrants (RTEs). Functional assays were performed to track central nervous system-autoreactive antigen-specific T-cell responses, and the relative capacity to generate Th1, Th17, or Th1/17 T-cell responses.. Complete abrogation of new clinical relapses and new focal inflammatory brain lesions throughout the 2 years of immune monitoring following treatment was associated with sustained decrease in naive T cells, in spite of restoration of both thymic function and release of RTEs during reconstitution. Re-emergence as well as in vivo expansion of autoreactive T cells to multiple myelin targets was evident in all patients studied. The reconstituted myelin-specific T cells exhibited the same Th1 and Th2 responses as preablation myelin-reactive T cells. In contrast, the post-therapy T-cell repertoire exhibited a significantly diminished capacity for Th17 responses.. Our results indicate that diminished Th17 and Th1/17 responses, rather than Th1 responses, are particularly relevant to the abrogation of new relapsing disease activity observed in this cohort of patients with aggressive MS following chemoablation and HSCT.

Topics: Adult; Antigens, CD; Cell Movement; Cell Proliferation; Cytokines; Female; Flow Cytometry; Follow-Up Studies; Glatiramer Acetate; Hematopoietic Stem Cell Transplantation; Humans; Immunosuppressive Agents; Lymphocyte Activation; Lymphocyte Count; Lymphokines; Male; Multiple Sclerosis; Myelin Basic Protein; Myelin-Oligodendrocyte Glycoprotein; Peptides; Th1 Cells; Th17 Cells

A novel highly sensitive impedimetric Myelin Basic Protein (MBP) immunosensor for the determination of a Multiple Sclerosis (MS) autoantibody, Anti-Myelin Basic Protein (Anti-MBP) was developed by immobilization of MBP on Gelatin and Gelatin-Titanium Dioxide (TiO₂) modified platinium electrode. Cyclic voltammetric (CV) and Electrochemical Impedance Spectroscopic (EIS) methods were employed in determination of the electrode responses and applicability. Gelatin-MBP and gelatin-TiO₂-MBP electrodes were prepared by chemical immobilization of the substrates onto the platinium electrodes. The formal potentials of MBP confined on gelatin-MBP and gelatin-TiO₂-MBP surfaces are estimated to be 195 and 205 mV, respectively. Thus, a little more reversible electron transfer reaction occurs on the gelatin-TiO₂-MBP immunosensor surface. The peak separations of MBP (150 mV and 110 mV s(-1) at 100 mV s(-1)) and the asymmetric anodic and cathodic peak currents indicate that the electron transfer between Anti-MBP and gelatin-MBP/gelatin-TiO₂-MBP immunosensor is quasireversible. Control samples containing a nonspecific human immunoglobulin G (hIgG) antibody were also studied, and calibration curves were obtained by subtraction of the responses for specific and nonspecific antibody-based sensors. Gelatin-MBP and gelatin-TiO₂-MBP immunosensors have detection limit of 0.1528 ng ml(-1) and 0.1495 ng ml(-1) respectively. This immunosensor exhibits high sensitivity and low response times (58 s for gelatin-MBP and 46 s for gelatin-TiO₂-MBP immunosensor). The developed label-free impedimetric immunosensors also provide a simple and sensitive detection method for the specific determination of Anti-MBP in human cerebrospinal fluid (CSF) and serum samples.

Topics: Antibodies, Immobilized; Biosensing Techniques; Dielectric Spectroscopy; Electrodes; Gelatin; Humans; Immunoassay; Limit of Detection; Multiple Sclerosis; Myelin Basic Protein; Nanoparticles; Reproducibility of Results; Titanium

Sardinia is a major Island in the Mediterranean with a high incidence of multiple sclerosis, a chronic autoimmune inflammatory disease of the central nervous system. Disease susceptibility in Sardinian population has been associated with five alleles of major histocompatibility complex (MHC) class II DRB1 gene. We performed 120 ns of molecular dynamics simulation on one predisposing and one protective alleles, unbound and in complex with the two relevant peptides: Myelin Basic Protein and Epstein Barr Virus derived peptide. In particular we focused on the MHC peptide binding groove dynamics. The predisposing allele was found to form a stable complex with both the peptides, while the protective allele displayed stability only when bound with myelin peptide. The local flexibility of the MHC was probed dividing the binding groove into four compartments covering the well known peptide anchoring pockets. The predisposing allele in the first half cleft exhibits a narrower and more rigid groove conformation in the presence of myelin peptide. The protective allele shows a similar behavior, while in the second half cleft it displays a narrower and more flexible groove conformation in the presence of viral peptide. We further characterized these dynamical differences by evaluating H-bonds, hydrophobic and stacking interaction networks, finding striking similarities with super-type patterns emerging in other autoimmune diseases. The protective allele shows a defined preferential binding to myelin peptide, as confirmed by binding free energy calculations. All together, we believe the presented molecular analysis could help to design experimental assays, supports the molecular mimicry hypothesis and suggests that propensity to multiple sclerosis in Sardinia could be partly linked to distinct peptide-MHC interaction and binding characteristics of the antigen presentation mechanism.

Topics: Alleles; Genetic Predisposition to Disease; Herpesvirus 4, Human; HLA-DR2 Antigen; Humans; Italy; Molecular Dynamics Simulation; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Protein Binding; Protein Structure, Tertiary

The efficacy of cannabinoids in the treatment of multiple sclerosis is widely documented; however their use is limited by psychoactivity mainly ascribed to the activation of the cannabinoid receptor CB1. Emerging findings support as alternative strategy in the treatment of neurodegenerative disorders, the application of compounds targeting the CB2 receptor, since likely unrelated to these side effects. Recently, a novel class of compounds, 1,8-naphthyridine, pyridine and quinoline derivatives have been demonstrated to show high CB2 receptor selectivity and affinity versus the CB1 receptor. Considering that the CB2 receptor is mainly expressed in cell and organs of the immune system, in this study we assessed the potential immune-modulatory effects of these compounds in activated lymphocytes isolated from MS patients with respect to healthy controls. These compounds blocked cell proliferation through a mechanism partially ascribed to the CB2 receptor, down-regulated TNF-α production and did not induce cell death. They also down-regulated Akt, Erk and NF-kB phosphorylation. Despite comparable effects observed in patients and healthy controls, these compounds, in particular, 1,8-naphthyridine and quinoline derivatives inhibited cell activation markers in MS patient derived lymphocytes more efficiently than in healthy control derived cells. Indeed, 1,8-naphthyridin-2-one derivative reduced the levels of Cox-2 in lymphocytes from patients whereas no effect was observed in control cells. Our findings suggest potential application of these drugs in neuro-inflammation, supporting further investigations of the effects of compounds in the therapy of MS, particularly on the aspects regarding activation and inflammation.

Topics: Anti-Inflammatory Agents; Antigens, CD; Antigens, Differentiation, T-Lymphocyte; Cell Proliferation; Cell Survival; Cells, Cultured; Cyclooxygenase 2; Extracellular Signal-Regulated MAP Kinases; Female; Gene Expression; Humans; Immunosuppressive Agents; Intercellular Adhesion Molecule-1; Lectins, C-Type; Lymphocyte Activation; Multiple Sclerosis; Myelin Basic Protein; Naphthyridines; NF-kappa B; Proto-Oncogene Proteins c-akt; Pyridones; Quinolones; Receptor, Cannabinoid, CB2; T-Lymphocytes; Tumor Necrosis Factor-alpha

Multiple sclerosis (MS) is characterized by the presence of inflammatory demyelinating foci throughout the brain and spinal cord, accompanied by axonal and neuronal damage. Although inflammatory processes are thought to underlie the pathological changes, the individual mediators of this damage are unclear. In order to study the role of pro-inflammatory cytokines in demyelination in the central nervous system, we have utilized a hyperbranched poly(2-dimethyl-aminoethylmethacrylate) based non-viral gene transfection system to establish an inflammatory demyelinating model of MS in an ex-vivo environment. The synthesized non-viral gene transfection system was optimized for efficient transfection with minimal cytotoxicity. Organotypic brain slices were then successfully transfected with the TNF or IFNγ genes. TNF and IFNγ expression and release in cerebellar slices via non-viral gene delivery approach resulted in inflammation mediated myelin loss, thus making it a promising ex-vivo approach for studying the underlying mechanisms of demyelination in myelin-related diseases such as MS.

Topics: Animals; Cerebral Cortex; Demyelinating Diseases; Humans; Inflammation; Interferon-gamma; Methacrylates; Models, Biological; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Neurofilament Proteins; Polymers; Rats; Rats, Sprague-Dawley; Transfection; Tumor Necrosis Factor-alpha

The role of CD8⁺ T cells in multiple sclerosis (MS) and experimental autoimmune encephalomyelitis (EAE) is still unclear. We describe here significantly reduced disease activity of EAE both in Lewis rats depleted of CD8⁺ T cells by monoclonal antibodies and CD8 knockout rats, which was accompanied by reduced leukocyte infiltration into the spinal cord. We detected myelin basic protein (MBP)-specific CD8⁺ T cells in peripheral lymphoid organs of CD8-depleted animals which, however, failed to differentiate into interferon-γ-producing effector cells. Our results indicate that CD8⁺ T cells interact with myelin-specific CD8⁺ T cells early in EAE enabling them to differentiate into pathogenic effector cells.

Topics: Animals; CD8-Positive T-Lymphocytes; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Female; Flow Cytometry; Immunization; Interferon-gamma; Leukocyte Reduction Procedures; Male; Multiple Sclerosis; Myelin Basic Protein; Rats; Rats, Inbred Lew; Rats, Mutant Strains; Spinal Cord

Studies of MS histopathology are largely dependent on suitable animal models. While light microscopic analysis gives an overview of tissue pathology, it falls short in evaluating detailed changes in nerve fiber morphology. The ultrastructural data presented here and obtained from studies of myelin oligodendrocyte glycoprotein (MOG):35-55-induced experimental autoimmune encephalomyelitis (EAE) in C57BL/6 mice delineate that axonal damage and myelin pathology follow different kinetics in the disease course. While myelin pathology accumulated with disease progression, axonal damage coincided with the initial clinical disease symptoms and remained stable over time. This pattern applied both to irreversible axolysis and early axonal pathology. Notably, these histopathological patterns were reflected by the normal-appearing white matter (NAWM), suggesting that the NAWM is also in an active neurodegenerative state. The data underline the need for neuroprotection in MS and suggest the MOG model as a highly valuable tool for the assessment of different therapeutic strategies.

Topics: Animals; Axons; Encephalomyelitis, Autoimmune, Experimental; Female; Kinetics; Lumbar Vertebrae; Mice; Mice, Inbred C57BL; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Myelin Sheath; Myelin-Oligodendrocyte Glycoprotein; Peptide Fragments; Recombinant Fusion Proteins; Spinal Cord

We have previously demonstrated that Sox17 expression is prominent at developmental stages corresponding to oligodendrocyte progenitor cell (OPC) cycle exit and onset of differentiation, and that Sox17 promotes initiation of OPC differentiation. In this study, we examined Sox17 expression and regulation under pathological conditions, particularly in two animal models of demyelination/remyelination and in post-mortem multiple sclerosis (MS) brain lesions. We found that the number of Sox17 expressing cells was significantly increased in lysolecithin (LPC)-induced lesions of the mouse spinal cord between 7 and 30 days post-injection, as compared with controls. Sox17 immunoreactivity was predominantly detected in Olig2(+) and CC1(+) oligodendrocytes and rarely in NG2(+) OPCs. The highest density of Sox17(+) oligodendrocytes was observed at 2 weeks after LPC injection, coinciding with OPC differentiation. Consistent with these findings, in cuprizone-treated mice, Sox17 expression was highest in newly generated and in maturing CC1(+) oligodendrocytes, but low in NG2(+) OPCs during the demyelination and remyelination phases. In MS tissue, Sox17 was primarily detected in actively demyelinating lesions and periplaque white matter. Sox17 immunoreactivity was co-localized with NOGO-A+ post-mitotic oligodendrocytes both in active MS lesions and periplaque white matter. Taken together, our data: (i) demonstrate that Sox17 expression is highest in newly generated oligodendrocytes under pathological conditions and could be used as a marker of oligodendrocyte regeneration, and (ii) are suggestive of Sox17 playing a critical role in oligodendrocyte differentiation and lesion repair.

Topics: Aged; Animals; Antigens; Autophagy-Related Proteins; Basic Helix-Loop-Helix Transcription Factors; Brain; Bromodeoxyuridine; Cuprizone; Demyelinating Diseases; Disease Models, Animal; Female; Humans; Intracellular Signaling Peptides and Proteins; Leukocyte Common Antigens; Lipopolysaccharides; Male; Mice; Mice, Inbred C57BL; Middle Aged; Monoamine Oxidase Inhibitors; Multiple Sclerosis; Myelin Basic Protein; Nerve Tissue Proteins; Oligodendrocyte Transcription Factor 2; Oligodendroglia; Proteoglycans; SOXF Transcription Factors; Time Factors; Up-Regulation

The strong association of HLA-DR2b (DRB1*1501) with multiple sclerosis (MS) suggests this molecule as prime target for specific immunotherapy. Inhibition of HLA-DR2b-restricted myelin-specific T cells has the potential to selectively prevent CNS pathology mediated by these MHC molecules without undesired global immunosuppression. In this study, we report development of a highly selective small molecule inhibitor of peptide binding and presentation by HLA-DR2b. PV-267, the candidate molecule used in these studies, inhibited cytokine production and proliferation of myelin-specific HLA-DR2b-restricted T cells. PV-267 had no significant effect on T cell responses mediated by other MHC class II molecules, including HLA-DR1, -DR4, or -DR9. Importantly, PV-267 did not induce nonspecific immune activation of human PBMC. Lastly, PV-267 showed treatment efficacy both in preventing experimental autoimmune encephalomyelitis and in treating established disease. The results suggest that blocking the MS-associated HLA-DR2b allele with small molecule inhibitors may be a promising therapeutic strategy for the treatment of MS.

Topics: Animals; Cell Proliferation; Cells, Cultured; Encephalomyelitis, Autoimmune, Experimental; HLA-DR2 Antigen; Humans; Leukocytes, Mononuclear; Lymphocyte Activation; Mice; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Peptides; T-Lymphocytes

Self-reactive CD4 T cells are thought to have a central role in the pathogenesis of many chronic inflammatory human diseases. Microbial peptides can activate self-reactive T cells, but the structural basis for such crossreactivity is not well understood. The Hy.1B11 T cell receptor (TCR) originates from a patient with multiple sclerosis and recognizes the self-antigen myelin basic protein. Here we report the structural mechanism of TCR crossreactivity with two distinct peptides from human pathogens. The structures show that a single TCR residue (CDR3α F95) makes the majority of contacts with the self-peptide and both microbial peptides (66.7-80.6%) due to a highly tilted TCR-binding topology on the peptide-MHC surface. Further, a neighbouring residue located on the same TCR loop (CDR3α E98) forms an energetically critical interaction with the MHC molecule. These data show how binding by a self-reactive TCR favors crossreactivity between self and microbial antigens.

Topics: Amino Acid Sequence; Autoantigens; Autoimmunity; Bacterial Proteins; Binding Sites; CD4-Positive T-Lymphocytes; Cross Reactions; Crystallography, X-Ray; Humans; Models, Molecular; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Protein Binding; Protein Structure, Secondary; Protein Structure, Tertiary; Pseudomonas aeruginosa; Receptors, Antigen, T-Cell; Sequence Alignment; Sequence Homology, Amino Acid; Simplexvirus; Viral Proteins

Activation of signal transducer and activator of transcription 3 (STAT3) by phosphorylation is thought to mediate anti-inflammatory responses to CNS injury. Several studies have reported an increase in phosphorylated STAT3 (pSTAT3) in peripheral T cells and monocytes from patients with multiple sclerosis (MS) during relapses, suggesting that pSTAT3 might represent an inflammatory marker. Here, we examined immunoreactivity for pSTAT3 in brain tissue samples from MS patients and controls. Phosphorylated STAT3 immunoreactivity was sparse within lesions, with no difference between active and inactive lesions. It was, however, significantly greater in white matter (WM) adjacent to active and inactive lesions; moreover, it was significantly greater in WM adjacent to active versus inactive lesions. Phosphorylated STAT3-positive cells were identified as astrocytes and macrophages/microglia. Phosphorylated STAT3 expression was also detected by Western blotting in WM of patients with MS. In comparison, pSTAT3 immunoreactivity was either rare or found focally in brain tissue samples from patients with other neurologic diseases. Our findings show that pSTAT3 does not correlate with inflammatory activity in MS lesions, but that it may play an important role in regulating reactive changes proximal to MS lesions.

Topics: Adolescent; Adult; Aged; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Brain; Calcium-Binding Proteins; DNA-Binding Proteins; Female; Gene Expression Regulation; Humans; Male; Microfilament Proteins; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Nerve Tissue Proteins; Neuroglia; Neurons; Phosphorylation; Postmortem Changes; Signal Transduction; STAT3 Transcription Factor; Young Adult

Multiple sclerosis (MS) is an autoimmune disease of the central nervous system, characterized by demyelination of white matter, loss of myelin forming oligodendrocytes, changes in the blood-brain barrier (BBB) and leucocyte infiltration. Myelin basic protein (MBP) is a component of the myelin sheath. Degradation of myelin is believed to be an important step that leads to MS pathology. Transmigration of leucocytes across the vasculature, and a compromised BBB participate in the neuroinflammation of MS. We examined the expression and regulation of the chemokine (C-C motif) ligand 2 (CCL2) and the cytokine interleukin-6 (IL-6) in human endothelial cells (EC), a component of the BBB, after treatment with MBP.. EC were treated with full-length MBP. CCL2 and IL-6 protein were determined by ELISA. Western blot analysis was used to determine signalling pathways. A BBB model was treated with MBP and permeability was assayed using albumin conjugated to Evan's blue dye. The levels of the tight junction proteins occludin and claudin-1, and matrix metalloprotease (MMP)-2 were assayed by Western blot.. MBP significantly induced CCL2 and IL-6 protein from EC. This induction was partially mediated by the p38 MAPK pathway as there was phosphorylation after MBP treatment. MBP treatment of a BBB model caused an increase in permeability that correlated with a decrease in occludin and claudin-1, and an induction of MMP2.. These data demonstrate that MBP induces chemotactic and inflammatory mediators. MBP also alters BBB permeability and tight junction expression, indicating additional factors that may contribute to the BBB breakdown characteristic of MS.

Topics: Blood-Brain Barrier; Blotting, Western; Capillary Permeability; Chemokine CCL2; Endothelial Cells; Enzyme-Linked Immunosorbent Assay; Humans; Interleukin-6; Multiple Sclerosis; Myelin Basic Protein

Modulation of autoimmune inflammation by the thymic peptides thymulin and thymopentin was studied in mice with acute experimental autoimmune encephalomyelitis (EAE), which resembles multiple sclerosis in humans. EAE was induced in NZW mice by a single immunisation with myelin basic protein coupled with adjuvants. Visible signs of pathology appeared on days 12-14 after the immunisation, peaked on days 20-25, were retained up to day 45, and then reverted. A biphasic cytokine response was also detected. In the "early" phase, which started at day 35, increased levels of interferon-gamma and interleukin-6 in the blood were observed; during the "delayed" phase, which started at day 48, the levels of plasma interleukin-17 and tumour necrosis factor-alpha were also raised. In addition, the phosphorylation of NF-kappaB signalling proteins and the production of heat shock protein Hsp72 were significantly increased in splenic lymphocytes from EAE-bearing mice. When applied intraperitoneally every other day for 30 days, either thymulin or thymopentin (15 μg per 100g of body weight) significantly reduced the disease severity compared to untreated EAE mice. The effect of thymulin but not thymopentin remained after its withdrawal. Thymulin reduced the cytokine response in both the early and the delayed phases, whereas thymopentin only reduced the "early phase cytokines" (IL-6 and interferon-gamma). Both peptides significantly reduced the level of phosphorylation of the NF-kappaB signalling protein IKK and the production of Hsp72 protein. The data presented here indicate the presence of time-dependent immune responses in EAE-bearing mice, which may be associated with the Th1 and Th17 subpopulations of T-cells. Thymulin and thymopentin demonstrated different patterns of activity, most likely via mechanisms involved in NF-kappa B signalling and Hsp72 expression.

Topics: Animals; Cells, Cultured; Cytokines; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; HSP72 Heat-Shock Proteins; Humans; Male; Mice; Mice, Inbred Strains; Multiple Sclerosis; Myelin Basic Protein; NF-kappa B; Th1 Cells; Th17 Cells; Thymic Factor, Circulating; Thymopoietins; Thymus Gland

Multiple sclerosis (MS) is an inflammatory and demyelinating disease of the central nervous system (CNS). Myelin oligodendrocyte glycoprotein (MOG) and myelin oligodendrocyte basic protein (MOBP) were both shown to be highly encephalitogenic in animal models of MS. In contrast, the association of MOG- and MOBP-specific humoral or cellular immune responses and MS in humans is far less established. In this study, we sought to analyse MOG- and MOBP-specific T-cell responses in a large cohort of patients with various stages of the disease. Patients with other neurological diseases and healthy subjects were enrolled to serve as control study subjects. We determined the proliferation and the secretion of IFN-γ secretion in our cohort. We found that MOG-specific T-cell responses were higher and more frequent as compared to MOBP-specific ones. However, both MS patients and control study subjects had similar myelin-specific T-cell responses at the periphery, thus calling for more precise studies at CNS level.

Topics: Adult; Aged; Cytokines; Enzyme-Linked Immunosorbent Assay; Female; Humans; Immunity, Cellular; Interferon-gamma; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Myelin-Oligodendrocyte Glycoprotein; Statistics, Nonparametric; T-Lymphocytes

Myelin presentation to T cells in the central nervous system (CNS) sustains inflammation in multiple sclerosis (MS). CD4(+) and CD8(+) T cells contribute to MS, but only cells that present myelin to CD4(+) T cells have been identified. We show that MHC class I-restricted myelin basic protein (MBP) was presented by oligodendrocytes and cross-presented by Tip-dendritic cells (DCs) during experimental autoimmune encephalomyelitis (EAE), an animal model of MS initiated by CD4(+) T cells. Tip-DCs activated naive and effector CD8(+) T cells ex vivo, and naive MBP-specific CD8(+) T cells were activated in the CNS during CD4(+) T cell-induced EAE. These results demonstrate that CD4(+) T cell-mediated CNS autoimmunity leads to determinant spreading to myelin-specific CD8(+) T cells that can directly recognize oligodendrocytes.

Topics: Animals; Antigen Presentation; Autoimmunity; CD11c Antigen; CD4-Positive T-Lymphocytes; CD8-Positive T-Lymphocytes; Cell Differentiation; Central Nervous System; Cross-Priming; Dendritic Cells; Encephalomyelitis, Autoimmune, Experimental; Epitopes; Lymphocyte Activation; Mice; Mice, Inbred C3H; Mice, Transgenic; Monocytes; Multiple Sclerosis; Myelin Basic Protein; Oligodendroglia

High intrathecal levels of anti-myelin basic protein (MBP) IgM were previously found to be significantly associated with early favorable course in a cohort of patients with multiple sclerosis (MS). A mAb to MBP 105-120 recognizing the 222-228 epitope of the extracellular domain of high affinity immunoglobulin gamma Fc-receptor I (CD64) was isolated from EBV(+) B cell clones of long-term stable RRMS patients. This mAb exerted immunosuppressive activity on MS-derived T cell lines through induction and release of high amounts of interleukin-10 and decreased levels of interleukin-12 from activated monocytes providing the biological basis for a potential new treatment for MS and other immune-mediated neurological disorders.

Topics: Adult; Antibodies, Monoclonal; B-Lymphocytes; Cell Line; Cell Proliferation; Cohort Studies; Cytokines; DNA-Binding Proteins; Enzyme-Linked Immunosorbent Assay; Epitope Mapping; Female; Flow Cytometry; Humans; Immunoglobulin G; Immunoglobulin M; Immunoprecipitation; Immunosuppressive Agents; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin-Oligodendrocyte Glycoprotein; Peptides; Receptors, IgG; RNA, Messenger; Statistics, Nonparametric; T-Lymphocytes; Transcription Factors; Transfection

Peptidylarginine deiminase 2 (PAD2) and peptidylarginine deiminase 4 (PAD4) are two members of PAD family which are over-expressed in the multiple sclerosis (MS) brain. Through its enzymatic activity PAD2 converts myelin basic protein (MBP) arginines into citrullines - an event that may favour autoimmunity - while peptidylarginine deiminase 4 (PAD4) is involved in chromatin remodelling.. Our aim was to verify whether an altered epigenetic control of PAD2, as already shown in the MS brain, can be observed in peripheral blood mononuclear cells (PBMCs) of patients with MS since some of these cells also synthesize MBP.. The expression of most suitable reference genes and of PAD2 and PAD4 was assessed by qPCR. Analysis of DNA methylation was performed by bisulfite method.. The comparison of PAD2 expression level in PBMCs from patients with MS vs. healthy donors showed that, as well as in the white matter of MS patients, the enzyme is significantly upregulated in affected subjects. Methylation pattern analysis of a CpG island located in the PAD2 promoter showed that over-expression is associated with promoter demethylation.. Defective regulation of PAD2 in the periphery, without the immunological shelter of the blood-brain barrier, may contribute to the development of the autoimmune responses in MS.

Topics: Adult; Brain; CpG Islands; DNA Methylation; Female; Humans; Hydrolases; Leukocytes, Mononuclear; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Protein-Arginine Deiminase Type 2; Protein-Arginine Deiminases; Up-Regulation

Neuroaxonal degeneration is a pathological hallmark of multiple sclerosis (MS) contributing to irreversible neurological disability. Pathological mechanisms leading to axonal damage include autoimmunity to neuronal antigens. In actively demyelinating lesions, myelin is phagocytosed by microglia and blood-borne macrophages, whereas the fate of degenerating or damaged axons is unclear. Phagocytosis is essential for clearing neuronal debris to allow repair and regeneration. However, phagocytosis may lead to antigen presentation and autoimmunity, as has been described for neuroaxonal antigens. Despite this notion, it is unknown whether phagocytosis of neuronal antigens occurs in MS. Here, we show using novel, well-characterized antibodies to axonal antigens, that axonal damage is associated with HLA-DR expressing microglia/macrophages engulfing axonal bulbs, indicative of axonal damage. Neuronal proteins were frequently observed inside HLA-DR(+) cells in areas of axonal damage. In vitro, phagocytosis of neurofilament light (NF-L), present in white and gray matter, was observed in human microglia. The number of NF-L or myelin basic protein (MBP) positive cells was quantified using the mouse macrophage cell line J774.2. Intracellular colocalization of NF-L with the lysosomal membrane protein LAMP1 was observed using confocal microscopy confirming that NF-L is taken up and degraded by the cell. In vivo, NF-L and MBP was observed in cerebrospinal fluid cells from patients with MS, suggesting neuronal debris is drained by this route after axonal damage. In summary, neuroaxonal debris is engulfed, phagocytosed, and degraded by HLA-DR(+) cells. Although uptake is essential for clearing neuronal debris, phagocytic cells could also play a role in augmenting autoimmunity to neuronal antigens.

Topics: Adult; Aged; Aged, 80 and over; Animals; Cathepsin D; Cathepsins; Cells, Cultured; Dose-Response Relationship, Drug; Female; HLA-DR Antigens; Humans; Male; Mice; Microglia; Microscopy, Confocal; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Nerve Fibers, Myelinated; Neurofilament Proteins; Neurons; Phagocytosis; Time Factors

Multiple sclerosis (MS) varies considerably in its incidence and progression in females and males. In spite of clinical evidence, relatively few studies have explored molecular mechanisms possibly involved in gender-related differences. The present study describes possible cellular- and molecular-involved markers which are differentially regulated in male and female rats and result in gender-dependent EAE evolution and progression. Attention was focused on markers of myelination (MBP and PDGFαR) and neuronal distress and/or damage (GABA synthesis enzymes, GAD65 and GAD67, NGF, BDNF and related receptors), in two CNS areas, i.e. spinal cord and cerebellum, which are respectively severely and mildly affected by inflammation and demyelination. Tissues were sampled during acute, relapse/remission and chronic phases and results were analysed by two-way ANOVA.. 1. A strong gender-dependent difference in myelin (MBP) and myelin precursor (PDGFαR) marker mRNA expression levels is observed in control animals in the spinal cord, but not in the cerebellum. This is the only gender-dependent difference in the expression level of the indicated markers in healthy animals; 2. both PDGFαR and MBP mRNAs in the spinal cord and MBP in the cerebellum are down-regulated during EAE in gender-dependent manner; 3. in the cerebellum, the expression profile of neuron-associated markers (GAD65, GAD67) is characterized by a substantial down-regulation during the inflammatory phase of the disease, which does not differ between male and female rats (two-way ANOVA); 4. there is an up-regulation of NGF, trkA and p75 mRNA expression in the early phases of the disease (14 and 21 days post-immunization), which is not different between male and female.. It is reported herein that the regulation of markers involved in demyelination and neuroprotection processes occurring during EAE, a well-established MS animal model, is gender- and time-dependent. These findings might contribute to gender- and phase disease-based therapy strategies.

Topics: Analysis of Variance; Animals; Cerebellum; Disease Models, Animal; Female; Freund's Adjuvant; Gene Expression Regulation; Glutamate Decarboxylase; Male; Multiple Sclerosis; Myelin Basic Protein; Nerve Tissue Proteins; Neurodegenerative Diseases; Polysaccharides; Rats; Receptor, Platelet-Derived Growth Factor alpha; RNA, Messenger; Sex Characteristics; Spinal Cord

Electromagnetic fields (EMFs) may affect the endogenous neural stem cells within the brain. The aim of this study was to assess the effects of EMFs on the process of toxin-induced demyelination and subsequent remyelination. Demyelination was induced using local injection of lysophosphatidylcholine within the corpus callosum of adult female Sprague-Dawley rats. EMFs (60 Hz; 0.7 mT) were applied for 2 h twice a day for 7, 14, or 28 days postlesion. BrdU labeling and immunostaining against nestin, myelin basic protein (MBP), and BrdU were used for assessing the amount of neural stem cells within the tissue, remyelination patterns, and tracing of proliferating cells, respectively. EMFs significantly reduced the extent of demyelinated area and increased the level of MBP staining within the lesion area on days 14 and 28 postlesion. EMFs also increased the number of BrdU- and nestin-positive cells within the area between SVZ and lesion as observed on days 7 and 14 postlesion. It seems that EMF potentiates proliferation and migration of neural stem cells and enhances the repair of myelin in the context of demyelinating conditions.

Topics: Animals; Bromodeoxyuridine; Cell Movement; Cell Proliferation; Corpus Callosum; Disease Models, Animal; Electric Stimulation Therapy; Female; Intermediate Filament Proteins; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Nerve Degeneration; Nerve Regeneration; Nerve Tissue Proteins; Nestin; Neural Stem Cells; Rats; Rats, Sprague-Dawley; Stem Cell Niche; Transcranial Magnetic Stimulation

Opticospinal demyelinating diseases in humans are mostly characterized by the opticospinal form of multiple sclerosis (MS) and neuromyelitis optica (NMO). Increasing attention has recently focused on astrocyte markers, aquaporin-4 (AQP4) and glial fibrillary acidic protein (GFAP) in these diseases. We induced opticospinal demyelination in Brown Norway rats with soluble recombinant rat myelin oligodendrocyte glycoprotein (1-116) and incomplete Freund's adjuvant. Clinical, MRI, neuropathological and immunological evaluations were performed, with a focus on AQP4 and GFAP. We confirmed the opticospinal phenotype, including extensive myelitis, but also showed the MRI-characterized involvement of the periventricular area. Expression levels of myelin, AQP4 and GFAP showed the early involvement of astrocytes before demyelination in the optic nerve. The overexpression of AQP4 was particularly pronounced in the spinal cord and was concomitant with demyelination and astrocyte apoptosis. The disability scores were correlated with demyelination and inflammation but not with AQP4/GFAP expression. No antibodies against the linear and conformational epitopes of AQP4 were detected. Whereas a NMO-like phenotype was observed in this model, the AQP4/GFAP expression during the disease process was more closely related to opticospinal MS than NMO. However, this model raises the question of a continuum between opticospinal MS and the seronegative NMO subtype.

Topics: Animals; Aquaporin 4; Disease Models, Animal; Encephalitis; Encephalomyelitis, Autoimmune, Experimental; Enzyme-Linked Immunosorbent Assay; Female; Gene Expression Regulation; Glial Fibrillary Acidic Protein; Magnetic Resonance Imaging; Multiple Sclerosis; Myelin Basic Protein; Myelin-Oligodendrocyte Glycoprotein; Neuromyelitis Optica; Optic Nerve; Peptide Fragments; Rats; Spinal Cord; Statistics, Nonparametric; Time Factors

Oligodendroglial Myelin Basic Protein (MBP) synthesis is essential for myelin formation in the central nervous system. During oligodendrocyte differentiation, MBP mRNA is kept in a translationally silenced state while intracellularly transported, until neuron-derived signals initiate localized MBP translation. Here we identify the small non-coding RNA 715 (sncRNA715) as an inhibitor of MBP translation. SncRNA715 localizes to cytoplasmic granular structures and associates with MBP mRNA transport granule components. We also detect increased levels of sncRNA715 in demyelinated chronic human multiple sclerosis lesions, which contain MBP mRNA but lack MBP protein.

Topics: Animals; Brain; Cell Line; Cytoplasmic Granules; Gene Expression Regulation; Humans; Mice; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Oligodendroglia; Protein Biosynthesis; Rats; RNA, Messenger; RNA, Small Untranslated

In contrast to canonical proteases, myelin basic protein (MBP)-Sepharose-purified IgG from multiple sclerosis (MS) and systemic lupus erythematosus (SLE) patients efficiently hydrolyze only MBP, but not many other tested proteins. It was shown that anti-MBP SLE IgGs cleave nonspecific tri- and tetrapeptides with an extremely low efficiency and cannot efficiently hydrolyse longer oligopeptides corresponding to antigenic determinants (AGDs) of HIV-1 integrase. To identify all sites of IgG-mediated proteolysis corresponding to two AGDs of MBP, we have used a combination of reverse-phase chromatography (RPhC), MALDI spectrometry, and TLC to analyze the cleavage products of two (17- and 19-mer) encephalytogenic oligopeptides corresponding to these AGDs. Both oligopeptides contained several clustered major and minor sites of cleavage. The active sites of anti-MBP abzymes are localized on their light chains, while the heavy chains are responsible for the affinity of protein substrates. Interactions of intact globular proteins with both light and heavy chains of abzymes provide high specificity of MBP hydrolysis. The affinity of anti-MBP abzymes for intact MBP was ∼10(3)-fold higher than for the oligopeptides. The data suggest that both oligopeptides interact mainly with the light chain of different monoclonal abzymes of total pool of IgGs, which possesses lower affinity for substrates, and therefore, depending on the oligopeptide sequences, their hydrolysis may be less specific.

Topics: Amino Acid Sequence; Antibodies, Catalytic; Humans; Immunoglobulin G; Kinetics; Lupus Erythematosus, Systemic; Molecular Sequence Data; Molecular Weight; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Proteolysis; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

Multiple sclerosis (MS) is a neuroinflammatory disease characterized by a progressive loss of myelin and a failure of oligodendrocyte (OL)-mediated remyelination, particularly in the progressive phases of the disease. An improved understanding of the signaling mechanisms that control differentiation of OL precursors may lead to the identification of new therapeutic targets for remyelination in MS. About 100 mammalian Protein Tyrosine Phosphatases (PTPs) are known, many of which are involved in signaling both in health and disease. We have undertaken a systematic genomic approach to evaluate PTP gene activity in multiple sclerosis autopsies and in related in vivo and in vitro models of the disease. This effort led to the identification of Dusp15/VHY, a PTP previously believed to be expressed only in testis, as being transcriptionally regulated during OL differentiation and in MS lesions. Subsequent RNA interference studies revealed that Dusp15/VHY is a key regulator of OL differentiation. Finally, we identified PDGFR-beta and SNX6 as novel and specific Dusp15 substrates, providing an indication as to how this PTP might exert control over OL differentiation.

Topics: Aged; Animals; Brain; Cell Differentiation; Cells, Cultured; Cerebellum; Dual-Specificity Phosphatases; Encephalomyelitis, Autoimmune, Experimental; Female; Gene Knockdown Techniques; Genomics; Humans; Male; Mice; Mice, Inbred C57BL; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Oligodendroglia; Phosphoproteins; Receptor, Platelet-Derived Growth Factor beta; RNA, Messenger; RNA, Small Interfering; Signal Transduction; Sorting Nexins; Spinal Cord; Substrate Specificity; Transcriptome

Chronic demyelination can result in axonopathy and is associated with human neurological conditions such as multiple sclerosis (MS) in adults and cerebral palsy in infants. In these disorders, myelin regeneration is inhibited by impaired differentiation of oligodendrocyte progenitors into myelin-producing oligodendrocytes. However, regulatory factors relevant in human myelin disorders and in myelin regeneration remain poorly understood. Here we have investigated the role of the transcription factor nuclear factor IA (NFIA) in oligodendrocyte progenitor differentiation during developmental and regenerative myelination.. NFIA expression patterns in human neonatal hypoxic-ischemic encephalopathy (HIE) and MS as well as developmental expression in mice were evaluated. Functional studies during remyelination were performed using a lysolecithin model, coupled with lentiviral misexpression of NFIA. The role of NFIA during oligodendrocyte lineage development was characterized using chick and mouse models and in vitro culture of oligodendrocyte progenitors. Biochemical mechanism of NFIA function was evaluated using chromatin immunoprecipitation and reporter assays.. NFIA is expressed in oligodendrocyte progenitors, but not differentiated oligodendrocytes during mouse embryonic development. Examination of NFIA expression in white matter lesions of human newborns with neonatal HIE, as well active MS lesions in adults, revealed that it is similarly expressed in oligodendrocyte progenitors and not oligodendrocytes. Functional studies indicate that NFIA is sufficient to suppress oligodendrocyte progenitor differentiation during adult remyelination and embryonic development through direct repression of myelin gene expression.. These studies suggest that NFIA participates in the control of oligodendrocyte progenitor differentiation and may contribute to the inhibition of remyelination in human myelin disorders.

Topics: Adenomatous Polyposis Coli Protein; Animals; Arabidopsis Proteins; Cell Differentiation; Cells, Cultured; Cerebral Cortex; Chromatin Immunoprecipitation; Disease Models, Animal; DNA-Binding Proteins; Electroporation; Embryo, Mammalian; Gene Expression Regulation, Developmental; Homeodomain Proteins; Humans; Hypoxia-Ischemia, Brain; Infant; Infant, Newborn; Intramolecular Transferases; Leukoencephalopathies; Lysophosphatidylcholines; Mice; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; NFI Transcription Factors; Oligodendroglia; Spinal Cord; Stem Cells; Time Factors; Transcription Factors

While the role of T cells has been studied extensively in multiple sclerosis (MS), the pathogenic contribution of B cells has only recently attracted major attention, when it was shown that B cell aggregates can develop in the meninges of a subset of MS patients and were suggested to be correlates of late-stage and more aggressive disease in this patient population. However, whether these aggregates actually exist has subsequently been questioned and their functional significance has remained unclear. Here, we studied myelin basic protein (MBP)-proteolipid protein (PLP)-induced experimental autoimmune encephalomyelitis (EAE), which is one of the few animal models for MS that is dependent on B cells. We provide evidence that B cell aggregation is reflective of lymphoid neogenesis in the central nervous system (CNS) in MBP-PLP-elicited EAE. B cell aggregation was present already few days after disease onset. With disease progression CNS B cell aggregates increasingly displayed the phenotype of tertiary lymphoid organs (TLOs). Our results further imply that these TLOs were not merely epiphenomena of the disease, but functionally active, supporting intrathecal determinant spreading of the myelin-specific T cell response. Our data suggest that the CNS is not a passive "immune-privileged" target organ, but rather a compartment, in which highly active immune responses can perpetuate and amplify the autoimmune pathology and thereby autonomously contribute to disease progression.

Topics: Animals; Central Nervous System; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Female; Lymphoid Tissue; Mice; Mice, Inbred C57BL; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Myelin Sheath; T-Lymphocytes

Diagnosis of multiple sclerosis (MS) is facilitated by analyzing biochemical properties of cerebrospinal fluid (CSF). Oligoclonal bands (OCBs) and immunoglobulin G (IgG) index are well-established markers for evaluating patients suspected of having MS. Myelin basic protein (MBP) is also ordered frequently, but its usefulness remains questionable. OCB, IgG index, and MBP were measured in 16,690 consecutive CSF samples. Samples were divided into 2 groups based on MS status known (n = 71) or unknown (n = 16,118). Medical charts of the MS status known group were reviewed to determine their MS status. OCBs have a stronger association to IgG index results than does MBP. Importantly, MBP does not add a statistically significant increase in diagnostic sensitivity or specificity when used in combination with OCB and/or IgG index. The data indicate that MBP is an unnecessary and overused test.

Topics: Biomarkers; Cross-Sectional Studies; Diagnostic Tests, Routine; Humans; Immunoglobulin G; Multiple Sclerosis; Myelin Basic Protein; Predictive Value of Tests; Retrospective Studies; Sensitivity and Specificity; Unnecessary Procedures

Multiple sclerosis is an inflammatory demyelinating and neurodegenerative disorder of the central nervous system (CNS). The primary cause of the disease remains unknown, but an altered immune regulation with features of autoimmunity has generally been considered to play a critical role in the pathogenesis. Historically, lesion development has been attributed to activation of CD4 and CD8 T lymphocytes, B lymphocytes, and monocytes in the peripheral circulation and the migration of these cells through the blood-brain barrier to exert direct or indirect cytotoxic effects on myelin, oligodendrocytes and neuronal processes in the CNS. This broadly accepted concept was significantly influenced by the experimental autoimmune encephalitis (EAE) model, in which either immunization with myelin antigens or injection of a myelin antigen-specific T cell line into a recipient results in inflammatory demyelination in the CNS. More recent studies reveal that the loss of oligodendrocytes and neurons begins in the earliest stages of the disease and may not always be associated with blood-derived inflammatory cells. The pathology affects both the white and the gray matters and the clinical disability best correlates with the overall neurodegenerative process. These newer observations prompted several revisions of the classical concept of MS and facilitated a shift from using EAE to using other model systems. This chapter summarizes the classical and more contemporary concepts of MS, and provides methodologies for employing the cuprizone model for further explorations of the pathogenesis and treatment of the disease.

Topics: Animals; Apoptosis; Cuprizone; Demyelinating Diseases; Gene Expression Regulation; Humans; Immunohistochemistry; Immunologic Techniques; Mice; Mice, Inbred C57BL; Models, Biological; Multiple Sclerosis; Myelin Basic Protein; Oligodendroglia

This study evaluated blood-brain barrier (BBB) integrity, using blood and cerebrospinal fluid (CSF) markers, and assessed the practicality of these markers in the differential diagnosis of neuromyelitis optica (NMO) and multiple sclerosis (MS).. This was a retrospective observational study of consecutive patients presenting with acute phase NMO or MS (first attack or relapse). Haematological tests (including antiaquaporin-4 antibody levels) and CSF parameters (using primary component analyses) were undertaken; the correlation between BBB permeability and disease severity (by Expanded Disability Status Scale [EDSS] score) was examined.. Levels of several markers of BBB permeability were higher in patients with NMO (n=21) than in those with MS (n=52). The CSF:serum albumin ratio (AR) was the one of the main differentiators of NMO and MS. Additionally, there was a significant correlation between AR and clinical severity for NMO but not for MS.. Markers of BBB permeability were significantly higher in NMO patients than in MS patients. AR was the best marker for differentiating NMO and MS. Thus, measurement of BBB disruption markers (such as AR) might help to differentiate the diagnosis of NMO and MS in acute clinical settings.

Topics: Adult; Aquaporin 4; Autoantibodies; Biomarkers; Blood-Brain Barrier; Capillary Permeability; Diagnosis, Differential; Female; Humans; Immunoglobulin G; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Neuromyelitis Optica; Principal Component Analysis; Retrospective Studies; Serum Albumin; Statistics, Nonparametric

Our objective was to evaluate risk of exacerbations in multiple sclerosis (MS) patients undergoing assisted reproduction technology (ART) infertility treatment.. Sixteen patients with relapsing-remitting MS subjected to 26 ART treatment cycles receiving gonadotropin-releasing hormone (GnRH) agonists and recombinant follicle-stimulating hormone were studied prospectively. The baseline study period encompassed 12 months prior to the first cycle and 9 months after final ART cycle. Neurological examinations, brain magnetic resonance imaging (MRI), and immunology testing were conducted every 3 months. Anti-myelin-oligodendrocyte glycoprotein (MOG) antibody production, interleukin (IL)-4, IL-8, IL-10, IL-12, IL-17, interferon (IFN)-γ, and transforming growth factor (TGF)-β secretion by myelin basic protein- and MOG-peptide-specific T cells, as well as ex vivo isolated peripheral blood mononuclear cells (PBMCs), were studied using enzyme-linked immunospot. vascular endothelial growth factor (VEGF) production by PBMCs was assessed using enzyme-linked immunosorbent assay.. ART was associated with a 7-fold increase in risk of MS exacerbation, and a 9-fold increase in risk of enhanced disease activity on MRI. Worsening was associated with higher number of cells producing IL-8, IL-12, IFN-γ, and TGF-β, as well as increased VEGF production by CD4(+) T cells and CXCL-12 plasma levels, all GnRH-mediated effects. A rise in 17-β estradiol production associated with ART increased anti-MOG antibody titers, as well as B-cell survival factor BAFF (B-cell activating factor) and antiapoptotic molecule Bcl-2 levels from purified CD19(+) B cells. Finally, ART facilitated PBMC transmigration across an in vitro blood-brain barrier model, an effect mediated by IL-8, VEGF, and CXCL-12.. Results indicate a significant increase in MS disease activity in patients receiving ART, a risk that neurologists should be aware of. Reproductive hormones appear to exert an important role in regulating immune responses during the course of autoimmune diseases.

Topics: Adult; Antibodies; B-Cell Activating Factor; Brain; Case-Control Studies; Cell Movement; Cytokines; Disability Evaluation; Enzyme-Linked Immunosorbent Assay; Female; Follicle Stimulating Hormone; Gonadotropin-Releasing Hormone; Humans; Immunosuppressive Agents; Infertility; Magnetic Resonance Imaging; Multiple Sclerosis; Myelin Basic Protein; Proto-Oncogene Proteins c-bcl-2; Recurrence; Reproductive Techniques, Assisted; Retrospective Studies; RNA, Small Interfering; T-Lymphocytes; Time Factors; Transfection; Vascular Endothelial Growth Factor A

In multiple sclerosis (MS), treatment with the monoclonal antibody natalizumab effectively reduces the formation of acute lesions in the central nervous system (CNS). Natalizumab binds the integrin very late antigen (VLA)-4, expressed on the surface of immune cells, and inhibits VLA-4 dependent transmigration of circulating immune-cells across the vascular endothelium into the CNS. Recent studies suggested that natalizumab treated MS patients have an increased T-cell pool in the blood compartment which may be selectively enriched in activated T-cells. Proposed causes are sequestration of activated T-cells due to reduced extravasation of activated and pro-inflammatory T-cells or due to induction of VLA-4 mediated co-stimulatory signals by natalizumab. In this study we examined how natalizumab treatment altered the distribution of effector and memory T-cell subsets in the blood compartment and if T-cells in general or myelin-reactive T-cells in particular showed signs of increased immune activation. Furthermore we examined the effects of natalizumab on CD4(+) T-cell responses to myelin in vitro. Natalizumab-treated MS patients had significantly increased numbers of effector-memory T-cells in the blood. In T-cells from natalizumab-treated MS patients, the expression of TNF-α mRNA was increased whereas the expression of fourteen other effector cytokines or transcription factors was unchanged. Natalizumab-treated MS patients had significantly decreased expression of the co-stimulatory molecule CD134 on CD4(+)CD26(HIGH) T-cells, in blood, and natalizumab decreased the expression of CD134 on MBP-reactive CD26(HIGH)CD4(+) T-cells in vitro. Otherwise CD4(+) T-cells from natalizumab-treated and untreated MS patients showed similar responses to MBP. In conclusion natalizumab treatment selectively increased the effector memory T-cell pool but not the activation state of T-cells in the blood compartment. Myelin-reactive T-cells were not selectively increased in natalizumab treated MS.

Topics: Adult; Antibodies, Monoclonal, Humanized; Case-Control Studies; CD4-Positive T-Lymphocytes; Cell Migration Inhibition; Cells, Cultured; Central Nervous System; Female; Gene Expression; Humans; Immunologic Memory; Integrin alpha4beta1; Lymphocyte Activation; Male; Multiple Sclerosis; Myelin Basic Protein; Natalizumab; Receptors, OX40; Signal Transduction; T-Lymphocyte Subsets; Tumor Necrosis Factor-alpha

2D-immunomics may be useful in the identification of autoantigens in neurological autoimmune diseases, but its application may be limited by denaturation of target proteins. Here we compared the capacity of a single or multiple antigens to elicit autoantibodies targeting multiple neural autoantigens by ELISA and 2D-immunomics. We induced experimental autoimmune encephalomyelitis (EAE) with MBP peptide(89-104), total MBP or spinal cord homogenate. Both techniques showed anti-MBP IgG only after immunization with total MBP. In addition, 2D-immunomics revealed the presence in EAE mice of autoantibodies targeting other neural proteins, some displaying partial sequence homology with MBP. The present finding by 2D-immunomics of multiple neural proteins targeted by autoantibodies generated by a single antigen may help to explain the complex autoimmune response observed in multiple sclerosis.

Topics: Animals; Autoantibodies; Autoantigens; Chromatography, High Pressure Liquid; Electrophoresis, Gel, Two-Dimensional; Encephalomyelitis, Autoimmune, Experimental; Enzyme-Linked Immunosorbent Assay; Female; Image Processing, Computer-Assisted; Immunoblotting; Immunoglobulin G; Mass Spectrometry; Mice; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Spinal Cord

Cannabinoids have been shown to have a beneficial effect in both animal models of multiple sclerosis (MS) and human disease, although the mechanisms of action are unclear. We examined expression of the major cannabinoid receptors [(CBRs) cannabinoid receptor 1 (CB1) and cannabinoid receptor 2 (CB2)] and a key enzyme involved in synthesis of the endocannabinoid anandamide [N-acyl phosphatidylethanolamine phospholipase D (NAPE-PLD)] in autopsy brain samples from patients with MS. CB1 was expressed in neurons, injured axons, oligodendrocytes, macrophages/microglia, some astrocytes, endothelial cells, smooth muscle cells and pericytes. CB2 and NAPE-PLD were localized to cerebral endothelial cells, pericytes, smooth muscle cells, astrocytes and macrophages/microglia. NAPE-PLD immunoreactivity was also seen in neurons. Endothelial CB2 expression was greatest in chronic inactive plaques, and in areas was seen in segments of endothelium where the endothelial expression of adhesion molecules (VCAM-1 and ICAM-1) was focally undetectable, and was often expressed in areas of blood-brain barrier damage. Vascular density was increased in chronic active plaques and normal-appearing white matter compared with controls. These data support findings from animal models which suggest a role for the endocannabinoid system in the MS, particularly in the regulation of endothelial leukocyte adhesion and the cellular response to injury.

Topics: Actins; Adult; Aged; Aged, 80 and over; Antigens, CD34; Astrocytes; Blood Vessels; Blood-Brain Barrier; Brain; Female; Gene Expression Regulation; HLA-DR Antigens; Humans; Intercellular Adhesion Molecule-1; Macrophages; Male; Membrane Proteins; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Phospholipase D; Phosphoproteins; Plaque, Amyloid; Receptor, Cannabinoid, CB1; Receptor, Cannabinoid, CB2; Receptors, Cannabinoid; Zonula Occludens-1 Protein

Mitochondrial dysfunction has been proposed to play a role in the neuropathology of multiple sclerosis (MS). Previously, we reported significant alterations in the transcription of nuclear-encoded electron transport chain genes in MS and confirmed translational alterations for components of Complexes I and III that resulted in reductions in their activity. To more thoroughly and efficiently elucidate potential alterations in the expression of mitochondrial and related proteins, we have characterized the mitochondrial proteome in postmortem MS and control cortex using Surface-Enhanced Laser Desorption Ionization Time of Flight Mass Spectrometry (SELDI-TOF-MS). Using principal component analysis (PCA) and hierarchical clustering techniques we were able to analyze the differential patterns of SELDI-TOF spectra to reveal clusters of peaks which distinguished MS from control samples. Four proteins in particular were responsible for distinguishing disease from control. Peptide fingerprint mapping unambiguously identified these differentially expressed proteins. Three proteins identified are involved in respiration including cytochrome c oxidase subunit 5b (COX5b), the brain specific isozyme of creatine kinase, and hemoglobin β-chain. The fourth protein identified was myelin basic protein (MBP). We then investigated whether these alterations were consistent in the experimental autoimmune encephalomyelitis (EAE) mouse model of MS. We found that MBP was similarly altered in EAE but the respiratory proteins were not. These data indicate that while the EAE mouse model may mimic aspects of MS neuropathology which result from inflammatory demyelinating events, there is another distinct mechanism involved in mitochondrial dysfunction in gray matter in MS which is not modeled in EAE.

Topics: Adult; Aged; Aged, 80 and over; Animals; Autopsy; Biomarkers; Blotting, Western; Brain; Case-Control Studies; Cerebral Cortex; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Female; Fluorescent Antibody Technique; Glycoproteins; Humans; Immunoprecipitation; Male; Mice; Mice, Inbred C57BL; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin-Oligodendrocyte Glycoprotein; Peptide Fragments; Peptide Mapping; Principal Component Analysis; Proteome; Proteomics; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

Myelin basic protein (MBP) is a candidate autoantigen in multiple sclerosis (MS). The immunodominant epitope for T-cell responses is assigned to the amino acid sequence MBP84-102, which binds to human leukocyte antigen (HLA)-DR2a (DRB5*0101) and HLA-DR2b (DRB1*1501) of the HLA-DR2 haplotype carrying the strongest genetic association with MS. In contrast with HLA-DR and -DQ molecules, HLA-DP molecules are poorly characterized with respect to the binding of self-peptides. We show here that HLA-DP2 binds MBP85-99 with high affinity, and that the amino acid residues in position MBP91, MBP92 and MBP93 are influencing the binding, as shown by alanine scans. We further used a series of truncated peptides to identify the core of the binding. Moving the frame along the peptide from residues 87-97 to 89-99 progressively decreased the binding affinity for HLA-DP2, while moving further towards the C-terminal completely abrogated the binding of peptides to HLA-DP2. The data suggest that the docking of the MBP85-99 peptide into the HLA-DP2 groove is dependent on MBP88V and MBP89V and may use either of them as primary anchor for the p1 position. HLA-DP2 might thus present the MBP85-99 peptide in the same register as the HLA-DRB1*1501, where the MBP89V is preferred as the p1 anchor. Notably, full-length MBP was able to compete for peptide binding with an affinity similar to that seen for the high-affinity binding peptides, DRα170-83 and IIP53-65. In summary, the HLA-DP2 molecule binds the immunodominant epitope in MS, MBP85-99, possibly in more than one register.

Topics: 1-Butanol; Amino Acid Sequence; Animals; Cells, Cultured; Drosophila melanogaster; Enzyme-Linked Immunosorbent Assay; HLA-DP Antigens; HLA-DP beta-Chains; Humans; Immunodominant Epitopes; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Protein Binding; Recombinant Proteins; Substrate Specificity

Patients with multiple sclerosis (MS) show a high prevalence of myelin-reactive CD8+ and CD4+ T-cell responses, which are the putative effectors/modulators of CNS neuropathology. Utilizing a novel combination of short-term culture, CFSE-based sorting and anchored PCR, we evaluated clonal compositions of neuroantigen-targeting T-cells from RRMS patients and controls. CDR3 region analysis of TCRβ chains revealed biased use of specific TCRBV-bearing CD4+ clones. CD8+ clones showed homology to published TCR from CNS-infiltrating T-cells in MS lesions. These studies are the first description of TCR usage of CNS-specific CD8+ T-cells and provide insights into their potential regulatory role in disease.

Topics: Adult; Antibodies; CD4-Positive T-Lymphocytes; CD8-Positive T-Lymphocytes; Cloning, Molecular; Female; Flow Cytometry; Humans; Male; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Myelin Sheath; Receptors, Antigen, T-Cell

The present study was performed to investigate the effects of dimethylfumarate (DMF) and methylhydrogen fumarate (MHF) on the cytokine pattern of peripheral blood mononuclear cells (PBMCs) of multiple sclerosis (MS) patients. The PBMCs from patients and healthy controls were stimulated with myelin basic protein (MBP) or phytohemagglutinin (PHA) and cultured in the presence of DMF and MHF. The percentage of CD4+IL-4+ and CD4+IFN-γ+ cells was determined by means of intracellular cytokine staining. CD4+IL-4+ cells were significantly increased in the presence of DMF and MHF when PBMCs were stimulated by MBP (P < 0.003). The same significant result was obtained by PHA stimulation (P < 0.049). In terms of CD4+IFN-γ+ cells, the percentage of cells did not significantly differ between the cultures stimulated with MBP or PHA in the presence and absence of the drugs. Results of MBP stimulation in control group also showed a significant increase in CD4+IL-4+ cells in the presence of DMF and MHF. In comparison between patient and control groups, no statistically significant changes were observed. In conclusion, both DMF and MHF effectively increased IL-4 production, whereas they did not significantly change IFN-γ level, indicating the role of these drugs in increasing the production of beneficial cytokines such as IL-4.

Topics: Adolescent; Adult; CD4-Positive T-Lymphocytes; Cell Count; Cell Survival; Cytokines; Dimethyl Fumarate; Female; Fumarates; Humans; Interferon-gamma; Interleukin-4; Leukocytes, Mononuclear; Lymphocyte Activation; Lymphocytes; Male; Maleates; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Phytohemagglutinins; Th1 Cells; Th2 Cells; Young Adult

Variations in the gene for the nucleotide-binding oligomerisation domain (NOD) 2 have been associated with Crohn's disease but not multiple sclerosis (MS). Here we investigate the effect of three polymorphisms in the NOD2 gene (rs5743277, rs2066842 and rs5743291) on cytokine production and CD4+ T cell proliferation elicited by human myelin basic protein (MBP) in blood mononuclear cell (MNC) cultures from 29 patients with MS. No polymorphism was observed at rs5743277. No associations with the rs2066842 polymorphism were found. Concerning rs5743291, none were homozygous for the minor allele. Seven of 29 (24%) patients were heterozygous, and five of these (71%) exhibited increased MBP-induced CD4+ T cell proliferation versus four of 22 (18%), who were homozygous for the major allele (p<0.04). Interleukin (IL)-5 was induced by MBP in MNC from the same five carriers versus two (9%) homozygotes (p<0.004); four carriers (57%) versus three non-carriers (14%) exhibited IL-17 responses to MBP (p<0.04). By contrast, we found no association between the polymorphisms investigated and interferon-gamma-, tumor necrosis factor-alpha-, IL-2, -4- or IL-10 responses to MBP. These results indicate that the rs5743291 polymorphism influences T helper (Th) cell 2- and Th17 cell responses in MNC from MS patients.

Topics: Adult; Female; Genetic Variation; Humans; Male; Multiple Sclerosis; Myelin Basic Protein; Nod2 Signaling Adaptor Protein; Th17 Cells; Th2 Cells

To investigate the effect of yellow fever (YF) immunization on the subsequent multiple sclerosis (MS) relapse risk.. Self-controlled case series study.. An MS outpatient clinic.. Seven patients with clinical relapsing-remitting MS traveling to endemic YF areas who received the YF 17D-204 vaccine were studied.. The YF 17D-204 vaccine.. Number of relapses. Secondary outcomes included the number of new lesions on magnetic resonance imaging and peripheral mononuclear cell cytokine and chemokine production.. The annual exacerbation rate during risk periods following immunization was 8.57, while the relapse rate outside the risk period was only 0.67 (rate ratio = 12.778; P < .001). Three months after immunization, patients showed a significant increase in new or enlarging T2-weighted lesions and gadolinium-enhancing lesions compared with 12 months prior to vaccination and 9 months after immunization (both P < .001). Moreover, blood myelin basic protein and myelin oligodendrocyte glycoprotein responses showed significant increases in interferon γ-induced protein 10 kDa-, interferon γ-, interleukin 1α-, interleukin 1β-, and tumor necrosis factor-secreting cell numbers as well as complement component C1qB production after YF vaccination in patients with MS compared with unvaccinated patients with MS, patients with MS vaccinated against influenza, and healthy control subjects (P = .01 and P < .001, respectively).. For patients with MS traveling to endemic YF areas, vaccination should be recommended on the basis of carefully weighing the risk of exacerbation against the likelihood of exposure to the YF virus.

Topics: Adult; Brain; Cytokines; Female; Follow-Up Studies; Humans; Immunologic Factors; Magnetic Resonance Imaging; Male; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Oligodendrocyte Glycoprotein; Peptide Fragments; Risk; Secondary Prevention; Travel; Yellow Fever; Yellow Fever Vaccine

Mitochondrial content within axons increases following demyelination in the central nervous system, presumably as a response to the changes in energy needs of axons imposed by redistribution of sodium channels. Myelin sheaths can be restored in demyelinated axons and remyelination in some multiple sclerosis lesions is extensive, while in others it is incomplete or absent. The effects of remyelination on axonal mitochondrial content in multiple sclerosis, particularly whether remyelination completely reverses the mitochondrial changes that follow demyelination, are currently unknown. In this study, we analysed axonal mitochondria within demyelinated, remyelinated and myelinated axons in post-mortem tissue from patients with multiple sclerosis and controls, as well as in experimental models of demyelination and remyelination, in vivo and in vitro. Immunofluorescent labelling of mitochondria (porin, a voltage-dependent anion channel expressed on all mitochondria) and axons (neurofilament), and ultrastructural imaging showed that in both multiple sclerosis and experimental demyelination, mitochondrial content within remyelinated axons was significantly less than in acutely and chronically demyelinated axons but more numerous than in myelinated axons. The greater mitochondrial content within remyelinated, compared with myelinated, axons was due to an increase in density of porin elements whereas increase in size accounted for the change observed in demyelinated axons. The increase in mitochondrial content in remyelinated axons was associated with an increase in mitochondrial respiratory chain complex IV activity. In vitro studies showed a significant increase in the number of stationary mitochondria in remyelinated compared with myelinated and demyelinated axons. The number of mobile mitochondria in remyelinated axons did not significantly differ from myelinated axons, although significantly greater than in demyelinated axons. Our neuropathological data and findings in experimental demyelination and remyelination in vivo and in vitro are consistent with a partial amelioration of the supposed increase in energy demand of demyelinated axons by remyelination.

Topics: Adult; Aged; Aged, 80 and over; Animals; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Axons; Brain; Cells, Cultured; Coculture Techniques; Demyelinating Diseases; Disease Models, Animal; Ethidium; Female; Ganglia, Spinal; HLA Antigens; Humans; Leukocyte Common Antigens; Lysophosphatidylcholines; Male; Microscopy, Electron, Transmission; Middle Aged; Mitochondria; Multiple Sclerosis; Myelin Basic Protein; Neurofilament Proteins; Rats; Rats, Sprague-Dawley; Schwann Cells; Voltage-Dependent Anion Channels

The presence of oligoclonal bands of IgG (OCB) in cerebrospinal fluid (CSF) is used to establish a diagnosis of multiple sclerosis (MS), but their specificity has remained an enigma since its first description over forty years ago. We now report that the use of lipid arrays identifies heteromeric complexes of myelin derived lipids as a prominent target for this intrathecal B cell response.

Topics: Analysis of Variance; Animals; B-Lymphocytes; Cells, Cultured; Embryo, Mammalian; Humans; Immunoglobulin G; Lipid Metabolism; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; O Antigens; Oligoclonal Bands; Rats; Rats, Sprague-Dawley; Spinal Cord

We had previously reported that Acanthamoeba castellanii (ACA) contains a mimicry epitope for proteolipid protein 139-151 capable of inducing central nervous system (CNS) autoimmunity in SJL/J mice. We now present evidence that ACA also contains a mimicry epitope for myelin basic protein (MBP) 89-101, a derivative from amoebic nicotinamide adenine dinucleotide dehydrogenase subunit 2 (NAD). The epitope, NAD 108-120, contains a discontinuous stretch of six amino acids in the core region (VVFFKNIILIGFL) sharing 46% identity with MBP 89-101 (VHFFKNIVTPRTP; identical residues are underlined). SJL mice immunized with NAD 108-120 develop encephalomyelitis similar to the disease induced by the cognate peptide. We demonstrate that NAD 108-120 induces T cells that cross-react with MBP 89-101; the antigen-sensitized T cells, which produce predominantly T helper (T(h)) 1 and T(h)17 cytokines, transfer disease in naive SJL recipients reminiscent of the disease induced with MBP 89-101. This is the first report to demonstrate that a solitary microbe can induce CNS autoimmunity by generating cross-reactive T cells for multiple myelin antigens.

Topics: Acanthamoeba castellanii; Animals; Antigens, Protozoan; Autoimmunity; Cells, Cultured; Central Nervous System; Cross Reactions; Encephalomyelitis, Autoimmune, Experimental; Epitopes, T-Lymphocyte; Humans; Lymphocyte Activation; Mice; Mice, Inbred Strains; Molecular Mimicry; Multiple Sclerosis; Myelin Basic Protein; NADH Dehydrogenase; Peptide Fragments; Th1 Cells; Th17 Cells

Human myelin basic protein (hMBP)-hydrolyzing activity was recently shown to be an intrinsic property of antibodies (Abs) from multiple sclerosis (MS) patients. Here, we present the first evidence demonstrating a significant diversity of different fractions of polyclonal IgGs (pIgGs) from MS patients in their affinity for hMBP and in the ability of pIgGs to hydrolyze hBMP at different optimal pHs (3-10.5). IgGs containing lambda- and kappa-types of light chains demonstrated comparable relative activities in the hydrolysis of hMBP. IgGs of IgG1-IgG4 sub-classes were analyzed for catalytic activity. IgGs of all four sub-classes were catalytically active, with their contribution to the total activity of Abzs in the hydrolysis of hMBP and its 19-mer oligopeptide increasing in the order: IgG1 (1.5-2.1%) < IgG2 (4.9-12.8%) < IgG3 (14.7-25.0%) < IgG4 (71-78%). Our findings suggest that the immune systems of individual MS patients generate a variety of anti-hMBP abzymes with different catalytic properties, which can attack hMBP of myelin-proteolipid shell of axons, playing an important role in MS pathogenesis.

Topics: Adolescent; Adult; Antibodies, Monoclonal; Antibody Affinity; Autoantibodies; Biocatalysis; Blotting, Western; Enzyme-Linked Immunosorbent Assay; Female; Humans; Hydrogen-Ion Concentration; Hydrolysis; Immunoglobulin G; Kinetics; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Peptide Hydrolases; Young Adult

Myelin basic protein peptide 83-99 (MBP83-99) is the most immunodominant epitope playing a significant role in the multiple sclerosis (MS), an autoimmune disease of the central nervous system. Many peptide analogues, linear or cyclic have been designed and synthesized based on this segment in order to inhibit the experimental autoimmune encephalomyelitis, the best well-known animal model of MS. In this study, the solution structural motif of MBP(83-99) has been performed using 2D (1)H-NMR spectroscopy in dimethyl sulfoxide. A rather extended conformation, along with the formation of a well defined alpha-helix spanning residues Val(87)-Phe(90) is proposed, as no long-range NOE are presented. Moreover, the residues of MBP peptide that are important for T-cell receptor recognition are solvent exposed. The spatial arrangement of the side chain all over the sequence of our NMR based model exhibits great similarity with the solid state model, while both TCR contacts occupy the same region in space.

Topics: Algorithms; Amino Acid Motifs; Amino Acid Sequence; Dimethyl Sulfoxide; Humans; Hydrogen Bonding; Immunodominant Epitopes; Models, Molecular; Multiple Sclerosis; Myelin Basic Protein; Nerve Tissue Proteins; Nuclear Magnetic Resonance, Biomolecular; Peptide Fragments; Protein Conformation; Software; Solvents; Surface Properties; Transcription Factors

Multiple sclerosis is an inflammatory, degenerative disease of the central nervous system. The most obvious pathological change in multiple sclerosis is multifocal demyelination of the white matter, but grey matter demyelination may be of equal or even greater importance for its clinical manifestations. In order to assess the pathogenetic role of lesions in the grey and white matter, and to explore the association between demyelinated and non-lesional brain tissue, tools are needed to depict each of these tissue components accurately in vivo. Due to its sensitivity in detecting white matter lesions, T(2)-weighted magnetic resonance imaging at 1.5 T is important in the diagnosis of multiple sclerosis. However, magnetic resonance imaging at 1.5 T largely fails to detect grey matter lesions. In this study, we used T(2)-weighted magnetic resonance imaging at 9.4 T to detect grey matter lesions in fixed post-mortem multiple sclerosis motor cortex. Furthermore, we produced T(1), T(2) and magnetization transfer ratio maps, and correlated these indices with quantitative histology [neuronal density, intensity of immunostaining for myelin basic protein (reflecting myelin content) and phosphorylated neurofilament (reflecting axonal area)] using t-tests and multivariate regression. In 21 tissue samples, 28 cortical grey matter lesions were visible on both T(2)-weighted magnetic resonance imaging and sections immunostained for myelin basic protein, 15/28 being mixed white and grey matter and 11/28 subpial cortical grey matter lesions; 2/28 cortical grey matter lesions involved all layers of the cortex. Compared with non-lesional cortex, cortical grey matter lesions showed reduction of neuronal density (98/mm(2), SD = 34/mm(2;) versus 129/mm(2), SD = 44; P < 0.01), phosphorylated neurofilament (1/transmittance = 1.16; SD = 0.09 versus 1.24; SD = 0.1; P < 0.01) and magnetization transfer ratio (31.1 pu; SD = 11.9 versus 37.5 pu; SD = 8.7; P = 0.01), and an increase of T(2) (25.9; SD = 5 versus 22.6 ms; SD = 4.7; P < 0.01). Associations were detected between phosphorylated neurofilament and myelin basic protein (r = 0.58, P < 0.01), myelin basic protein and T(2) (r = -0.59, P < 0.01), and neuronal density and T(1) (r = -0.57, P < 0.01). All indices correlated with duration of tissue fixation, however, including the latter in the analysis did not fundamentally affect the associations described. Our data show that T(2)-weighted magnetic resonance imaging at 9.4 T enables d

Topics: Cell Count; Humans; Magnetic Resonance Imaging; Middle Aged; Motor Cortex; Multiple Sclerosis; Multivariate Analysis; Myelin Basic Protein; Nerve Fibers, Myelinated; Nerve Fibers, Unmyelinated; Nerve Tissue Proteins; Neurofilament Proteins; Neurons; Phosphorylation; Regression Analysis; Transcription Factors

Albeit several studies pointed out the pivotal role that CD4+T cells have in Multiple Sclerosis, the CD8+ T cells involvement in the pathology is still in its early phases of investigation. Proteasome degradation is the key step in the production of MHC class I-restricted epitopes and therefore its activity could be an important element in the activation and regulation of autoreactive CD8+ T cells in Multiple Sclerosis.. Immunoproteasomes and PA28-alphabeta regulator are present in MS affected brain area and accumulated in plaques. They are expressed in cell types supposed to be involved in MS development such as neurons, endothelial cells, oligodendrocytes, macrophages/macroglia and lymphocytes. Furthermore, in a genetic study on 1262 Italian MS cases and 845 controls we observed that HLA-A*02+ female subjects carrying the immunoproteasome LMP2 codon 60HH variant have a reduced risk to develop MS. Accordingly, immunoproteasomes carrying the LMP2 60H allele produce in vitro a lower amount of the HLA-A*0201 restricted immunodominant epitope MBP(111-119).. The immunoproteasome LMP2 60HH variant reduces the risk to develop MS amongst Italian HLA-A*02+ females. We propose that such an effect is mediated by the altered proteasome-dependent production of a specific MBP epitope presented on the MHC class I. Our observations thereby support the hypothesis of an involvement of immunoproteasome in the MS pathogenesis.

Topics: Adult; Amino Acid Sequence; Brain; Cysteine Endopeptidases; Epitopes; Female; Gene Frequency; Genotype; HLA-A Antigens; HLA-A2 Antigen; Humans; Immunohistochemistry; Italy; Macrophages; Male; Microglia; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Muscle Proteins; Myelin Basic Protein; Oligodendroglia; Proteasome Endopeptidase Complex; Protein Binding; Risk Factors; Sex Factors

Anti-myelin basic protein (MBP) antibodies in pediatric-onset MS and controls were characterized. Serum samples were obtained from 94 children with MS and 106 controls. Paired CSF and serum were obtained from 25 children with MS at time of their initial episode of acute demyelinating syndrome (ADS). Complementary assays were applied across samples to evaluate the presence, and the physical binding properties, of anti-MBP antibodies. While the prevalence and titers of serum anti-MBP antibodies against both immature and mature forms of MBP were similar in children with MS and in controls, binding characteristics and formal Surface Plasmon Resonance (SPR) studies indicated surprisingly high binding affinities of all pediatric anti-MBP antibodies. Serum levels of anti-MBP antibodies correlated significantly with their CSF levels, and their presence in children with MS was associated with significantly increased risk of an acute disseminated encephalomyelitis-like initial clinical presentation. While antibodies to both immature and mature forms of MBP can be present as part of the normal pediatric humoral repertoire, these anti-myelin antibodies are of surprisingly high affinity, can access the CNS during inflammation, and have the capacity to modulate disease expression. Our findings identify an immune mechanism that could contribute to the observed heterogeneity in spectrum of clinical presentations in early-onset MS.

Topics: Acute Disease; Adolescent; Autoantibodies; Biomarkers; Child; Child, Preschool; Female; Humans; Infant; Male; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Nerve Tissue Proteins; Risk Factors; Syndrome; Transcription Factors; Young Adult

Multiple sclerosis is an autoimmune disease of the central nervous system believed to be mediated by pathogenic T lymphocytes. We have developed a next-generation therapy in which cells secrete specific therapeutic molecules to silence these aberrant T cells. We have shown that fibroblasts, transduced to secrete a myelin basic protein-derived peptide, abrogate disease in the murine experimental autoimmune encephalomyelitis model of multiple sclerosis, which we hypothesized using a low-zone tolerance mechanism. To determine the efficacy (or not) of this therapy in humans, we must ensure that patients receive comparable doses of therapeutic peptide. To this end, we have used liquid chromatography coupled to tandem mass spectrometry to detect a tryptic peptide, derived from the secreted therapeutic product, at nanomolar concentrations. Success depended on growing the transduced fibroblasts in defined PC-1 medium in the presence of a cocktail of protease inhibitors.

Topics: Animals; Chromatography, Liquid; Encephalomyelitis, Autoimmune, Experimental; Feasibility Studies; Mice; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Tandem Mass Spectrometry; Transduction, Genetic

Although peripheral blood myelin-autoreactive T cells are thought to play a key role in multiple sclerosis, they are generally considered to have qualitative differences rather than quantitative ones when compared to those found in healthy individuals. Here, we revisited the assessment of myelin-autoreactive T cells in a new approach based on their combined ability to acquire membrane proteins from autologous antigen presenting cells, and to respond to whole myelin extract as the stimulating autoantigen. Using this approach, the myelin-autoreactive T cell frequency in patients with multiple sclerosis was found to be unexpectedly high (n = 22, subtracted values median 2.08%, range 0-6%; background median 1%, range 0-4%) and to exceed that of age/gender-matched healthy individuals significantly (n = 18, subtracted values median 0.1%, range 0-5.3%, P < 0.0001; background median 1.45%, range 0.1-4%). Higher anti-myelin autoreactivity was stable in patients with multiple sclerosis after several months. These data correlated with whole myelin-induced gamma interferon-enzyme-linked immunosorbent spot assay performed under the same conditions, although the values obtained with enzyme-linked immunosorbent spot assay under all conditions were 58 times lower than with this new method. The myelin-autoreactive T cells were memory T cells expressing CD40L with a CD62(low) phenotype, suggesting their ability for homing to tissues. Collectively, these new data show a higher frequency of autoreactive T cells during multiple sclerosis than in age/gender-matched healthy individuals, and support an autoimmune aetiology in multiple sclerosis.

Topics: Adult; Antigen-Presenting Cells; Antigens, CD; Autoantibodies; Cohort Studies; Female; Genes, MHC Class I; Humans; Immunologic Memory; Interferon-gamma; Male; Middle Aged; Monocytes; Multiple Sclerosis; Multiple Sclerosis, Relapsing-Remitting; Myelin Basic Protein; Myelin Sheath; Nerve Tissue Proteins; Severity of Illness Index; T-Lymphocyte Subsets; T-Lymphocytes; Time Factors; Transcription Factors; Young Adult

Susceptibility to multiple sclerosis is higher in females than males. However, the underlying mechanism behind this gender difference is poorly understood. Because the presence of neuroantigen-primed T cells in the CNS is necessary to initiate the neuroinflammatory cascade of multiple sclerosis, we first investigated how these T cells interacted with astroglia, major resident glial cells of the CNS. Interestingly, we found that myelin basic protein (MBP)-primed T cells from female and castrated male mice, but not from male mice, produced proinflammatory molecules, such as NO, IL-1beta, and IL-6 in astroglia, and these responses were purely via contact between T cells and astroglia. Because T cell:glia contact requires several integrin molecules, we examined the involvement of integrins in this process. Both alpha4 and beta1, subunits of VLA-4 integrin, were found to be necessary for T cell contact-induced generation of proinflammatory molecules in astroglia. Interestingly, the expression of beta1, but not alpha4, was absent in male MBP-primed T cells. In contrast, female and castrated male MBP-primed T cells expressed both alpha4 and beta1. Similarly, we also detected beta1 in spleen of normal young female, but not male, mice. Furthermore, we show that male sex hormones (testosterone and dihydrotestosterone), but not female sex hormones (estrogen and progesterone), were able to suppress the mRNA expression of beta1 in female MBP-primed T cells. These studies suggest that beta1, but not alpha4, integrin of VLA-4 is the sex-specific molecule on T cell surface, and that the presence or absence of beta1 determines gender-specific T cell contact-mediated glial activation.

Topics: Animals; Astrocytes; Castration; Cell Separation; Dihydrotestosterone; Estrogens; Female; Flow Cytometry; Fluorescent Antibody Technique; Gene Expression; Gene Expression Regulation; Integrin alpha4beta1; Integrin beta1; Lymphocyte Activation; Male; Mice; Multiple Sclerosis; Myelin Basic Protein; Progesterone; Reverse Transcriptase Polymerase Chain Reaction; Sex Factors; T-Lymphocytes; Testosterone

Multiple sclerosis is an inflammatory, demyelinating, central nervous system disease mediated by myelin-specific T cells. Environmental triggers that cause the breakdown of myelin-specific T cell tolerance are unknown. Here we found that CD8(+) myelin basic protein (MBP)-specific T cell tolerance was broken and autoimmunity was induced by infection with a virus that did not express MBP cross-reactive epitopes and did not depend on bystander activation. Instead, the virus activated T cells expressing dual T cell antigen receptors (TCRs) that were able to recognize both MBP and viral antigens. Our results demonstrate the importance of dual TCR-expressing T cells in autoimmunity and suggest a mechanism by which a ubiquitous viral infection could trigger autoimmunity in a subset of infected people, as suggested by the etiology of multiple sclerosis.

Topics: Animals; Antigen Presentation; Autoimmunity; CD8-Positive T-Lymphocytes; Cell Proliferation; Cells, Cultured; Central Nervous System; Disease Models, Animal; Epitopes, T-Lymphocyte; Histocompatibility Antigens; Humans; Lymphocyte Activation; Mice; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Receptors, Antigen, T-Cell; Self Tolerance; Transgenes; Vaccinia; Vaccinia virus

Myelin-reactive T helper-17 cells are implicated in the pathogenesis of multiple sclerosis (MS). Here, we analyzed the reactivity of peripheral naive and memory conventional CD4(+)CD127(high) T cells (Tconv) of MS patients and healthy controls (HC) towards myelin basic protein (MBP), myelin oligodendrocyte glycoprotein (MOG) and tetanus toxoid (TT). Proliferative responses of Tconv cells towards MBP, MOG and TT were not significantly different between MS patients and HC. However, MBP and MOG but not TT reactive memory Tconv cells from MS patients, in contrast to HC, produced IL-17. These results suggest that myelin antigen reactive Th-17 cells are enriched in MS patients.

Topics: Analysis of Variance; Antigens, CD; Cell Proliferation; Cells, Cultured; Cytokines; Flow Cytometry; Humans; Interleukin-17; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; T-Lymphocytes, Helper-Inducer; Tetanus Toxoid; Time Factors

Topics: Animals; CD8-Positive T-Lymphocytes; Disease Susceptibility; Encephalomyelitis, Autoimmune, Experimental; Humans; Mice; Mice, Transgenic; Molecular Mimicry; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell; Self Tolerance; Vaccinia; Vaccinia virus

T cell vaccination (TCV) with irradiated encephalitogenic T cells induces resistance to EAE. However, the fate of the encephalitogenic T cells in vivo following TCV has yet to be studied. Here we used anti-MBP encephalitogenic T cells that were transduced to express GFP to study the effects of TCV on these cells. In naïve rats or in control-vaccinated (Ova-GFP) rats injected i.v. with GFP-labeled effector cells, high numbers of effector T cells were found along with macrophages, CD8 T cells and Non-GFP CD4 cells in the spleens, parathymic lymph nodes (PTLN) and spinal cords. In contrast, the recipients that had been treated with TCV (anti-MBP T-cell lines) showed few if any GFP-labeled effector T cells throughout the disease (day 1-8) and their spinal cords were almost clear of macrophages, CD4 and CD8 cells. Splenocytes in the control groups secreted IFNgamma in response to MBP and showed high numbers of IFNgamma secreting CD4 and CD8 cells in their spinal cords at the disease peak. In the TCV-protected groups, splenocytes showed no reactivity to MBP but secreted IFNgamma in response to irradiated encephalitogenic T cells--an anti-idiotypic response. Thus, TCV leads to a marked decrease in the numbers of effector T cells in the CNS and lymphoid organs, to a marked reduction in the Th1 cytokine producing cells in the CNS, and to the appearance of T cells responsive to the anti-MBP effector T cells.

Topics: Animals; CD4 Antigens; CD8 Antigens; Cell Line; Encephalomyelitis, Autoimmune, Experimental; Female; Green Fluorescent Proteins; Humans; Interferon-gamma; Lymphocyte Activation; Macrophages; Multiple Sclerosis; Myelin Basic Protein; Rats; Rats, Inbred Lew; Spinal Cord; T-Lymphocytes; Vaccination

To determine the sensitivity of T2*-weighted gradient-echo (T2*GRE) and inversion recovery turbo-field-echo (TFE) sequences for cortical multiple sclerosis lesions at 7 T.. Autopsied brain tissue from individuals with multiple sclerosis was scanned with 3-dimensional T2*GRE and 3-dimensional inversion recovery white matter-attenuated TFE sequences at 7 T. Cortical lesions visible with either sequence were scored for each anatomical lesion type. Imaged brain tissue was then processed for immunohistochemical analysis, and cortical lesions were identified by labeling with antibody against myelin basic protein and CD68 for microglia. Magnetic resonance images were matched with corresponding histological sections and scored retrospectively to determine the sensitivity for each cortical lesion type. Main Outcome Measure Cortical lesion detection by 3-dimensional T2*GRE and white matter-attenuated TFE sequences.. The 3-dimensional T2*GRE and white matter-attenuated TFE sequences retrospectively detected 93% and 82% of all cortical lesions, respectively (with varying sensitivities for different lesion types). Lesion visibility was primarily determined by size as all undetected lesions were smaller than 1.1 mm at their smallest diameter. The T2*GRE images showed hypointense rings in some cortical lesions that corresponded with increased density of activated microglia.. Three-dimensional T2*GRE and white matter-attenuated TFE sequences at a 7-T field strength detect most cortical lesions in postmortem multiple sclerosis tissue. This study indicates the potential of T2*GRE and white matter-attenuated TFE sequences in ultra-high-field magnetic resonance imaging for cortical lesion detection in patients with multiple sclerosis.

Topics: Adult; Aged; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Brain Injuries; Cerebral Cortex; Female; Humans; Image Processing, Computer-Assisted; Iron; Magnetic Resonance Imaging; Male; Microglia; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Postmortem Changes; Prospective Studies; Time Factors

Loss of aquaporin 4 and glial fibrillary acidic protein (GFAP) with necrosis and demyelination is a prominent pathologic feature of neuromyelitis optica (NMO). However, the clinicopathologic significance of astrocytic damage and its relation with demyelination are unknown.. To analyze clinical and pathologic values of a CSF biomarker of astrocytic damage in NMO.. We measured the levels of GFAP, S100B, myelin basic protein (MBP), and neurofilament H (NF-H) in CSF obtained from patients with NMO (n = 33), multiple sclerosis (MS) (n = 27), acute disseminated encephalomyelitis (ADEM), ischemia, meningitis, and other neurologic disease controls (OND).. The CSF-GFAP levels during relapse in NMO (2,476.6 +/- 8,815.0 ng/mL) were significantly higher than those in MS (0.8 +/- 0.4 ng/mL) and OND (0.7 +/- 0.5 ng/mL), and much beyond those in ADEM (14.1 +/- 27.4 ng/mL). The sensitivity and specificity of CSF-GFAP for NMO was 90.9% and 76.9% in all, but the specificity improved above 90% in cases limited to demyelinating diseases. CSF-S100B showed a similar trend but was less remarkable. In contrast, MBP and NF-H are not different between NMO and MS. Following treatments, the CSF-GFAP rapidly decreased to a normal level, but CSF-MBP remained high. There were strong correlations between the CSF-GFAP, CSF-S100B, or CSF-MBP levels and Expanded Disability Status Scale (EDSS) or spinal lesion length in the acute phase (r > 0.6). Only CSF-GFAP correlated with EDSS at 6-month follow-up (r = 0.51) in NMO.. Astrocytic damage reflected by elevated CSF glial fibrillary acidic protein is a clinically relevant, primary pathologic process in neuromyelitis optica, and is far more severe than demyelination.

Topics: Adult; Aged; Antibodies; Aquaporin 4; Astrocytes; Biomarkers; Central Nervous System; Demyelinating Diseases; Disability Evaluation; Encephalomyelitis, Acute Disseminated; Female; Follow-Up Studies; Glial Fibrillary Acidic Protein; Humans; Male; Methylprednisolone; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Nerve Growth Factors; Nervous System Diseases; Neurofilament Proteins; Neuromyelitis Optica; Neuroprotective Agents; S100 Calcium Binding Protein beta Subunit; S100 Proteins; Statistics, Nonparametric

A link between diffuse axonal loss and diffuse inflammation has been established in the brain of patients with progressive multiple sclerosis (MS). In the present paper, we sought to determine whether such a link could be similarly demonstrated in the spinal cord of patients with progressive MS.. A neuropathological quantitative assessment of inflammation and axonal loss was performed in the cervical spinal cord of 18 patients with progressive MS and 5 control subjects.. As previously reported, we found a mean 25% decrease of axonal density in the normal-appearing white matter (NAWM) of MS versus control spinal cords. T-cell perivascular infiltrates were rare, but a robust diffuse inflammation was observed in both the normal-appearing parenchyma and the meninges. The extent of diffuse axonal loss in the NAWM correlated with both the density of major histocompatibility complex (MHC) class II(+) microglia in the NAWM and, surprisingly, the density of CD3(+) T cells in the meninges. Interestingly, close interactions between T cells and MHC class II(+) macrophages were observed in the meninges of spinal cords from MS patients.. Recent studies assigned a major role to meningeal B-cell follicles in the pathophysiology of secondary progressive MS. The present work also emphasizes the link between meningeal inflammation and parenchymal lesions and points to a specific role exerted by both meningeal T cells and activated microglia in diffuse axonal loss in the spinal cord.

Topics: Adult; Antigens, CD; Axons; Cytokines; Demyelinating Diseases; Disease Progression; Female; Humans; Male; Meninges; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelitis; Neutrophil Infiltration; Postmortem Changes; Spinal Cord; Statistics, Nonparametric; T-Lymphocytes

Multiple sclerosis (MS) is an idiopathic chronic inflammatory demyelinating disease of the central nervous system with variable extent of remyelination. Remyelination originates from oligodendrocyte (OG) precursor cells, which migrate and differentiate into mature OG. Tubulin polymerization promoting protein (TPPP/p25) is located in mature OG and aggregates in oligodendroglial cytoplasmic inclusions in multiple system atrophy. We developed a novel monoclonal anti-TPPP/p25 antibody to quantify OG in different subtypes and disease stages of MS, and possible degenerative changes in OG. We evaluated autopsy material from 25 MS cases, including acute, primary progressive, secondary progressive, relapsing remitting MS, and five controls. Demyelinated lesions revealed loss of TPPP/p25-positive OG within the plaques. In remyelination, TPPP/p25 was first expressed in OG cytoplasms and later became positive in myelin sheaths. We observed increased numbers of TPPP/p25 immunoreactive OG in the normal appearing white matter (NAWM) in MS patients. In MS cases, the cytoplasmic area of TPPP/p25 immunoreactivity in the OG was higher in the periplaque area when compared with NAWM and the plaque, and TPPP/p25 immunoreactive OG cytoplasmic area inversely correlated with the disease duration. There was a lack of phospho-TDP-43, phospho-tau, α-synuclein, and ubiquitin immunoreactivity in OG with enlarged cytoplasm. Our data suggest impaired differentiation, migration, and activation capacity of OG in later disease stages of MS. Upregulation of TPPP/p25 in the periplaque white matter OG without evidence for inclusion body formation might reflect an activation state. Distinct and increased expression of TPPP/p25 in MS renders it a potential prognostic and diagnostic marker of MS.

Topics: Adult; Aged; Aged, 80 and over; alpha-Synuclein; Animals; Biomarkers; Cell Movement; DNA-Binding Proteins; Enzyme-Linked Immunosorbent Assay; Female; Glial Fibrillary Acidic Protein; Humans; Male; Mice; Mice, Inbred C57BL; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Myelin Sheath; Nerve Tissue Proteins; Oligodendroglia; Severity of Illness Index; tau Proteins

Topics: Autoantibodies; Biomarkers; Brain Neoplasms; Cerebrovascular Disorders; Enzyme-Linked Immunosorbent Assay; Globosides; Humans; Multiple Sclerosis; Myelin Basic Protein; Myelin P0 Protein; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating

Topics: Autoantigens; Autoimmune Diseases; Comorbidity; Genetic Predisposition to Disease; Genome-Wide Association Study; Humans; Multiple Sclerosis; Myelin Basic Protein; Retrospective Studies; Risk Factors; Social Environment

Cathepsins are required for the processing of antigens in order to make them suitable for loading on major histocompatibility complex (MHC) class II molecules, for subsequent presentation to CD4(+) T cells. It was shown that antigen processing in monocyte-derived dendritic cells (DC), a commonly used DC model, is different from that of primary human DC. Here, we report that the two subsets of human myeloid DC (mDC) and plasmacytoid DC (pDC) differ in their cathepsin distribution. The serine protease cathepsin G (CatG) was detected in mDC1, mDC2, pDC, cortical thymic epithelial cells (cTEC) and high levels of CatG were determined in pDC. To address the role of CatG in the processing and presentation of a Multiple Sclerosis-associated autoantigen myelin basic protein (MBP), we used a non-CatG expressing fibroblast cell line and fibroblasts, which were preloaded with purified CatG. We find that preloading fibroblasts with CatG results in a decrease of MBP84-98-specific T cell proliferation, when compared to control cells. Our data suggest a different processing signature in primary human antigen-presenting cells and CatG may be of functional importance.

Topics: Antigen Presentation; Antigen-Presenting Cells; Aspartic Acid Endopeptidases; Autoantigens; Cathepsin G; Cathepsins; Cell Line; Cysteine Endopeptidases; Humans; Male; Multiple Sclerosis; Myelin Basic Protein; Serine Endopeptidases

Altered peptide ligands that alter immune responses are a promising approach to the immunotherapy of multiple sclerosis. Cyclic peptides are of interest because the limited stability of linear peptides restricts their use in vivo. We designed and synthesized a cyclic double mutant peptide from MBP(87-99)-[cyclo(87-99)[A(91),A(96)]MBP(87-99)]. Immunization of mice, in CFA reduced Th1 responses. However, when conjugated to reduced mannan, a significant further reduction of Th1 responses and moderate Th2 responses were induced.

Topics: Adjuvants, Immunologic; Animals; Immunotherapy; Interferon-gamma; Interleukin-4; Mannans; Mice; Multiple Sclerosis; Mutation; Myelin Basic Protein; Peptide Fragments; Peptides, Cyclic; T-Lymphocytes

Anti-myelin basic protein (-MBP) autoantibodies have generally been considered to be absent from sera from healthy individuals, but to be detectable in sera from some patients with multiple sclerosis (MS). However, their pathogenic role is uncertain. We demonstrate the presence of MBP-reactive autoantibodies in sera from 17 healthy individuals and 17 MS patients. The addition of MBP to the sera caused a dose-dependent deposition of MBP and co-deposition of immunoglobulin M (IgM) and fragments of complement component 3 (C3) on allogeneic monocytes. Calcium chelation abrogated the immunoglobulin deposition, indicating that formation of complement-activating immune complexes played a role in the binding process. Furthermore, MBP elicited tumour necrosis factor (TNF)-alpha and interleukin (IL)-10 production by normal mononuclear cells in the presence of serum from both patients and controls. Mononuclear cells from MS patients responded to MBP with the production of interferon (IFN)-gamma, IL-4 and IL-5, in addition to TNF-alpha and IL-10. The production of IFN-gamma and IL-5 was increased when MS serum was added rather than normal serum. Denaturation of MBP strongly inhibited MBP deposition and the MBP-induced IgM deposition and cytokine production, indicating that these events were facilitated by autoantibodies recognizing conformational epitopes on MBP. We infer that MBP-elicited TNF-alpha and IL-10 responses are promoted to equal extents by naturally occurring MBP autoantibodies and autoantibodies contained in MS sera. However, the latter seem to be more efficient in facilitating the production of IFN-gamma and IL-5.

Topics: Adult; Autoantibodies; Calcium; Complement C3; Female; Humans; Immunoglobulin G; Immunoglobulin M; Interferon-gamma; Interleukin-10; Interleukin-4; Interleukin-5; Leukocytes, Mononuclear; Male; Multiple Sclerosis; Myelin Basic Protein; Tumor Necrosis Factor-alpha

To assess the value of cerebral spinal fluid (CSF) and serum myelin basic protein (MBP) levels in the diagnosis of multiple sclerosis (MS).. Enzyme-linked immunosorbent assay was used to detect the CSF and serum levels of MBP in patients with MS (n=45), patients with Guillain-Barre syndrome (GBS) (n=36) and control subjects (control) (n=33). The sensitivity and specificity of MBP in CSF and serum in the diagnosis of MS were evaluated using the receiver-operating characteristic (ROC) curves.. The MBP levels in CSF and serum both increased significantly in MS group as compared with those in GBS (P<0.01) and control groups (P<0.01). The area under the curve (AUC) of the ROC curve of MBP in CSF was 0.853-/+0.037 for MS diagnosis, and with the optimal cut-off value of 0.87 pg/ml, CSF MBP showed a diagnostic sensitivity of 83.7% and specificity of 78.3%. The AUC of the ROC curve of serum MBP was 0.761-/+0.046, and the optimal cut-off value of 0.25 pg/ml resulted in a diagnostic sensitivity of 62.8% and specificity of 73.9%. No statistically significant difference was found between the two AUCs (P>0.05).. Evaluation of CSF and serum MBP levels allows accurate diagnosis of MS, and MBP level in the CSF has greater diagnostic sensitivity than serum MBP. The combination of both CSF and serum MBP levels may serve as a sensitive index for the diagnosis of MS.

Topics: Adolescent; Adult; Aged; Early Diagnosis; Enzyme-Linked Immunosorbent Assay; Female; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; ROC Curve; Sensitivity and Specificity; Young Adult

Matrix metalloproteinases (MMPs) play a significant role in the fragmentation of myelin basic protein (MBP) and demyelination leading to autoimmune multiple sclerosis (MS) and experimental autoimmune encephalomyelitis (EAE). The classic MBP isoforms are predominantly expressed in the oligodendrocytes of the CNS. The splice variants of the single MBP gene (Golli-MBP BG21 and J37) are widely expressed in the neurons and also in the immune cells. The relative contribution of the individual MMPs to the MBP cleavage is not known.. To elucidate which MMP plays the primary role in cleaving MBP, we determined the efficiency of MMP-2, MMP-8, MMP-9, MMP-10, MMP-12, MT1-MMP, MT2-MMP, MT3-MMP, MT4-MMP, MT5-MMP and MT6-MMP in the cleavage of the MBP, BG21 and J37 isoforms in the in vitro cleavage reactions followed by mass-spectroscopy analysis of the cleavage fragments. As a result, we identified the MMP cleavage sites and the sequence of the resulting fragments. We determined that MBP, BG21 and J37 are highly sensitive to redundant MMP proteolysis. MT6-MMP (initially called leukolysin), however, was superior over all of the other MMPs in cleaving the MBP isoforms. Using the mixed lymphocyte culture assay, we demonstrated that MT6-MMP proteolysis of the MBP isoforms readily generated, with a near quantitative yield, the immunogenic N-terminal 1-15 MBP peptide. This peptide selectively stimulated the proliferation of the PGPR7.5 T cell clone isolated from mice with EAE and specific for the 1-15 MBP fragment presented in the MHC H-2(U) context.. In sum, our biochemical observations led us to hypothesize that MT6-MMP, which is activated by furin and associated with the lipid rafts, plays an important role in MS pathology and that MT6-MMP is a novel and promising drug target in MS especially when compared with other individual MMPs.

Topics: Alternative Splicing; Amino Acid Sequence; Animals; Humans; Lymphocyte Activation; Matrix Metalloproteinases; Metallothionein 3; Mice; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptides; Protein Isoforms; Sequence Alignment; T-Lymphocytes

The kinesin motor protein Kif1b has previously been implicated in the axonal transport of mitochondria and synaptic vesicles. More recently, KIF1B has been associated with susceptibility to multiple sclerosis (MS). Here we show that Kif1b is required for the localization of mbp (myelin basic protein) mRNA to processes of myelinating oligodendrocytes in zebrafish. We observe the ectopic appearance of myelin-like membrane in kif1b mutants, coincident with the ectopic localization of myelin proteins in kif1b mutant oligodendrocyte cell bodies. These observations suggest that oligodendrocytes localize certain mRNA molecules, namely those encoding small basic proteins such as MBP, to prevent aberrant effects of these proteins elsewhere in the cell. We also find that Kif1b is required for outgrowth of some of the longest axons in the peripheral and central nervous systems. Our data demonstrate previously unknown functions of kif1b in vivo and provide insights into its possible roles in MS.

Topics: Animals; Axons; Humans; Kinesins; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Oligodendroglia; Zebrafish; Zebrafish Proteins

Gray matter (GM) lesions are recognized as important components of the pathology of multiple sclerosis (MS), and involvement of the deep gray matter (DGM) is suggested by magnetic resonance imaging. The aims of this study were to determine the frequency and distribution of lesions and characterize the inflammatory and neurodegenerative changes in DGM of MS patients. Histochemistry, immunohistochemistry, and morphometry were performed on whole coronal sections of 14 MS and 12 control (6 normal, 6 from amyotrophic lateral sclerosis patients) brains. Demyelinating lesions were frequent in MS DGM; most often in the thalamus and caudate, but they were also seen in the putamen, pallidum, claustrum, amygdala, hypothalamus, and substantia nigra. Most DGM lesions involved both GM and white matter. Inflammation in active DGM lesions was similar to that in lesions only in white matter but was less intense, and there was a preponderance of activated microglia, scarce myelin-laden macrophages, and a lesser extent of axonal damage. Neuronal loss was observed both in DGM lesions and nondemyelinated DGM with neuron atrophy in nondemyelinated DGM. In conclusion, demyelination and neurodegenerative changes are common in MS DGM and may contribute to clinical impairment. Inflammation in DGM lesions is intermediate between the destructive inflammation of white matter lesions and the minimal inflammation of cortical lesions. We hypothesize that alterations of glutamate reuptake mechanisms may contribute to these differences.

Topics: Adult; Aged; Amyotrophic Lateral Sclerosis; Antigens, CD; Brain; Demyelinating Diseases; Female; Fibrinogen; HLA-DR Antigens; Humans; Inflammation; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Nerve Tissue Proteins; Neurodegenerative Diseases; Neuroglia; Neurons; Staining and Labeling

Tandem mass spectrometry was used to identify naturally processed peptides bound to major histocompatibility complex (MHC) I and MHC II molecules in central nervous system (CNS) of eight patients with multiple sclerosis (MS). MHC molecules were purified from autopsy CNS material by immunoaffinity chromatography with monoclonal antibody directed against HLA-A, -B, -C, and -DR. Subsequently peptides were separated by reversed-phase HPLC and analyzed by mass spectrometry. Database searches revealed 118 amino acid sequences from self-proteins eluted from MHC I molecules and 191 from MHC II molecules, corresponding to 174 identified source proteins. These sequences define previously known and potentially novel autoantigens in MS possibly involved in disease induction and antigen spreading. Taken together, we have initiated the characterization of the CNS-expressed MHC ligandome in CNS diseases and were able to demonstrate the presentation of naturally processed myelin basic protein peptides in the brain of MS patients.

Topics: Amino Acid Sequence; Antigen Presentation; Central Nervous System; Databases, Protein; Histocompatibility Antigens Class I; Histocompatibility Antigens Class II; Humans; Ligands; Mass Spectrometry; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptides; Protein Binding; Proteomics; Reproducibility of Results

Experimental autoimmune encephalomylitis (EAE), an animal mode of multiple sclerosis (MS), was previously considered that be mediated by Th1 cells. However, a number of recent studies provided strong evidence that T helper cells that produce IL-17 play a dominant role in the pathogenesis of EAE. Curcumin (1,7-Bis 94-hydroxy-3-methoxyphenyl)-1,6 heptadiene-3, 5-di-one) is a naturally occurring polyphenolic phytochemical isolated from the rhizome of the medicinal plant Curcuma longa. It has been strongly implicated as an anti-inflammatory agent, but the precise mechanisms of its action are largely unknown. In the present study, we have investigated the efficacy and mechanism of curcumin against EAE. The treatment of Lewis rats with curcumin significantly reduced the clinical severity of EAE, and had a dramatic reduction in the number of inflammatory cells infiltration in the spinal cord. The proliferation of the MBP-reaction lymphocyte also was reduced in a curcumin dose-dependent manner. Furthermore, the mRNA expression of the cytokine profiles was assessed by quantitative reverse-transcription polymerase chain reaction (qRT-PCR), revealing the dramatic decrease of IL-17, TGF-beta, IL-6, IL-21, STAT3, and RORgammat expression in curcumin-treated groups and STAT3-phosphorylation also was inhibited. These findings indicated that curcumin amelioration EAE was, to a large extent, due to inhibit differentiation and development of Th17 cells depends on down-regulating expression of IL-6, IL-21, RORgammat signaling and inhibition STAT3-phosphorylation, suggests it is useful in the treatment of MS and other Th17 cell-mediated inflammatory diseases.

Topics: Animals; Cell Proliferation; Curcuma; Curcumin; Disease Progression; Dose-Response Relationship, Drug; Down-Regulation; Encephalomyelitis, Autoimmune, Experimental; Female; Freund's Adjuvant; Guinea Pigs; Humans; Immunization; Interleukin-17; Interleukin-6; Interleukins; Jurkat Cells; Multiple Sclerosis; Myelin Basic Protein; Nuclear Receptor Subfamily 1, Group F, Member 3; Peptides; Phosphorylation; Phytotherapy; Rats; Rats, Inbred Lew; Rhizome; Spinal Cord; STAT3 Transcription Factor; T-Lymphocytes, Helper-Inducer; Transforming Growth Factor beta

Multiple sclerosis (MS) is an autoimmune disease linked to the human leucocyte antigen (HLA) class II genes DRB1*1501, DRB5*0101 and DQB1*0602. T cells reactive towards the DRB1*1501 in complex with various peptides derived from myelin basic protein (MBP), which is the major component of myelin, have been found in the peripheral blood of MS patients. These autoreactive T cells are believed to play a role in the pathogenesis of MS. In this article, antibodies against the HLA complex DR2b (DRA1*0101/DRB1*1501) in complex with the MBP-derived peptide MBP(85-99) have been generated by immunization of NMRI mice with three different antigen mimicking peptides displayed on M13 bacteriophages. The peptides mimick the epitope of a monoclonal antibody specific for the DR2b-MBP(85-99) complex. The mice developed IgG antibodies not only against the peptides injected, but they also developed antibodies against the DR2b complex and specific antibodies against the DR2b-MBP(85-99) complex. These data open up the possibility of designing antigen mimicking peptides for vaccination against MS.

Topics: Animals; Antibodies; Cloning, Molecular; Genetic Vectors; HLA-DR2 Antigen; Humans; Mice; Molecular Mimicry; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Peptides; Vaccination

Even though the etiology of multiple sclerosis (MS) remains largely unknown, research data support the hypothesis that autoimmunity plays a major role in disease development. Several disease-modifying agents have been approved for the treatment of MS; however, there is still a need for antigen-specific treatments that combine efficacy and safety. DNA vaccination represents a new therapeutic alternative in this respect. Preclinical studies in different models of autoimmunity have demonstrated that injection of plasmid DNA encoding a self-antigen in mice restores self-tolerance, leaving immunity against infectious and tumor antigens intact. Based on this evidence, the first DNA vaccine for MS has been created. Bayhill Therapeutic Inc's BHT-3009 encodes full-length, human myelin basic protein (MBP), and has recently been evaluated in a phase I/II and a phase II clinical trial. BHT-3009 was safe and well tolerated in both trials, inducing immune tolerance that extended beyond MBP to other myelin antigens. In addition, a reduction in the number of active lesions was observed, which was accompanied by a decrease in clinical relapse rates, particularly in patients with high immunological activity at baseline. BHT-3009 appears to be a promising new approach for the treatment of MS, although further clinical trials are warranted to confirm the early findings.

Topics: Clinical Trials as Topic; Contraindications; Drug Evaluation, Preclinical; Humans; Multiple Sclerosis; Myelin Basic Protein; Patents as Topic; Plasmids; Structure-Activity Relationship; Vaccines, DNA

Multiple sclerosis (MS) is a disease of the central nervous system with autoimmune etiology. Susceptibility to MS is linked to viral and bacterial infections. Matrix metalloproteinases (MMPs) play a significant role in the fragmentation of myelin basic protein (MBP) and demyelination. The splice variants of the single MBP gene are expressed in the oligodendrocytes of the central nervous system (classic MBP) and in the immune cells (Golli-MBPs). Our data suggest that persistent inflammation caused by environmental risk factors is a step to MS. We have discovered biochemical evidence suggesting the presence of the inflammatory proteolytic pathway leading to MS. The pathway involves the self-activated furin and PC2 proprotein convertases and membrane type-6 MMP (MT6-MMP/MMP-25) that is activated by furin/PC2. These events are followed by MMP-25 proteolysis of the Golli-MBP isoforms in the immune system cells and stimulation of the specific autoimmune T cell clones. It is likely that the passage of these autoimmune T cell clones through the disrupted blood-brain barrier to the brain and the recognition of neuronal, classic MBP causes inflammation leading to the further up-regulation of the activity of the multiple individual MMPs, the massive cleavage of MBP in the brain, demyelination, and MS. In addition to the cleavage of Golli-MBPs, MMP-25 proteolysis readily inactivates crystallin alphaB that is a suppressor of MS. These data suggest that MMP-25 plays an important role in MS pathology and that MMP-25, especially because of its restricted cell/tissue expression pattern and cell surface/lipid raft localization, is a promising drug target in MS.

Topics: Antigen-Presenting Cells; Brain; GPI-Linked Proteins; Humans; Inflammation; Matrix Metalloproteinases, Membrane-Associated; Membrane Microdomains; Multiple Sclerosis; Myelin Basic Protein; Proprotein Convertases; Signal Transduction; Tissue Distribution; Up-Regulation

T lymphocytes costimulatory molecules, including CD80, CD86, CD28, CTLA4, PD-1, PD-L1, and B7-H3, are associated with the preferential production of pro- or anti-inflammatory cytokines. We analyzed the expression of these molecules and myelin basic protein (MBP)-specific IL-10 and IFN-gamma production in patients with multiple sclerosis (MS) with relapsing-remitting acute (AMS, n = 40) or stable (SMS, n = 38). Twenty-two patients successfully undergoing therapy with glatimer acetate (n = 12) or IFNbeta (n = 10) were also analyzed. MBP-specific and PD-1-expressing T lymphocytes, PD-L1-expressing CD19(+) cells, and PD-L1(+)/IL-10(+)/CD14(+) and CD19(+) cells were significantly augmented in SMS patients. Additionally, MBP-specific and annexin V-expressing CD4(+) and CD8(+) (apoptotic) T lymphocytes were augmented and pAkt-positive (proliferating) cells were decreased in SMS compared with AMS patients. PD-1 ligation resulted in the increase of pAkt(+) lymphocytes in AMS patients alone. B7-H3 expression and IFN-gamma production were comparable in all individuals but the PD-L1(+)/IL-10(+) over B7-H3(+)/IFN-gamma(+) ratio was significantly lower in AMS compared with SMS patients. Finally, PD-L1 expression on immune cells was reduced in treated patients, suggesting that therapy-induced disease remission is not associated with the modulation of the expression of this molecule. The PD-1/PD-L1 pathway plays an important role in modulating immune functions in MS patients; monitoring and targeting these proteins could offer diagnostic and therapeutic advantages.

Topics: Adult; Antigens, CD; Apoptosis; Apoptosis Regulatory Proteins; B7 Antigens; B7-1 Antigen; B7-2 Antigen; B7-H1 Antigen; CD28 Antigens; CTLA-4 Antigen; Female; Humans; Interferon-gamma; Interleukin-10; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Oncogene Protein v-akt; Peptides; Programmed Cell Death 1 Receptor; Receptors, Immunologic; Signal Transduction; T-Lymphocytes

Cortical myelin can be severely affected in patients with demyelinating disorders of the central nervous system. However, the functional implication of cortical demyelination remains elusive. In this study, we investigated whether cortical myelin influences cortical spreading depression (CSD).. CSD measurements were performed in rodent models of toxic and autoimmune induced cortical demyelination, in neuregulin-1 type I transgenic mice displaying cortical hypermyelination, and in glial fibrillary acidic protein-transgenic mice exhibiting pronounced astrogliosis.. Cortical demyelination, but not astrogliosis or inflammation per se, was associated with accelerated CSD. In contrast, hypermyelinated neuregulin-1 type I transgenic mice displayed a decelerated CSD propagation.. Cortical myelin may be crucially involved in the stabilization and buffering of extracellular ion content that is decisive for CSD propagation velocity and cortical excitability, respectively. Our data thus indicate that cortical involvement in human demyelinating diseases may lead to relevant alterations of cortical function.

Topics: Animals; Astrocytes; Cerebral Cortex; Cortical Spreading Depression; Cuprizone; Demyelinating Diseases; Electroencephalography; Encephalomyelitis, Autoimmune, Experimental; Female; Functional Laterality; Glial Fibrillary Acidic Protein; Gliosis; Humans; Male; Mice; Mice, Inbred BALB C; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Neuregulin-1; Rats; Rats, Inbred Lew

MBP-specific autoreactive T cells are considered pro-inflammatory T cells and thought to play an important role in the pathogenesis of multiple sclerosis (MS). Here, we report that MBP(83-99)-specific T cells generated from MS patients (n = 7) were comprised of pro-inflammatory and regulatory subsets of distinct phenotypes. The pro-inflammatory phenotype was characterized by high production of IFN-gamma, IL-6, IL-21 and IL-17 and low expression of FOXP3, whereas the regulatory subset expressed high levels of FOXP3 and exhibited potent regulatory functions. The regulatory subset of MBP-specific T cells appeared to expand from the CD4(+)CD25(-) T-cell pool. Their FOXP3 expression was stable, independent of the activation state and it correlated with suppressive function and inversely with the production of IFN-gamma, IL-6, IL-21 and IL-17. In contrast, the phenotype and function of FOXP3(low) MBP-specific T cells were adaptive and dependent on IL-6. The higher frequency of FOXP3(high) MBP-specific T cells was observed when IL-6 was neutralized in the culture of PBMC with MBP. The study provides new evidence that MBP-specific T cells are susceptible to pro-inflammatory cytokine milieu and act as either pro-inflammatory or regulatory T cells.

Topics: Cell Differentiation; Forkhead Transcription Factors; Humans; Inflammation; Interleukin-6; Lymphocyte Activation; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes; T-Lymphocytes, Regulatory

Mutations of peptides to generate altered peptide ligands, capable of switching immune responses from T helper 1 (Th1) to T helper 2 (Th2), are promising candidates for the immunotherapy of autoimmune diseases such as multiple sclerosis (MS). We synthesized two mutant peptides from myelin basic protein 87-99 (MBP(87-99)), an immunodominant peptide epitope identified in MS. Mutations of residues K(91) and P(96), known to be critical T-cell receptor (TCR) contact sites, resulted in the mutant peptides [R(91), A(96)]MBP(87-99) and [A(91), A(96)]MBP(87-99). Immunization of mice with these altered peptide ligands emulsified in complete Freund's adjuvant induced both interferon-gamma (IFN-gamma) and interleukin-4 (IL-4) responses compared with only IFN-gamma responses induced to the native MBP(87-99) peptide. It was of interest that [R(91), A(96)]MBP(87-99) conjugated to reduced mannan induced 70% less IFN-gamma compared with the native MBP(87-99) peptide. However, [A(91), A(96)]MBP(87-99) conjugated to reduced mannan did not induce IFN-gamma-secreting T cells, but elicited very high levels of interleukin-4 (IL-4). Furthermore, antibodies generated to [A(91), A(96)]MBP(87-99) peptide conjugated to reduced mannan did not cross-react with the native MBP(87-99) peptide. By molecular modelling of the mutant peptides in complex with major histocompatibility complex (MHC) class II, I-A(s), novel interactions were noted. It is clear that the double-mutant peptide analogue [A(91), A(96)]MBP(87-99) conjugated to reduced mannan is able to divert immune responses from Th1 to Th2 and is a promising mutant peptide analogue for use in studies investigating potential treatments for MS.

Topics: Animals; Bystander Effect; Cross Reactions; Encephalomyelitis, Autoimmune, Experimental; Female; Freund's Adjuvant; Immunization; Immunoglobulin G; Interferon-gamma; Interleukin-4; Ligands; Mannans; Mice; Mice, Inbred Strains; Models, Molecular; Multiple Sclerosis; Mutation; Myelin Basic Protein; Peptide Fragments; Th1 Cells; Th2 Cells

Topics: Axons; Causality; HLA Antigens; Humans; Interferon-gamma; Interleukin-1; Matrix Metalloproteinases; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes; Tumor Necrosis Factor-alpha; Vitamin D Deficiency

Topics: Animals; Antibodies, Monoclonal; Clinical Trials as Topic; Cytokines; Disease Models, Animal; Humans; Immunotherapy; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments

Patients with multiple sclerosis (MS) display significant peripheral blood CD8(+) T cell receptor biases, suggesting clonal selection. Our objective was to identify relevant myelin-derived peptides capable of eliciting responses of fresh blood CD8+ T cells in MS patients. We focused our analysis on the HLA supertypes (HLA-A3, -A2, -B7, -B27, -B44) predominant in a patient cohort. Three myelin protein (MBP, PLP and MOG) sequences were screened for HLA binding motifs and peptides were tested for their binding to HLA molecules. The cellular responses of 27 MS patients and 19 age- and sex-matched healthy controls (HC) were tested in IFN-gamma ELISPOT assays only detecting pre-committed CD8+ T cells. Sixty-nine new epitopes elicited positive responses, with MOG-derived peptides being the most immunogenic and peptides binding to HLA-A3 being the most frequent. However, MS patients and HC displayed the same frequency of autoreactive cells. The epitopes inducing the strongest responses were not those with the highest HLA binding, suggesting an effective thymic selection in MS patients. Our data extend the concept that the frequency of myelin-reactive T cells in MS patient blood is not increased compared to HC. The description of this set of myelin-derived peptides (MHC class I restricted, recognized by CD8+ T cells) offers new tools to explore the CD8+ cell role in MS.

Topics: Adult; Antigen Presentation; CD8-Positive T-Lymphocytes; Epitopes; Female; Histocompatibility Antigens Class I; Humans; Immunodominant Epitopes; Immunologic Memory; Interferon-gamma; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Receptors, Antigen, T-Cell

Myelin basic protein (MBP) from multiple sclerosis (MS) patients contains lower levels of phosphorylation at Thr97 than normal individuals. The significance of phosphorylation at this site is not fully understood, but it is proposed to play a role in the normal functioning of MBP. Human Herpesvirus Type 6 encodes the protein U24, which has tentatively been implicated in the pathology of MS. U24 shares a 7 amino acid stretch encompassing the Thr97 phosphorylation site of MBP: PRTPPPS. We demonstrate using a combination of mass spectrometry, thin layer chromatography and autoradiography, that U24 can be phosphorylated at the equivalent threonine. Phospho-U24 may confound signalling or other pathways in which phosphorylated MBP may participate, precipitating a pathological process.

Topics: Base Sequence; Chromatography, Thin Layer; Herpesvirus 6, Human; Humans; Mitogen-Activated Protein Kinase Kinases; Molecular Mimicry; Multiple Sclerosis; Myelin Basic Protein; Phosphoamino Acids; Phosphorylation; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; Threonine; Viral Proteins

Interferon (IFN)-beta therapy has well-established clinical benefits in multiple sclerosis (MS), but the underlying modulation of cytokine responses to myelin self-antigens remains poorly understood. We analysed the CD4+ T cell proliferation and cytokine responses elicited by myelin basic protein (MBP) and a foreign recall antigen, tetanus toxoid (TT), in mononuclear cell cultures from fourteen MS patients undergoing IFN-beta therapy. The MBP-elicited IFN-gamma-, TNF-alpha- and IL-10 production decreased during therapy (p<0.007-0.03), while the IL-6 production increased (p<0.03). No significant change was observed in the MBP-induced CD4+ T cell proliferation, or in the production of IL-4, IL-5 and brain-derived neurotrophic factor. In comparison, IFN-beta therapy reduced IFN-gamma and IL-4 responses to TT (p<0.003 and p<0.04). Thus, IFN-beta inhibits IFN-gamma production in general, presumably alleviating the detrimental influence of IFN-gamma in MS. However, the increase in proinflammatory IL-6 and the decrease in anti-inflammatory IL-10 responses suggest that IFN-beta has more diverse effects than previously assumed.

Topics: Adult; CD4-Positive T-Lymphocytes; Cell Proliferation; Cytokines; Female; Humans; Interferon-beta; Male; Multiple Sclerosis; Myelin Basic Protein; Tetanus Toxoid

Symptomatic primary Epstein-Barr virus (EBV) infection and elevated humoral immune responses to EBV are associated with an increased risk of developing multiple sclerosis (MS). We explored mechanisms leading to this change in EBV-specific immunity in untreated patients with MS and healthy virus carriers matched for MS-associated HLA alleles. MS patients showed selective increase of T cell responses to the EBV nuclear antigen 1 (EBNA1), the most consistently recognized EBV-derived CD4(+) T cell antigen in healthy virus carriers, but not to other EBV-encoded proteins. In contrast, influenza and human cytomegalovirus-specific immune control was unchanged in MS. The enhanced response to EBNA1 was mediated by an expanded reservoir of EBNA1-specific central memory CD4(+) T helper 1 (Th1) precursors and Th1 (but not Th17) polarized effector memory cells. In addition, EBNA1-specific T cells recognized myelin antigens more frequently than other autoantigens that are not associated with MS. Myelin cross-reactive T cells produced IFN-gamma, but differed from EBNA1-monospecific cells in their capability to produce interleukin-2, indicative of a polyfunctional phenotype as found in controlled chronic viral infections. Our data support the concept that clonally expanded EBNA1-specific CD4(+) T cells potentially contribute to the development of MS by cross-recognition of myelin antigens.

Topics: Adult; Aged; Antibodies, Viral; Autoantigens; Case-Control Studies; CD4-Positive T-Lymphocytes; Cross Reactions; Epstein-Barr Virus Infections; Epstein-Barr Virus Nuclear Antigens; Female; Herpesvirus 4, Human; Humans; Immunoglobulin G; Interferon-gamma; Interleukin-2; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocyte Subsets

Based on evidence that pregnant women with multiple sclerosis (MS) show a decline in the relapse rate during the third trimester and an increase during the first 3 months postpartum, the suggestion was made that high levels of circulating sex steroids are responsible for pregnancy-mediated neuroprotection. As both estradiol (E(2)) and progesterone exert neuroprotective and myelinating effects on the nervous system, the effects of sex steroids were studied in the experimental autoimmune encephalomyelitis (EAE) model of MS.. EAE was induced in female C57BL/6 mice by administration of a myelin oligodendrocyte protein (MOG(40-45)) peptide. Clinical signs of EAE, myelin protein expression and neuronal parameters were determined in mice with or without hormonal treatment.. Progesterone given prior to EAE induction attenuated the clinical scores of the disease, slightly delayed disease onset and decreased demyelination foci, according to luxol fast blue staining (LFB), myelin basic protein (MBP) and proteolipid protein (PLP) and mRNA expression. Motoneuron expression of Na,K-ATPase mRNA was also enhanced by progesterone. In turn, combined E(2) plus progesterone therapy more effectively prevented neurological deficits, fully restored LFB staining, MBP and PLP immunoreactivity and avoided inflammatory cell infiltration. On the neuronal side, steroid biotherapy increased brain-derived neurotrophic factor (BDNF) mRNA.. Early treatment with progesterone alone or more evidently in combination with E(2) showed a clinical benefit and produced myelinating and neuroprotective effects in mice with MOG(40-45)-induced EAE. Therefore, sex steroids should be considered as potential novel therapeutic strategies for MS.

Topics: Animals; Brain-Derived Neurotrophic Factor; Central Nervous System; Disease Models, Animal; Drug Synergism; Drug Therapy, Combination; Encephalomyelitis, Autoimmune, Experimental; Estradiol; Female; Humans; Mice; Mice, Inbred C57BL; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Nerve Fibers, Myelinated; Neurosecretory Systems; Progesterone; RNA, Messenger; Sodium-Potassium-Exchanging ATPase; Treatment Outcome; Up-Regulation

Multiple sclerosis (MS) is characterized by a dynamic inflammatory process in which CNS lesions of distinct cellular composition coexist. In particular the formation of B cell plaques has been ascribed an important role as predictor of disease progression. Here we show that the novel MBP-PLP fusion protein (MP4)-induced experimental autoimmune encephalomyelitis (EAE) of C57BL/6 mice fulfils these criteria inducing differential cellular infiltration of B cells, T cells, macrophages and granulocytes and permitting the quantification and staging of the disease. On the contrary, both key features - dynamic CNS inflammation and B cell infiltration - were absent in the classical MOG:35-55-induced EAE of C57BL/6 mice, which was characterized by a static CD4(+) T cell and macrophage-mediated CNS immunopathology throughout the disease. MP4-induced EAE may thus provide a unique opportunity for studying immune-pathomechanisms of the disease that have been previously neglected due to experimental shortcomings in murine EAE.

Topics: Animals; B-Lymphocytes; Brain; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Female; Glycoproteins; Mice; Mice, Inbred C57BL; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Myelin-Oligodendrocyte Glycoprotein; Peptide Fragments; Recombinant Fusion Proteins; Spinal Cord

Evidence suggests that T-cell response to myelin basic protein (MBP) plays an important role in multiple sclerosis (MS). However, the mechanism of generation for MBP immunogenic epitopes is unclear. A series of specific CD4(+) T-cell lines was obtained by stimulating peripheral blood mononuclear cells from MS patients with synthetic peptides spanning the entire MBP sequence. T-cell lines recognizing MBP(8-27), MBP(13-32), and MBP(23-42) peptides, whose sequences are identical for humans and rats, specifically proliferated and produced large amounts of interferon-gamma in response to autologous dendritic cells (DCs) loaded in vitro with apoptotic rat oligodendrocytes. Results suggest that MBP epitopes generated from enzymatic processing of apoptotic glial cells by DCs might be relevant to MS pathogenesis.

Topics: Adult; Amino Acid Sequence; Animals; Apoptosis; Cells, Cultured; Cytokines; Dendritic Cells; Epitopes, T-Lymphocyte; Female; Histocompatibility Antigens Class II; HLA-DR Antigens; Humans; Lymphocyte Activation; Male; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Oligodendroglia; Rats

Immunoglobulins IgG and sIgA actively hydrolyzing histone H1 have been detected on analyzing proteolytic activity of antibodies isolated by chromatography on Protein A-agarose from blood serum of patients with multiple sclerosis and from colostrum of healthy mothers. These antibodies hydrolyze other histones less actively and virtually failed to cleave lysozyme of chicken egg. By gel filtration at acidic pH and subsequent analysis of protease activity of chromatographic fractions, it was shown that IgG and sIgA molecules were responsible for hydrolysis of histone H1. Anti-histone H1 antibodies of IgG and sIgA classes were purified by affinity chromatography on histone H1-Sepharose from catalytically active antibody preparations. The protease activity of anti-histone H1 IgG antibodies was inhibited by serine proteinase inhibitors, whereas anti-histone H1 sIgA antibodies were insensitive to inhibitors of serine, asparagine, and cysteine proteases.

Topics: Animals; Antibodies, Catalytic; Chickens; Colostrum; Female; Histones; Humans; Immunoglobulin A, Secretory; Immunoglobulin G; Multiple Sclerosis; Muramidase; Myelin Basic Protein

Myelin basic protein (MBP)-specific T cells are thought to play a role in the development of multiple sclerosis. MBP residues 111-129 compose an immunodominant epitope cluster restricted by HLA-DRB1*0401. The sequence of residues 111-129 of MBP (MBP(111-129)) differs in humans (MBP122:Arg) and mice (MBP122:Lys) at aa 122. We previously found that approximately 50% of human MBP(111-129) (MBP122:Arg)-specific T cell clones, including MS2-3C8 can proliferate in response to mouse MBP(111-129) (MBP122:Lys). However, the other half of T cell clones, including HD4-1C2, cannot proliferate in response to MBP(111-129) (MBP122:Lys). We found that MBP(111-129) (MBP122:Lys) is an antagonist for HD4-1C2 TCR, therefore, MS2-3C8 and HD4-1C2 TCRs are agonist- and antagonist-specific TCRs in mice, respectively. Therefore, we examined the development of HD4-1C2 TCR and MS2-3C8 TCR transgenic (Tg) T cells in the thymus and periphery. We found that dual TCR expression exclusively facilitates the development of MBP(111-129) TCR Tg T cells in the periphery of HD4-1C2 TCR/HLA-DRB1*0401 Tg mice although it is not required for their development in the thymus. We also found that MS2-3C8 TCR Tg CD8(+) T cells develop along with MS2-3C8 TCR Tg CD4(+) T cells, and that dual TCR expression was crucial for the development of MS2-3C8 TCR Tg CD4(+) and CD8(+) T cells in the thymus and periphery, respectively. These results suggest that thymic and peripheral development of MBP-specific T cells are different; however, dual TCR expression can facilitate their development.

Topics: Animals; CD4-Positive T-Lymphocytes; CD8-Positive T-Lymphocytes; Epitopes, T-Lymphocyte; Gene Expression; HLA-DR Antigens; HLA-DRB1 Chains; Humans; Mice; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Nerve Tissue Proteins; Peptides; Receptors, Antigen, T-Cell; Thymus Gland; Transcription Factors

Multiple sclerosis (MS) is a chronic autoimmune neurological disease characterized by infiltration of peripheral inflammatory cells to the central nervous system (CNS) and demyelination of CNS white matter. Epidemiological evidence suggests a possible infectious trigger. One potential mechanism by which an infectious agent may trigger MS is via molecular mimicry wherein T cells generated against foreign epitopes cross-react with self-myelin epitopes, such as myelin basic protein (MBP), with sufficient sequence similarity. It has been previously reported that an MBP(85-99)-reactive T cell clone derived from an MS patient cross-reacted with multiple bacterial-derived mimic peptides in vitro. We show that the same mimic peptides can induce clinical disease in two different strains of mice transgenic for both a human MBP(85-99)-specific TCR and HLA-DR2 (MHC II), albeit with different disease patterns - relapsing-remitting vs. monophasic. Interestingly, clinical disease correlates with CNS infiltration of CD4(+) T cells and F4/80(+) macrophages, but not with in vitro proliferative or cytokine responses of splenocytes in response to either MBP(85-99) or its mimics.

Topics: Animals; Antigens, Bacterial; CD4-Positive T-Lymphocytes; Clone Cells; Encephalomyelitis, Autoimmune, Experimental; Epitopes, T-Lymphocyte; HLA-DR2 Antigen; Humans; Macrophages; Mice; Mice, Transgenic; Molecular Mimicry; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Receptors, Antigen, T-Cell

Derangement of cellular immunity is central in the pathophysiology of multiple sclerosis (MS) and is often manifested by abnormal cytokine production. We investigated cytokine secretion in peripheral blood mononuclear cells (PBMC) of 18 MS patients and 15 controls and correlated cytokine polarization with the nature of antigenic stimulus. We synthesized two novel citrullinated peptides, linear [Cit(91), Ala(96), Cit(97)]MBP(87-99) and cyclo(87-99)[Cit(91), Ala(96), Cit(97)]MBP(87-99) that resulted from citrullination of 91,97 Arg residues in antagonists, linear [Arg(91), Ala(96)]MBP(87-99) and cyclo(87-99)[Arg(91), Ala(96)]MBP(87-99) peptides. PBMC from MS patients and controls were cultured with citrullinated peptides, and both peptides caused a Th1 polarization in all MS patients studied. In contrast, culture with noncitrullinated MBP peptides resulted in heterogeneous cytokine secretion that differed between individual patients. Thus, citrullination of self-antigens may potentially trigger disease in susceptible individuals. This finding may open new avenues in drug design of new substances that inhibit citrullination and arrest epitope spreading and worsening of MS.

Topics: Animals; Chemistry, Pharmaceutical; Citrulline; Drug Design; Epitopes; Humans; Leukocytes, Mononuclear; Ligands; Models, Chemical; Multiple Sclerosis; Myelin Basic Protein; Peptides; Peptides, Cyclic; Th1 Cells

Interleukin (IL)-17 is a proinflammatory cytokine primarily secreted by Th17 cells, which are a CD4(+) T-cell subset. Th17 cells and IL-17 are important in the pathogenesis of multiple sclerosis and in its established animal model, experimental autoimmune encephalomyelitis (EAE). However, it is unclear whether IL-17 contributes to EAE immune tolerance. We used the myelin basic protein (MBP) peptide MBP 68-86 to induce nasal tolerance to EAE, and simultaneously interfered with the tolerance by treatment with different doses of IL-17. We found that IL-17 dramatically interfered with MBP 68-86-induced immune tolerance. IL-17 administration increased IL-6 release, skewing T cell differentiation towards Th17 cells and decreasing the number of Treg cells. This led to an imbalance between Treg cells and Th17 cells and spurred the development of EAE.

Topics: Animals; CD4-Positive T-Lymphocytes; Cell Differentiation; Cell Proliferation; Encephalomyelitis, Autoimmune, Experimental; Female; Immune Tolerance; Interleukin-17; Interleukin-6; Lymphocyte Activation; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Rats; Rats, Inbred Lew; T-Lymphocyte Subsets; T-Lymphocytes, Regulatory

Topics: Clinical Trials as Topic; Humans; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments

Multiple sclerosis affects more women than men. The reasons for this are unknown. Previously, we have shown significant differences in women versus men in inflammatory cytokine responses to the major protein component of myelin, proteolipid protein (PLP), which is thought to be a target in MS patients. Here, using the ELISPOT assay, we examined sex differences in single-cell secretion of Th1 and Th2 cytokines from freshly isolated PBMC between relapsing remitting (RR) MS patients and healthy individuals. Cells were stimulated with MS-associated antigens including proteolipid protein (PLP), myelin basic protein (MBP), myelin oligodendrocyte glycoprotein (MOG), and non-disease related antigens. Our data show a sex bias in the cytokine responses to multiple MS-relevant myelin antigens: Women with MS show IFNgamma-skewed responses and men with MS show IL-5-skewed responses. These data extend our previous findings [Pelfrey, C.M., Cotleur, A.C., Lee, J.C., Rudick, R.A. 2002. Sex differences in cytokine responses to myelin peptides in multiple sclerosis. J. Neuroimmunol. 130, 211-223.]: (1) by demonstrating gender skewing in cytokine responses to an expanded myelin antigen repertoire, which includes MBP, MOG and PLP; (2) by showing TNFalpha and IL-10 do not display comparable gender skewing compared to IFNgamma and IL5; (3) by defining the patient population as early, untreated RRMS patients to avoid confounding factors, such as different disease stages/disability and immunomodulatory therapy; and (4) by showing HLA type does not appear to underlie the gender differences. These findings may explain increased susceptibility to MS in women and could contribute to the differences in disease severity between men and women.

Topics: Adult; Cytokines; Female; HLA-DR Antigens; Humans; Interferon-gamma; Interleukin-5; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Sex Characteristics; Th1 Cells; Th2 Cells

Multiple sclerosis (MS) is a chronic disease characterized by loss of myelin. However, data indicate that autoimmune cells could directly impair neuronal cell bodies and myelin sheath is lacking. The aim of the present study was to determine morphological evidence of the direct impairment of neurons by autoreactive lymphocytes and to further identify the subtypes of these lymphocytes.. Lymphocytes activated by myelin basic protein (MBP) 83-99 and neurons of human brain were co-cultured for 24 h.. Observations through scanning electron microscope showed that MBP-specific lymphocytes (CD4+, CD8+ cells, and NK cells) aggregated in the vicinity of the neuronal cell bodies and the myelin sheaths and attacked them directly, resulting in the degeneration of both neurons.. Our studies provide morphological evidences of the direct impairment of neuronal cell bodies and myelin sheaths by MBP-specific lymphocytes. Our studies also suggest that MBP-specific CD4+, CD8+, and NK cells might be involved in this process. These processes may play a role in the direct impairment of neurons and myelin sheaths in early stages of MS and provide evidences for the application of immunosuppressant therapy of MS.

Topics: Adult; CD4 Antigens; CD8 Antigens; Coculture Techniques; Female; Humans; Killer Cells, Natural; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Neurons; Peptide Fragments

The pathologic role of autoantibodies in autoimmune disease is widely accepted. Recently, we reported that anti-myelin basic protein (MBP) serum Abs from multiple sclerosis (MS) patients exhibit proteolytic activity toward the autoantigen. The aim of this study is to determine MBP epitopes specific for the autoantibodies in MS and compare these data with those from other neuronal disorders (OND), leading to the generation of new diagnostic and prognostic criteria. We constructed a MBP-derived recombinant "epitope library" covering the entire molecule. We used ELISA and PAGE/surface-enhanced laser desorption/ionization mass spectroscopy assays to define the epitope binding/cleaving activities of autoantibodies isolated from the sera of 26 MS patients, 22 OND patients, and 11 healthy individuals. The levels of autoantibodies to MBP fragments 48-70 and 85-170 as well as to whole MBP and myelin oligodendrocyte glycoprotein molecules were significantly higher in the sera of MS patients than in those of healthy donors. In contrast, selective reactivity to the two MBP fragments 43-68 and 146-170 distinguished the OND and MS patients. Patients with MS (77% of progressive and 85% of relapsing-remitting) but only 9% of patients with OND and no healthy donors were positive for catalysis, showing pronounced epitope specificity to the encephalitogenic MBP peptide 81-103. This peptide retained its substrate properties when flanked with two fluorescent proteins, providing a novel fluorescent resonance energy transfer approach for MS studies. Thus, anti-MBP autoantibody-mediated, epitope-specific binding and cleavage may be regarded as a specific characteristic of MS compared with OND and healthy donors and may serve as an additional biomarker of disease progression.

Topics: Adolescent; Adult; Aged; Amino Acid Sequence; Antibodies, Catalytic; Autoantibodies; Autoantigens; Biomarkers; Enzyme-Linked Immunosorbent Assay; Epitope Mapping; Epitopes; Female; Fluorescence Resonance Energy Transfer; Humans; Male; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptide Library; Peptides; Substrate Specificity

Multiple sclerosis (MS) is an inflammatory disease where phagocytic cells infiltrate the nerve tissue and act as terminal agents in destruction of the myelin sheath. However, the mechanism that triggers the ability of these cells to recognize myelin remains obscure. We show that myelin basic protein (MBP), a major autoantigen in MS, is a potent and specific ligand for the integrin alpha(M)beta(2) (Mac-1, CD11b/CD18) expressed mainly on phagocytic cells. MBP undergoes a dramatic conformational change when liberated from the lipid-rich environment of the myelin sheath. The MS drug glatiramer acetate mimics the conformationally labile regions of MBP, interacts in the unfolded state strongly with alpha(M)beta(2), and inhibits the MBP binding to alpha(M)beta(2). Our study reveals a link between MBP, glatiramer acetate, and the alpha(M)beta(2) integrin, and suggests a new model for MS pathogenesis based on the recognition of unfolded MBP by the alpha(M)beta(2) integrin.

Topics: Animals; Autoantigens; Binding, Competitive; Cattle; Cell Adhesion; Glatiramer Acetate; Humans; K562 Cells; Ligands; Macrophage-1 Antigen; Microspheres; Molecular Mimicry; Multiple Sclerosis; Myelin Basic Protein; Peptides; Protein Binding; Protein Folding

Competitive capture is a process by which different determinants of an unfolding antigen compete for binding to the same MHC class II molecule. The "winning" determinant is then dominantly displayed. For self antigens, T cells with specificity for dominantly displayed determinants will be subject to strong tolerance induction. With this in mind we set out to characterize the determinant hierarchy of the junctional region of the Golli-MBP complex. Within this region the MBP 1-9 determinant is known to be a strong inducer of experimental autoimmune encephalomyelitis. We found that the Golli-MBP junctional region contains a triad of three overlapping determinants: LDVM1-5, MBP 1-9, and MBP 7-20. We demonstrate that these three determinants are unique and compete for binding to I-A(u) and that a determinant hierarchy exists with MBP 7-20 being the most dominantly displayed determinant. Because of the prevention of MBP1-9 access to MHC-II, the residual T cell repertoire to this determinant remains complete, thereby permitting its highest affinity members to drive the response, and to convert MBP1-9 into a dominant determinant, despite its poor MHC binding capacity.

Topics: Animals; Antigen Presentation; Autoantigens; Binding, Competitive; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Epitopes, T-Lymphocyte; Histocompatibility Antigens Class II; Hybridomas; Lymphocyte Activation; Mice; Multiple Sclerosis; Myelin Basic Protein; Nerve Tissue Proteins; Self Tolerance; T-Lymphocytes; Transcription Factors

The disease mechanism of multiple sclerosis (MS) involves inflammation, demyelination and neurodegeneration. The relation between these components is not completely understood, but recent experiences with aggressive anti-inflammatory treatment suggest that inflammation drives neuronal damage in patients with relapsing remitting MS. Although infiltration of lymphocytes into the brain parenchyma was recognized as a key event in the pathogenesis of MS more than 120 years ago, important aspects of the mechanisms triggering and sustaining this immune response remain unknown. Furthermore, studies of MS lesions and evidence from therapeutic trials suggest that the disease mechanism may vary both throughout the disease course and between patients. The understanding of MS as an autoimmune disease targeting myelin proteins is shaped by the animal model experimental autoimmune encephalomyelitis (EAE), but translation from EAE to MS has proven to be difficult. Although both the EAE model and the prominent association to HLA class II molecules suggest a key role for CD4+ T helper cells, it is not known if or how their tolerance to myelin proteins or other putative autoantigens are broken in MS. This paper reviews some important concepts and controversies in the understanding of the immunological basis for MS and its treatment.

Topics: Animals; Antigen Presentation; B-Lymphocytes; CD4-Positive T-Lymphocytes; Encephalomyelitis, Autoimmune, Experimental; Herpesvirus 4, Human; HLA Antigens; Humans; Immune Tolerance; Immunity, Cellular; Multiple Sclerosis; Multiple Sclerosis, Chronic Progressive; Multiple Sclerosis, Relapsing-Remitting; Myelin Basic Protein; Myelin Sheath; Vitamin D Deficiency

Limited remyelination is a key feature of demyelinating Theiler's murine encephalomyelitis (TME). It is hypothesized that a dysregulation of differentiation of oligodendroglial progenitor cells (OPCs) represents the main cause of insufficient regeneration in this model of multiple sclerosis.. TME virus (TMEV)-infected SJL/J mice were evaluated by footprint analysis, light and electron microscopy, immunohistology, confocal immunofluorescence and RT-qPCR at multiple time points ranging from 1 h to 196 days post infection (dpi).. Footprint analysis revealed a significantly decreased stride length at 147 and 196 dpi. Demyelination progressively increased from 14 towards 196 dpi. A mild amount of remyelination was detected at 147 and 196 dpi. Early onset axonal injury was detected from 14 dpi on. TMEV RNA was detectable throughout the observation period and markedly increased between 7 and 28 dpi. Intralesional nerve/glial antigen 2 (NG2)-positive OPCs were temporarily increased between 28 and 98 dpi. Similarly, a transient upregulation of NG2 and platelet-derived growth factor alpha-receptor mRNA was noticed. In contrast, intralesional 2',3'-cyclic nucleotide 3'-phosphodiesterase (CNPase)-positive oligodendrocytes were decreased between 56 and 196 dpi. Although CNPase mRNA remained unchanged, myelin basic protein mRNA and especially its exon 2 containing splice variants were decreased. Glial fibrillary acidic protein (GFAP)-positive astrocytes and GFAP mRNA were increased in the late phase of TME. A mildly increased colocalization of both NG2/CNPase and NG2/GFAP was revealed at 196 dpi.. Summarized, the present results indicated a dysregulation of OPC maturation as the main cause for the delayed and limited remyelination in TME. A shift of OPC differentiation from oligodendroglial towards astrocytic differentiation is postulated.

Topics: 2',3'-Cyclic-Nucleotide Phosphodiesterases; Animals; Antigens; Cardiovirus Infections; Cell Differentiation; Encephalomyelitis; Female; Gene Expression; Glial Fibrillary Acidic Protein; Immunohistochemistry; Mice; Microscopy, Confocal; Microscopy, Electron; Microscopy, Fluorescence; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Nerve Tissue Proteins; Oligodendroglia; Proteoglycans; Receptor, Platelet-Derived Growth Factor alpha; RNA, Messenger; Spinal Cord; Stem Cells; Theilovirus

Histopathologic studies have shown that subpial cortical demyelination is extensive in chronic multiple sclerosis (MS).. To study whether subpial cortical demyelination in MS is associated with focal or diffuse white matter (WM) pathologic features on magnetic resonance imaging (MR imaging).. Comparison of postmortem MR imaging findings with histopathologic findings.. Brain donations from a general community.. Three patients with MS with extensive cortical demyelination and 3 patients with minor cortical demyelination were selected from an MS autopsy data set. The postmortem MR imaging and histopathologic data of the patients were compared.. Two observers blinded to the results of each other assessed the presence, extent, and distribution of focal and diffuse pathologic changes in WM by MR imaging and by histopathology.. Extensive subpial demyelination was not associated with a significant increase in the area of focal and diffuse WM pathologic changes as assessed by Luxol fast blue histochemistry or by MR imaging or with the presence or extent of juxtacortical abnormalities on MR imaging.. The lack of association of MS gray matter demyelination with diffuse or focal WM changes indicates that gray matter demyelination in MS occurs largely independent of WM pathologic changes. The extent or distribution of WM abnormalities cannot be used to identify extensive cortical demyelination in the clinical setting.

Topics: Aged; Aged, 80 and over; Autopsy; Cerebral Cortex; Demyelinating Diseases; Female; Humans; Immunohistochemistry; Magnetic Resonance Imaging; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Postmortem Changes; Statistics, Nonparametric

Topics: Autoantibodies; Brain; Disease Progression; Female; Humans; Longitudinal Studies; Magnetic Resonance Imaging; Male; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein

Disruption of myelin causes severe neurological diseases. An understanding of the mechanisms that control myelination and remyelination is needed to develop therapeutic strategies for demyelinating diseases such as multiple sclerosis (MS). Our previous finding indicating the critical involvement of the gamma chain of immunogloblin Fc receptors (FcRgamma) and Fyn signaling in oligodendrocyte differentiaion and myelination demands a fundamental revision of the strategies used for MS therapy, because antigen-antibody complexes in MS patients may induce the direct dysregulation of myelination process as well as the inflammatory destruction of myelin sheath. Here we show that the FcRgamma/Fyn signaling cascade is critically involved in cuprizone-induced demyelination/remyelination, with no lymphocytic response. The levels of phosphorylated myelin basic proteins (p-MBPs), especially the 21.5-kDa isoform, but not the levels of total MBPs, decreased markedly during demyelination induced by aging, cuprizone treatment, and double knockout of FcRgamma/Fyn genes. We also showed that the recovery from demyelination in cuprizone-treated and aged mice is achieved after administration of the herbal medicine Ninjin'yoeito, an effective therapy targeting the FcRgamma/Fyn-Rho (Rac1)-MAPK (P38 MAPK)-p-MBPs signaling cascade. These results suggest that the restoration of FcRgamma/Fyn signaling represents a new approach for the treatment of demyelinating diseases.

Topics: Aging; Animals; Anti-Inflammatory Agents; Central Nervous System; Cuprizone; Demyelinating Diseases; Disease Models, Animal; Drugs, Chinese Herbal; Female; Male; Mice; Mice, Inbred C57BL; Mice, Knockout; Monoamine Oxidase Inhibitors; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Nerve Regeneration; Neuroprotective Agents; Neurotoxins; Proto-Oncogene Proteins c-fyn; Receptors, IgG; Recovery of Function; Signal Transduction

We investigated the correlation of antimyelin oligodendrocyte glycoprotein-(anti-MOG) and anti-myelin basic protein antibodies (anti-MBP) in serum of CIS patients with inflammatory signs in MRI and in CSF and, as previously suggested,the incidence of more frequent and rapid progression to clinically definite MS (CDMS).. 133CIS patients were analysed for anti-MOG and anti-MBP (Western blot). Routine CSF and cranial MRI (quantitatively and qualitatively) measures were analyzed. 55 patients had a follow-up of at least 12 months or until conversion to CDMS.. Patients with anti-MOG and anti-MBP had an increased intrathecal IgG production and CSF white blood cell count(p = 0.048 and p = 0.036). When anti-MBP alone, or both antibodies were present the cranial MRI showed significantly more T2 lesions (p = 0.007 and p = 0.01,respectively). There was a trend for more lesion dissemination in anti-MBP positive patients (p = 0.076).Conversely, anti-MOG- and/or anti-MBP failed to predict conversion to CDMS in our follow-up group (n = 55). Only in female patients with at least one MRI lesion (n = 34) did the presence of anti-MOG correlate with more frequent (p = 0.028) and more rapid (p = 0.0209) transition to CDMS.. Presence of anti-MOG or anti-MBP or both was not significantly associated with conversion to CDMS in our CIS cohort. However, patients with anti-MOG and anti-MBP had higher lesion load and more disseminated lesions in cranial MRI as well as higher values for CSF leucocytes and intrathecal IgG production. Our data support a correlation of anti-MOG and anti-MBP to inflammatory signs in MRI and CSF. The prognostic value of these antibodies for CDMS, however, seems to be less pronounced than previously reported.

Topics: Adult; Antibodies; Chi-Square Distribution; Female; Follow-Up Studies; Humans; Inflammation; Magnetic Resonance Imaging; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Retrospective Studies; Statistics, Nonparametric

CD4(+)CD25(+) regulatory T cells (Tregs) are considered to play a key role as suppressors of immune mediated reactions. The analysis of Treg function in patients with autoimmune, allergic or oncogenic diseases has emerged over the past years. In the present study we describe a CFSE based protocol to measure Treg mediated suppression of CD4(+) T cells. Measuring Treg suppressive capacity towards proliferation of anti-CD3 Ab stimulated CD4(+)CD25(-) T cells in coculture experiments by means of a CFSE based and a classical [(3)H]thymidine incorporation assay gave similar results, provided that CD4(+)CD25(+) T cells were anergic. However, when CD4(+)CD25(+) T cells proliferated upon mitogenic stimulation, data obtained by the CFSE assay allowed the detection of a significant Treg suppression whereas this was clearly underestimated using the [(3)H]thymidine assay. In addition, an indirect CFSE based method was developed to analyze antigen specific responses of total CD4(+) T cells and Treg depleted CD4(+) T cells (i.e. CD4(+)CD25(-) T cells). Our results indicate that, in healthy individuals, CD4(+) T cell responses against the multiple sclerosis (MS) auto-antigens, myelin basic protein (MBP) and myelin oligodendrocyte glycoprotein (MOG), were increased in Treg depleted CD4(+) T cells as compared to total CD4(+) T cells. Our initial data suggest that Tregs in MS patients show an impaired suppression of myelin reactive T cells when compared to healthy controls. Moreover, this experimental setup permits the measurement of cytokine production of the antigen proliferated CFSE(low) T cells by additional flow cytometric analyses. In conclusion, the described CFSE based Treg suppression assay is a valuable tool to study suppressor T cells in (auto)immune disorders.

Topics: Autoantigens; CD4 Antigens; Clonal Anergy; Female; Flow Cytometry; Fluoresceins; Fluorescent Dyes; Humans; Immune Tolerance; Interleukin-2 Receptor alpha Subunit; Lymphocyte Depletion; Male; Multiple Sclerosis; Myelin Basic Protein; Succinimides; T-Lymphocytes, Regulatory; Thymidine

This work reports molecular dynamics studies at the receptor level of the immunodominant myelin basic protein (MBP) epitope 87-99 implicated in multiple sclerosis, and its antagonists altered peptide ligands (APLs), namely [Arg91, Ala96] MBP87-99 and [Ala91,96] MBP87-99. The interaction of each peptide ligand with the receptor human leukocyte antigen HLA-DR2b was studied, starting from X-ray structure with pdb code: 1ymm. This is the first such study of APL-HLA-DR2b complexes, and hence the first attempt to gain a better understanding of the molecular recognition mechanisms that underlie TCR antagonism by these APLs. The amino acids His88 and Phe89 serve as T-cell receptor (TCR) anchors in the formation of the trimolecular complex TCR-peptide-HLA-DR2b, where the TCR binds in a diagonal, off-centered mode to the peptide-HLA complex. The present findings indicate that these two amino acids have a different orientation in the APLs [Arg91, Ala96] MBP87-99 and [Ala91,96] MBP87-99: His88 and Phe89 remain buried in HLA grooves and are not available for interaction with the TCR. We propose that this different topology could provide a possible mechanism of action for TCR antagonism.

Topics: Computer Simulation; HLA-DR2 Antigen; Immunodominant Epitopes; Models, Molecular; Molecular Structure; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Protein Conformation; Receptors, Antigen, T-Cell; Structure-Activity Relationship; Thermodynamics

Neuromyelitis optica (NMO) is an inflammatory and necrotizing disease clinically characterized by selective involvement of the optic nerves and spinal cord. There has been a long controversy as to whether NMO is a variant of multiple sclerosis (MS) or a distinct disease. Recently, an NMO-specific antibody (NMO-IgG) was found in the sera from patients with NMO, and its target antigen was identified as aquaporin 4 (AQP4) water channel protein, mainly expressed in astroglial foot processes. However, the pathogenetic role of the AQP4 in NMO remains unknown. We did an immunohistopathological study on the distribution of AQP4, glial fibrillary acidic protein (GFAP), myelin basic protein (MBP), activated complement C9neo and immunoglobulins in the spinal cord lesions and medulla oblongata of NMO (n = 12), MS (n = 6), brain and spinal infarction (n = 7) and normal control (n = 8). The most striking finding was that AQP4 immunoreactivity was lost in 60 out of a total of 67 acute and chronic NMO lesions (90%), but not in MS plaques. The extensive loss of AQP4 accompanied by decreased GFAP staining was evident, especially in the active perivascular lesions, where immunoglobulins and activated complements were deposited. Interestingly, in those NMO lesions, MBP-stained myelinated fibres were relatively preserved despite the loss of AQP4 and GFAP staining. The areas surrounding the lesions in NMO had enhanced expression of AQP4 and GFAP, which reflected reactive gliosis. In contrast, AQP4 immunoreactivity was well preserved and rather strongly stained in the demyelinating MS plaques, and infarcts were also stained for AQP4 from the very acute phase of necrosis to the chronic stage of astrogliosis. In normal controls, AQP4 was diffusely expressed in the entire tissue sections, but the staining in the spinal cord was stronger in the central grey matter than in the white matter. The present study demonstrated that the immunoreactivities of AQP4 and GFAP were consistently lost from the early stage of the lesions in NMO, notably in the perivascular regions with complement and immunoglobulin deposition. These features in NMO were distinct from those of MS and infarction as well as normal controls, and suggest that astrocytic impairment associated with the loss of AQP4 and humoral immunity may be important in the pathogenesis of NMO lesions.

Topics: Adult; Aged; Aged, 80 and over; Aquaporin 4; Astrocytes; Brain Infarction; Case-Control Studies; Complement Activation; Complement C9; Disease Progression; Female; Glial Fibrillary Acidic Protein; Humans; Immunoglobulin G; Immunohistochemistry; Infarction; Male; Medulla Oblongata; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Neuromyelitis Optica; Optic Nerve; Spinal Cord

Multiple sclerosis (MS) is a central nervous system (CNS) chronic inflammatory autoimmune disease with limited treatment modalities. Oral tolerance is one of the experimental methods that protects from autoimmune diseases. However, this method failed to be therapeutic in clinical trials. In our previous work we found that epicutaneous (EC) immunization with protein antigen induced a state of profound immunosuppression that inhibited inflammatory response in contact sensitivity, in experimental autoimmune encephalomyelitis (EAE) and in allogeneic skin graft rejection. In our current work, we precisely determined the phenotype of EC induced T suppressor (Ts) cells that reduce the progress of EAE. Employing TCRdelta-/-, CD1d-/- mice, we showed that EC induced Ts cells do not belong either to the population of TCRgammadelta cells or CD1d restricted NKT cells. Moreover, we noticed that a lack of CD1d-/- restricted NKT lymphocytes resulted in the induction of much stronger suppression of EAE than in wild type mice. This might suggest that NKT cells could interfere with the induction of Ts cells. Using beta2m-/- mice, negative selection and positive selection of EC induced Ts cells, we showed that Ts cells protecting from EAE belong to the population of TCRalphabeta+ CD4+ CD8+ double positive lymphocytes.

Topics: Animals; Antigens, CD1; Antigens, CD1d; beta 2-Microglobulin; CD4-Positive T-Lymphocytes; CD8-Positive T-Lymphocytes; Encephalomyelitis, Autoimmune, Experimental; Female; Guinea Pigs; Immunization; Inflammation; Killer Cells, Natural; Mice; Mice, Knockout; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell, alpha-beta; Receptors, Antigen, T-Cell, gamma-delta; Skin Transplantation; Transplantation, Homologous

Autoimmune reactions associated with MS involve genetic and environmental factors. Because murine coronaviruses induce an MS-like disease, the human coronaviruses (HCoV) are attractive candidates as environmental factors involved in a demyelinating pathology. We previously reported the isolation of HCoV-229E/myelin basic protein (MBP) cross-reactive T-cell lines (TCL) in MS patients. To investigate antigenic cross-reactivity at the molecular level, 155 long-term T-cell clones (TCC) were derived from 32 MS patients by in vitro selection with MBP, proteolipid protein (PLP) or HCoV (strains 229E and OC43). Overall, 114 TCC were virus-specific, 31 were specific for myelin Ag and 10 other were HCoV/myelin cross-reactive. Twenty-eight virus-specific TCC and 7 myelin-specific TCC were obtained from six healthy donors. RACE RT-PCR amplification of the Vbeta chains of five of ten the cross-reactive TCC confirmed clonality and sequencing identified the CDR3 region associated with cross-reactivity. Our findings have promising implications in the investigation of the role of molecular mimicry between coronaviruses and myelin in MS as a mechanism related to disease initiation or relapses.

Topics: Adult; Aged; Amino Acid Sequence; Antigen-Presenting Cells; Antigens, Viral; Cell Proliferation; Clone Cells; Coronavirus; Epitopes; Female; Humans; Lymphocyte Activation; Male; Middle Aged; Multiple Sclerosis; Multiple Sclerosis, Chronic Progressive; Multiple Sclerosis, Relapsing-Remitting; Myelin Basic Protein; Myelin Proteolipid Protein; Myelin Sheath; Receptors, Antigen, T-Cell, alpha-beta; Reverse Transcriptase Polymerase Chain Reaction; T-Cell Antigen Receptor Specificity; T-Lymphocytes; Time Factors

In previous studies, we documented increased citrullinated myelin basic protein (MBP) was present in MBP isolated from multiple sclerosis (MS) normal appearing white matter (NAWM). This increase was due to the myelin enzyme peptidyl argininedeiminase 2 (PAD2). In this study, we show that methylation of cytosine of the PAD2 promoter in DNA from MS NAWM was decreased to one-third of the level of that in DNA from normal white matter. The PAD2 promoter in DNA from thymus obtained from the same MS patients and white matter DNA from Alzheimer's, Huntington's, and Parkinson's was not hypomethylated. DNA demethylase activity in supernatants prepared from NAWM of MS patients was 2-fold higher than the DNA demethylase from normal, Alzheimer's, Huntington's and Parkinson's disease white matter. The amount of PAD2 enzyme and citrullinated MBP was increased in MS NAWM. The decreased methylation of cytosines in the PAD2 promoter may explain the increased synthesis of PAD2 protein that is responsible for the increased amount of citrullinated MBP, which in turn results in loss of myelin stability in MS brain.

Topics: 5-Methylcytosine; Blotting, Western; Brain; Citrulline; CpG Islands; DNA; DNA, Single-Stranded; Fluorescent Antibody Technique; Humans; Hydrolases; Methylation; Multiple Sclerosis; Myelin Basic Protein; Promoter Regions, Genetic; Protein-Arginine Deiminase Type 2; Protein-Arginine Deiminases; Reverse Transcriptase Polymerase Chain Reaction; Sulfites; Thymus Gland

Topics: Autoantibodies; Biomarkers; Disease Progression; Humans; Multiple Sclerosis; Myelin Basic Protein; Myelin-Associated Glycoprotein; Patient Selection; Prognosis

Viral infections are thought to play an important role in the pathogenesis of multiple sclerosis potentially through molecular mimicry, but direct evidence from humans and animal models remains inadequate. Based on the fact that amino acid homology has been found between viral and host encephalitogenic protein, we designed four viral peptides (peptides of HBV polymerase protein, large T protein of JC virus, EB virus DNA polymerase and alkaline exonuclease of Human herpesvirus 6) with limited homology to myelin basic protein and explored their clinical, immunological and histological characteristics in Lewis rats. The immunization with JC virus peptide induced slight clinical signs of EAE in Lewis rats. Immunological examination indicated that rats immunized with JC virus peptide triggered T-cell cross-reactivity against MBP68-86, but failed to induce antibody cross-reactivity with MBP68-86. Histological staining exhibited the infiltration of inflammatory T cells and the activation of microglia in spinal cords of rats immunized with MBP68-86 and JC virus peptide. Other three peptides had negative findings in Lewis rats. These results suggested that molecular mimicry could be an important factor in the pathogenesis of EAE induced with JC virus peptide by expanding a population of reactive T cells that recognize MBP68-86 in Lewis rats inferring a possible pathogenesis for molecular mimicry in MS.

Topics: Animals; Chemotaxis, Leukocyte; Cross Reactions; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Female; JC Virus; Lymphocyte Activation; Molecular Mimicry; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Myelitis; Peptides; Rats; Rats, Inbred Lew; T-Lymphocytes; Viral Proteins

Experimental autoimmune encephalomyelitis (EAE) is an animal model of multiple sclerosis. Immunization of B10.PL mice with the Ac1-9 peptide, the immunodominant determinant of myelin basic protein (MBP), produced a single episode of EAE followed by recovery and resistance to reinduction of disease. Using the CDR3 length spectratyping technique, we characterized the clonal composition of the Ac1-9-specific T cell repertoire from induction through onset and resolution of disease. Two clonally restricted subsets within a heterogeneous self-reactive repertoire were found in mouse lymph nodes, spleen, and spinal cord soon after immunization, before any sign of EAE. These clonotypes, designated BV8S2/BJ2S7 and BV16/BJ2S5, were present in all mice examined and thus considered public. BV8S2/BJ2S7 was found in far greater excess; was exclusively Th1 polarized; disappeared from the spinal cord, spleen, and lymph nodes concomitantly with recovery; and transferred disease to naive recipients. In contrast, BV16/BJ2S5 and numerous private clonotypes were either Th1 or Th2 and persisted following recovery. These results are consistent with the hypothesis that the public clonotype BV8S2/BJ2S7 is a driver of disease and necessary for its propagation.

Topics: Animals; Complementarity Determining Regions; Encephalomyelitis, Autoimmune, Experimental; Epitopes, T-Lymphocyte; Mice; Multiple Sclerosis; Myelin Basic Protein; Organ Specificity; Peptide Fragments; Recovery of Function; Th1 Cells; Th2 Cells

The present study was aimed at confirming the presence of GluR3 on T lymphocytes and to assess the effect of glutamate on proliferative responses to myelin basic protein (MBP) and myelin oligodendrocyte glycoprotein (MOG) and chemotactic migration to CXCL12/stromal cell-derived factor-1, RANTES, and MIP-1alpha in 15 control subjects and 20 relapsing-remitting multiple sclerosis (MS) patients (10 in a stable clinical phase and 10 during relapse). T lymphocytes of control subjects and MS patients express both mRNA and protein of GluR3 receptors, as shown by RT-PCR and immunoblot analyses. An up-regulation was evident during relapse and in patients with neuroradiological evidence of disease activity. Glutamate and AMPA at concentrations of 10 nM to 10 muM were able to enhance T lymphocyte proliferation to MBP and MOG and the chemotactic migration of T cells both in controls and MS patients. In the latter group, significantly higher proliferation values in response to glutamate were found in patients assessed during relapse and in those with gadolinium (Gd)+ enhancing lesions on MRI. Glutamate concentrations above 10 muM appeared to be inhibitory on MBP and MOG-specific T-lymphocyte proliferation as well as chemotactic response in both patients and controls. Higher GluR3 expression and higher activating effect of glutamate on T cells of MS patients during relapses and with evidence of disease activity on MRI suggests the involvement of glutamate-mediated mechanisms in the T-cell detrimental effects. In MS patients, glutamate within physiological ranges in the cerebrospinal fluid and brain extracellular space might enhance myelin antigen-specific proliferation and chemotactic migration via activation of AMPA receptors, which can be relevant for myelin and neuronal damage in MS. Excess glutamate levels seem to induce an inhibitory effect on lymphocyte function, and therefore the detrimental effect of this excitatory amino acid in this case could be attributed to a direct toxicity on glial and neuronal cells.

Topics: Adult; Case-Control Studies; Cell Movement; Chemokine CCL5; Chemokine CXCL12; Chemokines, CXC; Chemotaxis, Leukocyte; Dose-Response Relationship, Drug; Drug Interactions; Female; Gene Expression Regulation; Glutamic Acid; Humans; Lymphocytes; Magnetic Resonance Imaging; Male; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Receptors, AMPA

BioMS Medical Corp, under license from the University of Alberta, is developing MBP-8298, a synthetic peptide analog of myelin basic protein, for the potential treatment of multiple sclerosis. Phase II and III clinical trials of MBP-8298 are underway.

Topics: Animals; Drug Design; Humans; Multiple Sclerosis; Myelin Basic Protein; Patents as Topic; Peptide Fragments; Randomized Controlled Trials as Topic

To explore the immunological pathogenesis of multiple sclerosis (MS) patients of different TCM syndrome types.. Fifty-nine MS patients were assigned to two types by syndrome typing according to their clinical manifestations, the Gan-Shen yin-deficiency (GSYD, 40 cases) type and the both yin-yang deficiency (YYD, 19 cases) type. Difference of patients' age of first attack, times of relapsing, duration of disease, MRI finding and evoked potential between the two groups were compared. The immunology indexes were also compared in part of the patients (26 cases in GSYD type and 12 cases in YYD type).. The age of first attack was later (P < 0.01), level of myelin basic protein in cerebrospinal fluid was higher (P < 0.05), in the YYD type than those in the GSYD type. Besides, the relapsing time in GSYD type, and the blood-brain barrier index and level of myelin basic protein in YYD type showed an ascending trend (P = 0.056, 0.074, 0.093, respectively).. Immunological difference exists between the MS patients of GSYD type and those of YYD type.

Topics: Adolescent; Adult; Child; Diagnosis, Differential; Drugs, Chinese Herbal; Female; Humans; Male; Medicine, Chinese Traditional; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Nerve Tissue Proteins; Phytotherapy; Syndrome; Transcription Factors; Yang Deficiency; Yin Deficiency; Young Adult

Multiple sclerosis (MS) is a devastating autoimmune demyelinating disease of the central nervous system (CNS). This study investigated whether expression and activity of the calcium-activated protease calpain correlated with Th1/Th2 dysregulation in MS patients during states of relapse and remission. Calpain expression and activity were significantly increased in peripheral blood mononuclear cells (PBMCs) from MS patients, compared to controls, with the highest expression and activity noted during relapse. Th1 cytokines were highest and Th2 cytokines were lowest in MS patients during relapse. Treatment with calpain inhibitor, calpeptin, decreased Th1 cytokines in PBMCs from MS patients. Calpain inhibitor also reduced degradation of myelin basic protein (MBP) by inhibiting the calpain secreted from MBP-specific T cells. Taken together, these results suggested calpain involvement in Th1/Th2 dysregulation in MS patients.

Topics: Biomarkers; Calcium; Calcium Signaling; Calpain; Cytokines; Dipeptides; Enzyme Inhibitors; Female; Humans; Male; Multiple Sclerosis; Myelin Basic Protein; Neutrophils; Recurrence; Th1 Cells; Th2 Cells; Up-Regulation

In patients with a clinically isolated syndrome (CIS), the time interval to convert to clinically definite multiple sclerosis (CDMS) is highly variable. Individual and geographical prognostic factors remain to be determined. Whether anti-myelin antibodies may predict the risk of conversion to CDMS in Swiss CIS patients of the canton Berne was the subject of the study.. Anti-myelin oligodendrocyte glycoprotein and anti-myelin basic protein antibodies were determined prospectively in patients admitted to our department.. After a mean follow-up of 12 months, none of nine antibody-negative, but 22 of 30 antibody-positive patients had progressed to CDMS. Beta-Interferon treatment delayed the time to conversion from a mean of 7.4 to 10.9 months.. In a Swiss cohort, antibody-negative CIS patients have a favorable short-term prognosis, and antibody-positive patients benefit from early treatment.

Topics: Adjuvants, Immunologic; Adult; Antibodies; Cohort Studies; Female; Humans; Interferon beta-1a; Interferon-beta; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Nerve Tissue Proteins; Risk Factors; Switzerland; Transcription Factors; Treatment Outcome

Topics: Antigens; Clinical Trials as Topic; Humans; Multiple Sclerosis; Myelin Basic Protein; Plasmids; T-Lymphocytes; Vaccines, DNA; Vaccines, Synthetic

Multiple sclerosis (MS) is a chronic inflammatory disease of the white matter of the central nervous system (CNS) characterized by focal areas of demyelination. Interferon-beta (IFN-beta) provides an effective treatment that lessens the frequency and severity of exacerbations in relapsing-remitting multiple sclerosis (RRMS), but the mechanisms by which IFN-beta is efficient remain uncertain. The data presented here demonstrate that IFN-beta impairs the proliferative response to myelin basic protein (MBP) and myelin, as well as increasing the expression of the CTLA4 intracellular molecule. Moreover, this treatment increases the expression of surface Fas molecules and of the soluble form of these molecules. Our hypothesis is that the increase in Fas and CTLA4 molecules in MS patients may lead to lymphocyte apoptosis, which suggests possible mechanisms underlying the therapeutic response to IFN-beta.

Topics: Adult; Antigens, CD; Antigens, Differentiation; CD4-Positive T-Lymphocytes; CD8-Positive T-Lymphocytes; Cell Proliferation; CTLA-4 Antigen; fas Receptor; Female; Humans; Interferon-beta; Lymphocyte Activation; Male; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Solubility; T-Lymphocytes

To determine the role of expanded CD4(+)CD28(null) T cells in multiple sclerosis and rheumatoid arthritis pathology, these cells were phenotypically characterized and their Ag reactivity was studied. FACS analysis confirmed that CD4(+)CD28(null) T cells are terminally differentiated effector memory cells. In addition, they express phenotypic markers that indicate their capacity to infiltrate into tissues and cause tissue damage. Whereas no reactivity to the candidate autoantigens myelin basic protein and collagen type II was observed within the CD4(+)CD28(null) T cell subset, CMV reactivity was prominent in four of four HC, four of four rheumatoid arthritis patients, and three of four multiple sclerosis patients. The level of the CMV-induced proliferative response was found to be related to the clonal diversity of the response. Interestingly, our results illustrate that CD4(+)CD28(null) T cells are not susceptible to the suppressive actions of CD4(+)CD25(+) regulatory T cells. In conclusion, this study provides several indications for a role of CD4(+)CD28(null) T cells in autoimmune pathology. CD4(+)CD28(null) T cells display pathogenic features, fill up immunological space, and are less susceptible to regulatory mechanisms. However, based on their low reactivity to the autoantigens tested in this study, CD4(+)CD28(null) T cells most likely do not play a direct autoaggressive role in autoimmune disease.

Topics: Adult; Aged; Antigens, Differentiation; Arthritis, Rheumatoid; Autoantigens; CD28 Antigens; Cell Differentiation; Collagen Type II; Female; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes, Helper-Inducer; T-Lymphocytes, Regulatory

To determine if neurofilament protein light (NF-L) and anti-NF-L antibody can be used as biologic markers in diagnosing multiple sclerosis (MS) and assessing prognosis thereof.. Samples of cerebrospinal fluid (CSF) and serum were corrected from 63 MS patients, 15 patients with neuromyelitis optica (ONM), 31 patients with other inflammatory neurological disease (OIND), 18 patients with noninflammatory neurological disease (NIND), and 46 neurological normal controls (NC group), all age- and sex- matched. ELISA was used to detect the concentrations of NF-L, anti-NF-L antibody, anti-myelin basic protein (MBP) antibody, and anti-myelin oligo-dendroglia glycoprotein (MOG) antibody in serum and cerebral spinal fluid. And the IgG level was tested.. The CSF levels of NF-L of the MS, ONM, OIND, and NIND groups were 26 ng/L (33), 20 ng/L (92), 19 ng/L (82), and 30 ng/L (194) respectively, without significant differences among these different groups, but all significantly higher than that of the NC group (10 ng/L, all P < 0.01). No NF-L was detected in the serum specimens of all groups. The CSF NF-L antibody level of the MS group was significantly lower than that of the OIND group (P < 0.01), and significantly higher than those of the NIND and NC groups (both P < 0.05). The CSF anti-NF-L antibody level of the MS patients was positively correlated with the MBP antibody level (r = 0.784, P < 0.01) and the IgG level (r = 0.675, P < 0.01).. Neither the NF-L nor the anti-NF-L antibody can be used as reliable biological markers for the diagnosis of MS. Strongly increased levels of NF-L were observed in patients with MS, ONM, OIND, and NIND, suggesting the occurrence of axonal injury in these conditions. Inflammation may not lead to the generation of anti-NF-L antibody which links to the axonal injury.

Topics: Adolescent; Adult; Aged; Autoantibodies; Child; Enzyme-Linked Immunosorbent Assay; Female; Humans; Immunoglobulin G; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Neurofilament Proteins; Neuromyelitis Optica; Prognosis

This unit details the materials and methods required for both active induction and adoptive transfer of experimental autoimmune encephalomyelitis (EAE) in the SJL mouse strain using intact proteins or peptides from the two major myelin proteins: proteolipid protein (PLP) and myelin basic protein (MBP). Detailed materials and methods required for the purification of both PLP and MBP are also described. Modifications of the specified protocols may be necessary for efficient induction of active or adoptive EAE in other mouse strains.

Topics: Adoptive Transfer; Animals; CD4-Positive T-Lymphocytes; Disease Models, Animal; Disease Progression; Encephalomyelitis, Autoimmune, Experimental; Female; Genetic Predisposition to Disease; Humans; Mice; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Vaccination

Systemic injection of small amounts of transforming growth factor-beta (TGF-beta), a cytokine produced by lymphoid and other cells, has a profound effect in protecting mice from the inflammatory demyelinating lesions of experimental allergic encephalomyelitis (EAE; an animal model for multiple sclerosis). However, TGF-beta has side-effects, which might be avoided if the cells producing TGF-beta can be delivered to the affected site in the nervous system to insure its local release in small amounts. Myelin basic protein (MBP)-specific, cloned CD4+ T cells were engineered by retroviral transduction to produce latent TGF-beta. Studies about the spontaneous form of EAE in T cell receptor (TCR)-transgenic recombination-activating gene (RAG)-1(-/-) mice showed that essentially all of the MBP-specific, TCR-transgenic RAG-1(-/-) (BALB/cxB10.PL)F1 mice develop spontaneous EAE by the age of 11 weeks. By 12 weeks, 25-50% of the mice have died from disease. A single injection of TGF-beta1-transduced T helper cell type 1 (Th1) cells significantly protected the mice from EAE, and untransduced Th1 cells did not protect. MBP-specific BALB/c Th2 clones, transduced with TGF-beta1-internal ribosome entry site-green fluorescent protein (GFP) significantly reduced EAE induction by untransduced Th1 cells in RAG-1(-/-) B10.PL mice. Furthermore, the GFP+ TGF-beta1-producing Th2 cells were detectable in the spinal cords of the injected mice.

Topics: Adoptive Transfer; Animals; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Homeodomain Proteins; Mice; Mice, Inbred BALB C; Mice, Knockout; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell; Th1 Cells; Th2 Cells; Transduction, Genetic; Transforming Growth Factor beta; Transforming Growth Factor beta1

Autoantibodies toward myelin basic protein (MBP) evidently emerge in sera and cerebrospinal fluid of the patients with multiple sclerosis (MS), as well as in a MS rodent model, i.e., experimental autoimmune encephalomyelitis (EAE). The studies of the last two decades have unveiled somewhat controversial data on the diagnostic applicability of anti-MBP autoantibodies as a disease' marker. Here, we present the results of new functional analysis of the anti-MBP autoantibodies isolated from MS (in patients) and EAE (in mice) sera, based on their proteolytic activity against the targeted autoantigen. The activity was shown to be the intrinsic property of the IgG molecule. No activity was found in the sera-derived antibody fraction of healthy donors and control mice. Sera of 24 patients with clinically proven MS at different stages of the disease, and 20 healthy controls were screened for the anti-MBP antibody-mediated proteolytic activity. The activity correlated with the scores on the MS expanded disability status scale (EDSS) (r(2)=0.85, P<0.001). Thus, the anti-MBP autoantibody-mediated proteolysis may be regarded as an additional marker of the disease progression.

Topics: Adolescent; Adult; Animals; Antibodies, Catalytic; Autoantibodies; Catalysis; Disability Evaluation; Encephalomyelitis, Autoimmune, Experimental; Humans; Mice; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Peptide Hydrolases; Severity of Illness Index

Homogeneous IgG fractions were obtained by chromatography of the sera of patients with multiple sclerosis (MS) on Protein G-Sepharose under conditions that remove non-specifically bound proteins. These IgGs contained several chelated metals, the relative amount of which decreases in the order: Fe>or=Ca>Cu>or=Zn>or=Mg>or=Mn>or=Pb>or=Co>or=Ni. In contrast to homogeneous IgGs of healthy individuals, Abs of MS patients effectively hydrolyzed human myelin basic protein (MBP). A minor metal-dependent fraction was obtained by chromatography of highly purified IgGs from MS patient on Chelex-100. This IgG fraction did not hydrolyze human MBP in the absence of Me(2+) ions but was activated after addition of Me(2+) ions: Mg(2+)>Mn(2+)>Cu(2+)>Ca(2+). Proteolytic activities of IgGs from other MS patients were also activated by other metal ions (Ni(2+), Fe(2+), Co(2+), Zn(2+), Pb(2+), and Co(2+)) and especially Ni(2+). Ni(2+)-activated IgGs were separated into distinct MBP-hydrolyzing fractions by chromatography on HiTraptrade mark Chelating Sepharose charged with Ni(2+). Detection of Mg(2+)-dependent proteolytic activity in the SDS-PAGE area corresponding only to IgG provided direct evidence that IgG from sera of MS patients possesses metal-dependent human MBP-hydrolyzing activity. Observed properties of MS abzymes distinguish them from other known mammalian metalloproteases and demonstrate their pronounced catalytic diversity. Metal-dependent IgGs from MS patients represent the first example of abzymes with metal-dependent proteolytic activity.

Topics: Adolescent; Adult; Antibodies, Catalytic; Female; Humans; Hydrolysis; Male; Metals, Alkaline Earth; Metals, Heavy; Middle Aged; Multiple Sclerosis; Myelin Basic Protein

Most autoantigens implicated in multiple sclerosis (MS) are expressed not only in the central nervous system (CNS) but also in the thymus and the periphery. Nevertheless, these autoantigens might induce a strong autoimmune response leading to severe destruction within the CNS. To investigate the influence of a dominantly presented autoantigen on experimental autoimmune encephalomyelitis (EAE), we generated transgenic mice expressing the autoantigenic peptide MBP 1-10 covalently bound to the MHC class II molecule I-Au. These mice were crossed either with B10.PL or with TCR-transgenic Tg4 mice, specific for the transgenic peptide-MHC combination. In double transgenic mice we found strong thymic deletion and residual peripheral T cells were refractory to antigen stimulation in vitro. Residual peripheral CD4+ T cells expressed activation markers and a high proportion was CD25 positive. Transfer of both CD25-negative and CD25-positive CD4+ T cells from double transgenic animals into B10.PL mice strongly inhibited the progression of EAE. Despite this thorough tolerance induction, some double transgenic mice developed severe signs of EAE after an extended period of time. Our data show that in the circumstances where autoantigenic priming persists, and where the number of antigen-specific T cells is high enough, autoimmunity may prevail over very potent tolerance-inducing mechanisms.

Topics: Animals; Autoantigens; Autoimmunity; CD4-Positive T-Lymphocytes; Crosses, Genetic; Encephalomyelitis, Autoimmune, Experimental; Gene Expression; Histocompatibility Antigens Class II; Immune Tolerance; Lymphocyte Activation; Mice; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Recombinant Fusion Proteins

Autologous stem cell transplantation is being considered as treatment of severe refractory autoimmune disorders, including MS. Stem cell mobilization is achieved with granulocyte-colony stimulating factor (G-CSF), however, G-CSF administration resulted in cases of worsened clinical MS status. We studied autoreactive T-cell properties, which can promote CNS inflammation in MS. We show that G-CSF enhances MS autoreactive T cell line adhesion to the ECM proteins collagen IV and fibronectin as effectively as the proinflammatory IFNgamma and TNFalpha, known to exacerbate MS symptoms. We propose a link between clinical worsening of MS symptoms induced by G-CSF and the hyperstimulation of T cell adhesion to ECM elicited by G-CSF.

Topics: Blotting, Western; Cell Adhesion; Cell Count; Cytokines; Epistasis, Genetic; Extracellular Matrix; Focal Adhesion Kinase 2; Gene Expression; Granulocyte Colony-Stimulating Factor; Hematopoietic Stem Cell Mobilization; Humans; Integrin alpha1beta1; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes; Time Factors

Autoantibody-mediated tissue destruction is among the main features of organ-specific autoimmunity. This report describes "an antibody enzyme" (abzyme) contribution to the site-specific degradation of a neural antigen. We detected proteolytic activity toward myelin basic protein (MBP) in the fraction of antibodies purified from the sera of humans with multiple sclerosis (MS) and mice with induced experimental allergic encephalomyelitis. Chromatography and zymography data demonstrated that the proteolytic activity of this preparation was exclusively associated with the antibodies. No activity was found in the IgG fraction of healthy donors. The human and murine abzymes efficiently cleaved MBP but not other protein substrates tested. The sites of MBP cleavage determined by mass spectrometry were localized within immunodominant regions of MBP. The abzymes could also cleave recombinant substrates containing encephalytogenic MBP(85-101) peptide. An established MS therapeutic Copaxone appeared to be a specific abzyme inhibitor. Thus, the discovered epitope-specific antibody-mediated degradation of MBP suggests a mechanistic explanation of the slow development of neurodegeneration associated with MS.

Topics: Amino Acid Sequence; Animals; Antigens; Autoantibodies; Catalytic Domain; Encephalomyelitis, Autoimmune, Experimental; Humans; Mass Spectrometry; Mice; Mice, Inbred C57BL; Multiple Sclerosis; Myelin Basic Protein; Substrate Specificity

Experimental autoimmune encephalomyelitis (EAE) is an instructive model for the human demyelinating disease multiple sclerosis. Lewis (LEW) rats immunized with myelin-basic protein (MBP) develop EAE characterized by a single episode of paralysis, from which they recover spontaneously and become refractory to a second induction of disease. LF 15-0195 is a novel molecule that has potent immunosuppressive effects in several immune-mediated pathological manifestations, including EAE. In the present study, we show that a 30-day course of LF 15-0195 treatment not only prevents MBP-immunized LEW rats from developing EAE but also preserves their refractory phase to reinduction of disease. This effect is Ag driven since it requires priming by the autoantigen during the drug administration. In contrast to other immunosuppressive drugs, short-term treatment with this drug induces a persistent tolerance with no rebound of EAE up to 4 mo after treatment withdrawal. This beneficial effect of LF 15-0195 on EAE does not result from the deletion of MBP-specific Vbeta8.2 encephalitogenic T cells. In contrast, this drug favors the differentiation of MBP-specific CD4 T cells into Foxp3-expressing regulatory T cells that, upon adoptive transfer in syngeneic recipients, prevent the development of actively induced EAE. Finally, we demonstrate that the tolerance induced by LF 15-0195 treatment is not dependent on the presence of TGF-beta. Together, these data demonstrate that short-term treatment with LF 15-0195 prevents MBP-immunized LEW rats from EAE by favoring the development of Foxp-3-expressing regulatory CD4 T cells.

Topics: Adoptive Transfer; Animals; Base Sequence; CD4-Positive T-Lymphocytes; DNA; Encephalomyelitis, Autoimmune, Experimental; Forkhead Transcription Factors; Gene Expression; Guanidines; Humans; Immunosuppressive Agents; Male; Multiple Sclerosis; Myelin Basic Protein; Neutralization Tests; Rats; Rats, Inbred Lew; Receptors, Antigen, T-Cell, alpha-beta; Receptors, Chemokine; Transforming Growth Factor beta

Dendritic cells (DC), as the most effective antigen presenting cells, are protagonists of the complex immune network involved in multiple sclerosis (MS) lesion formation. Glatiramer acetate (GA), a synthetic random copolymer, is thought to exert its therapeutical effect in MS by favouring both Th2 cell development and IL-10 production from peripheral lymphocytes as well as by systemically affecting the antigen presenting cells. In the present study we further analysed the mechanisms of action of GA by using an autologous DC-lymphocytes (Ly) coculture system from 11 MS patients and 12 matched healthy controls (HC). We found that, in MS patients, pretreatment with GA significantly decreases the in vitro proliferative effect of DC on lymphocytes as compared to HC and to unpulsed or myelin basic protein (MBP)-pulsed DC from MS patients (P < 0.05). In addition, GA-treated DC from both MS patients and HC significantly increase the lymphocyte production of IL-5 and IL-13 as compared to MBP-treated DC (P < 0.05). In conclusion our in vitro study may provide new therapeutical mechanisms of GA on lymphocytes, antiproliferative and Th2-favouring effects, which are mediated by monocyte-derived DC.

Topics: Adult; Cell Division; Coculture Techniques; Culture Media; Dendritic Cells; Female; Glatiramer Acetate; Humans; Immunosuppressive Agents; Interleukin-13; Interleukin-4; Interleukin-5; Interleukins; Lymphocyte Culture Test, Mixed; Lymphocytes; Male; Monocytes; Multiple Sclerosis; Myelin Basic Protein; Peptides

The etiology of multiple sclerosis (MS) remains unclear. To determine if autoantibodies to myelin basic protein (MBP) are produced during parvovirus B19 infection, a competitive ELISA was performed using plasma from MS patients exhibiting high IgG titers for parvovirus. Our results showed the addition of MBP decreased the binding of IgG to B19 antigen in a dose dependent fashion suggesting a possible link between parvovirus B19 and a subset of patients with clinical MS.

Topics: Autoantibodies; Enzyme-Linked Immunosorbent Assay; Humans; Immunoglobulin G; Multiple Sclerosis; Myelin Basic Protein; Parvoviridae Infections; Parvovirus B19, Human

A growing body of evidence suggests that axonal loss and neurodegeneration are responsible for the permanent neurological deficit that typically develops in the course of MS. To investigate the neurodegenerative component of MS pathogenesis, we examined the expression of alpha-synuclein, a protein whose accumulation is common to many neurodegenerative disorders, under conditions of immune-mediated inflammatory demyelination. alpha-Synuclein expression was examined in the spinal cord of myelin oligodendrocyte glycoprotein (MOG)-induced experimental autoimmune encephalomyelitis (EAE) in rats using immunofluorescence and in situ hybridization and in postmortem tissues from cases of secondary progressive MS using immunohistochemistry. alpha-Synuclein upregulation was detected in neurons and glia in and close by lesions and in normal appearing spinal cord EAE tissue at the protein and mRNA levels. alpha-Synuclein positive neurons and glia appeared early, and their number was maximal during EAE exacerbations, but some expression was maintained throughout the course of EAE. In addition, increased alpha-synuclein expression was detected in neurons and glia in and close to MS lesions. Although the increased expression of alpha-synuclein was detected as a granular cytoplasmic labeling rather than inclusion bodies, this result does suggest that neuronal cell death in immune-mediated demyelinating disease may share some common features with other neurodegenerative conditions.

Topics: alpha-Synuclein; Animals; Encephalomyelitis, Autoimmune, Experimental; Female; Humans; In Situ Hybridization; Mice; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Neuroglia; Neurons; Peripheral Nerves; Rats; Recombinant Proteins; Spinal Cord; Up-Regulation

Topics: Humans; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Protein Conformation

The degradation of myelin in the CNS is the hallmark of multiple sclerosis. Reduction in the net positive charge of myelin basic protein (MBP), through deimination, correlates strongly with disease severity and may mediate myelin instability and loss of compaction. Using Cys scanning, spin labeling, EPR spectroscopy, and site-specific proteolysis, we show that in the membrane-bound state the primary immunodominant epitope, V83-T92, of the less cationic recombinant murine MBP C8 mimic (rmC8) forms a more highly surface-exposed and shorter amphipathic alpha-helix than in the unmodified form, recombinant murine MBP C1 mimic (rmC1), analogous to the most cationic and abundant isomer of MBP in normal myelin. Moreover, cathepsin D digested lipid-associated rmC8 3-fold faster than rmC1, and cleavage at F86-F87 occurred more readily in rmC8 than rmC1. These findings suggest a mechanism for initial loss of myelin stability and the autoimmune pathogenesis of multiple sclerosis.

Topics: Animals; Autoimmunity; Cathepsin D; Cations; Cell Membrane; Electron Spin Resonance Spectroscopy; Immunodominant Epitopes; Mice; Multiple Sclerosis; Mutation; Myelin Basic Protein; Protein Structure, Secondary; Recombinant Proteins; Xenotropic and Polytropic Retrovirus Receptor

Topics: Biomarkers; Humans; Immunoglobulin M; Multiple Sclerosis; Myelin Basic Protein; Prognosis; Recurrence; Reproducibility of Results; Risk Factors

To investigate whether the presence of serum antibodies against myelin oligodendrocyte glycoprotein (MOG) and myelin basic protein (MBP) in patients with a clinically isolated syndrome (CIS) predicts the interval to develop more frequently and earlier a first relapse (clinically definite multiple sclerosis: CDMS) than seronegative patients.. Sera from 45 patients with a CIS and positive intrathecal IgG-synthesis were retrospectively tested for the presence of IgM antibodies against both MOG and MBP. Antibodies were detected by immunoblot using recombinant MOG (1-125) and human MBP antigen preparations. Clinical follow ups were performed retrospectively by telephone interviews and documented neurological examination.. Using the Cox proportional hazards model there was no significant increased risk for developing CDMS in anti-MOG and anti-MBP positive patients compared with negative. However regarding the median of the time span between CIS and CDMS over the whole follow up, antibody positive patients (MOG/MBP +/+) developed significantly earlier relapses (median 5.5 months (range 3-20)) than the antibody negative ones (median 25.0 months (range 7-43); p<0.006). On testing sera from 56 apparently healthy students, quite high frequencies of anti-MOG and anti-MBP antibodies (21% and 28% respectively) were detected. This limited specificity of anti-MOG and anti-MBP antibodies has been seen earlier and restricts their diagnostic relevance in MS despite their role as a predictor of relapses after a CIS.. This study confirms previous data only in a subanalysis indicating that patients with positive anti-MOG/MBP antibodies develop earlier relapses than patients who are antibody negative. However, the authors could not verify that the presence of these antibodies anticipates the overall risk of developing CDMS-according to study criteria-after a first demyelinating event within the study period of 21-106 months (mean 60 (SD 25)).

Topics: Adolescent; Adult; Antibody Formation; Case-Control Studies; Female; Humans; Immunoblotting; Immunoglobulin M; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Predictive Value of Tests; Recurrence; Retrospective Studies; Risk Factors

Experimental autoimmune encephalomyelitis (EAE) is a T-cell-mediated autoimmune disease. Chemokine receptor CCR5 has been shown to be essential for the T-cell recruitment to the inflammatory site in EAE. In this study, we assumed that an immunotoxin directed at CCR5+ cells would be able to reduce the disease activity of EAE. A recombinant immunotoxin, DT390-RANTES-SRalpha, was constructed in an eukaryotic cell expression plasmid consisting of regulated on activation normal T cells expressed and secreted (RANTES) as the targeting moiety and DT390 as the toxic moiety. DT390-RANTES was expressed in vitro and was highly toxic to activated mouse T cells with the inhibitory concentration 50 at 0.18 ng/ml. To evaluate whether DT390-RANTES was effective in preventing EAE, C57BL/6 mice were immunized with myelin basic protein, emulsified with complete Freund's adjuvant and were treated by injecting cationic liposome-embedded plasmid DNA into the muscle of hind limbs. Mice treated with DT390-RANTES-SRalpha developed a much milder EAE compared to mice treated with phosphate-buffered saline or the empty plasmid DNA. Much less CCR5+-infiltrating cells were found in the central nervous system in DT390-RANTES-SRalpha-treated mice than in the control mice. This study indicates that recombinant immunotoxin can be expressed in vivo, and targeting CCR5 can attenuate the disease activity of EAE in mice.

Topics: 3T3 Cells; Animals; Chemokine CCL5; Chemotaxis, Leukocyte; DNA; Encephalomyelitis, Autoimmune, Experimental; Female; Gene Expression; Genetic Therapy; Humans; Immunization; Immunotherapy; Immunotoxins; Injections, Intramuscular; Mice; Mice, Inbred C57BL; Multiple Sclerosis; Muscle, Skeletal; Myelin Basic Protein; Receptors, CCR5; Recombinant Fusion Proteins; T-Lymphocytes; Transfection

Molecular mimicry is a possible explanation for autoimmune side effects of microorganism infections. Protein sequences from a particular microorganism are compared to known autoimmune immunogens. For diseases such as multiple sclerosis (MS), where the infectious agent is unknown, guesses to its identity are made. Mimics are assumed to be rare. This study takes a radically different approach. Reported sequences from all known human bacterial and viral agents were searched for autoimmune immunogen mimics. Three encephalitogenic peptides, whose autoimmune requirements have been studied extensively, were selected for comparison. Mimics were seen in a wide variety of organisms. For each immunogen, the mimics were found predominantly in nonpathogenic gut bacteria. Since the three immunogens used in this study are related to MS, it is suggested that a microorganism responsible for autoimmune activity in MS could be a normally occurring gut bacterium. This would explain many of the peculiar MS epidemiological data and why no infective agent has been identified for MS and supports recently found MS gut metabolism abnormalities.

Topics: Amino Acid Sequence; Animals; Autoimmunity; Bacteria; Bacterial Proteins; Digestive System; Encephalomyelitis, Autoimmune, Experimental; Guinea Pigs; Humans; Mice; Molecular Mimicry; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Rabbits; Rats; Viral Proteins

Recent studies revealed an important involvement of the cerebral cortex in multiple sclerosis (MS) patients. Cortical lesions in MS were reported to be less inflammatory and to show less structural damage than white matter lesions. Animal models reflecting the histopathological hallmarks of cortical demyelinated lesions in MS are sparse. Induction of experimental autoimmune encephalomyelitis (EAE) in the common marmoset has turned out to be an attractive non-human-primate model for MS. In the present study we investigated the presence and detailed cellular composition of cortical inflammatory demyelinating pathology in the common marmoset upon immunization with myelin oligodendrocyte glycoprotein (MOG). Extensive cortical demyelination reflecting the topographically distinct cortical lesion types in MS patients was revealed by immunohistochemistry for myelin basic protein (MBP). We explored the density of T- and B-lymphocytes, MHC-II expressing macrophages/microglia cells and early activated macrophages (MRP14) at perivascular and parenchymal lesions sites in neocortex and subcortical white matter. Despite a similar density of perivascular inflammatory infiltrates in the demyelinated neocortex, a considerable lower fraction of macrophages was found to express MRP14 in the neocortex indicating a different activation pattern in cortical compared with white matter lesions. Furthermore, cortical EAE lesions in marmoset monkeys revealed immunoglobulin leakage and complement component C9 deposition in intracortical but not subpial demyelination. Our findings indicate that the inflammatory response, especially macrophage and microglia activation, may be regulated differently in gray matter areas in primate brain.

Topics: Animals; Callithrix; Demyelinating Diseases; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Female; Immunization; Macrophages; Male; Microglia; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Neocortex; Neutrophil Infiltration; Tissue Distribution

The pathogenic mechanisms that contribute to multiple sclerosis (MS) include leukocyte chemotaxis into the central nervous system (CNS) and the production of inflammatory mediators, resulting in oligodendrocyte damage, demyelination, and neuronal injury. Thus, factors that regulate leukocyte entry may contribute to early events in MS, as well as to later stages of lesion pathogenesis. CXCL12 (SDF-1alpha), a chemokine essential in CNS development and a chemoattractant for resting and activated T cells, as well as monocytes, is constitutively expressed at low levels in the CNS and has been implicated in T cell and monocyte baseline trafficking. To determine whether CXCL12 is increased in MS, immunohistochemical analyses of lesions of chronic active and chronic silent MS were performed. CXCL12 protein was detected on endothelial cells (EC) in blood vessels within normal human brain sections and on a small number of astrocytes within the brain parenchyma. In active MS lesions, CXCL12 levels were high on astrocytes throughout lesion areas and on some monocytes/macrophages within vessels and perivascular cuffs, with lesser staining on EC. In silent MS lesions, CXCL12 staining was less than that observed in active MS lesions, and also was detected on EC and astrocytes, particularly hypertrophic astrocytes near the lesion edge. Experiments in vitro demonstrated that IL-1beta and myelin basic protein (MBP) induced CXCL12 in astrocytes by signaling pathways involving ERK and PI3-K. Human umbilical vein EC did not produce CXCL12 after treatment with MBP or IL-1beta. However, these EC cultures expressed CXCR4, the receptor for CXCL12, suggesting that this chemokine may activate EC to produce other mediators involved in MS. In agreement, EC treatment with CXCL12 was found to upregulate CCL2 (MCP-1) and CXCL8 (IL-8) by PI3-K and p38-dependent mechanisms. Our findings suggest that increased CXCL12 may initiate and augment the inflammatory response during MS.

Topics: Adolescent; Adult; Aged, 80 and over; Astrocytes; Axons; Cells, Cultured; Central Nervous System; Chemokine CCL2; Chemokine CXCL12; Chemokines, CXC; Chemotaxis, Leukocyte; Endothelial Cells; Female; Humans; Interleukin-1; Interleukin-8; Macrophages; Male; MAP Kinase Signaling System; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Receptors, CXCR4; Wallerian Degeneration

In multiple sclerosis (MS) MBP is heavily citrullinated by peptidylarginine deiminase (PAD). This post-translational modification may be crucial for its pathogenesis. PADI4 is the isoform expressed in inflammatory infiltrates. The aim of this study was to analyse the role of PADI4 gene in conferring susceptibility to MS, by means of a family-based association study, testing three SNPs by RFLP. No association was found either with single SNPs or haplotypes. Similarly no significant association was detected partitioning the patients according to DRB1*15 positivity or disease severity. These results do not support a major role of the PADI4 gene, but further studies may contribute to clarify the genetic factors that regulate deimination.

Topics: Adult; Biomarkers; Central Nervous System; Chromosome Mapping; Citrulline; DNA Mutational Analysis; Female; France; Genetic Markers; Genetic Predisposition to Disease; Genetic Testing; Genotype; Haplotypes; Humans; Hydrolases; Male; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Polymorphism, Single Nucleotide; Protein Processing, Post-Translational; Protein-Arginine Deiminase Type 4; Protein-Arginine Deiminases; White People

Multiple Sclerosis is an autoimmune disease directed against myelin proteins. The etiology of MS is poorly defined though, with no definitive causative agent yet identified. It has been hypothesized that MS may be a multifactorial disease resulting in the same end product: the destruction of myelin by the immune system. In this report we describe a potential role for heat shock proteins in the pathogenesis of MS. We isolated Hsp70 from the normal appearing white matter of both MS and normal human brain and found this was actively associated with, among other things, immunodominant MBP peptides. Hsp70-MBP peptide complexes prepared in vitro were shown to be highly immunogenic, with adjuvant-like effects stimulating MBP peptide-specific T cell lines to respond to normally sub-optimal concentrations of peptide. This demonstration of a specific interaction between Hsp70 and different MBP peptides, coupled with the adjuvanticity of this association is suggestive of a possible role for Hsp70 in the immunopathology associated with MS.

Topics: Adjuvants, Immunologic; Amino Acid Sequence; Autoantigens; Brain Chemistry; Cell Line; Epitopes, T-Lymphocyte; HSP70 Heat-Shock Proteins; Humans; Immunodominant Epitopes; Immunoprecipitation; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Nerve Tissue Proteins; Peptide Fragments; Protein Interaction Mapping; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; T-Cell Antigen Receptor Specificity; T-Lymphocytes; Transcription Factors

Charge microheterogeneity of myelin basic protein is known to affect its conformation and function. Here, the citrullinated myelin basic protein charge isomer, component-8, was shown to be more susceptible to stromelysin-1 cleavage than myelin basic protein component-1. Since levels of component-8 are increased in multiple sclerosis brain, the increased susceptibility of component-8 to proteolytic digestion may play a role in the pathogenesis of multiple sclerosis. Interestingly, component-1 isolated from multiple sclerosis patients was digested at a faster rate by stromelysin-1 than component-1 isolated from normal individuals. The reason for this difference is not clear, but likely reflects conformational differences between the two proteins as a result of post-translational modifications. Stromelysin-1 was able to cleave myelin basic protein in the presence of lipids and within the context of myelin and released several peptides including peptides containing the immunodominant epitope.

Topics: Animals; Cattle; Humans; Immunodominant Epitopes; Matrix Metalloproteinase 3; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Peptide Fragments; Protein Isoforms

Although spontaneous remyelination does occur in multiple sclerosis lesions, its extent within the global population with this disease is presently unknown. We have systematically analysed the incidence and distribution of completely remyelinated lesions (so-called shadow plaques) or partially remyelinated lesions (shadow plaque areas) in 51 autopsies of patients with different clinical courses and disease durations. The extent of remyelination was variable between cases. In 20% of the patients, the extent of remyelination was extensive with 60-96% of the global lesion area remyelinated. Extensive remyelination was found not only in patients with relapsing multiple sclerosis, but also in a subset of patients with progressive disease. Older age at death and longer disease duration were associated with significantly more remyelinated lesions or lesion areas. No correlation was found between the extent of remyelination and either gender or age at disease onset. These results suggest that the variable and patient-dependent extent of remyelination must be considered in the design of future clinical trials aimed at promoting CNS repair.

Topics: Adult; Age Factors; Age of Onset; Aged; Autopsy; Disease Progression; Female; Humans; Immunohistochemistry; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Myelin Sheath; Nerve Fibers, Myelinated; Prosencephalon; Sex Factors; Time Factors

Combination therapy with multiple sclerosis (MS) therapeutics is gaining momentum over monotherapy for improving MS. Lovastatin, an HMG-CoA reductase inhibitor (statin), was immunomodulatory in an experimental autoimmune encephalomyelitis (EAE) model of MS. Lovastatin biases the immune response from Th1 to a protective Th2 response in EAE by a different mechanism than 5-aminoimidazole-4-carboxamide-1-beta-D-ribofuranoside, an immunomodulating agent that activates AMP-activated protein kinase. Here we tested these agents in combination in an EAE model of MS. Suboptimal doses of these drugs in combination were additive in efficacy against the induction of EAE; clinical symptoms were delayed and severity and duration of disease was reduced. In the central nervous system, the cellular infiltration and proinflammatory immune response was decreased while the anti-inflammatory immune response was increased. Combination treatment biased the class of elicited myelin basic protein antibodies from IgG2a to IgG1 and IgG2b, suggesting a shift from Th1 to Th2 response. In addition, combination therapy lessened inflammation-associated neurodegeneration in the central nervous system of EAE animals. These effects were absent in EAE animals treated with either drug alone at the same dose. Thus, our data suggest that agents with different mechanisms of action such as lovastatin and 5-aminoimidazole-4-carboxamide-1-beta-D-ribofuranoside, when used in combination, could improve therapy for central nervous system demyelinating diseases and provide a rationale for testing them in MS patients.

Topics: Aminoimidazole Carboxamide; AMP-Activated Protein Kinases; Animals; Dose-Response Relationship, Drug; Drug Evaluation, Preclinical; Drug Therapy, Combination; Encephalomyelitis, Autoimmune, Experimental; Enzyme Activation; Female; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Hypoglycemic Agents; Immunoglobulin G; Immunologic Factors; Lovastatin; Multienzyme Complexes; Multiple Sclerosis; Myelin Basic Protein; Protein Serine-Threonine Kinases; Rats; Rats, Inbred Lew; Ribonucleotides; Th1 Cells; Th2 Cells

Multiple sclerosis (MS) is an autoimmune disorder directed against self antigens of the central nervous system. CD4(+)CD25(+)FoxP3(+) regulatory T cell (T(reg)) mediated suppression is an essential mechanism of self-tolerance. We studied whether changes in the suppressive function of a mixture of CD25(high) and CD25(intemediate) expressing T(reg) cells in myelin basic protein (MBP)-induced proliferation occurred in untreated MS patients. Suppression of MBP-induced proliferation was observed in 13 out of 29 (45%) MS patients; this was significantly (p<0.05) less compared with 17 out of 19 (89%) healthy individuals. Relative T(reg) counts was significantly increased in MS patients (mean+/-S.D.; 20+/-8%) compared with healthy individuals (15+/-5%). These findings suggest that impaired T(reg) function may be involved in pathogenesis of MS.

Topics: Adult; Aged; CD4-Positive T-Lymphocytes; Cell Count; Cell Proliferation; Cells, Cultured; Female; Forkhead Transcription Factors; Humans; Immune Tolerance; Immunity, Cellular; Interleukin-2 Receptor alpha Subunit; Lymphocyte Activation; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; RNA, Messenger; T-Lymphocytes, Regulatory; Up-Regulation

We have characterized the lipid rafts in myelin from a spontaneously demyelinating mouse line (ND4), and from control mice (CD1 background), as a function of age and severity of disease. Myelin was isolated from the brains of CD1 and ND4 mice at various ages, and cold lysed with 1.5% CHAPS (3-[(3-cholamidopropyl) dimethylammonio]-1-propanesulphonate). The lysate was separated by low-speed centrifugation into supernatant and pellet fractions, which were characterized by Western blotting for myelin basic protein (MBP) isoforms and their post-translationally modified variants. We found that, with maturation and with disease progression, there was a specific redistribution of the 14-21.5 kDa MBP isoforms (classic exon-II-containing vs exon-II-lacking) and phosphorylated forms into the supernatant and pellet. Further fractionation of the supernatant to yield detergent-resistant membranes (DRMs), representing coalesced lipid rafts, showed these to be highly enriched in exon-II-lacking MBP isoforms, and deficient in methylated MBP variants, in mice of both genotypes. The DRMs from the ND4 mice appeared to be enriched in MBP phosphorylated by MAP kinase at Thr95 (murine 18.5 kDa numbering). These studies indicate that different splice isoforms and post-translationally modified charge variants of MBP are targeted to different microdomains in the myelin membrane, implying multifunctionality of this protein family in myelin maintenance.

Topics: Aging; Animals; Cell Fractionation; Cholic Acids; Detergents; Disease Models, Animal; Membrane Microdomains; Mice; Mice, Inbred Strains; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Phosphorylation; Protein Isoforms; Protein Processing, Post-Translational; Severity of Illness Index; Silver Staining; Subcellular Fractions; Threonine

Available treatments for multiple sclerosis (MS) require frequent injections and have significant side effects. Proteases generated during inflammation are involved in the induction of tissue damage during inflammatory demyelination in the central nervous system (CNS). The Bowman-Birk Inhibitor (BBI), a soy-derived protease inhibitor with anti-carcinogenic and anti-inflammatory properties, has been shown to be well tolerated in clinical trials for pre-cancerous conditions, such as oral leukoplakia and the inflammatory disease, ulcerative colitis. We hypothesized that BBI may modulate experimental autoimmune encephalomyelitis (EAE), an animal model of MS. The BBI concentrate (BBIC), a soybean extract enriched in BBI, was administered to myelin basic protein (MBP)-immunized Lewis rats by gastric gavage in different treatment regimens, during the induction or the effector phase of disease. BBIC significantly delayed disease onset and suppressed disease severity, clinically and pathologically, in all treatment protocols. Both in vitro and ex vivo, BBIC inhibited MBP-specific proliferation of lymph node cells. BBIC reduced the activity of matrix metalloproteinase (MMP)-2 and -9 in spleen cell supernatants and was detected in the CNS of treated rats. BBIC suppresses EAE, it can be administered orally, and it is safe and relatively inexpensive. It may have a therapeutic role in patients with MS.

Topics: Administration, Oral; Animals; Brain; Cell Division; Encephalomyelitis, Autoimmune, Experimental; Enzyme Inhibitors; Female; Gelatinases; Macrolides; Multiple Sclerosis; Myelin Basic Protein; Rats; Rats, Inbred Lew; Spleen; T-Lymphocytes; Trypsin Inhibitor, Bowman-Birk Soybean; Trypsin Inhibitors

Although dendritic cells (DCs) strongly stimulate the immune response, they can also induce unresponsiveness. Recently, a human monocyte-derived DC subpopulation was described that constitutively expresses indoleamine 2,3-dioxygenase (IDO). These DCs were defined as nonadherent CD123+/CC chemokine receptor 6+ (CCR6+) cells that suppress the allogeneic T-cell response. In the present study, we generated nonadherent, mature DCs from human blood monocytes. As expected, in addition to the classic markers, these cells expressed CD123 and CCR6. Reverse transcription-polymerase chain reaction (RT-PCR), however, did not show IDO gene transcription, nor did we detect enzymatic IDO activity. Treating the cells with interferon-gamma (IFN-gamma) resulted in significant IDO production. Subsequently, we studied the regulatory properties of IDO-producing DCs on autologous and allogeneic T-cell responses. Neither OKT3-stimulated T cells of healthy donors nor myelin basic protein (MBP)-specific T cells of patients with multiple sclerosis (MS) were suppressed by autologous IDO DCs. However, whereas IDO(neg) DCs supported further stimulation of preactivated MBP-specific T cells of an MS patient, IDO(pos) DCs had lost this capacity. The allogeneic T-cell response was only marginally suppressed by IDO DCs. Our findings show that nonadherent CD123+/CCR6+ human DCs do not constitutively express IDO, and, even if they express the enzyme after IFN-gamma treatment, they possess only limited T-cell regulatory function.

Topics: Antineoplastic Agents; Cells, Cultured; Dendritic Cells; Gene Expression Regulation, Enzymologic; Humans; Immune Tolerance; Indoleamine-Pyrrole 2,3,-Dioxygenase; Interferon-gamma; Interleukin-3 Receptor alpha Subunit; Isoantigens; Lymphocyte Activation; Monocytes; Multiple Sclerosis; Muromonab-CD3; Myelin Basic Protein; Receptors, CCR6; Receptors, Chemokine; Receptors, Interleukin-3; T-Lymphocytes; Transcription, Genetic

Topics: Acute Disease; Animals; Disease Models, Animal; Drug Administration Schedule; Humans; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Nerve Fibers, Myelinated; Nerve Regeneration; Oligodendroglia; Rats; Thyroid Hormones; Time Factors

Multiple sclerosis (MS) is thought to involve CD4 T cell recognition of self myelin, many studies focusing on a pathogenic role for anti-myelin, HLA-DR15-restricted T cells. In experimental allergic encephalomyelitis, it is known which epitopes trigger disease and that disease is associated with determinant spread of T cell reactivity. Characterization of these events in human MS is critical for the development of peptide immunotherapies, but it has been difficult to define the role of determinant spread or define which epitopes might be involved. In this study, we report humanized transgenic mice, strongly expressing HLA-DR15 with an MS-derived TCR; even on a RAG-2 wild-type background, mice spontaneously develop paralysis. Disease, involving demyelination and axonal degeneration, correlates with inter- and intramolecular spread of the T cell response to HLA-DR15-restricted epitopes of myelin basic protein, myelin oligodendrocyte glycoprotein, and alphaB-crystallin. Spread is reproducible and progressive, with two of the epitopes commonly described in responses of HLA-DR15 patients. The fact that this pattern is reiterated as a consequence of CNS tissue damage in mice demonstrates the value of the transgenic model in supplying an in vivo disease context for the human responses. This model, encompassing pathologically relevant, spontaneous disease with the presentation of myelin epitopes in the context of HLA-DR15, should offer new insights and predictions about T cell responses during MS as well as a more stringent test bed for immunotherapies.

Topics: Animals; Antigen Presentation; Cell Movement; Central Nervous System; Disease Models, Animal; Disease Progression; DNA-Binding Proteins; Epitopes, T-Lymphocyte; HLA-DR Antigens; HLA-DR Serological Subtypes; Mice; Mice, Inbred C57BL; Mice, Knockout; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Paralysis; Peptide Fragments; Receptors, Antigen, T-Cell, alpha-beta; T-Lymphocyte Subsets

A cyclic analogue, [cyclo(87-99)MBP(87)(-)(99)], of the human immunodominant MBP(87)(-)(99) epitope, was designed based on ROESY/NMR distance information and modeling data for linear epitope 87-99, taking into account T-cell (Phe(89), Lys(91), Pro(96)) and HLA (His(88), Phe(90), Ile(93)) contact side-chain information. The cyclic analogue was found to induce experimental allergic encephalomyelitis (EAE), to bind HLA-DR4, and to increase CD4 T-cell line proliferation, like that of the conformationally related linear MBP(87)(-)(99) epitope peptide. The mutant cyclic peptides, the cyclo(91-99)[Ala(96)]MBP(87)(-)(99) and the cyclo(87-99)[Arg(91)Ala(96)]MBP(87)(-)(99), reported previously for suppressing, to a varying degree, autoimmune encephalomyelitis in a rat animal model, were found in this study to possess the following immunomodulatory properties: (i) they suppressed the proliferation of a CD4 T-cell line raised from a multiple sclerosis patient, (ii) they scored the best in vitro TH2/TH1 cytokine ratio in peripheral blood mononuclear cell cultures derived from 13 multiple sclerosis patients, inducing IL-10 selectively, and (iii) they bound to HLA-DR4, first to be reported for cyclic MBP peptides. In addition, cyclic peptides were found to be more stable to lysosomal enzymes and Cathepsin B, D, and H, compared to their linear counterparts. Taken together, these data render cyclic mimics as putative drugs for treating multiple sclerosis and potentially other Th1-mediated autoimmune diseases.

Topics: Adjuvants, Immunologic; Animals; CD4-Positive T-Lymphocytes; Cell Line; Cell Proliferation; Cyclization; Cytokines; Drug Stability; Encephalomyelitis, Autoimmune, Experimental; Epitopes; HLA-DR4 Antigen; Humans; Leukocytes, Mononuclear; Lysosomes; Models, Molecular; Molecular Mimicry; Multiple Sclerosis; Mutation; Myelin Basic Protein; Peptide Fragments; Peptides, Cyclic; Protein Binding; Rats; Rats, Inbred Lew; Th1 Cells; Th2 Cells

Demonstration of different myelin proteins (myelin basic protein [MBP], proteolipid protein [PLP] and myelin oligodendrocyte glycoprotein [MOG]) is used as a tool to determine the stage of MS lesions in autopsy tissue. Since such tissue can never be obtained at well-defined stages of lesion formation, the time course of myelin degradation in MS lesions can only be estimated. In order to obtain a more precise indication on the sequence of events of myelin degradation in MS lesions, the breakdown of human myelin by human monocytes was studied in vitro. Human monocytes were fed with myelin; next cytocentrifuge preparations were made on several time points (day 0 until day 6). The cytospots were immunocytochemically stained with mono- and polyclonal antibodies directed against various myelin proteins (MOG, MBP, PLP). We found that MOG is degraded after 1 day, whereas PLP and MBP can be detected for a longer period, 2 and 3 days, respectively. The exact time frame of myelin degradation in our in vitro assay cannot be extrapolated to the MS lesion formation in vivo, but our data allow conclusions on the sequence of events as well as a rough indication of the time frame of myelin degradation by macrophages in MS lesions.

Topics: Autopsy; Brain; Cell Count; Cells, Cultured; Flow Cytometry; Humans; Immunohistochemistry; Macrophages; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; Myelin Sheath; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Time Factors

With the ultimate goal of developing a novel treatment for multiple sclerosis (MS), we have developed a cell-based gene therapy protocol for the treatment of murine experimental autoimmune encephalomyelitis (EAE), a powerful animal model for MS. We have determined that transduced fibroblasts secreting encephalogenic epitopes, when injected into mice with EAE, cause a striking abrogation of disease. Both myelin basic protein (MBP) and proteolipid protein mini-gene constructs expressed in syngeneic fibroblast cells were capable of ameliorating ongoing EAE induced by MBP protein. These experiments are crucial since they suggest that not all encephalogenic epitopes need be secreted for the control of disease. We also demonstrate the success of this protocol when transduced syngeneic, and most importantly, allogeneic cells are sequestered within an implantable chamber. Furthermore, we find that through modifying antigen expression by changing the signal sequence of the mini-gene construct, we were able to significantly reduce the dose of cells required for treatment. These improvements to the mini-gene delivery system are critical for the eventual translation of our protocol to the clinic.

Topics: Amino Acid Sequence; Animals; Base Sequence; Cell Line; Diffusion Chambers, Culture; Encephalomyelitis, Autoimmune, Experimental; Female; Fibroblasts; Genetic Therapy; Genetic Vectors; Mice; Mice, Inbred Strains; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Proteolipids; Retroviridae; Transduction, Genetic

Antibodies against myelin oligodendrocyte antigens have been found in the immunoreactive brain lesions of Multiple Sclerosis (MS) patients. Recently it has been proposed that these antibodies can be used as a prognostic marker in the course of disease. However, the serum levels of these autoantibodies during different phases of disease activity or after an immunomodulatory therapy have been poorly investigated. In this study the serum levels of anti-myelin oligodendrocyte glycoprotein (MOG) (directed against the epitopes 1-26 and 15-40) and anti-myelin basic protein (MBP) antibodies were sequentially measured in the same MS patient either in relapse or remission phases. We found that MS patients in the relapse phase had higher serum anti-MOG (peptides 1-26 and 15-40) and anti-MBP antibody levels than controls. In addition, the levels of anti-MOG 1-26 were also elevated during the relapse as compared with the remission phase but no significant changes were found in the levels of anti-MOG 15-40 of anti-MBP antibodies. We also evaluated the effect of interferon-beta (beta) therapy on anti-myelin antibodies. 1-year of interferon-beta treatment did not induce any changes in the levels of anti-MOG and anti-MBP antibodies. In conclusion, these data indicate that the use of peripheral levels of autoantibodies against MOG and MBP as marker of multiple sclerosis might be complicated by the phase of disease activity and by the epitope of the MOG protein used.

Topics: Adult; Amino Acid Sequence; Autoantibodies; Female; Humans; Interferon-beta; Male; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein

Females are more susceptible than males to multiple sclerosis (MS). However, the underlying mechanism behind this gender difference is poorly understood. Because the presence of neuroantigen-primed T cells within the CNS is necessary for the development of MS, the present study was undertaken to investigate the activation of microglia by myelin basic protein (MBP)-primed T cells of male, female, and castrated male mice. Interestingly, MBP-primed T cells isolated from female and castrated male but not from male mice induced the expression of inducible nitric-oxide synthase (iNOS) and proinflammatory cytokines (interleukin-1beta (IL-1beta), IL-1alpha, IL-6, and tumor necrosis factor-alpha) in microglia by cell-cell contact. Again there was no apparent defect in male microglia, because MBP-primed T cells isolated from female and castrated male but not male mice were capable of inducing the production of NO in male primary microglia. Inhibition of female T cell contact-mediated microglial expression of proinflammatory molecules by dominant-negative mutants of p65 and C/EBPbeta suggest that female MBP-primed T cells induce microglial expression of proinflammatory molecules through the activation of NF-kappaB and C/EBPbeta. Interestingly, MBP-primed T cells of male, female, and castrated male mice were able to induce microglial activation of NF-kappaB. However, MBP-primed T cells of female and castrated male but not male mice induced microglial activation of C/EBPbeta. These studies suggest that microglial activation of C/EBPbeta but not NF-kappaB by T cell:microglial contact is a gender-specific event and that male MBP-primed T cells are not capable of inducing microglial expression of proinflammatory molecules due to their inability to induce the activation of C/EBPbeta in microglia. This novel gender-sensitive activation of microglia by neuroantigen-primed T cell contact could be one of the mechanisms behind the female-loving nature of MS.

Topics: Animals; Castration; CCAAT-Enhancer-Binding Protein-beta; Cell Membrane; Cell Nucleus; Central Nervous System; Cytokines; Female; Genes, Dominant; Immunoblotting; Inflammation; Interleukin-1; Interleukin-6; Male; Mice; Microglia; Multiple Sclerosis; Mutation; Myelin Basic Protein; NF-kappa B; Nitric Oxide; Oligonucleotide Array Sequence Analysis; RNA; Sex Factors; T-Lymphocytes; Transcription, Genetic; Tumor Necrosis Factor-alpha

The presence of abzymes (Abzs) in human sera is a specific feature of different autoimmune pathologies. We have shown that IgGs of patients with multiple sclerosis (MS) specifically hydrolyze human myelin basic protein (hMBP). However, the presence of hMBP-hydrolyzing MS IgMs and IgAs in patients with MS has not been studied.. Homogeneous IgM and IgA fractions were isolated from human sera by affinity chromatography on different adsorbents. The Ab-dependent hydrolysis of hMBP was analyzed using SDS-PAGE.. We present evidence showing that MS IgMs and IgAs (but not Abs from the sera of healthy individuals) catalyze the hydrolysis of hMBP. Specific enzymatic activities of IgMs and sIgAs from sera of any single patient were usually significantly higher than those of IgGs. Specific inhibitors of acidic and thiol proteases demonstrated a weak effect on proteolytic activity of IgGs and IgMs. However, specific inhibitors of serine proteases (AEBSF, PMSF, and benzamidine) significantly inhibited proteolytic activity. IgMs and IgAs hydrolyze specifically both human and pig MBP but not many other tested proteins. Although the biological function of this proteolytic activity is not known, it is clear that MBP-hydrolyzing Abs may play an important role in MS pathogenesis.. The findings display the generation by the immune systems of individual MS patients of a variety of polyclonal IgGs, IgMs, and IgAs with different proteolytic properties, which hydrolyze MBP, the major protein component of the myelin-proteolipid shell of axons and a well-known MS autoantigen.

Topics: Adolescent; Adult; Animals; Chromatography, Gel; Female; Humans; Hydrolysis; Immunoglobulin G; Immunoglobulin M; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Swine

Multiple sclerosis is mediated by T-cell responses to central nervous system antigens such as myelin basic protein (MBP). To investigate self-peptide/major histocompatibility complex (MHC) recognition and T-cell receptor (TCR) degeneracy, we determined the crystal structure, at 2.8 A resolution, of an autoimmune TCR (3A6) bound to an MBP self-peptide and the multiple sclerosis-associated MHC class II molecule, human leukocyte antigen (HLA)-DR2a. The complex reveals that 3A6 primarily recognizes the N-terminal portion of MBP, in contrast with antimicrobial and alloreactive TCRs, which focus on the peptide center. Moreover, this binding mode, which may be frequent among autoimmune TCRs, is compatible with a wide range of orientation angles of TCR to peptide/MHC. The interface is characterized by a scarcity of hydrogen bonds between TCR and peptide, and TCR-induced conformational changes in MBP/HLA-DR2a, which likely explain the low observed affinity. Degeneracy of 3A6, manifested by recognition of superagonist peptides bearing substitutions at nearly all TCR-contacting positions, results from the few specific interactions between 3A6 and MBP, allowing optimization of interface complementarity through variations in the peptide.

Topics: Autoimmunity; Dimerization; HLA-DR2 Antigen; Humans; Hydrogen Bonding; Models, Molecular; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Peptides; Protein Conformation; Receptors, Antigen, T-Cell; Surface Plasmon Resonance

Immunoglobulin A (IgA), the predominant immunoglobulin class in mucosal secretions, has been found in the cerebrospinal fluid of patients with multiple sclerosis (MS). In this study we examined the infiltration of clonally expanded IgA plasma cells in lesions of MS brains. Sequences of complementarity-determining region 3 of IgA variable heavy chain (V(H)) genes demonstrated the clonal expansion of IgA-bearing plasma cells in MS lesions. Somatic mutations and ongoing intra-clonal mutations occurred in their V(H) genes. Immunohistochemical study demonstrated infiltration of dimer and polymer IgA1- and A2-positive plasma cells in perivascular spaces, in the parenchyma of MS lesions, and in the adjacent white matter. Double immunofluorescence staining showed binding of IgA antibody on axons and walls of microvessels in the areas of chronic active and inactive demyelination. Bielshowsky's silver impregnation revealed axonal damage in these areas. These findings suggest that IgA in the CNS are localized on axons in lesions and may contribute to axonal damage in MS.

Topics: Antibodies; Axons; B-Lymphocytes; Blotting, Northern; Central Nervous System; DNA Mutational Analysis; Female; Genes, Immunoglobulin; Humans; Immunoglobulin A; Immunoglobulin Joining Region; Immunohistochemistry; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Neurofilament Proteins; Plasma Cells; Postmortem Changes; Reverse Transcriptase Polymerase Chain Reaction; RNA, Messenger; Silver Staining

Multiple sclerosis (MS) is a chronic autoimmune demyelinating disorder of the central nervous system (CNS) of unknown etiology. Several studies have shown that demyelination in MS is caused by proinflammatory mediators which are released by perivascular infiltrates and/or activated glial cells. To understand if proinflammatory mediators such as IL (interleukin)-1beta and TNF (tumor necrosis factor)-alpha are capable of modulating the expression of myelin-specific genes, we investigated the effect of these cytokines on the expression of myelin basic protein (MBP), 2',3'-cyclic nucleotide 3'-phosphodiesterase (CNPase), myelin oligodendrocyte glycoprotein (MOG), and proteolipid protein (PLP) in human primary oligodendrocytes. Interestingly, both IL-1beta and TNF-alpha markedly inhibited the expression of MOG, CNPase, and PLP but not MBP, the effect that was blocked by antioxidants such as N-acetylcysteine (NAC) and pyrrolidine dithiocarbamate (PDTC). Consistently, oxidants and prooxidants like H(2)O(2) and diamide also markedly inhibited the expression of MOG, CNPase, and PLP. Furthermore, both IL-1beta and TNF-alpha induced the production of H(2)O(2). Taken together, these studies suggest that proinflammatory cytokines inhibit the expression of myelin genes in human primary oligodendrocytes through the alteration of cellular redox.

Topics: Acetylcysteine; Animals; Antioxidants; Cells, Cultured; Cytokines; DNA Primers; Dose-Response Relationship, Drug; Down-Regulation; Encephalomyelitis, Autoimmune, Experimental; Female; Gene Expression Regulation; Humans; Hydrogen Peroxide; Inflammation; Interleukin-1; Mice; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; Myelin Sheath; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Neuroglia; Oligodendroglia; Oxidants; Oxidation-Reduction; Phosphoric Diester Hydrolases; Proline; Pyrrolidines; Reactive Oxygen Species; Reverse Transcriptase Polymerase Chain Reaction; Sulfhydryl Compounds; Thiocarbamates; Time Factors; Tumor Necrosis Factor-alpha

The therapeutic potency of M2000 (beta-D-mannuronic acid), a novel designed nonsteroidal anti-inflammatory drug with immunosuppressive property in T-cell-mediated autoimmune disease, was tested. The influence of M2000 on myelin basic protein (MBP)-induced experimental autoimmune encephalomyelitis (EAE), an animal model of multiple sclerosis, was assessed. M2000 at two doses, 40 and 80 mg/kg/day, was administered intraperitoneally (i.p.) to prevention and treatment groups, respectively. Onset of i.p. injections of M2000 to prophylactic and therapeutic groups was day-1 and day-7 postimmunization. The WEHI-164 cell line was used for assaying the tolerability against M2000. The results of this experiment showed that the treatment of EAE with M2000 could significantly suppress disease development both prophylactically and therapeutically; the onset and symptoms of EAE in Lewis rats could be suppressed following the administration of M2000. Clinical improvement was accompanied by a marked decrease in mean numbers of vessels with perivascular cellular infiltration in M2000-treated rats compared with nontreated control. Disease suppression was associated with a marked suppression of MBP-specific T-cell reactivity in vitro, without any evidence for a generalized impairment of T-cell activity. Moreover, M2000 also showed a very high tolerability compared with certain steroidal and nonsteroidal anti-inflammatory drugs. Collectively, our data suggest that M2000 may provide a novel therapeutic option for T-cell-mediated autoimmune diseases in animal models and possibly in humans.

Topics: Animals; Anti-Inflammatory Agents, Non-Steroidal; Cell Line, Tumor; Cell Proliferation; Dose-Response Relationship, Immunologic; Encephalomyelitis, Autoimmune, Experimental; Female; Hexuronic Acids; Immunization; Immunosuppressive Agents; Lymph Nodes; Multiple Sclerosis; Mycobacterium tuberculosis; Myelin Basic Protein; Rats; Rats, Inbred Lew; Time Factors

The significance of catalytic autoantibodies abzymes in the pathogenesis of multiple sclerosis was evaluated in patients with different disease patterns and severity of disability.

Topics: Adult; Antibodies, Catalytic; Autoantibodies; Female; Humans; Male; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein

The prevalence of multiple sclerosis (MS) increases significantly with decreasing UV B light exposure, possibly reflecting a protective effect of vitamin D(3). Consistent with this theory, previous research has shown a strong protective effect 1,25-dihydroxyvitamin D(3) in experimental autoimmune encephalomyelitis (EAE), an MS model. However, it is not known whether the hormone precursor, vitamin D(3), has protective effects in EAE. To address this question, B10.PL mice were fed a diet with or without vitamin D(3), immunized with myelin basic protein, and studied for signs of EAE and for metabolites and transcripts of the vitamin D(3) endocrine system. The intact, vitamin D(3)-fed female mice had significantly less clinical, histopathological, and immunological signs of EAE than ovariectomized females or intact or castrated males. Correlating with reduced EAE, the intact, vitamin D(3)-fed female mice had significantly more 1,25-dihydroxyvitamin D(3) and fewer CYP24A1 transcripts, encoding the 1,25-dihydroxyvitamin D(3)-inactivating enzyme, in the spinal cord than the other groups of mice. Thus, there was an unexpected synergy between vitamin D(3) and ovarian tissue with regard to EAE inhibition. We hypothesize that an ovarian hormone inhibited CYP24A1 gene expression in the spinal cord, so the locally-produced 1,25-dihydroxyvitamin D(3) accumulated and resolved the inflammation before severe EAE developed. If humans have a similar gender difference in vitamin D(3) metabolism in the CNS, then sunlight deprivation would increase the MS risk more significantly in women than in men, which may contribute to the unexplained higher MS incidence in women than in men.

Topics: Animals; Cholecalciferol; Dietary Supplements; Encephalomyelitis, Autoimmune, Experimental; Female; Male; Mice; Multiple Sclerosis; Myelin Basic Protein; Ovariectomy; RNA, Messenger; Sex Factors; Spinal Cord; Steroid Hydroxylases; Vitamin D3 24-Hydroxylase

Multiple sclerosis (MS) is an autoimmune and chronic inflammatory disease characterized by plaques, areas of destroyed myelin sheaths in the CNS, which results in multiple disabilities for patients. In addition to demyelinated plaques, pathophysiological studies have shown "shadow plaques" that represent areas of partial remyelination. New myelin can be made by oligodendrocytes (OLs) generated from oligodendrocyte progenitor cells (OPCs) that pre-exist in the demyelinated area or recruited from surrounding areas. To successfully repopulate the demyelinated area, OPCs have to proliferate, migrate, and differentiate into mature OLs capable of forming myelin. Identifying factors that influence remyelination is a current topic in developmental neurobiology. Previously, we showed that Golli proteins, which have a broad distribution in the nervous and immune systems, are present both in OPCs and activated microglia around MS lesions. We hypothesized that in response to inflammation, Golli proteins may promote proliferation of OPCs through microglial cells. To test this, we established neonatal mouse brain slice and cell cultures and used lipopolysaccharide (LPS) to induce inflammation. In LPS-treated brain slices, Golli proteins displayed increased expression in the cortical subventricular zone. Furthermore, Golli proteins were demonstrated only in the conditioned medium from LPS-treated microglial cell cultures (LPS-MCM), and were absent in either conditioned medium from LPS-treated astrocytes or control media. Finally, proliferation of purified OPCs was promoted with LPS-MCM or Golli proteins, but not with LPS alone. In summary, these results demonstrate that activated microglia are beneficial for proliferation of OPCs and suggest possible involvement of Golli proteins as one of mediators in this process.

Topics: Animals; Cell Proliferation; Cells, Cultured; Humans; Inflammation; Lipopolysaccharides; Mice; Microglia; Multiple Sclerosis; Myelin Basic Protein; Nerve Tissue Proteins; Oligodendroglia; Stem Cells; Transcription Factors

We investigated the apoptosis of myelin basic protein (MBP)-specific T lymphocytes in multiple sclerosis (MS) patients with acute (AMS) or stable (SMS) MS by evaluating the expression of apoptosis markers on peripheral cells. Cells of healthy controls (HC) were evaluated as well. Results showed that mitogen-stimulated apoptosis was comparable among patients and controls, whereas MBP-stimulated CD4+ and CD8+ 7-AAD+ and 7-AAD+ Fas+ cell (apoptotic cells) were significantly reduced in AMS patients. A reduction of the apoptotic rate of myelin-specific CD4+ and CD8+ T lymphocytes could be involved in the immune-mediated destruction of the myelin sheath seen in AMS patients.

Topics: Acute Disease; Adult; Apoptosis; Biomarkers; Case-Control Studies; CD4-Positive T-Lymphocytes; fas Receptor; Female; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Proto-Oncogene Proteins c-bcl-2; Tetradecanoylphorbol Acetate

Although multiple sclerosis (MS) is thought to be an autoimmune disease, the mechanisms by which immunodominant epitopes are generated and lymphocytes are activated are not known. Here, myelin basic protein-component 1 (MBP-C1) from MS tissue was shown to undergo autocatalytic cleavage at slightly alkaline pH. Importantly, one of the major peptides released contained the immunodominant epitope 84-89. Interestingly, MBP isolated from MS patients showed a faster time course of cleavage and a more robust release of epitope 84-89 than MBP isolated from normal individuals. The cleavage reaction was not inhibited by protease inhibitors, except for phenylmethanesulfonyl fluoride (PMSF), a serine protease inhibitor. Since PMSF inhibition suggested a role for a serine residue in the cleavage, we labeled myelin basic protein with diisopropyl fluorophosphate (DFP), known to bind active site serine residues. Mass spectrometry was used to identify the labeled peptide, which consisted of residues 140-152. Since this peptide contained a single serine residue, we concluded it to be the active serine. The importance of this cleavage mechanism is that it provides for a ready source of the immunodominant peptide for sensitization of T-cells. It is not necessary to invoke other mechanisms such as molecular mimicry.

Topics: Animals; Catalysis; Humans; Hydrogen-Ion Concentration; Immunodominant Epitopes; Isoflurophate; Lipids; Mice; Molecular Mimicry; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Protease Inhibitors; Recombinant Proteins; Serine; Temperature

Topics: Catalysis; Chromatography, Gel; Humans; Hydrolysis; Immunoglobulin A; Immunoglobulin M; Multiple Sclerosis; Myelin Basic Protein

An assessment was undertaken of the attitudes of individuals within the science community towards a program to produce genetically modified cattle for altered milk composition, expectantly allowing for research into the treatment of multiple sclerosis in humans. The majority of respondents to an electronic survey expressed favorable attitudes to the program, thought it beneficial, respected individual freedom and was fair and just and disagreed that it was harmful. A passion for science and having a suitable lifestyle were the most important motivating factors for individuals. Finally, there were a wide range of responses to a number of cultural beliefs or myths. Science grouping significantly affected the responses. Compared with Systems and Land groups, Plant and Reproduction groups more strongly agreed with the project, thought it less harmful to interest groups, felt that genetic modification of animals was more morally acceptable, and more strongly agreed with the myth statements. These results indicate a diversity of beliefs and attitudes towards genetic modification amongst those within the science community, and highlight the importance of understanding ethics and myths in dealing with them. It is suggested that the diversity of beliefs could be better used to help shape public policy and understanding of biotechnology.

Topics: Agriculture; Animals; Attitude; Biological Science Disciplines; Cattle; Data Collection; Genetic Engineering; Humans; Internet; Milk; Multiple Sclerosis; Myelin Basic Protein; Nerve Tissue Proteins; Organisms, Genetically Modified; Organizations; Transcription Factors

On the basis of the reported association between hepatitis B vaccination (HBvacc) and autoimmune demyelinating complications such as multiple sclerosis (MS), we have looked for aminoacid similarities between the small hepatitis B virus surface antigen (SHBsAg), and the MS-autoantigens myelin basic protein (MBP) and myelin oligodendrocyte glycoprotein (MOG) that could serve as targets of immunological cross-reactivity. Twenty-mer peptides spanning 4 SHBsAg/MOG and 1 SHBsAg/MBP mimicking pairs, were constructed and tested by ELISA as targets of cross-reactive responses. A total of 147 samples from 58 adults were collected before HBvacc (58/58), and post-HBvacc (48/58 before the second and 41/58 before the third boost). Eighty-seven sera from anti-SHBsAg antibody negative patients with various diseases were tested as pathological controls. Reactivity to at least one of the SHBsAg peptides was found in 8 (14%) pre-HBvacc subjects; amongst the remaining 50, reactivity to at least one of the SHBsAg peptides appeared in 47 (94%) post-HBvacc. Reactivity to at least one of the MOG mimics was present in 4 (8%) pre-HBvacc and in 30 (60%) post-HBvacc (p < 0.001). Overall 30/50 (60%) vaccinees had SHBsAg/MOG double reactivity on at least one occasion compared to none before-vaccination and in 2 (2%) of the pathological controls (p < 0.001 for both). SHBsAg/MOG double reactivity was cross-reactive as confirmed by inhibition studies. At 6 months post-vaccination, 3 of the 4 anti-MOG reactive cases before vaccination and 7 of the 24 (29%) of the anti-MOG reactive cases at 3 months post-vaccination had lost their reactivity to MOG5-24. There was no reactivity to the SHBsAg/MBP mimics. None of the vaccinees reported symptoms of demyelinating disorders. In view of the observed SHBsAg/MOG cross-reactivity, the vaccine's possible role as an immunomodulator of viral/self cross-reactivity must be further investigated.

Topics: Adult; Amino Acid Sequence; Cross Reactions; Female; Hepatitis B Surface Antigens; Hepatitis B Vaccines; Humans; Male; Middle Aged; Molecular Mimicry; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Sequence Homology, Amino Acid

Advanced glycoxidation end products (AGEs) play an important role in the pathogenesis of neurodegenerations and we studied if AGEs could represent a useful marker in patients with multiple sclerosis (MS). AGE-products were assessed in cerebrospinal fluid (CSF) and serum of 31 patients with MS and 8 controls. We did not find any statistically significant differences in patients with MS and controls either in CSF or in serum. We have observed a significant association between pentosidine and total AGEs as well as a relationship of both to the protein content in CSF in MS patients. Despite of the involvement of both oxidative stress and RAGE (receptor for AGEs) in the pathogenesis of MS and its experimental model, neither pentosidine nor total AGE were shown as useful markers in this indication. Other compounds and ligands of RAGE are probably of higher significance in MS.

Topics: Adult; Arginine; Cerebrospinal Fluid Proteins; Female; Glycation End Products, Advanced; Humans; Lysine; Male; Multiple Sclerosis; Myelin Basic Protein; Receptor for Advanced Glycation End Products; Receptors, Immunologic

Oligoclonal bands (OBs) in electrophoresis of cerebrospinal fluid (CSF) are present in multiple sclerosis and here is investigated whether these also occur in experimental autoimmune encephalomyelitis (EAE).. Experimental autoimmune encephalomyelitis was induced in 42 DA rats after immunization with rat spinal chord homogenate and the occurrence of OBs were detected by electrophoresis of both sera and CSF. The relationship between disease symptoms, antibody response against myelin basic protein (MBP), myelin oligodendrocyte glycoprotein (MOG) and appearance of OBs was studied.. Development of CSF-specific OB was found to occur, 6 weeks after immunization, in seven of 42 rats. OB was detected in rats with an antibody response against MBP, whereas as a role no such bands were present in rats with an antibody response against MOG. Initially severe disease symptoms were correlated to a concomitant intense oligoclonal antibody response.. Cerebrospinal fluid-specific OB occurs in EAE. It is present in rats with an anti-MBP, but not in rats with an anti-MOG antibody response. A severe disease results in an intense oligoclonal antibody response, which might have an anti-inflammatory effect.

Topics: Animals; Disease Models, Animal; Disease Progression; Encephalomyelitis, Autoimmune, Experimental; Immunization; Immunoglobulin G; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Oligoclonal Bands; Rats; Severity of Illness Index; Spinal Cord

Human CD4(+) T-cell epitopes were identified in interferon-beta (IFN-beta)-1b. A prominent peptide epitope region was found that induced a proliferative response in 16% of all donors tested. Responses corresponded to the presence of the HLA-DR2 haplotype. Responsive donors expressing the HLA-DQ6 allele showed an increased level of proliferation to the epitope as compared to peptide-responsive HLA-DQ6 negative donors. A similar result was found for HLA-DR15-expressing donors. PBMC from donors expressing HLA-DR15 were more likely to proliferate in response to IFN-beta in a whole-protein in vitro assay than donors who did not carry this haplotype. It is striking that the common DQ6 allele HLA-DQB1(*)0602 is found in linkage disequilibrium with HLA-DRB1(*)1501, and this combination defines the HLA genotype associated with the development of multiple sclerosis. The HLA association between a response to IFN-beta and MS might explain the prevalence of neutralizing antibody development, and may underlie the etiology of the disease.

Topics: CD4-Positive T-Lymphocytes; Epitopes, T-Lymphocyte; Haplotypes; HLA-DQ Antigens; HLA-DR Antigens; Humans; Interferon-beta; Lymphocyte Activation; Multiple Sclerosis; Myelin Basic Protein; Polymorphism, Genetic

Multiple sclerosis is thought to involve aberrant immune responses to myelin autoantigens. Haematopoietic stem-cell transplantation (HSCT) is in clinical trials for progressive multiple sclerosis based on the rationale that it destroys aberrant immune system, while recapitulation of lymphocyte ontogeny might alter the immune system and slow down disease progression. This study was undertaken to analyse characteristics of the T-cell receptor (TCR) repertoire, serum cytokine profile and the T-cell responses to myelin basic protein (MBP) in the reconstituted immune system in progressive multiple sclerosis. The study revealed that, following autologous HSCT, the T-cell immunity recovered in two distinctive phases. The first phase was characterized by limited T-cell immunity as a result of selective expansion of pre-existing T cells commonly expressing the TCR beta chain variable region (TCR BV) 20 and increased serum cytokine production during the first several months. The second phase of T-cell reconstitution coincided with increased thymic T-cell output 9-12 months after HSCT. T cells reconstituted from stem-cell grafts had the distinctive properties of comprehensive T-cell immunity and a broad TCR repertoire. T cells recognizing MBP were initially depleted by immunoablation and rapidly expanded from the reconstituted T-cell repertoire in 12 months. The reconstituted MBP-reactive T cells exhibited a broader epitope recognition repertoire while maintaining the same skewed reactivity pattern compared with that seen at baseline. The findings have important implications in the understanding of the role of HSCT as a potential treatment for multiple sclerosis.

Topics: Autoantigens; Cell Division; Gene Rearrangement, beta-Chain T-Cell Antigen Receptor; Genes, Immunoglobulin; Humans; Immunoglobulin Variable Region; Interferon-gamma; Interleukin-10; Lymphocyte Count; Multiple Sclerosis; Myelin Basic Protein; Reverse Transcriptase Polymerase Chain Reaction; Stem Cell Transplantation; T-Lymphocytes; Thymus Gland; Time Factors; Transplantation, Autologous; Tumor Necrosis Factor-alpha

T cell reactivity to candidate myelin autoantigens, such as myelin basic protein (MBP), may play an important role in the pathogenesis of multiple sclerosis (MS). Although MBP-reactive T cells have been found to undergo in vivo activation in patients with MS, their true precursor frequency in MS is unknown as current frequency analysis is commonly based on the T cell functional responses to MBP. In this study, we developed a TCR sequence-based ex vivo detection system using colony hybridization with oligonucleotide probes specific for CDR3 of selected T cell clones for the analysis of true T cell precursor frequency in PBMC. The results revealed that the precursor frequency of five independent T cell clones recognizing the immunodominant MBP(83-99) region was found to be in the range of 1.6 x 10(-4) in total T cells in three HLA-DR2 patients with MS compared to that of 0.25 x 10(-4) in HLA-DR2 healthy individuals. The observed frequency of MBP(83-99)-reactive T cells in MS patients was considerably higher than those measured in parallel by cell culture-based analysis (2.3 x 10(-6)) or by enzyme-linked immunospot assay (3.9 x 10(-5)) in the same peripheral blood mononuclear cell specimens. Furthermore, the study showed that MBP(83-99)-reactive T cells detected ex vivo belonged to CD45RA+, CD25+ and CD95- T cell subsets as evidenced by preferential expression of specific TCR transcripts in these cell fractions.

Topics: Adult; Antigens, CD; Autoantigens; Base Sequence; Cells, Cultured; Clone Cells; Complementarity Determining Regions; Female; Genes, T-Cell Receptor; Humans; Male; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Oligonucleotide Probes; Peptide Fragments; Receptors, Antigen, T-Cell; Reverse Transcriptase Polymerase Chain Reaction; RNA, Messenger; Stem Cells; T-Lymphocytes

Multiple sclerosis (MS) is an autoimmune disease in which myelin-specific T cells are believed to play a crucial pathogenic role. Nevertheless, so far it has been extremely difficult to demonstrate differences in T cell reactivity to myelin Ag between MS patients and controls. We believe that by using unphysiologically high Ag concentrations previous studies have missed a highly relevant aspect of autoimmune responses, i.e., T cells recognizing Ag with high functional avidity. Therefore, we focused on the characterization of high-avidity myelin-specific CD4+ T cells in a large cohort of MS patients and controls that was matched demographically and with respect to expression of MHC class II alleles. We demonstrated that their frequency is significantly higher in MS patients while the numbers of control T cells specific for influenza hemagglutinin are virtually identical between the two cohorts; that high-avidity T cells are enriched for previously in vivo-activated cells and are significantly skewed toward a proinflammatory phenotype. Moreover, the immunodominant epitopes that were most discriminatory between MS patients and controls differed from those described previously and were clearly biased toward epitopes with lower predicted binding affinities to HLA-DR molecules, pointing at the importance of thymic selection for the generation of the autoimmune T cell repertoire. Correlations between selected immunological parameters and magnetic resonance imaging markers indicate that the specificity and function of these cells influences phenotypic disease expression. These data have important implications for autoimmunity research and should be considered in the development of Ag-specific therapies in MS.

Topics: Adult; Aged; Alleles; Amino Acid Sequence; CD4-Positive T-Lymphocytes; Cell Division; Cell Line; Cytokines; Epitopes, T-Lymphocyte; Female; Hematopoietic Stem Cells; HLA-DR2 Antigen; HLA-DR4 Antigen; Humans; Immunologic Memory; Immunophenotyping; Interleukin-7; Interphase; Lymphocyte Count; Magnetic Resonance Imaging; Male; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Predictive Value of Tests; Protein Binding

Multiple sclerosis (MS) is a progressive immune-mediated disease characterized by the loss of the oligodendrocytes that constitute the myelin sheath. Recent reports show that glutamate-mediated excitotoxic death of oligodendrocytes contributes to pathogenesis in demyelinating disease. A link between the immune-mediated inflammatory response and glutamate-mediated excitotoxicity of oligodendrocytes could involve the interaction of inducible isoforms of nitric oxide synthase (iNOS) and cyclooxygenase (COX-2). Both enzymes are tightly coupled to neuronal excitotoxic death. We examined tissue from two controls and seven MS patients with chronic active lesions to determine the extent of COX-2 and iNOS expression. In contrast to the lack of expression in controls, there was a marked induction of COX-2 in all these MS lesions. COX-2 was frequently expressed in association with iNOS. COX-2 was found in areas that contained catabolites of myelin basic protein, indicating recent demyelination. COX-2 expression was found near damaged oligodendrocytes in cells that expressed the macrophage/microglia marker CD64, indicating that a substantial portion of the COX-2 in the lesions was expressed in immune-derived cells. We discuss these findings in the context of how COX-2 could be coupled with iNOS to contribute to excitotoxic death and damage of oligodendrocytes.

Topics: 2',3'-Cyclic-Nucleotide Phosphodiesterases; Adult; Brain; Cell Count; Cyclooxygenase 2; Demyelinating Diseases; Female; Fluorescent Antibody Technique; Humans; Inflammation; Isoenzymes; Male; Membrane Proteins; Microscopy, Confocal; Middle Aged; Models, Neurological; Multiple Sclerosis; Myelin Basic Protein; Nitric Oxide Synthase; Nitric Oxide Synthase Type II; Oligodendroglia; Prostaglandin-Endoperoxide Synthases; Protein Isoforms; Receptors, IgG; Staining and Labeling

We studied CD4 T cell activation in patients with clinically isolated syndromes (CIS) suggesting an initial attack of multiple sclerosis. The percentage of blood CD26+ CD4 T cells was increased in these patients, and correlated with magnetic resonance imaging disease activity and clinical disease severity. In contrast, the percentage of CD25+ CD4 T cells in cerebrospinal fluid correlated negatively with the cerebrospinal fluid concentration of myelin basic protein and the presence of IgG oligoclonal bands. These results suggest that distinct systemic and intrathecal T cell activation states correlate with disease activity and risk of subsequently developing MS in CIS patients.

Topics: Adult; Antigens, Differentiation; CD4-Positive T-Lymphocytes; Dipeptidyl Peptidase 4; Disability Evaluation; Female; Flow Cytometry; Humans; Immunoglobulin G; Lymphocyte Activation; Magnetic Resonance Imaging; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Nervous System Diseases; Receptors, Interleukin-2

Autoreactive T cells of CD4 and CD8 subsets recognizing myelin basic protein (MBP), a candidate myelin autoantigen, are thought to contribute to and play distinct roles in the pathogenesis of multiple sclerosis (MS). In this study we identified four MBP-derived peptides that had high binding affinity to HLA-A2 and HLA-A24 and characterized the CD8(+) T cell responses and their functional properties in patients with MS. There were significantly increased CD8(+) T cell responses to 9-mer MBP peptides, in particular MBP(111-119) and MBP(87-95) peptides that had high binding affinity to HLA-A2, in patients with MS compared with healthy individuals. The resulting CD8(+) T cell lines were of the Th1 phenotype, producing TNF-alpha and IFN-gamma and belonged to a CD45RA(-)/CD45RO(+) memory T cell subset. Further characterization indicated that the CD8(+) T cell lines obtained were stained with MHC class I tetramer (HLA-A2/MBP(111-119)) and exhibited specific cytotoxicity toward autologous target cells pulsed with MBP-derived peptides in the context of MHC class I molecules. These cytotoxic CD8(+) T cell lines derived from MS patients recognized endogenously processed MBP and lysed COS cells transfected with genes encoding MBP and HLA-A2. These findings support the potential role of CD8(+) CTLs recognizing MBP in the injury of oligodendrocytes expressing both MHC class I molecules and MBP.

Topics: Adult; Antigen Presentation; Autoantigens; Cell Division; Cell Line; Cell Separation; Cytotoxicity, Immunologic; Female; Hematopoietic Stem Cells; Histocompatibility Antigens Class I; Histocompatibility Antigens Class II; Humans; Immunophenotyping; Lymphocyte Activation; Lymphocyte Count; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; T-Lymphocytes, Cytotoxic

Nature holds numerous viral and bacterial proteins with regions of similarity to myelin basic protein antigenic determinants. Bioinformatic technology, including sequence similarity searches, may allow for the detection of biochemical and biophysical relationships between these peptides. Understanding these relationships is essential to understanding immune-mediated disease and, consequently, may be used to elucidate the etiology of pathological demyelinating diseases such as multiple sclerosis. Studies of experimental autoimmune encephalomyelitis have been used to identify antigenic determinants. We have used these determinants to search available databases of viral and bacterial proteins. Our results indicate numerous viral and bacterial protein segments with probabilistic sequence similarity to myelin basic protein antigenic determinants.

Topics: Amino Acid Sequence; Animals; Bacterial Proteins; Computational Biology; Databases, Protein; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Epitope Mapping; Epitopes; Humans; Models, Statistical; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Sequence Homology, Amino Acid; Viral Proteins

Multiple sclerosis (MS) is an inflammatory demyelinating disorder of the central nervous system. Gender influences both susceptibility to MS, with the disease being more common in women, and the clinical course of disease, with an increased proportion of males developing the primary progressive form of the disease. The basis for these differences may include genetic and immunological factors, and the immunological differences between men and women may be influenced by the effects of the sex hormones. Over several years we have collected blood from MS patients and controls, and measured T-cell responses to myelin proteolipid protein (PLP) and myelin basic protein (MBP) and have shown increased responses to PLP in MS patients compared to healthy controls and patients with other neurological diseases. In the present study we analyzed data from over 500 individuals, to determine whether there are differences between males and females in their responses to PLP and MBP. We found that there was higher frequency of increased T-cell reactivity to immunodominant PLP peptides in women than in men, particularly in non-MS individuals. We suggest that this may be relevant to the higher prevalence of MS in women.

Topics: Amino Acid Sequence; Autoantigens; Case-Control Studies; Female; Humans; Immunodominant Epitopes; In Vitro Techniques; Lymphocyte Activation; Male; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Peptide Fragments; Sex Characteristics; T-Lymphocytes

We have previously demonstrated that there is a high-risk focus for multiple sclerosis (MS) in the southern Ostrobothnian region of western Finland (population 376121 in 1993). Of the two southern Ostrobothnian health-care districts, Vaasa and Seinäjoki, the incidence and prevalence of MS were especially high in the latter. In recent genetic studies, we identified haplotypes of the myelin basic protein (MBP) gene in a group of MS patients originating from southern Ostrobothnia, suggesting a founder effect. This finding led us to explore the population history of the southern Ostrobothnia and correlate it with MS epidemiology. Southern Ostrobothnia can be divided into three distinct regions with respect to its historical settlement: Vaasa, Seinäjoki-south, and Seinäjoki-north. Vaasa, the coastal region was settled by Swedes, who immigrated during the 13th century. In Vaasa, the prevalence of clinically definite MS (CDMS) in 1993 was 107/10(5) (95% CI 90-124). Seinäjoki-south was populated from the 13th century onwards from southwestern Finland, a region which has been recognised as a high-risk focus of MS. In Seinäjoki-south, the prevalence of CDMS in 1993 was 219/10(5) (95% CI 190-247). Seinäjoki-north was inhabited rather late starting in the 16th century from eastern Finland. In Seinäjoki-north the prevalence of CDMS in 1993 was 136/10(5) (95% CI 108-164). The historical settlement pattern of the southern Ostrobothnia indicates that its population is quite heterogeneous. Seinäjoki-south has a very high prevalence of MS, significantly higher than its two neighbouring regions. The distinctive settlement history of Seinäjoki-south, the historical link with the other southwestern high-risk foci and molecular genetic evidence, suggest that a founder effect plays an important role in the high-risk of MS in western Finland.

Topics: Catchment Area, Health; Finland; Founder Effect; Humans; Multiple Sclerosis; Myelin Basic Protein; Sweden

While EAE has been an invaluable model for the immunopathogenesis of multiple sclerosis, it has sometimes been difficult to bridge the gap between findings and therapies in the rodent models and the cellular and molecular interactions that can be studied in the human disease. Humanized transgenic models offer a means of achieving this, through the expression of disease-implicated HLA class II molecules, co-expressed with a cognate HLA-class II-restricted, myelin-specific TCR derived from a human T cell clone implicated in disease. We have generated such a transgenic line, called line 8, that co-expresses a high level of HLA-DR15 and a human TCR specific for HLA-DR15/MBP 85-99. T cells from the transgenic line are skewed to the CD4 single-positive compartment and produce IFN-gamma in response to peptide from mylein basic protein. Mice develop a spontaneous disease phenotype, showing poverty of movement, although this rarely develops into paralysis except following immunization with peptide. On induction of paralysis by immunization with peptide, disease correlates with epitope spread to a number of additional, HLA-DR15-restricted myelin epitopes. This model should be valuable for analyzing epitope spread in a humanized immunogenetic environment and for the testing of specific immunotherapies.

Topics: Animals; Cells, Cultured; Disease Models, Animal; Epitopes; Female; Humans; Male; Mice; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Phenotype; Receptors, Antigen, T-Cell; T-Lymphocytes

Multiple sclerosis is a chronic demyelinating disease of presumed autoimmune pathogenesis. The patients with multiple sclerosis typically shows alternating relapse and remission in the early stage of illness. We previously found that in the majority of multiple sclerosis patients in a state of remission, natural killer (NK) cells contain unusually high frequencies of the cells expressing CD95 (Fas) on their surface (>36.0%). Here we report that in such 'CD95+ NK-high' patients, NK cells may actively suppress potentially pathogenic autoimmune T cells that can mediate the inflammatory responses in the CNS. Using peripheral blood mononuclear cells (PBMCs) derived from 'CD95+ NK-high' or 'CD95+ NK-low' multiple sclerosis in a state of remission, we studied the effect of NK cell depletion on the memory T cell response to myelin basic protein (MBP), a major target antigen of multiple sclerosis. When we stimulated PBMCs of the 'CD95+ NK-high' multiple sclerosis after depleting CD56+ NK cells, a significant proportion of CD4+ T cells (1/2000 to 1/200) responded rapidly to MBP by secreting interferon (IFN)-gamma, whereas such a rapid T cell response to MBP could not be detected in the presence of NK cells. Nor did we detect the memory response to MBP in the 'CD95+ NK-low' multiple sclerosis patients in remission or healthy subjects, regardless of whether NK cells were depleted or not. Depletion of cells expressing CD16, another NK cell marker, also caused IFN-gamma secretion from MBP-reactive CD4+ T cells in the PBMCs from 'CD95+ NK-high' multiple sclerosis. Moreover, we showed that NK cells from 'CD95+ NK-high' multiple sclerosis could inhibit the antigen-driven secretion of IFN-gamma by autologous MBP-specific T cell clones in vitro. These results indicate that NK cells may regulate activation of autoimmune memory T cells in an antigen non-specific fashion to maintain the clinical remission in 'CD95(+) NK-high' multiple sclerosis patients.

Topics: Adult; Autoimmunity; CD4-Positive T-Lymphocytes; CD56 Antigen; Cells, Cultured; fas Receptor; Female; Humans; Immunologic Memory; Interferon-gamma; Killer Cells, Natural; Leukocytes, Mononuclear; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Receptors, IgG

Although multiple sclerosis is considered to be an autoimmune disease in the CNS, the immune responses that take place in the CNS and lymphoid organs remain to be elucidated. Here, we have successfully induced various subtypes of experimental autoimmune encephalitis (EAE) in LEW.1AV1 rats carrying RT1(av1) on the Lewis background genes by immunization with recombinant rat myelin oligodendrocyte glycoprotein (MOG) in various solutions with adjuvants. The purpose of the present study was to analyse in more detail the clinical and immunopathological features of MOG-induced EAE in LEW.1AV1 rats. Immunization with high doses of soluble MOG with pertussis toxin induced acute, frequently fatal EAE, whereas medium doses of partially aggregated MOG without pertussis toxin produced relapsing and remitting EAE. Secondary progressive EAE was induced in some rats by immunization with the immunization protocol having an intermediate nature between the above two. The optic nerve (approximately 60% of the immunized rats) and spinal cord (100%) were frequently involved and detectable both clinically and pathologically, while there was no lesion in the cerebrum. Histological examination revealed that, despite variety in the clinical subtypes, progression of the pathological processes was strikingly uniform, i.e. initial inflammation with minimal demyelination followed by predominant demyelination with minimal lymphocyte infiltration. These findings suggest that the lesion during the later stage is maintained by humoral factors. Taken together, this experimental system can serve as a model of neuromyelitis optica. Further analysis will provide useful information to elucidate the pathogenesis and to develop immunotherapy for neuromyelitis optica and multiple sclerosis.

Topics: Animals; Antibodies; Brain Stem; Encephalomyelitis, Autoimmune, Experimental; Immunization; Immunohistochemistry; Multiple Sclerosis; Multiple Sclerosis, Chronic Progressive; Multiple Sclerosis, Relapsing-Remitting; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Neuromyelitis Optica; Optic Nerve; Pertussis Vaccine; Rats; Rats, Inbred Lew; Spinal Cord

Experimental autoimmune encephalomyelitis (EAE) and Theiler's murine encephalitis virus-induced demyelinating disease (TMEV-IDD) are two clinically relevant murine models of multiple sclerosis (MS). Like MS, both are characterized by mononuclear cell infiltrate into the central nervous system and demyelination. EAE is induced by either the administration of protein or peptide in adjuvant or by the adoptive transfer of encephalitogenic T-cell blasts into naïve recipients. The relative merits of each of these protocols are compared. Depending on the type of question asked, different mouse strains and peptides are used. Different disease courses are observed with different strains and different peptides in active EAE. These variations are addressed, and grading of mice in EAE is discussed. In addition to EAE induction, useful references for other disease indicators, such as delayed-type hypersensitivity, in vitro proliferation, and immunohistochemistry, are provided. TMEV-IDD is a useful model for understanding the potential viral etiology of MS. This chapter provides detailed information on the preparation of viral stocks and subsequent intracerebral infection of mice. In addition, virus plaque assay and disease assessment are discussed. Recombinant TMEV strains have been created for the study of molecular mimicry; these strains incorporate 30 various amino acid myelin epitopes within the leader region of TMEV.

Topics: Adoptive Transfer; Amino Acid Sequence; Animals; Cardiovirus Infections; Cell Line; Cricetinae; Demyelinating Diseases; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Mice; Mice, Inbred Strains; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Peptide Fragments; Theilovirus; Virus Cultivation

Experimental autoimmune encephalomyelitis (EAE) is an inflammatory demyleinating disease of the central nervous system that is induced in laboratory animals by the generation of an immune response against myelin epitopes. It has been used as a prototype of Th1-driven, organ-specific autoimmunity and as a model for the human disease multiple sclerosis. This chapter describes two classic protocols for EAE induction (active immunization and adoptive transfer). Subheading 3.3. describes methods for rating clinical disease in symptomatic animals. Subheading 3.4. includes instructions for the isolation of mononuclear cells from the inflamed spinal cords from mice with EAE.

Topics: Adoptive Transfer; Amino Acid Sequence; Animals; Autoantigens; Encephalomyelitis, Autoimmune, Experimental; Humans; Mice; Mice, Inbred Strains; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Peptide Fragments; Th1 Cells; Vaccination

Copolymer 1 [Cop1, glatiramer acetate, Copaxone, poly(Y,E,A,K)n] is widely used in the treatment of relapsing/remitting multiple sclerosis in which it reduces the frequency of relapses by approximately 30%. In the present study, copolymers with modified amino acid compositions (based on the binding motif of myelin basic protein 85-99 to HLA-DR2) have been developed with the aim of suppressing multiple sclerosis more effectively. The enhanced efficacy of these copolymers in experimental autoimmune encephalomyelitis (EAE) induced in SJL/J mice with proteolipid protein 139-151 was demonstrated by using three protocols: (i) simultaneous administration of autoantigen and copolymer (termed prevention), (ii) pretreatment with copolymers (vaccination), or (iii) administration of copolymers after disease onset (treatment). Strikingly, in the treatment protocol administration of soluble VWAK and FYAK after onset of disease led to stasis of its progression and suppression of histopathological evidence of EAE. The mechanisms by which these effects are achieved have been examined in several types of assays: binding of copolymers to I-A(s) in competition with proteolipid protein 139-151 (blocking), cytokine production by T cells (T helper 2 polarization), and transfer of protection by CD3(+) splenocytes or, notably, by copolymer-specific T cell lines (induction of regulatory T cells). The generation of these copolymer-specific regulatory T cells that secrete IL-4 and IL-10 and are independent of the immunizing autoantigen is very prominent among the multiple mechanisms that account for the observed suppressive effect of copolymers in EAE.

Topics: Adoptive Transfer; Amino Acid Sequence; Animals; Cytokines; Encephalomyelitis, Autoimmune, Experimental; Glatiramer Acetate; HLA-DR2 Antigen; Mice; Mice, Inbred Strains; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Peptide Fragments; Peptides; Protein Binding; T-Lymphocytes; Vaccination

Multiple sclerosis (MS) and experimental autoimmune encephalomyelitis (EAE), an animal model of MS, are inflammatory demyelinating diseases of the central nervous system. The inflammatory attacks lead to glial dysfunction and death, axonal damage, and neurological deficits. Numerous studies in rat suggest that extracellular calcium influx, via voltage-gated calcium channels (VGCC), contributes to white matter damage in acute spinal cord injury and stroke. Our immunohistochemical finding that mouse spinal cord axons display subunits of L-type VGCC also supports this hypothesis. Furthermore, we hypothesized that VGCC also play a role in EAE, and possibly, MS. In our study, administration of the calcium channel blockers (CCB) bepridil and nitrendipine significantly ameliorated EAE in mice, compared with vehicle-treated controls. Spinal cord samples showed reduced inflammation and axonal pathology in bepridil-treated animals. Our data support the hypothesis that calcium influx via VGCC plays a significant role in the development of neurological disability and white matter damage in EAE and MS.

Topics: Animals; Axons; Bepridil; Calcium Channel Blockers; Calcium Channels, L-Type; Demyelinating Diseases; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Female; Immunohistochemistry; Mice; Multiple Sclerosis; Myelin Basic Protein; Neutrophil Infiltration; Nitrendipine; Spinal Cord; Time Factors; Wallerian Degeneration

Topics: CD4-Positive T-Lymphocytes; CD8-Positive T-Lymphocytes; fas Receptor; Humans; Killer Cells, Natural; Major Histocompatibility Complex; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes

Leflunomide inhibits de novo pyrimidine synthesis and is a novel, immunosuppressive agent that has been successfully used to treat rheumatoid arthritis. Here, we investigated the efficacy of leflunomide and its mode of action in experimental autoimmune encephalomyelitis (EAE), which is a T helper cell type 1 cell-borne disease model to simulate inflammatory aspects of multiple sclerosis and was induced in Lewis rats by adoptive transfer of myelin basic protein (MBP)-specific T line cells. Given in vivo for 7 days after cell transfer, leflunomide suppressed clinical signs of disease even in uridine-substituted animals. MBP-specific T line cells that had been antigen-activated in vitro in the presence of A77 1726 (active metabolite of leflunomide) produced less interferon-gamma, whereas interleukin (IL)-10 secretion had a tendency to be increased without changes in signal transducer and activator of transcription 6 trafficking. Furthermore, these T cells exhibited reduced chemotaxis and induced a significantly mitigated disease course upon transfer into naive rats. The effects of leflunomide on MBP-specific memory type T line cells in vitro may not be mediated by pyrimidine depletion, as they were not reversible by exogenous uridine. Moreover, A77 1726 led to increased expression of CD86 (B7-2) and secretion of IL-10 in cultured microglial cells in vitro, strengthening their down-modulatory impact on activated, autoantigen-specific T cells. In conclusion, our observations underline that the immunomodulatory potential of leflunomide in effector cells of EAE is clinically relevant and is not exclusively dependent on the depletion of cellular pyrimidine pools.

Topics: Adoptive Transfer; Animals; Animals, Newborn; Antigens, CD; B7-2 Antigen; Cells, Cultured; Chemotaxis, Leukocyte; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Guinea Pigs; Immunosuppressive Agents; Interferon-gamma; Interleukin-10; Interleukin-2; Isoxazoles; Leflunomide; Membrane Glycoproteins; Microglia; Multiple Sclerosis; Myelin Basic Protein; Pyrimidines; Rats; Rats, Inbred Lew; STAT6 Transcription Factor; T-Lymphocytes, Helper-Inducer; Trans-Activators; Uridine

Activated myelin-specific T cells are thought to mediate inflammatory tissue damage in multiple sclerosis (MS). Applying a large panel of myelin antigens, we demonstrate the direct ex vivo detection of viable IFN-gamma/TNF-alpha producing CD4+/CD69+ T cells 6 hours after antigenic challenge, by intracellular flow cytometry in 3/33 MS patients and 2/26 healthy controls with calculated frequencies of (mean +/- SEM): 0.031% +/- 0.002% versus 0.037% +/- 0.029%. By comparison, the recently developed IL-7 modified proliferation assay revealed i) a higher number of individuals showing myelin reactivity (17/37 MS patients and 12/24 healthy individuals) and ii) a significant difference in the response to myelin basic protein (MBP) between the two groups in a longitudinal analysis, indicating a higher activity of myelin-specific T cells in MS patients. Our data provide new perspectives in detecting pathogenetically relevant T cells, but clearly demonstrate the different conclusions which must be drawn from various approaches concerning the quantification of autoreactive T cells.

Topics: Adult; Amino Acid Sequence; Autoantigens; Binding Sites; Cell Separation; Cross-Sectional Studies; Female; Flow Cytometry; Humans; Longitudinal Studies; Lymphocyte Activation; Male; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Statistics, Nonparametric; T-Lymphocytes

Susceptibility to multiple sclerosis (MS) is associated genetically with human leucocyte antigen (HLA) class II alleles, including DRB1*1501, DRB5*0101, and DQB1*0602, and it is possible that these alleles contribute to MS through an enhanced ability to present encephalitogenic myelin peptides to pathogenic T cells. HLA-DRB1*1502, which contains glycine instead of valine at position 86 of the P1 peptide-binding pocket, is apparently not genetically associated with MS. To identify possible differences between these alleles in their antigen-presenting function, we determined if T-cell responses to known DRB1*1501-restricted myelin peptides might be diminished or absent in transgenic (Tg) DRB1*1502-expressing mice. We found that Tg DRB1*1502 mice had moderate to strong T-cell responses to several myelin peptides with favorable DRB1*1501 binding motifs, notably myelin oligodendrocyte glycoprotein (MOG)-35-55 (which was also encephalitogenic), proteolipid protein (PLP)-95-116, and MOG-194-208, as well as other PLP and MOG peptides. These peptides, with the exception of MOG-194-208, were also immunogenic in healthy human donors expressing either DRB1*1502 or DRB1*1501. In contrast, the DRB1*1502 mice had weak or absent responses to peptides with unfavorable DRB1*1501 binding motifs. Overall, none of the DRB1*1501-restricted myelin peptides tested selectively lacked immunogenicity in association with DRB1*1502. These results indicate that the difference in risk association with MS of DRB1*1501 versus DRB1*1502 is not due to a lack of antigen presentation by DRB1*1502, at least for this set of myelin peptides, and suggest that other mechanisms involving DRB1*1501 may account for increased susceptibility to MS.

Topics: Amino Acid Sequence; Animals; Antigen Presentation; Cell Line; Cells, Cultured; Female; HLA-DR Antigens; HLA-DRB1 Chains; Humans; Immunodominant Epitopes; Lymphocyte Activation; Male; Mice; Mice, Knockout; Mice, Transgenic; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Risk Factors

Topics: Apoptosis Regulatory Proteins; Autoantibodies; Biomarkers; Brain; GTP-Binding Proteins; Humans; Interferon-beta; Magnetic Resonance Imaging; Membrane Glycoproteins; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Myxovirus Resistance Proteins; Neutralization Tests; Prognosis; TNF-Related Apoptosis-Inducing Ligand; Treatment Outcome; Tumor Necrosis Factor-alpha

Epstein-Barr virus-specific CD4+ T cells could be involved in the pathogenesis of multiple sclerosis, provided they can gain entry to the intrathecal compartment. The authors have previously demonstrated that cerebrospinal fluid T cells from multiple sclerosis patients recognize autologous Epstein-Barr virus-transformed B cells. They now report that CD4+ T cells specific for the Epstein-Barr virus DNA polymerase peptide EBV 627-641 were present in the cerebrospinal fluid from one of two multiple sclerosis patients, and that a high proportion of these CD4+ T cells cross-recognized an immunodominant myelin basic protein peptide, MBP 85-99. In the observed patient, the proportion of EBV 627-641-specific CD4+ T cells seemed to exceed 1/10,000 in cerebrospinal fluid, compared to approximately 1/100,000 in blood. These findings prove that Epstein-Barr-virus specific CD4+ T cells can gain access to the intrathecal compartment, and suggest that Epstein-Barr virus-specific CD4+ T cells could target myelin basic protein in the central nervous system.

Topics: Adult; CD4-Positive T-Lymphocytes; Cerebrospinal Fluid; Cross Reactions; Epstein-Barr Virus Infections; Female; Herpesvirus 4, Human; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein

Chronic disabilities in multiple sclerosis are believed to be due to neuron damage and degeneration, which follow remyelination failure. Due to the presence of numerous oligodendrocyte precursors inside demyelination plaques, one reason for demyelination failure could be the inability of oligodendrocyte precursor cells to turn into myelinating oligodendrocytes. In this study, we show that thyroid hormone enhances and accelerates remyelination in an experimental model of chronic demyelination, i.e., experimental allergic encephalomyelitis in congenic female Dark Agouti rats immunized with complete guinea pig spinal cord. Thyroid hormone, when administered during the acute phase of the disease, increases expression of platelet-derived growth factor alpha receptor, restores normal levels of myelin basic protein mRNA and protein, and allows an early and morphologically competent reassembly of myelin sheaths. Moreover, thyroid hormone exerts a neuroprotective effect with respect to axonal pathology.

Topics: Animals; Demyelinating Autoimmune Diseases, CNS; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Female; Guinea Pigs; Immunization; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Rats; Rats, Inbred Lew; RNA, Messenger; Spinal Cord; Thyroxine

Autoreactive T cells can be induced by altered peptide ligands to switch Th1 and Th2 phenotypes. The underlying molecular mechanism is critical for understanding of activation of autoreactive T cells and development of novel therapeutic strategies for autoimmune conditions. In this study, we demonstrated that analog peptides of an immunodominant epitope of myelin basic protein (residues 83-99) with alanine substitution at Val(86) and His(88) had a unique partial agonistic property in the induction of Th1 or Th2 deviation in MBP(83-99)-reactive T cell clones typical of Th0 phenotype. The observed phenotypic switch involved differential activation of ERK, p38, and JNK MAPKs. More specifically, Th1 deviation induced by peptide 86V-->A (86A) correlated with enhanced p38 and JNK activities, while Th2 deviation by peptide 88H-->A (88A) was associated with up-regulated ERK activity and a basal level of p38 and JNK activity. Further characterization revealed that a specific inhibitor for ERK selectively prevented Th2 deviation of MBP(83-99)-specific T cells. Conversely, specific inhibitors for p38 and JNK blocked Th1 deviation in the same T cell preparations induced by peptide 86A. The findings have important implications in our understanding of regulation of ERK, p38, and JNK by altered peptide ligands and their role in cytokine regulation and phenotype switch of autoreactive T cells.

Topics: Alanine; Amino Acid Sequence; Amino Acid Substitution; Cell Differentiation; Clone Cells; Cytokines; Enzyme Activation; Extracellular Signal-Regulated MAP Kinases; Humans; Immunodominant Epitopes; JNK Mitogen-Activated Protein Kinases; Ligands; Lymphocyte Activation; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; p38 Mitogen-Activated Protein Kinases; Peptide Fragments; T-Lymphocyte Subsets; Th1 Cells; Th2 Cells

Experimental autoimmune encephalomyelitis (EAE) is a good model for human multiple sclerosis (MS) research. However, there are some defects in the traditional models. Here, we improved the model by using the human myelin basic protein (MBP) as antigen. EAE was induced by immunization of female Wistar rats with human MBP. Compared with the traditional models, the new model was evaluated by clinical signs to pathological changes. The immune state of the model was assessed by the lymphocyte infiltrative response and levels of TNF-alpha, IFN-gamma, IL-10. It was found that most of rats exhibited tail tone loss and hind-limb paralysis, also there were demyelination, infiltrative lymphocyte foci, "neuronophagia" in the cortex of cerebra and the white matter of spinal cords. PBMCs and spleen lymphocytes were strongly responsive to the stimulation of MBP and PHA. The levels of TNF-alpha and IFN-gamma were altered with the severity of EAE. In the remitting phase, IL-10 was increased significantly. This study demonstrates that the animal model of EAE induced by human MBP bears resemblance to the features of human multiple sclerosis and promises to be a better model than ever before for the study of MS.

Topics: Animals; Cytokines; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Evaluation Studies as Topic; Female; Humans; Lymphocytes; Multiple Sclerosis; Myelin Basic Protein; Rats; Rats, Wistar

Myelin-reactive T cells are considered to play an essential role in the pathogenesis of multiple sclerosis (MS), an autoimmune disease of the central nervous system. We have previously studied the effects of T cell vaccination (TCV), a procedure by which MS patients are immunized with attenuated autologous myelin basic protein (MBP)-reactive T cell clones. Because several myelin antigens are described as potential autoantigens for MS, T cell vaccines incorporating a broad panel of antimyelin reactivities may have therapeutic effects. Previous reports have shown an accumulation of activated T cells recognizing multiple myelin antigens in the cerebrospinal fluid (CSF) of MS patients. We conducted a pilot clinical trial of TCV with activated CD4+ T cells derived from CSF in five MS patients (four RR, one CP) to study safety, feasibility and immune effects of TCV. CSF lymphocytes were cultured in the presence of rIL-2 and depleted for CD8 cells. After 5-8 weeks CSF T cell lines (TCL) were almost pure TCR alpha beta+CD4+ cells of the Th1/Th0 type. The TCL showed reactivity to MBP, MOG and/or PLP as tested by Elispot and had a restricted clonality. Three immunizations with irradiated CSF vaccines (10 million cells) were administered with an interval of 2 months. The vaccinations were tolerated well and no toxicity or adverse effects were reported. The data from this small open-label study cannot be used to support efficacy. However, all patients remained clinically stable or had reduced EDSS with no relapses during or after the treatment. Proliferative responses against the CSF vaccine were observed in 3/5 patients. Anti-ergotypic responses were observed in all patients. Anti-MBP/PLP/MOG reactivities remained low or were reduced in all patients. Based on these encouraging results, we recently initiated a double-blind placebo-controlled trial with 60 MS patients to study the effects of TCV with CSF-derived vaccines in early RR MS patients.

Topics: Adoptive Transfer; Adult; Autoantigens; CD4-Positive T-Lymphocytes; Cell Division; Clone Cells; Female; Genes, T-Cell Receptor beta; Humans; Lymphocyte Activation; Lymphocyte Count; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Pilot Projects; Receptor-CD3 Complex, Antigen, T-Cell; Receptors, Antigen, T-Cell, alpha-beta

Viral infections are though to play an important role in the pathogenesis of multiple sclerosis (MS) potentially through molecular mimicry. An identical sequence was found in both myelin basic protein (MBP, residues 96-102), a candidate autoantigen for MS, and human herpesvirus-6 (HHV-6 U24, residues 4-10) that is a suspected viral agent associated with MS. In this study, we showed that greater than 50% of T cells recognizing MBP(93-105) cross-reacted with and could be activated by a synthetic peptide corresponding to residues 1 to 13 of HHV-6 U24 in MS patients. The estimated precursor frequency of these cross-reactive T cells recognizing both peptides, MBP(93-105) and HHV-6 (U24)(1-13), was significantly elevated in MS patients compared with that in healthy controls. These cross-reactive CD4+ T cells represented the same Th1 phenotype as that of monospecific T cells recognizing MBP(93-105). There were increased antibody titers for both peptide HHV-6 (U24)(1-13) and peptide MBP(93-105) in the same patients with MS compared with those in healthy controls, suggesting B-cell sensitization to the antigens in MS patients. The study provides important evidence in the understanding of the potential role of HHV-6 infection/reactivation in the activation of autoimmune reactivity to MBP and its implication in the pathogenesis of MS.

Topics: Adult; Antibodies, Viral; Autoantigens; Cell Line; Cross Reactions; Cytokines; Female; Herpesvirus 6, Human; Humans; Immunophenotyping; Male; Middle Aged; Molecular Mimicry; Multiple Sclerosis; Myelin Basic Protein; Roseolovirus Infections; T-Lymphocytes

Heat shock proteins (hsp) are known to facilitate the generation of specific immune responses by chaperoning proteins and peptides involved in T cell activation. Hsp have been shown to be strikingly elevated in multiple sclerosis (MS) lesions. The unique chaperonin properties of hsp70 have allowed identification of immunogenic proteins bound to it by the ex vivo demonstration of hsp associations with proteins implicated in the immune response. We have investigated the association of hsp70 with myelin basic protein (MBP), myelin proteolipid protein (PLP) and myelin oligodendrocyte protein (MOG) in MS and control brain tissue. In co-immunoprecipitation experiments, in all samples of MS brains examined (n = 3), but not control brain tissue (n = 3), direct association of MBP with hsp70, but not with hsp90, was found. In some MS brain samples, association between PLP and hsp70 was also seen. In similar co-immunoprecipitation experiments on brain tissue obtained from mice with experimental autoimmune encephalomyelitis (n = 5) induced by immunization with PLP peptide, specific association of hsp70 with PLP and MBP was found. Using surface plasmon resonance we demonstrated specific binding of hsp70 with MBP in vitro. Analysis of the amounts of MBP bound to hsp70 yielded a molecular ratio of MBP binding to hsp70 at 6.5:1. MBP complexed with hsp70 was taken up at significantly higher rates by antigen-presenting cells than MBP alone and enhanced MBP-specific immune responses. These results indicate that hsp70 specifically associates with MBP in MS brain tissue. This association might be relevant to the enhanced immune recognition of MBP in MS.

Topics: Antigen-Presenting Cells; Brain; HSP70 Heat-Shock Proteins; Humans; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Precipitin Tests

Multiple sclerosis (MS) is a devastating neuroinflammatory disorder of the central nervous system (CNS) in which T cells that are reactive with major components of myelin sheaths have a central role. The receptor for advanced glycation end products (RAGE) is present on T cells, mononuclear phagocytes and endothelium. Its pro-inflammatory ligands, S100-calgranulins, are upregulated in MS and in the related rodent model, experimental autoimmune encephalomyelitis (EAE). Blockade of RAGE suppressed EAE when disease was induced by myelin basic protein (MBP) peptide or encephalitogenic T cells, or when EAE occurred spontaneously in T-cell receptor (TCR)-transgenic mice devoid of endogenous TCR-alpha and TCR-beta chains. Inhibition of RAGE markedly decreased infiltration of the CNS by immune and inflammatory cells. Transgenic mice with targeted overexpression of dominant-negative RAGE in CD4+ T cells were resistant to MBP-induced EAE. These data reinforce the importance of RAGE-ligand interactions in modulating properties of CD4+ T cells that infiltrate the CNS.

Topics: Animals; Cell Line; Central Nervous System; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Female; Humans; Leukocyte L1 Antigen Complex; Mice; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Peptide Fragments; Receptor for Advanced Glycation End Products; Receptors, Immunologic; S100 Proteins; Spinal Cord; T-Lymphocytes

Multiple sclerosis (MS) is an inflammatory disease of the central nervous system, thought to be mediated in part by an autoimmune response of T cells to protein components of the myelin sheath. The reaction of naïve T cells against these antigens requires co-stimulation through CD28. However, the proliferative response of peripheral blood mononuclear cells isolated from patients with MS and stimulated with myelin basic protein (MBP) has been shown to be relatively independent of B7-CD28 co-stimulation, suggesting that dysregulation of co-stimulatory pathways may be involved in the pathogenesis of MS. Here, the role of CTLA-4 engagement was investigated. As expected, blocking CTLA-4-mediated signaling during stimulation of MBP-reactive T cells from healthy controls enhanced the proliferative and cytokine responses. In contrast, CTLA-4 blockade had less effect in patients with MS, suggesting that at least two regulatory mechanisms may be impaired in these individuals. Understanding how co-stimulatory signals may be dysregulated in patients with MS is important at a time when targeting of these pathways is being developed.

Topics: Adult; Antigens, CD; Antigens, Differentiation; Cell Division; CTLA-4 Antigen; Humans; Multiple Sclerosis; Myelin Basic Protein; Polymorphism, Genetic; T-Lymphocytes

We have previously found evidence for linkage as well as allelic and haplotype association between the myelin basic protein (MBP) gene and multiple sclerosis (MS). These findings have, however, not been reproduced in other populations. Here, we have analyzed association between MBP and MS in a new set of 349 Finnish triad families. Families with a parent born in the Southern Ostrobothnian region in western Finland (Bothnia families, n=98) were analyzed as a separate group since our previous studies included a high proportion of patients and families from this high-incidence region. Other families (n=251) were collected at five hospitals in southern, eastern, and northern Finland. The MBP short tandem repeat was genotyped, and haplotype patterns were verified by sequencing. In the Bothnia families, the previously detected associations with the 1.27 kb allele and haplotype 1.27-B10 were confirmed (P=0.01 and 0.02, respectively), whereas in the other families there was not even a trend toward association. These results demonstrate a geographic/genealogical restriction in the association between MS and the MBP short tandem repeat, highlight the importance of genealogical information in genetic studies of complex traits, and may provide an explanation why the association has not been found in many other populations.

Topics: Alleles; Base Sequence; Family Characteristics; Female; Finland; Genetic Predisposition to Disease; Haplotypes; Humans; Linkage Disequilibrium; Male; Microsatellite Repeats; Multiple Sclerosis; Myelin Basic Protein; Nuclear Family; Tandem Repeat Sequences

The presence of autoantibodies to the immunodominant antigen, myelin basic protein (MBP), in the serum and cerebrospinal fluid (CSF) of patients with multiple sclerosis (MS) has been poorly characterized. Many studies report detectable levels of autoantibodies to myelin basic protein though other studies, using similar techniques, report their absence. We compared a solution-phase assay that has detected clinically relevant autoantibodies in diabetes and other autoimmune diseases to solid phase assays similar to those used in previous reports. The solution-phase assay consistently measured autoantibodies to MBP in serum from human subjects with Semple rabies vaccine (SRV)-induced demyelinating disease and from MBP-immunized animals. A solid phase assay detected MBP autoantibodies in the serum of a fraction of patients with MS. Autoantibodies capable of binding to MBP in the solution-phase were not detected in the CSF or serum of patients with MS. Additional solution-phase measurements revealed that anti-MBP antibodies from individuals with SRV-induced demyelinating disease demonstrated a binding affinity profile consistent with that of polyclonal antibodies with a range of affinities from low to high. In contrast, antibodies to MBP in the serum of MS patients detected by ELISA did not bind soluble MBP in the same assay. These results indicate that the humoral response in patients with MS does not include moderate- or high-affinity autoantibodies to MBP.

Topics: Antibody Affinity; Antibody Formation; Autoantibodies; Enzyme-Linked Immunosorbent Assay; Humans; Multiple Sclerosis; Myelin Basic Protein; Protein Binding; Radioimmunoassay

CD4(+) T-cell lines (TCLs) from patients with clinically isolated syndromes (CIS) were selected with purified human myelin basic protein (MBP) and recombinant human myelin oligodendrocyte glycoprotein (rhMOG), at onset of neurological symptoms and when patients developed clinically definite multiple sclerosis (CDMS). The epitope specificity of each TCL was mapped with overlapping synthetic peptides. TCLs were assessed for their ability to secrete IFN-gamma, IL-4, and IL-6. Diverse patterns of epitope recognition were observed: (a) recognition of a broad spectrum of MBP peptide epitopes with evidence of shifts over time; (b) an initial T-cell response focused to a restricted segment of the MBP molecule (83-102) that broadened over the course of disease; and (c) persistence of a focused anti-MOG T-cell response. CIS patients who failed to develop CDMS maintained a focused epitope response against two to six MBP epitopes. Most MBP peptide-specific TCLs secreted considerable amounts of IFN-gamma and low amounts of IL-4 and IL-6, whereas anti rhMOG(Igd) peptide-specific TCLs secreted preferentially IL-4 and IL-6. These data raise important issues for the pathogenesis and treatment of multiple sclerosis (MS).

Topics: Adolescent; Adult; Antibody Specificity; Cells, Cultured; Cytokines; Epitopes; Female; Humans; Interferon-gamma; Interleukin-4; Interleukin-6; Male; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Reaction Time; T-Lymphocytes

We used a flow cytometry assay to measure proliferation and cytokine production of self-antigen-specific T cells in individual patients during the clinical course of multiple sclerosis (MS). Myelin-associated oligodendrocytic basic protein (MOBP) was selected for proof of principles in the assay, along with myelin basic protein (MBP) to assess specific activated T cells in 10 MS patients over an 18-month period, in parallel with brain magnetic resonance imaging (MRI) scans and clinical rating scale. A positive correlation occurred between antigen-specific T cell proliferation and interferon-gamma production with clinical relapses and MRI lesion activity that was absent when the same patients were in remission.

Topics: Adult; Autoantigens; Brain; Epitopes, T-Lymphocyte; Female; Flow Cytometry; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; T-Lymphocytes

Among candidate genes involved in multiple sclerosis (MS) genetic susceptibility, MHC genes and particularly HLA-DRB1*1501-DQB1*0602 haplotype play a major role. Based on the strong linkage disequilibrium observed in Caucasians between DRB1*1501 and DQB1*0602 alleles, it is still impossible to draw a firm conclusion about the DRB1 or DQB1 locus involvement. In order to address this issue a strategy associating a genetic and a functional approach was conducted in a population of-non-Caucasian MS patients. We observed that in Martinicans (55 MS and 100 controls), the DRB1*15 and DRB1*07 alleles were positively associated with the disease. However in Martinicans the most common DRB1*15 subtype was *1503 and not *1501. Moreover, in Martinicans, the frequency of DQB1*0602, found in association with other DRB1 alleles than DRB1*15 (42% of DQB1*0602 haplotypes), was not increased in DRB1*15-negative MS patients, suggesting a neutral role of DQB1*0602 in MS genetics. In a second step, we demonstrated the capability of the DRB1*1503 allele associated with MS in Martinicans to present the immunodominant autoantigen MBP 85-99 peptide to a DRB1*1501 restricted MBP specific T cell line. Interestingly, structural features of DRB1*1501 or DRB1*1503 molecules are in good fit with the hypothesis that *1501 and *1503 molecules may act similarly in MS development by presenting the same immunodominant MBP peptide. On the whole, our results show a prominent role of the DRB1 locus (DRB1*1501 and/or DRB1*1503 alleles) in the immunodominant MBP 85-99 peptide presentation to genetically different MS patients and suggest a neutral role of the DQB1 encoded molecule in MS susceptibility.

Topics: Alleles; Case-Control Studies; Cell Line; Gene Frequency; HLA-DQ Antigens; HLA-DQ beta-Chains; HLA-DR Antigens; HLA-DRB1 Chains; Humans; Martinique; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; T-Lymphocytes

Myelin basic protein (MBP) maintains the compaction of the myelin sheath in the central nervous system by anchoring the cytoplasmic face of the two apposing bilayers and may also play a role in signal transduction. Site-directed spin labeling was done at eight matching sites in each of two recombinant murine MBPs, qC1 (charge +19) and qC8 charge (+13), which, respectively, emulate the native form of the protein (C1) and a post-translationally modified form (C8) that is increased in multiple sclerosis. When interacting with large unilamellar vesicles, most spin-labeled sites in qC8 were more mobile than those in qC1. Depth measurement via continuous wave power saturation indicated that the N-terminal and C-terminal sites in qC1 were located below the plane of the phospholipid headgroups. In qC8, the C-terminal domain dissociated from the membrane, suggesting a means by which the exposure of natural C8 to cytosolic enzymes and ligands might increase in vivo in multiple sclerosis. The importance of two Phe-Phe pairs in MBP to its interactions with lipids was investigated by separately mutating each pair to Ala-Ala. The mobility at F42A/F43A and especially F86A/F87A increased significantly. Depth measurements and helical wheel analysis indicated that the Phe-86/Phe-87 region could form a surface-seeking amphipathic alpha-helix.

Topics: Amino Acid Sequence; Animals; Cell Membrane; Electron Spin Resonance Spectroscopy; Lipid Bilayers; Mice; Molecular Sequence Data; Multiple Sclerosis; Mutagenesis, Site-Directed; Myelin Basic Protein; Peptide Fragments; Protein Isoforms; Protein Structure, Secondary; Recombinant Proteins; Spin Labels; Static Electricity; Structure-Activity Relationship

Increased golli MBP (golli) expression has been observed in the peripheral immune system of mice in the relapsing phase of EAE, raising the possibility that golli MBP expression in the periphery may contribute to relapses. Here we describe the generation of golli MBP-deficient mice and a comparison of the clinical course of EAE between heterozygous (golli(+/-)) and wild-type (golli(+/+)) mice. There was no difference between the two groups in incidence of disease, severity of the first episode of disease, or remission after the first episode. However, there was a significant reduction in relapses in golli(+/-) mice vs. controls, suggesting a role for golli proteins in the relapses in EAE.

Topics: Animals; Central Nervous System; Disease Models, Animal; Disease Progression; Encephalomyelitis, Autoimmune, Experimental; Female; Gene Expression Regulation; Heterozygote; Immunity, Cellular; Male; Mice; Mice, Knockout; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Nerve Tissue Proteins; Recurrence; Transcription Factors

Idiotopic sequences are created after V, D and J recombinations and by somatic mutations during affinity maturation of immunoglobulin (Ig) molecules, and may therefore be potential immunogenic epitopes. Idiotope-specific T cells are able to activate and sustain the B cells producing such idiotopes. It is therefore possible that idiotope-specific intrathecal T cells could help maintain the persisting intrathecal synthesis of oligoclonal IgG observed in patients with multiple sclerosis (MS). This study was undertaken to examine T-cell responses to cerebrospinal fluid (CSF) IgG. Peripheral blood mononuclear cells (PBMC) from 14 of 21 MS patients and four of 17 control patients with other neurological diseases proliferated upon stimulation with autologous CSF IgG, while five and three, respectively, responded to serum IgG. By comparison, responses to myelin basic protein were recorded in only four MS and three control patients. Data from a limited number of patients indicate that the CSF IgG responsive cells were CD4+ and human leucocyte antigen DR restricted, that PBMC also respond to CSF IgG from other MS patients and that the CSF may contain T cells responding to autologous CSF IgG. This suggests that CSF IgG, or substances bound to this IgG, may represent T-cell immunogens, which could contribute to the intrathecal immune response in MS.

Topics: Adult; Case-Control Studies; CD4-Positive T-Lymphocytes; Cell Division; Female; HLA-DR Antigens; Humans; Immunoglobulin G; Male; Middle Aged; Monocytes; Multiple Sclerosis; Myelin Basic Protein; Nervous System Diseases; T-Lymphocytes

The effects of deimination (conversion of arginyl to citrullinyl residues) of myelin basic protein (MBP) on its binding to calmodulin (CaM) have been examined. Four species of MBP were investigated: unmodified recombinant murine MBP (rmMBP-Cit(0)), an engineered protein with six quasi-citrullinyl (i.e., glutaminyl) residues per molecule (rmMBP-qCit(6)), human component C1 (hMBP-Cit(0)), and human component C8 (hMBP-Cit(6)), both obtained from a patient with multiple sclerosis (MS). Both rmMBP-Cit(0) and hMBP-Cit(0) bound CaM in a Ca(2+)-dependent manner and primarily in a 1:1 stoichiometry, which was verified by dynamic light scattering. Circular dichroic spectroscopy was unable to detect any changes in secondary structure in MBP upon CaM-binding. Inherent Trp fluorescence spectroscopy and a single-site binding model were used to determine the dissociation constants: K(d) = 144 +/- 76 nM for rmMBP-Cit(0), and K(d) = 42 +/- 15 nM for hMBP-Cit(0). For rmMBP-qCit(6) and hMBP-Cit(6), the changes in fluorescence were suggestive of a two-site interaction, although the dissociation constants could not be accurately determined. These results can be explained by a local conformational change induced in MBP by deimination, exposing a second binding site with a weaker association with CaM, or by the existence of several conformers of deiminated MBP. Titration with the collisional quencher acrylamide, and steady-state and lifetime measurements of the fluorescence at 340 nm, showed both dynamic and static components to the quenching, and differences between the unmodified and deiminated proteins that were also consistent with a local conformational change due to deimination.

Topics: Acrylamides; Amino Acid Sequence; Animals; Calcium; Calmodulin; Cations, Divalent; Circular Dichroism; Citrulline; Humans; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Protein Isoforms; Scattering, Radiation; Spectrometry, Fluorescence

Myelin basic protein (MBP) represents a candidate autoantigen in multiple sclerosis (MS). We isolated MBP from normal and MS human white matter and purified six components (charge isomers) to compare the post-translational modifications on each. The sites and extent of methylation, deimination, and phosphorylation were documented for all tryptic peptides by mass spectrometry. We found that mono and dimethylated arginine 107 was increased in MS samples; deimination of arginine occurred at a number of sites and was elevated in MS; phosphorylation was observed in 10 peptides in normal samples but was greatly reduced or absent in most peptides from MS samples. Data obtained with MBP isolated from fresh brain obtained from a spontaneously demyelinating mouse model supported the view that the changes observed in human brain were probably related to pathogenesis of demyelination, i.e. we found decreased phosphorylation and decreased amounts of glycogen synthesis kinase in brain homogenates using specific antibodies. This study represents the first to define post-translational modifications in demyelinating disease and suggest an important role in pathogenesis.

Topics: Animals; Arginine; Brain; Case-Control Studies; Glycogen Synthase Kinases; Humans; Mice; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Phosphorylation; Protein Isoforms; Protein Processing, Post-Translational

Topics: Autoantibodies; Biomarkers; Humans; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Predictive Value of Tests

Most patients with multiple sclerosis initially present with a clinically isolated syndrome. Despite the fact that clinically definite multiple sclerosis will develop in up to 80 percent of these patients, the course of the disease is unpredictable at its onset and requires long-term observation or repeated magnetic resonance imaging (MRI). We investigated whether the presence of serum antibodies against myelin oligodendrocyte glycoprotein (MOG) and myelin basic protein (MBP) in patients with a clinically isolated syndrome predicts the interval to conversion to clinically definite multiple sclerosis.. A total of 103 patients with a clinically isolated syndrome, positive findings on cerebral MRI, and oligoclonal bands in the cerebrospinal fluid were studied. At base line, serum samples were collected to test for anti-MOG and anti-MBP antibodies with Western blot analysis, and the lesions detected by cerebral MRI were quantified. Neurologic examinations for relapse or disease progression (defined as conversion to clinically definite multiple sclerosis) were performed at base line and subsequently every three months.. Patients with anti-MOG and anti-MBP antibodies had relapses more often and earlier than patients without these antibodies. Only 9 of 39 antibody-seronegative patients (23 percent) had a relapse, and the mean (+/-SD) time to relapse was 45.1+/-13.7 months. In contrast, 21 of 22 patients (95 percent) with antibodies against both MOG and MBP had a relapse within a mean of 7.5+/-4.4 months, and 35 of 42 patients (83 percent) with only anti-MOG antibodies had a relapse within 14.6+/-9.6 months (P<0.001 for both comparisons with antibody-seronegative patients). The adjusted hazard ratio for the development of clinically definite multiple sclerosis was 76.5 (95 percent confidence interval, 20.6 to 284.6) among the patients who were seropositive for both antibodies and 31.6 (95 percent confidence interval, 9.5 to 104.5) among the patients who were seropositive only for anti-MOG antibodies, as compared with the seronegative patients.. Analysis of antibodies against MOG and MBP in patients with a clinically isolated syndrome is a rapid, inexpensive, and precise method for the prediction of early conversion to clinically definite multiple sclerosis. This finding may be important for the counseling and care of patients with a first demyelinating event suggestive of multiple sclerosis.

Topics: Adolescent; Adult; Autoantibodies; Cerebral Cortex; Cerebrospinal Fluid; Female; Follow-Up Studies; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Predictive Value of Tests; Recurrence

One favored mechanism of action of glatiramer acetate (GA) in multiple sclerosis (MS) involves the induction of GA-reactive Th2 cells that are believed to enter the central nervous system and mediate bystander suppression in response to cross-reactive myelin antigens. To test this hypothesis, we examined the proliferative response and cytokine release from peripheral blood mononuclear cells (PBMCs) of 12 MS patients treated with GA, in response to 16 myelin peptides that were previously described as immunodominant or encephalitogenic and a tetanus peptide as a control antigen. Interferon-gamma (IFN-gamma) and IL-5 (markers of Th1 and Th2 responses, respectively) were assayed by enzyme-linked immunosorbent assay (ELISA). GA-stimulated PBMCs from 9 of 12 patients (75%) proliferated to one or more myelin peptides. Among the 16 peptides tested, GA-stimulated PBMCs from the majority of the patients proliferated in response to MOG(21-44). PBMCs from two thirds of the patients produced IL-5 in response to myelin peptides, while half of them produced IFN-gamma. Th1/Th0/Th2 cytokine phenotypes demonstrated that responses from 10 of 12 patients were either Th0- or Th2-biased. Responses from two patients were Th1-biased. Conversely, some myelin-specific T-cell lines (TCLs) responded to GA by proliferation (3 of 21 TCLs), IL-5 release (11 of 21 TCLs), and IFN-gamma release (3 of 21 TCLs). These results indicate that GA-reactive TCLs can respond to a spectrum of myelin peptides in a Th2-biased fashion, which is consistent with the concept of bystander suppression. Furthermore, some myelin-specific TCLs are able to recognize GA, with a tendency to produce more IL-5 than IFN-gamma, which would suggest a systemic modulatory effect of the drug.

Topics: 2',3'-Cyclic-Nucleotide Phosphodiesterases; Adjuvants, Immunologic; Adult; Aged; Amino Acid Sequence; Cell Line; Cytokines; Female; Glatiramer Acetate; Humans; Immunophenotyping; Leukocytes, Mononuclear; Lymphocyte Activation; Male; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Peptide Fragments; Peptides; Th2 Cells

Much evidence now indicates that human leucocyte antigen (HLA) class I and class II transgenic (Tg) mice can be of value in analysing HLA-restricted presentation of T-cell epitopes relevant to experimental models of autoimmune diseases. One area where this has been applied is the characterization of myelin epitopes presented by HLA class II molecules in experimental model of multiple sclerosis (experimental allergic encephalomyelitis (EAE)). As a first step towards humanized disease models in HLA Tg mice, we have analysed immune response of lymph node cells of HLA-DR1 Tg mice immunized with the human myelin basic protein (MBP) peptides 13-33, 87-106 and 139-154 bound by HLA-DR1. We report here that HLA-DR1 Tg mice display a hierarchy of response in vivo and in vitro to MBP epitopes depending on the binding affinity to DRB*0101 molecule. In fact, the 13-33 epitope induced a strong T helper 1 (Th1) response accompanied by high T-cell precursor frequency and caused mild EAE, while the two other epitopes gave poor (139-154) or no disease (87-106), and these data correlate with in vitro Th1 response. These data could prove a useful tool in understanding the role played by different MBP epitopes in EAE.

Topics: Amino Acid Sequence; Animals; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Epitopes, T-Lymphocyte; Female; Genetic Predisposition to Disease; HLA-DR1 Antigen; Humans; Lymph Nodes; Male; Mice; Mice, Transgenic; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments

Topics: Biomarkers; Humans; Multiple Sclerosis; Myelin Basic Protein; Nervous System Diseases

The extent and pattern of demyelination in the cerebral cortex was determined in 78 tissue blocks from the brains of 20 multiple sclerosis (MS) patients and 28 tissue blocks from 7 patients without neurological disease. Tissue blocks from 4 predetermined areas (cingulate gyrus, frontal, parietal, and temporal lobe) were studied, irrespective of macroscopically evident MS plaques. All tissue blocks contained cerebral cortex and periventricular and/or subcortical white matter. One hundred and nine demyelinating lesions were detected in the cerebral cortex, of which 92 (84.4%) were purely intracortical and 17 (15.6%) were lesions extending through both white and gray matter areas. In 5 of the 20 MS brains, subpial demyelination was extensive in the 4 widely spaced cortical areas studied, thus considered to represent a general cortical subpial demyelination. The percentage of demyelinated area was significantly higher in the cerebral cortex (mean 26.5%, median 14.1%) than in white matter (mean 6.5%, median 0%) (p = 0.001). Both gray and white matter demyelination was more prominent in the cingulate gyrus than in the other areas examined (p < 0.05). These results indicate that the cerebral cortex is likely to be a predilection site for MS lesions and identify general cortical subpial demyelination as a distinct pattern occurring in a significant subpopulation of MS patients.

Topics: Adult; Aged; Axons; Cerebral Cortex; Female; Frontal Lobe; Gyrus Cinguli; Humans; Immunohistochemistry; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Nerve Fibers, Myelinated; Parietal Lobe; Pia Mater; Temporal Lobe

T cells recognizing myelin basic protein (MBP) are potentially involved in the pathogenesis of multiple sclerosis (MS). In vivo clonal expansion of MBP-reactive T cells in MS may relate in part to dysfunction of peripheral regulatory mechanisms, including the anti-idiotypic immune network. In this study, we examined anti-idiotypic immune responses and the functional properties of anti-idiotypic T cells in patients with MS and healthy controls using TCR peptides corresponding to a CDR3 sequence motif preferentially expressed among T cells recognizing the 83-99 immunodominant peptide of MBP in some patients with MS. The study demonstrated that anti-idiotypic T cells could be induced in vitro by 8mer and 15mer peptides containing the CDR3 motif in MS patients and healthy controls respectively. The estimated precursor frequency of the anti-idiotypic T cells was slightly reduced in MS patients compared to control subjects. The obtained anti-idiotypic T cells recognizing the 15mer TCR peptide were found to express the CD4 phenotype, produce predominantly IL-10 and inhibit the proliferation of autologous T cells recognizing the immunodominant peptide of MBP. Anti-idiotypic T cells induced by the 8mer TCR peptide were predominantly CD8+ cytotoxic T cells and exhibited cytotoxic activity against autologous MBP-specific T cells expressing the CDR3 sequence. When added in primary culture, both TCR peptides had a significant inhibitory effect on the T cell responses to the immunodominant peptide of MBP. The findings suggest that anti-idiotypic immune responses can be activated by selected TCR peptides and may play an important role in the in vivo regulation of MBP-reactive T cells.

Topics: Adult; Antibodies, Anti-Idiotypic; CD4-Positive T-Lymphocytes; CD8-Positive T-Lymphocytes; Cells, Cultured; Clone Cells; Complementarity Determining Regions; Enzyme-Linked Immunosorbent Assay; Female; HLA-DR Antigens; HLA-DRB1 Chains; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Receptors, Antigen, T-Cell, alpha-beta; Reverse Transcriptase Polymerase Chain Reaction; T-Lymphocyte Subsets; Tumor Necrosis Factor-alpha

We have demonstrated that sonic hedgehog (Shh), vital for oligodendrocyte development, is present in both gray and white matter of normal human brain. Both the 45 kDa precursor protein and the 20 kDa N-terminal sonic hedgehog signaling portion (ShhN) were demonstrated by immunoblot and a partial purification has been achieved. In gray matter from brains of multiple sclerosis (MS) victims, the total amount of Shh was less than normals and the signaling 20 kDa protein was greatly reduced. In white matter homogenates, prepared from MS victims, only the 45 kDa precursor protein was found. None of the 20 kDa signaling protein was detected, suggesting that the 45 kDa signaling protein was not cleaved in the autocatalytic reaction carried out by the C-terminal portion. The 45 kDa protein and a small amount of the 20 kDa ShhN was detected in isolated MS myelin by Western blot, demonstrating some cleavage was possible. The cleavage of the 45 kDa protein was demonstrated in normal myelin in vitro, but not in myelin prepared from MS brain.

Topics: Acids; Adult; Aged; Aged, 80 and over; Brain; Cell Fractionation; Hedgehog Proteins; Humans; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Nerve Fibers, Myelinated; Neurons; Oligodendroglia; Signal Transduction; Solubility; Trans-Activators

The expression of heme oxygenase-1 (HO-1) is increased in the CNS of mice and rats with experimental allergic encephalomyelitis (EAE), an animal model of multiple sclerosis (MS). To investigate the role of HO-1 in EAE, a putative inhibitor [tin-protoporphyrin IX (Sn-PP IX)] of HO-1 was administered to SJL mice during active disease. Sn-PP IX (200 micromol/kg) attenuated clinical scores, weight loss, and some signs of pathology in comparison to vehicle treatment. Glutathione levels were greater in treated EAE mice than in those receiving vehicle, indicating lower oxidative stress in the former group. These data suggest that inhibition of HO-1 attenuated disease and suppressed free radical production. In the SJL model of EAE, extravasated blood is present in the CNS, and iron released by HO-1 from this heme source may not be adequately sequestered by ferritin, allowing for iron-mediated tissue damage. Thus, HO-1 may act to amplify the disease process in this model.

Topics: Animals; Brain; Encephalomyelitis, Autoimmune, Experimental; Enzyme Inhibitors; Female; Ferritins; Glutathione; Heme Oxygenase (Decyclizing); Heme Oxygenase-1; Immunohistochemistry; Iron; Lectins; Membrane Proteins; Metalloporphyrins; Mice; Mice, Inbred Strains; Multiple Sclerosis; Myelin Basic Protein; Nerve Fibers, Myelinated; Oxidative Stress; Protoporphyrins; T-Lymphocytes

The myelin basic protein (MBP) gene may confer genetic susceptibility to multiple sclerosis (MS). The association of MS with alleles of the (TGGA)n variable number tandem repeat (VNTR) 5' to the MBP gene is the subject of conflicting reports.. To study possible MS association with VNTR alleles of MBP gene in ethnic Italians and ethnic Russians.. Two hundred sixty-nine unrelated patients with definite MS and 385 unrelated healthy control subjects from Italy and Russia were genotyped for the MBP VNTR region and for the human leukocyte antigen (HLA) class II DRB1 gene. The phenotype, allele, and genotype frequencies for two groups of MBP alleles were determined. Patients and control subjects were stratified according to HLA-DRB1 phenotypes.. The distribution of MBP alleles and genotypes in the two ethnic groups, including both MS patients and control subjects, was very similar. When MS patients and healthy control subjects were stratified according to HLA-DRB1 phenotypes, a significant association of MS with MBP alleles was found only in the DR4- and DR5-positive subgroups. A significant association with MBP alleles was also observed in the nonstratified groups, owing mainly to the contribution of the DR4- and DR5-positive individuals.. Polymorphism of the MBP or another gene in its vicinity appears to contribute to the etiology of MS for the subgroups of DR4- and DR5-positive Italians and Russians.

Topics: Adolescent; Adult; Alleles; Female; Gene Frequency; Genetic Predisposition to Disease; Genotype; Histocompatibility Testing; HLA-DR4 Antigen; HLA-DR5 Antigen; Humans; Italy; Male; Middle Aged; Minisatellite Repeats; Multiple Sclerosis; Myelin Basic Protein; Russia

A previously isolated and characterized IgM monoclonal antibody (mAb 1H6.2) specific to myelin basic protein (MBP) and to MBP epitopes expressed by nonneural cells was used to immunoprecipitate and investigate the expression of MBP epitopes by human T cells. Peripheral T lymphocytes secreted MBP epitopes, and secretion increased in time after mitogen stimulation. Conversely, thymocytes secreted these proteins independently on mitogen stimulation. Specific antibody reactivity (primarily due to IgG3) towards immunoprecipitated MBP epitopes was found in all tested sera from healthy donors and from multiple sclerosis patients as well as in sera from normal human cord blood. Collectively, these data provide insights into the immunological mechanisms leading to central and peripheral tolerance to MBP products.

Topics: Antibody Specificity; Autoantibodies; Binding Sites, Antibody; Cells, Cultured; Child, Preschool; Epitopes, T-Lymphocyte; Humans; Immune Sera; Immunity, Cellular; Immunity, Innate; Immunoglobulin G; Monoclonal Gammopathy of Undetermined Significance; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocyte Subsets

Early pregnancy factor (EPF) is a secreted protein with immunosuppressive and growth factor properties that has been shown to suppress acute experimental autoimmune encephalomyelitis (EAE) induced with myelin basic protein (MBP) in Lewis rats. EAE is associated with infiltration of the central nervous system (CNS) with inflammatory cells. Spontaneous recovery involves the loss of T lymphocytes from the CNS and the selective apoptosis of Vbeta8.2+ cells. In the present study, T cell, macrophage (CD11b/c+) and B cell (CD45RA+) populations in spinal cord and popliteal lymph nodes (LN) of Lewis rats with EAE were quantitated and apoptosis was studied. Rats were treated with EPF or vehicle. Following treatment on day 14 after inoculation with MBP, neither 1 x 100 microg nor 2 x 100 microg doses of EPF affected the total number of cells infiltrating the spinal cord on day 15, although the higher dose caused a decrease in the number of CD5+ and CD11b/c+ cells. Treatment with 2 x 100 microg/day from days 10 to 14 decreased the total number of infiltrating cells, and the numbers of CD5+, CD11b/c+ and CD45RA+ cells. Apoptosis was unaffected. No alteration on the number or type of inflammatory cells in the popliteal LN was observed after treatment on days 10-14. However, treatment with EPF from days 0 to 11 increased the total number of T and B cells and CD5+ T cells found on day 12 in the LN. Similarly, there was an increase in the frequency of MBP-reactive cells in the LN as determined by limiting dilution analysis. These results suggest that EPF treatment reduces the numbers of lymphocytes and macrophages in the CNS, possibly through an effect on cell trafficking.

Topics: Animals; Apoptosis; B-Lymphocytes; Cell Division; Chaperonin 10; Chemotaxis, Leukocyte; Disease Models, Animal; Dose-Response Relationship, Drug; Down-Regulation; Encephalomyelitis, Autoimmune, Experimental; Immunosuppressive Agents; Macrophages; Male; Multiple Sclerosis; Myelin Basic Protein; Peptides; Pregnancy Proteins; Rats; Rats, Inbred Lew; Reaction Time; Spinal Cord; Suppressor Factors, Immunologic; T-Lymphocytes

To measure neurone-specific humoral and cellular immune parameters in MRI-positive patients with multiple sclerosis (MS).. It has been postulated from animal models for MS and in situ evidence in MS patients that antibodies, activated T cells and proinflammatory cytokines are involved in the destruction of myelin sheaths and loss of oligodendrocytes in active areas.. Blood samples were obtained from 20 healthy control subjects and 20 patients with abnormal MRI and clinical diagnosis of MS. Sera were tested for levels of IgG, IgM and IgA against myelin basic protein (MBP), myelin oligodendrocyte glycoprotein (MOG) peptides, and a small heat-shock protein, alpha-beta-crystallin. Lymphocytes were isolated and cultured in the presence or absence of MBP, MOG peptides and alpha-beta-crystallin, measured for stimulated T cells, cytokine production and compared with controls.. Patients with MS showed the highest levels of IgG, IgM or IgA antibodies against one or all three tested antigens. Moreover, in the presence of MBP, MOG peptides or alpha-beta-crystallin, a significant percent- age of lymphocytes from MS patients underwent blast transformation, which resulted in high levels of interferon gamma (IFN-gamma), tumour necrosis factor alpha (TNF-alpha) and tumour necrosis factor beta (TNF-beta) production. Sensitivity of these assays was 60-80% and specificity, 65-70%.. Detection of antibodies against MBP, MOG peptides, alpha-beta-crystallin, lymphocyte stimulation and production of proinflammatory cytokines in response to these antigens could be used as surrogate markers for the confirmation of MS diagnosis. A combination of antibodies, lymphocyte activation or cytokine production with abnormal MRI may significantly increase the sensitivity and specificity of MS diagnosis.

Topics: Adult; alpha-Crystallin B Chain; Antibodies; Central Nervous System; Cytokines; Enzyme-Linked Immunosorbent Assay; Female; Glycoproteins; Humans; Immunoglobulin A; Immunoglobulin G; Immunoglobulin M; Interferon-gamma; Lymphocyte Activation; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Sensitivity and Specificity; T-Lymphocytes; Tumor Necrosis Factor-alpha

The mechanisms behind the beneficial effects of interferon-beta1a (IFN-beta1a) and glatiramer acetate (GA) in the treatment of multiple sclerosis (MS) are still uncertain. Altered cytokine patterns have been suggested including inhibition of proinflammatory cytokines like interferon-gamma (IFN-gamma) and enhancement of anti-inflammatory cytokines such as interleukin-4 (IL-4). Twenty-nine patients with MS (10 untreated, nine treated with IFN-beta1a and 10 with GA) were investigated with elispot of peripheral blood mononuclear cells. Spontaneous and myelin induced (myelin basic protein (MBP), myelin oligodendrocyte glycoprotein (MOG)-14-39 and MOG 63-87) IFN-gamma, IL-4, IL-5 and IL-10 secretion was studied. We found a significant reduction of spontaneous IFN-gamma, IL-4 and IL-5, but no difference in IL-10 secreting cells in both groups of treated patients compared with the untreated patients. Myelin-specific responses showed a significant decrease of IFN-gamma and an increase of IL-5, but no change in IL-4 and IL-10 secreting cells in treated compared with untreated patients. Both treatment groups revealed similar cytokine secretion patterns except for a more pronounced decrease of both spontaneous and MOG 14-39 induced IL-4 secretion in the IFN-beta1a treated group. Thus, immunological effects of IFN-beta1a and GA were similar showing that disease promoting Th1 (IFN-gamma) cells were reduced while the potentially beneficial Th2 response (IL-4) was maintained.

Topics: Adjuvants, Immunologic; Adult; Cytokines; Female; Glatiramer Acetate; Humans; Immunoassay; Interferon beta-1a; Interferon-beta; Interferon-gamma; Interleukin-10; Interleukin-4; Interleukin-5; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Peptides

Topics: Antibodies; Antigens, Surface; Biomarkers; Disease Progression; Humans; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein

Oral administration of autoantigens is a safe and convenient way to induce peripheral T-cell tolerance in autoimmune diseases like multiple sclerosis (MS). To increase the efficacy of oral tolerance induction and obviate the need for large-scale purification of human myelin proteins, we use genetically modified lactobacilli expressing myelin antigens. A panel of recombinant lactobacilli was constructed producing myelin proteins and peptides, including human and guinea pig myelin basic protein (MBP) and proteolipid protein peptide 139-151 (PLP(139-151)). In this study we examined whether these Lactobacillus recombinants are able to induce oral and intranasal tolerance in an animal model for multiple sclerosis, experimental autoimmune encephalomyelitis (EAE). Lewis rats received soluble cell extracts of Lactobacillus transformants intranasally three times prior to induction of EAE. For the induction of oral tolerance, rats were fed live transformed lactobacilli for 20 days. Ten days after the first oral administration EAE was induced. Intranasal administration of extracts containing guinea pig MBP (gpMBP) or MBP(72-85) significantly inhibited EAE in Lewis rats. Extracts of control transformants did not reduce EAE. Live lactobacilli expressing guinea pig MBP(72-85) fused to the marker enzyme beta-glucuronidase (beta-gluc) were also able to significantly reduce disease when administered orally. In conclusion, these experiments provide proof of principle that lactobacilli expressing myelin antigens reduce EAE after mucosal (intranasal and oral) administration. This novel method of mucosal tolerance induction by mucosal administration of recombinant lactobacilli expressing relevant autoantigens could find applications in autoimmune disease in general, such as multiple sclerosis, rheumatoid arthritis and uveitis.

Topics: Administration, Intranasal; Administration, Oral; Animals; Autoantigens; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Enzyme-Linked Immunosorbent Assay; Immune Tolerance; Immunoblotting; Lactobacillus; Multiple Sclerosis; Myelin Basic Protein; Rats; Rats, Inbred Lew

To investigate the possible role of molecular mimicry to bacterial components in multiple sclerosis (MS) pathogenesis we examined antibody responses to mimicry peptide sequences of Acinetobacter, Pseudomonas aeruginosa and myelin components. Antibodies to mimicry peptides from Acinetobacter (p<0.001), P. aeruginosa (p<0.001), myelin basic protein (MBP) (p<0.001) and myelin oligodendrocyte glycoprotein (MOG) (p<0.001) were significantly elevated in MS patients compared to controls. Antisera against MBP (residues 110-124) reacted with both Acinetobacter and Pseudomonas peptides from 4- and gamma-carboxymuconolactone decarboxylase, respectively. MOG (residues 43-57) antisera reacted with Acinetobacter peptide from 3-oxo-adipate-CoA-transferase subunit A. The role of these bacteria in MS is unclear but demonstrates that molecular mimicry is not restricted to viruses suggesting bacterial infections could play a role in MS pathogenesis. Further work is required to evaluate the relevance of these cross-reactive antibodies to the neuropathology of MS.

Topics: Acinetobacter; Adult; Aged; Aged, 80 and over; Amino Acid Sequence; Animals; Antibodies, Bacterial; Antigens, Bacterial; Carboxy-Lyases; Coenzyme A-Transferases; Cross Reactions; Encephalomyelitis, Autoimmune, Experimental; Female; Humans; Immune Sera; Male; Mice; Mice, Biozzi; Middle Aged; Molecular Mimicry; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Peptide Fragments; Pseudomonas aeruginosa; Sequence Homology, Amino Acid

Multiple sclerosis is a chronic inflammatory disease of the CNS leading to focal destruction of myelin, still the earliest changes that lead to lesion formation are not known. We have studied the gene-expression pattern of 12 samples of normal appearing white matter from 10 post-mortem MS brains. Microarray analysis revealed upregulation of genes involved in maintenance of cellular homeostasis, and in neural protective mechanisms known to be induced upon ischemic preconditioning. This is best illustrated by the upregulation of the transcription factors such as HIF-1alpha and associated PI3K/Akt signalling pathways, as well as the upregulation of their target genes such as VEGF receptor 1. In addition, a general neuroprotective reaction against oxidative stress is suggested. These molecular changes might reflect an adaptation of cells to the chronic progressive pathophysiology of MS. Alternatively, they might also indicate the activation of neural protective mechanisms allowing preservation of cellular and functional properties of the CNS. Our data introduce novel concepts of the molecular pathogenesis of MS with ischemic preconditioning as a major mechanism for neuroprotection. An increased understanding of the underlying mechanisms may lead to the development of new more specific treatment to protect resident cells and thus minimize progressive oligondendrocyte and axonal loss.

Topics: Aged; Aged, 80 and over; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Aurora Kinases; Blotting, Northern; Brain; Case-Control Studies; CD3 Complex; DNA-Binding Proteins; Female; Glial Fibrillary Acidic Protein; Humans; Hypoxia-Inducible Factor 1, alpha Subunit; Immunohistochemistry; In Situ Hybridization; Male; Middle Aged; Models, Neurological; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Nuclear Proteins; Oligonucleotide Array Sequence Analysis; Penicillamine; Protein Serine-Threonine Kinases; Reverse Transcriptase Polymerase Chain Reaction; RNA, Messenger; Transcription Factors

Topics: Autoantibodies; Humans; Immunoglobulin G; Immunoglobulin M; Multiple Sclerosis; Myelin Basic Protein; Prognosis; Recurrence

Topics: Autoantibodies; Blotting, Western; Diagnosis, Differential; Enzyme-Linked Immunosorbent Assay; Humans; Immunoglobulin G; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein

Topics: Autoantibodies; Disease Progression; Humans; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Prognosis

In multiple sclerosis (MS), the T-cell receptors (TCRS) of autoreactive T lymphocytes recognize various myelin components or derivatives including peptides of the myelin basic protein (MBP). Using the exhaustive immunoscope approach we showed that the T-cell repertoires of MS patients differ from those of healthy controls, with expansion of Vbeta13 cell clones in cerebrospinal fluid (CSF) and in peripheral blood lymphocytes (PBLs). Sequencing of the beta13(+) chains of T cells recovered from the CSF revealed high interindividual diversity, and no particular Vbeta13(+) rearrangements were shown to be myelin-autoreactive. Within the overall Vbeta13 repertoire in the CSF of patient MS3 at the onset of the disease, most of the overrepresented (N)Dbeta(N)Jbeta junctional regions were found to be associated with two or three different Vbeta13 segments. These rearrangements were most common in the PBLs of patient MS3. No such associations were detected in the Vbeta5 multigene family that was used as a control. Thus, Vbeta13 T cells infiltrating the CSF from patient MS3 may have been selected on the basis of both the Vbeta13 segments and the (N)Dbeta(N)Jbeta junctional CDR3 sequence.

Topics: Adult; Age of Onset; Aged; Aged, 80 and over; Base Sequence; Cell Division; Cerebrospinal Fluid; Clone Cells; Complementarity Determining Regions; DNA, Complementary; Female; Humans; Lymphocyte Activation; Lymphocyte Count; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell; T-Lymphocytes

Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the human central nervous system (CNS) mediated by autoimmune Th1 lymphocytes. We determined the serum levels of autoantibodies for myelin basic protein (MBP), proteolipid (PLP) and myelin oligodendrocyte glycoprotein sequence MOG 92-106 in a group of 54 healthy individuals and 26 MS patients expressing or not HLA-DQB1*0602. Regardless expression of the susceptibility allele DQB1*0602, MS patients presented marked (p<0.0001) IgG antibody production for MBP and MOG92-106. Yet, significant (p<0.0001) IgA antibody levels were mainly observed for PLP and MOG antigens. Our results suggest that other HLA class II alleles may be conferring susceptibility to MS in this population and influencing the pattern of immune recognition of encephalitogen antigens. Furthermore, distinct IgG and/or IgA autoantibody production may be contributing to the control or maintenance of the CNS inflammatory reaction.

Topics: Adolescent; Adult; Alleles; Autoantibodies; Case-Control Studies; Enzyme-Linked Immunosorbent Assay; Female; Gene Frequency; Genetic Predisposition to Disease; HLA-DQ Antigens; HLA-DQ beta-Chains; Humans; Immunoglobulin A; Immunoglobulin G; Male; Membrane Glycoproteins; Middle Aged; Multiple Sclerosis; Myelin Basic Protein

The degree of post-translational enzymatic deimination (conversion of arginyl to citrullinyl residues) of myelin basic protein (MBP) is correlated with the severity of the human autoimmune disease multiple sclerosis (MS). It is difficult to obtain large quantities of deiminated MBP from natural sources (autopsy material), and in vitro deimination using peptidylarginine deiminase (EC 3.5.3.15) is both non-specific and irreproducible. Since there is no known codon for citrulline, we have constructed a mutant form of recombinant murine MBP (rmMBP) in which 5 Arg and 1 Lys residues have been replaced by Gln as the most reasonable analogue of Cit. The residues were chosen to correspond to the 6 Arg residues in human MBP which are most commonly deiminated in chronic MS. The mutant species, rmMBP-qCit(6) where the "q" represents "quasi-," was probed by numerous biochemical and biophysical techniques. Highly homogeneous protein preparations were obtained using a modified expression system which minimised spurious misincorporation of Lys for Arg, as ascertained by electrospray ionisation mass spectrometry. The mutant form rmMBP-qCit(6) had a reduced ability to aggregate lipid vesicles, a slightly greater susceptibility to digestion by cathepsin D, a greater proportion of random secondary structure, and different conformational responses to lipids, compared with the unmodified rmMBP. Overall, the mutant protein's properties were consistent with the effects of deimination and support its use as a model for evaluating the effects of this modification.

Topics: Amino Acid Sequence; Animals; Arginine; Blotting, Western; Cathepsin D; Chromatography, High Pressure Liquid; Circular Dichroism; Glutamine; Kinetics; Lysine; Mice; Models, Molecular; Molecular Mimicry; Molecular Sequence Data; Molecular Weight; Multiple Sclerosis; Mutation, Missense; Myelin Basic Protein; Protein Binding; Protein Isoforms; Recombinant Proteins; Sequence Alignment; Spectrometry, Mass, Electrospray Ionization

To determine if retinoids might be beneficial in the treatment of multiple sclerosis (MS), all-trans-retinoic acid (tRA) was tested for its effects on proliferation and cytokine expression in human autoreactive T cells. tRA decreased human lymphocyte proliferation in vitro in a dose-dependent manner. In addition, tRA induced IL-4 gene expression in myelin basic protein (MBP)-specific T cell lines which had previously expressed a Th1-like phenotype. MBP-specific T cell lines generated in the presence of tRA had a Th2-like phenotype. Retinoids have previously been shown to have a similar effect on encephalitogenic T cells in experimental allergic encephalomyelitis (EAE; an animal model for MS) and treatment of EAE with retinoids stabilizes the disease. Since several oral retinoids have been shown to be safe in humans, retinoids may be beneficial in the treatment of MS.

Topics: Autoantigens; Cell Differentiation; Cell Line; Cells, Cultured; Dose-Response Relationship, Drug; Humans; Interferon-gamma; Interleukin-4; Lymphocyte Activation; Multiple Sclerosis; Myelin Basic Protein; RNA, Messenger; Th1 Cells; Th2 Cells; Tretinoin

Multiple sclerosis (MS) is considered as an immune process influenced by genetic and environmental factors. HLA-DR2 and -DR4 have been documented to be associated with MS. The HLA-dependent differences of immune response to myelin and other antigens might point out some relevant mechanisms in MS development The responses to myelin antigens and to PPD have been compared in 21 MS patients and 25 healthy controls (HCs) by primary proliferation and by short-term T-cell lines. There was a significantly higher response to MBP in DR2+ HCs compared to MS patients (SI: 5.9 versus 1.5, p = 0.02). In short-term T-cell lines, we observed a higher response to PLP30-49 in both DR4+ HCs and MS patients This response was significantly more frequent in DR4+ MS patients (34.6%) than both DR2+ MS patients (0%, p = 0.0001) and DR4+ HCs (7.7%, p = 0.001). The comparison between DR2+ and DR4+ MS patients has revealed that the response to MBP was also increased in DR4+ (p = 0.02). Among DR4+ groups, an increased PPD response was detected in HCs compared to MS (65.2% versus 33.3%, p = 0.01). These results may indicate that HLA-related differences to specific and recall antigens are detectable in MS and these differences may have implications in the disease pathogenesis.

Topics: Adult; Autoantigens; Cell Line; Female; HLA-DR2 Antigen; HLA-DR4 Antigen; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; T-Lymphocytes

In order to define an activity profile in patients with multiple sclerosis (MS), T-cell subpopulations and proliferative responses to myelin basic protein (MBP) associated with anti-MBP antibodies, nitrotyrosine levels in serum and cerebrospinal fluid (CSF), and serum CD40L (sCD154) were simultaneously assessed in 29 consecutive and untreated MS patients. When compared to controls, patients in secondary progressive stable (SP/I), or in full remission (RR/I) stages, individuals with secondary progressive active disease (SPIA) or in acute relapse (RR/A) showed a significant decrease of CD4/CD45RA+ T cells associated with an increase of absolute numbers of CD4/45R0+ T cells (p < 0.001). In addition, in vitro-specific T-cell proliferative responses against MBP (SP/A, RR/A, SP/I: p < 0.001 versus controls) in association with augmented sCD154 serum levels (SP/A, RR/A, versus controls p < 0.001) and a significant increase of both CSF and serum levels of anti-MBP antibodies and nitrotyrosine levels (p < 0.001) were also found. Thus, the simultaneous evaluation of antibody and cell-mediated immunopathological parameters, along with the effector mediators of inflammation such as the nitric oxide products, offers a new integrative approach to characterize markers of clinical activity in MS patients, which may be used at the moment of the initial diagnosis and during an apparent recurrences of the disease to monitor therapeutic protocols and to determine whether immune-based nerve destruction mechanisms are still operating in patients with few clinical findings.

Topics: Adolescent; Adult; Autoantibodies; Biomarkers; CD40 Ligand; Cell Division; Female; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Nitric Oxide; Pilot Projects; Prospective Studies; Severity of Illness Index; T-Lymphocyte Subsets; Tyrosine

The presence of autoreactive T cells recognizing self myelin antigens is necessary for the development of central nervous system autoimmune diseases such as multiple sclerosis (MS). The present study was undertaken to investigate the role of myelin basic protein (MBP)-primed T cells in the expression of inducible nitric oxide synthase (iNOS) in microglial cells. MBP-primed T cells alone markedly induced the production of NO and the expression of iNOS protein and mRNA in mouse BV-2 microglial cells. Similarly, MBP-primed T cells also induced the production of NO in mouse primary microglia. This induction of NO production was primarily dependent on the contact between MBP-primed T cells and microglia. The expression of very late antigen-4 (VLA-4) on the surface of MBP-primed T cells and inhibition of MBP-primed T cell-induced microglial NO production by functional blocking of antibodies to the alpha(4) chain of VLA-4 (CD49d) suggest that VLA-4 integrin on MBP-primed T cells plays an important role in contact-mediated induction of iNOS. Since IFN-beta has been used to treat MS patients, we examined the effect of IFN-beta on MBP-primed T cell-induced the production of NO. Surprisingly, IFN-beta alone induced the production of NO in microglial cells. However, the pretreatment of MBP-primed T cells with IFN-beta inhibited the expression of VLA-4 integrin on the surface of MBP-primed T cells and thereby inhibited the ability of those T cells to induce the production of NO in microglial cells. This study illustrates a novel role of neuroantigen-primed T cells in inducing contact-mediated expression of iNOS in microglial cells that may participate in the pathogenesis of MS.

Topics: Animals; Cell Division; Cell Separation; Cells, Cultured; Coculture Techniques; Dose-Response Relationship, Drug; Flow Cytometry; Immunoblotting; Integrin alpha4; Integrin alpha4beta1; Interferon-beta; Mice; Microglia; Multiple Sclerosis; Myelin Basic Protein; Nitric Oxide; Nitric Oxide Synthase; RNA, Messenger; T-Lymphocytes

Anti-myelin basic protein (MBP) autoreactive T cells play a key role in the pathogenesis of multiple sclerosis. Thus, we applied the Immunoscope strategy to cerebrospinal fluid (CSF) and peripheral blood lymphocytes (PBLs) of an HLA-DR2 patient. Both compartments showed major expansion for the V(beta)13S5 chain, which was associated in peripheral blood with significant proliferation of PBLs in response to MBP and the 84-102 HLA-DR2-restricted peptide. Sequencing revealed a unique nucleotide sequence in the CSF that gives rise to the amino acid sequence V(beta)13S5-RPGQGDQETQ-J(beta)2.5 if translated. This CDR3 sequence had already been reported to be reactive against the 84-102 peptide. This specific sequence was not detected in PBLs on day 0, whereas it was readily detectable on day 6 culture samples. Thus, cell culture may lead to enrichment in a T cell clone identified as autoreactive.

Topics: Adult; Amino Acid Sequence; Autoantibodies; Cell Survival; Cells, Cultured; Clone Cells; HLA-DR2 Antigen; Humans; Male; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Receptors, Antigen, T-Cell, alpha-beta; T-Cell Antigen Receptor Specificity; T-Lymphocytes

Several reports have suggested an association of human herpesvirus 6 (HHV-6) with multiple sclerosis. Autoreactive T lymphocytes directed against myelin components seem to contribute to the pathogenesis of the disease. It has been suggested that molecular mimicry between viral and self-antigens might be one of the mechanisms that determine the onset of several autoimmune diseases. Following this hypothesis, the purpose of the present study was to evaluate if HHV-6 could play a role in activating T cells capable of cross-reaction with an important myelin component, the myelin basic protein. T cell lines were established from 22 multiple sclerosis patients and from 16 healthy controls, and their capability to react to both virus and myelin basic protein antigens was compared. The analysis of T cell cross-reactivity in patients and controls did not show significant differences in the HHV-6 ability to activate myelin basic protein-reactive T cells. Similarly, the evaluation of the humoral immune response to HHV-6 in patients and controls did not mirror any abnormality in the HHV-6 status in multiple sclerosis patients. Therefore, although the findings of activity in vitro of T cell lines with dual specificity are consistent with the hypothesis of molecular mimicry, the lack of differences in cross-reactivity between patients and controls do not support molecular mimicry as an important mechanism in the physiopathology of this disease.

Topics: Adolescent; Adult; Antigens, Viral; Autoimmunity; Case-Control Studies; Cell Line; Cross Reactions; Female; Herpesvirus 6, Human; Humans; Lymphocyte Activation; Male; Middle Aged; Models, Immunological; Molecular Mimicry; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes

The multiple sclerosis (MS)-associated HLA major histocompatibility complex (MHC) class II alleles DRB1*1501, DRB5*0101 and DQB1*0602 are in strong linkage disequilibrium, making it difficult to determine which is the principal MS risk gene. Here we show that together the DRB1 and DRB5 loci may influence susceptibility to MS. We demonstrate that a T cell receptor (TCR) from an MS patient recognized both a DRB1*1501-restricted myelin basic protein (MBP) and DRB5*0101-restricted Epstein-Barr virus (EBV) peptide. Crystal structure determination of the DRB5*0101-EBV peptide complex revealed a marked degree of structural equivalence to the DRB1*1501-MBP peptide complex at the surface presented for TCR recognition. This provides structural evidence for molecular mimicry involving HLA molecules. The structural details suggest an explanation for the preponderance of MHC class II associations in HLA-associated diseases.

Topics: Animals; B-Lymphocytes; Cell Line; Cross Reactions; Crystallography, X-Ray; Herpesvirus 4, Human; HLA-DR Antigens; HLA-DRB1 Chains; HLA-DRB5 Chains; Humans; Mice; Mice, Transgenic; Models, Molecular; Multiple Sclerosis; Myelin Basic Protein; Protein Structure, Tertiary; Receptors, Antigen, T-Cell, alpha-beta

The aim of the present research was to verify the production of BDNF by peripheral blood mononuclear cells (PBMCs), unstimulated and stimulated with phytohemagglutinin (PHA), anti-OKT3 Ab and myelin basic protein (MBP), in 35 patients affected by multiple sclerosis (MS), 20 with relapsing-remitting (R-R) MS and 15 with secondary progressive (SP) MS. Seven R-R MS patients were assessed during the attack, in the subsequent recovery phase and also 3 months after relapse. The production of BDNF by PBMCs was also evaluated in 20 age- and sex-matched control subjects. Levels of BDNF were also determined in CSF of both patient groups and 20 control subjects.. Levels of BDNF (pg/ml) in the supernatants of unstimulated and PHA-, anti-OKT3 Ab- and MBP-stimulated PBMCs in patients with R-R MS were significantly higher during relapse and in the recovery phase compared with values detected in the stable phase of the disease. Significantly lower BDNF values were found in unstimulated and stimulated PBMC supernatants of patients with SP MS compared to control subjects. This reduction was greater in patients with a 1-point increase in the EDSS score in the last 6 months compared with that in patients without a progression of the disability score. Reduction in the levels of BDNF was also confirmed in the CSF of SP MS patients compared with R-R MS patients assessed during a stable phase of the disease and control subjects.. On the basis of recent experimental findings, a neuroprotective effect of BDNF produced by inflammatory cells can be hypothesized during relapses in MS. This can favor remyelination. The reduced production of BDNF by PBMCs of patients with SP MS can contribute to the progression of demyelinating disease and axonal loss in this form.

Topics: Adult; Brain-Derived Neurotrophic Factor; Female; Humans; Leukocytes, Mononuclear; Male; Multiple Sclerosis; Muromonab-CD3; Myelin Basic Protein; Phytohemagglutinins

A link between myelin basic protein (MBP) polymorphism and multiple sclerosis (MS) has been reported in some populations but not in others. We analysed two polymorphisms in the 5' flanking region of the MBP exon 1 gene in MS patients from the founder population of Sardinia. Using the transmission disequilibrium test (TDT), MBP polymorphisms were analysed in 363 singleton MS families. No distortion in transmission of the tetranucleotide repeat (ATGG)12 and of the 1116-1540 nt alleles was found. Moreover, we discovered no epistatic effect of the MBP gene on the HLA/MHC DRB1,DQB1, DPB1 loci or on alleles defined by D6S1683 marker found to be associated with MS in Sardinians. We concluded that the MBP gene does not play a role in MS susceptibility in Sardinians.

Topics: Adolescent; Adult; Aged; Child; DNA Mutational Analysis; Female; Gene Frequency; Genetic Predisposition to Disease; Genetic Testing; Genotype; Haplotypes; Humans; Italy; Male; Middle Aged; Multiple Sclerosis; Mutation; Myelin Basic Protein; Polymorphism, Genetic; Trinucleotide Repeat Expansion

Dendritic cells are thought to regulate tolerance induction vs immunization by transferring Ags and peripheral signals to draining lymph nodes (LN). However, whether myelin Ag transfer and presentation in LN occurs during demyelinating brain disease is unknown. In this study, we demonstrate redistribution of autoantigens from brain lesions to cervical LN in monkey experimental autoimmune encephalomyelitis (EAE) and in multiple sclerosis (MS). Immunohistochemical analysis revealed significantly more cells containing myelin Ags in cervical LN of monkeys with EAE compared with those of healthy control monkeys. Myelin Ags were observed in cells expressing dendritic cell/macrophage-specific markers, MHC class II, and costimulatory molecules. Moreover, these cells were directly juxtaposed to T cells, suggesting that cognate interactions between myelin-containing APC and T cells are taking place in brain-draining LN. Indeed, myelin Ag-reactive T cells were observed in cervical LN from marmosets and rhesus monkeys. Importantly, these findings were paralleled by our findings in human tissue. We observed significantly more myelin Ag-containing cells in LN of individuals with MS compared with those of control individuals. These cells expressed APC markers, as observed in marmosets and rhesus monkeys. These findings suggest that during MS and EAE, modulation of T cell reactivity against brain-derived Ags also takes place in cervical LN and not necessarily inside the brain. A major implication is that novel therapeutic strategies may be targeted to peripheral events, thereby circumventing the blood-brain barrier.

Topics: Animals; Antigen Presentation; Antigen-Presenting Cells; Autoantigens; Axilla; Biomarkers; Brain; Callithrix; Cell Aggregation; Encephalomyelitis, Autoimmune, Experimental; Epitopes, T-Lymphocyte; Humans; Inguinal Canal; Lymph Nodes; Macaca fascicularis; Macaca mulatta; Multiple Sclerosis; Myelin Basic Protein; Neck; Protein Transport; Spleen; T-Lymphocytes

We investigated the association of the antibody response to myelin oligodendrocyte glycoprotein (MOG) and myelin basic protein (MBP) with human leukocyte antigen (HLA) class II alleles in 41 patients with sporadic multiple sclerosis (MS) and 12 multiplex MS families. We found significantly increased antibody response to MOG and MBP in MS patients without any difference to asymptomatic relatives. HLA DRB1*04 was associated with IgM reactivity to MOG in MS patients, and DRB1*15 and DRB5 with anti-MOG IgA among asymptomatic relatives. We conclude that antibody responses to MOG and MBP depend on familial background. Moreover, the humoral immune reactivity against MOG is partially under control of certain HLA class II alleles.

Topics: Adult; Alleles; Autoantibodies; Family Health; Female; Gene Frequency; Genes, MHC Class II; Genotype; HLA-DQ Antigens; HLA-DQ beta-Chains; HLA-DR Antigens; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein

Radioimmunoassay for myelin basic protein in cerebrospinal fluid is commonly used as a biochemical marker of demyelination in multiple sclerosis patients. A sensitive enzyme-linked immunosorbent assay for myelin basic protein has been recently developed, which can make a clinical evaluation of myelin basic protein in cerebrospinal fluid of patients with multiple sclerosis and other neurological diseases. Most multiple sclerosis patients with acute exacerbation had markedly high myelin basic protein. Longitudinal studies of multiple sclerosis patients showed that myelin basic protein in CSF increases rapidly in agreement with acute relapse and then rapidly declines and disappears. Significantly higher cerebrospinal fluid myelin basic protein levels in human T-cell lymphotropic virus Type I-associated myelopathy/tropical spastic paraparesis patients were also detected. This enzyme-linked immunosorbent assay system can be used routinely to measure myelin basic protein in cerebrospinal fluid as a useful diagnostic indicator, not only for central active demyelination as in multiple sclerosis but, also for spinal cord demyelination as in human T-cell lymphotropic virus Type I-associated myelopathy/tropical spastic paraparesis.

Topics: Adolescent; Adult; Aged; Animals; Autoantigens; Autoimmune Diseases; Cattle; Disease Progression; Enzyme-Linked Immunosorbent Assay; Female; Forecasting; Humans; Longitudinal Studies; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Nervous System Diseases; Paraparesis, Tropical Spastic; Reagent Kits, Diagnostic

Heme oxygenase-1 (HO-1), also known as heat-shock protein 32 (HSP-32), is induced in many cells by a large variety of stimuli. Its induction in nervous system cells following toxic and oxidative stress was suggested to play a protective role. Its presence was recently detected by immunohistochemical studies at the level of inflammatory lesions of rat experimental autoimmune encephalomyelitis. In the present study, we demonstrate that myelin basic protein (MBP) induces HO-1 in human astroglial cells, as shown by Western blots and RT-PCR. Proteolytic fragments derived from the whole MBP show a different behavior in the HO-1 induction: MBP152-167 was able to produce a light but still significant increase in HO-1 mRNA and protein levels, whereas MBP68-84 was not. The increase in HO-1 production seems to be mediated by a Ca(2+)-dependent mechanism, since MBP addition to astrocytoma cultures induced a strong and immediate increment of [Ca(2+)](i) increase; MBP152-167 elicited a delayed and less pronounced [Ca(2+)](i) increase; no [Ca(2+)](i) changes were induced following cell treatment with MBP68-84. NO pathway involvement in the induction of HO-1 by MBP was ruled out since the expression of the inducible isoform of nitric oxide synthase was not upregulated in treated cells, neither nitrite levels were modified, as demonstrated by Greiss reaction. The possible significance of HO-1 induction following MBP stimulation is discussed.

Topics: Astrocytes; Calcium; Encephalitis; Heme Oxygenase (Decyclizing); Heme Oxygenase-1; Humans; Immunohistochemistry; Membrane Proteins; Multiple Sclerosis; Myelin Basic Protein; Nitric Oxide; Nitric Oxide Synthase; Oxidative Stress; Peptide Fragments; RNA, Messenger; Tumor Cells, Cultured

Multiple sclerosis (MS) is characterized by inflammation within the CNS. This inflammatory response is associated with production of nitric oxide (NO) and NO-related species that nitrosylate thiols. We postulated that MS patients would exhibit an antibody (Ab) response directed against proteins containing S-nitrosocysteine (SNO-cysteine) and showed that anti-NO-cysteine Abs of the IgM isotype are in fact present in the sera of some MS patients (Boullerne et al., 1995). We report here the presence of a seemingly identical Ab response directed against SNO-cysteine in an acute model of MS, experimental autoimmune encephalomyelitis (EAE) induced in Lewis rats with the 68-84 peptide of guinea pig myelin basic protein (MBP(68-84)). Serum levels of anti-SNO-cysteine Abs peaked 1 week before the onset of clinical signs and well before the appearance of anti-MBP(68-84) Abs. The anti-SNO-cysteine Ab peak titer correlated with the extent of subsequent CNS demyelination, suggesting a link between Ab level and CNS lesion formation. In relapsing-remitting MS patients, we found elevated anti-SNO-cysteine Ab at times of relapse and normal values in most patients judged to be in remission. Two-thirds of patients with secondary progressive MS had elevated anti-SNO-cysteine Ab levels, including those receiving interferon beta-1b. The data show that a rise in circulating anti-SNO-cysteine Ab levels precedes onset of EAE. Anti-SNO-cysteine Abs are also elevated at times of MS attacks and in progressive disease, suggesting a possible role for these Abs, measurable in blood, as a biological marker for clinical activity.

Topics: Animals; Antibody Specificity; Autoantibodies; Biomarkers; Cysteine; Demyelinating Diseases; Disease Models, Animal; Disease Progression; Encephalomyelitis, Autoimmune, Experimental; Female; Humans; Immunoglobulin M; Multiple Sclerosis; Myelin Basic Protein; Nitroso Compounds; Peptide Fragments; Predictive Value of Tests; Rats; Rats, Inbred Lew; Recurrence; Remission, Spontaneous; S-Nitrosothiols; Serum Albumin, Bovine; Spinal Cord

Lesions appearing in the CNS of patients in the chronic phase of the inflammatory, demyelinating disease multiple sclerosis often fail to repair, resulting in neurological dysfunction. This failure of remyelination appears, in many cases, to be due not to the destruction of the local oligodendrocyte precursor population, a source for new myelin-forming cells, but to the failure of the precursor cells to proliferate and differentiate, at least in brain lesions. The spinal cord is also a prominent site for lesions in multiple sclerosis, but nothing is known about the fate of the oligodendrocyte precursor population in this area. The present study has therefore analysed spinal cord samples with demyelination from 16 subjects with longstanding multiple sclerosis for the presence of oligodendrocyte precursor cells. Immunolabellings of 10 microm thick sections with the O4/anti-galactocerebroside (GalC) antibody combination, to visualize O4-positive, GalC-negative oligodendrocyte precursor cells, revealed that such cells were prevalent in many spinal cord lesions, with densities of up to 35 cells/mm(2). Six of the spinal cord lesions contained < or =3 O4-positive, GalC-negative cells/mm(2), but such cells were widespread in brain lesions from these multiple sclerosis cases that were available for study (8-26 cells/mm(2)). The density of the O4-positive, GalC-negative oligodendrocyte precursor cells in all spinal cord and brain lesions studied thus far (n = 41) decreased significantly with declining numbers of debris-laden macrophages. In addition, lesions lacking macrophages tended to be derived from the older patients and there was a negative correlation between the density of the oligodendrocyte precursor cells and clinical age of the multiple sclerosis subject at death, and disease duration. The analysis further revealed that lesions from subjects with primary progressive and secondary progressive multiple sclerosis contained, on average, similar numbers of oligodendrocyte precursor cells/mm(2) and that immature oligodendrocytes were only present in significant numbers in lesions with high precursor densities. Taken together, the present data suggest that there is a gradual reduction in the size of the O4-positive, GalC- negative oligodendrocyte precursor population with increasing age of the lesion, that the generation of new oligodendrocytes becomes increasingly more impaired and that lesions are not repopulated to a significant extent by migratory oligoden

Topics: Adult; Aged; Aged, 80 and over; Animals; Biomarkers; Cell Count; Female; Humans; Immunohistochemistry; Macrophages; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Neurofilament Proteins; Oligodendroglia; Spinal Cord; Statistics as Topic; Stem Cells

C4d-immunoreactive complement-activated oligodendrocytes (C4d-CAOs) have been described in several neurodegenerative diseases but have not been studied in multiple sclerosis (MS). Here we report that such CAOs delineate miniature MS plaques of 300-500 mum diameter. They are devoid of myelin and are surrounded by a rim of activated microglia intermingled with the C4d-CAOs. Although C4d-immunostained periaxonal oligodendroglial processes are often swollen, the axons of passage appear undamaged and extend through the demyelinated plaque area. No immunostaining with other components of the complement cascade (C1q-C9) was observed in association with these miniature plaques. However, in large MS lesions, C1q-C9 immunoreactive fibers were present, indicating complete activation of the complement cascade in these more developed lesions. It is possible that the miniature plaques, bordered by C4d-CAOs, represent the earliest stage of plaque development, preceding even the larger, transient plaques frequently observed in serial MRI studies. The association of CAOs with miniature areas of demyelination suggests a direct attack on oligodendroglial cells by the early complement components as an initiating event in MS. Incomplete complement activation indicates that this step may be reversible, whereas full and persistent activation as observed in large MS lesions may lead to death of oligodendroglia with permanent axonal damage.

Topics: Aged; Aged, 80 and over; Cerebral Cortex; Complement C4; Complement C4b; Complement System Proteins; Demyelinating Diseases; HLA-DR Antigens; Humans; Immunohistochemistry; Microglia; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Oligodendroglia; Peptide Fragments; Supranuclear Palsy, Progressive

Theiler's murine encephalomyelitis virus-induced demyelinating disease (TMEV-IDD), a multiple sclerosis (MS) model, is a central nervous system (CNS) demyelinating disease characterized by early peripheral T cell responses to virus epitopes which spreads to myelin epitopes during chronic disease. We show that CD4(+) T cells isolated from the spinal cords of chronically infected SJL mice proliferate and secrete pro-inflammatory cytokines upon in vitro challenge with both TMEV epitopes and proteolipid protein (PLP(139-151)). Importantly, myelin-specific tolerance induced by intravenous administration of MP4, a fusion of the myelin proteins myelin basic protein (MBP) and PLP, to SJL mice with ongoing TMEV-IDD attenuated disease progression and resulted in significantly less demyelination and decreased inflammatory cell infiltration in the CNS. Paradoxically, peptide-specific splenic T cell proliferative and IFN-gamma responses were enhanced in the tolerized mice. Collectively, these results indicate that myelin-specific T cell responses contribute to chronic disease progression in this virus-induced model of MS, and suggest caution in the use of antigen-specific tolerance for treatment of ongoing autoimmune disease.

Topics: Amino Acid Sequence; Animals; Cardiovirus Infections; Cytokines; Demyelinating Diseases; Epitopes; Female; Hypersensitivity, Delayed; Immune Tolerance; Mice; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Myelin Sheath; Peptide Fragments; Recombinant Fusion Proteins; T-Lymphocytes; Theilovirus

The ICAM-1-mediated brain endothelial cell (EC)-signaling pathway induced by adherent lymphocytes is a central element in facilitating lymphocyte migration through the tight endothelial barrier of the brain. Rho proteins, which must undergo posttranslational prenylation to be functionally active, have been shown to be an essential component of this signaling cascade. In this study, we have evaluated the effect of inhibiting protein prenylation in brain ECs on their ability to support T lymphocyte migration. ECs treated in vitro with protein prenylation inhibitors resulted in a significant reduction in transendothelial T lymphocyte migration. To determine the therapeutic potential of this approach, an animal model of multiple sclerosis, experimental autoimmune encephalomyelitis, was induced in Biozzi ABH mice. Animals treated before disease onset with protein prenylation inhibitors exhibited a dramatic and significant reduction in both leukocyte infiltration into the CNS and clinical presentation of disease compared with untreated animals. These studies demonstrate, for the first time, the potential for pharmacologically targeting CNS EC signaling responses, and particularly endothelial Rho proteins, as a means of attenuating leukocyte recruitment to the CNS.

Topics: Acute Disease; Animals; Benzamides; Brain; Cell Line; Cell Membrane; Cell Movement; Dimethylallyltranstransferase; Disease Models, Animal; Drug Combinations; Encephalomyelitis, Autoimmune, Experimental; Endothelium, Vascular; Enzyme Inhibitors; Guinea Pigs; Leukocytes; Methionine; Mice; Mice, Inbred Strains; Multiple Sclerosis; Myelin Basic Protein; Protein Prenylation; Rats; Rats, Inbred Lew; rho GTP-Binding Proteins; T-Lymphocytes

We have developed a sensitive, ELISA-based assay to detect autoantibodies to myelin basic protein (MBP) in human serum. Autoantibody levels were measured in 98 normal healthy adults (age range 20-66) and 94 clinically definite multiple sclerosis (MS) cases (age range 18-63). Of the MS patients, 77% had elevated levels of MBP autoantibodies (IgG) whereas only five normal individuals had antibody levels increased over normal. From the receiver-operator curve (ROC), the mean+/-2SD as clinical decision limit offers high sensitivity (77%) and specificity (95%). No change in assay performance was observed when hemoglobin, triglycerides or bilirubin were added to serum samples. The success of the assay is dependent on the use of heparin, an anionic molecule, which neutralizes the positive charge on the highly cationic MBP.

Topics: Adolescent; Adult; Aged; Autoantibodies; Biological Assay; Enzyme-Linked Immunosorbent Assay; Humans; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Sensitivity and Specificity; Time Factors

Several studies have suggested that peripheral inflammation may be involved in the etiology of multiple sclerosis (MS), a demyelinating disease of the central nervous system (CNS). T-cells activated in the periphery enter the CNS, leading to demyelination and axonal loss. We hypothesized that peripheral infection by Porphyromonas gingivalis can affect pathological processes in the CNS and aggravate MS.. Glial cells derived from rat brains were cultured and stimulated with P. gingivalis or P. gingivalis lipopolysaccharide (LPS). Secretion of nitric oxide (NO) and prostaglandin E2 (PGE2) was determined. In addition, we examined the proliferation of lymphocytes harvested from P. gingivalis-immunized mice in response to stimulation by echephalitogenic proteins. The effect of peripheral inflammation induced by P. gingivalis on the clinical course of the disease was tested in experimental autoimmune encephalomyelitis (EAE), a mouse model used for the study of MS.. P. gingivalis LPS and heat-killed bacteria induced secretion of the proinflammatory mediators NO and PGE2 by CNS glial cells. Lymphocytes derived from P. gingivalis-immunized mice proliferated in the presence of the echephalitogenic protein myelin basic protein. Injection of P. gingivalis into subcutaneous chambers in mice, followed by EAE induction led to aggravation of the disease.. The present study provides evidence that infection with a periodontal pathogen, such as P. gingivalis, may play a role in the pathogenesis of CNS inflammatory disorders such as MS.

Topics: Analysis of Variance; Animals; Bacteroidaceae Infections; Cells, Cultured; Dinoprostone; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Female; Inflammation Mediators; Lipopolysaccharides; Lymphocyte Activation; Lymphocytes; Mice; Multiple Sclerosis; Myelin Basic Protein; Neuroglia; Nitric Oxide; Porphyromonas gingivalis; Rats; Rats, Inbred Strains; Statistics as Topic

It has been suggested that Golli proteins, structurally related to myelin basic proteins (MBPs), have a role in autoimmune processes. We studied the expression of these proteins in multiple sclerosis (MS) and determined that the number of Golli-immunoreactive (ir) cells was significantly higher around lesions of chronic MS than in control white matter. Golli proteins were expressed in the adult oligodendrocyte precursor cells (OPCs), activated microglia/macrophages, and some demyelinated axons around MS lesions. Their expression in adult OPCs indicates remyelination attempts, whereas the expression in the subpopulation of microglia/macrophages suggests roles in the immune processes of MS. In addition, Golli proteins may be markers of axonal transection, which is characteristic for MS.

Topics: Acute Disease; Adult; Aged; Aged, 80 and over; Brain; Brain Chemistry; Chronic Disease; Female; Humans; Immunohistochemistry; Macrophages; Male; Microglia; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Nerve Tissue Proteins; Oligodendroglia; Stem Cells; Transcription Factors

Cytokine-polarized T cells have distinct chemokine receptor (CKR) expression patterns associated with their cytokine secretion profiles. In order to investigate this paradigm in autoreactive human T cells, we have determined the CKR expression pattern of myelin basic protein (MBP)-reactive T cell lines (TCL) and compared these profiles to those of TCL-generated in response to tetanus toxoid (TT). Expression of CXCR6 and CXCR3 on TCL was significantly positively correlated with IFNgamma, and inversely correlated with IL-5 production. TT TCL had significantly higher expression of CCR7(-)/CD45RA(-) T effector memory (Tem) cells than MBP TCL. However, in MBP-specific TCL, CXCR6 was found to be the best marker of conversion to the Tem phenotype. CXCR6 and CXCR3 are likely to be important in the migration of effector memory T cells in Th1-mediated inflammatory diseases such as multiple sclerosis (MS).

Topics: Biomarkers; Cell Division; Cells, Cultured; Epitopes; Flow Cytometry; Humans; Immunologic Memory; Interferon-gamma; Interleukin-5; Multiple Sclerosis; Myelin Basic Protein; Receptors, Chemokine; Receptors, CXCR3; Receptors, CXCR6; Receptors, Cytokine; Receptors, G-Protein-Coupled; Receptors, Virus; T-Lymphocytes; Th1 Cells; Th2 Cells

It is generally accepted that multiple sclerosis (MS) is mediated by autoreactive T cells and that myelin basic protein (MBP) is one of the target autoantigens. The T-cell response to MBP has been analysed extensively, largely through the use of T-cell lines (TCL) and T-cell clones (TCC), and to date, three immunodominant regions (13-32, 84-103 and 144-163) have been described. However, given that TCL may represent a skewed pattern of peptide reactivity, we have developed a kinetic response assay in which the proliferation of peripheral blood mononuclear cells (PBMC) from MS patients and healthy individuals was measured directly against a panel of peptides spanning the full length of human MBP. Furthermore, PBMC from each subject were tested three times over the course of 18 months. A high proportion of MS patients exhibited a significant response to eight MBP regions (1-24, 30-54, 75-99, 90-114, 105-129, 120-144, 135-159 and 150-170). TCC were subsequently generated from MS subjects and were used to further define the epitope recognized in each case. Overall, normal individuals recognized significantly fewer peptides. In addition, we noted that the T-cell recognition of any one peptide can fluctuate, appearing at one time point, regressing, and subsequently reappearing at a later date. This study provides new insight into the recognition profile and dynamics of myelin-antigen-specific T cells in MS.

Topics: Adult; Autoantigens; Cells, Cultured; HLA-DR Antigens; HLA-DR2 Antigen; HLA-DRB1 Chains; HLA-DRB5 Chains; Humans; Leukocytes, Mononuclear; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Peptide Mapping; Peptides; T-Lymphocytes; Time Factors

Multiple sclerosis (MS), a chronic demyelinating disease, is thought to be initiated by pathogenic T cells that transmigrate the vascular endothelium and enter the brain through vascular and parenchymal basement membranes (BM). Vaccination with T-cell lines reactive with myelin basic protein (MBP) and myelin oligodendrocytic glycoprotein (MOG) epitopes, expanded with interleukin-2 (IL-2), and attenuated by ionizing radiation is currently being evaluated as a therapeutic modality for this disease. We examined mechanisms potentially involved in pathogenic cell migration into the central nervous system (CNS) and the influence of irradiation on these processes. Seven of 7 autoantigen-responsive T-cell lines from MS patients adhered to collagen IV, the major collagenous constituent of BMs. This adhesion was inhibited almost completely by monoclonal antibody (MAb) to very late antigen (VLA)-1 and partially by anti-VLA-2. T-cell lines from healthy donors adhered more variably to collagen IV. Furthermore, patient derived T cells actively transmigrated through a collagen IV gel toward medium containing TNF-a, in a process that was inhibited by MAbs to VLA-1. Ionizing radiation at the dose used in vaccine preparation, inhibited morphological polarization associated with migratory capability, induced integrin clustering on the cell membrane, and abrogated adhesion to collagen IV. These findings may have important implications for understanding the pathogenesis of MS and how irradiation of potentially pathogenic T cells produces a reagent with possible therapeutic effects in T-cell vaccination (TCV).

Topics: Adolescent; Adult; Case-Control Studies; Cell Adhesion; Chemotaxis, Leukocyte; Collagen Type IV; Humans; Integrin alpha1beta1; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Radiation Effects; Receptors, Antigen, T-Cell; T-Lymphocytes; Tumor Necrosis Factor-alpha; Vaccines, Attenuated

Systemic administration of antigen/peptide for peripheral T cell tolerance has long been investigated as a potential approach to therapy of autoimmune diseases. The multiple antimyelin T cell reactivities likely to be associated with multiple sclerosis (MS) impose major difficulties in devising such an immune-specific therapeutic approach to the disease, because targeting T cells specific for a single autoantigen/epitope is unlikely to be sufficiently effective. Here, we present a pilot study on the possibility of concomitantly inhibiting multiple potentially pathogenic antimyelin T cell reactivities by tolerogenic administration of an artificial "multiantigen/multiepitope" protein. A synthetic gene was constructed to encode selected disease-relevant epitopes of myelin basic protein (MBP), proteolipid protein (PLP), and myelin oligodendrocyte glycoprotein (MOG). The protein product, hmTAP (synthetic human multitarget autoantigen protein), was adequately processed for antigenic presentation of the relevant integral epitopes, in vitro and in vivo. Systemic administration of hmTAP not only suppressed and treated experimental autoimmune encephalomyelitis (EAE) initiated by autoreactivity to a PLP epitope, but also abrogated complex EAE transferred by multispecific line T cells reactive against encephalitogenic epitopes of MBP, PLP, and MOG. These data indicate that multiantigen/multiepitope-directed therapy of complex autoimmune diseases is effective and can be mediated by the protein product of a specifically designed synthetic gene.

Topics: Amino Acid Sequence; Animals; Autoantigens; Base Sequence; Encephalomyelitis, Autoimmune, Experimental; Epitopes; Female; Humans; Immunosuppression Therapy; Mice; Mice, Inbred C3H; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Recombinant Proteins; T-Lymphocytes

The pathogenetic role of autoantibodies in multiple sclerosis (MS) is uncertain. CD5+ B cells commonly produce autoantibodies, but CD5 expression has also been implicated in B-cell tolerance. We studied B-cell subsets, anti-myelin protein antibody-secreting cells in cerebrospinal fluid (CSF) and a panel of serum autoantibodies in patients with clinically isolated syndromes (CIS), suggestive of MS and patients with clinically definite MS (CDMS). Patients with CDMS had a higher percentage of CD5- B cells in CSF than did control subjects (P = 0.02). CIS patients with immunoglobulin G (IgG) oligoclonal bands in CSF or multiple lesions on magnetic resonance imaging (MRI) had a higher percentage of CD5- B cells in CSF than did the remaining CIS patients (P = 0.03). The percentage of CD5- and CD80+ B cells correlated positively and the percentage of CD5+ B cells correlated negatively with the number of CSF cells secreting anti-myelin basic protein (anti-MBP) antibodies. The prevalence of serum autoantibodies was comparable in the three patient groups. We conclude that intrathecal expansion of CD5- B cells appears to be more characteristic in MS patients, and CD5+ B cells may be associated with a lower prevalence of anti-myelin antibody production.

Topics: Adult; Autoantibodies; B-Lymphocyte Subsets; B7-1 Antigen; CD5 Antigens; Female; Humans; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein

To observe the therapeutic effect of Bushen Gusui tablet (BSGS) in treating multiple sclerosis (MS) and its effects on experimental allergic encephalomyelitis (EAE) in guinea pigs.. Forty-three MS patients were treated with BSGS and their clinical symptoms, signs of nerve function, recurrent frequency, evoked potential and changes in magnetic resonance imaging (MRI) were observed. The EAE model of guinea pigs was induced by homogenate of rabbit spinal cord and complete Freund's adjuvant (CFA), the animals were treated with BSGS and compared with prednisone acetate, which was served as control. The mortality and pathomorphology of EAE animals were observed. The contents of serum interleukin-2 (IL-2), interleukin-6 (IL-6), tumor necrosis factor (TNF) as well as myelin basic protein (MBP) were determined.. BSGS could improve symptoms and signs of MS patients and reduce recurrent frequency. The total effective rate was 88.37%. High dose BSGS could obviously reduce incidence of EAE, inhibit inflammatory reaction of brain and spinal cord as well as demyelination, and simultaneously inhibit the activity of serum IL-2, IL-6, TNF and MBP, in comparing with model group (P < 0.01). There were insignificant difference as compared with prednisone acetate group (P > 0.05).. BSGS had certain effect on both MS patients and EAE model animals, which indicated that it was worth further studying and clinical application.

Topics: Adolescent; Adult; Animals; Drug Combinations; Drugs, Chinese Herbal; Encephalomyelitis, Autoimmune, Experimental; Evoked Potentials; Evoked Potentials, Auditory, Brain Stem; Female; Guinea Pigs; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Phytotherapy; Prednisone; Tablets

In a previously described case of Waldenstrom's Macroglobulinemia, complicated by polyneuropathy, the IgM/lambda monoclonal antibody (mAb) was highly reactive with myelin basic protein (MBP). Given our demonstration that V lambda x, a recently described murine lambda variable region gene product, can itself bind MBP as well as confer MBP reactivity to an Ab, the possibility of a shared idiotypy between murine V lambda x and this human IgM/lambda anti-MBP was investigated. We characterized the epitope specificity of the macroglobulinemia patient's MBP-reactive IgM/lambda using indirect ELISA procedures with MBP, a citrullinated isomer of MBP termed C8, or peptide fragments of MBP as the coating antigens and monospecific Ab to V lambda x as the secondary Ab. The patient's MBP-reactive IgM/lambda was recognized by Ab specific for V lambda x and, like murine mAb containing V lambda x bound human MBP but not MBP-C8 nor other common autoantigens such as DNA, thyroglobulin, or actin. The anti-MBP reactivity was selective for MBP peptide 90-170 and preferentially recognized MBP peptide 84-96. Thus, the patient's macroglobulin and perhaps certain other human Ab with a 'V lambda x idiotype' bind to MBP peptide residues 84-96, an immunodominant peptide in multiple sclerosis patients. Such binding may be involved in the pathogenesis of neural damage in patients with neuroimmunologic disorders related to plasma cell dyscrasias or autoimmunity.

Topics: Animals; Autoantibodies; Encephalomyelitis, Autoimmune, Experimental; Enzyme-Linked Immunosorbent Assay; Humans; Immunodominant Epitopes; Immunoglobulin M; Macroglobulins; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Polyneuropathies; Rabbits; Waldenstrom Macroglobulinemia

Mature T cells initially respond to Ag by activation and expansion, but high and repeated doses of Ag cause programmed cell death and can suppress T cell-mediated diseases in rodents. We evaluated repeated systemic Ag administration in a marmoset model of experimental allergic encephalomyelitis that closely resembles the human disease multiple sclerosis. We found that treatment with MP4, a chimeric, recombinant polypeptide containing human myelin basic protein and human proteolipid protein epitopes, prevented clinical symptoms and did not exacerbate disease. CNS lesions were also reduced as assessed in vivo by magnetic resonance imaging. Thus, specific Ag-directed therapy can be effective and nontoxic in primates.

Topics: Animals; Autoantibodies; Brain; Callithrix; Cytokines; Disease Models, Animal; Dose-Response Relationship, Immunologic; Drug Administration Schedule; Immunodominant Epitopes; Immunosuppressive Agents; Immunotherapy, Active; Injections, Intravenous; Lymphocyte Activation; Magnetic Resonance Imaging; Male; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Recombinant Fusion Proteins; Th1 Cells; Th2 Cells

Type I diabetes and multiple sclerosis (MS) are distinct autoimmune diseases where T cells target either islet or CNS self-proteins. Unexpectedly, we found that autoreactive T cells in diabetic patients, relatives with high diabetes risk, nonobese diabetic (NOD) mice, and MS patients routinely target classical islet as well as CNS autoantigens. The pathogenic potential of CNS autoreactivity was testable in NOD mice. Pertussis holotoxin, without additional Ags or adjuvants, allowed development of an NOD mouse-specific, autoimmune encephalitis with variable primary-progressive, monophasic, and relapsing-remitting courses. T cells from diabetic donors transferred CNS disease to pertussis toxin-pretreated NOD.scid mice, with accumulation of CD3/IFN-gamma transcripts in the brain. Diabetes and MS appear more closely related than previously perceived. NOD mouse-specific, autoimmune encephalitis provides a new MS model to identify factors that determine alternative disease outcomes in hosts with similar autoreactive T cell repertoires.

Topics: Acute Disease; Adoptive Transfer; Adult; Amino Acid Sequence; Animals; Autoantigens; Cell Division; Cytokines; Diabetes Mellitus, Type 1; Encephalomyelitis, Autoimmune, Experimental; Female; Follow-Up Studies; Humans; Islets of Langerhans; Lymphocyte Activation; Male; Mice; Mice, Inbred BALB C; Mice, Inbred C57BL; Mice, Inbred NOD; Mice, Inbred NZB; Mice, SCID; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Organ Specificity; Prospective Studies; Recurrence; Species Specificity; T-Lymphocyte Subsets

Myelin proteins, including myelin basic protein (MBP), proteolipid protein (PLP) and myelin oligodendrocyte glycoprotein (MOG) are candidate autoantigens in MS. It is not clear whether MS patients show a predominant reactivity to one or several myelin antigens. We evaluated the IFN-gamma production induced by MBP and MOG and selected MBP-, MOG- and PLP-peptides in MS patients and healthy controls using the IFN-gamma ELISPOT assay. Most MS patients and healthy controls showed a heterogeneous anti-myelin T-cell reactivity. Interestingly in MS patients a positive correlation was found between the anti-MOG and anti-MBP T-cell responses. No myelin peptide was preferentially recognized among the peptides tested (MBP 84-102, 143-168, MOG 1-22, 34-56, 64-86, 74-96, PLP 41-58, 184-199, 190-209). In addition the frequency of IL2R+ MBP reactive T-cells was significantly increased in blood of MS patients as compared with healthy subjects, indicating that MBP reactive T-cells exist in an in vivo activated state in MS patients. Most of the anti-MBP T-cells were of the Th1-type because reactivity was observed in IFN-gamma but not in IL-4 ELISPOT-assays. Using Th1 (IL-12) and Th2 (IL-4) promoting conditions we observed that the cytokine secretion pattern of anti-MBP T-cells still is susceptible to alteration. Our data further indicate that precursor frequency analysis of myelin reactive T-cells by proliferation-based assays may underestimate the true frequency of myelin specific T-cells significantly.

Topics: Adult; Antigens; Enzyme-Linked Immunosorbent Assay; Female; Humans; Interferon-gamma; Interleukin-12; Interleukin-2; Interleukin-4; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; T-Lymphocytes; T-Lymphocytes, Helper-Inducer

Topics: Axons; Brain; Cost of Illness; Disease Progression; Humans; Magnetic Resonance Imaging; Multiple Sclerosis; Myelin Basic Protein

A significant correlation exists between disability and the volume of black holes (BHL VOL), defined as hypointense lesions on T1-weighted cranial magnetic resonance imaging. A consistent correlation has also been reported between urinary myelin basic protein-like material (MBPLM) and the transition toward secondary progression (SP) from relapsing-remitting (RR) multiple sclerosis (MS).. To improve the management of MS through a noninvasive and cost-effective test for monitoring disease activity or disease status.. From 662 patients with MS (86 with RR MS, 259 with SP MS without continued attacks, and 317 with SP MS with continued attacks), 24-hour urine samples were obtained at enrollment in the phase 3 Linomide (roquinimex) drug study. The urine specimens were analyzed for MBPLM and correlated with clinical features and findings on cranial magnetic resonance imaging.. Significant but weak correlations existed between urinary MBPLM and BHL VOL in all patients with MS (r = 0.114, P =.003; n = 662), patients with SP MS without attacks (r = 0.185, P =.003; n = 259), and all patients with SP MS (r = 0.122, P =.003; n = 576). No significant correlations were detected in the RR MS group or any of the disease groups or subgroups whose Expanded Disability Status Scale score was 5.0 or lower. In subgroup analysis, the most significant correlation was detected between urinary MBPLM after adjustment for creatinine and BHL VOL in patients with SP MS with an Expanded Disability Status Scale score of 5.5 or higher but without continued relapses (r = 0.417, P<.001; n = 138).. In patients with advanced SP MS, urinary MBPLM may possibly serve as an indicator of failed remission and axonal damage. Urinary MBPLM correlates with disease status in MS, especially the transition of RR MS to SP MS with advancing disability.

Topics: Adjuvants, Immunologic; Axons; Brain; Cost-Benefit Analysis; Cross-Sectional Studies; Disability Evaluation; Disease Progression; Female; Humans; Hydroxyquinolines; Magnetic Resonance Imaging; Male; Multiple Sclerosis; Multiple Sclerosis, Chronic Progressive; Multiple Sclerosis, Relapsing-Remitting; Myelin Basic Protein; Predictive Value of Tests; Randomized Controlled Trials as Topic; Severity of Illness Index

The common marmoset Callithrix jacchus (C. jacchus) is an outbred species characterized by a naturally occurring bone marrow chimerism and susceptibility to a form of experimental autoimmune encephalomyelitis (EAE) resembling multiple sclerosis (MS). T cell clones specific for the myelin antigen, myelin basic protein (MBP), can be derived from both naive and immunized marmosets and can adoptively transfer EAE to compatible chimeric siblings. Here, we demonstrate that several different antigenic determinants of MBP are recognized by these encephalitogenic T cell clones. Furthermore, PCR-based analysis of TCR Vbeta families does not show the preferential usage of any gene segment. Characterization of third complementarity determining regions (CDR3) fails to demonstrate a recurring motif characteristic of the T cell immune response to MBP in this species. Nevertheless, brief amino acid motifs are shared among marmoset clones and CDR3 sequences from MS samples. These data suggest that, due to its outbred condition, the C. jacchus marmoset mounts a diverse pathogenic response to MBP. However, the findings that certain CDR3 sequences are identically expressed in different animals, or by different T cell clones, suggest that MBP-specific T cell populations may be clonally expanded following chronic antigenic stimulation in vivo.

Topics: Amino Acid Motifs; Amino Acid Sequence; Animals; Callithrix; Complementarity Determining Regions; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Epitopes, T-Lymphocyte; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell, alpha-beta; T-Lymphocytes

We studied the relationship between the HLA specificities associated with multiple sclerosis (MS) susceptibility in southern Italy and the reactivity of the human myelin basic protein (hMBP) immunogenic peptides 84-98 and 143-168, using short-term T-cell lines established from 9 MS patients and from 8 healthy individuals. In our population, DR15 was significantly associated with MS (34.9% in MS versus 13.7% in healthy controls, P < 0.05). This result is in agreement with the association found in northern Europe, but not with data obtained in a population from the island of Sardinia (Italy). In MS patients the frequency of reactive T-cell lines (TCL), tested for fine specificity against the immunodominant hMBP peptides 84-98 and 143-168, was increased for the hMBP 143-168 peptide (P < 0.05) but not for the 84-98 peptide. Although this reactivity was higher in DR15+ MS patients than in DR 15- MS patients, it seemed not to be associated with DR15 specificity in the MS population. Furthermore, there were no significant differences in frequency of reactive TCL to hMBP peptide 84-98 in DR15-positive or DR15-negative MS patients. Consequently, it appears that peptide 84-98, considered as a relevant autoantigen, is not implicated in the pathogenesis of MS in our population from southern Italy.

Topics: Autoantigens; Cell Line; Histocompatibility Testing; Humans; Italy; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes

Autoreactive T cells specific for candidate myelin antigens, including myelin basic protein (MBP) and proteolipid protein (PLP), are thought to play an important role in the pathogenesis of multiple sclerosis (MS). Myelin-reactive T cells primed in vivo by myelin breakdown products or microbial cross-reactive antigens during the disease processes may exhibit a reactivity pattern and cytokine profile different from those in the normal T cell repertoire. In this study, we examined the precursor frequency, the reactivity pattern and cytokine profile of myelin-reactive T cells that were primed in vitro with overlapping peptides of MBP and PLP in patients with MS and healthy individuals. The results revealed that T cells specific for peptides of MBP and PLP occurred at a relatively higher precursor frequency in patients with MS than that in healthy individuals. We identified a number of dominant T cell epitopes within MBP and PLP, some of which were not previously detected using whole myelin antigens as the primary stimuli. Some residues represented common immunodominant regions that were detected in both MS patients and healthy controls while others were associated only with MS. MBP-reactive T cell lines generally exhibited a Th0-like cytokine profile. There was significantly increased Th1 cytokine production (i. e. TNF and IFN-gamma) among MS-derived T cell lines. PLP-reactive T cell lines had a distinct cytokine profile, producing predominantly TNF-alpha and little or not IFN-gamma and IL-4. The findings have important implications in the understanding of the role of myelin-reactive T cells in MS.

Topics: Adult; Aged; Amino Acid Sequence; Autoimmunity; Cell Line; Cytokines; Epitopes; Female; Humans; Male; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Peptides; Stem Cells; T-Lymphocytes

Topics: Animals; Callithrix; Humans; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Recombinant Fusion Proteins

Topics: Animal Welfare; Animals; Cattle; Disease Models, Animal; Female; Genetic Engineering; Humans; Multiple Sclerosis; Myelin Basic Protein; New Zealand; Pregnancy

The proliferative response of preparations of whole PBMC populations from 20 healthy individuals and 28 multiple sclerosis (MS) patients to purified protein derivative (PPD) and myelin basic protein (MBP) was monitored in a kinetic assay over a period of up to 10 days. PPD produced a classical secondary response in both groups, the magnitude being significantly reduced in the MS cohort. The magnitude and pattern of response to MBP did not differ between the two populations. The kinetic profile characteristic of a primary response was observed in both groups. Enrichment of the CD45RO+ve and CD45RA+ve T-cell subsets in PBMC led to a secondary response to PPD in the RO+ve and primary response in the RA+ve population in both groups. The response to MBP in both RO+ve and RA+ve populations exhibited primary kinetics in both MS patients and healthy individuals. However, the use of T-cell subset enriched populations allowed a finer dissection of the response to MBP which highlighted the more active role of RO-positive cells in MS patients. The most striking difference between patients and healthy individuals occurred on day 4 of culture when a greater response to MBP occurred in the CD45RO enriched population, paralleling the response to PPD, in the majority of patients. Futhermore in 4/8 patients and only 1/8 healthy individuals the response in the RO+ve cultures was maintained at a higher level than that seen in the corresponding RA+ve cultures throughout the culture period. This data indicates that a measurable memory response to MBP exists in MS patients implying prior activation of MBP reactive T lymphocytes during the course of disease.

Topics: Adult; Cells, Cultured; Female; Hemocyanins; Histocompatibility Testing; HLA-DR Antigens; HLA-DRB1 Chains; Humans; Leukocyte Common Antigens; Lymphocyte Activation; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocyte Subsets; Tuberculin

An increased level of citrullinated myelin basic protein (MBP-C8) has been reported in the brains of multiple sclerosis (MS) patients. However, the involvement of the immune response to post-translational modified MBP in the pathophysiology of MS remains speculative. The aim of this study was to compare the levels of immunoglobulin G antibodies to several MBP epitopes, before and after citrullination, in the cerebrospinal fluid (CSF) and sera of MS patients using enzyme-linked immunosorbent assay (ELISA). We analyzed antibody reactivity against various MBP-peptides in the CSF and sera of 60 MS patients, and 30 patients with other neurological diseases (OND) as controls. The peptides tested were: MBP(75-98) (peptide 1), native (peptide 2) and citrullinated (peptide 3) MBP(108-126) (ARG(122)-->Cit(122)), and native (peptide 4) and citrullinated (peptide 5) MBP(151-170) (ARG(159, 170)-->Cit(159, 170)). All selected peptides could support an immune reactivity in CSF and sera of MS and OND patients. A higher reactivity against peptide 4 was found in the CSF of MS patients compared with OND patients (P<0.0001), but not against citrullinated peptides (peptides 3 and 5). However, we observed that the citrullination state of peptide 2 modified the patterns of immune reactivity more markedly in MS patients (P<0.0001) than in OND patients (P<0.02). Although some MBP epitopes could be a potential target in MS, our data did not demonstrate any difference of antibody response to MBP peptides in their citrullinated forms.

Topics: Adolescent; Adult; Aged; Amino Acid Sequence; Citrulline; Enzyme-Linked Immunosorbent Assay; Female; Humans; Immunoglobulin G; Male; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Protein Processing, Post-Translational

In Lewis rats, treatment with high doses of cyclosporin A (CsA) suppresses clinical signs of experimental autoimmune encephalomyelitis (EAE), although disease occurs when treatment is ceased. Treatment with low doses of CsA causes EAE to take a chronic relapsing course. We have previously shown that CsA treatment causes a decline in the number of T cells and increased inflammatory cell apoptosis in the spinal cord. The present study was undertaken to assess whether CsA therapy also modulates cytokine mRNA expression by inflammatory cells in the spinal cord of rats with EAE, looking for changes that might contribute to the observed effects of CsA on the course of EAE. EAE was induced in Lewis rats by inoculation with myelin basic protein and adjuvants. At the peak of neurological signs, on day 14 after inoculation, rats were given a single intraperitoneal injection of saline, or CsA at a dose of 8, 16, 32 or 64 mg/kg. The next day, rats were sacrificed, the spinal cords removed, inflammatory cells were extracted from the cords, and mRNA isolated from these cells. Expression of cytokine mRNA was assessed by semi-quantitative reverse transcription polymerase chain reaction (PCR) and by quantitative real-time PCR. With both techniques, we found that CsA suppressed the expression of interferon-gamma mRNA and interleukin-2 (IL-2) mRNA. With real-time PCR, we found that CsA caused significantly increased expression of transforming growth factor-beta mRNA. With the different techniques, we observed no consistent pattern of alteration of expression of interleukin-10 or interleukin-4 mRNA. It is possible that these changes in cytokine mRNA expression contribute to the modulation of the clinical course of EAE that is produced by CsA treatment.

Topics: Actins; Animals; Antifungal Agents; Cell Count; Cyclosporine; Cytokines; Dose-Response Relationship, Drug; Encephalomyelitis, Autoimmune, Experimental; Guinea Pigs; Interferon-gamma; Interleukin-10; Interleukin-2; Interleukin-4; Multiple Sclerosis; Myelin Basic Protein; Myelitis; Polymerase Chain Reaction; Rats; RNA, Messenger; T-Lymphocytes

Recently evidence has been provided for a genetic control of T-cell dependent cytokine production by HLA-class II. Candidate genes in multiple sclerosis, a T-cell mediated autoimmune disease, are the disease-associated DR2, DQ6, Dw2 haplotype. Previous observations by us and others imply a HLA-DR2 dependent propensity of antigen-specific T-cell lines to produce increased amounts of TNF-alpha/beta. Here, we tested a possible association between HLA or disease status with cytokine production employing the simple and widely used method of bulk cultures. Peripheral blood cells of 48 patients and 68 healthy individuals were analyzed. We observed no significant differences of the cytokine production in relation to disease status or any HLA polymorphism. Our data indicate that, in contrast to monoclonal T-cell cultures, bulk cultures are not suitable to detect immunogenetic control of T-cell function.

Topics: Alleles; Cells, Cultured; Disease Susceptibility; Histocompatibility Antigens Class II; HLA-DQ alpha-Chains; HLA-DQ Antigens; HLA-DQ beta-Chains; HLA-DR Antigens; HLA-DRB1 Chains; Humans; Leukocytes, Mononuclear; Lymphotoxin-alpha; Multiple Sclerosis; Myelin Basic Protein; Polymorphism, Genetic; Tetanus Toxoid; Tumor Necrosis Factor-alpha

Copolymer 1 (Cop 1, poly [Y, E, A, K]) is a random synthetic amino acid copolymer effective in the treatment of relapsing forms of multiple sclerosis (MS), a disease that is linked to HLA-DR2 (DRB1*1501). In the present study various peptides, synthesized according to the binding motifs for both the immunodominant epitope of myelin basic protein (MBP) 85-99, a candidate autoantigen in MS, and Cop 1, differentially inhibited binding of these antigens to disease-associated HLA-DR2 (DRB1*1501) molecules. In particular, two peptides with residue K at position P-1, as referred to MBP 85-99, inhibited effectively the binding of both biotinylated MBP 85-99 and Cop 1 to HLA-DR2 molecules as well as IL-2 production by two MBP-specific HLA-DR2-restricted T-cell clones. These findings suggest the possible utility of these compounds or their more stable derivatives in treatment of MS.

Topics: Antibodies; Cross Reactions; Dose-Response Relationship, Drug; HLA-DR2 Antigen; Humans; Immunodominant Epitopes; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Peptides; Protein Binding; T-Lymphocytes, Helper-Inducer

One of the distinctive features of multiple sclerosis (MS) attacks is homing to the CNS of activated T cells able to orchestrate humoral and cell-based events, resulting in immune-mediated injury to myelin and oligodendrocytes. Of the complex interplay occurring between T cells and CNS constituents, we have examined some aspects of T-cell interactions with astrocytes, the major components of the glial cells. Specifically, we focused on the ability of T cells to regulate the gene expression of interleukin-6 (IL-6) in astrocytes, based on previous evidence showing the involvement of this cytokine in CNS disorders. We found that T-cell adhesion and T-cell soluble factors induce IL-6 gene expression in U251 astrocytes through distinct signaling pathways, respectively, resulting in the activation of NF-kappaB and IRF-1 transcription factors. In a search for effector molecules at the astrocyte surface, we found that alpha3beta1 integrins play a role in NF-kappaB activation induced by T-cell contact, whereas interferon-gamma (IFN-gamma) receptors dominate in IRF-1 induction brought about by T-cell-derived soluble factors. Similar phenomena were observed also in normal fetal astrocyte cultures. We therefore propose that through astrocyte induction, T cells may indirectly regulate the availability of a cytokine which is crucial in modulating fate and behavior of cell populations involved in the pathogenesis of MS inflammatory lesions.

Topics: Astrocytes; Binding Sites; Cell Adhesion; Cell Communication; Cells, Cultured; Cloning, Molecular; DNA-Binding Proteins; Fetus; Gene Expression Regulation; Humans; Integrin beta1; Interferon Regulatory Factor-1; Interferon-gamma; Interleukin-6; Multiple Sclerosis; Myelin Basic Protein; NF-kappa B; Phenotype; Phosphoproteins; Phosphorylation; STAT1 Transcription Factor; T-Lymphocytes; Trans-Activators; Transcription, Genetic; Up-Regulation

T cell-mediated destruction of the myelin sheath causes inflammatory damage of the CNS in multiple sclerosis (MS). The major T and B cell responses in MS patients who are HLA-DR2 (about two-thirds of MS patients) react to a region between residues 84 and 103 of myelin basic protein (1 ). The crystal structure of HLA-DR2 complexed with myelin basic protein(84-102) confirmed that Lys(91) is the major TCR contact site, whereas Phe(90) is a major anchor to MHC and binds the hydrophobic P4 pocket (2 ). We have tested peptides containing repetitive 4-aa sequences designed to bind critical MHC pockets and to interfere with T cell activation. One such sequence, EYYKEYYKEYYK, ameliorates experimental autoimmune encephalomyelitis in Lewis rats, an animal model of MS.

Topics: Adjuvants, Immunologic; Amino Acid Sequence; Animals; Binding Sites; Encephalomyelitis, Autoimmune, Experimental; Female; Histocompatibility Antigens; Histocompatibility Antigens Class II; HLA-DR2 Antigen; Humans; Models, Molecular; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Peptides; Rats; Rats, Inbred Lew; Receptors, Antigen, T-Cell; Sequence Homology, Amino Acid; T-Lymphocytes

Brain tissue from 25 patients with clinically definite multiple sclerosis (MS) and as controls brain tissue from 36 patients without neurological disease was tested for the presence of human coronaviral RNA. Four PCR assays with primers specific for N-protein of human coronavirus strain 229E and three PCR assays with primers specific for the nucleocapsid protein of human coronavirus strain OC43 were performed. Sporadic positive PCR assays were observed in both patients and controls in some of the PCR assays. However, these results were not reproducible and there was no difference in the proportion of positive signals from the MS patients compared to controls. Evidence for a chronic infection with the human coronaviruses strain 229E or OC43 in brain tissue from patients with MS or controls has not been found in this study.

Topics: Adult; Aged; Aged, 80 and over; Brain; Coronavirus; DNA Primers; Female; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Reverse Transcriptase Polymerase Chain Reaction; RNA, Viral

We analyzed the sera of 51 patients with various phenotypes of X-linked adrenoleukodystrophy (X-ALD), 20 patients with multiple sclerosis (MS) and 22 healthy volunteers for the presence of autoantibodies specific for the recombinant extracellular immunoglobulin-like domain of human myelin oligodendrocyte glycoprotein (rhMOG(Igd)) and myelin basic protein (MBP). Anti-rhMOG(Igd) autoantibodies were significantly more frequent in X-ALD and MS patients as opposed to healthy individuals (p<0.05). Anti-MBP autoantibodies were present in about one-fourth of X-ALD and MS patients but in less than 10% of healthy individuals. Anti-rhMOG(Igd) autoantibody responses were not accompanied by increased T cell reactivity against rhMOG(Igd). These findings may have important implications for the understanding of humoral anti-myelin immunoreactivity in demyelinating diseases of the central nervous system such as X-ALD and MS.

Topics: Adolescent; Adrenoleukodystrophy; Adult; Autoantibodies; Female; Genetic Linkage; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Phenotype; Recombinant Proteins; X Chromosome

Multiple sclerosis (MS) is a demyelinating disease of the central nervous system (CNS) characterized by plaques of infiltrating CD4(+) and CD8(+) T cells. Studies of MS and experimental autoimmune encephalomyelitis (EAE), an animal model of MS, focus on the contribution of CD4(+) myelin-specific T cells. The role of CD8(+) myelin-specific T cells in mediating EAE or MS has not been described previously. Here, we demonstrate that myelin-specific CD8(+) T cells induce severe CNS autoimmunity in mice. The pathology and clinical symptoms in CD8(+) T cell-mediated CNS autoimmunity demonstrate similarities to MS not seen in myelin-specific CD4(+) T cell-mediated EAE. These data suggest that myelin-specific CD8(+) T cells could function as effector cells in the pathogenesis of MS.

Topics: Adoptive Transfer; Animals; Autoimmunity; Brain; CD4-Positive T-Lymphocytes; CD8-Positive T-Lymphocytes; Clone Cells; Disease Models, Animal; Mice; Mice, Inbred C3H; Mice, Inbred MRL lpr; Mice, SCID; Multiple Sclerosis; Myelin Basic Protein; Spinal Cord; T-Lymphocytes; Time Factors

In Japanese, susceptibility to the conventional form of multiple sclerosis (C-MS) is associated with the HLA-DRB1*1501-DRB5*0101 haplotype while susceptibility to the opticospinal form of MS (OS-MS) is associated with HLA-DPA1*0202-DPB1*0501. To clarify the characteristics of T cells autoreactive to myelin proteins in each MS subtype, we established T-cell lines reactive to such myelin antigens as myelin basic protein (MBP), proteolipid protein (PLP) and myelin oligodendrocyte glycoprotein (MOG) from 5 of 10 OS-MS patients, 6 of 11 C-MS patients and 7 of 13 healthy controls (HCs), and T-cell epitopes and their restriction molecules were determined. We found that (a) intermolecular epitope spreading was found to be significantly more frequent in MS patients than in HCs (P=0.0128), (b) intramolecular epitope spreading also tended to occur more frequently in MS patients than in HCs (P=0.0584), (c) in OS-MS, HLA-DR-restricted and MOG-autoreactive T cells were more frequently established as compared with those reactive to MBP or PLP epitopes and (d) in C-MS, HLA-DQ-restricted and PLP-autoreactive T cells dominated those autoreactive to MBP or MOG epitopes. A DPB1*0501-restricted MBP-reactive T-cell clone from a patient with OS-MS provided evidence that the first HLA class II anchor amino acid of peptide bound to disease-susceptible DP5 molecule was distinct from that for the DR2 molecule. Taken together, these differences in specificities of myelin-autoreactive T cells between C-MS and OS-MS as well as the difference in the anchor motif of the binding peptides between each MS subtype-susceptible HLA class II molecule may contribute to the development of distinct clinical phenotypes.

Topics: Adult; Amino Acid Sequence; Autoantibodies; Clone Cells; Epitope Mapping; Epitopes, T-Lymphocyte; Female; HLA-DP Antigens; Humans; Lymphocyte Activation; Male; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Optic Nerve; Peptide Fragments; Spinal Cord; T-Lymphocytes

Understanding the process of inducing T cell activation has been hampered by the complex interactions between APC and inflammatory Th1 cells. To dissociate Ag-specific signaling through the TCR from costimulatory signaling, rTCR ligands (RTL) containing the alpha1 and beta1 domains of HLA-DR2b (DRA*0101:DRB1*1501) covalently linked with either the myelin basic protein peptide 85-99 (RTL303) or CABL-b3a2 (RTL311) peptides were constructed to provide a minimal ligand for peptide-specific TCRs. When incubated with peptide-specific Th1 cell clones in the absence of APC or costimulatory molecules, only the cognate RTL induced partial activation through the TCR. This partial activation included rapid TCR zeta-chain phosphorylation, calcium mobilization, and reduced extracellular signal-related kinase activity, as well as IL-10 production, but not proliferation or other obvious phenotypic changes. On restimulation with APC/peptide, the RTL-pretreated Th1 clones had reduced proliferation and secreted less IFN-gamma; IL-10 production persisted. These findings reveal for the first time the rudimentary signaling pattern delivered by initial engagement of the external TCR interface, which is further supplemented by coactivation molecules. Activation with RTLs provides a novel strategy for generating autoantigen-specific bystander suppression useful for treatment of complex autoimmune diseases.

Topics: Calcium Signaling; Clone Cells; Fusion Proteins, bcr-abl; Genes, T-Cell Receptor beta; HLA-DR2 Antigen; Humans; Interleukin-10; Ligands; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Receptors, Antigen, T-Cell; Signal Transduction; Th1 Cells

Multiple lines of evidence suggest that CD4+ lymphocytes initiate autoimmune responses against myelin antigens in multiple sclerosis (MS). The increased frequency of activated myelin-specific cells in MS patients indicates that the activation of autoreactive cells represents a central event in the pathogenesis of the disease. We identified a CD4+ subpopulation that is characterized phenotypically by the persistent absence of surface CD28 expression and functionally by CD28-independent activation and Th1 cytokine secretion. Owing to their costimulation-independent activation and their expression of a full agonist signaling activation pattern, CD4+CD28- cells have the potential to initiate autoimmune responses in the central nervous system, a compartment devoid of professional antigen presenting cells. Long-term memory CD4+CD28- cells produce high amounts of IFN-gamma and maximally upregulate IFN-gamma and IL-12Rbeta2 chain expression in the absence of costimulation. They exhibit prominent growth characteristics and increased survival after activation, likely related to their persistent lack of CTLA-4 surface expression. The CD4+CD28- population is expanded in a subgroup of MS patients. Myelin basic protein-specific cells detected in this cell subset may play an important role in the inflammatory response within the central nervous system.

Topics: Adult; Antigens, CD; CD28 Antigens; CD4-Positive T-Lymphocytes; Female; Gene Expression; Glycoproteins; Humans; Immunoglobulins; In Vitro Techniques; Interferon-gamma; Lymphocyte Activation; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Phenotype; Receptors, Antigen, T-Cell, gamma-delta; Receptors, Cell Surface; Receptors, Interleukin; Receptors, Interleukin-12; RNA, Messenger; Signal Transduction; Signaling Lymphocytic Activation Molecule Family Member 1; T-Lymphocyte Subsets

Antibody responses to Acinetobacter (five strains), Pseudomonas aeruginosa, Escherichia coli, myelin basic protein (MBP), and neurofilaments were measured in sera from 26 multiple sclerosis (MS) patients, 20 patients with cerebrovascular accidents (CVA), 10 patients with viral encephalitis, and 25 healthy blood donors. In MS patients, elevated levels of antibodies against all strains of Acinetobacter tested were present, as well as antibodies against P. aeruginosa, MBP, and neurofilaments, but not antibodies to E. coli, compared to the CVA group and controls. The myelin-Acinetobacter-neurofilament antibody index appears to distinguish MS patients from patients with CVAs or healthy controls. The relevance of such antibodies to the neuropathology of MS requires further evaluation.

Topics: Acinetobacter; Acinetobacter Infections; Adult; Antibodies, Bacterial; Blotting, Western; Brain Chemistry; Escherichia coli; Female; Humans; Immunoglobulin A; Immunoglobulin G; Immunoglobulin M; Indicator Dilution Techniques; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Neurofilament Proteins; Pseudomonas aeruginosa; Pseudomonas Infections

Topics: Animals; CD4-Positive T-Lymphocytes; CD8-Positive T-Lymphocytes; Encephalomyelitis, Autoimmune, Experimental; Humans; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes; Vaccination

T cells express MHC class II glycoproteins under various conditions of activation or inflammation. To assess whether T cell APC (T-APC) activity had long-term tolerogenic consequences, myelin basic protein (MBP)-specific rat T cells were induced to acquire MBP-derived I-A complexes to promote reciprocal antigen presentation. T-T antigen presentation caused extensive cell death among T-APC and MBP-specific T responders and caused long-term desensitization of surviving responders. Addition of the anti-I-A mAb OX6 to activated I-A+ responders inhibited T-APC activity, accelerated recovery from postactivation refractoriness, and prevented long-term loss of reactivity in responder T cells. Antigenic activation of responder T cells with irradiated T-APC induced profound losses in reactivity that lasted for over 1 month of propagation in IL-2 and was associated with preferential outgrowth of CD4- T cells. Antigen-activated CD4- T cells exhibited more rapid IL-2-dependent growth that eventually normalized compared to CD4+ T cells 1-2 months after antigen exposure. In conclusion, expression of T-APC activity by activated T cells represents an important negative feedback pathway that depletes antigen-reactive T cells and causes long-term desensitization of surviving T cells. Hence, T cell APC may be an important mechanism of self-tolerance.

Topics: Animals; Antigen Presentation; Autoimmunity; CD4 Antigens; CD4-Positive T-Lymphocytes; Encephalomyelitis, Autoimmune, Experimental; Histocompatibility Antigens Class II; Multiple Sclerosis; Myelin Basic Protein; Rats

In a subset of multiple sclerosis (MS) patients antibodies against myelin antigens seem to be important in the demyelinating process. In this study we investigated IgM, IgA and IgG serum antibodies against the myelin oligodendrocyte glycoprotein (MOG) and the myelin basic protein (MBP) in 261 MS patients. Seventy-two per cent had anti-MOG antibodies, 59% were anti-MBP seropositive. The dominating antibody was anti-MOG IgM. A significant relationship between IgA and a progressive disease course was found. The predominance of IgGI together with the significantly associated occurrence of IgG3 against MOG corresponds to the prevailing IgGI and IgG3 isotypes in other autoimmune diseases. Patients who actually suffered from a relapse were significant more often anti-MOG and anti-MBP IgG3 seropositive than those in remission. However, patients treated either with intravenous immunoglobulins or interferon-beta showed a significant reduction of anti-MOG IgG3 antibodies.

Topics: Adult; Autoantibodies; Disease Progression; Humans; Immunoglobulin A; Immunoglobulin G; Immunoglobulin M; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein

T cells reactive to self-antigens are present in the peripheral blood of patients with autoimmune diseases as well as in healthy subjects. Although T cell-response to the self-myelin antigen myelin basic protein (MBP) has been widely investigated in multiple sclerosis (MS) patients, very little is known about the evolution over time of this response and its correlation with the disease activity. In recent years magnetic resonance imaging (MRI) techniques have provided new tools for following the inflammatory activity in the central nervous system (CNS) of MS patients. In the present study the T cell response to MBP was longitudinally investigated in terms of frequency, epitope specificity, and cytokine production profile in four patients with relapsing-remitting MS enrolled in a gadolinium-enhanced MRI serial study. In spite of different profiles of inflammatory activity within the CNS, all the patients examined showed major changes in their reactivity to MBP during the follow-up period in terms of both frequency and epitope specificity. Episodic expansions of MBP-specific T cell populations were observed in each patient, and overall they did not correlate with disease activity. In these patients the expansions: 1) occurred in the context of a steady level of disease activity, 2) correlated with a burst of CNS inflammation, 3) followed the appearance of a new active lesion, and 4) were observed even in the absence of detectable signs of CNS inflammation during the entire follow-up period. These results suggest that the evolution over time of the T cell response to a self-antigen such as MBP is more complex than previously expected. The short-term repertoire dynamics of autoreactive T cells in MS underscore the importance of longitudinal studies for evaluating autoreactivity to myelin antigens and probably to any self-antigen in other autoimmune diseases.

Topics: Adult; Antibody Specificity; Autoantigens; Cell Division; Cells, Cultured; Central Nervous System; Cytokines; Disease Progression; Epitopes, T-Lymphocyte; Female; Humans; Interferon-gamma; Interleukin-4; Magnetic Resonance Imaging; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Peptides; T-Lymphocytes; Time Factors

An increased level of myelin basic protein (MBP) degradation peptide 80-89, representative of myelin breakdown, is detected in myelinating foetal rat brain aggregate cultures supplemented with peritoneal macrophages at a time coinciding with the onset of myelination. During the period of myelination, the proportion of activated macrophages/microglia in the aggregates decreases, accompanied by a reduction in the content of MBP degradation products. During the recovery period following a demyelinating episode, the rate of MBP synthesis in antibody-treated standard aggregates was greater than in their medium controls. However, the rate of MBP accumulation was not as efficient in macrophage-enriched aggregates and was associated with persistently raised MBP peptide levels. Thus, as occurs in multiple sclerosis lesions, attempts at remyelination appear to be counterbalanced by macrophage-mediated demyelination, with the continued presence of degraded myelin rendering a local environment that is not fully conducive to remyelination.

Topics: Adult; Animals; Antibodies; Antigens, CD; Antigens, Neoplasm; Antigens, Surface; Avian Proteins; Basigin; Blood Proteins; Brain; Cell Count; Cell Size; Cells, Cultured; Ectodysplasins; Fetus; Humans; Immunohistochemistry; Macrophages; Membrane Glycoproteins; Membrane Proteins; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Sheath; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Nerve Regeneration; Peptide Fragments; Phagocytosis; Rats; Rats, Sprague-Dawley

Autoreactive T-cells are involved in demyelination, neurodegeneration, and the recruitment of peripheral macrophages and nonspecific activated T-cells in autoimmune diseases such as multiple sclerosis (MS). The ligation of costimulatory B7 molecules on microglia with CD28/CTLA-4 on T-cells is thought to be crucial to the onset and course of MS and its rodent model experimental autoimmune encephalomyelitis (EAE). It is currently unclear as to how far the nature of infiltrating T-cells has an impact on the expression of the B7 molecules on microglia, the resident antigen-presenting cells (APCs) of the brain. We studied the expression of B7-1 and B7-2 on microglia after encounter with preactivated Th1 and Th2 cells from transgenic mice whose T-cells express a receptor (TCR) either specific to myelin basic protein (MBP) or ovalbumin (OVA) using murine organotypic entorhinal-hippocampal slice cultures (OEHSC). Our main finding was that Th1 cells downregulate the constitutive expression of B7-2 and induce B7-1 expression while Th2 cells do not induce this B7-1 upregulation. The main difference between MBP- and OVA-specific cells was seen in experiments were Th1 cells had direct contact to APCs but not to brain tissue. In contrast to MBP-specific Th1 cells, OVA-specific Th1 cells required the addition of antigen to upregulate B7-1 and downregulate B7-2. When the cells were allowed to have contact to brain tissue, no difference was seen in the pattern of B7 regulation between OVA- and MBP-specific T-cells. Our data suggest that T-cells are able to modulate B7 expression on microglial cells in the brain independent of antigen presentation through TCR/MHC-II ligation but presumably by soluble mediators.

Topics: Animals; Antigen Presentation; Antigens; Antigens, CD; B7-1 Antigen; B7-2 Antigen; Brain; Coculture Techniques; Down-Regulation; Epitopes; Gene Expression Regulation; Membrane Glycoproteins; Mice; Mice, Inbred BALB C; Microglia; Models, Biological; Multiple Sclerosis; Myelin Basic Protein; Ovalbumin; Th1 Cells; Th2 Cells; Up-Regulation

Topics: Cell Line; Clone Cells; Coronavirus 229E, Human; Cross Reactions; Humans; Lymphocyte Activation; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes

Antigen-coupled antigen-presenting cells (APC) serve as potent tolerogens for inhibiting immune responses in vivo and in vitro, apparently by providing an antigen-specific signal through the TCR in the absence of co-stimulation. Although this approach has been well studied in rodents, little is known about its effects on human T cells. We evaluated the specificity and mechanisms of tolerization of human T cells in vitro using monocyte-enriched adherent cells that were pulsed with antigen and treated with the cross-linker, 1-ethyl-3-(3-dimethylaminopropyl)-carbodiimide (ECDI). Autologous antigen-coupled APC selectively tolerized T cells of the T(h)1 but not T(h)2 lineage through a mechanism that involved both antigen-specific and antigen-non-specific elements. The tolerization process was dependent on the ECDI and antigen concentration, and the coupling time, and was reflected by initial up-regulation of CD25. However, upon re-stimulation with fresh APC and antigen, tolerized T(h)1 cells failed to proliferate or to produce T(h)1 cytokine message or secreted protein, had decreased expression of CD25, CD28 and B7 and increased expression of MHC class II molecules, and demonstrated an enhanced commitment to apoptosis. T(h)1 cell tolerization could be prevented by adding anti-CD28 antibody, IL-2 or untreated APC at the same time as the ECDI/antigen-coupled APC, or reversed by adding anti-CD28 antibody or IL-2 upon re-stimulation with fresh APC plus antigen. Thus, the tolerizing effect of ECDI/antigen-coupled APC on human T(h)1 cells appears to involve a reversible anergy mechanism leading to apoptosis, whereby the targeted T cells receive full or partial activation through the TCR, without coordinate co-stimulation. These data suggest dichotomous signaling requirements for inactivating cells of the T(h)1 and T(h)2 lineages that may have important implications for treatment of T(h)1-mediated autoimmune or inflammatory diseases.

Topics: Antigen Presentation; Antigen-Presenting Cells; Apoptosis; CD28 Antigens; Clonal Anergy; Cross-Linking Reagents; Ethyldimethylaminopropyl Carbodiimide; Humans; Interleukin-10; Interleukin-2; Interleukin-5; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell; Signal Transduction; Simplexvirus; Tetanus Toxoid; Th1 Cells; Th2 Cells

Multiple sclerosis is an immune-mediated disorder of the central nervous system leading to progressive decline of motor and sensory functions and permanent disability. The therapy of multiple sclerosis is only partially effective, despite anti-inflammatory, immunosuppresive and immunomodulatory measures. White matter inflammation and loss of myelin, the pathological hallmarks of multiple sclerosis, are thought to determine disease severity. Experimental autoimmune encephalomyelitis reproduces the features of multiple sclerosis in rodents and in nonhuman primates. The dominant early clinical symptom of acute autoimmune encephalomyelitis is progressive ascending muscle weakness. However, demyelination may not be profound and its extent may not correlate with severity of neurological decline, indicating that targets unrelated to myelin or oligodendrocytes may contribute to the pathogenesis of acute autoimmune encephalomyelitis. Here we report that within the spinal cord in the course of autoimmune encephalomyelitis not only myelin but also neurons are subject to lymphocyte attack and may degenerate. Blockade of glutamate AMPA receptors ameliorated the neurological sequelae of autoimmune encephalomyelitis, indicating the potential for AMPA antagonists in the therapy of multiple sclerosis.

Topics: Animals; Brain Stem; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Excitatory Amino Acid Antagonists; Guinea Pigs; Motor Neurons; Multiple Sclerosis; Muscle Tonus; Myelin Basic Protein; Neurons; Organophosphonates; Quinoxalines; Rats; Rats, Inbred Lew; Receptors, AMPA; Receptors, Kainic Acid; Recurrence; Spinal Cord; T-Lymphocytes

Phosphodiesterase-4 (PDE4) inhibitors have the potential to modulate immune responses from the Th1 toward the Th2 phenotype and are considered candidate therapies for Th1-mediated autoimmune disorders. However, depending on the model and cell types employed, studies of atopic individuals have come to the opposite conclusion, i.e., that PDE inhibitors may be beneficial in asthma. Using in vitro immunopharmacologic techniques we analyzed the effects of PDE4 and PDE3 inhibitors on human immune cells to address these discrepancies and broaden our understanding of their mechanism of action. Our results indicate that PDE inhibitors have complex inhibitory effects within in vivo achievable concentration ranges on Th1-mediated immunity, whereas Th2-mediated responses are mostly unaffected or enhanced. The Th2 skewing of the developing immune response is explained by the effects of PDE inhibitors on several factors contributing to T cell priming: the cytokine milieu; the type of costimulatory signal, i.e., up-regulation of CD86 and down-regulation of CD80; and the Ag avidity. The combination of PDE4 and PDE3 inhibitors expresses synergistic effects and may broaden the therapeutic window. Finally, we observed a differential sensitivity to PDE inhibition in autoreactive vs foreign Ag-specific T cells and cells derived from multiple sclerosis patients vs those derived from healthy donors. This suggests that PDE inhibition weakens the strength of the T cell stimulus and corrects the underlying disease-associated cytokine skew in T cell-mediated autoimmune disorders. These new findings broaden the understanding of the immunomodulatory actions of PDE inhibitors and underscore their promising drug profile for the treatment of autoimmune disorders.

Topics: 3',5'-Cyclic-AMP Phosphodiesterases; Adjuvants, Immunologic; Amino Acid Sequence; Autoantigens; B7-1 Antigen; Cell Line; Cyclic Nucleotide Phosphodiesterases, Type 3; Cyclic Nucleotide Phosphodiesterases, Type 4; Cytokines; Dose-Response Relationship, Immunologic; Epitopes, T-Lymphocyte; Hemagglutinin Glycoproteins, Influenza Virus; Humans; Lymphocyte Activation; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Phosphodiesterase Inhibitors; Rolipram; T-Lymphocyte Subsets; Th1 Cells

Myelin basic protein (MBP) is a well-characterized autoantigen potentially involved in the pathogenesis of the most common human demyelinating disease of the central nervous system (CNS), multiple sclerosis (MS). It is known that MBP-specific T-cell responses differ widely among different individuals and also within a single donor in terms of fine specificity and functional characteristics including the avidity in antigen recognition. In this report, we demonstrate that the in vitro selection of MBP-reactive T-cell repertoire is strictly dependent upon the antigen dose used in the primary cultures. MBP-specific T-cell lines (TCLs) were generated from MS patients and healthy donors using different antigen concentration in cultures (0.1 to 50 microg/ml). In both MS patients and controls, the number of obtained T-cell lines was affected by the antigen concentration. In addition, low and high antigen concentrations selected in vitro different T-cell populations in terms of peptide specificity patterns and different functional avidities in antigen recognition. Low concentrations of MBP in the primary cultures yielded a small number of TCLs recognizing the specific antigen with higher avidity whereas high antigen concentrations allowed the in vitro expansion of a higher numbers of T-cells recognizing MBP with lower avidity. The use of different antigen concentrations in the primary cultures can be applied as a simple experimental system to investigate the overall avidity repertoire of antigen-specific T-cell response in humans.

Topics: Antibody Affinity; Epitopes; Humans; Immunodominant Epitopes; Multiple Sclerosis; Myelin Basic Protein; Reference Values; T-Lymphocytes

Interferon (IFN)-beta, the most effective immunomodulatory treatment for MS, inhibits the proliferation of myelin-specific T cells. We report that IFN-beta moderately enhances the expression of the death receptor, CD95, at the surface of human antigen-specific T cells. However, T-cell apoptosis was not induced by IFNbeta-1a or IFNbeta-1b as assessed by caspase activity or DNA fragmentation. Immunomodulation mediated by IFN-beta does not directly involve apoptotic pathways in human T cells.

Topics: Adjuvants, Immunologic; Apoptosis; Caspase 3; Caspases; Coumarins; DNA Fragmentation; Epitopes; fas Receptor; Fluorescent Dyes; Gene Expression; Humans; In Vitro Techniques; Interferon-beta; Multiple Sclerosis; Myelin Basic Protein; Oligopeptides; RNA, Messenger; T-Lymphocytes

Myelin basic protein (MBP) is considered to be essential for the maintenance of stability of the myelin sheath. Reduction in cationicity of MBP, especially due to conversion of positively charged arginine residues to uncharged citrulline (Cit), has been found to be associated with multiple sclerosis (MS). Here, the interactions of an anionic phosphatidylserine/monosialoganglioside-G(M1) (4:1, w:w) lipid monolayer with 18.5-kDa MBP preparations from age-matched adult humans without MS (no Cit residues), with chronic MS (6 Cit), and with acute Marburg-type MS (18 Cit) were studied by transmission and ultralow dose scanning transmission electron microscopy under cryogenic conditions. Immunogold labeling and single particle electron crystallography were used to define the nature of the complexes visualized. These electron microscopical analyses showed that the three different MBP charge isomers all formed uniformly sized and regularly shaped protein-lipid complexes with G(M1), probably as hexamers, but exhibited differential association with and organization of the lipid. The least cationic Marburg MBP-Cit(18) formed the most open protein-lipid complex. The data show a disturbance in lipid-MBP interactions at the ultrastructural level that is related to degree of citrullination, and which may be involved in myelin degeneration in multiple sclerosis.

Topics: Adult; Arginine; Autoimmune Diseases; Citrulline; Cryoelectron Microscopy; G(M1) Ganglioside; Humans; Image Processing, Computer-Assisted; Immunohistochemistry; Macromolecular Substances; Microscopy, Electron, Scanning; Multiple Sclerosis; Myelin Basic Protein; Phosphatidylserines; Protein Isoforms; Protein Processing, Post-Translational

Autoantigen-specific T-lymphocytes are present in patients with autoimmune disease and in normal subjects. Little is currently known about the temporal variation (dynamics) of the immune repertoire of these autoreactive T cells. We analysed the long-term variation of the immune repertoire of T cells specific for myelin basic protein (MBP) in five untreated patients with multiple sclerosis and four normal control subjects over a mean observation period of 6 years. MBP-specific CD4(+) T-cell lines were selected with purified human MBP, and their epitope specificity was mapped with overlapping synthetic peptides. Three distinct patterns of repertoire development were observed. (i) Two patients and three control subjects maintained a broad epitope response with fluctuations over time. (ii) Two patients initially showed a focused response that broadened over the course of 6 years; this finding could be described as intramolecular epitope spreading. (iii) In one patient and one control subject, a strikingly focused response, which was directed to a cluster of nested epitopes in the MBP region 83-102, persisted over time. T-cell receptor Vbeta sequence analysis allowed us to trace individual clones of MBP-specific T cells for up to 7 years in the peripheral circulation in four of the five patients and three of the four controls, suggesting that the long-term persistence of MBP-specific T-cell clones is a common feature of the T-cell repertoire not unique to multiple sclerosis. The persisting MBP-specific T-cell clones were not detectable in the blood of one of the patients by complementarity-determining region (CDR)-3 spectratyping, indicating that their frequency does not exceed 1 in 5000 T cells. The temporal characteristics of the MBP-specific T-cell repertoire described here are relevant to therapeutic strategies targeting autoantigen-specific T cells in multiple sclerosis and other autoimmune diseases.

Topics: Adult; Amino Acid Sequence; Autoantigens; CD4-Positive T-Lymphocytes; Complementarity Determining Regions; Epitopes, T-Lymphocyte; Female; Histocompatibility Testing; Humans; Immunoglobulin Variable Region; Immunologic Memory; Immunophenotyping; Immunotherapy; Male; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein

To investigate the contribution of human leukocyte antigen (HLA) class II molecules in susceptibility to inflammatory demyelination, we induced experimental autoimmune encephalomyelitis (EAE) in transgenic (tg) mice expressing the HLA-DR3, HLA-DQ8 and HLA-DQ6 molecules in the absence of endogenous class II (Ab(o)). Following immunization with mouse myelin, HLA-DR3 tg mice mounted strong T-cell proliferative responses, and developed inflammatory lesions and demyelination in the central nervous system with mild to moderate clinical symptoms of EAE. HLA-DQ8 and HLA-DQ6 tg mice elicited weak T-cell proliferative responses and did not develop clinical symptoms of EAE. HLA-DR3/DQ6 double tg mice immunized with mouse myelin experienced clinical disease similar to the single tg HLA-DR3 tg mice, indicating that expression of DQ6 in this line had no effect on disease. In contrast, HLA-DR3/DQ8 double tg mice developed severe inflammatory lesions and clinical disease in response to immunization with mouse myelin. Our data suggest that in the presence of two susceptible class II alleles, namely HLA-DR3 and DQ8, there is additional selection and expansion of potential autoreactive T cells, resulting in enhanced severity of disease.

Topics: Animals; Central Nervous System; Cytokines; Encephalomyelitis, Autoimmune, Experimental; Genes, MHC Class II; Genetic Predisposition to Disease; HLA-DQ Antigens; HLA-DR3 Antigen; Humans; Lymph Nodes; Mice; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Peptide Fragments; T-Lymphocytes

Two methods prevail at present in producing demyelinated areas in the central nervous system. One uses the detergent-like effect of lysolecithin, the other is based on a cell killing effect of ethidium bromide plus x-irradiation. Unwanted side-effects are inherent in both methods. Based on the fact that myelin basic protein (MBP) kills adult pig oligodendrocytes but almost no astrocytes in vitro, we have used MBP for creating demyelinated areas in the centrum semiovale of the pig brain. These lesions are characterized by a loss of oligodendrocytes and myelin, a preservation of axons and astrocytes, and by the presence of macrophages. Thus, this type of lesion might present an alternative option for studying the fate of transplanted myelinating cells.

Topics: Animals; Apoptosis; Axons; Brain; Cell Culture Techniques; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Oligodendroglia; Swine

T cell responses to myelin basic protein (MBP) are potentially involved in the pathogenesis of multiple sclerosis (MS). In this study, we demonstrated that subcutaneous inoculations with irradiated autologous MBP-reactive T cell clones (T cell vaccination) elicited CD8+ anti-idiotypic T cell responses and CD4+ Th2 cell responses in patients with MS. Both regulatory cell types induced by T cell vaccination contributed to the inhibition of MBP-reactive T cells while they differed in the recognition pattern and functional properties. We describe for the first time that the Th2 regulatory cells reacted with activated but not resting T cells in the context of MHC class II molecules and inhibited the proliferation of MBP-reactive T cells through the secretion of IL-4 and IL-10. The T-T cell interaction mediated by Th2 regulatory cells was independent of the antigen specificity of activated T cells. The findings have important implications for our understanding of the regulatory mechanism induced by T cell vaccination.

Topics: Autoimmunity; Cell Line; Cytokines; Humans; Immunosuppression Therapy; Lymphocyte Activation; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes; Th2 Cells; Vaccination

Topics: Adult; Brain; Functional Laterality; Humans; Magnetic Resonance Imaging; Male; Multiple Sclerosis; Myelin Basic Protein

T cell responses to myelin basic protein (MBP) are potentially involved in the pathogenesis of multiple sclerosis (MS). Immunization with irradiated MBP-reactive T cells (T cell vaccination) induces anti-idiotypic T cell responses that suppress circulating MBP-reactive T cells. This T cell-T cell interaction is thought to involve the recognition of TCR expressed on target T cells. The study was undertaken to define the idiotypic determinants responsible for triggering CD8+ cytotoxic anti-idiotypic T cell responses by T cell vaccination in patients with MS. A panel of 9-mer synthetic TCR peptides corresponding to complementarity-determining region 2 (CDR2) and CDR3 of the immunizing MBP-reactive T cell clones were used to isolate anti-idiotypic T cell lines from immunized MS patients. The resulting TCR-specific T cell lines expressed exclusively the CD8 phenotype and recognized preferentially the CDR3 peptides. CDR3-specific T cell lines were found to lyze specifically autologous immunizing MBP-reactive T cell clones. The findings suggest that CDR3-specific T cells represented anti-idiotypic T cell population induced by T cell vaccination. In contrast, the CDR2 peptides were less immunogenic and contained cryptic determinants as the CDR2-specific T cell lines did not recognize autologous immunizing T cell clones from which the peptide sequence was derived. The study has important implications in our understanding of in vivo idiotypic regulation of autoimmune T cells and the regulatory mechanism underlying T cell vaccination.

Topics: Amino Acid Sequence; Antibodies, Anti-Idiotypic; CD8-Positive T-Lymphocytes; Cell Line; Cell Separation; Clone Cells; Cytotoxicity, Immunologic; Humans; Immunoglobulin Idiotypes; Injections, Subcutaneous; Lymphocyte Activation; Lymphocyte Transfusion; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Receptors, Antigen, T-Cell, alpha-beta; Vaccination

Susceptibility to multiple sclerosis (MS) is associated with the human histocompatibility leukocyte antigen (HLA)-DR2 haplotype, suggesting that major histocompatibility complex class II-restricted presentation of central nervous system-derived antigens is important in the disease process. Antibodies specific for defined HLA-DR2-peptide complexes may therefore be valuable tools for studying antigen presentation in MS. We have used phage display technology to select HLA-DR2-peptide-specific antibodies from HLA-DR2-transgenic mice immunized with HLA-DR2 molecules complexed with an immunodominant myelin basic protein (MBP) peptide (residues 85-99). Detailed characterization of one clone (MK16) demonstrated that both DR2 and the MBP peptide were required for recognition. Furthermore, MK16 labeled intra- and extracellular HLA-DR2-MBP peptide complexes when antigen-presenting cells (APCs) were pulsed with recombinant MBP. In addition, MK16 inhibited interleukin 2 secretion by two transfectants that expressed human MBP-specific T cell receptors. Analysis of the structural requirement for MK16 binding demonstrated that the two major HLA-DR2 anchor residues of MBP 85-99 and the COOH-terminal part of the peptide, in particular residues Val-96, Pro-98, and Arg-99, were important for binding. Based on these results, the antibody was used to determine if the HLA-DR2-MBP peptide complex is presented in MS lesions. The antibody stained APCs in MS lesions, in particular microglia/macrophages but also in some cases hypertrophic astrocytes. Staining of APCs was only observed in MS cases with the HLA-DR2 haplotype but not in cases that carried other haplotypes. These results demonstrate that HLA-DR2 molecules in MS lesions present a myelin-derived self-peptide and suggest that microglia/macrophages rather than astrocytes are the predominant APCs in these lesions.

Topics: Amino Acid Sequence; Animals; Antibodies, Monoclonal; Antibody Specificity; Binding Sites; Cell Line; Drosophila melanogaster; HLA-DR2 Antigen; Humans; Immunodominant Epitopes; Immunohistochemistry; Mice; Mice, Inbred BALB C; Mice, Inbred DBA; Mice, Transgenic; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Recombinant Proteins

Multiple sclerosis (MS) is a demyelinating disease of the central nervous system with a presumed autoimmune pathogenesis involving autoantigen-specific CD4+ T cells and cytokines. A similar frequency of T cells responding to myelin basic protein (MBP), a putative target in MS, has been observed in MS patients and controls. To dissect the differences between MBP-specific T cells in patients and controls, we have analyzed the cytokine secretion profile of such autoreactive T cells. MBP-specific T cell clones (TCC) were isolated from the peripheral blood of MS patients and controls by limiting dilution. Expression of mRNA for interferon-gamma (IFN-gamma), interleukin (IL)-4, IL-10, tumor necrosis factor-alpha (TNF-alpha) and transforming growth factor-beta (TGF-beta) was assessed by polymerase chain reaction whereas secretion of cytokine protein was measured by ELISA. MBP-specific TCC exhibited a heterogeneous cytokine secretion profile with clones displaying Th1, Th2 and Th0 phenotypes. A significant difference in the distribution of the cytokine profile was noted between MS patients and controls. Although the frequency of Th1 secreting MBP-reactive TCC was similar between MS patients and controls, stable MS patients had a significant association with the Th0 phenotype whereas healthy individuals were associated with the Th2 phenotype. In comparison to control TCC, MBP-specific TCC from MS patients secreted increased amounts of IFN-gamma, IL-4 and IL-10 and decreased quantities of TGF-beta. Thus, these studies suggest that there is a dysregulation in the balance between pro-inflammatory Th1 and anti-inflammatory Th2 cytokines in MS. It appears that the presence of Th1 secreting autoreactive T cells in healthy individuals may be counterbalanced by the presence of cells secreting Th2 cytokines and by the augmented production of the immunosuppressive cytokine TGF-beta, whereas in MS there is a decrease in these anti-inflammatory agents.

Topics: Adult; Autoimmunity; Clone Cells; Cytokines; Enzyme-Linked Immunosorbent Assay; Female; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Phenotype; Reference Values; Reverse Transcriptase Polymerase Chain Reaction; RNA, Messenger; T-Lymphocytes; Th1 Cells; Th2 Cells

Multiple sclerosis (MS) is clinically heterogeneous and has an uncertain natural history. A high priority for more effective treatment of MS is an objective and feasible laboratory test for predicting the disease's course and response to treatments. Urinary myelin basic protein (MBP)-like material (MBPLM), so designated because it is immunoreactive as a cryptic epitope in peptide 83-89 of the human MBP molecule of 170 amino acids, is present in normal adults, remains normal in relapsing-remitting, but increases in progressive MS. In the present investigation, MBPLM was purified from urine and characterized. p-Cresol sulfate is the major component of urinary MBPLM. This conclusion is based on the following: (1) MBPLM and p-cresol sulfate both have a mass of 187 on negative scans by electrospray ionization mass spectrometry, the same fragments on tandem mass spectrometry of 80 (SO(-)(3)) and 107 (methylphenol), and similar profiles on multiple reaction monitoring; (2) (1)H and (13)C nuclear magnetic resonance spectroscopy revealed identical spectra for MBPLM and p-cresol sulfate; (3) purified p-cresol sulfate reacted in parallel with MBP peptide 83-89 in the same radioimmunoassay for MBPLM; and (4) p-cresol sulfate has the same behavior on preparative HPLC columns as urinary MBPLM. The unexpected immunochemical degeneracy permitting a cross-reaction between p-cresol sulfate and a peptide of an encephalitogenic myelin protein is postulated to be based on shared conformational features. The mechanisms by which urinary p-cresol sulfate, possibly derived from tyrosine-SO(4), reflects progressive worsening that is disabling in MS are unknown.

Topics: Acetic Acid; Amino Acids; Ammonium Hydroxide; Chromatography, High Pressure Liquid; Cresols; Cross Reactions; Epitopes; Female; Humans; Hydroxides; Isomerism; Magnetic Resonance Spectroscopy; Male; Mass Spectrometry; Middle Aged; Molecular Weight; Multiple Sclerosis; Myelin Basic Protein; Polymers; Radioimmunoassay; Sequence Analysis, Protein; Sulfates; Sulfuric Acid Esters; Tetraethylammonium

Deimination of myelin basic protein (MBP) has been implicated in the chemical pathogenesis of multiple sclerosis (MS). Degradation of bovine MBP by cathepsin D, a myelin-associated protease, was increased when 6 arginyl residues were deiminated and became very rapid when all 18 arginyl residues were deiminated. Since MBP contains a number of modifications, including methylation, phosphorylation, etc., we studied the effect of methylation, an irreversible modification, to determine how this modification affected deimination. Methylation of Arg 106 in bovine MBP (Arg 107 in human), a naturally occurring modification of MBP, has been shown to affect the deimination of arginyl residues in the present study. Since fractionation of MBP into unmethylated, monomethylated, and dimethylated species cannot be done readily on a preparative scale, mass spectrometry with the Q-TOF instrument resolved these species readily since each differed from the other by 14 atomic mass units (amu). Examination of five different hMBP samples, two from normal brain and three from MS brain, revealed that increased deimination of arginyl residues correlated with a decreased methylation of Arg 107 (human sequence). To study this process in vitro, bovine MBP (bMBP) was used. Component 1 (C-1) is the most cationic of the MBP "charge isomers" and the most unmodified, in which all arginyl residues are intact. It was deiminated to various extents with purified bovine brain peptidylarginine deiminase, generating a number of species containing 0-13.7 mol of citrulline/mol of bMBP. Mass spectrometry of each of these species permitted us to determine the influence of methylation of Arg 106 (bovine sequence) on deimination by this enzyme. We found that bMBP with unmethylated arginine was deiminated at a rate of 0.081 mol of citrulline/min, with monomethylarginine, 0.068 mol of citrulline/min, and with dimethylarginine, 0.036 mol of citrulline/min. We suggest that the methylated arginyl residue becomes sequestered in the hydrophobic beta-sheet structure and disrupts the three-dimensional structure of the protein so that other arginyl residues are less accessible to peptidylarginine deiminase.

Topics: Animals; Arginine; Brain; Cathepsin D; Cattle; Citrulline; Humans; Hydrolases; Kinetics; Mass Spectrometry; Methylation; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Protein Processing, Post-Translational; Protein Structure, Secondary; Protein Structure, Tertiary; Protein-Arginine Deiminase Type 4; Protein-Arginine Deiminases

Current pathogenic concepts of inflammatory demyelinating disorders such as multiple sclerosis (MS) are based on the hypothesis that a T cell-mediated autoimmune response is involved in the disease process. One of the primary goals in the in the development of immunotherapies for autoimmune diseases has been to achieve inactivation of disease-inducing lymphocytes either by direct inhibition or suppression through regulatory cells and/or cytokines. The CD26 antigen is identical with the cell surface ectopeptidase dipeptidyl peptidase IV (DP IV, EC 3.4.14.5) which is involved in regulating T cell activation and growth. Activated T cells, including those specific for myelin antigens, express high levels of CD26/DP IV. In vitro, reversible DP IV inhibitors suppress T cell proliferation and pro-inflammatory cytokine production in response to myelin antigens. Further studies will evaluate the role of DP IV inhibition in T cell-mediated inflammatory disease of the central nervous system.

Topics: Animals; Animals, Outbred Strains; Autoimmune Diseases; Dipeptidyl Peptidase 4; Encephalomyelitis, Autoimmune, Experimental; Female; Humans; Lymphocyte Activation; Lysine; Mice; Multiple Sclerosis; Myelin Basic Protein; Pyrrolidines; Rats; Serine Proteinase Inhibitors; T-Lymphocyte Subsets; T-Lymphocytes, Helper-Inducer; Thiazoles

The ectoenzyme dipeptidyl peptidase IV (DP IV; EC 3.4.14.5; CD26) has been shown to play a crucial role in T cell activation. In the present study, we show by flow cytometry and by enzymatic DP IV assay that myelin basic protein (MBP)-specific, CD4+ T cell clones (TCC) derived from patients with multiple sclerosis (MS) express high levels of DP IV/CD26. The enzymatic activity of resting TCC was found to be three to fourfold higher than on resting peripheral blood T cells and close to that of T cells 48 hours after PHA stimulation. The DP IV inhibitors Lys[Z(NO2)]-thiazolidide and Lys[Z(NO2)]-pyrrolidide suppress in a dose-dependent manner DNA synthesis and IFN-gamma, IL-4, and TNF-alpha production of the antigen-stimulated TCC. These data suggest that CD26 plays a role in regulating activation of autoreactive TCC. Further in vivo investigations will clarify, whether the inhibition of the enzymatic activity of DP IV could be a useful tool for therapeutic interventions in MS and/or other autoimmune diseases.

Topics: Autoimmune Diseases; CD4-Positive T-Lymphocytes; Dipeptidyl Peptidase 4; DNA Replication; Flow Cytometry; Humans; Immunodominant Epitopes; Lymphocyte Activation; Lymphokines; Lysine; Multiple Sclerosis; Myelin Basic Protein; Phytohemagglutinins; Pyrrolidines; Serine Proteinase Inhibitors; Thiazoles

IL-12 is a proinflammatory cytokine secreted by dendritic cells in response to microbial Ags and mitogens. IL-12 is thought to contribute to the pathogenesis of autoimmune diseases such as multiple sclerosis (MS). This is based on studies in experimental allergic encephalomyelitis and the demonstration that PBMC IL-12 production correlates with disease progression in MS. IFN-beta-1b is an effective treatment for MS, which is thought to involve in part inhibition of proinflammatory cytokines. In this study we examined the effect of in vitro treatment with IFN-beta-1b, on mitogen-induced IL-12 production in human PBMC and myelin basic protein-specific T cell lines obtained from healthy donors and MS patients. We demonstrate that IFN-beta-1b significantly inhibits inducible IL-12 p40 up to 80% and biologically active IL-12 p70 up to 70% beginning at a dose of 10 IU/ml. This inhibition is IL-10 dependent, as it could be blocked by anti-IL-10 but not anti-IL-4 or control Abs. Thus, endogenously produced IL-10 is a required cofactor for the IFN-beta-1b inhibitory effect on IL-12 to occur. We conclude that IFN-beta-1b has a profound inhibitory effect on PBMC IL-12 production in vitro, and that this effect is IL-10 dependent. These findings are potentially relevant to the therapeutic mechanism of IFN-beta-1b in MS.

Topics: Cell Line; Clone Cells; Epitopes, T-Lymphocyte; Humans; Interferon beta-1a; Interferon beta-1b; Interferon-beta; Interferon-gamma; Interleukin-10; Interleukin-12; Leukocytes, Mononuclear; Lipopolysaccharides; Multiple Sclerosis; Myelin Basic Protein; Staphylococcus aureus

The immunological effects of high-dose methylprednisolone in attacks of multiple sclerosis and acute optic neuritis have only been examined in a few randomized, controlled trials. We studied immunological changes in 50 patients with optic neuritis or multiple sclerosis who underwent lumbar puncture before and 1 week after completing a 15-day course of oral high-dose methylprednisolone treatment. Treatment resulted in a decrease in the concentration of myelin basic protein, a decrease in the serum concentration of immunoglobulin G (IgG) and intrathecal IgG synthesis, an increase in the cerebrospinal fluid concentration of transforming growth factor-beta1, and changes in the expression of CD25, CD26, and human leukocyte antigen-DR (HLA-DR) on CD4 T-cells. No effect was seen on the cerebrospinal fluid leucocyte count or the cerebrospinal fluid activity of matrix metalloproteinase-9 (MMP-9). The lack of a persistent effect on cerebrospinal fluid leucocyte recruitment and MMP-9 activity, despite changes in IgG synthesis, T-cell activation, and cytokine production, suggests that modulation of the function of inflammatory cells may contribute to the clinical efficacy of oral high-dose methylprednisolone treatment in optic neuritis and multiple sclerosis.

Topics: Acute Disease; Administration, Oral; Adult; Anti-Inflammatory Agents; Antigens; CD4-Positive T-Lymphocytes; Dose-Response Relationship, Drug; Female; Flow Cytometry; Humans; Immune System; Immunoglobulin G; Leukocyte Count; Male; Matrix Metalloproteinase 9; Methylprednisolone; Multiple Sclerosis; Myelin Basic Protein; Optic Neuritis; Randomized Controlled Trials as Topic; Spinal Cord; Spinal Puncture; Transforming Growth Factor beta

Deletion of T cells due to apoptosis induction is a regulatory mechanism in the human immune system that may be impaired in autoimmune diseases such as multiple sclerosis (MS). Involvement of the apoptosis-mediating CD95/CD95 ligand system in MS has been demonstrated. Here, we report that (auto)antigen-specific human T cells are not killed in vitro by soluble TNF-related apoptosis-inducing ligand (TRAIL) although expressing death-inducing receptors, TRAIL receptor 1 (TRAIL-R1) and TRAIL-R2. Apoptosis was assessed by caspase activation and DNA fragmentation, receptor expression was detected by RT - PCR and flow cytometry. The (auto)antigen-specific T cells were also resistant to specific TRAIL-R1/TRAIL-R2-directed induction of apoptosis, indicating that coexpression of the truncated TRAIL-R3 and TRAIL-R4 in these T cells is not responsible for the observed resistance. Upon stimulation, levels of death-inducing TRAIL receptors decreased whereas TRAIL was up-regulated on the cell surface. In contrast to CD95, the role of TRAIL receptors in MS might not involve regulation of T cell vulnerability.

Topics: Apoptosis; Apoptosis Regulatory Proteins; Autoantigens; Caspases; CD4-Positive T-Lymphocytes; Cells, Cultured; DNA Fragmentation; fas Receptor; Glioma; GPI-Linked Proteins; Humans; Jurkat Cells; Membrane Glycoproteins; Multiple Sclerosis; Myelin Basic Protein; Receptors, TNF-Related Apoptosis-Inducing Ligand; Receptors, Tumor Necrosis Factor; Receptors, Tumor Necrosis Factor, Member 10c; Recombinant Proteins; T-Lymphocytes; Tetanus Toxoid; TNF-Related Apoptosis-Inducing Ligand; Tumor Cells, Cultured; Tumor Necrosis Factor Decoy Receptors; Tumor Necrosis Factor-alpha

Bone marrow transplantation (BMT) is increasingly used to treat Multiple Sclerosis (MS) a CNS inflammatory disease with elevated CNS and systemic IFNgamma levels. We wished to determine the effect of IFNgamma on BM graft survival in a transgenic mouse model for chronic MS. BM transplantation into transgenic mice which express elevated levels of IFNgamma in the CNS was unsuccessful. By contrast, there was 100% survival of even fully allogeneic, T-depleted transplants to transgenics that over express TNFalpha in the CNS, using the same MBP promoter. IFNgamma was detectable in spleen of irradiated mice but levels were higher in IFNgamma transgenics. BM transplantation into IFNgamma-deficient recipients also had a high failure rate. Transplants of BM from mice lacking expression of IFNgamma-receptor failed, whereas IFNgamma-deficient grafts survived, suggesting that IFNgamma response status of the graft can also positively influence survival. IFNgamma therefore has a dual role in BM transplantation and the outcome will depend on relative levels of cytokine expression.

Topics: Animals; Bone Marrow Transplantation; Central Nervous System; Central Nervous System Diseases; Female; Gene Expression; Graft Rejection; Graft Survival; Inflammation; Interferon gamma Receptor; Interferon-gamma; Mice; Mice, Inbred Strains; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Promoter Regions, Genetic; Receptors, Interferon; Specific Pathogen-Free Organisms; Spleen; Survival Rate; Transgenes; Transplants; Tumor Necrosis Factor-alpha

Experimental allergic encephalomyelitis (EAE), an animal model for multiple sclerosis (MS), is useful for preclinical testing for agents to be considered for treatment for this human demyelinating disease. Microtubules in lymphocytes play an important role in the cascade of human T cell activation, and paclitaxel (PTX), a microtubule stabilizer, can inhibit T cell function. A new formulation of micellar PTX, free of Cremophor and ethanol, was tested for its effect on the induction of EAE in Lewis rats. Adoptive EAE was induced with an encephalitogenic T cell line activated with guinea pig myelin basic protein (GP MBP) peptide 68-88. PTX (10 mg/kg) was administered 24 and 72 h after cell transfer. The clinical signs, fulminating in controls, were completely blocked by PTX, but mild CNS inflammation remained unaltered. A similar dose of PTX, given on days 6 and 8 to animals developing active EAE after immunization with GP MBP peptide 68-88 in complete Freund's adjuvant, greatly reduced the severity of paralysis and delayed the onset of disease by 8-9 days. Marked weight loss and severe toxicity were noted with higher and more prolonged administration. In vitro micellar PTX inhibited activation of encephalitogenic T cells by both specific antigen and mitogen. Lower doses and longer treatment programs may provide effective treatment with acceptable adverse effects with this agent in the treatment of inflammatory demyelinating disease.

Topics: Amino Acid Sequence; Animals; Antigens; Chemistry, Pharmaceutical; Dose-Response Relationship, Drug; Encephalomyelitis, Autoimmune, Experimental; Female; Freund's Adjuvant; Guinea Pigs; Immunization, Passive; Inflammation; Lymphocyte Activation; Micelles; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Paclitaxel; Paralysis; Peptide Fragments; Rats; Rats, Inbred Lew; T-Lymphocytes; Weight Loss

We analyzed the effects of glatiramer acetate (GA) therapy on in vitro proliferative responses and cytokine production by lymphocytes derived from multiple sclerosis patients receiving this therapy. We confirmed that lymphocytes derived from GA naïve patients show a high frequency of response when initially exposed to GA in vitro; this frequency decreased following GA therapy. The frequency of lymphocytes responding to whole MBP stimulation did not change with GA therapy. GA- and MBP-specific T cell lines generated from these patients by repeated cycles of in vitro stimulation did not cross react. Some (23%) whole MBP-reactive T cell lines did cross react with MBP peptide 83-99. The mean levels of interferon (IFN) gamma secretion and the mean ratio of IFN-gamma/IL-5 were lower for GA-reactive cell lines, derived from patients both prior to and during GA therapy, compared to MBP-reactive T cell lines. The proportion of IFN-gamma(+) cells in unfractionated lymphocyte preparations derived from the GA-treated patients did not differ from that found for healthy controls. Our findings indicate that GA-reactive T cell lines derived from GA-treated MS patients continue to show a relative Th2 cytokine bias consistent with a bystander suppressor function. GA treatment is not associated with a cytokine phenotype shift in the total T cell or MBP-reactive T cell populations.

Topics: Adult; Cell Division; Cells, Cultured; Controlled Clinical Trials as Topic; Double-Blind Method; Female; Glatiramer Acetate; Humans; Immunosuppressive Agents; Interferon-gamma; Interleukin-10; Interleukin-5; Lymphocyte Count; Male; Multiple Sclerosis; Myelin Basic Protein; Peptides; T-Lymphocytes; Th2 Cells; Time Factors

We studied intrathecal IgG synthesis and autoantibody-secreting cells in 148 patients with possible onset symptoms of MS (POSMS) or clinically definite MS (CDMS). In POSMS intrathecal synthesis of IgG oligoclonal bands and abnormalities on T2-weighted magnetic resonance imaging were associated but the former were more prevalent. The cerebrospinal fluid (CSF) leukocyte count and the number of anti-protelipid protein antibody-secreting cells in cerebrospinal fluid (CSF) correlated with disease activity in POSMS. Intrathecal IgG synthesis levels and the number of anti-myelin basic protein antibody-secreting cells in CSF correlated with disease activity in CDMS. Our results support recent reports of pathogenetic heterogeneity and a pathogenetic role of the antibody response in MS.

Topics: Adult; Antibody Specificity; Autoantibodies; B-Lymphocytes; Female; Humans; Immunoglobulin G; Leukocyte Count; Magnetic Resonance Imaging; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein

A therapy aimed at blocking the Fas/Fas ligand (FasL) system was investigated using a relapsing form of experimental autoimmune encephalomyelitis (EAE) in mice, an animal model of multiple sclerosis (MS). Intracisternal administration of neutralizing antibody against FasL during the progression phase of EAE significantly reduced the severity of the disease with milder inflammation and myelin breakdown in the central nervous system (CNS). These results raised the possibility that the Fas/FasL system might contribute to tissue destruction in the CNS in the acute phase of EAE and that the intrathecal administration of neutralizing antibody against FasL may be beneficial for suppression of the acute phase of MS.

Topics: Acute Disease; Animals; Antibodies; Central Nervous System; Disease Models, Animal; Disease Progression; DNA Fragmentation; Encephalomyelitis, Autoimmune, Experimental; Fas Ligand Protein; Female; Histocytochemistry; In Situ Nick-End Labeling; Inflammation; Injections, Spinal; Membrane Glycoproteins; Mice; Mice, Inbred Strains; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath

Injection of the rat with guinea pig myelin basic protein (MBP) induces an inflammatory demyelination that leads to development of a condition mimicking human multiple sclerosis (MS), including severe depressions in mobility, coordination, and strength in the affected animal. This model was used to observe and compare the antiinflammatory effects of the intestinal and late migratory phases of infection with Trichinella pseudospiralis on development of MBP-induced, MS-like debilitation in rats. Animal performance was measured in an activity monitor and in a series of physical tests designed to assess animal coordination and strength. Uninfected animals injected with MBP showed declines in mobility, coordination, and strength typical for this model. These changes were similar in rats infected so that the intestinal phase of infection coincided with the peak of MBP-induced debilitation. Rats infected so that the late migratory phase of infection occurred during the period of peak MBP-induced debilitation showed significantly higher performance scores in mobility, coordination and strength compared to the latter 2 groups. These finding demonstrate the potency of the anti-inflammatory effects of elevations in host corticosteroids seen during the migratory phase of infection with T. pseudospiralis.

Topics: Animals; Disease Models, Animal; Guinea Pigs; Male; Multiple Sclerosis; Myelin Basic Protein; Random Allocation; Rats; Rats, Inbred Lew; Single-Blind Method; Trichinellosis

Multiple sclerosis (MS) is believed to be an autoimmune disease in which autoreactive T cells infiltrate the central nervous system (CNS). Animal models of MS have shown that CNS-specific T cells are present in the peripheral T cell repertoire of healthy mice and cause autoimmune disease only when they are activated by immunization. T cell entry into the CNS is thought to require some form of peripheral activation because the blood-brain barrier prohibits trafficking of this tissue by naive cells. We report here that naive T cells can traffic to the CNS without prior activation. Comparable numbers of T cells are found in the CNS of both healthy recombinase activating gene (Rag)(-/)- T cell receptor (TCR) transgenic mice and nontransgenic mice even when the transgenic TCR is specific for a CNS antigen. Transgenic T cells isolated from the CNS that are specific for non-CNS antigens are phenotypically naive and proliferate robustly to antigenic stimulation in vitro. Strikingly, transgenic T cells isolated from the CNS that are specific for myelin basic protein (MBP) are also primarily phenotypically naive but are unresponsive to antigenic stimulation in vitro. Mononuclear cells from the CNS of MBP TCR transgenic but not nontransgenic mice can suppress the response of peripheral MBP-specific T cells in vitro. These results indicate that naive MBP-specific T cells can traffic to the CNS but do not trigger autoimmunity because they undergo tolerance induction in situ.

Topics: Animals; Central Nervous System; Crosses, Genetic; Genes, RAG-1; Homeodomain Proteins; Immune Tolerance; Mice; Mice, Inbred C57BL; Mice, Knockout; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell; T-Lymphocytes

Peroxynitrite (ONOO(-)), the product of nitric oxide (NO(radical)) and superoxide (O(2)(-radical)), is believed to be a major contributor to immunotoxicity when produced by activated cells expressing inducible nitric oxide synthase (iNOS). Uric acid (UA) is a natural scavenger of ONOO(-) that is present at high levels in the sera of humans and other higher order primates relative to most lower mammals. We have previously shown that UA treatment is therapeutic in experimental allergic encephalomyelitis (EAE), a rodent model of multiple sclerosis (MS). In this study we have examined the effect of UA therapy on the dynamics of the appearance of iNOS-positive cells in central nervous system (CNS) tissue of mice subjected to the stimuli that cause EAE. The results indicate that UA prevents activated monocytes from entering CNS tissue where they may contribute to the pathogenesis of MS and other CNS diseases.

Topics: Animals; Blood-Brain Barrier; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Female; Free Radicals; Gene Expression Regulation, Enzymologic; Immunization; Lipid Peroxidation; Mice; Mice, Inbred Strains; Monocytes; Multiple Sclerosis; Myelin Basic Protein; Nitrates; Nitric Oxide Synthase; Nitric Oxide Synthase Type II; RNA, Messenger; Uric Acid

Topics: Clinical Trials as Topic; Dose-Response Relationship, Drug; Humans; Immunotherapy; Ligands; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Th1 Cells; Th2 Cells

Multiple sclerosis is a disease of discrete phenotypes in different individuals. Animal models have been useful in identifying self-antigens that become the focus of autoimmune attack and genetic loci that control susceptibility to disease. We have previously demonstrated a role for Fas-dependent pathogenesis in the induction of EAE in B10.PL mice immunized with MBP. Others have indicated a Fas-independent mechanism predominates in SJL mice immunized with PLP. Here we compare the response of (B10.PLxSJL)F1 and parental mice under similar conditions for induction of EAE. The results indicate that immunodominance and dominant pathogenic mechanisms are both under genetic control, but can be inherited independently. The data also indicate that the dominant pathogenic mechanism can change during the course of disease in an individual. Elucidation of the genetic elements controlling pathogenesis during the course of disease would provide important information in designing therapeutic strategies for individuals in a heterogeneous patient population.

Topics: Animals; Disease Models, Animal; Disease Progression; Encephalomyelitis, Autoimmune, Experimental; fas Receptor; Gene Expression; Genetic Heterogeneity; Guinea Pigs; Immunization; Mice; Mice, Congenic; Mice, Mutant Strains; Multiple Sclerosis; Myelin Basic Protein; Phenotype; Spinal Cord

A case with stable multiple sclerosis (MS) and T cell responses which initially focused on peptide 16-38 of myelin basic protein (MBP) allowed us to investigate the dynamics of the MBP-specific T cell repertoire and its relationship with disease progression. Epitope mapping experiments and T cell receptor usage of MBP-reactive T cell lines (obtained at four distinct time points over a 7-year period) showed a spreading of the response. Transient expansions and persistence of T cells recognizing different MBP epitopes were also detected. The patient's expanded disability status scale and magnetic resonance imaging lesion load remained stable. Our case shows both persistent self-recognitions and determinant spreading in stable MS. This finding suggests that the relationship between dynamics of self-recognition and disease progression is highly complex.

Topics: Adult; Amino Acid Sequence; Antibody Specificity; Disease Progression; Epitope Mapping; Epitopes, T-Lymphocyte; Female; Humans; Longitudinal Studies; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes

Topics: Administration, Oral; Antigens; Autoimmune Diseases; Diabetes Mellitus; Humans; Immune Tolerance; Insulin; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell

We assessed the immune response induced in multiple sclerosis (MS) patients who had received NBI-5788, an altered peptide ligand (APL) designed from an immunodominant region (83-99) of the neuroantigen myelin basic protein (MBP) (5, 10, or 20 mg subcutaneously weekly for 4 weeks). The mean frequency of NBI-5788-responsive T cells (stimulation index > 3) in MS patients treated with the APL was 35.8 +/- 12.8% (n = 7) compared with a mean frequency of 6.2 +/- 1.3% (n = 7) for the untreated patients. The mean frequency of whole MBP-responsive T cells in MS patients treated with the APL was not significantly different from that of untreated patients (16.4 +/- 5.7% vs 18.0 +/- 6.3%, respectively). NBI-5788-reactive T-cell lines generated from NBI-5788-treated patients exhibited an increased frequency of cross-reactivity with MBP peptide 83-99 compared with NBI-5788-reactive lines from control MS patients. Cytokine secretion by APL-reactive T-cell lines from NBI-5788-treated MS patients was more frequently T-helper 2-like compared with T-cell lines from untreated MS patients. These results demonstrate that subcutaneous administration of a soluble APL based on the MBP peptide 83-99 in MS patients can induce an APL-reactive immune response in which T lymphocytes cross-reactive with the immunodominant neuroantigen MBP secrete anti-inflammatory cytokines. The significant heterogeneity in immune response between individuals indicates the need for clinical laboratory correlation during the course of therapeutic trials.

Topics: Adult; Antibody Specificity; Cytokines; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; T-Lymphocytes, Helper-Inducer

Susceptibility to multiple sclerosis (MS) is associated with certain MHC class II haplotypes, in particular HLA-DR2. Two DR beta chains, DRB1*1501 and DRB5*0101, are co-expressed in the HLA-DR2 haplotype, resulting in the formation of two functional cell surface heterodimers, HLA-DR2a (DRA*0101, DRB5*0101) and HLA-DR2b (DRA*0101, DRB1*1501). Both isotypes can present an immunodominant peptide of myelin basic protein (MBP 84-102) to MBP-specific T cells from MS patients. We have determined the crystal structure of HLA-DR2a complexed with MBP 86-105 to 1.9 A resolution. A comparison of this structure with that of HLA-DR2b complexed with MBP 85-99, reported previously, reveals that the peptide register is shifted by three residues, such that the MBP peptide is bound in strikingly different conformations by the two MHC molecules. This shift in binding register is attributable to a large P1 pocket in DR2a, which accommodates Phe92, in conjunction with a relatively shallow P4 pocket, which is occupied by Ile95. In DR2b, by contrast, the small P1 pocket accommodates Val89, while the deep P4 pocket is filled by Phe92. In both complexes, however, the C-terminal half of the peptide is positioned higher in the binding groove than in other MHC class II/peptide structures. As a result of the register shift, different side-chains of the MBP peptide are displayed for interaction with T cell receptors in the DR2a and DR2b complexes. These results demonstrate that MHC molecules can impose different alignments and conformations on the same bound peptide as a consequence of topological differences in their peptide-binding sites, thereby creating distinct T cell epitopes.

Topics: Alleles; Amino Acid Sequence; Binding Sites; Crystallography, X-Ray; HLA-DR2 Antigen; Humans; Immunodominant Epitopes; Models, Molecular; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Protein Conformation; Protein Subunits; Receptors, Antigen, T-Cell; Sequence Alignment

Multiple sclerosis (MS) is a common and severe neurological disorder associated with an autoimmune response directed against myelin components within the CNS. Lymphocyte activation, extravasation, and recruitment, as well as effector function, involves the turning on and off of a number of genes, thus triggering specific transcriptional pathways. The characterization of the transcriptome in MS lesions should provide a better understanding of the mechanisms that generate and sustain the pathogenic immune response in this disease. Here we performed transcriptional profiling of 56 relevant genes in brain specimens from eight MS patients and eight normal controls by kinetic RT-PCR. Results showed a high transcriptional activity for the gene coding for myelin basic protein (MBP); however, it was not differentially expressed in MS samples, suggesting that remyelination is an active process also in the noninflammatory brain. CD4 and HLA-DRalpha transcripts were dramatically increased in MS as compared with controls. This reveals a robust MHC class II up-regulation and suggests that Ag is being presented locally to activated T cells. Although analysis of cytokine and cytokine receptor genes expression showed predominantly increased levels of several Th1 molecules (TGF-ss, RANTES, and macrophage-inflammatory protein (MIP)-1alpha) in MS samples, some Th2 genes (IL-3, IL-5, and IL-6/IL-6R) were found to be up-regulated as well. Similarly, both proinflammatory type (CCR1, CCR5) and immunomodulatory type (CCR4, CCR8) chemokine receptors were differentially expressed in the MS brain. Overall, our data suggest a complex regulation of the inflammatory response in human autoimmune demyelination.

Topics: Algorithms; Brain; CD8 Antigens; Cluster Analysis; Cytokines; Gene Expression Profiling; HLA-DR Antigens; Humans; Kinetics; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell; Reverse Transcriptase Polymerase Chain Reaction; Th2 Cells; Transcription, Genetic; Up-Regulation

Multiple sclerosis (MS) is a demyelinating disease of presumed T cell autoimmunity against self myelin. We hypothesized that if myelin-reactive T cells are associated with the disease processes, they may undergo activation and expansion during acute exacerbation. In this study, we examined the precursor frequency, epitope recognition and cytokine profile of myelin-reactive T cells in 14 relapsing/remitting MS patients during exacerbation and remission. The study revealed that T cells recognizing the immunodominant peptides of candidate myelin antigens, including myelin basic protein (MBP), proteolipid protein and myelin oligodendrocyte glycoprotein, occurred at increased precursor frequency during acute exacerbation. The T cell responses to MBP focused on the immunodominant regions (residues 83-99 and 151-170) during exacerbation and shifted toward other epitopes of MBP at the time of remission. Furthermore, there was a marked increase in the production of T(h)1 cytokines among T cell lines obtained during exacerbation compared to those obtained during remission. The study demonstrated that myelin-reactive T cells underwent selective activation and expansion during acute MS exacerbation. In contrast, myelin-reactive T cells found during remission in the same patients generally resembled those identified in healthy controls with some discrepancies. The findings suggest potential association of aberrant myelin-reactive T cell responses with acute exacerbation in MS, which may reflect transient activation of myelin-reactive T cell populations of pathogenic potential.

Topics: Adult; Aged; Cells, Cultured; Cytokines; Epitopes; Erythroid Precursor Cells; Female; Humans; Lymphocyte Count; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Remission, Spontaneous; T-Lymphocytes; Th1 Cells

The T helper-1 (Th-1)/T helper-2 (Th-2) paradigm is relevant for the pathogenesis and therapy of multiple sclerosis. In experimental autoimmune encephalomyelitis, a shift towards a Th-2 immune response serves as treatment of the disease. In the human immune system, the factors which determine and modulate the differentiation of CD4+ T cells into the Th-1 or Th-2 phenotype have yet to be elucidated completely. Here, the split-well approach was used to analyse costimulatory requirements for the generation of myelin basic protein-specific T-cell subsets considered to play a major role in the pathogenesis of multiple sclerosis. Myelin basic protein-specific T-cell lines were isolated from peripheral blood cells of healthy individuals in the presence or absence of a blockade of the costimulatory molecule B7-1, previously reported to be involved in the development of Th-1 cells. T-helper type was determined by the interferon/interleukin ratio. Blockade of B7-1 did not increase the number of Th-2-like myelin basic protein-specific T-cell lines. Thus, these data show no evidence for an influence of B7-1 blockade on the development of human myelin basic protein-specific T-cell subsets. These results have to be taken into account when discussing whether antibody-mediated B7-1 blockade might be a suitable therapy in multiple sclerosis, as demonstrated in experimental autoimmune encephalomyelitis.

Topics: Adjuvants, Immunologic; B7-1 Antigen; Cell Line; Humans; Multiple Sclerosis; Myelin Basic Protein; Th1 Cells; Th2 Cells

Immunization with irradiated autoreactive T cells (T cell vaccination) induces anti-idiotypic T cell responses that preferentially recognize complementarity-determining region 3 sequences, contributing to clonal depletion of autoreactive T cells. However, it remains unknown whether T cell vaccination elicits anti-idiotypic humoral responses and whether the anti-idiotypic Abs play a similar role in the regulatory mechanism induced by T cell vaccination. In this study we examined the occurrence, the reactivity pattern, and the regulatory role of anti-idiotypic Abs elicited by T cell vaccination in patients with multiple sclerosis. We demonstrated for the first time that B cells producing anti-idiotypic Abs could be isolated from vaccinated patients. These EBV-transformed B cell lines were selected for specific reactivity to a 20-mer TCR peptide incorporating a common complementarity-determining region 3 sequence of the immunizing T cell clones. The resulting anti-idiotypic Abs were found to react with the original immunizing T cell clones and exhibit an inhibitory effect on their proliferation. The findings suggest that anti-idiotypic Ab responses can be induced by T cell vaccination in humans and that their regulatory properties are likely to contribute to the suppression of myelin basic protein-reactive T cells in vaccinated patients. The study has important implications in our understanding of the regulatory role of the anti-idiotypic humoral responses induced by T cell vaccination.

Topics: Adoptive Transfer; Amino Acid Sequence; Antibodies, Anti-Idiotypic; Antibody Formation; Antibody Specificity; Antigen-Antibody Reactions; B-Lymphocytes; Binding Sites, Antibody; Cell Line, Transformed; Clone Cells; Humans; Injections, Subcutaneous; Lymphocyte Activation; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Receptors, Antigen, T-Cell, alpha-beta; T-Lymphocytes; Vaccination

The myelin basic protein (MBP) gene is a candidate locus for susceptibility to multiple sclerosis. Several groups have tested a complex (TGGA)n repeat in the 5' region of this gene for association/linkage with multiple sclerosis, with divergent results. This region of tandem repetitive sequence has been subjected to complex rearrangements, and there is a possibility that alleles of the same size have different internal structures, which reduces the interest of this marker for linkage disequilibrium studies and may at least partly explain the conflicting results obtained so far. To overcome this problem, we isolated a new polymorphic (CA)n repeat within the Golli-MBP locus. The limited number of alleles identified makes this other marker suitable for transmission disequilibrium studies. We tested this marker for linkage with multiple sclerosis, using the transmission-disequilibrium test (TDT) on a sample of 196 nuclear families in which the genotypes of both parents could be unambiguously defined. We found no evidence of transmission disequilibrium between multiple sclerosis and any of the three alleles of this marker, even when the patients were subdivided according to their HLA-DRB1*1501 status. The present data thus provide no evidence for a contribution of the MBP gene to multiple sclerosis susceptibility in French patients.

Topics: Base Sequence; France; Humans; Linkage Disequilibrium; Microsatellite Repeats; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein

The encephalitogenic epitope P81-100 from mouse myelin basic protein was used to generate two simplified derivatives with glycine substitutions in alternating positions which were tested for their biological activity in a murine model of multiple sclerosis, experimental autoimmune encephalomyelitis. While both derivatives were unable to induce in mice the disease at the same parent peptide P81-100 dosage, T cell proliferation assays demonstrated their ability to compete with the parental peptide in a dose related manner. Experiments of cell surface binding and T cell tolerance revealed a different behavior of the two derivatives, suggesting different roles in the MHC blockade or T cell tolerance. On induction of encephalomyelitis in animals by P81-100 treatment, one variant proved in vivo to be very effective in protecting from the disease.

Topics: Animals; Antigenic Variation; Encephalomyelitis, Autoimmune, Experimental; Epitopes; Glycine; Histocompatibility Antigens; Immune Tolerance; Immunotherapy; Lymphocyte Activation; Mice; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; T-Lymphocytes

The synthetic random amino acid copolymer Copolymer 1 (Cop 1, Copaxone, glatiramer acetate) suppresses experimental autoimmune encephalomyelitis, slows the progression of disability, and reduces relapse rate in multiple sclerosis (MS). Cop 1 binds to various class II major histocompatibility complex (MHC) molecules and inhibits the T cell responses to several myelin antigens. In this study we attempted to find out whether, in addition to MHC blocking, Cop 1, which is immunologically cross-reactive with myelin basic protein (MBP), inhibits the response to this autoantigen by T cell receptor (TCR) antagonism. Two experimental systems, "prepulse assay" and "split APC assay," were used to discriminate between competition for MHC molecules and TCR antagonism. The results in both systems using T cell lines/clones from mouse and human origin indicated that Cop 1 is a TCR antagonist of the 82-100 epitope of MBP. In contrast to the broad specificity of the MHC blocking induced by Cop 1, its TCR antagonistic activity was restricted to the 82-100 determinant of MBP and could not be demonstrated for proteolipid protein peptide or even for other MBP epitopes. Yet, it was shown for all the MBP 82-100-specific T cell lines/clones tested that were derived from mice as well as from an MS patient. The ability of Cop 1 to act as altered peptide and induce TCR antagonistic effect on the MBP p82-100 immunodominant determinant response elucidates further the mechanism of Cop 1 therapeutic activity in experimental autoimmune encephalomyelitis and MS.

Topics: Animals; Antigen-Presenting Cells; Cell Division; Clone Cells; Encephalomyelitis, Autoimmune, Experimental; Epitopes; Female; Glatiramer Acetate; Humans; Major Histocompatibility Complex; Mice; Mice, Inbred Strains; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Peptides; Receptors, Antigen, T-Cell; T-Lymphocytes

Myelin antigen-reactive T cells have been implicated in the pathogenesis of multiple sclerosis (MS). Myelin-reactive T cells can be isolated from control subjects as well as individuals who have MS. Experimental models of MS indicate that recently stimulated, myelin-reactive T cells have greater encephalitogenic potential than resting T cells. Activation induces changes in T-cell surface antigens that may distinguish previously stimulated, memory T cells from naive T cells. Therefore, we examined 108 myelin basic protein (MBP)-reactive T-cell lines from 7 MS and 8 control subjects to determine whether MBP-reactive T cells originated in the memory T-cell subset or in the naive subset. Isotypes of CD45 were used that designate memory or naive T cells. In subjects having MS, 84% of the MBP-reactive T cells resided in the memory T-cell subset. However, in control subjects, only 13% of MBP-specific T cells originated from the memory T-cell subset. This result suggests that a substantial proportion of MBP-reactive T cells from some individuals with MS have been previously activated in vivo. This difference provides additional support for the hypothesis that myelin antigen-specific T cells are involved in the pathogenesis of MS.

Topics: Adult; Aged; Cell Compartmentation; Female; Humans; Immunologic Memory; Interferon-gamma; Interleukin-4; Leukocyte Common Antigens; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocyte Subsets

Although clonal expansion of autoimmune T cells has been reported in multiple sclerosis (MS), very limited information is available on specificities, clonal size, or activation state of the expanded clones. Here we address the issue of clonal expansion by using a novel technique demonstrating clonotypes defined by single-strand conformation polymorphism of TCR beta-chain cDNAs. Examination of activated T cells (CD3+CD25+) isolated from the peripheral blood of MS revealed limited numbers (20 approximately 82) of expanded clones defined by single-strand conformation polymorphism clonotype. To estimate the Ag specificities of dominant clonotypes in the activated T cells, these samples were examined in parallel with Th1 T cell clones specific for myelin basic protein or proteolipid protein (PLP) derived from the same patients. Analysis of two patients demonstrated that the dominant clonotypes would contain those specific for myelin basic protein or PLP. Although the majority of the clonotypes could be detected only transiently, a PLP95-116-specific clonotype was found to persist for over 1 yr. Thus, single-strand conformation polymorphism clonotype analysis allows us to monitor the kinetics of given T cell clones in vivo and could provide useful information for designing clonotype (Id)-specific manipulation of human diseases such as MS.

Topics: Adult; Amino Acid Sequence; Autoantigens; Autoimmune Diseases; Base Sequence; CD3 Complex; CD4-Positive T-Lymphocytes; Clone Cells; DNA Primers; Female; Humans; Lymphocyte Activation; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Polymorphism, Single-Stranded Conformational; Receptors, Antigen, T-Cell, alpha-beta; Receptors, Interleukin-2; T-Lymphocyte Subsets

Definition of the immune process that causes demyelination in multiple sclerosis is essential to determine the feasibility of Ag-directed immunotherapy. Using the nonhuman primate, Callithrix jacchus jacchus (common marmoset), we show that immunization with myelin basic protein and proteolipid protein determinants results in clinical disease with significant demyelination. Demyelination was associated with spreading to myelin oligodendrocyte glycoprotein (MOG) determinants that generated anti-MOG serum Abs and Ig deposition in central nervous system white matter lesions. These data associate intermolecular "determinant spreading" with clinical autoimmune disease in primates and raise important issues for the pathogenesis and treatment of multiple sclerosis.

Topics: Adjuvants, Immunologic; Animals; Autoantibodies; Callithrix; Demyelinating Diseases; Disease Models, Animal; Epitopes; Injections, Intradermal; Longitudinal Studies; Magnetic Resonance Imaging; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Oligodendroglia; Recombinant Fusion Proteins

Brain-derived neurotrophic factor (BDNF) has potent effects on neuronal survival and plasticity during development and after injury. In the nervous system, neurons are considered the major cellular source of BDNF. We demonstrate here that in addition, activated human T cells, B cells, and monocytes secrete bioactive BDNF in vitro. Notably, in T helper (Th)1- and Th2-type CD4(+) T cell lines specific for myelin autoantigens such as myelin basic protein or myelin oligodendrocyte glycoprotein, BDNF production is increased upon antigen stimulation. The BDNF secreted by immune cells is bioactive, as it supports neuronal survival in vitro. Using anti-BDNF monoclonal antibody and polyclonal antiserum, BDNF immunoreactivity is demonstrable in inflammatory infiltrates in the brain of patients with acute disseminated encephalitis and multiple sclerosis. The results raise the possibility that in the nervous system, inflammatory infiltrates have a neuroprotective effect, which may limit the success of nonselective immunotherapies.

Topics: Autoantigens; B-Lymphocytes; Brain Diseases; Brain-Derived Neurotrophic Factor; Encephalitis; Glycoproteins; Humans; Inflammation; Lymphocyte Activation; Monocytes; Multiple Sclerosis; Myelin Basic Protein; Neurodegenerative Diseases; Oligodendroglia; RNA, Messenger; T-Lymphocytes; Transcription, Genetic

Regulatory sequences used in plasmids for naked DNA vaccination can modulate cytokine production in vivo. We demonstrate here that injection of plasmid DNA can suppress the prototypic T cell-mediated autoimmune disease, experimental autoimmune encephalomyelitis, by inducing IFN-gamma.

Topics: Animals; Autoimmune Diseases; Encephalomyelitis; Female; Interferon-gamma; Lymph Nodes; Multiple Sclerosis; Myelin Basic Protein; Plasmids; Rats; Rats, Inbred Lew; Spleen; Vaccines, DNA

Topics: Animals; Antigenic Variation; Antigens, Viral; Autoantigens; Autoimmune Diseases; Autoimmunity; Chronic Disease; Disease Models, Animal; Disease Progression; Encephalomyelitis, Autoimmune, Experimental; Epitopes; Humans; Immunity, Cellular; Immunization; Lymphocyte Subsets; Mice; Models, Immunological; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Self Tolerance

Experimental autoimmune encephalomyelitis (EAE) is a widely used animal model for multiple sclerosis (MS). EAE is typically initiated by CD4(+) T helper cell type 1 (Th1) autoreactivity directed against a single priming immunodominant myelin peptide determinant. Recent studies have shown that clinical progression of EAE involves the accumulation of neo-autoreactivity, commonly referred to as epitope spreading, directed against peptide determinants not involved in the priming process. This study directly addresses the relative roles of primary autoreactivity and secondary epitope spreading in the progression of both EAE and MS. To this end we serially evaluated the development of several epitope-spreading cascades in SWXJ mice primed with distinctly different encephalitogenic determinants of myelin proteolipid protein. In a series of analogous experiments, we examined the development of epitope spreading in patients with isolated monosymptomatic demyelinating syndrome as their disease progressed to clinically definite MS. Our results indicate that in both EAE and MS, primary proliferative autoreactivity associated with onset of clinical disease invariably regresses with time and is often undetectable during periods of disease progression. In contrast, the emergence of sustained secondary autoreactivity to spreading determinants is consistently associated with disease progression in both EAE and MS. Our results indicate that chronic progression of EAE and MS involves a shifting of autoreactivity from primary initiating self-determinants to defined cascades of secondary determinants that sustain the self-recognition process during disease progression.

Topics: Acute Disease; Adult; Animals; Antigenic Variation; Autoantigens; Autoimmune Diseases; Autoimmunity; Brain; Chronic Disease; Disease Models, Animal; Disease Progression; Encephalomyelitis, Autoimmune, Experimental; Epitopes; Female; Humans; Immunity, Cellular; Immunization; Immunodominant Epitopes; Male; Mice; Models, Immunological; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Peptide Fragments; Self Tolerance; Spinal Cord; Spleen; Th1 Cells

To evaluate the use of estriol in the treatment of experimental autoimmune encephalomyelitis (EAE) and other cell mediated autoimmune diseases.. Experimental autoimmune encephalomyelitis is a T helper 1 (Th1)-mediated autoimmune demyelinating disease that is a useful model for the study of immune responses in MS. Interestingly, both EAE and MS have been shown to be ameliorated during late pregnancy.. Estriol, progesterone, and placebo pellets were implanted in mice during the effector phase of adoptive EAE. Disease scores were compared between treatment groups, and autoantigen-specific humoral and cellular responses were examined.. Estriol treatment reduced the severity of EAE significantly compared with placebo treatment whereas progesterone treatment had no effect. Estriol doses that induced serum estriol levels that approximated estriol levels during late pregnancy were capable of ameliorating disease. Estriol-treated EAE mice had significantly higher levels of serum antibodies of the immunoglobulin (Ig) G1 isotype specific for the autoantigen myelin basic protein (MBP). Further, MBP-specific T-lymphocyte responses from estriol-treated EAE mice were characterized by significantly increased production of the Th2 cytokine interleukin 10 (IL-10). T lymphocytes were shown to be the primary source of IL-10 within antigen-stimulated splenocyte populations.. Estriol as a hormone involved in immune changes during pregnancy may provide a basis for the novel therapeutic use of estriol for MS and other putative Th1-mediated autoimmune diseases that improve during late pregnancy.

Topics: Animals; Autoimmune Diseases; Brain; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Estriol; Female; Interleukin-10; Male; Mice; Multiple Sclerosis; Myelin Basic Protein; Pregnancy; Th1 Cells

Multiple sclerosis (MS) is a demyelinating disorder of the central nervous system of unknown etiology. Immune mechanisms involving the proinflammatory cytokine gamma interferon (IFN-gamma) are believed to play an important role in the pathogenesis of MS. IFN-beta-1b has been introduced as a treatment for MS and was found to reduce the number and severity of clinical exacerbations. To examine the influence of IFN-beta-1b on myelin basic protein (MBP)-specific and phytohemagglutinin-induced IFN-gamma production, we developed a cell-released capturing enzyme-linked immunosorbent assay (CRC-ELISA), which rapidly measures spontaneous and antigen- or mitogen-induced cellular IFN-gamma production. CRC-ELISA documented a significant MBP-specific T-cell response in the blood of untreated MS patients, as assessed by IFN-gamma production. This response was suppressed in MS patients treated with IFN-beta-1b. The present work confirms in vivo the in vitro suppressive effects of IFN-beta-1b on IFN-gamma production in MS. Moreover, it provides a powerful new technique for detection of cytokines.

Topics: Adult; Aged; Enzyme-Linked Immunosorbent Assay; Female; Humans; Interferon beta-1a; Interferon beta-1b; Interferon-beta; Interferon-gamma; Lymphocyte Activation; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Phytohemagglutinins; T-Lymphocytes

The cytokine interleukin (IL)-10 has immune response down-regulatory properties, which include suppression of the synthesis of pro-inflammatory cytokines such as interferon (IFN)-gamma and of major histocompatibility complex (MHC) class II expression on monocytes. To further elucidate the involvement of IL-10 in multiple sclerosis (MS), an enzyme-linked immunospot assay was adopted to enumerate IL-10-secreting mononuclear cells (MNC) in peripheral blood. IFN-gamma secreting MNC were detected in parallel. Levels of IL-10-secreting cells were lower in patients with MS compared with other neurological diseases (OND) and healthy subjects. This difference was seen only in patients with untreated MS, and not in those undergoing treatment with IFN-beta-1b. No differences were observed when subgrouping the patients with MS regarding clinical phase (exacerbation, remission, secondary progression), duration of MS or disability status. Levels of IFN-gamma-secreting blood MNC did not differ in patients with MS, irrespective of treatment with IFN-beta-1b, compared with OND and healthy subjects. Patients with MS, but not the two groups of controls, had elevated numbers of IL-10- and IFN-gamma-secreting cells upon stimulation with MBP compared with culture in the absence of antigen. The data suggest that IL-10 is decreased in MS and that treatment resulting in its up-regulation beneficially influence the disease.

Topics: Adult; Aged; Cells, Cultured; Female; Humans; Interferon beta-1a; Interferon beta-1b; Interferon-beta; Interferon-gamma; Interleukin-10; Leukocytes, Mononuclear; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Recombinant Proteins

Multiple sclerosis (MS) is an autoimmune disease in which the myelin sheath of the central nervous system is degraded, and the 18.5 kDa isoform of myelin basic protein (MBP) is reduced in cationicity. In a unique case of acute, fulminating MS (Marburg's variant), MBP is considerably less cationic than MBP from both normal, and chronic MS-afflicted individuals. This electron microscopical study has identified that, in vitro, the less cationic Marburg MBP isomer forms a more extended protein-lipid complex than MBP from healthy or chronic MS-afflicted individuals. This correlation implies that chemical modifications to MBP in vivo contribute directly to the structural instability of myelin, and subsequent autoantigenic presentation of this protein, observed in vivo in MS.

Topics: Acute Disease; Autoantigens; Citrulline; Humans; Image Processing, Computer-Assisted; Microscopy, Electron; Microscopy, Electron, Scanning Transmission; Multiple Sclerosis; Myelin Basic Protein; Protein Conformation; Protein Isoforms

We selected two multiple sclerosis (MS) patients, compatible for HLA-DR2 subtype, and differing for HLA-DM haplotype as well as for the myelin basic protein (MBP) epitope recognized by the vast majority of their T cell lines (TCL) (residues 16-38 and 86-99, respectively). TCL sharing the same restriction element were re-assayed in the presence of reciprocally mismatched antigen-presenting cells (APC). The TCL recognized both the whole MBP and the relevant peptide also in the presence of non-autologous APC, (compatibility for processing, despite a difference in the DM haplotype). The same protocol, performed in serum-free pulsing experiments or in the presence of 'fixed' APC, excluded extracellular processing or mutual T cell presentation, and confirmed the need for MBP processing in our system. The finding, that only TCL recognizing MBP peptide 16-38 (a region not previously related to the DR2 haplotype) used a novel Vbeta, supports the importance of the TCR repertoire over the processing-presentation machinery in the selection of MBP epitopes in MS.

Topics: Antigen-Presenting Cells; Antigens; Cell Line; Epitopes; Humans; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Receptors, Antigen, T-Cell; Receptors, Antigen, T-Cell, alpha-beta; T-Lymphocytes

T cell responses to myelin basic protein (MBP) may play an important role in the pathogenesis of multiple sclerosis (MS). If MBP-reactive T cells are involved in the disease processes and undergo clonal activation and expansion, their precursor frequency would be increased in patients with MS. The frequency of MBP-reactive T cells is also influenced by regulatory mechanisms in vivo, including apoptotic deletion. In this study, we examined changes in the frequency of MBP-reactive T cells in patients with MS as a function of the apoptotic deletional mechanism in vivo, using a cell culture-based assay. A significantly increased frequency of MBP-reactive T cells was found in patients with MS relative to healthy individuals only when Fas-ligand antibody was used to block apoptosis. This result indicates that a significant proportion of MBP-reactive T cells are sensitive to apoptosis and are not deleted in vivo in patients with MS, as opposed to healthy individuals, thus suggesting a functional deficit in apoptotic deletional mechanism. Surviving Fas-sensitive MBP-reactive T cell lines represent distinct subpopulations preferentially recognizing the 111-139 region of MBP and exhibiting a Th2 cytokine profile. The findings are relevant to our understanding of regulation of MBP-reactive T cells in vivo in MS.

Topics: Antibodies, Monoclonal; Apoptosis; Cell Line; Cytokines; Fas Ligand Protein; fas Receptor; Humans; Membrane Glycoproteins; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes

Lactobacillus strains possess properties that make them attractive candidates as vehicles for oral administration of therapeutics. In this report we describe the construction and analysis of recombinant Lactobacillus casei applicable in oral vaccination against an infectious disease (tetanus) and in oral tolerance induction for intervention in an autoimmune disease, multiple sclerosis. Recombinant L. casei which express surface-anchored tetanus toxin fragment C (TTFC) were generated. Quantitative analysis by flow cytometry demonstrated a high level of cell wall-bound expression of TTFC and immunogenicity was demonstrated by parenteral immunization with whole cell extracts of the recombinants. A series of expression vectors was constructed to secrete human myelin basic protein (hMBP) or hMBP as a fusion protein with beta-glucuronidase from Escherichia coli. These heterologous products produced by L. casei were detected in the growth medium and parenteral immunization with this medium evoked antibodies against hMBP, confirming that secretion indeed had occurred. Based on the different localization of the heterologous proteins, lactobacilli expressing surface-anchored TTFC are ideally suited for the induction of antibody responses, whereas lactobacilli that secrete myelin proteins can be used for the induction of peripheral T-cell tolerance. In conclusion, the specific technology described here allows the construction of a wide array of safe live recombinant lactobacilli which may prove to be useful in oral intervention strategies for the prevention of infectious diseases or treatment of autoimmune diseases.

Topics: Administration, Oral; Animals; Bacterial Vaccines; Cattle; Flow Cytometry; Genetic Vectors; Guinea Pigs; Humans; Immune Tolerance; Immunohistochemistry; Lacticaseibacillus casei; Mice; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Rabbits; Recombinant Fusion Proteins; Tetanus; Tetanus Toxin

Cytokines have a crucial role in initiation and perturbation of EAE that represents an animal model of multiple sclerosis (MS). Administration of transforming growth factor-beta1 (TGF-beta1) to EAE mice improves clinical EAE and prevents relapses by unknown mechanisms. Administering low doses of TGF-beta1 nasally, we confirmed that TGF-beta1 inhibited development and relapse of protracted-relapsing EAE (PR-EAE) in DA rats. Infiltration of CD4+ T-cells and macrophages within the central nervous system was clearly reduced, while proliferation and IFN-gamma secretion of mononuclear cells (MNC) was augmented in TGF-beta1-treated EAE rats compared to PBS-treated control EAE rats. TGF-beta1 administered nasally also increased nitric oxide production and CD4+ T cell apoptosis. TGF-beta1 treated rats showed augmented proliferation of dendritic cells (DC) compared to MNC. These data imply that low doses of TGF-beta1 given by the nasal route prevent PR-EAE and upregulate DC functions that may be involved for disease prevention.

Topics: Administration, Intranasal; Animals; Apoptosis; CD4 Lymphocyte Count; Cell Division; Cells, Cultured; Data Interpretation, Statistical; Dendritic Cells; Encephalomyelitis, Autoimmune, Experimental; Guinea Pigs; Immunohistochemistry; Immunotherapy; Male; Mice; Multiple Sclerosis; Myelin Basic Protein; Nitric Oxide; Rats; Spleen; Transforming Growth Factor beta; Up-Regulation

Semple rabies vaccine is composed of rabies virus-infected sheep or goat brain inactivated with phenol and is administered daily after exposure for 14-21 days. Semple rabies vaccine-induced autoimmune encephalomyelitis (SAE) has clinico-pathological findings of demyelination similar to experimental autoimmune encephalomyelitis (EAE) caused by injection of central nervous system tissue or purified myelin proteins into experimental animals and frequently studied as a model for the human demyelinating disease, multiple sclerosis (MS). T-cell-mediated immune responses play a major role in induction of EAE, and antibody responses enhance disease severity. We studied the antibody responses to myelin basic protein (MBP) in 24 Thai patients with SAE and 77 control individuals to define the linear epitopes in human MBP that are encephalitogenic. Antibody levels were assessed by ELISA using native human MBP or synthetic MBP peptides of 20 amino acids. The major B-cell epitope was MBP61-80 and a minor epitope was MBP106-140 in SAE while in MS the major B-cell epitope is MBP84-96. MBP61-80-specific IgG1 and IgG3 levels were significantly higher in patients than controls while IgG2 and IgG4 were not. The data support the hypothesis that autoreactive Th1 cells induce SAE. The difference in B-cell epitope recognition may be due to differences in the genetic backgrounds of the populations studied or may reflect underlying differences in the pathogenesis of SAE and MS.

Topics: Adolescent; Adult; Amino Acid Sequence; Animals; Antibody Specificity; Autoantigens; B-Lymphocytes; Brain Chemistry; Encephalomyelitis, Autoimmune, Experimental; Enzyme-Linked Immunosorbent Assay; Epitopes; Goats; Humans; Immunoglobulin A; Immunoglobulin Class Switching; Immunoglobulin G; Immunoglobulin M; Multiple Sclerosis; Myelin Basic Protein; Rabies Vaccines; Sheep; Th1 Cells

Autoimmune inflammation secondary to myelin destruction may play an inhibitory role in restoration of nerve functions in spinal cord injury (SCI). In this study, we demonstrated that T cells recognizing myelin basic protein (MBP) occurred at a high precursor frequency in patients with SCI, which was compatible to that in patients with multiple sclerosis (MS), a disease of presumed autoimmune pathology. The findings suggest of hyperactivity of MBP-reactive T cells in patients with SCI. MBP-reactive T cell lines derived from patients with SCI exhibited a preferential recognition pattern toward the 81-99 and the 151-169 regions of MBP. There were functional differences in the epitope recognition and cytokine profile between two panels of MBP-reactive T cell lines derived from patients with SCI and patients with MS. The study provides new evidence important for further investigation of the role of the inflammatory component in SCI.

Topics: Adult; Enzyme-Linked Immunosorbent Assay; Epitopes; Humans; Interferon-gamma; Interleukin-10; Interleukin-4; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Spinal Cord Injuries; T-Lymphocytes; Tumor Necrosis Factor-alpha

Myelin basic protein (MBP) occurs as a number of charge isomers due to phosphorylation, deamidation, and deimination of arginine to citrulline. All of these modifications decrease the net positive charge of the protein and its ability to cause aggregation of negatively charged lipid vesicles. This is used as a model system for the ability of MBP to cause adhesion of the cytosolic surfaces of myelin. Therefore, the effect of two deiminated forms of MBP on lipid vesicles was compared with that of the unmodified, most positively charged isomer, C1, to determine how loss of positively charged arginines would affect the function of MBP. The deiminated forms were the isomer isolated from normal human brains, in which only 6 Arg are deiminated to citrulline (MBP-Cit(6)), and an isomer isolated from the brain of a patient who died with acute, fulminating multiple sclerosis (Marburg type), in which 18 of the 19 Arg were deiminated (MBP-Cit(18)). Whereas C1 caused aggregation of lipid vesicles, resulting in an increase in absorbance due to light scattering, MBP-Cit(18) caused a decrease in absorbance of the lipid vesicles. Size exclusion chromatography and negative staining electron microscopy showed that this was due to fragmentation of the large multilayered vesicles into much smaller vesicles. MBP-Cit(6) caused less aggregation of lipid vesicles than did C1. However, no fragmentation of the vesicles into smaller ones in the presence of C1 and MBP-Cit(6) was detected by size exclusion chromatography or electron microscopy. The membrane fragmentation caused by MBP-Cit(18) is dramatically different from the effects of other forms of MBP from normal brain and may indicate a pathogenic effect of this charge isomer, which may have contributed to the severity of the Marburg type of multiple sclerosis. Alternatively, the deimination may have been a secondary effect resulting from the disease process. Regardless of the role of MBP-Cit(18) in multiple sclerosis, the effect of this modification indicates that, when most of the arginines of MBP are modified to an uncharged amino acid, the protein acquires properties similar to an apolipoprotein; thus, it may take up an amphipathic structure when bound to lipid. A partly amphipathic character may also be related to the role of MBP-Cit(6) in normal immature myelin, where it is the predominant charge isomer.

Topics: Animals; Arginine; Cattle; Citrulline; Electrochemistry; Humans; Imines; Light; Liposomes; Multiple Sclerosis; Myelin Basic Protein; Protein Isoforms; Scattering, Radiation

The autoimmune T cell repertoire in experimental autoimmune encephalomyelitis (EAE) and multiple sclerosis (MS) is characterized by CD4(+)T cells of the Th1 phenotype that recognize peptide determinants of central nervous system (CNS) myelin proteins in an MHC class II-restricted manner. Our recent studies and those performed by others have shown that progression to chronicity in EAE and MS is accompanied by a broadening of the T cell repertoire with time. This acquired neo-autoreactivity is commonly referred to as epitope spreading and is presumably the result of endogenous priming to new self-determinants during the CNS inflammation that accompanies disease onset and relapse. In the present study we extend our earlier observations by showing that disease progression in both EAE and MS is accompanied by two concurrent events, viz. (1) the spontaneous regression of the primary established autoimmune repertoire associated with disease onset, and (2) the emergence of the epitope spreading cascade associated with disease progression. Our data show that disease initiation and disease progression in both EAE and MS are typically associated with distinctly different autoimmune T cell repertoires. Our data support the view that the natural development of self-recognition during autoimmune disease may best be understood when considered in the temporal context of an 'epitope du jour' and 'moving target' perspective.

Topics: Amino Acid Sequence; Animals; Autoantigens; Autoimmunity; Encephalomyelitis, Autoimmune, Experimental; Epitope Mapping; Epitopes; Female; Male; Mice; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Peptide Fragments; T-Lymphocytes, Regulatory; Th1 Cells; Time Factors

The proliferative response of mononuclear cells from MS patients and normal control subjects to intact and delipidated myelin membranes was examined. The mean frequency of recognition in both groups of human subjects was greater for delipidated myelin than for intact myelin. Human T cell lines established using intact or delipidated myelin as the antigen were highly heterogeneous in response, and were each able to recognize myelin basic protein and myelin proteolipid protein peptides. However, there was no difference in the frequency of recognition of either form of myelin membrane when MS patients were compared to control subjects. Our results suggest that the presentation of delipidated forms of membrane proteins might enhance the response to myelin antigens in vivo, and be relevant to demyelinating diseases.

Topics: Adult; Case-Control Studies; Cell Division; Central Nervous System; Female; Humans; Leukocytes, Mononuclear; Male; Membrane Lipids; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Myelin Sheath; T-Lymphocytes

Inflammation of multiple sclerosis (MS) brain and spinal cord tissue consists of macrophages, T lymphocytes and cytokines as well as B lymphocytes and immunoglobulins (IgGs). IgG can be detected in high concentrations in both central nervous system tissue and cerebrospinal fluid (CSF). Using a sensitive radioimmunoassay (RIA), autoantibodies to myelin basic protein (anti-MBP) can be detected in the CSF of 90-95% of MS patients with active disease. The purpose of the present report was to determine whether these same autoantibodies can be reliably detected in non-MS patients. Between 1978 and 1998, CSF was collected from 1,968 control non-MS patients with psychiatric, inflammatory and noninflammatory neurological diseases as well as nonneurological systemic diseases, and anti-MBP were measured by the same RIA used to detect anti-MBP in MS CSF. Anti-MBP were undetectable in 98% of CSF samples from non-MS controls. In the remaining 2% of control samples, CSF IgGs capable of binding to MBP in vitro were unpredictably detected. This latter group included 1% of patients with miscellaneous diseases such as encephalomyelitis, 5 siblings with familial spastic paraparesis, rare patients with strokes, Wernicke-Korsakoff's syndrome, inherited leukodystrophy, motor neuron disease and some patients with miscellaneous spinal cord diseases. An additional 1% of patients included a group with neurological symptoms suggestive of early or predisseminated MS. The high prevalence of free and/or bound anti-MBP in the CSF of MS patients and the rare and unpredictable occurrence in the CSF of non-MS patients suggest that autoimmunity to MBP may be operative in the demyelination of MS. Molecular clones of anti-MBP with specificity towards variable surface or cryptic MBP epitopes in vivo may determine whether or not they are involved in the demyelinating process, and this variability may also be present within the MS population. Potential mechanisms of anti-MBP-mediated demyelination in MS patients are discussed.

Topics: Adult; Aged; Aged, 80 and over; Autoantibodies; Central Nervous System Diseases; Cerebrovascular Disorders; Child; Encephalomyelitis; Female; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Neurodegenerative Diseases; Sclerosis; Spinal Cord Diseases

T cell responses to the immunodominant peptide (residues 83-99) of myelin basic protein are potentially associated with multiple sclerosis (MS). This study was undertaken to examine whether a common sequence motif(s) exists within the TCR complementarity-determining region (CDR)-3 of T cells recognizing the MBP83-99 peptide. Twenty MBP83-99-reactive T cell clones derived from patients with MS were analyzed for CDR3 sequences, which revealed several shared motifs. Some V beta 13.1 T cell clones derived from different patients with MS were found to contain an identical CDR3 motif, V beta 13.1-LGRAGLTY. Oligonucleotides complementary to the shared CDR3 motifs were used as specific probes to detect identical target CDR3 sequences in a large panel of T cell lines reactive to MBP83-99 and unprimed PBMC. The results revealed that, in contrast to other CDR3 motifs examined, the LGRAGLTY motif was common to T cells recognizing the MBP83-99 peptide, as evident by its expression in the majority of MBP83-99-reactive T cell lines (36/44) and PBMC specimens (15/48) obtained from randomly selected MS patients. The motif was also detected in lower expression in some PBMC specimens from healthy individuals, suggesting the presence of low precursor frequency of T cells expressing this motif in healthy individuals. This study provides new evidence indicating that the identified LGRAGLTY motif is preferentially expressed in MBP83-99-reactive T cells. The findings have important implications in monitoring and targeting MBP83-99-reactive T cells in MS.

Topics: Amino Acid Sequence; Base Sequence; Cell Line; Clone Cells; Cloning, Molecular; DNA Primers; DNA, Recombinant; Epitopes, T-Lymphocyte; Gene Rearrangement, alpha-Chain T-Cell Antigen Receptor; Gene Rearrangement, beta-Chain T-Cell Antigen Receptor; Humans; Immunodominant Epitopes; Leukocytes, Mononuclear; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Receptors, Antigen, T-Cell, alpha-beta; T-Lymphocyte Subsets

The presence of T-cell reactivity to alphaB-crystallin in patients with multiple sclerosis (MS) has suggested that this small molecular weight heat shock protein (Hsp) may be an autoantigen in MS.. We have tested the serum of patients with clinically definite MS (n=30), other inflammatory neurological disease (n=22), non-inflammatory neurological disease (n=42) and healthy individuals (n=23) for systemic humoral responses to bovine alphaB-crystallin, to the homologous chaperone protein, alphaA-crystallin, and to another small Hsp, Hsp 27.. Sixty-three percent of MS patients exhibited immunoreactivity to alpha-crystallin and this was present in all 4 of 4 non-ambulatory patients with MS. In contrast, serum concentrations in MS patients of antibodies to the small Hsp, Hsp27, and to myelin basic protein were negligible (P<0.001). Serum anti-alpha-crystallin immune responses were detected in significantly lower percentages of patients with other inflammatory neurological diseases (32%, P<0.025), and with non-inflammatory neurological diseases (12%, P<0.001). None of the healthy control individuals showed anti-alpha-crystallin reactivity. The concentration of anti-alpha-crystallin antibodies in patients with MS correlated with severe disease (P<0.05) and with active disease (P<0.025).. Our observations support the notion that anti-alpha-crystallin autoimmune responses may contribute to pathogenicity in MS and may represent a mechanism of how recurrent attacks of MS develop subsequent to an isolated demyelinating episode.

Topics: Adult; Aged; Antibody Specificity; Autoantibodies; Autoantigens; Crystallins; Enzyme-Linked Immunosorbent Assay; Epitopes; Female; Heat-Shock Proteins; Humans; Immunoblotting; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Recurrence; Serine Endopeptidases; Seroepidemiologic Studies; Severity of Illness Index

Myelin basic protein (MBP)-reactive T cells may play an important role in the autoimmune pathogenesis of multiple sclerosis (MS). MBP-reactive T cells can be specifically targeted by T cell vaccination, a procedure whereby MS patients are immunized with attenuated autologous MBP reactive T cells. T cell vaccination induces immune responses to the vaccine cells together with a depletion of MBP reactive T cells. Forty-nine MS patients were treated with T cell vaccination in an extended phase I trial to study the safety, immune responses and clinical effects of T cell vaccination. In the present paper the immune responses towards the vaccine cells were characterized. Substantial long-term in vitro proliferative responses were observed in all treated patients. Some patients, immunized with different clones, displayed distinct proliferative reactivity against the various vaccine clones, suggesting unequal immunogenic properties of these clones. Reactive TCRalphabeta(+), CD8(+)and CD4(+)T cells, and to a lesser extent, gammadelta T cells and NK cells were observed to in vitro stimulation with the vaccine cells. A small fraction only of CD8(+)T cells expressed cytolytic and inhibitory anti-clonotypic reactivity against the vaccine cells. Stimulation with the vaccine clones predominantly induced expression of pro-inflammatory cytokines in these mixed cultures, although one vaccine clone consistently induced production of IL-4. CD4(+)T cells are the major cytokine-producing cells in these anti-vaccine lines. We could not detect upregulated antibody responses to the vaccine cells in most patients, although a temporary antibody response was observed in one patient. In conclusion, immunization with attenuated autoreactive T cells induces a complex cellular response specifically targeted at the vaccine cells, but no antibody responses. These data provide further insights into the mechanisms of T cell vaccination and improve our understanding of the complex regulatory networks of autoreactive T cells.

Topics: Antibody Formation; CD4-Positive T-Lymphocytes; Clinical Trials, Phase I as Topic; Cytokines; Humans; Immunity, Cellular; Immunotherapy; Lymphocyte Activation; Lymphocyte Subsets; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes; Vaccination; Vaccines; Vaccines, Inactivated

Autoreactive T cells specific for myelin antigens are thought to play a role in the pathogenesis of multiple sclerosis (MS). We compared T cell proliferative responses in peripheral blood following challenge in vitro with myelin/oligodendrocyte glycoprotein (recombinant protein, rMOG), myelin basic protein (MBP) and proteolipid apoprotein (PLP) in 50 patients with MS and 40 healthy controls. T cell reactivity against rMOG (defined by a specific stimulation index of 2.5 or greater) was present in 13 (26%) MS patients and 12 (30%) healthy controls and was MHC-restricted, as anti-MHC class II antibodies abolished all proliferative responses. By contrast, reactivity against PLP was present in only one (2%) MS patient and six (15%) controls, and no reactivity against MBP was found in any subject. Thus, by the criteria of the present study, an increased reactivity of circulating T cells to MOG is present to a similar degree in healthy individuals and in patients with MS. This finding raises the possibility that additional factors contribute to the pathogenicity of these autoreactive T cell populations in demyelinating disorders of the central nervous system.

Topics: Adult; Aged; Animals; Autoantibodies; Autoantigens; Autoimmune Diseases; Female; Humans; Lymphocyte Activation; Lymphokines; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Rats; Recombinant Proteins; Reference Values; T-Lymphocytes

Studies on the in vivo effects of interferon-beta (IFNbeta) therapy on autoreactive T cells have never been carried out in multiple sclerosis (MS). We investigated the T cell response to myelin basic protein (MBP), before and after IFN-beta therapy, raising MBP-specific T cell lines (TCL) from the peripheral blood of six MS patients with a satisfactory response to the treatment. IFNbeta did not affect the relative frequency and epitope specificity of the TCL. After IFNbeta therapy, the production of interleukin-4 was decreased in MBP-stimulated TCL while the secretion of interferon-gamma was increased in unstimulated TCL. Interleukin-10 and tumor necrosis factor-alpha did not show significant variations. This finding supports recent suggestions about the complexity of the T helper 1/T helper 2 paradigm in MS and other organ-specific autoimmune diseases. In fact, the beneficial effects of IFNbeta do not exclude an immunostimulatory action that may involve potentially autoreactive T cells. This has implications for future treatment options, including combination therapies.

Topics: Adult; Autoimmune Diseases; Female; Humans; Immunologic Factors; Interferon-beta; Interferon-gamma; Interleukin-10; Interleukin-4; Male; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocyte Subsets; Th1 Cells; Th2 Cells; Tumor Necrosis Factor-alpha

Multiple sclerosis (MS) is an autoimmune demyelinating disease of the central nervous system. A complex genetic etiology is thought to underlie susceptibility to this disease. The present study was designed to analyze whether differences in genes that encode myelin proteins influence susceptibility to MS. We performed linkage analysis of MS to markers in chromosomal regions that include the genes encoding myelin basic protein (MBP), proteolipid protein (PLP), myelin-associated glycoprotein (MAG), oligodendrocyte myelin glycoprotein (OMGP), and myelin oligodendrocyte glycoprotein (MOG) in a well-characterized population of 65 multiplex MS families consisting of 399 total individuals, 169 affected with MS and 102 affected sibpairs. Physical mapping data permitted placement of MAG and PLP genes on the Genethon genetic map; all other genes were mapped on the Genethon genetic map by linkage analysis. For each gene, at least one marker within the gene and/or two tightly linked flanking markers were analyzed. Marker data analysis employed a combination of genetic trait model-dependent (parametric) and model-independent linkage methods. Results indicate that MAG, MBP, OMGP, and PLP genes do not have a significant genetic effect on susceptibility to MS in this population. As MOG resides within the MHC, a potential role of the MOG gene could not be excluded.

Topics: DNA Primers; Family Health; Genetic Linkage; Genetic Markers; Genotype; GPI-Linked Proteins; Humans; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; White People

We report a comparative study of the B- and T-cell responses to the extracellular immunoglobulin (Ig)-like domain of human myelin-oligodendrocyte glycoprotein (MOG(Igd)) in the blood of patients with multiple sclerosis and healthy controls using a bacterial recombinant human protein (rhMOG(Igd)). The frequency of anti-rhMOG(Igd)-seropositive samples, as determined by Western blotting, was significantly higher in the multiple sclerosis group (54%) than in normal random controls (excluding laboratory workers exposed to MOG) (22%; P = 0.02). In contrast, there was no difference in rhMOG(Igd)-induced proliferation indices of peripheral blood T cells between patients and controls. To characterize the rhMOG(Igd)-reactive T-cell repertoire, we isolated a panel of MOG-specific CD4(+) T-cell lines from multiple sclerosis patients and normal subjects, and these revealed a heterogeneous response with respect to epitope specificity, cytokine response, MHC (major histocompatibility complex) restriction and T-cell receptor Vbeta-chain usage. The majority of the T-cell lines recognized epitopes in the N-terminal region of MOG (amino acids 1-60). One epitope (represented by peptide 27-50) was exclusively recognized by T-cell lines from normal controls. Forty per cent of the MOG-specific T-cell lines analysed displayed a Th-2 or Th-0 cytokine profile and could therefore act as helper T cells in vivo.

Topics: Amino Acid Sequence; Antigens, Surface; Autoantibodies; B-Lymphocytes; Blotting, Western; CD4-Positive T-Lymphocytes; Cell Division; Cell Line; Epitope Mapping; Extracellular Space; Flow Cytometry; Humans; Immunohistochemistry; Interferon-gamma; Interleukin-4; Major Histocompatibility Complex; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Receptors, Antigen, T-Cell, alpha-beta; T-Lymphocytes

Topics: Animals; CD4 Antigens; Disease Models, Animal; DNA-Binding Proteins; Encephalitis; Genetic Predisposition to Disease; HLA-DR2 Antigen; Humans; Mice; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Nuclear Proteins; Receptors, Antigen, T-Cell; T-Lymphocytes

To define the in vitro effects of interferon beta la (IFN-beta1a) on myelin basic protein (MBP)-reactive T cells and to determine its regulatory mechanism on cytokine networks in patients with MS.. The proliferation and cytokine production of MBP-reactive T-cell clones were measured in thymidine uptake assays and ELISA respectively. The precursor frequency of MBP-reactive T cells was estimated in a microwell culture system.. IFN-beta inhibited the proliferation of established MBP-reactive T-cell clones, which correlated with enhanced production of anti-inflammatory interleukin (IL)-4 and IL-10, and a decrease in tumor necrosis factor alpha (TNF-alpha) and IFN-gamma. When examined with peripheral blood mononuclear cells (PBMCs), IFN-beta was found to reduce the in vitro T-cell responses to MBP, as indicated by the significantly decreased frequency of MBP-reactive T cells. The decreased frequency of MBP-reactive T cells corresponded to an augmented production of IL-4 and IL-10. Although the level of TNF-alpha and IFN-gamma was generally unaltered or decreased, IFN-beta appeared to enhance the production of IFN-gamma in PBMCs derived from some individuals with MS.. Interferon beta la (IFN-beta) suppresses myelin basic protein (MBP)-reactive T cells and induces immune deviation toward the production of T-helper 2 cytokines, which may contribute to its therapeutic benefit in MS. The study also suggests some heterogeneity in MBP-reactive T-cell responses to IFN-beta in different individuals with MS.

Topics: Cell Division; Clone Cells; Cytokines; Humans; Interferon-beta; Monocytes; Multiple Sclerosis; Myelin Basic Protein; Recombinant Proteins; Th2 Cells

Multiple sclerosis (MS) is a complex chronic neurologic disease with a suspected autoimmune pathogenesis. Although there is evidence that the development of MS is determined by both environmental influences and genes, these factors are largely undefined, except for major histocompatibility (MHC) genes. Linkage analyses and association studies have shown that susceptibility to MS is associated with genes in the human histocompatibility leukocyte antigens (HLA) class II region, but the contribution of these genes to MS disease development less compared with their contribution to disorders such as insulin-dependent diabetes mellitus. Due to the strong linkage disequilibrium in the MHC class II region, it has not been possible to determine which gene(s) is responsible for the genetic predisposition. In transgenic mice, we have expressed three human components involved in T-cell recognition of an MS-relevant autoantigen presented by the HLA-DR2 molecule: DRA*0101/DRB1*1501 (HLA-DR2), an MHC class II candidate MS susceptibility genes found in individuals of European descent; a T-cell receptor (TCR) from an MS-patient-derived T-cell clone specific for the HLA-DR2 bound immunodominant myelin basic protein (MBP) 4102 peptide; and the human CD4 coreceptor. The amino acid sequence of the MBP 84-102 peptide is the same in both human and mouse MBP. Following administration of the MBP peptide, together with adjuvant and pertussis toxin, transgenic mice developed focal CNS inflammation and demyelination that led to clinical manifestations and disease courses resembling those seen in MS. Spontaneous disease was observed in 4% of mice. When DR2 and TCR double-transgenic mice were backcrossed twice to Rag2 (for recombination-activating gene 2)-deficient mice, the incidence of spontaneous disease increased, demonstrating that T cells specific for the HLA-DR2 bound MBP peptide are sufficient and necessary for development of disease. Our study provides evidence that HLA-DR2 can mediate both induced and spontaneous disease resembling MS by presenting an MBP self-peptide to T cells.

Topics: Animals; Autoantigens; CD4 Antigens; Central Nervous System; Disease Models, Animal; DNA-Binding Proteins; Encephalitis; Freund's Adjuvant; Genes, Immunoglobulin; Genetic Predisposition to Disease; HLA-DR2 Antigen; Humans; Mice; Mice, Inbred C57BL; Mice, Inbred DBA; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Nuclear Proteins; Peptide Fragments; Pertussis Toxin; Receptors, Antigen, T-Cell; T-Lymphocytes; Virulence Factors, Bordetella

The occurrence and role of autoantibodies to gangliosides and other lipid-containing components of the central nervous system in Multiple Sclerosis (MS) are unsettled. Using sensitive ELISAs, we measured IgG and IgM antibody titers and absorbances to the three major gangliosides GD1a, GD1b and GM1, and to sulfatides, cardiolipin and myelin proteins in paired serum and cerebrospinal fluid (CSF) from patients with untreated MS, optic neuritis (ON), acute aseptic meningo-encephalitis (AM) and other neurological diseases (OND). Twenty-three per cent of 30 MS (P<0.04) and 18% of 32 ON patients (P<0.05) presented elevated IgG antibody titers to GD1a in serum compared to 9% of patients with OND. Six (40%) of the patients with malignant MS had elevated serum IgG antibody titers to GD1a compared to one (6%) of the patients with benign MS (P<0.04). In CSF, elevated IgG antibody titers to GD1a were measured in 13% of MS and 20% of ON patients compared to 4% of patients with OND (P<0. 03 and P<0.02, respectively). The augmented IgG response to GD1a in serum also separated MS from Guillain-Barré syndrome. Compared to OND increased IgM absorbances to sulfatides and cardiolipin were observed in CSF of patients with MS, but also in AM. Elevated IgG antibody titers to myelin proteins were found more often in MS patients' serum and MS, ON and AM patients' CSF compared to OND. The data implicate that among the multitude of enhanced B-cell responses occurring in MS and ON, that directed to GD1a is common and more discriminative, and should be evaluated in future MS treatment studies.

Topics: Adult; Antibodies, Anticardiolipin; Autoantibodies; B-Lymphocytes; Cerebrovascular Disorders; Female; G(M1) Ganglioside; Gangliosides; Humans; Immunoglobulin G; Immunoglobulin M; Male; Meningoencephalitis; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Nervous System Diseases; Optic Neuritis; Recurrence; Sulfoglycosphingolipids

Although immunoglobulin G and free light (L) chains of oligoclonal origin in cerebrospinal fluid (CSF) are the most common immunologic abnormalities in multiple sclerosis (MS), it is unknown whether homologous CSF L chain sequences are present in different individuals with MS. Using Southern blotting, a particular kappa (kappa) L chain variable region (V) probe was recently found to hybridize to Vkappa cDNA from CSF B cells from almost one half of the MS patients tested but only 10% of normal or other neurologic disease controls [Zhou, S.-R., Maier, C.C., Mitchell, G.W., LaGanke, C.C., Blalock, J.E., Whitaker, J.N., 1998. A cross-reactive idiotope in cerebrospinal fluid cells in multiple sclerosis: further evidence for the role of myelin basic protein. Neurology 50, 411-417.] Here, we report that this likely results from remarkable sequence similarity in certain Vkappa from CSF B cells from different individuals with MS. The high degree of sequence homology even extended to all three complementarity determining regions (CDR) which in part form an antibody combining site. In addition, marked sequence homology was observed between the light chains from the MS patients and those from certain mouse antibodies against myelin basic protein (MBP). The results establish, in principle, that the same or very similar kappa light chain variable regions can be shared between CSF B lymphocytes from different individuals with MS as well as with certain antibodies against MBP.

Topics: Amino Acid Sequence; Animals; B-Lymphocytes; Genetic Variation; Humans; Immunoglobulin Light Chains; Immunoglobulin Variable Region; Mice; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Sequence Homology, Amino Acid

We have developed a new technique that allows us to quantify antigen-specific T cells, and to determine their functional phenotype and origin from naive versus memory populations. Using this methodology, we have characterized a total of 286 T-cell lines specific for myelin basic protein (MBP) and influenza hemagglutinin from 16 multiple sclerosis (MS) patients and nine healthy donors. Our data support the notion that MBP-specific T cells undergo in vivo activation in MS patients and indicate a presence of immune dysregulation that renders MS patients prone to develop autoimmunity. Our methodology offers a way to study antigen-specific T-cell characteristics as a surrogate marker in immunotherapy trials.

Topics: Adult; Antibody Specificity; Autoantigens; Autoimmunity; Biomarkers; Case-Control Studies; CD4-Positive T-Lymphocytes; Cell Division; Flow Cytometry; Humans; Immunologic Memory; Immunophenotyping; Interferon-gamma; Interleukin-4; Interleukin-7; Kinetics; Leukocyte Common Antigens; Leukocytes, Mononuclear; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes; Time Factors

The studied material consisted of patients in the first and second year from the onset of multiple sclerosis. In majority of the studied 18 cases the junctional repertoire of TCR in blood lymphocytes of patients in early phase of MS was restricted demonstrating the mono- or oligoclonal character of rearrangement in the spectrum V delta 1-J delta 1, V delta 5-J delta 1 and V delta 3-J delta 1 in contrast to overwhelming polyclonal picture in the control group. In majority of the cases oligoclonal bands were detected and IgG index was above normal level indicating on intrathecal IgG synthesis. The comparison of humoral immunological markers in the early phase of MS with the control group revealed several higher values in patients, but only concerning TNF alpha level in serum, IgG in CSF and IgG index the differences were statistically significant. After treatment with Prednisone the decrease of all studied markers was established, but significant only of free kappa chains to creatinine ratio in urine. The obtained results indicate, that the early phase of MS is characterised by the profound shift of gamma/delta TCR receptors in direction of mono- or oligoclonal bands in CSF, what may be explained by the oligoclonal expansion of certain B and T cells due to stimulation by an antigen related to MS pathogen.

Topics: Adult; Anti-Inflammatory Agents; Autoantibodies; Biomarkers; Gene Rearrangement, T-Lymphocyte; Humans; Immunoglobulin G; Multiple Sclerosis; Myelin Basic Protein; Prednisolone; Receptors, Interleukin-2; T-Lymphocytes; Tumor Necrosis Factor-alpha

Autoimmune encephalomyelitis can be initiated spontaneously and developed progressively in TCR transgenic mice specific for myelin basic protein when exposed to non-sterile environment, thus more closely mimicking human multiple sclerosis. By intravenous administration of myelin basic protein, we succeeded in reversing the clinical and pathological signs of progressive spontaneous disease in these mice. Flow cytometry showed that the majority of transgenic T cells in lymph nodes and spleen as well as spinal cords of treated mice were deleted. Dramatically increased numbers of apoptotic cells were found in peripheral immune organs of treated animals. Proliferative responses of single transgenic T cell to autoantigen were significantly decreased in treated mice, indicating that the remaining T cells were anergic. Moreover, production of both Th1 and Th2 cytokines was suppressed. This study is the first demonstration of reversal of progressive, spontaneous autoimmune disease of the central nervous system, and provides direct evidence that apoptosis-induced clonal deletion, along with anergy of remaining cells, but not Th2 switch, play a major part in the reversal of this disease by intravenous administration of autoantigen.

Topics: Animals; Apoptosis; Autoantigens; Clonal Anergy; Cytokines; Encephalomyelitis, Autoimmune, Experimental; In Situ Nick-End Labeling; Injections, Intravenous; Lymphoid Tissue; Mice; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell, alpha-beta; Spinal Cord; Th1 Cells; Th2 Cells

Although multiple sclerosis (MS) patients and healthy individuals have similar frequencies of myelin basic protein (MBP)-specific T cells, the activation state of these cells has not been well characterized. Therefore, we investigated the dependence of MBP-reactive T cells on CD28-mediated costimulation in MS patients, healthy controls, and stroke patients. MBP-reactive T cells from healthy controls and stroke patients failed to proliferate efficiently when costimulation was blocked using anti-CD28, consistent with a naive T cell response. In contrast, MBP-specific T cell proliferation was not inhibited, or was only partially inhibited when CD28-mediated costimulation was blocked in MS patients. Blockade of CD28 failed to inhibit tetanus toxoid-specific T cell proliferation in both the controls and MS patients, demonstrating that memory cells are not dependent on CD28-mediated costimulation. Limiting dilution analysis indicated that the frequency of MBP-reactive T cells was significantly decreased in healthy controls compared with MS patients when CD28-mediated costimulation was blocked. These data suggest that MBP-reactive T cells are more likely to have been activated in vivo and/or differentiated into memory T cells in MS patients compared with controls, indicating that these cells may be participating in the pathogenesis of MS.

Topics: Abatacept; Adult; Antigens, CD; Antigens, Differentiation; B7-2 Antigen; CD28 Antigens; Cell Division; CTLA-4 Antigen; Humans; Immunoconjugates; Immunoglobulins; Lymphocyte Count; Membrane Glycoproteins; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes

The close resemblance of MS to the animal model experimental autoimmune encephalomyelitis (EAE) has provided compelling data sustaining a pathogenic role of circulating T cells reactive against MBP. T cell antigen receptor (TCR) usage in EAE is commonly considered restricted; nevertheless, dynamic changes of TCR usage correlate with the course of EAE, resulting in a limited repertoire during early stages of disease activity followed by the recruitment of other T cells reactive against new determinants. Although a broader TCR repertoire mediates the response to MBP in humans, a restricted intraindividual heterogeneity may occur in some MS patients. In the present study we characterize the response to MBP in MS subjects with relapsing remitting disease from two sampling time points 12 months apart. MBP-specific T cell lines (TCL) were first generated from eight MS individuals and two healthy subjects. New TCL were obtained after 12 months from one control and three MS patients whose response, at the first time point, was directed against a single epitope. Interestingly, these three subjects had a stable and mild disease. Few TCL obtained at two time points from the MS individuals recognized the same immunodominant epitope and shared identical TCR Vbeta sequences. In the control we could not detect a restriction of the repertoire. These findings suggest that in some MS patients with benign disease a predominant T cell response to a single determinant may be detectable at different moments and is mediated by clonally expanded populations.

Topics: Adult; Antigen Presentation; Female; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocyte Subsets; T-Lymphocytes

Myelin basic protein (MBP) is a potential autoantigen in multiple sclerosis (MS) and its gene therefore is an attractive candidate to confer genetic susceptibility to this disease. Linkage and association with certain alleles of a 1.2 kb tetranucleotide repeat region 5' to the MBP gene with MS have been reported in Finnish patients, and an association has been reported from Denmark. However, these findings have not been confirmed in subsequent analyses in other populations. A limitation of previous studies has been the low resolution of the typing procedure. We have investigated the same polymorphism in thirty-four Swedish nuclear families with 2 or 3 MS patients. and in 149 unrelated Swedish MS patients and 95 healthy controls using a fluorescence-based semi-automated technique which allowed the identification of discrete tetrarepeat numbers. Neither parametric two-point linkage analysis nor a nonparametric affected pedigree members analysis showed any sign of linkage. In addition, the distribution of alleles was similar in patients and controls. We conclude that the MBP gene does not influence susceptibility to MS in Swedish patients.

Topics: Alleles; Genetic Linkage; Genotype; Humans; Multiple Sclerosis; Myelin Basic Protein; Polymorphism, Genetic; Repetitive Sequences, Nucleic Acid; Risk Factors

We wanted to find evidence of antibody to myelin basic protein (MBP) in patients with MS by detecting their shared usage of immunoglobulin genes. As demonstrated by the idiotopes (i.d.) of murine monoclonal antibody to peptides of MBP, there is limited use of the variable (V) region immunoglobulin genes for the immune response in mice to this encephalitogenic protein. Cross-reactive Ids have been detected across different murine strains and shared by T and B cells. One cross-reactive Id, designated as 845D3 Id, is located on the V region of kappa light chains of two murine monoclonal antibodies, one to MBP peptide 80-89 and the other to MBP peptide acetyl 1-9. To examine the occurrence of 845D3 Id in MS, we used the V region of a light chain (VL) of one of the monoclonal antibodies to probe the VL genes expressed in B cells in CSF of 50 patients (31 MS and 19 non-MS). The VL genes expressed in B cells found in CSF were amplified by polymerase chain reaction using universal human V-region primers. The 845D3 Id probe detected the Id+ V region in the CSF of 14 of 31 MS patients, 1 of 9 patients with other neurologic diseases, and 1 of 10 non-neurologic patients. The gene product was more common in but not restricted to CSF with oligoclonal bands. The presence in CSF of MS patients of a cross-reactive Id to different MBP peptides is indicative of an immune response to this encephalitogenic myelin protein in a segment of MS patients. These findings are also evidence for limited usage of V-region Ig genes in the immune response of humans to MBP and the possible importance of an Id network for MBP in demyelinating disease.

Topics: Adult; Animals; Antibodies, Monoclonal; B-Lymphocytes; Cross Reactions; DNA Primers; Female; Genes, Immunoglobulin; Humans; Immunoglobulin Idiotypes; Immunoglobulin kappa-Chains; Immunoglobulin Variable Region; Male; Mice; Mice, Inbred BALB C; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Polymerase Chain Reaction; Reference Values

Multiple sclerosis (MS) is considered to be an autoimmune disease that is directed either at myelin or at its cell of origin, the oligodendrocytes (OL). The inflammatory lesions in the central nervous system contain multiple myelin Ag-restricted and nonrestricted cell populations with the potential to mediate tissue injury. Previous studies indicate that it is possible to generate MHC class I-restricted myelin peptide-specific cytotoxic CD8 T cells, and that human adult OLs express MHC class I molecules in vitro. The purpose of this study was to demonstrate that myelin basic protein peptide-specific CD8 T cells could induce OL injury. We generated CD8 T cell lines from six healthy donors and five MS patients, and all cell lines were HLA-A2 positive. The obtained CD8 cell lines induced lysis of HLA-A2- but not HLA-A3-transfected HMy2.C1R cells in the presence of myelin basic protein peptide 110-118. In the absence of exogenous peptide, the CD8 T cell lines were cytotoxic to HLA-A2 but not to non-HLA-A2 OLs. Cytotoxicity was blocked with anti-MHC class I-blocking Ab. These results support the postulate that autoreactive CD8 cytotoxic T cells can contribute to the tissue injury in MS.

Topics: Adult; CD8-Positive T-Lymphocytes; Cell Line; Cytotoxicity, Immunologic; HLA-A2 Antigen; Humans; Multiple Sclerosis; Myelin Basic Protein; Oligodendroglia

Multiple sclerosis (MS) is an oligo- or polygenic disease but no specific susceptibility genes have been identified so far. In the Finnish population we have previously found evidence for linkage between MS and the myelin basic protein gene (here called Golli-MBP gene) suggesting that either Golli-MBP or another gene in its vicinity contributes to MS suceptibility. Here we have screened the Golli-MBP gene for nucleotide variations and carried out multipoint association analyses in a Finnish case-control data-set as well as in an independent data-set composed of 151 MS families from Finland and Sweden. In both data-sets we found association between MS and alleles in the 1.27 kilobase (kb) range at a tetranucleotide repeat element (TGGA)n which is located 1 kb upstream of the MBP exon 1. Haplotype analyses suggested that the MS-associated 1.27 kb alleles can be split into predisposing and non-predisposing variants and provided evidence that the candidate DNA region contributing to MS susceptibility should be located at the Golli-MBP gene within a 20-25 kb segment that was conserved in the predisposing haplotypes. These findings suggest a role for the Golli-MBP locus in MS susceptibility, at least in a subset of patients, and serve as a basis for highly focused attempts to identify predisposing mutation(s).

Topics: Adult; Aged; Aged, 80 and over; Alleles; Case-Control Studies; Disease Susceptibility; DNA; DNA Mutational Analysis; Female; Finland; Genes; Haplotypes; Humans; Linkage Disequilibrium; Male; Microsatellite Repeats; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Polymerase Chain Reaction; Sweden

An autoimmune T-cell response to myelin proteins is thought to be involved in the pathogenesis of multiple sclerosis (MS) and myelin basic protein (MBP) is the most widely studied potential target antigen. We investigated the T-cell response to MBP in MS patients and controls using two different molecular forms of the protein: the classical hydrophilic MBP (lipid-free MBP, LF-MBP) and a lipid-bound, native-like preparation of MBP isolated in a molecular form retaining the binding to all myelin lipids (lipid-bound-MBP, LB-MBP). Short term T-cell lines (TCL) were generated using either LF- or LB-MBP and tested for their reactivity to the in vitro stimulating antigen. No differences were detected between MS patients and healthy donors in the percentage of T-cell cultures responsive to the LF-MBP. In contrast, the number of LB-MBP reactive cultures was higher in MS patients than in controls. This difference was almost entirely due to the presence of high numbers of LB-MBP-specific TCL in MS patients which did not cross-react with LF-MBP and were not present in healthy subjects. LB-MBP may represent a novel antigen worth to be investigated in MS.

Topics: Cell Line; Cross Reactions; Humans; Lipid Metabolism; Lipids; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes

The demyelination process that occurs in the central nervous system (CNS) of patients with multiple sclerosis (MS) is due, in part, to an inflammatory response in which CD4+ and CD8+ T cells and macrophages infiltrate white matter. While it is thought that the inflammatory and demyelination process in MS is the product of Th1-associated cytokines secreted by CD4+ myelin protein-specific T cells present in the CNS, the mechanisms that are responsible for the recruitment and maintenance of these myelin-reactive CD4+ T cells in the CNS have not been elucidated. We have shown previously that CD8+ CTL that recognize peptides derived from sequences of the myelin proteolipid protein (PLP) presented by HLA class I molecules can be generated in vitro, and that these PLP-specific CD8+ CTL secrete the proinflammatory chemokines macrophage-inflammatory protein-1alpha and -1beta, IL-16, and IP-10. In this study, we demonstrate that soluble products of these PLP-specific CD8+ CTL can chemoattract CD4+ T cells that are specific for a myelin basic protein peptide and a PLP peptide, and that the majority of this chemotactic activity is mediated by IFN-inducible protein 10. These results demonstrate that PLP-specific CD8+ T cells can play a role in the recruitment and retention of myelin-derived peptide-specific CD4+ T cells, and indicate that they may play a proinflammatory role in the pathogenesis of MS.

Topics: Amino Acid Sequence; CD4-Positive T-Lymphocytes; CD8-Positive T-Lymphocytes; Cells, Cultured; Chemokine CXCL10; Chemokines; Chemokines, CXC; Chemotaxis, Leukocyte; Cytokines; Humans; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Peptides

Experimental autoimmune encephalomyelitis (EAE) is an important model for developing therapies for multiple sclerosis (MS). The oral administration of the central nervous system antigen, myelin basic protein (MBP), to Lewis rats and susceptible mouse strains prior to MBP immunization prevents the induction of EAE. Clinical trials administering myelin orally to MS patients have met with only partial success, and thus require that oral tolerance be further studied to improve this treatment strategy. Clonal anergy, clonal deletion, immune deviation from Th1 to Th2 T cell subsets, and active suppression by TGF-beta-secreting T cells have all been implicated as possible mechanisms in oral tolerance. Which mechanism predominates depends on antigen dosage, frequency of feeding, and timing of antigen administration. In this study, we have characterized T cells derived from MBP-fed rats and determined the level of their unresponsiveness. Myelin basic protein-specific T cells are indeed present although in reduced numbers in lymphoid tissue of orally tolerized animals. Following several cell divisions in the presence of IL-2, these MBP-specific T cells undergo a dramatic reversal of unresponsiveness, proliferate in response to MBP and are capable of transferring EAE. These results support clonal anergy as an important mechanism for oral tolerance. Recent developments in clinical trials of oral tolerance are described.

Topics: Administration, Oral; Animals; Cells, Cultured; Clonal Anergy; Cytokines; Encephalomyelitis, Autoimmune, Experimental; Female; Guinea Pigs; Immune Tolerance; Male; Multiple Sclerosis; Myelin Basic Protein; Phenotype; Rats; Rats, Inbred Lew; T-Lymphocytes; Tuberculin

The NH2-terminal peptide of myelin basic protein (MBP) bound to the class II major histocompatibility complex (MHC) protein I-Au is an immunodominant epitope in experimental autoimmune encephalomyelitis, a murine model of multiple sclerosis. However, the MBP-I-Au complex is very unstable. To investigate this, we performed site-directed mutagenesis of the I-Au MHC protein and the MBP peptide. Biochemical, T cell activation, and molecular modeling studies of mutant complexes demonstrate that the MBP peptide's key residue for MHC binding, lysine 4, is buried in the P6 pocket of I-Au, which is predominantly hydrophobic. This implies that the MBP-I-Au complex differs from more stable complexes in two respects: (a) the peptide leaves the NH2-terminal region of the MHC peptide-binding cleft unoccupied; (b) the peptide is not anchored by typical favorable interactions between peptide side chains and MHC pockets. To test these hypotheses, a modified MBP peptide was designed based on molecular modeling, with the aim of producing strong I-Au binding. Extension of the NH2 terminus of MBP with six amino acids from the ova peptide, and replacement of the lysine side chain in the P6 pocket with an aromatic anchor, results in >1,000-fold increased binding stability. These results provide an explanation for the unusual peptide-MHC-binding kinetics of MBP, and should facilitate an understanding of why mice are not tolerant to this self-peptide- MHC complex.

Topics: Amino Acid Sequence; Animals; Autoimmune Diseases; Disease Models, Animal; Immune Tolerance; Kinetics; Major Histocompatibility Complex; Mice; Models, Molecular; Molecular Sequence Data; Multiple Sclerosis; Mutagenesis, Site-Directed; Myelin Basic Protein; Peptide Fragments; Protein Binding

Multiple sclerosis (MS) is an inflammatory disease of the myelinated central nervous system that is postulated to be induced by myelin-reactive CD4 T cells. T cell activation requires an antigen-specific signal through the TCR and a costimulatory signal, which can be mediated by B7-1 or B7-2 engagement of CD28. To directly examine the activation state of myelin-reactive T cells in MS, the costimulation requirements necessary to activate myelin basic protein (MBP) or tetanus toxoid (TT)-reactive CD4 T cells were compared between normal controls and MS patients. Peripheral blood T cells were stimulated with Chinese hamster ovary (CHO) cells transfected either with DRB1*1501/DRA0101 chains (t-DR2) alone, or in combination with, B7-1 or B7-2. In the absence of costimulation, T cells from normal subjects stimulated with the recall antigen TT p830-843 were induced to expand and proliferate, but stimulation with MBP p85-99 did not have this effect. In marked contrast, T cells from patients with MS stimulated with MBP p85-99 in the absence of B7-1 or B7-2 signals expanded and proliferated. Thus, MBP-reactive CD4 T cells in patients with MS are costimulation independent and have been previously activated in vivo. These experiments provide further direct evidence for a role of activated MBP-specific CD4 T cells in the pathogenesis of MS.

Topics: Abatacept; Antigens, CD; Antigens, Differentiation; Autoantigens; B7-1 Antigen; B7-2 Antigen; Clone Cells; CTLA-4 Antigen; Epitopes, T-Lymphocyte; Humans; Immunoconjugates; Immunoglobulin Fc Fragments; Immunosuppressive Agents; Interleukin-4; Lymphocyte Activation; Membrane Glycoproteins; Multiple Sclerosis; Myelin Basic Protein; Recombinant Fusion Proteins; T-Lymphocyte Subsets; Tetanus Toxoid; Thymidine

Based on studies reporting an overexpression of certain V genes in myelin basic protein (MBP)-specific T cells from MS patients, immunotherapies targeting single TCR (Vbeta5.2, Vbeta6.1) are currently under way. In order to assess the basic assumption for one of these therapeutic strategies, i.e. the overexpression of Vbeta5.2 by MBP-specific T cells, we analyzed 100 MBP-specific T cell lines (TCL) for Vbeta5.2 expression. Only 4 out of 100 TCL expressed Vbeta5.2, and expression of this TCR gene is therefore not more frequent than expected from the normal peripheral blood distribution.

Topics: Adult; Aged; Female; Genes, T-Cell Receptor beta; HLA-DR2 Antigen; Humans; Immunotherapy; Leukocytes, Mononuclear; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; RNA, Messenger; T-Lymphocytes

Myelin basic protein (MBP)-reactive T cells may play an important role in the pathogenesis of multiple sclerosis (MS). The T cell response to the 83-99 region of MBP represents a dominant autoreactive response to MBP in MS patients of DR2 haplotype. In this study, a large panel of DR2- and DR4-restricted T cell clones specific for the MBP83-99 peptide were examined for the recognition motifs and structural requirements for antigen recognition using alanine-substituted peptides. Our study revealed that although the recognition motifs of the T cell clones were diverse, the TCR contact residues within the 83-99 region of MBP were highly conserved. Two central residues (Phe90 and Lys91) served as the critical TCR contact points for both DR2- and DR4-restricted T cell clones. Single alanine substitution at residue 90 or residue 91 abolished the responses of 81-95 % of the T cell clones while a double alanine substitution rendered all T cell clones unresponsive. It was also demonstrated in this study that the substituted peptides altered the cytokine profile of some, but not all, T cell clones. Some MBP83-99-specific T cell clones were able to sustain alanine substitutions and were susceptible to activation by microbial antigens. The study has an important implication in designing a peptide-based therapy for MS.

Topics: Alanine; Cells, Cultured; Cross Reactions; Epitopes, T-Lymphocyte; Herpesvirus 2, Human; Humans; Immunodominant Epitopes; Interferon-gamma; Interleukin-10; Lysine; Multiple Sclerosis; Myelin Basic Protein; Papillomaviridae; Peptide Fragments; Peptides; Phenylalanine; Receptors, Antigen, T-Cell; Structure-Activity Relationship; T-Lymphocytes; Viral Proteins

Cytokines are suggested to orchestrate an abnormal immune response in multiple sclerosis (MS). The regulatory cytokine interleukin (IL)-12 induces T-helper (Th) cell switch to the Th1 type and the production by cytotoxic T cells of perforin, a cell lysis-inducing factor. It has been suggested that Th1-like cytokines may promote the development of MS, and the production of perforin to induce oligodendrocyte damage. In-situ hybridization with radiolabelled synthetic oligonucleotide probes was used to detect and enumerate mononuclear cells (MNC) expressing IL-12 and perforin mRNA in blood and cerebrospinal fluid (CSF) from patients with MS and controls. Plasma and CSF levels of IL-12 (p70) were evaluated by ELISA. Higher numbers of IL-12 and perforin mRNA-expressing MNC were registered in blood in MS and also in controls with aseptic meningoencephalitis (AM) compared to healthy subjects. There were a few patients with other non-inflammatory neurological diseases who also had high levels of IL-12 or perforin mRNA expressing blood MNC. A parallel elevation was observed for IL-12 (p70) concentrations in plasma. In the MS patients' CSF, there was a further augmentation of IL-12 mRNA expressing MNC. To evaluate autoantigen-induced IL-12 and perforin mRNA expression, blood MNC were cultivated +/- myelin basic protein (MBP), a candidate autoantigen in MS. Higher numbers of MBP-reactive IL-12 and perforin mRNA expressing blood MNC were detected in MS than controls. The augmentation of both IL-12 and perforin in MS might reflect ongoing inflammatory processes in MS and could represent targets for future treatments.

Topics: Adult; Aged; Aged, 80 and over; Cells, Cultured; Female; Gene Expression; Humans; Interleukin-12; Leukocytes, Mononuclear; Male; Membrane Glycoproteins; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Perforin; Pore Forming Cytotoxic Proteins; RNA, Messenger

The ectoenzyme dipeptidyl peptidase IV (DP IV, EC 3.4.14.5, CD26) has been shown to play a crucial role in T cell activation. Specific inhibitors of DP IV suppress DNA synthesis as well as cytokine production (IL-2, IL-10, IL-12, IFN-gamma) of stimulated human and mouse T cells suggesting a potential application of these effectors in transplantations and autoimmune diseases. In the present study, we have examined the expression of DP IV/CD26 on six myelin basic protein (MBP)(87-99)-specific, CD4+ T cell clones (TCC) derived from patients with multiple sclerosis (MS) as well as the biological effects of the two synthetic DP IV inhibitors Lys[Z(NO2)]-thiazolidide and Lys[Z(NO2)]-pyrrolidide on the function of these cells. All TCC expressed high levels of DP IV/CD26, as shown by flow cytometry and by enzymatic DP IV assay. Enzymatic activity of resting TCC was found to be three to fourfold higher than on resting peripheral blood T cells and close to that of T cells 48 h after PHA stimulation. The DP IV inhibitors suppress DNA synthesis and IFN-gamma, IL-4, and TNF-alpha production of the antigen-stimulated TCC. These data suggest that CD26 plays a role in regulation of activation of autoreactive TCC. Further in-vivo investigations, first in experimental models, will clarify, whether the inhibition of the enzymatic activity of DP IV could be a useful tool for therapeutic interventions in MS or other autoimmune diseases.

Topics: CD4 Antigens; Clone Cells; Cytokines; Dipeptidyl Peptidase 4; DNA; Humans; Lysine; Multiple Sclerosis; Myelin Basic Protein; Protease Inhibitors; Pyrrolidines; T-Lymphocytes; Thiazoles

Multiple sclerosis (MS) is a presumed cell-mediated Th1-type autoimmune disease. Thus therapies which decrease T cells secreting IFN-gamma production or increase IL-4 production would be expected to have an ameliorating effect on MS. We have previously reported increased anti-CD3-induced IL-4 secretion by T cells in progressive MS patients treated with cyclophosphamide plus methylprednisolone (CY/MP) which was associated with eosinophilia. To investigate whether the increased IL-4 secretion was myelin antigen specific, we generated 3990 short-term T cell lines to myelin basic protein (MBP), proteolipid protein (PLP), or tetanus toxoid (TT) from 31 progressive MS patients: 11 MS patients treated with CY/MP, 10 MS patients treated with MP alone, and 10 untreated MS patients. We found increased frequencies of both MBP- and PLP-specific IL-4-secreting T cell lines in CY/MP-treated patients compared to untreated MS patients. However, no change in the frequency of TT-specific IL-4-secreting T cells was observed. MP treatment alone did not increase the frequency of antigen-specific IL-4-secreting T cell lines. These results demonstrate immune deviation favoring Th2-type responses specific to autoantigens following pulse cyclophosphamide therapy in MS patients.

Topics: Adult; Autoantigens; Cell Line; Cyclophosphamide; Female; Humans; Interleukin-4; Male; Methylprednisolone; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Tetanus Toxoid; Th2 Cells

We measured sICAM-1 in paired samples of serum and cerebrospinal fluid (CSF) from patients with an attack of multiple sclerosis (MS) (n = 50) and patients with acute monosymptomatic optic neuritis (ON) as a possible first attack of MS were also included (n = 25). Based on calculations of extended indices we found evidence of intrathecal synthesis of sICAM-1 both in patients with clinically definite MS and in patients with idiopathic ON compared to neurological control subjects. The amount of intrathecally synthesized sICAM-1 correlated significantly to the CSF leukocyte count and to the concentration of myelin basic protein in the CSF. The serum concentrations of sICAM-1 were not increased in patients with demyelinating disease compared to the neurological control subjects.

Topics: Acute Disease; Adult; Aged; Aged, 80 and over; Female; Humans; Inflammation; Intercellular Adhesion Molecule-1; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Optic Neuritis; Osmolar Concentration; Regression Analysis; Serum Albumin; Solubility; Spinal Cord

Multiple episodes of blood-brain barrier disruption were induced by sequential intraspinal injections of ethidium bromide. In addition to the barrier disruption, there was toxic demyelination and exposure of myelin components to the immune system. Twenty-seven 3-month-old Wistar rats received 2, 3 or 4 injections of 1 microliter of either 0.1% ethidium bromide in normal saline (19 rats) or 0.9% saline (8 rats) at different levels of the spinal cord. The time intervals between the injections ranged from 28 to 42 days. Ten days after the last injection, all rats were perfused with 2.5% glutaraldehyde. The spinal sections were evaluated macroscopically and by light and transmission electron microscopy. All the lesions demonstrated a mononuclear phagocytic infiltrate apparently removing myelin. Lymphocytes were not conspicuous and were found in only 34% of the lesions. No perivascular cuffings were detected. In older lesions (38 days and older) they were found only within Virchow-Robin spaces. This result suggests that multiple blood-brain barrier disruptions with demyelination and exposure of myelin components to the immune system were not sufficient to induce an immune-mediated reaction in the central nervous system.

Topics: Animals; Blood-Brain Barrier; Central Nervous System; Demyelinating Diseases; Ethidium; Female; Injections, Spinal; Lymphocytes; Male; Microscopy, Electron; Multiple Sclerosis; Myelin Basic Protein; Nicotinic Antagonists; Rats; Rats, Wistar; Spinal Cord

T cell responses to myelin basic protein (MBP) are thought to play an important role in the pathogenesis of multiple sclerosis (MS). The response to the 83-99 region of MBP represents a dominant response to MBP in patients with MS and is associated with HLA-DR2 that is linked with susceptibility to MS. Although T cell clones reactive to various regions of MBP have been found to exhibit heterogeneous TCR Vbeta gene usage in patients with MS, it is unclear whether T cell clones uniformly recognizing the 83-99 peptide of MBP in the context of the same DR molecule would have restricted TCR V gene rearrangements and recognition motifs. In this study, a panel of DR2- or DR4-restricted T cell clones specific for the MBP83-99 peptide were derived from 11 patients with MS and examined for TCR V gene usage by PCR and the recognition motifs using analog peptides. Our study revealed that despite a few T cell clone pairs having similar recognition motifs and shared sequence homology in the CDR3, the overall recognition motifs of MBP83-99-specific T cells were considerably diverse. Interestingly, the DR2-restricted T cell clones displayed a biased V gene usage for Valpha3 and Valpha8, while Vbeta gene rearrangements were highly heterogeneous. This study provided experimental evidence suggesting a limited heterogeneity in TCR Valpha gene rearrangements of MBP-reactive T cells in DR2 patients with MS.

Topics: Amino Acid Sequence; DNA; Gene Rearrangement, alpha-Chain T-Cell Antigen Receptor; HLA-DR2 Antigen; Humans; Immunodominant Epitopes; Immunoglobulin Variable Region; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes

Glial growth factor 2 (GGF2) is a neuronal signal that promotes the proliferation and survival of the oligodendrocyte, the myelinating cell of the central nervous system (CNS). The present study examined whether recombinant human GGF2 (rhGGF2) could effect clinical recovery and repair to damaged myelin in chronic relapsing experimental autoimmune encephalomyelitis (EAE) in the mouse, a major animal model for the human demyelinating disease, multiple sclerosis. Mice with EAE were treated with rhGGF2 during both the acute and relapsing phases. Clinically, GGF2 treatment delayed signs, decreased severity, and resulted in statistically significant reductions in relapse rate. rhGGF2-treated groups displayed CNS lesions with more remyelination than in controls. This correlated with increased mRNA expression of myelin basic protein exon 2, a marker for remyelination, and with an increase in the CNS of the regulatory cytokine, interleukin 10, at both the RNA and protein levels. Thus, a beneficial effect of a neurotrophic growth factor has been demonstrated on the clinical, pathologic, and molecular manifestations of autoimmune demyelination, an effect that was associated with increased expression of a T helper 2 cytokine. rhGGF2 treatment may represent a novel approach to the treatment of multiple sclerosis.

Topics: Animals; Base Sequence; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Exons; Glia Maturation Factor; Humans; In Situ Hybridization; Mice; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Nerve Growth Factors; Nerve Tissue Proteins; Oligonucleotide Probes; Recombinant Proteins; RNA, Messenger; Th2 Cells

HLA-DR2 is associated with susceptibility to multiple sclerosis (MS). A peptide from human myelin basic protein (MBP, residues 85-99) was previously found to bind to purified HLA-DR2 (DRA, DRB1*1501) and to be recognized by human MBP-specific T cell clones. Soluble HLA-DR2 was expressed in the baculovirus system by replacing the hydrophobic transmembrane regions and cytoplasmic segments of DRalpha and DRbeta with leucine zipper dimerization domains from the transcription factors Fos and Jun. In the expression construct, the MBP(85-99) sequence was covalently linked to the N terminus of the mature DRbeta chain. The recombinant protein was secreted by Sf9 cells infected with the recombinant baculovirus and purified by affinity chromatography. The leucine zipper dimerization domains were then cleaved from the assembled HLA-DR2/MBP peptide complex with V8 protease, and the protein was further purified by anion-exchange HPLC. Analysis by HPLC gel filtration indicated that the HLA-DR2/MBP peptide complex did not have a tendency to aggregate. The purified HLA-DR2/MBP peptide complex readily crystallized by the hanging drop method in 15-18% polyethylene glycol 6000/100 mM glycine, pH 3.5. At a synchrotron radiation source, a crystal with a tetragonal space group diffracted to a resolution of 2.6 A. The expression of such homogenous HLA-DR/peptide complexes may facilitate cocrystallization with T cell receptors as well as other molecules involved in T cell receptor recognition and signaling.

Topics: Amino Acid Sequence; Animals; Baculoviridae; Base Sequence; Cell Line; Crystallization; Dimerization; DNA Primers; Gene Expression; HLA-DR2 Antigen; Humans; Immunodominant Epitopes; Leucine Zippers; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Recombinant Proteins; Solubility; Spodoptera; T-Lymphocytes

Autoimmune mechanisms involving T-cell responses to (a) myelin autoantigen(s), such as myelin basic protein (MBP), are thought to contribute to the pathogenesis of multiple sclerosis (MS). Cytokines may play a central role in the regulation of the pathogenic autoimmune responses in MS and the mediation of tissue damage in the disease. To study the cytokine expression of myelin reactive T-cells in MS, we determined the cytokine mRNA levels in a panel of blood derived MBP-specific T-cell clones derived from MS patients (33 clones) and normal controls (21 clones), using a novel quantitative RT-PCR method. Our results demonstrate that MBP-specific T-cells, both from MS patients and control subjects, predominantly display a Th1- or Th0-like cytokine pattern. Although MS clones express higher levels of TNFalpha and IL-10 mRNA, these differences do not reach statistical significance. Interestingly, significantly increased TNFalpha and IFNgamma mRNA levels were observed among clones derived from HLA-DR2 positive versus HLA-DR2 negative MS patients. This HLA halpotype is known to be associated with MS. The high levels of TNFalpha and IFNgamma mRNA observed in MBP-reactive T-cell clones from MS patients indicate an important role of these cytokines in the disease process. Our data lend further support to the pathogenic role of MBP-reactive T-cells in MS.

Topics: Adult; Autoantigens; Clone Cells; Cytokines; Enzyme-Linked Immunosorbent Assay; Female; Gene Expression; Genes, T-Cell Receptor; HLA-DR2 Antigen; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Reverse Transcriptase Polymerase Chain Reaction; RNA, Messenger; T-Lymphocytes, Helper-Inducer

Multiple sclerosis (MS) is a central nervous system-specific inflammatory and demyelinating disease where a myelin-directed autoimmune response is thought to be pathogenetically relevant. Myelin oligodendrocyte glycoprotein (MOG) is a surface-exposed minor myelin component that is a prime candidate autoantigen. We have investigated peripheral blood lymphocyte responses to synthetic 15-26 amino acids long overlapping MOG peptides in 20 MS patients and 14 healthy controls with the MS-associated HLA haplotype DR2(15). There were significantly increased responses, in terms of numbers of cells secreting IFN-gamma detected by Elispot in response to several MOG-derived peptides in the MS patients, but not the healthy controls. MOG peptide 63-87 evoked the strongest response, and the stimulatory property of this peptide was confirmed in additional DR2(15)+ MS patients where a peptide concentration-dependent proliferative response, which was inhibited by the addition of anti-HLA class II antibodies, was observed. This is the first work detailing putative immunodominant T cell epitopes of MOG in DR2(15)+ MS patients.

Topics: Adult; Amino Acid Sequence; Antigens, Surface; Cell Division; Epitope Mapping; Epitopes, T-Lymphocyte; Female; HLA-DR2 Antigen; Humans; Interferon-gamma; Leukocytes, Mononuclear; Male; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Peptides

Autoimmune diseases result from a failure of tolerance. Although many self-reactive T cells are present in animals and humans, their activation appears to be prevented normally by regulatory T cells. In this study, we show that regulatory CD4(+) T cells do protect mice against the spontaneous occurrence of experimental autoimmune encephalomyelitis (EAE), a mouse model for multiple sclerosis. Anti-myelin basic protein (MBP) TCR transgenic mice (T/R+) do not spontaneously develop EAE although many self-reactive T cells are present in their thymi and peripheral lymphoid organs. However, the disease develops in all crosses of T/R+ mice with recombination-activating gene (RAG)-1 knockout mice in which transgenic TCR-expressing cells are the only lymphocytes present (T/R- mice). In this study, crosses of T/R+ mice with mice deficient for B cells, CD8(+) T cells, NK1.1 CD4(+) T (NKT) cells, gamma/delta T cells, or alpha/beta T cells indicated that alpha/beta CD4(+) T cells were the only cell population capable of controlling the self-reactive T cells. To confirm the protective role of CD4(+) T cells, we performed adoptive transfer experiments. CD4(+) T cells purified from thymi or lymph nodes of normal mice prevented the occurrence of spontaneous EAE in T/R- mice. To achieve full protection, the cells had to be transferred before the recipient mice manifested any symptoms of the disease. Transfer of CD4(+) T cells after the appearance of symptoms of EAE had no protective effect. These results indicate that at least some CD4(+) T cells have a regulatory function that prevent the activation of self-reactive T cells.

Topics: Animals; CD4-Positive T-Lymphocytes; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Flow Cytometry; Mice; Mice, Knockout; Multiple Sclerosis; Myelin Basic Protein; Phenotype; Receptors, Antigen, T-Cell; Thymus Gland

The objective of this study was to determine whether autoreactive T cells in patients with multiple sclerosis (MS) are polarized and committed in their differentiation to a stable cytokine phenotype or whether the cytokine secretion can be altered. We examined the cytokines secreted by myelin basic protein (MBP) as compared to tetanus toxoid-reactive (TT) T cells in 12 patients with relapsing remitting MS (RR-MS), 9 patients with chronic progressive MS (CP-MS), and 14 normal individuals. A total of 5094 short term T cell lines to MBP and TT were generated in the presence of growth conditions promoting Th1 (IL-12/alpha-IL-4 mAb) or Th2 (IL-4/alpha-IL-12 mAb) cytokine secretion. Antigen-specific cytokine secretion from normals and MS patients could be shifted to a Th1 or Th2 type phenotype depending upon culture conditions, indicating that the phenotype of MBP reactive T cells can be altered even in longstanding chronic progressive MS. There were no significant differences in the cytokine patterns secreted by MBP reactive T cells in patients with MS as compared to normal individuals. However, CP-MS patients tended to have fewer MBP reactive T cells secreting IL-4 when cultured with IL-12/anti-IL-4 mAb and more IFN-gamma secreting MBP reactive T cells when cultured with IL-4/anti-IL-12 mAb as compared to both normal controls and RR-MS, suggesting that cells from these patients might be more polarized or that fewer undifferentiated MBP-reactive cells are present in these individuals. The most striking observation was that in contrast to the RR-MS patients and normal controls, almost none of the MBP reactive T cells secreting cytokines in CP-MS incorporated 3[H]thymidine. This may be due to chronic in vivo stimulation in the presence of IL-12, or because these T cells may have entered a terminally differentiated state. Nonetheless, the ability to alter the cytokine secretion of autoreactive T cell lines even in longstanding autoimmune disease indicates that cytokine therapy might have therapeutic benefits by switching the function of myelin reactive T cells such that they are non-pathogenic.

Topics: Antibodies, Monoclonal; Antibody Specificity; Cell Division; Cells, Cultured; Cytokines; Humans; Interferon-gamma; Interleukin-10; Interleukin-12; Interleukin-4; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes

The synthetic amino acid copolymer, copolymer 1 (Cop 1) induces T suppressor (Ts) lines/clones, which are confined to the Th2 pathway, cross react with myelin basic protein (MBP), but not with other myelin antigens on the level of Th2 cytokine secretion. Nevertheless, Cop 1 Ts cells inhibited the IL-2 response of a proteolipid protein (PLP) specific line. Furthermore, Cop 1 Ts cells ameliorated EAE induced by two unrelated encephalitogenic epitopes of PLP: p139-151 and p178-191, that produced different forms of disease. This bystander suppression demonstrated by the Cop 1 Ts cells may explain the therapeutic effect of Cop 1 in EAE and MS.

Topics: Animals; Clone Cells; Cross Reactions; Cytokines; Encephalomyelitis, Autoimmune, Experimental; Epitopes; Female; Glatiramer Acetate; Immunosuppressive Agents; Mice; Mice, Inbred BALB C; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Peptide Fragments; Peptides; Th2 Cells

Experimental autoimmune encephalomyelitis (EAE) can be effectively treated during disease exacerbation by administration of a peptide corresponding to the major T cell epitope of myelin basic protein (MBP), but the mechanism by which T cell tolerance leads to clinical improvement is not well-defined. Acute exacerbations of EAE are accompanied by an infiltration of blood-borne leukocytes into the brain and spinal cord, where they mediate inflammation and demyelination. To investigate peptide effects on infiltrating cells, we collected cerebrospinal fluid (CSF) from (PL/JxSJL)F1 mice with MBP-induced EAE. Pleiocytosis by lymphocytes, neutrophils, and macrophages was seen throughout the course of relapsing-remitting disease. A single administration of the MBP peptide analog, Ac1-11[4Y], reduced disease severity, accompanied by a dramatic and selective loss of neutrophil pleiocytosis. A longer course of peptide therapy resulted in complete recovery from clinical signs of disease, and decreased pleiocytosis by all cell types. Clinical severity throughout the course of disease and therapy was directly related to the degree of infiltration by neutrophils and macrophages, and the clinical improvement following peptide therapy was accompanied by decreased central nervous system (CNS) expression of chemoattractants for these cell types. These observations support a model of disease exacerbation mediated by phagocytic cellular infiltration under the ultimate control of T cell-derived factors, amenable to treatment by down-regulation of the T cell activation state.

Topics: Actins; Amino Acid Sequence; Animals; CD11 Antigens; CD4-Positive T-Lymphocytes; Cerebrospinal Fluid; Chemokine CCL2; Encephalomyelitis, Autoimmune, Experimental; Female; Gene Expression; Mice; Mice, Inbred Strains; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Neutrophils; Oligonucleotide Probes; Phagocytosis; Transcription, Genetic

The potential of magnetic resonance imaging to serve as a surrogate marker of disease activity in patients with multiple sclerosis (MS) is increasingly recognised. In contrast, the use of cerebrospinal fluid analysis has received less attention. We analysed the correlation between clinical data and cerebrospinal fluid parameters in 75 patients with acute optic neuritis (ON) as a possible first symptom of MS, as a symptom of clinically definite MS, and in patients with an attack of MS other than ON. The samples were obtained within 30 days from the onset of an exacerbation. The concentration of myelin basic protein (MBP) in cerebrospinal fluid was significantly correlated with the visual acuity in patients with ON and the Kurtzke EDSS score in patients with MS. The concentration of MBP in CSF also correlated positively with the CSF leukocyte count, intrathecal IgG synthesis, and the CSF-serum albumin concentration quotient. The concentration of MBP in CSF correlated negatively with intrathecal IgA synthesis. The results support the use of the concentration of MBP in CSF as a surrogate marker of disease activity during acute exacerbations of MS; the data also link the presence of MBP in CSF to neuroimmunological parameters.

Topics: Adolescent; Adult; Cerebrospinal Fluid; Female; Humans; Immunoglobulin A; Immunoglobulin G; Immunoglobulin M; Leukocyte Count; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Optic Neuritis

A computational model of myelin basic protein (MBP) has been constructed based on the premise of a phylogenetically conserved beta-sheet backbone and on electron microscopical three-dimensional reconstructions. Many residues subject to post-translational modification (phosphorylation, methylation, or conversion of arginines to citrullines) were located in loop regions and thus accessible to modifying enzymes. The triproline segment (residues 99-101) is fully exposed on the back surface of the protein in a long crossover connection between two parallel beta-strands. The proximity of this region to the underlying beta-sheet suggests that post-translational modifications here might have potential synergistic effects on the entire structure. Post-translational modifications that lead to a reduced surface charge could result first in a weakened attachment to the myelin membrane rather than in a gross conformational change of the protein itself. Such mechanisms could be operative in demyelinating diseases such as multiple sclerosis.

Topics: Humans; Microscopy, Electron; Models, Molecular; Multiple Sclerosis; Myelin Basic Protein; Protein Conformation

Monoclonal Abs to the complex formed between human MHC class II molecules (DR7 and DRw11) and myelin basic protein (MBP) were produced. The specificity of these Abs was established by both FACS analysis and complement-mediated cytotoxicity of MBP- or OVA-pulsed human APC of the same or of different DR restriction. These Abs bound to and lysed only MBP-pulsed human APC of the same DR restriction (DR7 or DRw11) but not to APC of different DR restriction or pulsed with a different Ag (OVA). The physiologic role of these Abs was further investigated. They blocked the in vitro proliferative response to MBP-specific T cell clones isolated from multiple sclerosis patients in an antigen-specific and DR-restricted manner. However, the Abs did not affect the response of MBP-specific T cell clones of other DR restriction nor did they interfere with the response to other Ags (purified protein derivative or copolymer 1) presented on APC with the same DR restriction. These Abs may be useful for treating multiple sclerosis in which reactivity to MBP is implicated. Moreover, this approach may be extended to other autoantigens and their counterpart autoimmune diseases.

Topics: Animals; Antibodies, Monoclonal; Antibody Specificity; Antigen-Presenting Cells; Binding Sites, Antibody; Clone Cells; Complement System Proteins; Cytotoxicity, Immunologic; Epitopes; HLA-DR Antigens; HLA-DR Serological Subtypes; HLA-DR7 Antigen; Humans; Immunosuppressive Agents; Lymphocyte Activation; Multiple Sclerosis; Myelin Basic Protein; Rats; T-Lymphocytes

Antibody and T cell-mediated immune responses to oligodendroglial autoantigens transaldolase (TAL) and myelin basic protein (MBP) were examined in patients with multiple sclerosis (MS). Immunohistochemical studies of postmortem brain sections revealed decreased staining by MBP- and TAL-specific antibodies in MS plaques, indicating a concurrent loss of these antigens from demyelination sites. By Western blot high titer antibodies to human recombinant TAL were found in 29/94 sera and 16/23 cerebrospinal fluid samples from MS patients. Antibodies to MBP were undetectable in sera or cerebrospinal fluid of these MS patients. Proliferative responses to human recombinant TAL (stimulation index [SI] = 2.47+/-0.3) were significantly increased in comparison to MBP in 25 patients with MS (SI = 1.37+/-0.1; P < 0.01). After a 7-d stimulation of PBL, utilization of any of 24 different T cell receptor Vbeta gene segments in response to MBP was increased less than twofold in the two control donors and six MS patients investigated. In response to TAL-H, while skewing of individual Vbeta genes was also less than twofold in healthy controls, usage of specific Vbeta gene segments was differentially increased ranging from 2.5 to 65.9-fold in patients with MS. The results suggest that TAL may be a more potent immunogen than MBP in MS.

Topics: Adult; Aged; Autoantibodies; Female; Humans; Immunity, Cellular; Lymphocyte Activation; Male; Middle Aged; Multigene Family; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell, alpha-beta; T-Lymphocytes; Transaldolase

The CSF and sera of 185 patients with multiple sclerosis (MS), 130 patients with other inflammatory diseases of the CNS (OID) and 50 patients with spinal disc syndrome (controls) were investigated for IgG-antibodies to CNS proteins by SDS-PAGE and immunoblotting and by isoelectric focusing combined with affinity blotting. IgG-antibodies to CNS proteins in serum (immunoblotting) were detected in 18 patients with MS (10%), in 29 patients with OID (22%) and in four controls (8%). Intrathecal synthesis of IgG-antibodies to CNS proteins was demonstrated in 11 patients with MS (6%), in 37 patients with OID (28%) and in none of the controls. In 4/11 patients with MS intrathecally produced antibodies were shown to be specific for glial fibrillary acidic protein (GFAP). Of patients with MS, 180 displayed oligoclonal IgG-bands in the CSF. Specificity of these bands for CNS proteins was demonstrated only in 2/180 specimens (1%). These findings indicate, that in most patients with MS oligoclonal IgG-bands in the CSF do not contain relevant amounts of antibodies to CNS proteins.

Topics: Enzyme-Linked Immunosorbent Assay; Glial Fibrillary Acidic Protein; Humans; Immunoblotting; Immunoglobulin G; Isoelectric Focusing; Multiple Sclerosis; Myelin Basic Protein

The frequency of clonally expanded and persistent T cells recognizing the immunodominant autoantigenic peptide of myelin basic protein (MBP)p85-99 was directly measured ex vivo in subjects with typical relapsing remitting multiple sclerosis (MS). T cells expressing mRNA transcripts encoding T cell receptor (TCR)-alpha and -beta chains found in T cell clones previously isolated from these subjects recognizing the MBPp85-99 epitope were examined. In contrast to frequencies of 1 in 10(5)-10(6) as measured by limiting dilution analysis, estimates of the T cell frequencies expressing MBPp85-99-associated TCR chain transcripts were as high as 1 in 300. These high frequencies were confirmed by performing PCR on single T cells isolated by flow cytometry. MBPp85-99 TCR transcripts were present in IL-2 receptor alpha-positive T cells which were induced to undergo Fas-mediated cell death upon antigen stimulation. These data demonstrate that at least a subpopulation of patients with MS can have a very high frequency of activated autoreactive T cells.

Topics: Autoantigens; Autoimmune Diseases; Cell Death; Clone Cells; fas Receptor; Gene Rearrangement, alpha-Chain T-Cell Antigen Receptor; Gene Rearrangement, beta-Chain T-Cell Antigen Receptor; Humans; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell, alpha-beta; T-Lymphocytes

CD4+ class II-restricted T cells specific for self antigens are thought to be involved in the pathogenesis of most human autoimmune diseases and molecular mimicry between foreign and self ligands has been implicated as a possible mechanism for their activation. In this report we introduce combinatorial peptide libraries as a powerful tool to identify cross-reactive ligands for these T cells. The antigen recognition of a CD4+ T cell clone (TCC) specific for myelin basic protein peptide (MBP) (86-96) was dissected by the response to a set of 220 11-mer peptide sublibraries. Based on the results obtained with the libraries for each position of the antigen, artificial peptides were found that induced proliferative responses at much lower concentrations than MBP(86-96). In addition stimulatory ligands derived from protein sequences of self and microbial proteins were identified, some of them even more potent agonists than MBP(86-96). These results indicate that: (a) for at least some autoreactive CD4+ T cells antigen recognition is highly degenerate; (b) the autoantigen used to establish the TCC represents only a suboptimal ligand for the TCC; (c) a completely random and unbiased approach such as combinatorial peptide libraries can decrypt the spectrum of stimulatory ligands for a T cell receptor (TCR).

Topics: Amino Acid Sequence; Autoantigens; Autoimmunity; Clone Cells; Humans; Ligands; Lymphocyte Activation; Multiple Sclerosis; Myelin Basic Protein; Peptides; Structure-Activity Relationship; T-Lymphocytes

Topics: Administration, Oral; Animals; Cell Line; Cytokines; Humans; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes; Transforming Growth Factor beta

Topics: Animals; Antibodies, Monoclonal; Brain; Humans; In Vitro Techniques; Mice; Microscopy, Electron; Multiple Sclerosis; Myelin Basic Protein; Rats; Sulfoglycosphingolipids

Central nervous system tissue from multiple sclerosis and non-multiple sclerosis subjects was studied for the expression of exon 2 myelin basic protein gene products at the protein and message levels by immunocytochemistry and in situ hybridization, respectively. The exon 2-encoded protein sequence is normally expressed during development (myelination) within the 21.5- and 20.2-kd isoforms of myelin basic protein and is downregulated in the adult central nervous system where the 18.5- and 17.2-kd isoforms predominate, the latter devoid of exon 2 owing to alternative splicing. Exon 2 myelin basic protein gene products were readily demonstrable in multiple sclerosis samples, the highest levels correlating with remyelination in chronic lesions while normal adult central nervous system and non-multiple sclerosis material showed very low levels and fetal human central nervous system tissue (a positive control) showed high levels. We conclude that recapitulation of ontogenetic events during myelin repair accounts for the increased expression of the exon 2-encoded protein sequence in the adult central nervous system during multiple sclerosis, an event that might underly the previously observed T-cell activation to this protein sequence during relapses.

Topics: Acute Disease; Adult; Aged; Aged, 80 and over; Central Nervous System; Chronic Disease; Exons; Female; Fetus; Genes; Genes, Developmental; Humans; Immunohistochemistry; In Situ Hybridization; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Nervous System Diseases

The combination of genetic and environmental factors that contribute to human autoimmune responses has made potential triggers of these diseases difficult to identify. We examined how experimental allergic encephalomyelitis (EAE), an animal model of multiple sclerosis, is triggered using TCR-transgenic mice specific for myelin basic protein (MBP). In these TCR-transgenic mice, EAE can be actively induced and also occurs spontaneously. The incidence of spontaneous EAE in this model is largely confined to adolescence and early adulthood and is more prevalent among males than females, indicating that hormonal influences may contribute to triggering central nervous system autoimmune disease. Disease induction studies show that not all stimuli that activate MBP-specific T cells in vivo also induce EAE. Immunization with MBP peptide stimulates the transgenic T cells to produce Th1 cytokines; however, the activated T cells do not accumulate in the central nervous system and induce EAE unless pertussis toxin is also administered. EAE can be induced by intrathecal injection of either stimulated or nonstimulated transgenic T cells into nontransgenic or transgenic recipients. Therefore, gaining access to the central nervous system appears to be the critical step in this model for the induction of EAE, regardless of the activation state of the T cells.

Topics: Animals; Autoimmune Diseases; Disease Models, Animal; Humans; Mice; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell; T-Lymphocytes

We assessed human myelin basic protein (MBP) binding IgM levels in CSF. MBP is the most studied putative antigen in multiple sclerosis (MS) and immune responses against it may be involved in the demyelination process. We also correlated these levels with EDSS score and other parameters of disease progression and prognosis, both at the time of CSF analysis and during follow-up. CSF IgM anti-MBP levels were assayed by measuring total IgM levels with solid-phase ELISA in CSF samples from 66 patients with relapsing-remitting MS, 11 subjects without neurological diseases, 20 patients with non-inflammatory neurological diseases and 7 patients with lymphocytic meningitis, before and after immunoabsorption with human MBP. Confirmation of IgM binding specificity was performed by immunoblotting of positive CSF samples onto MBP coated-nitrocellulose sheets. Clinical evaluation (disability score, number and time of attacks) was performed during a mean follow-up of 2.7 +/- 1.1 years. 23 of the 66 relapsing-remitting MS patients (33.8%) had elevated IgM anti-MBP levels. In this patient subgroup, IgM anti-MBP levels correlated with the IgM index (r = 0.71; P = 0.0001), but not with CSF/serum albumin (r = 0.08; P = 0.72). In the first year of follow-up, patients with low IgM anti-MBP suffered from more numerous attacks than those with elevated levels (0.86 +/- 0.63 versus 0.43 +/- 0.58; P = 0.017). Patients with high IgM binding to MBP had a first attack during follow-up in a significantly higher time than those with low binding (28.87 +/- 4.7 versus 17 +/- 2.6 months, respectively; P = 0.005) and reached a decrease of 0.5 EDSS point significantly faster than those with low IgM (16.17 +/- 1.2 versus 29.7 +/- 2.6 months, respectively; P = 0.0002). A similar significant finding was observed when the time to reach low disability score (EDSS < or = 2.0) was analyzed (10.7 +/- 2.57 +/- 3.3 months, respectively; P = 0.014). These findings demonstrate that in a subgroup of MS patients, elevated CSF levels of IgM anti-MBP are associated with early favorable course and therefore suggest that IgM binding to MBP could be a possible prognostic marker in relapsing-remitting MS to select early MS patients for future trials.

Topics: Adolescent; Adult; Autoantibodies; Demyelinating Diseases; Disease Progression; Female; Follow-Up Studies; Humans; Immunoblotting; Immunoglobulin M; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Prognosis; Survival Analysis

The pathogenesis of multiple sclerosis (MS) is currently ascribed in part to a T cell-mediated process targeting myelin components. The T cell response to one candidate autoantigen, myelin basic protein (MBP), in the context of HLA-DR15Dw2, has been previously studied in detail. However, the characteristics of cellular immunity in the context of other MS-associated HLA-DR haplotypes are scarcely known. MBP-specific T cell lines (TCL) were generated from HLA-DR4 (B1*0401)-positive MS subjects. Out of 275 MBP-specific TCL, 178 (64. 7%) specifically recognized region MBP(111-129), predominantly in the context of DRB1*0401. The major T cell epitope for MBP recognition corresponded to residues MBP(116-123). These TCL expressed disparate profiles of cytokine secretion and cytotoxicity. T cell receptor analysis, on the other hand, revealed a strikingly limited heterogeneity of rearrangements. In contrast to MBP(81-99), which binds with high affinity to HLA-DR15 and is recognized by a diverse T cell repertoire, MBP(111-129) binds weakly to DRB1*0401, suggesting that only high affinity T cell receptors might be able to efficiently engage such unstable MHC/peptide complexes, thus accounting for the T cell receptor restriction we observed. This study provides new insight about MBP recognition and proposes an alternative mechanism for immunodominance of self-antigen T cell epitopes in humans.

Topics: Adult; Amino Acid Sequence; Autoimmune Diseases; Binding, Competitive; CD4-Positive T-Lymphocytes; Cell Division; Coumarins; Cytokines; Cytotoxicity Tests, Immunologic; DNA, Complementary; Female; HLA-DR Antigens; HLA-DR4 Antigen; HLA-DRB1 Chains; Humans; Immunodominant Epitopes; Male; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Protein Binding; Receptors, Antigen, T-Cell

Myelin basic protein (MBP)-reactive T cells have been implicated in the autoimmune pathogenesis of multiple sclerosis (MS). In this study, we examined the cytokine profile of 531 primary MBP-reactive T-cell lines and 72 independently established clones from 32 patients with MS and 18 healthy controls (NS) by using highly sensitive enzyme-linked immunosorbent assays. An increased number of primary T-cell lines producing interferon-gamma (IFN gamma) and/or interleukin-4 (IL-4) in response to MBP were found in patients with MS compared with controls. No distinct Th1 or Th2 subtypes could be demonstrated among the MBP-reactive clones. IL-4 was more frequently observed among MS-derived clones. Clones derived from MS patients produced increased levels of IL-2, IL-4, tumor necrosis factor-alpha (TNF alpha), IFN gamma, and IL-10, but not IL-6. It is interesting that MBP-reactive T cells from MS patients expressing the disease-associated HLA-DRB1*15 allele produced increased quantities of TNF alpha, a cytokine suggested to play an important role in inflammation and demyelination. When challenged with either MBP or a bacterial superantigen, the clones expressed similar levels of the proinflammatory cytokine IFN gamma. Our study suggests a functional difference in T-cell responses to MBP in patients with MS compared with healthy individuals, and provides further insights into the role of MBP-reactive T cells and their cytokine profile in the inflammatory processes of MS.

Topics: Adult; Cell Line; Clone Cells; Cytokines; Enterotoxins; Female; Haplotypes; HLA Antigens; Humans; Kinetics; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Reference Values; T-Lymphocytes

The MHC region on 6p harbors at least one susceptibility gene for multiple sclerosis (MS). Within this region, HLA-DM loci are of interest being involved in class II antigen processing. We investigated the association of HLA-DM polymorphisms with MS. Sixty-three patients with MS and 46 healthy controls from continental Italy were typed for HLA-DM polymorphisms and HLA-DRB1 alleles. Besides, among the donors characterized for the DM polymorphisms, we considered 6 MS patients previously studied for the fine specificity of their MBP-specific T lymphocyte lines (TLL). The frequencies of allelic variants at the DMA and DMB loci were similar between MS patients and controls, even when HLA-DRB1*1501 positive and negative donors were analyzed separately. Patients with predominant responses to different MBP epitopes did not differ for their HLA-DM haplotype while patients with predominant responses to the same MBP epitope could present different HLA-DM haplotypes. HLA-DM polymorphisms do not associate with MS and may not affect specific patterns of T cell responses to MBP.

Topics: Adult; Alleles; Epitopes; Female; Gene Frequency; Histocompatibility Antigens Class II; Histocompatibility Testing; HLA-D Antigens; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Polymorphism, Genetic; T-Lymphocytes

In this study, we evaluated the role of the two functional HLA-DR heterodimers, DR2a (DR alpha paired with the beta chain encoded by DRB5*0101) and DR2b (DR alpha paired with the beta chain encoded by DRB1*1501), that are coexpressed in the multiple sclerosis (MS)-associated haplotype HLA-DR15 Dw2, in presenting myelin basic protein (MBP) peptides to MBP-specific T cell lines (TCL). Our results show that both HLA-DR molecules serve as restriction elements for HLA-DR15-restricted TCL. Slightly higher numbers of TCL use DR2a as restriction element, and the epitopes contained in the immunodominant C-terminal region (131-159) are uniquely restricted by DR2a. The immunodominant middle epitope (81-99) is recognized in the context of both DR2a and DR2b, but this specificity strongly dominates the DR2b-restricted T cell response. Overall, immunodominance in the MBP-specific T cell response correlated well with peptide binding to DR2a or DR2b, demonstrating that the affinity of MHC-peptide interactions is important for shaping the T cell response to this autoantigen. Furthermore, we show that binding of the middle MBP peptide to HLA-DR15 molecules prevents cleavage by cathepsin D, a protease abundantly found in endosomal processing compartments, and thus contributes to its immunodominance. Surprisingly, the restriction element employed by MBP-specific T cell clones influenced the effector function (i.e., cytotoxic activity) of T cells irrespective of their peptide fine specificity.

Topics: Alleles; Amino Acid Sequence; Cathepsin D; Cell Line; Clone Cells; Cytotoxicity, Immunologic; Haplotypes; HLA-DR Antigens; HLA-DR Serological Subtypes; HLA-DR2 Antigen; Humans; Hydrolysis; Immunodominant Epitopes; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptides; Protein Binding; T-Lymphocyte Subsets; T-Lymphocytes, Cytotoxic

Myelin basic protein (MBP) may be an important autoantigen in multiple sclerosis (MS), with the MBP(82-100) region being immunodominant for T cells and autoantibodies. The structural requirements for autoantibody recognition were compared to those previously defined for MBP-specific T cell clones. MBP autoantibodies were affinity-purified from central nervous system lesions of 11/12 postmortem cases studied. The MBP(83-97) peptide was immunodominant in all 11 cases since it inhibited autoantibody binding to MBP > 95%. Residues contributing to autoantibody binding were located in a 10-amino acid segment (V86-T95) that also contained the MHC/T cell receptor contact residues of the T cell epitope. In the epitope center, the same residues were important for antibody binding and T cell recognition. Based on the antibody-binding motif, microbial peptides were identified that were bound by purified autoantibodies. Autoantibody binding of microbial peptides required sequence identity at four or five contiguous residues in the epitope center. Microbial peptides previously found to activate T cell clones did not have such obvious homology to MBP since sequence identity was not required at MHC contacts. The similar fine specificity of B cells and T cells may be useful for tolerance induction to MBP in MS.

Topics: Amino Acid Sequence; Autoantibodies; B-Lymphocytes; HLA-DR2 Antigen; Humans; Immunodominant Epitopes; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes

Myelin basic protein (MBP)-specific T cells were isolated directly from peripheral blood by stimulation either with native MBPp85-99 or altered peptide ligands (APLs) in which substitutions of the lysine were made at position 93, a TCR contact residue. We report here that the APL 93A could alter the cytokine profile of some autoreactive MBPp85-99 reactive T cell clones, switching them from a Th0 phenotype secreting high concentrations of IL-4, IL-5, and IFN-gamma into Th2 cells secreting significantly less IFN-gamma. However, in vitro stimulation with the 93A peptide, in some instances, induced T cells that responded better to the native MBPp85-99 peptide. Functionally, the APL 93A was shown to act as an antagonist for IFN-gamma secretion. Based on TCR sequencing and single cell cloning, this alteration in cytokine profile was determined to be the result of the differential activation of individual T cell clones. We discuss the implications of these data for the strength of signal model of T cell activation.

Topics: Autoimmune Diseases; Cell Differentiation; Cell Line; Clone Cells; Gene Rearrangement, T-Lymphocyte; Humans; Immunodominant Epitopes; Interferon-gamma; Interleukin-4; Interleukin-5; Lymphocyte Activation; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Receptors, Antigen, T-Cell, alpha-beta; Structure-Activity Relationship; T-Lymphocyte Subsets; Th1 Cells; Th2 Cells

The adoptive transfer of autoreactive S100 beta-specific T cells induces experimental autoimmune panencephalomyelitis and uveoretinitis in the Lewis rat, mimicking the distribution of lesions seen in a subset of patients with multiple sclerosis. We studied the frequency and functional properties of the human T-cell response to S100 beta in eight patients (two relapsing-remitting multiple sclerosis, one chronic-progressive multiple sclerosis, two with multiple sclerosis and uveitis, two neuromyelitis optica, one panuveitis) and in seven healthy individuals, using bovine S100 beta for T-cell stimulation. Both in patients and controls, the frequency of S100 beta-specific T-cell responses was half of that obtained for myelin basic protein (MBP), and only 10% of that obtained using purified protein derivative (PPD). The stimulation indices obtained in response to S100 beta were also less than half those obtained with either MBP or PPD. However, four long-term S100 beta-specific T-cell lines were established and studied in more detail. The four T-cell lines all exhibited a CD4+, CD8-, T-cell receptor alpha beta + surface phenotype and secreted tumour necrosis factor-alpha, interferon-gamma, interleukin-10 and interleukin-4 upon antigenic stimulation, but they were heterogenous with respect to T-cell receptor usage; two T-cell lines expressed V beta 2, one V beta 6.7 and one V beta 13. Antigen-specificity was confirmed using bovine S100 beta beta and alpha beta-isoforms, as well as a recombinant rat S100 beta preparation. The response to S100 beta was shown to the HLA-(human leukocyte antigen-) DR-restricted for two of the S100 beta-specific T-cell lines. Human S100 beta-specific T-cell lines were cytotoxic, although to a lesser extent than MBP-specific T-cell lines derived from the same donors. The phenotypic and functional properties of human S100 beta-specific T-cell lines raise the possibility that these T cells are pathogenic, as they are in the rat. The low frequency and proliferative index of S100 beta-specific, as opposed to MBP-specific T-cell responses suggests that the T-cell response to this widely expressed calcium-binding protein is under more efficient regulatory control.

Topics: Adult; Animals; Antibody Specificity; Autoantigens; Calcium-Binding Proteins; Cattle; Cell Line; Cytokines; Cytotoxicity Tests, Immunologic; Demyelinating Diseases; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Female; Histocompatibility Antigens; Histocompatibility Testing; Humans; Immunophenotyping; Immunotherapy, Adoptive; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Nerve Growth Factors; Rats; Rats, Inbred Lew; Receptors, Antigen, T-Cell; S100 Calcium Binding Protein beta Subunit; S100 Proteins; T-Lymphocytes; Tuberculin; Uveitis

We tested the proliferative responses of peripheral blood mononuclear cells from 61 patients with multiple sclerosis, 56 healthy control subjects and 52 patients with other neurological diseases to seven synthetic peptides of myelin proteolipid protein (PLP) and 19 synthetic peptides of myelin basic protein (MBP). Increased proliferative responses to two overlapping PLP peptides, PLP184-199 and PLP190-209 were found significantly more frequently in blood from patients with relapsing-remitting or secondary progressive multiple sclerosis (52.3%), but not from those with primary progressive multiple sclerosis (18.2%), than in that from healthy control subjects (8.9%) and patients with other neurological diseases (20.8%). Reactivity to these PLP peptides was most frequently seen in blood from patients with multiple sclerosis of 6-15 years duration and with moderate to severe disability (Kurtzke's Expanded Disability Status Scale > 4.0); the blood from 15 of 19 patients in this group reacted to one or both of the peptides. Both peptides could be recognized by short-term T-cell lines specific for whole PLP, and lines specific for one or other of the two overlapping peptides were able to recognize whole PLP, indicating that these peptides can be processed naturally from the intact molecule. This region of PLP is encephalitogenic in a number of strains of mice. Samples from multiple sclerosis patients did not react more frequently to any of the MBP peptides than those from healthy control subjects. The proportions of patients with other neurological diseases whose blood responded to the MBP peptides that most frequently elicited responses in blood from multiple sclerosis patients were significantly lower than the proportions of multiple sclerosis patients and healthy control subjects whose blood responded to these peptides.

Topics: Adolescent; Adult; Aged; Amino Acid Sequence; Autoantigens; Cell Division; Cell Line; Epitopes; Female; Humans; Male; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Peptide Fragments; Protein Structure, Tertiary; T-Lymphocytes

This study analyzed the stability of the myelin basic protein (MBP)-specific T-cell receptor (TCR) repertoire during the course of multiple sclerosis (MS) in three patients who were monitored for three years by gadolinium-enhanced magnetic resonance imaging. Bulk-culture T-cell lines (TCLs) were generated from 3-4 time points for each patient, including times of active and quiescent disease. TCR analysis of these TCLs indicated that both the V alpha and V beta usage was similar over time for each patient. Sequencing of TCRs demonstrated conserved complementarity-determining region 3 (CDR3) sequences within TCLs that expressed the same V alpha segment over time, although the J alpha usage was different for each TCR. This indicates that the population of MBP-reactive T-cells is changing during the course of MS, but that host and/or environmental factors may be selecting T-cells with particular MHC/peptide binding domains.

Topics: Adult; Amino Acid Sequence; Base Sequence; Epitopes; Female; Humans; Longitudinal Studies; Male; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell, alpha-beta

Susceptibility to multiple sclerosis (MS) involves a genetically complex autoimmune component. However, except for genes in the HLA system, specific susceptibility loci are unknown or unconfirmed.. To investigate several loci spanning 3 candidate regions for a role in multiple sclerosis (MS) susceptibility in 2 ethnic groups using both single-locus and haplotype analyses. The 3 regions include HLA on chromosome 6p21.3, APOE on chromosome 19ql 3.2, and MBP(myelin basic protein) on chromosome 18q23.. Case-control association testing.. A total of 120 Caucasian patients with MS and 107 unrelated control individuals from California, and 32 patients and 32 unrelated control individuals from Beijing, China. All patients with MS were diagnosed as having clinically definite disease according to published criteria.. Chi2 Testing of loci and individual alleles and haplotypes. Haplotype frequencies were estimated with standard maximum likelihood methods.. The HLA effect is due to the class II DR2 haplotype, DRB1*1501-DQA1*0102-DRB1*0602; contributions to MS susceptibility from additional DRB1-DQB1 alleles or other HLA region loci were not observed. Variation within the MBP locus on chromosome 18q23 showed no effect in MS. The distribution of haplotypes from 5 loci within the chromosome 19q13.2 region, including D19S178, D19S574, APOE, APOC2, and D19S219, differed between patient and control samples. D19S574 showed a significant effect (P=.015) in Caucasian patients with MS due to the increased frequency of a single allele (P=.002). The APOE variation, prominent in other neurological diseases, showed no influence on MS susceptibility, despite its location within the chromosome 19q13.2 region. Interaction effects between DR2 and chromosome 19q13.2 or MBP in MS susceptibility were not apparent.. The significant chromosome 19q13.2 single-locus and multilocus haplotype associations with MS in Caucasian and Chinese patient samples indicate an effect from a nearby disease susceptibility locus. These initial observations are an encouraging step toward the description of non-HLA genetic susceptibility to MS.

Topics: Alleles; Apolipoproteins E; Asian People; Case-Control Studies; China; Chromosomes, Human, Pair 18; Chromosomes, Human, Pair 19; Chromosomes, Human, Pair 6; Gene Frequency; Haplotypes; HLA Antigens; HLA-D Antigens; Humans; Microsatellite Repeats; Models, Statistical; Multigene Family; Multiple Sclerosis; Myelin Basic Protein; United States; White People

To find whether CSF analysis may differentiate between relapsing-remitting and secondary progressive multiple sclerosis.. In 17 patients with relapsing-remitting and 16 patients with secondary progressive multiple sclerosis, all without current or recent relapses, albumin CSF: peripheral blood ratio, mononuclear cell number, CD4+, CD8+, and B1+ subsets, CD4+:CD8+ ratio, IgG, IgG index, IgM, IgM index, complement components C3 and C4, and C3 and C4 indices, myelin basic protein, neuron specific enolase, S100, and lactate were determined. For each measure the statistical distance measure D2 was calculated. For computation of a discriminant score variables with a P value< or =0.15 were included (two sided univariate t test). These were albumin CSF: peripheral blood ratio, mononuclear cell number, IgM, IgM index, C3, C4, neuron specific enolase, S100, and lactate. Simultaneous distributions of the variables were compared between both groups (multivariate t test) and a discriminant score was computed (linear discriminant analysis).. The discriminant score allocated all 14 relapsing-remitting patients to the relapsing-remitting group (positive score) and 12 of 13 secondary progressive patients to the secondary progressive group (negative score). One secondary progressive patient was allocated to the relapsing-remitting group.. Patients with relapsing-remitting or secondary progressive multiple sclerosis differ in CSF profile and CSF analysis may help to differentiate between relapsing-remitting and secondary progressive multiple sclerosis.

Topics: Adult; Albumins; Antigens, CD; Blood-Brain Barrier; Complement System Proteins; Demyelinating Diseases; Disease Progression; Female; Humans; Immunoglobulin G; Immunoglobulin M; Lactates; Male; Multiple Sclerosis; Myelin Basic Protein; Phosphopyruvate Hydratase; Recurrence; Remission, Spontaneous

The aim of this study was to develop a test allowing to monitor disease activity in patients with multiple sclerosis (MS). A simple, fast and reliable test was used to assess the cytokine production capacity of blood leucocytes. The whole blood test (WBT) involved in vitro stimulation of a whole blood sample with either the mitogen phytohaemagglutinin (PHA), or specific antigens. We focused our attention on the production of tumor necrosis factor alpha (TNF), because of the possible involvement of this cytokine in MS pathogenesis. Under in vitro stimulation with PHA or MBP, TNF production was found to be significantly higher in patients during the clinical relapses than during remissions. The increment of TNF production correlated with the severity of the relapses, as determined by the modification of Kurtzke EDSS scale. Moreover, each clinical relapse appeared to be preceded by a peak of TNF production. We then retrospectively analysed 21 patients with the relapsing-remitting form of the disease, in whom the WBT was performed every 2-4 weeks, for periods ranging from 16 to 52 months. Seventy-three peaks of TNF production (defined as the doubling or more of the individual baseline value, which was found to be stable for each patient during remissions), and 47 relapses, including 36 objective and 11 subjective, were observed. Forty-seven out of the 73 TNF peaks were followed by or concomitant with a clinical relapse. In 10 out of the 26 cases where no relapse followed the TNF peak, another cause (mainly infections) of increased TNF production was found. Thus, by excluding other causes, the specificity of the WBT, i.e., the probability to develop a relapse when a TNF peak was found to be 74.6% (47/63). The sensitivity of the WBT was 100%, since all the 47 relapses were preceded by a TNF peak. Assessment of TNF production capacity by the WBT may thus be useful in the follow-up of MS patients, particularly for the follow-up of various treatments. Information provided by the WBT may also be useful to orientate the therapeutic decision for an incipient relapse. Earlier treatment is likely to result in an improved prevention of neurological damage.

Topics: Case-Control Studies; Evaluation Studies as Topic; Humans; In Vitro Techniques; Leukocytes; Multiple Sclerosis; Myelin Basic Protein; Phytohemagglutinins; Recurrence; Retrospective Studies; Sensitivity and Specificity; Tumor Necrosis Factor-alpha

Determination of immunodominant epitopes of MHC class I-restricted self-Ags and elucidation of TCR contact residues is of potential importance in providing a means of manipulating the immune response to self-Ags in human autoimmune diseases. A computer algorithm was used to examine the sequences of the two major encephalitogenic proteins of myelin, MBP and PLP, for HLA-A2 binding motifs. Thirty-eight peptides with HLA-A2.1 binding motifs were synthesized and their binding to HLA-A2.1 was measured. A panel of HLA-A2-restricted T cell clones directed against the PLPp80-88 epitope, which exceeded the binding affinity of the other myelin-peptides tested by at least one order of magnitude, was generated. Using a set of analogue peptides with single amino acid substitutions, we detected a distinct pattern of TCR contact residues for each clone. Surprisingly, modification of different presumed TCR contact residues generated superagonist peptides, which are defined as peptides with equal or lower MHC binding affinity to HLA-A2 that induce half-maximal effector responses at 100-fold lower concentrations than the original peptide. These agonist peptides could drive cytotoxic T cell clones to proliferate, secrete cytokines, and clonally expand at concentrations at which the native peptide induced only cytotoxic responses. The proliferation induced by the superagonist peptides gives additional evidence that the clonal expansion of CD8 T cell clones may in part be regulated on the level of Ag recognition by the TCR.

Topics: Amino Acid Substitution; Autoantigens; CD8-Positive T-Lymphocytes; Cell Line; Clone Cells; Cytotoxicity, Immunologic; HLA-A2 Antigen; Humans; Interferon-gamma; Interleukin-4; Ligands; Multiple Sclerosis; Myelin Basic Protein; Peptides; Proteolipids; Receptors, Antigen, T-Cell

Our previous analysis of the T cell reactivity to myelin antigens in a group of 24 patients with multiple sclerosis (MS) and 16 control individuals revealed that the autoimmune response to myelin oligodendrocyte glycoprotein (MOG) predominates in MS over that to myelin basic protein (MBP), proteolipid protein or myelin-associated glycoprotein, suggesting a prevalent role for the autoimmune response to MOG in the pathogenesis of MS. Using a recombinant human MOG (rhMOG) preparation corresponding to the extracellular immunoglobulin-like domain of the MOG molecule, we have now analyzed another group of 52 MS patients and 49 control individuals for reactivity of their peripheral blood lymphocytes (PBL) to rhMOG and to MBP concomitantly. Of the 52 MS patients tested 24 responded to MOG and 10 out of 49 responded to MBP, whereas only 5 MOG-reactive and 4 MBP-reactive control individuals were detected out of the 49 tested. These results are therefore highly confirmatory of the predominant reactivity to MOG in MS. The analysis of the primary proliferative response to 11 synthetic overlapping peptides (phMOG) spanning the extracellular domain of human MOG by PBL from 9 MS patients and 15 control individuals (9 healthy controls and 6 patients with neurological diseases other than MS) further supports a prevalent role for the autoimmune response to MOG in MS, as only 1 of the 15 controls tested showed reactivity to any of the phMOG, whilst 5 out of the 9 patients studied reacted to at least 1 of the phMOG. PBL from 10 MS patients, and from 4 controls, were selected in vitro with each of the phMOG. Of the 10 patients studied 7 reacted to at least 1 phMOG upon secondary stimulation and the reactivity was mostly directed to epitopes localized within three main regions (amino acids 1-22, 34-56 and 64-96), as was observed for the primary response of PBL. The predominant response to MOG of PBL from MS patients as demonstrated in two separate studies using native MOG and rhMOG as antigens, and the high incidence of reactivity of these PBL compared to the lack of response to phMOG by control PBL, emphasize the relevance of MOG in MS pathogenesis and support a primary role for the autoimmune T cell response to MOG in disease development.

Topics: Adult; Extracellular Space; Female; Humans; Immunoglobulins; Lymphocyte Activation; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Oligodendroglia; Peptide Fragments; Protein Structure, Tertiary; Recombinant Proteins; T-Lymphocyte Subsets

Susceptibility to multiple sclerosis (MS) is widely held to have a strong genetic component. While the identities of genes conferring susceptibility are currently unknown, possible candidates include those genes coding for proteins which function in central nervous system (CNS) myelin. Two such genes are the human myelin basic protein (MBP) and proteolipid protein (PLP) genes, whose products make up approximately 80% of the total protein in CNS myelin. The association of a variable number tandem repeat (VNTR) 5' to the human MBP gene with MS has been the subject of conflicting reports. Here we test the hypothesis that mutations in the human MBP and PLP genes might be associated with MS by examining the entire expressed sequence of both genes by single strand conformation polymorphism (SSCP) analysis, using a panel of 71 MS patients and 71 controls. We have also re-examined the VNTR region in patients and controls. Three base changes were found in the human PLP gene and nine base changes in the human MBP gene; these were essentially equally distributed between patients and controls. No preferential distribution of various alleles of the VNTR between patients and controls was found. Although intronic and regulatory regions have not been examined, it would appear unlikely that mutations in these genes coding for the two major CNS myelin proteins contribute significantly to genetic susceptibility to MS.

Topics: Adult; Aged; Aged, 80 and over; DNA Primers; Female; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Polymerase Chain Reaction; Polymorphism, Genetic; Polymorphism, Single-Stranded Conformational

Transgenic mice containing different numbers of transgenes (2-70) of the myelin proteolipid protein DM20 were phenotypically normal up to 3 mo of age, after which the mice containing 70 copies of the transgene spontaneously demyelinated and died at 10-12 mo. Since we demonstrated that demyelination in multiple sclerosis involved specific chemical changes in myelin basic protein (MBP), we investigated the MBP in our transgenic line for similar changes. Both the total amount of MBP in brain and the MBP mRNA levels were unaffected at the different ages. All the isoforms (14-21 kD) of MBP were present, but the microheterogeneity (a posttranslational event) was changed resulting in a higher proportion of the less cationic components reminiscent of the changes in MBP found in multiple sclerosis. An increased amount of the citrullinated form of MBP was found by Western blot analysis. Immunogold labeling of cryosections of brain revealed a greater density of particles with the anticitrulline antibody at 10 mo and that the levels of peptidylarginine deiminase (which deiminates protein-bound arginine to citrulline) were increased. This stable transgenic line represents a useful animal model for the human disease multiple sclerosis.

Topics: Animals; Citrulline; Demyelinating Diseases; Encephalomyelitis, Autoimmune, Experimental; Gene Dosage; Hydrolases; Isoelectric Point; Mice; Mice, Mutant Strains; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Protein-Arginine Deiminase Type 4; Protein-Arginine Deiminases

Experimental allergic encephalomyelitis is a prototypic autoimmune disease characterized by central nervous system inflammation and demyelination. Previously, we demonstrated that intravenous administration of high doses of myelin basic protein abrogated the clinical and pathological signs of experimental allergic encephalomyelitis by causing the deletion of encephalitogenic, CD4+, myelin basic protein-specific T cells through antigen-induced programmed cell death. In the present study, we further characterized the ability of intravenous antigen administration to attenuate an immune response by myelin basic protein-reactive encephalitogenic T cells. We demonstrated that multiple injections of myelin basic protein are required to achieve a therapeutic response, and that this form of therapy is effective even after prolonged chronic disease. These studies showed that although interleukin-2-stimulated cell cycling is an important factor leading to T-cell death, the administration of exogenous interleukin-2 with antigen can result in the aggravation of clinical disease compared to administration of antigen alone. More importantly, administration of myelin basic protein alone without interleukin-2 was sufficient to reduce autoreactive T cells and clinical disease in experimental autoimmune encephalomyelitis. Our experiments support the rationale for antigen-specific therapy aimed at inducing the programmed death of autoreactive T cells in autoimmune diseases, potentially including the human demyelinating disease multiple sclerosis.

Topics: Animals; Apoptosis; Drug Therapy, Combination; Encephalomyelitis, Autoimmune, Experimental; Female; Humans; Immunotherapy, Adoptive; Infusions, Intravenous; Interleukin-2; Mice; Mice, Inbred Strains; Multiple Sclerosis; Myelin Basic Protein; Recombinant Proteins; T-Lymphocytes

Multiple sclerosis is a presumed autoimmune disease, associated with inflammation in the CNS white matter, mediated by autoreactive T cells. We previously reported that oral myelin tolerization of relapsing-remitting MS patients resulted in fewer attacks, as compared to a placebo-fed group. Here, we examined whether oral tolerization with bovine myelin resulted in altered autoreactive T-cell populations or altered T-cell fraction. We generated 4,620 T-cell lines from 34 relapsing-remitting MS patients (17 were fed bovine myelin daily), and each line was examined for proliferation to MBP, PLP, and TT and for secretion of IL-4, IFN-gamma, and TGF-beta1. The frequency of TGF-beta1-secreting T-cell lines after MBP and PLP stimulation in fed patients was greater than that of nonfed patients. These experiments demonstrate that oral tolerization with autoantigen results in altered cytokine secretion in a human autoimmune disease with the generation of TGF-beta1-secreting T cells that may regulate the inflammatory response at the site of the demyelinating lesions in multiple sclerosis. These data provide the first evidence of antigen-specific modification of cytokine secretion in a human autoimmune disease.

Topics: Administration, Oral; Animals; Antigens; Apoproteins; Cattle; Cell Line; Cytokines; Humans; Immune Tolerance; Immunotherapy; Mice; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; Myelin Sheath; Recurrence; T-Lymphocyte Subsets; T-Lymphocytes

Topics: Antigen-Presenting Cells; Humans; Ligands; Lymphocyte Activation; Major Histocompatibility Complex; Multiple Sclerosis; Myelin Basic Protein; Peptides; Receptors, Antigen, T-Cell; T-Lymphocytes

The involvement of proinflammatory cytokines tumour necrosis factor-alpha (TNF-alpha) and lymphotoxin (LT) in multiple sclerosis is suggested by the parallel occurrence of these proinflammatory cytokines in acute and chronic active multiple sclerosis brain lesions. We describe the use of in situ hybridization with radiolabelled cDNA oligonucleotide probes to detect and enumerate TNF-alpha and LT mRNA expressing mononuclear cells without culture, and after culture in the presence of myelin basic protein (MBP), control antigens or without antigen. Compared with patients with aseptic meningo-encephalitis, non-inflammatory neurological diseases and healthy controls, the multiple sclerosis patients had elevated numbers of TNF-alpha and LT mRNA expressing mononuclear cells in blood when enumerated without previous culture, and also after culture with MBP. The MBP-induced upregulation of TNF-alpha and LT was major histocompatibility complex (MHC) class II molecule dependent. Tumour necrosis factor-alpha mRNA expressing mononuclear cells were further enriched in the multiple sclerosis patients' CSF. Positive correlations were observed in multiple sclerosis between TNF-alpha and LT mRNA expressing blood mononuclear cells, MBP-reactive TNF-alpha and LT mRNA expressing cells, and TNF-alpha and interferon-gamma (INF-gamma) mRNA expressing mononuclear cells. Upregulation of TNF-alpha correlated positively with exacerbation, enhanced disability and the secondary progressive phase of multiple sclerosis. Patients with optic neuritis, in many instances representing very early multiple sclerosis, had TNF-alpha and LT positive blood mononuclear cells that were elevated to the same extent as patients with clinically definite multiple sclerosis. The findings support the hypothesis that TNF-alpha and LT play a harmful role in the development of multiple sclerosis and suggest that TNF-alpha could be useful as a disease activity marker in multiple sclerosis.

Topics: Adult; Aged; Cells, Cultured; Cerebrospinal Fluid; DNA Probes; Female; Humans; In Situ Hybridization; Lymphotoxin-alpha; Male; Middle Aged; Monocytes; Multiple Sclerosis; Myelin Basic Protein; Optic Neuritis; Reference Values; RNA, Messenger; Tumor Necrosis Factor-alpha; Up-Regulation

Somatic mutation as an index of in vivo T-cell amplification is a powerful tool to analyze the specificity and size of the autoreactive T-cell repertoire. Using this strategy, we determined the precursor frequency of T cells reactive to myelin basic protein (MBP) and overlapping MBP peptides spanning regions p84-168 in patients with MS and controls in the HPRT mutant T-cell population. Among 19 MS patients, nine had estimatable frequencies to MBP or MBP peptides, p93-112, p124-142 and p143-168 in the HPRT mutant T-cell population. Only one of the 10 controls showed measurable frequency to MBP in the HPRT mutant T-cell population. These studies suggest that increased frequency of T cells reactive to MBP and MBP peptides might indicate putative disease-related epitopes in MS.

Topics: Adolescent; Adult; Amino Acid Sequence; Cells, Cultured; Female; Histocompatibility Testing; HLA-DR Antigens; Humans; Hypoxanthine Phosphoribosyltransferase; Male; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Mutation; Myelin Basic Protein; Nervous System Diseases; Peptide Fragments; Reference Values; T-Lymphocytes

Ultrastructural localization of a specific phosphorylated isomer of myelin basic protein (MBP) has been achieved with a monoclonal antibody specific for human MBP sequence, 89-105, in which Thr98 was phosphorylated. Cryosections of human brain white matter revealed that gold particles were found localized almost exclusively to the major dense line demonstrating that threonine 98 in the sequence Thr-Pro-Arg-Thr-Pro-Pro-Pro, a mitogen-activated protein kinase-specific site, was phosphorylated in vivo. In two cases of multiple sclerosis, the density of gold particles in myelin was reduced by about 30%, in one case by 42%, and by 80% in a fourth case. However, gold labelling was seen in areas of demyelination suggesting that the phosphorylated threonyl peptide was protected from degradation.

Topics: Amino Acid Sequence; Antibody Specificity; Binding Sites; Brain; Calcium-Calmodulin-Dependent Protein Kinases; Citrulline; Humans; Immunohistochemistry; Microscopy, Electron; Mitogens; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Phosphorylation; Threonine

Topics: Creatinine; Humans; Multiple Sclerosis; Myelin Basic Protein

We have studied a case of acute, fulminating multiple sclerosis (MS) (Marburg type) at the pathological and biochemical levels. Postmortem examination of the brain revealed extensive areas of gross rarefaction in the hemispheric white matter. Histologically, well-demarcated areas of demyelination with a large influx of macrophages and a subtle perivascular infiltration of lymphocytes were seen with relative preservation of the axis cylinders. Myelin basic protein (MBP) was isolated and purified [correction of purifed] from noninvolved white matter. It was slightly larger in molecular weight than MBP from normal brain or from chronic MS brain. The increase in mass was accounted for, in part, by the deimination of 18 of 19 arginyl residues to citrulline, making the patient's MBP much less cationic than MBP from normal white matter. When expressed as the ratio of least cationic form of MBP to the most cationic (C-8/C-1), the normal ratio was 0.82, chronic MS 2.5, and the patient in this study 6.7. Because the ratio of 6.7 was similar to 7.5 found for a 15-month-old infant, MBP was considered to be of the immature form. The data are consistent with a genetic factor influencing the charge microheterogeneity of MBP. The resulting less cationic MBP cannot carry out its normal function of compacting multilayers.

Topics: Adult; Antibodies, Monoclonal; Arginine; Blotting, Western; Brain; Brain Chemistry; Chronic Disease; Citrulline; Demyelinating Diseases; Fatal Outcome; Female; Humans; Lymphocytes; Macrophages; Magnetic Resonance Imaging; Multiple Sclerosis; Myelin Basic Protein

Topics: Chromosomes, Human, Pair 18; Demyelinating Diseases; Humans; Multiple Sclerosis; Myelin Basic Protein; Phosphorylation

The myelin basic protein (MBP) gene is a candidate locus for disease susceptibility in multiple sclerosis (MS). In the present study a part of the tetranucleotide (TGGA)n repeat polymorphism 5' to the MBP gene was examined in 90 Danish MS patients and 106 controls. Lymphocyte DNA was isolated and used in PCR assay. The PCR fragments produced were separated by agarose and acrylamide electrophoresis. Hereby we found three different bandpatterns i.e. a homozygote with a 450 bp fragment, a homozygote with a fragment 375 bp and a heterozygote with both bands present. The 450 bp fragment occurred significantly more often among MS than in the control group and the 375 bp fragment was underrepresented among MS than in the control group. The differences between incidence of the three band pattern in the MS and the control group were significant different at 1% level. Our study thus indicate that there is an association between MS and a length polymorphism of the 5' end to the MBP gene in Danish MS patients.

Topics: Adult; DNA; Female; Homozygote; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Polymerase Chain Reaction; Polymorphism, Genetic; Polymorphism, Restriction Fragment Length; Repetitive Sequences, Nucleic Acid

Experimental autoimmune encephalomyelitis (EAE) is an autoimmune disease believed to be a model for the human disease multiple sclerosis (MS). Induced by immunizing B10.PL mice with myelin basic protein (MBP), EAE was completely prevented by the administration of 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3]. 1,25-(OH)2D3 could also prevent the progression of EAE when administered at the appearance of the first disability symptoms. Withdrawal of 1,25-(OH)2D3 resulted in a resumption of the progression of EAE. Thus, the block by 1,25-(OH)2D3 is reversible. A deficiency of vitamin D resulted in an increased susceptibility to EAE. Thus, 1,25-(OH)2D3 or its analogs are potentially important for treatment of MS.

Topics: Animals; Calcitriol; Disease Progression; Encephalomyelitis, Autoimmune, Experimental; Female; Guinea Pigs; Humans; Male; Mice; Mice, Inbred Strains; Multiple Sclerosis; Mycobacterium tuberculosis; Myelin Basic Protein; Spinal Cord; Time Factors; Vitamin D Deficiency

We generated T-cell lines from the peripheral blood of controls and of patients with multiple sclerosis (MS) by stimulation with overlapping synthetic peptides representing the entire sequences of all four isoforms of human myelin basic protein (MBP). The T-cell lines reacted to a wide range of epitopes in the major isoforms of MBP and to epitopes that were present only in the minor isoforms. Many MS patients and controls had T-cells responding to one or more cryptic MBP epitopes, as indicated by the generation of a peptide-specific T-cell line(s) by stimulation with synthetic peptides but not by stimulation with whole MBP. About one-third of the peptide-generated lines were cytotoxic. Although we have shown that this technique of peptide stimulation is effective in generating human antiviral cytotoxic CD8+ T-cell lines, all the cytotoxic MBP-specific lines generated by this method were predominantly CD4+. Our study did not reveal any significant differences, between MS patients and controls, in reactivity to epitopes within any of the isoforms of MBP.

Topics: Adolescent; Adult; Aged; Amino Acid Sequence; Autoimmune Diseases; CD4-Positive T-Lymphocytes; Cell Line; Epitopes; Female; Flow Cytometry; HLA-DR Antigens; Humans; Male; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; T-Lymphocytes, Cytotoxic

Myelin basic protein (MBP) is a candidate autoantigen in the disease multiple sclerosis. Although MBP was thought to be sequestered behind the blood-brain barrier, isoforms of MBPs have recently been demonstrated in lymphoid tissues. These isoforms, termed golli MBPs, contain sequences that are shared with "classic" MBP within the CNS. In the present study, we have determined that epitopes within golli MBP isoforms may be recognized by human T lymphocyte clones specific for classic MBP. Ten of 12 T-cell clones recognized golli MBP. Although 11 clones were specific for the immunodominant 83-99 sequence, the clones differed with respect to human leukocyte antigen (HLA) restriction, T-helper phenotype, cytolytic activity, and T-cell receptor usage. Greater responses to classic MBP than to golli MBP suggested a difference in the ability of the two proteins to be processed and to present epitopes therein. These data advance the hypothesis that golli MBP sequences expressed within lymphoid tissues may be recognized by classic MBP-specific T lymphocytes during central or peripheral tolerance.

Topics: Antibody Specificity; Antigen-Antibody Reactions; Case-Control Studies; Clone Cells; Epitopes, T-Lymphocyte; Humans; Immune Tolerance; Immunodominant Epitopes; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes

Experimental allergic encephalomyelitis (EAE), an animal model resembling multiple sclerosis (MS), is mediated by myelin antigen-specific CD4+ T cells secreting cytokines such as interferon-gamma (IFN-gamma), tumor necrosis factor-beta (TNF-beta), and the proinflammatory cytokine TNF-alpha-all associated with the T-helper-1 (Th1) T cell subset. Based on numerous similarities between MS and EAE, it has been postulated that Th1-like T cells are involved in the pathogenesis of MS. Production of proinflammatory cytokines such as IFN-gamma and, in particular, TNF-alpha/beta by autoreactive T cells is considered crucial for the initiation and amplification of inflammatory brain lesions and possibly also for direct myelin damage. In contrast, regulatory cytokines such as interleukin-4 (IL-4), IL-10, and IL-13, which are associated with the Th2-like phenotype, may play a role in the resolution of relapses. Although the human T cell response to myelin basic protein (MBP) is well characterized in terms of antigen specificity, HLA restriction, and T cell-receptor (TCR) usage, little is known about the cytokine pattern of these autoreactive T cells. To gain such information, conditions for studying cytokine secretion by human autoreactive T cell clones (TCC) were established. The cytokine secretion profile of human autoreactive CD4+ TCC, specific for myelin basic protein peptide (83-89) [MBP(83-99)], a candidate autoantigen in MS, was investigated. Our results show that TCC cytokine production in long-term culture was stable. In addition, the correlation of various cytokines within specific TCC revealed differences compared to murine T cells. The comparison of 30 human MBP (83-99)-specific TCC demonstrated heterogeneity in cytokine secretion, with a continuum between Th1- and Th2-like cells rather than distinct Th1 or Th2 subsets. These data are important for further investigation of the potential role of cytokines in the inflammatory process of MS, and provide a powerful tool to investigate therapeutic interventions with respect to their influence on cytokine secretion of autoreactive T cells.

Topics: Amino Acid Sequence; Autoantibodies; Clone Cells; Cytokines; Epitopes, T-Lymphocyte; Humans; Immunodominant Epitopes; Lymphocyte Activation; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Phenotype; T-Lymphocytes

HLA-DR2+ patients with multiple sclerosis (MS) that respond to vaccination with TCR V beta 5.2-38-58 peptides have increased frequencies of TCR peptide-specific T cells, reduced frequencies of myelin basic protein (MBP)-specific T cells, and a better clinical course than non-responders. To evaluate possible network regulation of MBP responses by TCR peptide-specific T cells, we compared properties of both cell types. Both MBP- and TCR peptide-specific T cell clones were CD4+ and predominantly HLA-DR restricted. HLA-DR2, which is in linkage disequilibrium in MS patients, preferentially restricted TCR peptide-specific clones as well as MBP-specific responses in HLA-DR2 and DR2,3+ donors. Within the DR2 haplotype, however, both DR beta 1*1501 and DR beta 5*0101 alleles could restrict T cell responses to V beta CDR2 peptides, whereas responses to MBP were restricted only by DR beta 5*0101. TCR peptide-specific clones expressed message for Th2 cytokines, including IL-4, IL-5, IL-6, IL-10, and TGF-beta, whereas MBP-specific T cell clones expressed the Th1 cytokines IFN-gamma and IL-2. Consistent with the Th2-like cytokine profile, TCR peptide-specific T cell clones expressed higher levels of CD30 than MBP-specific T cells. Culture supernatants from TCR peptide-specific T cell clones, but not from MBP- or Herpes simplex virus-specific T cells, inhibited both proliferation responses and cytokine message production of MBP-specific T cells. These results demonstrate distinct properties of MBP and TCR peptide-specific T cells, and indicate that both target and bystander Th1 cells can be inhibited by Th2 cytokines secreted by activated TCR peptide-specific T cells. These data support the rationale for TCR peptide vaccination to regulate pathogenic responses mediated by oligoclonal T cells in human autoimmune diseases.

Topics: Adult; Aged; Amino Acid Sequence; Antibody Specificity; Clone Cells; Cytokines; Epitopes, T-Lymphocyte; Female; Humans; Major Histocompatibility Complex; Male; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell; Th1 Cells

Lymphotoxin-alpha (LT-alpha) and tumour necrosis factor-alpha (TNF-alpha) promote inflammation in autoimmune diseases and have been detected in the multiple sclerosis (MS) brain lesions and blood, suggesting these cytokines are also present in the cerebrospinal fluid (CSF). To study this, mononuclear cells (MNC) were examined for transcripts of LT-alpha and TNF-alpha, using in situ hybridization (ISH) with synthetic oligonucleotide probes. Most patients with MS had LT-alpha and TNF-alpha mRNA-expressing MNC in their CSF at mean frequencies of about 1/2800 cells for both cytokines. Numbers were dramatically higher than in the paired blood specimens. Control patients with other inflammatory neurological diseases (OIND) also had LT-alpha and TNF-alpha mRNA-expressing cells in CSF but at mean frequencies of only 1/36,000 and 1/18,000 cells, respectively. In blood, levels were similar in OIND and MS. To elucidate the influence of myelin antigen stimulation on LT-alpha and TNF-alpha expression, MNC were cultivated with or without myelin basic protein. Strongly elevated levels of MBP-reactive TNF-alpha mRNA-expressing cells were detected in the MS patients' CSF, in particular when examined during clinical exacerbations, as well as MBP-reactive LT-alpha mRNA-expressing MNC. No such patterns were observed in the OIND controls. The strong accumulation of LT-alpha- and TNF-alpha-producing cells and of MBP-reactive LT-alpha and TNF-alpha mRNA-positive cells in the immediate vicinity of the demyelinating process in MS patients implicates a role of these cytokines in the development of MS.

Topics: Adult; Cerebrospinal Fluid; Humans; In Situ Hybridization; Lymphotoxin-alpha; Middle Aged; Molecular Sequence Data; Monocytes; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteolipid Protein; RNA, Messenger; Tumor Necrosis Factor-alpha

Multiple sclerosis (MS) is an inflammatory demyelinating neurological disease in which autoreactive T lymphocytes sensitized to myelin components of the central nervous system are postulated to contribute to pathogenesis. The possible relevance of molecular mimicry between a human coronavirus and the myelin basic protein component of myelin in the generation of this autoimmune reaction was evaluated. Myelin basic protein- and virus-reactive T-cell lines were established from 16 MS patients and 14 healthy donors and shown to be mostly CD4+. In contrast to healthy donors, several T-cell lines isolated from MS patients showed cross-reactivity between myelin and coronavirus antigens. Overall, 29% of T-cell lines from MS patients (10 donors) but only 1.3% of T-cell lines from normal control subjects (2 donors) showed an HLA-DR-restricted cross-reactive pattern of antigen activation after in vitro selection with either myelin basic protein or human coronavirus strain 229E antigens. Moreover, reciprocal reactivities were only observed in MS patients (4 donors). This establishes molecular mimicry between a common viral pathogen, such as this human coronavirus, and myelin as a possible immunopathological mechanism in MS and is consistent with the possible involvement of more than one infectious pathogen as an environmental trigger of disease.

Topics: Adult; Cell Line; Coronavirus; Coronavirus 229E, Human; Cross Reactions; Female; Humans; Male; Middle Aged; Molecular Mimicry; Multiple Sclerosis; Myelin Basic Protein; Reference Values; T-Lymphocytes

Myelination in the central nervous system requires synthesis by oligodendrocytes of enormous amounts of lipids and proteins for incorporation in the developing myelin membranes. To approach the regulatory events coordinating the transcriptional activation of the genes that encode myelin proteins, we examined control of the myelin basic protein (MBP) locus. MBP plays a major role in myelin compaction. During development, MBP is already expressed in mature non-myelinating oligodendrocytes. Here we show that, in transgenic animals in which the E. coli lacZ reporter gene is under the control of increasingly large portions (256, 1900 and 3200 bp) of the MBP promoter, 5' of the initiation of transcription site, reporter gene expression was initiated after myelin formation had started. This delayed expression of the transgene compared to MBP, strongly suggests that premyelinating expression is dependent on regulatory elements located outside of the 3200 bp sequence studied, while expression occurring at the time of myelin formation is dependent on the proximal promoter sequence.

Topics: Animals; Antibodies, Monoclonal; beta-Galactosidase; Cells, Cultured; Gene Expression Regulation, Developmental; Genes, Reporter; In Situ Hybridization; Lac Operon; Mice; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Oligodendroglia; Promoter Regions, Genetic; RNA, Messenger; Transgenes

T cells, B cells, and antibody are found in the white matter of the central nervous system in multiple sclerosis. The epitope center for the antibody response to human myelin basic protein (MBP) fits precisely the minimal epitope Pro85-Val-Val-His-Phe-Phe-Lys-Asn-Ile-Val-Thr-Pro96 for that reported for HLA DR2b (DRB1*1501)-restricted T cells that recognize MBP [Wucherpfenning, K.W., Sette, A., Southwood, S., Oseroff, C., Matsui, M., Strominger, J. & Hafler, D. (1994) J. Exp. Med. 179, 279-290], and overlaps with the reported DR2a-restricted epitope for T cells reactive to MBP [Martin, R., Howell, M. D., Jaraquemada, D., Furlage, M., Richert, J., Brostoff, S., Long, E. O., McFarlin, D. E. & McFarland, H. F. (1991) J. Exp. Med. 173, 19-24]. We describe a molecular model of this epitope.

Topics: Amino Acid Sequence; Autoantibodies; Epitope Mapping; Epitopes, B-Lymphocyte; Humans; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Protein Structure, Secondary

Multiple strategies for specific therapies are presently attempted in multiple sclerosis, in which an autoimmune reaction leads to demyelinisation within the central nervous system. Similar approaches are generally used in other potential autoimmune diseases. They try to interfere with the presentation and recognition of putative autoantigens by the immune system and also with the inflammatory process that gives rise to the demyelinating lesion. The authors review extensively these various prospects and their immediate implications for multiple sclerosis patients.

Topics: Autoantigens; Glatiramer Acetate; Humans; Immunotherapy; Major Histocompatibility Complex; Multiple Sclerosis; Myelin Basic Protein; Peptides; Polymers; T-Lymphocytes

Simplified enzyme-linked immunoadsorbent assays (ELISA) for myelin basic protein (MBP) and antibodies to myelin basic protein (Anti-MBP) have been used to test 337 patients with diseases of the nervous system including 36 compressive diseases (CMP), 33 multiple sclerosis (MS), 34 cerebrovascular diseases (CVD), 31 inflammatory diseases of central nervous system (ID), 161 epilepsy (EP) and 42 other nervous diseases (OND). Comparison of results among various groups indicates that serum mean MBP values of CMP, MS, CVD, ID and EP groups are significantly higher than those of OND group and normal control (P < 0.01). The serum mean MBP value of 33 acute trauma patients with spine fracture and paraplegia, the majority of CMP group, is the highest compared with MS group (P < 0.05), CVD, ID and EP groups (P < 0.01). CSF mean MBP value of 15 CVD patients is markedly greater than that of OND group (P < 0.05). No statistically significant differences are found in serum MBP values between OND group and normal control, and in serum and CSF Anti-MBP values among six groups by using our method.

Topics: Autoantibodies; Enzyme-Linked Immunosorbent Assay; Epilepsy, Tonic-Clonic; Humans; Multiple Sclerosis; Myelin Basic Protein; Nervous System Diseases; Spinal Cord Compression

Autoreactive T cells specific for myelin basic protein (MBP) are part of the normal T cell repertoire and are present both in patients with multiple sclerosis (MS) and healthy individuals. There is evidence suggesting in vivo activation and persistent clonal expansion of MBP-reactive T cells in MS. This study was undertaken to investigate the potential role of bacterial superantigens (SA) in the activation of MBP-reactive T cells. Twenty-seven MBP-reactive T cell clones generated from 10 MS patients and one normal individual were examined for reactivity to SA, in association with their T cell receptor V beta gene usage. The majority of the clones responded to at least one of the SA tested, staphylococcal enterotoxins (SEA and SEB) and toxic shock syndrome toxin-1 (TSST-1). The clones reactive to SEA and SEB expressed various V beta genes while T cell reactivity to TSST-1 correlated with the V beta 2 expression. Furthermore, circulating MBP-reactive T cells could be expanded from lymphocyte cultures primarily exposed to respective SA in more than 50% of MS patients and normal individuals tested. However, activation and expansion of circulating MBP-reactive T cells by SA was not directly associated with the disease. This study lends support to the potential role of SA in the activation of MBP-reactive T cells and suggests that an altered regulatory mechanism may account for further expansion and persistence of MBP-reactive T cells in MS.

Topics: Adult; Bacterial Toxins; Cells, Cultured; Clone Cells; Cytotoxicity, Immunologic; Enterotoxins; Epitopes; Female; Humans; Lymphocyte Activation; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell, alpha-beta; Staphylococcus aureus; Superantigens; T-Lymphocytes

Autoreactive T cells specific for myelin basic protein (MBP) are implicated in the pathogenesis of multiple sclerosis. The mechanism by which MBP-reactive T cells are regulated in vivo remains unknown, but is thought to involve the clonotypic regulatory network that can be induced by immunization with attenuated T cells and TCR peptides. We reported previously that immunization of multiple sclerosis patients with irradiated MBP-reactive T cells (T cell vaccination) induced T cell responses to the immunizing clones, resulting in a clonal depletion of circulating MBP-reactive T cells. In this study, we demonstrated that in the majority of the recipients, MBP-reactive T cells remained undetectable in circulation over a period of 1 to 3 yr after vaccination, while they reappeared in some individuals (three of nine), coinciding with clinical exacerbation. The reappearing MBP-reactive T cells were found to originate from clonal origins different from those of T cells persisting before immunization, suggesting a shift of the T cell repertoire to other determinants of MBP. The immunization induces predominantly CD8+ regulatory T cells capable of lysing the immunizing clones in a clonotype-specific manner. The T cell responses induced by immunization were restricted to the immunizing clones and did not affect MBP-reactive clones not used for immunization. Our data further suggest that different hypervariable regions of the TCR may be involved in the observed clonotypic interaction. This study provides useful information for designing future clinical trials using T cell vaccination and other TCR-based therapeutic strategies.

Topics: Amino Acid Sequence; Base Sequence; Cell Communication; Clonal Deletion; Epitopes; Humans; Immunization, Passive; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell, alpha-beta; T-Lymphocyte Subsets

The inflammatory nature of multiple sclerosis (MS) implicates the participation of immunoregulatory cytokines, including the Th2 related IL-10. We describe the use of in situ hybridization with cDNA oligonucleotide probes to detect and enumerate mononuclear cells (MNC) expressing mRNA for IL-10, which is known to down-regulate Th1 cell related cytokines such as interferon-gamma. Expression of IL-10 was studied in blood MNC of MS and blood and cerebrospinal fluid (CSF) MNC of optic neuritis (ON) patients without culture and after culture in the presence of myelin basic protein (MBP), the control antigen acetylcholine receptor (AChR), and without antigen. Numbers of IL-10 mRNA expressing MNC were elevated in the MS patients' blood both when enumerated without culture and after culture with MBP. Control patients with myasthenia gravis had elevated numbers of AChR-reactive IL-10 mRNA expressing cells, while numbers of MBP-reactive IL-10 positive cells did not differ from numbers registered in cells without antigen. Patients with ON, in many instances representing early MS, had IL-10 positive blood MNC that were elevated to the same extent as in clinically definite MS, and further increased in the CSF. ON patients examined within 1 month after onset had lower numbers of MBP induced IL-10 mRNA expressing blood MNC compared with patients examined later suggesting that IL-10 is related to the degree of inflammation and outcome in ON.

Topics: Adolescent; Adult; Aged; Cells, Cultured; Child; Female; Humans; Interleukin-10; Leukocytes, Mononuclear; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Optic Neuritis; Receptors, Cholinergic; RNA, Messenger

Structural similarity between viral T cell epitopes and self-peptides could lead to the induction of an autoaggressive T cell response. Based on the structural requirements for both MHC class II binding and TCR recognition of an immunodominant myelin basic protein (MBP) peptide, criteria for a data base search were developed in which the degeneracy of amino acid side chains required for MHC class II binding and the conservation of those required for T cell activation were considered. A panel of 129 peptides that matched the molecular mimicry motif was tested on seven MBP-specific T cell clones from multiple sclerosis patients. Seven viral and one bacterial peptide efficiently activated three of these clones. Only one peptide could have been identified as a molecular mimic by sequence alignment. The observation that a single T cell receptor can recognize quite distinct but structurally related peptides from multiple pathogens has important implications for understanding the pathogenesis of autoimmunity.

Topics: Amino Acid Sequence; Antigenic Variation; Autoimmunity; Cell Line, Transformed; Databases, Factual; HLA-D Antigens; Humans; Immunodominant Epitopes; Lymphocyte Activation; Models, Immunological; Molecular Mimicry; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Peptides; Receptors, Antigen, T-Cell; T-Lymphocytes; Viral Proteins

Multiple sclerosis (MS) is associated with high levels of circulating T lymphocytes that respond to the myelin antigens myelin basic protein (MBP) and proteolipid protein (PLP) by producing various cytokines including interferon-gamma (IFN-gamma) that makes MS worse and transforming growth factor-beta (TGF-beta), an endogenously produced immunosuppressant that might act beneficially. To further define the role of TGF-beta in MS, we examined the effects of recombinant TGF-beta 1 (rTGF-beta 1) on autoantigen-mediated regulation of cytokines in MS and myasthenia gravis (MG). Blood mononuclear cells (MNC) were cultivated with or without rTGF-beta 1, and with or without autoantigen or the recall antigen PPD. MNC expressing cytokine mRNA were detected after in situ hybridization with radiolabeled cDNA oligonucleotide probes. Femtogram concentrations of rTGF-beta 1 suppressed MBP-, PLP- and PPD-induced upregulation of IFN-gamma, IL-4, IL-6, tumor necrosis factor-alpha (TNF-alpha), TNF-beta and perforin in MS, and acetylcholine receptor (AChR)-induced augmentation of these pro-inflammatory cytokines in MG, but had no effects on autoantigen- or PPD-induced expression of IL-10 or TGF-beta itself. rTGF-beta 1 also suppressed numbers of myelin antigen-reactive IFN-gamma- and IL-4-secreting cells in MS and AChR-reactive IFN-gamma and IL-4 secreting cells in MG. The selective suppressive effects of TGF-beta 1 on autoantigen-induced upregulation of pro-inflammatory cytokines makes TGF-beta 1 attractive as a treatment alternative in MS and MG.

Topics: Adult; Aged; Autoantigens; Cells, Cultured; Cytokines; Female; Gene Expression; Humans; In Situ Hybridization; Inflammation; Interferon-gamma; Interleukin-10; Interleukin-4; Leukocytes, Mononuclear; Male; Middle Aged; Multiple Sclerosis; Myasthenia Gravis; Myelin Basic Protein; Oligonucleotide Probes; Recombinant Proteins; RNA, Messenger; Transforming Growth Factor beta

Myelin basic protein (MBP)-reactive T cells are thought to play an important role in the pathogenesis of multiple sclerosis (MS). In some patients with MS, these autoreactive T cells display a limited heterogeneity in their epitope recognition and T cell receptor (TCR) variable (V) gene usage. These individual-dependent properties of MBP-reactive T cells have led to the speculation that they may represent clonal expansion in vivo in some MS patients. In the present study, 51 MBP-reactive T cell clones derived from patients with MS and healthy individuals were examined for their epitope recognition and the TCR V alpha and V beta gene rearrangements. The V gene junctional region sequences of identified alpha and beta genes were further analyzed to probe their clonal origins, as the sequences are unique for individual clones. Our data showed that 26 clones derived from nine patients with MS shared a predominant reactivity to the immunodominant regions of MBP, 84-102, 110-129 and 143-168, and used various TCR V alpha and V beta rearrangements. The V gene usage of the clones was restricted to certain V alpha V beta combination(s) in a given MS patient, but varied among different patients. The sequence analysis revealed that the clones generated from a given patient shared a limited or a single junctional region sequence pattern(s), indicating their oligoclonal or monoclonal origin(s). In contrast, 25 MBP-reactive T cell clones derived from normal individuals exhibited unfocused epitope recognition and V gene usage. Thus, the limited heterogeneity of MBP-reactive T cells in their structural and functional characteristics reflects their clonal expansion in vivo in some patients with MS.

Topics: Amino Acid Sequence; Base Sequence; Cells, Cultured; Clone Cells; DNA, Complementary; Humans; Immunoglobulin Variable Region; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell, alpha-beta; Sequence Analysis; T-Lymphocytes

T-cell reactivity to human myelin basic protein (MBP) has been extensively studied using T-cell lines and clones generated from both peripheral blood and cerebrospinal fluid, from normal controls and multiple sclerosis (MS) patients. These studies have largely utilized myelin basic protein isolated from control human adult white matter. In our study, we used MBP reactive T-cell lines as a probe to investigate antigenic differences in a series of MBP preparations isolated from either control human white matter or white matter from the central nervous system (CNS) of MS patients. Autologous peripheral blood derived mononuclear cells were used as antigen presenting cells (APC). Although the majority of T-cells were found to react equally well with all preparations of MBP isolated from both control and MS white matter, we were also able to identify T-cell lines which reacted well with all preparations of MBP isolated from controls but failed to react with MBP isolated from MS white matter. These differences were unlikely to reflect differences in degradation products or excess peptides present in the MS brain since SDS-PAGE and HPLC did not show any difference in the MS samples compared to the controls, and the concentration response curves for a human T-cell clone specific for the 84-102 region of MBP were similar for all the MBP preparations. We did not detect differences in amino acid content amongst MBP preparations although single amino acid substitutions cannot be ruled out. These results raise the possibility that MBP isolated from MS brain may differ in charge microheterogeneity which would affect antigenic determinants.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Aged; Aged, 80 and over; Autoantigens; Brain; Brain Chemistry; Cells, Cultured; Female; HLA-D Antigens; Humans; Lymphocyte Activation; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes

Several stimuli induce mature T cells to undergo apoptosis or programmed cell death (PCD) including specific Ag. We have demonstrated previously that Ag induces the death of encephalitogenic T cells in vitro and deletion in vivo, leading to amelioration of autoimmune encephalomyelitis. We have now examined whether activated, myelin basic protein (MBP)-specific human T cells may be eliminated by Ag-induced PCD. We demonstrate that activated MBP-specific T cell lines (TCL) undergo the classic nuclear morphologic changes and DNA fragmentation characteristic of apoptosis when given a TCR challenge. We found evidence that two mechanisms led to apoptosis: a propriocidal mechanism that was highly Ag-specific and dependent on the dose of exogenously added rIL-2, and a cytolytic mechanism in which MBP-specific TCL lysed B cell targets and engaged in considerable "fratricidal" cytolysis of other MBP-specific T cells. These two pathways leading to MBP-specific apoptotic death could be distinguished by their glucocorticoid sensitivity. Glucocorticoid treatment significantly blocked MBP-induced propriocidal apoptosis but had no effect on T cell cytolysis of B cell targets. Although it has been proposed that autoimmune disease could result from the failure of normal deletional mechanisms, this preliminary survey of MBP-reactive mature TCL from multiple sclerosis patients revealed that such cells are highly susceptible to TCR-induced PCD and comparable with TCL from normal subjects. Thus, therapeutic strategies based on Ag-induced PCD of T lymphocytes may be feasible in man.

Topics: Apoptosis; Autoantigens; Cell Line; Cell Survival; Cytotoxicity Tests, Immunologic; Glucocorticoids; Humans; Lymphokines; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes

Multiple sclerosis affects the lower urinary tract in many patients. The relationship between lower urinary tract abnormalities and disease-related parameters of multiple sclerosis is not well described. We screened urologically and neurologically 212 patients according to a standard protocol. Micturition complaints were noted in 52% of the patients and urodynamic abnormalities were found in 64%. A statistical correlation was found between detrusor hyperactivity and detrusor hypoactivity with disease-related parameters, that is disease duration, disability status, myelin basic protein concentration in the cerebrospinal fluid and neurophysiological investigations. No relationship was found between detrusor hypersensibility or detrusor hyposensibility and the aforementioned disease-related parameters. In 1 patient upper urinary tract abnormalities were noted in combination with urodynamic abnormalities. We conclude that lower urinary tract abnormalities can be found in every patient with multiple sclerosis unrelated to the state of the disease. Severe upper urinary tract abnormalities are rare.

Topics: Adolescent; Adult; Aged; Anal Canal; Evoked Potentials, Somatosensory; Female; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Pressure; Reaction Time; Reflex; Sex Characteristics; Urethra; Urinary Bladder; Urinary Bladder Diseases; Urinary Incontinence; Urination; Urination Disorders; Urodynamics

Topics: Autoantigens; Crystallins; Humans; Immune Tolerance; Lymphocyte Activation; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; Myelin Sheath; Neuroglia; T-Lymphocytes

In the present study we attempted to examine whether copolymer 1 (Cop 1), a synthetic basic random copolymer of amino acids (a candidate drug for multiple sclerosis (MS)), and myelin basic protein (MBP) undergo processing prior to their binding to MHC class II molecules on antigen-presenting cells (APC). The direct binding of biotinylated Cop 1 and MBP to living APC was monitored by flow cytometry using phycoerythrin (PE)-streptavidin. The time course for either Cop 1 or MBP binding was similar at 37 degrees C and on ice. Both Cop 1 and MBP bound to glutaraldehyde-fixed APC. Furthermore, these biotinylated antigens bound also in the presence of protease inhibitors and lysosomotropic agents, suggesting that proteolysis is not required prior to their interaction with the MHC determinants. Finally, short fragments of Cop 1 molecule did not bind to most of the APC, suggesting that the polymeric nature of Cop 1 is important for its efficient and promiscuous binding.

Topics: Amino Acid Sequence; Animals; Antigen Presentation; Antigen-Presenting Cells; Flow Cytometry; Glatiramer Acetate; Histocompatibility Antigens Class II; Humans; Mice; Mice, Inbred BALB C; Mice, Inbred Strains; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptides; Protease Inhibitors; Protein Binding

The cytotoxic cytokines tumor necrosis factor alpha (TNF-alpha) and lymphotoxin (LT) possess toxic activity against myelin and/or oligodendrocytes in vitro. Multiple sclerosis (MS) plaques within the central nervous system (CNS) are infiltrated by peripheral blood mononuclear cells (PBMC). In this study the production of TNF-alpha and LT by PBMC in active MS were measured. PBMC were isolated from the blood of MS patients in relapse and also patients with other neurological diseases (OND) and healthy controls (HC). Isolated cells were cultured unstimulated or stimulated with phytohemagglutinin A (PHA), lipopolysaccharide (LPS) and myelin basic protein (MBP)--a hypothetical autoantigen for MS. Cytokine production was assessed using ELISA method. In the MS group, PBMC without stimulation as well as after stimulation with MBP displayed a significantly increased production of TNF-alpha. LT production was similar in MS and control groups. These results suggest that TNF-alpha but not LT is overproduced by PBMC during MS relapse.

Topics: Adolescent; Adult; Autoimmune Diseases; Cells, Cultured; Female; Humans; Lipopolysaccharides; Lymphocyte Activation; Male; Middle Aged; Monocytes; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Nervous System Diseases; Oligodendroglia; Phytohemagglutinins; T-Lymphocytes, Cytotoxic; Tumor Necrosis Factor-alpha

Topics: Autoantigens; Clone Cells; Epitope Mapping; Gene Rearrangement, alpha-Chain T-Cell Antigen Receptor; Gene Rearrangement, beta-Chain T-Cell Antigen Receptor; HLA-DR Antigens; Humans; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell, alpha-beta; T-Lymphocytes; Twins, Monozygotic

We have used two approaches to isolate TCR sequences that are unique to patients with multiple sclerosis. One strategy was to sequence TCR gene rearrangements directly from MS lesions. The second strategy utilized T-cell clones with a selectable mutation that are found only in MS patients. The selection of T-cell clones with mutations in the hypoxanthine guanine phosphoribosyltransferase (hprt) gene was used to isolate T-cells reactive to myelin basic protein (MBP) in patients with multiple sclerosis (MS). These T-cell clones are activated in vivo, and are not found in healthy individuals. The third complementarity determining regions (CDR3) of the T-cell receptor (TCR) alpha and beta chains are the putative contact sites for peptide fragments of MBP bound in the groove of the HLA molecule. The TCR V gene usage and CDR3s of these MBP-reactive hprt- T-cell clones are homologous to TCRs from other T-cells relevant to MS, including T-cells causing experimental allergic encephalomyelitis (EAE) and T-cells found in brain lesions and in the cerebrospinal fluid (CSF) of MS patients. In vivo activated MBP-reactive T-cells in MS patients may be critical in the pathogenesis of MS.

Topics: Amino Acid Sequence; Base Sequence; Brain; Encephalomyelitis, Autoimmune, Experimental; Gene Rearrangement, T-Lymphocyte; Humans; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell, alpha-beta; Sequence Alignment; Sequence Homology, Amino Acid; Sequence Homology, Nucleic Acid; T-Lymphocytes

Topics: Amino Acid Sequence; Clone Cells; Gene Rearrangement, alpha-Chain T-Cell Antigen Receptor; Gene Rearrangement, beta-Chain T-Cell Antigen Receptor; Humans; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell, alpha-beta; T-Lymphocytes

Topics: Clone Cells; Gene Rearrangement, alpha-Chain T-Cell Antigen Receptor; Gene Rearrangement, beta-Chain T-Cell Antigen Receptor; Humans; Lymphocyte Activation; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell, alpha-beta; T-Lymphocytes

Topics: Cell Line; Humans; In Vitro Techniques; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell, alpha-beta; T-Lymphocytes; Transfection

Chronic relapsing experimental allergic encephalomyelitis (CR.EAE) was induced by immunizing Lewis rats with total guinea-pig spinal cord (GPSC) tissue emulsified in enriched complete Freund's adjuvant (CFA). The proliferative responses of draining inguinal and popliteal lymph node cells to GP.MBP, purified protein derivative (PPD) and concanavalin A (ConA) appeared significantly modulated according to the clinical state of the animals. Responses appeared significantly decreased in both lymphoid compartments during the recovery periods compared with that during relapses. Therapeutic treatment of CR.EAE with cyclosporin and different lysolecithin derivatives, such as ET-18-OCH3, SRI 62-843 and MLS 266-337, starting at the spontaneous remission of the first disease bout, could suppress the manifestation of further relapses. Whereas cyclosporin only delayed the onset of the disease relapse until discontinuation of treatment, all lysolecithins showed a curative effect in most animals. Plasma corticosterone levels measured at different time points in placebo, cyclosporin and MLS 266-377-treated rats showed a strong correlation with the clinical state of the animals. High corticosterone levels were detected during stages of acute paralysis, whereas a decrease to normal levels was noted during each recovery phase.

Topics: Animals; Autoimmune Diseases; Concanavalin A; Corticosterone; Cyclosporine; Dexamethasone; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Female; Furans; Guinea Pigs; Lymph Nodes; Lymphocyte Activation; Lysophosphatidylcholines; Multiple Sclerosis; Myelin Basic Protein; Phospholipid Ethers; Rats; Rats, Inbred Lew; Tuberculin

In a pilot trial, eight patients with multiple sclerosis were matched to control patients and received T-cell vaccination with irradiated T cells reactive to myelin basic protein (MBP) to deplete circulating MBP-reactive T cells. In the 2 years before and after vaccination, exacerbations decreased in five vaccinated patients (numbers 1, 2, 6-8) with relapsing-remitting disease from sixteen to three, respectively, and from twelve to ten in their matched controls. Magnetic resonance imaging showed a mean 8.0% increase in brain lesion size in the vaccinated patients compared with a 39.5% increase in the controls. Lesions and/or relapses worsened in three cases after vaccination in association with reappearance of circulating MBP-reactive T cells.

Topics: Adult; Autoimmunity; Brain; Case-Control Studies; Female; Follow-Up Studies; Humans; Lymphocyte Depletion; Magnetic Resonance Imaging; Male; Multiple Sclerosis; Myelin Basic Protein; Pilot Projects; Recurrence; T-Lymphocytes; Vaccination; Vaccines

The cellular immunology of experimental autoimmune encephalomyelitis, a model for multiple sclerosis, has been studied, for the most part, using T cells directed to dominant epitopes of the Ag myelin basic protein (MBP). To characterize T cells reactive to cryptic epitopes of MBP, we immunized Lewis rats with each of 17 overlapping peptides of the 18.5-kDa isoform of rat MBP. We found that, in addition to the known 71-90 epitope, six other peptides induced active encephalomyelitis in the majority the injected rats. T cell lines raised to six different MBP epitopes were encephalitogenic upon adoptive transfer to naive rats. In contrast to the T cells specific for the dominant 71-90 peptide, the T cell lines reactive to cryptic epitopes were not restricted in their TCR genes to V beta 8.2, and some of the lines caused prolonged disease. Thus, T cells of different specificities and TCR usage can be pathogenic.

Topics: Amino Acid Sequence; Animals; Disease Models, Animal; Epitopes; Female; Immunity, Cellular; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptides; Rats; Rats, Inbred Lew; Spinal Cord; T-Lymphocytes

The present paper compares the genetic polymorphism of a part of the myelin basic protein (MBP) gene in 64 Danish MS patients with that of 57 normal controls. PCR analysis, using primers flanking the 5' area from 479 to 1812 bp upstream the initiator methionine in the MBP gene, revealed that genetic susceptibility to MS is linked to polymorphism in the part of the MBP gene studied. Thus we found three different band patterns i.e. a homozygote with a 1445 bp long fragment, a homozygote with a fragment 1318 bp long and a heterozygote with both bands present. 59% of 64 patients with MS were homozygous for 1.445 kb allele, versus 40% of 57 control subjects, 18% of the control subjects were homozygous for the 1.318 kb, while only 0.7% of the MS patients possessed this allele. The differences between incidence of the three band pattern in the MS and the control group were significant at 1% level. Validation analysis furthermore support, the view that the 1445 bp PCR fragment is associated with MS.

Topics: Adult; Base Sequence; DNA; Electrophoresis, Agar Gel; Female; Humans; Lymphocytes; Male; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Polymerase Chain Reaction; Polymorphism, Genetic

A 9-year-old girl had hemiparesis, and a diagnosis of primary Sjögren syndrome was made. The neurologic dysfunction was multifocal, involving both the brain and spinal cord, and was recurrent; the findings mimicked multiple sclerosis. Corticosteroid treatment during episodes of acute neurologic dysfunction appeared to be beneficial.

Topics: Brain; Child; Diagnosis, Differential; Encephalomyelitis; Female; Hemiplegia; Humans; Immunoglobulin G; Magnetic Resonance Imaging; Multiple Sclerosis; Myelin Basic Protein; Prednisolone; Sjogren's Syndrome; Spinal Cord Diseases; Tomography, X-Ray Computed

Multiple sclerosis (MS) is an autoimmune demyelinating disorder of the central nervous system (CNS). The disease is characterized by inflammatory lesions in the white matter of the CNS, consisting of a specific immune response to the myelin sheath. We investigated peripheral blood mononuclear cell (PBMC) cytokine production by enzyme-linked immunosorbent assays of 21 MS patients and 19 age-matched normal controls in response to the T-cell mitogen phytohemagglutinin (PHA). Peripheral blood mononuclear cells were cultured in medium alone or in medium with 5 micrograms of PHA per ml for 48 h, and culture supernatants were collected for analysis. Cytokines selected for study were interleukin-10 (IL-10), gamma interferon (IFN-gamma), IL-2, and IL-4. All cytokine activities described were expressed as concentrations per 500,000 cells. We found that 48% (10 of 21) of the MS patients produced small but detectable levels of IL-10 in medium alone, compared with 26% (5 of 18) of the controls. We found that the MS patients produced significantly higher quantities of IL-10 protein than the controls in response to PHA (mean supernatant concentrations of IL-10 for patients and controls, 421 and 204 pg/ml, respectively [P < 0.05]). No significant differences were detected in the production of IL-2, IFN-gamma, and IL-4 between patients and controls in response to PHA, although patients appeared to display a trend toward decreased production of IFN-gamma.

Topics: Adult; Aged; Cytokines; Enzyme-Linked Immunosorbent Assay; Female; Humans; Immunoassay; Interferon-gamma; Interleukin-10; Interleukin-2; Interleukin-4; Leukocytes, Mononuclear; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Phytohemagglutinins; T-Lymphocytes

Topics: Humans; Immune Tolerance; Multiple Sclerosis; Myelin Basic Protein

In the human disease multiple sclerosis (MS), the immune mechanisms responsible for selective destruction of central nervous system myelin are unknown. In the common marmoset Callithrix jacchus, a unique demyelinating form of experimental allergic encephalomyelitis resembling MS can be induced by immunization with whole myelin. Here we show that the MS-like lesion can be reproduced by immunization against the extracellular domain of a single myelin protein, myelin/oligodendrocyte glycoprotein (MOG). By contrast, immunization against the quantitatively major myelin proteins myelin basic protein or proteolipid protein results in inflammation but little or no demyelination. Furthermore, in the presence of encephalitogenic (e.g., disease-inducing) T cells, the fully demyelinated lesion is reconstructed by systemic administration of IgG purified from whole myelin-, or MOG-immunized animals, and equally by a monoclonal antibody against MOG, but not by control IgG. Encephalitogenic T cells may contribute to the MS-like lesion through disruption of the blood-brain barrier that permits access of demyelinating antibody into the nervous system. The identification of MOG as a major target antigen for autoimmune demyelination in a nonhuman primate should facilitate development of specific immunotherapies for human MS.

Topics: Animals; Autoantibodies; Brain; Callithrix; Chromatography, Affinity; Encephalomyelitis, Autoimmune, Experimental; Humans; Immunotherapy, Adoptive; Inflammation; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Sheath; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Proteolipids; Recombinant Proteins

To determine the relationship between baseline CSF immunologic abnormalities and MS disease progression; To determine progression rates in an untreated, recently-diagnosed MS sample using several validated clinical measures.. CSF immune abnormalities are common in MS but have not been linked to disease progression.. Thirty-six patients with definite (n = 28), probable (n = 2), or possible (n = 6) MS were studied prospectively. Baseline CSF was analyzed for free kappa and lambda light chains, myelin basic protein, IgG synthesis rate, and IgG index. MS patients were entered into the study within 5 years of symptom onset and examined semiannually for as long as 53.4 months (median length of follow up 38.9 months). MS progression was defined as sustained worsening on the following clinical measurement instruments: the Expanded Disability Status Scale (EDSS), the Ambulation Index (AI), the 9 Hole Peg Test (9HT) and the Box and Blocks test (BBT). Kaplan-Meier estimates of disease progression were calculated and the relationship between baseline CSF values and disease progression was determined using Cox proportional hazards regression models.. By 36 months, 33% (95% CI = 10.3, 55.7) of patients had progressed on EDSS and 49.7% (95% CI = 27.7, 71.7) had progressed on at least one of the outcome measures. Patients with CSF free kappa chain levels in the upper quartile had a significantly higher risk of progression on EDSS (Hazard Ratio 3.78; p = 0.04) and 9HT (Hazard Ratio 10.77, p = 0.04).. In this study, CSF free kappa light chains predicted subsequent physical deterioration in prospectively evaluated MS patients. If this is confirmed by larger studies, then CSF free kappa light chains could serve as a target for intervention in therapeutic trials.

Topics: Adolescent; Adult; Age of Onset; Disease Progression; Female; Follow-Up Studies; Humans; Immunoglobulin G; Immunoglobulin kappa-Chains; Immunoglobulin lambda-Chains; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Predictive Value of Tests; Prospective Studies; Regression Analysis

We investigated two short tandem tetranucleotide (TGGA) repeat polymorphisms upstreams of the myelin basic protein (MBP) gene. The region was amplified by the polymerase chain reaction (PCR) and the two repeat systems were separated by cutting with the restriction enzyme NlaIII. The lengths of the DNA fragments were analyzed by vertical electrophoresis in polyacrylamide gels followed by silver staining. We compared the DNA fragment frequencies of the two MBP regions in 34 patients suffering from multiple sclerosis and in 78 suffering from monosymptomatic idiopathic optic neuritis to those in 200 healthy controls. We found no significant differences between the MBP fragment frequencies in either of the patient groups and in the control group.

Topics: Alleles; Chromosome Deletion; Cloning, Molecular; Denmark; DNA; Gene Frequency; Genes; Genetic Predisposition to Disease; Humans; Microsatellite Repeats; Multiple Sclerosis; Myelin Basic Protein; Optic Neuritis; Polymerase Chain Reaction

Topics: Controlled Clinical Trials as Topic; Disease Susceptibility; Female; HLA Antigens; Humans; Immunotherapy; Interferon-beta; Male; Multiple Sclerosis; Myelin Basic Protein; Peptides; Receptors, Antigen, T-Cell; Recombinant Proteins; Recurrence; Self Tolerance

The cause of MS is uncertain, but an autoimmune disorder of the CNS is likely, and myelin basic protein (MBP) is a candidate antigen. MBP exists in different isoforms, generated by differential splicing of exons, and in charge isomers, generated by posttranslational modifications. Different isoforms and charge isomers presumably subserve different functions, and they vary in abundance in immature myelin found during myelinogenesis and remyelination compared with mature myelin. The 18.5-kd isomer is most abundant in normal human adults and consequently has been used almost exclusively for immunologic studies in MS. In the present study, we examined a different but abundant charge isomer of MBP, termed MBP-C8, to determine whether it could be recognized by MBP-specific cytotoxic and proliferative T-cell lines (TCL) and whether a T-cell response directed exclusively against citrulline-containing residues of MBP-C8 exists in MS patients and healthy controls. We showed that citrulline affects antigen recognition by some TCL that are specific for areas of MBP that contain the citrulline residues. Following stimulation with MBP-C8, MBP-C8-specific TCL could be generated from both MS patients and controls. T-cell responses against antigens that appear during myelinogenesis and during remyelination may be important in inducing and perpetuating an autoimmune response involved in the pathogenesis of MS.

Topics: Adult; Amino Acid Sequence; Antigen-Presenting Cells; Cell Line; Citrulline; Female; Humans; Lymphocyte Activation; Male; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Reference Values; Stereoisomerism; T-Lymphocytes

Irrespective of the large body of literature on the putative role of antibodies in the development of multiple sclerosis (MS), the detection of specific antibody-forming B cells (AFCs) in the central nervous system (CNS) tissues has not been described. In this study we show that autoantigen-specific AFCs can be found in CSN tissue sections of MS patients. Applying a newly developed myelin basic protein (MBP)-enzyme conjugate technique, we have detected MBP-specific AFCs in autopsy periventricular white matter and cerebellum tissue sections of MS patients. We demonstrated the presence of MBP-specific AFCs in CNS tissue sections in five out of 12 MS patients. No MBP-specific AFCs were detected in CNS tissue sections of 11 patients with other neurological diseases, such as Parkinson's and Alzheimer's disease, or in brain tissue sections of eight deceased persons without neurological diseases. In MS patients, anti-MBP AFCs were present in brain tissue sections both with and without plaques. The proportion of MBP-specific AFCs in some of the MS patient brain tissues reached over 50% of all AFCs. The high relative frequency of the anti-MBP AFCs and their localization in periventricular white matter and cerebellum of MS patients only, suggests that anti-MBP AFCs represent a cell population, which could play an important role in MS immunopathology.

Topics: Adult; Aged; Aged, 80 and over; Antibodies; Antibody-Producing Cells; Humans; Middle Aged; Multiple Sclerosis; Myelin Basic Protein

We investigated whether myelin basic protein (MBP)-reactive T cells from multiple sclerosis (MS) patients can recognize mouse MBP since this is an expected requirement for the transfer of experimental autoimmune encephalomyelitis (EAE) into severe combined immunodeficiency (SCID) mouse-human chimeras. Peripheral blood mononuclear cells from 11 MS patients were analyzed for in vitro proliferation to mouse MBP. Six patients (55%) responded to mouse MBP at the first or second stimulation. Five T cell lines, selected with mouse MBP from five MS patients, were analyzed for their proliferation to mouse and human MBP and to a panel of synthetic peptides of human MBP. Four of the five lines recognized mouse MBP. In vitro proliferation was restricted by MHC class II in one line tested for MHC restriction. One of the five lines recognized whole human MBP and all five of the lines responded to at least one of the five synthetic peptides corresponding to human MBP residues 8-28, 67-90, 84-102, 87-99 or 130-149. These results show that MS patient T cells recognize mouse MBP and suggest that distinct human MBP epitopes are immunologically cross-reactive with epitopes of mouse MBP.

Topics: Amino Acid Sequence; Animals; Cell Line; Cross Reactions; Epitopes; Histocompatibility Antigens Class I; Histocompatibility Antigens Class II; Humans; Mice; Mice, SCID; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; T-Lymphocytes

Studies on patients with monosymptomatic optic neuritis (ON) should give opportunities to identify features typical for early multiple sclerosis (MS). There are increased T and B cell responses to the myelin components myelin basic protein (MBP) and proteolipid protein (PLP) in both ON and MS, but there is little information on the types of cytokines produced by such cells. We describe the use of in situ hybridization with complementary DNA oligonucleotide probes to detect and enumerate mononuclear cells expressing mRNA for the cytokines interferon-gamma (IFN-gamma) which augments cell-mediated immunity; interleukin-4 (IL-4) which promotes the B cell response; and transforming growth factor beta (TGF-beta) that in many cases downregulates immune responses. Expression of these cytokines was studied in mononuclear cells from peripheral blood and cerebrospinal fluid (CSF) from patients with ON and MS after in vitro exposure to MBP and PLP, and in absence of antigen. There were elevated levels of cells that in response to MBP and PLP expressed IFN-gamma, IL-4 and TGF-beta mRNA in blood and further enriched in CSF in both ON and MS, compared to patients with other neurological diseases. The results suggest that IFN-gamma, IL-4 as well as TGF-beta are involved in both ON and MS, and that the cytokine profile in early MS as reflected by ON is not different from that in clinically definite MS.

Topics: Adult; Female; Humans; Interferon-gamma; Interleukin-4; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; Optic Neuritis; RNA, Messenger; Transforming Growth Factor beta

Equal numbers of CD4+ T cells recognizing myelin basic protein (MBP) and proteolipid protein (PLP) are found in the circulation of normal individuals and multiple sclerosis (MS) patients. We hypothesized that if myelin-reactive T cells are critical for the pathogenesis of MS, they would exist in a different state of activation as compared with myelin-reactive T cells cloned from the blood of normal individuals. This was investigated in a total of 62 subjects with definitive MS. While there were no differences in the frequencies of MBP- and PLP-reactive T cells after primary antigen stimulation, the frequency of MBP or PLP but not tetanus toxoid-reactive T cells generated after primary recombinant interleukin (rIL-2) stimulation was significantly higher in MS patients as compared with control individuals. Primary rIL-2-stimulated MBP-reactive T cell lines were CD4+ and recognized MBP epitopes 84-102 and 143-168 similar to MBP-reactive T cell lines generated with primary MBP stimulation. In the cerebrospinal fluid (CSF) of MS patients, MBP-reactive T cells generated with primary rIL-2 stimulation accounted for 7% of the IL-2-responsive cells, greater than 10-fold higher than paired blood samples, and these T cells also selectively recognized MBP peptides 84-102 and 143-168. In striking contrast, MBP-reactive T cells were not detected in CSF obtained from patients with other neurologic diseases. These results provide definitive in vitro evidence of an absolute difference in the activation state of myelin-reactive T cells in the central nervous system of patients with MS and provide evidence of a pathogenic role of autoreactive T cells in the disease.

Topics: Adult; Antigens, CD; Cell Line; Female; Flow Cytometry; HLA-DQ Antigens; HLA-DR Antigens; Humans; Interleukin-2; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; Nervous System Diseases; Recombinant Proteins; T-Lymphocyte Subsets; T-Lymphocytes

Human myelin basic protein (hMBP) and proteolipid protein (PLP) were used as antigens in a solid-phase radioimmunoassay to determine relative frequencies of anti-MBP and anti-PLP in cerebrospinal fluid (CSF) of optic neuritis and multiple sclerosis (MS) patients. Forty-nine of 55 patients with optic neuritis had increased CSF anti-MBP and the remaining 6 had increased anti-PLP. Of 385 MS patients, MS relapse: 173 of 180 patients had increased anti-MBP, 5 of the remaining 7 patients had elevated anti-PLP, and 2 had neither of these autoantibodies. Progressive MS: 111 of 116 patients had increased anti-MBP in either free and/or bound form, of the remaining 5 patients 4 had increased anti-PLP, and 1 had neither anti-MBP nor anti-PLP. MS remission: 15 of 87 patients had somewhat increased anti-MBP, none had anti-PLP. IgG was purified by affinity chromatography from necropsy central nervous system (CNS) tissue samples of 4 individual patients with clinically definite and neuropathologically confirmed MS. Three of these 4 patients who had increased levels of CSF anti-MBP also had increased anti-MBP titers in CNS tissue-extracted IgG. The fourth patient who had anti-PLP in CSF also had anti-PLP in brain tissue IgG. These autoantibodies were not detected simultaneously in any patient. These results suggest that there are at least two immunologically distinct forms of MS, i.e., a common form highly associated with anti-MBP and more frequent prominent inflammatory characteristics in CSF and CNS, and an infrequent form associated with anti-PLP in CSF and tissue, and less abundant inflammation.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Amino Acid Sequence; Autoantibodies; Brain; Central Nervous System; Humans; Magnetic Resonance Imaging; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; Optic Neuritis; Radioimmunoassay

The biased expression of V beta 5.2 and V beta 6.1 by T cells specific for myelin basic protein (BP) has led to our use of TCR peptides from these V gene sequences to induce anti-TCR immunity in patients with multiple sclerosis (MS). Injection of V beta 5.2-39-59 or V beta 6.1-39-59 peptides significantly increased the peptide specific T cell frequency in 7 of 11 MS patients, often with an accompanying delayed hypersensitivity reaction at the injection site. Here, we validate these cellular immune responses by characterizing TCR peptide specific T cells from an MS patient with biased V beta 5.2 expression in BP reactive T cells before treatment with TCR peptides, and from two MS patients in whom the frequencies of anti-TCR peptide specific T cells were significantly boosted after injection with low doses of TCR peptides. In both cases, T cell lines were established with relative ease, especially after boosting with the peptides. A V beta 5.2-39-59 reactive line responded selectively to the boosting peptide and was restricted by both MHC class I (HLA-B7) and MHC class II (HLA-DR2) molecules. Characterization of 22 clonal isolates revealed that the responding T cells were predominantly activated CD4+CD8lo, circulating memory cells restricted by either HLA-B7 or HLA-DR2, that utilized mainly V beta 4, V beta 6, V beta 12, and V beta 14, but not V beta 5.2 in their TCR. T cell isolates specific for V beta 6.1-39-59 possessed similar characteristics but contained specificities cross-reactive with an N-terminal sequence on V beta 5.2-39-59. Upon stimulation with peptide or Con A, the TCR peptide specific T cell lines had increased message production for IFN-gamma, GM-CSF, IL-4, IL-5, and to a lesser degree, IL-2. This lymphokine mRNA profile differed from a BP-specific T cell line that produced message for IFN-gamma and GM-CSF but low or absent levels of IL-4 and IL-5. The extensive parallels between human T cells specific for V beta 5.2 and V beta 6.1 CDR2 peptides and rat T cells specific for V beta 8.2 CDR2 peptide that are highly protective against experimental encephalomyelitis strengthen the rationale for the therapeutic use of TCR peptides in human autoimmunity.

Topics: Adult; Aged; Amino Acid Sequence; Base Sequence; Cell Line; DNA Primers; Female; Gene Expression; Humans; Immunotherapy; Lymphokines; Male; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Receptors, Antigen, T-Cell, alpha-beta; RNA, Messenger; T-Lymphocytes

Myelin basic protein (MBP) and proteolipid protein (PLP) were purified from non-MS human brain and used in solid phase radioimmunoassays to detect their specific antibodies in cerebrospinal fluid (CSF) of optic neuritis and clinically definite multiple sclerosis (MS) patients. In 53 optic neuritis patients free anti-MBP was elevated in 47 and in 6 of these 47 patients bound anti-MBP was also increased. The remaining 6 patients with undetectable anti-MBP had increased levels of anti-PLP in their CSF. None of these optic neuritis patients had autoantibodies to both antigens. Of 173 MS patients with acute relapses 169 had increased free anti-MBP. Three of the 4 remaining patients with undetectable anti-MBP had increased anti-PLP in their CSF. Of 110 MS patients with chronic progressive disease, 107 had increased CSF anti-MBP and 2 had elevated anti-PLP. Of 87 MS patients in remission, 15 had modestly elevated anti-MBP and none had detectable anti-PLP. Considering the total of 370 clinically definite MS patients with active and inactive disease, 77% had increased CSF anti-MBP and 1% had increased CSF anti-PLP. These findings are suggesting 2 immunochemically distinct forms of MS: a common form with autoantibodies directed against MBP and a more rare form associated with anti-PLP.

Topics: Adult; Autoantibodies; Blood-Brain Barrier; Brain; Female; Humans; Immunoglobulin G; Magnetic Resonance Imaging; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; Optic Neuritis

Because of its proximity to the central nervous system, the cerebrospinal fluid (CSF) represents an important source of T cells that potentially could mediate putative autoimmune diseases such as multiple sclerosis (MS). To overcome the low CSF cellularity, we evaluated culture conditions that could expand CSF T cells, with a focus on the expression of T-cell receptor V beta genes utilized by T cells specific for the potentially encephalitogenic autoantigen myelin basic protein (BP). Expansion of "activated" CSF cells with IL-2/IL-4 plus accessory cells optimally retained BP-responsive T cells that over-expressed V beta 1, V beta 2, V beta 5, or V beta 18, compared to expansion using supernatants from PHA-stimulated blood cells, or anti-CD3 antibody that led to different V gene bias and rare reactivity to BP. Sequential evaluation of paired CSF and blood samples from a relapsing remitting MS patient indicated that BP-reactive T cells were present in CSF during the period of clinical activity, and the pattern of BP recognition in CSF was partially reflected in blood, even after CSF reactivity had dissipated during remission. Over-expressed V beta genes were not always constant, however, since in three sequential evaluations of a chronic progressive MS patient, V beta genes over-expressed in the first BP-reactive CSF switched to a different V beta gene bias that was present in the second and third CSF samples. Blood samples reflected each pattern of CSF V beta gene bias, but retained the initial bias for at least 4 months after its disappearance from CSF. These data indicate that selective expansion of IL-2/IL-4-responsive CSF cells favors growth of the BP-reactive subpopulation, and, in a limited number of patients studied, reflected clinical disease activity. In comparison, blood T cells provided a partial but longer lasting reflection of the CSF BP reactivity and V beta gene bias.

Topics: Adult; Aged; Base Sequence; Cell Division; Chronic Disease; Female; Gene Expression Regulation; Humans; Male; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Phenotype; Polymerase Chain Reaction; Receptors, Antigen, T-Cell, alpha-beta; Recurrence

T cells recognizing the myelin components myelin basic protein (MBP) and proteolipid protein (PLP) are increased in multiple sclerosis (MS), and there are elevated numbers of T cells recognizing the nicotinic acetylcholine receptor (AChR) in myasthenia gravis (MG). However, the cytokine repertoires in these diseases are largely unknown. We adopted in situ hybridization with radiolabeled complementary DNA oligonucleotide probes to enumerate mononuclear cells that expressed the T-helper type 1 (Th1) cell-related interferon-gamma (IFN-gamma) and Th2-associated interleukin-4 (IL-4) after short-term culture in the presence of autoantigen. High numbers of IFN-gamma and IL-4 mRNA-expressing cells in response to MBP and PLP were detected in patients with untreated MS, and to AChR in MG. The levels of IFN-gamma and IL-4 mRNA-positive cells in MS after culture in the presence of AChR, and in MG after culture in the presence of MBP or PLP, did not differ from those detected after culture without antigen. The CSF of MS patients contained four- to eightfold more myelin protein-reactive IFN-gamma and IL-4 expressing cells. The findings imply that MS and MG are associated with mixed Th1- and Th2-like cell responses directed to organ-specific target antigens.

Topics: Adult; Autoantigens; Epitopes; Female; Gene Expression; Humans; Interferon-gamma; Interleukin-4; Male; Middle Aged; Monocytes; Multiple Sclerosis; Myasthenia Gravis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; Receptors, Cholinergic; RNA, Messenger

One of the major challenges in genetic linkage analyses is the study of complex diseases. We demonstrate here the use of two-locus linkage analysis in multiple sclerosis (MS), a multifactorial disease with a complex mode of inheritance. In a set of Finnish multiplex families, we have previously found evidence for linkage between MS susceptibility and two independent loci, the myelin basic protein gene (MBP) on chromosome 18 and the HLA complex on chromosome 6. This set of families provides a unique opportunity to perform linkage analysis conditional on two loci contributing to the disease. In the two-trait-locus/two-marker-locus analysis, the presence of another disease locus is parametrized and the analysis more appropriately treats information from the unaffected family members than single-disease-locus analysis. As exemplified here in MS, the two-locus analysis can be a powerful method for investigating susceptibility loci in complex traits, best suited for analysis of specific candidate genes, or for situations in which preliminary evidence for linkage already exists or is suggested.

Topics: Alleles; Chromosomes, Human, Pair 18; Chromosomes, Human, Pair 6; Epistasis, Genetic; Finland; Genes; Genetic Linkage; Genetic Predisposition to Disease; HLA-DQ alpha-Chains; HLA-DQ Antigens; Humans; Lod Score; Major Histocompatibility Complex; Multiple Sclerosis; Myelin Basic Protein

Monosymptomatic unilateral optic neuritis is a common first manifestation of multiple sclerosis. Abnormal T cell responses to myelin components including myelin basic protein (MBP), proteolipid protein (PLP), and myelin-associated glycoprotein (MAG) have been implicated in the pathogenesis of multiple sclerosis. Antigen-reactive T helper type 1 (Th1)-like cells that responded by interferon gamma (IFN-gamma) secretion on antigen stimulation in vitro were counted. Untreated patients with optic neuritis and multiple sclerosis had similarly raised levels of T cells recognising MBP, PLP, and MAG in peripheral blood. Such T cells were strongly enriched in CSF. None of these myelin antigens functioned as immunodominant T cell antigen characteristic for optic neuritis or multiple sclerosis. The autoimmune T cell repertoire was not more restricted in optic neuritis (as an example of early multiple sclerosis). The autoreactive T cell repertoires differed in blood compared with CSF in individual patients with optic neuritis and multiple sclerosis. No relations were found between specificity or quantity of autoreactive T cells in blood or CSF, and clinical variables of optic neuritis or multiple sclerosis, or occurrence of oligoclonal IgG bands in CSF. The role of raised MBP, PLP, and MAG reactive Th1-like cells found in optic neuritis and multiple sclerosis remains unexplained.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Cerebrospinal Fluid; Female; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; Myelin-Associated Glycoprotein; Optic Neuritis; T-Lymphocytes

The pathogenesis of multiple sclerosis (MS) is thought to involve a T-cell-mediated autoimmune process. Experimental allergic encephalomyelitis (EAE), an animal model resembling MS, can be induced by immunization with myelin antigens such as myelin basic protein. The T-cell antigen receptor (TCR) usage in EAE is highly restricted in some strains of animals and experimental treatments targeting the TCR have been successful in EAE. Examination of the TCR beta-chain variable-region (V beta) usage of MBP-specific T-cell lines in MS patients has produced conflicting results. Our previous studies of TCR alpha-chain variable-region usage in monozygotic twins demonstrated a general skewing of the TCR repertoire in individuals with MS. This skewing became apparent only after stimulation with antigens; in peripheral blood lymphocyte preparations from individuals with MS V alpha 8-bearing T cells were preferentially selected by stimulation with myelin basic protein. In the present study we examined complementarity-determining region 3 of those V alpha 8-positive TCRs. Marked sequence heterogeneity was found in all individuals with severe MS. In contrast, restricted areas of complementarity-determining region 3 were found in healthy control individuals and in individuals with a mild form of MS. Sequences from tetanus toxoid-specific V alpha 8-positive T cells generated from the same individuals were relatively homogeneous within individuals regardless of disease activity and were distinct from the sequences of complementarity-determining region 3 in myelin basic protein-stimulated lines. These findings suggest that disease severity may be associated with increased heterogeneity of myelin antigen-specific T cells and could reflect an impaired ability of the immune system to down-regulate these anti-self responses.

Topics: Adult; Amino Acid Sequence; Gene Rearrangement, alpha-Chain T-Cell Antigen Receptor; Humans; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell, alpha-beta; Sequence Alignment; Sequence Homology, Amino Acid; T-Lymphocytes; Tetanus Toxoid; Twins, Monozygotic

In the present study a tetranucleotide (TGGA)n repeat polymorphism 5' to the myelin basic protein (MBP) gene was evaluated in a group of HLA-class II-typed, chronic progressive multiple sclerosis (MS) patients. This polymorphism has been reported by others to be associated with MS. Contrary to these reports we observed similar allele frequencies in patients and controls. Our results indicate that there is no association between MS and a polymorphism 5' to the MBP gene.

Topics: Alleles; Base Sequence; Chronic Disease; HLA-DR Antigens; Humans; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Polymorphism, Genetic

Multiple sclerosis (MS) may be an autoimmune disease, partially caused by autoreactivity to myelin basic protein (MBP) and other central nervous system proteins. Acute optic neuritis (ON) is a frequent first symptom of MS. The role of the HLA system in anti-MBP antibody production in ON was investigated employing a restriction fragment length polymorphism system for genomic HLA-DQ and -DR typing and an immunospot assay for the detection of individual cells secreting antibodies to three different synthetic MBP peptides. Thirty-two out of 40 patients (80%) with ON had cells in cerebrospinal fluid secreting anti-MBP peptide antibodies while this occurred in 10/19 patients with other neurological diseases (53%; mainly in patients with inflammatory diseases in the central nervous system). This difference was statistically significant (P = 0.03). None of the three examined peptides were immunodominant in any patient group. It was found, however, that presence of HLA DR15, which is associated with MS, may be associated further with predominant production of antibodies to the MBP amino acids 63-88 in patients with ON (P = 0.002, corrected for multiple comparisons).

Topics: Adult; Aged; Autoantibodies; B-Lymphocytes; Epitopes; Female; HLA-D Antigens; HLA-DQ Antigens; HLA-DR Antigens; Humans; Immunoassay; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Optic Neuritis

Topics: Adult; Clinical Trials as Topic; Double-Blind Method; Encephalomyelitis, Autoimmune, Experimental; Humans; Israel; Multiple Sclerosis; Myelin Basic Protein; Peptides; Pilot Projects; Placebos; Recurrence; Treatment Outcome; United States

Genetic factors influence the susceptibility to multiple sclerosis (MS). This disease is accompanied by augmented T cell responses to CNS myelin components such as myelin basic protein. To evaluate the familial occurrence of such T cell autoreactivity, we have studied 12 MS families including 37 healthy first-degree relatives for occurrence of numbers of interferon-gamma (IFN-gamma) secreting cells among blood mononuclear after culture in presence of myelin basic protein (MBP), eight synthetic MBP peptides and the control antigen acetylcholine receptor (AChR). There were no differences between MS patients and healthy family members regarding frequencies of autoreactive T cells recognizing MBP, the eight different MBP peptides or AChR. None of the MBP peptides predominated as T cell antigen among the MS patients or their unaffected family members. In some families the highest number of MBP peptide reactive T cells were found among unaffected family members. No correlation was observed between numbers of MBP or MBP peptide reactive T cells in various subjects and their HLA-DR-DQ phenotypes. In conclusion, this study has revealed the presence of MBP and MBP peptide reactive T cells of similar frequencies in MS patients and their healthy family members.

Topics: Adult; Autoimmunity; Female; HLA-DQ Antigens; HLA-DR Antigens; Humans; Interferon-gamma; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Pedigree; T-Lymphocytes

The etiology of multiple sclerosis (MS) is considered to involve genetic, environmental, infective, and immunological factors which affect the integrity of a normally assembled myelin sheath, either directly or indirectly resulting in demyelination. In a correlative study involving protein chemical, mass spectrometric, and electron microscopic techniques we have determined that myelin obtained from victims of MS is arrested at the level of the first growth spurt (within the first 6 yr of life) and is therefore developmentally immature. The data supporting this conclusion include (a) the pattern of microheterogeneity of myelin basic protein (MBP); (b) the NH2-terminal acylation of the least cationic component of MBP ("C-8"); (c) the phase transition temperature (Tc) of myelin isolated from victims of MS correlated with the increased proportion of the least cationic component of MBP; and (d) immunogold electron microscopy using an antibody specific for "C-8" showed that the distribution of gold particles in a 2-yr-old infant was similar to the distribution found in a victim of MS. We postulate that this developmentally immature myelin is more susceptible to degradation by one or a combination of factors mentioned above, providing the initial antigenic material to the immune system.

Topics: Acylation; Adult; Age Factors; Aged; Amino Acids; Brain Chemistry; Child; Child, Preschool; Humans; Immunohistochemistry; Infant; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath

Multiple sclerosis [MS] is a chronic inflammatory disease of the central nervous system which has been postulated to be a T cell mediated disease. We examined proliferation of mononuclear cells to OKT3 mAb, Con A, ionomycin plus PMA and human myelin basic protein in subjects with relapsing-remitting and chronic progressive multiple sclerosis. Age and sex matched controls demonstrated a good proliferation to anti-CD3 mAb whereas subjects with relapsing-remitting multiple sclerosis showed a significantly decreased anti-CD3 mAb response. There was no difference in mitogen, ionomycin plus PMA or human MBP proliferation between controls and MS subjects. There was also a trend for decreasing anti-CD3 mAb proliferation in patients with chronic progressive multiple sclerosis compared to controls. LPS significantly decreased anti-CD3 mAb proliferation in controls but not in the MS subjects. An abnormality of signal transduction via the CD3 T-cell receptor complex in T cells and responsiveness to the immunomodulatory effect of IFN inducers may exist in multiple sclerosis.

Topics: CD3 Complex; Female; Humans; Interferon-alpha; Lipopolysaccharides; Lymphocyte Activation; Male; Multiple Sclerosis; Myelin Basic Protein; Poly I-C; T-Lymphocytes

Low density lipoprotein (LDL), the major carrier of plasma cholesterol, may enter the parenchyma of early multiple sclerosis (MS) lesions as a result of blood-brain barrier damage. We have used antibodies against LDL and epitopes found in LDL oxidized by two peroxidative end-products, malondialdehyde (MDA) and 4-hydroxynonenal (4-HNE), to immunocytochemically stain MS plaques at different stages of pathology. Native LDL, epitopes of MDA-LDL, peptides of myelin basic protein and neutral lipid oil red O (ORO) staining were found to be co-localized within foamy macrophages in early and actively demyelinating MS plaques. Thus cholesterol esters, which are seen as Maltese crosses under polarized light in a proportion of foamy macrophages, appear to be derived from both LDL and myelin. ORO-negative astrocytes were strongly stained with the antibodies against 4-HNE-LDL and MDA-LDL, suggesting uptake of oxidatively modified protein products alone. Our findings suggest that a large proportion of the plasma LDL which enters the parenchyma of MS plaques is oxidatively modified in the lesion. Lipid peroxidation and oxidized LDL uptake by activated microglia and infiltrating macrophages in the early stages of MS plaque development may play important roles in demyelination.

Topics: Adult; Aged; Aldehydes; Astrocytes; Demyelinating Diseases; Humans; Immunohistochemistry; Lipoproteins, LDL; Macrophages; Malondialdehyde; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Oxidation-Reduction

Myelin basic protein was examined as a candidate gene for susceptibility to multiple sclerosis using two adjacent amplification fragment length polymorphisms (AmpFLPs), containing seven and six highly informative alleles respectively. No allelic association was found with multiple sclerosis, comparing 77 cases and 88 controls, and there was no evidence for linkage in 73 affected sibling pairs, using the methods of identity by descent and identity by state.

Topics: Adult; Aged; Alleles; DNA, Satellite; Gene Amplification; Genetic Linkage; Humans; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Pedigree; Polymorphism, Genetic; Repetitive Sequences, Nucleic Acid

Autoreactive T cells recognizing myelin basic protein (MBP), proteolipid protein (PLP) and MBP peptides have been described in multiple sclerosis (MS) and optic neuritis (ON), but their role in disease pathogenesis, if any, is unknown. A consistency of the T cell repertoire over the course of MS and ON should facilitate the development of specific immunotherapies. We have examined the T cell responses to autoantigens in two consecutive blood specimens taken from patients with ON and MS, and in two consecutive CSF specimens obtained from ON patients. As read-out numbers of T cells responding to antigen stimulation by the secretion of interferon-gamma were estimated. Pronounced differences in occurrence and numbers of T cells recognizing MBP, MBP peptides with the amino acid sequences 63-88, 110-128 and 148-165, and PLP were noticed in individual ON and MS patients over the course of disease. The MBP peptide among those three included, that was predominantly recognized by T cells in the individual patient, also varied over the course. The quantitative and qualitative changes of the myelin antigen-specific T cell response in MS and in ON, the latter to a certain extent reflecting the situation in early MS, do not favor the future useful development of specific immunotherapies in these diseases.

Topics: Adult; Autoantigens; Female; Humans; Interferon-gamma; Leukocytes, Mononuclear; Lymphocyte Count; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Optic Neuritis; T-Lymphocytes

Previous investigations of the major 18.5-kDa isoform of myelin basic protein (MBP) as a target autoantigen in multiple sclerosis (MS) have failed to identify an epitope uniformly recognized with higher frequency in MS patients compared with controls. Because remyelination has been observed in MS plaques, we were prompted to investigate T cells specific for myelin protein isoforms with up-regulated expression during remyelination. We have recently described such T cells that recognize the exon 2-encoded region of MBP (X2 MBP), a sequence included in the 21.5- and 20.2-kDa isoforms of MBP. These cells were shown to be CD4+, HLA class II restricted, and cytolytic. In members of one multiplex MS family, X2 MBP-specific T lymphocytes were as prevalent as T cells specific for immunodominant regions within the major 18.5-kDa isoform of MBP. The present study characterizes X2 MBP-specific T cell responses in additional multiplex MS family members as well as in heterogeneous (non-familial) MS patients and in healthy controls. The frequencies of X2 MBP-specific T cells in each of the affected family members from two of three MS families were significantly increased as compared with both the heterogeneous MS group and the healthy control group. Also, X2 MBP-specific T cell lines from affected family members were primarily restricted to molecules encoded by the DR2/DQw1 allele. Although TCR usage was generally heterogeneous, there was evidence of intraindividual sequence identity. These data suggest that: 1) Myelin proteins with up-regulated expression during the course of disease should be considered as candidate autoantigens in MS. 2) The functional basis for the association of DR2/DQw1 inheritance with MS susceptibility may be related to presentation of autoantigens by this allele. 3) TCR therapy will need to be individually tailored to target the most prevalent autoantigen-specific response.

Topics: Adult; Amino Acid Sequence; Autoantigens; Base Sequence; Female; HLA Antigens; Humans; Male; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell, alpha-beta; T-Lymphocytes

Myelin basic protein (MBP) is one of the main constituents of the CNS myelin sheaths, and an autoimmune response directed against MBP may be crucial in the demyelination process in patients with multiple sclerosis (MS). In this study sera and cerebrospinal fluid (CSF) from 25 MS patients, 25 patients with other neurological diseases and 16 healthy controls were examined for antibodies against MBP by using radio immunoblot, western blot, radio immunoassay and enzyme-linked immunosorbent assay. No evidence for the presence of antibodies to MBP was found in sera or CSFs in either the MS patients, or in the control groups tested.

Topics: Adult; Aged; Antibodies; Blotting, Western; Cerebrospinal Fluid; Enzyme-Linked Immunosorbent Assay; Female; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Radioimmunoassay

Characterization of T cells responding to autoantigens is central to understanding autoimmune disease. We have used somatic mutation at the hypoxanthine guanine phosphoribosyltransferase (HPRT) gene as an index of T-cell amplification in vivo. With this strategy we previously showed that myelin basic protein-reactive T cells can be isolated only from the HPRT mutant T-cell population cultured from the peripheral blood of multiple sclerosis patients and not from normal individuals. In this study, 165 HPRT mutant and 104 wild-type clones were examined for their reactivity to myelin basic protein and overlapping peptides of myelin basic protein. Five HPRT mutant clones that recognized myelin basic protein and myelin basic protein peptides along with three clones that responded to myelin basic protein peptide alone were isolated. All but one of the eight clones recognized peptides derived from the carboxy terminus of myelin basic protein (p84-168). Sequence analysis showed heterogeneous expression of T-cell receptor V alpha and V beta genes and CDR3s. These studies showed that in vivo amplified autoimmune T cells from patients with long-standing disease use diverse T-cell receptor elements in the recognition of C-terminal myelin basic protein peptides.

Topics: Adult; Amino Acid Sequence; Base Sequence; Clone Cells; Epitopes; Female; Humans; Hypoxanthine Phosphoribosyltransferase; Male; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Mutation; Myelin Basic Protein; Polymerase Chain Reaction; Receptors, Antigen, T-Cell

To verify whether multiallelic polymorphism adjacent to the gene encoding for myelin basic protein is associated with or linked to multiple sclerosis in Italians, we studied 54 sporadic patients, 55 control subjects and 18 families with two or more affected individuals. Allelic typing was carried out by analysis of fragment length polymorphisms after DNA amplification by the polymerase chain reaction. The presence of linkage with the disease was tested according to either autosomal dominant or autosomal recessive modes of inheritance, and with or without the introduction of liability classes accounting for the age of the individuals. Furthermore sib-pair analysis was performed in 11 siblings. No evidence for association or linkage between the myelin basic protein gene polymorphism and multiple sclerosis was found. Our data indicate that in the Italian population the myelin basic protein gene does not play a major role in conferring genetic susceptibility to multiple sclerosis, and suggest that the latter is a heterogeneous phenomenon, possibly influenced by the different ethnic origin of the populations which have been investigated.

Topics: Adult; Base Sequence; DNA; DNA Primers; Female; Genetic Linkage; Genetic Predisposition to Disease; Humans; Italy; Male; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Polymerase Chain Reaction; Polymorphism, Genetic; Polymorphism, Restriction Fragment Length

Human immunodeficiency virus type 1 (HIV-1)-infected individuals frequently develop a broad spectrum of neurological syndromes, classified as HIV-1-associated cognitive/motor complex. Diffuse demyelination of hemispheric white matter is a commonly observed in HIV-1 infected brain, but the events leading to myelin destruction are still obscure. Since oligodendrocyte infection by HIV-1 is not proven as yet, myelin damage in HIV-1 infection may result from indirect mechanisms such as the excessive release of myelinotoxic substances or the triggering of autoimmune responses directed to myelin constituents. To verify the latter hypothesis, we searched for elevated anti-myelin basic protein (MBP) IgG levels in the cerebrospinal fluid (CSF) and serum of 25 patients with HIV-1 infection, 12 with multiple sclerosis (MS), and 9 with non-inflammatory neurological diseases (NIND). CSF, but not serum, anti-MBP IgG levels were more frequently elevated in HIV-1+ (16/25, 64%) than in MS (3/12, 25%) or NIND (0/9) patients. By using the anti-MBP IgG index, the anti-MBP IgG antibody specificity index (ASI), and the search for anti-MBP oligoclonal IgG, we ascertained that anti-MBP IgG were produced within the CNS in 13 of 25 (52%) HIV-1+, in 6 of 12 (50%) MS, and in none of NIND patients. The incidence of increased CSF anti-MBP IgG levels was higher among HIV-1+ patients at stage II-III (4/4, 100%) or at stage IV B (7/9, 78%) than among those at stage IV C-IV D (5/12, 42%). Although our data indicate that intrathecal anti-MBP IgG may occur early during HIV-1 infection and that they are more common in patients with HIV-1-associated cognitive/motor complex, the possible demyelinating role of these antibodies remains to be demonstrated.

Topics: AIDS Dementia Complex; Autoantibodies; Blood-Brain Barrier; Diagnosis, Differential; Enzyme-Linked Immunosorbent Assay; HIV Seropositivity; HIV-1; Humans; Immunoglobulin G; Immunoglobulins; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; Nervous System Diseases; Neurologic Examination; Neuropsychological Tests; Oligoclonal Bands

Investigations of myelin disorders, in particular multiple sclerosis (MS), have concentrated on immunemediated damage to formed myelin, while there has been less emphasis on the molecular genetics of myelin formation. We have generated a transgenic mouse mutant (designated 2-50) which carries an insertional mutation in a locus regulating myelination. These mice carry a transgene comprising 1.3 Kb of the mouse myelin basic protein (MBP) promoter conjugated to a fragment containing exons 2 and 3 of the human c-myc gene. Positive mice show a significant reduction in myelin compared to controls and a shivering phenotype. Unlike other myelin mutants, all 2-50 mice lose the shivering phenotype and breed normally. Expression of c-myc is detectable in only 65% of transgene-carrying mice, and when present occurs at extremely low levels. This shows that the phenotype is caused by insertional inactivation of a gene necessary for myelination rather than ectopic expression of the transgene. The transgene was found by in situ hybridization to be inserted into a single site which is very distally located on chromosome 9. The 2-50 mice represent a unique model which will be ideal for investigating the molecular basis of myelin assembly and for developing gene therapy to promote remyelination in conditions such as MS.

Topics: Animals; Brain Chemistry; Chromosome Mapping; Disease Models, Animal; Genes, myc; Genes, Synthetic; Humans; In Situ Hybridization; Male; Mice; Mice, Inbred C57BL; Mice, Neurologic Mutants; Mice, Transgenic; Multiple Sclerosis; Mutagenesis, Insertional; Myelin Basic Protein; Myelin Sheath; RNA, Messenger; Spinal Cord

Although T cell responses to the quantitatively major myelin proteins, myelin basic protein (MBP) and proteolipid protein (PLP), are likely to be of importance in the course of multiple sclerosis (MS), cell-mediated autoimmune responses to other myelin antigens, in particular quantitatively minor myelin antigens, such as myelin-associated glycoprotein (MAG) and the central nervous system-specific myelin oligodendrocyte glycoprotein (MOG), could also play a prevalent role in disease initiation or progression. Highly purified myelin antigens were used in this study to assess cell-mediated immune response to MOG in MS patients, in the context of the reactivity to other myelin antigens, MBP, PLP, and MAG. The greatest incidence of proliferative response by MS peripheral blood lymphocytes was to MOG, as 12 of 24 patients tested reacted and, of these, 8 reacted to MOG exclusively. In contrast, only 1 control individual of 16 tested reacted positively to MOG. The incidence of responses to MBP, PLP, and MAG did not differ greatly between MS patients and control individuals. A predominant T cell reactivity to MOG in MS suggests an important role for cell-mediated immune response to this antigen in the pathogenesis of MS.

Topics: Adolescent; Adult; Animals; Antigens; Cattle; Electrophoresis, Polyacrylamide Gel; Female; Humans; Immunity, Cellular; Immunoblotting; Lymphocyte Activation; Lymphocytes; Male; Membrane Glycoproteins; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Oligodendroglia; Proteolipids

The human T cell response to the myelin basic protein (MBP) has been studied with respect to T cell receptor (TCR) usage, HLA class II restriction elements, and epitope specificity using a total of 215 long-term MBP-specific T cell lines (TCL) isolated from the peripheral blood of 13 patients with multiple sclerosis (MS) and 10 healthy donors. In most donors, the anti-MBP response was exceedingly heterogeneous. Using a panel of overlapping synthetic peptides spanning the entire length of human MBP, at least 26 epitopes recognized by human TCL could be distinguished. The MBP domain most commonly recognized was sequence 80-105 (31% of MS TCL, and 24% of control TCL). Sequence 29-48 was recognized more frequently by control-derived TCL (24%) than by TCL from MS patients (5%). The MBP epitopes were recognized in the context of DRB1 *0101, DRB5*0101, DRB1*1501, DRB1*0301, DRB1*0401, DRB1*1402, and DRB3*0102, as demonstrated using a panel of DR gene-transfected L cells. The TCR gene usage was also heterogeneous. V beta 5.2, a peptide of which is currently being used in a clinical trial for treatment of MS patients, was expressed by only one of our TCL. However, within this complex pattern of MBP-specific T cell responses, a minority of MS patients were found to exhibit a more restricted response with respect to their TCL epitope specificity. In these patients 75-87% of the TCL responded to a single, patient-specific cluster of immunodominant T cell epitopes located within a small (20-amino acid) domain of MBP. These nested clusters of immunodominant epitopes were noted within the amino acids 80-105, 108-131, and 131-153. The T cell response to the immunodominant epitopes was not monoclonal, but heterogeneous, with respect to fine specificity, TCR usage, and even HLA restriction. In one patient (H.K.), this restricted epitope profile remained stable for > 2 yr. The TCR beta chain sequences of TCL specific for the immunodominant region of HK are consistent with an oligoclonal response against the epitopes of this region (80-105). Further, two pairs of identical sequences were established from TCL generated from this patient at different times (June 1990 and June 1991), suggesting that some TCL specific for the immunodominant region persisted in the peripheral repertoire. The possible role of persistent immunodominant epitope clusters in the pathogenesis of MS remains to be established.

Topics: Adult; Amino Acid Sequence; Base Sequence; Brain Chemistry; DNA; DNA Primers; Epitopes; Female; HLA Antigens; HLA-D Antigens; Humans; Lymphocyte Activation; Male; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Polymerase Chain Reaction; Receptors, Antigen, T-Cell; Receptors, Antigen, T-Cell, alpha-beta; Reference Values; T-Lymphocytes; Thymidine

A transgenic mouse containing 70 copies (ND4) of the transgene encoding DM20, a myelin proteolipid protein, appeared clinically normal up to 3 months of age. By 8-10 months, it showed tremors, unsteady gait, and died shortly thereafter. We concluded that the clinical symptoms correlated with demyelination based on the following criteria: 1) at 10 months of age only 17% of the amount of myelin obtained from normal mice was isolated from the ND4 mice; 2) astrogliosis, a prominent feature of demyelinating disease was minimal at 3 months of age but prominent by 10 months; 3) at the electron microscopic level disrupted myelin was seen at 8 months of age in the ND4 mice and ingested myelin debris was found in astrocytes; 4) lymphocytic infiltration in association with endothelial cells was observed routinely in the ND4 mice; 5) sections through optic nerves showed denuded and thinly myelinated axons in the 8 month old ND4 mice. Although the mechanism by which demyelination takes place is not fully understood, measurements of the amounts of PLP suggest it is down-regulated by the large amount of DM20. Since DM20 is a major proteolipid in the young but a minor one in the adult, the persistence of high levels in the adult results in improperly assembled myelin which is prone to disruption. Therefore demyelination in the ND4 mouse appears to result from the persistence of immature myelin into the adult.

Topics: Animals; Astrocytes; Axons; Demyelinating Diseases; Disease Models, Animal; Glial Fibrillary Acidic Protein; Immunohistochemistry; Mice; Mice, Transgenic; Microscopy, Electron; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; Myelin Sheath; Nerve Tissue Proteins; Optic Nerve; Proteolipids

In this study myelin basic protein (MBP) was tested for its effect on chemotaxis of human peripheral blood leukocytes (PBL) and neutrophils from multiple sclerosis (MS) patients. MBP appeared to inhibit specifically the formyl-methionyl-leucyl-phenylalanine (FMLP)-induced chemotaxis of both the total leukocyte population and neutrophils. In comparison, no inhibition of chemotaxis was observed in healthy donors and patients with other neurological diseases. From MS patients we collected neutrophil supernatants obtained by incubation of the cells in a serum-free medium at 37 degrees C for 60 min and evaluated their effect on chemotaxis of neutrophils from healthy donors. Chemotaxis of healthy donor neutrophils was inhibited specifically in the presence of MBP after treatment with these supernatants, presumably relating to the presence of immune complexes on the surface of neutrophils from MS patients. Those complexes can be eluted into the incubation medium and coat healthy donor neutrophils, thus arming them specifically.

Topics: Adult; Cells, Cultured; Chemotaxis, Leukocyte; Culture Media, Conditioned; Female; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Neutrophils

Subacute sclerosing panencephalitis (SSPE) patients carry persistent measles virus infection in the brain. Furthermore, the blood lymphocytes contain viral RNA. Lymphocytes derived from 6 SSPE patients were stimulated with Epstein-Barr virus (EBV). Production of antibodies against measles virus of the IgG isotype was detected in the supernatants of cell cultures of all patients, regardless of the disease's activity, duration or interferon therapy. In contrast, only some of these cell cultures also produced antibodies against myelin.

Topics: Adolescent; Adult; Antibodies, Viral; Antibody Specificity; B-Lymphocytes; Cell Line, Transformed; Cells, Cultured; Child; Encephalitis; Female; Galactosylceramides; Herpesvirus 4, Human; Humans; Immunoglobulin G; Lymphocyte Activation; Male; Measles virus; Multiple Sclerosis; Myelin Basic Protein; Pregnancy; Pregnancy Complications, Infectious; Subacute Sclerosing Panencephalitis

Monosymptomatic unilateral optic neuritis (ON) is a common first manifestation of multiple sclerosis (MS) in which increased numbers of autoimmune T and B cells, recognizing different myelin autoantigens including myelin basic protein (MBP) and its peptides, have been implicated in a hypothetical immunopathogenesis. Using an immunospot assay to detect specific antibodies secreted by individual cells, we analyzed the B-cell repertoire to MBP and its amino acid residues 1-20, 63-88, 110-128, and 148-165 in blood and CSF from patients with ON and MS, and from controls. There were cells secreting IgG antibodies to MBP and the four peptides in blood at mean numbers of 0.9 to 4.6 per 10(5) mononuclear cells, without differences between the three patient groups. Mostly, more than 100-fold more B cells with these specificites per 10(5) cells were found in CSF from the patients with ON and MS, without differences between these two groups but with many fewer in CSF from controls. None of the four included MBP peptides represented an immunodominant B-cell epitope in either ON or MS, and the B-cell response was not more restricted in ON than in MS. The autonomy of the autoimmune B-cell response in CSF was further supported by the pronounced asynchrony of the repertoire to the four MBP peptides in CSF compared with blood in individual patients. The large numbers of MBP- and MBP peptide-reactive B cells in CSF in early MS, as manifested by ON, could play a major role in the immunopathogenesis and perpetuation of MS. Alternatively, they could represent myelin breakdown or restoration.

Topics: Adult; Antibodies, Anti-Idiotypic; B-Lymphocytes; Female; Humans; Immunoglobulin A; Immunoglobulin M; Magnetic Resonance Imaging; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Nervous System Diseases; Optic Neuritis

A panel of autoantigens (myosin, actin, myelin basic protein MBP, and thyroglobulin) was used to analyze antigen recognition by the peripheral blood leukocytes (PBL) of patients with active and stable multiple sclerosis (MS), patients with other neurological diseases (OND) and healthy individuals. The immune responsiveness was studied by examining the in vitro cell proliferation and the increase in the expression of two T-cell-surface activation markers (the interleukin-2 receptor IL-2R, and a late activation antigen recognized by the 19.2 monoclonal antibody). In MS, autoantigen recognition occurred more frequently than in the other groups and it was manifested by moderate proliferation or marked elevation of the expression of the IL-2R, whereas autoantigen recognition in the other groups concerned essentially the expression of the late activation antigen. Results similar to those described above were obtained with enriched T lymphocytes either in the presence or absence of IL-2. Our results suggest that the peripheral immune system in MS patients may recognize and can be activated by different autoantigens and not only by MBP, and that this response is quantitatively and qualitatively different from that of PBL from OND patients and healthy individuals.

Topics: Actins; Adult; Animals; Autoantigens; Autoimmune Diseases; Biomarkers; Cattle; Cells, Cultured; Female; Humans; Lymphocyte Activation; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myosins; Nervous System Diseases; Receptors, Interleukin-2; T-Lymphocytes; Thyroglobulin

Topics: Animals; Disease Susceptibility; Genes; Humans; Male; Mice; Multiple Sclerosis; Myelin Basic Protein; Optic Neuritis; Pedigree

The major isoform of myelin basic protein (MBP) in the healthy adult central nervous system is the 18.5-kDa protein which is produced by mRNA derived from exons 1, 3, 4, 5, 6 and 7 of the MBP gene. Since isoforms containing exon 2-encoded protein (X2MBP) are expressed during myelin formation, we examined T cell reactivity specific for X2MBP in a disease characterized by remyelination subsequent to demyelination, multiple sclerosis (MS). T cell lines specific for X2MBP were derived from three MS patients as well as one healthy control. This suggests that candidate autoantigens in demyelinating/remyelinating diseases should include not only the major isoforms of myelin proteins, but also isoforms expressed aberrantly during a disease process since they too may be the target of a T cell-mediated autoimmune process.

Topics: Adult; Amino Acid Sequence; Cytotoxicity, Immunologic; Epitopes; Exons; Female; Humans; Male; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath; T-Lymphocytes

This study has examined the cellular response to myelin basic protein (MBP) in a multiplex family with multiple sclerosis (MS). A total of 81 MBP-specific T cell lines (TCLs) were derived from three affected siblings and four healthy siblings. No difference was observed in estimated precursor frequencies of MBP-specific TCLs or peptide specificity of TCLs when comparing affected and unaffected siblings. MBP-specific TCLs from affected siblings, however, were restricted to the DRw15/DQw6 allele more frequently than those from unaffected siblings (P < 0.02). These data suggest that restriction of autoantigen-specific T cells may be the functional basis for disease susceptibility related to HLA class II inheritance.

Topics: Adult; Disease Susceptibility; Female; Histocompatibility Antigens Class II; HLA-DQ Antigens; HLA-DR Antigens; Humans; Immunity, Cellular; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes

Multiple sclerosis (MS) is an autoimmune disease in which myelin proteins have been implicated as autoantigens recognized by pathogenic autoreactive T cells. To study the relationship between human myelin basic protein (hMBP) and HLA alleles associated to MS susceptibility, such as DRB1*1501, the binding of synthetic peptides spanning the entire hMBP sequence to 10 purified HLA-DR molecules was determined. All the hMBP peptides tested showed binding affinity for at least one of the DR molecules analyzed, but three hMBP peptides, included in sequences 13-32, 84-103, and 144-163 were found capable of binding to three or more DR molecules. The hMBP peptide 84-103 was the most degenerate in binding, in that it bound to 9 out of 10 DR molecules tested. Interestingly, it bound with highest affinity to DRB1*1501 molecules. To correlate the binding pattern of hMBP peptides to HLA class II molecules with their recognition by T cells, 61 hMBP-specific T cell lines (TCL) were established from the peripheral blood of 20 MS patients, who were homozygous, heterozygous, or negative for DRB1*1501. Analysis of hMBP epitopes recognized by these TCL and their HLA restriction demonstrated a very good correlation between binding data and T cell proliferation to hMBP peptides. Although virtually all hMBP peptides tested could be recognized by at least one TCL from MS patients, three immunodominant T cell epitopes were apparent among the TCL examined, corresponding exactly to the hMBP peptides capable of binding to several DR molecules. No major difference could be detected in the recognition of immunodominant hMBP peptides by TCL from DRB1*1501 positive or negative MS patients. These results have implications for the role of hMBP as relevant autoantigen, and of DRB1*1501 as susceptibility allele in MS.

Topics: Adult; Aged; Alleles; Amino Acid Sequence; Cell Line; Female; Histocompatibility Antigens Class II; HLA-DQ Antigens; HLA-DR Antigens; Humans; Immunodominant Epitopes; Male; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; T-Lymphocytes

In addition to myelin basic protein (MBP), other minor components of myelin, such as myelin-associated glycoprotein (MAG), may be important autoantigens in MS. To determine whether MAG might be involved in an autoimmune reaction in MS, we screened peripheral blood lymphocytes from MS patients and normal subjects for their sensitization to human MBP and MAG antigen using a [3H]thymidine incorporation assay. We recorded three patterns in MS patients: (1) patients who responded neither to MAG nor to MBP (4/11); (2) patients who responded to both MBP and MAG (5/11); and (3) patients who gave an exclusive response to MAG (2/11). The 10 healthy controls did not respond to either MAG or MBP. That some individuals with MS expressed a specific response against MAG and that more than 50% of MS patients expressed a sensitization to MAG suggest that MAG may have a role in the pathogenesis of MS.

Topics: Adult; Female; HLA-D Antigens; Humans; Lymphocyte Activation; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Phenotype; T-Lymphocytes

We constructed a transgenic mouse model that mimics the human autoimmune disease multiple sclerosis in its spontaneous induction and pathology. Transgenic mice were constructed expressing genes encoding a rearranged T cell receptor specific for myelin basic protein (MBP). T cell tolerance was not induced in the periphery, and functional, autoreactive T cells were found in the spleen and lymph nodes of these mice. Transgenic mice developed experimental allergic encephalomyelitis (EAE) following immunization with MBP and adjuvant plus pertussis toxin as well as with administration of pertussis toxin alone. Spontaneous EAE can develop in transgenic mice housed in a non-sterile facility but not in those maintained in a sterile, specific pathogen-free facility. This model system affords a unique opportunity to dissect the genetic and environmental variables that may contribute to the development of spontaneous autoimmune disease.

Topics: Animals; Autoimmunity; Base Sequence; Encephalomyelitis, Autoimmune, Experimental; Immune Tolerance; Lymphocyte Activation; Mice; Mice, Transgenic; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Oligodeoxyribonucleotides; Polymerase Chain Reaction; Receptors, Antigen, T-Cell, alpha-beta

The cause of multiple sclerosis (MS) is unknown. Recently reported abnormal T-cell responses to several myelin proteins and myelin basic protein (MBP) peptides in peripheral blood constitute one line of evidence that autoimmune mechanisms could be involved in the pathogenesis of the disease. Monosymptomatic unilateral optic neuritis (ON) is a common first manifestation of MS and important to examine for a possible restriction of the T-cell repertoire early in the disease. T-cell activities to MBP and the MBP amino acid sequences 63-88, 110-128 and 148-165 were examined by short-term cultures of mononuclear cells from cerebrospinal fluid (CSF) and blood in the presence of these antigens, and subsequent detection and counting of antigen-specific T cells that responded by interferon-gamma (IFN-gamma) secretion. Most patients with MS and ON had MBP and MBP peptide-reactive T cells in CSF, amounting to mean values of between about 1 per 2000 and 1 per 7000 CSF cells and without immunodominance for any of the peptides. Numbers were 10-fold to 100-fold lower in the patients' blood. Values were similar in ON and MS, and no evidence was obtained for a more restricted T-cell repertoire in ON. The MBP peptide-recognizing T-cell repertoire was different in CSF than in blood in individual patients with ON and MS, thereby giving further evidence for an autonomy of the autoimmune T-cell response in the CSF compartment. No relations were observed between numbers of autoreactive T cells and presence of oligoclonal IgG bands in CSF or abnormalities on magnetic resonance imaging of the brain in ON or clinical variables of MS. The high numbers of MBP and MBP peptide-reactive T cells could play a role in the pathogenesis of ON via secretion of effector molecules, one of them being IFN-gamma, as well as in the transfer of ON to MS.

Topics: Adult; Cerebrospinal Fluid; Cross Reactions; Epitopes; Female; Humans; Interferon-gamma; Lymphocyte Activation; Magnetic Resonance Imaging; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Optic Neuritis; Peptides; T-Lymphocytes

Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system in which a restricted cellular immune response has been observed. In order to establish whether such T cell responses are likely to be antigen-specific particularly with regard to myelin basic protein (MBP), we analysed T-cell receptor (TCR) gene rearrangements directly from MS brain plaques, using the polymerase chain reaction on reverse transcribed messenger RNA, and compared these with TCR of previously described MBP-specific T cell clones from MS and the rat model experimental allergic encephalomyelitis. Rearranged V beta 5.2 genes were detected in the brains of all patients who were HLA DRB1*1501, DQA1*0102, DQB1*0602, DPB1*0401. The V beta 5.2-D beta-J beta sequences in these MS brain plaques revealed five motifs. One of the common motifs was identical to that described for the VDJ region of a V beta 5.2 T-cell clone. This clone was from an MS patient who was HLA DRB1*1501, DQB1*0602, DPB1*0401, and it was cytotoxic towards targets containing the MBP peptide 89-106 (ref. 1). The deduced amino-acid sequence of this VDJ rearrangement, Leu-Arg-Gly, has also been described in rat T cells cloned from experimental allergic encephalomyelitis lesions, which are specific for MBP peptide 87-99 (ref. 2). VDJ sequences with specificity for this MBP epitope constitute a large fraction (40%) of the TCR V beta 5.2 N(D)N rearrangements in MS lesions. The capacity of rat T cells with these VDJ sequences to cause experimental allergic encephalomyelitis and the prevalence of such sequences in demyelinated human lesions indicate that T cells with this rearranged TCR may be critical in MS.

Topics: Amino Acid Sequence; Animals; Base Sequence; Brain; CD3 Complex; Cloning, Molecular; Encephalomyelitis, Autoimmune, Experimental; Gene Rearrangement, beta-Chain T-Cell Antigen Receptor; HLA-D Antigens; Humans; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Oligodeoxyribonucleotides; Phenotype; Polymerase Chain Reaction; Rats; RNA, Messenger; Spinal Cord; T-Lymphocytes

Immune complexes from sera of MS patients, other neurological diseases, and healthy donors were precipitated using polyethyleneglycol and analyzed by sodium dodecylsulfate-polyacrylamide gel electrophoresis. Silver staining evidenced additional protein bands whose molecular weights were 14-16, 38, and 43 kDa. These IC proteins were present in most MS patients studied. To identify their nature, immunoblotting was performed with antihuman immunoglobulins A, M, G antibodies. No immunoreactivity was found below a molecular weight of 66 kDa on a nitrocellulose sheet having the transferred protein pattern of MS IC. Using purified human myelin, MS IC transferred to an immobilon sheet and antihuman myelin basic protein antibodies, an immunoreactivity was seen only on purified human MBP. The small proteins of 14-16 kDa and the others of 38, 43 kDa were not immunoreactive. Identification of the nature of these additional proteins in MS IC is in progress.

Topics: Antigen-Antibody Complex; Epitopes; Humans; Molecular Weight; Multiple Sclerosis; Myelin Basic Protein; Nervous System Diseases

Free and bound hydrosoluble protein extracts were prepared from four anatomical areas of a multiple sclerosis (MS) cerebrum and from corresponding anatomical areas of a normal (non-MS) control. Increased levels of IgG and anti-myelin basic protein antibodies (anti-MBP) were detected in all MS samples and they were undetectable in the controls. IgG and anti-MBP from free (unbound) hydrosoluble protein extracts are defined as free IgG and free anti-MBP while IgG and anti-MBP from tissue bound protein extracts are defined as bound IgG and bound anti-MBP. IgG was purified from free protein extracts by protein G Sepharose affinity chromatography and anti-MBP was further isolated from purified IgG by antigen specific (MBP) Sepharose affinity chromatography. Free and bound anti-MBP were reacted with 20 synthetic peptides of human MBP prepared by the Fmoc method. Free anti-MBP, whether in the context of whole protein extracts, or as purified IgG or as purified antibody was completely neutralized by peptides #12, #15, #56 and #56* containing overall residues 75-106, partially neutralized by peptides #27, #16 and #21 containing overall residues 61-83 and did not react with the remaining 13 peptides. Tissue bound anti-MBP was completely neutralized only by peptides #12, #15, #56 and #56* (overall residues 75-106) and showed no reactivity towards the remaining 16 peptides including peptides #27, #16 and #21. Synthetic peptide specificity of free anti-MBP purified from MS cerebrum was identical to previously reported specificity of free anti-MBP from MS cerebrospinal fluid (CSF), while tissue bound anti-MBP, as well as bound anti-MBP from CSF had a more restricted synthetic peptide specificity than free anti-MBP. This suggests that the most likely epitope of anti-MBP is located between residues 84 and 95 of human MBP just proximal to the tri-proline sequence (99-101).

Topics: Adult; Antibody Specificity; Autoantibodies; Brain; Chromatography, Affinity; Humans; Immunoglobulin G; Male; Multiple Sclerosis; Myelin Basic Protein; Neutralization Tests; Peptide Fragments; Radioimmunoassay

Costimulatory signals regulate T cell responses to myelin basic protein (MBP) during induction of EAE in Lewis rats. However, the physiology of these costimulatory pathways has yet to be resolved. In this study, costimulatory pathways were defined by comparing MBP-stimulated IL-2 production by two types of T cell hybridoma (designated THYB-1 and THYB-2). THYB-1 hybrids required presentation of MBP/Ia complexes to stimulate IL-2 production, whereas THYB-2 hybrids also required the additional presence of costimulatory signals from radiosensitive (RS), nonadherent (NAdh) splenocytes (SPL). This study shows that allogeneic SPL, syngeneic B cells, or syngeneic T cells provided costimulatory signals to THYB-2 hybrids, although only syngeneic B cells were able to provide APC activity. Transduction of costimulatory signals did not occur across a microporous membrane but rather required close proximity of T cell hybrids with RS accessory cells. Simultaneous presence of costimulatory signals together with MHC-restricted antigen were required to initiate and maintain IL-2 production by THYB-2 hybrids. These findings support a model in which costimulatory molecules expressed by effector cells serve to restrict lymphokine production by T-helper cells. That is, THYB-2-like T-helper cells may mediate a paracrine pathway of IL-2 production that provides "help" to antigen-activated effector cell types that coexpress IL-2 receptors with appropriate costimulatory molecules.

Topics: Animals; Cell Communication; Guinea Pigs; Hybrid Cells; Hybridomas; Interleukin-2; Mice; Mice, Inbred BALB C; Multiple Sclerosis; Myelin Basic Protein; Rats; Rats, Inbred F344; Rats, Inbred Lew; Rats, Inbred WF; Rats, Sprague-Dawley; Signal Transduction; T-Lymphocytes, Helper-Inducer

Previous research has demonstrated that free (F) and bound (B) anti-myelin basic protein (anti-MBP) can be detected in the cerebrospinal fluid (CSF) of patients with active multiple sclerosis (MS). The purpose of this report was to determine whether the immunoglobulin G (IgG) isolated from central nervous system (CNS) tissue of MS patients contains anti-MBP. IgG was detected in free and bound hydrosoluble protein extracts obtained from the brain, spinal cord and optic nerves of a patient with clinically definite and neuropathologically confirmed MS. IgG was purified from free protein extracts from brain and spinal cord by Protein G-Sepharose affinity chromatography. Anti-MBP was detected by a solid phase radioimmunoassay (RIA) in all free and bound protein extracts. Anti-MBP was isolated from purified IgG from brain and spinal cord by MBP-Sepharose affinity chromatography. Free anti-MBP in the context of whole protein extracts, within purified IgG or as purified antibody as well as tissue-bound anti-MBP in the context of whole protein extracts was completely neutralized by human MBP (h-MBP) and synthetic peptide No. 56 (residues 75-95 of h-MBP) and did not react with synthetic peptide No. 41 (residues 35-58 of h-MBP). Anti-MBP which has previously been detected in the CSF of MS patients with active disease is also present as free antibody in the extracellular space of MS-central nervous system tissue and in a smaller proportion as tissue-bound antibody.

Topics: Adult; Autoantibodies; Brain; Central Nervous System; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Neutralization Tests; Optic Nerve; Reference Values; Spinal Cord

The myelin basic protein (MBP) gene is a candidate locus for disease susceptibility in familial multiple sclerosis. Amplification of a polymorphic tetranucleotide repeat region immediately 5' to MBP exon 1 demonstrated the presence of eight different alleles among members of 14 multiplex multiple sclerosis families (36 affected individuals). Linkage analysis was performed with autosomal dominant and autosomal recessive models, normal individuals with abnormal magnetic resonance scans being scored as either unknown or affected. Cumulative LOD scores were negative for both models of inheritance. The results do not demonstrate linkage between the MBP gene region and multiple sclerosis.

Topics: Alleles; Base Sequence; Chromosome Mapping; Disease Susceptibility; DNA; Gene Frequency; Genes, Dominant; Genes, Recessive; Genetic Linkage; Humans; Incidence; Lod Score; Magnetic Resonance Imaging; Models, Genetic; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Polymerase Chain Reaction; Polymorphism, Genetic; Prevalence; Risk Factors

Although T cells play a pathogenetic role in MS, specific disease-inducing T cells have not been identified. T cells can be labeled and traced in adoptively transferred experimental autoimmune encephalomyelitis (EAE), a T-cell-mediated animal model for MS. We have followed the appearance and topographic localization of radio-labeled myelin basic protein-reactive (MBP+) T cells in evolving lesions as EAE extended to other regions of the CNS. By high-resolution autoradiography, we confirmed that MBP+ cells initially homed to perivascular regions in the lower spinal cord. With increasing time after cell transfer, labeled cells appeared in more recent lesions in rostral locations (upper spinal cord, cerebellum, and forebrain) and constituted a progressively smaller percentage of cells in lower spinal cord lesions. The presence of unlabeled inflammatory cells in the CNS parenchyma coincided temporally with clinical signs. In agreement with previous studies, we have shown that MBP+ cells constituted a minority (mean, < 1.5%) of the total infiltrating cells and were most numerous in fresh lesions. We suggest that the perivascular regions of recent lesions would be the most likely areas to detect putative antigen-specific cells in MS lesions.

Topics: Animals; Autoradiography; Brain; Carbon Radioisotopes; Encephalomyelitis, Autoimmune, Experimental; Female; Humans; Immunotherapy, Adoptive; Inflammation; Mice; Mice, Inbred Strains; Multiple Sclerosis; Myelin Basic Protein; Spinal Cord; T-Lymphocytes; Thymidine; Time Factors

Predictors and laboratory correlates of the response of patients with multiple sclerosis to glucocorticoids are not well defined. Our study was undertaken to determine if the levels of myelin basic protein (MBP)-like material in cerebrospinal fluid (CSF) might indicate which patients with multiple sclerosis would show a short-term (5 day) or intermediate-term (40 day) improvement of at least a full-grade Kurtzke disability score after initiating treatment with glucocorticoids. A total of 62 patients received 71 courses of treatment consisting of 5 days of intravenous methylprednisolone (500 mg per day) usually followed by a 4-week tapering dose of oral prednisone. CSF was obtained before initiation of treatment and analyzed for MBP-like material by radioimmunoassay. Results were analyzed by chi 2 tests of association and by logistic regression. Individuals having a CSF MBP-like material level of > or = 0.1 ng/ml overall showed a greater likelihood of continued improvement at day 40 (p = 0.014) or further improvement between days 5 and 40 (p = 0.003). Those in the first 15 days of worsening and with an elevated CSF MBP-like level were more likely to respond by day 5. Relapsing-remitting and relapsing-progressive forms of the disease were more likely to respond at both time points than were patients with primary or secondary chronic progressive patterns. The Kurtzke disability score at entry and the major anatomical site of the central nervous system symptomatically affected were not predictive of outcome at either time.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Aged; Disability Evaluation; Drug Therapy, Combination; Female; Humans; Male; Methylprednisolone; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Predictive Value of Tests; Prednisone; Regression Analysis; Treatment Outcome

Recent evidence supports the possible involvement of myelin basic protein (BP) as one of the target autoantigens in multiple sclerosis (MS), including elevated frequencies of MS blood and cerebrospinal fluid (CSF) T cells, and the presence in MS plaque tissue of V beta gene sequences and CDR3 motifs characteristic of BP-reactive T cells. Because of its proximity to the target organ, the CSF has long been thought to harbor T cells involved in the pathogenic process. In order to evaluate their frequency and response characteristics, BP-reactive T cells were isolated by limiting dilution from the CSF of patients with MS and other neurological diseases (OND) for quantitation and determination of epitope specificity and V alpha and V beta gene expression. In addition to isolates responsive to intact BP epitopes that were present at a significantly higher frequency in MS versus OND CSF, we here describe a second clonotype responsive to 'cryptic' BP epitopes that is present at approximately equal frequencies in MS and OND patients. In spite of their difference in recognition of intact versus 'cryptic' BP determinants, both clonotypes predominantly recognized epitopes in the N terminal half of human BP, using a similar V gene repertoire that included biased use of V alpha 2 and to a lesser degree V beta 7 and V beta 18. These V gene biases were not related to the epitope specificity of the T cells, indicating that V gene selection is not epitope-driven. These data suggest that there is differential recognition of intact versus 'cryptic' BP determinants in MS versus OND patients that may be related to the processing and presentation of BP to the immune system.

Topics: Adult; Cerebrospinal Fluid; Epitopes; Female; Gene Expression; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Nervous System Diseases; Receptors, Antigen, T-Cell, alpha-beta; T-Lymphocytes

T lymphocytes from patients with multiple sclerosis (MS) recognize multiple myelin basic protein (MBP) epitopes. This situation complicates the design of specific immunotherapies. We investigated to which extent the T cell response to MBP is heterogeneous in single subjects in terms of preferentially recognized regions of the molecule, major histocompatibility complex (MHC) restriction, and stability over time. From each of nine patients with MS, a minimum of six MBP-specific T lymphocyte lines (TLL) were assayed for the proliferative response to a panel of overlapping peptides, encompassing the whole MBP. Predominant T cell recognitions of distinct MBP regions were present in three patients, all HLA-DR2+, independently of the clinical features of their disease. T cell reactivity was preferentially directed to residues 16-38 in one patient. In this case the response was also stable over time, during different phases of the disease. Predominant reactivity to residues 86-99 was detected in the two other DR2+ patients. In each of the patients with other HLA-DR haplotypes (DR2-), as well as in three DR2+ non-MS donors, the T cell response to MBP appeared to be considerably more heterogeneous. The HLA restriction element varied among TLL recognizing the same MBP region, even when raised from the same individual. The genomic HLA typing, performed on the DRB1 and DRB5 genes in the DR2+ subjects, showed no obvious correspondence between preferential responses to regions of MBP and HLA-DR2 subtypes. In this context, a simple, new method for the genomic typing of the HLA-DRB1 gene in individuals with the HLA-DR2 serological specificity is also described. We conclude that predominant and stable T cell responses to a single MBP region can be detected in some patients with MS. In these individuals, the MHC restriction of the T cell recognition of predominant regions appears to be variable. Polymorphisms of the HLA-DR2 gene products alone do not account for the selection of the dominant MBP T cell epitope.

Topics: Adolescent; Adult; Autoantigens; Base Sequence; Female; Genes, MHC Class II; HLA-DR Antigens; Humans; Lymphocyte Activation; Male; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Oligodeoxyribonucleotides; T-Lymphocytes

A highly efficient new method for the generation of antigen specific T cell lines (TCL) is now available. By this method we established 134 myelin basic protein (MBP) TCL from the peripheral blood of 9 patients with definite multiple sclerosis (n = 69) and 8 healthy donors (n = 65). The yield of MBP reactive TCL in the two groups was comparable. So far 22 MBP specific TCL from 7 patients and 24 from 7 healthy individuals have been tested for their proliferative response to a panel of four synthetic peptides representing MBP residues 7-26, 80-99, 139-153 and 148-162. Although the peptide sequences did not encompass the whole MBP, the pattern of reactivity to these peptides in patients and controls seems to be similar. Further, when multiple TCL from the same donor were analysed, no dominant recognition emerged.

Topics: Adult; Epitopes; Female; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes

Topics: DNA, Satellite; Humans; Multiple Sclerosis; Myelin Basic Protein; Polymorphism, Genetic; Repetitive Sequences, Nucleic Acid

Myelin basic protein (MBP)-specific T-cell lines from patients with multiple sclerosis (MS) and healthy controls were analyzed for the expression of CD45 isoforms and adhesion molecules. In the multiple sclerosis group, 22 of 24 MBP-specific T-cell lines were CD4+. Two distinct patterns were observed with regard to CD45 isoform expression. Pattern I showed dual expression of CD45 isoforms (CD4+CD45RA+CD45RO+CD29+) and Pattern II included cells with a single CD45 isoform (CD4+CD45RA-CD45RO+CD29+). All 10 cell lines from healthy controls were CD4+ and displayed Pattern II (CD4+CD45RA-CD45RO+CD29+). The dual expression of CD45 isoform in T-cell lines from MS was stable, did not represent a transition stage from CD45RA to CD45RO, and was cell-cycle independent. All cell lines from MS and controls expressed increased levels of LFA-1 (CD11a), LFA-2 (CD2), LFA-3 (CD58), ICAM-1 (CD54), and VLA-4 (CDw49d). These data show the presence of unique MBP-specific T cells (CD4+CD45RA+CD45RO+CD29+) that might play a role in the pathogenesis of MS.

Topics: Adolescent; Adult; Antigens, CD; Autoantigens; CD4 Antigens; CD4-Positive T-Lymphocytes; Cell Adhesion Molecules; Cell Cycle; Cell Line; Cells, Cultured; Female; Humans; Integrin beta1; Leukocyte Common Antigens; Lymphocyte Activation; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein

Although the cause of multiple sclerosis (MS) is unknown, it is thought to involve a T cell-mediated autoimmune mechanism. Susceptibility to the disease is influenced by genetic factors such as genes of the HLA and T-cell receptor (TCR) complex. Other evidence for a genetic influence includes the low incidence in certain ethnic groups, the increased risk if there are affected family members and the increased concordance rate for disease in monozygotic twin pairs (26%), compared to dizygotic twins. Epidemiological studies indicate that there may be an additional role for environmental factors. Although the target antigen(s) are not yet identified, several myelin or myelin-associated proteins have been suspected, among them myelin basic protein. A lack of genetically comparable controls has impaired the analysis of the T-cell response in MS patients and caused disagreement on TCR usage in the disease. Here we analyse the role of TCR genes in MS by comparing TCR usage in discordant versus concordant monozygotic twins in response to self and foreign antigens. We find that after stimulation with myelin basic protein or tetanus toxoid, control twin sets as well as concordant twin sets select similar V alpha chains. Only the discordant twin sets select different TCRs after stimulation with antigens. Thus exogenous factors or the disease shape the TCR repertoire in MS patients, as seen by comparison with unaffected genetically identical individuals. This skewing of the TCR repertoire could contribute to the pathogenesis of MS and other T-cell-mediated diseases.

Topics: Adult; Autoantigens; Base Sequence; Cells, Cultured; Cloning, Molecular; Diseases in Twins; DNA, Single-Stranded; Humans; Lymphocyte Activation; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Polymerase Chain Reaction; Receptors, Antigen, T-Cell; Receptors, Antigen, T-Cell, alpha-beta; Tetanus Toxoid; Twins, Monozygotic

Populations of phagocytic cells in multiple sclerosis (MS) plaques were examined by quantitative immunocytochemical analysis of macrophage markers and myelin degradation products in serial cryostat sections from 10 cases of MS. Around lesions with ongoing demyelination expression of the Class II antigen HLA-DQ appeared to be a marker of microglial activation. Alpha 1-antichymotrypsin+ monocytes and myelin-laden macrophages expressing the later differentiation markers Ber-MAC3 and RFD7 were predominantly perivascular in location. On the basis of the distribution of oil red O (ORO)+ phagocytes and myelin loss, plaques were divided into groups representing different stages in lesion development. In early lesions (group 1), there was no apparent myelin loss around ORO+ macrophages although these cells contained material stained with antibodies against myelin basic protein (MBP) epitopes and neoepitopes. However, patchy myelin loss was detectable around the phagocytic macrophages uniformly distributed throughout group 2 plaques. ORO+ macrophages containing MBP peptides were confined to the hypercellular border of group 4 lesions, in which the demyelinating process may be recurrent.

Topics: Adult; Biomarkers; Demyelinating Diseases; HLA-DQ Antigens; Humans; Immunohistochemistry; Macrophages; Middle Aged; Monocytes; Multiple Sclerosis; Myelin Basic Protein; Phagocytosis

Interleukin 4 (IL-4)- and interferon gamma (IFN gamma)-secreting peripheral blood cells were enumerated by immunospot assay in 13 multiple sclerosis (MS) patients during exacerbations, in 24 patients with progressive multiple sclerosis (CPMS), and in 20 controls. Cells that spontaneously secreted IFN gamma were significantly higher in MS patients experiencing an attack (P < 0.001) than in controls or in CPMS (P < 0.04). IL-4-secreting cell numbers were elevated significantly and to a comparable extent in both MS groups compared to controls. Our finding of increased numbers of IFN gamma-secreting cells is in keeping with prior work showing increased IFN gamma levels in the circulation prior to and during MS attacks and increased release of IFN gamma to the supernatant in bulk cultured blood cells from MS patients. What role an increase in IL-4-secreting cells might play in MS is unclear, but it could relate to immune system regulation. Following in vitro exposure to MBP, IFN gamma-secreting cell number rose above levels observed in the absence of stimulation in controls and in both MS groups with the rise in acutely exacerbating MS patients being significantly greater than in controls. Our results provide further evidence for reactivity to MBP in MS, the significance of which in terms of pathogenesis remains clouded.

Topics: Acute Disease; Adult; Female; Humans; Interferon-gamma; Interleukin-4; Leukocytes, Mononuclear; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein

Although the major isoform of myelin basic protein (MBP) in the healthy adult CNS is the 18.5-kDa protein, other isoforms containing exon 2 encoded protein (21.5 kDa and 20.2 kDa) exist and are expressed primarily during myelin formation. Since remyelination is a prominent feature in MS lesions, we examined the frequencies of T cell lines (TCLs) specific for epitopes within exon 2 encoded MBP (X2MBP), and also within 18.5-kDa MBP, in members of a multiplex family with MS. TCLs specific for X2MBP were as prevalent as TCLs specific for immunodominant epitopes within 18.5-kDa MBP. In addition, while frequencies of TCLs specific for 18.5-kDa MBP were no different between the affected and unaffected, the frequency of X2MBP-specific TCLs correlated with disease.

Topics: Aged; Alternative Splicing; Amino Acid Sequence; Autoantigens; Brain; Cell Line; Epitopes; Exons; Female; Genes; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Pedigree; T-Lymphocytes; T-Lymphocytes, Cytotoxic

As has been indicated in experimental autoimmune encephalomyelitis (EAE), the application of synthetic peptides for the selection of T cell lines may provide new insights into the pathogenesis of multiple sclerosis (MS). We report here on T cell lines/clones generated from peripheral blood of MS patients against an immunodominant myelin basic protein (MBP) peptide 82-102. This study demonstrates that the selection of T cell lines against the MBP peptide is much more efficient than against whole MBP in generating a large panel of T cell lines/clones, and therefore provides a powerful strategy for studying autoimmune T cell repertoire in individual subjects. The peptide-selected lines and clones recognized MBP 82-102, shorter peptides MBP 89-101, 89-100 and guinea pig whole MBP mainly in the context of HLA-DR, but did not cross-recognize virus-derived peptides homologous to MBP 82-102. Seven out of ten clones were found to recognize MBP 82-102 in the absence of autologous antigen presenting cells (APC), and in three of the seven clones, specificity for MBP 82-102 could be demonstrated only in the absence of APC because of their strong reactivity against autologous APC. Two-color flow cytometry revealed that the clones were heterogeneous with regard to expression of CD4 and CD8 molecules. Overall, the clones selected by the peptide were rather heterogeneous in phenotype and function compared with those selected by whole MBP.

Topics: Adult; Amino Acid Sequence; Animals; Antigen-Presenting Cells; Antigens, Viral; Cell Line; Clone Cells; Cross Reactions; Enterovirus; Female; HLA-D Antigens; Humans; Japan; Lymphocyte Activation; Male; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptides; Swine; Swine Vesicular Disease; T-Lymphocytes

Indirect evidence suggests that an autoimmune response to myelin basic protein (MBP) may be involved in the pathogenesis of multiple sclerosis (MS). In MS, several reports have suggested that restricted T-cell populations respond to MPB, as in inbred rodents with the MS disease model experimental allergic encephalomyelitis. In experimental allergic encephalomyelitis, the T-cell repertoire to MBP varies between strains, and in MS it is likely that the response to MBP is also best defined under conditions where genetic differences between subjects are controlled. In this report, the fine specificity of the T-cell response to MBP was assessed in three families, each with multiple individuals affected with MS. We found that (1) comparable frequencies of MBP-reactive T-cell lines were obtained from peripheral blood of MS patients and their healthy siblings. Human leukocyte antigen (HLA) identical sibling pairs discordant for MS had similar frequencies of MBP-reactive T-cell lines. (2) A broad spectrum of MBP epitopes was recognized by T-cell lines from all individuals studied. Within a family, the fine specificity of MBP recognition showed little or no overlap between individuals, even between HLA identical siblings. (3) Recognition of MBP epitopes occurred in the context of different HLA class II alleles. At least four DR alleles each served as restricting elements for recognition of P82-101 or the carboxy terminal region of MBP, two regions thought to be important in the human T-cell response to the molecule. No relationship between the use of a particular DR allele and a response to a particular region of MBP could be established.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Alleles; Cell Line; Cells, Cultured; Female; Haplotypes; HLA-D Antigens; Humans; Major Histocompatibility Complex; Male; Multiple Sclerosis; Myelin Basic Protein; Pedigree; Receptors, Antigen, T-Cell; T-Lymphocytes

Multiple sclerosis, a demyelinating disease of the human central nervous system occurs in genetically susceptible individuals through a presumably autoimmune mechanism directed against the myelin sheath. The influence of the major histocompatibility locus on T cell recognition of myelin basic protein (MBP), a suspected target autoantigen, was investigated by analyzing MBP-specific T cell clones generated from the peripheral blood of healthy individuals. Inhibition studies using monoclonal antibodies demonstrated that MBP recognition was restricted by HLA-DR antigens. MBP recognition of the majority of T cell clones from each individual was restricted predominantly by one of the DR alleles. Thus, there appears to be a bias in the use of allelic DR restricting elements for MBP responses.

Topics: Adult; Alleles; Autoantigens; CD4-Positive T-Lymphocytes; Cell Line; Clone Cells; Female; HLA-DR Antigens; Humans; Immunodominant Epitopes; Interferon-gamma; Male; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocyte Subsets

Topics: Female; Humans; Longitudinal Studies; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes

Myelin basic protein (MBP) was measured in the serum and CSF of patients with acute cerebrovascular disease (CVD, 34 cases), demyelinating disorders (DMD, 30 cases) and other neurological diseases (OND, 26 cases) by using a double antibody radioimmunoassay (RIA). Patients with acute CVD had a mean serum MBP concentration and positivity rate much higher than those with DMD and OND. The differences were significant (P < 0.05). In CSF, MBP levels in patients with acute CVD and patients with DMD were significantly greater than those in OND patients (P < 0.05). The results also show that there was a linear relationship between the CSF MBP levels and the serum MBP levels in patients with acute CVD (r = 0.72, P < 0.01), but no such relationship in patients with DMD and OND. The amount of serum MBP was also significantly correlated to the severity of acute CVD, to the level of consciousness disorder and limb paralysis, and to the extent and site of the cerebral lesion at CT-scan (P < 0.05). This study shows that the measurement of brain specific MBP in serum as a marker of cerebral damage may have clinical value in the diagnosis and prognosis of patients with CVD.

Topics: Cerebral Hemorrhage; Cerebral Infarction; Cerebrovascular Disorders; Humans; Multiple Sclerosis; Myelin Basic Protein; Polyradiculoneuropathy; Radioimmunoassay

Suppressor T cell (Ts) lines specific for myelin basic protein (MBP)-reactive helper T cell (Th) clones were generated from two patients with multiple sclerosis (MS) following a primary culture of peripheral blood mononuclear cells (PBMC) with MBP and cyclosporine A (CsA). These suppressor T cell lines were maintained in culture by alternate stimulation with MBP and antigen-presenting cells (APC). The Ts lines expressed preferentially the CD4 phenotype (5/6 Ts lines tested) and exhibited potent antigen-specific suppressor activity on the proliferation of MBP-specific Th clones and not on the T cell lines with other antigen specificity. For some Ts lines, a Ts-to-Th ratio of 1 was sufficient to inhibit the proliferation of MBP-specific T cells by 90%. The suppressor T cells obtained were weakly responsive to MBP and required the presence of the autologous PBMC for proliferation. Furthermore, proliferation of these suppressor T cell lines was restricted by HLA-DR molecules (for CD4+ Ts lines) and HLA class I (for a CD8+ Ts line). The suppressor T cell lines generated and the techniques described in this study may be helpful in our understanding of the events involved in the immune regulation in MS and other autoimmune diseases.

Topics: Antigens, Differentiation, T-Lymphocyte; CD3 Complex; CD4-Positive T-Lymphocytes; CD8 Antigens; Cells, Cultured; Clone Cells; Cyclosporine; Cytotoxicity, Immunologic; HLA-DR Antigens; Humans; In Vitro Techniques; Lymphocyte Activation; Lymphokines; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell; T-Lymphocyte Subsets; T-Lymphocytes, Helper-Inducer; T-Lymphocytes, Regulatory

Copolymer 1 (Cop 1) is a synthetic basic random copolymer of amino acids that has been shown to be effective in suppression of experimental allergic encephalomyelitis and has been proposed as a candidate drug for multiple sclerosis. Cop 1 is immunologically cross reactive with myelin basic protein (BP) and was shown to inhibit murine BP-specific T-cell lines of various H-2 restrictions. In the present study these findings were extended to include human T-cell lines. Cop 1 competitively inhibited the proliferative responses and interleukin 2 secretion of six BP-specific T-cell lines and 13 clones with several DR restrictions and epitope specificities. Conversely, BP inhibited--albeit to a lesser extent--the response of all the Cop 1-specific T-cell lines and clones, irrespective of their DR restrictions. Another random copolymer of tyrosine, glutamic acid, and alanine, denoted TGA, had no effect on these lines. Neither Cop 1 nor BP inhibited the response of lines and clones specific for purified protein derivative. Cop 1 and BP exerted their cross-inhibitory effects only in the presence of antigen-presenting cells. These results suggest that Cop 1 can compete with BP for the binding to human major histocompatibility complex molecules. In view of recent studies implicating BP reactivity in multiple sclerosis, these findings suggest a possible mechanism for the beneficial effect of Cop 1 in this disease.

Topics: Antigen-Presenting Cells; Binding, Competitive; Clone Cells; HLA-DR Antigens; Humans; In Vitro Techniques; Lymphocyte Activation; Major Histocompatibility Complex; Multiple Sclerosis; Myelin Basic Protein; Peptides; T-Lymphocytes

In a prospective study, we compared the number of gadolinium-DTPA (Gd-DTPA) enhancing lesions on MRI with the CSF and clinical findings before and after a total of 20 courses of high-dose intravenous methylprednisolone in relapsing multiple sclerosis patients. Before treatment, there was a significant correlation of Gd-DTPA enhancement (seen on 16 of 20 scans) and CSF myelin basic protein (MBP). If enhancement with Gd-DTPA represents inflammation and CSF-MBP indicates myelin breakdown, the amount of inflamed tissue should correlate with the amount of myelin being damaged. Clinical improvement occurred following 15 of 20 courses, and decrease of Gd-DTPA enhancement in 12 of 16 scans; the mean CSF-MBP level was the only CSF variable to return to reference values. There was a significant correlative triad of decrease in CSF-MBP, Gd-DTPA enhancement, and clinical disability. Thus, the clinical effect of methylprednisolone might be accompanied by a reduction of inflammation and myelin breakdown.

Topics: Adult; Contrast Media; Disability Evaluation; Female; Gadolinium DTPA; Humans; Injections, Intravenous; Magnetic Resonance Imaging; Male; Methylprednisolone; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Organometallic Compounds; Pentetic Acid

Topics: Animals; Gene Expression; Mice; Mice, Mutant Strains; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Phenotype; Promoter Regions, Genetic

T cell receptor (TcR) alpha and beta nucleotide sequences involved in the human autoreactivity to myelin basic protein (MBP) were studied by screening cDNA libraries derived from 11 independent T lymphocyte clones (TCC) established from multiple sclerosis patients and healthy donors. The TCC with defined MBP peptide specificity and HLA-DR restriction expressed multiple TcR. Even TCC recognizing the same human MBP peptide [amino acids (aa) 139-153] in identical or very similar HLA-DR context expressed diverse TcR. Two TCC which recognized peptide aa 139-153 equally well in the context of both HLA-DR2a and -DR1 molecules used distinct TcR alpha but identical beta chains. The knowledge of TcR beta and TcR alpha chain sequences of human MBP-specific T cells will allow studies correlating structure and function of TcR and their targets in MBP autoreactivity. This may have an impact on the development of immunotherapies in multiple sclerosis.

Topics: Amino Acid Sequence; Autoimmunity; Base Sequence; Clone Cells; HLA-DR Antigens; Humans; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell, alpha-beta; T-Lymphocytes

We describe two families with conjugal multiple sclerosis. Onset of symptoms in the husbands occurred 11 and 17 years after onset of relapsing/remitting symptoms in their wives. There were no similarities regarding clinical manifestations of MS within each family. Evaluation of T-cell repertoire by enumeration of cells secreting interferon-gamma in response to proteolipid protein (PLP), myelin basic protein (MBP), and to various synthetic MBP peptides revealed similar patterns of T-cell reactivity within the families both in MS-affected parents and unaffected children. Genomic HLA-DR-DQ typing showed that T-cell reactivity was independent of HLA class II phenotype. Analysis of B-cell responses in blood showed low numbers of cells secreting IgG, IgA, or IgM antibodies against MBP, PLP, myelin-associated glycoprotein, and myelin-oligodendrocyte glycoprotein both in MS-affected and unaffected family members. In conclusion, our study of two families with conjugal MS has shown a dominant T-cell response against the same MBP peptide within the family both in MS-affected parents and unaffected children, and this T-cell response seems to be independent of the HLA class II phenotypes of the family members.

Topics: Adult; B-Lymphocytes; Family; Female; HLA-D Antigens; Humans; Male; Marriage; Membrane Glycoproteins; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Pedigree; T-Lymphocytes

Myelin basic protein (MBP)-autoreactive T cells have a crucial pathogenetic role in experimental allergic encephalomyelitis (EAE) and certain MBP epitopes may be immunodominantly recognized. The heterogeneity and quantity of the T cell response to different epitopes of MBP in multiple sclerosis (MS) and non-MS controls is not so clearly defined. We now study T cell reactivity to six different peptides of MBP in MS compared to controls in short-term cultures of blood mononuclear cells by measuring numbers of T cells that secrete interferon-gamma in response to antigen. In comparison with controls, MS patients showed dramatically increased numbers of MBP peptide-reactive T cells with mean values varying between 10.4 and 22.5 per 10(5) blood mononuclear cells. Among those MBP peptides examined (amino acid 1-20, 63-88, 89-101, 96-118, 110-128 and 148-165), no single peptide is preferentially recognized. Neither is any preferential response apparent after subdivision of the MS patients according to their HLA-DR genotype. Our findings suggest that a quantitative increase of a broad repertoire of myelin-autoreactive T cells with capacity to secrete IFN-gamma can be important for the pathogenesis of MS.

Topics: Adult; Aged; Amino Acid Sequence; Epitopes; Female; Humans; Interferon-gamma; Lymphocyte Activation; Male; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptides; T-Lymphocytes

Previous research has demonstrated a myelin basic protein (MBP) antibody cascade in cerebrospinal fluid (CSF) of multiple sclerosis (MS) patients. The purpose of this study was to determine whether primary antibodies to MBP (anti-MBP) reacted similarly with homologous (human) and heterologous (bovine and porcine) MBP. Myelin basic protein was prepared from central nervous system white matter of humans as well as bovine and porcine species. Immunoglobulin G (IgG) was purified by protein A-Sepharose affinity chromatography from concentrated CSF of MS patients with active or inactive disease or from non-MS controls. Antibodies to MBP were isolated from purified CSF IgG of MS patients with acute relapses by two-step antigen specific (MBP-Sepharose) affinity chromatography. Anti-MBP in the context of whole CSF, in purified CSF-IgG or as purified antibody, reacted identically with homologous and heterologous MBP. Kinetic studies of anti-MBP titers demonstrated that when anti-MBP was reacted in vitro with increasing amounts of homologous or heterologous MBP, the antibody was equally neutralized by either antigen. Neutralization of anti-MBP by homologous and heterologous MBP or their synthetic peptides may also be possible in vivo as a potential therapeutic tool.

Topics: Animals; Antibodies; Antigen-Antibody Reactions; Antigens; Cattle; Chromatography, Affinity; Epitopes; Humans; Immunoglobulin G; Multiple Sclerosis; Myelin Basic Protein; Swine

T cell sensitization to two myelin components, myelin basic protein (MBP) and myelin proteolipid protein (PLP), may be important to the pathogenesis of multiple sclerosis (MS). Using the limiting dilution assay, we demonstrated that the blood of MS patients had an increased frequency of MBP-reactive T cells compared with normal subjects and patients with other neurological diseases (OND) and rheumatoid arthritis. There was no difference in T cell frequency to a synthetic peptide, PLP139-151, or Herpes simplex virus. Within cerebrospinal fluid (CSF), 37% of IL-2/IL-4-reactive T cell isolates from MS patients responded either to MBP or PLP139-151 while only 5% of similar isolates from OND patients responded to these myelin antigens. The mean relative frequency of MBP-reactive T cells within CSF from MS patients was significantly higher than that of OND patients (22 x 10(-5) cells versus 1 x 10(-5) cells) and was similar to that of MBP reactive T cells within the central nervous system of rats with experimental autoimmune encephalomyelitis. These results lend new support to the hypothesis that myelin-reactive T cells mediate disease in MS.

Topics: Amino Acid Sequence; Amino Acids; Blood Cells; Cerebrospinal Fluid; Humans; Indicator Dilution Techniques; Interleukin-2; Interleukin-4; Leukocyte Count; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; T-Lymphocytes

This study examined the linkage between elevated blood serotonin in autism and the presence of circulating autoantibodies against the serotonin 5HT1A receptor. Information was also obtained on the diagnostic and receptor specificity of these autoantibodies. Blood serotonin was measured as was inhibition of serotonin binding to human cortical membranes by antibody-rich fractions of blood from controls and from patients with childhood autism, schizophrenia, obsessive-compulsive disorder, Tourette's, and multiple sclerosis. The results showed elevated blood serotonin was not closely related to inhibition of serotonin binding by antibody-rich blood fractions. Inhibition of binding was highest for patients with multiple sclerosis and was not specific to the 5HT1A receptor as currently defined. Although inhibition was not specific to autism, the data were insufficient to establish if people with autism differed from normal controls on this measure.

Topics: Adolescent; Adult; Autistic Disorder; Autoantibodies; Binding, Competitive; Child; Child, Preschool; Female; Frontal Lobe; Humans; Immunoglobulin G; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Obsessive-Compulsive Disorder; Receptors, Serotonin; Schizophrenia, Childhood; Serotonin; Tourette Syndrome

To characterize the role of B lymphocytes in the pathogenesis of Multiple Sclerosis (MS), we have isolated mononuclear cells from cerebrospinal fluid (CSF) and stimulated them with a polyclonal B-cell mitogen (pokeweed mitogen). This study has been done with MS patients selected for the occurrence of an acute attack in the course of the disease and with patients hospitalized for other neurological diseases. Five of the 11 MS patients had B lymphocytes producing in vitro antibodies (Abs) directed against purified human myelin basic protein (hMBP), as revealed by Western blot analysis. None of the 20 patients with other neurological diseases showed such a reactivity. The produced Abs recognized only 1 or 2 hMBP peptides without dominance for a certain peptide. This result emphasizes the presence of B cells producing Abs against MBP in CSF of MS patients and shows the interest of studying mononuclear cells of CSF as a good marker of the pathogenesis.

Topics: Acute Disease; Adult; Aged; Autoantibodies; B-Lymphocytes; Biomarkers; Blotting, Western; Brain Diseases; Cells, Cultured; Cerebrospinal Fluid; Enzyme-Linked Immunosorbent Assay; Female; Humans; Lymphocyte Activation; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Pokeweed Mitogens

Human myelin basic protein (h-MBP) purified from central nervous system (CNS) myelin has a molecular mass of 18.5 kDa and 170 residues. Eighteen synthetic peptides ranging from 8 to 25 residues and covering the length of h-MBP were prepared by the Fmoc method. Antibodies to h-MBP (anti-MBP) were isolated and purified from cerebrospinal fluid (CSF) of patients with multiple sclerosis (MS) by two-step affinity chromatography. Purified anti-MBP was reacted with increasing amounts of h-MBP as well as each of the 18 synthetic peptides in an initial liquid phase assay, and then titers of free anti-MBP in the resulting mixtures were determined by a solid phase radioimmunoassay. Purified anti-MBP was neutralized by h-MBP and 6 of the 18 synthetic peptides used in this study. The antibody was completely neutralized by peptides No. 12 (residues: 80-97), No. 15 (residues: 91-106) and No. 56 (residues: 75-95) and was partially neutralized by peptides No. 27 (residues: 61-75), No. 16 (residues: 64-78) and No. 21 (residues: 69-83). The 12 remaining synthetic peptides covering both the amino (residues 1-63) and carboxyl (residues 117-162) terminals of h-MBP did not neutralize purified anti-MBP. These results suggest that anti-MBP purified from CSF of patients with MS have affinity for discontinuous epitopes located between residues 61 and 106 on the h-MBP molecule. Alternatively anti-MBP may be polyspecific recognizing different amino acid sequences.

Topics: Amino Acid Sequence; Antibodies; Antibody Specificity; Humans; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Neuropeptides

Topics: Animals; Encephalomyelitis, Autoimmune, Experimental; Female; Guinea Pigs; Humans; Magnetic Resonance Imaging; Male; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments

The Epstein-Barr virus (EBV) causes infectious mononucleosis and is linked to several disparate malignancies. Prior studies on patients with multiple sclerosis (MS) showed that 100% are EBV-seropositive and that their blood contains higher antibody titers than those of controls to both transformation and lytic cycle antigens. We performed three different assays for antibodies in CSF to three major EBV antigens from patients with MS and controls. Among 93 patients with MS, 79 (85%) had CSF that reacted with a 70 kD protein, shown to be the nuclear antigen, EBNA-1, whereas only 11 (13%) of 81 EBV-seropositive controls reacted, p less than 0.001. The CSF of all 14 MS patients, unreactive on immunoblots, contained oligoclonal bands on agarose electrophoresis. Together, the two techniques exhibit 100% sensitivity in the confirmatory diagnosis of MS. We also performed amino acid searches of the Protein Identification Resource sequence database for protein homologies to EBNA. Two pentapeptide identities were found between EBNA-1 and myelin basic protein: QKRPS and PRHRD. None of more than 32,000 other proteins in the database contained both pentapeptides. In healthy EBV-seropositive persons, the EBV-specific, MHC-restricted T lymphocytes keep the EBV-containing B lymphocytes locked in the transformed state. However, in the host genetically susceptible to MS, the same population of lymphocytes might recognize and interact with either of the two identified pentapeptides, inadvertently damaging MBP.

Topics: Amino Acid Sequence; Antibodies, Viral; Antigens, Viral; Blotting, Western; DNA-Binding Proteins; Enzyme-Linked Immunosorbent Assay; Epstein-Barr Virus Nuclear Antigens; Fluorescent Antibody Technique; Herpesviridae Infections; Herpesvirus 4, Human; Humans; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Predictive Value of Tests; Sensitivity and Specificity; Sequence Homology, Nucleic Acid

Elevated titers of anti-myelin basic protein (anti-MBP) are highly associated with acute idiopathic unilateral optic neuritis as well as acute relapses of multiple sclerosis (MS). During acute phases of optic neuritis, free/bound antibody ratios are generally above unity, with high titers of free anti-MBP and relatively low or undetectable values of bound antibody. Three to 5 months after the acute phase when the majority of patients have recovered, free/bound anti-MBP ratios are below unity with low titers of free antibody and relatively higher levels of bound anti-MBP. Anti-MBP purified from cerebrospinal fluid of patients with optic neuritis are neutralized by synthetic peptides of human MBP containing overall amino acid residues 61-106 and do not react with synthetic peptides corresponding to residues 1-60 and 107-170. Anti-MBP may either have multiple epitopes in the region corresponding to residues 61-106 or it may react with a discontinuous epitope in this range. The mechanism of the optic nerve demyelination may be associated with anti-MBP binding in situ to MBP in the 61-106 amino acid region.

Topics: Acute Disease; Amino Acid Sequence; Antibody Specificity; Autoantibodies; Autoimmune Diseases; Cerebrospinal Fluid Proteins; Convalescence; Epitopes; Humans; Immunoglobulin G; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Optic Neuritis; Peptide Fragments

Myelin basic protein (MBP) consists of several components or charge isomers (C-1 through C-8) generated by one or a combination of posttranslational modifications. One of these, C-8, has been shown to contain citrulline (Cit) at defined sites formed by deimination of six arginyl residues. This unusual modification has allowed us to raise antibodies specific for this charge isomer only. To do this, a synthetic peptide, Gly-Cit-Cit-Cit-Cit, was coupled to keyhole limpet hemocyanin and injected into rabbits. The antibodies so generated reacted only with C-8 and not with any of the other charge isomers. A second antibody fraction was raised against the synthetic peptide ACitHGFLPCitHR naturally occurring between residues 24 and 33 of C-8 (all other charge isomers contain R instead of Cit at positions 25 and 31). These antibodies preferred C-8 but reacted with the other charge isomers, to the extent of approximately 25-30% of the reactivity shown with C-8. In studies with C-8 from multiple sclerosis (MS) MBP, much greater reactivity was obtained with these antibodies when compared with their reactivity with C-8 from normal MBP. Because the total number of Cit residues in C-8 from MS and normal MBP is the same, the difference in reactivity may be related to structural factors. The antibodies raised with the tetra-Cit peptide were reacted with three pairs of synthetic peptides: 24ARHGFLPRHR33 and ACitHGFLPCitHR; 120GQRPGFGYGGRAS132 and GQCitPGFGYGGCitAS; and 157GGRDSRSGSPMARR170 and GGCitDSRSGSPMACitR. They reacted only with the Cit-containing peptides in the order 157-170 greater than 120-130 greater than 24-33.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Alzheimer Disease; Antibodies; Brain; Electrochemistry; Enzyme-Linked Immunosorbent Assay; Humans; Huntington Disease; Isomerism; Multiple Sclerosis; Myelin Basic Protein; Parkinson Disease; Peptides; Reference Values

Genetic factors have been implicated in the aetiology of multiple sclerosis (MS), but the genes conferring susceptibility to MS have not been identified. We carried out genetic linkage and association analyses by studying polymorphism of the myelin basic protein (MBP) gene on chromosome 18, a candidate gene for MS, in 21 MS families, 51 additional unrelated patients with definite MS, and 85 controls. All subjects were Finnish, and 14 of the families were from an area with an exceptional familial clustering of MS. Magnetic resonance imaging (MRI) was used to examine subclinical disease in symptom-free family members. In the association analysis, the allele frequencies between MS patients and controls differed significantly, p = 0.000049), the difference being attributable mainly to a higher frequency of a 1.27 kb allele among patients. In the linkage analysis, based on an autosomal dominant model and penetrance 0.05, a maximum LOD score of 3.42 (theta = 0.00) was obtained when patients with optic neuritis and their symptom-free siblings with abnormal MRI findings were classified as "affected". When these subjects were classified as "unknown" the maximum LOD scores ranged from 2.99 to 3.25 (theta = 0.00). The results suggest that in this population genetic predisposition to MS is closely linked to the MBP gene and that polymorphism at the MBP locus or an adjacent locus has a role in the aetiology of MS.

Topics: Adult; Aged; Base Sequence; Chromosome Mapping; Chromosomes, Human, Pair 18; Confounding Factors, Epidemiologic; DNA; Female; Finland; Gene Frequency; Genes, Dominant; Genetic Linkage; Genetic Predisposition to Disease; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Pedigree; Polymorphism, Genetic

A total of 101 patients (62 women; 39 men) with definite MS were treated with 1000 mg methylprednisolone (MP) intravenously for 10 consecutive days. Immediately before and after MP treatment clinical scoring (Kurtzke's Expanded Disability Status Scale) and CSF analysis were performed. Before MP treatment CSF MBP, IgG and IgM immunoglobulin levels (CSF Ig, index and intrathecal synthesis) were significantly elevated. The mean CSF MBP levels were significantly higher in the relapsing-remitting (RR) and chronic progressive MS patients with relapses (CP + RR) than in the CP group without a RR disease course, respectively 2.1, 2.3 and 1.5 micrograms/l. A weak positive correlation was found between CSF MBP level and EDSS in the RR MS group (r = 0.34). CSF MBP was significantly correlated with IgM index (r = 0.36), IgM synthesis (r = 0.26), but not with the IgG levels. Therefore demyelination seems to be related to intrathecal IgM production. After MP treatment mean (median) EDSS decreased from 4.4 (4.0) to 3.3 (3.0). Except for Q albumin and IgM index, all CSF immunoglobulin levels decreased significantly after MP. The mean CSF MBP returned to reference values. In the RR group the decrease in CSF MBP was significantly correlated with the change in EDSS (r = 0.39). CSF MBP seems to be a good parameter for disease activity in relapsing MS. Following treatment CSF MBP was found to be related with the change in IgM index (r = 0.30). MP treatment reduces CSF MBP and intrathecal IgM in a similar way indicating a relation between these 2 parameters.

Topics: Adult; Blood-Brain Barrier; Dose-Response Relationship, Drug; Female; Humans; Immunoglobulin G; Immunoglobulin M; Infusions, Intravenous; Leukocyte Count; Male; Methylprednisolone; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Neurologic Examination; Reference Values

A panel of 90 myelin basic protein (MBP)-specific T-cell lines were derived from peripheral blood of eight patients with multiple sclerosis and four normal subjects. The precursor frequency of MBP-reactive T cells in peripheral blood mononuclear cells ranged from 10(-7) to 9 x 10(-7) (mean, 6.7 x 10(-7)) in the group of patients with multiple sclerosis and from 0.5 x 10(-7) to 9.8 x 10(-7) (mean, 5.6 x 10(-7)) in the control subjects. This difference between the two groups was not statistically significant (p greater than 0.1). These T-cell lines expressed exclusively CD3+CD4+CD8- phenotypes and were restricted predominantly by HLA-DR molecules. When tested with fragments and synthetic peptides of human MBP, these MBP-specific T-cell lines (45 lines for each group) displayed a limited heterogeneous pattern with a biased recognition to peptide 84-102 and the C-terminal peptide 149-171. The reactivity to the 84-102 region of MBP was associated with the HLA-DR2, DRw15 (DRw15,2) haplotype, whereas the recognition to peptide 149-171 did not correlate with a particular HLA-DR allele(s). Furthermore, the majority of T-cell lines (greater than 75%) were found to exhibit substantial cytotoxic activity against MBP-coated target cells, but showing no significant difference between these two groups. This MBP-dependent cytotoxicity was not associated with epitope specificities of the T-cell lines tested.

Topics: Adult; Autoimmune Diseases; Cell Line; Cytotoxicity, Immunologic; Female; HLA Antigens; Humans; Leukocyte Count; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; T-Lymphocyte Subsets; T-Lymphocytes, Cytotoxic

In vivo-activated interleukin-2 responsive T cell clones were generated from peripheral blood (PBL) of multiple sclerosis patients (MS) and normal subjects (N) by limiting dilution analysis. The frequency with which interleukin-2 responsive cells were cloned from PBL was higher in MS than N. CD8 was the predominant phenotype expressed by both MS (85%) and N (89%) clones. Seven clones from four MS patients but none from five N subjects specifically proliferated against myelin basic protein. These studies demonstrate the existence of MBP-reactive T cells in PBL of MS patients.

Topics: Antigens, Surface; Clone Cells; Humans; Interleukin-2; Lymphocyte Activation; Multiple Sclerosis; Myelin Basic Protein; Phenotype; T-Lymphocytes

We have examined previously the peptide specificity of the T cell response to myelin basic protein (MBP) in patients with multiple sclerosis (MS) and healthy controls, and demonstrated that an epitope spanning amino acids 87-106 was frequently recognized. Because this region is encephalitogenic in some experimental animals, it has been postulated that the response to the epitope may have relevance to MS. In this study, the fine specificity of this response is studied using four well-characterized, monospecific T cell lines from three MS patients and an identical twin of a patient. Each of the lines recognized a peptide with the same core sequence, amino acids 89-99, although the responses were affected to various degrees by truncations at the COOH- or NH2 terminal ends of the 87-106 epitope. Importantly, the epitope was recognized in conjunction with four different HLA-DR molecules. Also, the T cell receptor beta chain usage was heterogeneous, and each line expressed a different VDJ sequence. The four HLA-DR molecules restricting the response to this epitope have been shown to be overrepresented in MS populations in various geographic areas, suggesting that the response to this region of the MBP molecule may be relevant to the pathogenesis of MS. These findings may have important implications in designing therapeutic strategies for the disease.

Topics: Amino Acid Sequence; Base Sequence; Cell Line; Epitopes; HLA-DR Antigens; Humans; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Receptors, Antigen, T-Cell; Receptors, Antigen, T-Cell, alpha-beta; T-Lymphocytes, Cytotoxic

We evaluated the B-cell response in cerebrospinal fluid (CSF) and blood by enumerating cells secreting antibodies to myelin-associated glycoprotein (MAG) and, for reference, to myelin basic protein (MBP), two myelin components which may constitute targets for autoimmune attack in multiple sclerosis (MS). Among 25 untreated MS patients, 12 had cells in CSF secreting anti-MAG IgG antibodies (mean value 1 per 1429 CSF cells) and three also had cells secreting anti-MAG antibodies of the IgM isotype but at lower levels. In CSF from 2 out of 10 MS patients examined, anti-MAG and anti-MBP IgG antibody-secreting cells were present concurrently. Antibody-secreting cells were less frequent in blood and bone marrow, reflecting compartmentalization to CSF. Anti-MAG antibody-secreting cells were found in CSF from only 1 out of 27 control patients. The intrathecal production of anti-MAG and anti-MBP antibodies may be important in the pathogenesis of MS.

Topics: Adult; Aged; B-Lymphocytes; Blotting, Western; Cerebrospinal Fluid; Electrophoresis, Polyacrylamide Gel; Enzyme-Linked Immunosorbent Assay; Female; Humans; Immunoglobulin G; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein

Cerebrospinal fluid samples were obtained at lumbar puncture from 53 patients with a wide variety of neurological disorders. Cerebrospinal fluid samples were tested for the presence of P2 protein, a constituent of myelin, with an enzyme linked immunosorbent assay technique using a specific polyclonal antibody. High concentrations of P2 in the cerebrospinal fluid paralleled a raised IgG index (clearance ratio), the presence of oligoclonal bands, as well as raised white cell counts or depressed albumin:IgG ratios. Twenty one patients had been diagnosed as having definite or probable multiple sclerosis and the remaining 32 had other conditions. Of the 13 patients with high positive P2, 12 (92%) were in the multiple sclerosis category; of the 40 patients with low (12) or undetectable (28) P2 concentrations, only nine (23%) were diagnosed as having multiple sclerosis. In this patient population the presence of high immunoreactive P2 concentrations in cerebrospinal fluid was closely associated with evidence of intrathecal immunoglobulin synthesis and with the clinical diagnosis of multiple sclerosis. On this basis it is suggested that immunoassay of P2 concentration in the cerebrospinal fluid may be of potential value in the investigation of patients with demyelinating disorders.

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Demyelinating Diseases; Enzyme-Linked Immunosorbent Assay; Female; Humans; Immunoglobulin G; Infant; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin P2 Protein; Sensitivity and Specificity

Topics: Autoantigens; CD4 Antigens; Epitopes; Humans; Lymphocyte Activation; Magnetic Resonance Imaging; Major Histocompatibility Complex; Multiple Sclerosis; Myelin Basic Protein; Receptors, Immunologic; T-Lymphocytes

Recent studies in experimental autoimmune encephalomyelitis as a model for multiple sclerosis (MS) have demonstrated limited heterogeneity in T-cell antigen receptors (TCR) specific for myelin basic protein (MBP). To investigate restricted beta-chain variable-region (V beta) gene usage in humans, we analyzed TCR gene rearrangements in two lines and 34 MBP-specific T-cell clones that were isolated from five MS patients and two healthy subjects. The T cells were characterized for their specificity to MBP epitopes and HLA-restricting molecules. We demonstrate here that MBP-specific T-cell clones from these different MS patients and healthy individuals, in contrast to T cells from rodents, display a more diverse V beta gene usage as evidenced by their TCR V beta gene rearrangements. However, the different MBP-specific T-cell clones isolated from each individual MS patient showed a common V beta gene usage, suggesting individual-specific TCR restriction. Out of 16 MBP-specific clones derived from a single MS patient, 12 clones (75%) utilized the V beta 15 gene for their TCR gene rearrangement. MBP-specific clones isolated from four other MS patients also showed a consistent tendency for a predominant, but different, TCR V beta gene rearrangement. These results suggest a TCR heterogeneity among MBP-specific T-cell clones from different individuals but a limited TCR V beta gene usage among MBP-specific T-cell clones of the same individual. The predominant V beta gene used by the MBP-specific T-cell clones studied here was not found to correlate with the epitope specificity of T cells or with their restricting HLA molecule. These findings may support the possibility of intervention with monoclonal antibodies to specific V beta gene products as an approach to immune therapy of MS but also imply the necessity for an individual-specific immunotherapeutic approach.

Topics: Base Sequence; Gene Rearrangement, beta-Chain T-Cell Antigen Receptor; Genetic Variation; Humans; Molecular Sequence Data; Multigene Family; Multiple Sclerosis; Myelin Basic Protein; Oligonucleotide Probes; Polymerase Chain Reaction; Receptors, Antigen, T-Cell; T-Lymphocytes

Several recently discovered lines of evidence support the involvement of myelin basic protein (BP)-specific T cells in multiple sclerosis (MS). To identify potentially relevant immunodominant T cell epitopes, human BP (Hu-BP)-reactive T cell lines were selected from MS and normal donors and tested for reactivity to cleavage fragments and synthetic peptides of Hu-BP. The MS T cell lines responded to more Hu-BP epitopes than did normal lines, showing biased recognition of the N terminal half of the molecule, and one region in the C terminal half, suggesting increased sensitization to BP. The MS lines also differed from normal lines in their decreased percentage of CD8+ T cells. One hundred nine T cell clones isolated from these lines confirmed the reactivity pattern of the lines but did not reflect the mixed phenotype, since all but three clones tested were CD4+. T cell clones from HLA-DR2 homozygous donors responded to a variety of epitopes, indicating that this molecule was permissive in its ability to restrict T cell responses. Other epitopes, including the immunodominant 149-170 sequence, were restricted by several different major histocompatibility complex (MHC) molecules from both MS and normal donors. T cell receptor (TCR) V gene products could be identified on six of 38 clones tested using monoclonal antibodies. From one HLA-DR2 homozygous donor, four of eight clones utilized V beta 5.2 in response to different BP epitopes, providing initial support for the preferential use of a limited set of V region genes in the human response to BP. Preferential TCR V gene use in MS patients would provide the rationale to regulate selectively BP-reactive T cells through immunity directed at the TCR and thus test for the first time the hypothesis that BP-reactive T cells play a critical role in the pathogenesis of MS.

Topics: Adult; Aged; Clone Cells; Epitopes; Female; Genes; HLA-DR2 Antigen; Humans; Immunodominant Epitopes; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell; Reference Values; T-Lymphocytes

Seventeen T-cell clones derived from the peripheral blood of a patient with multiple sclerosis and reactive with a synthetic peptide corresponding to residues 152-170 of the human myelin basic protein molecule were previously shown to be cytotoxic for myelin basic protein-coated target cells. Genetic restriction studies have now demonstrated that these clones recognize myelin basic protein in association with human leukocyte antigen DRw13. Studies of the T-cell receptor beta gene rearrangements generated by these clones demonstrated 12 different patterns, as evaluated by Southern blot analysis. Thus, the human T-cell response to myelin basic protein is exceedingly heterogeneous, even among T cells that recognize the same small fragment of the molecule in association with the same class II restriction element.

Topics: Clone Cells; DNA Restriction Enzymes; Gene Rearrangement, beta-Chain T-Cell Antigen Receptor; Humans; Major Histocompatibility Complex; Multiple Sclerosis; Myelin Basic Protein; T-Lymphocytes; T-Lymphocytes, Cytotoxic

T cell lines and clones specific for human myelin basic protein (BP) were selected from three multiple sclerosis (MS) patients and two healthy subjects and tested for their proliferative responses to a battery of synthetic peptides, 9 to 21 amino acid residues long. The combined amino acid sequence of the peptides spanned the complete sequence of the human BP. The results suggest the development of T cells sensitized to at least four independent regions of the human BP, indicating some diversity of the human T cell repertoire to BP. However, an immunodominant T cell epitope was located in the C-terminal region, defined by residues 149-162. This epitope was recognized by T cells from three subjects out of five (one MS patient and both healthy controls) in the context of different DR specificities. Another epitope (located in the 57-75 region) which triggered one MS patient's T cell response was also recognized by a mycobacteria-specific T cell clone cross-reacting with BP.

Topics: Epitopes; HLA-DR Antigens; Humans; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; T-Lymphocytes

The pathogenesis of multiple sclerosis (MS) could involve an autoimmune response to proteolipid protein (PLP). Immunization of experimental animals with this major myelin protein can lead to experimental allergic encephalomyelitis. To identify a possible role of PLP as target antigen in MS, we evaluated T cell immunity to PLP in blood and cerebrospinal fluid (CSF) from patients with MS and controls by counting cells which in response to PLP in short-term cultures secreted interferon-gamma. The PLP-specific B cell response was analyzed by counting cells secreting anti-PLP antibodies. PLP-reactive T cells were detected in blood of most MS patients (mean value 1 per 20,408 mononuclear cells), and at 41-fold higher numbers in CSF (mean 1 per 500 CSF cells). Anti-PLP IgG antibody-secreting cells were detected in blood from most MS patients (mean 1 per 30,303 cells), but such cells were 49-fold more frequent in CSF (mean 1 per 625 cells). PLP-reactive T and B cells were also detected in blood and CSF from control patients, but at much lower numbers. A strong and persistent autoimmune response to PLP as well as to other myelin proteins, enriched in CSF, is proposed to be pathogenetically important in MS.

Topics: Adolescent; Adult; Antibody-Producing Cells; B-Lymphocytes; Encephalomyelitis, Autoimmune, Experimental; Female; Humans; Immunoglobulin G; Interferon-gamma; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; T-Lymphocytes

Topics: Antibodies; Cerebrovascular Disorders; Encephalitis; Humans; Multiple Sclerosis; Myelin Basic Protein

Multiple sclerosis (MS) is characterised by intrathecal synthesis of IgG, less frequently of IgA and IgM. Local production of antibodies to myelin basic protein (MBP) and other myelin components has also been reported, and autoimmune pathogenesis has been postulated. Whether MS is accompanied by a systemic B cell response is less clear. To elucidate this question, we examined bone marrow and peripheral blood from patients with MS and controls for cells secreting IgG, IgA and IgM, as well as anti-MBP antibodies of these three isotypes. Patients with MS without any signs of concurrent infections had higher numbers of IgG + IgA + IgM secreting cells both in bone marrow and peripheral blood compared with healthy controls. The same abnormalities were observed in patients with other inflammatory neurological diseases (OIND). When analysing individual isotypes, patients with MS and OIND had higher numbers of IgA secreting cells both in bone marrow and blood compared with healthy controls. Only one of 13 MS patients examined had anti-MBP antibody secreting cells in bone marrow and blood. The systemic B cell response registered in MS is also present in other inflammatory neurological diseases and its specificity and possible role in the pathogenesis of MS remains unknown.

Topics: Adult; Aged; Antibody Formation; B-Lymphocytes; Bone Marrow; Bone Marrow Cells; Female; Humans; Immunoglobulin A; Immunoglobulin G; Immunoglobulin M; Immunoglobulins; Leukocyte Count; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein

Immunoglobulin G (IgG) was purified by single-step protein A-Sepharose (Pharmacia) affinity chromatography from the cerebrospinal fluid (CSF) of multiple sclerosis (MS) patients and controls. Autoantibodies to myelin basic protein (anti-MBP) were isolated from the purified IgG fraction by two-step antigen specific affinity chromatography. Anti-MBP in the context of whole CSF or in purified form reacts equally to MBP prepared from non-MS or MS brain tissue. Kinetic studies of anti-MBP titers demonstrate that when anti-MBP is reacted with increasing amounts of non-MS or MS MBP, the autoantibody is immunoabsorbed by either antigen in vitro. Immunoabsorption of anti-MBP by MBP or its synthetic peptides may also be possible in vivo as a potential therapeutic tool.

Topics: Autoantibodies; Brain; Chromatography, Affinity; Humans; Immunoglobulin G; Multiple Sclerosis; Myelin Basic Protein; Optic Neuritis

The presence, level and disease activity relationships of soluble interleukin-2 receptor (sIL-2R) in the cerebrospinal fluid (CSF) of multiple sclerosis (MS) patients are unresolved. We measured CSF immunoreactive myelin basic protein (MBP), a marker of acute myelin damage, and sIL-2R levels in the CSF from 11 patients with active relapsing remitting (RR) MS, five with stable RR MS, eight with chronic progressive (CP) MS, five with other neurologic diseases, and three normal controls. No measurable (less than 100 units/ml) sIL-2R was present in any of the samples. Conversely, MBP levels were elevated in the active RR group compared to the other four groups. These results indicate that, at the sensitivity of assays currently available, levels of CSF sIL-2R do not correlate with the diagnosis or disease activity of MS.

Topics: Humans; Multiple Sclerosis; Myelin Basic Protein; Receptors, Interleukin-2; Recurrence; Solubility

Major histocompatibility complex (MHC) molecules are not normally expressed in the central nervous system (CNS). However, aberrant expression has been observed in multiple sclerosis lesions and could contribute to the destruction of myelin or the myelinating cells known as oligodendrocytes. The mechanism of cell damage associated with aberrant MHC molecule expression is unclear: for example, overexpression of class I and class II MHC molecules in pancreatic beta cells in transgenic mice leads to nonimmune destruction of the cells and insulin-dependent diabetes mellitus. We have generated transgenic mice that express class I H-2Kb MHC molecules, under the control of the myelin basic protein promoter, specifically in oligodendrocytes. Homozygous transgenic mice have a shivering phenotype, develop tonic seizures and die at 15-22 days. This phenotype, which we term 'wonky', is due to hypomyelination in the CNS, and not to involvement of the immune system. The primary defect appears to be a shortage of myelinating oligodendrocytes resulting from overexpression of the class I MHC molecules.

Topics: Animals; Brain; Demyelinating Diseases; Gene Expression; H-2 Antigens; Mice; Mice, Transgenic; Multiple Sclerosis; Myelin Basic Protein; Oligodendroglia; Promoter Regions, Genetic; Spinal Cord

Multiple sclerosis is an autoimmune disease in which T lymphocytes reactive to myelin basic protein (BP) could play a central role. T cells specific for BP were cloned from the blood of multiple sclerosis patients and normal individuals, and expression of T-cell receptor variable region genes was analyzed. A remarkable bias for use of beta-chain variable region (V beta) 5.2 and, to a lesser extent, V beta 6.1 was seen among BP-specific clones from patients but not from controls. The preferential use of V beta 5.2 for BP recognition did not reflect altered expression of this V beta in the peripheral repertoire. Interestingly, shared V beta 5.2 usage was apparent for clones specific for different BP determinants, even when derived from the same individual. The concurrent demonstration by others (J. R. Oksenberg, M. A. Panzara, A. B. Begovich, H. Erlich, R. Murray, M. Sherritt, S. Stuart, C. C. Bernard, and L. Steinman, personal communication) that T cells within demyelinating areas of multiple sclerosis brains preferentially express V beta 5.2 and V beta 6.1 suggests that the BP-specific clones derived from blood may be relevant to disease pathogenesis. These findings may have important implications for the treatment of multiple sclerosis.

Topics: Base Sequence; CD4 Antigens; Clone Cells; Genes; Genetic Variation; Humans; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Oligodeoxyribonucleotides; Polymerase Chain Reaction; Receptors, Antigen, T-Cell, alpha-beta; T-Lymphocytes

Topics: Autoimmune Diseases; Humans; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell; T-Lymphocytes

Cells secreting antibodies against guinea pig myelin and synthetic myelin basic protein (MBP) peptides were evaluated in cerebrospinal fluid (CSF) and blood from patients with multiple sclerosis (MS) and a variety of other neurological diseases (OND). The peptides used, reproducing amino acid sequences 1-20, 70-89, 108-126, or 157-166 of MBP, were selected on the basis of their hydrophilic and encephalitogenic properties. Low numbers of cells secreting IgG antibodies against myelin or each of the MBP peptides (about 1 per 50,000) were detected in peripheral blood, with no difference between MS and OND. In CSF, cells secreting IgG antibodies to MBP 70-89 were more frequently (p = 0.007) detected in patients with MS (1/380 IgG-secreting cells on average) than in patients with OND (1/2083 IgG-secreting cells on average). The frequencies of cells secreting antibodies against myelin or the three other MBP peptides were similar in MS and OND. Thus, evaluation of B cell immunity at the cellular level indicates that MBP 70-89 is an immunodominant B cell epitope in MS. It is not clear whether this intrathecal anti-MBP 70-89 IgG antibody response has any pathogenetic relevance in MS or is the result of myelin breakdown.

Topics: Adult; Antibody Specificity; Autoantibodies; B-Lymphocytes; Cerebrospinal Fluid; Encephalomyelitis, Autoimmune, Experimental; Female; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Peptides

Topics: Amino Acid Sequence; Antigens, Viral; Autoantigens; Autoimmune Diseases; Enterovirus B, Human; Humans; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Sequence Homology, Nucleic Acid; Viral Proteins

Topics: Adult; Amino Acid Sequence; Base Sequence; Epitopes; Female; HLA-DR Antigens; Humans; Male; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Receptors, Antigen, T-Cell; T-Lymphocytes

To further characterize the nature of retinal periphlebitis and retinitis in multiple sclerosis, immunoperoxidase studies were performed on retinal tissue from multiple sclerosis patients at autopsy. Antibodies against myelin basic protein stained the optic nerve but not the retina. Both normal and multiple sclerosis retinas showed staining of Müller cells with Leu-7 (a monoclonal antibody that cross-reacts with myelin associated glycoprotein and natural killer cells). Nerve fiber bundles of the optic nerve in cases with multiple sclerosis and controls also showed staining with Leu-7 antibody. Tissue-bound IgG was demonstrated on retinal ganglion cells in six of seven multiple sclerosis cases but not in controls.

Topics: Antibodies, Monoclonal; Cross Reactions; Humans; Immunoenzyme Techniques; Immunoglobulins; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin-Associated Glycoprotein; Nerve Fibers; Optic Nerve; Retinal Diseases; Retinal Ganglion Cells; Retinitis

Antibody-producing B lymphocytes were polyclonally activated and transformed, by Epstein-Barr virus (EBV), into multiple B lymphoblastoid cell lines in a microculture system. The frequencies of B precursor cells producing antibodies to myelin basic protein (MBP) and measles virus were analyzed in peripheral blood of patients with multiple sclerosis (MS) and control subjects. Measles virus-specific B cells were detected at a significantly higher frequency in MS patients (n = 10, P less than 0.005) than patients with other neurological diseases (n = 10) and normal subjects (n = 10). In contrast, the frequencies of B cells producing anti-MBP antibodies and natural antibodies did not differ statistically among the three groups tested (P greater than 0.05). In addition, the anti-MBP antibodies produced by a panel of stable B cell lines obtained were found to react selectively with an epitope(s) within the C-terminal half fragment 90-171 of the human MBP molecule. In our experiments, no antibody cross-reactivity between MBP and measles virus could be detected in a total of 2760 B cell cultures.

Topics: B-Lymphocytes; Cell Transformation, Viral; Cells, Cultured; Cross Reactions; Enzyme-Linked Immunosorbent Assay; Flow Cytometry; Herpesvirus 4, Human; Histones; Humans; Immunoglobulin M; In Vitro Techniques; Measles virus; Multiple Sclerosis; Mumps virus; Myelin Basic Protein; Tetanus Toxoid

Using purified human brain myelin basic protein (MBP) to raise antiserum in rabbits and to prepare 125I-labelled MBP (chloramine-T method), We have established a high specific, precise and sensitive double-antibody radioimmunoassay for the measurement of human serum MBP. The sensitivity was 0.5 ng/ml. In the present study, the serum samples of thirty patients with various neurological diseases were detected. An important clinical implication is that serum MBP level should serve as an index for the damage degree of central neurological diseases.

Topics: Animals; Cerebrovascular Disorders; Multiple Sclerosis; Myelin Basic Protein; Radioimmunoassay; Rats

Gene mutation in vivo in human T lymphocytes appears to occur preferentially in dividing cells. Individuals with multiple sclerosis (MS) are assumed to have one or more populations of diving T cells that are being stimulated by autoantigens. Mutant T cell clones from MS patients were isolated and tested for reactivity to myelin basic protein, an antigen that is thought to participate in the induction of the disease. The hypoxanthine guanine phosphoribosyltransferase (hprt) clonal assay was used to determine mutant frequency values in MS patients with chronic progressive disease. Eleven of 258 thioguanine-resistant (hprt-) T cell clones from five of the six MS patients who were tested proliferated in response to human myelin basic protein without prior in vitro exposure to this antigen. No wild-type clones from these patients, nor any hprt- or wild-type clones from three healthy individuals responded to myelin basic protein. Thus, T cell clones that react with myelin basic protein can be isolated from the peripheral blood of MS patients.

Topics: Adult; Autoantigens; Cell Division; Clone Cells; Female; Humans; Hypoxanthine Phosphoribosyltransferase; Male; Middle Aged; Multiple Sclerosis; Mutation; Myelin Basic Protein; T-Lymphocytes; Thioguanine; X Chromosome

The B-cell response to myelin and myelin basic protein was studied in patients with multiple sclerosis and in patients with acute aseptic meningoencephalitis by using a nitrocellulose immunospot assay. This method allows detection of single cells producing antibodies. Twenty-seven (79%) of 34 patients with multiple sclerosis had cells producing IgG antibodies against myelin, and 11 (57%) of 19 had cells producing IgG antibodies against myelin basic protein in cerebrospinal fluid (CSF), with mean values of 30 and 14 per 10(4) mononuclear cells, respectively. Total numbers of IgG-producing cells occurred at a mean number of 75 per 10(4) CSF cells. Cells producing antimyelin or anti-myelin basic protein antibodies of IgA or IgM isotypes were rarely found in CSF. Patients with acute aseptic meningoencephalitis less frequently showed CSF cells producing IgG antibodies against myelin and myelin basic protein. No cells producing antibodies against myelin or myelin basic protein were detected in peripheral blood of patients with multiple sclerosis or meningoencephalitis. Thus, a majority of patients with multiple sclerosis had CSF cells that produced IgG antibodies against myelin and myelin basic protein. These cells comprised a large proportion of the total IgG-producing cells. A pronounced B-cell response against autoantigens produced at the target for immune attack might be important in the pathogenesis of multiple sclerosis.

Topics: Adult; Aged; Autoantibodies; Female; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Sheath

A site of DNA polymorphism linked to the myelin basic protein gene, identified as restriction fragment length polymorphism, was analyzed in a population-based study comparing patients with clinically definite multiple sclerosis (MS) and population-matched control subjects. A 0.9-kilobase (kb) genomic DNA fragment (EcoG) encompassing the first exon of the human myelin basic protein gene, located on the long arm of chromosome 18, identified ten alleles arising from a region of DNA, 1.5 kb 5' to the myelin basic protein gene first exon coding region. Produced by RsaI digests and ranging in length from 2.05 to 2.15 kb, these alleles vary in size by up to 100 base pairs due to insertion or deletion, or both, from a 1-kb length of repetitive DNA. Allele frequencies among 65 patients with MS were compared with those of 63 control subjects. Chi square for these data was significant (p less than 0.001), largely due to a preponderance in the patients with MS of alleles in the 2.14- to 2.15-kb range. Comparison of the numbers of patients with MS and control subjects bearing specific alleles showed that 45% of the patients carried at least one allele of 2.14 to 2.15 kb as opposed to 19% of control subjects (p less than 0.005). These data, while preliminary, suggest that patients with MS differ from population-matched control subjects with respect to DNA polymorphism linked to the myelin basic protein gene. Although no pathogenic relationship between this polymorphism and MS can be presupposed, this finding raises the possibility that the myelin basic protein gene or some other myelin basic protein-linked locus may be a factor in susceptibility to MS.

Topics: Adult; Aged; Female; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Polymorphism, Restriction Fragment Length

Multiple sclerosis (MS) may be an autoimmune disease mediated by T cells specific for a myelin protein. Investigations have demonstrated myelin basic protein (MBP)-reactive T cells that were activated in vivo in MS patients, suggesting that MBP may be a target antigen in MS. The variable (V) region of the T cell receptor (TCR) beta chain was examined among 83 T cell lines from both MS patients and healthy subjects that were reactive with the immunodominant region of human MBP (residues 84 to 102) or with a second immunodominant region of MBP (143 to 168). V beta 17 and to a lesser extent V beta 12 were frequently used in recognition of MBP(84-102) among different individuals. In contrast, V beta 17 was very infrequent among lines reactive with MBP (143-168). These data demonstrate shared TCR V beta gene usage for the recognition of immunodominant regions of the human autoantigen MBP. Such TCR structures may be used as targets for specific immunotherapy in MS.

Topics: Amino Acid Sequence; Base Sequence; Blotting, Southern; Epitopes; Gene Rearrangement, beta-Chain T-Cell Antigen Receptor; Humans; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Polymerase Chain Reaction; Receptors, Antigen, T-Cell; Receptors, Antigen, T-Cell, alpha-beta; T-Lymphocytes

Immunoglobulin G (IgG) was purified by affinity chromatography from the CSF of multiple sclerosis (MS) patients and controls. In MS patients, the IgG fraction contains anti-myelin basic protein (anti-MBP), anti-MBP neutralizing antibody and an antibody which inhibits neutralization of anti-MBP. Anti-MBP was detected in patients with acute relapses, anti-MBP neutralizing antibody was present in patients in clinical remission and the inhibiting antibody was detected in patients with chronically progressing MS. A myelin basic protein antibody cascade could be involved in the mechanism of MS.

Topics: Autoantibodies; Humans; Multiple Sclerosis; Myelin Basic Protein

Topics: Autoantibodies; Behcet Syndrome; Diagnosis, Differential; Humans; Multiple Sclerosis; Myelin Basic Protein; Parkinson Disease; Radioimmunoassay

A panel of 17 myelin basic protein (MBP)-specific T lymphocyte clones were generated from four multiple sclerosis (MS) patients. All T cell clones expressed CD4 phenotype and 14 clones exhibited substantial cytotoxic activity on MBP-coated target cells. T cell recognition sites of the clones on human MBP were identified by using MBP fragments and synthetic peptides. Despite the fact that at least three epitopes were defined, these T cell clones displayed a striking bias to the C-terminal peptide 149-171 independent of differences in HLA-DR and DQ expression. In addition, the T cell responses of the clones appeared to be restricted by HLA-DR molecules irrespective of peptide specificities. The present study suggests an immunodominant property of the C-terminal peptide for HLA-DR-restricted T cell responses to MBP. However, its association with encephalitogenicity in humans and its potential pathologic importance in MS await further clarification.

Topics: Amino Acid Sequence; CD4-Positive T-Lymphocytes; Clone Cells; Cytotoxicity, Immunologic; Epitopes; HLA-D Antigens; Humans; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; Phenotype; T-Lymphocytes

Myelin basic protein (MBP) is a candidate Ag for the autoimmune process believed to be involved in the pathogenesis of multiple sclerosis (MS). To investigate the fine specificity and HLA restriction of human MBP-specific CTL, long term T cell lines (TCL) were established from 22 MS patients and 16 healthy individuals by repeated antigenic restimulation. By using this approach, MBP-specific cytotoxic TCL were generated from 81% of the lines from MS patients and 69% of those from controls. TCL from both groups expressed the CD3+, CD4+, CD8- phenotype and secreted substantial amounts of IFN-gamma. By using large enzymatic and small synthetic peptides of MBP, TCL were primarily specific for the C-terminal part of the molecule and to a lesser extent for the N-terminal portion. Two regions of the molecule, MBP peptide 87-106 and MBP peptide 154-172, were recognized by the majority of the polyspecific lines and by four and three of 14 monospecific TCL, respectively. These highly immunogenic regions are of interest because they include sequences encephalitogenic in other species. The HLA restriction of each line was determined by using antibody blocking as well as various target cells including EBV-transformed B cells, homozygous typing cells, and fibroblasts transfected with cDNA for DR-alpha and DR-beta genes. All TCL were restricted by HLA-DR Ag. Several HLA-DR molecules restricted multiple cathepsin D-derived and synthetic MBP peptides, including the regions of peptides 87-106 and 154-172 which, respectively, were recognized in conjunction with four and three HLA-DR types. Three of these HLA-DR types are overrepresented in MS patients in different geographic regions. Together, these findings suggest that the MBP-specific cytotoxic T cell response, although not sufficient for disease, may be important for the pathogenesis of MS.

Topics: Amino Acid Sequence; Cathepsin D; Cytotoxicity, Immunologic; Epitopes; HLA Antigens; Humans; Lymphocyte Activation; Major Histocompatibility Complex; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; T-Lymphocytes, Cytotoxic

Multiple sclerosis is thought to be an autoimmune disease of the central nervous system mediated by T cells specific for a myelin antigen. Myelin basic protein has been studied as a potential autoantigen in the disease because of its role as an encephalitogen in experimental autoimmune encephalomyelitis and post-viral encephalomyelitis and because of the presence in the blood of multiple sclerosis patients of in vivo-activated T cells reactive to myelin basic protein. Immune involvement in multiple sclerosis has been further suggested by the association with the major histocompatibility complex class II phenotype DR2, DQw1. To define the T-cell specificity toward myelin basic protein, 15,824 short-term T-cell lines were established from multiple sclerosis subjects, subjects with other neurological diseases, and normal controls. Here we report a higher frequency of T-cell lines reactive with a DR2-associated region of myelin basic protein between residues 84-102 in patients with multiple sclerosis compared with controls. A second region, identified between residues 143-168, was recognized equally in multiple sclerosis patients and controls and was associated with the DRw11 phenotype. These DR2 and DRw11 associations were also observed among T-cell lines generated from family members of a multiple sclerosis patient. The immunodominant 84-102 peptide from myelin basic protein was both DR2- and DQw1-restricted among different T-cell lines. These results raise the possibility that this immunodominant region may be encephalitogenic in some DR2+ individuals.

Topics: Amino Acid Sequence; Antigen-Presenting Cells; Apoproteins; Autoantigens; Cells, Cultured; Epitopes; HLA-DR Antigens; Humans; In Vitro Techniques; Major Histocompatibility Complex; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; Peptide Fragments; T-Lymphocytes

Antibodies to myelin components, such as myelin basic protein (MBP), may play a role in pathogenesis of multiple sclerosis (MS) but results from determinations of anti-MBP antibodies are inconsistent. Enumeration of cells secreting antibodies represents a new approach to evaluate a specific antibody response regarding extent and localization, and reduces effects of e.g. antibody binding to target. Anti-MBP IgG antibody secreting cells were present in MS patients' cerebrospinal fluid (CSF) at a mean value of 1 per 833 cells, and they amounted to a mean value of about 2454 in the whole CSF compartment. Similar numbers were encountered in patients with other inflammatory neurological diseases (OIND). During follow-up, anti-MBP IgG antibody secreting cells persisted regarding frequency and numbers in MS, but decreased in OIND. Such cells were rarely detected in patients with tension headache. No correlations to clinical exacerbation of MS, disability or duration were discernable. In blood from MS and OIND patients, anti-MBP IgG antibody secreting cells were detected infrequently and at low numbers. The anti-MBP antibody response is strongly restricted to the IgG isotype. The anti-MBP IgG antibody response which is persistent and compartmentalized to the diseased organ, may be important for the development of MS.

Topics: Adult; Aged; Antibody-Producing Cells; Female; Headache; Humans; Immunoglobulin G; Male; Meningitis; Middle Aged; Multiple Sclerosis; Myelin Basic Protein

Reversed-phase high-performance liquid chromatography was applied to isolate myelin basic protein from human brain, followed by separation of proteolytic peptides thereof on the same chromatographic system. Brain tissue was delipidated under conditions that keep copurifying proteases inactive. The crude brain protein fraction was applied directly to a C4 column. The homogeneous protein obtained in this way was digested with thrombin and endoproteinase Lys-C in order to produce short defined myelin basic protein peptides. The purified peptides were used to determine the antigen fine specificity of myelin basic protein recognizing T lymphocyte lines isolated from multiple sclerosis patients.

Topics: Brain Chemistry; Cell Line; Chromatography, High Pressure Liquid; Endopeptidases; Humans; Lymphocyte Activation; Metalloendopeptidases; Multiple Sclerosis; Myelin Basic Protein; Nerve Tissue Proteins; Peptide Fragments; T-Lymphocytes; Thrombin

64 multiple sclerosis patients were studied for lymphocyte transformation responses to PHA, CON A, PWM and BMP. Some immunological parameter of multiple sclerosis patients, of patients with other neurological diseases and of healthy volunteers were compared. Mitogens (PHA, ConA and PWM) responsiveness of the peripheral blood mononuclear cells was significantly (P less than 0.05) diminished in multiple sclerosis patients compared to that of the blood donors. On the contrary MBP responsiveness was significantly increased after MBP exposure for 5 d. and 7 d. It was considered that the increased responsiveness was due to increased spontaneous proliferation.

Topics: Adult; Humans; Lymphocyte Activation; Middle Aged; Mitogens; Multiple Sclerosis; Myelin Basic Protein

Multiple sclerosis (MS) is a disease with unknown cause characterized by inflammation and demyelination in the central nervous system. Although an autoimmune pathogenesis has been suggested, there are no conclusive data on the number of T cells autoreactive with myelin antigens in MS compared to controls. We showed that T lymphocytes secreting interferon-gamma in response to possible target autoantigens are severalfold more common among PBL mononuclear cells in patients with MS than in patients with aseptic meningitis and tension headache. On average T cells reactive with myelin basic protein (MBP), two different MBP peptides, or with proteolipid protein amounted to 2.7-5.2/10(5) PBL from MS patients. MBP-reactive T cells were still more frequent among mononuclear cells isolated from the cerebrospinal fluid (CSF; 185/10(5) CSF cells). We concluded that T cells reactive with myelin autoantigens are strongly increased in MS. This approach to detect them could allow definition of immunodominant T cell epitopes in individual MS patients, and thereby enable further development towards specific immunotherapy.

Topics: Adult; Aged; Autoantigens; Autoimmune Diseases; Cerebrospinal Fluid; Humans; Interferon-gamma; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Myelin Proteins; Myelin Proteolipid Protein; T-Lymphocytes

We derived a total of 146 T lymphocyte lines specific for human myelin basic protein (MBP) from the peripheral blood of 20 MS patients and from a control group of 12 healthy donors, and determined the reactivities of T cell lines by [3H]thymidine incorporation on exposure to MBP and MBP peptides 1-44, 45-89, and 90-170. We defined HLA restriction of the T lines by using monoclonal antibodies against monomorphic determinants on human HLA-DR, HLA-DQ, and HLA-DP molecules. MBP-specific T cell lines could be isolated with a comparable efficiency from MS patients and healthy individuals. In both groups, MBP-specific T lymphocytes recognized at least 4 different epitopes in the MBP molecule, and specificities showed comparable patterns for different MBP peptides. MBP-specific T cell lines derived from MS patients and controls were restricted by DR products of the human major histocompatibility class II locus. Notable phenotypic differences of T cell lines existed between the 2 groups. Lines isolated from MS patients expressed predominantly the CD3+ CD4+ CD8- phenotype, while some control lines were composed of up to 87% CD3+CD4+CD8+ T lymphocytes. These findings illustrate the presence of MBP-specific T cells in MS patients and controls that are similarly sensitized to MBP and restricted by HLA-DR products.

Topics: Adult; Cell Line; Epitopes; Female; HLA-DR Antigens; Humans; Immunophenotyping; Lymphocyte Activation; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments; T-Lymphocytes

A panel of 20 human myelin basic protein (hMBP)-specific T-lymphocyte lines was generated from the peripheral blood of eight multiple sclerosis (MS) patients and two healthy donors, most of them expressing the HLA-DR2 haplotype, which is associated with an increased susceptibility to MS. Using HLA-DR gene-transfected mouse L-cell lines as antigen-presenting cells, we established that of the 20 hMBP-specific T-lymphocyte lines, 7 were restricted by the DR2a gene products of the DR2Dw2 haplotype. Four T-cell lines recognized hMBP in the context of the DR2b products of the DR2Dw2 haplotype. DR2b-restricted T-cell responses were demonstrable only in T-cell lines derived from MS patients. The hMBP epitopes presented by the DR2a heterodimer were mapped to peptides covering amino acid residues 1-44, 76-91, 131-145, or 139-153 and to a region spanning the thrombin-cleaved bond at Arg130-Ala131. DR2b-restricted T-cell lines recognized epitopes within amino acids 80-99 and 148-162. Peptide 139-153 was also presented in the context of HLA-DR1 molecules. Our data show that (i) in MS patients both the DR2a and DR2b products of the DR2Dw2 haplotype function as restriction elements for the myelin autoantigen hMBP, (ii) the DR2a molecule presents at least five different epitopes to hMBP-specific T lymphocytes, and (iii) anti-hMBP T-cell lines derived from individual donors can differ in their antigen fine specificity as well as in their HLA restriction.

Topics: Adult; Animals; Epitopes; Female; HLA-DR2 Antigen; Humans; L Cells; Major Histocompatibility Complex; Male; Mice; Multiple Sclerosis; Myelin Basic Protein; Reference Values; T-Lymphocytes; Transfection

The macrophage/monocyte procoagulant activity (MPCA) assay, a sensitive and specific in vitro test for cell-mediated immunity, has been used to ascertain the reactivity of MS peripheral blood mononuclear cells (PBM) to copolymer I (Copl), a synthetic peptide analogue of myelin basic protein (MBP) currently being tested as a possible therapeutic agent in multiple sclerosis (MS). Because the suppressive effect of Copl is believed to lie in its possible cross-reactivity with MBP, the reactivity of PBM of MS patients to MBP was also tested. MS patients either at the stable phase of the relapsing/remitting form or with chronic progressive disease were investigated and compared with patients with other diseases and with healthy subjects. The reactivity to Copl was significantly increased in patients with chronic progressive disease but not in stable MS patients or in control subjects. No difference in reactivity to MBP between MS patients and healthy subjects was found regardless of disease status. However, in the control group comprising patients with other diseases, MBP reactivity was significantly elevated. In chronic progressive MS patients, a relationship was found between the response to Copl and that to MBP, supporting the possibility of an immunological cross-reactivity between these two antigens. There was no significant difference in reactivity to the non-specific stimulant, lipopolysaccharide, between the MS and control groups.

Topics: Adult; Aged; Blood Coagulation Factors; Female; Humans; Immunity, Cellular; In Vitro Techniques; Macrophages; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Peptides; T-Lymphocytes

Myelin basic protein (MBP)-like material in 15 cerebrospinal fluid (CSF) samples from patients with multiple sclerosis (MS) was analyzed by isoelectric focusing (IEF) followed by immunoblot assay using rabbit antiserum against human MBP- peptide 69-89, which contains the dominant epitope for MBP-like material. Samples from seven of 10 MS patients with disease in the exacerbation stage showed one band and in three other samples, a number of faint bands also appeared in the alkaline pH region in addition to the one band. CSF from five MS patients whose disease was in remission showed no detectable bands. Our results are consistent with those obtained by quantitative assay, reported in the literature.

Topics: Amino Acid Sequence; Epitopes; Humans; Immune Sera; Immunoblotting; Isoelectric Focusing; Molecular Sequence Data; Multiple Sclerosis; Myelin Basic Protein; Peptide Fragments

Cerebrospinal fluid (CSF) and sera from 17 patients with primary Sjögren's syndrome (PSS) with or without clinical evidence of nervous system involvement were studied. Intrathecal IgG synthesis as measured by oligoclonal IgG bands on agarose isoelectric focusing or elevated IgG index in CSF was found in 6 of 8 patients with clinical nervous system involvement but also in 5 of 9 patients without clinical nervous system involvement. Elevated IgM-index in CSF was found in 7 of 8 patients with clinical nervous system involvement and in 6 of 9 patients without clinical nervous system involvement. By immunoblotting, CSF IgG-antibodies against myelin basic protein (MBP) were found in 3 of 12 patients with multiple sclerosis (MS), but in none of the patients with PSS or in the 12 controls. Intrathecal anti-viral IgG-antibodies, as measured by immunoblotting against measles, mumps, varicella or herpes simplex, were found in 8 of 17 patients with PSS, and in 7 of 12 patients with MS, but were not detected in the controls. Our observations support the concept that the central nervous system (CNS) is included in the multiple immunological phenomena of PSS. Interestingly, in some PSS patients intrathecal IgG synthesis occurred without overt clinical nervous system involvement and thus the clinical significance of intrathecal IgG synthesis in PSS is uncertain. The similarities with MS regarding intrathecal antiviral antibody production may be interpreted as the result of polyclonal B-cell activation.

Topics: Adult; Aged; Antibodies, Viral; Autoantibodies; Autoimmune Diseases; Headache; Humans; Immunoglobulin G; Immunoglobulin M; Lymphocyte Activation; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Nervous System Diseases; Sjogren's Syndrome

Cerebrospinal fluids and paired serums from 23 patients with multiple sclerosis (MS) were studied for intrathecal synthesis of oligoclonal band and antimyelin basic protein (MBP) antibody. Three parameters for anti-MBP antibody were designed to represent three different pathophysiological meanings, including value, index and ratio of anti-MBP antibody. Oligoclonal band was detected by agarose gel electrophoresis in 23 MS patients, and anti-MBP was assayed by enzyme-linked immunosorbent assay in 11 MS patients to investigate these anti-MBP parameters in MS group and non-inflammatory control group. The anti-MBP assay revealed that intrathecal anti-MBP antibody production was increased during active stage of MS. However, anti-MBP antibody production correlated poorly with the IgG index, nor was it conspicuously higher than IgG production. This might imply that, except for MBP, still other protein components are involved in this immune process.

Topics: Adolescent; Adult; Aged; Antibodies; Female; Humans; Immunoglobulin G; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein