Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Glia. 2011 Mar;59(3):452-62. doi: 10.1002/glia.21114. Epub 2010 Dec 29.
Osmotic demyelination syndrome (ODS) is a serious demyelinating disease in the central nervous system usually caused by rapid correction of hyponatremia. In an animal model of ODS, we previously reported microglial accumulation expressing proinflammatory cytokines. Microglia and astrocytes secreting proinflammatory cytokines and neurotrophic factors are reported to be involved in the pathogenesis of demyelinative diseases. Therefore, to clarify the role of microglial and astrocytic function in ODS, we examined the time-dependent changes in distribution, morphology, proliferation, and mRNA/protein expression of proinflammatory cytokines, neurotrophic factors, and matrix metalloproteinase (MMP) in microglia and astrocytes 2 days (early phase) and 5 days (late phase) after the rapid correction of hyponatremia in ODS rats. The number of microglia time dependently increased at demyelinative lesion sites, proliferated, and expressed tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, inducible nitric oxide synthase, and MMP2, 9, and 12 at the early phase. Microglia also expressed leukemia inhibitory factor (a neurotrophic factor) and phagocytosed myelin debris at the late phase. The number of astrocytes time dependently increased around demyelinative lesions, extended processes to lesions, proliferated, and expressed nerve growth factor and glial cell line-derived neurotrophic factor at the late phase. Moreover, treatment with infliximab, a monoclonal antibody against TNF-α, significantly attenuated neurological impairments. Our results suggest that the role of microglia in ODS is time dependently shifted from detrimental to protective and that astrocytes play a protective role at the late phase. Modulation of excessive proinflammatory responses in microglia during the early phase after rapid correction may represent a therapeutic target for ODS.
渗透压性脱髓鞘综合征(ODS)是一种中枢神经系统的严重脱髓鞘疾病,通常由低钠血症的快速纠正引起。在 ODS 的动物模型中,我们之前报道了表达促炎细胞因子的小胶质细胞积累。据报道,分泌促炎细胞因子和神经营养因子的小胶质细胞和星形胶质细胞参与脱髓鞘疾病的发病机制。因此,为了阐明小胶质细胞和星形胶质细胞功能在 ODS 中的作用,我们检查了快速纠正 ODS 大鼠低钠血症后 2 天(早期)和 5 天(晚期)小胶质细胞和星形胶质细胞中促炎细胞因子、神经营养因子和基质金属蛋白酶(MMP)的分布、形态、增殖和 mRNA/蛋白表达的时间依赖性变化。在脱髓鞘病变部位,小胶质细胞数量随时间增加,增殖,并在早期表达肿瘤坏死因子(TNF)-α、白细胞介素(IL)-1β、IL-6、诱导型一氧化氮合酶和 MMP2、9 和 12。小胶质细胞在晚期还表达白血病抑制因子(一种神经营养因子)并吞噬髓鞘碎片。星形胶质细胞数量随时间在脱髓鞘病变周围增加,延伸突起至病变部位,在晚期增殖并表达神经生长因子和胶质细胞源性神经营养因子。此外,使用抗 TNF-α的单克隆抗体 infliximab 治疗可显著减轻神经功能障碍。我们的结果表明,小胶质细胞在 ODS 中的作用随时间从有害转变为保护,星形胶质细胞在晚期发挥保护作用。在快速纠正后早期过度的促炎反应的调节可能是 ODS 的治疗靶点。