Wootla Bharath, Denic Aleksandar, Watzlawik Jens O, Warrington Arthur E, Rodriguez Moses
Departments of Neurology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA.
Mayo Clinic Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Mol Neurobiol. 2016 Oct;53(8):5217-28. doi: 10.1007/s12035-015-9436-3. Epub 2015 Sep 26.
Demyelination underlies early neurological symptoms in multiple sclerosis (MS); however, axonal damage is considered critical for permanent chronic deficits. The precise mechanisms by which axonal injury occurs in MS are unclear; one hypothesis is the absence or failure of remyelination, suggesting that promoting remyelination may protect axons from death. This report provides direct evidence that promoting oligodendrocyte remyelination protects axons and maintains transport function. Persistent Theiler's virus infection of Swiss Jim Lambert (SJL)/J mice was used as a model of MS to assess the effects of remyelination on axonal injury following demyelination in the spinal cord. Remyelination was induced using an oligodendrocyte/myelin-specific recombinant human monoclonal IgM, rHIgM22. The antibody is endowed with strong anti-apoptotic and pro-proliferative effects on oligodendrocyte progenitor cells. We used (1)H-magnetic resonance spectroscopy (MRS) at the brainstem to measure N-acetyl-aspartate (NAA) as a surrogate of neuronal health and spinal cord integrity. We found increased brainstem NAA concentrations at 5 weeks post-treatment with rHIgM22, which remained stable out to 10 weeks. Detailed spinal cord morphology studies revealed enhanced remyelination in the rHIgM22-treated group but not in the isotype control antibody- or saline-treated groups. Importantly, we found rHIgM22-mediated remyelination protected small- and medium-caliber mid-thoracic spinal cord axons from damage despite similar demyelination and inflammation across all experimental groups. The most direct confirmation of remyelination-mediated protection of descending neurons was an improvement in retrograde transport. Treatment with rHIgM22 significantly increased the number of retrograde-labeled neurons in the brainstem, indicating that preserved axons are functionally competent. This is direct validation that remyelination preserves spinal cord axons and protects functional axon integrity.
脱髓鞘是多发性硬化症(MS)早期神经症状的基础;然而,轴突损伤被认为是导致永久性慢性功能缺陷的关键因素。MS中轴突损伤发生的确切机制尚不清楚;一种假说是髓鞘再生的缺失或失败,这表明促进髓鞘再生可能保护轴突免于死亡。本报告提供了直接证据,表明促进少突胶质细胞髓鞘再生可保护轴突并维持运输功能。将瑞士吉姆·兰伯特(SJL)/J小鼠持续感染泰勒氏病毒用作MS模型,以评估髓鞘再生对脊髓脱髓鞘后轴突损伤的影响。使用少突胶质细胞/髓鞘特异性重组人单克隆IgM(rHIgM22)诱导髓鞘再生。该抗体对少突胶质细胞祖细胞具有强大的抗凋亡和促增殖作用。我们使用脑干的氢磁共振波谱(MRS)测量N-乙酰天门冬氨酸(NAA),作为神经元健康和脊髓完整性的替代指标。我们发现,用rHIgM22治疗5周后脑干NAA浓度升高,并在10周内保持稳定。详细的脊髓形态学研究显示,rHIgM22治疗组的髓鞘再生增强,而同型对照抗体或生理盐水治疗组则没有。重要的是,我们发现rHIgM22介导的髓鞘再生保护了胸段脊髓中小口径轴突免受损伤,尽管所有实验组的脱髓鞘和炎症情况相似。髓鞘再生介导的对下行神经元保护的最直接证据是逆行运输的改善。用rHIgM22治疗显著增加了脑干中逆行标记神经元的数量,表明保留的轴突在功能上是正常的。这直接验证了髓鞘再生可保留脊髓轴突并保护功能性轴突完整性。