Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287.
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287.
Proc Natl Acad Sci U S A. 2018 Feb 27;115(9):2186-2191. doi: 10.1073/pnas.1719902115. Epub 2018 Feb 12.
Multiple sclerosis (MS) is an inflammatory disorder targeting the central nervous system (CNS). The relapsing-remitting phase of MS is largely driven by peripheral activation of autoreactive T-helper (Th) 1 and Th17 lymphocytes. In contrast, compartmentalized inflammation within the CNS, including diffuse activation of innate myeloid cells, characterizes the progressive phase of MS, the most debilitating phase that currently lacks satisfactory treatments. Recently, bryostatin-1 (bryo-1), a naturally occurring, CNS-permeable compound with a favorable safety profile in humans, has been shown to act on antigen-presenting cells to promote differentiation of lymphocytes into Th2 cells, an action that might benefit Th1-driven inflammatory conditions such as MS. In the present study, we show that bryo-1 provides marked benefit in mice with experimental autoimmune encephalomyelitis (EAE), an experimental MS animal model. Preventive treatment with bryo-1 abolishes the onset of neurologic deficits in EAE. More strikingly, bryo-1 reverses neurologic deficits after EAE onset, even when treatment is initiated at a late stage of disease when peak adaptive immunity has subsided. Treatment with bryo-1 in vitro promotes an anti-inflammatory phenotype in antigen-presenting dendritic cells, macrophages, and to a lesser extent, lymphocytes. These findings suggest the potential for bryo-1 as a therapeutic agent in MS, particularly given its established clinical safety. Furthermore, the benefit of bryo-1, even in late treatment of EAE, combined with its targeting of innate myeloid cells suggests therapeutic potential in progressive forms of MS.
多发性硬化症(MS)是一种针对中枢神经系统(CNS)的炎症性疾病。MS 的复发缓解期主要由自身反应性辅助性 T 细胞(Th)1 和 Th17 淋巴细胞在外周的激活驱动。相比之下,CNS 内的局灶性炎症,包括固有髓样细胞的弥漫性激活,是 MS 进展期的特征,这是目前缺乏满意治疗方法的最具致残性阶段。最近,苔藓虫内酯-1(bryo-1),一种天然存在的、可穿透 CNS 的化合物,在人类中具有良好的安全性,已被证明作用于抗原呈递细胞,促进淋巴细胞向 Th2 细胞分化,这种作用可能有益于 Th1 驱动的炎症性疾病,如 MS。在本研究中,我们表明 bryo-1 在实验性自身免疫性脑脊髓炎(EAE)小鼠中具有显著的益处,EAE 是一种 MS 动物模型。预防性 bryo-1 治疗可消除 EAE 小鼠神经功能缺陷的发生。更引人注目的是,即使在疾病的晚期(当适应性免疫已经消退时)开始治疗,bryo-1 也能逆转 EAE 后的神经功能缺陷。体外 bryo-1 治疗可促进抗原呈递树突状细胞、巨噬细胞以及在较小程度上的淋巴细胞的抗炎表型。这些发现表明 bryo-1 作为 MS 的治疗药物具有潜在的可能性,特别是鉴于其已确立的临床安全性。此外,bryo-1 的益处,即使在 EAE 的晚期治疗中,加上其针对固有髓样细胞的作用,提示其在 MS 的进行性形式中具有治疗潜力。