Department of Microbiology, Infectious Diseases, and Immunology, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.
Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.
J Clin Invest. 2018 May 1;128(5):2000-2009. doi: 10.1172/JCI97098. Epub 2018 Apr 9.
Rasmussen's encephalitis (RE) is a chronic inflammatory brain disorder that causes frequent seizures and unilateral hemispheric atrophy with progressive neurological deficits. Hemispherectomy remains the only treatment that leads to seizure freedom for this refractory epileptic syndrome. The absence of an animal model of disease has been a major obstacle hampering the development of effective therapies. Here, we describe an experimental mouse model that shares several clinical and pathological features with the human disease. Immunodeficient mice injected with peripheral blood mononuclear cells from RE patients and monitored by video electroencephalography developed severe seizures of cortical origin and showed intense astrogliosis and accumulation of human IFN-γ- and granzyme B-expressing T lymphocytes in the brain compared with mice injected with immune cells from control subjects. We also provide evidence for the efficacy of α4 integrin blockade, an approved therapy for the treatment of multiple sclerosis and Crohn's disease, in reducing inflammatory markers associated with RE in the CNS. This model holds promise as a valuable tool for understanding the pathology of RE and for developing patient-tailored experimental therapeutics.
拉森氏脑炎(RE)是一种慢性炎症性脑疾病,可导致频繁发作和单侧大脑半球萎缩,并伴有进行性神经功能缺损。对于这种难治性癫痫综合征,半球切除术仍然是唯一能实现无癫痫发作的治疗方法。疾病动物模型的缺失一直是阻碍有效治疗方法发展的主要障碍。在这里,我们描述了一种实验性小鼠模型,该模型具有与人类疾病相似的临床和病理学特征。用来自 RE 患者的外周血单核细胞注射免疫缺陷小鼠,并通过视频脑电图监测,与用对照供体免疫细胞注射的小鼠相比,这些小鼠会发展出严重的皮质起源癫痫发作,并显示出强烈的星形胶质增生,以及大量表达 IFN-γ 和颗粒酶 B 的人类 T 淋巴细胞在大脑中的积累。我们还提供了证据,证明α4 整合素阻断(一种用于治疗多发性硬化症和克罗恩病的已批准疗法)可降低与 CNS 中的 RE 相关的炎症标志物。该模型有望成为理解 RE 病理学和开发针对患者的实验性治疗方法的有价值工具。