Grupo de Neuroinmuno-Reparación, Hospital Nacional de Parapléjicos, Finca La Peraleda s/n, 45071 Toledo, Spain; Grupo de Neurobiología del Desarrollo-GNDe, Instituto Cajal-CSIC, Avenida Doctor Arce 37, 28002 Madrid, Spain.
Grupo de Neuroinmuno-Reparación, Hospital Nacional de Parapléjicos, Finca La Peraleda s/n, 45071 Toledo, Spain.
Neurobiol Dis. 2020 Jul;140:104869. doi: 10.1016/j.nbd.2020.104869. Epub 2020 Apr 9.
Multiple Sclerosis (MS) is the second cause of paraplegia among young adults, after all types of CNS traumatic lesions. In its most frequent relapsing-remitting form, the severity of the disease course is very heterogeneous, and its reliable evaluation remains a key issue for clinicians. Myeloid-Derived sSuppressor Cells (MDSCs) are immature myeloid cells that suppress the inflammatory response, a phenomenon related to the resolution or recovery of the clinical symptoms associated with experimental autoimmune encephalomyelitis (EAE), the most common model for MS. Here, we establish the severity index as a new parameter for the clinical assessment in EAE. It is derived from the relationship between the maximal clinical score and the time elapsed since disease onset. Moreover, we relate this new index with several histopathological hallmarks in EAE and with the peripheral content of MDSCs. Based on this new parameter, we show that the splenic MDSC content is related to the evolution of the clinical course of EAE, ranging from mild to severe. Indeed, when the severity index indicates a severe disease course, EAE mice display more intense lymphocyte infiltration, demyelination and axonal damage. A direct correlation was drawn between the MDSC population in the peripheral immune system, and the preservation of myelin and axons, which was also correlated with T cell apoptosis within the CNS (being these cells the main target for MDSC suppression). The data presented clearly indicated that the severity index is a suitable tool to analyze disease severity in EAE. Moreover, our data suggest a clear relationship between circulating MDSC enrichment and disease outcome, opening new perspectives for the future targeting of this population as an indicator of MS severity.
多发性硬化症(MS)是年轻人除中枢神经系统创伤性病变以外导致截瘫的第二大病因。在其最常见的复发缓解型中,疾病过程的严重程度非常不均匀,其可靠评估仍然是临床医生的关键问题。髓源性抑制细胞(MDSCs)是不成熟的髓样细胞,可抑制炎症反应,这种现象与实验性自身免疫性脑脊髓炎(EAE)相关的临床症状的缓解或恢复有关,EAE 是 MS 最常见的模型。在这里,我们将严重度指数确立为 EAE 临床评估的新参数。它源自最大临床评分与疾病发病以来时间的关系。此外,我们将该新指标与 EAE 中的几种组织病理学特征以及外周 MDSC 含量相关联。基于该新参数,我们表明脾脏 MDSC 含量与 EAE 临床病程的演变有关,从轻度到重度。实际上,当严重度指数指示疾病严重程度时,EAE 小鼠表现出更强烈的淋巴细胞浸润、脱髓鞘和轴突损伤。在外周免疫系统中 MDSC 群体与髓鞘和轴突的保存之间存在直接相关性,这也与中枢神经系统内 T 细胞凋亡相关(这些细胞是 MDSC 抑制的主要靶标)。呈现的数据清楚地表明,严重度指数是分析 EAE 疾病严重程度的合适工具。此外,我们的数据表明循环 MDSC 富集与疾病结局之间存在明确的关系,为将来将该群体作为 MS 严重程度的指标进行靶向治疗开辟了新的前景。