Division of Neuroimmunology and Neurological Infections, Johns Hopkins Hospital, Pathology Building 509, 600 N. Wolfe St., Baltimore, Md, 21287, USA.
Solomon H. Snyder Department of Neuroscience, Johns Hopkins University, Baltimore, MD, 21205, USA.
Acta Neuropathol. 2021 Nov;142(5):899-915. doi: 10.1007/s00401-021-02366-4. Epub 2021 Sep 6.
Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system (CNS) characterized by varying degrees of secondary neurodegeneration. Retinal ganglion cells (RGC) are lost in MS in association with optic neuritis but the mechanisms of neuronal injury remain unclear. Complement component C3 has been implicated in retinal and cerebral synaptic pathology that may precede neurodegeneration. Herein, we examined post-mortem MS retinas, and then used a mouse model, experimental autoimmune encephalomyelitis (EAE), to examine the role of C3 in the pathogenesis of RGC loss associated with optic neuritis. First, we show extensive C3 expression in astrocytes (C3/GFAP cells) and significant RGC loss (RBPMS cells) in post-mortem retinas from people with MS compared to retinas from non-MS individuals. A patient with progressive MS with a remote history of optic neuritis showed marked reactive astrogliosis with C3 expression in the inner retina extending into deeper layers in the affected eye more than the unaffected eye. To study whether C3 mediates retinal degeneration, we utilized global C3 EAE mice and found that they had less RGC loss and partially preserved neurites in the retina compared with C3 EAE mice. C3 EAE mice had fewer axonal swellings in the optic nerve, reflecting reduced axonal injury, but had no changes in demyelination or T cell infiltration into the CNS. Using a C3-tdTomato reporter mouse line, we show definitive evidence of C3 expression in astrocytes in the retina and optic nerves of EAE mice. Conditional deletion of C3 in astrocytes showed RGC protection replicating the effects seen in the global knockouts. These data implicate astrocyte C3 expression as a critical mediator of retinal neuronal pathology in EAE and MS, and are consistent with recent studies showing C3 gene variants are associated with faster rates of retinal neurodegeneration in human disease.
多发性硬化症(MS)是一种中枢神经系统(CNS)的炎症性脱髓鞘疾病,其特征是继发性神经退行性变的程度不同。在 MS 中,与视神经炎相关的视网膜神经节细胞(RGC)丢失,但神经元损伤的机制仍不清楚。补体成分 C3 已被牵连到视网膜和大脑突触病理学中,这些可能先于神经退行性变。在此,我们检查了 MS 死后的视网膜,然后使用了一种小鼠模型,实验性自身免疫性脑脊髓炎(EAE),来研究 C3 在与视神经炎相关的 RGC 丢失的发病机制中的作用。首先,我们发现大量的 C3 在星形胶质细胞(C3/GFAP 细胞)中表达,并且与非 MS 个体的视网膜相比,MS 患者的死后视网膜中的 RGC 丢失(RBPMS 细胞)显著。一名患有进行性 MS 的患者,其病史中有视神经炎,在受影响的眼中,内层的 C3 表达明显的反应性星形胶质增生,并延伸到更深的层,而在未受影响的眼中则没有。为了研究 C3 是否介导视网膜变性,我们利用了全局 C3 EAE 小鼠,并发现与 C3 EAE 小鼠相比,它们的 RGC 丢失更少,并且视网膜中的神经突部分得到保留。C3 EAE 小鼠的视神经中轴突肿胀较少,反映了轴突损伤减少,但脱髓鞘或 T 细胞浸润到中枢神经系统没有变化。使用 C3-tdTomato 报告小鼠系,我们在 EAE 小鼠的视网膜和视神经中明确地证明了 C3 在星形胶质细胞中的表达。星形胶质细胞中 C3 的条件性缺失显示出对 RGC 的保护,复制了在全局敲除中观察到的效果。这些数据表明,星形胶质细胞中的 C3 表达是 EAE 和 MS 中视网膜神经元病理学的关键介质,并且与最近的研究一致,这些研究表明 C3 基因变体与人疾病中的视网膜神经退行性变的更快速度相关。