Ganz Tal, Zveik Omri, Fainstein Nina, Lachish Marva, Rechtman Ariel, Sofer Lihi, Brill Livnat, Ben-Hur Tamir, Vaknin-Dembinsky Adi
Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
The Department of Neurology and Laboratory of Neuroimmunology, The Agnes-Ginges Center for Human Neurogenetics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Glia. 2023 Dec;71(12):2815-2831. doi: 10.1002/glia.24453. Epub 2023 Aug 23.
Remyelination failure is considered a major obstacle in treating chronic-progressive multiple sclerosis (MS). Studies have shown blockage in the differentiation of resident oligodendrocyte progenitor cells (OPC) into myelin-forming cells, suggesting that pushing OPC into a differentiation program might be sufficient to overcome remyelination failure. Others stressed the need for a permissive environment to allow proper activation, migration, and differentiation of OPC. PD0325901, a MAPK/ERK inhibitor, was previously shown to induce OPC differentiation, non-specific immunosuppression, and a significant therapeutic effect in acute demyelinating MS models. We examined PD0325901 effects in the chronically inflamed central nervous system. Treatment with PD0325901 induced OPC differentiation into mature oligodendrocytes with high morphological complexity. However, treatment of Biozzi mice with chronic-progressive experimental autoimmune encephalomyelitis with PD0325901 showed no clinical improvement in comparison to the control group, no reduction in demyelination, nor induction of OPC migration into foci of demyelination. PD0325901 induced a direct general immunosuppressive effect on various cell populations, leading to a diminished phagocytic capability of microglia and less activation of lymph-node cells. It also significantly impaired the immune-modulatory functions of OPC. Our findings suggest OPC regenerative function depends on a permissive environment, which may include pro-regenerative inflammatory elements. Furthermore, they indicate that maintaining a delicate balance between the pro-myelinating and immune functions of OPC is of importance. Thus, the highly complex mission of creating a pro-regenerative environment depends upon an appropriate immune response controlled in time, place, and intensity. We suggest the need to employ a multi-systematic therapeutic approach, which cannot be achieved through a single molecule-based therapy.
髓鞘再生失败被认为是治疗慢性进行性多发性硬化症(MS)的主要障碍。研究表明,驻留少突胶质前体细胞(OPC)向形成髓鞘细胞的分化受阻,这表明促使OPC进入分化程序可能足以克服髓鞘再生失败。其他人则强调需要一个允许的环境,以允许OPC进行适当的激活、迁移和分化。PD0325901是一种MAPK/ERK抑制剂,先前已证明它能诱导OPC分化、非特异性免疫抑制,并在急性脱髓鞘MS模型中产生显著的治疗效果。我们研究了PD0325901在慢性炎症中枢神经系统中的作用。用PD0325901治疗可诱导OPC分化为形态复杂性高的成熟少突胶质细胞。然而,与对照组相比,用PD0325901治疗慢性进行性实验性自身免疫性脑脊髓炎的Biozzi小鼠,临床症状没有改善,脱髓鞘没有减少,也没有诱导OPC迁移到脱髓鞘病灶。PD0325901对各种细胞群体产生直接的一般免疫抑制作用,导致小胶质细胞的吞噬能力减弱,淋巴结细胞的激活减少。它还显著损害了OPC的免疫调节功能。我们的研究结果表明,OPC的再生功能取决于一个允许的环境,其中可能包括促再生的炎症成分。此外,它们表明在OPC的促髓鞘形成和免疫功能之间保持微妙的平衡很重要。因此,创造一个促再生环境的高度复杂任务取决于在时间、地点和强度上得到控制的适当免疫反应。我们建议需要采用多系统治疗方法,这是基于单一分子的治疗无法实现的。