Liu Li, Yang Lina, Du Xinke, Kan Xiaoxi, Ran Qingsen, Zhang Yang, Li Manjing, Liu Qingwu, Li Yujie, Yang Qing, Chen Ying, Dong Keshan, Zhu Xiaoxin, Li Qi
State Key Laboratory for Quality Ensurance and Sustainable Use of Dao-Di Herbs, Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
State Key Laboratory of Respiratory Health and Multimorbidity, Ministry of Health, Laboratory of Oncology, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100050, China.
J Neuroinflammation. 2025 Aug 1;22(1):197. doi: 10.1186/s12974-025-03510-7.
BACKGROUND: Boosting myelin repair is widely recognized as one of the most powerful approaches for demyelinating therapy, essentially contributing to the recovery of neurological functions. Maintaining immune homeostasis in microglia is a prerequisite for creating a reparative environment for myelin. Dihydroartemisinin (DHA) is clinically effective in reshaping immunological status and implies potential in treating demyelinating disease. However, its relevance to pro-remyelination remains unclear. METHODS: We first evaluated the effects of DHA on neurofunctional recovery and white matter integrity in chronic experimental autoimmune encephalomyelitis (EAE), an ideal model for secondary progressive multiple sclerosis (SPMS) characterized by remyelination deficiency. Single-cell sequencing and microglial depletion with PLX3397 in vivo were used to reveal the dependency between DHA and microglia. The effect of DHA on the reparative phenotype of microglia, particularly on cholesterol recycling and differentiation of oligodendrocyte progenitor cells (OPCs), was evaluated in microglia-OPCs unit either in vitro or in vivo challenged with myelin debris. Finally, to broaden the clinical application for DHA in myelin repair, it was tested in the cuprizone (CPZ) model which shows remyelination failure, a condition common in various neurodegenerative diseases. RESULTS: We demonstrated for the first time that DHA enhanced white matter integrity and OPCs proliferation and differentiation. This effect is dependent on the transition of microglia to a reparative phenotype. Specifically, DHA increased the secretion of inflammatory-resolving and neurotrophic cytokines. It further functionalized cholesterol recycling and provided metabolic support for myelin regeneration predominantly mediated by liver X receptor (LXR) in microglia. This was evidenced by the promotion of myelin debris uptake, cholesterol catabolism, efflux and transport. Notably, DHA promoted remyelination and neurological functional recovery in CPZ-induced demyelinating model, supporting its potential application in neurodegenerative diseases featuring insufficient remyelination. CONCLUSION: By highlighting the importance of microglia in promoting myelin regeneration, our study proved DHA as a promising candidate for promoting remyelination.
背景:促进髓鞘修复被广泛认为是脱髓鞘治疗最有效的方法之一,对神经功能的恢复至关重要。维持小胶质细胞的免疫稳态是为髓鞘形成修复环境的前提条件。双氢青蒿素(DHA)在重塑免疫状态方面具有临床疗效,提示其在治疗脱髓鞘疾病方面具有潜力。然而,其与促髓鞘再生的相关性尚不清楚。 方法:我们首先评估了DHA对慢性实验性自身免疫性脑脊髓炎(EAE)神经功能恢复和白质完整性的影响,EAE是继发进展型多发性硬化症(SPMS)的理想模型,其特征为髓鞘再生缺陷。采用单细胞测序和体内用PLX3397清除小胶质细胞来揭示DHA与小胶质细胞之间的依赖性。在体外或体内用髓鞘碎片刺激的小胶质细胞-少突胶质前体细胞(OPC)单元中,评估了DHA对小胶质细胞修复表型的影响,特别是对胆固醇循环和OPC分化的影响。最后,为了拓宽DHA在髓鞘修复中的临床应用,在铜螯合剂(CPZ)模型中进行了测试,该模型显示髓鞘再生失败,这是各种神经退行性疾病中常见的情况。 结果:我们首次证明DHA增强了白质完整性以及OPC的增殖和分化。这种作用依赖于小胶质细胞向修复表型的转变。具体而言,DHA增加了炎症消退和神经营养细胞因子的分泌。它进一步使胆固醇循环功能化,并主要通过小胶质细胞中的肝脏X受体(LXR)为髓鞘再生提供代谢支持。这通过促进髓鞘碎片摄取、胆固醇分解代谢、流出和转运得到证明。值得注意的是,DHA促进了CPZ诱导的脱髓鞘模型中的髓鞘再生和神经功能恢复,支持了其在髓鞘再生不足的神经退行性疾病中的潜在应用。 结论:通过强调小胶质细胞在促进髓鞘再生中的重要性,我们的研究证明DHA是促进髓鞘再生的有希望的候选药物。
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