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A Compston

Publications and source records attributed to A Compston.

At least 19 recordsLinked to original sources
PubMed1997

Empirical genomewide significance levels established by whole genome simulations.

The advent of high-resolution genetic maps and semiautomated genotyping technology has opened the way for genome screening in genetically complex traits. Many such screens are now under way, or completed, most using multipoint nonparametric linkage analysis of affected sibling pairs. This type of linkage analysis uses all the available genotype information to calculate the maximum lod score (MLS) value at each point in the genome, and thereby generates MLS profiles along each chromosome. Any positive MLS values indicate potential linkage, but the peaks in these profiles, which may be referred to as "hits," identify the most likely locations of disease susceptibility genes. However, such analysis presents serious problems of multiple testing, and the assessment of the statistical significance of hits has become a contentious issue [Lander and Kruglyak (1995) Nat Genet 11:241-247; Curtis (1996) Nat Genet 12:356-357; Witte et al. (1996) Nat Genet 12:355-356]. Having recently completed a genome screen in multiple sclerosis, we decided to investigate the statistical properties of our study by simulation. We report here in detail the results of this simulation study. Our main conclusion is that, for the particular set of families and markers used in our screen, an MLS of 3.2 carries a genome-wide significance of 5% (that is, there is a 5% probability of observing at least one false hit, above this threshold in a complete genome screen). This value is closer to the familiar limit of 3.0, originally suggested by Morton [1955; Am J Hum Genet 7:277-318] than to the more stringent limit of 4.0 recently proposed by Lander and Kruglyak [1995; Nat Genet 11:241-247]. This is somewhat reassuring, in view of the very large sample sizes that would be necessary to achieve adequate power to detect linkage at the more stringent threshold.

Female↗
PubMed1997

Beta-interferon and multiple sclerosis.

Interferon-beta (IFN-beta) is the first therapeutic intervention shown to alter the natural history of multiple sclerosis (MS), a relapsing then progressive inflammatory degenerative disease of the CNS. Since publication of the first randomized placebo-controlled trial of IFN-beta, and subsequent acquisition of US and European product licences for use in relapsing-remitting MS, the hopes and expectations of patients have been elevated greatly only to be dampened as more critical analysis of the trial results, in conjunction with the cost of treatment, led to marked limitations on prescription in several countries. IFN-beta is not a cure. Here we review what is known about the mechanisms of action of IFN-beta in demyelinating disease, and propose a possible model of action of IFN-beta in the treatment of MS.

Humans↗
PubMed1997

The genetic analysis of multiple sclerosis.

Although monogenic diseases often show extreme clinical phenotypes, the major burden of genetic ill health lies in the more prevalent polygenic disorders, such as diabetes, hypertension and multiple sclerosis. These conditions affect many thousands of individuals and their management consumes vast amounts of health care resources: in the UK some 80,000 people have multiple sclerosis; the estimated financial cost to society of introducing treatments, such as beta interferon, could be as high as 250 million pounds per year. Knowledge on the genetics of these common diseases is poor, but has potentially received a considerable boost with the arrival of whole genome screening. The genome screen in insulin-dependent diabetes mellitus (IDDM) reported in 1994 was the first in a human polygenic disease. Since this publication, whole genome screening has been performed in a variety of human polygenic diseases, including schizophrenia, bipolar affective disorder, non-insulin-dependent diabetes mellitus (NIDDM), inflammatory bowel disease, asthma and multiple sclerosis.

Americas↗
PubMed1997

Glial lineages and myelination in the central nervous system.

Oligodendrocytes, derived from stem cell precursors which arise in subventricular zones of the developing central nervous system, have as their specialist role the synthesis and maintenance of myelin. Astrocytes contribute to the cellular architecture of the central nervous system and act as a source of growth factors and cytokines; microglia are bone-marrow derived macrophages which function as primary immunocompetent cells in the central nervous system. Myelination depends on the establishment of stable relationships between each differentiated oligodendrocyte and short segments of several neighbouring axons. There is growing evidence, especially from studies of glial cell implantation, that oligodendrocyte precursors persist in the adult nervous system and provide a limited capacity for the restoration of structure and function in myelinated pathways damaged by injury or disease.

Adult↗
PubMed1996

Mechanism of first-dose cytokine-release syndrome by CAMPATH 1-H: involvement of CD16 (FcgammaRIII) and CD11a/CD18 (LFA-1) on NK cells.

The administration of the immunosuppressive humanized monoclonal antibody CAMPATH 1-H, which recognizes CD52 on lymphocytes and monocytes, is associated with a first-dose cytokine-release syndrome involving TNFalpha, IFNgamma, and IL-6 clinically. In vitro models have been used to establish the cellular source and mechanism responsible for cytokine release, demonstrating that cytokine release is isotype dependent, with the rat IgG2b and human IgG1 isotype inducing the highest levels of cytokine release, which was inhibited with antibody to CD16, the low affinity Fc-receptor for IgG (FcgammaR). Cross-linking antibody opsonized CD4 T lymphocytes failed to stimulate TNFalpha release, which together with the observation that TNFalpha release by purified natural killer (NK) cells stimulated by fixed autologous CAMPATH 1-H-opsonized targets was inhibited with anti-CD16, indicates that cytokine release results from ligation of CD16 on the NK cells, rather than Fc-receptor (FcR)-dependent cross-linking of CD52 on the targeted cell. Since the hierarchy of isotypes inducing cytokine release in these cultures matches that seen clinically, we conclude that ligation of CD16 on NK cells is also responsible for cytokine release after injection of CAMPATH 1-H in vivo.

Alemtuzumab↗
PubMed1996

A genome screen in multiple sclerosis reveals susceptibility loci on chromosome 6p21 and 17q22.

The population prevalence of multiple sclerosis is 0.1%; however, the risk of the disease in the siblings of affected individuals is very much higher at 3-5%. The importance of genetic factors in accounting for this increased risk is confirmed by the results of twin and adoption studies. Despite the evidence for a strong genetic effect, a weak major histocompatibility complex (MHC) association is the only consistently observed feature in the genetics of multiple sclerosis. Other candidates have been proposed, including genes encoding the immunoglobulin heavy chain, T cell receptor beta chain and APOC2, but none has yet been confirmed. Evidence for linkage and association to the myelin basic protein gene has been reported in a genetically isolated Finnish population, but it has not been possible to reproduce these results in other populations. We used a two-stage approach to search the human genome for the genes causing susceptibility to multiple sclerosis. Two principal regions of linkage are identified, chromosomes 17q22 and 6p21 (MHC). Our results are compatible with genetic models involving epistatic interaction between these and several additional genes.

Chromosome Mapping↗
PubMed1996

Transient increase in symptoms associated with cytokine release in patients with multiple sclerosis.

Fourteen patients with multiple sclerosis were treated with the humanized monoclonal antibody CAMPATH-1H which targets the CD52 antigen present on all lymphocytes and some monocytes; four also received anti-CD4 antibody. Lymphopaenia developed rapidly and was sustained for at least 1 year. In 12 patients, the first infusion of antibody was characterized by significant exacerbation or re- awakening of pre-existing symptoms lasting several hours. These clinical effects of antibody treatment correlated with increased levels of circulating cytokines. Peak levels of tumour necrosis factor (TNF)-alpha and interferon (IFN)-gamma occurred at 2 h, whereas the rise in interleukin-6 (IL-6) was significantly delayed and peaked at 4 h after starting antibody treatment. There was a decline in CH50, indicating complement activation. The neurological symptoms could not be attributed directly to pyrexia and were not provoked (in one patient) by an artificial rise in temperature. In the remaining two patients, a single pre-treatment with intravenous methylprednisolone (500 mg) prevented both the transient increase in neurological symptoms and the cytokine release. Our results, involving 14 intensively studied patients treated with humanized monoclonal antibodies, suggested that soluble immune mediators contribute to symptom production in multiple sclerosis; the mechanism remains uncertain but, on the available evidence, we favour the interpretation that cytokines directly affect conduction through partially demyelinated pathways.

Adult↗
PubMed1995

Affinity of antigen-specific IgG distinguishes multiple sclerosis from encephalitis.

The characteristics of antigen-specific IgG in patients with multiple sclerosis and patients with encephalitis have been compared. Both groups of patients showed antigen-specific oligoclonal bands locally synthesised in the CSF. When the affinity distribution of the antigen-specific IgG was measured there was a marked difference between the two groups. Encephalitis patients had high affinity antibody against the causative antigen. This was consistent with the antibody undergoing affinity maturation as a result of the immune system fighting a primary infection. Multiple sclerosis patients lacked high affinity response. This lack of high affinity antibody was also seen in those encephalitis patients when antigens other than the causative antigen were studied.

Adolescent↗
PubMed1995

Brain repair.

Significant improvements in the treatment of common neurological diseases can be expected over the next few years from the application of advances now occurring in the basic neurosciences. In many disorders of the central nervous system, disability accumulates as a result of the degenerative process and its failure to repair. In part, this is because with differentiation, cells in the adult nervous system lose the ability to proliferate and migrate. A family of growth factors orchestrates proliferation, migration, differentiation and survival of neurones and glia; because certain of these growth factors also protect from injury cells which they support during development, there should soon be opportunities for limiting damage following a variety of insults and for rescuing degenerating neurones and glia. The discovery that axon regeneration is actively inhibited, perhaps in order to maintain stability in the complex systems and circuits that are established during development, suggests new strategies for enhancing axonal regeneration in spinal and head injury. Recruiting cells that are capable of restoring glial-neuronal interactions into areas of damage will be an important part of the brain repair strategy but it may prove possible to restore complex cellular arrangements through cell implantation only. Grafted neurones survive, produce appropriate neurotransmitters, form connections and restore some behaviours, but their relative inability to grow limits the degree of structural and functional repair that can be achieved: nevertheless, nerve cell implantation is now being used in the management of certain neurodegenerative diseases of the human central nervous system. There are also prospects for increasing the remyelination which occurs following acute inflammatory disease of the central nervous system, through the combination of immunological treatments that limit the disease process, growth factors that recruit oligodendrocytes and implantation of glial progenitors into demyelinated areas.

Animals↗
PubMed1995

Guidance of oligodendrocytes and their progenitors by substratum topography.

Oligodendrocyte progenitors arise in subventricular zones and migrate extensively during development before differentiating into mature oligodendrocytes, which myelinate nerve tracts in the central nervous system. We have used microfabricated substrata, containing periodic patterns of contours similar to those of central nervous system axons to assess the influence in vitro of substratum topography on oligodendrocytes isolated from 7 day rat optic nerve. Antiganglioside antibody A2B5 positive oligodendrocyte-type 2 astrocyte progenitors, and galactocerebroside positive and myelin basic protein positive oligodendrocytes, were highly aligned by surface contours as small as 100 nm depth and 260 nm repeat spacing. Rat optic nerve astrocytes also aligned on surface contours, but rat hippocampal and cerebellar neurons were unresponsive. Oligodendrocytes demonstrated enhanced parallel extension of their processes on narrow repeating topography in an arrangement similar to that found in the intact optic nerve. This is in marked contrast to the phenotype displayed by this cell type on planar substrata. Neither oligodendrocytes nor oligodendrocyte-type 2 astrocyte progenitors showed high-order F-actin cytoskeletal networks; thus their alignment on gratings is unlikely to result from deformation of actin cables and focal contacts. In contrast, aligned astrocytes showed striking arrangements of actin stress fibres. These results establish glial cells as potentially the most topographically sensitive cell types within the central nervous system. Furthermore, the topographical pattern inducing maximal alignment of oligodendrocyte lineage cells corresponds to the diameters of single axons within the 7 day optic nerve. Thus the migration of oligodendrocyte-type 2 astrocyte progenitors and axonal ensheathment by oligodendrocytes may be guided by axonal topography within the developing nerve.

Animals↗
PubMed1995

Human oligodendrocytes are not sensitive to complement. A study of CD59 expression in the human central nervous system.

BACKGROUND: One or more components of the oligodendrocyte-myelin unit are the target of immune attack in multiple sclerosis. The role of complement in this process has been suggested by the demonstration in vitro that rat oligodendrocytes are sensitive to lysis by Ab-independent complement attack, partly because of a lack of the complement regulatory protein molecule, CD59. EXPERIMENTAL DESIGN: This study assessed the sensitivity in vitro of human oligodendrocytes derived from neurosurgical specimens to complement attack and analyzed CD59 expression on their surface. The presence of CD59 was also examined in the human central nervous system during myelination and in both the normal and diseased adult brain. RESULTS: Human oligodendrocytes are insensitive in vitro to complement attack in the absence of Ab and using the Ab YTH 53.1 and were shown to possess CD59 on their surface. CD59 is absent from the human central nervous system before myelination, at which stage strong expression occurs in areas of myelin production. CD59 expression is then normally down-regulated but is particularly strong in reactive astrocytes in diseases such as multiple sclerosis. CONCLUSIONS: The findings suggest that the previous demonstration of rat oligodendrocyte complement sensitivity and lack of CD59 expression do not extend to the human central nervous system. There may be a role for CD59 in normal human myelination.

Adult↗
PubMed1994

Preliminary evidence from magnetic resonance imaging for reduction in disease activity after lymphocyte depletion in multiple sclerosis.

The central nervous system lesions of multiple sclerosis (MS) can be detected by magnetic resonance imaging (MRI) and the initial perivascular inflammatory component is distinguished by the presence of gadolinium enhancement. To assess the effect of systemic lymphocyte depletion on disease activity, seven patients with MS received a 10-day intravenous course of the humanised monoclonal antibody CAMPATH-1H (anti-CDw52). With some variations in the protocol, enhanced cerebral MR images were obtained monthly for 3-4 months before and at least 6 months after treatment. 28 enhancing areas were detected on the first series of 7 scans; 51 additional active lesions were identified on 18 scans before treatment; 15 were detected on 20 scans done over the next 3 months, but only 2 active lesions were seen on 23 scans during follow-up beyond 3 months. The difference in lesion incidence rate before and after treatment varied and the rate ratio was significantly reduced in only three patients. Collectively, in a "meta-analysis", the rate ratios were 0.15 [corrected] (95% CI 0.09-0.24) for all seven patients and 0.24 (0.14-0.42; p < 0.001) with exclusion of the patient whose scanning schedule differed. The effect of CAMPATH-1H on disease activity provides direct, but preliminary, evidence that disease activity in MS depends on the availability of circulating lymphocytes and can be prevented by lymphocyte depletion. It is too early to say anything about the clinical results of treatment with this agent.

Antigens, CD↗
PubMed1994

Future prospects for the management of multiple sclerosis.

A comprehensive strategy for the future management of multiple sclerosis will involve limiting the inflammatory process and repairing the damage. Monoclonal antibody therapy offers one means for achieving very rapid and substantial antiinflammatory effects, but the presently available reagents will almost certainly not prove to be definitive. Other candidates in the cascade of events that leads to myelin destruction will need to be considered, including TNF-alpha and other cytokines. But for the large number of individuals who are currently disabled, the more ambitious but realizable approach of glial repair holds the best hope for reversing persistent disabilities, transferring the technology and discoveries of contemporary experimental cellular neurobiology to the clinic.

Adult↗
PubMed1994

Brain repair: an overview.

The need to limit disease processes in the central nervous system and repair the damage is a major challenge for contemporary medicine but one which can now be addressed by applying the techniques of molecular, cellular, systems and behavioral neuroscience; we can be confident that, in due course, the brain repair strategy will work and have dividends for individuals with a range of neurological diseases.

Animals↗
PubMed1994

Myelination in vitro of rodent dorsal root ganglia by glial progenitor cells.

Oligodendrocytes synthesize myelin in the mammalian central nervous system; they develop from glial progenitors which, at least in vitro, are bipotential and also differentiate into astrocytes. Maturation of these O-2A progenitors is known to be influenced by growth factors and by extracellular matrix molecules. We investigated the effect of neurons on glial development by co-culturing highly purified rodent embryonic dorsal root ganglia with neonatal O-2A progenitors. Neurons produce signals, including platelet-derived growth factor BB and basic fibroblast growth factor, which stimulate progenitor cells to synthesize DNA; axonal contact is associated with down-regulation in the expression of complex ganglioside surface molecules on O-2A progenitors; with maturation, many of these cells develop into oligodendrocytes allowing the normal process of myelination to take place, but neurons also promote the differentiation of type 2 astrocytes. This orchestration of proliferation and differentiation in O-2A progenitor cells favours the development of glial-neuronal interactions needed for saltatory conduction of the nerve impulse.

Animals↗