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Biomedical subjects

M L Cuzner

Publications and source records attributed to M L Cuzner.

At least 19 recordsLinked to original sources

Expression of costimulatory molecules B7-1 (CD80), B7-2 (CD86), and interleukin 12 cytokine in multiple sclerosis lesions.

Resting autoreactive T cells are present in the circulation of normal individuals without pathologic consequences. In autoimmune animal models, stimulation of these self-reactive T cells in the presence of costimulatory molecules B7-1 results in T cell-mediated autoimmune disease, whereas B7-2 stimulation generates regulatory autoreactive T cells that abrogate disease severity. Thus, reactivation in the brain of myelin-autoreactive T cells by antigen with costimulatory molecules may be a critical event in the pathophysiology of multiple sclerosis (MS), a putative autoimmune disease of central nervous system (CNS) myelin. We investigated the expression of cytokines and costimulatory molecules in a panel of 41 histologically characterized CNS specimens from 15 MS and 10 control cases using semiquantitative reverse transcriptase-polymerase chain reaction and immunocytochemistry. In four cases, vascular CNS infarcts with inflammation were compared with MS plaques from the same brain. We observed increased expression of B7-1 and interleukin (IL) 12p40 in acute MS plaques, particularly from early disease cases but not in inflammatory infarcts. B7-1 staining was localized predominantly to the lymphocytes in perivenular inflammatory cuffs but not the parenchyma. In contrast, B7-2 was expressed predominantly on macrophages both in MS lesions of varied time duration and in inflammatory infarcts. These findings indicate that an early event in the initiation of MS involves upregulation of B7-1 and IL-12, resulting in conditions that maximally stimulate T cell activation and induction of T helper 1-type immune responses.

Adult

Amyloid precursor protein (APP) expression in multiple sclerosis lesions.

The amyloid precursor protein (APP) is rapidly induced in reactive glial cells in response to several pathological stimuli including inflammation. In the present study, observations previously made in animal models of autoimmune central nervous system inflammation have been extended to the analysis of multiple sclerosis (MS) lesions. A total of thirty fresh-frozen tissue blocks from six histopathologically normal control and six MS cases have been examined immunocytochemically with monoclonal antibodies directed against either C- or N-terminal epitopes of APP. Histopathological evaluation of disease progression was based on hematoxylin-eosin and oil red O staining and immunocytochemistry for T cells, macrophages/microglia, astrocytes, and oligodendrocytes. In control cases, APP immunoreactivity was generally low and confined to blood vessel walls, oligodendrocytes in white, and neurons in grey matter. In actively demyelinating plaques, however, levels of APP immunoreactivity were high, localised on T lymphocytes, foamy macrophages, activated microglia, and reactive astrocytes including astrocytic processes. In more chronic lesions, levels of APP immunoreactivity were generally lower than in acute lesions, mainly found on reactive astrocytes, their processes and a few macrophages/microglia depending on the stage of plaque development. In addition, a few 14E-positive oligodendrocytes and, moreover, numerous axons exhibited APP immunoreactivity, which was particularly pronounced with anti-C-terminal antibodies. These results demonstrate that APP is induced on reactive glial cells but also on T lymphocytes during demyelination. The extent of APP expression appears to be correlated to histopathological lesion development and thus suggests that APP detection serves as a sensitive marker for disease progression in MS.

Adult

Suppression of experimental allergic encephalomyelitis in the Lewis rat by the matrix metalloproteinase inhibitor Ro31-9790.

Matrix metalloproteinases (MMPs) are implicated in the tissue destruction associated with inflammatory demyelinating diseases such as multiple sclerosis. The effect of a hydroxamate inhibitor of MMPs, Ro31-9790, on inflammatory demyelination was assessed in two acute models of experimental allergic encephalomyelitis (EAE). Daily intraperitoneal injections of Ro31-9790 (50 mg kg-1), beginning either at the time of disease induction or from day 3 post induction, significantly reduced the clinical severity of adoptively transferred EAE. Administration of the inhibitor from the day of induction of active EAE prevented disease onset in 9/10 animals. However, in a repeat study, in which clinical disease was much more severe in the vesicle treated animals, the inhibitor was less effective. Clinical signs and CNS histopathology correlated well, with greater numbers of inflammatory lesions associated with increased disease severity. The present study confirms a role for then MMP cascade in inflammation in EAE.

Animals

Myelin basic protein content of aggregating rat brain cell cultures treated with cytokines and/or demyelinating antibody: effects of macrophage enrichment.

The demyelinative potential of the cytokines interleukin-1 alpha (IL-1 alpha), interferon-gamma (IFN-gamma), and tumor necrosis factor-alpha (TNF-alpha) has been investigated in myelinating aggregate brain cell cultures. Treatment of myelinated cultures with these cytokines resulted in a reduction in myelin basic protein (MBP) content. This effect was additively increased by anti-myelin/oligodendrocyte glycoprotein (alpha-MOG) in the presence of complement. Qualitative immunocytochemistry demonstrated that peritoneal macrophages, added to the fetal telencephalon cell suspensions at the start of the culture period, successfully integrated into aggregate cultures. Supplementing the macrophage component of the cultures in this fashion resulted in increased accumulation of MBP. The effect of IFN-gamma on MBP content of cultures was not affected by the presence of macrophages in increased numbers.

2',3'-Cyclic-Nucleotide Phosphodiesterases

Increased expression of high affinity IL-2 receptors and beta-adrenoceptors on peripheral blood mononuclear cells is associated with clinical and MRI activity in multiple sclerosis.

Enhanced expression of beta-adrenoceptor densities on peripheral blood mononuclear cells (PBMCs) in progressive multiple sclerosis patients has been observed in a number of independent studies. A link between increased number of beta-adrenoceptors and inflammatory disease has been further indicated by studies in rheumatoid arthritis and relapsing-remitting multiple sclerosis patients. In a serial monthly assessment of relapsing-remitting multiple sclerosis patients, we have demonstrated that increased beta-adrenoceptors on PBMCs correlate with the expression of high affinity interleukin-2 receptors (IL-2Rs) and disease activity as determined by clinical and MRI findings. Magnetic resonance imaging activity was strongly correlated with IL-2R expression and it appears to be a sensitive marker of PBMC immunoactivation in multiple sclerosis. In vitro studies showed that beta-agonist stimulation of PBMCs reduces the IL-2R expression and suppresses cell proliferation following mitogenic stimulation. This observation may indicate a recovery role for the enhanced beta-adrenoceptor expression in multiple sclerosis. However, its therapeutic importance remains to be tested by appropriate trials using either beta-agonists or agents activating the second messenger system, c-AMP, in lymphocytes.

Adult

Neuroendocrine-immune interactions in homeostasis and autoimmunity.

Recent experimental evidence confirms the interrelationships between the central nervous, neuroendocrine and immune systems. Indeed, extensive duality exists in the use of neurotransmitters, hormones and receptors each system displays. In the present annotation, the effect of cytokines, soluble mediators of immune function, on the CNS and neuroendocrine systems is addressed and conversely, we discuss the modification of the immune compartment by the sympathetic nervous and neuroendocrine systems, with particular reference to the role of noradrenaline and corticosterone. Dysfunction between the systems is considered in the context of autoimmune conditions, with emphasis on experimental allergic encephalomyelitis and the contribution of corticosterone-driven T-cell apoptosis to recovery from the disease. Finally, we speculate on the relevance of neuroimmune interactions in the pathogenesis of multiple sclerosis.

Animals

In situ hybridization in neuropathology.

In situ hybridization (ISH) allows the demonstration and localization of deoxyribonucleic acid (DNA) and ribonucleic acid (RNA) in tissue sections, cells and chromosomes by utilizing a specific interaction with a labelled nucleotide probe of known composition. Although this technique has been employed for many years using radiolabelled probes, the recent development of nonisotopic labelling systems and the greatly increased availability of synthetic nucleic acids has allowed an enormous expansion in the potential applications of ISH. The technique is now applicable to unfixed and fixed tissues, including archival material. The use of enzyme-linked antibody techniques to detect labelled probes has greatly increased the sensitivity of non-isotopic ISH without a loss of specificity. The successful use of ISH demands careful selection of labelled probes, adequate tissue pretreatment to allow access of the probe, control of the stringency of probe binding and a sensitive reporter system, in addition to adequate controls. The accurate localization of nucleotides in the central nervous system (CNS) has many current research applications in the study of gene expression in multiple sclerosis and other inflammatory disorders, and a wide range of neurodegenerative disorders, viral infections and neoplasms. The technique is of diagnostic value in viral disorders, particularly where multiple infections occur. The combination of non-isotopic ISH with immunocytochemistry electron microscopy and quantitative image analysis greatly increases its research potential, while the development of a related method, the in situ polymerase chain reaction, offers an additional opportunity for further enhancing the sensitivity of this technique.

Brain Neoplasms

Low density lipoprotein uptake by macrophages in multiple sclerosis plaques: implications for pathogenesis.

Low density lipoprotein (LDL), the major carrier of plasma cholesterol, may enter the parenchyma of early multiple sclerosis (MS) lesions as a result of blood-brain barrier damage. We have used antibodies against LDL and epitopes found in LDL oxidized by two peroxidative end-products, malondialdehyde (MDA) and 4-hydroxynonenal (4-HNE), to immunocytochemically stain MS plaques at different stages of pathology. Native LDL, epitopes of MDA-LDL, peptides of myelin basic protein and neutral lipid oil red O (ORO) staining were found to be co-localized within foamy macrophages in early and actively demyelinating MS plaques. Thus cholesterol esters, which are seen as Maltese crosses under polarized light in a proportion of foamy macrophages, appear to be derived from both LDL and myelin. ORO-negative astrocytes were strongly stained with the antibodies against 4-HNE-LDL and MDA-LDL, suggesting uptake of oxidatively modified protein products alone. Our findings suggest that a large proportion of the plasma LDL which enters the parenchyma of MS plaques is oxidatively modified in the lesion. Lipid peroxidation and oxidized LDL uptake by activated microglia and infiltrating macrophages in the early stages of MS plaque development may play important roles in demyelination.

Adult

High beta-adrenoceptor density on peripheral blood mononuclear cells in progressive multiple sclerosis: a manifestation of autonomic dysfunction?

In multiple sclerosis (MS) up-regulation of beta-adrenoceptors on peripheral blood mononuclear cells (PBMCs) has been attributed to either autonomic dysfunction, inflammation or a combination of the two. We have compared secondary progressive MS patients with normal subjects (NS) and two models of autonomic dysfunction; pure autonomic failure (PAF) and multiple system atrophy (MSA, Shy-Drager syndrome). There was up-regulation of beta-adrenoceptors on PBMCs in MS and PAF patients but not in MSA patients. Only in PAF patients beta-adrenoceptor up-regulation was correlated with low plasma levels of noradrenaline (NA) and adrenaline (Ad). In addition to studies in the basal state, measurements also were made after the centrally acting sympatholytic agent clonidine. These were combined with haemodynamic and neurohormonal measurements. After clonidine, there was a fall in blood pressure in NS and MSA patients but not in MS and PAF patients; a rise in growth hormone (GH) in NS and PAF patients but not in MS and MSA patients; and an up-regulation in PBMCs beta-adrenoceptors in NS but not in MS, MSA and PAF patients. Up-regulation of beta-adrenoceptors on PBMCs in MS could be attributed to autonomic dysfunction but the disparity between MS and PAF patients when considering their plasma levels of NA and Ad argue against. Although the neurohormonal responses to clonidine and the physiological assessment of autonomic function in progressive MS patients, demonstrate central autonomic dysfunction resembling that of the MSA patients, the normal basal beta-adrenoceptor densities in the latter, suggests that the up-regulation of these receptors is independent of the central autonomic dysfunction in MS.

Adult

Hypothalamic PGE2 and cAMP production and adrenocortical activation following intraperitoneal endotoxin injection: in vivo microdialysis studies in Lewis and Fischer rats.

Inflammatory disease-susceptible Lewis (LEW) rats exhibit reduced glucocorticoid release in response to inflammatory and neurotransmitter stimuli, compared to histocompatible Fischer (F/344) rats. This compromised hypothalamo-pituitary-adrenal (HPA) axis activity has been ascribed to a primary defect in hypothalamic corticotrophin-releasing factor-41 (CRF) secretion, possibly caused by abnormal signal transduction in the CRF neuron. In the present study, we have used in vivo microdialysis to asses the role of hypothalamic prostaglandin E2 (PGE2) and cyclic adenosine monophosphate (cAMP) in endotoxin-mediated HPA axis activation in adult hyporesponsive LEW and hyperresponsive F/344 rats. Basal plasma corticosterone concentration was significantly higher in F/344 relative to LEW rats; however, the basal levels of PGE2 and cAMP, recovered from microdialysis probes in the anterior hypothalamus, were significantly greater in the LEW rat. Lipopolysaccharide (LPS) (200 micrograms/kg) caused a time-dependent increase in corticosterone secretion, the magnitude of which was markedly greater in the F/344 rat. Both LEW and F/344 rats displayed a similar PGE2 profile in response to LPS, although in absolute terms the response was more pronounced in LEW rats. LPS caused a dose-related increase in cAMP production in the LEW rat and comparison with F/344 animals, following the 200 micrograms/kg dose of LPS, revealed a larger and more prolonged cAMP response in the LEW strain. Simultaneous administration of indomethacin (50 mg/kg) with LPS (200 micrograms/kg) in the LEW rat completely blocked the PGE2 and cAMP responses to the toxin and whilst the corticosterone response to LPS was significantly attenuated at 140 min, no difference was apparent by 240 min. Hence, PGE2 and cAMP participate in the hypothalamic response to endotoxin-mediated adrenocortical activation in both LEW and F/344 adult rats but the steroid and second messenger profiles are strain-specific. The cAMP response to LPS appears to depend on products of arachidonic acid metabolism, such as PGE2, and hence basal and stimulated production of these mediators may be effected by the steroid milieu.

Adrenal Cortex

Expression of beta-adrenoceptors on circulating mononuclear cells in hypertensives and normotensives before and after reduction of central sympathetic outflow by clonidine.

We have studied beta-adrenoceptor number and affinity on peripheral blood mononuclear cells (PBMCs) in normotensives (NT) and hypertensives (HT), before and after intravenous administration of clonidine, an alpha 2-adrenoceptor agonist which lowers blood pressure predominantly by reducing central nervous system sympathetic outflow. After clonidine, there was a decrease in blood pressure and plasma noradrenaline (NA) and adrenaline (Ad) levels, with an increase in growth hormone (GH) levels, in both NT and HT. There was no difference in basal beta-adrenoceptor densities on PBMCs between NT and HT. After clonidine at 30 and 60 min, there was an increase in beta-adrenoceptor density associated with a low affinity in NT. In HT, no changes were observed. The increased beta-adrenoceptor densities on PBMCs in NT after clonidine, returned to baseline values after 2 h. Short term up-regulation of beta-adrenoceptors on PBMCs in NT after clonidine is accompanied by a fall in blood pressure (BP) and plasma levels of catecholamines. The changes may represent a compensatory mechanism reflecting a rapid externalization-activation of adrenoceptors residing on the internal surface of the membranes with a change of the coupling ability between the receptor and the catalytic component. In HT, although the haemodynamic and neurohormonal response to clonidine was similar to NT, short term upregulation of receptors did not occur. The lack of such response may mirror a form of regulatory dysfunction of beta-adrenoceptors in HT.

Aged

Changes in hypothalamic corticotrophin-releasing factor and anterior pituitary pro-opiomelanocortin mRNA during the course of experimental allergic encephalomyelitis.

The pituitary-adrenal axis is activated during the course of experimental allergic encephalomyelitis (EAE), a paralytic disease resulting from an immunological reaction against central nervous system myelin. The magnitude of the adrenal response not only correlates with the severity of disease, but also serves an important functional role in recovery. We have shown that in EAE there are short-term changes in anterior pituitary pro-opiomelanocortin (POMC) mRNA as well as plasma corticosterone which can be detected before the development of clinical disease. At peak clinical signs when corticosterone and POMC mRNA are maximal, hypothalamic corticotrophin-releasing factor (CRF) mRNA is suppressed, suggesting that pituitary-adrenal activation is not mediated by CRF. Following recovery all parameters return to normal.

Animals

Cytokine mRNA expression in inflammatory multiple sclerosis lesions: detection by non-radioactive in situ hybridization.

The predominant pathological features in the central nervous system (CNS) in multiple sclerosis (MS) are perivascular inflammation and demyelination. The cells in the inflammatory cuff consist mainly of T lymphocytes and macrophages. Cytokines produced by inflammatory cells within the CNS have the potential to enhance local inflammation and promote phagocytosis of myelin by macrophages, resulting in demyelination. Resident brain cells, microglia and astrocytes, also produce cytokines after stimulation in vitro. We have applied the technique of non-radioactive in situ hybridization to examine which cells in the CNS are producing cytokines in MS. Using digoxigenin-labelled oligonucleotide probes we have detected expression of the cytokines IL-1 alpha, IL-2, IL-4, IL-6, IL-10, IFN-gamma, TGF beta 1 & 2 and TNF-alpha in frozen sections of CNS tissue from MS cases. The intensity and distribution of the staining for mRNA is cytokine specific, IL-6, IFN-gamma and TNF-alpha predominating in the perivascular inflammatory cuffs, the others being more weakly expressed. Expression of all cytokine mRNAs is stronger in perivascular cells rather than in parenchymal cells, suggesting that circulating inflammatory cells which have crossed the blood brain barrier are the major source of cytokines in MS tissue.

Adult

Characterization and distribution of phagocytic macrophages in multiple sclerosis plaques.

Populations of phagocytic cells in multiple sclerosis (MS) plaques were examined by quantitative immunocytochemical analysis of macrophage markers and myelin degradation products in serial cryostat sections from 10 cases of MS. Around lesions with ongoing demyelination expression of the Class II antigen HLA-DQ appeared to be a marker of microglial activation. Alpha 1-antichymotrypsin+ monocytes and myelin-laden macrophages expressing the later differentiation markers Ber-MAC3 and RFD7 were predominantly perivascular in location. On the basis of the distribution of oil red O (ORO)+ phagocytes and myelin loss, plaques were divided into groups representing different stages in lesion development. In early lesions (group 1), there was no apparent myelin loss around ORO+ macrophages although these cells contained material stained with antibodies against myelin basic protein (MBP) epitopes and neoepitopes. However, patchy myelin loss was detectable around the phagocytic macrophages uniformly distributed throughout group 2 plaques. ORO+ macrophages containing MBP peptides were confined to the hypercellular border of group 4 lesions, in which the demyelinating process may be recurrent.

Adult

Beta-adrenoceptor expression on circulating mononuclear cells of idiopathic Parkinson's disease and autonomic failure patients before and after reduction of central sympathetic outflow by clonidine.

There is a short-term up-regulation of beta-adrenoceptors on peripheral blood mononuclear cells (PBMC) after reduction of central sympathetic outflow by clonidine in normal individuals. We have studied beta-adrenoceptor number and affinity on PBMC in idiopathic Parkinson's disease (PD), pure autonomic failure (PAF), and multiple system atrophy (MSA; Shy-Drager syndrome) patients and age- and sex-matched normal controls (NC) before and after intravenous administration of clonidine, an alpha 2-adrenoceptor agonist which lowers blood pressure predominantly by reducing CNS sympathetic outflow. Basal beta-adrenoceptor density was high in PAF but within the normal range in PD and MSA patients. After clonidine there was a decrease in plasma levels of noradrenaline (NA) and adrenaline (Ad) in PD, MSA, and NC, and an increase in growth hormone (GH) in PD, PAF, and NC. NC. In PAF, NA and Ad remained unchanged. In MSA, there was no increase in GH levels. There was an up-regulation of beta-adrenoceptors on PBMC at 30 and 60 minutes after clonidine administration, which returned to baseline values after 2 hours, and the affinity of the receptors was decreased in NC and PD patients. Intracellular production of cAMP after isoproterenol stimulation demonstrated that the up-regulation was not functional. Up-regulation after clonidine did not occur in PAF and MSA patients. The observed correlation of plasma NA and sympathetic defect with basal and clonidine-induced up-regulation of beta-adrenoceptors on PBMC may provide insight into beta-adrenoceptor changes in other tissues and also help in differentiating subgroups of autonomic failure patients.

Adult

Organization and research applications of the U.K. Multiple Sclerosis Society Tissue Bank.

The Multiple Sclerosis Society Tissue Bank contains post-mortem central nervous system tissue from over 100 clinically and neuropathologically well-documented multiple sclerosis (MS) cases, and from normal control subjects. This bank is a resource centre which provides histologically screened snap-frozen material for immunological, neurochemical and nucleic acid studies in our own and other MS laboratories in Europe and the USA. In addition to immunopathological studies, Tissue Bank material has been used to investigate changes in CNS-specific proteins and lipids in MS plaques and responses of oligodendrocytes and astrocytes to the inflammatory demyelinating process. MS lesions detected in unfixed post-mortem brain and spinal cord by magnetic resonance imaging techniques prior to dissection have been characterized histologically and biochemically. A computer database on Tissue Bank post-mortem cases has been established to link clinical, pathological and scientific aspects of MS research.

Brain

Modulation of interferon-gamma-induced major histocompatibility complex class II and Fc receptor expression on isolated microglia by transforming growth factor-beta 1, interleukin-4, noradrenaline and glucocorticoids.

Interleukin-4 (IL-4) enhances Fc receptor (FcR) expression on isolated rat brain microglia and peritoneal macrophages but has little effect on major histocompatibility complex (MHC) class II antigen expression. In contrast transforming growth factor-beta 1 (TGF-beta 1) causes a reduction in expression of MHC class II on macrophages and of FcR on both cell types. Both microglia and peritoneal macrophages demonstrate enhanced expression of FcR and MHC class II on treatment with interferon-gamma (IFN-gamma). The effect of IL-4 or TGF-beta 1 in combination with IFN-gamma, added either sequentially or simultaneously, has been investigated. TGF-beta 1 down-regulates IFN-gamma-induced effects in both microglia and macrophages when present before or during the activation stage. In combination, IL-4 and IFN-gamma can be additive or antagonistic, depending on their concentrations and the sequence in which cells are exposed to the cytokines. Non-cytokine mediators present during stimulation, such as noradrenaline, dexamethasone and corticosterone, are also potent inhibitors of IFN-gamma-induced activation of microglia and macrophages.

Brain