1. Association of Regulatory T-Cell Expansion With Progression of Amyotrophic Lateral Sclerosis: A Study of Humans and a Transgenic Mouse Model
- Author
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Sheean, Rebecca, McKay, Fiona C, Cretney, Erika, Bye, Christopher, Perera, Nirma, Tomas, Doris, Weston, Richard, Scheller, Karlene, Djouma, Elvan, Menon, Parvathi, Schibeci, Stephen, Marmash, Najwa, Yerbury, Justin J, Nutt, Stephen, Booth, David, Stewart, Graeme J, Kiernan, Mathew, Vucic, Steve, Turner, Bradley J, Sheean, Rebecca, McKay, Fiona C, Cretney, Erika, Bye, Christopher, Perera, Nirma, Tomas, Doris, Weston, Richard, Scheller, Karlene, Djouma, Elvan, Menon, Parvathi, Schibeci, Stephen, Marmash, Najwa, Yerbury, Justin J, Nutt, Stephen, Booth, David, Stewart, Graeme J, Kiernan, Mathew, Vucic, Steve, and Turner, Bradley J
- Abstract
Importance Neuroinflammation appears to be a key modulator of disease progression in amyotrophic lateral sclerosis (ALS) and thereby a promising therapeutic target. The CD4+Foxp3+ regulatory T-cells (Tregs) infiltrating into the central nervous system suppress neuroinflammation and promote the activation of neuroprotective microglia in mouse models of ALS. To our knowledge, the therapeutic association of host Treg expansion with ALS progression has not been studied in vivo. Objective To assess the role of Tregs in regulating the pathophysiology of ALS in humans and the therapeutic outcome of increasing Treg activity in a mouse model of the disease. Design, Setting, and Participants This prospective multicenter human and animal study was performed in hospitals, outpatient clinics, and research institutes. Clinical and function assessment, as well as immunological studies, were undertaken in 33 patients with sporadic ALS, and results were compared with 38 healthy control participants who were consecutively recruited from the multidisciplinary ALS clinic at Westmead Hospital between February 1, 2013, and December 31, 2014. All data analysis on patients with ALS was undertaken between January 2015 and December 2016. Subsequently, we implemented a novel approach to amplify the endogenous Treg population using peripheral injections of interleukin 2/interleukin 2 monoclonal antibody complexes (IL-2c) in transgenic mice that expressed mutant superoxide dismutase 1 (SOD1), a gene associated with motor neuron degeneration. Main Outcomes and Measures In patients with ALS, Treg levels were determined and then correlated with disease progression. Circulating T-cell populations, motor neuron size, glial cell activation, and T-cell and microglial gene expression in spinal cords were determined in SOD1G93A mice, as well as the association of Treg amplification with disease onset and survival time in mice. Results The cohort of patients with ALS included 24 male patients and 9 femal
- Published
- 2018