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Publication : Biochemically altered myelin triggers autoimmune demyelination.

First Author  Caprariello AV Year  2018
Journal  Proc Natl Acad Sci U S A Volume  115
Issue  21 Pages  5528-5533
PubMed ID  29728463 Mgi Jnum  J:262489
Mgi Id  MGI:6159247 Doi  10.1073/pnas.1721115115
Citation  Caprariello AV, et al. (2018) Biochemically altered myelin triggers autoimmune demyelination. Proc Natl Acad Sci U S A 115(21):5528-5533
abstractText  Although immune attack against central nervous system (CNS) myelin is a central feature of multiple sclerosis (MS), its root cause is unresolved. In this report, we provide direct evidence that subtle biochemical modifications to brain myelin elicit pathological immune responses with radiological and histological properties similar to MS lesions. A subtle myelinopathy induced by abbreviated cuprizone treatment, coupled with subsequent immune stimulation, resulted in lesions of inflammatory demyelination. The degree of myelin injury dictated the resulting immune response; biochemical damage that was too limited or too extensive failed to trigger overt pathology. An inhibitor of peptidyl arginine deiminases (PADs), enzymes that alter myelin structure and correlate with MS lesion severity, mitigated pathology even when administered only during the myelin-altering phase. Moreover, cultured splenocytes were reactive against donor myelin isolates, a response that was substantially muted when splenocytes were exposed to myelin from donors treated with PAD inhibitors. By showing that a primary biochemical myelinopathy can trigger secondary pathological inflammation, "cuprizone autoimmune encephalitis" potentially reconciles conflicting theories about MS pathogenesis and provides a strong rationale for investigating myelin as a primary target for early, preventative therapy.
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