Despite immune-cell infiltration being a hallmark of multiple sclerosis (MS), the interplay between the periphery and central nervous system immune responses is still incompletely characterized. We performed single-cell transcriptomic and V(D)J sequencing of paired blood and cerebrospinal fluid (CSF) immune cells from treatment-naive relapsing-remitting women with MS and compared them to age– and sex-matched healthy controls. Across major immune lineages, we identified coordinated, compartment-specific immune alterations, with enrichment of activated and memory lymphocyte populations in the CSF and concomitant depletion of related populations in peripheral blood, suggesting their recruitment from blood to CSF. Clonally expanded CD4 memory T-cells, together with activated, expanded IgM-positive B-cells, accumulated predominantly in the CSF of people with MS compared to healthy subjects. Interestingly, tissue-primed cytotoxic populations and CXCR3-associated memory populations were depleted from the CSF of MS, implying their recruitment to the target tissue in early disease. These findings reveal coordinated, compartment-specific immune changes in early MS and provide a systems-level view of immune-cell trafficking between peripheral and central nervous system compartments.
Nils Hallén, S. J. Fernandes, Soudabeh Rad Pour et al.· bioRxiv· 0 citations
The identification of autoantibodies against aquaporin-4 (AQP4) and myelin oligodendrocyte glycoprotein (MOG) has been essential in distinguishing neuromyelitis optica spectrum disorder (NMOSD) and MOG antibody-associated disease (MOGAD) from classical multiple sclerosis (MS), with important implications for treatment. However, for several patients within this disease spectrum, the target of the autoimmune response remains unknown. Here, we describe the modulator of VRAC current 1 (MLC1), a membrane protein with extracellular epitopes enriched at astrocytic end feet, as an autoantigen. Serum MLC1 antibodies were verified with a cell-based assay, identifying four MLC1 immunoglobulin G (IgG)-positive patients among 297 patients with inflammatory autoimmune diseases of the central nervous system who were screened. All four MLC1 IgG-positive patients exhibited overlapping yet atypical clinical features of MS and NMOSD and tested negative for AQP4 and MOG antibodies. Moreover, treatment with a monoclonal MLC1 antibody induced astrocytopathy in mouse cerebellar slice cultures and in a rat encephalitis model. Thus, MLC1 antibodies identify a subset of patients with an NMOSD-like phenotype, underscoring their potential as a disease marker with pathogenic relevance.
H. Wong, Samantha Ho, Qian Yu et al.· Science Translational Medici...· 0 citations
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