Dr Denise Fitzgerald is a Neuroimmunologist based
at Queens University Belfast, Northern Ireland
Dr Denise Fitzgerald, who herself experienced a condition similar to MS, called Transverse Myelitis when she was 21. As a result of inflammation in her spinal cord, she was paralysed in less than two hours. Dr Fitzgerald had to learn to walk again as the damage in her spinal cord repaired itself over the following months and years.
We are delighted that she has agreed to do a guest-post on her recent publication in the Journal Nature Neuroscience, which is about the subject of repair.
Dr Fitzgerald says
"This early-stage study in mouse models has identified that a
subset of T cells known as regulatory T cells (Treg) are important for
efficient regeneration of myelin in the CNS.
Tregs are anti-inflammatory T
cells that help to resolve inflammation and we hypothesised that these cells
would be beneficial in regeneration of CNS tissue that should ideally occur
with resolution of inflammation.
It is challenging to study myelin regeneration
in humans and especially challenging to study it in the absence of Tregs so we
used a mouse model that collaborators shared with us in which we could delete
Tregs at specific times.
We found that following myelin damage, remyelination
in both spinal cord and brain was significantly impaired when mice did not have
Tregs and this could be restored when animals were given ‘normal’ Tregs.
We next studied the effect of Tregs on brain tissue in a
dish which has two key advantages; it reduces the number of experiments in live
animals and it zones in on interactions between immune cells and the neural
tissue itself, which helps work out how Tregs may be working.
In this brain
tissue model we observed that the production of myelin was accelerated by
addition of Treg cells or even just by adding products released by Tregs (the
This could have been due to the anti-inflammatory effect of Tregs
because this brain tissue is in an inflamed state when it is first prepared,
but even when we allowed the tissue to ‘rest’ for 7 days to allow local
inflammation signals to subside, Treg soups still accelerated myelin
This suggested to us that these observations were very different to
the classical anti-inflammatory functions of Treg so we next zoned in on target
One reason for impaired remyelination is that
oligodendrocyte progenitor cells can get stuck in an immature state and not
develop into myelin-producing cells (oligodendrocytes).
In our early spinal
cord experiments we had observed that mice without Tregs had normal numbers of
oligodendrocyte progenitor cells after demyelination but few differentiated
(mature) oligodendrocytes so we hypothesised that Tregs promoted
To test this, we added Treg soups to glial
cells growing in dishes and indeed observed significantly enhanced conversion
of oligodendrocyte progenitor cells to ‘mature’ cells.
It was still possible
however that other glial cells in the culture that are involved in inflammatory
responses (e.g. astrocytes, microglia) were mediating this effect of Treg so we turned to our collaborators in
UCSF (University of California San Franscisco) to test the effect of Treg soups in pure oligodendrocyte progenitor cell cultures.
We were very encouraged when they reported back that not only did Treg soups
drive the development of mature oligodendrocytes but also myelination of
neurons in culture!
Together, these sets of experiments identified that Treg
were directly signaling to progenitor cells in the CNS, to carry out a function
very different to known anti-inflammatory roles.
The next key question was - how were Tregs promoting oligodendrocyte differentiation?
As immunologists, our natural choice would have been to test for known immune
products of Treg but we were trying to work out a ‘regenerative’ mechanism of
Treg. Hence, we chose to measure around 50 proteins known to be involved in
regeneration of other types of tissue instead.
It was through this approach
that we stumbled upon CCN3, a protein that was not known to be produced by T cells
of any type or to have an effect on oligodendrocyte progenitor cells.
CCN3 is a
complex protein, structurally and functionally, and for this reason we took two
approaches to studying whether CCN3 was important in Treg-driven
oligodendrocyte differentiation and myelin production.
We first added an
antibody that would bind to (and potentially neutralise) CCN3 in Treg soups and
we also captured the CCN3 and removed it from soups using beads and magnets.
both cases, the capacity for Treg soups to promote oligodendrocyte
differentiation and myelination was significantly impaired, identifying a key role
for CCN3. Finally, we added the captured CCN3 to brain tissue in a dish and
found that this was sufficient to drive myelin production.
In summary, in mouse experimental models we have identified
a new role for Treg in promoting myelin production in the brain and spinal cord
and a key part of this mechanism is CCN3, though there are likely other
mechanisms also (T cells rarely rely on just one way of doing things!).
we are very excited about the possibilities that these discoveries open, we do
not want to raise false or premature hope.
This is an early-stage study done
entirely in mice. We don’t yet know how much of this translates to humans (we have started this) or how realistic it will be to make a
remyelinating treatment from this knowledge.
These are all questions we are
addressing with support from the Wellcome Trust and BBSRC (Biotechnology and Biological Sciences Research Council) and the new Northern Ireland MS Research Network of patients, scientists and clinicians, through which we are recruiting 300 volunteers that are kindly providing blood samples for our work.
As an immunologist, one of the most positive aspects of this study was how much support we received from our neuroscience collaborators particularly Robin Franklin, Jonah Chan and Anna Williams.
This international team helped our team of immunologists to set up a range of CNS experimental models in our lab, shared protocols, performed experiments, hosted our visiting scientists and generally kept us right on all things ‘oligodendrocyte’!"
You can read the paper here
Dombrowski Y, O'Hagan T, Dittmer M, Penalva R, Mayoral SR, Bankhead P, Fleville S, Eleftheriadis G, Zhao C, Naughton M, Hassan R, Moffat J, Falconer J, Boyd A, Hamilton P, Allen IV, Kissenpfennig A, Moynagh PN, Evergren E, Perbal B, Williams AC, Ingram RJ, Chan JR, Franklin RJ, Fitzgerald DC. Regulatory T cells promote myelin regeneration in the central nervous system.
Nat Neurosci. 2017. doi: 10.1038/nn.4528. [Epub ahead of print]
Regeneration of CNS myelin involves differentiation of oligodendrocytes from oligodendrocyte progenitor cells. In multiple sclerosis, remyelination can fail despite abundant oligodendrocyte progenitor cells, suggesting impairment of oligodendrocyte differentiation. T cells infiltrate the CNS in multiple sclerosis, yet little is known about T cell functions in remyelination. We report that regulatory T cells (Treg) promote oligodendrocyte differentiation and (re)myelination. Treg-deficient mice exhibited substantially impaired remyelination and oligodendrocyte differentiation, which was rescued by adoptive transfer of Treg. In brain slice cultures, Treg accelerated developmental myelination and remyelination, even in the absence of overt inflammation. Treg directly promoted oligodendrocyte progenitor cell differentiation and myelination in vitro. We identified CCN3 as a Treg-derived mediator of oligodendrocyte differentiation and myelination in vitro. These findings reveal a new regenerative function of Treg in the CNS, distinct from immunomodulation. Although the cells were originally named 'Treg' to reflect immunoregulatory roles, this also captures emerging, regenerative Treg functions.
CoI: None relevant