Managing Editor: GlANCARLO COMI. Co-Editor: JACOPO MELDOLESI. Associate Editors: UGO ECARI MASSIMO FILIPPI. GlANVITO MARTINO

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1 Topics in Neuroscience Managing Editor: GlANCARLO COMI Co-Editor: JACOPO MELDOLESI Associate Editors: UGO ECARI MASSIMO FILIPPI GlANVITO MARTINO

2 Springer-Verlag Italia Sri.

3 G. Martino L. Adorini (Eds) From Basic Immunology to Immune-Mediated Demyelination

4 GIANVITO MARTINO Department of Neuroscience S. Raffaele Scientific Institute LUCIANO ADORINI Roche Milano Ricerche The Editors and Authors wish to thank FARMADES-SCHERING GROUP (Italy) for the support and help in the realization and promotion of this volume Springer-Verlag Italia 1999 Originally published by Springer-Verlag Italia, Milano in 1999 Softcover reprint of the hardcover 1st edition 1999 ISBN DOI / ISBN (ebook) Library of Congress Cataloging-in-Publication Data: applied for This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, re-use of illustrations, recitation, broadcasting, reproduction on microfilms or in other ways, and storage in data banks. Duplication of this publication or parts thereof is only permitted under the provisions of the Italian Copyright Law in its current version, and permission for use must always be obtained from Springer-Verlag. Violations are liable for prosecution under the Italian Copyright Law. The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. Product liability: the publisher cannot guarantee the accuracy of any information about dosage and application contained in this book. In every individual case the user must check such information by consulting the relevant literature. Typesetting: Photo Life (Milan) Cover design: Simona Colombo SPIN:

5 To Nicolo and Cristina, who make my life serene (G. MARTINO) To Silvano, who wants to become a scientist (1. ADORINI)

6 Preface Morphological, physiological and pathological evidence demonstrates that nervous and immune systems interact not only in maintaining brain homeostasis, but also in causing neurological diseases. The study of these interactions represents the basis on which neuroimmunology has grown during the years. At present, several neurological diseases are recognized to be caused by a derangement of the immune system in either its regulatory or effector functions. The main scope of this book, to discuss how an unbalanced immune system may lead to immune-mediated neurological diseases, is achieved in three parts. The first part provides an overview on how the immune system works. This is propaedeutical to understanding interactions between the immune and nervous systems, which are discussed in the second part. The third part of the book focuses on one particular area of neuroimmunology, the immune disorders leading to the damage of central and peripheral myelin. Given the opportunity to review first the immune system in itself and then how it operates during immune-mediated demyelinating disorders, we have tried to provide the reader with a basis for clearly understanding how interactions between the immune and nervous systems can be protective or pathogenic. This knowledge is a prerequisite for a rationale immune intervention targeting these disorders. G. Martino L. Adorini

7 Table of Contents Chapter 1 - Protective Versus Harmful Responses and Immune Regulation F. DI ROSA, V. BARNABA Chapter 2 - Antigen Recognition and Autoimmunity F. SINIGAGLIA, J. HAMMER o. Chapter 3 - Assembly and Function of Immunoglobulins During BCell Development R. SITIA Chapter 4 - Pathogenetic Mechanisms of Autoimmunity L. AOORINI Chapter 5 - Adhesion Receptors Involved in Leukocyte Functions E. BIANCHI, M. FABBRI, R. PARDI Chapter 6 - The Endothelium of the Brain Microvasculature and the Organization of Intercellular Junctions M.G. LAMPUGNANI, Go BAZZONI, Eo DEJANA 0 Chapter 7 - Chemokines and Chemokine Receptors A. MANTOVANI, Po ALLAVENA, C. GARLANOA, S. RAMPONI, C. PAGANINI, A. VECCHI, S. SOZZANI... 0 Chapter 8 - Th1/Th2 Cytokine Network M.M. D'ELIOS, G. DEL PRETE Chapter 9 - Lymphocyte Trafficking in the Central Nervous System H. LASSMANN Chapter 10 - Antigen Presentation in the Central Nervous System F. ALOISI Chapter 11 - Myelination of the Central Nervous System GoG. CONSALEZ, V. AVELLANA-AoALID, C. ALLI, A. BARON VAN EVERCOOREN 0 101

8 x Table of Contents Chapter 12 - Genomic Screening in Multiple Sclerosis P. MOMIGLIANO RICHIARDI Chapter 13 - MHC and Multiple Sclerosis M.G. MARROSU Chapter 14 - Cytokine Genes in Multiple Sclerosis EL. SCIACCA, L.M.E. GRIMALDI Chapter 15 - Adhesion Molecules and the and Blood-Brain-Barrier in Multiple Sclerosis J.J. ARCHELOS, H.-P. HARTUNG Chapter 16 - Non-Myelin Antigen Autoreactivity in Multiple Sclerosis G. RISTORI, e. MONTESPERELLI, e. BUTTINELLI, L. BATTISTINI, S. CANNONI, G. BORSELLlNO, R. BOMPREZZI, A. PERNA, M. SALVETTI Chapter 17 - Myelin Antigen Autoreactivity in Multiple Sclerosis M. VERGELLI Chapter 18 -Inflammation and Multiple Sclerosis: a Close Interplay G. MARTINO, R. FURLAN, P.L. POLIANI Chapter 19 - Magnetic Resonance and Blood-Brain Barrier Dysfunction in Multiple Sclerosis M. ROVARIS, C. TORTORELLA, J.e. SIPE, M. FILIPPI Chapter 20 - Immunotherapies for Multiple Sclerosis P. PERINI, P. GALLO Chapter 21- Animal Models of Demyelination of the Central Nervous System A. UCCELLI Chapter 22 - MHC and Non-MHC Genetics of Experimental Autoimmune Encephalomyelitis T. OLSSON, I. DAHLMAN, E. WALLSTROM Chapter 23 - Genetics of Hereditary Neuropathies G.L. MANCARDI Chapter 24 - Immunopathogenetic Role of Anti-Neural Antibodies in Demyelinating Dysimmune Neuropathies E. NOBILE-ORAZIO, M. CARPO Chapter 25 - Treatment of Inflammatory Demyelinating Polyneuropathy G. COMI, L. ROVERI Subject Index 313

9 List of Contributors L. Adorini Roche Milano Ricerche, P. Allavena Mario Negri Institute of Pharmacological Research, C. Alli F. Aloisi Neurophysiology Unit, Laboratory of Organ and System Pathophysiology, Istituto Superiore di Sanita, ].J. Archelos Department of Neurology, Karl-Franzens-Universitat, Graz, Austria V. Avellana-Adalid INSERM 134, Cellular, Molecular and Clinical Neurobiology, H6pital de la Salpetriere, Paris, France V. Barnaba Andrea Cesalpino Foundation, I Institute of Internal Medicine, University of Rome La Sapienza, Rome, Italy; Pasteur-Cenci Bolognetti Institute, A. Baron Van Evercooren INSERM 134, Cellular, Molecular and Clinical Neurobiology, H6pital de la Salpetriere, Paris, France L. Battistini Neuroimmunology Laboratory, Santa Lucia Scientific Institute, G. Bazzoni Laboratory of Vascular Biology, Mario Negri Instiute of Pharmacological Research, E. Bianchi Human Immunology Unit, DlBIT San Raffaele Scientific Hospital, R. Bomprezzi University of Rome La Sapienza, G. Borsellino Neuroimmunology Laboratory, Santa Lucia Scientific Institute, C. Buttinelli University of Rome La Sapienza, S. Cannoni University of Rome La Sapienza,

10 XII List of Contributors M. Carpo Giorgio Spagnol Service of Clinical Neuroimmunology, Centro Dino Ferrari, Institute of Clinical Neurology, University of Milan, IRCCS Ospedale Maggiore Policlinico, G.G. Consalez G.Comi Department ofclinical Neurophysiology, 1. Dahlman Neuroimmunology Unit, Center for Molecular Medicine, Department of Medicine, Karolinska Institutet, Stockholm, Sweden E. Dejana Laboratory ofvascular Biology, Mario Negri Institute of Pharmacological Research, M.M. D'Elios Institute of Internal Medicine and Immunoallergology, University of Florence, Italy G. Del Prete Institute of Internal Medicine and Immunoallergology, University of Florence, Italy F. Di Rosa Andrea Cesalpino Foundation, I Institute of Internal Medicine, University of Rome La Sapienza, M. Fabbri Human Immunology Unit, DIBIT Scientific Institute San Raffaele, M. Filippi Neuroimaging Research Unit, R. Furlan Departement of Neuroscience, P. Gallo Department of Neurological and Psychiatrical Sciences, Second Neurological Clinic, University of Padua, School of Medicine, Geriatric Hospital, Padua, Italy C. Garlanda Mario Negri Institute of Pharmacological Research, L.M.E. Grimaldi Neuroimmunology Unit, J. Hammer Hoffmann-La-Roche Inc., Preclinical R&D, 3 Nutley, NJ, US H.-P. Hartung Department of Neurology, Karl-Franzens-Universitat, Graz, Austria H. Lassmann Institute of Neurology, University ofvienna, Austria M.G. Lampugnani Laboratory ofvascular Biology, Mario Negri Institute of Pharmacological Research, G.L. Mancardi University of Genoa, Italy

11 List of Contributors XIII A. Mantovani Mario Negri Institute of Pharmacological Research, ; Department of Biotechnology, Section of General Pathology, University of Brescia, Italy G. Martino M.G. Marrosu Neurophysiopathology Section, University of Cagliari, Cagliari, Italy P. Momigliano Richiardi Chair of Human Genetics, Department of Medical Sciences, University of Eastern Piedmont "A. Avogadro", Novara, Italy C. Montesperelli University of Rome La Sapienza, Rome, Italy E. Nobile-Orazio Giorgio Spagnol Service of Clinical Neuroimmunology, Centro Dino Ferrari, Institute of Clinical Neurology, University of Milan, IRCCS Ospedale Maggiore Policlinico, T. Olsson Neuroimmunology Unit, Center for Molecular Medicine, Department of Medicine, Karolinska Institutet, Stockholm, Sweden C. Paganini Mario Negri Institute ofpharmacological Research, R. Pardi Human Immunology Unit, DIBIT- A. Perna University of Rome La Sapienza, P. Perini Department of Neurological and Psychiatrical Sciences, Second Neurological Clinic, University of Padua, School of Medicine, Geriatric Hospital, Padua, Italy P.L. Poliani Departement of Neuroscience, S. Ramponi Mario Negri Institute of Pharmacological Research, L. Roveri Department ofclinical Neurophysiology, G. Ristori University of Rome La Sapienza, Rome, Italy M. Rovaris Neuroimaging Research Unit, M. Salvetti University of Rome La Sapienza, F.L. Sciacca Neuroimmunology Unit, F. Sinigaglia Roche Milano Ricerche,

12 XIV J.e. Sipe Scripps Clinic, Division of Neurology and The Scripps Research Institute, La Jolla, California, USA R. Sitia Laboratory of Molecular Immunology, DIBIT- S. Sozzani Mario Negri Institute of Pharmacological Research, e. Tortorella Neuroimaging Research Unit, List of Contributors A. Uccelli Neuroimmunology Unit, Department of Neurological Sciences and Neurorehabilitation, University of Genoa, Italy A. Vecchi Mario Negri Institute of Pharmacological Research, M. Vergel/i Department of Neurological and Psychiatric Sciences, University of Florence, Italy E. Wallstrom Neuroimmunology Unit, Center for Molecular Medicine, Department of Medicine, Karolinska Institutet, Stockholm, Sweden