3rd International Conference on Neurology & Therapeutics.

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3rd International Conference on Neurology & Therapeutics www.neuroimmunology.ca

Multiple sclerosis is a devastating disease The first description of the disease was mentioned in 14th century In 1838 Dr. Charcot connected the symptoms to the pathology of the central nervous system (CNS) MS is characterized by appearance of demyelinating plaques throughout the brain and spinal cord Approximately 400,000 North Americans acknowledge having MS, and every week about 200 people are diagnosed. Worldwide, MS may affect 2.5 million MS follows geographical gradient with the risk increasing further from equator. Canada and northern Europe have the highest risk of acquiring MS Genetic predisposition among twins is 30% Sex ration is 2 to 1, females to males MS is an autoimmune disorder MS is a progressive disease

Mechanism of MS Macrophages, Microglia, Astrocytes MMPs, FasL, IL-18, IL-1β, TNFa, NO, ROS, Complement Antigen presenting cell MHC II, CD80, CD86 IL-18, IL-12, IL-1β, Autoreactive CD4 T Cells Th1- IFN-γ, Th17- IL-17 CD8 FasL,TNF-α, Granzymes B cells auto antibody Myelin degradation, Oligodendrocyte, and neuronal loss Neurological symptoms

NLRS Nucleotide-binding Leucine-rich repeat - containing proteins NOD-like receptors Card N-terminal Nucleotide-binding Leucine-rich repeat Pyrin Nlrs Inflammasome Caspase-1, IL-1β, IL-18 Nlrp1 Nlrp3 Nlrc4 Nlrc5 Positive NOD-1 NOD-2 Non-inflammasome NF-κB regulators Negative Nlrp12 Nlrx1 Transcription factors CIITA, Nlrc5 TNFα, IL-1, IL-6, inos NLRs are sensing and redirecting multiple molecular pathways

Inflammasome in MS Stimulation ATP Poreforming toxins Nigiricine MSU NLRP3 NBD PyD PyD Asbestos NBD PyD NLRP3 Silica Bacterial RNA ASC PyD ASC CARD CARD CARD CARD Pro-IL-1β Caspase1 Caspase1 Pro-IL-18 Caspase 1 IL-1β IL-18 Inflammasome Hypothesis Inflammasome exacerbates MS

EAE model of MS Experimental Autoimmune Encephalomyelitis Clinical scores 5 3 Myelin oligodendrocyte glycoprotein (MOG 35-55 ) T cell infiltration T cell infiltration Ptx 0 Immunization 2 wks 3-4 wks 2 days 4-6 wks 0 healthy animal 1 tail dragging on ground constantly 2 tail dragging and locomotor disturbance of at least one hind leg 3 severe hind body paralysis 4 severe locomotor deficiency of front limbs 5 conditions to terminate experiment

Progression of EAE in Nlrp3 -/- mice WT Nlrp3 -/- Mg Mφ Mg Mφ 0.68%±0.1 0.35%±0.13 0.6%±0.14 0.13%±0.05* CD11b CD45 Expression of Nlrp3 drives inflammation within the spinal cord

Demyelination and gliosis are reduced in Nlrp3-/- mice Three weeks after immunization spinal cords were prepared for immunohistochemistry Myelin Astrocytes WT Nlrp3 -/- WT Nlrp3 -/- Spinal cords from Nlrp3 -/- mice had significantly more myelin and reduced gliosis

Th1 and Th17 responses after ex vivo recall WT Nlrp3 -/- 9.2 ± 4.2 2.9 ± 1.2* IFN-γ 3.5 ± 0.9 1.84 ± 1.1* IL-17 CD44 Th1 and Th17 responses are reduced in Nlrp3 -/- mice

NLRP3 plays detrimental role in MS Gris et al J Immunology 2011 Inoue and Shinohara Autoimmune Dis. 2013 Cuprizone model The inflammasome sensor, NLRP3, regulates CNS inflammation and demyelination via caspse-1 and IL-18. Jha et al J Neurosci. 2010 Nov Caspase 1 KO has improved course of EAE ASC KO Shaw et al J Immunol. 2010 May NOD1 and NOD 2 enhance pro-infammatory role of dendritic cells and augment CNS inflammation in mice. Immunity 2011 Jan 28

Nlrx1 and Nlrp12 Negative regulators of NFkB Nlrx1 X Nucleotide-binding Leucine-rich repeat Localized to mitochondria Inhibits NFkB and Type I interferon signaling during viral infections Plays role in cell death (autophagy and apoptosis) Augments ROS production Nlrp12 Pyrin Nucleotide-binding Leucine-rich repeat Inhibits NFkB pathway Plays role in intestinal tumorogenesis Forms an inflammasome Associates with human diseases

Nlrx1 controls inflammation within the CNS Adoptive transfer of encephalitogenic T cells from 2D2 mice

Nlrx1 -/- mice have exacerbated EAE Myelin Astrocytes Neurons

Nlrx1 / microglia have enhanced inflammatory responses. Eitas T K et al. J. Biol. Chem. 2014;289:4173-4179

Conclusions NLRs play detrimental role in development of EAE by augmenting pro-inflammatory effect of T cells, dendritic cells, macrophages, and microglia. Inflammasome, Nlrp3, NOD1, and NOD2 NLRS can play protective role by acting at the level of microglia and macrophages to control excessive inflammation. NLRX1 and NLRP12

Acknowledgements UNC at Chapel Hill Dr. Ting Dr. Eitas Dr. Wen University of Florida Dr. Jobin University of Sherbrooke Autism group Dr. Takser McGill University Dr. Gris Dr. Antel University of Bayreuth Dr. Braun University of Klien Dr. Rosenstiel

Nlrp12 Nlrp12 -/- mice have exacerbated form of EAE and elevated inflammatory response

Nlrp12 inhibitor of inos and cytokines expression Significant increase in inos expression and TNFα and IL-6 production by Nlrp12 -/- microglia

Microglia and macrophages are hyperactivated in Nlrx1 / mice during EAE Macrophages Microglia Eitas T K et al. J. Biol. Chem. 2014;289:4173-4179

T cell infiltration 3 weeks after immunization WT Nlrp3 -/- Spinal cords from Nlrp3 -/- animals had fewer CD4 and CD8 T cells