Protective effects of catalpol and rhein in murine experimental autoimmune encephalomyelitis via regulation of T helper (Th) 1, Th2, Th17, and regulatory T cell responses.

OBJECTIVE: To examine the effects of catalpol and rhein on pro- and anti-inflammatory responses in C57BL/6 mice with experimental autoimmune encephalomyelitis (EAE), a model of multiple sclerosis. METHODS: Female C57BL/6 mice were randomly divided into four groups (n = 30): (a) normal saline control, (b) EAE control, (c) EAE + prednisone acetate (PA, 6 mg/kg), and (d) EAE + catalpol (40 mg/kg) and rhein (5 mg/kg). EAE was induced by injection of myelin oligodendrocyte glycoprotein 35-55 plus pertussis toxin. Treatments were orally administered daily for 40 d. Disease progression and neurological function were assessed using a semi-quantitative scale of tail and limb paralysis. Brains and spinal cords were collected on Days 6, 20, and 40 and assessed for histopathological changes by hematoxylin and eosin staining. Production of interleukin (IL)-2, IL-4, IL-10, and IL-17A protein was measured by enzyme-linked immunosorbent assay. Expression of the T helper (Th)1-, Th2-, Th17-, and regulatory T cell (Treg)-specific transcription factors T-bet, GATA3, ROR-γt, and Foxp3, respectively, were analyzed by quantitative reverse-transcription polymerase chain reaction and western blot analysis. RESULTS: Combination treatment with catalpol and rhein significantly alleviated the clinical disability and neurological dysfunction of mice with EAE. Catalpol and rhein treatment also reduced the infiltration of pro-inflammatory T cells into pathological lesions; significantly increased the expression of the anti-inflammatory factors GATA3, Foxp3, IL-4, and IL-10; and significantly decreased the expression of the pro-inflammatory factors T-bet, ROR-γt, IL-2, and IL-17A. CONCLUSION: Catalpol and rhein reduced the neurological disabilities of mice with EAE, at least in part by rebalancing the pro- and anti-inflammatory environment in the brains and spinal cords.

Upregulation of Bcl-2 and Its Promoter Signals in CD4+ T Cells during Neuromyelitis Optica Remission.

The homeostatic balance between production and elimination of CD4+ T cells in peripheral blood plays an important role in patients with neuromyelitis optica (NMO). The objective of the present study was to evaluate the anti-apoptosis genes Bcl-2 and its promoter signal (nuclear factor kappa-light-chain-enhancer of activated B cells, NFκB) in CD4+ T cells. Healthy subjects (HS, n = 25) and patients with multiple sclerosis (MS) (n = 25) and NMO (n = 30) in remission were consecutively enrolled in this prospective study between May and December 2015. CD4+ T cells were isolated using magnetic beads coated with anti-CD4 monoclonal antibodies, and gene expression of Bcl-2, NFκB, phosphatidylinositol-4, 5-bisphosphate 3-kinase/protein kinase B (PI3K/Akt), and MAP kinase kinase kinase 7 (MAP3K7) was measured by real-time reverse transcription-polymerase chain reaction (rt-PCR). Cytokines of tumor necrosis factor (TNF)-α and interleukin (IL)-1ß were detected using human cytokine multiplex assay. Bcl-2 and NFκB gene expressions were elevated in NMO patients (1.63 ± 0.25; 2.35 ± 0.25) compared with those of HS (0.90 ± 0.11; 1.42 ± 0.22) and/or MS patients (1.03 ± 0.18; 1.55 ± 0.20) (P < 0.05). MAP3K7, but not Akt, was increased in NMO patients (1.23 ± 0.18; 1.56 ± 0.22) (P < 0.01) and was a significant factor related to elevated NFκB gene expressions (P < 0.001). On the other hand, IL-1ß and TNF-α were also detected in the study and the results showed that both were elevated in NMO patients (23.84 ± 1.81; 56.40 ± 2.45) (P < 0.01; P < 0.05, respectively). We propose that MAP3K7 induced by IL-1ß and TNF-α but not Akt promotes NFκB expression and, in turn, prolongs Bcl-2-mediated survival of CD4+ T cells in NMO patients.

Increased plasma levels of epithelial neutrophil-activating peptide 78/CXCL5 during the remission of Neuromyelitis optica.

BACKGROUND: In neuromyelitis optica (NMO), one of the underlying pathogenic mechanisms is the formation of antigen-antibody complexes which can trigger an inflammatory response by inducing the infiltration of neutrophils in lesions. Epithelial neutrophil-activating peptide 78 (ENA 78), known as Chemokine (C-X-C motif) ligand 5 (CXCL5), belongs to the ELR-CXCL family. It recruits and activates neutrophils. The aim of this study was to evaluate ENA 78, IL-1ß and TNF-α plasma levels in multiple sclerosis (MS) and neuromyelitis optica (NMO) patients. METHODS: ENA 78, IL-1ß and TNF-α plasma levels were detected in 20 healthy controls (HC), 25 MS and 25 NMO patients using MILLIPLEX® map Human High Sensitivity Cytokine/Chemokine Panels. RESULTS: Plasma levels of ENA 78 were significantly higher in NMO patients than in HC (P < 0.001) and MS patients (P < 0.05). The NMO patients showed higher plasma levels of IL-1ß compared with HC (P < 0.01). Further, increased plasma levels of TNF-α were found in the MS (P < 0.05) and NMO patients (P < 0.001). In addition, NMO patients had higher Expanded Disability Status Scale (EDSS) scores compared with MS patients (P < 0.05). EDSS scores were correlated with plasma levels of ENA 78 in NMO patients (P < 0.05). There were no significant correlations between EDSS scores and plasma levels of ENA 78 in MS patients (P > 0.05). CONCLUSIONS: The overproduction of pro-inflammatory cytokines such as IL-1ß and TNF-α during the remission of NMO activates ENA 78, which in turn leads to neutrophil infiltration in lesions. ENA 78 plasma levels were correlated with EDSS scores in NMO patients. Elevated secretion of ENA 78 may be a critical step in neutrophil recruitment during the remission of NMO.