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Highly encephalitogenic aquaporin 4-specific T cells and NMO-IgG jointly orchestrate lesion location and tissue damage in the CNS #MMPMID26530185
Zeka B; Hastermann M; Hochmeister S; Kögl N; Kaufmann N; Schanda K; Mader S; Misu T; Rommer P; Fujihara K; Illes Z; Leutmezer F; Sato DK; Nakashima I; Reindl M; Lassmann H; Bradl M
Acta Neuropathol 2015[]; 130 (6): 783-98 PMID26530185show ga
In neuromyelitis optica (NMO), astrocytes become targets for pathogenic aquaporin 4 (AQP4)-specific antibodies which gain access to the central nervous system (CNS) in the course of inflammatory processes. Since these antibodies belong to a T cell-dependent subgroup of immunoglobulins, and since NMO lesions contain activated CD4+ T cells, the question arose whether AQP4-specific T cells might not only provide T cell help for antibody production, but also play an important role in the induction of NMO lesions. We show here that highly pathogenic, AQP4-peptide-specific T cells exist in Lewis rats, which recognize AQP4268?285 as their specific antigen and cause severe panencephalitis. These T cells are re-activated behind the blood?brain barrier and deeply infiltrate the CNS parenchyma of the optic nerves, the brain, and the spinal cord, while T cells with other AQP4-peptide specificities are essentially confined to the meninges. Although AQP4268?285-specific T cells are found throughout the entire neuraxis, they have NMO-typical ?hotspots? for infiltration, i.e. periventricular and periaqueductal regions, hypothalamus, medulla, the dorsal horns of spinal cord, and the optic nerves. Most remarkably, together with NMO-IgG, they initiate large astrocyte-destructive lesions which are located predominantly in spinal cord gray matter. We conclude that the processing of AQP4 by antigen presenting cells in Lewis rats produces a highly encephalitogenic AQP4 epitope (AQP4268?285), that T cells specific for this epitope are found in the immune repertoire of normal Lewis rats and can be readily expanded, and that AQP4268?285-specific T cells produce NMO-like lesions in the presence of NMO-IgG.Electronic supplementary material: The online version of this article (doi:10.1007/s00401-015-1501-5) contains supplementary material, which is available to authorized users.