Immunopathogenicity of MSRV envelope targeting brain macrophages/microgliocytes:
a common pathogenic pathway for Multiple Sclerosis and Schizophrenia, with
common immunotherapeutic outcomes ?
H.
Perron* and P. Marche**
*bioMérieux
S, R&D Neuroimmunologie, Chemin de L’Orme, 69280 March L’Etoile, France; **INSERM
U548, Immunologie cellulaire et moléculaire,
CEA-G, Avenue des Martyrs, 3800 Grenoble, France
Following
isolation in Leptomeningeal cell cultures from patients with Multiple Sclerosis
–MS- a novel retroviral element was identified and denominated “multiple
sclerosis associated retroviral element” –MSRV-. Its discovery led to the
subsequent identification of a genetically related family of human endogenous
retroviruses (HERV-W), which entered the germ line of primates at the level of
African monkeys, in which it should be named ERV-W. The peculiar nature of such
retroviral families comprising multiple endogenous copies in the genome of
animal species, made it impossible to set up tools for large epidemiological
studies as for, e.g., classical exogenous retroviruses in humans-HTLV or HIV-,
and therefore to quickly elucidate an eventual link between MSRV and MS
pathogenesis and/or aetiology. We thus focused on the study of eventual
pathogenic properties of MSRV retroviral particles, as detected in disease,
which would be compatible with pro-inflammatory and dysimmune mechanisms
described in MS.
MSRV
Immunopathogenicity
In a
collaborative study with Dr Monique Lafon (Institut Pasteur, Paris) and Dr
Patrice Marche (INSERM/CEA, Grenoble), we have evidenced pro-inflammatory and
superantigen-like effects of MSRV virions purified from MS cultures and could
attribute these effects to its envelope protein. In a parallel collaboration
with Pr JL Touraine (Faculté Laënnec, Lyon) , we have set up an human-animal
hybdrid model (SCID mice grafted with a functional human lymphoid system), which
confirmed in vivo the extremely potent immunopathogenicity of MSRV virions and
their ability to induce massive pro-inflammatory cytokine production resulting
severe immunopathogenic effects. The effects observed in this model are
interpreted as a « systemic » version of MSRV immunopathogenic effects, which
would be limited to focal areas when MSRV expression is reactivated in disease
by co-factors targeting few brain microgliocyte/macrophages.
Elsewhere, the
independent publications confirming the detection of MSRV in MS sera and the
clinical significance of its early detection in CSF provide renewed evidence
that this novel concept in MS is emerging from the past confusion towards an
enlarged consensus.
From
retrovirally-induced inflammation to co-factor oriented diseases
In the
Sardinian studies, other neurological diseases such as “chronic inflammatory
demyelinating polyneuropathy” (CIDP) were over-represented and obviously
influenced the figures obtained in “neurological controls”-though remaining
significantly different from MS results. Interestingly, it corroborated our
unpublished data on a plausible association between CIDP and MSRV, in addition
to MS. This may also be the case for certain patients with schizophrenia -SCZ,
thus suggesting a role for MSRV in several neurological or psychiatric diseases,
probably with a common pathogenic pathway. This would be likely to consist in
the pro-inflammatory effects of MSRV envelope protein, which, in addition to
inflammatory demyelinating diseases, could also be relevant in SCZ: such
inflammatory phenomena in a “grey matter” context, were reported in to
contribute to neurotoxicity and were detected in SCZ, with interesting data on
SCZ and IL-6 paralleling our results in MS.
Today, the
belief that MSRV would be “the virus causing MS” -as many opinion leaders are
still expecting a unique “causative agent” in MS-, is the best way to
misunderstand the significance of these findings, which extends beyond MS.
Models such as
HTLV-1 causing either “Adult T-cell leukaemia”, either “tropical spastic
praparesis, either certain types of polymyositis or arthritis, but more
often…nothing at all, appear more relevant for understanding the concept of a
“multi-disease” association with a single pathogen.
The role of
co-factors in HIV-associated diseases is another contribution to the
understanding of how a particular disease may result from, and be
tissue-targeted by, the combination of two pathogens: HHV-8 and HIV-1 in
Kaposi’s sarcoma, Pneumocystis carinii and HIV-1 in AIDS pneumocytosis, etc…
The
contribution of the “endogenous retroviral genotype” is much more difficult to
illustrate in human diseases, since we are indeed building knowledge in humans
today. An insight into animal immunovirology of mouse mammary tumour virus (MMTV),
could nonetheless evidence the pathogenic role of transmissible and pathogenic
retroviral elements of such retroviral families.
Therapeutic
outcomes
Since the
presence of circulating virions in MS, the relationship with disease outcome and
the direct pathogenicity of MS circulating virions have now been evidenced,
blocking pro-inflammatory effects of MSRV Envelope protein in diseases
associated with circulating MSRV virions has a good probability to have positive
influence on the disease course.
Our therapeutic
strategy therefore focuses on potential inhibitors of MSRV-Env mediated
immunopathological effects.