DICAM promotes TH17 lymphocyte trafficking across the blood-brain barrier during autoimmune neuroinflammation

Sci Transl Med. 2022 Jan 5;14(626):eabj0473. doi: 10.1126/scitranslmed.abj0473. Epub 2022 Jan 5.

Abstract

The migration of circulating leukocytes into the central nervous system (CNS) is a key driver of multiple sclerosis (MS) pathogenesis. The monoclonal antibody natalizumab proved that pharmaceutically obstructing this process is an effective therapeutic approach for treating relapsing-remitting MS (RRMS). Unfortunately, the clinical efficacy of natalizumab is somewhat offset by its incapacity to control the progressive forms of MS (PMS) and by life-threatening side effects in RRMS rising from the expression of its molecular target, very late antigen 4 (VLA4), on most immune cells and consequent impairment of CNS immunosurveillance. Here, we identified dual immunoglobulin domain containing cell adhesion molecule (DICAM) as a cell trafficking molecule preferentially expressed by T helper 17 (TH17)–polarized CD4+ T lymphocytes. We found that DICAM expression on circulating CD4+ T cells was increased in patients with active RRMS and PMS disease courses, and expression of DICAM ligands was increased on the blood-brain barrier endothelium upon inflammation and in MS lesions. Last, we demonstrated that pharmaceutically neutralizing DICAM reduced murine and human TH17 cell trafficking across the blood-brain barrier in vitro and in vivo, and alleviated disease symptoms in four distinct murine autoimmune encephalomyelitis models, including relapsing-remitting and progressive disease models. Collectively, our data highlight DICAM as a candidate therapeutic target to impede the migration of disease-inducing leukocytes into the CNS in both RRMS and PMS and suggest that blocking DICAM with a monoclonal antibody may be a promising therapeutic approach.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Blood-Brain Barrier / metabolism
  • Cell Adhesion Molecules / metabolism
  • Humans
  • Mice
  • Multiple Sclerosis* / drug therapy
  • Multiple Sclerosis* / metabolism
  • Multiple Sclerosis, Relapsing-Remitting*
  • Natalizumab / metabolism
  • Natalizumab / pharmacology
  • Natalizumab / therapeutic use
  • Neuroinflammatory Diseases
  • T-Lymphocytes / metabolism
  • Th17 Cells

Substances

  • Cell Adhesion Molecules
  • DICAM protein, mouse
  • Natalizumab

Grants and funding