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Early adaptive immune activation detected in monozygotic twins with prodromal multiple sclerosis
Eduardo Beltrán, … , Reinhard Hohlfeld, Klaus Dornmair
Eduardo Beltrán, … , Reinhard Hohlfeld, Klaus Dornmair
Published November 1, 2019; First published September 30, 2019
Citation Information: J Clin Invest. 2019;129(11):4758-4768. https://doi.org/10.1172/JCI128475.
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Categories: Research Article Immunology Neuroscience

Early adaptive immune activation detected in monozygotic twins with prodromal multiple sclerosis

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Abstract

Multiple sclerosis (MS) is a disabling disease of the CNS. Inflammatory features of MS include lymphocyte accumulations in the CNS and cerebrospinal fluid (CSF). The preclinical events leading to established MS are still enigmatic. Here we compared gene expression patterns of CSF cells from MS-discordant monozygotic twin pairs. Six “healthy” co-twins, who carry a maximal familial risk for developing MS, showed subclinical neuroinflammation (SCNI) with small MRI lesions. Four of these subjects had oligoclonal bands (OCBs). By single-cell RNA sequencing of 2752 CSF cells, we identified clonally expanded CD8+ T cells, plasmablasts, and, to a lesser extent, CD4+ T cells not only from MS patients but also from subjects with SCNI. In contrast to nonexpanded T cells, clonally expanded T cells showed characteristics of activated tissue-resident memory T (TRM) cells. The TRM-like phenotype was detectable already in cells from SCNI subjects but more pronounced in cells from patients with definite MS. Expanded plasmablast clones were detected only in MS and SCNI subjects with OCBs. Our data provide evidence for very early concomitant activation of 3 components of the adaptive immune system in MS, with a notable contribution of clonally expanded TRM-like CD8+ cells.

Authors

Eduardo Beltrán, Lisa Ann Gerdes, Julia Hansen, Andrea Flierl-Hecht, Stefan Krebs, Helmut Blum, Birgit Ertl-Wagner, Frederik Barkhof, Tania Kümpfel, Reinhard Hohlfeld, Klaus Dornmair

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Figure 1

Cellular composition of lymphocytes upon analysis by scRNA-Seq.

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Cellular composition of lymphocytes upon analysis by scRNA-Seq.
(A) Flow...
(A) Flowchart of the analysis of human CSF by scRNA-Seq. Because CD4+ cells make up the majority of CSF cells, they were collected by magnetic beads and single CD4+ cells were isolated by flow cytometry. The remaining non-CD4+ cells were separately isolated by single-cell index sorting using different markers. Thus, the ratio of CD4+ and non-CD4+ cell numbers does not reflect the ratio of absolute cell numbers in the CSF samples. Nevertheless, ratios and cell numbers within the non-CD4+ populations are comparable. Whole transcriptomes of each single cell were determined by next-generation sequencing (NGS) with a read length of 2 × 150 bp that allows identification of the hypervariable regions of TCRs and BCRs together with their corresponding V families. Thus, not only transcriptome profiles of each single cell are determined, but also matching α:β TCR and H:L BCR chains. This allows tracking of distinct clones. (B) t-SNE projection of transcriptome data from 2752 single CSF cells and 332 PBMCs from 16 patients, profiled in 9 main clusters. For better visualization, background areas were shaded manually to indicate major cell populations, although some cells will appear in “foreign” areas. Each dot corresponds to one single cell, colored according to the respective cell cluster. DCs, pDCs, and monocytes were not specifically labeled during flow cytometry analyses; therefore up to 6 transcripts were used as discriminators and are listed next to each cluster. (C) Heatmap showing normalized mean expression levels of discriminative gene sets for T cell cluster I CD4+ (lane 1) and CD8+ cells (lane 2), and cluster II CD4+ (lane 3) and CD8+ cells (lane 4). (D) t-SNE projection of all index-sorted CD8+ T cells. (E) t-SNE projection of all index-sorted CD4+ T cells.
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ISSN: 0021-9738 (print), 1558-8238 (online)

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