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The Journal of Neuroscience, October 1, 2000, 20(19):7307-7316
GluR3 Autoantibodies Destroy Neural Cells in a
Complement-Dependent Manner Modulated by Complement Regulatory
Proteins
Karl D.
Whitney1, 2 and
James O.
McNamara1, 2, 3, 4
1 Epilepsy Research Laboratory and Departments of
2 Pharmacology and Molecular Cancer Biology and
3 Neurobiology, Duke University Medical Center, Durham,
North Carolina 27710, and 4 Durham Veterans Affairs Medical
Center, Durham, North Carolina 27705
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ABSTRACT |
GluR3 autoantibodies have been implicated in the development of
Rasmussen's encephalitis, a rare neurodegenerative disease of humans
characterized by epilepsy and degeneration of a single cerebral
hemisphere. GluR3 autoantibodies are found in some Rasmussen's encephalitis patients, and GluR3 antibodies raised in rabbits destroy
cultured cortical cells in a complement-dependent manner. In this
study, the cellular targets of anti-GluR3 antisera-mediated cytotoxicity were examined in mixed primary neuronal-glial cultures of
rat cortex. Unexpectedly, astrocytes were the principal target of the
cytotoxic effects as assessed by immunohistochemistry and lactate
dehydrogenase activity; neurons were destroyed to a lesser extent.
Astrocyte vulnerability was rescued by transfection with complement
regulatory proteins, and neuronal resistance was defeated by impairing
complement regulatory protein function. Astrocyte death may occur in
Rasmussen's encephalitis, and destruction of this cell type may play a
critical role in the progression of this disorder. The present findings
suggest complement regulatory protein expression may in part determine
the nature and severity of Rasmussen's encephalitis and other
complement-dependent nervous system diseases and thus underscore the
need for a systematic investigation of the expression of all known
complement regulatory proteins in healthy and diseased nervous system tissues.
Key words:
GluR3 autoantibody; Rasmussen's encephalitis; complement; complement regulatory protein; autoimmunity; epilepsy; glutamate receptor
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INTRODUCTION |
Rasmussen's encephalitis (RE) is an
intractable epilepsy generally beginning during childhood or
adolescence and characterized by progressive degeneration of a single
cerebral hemisphere. Progressively worsening unilateral seizures and
unihemispheric neurological problems, such as language deficits,
hemiparesis, and hemisensory loss, develop in parallel with the
hemispheric atrophy. Microscopic examination of resected brain tissue
reveals focal inflammatory changes localized primarily to the cortex of
the affected hemisphere, including microglial nodules, perivascular
lymphocytic cuffing, meningeal infiltrates, neuronal loss, and gliosis
(Rasmussen et al., 1958 ). Because the seizures are unresponsive to
standard antiseizure pharmacotherapy, hemispherectomy is the standard
treatment, typically leaving the child free of seizures but with a
severe neurological deficit (Rasmussen et al., 1958 ; Oguni et al.,
1991 ; Robitaille, 1991 ).
Although the etiology and pathogenesis of RE and the mechanism limiting
the process to one hemisphere have yet to be completely elucidated, a
series of recent studies has established autoantibodies and complement
(C') as possible agents in disease progression. Immunization of rabbits
with the glutamate receptor subunit GluR3 serendipitously led to an
animal model recapitulating many of the principal features of RE and in
turn to the discovery that many RE patients harbor antibodies directed
at GluR3 (Rogers et al., 1994 ). Importantly, seizure severity and
frequency are reduced in some RE patients treated with plasmapheresis
or IgG-selective immunoadsorption, in parallel with reduction of GluR3
antibody titers (Rogers et al., 1994 ; Andrews et al., 1996 ; Antozzi et al., 1998 ). Additionally, some antibodies collected from immunized rabbits or humans with RE elicit excitatory currents in cultured neurons (Twyman et al., 1995 ). We have also found that rabbit anti-GluR3 can destroy primary mixed neuronal-glial cultures in a
C'-dependent manner (He et al., 1998 ). Additional support for IgG and
C' in RE pathogenesis emerged from immunohistochemical studies
revealing IgG and C' deposition on neurons in resected tissue from a
subset of RE but not complex partial epilepsy patients (He et al.,
1998 ; Whitney et al., 1999 ). These observations, along with the fact
that most GluR3 in mixed neuronal-glial cultures are found on neurons
(He et al., 1998 ), led to the hypothesis that anti-GluR3 binds
selectively to neurons in culture, leading to antibody-dependent C'
activation in the vicinity of the neurons and selective neuronal
destruction. The experiments described here reveal that anti-GluR3
unexpectedly does not selectively destroy neurons. Not only does
anti-GluR3 destroy both neurons and astrocytes, neuronal death is more
restricted and occurs more slowly than does astrocyte destruction.
Neuronal resistance is reduced by impairing complement regulatory
protein (CRP) function, and astrocyte resistance is improved by
overexpression of CRPs.
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MATERIALS AND METHODS |
Unless otherwise indicated, all reagents were from Sigma (St.
Louis, MO).
Production of antisera and purification of IgG. White New
Zealand male rabbits were immunized as described previously (Rogers et
al., 1994 ; He et al., 1998 ). Briefly, rabbits weighing 2.5 kg were
injected subcutaneously with 100 µg of glutathione
S-transferase (GST)-GluR3, GST,
trpE-GluR3, or trpE in complete Freund's
adjuvant. The GST-GluR3 fusion protein contains GluR3 residues
246-455, whereas trpE-GluR3 encompasses residues 246-458
(Keinanen et al., 1990 ). Booster injections, given in incomplete
Freund's adjuvant, were given 2 weeks after the initial immunization
and then at 4 week intervals. Serum was obtained by allowing blood to
clot at 4°C followed by centrifugation. Sephadex G-50 chromatography was used to reduce the concentration of glutamate and other small molecular weight substances in serum. Serum diluted 1:1 in
HBSS-HEPES (Life Technologies, Rockville, MD) was passed
sequentially over two Sephadex G-50 columns (Amersham Pharmacia
Biotech, Piscataway, NJ). Serum filtrates were
filter-sterilized, aliquotted, and stored at 80°C. Because
trpE-GluR3 and GST-GluR3 antisera are functionally indistinguishable in the experiments reported here, they will be
collectively referred to as "anti-GluR3" or "GluR3 antisera." TrpE and GST antisera will be referred to as "control antisera" for
similar reasons.
Purified IgG was prepared with protein G agarose (Pierce, Rockford, IL)
affinity chromatography according to the instructions of the
manufacturer. The eluted immunoglobulin fraction was
concentrated using Centricon centrifugal concentrators with a nominal
molecular weight cutoff of 50 kDa (Millipore, Bedford, MA) and then
dialyzed in four exchanges of PBS. Filter-sterilized purified
IgG was stored until use at 4°C.
Tissue culture. Mixed neuronal-glial cultures were prepared
as described previously (He et al., 1998 ). Briefly, day 18 embryos were
removed by cesarean section, the cerebral cortices were dissected, and
the meninges were removed with forceps. Cortices were rinsed with
Ca2+- and
Mg2+-free HBSS (containing 1 mM HEPES; Life Technologies), minced, and then
incubated with 0.25% trypsin in HBSS for 20 min at 37°C. Brain
tissue was then rinsed twice in HBSS followed by two washes in plating
media (minimal essential medium [MEM] supplemented with 3 mg/ml
glucose, 5% fetal bovine serum, and 5% horse serum; all from Life
Technologies) containing 10 µg/ml DNase (Life Technologies). The
tissue was then dispersed by trituration through a fire-polished Pasteur pipette. After centrifugation and resuspension, cells were
plated at 860,000 cells/ml in 90 µl/well in 96-well plates or glass
16-well chamber slides in plating media. Cultures were maintained at
37°C in 5% CO2-95% air in a humidified
incubator until used for experiments on 14-16 days in vitro
(DIV). The media was not exchanged during this time period. The numbers
of neurons and glia as assessed by quantification of GFAP- and
neuronal-specific nuclear protein (NeuN)-immunostained cells
(see below) were found to vary by <10% from experiment to experiment;
astrocytes represented ~43% of the cells, with neurons making up the rest.
Transfection. Cultures were transfected using the Fugene 6 transfection reagent (Roche Molecular Biochemicals, Indianapolis, IN)
according to a method developed by VanDongen and colleagues (T. VanDongen [Duke University, Durham, NC], personal
communication). Briefly, Fugene 6 was diluted 1:14 into
Neurobasal medium (Life Technologies) and incubated at room temperature
(RT) for 10 min. In a separate tube containing Neurobasal, each plasmid
to be transfected was added at 2 µg/100 µl. Diluted Fugene was
mixed 1:1 with the DNA mix, incubated at RT for 5 min, and then added
to DIV 10 cultures. After 30 min at 37°C, the transfection mix was
replaced with the original growth medium. Transfected cells were used
on DIV 14. This method produced transfection efficiencies of ~1%
with minimal toxicity.
Expression vectors containing green fluorescent protein (GFP),
CD8, or CD59 were kindly provided, respectively, by Drs. Donald Lo
(Duke University), Brian Seed (Massachusetts General Hospital, Boston,
MA), and B. P. Morgan (University of Cardiff, Cardiff, UK). A Crry
expression vector was constructed using a PCR amplification product
obtained from reverse-transcribed rat primary glial culture poly(A+) RNA. The primers used for the PCR
amplification were as follows (5' to 3'): (upstream primer) GAT CGA GCG
GCC GCT ATG GAG GCT TCT TCG CCT CTG GAC CCC and (downstream primer) AAT
ATC CTC GAG TGG CGG CTA TTA GAC TTC TTG AGT GAG. The upstream primer
contains a NotI site ahead of the start codon, and the
downstream primer contains an XhoI site downstream of the
stop codon. The PCR product was gel-purified, digested with
NotI and XhoI, and inserted at these sites into
pcDNA3 (Invitrogen, Carlsbad, CA). The construct was confirmed by
restriction and sequence analysis. The Crry cDNA isolated contains
three divergent nucleotides compared with the original published
sequence (Sakurada et al., 1994 ; Quigg et al., 1995 ) (the first, at
base 1145 encodes a silent mutation; the second, at base 1272, encodes
a methionine in place of a valine; and the third, at base 1545, encodes
leucine in place of phenylalanine). In preliminary immunocytochemistry
experiments in which GFP was cotransfected with CD59 or CD8, ~80% of
GFP-positive astrocytes were also positive to varying degrees for the
second transfected gene. GFP fluorescence was therefore used in cell
counting (see below) as a surrogate indicator of transfection with the
second gene.
HEK-293 cells maintained in DMEM (Life Technologies) containing
10% FBS were transfected using the calcium phosphate method as
described previously (He et al., 1998 ). HEK cultures were transfected with either pCMV-GluR3 or pCMV (generous gifts of Ray
Dingledine, Emory University, Atlanta, GA).
Toxicity assays. On the day of the experiment, cultures were
exposed to various compounds in MEM containing 100 µM APV (Tocris Cookson, Ballwin, MO). Control
wells were incubated in MEM-APV alone. In some experiments, before
addition of toxins, cultures were incubated for 30 min with
phosphatidylinositol-specific phospholipase C (PI-PLC) (ICN
Biochemicals, Costa Mesa, CA) diluted to 0.3-0.6 U/ml in MEM-APV
followed by one wash in MEM. PI-PLC was heat-inactivated by boiling for
1 hr. In other experiments, cultures were exposed to vehicle or
anti-GluR3 in the presence of 100 µg/ml anti-CD59 (monoclonal
antibody clone 6D1, IgG1 isotype, generously provided by B. P. Morgan) or a nonspecific IgG1 isotype control (American Type Culture
Collection clone MOPC-31C). This anti-CD59 antibody neutralizes
cell-surface CD59 without itself activating C' (Hughes et al., 1992 ;
Rushmere et al., 1997 ). The soluble C' inhibitor sCR1 (Avant
Immunotherapeutics, Needham, MA) was added in some experiments at a
final concentration of 200 µg/ml. Thirty minutes to 24 hr after the
beginning the experiment, cell death was assessed by measuring lactate
dehydrogenase (LDH) activity released from cells, by a
spectrophotometric method (Vassault, 1983 ). In some experiments,
propidium iodide was added to a final concentration of 5 µg/ml 30 min
before the end of the experiment to label dying cells.
Immunocytochemistry. All steps were performed at room
temperature on a shaker plate unless otherwise indicated. In some
experiments, unfixed cells were exposed to antisera for 30 min on ice
to minimize nonspecific antibody internalization, followed by three
washes in PBS. In other experiments, cultures were exposed to primary antibody after fixation. Cells were fixed for 30 min in 4%
paraformaldehyde-0.075% glutaraldehyde in 0.1 M
phosphate buffer, pH 7.4. After three washes in PBS, cells were
permeabilized in blocking buffer (PBS containing 2% BSA, 0.1% Triton
X-100, and 2% donkey serum). Cells were then incubated with primary
antibody [13 µg/ml anti-GFAP or 8 µg/ml
anti-microtubule-associated protein 2 (MAP-2) (Sigma); 2.5 µg/ml anti-NeuN (Chemicon, Temecula, CA); anti-growth-associated protein 43 (GAP-43), 1:200 ascites (J. H. P. Skene,
Duke University); and 1.25 µg/ml anti-Crry or 1.6 µg/ml anti-CD59
clone 1B4 (B. P. Morgan)] diluted in blocking buffer for 1 hr at
RT or overnight at 4°C. Cultures were washed in blocking buffer and
incubated for 1 hr in secondary antibody [1 µg/ml biotinylated
anti-rabbit IgG (Jackson ImmunoResearch, West Grove, PA); 2 µg/ml
anti-mouse IgG1-FITC (ICN Biochemicals); and 1.2 µg/ml biotinylated
anti-mouse IgG2b (Zymed, South San Francisco, CA)] diluted in blocking
buffer. To visualize biotinylated secondary antibodies, cultures were washed three times in PBS containing 2% BSA and 0.1% Triton X-100 (PBS+) and incubated for 1 hr in Vectastain ABC reagent (1:100; Vector
Laboratories, Burlingame, CA) diluted in PBS containing 0.1% Triton
X-100. In some experiments, the immunocytochemical signal was developed
in 175 mM sodium acetate containing 0.001% H202, 0.25 mg/ml 3-3'
diaminobenzidine tetrahydrochloride, and 6.25 mg/ml
NiSO4. In other experiments, cells were treated
with biotinyl tyramide reagent (1:200; NEN Life Science Products,
Boston, MA) in PBS for 15 min, followed by three washes and a 60 min
incubation with streptavidin-linked rhodamine (4 µg/ml; Molecular
Probes, Eugene, OR) in PBS+. After three washes in 175 mM sodium acetate, cultures were dried, mounted
in Vectashield (Vector Laboratories), and examined in a fluorescent
microscope. Control experiments confirming the specificity of staining
involved omitting the primary antibody or substituting the primary
antibody with one of a different species or isotype; in all cases, no
specific cellular labeling was observed.
Cell counting. In a subset of experiments, cells transfected
with GFP, labeled with propidium iodide, or stained with various antibodies were counted in a blinded manner. For cells transfected with
GFP, all GFP-positive astrocytes and neurons present in each well were
counted. For the other labeling techniques, three random fields of
antibody-stained cells or propidium iodide-stained nuclei were counted
in each well and averaged. Astroglia, labeled with anti-GFAP, and
neuronal somata, stained with anti-MAP-2, were counted if the cell body
was intact. Neuronal nuclei, labeled with anti-NeuN, were counted if
the nucleus was not shrunken. A nucleus was defined as shrunken if it
was <10 µm in diameter and was considered indicative of neuronal
damage because the majority of neuronal nuclei were of this size after
treatment with the neurotoxin kainic acid (KA). In contrast, most
nuclei in untreated or vehicle-treated cultures were 12-16 µm in diameter.
Data analysis. Differences among experimental conditions
were ascertained by t test and ANOVA with post
hoc Tukey t tests and are summarized in Tables
1 and 2.
Statistical significance was established at p < 0.05.
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RESULTS |
Cellular specificity of GluR3 antiserum cytotoxicity
To test the prediction that exposure of mixed neuronal-glial
cultures to GluR3 antisera should selectively destroy neurons, GFAP-immunoreactive glia and Neu-N-immunopositive neurons were counted
in cultures exposed for 24 hr to various antiserum preparations. Unexpectedly, most astrocytes (85%) and significantly fewer neurons (47%) were destroyed by each of six GluR3 antisera raised against either the trpE-GluR3 or GST-GluR3 fusion proteins (Fig.
1; Table 1, Experiment #1). One
anti-GluR3 antiserum was not toxic at the concentrations tested here
(0.5-1.0 mg/ml) and was excluded from this cell death analysis. In
contrast, neither vehicle alone, equal concentrations of four control
antisera (Fig. 1; Table 1, Experiment #1), nor commercial C' (data not
shown) produced significant destruction of cells when compared with
untreated cultures. Importantly, the C' inhibitor sCR1 reduced
anti-GluR3-mediated death of astrocytes and neurons to 22 and <10%,
respectively (Table 1, Experiment #2). sCR1 also prevented cell death
as assessed by LDH assays (data not shown), confirming our previous
report (He et al., 1998 ). Interestingly, the selective astrotoxin
L-amino adipate (L-AA) (Khurgel et al.,
1996 ) likewise destroyed not only most astrocytes (66%) but also a
significant number of neurons (38%) (Table 1, Experiment #1). Our
recent demonstration (He et al., 1998 ) that cytotoxicity is eliminated
by selective removal of GluR3 antibodies from GST-GluR3 antisera,
together with the present observations of equivalent cytotoxicity with
antisera raised against two distinct GluR3 fusion proteins, strongly
implicate antibodies against GluR3 as the critical initiating
factor.

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Figure 1.
Anti-GluR3 destroys astrocytes and neurons after
24 hr exposure. Mixed cultures were incubated with vehicle, various
serum samples, or L-AA for 24 hr, fixed, and then
immunostained for GFAP (white bars) or NeuN
(black bars) to label astrocytes or neuronal nuclei,
respectively. Data presented are averaged cell counts from three random
fields per well from several experiments. Whereas anti-GluR3
(n = 6 antisera) destroy the majority of astrocytes
and approximately half the neurons, control antisera
(n = 5) destroy <10% of cells. The astrotoxin
L-AA also destroys substantial numbers of both glia and
neurons. *p < 0.05 compared with control groups;
**p < 0.001 compared with vehicle or control
serum-treated groups.
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To begin to investigate the unexpected preferential destruction of
astrocytes, cells were examined after 4 hr exposure to anti-GluR3 or
other serum samples. In preliminary work, cell death as assessed by
analysis of LDH release was first detected at 4 hr, increasing in
magnitude during the subsequent 20 hr. Cultures were incubated with
propidium iodide for 30 min before fixation to label dead or dying
cells. In these experiments, astrocytes were labeled with anti-GFAP and
neurons were stained for MAP-2 to facilitate qualitative evaluation of
modest morphological changes. Although neurons and astrocytes both
appeared normal in cultures exposed to vehicle alone, scattered
confluent patches of astrocytes in cultures exposed to anti-GluR3 at 1 mg/ml were swollen or fragmented and propidium iodide-positive (Fig.
2), indicating that the cells were either
dead or dying. The remaining astrocytes in surrounding areas were
propidium iodide-negative and of normal stellate morphology. The
left panel in Figure 2 highlights the morphological changes seen in damaged (red arrows) compared with normal
(green arrow) astrocytes. In contrast to the
astrocytes, the great majority of neurons were healthy-appearing and
propidium iodide-negative at this time point (Fig. 2, right
panel, green arrows). Blinded cell counts (Table 1,
Experiment #3) revealed that, whereas exposure to vehicle alone
resulted in propidium iodide uptake in 12% of astrocytes, 47% of
astrocytes had taken up propidium iodide after treatment with antisera.
In contrast, <7% of neurons were stained by propidium iodide,
irrespective of treatment.

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Figure 2.
Anti-GluR3 selectively destroys
astrocytes after 4 hr exposure. Mixed cultures exposed to vehicle or
various antisera for 4 hr were incubated with propidium iodide
(PI) for 30 min, fixed, and immunostained for
GFAP or MAP-2. In cultures incubated with anti-GluR3 (1 mg/ml),
approximately half the astrocytes (left) display a
deranged morphology characterized by swelling, fragmentation, and lysis
(red arrows). Binucleated astrocytes are a common
feature (double red arrows). Other neighboring
astrocytes appear morphologically normal (green arrow).
Only deranged astrocytes are propidium iodide-positive, indicating
damage to the plasma membrane occurring presumably as the cell begins
to die (red nuclei). In contrast, most neurons appear
morphologically normal and propidium iodide-negative at this time point
(right, green arrows). The red
arrowhead marks a propidium iodide-positive nucleus, possibly a
dying astrocyte unlabeled by the MAP-2 antibody. Both astrocytes and
neurons were comparatively unperturbed in vehicle-treated cultures
(data not shown). The images presented are representative of seven
experiments. Scale bar, 50 µm (pertains to this and all subsequent
images).
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One possible explanation for selective destruction of astrocytes at
early time points by anti-GluR3 is that large numbers of antibodies
might bind to these cells and fix C'. To explore antibody binding to
glia, unfixed neuronal-glial cultures were incubated with various
antisera or purified IgG for 30 min and then counterstained for GFAP or
MAP-2. The percent of GFAP- or MAP-2-positive cells labeled by the
various antisera was then determined by blinded cell counting. Whereas
no more than 3% of astrocytes were labeled by any antiserum or
antibody tested, on average 66% of neurons were labeled on their
somata and processes by the cytotoxic GluR3 antisera (Fig.
3; Table 1, Experiment #4). This staining
pattern was observed with six different cytotoxic antisera and purified
IgG analyzed in multiple experiments and is consistent with the
predominantly neuronal expression of GluR3 in mixed neuronal-glial
cultures (Eshar et al., 1993 ; He et al., 1998 ). Only 7% of neurons
were labeled in cultures exposed to three control antisera (Table 1,
Experiment #4), two commercial rabbit serum sources, or the single
anti-GluR3 serum that was not cytotoxic at the concentrations used
here. This last antiserum also failed to stain GluR3-transfected HEK
cells, whereas the other GluR3 antisera stained GluR3 (but not
mock-transfected) HEK cells (data not shown). Thus, only cytotoxic
antisera contain anti-GluR3 antibodies capable of binding the antigen
in a living cell, and when exposed to mixed neuronal-glial cultures,
these antibodies preferentially bind neurons.

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Figure 3.
GluR3 antibodies bind exclusively to
living neurons. Unfixed mixed cultures were incubated with various
antisera, washed, fixed, and double-immunostained for rabbit IgG
(left panels) and MAP-2 (top middle
panel) or GFAP (bottom middle
panel) to reveal neurons and astrocytes, respectively.
Yellow structures in the overlaid or combined images
(right panels) reveal concordant staining. All cytotoxic
anti-GluR3 label neurons; results from a representative antiserum are
presented. Cytotoxic antisera label most MAP-2-positive neurons but few
GFAP-positive astrocytes (red arrowheads and
arrows, respectively). Two of six GluR3 antisera that
label neurons also label a small number of cells negative for GFAP and
MAP-2 of possible oligodendroglial or microglial morphology
(blue arrowheads). Six distinct noncytotoxic control
rabbit sera all fail to substantially label cells, even at higher
concentrations, with staining being limited to punctate labeling of
particulate, noncellular debris similar to that seen in the background
of the left panels (data not shown).
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Cellular specificity of C' regulatory protein expression
That neurons abundantly bind the IgG in GluR3 antisera predicts
they would experience the greatest C' attack. Yet neurons are not the
cells most rapidly killed by GluR3 antisera. Instead, astrocytes, which
apparently bind little high-affinity IgG in the GluR3 antisera, are
rapidly destroyed by anti-GluR3. We hypothesized that neurons may
resist the toxic effects of anti-GluR3 better than astrocytes because
they express higher levels of CRPs than do astrocytes. CRPs are a
family of proteins that protect self tissues from attack by inhibiting
C' activation and deposition (for review, see Ashgar, 1998 ). The
fact that dying astrocytes appeared to be swollen suggested that CRP
deficiencies had allowed membrane insertion of the cytotoxic membrane
attack complex (MAC). The MAC is a multimeric 100 Å pore composed of
the C' factors C5b, C6, C7, C8, and multiple copies of C9, which allows
ions and water free passage across the membrane of an attacked cell, causing cell swelling and lysis (Austyn and Wood, 1993 ). The CRP CD59
prevents MAC formation by preventing incorporation of C9 into the
developing MAC (Morgan and Meri, 1994 ). To explore whether neurons
express higher levels of CD59 than do astrocytes, cultures were stained
with an anti-CD59 antibody (Fig. 4; Table
1, Experiment #5). CD59 was found on virtually all (97%)
GAP-43-positive axonal processes. In contrast, only 4% of
GFAP-positive astrocytes expressed CD59. Importantly, substantial
immunoreactivity was also found in these experiments on subsets of
MAP-2-positive neuronal dendrites and neuronal somata (data not shown).
Thus, whereas astrocytes express little CD59, neurons are coated from
axon to dendrite with this protective protein.

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Figure 4.
CD59 is expressed predominantly on
neuronal structures. Mixed cultures were double-immunostained for CD59
(anti-CD59 antibody clone 1B4) and glial or neuronal markers. Most
GAP-43-positive axonal structures are also CD59-positive (top
panels), as seen when the left and middle
panels are combined (right panel). In
contrast, few GFAP-positive cells are CD59-positive (bottom
panels). Staining with MAP-2 returned results similar to the
GAP-43 staining (data not shown). These images are representative of
four different experiments.
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CRP inhibition, MAC formation, and cell death
The fact that CD59 is anchored to the cell membrane through a
glycosylphosphatidyl inositol (GPI) linker can be exploited to test
whether neuronal anti-GluR3 resistance is attributable to high
CD59 expression levels. Cultures were treated with PI-PLC to remove
GPI-anchored proteins such as CD59. As measured by LDH assay,
PI-PLC-pretreated cultures were far more sensitive to low concentrations of anti-GluR3 than were vehicle pretreated cultures (Fig. 5, black vs white
bars; Table 2, Experiment #6). The effects of PI-PLC were specific
in that there was no significant effect on the toxicity produced by the
neurotoxin KA or the astrotoxin L-AA. Moreover,
basal cell viability, assessed in vehicle-challenged cultures, was
unaffected by PI-PLC pretreatment. Heat-inactivated PI-PLC had no
effect on the toxicity produced by any agent.

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Figure 5.
PI-PLC sensitizes cultures to C'-dependent toxins.
Whereas exposure of vehicle-pretreated mixed cultures (white
bars) to anti-GluR3 (0.4 mg/ml) produces only modest
cytotoxicity, PI-PLC-pretreated cultures (0.6 U/ml for 30 min;
black bars) are destroyed by anti-GluR3
(*p < 0.05). Pretreatment with PI-PLC does not
dramatically enhance the toxicity produced by the non-C'-dependent
toxins KA (80 µM) or L-AA (1 mM),
and PI-PLC treatment is not toxic on its own. Heat-inactivated PI-PLC
has no effect on the cytotoxicity produced by any compound (data not
shown). Data are presented as percent unpretreated, vehicle-challenged
control and are pooled from three experiments.
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To determine whether PI-PLC pretreatment sensitizes otherwise resistant
neurons to anti-GluR3, a set of immunocytochemistry experiments was
performed in which vehicle- and PI-PLC-pretreated cultures were
challenged for 4 hr with vehicle or anti-GluR3. Dying cells were
labeled by incubation with propidium iodide during the last 30 min. The
percent of GFAP- and MAP-2-positive cells also positive for propidium
iodide was then determined by blinded cell counting. Whereas <7% of
neurons in cultures pretreated with vehicle and challenged with
anti-GluR3 were propidium iodide-positive, 72% of neurons in
PI-PLC-pretreated cultures challenged with anti-GluR3 were propidium
iodide-positive, bereft of neurites, and swollen (Table 1, Experiment
#7). Images representative of three experiments are shown in Figure
6 (top row). Astrocytes were
also sensitized by PI-PLC pretreatment, with the percentage of
astrocytes labeled by propidium iodide after 4 hr incubation with
anti-GluR3 rising from ~50% in the vehicle-pretreated cultures to
>80% in the PI-PLC-pretreated cultures (Table 1, Experiment #7). No
significant changes were observed in the numbers of propidium
iodide-labeled astrocytes or neurons, or in their morphology, in
vehicle-challenged wells, irrespective of pretreatment.

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Figure 6.
CRP debilitation sensitizes neurons to GluR3
antisera. In several experiments, mixed cultures (top
panels) were pretreated with either vehicle or 0.3 U/ml PI-PLC
and then challenged with either vehicle (data not shown) or GluR3
antisera (0.8 mg/ml), or were (bottom panels) exposed to
either vehicle (data not shown) or GluR3 antisera (0.8 mg/ml) in the
presence of 100 µg/ml of either neutralizing anti-CD59 (clone 6D1) or
a nonspecific control IgG1 (MOPC). Note anti-CD59 and
anti-MOPC are non-C'-fixing IgG1 (Hughes et al., 1992 ; Rushmere et al.,
1997 ). Propidium iodide was added at 3.5 hr, and 30 min later the
cultures were fixed and stained for GFAP (data not shown) or MAP-2.
Whereas the majority of neurons in anti-GluR3-challenged cultures
pretreated with vehicle or coincubated with anti-MOPC are
normal-appearing and propidium iodide-negative (green
arrows in left panels), many neurons in the
PI-PLC-pretreated or anti-CD59 cotreated cultures appear swollen,
deficient in neurites, and propidium iodide-positive after anti-GluR3
treatment (red arrows in right panels). A
minority of neurons remains unaffected and healthy-appearing
(green arrows). MAP-2-negative, propidium
iodide-positive nuclei may represent lysed astrocytes (red
arrowheads). In vehicle-challenged cultures, the numbers of
propidium iodide-positive neurons and glia were not significantly
affected by any pretreatment or cotreatment regimen (data not
shown).
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CD59 is just one of multiple proteins removed by PI-PLC. To directly
test the role of CD59, a neutralizing anti-CD59 monoclonal antibody was
used. Cultures were treated with GluR3 antisera in the presence of 100 µg/ml of this neutralizing antibody (clone 6D1) or a nonspecific
control antibody (clone MOPC-31C). Note that neither of these
antibodies can itself fix C', being of the IgG1 isotype (Hughes et al.,
1992 ; Rushmere et al., 1997 ). Whereas only 7% of neurons were
propidium iodide-positive in cultures challenged with GluR3 antisera
alone, 37% were positive in cultures challenged with GluR3 antisera in
the presence of anti-CD59 (Table 1, Experiment #7). In contrast, only
11% of neurons were stained by propidium iodide in cultures challenged
with GluR3 antisera in the presence of the MOPC control antibody.
Images representative of four experiments are shown in the bottom
row of Figure 6. Astrocyte death after challenge with anti-GluR3
was not appreciably affected by cotreatment with anti-CD59 (or
anti-MOPC) (Table 1, Experiment #7), presumably reflecting the fact
that these cells express little CD59. Furthermore, no significant
changes in the numbers of propidium iodide-positive neurons or
astrocytes were noted in cultures challenged with vehicle in either
cotreatment group. As an independent indicator of cell death, LDH
release was measured in cultures subjected to these cotreatment
regimens. LDH release in anti-CD59, GluR3 antiserum cotreated cultures
was 132% of that from cultures treated with anti-GluR3 alone (218 vs
165% of baseline control, respectively); cotreatment with anti-MOPC
had no significant effect on cell death. Notably, KA toxicity was not
affected by either antibody (LDH values ~230% of baseline in each KA
group) (Table 2, Experiment #8).
Together, these results indicate that GPI-anchored proteins such as
CD59 play an important role in neuronal C' defense. The greater
neuronal death in GluR3-challenged cultures after PI-PLC treatment than
anti-CD59 treatment (79 vs 37%) may reflect the fact that PI-PLC
removes all GPI-anchored proteins, including other CRPs that may
provide additional C' defense. Similarly, enhanced astrocyte death
after PI-PLC treatment may reflect removal of additional GPI-anchored
CRPs from the membrane of this cell type.
Although the results of the CD59 inhibition experiments implicate
MAC-mediated swelling and lysis as the mechanism of C'-mediated death,
we could not directly assess MAC deposition on astrocytes (or on
neurons with debilitated CD59) because the majority of commercially
available anti-C' antibodies are neither specific for rabbit C' nor
sufficiently robust to enable useful immunocytochemical analyses.
Moreover, C' cytotoxicity can in principle also result from the
biological actions of small peptides liberated during the proteolytic
processing of C' factors C3 and C5. These peptides, C3a and C5a,
potently activate cells bearing specific receptors such as T-cells,
macrophages, neurons, astrocytes, and microglia (Armstrong et al.,
1990 ; Yao et al., 1990 ; Austyn and Wood, 1993 ; Nolte et al., 1996 ;
Nataf et al., 1999 ). Therefore, to determine by a functional endpoint
whether anti-GluR3-mediated cell death results specifically from MAC
deposition as opposed to C5a-mediated activation of microglia for
example, cultures were exposed to IgG purified from
trpE-GluR3 or trpE antisera in the presence of
low concentrations of rabbit serum deficient in the C' factor C6.
Although C6-deficient serum (C6d) can be activated like normal serum,
activation halts after processing C5 because incorporation of the
downstream factors C7, C8, and C9 into the MAC is impossible without
previous C6 incorporation. Thus, this serum produces normal amounts of
C3a and C5a but no MACs. Cytotoxicity was observed only when C6d was
coincubated with C6 and an anti-GluR3 antibody (Fig.
7; Table 2, Experiment #9). The highly
sensitive LDH assay was used in these experiments as opposed to direct
cell counts because the effect was relatively modest compared with that
presented, for example, in Figure 1. In the absence of C6, C6d was not
toxic at concentrations up to 1.5 mg/ml, sevenfold more C6d than used in this experiment (data not shown). These findings indicate that GluR3
antibody-mediated cell death requires not only activation of the C'
cascade but also formation of the complete MAC channel.

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Figure 7.
GluR3 cytotoxicity requires MAC formation. In five
experiments, mixed cultures were incubated with vehicle (white
bars), purified trpE-GluR3 IgG; 200 µg/ml;
hatched bars) or trpE IgG (200 µg/ml;
black bars) alone (left set of bars)
or in the presence of C6-deficient rabbit serum (C6d, 213 µg/ml;
middle set of bars) or C6d reconstituted with
human C6 (25 µg/ml; right set of bars).
Elevated cytotoxicity is observed only when cultures are incubated with
anti-GluR3 and reconstituted serum. *p < 0.05-0.001 compared with all other groups; #no difference compared
with other unmarked groups.
|
|
CRP overexpression, cytoprotection, and the
bystander hypothesis
The findings presented so far suggest that neuronal resistance
results from high-level CRP expression and that astrocytes are lysed by
MACs inserted into their membranes. However, although the C6d
experiments indicate that MAC formation is essential for cell death,
they do not prove MAC formation must occur specifically on astrocytes
for astrocytes to die. For instance, MAC deposition on neurons may
trigger the release of a compound that then kills astrocytes. One way
to distinguish these possibilities is to examine the ability of
transiently overexpressed CD59 to protect astrocytes against
anti-GluR3-mediated destruction, because the role of CD59 is to prevent
MAC formation. To address this question, cultures were cotransfected
with GFP and CD59 and then challenged with anti-GluR3; the number of
surviving GFP-positive astrocytes were compared with cultures
cotransfected with GFP and CD8 as a control. Whereas anti-GluR3
destroyed ~40% of CD8-cotransfected astrocytes (Fig.
8, hatched vs white
bar in left group of bars), anti-GluR3 destroyed <8% of CD59-cotransfected astrocytes (Fig. 8, middle set of bars; Table 1, Experiment #10). CD59
specifically protects against C' attack because
L-AA destroyed >80% of astrocytes in both
transfection conditions (black bars) (Table 1, Experiment #10). When combined with the C6d work, these observations indicate that
MAC formation on astrocytes is required for astrocyte destruction.

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Figure 8.
Expression of either CD59 or Crry protects glia.
Cultures transfected with GFP and CD8, CD59, or Crry were incubated for
4 hr with vehicle (white bars), anti-GluR3
(hatched bars; 0.8 mg/ml), or L-AA
(black bars; 1 mM). Cultures were then
fixed, and the total number of GFP-positive astrocytes were counted.
Pooled data from seven experiments are presented and expressed as
percent vehicle control. Compared with transfection with CD8,
transfection with CD59 or Crry protects astrocytes against
GluR3-mediated toxicity. L-AA destroys the majority of
astrocytes in all transfection conditions. @ or *p < 0.05; # or ns, no difference.
|
|
If cell death is initiated by anti-GluR3 binding to GluR3 protein on
neurons, with consequent C' activation on this same cell type, how can
MAC-dependent astrocyte death occur? One possibility is that C'
originally activated on neurons envelops and ultimately kills
neighboring astrocytes. According to this "bystander" process, as
the C' cascade activates on neurons, a transiently water-soluble, incomplete MAC (C5b-7) deposits on both neurons and bystander astrocytes. To the extent a cell expresses CD59, construction of the
complete MAC will be inhibited. The relative lack of CD59 on astrocytes
suggests they would permit more construction of the full MAC than
neurons and therefore suffer more C'-mediated lysis. This bystander
mechanism has been established in C'-mediated destruction of
other closely juxtaposed cell types (Park et al., 1997 ). An alternative
possibility is that antibodies binding to neurons have no effect on
astrocyte death at all; instead, small numbers of antibodies may bind
to astrocytes and fix C' directly on them. To distinguish these
possibilities, the protective effect of overexpressing a CRP that acts
at earlier stages of the C' cascade was examined. Crry was chosen
because (1) it is a multifunctional CRP that potently inhibits cascade
activation and (2) immunocytochemistry experiments revealed Crry is
selectively expressed on neuronal processes and not astrocytes, an
expression pattern exactly matching that of endogenous CD59
(Fig. 4). If astrocytes are destroyed by the insertion of C5b-7,
then Crry overexpression should fail to protect because this CRP acts
upstream of C5b-7 formation. If the bystander process is not
involved, however, and C' activation is initiated directly on
astrocytes, then astrocytes expressing Crry should be protected because
the protein will halt the cascade as soon as it is activated. Only 8%
of Crry-transfected astrocytes were destroyed by anti-GluR3, a level of
protection equivalent to that afforded by CD59 transfection (Fig. 8,
right set of bars; Table 1, Experiment #10).
Importantly, L-AA destroyed >80% of astrocytes
in this group as well, confirming the C'-specificity of Crry protection
(Table 1, Experiment #10). That transfection of either CD59 or Crry
protects astrocytes against the toxic effects of GluR3 antiserum
implies that both early and late C' cascade components are deposited on
astrocytes and that bystander processes do not appear to contribute
significantly to astroglial death.
 |
DISCUSSION |
Overview
This study investigates the cytotoxic actions of anti-GluR3 in
primary cultures containing a mixture of astrocytes and neurons. The
principal findings are fivefold. (1) Whereas the majority of GluR3
antibodies binds rapidly to neurons and not astrocytes, anti-GluR3
antisera preferentially and unexpectedly destroy astrocytes. Prominent
neuronal damage is only seen at later time points, and even after 24 hr, the proportion of astrocytes destroyed exceeds that of neurons. (2)
GluR3 antiserum-mediated cell death requires complement (C') activation
because cytotoxicity can be inhibited by sCR1. (3) The C6-deficient
serum experiments reveal that anti-GluR3 cytotoxicity specifically
requires construction of the MAC. (4) Neuronal resistance to C' attack
is enabled by high levels of CRPs because resistant neurons can be
sensitized by interfering with CD59 function. (5) Conversely,
astrocytes can be protected from C' attack by transfection with either
of two CRPs, CD59, or Crry. Together, these observations suggest a
model explaining how GluR3 antisera damage both neurons and astrocytes
(Fig. 9). Succinctly, anti-GluR3 binding
to both neurons and astrocytes activates C' on both cell types; that
most antibodies bind to neurons suggests that extensive C' deposition
occurs on this cell type. However, high CRP expression levels by
neurons protect them from C'-mediated destruction, whereas low
astrocytic CRP expression levels leave this cell type incapable of
preventing MAC construction. Consequently, astrocytes and not neurons
suffer lytic death at early time points.

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Figure 9.
Model of GluR3 antibody-mediated
in vitro cytotoxicity. The experiments presented here
support a multistep process: (1) anti-GluR3
antibodies bind to GluR3 antigen, which is expressed on neurons and, to
a lesser extent, astrocytes; (2) although C'
activation occurs on both cell types, (3)
neurons are initially protected from C'-mediated lysis by high
expression levels of CRPs such as CD59; (3') astrocytes,
in contrast, lack CRPs and the protection they afford; thus,
(4) MACs form on their surfaces, leading
ultimately to their lytic demise; (5) at later
time points, neurons suffer damage either by virtue of previous damage
to astrocytes or finally succumbing to long-term low-level C'
attack.
|
|
There are several plausible explanations for the neuronal death that
occurs at later time points. One is that neurons die principally as a
consequence of previous destruction of astrocytes by anti-GluR3, as
suggested by the similar pattern of neuronal and glial damage caused in
the present work by the L-AA, a selective astrotoxin
(Khurgel et al., 1996 ). Potential mechanisms of neuronal death include
loss of astrocyte-derived BDNF or other growth factors upon which
neurons are known to depend for survival in primary culture (Banker,
1980 ; Barde, 1989 ; Eddleston and Mucke, 1993 ) or from toxic
accumulations of, for example, extracellular glutamate normally
buffered by astrocytes (Choi, 1992 ; Rothstein et al., 1996 ; Tanaka et
al., 1997 ). Alternatively, neurons may die only after exhausting their
ability to resist C' attack. For instance, CD59 complexes
stoichiometrically with membrane-deposited C8 and C9 in preventing MAC
formation, and because the CD59 stock of a cell is finite, it may
eventually be depleted (Rollins et al., 1991 ; Morgan and Meri,
1994 ).
The bystander hypothesis, CRP expression levels, and
neurological disease
The experiments with sCR1 and C6-deficient serum indicate that
astrocyte destruction requires not only activation of the C' cascade
but also construction of the MAC channel. However, these experiments do
not prove that cytotoxic MAC deposition occurs directly on astrocytes;
conceivably, neuronal MAC deposition triggers release of a compound
that then kills astrocytes. The CD59 transfection experiments were
undertaken to investigate this possibility and revealed that astrocytes
are protected by CD59 expression, implying that MAC deposition does
occur directly on astrocytes. These findings beg the additional
interesting question of whether astrocyte MAC deposition could result
from C' activation occurring in the vicinity of GluR3 on neurons. The
bystander hypothesis predicts that MAC deposition on astrocytes occurs
when incomplete MACs spread from neurons to nearby defenseless
astrocytes. This possibility was tested by transfection with Crry,
which will not protect astrocytes if the bystander hypothesis is
correct because Crry acts at a stage earlier than formation of the
free-floating nascent MAC. That expression of Crry on astrocytes
enhances astrocyte resistance implies that early C' components are
deposited directly on astrocytes.
Together, these transfection experiments indicate that the C' cascade
is initiated and completed directly on astrocytes and that the
bystander hypothesis is incorrect. Because of the paucity of astrocyte
CRPs and the catalytic manner in which C' cascade activation proceeds,
even a small number of antibodies binding to astrocytes may trigger
sufficient C' activation to kill these cells. The antibodies may be so
few in number or of such low affinity that they remain
immunocytochemically undetectable. Based on previous immunodepletion
experiments in which removal of GluR3 but not GST antibodies from
GST-GluR3 antiserum completely abrogated toxicity, the
astrocyte-binding antibodies are likely directed against GluR3 (He et
al., 1998 ). Astrocytes express multiple types of glutamate receptors
in vitro, albeit at lower levels than neurons, including AMPA receptors containing GluR3 (for review, see Steinhäuser and
Gallo, 1996 ).
Astrocytes express GluR3 in vivo and may likewise suffer
antibody-mediated C'-dependent destruction in RE given the low CRP expression levels described by immunocytochemistry and in
situ hybridization studies in the literature (Meri et al., 1991 ;
Johnstone et al., 1993 ; Funabashi et al., 1994 ; Vedeler et al., 1994 ;
Zajicek et al., 1995 ; Koski et al., 1996 ; Davoust et al., 1999 ; Spiller et al., 1999 ). However, the CRP family is a large one, and a
comprehensive investigation of the cellular (i.e., neuronal vs glial)
localization of all known family members in diseased and normal nervous
system tissues from humans and the rodents used for neurological
disease models remains to be completed. The pivotal role cellular CRP expression plays in vitro in protecting against C'-mediated
attack underscores the need for such a systematic description. Indeed, deficient CRP expression or expression of a defective isoform of a CRP
in vivo may constitute an important risk factor for RE, myasthenia gravis, multiple sclerosis, Alzheimer's disease, and other
neurological disorders in which autoantibodies and C' have been
implicated (McRae et al., 1996 ; Whitney and McNamara, 1999 ). Although
the ideas of CRP function and dysfunction are a central concept in the
organ transplantation field (Baldwin et al., 1995 ; Cozzi and White,
1995 ; Ryan, 1995 ), comparatively little effort has been expended
investigating their relationship to neurological disease.
Determining whether CRP function is impaired in such diseases may prove
helpful in understanding their pathogeneses and therefore in developing
novel therapies, perhaps involving gene therapy to enhance surface
expression of the deficient CRP.
Astrocyte death and RE progression
Whether or not RE patients suffer from defective CRP expression,
this disease is classically defined by broad neuronal death and
reactive astrogliosis. However, the drastic hemispheric degeneration common in advanced RE cases in which large parts of a hemisphere are
destroyed is not likely attributable to the exclusive loss of neurons,
because glia are the predominant cell type and probably are a major
contributor to tissue volume in the CNS. Additionally, the magnitude of
astrocyte loss may be obscured by the proliferation of normal glia
responding to tissue damage. Damage to astrocytes in the context of
neurodegeneration and reactive astrogliosis has been observed in other
pathological conditions. For instance, degenerating astroglia have been
detected in the brains of patients with frontotemporal dementia, a
disease characterized by widespread layer-specific neuron loss and
reactive astrogliosis (Martin et al., 1998 ). In this study,
degenerating astrocytes were found scattered among proliferating
reactive astroglia with the overall number of intact astrocytes being
similar to control specimens.
How might such astrocyte death contribute to the neuronal loss,
seizures, gliosis, and CNS inflammation typical of RE? Perhaps most
simply, as alluded to above, neurons may die for lack of astrocyte-derived trophic support or from exposure to toxic compounds no longer sequestered by astrocytes. Also, seizures may result from
deficient glutamate buffering (Rothstein et al., 1996 ; Tanaka et al.,
1997 ). Additionally, cell death will activate neighboring astrocytes
and microglia, both of which rapidly respond to even minute changes in
the CNS environment by assuming an activated posture that includes
proliferation, upregulation of numerous cell-surface receptors, and
other genes, and for microglia the additional capacity to phagocytose
cellular debris (Eddleston and Mucke, 1993 ; Kreutzberg, 1996 ; Streit,
1996 ). Fc , CR1, and CR3, which bind to IgG, C3b, and C4b,
respectively, are among the upregulated microglial receptors, and
interactions between these receptors and their membrane-bound ligands
may trigger phagocytosis (Austyn and Wood, 1993 ). Brain sections from
RE patients often contain neurons surrounded by microglia thought to be
engaged in neuronophagia (Robitaille, 1991 ). We speculate that, after proliferating and clearing away cellular debris, the glia remain as the
microglial nodules and gliotic scars often noted in RE specimens
(Robitaille, 1991 ). Finally, high local concentrations of C5a may also
underlie the formation of perivascular lymphocytic cuffs, because
T-cells bear C5a receptors that mediate chemotaxis up C5a gradients
in vitro (Nataf et al., 1999 ).
A recent study of the role reactive astrocytes play in wound repair in
the CNS provides evidence in support of some of these suggestions (Bush
et al., 1999 ). Transgenic mice were generated whose astrocytes
expressed the viral thymidine kinase gene driven by a GFAP promoter.
Reactive astrocytes were selectively destroyed after an experimental
stab wound with systemically administered ganciclovir because thymidine
kinase levels rose in parallel with GFAP transcription around the wound
site. Reactive astrocyte ablation was associated with exacerbated
inflammation at the wound site, defective repair of the blood-brain
barrier (BBB) as judged by prolonged permeability to
circulating proteins, and destruction of neighboring neurons in a
glutamate receptor activation-dependent manner. Extrapolating these
findings to RE, astrocyte destruction may enable inflammatory cells,
pathogenic IgG, and C' easy access to the neural environment through a
persistently damaged BBB. The phenomena that we postulate stem from
these agents (inflammation, seizures, and cell death) would represent
not only an exacerbation of the disease but also a means of disease
perpetuation, because activated inflammatory cells, seizures, and C'
activation products can all disrupt the BBB (Cornford and Oldendorf,
1986 ; Hollerhage et al., 1989 ; Kadurugamuwa et al., 1989 ; Steinman,
1996 ). Consistent with the notion that peripheral pathogenic factors
enter the CNS via a disrupted BBB are the immunocytochemical findings
of preferential perivascular IgG and C' deposition in brain samples
from a subset of RE patients (Whitney et al., 1999 ) and responsiveness
of some RE patients to plasma exchange or removal of circulating IgG
(Rogers et al., 1994 ; Andrews et al., 1996 ; Antozzi et al., 1998 ).
Examined in the context of these studies, C'-mediated astrocyte damage may be a pivotal event in RE pathogenesis that ensures the development of a chronic disease marked by seizures, neuronal and glial death, inflammation, and gliosis.
 |
FOOTNOTES |
Received Feb. 15, 2000; revised June 12, 2000; accepted July 17, 2000.
This work was supported by National Institutes of Health Grant
NS 036808. K.D.W. was supported by a predoctoral fellowship from the
Howard Hughes Medical Institute. We thank Wei Hua Qian for her
excellent technical support in this project.
Correspondence should be addressed to Dr. James O. McNamara, Epilepsy
Research Laboratory, Campus Box 3676, Duke University Medical Center,
Durham, NC 27710. E-mail: jmc{at}neuro.duke.edu.
 |
REFERENCES |
-
Andrews PI,
Dichter MA,
Berkovic SF,
Newton MR,
McNamara JO
(1996)
Plasmapheresis in Rasmussen's encephalitis.
Neurology
46:242-246[Abstract/Free Full Text].
-
Antozzi C,
Granata T,
Aurisano N,
Zardini G,
Confalonieri P,
Airaghi G,
Mantegazza R,
Spreafico R
(1998)
Long-term selective IgG immunoadsorption improves Rasmussen's encephalitis.
Neurology
51:302-305[Abstract/Free Full Text].
-
Armstrong RC,
Harvath L,
Dubois-Dalcq ME
(1990)
Type 1 astrocytes and oligodendrocyte-type 2 astrocyte glial progenitors migrate toward distinct molecules.
J Neurosci Res
27:400-407[Web of Science][Medline].
-
Ashgar SS,
Pasch MC
(1998)
Complement as a promiscuous signal transduction device.
Lab Invest
78:1203-1225[Web of Science][Medline].
-
Austyn JM,
Wood KJ
(1993)
In: Principles of cellular and molecular immunology. Oxford: Oxford UP.
-
Baldwin III WM,
Pruitt SK,
Brauer RB,
Daha MR,
Sanfilippo F
(1995)
Complement in organ transplantation.
Transplantation
59:797-808[Medline].
-
Banker GA
(1980)
Trophic interactions between astroglial cells and hippocampal neurons in culture.
Science
209:809-810[Abstract/Free Full Text].
-
Barde YA
(1989)
Trophic factors and neuronal survival.
Neuron
2:1525-1534[Web of Science][Medline].
-
Bush TG,
Puvanachandra N,
Horner CH,
Polito A,
Ostenfeld T,
Svendsen CN,
Mucke L,
Johnson MH,
Sofroniew MV
(1999)
Leukocyte infiltration, neuronal degeneration, and neurite outgrowth after ablation of scar-forming reactive astrocytes in adult transgenic mice.
Neuron
23:297-308[Web of Science][Medline].
-
Choi DW
(1992)
Excitotoxic cell death.
J Neurobiol
23:1261-1276[Web of Science][Medline].
-
Cornford EM,
Oldendorf WH
(1986)
Epilepsy and the blood-brain barrier.
In: Advances in neurology (Delgado-Escuelta AV,
Ward Jr AA,
Woodbury DM,
Porter RJ,
eds), pp 787-812. New York: Raven.
-
Cozzi E,
White DJG
(1995)
The generation of transgenic pigs as potential organ donors for humans.
Nat Med
1:964-966[Web of Science][Medline].
-
Davoust N,
Nataf S,
Holers VM,
Barnum SR
(1999)
Expression of the murine complement regulatory protein Crry by glial cells and neurons.
Glia
27:162-170[Web of Science][Medline].
-
Eddleston M,
Mucke L
(1993)
Molecular profile of reactive astrocytes: implications for their role in neurologic disease.
Neuroscience
54:15-36[Web of Science][Medline].
-
Eshar N,
Petralia RS,
Winters CA,
Niedzielinski AS,
Wenthold RJ
(1993)
The segregation and expression of glutamate receptor subunits in cultured hippocampal neurons.
Neuroscience
57:943-964[Web of Science][Medline].
-
Funabashi K,
Okada N,
Matsuo S,
Yamamoto T,
Morgan BP,
Okada H
(1994)
Tissue distribution of complement regulatory proteins in rats.
Immunology
81:444-451[Web of Science][Medline].
-
He X-P,
Patel M,
Whitney KD,
Janumpalli S,
Tenner A,
McNamara JO
(1998)
Glutamate receptor GluR3 antibodies and death of cortical cells.
Neuron
20:153-163[Web of Science][Medline].
-
Hollerhage HG,
Walter GF,
Stolke D
(1989)
Complement-derived polypeptide C3adesArg as a mediator of inflammation at the blood-brain barrier in a new experimental cat model.
Acta Neuropathol
77:307-313[Medline].
-
Hughes TR,
Piddlesden SJ,
Williams JD,
Harrison RA,
Morgan BP
(1992)
Isolation and characterization of a membrane protein from rat erythrocytes which inhibits lysis by the membrane attack complex of rat complement.
Biochem J
284:169-176.
-
Johnstone RW,
Loveland BE,
McKenzie IFC
(1993)
Identification and quantification of complement regulator CD46 on normal human tissues.
Immunology
79:341-347[Web of Science][Medline].
-
Kadurugamuwa JL,
Hengstler B,
Bray MA,
Zak O
(1989)
Inhibition of complement-factor-5a-induced inflammatory reactions by prostaglandin E2 in experimental meningitis.
J Infect Dis
160:715-719[Medline].
-
Keinanen K,
Wisden W,
Sommer B,
Werner P,
Herb A,
Verdoorn T,
Sakmann B,
Seeburg PH
(1990)
A family of AMPA-selective glutamate receptors.
Science
249:556-560[Abstract/Free Full Text].
-
Khurgel M,
Koo AC,
Ivy GO
(1996)
Selective ablation of astrocytes by intracerebral injections of alpha-aminoadipate.
Glia
16:351-358[Web of Science][Medline].
-
Koski CL,
Estep AE,
Sawant-Mane S,
Shin ML,
Highbarger L,
Hansch GM
(1996)
Complement regulatory molecules on human myelin and glial cells: differential expression affects the deposition of activated complement proteins.
J Neurochem
66:303-312[Web of Science][Medline].
-
Kreutzberg GW
(1996)
Microglia: a sensor for pathological events in the CNS.
Trends Neurosci
19:312-318[Web of Science][Medline].
-
Martin JA,
Su JH,
Cotman CW
(1998)
Astrogliosis, astrodegeneration, and neuron loss in frontotemporal dementia.
Soc Neurosci Abstr
24:1472.
-
McRae A,
Ling EA,
Wigander A,
Dahlstrom A
(1996)
Microglial cerebrospinal fluid antibodies. Significance for Alzheimer's disease.
Mol Chem Neuropathol
28:89-95[Medline].
-
Meri S,
Waldmann H,
Lachmann PJ
(1991)
Distribution of protectin (CD59), a complement membrane attack inhibitor, in normal human tissues.
Lab Invest
65:532-537[Web of Science][Medline].
-
Morgan BP,
Meri S
(1994)
Membrane proteins that protect against complement lysis.
Springer Semin Immunopathol
15:369-396[Web of Science][Medline].
-
Nataf S,
Davoust N,
Ames RS,
Barnum SR
(1999)
Human T cells express the C5a receptor and are chemoattracted to C5a.
J Immunol
162:4018-4023[Abstract/Free Full Text].
-
Nolte C,
Moller T,
Walter T,
Kettenmann H
(1996)
Complement 5a controls motility of murine microglial cells in vitro via activation of an inhibitory G-protein and the rearrangement of the actin cytoskeleton.
Neuroscience
73:1091-1107[Web of Science][Medline].
-
Oguni H,
Andermann F,
Rasmussen TB
(1991)
The natural history of the syndrome of chronic encephalitis and epilepsy: a study of the MNI series of 48 cases.
In: Chronic encephalitis and epilepsy (Andermann F,
ed), pp 7-35. Boston: Butterworth-Heinemann.
-
Park CC,
Shin ML,
Simard JM
(1997)
The complement membrane attack complex and the bystander effect in cerebral vasospasm.
J Neurosurg
87:294-300[Medline].
-
Quigg RJ,
Lo CF,
Alexander JJ,
Sneed III AE,
Moxley G
(1995)
Molecular characterization of rat Crry: widespread distribution of two alternative forms of Crry mRNA.
Immunogenetics
42:362-367[Medline].
-
Rasmussen T,
Olszweski J,
Lloyd-Smith D
(1958)
Focal seizures due to chronic localized encephalitis.
Neurology
8:435-455.
-
Robitaille Y
(1991)
Neuropathologic aspects of chronic encephalitis.
In: Chronic encephalitis and epilepsy (Andermann F,
ed), pp 79-110. Boston: Butterworth-Heinemann.
-
Rogers SW,
Andrews PI,
Gahring LC,
Whisenand T,
Cauley K,
Crain B,
Hughes TE,
Heinemann SF,
McNamara JO
(1994)
Autoantibodies to glutamate receptor GluR3 in Rasmussen's encephalitis.
Science
265:648-651[Abstract/Free Full Text].
-
Rollins SA,
Zhao J,
Ninomiya H,
Sims PJ
(1991)
Inhibition of homologous complement by CD59 is mediated by a species-specific recognition conferred through binding to C8 within C5b-8 or C9 within C5b-9.
J Immunol
146:2345-2351[Abstract].
-
Rothstein JD,
Dykes-Hoberg M,
Pardo CA,
Bristol LA,
Jin L,
Kunci RW,
Kanai Y,
Hediger MA,
Wang Y,
Schielke JP,
Welty DF
(1996)
Knockout of glutamate transporters reveals a major role for astroglial transport in excitotoxicity and clearance of glutamate.
Neuron
16:675-686[Web of Science][Medline].
-
Rushmere NK,
Tomlinson S,
Morgan BP
(1997)
Expression of rat CD59: functional analysis confirms lack of species selectivity and reveals that glycosylation is not required for function.
Immunology
90:640-646[Web of Science][Medline].
-
Ryan US
(1995)
Complement inhibitory therapeutics and xenotransplantation.
Nat Med
1:967-968[Medline].
-
Sakurada C,
Seno H,
Dohi N,
Takizawa H,
Nonaka M,
Okada N,
Okada H
(1994)
Molecular cloning of the rat complement regulatory protein, 5I2 antigen.
Biochem Biophys Res Commun
193:819-826.
-
Spiller OB,
Hanna SM,
Morgan BP
(1999)
Tissue distribution of the rat homolog of decay-accelerating factor.
Immunology
97:374-384[Medline].
-
Steinhäuser C,
Gallo V
(1996)
News on glutamate receptors in glial cells.
Trends Neurosci
19:339-345[Web of Science][Medline].
-
Steinman L
(1996)
Multiple sclerosis: a coordinated immunological attack against myelin in the central nervous system.
Cell
85:299-302[Web of Science][Medline].
-
Streit WJ
(1996)
The role of microglia in brain injury.
Neurotoxicology
17:671-678[Web of Science][Medline].
-
Tanaka K,
Watase K,
Manabe T,
Yamada K,
Watanabe M,
Takahashi K,
Iwama H,
Nishikawa T,
Ichihara N,
Kikuchi T,
Okuyama S,
Kawashima N,
Hori S,
Takimoto M,
Wada K
(1997)
Epilepsy and exacerbation of brain injury in mice lacking the glutamate transporter GLT-1.
Science
276:1699-1702[Abstract/Free Full Text].
-
Twyman RE,
Gahring LC,
Spiess J,
Rogers SW
(1995)
Glutamate receptor antibodies activate a subset of receptors and reveal an agonist binding site.
Neuron
14:755-762[Web of Science][Medline].
-
Vassault A
(1983)
Lactate dehydrogenase.
In: Methods of enzymatic analysis (Bergmeyer HU,
ed), pp 118-126. Weinheim, Germany: Verlag Chemie.
-
Vedeler C,
Ulvestad E,
Bjorge L,
Conti G,
Williams K,
Mork S,
Matre R
(1994)
The expression of CD59 in normal human nervous tissue.
Immunology
82:542-547[Web of Science][Medline].
-
Whitney KD,
McNamara JO
(1999)
Humoral autoimmunity and modulation of synaptic transmission.
Annu Rev Neurosci
22:175-195[Web of Science][Medline].
-
Whitney KD,
Andrews PI,
McNamara JO
(1999)
Immunoglobulin G and complement immunoreactivity in the cerebral cortex of patients with Rasmussen's encephalitis.
Neurology
53:699-708[Abstract/Free Full Text].
-
Yao J,
Harvath L,
Gilbert DL,
Colton CA
(1990)
Chemotaxis by a CNS macrophage, the microglia.
J Neurosci Res
27:36-42[Web of Science][Medline].
-
Zajicek J,
Wing M,
Skepper J,
Compston A
(1995)
Human oligodendrocytes are not sensitive to complement.
Lab Invest
73:128-138[Web of Science][Medline].
Copyright © 2000 Society for Neuroscience 0270-6474/00/20197307-10$05.00/0
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