Journal
METABOLIC BRAIN DISEASE
Volume 30, Issue 1, Pages 57-65Publisher
SPRINGER/PLENUM PUBLISHERS
DOI: 10.1007/s11011-014-9558-8
Keywords
Multiple sclerosis; Thrombin; Antithrombotics; Activated protein C
Categories
Funding
- National Multiple Sclerosis Society [PP1900]
- National Institutes of Health [R44HL117589, R01HL101972]
- Oregon Clinical and Translational Research Institute (OCTRI) from the National Center for Advancing Translational Sciences [UL1TR000128]
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Multiple sclerosis (MS) is a neuroinflammatory disease characterized by demyelination and axonal damage of the central nervous system. The pathogenesis of MS has also been linked to vascular inflammation and local activation of the coagulation system, resulting in perivascular fibrin deposition. Treatment of experimental autoimmune encephalomyelitis (EAE), a model of human MS, with antithrombotic and antiinflammatory activated protein C (APC) reduces disease severity. Since recombinant APC (Drotecogin alfa), originally approved for the treatment of severe sepsis, is not available for human MS studies, we tested the hypothesis that pharmacologic activation of endogenous protein C could likewise improve the outcome of EAE. Mice were immunized with murine myelin oligodendrocyte glycoprotein (MOG) peptides and at the onset of EAE symptoms, were treated every other day with either WE thrombin (25 mu g/kg; i.v.), a selective recombinant protein C activator thrombin analog, or saline control. Mice were monitored for changes in disease score until euthanized for ex vivo analysis of inflammation. Administration of WE thrombin significantly ameliorated clinical severity of EAE, reduced inflammatory cell infiltration and demyelination, suppressed the activation of macrophages comprising the CD11b + population and reduced accumulation of fibrin (ogen) in the spinal cord. These data suggest that symptomatic MS may respond to a treatment strategy that involves temporal pharmacological enhancement of endogenous APC generation.
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