When the immune system erroneously turns against our own body, an “autoimmune disease” occurs. In the case of the central nervous system (the brain and the spinal cord), the resulting disease is known as multiple sclerosis. Multiple sclerosis is a relatively common cause of paralysis in young adults. Recently it has become clear that the nerve cell processes themselves, the axons, are damaged in multiple sclerosis and that this axon damage determines how severely a patient is incapacitated by the disease. To understand how nerve processes are damaged will be an important step towards finding ways to prevent or at least reduce such damage. As nerve processes in the inflamed brain interact with many different cells, one big step forward would be to observe which kind of interactions can lead to damage of nerve processes. This is currently not possible in humans, but seems feasible in small animals such as mice, where a disease state similar to multiple sclerosis can be induced.
Supported by the Dana Foundation, we have developed a method that allows us to do just that: watch the interaction of immune cells and nerve processes in the inflamed nervous system. We found that for a nerve process to be damaged it has to be in contact with an immune cell for an extended period of time. Such an interaction can then either result in complete destruction of the axon or its recovery. Locally within the attacked nerve processes, important structures known as mitochondria appear to be damaged early. Mitochondria are intracellular structures that produce energy, but can also be the source of toxic substances such as reactive derivates of oxygen. Currently we are exploring the possibility that the local changes in mitochondria determine whether an axon is doomed or can survive.
Despite being a demyelinating disease, multiple sclerosis (MS) is characterized by substantial axon damage, which critically determines to a patient’s permanent disability. Underlying neuroinflammatory axon damage is a complicated and poorly understood mechanism, which likely involves the dynamic interaction of multiple immune and neural cell types. In order to elucidate the events that elicit axon damage in a mouse model of MS (experimental autoimmune encephalomyelitis, EAE), we have developed an in vivo imaging technique that allows direct visualization of interactions between axons and immune cells. We have focused our investigations on the actively inflamed areas of EAE lesions and found that microphages and axons engage in long-lasting contacts. Axons undergo reversible changes that manifest as local beading, which can either reverse or progress to overt fragmentation. Exploring the subcellular changes at sites of neuro-immune contacts, we found that neuronal mitochondria are disrupted locally even before any changes in axonal morphology become apparent. Currently we are exploring how these mitochondrial changes are induced and whether therapeutic strategies that protect mitochondria can prevent subsequent axon damage.