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Articles

Vincent K. Tuohy^*,, Min Yu^*, Ling Yin^*, Julie A. Kawczak^*, and R. Philip Kinkel

From the ^* Department of Immunology, Lerner Research Institute, and the Mellen Center for Multiple Sclerosis Research and Treatment, The Cleveland Clinic Foundation, Cleveland, Ohio 44195

Experimental autoimmune encephalomyelitis (EAE) is a widely used animal model for multiple sclerosis (MS). EAE is typically initiated by CD4⁺ T helper cell type 1 (Th1) autoreactivity directed against a single priming immunodominant myelin peptide determinant. Recent studies have shown that clinical progression of EAE involves the accumulation of neo-autoreactivity, commonly referred to as epitope spreading, directed against peptide determinants not involved in the priming process. This study directly addresses the relative roles of primary autoreactivity and secondary epitope spreading in the progression of both EAE and MS. To this end we serially evaluated the development of several epitope-spreading cascades in SWXJ mice primed with distinctly different encephalitogenic determinants of myelin proteolipid protein. In a series of analogous experiments, we examined the development of epitope spreading in patients with isolated monosymptomatic demyelinating syndrome as their disease progressed to clinically definite MS. Our results indicate that in both EAE and MS, primary proliferative autoreactivity associated with onset of clinical disease invariably regresses with time and is often undetectable during periods of disease progression. In contrast, the emergence of sustained secondary autoreactivity to spreading determinants is consistently associated with disease progression in both EAE and MS. Our results indicate that chronic progression of EAE and MS involves a shifting of autoreactivity from primary initiating self-determinants to defined cascades of secondary determinants that sustain the self-recognition process during disease progression.

Key Words: multiple sclerosis • autoimmunity • epitope spreading • demyelination • myelin proteolipid protein

¹ Abbreviations used in this paper: CDMS, clinically definite multiple sclerosis; CNS, central nervous system; EAE, experimental autoimmune encephalomyelitis; IMDS, isolated monosymptomatic demyelinating syndrome; MBP, myelin basic protein; MOG, myelin oligodendrocyte glycoprotein; MRI, magnetic resonance imaging; MS, multiple sclerosis; PLP, myelin proteolipid protein; SI, stimulation index.

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