DICAM promotes TH17 lymphocyte trafficking across the blood-brain barrier during autoimmune neuroinflammation

M Charabati, C Grasmuck, S Ghannam… - Science Translational …, 2022 - science.org
M Charabati, C Grasmuck, S Ghannam, L Bourbonnière, AP Fournier, MA Lécuyer, O Tastet…
Science Translational Medicine, 2022science.org
The migration of circulating leukocytes into the central nervous system (CNS) is a key driver
of multiple sclerosis (MS) pathogenesis. The monoclonal antibody natalizumab proved that
pharmaceutically obstructing this process is an effective therapeutic approach for treating
relapsing-remitting MS (RRMS). Unfortunately, the clinical efficacy of natalizumab is
somewhat offset by its incapacity to control the progressive forms of MS (PMS) and by life-
threatening side effects in RRMS rising from the expression of its molecular target, very late …
The migration of circulating leukocytes into the central nervous system (CNS) is a key driver of multiple sclerosis (MS) pathogenesis. The monoclonal antibody natalizumab proved that pharmaceutically obstructing this process is an effective therapeutic approach for treating relapsing-remitting MS (RRMS). Unfortunately, the clinical efficacy of natalizumab is somewhat offset by its incapacity to control the progressive forms of MS (PMS) and by life-threatening side effects in RRMS rising from the expression of its molecular target, very late antigen 4 (VLA4), on most immune cells and consequent impairment of CNS immunosurveillance. Here, we identified dual immunoglobulin domain containing cell adhesion molecule (DICAM) as a cell trafficking molecule preferentially expressed by T helper 17 (TH17)–polarized CD4+ T lymphocytes. We found that DICAM expression on circulating CD4+ T cells was increased in patients with active RRMS and PMS disease courses, and expression of DICAM ligands was increased on the blood-brain barrier endothelium upon inflammation and in MS lesions. Last, we demonstrated that pharmaceutically neutralizing DICAM reduced murine and human TH17 cell trafficking across the blood-brain barrier in vitro and in vivo, and alleviated disease symptoms in four distinct murine autoimmune encephalomyelitis models, including relapsing-remitting and progressive disease models. Collectively, our data highlight DICAM as a candidate therapeutic target to impede the migration of disease-inducing leukocytes into the CNS in both RRMS and PMS and suggest that blocking DICAM with a monoclonal antibody may be a promising therapeutic approach.
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