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Intranasal delivery of a small-molecule ErbB inhibitor promotes recovery from acute and late-stage CNS inflammation
Mathias Linnerbauer, … , Francisco J. Quintana, Veit Rothhammer
Mathias Linnerbauer, … , Francisco J. Quintana, Veit Rothhammer
Published April 8, 2022
Citation Information: JCI Insight. 2022;7(7):e154824. https://doi.org/10.1172/jci.insight.154824.
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Research Article Neuroscience

Intranasal delivery of a small-molecule ErbB inhibitor promotes recovery from acute and late-stage CNS inflammation

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Abstract

Multiple sclerosis (MS) is an autoimmune inflammatory disease of the CNS that is characterized by demyelination and axonal degeneration. Although several established treatments reduce relapse burden, effective treatments to halt chronic progression are scarce. Single-cell transcriptomic studies in MS and its animal models have described astrocytes and their spatial and functional heterogeneity as important cellular determinants of chronic disease. We combined CNS single-cell transcriptome data and small-molecule screens in primary mouse and human astrocytes to identify glial interactions, which could be targeted by repurposing FDA-approved small-molecule modulators for the treatment of acute and late-stage CNS inflammation. Using hierarchical in vitro and in vivo validation studies, we demonstrate that among selected pathways, blockade of ErbB by the tyrosine kinase inhibitor afatinib efficiently mitigates proinflammatory astrocyte polarization and promotes tissue-regenerative functions. We found that i.n. delivery of afatinib during acute and late-stage CNS inflammation ameliorates disease severity by reducing monocyte infiltration and axonal degeneration while increasing oligodendrocyte proliferation. We used unbiased screening approaches of astrocyte interactions to identify ErbB signaling and its modulation by afatinib as a potential therapeutic strategy for acute and chronic stages of autoimmune CNS inflammation.

Authors

Mathias Linnerbauer, Lena Lößlein, Oliver Vandrey, Thanos Tsaktanis, Alexander Beer, Ulrike J. Naumann, Franziska Panier, Tobias Beyer, Lucy Nirschl, Joji B. Kuramatsu, Jürgen Winkler, Francisco J. Quintana, Veit Rothhammer

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Figure 6

Therapeutic potential of i.n. afatinib application in chronic stages of CNS inflammation.

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Therapeutic potential of i.n. afatinib application in chronic stages of ...
(A) Clinical course (left) and linear regression analysis (right) of EAE in mice after daily i.n. treatment with vehicle or afatinib starting from peak of disease. The experiment was repeated twice. Vehicle (PBS), n = 7; afatinib, n = 12. Data are reported as mean ± SEM. (B and C) Abundance (percentage of total cell counts) of CNS cell populations during late-stage CNS inflammation in mice treated with vehicle or afatinib from symptom onset (vehicle, n = 4 or 5; afatinib, n = 4 or 5) (B) or peak of disease (C) (vehicle, n = 7; afatinib, n = 9), quantified by high-dimensional flow cytometry. Two-way ANOVA with Šidák’s multiple comparisons test. (D and E) Intracellular flow cytometry quantification of iNOS, TNF-α, and GM-CSF in astrocytes and microglia during late-stage CNS inflammation in mice treated with afatinib (n = 5) or vehicle (n = 5) from symptom onset (D) or peak of disease (E) (vehicle, n = 7; afatinib n = 8). Two-way ANOVA with Šidák’s multiple comparison test. (F) Relative expression of Gfap, Ngf, and Bdnf in ACSA2+ astrocytes during late-stage CNS inflammation in mice treated with afatinib (n = 8) or vehicle (n = 7) from peak of disease. Unpaired t test with Welch’s correction; data are reported as mean ± SD. (G and H) Representative fluorescence images (G) and quantification (H) of immunohistochemically labeled Olig2+ oligodendrocytes in lumbar spinal cord of mice treated with vehicle (n = 5) or afatinib (n = 5). Scale bars: 15 μm. Two-way ANOVA with Dunnett’s multiple comparisons test. (I and J) Representative fluorescence images (I) and corrected total cell fluorescence (CTCF) quantification (J) of axonal damage (SMI32+) in lumbar spinal cord of mice treated with vehicle (n = 5) or afatinib (n = 5). Two-way ANOVA with Dunnett’s multiple comparisons test. Scale bars: 15 μm. *P < 0.05; **P < 0.01; ***P < 0.001; ****P < 0.0001. p.i., postimmunization.

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