Go to JCI Insight
  • About
  • Editors
  • Consulting Editors
  • For authors
  • Publication ethics
  • Publication alerts by email
  • Advertising
  • Job board
  • Contact
  • Clinical Research and Public Health
  • Current issue
  • Past issues
  • By specialty
    • COVID-19
    • Cardiology
    • Gastroenterology
    • Immunology
    • Metabolism
    • Nephrology
    • Neuroscience
    • Oncology
    • Pulmonology
    • Vascular biology
    • All ...
  • Videos
    • Conversations with Giants in Medicine
    • Video Abstracts
  • Reviews
    • View all reviews ...
    • Pancreatic Cancer (Jul 2025)
    • Complement Biology and Therapeutics (May 2025)
    • Evolving insights into MASLD and MASH pathogenesis and treatment (Apr 2025)
    • Microbiome in Health and Disease (Feb 2025)
    • Substance Use Disorders (Oct 2024)
    • Clonal Hematopoiesis (Oct 2024)
    • Sex Differences in Medicine (Sep 2024)
    • View all review series ...
  • Viewpoint
  • Collections
    • In-Press Preview
    • Clinical Research and Public Health
    • Research Letters
    • Letters to the Editor
    • Editorials
    • Commentaries
    • Editor's notes
    • Reviews
    • Viewpoints
    • 100th anniversary
    • Top read articles

  • Current issue
  • Past issues
  • Specialties
  • Reviews
  • Review series
  • Conversations with Giants in Medicine
  • Video Abstracts
  • In-Press Preview
  • Clinical Research and Public Health
  • Research Letters
  • Letters to the Editor
  • Editorials
  • Commentaries
  • Editor's notes
  • Reviews
  • Viewpoints
  • 100th anniversary
  • Top read articles
  • About
  • Editors
  • Consulting Editors
  • For authors
  • Publication ethics
  • Publication alerts by email
  • Advertising
  • Job board
  • Contact
Blood-brain barrier resealing in neuromyelitis optica occurs independently of astrocyte regeneration
Anne Winkler, … , Stefan Nessler, Christine Stadelmann
Anne Winkler, … , Stefan Nessler, Christine Stadelmann
Published March 1, 2021
Citation Information: J Clin Invest. 2021;131(5):e141694. https://doi.org/10.1172/JCI141694.
View: Text | PDF
Research Article Neuroscience

Blood-brain barrier resealing in neuromyelitis optica occurs independently of astrocyte regeneration

  • Text
  • PDF
Abstract

Approximately 80% of neuromyelitis optica spectrum disorder (NMOSD) patients harbor serum anti–aquaporin-4 autoantibodies targeting astrocytes in the CNS. Crucial for NMOSD lesion initiation is disruption of the blood-brain barrier (BBB), which allows the entrance of Abs and serum complement into the CNS and which is a target for new NMOSD therapies. Astrocytes have important functions in BBB maintenance; however, the influence of their loss and the role of immune cell infiltration on BBB permeability in NMOSD have not yet been investigated. Using an experimental model of targeted NMOSD lesions in rats, we demonstrate that astrocyte destruction coincides with a transient disruption of the BBB and a selective loss of occludin from tight junctions. It is noteworthy that BBB integrity is reestablished before astrocytes repopulate. Rather than persistent astrocyte loss, polymorphonuclear leukocytes (PMNs) are the main mediators of BBB disruption, and their depletion preserves BBB integrity and prevents astrocyte loss. Inhibition of PMN chemoattraction, activation, and proteolytic function reduces lesion size. In summary, our data support a crucial role for PMNs in BBB disruption and NMOSD lesion development, rendering their recruitment and activation promising therapeutic targets.

Authors

Anne Winkler, Claudia Wrzos, Michael Haberl, Marie-Theres Weil, Ming Gao, Wiebke Möbius, Francesca Odoardi, Dietmar R. Thal, Mayland Chang, Ghislain Opdenakker, Jeffrey L. Bennett, Stefan Nessler, Christine Stadelmann

×

Figure 2

Breakdown of the BBB is accompanied by loss of occludin from blood vessels in experimental NMOSD lesions.

Options: View larger image (or click on image) Download as PowerPoint
Breakdown of the BBB is accompanied by loss of occludin from blood vesse...
Immunolabeling for occludin, claudin-3, and claudin-5 (magenta) was performed to assess the localization of these tight junction proteins in brain vessels (visualized with the basal lamina LAMγ1 marker, yellow) in focal NMOSD-like lesions. Immunoreactivity for occludin (A), claudin-3 (B), and claudin-5 (C) was localized at the tight junctions between adjacent endothelial cells and formed sharply defined, continuous strands in uninjected, naive controls. Loss of occludin immunoreactivity was observed 10 hours and 24 hours after lesion induction in astrocyte-depleted areas. Vascular occludin localization recovered to 68.5% ± 4.6% within 3 days after focal injection of AQP4 Ab and human complement (A). Quantification of occludin-positive vessels confirms the transient loss of occludin immunoreactivity from blood vessels in areas of GFAP loss (41–307 vessels/animal evaluated depending on astrocyte lesion size; n = 3 animals per time point, except 6 hours n = 4; D). In contrast, no loss of claudin-3 and claudin-5 immunoreactivity was detected after lesion induction, and sharply defined immunopositive strands were observed at the tight junctions of LAMγ1-positive vessels at 10 hours (B and C, respectively). Quantification of claudin-3–positive vessels (45–218 vessels/animal evaluated; ctrl n = 3, 6h: n = 4, 10h: n = 2, 24h: n = 3, 3d: n = 2, 6d: n = 3; E) and claudin-5–positive vessels (28–209 vessels/animal, n = 3 animals per time point, except 6h n = 4; F) confirms this observation. Temporal evolution of experimental NMOSD lesions (G). The y axis represents the extent of the investigated factors in arbitrary units. (D–F) Kruskal-Wallis test followed by Dunn’s multiple comparison test. *P < 0.05. Data are shown as mean ± SEM. bv, blood vessels. Scale bars: 50 μm (A–C).

Copyright © 2025 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

Sign up for email alerts