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March 2021; 8 (2) ArticleOpen Access

Aryl Hydrocarbon Receptor Plasma Agonist Activity Correlates With Disease Activity in Progressive MS

Thanos Tsaktanis, Tobias Beyer, Lucy Nirschl, Mathias Linnerbauer, Verena Grummel, Mathias Bussas, Emily Tjon, Mark Mühlau, View ORCID ProfileThomas Korn, View ORCID ProfileBernhard Hemmer, Francisco J. Quintana, Veit Rothhammer
First published December 24, 2020, DOI: https://doi.org/10.1212/NXI.0000000000000933
Thanos Tsaktanis
From the Department of Neurology (T.T., T.B., L.N., M.L., V.G., M.B., M.M., T.K., B.H., V.R.), Klinikum rechts der Isar, Technical University of Munich; Department of Neurology (T.T., V.R.), University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuernberg; Munich Cluster for Systems Neurology (SyNergy) (T.K., B.H.), Germany; Ann Romney Center for Neurologic Diseases (E.T., F.J.Q.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Broad Institute of MIT and Harvard (F.J.Q.), Cambridge, MA; and TUM-Neuroimaging Center (M.B., M.M.), Klinikum rechts der Isar, Technische Universität München, Germany.
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  • For correspondence: ge56naq@mytum.de
Tobias Beyer
From the Department of Neurology (T.T., T.B., L.N., M.L., V.G., M.B., M.M., T.K., B.H., V.R.), Klinikum rechts der Isar, Technical University of Munich; Department of Neurology (T.T., V.R.), University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuernberg; Munich Cluster for Systems Neurology (SyNergy) (T.K., B.H.), Germany; Ann Romney Center for Neurologic Diseases (E.T., F.J.Q.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Broad Institute of MIT and Harvard (F.J.Q.), Cambridge, MA; and TUM-Neuroimaging Center (M.B., M.M.), Klinikum rechts der Isar, Technische Universität München, Germany.
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  • For correspondence: t.beyer@tum.de
Lucy Nirschl
From the Department of Neurology (T.T., T.B., L.N., M.L., V.G., M.B., M.M., T.K., B.H., V.R.), Klinikum rechts der Isar, Technical University of Munich; Department of Neurology (T.T., V.R.), University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuernberg; Munich Cluster for Systems Neurology (SyNergy) (T.K., B.H.), Germany; Ann Romney Center for Neurologic Diseases (E.T., F.J.Q.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Broad Institute of MIT and Harvard (F.J.Q.), Cambridge, MA; and TUM-Neuroimaging Center (M.B., M.M.), Klinikum rechts der Isar, Technische Universität München, Germany.
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  • For correspondence: lucy.nirschl@tum.de
Mathias Linnerbauer
From the Department of Neurology (T.T., T.B., L.N., M.L., V.G., M.B., M.M., T.K., B.H., V.R.), Klinikum rechts der Isar, Technical University of Munich; Department of Neurology (T.T., V.R.), University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuernberg; Munich Cluster for Systems Neurology (SyNergy) (T.K., B.H.), Germany; Ann Romney Center for Neurologic Diseases (E.T., F.J.Q.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Broad Institute of MIT and Harvard (F.J.Q.), Cambridge, MA; and TUM-Neuroimaging Center (M.B., M.M.), Klinikum rechts der Isar, Technische Universität München, Germany.
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  • For correspondence: mathias.linnerbauer@gmail.com
Verena Grummel
From the Department of Neurology (T.T., T.B., L.N., M.L., V.G., M.B., M.M., T.K., B.H., V.R.), Klinikum rechts der Isar, Technical University of Munich; Department of Neurology (T.T., V.R.), University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuernberg; Munich Cluster for Systems Neurology (SyNergy) (T.K., B.H.), Germany; Ann Romney Center for Neurologic Diseases (E.T., F.J.Q.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Broad Institute of MIT and Harvard (F.J.Q.), Cambridge, MA; and TUM-Neuroimaging Center (M.B., M.M.), Klinikum rechts der Isar, Technische Universität München, Germany.
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  • For correspondence: v.grummel@tum.de
Mathias Bussas
From the Department of Neurology (T.T., T.B., L.N., M.L., V.G., M.B., M.M., T.K., B.H., V.R.), Klinikum rechts der Isar, Technical University of Munich; Department of Neurology (T.T., V.R.), University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuernberg; Munich Cluster for Systems Neurology (SyNergy) (T.K., B.H.), Germany; Ann Romney Center for Neurologic Diseases (E.T., F.J.Q.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Broad Institute of MIT and Harvard (F.J.Q.), Cambridge, MA; and TUM-Neuroimaging Center (M.B., M.M.), Klinikum rechts der Isar, Technische Universität München, Germany.
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  • For correspondence: matthias.bussas@mri.tum.de
Emily Tjon
From the Department of Neurology (T.T., T.B., L.N., M.L., V.G., M.B., M.M., T.K., B.H., V.R.), Klinikum rechts der Isar, Technical University of Munich; Department of Neurology (T.T., V.R.), University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuernberg; Munich Cluster for Systems Neurology (SyNergy) (T.K., B.H.), Germany; Ann Romney Center for Neurologic Diseases (E.T., F.J.Q.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Broad Institute of MIT and Harvard (F.J.Q.), Cambridge, MA; and TUM-Neuroimaging Center (M.B., M.M.), Klinikum rechts der Isar, Technische Universität München, Germany.
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  • For correspondence: emilyctjon@gmail.com
Mark Mühlau
From the Department of Neurology (T.T., T.B., L.N., M.L., V.G., M.B., M.M., T.K., B.H., V.R.), Klinikum rechts der Isar, Technical University of Munich; Department of Neurology (T.T., V.R.), University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuernberg; Munich Cluster for Systems Neurology (SyNergy) (T.K., B.H.), Germany; Ann Romney Center for Neurologic Diseases (E.T., F.J.Q.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Broad Institute of MIT and Harvard (F.J.Q.), Cambridge, MA; and TUM-Neuroimaging Center (M.B., M.M.), Klinikum rechts der Isar, Technische Universität München, Germany.
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  • For correspondence: mark.muehlau@tum.de
Thomas Korn
From the Department of Neurology (T.T., T.B., L.N., M.L., V.G., M.B., M.M., T.K., B.H., V.R.), Klinikum rechts der Isar, Technical University of Munich; Department of Neurology (T.T., V.R.), University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuernberg; Munich Cluster for Systems Neurology (SyNergy) (T.K., B.H.), Germany; Ann Romney Center for Neurologic Diseases (E.T., F.J.Q.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Broad Institute of MIT and Harvard (F.J.Q.), Cambridge, MA; and TUM-Neuroimaging Center (M.B., M.M.), Klinikum rechts der Isar, Technische Universität München, Germany.
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  • ORCID record for Thomas Korn
  • For correspondence: thomas.korn@tum.de
Bernhard Hemmer
From the Department of Neurology (T.T., T.B., L.N., M.L., V.G., M.B., M.M., T.K., B.H., V.R.), Klinikum rechts der Isar, Technical University of Munich; Department of Neurology (T.T., V.R.), University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuernberg; Munich Cluster for Systems Neurology (SyNergy) (T.K., B.H.), Germany; Ann Romney Center for Neurologic Diseases (E.T., F.J.Q.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Broad Institute of MIT and Harvard (F.J.Q.), Cambridge, MA; and TUM-Neuroimaging Center (M.B., M.M.), Klinikum rechts der Isar, Technische Universität München, Germany.
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Francisco J. Quintana
From the Department of Neurology (T.T., T.B., L.N., M.L., V.G., M.B., M.M., T.K., B.H., V.R.), Klinikum rechts der Isar, Technical University of Munich; Department of Neurology (T.T., V.R.), University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuernberg; Munich Cluster for Systems Neurology (SyNergy) (T.K., B.H.), Germany; Ann Romney Center for Neurologic Diseases (E.T., F.J.Q.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Broad Institute of MIT and Harvard (F.J.Q.), Cambridge, MA; and TUM-Neuroimaging Center (M.B., M.M.), Klinikum rechts der Isar, Technische Universität München, Germany.
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  • For correspondence: fquintana@rics.bwh.harvard.edu
Veit Rothhammer
From the Department of Neurology (T.T., T.B., L.N., M.L., V.G., M.B., M.M., T.K., B.H., V.R.), Klinikum rechts der Isar, Technical University of Munich; Department of Neurology (T.T., V.R.), University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuernberg; Munich Cluster for Systems Neurology (SyNergy) (T.K., B.H.), Germany; Ann Romney Center for Neurologic Diseases (E.T., F.J.Q.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Broad Institute of MIT and Harvard (F.J.Q.), Cambridge, MA; and TUM-Neuroimaging Center (M.B., M.M.), Klinikum rechts der Isar, Technische Universität München, Germany.
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Full PDF
Citation
Aryl Hydrocarbon Receptor Plasma Agonist Activity Correlates With Disease Activity in Progressive MS
Thanos Tsaktanis, Tobias Beyer, Lucy Nirschl, Mathias Linnerbauer, Verena Grummel, Mathias Bussas, Emily Tjon, Mark Mühlau, Thomas Korn, Bernhard Hemmer, Francisco J. Quintana, Veit Rothhammer
Neurol Neuroimmunol Neuroinflamm Mar 2021, 8 (2) e933; DOI: 10.1212/NXI.0000000000000933

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    Figure 1 AHR Agonistic Activity Is Decreased in Patients With RRMS

    Human embryonic kidney cells (HEK293) were transfected with pGud-Luc and pTK-Renilla plasmids. One day after transfection, cells were incubated with human healthy control serums (control; n = 36) or serum from patients with relapsing-remitting MS (RRMS; n = 84). Luciferase activity was assessed after 24 hours. Values are means of technical duplicate measurements. Lines represent mean and error bars SEM. ****p < 0.0001 by the Student t test. AHR = aryl hydrocarbon receptor.

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    Figure 2 AHR Ligand Levels Correlate With Disease Severity and Duration in Patients With RRMS

    (A) HEK293 cells were transfected with AHR reporter and control plasmid (pGud-Luc and pTK-Renilla). One day after transfection, cells were incubated with human serum from healthy controls (control; n = 36) or serum from patients with relapse-remitting MS (RRMS; n = 84) with different disability levels as determined by Expanded Disability Status Scale (EDSS), where higher scores indicate increased disease severity. Luciferase activity was assessed after 24 hours. Values are means of technical duplicate measurements. Lines represent mean and error bars SEM. **p < 0.01, and ****p < 0.0001 by the Student t test. (B) Solid line shows linear regression with correlation of AHR agonistic activity and disease severity as determined by EDSS in patients with RRMS (RRMS; n = 84). Values are means of technical duplicate measurements. Numbers indicated R2 and p value of linear regression analysis. p < 0.05 is considered significant. (C) Solid line shows linear regression correlating agonistic activity with disease duration in patients with RRMS (RRMS; n = 84). Values are means of technical duplicate measurements. p < 0.05 is considered significant. (D) 3D plot analyses of EDSS scores (x-axis), disease duration (y-axis), and AHR ligand levels (z-axis) in patients with RRMS. AHR = aryl hydrocarbon receptor.

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    Figure 3 AHR Agonistic Activity Is Decreased in the Progressive Form of MS

    (A) AHR agonistic activity in serum samples of healthy controls (control; n = 36) and patients with secondary progressive MS (SPMS; n = 35) was assessed in duplicates using AHR ligand–sensitive luciferase assay. (B) AHR agonistic activity in serum samples of healthy controls (control; n = 36) and patients with primary progressive MS (PPMS; n = 41) was assessed in technical duplicates using an AHR ligand–sensitive luciferase assay. Values are means of technical duplicate measurements. Lines represent mean and error bars SEM. Significance levels were determined by the Student t test. ***p < 0.001 and ****p < 0.0001. AHR = aryl hydrocarbon receptor.

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    Figure 4 Longitudinal Reduction of AHR Agonistic Activity Correlates With Increasing White Matter Atrophy and Lesion Load Volume in Individual Patients With RRMS

    (A) Analysis of AHR agonistic activity in 13 individual patients in serial measurements. Solid line shows correlation of sample drawing year with AHR agonistic activity. (B) Analysis of white matter volume in 13 individual patients in serial cerebral MRIs. Solid line shows correlation of drawing year with relative white matter volume in each individual patient. (C) Analysis of lesion load volume change in 13 individual patients in serial cerebral MRIs. Group 1 (7 patients) and group 2 (3 patients) consist of patients with a stable AHR activity course and were compared with group 3 consisting of 3 patients with a decreasing AHR activity course over the years. Lines represent mean and error bars SEM. **p < 0.01 by 1-way analysis of variance followed by the Tukey post hoc test. AHR = aryl hydrocarbon receptor; ns = not significant; RRMS = relapsing-remitting MS.

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