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November 2021; 8 (6) ArticleOpen Access

Teriflunomide Promotes Oligodendroglial 8,9-Unsaturated Sterol Accumulation and CNS Remyelination

Elodie Martin, Marie-Stephane Aigrot, Foudil Lamari, Corinne Bachelin, Catherine Lubetzki, Brahim Nait Oumesmar, Bernard Zalc, Bruno Stankoff
First published October 12, 2021, DOI: https://doi.org/10.1212/NXI.0000000000001091
Elodie Martin
From the Sorbonne Université, Paris Brain Institute, CNRS, Inserm (E.M., M.-S.A., C.B., C.L., B.N.O., B.Z., B.S.); Pitié-Salpêtrière Hospital, APHP (F.L., C.L.); and Saint Antoine Hospital, APHP (B.S.), Paris, France.
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  • For correspondence: elodie-marie.martin@icm-institute.org
Marie-Stephane Aigrot
From the Sorbonne Université, Paris Brain Institute, CNRS, Inserm (E.M., M.-S.A., C.B., C.L., B.N.O., B.Z., B.S.); Pitié-Salpêtrière Hospital, APHP (F.L., C.L.); and Saint Antoine Hospital, APHP (B.S.), Paris, France.
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  • For correspondence: mariestephane.aigrot@icm-institute.org
Foudil Lamari
From the Sorbonne Université, Paris Brain Institute, CNRS, Inserm (E.M., M.-S.A., C.B., C.L., B.N.O., B.Z., B.S.); Pitié-Salpêtrière Hospital, APHP (F.L., C.L.); and Saint Antoine Hospital, APHP (B.S.), Paris, France.
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  • For correspondence: foudil.lamari@aphp.fr
Corinne Bachelin
From the Sorbonne Université, Paris Brain Institute, CNRS, Inserm (E.M., M.-S.A., C.B., C.L., B.N.O., B.Z., B.S.); Pitié-Salpêtrière Hospital, APHP (F.L., C.L.); and Saint Antoine Hospital, APHP (B.S.), Paris, France.
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  • For correspondence: corinne.bachelin@upmc.fr
Catherine Lubetzki
From the Sorbonne Université, Paris Brain Institute, CNRS, Inserm (E.M., M.-S.A., C.B., C.L., B.N.O., B.Z., B.S.); Pitié-Salpêtrière Hospital, APHP (F.L., C.L.); and Saint Antoine Hospital, APHP (B.S.), Paris, France.
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  • For correspondence: catherine.lubetzki@aphp.fr
Brahim Nait Oumesmar
From the Sorbonne Université, Paris Brain Institute, CNRS, Inserm (E.M., M.-S.A., C.B., C.L., B.N.O., B.Z., B.S.); Pitié-Salpêtrière Hospital, APHP (F.L., C.L.); and Saint Antoine Hospital, APHP (B.S.), Paris, France.
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  • For correspondence: brahim.naitoumesmar@icm-institute.org
Bernard Zalc
From the Sorbonne Université, Paris Brain Institute, CNRS, Inserm (E.M., M.-S.A., C.B., C.L., B.N.O., B.Z., B.S.); Pitié-Salpêtrière Hospital, APHP (F.L., C.L.); and Saint Antoine Hospital, APHP (B.S.), Paris, France.
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  • For correspondence: bernard.zalc@upmc.fr
Bruno Stankoff
From the Sorbonne Université, Paris Brain Institute, CNRS, Inserm (E.M., M.-S.A., C.B., C.L., B.N.O., B.Z., B.S.); Pitié-Salpêtrière Hospital, APHP (F.L., C.L.); and Saint Antoine Hospital, APHP (B.S.), Paris, France.
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Citation
Teriflunomide Promotes Oligodendroglial 8,9-Unsaturated Sterol Accumulation and CNS Remyelination
Elodie Martin, Marie-Stephane Aigrot, Foudil Lamari, Corinne Bachelin, Catherine Lubetzki, Brahim Nait Oumesmar, Bernard Zalc, Bruno Stankoff
Neurol Neuroimmunol Neuroinflamm Nov 2021, 8 (6) e1091; DOI: 10.1212/NXI.0000000000001091

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    Figure 1 Effect of TF on OPC Survival and Proliferation

    (A–C) Immunolabeling for Olig2 (A) and nuclei staining with 4',6-diamidino-2-phenylindole (B) showing that 80% of cells are Olig2+ cells. (C) Cell survival was evaluated with MTT assay: results are expressed as % of controls and show that TF does not induce cell death at concentrations ranging between 10 nM and 5 µM. (D and E) Coimmunolabeling for Olig2 and BrDU in control (Ctrl)- (D) and TF-treated conditions (E). (F) Cell proliferation was measured as the proportion of Olig2+ cells that are also BrDU+. TF decreased the percentage of Olig2+ cells coexpressing BrDU for concentrations ranging between 10 nM and 5 µM. (G and H) Coimmunolabeling for Olig2 and Ki67 in control (Ctrl)- (G) and TF-treated conditions (H). (I) The proportion of Olig2+ cells coexpressing Ki67 was lower in the teriflunomide condition (10 nM) compared with control. White arrowheads indicate cells coexpressing the 2 markers. Data shown are mean ± SEM from 3 to 5 individual experiments. *p < 0.05; **p < 0.01; ***p < 0.001 (1-way ANOVA, Dunn post hoc test (C and F); Student 2-tailed unpaired t test (I)). Scale bar in A–F = 10 µm. BrdU = bromodeoxyuridine; TF = teriflunomide.

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    Figure 2 Effect of TF on OPC Differentiation

    (A and B) Newborn-derived OPCs cultures fixed at DIV 7. Coimmunolabeling for Olig2 and MOG in control (Ctrl)- (A) and TF-treated conditions (B). White arrowheads indicate cells coexpressing Olig2 and MOG. (C) A higher proportion of Olig2+ cells were coexpressing MOG when treated with TF (10 nM–1 µM) compared with the control condition. (D and E) Adult OPCs were isolated by fluorescence-activated cell sorting from the CNS of 2 months old PDGFRa:GFP mice and immunostained for Olig2 and MOG in control (Ctrl)- (D) and TF-treated conditions (E). (F) The percentage of Olig2+ cells coexpressing MOG is significantly increased in cultures treated with TF compared to control. Data shown are mean ± SEM from 3 to 5 individual experiments. *p < 0.05; **p < 0.01; ***p < 0.001 (1-way ANOVA, Dunn post hoc test (C); Student 2-tailed unpaired t test [F]). Scale bar in A–F = 10 µm. MOG = myelin oligodendrocyte glycoprotein; OPC = oligodendrocyte precursor cell; TF = teriflunomide.

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    Figure 3 OPC Differentiation Induced by Teriflunomide Is Reversed by Ro 48-8071 and Associated With 8,9-Unsaturated Sterol Production

    (A) OPCs treated with unconditioned (Ctrl) or TF and/or Ro 48-8071 were immunostained against Olig2 and MOG at 96 hours following treatment. The percentage of Olig2+ cells coexpressing MOG was significantly increased in cultures treated with TF compared with control, an effect blocked by the Ro 48-8071 treatment. (B) Quantitation of sterol levels in OPCs treated with TF and/or Ro 48-8071. In OPC cultures treated for 24 hours with TF, the level of zymosterol was increased (results are expressed as % of controls), whereas lanosterol and cholesterol levels were unchanged. (C and D) EBP and DHODH messenger RNA levels measured by reverse transcriptase-quantitative polymerase chain reaction in OPCs, Br, and SC. The Li and Sp were used as positive control for EBP and DHODH enzymatic gene expression, respectively. Glyceraldehyde 3-phosphate dehydrogenase was used as the reference gene. (E) The percentage of MOG+/Olig2+ oligodendrocytes at 96 hours was significantly increased in OPCs treated with TF compared with control, an effect reversed by the uridine treatment. (F) Uridine blocked the accumulation of zymosterol induced by teriflunomide. (G) The percentage of MOG+/Olig2+ oligodendrocytes at 96 hours following treatment with TF and/or IFNγ/IL-17 was significantly decreased in OPCs treated with TF and exposed to IFNγ/IL-17 cytokines compared with TF. Data are shown as mean ± SEM from 3 individual experiments. *p < 0.05; ***p < 0.001 (1-way ANOVA, Newman-Keuls post hoc test). Br = brain; DHODH =dihydroorotate dehydrogenase; EBP = emopamil binding protein; Li = liver; OPC = oligodendrocyte precursor cell; SC = spinal cord; Sp = spleen; TF = teriflunomide.

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    Figure 4 Effect of TF on Remyelination

    Dose response of remyelination potency of TF. (A and B) Detection of GFP+ oligodendroglial cells in optic nerves of stage53 Mbp:GFP-NTR tadpoles. Demyelination of stage53 Mbp:GFP-NTR tadpoles was achieved by 10 days exposure to metronidazole (10 mM) in the swimming water. Tadpoles were then returned to normal water (control) or TF for 3 days. The number of GFP+ cells in the optic nerve in control (A) is lower compared with TF-treated tadpoles (B). (C) Remyelination was assayed by counting the number of GFP+ cells per optic nerve on day 3 of the repair period. Treatment of tadpoles with TF at concentrations ranging between 1 µM and 100 µM improved remyelination up to 2.25-fold compared with spontaneous recovery (control) set as 1. Data shown are mean ± SEM, n = 5–8 tadpoles per group. *p < 0.05; **p < 0.01 (1-way ANOVA, Dunn post hoc test. Scale bar in A and B = 20 µm. MBP-GFP-NTR = myelin basic protein–GFP-nitroreductase; TF = teriflunomide.

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    Figure 5 TF Induces Oligodendrocyte Differentiation During Remyelination

    Demyelination was induced by lysophosphatidylcholine on day 0, and differentiation was assessed on day 11. (A and B) Triple immunolabeling for Olig2, MBP, and CC1 in the spinal cord lesion of control (NaCl)-treated mice (A) and TF-treated mice (B). The lesion limits are indicated by white dashed lines. (C and D) Immunolabeling for Olig2 in the core of the lesion of control (NaCl)-treated mice (C) and TF-treated mice (D). (E) No difference in the number of Olig2+cells/mm2 is observed between the groups. (F and G) Immunolabeling for CC1 in the core of the lesion of control (NaCl)-treated mice (F) and TF-treated mice (G). (H) Significantly, more CC1+ cells are present in the lesion of TF-treated mice compared with control. (I and J) Merge showing the colabeling for Olig2 and CC1. White arrowheads indicate cells coexpressing Olig2 and CC1. (K) The percentage of Olig2+ cells coexpressing CC1 is significantly increased in the lesion of TF treated mice compared with control. Data shown are mean ± SEM, n = 5 mice per group. *p < 0.05; ***p < 0.001 (Student 2-tailed unpaired t test). Scale bar = 10 µm. MBP = myelin basic protein; TF = teriflunomide.

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    Figure 6 Effect of TF on Remyelination

    (A and B) Electron micrographs of the lesion area at 11 days postlesion. In control-treated mice (A) and in TF-treated mice (B). The proportion of remyelinated axons was increased in TF-treated mice. (C) The percentage of remyelinated axons is significantly increased in the lesion of TF-treated mice compared with controls. Data shown are mean ± SEM, n = 5 mice. *p < 0.05 (Student 2-tailed unpaired t test). Scale bars = 5 µm. TF = teriflunomide.

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