Fast direct neuronal signaling via the IL-4 receptor as therapeutic target in neuroinflammation

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Science Translational Medicine  28 Feb 2018:
Vol. 10, Issue 430, eaao2304
DOI: 10.1126/scitranslmed.aao2304

IL-4 empowers axons

Multiple sclerosis (MS) is a neuroinflammatory disorder, and current therapies focus on altering immune activity to reduce symptoms. Vogelaar and colleagues tested the ability of intrathecally applied IL-4, a cytokine typically associated with T helper type 2 responses, to treat established disease in several experimental autoimmune encephalomyelitis (EAE) models. IL-4 treatment led to reduced clinical scores, improved locomotor activity, and diminished axon damage. Somewhat surprisingly, the beneficial effects of IL-4 did not depend on T cell modulation in the chronic disease phase. The receptor for IL-4 was observed in postmortem brain histology of several MS patients, and they demonstrated that IL-4 could act directly on neurons in vitro. They also showed benefits of intranasal IL-4 administration in one of the EAE models, which could be a promising avenue to pursue in the clinic.


Ongoing axonal degeneration is thought to underlie disability in chronic neuroinflammation, such as multiple sclerosis (MS), especially during its progressive phase. Upon inflammatory attack, axons undergo pathological swelling, which can be reversible. Because we had evidence for beneficial effects of T helper 2 lymphocytes in experimental neurotrauma and discovered interleukin-4 receptor (IL-4R) expressed on axons in MS lesions, we aimed at unraveling the effects of IL-4 on neuroinflammatory axon injury. We demonstrate that intrathecal IL-4 treatment during the chronic phase of several experimental autoimmune encephalomyelitis models reversed disease progression without affecting inflammation. Amelioration of disability was abrogated upon neuronal deletion of IL-4R. We discovered direct neuronal signaling via the IRS1-PI3K-PKC pathway underlying cytoskeletal remodeling and axonal repair. Nasal IL-4 application, suitable for clinical translation, was equally effective in improving clinical outcome. Targeting neuronal IL-4 signaling may offer new therapeutic strategies to halt disability progression in MS and possibly also neurodegenerative conditions.

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