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* Department of Nutritional Sciences and
Department of Biochemistry, College of Agricultural and Life Sciences, University of Wisconsin, Madison, WI 53706; and
Blood Research Institute, Blood Center of Wisconsin, Milwaukee, WI 53226
| Abstract |
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| Introduction |
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Consistent with this hypothesis, 1,25-dihydroxyvitamin D3 (1,25-(OH)2D3) strongly inhibited experimental autoimmune encephalomyelitis (EAE), an MS model (8, 9). The 1,25-(OH)2D3-mediated inhibition of EAE required Rag-1-dependent lymphocytes other than the encephalitogenic CD4+ T cells (10). To explain this result, we hypothesized that 1,25-(OH)2D3 might strengthen the function of lymphocytes that regulate potentially autoreactive T cell responses (10). The CD4+CD25+ lymphocytes that suppress EAE do so via an IL-10-dependent mechanism (11, 12, 13, 14). IL-10 is a potent inhibitor of APC function, inflammatory T cell activation, cytokine synthesis, and chemokine synthesis (15). Increases in spinal cord IL-10 correlated with EAE remissions (16). Mice with transgenic IL-10 resisted EAE (17), whereas mice with a disrupted IL-10 gene were highly EAE susceptible (18, 19). These data indicate that the IL-10-IL-10R pathway has very important suppressor functions in EAE.
The present experiments evaluated vitamin D3- and 1,25-(OH)2D3-mediated protection from myelin oligodendrocyte peptide (MOG3555)-induced EAE in C57BL/6 (B6) mice with targeted disruptions of the IL-10 or IL-10R genes to test the hypothesis that the inhibition mechanism might be IL-10 dependent. Having established that the IL-10-IL-10R pathway was essential, we also evaluated irradiation bone marrow (BM) chimeras to pinpoint the source of the essential IL-10. Furthermore, we investigated a possible direct effect of the hormone on IL-10 or IL-10R expression. We present a model for a bidirectional, IL-10-dependent, anti-inflammatory loop to explain how vitamin D may implement sunlights protective biological effects in MS, and discuss the implications of this model for vitamin D-based preventive and therapeutic strategies in MS.
| Materials and Methods |
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We purchased the B6, B6.SJL-Ptprca Pep3b/BoyJ (B6.CD45.1), and C57BL/6-Il10tm1Cgn mice (B6.IL-10/) from The Jackson Laboratory. Genentech donated the CFR2.4 (B6.IL-10R
/) breeder mice; they were genotyped for the loss of IL-10R
and the acquisition of neo as described (20). Mice were housed in our pathogen-free mouse colony at 23°C with 4060% humidity, 12-h light-dark cycles, and ad libitum access to water. Before experiments, they were fed Lab Diet no. 5008 (PMI Nutrition International) containing 0.33 µg/day vitamin D3 and 1% calcium. Experiments used male and female mice aged 68 wk (age- and sex-matched within experiments). The Institutional Animal Care and Use Committee approved all of the experimental protocols.
Antigens
The MOG3555 was purchased from BioSynthesis and had the amino acid sequence MEVGWYRSPFSRVVHLYRNGK.
Vitamin D3 or 1,25-(OH)2D3 treatment and EAE induction
A nutritionally complete synthetic diet was formulated as we described (21), except that vitamin D was omitted. The vitamin D3 (Sigma-Aldrich) was added to this diet in an amount to provide 1 µg/day. Alternatively, the 1,25-(OH)2D3 (Sigma-Aldrich) was added in an amount to provide 50 ng/day to females and 100 ng/day to males. These doses significantly inhibited EAE in previous studies (9, 10, 22, 23, 24, 25, 26). Fresh diet was provided three times per week. For prevention studies, mice were fed the synthetic diets before EAE induction (10). For treatment studies, EAE was induced in chow-fed mice, and at the peak of disease, 200 ng of 1,25-(OH)2D3 in oil or oil only as the placebo was injected i.p (27). EAE was induced and clinical EAE severity was assessed daily exactly as described (10). Blood samples were obtained before EAE induction and at the end of the study.
Histopathology
For histopathological evaluation, mice were euthanized and perfused with saline. The spinal cords were removed, divided into six equal segments, frozen in OCT compound (Sakura Finetek). And sectioned transversely (10 µm). The cryosections were fixed in 4% paraformaldehyde, stained with Gills no. 3 H&E Y (Sigma Diagnostics), and examined using a Zeiss Axioskop microscope equipped with a Plan-Neofluar x20/0.5 objective. Bright field images were acquired with AxioVision 3.0 software controlling an Axiocam digital camera. For the histopathology analysis, each of six sections per mouse was divided into quadrants, and each quadrant was scored in a blinded fashion as 0 or 1, based on the absence or presence, respectively, of infiltrating inflammatory cells. The histopathology score was recorded as the percentage of spinal cord quadrants that showed a readily identifiable inflammatory cell infiltrate.
Serum calcium analysis
Blood was collected, clotted, and centrifuged (2000 x g for 10 min) at 6°C. The serum was decanted and stored at 20°C. The samples, standards, and buffer blanks (2 µl each) were aliquoted into duplicate wells of a 96-well plate. The calcium detection reagent was prepared according to the manufacturers directions (Sigma Diagnostics), and 0.25 ml was added to each well. The absorbance at 570 nm less the blank was measured 10 to 30 min later. The Ca2+ mM/L serum was determined from a standard curve.
Real-time PCR
Real-time PCR was performed as described (28) with minor modifications (29). In brief, total RNA was extracted using TRI Reagent (Molecular Research Center) and reverse transcribed from an oligo(dT) primer using the Reverse Transcription System (Promega). Real-time PCR was performed with SYBRGreen PCR Master Mix (Applied Biosystems) in a GeneAmp 5700 Sequence Detection System. Purified and quantified control cDNA was serially diluted, and amplified in each run; the control cDNA vs the threshold cycle formed a standard curve. The transcript abundance, determined with the aid of the standard curve, is reported relative to GAPDH. Published primers for the GAPDH and IFN-
(30), and for Foxp3 (31) were used. The IL-10 primers were 5'-CCC TTT GCT ATG GTG TCC TT-3' and 5'-TGG TTT CTC TTC CCA AGA CC-3'; they were designed with Primer Express (Applied Biosystems).
Flow cytometry
For flow cytometric studies, PBS perfusion was done and single-cell suspensions of spinal cord cells or splenocytes were prepared as described (10, 32). In brief, dissociated spleen cells in cold staining buffer (5% heat-inactivated FBS and 0.1% sodium azide in PBS, pH 7.3) were depleted of RBC, and stained (106 cells/sample) for 3040 min on ice with predetermined optimal amounts of FITC-, PE-, or allophycocyanin-conjugated mAb. Spinal cord cells were centrifuged through a Percoll gradient, washed, and stained as previously described (10). Reference samples were stained with fluorochrome-coupled isotype control mAb, or single-color specific mAb stains for compensation. Stained samples were analyzed on a FACSCalibur (BD Biosciences) using CellQuest software. The fluorescent mAbs to IFN-
, IL-10, IL-10R, CD4, CD11b, CD25, CD45.2, and CD45.1 were purchased from Southern Biotechnology Associates or BD Biosciences.
Intracellular staining for cytokines
To enumerate cytokine-producing cells, EAE was induced, and when the placebo-treated mice reached stage 2 EAE (20 days post MOG immunization), all mice were euthanized, and the spinal cord and cervical lymph node cells were collected and analyzed (33). The cells were stimulated overnight with immobilized Abs to CD3, cultured 4 h with monensin, washed, and stained with FITC-coupled Abs to CD4 or isotype control Abs. The stained cells were paraformaldehyde-fixed, permeabilized in buffer with 0.01% Triton X-100, and stained with PE-coupled Abs to IFN-
and allophycocyanin-coupled Abs to IL-10 or isotype control Abs (BD Pharmingen). Flow cytometric data were acquired on a FACSCalibur using CellQuest software (BD Biosciences).
Irradiation BM chimeras
Irradiation BM chimeras were constructed by a standard protocol (34, 35). In brief, recipient mice (6 wk of age) were given antibiotics in the drinking water for 3 days, irradiated with a total of 1200 rad (2 doses 4 h apart), injected i.v. with 25 x 106 BM cells, and maintained in a sterile environment with antibiotics for 2 wk. Thereafter, they were maintained under standard conditions without antibiotics. At 67 wk posttransplantation, blood lymphocytes were stained and analyzed for CD45.1 and CD45.2 to quantify donor BM engraftment. At 7 wk posttransplantation, the mice were placed on the 1,25-(OH)2D3-supplemented or placebo control diet. At 8 wk posttransplantation, EAE was induced and evaluated as above.
Statistical analysis
Individual mice were analyzed and the mean and SD were calculated for each group of mice. Experiments were repeated at least once. The group sizes are given in the table and figure legends. The significance of differences between the group means was determined using the Mann-Whitney U test (n
16), Students t test (n > 16), or
2 test (binomial data) as indicated (36); p < 0.05 was considered significant.
| Results |
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The experiments reported here used MOG3555-induced EAE in B6 mice to investigate why Rag-1-dependent lymphocytes other than the neuroantigen-reactive CD4 T cells were needed for 1,25-(OH)2D3 to inhibit EAE (10). To test the hypothesis that the vitamin D3 system might be enhancing the function of IL-10-producing regulatory lymphocytes, we studied vitamin D3-mediated inhibition of MOG3555-induced EAE in mice with a Wt or disrupted IL-10 gene. Mice were fed synthetic diets that provided 0 (D diet) or 1 µg/day (+D diet) of vitamin D3 beginning at age 4 wk exactly as described (26). At age 8 wk, the +D mice had 56 ± 3 nM/L serum 25-hydroxyvitamin D3, whereas the D mice had 8 ± 3 nM/L. All mice were then primed with MOG3555 and evaluated for EAE disease. The +D diet significantly reduced the incidence, peak clinical score, and cumulative disease index for MOG3555-induced EAE in female but not male B6 mice (Table I). These results confirm the female-specific protective effect of dietary vitamin D3 that we reported previously for MBP-induced EAE in B10.PL mice (26). However, the +D diet did not inhibit MOG3555-induced EAE in B6.IL-10/ mice (Table I). We conclude that vitamin D3-mediated inhibition of EAE requires IL-10 gene expression.
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One explanation for the failure of vitamin D3 to inhibit EAE in B6.IL-10/ mice could be an unanticipated requirement for IL-10 to stimulate the conversion of the biologically inactive vitamin D3 and 25-hydroxyvitamin D3 compounds into the biologically active hormone, 1,25-(OH)2D3. To bypass a possible vitamin D3 metabolism problem in B6.IL-10/ mice, we repeated the experiment except that biologically active 1,25-(OH)2D3 was used in place of vitamin D3. The 1,25-(OH)2D3-fed male and female B6 had a lower EAE incidence (p < 0.001), decreased mortality (p < 0.05), and lower peak severity and cumulative disease index (p < 0.0001) than the placebo-fed controls (Fig. 1A and Table II). Histopathology showed that the 1,25-(OH)2D3-fed B6 mice had lesions with inflammatory cell infiltration in 17% of the microscopic fields examined, whereas the placebo-fed controls had lesions in >60% of the fields (Fig. 2). The 1,25-(OH)2D3-treated B6 mice also had 66% fewer spinal cord IFN-
transcripts than the placebo-treated controls, as determined by real-time PCR (Table III). In contrast, the 1,25-(OH)2D3-treated and placebo-treated mice had equivalent numbers of IFN-
-producing CD4+ Th1 cells in the lymph nodes (placebo, 16 ± 5%; 1,25-(OH)2D3, 16 ± 6%). Collectively, the clinical, histological, and immunological data establish that 1,25-(OH)2D3 inhibits MOG3555-induced EAE in B6 mice, as it does MBP-induced EAE in B10.PL mice (9, 10, 29).
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transcripts in the spinal cord (Table III). The 1,25-(OH)2D3 also inhibited MBP-induced EAE in Wt B10.PL mice, but not B10.PL mice lacking IL-10 gene expression, confirming these results (data not shown). We conclude that a functional IL-10 gene is necessary for 1,25-(OH)2D3 to inhibit EAE. The precise mechanism for 1,25-(OH)2D3-mediated inhibition of EAE is debated. It was recently suggested that elevated serum calcium may be necessary and sufficient to inhibit EAE in female mice, and that 1,25-(OH)2D3 may have no functional role other than to elevate serum calcium (37). To investigate this point, we analyzed serum calcium before and during the study shown in Fig. 1. The serum calcium levels were equivalent in all groups before the study (Table IV). The 1,25-(OH)2D3-treated B6 mice had no increase in the serum calcium on day 0, but elevated serum calcium by day 53. Therefore, elevated calcium correlated with decreased EAE in these mice. However, the 1,25-(OH)2D3-treated B6.IL-10/ mice had a significant increase in serum calcium on day 0, and a further increase by day 53 (Table IV), but no decrease in any measure of EAE disease (Table II). Thus, elevated serum calcium was not sufficient to inhibit EAE in the B6.IL-10/ female mice. Moreover, the high vitamin D3 diet inhibited all measures of EAE disease in females without causing hypercalcemia (Table I and Ref. 26). Thus elevated serum calcium was neither necessary nor sufficient to inhibit EAE.
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We reasoned that a fully functional IL-10-IL-10R pathway might be necessary for 1,25-(OH)2D3 to inhibit EAE. To test this hypothesis, we repeated the prevention study using B6.IL-10R
/ mice (with a nonfunctional IL-10R
-signaling chain) in place of B6.IL-10/ mice (20). The results showed that 1,25-(OH)2D3 did not inhibit MOG3555-induced EAE in B6.IL-10R
/ mice (Fig. 1C). The EAE incidence, onset, mortality, peak disease severity, and cumulative disease index were not significantly different for 1,25-(OH)2D3-fed and placebo-fed B6.IL-10R
/ mice (Table II). Collectively, our data show for the first time that the CNS-specific, 1,25-(OH)2D3-activated, neuroprotective mechanism depends on a functional IL-10-IL-10R pathway.
1,25-(OH)2D3 did not alter IL-10 or IL-10R in the CNS
We next looked for possible 1,25-(OH)2D3-mediated enhancement of IL-10 gene expression. The experiment shown in Fig. 1A was repeated, and the IL-10-producing CD4+ T cells were analyzed by flow cytometry 28 days postimmunization. The IL-10-producing CD4+ T cells in the CNS cell suspension were too infrequent to measure. In the cervical lymph node cell suspension, the two groups had equivalent IL-10-producing CD4+ T cell percentages (placebo, 15 ± 8%; 1,25-(OH)2D3, 12 ± 4%) and fluorescence intensities (data not shown). Furthermore, when 1,25-(OH)2D3 or a placebo was administered to mice with acute EAE, the spinal cord and the lymph nodes had equivalent IL-10 transcripts 6-h posttreatment (placebo 0.4 ± 0.2 and 1,25-(OH)2D3 0.3 ± 0.1 IL-10 transcripts per 103 GAPDH transcripts). We have shown that direct, 1,25-(OH)2D3-mediated changes in gene expression can be detected using the 6 h treatment (29). Thus, neither protein nor transcript studies showed 1,25-(OH)2D3-mediated enhancement of IL-10 synthesis. However, the data do not rule out 1,25-(OH)2D3-mediated effects on minor cell populations like regulatory lymphocytes.
We also looked for 1,25-(OH)2D3-mediated enhancement of IL-10R gene expression. The 1,25-(OH)2D3 or a placebo was administered to mice with acute EAE, and flow cytometry was performed on spinal cord cells collected 6 h later. We have established that no hormone-mediated changes in the CNS cell populations occur within this time period (29). The nonimmunized control mice had microglial cells expressing an intermediate level of CD11b and the IL-10R (Fig. 3A) (38, 39, 40). The placebo-treated mice with EAE had the CD11bintIL-10R+ microglial cells, plus a CD11b+IL-10R cell population not found in the nonimmunized control mice (Fig. 3B). These CD11b+IL-10R myeloid lineage cells appear to be infiltrating, activated macrophages. To our knowledge, this is the first report that CNS-infiltrating, activated macrophages do not express the IL-10R. We found no differences in the IL-10R+ or IL-10R cell percentages or the IL-10R density between the two treatment groups (Fig. 3, B and C, and data not shown). Thus, we found no evidence for a direct effect of 1,25-(OH)2D3 on IL-10R expression. However, we cannot rule out effects on minor cell populations like regulatory lymphocytes, astrocytes, or neurons that are not represented in the cell suspension.
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Reciprocal BM chimera studies
Having established that a functional IL-10-IL-10R pathway is necessary for the 1,25-(OH)2D3-activated protective mechanism, we next sought to determine the source of the essential IL-10. The T and B lymphocytes, infiltrating macrophages, microglial cells, and astrocytes all have the capacity to produce IL-10 (15, 44). Reciprocal irradiation BM chimeras were constructed by transferring Wt BM into lethally irradiated, IL-10/ recipients (B6.CD45.1
B6.IL-10/) and vice versa (B6.IL-10/
B6.CD45.1). Cells with a Wt IL-10 gene carried the CD45.1 allotype, whereas cells with an IL-10/ genotype carried the CD45.2 allotype as described (34, 35). Control B6.CD45.1
B6 and B6.IL-10/
B6.IL-10/ chimeras were also constructed. At 6 wk post-BM transplantation, PBLs were >85% donor origin. At the end of each study, the splenocytes and splenic CD3+ T cells were 8591% donor origin (Table V and data not shown). These CD45 allotype data indicated that all animals were chimeras.
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B6 mice had a lower incidence of EAE, a later onset, a lower peak clinical score, and a lower cumulative disease index than the placebo-treated B6.CD45.1
B6 mice (Fig. 4A and Table V). Also as expected, the 1,25-(OH)2D3-treated and placebo-treated B6.IL-10/
B6.IL-10/ mice did not differ in the incidence of EAE, the day of onset, the peak clinical score, or the cumulative disease index (Fig. 4B and Table V). These data confirm that a functional IL-10-IL-10R pathway is necessary for 1,25-(OH)2D3-mediated protection from EAE.
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B6.CD45.1 chimeric mice had significantly more severe clinical EAE disease on days 13 and 14, and a higher cumulative EAE disease index on day 15, than the placebo-treated B6.CD45.1
B6.IL-10/ chimeric mice. These data suggest that hemopoietic cell-produced IL-10 is especially critical for protection from EAE.
Surprisingly, the 1,25-(OH)2D3 did not inhibit EAE in B6.CD45.1
B6.IL-10/ or B6.IL-10/
B6.CD45.1 mice (Fig. 4, C and D; Table V). Thus, limiting IL-10 synthesis to either the radio-sensitive or the radio-resistant cells abrogated 1,25-(OH)2D3-mediated protection. These data suggest that IL-10 synthesis from both cell types is essential for optimal 1,25-(OH)2D3-mediated protection. In fact, there may be an anti-inflammatory amplification loop involving bidirectional IL-10 signaling.
| Discussion |
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Several caveats apply to our interpretation of the present data. First, we may have missed minor IL-10-independent protective effects of the 1,25-(OH)2D3, if the major protective activities were IL-10 dependent and determined the experimental results. We may also have missed IL-10-independent protective effects occurring at a later stage of EAE than was studied here. With respect to the chimera studies, because chimerism was 8591%, a small percentage of the hemopoietic cells in the B6.IL-10/
B6.CD45.1 chimeric mice had the Wt IL-10 gene. Furthermore, because a minor percentage of microglial cells in irradiation BM chimeras derived from hemopoietic stem cells (45, 46), some brain parenchymal cells in the B6.CD45.1
B6.IL-10/ chimeric mice would likely have had the Wt IL-10 gene. Nevertheless, in both cases, the IL-10 producers were insufficient to enable 1,25-(OH)2D3-mediated protection, further supporting the concept of a bidirectional IL-10 amplification loop.
To envision how an 1,25-(OH)2D3-activated, IL-10- and IL-10R-dependent, Rag-1-dependent protective mechanism could limit encephalitogenic CD4+ Th1 cells in the CNS, it is important to consider which CNS cells produce IL-10, and how IL-10 protects the CNS during inflammation. The major IL-10-producing brain parenchymal cells are the microglial cells and astrocytes (44, 47). The IL-10 promotes neuron and glial cell survival by blocking apoptotic signaling. More specifically, IL-10R stimulation regulates the Jak1/Stat3, PI3-kinase, MAP-kinase, suppressor of cytokine signaling (SOCS), and NF-
B life- and death-signaling pathways, ultimately inhibiting both proapoptotic cytokine-induced and mitochondrial-induced apoptosis in neurons and glial cells. The IL-10 also blocks proinflammatory cytokine induction and signaling. Specifically, IL-10R-mediated activation of SOCS reduces proinflammatory cytokine synthesis and cytokine receptor expression and activation. Finally, IL-10 inhibits costimulation of brain-infiltrating T cells via the CD28-CD80/86 pathway, thereby favoring anergy induction.
A model explaining how a 1,25-(OH)2D3-activated, IL-10- and IL-10R-dependent, Rag-1-dependent protective mechanism could limit encephalitogenic CD4+ Th1 cell activation in the CNS must also take into account which cells express the vitamin D receptor (VDR) (48). Myeloid cells, lymphoid cells, astrocytes, microglial cells, neurons, and oligodendrocytes all express the VDR (reviewed in (49). The T cells and type 2 astrocytes increase their VDR expression when activated, whereas the myeloid lineage cells diminish their VDR expression when activated (49). Our present and previous data rule out a direct effect of 1,25-(OH)2D3 on APCs and on naive encephalitogenic CD4+ T cells in the absence of additional Rag-1-dependent lymphocytes in the EAE model (10). Therefore, it is most likely that the 1,25-(OH)2D3 acted directly on regulatory lymphocytes and/or on CNS-resident cells like astrocytes, neurons, and/or microglia. The requirement for IL-10 gene expression in both hemopoietic cells and brain parenchymal cells suggests that 1,25-(OH)2D3 may be acting on both types of cells. The model that is most consistent with our data is bi-directional IL-10 signaling. The 1,25-(OH)2D3 could act directly on regulatory lymphocytes to increase their IL-10-dependent suppressive functions, and the regulatory lymphocyte-produced IL-10 could act on the brain parenchymal cells, altering their function such that they stimulate potentially encephalitogenic, autoreactive T cells to apoptose or to become anergic. To complete the bi-directional IL-10-signaling, the 1,25-(OH)2D3 could also be acting directly on the brain parenchymal cells to increase their IL-10-dependent suppressive functions. Further experimentation will be required to test this model. In particular, it will be important to demonstrate that there are direct effects of the 1,25-(OH)2D3 on regulatory lymphocytes and on brain parenchymal cells like neurons, astrocytes, and microglia that result in an immunosuppressive environment in the CNS.
Given the importance of IL-10 for the protection of the CNS during inflammation (44), it is not surprising that IL-10 deficiency correlates strongly with susceptibility to EAE and MS. The IL-10-deficient mice were highly susceptible to EAE (18, 19). Similarly, IL-10 deficiency appears to be an MS risk factor in humans. The IL-10-secreting T cell frequency was lower in MS patients than controls (50). Also, MS patients had less serum IL-10 protein (51), blood cell IL-10 mRNA (52, 53, 54), and blood cell IL-10 protein (55) than controls. Finally, the IL-10 allele with the low expresser promoter polymorphism was more common in MS patients than controls (56, 57). These correlations suggest a possible cause and effect relationship between IL-10 deficiency and EAE in mice and MS in humans.
Our data showing that IL-10 deficiency in mice eliminated the protective effects of 1,25-(OH)2D3 in EAE has very important implications for MS. Specifically, our data suggest that IL-10 deficiency in humans may diminish the protective effects of sunlight and vitamin D3 in MS-susceptible individuals. There may be synergy between a genetic MS risk factor, IL-10 deficiency, and an environmental MS risk factor, insufficient vitamin D3 synthesis due to inadequate sunlight exposure, increasing the risk of MS by compromising regulatory lymphocyte functions. If this hypothesis is correct, then it will be important to correct the IL-10 deficiency in MS-susceptible individuals for sunlight and vitamin D3 prevention and treatment strategies to be beneficial.
| Acknowledgments |
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| Disclosures |
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| Footnotes |
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1 This work was supported by National Multiple Sclerosis Society Research Grant RG-3107 and National Institutes of Health Predoctoral Training Grant DK 07665-08 through the Department of Nutritional Sciences (University of Wisconsin, Madison, WI) (to K.M.S). ![]()
2 Address correspondence and reprint requests to Dr. Colleen E. Hayes, Department of Biochemistry, College of Agricultural and Life Sciences, University of Wisconsin, 433 Babcock Drive, Madison, WI 53706. E-mail address: hayes{at}biochem.wisc.edu ![]()
3 Abbreviations used in this paper: MS, multiple sclerosis, 1,25-(OH)2D3, 1,25-dihydoxyvitamin D3; BM, bone marrow; EAE, experimental autoimmune encephalomyelitis; MBP, myelin basic protein; MOG3555, myelin oligodendrocytic glycoprotein peptide; VDR, vitamin D receptor. ![]()
Received for publication December 20, 2005. Accepted for publication August 15, 2006.
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induced mouse primary astrocyte activation: a comparative study. Glia 26: 12-21. [Medline]
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-1a therapy in patients with relapsing remitting MS. J. Neuroimmunol. 112: 139-145. [Medline]This article has been cited by other articles:
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