Neuroprotection from Complement‐Mediated Inflammatory Damage

Abstract: Several neurodegenerative disorders, such as multiple sclerosis, Alzheimer's disease, and Parkinson's disease, are associated with inflammatory damage. The complex process of neuroinflammation involves various components of the immune system and the central nervous system. Particularly, brain astrocytes and microglial cells generate several inflammatory mediators like cytokines, leukotrienes, superoxide radicals, eicasonoids, and the components of the complement cascade. Complement plays an important role in the etiology of most of the neuroinflammatory disorders. To prevent long‐term dysfunction inflammation in the central nervous system must be modulated with neuroprotective agents such as nonsteroidal anti‐inflammatory drugs, steroids, phenolic thiazoles, nitrones, catechins, nitric oxide synthetase inhibitors, flavonoids, and phosphodiesterase inhibitors. Few drugs are found to be effective and their therapeutic benefit is hampered by side effects. Most of the neuroprotective agents are free radical scavengers and many inhibit only one or two aspects of inflammation. The complement inhibitory activity of most of these agents is either unknown or not established. Thus, there is doubt regarding their therapeutic value in most of the inflammatory disorders in which complement plays a major role. In this context the role of a multifunctional protein, vaccinia virus complement control protein (VCP), is quite significant as it may play a pivotal role in the treatment of several neuroinflammatory disorders. VCP is known to inhibit both complement pathways involved in inflammation. It is also known to inhibit cytokines and chemokines in inflammation. Our recent studies on rats demonstrate that VCP administration inhibits macrophage infiltration, reduces spinal cord destruction, and improves motor skills associated with spinal cord injury, establishing VCP as a strong candidate for neuroprotection. Thus, complement inhibitors such as VCP can serve as neuroprotective agents in inflammation associated with several neurodegenerative disorders.

[1]  G. Kotwal Poxviral mimicry of complement and chemokine system components: what's the end game? , 2000, Immunology today.

[2]  Šimon Scharf,et al.  A double-blind, placebo-controlled trial of diclofenac/misoprostol in Alzheimer’s disease , 1999, Neurology.

[3]  P. Gasque,et al.  Complement expression in human brain. Biosynthesis of terminal pathway components and regulators in human glial cells and cell lines. , 1995, Journal of immunology.

[4]  G. Kreutzberg Microglia: a sensor for pathological events in the CNS , 1996, Trends in Neurosciences.

[5]  J. Weiss,et al.  Astrocyte-derived monocyte-chemoattractant protein-1 directs the transmigration of leukocytes across a model of the human blood-brain barrier. , 1998, Journal of immunology.

[6]  V. Perry,et al.  Upregulation of the macrophage scavenger receptor in response to different forms of injury in the CNS , 1994, Journal of neurocytology.

[7]  M. Svensson,et al.  Activation of microglial cells and complement following traumatic injury in rat entorhinal-hippocampal slice cultures. , 2004, Journal of neurotrauma.

[8]  R. Würzner Deficiencies of the complement MAC II gene cluster (C6, C7, C9): is subtotal C6 deficiency of particular evolutionary benefit? , 2003, Clinical and experimental immunology.

[9]  M. Schumacher,et al.  Basis of progesterone protection in spinal cord neurodegeneration , 2002, The Journal of Steroid Biochemistry and Molecular Biology.

[10]  P. Gasque,et al.  Activation of Complement in the Central Nervous System , 2003, Annals of the New York Academy of Sciences.

[11]  L. Thal,et al.  A randomized controlled trial of prednisone in Alzheimer's disease. Alzheimer's Disease Cooperative Study. , 2000, Neurology.

[12]  T. Kurotani,et al.  Neuroprotective role of phosphodiesterase inhibitor ibudilast on neuronal cell death induced by activated microglia , 2004, Neuropharmacology.

[13]  Y. Katayama,et al.  Neuroprotective effect of NS-7, a novel Na+ and Ca2+ channel blocker, in a focal ischemic model in the rat , 2003, Brain Research.

[14]  S. Makrides Therapeutic inhibition of the complement system. , 1998, Pharmacological reviews.

[15]  D. Lahiri,et al.  Potential Intervention by Vaccinia Virus Complement Control Protein of the Signals Contributing to the Progression of Central Nervous System Injury to Alzheimer's Disease , 2002, Annals of the New York Academy of Sciences.

[16]  E. Feldman,et al.  Neuroinflammation, COX-2, and ALS—a dual role? , 2004, Experimental Neurology.

[17]  R. Hicks,et al.  Local neutrophil influx following lateral fluid-percussion brain injury in rats is associated with accumulation of complement activation fragments of the third component (C3) of the complement system , 2000, Journal of Neuroimmunology.

[18]  P. Mcgeer,et al.  Inflammation in Parkinson's disease. , 2001, Advances in neurology.

[19]  R. Yezierski,et al.  The role of neuroinflammation and neuroimmune activation in persistent pain , 2001, Pain.

[20]  B. Liu,et al.  Role of Nitric Oxide in Inflammation‐Mediated Neurodegeneration , 2002, Annals of the New York Academy of Sciences.

[21]  J. Schröder,et al.  Inflammatory infiltrates in the spinal cord of patients with Guillain-Barré syndrome , 2003, Acta Neuropathologica.

[22]  K. Davis,et al.  Effects of rofecoxib or naproxen vs placebo on Alzheimer disease progression: a randomized controlled trial. , 2003, JAMA.

[23]  S. Barnum,et al.  Expression of the anaphylatoxin C5a receptor in the oligodendrocyte lineage , 2001, Brain Research.

[24]  P. Gasque,et al.  Spontaneous classical pathway activation and deficiency of membrane regulators render human neurons susceptible to complement lysis. , 2000, The American journal of pathology.

[25]  P. Gasque,et al.  Role of Complement in the Aetiology of Pick's Disease? , 1996, Journal of neuropathology and experimental neurology.

[26]  R. Veerhuis,et al.  Neuroinflammation in Alzheimer's disease and prion disease , 2002, Glia.

[27]  P. Gasque,et al.  Increased Complement Biosynthesis By Microglia and Complement Activation on Neurons in Huntington's Disease , 1999, Experimental Neurology.

[28]  W. Reichman Alzheimer's disease: clinical treatment options. , 2000, The American journal of managed care.

[29]  James O. McNamara,et al.  Formation of Complement Membrane Attack Complex in Mammalian Cerebral Cortex Evokes Seizures and Neurodegeneration , 2003, The Journal of Neuroscience.

[30]  J. Halperin,et al.  Characterization of neuronal cell death induced by complement activation. , 1997, Brain research. Brain research protocols.

[31]  T. Theoharides,et al.  Critical role of mast cells in inflammatory diseases and the effect of acute stress , 2004, Journal of Neuroimmunology.

[32]  K. Joiner,et al.  Activated terminal complement in cerebrospinal fluid in Guillain-Barré syndrome and multiple sclerosis. , 1986, Journal of immunology.

[33]  L. Bergamaschini,et al.  The powerful neuroprotective action of C1-inhibitor on brain ischemia-reperfusion injury does not require C1q. , 2004, The American journal of pathology.

[34]  A. Ischenko,et al.  Expression of Cytokines by Human Astrocytomas Following Stimulation by C3a and C5a Anaphylatoxins , 1999, Journal of neurochemistry.

[35]  N. Davoust,et al.  Complement anaphylatoxin receptors on neurons: new tricks for old receptors? , 1999, Trends in Neurosciences.

[36]  P. Mcgeer,et al.  Glial Cell Reactions in Neurodegenerative Diseases Pathophysiology and Therapeutic Interventions , 1998, Alzheimer disease and associated disorders.

[37]  S. Ibayashi,et al.  Free radical scavenger, edaravone, in stroke with internal carotid artery occlusion , 2004, Journal of the Neurological Sciences.

[38]  M. Christiansen,et al.  Intrathecal activation of the complement system and disability in multiple sclerosis , 1998, Journal of the Neurological Sciences.

[39]  Steven C. R. Williams,et al.  The neuronal nitric oxide synthase inhibitor, TRIM, as a neuroprotective agent: effects in models of cerebral ischaemia using histological and magnetic resonance imaging techniques , 2003, Brain Research.

[40]  A. Blake Dipyridamole is neuroprotective for cultured rat embryonic cortical neurons. , 2004, Biochemical and biophysical research communications.

[41]  C. Glabe,et al.  Multivalent Binding of Complement Protein C1q to the Amyloid β-Peptide (Aβ) Promotes the Nucleation Phase of Aβ Aggregation , 1995 .

[42]  C. Kawas,et al.  Neuronal localization of C1q in preclinical Alzheimer's disease , 2004, Neurobiology of Disease.

[43]  John D Lambris,et al.  Interaction of vaccinia virus complement control protein with human complement proteins: factor I-mediated degradation of C3b to iC3b1 inactivates the alternative complement pathway. , 1998, Journal of immunology.

[44]  S. Meri,et al.  Yin and Yang: complement activation and regulation in Alzheimer’s disease , 2003, Progress in Neurobiology.

[45]  J. Rogers,et al.  Detection of complement alternative pathway mRNA and proteins in the Alzheimer's disease brain. , 2000, Brain research. Molecular brain research.

[46]  John D Lambris,et al.  Prominent neurodegeneration and increased plaque formation in complement-inhibited Alzheimer's mice , 2002, Proceedings of the National Academy of Sciences of the United States of America.

[47]  M. Polley,et al.  C3a-induced contraction of guinea pig ileum consists of two components: fast histamine-mediated and slow prostanoid-mediated. , 1989, The Journal of pharmacology and experimental therapeutics.

[48]  P. Mcgeer,et al.  Inflammation and neurodegeneration in Parkinson's disease. , 2004, Parkinsonism & related disorders.

[49]  Jun Zhou,et al.  Absence of C1q Leads to Less Neuropathology in Transgenic Mouse Models of Alzheimer's Disease , 2004, The Journal of Neuroscience.

[50]  P. Gasque,et al.  The receptor for complement anaphylatoxin C3a is expressed by myeloid cells and nonmyeloid cells in inflamed human central nervous system: analysis in multiple sclerosis and bacterial meningitis. , 1998, Journal of immunology.

[51]  N. Davoust,et al.  Central nervous system-targeted expression of the complement inhibitor sCrry prevents experimental allergic encephalomyelitis. , 1999, Journal of immunology.

[52]  P. Wood,et al.  Nitrones as Neuroprotectants and Antiaging Drugs , 2002, Annals of the New York Academy of Sciences.

[53]  Y. Sarne,et al.  Are cannabinoid drugs neurotoxic or neuroprotective? , 2004, Medical hypotheses.

[54]  B. Moss,et al.  Regulation of complement activity by vaccinia virus complement-control protein. , 1992, The Journal of infectious diseases.

[55]  D. Walker,et al.  Microglia in degenerative neurological disease , 1993, Glia.

[56]  A. Rolland,et al.  Phenolic thiazoles as novel orally-active neuroprotective agents. , 2004, Bioorganic & medicinal chemistry letters.

[57]  L. Schneider,et al.  A critical analysis of new molecular targets and strategies for drug developments in Alzheimer's disease. , 2003, Current drug targets.

[58]  Kapp,et al.  Evaluation of C3a receptor expression on human leucocytes by the use of novel monoclonal antibodies , 1999, Immunology.

[59]  B. Moss,et al.  Vaccinia virus encodes a secretory polypeptide structurally related to complement control proteins , 1988, Nature.

[60]  R. Hohlfeld,et al.  Molecular pathogenesis of neuroinflammation , 2003 .

[61]  K. Murakami,et al.  Involvement of protein kinase C in glutamate release from cultured microglia , 2003, Brain Research.

[62]  Rena Li,et al.  Deficiency of Complement Defense Protein CD59 May Contribute to Neurodegeneration in Alzheimer's Disease , 2000, The Journal of Neuroscience.

[63]  D. Gruol,et al.  Neuronal Expression of a Functional Receptor for the C5a Complement Activation Fragment1 , 2001, The Journal of Immunology.

[64]  D. Metcalfe,et al.  Activation of human mast cells by aggregated IgG through FcgammaRI: additive effects of C3a. , 2004, Clinical immunology.

[65]  S. Hunot,et al.  Neuroinflammatory processes in Parkinson's disease , 2003, Annals of neurology.

[66]  Virginia M. Y. Lee,et al.  Complement activation by neurofibrillary tangles in Alzheimer's disease , 2001, Neuroscience Letters.

[67]  R. Hohlfeld,et al.  Molecular pathogenesis of neuroinflammation , 2003, Journal of neurology, neurosurgery, and psychiatry.

[68]  A. Easton,et al.  Neutrophils both reduce and increase permeability in a cell culture model of the blood–brain barrier , 2004, Brain Research.

[69]  P. Murphy,et al.  Amyloid-β Induces Chemotaxis and Oxidant Stress by Acting at Formylpeptide Receptor 2, a G Protein-coupled Receptor Expressed in Phagocytes and Brain* , 2001, The Journal of Biological Chemistry.

[70]  N. Greig,et al.  Role of cytokines in the gene expression of amyloid beta-protein precursor: identification of a 5'-UTR-binding nuclear factor and its implications in Alzheimer's disease. , 2003, Journal of Alzheimer's disease : JAD.

[71]  M. Freeman,et al.  Expression of the macrophage scavenger receptor, a multifunctional lipoprotein receptor, in microglia associated with senile plaques in Alzheimer's disease. , 1996, The American journal of pathology.

[72]  C. J. Chen,et al.  Association of immune responses and ischemic brain infarction in rat , 2001, Neuroreport.

[73]  G. Kotwal,et al.  Pro-inflammatory complement activation by the Aβ peptide of Alzheimer’s disease is biologically significant and can be blocked by vaccinia virus complement control protein , 1998, Neurobiology of Aging.

[74]  G. Kotwal,et al.  VACCINIA VIRUS COMPLEMENT CONTROL PROTEIN IS CAPABLE OF PROTECTING XENOENDOTHELIAL CELLS FROM ANTIBODY BINDING AND KILLING BY HUMAN COMPLEMENT AND CYTOTOXIC CELLS1 , 2001, Transplantation.

[75]  M. Baudry,et al.  Hereditary Deficiencies in Complement C5 Are Associated with Intensified Neurodegenerative Responses That Implicate New Roles for the C-System in Neuronal and Astrocytic Functions , 1996, Neurobiology of Disease.

[76]  H J Koch,et al.  A randomized controlled trial of prednisone in Alzheimer’s disease , 2000, Neurology.

[77]  T. Johns,et al.  Binding of complement component Clq to myelin oligodendrocyte glycoprotein: A novel mechanism for regulating CNS inflammation , 1997 .

[78]  M. Mattson,et al.  Antiinflammatory effects of estrogen on microglial activation. , 2000, Endocrinology.

[79]  D. Pitt,et al.  Glutamate excitotoxicity--a mechanism for axonal damage and oligodendrocyte death in Multiple Sclerosis? , 2000, Journal of neural transmission. Supplementum.

[80]  C. Cotman,et al.  Complement Association with Neurons and β-Amyloid Deposition in the Brains of Aged Individuals with Down Syndrome , 2001, Neurobiology of Disease.

[81]  A. Kaplan,et al.  Complement dependence of histamine release in chronic urticaria. , 1999, The Journal of allergy and clinical immunology.

[82]  Jialin Su,et al.  Peroxynitrite induces apoptosis in canine cerebral vascular muscle cells: possible relation to neurodegenerative diseases and strokes , 2003, Neuroscience Letters.

[83]  S. Rojas,et al.  Astrocyte‐targeted expression of interleukin‐6 protects the central nervous system during neuroglial degeneration induced by 6‐aminonicotinamide , 2003, Journal of neuroscience research.

[84]  P. Mukherjee,et al.  The role of complement anaphylatoxin C5a in neurodegeneration: implications in Alzheimer’s disease , 2000, Journal of Neuroimmunology.

[85]  Z. Qin,et al.  Tumor necrosis factor alpha expression produces increased blood-brain barrier permeability following temporary focal cerebral ischemia in mice. , 1999, Brain research. Molecular brain research.

[86]  J. Thurman,et al.  The alternative pathway of complement in disease: opportunities for therapeutic targeting. , 2004, Molecular immunology.

[87]  P. Moore,et al.  Microglial cell activation in demyelinating canine distemper lesions , 2004, Journal of Neuroimmunology.

[88]  S. Heales,et al.  Neurodegeneration or Neuroprotection: The Pivotal Role of Astrocytes , 2004, Neurochemical Research.

[89]  D. Colcher,et al.  Conformationally biased analogs of human C5a mediate changes in vascular permeability. , 1996, The Journal of pharmacology and experimental therapeutics.

[90]  H. Müller-Eberhard,et al.  Molecular organization and function of the complement system. , 1988, Annual review of biochemistry.

[91]  E. Iseki,et al.  Nitric oxide pathways in Alzheimer's disease and other neurodegenerative dementias , 2004, Neurological research.

[92]  D. Woolley,et al.  Mast cell activation and its relation to proinflammatory cytokine production in the rheumatoid lesion , 1999, Arthritis research.

[93]  D. Figarella-Branger,et al.  Immunohistochemical localization of cytokines, C5b-9 and ICAM-1 in peripheral nerve of Guillain–Barré Syndrome , 2000, Journal of the Neurological Sciences.

[94]  F. Bao,et al.  Peroxynitrite generated in the rat spinal cord induces neuron death and neurological deficits , 2002, Neuroscience.

[95]  E. Mackenzie,et al.  Complement anaphylatoxin C3a is selectively protective against NMDA-induced neuronal cell death , 2001, Neuroreport.

[96]  G. Gibson,et al.  Selective response of various brain cell types during neurodegeneration induced by mild impairment of oxidative metabolism , 2004, Neurochemistry International.

[97]  C. Glabe,et al.  Multivalent binding of complement protein C1Q to the amyloid beta-peptide (A beta) promotes the nucleation phase of A beta aggregation. , 1995, Biochemical and biophysical research communications.

[98]  R. Hicks,et al.  Vaccinia virus complement control protein enhances functional recovery after traumatic brain injury. , 2002, Journal of neurotrauma.

[99]  Adanma Ndubuizu,et al.  Neuroprotective effects of estradiol in newborn female rat hippocampus. , 2004, Brain research. Developmental brain research.

[100]  G. Rotilio,et al.  Interplay of Cu,Zn Superoxide Dismutase and Nitric Oxide Synthase in Neurodegenerative Processes , 2003, IUBMB life.

[101]  H. Budka,et al.  Complement activation in human prion disease , 2004, Neurobiology of Disease.