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      Changes in expression profiles of internal jugular vein wall and plasma protein levels in multiple sclerosis

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          Abstract

          Background

          Multiple sclerosis (MS) is an inflammatory, demyelinating and degenerative disorder of the central nervous system (CNS). Several observations support interactions between vascular and neurodegenerative mechanisms in multiple sclerosis (MS). To investigate the contribution of the extracranial venous compartment, we analysed expression profiles of internal jugular vein (IJV), which drains blood from CNS, and related plasma protein levels.

          Methods

          We studied a group of MS patients ( n = 19), screened by echo-color Doppler and magnetic resonance venography, who underwent surgical reconstruction of IJV for chronic cerebrospinal venous insufficiency (CCSVI). Microarray-based transcriptome analysis was conducted on specimens of IJV wall from MS patients and from subjects undergoing carotid endarterectomy, as controls. Protein levels were determined by multiplex assay in: i) jugular and peripheral plasma from 17 MS/CCSVI patients; ii) peripheral plasma from 60 progressive MS patients, after repeated sampling and iii) healthy individuals.

          Results

          Of the differentially expressed genes (≥ 2 fold-change, multiple testing correction, P < 0.05), the immune-related CD86 (8.5 fold-change, P = 0.002) emerged among the up regulated genes ( N = 409). Several genes encoding HOX transcription factors and histones potentially regulated by blood flow, were overexpressed. Smooth muscle contraction and cell adhesion processes emerged among down regulated genes ( N = 515), including the neuronal cell adhesion L1CAM as top scorer (5 fold-change, P = 5 × 10 − 4).

          Repeated measurements in jugular/peripheral plasma and overtime in peripheral plasma showed conserved individual plasma patterns for immune-inflammatory (CCL13, CCL18) and adhesion (NCAM1, VAP1, SELL) proteins, despite significant variations overtime (SELL P < 0.0001). Both age and MS disease phenotypes were determinants of VAP1 plasma levels.

          Data supported cerebral related-mechanisms regulating ANGPT1 levels, which were remarkably lower in jugular plasma and correlated in repeated assays but not between jugular/peripheral compartments.

          Conclusions

          This study provides for the first time expression patterns of the IJV wall, suggesting signatures of altered vascular mRNA profiles in MS disease also independently from CCSVI. The combined transcriptome-protein analysis provides intriguing links between IJV wall transcript alteration and plasma protein expression, thus highlighting proteins of interest for MS pathophysiology.

          Electronic supplementary material

          The online version of this article (10.1186/s10020-018-0043-4) contains supplementary material, which is available to authorized users.

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          Most cited references36

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          Multiple Sclerosis

          New England Journal of Medicine, 343(13), 938-952
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            Cerebral hypoperfusion: a new pathophysiologic concept in multiple sclerosis?

            The exact pathogenesis of multiple sclerosis (MS) is incompletely understood. Although auto-immune responses have an important role in the development of hallmark focal demyelinating lesions, the underlying mechanism of axonal degeneration, the other key player in MS pathology and main determinant of long-term disability, remains unclear and corresponds poorly with inflammatory disease activity. Perfusion-weighted imaging studies have demonstrated that there is a widespread cerebral hypoperfusion in patients with MS, which is present from the early beginning to more advanced disease stages. This reduced cerebral blood flow (CBF) does not seems to be secondary to loss of axonal integrity with decreased metabolic demands but appears to be mediated by elevated levels of the potent vasospastic peptide endothelin-1 in the cerebral circulation. Evidence is evolving that cerebral hypoperfusion in MS is associated with chronic hypoxia, focal lesion formation, diffuse axonal degeneration, cognitive dysfunction, and fatigue. Restoring CBF may therefore emerge as a new therapeutic target in MS.
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              Perivascular iron deposition and other vascular damage in multiple sclerosis.

              C W Adams (1988)
              Evidence of damage to cerebral vein walls was sought in 70 cases of multiple sclerosis. Seventy control cases were also examined. The multiple sclerosis cases showed venous intramural fibrinoid deposition (7%), recent haemorrhages (17%), old haemorrhages revealed by haemosiderin deposition (30%), thrombosis (6%) and thickened veins (19%). In all, 41% of all multiple sclerosis cases showed some evidence of vein damage. Occasional control cases showed haemosiderin deposition in the brain but, unlike the multiple sclerosis cases, these were diffuse and almost entirely related to coexistent cardiovascular or cerebrovascular disease. Haemosiderin deposition was common in the substantia nigra and other pigmented nuclei in all cases. It is concluded that the cerebral vein wall in multiple sclerosis is subject to chronic inflammatory damage, which promotes haemorrhage and increased permeability, and constitutes a form of vasculitis.
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                Author and article information

                Contributors
                mrg@unife.it
                Journal
                Mol Med
                Mol. Med
                Molecular Medicine
                BioMed Central (London )
                1076-1551
                1528-3658
                9 August 2018
                9 August 2018
                2018
                : 24
                : 42
                Affiliations
                [1 ]ISNI 0000 0004 1757 2064, GRID grid.8484.0, Department of Biomedical and Specialty Surgical Sciences, , University of Ferrara, ; via Fossato di Mortara n 74, 44121 Ferrara, Italy
                [2 ]ISNI 0000 0004 1757 2064, GRID grid.8484.0, Department of Life Science and Biotechnology, , University of Ferrara, ; Ferrara, Italy
                [3 ]ISNI 0000 0004 1757 2064, GRID grid.8484.0, Department of Morphology, Surgery and Experimental Medicine, , University of Ferrara, ; Ferrara, Italy
                [4 ]GRID grid.416315.4, Department of Experimental and Diagnostic Medicine, Sant’Anna University- Hospital, ; Ferrara, Italy
                [5 ]ISNI 0000 0004 1784 5501, GRID grid.414405.0, Center for Immunological and Rare Neurological Diseases, Bellaria Hospital, IRCCS of Neurological Sciences, ; Bologna, Italy
                [6 ]GRID grid.416315.4, Department of Neurosciences and Rehabilitation, , Sant’Anna University- Hospital, ; Ferrara, Italy
                [7 ]GRID grid.416315.4, Unit of Vascular and Endovascular Surgery, , S. Anna University-Hospital, ; Ferrara, Italy
                Author information
                http://orcid.org/0000-0002-5727-960X
                Article
                43
                10.1186/s10020-018-0043-4
                6085618
                ece431cb-4670-41de-9e60-2c2ce0c530e4
                © The Author(s) 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 23 January 2018
                : 24 July 2018
                Funding
                Funded by: Italian Ministry of University and Research
                Award ID: 2010XE5L2R_002
                Funded by: strategic 2010–2012 Research Program of Emilia Romagna Region - Italy
                Award ID: 1786/2012
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

                gene expression,jugular vein wall,multiple sclerosis,chronic cerebrospinal venous insufficiency,venous abnormalities,jugular plasma protein levels,multiplex protein assay,chemokines,adhesion molecules

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