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Sapropterin (BH4) Aggravates Autoimmune Encephalomyelitis in Mice.


ABSTRACT: Depletion of the enzyme cofactor, tetrahydrobiopterin (BH4), in T-cells was shown to prevent their proliferation upon receptor stimulation in models of allergic inflammation in mice, suggesting that BH4 drives autoimmunity. Hence, the clinically available BH4 drug (sapropterin) might increase the risk of autoimmune diseases. The present study assessed the implications for multiple sclerosis (MS) as an exemplary CNS autoimmune disease. Plasma levels of biopterin were persistently low in MS patients and tended to be lower with high Expanded Disability Status Scale (EDSS). Instead, the bypass product, neopterin, was increased. The deregulation suggested that BH4 replenishment might further drive the immune response or beneficially restore the BH4 balances. To answer this question, mice were treated with sapropterin in immunization-evoked autoimmune encephalomyelitis (EAE), a model of multiple sclerosis. Sapropterin-treated mice had higher EAE disease scores associated with higher numbers of T-cells infiltrating the spinal cord, but normal T-cell subpopulations in spleen and blood. Mechanistically, sapropterin treatment was associated with increased plasma levels of long-chain ceramides and low levels of the poly-unsaturated fatty acid, linolenic acid (FA18:3). These lipid changes are known to contribute to disruptions of the blood-brain barrier in EAE mice. Indeed, RNA data analyses revealed upregulations of genes involved in ceramide synthesis in brain endothelial cells of EAE mice (LASS6/CERS6, LASS3/CERS3, UGCG, ELOVL6, and ELOVL4). The results support the view that BH4 fortifies autoimmune CNS disease, mechanistically involving lipid deregulations that are known to contribute to the EAE pathology.

SUBMITTER: Schmitz K 

PROVIDER: S-EPMC8609075 | biostudies-literature | 2021 Jul

REPOSITORIES: biostudies-literature

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Sapropterin (BH4) Aggravates Autoimmune Encephalomyelitis in Mice.

Schmitz Katja K   Trautmann Sandra S   Hahnefeld Lisa L   Fischer Caroline C   Schreiber Yannick Y   Wilken-Schmitz Annett A   Gurke Robert R   Brunkhorst Robert R   Werner Ernst R ER   Watschinger Katrin K   Wicker Sabine S   Thomas Dominique D   Geisslinger Gerd G   Tegeder Irmgard I  

Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics 20210412 3


Depletion of the enzyme cofactor, tetrahydrobiopterin (BH4), in T-cells was shown to prevent their proliferation upon receptor stimulation in models of allergic inflammation in mice, suggesting that BH4 drives autoimmunity. Hence, the clinically available BH4 drug (sapropterin) might increase the risk of autoimmune diseases. The present study assessed the implications for multiple sclerosis (MS) as an exemplary CNS autoimmune disease. Plasma levels of biopterin were persistently low in MS patien  ...[more]

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