Do adult human oligodendrocytes remyelinate poorly and can we change this to better treat progressive multiple sclerosis?
Lead Research Organisation:
University of Edinburgh
Department Name: MRC Centre for Regenerative Medicine
Abstract
Multiple sclerosis (MS) is a common chronic disease of the brain and spinal cord, often starting in young adulthood, which frequently causes disability. Although the early stages of the disease can now be controlled with medication, in the later stages, there are no treatments to either slow, stop or reverse disability. One focus of research to help the later 'progressive' phase of MS is to encourage repair of the myelin sheath that covers the nerves. This is damaged in MS and when replaced can protect nerves from dying. The cells that carry out repair of this myelin sheath are called oligodendrocytes, which are present in brains of people with MS, but these cells struggle to repair the myelin sheaths. Researchers have now developed drugs that might help oligodendrocytes to repair myelin sheaths but in trials in people they only showed a very small effect. This project will investigate ways to improve this effect.
Firstly, we now know that rat oligodendrocytes are worse at repairing myelin as they get older, and most drugs are tested in the lab on very young oligodendrocytes. We found that these drugs currently being tested in clinical trials do not help adult brain oligodendrocytes repair myelin. However, these drugs become effective again if they are first treated with another drug called metformin. Secondly, we recently found that there are different types of human oligodendrocytes, which are different from in rat oligodendrocytes, and some of these types might be better at repairing myelin than others.
In this project, we will test whether adult human oligodendrocytes also become worse at repairing myelin with age, and can be rejuvenated to respond better to the pro-repair drugs with metformin. To do this we need to be able to grow adult human oligodendrocytes in a dish. We will obtain some from human brain biopsies, but also we will try and make 'aged' cells from stem cells (which normally represent very young cells) by using genetic tricks. We will also see whether we can use this method of rejuvenation in combination with drugs to help encourage the formation of the best type of oligodendrocytes for myelin repair.
This project will find out whether we can better test MS therapies on relevant adult human cells, to improve their response to drugs helping myelin repair. Some of these pro-repair drugs and metformin are being considered for use in 'The Efficient Clinical Trials Platform' to be launched by the MS Society UK in 2020, and so this project will help select some of these current drugs and provide a relevant testing platform for other drugs. This means we will better at finding drugs that are more likely to work in MS and can test them in MS patients quickly.
Firstly, we now know that rat oligodendrocytes are worse at repairing myelin as they get older, and most drugs are tested in the lab on very young oligodendrocytes. We found that these drugs currently being tested in clinical trials do not help adult brain oligodendrocytes repair myelin. However, these drugs become effective again if they are first treated with another drug called metformin. Secondly, we recently found that there are different types of human oligodendrocytes, which are different from in rat oligodendrocytes, and some of these types might be better at repairing myelin than others.
In this project, we will test whether adult human oligodendrocytes also become worse at repairing myelin with age, and can be rejuvenated to respond better to the pro-repair drugs with metformin. To do this we need to be able to grow adult human oligodendrocytes in a dish. We will obtain some from human brain biopsies, but also we will try and make 'aged' cells from stem cells (which normally represent very young cells) by using genetic tricks. We will also see whether we can use this method of rejuvenation in combination with drugs to help encourage the formation of the best type of oligodendrocytes for myelin repair.
This project will find out whether we can better test MS therapies on relevant adult human cells, to improve their response to drugs helping myelin repair. Some of these pro-repair drugs and metformin are being considered for use in 'The Efficient Clinical Trials Platform' to be launched by the MS Society UK in 2020, and so this project will help select some of these current drugs and provide a relevant testing platform for other drugs. This means we will better at finding drugs that are more likely to work in MS and can test them in MS patients quickly.
Technical Summary
Multiple sclerosis (MS) is a common chronic demyelinating, neurodegenerative disease of the CNS, with major societal impact. There are now effective treatments to reduce relapses in early disease, but not to slow, stop or reverse disability progression in later disease. As disability reflects neurodegeneration, one focus of research into therapies to limit progressive disease is to enhance repair of demyelinated lesions (remyelination), restoring saltatory conduction and metabolic support to the underlying axon. Three such therapies have now been tested in clinical trials but with only minor effects. This may be due to two problems: 1) we have shown that aged adult rat oligodendrocytes do not respond to these pro-remyelinating drugs compared to young adult cells, but these drugs become effective again after metformin treatment, 2) our snRNAseq from human brain shows six distinct human oligodendrocyte 'states', different from rat, the proportion of which are different in MS, suggesting it may be best to enhance particular oligodendrocyte states e.g. those better at remyelination.
We hypothesise that pro-remyelinating drug efficacy will be improved if preclinical testing is performed on aged human oligodendroglia with relevant functional states similar to those in MS. In this project, we will use adult human oligodendrocytes to determine whether remyelination declines with age and is rejuvenated after metformin treatment. Thus we need in vitro adult human oligodendrocytes, preferably from a stem cell source for a limitless supply. We will obtain some from human brain biopsies, but we will test strategies to induce 'aged' cells from stem cells. We will assess oligodendrocyte states formed under these conditions.
These drugs and metformin are being considered for use in the MS Society UK's 'Efficient Clinical Trials Platform'. This project will provide a relevant testing platform for current and future drugs, accelerating movement of effective drugs into MS patients.
We hypothesise that pro-remyelinating drug efficacy will be improved if preclinical testing is performed on aged human oligodendroglia with relevant functional states similar to those in MS. In this project, we will use adult human oligodendrocytes to determine whether remyelination declines with age and is rejuvenated after metformin treatment. Thus we need in vitro adult human oligodendrocytes, preferably from a stem cell source for a limitless supply. We will obtain some from human brain biopsies, but we will test strategies to induce 'aged' cells from stem cells. We will assess oligodendrocyte states formed under these conditions.
These drugs and metformin are being considered for use in the MS Society UK's 'Efficient Clinical Trials Platform'. This project will provide a relevant testing platform for current and future drugs, accelerating movement of effective drugs into MS patients.
Planned Impact
Who will benefit from this research and how?
MS patients
There is an unmet need for therapies for progressive MS patients, but the MS Society UK is committed to providing 'The Efficient Trials Platform' which will test new therapies for progressive MS in an adaptive trial design. There is a list of potential candidate drugs for trial within this from preclinical work. We believe this project will allow better selection of these drugs for myelin repair singly and in combination on disease-relevant human cells, with all likelihood of a bigger clinical effect in patients. If any treatment works in progressive MS, the societal impact is large.
MS researchers
This research will answer the questions as to whether aged/adult human oligodendroglia are poorer at remyelination and the mechanisms as to why, if they can be rejuvenated in vitro and whether they can be modelled using stem cell-derived oligodendroglia. We will share techniques of human OPC culture, conversion to aged/adult cells in vitro, and in vivo human OPC transplants. We will generate single cell/nuclei RNAseq data which will be made publicly available.
Private sector companies e.g. pharma:
There will be interest in using the best type of adult disease-relevant human oligodendroglia to use for screening drugs for pro-remyelinating effects.
Local, national and international policy-makers, for determining best use of funding:
There will be interest as to quickly finding which future therapies for MS (and similar diseases) are worth funding further.
MS patients
There is an unmet need for therapies for progressive MS patients, but the MS Society UK is committed to providing 'The Efficient Trials Platform' which will test new therapies for progressive MS in an adaptive trial design. There is a list of potential candidate drugs for trial within this from preclinical work. We believe this project will allow better selection of these drugs for myelin repair singly and in combination on disease-relevant human cells, with all likelihood of a bigger clinical effect in patients. If any treatment works in progressive MS, the societal impact is large.
MS researchers
This research will answer the questions as to whether aged/adult human oligodendroglia are poorer at remyelination and the mechanisms as to why, if they can be rejuvenated in vitro and whether they can be modelled using stem cell-derived oligodendroglia. We will share techniques of human OPC culture, conversion to aged/adult cells in vitro, and in vivo human OPC transplants. We will generate single cell/nuclei RNAseq data which will be made publicly available.
Private sector companies e.g. pharma:
There will be interest in using the best type of adult disease-relevant human oligodendroglia to use for screening drugs for pro-remyelinating effects.
Local, national and international policy-makers, for determining best use of funding:
There will be interest as to quickly finding which future therapies for MS (and similar diseases) are worth funding further.
Organisations
Publications
Seeker LA
(2022)
Oligodendroglia heterogeneity in the human central nervous system.
in Acta neuropathologica
Procter TV
(2021)
Interplay between Brain Pericytes and Endothelial Cells in Dementia.
in The American journal of pathology
Nicaise AM
(2019)
Cellular senescence in progenitor cells contributes to diminished remyelination potential in progressive multiple sclerosis.
in Proceedings of the National Academy of Sciences of the United States of America
Neely S
(2022)
New oligodendrocytes exhibit more abundant and accurate myelin regeneration than those that survive demyelination
in Nature Neuroscience
Matjusaitis M
(2019)
Reprogramming of Fibroblasts to Oligodendrocyte Progenitor-like Cells Using CRISPR/Cas9-Based Synthetic Transcription Factors.
in Stem cell reports
Bøstrand SMK
(2021)
Oligodendroglial Heterogeneity in Neuropsychiatric Disease.
in Life (Basel, Switzerland)
Description | Academy of Medical Sciences meeting |
Geographic Reach | National |
Policy Influence Type | Participation in a guidance/advisory committee |
Description | A 3D Neurosterol Atlas of Mouse Brain |
Amount | £248,091 (GBP) |
Funding ID | BB/T018518/1 |
Organisation | Biotechnology and Biological Sciences Research Council (BBSRC) |
Sector | Public |
Country | United Kingdom |
Start | 11/2020 |
End | 12/2024 |
Description | Edinburgh DRI hub |
Amount | £20,000,000 (GBP) |
Organisation | UK Dementia Research Institute |
Sector | Charity/Non Profit |
Country | United Kingdom |
Start | 03/2023 |
End | 04/2028 |
Description | How does oligodendrocyte transcriptional heterogeneity change biological function? |
Amount | £625,951 (GBP) |
Funding ID | BB/X002799/1 |
Organisation | United Kingdom Research and Innovation |
Sector | Public |
Country | United Kingdom |
Start | 05/2023 |
End | 06/2026 |
Description | MS Centre |
Amount | £1,850,000 (GBP) |
Organisation | Multiple Sclerosis Society |
Sector | Charity/Non Profit |
Country | United Kingdom |
Start | 01/2021 |
End | 12/2025 |
Title | analysis tool |
Description | To assess myelin thickness around nerves |
Type Of Material | Technology assay or reagent |
Year Produced | 2024 |
Provided To Others? | Yes |
Impact | PUblication |
URL | https://pubmed.ncbi.nlm.nih.gov/37976310/ |
Description | Goncalo Castelo-Branco |
Organisation | Karolinska Institute |
Country | Sweden |
Sector | Academic/University |
PI Contribution | Biological input for snRNASeq on MS tissue, plus tissue. |
Collaborator Contribution | Bioinformatic input to the same |
Impact | 2 publications 2 grants - HCA and CZI |
Start Year | 2016 |
Description | Robin Franklin, University of Cambridge |
Organisation | University of Cambridge |
Department | Cambridge Stem Cell Institute |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | We have a post doc together. Most work will be done in Edinburgh. |
Collaborator Contribution | Training in spinal cord surgery to be done in Cambridge and use of a transgenic mouse in Cambridge. |
Impact | We will generate cell lines, but these are not yet finished. |
Start Year | 2017 |
Description | ARRNC open research evening |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Public/other audiences |
Results and Impact | Open research evening in clinic 95 people attended and feedback was positive |
Year(s) Of Engagement Activity | 2023 |
Description | Academy of Medical sciences meeting |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | Working group for biomarkers of early neurodegenerative diseases 50 mixed people - GPs, PhD sstudents, neurologists, geriattiriciass, people with lived experience, charity organisers |
Year(s) Of Engagement Activity | 2024 |
Description | Borders MS society group |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Patients, carers and/or patient groups |
Results and Impact | Borders MS society group invited me for a talk about progressive MS |
Year(s) Of Engagement Activity | 2023 |
Description | Edinburgh medical students neuoscience society talk |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Undergraduate students |
Results and Impact | Online talk to medical students as their society event - sharing science and career ideas |
Year(s) Of Engagement Activity | 2023 |
Description | Interview BBC scotland |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Media (as a channel to the public) |
Results and Impact | Interview for MS Centre status re-awarded. Interest from patients, general public |
Year(s) Of Engagement Activity | 2021 |
Description | MS society visit stirling |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Patients, carers and/or patient groups |
Results and Impact | MS society UK day meeting for people with MS and carers |
Year(s) Of Engagement Activity | 2022 |
Description | MS supporters visit to institute |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Patients, carers and/or patient groups |
Results and Impact | Visit of supporters to institute for tour/chat |
Year(s) Of Engagement Activity | 2023 |
Description | Press release on paper publication |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Public/other audiences |
Results and Impact | press release for paper publication - interview for Glasgow herald newspaper, coverage in Scotsman paper and online science magazines |
Year(s) Of Engagement Activity | 2021 |
URL | https://www.edinburghnews.scotsman.com/health/edinburgh-university-research-could-help-prevent-disab... |
Description | RCP neuroinflammation day |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | 150 doctors treatting patients with neuroinflammation |
Year(s) Of Engagement Activity | 2023 |
URL | https://edinburghbioquarter.com/neuroinflammation-2023-neurolupus-and-beyond/ |
Description | STOPMS panel |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Patients, carers and/or patient groups |
Results and Impact | Panel discussion for STOPMS campaign |
Year(s) Of Engagement Activity | 2020 |
Description | interview with Understanding Animal Research |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Public/other audiences |
Results and Impact | https://www.understandinganimalresearch.org.uk/news/a-new-animal-model-for-late-stage-multiple-sclerosis/ |
Year(s) Of Engagement Activity | 2021 |
URL | https://www.understandinganimalresearch.org.uk/news/a-new-animal-model-for-late-stage-multiple-scler... |
Description | masters student workshop in Paris, France |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Postgraduate students |
Results and Impact | day of work of science and career advice for postgraduate students at the Sorbonne university in Paris |
Year(s) Of Engagement Activity | 2023 |
Description | myelin satellite meeting speaker |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Satellite meeting on myelin |
Year(s) Of Engagement Activity | 2023 |