Cerebrospinal fluid ceramides from patients with multiple sclerosis impair neuronal bioenergetics.
Axonal damage is a prominent cause of disability and yet its pathogenesis is incompletely understood. Using a xenogeneic system, here we define the bioenergetic changes induced in rat neurons by exposure to cerebrospinal fluid samples from patients with multiple sclerosis compared to control subjects. A first discovery cohort of cerebrospinal fluid from 13 patients with multiple sclerosis and 10 control subjects showed that acute exposure to cerebrospinal fluid from patients with multiple sclerosis induced oxidative stress and decreased expression of neuroprotective genes, while increasing expression of genes involved in lipid signalling and in the response to oxidative stress. Protracted exposure of neurons to stress led to neurotoxicity and bioenergetics failure after cerebrospinal fluid exposure and positively correlated with the levels of neurofilament light chain. These findings were validated using a second independent cohort of cerebrospinal fluid samples (eight patients with multiple sclerosis and eight control subjects), collected at a different centre. The toxic effect of cerebrospinal fluid on neurons was not attributable to differences in IgG content, glucose, lactate or glutamate levels or differences in cytokine levels. A lipidomic profiling approach led to the identification of increased levels of ceramide C16:0 and C24:0 in the cerebrospinal fluid from patients with multiple sclerosis. Exposure of cultured neurons to micelles composed of these ceramide species was sufficient to recapitulate the bioenergetic dysfunction and oxidative damage induced by exposure to cerebrospinal fluid from patients with multiple sclerosis. Therefore, our data suggest that C16:0 and C24:0 ceramides are enriched in the cerebrospinal fluid of patients with multiple sclerosis and are sufficient to induce neuronal mitochondrial dysfunction and axonal damage.
['Vidaurre|Oscar G|OG|', 'Haines|Jeffery D|JD|', 'Katz Sand|Ilana|I|', 'Adula|Kadidia P|KP|', 'Huynh|Jimmy L|JL|', 'McGraw|Corey A|CA|', 'Zhang|Fan|F|', 'Varghese|Merina|M|', 'Sotirchos|Elias|E|', 'Bhargava|Pavan|P|', 'Bandaru|Veera Venkata Ratnam|VV|', 'Pasinetti|Giulio|G|', 'Zhang|Weijia|W|', 'Inglese|Matilde|M|', 'Calabresi|Peter A|PA|', 'Wu|Gang|G|', 'Miller|Aaron E|AE|', 'Haughey|Norman J|NJ|', 'Lublin|Fred D|FD|', 'Casaccia|Patrizia|P|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D000818:Animals D002478:Cells, Cultured D002518:Ceramides D015331:Cohort Studies D004734:Energy Metabolism D006801:Humans D008875:Middle Aged D009103:Multiple Sclerosis D009474:Neurons D051381:Rats D017207:Rats, Sprague-Dawley D055815:Young Adult
axonal degeneration demyelinating disease lipid metabolism mitochondria neurodegenerative mechanism