Acta Neuropathologica Communications (Feb 2025)

AQP4-specific T cells determine lesion localization in the CNS in a model of NMOSD

  • Ali Maisam Afzali,
  • Oleksii Ulianov,
  • Luise Eckardt,
  • Ingrid Stas,
  • Lea Seeholzer,
  • Katja Steiger,
  • Doron Merkler,
  • Thomas Korn

DOI
https://doi.org/10.1186/s40478-025-01947-8
Journal volume & issue
Vol. 13, no. 1
pp. 1 – 14

Abstract

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Abstract Neuromyelitis optica spectrum disorder (NMOSD) is a paradigmatic autoimmune disease of the central nervous system (CNS), in which the water channel protein Aquaporin-4 (AQP4) is targeted by a self-reactive immune response. While the immunopathology of human NMOSD is largely dependent on antibodies to astrocytic AQP4, the role of AQP4-specific T cells for the localization and quality of NMOSD lesions in the CNS is not known. Only recently, we established that thymic B cells express and present AQP4 in the context of MHC class II molecules to purge the naive T cell receptor repertoire of AQP4-specific clones. Here, we exploited this finding to investigate the lesion localization in the CNS of B cell conditional AQP4-deficient (Aqp4 ΔB) mice, which harbor AQP4-specific precursors in their naive T cell repertoire and can be sensitized to mount a strong AQP4(201–220)-specific CD4+ T cell response. Sensitization of Aqp4 ΔB mice with AQP4(201–220) was sufficient to induce clinical disease. The spatiotemporal lesion distribution and the glial cell response in AQP4(201–220)-induced experimental autoimmune encephalomyelitis (EAE) was compared to classical MOG(35–55)-induced EAE in Aqp4 ΔB mice. In contrast to MOG-EAE, AQP4(201–220)-induced EAE was characterized by midline lesions in the brain, retinal pathology, and lesions at the grey matter/white matter border zone in the spinal cord. Therefore, we conclude that antigen-specific T cells dictate the localization of NMOSD-lesions in the CNS.

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