Cited by 128Amyotrophic Lateral Sclerosis ResearchNeuroinflammation and Neurodegeneration MechanismsMultiple Sclerosis Research Studies

Immunity in amyotrophic lateral sclerosis: blurred lines between excessive inflammation and inefficient immune responses

Open access
Béland, Louis-Charles, Markovinovic, Andrea, Jakovac, Hrvoje, De Marchi, Fabiola, Bilic, Ervina, Mazzini, Letizia, Kriz, Jasna, Munitic, Ivana·2020·Brain Communications

Abstract

Despite wide genetic, environmental and clinical heterogeneity in amyotrophic lateral sclerosis, a rapidly fatal neurodegenerative disease targeting motoneurons, neuroinflammation is a common finding. It is marked by local glial activation, T cell infiltration and systemic immune system activation. The immune system has a prominent role in the pathogenesis of various chronic diseases, hence some of them, including some types of cancer, are successfully targeted by immunotherapeutic approaches. However, various anti-inflammatory or immunosuppressive therapies in amyotrophic lateral sclerosis have failed. This prompted increased scrutiny over the immune-mediated processes underlying amyotrophic lateral sclerosis. Perhaps the biggest conundrum is that amyotrophic lateral sclerosis pathogenesis exhibits features of three otherwise distinct immune dysfunctions—excessive inflammation, autoimmunity and inefficient immune responses. Epidemiological and genome-wide association studies show only minimal overlap between amyotrophic lateral sclerosis and autoimmune diseases, so excessive inflammation is usually thought to be secondary to protein aggregation, mitochondrial damage or other stresses. In contrast, several recently characterized amyotrophic lateral sclerosis-linked mutations, including those in TBK1, OPTN, CYLD and C9orf72, could lead to inefficient immune responses and/or damage pile-up, suggesting that an innate immunodeficiency may also be a trigger and/or modifier of this disease. In such cases, non-selective immunosuppression would further restrict neuroprotective immune responses. Here we discuss multiple layers of immune-mediated neuroprotection and neurotoxicity in amyotrophic lateral sclerosis. Particular focus is placed on individual patient mutations that directly or indirectly affect the immune system, and the mechanisms by which these mutations influence disease progression. The topic of immunity in amyotrophic lateral sclerosis is timely and relevant, because it is one of the few common and potentially malleable denominators in this heterogenous disease. Importantly, amyotrophic lateral sclerosis progression has recently been intricately linked to patient T cell and monocyte profiles, as well as polymorphisms in cytokine and chemokine receptors. For this reason, precise patient stratification based on immunophenotyping will be crucial for efficient therapies.

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Crossref · 10.1093/braincomms/fcaa124

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  • Many ALS genetic mutations are associated with immune response, such as C9orf72, TBK1, CYLD, OPTN, and PGRN.

    “Many of the genetic mutations are associated with immune response, such as C9orf72, TBK1, CYLD, OPTN, PGRN, and so on.85,272”

    From Role of neuroinflammation in neurodegeneration development (2023) · cites this paper as [85]

    The ‘ALS genetics and mechanisms’ section (page unavailable) links C9orf72, TBK1, CYLD and OPTN to innate immune reactions, but describes these as a small subset of ALS-linked genes rather than ‘many’ mutations. Our copy does not establish the claimed link for PGRN (searched: PGRN and progranulin). (LLM, conf=0.89)

    Experimental — accuracy not yet measured
  • Persistent inflammation damages neurons directly and exacerbates ALS.

    “Persistent inflammation damages neurons directly and exacerbates ALS78,85”

    From Role of neuroinflammation in neurodegeneration development (2023) · cites this paper as [85]

  • More than 30 genes strongly correlate with ALS, although their exact roles in disease development are still not completely understood.

    “More than 30 of these genes strongly correlate with the disease, although their exact roles in disease development are still not completely understood.85”

    From Role of neuroinflammation in neurodegeneration development (2023) · cites this paper as [85]

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Authors
Béland, L.-C., Markovinovic, A., Jakovac, H., De Marchi, F., Bilic, E., Mazzini, L., Kriz, J., & Munitic, I.
Affiliations
  • Université Laval (CA)
  • Laboratory for Molecular Immunology, Department of Biotechnology, University of Rijeka, 51000 Rijeka, Croatia
  • University of Rijeka (HR)
  • Department of Neurology, ALS Centre, University of Piemonte Orientale, “Maggiore della Carità” Hospital, 28100 Novara, Italy
  • Department of Neurology, Clinical Hospital Centre Zagreb, 10000 Zagreb, Croatia
  • Università degli Studi del Piemonte Orientale “Amedeo Avogadro” (IT)
  • CERVO Research Centre, Laval University, Quebec City, Quebec G1J 2G3, Canada
Venue
Brain Communications
Published
2020
Volume
2
Issue
2
Pages
fcaa124-fcaa124
ISSN
2632-1297 (ISSN-L)
OpenAlex
W3049334858
Cited by
125
References
282
Citations by year
2026: 15 · 2025: 33 · 2024: 26 · 2023: 17 · 2022: 18 · 2021: 16
FWCI
1.43
Type
journal article
Language
en
Open access
Locations
  • Brain Communications (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
Funders
  • Croatian Science Foundation (UIP-2013-11-7459, IP-2018-01-8563)
  • University of Rijeka (18-211-1369)
  • Università del Piemonte Orientale
Topics
  • Health Sciences › Medicine › Neurology › Amyotrophic Lateral Sclerosis Research
  • Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
Keywords
amyotrophic lateral sclerosis, neuroinflammation, autoimmunity, immune dysregulation, T cell infiltration, glial activation, C9orf72, TBK1, optineurin, CYLD, neuroprotection, neurotoxicity, immunophenotyping, patient stratification, immunosuppressive therapy failure

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