Cited by 25Multiple Sclerosis Research StudiesNeuroinflammation and Neurodegeneration MechanismsPhagocytosis and Immune Regulation

The DOI matches its Crossref record; 26 of the 26 references it cites were found in a registry or an index; 7 of the 29 sources its claims cite were checked for support.

Reduced Angiopoietin-Like 4 Expression in Multiple Sclerosis Lesions Facilitates Lipid Uptake by Phagocytes via Modulation of Lipoprotein-Lipase Activity

Open access
Kamermans, Alwin, Rijnsburger, Merel, Chakraborty, Ananya, van der Pol, Susanne, de Vries, Helga E., van Horssen, Jack·2019·Frontiers in Immunology

Abstract

Multiple sclerosis (MS) is a chronic inflammatory disorder of the central nervous system (CNS) characterized by the presence of focal demyelinated plaques. Sufficient clearance of myelin and cellular debris is one of the requirements for proper tissue repair and remyelination. The mechanisms underlying the clearance of such debris by phagocytes are not fully understood, but recent findings suggest a prominent role for lipoprotein-lipase (LPL) in this process. Here, we demonstrate that angiopoietin-like 4 (ANGPTL4), a potent inhibitor of LPL, is abundantly expressed in astrocytes in control white matter tissue and its expression is markedly reduced in active MS lesions. We provide evidence that ANGPTL4 inhibits the uptake of myelin-derived lipids by LPL-immunoreactive phagocytes. Taken together, our data suggest that the strong reduction in astrocytic ANGPTL4 expression in active demyelinating MS lesions enables phagocytes to adequately clear myelin debris, setting the stage for remyelination.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

In active multiple sclerosis lesions, astrocytic ANGPTL4 expression is markedly reduced while LPL is expressed by Iba1-positive phagocytes. ANGPTL4 inhibits LPL activity and myelin-derived lipid uptake by macrophages without blocking myelin phagocytosis, suggesting reduced ANGPTL4 may facilitate debris clearance for repair.

Key findings

  • ANGPTL4 was predominantly expressed by GFAP-positive astrocytes in control/NAWM tissue and was consistently reduced in active MS lesions compared with surrounding NAWM and inactive lesions (one-way ANOVA; N = 6 NAWM, 5 active, 4 inactive; *p < 0.05).
  • LPL was weakly expressed in NAWM but abundantly expressed in active lesions, localized to Iba1-positive macrophages/microglia.
  • Myelin exposure did not affect astrocytic ANGPTL4 expression (Mann–Whitney; N = 8 control, 11 myelin), but coculture with alternatively activated macrophages significantly reduced astrocytic ANGPTL4 (Student’s t-test; N = 7; p < 0.01).
  • ANGPTL4 inhibited macrophage LPL activity (Mann–Whitney; N = 4) and reduced Oil-Red-O lipid accumulation after myelin exposure, similar to Orlistat (one-way ANOVA; N = 5), but did not inhibit phagocytosis of Atto633-labeled myelin; Cytochalasin D completely blocked phagocytosis (one-way ANOVA; N = 5; *p < 0.05, p < 0.01, p ≤ 0.0001).

Methods

  • Immunohistochemistry and immunofluorescence were performed on formalin-fixed paraffin-embedded post-mortem brain tissue from 12 MS patients and 3 non-neurological controls, with active, inactive, and NAWM regions classified by PLP and HLA-DR staining.
  • Human astrocytoma U373 cells and human monocyte-derived macrophages were used in culture; macrophages were differentiated with M-CSF and alternatively activated with IL-4, and astrocyte/macrophage coculture used transwell inserts.
  • Myelin was isolated from three healthy control CNS white matter samples and labeled with Atto633; outcomes included qPCR, Oil-Red-O staining, FACS-based myelin phagocytosis, and a fluorometric LPL activity assay, analyzed with t-tests, Mann–Whitney U-tests, or one-way ANOVA in GraphPad Prism 5.0.

Limitations

  • The paper does not include a dedicated limitations section; the discussion states that future studies are needed to understand how macrophages regulate astrocytic ANGPTL4 production.
  • The discussion also notes that global ANGPTL4 knockout mice did not show significant differences in brain LPL activity, which may relate to lack of LPL protein expression in control white matter.
  • Evident from the text: sample sizes are small (e.g., N = 4–11 per experiment; 12 MS and 3 control brains), astrocyte experiments use U373 astrocytoma cells rather than primary human astrocytes, and the study is largely in vitro/human tissue correlative without direct in vivo remyelination or functional repair data.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.3389/fimmu.2019.00950

Cites

26 of 26 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

7 of 29 cited sources checked · 2 supported · 0 flagged · accuracy not yet measured

  • Premisecitation

    LPL plays an important role during initiation of remyelination.

    “evidence is emerging that lipoprotein-lipase (LPL), an enzyme involved in lipid-processing, plays an important role during initiation of remyelination (4, 6).”
    Quote in the paperSubstantial claim2 of 2 sources checked
    • cites [4] Olah, 2012, Identification of a microglia phenotype supportive of remyelination, Glia. source

      The gene-expression section reports that Lpl, a lipid-recycling factor, was strongly expressed in lesion-associated microglia before remyelination and remained expressed during remyelination. The Discussion suggests a supportive role for microglial lipid processing, but does not establish that LPL itself plays an important role specifically in initiating remyelination. Page numbers were not available in our copy. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
    • cites [6] Bruce, 2018, Lipoprotein lipase is a feature of alternatively-activated microglia and may facilitate lipid uptake in the CNS during demyelination, Front Mol Neurosci. source
  • Premisecitation

    LPL protein expression is lacking in control white matter brain tissue.

    “the lack of LPL protein expression in control white matter brain tissue (17).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [17] Wang, 2012, Lipoprotein lipase in the brain and nervous system, Annu Rev Nutr. source

      The section “LPL mRNA, Protein, and Enzyme Activity in Brain and CNS” (page unavailable) reports very low LPL protein levels in glial-rich areas adjacent to neurons. It does not establish that LPL protein is absent from control brain white matter specifically; it also reports LPL protein on brain vascular endothelium. (LLM, conf=0.83)

      Experimental — accuracy not yet measured
  • Findingown data

    ANGPTL4 does not inhibit phagocytosis of myelin by macrophages.

    “Phagocytosis of atto633-labeled myelin was not inhibited by ANGPTL4”
    • Also stated in: § Discussion · plain
      “we did not observe differences in their capacity to phagocytose myelin”
    Quote in the paperSubstantial claim
  • Findingown data

    Myelin treatment increases lipid accumulation in macrophages.

    “we observed increased lipid accumulation after myelin treatment”
    • Also stated in: § Discussion · boosted
      “Upon exposure to myelin fragments, the lipid storage in macrophages was dramatically increased as determined by Oil-Red-O staining.”
    Quote in the paperSubstantial claim
  • Findingown data

    ANGPTL4 significantly decreases LPL activity in macrophages.

    “we confirmed that ANGPTL4 causes a significant decrease in LPL activity in macrophages compared to non ANGPTL4 treated macrophages”
    Quote in the paperSubstantial claim
  • It may state two separate claims as one. 6
  • Probably not a substantial claim. 10
  • It may state two separate claims as one.

    Premisecitation

    LPL mRNA expression is almost exclusively detected in microglia/macrophage and specifically in alternatively activated microglia/macrophages.

    “LPL mRNA expression was almost exclusively detected in microglia/macrophage and specifically in alternatively activated microglia/macrophages (18, 19).”
    Quote in the paperSubstantial claim2 of 2 sources checked
    • cites [18] Zhang, 2014, An RNA-sequencing transcriptome and splicing database of glia, neurons, and vascular cells of the cerebral cortex, J Neurosci. source

      The cell-type expression and microglia-purification sections discuss microglia, but the passages found do not report LPL mRNA expression. Searches for Lpl/lipoprotein lipase and alternatively activated microglia/macrophages found no passage addressing either part of the claim. (LLM, conf=0.72)

      Experimental — accuracy not yet measured
    • cites [19] Zhang, 2016, Purification and characterization of progenitor and mature human astrocytes reveals transcriptional and functional differences with mouse, Neuron. source

      The Results sections on cell-type transcriptomes and reactive astrocytes discuss microglia or macrophage responses, but do not address LPL mRNA or alternatively activated microglia/macrophages. Searches for “LPL” and “lipoprotein lipase” found no passage supporting the claimed expression pattern. (LLM, conf=0.76)

      Experimental — accuracy not yet measured
  • Probably not a substantial claim.

    Premisecitation

    Recent reports highlight a pivotal role of microglial LPL in remyelination.

    “Recent reports have highlighted the pivotal role of microglial LPL in remyelination (4, 6, 12)”
    Quote in the paperSubstantial claim2 of 3 sources checked
    • cites [4] Olah, 2012, Identification of a microglia phenotype supportive of remyelination, Glia. source

      The gene-expression confirmation section reports strong Lpl mRNA expression in lesion-associated microglia during demyelination and remyelination. The Discussion interprets this as an indication that microglia may support remyelination through lipid recycling, but it does not establish that LPL itself has a pivotal functional role. Page numbers were not available in our copy. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [6] Bruce, 2018, Lipoprotein lipase is a feature of alternatively-activated microglia and may facilitate lipid uptake in the CNS during demyelination, Front Mol Neurosci. source
    • cites [12] Huey, 2002, Lipoprotein lipase is expressed in rat sciatic nerve and regulated in response to crush injury, J Lipid Res. source
  • It may state two separate claims as one.

    Findingown data

    LPL is weakly expressed in normal appearing white matter and abundantly expressed in active MS lesions.

    “LPL was weakly expressed in NAWM and abundantly expressed in active lesions”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    Macrophage depletion in an experimental MS animal model significantly reduces clinical symptoms.

    “Macrophage depletion in an experimental MS animal model significantly reduces clinical symptoms underscoring the pathogenic role of these cells (1).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] Huitinga, 1990, Suppression of experimental allergic encephalomyelitis in Lewis rats after elimination of macrophages, J Exp Med. source
  • It may state two separate claims as one.

    Premisecitation

    Phagocytes promote clearance of cellular debris after myelin damage, which is a prerequisite for remyelination.

    “phagocytes promote the clearance of cellular debris after myelin damage, which is a prerequisite for remyelination (14, 15).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [14] Kotter, 2005, Macrophage-depletion induced impairment of experimental CNS remyelination is associated with a reduced oligodendrocyte progenitor cell response and altered growth factor expression, Neurobiol Dis. source
    • cites [15] Merson, 2010, Role of cytokines as mediators and regulators of microglial activity in inflammatory demyelination of the CNS, Neuromolecular Med. source
  • It may state two separate claims as one.

    Interpretationown data

    Crosstalk between macrophages and astrocytes is involved in and necessary for downregulation of astrocytic ANGPTL4 expression.

    “We show that the cellular communication between astrocytes and macrophages is necessary for the downregulation of astrocytic ANGPTL4 expression.”
    • Also stated in: § Discussion · hedged
      “It thus appears that crosstalk between alternatively activated macrophages and astrocytes is involved in the downregulation of astrocytic ANGPTL4.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Study design and conductnone given

    GFAP and ANGPTL4 fluorescence intensity were measured by a blinded observer.

    “GFAP and ANGPTL4 fluorescence intensity were measured by a blinded observer using ImageJ software”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    Regulation of phagocyte function and activity is under control of astrocytes.

    “Regulation of phagocyte function and activity is under control of astrocytes (7)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7] Smith, 2000, Astrocytes modulate macrophage phagocytosis of myelin in vitro, J Neuroimmunol. source
  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    Myelin debris induces a reactive astrocyte profile.

    “myelin debris, which has been shown to induce a reactive astrocyte profile (21)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [21] Ponath, 2017, Myelin phagocytosis by astrocytes after myelin damage promotes lesion pathology, Brain. source
  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Premisecitation

    Scavenger receptors are suggested to be involved in myelin phagocytosis and are upregulated in and around demyelinating areas in MS tissue.

    “These scavenger receptors have been suggested to involved in myelin phagocytosis and have been shown to be upregulated in and around demyelinating areas in MS tissue (13).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [13] Hendrickx, 2013, Selective upregulation of scavenger receptors in and around demyelinating areas in multiple sclerosis, J Neuropathol Exp Neurol. source
  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    ANGPTL4 is expressed by astrocytes in white matter and gray matter of patients with capillary cerebral amyloid angiopathy.

    “We previously demonstrated that angiopoietin-like 4 (ANGPTL4) is expressed by astrocytes in white matter and in gray matter of patients suffering from capillary cerebral amyloid angiopathy (8).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [8] Chakraborty, 2018, Angiopoietin like-4 as a novel vascular mediator in capillary cerebral amyloid angiopathy, Brain. source
  • Probably not a substantial claim. It may state two separate claims as one.

    Premisecitation

    Microglial LPL processes myelin, after which myelin-derived lipids can be taken up via scavenger receptors on microglia.

    “it is thought that microglial LPL is able to process myelin after which the myelin derived lipids can be taken up via scavenger receptors expressed on microglia (13).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [13] Hendrickx, 2013, Selective upregulation of scavenger receptors in and around demyelinating areas in multiple sclerosis, J Neuropathol Exp Neurol. source
  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    Intravenous administration of anti-inflammatory macrophages or microglia reduces clinical signs in experimental autoimmune encephalomyelitis.

    “intravenous administration of anti-inflammatory macrophages or microglia reduced clinical signs in the MS animal model experimental autoimmune encephalomyelitis (EAE) (2, 3).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [2] Zhang, 2014, Adoptive transfer of cytokine-induced immunomodulatory adult microglia attenuates experimental autoimmune encephalomyelitis in DBA/1 mice, Glia. source
    • cites [3] Mikita, 2011, Altered M1/M2 activation patterns of monocytes in severe relapsing experimental rat model of multiple sclerosis. Amelioration of clinical status by M2 activated monocyte administration, Mult Scler J. source
  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    ANGPTL4-mediated inhibition of LPL limits formation of foam cells in atherosclerosis.

    “ANGPTL4 mediated inhibition of LPL has been shown to limit the formation of foam cells in the context of atherosclerosis (23, 24).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [23] Aryal, 2016, ANGPTL4 deficiency in haematopoietic cells promotes monocyte expansion and atherosclerosis progression, Nat Commun. source
    • cites [24] Georgiadi, 2013, Overexpression of angiopoietin-like protein 4 protects against atherosclerosis development, Arterioscler Thromb Vasc Biol. source
14 of 14
  • The paper relies on this without support.

    LPL hydrolyses triglycerides into glycerol and free fatty acids.

    “LPL hydrolyses triglycerides into glycerol and free fatty acids (FFA).”
1 of 1

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Metadata

Authors
Kamermans, A., Rijnsburger, M., Chakraborty, A., van der Pol, S., de Vries, H. E., & van Horssen, J.
Affiliations
Amsterdam Neuroscience (NL)
Corresponding author
van Horssen, Jack
Venue
Frontiers in Immunology
Published
2019-05-03
Volume
10
Pages
950-950
ISSN
1664-3224 (ISSN-L)
OpenAlex
W2943302790
Cited by
25
References
26
Citations by year
2026: 3 · 2025: 2 · 2024: 4 · 2023: 5 · 2022: 4 · 2021: 3 · 2020: 3 · 2019: 1
FWCI
1.83
Type
journal article
Language
en
Open access
Locations
  • Frontiers in Immunology (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (publishedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
Funders
Stichting MS Research (MS-14-358e, AK)
Topics
  • Health Sciences › Medicine › Clinical Neurology › Multiple Sclerosis Research Studies
  • Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
  • Life Sciences › Immunology and Microbiology › Immunology › Phagocytosis and Immune Regulation
Keywords
ANGPTL4, lipoprotein lipase, multiple sclerosis, demyelination, myelin debris clearance, phagocytes, astrocytes, remyelination, lipid uptake, demyelinating lesions, white matter
MeSH terms
Angiopoietin-Like Protein 4, Adult, Aged, Aged, 80 and over, Brain, Female, Humans, Lipoprotein Lipase, Macrophages, Male, Middle Aged, Multiple Sclerosis, Myelin Sheath, Phagocytes, Cell Line, Tumor, Lipid Metabolism

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