CCR5⁺ and CXCR3⁺ T cells are increased in multiple sclerosis and their ligands MIP-1α and IP-10 are expressed in demyelinating brain lesions

Multiple sclerosis (MS)is a T cell-dependent chronic inflammatory disease of the central nervous system. The role of chemokines in MS and its different stages is uncertain. Recent data suggest a bias in expression of chemokine receptors by Th1 vs. Th2 cells; human Thl clones express CXCR3 and CCR5 and Th2 clones express CCR3 and CCR4. Chemokine receptors expressed by Thl cells may be important in MS, as increased interferon-γ (IFN-γ) precedes clinical attacks, and IFN-γ injection induces disease exacerbations. We found CXCR3⁺ T cells increased in blood of relapsing- remitting MS, and both CCR5⁺ and CXCR3⁺ T cells increased in progressive MS compared with controls. Furthermore, peripheral blood CCR5⁺ T cells secreted high levels of IFN-γ. In the brain, the CCR5 ligand, MIP-1α, was strongly associated with microglia/maerophages, and the CXCR3 ligand, IP-10, was expressed by astroeytes in MS lesions but not unaffected white matter of control or MS subjects. Areas of plaque formation were infiltrated by CCR5expressing and, to a lesser extent, CXCR3-expressing cells; Interleukin (IL)-18 and IFN-γ were expressed in demyelinating lesions. No leukocyte expression of CCR3, CCR4, or six other ehemokines, or anti-inflammatory cytokines IL-5, IL-10, IL-13, and transforming growth factor-β was observed. Thus, chemokine receptor expression may be used for immunologic staging of MS and potentially for other chronic autoimmune/inflammatory processes such as rheumatoid arthritis, autoimmune diabetes, or chronic transplant rejection. Furthermore, these results provide a rationale for the use of agents that block CCR5 and/or CXCR3 as a therapeutic approach in the treatment of MS.