Johnson, Aaron J.

Hypoxia is a prevalent characteristic of neurological diseases, including ischemic injury, neurodegeneration and infectious disease complications. Concurrently, hypoxia shapes both protective and pathological responses within the central nervous system (CNS). Central to this process is hypoxia-inducible factor 1α (HIF1α), a transcription factor that regulates cellular adaptation to reduced oxygen availability through coordinated glycolytic, inflammatory and cell survival pathways. Under hypoxic conditions, HIF1α transcriptional activity influences microglial activation, mitochondrial quality control, and cytokine production, thereby modulating neuroinflammation and neuroprotection. Preclinical evidence points toward hypoxia preconditioning being neuroprotective through HIF1α-dependent mechanisms in a context-dependent matter. This review synthesizes the current understanding of the role of HIF1α across neurological disease contexts, highlighting the intersection of hypoxia, neuroinflammation and neuronal survival. Ultimately, defining the cell-specific and context-dependent involvement of HIF1α will be critical for targeted therapeutic approaches to alleviate neuronal death and slow disease progression.

Blood-brain barrier (BBB) disruption is a potentially deadly complication of numerous neurological diseases as diverse as cerebral malaria, dengue hemorrhagic fever, tauopathies, multiple sclerosis, schizophrenia, Parkinson’s disease, narcolepsy, and COVID-19. Neuroinflammation and immune cell infiltration are both drivers and consequences of BBB disruption. In this review, we will provide an overview of how brain-infiltrating T-cell responses engage the cellular components of the neurovascular unit (NVU), which regulates the BBB in preclinical models. This will provide context on how the immune system can contribute to vascular leakage and neuropathology in neurological diseases. We will discuss how discrete major histocompatibility complex (MHC) class I and class II molecules on NVU cell types govern T-cell entry, retention, and barrier disruption in neuroinflammatory diseases. Finally, we will summarize our current understanding of how discrete human leukocyte antigen (HLA) genes associate with specific neurological diseases characterized by neuroinflammation and BBB disruption.

Abstract Description Therapeutic in situ chimeric antigen receptor (isCAR) T cells can be generated by targeting activated T cells within a lymph node (LN) with retroviruses encoding CARs. While isCAR T cells are successfully generated by intradermal LN priming using adenovirus encoding allogeneic MHC in all mouse lines tested, differences in emerging therapeutic peripheral isCAR T cells are found in a strain dependent manner. Potentially harmful off target retroviral transduction of B cells with CARs is observed within the targeted LN. Here we report the blockade of B cell transduction using anti-CD20 antibody B cell depletion with the introduction of anti-CD19 chimeric antigen receptors into the activated CD8+ T cells. Lymphocytes were analyzed in blood and LN following isCAR T cell generation. When B cells were depleted by systemic administration of anti-CD20 antibodies during isCAR T cell induction, >97.5% systemic depletion of B cells was achieved. Whereas very small numbers of CAR transduced B cells were found in the blood of mice not treated with anti-CD20, none were observed in animals systemically depleted of B cells. In contrast, CAR B cells persisted in the LN of local anti-CD20 treated animals. However, animals expressing dominant CD8+ isCAR T cell populations eliminated LN B cells expressing CARs by week two. Furthermore, systemic treatment of lymphoma in animals with anti-CD20 antibody complemented anti-CD19 isCAR T therapy while blocking off target B cell transduction. Funding Sources Mayo Clinic Ventures Mayo Clinic Graduate School of Biomedical Sciences Mayo Clinic Topic Categories Tumor Immunology: Checkpoints, Prevention, and Treatment (TIPT)

Abstract Description Glioblastoma (GBM) is an aggressive brain cancer with poor survival. GBM patients have severe peripheral immunosuppression, including defective T cell responses. We showed that serum-derived factors were sufficient to inhibit T cell proliferation. This factor was nonsteroidal and larger than 100kDa. Mass-spectrometry and pathway analysis of suppressive serum implicated proteins involved in DNA response elements. We hypothesized that the suppressive factor is cell-free DNA (cfDNA). In support of this, serum levels of cfDNA are increased in glioma-bearing mice. Exposure to cfDNA from serum of glioma-bearing mice was sufficient to directly and potently inhibit T cell proliferation. Exposure to genomic DNA was not sufficient to induce proliferation defects in T cells, highlighting the unique features of cfDNA. Importantly, reducing cfDNA content using DNaseI was sufficient to partially restore proliferation capacity. We determined that the T cell proliferation defects were independent of AIM2 DNA sensing mechanisms, implicating a novel pathway of DNA sensing in T cells. Finally, to determine the origin of the cfDNA, we used methylation-seq and found that the majority of cfDNA originated from neutrophils, implicating NETosis. Together, we contend that cfDNA from neutrophils induces immunosuppressive effects in GBM. Our work highlights a potential role for targeting cfDNA, neutrophils, and/or NETs in order to reverse T cell dysfunction and improve patient outcomes in GBM. Funding Sources R00NS117799 Topic Categories Tumor Immunology: Cellular Responses and Tumor Microevironment (TIME)

Abstract Description Tauopathies are a subset of neurological diseases associated with pathologic tau protein accumulation and the formation of neurofibrillary tangles in the brain. There is growing evidence of immune cell infiltration including T cells and an increase of inflammatory microglia in human brains from patients that have Tauopathies. However, the effect of T cells and how they interact with CNS-resident immune cells in these pathologies is not well understood. To answer this question, we developed a neurotropic AAV1 encoding human mutant P301L-Tau. AAV-Tau transduction of neurons in neonatal mice recapitulates features of Tauopathies found in human patients. As microglia are the predominant resident antigen presenting cells within the CNS, we hypothesized that CD8 T cells may be dependent on MHC class I presentation by microglia in mice with Tauopathy to achieve full infiltration and expansion in the brain. To address this hypothesis, we introduced AAV-Tau into our novel transgenic mice for which MHC class I antigen presentation by H-2Kb on microglia can be conditional ablated. We observed lower frequencies of CD8 T cell populations and less CD8 T cell CD69+CD103+ expression in mice with Tauopathy when MHC class I was ablated in microglia. We conclude that microglia class I restricted antigen presentation contributes to the expansion of resident memory CD8 T cells in experimental Tauopathy and therefore are an important driver of the immune response observed in this dementia model. Funding Sources NIH/NINDS: R01NS122174 Mayo Graduate School of Biomedical Sciences Topic Categories Neuroimmunology (NEUR)

Abstract Description Blood-brain barrier (BBB) disruption is a putative mechanism of neurodegeneration, neuropsychiatric disorders, and long covid. Our laboratory was the first to demonstrate antigen-specific CD8 T cells induce BBB disruption. We now introduce a novel neurologic disease model in which CD8 T resident memory (TRM) cells induce BBB disruption via administration of cognate antigen, long after neurotropic virus is cleared. C57BL/6 mice intracranially infected with Theiler’s murine encephalomyelitis virus (TMEV) clear virus within 21 days. At 2 months post infection, mice received intravenous injection of viral peptide VP2(121-130) for which the largest population of CD8 TRM have T cell receptor specificity for, resulting in BBB permeability detectable by gadolinium enhanced T1 weighted MRI. A second round of BBB disruption was then initiated with VP2 peptide at 4 months post infection. One month after this second induction of BBB disruption, mice underwent behavioral assessments and whole brain flow cytometric analysis. In these mice, we found a significant inverse correlation of BBB breakdown with a shift from active to passive anxiety-like behavior to contextual fear memory compared to mock peptide controls. This shift in anxiety correlated with virus antigen specific CD8 TRM, myeloid, and NK cells. These results demonstrate memory antiviral CD8 T cells can induce BBB disruption, long after virus is cleared, a process that contributes to a shift in anxiety-like behaviors Funding Sources RO1 NS103212, R01 NS122174 Topic Categories Neuroimmunology (NEUR)

Abstract Description Brain Barrier (BBB) disruption plays a role in various neurodegenerative diseases such as ALS, stroke, Huntington’s disease and Cerebral Malaria. In our laboratory, we aim to interrogate the immunological underpinnings associated with neuroinflammation and barrier leakage. In clinical studies, aging is associated with a decline in T cell production and a gradual shift to resident memory T cells in the brain characterized by reduced T cell repertoire diversity and weak activation. To model these clinical observations, we sought to define the effect of MHC class I restricted antigen presentation on endothelial cells of brain vasculature on CD8 T cell infiltration of the CNS. We conditionally ablated H-2Kb and H-2Db molecules on endothelial cells using Cdh5-Cre mice crossed with our novel Kb LoxP and Db LoxP mice generated by our research program. In these animals we studied CD8 T cell accumulation in the brain using Theiler’s Murine Endothelial Virus (TMEV) infection of young mice (<12 months) compared to old mice (>12 months). Our results indicate that the loss of endothelial cell Kb induces a defect in establishment of antigen experienced CD8 T cell populations in acute infection. These finding will allow us to further investigate the role of endothelial cell MHC Class I molecules in the immune response to chronic TMEV infection, as well as other neurologic disease models. Funding Sources NIH Grants R01 NS103212 and R01 NS122174 Topic Categories Neuroimmunology (NEUR)

Abstract Description Bone marrow (BM) is the primary immune organ responsible for stem cell maintenance. Neurotropic infections elicit sequestration of T cells within the BM. Changes of the BM niche during brain viral infections are unknown. Intracranial infection with the neurotropic Theiler’s Murine Encephalomyelitis Virus (TMEV) in C57BL/6 mouse is cleared by 30 days due to generation of an antigen-specific CD8 T cell response. We determined that 1-10% of CD8 T cells present in the sternal, femoral, and cranial BM were virus antigen-specific 7 days post intracranial infection. Over 70% of these CD8 T cells were tissue resident. We determined antigen-specific CD8 T cells were generated in the BM within 4 days of infection, a timeline similar to lymph nodes. Continuous treatment with FTY720, which sequesters T cells outside of the blood, did not eliminate antigen-specific CD8 T cells in any BM compartment. CD8 T cells in the BM established durable memory populations and were reactivated upon antigen reencounter. Both acute infection and reactivation caused an increase in lineage-, Sca-1+, ckit + (LSK) cells in the BM. This LSK dysregulation was abrogated upon CD8 T cell depletion and was limited to the intracranial routes of infection. We conclude that brain viral infections induce in situ effector and memory T cell responses within the BM and cause stem cell dysregulation. Our data paves the way for crucial studies of BM resident antigen-specific CD8 T cells in health and disease. Topic Categories Viral Immunology (VIR)

Abstract Description Neutrophils heavily infiltrate the brain following acute and chronic brain insults. Neutrophils infiltrating brain tumors display a prolonged lifespan compared to blood neutrophils. We investigated presence and potential function of neutrophils in the brain following infection with Theiler’s Murine Encephalomyelitis (TMEV) and kainic acid-induced seizures. Both total myeloid cells and neutrophils started infiltrating the brain as early as day 1, peaked at day 3, and remained elevated at least 7 days post-infection. Further characterization of the neutrophils revealed upregulation of MHC-II, indicating a potential role in antigen presentation. We detected similar accumulation of total myeloid cells and neutrophils in the brain of mice following seizures. MHC-II expression was upregulated on infiltrating neutrophils. Given the sustained and unusual accumulation of neutrophils in the brain past innate time points, we evaluated the bone marrow niche for evidence of myelopoiesis. Frequencies of Lin-Sca-1+c-Kit + (LSK) were significantly higher in all bone marrow compartments in mice infected intracranially with TMEV. This increase in LSK cells concurred with an increase in frequencies of total myeloid cells. These changes were not observed when mice were infected with TMEV systemically. Our data highlights dysregulation of bone marrow hematopoiesis and a potential novel role of neutrophils in response to neuroinflammation following intracranial pathologies. Topic Categories Neuroimmunology (NEUR)

Abstract Description This study dissects mechanisms of spontaneous tumor rejection leading to better understanding of successful immune responses to cancer. Cancers persist despite expression of tumor-specific neoantigens promoting ongoing anti-tumor immune responses. While some occult tumor cells likely are cleared by effective anti-tumor immune responses, the targeted antigens are not easily identifiable as those cells spontaneously disappear. Congenic mouse breast carcinoma models expressing a defined protein mimicking neoantigens were used to dissect the protective spontaneous immune response. BALB/c (MHC H-2d) mice challenged with BALB/c breast tumors expressing the rat-erbB2 oncoprotein succumb to their tumors despite demonstrated tumor immunogenicity, mimicking known patient responses to cancer. Meanwhile, H-2b positive BALB.B and H-2d/H-2b F1 hybrid mice spontaneously eliminate genetically matched tumors in an MHC-II dependent manner. CD4+ T-cells and B-cells or the rat-erbB2-specific antibodies they produce are crucial mediators of this protective response. Differences in the tumor microenvironments in rat-erbB2+ tumor-bearing BALB.B and BALB/c mice at the time of fate decision in the models reflect the differences between effective and ineffective anti-tumor immunity. Identifying the nature of the optimal MHC-II antigens, how they activate protective CD4+ T-cells, and the interactions that promote protective antibodies will better inform future cancer therapies. Funding Sources Bernie Fineman Research Fund Mayo Clinic Center for Biomedical Discovery Mayo Clinic Department of Immunology Mayo Clinic Graduate School of Biomedical Sciences NIH Traning Grant 5 R25 GM 55252 Topic Categories Tumor Immunology: Cellular Responses and Tumor Microevironment (TIME)