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Open Access Highly Accessed Research

Neither T-helper type 2 nor Foxp3+ regulatory T cells are necessary for therapeutic benefit of atorvastatin in treatment of central nervous system autoimmunity

Martin S Weber1234, Thomas Prod’homme12, Sawsan Youssef5, Shannon E Dunn5, Lawrence Steinman5 and Scott S Zamvil12*

Author Affiliations

1 Department of Neurology, University of California, 675 Nelson Rising Lane NS-215A, San Francisco, CA 94158, USA

2 Program in Immunology, University of California, 675 Nelson Rising Lane, NS-215A, San Francisco 94158, USA

3 Department of Neuropathology, University Medical Center, Georg August University, Robert-Koch-Str. 40, 37075 Göttingen, Germany

4 Department of Neurology, University Medical Center, Georg August University, Göttingen, Germany

5 Department of Neurology and Neurological Sciences, Interdepartmental Program in Immunology, Stanford University, Stanford, CA 94305, USA

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Journal of Neuroinflammation 2014, 11:29  doi:10.1186/1742-2094-11-29

Published: 6 February 2014

Abstract

Oral atorvastatin has prevented or reversed paralysis in the multiple sclerosis (MS) model experimental autoimmune encephalomyelitis (EAE), and reduced development of new MS lesions in clinical trials. Besides inhibiting development of encephalitogenic T cells, atorvastatin treatment of EAE has been associated with an induction of anti-inflammatory myelin-reactive T-helper type (Th)-2 cells. To investigate the clinical significance of atorvastatin-mediated Th2 differentiation, we first evaluated atorvastatin treatment in interleukin (IL)-4 green fluorescent protein-enhanced transcript (4-GET) reporter mice. Atorvastatin treatment failed to induce IL-4-producing Th2 cells in vivo; however, when T cells from atorvastatin-treated 4-GET mice were reactivated in vitro, T cells preferentially differentiated into Th2 cells, while antigen-specific T-cell proliferation and secretion of proinflammatory cytokines (interferon gamma, IL-17, tumor necrosis factor and IL-12) were reduced. Oral atorvastatin also prevented or reversed EAE in signal transducer and activator of transcription 6-deficient (STAT6−/−) mice, which cannot generate IL-4-producing Th2 cells. Further, atorvastatin treatment did not induce or expand Foxp3+ regulatory T cells in either wild-type or STAT6−/− mice. In vivo proliferation of T cells, as measured by incorporation of bromodeoxyuridine, was inhibited in atorvastatin-treated wild-type and STAT6−/− mice. These data imply that atorvastatin ameliorates central nervous system autoimmune disease primarily by inhibiting proliferation of proinflammatory encephalitogenic T cells, and not simply through induction of anti-inflammatory Th2 cells. This cytostatic effect may be a relevant mechanism of action when considering use of statins in MS and other inflammatory conditions.