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Originally published online as doi:10.1189/jlb.0504308 on August 24, 2004

Published online before print August 24, 2004
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(Journal of Leukocyte Biology. 2004;76:950-960.)
© 2004 by Society for Leukocyte Biology

Modulation of effector cell functions in experimental autoimmune encephalomyelitis by leflunomide— mechanisms independent of pyrimidine depletion

Thomas Korn*,1, Tim Magnus*, Klaus Toyka{dagger} and Stefan Jung*

* Department of Neurology, Universität des Saarlandes, Homburg, Germany; and
{dagger} Department of Neurology, Julius-Maximilians-Universität, Würzburg, Germany

1 Correspondence: Dept. of Neurology, Universität des Saarlandes, 66421 Homburg/Saar, Germany. E-mail: netkor{at}uniklinik-saarland.de

Leflunomide inhibits de novo pyrimidine synthesis and is a novel, immunosuppressive agent that has been successfully used to treat rheumatoid arthritis. Here, we investigated the efficacy of leflunomide and its mode of action in experimental autoimmune encephalomyelitis (EAE), which is a T helper cell type 1 cell-borne disease model to simulate inflammatory aspects of multiple sclerosis and was induced in Lewis rats by adoptive transfer of myelin basic protein (MBP)-specific T line cells. Given in vivo for 7 days after cell transfer, leflunomide suppressed clinical signs of disease even in uridine-substituted animals. MBP-specific T line cells that had been antigen-activated in vitro in the presence of A77 1726 (active metabolite of leflunomide) produced less interferon-{gamma}, whereas interleukin (IL)-10 secretion had a tendency to be increased without changes in signal transducer and activator of transcription 6 trafficking. Furthermore, these T cells exhibited reduced chemotaxis and induced a significantly mitigated disease course upon transfer into naive rats. The effects of leflunomide on MBP-specific memory type T line cells in vitro may not be mediated by pyrimidine depletion, as they were not reversible by exogenous uridine. Moreover, A77 1726 led to increased expression of CD86 (B7-2) and secretion of IL-10 in cultured microglial cells in vitro, strengthening their down-modulatory impact on activated, autoantigen-specific T cells. In conclusion, our observations underline that the immunomodulatory potential of leflunomide in effector cells of EAE is clinically relevant and is not exclusively dependent on the depletion of cellular pyrimidine pools.

Key Words: clinical immunology • Th1 cells • EAE • multiple sclerosis • cellular activation