Unités de recherche UMR INSERM-UPEC U955 - Team 10 ‘Cell Interactions in neuromuscular system’ 1. Introduction a. History of our research lab Current lab INSERM UPEC U955-Team 10 ‘Cell interactions in the neuromuscular system’ is dedicated to clinical, translational and basic research in myology, through privileged interplays with the Reference Neuromuscular Center Garches-Necker-Mondor-Hendaye (GNMH). Team 10’ main expertise is situated in the field of neuromuscular diseases (NMD) with special skills in cell and tissue biology, animal models, and clinical research due to the large spectrum of formations of its members (INSERM, MD-PhDs with both clinical and pathological practice, tenure members of the faculty of Sciences of UPEC). Since 2008, two groups left the team, one led by B. Chazaud which joined the Cochin Institute (Paris 5 University) and the other led by F. Chretien who created the ‘Human histopathology and animal models’ unit in Pasteur Institute (Paris), these both groups being mainly involved in translational/basic research. In 2012, V. Planté-Bordeneuve (Neurologist, PUPH) who is in charge of neuromuscular amyloidosis cohorts in GNMH Reference Center joined the team. In 2014, three research groups will have joined Team 10 to reinforce its translational/basic research axis: (i) a group from the lab UMR955 INRA-ENVA Functional & Medical Genetics led by L. Tiret; (ii) the ‘Laboratory of neurobiology’ from the Alfort School of Veterinary Medicine (dir. S. Blot); and (iii) the ‘Development and Stem cells’ lab (dir. F Relaix, DR2), currently Team 2 of INSERM/UPMC UMR 787 (dir. D Sassoon), the future lab being co-head by FJ Authier and F Relaix (2015). b. Characterization of our research In line with our medical activity in GNMH Reference Center, our biomedical research aims (to 1) to develop from databases staging models that better predict prognosis and evolution of diseases; (2) to define disease pathways and biomarkers to inform the selection of novel drug targets that can then be further explored and validated by animal models; (3) to develop Innovative treatments of NMDs including bio-therapeutic approaches. By including in the same lab physicians with expertise in neuromuscular clinics and pathology, biologists specialized in animal/cell modeling of NMDs, and basic scientists working in muscle tissue biology, we will gather all skills required for our purposes. Our research can be schematically divided in 3 parts: clinical, translational and basic research. In clinical research, we focus on the most representative NMDs of our Reference Center (myotonic dystrophies, neuromuscular amyloidosis, inflammatory myopathies and chronic fatigue syndrome/myalgic encephalomyelitis CFS/ME) and study their phenotypic characterization, the identification of severity/prognosis biomarkers and the setting up of therapeutic trials. In translational research, we use small (mouse) and large (domestic carnivores) animal models of NMD including spontaneous murine or canine models of inherited conditions, transgenic mice and nanoparticles-injected normal mice. These models allow us to investigate pathways implicated in disease pathophysiology and the role of exogenous/endogenous modifying factors, and to pre-clinically evaluate innovative therapeutic strategies. In basic research we use cell culture and transgenic animal models to investigate (i) the molecular mechanisms involved in skeletal muscle and peripheral nervous system development; (ii) the physiological interplays between different cell types in normal muscle; and (iii) the elementary mechanisms at work in post-injury muscular regeneration process. 2. Scientific project The team aims at characterizing pathogenic mechanisms of neuromuscular diseases (NMD) and developing biomarkers and innovative therapies, and includes (i) biomarkers/therapeutic trials in NMD, (ii) experimental modeling of NMD, and (iii) cellular/molecular studies in basic mycology (in blue, refs authored by team members). a. Cohort studies: Biomarkers and innovative therapies in NMD 1 Unités de recherche Myotonic dystrophies (PI, G Bassez) We are responsible for the DM-Scope registry (AFM/APHP/Inserm), a European virtual registry (www.dmscope.fr) including patients with myotonic dystrophies (MD) followed in a standardized manner in different countries, with a North American counterpart in Québec (Laval University). Record includes personal details, social and professional consequences, diagnosis, natural history, neuromuscular attempt, cardiologic troubles, respiratory defects, digestive and endocrine aspects (Udd, 2011). This tool was set up in the perspective of therapeutic trials in MD. Neuromuscular amyloidosis (PI, V Planté-Bordeneuve) Tranthyretin (TTR) amyloidosis is due to fibrillar amyloid deposition of misfolded TTR and is the most severe dominantly inherited neuropathy of adulthood (Planté-Bordeneuve, 2011). Our research aims to refine knowledge on the phenotypic spectrum as well as unravel the factors underlying the amyloid process. THAOS1 is an international database including comprehensive data from 1500 patients and representing a major tool to refine our knowledge on the phenotypic spectrum, geno-phenotypic correlations, and natural history of the disease... Our site is running the database in France and actively implicated in the executive scientific committee in charge of the clinical research projects beyond the survey. We develop 2 specific projects: 1/ Refining TTR amyloidosis genetics. To understand the phenotypic variability of ATTR, we investigate the role of modifying genetic factors (Bonaïti, 2009; Olsson, 2009; Saporta, 2009a, 2009b) in through transcriptomic microarray studies on various samples, i.e. liver biopsies, the main source of TTR synthesis (collaboration with Pr O SuhrUniversity of Umea- Sweden), and blood lymphocytes (collaboration with Pr Levy- Inserm CHU Henri Mondor). 2/ Investigating innovative therapies. The oral drug tafamidis* has proven to slow the neuropathy if administered at an early stage (Coehlo, 2012). Antisense oligonucleotide (ASO) strategy and RNA interference TTR gene silencing (siRNA) are currently being developed. Both are particles of systemic delivery containing sequence-specific TTR genesilencing. They target hepatocytes in order to suppress wild type and mutated TTR transcription. Phase 2-3 trials are planned in 2013 for each compound, at our site. The need for early diagnostic biomarkers is critical in order to administer therapeutics at the earliest stage. In this context, we are setting up works dedicated to detect small nerve fibers dysfunction, which are first altered by the amyloid process, including both neurophysiological and morphological approaches (intraepidermal nerve fibers density evaluation; Sene, 2010). Inflammatory/dysimmune myopathies (PI, FJ Authier) In the field of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), we focused our research on the specific case of aluminum hydroxide (alum)-induced macrophagic myofasciitis (MMF) for years. Or group first identified this condition (Gherardi, 1998) and provided almost all works dealing with its phenotypic characterization and pathophysiology (Gherardi, 2001; Authier, 2001; Authier, 2003; Authier, 2006; Couette, 2009; Exley, 2009; Passeri, 2011). Among CFS syndromes, MMF is characterized by a severe neurocognitive disorder, with a neuropsychological pattern suggestive of organic toxic/inflammatory fronto-subcortical involvement (Couette, 2009; Passeri, 2011). Experimental data indicate that intramacrophagic nanomaterials can enter brain tissue through a MCP1-dependent Trojan horse process (Khan, submitted). This phenomenon could be at the origin of a toxic neuroinflammatory reaction, leading to neuronal impairment and cognitive dysfunction. Our main programs in this field are: (1) Neurotox-Alu (Region Ile-de-France, PICRI) to set up a national database for ASIA 2/MMF, and to investigate chemokine genes polymorphisms in MMF patients; (2) DIASCOM study aiming to generate non-histological predictive scores for MMF combining clinical and/or biological and/or ultrasonographic parameters, obtained from multivariate analysis of myalgic patients cohort. These scores will be designed to be suitable for large-scale prospective studies or epidemiological surveys; and (3) Robot-MFM, the first therapeutic trial in MMF, exploring the therapeutic efficiency of transcranial magnetic stimulation (collaboration with NET team/EA4391). In the field of myopathology, we develop a program investigating the diagnostic value of various tissue biomarkers (MHC-1 and -2, STAT1, IFITM3, microvasculature) (Ranque, 2010). We also investigate the role of complement system activation in acquired and nonacquired myopathies and evaluate the potential therapeutic benefits of its deactivation in dysferlinopathy. b. Experimental modeling of NMD Animal models are suitable to investigate pathophysiological mechanisms and innovative therapeutic approaches of human NMD. We developed programs using various type of models: spontaneous genopathy homologous of human myopathies (mouse: dysferlinopathy), transgenic mice (dysferlinopathy, type 1-myotonic dystrophy), or experimentally manipulated nanoparticles-injected normal mice (MMF). Murine models of NMD: Pathophysiological investigations and therapeutic screening (PI, J Cadusseau) Systemic transport of particles by phagocytes. Though alum safety crucially depends on whether the compound will remain localized at site of injection or diffuse and accumulate in distant organs, the biodistribution of nanomaterials 1 THAOS: Transthyretin Hereditary Amyloidosis Outcome Survey ASIA, Autoimmune/inflammatory syndrome induced by adjuvants. ASIA is a term coined by Y Shoenfeld (J Autoimmun, 2011;36:4-8) to encompass all inflammatory or immune-mediated conditions induced by the exposure to a component with immune adjuvant properties. 2 2 Unités de recherche injected into muscle has not been investigated. Since muscle injury elicits monocyte/macrophage (MO/MP) infiltration and migration to lymphoid organs, and since alum is avidly phagocytozed by cells of this lineage, we hypothesized that a proportion of nanomaterials injected into muscle could translocate to distant organs as part of a general mechanism linked to phagocytosis. Preliminary results have substantiated this view and have pointed to the possible implication of MCP-1/CCL2 chemokine–dependent mechanism for the translocation of nanomaterials into the brain (Khan, submitted). We will address this issue in a multitask manner: 1 / construction of fluorescent nanohybrids mimicking alum; 2/ determining the systemic biodistribution of fluorescent particles injected in mouse; 3/ investigating the role of MCP-1 through loss or gain of function experiments; 4/evaluating the impact of chronic blood-brain barrier alteration on neurodelivery; 5/ quantitative assessment of neurotranslocation using 26Al as a tracer; and 6/ evaluating the neurotoxicological potential of aluminum adjuvants. Pathophysiology and therapies of dysferlinopathies. Dysferlin deficiency is the causal factor of muscular dystrophies called ‘dysferlinopathies’, characterized a defective membrane repair and which have in common the following peculiarities: (i) a non-conventional course, with a long period of time, during which muscle function is normal; (ii) a phenotypic variability, not correlated with genotype; and (iii) a muscle pathology characterized by inflammation and complement activation (Bansal, 2004; Han, 2011). Using mouse models of dysferlin deficiency, we evidenced 1/ the determining role of eccentric exercise in disease phenotype and severity, and 2/ the benefit of chronic concentric exercise (Biondi, in revision). At present, we focus on deciphering the role of complement in muscle pathology and evaluating the potential therapeutic efficiency of approaches aiming to deactivate complement system. c. Basic biology of skeletal muscle tissue Relationships between microvascular cells and muscle SCs during post-natal muscle growth (PI, R Gherardi) We aim at understanding the functional relationships between microvascular cells and muscle satellite cells (mSCs) during post-natal muscle growth. We previously showed that (1) similarly to rodents, muscle microvasculature is stereotypically organized into microvascular units of 6-to-8 capillaries in humans, (Gitiaux 2012); (2) capillaries are closely associated to, and functionally interact with mSCs in adult humans and mice (Christov 2007); 3) both autocrine and paracrine Angiopoietin1 (Ang1/Tie2) signalling promotes mSC quiescence and self-renewal (Abou-Khalil 2009). Capillaries host endothelial cells (ECs) and periendothelial cells (pericytes) that exert EC stabilizing properties, and represent one important source of Ang1. We showed that in adult muscle almost all capillary sections show pericyte coverage, and 80-90% of quiescent mSCs are closely associated with a pericyte. Moreover, preliminary results indicate that during post-natal muscle growth, microvessels are initially remote from actively cycling mSCs and progressively enter in their vicinity as they fuse with growing myofibers or become mitotically quiescent. The phenomenon is associated with myofiber growth suggesting coordinated angio-myogenesis. Muscle microvasculature, which represents a major aspect of muscle stem cell biology, is only beginning to be explored. Our working hypothesis, supported by a large set of preliminary functional studies, is that ECs and pericytes exert paracrine supportive effects on neighbouring mSCs at play during muscle growth, and homeostasis. We observed that, in culture models mimicking growing immature vessels, ECs basically exert mitogenic effects whereas pericytes promote fusion of myogenic cells. In this project the juxtaposition between vascular cells and mSCs will be mapped more precisely and the influence of these cells on SCs behaviour examined in coculture. Transcriptome and secretome profiles of adult human muscle derived ECs and pericytes will be analysed and candidates examined for function on cultured mSCs and in single myofiber studies. In vivo analyses will use Cre-Lox models already constructed in the lab to allow conditional muscle pericyte ablation and inducible pericyte targeted genetic strategies. 3. References Abitbol M., Thibaud J.L., Olby N.J., Hitte C., Puech J.P., Maurer M., Pilot-Storck F., Hedan B., Dreano S., Brahimi S., Delattre D., Andre C., Gray F., Delisle F., Caillaud C., Bernex F., Panthier J.J., Aubin-Houzelstein G., Blot S., Tiret L. (2010). A canine Arylsulfatase G (ARSG) mutation leading to a sulfatase deficiency is associated with neuronal ceroid lipofuscinosis. 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