BTK inhibition limits microglia-perpetuated CNS inflammation and promotes myelin repair

Acta Neuropathol. 2024 Apr 24;147(1):75. doi: 10.1007/s00401-024-02730-0.

Abstract

In multiple sclerosis (MS), persisting disability can occur independent of relapse activity or development of new central nervous system (CNS) inflammatory lesions, termed chronic progression. This process occurs early and it is mostly driven by cells within the CNS. One promising strategy to control progression of MS is the inhibition of the enzyme Bruton's tyrosine kinase (BTK), which is centrally involved in the activation of both B cells and myeloid cells, such as macrophages and microglia. The benefit of BTK inhibition by evobrutinib was shown as we observed reduced pro-inflammatory activation of microglia when treating chronic experimental autoimmune encephalomyelitis (EAE) or following the adoptive transfer of activated T cells. Additionally, in a model of toxic demyelination, evobrutinib-mediated BTK inhibition promoted the clearance of myelin debris by microglia, leading to an accelerated remyelination. These findings highlight that BTK inhibition has the potential to counteract underlying chronic progression of MS.

Keywords: BTK inhibition; Microglia; Multiple sclerosis; Progression.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Agammaglobulinaemia Tyrosine Kinase* / antagonists & inhibitors
  • Agammaglobulinaemia Tyrosine Kinase* / metabolism
  • Animals
  • Biphenyl Compounds / pharmacology
  • Encephalomyelitis, Autoimmune, Experimental* / drug therapy
  • Encephalomyelitis, Autoimmune, Experimental* / pathology
  • Female
  • Mice
  • Mice, Inbred C57BL
  • Microglia* / drug effects
  • Microglia* / metabolism
  • Microglia* / pathology
  • Myelin Sheath* / metabolism
  • Myelin Sheath* / pathology
  • Piperidines* / pharmacology
  • Protein Kinase Inhibitors / pharmacology
  • Pyrimidines* / pharmacology
  • Remyelination / drug effects
  • Remyelination / physiology

Substances

  • Agammaglobulinaemia Tyrosine Kinase
  • Biphenyl Compounds
  • Btk protein, mouse
  • evobrutinib
  • Piperidines
  • Protein Kinase Inhibitors
  • Pyrimidines