Neuroinflammatory disease disrupts the blood-CNS barrier via crosstalk between proinflammatory and endothelial-to-mesenchymal-transition signaling

Breakdown of the blood-central nervous system barrier (BCNSB) is a hallmark of many neuroinflammatory disorders, such as multiple sclerosis (MS). Using a mouse model of MS, experimental autoimmune enceph-alomyelitis (EAE), we show that endothelial-to-mesenchymal transition (EndoMT) occurs in the CNS before the onset of clinical symptoms and plays a major role in the breakdown of BCNSB function. EndoMT can be induced by an IL-10-stimulated signaling pathway in which activation of the small GTPase ADP ribosyla-tion factor 6 (ARF6) leads to crosstalk with the activin receptor-like kinase (ALK)-SMAD1/5 pathway. Inhibit-ing the activation of ARF6 both prevents and reverses EndoMT, stabilizes BCNSB function, reduces demyelination, and attenuates symptoms even after the establishment of severe EAE, without immunocom-promising the host. Pan-inhibition of ALKs also reduces disease severity in the EAE model. Therefore, mul-tiple components of the IL-10-ARF6-ALK-SMAD1/5 pathway could be targeted for the treatment of a variety of neuroinflammatory disorders.

Automated summary

Breakdown of the blood-central nervous system barrier is a significant feature in neuroinflammatory disorders. In this study, endothelial-to-mesenchymal transition was found to occur in the CNS and play a crucial role in BCNSB dysfunction. Multiple components of the IL-10-ARF6-ALK-SMAD1/5 pathway could be targeted for the treatment of neuroinflammatory disorders.