Laquinimod arrests experimental autoimmune encephalomyelitis by activating the aryl hydrocarbon receptor
Significance Laquinimod is an oral drug currently being evaluated for the treatment of relapsing, remitting, and primary progressive multiple sclerosis as well as Huntington's disease. It is thought that laquinimod has a primary effect on the peripheral innate immune system and also acts directly on resident cells within the CNS. However, the exact mechanism of action of laquinimod has not been fully elucidated. We investigated gene expression in laquinimod treated mice and show induction of genes downstream to activation of the aryl hydrocarbon receptor (AhR) In this paper, we examine the role of the AhR in laquinimod treatment of experimental autoimmune encephalomyelitis and demonstrate that AhR is the molecular target of laquinimod in this model. Laquinimod is an oral drug currently being evaluated for the treatment of relapsing, remitting, and primary progressive multiple sclerosis and Huntington's disease. Laquinimod exerts beneficial activities on both the peripheral immune system and the CNS with distinctive changes in CNS resident cell populations, especially astrocytes and microglia. Analysis of genome wide expression data revealed activation of the aryl hydrocarbon receptor (AhR) pathway in laquinimod treated mice. The AhR pathway modulates the differentiation and function of several cell populations, many of which play an important role in neuroinflammation. We therefore tested the consequences of AhR activation in myelin oligodendrocyte glycoprotein (MOG) induced experimental autoimmune encephalomyelitis (EAE) using AhR knockout mice. We demonstrate that the pronounced effect of laquinimod on clinical score, CNS inflammation, and demyelination in EAE was abolished in AhR mice. Furthermore, using bone marrow chimeras we show that deletion of AhR in the immune system fully abrogates, whereas deletion within the CNS partially abrogates the effect of laquinimod in EAE. These data strongly support the idea that AhR is necessary for the efficacy of laquinimod in EAE and that laquinimod may represent a first in class drug targeting AhR for the treatment of multiple sclerosis and other neurodegenerative diseases.
Proceedings of the National Academy of Sciences