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                      <nl_mods:title>Transfer of central nervous system autoantigens and presentation in secondary lymphoid organs</nl_mods:title>
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                    <nl_mods:abstract>Dendritic cells are thought to regulate tolerance induction vs
      immunization by transferring Ags and peripheral signals to draining lymph
      nodes (LN). However, whether myelin Ag transfer and presentation in LN
      occurs during demyelinating brain disease is unknown. In this study, we
      demonstrate redistribution of autoantigens from brain lesions to cervical
      LN in monkey experimental autoimmune encephalomyelitis (EAE) and in
      multiple sclerosis (MS). Immunohistochemical analysis revealed
      significantly more cells containing myelin Ags in cervical LN of monkeys
      with EAE compared with those of healthy control monkeys. Myelin Ags were
      observed in cells expressing dendritic cell/macrophage-specific markers,
      MHC class II, and costimulatory molecules. Moreover, these cells were
      directly juxtaposed to T cells, suggesting that cognate interactions
      between myelin-containing APC and T cells are taking place in
      brain-draining LN. Indeed, myelin Ag-reactive T cells were observed in
      cervical LN from marmosets and rhesus monkeys. Importantly, these findings
      were paralleled by our findings in human tissue. We observed significantly
      more myelin Ag-containing cells in LN of individuals with MS compared with
      those of control individuals. These cells expressed APC markers, as
      observed in marmosets and rhesus monkeys. These findings suggest that
      during MS and EAE, modulation of T cell reactivity against brain-derived
      Ags also takes place in cervical LN and not necessarily inside the brain.
      A major implication is that novel therapeutic strategies may be targeted
      to peripheral events, thereby circumventing the blood-brain barrier.</nl_mods:abstract>
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                      <nl_mods:topic>Research Support, Non-U.S. Gov't</nl_mods:topic>
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