ALCAM : cell adhesion molecule or tight junction? The characterization of its role in the context of neuroinflammation

Aim: The loss of blood-brain barrier (BBB) integrity is a hallmark of multiple sclerosis. It is associated with a disorganization of junctional molecules and an upregulation of cell adhesion molecules essential for immune cell transmigration. Identifying novel key players involved in this process is thus crucial for the development of MS therapies aimed at promoting BBB integrity and decreasing leukocytes trafficking into the central nervous system (CNS) during neuroinflammation. In this study, the specific role of the adhesion molecule ALCAM, found on BBB endothelial cells (BBB-ECs) and subsets of leukocytes, was assessed. Methods: We first identified ALCAM as an important molecule upregulated during inflammation in a proteomic screen of in vitro cultured primary human BBB-ECs. In order to study the effects of ALCAM on leukocyte transmigration, both active and passive experimental autoimmune encephalomyelitis (EAE) was induced in ALCAM KO and WT animals. The specific role of ALCAM during leukocyte transmigration was also assessed using a modified adhesion assay under sheer-stress, in which leukocytes flow across a capillary-like channel lined with a monolayer of BBB-ECs under physiological pressure.   Results: Using the modified adhesion assay, we demonstrated that anti-ALCAM blocking antibodies significantly reduce the rolling and the adhesion of human CD14+ monocytes interacting with primary human BBB-ECs, as well as prevent their overall decrease in velocity. Concurrently, we also observed a significant reduction in the migration of ex vivo CD14+ monocytes, across a monolayer of human BBB-ECs. These monocytes also migrated more rapidly and in higher number across meningeal endothelial cells, as compared to BBB-ECs. While similar observations were made using ex vivo CD4+ T lymphocytes, we failed to reproduce these results using in vitro activated Th1 and Th17 cells. In opposition to our in vitro data, ALCAM KO mice developed a more severe active EAE associated with a significant increase in perivascular infiltration of pro-inflammatory lymphocytes (Th1/Th17) and M1 monocytes/macrophages, as compared to WT controls. In addition, EAE transfer experiments, in which ALCAM KO mice received WT MOG-reactivated splenocytes, suggested that the pathophysiology observed in active EAE was linked to the absence of ALCAM on BBB-ECs. Phenotypic characterization of un-immunized ALCAM KO mice revealed a reduced expression of BBB junctional proteins. Further analysis showed that ALCAM is indirectly associated with tight junction molecules of the BBB-ECs, which explains the increased CNS parenchymal blood vessel in vivo permeability in ALCAM KO animals. Correlating with these data, primary culture of mouse brain BBB-ECs was shown to possess a lower TEER and an increased permeability coefficient.  Conclusion: Collectively, our data provide evidence of the implication of ALCAM in monocyte transmigration, but not Th1 or Th17 lymphocyte diapedesis across CNS endothelium. Our results also point to a biologically crucial function of ALCAM in maintaining BBB integrity by acting as an adaptor molecule between tight junctions and the cytoskeleton. As such, the absence of ALCAM at the level of BBB-ECs indirectly promotes the recruitment of pro-inflammatory leukocytes in the CNS of EAE animals by increasing the BBB vessels permeability.

Keyphrases: Activated leukocyte cell adhesion molecule (ALCAM), neuroinflammation, multiple sclerosis (MS), experimental autoimmune encephalomyelitis (EAE), blood-brain barrier (BBB), leukocyte transmigration, tight junction molecules