title: Erythropoietin: a potent inducer of peripheral immuno/inflammatory modulation in autoimmune EAE.
abstract: BACKGROUND
  Beneficial effects of short-term erythropoietin (EPO) therapy have been demonstrated in several animal models of acute neurologic injury, including experimental autoimmune encephalomyelitis (EAE)--the animal model of multiple sclerosis. We have found that EPO treatment substantially reduces the acute clinical paralysis seen in EAE mice and this improvement is accompanied by a large reduction in the mononuclear cell infiltration and downregulation of glial MHC class II expression within the inflamed CNS. Other reports have recently indicated that peripherally generated anti-inflammatory CD4(+)Foxp3(+) regulatory T cells (Tregs) and the IL17-producing CD4+ T helper cell (Th17) subpopulations play key antagonistic roles in EAE pathogenesis. However, no information regarding the effects of EPO therapy on the behavior of the general mononuclear-lymphocyte population, Tregs or Th17 cells in EAE has emerged.
  
  
  RESULTS
  We first determined in vivo that EPO therapy markedly suppressed MOG specific T cell proliferation and sharply reduced the number of reactive dendritic cells (CD11c positive) in EAE lymph nodes during both inductive and later symptomatic phases of MOG(35-55) induced EAE. We then determined the effect in vivo of EPO on numbers of peripheral Treg cells and Th17 cells. We found that EPO treatment modulated immune balance in both the periphery and the inflamed spinal cord by promoting a large expansion in Treg cells, inhibiting Th17 polarization and abrogating proliferation of the antigen presenting dendritic cell population. Finally we utilized tissue culture assays to show that exposure to EPO in vitro similarly downregulated MOG-specific T cell proliferation and also greatly suppressed T cell production of pro-inflammatory cytokines.
  
  
  CONCLUSIONS
  Taken together, our findings reveal an important new locus whereby EPO induces substantial long-term tissue protection in the host through signaling to several critical subsets of immune cells that reside in the peripheral lymphatic system.
authors.affiliation: Department of Veterans Affairs, New Jersey Health Care System, East Orange, New Jersey, United States of America.
authors.forename: RuiRong
authors.initials: R
authors.lastname: Yuan
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Maeda
authors.forename: Weiping
authors.initials: W
authors.lastname: Li
authors.forename: Wei
authors.initials: W
authors.lastname: Lu
authors.forename: Stuart
authors.initials: S
authors.lastname: Cook
authors.forename: Peter
authors.initials: P
authors.lastname: Dowling
mesh_terms: D000818:Animals; D001327:Autoimmune Diseases; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D002490:Central Nervous System / Q000378:metabolism; D016207:Cytokines / Q000378:metabolism; D004681:Encephalomyelitis, Autoimmune, Experimental / Q000276:immunology* / Q000378:metabolism; D004921:Erythropoietin / Q000494:pharmacology*; D051858:Forkhead Transcription Factors / Q000378:metabolism; D005802:Genes, MHC Class II; D007249:Inflammation / Q000378:metabolism; D020381:Interleukin-17 / Q000096:biosynthesis; D007963:Leukocytes, Mononuclear / Q000166:cytology; D008198:Lymph Nodes / Q000378:metabolism; D051379:Mice; D008810:Mice, Inbred C57BL
chemical_list: D016207:Cytokines; C418974:FOXP3 protein, human; D051858:Forkhead Transcription Factors; D020381:Interleukin-17; D004921:Erythropoietin