Inhibition of the membrane attack complex of the complement system reduces secondary neuroaxonal loss and promotes neurologic recovery after traumatic brain injury in mice

J Immunol. 2014 Mar 1;192(5):2339-48. doi: 10.4049/jimmunol.1302793. Epub 2014 Jan 31.

Abstract

Traumatic brain injury (TBI) is the leading cause of disability and death in young adults. The secondary neuroinflammation and neuronal damage that follows the primary mechanical injury is an important cause of disability in affected people. The membrane attack complex (MAC) of the complement system is detected in the traumatized brain early after TBI; however, its role in the pathology and neurologic outcome of TBI has not yet been investigated. We generated a C6 antisense oligonucleotide that blocks MAC formation by inhibiting C6, and we compared its therapeutic effect to that of Ornithodoros moubata complement inhibitor (OmCI), a known inhibitor of C5 activation that blocks generation of the anaphylatoxin C5a and C5b, an essential component of MAC. Severe closed head injury in mice induced abundant MAC deposition in the brain. Treatment with C6 antisense reduced C6 synthesis (85%) and serum levels (90%), and inhibited MAC deposition in the injured brain (91-96%). Treatment also reduced accumulation of microglia/macrophages (50-88%), neuronal apoptosis, axonal loss and weight loss (54-93%), and enhanced neurologic performance (84-92%) compared with placebo-treated controls after injury. These data provide the first evidence, to our knowledge, that inhibition of MAC formation in otherwise complement-sufficient animals reduces neuropathology and promotes neurologic recovery after TBI. Given the importance of maintaining a functional complement opsonization system to fight infections, a critical complication in TBI patients, inhibition of the MAC should be considered to reduce posttraumatic neurologic damage. This work identifies a novel therapeutic target for TBI and will guide the development of new therapy for patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Arthropod Proteins / pharmacology*
  • Axons / immunology*
  • Axons / pathology
  • Brain Injuries / drug therapy*
  • Brain Injuries / immunology
  • Brain Injuries / pathology
  • Carrier Proteins / pharmacology*
  • Complement C5a / antagonists & inhibitors
  • Complement C5a / immunology
  • Complement C5b / antagonists & inhibitors
  • Complement C5b / immunology
  • Complement Membrane Attack Complex / antagonists & inhibitors*
  • Complement Membrane Attack Complex / immunology
  • Female
  • Macrophages / immunology*
  • Macrophages / pathology
  • Mice
  • Mice, Inbred BALB C
  • Microglia / immunology
  • Microglia / pathology
  • Oligodeoxyribonucleotides, Antisense / pharmacology*
  • Recovery of Function / drug effects
  • Recovery of Function / immunology

Substances

  • Arthropod Proteins
  • Carrier Proteins
  • Complement Membrane Attack Complex
  • Oligodeoxyribonucleotides, Antisense
  • OmCI protein, tick
  • Complement C5a
  • Complement C5b