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While multiple rodent preclinical studies, and to a lesser extent human clinical trials, claim the feasibility, safety, and potential clinical benefit of cell grafting in the central nervous system (CNS), currently only little convincing knowledge exists regarding the actual fate of the grafted cells and their effect on the surrounding environment (or vice versa). Our preceding studies already indicated that only a minor fraction of the initially grafted cell population survives the grafting process, while the surviving cell population becomes invaded by highly activated microglia/macrophages and surrounded by reactive astrogliosis. In the current study, we further elaborate on early cellular and inflammatory events following syngeneic grafting of eGFP(+) mouse embryonic fibroblasts (mEFs) in the CNS of immunocompetent mice. Based on obtained quantitative histological data, we here propose a detailed mathematically derived working model that sequentially comprises hypoxia-induced apoptosis of grafted mEFs, neutrophil invasion, neoangiogenesis, microglia/macrophage recruitment, astrogliosis, and eventually survival of a limited number of grafted mEFs. Simultaneously, we observed that the cellular events following mEF grafting activates the subventricular zone neural stem and progenitor cell compartment. This proposed model therefore further contributes to our understanding of cell graft-induced cellular responses and will eventually allow for successful manipulation of this intervention. ; This work was supported by research grants G.0136.11 and G.0130.11 (granted to Zwi Berneman, Annemie Van der Linden, and Peter Ponsaerts) of the Fund for Scientific Research-Flanders (FWO-Vlaanderen, Belgium), in part by a Methusalem research grant from the Flemish government (granted to Zwi Berneman and Herman Goossens) and in part by funding received from the European Union's Seventh Framework Programme (FP7/2007-2013) under grant agreement No. 278850 (INMiND; granted to Annemie Van der Linden). Debbie Le Blon holds a Ph.D.-studentship from the Flemish Institute for Science and Technology (IWT-Vlaanderen). Chloe Hoornaert holds a Ph.D.-studentship from the FWO-Vlaanderen. The authors declare no conflict of interest.

Conventional MRI is frequently used during the diagnosis of multiple sclerosis but provides only little additional pathological information. Proton MRS (H-1-MRS), however, provides biochemical information on the lesion pathology by visualization of a spectrum of metabolites. In this study we aimed to better understand the changes in metabolite concentrations following demyelination of the white matter. Therefore, we used the cuprizone model, a wellestablished mouse model to mimic type III human multiple sclerosis demyelinating lesions. First, we identified CX(3)CL1/CX(3)CR1 signaling as a major regulator of microglial activity in the cuprizone mouse model. Compared with control groups (heterozygous CX(3)CR1(+/-) C57BL/6 mice and wild type CX3CR1(+/+) C57BL/6 mice), microgliosis, astrogliosis, oligodendrocyte cell death and demyelination were shown to be highly reduced or absent in CX3CR1(-/-) C57BL/6 mice. Second, we show that 1H-MRS metabolite spectra are different when comparing cuprizone-treated CX3CR1(-/-) mice showing mild demyelination with cuprizone-treated CX3CR1(+/+) mice showing severe demyelination and demyelination-associated inflammation. Following cuprizone treatment, CX3CR1(+/+) mice show a decrease in the Glu, tCho and tNAA concentrations as well as an increased Tau concentration. In contrast, following cuprizone treatment CX3CR1(-/-) mice only showed a decrease in tCho and tNAA concentrations. Therefore, H-1-MRS might possibly allow us to discriminate demyelination from demyelination-associated inflammation via changes in Tau and Glu concentration. In addition, the observed decrease in tCho concentration in cuprizoneinduced demyelinating lesions should be further explored as a possible diagnostic tool for the early identification of human MS type III lesions. Copyright (C) 2015 John Wiley & Sons, Ltd. ; This work was supported by research grants G.0136.11 and G.0130.11 (granted to ZB, AVdL and PP) of the Fund for Scientific Research - Flanders (FWO - Vlaanderen, Belgium) and in addition by an "FWO - Krediet aan Navorsers" grant of the Fund for Scientific Research - Flanders (FWO -Vlaanderen, Belgium, granted to MV); next, by a Methusalem research grant from the Flemish government (granted to ZB) and in part by funding received from the European Union's Seventh Framework Programme (FP7/2007-2013) under grant agreement 278850 (INMiND) (granted to AVdL). Caroline Guglielmetti is holder of an IWT PhD grant (Institute for the Promotion of Innovation through Science and Technology in Flanders, IWT - Vlaanderen). Firat Kara is holder of an "FWO - Postdoc" grant of the Fund for Scientific Research - Flanders (FWO - Vlaanderen, Belgium). MRI equipment was funded by the Flemish Impulse funding for heavy scientific equipment (granted to AVdL).

Although intracerebral transplantation of various fibroblast(-like) cell populations has been shown feasible, little is known about the actual in vivo remodeling of these cellular grafts and their environment. In this study, we aimed to compare the in vitro and in vivo behavior of two phenotypically similar but developmentally distinct fibroblast-like cell populations, namely, mouse embryonic fibroblasts (mEFs) and mouse fetal membrane-derived stromal cells (mFMSCs). While both mEFs and mFMSCs are readily able to reduce TNF-alpha secretion by LPS/IFN-gamma-activated BV-2 microglia, mFMSCs and mEFs display strikingly opposite behavior with regard to VEGF production under normal and inflammatory conditions. Whereas mFMSCs downregulate VEGF production upon coculture with LPS/IFN-gamma-activated BV-2 microglia, mEFs upregulate VEGF production in the presence of LPS/IFN-gamma-activated BV-2 microglia. Subsequently, in vivo grafting of mFMSCs and IDEFs revealed no difference in microglial and astroglial responses toward the cellular grafts. However, mFMSC grafts displayed a lower degree of neoangiogenesis compared to mEF grafts, thereby potentially explaining the lower cell number able to survive in mFMSC grafts. In summary, our results suggest that physiological differences between fibroblast-like cell populations might lie at the basis of variations in histopathological and/or clinical outcome following cell grafting in mouse brain. ; This work was supported by research grants G.0136.11 and G.0130.11 (granted to Z.B. and P.P.) of the Fund for Scientific Research-Flanders (FWO-Vlaanderen, Belgium) and in part by a Methusalem research grant from the Flemish government (granted to Z.B. and H.G.). Nathalie De Vocht and Chloe Hoornaert hold a Ph.D.-studentship from the FWO-Vlaanderen. Debbie Le Blon holds a Ph.D.-studentship from the Flemish Institute for Science and Technology (IWT). The authors declare no conflicts of interest.

The establishment and validation of reliable induced pluripotent stem cell (iPSC)-derived in vitro models to study microglia and monocyte/macrophage immune function holds great potential for fundamental and translational neuro-immunology research. In this study, we first demonstrate that ramified CX(3)CR1(+) iPSC-microglia (cultured within a neural environment) and round-shaped CX(3)CR1(-) iPSC-macrophages can easily be differentiated from newly established murine CX(3)CR1(eGFP/+)CCR2(RFP/+) iPSC lines. Furthermore, we show that obtained murine iPSC-microglia and iPSC-macrophages are distinct cell populations, even though iPSC-macrophages may upregulate CX(3)CR1 expression when cultured within a neural environment. Next, we characterized the phenotypical and functional properties of murine iPSC-microglia and iPSC-macrophages following classical and alternative immune polarisation. While iPSC-macrophages could easily be triggered to adopt a classically-activated or alternatively-activated phenotype following, respectively, lipopolysaccharide + interferon gamma or interleukin 13 (IL13) stimulation, iPSC-microglia and iPSC-macrophages cultured within a neural environment displayed a more moderate activation profile as characterised by the absence of MHCII expression upon classical immune polarisation and the absence of Ym1 expression upon alternative immune polarisation. Finally, extending our preceding in vivo studies, this striking phenotypical divergence was also observed for resident microglia and infiltrating monocytes within highly inflammatory cortical lesions in CX(3)CR1(eGFP/+)CCR2(RFP/+) mice subjected to middle cerebral arterial occlusion (MCAO) stroke and following IL13-mediated therapeutic intervention thereon. In conclusion, our study demonstrates that the applied murine iPSC-microglia and iPSC-macrophage culture models are able to recapitulate in vivo microglia and monocyte/macrophage ontogeny and corresponding phenotypical/functional properties upon classical and alternative immune polarisation, and therefore represent a valuable in vitro platform to further study and modulate microglia and (infiltrating) monocyte immune responses under neuro-inflammatory conditions within a neural environment. ; This work was supported by research grant G091518N (granted to PP) of the Fund for Scientific Research-Flanders (FWO-Vlaanderen, Belgium), by a Methusalem research grant from the Flemish government (granted to HG and ZB), by funding received from the Belgian Charcot Foundation (granted to PP and DLB) and by the ASCID (Antwerp Study Centre for Infectious Diseases). AQ and EL are holders of a PhD studentship from the FWO-Vlaanderen. EVB is holder of a PhD studentship from the University of Antwerp. DLB is holder of a postdoctoral fellowship from the FWO-Vlaanderen. FM is supported by the Penis 2016 from the Health Department of Generalitat de Catalunya. Research in the Pasque lab is supported by the Research Foundation - Flanders (FWO) (Odysseus Return Grant G0F7716N, to V.P.), the KU Leuven Research Fund (BOFZAP starting grant StG/15/021BF to V.P. Cl grant C14/16/077 to V.P. and Project financing).

Detrimental inflammatory responses in the central nervous system are a hallmark of various brain injuries and diseases. With this study we provide evidence that lentiviral vector-mediated expression of the immune-modulating cytokine interleukin 13 (IL-13) induces an alternative activation program in both microglia and macrophages conferring protection against severe oligodendrocyte loss and demyelination in the cuprizone mouse model for multiple sclerosis (MS). First, IL-13 mediated modulation of cuprizone induced lesions was monitored using T-2-weighted magnetic resonance imaging and magnetization transfer imaging, and further correlated with quantitative histological analyses for inflammatory cell influx, oligodendrocyte death, and demyelination. Second, following IL-13 immune gene therapy in cuprizone-treated eGFP(+) bone marrow chimeric mice, we provide evidence that IL-13 directs the polarization of both brain-resident microglia and infiltrating macrophages towards an alternatively activated phenotype, thereby promoting the conversion of a pro-inflammatory environment toward an anti-inflammatory environment, as further evidenced by gene expression analyses. Finally, we show that IL-13 immune gene therapy is also able to limit lesion severity in a pre-existing inflammatory environment. In conclusion, these results highlight the potential of IL-13 to modulate microglia/macrophage responses and to improve disease outcome in a mouse model for MS. ; This work was supported by research grants G.0136.11 (granted to PP, AVDL and ZB), G.0130.11 (granted to PP, AVDL and ZB) and G.0834.11 (granted to PP and SH) of the Fund for Scientific Research-Flanders (FWO-Vlaanderen, Belgium), in part by a Methusalem research grant from the Flemish government (granted to HG), in part by funding received from the European Union's Seventh Framework Programme (FP7/2007-2013) under grant agreement 278850 (INMiND) (granted to AVdL and AMP), in part by the Brainpath project (MSCA IAPP project granted to AVdL) and in part by funding received from the Belgian Charcot Foundation (granted to PP and AVdL). DLB, DS and CG hold a PhD-studentship from the Flemish Institute for Science and Technology (IWT-Vlaanderen). NDV and CH hold a PhD-studentship from the FWO-Vlaanderen. FK and JP hold a post-doctoral fellowship from the FWO-Vlaanderen.

Transplantation of mesenchymal stem cells (MSCs) into injured or diseased tissuefor the in situ delivery of a wide variety of MSC-secreted therapeutic proteinsis an emerging approach for the modulation of the clinical course of several diseases and traumata. From an emergency point-of-view, allogeneic MSCs have numerous advantages over patient-specific autologous MSCs since off-the-shelf cell preparations could be readily available for instant therapeutic intervention following acute injury. Although we confirmed the in vitro immunomodulatory capacity of allogeneic MSCs on antigen-presenting cells with standard coculture experiments, allogeneic MSC grafts were irrevocably rejected by the host's immune system upon either intramuscular or intracerebral transplantation. In an attempt to modulate MSC allograft rejection in vivo, we transduced MSCs with an interleukin-13 (IL13)-expressing lentiviral vector. Our data clearly indicate that prolonged survival of IL13-expressing allogeneic MSC grafts in muscle tissue coincided with the induction of an alternatively activated macrophage phenotype in vivo and a reduced number of alloantigen-reactive IFN- and/or IL2-producing CD8(+) T cells compared to nonmodified allografts. Similarly, intracerebral IL13-expressing MSC allografts also exhibited prolonged survival and induction of an alternatively activated macrophage phenotype, although a peripheral T cell component was absent. In summary, this study demonstrates that both innate and adaptive immune responses are effectively modulated in vivo by locally secreted IL13, ultimately resulting in prolonged MSC allograft survival in both muscle and brain tissue. ; We thank A. Liston and S. Humblet-Baron (VIB Translational Immunology Lab, KU Leuven, Belgium) for sharing their optimized staining protocols for intracellular cytokine analysis by flow cytometry. This work was supported by research grants G.0130.11 and G.0136.11 (granted to A.V.d.L., Z.N.B. and P.P.), G.0131.11 (granted to Z.N.B. and P.P.), G.0834.11 (granted to S.H. and P.P.) and G.0851.11 (granted to C.V. and Z.N.B.) of the Research Foundation Flanders (FWO Vlaanderen, Belgium) and in part by a Methusalem research grant from the Flemish government (granted to H.G.). C.J.H. and E.Lu. hold a PhD studentship from the FWO Vlaanderen. C.G. and D.L.B. hold a PhD studentship from the Flemish Institute for Science and Technology (IWT Vlaanderen).

Introduction Based on the advances in the treatment of multiple sclerosis (MS), currently available disease-modifying treatments (DMT) have positively influenced the disease course of MS. However, the efficacy of DMT is highly variable and increasing treatment efficacy comes with a more severe risk profile. Hence, the unmet need for safer and more selective treatments remains. Specifically restoring immune tolerance towards myelin antigens may provide an attractive alternative. In this respect, antigen-specific tolerisation with autologous tolerogenic dendritic cells (tolDC) is a promising approach. Methods and analysis Here, we will evaluate the clinical use of tolDC in a well-defined population of MS patients in two phase I clinical trials. In doing so, we aim to compare two ways of tolDC administration, namely intradermal and intranodal. The cells will be injected at consecutive intervals in three cohorts receiving incremental doses of tolDC, according to a best-of-five design. The primary objective is to assess the safety and feasibility of tolDC administration. For safety, the number of adverse events including MRI and clinical outcomes will be assessed. For feasibility, successful production of tolDC will be determined. Secondary endpoints include clinical and MRI outcome measures. The patients' immune profile will be assessed to find presumptive evidence for a tolerogenic effect in vivo. Ethics and dissemination Ethics approval was obtained for the two phase I clinical trials. The results of the trials will be disseminated in a peer-reviewed journal, at scientific conferences and to patient associations. ; A FACTT network (Cost Action) [BM1305]; EU Framework Program Horizon 2020; European Union's Horizon 2020 research and innovation program [779316]; applied biomedical research project of the Institute for the Promotion of Innovation by Science and Technology in Flanders [IWT-TBM 140191]; Platform for Clinical Research and Clinical Trial Units, Spanish Clinical Research Network, SCReN [PI11/02416, PI14/01175, PI16/01737, PT13/0002/0038]; Health Institute Carlos III -Subdireccion General de Evaluacion y Fomento de la Investigacion of the Spanish Ministry of Economy and Competitiveness; Fondo Europeo de Desarrollo Regional (FEDER)European Union (EU); Fundacio La Marato de TV3 [07/2410]; Sanofi Genzyme, Belgium; Research Foundation Flanders (FWO)FWO; Hospital Germans Trias i Pujol ('Germans Trias Talents 2016-2018'); University of Antwerp; Research Foundation FlandersFWO [FWO 1701919N]; Spanish Patient association 'Treball de Vida' (Associacio d'Afectats d'Esclerosi Multiple del Barcelones Nord i Maresme)