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Introduction: Astrocytopathy is known to be an early feature of different neuroinflammatory diseases. However, the impact of astrocyte loss and repopulation on the development and progression of demyelinating lesions in complex etiologies, such as multiple sclerosis, is difficult to determine. To more easily analyse astrocyte- oligodendrocyte-interactions during lesion formation and progression in the human brain, diseases like Central pontine myelinolysis (CPM) can be used as a less complex model of demyelinating disorders. CPM is a rare neurological condition characterized by damage to the myelin sheath of pontine nerves after osmotic shifts in serum. Astrocytopathy is regarded to be the first event in the pathogenesis of CPM lesions. Methods: Histological investigation of autopsy tissue from human CPM patients was performed. Lesions were staged considering the myelination and the appearance of different astrocyte subtypes, which was used to judge behaviour of the astrocytic compartment. Further, dynamics of oligodendrocyte loss and repopulation were analysed and compared to the astrocytic repopulation. Results: Early-staged lesions were largely demyelinated and showed an overall reduction of astrocyte densities. The few astrocytes present showed a bipolar morphology and were APQ4-negative, indicating an immature state. Intermediate- stage lesions were still largely demyelinated, but had increased overall densities of astrocytes, which did not yet reflect densities observed in the perilesion. Astrocytes appeared mostly ramified and AQP4-positive, indicating maturity. Nevertheless, bipolar astrocytes were still observable, indicating that repopulation was not yet finalized. Late-stage CPM-lesions were at least partially remyelinated. Astrocytes were detectable in overall densities comparable to the perilesion and showed a ramified (or even reactive morphology), as well as regular expression of AQP4. Investigating the oligodendrocytes, intralesional densities were reduced in early- and intermediate-stage lesions when compared to the perilesion. Re-increase in oligodendrocyte densities was first observable in late-stage lesions, but did not reach perilesional levels. Conclusion: The study at hand indicates that the recovery of demyelinated osmolyte- induced pontine lesions follows a distinct time-course. Repopulation of the lesion with oligodendrocytes is not carried out until lesions are completely repopulated with functional resident astrocytes, as indicated by the ramified morphology and the expression of AQP4. Further studies will be needed to determine, whether the appearance of immature astrocytes, indicating an ongoing repopulation of lesions with astrocytes, correlates with an inefficient repair of demyelinated lesions.:List of Abbreviations.................................................................................................................6 1 Introduction................................................................................................................7 1.1 Osmotic Demyelinating Syndrome......................................................................... 7 1.2 Clinical manifestation............................................................................................. 9 1.3 Diagnosis and Management of CPM.....................................................................11 1.4 Aetiology of Central Pontine Myelinolysis.................................. ......................... 14 1.5 The brain, its adaptation to hyponatraemia and response to correction – pathophysiology of CPM............................................................................................16 1.6 Pathology of myelin............................................................................................. 19 1.6.1 Astrocytopathy and oligodendrocytopathy.................................................................................................20 1.7 Aims of the study................................................................................................. 23 2 Material und Methods............................................................................................. 24 2.1 Patient tissue........................................................................................................ 24 2.2 Histology and immunohistochemistry................................................................................................24 2.2.1 Basic concepts........................................................................................... ......24 2.2.2 Hematoxylin and Eosin (HE)............................................................................. 26 2.2.3 Luxol Fast Blue/ Periodic Acid Schiff stain........................................................27 2.2.4 Immunohistochemistry. Application and Protocol.............................................28 2.3 Implementation.................................................................................................... 31 2.4 Estimation of demyelination................................................................................. 32 2.5 Analysis of cell density and proliferation.............................................................. 32 2.6 Data plotting and statistical analysis.................................................................... 32 3 Results..................................................................................................................... 33 3.1 Patient cohort....................................................................................................... 33 3.2 Characteristics of demyelination.......................................................................... 35 3.3 CPM lesion and disease staging.......................................................................... 37 3.4 Astrocytes within human CPM lesions................................................................. 42 3.4.1 Astrocyte densities are decreased in early CPM lesions....................................42 3.4.2 Astrocytes in CPM– morphological distinctions.................................................45 3.5 Oligodendrocyte densities within human CPM lesions.........................................48 3.6 Macrophages and activated microglia.................................................................. 54 3.6.1 KiM1P – a marker for infiltrating macrophages and activated microglia............54 3.6.2 Proliferating Iba1+ cells are observed in all lesion stages..................................58 4 Discussion................................................................................................................ 61 4.1 Lesion Staging...................................................................................................... 61 4.2 Astrocytes in the pathogenesis of CPM............................................................... 65 4.3 Oligodendrocyte pathology in CPM..................................................................... 69 4.4 Mechanisms of regeneration in human CPM lesions............................................72 4.5 Summary, interpretation and limitations of our study............................................78 5 Conclusion and Outlook.......................................................................................... 80 6 Bibliography............................................................................................................. 82 7 List of Tables.............................................................................................................91 8 List of Figures.......................................................................................................... 92 9 Appendix.................................................................................................................. 94 9.1 Declaration of Authenticity.....................................................................................94 9.2 Acknowledgements...............................................................................................95

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Lipids are important for the structural and physiological functions of neuronal cell membranes. Alterations in their lipid composition may result in membrane dysfunction and subsequent neuronal deficits that characterise various disorders. This study focused on profiling lipids of aged and LPS-treated rat brain and liver tissue with a view to explore the effect of atorvastatin in neuroinflammation, and examining lipid changes in different areas of rat brain of the Flinders Sensitive Line (FSL) rats, a genetic model of depression. Lipids and other analytes extracted from tissue samples were analysed with proton nuclear magnetic resonance spectroscopy (1H-NMR), gas chromatography (GC) and liquid chromatography-tandem mass spectroscopy (LC/ESI-MS/MS). Changes in the lipid profiles suggested that brain and liver responded differently to ageing and LPS-induced neuroinflammation. In the aged animals, n-3 PUFA were reduced in the brain but were increased in the liver. However, following treatment with LPS, these effects were not observed. Nevertheless, in both models, brain concentration of monounsaturated fatty acids was increased while the liver was able to maintain its monounsaturated fatty acid concentration. Atorvastatin reversed the reduction in n-3 PUFA in the aged brain without reducing brain and liver concentration of cholesterol. These findings further highlight alterations in lipid metabolism in agerelated neuroinflammation and show that the anti-inflammatory actions of atorvastatin may include a modulation of fatty acid metabolism. When studying the FSL model, there were differences in the lipid profile of different brain areas of FSL rats compared to Sprague-Dawley controls. In all brain areas, arachidonic acid was increased in the FSL rats. Docosahexaenoic acid and ether lipids were reduced, while cholesterol and sphingolipids were increased in the hypothalamus of the FSL rats. Furthermore, total diacylglycerophospholipids were reduced in the prefrontal cortex and hypothalamus of the FSL rats. These results show differences in the lipid metabolism of the FSL rat brain and may be suggestive of changes occurring in the brain tissue in depression.

Organotypic hippocampal slice cultures were used to model the effects of neuroinflammatory conditions following an epileptic state on functional P2X7 receptors (Rs) of subgranular zone (SGZ) neural progenitor cells (NPCs). The compound, 4-aminopyridine (4-AP), is known to cause pathological firing of neurons, consequently facilitating the release of various transmitter substances including ATP. Lipopolysaccharide (LPS) and interleukin-1(IL-1) both potentiated the dibenzoyl-ATP (Bz-ATP)-induced current amplitudes in NPCs, although via different mechanisms. Whereas LPS acted via promoting ATP release, IL-1 acted via its own receptor to directly influence P2X7Rs. Thus, the effect of LPS was inhibited by the ecto-ATPase inhibitor, apyrase, but not by the IL-1 antagonist, interleukin-1RA (IL-1RA); by contrast, the effect of IL-1 was inhibited by IL-1RA, but not by apyrase. Eventually, incubation with 4-AP upregulated the number of nestin/glial fibrillary acidic protein/P2X7R immunoreactive cells and their appropriate staining intensity, suggesting increased synthesis of P2X7Rs at NPCs. In conclusion, inflammatory cytokines accumulating after epilepsy-like neuronal firing may facilitate the effect of endogenous ATP at P2X7Rs of NPCs, thereby probably promoting necrosis/apoptosis and subsequent cell death.

L’inflammation systémique induite par l’obésité augmente la neuroinflammation et la réactivité gliale dans le noyau accumbens (NAc), associées à des comportements de type dépressif et anxieux. Les neurones à épines moyennes (MSN) du NAc font partie intégrante des circuits neuronaux qui contrôlent la motivation et l’humeur. Les différences fonctionnelles dans les entrées et les sorties des sous-régions du NAc – le cœur du NAc (NAcC) et la coquille du NAc (NAcSh) – fournissent une base pour étudier la divergence fonctionnelle dans les sous-territoires. Nos résultats biochimiques et chimiogénétiques préliminaires suggèrent que l’inflammation causée par une alimentation chronique riche en graisses entraîne une diminution de l’excitabilité des récepteurs D1 de la dopamine (D1R) des MSN. Notre objectif était d’étudier l’impact des états inflammatoires aigus et chroniques en étudiant l’impact du LPS et de l’alimentation riche en graisses saturées (HFD) sur l’activité des MSN du NAc et la plasticité synaptique. Pour ce faire, nous avons utilisé deux méthodes électrophysiologiques, les enregistrements de champ extracellulaire et le patch clamp intracellulaire à cellules entières, pour étudier la potentialisation à long terme (LTP) et l’activité excitatrice cellulaire dans le NAc en réponse à l’inflammation aiguë et chronique. Nos résultats suggèrent que le LPS peut induire des changements dans la LTP dans les champs de neurones du NAcC. Cela suggère que la neuroinflammation aiguë peut induire des changements dans la transmission du signal entre les synapses du NAcC. Dans les cellules patchées, nous avons constaté que les entrées excitatrices sur les MSN D1R du NAcC et du NAcSh présentaient une fréquence réduite, en réponse au LPS. Nous avons également constaté que le LPS peut induire une réduction de l’amplitude maximale des entrées inhibitrices sur les MSN D1R du NAcC et du NAcSh. Après 12 semaines d’un régime à base d’huile de palme (graisse saturée) amenant à l’obésité, les entrées excitatrices sur les MSN NAc D1R n’ont pas montré de changements significatifs. Collectivement, nos données suggèrent qu’un défi aigu au LPS, mais pas un défi chronique au Palm, peut provoquer des changements aigus dans l’activité neuronale du NAc qui pourraient être médiés par des changements dans la signalisation de la dopamine. / Obesity induced systemic inflammation upregulates neuroinflammation and glial reactivity in the nucleus accumbens (NAc) which is associated with depressive- and anxiety-like behaviors. Medium spiny neurons (MSNs) of the NAc are integral populations of the neural circuitry controlling motivation and mood. Functional differences in the inputs and outputs of NAc subregions- NAc core (NAcC) and NAc shell (NAcSh)- provide a basis to study functional divergence in the subterritories. Our preliminary biochemical and chemogenetic findings suggest that inflammation caused by chronic high-fat feeding results in decreased excitability of dopamine D1 receptor (D1R) MSNs. Our aims were to investigate the impact of acute and chronic inflammatory states by studying the impact of LPS and Palm saturated high-fat diet (HFD) on NAc MSN activity and synaptic plasticity. Given this, we used two electrophysiology methods, extracellular field recordings & intracellular whole-cell patch clamp, to study NAc long-term potentiation (LTP) and cellular excitatory activity in response to acute and chronic inflammation. Our results suggest that LPS may induce changes in LTP in neuron fields in the NAcC. This suggests that acute neuroinflammation may induce changes in signal transmission between synapses of the NAcC. In patched cells, excitatory inputs onto D1R MSNs of the NAcC and NAcSh displayed reduced frequency in response to LPS. We also demonstrate that LPS induces a reduction in the peak amplitude of inhibitory inputs onto both NAcC and NAcSh D1R MSNs. After 12 weeks on a saturated Palm diet, NAc D1R MSN excitatory inputs displayed no significant changes. Collectively, our data suggests that an acute LPS, but not chronic Palm challenge may illicit acute changes in NAc neuronal activity, perhaps mediated by changes in DA signaling.

Traumatic brain injury (TBI) is a leading cause of morbidity and mortality around the world. It has multiple causative factors including sports injuries, vehicular accidents, war, and other forms of trauma. Though patients can recover, it has the potential to cause mild to severe persistent cognitive deficits. Medical treatment involves treating individual problems as they arise; this treatment is based upon clinical signs. Developing a standard of care for TBI is complex due to the difficulty in finding common cell and molecular changes in TBI variants that can be prevented or ameliorated. Tumor necrosis factor (TNF) is a prominent inflammatory cytokine present in all forms of traumatic brain injury. It is the target of multiple therapies in other disease processes. As TNF inhibitors lead to billions of dollars in worldwide sales, their use in neuropathologies is an active research area. XPro1595, a preclinical drug developed by Xencor, uniquely inhibits more than 99% of soluble TNF. However, there is only one published study to date on the effects of XPro1595 in any model of traumatic brain injury. The purpose of this study was to characterize the presence of TNF and the proinflammatory TNFR1 pathway in a controlled cortical impact (CCI) mouse model of TBI and to determine if XPro1595 could improve behavioral and neuropathological outcomes. TNF and the TNFR1 pathway have shown to be chronically present in a CCI mouse model for at least two weeks. Injured animals treated with one course of the drug did not show any improvements in spatial learning or memory. However, decreased activity in the TNFR1 pathway and changes in glial markers indicated that XPro1595 lessened neuroinflammation via this mechanism. This study suggests potential benefits of XPro1595 in TBI that could lead to a common standard of care.