Direct effects of prolonged TNF-α and IL-6 exposure on neural activity in human iPSC-derived neuron-astrocyte co-cultures, 2025, Goshi et al

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Direct effects of prolonged TNF-α and IL-6 exposure on neural activity in human iPSC-derived neuron-astrocyte co-cultures

Noah Goshi, Doris Lam, Chandrakumar Bogguri, Vivek Kurien George, Aimy Sebastian, Jose Cadena, Nicole F. Leon, Nicholas R. Hum, Dina R. Weilhammer, Nicholas O. Fischer, Heather A. Enright

Abstract
Cognitive impairment is one of the many symptoms reported by individuals suffering from long-COVID and other post-viral infection disorders such as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). A common factor among these conditions is a sustained immune response and increased levels of inflammatory cytokines. Tumor necrosis factor alpha (TNF-α) and interleukin-6 (IL-6) are two such cytokines that are elevated in patients diagnosed with long-COVID and ME/CFS.

In this study, we characterized the changes in neural functionality, secreted cytokine profiles, and gene expression in co-cultures of human iPSC-derived neurons and primary astrocytes in response to prolonged exposure to TNF-α and IL-6.

We found that exposure to TNF-α produced both a concentration-independent and concentration-dependent response in neural activity. Burst duration was significantly reduced within a few days of exposure regardless of concentration (1 pg/mL – 100 ng/mL) but returned to baseline after 7 days. Treatment with low concentrations of TNF-α (e.g., 1 and 25 pg/mL) did not lead to changes in the secreted cytokine profile or gene expression but still resulted in significant changes to electrophysiological features such as interspike interval and burst duration.

Conversely, treatment with high concentrations of TNF-α (e.g., 10 and 100 ng/mL) led to reduced spiking activity, which may be correlated to changes in neural health, gene expression, and increases in inflammatory cytokine secretion (e.g., IL-1β, IL-4, and CXCL-10) that were observed at higher TNF-α concentrations. Prolonged exposure to IL-6 led to changes in bursting features, with significant reduction in the number of spikes in bursts across a wide range of treatment concentrations (i.e., 1 pg/mL–10 ng/mL).

In combination, the addition of IL-6 appears to counteract the changes to neural function induced by low concentrations of TNF-α, while at high concentrations of TNF-α the addition of IL-6 had little to no effect. Conversely, the changes to electrophysiological features induced by IL-6 were lost when the cultures were co-stimulated with TNF-α regardless of the concentration, suggesting that TNF-α may play a more pronounced role in altering neural function.

These results indicate that increased concentrations of key inflammatory cytokines associated with long-COVID can directly impact neural function and may be a component of the cognitive impairment associated with long-COVID and other post-viral infection disorders.

Link | PDF (Frontiers in Cellular Neuroscience) [Open Access]
 
A common factor among these conditions is a sustained immune response and increased levels of inflammatory cytokines. Tumor necrosis factor alpha (TNF-α) and interleukin-6 (IL-6) are two such cytokines that are elevated in patients diagnosed with long-COVID and ME/CFS.
This hasn't been established, I don't think. The Columbia study back in 2015(?), the most authoritative one I'm aware of, concluded that the inflammation level does not predict the symptom severity, even though the elevation was seen in patients in early phase.
 
A couple of quotes —

An interesting finding in our study was the direct effect of TNF-α, independent of concentration, on the reduction in average burst duration. Bursts are specific spike patterns that are thought to play a critical role in the “neural code” involved in many functions, and include memory, learning, and attention. Many computational models have been developed to gain a better understanding of how different input parameters such as ion channel conductance, synaptic input strengths, and input frequency impact bursting features. TNF-α treatment has been shown to influence all these parameters through direct interactions with ion channels, alterations in surface expression, and changes in gene expression.

(Another possible mechanism for FND?)

Unlike with TNF-α, we did not observe any concentration dependent effect of prolonged IL-6 exposure on neural activity, but only an overall decrease in the number of spikes in bursts that was present across all IL-6 concentrations tested. […] IL-6 is constitutively expressed within the CNS and plays a significant role in neural stem cell differentiation, synaptic plasticity, memory mechanisms, and neuronal injury repair. IL-6 primarily acts through the IL-6 receptor system that consists of the signal-transducing glycoprotein 130 (gp130) and the IL-6 receptor.

The IL-6 receptor has two forms, a membrane bound form (mIL-6R) or a soluble form (sIL-6R) leading to either the classic or transsignaling pathways, respectively. Additionally, there is another signaling pathway, cluster signaling, in which the IL-6/mIL-6R complex forms on one cell and then activates membrane-bound gp130 on a neighboring cell. It is hypothesized that these different signaling modalities may lead to different responses to IL-6, with classic signaling typically associated with homeostatic processes, while trans-signaling is involved with neuroinflammatory pathways. […] Additionally, both gp130 and mIL-6R have been shown to be localized to both pre- and postsynaptic membranes, which also suggests that the addition of “free” IL-6 may be influencing neuronal function.
 
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