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Distinguishing the effects of systemic CSF1R inhibition by PLX3397 on microglia and peripheral immune cells
Akhabue K Okojie1,2, Joseph O Uweru3,4, Morgan A Coburn3,4
1Department of Neuroscience, University of Virginia School of Medicine, Charlottesville, VA, USA. gsg4pb@virginia.edu.
Abstract:
Microglia, the primary immune cells of the central nervous system (CNS), are derived from the yolk sac and populate the brain during development. Once microglia migrate to the CNS, they are self-renewing and require CSF1R signaling for their maintenance. Pexidartinib (PLX3397, PLX), a small molecule inhibitor of the CSF1R, has been shown to effectively deplete microglia since microglial maintenance is CSF1R-dependent. There have, however, been several conflicting reports that have shown the potential off-target effects of PLX on peripheral immune cells particularly those of lymphoid origin. Given this controversy in the use of the PLX family of drugs, it has become important to ascertain to what extent PLX affects the peripheral immune profile in lymphoid (spleen, and bone marrow) and non-lymphoid (kidney, lungs, and heart) organs. PLX3397 chow treatment at 660 mg/kg for 7 days significantly reduced CD45+ macrophages, CX3CR1-GFP cells, CD11b+CD45intermediate cells, and P2RY12 expression in the brain. However, there were minimal effects on peripheral immune cells from both lymphoid and non-lymphoid organs except in the heart where there was a significant decrease in CD3+ cells, inflammatory and patrolling monocytes, and CD11b+Ly6G+ neutrophils. We then stimulated the immune system with 1 mg/kg of LPS which resulted in a significant reduction in the number of innate immune cells. In this context, PLX did not alter the cytokine profile in the serum and the brain of naïve mice but did so in the LPS-stimulated group resulting in a significant reduction in TNFα, IL-1α, IFN-γ and IL-1β. Furthermore, PLX did not alter locomotor activity in the open field test suggesting that microglia do not contribute to LPS-induced sickness behavior. Our results provide an assessment of immune cell populations with PLX3397 treatment on brain, lymphoid and non-lymphoid organs without and during LPS treatment that can serve as a resource for understanding consequences of such approaches.
Insights
Pexidartinib (PLX) effectively depletes microglia in the brain but has minimal impact on most peripheral immune cells. However, PLX treatment reduced certain immune cells in the heart and altered cytokine profiles during LPS stimulation.
Area of Science:
- Neuroimmunology
- Pharmacology
Background:
- Microglia are central nervous system immune cells dependent on CSF1R signaling for maintenance.
- Pexidartinib (PLX3397) inhibits CSF1R and depletes microglia, but concerns exist regarding peripheral immune cell effects.
Purpose of the Study:
- To investigate the effects of Pexidartinib (PLX3397) on peripheral immune cell populations in lymphoid and non-lymphoid organs.
- To assess PLX3397's impact on immune responses during lipopolysaccharide (LPS) challenge.
Main Methods:
- Mice were treated with PLX3397 chow (660 mg/kg for 7 days) and subsequently stimulated with LPS (1 mg/kg).
- Flow cytometry was used to analyze immune cell populations in the brain, spleen, bone marrow, kidney, lungs, and heart.
- Cytokine levels in serum and brain were measured, and locomotor activity was assessed.
Main Results:
- PLX3397 significantly reduced microglia markers in the brain but had minimal effects on peripheral immune cells, except for a decrease in CD3+ cells and monocytes in the heart.
- LPS stimulation led to a reduction in innate immune cells, and PLX3397 treatment significantly reduced TNFα, IL-1α, IFN-γ, and IL-1β in LPS-stimulated mice.
- PLX3397 did not affect locomotor activity, suggesting microglia are not essential for LPS-induced sickness behavior.
Conclusions:
- Pexidartinib (PLX3397) primarily targets microglia in the CNS with limited off-target effects on most peripheral immune cells.
- PLX3397 can modulate systemic cytokine responses during inflammation, particularly in LPS-challenged mice.
- The study provides a comprehensive resource for understanding the systemic immune consequences of PLX3397 treatment.

