Microglia cells are the resident immune cells of the central nervous system. They act as the first-line immune guardians of nervous tissue and central drivers of neuroinflammation. Any homeostatic alteration that can compromise neuron and tissue integrity could activate microglia.
Microglia are extremely sensitive to changes in the environment, thus being rapidly activated after exposure to specific signals, such as growth factors, neurotransmitters, or cytokines, that indicate the presence of infection, trauma, neuronal damage, or inflammation [48,49]. Moreover, microglia classify pathogens by recognizing damage-associated molecular patterns (DAMPs), receptor patterns of exogenous microorganisms, or endogenous cells involved in the immune response. As for peripheral macrophages, according to the first proposed nomenclature, the microglia activation state includes at least two distinct phenotypes: M1, described as a pro-inflammatory and neurotoxic phenotype, and M2, also known as the “alternative activation phenotype” [50,51,52], with anti-inflammatory and neuroprotective properties. These two phenotypes differently respond to distinct signals from the microenvironment and, in turn, are involved in producing many effector molecules [53], promoting the transcription of genes that activate cellular defense mechanisms, including the release of inflammatory cytokines and chemokines [50,54]. However, this unequivocal classification is inconsistent with the vast repertoire of micro-glial phenotypes and core functions in different situations, i.e., development, plasticity, ageing, and diseases. As recently reported, considering the coexistence of multiple states, microglia phenotypes occurring in a specific condition should be characterized by more potent analysis tools than those presently applied, such as proteomic, metabolomic, transcriptomic, morphological, and epigenetic ones [55][58]. Accordingly, a new nomenclature is needed to define the microglia phenotype in each specific physio-pathological environment. This scenario is even more complex since microglia cells can acquire specific activation cellular patterns depending on the pathological environmental conditions in which microglia participate, thus leading to different and peculiar “disease-associated microglia” (DAM) phenotypes [56][59].
3.1. Role of Group I Metabotropic GLU Receptors expressed by Microglia cells in amyotrophic lateral sclerosis
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease characterized by the progressive loss of up-per and lower motor neurons (MNs). In the early phase, symptoms are muscle weakness, followed by a gradual loss of muscle control and contraction, atrophy, and paralysis, which lead to death by respiratory failure [110][226]. Around 90% of cases of ALS are sporadic or unrelated to a specific etiological or hereditary genetic cause. However, 10% of patients are familial, attributable to specific transmissible genetic mutations [111][112].[227,228]
Although the initial ALS approach was mainly focused on neurons, growing and unequivocal evidence indicates that also non-neuronal cells also play a key role in the pathogenesis of ALS, thus contributing to the definition of ALS as a non-cell-autonomous dis-ease [113][114][115][116][117][118][241,242,243,244,245,246]. Glial cells, such as astrocytes and microglia, can participate in the local inflammatory response with peripheral lymphocytes and macrophages. They acquire a reactive phenotype, migrate to the lesion site, proliferate, and secrete pro-inflammatory and neurotoxic mediators [119][120][121][122][123][124][125][126][127][247,248,249,250,251,252,253,254,255]. Glial activation modifies the expression of a wide range of soluble molecules, such as cytokines and chemokines, DAMPs, reactive nitrogen species (RNS), and ROS, giving rise to profound changes in fundamental aspects of the interactions between glia and neurons [128][256].
Microglia become reactive before the symptomatic phase of the disease [52][129][52,257], concomitantly with the first loss of neuromuscular junctions [130][258] and MNs [131][259].
Several findings indicate that, during ALS progression, microglia cells do not undergo a stage-dependent transition [132][269]; instead, they show the coexistence of the different phenotypes, thus producing a peculiar functional profile as a complex outcome of multiple regulation factors.
Differing from other pathological or traumatic conditions, the involvement of group I mGluRs in the modulation of the microglia phenotype in ALS is poorly documented. Nevertheless, mGluR1, mGluR5, and microglia cells are indeed a promising target for ALS treatment and other neurodegenerative diseases in which neuroinflammation plays a pivotal role [70][87][89][133][73,90,92,271]. In ALS patients, mGluR1 and mGluR5 mRNAs are abundantly expressed in the dorsal horn rather than in the ventral horn of the spinal cord. Of note, spared MNs express abundant mGluR5, while vulnerable MNs do not [134][290]. Aronica and Collaborators showed that mGluR1 and mGluR5 were highly represented in neuronal cells throughout the human spinal cord, with mGluR1 having high expression in ventral horn neurons. In contrast, intense mGluR5 immunoreactivity was observed in the dorsal horns [135][291]. This different CNS area- and cell-specific expression of group I mGluRs high-lights an intriguing clue possibly linked to the selective vulnerability of MNs in ALS [136][137][138][139][292,293,294,295]. Regarding glial cells, only sparse astrocytes showed weak to moderate staining for mGluR1 and mGluR5 in the spinal cords of healthy patients [135][140][291,296]. In ALS patients, the mGluR1 and mGluR5 immunolabeling intensity increased in cells with an astroglia morphology in the grey and white matter. At the same time, their expression in neurons was comparable to that observed in healthy subjects [135][140][291,296].
Although the role of mGluR5 in regulating astrocyte function and their neurotoxic phenotype during ALS progression was largely investigated [141][142][143][144][145][146][297,298,299,300,301,302], there is only one paper describing mGluRs affecting microglia functionality [147][122]. Berger etand aColl. examined in vitro the modulation of mGluRs expressed by microglial cells in two distinct models of inflammatory conditions, including microglia cell cultures obtained from rats ex-pressing the SOD1G93A ALS-linked mutation. As expected, SOD1G93A microglia were characterized by increased neuroinflammation and enhanced reactivity. The results showed that the mGluR5 mRNA was upregulated in microglia cell cultures prepared from the brains of neonatal SOD1G93A rats. Interestingly, the exposure to LPS, mimicking an inflammatory environment, increased mGluR3 and decreased mGluR5 gene expression in both SOD1G93A and wtSOD1 microglia [147][122]. This evidence indicates that an inflammatory environment may trigger the opposite regulation of mGluR subtype gene expression. These events seem particularly robust in SOD1G93A microglia cultures. Thus, it will be crucial to consider the possible cell-specific receptor expression and localization when con-sidering these therapeutic targets in ALS.
Using the SOD1G93A mouse model, it has been first demonstrated that the expression and function of mGluR1 and mGluR5 were enhanced at glutamatergic synapses in the spinal cord at the early pre-symptomatic and late symptomatic stages of the disease [75][76][78,79]. These alterations could further exacerbate the excessive glutamatergic neurotransmission previously demonstrated in the spinal cords of SOD1G93A mice [148][149][150][282,284,308]. In subsequent studies, genetically halving mGluR1 and mGluR5, or ablating mGluR5, significantly ameliorated disease progression and survival probability in SODG93A mice [151][152][153][309,310,311], and produced a reduction in astrogliosis and microgliosis, always accompanied by positive outcomes for the ALS phenotype. In vivo, the beneficial effects can hardly be ascribed to a specific cell subtype; however, rwesearchers postulated that the observed modulation of reactive astrocytes and microglia could represent a potential contribution to the improved MN survival [151][152][153][309,310,311]. Then, the effect of the chronic oral administration of the mGluR5 NAM CTEP was tested [154][312]. Differing from the mGluR5 genetic ablation, the pharmacological treatment was started after symptom onset and maintained until the late symptomatic stage of the disease [154][312]. CTEP dose-‐dependently ameliorated the survival and clinical course in SOD1G93A mice. Of relevance, paralleling the genetic studies, chronic treatment with CTEP also reduced astrogliosis and microglia proliferation in the spinal cords of SOD1G93A mice, possibly contributing to the amelioration of the extracellular noxious milieu towards MNs, thus in turn reducing the disease severity.
Considering the dual role of microglia during ALS progression and the fact that blocking mGluR5 before or after disease onset, by genetic or pharmacological strategies, respectively, always ameliorated disease progression and reduced glial reactivity, uncertainty about the mixed effects of dampening mGluR5 in ALS arises. The negative modulation of group I mGluRs should differently affect astrocyte or microglia cells early in the pathology, when microglia probably possess an anti-inflammatory phenotype and astrocytes should start to be reactive, with respect to the late symptomatic stages, when both astrocytes and microglia are detrimental for MNs.
The studies mentioned above, including the microglia-specific effects of group I mGluR modulation, are worth considering in the potential therapeutic application of mGluR5-targeted drugs to be exploited for ALS and other neurodegenerative diseases characterized by glial activation and neuroinflammatory features. Due to the subtle modifications that the microglia phenotype may undergo during specific ALS stages, and the uncertain role played by mGluRs, the only way to shed light on this complex scenario would be to expand the studies by exploiting more powerful and “omic” approaches, including transcriptomics, proteomics, metabolomics, and epigenomics, besides those adopted till now.
The pharmacological or genetic modulation of group I mGluRs expressed by micro-glia cells represents an attractive multipotential therapeutic strategy for acute traumatic and chronic neurodegenerative disorders. Although the literature has frequently investigated the roles of mGluRs and related therapeutic approaches focusing on neurons, other cell types, including astrocytes and microglia, express these receptors. Many neuroprotective strategies aimed at modulating the aberrant reactive state of these cells have high-lighted microglia as a new target to improve clinical outcomes in different pathological conditions, particularly neurodegenerative diseases characterized by prominent neuroinflammatory hallmarks. Group I mGluR modulation reduces inflammation, excitotoxicity, necroptosis, and apoptotic cell death.
Further collection of preclinical and clinical evidence will be essential to optimize group I mGluRs as multipotential targets to modulate the complex balance of microglia phenotypes in CNS disorders.