Regulation of 2',3'-cyclic nucleotide phosphodiesterase gene expression in experimental peripheral neuropathies

2',3'-Cyclic nucleotide 3'-phosphodiesterase (CNPase) is an enzyme associated with central nervous system myelination. Although present in the mammalian peripheral nerve, it is not clear what its role is during myelination nor how the expression of this gene is regulated in the PNS. In this study, CNPase gene expression was studied in the crushed and permanently transected rat sciatic nerve, two models of peripheral nerve neuropathy. The Schwann cells of the crushed nerve initially demyelinate, remain in a non-myelinating condition until active regeneration induces remyelination (10-21 days after injury), whereas those of the permanently transected nerve remain in a quiescent, non-myelinating state after the initial demyelination. An increase of CNPase mRNA levels is observed during degeneration and remains high whether the peripheral nerve is regenerating or not, suggesting transcriptional activation of CNPase mRNA and/or increased CNPase mRNA stability as a response to nerve injury. In contrast, the steady state level of CNPase protein did not increase during degeneration or regeneration suggesting either negative translational regulation of CNPase gene expression or a higher turnover of this protein in the injured peripheral nerve. Furthermore, CNPase activity dropped sharply during early degeneration and remained low in the quiescent cells of the permanently transected nerve while it increased in the regenerating nerve. The results suggest that although transcriptional or post-transcriptional regulation of CNPase gene expression is not dependent on Schwann cell-axonal contact, the activity of CNPase appears to be dependent on myelination and indirectly dependent on the presence of axons in the peripheral nerve.

Increased permeability across the blood-nerve barrier of albumin glycated in vitro and in vivo from patients with diabetic polyneuropathy

The blood-nerve transfer of human plasma albumin glycated with D-glucose was investigated by measuring the permeability coefficient-surface area product (PS) of the blood-nerve barrier to radioiodinated albumin in normal adult rat sciatic nerve. Human albumin (ALB) from normal individuals, freshly isolated by CM-Affi-Gel Blue affinity chromatography, was glycated in vitro for 1, 3, 10, 19, and 30 weeks. Glycated ALB (gALB) was separated from the nonglycated form by boronate-affinity chromatography. The efficiency of this separation was assessed by chromatography of ALB glycated with [14C]glucose and by rechromatography of isolated ALB and gALB after radioiodination. The gALB was also shown to have a higher molecular weight and be completely separated from ALB after SDS/pore gradient electrophoresis in a Tris borate/EDTA buffer. After 1 week of glycation, the gALB PS was 2.2-fold greater than the ALB PS (0.724 +/- 0.063 x 10(-6) vs. 0.328 +/- 0.053 x 10(-6) ml.g-1.s-1; mean +/- SD; P less than 0.0001) and it increased with the time of glycation reaching a maximum value of 16.2-fold greater at 30 weeks (4.656 +/- 1.117 x 10(-6) vs. 0.288 +/- 0.042 x 10(-6) ml.g-1.s-1; mean +/- SD; P less than 0.0001). No change was observed in the residual endoneurial plasma volume. In addition, the PS of gALB isolated from patients with diabetic polyneuropathy was significantly increased (P less than 0.0001) compared to the PS for ALB isolated from the same patients. It is hypothesized that the increased permeability of gALB and presumably other glycated serum components across the blood-nerve barrier, as well as the observed quantitative increase in ALB, IgG, and IgM in sural nerve biopsies from patients with diabetic polyneuropathy contribute to the development of diabetic polyneuropathy over a prolonged period of time by mechanisms that might involve osmotic changes in the nerve microenvironment, direct toxic effects of glycated macromolecules on cells within the endoneurium, or nerve damage by classical immunological mechanisms due to trapping of glycated immunoglobulins within nerve.

P0 gene expression in Schwann cells is modulated by an increase of cAMP which is dependent on the presence of axons

The role of cAMP in the regulation of P0 gene expression was investigated in Schwann cells of normal, regenerated, and permanently transected rat sciatic nerve. Forskolin treatment of endoneurial segments of rat sciatic nerve resulted in increased cAMP and P0 mRNA levels in normal and regenerated nerves but not in permanently transected nerves, where axonal regeneration is prevented. This increase of cAMP and P0 mRNA occurred within 30 and 90 min, respectively. P0 mRNA levels in the endoneurial segment of the permanently transected nerve were not increased with dibutyryl cAMP. The Schwann cells of the permanently transected nerve, however, retained the ability to myelinate 15 embryonic day (E15) dorsal root ganglia (DRG) neuron and neurite networks cultured in vitro. P0 mRNA levels increased within 4 days in transected endoneurium segments cocultured with E15 DRG neurons and neurites and further increased in 21 day myelinating cocultures. Although cAMP was not detectable in 4 day cocultures, it increased to detectable levels in 21 day cultures, suggesting that cAMP is involved in the myelinating process. These results indicate that the presence of the axon is required for the observed increase of cAMP and P0 mRNA levels and suggest that the increase of cAMP occurs within the axon which then presumably activates a different Schwann cell second messenger pathway to induce P0 gene expression.

Aminoguanidine effects on nerve blood flow, vascular permeability, electrophysiology, and oxygen free radicals

Since advanced glycosylation end products have been suggested to mediate hyperglycemia-induced microvascular atherogenesis and because aminoguanidine (AG) prevents their generation, we examined whether AG could prevent or ameliorate the physiologic and biochemical indices of streptozotocin (STZ)-induced experimental diabetic neuropathy. Four groups of adult Sprague-Dawley rats were studied: group I received STZ plus AG (25 mg.kg-1.day-1), group II received STZ plus AG (50 mg.kg-1.day-1), group III received STZ alone, and group IV was a control. We monitored conduction and action potential amplitudes serially in sciatic-tibial and caudal nerves, nerve blood flow, oxygen free radical activity (conjugated dienes and hydroperoxides), and the product of the permeability coefficient and surface area to 125I-labeled albumin. STZ-induced diabetes (group III) caused a 57% reduction in nerve blood flow and in abnormal nerve conduction and amplitudes and a 60% increase in conjugated dienes. Nerve blood flow was normalized by 8 weeks with AG (groups I and II) and conduction was significantly improved, in a dose-dependent manner, by 16 and 24 weeks in sciatic-tibial and caudal nerves, respectively. The permeability coefficient was not impaired, suggesting a normal blood-nerve barrier function for albumin, and the oxygen free-radical indices were not ameliorated by AG. We suggest that AG reverses nerve ischemia and more gradually improves their electrophysiology by an action on nerve microvessels. AG may have potential in the treatment of diabetic neuropathy.

Levels of proteolipid protein mRNAs in peripheral nerve are not under stringent axonal control

The proteolipid protein (PLP) is the major protein in the myelin sheath of the CNS. It was recently reported that PLP coding transcripts are also found in the PNS, although the protein was not detectable in peripheral nerve myelin. In the present investigation, levels of mRNA for PLP in sciatic nerve were studied during development and following transection and crush injury. Results were compared to those for P0, the major PNS myelin protein, and the myelin-associated glycoprotein (MAG). PLP transcript levels were very low at 21 days in sciatic nerve and remained unchanged in the adult sciatic nerve. This contrasts markedly with P0 and MAG mRNAs, which are expressed at high levels during development and decrease in content significantly by adulthood. The level of PLP messages was reduced approximately 40% in the quiescent Schwann cells in the distal segment of the sciatic nerve at 21 days after permanent transection, yet P0 mRNA levels were very low, and MAG mRNAs were undetectable in this tissue. The distal segment of the crush-injured sciatic nerve is characterized by transient demyelination followed by rapid myelination. PLP mRNA levels remained comparatively unaffected in the 3-week period following crush injury. RNase protection experiments using two antisense riboprobes confirmed that levels of PLP-derived protected fragments, corresponding to PLP and DM-20 messages, remained unchanged in the developing and adult sciatic nerve. These results indicate that myelin-specific P0 and MAG genes are tightly controlled at the level of transcription through Schwann cell-axonal interactions, whereas PLP transcription in the peripheral nerve remains nearly dissociated from axonal influences.

Polyglucosan body axonal enlargement increases myelin spiral length but not lamellar number

The area of the unrolled myelin sheet of internodes of myelinated fibers (MF) of peripheral nerve is thought to be determined by axonal caliber and internodal length. We studied the effect of a focal increase of axonal caliber due to the deposition of polyglucosan bodies (PGB), amylopectin-like glucose polymers, on number of myelin lamellae (NL), interlamellar distance (periodicity), and myelin spiral length (MSL) from a sural nerve biopsy specimen of a patient with chronic inflammatory demyelinating polyneuropathy. Axonal area, NL, periodicity, and MSL were estimated within internodes of MF above, at, and below PGB. The axon caliber at the level of the PGB was significantly (P less than 0.002) increased when the PGB was included. At the PGB, NL and their periodicity were not significantly different from those above or below the PGB. The MSL was significantly longer overlying the PGB than it was in the same internode above or below the PGB. Because slippage or stretching of the myelin sheath as well as movement of molecular constituents of myelin is not likely over large distances, localized biosynthesis and assembly of new myelin may explain this increase of MSL.

Axonal modulation of myelin gene expression in the peripheral nerve

Myelin gene expression (P0, MBP, P2, and MAG) was investigated during Wallerian degeneration and in the presence or absence of subsequent axonal regeneration and remyelination. The steady state levels of mRNA and protein were assessed in the crushed or permanently transected rat sciatic nerve at 0, 1, 4, 7, 10, 12, 14, 21, and 35 days after injury. The mRNA and protein steady state levels of the myelin specific genes, P0 and the MBPs, decreased to low yet detectable levels during Wallerian degeneration and returned to normal levels with subsequent axonal regeneration. The steady state level of P2 protein also followed a similar pattern of expression. The steady state level of MAG mRNA decreased to undetectable levels by 4 days of injury in the permanently transected nerve. After crush injury, re-expression of MAG to levels comparable to those of normal nerves preceded that of P2 by 2 days and that of P0 and the MBPs by 3 weeks during axonal regeneration and remyelination. These results support the proposed roles for MAG in the formation of initial Schwann cell-axonal contact required for myelin assembly, for P2 in fatty acid transport during myelination, and for P0 and the MBPs in the maintenance of the integrity and compactness of the myelin sheath. In addition, these results indicate that the expression of the myelin specific genes, P0 and MBP, is constitutive and that the level of myelin specific mRNAs is modulated by axonal contact and myelin assembly.

Developmental changes in blood-nerve transfer of albumin and endoneurial albumin content in rat sciatic nerve

The rate of entry of albumin into the endoneurial space and its content within that compartment during development were investigated by measuring the permeability coefficient-surface area product to 125I-albumin (PSA) of the blood-nerve interface (BNI), endoneurial residual plasma volume (Vp), blood-nerve interface index to albumin, and endoneurial water content in sciatic nerves of rats ranging in age from 1 to 24 weeks. There was a 30-fold reduction in PSA and a 4-fold decrease in Vp from 2 to 24 weeks, indicating that the endoneurial capillaries and perineurium become less permeable during development. On the other hand, the Alb-BNI index was relatively small at 1 week, increased to a peak value around 6-8 weeks, and then decreased to adult values by 13 weeks. The smaller Alb-BNI index in the neonatal period is consistent with endoneurial albumin being cleared across a permeable perineurium by epineurial lymphatics. Subsequently, as the perineurium becomes less permeable, endoneurial albumin content increases. It then decreases as the endoneurial capillary permeability also decreases. Additionally, metabolic clearance of albumin, especially during the first 2-3 weeks, by axons and glia to meet the nutritive requirements of rapid axonal growth and myelination could be partly responsible for a lower Alb-BNI index. It is suggested that in the developing nerve, the combination of epineurial lymphatics and a relatively permeable perineurium, together with axonal and glial uptake and protein catabolism aid in the clearance of plasma-derived osmolytes from the endoneurial space, and thus prevent the elevation of endoneurial hydrostatic pressure and onset of oedema that would have been seen in an adult nerve with a comparably permeable BNI.

Sulfate incorporation into peripheral nerve endoneurial glycolipids after crush and permanent transection injury

The sulfation of peripheral nerve glycolipids was examined at 35 days after both crush injury or permanent transection of the adult rat sciatic nerve by in vitro incorporation of [35S]sulfate into endoneurial slices. These experimental models of neuropathy are characterized by the presence and absence of both axonal regeneration and subsequent myelin assembly. Although the sulfo-glucuronosyl glycosphingolipids (SGGLs) were not detected by alpha-napthol reagent after HPTLC separation of the total acidic lipid extract, fluorographic analysis after sulfate incorporation revealed a 4.7-fold increase in [35S]sulfate in the sulfo-glucuronosyl paragloboside (SGPG) and a 3.5-fold increase in the sulfo-glucuronosyl-lactosaminosyl paragloboside (SGLPG) after the crush injury compared to permanent transection. These [35S]sulfate-labeled lipids were identified by comigration after HPTLC separation by immunostaining with specific IgM monoclonal antibodies from a patient with demyelinating neuropathy and plasma cell dyscrasia. Enhanced incorporation of sulfate in the crushed nerves was also observed in the sulfatides and in several unknown lipids migrating between GM2 and GM3, between GM1, and GM2, slightly above the origin, and at the origin. Since previous studies (Yao and Poduslo: J Neurochem 50:630-638, 1988) have shown [35S]sulfate incorporation, but not [3H]Gal or [3H]Glc, into sulfatides at 35 days after transection, it is possible that the sulfation observed in the present studies does not represent de novo biosynthesis but rather sulfation of an endogenous pool of glycolipids that results from the nerve injury.(ABSTRACT TRUNCATED AT 250 WORDS)

Role of axons in the regulation of P0 biosynthesis by Schwann cells

The role of axons in the expression of the major myelin glycoprotein, P0, has been investigated using neuron/Schwann cell cultures. These cultures were either nonmyelinating or myelinating due to growth in defined medium or in medium containing serum and chick embryo extract, respectively. The neurons and Schwann cells used in the studies were derived from embryonic day 15 rat dorsal root ganglia (DRG), and the Schwann cells from these ganglia are shown not to synthesize appreciable levels of P0 prior to growth in culture. Myelinating cultures of Schwann cells and neurons grown together for 18-21 days synthesize P0 that is readily identified by immunoblotting. The nonmyelinating cultures, which do not assemble basal lamina, also synthesize P0 that is detectable by either [3H]mannose precursor incorporation or by immunoblotting. The steady-state level of P0 in the nonmyelinating cultures is less than that of the myelinating cultures, and the P0 that is synthesized by the former appears to be catabolized shortly after its biosynthesis. Since nonmyelinating Schwann cells synthesize P0 when in contact with neurites in vitro, we have examined the ability of such nonmyelinating cells to express the glycoprotein in vivo. Very little steady-state P0 is detected in immunoblots of the adult rat cervical sympathetic trunk (CST), a nerve in which approximately 99% of the axons are nonmyelinated. Similarly, the amounts of [3H]mannose and [3H]amino acids that are incorporated into newly synthesized P0 are much lower in the CST than in the adult sciatic nerve.(ABSTRACT TRUNCATED AT 250 WORDS)

Physiological changes in the sciatic nerve endoneurium of lead-intoxicated rats: a model of endoneurial homeostasis

The effects of inorganic lead (Pb) on peripheral nerves were studied by measuring the permeability coefficient-surface area product to albumin (PSA) of the blood-nerve interface (BNI), water and Pb content of endoneurium, and residual endoneurial plasma volume (Vp) of sciatic nerves of adult rats maintained on a 4% Pb diet for 2-12 weeks. Additionally, body weight, haematocrit, and blood Pb levels were also monitored. Within 1 week, both blood and endoneurial Pb levels had increased significantly above background levels and continued to increase up to the 6th week. Thereafter, over the next 6 weeks, the blood Pb levels were relatively stable, while the endoneurial Pb levels decreased sharply to a quarter of their peak values. The wet/dry weight ratio of the endoneurium, an indicator of nerve oedema, increased by about 30% from the 4th to 12th week, reaching a water content of 75% corresponding to a 24% increase of the total fascicular area. PSA increased only by the 8th week, without an accompanying increase in Vp. This suggests that the increase in PSA reflects an increase in the permeability of the BNI. Furthermore, the moderate 3-fold increase in PSA is more consistent with an adaptive response of the BNI to changes in the endoneurial microenvironment rather than a massive breakdown or disruption of the BNI. This is supported by the inconsistent or mild leakage of horseradish peroxidase from endoneurial capillaries observed in Pb-intoxicated rats.(ABSTRACT TRUNCATED AT 250 WORDS)

Golgi sulfation of the oligosaccharide chain of P0 occurs in the presence of myelin assembly but not in its absence

To decipher the intracellular targeting mechanism by which the major glycoprotein of peripheral nerve myelin, P0, is delivered to myelin after crush injury, as well as to the lysosome after permanent transection injury of the sciatic nerve--experimental paradigms characterized by the presence and absence of axonal regeneration and subsequent myelin assembly, respectively--the role of sulfation of P0 was investigated. P0 sulfation is shown to occur within the Golgi apparatus as a post-translational modification of the oligosaccharide chain which is dependent on processing beyond the action of mannosidase I. It is associated with myelination as observed during development and after crush injury, but does not occur after transection injury, even in the presence of the mannosidase II inhibitor, swainsonine, or the lysosomotrophic agent, L-methionine methyl ester. Although P0 accumulation can be demonstrated with both agents when other precursors are used (e.g. fucose, mannose, amino acids) and indicates lysosomal targeting and delivery of P0 after the action of GlcNAc transferase I, the absence of P0 sulfation after transection suggests that the lack of this modification may result in a default mechanism for lysosomal targeting after nerve transection. Lysosomal degradation of P0 was evaluated after crush injury by pulse-chase analyses with 35SO4 and [3H] mannose in the presence and absence of chlorate, an inhibitor of ATP-sulfarylase. Although P0 sulfation of the oligosaccharide chain is a stable modification whose labeling is dramatically inhibited by chlorate, no decrease in mannose-labeled P0 was seen with chlorate even with prolonged chase times. Because of this lack of degradation of mannose-labeled P0 in the presence of chlorate in the crushed nerve, it is concluded that the absence of P0 sulfation does not result in a default mechanism for lysosomal delivery.

Axonal regulation of Schwann cell glycolipid biosynthesis

Schwann cell biosynthesis of glycolipids was studied by in vitro incorporation of [3H]galactose into neonatal rat sciatic nerves before and after endoneurial explant culture and in culture of purified Schwann cells. In neonatal nerves prior to culture, [3H]galactose was actively incorporated into galactocerebrosides (GalCe), monogalactosyl diacylglycerol (MGDG), and the sulfatides (Su). In contrast, the incorporation of [3H]galactose into MGDG, GalCe, and Su was nearly undetected in endoneurial explants after 4 days in vitro (div). Instead, there was increased 3H-labeling of glucocerebrosides (GlcCe) and its homologues, with tetrahexosylceramides (GL-4) being a major product, which continued through 8 div. This shift in glycolipid biosynthesis was further demonstrated in the purified Schwann cell cultures. These observations, together with our early findings in the permanent transection paradigm support a direct role of axons in specifying Schwann cell biosynthesis of the GalCe, MGDG, and Su and that the absence of this Schwann cell-axon interaction results in the phenotypic expression of glucocerebroside homologues by the Schwann cell.

Regulation of apolipoprotein E gene expression after injury of the rat sciatic nerve

The expression of apolipoprotein E (apo E) is dramatically increased following peripheral nerve injury. This increased expression has been postulated to be negatively influenced by unknown mechanisms during subsequent axonal regeneration (Muller et al.: Science 228:499-501, 1985). The present study investigates the role of the regenerating axon in regulating apo E gene expression in two experimental paradigms which permit or prevent axonal regeneration in the adult rat sciatic nerve--the crush or permanent transection injuries. The nerves in these two models undergo axonal degeneration, demyelination, and Schwann cell proliferation; however, subsequent axonal regeneration and remyelination occur only in the distal segment of the crush-injured and not in the permanently transected nerve. The steady-state levels of apo E mRNA in both models increase sharply between 1 and 4 days and reach a maximum level at 12-14 days, which did not change significantly between 14 and 35 days after injury. No significant difference is observed in the steady-state levels of apo E mRNA between the crushed and permanently transected nerves as a function of time after injury. The steady-state protein level of apo E in the endoneurial segments initially increases, peaks at 14-21 days, and then decreases between 35 and 60 days after injury in both models. In contrast, the rate of newly translated and secreted apo E significantly increases by fourfold (P less than 0.005) between 35 and 60 days after permanent transection whereas it does not significantly differ at these times after crush injury. The increased rate of translation and secretion of apo E after transection compared to the constant rate observed after crush injury, together with the comparable steady-state levels of apo E mRNA and protein in both models, suggests translational or post-translational control, but not transcriptional and/or posttranscriptional control, by the regenerating axons. Furthermore, the increasing rate of biosynthesis and secretion of apo E after permanent transection concomitant with the decreasing steady-state levels of the protein suggests that apo E is either removed from the endoneurium or subsequently utilized or degraded by mechanisms that are independent from nerve regeneration.

Catabolic regulation of the expression of the major myelin glycoprotein by Schwann cells in culture

Previous studies have suggested that neonatal Schwann cell cultures deprived of axonal contact do not express components of the myelin membrane, including the major myelin glycoprotein, P0. In contrast, Schwann cells from permanently transected, adult nerve exhibit continued biosynthesis of P0 after culture, suggesting that the ability to express the myelin glycoprotein may depend on the degree of cellular differentiation. To examine further the ability of Schwann cell cultures to express P0 as a function of age, we have performed precursor incorporation studies on endoneurial explants from 4- to 12-day-old rat sciatic nerves after 5 days in culture. The data reveal that explants from 12-day-old animals synthesize detectable levels of this integral myelin protein when assayed by [3H]mannose incorporation, even though there is no apparent myelin assembly in the cultures. Pulse-chase analysis of cultures from 12-day-old rats demonstrates that [3H]mannose-labeled P0 is substantially degraded within 3 h. This catabolism largely can be prevented by the addition of swainsonine, ammonium chloride, or L-methionine methyl ester to the pulse-chase media. The former agent alters oligosaccharide processing whereas the latter two compounds inhibit lysosomal function. The P0 synthesized by the 12-day explant cultures following the addition of swainsonine is readily fucosylated, implying that the protein has progressed at least as far as the medial Golgi before its exit and subsequent catabolism. If cultures from 4-, 6-, and 8-day-old animals are analyzed for P0 biosynthesis by [3H]mannose incorporation in the presence of swainsonine, detectable levels of the glycoprotein are seen.(ABSTRACT TRUNCATED AT 250 WORDS)

Myelin-associated glycoprotein gene expression in the presence and absence of Schwann cell-axonal contact

The distal segments of the crush-injured and permanently transected sciatic nerve provide models to study Schwann cell activity in the presence and absence of Schwann cell-axonal contact, respectively. We examined the quantity and quality of transcript coding for the myelin-associated glycoprotein (MAG) over a 3-week period following crush injury and at 35 days after transection to investigate possible regulation of this gene during nerve injury and subsequent repair. Northern blot and slot blot analysis indicated a sharp decrease in levels of MAG mRNA 2 days after crush injury which was followed by a progressive increase in levels of message between 7 and 21 days after injury. Western blot analysis showed that levels of MAG protein decreased substantially 7 days after crush injury, which returned to 70% of the adult value by 21 days after injury. MAG mRNA and protein were undetectable by Northern and Western analysis, respectively, in the distal segment of the sciatic nerve 35 days after permanent transection. This infers distinct down-regulation of MAG gene expression after permanent transection of a peripheral nerve. These comparative studies of MAG transcripts and encoded protein may indicate regulation of MAG gene expression at the level of transcription, and possibly at the level of post-transcription in these experimental models of peripheral neuropathies.

Blood-nerve transfer of albumin and its implications for the endoneurial microenvironment

Blood-nerve transfer of plasma albumin was studied by measuring the permeability coefficient-surface area (PS) product of the blood-nerve barrier (BNB) to 125I-albumin in rat sciatic nerve using the i.v. bolus injection method. The calculated PS was 6.3 +/- 0.5 (S.E.M.) x 10(-7) ml.g-1.s-1. This value is smaller by more than an order of magnitude of that measured for sucrose and confirms the relative impermeance of the BNB to blood-borne solutes. From a review of the available evidence, it is concluded that normal blood-nerve exchange occurs predominantly across the endoneurial microvasculature, and the PS of the BNB reflects the permeability of capillaries to a greater extent than that of the perineurium. The only capillaries found to be less permeable than these are the cerebral capillaries. Proximo-distal differences (sciatic vs tibial) of the PS could not be detected. Blood-nerve albumin transfer was calculated at 1.2 mg.g-1.day-1, and the daily turnover of endoneurial albumin to be about 30%. It is postulated that small increases in PS of BNB to albumin lead to an elevation of endoneurial albumin concentration and, through the operation of Starling forces, subsequently produce endoneurial oedema. A major question posed by the results of this study is the identity of pathways for clearance of albumin and other macromolecules from the endoneurium.

Regulation of UDP-galactose:ceramide galactosyltransferase and UDP-glucose:ceramide glucosyltransferase after crush and transection nerve injury

The enzyme activities of ceramide galactosyltransferase and ceramide glucosyltransferase were assayed as a function of time (0, 1, 2, 4, 7, 14, 21, 28, and 35 days) after crush injury or permanent transection of the adult rat sciatic nerve. These experimental models of neuropathy are characterized by the presence and absence of axonal regeneration and subsequent myelin assembly. Within the first 4 days after both injuries, a 50% reduction of ceramide galactosyltransferase-specific activity was observed compared to values found in the normal adult nerve. This activity remained unchanged at 7 days after injury; however, by 14 days the ceramide galactosyltransferase activity diverged in the two models. The activity increased in the crushed nerve and reached control values by 21 days, whereas a further decrease was observed in the transected nerve such that the activity was nearly immeasurable by 35 days. In contrast, the ceramide glucosyltransferase activity showed a rapid increase between 1 and 4 days, followed by a plateau that was 3.4-fold greater than that in the normal adult nerve, which persisted throughout the observation period in both the crush and transection models. [3H]Galactose precursor incorporation studies at 7, 14, 21, and 35 days after injury confirmed the previously observed shift in biosynthesis from the galactocerebrosides during myelin assembly in the crush model to the glucocerebrosides and oligohexosylceramide homologues in the absence of myelin assembly in the transection model. The transected nerves were characterized by a peak of biosynthesis of the glucocerebrosides at 14 days. Of particular interest is the biosynthesis of the glucocerebrosides and the oligohexosylceramides at 7 and 14 days after crush injury.(ABSTRACT TRUNCATED AT 250 WORDS)

Nerve glucose, fructose, sorbitol, myo-inositol, and fiber degeneration and regeneration in diabetic neuropathy

We measured the alcohol sugars in sural nerves from 11 controls, 21 conventionally treated patients with diabetes and neuropathy, and 4 diabetics without neuropathy. The results were related to metabolic control and to clinical, neuropathological, and morphometric abnormalities in the nerves. The mean endoneurial glucose, fructose, and sorbitol values were higher in diabetic patients than in controls. Linear regression analysis revealed that nerve sorbitol content in the diabetics was inversely related to the number of myelinated fibers (P = 0.003). Mean nerve levels of myo-inositol were not decreased in the diabetic patients, with or without neuropathy, and were not associated with any of the neuropathological end points of diabetes. Our results indicate that myo-inositol deficiency is not part of the pathogenesis of human diabetic neuropathy, as had been hypothesized. Other accumulated alcohol sugars, however, were increased in diabetes and were associated with the severity of neuropathy. On repeat biopsy, six diabetics, treated for a year with the aldose reductase inhibitor sorbinil, had decreased endoneurial levels of sorbitol (P less than 0.01) and fructose (0.05 less than P less than 0.1), but unchanged levels of myo-inositol.

Temporal changes in PO and MBP gene expression after crush-injury of the adult peripheral nerve

The crush-injured sciatic nerve provides a model to study Schwann cell regulation of myelin gene expression during the process of demyelination and remyelination. In order to investigate the possible transcriptional regulation of myelin gene expression, the quantity, quality and translational efficiency of PO (the major myelin glycoprotein) and MBP (the myelin basic proteins) coding messages were investigated as a function of time following crush-injury of the adult rat sciatic nerve. Northern blot analysis indicated that the size of the PO and MBP transcripts remain unchanged in the distal segments of crushed sciatic nerves at 1, 2, 4, 7, 10, 14 and 21 days after crush-injury. Dot-blot analysis showed a sharp drop in levels of PO and MBP coding transcripts 1 day after crush-injury with the lowest steady-state levels at 4-7 days. Message levels were found to increase after 7 days, the highest increase in levels of message was found to be between 10 and 14 days. The highest steady-state level of both transcripts was observed at 21 days. In vitro translation and immunoprecipitation of PO-translated products from various stages of crush-injury also indicated this trend. The pattern of gene expression of PO- and MBP-coding transcripts parallel each other and follow the pattern of demyelination and remyelination. The results are also consistent with our previous interpretation which suggests that PO and MBP gene expression is regulated at the level of transcription and that these two genes might be coordinately expressed. Western blot analysis of PO protein from these stages revealed a similar decrease and then increase in the levels of the protein.(ABSTRACT TRUNCATED AT 250 WORDS)

Increase in albumin, IgG, and IgM blood-nerve barrier indices in human diabetic neuropathy

The albumin (Alb), IgG, and IgM concentrations in the endoneurium of fascicular sural nerve biopsy samples were evaluated in controls (n = 9 or 10), diabetic patients without neuropathy (n = 6), and diabetic patients with polyneuropathy (n = 17 or 18). These values were significantly increased in diabetic patients with and without neuropathy when expressed both per endoneurial dry weight or endoneurial total protein compared to biopsy samples from healthy controls. When these concentrations, expressed per endoneurial total protein, were related to plasma concentrations similarly expressed, the resulting blood-nerve barrier (BNB) indices were significantly increased for Alb (6.1 times; P less than 0.00001), IgG (4.9 times; P = 0.00037), and IgM (2.7 times; P = 0.015). The diabetic patients without neuropathy (defined as having an index of pathology of greater than 0.65; a measure of the severity of the pathological abnormality based on morphological criteria) also had significant increases in two of these BNB indices that were intermediate between the diabetic neuropathy patients and controls (Alb, 3.9 times controls; P = 0.00002: IgG, 4.6 times controls; P = 0.00016: IgM, 1.8 times controls; not significant). No correlations were observed between the endoneurial concentrations of these plasma proteins or the BNB indices and the index of pathology, suggesting that these increases in endoneurial plasma proteins precede the pathologic alterations. The increased values for the diabetics in the absence of pathological abnormalities may prove useful in predicting neuropathic complications. The ratio of the IgG-BNB index to the Alb-BNB index was decreased 19%, and the ratio of the IgM-BNB index to the Alb-BNB index was decreased 56% in diabetic neuropathy patients compared to controls. Although the IgG and IgM concentrations are increased in the diabetic endoneurium, the Alb increase is greater and a mechanism other than size indiscriminate extravasation of plasma proteins, therefore, is suggested. Morphometric assessment of the endoneurial compartments, which would be expected to contain these plasma proteins, suggests that they are not altered in diabetic neuropathy; hence, it is hypothesized that the observed increase in endoneurial concentration of these plasma proteins results from altered transport through the endothelial or perineurial barrier, which supports an underlying vascular mechanism in the development of diabetic polyneuropathy.

IgM/IgG solid-phase antibody-capture assay with biotin/125I-streptavidin amplification: application to normal human sural nerve biopsies

A highly sensitive and specific solid-phase antibody-capture assay was developed to measure IgM and IgG in endoneurial preparations of human sural nerve biopsies. Assay amplification was obtained by utilizing biotin-labeled anti-IgM or anti-IgG antibody and 125I-streptavidin, resulting in multiple streptavidin molecules binding per biotinylated antibody molecule. A minimal detectable dose of 0.16 +/- 0.08 ng (mean +/- SD; n = 7) for IgM and 0.03 +/- 0.02 ng (mean +/- SD; n = 5) for IgG was obtained in a 100 microliters sample. When this assay was applied to normal fascicular biopsies from human sural nerve, the percent of IgM and IgG, respectively, of the total endoneurial protein was 0.026 +/- 0.015% (n = 9) and 0.27 +/- 0.15% (n = 10; mean +/- SD). When these endoneurial concentrations of IgM and IgG were related to the plasma concentrations (mg IgM or IgG/mg total plasma protein), an IgM-blood-nerve barrier (BNB) index of 4.09 +/- 1.95 and an IgG-BNB index of 2.07 +/- 1.10 were obtained (X10(2); mean +/- SD). These values were also related to the albumin (Alb) concentration in the biopsies as a percent of total endoneurial protein (2.48 +/- 1.07%; mean +/- SD) and with the Alb-BNB index (5.40 +/- 2.53; X10(2); mean +/- SD; n = 10). Although these normal values will be expected to change with age, sex, nerve, and proximal-distal distance from nerve root, they should provide a basis for the comparison of BNB indices from patients with peripheral neuropathy.