Brain grafts and Parkinson's disease

Orexin supplementation in narcolepsy treatment: A review

Narcolepsy is a rare, chronic neurological disease characterized by excessive daytime sleepiness, cataplexy, vivid hallucinations, and sleep paralysis. Narcolepsy occurs in approximately 1 of 3000 people, affecting mainly adolescents aged 15 to 30 years. Recently, people with narcolepsy were shown to exhibit extensive orexin/hypocretin neuronal loss. The orexin system regulates sleep/wake control via complex interactions with monoaminergic, cholinergic and GABA-ergic neuronal systems. Currently, no cure for narcolepsy exists, but some symptoms can be controlled with medication (eg, stimulants, antidepressants, etc). Orexin supplementation represents a more sophisticated way to treat narcolepsy because it addresses the underlying cause of the disease and not just the symptoms. Research on orexin supplementation in the treatment of sleep disorders has strongly increased over the past two decades. This review focuses on a brief description of narcolepsy, the mechanisms by which the orexin system regulates sleep/wake cycles, and finally, possible therapeutic options based on orexin supplementation in animal models and patients with narcolepsy.

Short-Term Immunosuppression Enhances Long-Term Survival of Bovine Chromaffin Cell Xenografts in Rat Cns

Xenogeneic donors, a largely untapped resource, would solve many of the problems associated with the limited availability of human donor tissue for neural transplantation. Previous work in our laboratory has revealed that xenografts of isolated bovine chromaffin cells survive transplantation into the periaqueductal gray (PAG) of immunosuppressed adult rats. Electron microscopic analysis reveals that graft sites contain healthy chromaffin cells, but do not contain host immune cells typical of graft rejection.

The aim of the current study was to assess the necessary conditions for long-term survival of bovine chromaffin cell xenografts in the central nervous system (CNS). In particular, the need for short-course vs. permanent immunosuppressive therapy with cyclosporine A (CsA) for the long-term survival of grafted bovine chromaffin cells was addressed. Grafts from animals receiving continuous CsA treatment for either 3, 6, or 12 wk contained large clumps of dopamines-β-hydroxylase (DBH) positive cells in contrast to the few surviving cells observed in nonimmunosuppressed animals. In addition, grafts from animals that had CsA treatment terminated at 3 or 6 wk contained similarly large clumps of DBH-positive cells. Furthermore, short-term immunosuppression (3 wk) appeared to enhance the long-term survival of grafted cells, since clumps of DBH staining cells could still be positively identified in the host PAG at least 1 yr after transplantation.

Complete rejection of graft tissue depends on several factors, such as blood–brain barrier integrity, the presence of major histocompatability complex (MHC) antigens in either the host or graft, and the status of the host immune system. By using a suspension of isolated bovine chromaffin cells, potential MHC antigen presenting cells, such as endothelial cells, are eliminated. In addition, CsA treatment may negate the immunologic consequences of increased blood–brain barrier permeability following surgical trauma by attenuating the host cell mediated response. In summary, long-term survival of isolated chromaffin cell xenografts in the rat CNS may be attained by a short-term course of CsA.

Transplantation of NGF secreting primary monocytes counteracts NMDA-induced cell death of rat cholinergic neurons in vivo

Cholinergic neurons of the basal forebrain degenerate in Alzheimer's disease. Nerve growth factor (NGF) is so far the most potent molecule to counteract this neurodegeneration; however, the delivery of NGF into the brain is very difficult. The aim of the present study was to observe, if transplanted primary monocytes secreting NGF may counteract N-methyl-D-aspartate (NMDA)-induced cell death of cholinergic neurons of the basal nucleus of Meynert (nBM) in vivo. Monocytes were purified by indirect magnetic separation from rat blood. Recombinant NGF was introduced into cells using the novel protein-delivery reagent BioPORTERtrade mark and secretion of NGF was measured by ELISA. Monocytes secreted approximately 4000 pg NGF/day/1 x 10(6) cells. Injection of monocytes onto organotypic brain slices of the nBM in vitro protected cholinergic neurons against cell death. When monocytes were transplanted in vivo into the lateral ventricle, the cells survived for up to 7 days and counteracted the NMDA-induced cell death of cholinergic neurons. In conclusion, primary monocytes secreting recombinant NGF are useful to deliver NGF directly into the brain.

Transplantation of hypocretin neurons into the pontine reticular formation: preliminary results

STUDY OBJECTIVES

The sleep disorder narcolepsy is now considered a neurodegenerative disease because there is a massive loss of neurons containing the neuropeptide, hypocretin, and because narcoleptic patients have very low cerebrospinal fluid levels of hypocretin. Transplants of various cell types have been used to induce recovery in a variety of neurodegenerative animal models. In models such as Parkinson disease, cell survival has been shown to be small but satisfactory. Currently, there are no data indicating whether hypocretin neurons can survive when grafted into host tissue. Here we examined the survival of hypocretin-containing neurons grafted into the pontine reticular formation, a region traditionally regarded to be key for rapid eye movement sleep generation.

DESIGN

In 2 experiments, a suspension of cells from the posterior hypothalamus of 8- to 10-day old rat pups was injected into the pons (midline, at the level of the locus coeruleus) of adult rats. Control rats received cells from the cerebellum, tissue that is devoid of hypocretin neurons. In the first experiment (n = 33), the adult rats were sacrificed 1, 3, 6, 12, 24, or 36 days after transplant, and cryostat-cut coronal sections of the brainstem were examined for presence of hypocretin-immunoreactive neurons. In the second experiment (n = 9), the transplant medium was modified to include agents that stimulate cell growth, and recipient rats were sacrificed 9, 12, and 36 days after receiving the graft.

SETTINGS

Basic neuroscience research laboratory.

MEASUREMENTS AND RESULTS

In the first experiment, clearly defined hypocretin-immunoreactive containing somata and varicosities were visible in pons of rats sacrificed 1 day after grafting of posterior hypothalamic cells but not in rats receiving cerebellum tissue. The hypocretin-immunoreactive somata were not visible in rats sacrificed at 12, 24, or 36 days, indicating that the neurons had died. However, in the second experiment, where enriched transplant medium was used, clearly defined hypocretin-immunoreactive somata with processes and varicosities were present in the graft zone 36 days after implant. These somata were similar in size and appearance to adult rat hypocretin-immunoreactive neurons.

CONCLUSIONS

These results indicate that hypocretin neurons obtained from rat pups can be grafted into a host brain, and efforts should be made to increase survival of these neurons.

Combined mesencephalic and hypothalamic transplants reverse lesion-induced sexual behavior deficits in the male rat

Studies of sexual behavior in rodent animal models have provided evidence about the relevant role played by the medial preoptic area of the anterior hypothalamus and the central tegmental field within the mesencephalon in the control of this behavior. Bilateral lesions of the anterior hypothalamus or central tegmental field as well as combined unilateral lesions of both these regions result in sexual behavior deficits. Studies using fetal hypothalamic transplants have been shown to reverse sexual behavior deficits induced either by lesions or aging. However, no previous study has evaluated the effect of combined homotopic transplants into both the anterior hypothalamus and the mesencephalon. In the present study male Wistar animals received two electrolytic lesions, one aimed at the ipsilateral medial preoptic area of the anterior hypothalamus and the other at the contralateral central tegmental field. Following these lesions, unilateral homotopic fetal hypothalamic and mesencephalic transplants were placed into the lesioned areas. Sexual behavior recovered gradually and by weeks 14-15 after transplantation, above 90% of animals with bilateral transplants showed mounts, intromissions, and ejaculations. Only animals with viable transplants located within both lesioned areas showed recovery. These results indicate that the behavioral deficits induced by combined unilateral lesions of hypothalamic and mesencephalic regions can be reversed by homotopic fetal transplants and that this recovery could be the result of the restoration of a behavioral relevant circuit between transplants and host brain nuclei separated by as much as 5 mm, which makes this an excellent model to study mechanisms underlying behavioral recovery after transplantation.

Xenotransplantation of microencapsulated bovine chromaffin cells into hemiparkinsonian monkeys

This study examines the effects of xenografts of microencapsulated bovine chromaffin cells (BCCs) on the rotational behavior of hemiparkinsonian monkey recipients. In addition, it determines the content of monoamine neurotransmitters and their major metabolites in the neostriatum in hemiparkinsonian monkeys. The hemiparkinsonian model in monkeys was induced by a unilateral intracarotid injection of methyl-phenyl-tetrahydropyridine (MPTP). Unencapsulated BCCs, BCCs microencapsulated in alginate-polylysine-alginate (ALA) membranes as well as empty microencapsules were grafted into the neostriatum of the hemiparkinsonian monkeys. Following the transplantation the hemiparkinsonian symptoms subsided and the number of rotations induced by apomorphine decreased for up to nine months in the group of recipients grafted with microencapsulated BCCs, while only a temporary improvement (one month) was detected in the recipients of the unencapsulated BCCs. No change was observed in the recipients of empty microencapsules. Dopamine and its metabolites were found considerably depleted in the MPTP-lesioned side versus the unlesioned side of the neostriatum in the hemiparkinsonian monkeys(P<0.05).

Apoptosis in primary cultures of E14 rat ventral mesencephala: time course of dopaminergic cell death and implications for neural transplantation

Transplantation using fetal nigral grafts has been performed by various groups worldwide in over 200 Parkinson's disease (PD) patients in an attempt to restore dopaminergic (DA) input to the striatum. However, the proportion of the implanted DA neurons that survives, whether using suspension, partially dissociated, or solid grafts, is small, often as low as 5 to 10%, which is insufficient to allow a full functional recovery. A significant proportion of the transplanted neurons in animal models of PD has been shown to die via apoptosis, but the reason for this is unclear. Since the methods used to prepare donor tissue for neural transplantation and in vitro culture are identical, we have looked at the time course of DA neuron loss following cell suspension preparation using an in vitro assay system and considered whether the procedures used may, in part, be responsible for the poor DA neuron survival. Primary dissociated cultures of E14 rat ventral mesencephala were incubated for different periods in serum-containing and serum-free media. After fixation, the TUNEL method, as well as ethidium bromide and acridine orange, were used to detect apoptosis, and DA neurons were localized immunocytochemically. Results showed that most apoptosis occurred during the first 24 h and that 50% of the DA neurons were lost in the first 8 h. Double-immunofluorescent labeling confirmed the presence of TUNEL+ve nuclei within DA neurons. There was no difference in either the extent or rate of loss between the serum-containing and serum-free medium during the first 32 h. We suggest, therefore, that existing methods used to prepare cell suspensions probably induce apoptosis and may need to be modified in order to increase the survival of DA neurons.

Analysis of neocortical grafts placed into focal ischemic lesions in adult rats

This study investigated the viability of fetal neocortical block grafts transplanted into adult ischemic cortical lesions. Recipient rats sustained focal ischemic lesions by permanent occlusion of the middle cerebral artery 4-7 days prior to transplantation. Twenty days later, the animals were sacrificed and the brains examined using triphenyltetrazolium chloride, routine Nissl or acetylcholinesterase histochemistry. Ischemic infarctions were localized to the ipsilateral sensorimotor cortex and transplants were integrated with the host cerebral cortex or striatum. Cholinergic fibers were found crossing the host-transplant interface, presumably innervating the graft. This study demonstrates that fetal neocortical block grafts placed into adult focal ischemic lesions following permanent arterial occlusion can survive and establish connections with the host brain.