Nerve fibre degeneration of the central and peripheral nervous systems in severe protein deprivation in rats

The Role of Dietary Nutrients in Peripheral Nerve Regeneration

Peripheral nerves are highly susceptible to injuries induced from everyday activities such as falling or work and sport accidents as well as more severe incidents such as car and motorcycle accidents. Many efforts have been made to improve nerve regeneration, but a satisfactory outcome is still unachieved, highlighting the need for easy to apply supportive strategies for stimulating nerve growth and functional recovery. Recent focus has been made on the effect of the consumed diet and its relation to healthy and well-functioning body systems. Normally, a balanced, healthy daily diet should provide our body with all the needed nutritional elements for maintaining correct function. The health of the central and peripheral nervous system is largely dependent on balanced nutrients supply. While already addressed in many reviews with different focus, we comprehensively review here the possible role of different nutrients in maintaining a healthy peripheral nervous system and their possible role in supporting the process of peripheral nerve regeneration. In fact, many dietary supplements have already demonstrated an important role in peripheral nerve development and regeneration; thus, a tailored dietary plan supplied to a patient following nerve injury could play a non-negotiable role in accelerating and promoting the process of nerve regeneration.

Interrelationships of undernutrition and neurotoxicity: food for thought and research attention

The neurotoxic actions of chemical agents on humans and animals are usually studied with little consideration of the subject's nutritional status. States of protein-calorie, vitamin and/or mineral undernutrition are associated with a range of neurodevelopmental, neurological and psychiatric disorders, commonly with involvement of both the central and the peripheral nervous system. Undernutrition can modify risk for certain chemical-induced neurologic diseases, and in some cases undernutrition may be a prerequisite for neurotoxicity to surface. In addition, neurologic disease associated with undernutrition or neurotoxicity may show similarities in clinical and neuropathological expression, especially in the peripheral nervous system. The combined effects of undernutrition and chemical neurotoxicity are most relevant to people with low incomes who experience chronic hunger, parasitism and infectious disease, monotonous diets of plants with neurotoxic potential (notably cassava), environmental pollution from rapid industrial development, chronic alcohol abuse, or prolonged treatment with certain therapeutic drugs. Undernutrition alone or in combination with chemical exposure is also important in high-income societies in the setting of drug and alcohol abuse, old age, food faddism, post-bariatric surgery, and drug treatment for certain medical conditions, including cancer and tuberculosis. The nutritional demands of pregnancy and lactation increase the risk of fetal and infant undernutrition and chemical interactions therewith.

Quantitative and qualitative analysis of Wallerian degeneration using restricted axonal labelling in YFP-H mice

We investigated the usefulness of YFP-H transgenic mice [Neuron 28 (2000) 41] which express yellow fluorescent protein (YFP) in a restricted subset of neurons to study Wallerian degeneration in the PNS. Quantification of YFP positive axons and myelin basic protein (MBP) immunocytochemistry revealed that YFP was randomly distributed to approximately 3% of myelinated motor and sensory fibres. Axotomy-induced Wallerian degeneration appeared as fragmentation of fluorescent signals in individual YFP positive axons with a morphology and timing similar to Wallerian degeneration observed by more traditional methods. In YFP-H transgenic mice co-expressing a high dosage of WldS, a chimeric gene that protects from Wallerian degeneration [Nat Neurosci. 4 (2001) 1199], axonal fragmentation in distal tibial nerves after sciatic nerve axotomy was approximately 10 times delayed. Considerable retardations of Wallerian degeneration using the same transgenic expression system were also observed in cultures of nerve explants, enabling in vitro real-time imaging of axonal fragmentation. Remarkably, single YFP-labelled axons could be traced in peripheral nerves for unusually long distances of up to 2.9 cm exploiting confocal fluorescence imaging. Altogether transgenic YFP-H mice prove to be a valuable tool to study mechanisms of Wallerian degeneration in vivo and in vitro.

Protein energy malnutrition and the nervous system

Protein-energy malnutrition (PEM), a natural ramification of poverty, continues to be a perennial source of concern to a large segment of the world population. The developing nervous system of a child is specially vulnerable to deprivations in nurture. Peripheral nerve and muscle derangements are clinically evident by weakness, hypotonia and hyporeflexia in accordance with severity and duration of PEM. Motor and sensory nerve conduction studies exhibit significant abnormalities and often furnish useful and ominous correlation with grades of PEM. The human sural nerve histology in cases of severe PEM is characterized by persistence of small myelinated fibres, striking failure of internodal elongation and significant segmental demyelination. Young rhesus monkeys are ideal experimental PEM models and they show myopathic EMG changes amenable to rehabilitation. Muscle pathology comprises obliteration of cross-striations, streaming of Z bands, increased interfibrillary spaces, mitochondriomegaly and small-for-age fibres. Radioisotope assays reveal anomalous incorporation into various nerve and muscle constituents. Central nervous system, specially the neuropsychological functions are affected in a lasting manner. Learning deficits, behavioural problems and manual indexterity are most obtrusive features.

Can protein-calorie malnutrition cause dysphagia?

Nutrient deprivation has previously been shown to cause alterations in muscle and nerve function. Although an effect has never been studied in the neuromusculature of deglutition, the authors argue that an effect is likely. The proposed result is an increase in swallowing impairment in dysphagic individuals and associated risk of aspiration. Research studying the relationship between malnutrition and dysphagia is needed to verify clinical significance. Until controlled studies are completed, the authors suggest alternative alimentation in repleting severely malnourished dysphagic patients prior to attempting oral diet. A review of nutritional status indices is included to aid in identifying dysphagic patients at nutritional risk. Early identification of nutritional compromise and intervention can prevent malnutrition and its deleterious effects.

A freeze-fracture study of the perineurium in normal and protein-deprived rats

Observations have been made using the freeze-fracture replication technique on the perineurium of normal and protein-deprived rats in which its permeability barrier function is known to be deficient. The perineurial cells of young normal rats possessed belt-like tight junctions (zonulae occludentes) at the borders and maculae occludentes at sites remote from their borders. In older rats, the zonulae occludentes were more prominent and the maculae occludentes relatively less frequent. No abnormalities were detected in the tight junctions of young rats with early induction of protein deficiency but this may have been related to sampling problems. In older severely protein-deficient animals, although many of the tight junctions were normal, some were abnormal and contained focal regions of dispersed strands. The density of caveolae in the surface membrane of the perineurial cells of older rats with severe protein deficiency was significantly greater than in the control animals. This provides support for the view that the pinocytotic-like vesicles of perineurial cells are involved in transport of substances across the cells. The increased numbers of caveolae in the protein deficient rats may reflect increased transcellular traffic. There were considerable differences in the density of P-face IMPs between the different perineurial lamellae, but the results did not allow a decision to be made as to whether there was a polarization of the cells between their endoneurial and epineurial aspects. No differences were detected in the density of P-face IMPs between the young control and protein-deprived rats. In the perineurium of the older rats with protein deficiency, IMP density was significantly greater in the E face than in the controls but not different in the P face. The delay in the development of enzymatic activity in the perineurium of protein-deficient rats that has been demonstrated histochemically is therefore not paralleled by a reduction in IMPs.

Functional development of the visual system in normal and protein-deprived rats. VI. Evoked responses in adult rats, protein deprived in early life and nutritionally rehabilitated from weaning

Previous studies have shown an increase in latency of the visual evoked response (VER) recorded from the cortical surface of adult rats subjected to protein deprivation (PD) during pre- and postnatal development. This alteration has been shown to originate mainly from the cortex itself. In the present study the possibility of normalizing such VER alterations by nutritional rehabilitation after early protein deprivation (R-PD) was investigated. Male rats were subjected to pre- and early postnatal protein deprivation through their mothers. Nutritional rehabilitation was started from weaning. The rats gained weight rapidly compared with rats subjected to protein deprivation throughout postnatal development but never reached the weight of controls (C) of the same age. Food consumption in relation to body weight was similar to that of controls. Rehabilitation continued until adult age when neurophysiological experiments were performed. The VER recordings from the dorsal lateral geniculate nucleus (dLGN) showed latencies similar to those reported previously for adult C and PD rats. The latencies of onset and first peaks of the cortical response recorded from the surface were increased by 5-6 ms in R-PD compared with C rats and hence similar to the latencies of adult PD rats. Intracortical responses to electrical stimulation in the dLGN were also similar to those of adult PD rats showing an normal onset latency but an increased latency of the peaks of the monosynaptic and late responses compared with C rats. The present results imply that the increased VER latencies noted in adult PD and R-PD rats are due to changes installed by protein deprivation during early development since they can not be reversed by nutritional rehabilitation starting at weaning.

Experimental clioquinol intoxication in rats: abnormalities in optic nerves and small nerve cells of dorsal root ganglia

Pathological abnormalities in the central (CNS) and peripheral nervous system (PNS) were produced in rats by daily administration of 300-400 mg/kg clioquinol for 7-40 days. The changes comprised axonal degeneration of optic nerve fibers and mitochondrial swellings in small nerve cells of dorsal root ganglia. There were occasional myelin splittings in the spinal nerve roots. No apparent changes were observed in the spinal cord or peripheral nerves. Similar changes were occasionally encountered to a lesser extent in control rats by restricting the diet and water to maintain the body weight comparable to the ranges of experimental animals. It seemed that not only clioquinol intoxication but nutritional deficiency also contributed, in part, to the production of these CNS and PNS abnormalities. The possibility of the presence of peripheral neuropathy in subacute myelooptic neuropathy is discussed.

Amino acid uptake by dorsal root ganglia from streptozotocin-diabetic rats

Dorsal root ganglia from streptozotocin-diabetic rats and age- and weight-matched control animals were incubated with 4-amino 3H-butyric acid. A significant reduction in uptake was observed in the diabetic animals. The incorporation of 3H-leucine into protein was also significantly reduced but the results did not allow a conclusion as to whether this was a secondary or an independent effect. These findings are discussed in relation both to the abnormalities known to develop in diabetic rats and to the causation of human diabetic neuropathy.

Peripheral nerve fibre degeneration in protein-deprived young rats. An ultrastructural study

In a previous study the occurrence of nerve fibre degeneration with a distribution as in dying-back neuropathies was described in young rats subjected to severe protein deprivation (Oldfors 1981). In this study the ultrastructural appearance of the degeneration of the nerve fibres at different levels of the longitudinal tail nerve in severely protein-deprived rats has been investigated. Various structural changes were noted, the most common being bands of Bŭngner indistinguishable from those seen in Wallerian degeneration. In nerve fibres which were less severely affected the most common finding was shrinkage of the axon with concomitant folding of the myelin sheath. Other structural changes included axonal accumulation of 10 nm filaments or mitochondria and other cell organelles, areas of demyelination, and projections of axolemma and Schwann cell membrane into the axon. Signs of axonal regeneration occurred but were infrequent. The degenerative changes seen at various levels of the nerves support the view that the neuropathy is of distal axonal type, but the structural appearance differs from several of the toxic dying-back neuropathies.