Evaluation of transected spinal cord regeneration in the rat

Scaffolds to promote spinal cord regeneration

Substantial research effort in the spinal cord injury (SCI) field is directed towards reduction of secondary injury changes and enhancement of tissue sparing. However, pathway repair after complete transections, large lesions, or after chronic injury may require the implantation of some form of oriented bridging structure to restore tissue continuity across a trauma zone. These matrices or scaffolds should be biocompatible and create an environment that facilitates tissue growth and vascularization, and allow axons to regenerate through and beyond the implant in order to reconnect with "normal" tissue distal to the injury. The myelination of regrown axons is another important requirement. In this chapter, we describe recent advances in biomaterial technology designed to provide a terrain for regenerating axons to grow across the site of injury and/or create an environment for endogenous repair. Many different types of scaffold are under investigation; they can be biodegradable or nondegradable, natural or synthetic. Scaffolds can be designed to incorporate immobilized signaling molecules and/or used as devices for controlled release of therapeutic agents, including growth factors. These bridging structures can also be infiltrated with specific cell types deemed suitable for spinal cord repair.

Injectable hydrogel materials for spinal cord regeneration: a review

Spinal cord injury (SCI) presents a complex regenerative problem due to the multiple facets of growth inhibition that occur following trauma to the cord parenchyma and stroma. Clinically, SCI is further complicated by the heterogeneity in the size, shape and extent of human injuries. Many of these injuries do not breach the dura mater and have continuous viable axons through the injury site that can later lead to some degree of functional recovery. In these cases, surgical manipulation of the spinal cord by implanting a preformed scaffold or drug delivery device may lead to further damage. Given these circumstances, in situ-forming scaffolds are an attractive approach for SCI regeneration. These synthetic and natural polymers undergo a rapid transformation from liquid to gel upon injection into the cord tissue, conforming to the individual lesion site and directly integrating with the host tissue. Injectable materials can be formulated to have mechanical properties that closely match the native spinal cord extracellular matrix, and this may enhance axonal ingrowth. Such materials can also be loaded with cellular and molecular therapeutics to modulate the wound environment and enhance regeneration. This review will focus on the current status of in situ-forming materials for spinal cord repair. The advantages of, and requirements for, such polymers will be presented, and examples of the behavior of such systems in vitro and in vivo will be presented. There are helpful lessons to be learned from the investigations of injectable hydrogels for the treatment of SCI that apply to the use of these biomaterials for the treatment of lesions in other central nervous system tissues and in organs comprising other tissue types.

Spontaneous long-term remyelination after traumatic spinal cord injury in rats

The capability of the central nervous system to remyelinate axons after a lesion has been well documented, even though it had been described as an abortive and incomplete process. At present there are no long-term morphometric studies to assess the spinal cord (S.C.) remyelinative capability. With the purpose to understand this phenomenon better, the S.C. of seven lesionless rats and the S.C. of 21 rats subjected to a severe weight-drop contusion injury were evaluated at 1, 2, 4, 6, and 12 months after injury. The axonal diameter and the myelination index (MI = axolemmal perimeter divided by myelinated fiber perimeter) were registered in the outer rim of the cord at T9 SC level using a transmission electron microscope and a digitizing computer system. The average myelinated fiber loss was 95.1%. One month after the SC, 64% of the surviving fibers were demyelinated while 12 months later, only 30% of the fibers had no myelin sheath. The MI in the control group was 0.72 +/- 0.07 (X +/- S.D.). In the experimental groups, the greatest demyelination was observed two months after the lesion (MI = 0.90 +/- 0.03), while the greatest myelination was observed 12 months after the injury (MI = 0.83 +/- 0.02). There was a statistical difference (p < 0.02) in MI between 2 and 12 months which means that remyelination had taken place. Remyelination was mainly achieved because of Schwann cells. The proportion of small fibers (diameter = 0.5 micron or less) considered as axon collaterals, increased from 18.45% at 1 month to 27.66% a year after the contusion. Results suggest that remyelination is not an abortive phenomenon but in fact a slow process occurring parallel to other tissue plastic phenomena, such as the emission of axon collaterals.

Corticospinal tract regrowth

The natural ability of the adult central nervous system of higher vertebrates to recover from injury is highly limited. This limitation is most likely due to an inhospitable environment and/or intrinsic incapacities of the neurons to re-extend their neurites after injury or axotomy. The rat corticospinal tract is the largest tract leading from brain to spinal cord and is often used as a model in developmental and regeneration studies. The extensive know-how of factors involved in the development of the corticospinal tract did provide the foundation for many studies on corticospinal tract regrowth after injury in the adult spinal cord. The results of these experiments, as discussed in this review, have led to important contributions to the further understanding of central nervous system regeneration.

Directional regrowth of lesioned corticospinal tract axons in adult rat spinal cord

During central nervous system development, gradients of diffusible molecules play an important role in the attraction of outgrowing axons. A diffusible tropic factor released by the cervical spinal gray matter attracts outgrowing corticospinal tract axons, as shown by in vitro collagen co-culture studies [Joosten E. A. J. et al. (1994) Neuroscience 59, 33-41]. Here we study the effects of local application of timed cervical spinal gray matter extracts on regrowth of injured corticospinal tract axons in the adult rat spinal cord. For local application of target-derived extracts at the site of lesion we used rat tail collagen type 1 as a matrix. Ingrowth of anterogradely labelled corticospinal tract axons into the collagen was studied four weeks after the spinal cord injury. No ingrowth of labelled corticospinal tract axons can be observed in the control experiment when collagen only was applied into the lesion gap. Furthermore, we found that local application of an extract derived from four-day, but not from one-day or 16-day-old, cervical spinal cord gray matter directs a substantial amount of the lesioned adult corticospinal tract axons into the collagen implant. We conclude that directional regrowth of injured corticospinal tract axons in the adult rat spinal cord is possible by local application of timed target-derived extracts. In this respect spatiotemporal aspects are of the utmost importance.

Collagen implants and cortico-spinal axonal growth after mid-thoracic spinal cord lesion in the adult rat

We describe an experimental model to study regeneration of lesioned corticospinal tract (CST) fibers in the adult rat spinal cord. After transection of all CST fibers at mid-thoracic level the gap is grafted with a sterile, cell-free collagen matrix. Two methods of collagen-application are used: 1) injection of a fluid collagen solution into the lesioned area which self-assembles in situ and 2) implantation of a solid collagen gel. At 4 weeks post-implantation CST axons are anterogradely labelled with horseradish-peroxidase (HRP). The collagen implant is evaluated for ingrowth of CST axons. The histopathological reaction (gliotic response) around the lesion and within the matrix is also studied. After application of a fluid collagen solution into the lesion area HRP-labelled CST axons can be visualized within the implant. In addition, astroglial and reactive microglial cells invade the collagen-matrix. On the other hand, if collagen is implanted as an already self-assembled gel, no ingrowth of labelled CST axons nor of astroglial/reactive microglial cells is observed. Both methods of collagen-application result in a considerable reduction of the gliotic response as compared to the ungrafted animals. We conclude that the method of application of collagen (i.e., fluid or gel) considerably affects the response of lesioned CST axons. The application of a fluid collagen graft which in situ self-assembles is beneficial for the regrowth of lesioned CST axons in rat spinal cord. In this respect the formation of an astroglial scaffolding structure within the (fluid) collagen, probably due to optimal integration between host and graft, is very important. The inability of injured CST fibers to enter the solid collagen graft may be related to the absence of an astroglial scaffolding structure within the implant.

Fetal grafts alter chronic behavioral outcome after contusion damage to the adult rat spinal cord

In the present experiments, we have examined the capacity of intraspinal transplants to effect alterations in certain locomotor behaviors after spinal contusion injuries. An electromechanical impactor that was sensitive to tissue biomechanical characteristics was used to produce rapid (20 ms) compression injuries to the thoracic spinal cord (T8). Suspensions of fetal spinal tissue (14-day) were placed at 10 days postinjury into the intraspinal cavity created by these reproducible spinal injuries. In the pre- and postinjury period, a number of general and sensitive motor behaviors were used to characterize the immediate and long-term progress of hindlimb behavioral recovery over an extended period of time (73 days). Our data reveal that a lasting alteration in some motor behaviors can be achieved by suspension grafts. While little improvement in some generalized motor tasks (inclined plane analysis, grid walking) takes place, fetal transplants precipitate a rapid and enduring change in certain motivated fine motor behaviors (gait analysis). The base of support and stride length of the hindlimbs were improved by 7 days post-transplantation and the effect was stable over time. The angle of rotation was, however, not altered. The lasting effect in two gait parameters noted was accompanied by the presence of well-developed spinal grafts that often fused with the host spinal parenchyma. These results provide the first documentation of an influence of fetal transplants on motivated locomotor capacity in a well-characterized spinal injury model that mimics lesions seen in the contused adult human spinal cord.

The electrolytic lesion as a model of spinal cord damage and repair in the adult rat

The utility of the electrolytic lesion as a model of spinal cord injury and repair has been studied in adult Wistar rats. Lesions were created using an 0.1 mA current applied for 30 s in the right hand intermediate zone of the cord, at the level of the 10th thoracic vertebra. After three months, secondary pathological changes at these sites resulted in a variable degree of grey matter atrophy, cavitation, macrophage infiltration and loss of white matter in the dorsolateral funiculus. Functionally, lesioned animals exhibited an incomplete spastic paraparesis of the right hind limb, had normal scores on the inclined plane test, but showed subnormal performance of the right hind limb on the Tarlov scale. Spinal cord neurones dissociated from E14 rat embryos survived for at least 3 months if transplanted into a freshly made electrolytic lesion. However, these implants had no ameliorating effect on the motor deficit induced by electrolytic lesions. It was concluded that the electrolytic lesion represents a useful model for qualitative studies on secondary histopathological changes in the injured cord. Electrolytic lesions also support long-term survival of implanted spinal neurones. However, the possible trophic influence of these implants on motor and sensory tracts could probably be better studied using neonatal, rather than adult rats.

Transected spinal cords grafted with in situ self-assembled collagen matrices

The purpose of this work was to evaluate if the implantation into the gap of a transected spinal cord of a biomaterial providing a scaffolding structure for tissue ingrowth would favor the permeation and the growth of regenerating axons across the spinal-bioimplant interface. The interstump gap of rat transected spinal cords was injected with an ice-cold neutral solution of collagen, either alone or mixed with glyoxal, a harmless tanning agent. Upon warming to the temperature of the tissue, the fluid implant self-assembled forming a loose fibrillar network which simultaneously re-established a physical continuity to the transected organ. At various post-implantation timepoints, the bioimplants were studied by light microscopy, with the picrosirius-polarization method and with scanning electron microscopy. We observed that the bioimplants evolved following three overlapping phases: first a massive inflammatory response characterized by the invasion of cells of heterogeneous nature, then, a phase where microcysts predominated and during which, there is a major remodeling of the biomatrix by the deposition of newly synthesized collagen and of a periodic acid Schiff-positive material. Finally, a regeneration phase occurred where astroglial processes followed by regenerating axons invaded the biomatrix. Three months after implantation, spinal axons had grown from the two spinal stumps and penetrated the bioimplant across at least one lesion interface. However, the glyoxal-tanned collagen matrices showed a better biostability and durability than collagen alone. We conclude that the histopathological reaction of the mammalian lesioned spinal cord, when adequately directed by a scaffolding structure can be beneficial for the expression of the intrinsic regenerative capacity of the spinal cord tissue.

Associated norepinephrine loss following calcium-induced spinal paralysis

A 10% calcium chloride solution or normal physiological saline was instilled onto the intact dorsal surface of the spinal cord via a specially constructed catheter-canopy system fixed above the T9 level in conscious rats. Within 5 min after calcium instillation rats developed flaccid paralysis of the lower limbs with sensory loss. Sensory loss was accompanied by abnormal or negative evoked potentials. Rats instilled with physiological or 10% sodium chloride remained normal. Rats were sacrificed at 1, 16 and 48 h post-calcium exposure and following full functional recovery from paralysis. Spinal cords were removed for histologic and high-performance liquid chromatography (HPLC) analysis. Histologic examination for catecholamines using SPG histofluorescence showed loss of catecholamine-containing varicosities in gray matter below calcium exposure which returned to normal levels upon sensorimotor recovery of hindlimbs about 14 days pce. Light microscopic examination of vascular permeability and general morphology of cord tissue axons and neurons remained normal in calcium and saline instilled rats. HPLC analysis of spinal cord below calcium exposure, also showed norepinephrine (NE) and 3-methoxy-4-hydroxyphenylglycol (MHPG) tissue level reductions which returned to normal upon sensorimotor recovery of paralysis about 2 weeks later. No significant changes were noted in dopamine or serotonin levels in any group. Our findings suggest an impairment of ascending and descending tract transmitter transport, specifically reflected in the noradrenergic bulbospinal pathway. The results implicate a neurofilament-microtubule disassembly in axonal cytoskeleton triggered by the sudden calcium influx.

Motor and somatosensory evoked potentials recorded from the rat

An accurate neurophysiological technique that is able to monitor both the sensory and motor tracts of the spinal cord is required to assess patients with injury or other lesions of the cord, and for the evaluation of experimental studies of cord injury. We have recorded and characterized the motor and somatosensory evoked potentials (MEPs and SSEPs) from 20 normal rats and from 16 rats with cord lesions. MEPs were elicited by applying constant current anodal stimuli to the sensorimotor cortex (SMC) with the responses recorded from microelectrodes in the spinal cord at T10 (MEP-C) and from a bipolar electrode placed on the contralateral sciatic nerve (MEP-N). SSEPs were elicited by stimulating the sciatic nerve and were recorded from the cord at T10 and the contralateral SMC. The MEP-C consisted of an initial D wave (mean latency 1.21 +/- 0.12 msec and 4 subsequent I waves, 11-14). The D wave was elicited at stimulation frequencies exceeding 100 Hz. The initial positive wave of the MEP-N (mean latency 3.09 +/- 0.19 msec) was followed by several slower components which were attenuated by repetition rates exceeding 8.2 Hz. The grand mean SSEP consisted of 7 peaks. Sectioning of the dorsal columns abolished the SSEP but spared the MEP. Complete cord transection abolished both the MEP and SSEP. These experiments demonstrate that the combined recording of MEPs and SSEPs is an accurate and easily performed method of monitoring the functional integrity of the rat cord, and suggest that this technique would be of value in patients, especially those undergoing operative treatment of spinal lesions.

Presynaptic elements on artificial surfaces. A model for the study of development and regeneration of synapses

Recently a model has been developed to study the synapse formation in which the components of a synapse can be isolated and examined independently. The observation of neurites forming presynaptic elements on polylysine-coated surfaces is a model for which the formation of presynaptic elements can be studied independently of a cellular postsynaptic element. Studies with neurons from both cell cultures and the intact cerebellum have shown that beads coated with poly-basic proteins can serve as a "postsynaptic element." With use of this system, observation have shown that the presynaptic element can form quickly, within 3 h, and contain many of the characteristics of a mature presynaptic element, such as synaptic vesicle antigens. Additional studies have shown that astrocytes appear to be involved in the loss or removal of the presynaptic elements on beads. Thus, synaptogenesis may involve the development of inappropriate synaptic contacts, which are eliminated by astrocytes. The lack of regeneration in the central nervous system (CNS) also may involve the astrocyte's ability to remove immature and/or inappropriate presynaptic elements and growth cones as they attempt to cross the lesion site.

Effects of intracerebroventricular 6-hydroxydopamine on catecholaminergic fibers in the rat hypothalamus

Regeneration in the central nervous system has been claimed to be very limited and abortive, although functional regeneration of some of its pathways after destruction has been observed. The exact mechanisms by which axons regenerate fully or fail to have functional regeneration remain to be studied further. We explored whether or not there is a regional difference in regeneration of central catecholaminergic (CA) neurons in the hypothalamus of young adult rats after 6-hydroxydopamine (6-OH-DA) treatment. Four days after treatment, the numbers of CA terminals and axons were significantly reduced in the paraventricular hypothalamic nucleus, periventricular hypothalamic nucleus, supraoptic commissure (SOC), and dorsomedial hypothalamic nucleus as assessed by a morphometric quantitation on fluorescence microscopy micrographs; CA axons were gradually increased in numbers after the treatment. The number of CA varicosities in the supraoptic commissure was restored to 96% of control 180 days after the 6-OH-DA lesion, whereas the actual numbers of CA varicosities in the paraventricular, periventricular, and dorsomedial hypothalamic nuclei were attained at 79, 79, and 68% of control values, respectively. Our results indicate that CA fibers in the supraoptic commissure possess more regenerative potential than the three other hypothalamic regions studied, suggesting a regional difference in CA nerve sprouting during neuroplasticity within the hypothalamus. The favorable regeneration of CA axons in the supraoptic commissure implies to us that some trophic features along that pathway, particularly near the third ventricle, may have been stimulated after chemical lesion using 6-OH-DA, and gradually released in the distal field of the supraoptic commissure to attract CA stumps to sprout. These factors may thus induce both regenerative sprouting and collateral sprouting resulting in vigorous regrowth of CA fibers in the supraoptic commissure.

Promoting functional plasticity in the damaged nervous system

Damage to the central and peripheral nervous system often produces lasting functional deficits. A major focus of neuroscience research has been to enhance functional restitution of the damaged nervous system and thereby produce recovery of behavioral or physiological processes. Promising procedures include surgical, physical, and chemical manipulations to reduce scar formation and minimize the disruption of support elements, administration of growth-stimulating substances, tissue grafts to bridge gaps in fiber pathways, and embryonic brain tissue grafts to provide new cells with the potential to generate fiber systems. Two elements are required for functional nervous system repair: (i) neurons with the capacity to extend processes must be present, and (ii) the regenerating neurites must find a continuous, unbroken pathway to appropriate targets through a supportive milieu.