Microdissection of peripheral nerve: collagen and lipid distribution with morphological correlation

Needle stylet with integrated optical fibers for spectroscopic contrast during peripheral nerve blocks

The effectiveness of peripheral nerve blocks is highly dependent on the accuracy at which the needle tip is navigated to the target injection site. Even when electrical stimulation is utilized in combination with ultrasound guidance, determining the proximity of the needle tip to the target region close to the nerve can be challenging. Optical reflectance spectroscopy could provide additional information about tissues that is complementary to these navigation methods. We demonstrate a novel needle stylet for acquiring spectra from tissue at the tip of a commercial 20-gauge needle. The stylet has integrated optical fibers that deliver broadband light to tissue and receive scattered light. Two spectrometers resolve the light that is received from tissue across the wavelength range of 500-1600 nm. In our pilot study, measurements are acquired from a postmortem dissection of the brachial plexus of a swine. Clear differences are observed between spectra acquired from nerves and those acquired from adjacent tissue structures. We conclude that spectra acquired with the stylet have the potential to increase the accuracy with which peripheral nerve blocks are performed.

Laminin B1 and collagen type IV gene expression in transected peripheral nerve: reinnervation compared to denervation

The expression of B1 laminin and type IV collagen was followed in the microsurgically isolated endoneurium of transected rat sciatic nerves from 3 days until 8 weeks. Northern hybridizations revealed that after nerve transection the proximal stumps of denervated, as well as freely regenerating, nerves showed a markedly increased expression of laminin and type IV collagen which lasted from 3 days up to 8 weeks. In the distal stumps, close to the site of transection (2-7 mm), the expression of laminin, and to a certain extent that of type IV collagen, seemed to be enhanced if free axonal reinnervation was allowed. Further distally (10-15 mm), the patterns of B1 laminin and type IV collagen expression were similar in both experimental groups, so that an increased expression was noticed during the first 2 weeks. The present results suggest that laminin and type IV collagen gene expression is markedly different in different parts of transected rat sciatic nerve. During peripheral nerve regeneration, there is a long-lasting basement membrane gene expression in the proximal stump. In the distal part of the transected nerve, the axonal reinnervation possibly up-regulates, but is not essential for, the expression of B1 laminin and type IV collagen.

Collagenosis in wallerian degeneration depends on peripheral nerve type

In the mature rat we determined the extent of peripheral nerve collagenosis in response to Wallerian degeneration and examined whether or not nonfibroblastic elements such as Schwann cells were important. Collagen was estimated as the hydroxy-proline content of normal and axotomized nerve fascicles after single or double crush lesions of both myelinated and unmyelinated nerves. Crushed unmyelinated nerve produced two to four times more collagen relative to control nerve than did the sciatic nerve. The nature of the interaction between two successive crushes was different in the two nerves. These results suggest that the degree of collagen fibrillogenesis occurring in Wallerian degeneration is dependent on peripheral nerve type and that the presence of myelin is not necessary for collagen fibrillogenesis.

Collagen synthesis in axotomized peripheral nerve: evidence against Schwann cell involvement

To explore the role of Schwann cells in nerve collagen formation, fascicular collagen was measured in axotomized rat sciatic nerve after regeneration or permanent axotomy. The same increase in fascicular collagen was seen in both paradigms. Thus there is no evidence that Schwann cells unassociated with axons make an important contribution to nerve collagen synthesis after transection.

Fatty acid composition of endoneurium and perineurium from adult rat sciatic nerve

Reports on lipid composition of peripheral nervous system have generally been restricted to the saturated fatty acids of the endoneurium. In this work we attempt to determine the fatty acid composition of the different lipid classes in both endo- and perineurium from sciatic nerve microdissection on adult rats. Unsaturated fatty acids were found to make up around 60% of total fatty acids in samples of endoneurium and perineurium, with monounsaturated fatty acids forming 40-50% of total unsaturated fatty acid content. Although the same fatty acids were present in both tissues there was a striking difference in C 18:1 (n-9) and C 18:2 (n-6) ratio between endoneurium and perineurium, which is particularly rich in linoleic acid. The nonpolar perineurial lipids were found to be richest in linoleic acid. Phospholipids were present in the perineurium, and they contained high proportions of saturated and medium-chain monounsaturated fatty acids.

Proximal and distal changes in collagen content of peripheral nerve that follow transection and crush lesions

Collagen content of rat sciatic nerve was measured 10 weeks after either nerve transection or nerve crush. Nerve transection led to a significant increase in fascicular collagen in nerve segments 2.5 mm proximal and distal to the injury site. Remote from the transection, fascicular collagen was also significantly increased, this effect being most marked distally. Nerve crush by comparison resulted in only a small increase in fascicular collagen, significantly less than after transection. The greater amount of fascicular collagen far distal to the nerve injury could relate to a predominantly caudal endoneurial flow of inflammatory or growth factors. Differences in the amount of fascicular collagen formed after nerve transection compared with nerve crush are clearly due to factors other than axonal degeneration, and may relate to collagen synthesis by denervated Schwann cells or to the severity of the nerve injury.

Endoneurial ATPase activity in Tangier disease and other peripheral neuropathies

Endoneurial sodium, potassium adenosine triphosphatase (Na+,K+-ATPase) and Mg2+-ATPase activities were determined in routine sural nerve biopsies from patients being evaluated for peripheral neuropathy. A significant reduction of endoneurial Na+,K+-ATPase and Mg2+-ATPase activities was shown in six sural nerve biopsies from patients with Tangier disease complicated by mononeuropathy multiplex or progressive axonal neuropathy. Peripheral nerve ATPase activities did not correlate with myelinated or unmyelinated nerve fiber densities in these biopsies. Other peripheral neuronal disorders with reduced endoneurial Na+,K+-ATPase and Mg2+-ATPase activities included severe vasculitic neuropathy, diabetic neuropathy, tomaculous neuropathy, and motoneuron disease. Such reduced levels of ATPase activity in peripheral nerve may relate to altered endoneurial lipid metabolism and impaired axoplasmic flow.

Cyclic AMP-stimulated protein kinase activity in rabbit peripheral myelin

Cyclic AMP-sensitive protein kinase activity has been found in suspensions of purified rabbit peripheral myelin. The enzyme phosphorylated the P0, "Y", X, P1, and P2 myelin proteins. Kinase activity, which was maximal at physiological pH, 2.5 mM Mg2+, and 2 microM cAMP, was stimulated three-fold over basal levels by cyclic AMP. Addition of calcium or EGTA had no effect on the enzyme activity in the presence or absence of cyclic AMP. Cyclic GMP also did not stimulate endogenous or exogenous protein phosphorylation. Theophylline, an inhibitor of 3',5'-cyclic nucleotide phosphodiesterase activity, increased protein kinase activity in the presence of cyclic AMP. These data show that PNS myelin proteins can be phosphorylated in situ by a protein kinase system whose activity is stimulated selectively by cyclic AMP.

Isolation and partial characterization of plasmalemma from quiescent Schwann cells in denervated cat sciatic nerve

Fractions enriched in plasma membranes have been obtained from peripheral nerves enriched 89% in quiescent Schwann cells. Fractions were prepared from the intrafascicular tissue of desheathed distal stumps of cat sciatic nerve 8-10 weeks after transection and suture in the upper thigh. Tissue enriched in Schwann cells was minced, homogenized, and centrifuged to remove nuclei and undispersed tissue. Centrifugation of the resulting supernatant produced a pellet that was osmotically shocked, layered over a discontinuous sucrose gradient, and recentrifuged. Fractions enriched in plasma membrane (PM) markers were pooled, osmotically shocked for 16 h, layered over a second discontinuous sucrose density gradient, and recentrifuged. Membrane fractions (0.6 M:0.85 M and 0.85 M:1.0 M interfaces) contained a homogeneous population of unilamellar vesicles free of myelin. The 0.85 M fraction was enriched in 5'-nucleotidase, 2',3'-cyclic nucleotide 3'-phosphohydrolase. and specific [3H]ouabain binding, 4.8-, 3.0-, and 5.7-fold over the crude homogenate, respectively. These fractions also demonstrated low enzyme activities for succinate dehydrogenase, lactate dehydrogenase, and glucose-6-phosphatase (9, 13, and 15% of control values, respectively). Protein yield of the PM fraction (0.85 M) was approximately 0.6 mg/g of denervated nerve. This preparation should be suitable to characterize the surface properties of Schwann cells free of neuronal regulation.

Structural alterations of peripheral nerve monogalactosylceramides during development and Wallerian degeneration

The structural alterations of monogalactosylceramides in peripheral nerve were investigated during development, nerve fiber degeneration and regeneration. During early development, hydroxy cerebrosides and sulfatides were the main constituents of the monogalactosylceramides of immature rat sciatic endoneurium. The ratio of hydroxy to nonhydroxy cerebrosides decreased rapidly as myelination proceeded but remained fairly constant throughout adulthood. More than 50% of the adult content of endoneurial monogalactosylceramides was achieved before 21 days of age. The long-chain nonhydroxy fatty acids (above C21) had increased from under 20% to over 80% by day 20, while 24h:0 (h, hydroxy) had already reached approximately 50% of hydroxy cerebrosides by day 12. These results suggest that the biosynthesis of endoneurial monogalactosylceramides and fatty acid elongation take place preferentially at the time when peripheral nerve is undergoing active myelination. During Wallerian degeneration, the maximum decrease of monogalactosylceramides was associated temporally with axonal degeneration and demyelination and particularly with myelin conversion to sudanophilic lipids. By the time that nerve fiber regeneration was well established, both the cerebroside and sulfatide contents had returned to near control values. Cerebrosides and long-chain fatty acids (above C21) appear to be the most sensitive to fiber degeneration while fatty acid elongation is selectively increased during nerve regeneration.

Increased polyunsaturated fatty acids in developing and regenerating peripheral nerve

Characteristic fatty acids of peripheral nerve myelin are mainly saturated and monounsaturated. A marked increase of polyunsaturated fatty acids, particularly arachidonic acid, was found in endoneurial phosphatidylethanolamine of both developing and regenerating rat sciatic nerve, suggesting a close association between polyunsaturated fatty acids and peripheral nerve myelination.

Accumulation and depletion of trans octadecenoic acid in rat peripheral nerve phospholipid

The accumulation and depletion of trans 18:1 acids in the sciatic nerve phospholipids was studied in rats fed a diet containing 18% partially hydrogenated soybean oil of which 45% was trans 18:1. The nerve phospholipid of rats fed partially hydrogenated soybean oil beginning at weaning age reached a maximum incorporation of trans 18:1 or 0.8% in 4 weeks; whereas the nerve phospholipid of 18-day-old pre-weanling pups of mothers fed the partially hydrogenated soybean oil diet since their weaning contained 3.3% trans 18:1. The trans content decreased rapidly after the weaning of these second-generation rats to a steady-state level 50% higher than the maximum level reached in the first generation. Upon removal of partially hydrogenated soybean oil from the diet, the trans 18:1 of nerve phospholipid decreased much more slowly than from liver or heart phospholipid. Essential fatty acid deficiency had no influence on incorporation or removal of trans 18:1 in nerve phospholipid. The accumulation and depletion of trans 18:1 in nerve phospholipid of second-generation partially hydrogenated soybean oil-fed rats paralleled the changes of polyunsaturated fatty acids and was quite different from the changes observed in 18:0 and cis 18:1. Polyunsaturated fatty acids increased in nerve phospholipid from second but not first-generation rats fed partially hydrogenated soybean oil and declined rapidly when partially hydrogenated soybean oil was removed from the diet.

Preparation of cell-free extracellular matrix from human peripheral nerve

The extracellular matrix of human peripheral nerve, which is mainly basement membrane and fibrillar collagen, has been prepared by a procedure involving extensive detergent extraction of isolated endoneurium and perineurium obtained from various nerves. The ultrastructure of the isolated nerve extracellular matrix was indistinguishable from that seen in sections of intact nerve, indicating that the extraction procedure preserved the morphological integrity of these connective tissue components. The amino acid and carbohydrate compositions of the nerve extracellular matrix preparations were typically collagenous in nature containing a high content of glycine, proline, 4-hydroxyproline, and alanine and significant amounts of lysine and hydroxylysine. The preparations contained virtually no 3-hydroxyproline and low content of glucose and galactose compared to pure basement membranes, indicating that interstitial rather than basement membrane collagens predominated. This preparation appears well-suited to both the ultrastructural and biochemical study of the extracellular matrix of peripheral nerve.

Intermediate filaments of Schwann cells

Intermediate filaments were prepared from distal stumps of rabbit sciatic nerve 5 weeks after nerve section, at which time Schwann cells account for 85--90% of the cell area. A polypeptide of molecular weight 58,000 was the main component of this fraction. An antiserum raised in guinea pig against this polypeptide stained all cells present in the distal stump, as well as Schwann cells and 3T3 cells in culture. The identity of the molecular weight 58,000 polypeptide obtained from distal stumps with vimentin was proved with one and two-dimensional sodium dodecyl sulfate polyacrylamide gel electrophoresis and with immunoautoradiography. It is concluded that the intermediate filament subunit of undifferentiated Schwann cells is vimentin. The possibility that Schwann cells in normal nerve may have another type of intermediate filament besides vimentin cannot be ruled out.

Enrichment of Schwann cell cultures from neonatal rat sciatic nerve by differential adhesion

A novel method of Schwann cell purification from neonatal rat sciatic nerve has been developed using differential adhesion. After enzymatic and mechanical dissociation, the cell digest is allowed to settle on polylysine-coated glass coverslips for 30 min with intermittent shaking. After an 18-h incubation, bipolar cells comprise greater than 95% of the non-adherent population. Indirect immunofluorescence with the cell-specific markers rabbit anti-galactocerebroside and rabbit anti-bovine-P-2 basic protein antiserum confirmed light microscopic identification of these bipolar cells as Schwann cells. Rabbit anti-human fibronectin specifically labeled fibroblasts which comprised less than 5% of the cell population, but did not bind to Schwann cells. Schwann cells isolated by differential adhesion were injected into a rabbit. When absorbed with cultured rat skin fibroblasts, serum from this rabbit specifically surface labeled greater than 99% of the bipolar and round cells after 18 h and 5 days in vitro and also labeled Schwann cells in fetal rat dorsal root ganglia cultures, but not fibroblasts or neurons.

Collagen content in human ulnar nerve

A quantitative analysis of ulnar nerve collagen in the arm and forearm was undertaken in nine subjects. While endoneurial collagen was found to be significantly increased within the cubital tunnel, extrafascicular collagen did not increase at the elbow except in two nerves showing fusiform enlargements. Renaut bodies increased in frequency at sites of high endoneurial collagen content. Morphological determinations of cross-sectional area along the ulnar nerve did not correlate with quantitative collagen data.

Anin vivo method to prepare normal Schwann cells free of axons and myelin

A viable population of undifferentiated Schwann cells may be prepared from chronically denervated peripheral nerves. Nerve transection stimulates a sequence of cellular events in distal stumps leading to removal of axons and myelin, and proliferation of Schwann cells. Sealing the ends of nerve stumps prevents reinnervation and leaves daughter Schwann cells residing in longitudinal columns. Schwann cells may be harvested from the endoneurial tissue of the nerve stumps 5-12 weeks after nerve transection. Unlike myelinating cells prepared from intact tissue, where function has been specified by associated axons, Schwann cells obtained from denervated stumps are functionally naive. Their usefulness in analyzing axonal regulation of myelinogenesis and mitosis is therefore suggested.

Analysis of the major lipid classes in human peripheral nerve biopsies. Age group differences and abnormalities of ganglioside level in perhexiline maleate therapy

We report here the results of a simple and reproducible technique which can be used in semi-routine analysis of peripheral nerve biopsy specimens, so as to have a quantitative analysis of the major lipid classes, i.e. cholesterol, cerebrosides, ethanolamine phospholipids, phosphatidyl-choline, phosphatidyl-serine + phosphatidylinositol, sphingomyelin and gangliosides. Glycolipid hexoses, cholesterol and total phospholipids have been compared in different age groups. Although all lipid classes increased from the younger to the older age group, the molar ratio of cholesterol to phospholipid differed less than the glycolipid to phospholipid ratio. Both increased significantly, even between age group 10--16 and older patients (36, 54, 61, 68, 72 and 73 years old). Although individual variations in lipid content are noteworthy, it must be emphasized that evolution with age of the lipid composition must be taken into account. Furthermore, this study confirms and extends earlier findings of increased ganglioside levels in some cases of peripheral neuropathies observed during perhexiline maleate therapy where characteristic lipid-like polymorphous inclusions have been demonstrated.

Endoneurial lipid composition of normal human sural nerve

The endoneurial lipid composition was determined in 7 human sural nerves from subjects without known neurological disease. The nerves were morphologically normal, with myelinated fiber density of 7,710 +/- 1,210/mm2 (mean +/- SD). Endoneurium contained 30.7 +/- 1.5 mg total lipid per 100 mg of dry weight. Cholesterol was the predominant lipid (9.1 +/- 1.0 mg). Cholesterol ester was present only in very small quantities (0.2 +/- 0.1 mg). Cerebroside concentration was 4.5 +/- 0.3 mg, and sulfatide was 1.5 +/- 0.3 mg. The most abundant phospholipid was sphingomyelin (4.3 +/- 0.3 mg), followed by phosphatidylethanolamine (4.1 +/- 0.2 mg), phosphatidylcholine (3.8 +/- 0.2 mg), and phosphatidylinositol-phosphatidylserine (1.7 +/- 0.2 mg). Eighty-one percent of cerebroside nonhydroxy fatty acids were long chain (C20 to C26), and 67% were saturated. Technological advances now permit microchemical lipid analysis of human sural nerve biopsies in cases of neuropathy. When compared with our normative data, such studies may further the understanding of peripheral nerve disorders.

Nerve lipid abnormalities in human diabetic neuropathy: a correlative study

To study endoneurial lipid composition in human diabetic neuropathy, we biopsied sural nerves from 3 middleaged men with adult-onset diabetes mellitus. Magnitude of electrophysiological abnormalities and myelinated fiber loss paralleled the clinical severity of neuropathy in all cases. Cholesterol ester concentration was elevated to about 800% of normal in diabetic nerves. Reduction in total endoneurial lipid concentration correlated best with decrease in myelin volume as calculated from measured fiber diameters. Cholesterol, cerebroside, and most phospholipids were reduced in keeping with the severity of fiber loss in each nerve. The phosphatidylinositol-phosphatidylserine fraction was most reduced in the least affected nerves. Cerebroside nonhydroxy fatty acids in diabetic nerves were of shorter chain length and more saturated than normal. It is not yet clear whether the abnormalities of phosphatidylinositol-phosphatidylserine and cerebroside fatty acids are of pathogenetic importance or whether these changes may be the nonspecific consequence of axonal degeneration.