Ensheathment and myelination of regenerating PNS fibres by transplanted optic nerve glia

Application of electrostimulation and magnetic stimulation in patients with optic neuropathy: A mechanistic review

Visual impairment caused by optic neuropathies is irreversible because retinal ganglion cells (RGCs), the specialized neurons of the retina, do not have the capacity for self-renewal and self-repair. Blindness caused by optic nerve neuropathies causes extensive physical, financial, and social consequences in human societies. Recent studies on different animal models and humans have established effective strategies to prevent further RGC degeneration and replace the cells that have deteriorated. In this review, we discuss the application of electrical stimulation (ES) and magnetic field stimulation (MFS) in optic neuropathies, their mechanisms of action, their advantages, and limitations. ES and MFS can be applied effectively in the field of neuroregeneration. Although stem cells are becoming a promising approach for regenerating RGCs, the inhibitory environment of the CNS and the long visual pathway from the optic nerve to the superior colliculus are critical barriers to overcome. Scientific evidence has shown that adjuvant treatments, such as the application of ES and MFS help direct thetransplanted RGCs to extend their axons and form new synapses in the central nervous system (CNS). In addition, these techniques improve CNS neuroplasticity and decrease the inhibitory effects of the CNS. Possible mechanisms mediating the effects of electrical current on biological tissues include the release of anti-inflammatory cytokines, improvement of microcirculation, stimulation of cell metabolism, and modification of stem cell function. ES and MFS have the potential to promote angiogenesis, direct axon growth toward the intended target, and enhance appropriate synaptogenesis in optic nerve regeneration.

Neuronal Redevelopment and the Regeneration of Neuromodulatory Axons in the Adult Mammalian Central Nervous System

One reason that many central nervous system injuries, including those arising from traumatic brain injury, spinal cord injury, and stroke, have limited recovery of function is that neurons within the adult mammalian CNS lack the ability to regenerate their axons following trauma. This stands in contrast to neurons of the adult mammalian peripheral nervous system (PNS). New evidence, provided by single-cell expression profiling, suggests that, following injury, both mammalian central and peripheral neurons can revert to an embryonic-like growth state which is permissive for axon regeneration. This “redevelopment” strategy could both facilitate a damage response necessary to isolate and repair the acute damage from injury and provide the intracellular machinery necessary for axon regrowth. Interestingly, serotonin neurons of the rostral group of raphe nuclei, which project their axons into the forebrain, display a robust ability to regenerate their axons unaided, counter to the widely held view that CNS axons cannot regenerate without experimental intervention after injury. Furthermore, initial evidence suggests that norepinephrine neurons within the locus coeruleus possess similar regenerative abilities. Several morphological characteristics of serotonin axon regeneration in adult mammals, observable using longitudinal in vivo imaging, are distinct from the known characteristics of unaided peripheral nerve regeneration, or of the regeneration seen in the spinal cord and optic nerve that occurs with experimental intervention. These results suggest that there is an alternative CNS program for axon regeneration that likely differs from that displayed by the PNS.

Optic Nerve Regeneration: How Will We Get There?

BACKGROUND

Restoration of vision in patients blinded by advanced optic neuropathies requires technologies that can either 1) salvage damaged and prevent further degeneration of retinal ganglion cells (RGCs), or 2) replace lost RGCs.

EVIDENCE ACQUISITION

Review of scientific literature.

RESULTS

In this article, we discuss the different barriers to cell-replacement based strategies for optic nerve regeneration and provide an update regarding what progress that has been made to overcome them. We also provide an update on current stem cell-based therapies for optic nerve regeneration.

CONCLUSIONS

As neuro-regenerative and cell-transplantation based strategies for optic nerve regeneration continue to be refined, researchers and clinicians will need to work together to determine who will be a good candidate for such therapies.

Repulsive Environment Attenuation during Adult Mouse Optic Nerve Regeneration

The regenerative capacity of CNS tracts has ever been a great hurdle to regenerative medicine. Although recent studies have described strategies to stimulate retinal ganglion cells (RGCs) to regenerate axons through the optic nerve, it still remains to be elucidated how these therapies modulate the inhibitory environment of CNS. Thus, the present work investigated the environmental content of the repulsive axon guidance cues, such as Sema3D and its receptors, myelin debris, and astrogliosis, within the regenerating optic nerve of mice submitted to intraocular inflammation + cAMP combined to conditional deletion of PTEN in RGC after optic nerve crush. We show here that treatment was able to promote axonal regeneration through the optic nerve and reach visual targets at twelve weeks after injury. The Regenerating group presented reduced MBP levels, increased microglia/macrophage number, and reduced astrocyte reactivity and CSPG content following optic nerve injury. In addition, Sema3D content and its receptors are reduced in the Regenerating group. Together, our results provide, for the first time, evidence that several regenerative repulsive signals are reduced in regenerating optic nerve fibers following a combined therapy. Therefore, the treatment used made the CNS microenvironment more permissive to regeneration.

Inside Out: Core Network of Transcription Factors Drives Axon Regeneration

In this issue, Chandran et al. (2016) pursue a multi-level bioinformatics approach combined with wet bench validation to identify gene networks associated with the regenerative state of injured adult sensory neurons. A small molecular compound, ambroxol, mimics aspects of the identified gene expression patterns and promotes axon regeneration in the injured adult mouse CNS, demonstrating feasibility of in silico-based methods to identify compounds that promote neuronal growth following CNS injury.

In vitro models of axon regeneration

A variety of in vitro models have been developed to understand the mechanisms underlying the regenerative failure of central nervous system (CNS) axons, and to guide pre-clinical development of regeneration-promoting therapeutics. These range from single-cell based assays that typically focus on molecular mechanisms to organotypic assays that aim to recapitulate in vivo behavior. By utilizing a combination of models, researchers can balance the speed, convenience, and mechanistic resolution of simpler models with the biological relevance of more complex models. This review will discuss a number of models that have been used to build our understanding of the molecular mechanisms of CNS axon regeneration.

Rat Nasal Respiratory Mucosa-Derived Ectomesenchymal Stem Cells Differentiate into Schwann-Like Cells Promoting the Differentiation of PC12 Cells and Forming Myelin In Vitro

Schwann cell (SC) transplantation as a cell-based therapy can enhance peripheral and central nerve repair experimentally, but it is limited by the donor site morbidity for clinical application. We investigated weather respiratory mucosa stem cells (REMSCs), a kind of ectomesenchymal stem cells (EMSCs), isolated from rat nasal septum can differentiate into functional Schwann-like cells (SC-like cells). REMSCs proliferated quickly in vitro and expressed the neural crest markers (nestin, vimentin, SOX10, and CD44). Treated with a mixture of glial growth factors for 7 days, REMSCs differentiated into SC-like cells. The differentiated REMSCs (dREMSCs) exhibited a spindle-like morphology similar to SC cells. Immunocytochemical staining and Western blotting indicated that SC-like cells expressed the glial markers (GFAP, S100β, Galc, and P75) and CNPase. When cocultured with dREMSCs for 5 days, PC12 cells differentiated into mature neuron-like cells with long neurites. More importantly, dREMSCs could form myelin structures with the neurites of PC12 cells at 21 days in vitro. Our data indicated that REMSCs, a kind of EMSCs, could differentiate into SC-like cells and have the ability to promote the differentiation of PC12 cells and form myelin in vitro.

Chemical priming for spinal cord injury: a review of the literature. Part I-factors involved

INTRODUCTION

There are significant differences between the propensity of neural regeneration between the central and peripheral nervous systems.

MATERIALS AND METHODS

Following a review of the literature, we describe the role of growth factors, guiding factors, and neurite outgrowth inhibitors in the physiology and development of the nervous system as well as the pathophysiology of the spinal cord. We also detail their therapeutic role as well as those of other chemical substances that have recently been found to modify regrowth following cord injury.

CONCLUSIONS

Multiple factors appear to have promising futures for the possibility of improving spinal cord injury following injury.

Guidance molecules in axon regeneration

The regenerative capacity of injured adult mammalian central nervous system (CNS) tissue is very limited. Disease or injury that causes destruction or damage to neuronal networks typically results in permanent neurological deficits. Injury to the spinal cord, for example, interrupts vital ascending and descending fiber tracts of spinally projecting neurons. Because neuronal structures located proximal or distal to the injury site remain largely intact, a major goal of spinal cord injury research is to develop strategies to reestablish innervation lost as a consequence of injury. The growth inhibitory nature of injured adult CNS tissue is a major barrier to regenerative axonal growth and sprouting. An increasing complexity of molecular players is being recognized. CNS inhibitors fall into three general classes: members of canonical axon guidance molecules (e.g., semaphorins, ephrins, netrins), prototypic myelin inhibitors (Nogo, MAG, and OMgp) and chondroitin sulfate proteoglycans (lecticans, NG2). On the other end of the spectrum are molecules that promote neuronal growth and sprouting. These include growth promoting extracellular matrix molecules, cell adhesion molecules, and neurotrophic factors. In addition to environmental (extrinsic) growth regulatory cues, cell intrinsic regulatory mechanisms exist that greatly influence injury-induced neuronal growth. Various degrees of growth and sprouting of injured CNS neurons have been achieved by lowering extrinsic inhibitory cues, increasing extrinsic growth promoting cues, or by activation of cell intrinsic growth programs. More recently, combination therapies that activate growth promoting programs and at the same time attenuate growth inhibitory pathways have met with some success. In experimental animal models of spinal cord injury (SCI), mono and combination therapies have been shown to promote neuronal growth and sprouting. Anatomical growth often correlates with improved behavioral outcomes. Challenges ahead include testing whether some of the most promising treatment strategies in animal models are also beneficial for human patients suffering from SCI.

Accelerating axon growth to overcome limitations in functional recovery after peripheral nerve injury

OBJECTIVE

Injured peripheral nerves regenerate at very slow rates. Therefore, proximal injury sites such as the brachial plexus still present major challenges, and the outcomes of conventional treatments remain poor. This is in part attributable to a progressive decline in the Schwann cells' ability to provide a supportive milieu for the growth cone to extend and to find the appropriate target. These challenges are compounded by the often considerable delay of regeneration across the site of nerve laceration. Recently, low-frequency electrical stimulation (as brief as an hour) has shown promise, as it significantly accelerated regeneration in animal models through speeding of axon growth across the injury site.

METHODS

To test whether this might be a useful clinical tool, we carried out a randomized controlled trial in patients who had experienced substantial axonal loss in the median nerve owing to severe compression in the carpal tunnel. To further elucidate the potential mechanisms, we applied rolipram, a cyclic adenosine monophosphate agonist, to rats after axotomy of the femoral nerve.

RESULTS

We demonstrated that effects similar to those observed in animal studies could also be attained in humans. The mechanisms of action of electrical stimulation likely operate through up-regulation of neurotrophic factors and cyclic adenosine monophosphate. Indeed, the application of rolipram significantly accelerated nerve regeneration.

CONCLUSION

With new mechanistic insights into the influencing factors of peripheral nerve regeneration, the novel treatments described above could form part of an armament of synergistic therapies that could make a meaningful difference to patients with peripheral nerve injuries.

Type III neuregulin-1 promotes oligodendrocyte myelination

The axonal signals that regulate oligodendrocyte myelination during development of the central nervous system (CNS) have not been established. In this study, we have examined the regulation of oligodendrocyte myelination by the type III isoform of neuregulin-1 (NRG1), a neuronal signal essential for Schwann cell differentiation and myelination. In contrast to Schwann cells, primary oligodendrocytes differentiate normally when cocultured with dorsal root ganglia (DRG) neurons deficient in type III NRG1. However, they myelinate type III NRG1-deficient neurites poorly in comparison to wild type cultures. Type III NRG1 is not sufficient to drive oligodendrocyte myelination as sympathetic neurons are not myelinated even with lentiviral-mediated expression of NRG1. Mice haploinsufficient for type III NRG1 are hypomyelinated in the brain, as evidenced by reduced amounts of myelin proteins and lipids and thinner myelin sheaths. In contrast, the optic nerve and spinal cord of heterozygotes are myelinated normally. Together, these results implicate type III NRG1 as a significant determinant of the extent of myelination in the brain and demonstrate important regional differences in the control of CNS myelination. They also indicate that oligodendrocyte myelination, but not differentiation, is promoted by axonal NRG1, underscoring important differences in the control of myelination in the CNS and peripheral nervous system (PNS).

Dorsal root repair by means of an autologous nerve graft: experimental study in the rat

Rat dorsal root regeneration was studied after 6th and 7th cervical root surgical removal and replacement with an autologous graft of peripheral nerve harvested from the surval nerve from dorsal root ganglion to dorsal horn. Histological studies showed axonal regeneration within the grafts. When the distal end of the graft was placed inside the posterior horn of the spinal cord by use of a myelotomy, axonal sprouts (revealed by the transganglionic staining method of horseradish peroxidase or HSP) reached the neurones of the posterior horn in a limited fashion.

Signals that initiate myelination in the developing mammalian nervous system

The myelination of axons by oligodendrocytes in the central nervous system and Schwann cells in the peripheral nervous system is essential for the establishment of saltatory conduction. In the absence or destruction of the myelin sheath, as seen in demyelinating diseases, impulse conduction is impeded resulting in severe sensory and motor deficits. Axon myelination is the culmination of a sequence of events that begins with the differentiation of glial cells and proceeds to the transcription and translation of myelin genes, the elaboration of a myelin sheath, and the recognition and ensheathment of axons. This review examines the regulatory mechanisms for each of these steps and compares and contrasts the role of the axon in initiating myelination in the central and peripheral nervous system.

Vascular permeability in the peripheral autonomic and somatic nervous systems: controversial aspects and comparisons with the blood-brain barrier

Endothelium, choroidal epithelium, and arachnoid exclude plasma proteins from most parts of the mammalian central nervous system (CNS). Nerve roots, in contrast, have permeable capillaries and permeable pia-arachnoid sheaths. Diffusion of plasma proteins into the cerebrospinal fluid is probably prevented by slow bulk flow along a pressure gradient from the subarachnoid space into the veins of the roots. In nerves, the perineurium prevents diffusion of proteins from the epineurium into the endoneurium. Capillaries within fascicles are permeable to macromolecules, though less so than the microvessels of roots and ganglia. Endoneurial vascular permeability is lowest in rats and mice, but even in these species albumin is normally present in the extracellular spaces around the nerve fibers. The so-called blood-nerve barrier is not equivalent to the blood-brain barrier. Capillaries in sensory and sympathetic ganglia are fully permeable to macromolecules, and extravasated protein is in contact with neuronal cell bodies and neurites. An impenetrable perineurium surrounds each ganglion, but serves no obvious purpose when the vessels inside are as permeable as those outside. The enteric nervous system lacks a perineurium, and the neurons in its avascular ganglia and tracts are exposed to extracellular fluid formed by permeable vessels in adjacent tissues of the gut. The reasons for excluding macromolecules from some parts of the nervous system are obscure. Carrier-mediated transport, which maintains a constant supply of ions, glucose, and other metabolites to cells in the CNS, would be impossible if larger molecules could diffuse freely. Presumably the metabolic needs of ganglia are adequately met by exchange vessels similar to those of nonnervous tissues. Most of the CNS is protected from exogenous toxic substances that bind to plasma proteins. Peripheral neurons and glial cells are damaged by some such substances because of the lack of blood-tissue barriers.

Human central nervous system myelin inhibits neurite outgrowth

In vitro and animal studies have identified molecules in mammalian CNS myelin which inhibit neuritic extension and which may be responsible, at least in part, for the lack of axonal regeneration after injury in the injured brain, optic nerve and spinal cord. To determine whether such inhibitory activity may be present in human CNS myelin, we used a bioassay to characterize neurite outgrowth on this substrate. Human CNS myelin strongly inhibited neuritic outgrowth from newborn rat dorsal root ganglion neurons and NG-108-15 cells, a neuroblastoma-glioma hybrid cell line. Similar but less potent inhibitory activity was identified in human gray matter. The CNS myelin inhibition of neuritic outgrowth appeared to be dependent on direct contact between the myelin substrate and neurites. The inhibitory activity in human CNS myelin closely resembled that described in adult rodents. Inhibition of neurite growth by human CNS myelin in this in vitro bioassay mirrors the lack of regeneration in vivo and can be used as a model to develop strategies designed to enhance axonal regeneration and neural recovery.

A novel role for myelin-associated glycoprotein as an inhibitor of axonal regeneration

Following nerve injury, axons in the CNS do not normally regenerate. It has been shown that CNS myelin inhibits neurite outgrowth, though the nature of the molecules responsible for this effect are not known. Here, we demonstrate that the myelin-associated glycoprotein (MAG), a transmembrane protein of both CNS and PNS myelin, strongly inhibits neurite outgrowth from both developing cerebellar and adult dorsal root ganglion (DRG) neurons in vitro. This inhibition is reversed by an anti-MAG antibody. In contrast, MAG promotes neurite outgrowth from newborn DRG neurons. These results suggest that MAG may be responsible, in part, for the lack of CNS nerve regeneration in vivo and may influence, both temporally and spatially, regeneration in the PNS.

Astrocyte-Schwann cell interactions in culture

After injury, either as a result of trauma or degenerating/demyelinating diseases, axons of the central nervous system (CNS) normally fail to regenerate. Transplantation of glial cells, particularly Schwann cells, into areas of injury or demyelination has been considered a promising approach to promote recovery. However, the extent of Schwann cell interaction with CNS axons is greatly influenced by the presence of astrocytes which redefine the CNS-PNS (peripheral nervous system) boundary in a lesioned CNS, thereby preventing invasion of Schwann cells. The molecular basis for this restrictive effect of astrocytes on Schwann cells is not known. In the present study, we have cocultured astrocytes and Schwann cells to develop an in vitro model to characterize this interaction. Astrocytes in contact with Schwann cells appeared hypertrophied and showed increased staining for glial fibrillary acidic protein (GFAP). In cocultures maintained for 2-3 weeks, segregation of the two cell types was observed, Schwann cells appeared in groups, and each group was surrounded and separated from one another by astrocytic processes. Since the behavior of these two cell types observed in culture is very similar to their interaction seen in vivo, this coculture model may be useful in further studying the relationship between astrocytes and Schwann cells.

Effects of arginine, S-adenosylmethionine and polyamines on nerve regeneration

INTRODUCTION

Axon growth and axon regeneration are complex processes requiring an adequate supply of certain metabolic precursors and nutrients.

MATERIAL AND METHODS

This article reviews the studies examining some of the processes of protein modification fundamental to both nerve regeneration and to the continuous and adequate supply of specific factors such as arginine, S-adenosylmethionine and polyamines.

RESULTS

The process of arginylation notably increases following nerve injury and during subsequent regeneration of the nerve, with the most likely function of arginine-modification of nerve proteins being the degradation of proteins damaged through injury. It appears that defective methyl group metabolism may be one of the leading causes of demyelination, as suggested by the observation of reduced cerebrospinal fluid concentrations of s-adenosylmethionine (SAMe) and 5-methyltetrahydrofolate, the key metabolites in methylation processes, in patients with a reduction in myelination of corticospinal tracts. Polyamine synthesis, which depends strongly on the availability of both SAMe and arginine, markedly increases in neurons soon after an injury. This "polyamine-response" has been found to be essential for the survival of the parent neurons after injury to their axons. Polyamines probably exert their effects through involvement in DNA, RNA and protein synthesis, or through post-translational modifications that are indicated as the most relevant events of the "axon reaction."

CONCLUSIONS

Nerve regeneration requires the presence of arginine, s-adenosylmethionine, and polyamines. Further studies are needed to explore the mechanisms involved in these processes.

CNS white matter can be altered to support neuronal outgrowth

Previous work has demonstrated that white matter in the adult mammalian CNS inhibits cell adhesion and neurite outgrowth. This phenomenon has been investigated most recently by culturing neurons on cryostat sections of the adult CNS. Employing this same technique, we have found, in accord with others, that neurons seldom adhere to or grow on central nervous system white matter but will attach and grow on gray matter. In the experiments presented here, embryonic rat hippocampal neurons were grown on cryostat sections from the adult rat CNS, in the presence of brain derived glial cocultures. It was found that the white matter in cryostat sections can be modified by interaction with medium conditioned by brain-derived glial cells. Neurons plated on sections pretreated by such media show significant increases in both attachment and neurite outgrowth. The activity contained in glial conditioned medium is likely complex in nature. While the majority of the activity can be eliminated by heat treatment and trypsinization, neural adhesion but not neurite initiation is affected by protease treatment. Therefore, cell attachment and neurite outgrowth may be regulated by different factors in the conditioned media.

Regrowth of PNS axons through grafts of the optic nerve of the Browman-Wyse (BW) mutant rat

We have examined the behaviour in vivo of regenerating PNS axons in the presence of grafts of optic nerve taken from the Browman-Wyse mutant rat. Browman-Wyse optic nerves are unusual because a 2-4 mm length of the proximal (retinal) end of the nerve lacks oligodendrocytes and CNS myelin and therefore retinal ganglion cell axons lying within the proximal segment are unmyelinated and ensheathed by processes of astrocyte cytoplasm. Schwann cells may also be present within some proximal segments. Distally, Browman-Wyse optic nerves are morphologically and immunohistochemically indistinguishable from control optic nerves. When we grafted intact Browman-Wyse optic nerves or 'triplets' consisting of proximal, junctional and distal segments of Browman-Wyse optic nerve between the stumps of freshly transected sciatic nerves, we found that regenerating axons avoided all the grafts which did not contain Schwann cells, i.e., proximal segments which contained only astrocytes; regions of Schwann cell-bearing proximal segments which did not contain Schwann cells; junctional and distal segments (which contained astrocytes, oligodendrocytes and CNS myelin debris). However, axons did enter and grow through proximal segments which contained Schwann cells in addition to astrocytes. Schwann cells were seen within grafts even after mitomycin C pretreatment of sciatic proximal nerve stumps had delayed outgrowth of Schwann cells from the host nerves; we therefore conclude that the Schwann cells which became associated with regenerating axons within the grafts of Browman-Wyse optic nerve were derived from an endogenous population. Our findings indicate that astrocytes may be capable of supporting axonal regeneration in the presence of Schwann cells.

Regeneration of axons in the optic nerve of the adult Browman-Wyse (BW) mutant rat

We have studied the regeneration of axons in the optic nerves of the BW rat in which both oligodendrocytes and CNS myelin are absent from a variable length of the proximal (retinal) end of the nerve. In the optic nerves of some of these animals, Schwann cells are present. Axons failed to regenerate in the exclusively astrocytic environment of the unmyelinated segment of BW optic nerves but readily regrew in the presence of Schwann cells even across the junctional zone and into the myelin debris filled distal segment. In the latter animals, the essential condition for regeneration was that the lesion was sited in a region of the nerve in which Schwann cells were resident. Regenerating fibres appeared to be sequestered within Schwann cell tubes although fibres traversed the neuropil intervening between the ends of discontinuous bundles of Schwann cell tubes, in both the proximal unmyelinated and myelin debris laden distal segments of the BW optic nerve. Regenerating axons never grew beyond the distal point of termination of the tubes. These observations demonstrate that central myelin is not an absolute requirement for regenerative failure, and that important contributing factors might include inhibition of astrocytes and/or absence of trophic factors. Regeneration presumably occurs in the BW optic nerve because trophic molecules are provided by resident Schwann cells, even in the presence of central myelin, oligodendrocytes and astrocytes. All the above experimental BW animals also have Schwann cells in their retinae which myelinate retinal ganglion cell axons in the fibre layer. Control animals comprised normal Long Evans Hooded rats, BW rats in which both retina and optic nerve were normal, and BW rats with Schwann cells in the retina but with normal, i.e. CNS myelinated, optic nerves. Regeneration was not observed in any of the control groups, demonstrating that, although the presence of Schwann cells in the retina may enhance the survival of retinal ganglion cells after crush, concomitant regrowth of axons cut in the optic nerve does not take place.

Spinal cord repair: future directions

The main cause of disability following spinal injury is failure of axons to regenerate and reconnect the spinal cord with the brain. If patients with cord lesions are ever to make a full recovery some means will have to be found to restore ascending sensory and descending motor connections. Until the last few years there has been a very limited understanding of the reasons why axons in the central nervous system (CNS) fail to regenerate, but as a result of recent work the picture is now much clearer.

Intrinsic neuronal determinants of regeneration

Axon growth and axon regeneration are co-operative processes; the speed and extent of axon growth are influenced both by the properties of the environment surrounding the axon growth cone, and the properties of the neuron itself. In recent years, the environmental influences on axon growth have received most of the attention directed towards this area of research, but the properties of the neurons themselves are likely to be just as important. Within both adults and embryos there are differences in the growth potential of different neuronal types, and there is also evidence for an overall decrease in the vigour of axon growth with neuronal age.

Regenerated synapses persist in the superior colliculus after the regrowth of retinal ganglion cell axons

Synapse formation by retinal ganglion cell axons was sought in the superior colliculus of four adult rats 16-18 months after the optic nerve was transected and replaced by a peripheral nerve graft that guided regenerating RGC axons from the eye to the superior colliculus. The terminals of retinal ganglion cell axons were labelled by intravitreal injections of tritiated amino acids and studied by light and electron microscopic autoradiography. We found that (i) retinal ganglion cell axons had extended from the tips of the peripheral nerve grafts into the superior colliculus for approximately 350 microns; (ii) within the superior colliculus, some regenerated retinal ganglion cell axons became ensheathed by CNS myelin; (iii) retinal ganglion cell terminals formed asymmetric synapses with dendrites of neurons in the superficial layers of the superior colliculus, mainly the stratum griseum superficialis. Regenerated (n = 418) and normal retinal ganglion cell terminals (n = 1775) in the superior colliculus were compared in terms of their size (area, perimeter, and maximum diameter), contacts per terminal, contacts per 10 microns terminal perimeter, and post-synaptic structure contacted (dendritic spine, shaft, or soma). No statistically significant differences in the ultrastructural characteristics of the pre-synaptic profiles were apparent between the two groups. The post-synaptic structures contacted by axon terminals were similar in regenerated and control animals, although there were quantitative differences in the distributions of these contacts among dendritic spines and shafts. These results suggest that the regeneration of retinal ganglion cell axons in adult rats can lead to the formation of ultrastructurally normal synapses in the appropriate layers of the superior colliculus. The re-formed connections appear to persist for the life-span of these animals.

Interaction of regrowing PNS axons with transplanted aggregates of cultured CNS glia in vivo

Aggregates of cultured neonatal mouse cerebellar astrocytes were implanted into adult mouse sciatic nerves. Two different experimental models were used: aggregates were either placed between proximal and distal stumps of totally transected nerves, or were placed in gaps in partially transected nerves in direct apposition with the cut surface of the proximal stumps. In the model where aggregates were not placed in contact with the proximal stump, regrowing axons rarely entered the aggregates. Where aggregates were placed in contact with the proximal stumps, axons entered the astrocyte-rich environment. Experimental depression of the supply of Schwann cells available to comigrate with regenerating axons proved to be unnecessary: astrocytes provided an alternative substrate for axons. Some axons became myelinated by oligodendrocytes which differentiated within the aggregates; however, few axons remained, unmyelinated, in long-term association with the transplanted astrocytes.

Growth cone inhibition--an important mechanism in neural development?

Since the growth cone was first described a century ago by Cajal, considerable effort has been directed towards understanding the mechanisms responsible for its guidance. Traditionally, attention has focussed on the role of adhesive molecules in determining neural development. Recently, it has become apparent that inhibitory interactions may play a crucial part in axonal navigation. A common feature of inhibition seen in three model systems (peripheral nerve segmentation, retinotectal mapping and CNS/PNS segregation) is a collapse of the motile structures of the growth cone. It is increasingly clear that the identification of molecular mechanisms of inhibition, as well as those of adhesion, will be of fundamental importance to understanding neural development.

Changes in astroglial scar formation in rat optic nerve as a function of development

Although astroglial scar formation is a common response to almost any type of injury to the adult central nervous system, lesions in fetal and neonatal rats have been reported to induce little or no scar formation. To examine this developmental difference further, rats ranging in age from 1 to 65 days postnatal were unilaterally enucleated, a surgical procedure that causes the axons in the optic nerve to degenerate. The optic nerves were processed for light and electron microscopy at times ranging from 7 to 365 days postenucleation. Pronounced and permanent glial scars were formed in every age group examined, including the neonates. However, the time course for removal of the degenerating axonal debris and formation of a compact, debris-free glial scar varied as a function of developmental age. In neonatal rats, a compact glial scar formed in 1-2 weeks whereas 3-5 months were required for compact glial scar formation in juveniles and adults. Changes in cross-sectional area were also associated with optic nerve degeneration and glial scar formation. Whereas lesioned neonatal optic nerves underwent little change in area, there was a substantial decrease in area in the juvenile and adult. Morphometric analysis showed that irrespective of the age of the animal at the time of enucleation, the final area of the compact glial scar was 10-20% of the unlesioned adult control. These results suggest that conflict in the literature over the ability of neonatal astrocytes to form a glial scar may be due to the nature of the lesion or the method of detection since astrocytes in the neonatal rat optic nerve clearly have the capacity to become reactive and form a glial scar.

The growth of axons in three-dimensional astrocyte cultures

The environment of the adult central nervous system (CNS) does not support axon regeneration. We have been unable to replicate this behaviour using monolayer cultures of glia, so we have developed a technique for three dimensional culture of glial cells. We have examined the growth of axons from embryonic and postnatal retina and dorsal root ganglia (DRG's) through purified three-dimensional astrocyte cultures. Neither postnatal DRG's nor adult retina were able to grow axons through astrocytes from cultures 3 weeks or more old, although some DRG axons grew in astrocyte cultures which were 10 days or less old. However axons from embryonic DRG's and retina grew axons profusely into even elderly astrocyte cultures. All the tissues grew axons into three-dimensional Schwann cell cultures. The behaviour of axons in three-dimensional glial cultures therefore reproduces the behaviour of axons in vivo.

Tissue sections from the mature rat brain and spinal cord as substrates for neurite outgrowth in vitro: extensive growth on gray matter but little growth on white matter

The failure of axons to regenerate within the brain and spinal cord of mature mammals has been attributed to the absence of growth-promoting substances, especially extracellular matrix components, or to the presence of growth-inhibiting substances, particularly components associated with CNS myelin. The ability of mature mammalian CNS tissue to support neurite regeneration was tested by growing explants of embryonic chick lumbar sympathetic ganglia on fresh frozen sections of the mature rat brain and spinal cord. The extent of neurite outgrowth was quantified using morphometric analysis for explants grown on sections that included most of the major anatomical divisions of the CNS. Extensive, but variable, regeneration was present on gray matter regions, whereas major white matter tracts showed poor support, if any, for neurite growth. The results are consistent with the presence of growth-inhibiting factors associated with CNS white matter but also indicate that most gray matter regions of the mature mammalian brain and spinal cord will support axonal regeneration in tissue culture in spite of the absence of known extracellular matrix components.

Peripheral nerve regeneration through optic nerve grafts

Grafts of optic nerve were placed end-to-end with the proximal stumps of severed common peroneal nerves in inbred mice. It was found that fraying the proximal end of adult optic nerve grafts to disrupt the glia limitans increased their chances of being penetrated by regenerating peripheral nerve fibres. Suturing grafts to the proximal stump also enhanced their penetration by axons. The maximum distance to which the axons grew through the CNS tissue remained about 1.5 mm from 2-12 weeks after grafting. Schwann cells were seldom identified in the grafts. Varicose and degenerating nerve fibres were often seen within the grafts. Some varicose profiles were shown to be the terminal parts of axons within the grafts. Axons containing clusters of organelles resembling synaptic vesicles became more abundant in the longer-term grafts. Immunohistochemical studies performed on sutured grafts using a polyclonal antiserum to neurofilaments confirmed the impressions given by the electron microscopical observations. Grafts of neonatal optic nerve lacked myelin debris but were not usually penetrated by regenerating peripheral axons within a 6-week period. Sixty minutes after the intravenous injection of horseradish peroxidase, reaction product could be detected in the extracellular spaces around blood vessels in all types of living optic nerve graft. This indicates that blood-borne macromolecules could penetrate the grafts. However, the profiles of axons which were found within living optic nerve grafts had no obvious relationship to blood vessels and were usually surrounded by astrocytic processes. These results suggest that living astrocytes, rather than the absence of serum-derived trophic factors or the presence of CNS myelin, constitute the major barrier to the extension of axons and the migration of Schwann cells into CNS tissue.

Detection of a nerve growth factor receptor on fetal human Schwann cells in culture: absence of the receptor on fetal human astrocytes

Cultures of human Schwann cells and astrocytes were established from fetal nerves and brains respectively. The human Schwann cells in culture expressed a nerve growth factor (NGF) receptor as determined by indirect immunofluorescence, autoradiography, and immunoprecipitation. In contrast, the human astrocytes in culture did not have an NGF receptor. Cultures of rat Schwann cells and astrocytes were also established for comparison, with similar results. The rat Schwann cells had an NGF receptor whereas the astrocytes did not. The functional significance of this NGF receptor on Schwann cells, as well as the lack of the receptor on astrocytes, is discussed.

Differentiating astroglia in nervous tissue histogenesis/regeneration: studies in a model system of regenerating peripheral nerve

The role of astroglia in nervous system histogenesis/regeneration (morphogenesis) was studied as a function of cell age. The effect of inoculated astroglia at different cell maturation stages on axonal growth was examined in a peripheral nerve regenerating model system. This model system consists of rat sciatic nerve stumps that regenerate through an empty silicone chamber (Lundborg et al.: Journal of Neuropathology and Experimental Neurology 41:412-422, 1982). Rat astroglial cell populations grown in cell culture were suspended either in a liquid (physiological solution) or in a solid (isotonic collagen gel) medium and inoculated within the silicone chamber at the time of surgery. Immature and mature cell populations, at ages corresponding to 9-69 postnatal days (P9-P69), were inoculated, and their effect on neural growth was analyzed by histological, immunocytochemical, and ultrastructural techniques, 2-6 weeks later. Astroglial cells differentially modulated the process of nerve regeneration, an effect that is a function of the cells' developmental stage. P19 astroglia and older cells inhibited the regeneration process, encapsulating the axons in a glia-limitans-like structure. Immature astrocytes (P9) did not seem to interfere with the regeneration process; nerve outgrowth in their presence resembled and was comparable to the ones obtained in the presence of inoculated Schwann cells. The differential effects of the developing astroglia were not significantly changed by the inoculation media, e.g., liquid or solid, and were already pronounced 2 weeks after neural transection. It is suggested by the results of the study that the role and function of astroglia in nervous system morphogenesis are changing with cell differentiation. Adult astrocytes seem to downregulate axonal growth; presumably, their function is to confine the neurites within designated structural and functional boundaries.

Neurite extension on dibutyryl cyclic AMP-stimulated astrocytes

Although both central and peripheral neurons successfully regenerate cut axons along peripheral nerve and other suitable substrates, axonal elongation through the mature central nervous system (CNS) is limited. It has been proposed that the presence of reactive astrocytes formed in response to CNS injury act as a barrier to axonal regeneration. In contrast, in vitro, astrocytes in a flat or unstimulated state have been shown to be a preferred substrate for neurite extension. We have investigated whether induced modifications of astrocytes alter the capacity of these cells to act as a substrate for axonal elongation. Treatment with dibutyryl cyclic AMP (dBcAMP) results in a marked morphological and biochemical change in astrocytes, considered by some to be a model of reactive astrocytosis. Retinal and dorsal root ganglia explants from embryonic mice were cultured on top of untreated glial monolayers and those treated with dBcAMP. The subsequent neuritic growth was measured at 48 h. No difference was found between the groups, indicating that astrocytes are an excellent substrate for axonal growth, even after they develop a stellate shape and high levels of glial fibrillary acidic protein.

Immature optic nerve glia of rat do not promote axonal regeneration when transplanted into a peripheral nerve

The ability of immature central nervous system (CNS) glia to promote axonal regeneration was studied by grafting segments of embryonic and neonatal rat optic nerves into the sciatic nerves of adult rats. Unexpectedly, very few axons regenerated through these grafts. The majority of the axons bypassed the grafts and were associated with Schwann cells. These results were similar to those obtained with grafts of adult rat optic nerves. The failure of immature CNS glia to promote axonal regeneration under these conditions suggests that they may be less effective than Schwann cells in promoting the regeneration and growth of axons.

Growth of retinal ganglion cell axons following optic nerve crush in adult hamsters

Regrowth of retinal ganglion cell axons was examined 2 to 60 days after intraorbital optic nerve crush lesions in adult hamsters. Anterograde axonal transport of intraocularly injected wheat germ agglutinin-horseradish peroxidase conjugate was used to label the axons after specific postinjury time periods. Labeled axons were present in the region of the optic nerve lying between the eye and the crush site at all times, but their numbers appeared to decrease with increasing survival time. Labeled axons were first detected in the segment of optic nerve lying distal to the crush site 1 week after injury and had extended as far as 2.3 mm beyond the crush site by 60 days postinjury, growing at a rate similar to that at which the collateral branches of developing ganglion cell axons extend into their targets. Although most axons failed to regrow after these lesions, the slow reextention exhibited by members of a small population of axons indicates that the degenerating adult mammalian optic nerve provides an adequate environment for a particular mode of regrowth by injured axons of the central nervous system.

The response of regenerating peripheral neurites to a grafted optic nerve

Optic nerves, both viable (fresh or pre-degenerate) or non-viable (frozen-thawed) were grafted between the proximal and distal stumps of freshly transected sciatic nerves, using either 10/0 sutures or strips of nitrocellulose paper. The majority of regenerating peripheral neurites, always in association with Schwann cells, avoided the viable optic nerve grafts, growing along the outside of the grafts in well vascularized minifascicles until they gained the distal stumps. A very small number of axons entered the grafts and grew, for distances typically less than 2 mm, between layers of astrocyte processes. The number of axons entering was not increased by using predegenerate grafts or by blocking Schwann cell proliferation in the proximal stumps by pre-treating the latter with mitomycin C. There was no evidence of a continuous cellular-acellular partition between graft and host during the outgrowth phase of the neurites: it was concluded that axons failed to enter the grafts as a result of inhibitory interactions between Schwann cells and astrocytes. When grafts were rendered acellular, all structured debris, including recognizable components of the extracellular matrix, was rapidly removed and the space thus vacated was invaded by manifascicles of Schwann cells and regenerating neurites. Glial fibrillary acidic protein-positive astrocytes and carbonic anhydrase II-positive oligodendrocytes persisted within viable grafts for 17 months; they did not migrate into the surrounding nerve.

Molecular and cellular aspects of nerve regeneration

Injury of an axon leads to at least four independent events, summarized in Figure 1: first, deprivation of the nerve cell body from target-derived or mediated substances, which leads to a derepressed or a permissive state; second, disruption of anterograde transport, with a resultant accumulation of anterogradely transported molecules; third, environmental response with possible consequent changes in constituents of the extracellular matrix and substances secreted from the surrounding cells; and fourth, appearance of growth inhibitors and modified protease activity. It seems that the first three of these events are obligatory, but not sufficient, i.e., they lead to a growth state only if the cell body is able to respond to the injury-induced signals from the environment (a and b). The regenerative state is characterized by alterations in protein synthesis and axonal transport and by sprouting activity. The subsequent elongation of the growing fibers depends on a continuous supply of appropriate growth factors. These factors are presumably anchored to the appropriate extracellular matrix that serves as a substratum for elongating fibers. It should be mentioned that the proliferating nonneuronal cells have a conducive effect on regeneration by forming a scaffold for the growing fibers. Accordingly, the lack of regeneration may stem from a deficiency in the ability of glial cells to provide the appropriate soluble components or from insufficient formation of extracellular matrix. In this respect, one may consider regeneration of an injured axon as a process which involves regeneration of both the nonneuronal cells and the supported axons. The regeneration of glial cells may fulfill the rules which are applied to regeneration of any other proliferating tissue. Furthermore, the processes of regeneration in the axon and the glial cells are mutually dependent. Perhaps the triggering factors provided by the nonneuronal cells affect the nonneuronal cells themselves by modulating their postlesion gliosis and thereby inducing their appropriate activation. In such a case, regeneration of nonneuronal cells may resemble an autocrine type of regulation that exists also during ontogeny. The growth regulation is shifted back to the paracrine type upon neuronal maturation or cessation of axonal growth. When the elongating fibers reach the vicinity of the target organ, they are under the influence of the target-derived factors, which guide the fibers and eventually cease their elongation.

Effects of delayed myelination by oligodendrocytes and Schwann cells on the macromolecular structure of axonal membrane in rat spinal cord

The macromolecular structure of axonal membrane from dorsal funiculi of control and irradiated spinal cord of 45-day-old rats was examined with freeze-fracture electron microscopy. In control spinal cords, virtually all myelination is mediated by oligodendrocytes, and the internodal axonal membrane of these fibres displays highly asymmetrical partitioning of intramembranous particles (IMPs). The internodal P-face particle density is approximately 2350IMPs per micron 2, whereas the E-face IMP density is approximately 150 per micron 2. In control dorsal spinal roots, myelination is mediated by Schwann cells, and the ultrastructure of the internodal axolemma of the myelinated fibres is similar to that displayed by myelinated fibres of dorsal funiculi. On the internodal P-face of Schwann cell-myelinated fibres the IMP density is approximately 2350 per micron 2, whereas on the E-face the density is approximately 175 per micron 2. Irradiation of the lumbosacral spinal cord at 3 days of age results in a glial cell-deficient region within the spinal cord such that myelination in irradiated dorsal funiculi is delayed and subsequent myelination is mediated by both oligodendrocytes and Schwann cells. By 45 days of age, dorsal funiculi of irradiated spinal cords are well populated with fibres myelinated by oligodendrocytes and Schwann cells. However, fibres myelinated by oligodendrocytes display very thin myelin sheaths whereas Schwann cell-myelinated fibres exhibit myelin sheaths with normal thicknesses. Internodal membrane of fibres myelinated by Schwann cells and oligodendrocytes exhibit similar macromolecular structure, with approximately 2400 IMPs per micron 2 on P-faces and approximately 150 IMPs per micron 2 on E-faces. Occasional large (greater than 1.5 micron diameter) axons without glial-Schwann cell ensheathment are observed. These axons display a high density of P-face particles (approximately 2000 per micron 2) and a moderate density (approximately 350 per micron 2) of E-face IMPs on their fracture faces. These results demonstrate that CNS fibers exhibit similar axonal membrane ultrastructure irrespective of whether they are myelinated by Schwann cells or oligodendrocytes, or whether myelination is delayed. Moreover, when myelination does not occur, the axolemmal E-face IMP density, which may be related to the density of voltage-sensitive sodium channels, is not reduced.

Peripheral nerve regeneration through grafts of living and freeze-dried CNS tissue

The ability of peripheral nerve fibres to regenerate through the central nervous system (CNS) extracellular matrix in the presence of CNS myelin debris was examined using living and freeze-dried optic nerve grafts. The grafts were placed end-to-end with the proximal stumps of severed common peroneal nerves of inbred mice. Within a 4 week period, regenerating peripheral nervous system fibres were found in only two of 14 living grafts. However axons always grew into freeze-dried grafts within one week, despite the presence of CNS myelin debris. The regenerating axons in freeze-dried grafts were accompanied by Schwann cells and were initially found associated with the inner aspect of the glial basal lamina. Although the extracellular matrix of the freeze-dried CNS tissue was subsequently reorganized by invading cells, it seems likely that neither the nature of the CNS extracellular matrix nor the presence of CNS myelin debris had a major inhibitory influence on peripheral nerve regeneration. It is suggested that the presence of living astrocytes covered by a basal lamina at the proximal end of the living optic nerve grafts may inhibit their penetration by regenerating axons.

Central nervous system axonal regeneration into sciatic nerve grafts: physiological properties of the grafts and histologic findings in the neuraxis

Autologous nerve grafts were implanted extraspinally between the medulla and the ipsilateral cervical spinal cord in adult rats. Four to eight months after implantation, electrical stimulation of the grafts evoked EMG activity in a variety of head and neck muscles in 8/10 rats. In 5/10 rats, electrical stimulation of the graft during inspiration potentiated or inhibited EMG activity in each of the diaphragms. After the recordings were completed, the grafts were cut and their ends soaked in horseradish peroxidase (HRP). The average count of HRP-labeled neurons, both in the spinal cord and brain stem, was 969 (252 to 1961). Most labeled neurons were located within +/- 2 mm of the implant sites, with labeling seen in neurons as far as 9 mm away. In the brain stem, 20 different nuclei were labeled. Among them were the reticular formation, raphe complex, cranial nerve nuclei, the subceruleus, ventrolateral pontine tegmentum regions, and contralateral red nucleus. These results in adult rats showed that (i) CNS axons elongating within peripheral nerve grafts were able to conduct action potentials and maintain functional synapses on CNS neurons; (ii) newly growing neurons were situated in close proximity to the nerve graft; and (iii) many different kinds of central neurons, including monoaminergic and descending spinal tract neurons, can elongate their axons into peripheral nerve grafts.

Regeneration of central nervous system axons into an acellular tube in the absence of distal tissue

To differentiate between local and distant influences on central nerve regeneration, an impervious, stainless-steel cannula, 12 mm long, was placed in the path of severed axons within the corpus callosum of adult rats. The cannula was occluded for 1 week after implantation to prevent herniation of tissue into its lumen. The extracranial end of the tube was plugged with Gelfoam rather than tissue. Inflammatory cells within the tube decreased in number with time and all animals survived for the experiment's duration of 4 to 16 weeks. Some callosal axons grew into the cannula and eventually extended about 1.3 mm. After 8 to 16 weeks, the lumen of the cannula contained many unmyelinated axons, some of which formed fascicles, myelinated axons, demyelinating axons, a few oligodendrocytes, and many astrocytic processes, macrophages, and blood vessels. A striking feature was the linear orientation of cells and their processes. The distal tip of the core resembled a central nervous system explant: it included an appreciable number of growth cones, synaptic terminals embedded in a generous extracellular space, and occasional remyelinating axons. Thus, within an impervious, acellular conduit and in the absence of distal tissue, intrinsic, neuronal processes can be redirected, fasciculate, myelinate, and can regrow alongside glia and endothelium. An indwelling tube, isolating the growth from surrounding brain fluid, may permit assessment of glial, neuronal, and extracellular contributions to the directed regeneration of adult, central axons.

Antiserum-induced growth of axons across lesions of the adult rat brain

Growth of axons across lesions of the adult rat brain occurred when the lesions were treated with a heterologous antiserum developed against lesioned areas of the brain. Rabbits were immunized with blocked dissected damaged rat brain plus adjuvant. The antiserum was prepared by ammonium sulfate precipitation of the immune rabbit sera followed by pepsin digestion to prevent complement-mediated damage to the recipient rats. Rats treated with the antiserum had dense cellular bridges crossing the brain lesions which contained axons. The axons within the dense cellular bridges were newly formed, since they were observed to pass through the center of paper rings which were implanted into the lesion. Individual axons were traced from one side of the lesion, through a dense cellular bridge, and into the tissue on the opposite side of the lesion. Rats lesioned in a similar manner, but treated with either phosphate-buffered saline or normal rabbit serum displayed no such growth. In addition, the limited axonal growth observed was enhanced by increasing the concentration of the antiserum administered. Thus, the antiserum induced the formation of dense cellular bridges and the growth of axons across lesions of the mammalian central nervous system.

Regrowth of cholinergic and catecholaminergic neurons along a peripheral and central nervous pathway

The transitional region between the peripheral and central nervous system in lumbosacral dorsal roots of rats were used in order to test the regeneration capacity of neurons with different metabolic characteristics. Ventral root fibres (cholinergic) and hypogastric nerve fibres (catecholaminergic) were coapted to the central stump of cut lumbosacral dorsal roots and permitted to regrow along the peripheral nervous and central nervous parts of the dorsal root. After a postoperative period of 1.5-9 months the animals were sacrificed and the coapted nerves and roots were investigated by histochemistry, light and electron microscopy. Regrowth of both cholinergic and catecholaminergic neurons had occurred into the peripheral nervous part of the root. In the central nervous part of the root, regeneration was abortive for both types of neurons. The astrocytes of the central nervous part of the root showed different morphological features according to the type of neuron that had been coapted to the dorsal root. The results are discussed in terms of neurotropism, neuron target dependence, microenvironment and type of regenerating neuron.