The influence of mechanoreceptor structures on regenerating sensory axons after cutaneous nerve transection in the cat

Dendritic atoh1a+ cells serve as transient intermediates during zebrafish Merkel cell development and regeneration

Sensory cells often adopt specific morphologies that aid in the detection of external stimuli. Merkel cells encode gentle touch stimuli in vertebrate skin and adopt a reproducible shape characterized by spiky, actin-rich microvilli that emanate from the cell surface. The mechanism by which Merkel cells acquire this stereotyped morphology from basal keratinocyte progenitors is unknown. Here, we establish that dendritic Merkel cells (dMCs) express atonal homolog 1a (atoh1a), extend dynamic filopodial processes, and arise in transient waves during zebrafish skin development and regeneration. We find that dMCs share molecular similarities with both basal keratinocytes and Merkel cells, yet display mesenchymal-like behaviors, including local cell motility and proliferation within the epidermis. Furthermore, dMCs can directly adopt the mature, microvilliated Merkel cell morphology through substantial remodeling of the actin cytoskeleton. Loss of Ectodysplasin A signaling alters the morphology of dMCs and Merkel cells within specific skin regions. Our results show that dMCs represent an intermediate state in the Merkel cell maturation program and identify Ectodysplasin A signaling as a key regulator of Merkel cell morphology.

Substance P axons and sensory threshold increase in burn-graft human skin

BACKGROUND

Our knowledge of afferent nerve fiber reinnervation of grafted skin following third-degree burn is limited by a lack of quantitative histological and psychophysical assessment from the same cutaneous area. The current study compares fiber profile and functional recovery measurements in injured and control skin from the same subject.

MATERIALS AND METHODS

Nerve regeneration and modality-specific sensory thresholds were compared using immunocytochemical labeling with protein gene product 9.5 antibody to stain all axons and anti-substance P to label substance P axons (which are predominantly unmyelinated), as well as computerized instrumentation to obtain psychophysical estimates.

RESULTS

Compared to control skin, threshold measures of pinprick (P < 0.001), warming (P < 0.001), touch (P < 0.001), and vibration (P < 0.01) were significantly elevated in burn-graft skin and correlated with histological analysis of skin biopsies obtained from the same site. Immunohistochemical staining of all axons innervating the dermis and epidermis revealed a significant reduction in burn-graft relative to control skin (54% decrease, P < 0.0001). In contrast, the incidence of substance P nerve fibers was significantly elevated in burn-graft (177% increase, P < 0.05) and appeared to correlate with patient reports of pruritus and pain.

CONCLUSIONS

Observations support the hypothesis that sensory regeneration is fiber-size-dependent in burn-graft skin. The findings that substance P fiber growth increased while total fiber count decreased and that thermal threshold showed the greatest degree of functional recovery suggest that unmyelinated neurons have the greater ability to transverse scar tissue and reinnervate grafted skin following third-degree burn injury.

Assessment of muscle flap sensibility by evoked potentials in the rat

This study investigated whether the sensory-to-motor reinervation of the muscle flap provides a better sensory recovery of an overlying skin graft. Fifty-four animals were studied in three groups of 18 rats each: group I (control): 1 cm of the gastrocnemius muscle motor nerve was excised and no repair was performed; group II (motor-to-motor repair): the motor nerve of the gastrocnemius flap was transected and repaired; group III (sensory-to-motor repair): the motor nerve of the gastrocnemius muscle and sural nerve were transected and their distal and proximal ends, respectively, were repaired. At follow-up periods of 6, 12, and 24 weeks, evaluation of hair growth, muscle atrophy, and sensory evoked potentials was performed. Somatosensory evoked potentials (SSEP) at 6 weeks in the sensory-to-motor repair (group III) revealed a significant (P < 0. 05) increase (104.4% +/- 22.9) in the relative response of peak-to-peak potentials when compared with group I (46.6% +/- 19) and group II (51.8% +/- 14.0). Muscle flap stimulation was most prominent at 6 weeks in sensory-to-motor reinvervated flaps (group III 133.1% +/- 25.4; group I 84.9% +/- 20.2). In this study, sensory-to-motor nerve repair significantly improved the sensibility of skin flaps at 6 weeks. Denervated flaps presented with 3 months of sensory recovery delay.

Degeneration and regeneration of cutaneous sensory nerve formations

Auxiliary structures of the cutaneous sensory nerve formations (SNF) are dependent on sensory innervation during their critical period of development. Denervation of mature cutaneous corpuscles results in survival of the terminal Schwann cells and the capsular structures which are probably responsible for successful reinnervation of the cutaneous SNF. In addition, the basal lamina tubes of Schwann cells are connected with the terminal Schwann cells and play an important role in the guidance of regrowing axons to their original targets. Long-lasting denervation causes atrophic changes of the terminal Schwann cells and alterations of their molecular equipment. These atrophic changes in the terminal Schwann cells may be responsible for erroneous reinnervation of cutaneous SNF. A population of the cutaneous Merkel cells surviving denervation may also serve as targets for regrowing sensory axons. The basal laminae of terminal Schwann cells are produced under control of the sensory terminals during maturation of cutaneous SNF. In adult animals, the basal laminae are capable of stimulating differentiation of migrated Schwann cells to the terminal Schwann cells without the presence of the sensory terminals. Nonspecific cholinesterase (nChE) is secreted by the terminal Schwann cells and is attached to their extracellular matrix. The synthesis of these molecules in adult animals is not influenced by the sensory terminals. However, the presence of nChE molecules is associated with living terminal Schwann cells. Fetal orthotopically grafted dorsal root ganglion (DRG) neurons have the ability to reinnervate cutaneous SNF of adult hosts. When cutaneous areas are denervated, axons from adjacent sensory nerves may extend collateral branches into this area. The capacity for such extension is dependent on: (1) type of sensory nerve ending, C and A delta fibers having significantly greater capacity than sensory axons of larger caliber; (2) age of the animal, immature animals generally showing a greater capacity for collateral sprouting; (3) the state of the adjacent axons, those already in a growth mode being more capable than "resting" ones; and (4) the regional and mechanical conditions at the site of denervation, hindpaw skin being much less extensively reinnervated by collateral fibers than that of the trunk.

The role of conduits in nerve repair: a review

The restoration of effective and meaningful axonal function following peripheral nerve injury continues to be a considerable clinical challenge. The use of conduits to bridge the gap between severed ends is a contemporary experimental maneuver that isolates the microenvironment of regenerating axons. Entubulation has allowed analysis and manipulation of putative influences upon nerve regeneration. A review is provided of the research efforts that have explored the neurobiological and mechanical factors that guide nerve regeneration within conduits. Levels of specificity, from tissue specific growth to end-organ specific growth, are outlined within the framework of the theories of Neurotropism, Contact Guidance and Neurotrophism. Included are investigations utilizing different conduit materials and the few clinical applications of these conduits. A number of chamber manipulations, extra-cellular matrix substrates and growth factors and their molecular receptors have been implicated in enhanced regeneration specificity. This information has been extended to the conduit model. The interposition of healthy nerve segments into conduits is proposed as a means of extending the length of successful nerve regeneration.

Functional innervation of cultured skin grafts

The aims of the present study were to determine 1) if grafts of cultured skin become innervated; and 2) whether tactile function of these grafts could be improved by implanting target tissue into them. Autologous skin equivalents were generated in vitro (30 d) for individual adult Sprague-Dawley rats. Some animals received pure skin equivalent grafts; others had target tissue consisting of 2-mm punch biopsies (normal skin or touch domes) inserted into their skin equivalents at the time of grafting. After 83 d, physiologic recordings were obtained from afferent nerves innervating the grafts. Tissue was processed for histology at various intervals. Silver staining of the tissues demonstrated many isolated nerve fibers in the dermis of cultured areas of skin as well as in implant zones. When grafts were rubbed with a glass rod or pinched with watchmaker forceps, impulses were evoked in nerves innervating both implant and cultured regions. In contrast, the afferent response to gently stroking grafts with a camel hair brush was severely reduced in cultured areas but was vigorous in implanted skin. Neuronal activity characteristic of type I neurons innervating touch domes was only found in cutaneous nerves innervating implants originally possessing domal tissue. Furthermore, grafts with good takes had better return of sensory function than grafts undergoing episodes of crusting. These results suggest that structural components or trophic factors present in implants enhanced the return of neural function related to the sensory modality of light touch; and this was also affected by the engraftment quality.

Tactile function in skin-equivalent grafts

Cultured grafts are excellent wound covers; however, their somatosensory capabilities are unknown. This is a preliminary report of a study which determined whether grafts of cultured skin become innervated and also examined whether seeding grafts with target tissue improved nerve growth or functional recovery. Autologous skin for grafting was generated from adult rat biopsy tissue. Dissociated keratinocytes were seeded on top of fibroblast-contracted collagen gels (skin-equivalents). Some animals received grafts composed entirely of skin-equivalents. Others had grafts with 2-mm punch biopsies (normal skin or touch domes) inserted into them. Prior to sacrifice, whole nerve recordings of the cutaneous nerves supplying the grafts were made following tactile mechanical stimulation of the graft surfaces. Tissue was processed for light and electron microscopy as well as silver stained. Nerve fibers were present in the dermis (generated from the fibroblast contracted collagen gels) of all animals and often extended to the epidermis. Light brushing of the cultured areas of the grafts produced little or no activity in the cutaneous nerves; however, afferent impulses were generated after rubbing the skin with a glass rod or pinching it with fine forceps. The implanted regions within the skin-equivalents varied from this pattern. Lightly brushing their surface resulted in vigorous activity in the nerves. Elements in the skin therefore seemed to enhance nerve regeneration and function. However, the quality of the engraftment was also important. Implanted regions of grafts experiencing poor "takes" had compromised innervation.

Patterning in the regeneration of electroreceptors in the fin of Kryptopterus

The influence of the target tissue on afferent nerve regeneration was studied in the adult glass catfish, Kryptopterus. In this fish, electroreceptors in the anal fin are distributed in a characteristic pattern in the proximal part of the fin and are absent in the distal portion of the fin. We tested whether axons were more likely to induce electroreceptors in certain regions of fin epidermis than in others. We rotated fin transplants so that the location of the degenerating electroreceptors was altered with respect to the regenerating axons in the host tissue dorsal to the fin. The effects of these rotations were observed in the living animal with differential interference contrast optics over a period of 10 weeks. When transplants were reversed rostrocaudally, new electroreceptors formed in the caudal half of the interradial zone, where degenerating electroreceptors were at the time of transplantation. When transplants were rotated so that the dorsoventral and rostrocaudal axes were reversed, some new receptors formed in the old target site regions that were located in the caudal interradial zones (in the distal half of the graft with respect to the host). Regenerating axons reached these regions of the transplant by taking unusual routes around the electroreceptor-free regions of fin. Very few electroreceptors formed in the distal/caudal or proximal/caudal interradial quadrants of grafts where the original orientation of the tissue was maintained. We suggest that old target sites have a neurotropic influence on the regenerating afferent axons and discuss the possibility that the distal fin epidermis is not as permissive to electroreceptor formation as proximal fin epidermis.

Selective reinnervation of distal motor stumps by peripheral motor axons

Random matching of regenerating axons with Schwann tubes in the distal nerve stump is thought to contribute to the often poor results of peripheral nerve repair. Motor axons would be led to sensory end organs and sensory axons to motor end plates; both would remain functionless. However, the ability of regenerating axons to differentiate between sensory and motor environments has not been adequately examined. The experiments reported here evaluated the behavior of regenerating motor axons when given equal access to distal sensory and motor nerve stumps across an unstructured gap. "Y"-shape silicon chambers were implanted within the rat femoral nerve with the proximal motor branch as axon source in the base of the Y. The distal sensory and motor branches served as targets in the branches of the Y, and were placed 2 or 5 mm from the axon source. After 2 months for axon regeneration, horseradish peroxidase was used to label the motoneurons projecting axons into either the motor or the sensory stump. Equal numbers of motoneurons were labeled from the sensory and motor stumps at 2 mm, but significantly more motoneurons were labeled from the motor stump at 5 mm. (P = 0.016). This finding is consistent with selective reinnervation of the motor stump. Augmentation of this phenomenon to produce specific reunion of individual motor axons could dramatically improve the results of nerve suture.

Reinnervation of the rat touch dome restores the Merkel cell population reduced after denervation

By using the fluorescent dye quinacrine as a marker for the Merkel cells in the rat touch dome, we previously showed that a sustained denervation of the dome causes a rapid and persistent loss of about 60% of its Merkel cells [Nurse, Macintyre and Diamond (1984) Neuroscience 11, 521-533]. We now show that if the sensory nerves to the skin are crushed (or cut) in 2-week old pups and allowed to regenerate, the Merkel cell population within touch domes shows a biphasic response; there is an initial loss of Merkel cells associated with the early phase of denervation, followed by an increase, associated with the phase of reinnervation. Physiological tests revealed that many (though not all) domes within initially deafferented skin had become functionally reinnervated and had their Merkel cell numbers either wholly or partially restored some 40-100 days post operatively. In one case an adult reinnervated dome, that appeared normal physiologically and by its complement of quinacrine fluorescent (Merkel) cells, also had normal histological features in toluidine blue sections and normally innervated Merkel cells in the electron microscope. These results, based on the use of quinacrine to visualize the Merkel cell population in the touch dome, suggest that sensory nerves may induce the differentiation of new Merkel cells in domes where these cells have become reduced after denervation.

Effects of chronic denervation in type I cutaneous mechanoreceptors (Haarscheiben)

Cutaneous type I receptor sites (Haarscheiben or tactile domes) were examined at intervals of 4 to 275 days after chronic denervation of the skin. The number of domes decreased with denervation time, and only about one-third of the domes originally present were still visible at 275 days. Most but not all of the Merkel cells from these domes were absent by 48 days, and the epithelium was significantly thinner than in nondenervated domes. Only a few of the examined domes appeared to be completely devoid of Merkel cells. It is concluded that after nerve transection, domes degenerate but do not always disappear entirely. The remnants may thus act as target sites which either attract regenerating type I nerve fibers or facilitate the formation of new dome structures after nerve regeneration.