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Ikemoto‐Uezumi M, Zhou H, Kurosawa T, Yoshimoto Y, Toyoda M, Kanazawa N, Nakazawa T, Morita M, Tsuchida K, Uezumi A. Increased MFG-E8 at neuromuscular junctions is an exacerbating factor for sarcopenia-associated denervation. Aging Cell 2022; 21:e13536. [PMID: 34953020 PMCID: PMC8761010 DOI: 10.1111/acel.13536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 11/11/2021] [Accepted: 11/30/2021] [Indexed: 11/28/2022] Open
Abstract
Sarcopenia is an important health problem associated with adverse outcomes. Although the etiology of sarcopenia remains poorly understood, factors apart from muscle fibers, including humoral factors, might be involved. Here, we used cytokine antibody arrays to identify humoral factors involved in sarcopenia and found a significant increase in levels of milk fat globule epidermal growth factor 8 (MFG‐E8) in skeletal muscle of aged mice, compared with young mice. We found that the increase in MFG‐E8 protein at arterial walls and neuromuscular junctions (NMJs) in muscles of aged mice. High levels of MFG‐E8 at NMJs and an age‐related increase in arterial MFG‐E8 have also been identified in human skeletal muscle. In NMJs, MFG‐E8 is localized on the surface of terminal Schwann cells, which are important accessory cells for the maintenance of NMJs. We found that increased MFG‐E8 at NMJs precedes age‐related denervation and is more prominent in sarcopenia‐susceptible fast‐twitch than in sarcopenia‐resistant slow‐twitch muscle. Comparison between fast and slow muscles further revealed that arterial MFG‐E8 can be uncoupled from sarcopenic phenotype. A genetic deficiency in MFG‐E8 attenuated age‐related denervation of NMJs and muscle weakness, providing evidence of a pathogenic role of increased MFG‐E8. Thus, our study revealed a mechanism by which increased MFG‐E8 at NMJs leads to age‐related NMJ degeneration and suggests that targeting MFG‐E8 could be a promising therapeutic approach to prevent sarcopenia.
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Affiliation(s)
- Madoka Ikemoto‐Uezumi
- Muscle Aging and Regenerative Medicine Tokyo Metropolitan Institute of Gerontology (TMIG) Tokyo Japan
| | - Heying Zhou
- Muscle Aging and Regenerative Medicine Tokyo Metropolitan Institute of Gerontology (TMIG) Tokyo Japan
| | - Tamaki Kurosawa
- Muscle Aging and Regenerative Medicine Tokyo Metropolitan Institute of Gerontology (TMIG) Tokyo Japan
- Laboratory of Veterinary Pharmacology Department of Veterinary Medical Sciences Graduate School of Agriculture and Life Sciences Tokyo University Tokyo Japan
| | - Yuki Yoshimoto
- Muscle Aging and Regenerative Medicine Tokyo Metropolitan Institute of Gerontology (TMIG) Tokyo Japan
| | | | - Nobuo Kanazawa
- Department of Surgery Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology Tokyo Japan
| | | | - Mitsuhiro Morita
- Department of Orthopaedic Surgery Fujita Health University Toyoake Japan
| | - Kunihiro Tsuchida
- Division for Therapies against Intractable Diseases Institute for Comprehensive Medical Science Fujita Health University Toyoake Japan
| | - Akiyoshi Uezumi
- Muscle Aging and Regenerative Medicine Tokyo Metropolitan Institute of Gerontology (TMIG) Tokyo Japan
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Alhindi A, Boehm I, Forsythe RO, Miller J, Skipworth RJE, Simpson H, Jones RA, Gillingwater TH. Terminal Schwann cells at the human neuromuscular junction. Brain Commun 2021; 3:fcab081. [PMID: 33977269 PMCID: PMC8093923 DOI: 10.1093/braincomms/fcab081] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/09/2021] [Accepted: 03/03/2021] [Indexed: 12/13/2022] Open
Abstract
Terminal Schwann cells are non-myelinating glial cells localized to the neuromuscular junction. They play an important role in regulating many aspects of neuromuscular junction form and function, in health and during disease. However, almost all previous studies of mammalian terminal Schwann cells have used rodent models. Despite a growing awareness of differences in the cellular and molecular anatomy of rodent and human neuromuscular junctions, it remains unclear as to whether these differences also extend to the terminal Schwann cells. Here, we have adapted immunohistochemical protocols to facilitate visualization and comparative morphometric analyses of terminal Schwann cells at the human and mouse neuromuscular junction. We labelled terminal Schwann cells in the peroneus brevis muscle in six adult mice and five humans with antibodies against S100 protein. All human neuromuscular junctions were associated with at least one terminal Schwann cell, consistent with findings from other species, with an average of ∼1.7 terminal Schwann cells per neuromuscular junction in both humans and mice. In contrast, human terminal Schwann cells were significantly smaller than those of mice (P ≤ 0.01), in keeping with differences in overall synaptic size. Human terminal Schwann cell cytoplasm extended significantly beyond the synaptic boundaries of the neuromuscular junction, whereas terminal Schwann cells in mice were largely restricted to the synapse. Moreover, there was a significant difference in the location of terminal Schwann cell nuclei (P ≤ 0.01), with human terminal Schwann cells having their nuclear compartment located beyond the perimeter of the synapse more than the mouse. Taken together, these findings demonstrate that terminal Schwann cells at the human neuromuscular junction have notable differences in their morphology and synaptic relationships compared to mice. These fundamental differences need to be considered when translating the findings of both neuromuscular junction biology and pathology from rodents to humans.
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Affiliation(s)
- Abrar Alhindi
- Edinburgh Medical School: Biomedical Sciences, University of Edinburgh, Edinburgh EH8 9XD, UK.,Euan MacDonald Centre for Motor Neurone Disease Research, University of Edinburgh, Edinburgh EH16 4SB, UK.,Faculty of Medicine, Department of Anatomy, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Ines Boehm
- Edinburgh Medical School: Biomedical Sciences, University of Edinburgh, Edinburgh EH8 9XD, UK.,Euan MacDonald Centre for Motor Neurone Disease Research, University of Edinburgh, Edinburgh EH16 4SB, UK
| | - Rachael O Forsythe
- Clinical Surgery, Edinburgh Medical School, and Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
| | - Janice Miller
- Clinical Surgery, Edinburgh Medical School, and Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
| | - Richard J E Skipworth
- Clinical Surgery, Edinburgh Medical School, and Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
| | - Hamish Simpson
- Department of Orthopaedic Surgery, University of Edinburgh, Edinburgh EH16 4SB, UK
| | - Ross A Jones
- Edinburgh Medical School: Biomedical Sciences, University of Edinburgh, Edinburgh EH8 9XD, UK.,Euan MacDonald Centre for Motor Neurone Disease Research, University of Edinburgh, Edinburgh EH16 4SB, UK
| | - Thomas H Gillingwater
- Edinburgh Medical School: Biomedical Sciences, University of Edinburgh, Edinburgh EH8 9XD, UK.,Euan MacDonald Centre for Motor Neurone Disease Research, University of Edinburgh, Edinburgh EH16 4SB, UK
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Fuertes-Alvarez S, Izeta A. Terminal Schwann Cell Aging: Implications for Age-Associated Neuromuscular Dysfunction. Aging Dis 2021; 12:494-514. [PMID: 33815879 PMCID: PMC7990373 DOI: 10.14336/ad.2020.0708] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 07/08/2020] [Indexed: 12/11/2022] Open
Abstract
Action potential is transmitted to muscle fibers through specialized synaptic interfaces called neuromuscular junctions (NMJs). These structures are capped by terminal Schwann cells (tSCs), which play essential roles during formation and maintenance of the NMJ. tSCs are implicated in the correct communication between nerves and muscles, and in reinnervation upon injury. During aging, loss of muscle mass and strength (sarcopenia and dynapenia) are due, at least in part, to the progressive loss of contacts between muscle fibers and nerves. Despite the important role of tSCs in NMJ function, very little is known on their implication in the NMJ-aging process and in age-associated denervation. This review summarizes the current knowledge about the implication of tSCs in the age-associated degeneration of NMJs. We also speculate on the possible mechanisms underlying the observed phenotypes.
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Affiliation(s)
- Sandra Fuertes-Alvarez
- 1Biodonostia, Tissue Engineering Group, Paseo Dr. Begiristain, s/n, San Sebastian 20014, Spain
| | - Ander Izeta
- 1Biodonostia, Tissue Engineering Group, Paseo Dr. Begiristain, s/n, San Sebastian 20014, Spain.,2Tecnun-University of Navarra, School of Engineering, Department of Biomedical Engineering and Science, Paseo Mikeletegi, 48, San Sebastian 20009, Spain
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4
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Perisynaptic schwann cells - The multitasking cells at the developing neuromuscular junctions. Semin Cell Dev Biol 2020; 104:31-38. [PMID: 32147379 DOI: 10.1016/j.semcdb.2020.02.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 02/27/2020] [Accepted: 02/28/2020] [Indexed: 12/27/2022]
Abstract
Neuromuscular junctions (NMJs) are specialized synapses in the peripheral nervous system that allow the transmission of neuronal impulses to skeletal muscles for their contraction. Due to its size and accessibility, the NMJ is a commonly used model for studying basic principles of synapse organization and function. Similar to synapses in the central nervous system, NMJs are composed of presynaptic axonal terminals, the postsynaptic machinery formed at the membrane of the muscle fibers, and the synapse-associated glial cells. The special glial cells at the NMJs are called terminal Schwann cells or perisynaptic Schwann cells (PSCs). Decades of studies on the NMJ, as well as the most recent discoveries, have revealed multiple functions for PSCs at different stages of synaptic formation, maintenance, and disassembly. This review summarizes major observations in the field.
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Snyder-Warwick AK, Satoh A, Santosa KB, Imai SI, Jablonka-Shariff A. Hypothalamic Sirt1 protects terminal Schwann cells and neuromuscular junctions from age-related morphological changes. Aging Cell 2018; 17:e12776. [PMID: 29851253 PMCID: PMC6052483 DOI: 10.1111/acel.12776] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2018] [Indexed: 12/29/2022] Open
Abstract
Neuromuscular decline occurs with aging. The neuromuscular junction (NMJ), the interface between motor nerve and muscle, also undergoes age‐related changes. Aging effects on the NMJ components—motor nerve terminal, acetylcholine receptors (AChRs), and nonmyelinating terminal Schwann cells (tSCs)—have not been comprehensively evaluated. Sirtuins delay mammalian aging and increase longevity. Increased hypothalamic Sirt1 expression results in more youthful physiology, but the relationship between NMJ morphology and hypothalamic Sirt1 was previously unknown. In wild‐type mice, all NMJ components showed age‐associated morphological changes with ~80% of NMJs displaying abnormalities by 17 months of age. Aged mice with brain‐specific Sirt1 overexpression (BRASTO) had more youthful NMJ morphologic features compared to controls with increased tSC numbers, increased NMJ innervation, and increased numbers of normal AChRs. Sympathetic NMJ innervation was increased in BRASTO mice. In contrast, hypothalamic‐specific Sirt1 knockdown led to tSC abnormalities, decreased tSC numbers, and more denervated endplates compared to controls. Our data suggest that hypothalamic Sirt1 functions to protect NMJs in skeletal muscle from age‐related changes via sympathetic innervation.
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Affiliation(s)
- Alison K. Snyder-Warwick
- Division of Plastic Surgery; Department of Surgery; Washington University School of Medicine; St. Louis MO USA
| | - Akiko Satoh
- Department of Developmental Biology; Washington University School of Medicine; St. Louis MO USA
- Sleep and Aging Regulation Research Project Team; National Center for Geriatrics and Gerontology; Obu Aichi Japan
- Project for Elucidating and Controlling Mechanisms of Aging and Longevity; Japan Agency for Medical Research and Development; Tokyo Japan
| | - Katherine B. Santosa
- Division of Plastic Surgery; Department of Surgery; Washington University School of Medicine; St. Louis MO USA
| | - Shin-ichiro Imai
- Department of Developmental Biology; Washington University School of Medicine; St. Louis MO USA
- Project for Elucidating and Controlling Mechanisms of Aging and Longevity; Japan Agency for Medical Research and Development; Tokyo Japan
| | - Albina Jablonka-Shariff
- Division of Plastic Surgery; Department of Surgery; Washington University School of Medicine; St. Louis MO USA
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Kuhman D, Willson J, Mizelle J, DeVita P. The relationships between physical capacity and biomechanical plasticity in old adults during level and incline walking. J Biomech 2018; 69:90-96. [DOI: 10.1016/j.jbiomech.2018.01.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Revised: 11/06/2017] [Accepted: 01/08/2018] [Indexed: 11/30/2022]
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Effects of ageing on expression of the muscle-specific E3 ubiquitin ligases and Akt-dependent regulation of Foxo transcription factors in skeletal muscle. Mol Cell Biochem 2015; 412:59-72. [PMID: 26590085 DOI: 10.1007/s11010-015-2608-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 11/14/2015] [Indexed: 12/11/2022]
Abstract
Controversy exists as to whether the muscle-specific E3 ubiquitin ligases MAFbx and MuRF1 are transcriptionally upregulated in the process of sarcopenia. In the present study, we investigated the effects of ageing on mRNA/protein expression of muscle-specific E3 ubiquitin ligases and Akt/Foxo signalling in gastrocnemius muscles of female mice. Old mice exhibited a typical sarcopenic phenotype, characterized by loss of muscle mass and strength, decreased amount of myofibrillar proteins, incidence of aberrant muscle fibres, and genetic signature to sarcopenia. Activation levels of Akt were lower in adult and old mice than in young mice. Consequently, Akt-mediated phosphorylation levels of Foxo1 and Foxo3 proteins were decreased. Nuclear levels of Foxo1 and Foxo3 proteins showed an overall increasing trend in old mice. MAFbx mRNA expression was decreased in old mice relative to adult mice, whereas MuRF1 mRNA expression was less affected by ageing. At the protein level, MAFbx was less affected by ageing, whereas MuRF1 was increased in old mice relative to adult mice, with ubiquitin-protein conjugates being increased with ageing. In conclusion, we provided evidence for no mRNA upregulation of muscle-specific E3 ubiquitin ligases and disconnection between their expression and Akt/Foxo signalling in sarcopenic mice. Their different responsiveness to ageing may reflect different roles in sarcopenia.
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Striking denervation of neuromuscular junctions without lumbar motoneuron loss in geriatric mouse muscle. PLoS One 2011; 6:e28090. [PMID: 22164231 PMCID: PMC3229526 DOI: 10.1371/journal.pone.0028090] [Citation(s) in RCA: 158] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2011] [Accepted: 11/01/2011] [Indexed: 01/06/2023] Open
Abstract
Reasons for the progressive age-related loss of skeletal muscle mass and function, namely sarcopenia, are complex. Few studies describe sarcopenia in mice, although this species is the mammalian model of choice for genetic intervention and development of pharmaceutical interventions for muscle degeneration. One factor, important to sarcopenia-associated neuromuscular change, is myofibre denervation. Here we describe the morphology of the neuromuscular compartment in young (3 month) compared to geriatric (29 month) old female C57Bl/6J mice. There was no significant difference in the size or number of motoneuron cell bodies at the lumbar level (L1–L5) of the spinal cord at 3 and 29 months. However, in geriatric mice, there was a striking increase (by ∼2.5 fold) in the percentage of fully denervated neuromuscular junctions (NMJs) and associated deterioration of Schwann cells in fast extensor digitorum longus (EDL), but not in slow soleus muscles. There were also distinct changes in myofibre composition of lower limb muscles (tibialis anterior (TA) and soleus) with a shift at 29 months to a faster phenotype in fast TA muscle and to a slower phenotype in slow soleus muscle. Overall, we demonstrate complex changes at the NMJ and muscle levels in geriatric mice that occur despite the maintenance of motoneuron cell bodies in the spinal cord. The challenge is to identify which components of the neuromuscular system are primarily responsible for the marked changes within the NMJ and muscle, in order to selectively target future interventions to reduce sarcopenia.
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9
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Age-associated alterations of the neuromuscular junction. Exp Gerontol 2010; 46:193-8. [PMID: 20854887 DOI: 10.1016/j.exger.2010.08.029] [Citation(s) in RCA: 173] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2010] [Revised: 08/19/2010] [Accepted: 08/27/2010] [Indexed: 01/09/2023]
Abstract
Age-related loss of muscle mass and function greatly affects quality of life in the elderly population. Several hypotheses have been proposed but accumulating evidence point to alterations in neuromuscular system during aging as a key event that leads to functional denervation, muscle wasting, and weakness. Over the past few decades, age-associated degeneration of the neuromuscular junction (NMJ) and its components have been well documented. With advancing age, pre-terminal portions of motor axons exhibit regions of abnormal thinning, distension, and sprouting whereas postsynaptic endplates decrease in size and reduce in number, length, and density of postsynaptic folds. Although the exact underlying mechanisms are still lacking, recent studies provided direct evidence that age-associated increase in oxidative stress plays a crucial role in NMJ degeneration and progression of sarcopenia. Homozygous deletion of an important antioxidant enzyme, Cu,Zn superoxide dismutase (CuZnSOD, SOD1) leads to acceleration of age-dependent muscle atrophy, with a significant NMJ degeneration similar to that seen in old wild-type sarcopenic animals. In this short review, we briefly summarize the current understanding of some of the cellular and molecular changes in the NMJ during aging and suggest a role for oxidative stress and mitochondrial dysfunction in age-related changes in the maintenance of neuromuscular innervation.
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10
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Abstract
The spinal stretch reflex consists of a relatively simple neuronal network. The Ia afferent fiber of the muscle spindle communicates to the alpha motoneuron via a single synapse. This basic pathway has been studied extensively over the past century, yet considerable information continues to emerge concerning the manner in which this pathway adapts to aging. It is well accepted that the amplitude of the spinal stretch reflex declines with normal aging, and it is intuitively agreed that these changes have a detrimental impact on the motor output of aging individuals. Understanding the changes observed in the spinal stretch reflex pathway due to aging requires a recognition of the changes that can occur in each component of this spinal network. This review will address these changes by following the spinal stretch reflex from initiation to completion. The components that result in the sensory input to the motoneuron will be covered first, followed by a review of the physiological changes that can occur to the motoneuron soma that can affect the processing of the sensory input. The output of the motoneuron encompasses the remaining components from the motor axon itself, to the neuromuscular junction, and then to the characteristic changes in the muscle. Finally, the functional effect that these changes have on the reflex as a fundamental motor behavior will be addressed, especially in terms of its impact on posture and balance.
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Abstract
We describe the formation, maturation, elimination, maintenance, and regeneration of vertebrate neuromuscular junctions (NMJs), the best studied of all synapses. The NMJ forms in a series of steps that involve the exchange of signals among its three cellular components--nerve terminal, muscle fiber, and Schwann cell. Although essentially any motor axon can form NMJs with any muscle fiber, an additional set of cues biases synapse formation in favor of appropriate partners. The NMJ is functional at birth but undergoes numerous alterations postnatally. One step in maturation is the elimination of excess inputs, a competitive process in which the muscle is an intermediary. Once elimination is complete, the NMJ is maintained stably in a dynamic equilibrium that can be perturbed to initiate remodeling. NMJs regenerate following damage to nerve or muscle, but this process differs in fundamental ways from embryonic synaptogenesis. Finally, we consider the extent to which the NMJ is a suitable model for development of neuron-neuron synapses.
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Affiliation(s)
- J R Sanes
- Department of Anatomy and Neurobiology, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
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Luff AR. Age-associated changes in the innervation of muscle fibers and changes in the mechanical properties of motor units. Ann N Y Acad Sci 1998; 854:92-101. [PMID: 9928423 DOI: 10.1111/j.1749-6632.1998.tb09895.x] [Citation(s) in RCA: 125] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In both humans and animals there is a progressive loss of muscle strength with age. Tests of handgrip and knee extension in men show that some decline in strength is evident by the age of 55 years and is pronounced by the age of 65, compared with the 25- to 35-year period when strength is at a maximum. A comparable age-related decline in peak force development has also been shown in hind-limb muscles of aged rats. Motoneurons and consequently motor units are lost with age, and this is apparent in man after the age of 60. Again, a comparable decline has been demonstrated in the motoneuron population of hindlimb muscles of rats aged 20-24 months. Loss of motoneurons in young adults (through either injury or disease) results in the remaining intact motoneurons sprouting to innervate the denervated fibers. This capacity for sprouting has been shown to be seriously impaired in the hindlimb muscles of aged rats. Furthermore, the well-established relationship between motor unit size and fatigability (smaller units tend to be more fatigue resistant) also tends to break down, with large units just as likely to be fatigable as fatigue resistant. The normally large, fatigable motor units also appear to be reduced in size in the aged muscles. The age-related loss of motoneurons and associated loss of muscle fibers accounts in part for the reduced functional capacity of muscle with age. The reason for the impairment of the aged motoneuron remains to be investigated, but it may relate to the integrity of the oxidative metabolic pathways within the cell, given that mitochondrial respiratory chain function is known to be reduced with age.
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Affiliation(s)
- A R Luff
- Department of Physiology, Monash University, Clayton, Victoria, Australia.
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Ludatscher RM, Silbermann M. Abnormalities of intramuscular nerves in old mice: an ultrastructural study. Exp Gerontol 1988; 23:127-37. [PMID: 3402552 DOI: 10.1016/0531-5565(88)90077-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Intramuscular branches of tibial nerves of 5- and 27-month-old mice were compared. Seventeen intramuscular nerve fascicles were studied in each group: 174 myelinated axons were evaluated in the young mice, and 136 in the aged mice. The old mice showed significant decreases in numbers of myelinated axons per nerve, and these had significant decreases in concentrations of mitochondria. Interaxonal collagen and numbers of collagen fibrils were increased, as was the concentration of unmyelinated axons. Myelinated axons of old mice demonstrated myelin disorganization, myelin nodules, degeneration of axoplasm and Schwann cells.
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Affiliation(s)
- R M Ludatscher
- Department of Pathology, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa
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