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Jia H, Wang Y, Chen J, Li JP, Han HQ, Tong XJ, He ZY, Ma WZ. Combination of BMSCs-laden acellular nerve xenografts transplantation and G-CSF administration promotes sciatic nerve regeneration. Synapse 2019; 73:e22093. [PMID: 30761618 DOI: 10.1002/syn.22093] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 02/03/2019] [Accepted: 02/11/2019] [Indexed: 12/12/2022]
Abstract
Peripheral nerve gaps often lead to interrupted innervation, manifesting as severe sensory and motor dysfunctions. The repairs of the nerve injuries have not achieved satisfactory curative effects in clinic. The transplantation of bone marrow stromal cells (BMSCs)-laden acellular nerve xenografts (ANX) has been proven more effective than the acellular nerve allografting. Besides, granulocyte colony-stimulating factor (G-CSF) can inhibit inflammation and apoptosis, and thus is conducive to the microenvironmental improvement of axonal regeneration. This study aims to investigate the joint effect of BMSCs-seeded ANX grafting and G-CSF administration, and explore the relevant mechanisms. Adult SD rats were divided into five groups randomly: ANX group, ANX combined with G-CSF group, BMSCs-laden ANX group, BMSCs-laden ANX combined with G-CSF group, and autograft group. Eight weeks after transplantation, the detection of praxiology and neuroelectrophysiology was conducted, and then the morphology of the regenerated nerves was analyzed. The inflammatory response and apoptosis in the nerve grafts as well as the expression of the growth-promoting factors in the regenerated tissues were further assayed. G-CSF intervention and BMSCs implanting synergistically promoted peripheral nerve regeneration and functional recovery following ANX bridging, and the restoration effect was matchable with that of the autologous nerve grafting. Moreover, local inflammation was alleviated, the apoptosis of the seeded BMSCs was decreased, and the levels of the neuromodulatory factors were elevated. In conclusion, the union application of BMSCs-implanted ANX and G-CSF ameliorated the niche of neurotization and advanced nerve regeneration substantially. The strategy achieved the favorable effectiveness as an alternative to the autotransplantation.
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Affiliation(s)
- Hua Jia
- Department of Human Anatomy and Histoembryology, College of Basic Medical Sciences, Ningxia Medical University, Yinchuan, China
| | - Ying Wang
- Research Institute of Neural Tissue Engineering, Department of Anatomy, Mudanjiang College of Medicine, Mudanjiang, China
| | - Jiao Chen
- Department of Human Anatomy and Histoembryology, College of Basic Medical Sciences, Ningxia Medical University, Yinchuan, China
| | - Jun-Ping Li
- Department of Human Anatomy and Histoembryology, College of Basic Medical Sciences, Ningxia Medical University, Yinchuan, China
| | - Huai-Qin Han
- Department of Human Anatomy and Histoembryology, College of Basic Medical Sciences, Ningxia Medical University, Yinchuan, China
| | - Xiao-Jie Tong
- Department of Anatomy, College of Basic Medical Sciences, China Medical University, Shenyang, China
| | - Zhong-Yi He
- Department of Human Anatomy and Histoembryology, College of Basic Medical Sciences, Ningxia Medical University, Yinchuan, China
| | - Wen-Zhi Ma
- Department of Human Anatomy and Histoembryology, College of Basic Medical Sciences, Ningxia Medical University, Yinchuan, China.,Key Laboratory of Fertility Preservation and Maintenance of Ministry of Education, Key Laboratory of Reproduction and Genetics of Ningxia Hui Autonomous Region, Ningxia Medical University, Yinchuan, China
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2
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Setter DO, Runge EM, Schartz ND, Kennedy FM, Brown BL, McMillan KP, Miller WM, Shah KM, Haulcomb MM, Sanders VM, Jones KJ. Impact of peripheral immune status on central molecular responses to facial nerve axotomy. Brain Behav Immun 2018; 68:98-110. [PMID: 29030217 PMCID: PMC5767532 DOI: 10.1016/j.bbi.2017.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 10/03/2017] [Accepted: 10/03/2017] [Indexed: 12/13/2022] Open
Abstract
When facial nerve axotomy (FNA) is performed on immunodeficient recombinase activating gene-2 knockout (RAG-2-/-) mice, there is greater facial motoneuron (FMN) death relative to wild type (WT) mice. Reconstituting RAG-2-/- mice with whole splenocytes rescues FMN survival after FNA, and CD4+ T cells specifically drive immune-mediated neuroprotection. Evidence suggests that immunodysregulation may contribute to motoneuron death in amyotrophic lateral sclerosis (ALS). Immunoreconstitution of RAG-2-/- mice with lymphocytes from the mutant superoxide dismutase (mSOD1) mouse model of ALS revealed that the mSOD1 whole splenocyte environment suppresses mSOD1 CD4+ T cell-mediated neuroprotection after FNA. The objective of the current study was to characterize the effect of CD4+ T cells on the central molecular response to FNA and then identify if mSOD1 whole splenocytes blocked these regulatory pathways. Gene expression profiles of the axotomized facial motor nucleus were assessed from RAG-2-/- mice immunoreconstituted with either CD4+ T cells or whole splenocytes from WT or mSOD1 donors. The findings indicate that immunodeficient mice have suppressed glial activation after axotomy, and cell transfer of WT CD4+ T cells rescues microenvironment responses. Additionally, mSOD1 whole splenocyte recipients exhibit an increased astrocyte activation response to FNA. In RAG-2-/- + mSOD1 whole splenocyte mice, an elevation of motoneuron-specific Fas cell death pathways is also observed. Altogether, these findings suggest that mSOD1 whole splenocytes do not suppress mSOD1 CD4+ T cell regulation of the microenvironment, and instead, mSOD1 whole splenocytes may promote motoneuron death by either promoting a neurotoxic astrocyte phenotype or inducing Fas-mediated cell death pathways. This study demonstrates that peripheral immune status significantly affects central responses to nerve injury. Future studies will elucidate the mechanisms by which mSOD1 whole splenocytes promote cell death and if inhibiting this mechanism can preserve motoneuron survival in injury and disease.
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Affiliation(s)
- Deborah O. Setter
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN,Research and Development Service, Richard L. Roudebush VAMC, Indianapolis, IN
| | - Elizabeth M. Runge
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN,Research and Development Service, Richard L. Roudebush VAMC, Indianapolis, IN
| | - Nicole D. Schartz
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN
| | - Felicia M. Kennedy
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN,Research and Development Service, Richard L. Roudebush VAMC, Indianapolis, IN
| | - Brandon L. Brown
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN
| | - Kathryn P. McMillan
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN,Research and Development Service, Richard L. Roudebush VAMC, Indianapolis, IN
| | - Whitney M. Miller
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN,Research and Development Service, Richard L. Roudebush VAMC, Indianapolis, IN
| | - Kishan M. Shah
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN
| | - Melissa M. Haulcomb
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN,Research and Development Service, Richard L. Roudebush VAMC, Indianapolis, IN
| | - Virginia M. Sanders
- Molecular Virology, Immunology, and Medical Genetics, The Ohio State University, Columbus, OH
| | - Karthryn J. Jones
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN,Research and Development Service, Richard L. Roudebush VAMC, Indianapolis, IN
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Th17 Cell Response in SOD1G93A Mice following Motor Nerve Injury. Mediators Inflamm 2016; 2016:6131234. [PMID: 27194826 PMCID: PMC4852359 DOI: 10.1155/2016/6131234] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 02/22/2016] [Indexed: 12/13/2022] Open
Abstract
An increased risk of ALS has been reported for veterans, varsity athletes, and professional football players. The mechanism underlying the increased risk in these populations has not been identified; however, it has been proposed that motor nerve injury may trigger immune responses which, in turn, can accelerate the progression of ALS. Accumulating evidence indicates that abnormal immune reactions and inflammation are involved in the pathogenesis of ALS, but the specific immune cells involved have not been clearly defined. To understand how nerve injury and immune responses may contribute to ALS development, we investigated responses of CD4+ T cell after facial motor nerve axotomy (FNA) at a presymptomatic stage in a transgenic mouse model of ALS (B6SJL SOD1G93A). SOD1G93A mice, compared with WT mice, displayed an increase in the basal activation state of CD4+ T cells and higher frequency of Th17 cells, which were further enhanced by FNA. In conclusion, SOD1G93A mice exhibit abnormal CD4+ T cell activation with increased levels of Th17 cells prior to the onset of neurological symptoms. Motor nerve injury exacerbates Th17 cell responses and may contribute to the development of ALS, especially in those who carry genetic susceptibility to this disease.
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Jeyachandran A, Mertens B, McKissick EA, Mitchell CS. Type I Vs. Type II Cytokine Levels as a Function of SOD1 G93A Mouse Amyotrophic Lateral Sclerosis Disease Progression. Front Cell Neurosci 2015; 9:462. [PMID: 26648846 PMCID: PMC4664727 DOI: 10.3389/fncel.2015.00462] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 11/13/2015] [Indexed: 01/01/2023] Open
Abstract
Amyotrophic Lateral Sclerosis (ALS) is a fatal motoneuron disease that is characterized by the degradation of neurons throughout the central nervous system. Inflammation have been cited a key contributor to ALS neurodegeneration, but the timeline of cytokine upregulation remains unresolved. The goal of this study was to temporally examine the correlation between the varying levels of pro-inflammatory type I cytokines (IL-1β, IL-1α, IL-12, TNF-α, and GFAP) and anti-inflammatory type II cytokines (IL-4, IL-6, IL-10) throughout the progression of ALS in the SOD1 G93A mouse model. Cytokine level data from high copy SOD1 G93A transgenic mice was collected from 66 peer-reviewed studies. For each corresponding experimental time point, the ratio of transgenic to wild type (TG/WT) cytokine was calculated. One-way ANOVA and t-tests with Bonferonni correction were used to analyze the data. Meta-analysis was performed for four discrete stages: early, pre-onset, post-onset, and end stage. A significant increase in TG cytokine levels was found when compared to WT cytokine levels across the entire SOD1 G93A lifespan for majority of the cytokines. The rates of change of the individual cytokines, and type I and type II were not significantly different; however, the mean fold change of type I was expressed at significantly higher levels than type II levels across all stages with the difference between the means becoming more pronounced at the end stage. An overexpression of cytokines occurred both before and after the onset of ALS symptoms. The trend between pro-inflammatory type I and type II cytokine mean levels indicate a progressive instability of the dynamic balance between pro- and anti-inflammatory cytokines as anti-inflammatory cytokines fail to mediate the pronounced increase in pro-inflammatory cytokines. Very early immunoregulatory treatment is necessary to successfully interrupt ALS-induced neuroinflammation.
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Affiliation(s)
- Amilia Jeyachandran
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University Atlanta, GA, USA
| | - Benjamin Mertens
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University Atlanta, GA, USA
| | - Eric A McKissick
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University Atlanta, GA, USA
| | - Cassie S Mitchell
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University Atlanta, GA, USA
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5
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Tovar-y-Romo LB, Penagos-Puig A, Ramírez-Jarquín JO. Endogenous recovery after brain damage: molecular mechanisms that balance neuronal life/death fate. J Neurochem 2015; 136:13-27. [PMID: 26376102 DOI: 10.1111/jnc.13362] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 07/27/2015] [Accepted: 08/25/2015] [Indexed: 01/08/2023]
Abstract
Neuronal survival depends on multiple factors that comprise a well-fueled energy metabolism, trophic input, clearance of toxic substances, appropriate redox environment, integrity of blood-brain barrier, suppression of programmed cell death pathways and cell cycle arrest. Disturbances of brain homeostasis lead to acute or chronic alterations that might ultimately cause neuronal death with consequent impairment of neurological function. Although we understand most of these processes well when they occur independently from one another, we still lack a clear grasp of the concerted cellular and molecular mechanisms activated upon neuronal damage that intervene in protecting damaged neurons from death. In this review, we summarize a handful of endogenously activated mechanisms that balance molecular cues so as to determine whether neurons recover from injury or die. We center our discussion on mechanisms that have been identified to participate in stroke, although we consider different scenarios of chronic neurodegeneration as well. We discuss two central processes that are involved in endogenous repair and that, when not regulated, could lead to tissue damage, namely, trophic support and neuroinflammation. We emphasize the need to construct integrated models of neuronal degeneration and survival that, in the end, converge in neuronal fate after injury. Under neurodegenerative conditions, endogenously activated mechanisms balance out molecular cues that determine whether neurons contend toxicity or die. Many processes involved in endogenous repair may as well lead to tissue damage depending on the strength of stimuli. Signaling mediated by trophic factors and neuroinflammation are examples of these processes as they regulate different mechanisms that mediate neuronal demise including necrosis, apoptosis, necroptosis, pyroptosis and autophagy. In this review, we discuss recent findings on balanced regulation and their involvement in neuronal death.
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Affiliation(s)
- Luis B Tovar-y-Romo
- División de Neurociencias, Instituto de Fisiología Celular, Universidad Nacional Autónoma de México, México, D. F., México
| | - Andrés Penagos-Puig
- División de Neurociencias, Instituto de Fisiología Celular, Universidad Nacional Autónoma de México, México, D. F., México
| | - Josué O Ramírez-Jarquín
- División de Neurociencias, Instituto de Fisiología Celular, Universidad Nacional Autónoma de México, México, D. F., México
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6
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Jones KJ, Lovett-Racke AE, Walker CL, Sanders VM. CD4 + T Cells and Neuroprotection: Relevance to Motoneuron Injury and Disease. J Neuroimmune Pharmacol 2015; 10:587-94. [PMID: 26148561 DOI: 10.1007/s11481-015-9625-x] [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: 02/16/2015] [Accepted: 06/30/2015] [Indexed: 12/12/2022]
Abstract
We have established a physiologically relevant mechanism of CD4+ T cell-mediated neuroprotection involving axotomized wildtype (WT) mouse facial motoneurons (FMN) with significance in the treatment of amyotrophic lateral sclerosis (ALS), a fatal MN disease. Use of the transgenic mouse model of ALS involving expression of human mutant superoxide dismutase genes (SOD1(G93A); abbreviated here as mSOD1) has accelerated basic ALS research. Superimposition of facial nerve axotomy (FNA) on the mSOD1 mouse during pre-symptomatic stages indicates that they behave like immunodeficient mice in terms of increased FMN loss and decreased functional recovery, through a mechanism that, paradoxically, is not inherent within the MN itself, but, instead, involves a defect in peripheral immune: CNS glial cell interactions. Our goal is to utilize our WT mouse model of immune-mediated neuroprotection after FNA as a template to elucidate how a malfunctioning peripheral immune system contributes to motoneuron cell loss in the mSOD1 mouse. This review will discuss potential immune defects in ALS, as well as provide an up-to-date understanding of how the CD4+ effector T cells provide neuroprotection to motoneurons through regulation of the central microglial and astrocytic response to injury. We will discuss an IL-10 cascade within the facial nucleus that requires a functional CD4+ T cell trigger for activation. The review will discuss the role of T cells in ALS, and our recent reconstitution experiments utilizing our model of T cell-mediated neuroprotection in WT vs mSOD1 mice after FNA. Identification of defects in neural:immune interactions could provide targets for therapeutic intervention in ALS.
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Affiliation(s)
- Kathryn J Jones
- Indiana University School of Medicine, Indianapolis, IN, USA.
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7
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Haulcomb MM, Mesnard-Hoaglin NA, Batka RJ, Meadows RM, Miller WM, Mcmillan KP, Brown TJ, Sanders VM, Jones KJ. Identification of B6SJL mSOD1(G93A) mouse subgroups with different disease progression rates. J Comp Neurol 2015; 523:2752-68. [PMID: 26010802 DOI: 10.1002/cne.23814] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 05/14/2015] [Accepted: 05/15/2015] [Indexed: 12/16/2022]
Abstract
Disease progression rates among patients with amyotrophic lateral sclerosis (ALS) vary greatly. Although the majority of affected individuals survive 3-5 years following diagnosis, some subgroups experience a more rapidly progressing form, surviving less than 1 year, and other subgroups experience slowly progressing forms, surviving nearly 50 years. Genetic heterogeneity and environmental factors pose significant barriers in investigating patient progression rates. Similar to the case for humans, variation in survival within the mSOD1 mouse has been well documented, but different progression rates have not been investigated. The present study identifies two subgroups of B6SJL mSOD1(G93A) mice with different disease progression rates, a fast progression group (FPG) and slow progression group, as evidenced by differences in the rate of motor function decline. In addition, increased disease-associated gene expression within the FPG facial motor nucleus confirmed the presence of a more severe phenotype. We hypothesize that a more severe disease phenotype could be the result of 1) an earlier onset of axonal disconnection with a consistent degeneration rate or 2) a more severe or accelerated degenerative process. We performed a facial nerve transection axotomy in both mSOD1 subgroups prior to disease onset as a method to standardize the axonal disconnection. Instead of leading to comparable gene expression in both subgroups, this standardization did not eliminate the severe phenotype in the FPG facial nucleus, suggesting that the FPG phenotype is the result of a more severe or accelerated degenerative process. We theorize that these mSOD1 subgroups are representative of the rapid and slow disease phenotypes often experienced in ALS.
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Affiliation(s)
- Melissa M Haulcomb
- Neuroscience Program, Loyola University Medical Center, Maywood, Illinois, 60153.,Research and Development Service, Hines Veterans Administration Hospital, Hines, Illinois, 60141.,Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana, 46202.,Research and Development Service, Roudebush Veterans Administration Medical Center, Indianapolis, Indiana, 46202
| | - Nichole A Mesnard-Hoaglin
- Neuroscience Program, Loyola University Medical Center, Maywood, Illinois, 60153.,Research and Development Service, Hines Veterans Administration Hospital, Hines, Illinois, 60141
| | - Richard J Batka
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana, 46202.,Research and Development Service, Roudebush Veterans Administration Medical Center, Indianapolis, Indiana, 46202
| | - Rena M Meadows
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana, 46202.,Research and Development Service, Roudebush Veterans Administration Medical Center, Indianapolis, Indiana, 46202.,Program in Medical Neurosciences, Indiana University School of Medicine, Indianapolis, Indiana, 46202
| | - Whitney M Miller
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana, 46202.,Research and Development Service, Roudebush Veterans Administration Medical Center, Indianapolis, Indiana, 46202
| | - Kathryn P Mcmillan
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana, 46202.,Research and Development Service, Roudebush Veterans Administration Medical Center, Indianapolis, Indiana, 46202
| | - Todd J Brown
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana, 46202.,Research and Development Service, Roudebush Veterans Administration Medical Center, Indianapolis, Indiana, 46202
| | - Virginia M Sanders
- Department of Molecular Virology, Immunology, and Medical Genetics, The Ohio State University, Columbus, Ohio, 43210
| | - Kathryn J Jones
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana, 46202.,Research and Development Service, Roudebush Veterans Administration Medical Center, Indianapolis, Indiana, 46202
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Olmstead DN, Mesnard-Hoaglin NA, Batka RJ, Haulcomb MM, Miller WM, Jones KJ. Facial nerve axotomy in mice: a model to study motoneuron response to injury. J Vis Exp 2015:e52382. [PMID: 25742324 DOI: 10.3791/52382] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The goal of this surgical protocol is to expose the facial nerve, which innervates the facial musculature, at its exit from the stylomastoid foramen and either cut or crush it to induce peripheral nerve injury. Advantages of this surgery are its simplicity, high reproducibility, and the lack of effect on vital functions or mobility from the subsequent facial paralysis, thus resulting in a relatively mild surgical outcome compared to other nerve injury models. A major advantage of using a cranial nerve injury model is that the motoneurons reside in a relatively homogenous population in the facial motor nucleus in the pons, simplifying the study of the motoneuron cell bodies. Because of the symmetrical nature of facial nerve innervation and the lack of crosstalk between the facial motor nuclei, the operation can be performed unilaterally with the unaxotomized side serving as a paired internal control. A variety of analyses can be performed postoperatively to assess the physiologic response, details of which are beyond the scope of this article. For example, recovery of muscle function can serve as a behavioral marker for reinnervation, or the motoneurons can be quantified to measure cell survival. Additionally, the motoneurons can be accurately captured using laser microdissection for molecular analysis. Because the facial nerve axotomy is minimally invasive and well tolerated, it can be utilized on a wide variety of genetically modified mice. Also, this surgery model can be used to analyze the effectiveness of peripheral nerve injury treatments. Facial nerve injury provides a means for investigating not only motoneurons, but also the responses of the central and peripheral glial microenvironment, immune system, and target musculature. The facial nerve injury model is a widely accepted peripheral nerve injury model that serves as a powerful tool for studying nerve injury and regeneration.
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Affiliation(s)
- Deborah N Olmstead
- Anatomy and Cell Biology, Indiana University School of Medicine; Research and Development Services, Richard L. Roudebush VA Medical Center
| | | | - Richard J Batka
- Anatomy and Cell Biology, Indiana University School of Medicine; Research and Development Services, Richard L. Roudebush VA Medical Center
| | - Melissa M Haulcomb
- Anatomy and Cell Biology, Indiana University School of Medicine; Research and Development Services, Richard L. Roudebush VA Medical Center
| | - Whitney M Miller
- Anatomy and Cell Biology, Indiana University School of Medicine; Research and Development Services, Richard L. Roudebush VA Medical Center
| | - Kathryn J Jones
- Anatomy and Cell Biology, Indiana University School of Medicine; Research and Development Services, Richard L. Roudebush VA Medical Center;
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