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Sbragia L, da Costa KM, Nour ALA, Ruano R, Santos MV, Machado HR. State of the art in translating experimental myelomeningocele research to the bedside. Childs Nerv Syst 2021; 37:2769-2785. [PMID: 34333685 DOI: 10.1007/s00381-021-05299-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 07/18/2021] [Indexed: 11/30/2022]
Abstract
Myelomeningocele (MMC), the commonest type of spina bifida (SB), occurs due to abnormal development of the neural tube and manifest as failure of the complete fusion of posterior arches of the spinal column, leading to dysplastic growth of the spinal cord and meninges. It is associated with several degrees of motor and sensory deficits below the level of the lesion, as well as skeletal deformities, bladder and bowel incontinence, and sexual dysfunction. These children might develop varying degrees of neuropsychomotor delay, partly due to the severity of the injuries that affect the nervous system before birth, partly due to the related cerebral malformations (notably hydrocephalus-which may also lead to an increase in intracranial pressure-and Chiari II deformity). Traditionally, MMC was repaired surgically just after birth; however, intrauterine correction of MMC has been shown to have several potential benefits, including better sensorimotor outcomes (since exposure to amniotic fluid and its consequent deleterious effects is shortened) and reduced rates of hydrocephalus, among others. Fetal surgery for myelomeningocele, nevertheless, would not have been made possible without the development of experimental models of this pathological condition. Hence, the aim of the current article is to provide an overview of the animal models of MMC that were used over the years and describe how this knowledge has been translated into the fetal treatment of MMC in humans.
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Affiliation(s)
- Lourenço Sbragia
- Division of Pediatric Surgery - Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Karina Miura da Costa
- Division of Pediatric Surgery - Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Antonio Landolffi Abdul Nour
- Division of Pediatric Surgery - Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Rodrigo Ruano
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas, Houston, TX, USA
| | - Marcelo Volpon Santos
- Division of Pediatric Neurosurgery - Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Hélio Rubens Machado
- Division of Pediatric Neurosurgery - Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
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Morphogenetic Variability as Potential Biomarker of Neurogenic Lesion Degree in Children with Spina Bifida. Healthcare (Basel) 2020; 8:healthcare8010068. [PMID: 32214024 PMCID: PMC7151050 DOI: 10.3390/healthcare8010068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 03/13/2020] [Accepted: 03/23/2020] [Indexed: 12/04/2022] Open
Abstract
Aims. In this study we analyzed the degree of genetic homozygosity among spina bifida patients with different degrees of neurogenic lesion (N = 82), as well as their clinical and neurological characteristics, compared to healthy control individuals (N = 100). Methods. According to clinical and electromyographic findings, we separately assessed the type of neurogenic lesion (paresis or paralysis). Regarding the degree of neurogenic lesion, patients were classified into three groups: mild, moderate and severe. We analyzed six muscles. For assessing the degree of individual genetic homozygosity, we tested the presence and distribution of 15 homozygous recessive characteristics (HRC). Results. The predominant type of neurogenic lesion was paresis. Every third evaluated muscle was affected in the group with mild neurogenic lesion, while more than half were affected in the group with severe neurogenic lesion. The average values of HRCs among different groups of patients and the control showed the population-genetic differences that exist among them (control x¯HRC/15 = 3.0 ± 0.2; mild x¯HRC/15 = 3.6 ± 0.2; moderate x¯HRC/15 = 4.8 ± 0.3; severe neurogenic lesion x¯HRC/15 = 5.0 ± 0.3). Conclusions. Spina bifida patients have a significant increase of recessive homozygosity and a decreased variability compared to the control group. As neurogenic lesions are more severe, more affected muscles are present, as well as the increase of individual recessive homozygosity.
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Khan MSI, Nabeka H, Islam F, Shimokawa T, Saito S, Li X, Kawabe S, Hamada F, Tachibana T, Matsuda S. Early neonatal loss of inhibitory synaptic input to the spinal motor neurons confers spina bifida-like leg dysfunction in a chicken model. Dis Model Mech 2017; 10:1421-1432. [PMID: 28982681 PMCID: PMC5769610 DOI: 10.1242/dmm.031054] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 10/02/2017] [Indexed: 01/03/2023] Open
Abstract
Spina bifida aperta (SBA), one of the most common congenital malformations, causes lifelong neurological complications, particularly in terms of motor dysfunction. Fetuses with SBA exhibit voluntary leg movements in utero and during early neonatal life, but these disappear within the first few weeks after birth. However, the pathophysiological sequence underlying such motor dysfunction remains unclear. Additionally, because important insights have yet to be obtained from human cases, an appropriate animal model is essential. Here, we investigated the neuropathological mechanisms of progression of SBA-like motor dysfunctions in a neural tube surgery-induced chicken model of SBA at different pathogenesis points ranging from embryonic to posthatch ages. We found that chicks with SBA-like features lose voluntary leg movements and subsequently exhibit lower-limb paralysis within the first 2 weeks after hatching, coinciding with the synaptic change-induced disruption of spinal motor networks at the site of the SBA lesion in the lumbosacral region. Such synaptic changes reduced the ratio of inhibitory-to-excitatory inputs to motor neurons and were associated with a drastic loss of γ-aminobutyric acid (GABA)ergic inputs and upregulation of the cholinergic activities of motor neurons. Furthermore, most of the neurons in ventral horns, which appeared to be suffering from excitotoxicity during the early postnatal days, underwent apoptosis. However, the triggers of cellular abnormalization and neurodegenerative signaling were evident in the middle- to late-gestational stages, probably attributable to the amniotic fluid-induced in ovo milieu. In conclusion, we found that early neonatal loss of neurons in the ventral horn of exposed spinal cord affords novel insights into the pathophysiology of SBA-like leg dysfunction.
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Affiliation(s)
- Md Sakirul Islam Khan
- Department of Anatomy and Embryology, Graduate School of Medicine, Ehime University, Toon 791-0295, Ehime, Japan .,Department of Animal Science, Bangladesh Agricultural University, Mymensingh 2202, Bangladesh
| | - Hiroaki Nabeka
- Department of Anatomy and Embryology, Graduate School of Medicine, Ehime University, Toon 791-0295, Ehime, Japan
| | - Farzana Islam
- Department of Anatomy and Embryology, Graduate School of Medicine, Ehime University, Toon 791-0295, Ehime, Japan
| | - Tetsuya Shimokawa
- Department of Anatomy and Embryology, Graduate School of Medicine, Ehime University, Toon 791-0295, Ehime, Japan
| | - Shouichiro Saito
- Laboratory of Veterinary Anatomy, Faculty of Applied Biological Sciences, Gifu University, Yanagido, Gifu 501-1128, Japan
| | - Xuan Li
- Department of Anatomy and Embryology, Graduate School of Medicine, Ehime University, Toon 791-0295, Ehime, Japan
| | - Soichiro Kawabe
- Fukui Prefectural Dinosaur Museum, Katsuyama, Fukui 911-8601, Japan
| | - Fumihiko Hamada
- Department of Human Anatomy, Faculty of Medicine, Oita University, Yufu, Oita 879-5593, Japan
| | - Tetsuya Tachibana
- Department of Agrobiological Science, Faculty of Agriculture, Ehime University, Matsuyama 790-8566, Japan
| | - Seiji Matsuda
- Department of Anatomy and Embryology, Graduate School of Medicine, Ehime University, Toon 791-0295, Ehime, Japan
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Hsieh CL, Chen KC, Lin PX, Peng CC, Peng RY. Resveratrol and vitamin E rescue valproic acid-induced teratogenicity: The mechanism of action. Clin Exp Pharmacol Physiol 2014; 41:210-9. [DOI: 10.1111/1440-1681.12205] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2013] [Revised: 11/05/2013] [Accepted: 11/11/2013] [Indexed: 01/23/2023]
Affiliation(s)
- Chiu-Lan Hsieh
- Graduate Institute of Biotechnology; Changhua University of Education; Changhua Taiwan
| | - Kuan-Chou Chen
- Department of Urology; School of Medicine; Taipei Medical University; Taichung Hsien Taiwan
- Department of Urology; Shuang Ho Hospital; Taipei Medical University; Taichung Hsien Taiwan
| | - Ping-Xiao Lin
- Graduate Institute of Biotechnology; Changhua University of Education; Changhua Taiwan
| | - Chiung-Chi Peng
- Graduate Institute of Clinical Medicine; College of Medicine; Taipei Medical University; Taichung Hsien Taiwan
| | - Robert Y Peng
- Research Institute of Biotechnology; Hungkuang University; Taichung Hsien Taiwan
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Sim KB, Lee JY, Phi JH, Kim SK, Wang KC. Experimental models of spinal open neural tube defect and Chiari type II malformation. Childs Nerv Syst 2013; 29:1435-49. [PMID: 24013317 DOI: 10.1007/s00381-013-2148-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2013] [Accepted: 05/02/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Experimental animal models are essential for investigation of the pathoembryogenesis, pathophysiology, and management strategy of spinal open neural tube defect (ONTD) and its associated anomalies including Chiari type II malformation. Genetic, chemical/nutrient, and surgical models have been widely used for a variety of purposes. The aim of this article is to review the representative animal models of spinal ONTD and associated Chiari type II malformation with respect to their advantages and disadvantages. DISCUSSION Among them, the surgical model was described in detail because it is familiar to neurosurgeons and it is used for evaluations of prenatal repair of spinal ONTDs. The surgical model also has advantages because it allows quantitative analysis of the lesions. A description of our previous studies on spinal ONTDs using a chick surgical model is presented as an example.
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Affiliation(s)
- Ki-Bum Sim
- Department of Neurosurgery, Jeju National University College of Medicine, Jeju, South Korea
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Multiple point action mechanism of valproic acid-teratogenicity alleviated by folic acid, vitamin C, And N-acetylcysteine in chicken embryo model. Toxicology 2012; 291:32-42. [DOI: 10.1016/j.tox.2011.10.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2011] [Revised: 10/19/2011] [Accepted: 10/20/2011] [Indexed: 01/10/2023]
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Tsujimura R, Mominoki K, Kinutani M, Shimokawa T, Doihara T, Nabeka H, Wakisaka H, Kobayashi N, Matsuda S. Sensory tract abnormality in the chick model of spina bifida. Neurosci Res 2011; 71:85-91. [PMID: 21658418 DOI: 10.1016/j.neures.2011.05.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2011] [Revised: 05/17/2011] [Accepted: 05/25/2011] [Indexed: 10/18/2022]
Abstract
Spina bifida aperta (SBA) is an open neural tube defect that occurs during the embryonic period. We created SBA chicks by incising the roof plate of the neural tube in the embryo. The area of the dorsal funiculus was smaller in the SBA chicks than in the normal controls. Additionally, the SBA group had fewer nerve fibres in the dorsal funiculus than the normal controls. The pathway of the ascending sensory nerves was revealed by tracing the degenerated nerve fibres using osmification. We cut the sciatic nerve (L5) of the control and SBA chicks at the central end of the dorsal root ganglion 1 day after hatching and fixed the tissue 3 days later. Degenerated sensory nerve fibres were observed in the ipsilateral dorsal funiculus in the control chicks. In contrast, degenerated sensory nerve fibres were observed in the ipsilateral and contralateral dorsal, ventral and lateral funiculi of the spinal cord in the SBA chicks. Consequently, fewer sensory nerve fibres ascended to the thoracic dorsal funiculus in the SBA chicks than in the normal controls. This is the first report of abnormal changes in the ascending sensory nerve fibres in SBA.
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Affiliation(s)
- Ryusuke Tsujimura
- Department of Legal Medicine, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
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Wang M, Mominoki K, Kinutani M, Wang Z, Kobayashi N, Shimokawa T, Nabeka H, Fujiwara T, Matsuda S. Developmental delay in islet-1-positive motor neurons in chick spina bifida. J Vet Med Sci 2010; 73:447-52. [PMID: 21127393 DOI: 10.1292/jvms.10-0385] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Spina bifida aperta (SBA) is a congenital malformation of the spinal cord with complications such as spinal ataxia and bowel and bladder dysfunction. We have developed a chick model with surgery-induced SBA that shows spinal ataxia after hatching. In the present study, motor neurons in the early stages in chicks with and without SBA were observed by immunohistochemical staining with a monoclonal antibody against Islet-1, a motor neuron marker. Delay in migration and maturation of motor neurons was observed in SBA. Although the final numbers of Islet-1-positive neurons in these two groups were not different, a defect in the production and elimination of excess motor neurons in the early developmental stages in the SBA group may be involved in the pathological mechanism of the motor complications of this disease.
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Affiliation(s)
- Min Wang
- Department of Anatomy and Embryology, Ehime University Graduate School of Medicine, Ehime, Japan
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