Reconstructing myelin-deficient environments in the CNS by glial cell transplantation

A technique for producing demyelination of the rat optic nerves

Demyelination is a major cause of neurological disability within the human population, and the end product of a number of pathological processes, though the most common is the disease multiple sclerosis. This disease commonly affects the optic pathway, particularly the optic nerve and chiasm. This paper reports a novel technique of producing chemical glial toxin induced demyelination in the rat optic nerves and chiasm by the direct instillation of the glial toxin ethidium bromide into the rat cranial subarachnoid space causing demyelination of the optic nerves and chiasm. This model, because of its involvement of the optic pathways, will allow both histological and functional assessments of the processes of demyelination and remyelination in the rat animal model.

Therapeutic strategies in multiple sclerosis. II. Long-term repair

Spontaneous myelin repair in multiple sclerosis (MS) provides a striking example of the brain's inherent capacity for sustained and stable regenerative tissue repair--but also clearly emphasizes the limitations of this capacity; remyelination ultimately fails widely in many patients, and disability and handicap accumulate. The observation of endogenous partial myelin repair has raised the possibility that therapeutic interventions designed to supplement or promote remyelination might have a useful and significant impact both in the short term, in restoring conduction, and in the long term, in safeguarding axons. Therapeutic remyelination interventions must involve manipulations to either the molecular or the cellular environment within lesions; both depend crucially on a detailed understanding of the biology of the repair process and of those glia implicated in spontaneous repair, or capable of contributing to exogenous repair. Here we explore the biology of myelin repair in MS, examining the glia responsible for successful remyelination, oligodendrocytes and Schwann cells, their 'target' cells, neurons and the roles of astrocytes. Options for therapeutic remyelinating strategies are reviewed, including glial cell transplantation and treatment with growth factors or other soluble molecules. Clinical aspects of remyelination therapies are considered--which patients, which lesions, which stage of the disease, and how to monitor an intervention--and the remaining obstacles and hazards to these approaches are discussed.

Do olfactory glia have advantages over Schwann cells for CNS repair?

To a large extent the success of axon regeneration and sustained remyelination which distinguishes the PNS from the CNS is attributable to differences in their respective glial environments. For this reason, many have been attracted to the idea that repair of the CNS might be achieved by transplanting Schwann cells into areas of CNS pathology. Schwann cells will not only promote regeneration but will also myelinate axons thereby making them an appropriate cell type to mediate repair of lesions characterised by demyelination as well as axotomy. The recent discovery that olfactory glia are capable of forming myelin sheaths, together with their well-documented ability to support axon regeneration, means that these cells have a range of repair properties similar to that of Schwann cells. It is not clear at present which of these two alternatives, the Schwann cells or the olfactory glial cell, would be of greater benefit for achieving regeneration of axons or remyelination of persistent demyelination following transplantation into the CNS. In this article we review the repair properties of olfactory glia and identify the areas in which their use for repairing the CNS may have advantages over Schwann cells.

Local recruitment of remyelinating cells in the repair of demyelination in the central nervous system

The distance over which remyelinating cells within surrounding intact tissue are stimulated to respond to a demyelinating lesion and migrate toward it is unknown. To address this issue we have conducted a series of experiments in which the generation of remyelinating cells in tissue surrounding a spontaneously repairing area of demyelination induced in the adult rat spinal cord is suppressed by exposure to X-irradiation. By regulating the area of X-irradiation relative to the length of the demyelinating lesion within dorsal white matter we have shown that remyelinating cells are not recruited over distances greater than 2 mm into areas of demyelination, implying that most of the remyelinating cells are locally generated. This result indicates that there is only a narrow rim of normal tissue surrounding an area of demyelination from which remyelinating cells can be recruited. The depletion of cells within this rim may account for the poor remyelination associated with large areas of demyelination and following repeated episodes of demyelination. We have also shown that, in contrast to Schwann cells, oligodendrocyte lineage cells recruited into lesions have a limited ability to rapidly repopulate large areas of demyelination. Attempts to enhance remyelination in situations where it fails should therefore focus on increasing the size of the surrounding area from which remyelinating cells can be recruited by augmenting the level of recruitment signal, and preventing premature differentiation of oligodendrocytes so as to maximize their migratory and proliferative potential.

To what extent is oligodendrocyte progenitor migration a limiting factor in the remyelination of multiple sclerosis lesions?

In this article we describe a series of experimental approaches, involving the use of gliotoxin-induced demyelination, X-irradiation and glial cell transplantation, which examine the size of the area around demyelinating lesions from which new remyelinating cells are generated, and the distance over which they are able to migrate. Taken together, these studies suggest that the recruitment of remyelinating cells takes place over a very limited area and that long distance migration of remyelinating cells is not a feature of remyelination. The implications of these findings for spontaneous remyelination of multiple sclerosis plaques, and the development of strategies for enhancing remyelination are discussed.

Inhibition of oligodendrocyte precursor motility by oligodendrocyte processes: implications for transplantation-based approaches to multiple sclerosis

Transplantation of oligodendrocyte precursor cells represents a promising approach to the treatment of the chronic demyelinated lesions of multiple sclerosis. In view of the multi-focal nature of the disease it will be necessary for the transplanted oligodendrocyte precursor cells to migrate through normal white matter between lesions. Work in other systems has shown that differentiated oligodendrocytes within white matter express molecules inhibitory for axon outgrowth. In light of this we have examined the effect of oligodendrocytes on the migration of oligodendrocyte precursors in vitro using time lapse video microscopy. We find that oligodendrocytes induce collapse and loss of motility in oligodendrocyte precursor processes, with this effect being lost as oligodendrocytes undergo programmed cell death. We conclude that the inhibitory factors present on differentiated oligodendrocytes may prevent effective migration between lesion in vivo, and that strategies to overcome this inhibition may be required for successful repair.

Reconstruction of the glia limitans by sub-arachnoid transplantation of astrocyte-enriched cultures

Lesions in CNS white matter involving loss of glial cells with concurrent destruction of the glia limitans lead to widespread remyelination of CNS axons by Schwann cells. Previous studies have demonstrated that this situation can be changed by transplanting cultured CNS glial cells into lesions early on in the repair process. In this study we have transplanted cultured astrocytes into the sub-arachnoid space above such a lesion in order to (1) influence the normal repair process by transplant-assisted reconstruction of the glia limitans, and (2) explore the potential of a minimally invasive route for introducing cells to white matter lesions. In some cases, it proved possible to influence normal repair by transplanting cells via the sub-arachnoid route, although the results were inconsistent. However, the experiment permitted observations to be made on the migration of transplanted astrocytes across the surface of and within the spinal cord.

Glial-cell transplantation and plasticity in the O-2A lineage--implications for CNS repair

The close association that exists between development and regeneration stems from the many shared functions and the similar mechanisms by which these functions are achieved. For this reason, advances made in developmental neurobiology have provided important insights for neurobiologists interested in repair of the damaged CNS. Through the technique of transplantation, it has been possible to demonstrate that the differentiation of the 'O-2A' glial progenitor cell in vitro into oligodendrocytes and astrocytes described initially by developmental biologists can also occur within pathological states of the adult CNS.

Differentiation of the O-2A progenitor cell line CG-4 into oligodendrocytes and astrocytes following transplantation into glia-deficient areas of CNS white matter

The in vitro properties of the CG4 cell line have led to its increasing use as a cell line with which to study the behaviour of the O-2A progenitor cell. In this study we have examined the in vivo behaviour of the CG4 cell line following transplantation into areas of adult rat spinal cord white matter which have been permanently depleted of glial cells by the combination of local X-irradiation and direct injection of 0.1% ethidium bromide. Twenty-one days after transplantation, both myelin-forming oligodendrocytes and glial fibrillary acidic protein-positive astrocytes were identified within the lesion, indicating that the CG4 cell line has bipotential differentiation properties when introduced into a pathological environment consisting of demyelinated axons but devoid of oligodendrocytes or astrocytes. In this respect, the CG4 cell line resembles other glial progenitor cell lines that have been transplanted into similar lesions. In some areas of the lesion, remyelination was observed that was similar in extent to that achieved by growth factor-expanded populations of O-2A progenitor cells. The transplant origin of the cell types within the lesion was confirmed by retroviral incorporation of the lacZ marker gene, the expression of which allowed their identification by histochemistry. In conclusion, the in vivo properties of the CG4 cell line make it a highly suitable line with which to study the behaviour of O-2A progenitors following transplantation into normal and damaged CNS.

The use of xenografting to evaluate the remyelinating potential of glial cell cultures

Experiments in rodents have shown a potential role for glial cell transplantation as a means of influencing repair in the central nervous system of man. A crucial step in developing human therapy is to establish whether knowledge gained from studies in rodents is applicable to larger mammalian species. In order to explore this issue we examined the ability of cat glial cell cultures to remyelinate areas of ethidium-bromide-induced demyelination in the spinal cord of immunosuppressed rats and cats. Transplantation of density-gradient-isolated glial cells obtained from the forebrain of 7-day-old kittens resulted in enhanced oligodendrocyte remyelination in the rat but failed to enhance oligodendrocyte remyelination in the cat. The feasibility of enhancing oligodendrocyte remyelination in the cat lesion was demonstrated by transplanting a rat culture containing a high proportion of cells of the oligodendrocyte lineage. Tissue culture of the density-gradient-isolated cell preparations suggested that the failure of the kitten glial preparation to enhance oligodendrocyte remyelination in the cat was most probably due to its poor oligodendrocyte-generating capacity. However, our lack of understanding of the biology of feline glial cells precludes a full understanding of these experiments.