Nerve Growth Factor Delivery and Cell Aggregation Enhance Choline Acetyltransferase Activity after Neural Transplantation

Brain-Derived Neurotrophic Factor and Nerve Growth Factor Therapeutics for Brain Injury: The Current Translational Challenges in Preclinical and Clinical Research

Ischemic stroke and traumatic brain injury (TBI) are among the leading causes of death and disability worldwide with impairments ranging from mild to severe. Many therapies are aimed at improving functional and cognitive recovery by targeting neural repair but have encountered issues involving efficacy and drug delivery. As a result, therapeutic options for patients are sparse. Neurotrophic factors are one of the key mediators of neural plasticity and functional recovery. Neurotrophic factors such as brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) serve as potential therapeutic options to increase neural repair and recovery as they promote neuroprotection and regeneration. BDNF and NGF have demonstrated the ability to improve functional recovery in preclinical and to a lesser extent clinical studies. Direct and indirect methods to increase levels of neurotrophic factors in animal models have been successful in improving postinjury outcome measures. However, the translation of these studies into clinical trials has been limited. Preclinical experiments have largely failed to result in significant impacts in clinical research. This review will focus on the administration of these neurotrophic factors in preclinical and clinical stroke and TBI and the challenges in translating these therapies from the bench to the clinic.

Change in neuron aggregation and neurite fasciculation on EVAL membranes modified with different diamines

In this study, we modified poly(ethylene-co-vinyl alcohol) (EVAL) membranes by the covalent bonding of diamines via epoxidation of surface hydroxyl groups of EVAL to analyze the effect of immobilized diamines with different carbon chain length on the cultured cerebellar granule neurons. Morphological studies showed that neurons seeded on the diamine-immobilized EVAL membrane were able to survive and regenerate with formation of an extensive neuritic network. Furthermore, cultured neurons showed that the presence of diamine with different carbon chain length was able to effectively regulate the neuron adhesion, migration, aggregation, and neurite growth pattern, but mediated neuronal activity with equal efficacy. The short-chain amine stimulated neuron migration, aggregation, and neurite fasciculation, whereas the long carbon chain diamine maintained single neuron distribution with the defasciculated feature of the neurite. Although it is known that positively charged amine molecules can interact directly with cell surface proteoglycans to mediate cell attachment, this study further demonstrated that the terminal primary amine with different carbon chain length is involved in mediating cell-substrate interaction to further regulate neuron aggregation and neurite fasciculation. This indicates a delicate interaction of neuron with the immobilized diamine molecules on the EVAL membrane surface. This work is encouraging because the diamine- immobilized EVAL membranes can be applied for the establishment of different neural culture systems useful for future investigations of neuron biology under in vitro conditions.

Aggregation enhances catecholamine secretion in cultured cells

Transplanted cells and tissues have potential uses in the treatment of genetic, geriatric, and metabolic disorders, but optimal conditions for transplantation are not yet known. In this report, PC12 cells were aggregated in rotary and microgravity culture, using serum-free or serum-supplemented medium, and using a multifunctional polymer-peptide aggregation factor. Aggregates and single cells were then encapsulated and cultured within agarose gels, and the dopamine secretion in response to a depolarization buffer was measured using high-performance liquid chromatography combined with electrochemical detection (HPLC-ECD). On a per-cell basis, aggregated cells secreted higher levels of dopamine than did single cells. The size of the aggregates was also a factor in catecholamine secretion; dopamine release from the larger aggregates formed in rotary culture was observed to increase at a faster rate, then achieve a plateau level at an earlier time than did the smaller aggregates. Cells aggregated in microgravity culture exhibited a markedly different behavior, lacking the rapid rise in dopamine secretion characteristic of the rotary-aggregates cells: on a per-cell basis, the dopamine secretion remained at a level corresponding to the plateau level expressed by the rotary-aggregates cells. Dopamine secretion in aggregates may be enhanced by the increase in number of cell-cell contacts, as occurs during high-density culture of PC12 cells. These results provide further evidence that cell-cell contact regulates the behavior of differentiated cells, and therefore is important in tissue engineering.

Millimeter-scale positioning of a nerve-growth-factor source and biological activity in the brain

Toxicity prevents the systemic administration of many therapeutic proteins, and attempts at protein targeting via the circulatory system (i.e., "magic bullets") have failed in all but a few special cases. Direct administration at the target site is a logical alternative, particularly in the central nervous system, but the limits of direct administration have not been defined clearly. Nerve growth factor (NGF) enhances survival of cholinergic neurons and, therefore, has generated considerable interest for the treatment of Alzheimer's disease. We tested the effectiveness of local delivery by implanting small polymer pellets that slowly released NGF into the central nervous system of adult rats at controlled distances from a target site containing transplanted fetal cholinergic cells. NGF-releasing implants placed within 1-2 mm of the treatment site enhanced the biological function of cellular targets, whereas identical implants placed approximately 3 mm from the target site of treatment produced no beneficial effect. Effective NGF therapy required millimeter-scale positioning of the NGF source, and efficacy correlated with the spatial distribution of NGF concentration in the tissue; this result suggests that NGF must be delivered within several millimeters of the target to be effective in treating Alzheimer's disease. Because the human brain is divided into functional regions that are typically several centimeters in diameter and often irregular in shape, new methods for sculpting larger-scale drug fields are needed. We illustrate a concept, called pharmacotectonics, in which drug-delivery systems are arranged spatially in tissues to shape concentration fields for potent agents.

Cultures of cells from fetal rat brain: methods to control composition, morphology, and biochemical activity

Fetal tissue transplantation is a promising new approach for the treatment of neurodegenerative diseases, but the optimal conditions for preparing cells for transplantation have not been defined. The growth of a population of septal brain cells, primarily containing cholinergic neurons and glia, was characterized after seeding at densities from 5 x 10(4) to 6 x 10(5) cells/cm2, on polystyrene-, collagen-, laminin-, and fibronectin-coated surfaces, in the presence of serum and/or serum-free medium. Differentiated glial cells were selected by culture on fibronectin or laminin surfaces, in the presence of low amounts of serum (2.5% FBS) and G5, a soluble factor containing EGF and insulin. Differentiated neuronal cells were selected by culture on laminin, in the presence of low amounts of serum (2.5% FBS) and N2, a soluble factor containing supplemental hormones. In each case, a minimum seeding density of 1 x 10(5) cells/cm2 was required. Neuronal growth could be maintained long term (21 days) with high levels of neuronal activity (ChAT activity).

Intracranial delivery of recombinant nerve growth factor: release kinetics and protein distribution for three delivery systems

PURPOSE

Three different polymeric delivery systems, composed of either poly(ethylene-co-vinyl acetate) (EVAc) or poly(lactide-co-glycolide) (PLGA), were used to administer recombinant human nerve growth factor (rhNGF) intracranially in rats.

METHODS

The delivery systems were characterized with respect to release kinetics, both in the brain and in well-stirred buffer solutions.

RESULTS

During incubation in buffered saline, the delivery systems released rhNGF in distinct patterns: sustained (EVAc), immediate (PLGA1) and delayed (PLGA2). One 10-mg delivery system was implanted in each rat and an ELISA technique was used to determine the amount of rhNGF in 1-mm coronal brain slices produced immediately after removal of the delivery system. High levels of rhNGF (as high as 60,000 ng in a brain slice of approximately 50 microliters) were recovered from the brain tissue at 1, 2, and 4 weeks after implantation. With all three delivery systems, the amount of rhNGF in each brain slice decreased exponentially with distance from the implant site: the distance over which concentration decreased by 10-fold was 2-3 mm for all delivery systems. When rhNGF release was moderate (10 to 200 ng rhNGF/day), the total amount of rhNGF in the brain increased linearly with release rate, suggesting an overall rate of rhNGF elimination of 0.4 hr-1 or a half-life of 1.7 hr. With higher release rates (500 to 50,000 ng rhNGF/day), total amounts of rhNGF in the brain were considerably higher than anticipated based on this rate of elimination.

CONCLUSIONS

Polymeric controlled release can provide high, localized doses of rhNGF in the brain. All of the experimental data were consistent with penetration of rhNGF through the brain tissue with a diffusion coefficient approximately 8 x 10(-7) cm2/s, which is approximately 50% of the diffusion coefficient in water.

Materials for protein delivery in tissue engineering

The ability of protein agents to modulate cellular behaviors, such as motility, proliferation, adhesion and function, is the subject of intense research; new therapies involving proteins will likely result. Unfortunately, many proteins have short half-lives and the potential for toxicity after systemic delivery, so traditional routes of administration are not appropriate. Alternate methods for sustained delivery of these agents to the desired cells and tissues in biologically active conformations and concentrations are necessary. Techniques similar to those long used in the controlled delivery of drugs have been used to administer certain growth factors to cells and tissues; although clinical success has been limited to date, studies in animal models suggest the potential for tremendous advances in the near future. This review outlines the basic technology of controlled protein delivery using polymeric materials, and discusses some of the techniques under investigation for the efficient administration of proteins in tissue engineering.

Nerve growth factor delivery systems

Growth factors encourage tissue regeneration and differentiation, accelerate wound healing, and modulate neural repair. Thus, growth factor administration may become a useful treatment for neurodegenerative diseases, such as Alzheimer's disease or Parkinson's disease, which are characterized by the degeneration of neuronal cell populations. Controlled-release polymer delivery systems may be an important technology in enabling the prevention of neuronal degeneration, or even the stimulation of neuronal regeneration, by providing a sustained release of growth factors to promote the long-term survival of endogenous or transplanted cells.

Localized delivery of proteins in the brain: can transport be customized?

Certain central nervous system (CNS) diseases are characterized by the degeneration of specific cell populations. One strategy for treating neurodegenerative diseases is long-term, controlled delivery of proteins such as epidermal growth factor (EGF) and nerve growth factor (NGF). Since proteins permeate through brain capillaries very slowly, local administration using polymeric implants, continuous infusion pumps, or transplanted, protein-secreting cells may be required to achieve therapeutic concentrations in the tissue. The efficiency of local distribution, and hence effectiveness of local therapy, depends on the rate of protein migration through tissue. The rate of dispersion of molecules in a quiescent, isotropic medium can be characterized by the molecular diffusion coefficient, D, which can be measured by techniques such as quantitative autoradiography, iontophoresis, and fluorescence photobleaching recovery (FPR). These methods are reviewed, with an emphasis on their application to measurement of D for proteins in the brain. Biophysical techniques yield quantitative descriptions of local protein distribution and may enable discrimination of mechanisms of protein transport in the brain. This capability suggests a new paradigm for design of protein therapies, in which proteins and delivery systems are collectively customized to provide sustained protein availability over predetermined volumes of tissue.