Ultrastructural changes in the region of the node of ranvier in the rat caused by diphtheria toxin

Interruptible demyelination in avian riboflavin deficient neuropathy

BACKGROUND AND AIMS

The evolution of demyelination in individual internodes remains unclear although it has been noticed the paranodal demyelination precedes internodal demyelination in neuropathies with diverse aetiologies. For therapeutic purpose, it is fundamental to know whether the demyelinating procedure in affected internodes can be interrupted. This study aimed to delineate the development of demyelination in individual internodes in avian riboflavin deficient neuropathy.

METHODS

Newborn broiler meat chickens were maintained either on a routine diet containing 5.0 mg/kg riboflavin, a riboflavin deficient diet containing 1.8 mg/kg riboflavin, or initially a riboflavin deficient diet for 11 days and then routine diet plus riboflavin repletion from day 12. Evolution of demyelination in individual internodes was analyzed by teased nerve fibre studies from day 11 to 21.

RESULTS

In riboflavin deficient chickens, demyelination was the predominant feature: it was mainly confined to the paranodal region at day 11; extended into internodal region, but less than half of the internodal length in most affected internodes at day 16; involved more than half or whole internode at day 21. In the internode undergoing demyelination, myelin degeneration of varying degrees was noticed in the cytoplasm of the Schwann cell wrapping the internode. Two days after riboflavin repletion, co-existence of remyelination and active demyelination within individual internodes was noticed. Remyelination together with preserved short original internodes was the characteristic feature 4 and 9 days after riboflavin repletion.

CONCLUSION

Riboflavin repletion interrupts the progression from paranodal to internodal demyelination in riboflavin deficient chickens and promotes remyelination before complete internodal demyelination.

Activity-dependent regulation of prestin expression in mouse outer hair cells

Prestin is a membrane protein necessary for outer hair cell (OHC) electromotility and normal hearing. Its regulatory mechanisms are unknown. Several mouse models of hearing loss demonstrate increased prestin, inspiring us to investigate how hearing loss might feedback onto OHCs. To test whether centrally mediated feedback regulates prestin, we developed a novel model of inner hair cell loss. Injection of diphtheria toxin (DT) into adult CBA mice produced significant loss of inner hair cells without affecting OHCs. Thus, DT-injected mice were deaf because they had no afferent auditory input despite OHCs continuing to receive normal auditory mechanical stimulation and having normal function. Patch-clamp experiments demonstrated no change in OHC prestin, indicating that loss of information transfer centrally did not alter prestin expression. To test whether local mechanical feedback regulates prestin, we used Tecta(C1509G) mice, where the tectorial membrane is malformed and only some OHCs are stimulated. OHCs connected to the tectorial membrane had normal prestin levels, whereas OHCs not connected to the tectorial membrane had elevated prestin levels, supporting an activity-dependent model. To test whether the endocochlear potential was necessary for prestin regulation, we studied Tecta(C1509G) mice at different developmental ages. OHCs not connected to the tectorial membrane had lower than normal prestin levels before the onset of the endocochlear potential and higher than normal prestin levels after the onset of the endocochlear potential. Taken together, these data indicate that OHC prestin levels are regulated through local feedback that requires mechanoelectrical transduction currents. This adaptation may serve to compensate for variations in the local mechanical environment.

Imbalances in N-CAM, SAM and polysialic acid may underlie the paranodal ion channel barrier defect in diabetic neuropathy

Breakdown of protective tissue barrier systems characterizes the chronic diabetic complications affecting the retina, and peripheral and central nerve tracts. The progressive damages to the blood-retina-, blood-nerve-, and paranodal ion channel barriers have pathophysiological consequences for the relentless progression of these complications. The continuing damage to the paranodal ion channel barrier in the spontaneously diabetic BB/W rat is associated with an increasingly irreversible nerve conduction defect, due to impaired nodal Na+ currents associated with displacement of nodal Na+ channels across the damaged paranodal barrier. The structural substrate for the mechanical barrier of the paranode is provided by electron-dense junctional complexes made up by a moiety of neural cell adhesive-(N-CAM), neural-glial adhesive (Ng-CAM), substrate adhesive molecules (SAMs) and polysialic acid (PSA). To further explore the mechanism underlying the protective barrier defect in diabetic neuropathy we examined the expression and immunolocalization of these molecules in peripheral nerve. In 6-month diabetic BB/W rats, direct and indirect ELISAs revealed significantly up-regulated N-CAM (P < 0.05), tenascin (Ng-CAM), (P < 0.001) and N-cadherin (A-CAM) (P < 0.03). On the other hand, SAMs showed little change, except for PSA which showed a significantly (P < 0.03) decreased concentration in the diabetic nerve. Immunocytochemical identification of these molecules revealed no visually detectable differences between diabetic and control rats. In conclusion, these data suggest that imbalances between highly interactive molecules responsible for the adhesiveness between terminal Schwann cell loops and the paranodal axolemma may underlie the critical paranodal barrier defect in diabetic neuropathy.

An orderly development of paranodal axoglial junctions and bracelets of Nageotte in the rat sural nerve

The present study was designed to assess the normal development of the paranodal apparatus with particular emphasis on axoglial junctions (AGJs) which constitute the paranodal barrier system. The sural nerve was examined in 10- and 31-day-old rats. During the early phase of myelination AGJ attachment of terminal myelin loops to the axolemma proceeded from the node to the internode. The frequency of terminal loops with AGJ attachment increased with fiber growth. As myelination advanced internodal-most loops became almost 100% attached to the axolemma by AGJs, whereas at the same time an increasing number of nodal-most loops were unattached, suggesting a lack of AGJ formation at this site. The formation of bracelets of Nageotte increased with the progressive addition of myelin loops. They formed most frequently at the juxtanodal interface between unattached and attached loops, probably reflecting crowding of terminal loops along the unchanged length of the paranodal axolemma. The findings suggest a complex but orderly age- and fiber size-dependent maturation process of the paranode and its structural barrier system. The present data will serve as a basis for the evaluation of this anatomical region in regenerating and remyelinating fibers in various neuropathies.

Myelin sheath remodelling in remyelinated rat sciatic nerve

In order to elicit de- and remyelination adult rat sciatic nerves were injected with diphtheria toxin dissolved in phosphate buffered saline (PBS). Control nerves were injected with PBS alone. After survival times of 1-10 weeks, the animals were perfused with glutaraldehyde. Specimens from the injected nerves were processed for light microscopic (LM) examination of teased fibres or for electron microscopic (EM) examination of longitudinal thin sections. LM examination of teased fibres after survival times of 6-10 weeks, showed that most remyelinated internodes are 150-300 microns long. In addition, some exceptionally short Schwann cell sheaths, with lengths of 15-150 microns, occur intercalated between conventional remyelinated internodes. EM analysis of thin sections showed that axonal evaginations penetrate in between the terminating myelin lamellae in fibres with nodal widening and/or paranodal demyelination, at early stages of demyelination. Such alterations are not present in relation to myelin sheaths formed during remyelination, which commences about 3 weeks after injection. In addition, some scattered contracted Schwann cell sheaths, which may be as short as 5-10 microns, occur at all stages. These are more frequent shortly after onset of remyelination than at later stages, and they are either composed of a cytoplasmic investment bordered by heminodes, or a more or less distorted myelin sheath bordered by nodes of Ranvier. This picture is very similar to the myelin sheath remodelling observed in regenerated rat sciatic nerves, and in some developing nerves with a mismatch between nerve growth and internodal elongation. It is concluded that a myelin sheath remodelling occurs in de- and remyelinated rat sciatic nerve, presumably as a result of the lack of longitudinal growth.

Nodes of Ranvier in acrylamide neuropathy: voltage clamp and electron microscopic analysis of rat sciatic nerve fibres at proximal levels

Adult male rats were injected with acrylamide monomer (50 mg/kg i.p., 3 times/week). The animals developed hind limb paresis and distal motor nerve conduction velocity decreased. Three of 14 examined isolated myelinated sciatic nerve fibres showed a reduced excitability. In the remaining fibres the action potentials were normal. Potential clamp analysis of nodes of Ranvier in the single fibres revealed large delayed nodal K currents in 6 cases. Four of these 6 fibres exhibited a markedly increased membrane capacitance and in 2 fibres an increased Na permeability was found. Electron microscopic examination of sciatic nerves revealed comparatively subtle internodal and nodal-paranodal alterations in large myelinated fibres. Internodally, focal aggregates of tubulovesicular profiles could be found and some Schwann cells were hypertrophic. Paranodally, axonal evaginations penetrated in between the terminating myelin lamellae. Some paranodes had a very thin myelin covering and/or exhibited varying degrees of myelin sheath retraction. In the nodal axon domains lacking an axolemmal undercoating and partly non-undercoated axolemmal protrusions could be found. Similar physiological and morphological alterations occur in the rat sciatic nerve above a neuroma. Therefore, the presently observed proximal changes may, to some extent, represent non-specific alterations, secondary to a target deprivation caused by the distal axon degeneration typical for acrylamide neuropathy.

Nodes of Ranvier above a neuroma in the rat sciatic nerve: voltage clamp analysis and electron microscopy

Neuroma formation was induced in adult rat sciatic nerves and the animals were allowed to survive for 1-10 months. In 10 animals single large myelinated fibres from the nerve segment above the neuroma were subjected to voltage clamp analysis. Six animals were fixed by glutaraldehyde perfusion and nodes of Ranvier or large myelinated fibres above the neuroma were examined in the electron microscope (EM). Most fibres exhibited normal action potentials, but a few had a reduced excitability and small action potentials. Some fibres had increased membrane time constant and leak conductance and a markedly increased membrane capacitance. Most of the examined nodes of Ranvier exhibited abnormally large delayed K currents, which could be blocked with 4-aminopyridine (4-AP). The Na current was normal. In the EM most large cross-cut myelinated axons were markedly atrophic, particularly after long survival times. Evaginations from the paranodal region of these axons penetrated between the terminating paranodal myelin lamellae. The nodal axolemmal undercoating could be very prominent and in some cases the nodal axon was irregular. These findings show that large myelinated peripheral nerve fibres, which are chronically disconnected from their peripheral targets, exhibit specific structural and functional abnormalities of the nodes of Ranvier.

Distortions of the nodes of Ranvier from axonal distension by filamentous masses in hexacarbon intoxication

A study has been made of the structural changes of nodal and paranodal regions of the nodes of Ranvier of peripheral nerves of rats in which marked accumulations of neurofilaments have occurred within axons under the influence of 2,5-hexanediol over 10 weeks. The neurofilamentous masses caused distension of the axon at two points of apparent weakness as they attempted to slide through the axonal constriction at the nodes. Principally, a spiral axonal protrusion pushed into the zone of unattached myelin loops in the proximal paranodal spinous bracelet of Nageotte. This led to a conical widening of the paranodal constriction and considerable attenuation of the overlying myelin. No degeneration of the myelin occurred however. Alternatively, or additionally, a protrusion occurred of the axon at the nodal region which increased the nodal gap width and occasionally compressed and displaced the adjacent distal paranodal constriction which could have led to some obstruction of axoplasmic flow. Swelling of distal paranodal regions occurred later and was usually associated with proximal swelling. It was also accompanied by evidence suggesting transnodal passage of filamentous material. Sometimes, however, striking nodal constriction occurred in association with symmetrical paranodal swelling. These observations suggest that the spiral glial-axonal relationships at nodes of Ranvier are capable of marked deformation that might allow the intra-axonal neurofilamentous masses to move distally. These findings are discussed in relation to the structural features of the paranodal constrictions.

Electrical properties of isolated demyelinated rat nerve fibres

Isolated large rat nerve fibres with diphtheria toxin induced paranodal demyelination were investigated. These fibres had increased membrane time constant of the demyelinated nodal segment, related to a large increase in capacitance (5 to 50 times). The resting conductance was less increased (2 to 3 times), meaning that the internodal axolemma has considerably higher resting resistance than the nodal membrane. A large variation in action potential amplitude was found which was unrelated to the size of the nodal widening and the passive electrical properties.

Peripheral neuropathies associated with chronic renal failure

A variety of peripheral nerve disorders may be associated with chronic renal failure. The polyneuropathy due to uremic toxins is a distal, motor and sensory polyneuropathy in which there is segmental demyelination, axonal degeneration, and segmental remyelination. The nature of the uremic toxin and the underly mechanism of these changes is unknown. The incidence in patients with "end-stage" renal disease has fallen in recent years, severe cases now being rare, perhaps due to refinements in chronic hemodialysis, transplantation, and other therapies. However, while chronic hemodialysis stabilizes uremic neuropathy, manipulation of hemodialysis schedules may not alter its course, according to current assessment. Successful renal transplantation improves both the clinical and electrophysiological signs, even in severe uremic neuropathy.

Conduction velocity in hexachlorophane neuropathy: correlation between electrophysiological and histological findings

After 2-3 weeks exposure to hexachlorophane, maximum motor nerve conduction velocity in sciatic nerves of rats was reduced by 7.5% and evoked muscle action potential amplitude by 9%. Histological examination at this stage showed intramyelin oedema affecting some fibres and axonal degeneration of other fibres. After longer periods of exposure velocity and amplitude fell further. Velocity was reduced by 27% after 6-7 months treatment. In addition to intramyelin oedema and axonal degeneration, segmental demyelination was present in animals intoxicated for more than three months. There was no correlation between the degree of oedema and reduction of conduction velocity. It is concluded that intramyelin oedema has little or no effect on conduction velocity. Nodes of Ranvier are normal in the early stages of the lesion and this may contribute to the preservation of normal conduction. The electrophysiological findings can be attributed to secondary changes of axonal degeneration and segmental demyelination.

Atypical axon-Schwann cell relationships in the common peroneal nerve of the dystrophic mouse: an ultrastructural study

Several atypical features of myelination of the peripheral nervous system are reported in common peroneal nerve of dystrophic mice (129 Re J dy/dy): (i) central nervous system-like contact between myelin sheaths of adjacent nerve fibres; (ii) nodes and internodes of myelinated fibres enwrapped with cytoplasmic processes of Schwann cells from adjacent nerve fibres; (iii) Schwann cells of adjacent nerve fibres co-operating in formation of a single myelin sheath; and (iv) a single Schwann cell myelinating two separate axons. In view of the presence of similar features of myelination in the central nervous system, where the myelin producing cells lack basement membrane, we suggest that in the dystrophic peripheral nerves the development of these features can be attributed to the partial deficiency of the Schwann cell basement membrane. Two types of widened nodes of Ranvier are also identified: (i) nodes with paranodal damage; and (ii) nodes without paranodal damage. In addition, abnormal features of myelination are described which are likely to represent altered Schwann cell/axon relationships during demyelination and remyelination and/or decreased myelinating ability of Schwann cells. We interpret these findings as indicating a metabolic disorder of Schwann cells. They provide an experimental model for the investigation of factors involved in the origin and maintenance of the structural organization of peripheral nerve.

Conduction of nervous impulses in spinal roots and peripheral nerves of dystrophic mice

Conduction was studied in the sacral ventral roots and ventral tail nerves of dystrophic mice (dy/dy) and phenotypically normal littermates. In myelinated ventral root fibers of normal mice, conduction velocity was uniform with internodal conduction time 45 +/- 5 musec (26 degrees C). In ventral root fibers of dystrophic mice, conduction velocity was decreased and strikingly non-uniform; both saltatory and continuous conduction were observed in different portions of the same nerve fiber. Continuous conduction with velocity less than 2 m/sec (26 degrees C) was characteristically observed in mid-root where the axons are bare; conduction was saltatory close to the exit from the spinal canal and near the spinal cord where the axons are myelinated. Maximum conduction velocity in ventral tail nerves was 21 +/- 3 m/sec for dystrophic mice and 31 +/- 4 m/sec for littermate controls (37 degrees C). Internodal lengths were somewhat decreased in the dystrophic peripheral nerves but there was no significant difference in maximum fiber diameters, myelin thickness or nodal morphology between dystrophic and normal nerves.

[Quantitative study of isolated nerve fibers in alcoholic neuropathy (author's transl)]

This is a report of qualitative and quantitative study of nerve fibres in alcoholic neuropathy. In order to determine the frequency of segmental demyelination in alcoholic neuropathy, 10 nerve biopsies from 9 patients were studied by teasing; 100 consecutive fibres were isolated from each nerve and classified according to their morphology. This study confirms that segmental demyelination is a rare finding in this condition. Segmental demyelination of peripheral nerve fibres occurred in three cases and affected 6 to 8 per cent of the fibres. Wallerian degeneration of nerve fibres was found in all ten nerve biopsy specimens and affected 31 to 98 percent of the isolated fibres.

Effect of diphtheritic demyelination on axonal transport in the sciatic nerve and subsequent muscle changes in the chicken

Chicken sciatic nerves undergo demyelination following intraneural injection of diphtheria toxin and subsequent atrophy of some muscular cells. Paresis occurs after one week and lasts approximately three weeks; at the height of the lesion C14-leucine was injected into the ventral horn cells of the spinal cord. The axonal transport of fast flowing labelled proteins was followed down the sciatic nerve axons and flow rates at two different times were measured. Muscle cells were stained for succinic dehydrogenase and ATPase; fibre diameters, total protein, and total radioactivity associated with the nerves were also measured. The results showed that the fast flowing labelled proteins accumulated at the demyelination site while the muscle cells supplied by these nerves showed reduction of fibre diameter and evidence of degeneration. Further studies are in progress on slow moving proteins and muscle cells.

Alcoholic neuropathy. An electron-microscopic study

The sural nerves of 6 patients with different signs of alcoholic neuropathy were studied qualitatively and quantitatively by electron microscopy. Myelinated and unmyelinated fibres showed degenerative changes of the Wallerian type. Concomitant involvement of the myelin appears to be secondary to axonal lesions. Regenerative processes, although frequently observed, did not balance the destruction of fibres in the degenerative phase. Quantitative studies indicated a reduced number of myelinated fibres and decreased percentage of the area covered in cross-section by myelinated and unmyelinated axons. The histograms of myelinated fibres showed a shift to the left of the peak of large and small fibres and an increased number of small-sized fibres. Similarly the histograms of unmyelinated fibres showed a shift to the left and a bimodal distribution with an increased number of small-sized fibres. Imbalance in degenerative and regenerative processes seems to be the basis of the chronic partial denervation observed in the nerves of alcoholic patients in this study.

The node of Ranvier in experimental allergic neuritis: an electron microscope study

Pathological breakdown of the node of Ranvier in experimental allergic neuritis (EAN) in the rabbit was examined by electron microscopy. The study was concerned principally with the mechanism of disruption of paranodal myelin. Two types of change in myelin structure were observed, both apparently related to the presence of cytoplasmic processes of macrophages: (1) a vesicular disorganization of myelin lamellae and (2) a separation of myelin lamellae. Both methods of disorganization were used by macrophages as they apparently lifted off the myelin terminal loops of the paranode from the underlying axon and also penetrated between myelin loops and adjoining myelin lamellae. In some pathologically damaged nodes of Ranvier no macrophages were observed. The findings raise important immunological and electrophysiological questions concerning the involvement of the macrophage in the autoimmune response and the effect of the loss of paranodal myelin on nerve conduction.

Development of onion bulb neuropathy in the Trembler mouse. Comparison with normal nerve maturation

The Trembler mouse is a neurological mutant showing dominant inheritance. Adult animals show a segmental demyelinating lesion of the peripheral nerves characterized by prominent onion bulb formation which is very similar to that of human hypertrophic interstitial neuropathy. Electron microscopic study of the development of this lesion in Trembler mice nerves from 1 to 21 days of age shows: 1. Axon differentiation towards a mature 1:1 axon/Schwann cell relationship is retarded, and the initiation of myelin formation is delayed. 2. Compact myelin formation is often incomplete, and when produced undergoes rapid degeneration. 3. Schwann cells become reactive to the presence of myelin debris, undergo hypertrophy and hyperplasia resulting in digestion of myelin debris and remyelination. These processes lead to early onion bulb formation. The presence of normal axons associated with reactive changes in Schwann cells suggest that the Schwann cell change is primary and not secondary to an axonal disorder.

Internodal conduction in undissected demyelinated nerve fibres

1. A new method is described for recording external longitudinal currents from single undissected nerve fibres in rat ventral roots. The method permits identification of the sites of fifteen or more successive nodes of Ranvier in a given single fibre and the measurement of internodal conduction times between them.2. Average internodal conduction time for normal ventral root fibres of internodal length between 0.75 and 1.45 mm is 19.7 +/- 4.6 (S.D.) musec at 37 degrees C. Internodal conduction time appeared to show a minimum for fibres of internodal length 1.0 mm.3. Ventral roots were demyelinated by focal application of diphtheria toxin. Although conduction is markedly slowed in demyelinated fibres, sites of inward membrane current remain spatially separated indicating that conduction remains saltatory to the point of conduction block rather than becoming continuous as in unmyelinated fibres.4. Slowing of conduction appears to be due to changes in the passive electrical properties of the internodal myelin. Evidence is presented suggesting that there is an increase in internodal capacitance and a decrease in internodal transverse resistance at internodes of demyelinated fibres; such changes would have the effect of delaying excitation at the nodes. The changes in passive electrical properties, which appear to be primarily in the vicinity of the nodes, would be consistent with the pathological changes observed in demyelinated fibres.5. Internodal conduction times in demyelinated fibres have ranged from normal (26 musec at 30 degrees C) to more than 600 musec. There is a great variation in internodal conduction time at successive internodes of a given single fibre; this presumably reflects the varying severity of demyelination of successive internodes.6. As in normal fibres, nodes of demyelinated fibres generate less current when excited by the second of two closely spaced impulses. This results in an increased internodal conduction time for the second impulse and, at a critically short interstimulus interval, conduction block of the second impulse.7. The increased refractory period of transmission of internodes with increased internodal conduction times is a consequence of the decreased ability of such internodes to sustain propagation in the face of small decreases in nodal current.8. During tetanic stimulation, increases in internodal conduction time are associated with corresponding decreases in nodal current generated by the node proximal to the internode in question.9. It is suggested that changes in the magnitude of the nodal current during repetitive activity are due to changes in transmembrane concentration gradients of sodium, the increased internodal conduction time and eventual conduction block during tetanic stimulation being caused by intracellular sodium accumulation.10. Intracellular sodium accumulation is also offered as the explanation for the post-tetanic depression seen in demyelinated fibres.

A computer simulation of conduction in demyelinated nerve fibres

1. The theoretical effects of demyelination on conduction of a propagated impulse have been examined in a computer simulated myelinated nerve fibre. Demyelination was simulated by increasing the capacitance and conductance of the myelin sheath of individual internodes or parts of internodes.2. Internodal conduction time increased as myelin thickness was decreased. The increase in internodal conduction time became more precipitous as the myelin became thinner. Propagation continued past a single demyelinated internode until myelin thickness was uniformly reduced to less than 2.7% of normal myelin thickness.3. Paranodal demyelination was more effective in slowing impulse conduction than was uniform demyelination of an entire internode with an equivalent rise in overall internodal capacitance and conductance.4. The effects on conduction of demyelination of two adjacent internodes or of two internodes separated by a normal internode were more than the sum of the effects of demyelination of each internode individually.5. Propagation across a severely demyelinated internode was blocked with an increase in internal sodium concentration which had a trivial effect on conduction in a normal fibre.6. Propagation across a severely demyelinated internode was blocked with increased temperature at a temperature at which propagation proceeds normally across normal internodes.7. The similarity between the findings of the computer simulations and the experimental findings in demyelinated fibres is discussed.