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Dendntes are the primary site of synaptic input to neurons in the CNS. They are imbued with specialized structures, such as dendritic spines, which receive much of the synaptic inputs from other neurons. They have long been considered electrically passive in that they receive nonregenerative synaptic inputs, both excitatory and inhibitory, and, through summation of passive electrotonic spread of current, they convey information in the form of membrane potential changes to the cell body and the initial axon segment, which are specialized to initiate action potentials. More than 40 years ago, this view was challenged by electrophysiological studies suggesting that dendrites can also generate action po tentials. It was proposed that these regenerative dendritic action potentials can serve as "booster" sites to assure the fidelity of synaptic signaling to the distant initial axon seg ment where nerve impulses are initiated for propagation to their terminals for signal trans mission to other neurons. Two recent articles in Science reporting the use of simultaneous patch clamp recordings from a dendrite and the cell body of rat hippocampal neurons have rekindled interest in dendrites as active generators of action potentials. In this Up date, these articles are reviewed and discussed in the context of the functional implica tions of active dendritic electrogenesis. The Neuroscientist 1:312-316, 1995

The mechanism of action of the recently developed anticonvulsant gabapentin (GBP) used for treatment of partial seizures [12] is largely unknown. Rat hippocampal slices were maintained in vitro and the effects of microapplication of nipecotic acid (NPA), which promotes the release and blocks uptake of GABA, on the synaptically-evoked population excitatory postsynaptic potential (EPSP) were assessed before and after 1 h bath application of GBP. GBP treatment did not alter the population EPSP amplitude to paired or multiple stimuli, but nearly doubled the shunting effects of NPA on the EPSP with no effect on the presynaptic volley. The NPA-induced shunting of the EPSP was bicuculline-sensitive, indicating its mediation by GABAA receptor activation. These results suggest that GBP may increase free GABA levels in hippocampal cells, the release of which may be enhanced under conditions of promoted GABA release. Moreover, the study presents a methodology to electrophysiologically assess relative free GABA levels using field potential analysis in the adult rat brain.

The effects of axotomy on the electrophysiologic properties of adult rat dorsal root ganglion (DRG) neurons were studied to understand the changes in excitability induced by traumatic nerve injury. Nerve injury was induced in vivo by sciatic nerve ligation with distal nerve transection. Two to four weeks after nerve ligation, a time when a neuroma forms, lumbar (L4 and L5) DRG neurons were removed and placed in short-term tissue culture. Whole cell patch-clamp recordings were made 5–24 h after plating.DRG neurons were grouped into large (43–65 μm)-, medium (34–42 μm)-, and small (20–32 pm)- sized classes. Large neurons had short duration action potentials with ∼60% having inflections on the falling phase of their action potentials. In contrast, action potentials of medium and small neurons were longer in duration and ∼68% had inflections.Pressure microejection of γ-aminobutyric acid (GABA, 100 μM) or muscimol (100 μM) onto voltage-clamped DRG neurons elicited a rapidly desensitizing inward current that was blocked by 200 μM bicuculline. To measure the peak conductance induced by GABA or muscimol, neurons were voltage-clamped at a holding potential of -60 mV, and pulses to -80 mV and -100 mV were applied at a rate of 2.5 or 5 Hz during drug application. Slope conductances were calculated from plots of whole cell current measured at each of these potentials.GABA-induced currents and conductances of control DRG neurons increased progressively with cell diameter. The mean GABA conductance was 36 ± 10 nS (mean ± SE) in small neurons, 124 ± 21 nS in medium neurons, and 527 ± 65 nS in large neurons.After axotomy, medium neurons had significantly larger GABA-induced conductances compared with medium control neurons (390 ± 50 vs. 124 ± 21; P < 0.001). The increase in GABA conductance of medium neurons was associated with a decrease in duration of action potentials. In contrast, small neurons had no change in GABA conductance or action potential duration after ligation. The GABA conductance of large control neurons was highly variable, and ligation resulted in an increase that was significant only for neurons >50 μm. The mean action potential duration in large neurons was not significantly changed, but neurons with inflections on the falling phase of the action potential were less common after ligation. There was no difference in resting potential or input resistance between control and ligated groups, except that the resting potential was less negative in small cells after axotomy.Histograms of neuronal diameter distributions were constructed for control and ligated groups. The cell diameter distribution of control and ligated neurons were similar, but the ligated group had a decrease in the proportion of large neurons and a 27% increase in medium neurons, with no change in the relative proportion of other size classes. The 27% increase in the number of medium neurons was unlikely to be solely responsible for the 314% increase in GABA conductance seen in medium neurons after ligation, although some of the observed change could be attributed to a shift of large neurons (and their associated electrophysiologic properties) into the medium group.These results indicate that axotomy resulted in a significant increase in GABAA receptor-mediated conductance in specific size classes of sensory neurons. We hypothesize that this selective increase in GABA conductance results from an injury-induced increase in the density of GABAA receptors on the soma or a change in the expression of specific GABAA receptor subtypes with different single channel conductances.

Adult rat DRG neurons rapidly extend extensive neuritic arbors after a 1–2-day delay in culture and generate large depolarization-induced calcium signals during this time period that are derived primarily from intracellular calcium release. To assess whether intracellular calcium mobilization is required for neurite initiation, calcium stores were depleted by brief exposure to the irreversible endoplasmic reticulum calcium ATPase inhibitor thapsigargin; cultures were then maintained for 3 days, immunostained for neurofilament and scored for percentage of neurons with neurites at least twice as long as the cell body. Brief thapsigargin treatment (20 min) during the first 24 h in culture resulted in a substantial decrease in neurite initiation frequency without affecting neuronal or nonneuronal cell survival, suggesting that intracellular calcium mobilization is necessary for triggering neurite initiation in these neurons.

Adult bone marrow-derived mesenchymal stem cells (MSCs) have a remarkable spectrum of functional properties. Transplantation of MSCs improves clinical outcome in animal models of cerebral ischemia, and traumatic brain and spinal cord injury, via mechanisms that may include induction of axonal sprouting and remyelination, protection of injured neurons, neovascularization, and, potentially, replacement of damaged cells. Beneficial therapeutic effects have been reported in experimental models of stroke following intravenous delivery of MSCs. Initial clinical studies using intravenously delivered MSCs have been initiated in human subjects with stroke. This chapter reviews multiple beneficial effects of MSCs in experimental stroke models, describes initial human clinical studies on intravenous MSC delivery in stroke, and provides a perspective on further experimental and clinical studies of MSCs.

Elevated nerve growth factor (NGF) is believed to play a role in many types of pain. An NGF-blocking antibody (muMab 911) has been shown to reduce pain and hyperalgesia in pain models, suggesting a novel therapeutic approach for pain management. Since NGF also plays important roles in peripheral nervous system development and sensory nerve outgrowth, we asked whether anti-NGF antibodies would adversely impact peripheral nerve regeneration. Adult rats underwent a unilateral sciatic nerve crush to transect axons and were subcutaneously dosed weekly for 8weeks with muMab 911 or vehicle beginning 1day prior to injury. Plasma levels of muMab 911 were assessed from blood samples and foot print analysis was used to assess functional recovery. At 8-weeks post-nerve injury, sciatic nerves were prepared for light and electron microscopy. In a separate group, Fluro-Gold was injected subcutaneously at the ankle prior to perfusion, and counts and sizes of retrogradely labeled and unlabeled dorsal root ganglion neurons were obtained. There was no difference in the time course of gait recovery in antibody-treated and vehicle-treated animals. The number of myelinated and nonmyelinated axons was the same in the muMab 911-treated crushed nerves and intact nerves, consistent with observed complete recovery. Treatment with muMab 911 did however result in a small decrease in average cell body size on both the intact and injured sides. These results indicate that muMab 911 did not impair functional recovery or nerve regeneration after nerve injury in adult rats.

Olfactory ensheathing cells (OECs) and Schwann cells (SCs) share many characteristics, including the ability to promote neuronal repair when transplanted directly into spinal cord lesions, but poor survival and migration when transplanted into intact adult spinal cord. Interestingly, transplanted OECs, but not SCs, migrate extensively within the X-irradiated (40 Gy) adult rat spinal cord, suggesting distinct responses to environmental cues [Lankford et al., (2008) GLIA 56:1664-1678]. In this study, GFP-expressing OECs and SCs were transplanted into juvenile rat brains (hippocampus) subjected to a moderate radiation dose (16 Gy). As in the adult spinal cord, OECs, but not SCs, migrated extensively within the irradiated juvenile rat brain. Unbiased stereology revealed that the number of OECs observed within irradiated rat brains three weeks after transplantation was as much as 20 times greater than the number of cells transplanted, and the cells distributed extensively within the brain. In conjunction with the OEC dispersion, the number of activated microglia in OEC-transplanted irradiated brains was reduced. Unlike in the intact adult spinal cord, both OECs and SCs showed some, but limited, migration within nonirradiated rat brains, suggesting that the developing brain may be a more permissive environment for cell migration than the adult CNS. These results show that OECs display unique migratory, proliferative, and microglia interaction properties as compared with SCs when transplanted into the moderately X-irradiated brain.

Adult bone marrow-derived mesenchymal stem cells (MSCs) have a remarkable spectrum of functional properties. Transplantation of MSCs improves clinical outcome in animal models of cerebral ischemia, and traumatic brain and spinal cord injury, via mechanisms that may include induction of axonal sprouting and remyelination, protection of injured neurons, neovascularization, and, potentially, replacement of damaged cells. Beneficial therapeutic effects have been reported in experimental models of stroke following intravenous delivery of MSCs. Initial clinical studies using intravenously delivered MSCs have been initiated in human subjects with stroke. This chapter reviews multiple beneficial effects of MSCs in experimental stroke models, describes initial human clinical studies on intravenous MSC delivery in stroke, and provides a perspective on further experimental and clinical studies of MSCs.

Voltage-dependent Na+ conductances were studied in small (18–25 μm diam) adult rat dorsal root ganglion (DRG) neurons with the use of the whole cell patch-clamp technique. Na+ currents were also recorded from larger (44–50 μm diam) neurons and compared with those of the small neurons.The predominant Na+ conductance in the small neurons was selective over tetramethylammonium by at least 10-fold and was resistant to 1 μM external tetrodotoxin (TTX). Na+ conductances in many larger DRG neurons were kinetically faster and, in contrast, were blocked by 1 μM TTX.The Na+ conductance in the small neurons was kinetically slow. Activation half-times were voltage dependent and ranged from 2 ms at −20 mV to 0.7 ms at +50 mV. Approximately 50% of the activation half-time was comprised of an initial delay. Inactivation half-times were voltage dependent and ranged from 11 ms at −20 mV to 2 ms at +50 mV.Peak slow Na+ conductances were near maximal with conditioning potentials negative to −120 mV and were significantly reduced or eliminated with conditioning potentials positive to −40 mV. The slow Na+ conductance increased gradually with test potentials extending from −40 to +40 mV. In some cells the conductance could be saturated at +10 mV. Peak conductance/voltage relationships, although stable in a given neuron, revealed marked variability among neurons, spanning >20- and 50-mV domains for steady-state activation and inactivation (current availability), respectively.Kinetics remained stable within a given neuron over the course of an experiment. However, considerable kinetic variation was exhibited from neuron to neuron, such that the half-times of activation and of inactivation spanned an order of magnitude. In all small neurons studied there appeared to be a singular kinetic component of the current, based on sensitivity to the conditioning potential, voltage dependence of activation, and inactivation half-time.Unique closing properties were exhibited by Na+ channels of the small neurons. Hyperpolarization following a depolarization-induced fully inactivated state resulted in tail currents that appeared to be the consequence of reactivation of the slow Na+ conductance. Tail currents recorded at various times during a fixed level of depolarization revealed that the underlying channels accumulated into a volatile inactivated state over the course of the preceding depolarization.Larger neurons had a different repertoire of Na+ conductances, with either only a TTX-sensitive, kinetically fast type, or a combination of fast TTX-sensitive and slow currents. In larger neurons the kinetically separable fast current had a greater sensitivity to the conditioning potential, i.e., a left-shifted steady-state inactivation curve.The different properties of the slow Na+ conductance in different neurons is likely to reflect heterogeneity of the structure of the underlying channel molecule. Although consistent with what others have found in equivalent preparations, this heterogeneity is far broader in scope than what has so far been described. We suggest that biosynthetic constraints within a given small neuron maintain ion channel uniformity.

The permeability of non-N-methyl-D-aspartate (non-NMDA) glutamate channels to divalent cations and specifically the entry of Ca2+ and subsequent elevations in cytoplasmic and nuclear Ca2+ signals were investigated in cultured neonatal rat retinal ganglion cells using the whole cell patch-clamp technique and Ca2+ imaging with confocal microscopy. In addition, divalent-permeable non-NMDA receptor channels were studied in retinal slices using a Co2+ staining technique.Using Ca2+ (2.5 mM) as the only permeable cation in the external solution, stimulation with 100 μM kainate produced nondesensitizing, nonselective cation currents with either low or high Ca2+ permeability. Both currents were reversibly blocked by 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX). Neurons with the low divalent-permeable currents (type 1) had reversal potentials of −41.5 ± 4.4 mV (mean ± SD), and neurons with the high divalent-permeable currents (type 2) had reversal potentials of −22.6 ± 5.5 mV. The permeability ratio PCa/PCs was 3.3 for the type 1 currents and 8.5 for the type 2 currents, indicating a 2.5-fold greater permeability to Ca2+ for the type 2 non-NMDA glutamate channels.Both types of non-NMDA glutamate channels showed relatively little selectivity between Ca2+ and Co2+. The type 1 neurons had a slightly higher permeability to Co2+ than to Ca2+, whereas the type 2 neurons were equally permeable to both divalent cations. The type 2 neurons had a much higher permeability for both divalent cations compared with the type 1 neurons.Staining for Co2+ uptake through kainate-stimulated non-NMDA glutamate channels in retinal slices provided additional evidence for the presence of the two ganglion cell populations. Activation of the neurons by kainate in conditions isolating the non-NMDA glutamate channel caused differential uptake of Co2+. In contrast, depolarization in the presence of the non-NMDA antagonist CNQX failed to cause Co2+ influx.Imaging experiments using confocal microscopy showed that kainate stimulation induced an increase in intracellular Ca2+ in both types of retinal ganglion cells, but only the type 2 neurons showed a substantial increase in cytoplasmic and nuclear Ca2+ signals. Kainate-induced Ca2+ signals in the type 2 neurons were almost nine times greater than those of the type 1 neurons.When intracellular Ca2+ stores were depleted by brief treatment with thapsigargin, kainate-induced Ca2+ signals in the type 1 neurons were unchanged. However, in the type 2 neurons kainate no longer induced large Ca2+ signals in the cytoplasm and nucleus, despite normal influx of Ca2+. After thapsigargin treatment, kainate-induced Ca2+ signals in the type 2 neurons were reduced to the levels of the treated or untreated type 1 neurons. Calcium influx via the type 2 receptor channels therefore appears capable of triggering the release of intracellular Ca2+ stores.The two types of non-NMDA glutamate channels described here are likely to contribute to a variety of Ca2+-dependent intracellular processes. Glutamate may differentially affect intracellular Ca2+ in retinal ganglion cells. In particular, it appears that Ca2+ entry via the high divalent-permeable type 2 non-NMDA glutamate channel can trigger Ca2+-induced Ca2+ release and thereby amplify intracellular Ca2+ signals.

1. In situ hybridization with subtype-specific probes was used to ask whether there is a change in the types of sodium channels that are expressed in dorsal root ganglion (DRG) neurons after axotomy. 2. Types I and II sodium channel mRNA are expressed at moderate-to-high levels in control DRG neurons of adult rat, but type III sodium channel mRNA is not detectable. 3. When adult rat DRG neurons are examined by in situ hybridization 7–9 days following axotomy, type III sodium channel mRNA is expressed at moderate-to-high levels, in addition to types I and II mRNA that are present at relatively high levels. 4. To determine whether the expression of type III sodium channel mRNA following axotomy represents up-regulation of a gene that had been expressed at earlier developmental stages, we also studied DRG neurons from embryonic (E17) rats. In these embryonic DRG neurons, type I sodium channel mRNA is expressed at low levels, type II mRNA at high levels, and type III at high levels. 5. These results demonstrate altered expression of sodium channel mRNA in DRG neurons following axotomy, and suggest that in at least some DRG neurons, there is a de-differentiation after axotomy that includes a reversion to an embryonic mode of sodium channel expression. Different channel characteristics, as well as an altered spatial distribution of sodium channels, may contribute to the electrophysiological changes that are observed in axotomized neurons.

Confocal microscopy and the Ca 2+ -sensitive fluorescent dye fluo-3 were used to study subcellular Ca 2+ signals in embryonic, neonatal, and adult dorsal root ganglion (DRG) neurons in excised dorsal rooot ganglia. Optical images obtained from isolated' whole embryonic and neonatal ganglia revealed a marked variability in the resting Ca 2+ signals of different neurons as compared to signals in adult neurons which were uniformly faint. Many of the embryonic and neonatal neurons displayed nuclear Ca 2+ signals at rest which were larger than those in the cytoplasm. Embryonic DRG neurons showed a significant increase in nuclear and cytoplasmic fluorescence in response to depolarization with elevated extracellular potassium or electrical stimulation. A single brief electrical stimulus was sufficient to elicit nuclear Ca 2+ signals in a subset of the embryonic neurons. The depolarization-induced Ca 2+ signals were blocked by removal of extracellular Ca 2+ , but not by treatment with 2,5-di ( tert -butyl)- 1,4 benzohydroquinone (DTBHQ), a compound which depletes intracellular Ca 2+ stores. The intensity of the depolarization-induced Ca 2+ signals declined significantly between the late embryonic (E18–E20) and early postnatal time periods (P0–P1). The nuclear and cytoplasmic Ca 2+ signals of the embryonic DRG neurons in the excised tissue preparation occur at a time of intense target innervation, suggesting a role for Ca 2+ signals in the development and maturation of rat DRG neurons.

A large body of work supports the proposal that transplantation of olfactory ensheathing cells (OECs) into nerve or spinal cord injuries can promote axonal regeneration and remyelination. Yet, some investigators have questioned whether the transplanted OECs associate with axons and form peripheral myelin, or if they recruit endogenous Schwann cells that form myelin. Olfactory bulbs from transgenic mice expressing the enhanced green fluorescent protein (eGFP) under the control of the 2-3-cyclic nucleotide 3-phosphodiesterase (CNPase) promoter were studied. CNPase is expressed in myelin-forming cells throughout their lineage. We examined CNPase expression in both in situ in the olfactory bulb andin vitroto determine if OECs express CNPase commensurate with their myelination potential. eGFP was observed in the outer nerve layer of the olfactory bulb. Dissociated OECs maintained in culture had both intense eGFP expression and CNPase immunostaining. Transplantation of OECs into transected peripheral nerve longitudinally associated with the regenerated axons. These data indicate that OECs in the outer nerve layer of the olfactory bulb of CNPase transgenic mice express CNPase. Thus, while OECs do not normally form myelin on olfactory nerve axons, their expression of CNPase is commensurate with their potential to form myelin when transplanted into injured peripheral nerve.

Adult bone marrow-derived mesenchymal stem cells (MSCs) display a spectrum of functional properties. Transplantation of these cells improves clinical outcome in models of cerebral ischemia and spinal cord injury via mechanisms that may include replacement of damaged cells, neuroprotective effects, induction of axonal sprouting, and neovascularization. Therapeutic effects have been reported in animal models of stroke after intravenous delivery of MSCs, including those derived from adult human bone marrow. Initial clinical studies on intravenously delivered MSCs have now been completed in human subjects with stroke. Here, we review the reparative and protective properties of transplanted MSCs in stroke models, describe initial human studies on intravenous MSC delivery in stroke, and provide a perspective on prospects for future progress with MSCs.

Transplantation of human mesenchymal stem cells has been shown to reduce infarct size and improve functional outcome in animal models of stroke. Here, we report a study designed to assess feasibility and safety of transplantation of autologous human mesenchymal stem cells expanded in autologous human serum in stroke patients. We report an unblinded study on 12 patients with ischaemic grey matter, white matter and mixed lesions, in contrast to a prior study on autologous mesenchymal stem cells expanded in foetal calf serum that focused on grey matter lesions. Cells cultured in human serum expanded more rapidly than in foetal calf serum, reducing cell preparation time and risk of transmissible disorders such as bovine spongiform encephalomyelitis. Autologous mesenchymal stem cells were delivered intravenously 36-133 days post-stroke. All patients had magnetic resonance angiography to identify vascular lesions, and magnetic resonance imaging prior to cell infusion and at intervals up to 1 year after. Magnetic resonance perfusion-imaging and 3D-tractography were carried out in some patients. Neurological status was scored using the National Institutes of Health Stroke Scale and modified Rankin scores. We did not observe any central nervous system tumours, abnormal cell growths or neurological deterioration, and there was no evidence for venous thromboembolism, systemic malignancy or systemic infection in any of the patients following stem cell infusion. The median daily rate of National Institutes of Health Stroke Scale change was 0.36 during the first week post-infusion, compared with a median daily rate of change of 0.04 from the first day of testing to immediately before infusion. Daily rates of change in National Institutes of Health Stroke Scale scores during longer post-infusion intervals that more closely matched the interval between initial scoring and cell infusion also showed an increase following cell infusion. Mean lesion volume as assessed by magnetic resonance imaging was reduced by >20% at 1 week post-cell infusion. While we would emphasize that the current study was unblinded, did not assess overall function or relative functional importance of different types of deficits, and does not exclude placebo effects or a contribution of recovery as a result of the natural history of stroke, our observations provide evidence supporting the feasibility and safety of delivery of a relatively large dose of autologous mesenchymal human stem cells, cultured in autologous human serum, into human subjects with stroke and support the need for additional blinded, placebo-controlled studies on autologous mesenchymal human stem cell infusion in stroke.

Excitability of rat dorsal root axons were studied 3 weeks after injuryto the sciatic nerve. Whole nerve recordings were obtained from injured andcontrol nerves in a sucrose gap chamber. Constant current depolarization pulses (30–200 ms) applied approximately 50% above the stimulus strength required for maximal amplitude compound action potentials (CAPs) evoked burst of action potentials in the dorsal root which displayed spike adaptation. The depolarization-induced burst response of the dorsal roots was greatly reduced after crush or transection of the sciatic nerve. However, application of the potassium channel blocker, tetraethylammonium (TEA), restored the burst discharge in injured dorsal root axons. Brief tetanic stimulation of the dorsal root also induced an afterhyperpolarization (AHP) that was twice as large in the transection group as compared to the control group, and which was blocked by TEA. There were no changes seen in the amplitude of the compound action potential, frequency-following characteristics, refractory properties, or 4-AP sensitivity in the dorsal roots after peripheral nerve injury. These results suggest that there is enhanced spike adaptation that occurs at the same time as an increase in the sensitivity to the potassium channel blocker, TEA, in axon regions proximal to the site of nerve injury and have implications for the pathophysiology of nerve injury. © 1993 John Wiley & Sons, Inc.

Olfactory ensheathing cells (OECs) can remyelinate demyelinated spinal cord axons when transplanted into chemically induced demyelinated lesions. Cell transplantation is typically performed within a few days after lesion induction, i.e. during active demyelination when myelin debris, cytokine level increases and macrophage/microglia activation is extensive. Inflammatory signaling has been suggested to facilitate remyelination in cell transplant studies. In this review we discuss the migration and remyelination properties of OECs transplanted into various demyelinating lesion environments including conditions when inflammation is active and when it is largely subsided. While sharing many common properties, comparisons of the in vivo fate between OECs and SCs suggest unique properties of OECs as compared to SCs. A complicating factor in the assessment of experimental remyelination by transplantation of myelin-forming cells in general is the rapidity of endogenous myelin repair in most rodent models of demyelination. Alternative persistent demyelination models are discussed as potential tools to study both the competency of chronic demyelinated axons for remyelination and the remyelination potential of cells such as human progenitors that require longer times to mobilize and remyelinate axons. This article is part of a Special Issue entitled: Understanding olfactory ensheathing glia and their prospect for nervous system repair.

Various models of experimental autoimmune encephalomyelitis (EAE) have led to insights into the pathogenesis and novel therapies for multiple sclerosis. One generalized EAE model uses immunizing the Lewis Rat with myelin oligodendrocyte glycoprotein (MOG) and complete Freund's adjuvant that induces systemic disease and inflammatory lesions at random central nervous system (CNS) locations. These lesions result from a combination of sensitized T cells and pathogenic antibodies gaining access to the CNS to cause an immune assault on myelin-expressing oligodendrocytes. We report a focal and temporal variant of the EAE model that results in immune-mediated demyelination at a predictable time and location. Lewis rats were immunized with the extracellular domain (1-125) of recombinant rat MOG in incomplete Freund's adjuvant (IFA) to induce a clinically silent humoral response. Vascular endothelial growth factor (VEGF) was then microinjected into the spinal cord to induce a transient, focal breakdown of the blood brain barrier (BBB). Clinical signs were apparent within 72 hours and began to resolve by day 21. The histopathology at the site of injection consisted of a focal region containing OX-42(+) cells, phagocytic cells with debris, extensive demyelination, and some lymphocyte infiltration. Neither intraspinal injection of PBS into immunized animals nor VEGF into animals treated with IFA alone resulted in clinical lesions. Thus, a transient, focal opening of the BBB with VEGF in animals with subclinical MOG immunization leads to a discrete inflammatory demyelinating lesion. This model may be useful for the study of transplanted myelin-forming cells in a discrete inflammatory demyelinating lesion.

Radtke C, Lankford KL, Wewetzer K, Imaizumi T, Fodor WL, Kocsis JD. Impaired spinal cord remyelination by long-term cultured adult porcine olfactory ensheathing cells correlates with altered in vitro phenotypic properties. Xenotransplantation 2010; 17: 71–80. © 2010 John Wiley & Sons A/S. Abstract: Background: Extensive studies in rodents have identified olfactory ensheathing cells (OECs) as promising candidates for cell-based therapies of spinal cord and peripheral nerve injury. Previously, we demonstrated that short-term cultured adult porcine OECs can remyelinate the rodent and non-human primate spinal cord. Here, we studied the impact of the culturing interval on the remyelinating capacity of adult porcine OECs. Methods: Cells were maintained for 1, 2, and 4 to 6 weeks in vitro prior to transplantation into the demyelinated rat spinal cord. Parallel to this, the in vitro phenotypic properties of the OEC preparations used for transplantation were analyzed with regard to morphology, low affinity nerve growth factor receptor (p75NTR) expression and proliferation. Results: We report that prolonged culturing of adult porcine OECs resulted in impaired remyelination of the adult rat spinal cord. Animals receiving transplants of OECs maintained in vitro for 2 weeks displayed significantly less remyelinated axons than those animals that received OEC transplants cultured for 1 week. There was virtually no remyelination after transplantation of OECs cultured for 4 to 6 weeks. The adult porcine OECs displayed a progressive lost of p75NTR-expression as determined by immunostaining and flow cytometry with time in culture. Conclusions: Taken together, the results indicate that porcine OECs undergo systematic changes with time in culture that result in reduced p75NTR-expression, decreased proliferation, and reduced remyelinating capability with time in vitro indicating that relatively short term cultures with limited expansion would be required for transplantation studies.

Transplantation of mesenchymal stem cells (MSCs) derived from bone marrow has been shown to improve functional outcome in spinal cord injury (SCI). Systemic delivery of MSCs results in therapeutic benefits in a number of experimental central nervous system disorders. In the present study we intravenously administered rat MSCs derived from bone marrow at various time points after induction of a severe contusive SCI in rat to study their therapeutic effects. MSCs were systemically delivered at varied time points (6h to 28 days after SCI). The spinal cords were examined histologically 6 weeks after SCI. Stereological quantification was performed on the spinal cords to determine donor cell (MSCs transduced with the LacZ gene) density in the lesions. Light microscopic examination revealed that cavitation in the contused spinal cords was less in the MSC-treated rats. A limited number of cells derived from MSCs (LacZ(+)) in the injury site expressed neural or glial markers. Functional outcome measurements using the Basso-Beattie-Bresnehan (BBB) score were performed periodically up to 6 weeks post-SCI. Locomotor recovery improvement was greater in the MSC-treated groups than in sham controls with greatest improvement in the earlier post-contusion infusion times. The availability of autologous MSCs in large number and the potential for systemically delivering cells to target lesion areas without neurosurgical intervention suggests the potential utility of intravenous cell delivery as a prospective therapeutic approach in acute and subacute SCI.

Intravenous transplantation of mesenchymal stem cells (MSCs) prepared from bone marrow ameliorates functional deficits in rat cerebral infarction models. Although several hypotheses to account for these therapeutic effects have been suggested, angiogenesis is thought to be largely responsible. MSCs were intravenously infused into rats in the relatively later time points after permanent middle cerebral artery occlusion (MCAO) to determine if they could contribute to neovascularization and functional recovery. Although MRI analysis revealed that only rats receiving MSCs 7days after MCAO exhibited decreased ischemic lesion volume than the control group, all MSCs treated rats receiving MSCs up to 1month after MCAO had greater angiogenesis near the border of the ischemic lesions and showed greater functional recovery in the treadmill stress test than did control rats. Thus, these results suggest that the time window of MSC therapy is at least over 1 month after cerebral infarction in the rat permanent MCAO model, and systemic delivery of MSCs in the later phase after cerebral ischemia may have beneficial effect through an angiogenic mechanism.

Blasts are responsible for about two-thirds of the combat injuries in Operation Iraqi Freedom and Operation Enduring Freedom, which include at least 1,200 traumatic brain injuries. Blasts inflict damage to the brain directly and by causing injuries to other organs, resulting in air emboli, hypoxia, and shock. Direct injuries to the brain result from rapid shifts in air pressure (primary blast injury), from impacts with munitions fragments and other objects propelled by the explosion (secondary blast injury), and from collisions with objects and rapid acceleration of individuals propelled by the explosion (tertiary blast injury). Tertiary injury can occur from a building or other structure collapsing and from an individual being thrown by the blast wind. The pathological consequences of secondary and tertiary blast injuries are very likely to be similar to those of other types of mechanical trauma seen in civilian life. The damage attributable to the specific effects of a blast, however, has received little study, although it has been assumed to include the focal and diffuse lesions characteristic of closed head injuries. Available clinical studies of blast injuries show focal damage similar to that found in other types of closed head injuries but have not determined whether diffuse axonal injury also occurs. In this article, we will try to reach a better understanding of the specific pathology of blast-related brain injury by reviewing the available experimental studies and the autopsy reports of victims of terrorist attacks and military casualties dating back to World War I.

GABA ($\gamma $-aminobutyric acid) is a major inhibitory synaptic neurotransmitter with widespread distribution in the central nervous system (CNS). GABA can also modulate axonal excitability by activation of GABA$_{\text{A}}$ receptors in CNS white matter regions where synapses and neuronal cell bodies are not present. Studies on cultured glia cells have revealed the synthesis of GABA in rat optic nerve O-2A progenitor cells that give rise to oligodendrocytes and type 2 astrocytes in vitro. We report here that: (i) GABA is detected by immuno-electron microscopy in intact rat optic nerve and is localized to glia and pre-myelinated axons during the first few weeks of postnatal development, but is markedly reduced or absent in the adult; and (ii) neonatal optic nerve is depolarized by GABA$_{\text{A}}$ receptor agonists or by the inhibition of GABA uptake. These results demonstrate the presence of functional GABA$_{\text{A}}$ receptors, and GABA uptake and release mechanisms in developing rat optic nerve, and suggest that excitability of developing axons can be modulated by endogenous neurotransmitter at non-synaptic sites.

BACKGROUND:Progenitor cells isolated from adult brain tissue are important tools for experimental studies of remyelination. Cells harvested from neurogenic regions in the adult brain such as the subependymal zone have demonstrated remyelination potential. Multipotent cells from the progenitor fraction have been isolated from the adult olfactory bulb (OB) but their potential to remyelinate has not been studied. METHODOLOGY/PRINCIPAL FINDINGS:We used the buoyant density gradient centrifugation method to isolate the progenitor fraction and harvest self-renewing multipotent neural cells grown in monolayers from the adult green-fluorescent protein (GFP) transgenic rat OB. OB tissue was mechanically and chemically dissociated and the resultant cell suspension fractionated on a Percoll gradient. The progenitor fraction was isolated and these cells were plated in growth media with serum for 24 hrs. Cells were then propagated in N2 supplemented serum-free media containing b-FGF. Cells at passage 4 (P4) were introduced into a demyelinated spinal cord lesion. The GFP(+) cells survived and integrated into the lesion, and extensive remyelination was observed in plastic sections. Immunohistochemistry revealed GFP(+) cells in the spinal cord to be glial fibrillary acidic protein (GFAP), neuronal nuclei (NeuN), and neurofilament negative. The GFP(+) cells were found among primarily P0(+) myelin profiles, although some myelin basic protein (MBP) profiles were present. Immuno-electron microscopy for GFP revealed GFP(+) cell bodies adjacent to and surrounding peripheral-type myelin rings. CONCLUSIONS/SIGNIFICANCE:We report that neural cells from the progenitor fraction of the adult rat OB grown in monolayers can be expanded for several passages in culture and that upon transplantation into a demyelinated spinal cord lesion provide extensive remyelination without ectopic neuronal differentiation.

Peripheral nerve injury is a common clinical problem, and the development of novel strategies to enhance peripheral nerve regeneration is important. Traumatic events, including motor vehicle accidents, sports-related injuries, violence, and falls, lead to significant numbers of peripheral nerve lesions. Traumatic nerve injuries are often associated with life-threatening injuries, which must be treated first. During the delay in nerve repair, the transected nerves undergo Wallerian degeneration. Therefore, delay before surgical treatment is critical, but care must also be taken to ensure that nerve reapposition is performed in a manner that will result in a therapeutic benefit. Peripheral nerve repair after transection injury combined with transplantation of myelin-forming glia cells, for example, Schwann cells (SCs) or olfactory ensheathing cells (OECs), may facilitate the regenerative process. Cell-based therapies are being considered in clinical trials for a number of neurological diseases, including multiple sclerosis, spinal cord injury, Parkinson's disease, and stroke. The rationale is that transplanted cells may provide neuroprotection by production of chemokines and neurotrophins or could serve as a replacement therapy. A number of cells derived from adult peripheral tissues for cell therapies are also being actively investigated. These cells include SCs from peripheral nerve, olfactory OECs from the olfactory system, and stromal cells from bone marrow (mesenchymal stem cells, MSCs). In principle, these cells could be derived autologously, and used acutely or expanded in culture and used for cell-based therapies. Here, we review experimental work demonstrating the potential of one of these cells, the OEC, as an experimental tool for promoting recovery in peripheral nerve injury.

A useful experimental model to study the pathophysiology of cerebral ischemia without craniectomy is the middle cerebral artery occlusion (MCAO) model. In this model, an intraluminal suture is advanced from the internal carotid artery to occlude the base of the MCA. Standardized procedures in terms of suture size, animal weight, and the details of intraluminal suture insertion are well established. This procedure can produce reversible occlusion after insertion of the intraluminal suture for a specified period of time, or a permanent occlusion by leaving the suture in place. This model has been useful in the study of both the normal pathophysiology of cerebral ischemia and in assessing interventional therapeutic approaches for stroke therapy. One approach has been the intravenous delivery of bone marrow-derived mescenchymal stem cells at various times after MCAO. Histological and magnetic resonance imaging have been used to quantify infarction volume in this model system.

A useful experimental model to study the pathophysiology of cerebral ischemia without craniectomy is the middle cerebral artery occlusion (MCAO) model. In this model, an intraluminal suture is advanced from the internal carotid artery to occlude the base of the MCA. Standardized procedures in terms of suture size, animal weight, and the details of intraluminal suture insertion are well established. This procedure can produce reversible occlusion after insertion of the intraluminal suture for a specified period of time, or a permanent occlusion by leaving the suture in place. This model has been useful in the study of both the normal pathophysiology of cerebral ischemia and in assessing interventional therapeutic approaches for stroke therapy. One approach has been the intravenous delivery of bone marrow-derived mescenchymal stem cells at various times after MCAO. Histological and magnetic resonance imaging have been used to quantify infarction volume in this model system.

Peripheral nerve injury is a common clinical problem, and the development of novel strategies to enhance peripheral nerve regeneration is important. Traumatic events, including motor vehicle accidents, sports-related injuries, violence, and falls, lead to significant numbers of peripheral nerve lesions. Traumatic nerve injuries are often associated with life-threatening injuries, which must be treated first. During the delay in nerve repair, the transected nerves undergo Wallerian degeneration. Therefore, delay before surgical treatment is critical, but care must also be taken to ensure that nerve reapposition is performed in a manner that will result in a therapeutic benefit. Peripheral nerve repair after transection injury combined with transplantation of myelin-forming glia cells, for example, Schwann cells (SCs) or olfactory ensheathing cells (OECs), may facilitate the regenerative process. Cell-based therapies are being considered in clinical trials for a number of neurological diseases, including multiple sclerosis, spinal cord injury, Parkinson's disease, and stroke. The rationale is that transplanted cells may provide neuroprotection by production of chemokines and neurotrophins or could serve as a replacement therapy. A number of cells derived from adult peripheral tissues for cell therapies are also being actively investigated. These cells include SCs from peripheral nerve, olfactory OECs from the olfactory system, and stromal cells from bone marrow (mesenchymal stem cells, MSCs). In principle, these cells could be derived autologously, and used acutely or expanded in culture and used for cell-based therapies. Here, we review experimental work demonstrating the potential of one of these cells, the OEC, as an experimental tool for promoting recovery in peripheral nerve injury.

Monitoring pathology/regeneration in experimental models of de-/remyelination requires an accurate measure not only of functional changes but also of the amount of myelin. We tested whether X-ray diffraction (XRD), which measures periodicity in unfixed myelin, can assess the structural integrity of myelin in fixed tissue. From laboratories involved in spinal cord injury research and in studying the aging primate brain, we solicited "blind" samples and used an electronic detector to record rapidly the diffraction patterns (30 min each pattern) from them. We assessed myelin integrity by measuring its periodicity and relative amount. Fixation of tissue itself introduced +/-10% variation in periodicity and +/-40% variation in relative amount of myelin. For samples having the most native-like periods, the relative amounts of myelin detected allowed distinctions to be made between normal and demyelinating segments, between motor and sensory tracts within the spinal cord, and between aged and young primate CNS. Different periodicities also allowed distinctions to be made between samples from spinal cord and nerve roots and between well-fixed and poorly fixed samples. Our findings suggest that, in addition to evaluating the effectiveness of different fixatives, XRD could also be used as a robust and rapid technique for quantitating the relative amount of myelin among spinal cords and other CNS tissue samples from experimental models of de- and remyelination.

Sucrose gap and intra-axonal recording techniques were used to identify the types of ion channels and inward rectification that are present in regenerated axons of adult (greater than 8 weeks) rat sciatic nerve after crush injury. In sucrose gap recordings, 4-aminopyridine (4-AP) led to slight broadening of the compound action potential (CAP) in normal nerve, and a greater broadening in regenerated nerves. By 12 days after sciatic nerve crush, regenerated nerves manifested an afterhyperpolarization (AHP) lasting up to 250 ms that was sensitive to tetraethylammonium (TEA). A similar TEA-sensitive AHP could be elicited with repetitive stimulation. Hyperpolarizing constant current steps (0.1 to 0.5 mA; 600-900 ms duration) applied across the sucrose gap through regenerated axons evoked membrane hyperpolarizations with a depolarizing, Cs(+)-sensitive relaxation in the response to hyperpolarization, which is characteristic of inward rectification, occurring after about 70 ms. The relaxation was present as early as 21 days after nerve crush. Intra-axonal recordings showed burst firing in 4-AP that was terminated by an AHP that temporally correlated with the TEA-sensitive AHP, and a relaxation in the response to hyperpolarizing current, similar to that of whole nerve recordings. The results demonstrate that in addition to voltage-sensitive sodium channels and 4-AP-sensitive potassium channels, there are TEA-sensitive and inwardly rectifying channels on mammalian regenerated peripheral nerve axons.

Myelinated primary afferent fibers have both peripheral and central nervous system components. As the fibers course through peripheral nerve and dorsal roots they are myelinated by Schwann cells, but after they invade the spinal cord they become myelinated by oligodendrocytes and have associations with astrocytes. This presents the opportunity to compare the pathophysiology of PNS (Schwann cell-associated) vs. CNS (oligodendrocyte/astrocyte-associated) portions of the same axonal trunk located in the dorsal roots and dorsal columns, respectively. Dorsal spinal roots and slices of dorsal columns isolated from adult rats were studied in a sucrose gap chamber from which compound action potential and membrane potential changes could be recorded. The results indicate that the peripheral component of the afferent fibers is resistant to hypoxia as evidenced by stable action and membrane potential when O2 in the bathing medium was completely replaced with N2 for periods up to 2 h. In contrast, the axons become sensitive to hypoxia as they project through the dorsal columns as evidenced by rapid reduction in action potential amplitude accompanied by membrane depolarization when O2 is replaced by N2. This differential response to hypoxia, observed on the same axon branches but over CNS vs. PNS trajectories, suggests that differences related to the extracellular environment or in axo-glial organization in dorsal root vs. dorsal column may confer different degrees of susceptibility to anoxia.

While axonal regeneration is more successful in peripheral nerve than in the central nervous system, it is by no means complete and research to enhance peripheral nerve regeneration is clinically important. Olfactory ensheathing cells (OECs) are known to enhance axonal regeneration and to produce myelin after transplantation. In contrast to Schwann cells their migratory potential and ability to penetrate glial scars is higher. This study evaluated the effect of OEC transplantation on microsurgically repaired sciatic nerves. Rat sciatic nerves were transected followed by microsurgical repair and transplantation of OECs or injection of medium without cells. Twenty-one days later the nerves were removed and prepared for either histology or electrophysiological analysis. Footprint analysis was carried out at 7, 14 and 21 days. The OECs survived and integrated into the repaired nerves as indicated by eGFP-expressing cells aligned with neurofilament identified axons bridging the repair site. Moreover, regenerated axons were myelinated by the transplanted OECs and nodes of Ranvier were formed. Conduction velocity in the OEC transplant group was increased in comparison to the microsurgical repair alone, and improved stepping was observed in the transplant group. These results suggest that presentation of OECs at the time of nerve injury enhances regeneration and improves functional outcome. Even a modest improvement in nerve regeneration could have significant clinical implications for reconstructive nerve surgery.

The systemic injection of human mesenchymal stem cells (hMSCs) prepared from adult bone marrow has therapeutic benefits after cerebral artery occlusion in rats, and may have multiple therapeutic effects at various sites and times within the lesion as the cells respond to a particular pathological microenvironment. However, the comparative therapeutic benefits of multiple injections of hMSCs at different time points after cerebral artery occlusion in rats remain unclear. In this study, we induced middle cerebral artery occlusion (MCAO) in rats using intra-luminal vascular occlusion, and infused hMSCs intravenously at a single 6 h time point (low and high cell doses) and various multiple time points after MCAO. From MRI analyses lesion volume was reduced in all hMSC cell injection groups as compared to serum alone injections. However, the greatest therapeutic benefit was achieved following a single high cell dose injection at 6 h post-MCAO, rather than multiple lower cell infusions over multiple time points. Three-dimensional analysis of capillary vessels in the lesion indicated that the capillary volume was equally increased in all of the cell-injected groups. Thus, differences in functional outcome in the hMSC transplantation subgroups are not likely the result of differences in angiogenesis, but rather from differences in neuroprotective effects.

Demyelinating diseases can arise in a variety of forms in the central and as well as in the peripheral nervous system, and loss of myelin results in conduction abnormalities and functional deficits. Remyelination can occur from activation of endogenous progenitor cells and by exogenously transplanted myelin-forming cells. Here we discuss conduction abnormalities associated with demyelination and myelin repair by transplanted myelin-forming cells. Axonal repair and proper impulse conduction following remyelination also requires appropriate ion channel organization on the remyelinated axon. Axonal sodium and potassium channel distribution on remyelinated axons is discussed. Axon damage and transection is another prominent pathological feature of demyelinated lesions in multiple sclerosis (MS). This chapter also discusses potential neuroprotective effects of transplantation of myelin-forming cells into sites of axonal transection.

The depolarizing action of gamma-aminobutyric acid (GABA), or the GABAA receptor agonist muscimol, on rat dorsal root (L4 and L5) fibers is attenuated following transection, but not crush, of the sciatic nerve. Following discrete nerve crush, axons actively regenerate and contact both the distal nerve segment and the peripheral target tissues. The aim of the present study was to distinguish between these two regions as possible sources of trophic support for retrograde maintenance of dorsal root GABA receptor sensitivity. A surgical procedure was employed to permit a delimited segment of axonal regeneration while prohibiting reestablishment of end organ innervation; the sciatic nerve was crushed and a ligature was placed 3 cm distal to the crush site. Under these conditions, the injury-induced decrement in the dorsal root GABA response, observed between 12 and 21 postoperative days, was significantly attenuated relative to that of ligated nerves, in which regeneration into the distal stump does not occur. The data suggest that nerve transection by ligation restricts trophic support for maintenance of GABA receptor expression in dorsal root ganglion (DRG) neurons. Furthermore, during regeneration the denervated distal nerve segment assumes a neurotrophic role in the maintenance of dorsal root GABA sensitivity, consistent with the hypothesis that growth factors derived from reactive Schwann cells may positively regulate the expression of receptors on axotomized sensory neurons.

1. Rat optic nerves were studied using intra-axonal and whole-nerve recording techniques in a sucrose-gap chamber. Constant-current pulses were applied across the outer compartments of the chamber to achieve a current clamp. 2. The nerves displayed a prominent time-dependent conductance increase elicited by a hyperpolarizing constant-current pulse, as evidenced by a relaxation or 'sag' in membrane potential towards resting potential. The inward current began at about 80 ms and reached a steady level over the next 100-200 ms. Its magnitude progressively increased with increasing levels of hyperpolarization. 3. The inward current elicited by hyperpolarization was reduced, but not abolished, when Na+ was reduced from the normal bath concentration of 151 mM to 0 mM. In Na(+)-free solutions the bath K+ concentration, [K+]o, was varied between 0 and 5 mM; the inward current was greatest when [K+]o was 5 mM and was abolished when [K+]o was zero. 4. The inward current was not abolished by tetrodotoxin (TTX), tetraethylammonium (TEA) or 4-aminopyridine (4-AP) suggesting that conventional voltage-dependent sodium and potassium channels do not underlie the time-dependent conductance increase. Low concentrations of Cs+ completely blocked the inward current, and Ba2+ induced a partial block. External application of divalent cations (Cd2+ and Mg2+) did not block the inward current. These properties are similar to the inwardly rectifying conductance observed in a central nervous system neurone. 5. Stimulus-response curves obtained during the hyperpolarization pulse, before and during the conductance increase, indicate that excitability is increased during the conductance increase. This along with the intra-axonal recordings demonstrates that the origin of the increased conductance is axonal and not glial. 6. It is concluded that central nervous system myelinated fibres in rat optic nerve display a prominent time-dependent conductance increase in response to hyperpolarization that depends on both Na+ and K+ and is blocked by Cs+. This conductance is similar to an inward rectifier described for a variety of neurone types. The increased axonal excitability observed during the conductance increase suggests that its functional role may be to maintain or stabilize axonal excitability during periods of intense action potential activity.

The biophysical properties of N-methyl-D-aspartate (NMDA) receptor-mediated conductances have been well described, but the means by which NMDA receptors are synaptically activated under physiological conditions remain unclear. Activation of NMDA receptors in the CA1 region of the rat hippocampus by paired and multiple stimuli occurred here with orthodromic stimulation at 10 Hz. Elevating extracellular potassium ion concentration [( K+]o) to 7.5 mM selectively enhanced the NMDA receptor-mediated component of the response to repetitive stimulation, and led to burst-firing of pyramidal cells. The effects of elevated [K+]o on NMDA receptor activation were accompanied by relatively small changes in resting potential, however, and may in part result from a decrease in the potassium equilibrium potential producing slowed repolarization. Supporting this hypothesis, low concentrations of the K(+)-channel blocker tetraethylammonium added to normal [K+]o solution slowed repolarization and reproduced the effects of elevated [K+]o on NMDA receptor activation. Significant changes in [K+]o occur with neuronal activity in the central nervous system, and thus may play a role in regulating NMDA receptor-mediated postsynaptic activity.

Transplantation of human mesenchymal stem cells (hMSCs) prepared from adult bone marrow has been reported to ameliorate functional deficits after cerebral artery occlusion in rats. Although several hypotheses to account for these therapeutic effects have been suggested, current thinking is that both neuroprotection and angiogenesis are primarily responsible. In this study, we compared the effects of hMSCs and angiopoietin-1 gene-modified hMSCs (Ang-hMSCs) intravenously infused into rats 6 h after permanent middle cerebral artery occlusion. Magnetic resonance imaging and histologic analyses revealed that rats receiving hMSCs or Ang-hMSCs exhibited comparable reduction in gross lesion volume as compared with the control group. Although both cell types indeed improved angiogenesis near the border of the ischemic lesions, neovascularization and regional cerebral blood flow were greater in some border areas in Ang-hMSC group. Both hMSC- and Ang-hMSC-treated rats showed greater improved functional recovery in the treadmill stress test than did control rats, but the Ang-hMSC group was greater. These results indicate the intravenous administration of genetically modified hMSCs to express angiopoietin has a similar effect on reducing lesion volume as hMSCs, but the Ang-hMSC group showed enhanced regions of increased angiogenesis at the lesion border, and modest additional improvement in functional outcome.

Contusive spinal cord injury (SCI) can result in necrosis of the spinal cord, but often long white matter tracts outside of the central necrotic core are demyelinated. One experimental strategy to improve functional outcome following SCI is to transplant myelin-forming cells to remyelinate these axons and improve conduction. This review focuses on transplantation studies using olfactory ensheathing cell (OEC) to improve functional outcome in experimental models of SCI and demyelination. The biology of the OEC, and recent experimental research and clinical studies using OECs as a potential cell therapy candidate are discussed.

Demyelination is associated with a number of neurological disorders including multiple sclerosis (MS), spinal cord injury and nerve compression. MS lesions often show axon loss and therefore reparative therapeutic goals include remyelination and neuroprotection of vulnerable axons. Experimental cellular transplantation has proven successful in a number of demyelination and injury models to remyelinate and improve functional outcome. Here we discuss the remyelination and neuroprotective potential of several myelin-forming cells types and their behavior in different demyelination and injury models. Better understanding of these models and current cell-based strategies for remyelination and neuroprotection offer exciting opportunities to develop strategies for clinical studies.

Intravenous delivery of mesenchymal stem cells (MSCs) prepared from bone marrow (BMSCs) reduces infarction volume and ameliorates functional deficits in a rat cerebral ischemia model. MSC-like multipotent precursor cells (PMSCs) have also been suggested to exist in peripheral blood. To test the hypothesis that treatment with PMSCs may have a therapeutic benefit in stroke, we compared the efficacy of systemic delivery of BMSCs and PMSCs. A permanent middle cerebral artery occlusion (MCAO) in rat was induced by intraluminal vascular occlusion with a microfilament. Rat BMSCs and PMSCs were prepared in culture and intravenously injected into the rats 6 h after MCAO. Lesion size was assessed at 6 h, and 1, 3, and 7 days using MR imaging and histology. The hemodynamic change of cerebral blood perfusion on stroke was assessed the same times using perfusion-weighted image (PWI). Functional outcome was assessed using the treadmill stress test. Both BMSCs and PMSCs treated groups had reduced lesion volume, improved regional cerebral blood flow, and functional improvement compared to the control group. The therapeutic benefits of both MSC-treated groups were similar. These data suggest that PMSCs derived from peripheral blood could be an important cell source of cell therapy for stroke.

Cell-based therapies are being considered in clinical trials for a number of neurological diseases including multiple sclerosis, spinal cord injury, Parkinson’s disease, and stroke. The rationale is that cells could serve as replacement therapy, provide neuroprotection, or stimulate neurogenesis or angiogenesis by producing chemokines and neurotrophins. Although the use of embryonic stem cells shows promise because of the totipotency of these cells and the prospect of developing large numbers of cells, a number of other cells derived from adult peripheral tissues are also being actively investigated. These cells include Schwann cells from peripheral nerve, olfactory ensheathing cells (OECs) from the olfactory system, and stromal cells from bone marrow (mesenchymal stem cells, or MSCs). In principle, these cells could be derived autologously, expanded in culture, and used for cellbased therapies. This chapter reviews experimental work demonstrating the potential of peripherally derived cells as a tool for promoting recovery in CNS injury.

Intravenous administration of human mesenchymal stem cells (hMSCs) prepared from adult bone marrow has been reported to ameliorate functional deficits after cerebral artery occlusion in rats. Several hypotheses to account for these therapeutic effects have been suggested, and current thinking is that neuroprotection rather than neurogenesis is responsible. To enhance the therapeutic benefits of hMSCs potentially, we transfected hMSCs with the glial cell line-derived neurotrophic factor (GDNF) gene using a fiber-mutant F/RGD adenovirus vector and investigated whether GDNF gene-modified hMSCs (GDNF-hMSCs) could contribute to functional recovery in a rat permanent middle cerebral artery occlusion (MCAO) model. We induced MCAO by using intraluminal vascular occlusion, and GDNF-hMSCs were intravenously infused into the rats 3 hr later. MRI and behavioral analyses revealed that rats receiving GDNF-hMSCs or hMSCs exhibited increased recovery from ischemia compared with the control group, but the effect was greater in the GDNF-hMSC group. Thus, these results suggest that intravenous administration of hMSCs transfected with the GDNF gene using a fiber-mutant adenovirus vector may be useful in the cerebral ischemia and may represent a new strategy for the treatment of stroke.

Intravenous delivery of mesenchymal stem cells (MSCs) prepared from adult bone marrow reduces infarction size and ameliorates functional deficits in rat cerebral ischaemia models. Placental growth factor (PlGF) is angiogenic to impaired non-neural tissue. To test the hypothesis that PlGF contributes to the therapeutic benefits of MSC delivery in cerebral ischaemia, we compared the efficacy of systemic delivery of human MSCs (hMSCs) and hMSCs transfected with a fibre-mutant F/RGD adenovirus vector with a PlGF gene (PlGF-hMSCs). A permanent middle cerebral artery occlusion (MCAO) was induced by intraluminal vascular occlusion with a microfilament. hMSCs and PlGF-hMSCs were intravenously injected into the rats 3 h after MCAO. Lesion size was assessed at 3 and 6 h, and 1, 3, 4 and 7 days using MR imaging and histology. Functional outcome was assessed using the limb placement test and the treadmill stress test. Both hMSCs and PlGF-hMSCs reduced lesion volume, induced angiogenesis and elicited functional improvement compared with the control sham group, but the effect was greater in the PlGF-hMSC group. Enzyme-linked immunosorbent assay of the infarcted hemisphere revealed an increase in PlGF in both hMSC groups, but a greater increase in the PlGF-hMSC group. These data support the hypothesis that PlGF contributes to neuroprotection and angiogenesis in cerebral ischaemia, and cellular delivery of PlGF to the brain can be achieved by intravenous delivery of hMSCs.

Transplantation of cell suspensions containing olfactory ensheathing cells (OECs) has been reported to remyelinate demyelinated axons in the spinal cord with a Schwann cell (SC)-like pattern of myelination. However, questions have been raised recently as to whether OECs can form SC-like myelin. To address this issue we prepared SCs and OECs from transgenic rats in which a marker gene, human placental alkaline phosphatase (hPAP), is linked to the ubiquitously active promoter of the R26 gene. SCs were prepared from the sciatic nerve and OECs from the outer nerve-fiber layer of the olfactory bulb. Positive S100 and p75 immunostaining indicated that >95% of cells in culture displayed either SC or OEC phenotypes. Suspensions of either SCs or OECs were transplanted into an X-irradiation/ethidium bromide demyelinating lesion in the spinal cord. We observed extensive SC-like remyelination following either SC or OEC transplantation 3 weeks after injection of the cells. Alkaline phosphatase (ALP) chromagen reaction product was associated clearly with the myelin-forming cells. Thus, cell suspensions that are enriched in either SCs or OECs result in peripheral-like myelin when transplanted in vivo.

Myelin-forming glial cells transplanted into the demyelinated spinal cord can form compact myelin and improve conduction properties. However, little is known of the expression and organization of voltage-gated ion channels in the remyelinated central axons or whether the exogenous cells provide appropriate signaling for the maturation of nodes of Ranvier. Here, we transplanted olfactory ensheathing cells from green fluorescent protein (GFP)-expressing donor rats [GFP-olfactory ensheathing cells (OECs)] into a region of spinal cord demyelination and found extensive remyelination, which included the development of mature nodal, paranodal, and juxtaparanodal domains, as assessed by ultrastructural, immunocytochemical, and electrophysiological analyses. In remyelinated axons, Nav1.6 was clustered at nodes, whereas Kv1.2 was aggregated in juxtaparanodal regions, recapitulating the distribution of these channels within mature nodes of uninjured axons. Moreover, the recruitment of Navand Kvchannels to specific membrane domains at remyelinated nodes persisted for at least 8 weeks after GFP-OEC transplantation.In vivoelectrophysiological recordings demonstrated enhanced conduction along the GFP-OEC-remyelinated axons. These findings indicate that, in addition to forming myelin, engrafted GFP-OECs provide an environment that supports the development and maturation of nodes of Ranvier and the restoration of impulse conduction in central demyelinated axons.