Regenerating ganglion cell axons in the adult rat establish retinofugal topography and restore visual function

Addressing neurodegeneration in glaucoma: Mechanisms, challenges, and treatments

Glaucoma is the leading cause of irreversible blindness globally. The disease causes vision loss due to neurodegeneration of the retinal ganglion cell (RGC) projection to the brain through the optic nerve. Glaucoma is associated with sensitivity to intraocular pressure (IOP). Thus, mainstay treatments seek to manage IOP, though many patients continue to lose vision. To address neurodegeneration directly, numerous preclinical studies seek to develop protective or reparative therapies that act independently of IOP. These include growth factors, compounds targeting metabolism, anti-inflammatory and antioxidant agents, and neuromodulators. Despite success in experimental models, many of these approaches fail to translate into clinical benefits. Several factors contribute to this challenge. Firstly, the anatomic structure of the optic nerve head differs between rodents, nonhuman primates, and humans. Additionally, animal models do not replicate the complex glaucoma pathophysiology in humans. Therefore, to enhance the success of translating these findings, we propose two approaches. First, thorough evaluation of experimental targets in multiple animal models, including nonhuman primates, should precede clinical trials. Second, we advocate for combination therapy, which involves using multiple agents simultaneously, especially in the early and potentially reversible stages of the disease. These strategies aim to increase the chances of successful neuroprotective treatment for glaucoma.

Aberrant information transfer interferes with functional axon regeneration

Functional axon regeneration requires regenerating neurons to restore appropriate synaptic connectivity and circuit function. To model this process, we developed an assay in Caenorhabditis elegans that links axon and synapse regeneration of a single neuron to recovery of behavior. After axon injury and regeneration of the DA9 neuron, synapses reform at their pre-injury location. However, these regenerated synapses often lack key molecular components. Further, synaptic vesicles accumulate in the dendrite in response to axon injury. Dendritic vesicle release results in information misrouting that suppresses behavioral recovery. Dendritic synapse formation depends on dynein and jnk-1. But even when information transfer is corrected, axonal synapses fail to adequately transmit information. Our study reveals unexpected plasticity during functional regeneration. Regeneration of the axon is not sufficient for the reformation of correct neuronal circuits after injury. Rather, synapse reformation and function are also key variables, and manipulation of circuit reformation improves behavioral recovery.

Optic nerve regeneration in mammals: Regenerated or spared axons?

Intraorbital optic nerve crush in rodents is widely used as a model to study axon regeneration in the adult mammalian central nervous system. Recent studies using appropriate genetic manipulations have revealed remarkable abilities of mature retinal ganglion cell (RGC) axons to regenerate after optic nerve injury, with some studies demonstrating that axons can then go on to re-innervate a number of central visual targets with partial functional restoration. However, one confounding factor inherent to optic nerve crush injury is the potential incompleteness of the initial lesion, leaving spared axons that later on could erroneously be interpreted as regenerating distal to the injury site. Careful examination of axonal projection pattern and morphology may facilitate separating spared from regenerating RGC axons. Here we discuss morphological criteria and strategies that may be used to differentiate spared versus regenerated axons in the injured mammalian optic nerve.

Clinical Considerations for Vascularized Composite Allotransplantation of the Eye

Vascularized composite allotransplantation represents a potential shift in approaches to reconstruction of complex defects resulting from congenital differences as well as trauma and other acquired pathology. Given the highly specialized function of the eye and its unique anatomical components, vascularized composite allotransplantation of the eye is an appealing method for restoration, replacement, and reconstruction of the nonfunctioning eye. Herein, we describe conventional treatments for eye restoration and their shortcomings as well as recent research and events that have brought eye transplantation closer to a potential clinical reality. In this article, we outline some potential considerations in patient selection, donor facial tissue procurement, eye tissue implantation, surgical procedure, and potential for functional outcomes.

Advances in retinal ganglion cell imaging

Glaucoma is one of the leading causes of blindness worldwide and will affect 79.6 million people worldwide by 2020. It is caused by the progressive loss of retinal ganglion cells (RGCs), predominantly via apoptosis, within the retinal nerve fibre layer and the corresponding loss of axons of the optic nerve head. One of its most devastating features is its late diagnosis and the resulting irreversible visual loss that is often predictable. Current diagnostic tools require significant RGC or functional visual field loss before the threshold for detection of glaucoma may be reached. To propel the efficacy of therapeutics in glaucoma, an earlier diagnostic tool is required. Recent advances in retinal imaging, including optical coherence tomography, confocal scanning laser ophthalmoscopy, and adaptive optics, have propelled both glaucoma research and clinical diagnostics and therapeutics. However, an ideal imaging technique to diagnose and monitor glaucoma would image RGCs non-invasively with high specificity and sensitivity in vivo. It may confirm the presence of healthy RGCs, such as in transgenic models or retrograde labelling, or detect subtle changes in the number of unhealthy or apoptotic RGCs, such as detection of apoptosing retinal cells (DARC). Although many of these advances have not yet been introduced to the clinical arena, their successes in animal studies are enthralling. This review will illustrate the challenges of imaging RGCs, the main retinal imaging modalities, the in vivo techniques to augment these as specific RGC-imaging tools and their potential for translation to the glaucoma clinic.

Towards axonal regeneration and neuroprotection in glaucoma: Rho kinase inhibitors as promising therapeutics

Due to a prolonged life expectancy worldwide, the incidence of age-related neurodegenerative disorders such as glaucoma is increasing. Glaucoma is the second cause of blindness, resulting from a slow and progressive loss of retinal ganglion cells (RGCs) and their axons. Up to now, intraocular pressure (IOP) reduction is the only treatment modality by which ophthalmologists attempt to control disease progression. However, not all patients benefit from this therapy, and the pathophysiology of glaucoma is not always associated with an elevated IOP. These limitations, together with the multifactorial etiology of glaucoma, urge the pressing medical need for novel and alternative treatment strategies. Such new therapies should focus on preventing or retarding RGC death, but also on repair of injured axons, to ultimately preserve or improve structural and functional connectivity. In this respect, Rho-associated coiled-coil forming protein kinase (ROCK) inhibitors hold a promising potential to become very prominent drugs for future glaucoma treatment. Their field of action in the eye does not seem to be restricted to IOP reduction by targeting the trabecular meshwork or improving filtration surgery outcome. Indeed, over the past years, important progress has been made in elucidating their ability to improve ocular blood flow, to prevent RGC death/increase RGC survival and to retard axonal degeneration or induce proper axonal regeneration. Within this review, we aim to highlight the currently known capacity of ROCK inhibition to promote neuroprotection and regeneration in several in vitro, ex vivo and in vivo experimental glaucoma models.

α-Crystallin protects RGC survival and inhibits microglial activation after optic nerve crush

AIMS

Activation of retinal microglial cells (RMCs) is known to contribute to retinal ganglion cell (RGC) death after optic nerve injury. The purpose of this study was to investigate the effects of intravenous injection of α-crystallin on RGC survival and RMC activation in a rat model of optic nerve crush.

MAIN METHODS

RGCs were retrogradely labeled with fluorogold. Rats were intravenously injected with normal saline or α-crystallin (0.05g/kg, 0.5g/kg, and 5 g/kg) at 2, 4, 6, 8, 10, and 12 days after the optic nerve crush. Activated RMCs were characterized using immunofluorescence labeling with CD11b, and TNF-α and iNOS expression was detected using immunoblot analyses. We analyzed the morphology and numbers of RGC and RMC 2 and 4 weeks after injury using fluorescence and confocal microscopy.

KEY FINDINGS

The number of RGCs decreased after optic nerve injury, accompanied by significantly increased numbers of activated RMCs. Intravenous injection of α-crystallin decreased the number of RMCs, and enhanced the number of RGCs compared to saline injection. α-Crystallin administration inhibited TNF-α and iNOS protein expression induced by optic nerve injury.

SIGNIFICANCE

Our results suggest that α-crystallin promotes RGC survival and inhibits RMC activation. Intravenous injection of α-crystallin could be a possible strategy for the treatment of optic nerve injury.

Variable functional recovery and minor cell loss in the ganglion cell layer of the lizard Gallotia galloti after optic nerve axotomy

The lizard Gallotia galloti shows spontaneous and slow axon regrowth through a permissive glial scar after optic nerve axotomy. Although much of the expression pattern of glial, neuronal and extracellular matrix markers have been analyzed by our group, an estimation of the cell loss in the ganglion cell layer (GCL) and the degree of visual function recovery remained unresolved. Thus, we performed a series of tests indicative of effective visual function (pupillary light reflex, accommodation, visually elicited behavior) in 18 lizards at 3, 6, 9 and 12 months post-axotomy which were then processed for immunohistochemistry for the neuronal markers SMI-31 (neurofilaments), Tuj1 (beta-III tubulin) and SV2 (synaptic vesicles) at the last timepoint. Separately, cell loss in the GCL was estimated by comparative quantitation of DAPI(+) nuclei in control and 12 months experimental lizards. Additionally, 15 lizards were processed for electron microscopy to monitor relevant ultrastructural changes in the GCL, optic nerve and optic tract throughout regeneration. Hypertrophy of RGCs was persistent, morphology of the regenerated nerves varied from narrow to neuroma-like features and larger regenerated axons underwent remyelination by 9 months. The estimated cell loss in the GCL was 27% and two-third of the animals recovered the pupillary light reflex which involves the pretectum. Strikingly, visually elicited behavior involving the tectum was only restored in two specimens, presumably due to the higher complexity of this pathway. These preliminary results indicate that limited functional regeneration occurs spontaneously in the severely injured visual system of the lacertid G. galloti.

Down-regulation of microglial activity attenuates axotomized nigral dopaminergic neuronal cell loss

BACKGROUND

There is growing evidence that inflammatory processes of activated microglia could play an important role in the progression of nerve cell damage in neurodegenerative disorders such as Parkinson's disease and Alzheimer's disease which harbor features of chronic microglial activation, though the precise mechanism is unknown. In this study, we presented in vivo and ex vivo experimental evidences indicating that activated microglia could exacerbate the survival of axotomized dopaminergic neurons and that appropriate inactivation of microglia could be neuroprotective.

RESULTS

The transection of medial forebrain bundle (MFB) of a rat induced loss of dopaminergic neurons in a time-dependent manner and accompanied with microglial activation. Along with microglial activation, production of reactive oxygen species (ROS) was upregulated and TH/OX6/hydroethidine triple-immunofluorescence showed that the microglia mainly produced ROS. When the activated microglial cells that were isolated from the substantia nigra of the MFB axotomized animal, were transplanted into the substantia nigra of which MFB had been transected at 7 days ago, the survival rate of axotomized dopaminergic neurons was significantly reduced as compared with sham control. Meanwhile, when the microglial activation was attenuated by administration of tuftsin fragment 1-3 (microglia inhibitory factor) into the lateral ventricle using mini-osmotic pump, the survival rate of axotomized dopaminergic neurons was increased.

CONCLUSION

The present study suggests that activated microglia could actively produce and secrete unfavorable toxic substances, such as ROS, which could accelerate dopaminergic neuronal cell loss. So, well-controlled blockade of microglial activation might be neuroprotective in some neuropathological conditions.

Towards retinal ganglion cell regeneration

Traumatic optic nerve injury and glaucoma are among the leading causes of incurable vision loss across the world. What is worse, neither pharmacological nor surgical interventions are significantly effective in reversing or halting the progression of vision loss. Advances in cell biology offer some hope for the victims of optic nerve damage and subsequent partial or complete visual loss. Retinal ganglion cells (RGCs) travel through the optic nerve and carry all visual signals to the brain. After injury, RGC axons usually fail to regrow and die, leading to irreversible loss of vision. Various kinds of cells and factors possess the ability to support the process of axon regeneration for RGCs. This article summarizes the latest advances in RGC regeneration.

Crystallins are regulated biomarkers for monitoring topical therapy of glaucomatous optic neuropathy

Optic nerve atrophy caused by abnormal intraocular pressure (IOP) remains the most common cause of irreversible loss of vision worldwide. The aim of this study was to determine whether topically applied IOP-lowering eye drugs affect retinal ganglion cells (RGCs) and retinal metabolism in a rat model of optic neuropathy. IOP was elevated through cauterization of episcleral veins, and then lowered either by the daily topical application of timolol, timolol/travoprost, timolol/dorzolamide, or timolol/brimonidine, or surgically with sectorial iridectomy. RGCs were retrogradely labeled 4 days prior to enucleation, and counted. Two-dimensional polyacrylamide gel electrophoresis (2D-PAGE), matrix-assisted laser desorption ionization mass spectrometry, Western blotting, and immunohistochemistry allowed the identification of IOP-dependent proteomic changes. Genomic changes were scrutinized using microarrays and qRT-PCR. The significant increase in IOP induced by episcleral vein cauterization that persisted until 8 weeks of follow-up in control animals (p<0.05) was effectively lowered by the eye drops (p<0.05). As anticipated, the number of RGCs decreased significantly following 8 weeks of elevated IOP (p<0.05), while treatment with combination compounds markedly improved RGC survival (p<0.05). 2D-PAGE and Western blot analyses revealed an IOP-dependent expression of crystallin cry-βb2. Microarray and qRT-PCR analyses verified the results at the mRNA level. IHC demonstrated that crystallins were expressed mainly in the ganglion cell layer. The data suggest that IOP and either topically applied antiglaucomatous drugs influence crystallin expression within the retina. Neuronal crystallins are thus suitable biomarkers for monitoring the progression of neuropathy and evaluating any neuroprotective effects.

Four steps to optic nerve regeneration

The failure of the optic nerve to regenerate after injury or in neurodegenerative disease remains a major clinical and scientific problem. Retinal ganglion cell (RGC) axons course through the optic nerve and carry all the visual information to the brain, but after injury, they fail to regrow through the optic nerve and RGC cell bodies typically die, leading to permanent loss of vision. There are at least 4 hurdles to overcome in preserving RGCs and regenerating their axons: 1) increase RGC survival, 2) overcome the inhibitory environment of the optic nerve, 3) enhance RGC intrinsic axon growth potential, and 4) optimize the mapping of RGC connections back into their targets in the brain.

Emerging options for the management of age-related macular degeneration with stem cells

Age-related macular degeneration (AMD) is a devastating retinal disease that occurs in later life as the retinal pigment epithelium (RPE) cells die, with subsequent photoreceptor degeneration. In the past, RPE transplant surgeries gave evidence that AMD was potentially treatable, but it involved limited amounts of ocular tissue, and the complication rate was high. Then, stem cell transplants offered an unlimited supply of retinal precursors for endogenous repair and exogenous cell replacement. Debate continues as to which type of stem cell is most appropriate for treating AMD. The prospects include adult-derived progenitor stem cells (including progenitor cells from ocular tissues), hematopoietic stem cells, embryonic stem cells, and induced pluripotent stem cells. Now the therapy is expanding into phase I human trials. This review examines the collective research contributions toward a clinical model of AMD management with stem cells.

A review of the potential to restore vision with stem cells

Vision research involving stem cells is a rapidly evolving field. Animal experiments have shown that in response to environmental cues, stem cells can repopulate damaged retinas, regrow neuronal axons, repair higher cortical pathways, and restore pupil reflexes, light responses and basic pattern recognition. Viable corneas have been grown from stem cells and transplanted into humans. Similarly, human trials to repair damaged retinas in retinitis pigmentosa and age-related macular degeneration patients have produced preliminary successes. This review attempts to place the collective contributions toward stem cell/vision research into a broader clinical model of how stem cells might ultimately be used to restore the entire visual pathway.

ROCK inhibition and CNTF interact on intrinsic signalling pathways and differentially regulate survival and regeneration in retinal ganglion cells

Functional regeneration in the CNS is limited by lesion-induced neuronal apoptosis and an environment inhibiting axonal elongation. A principal, yet unresolved question is the interaction between these two major factors. We thus evaluated the role of pharmacological inhibition of rho kinase (ROCK), a key mediator of myelin-derived axonal growth inhibition and CNTF, a potent neurotrophic factor for retinal ganglion cells (RGC), in models of retinal ganglion cell apoptosis and neurite outgrowth/regeneration in vitro and in vivo. Here, we show for the first time that the ROCK inhibitor Y-27632 significantly enhanced survival of RGC in vitro and in vivo. In vitro, the co-application of CNTF and Y-27632 potentiated the effect of either substance alone. ROCK inhibition resulted in the activation of the intrinsic MAPK pathway, and the combination of CNTF and Y-27632 resulted in even more pronounced MAPK activation. While CNTF also induced STAT3 phosphorylation, the additional application of ROCK inhibitor surprisingly diminished the effects of CNTF on STAT3 phosphorylation. ROCK activity was also decreased in an additive manner by both substances. In vivo, both CNTF and Y-27632 enhanced regeneration of RGC into the non-permissive optic nerve crush model and additive effects were observed after combination treatment. Further evaluation using specific inhibitors delineate STAT3 as a negative regulator of neurite growth and positive regulator of cell survival, while MAPK and Akt support neurite growth. These results show that next to neurotrophic factors ROCK inhibition by Y-27632 potently supports survival of lesioned adult CNS neurons. Co-administration of CNTF and Y-27632 results in additive effects on neurite outgrowth and regeneration. The interaction of intracellular signalling pathways may, however, attenuate more pronounced synergy and has to be taken into account for future treatment strategies.

Attempts to restore visual function after optic nerve damage in adult mammals

Retinal ganglion cells (RGCs) and their axons, i.e., optic nerve (ON) fibers, provide a good experimental model for research on damaged CNS neurons and their functional ecovery. After the ON transection most RGCs undergo retrograde and anterograde degeneration but they can be rescued and regenerated by transplantation of a piece of peripheral nerve (PN). When the nerve graft was bridged to the visual center, regenerating RGC axons can restore the central visual projection. Behavioral recovery of relatively simple visual function has been proved in such PN-grafted rodents. Intravitreal injections of various neurotrophic factors and cytokines to activate intracellular signaling mechanism of RGCs and electrical stimulation to the cut end of ON have promoting effects on their survival and axonal regeneration. Axotomized RGCs in adult cats are also shown to survive and regenerate their axons through the PN graft. Among the cat RGC types, Y cells, which function as visual motion detector, tend to survive and regenerate axons better than others. X cells, which are essential for acute vision, suffer from rapid death after ON transection but they can be rescued by intravitreal application of neurotrophins accompanied with elevation of cAMP. To restore visual function in adult mammals with damaged optic pathway, the comprehensive and integrative strategies of multiple approaches will be needed, taking care of functional diversity of RGC types.

EphA5 and ephrin-A2 expression during optic nerve regeneration: a ‘two-edged sword’

During development, gradients of EphA receptors (nasal(low)-temporal(high)) and their ligands ephrin-As (rostral(low)-caudal(high)) are involved in establishing topography between retinal ganglion cells (RGCs) and the superior colliculus (SC). EphA5-expressing RGC axons are repulsed by ephrin-A2-expressing SC neurones. In adult rats RGCs maintain graded EphA5 expression but ephrin-A2 expression is down-regulated in the SC to a weak gradient. At 1 month after optic nerve transection, EphA5 expression is reduced in the few remaining RGCs and is no longer graded; by contrast, SC ephrin-A2 is up-regulated to a rostral(low)-caudal(high) gradient. Here we examined expression in adult rat 1 month after bridging the retina and SC with a peripheral nerve graft, a procedure that enhances RGC survival and permits RGC axon regeneration. Double labelling with cell markers revealed preservation of a nasal(low)-temporal(high) EphA5 gradient in RGCs and establishment of a rostral(low)-caudal(high) ephrin-A2 gradient within neurones of the SC. The results suggest a potential for guidance cues to restore the topography of RGC axons in the SC. However, high ephrin-A2 levels were also found in astrocytes surrounding the peripheral nerve graft insertion site. The repulsive ephrin-A2 environment offers at least a partial explanation for the observation that only a limited number of RGC axons can exit the graft to enter target central nervous system tissue.

Implantable visual prostheses

Visual impairment and blindness is primarily caused by optic neuropathies like injuries and glaucomas, as well as retinopathies like agerelated macular degeneration (MD), systemic diseases like diabetes, hypertonia and hereditary retinitis pigmentosa (RP). These pathological conditions may affect retinal photoreceptors, or retinal pigment epithelium, or particular subsets of retinal neurons, and in particular retinal ganglion cells (RGCs). The RGCs which connect the retina with the brain are unique cells with extremely long axons bridging the distance from the retina to visual relays within the thalamus and midbrain, being therefore vulnerable to heterogeneous pathological conditions along this pathway. When becoming mature, RGCs loose the ability to divide and to regenerate their accidentally or experimentally injured axons. Consequently, any loss of RGCs is irreversible and results to loss of visual function. The advent of micro- and nanotechnology, and the construction of artificial implants prompted to create visual prostheses which aimed at compensating for the loss of visual function in particular cases. The purpose of the present contribution is to review the considerable engineering expertise that is essential to fabricate current visual prostheses in connection with their functional features and applicability to the animal and human eye. In this chapter, 1) Retinal and cortical implants are introduced, with particular emphasis given to the requirements they have to fulfil in order to replace very complex functions like vision. 2) Advanced work on material research is presented both from the technological and from the biocompatibility aspect as prerequisites of any perspectives for implantation. 3) Ultimately, experimental studies are presented showing the shaping of implants, the procedures of testing their biocompatibility and essential modifications to improve the interfaces between technical devices and the biological environment. The review ends by pointing to future perspectives in the rapidly accelerating process of visual prosthetics and in the increasing hope that restoration of the visual system becomes reality.

Regulation of intrinsic neuronal properties for axon growth and regeneration

Regulation of neuritic growth is crucial for neural development, adaptation and repair. The intrinsic growth potential of nerve cells is determined by the activity of specific molecular sets, which sense environmental signals and sustain structural extension of neurites. The expression and function of these molecules are dynamically regulated by multiple mechanisms, which adjust the actual growth properties of each neuron population at different ontogenetic stages or in specific conditions. The neuronal potential for axon elongation and regeneration are restricted at the end of development by the concurrent action of several factors associated with the final maturation of neurons and of the surrounding tissue. In the adult, neuronal growth properties can be significantly modulated by injury, but they are also continuously tuned in everyday life to sustain physiological plasticity. Strict regulation of structural remodelling and neuritic elongation is thought to be required to maintain specific patterns of connectivity in the highly complex mammalian CNS. Accordingly, procedures that neutralize such mechanisms effectively boost axon growth in both intact and injured nervous system. Even in these conditions, however, aberrant connections are only formed in the presence of unusual external stimuli or experience. Therefore, growth regulatory mechanisms play an essentially permissive role by setting the responsiveness of neural circuits to environmental stimuli. The latter exert an instructive action and determine the actual shape of newly formed connections. In the light of this notion, efficient therapeutic interventions in the injured CNS should combine targeted manipulations of growth control mechanisms with task-specific training and rehabilitation paradigms.

Early decompression of the injured optic nerve reduces axonal degeneration and improves functional outcome in the adult rat

The putative beneficial role of an early decompression of injured CNS tissue following trauma remains controversial. In this study, we approach this scientific query using a standardized injury of the optic nerve in adult rats. Adult Sprague-Dawley rats were subjected to a standardized optic nerve constriction injury by applying a loose ligature around the nerve for 5 min, 1, 6 or 24 h. All animals were sacrificed at 28 dpi. Viable axons distal to the injury were quantified using semithin sections, and regenerative fibers were studied using antisera to neurofilament and GAP43. Axonal degeneration and glial scar development were analyzed using Fluoro-Jade staining and anti-GFAP, respectively. Visual function was studied with visual evoked potentials (VEP). No significant differences were observed between 1 and 6 h of optic nerve compression. However, the number of viable axons analyzed with neurofilament and on semithin sections, decreased significantly between 6 and 24 h, paralleled by an increase in Fluoro-Jade labeled axonal debris (P < 0.001). GFAP-IR density was significantly higher (P < 0.001) in the 24 h compression group in comparison to 6 h. VEP showed preserved, but impaired visual function in animals subjected to compression up to 6 h, compared to an abolished cortical response at 24 h. Regenerative GAP43-positive sprouts were occasionally found distal to the lesion in animals subjected to compression up to 6 h, but not at 24 h. These findings suggest that early optic nerve decompression within hours after the initial trauma is beneficial for functional outcome.

Reparative mechanisms in the cerebellar cortex

In the adult brain, different neuronal populations display different degrees of plasticity. Here, we describe the highly different plastic properties of inferior olivary neurones and Purkinje cells. Olivary neurones show a basal expression of growth-associated proteins, such as GAP-43 and Krox24/EGR-1, and remarkable remodelling capabilities of their terminal arbour. They also regenerate their transected neurites into growth-permissive territories and may reinnervate the lost target. Sprouting and regrowing olivary axons are able to follow specific positional information cues to establish new connections according to the original projection map. In addition, they set a strong cell body reaction to injury, which in specific olivary subsets is regulated by inhibitory target-derived cues. In contrast, Purkinje cells do not have a constitutive level of growth-associated genes, and show little cell body reaction, no axonal regeneration after axotomy, and weak sprouting capabilities. Block of myelin-derived signals allows terminal arbour remodelling, but not regeneration, while selective over-expression of GAP-43 induces axonal sprouting along the axonal surface and at the level of the lesion. We suggest that the high constitutive intrinsic plasticity of the inferior olive neurones allows their terminal arbour to sustain the activity-dependent ongoing competition with the parallel fibres in order to maintain the post-synaptic territory, and possibly underlies mechanisms of learning and memory. Such a plasticity is used also as a reparative mechanism following axotomy. In contrast, in Purkinje cells, poor intrinsic regenerative capabilities and myelin-derived signals stabilise the mature connectivity and prevent axonal regeneration after lesion.

Failure to restore vision after optic nerve regeneration in reptiles: Interspecies variation in response to axotomy

Optic nerve regeneration within the reptiles is variable. In a snake, Viper aspis, and the lizard Gallotia galloti, regeneration is slow, although some retinal ganglion cell (RGC) axons eventually reach the visual centers (Rio et al. [1989] Brain Res 479:151-156; Lang et al. [1998] Glia 23:61-74). By contrast, in a lizard, Ctenophorus ornatus, numerous RGC axons regenerate rapidly to the visual centers, but unless animals are stimulated visually, the regenerated projection lacks topography and animals remain blind via the experimental eye (Beazley et al. [2003] J. Neurotrauma 20:1263-1269). V. aspis, G. galloti, and C. ornatus belong respectively to the Serpentes, Lacertidae, and Agamidae within the Eureptilia, the major modern group of living reptiles comprising the Squamata (snakes, lizards, and geckos) and the Crocodyllia. Here we have extended the findings on Eureptilia to include two geckos (Gekkonidae), Cehyra variegata and Nephrurus stellatus. We also examined a turtle, Chelodina oblonga, the Testudines being the sole surviving representatives of the Parareptilia, the more ancient reptilian group. In all three species, visually elicited behavioral responses were absent throughout regeneration, a result supported electrophysiologically; axonal tracing revealed that only a small proportion of RGC axons crossed the lesion and none entered the contralateral optic tract. RGC axons failed to reach the chiasm in C. oblonga, and in G. variegata, and N. stellatus RGC axons entered the opposite optic nerve; a limited ipsilateral projection was seen in G. variegata. Our results support a heterogeneous response to axotomy within the reptiles, each of which is nevertheless dysfunctional.

Axonal regrowth of layer II-III visual-projecting cortical neurons in rats fails beyond eye opening

Fetal neurons (embryonic age E16) of occipital origin grafted in the visual cortex of albino rats at increasing postnatal stages (P0, P7, P15, P30, P60, P120) can be activated by photic stimulation. Inputs originate from five major areas of the brain ipsilateral to the graft, namely, the claustrum, the periallocortex/proisocortex, the isocortex, the visual thalamus, and some unspecific subthalamic and hypothalamic nuclei. All inputs decrease in number with the age at which grafting was performed. Isocortical afferents exhibit furthermore a progressive laminar shaping. In neonates, layer II-III and layer V-VI neurons contribute equally to the graft input. In adults, grafts receive prominent input (approximately 70-80%) from layer VI neurons whereas layer II-III neurons account for less than 10%. Proportions of layer IV (approximately 2-4%) and layer V (approximately 15-20%) neurons innervating the graft remain stable, irrespective of the age of the recipient. The adult pattern of connectivity between the host brain and the graft establishes in frontal and temporal areas 1 week earlier than in occipital areas. It is nearly completed in postnatal day 15 (P15) grafted recipients. Supragranular neurons would be thus unable to innervate and to make stable synapses at the graft level beyond P15, i.e., when eyes open. Some infragranular neurons (supposedly remnants of the earliest generated cortical cell population) still have this capacity in adults.

Reinnervation of the pretectum in adult rats by regenerated retinal ganglion cell axons: anatomical and functional studies

We have investigated the specificity of reinnervation and terminal arborization of injured retinal ganglion cell (RGC) axons in the brainstem with the object of studying in a simple situation the degree to which regenerating axons are able to replicate the characteristic patterns of terminal arborization and restore normal function. We have focussed here on the pathway that is responsible for the pupillary light reflex, which is mediated through the olivary pretectal nucleus (OPN). In adult rats, the left optic nerve was transected and a segment of peripheral nerve (PN) graft was used to bridge between the retina and different regions of the ipsilateral brainstem, including the superior colliculus. After 4-13 months, regenerated RGC axons were examined in coronal sections stained for cholera toxin B subunit. RGC axons were found extending into the ipsilateral brainstem for distances of up to 6 mm. Within the pretectum, axons innervated the OPN and the nucleus of the optic tract preferentially, and formed distinctive terminal arbors within each. Within the SC axons extended laterally into the visual layers and formed a different type of arborization. On testing the pupillary light reflex, it was found in best cases to show response amplitudes which were comparable to those recorded from control intact animals. However, unlike normals, the response amplitude tended to diminish with repeated stimulation and also appeared to deteriorate with age, although responses could still be detected in some cases as long as 15 months after grafting. These results indicate that regenerating axons can selectively reinnervate denervated nuclei, where they form typical terminal arborizations, and provide the substrates for restoring functional circuitry.

Target-specific innervation of embryonic cerebellar transplants by regenerating olivocerebellar axons in the adult rat

The reestablishment of topographically organized connections is a necessary prerequisite to obtain a full anatomical repair following brain injury. One system where such an issue can be addressed is the olivocerebellar system, where, normally, clusters of inferior olive neurons project to neurochemically heterogeneous Purkinje cell compartments defined by the expression of cell-specific markers, such as zebrin II. To assess whether adult injured olivocerebellar axons that regenerate into cerebellar transplants are able to establish target-specific innervation of grafted Purkinje cells, we made surgical transections in the white matter of adult rat cerebella and placed solid grafts from the embryonic cerebellar anlage into the lesion site. The transplanted tissue developed highly organized minicerebella, in which Purkinje cells were distributed into distinct clusters of zebrin II-immunopositive or -immunonegative neurons, mimicking the cortical compartments present in the normal adult cerebellum. Olivocerebellar axons, labeled by biotinylated dextran amine tracing, regenerated into the transplants where they formed discrete patches made of several terminal arbors impinging upon Purkinje cell dendrites. Among 401 such climbing fiber patches, 96% exclusively innervated Purkinje cells of either phenotype and stopped at the border of the zebrin II(+/-) Purkinje cell clusters, whereas only 4% were extended across this boundary and innervated both zebrin II-positive and -negative Purkinje cells. The results obtained support the view that the embryonic cerebellar tissue provides target-specific information that can be decoded by ingrowing adult olivocerebellar axons in order to establish appropriate innervation patterns with zebrin II-positive or -negative Purkinje cell compartments.

Expression of ephrin-A2 in the superior colliculus and EphA5 in the retina following optic nerve section in adult rat

The vertebrate retina projects topographically to visual brain centres. In the developing visual system, gradients of ephrins and Eph receptors play a role in defining topography. At maturity, ephrins but not Ephs are downregulated. Here we show that optic nerve section in adult rat differentially regulates the expression of ephrin-A2 in the superior colliculus (SC) and of EphA5 in the retina. Expression was quantified immunohistochemically; ephrin-A2 levels were also estimated by semiquantitative reverse transcriptase polymerase chain reaction. In the normal SC, ephrin-A2 was expressed at low levels. At 1 month, levels of protein and of mRNA were upregulated across the contralateral SC giving rise to an increasing rostro-caudal gradient. At 6 months, levels had fallen but a gradient remained. In the retina of normal animals, EphA5 was expressed as an increasing naso-temporal gradient. By 1 month, expression was decreased in far temporal retina, resulting in a uniform expression across the naso-temporal axis. We suggest that denervation-induced plastic changes within the SC modify expression of these molecules.

Optic nerve protection, regeneration, and repair in the 21st century: LVIII Edward Jackson Memorial lecture

PURPOSE

To present the current status and clinical implications of optic nerve protection, repair, and regeneration after experimental injury in mammals, including nonhuman primates.

DESIGN

Optic nerve and neuro-ophthalmology experimental study review.

METHOD

Synthesis of experimental data regarding experimental studies of optic nerve protection, repair, and regeneration.

RESULTS

Under certain conditions, mammalian retinal ganglion cells can be prevented from dying despite injury to the cell bodies or their axons, injured mammalian retinal ganglion cells whose axons have degenerated can be induced to extend new axons, and regenerating axons can reach their correct targets in the central nervous system. In addition, stem cells can be induced to become retinal ganglion cells.

CONCLUSIONS

It may soon be possible to preserve and restore vision in persons whose sight is threatened or has been lost from disease or damage to the optic nerve.

Lens-injury-stimulated axonal regeneration throughout the optic pathway of adult rats

Axonal regrowth and restoration of visual function were studied in adult rats. The optic nerve was completely cut behind the eye. The proximal and distal nerve stumps were realigned and the meninges sutured back together. During the same surgical procedure, the lens was lesioned in order to induce secondary cellular cascades, which are known to strongly support the survival of retinal ganglion cells (RGCs) and to promote axonal regeneration. The anatomical and topographic restoration of the visual pathway was assessed neuroanatomically with the aid of anterograde and retrograde tracing using fluorescent dyes. It appeared that the axons formed growth cones at the junction of the suture soon after injury, before glial cells and extracellular matrix proteins were able to cause local scar formation. Growth cones first entered the distal optic nerve stump 3 days after injury, grew through it to reach the optic chiasm approximately 3 weeks after the lesion was made, and terminated within the retinoreceptive layers of the superior colliculus 5 weeks after lesioning. Quantification of the retrogradely labeled cell bodies within the regenerating retina revealed that up to 30% of the RGCs, which includes all major cell types, were capable of regenerating their axons along the entire visual pathway. To assess whether topography was restored, double-labeling experiments were performed, revealing only crude topographic restoration during the initial stages of regeneration. However, visual-evoked potentials could be recorded, indicating that synaptic transmission in higher visual areas was relatively intact. The data show, in principle, that cut axons can regenerate over long distances within the white matter of a central nerve like the adult optic nerve, spanning over 11 mm to the chiasm and between 12 and 15 mm to the thalamus and midbrain. The findings suggest, for the first time, that lentogenic stimulation of RGCs is sufficient to induce the formation of growth cones that can override inhibitors at the site of injury, grow through the white matter of the optic nerve, pass through the optic chiasm, and make synaptic connections within the brain.

Perforated microelectrode arrays implanted in the regenerating adult central nervous system

Adult mammalian optic nerve axons are able to regenerate, when provided with the permissive environment of an autologous peripheral nerve graft, which is usually the sciatic nerve. This study demonstrates the ability of adult rat optic nerve axons to regenerate through the preformed perforations of a polyimide electrode carrier implanted at the interface between the proximal stump of the cut optic nerve and the stump of the peripheral nerve piece used for grafting. Evidence that retinal ganglion cells regenerated their axons through the perforated electrode carrier was obtained by retrograde labeling with a fluorescent dye deposited into the sciatic nerve graft beyond the nerve-carrier-nerve junction. The number of regenerating cells could be enhanced by injecting neuroprotective drugs like aurintricarboxylic acid and cortisol intravitreally. A second line of evidence was obtained by immunohistochemical staining with antibodies to neurofilament. Third, electrical activity of the regenerating nerves was recorded after stimulating the retina with a flash of light. The results suggest that a regenerating central nerve tract may serve as an experimental model to implant artificial microdevices to monitor the physiological and topographical properties of neurites passing through the device or to stimulate them, thus interfering with their potential to grow. This study reports for the first time that the optic nerve has unique properties, which aids in the realization of these goals.

Continued neurogenesis is not a pre-requisite for regeneration of a topographic retino-tectal projection

Electrophysiological recording demonstrated that visuo-tectal projections are topographically organised after optic nerve regeneration in aged Xenopus laevis. 3H-thymidine autoradiography confirmed previous reports [Taylor, Lack, & Easter, Eur. Journal of Neuroscience 1 (1989) 626-638] that cell division had already ceased at the retinal ciliary margin. The results demonstrate that, contrary to a previous suggestion [Holder & Clarke, Trends in Neuroscience 11 (1988) 94-99], continued neurogenesis is not a pre-requisite for the re-establishment of appropriate connections with target cells.

Evidence that regenerating optic axons maintain long-term growth in the lizard Ctenophorus ornatus: growth-associated protein-43 and gefiltin expression

In the lizard, Ctenophorus ornatus, the optic nerve regenerates but animals remain blind via the experimental eye, presumably as a result of axons failing to consolidate a retinotopic map in the optic tectum. Here we have examined immunohistochemically the expression of the growth-associated protein GAP-43 and the low-molecular-weight intermediate filament protein gefiltin, up to one year after optic nerve crush. Both proteins were found to be permanently up-regulated, suggesting that regenerating axons are held in a permanent state of re-growth. We speculate that, in the lizard, the continued expression of GAP-43 and the failure to switch from the expression of low- to high-molecular-weight intermediate filament proteins are associated with the inability to consolidate a retinotopic projection.

Restoration of the retinofugal pathway

In a relatively short period of time covering the last 2 decades, regeneration of retinofugal axons has become one of most prominent experimental models in restorative neurobiology. There is now a significant knowledge both on the mechanisms governing retinal ganglion cell responses to transection of the optic nerve, and the subsequent cell-cell interactions accumulating in death of the neurons. In addition, retinofugal axons served as an excellent model to examine whether, and to conclude that these axons have remarkable abilities for re-growth. This last issue was of invaluable importance, because axons could regenerate in vivo, into peripheral nerve grafts, and last but not least within the white matter of the cut optic nerve. As it stands to date, the extremely complex aspects of axonal regeneration will probably be understood within the retinofugal pathway. Final elucidation of this delicate system will essentially lead to some revision of our knowledge concerning neurotraumatology and CNS-repair.

Retinal ganglion cells regenerating through the peripheral nerve graft retain their electroretinographic responses and mediate light-induced behavior

To assess the light-induced electrical activity of rodent retinal ganglion cells (RGCs) regenerating into a peripheral nerve (PN) graft we used non-invasive recording of electroretinographic responses to the contrast-reversal of sinusoidal gratings (p-ERG). On comparing the retinas that received a PN graft and retinas with only optic nerve (ON) transection, p-ERG responses were present in grafted retinas as late as 20 months after the surgery while they completely disappeared in non-transplanted controls within 4 months of ON transection. Next, the ability of regenerating RGCs to form functional connections with their targets in the superior colliculus (SC) was tested by a light-escape task. While the bilaterally blinded animals did not improve during the test, unilaterally grafted animals (with the contralateral eye blinded) reached 26% success in the last quartile of the light-escape task. This performance was significantly better than that of blind animals (ANOVA and Student-Newman-Keuls test; p<0.05), but did not reach the level of intact rats (87%). The transplanted rats, therefore, were capable of light perception, but at a sub-normal ability. In addition, we were also able to correlate the amplitude of the p-ERG response with the visual behavioral performance for each transplanted animal. This finding indicates that there is a direct link between the RGC electrophysiological activity and the functional capacity of the regenerated visual pathway. In conclusion, the above results indicate that (a) PN grafts help to preserve the normal electroretinographic activity of injured and regenerating RGCs (b) the regenerated visual pathway is functional and capable of mediating simple visual behavior and that (c) there is a correlation between the light-evoked RGC electrical activity and visual behavior and, finally, that (d) the effect of PN graft on the electrophysiological and functional restoration of the visual pathway is long-lasting or even permanent.

Aurintricarboxylic acid promotes survival and regeneration of axotomised retinal ganglion cells in vivo

Aurintricarboxylic acid (ATA) has been used as an anti-apoptotic drug to counteract ischemic or cytotoxic injury to neurons. We investigated whether ATA has a neuroprotective effect on axotomized, adult retinal ganglion cells (RGC) as a model for traumatic neuronal cell death. A solution of ATA was injected into the vitreous body of rat eyes whose optic nerves had been cut. In controls, 14% of RGC survived 14 days after axotomy, whereas 44% of RGC survived after a single injection of ATA solution, and 59% survived when the injection was repeated after 7 days. A single injection of ATA 1 day after axotomy rescued 58% of RGC. However, injection of ATA 4 days after axotomy did not influence the survival of RGC, indicating that crucial, irreversible cascades of death are initiated prior to this point in time. The TUNEL technique was used to visualise apoptotic ganglion cells and revealed that 4 days after axotomy their number was significantly less in retinas whose optic nerves were axotomized and treated with ATA, than those of controls. As a consequence of neuroprotection, more RGC were recruited to regenerate into a peripheral nerve graft used to replace the cut optic nerve. In this paradigm, ATA-treated RGC extended significantly more axons within the graft than control RGC. This number could be increased by a second injection of ATA 7 days after axotomy. These data show that ATA is not only able to delay post-traumatic neuronal death but also enhances the extent of axonal regeneration in vivo.

Laminar distribution of isocortical neurons projecting to occipital grafts in neonate and adult rats

Physiologically responsive grafts of embryonic (E16) occipital neurons placed into the visual cortex of adult rats were shown previously (Gaillard et al., 1998, Restor. Neurol. Neurosci. 12: 13-25) to receive a predominant (93-97%) cortical input from the infragranular layers V-VI. The present paper examines whether this specific pattern of connections is related to some process of maturation of the host cortex. Pieces of embryonic (E16) occipital cortical tissue were grafted into the visual cortex of neonate (P0), 1-week-old (P7), and adult (P120) subjects. Four months later, graft responsiveness was assessed through field potential recordings and host-to-graft afferents were labeled with a retrograde tracer (cholera toxin subunit B). The data show first that afferents to physiologically active grafts originate about equally from both supra- and infragranular cortical layers in newborn subjects and second that supragranular neurons contribute only 20 and 1.5% of these inputs in P7 and P120 recipients, respectively. This strong upside-down laminar shift of afferents may correlate with the layout of subsets of host neurons that at a given developmental stage would have the intrinsic capacity to regrow an axon. Substantial axogenesis and synaptic stabilization of host-to-graft cortical afferents appear possible only within the critical period for the supragranular neurons but may occur throughout life for the infragranular neurons.

Selective innervation of retinorecipient brainstem nuclei by retinal ganglion cell axons regenerating through peripheral nerve grafts in adult rats

The pattern of axonal regeneration, specificity of reinnervation, and terminal arborization in the brainstem by axotomized retinal ganglion cell axons was studied in rats with peripheral nerve grafts linking the retina with ipsilateral regions of the brainstem, including dorsal and lateral aspects of the diencephalon and lateral aspect of the superior colliculus. Four to 13 months later, regenerated retinal projections were traced using intraocular injection of cholera toxin B subunit. In approximately one-third of the animals, regenerated retinal axons extended into the brainstem for distances of up to 6 mm. Although axons followed different patterns of ingrowth depending on their site of entry to the brainstem, within the pretectum, they innervated preferentially the nucleus of the optic tract and the olivary pretectal nucleus in which they formed two types of terminal arbors. Within the superior colliculus, axons extended laterally and formed a different terminal arbor type within the stratum griseum superficiale. In the remaining two-thirds of the animals, retinal fibers formed a neuroma-like structure at the site of entry into the brainstem, or a few fibers extended for very short distances within the neighboring neuropil. These experiments suggest that regenerated retinal axons are capable of a highly selective reinnervation pattern within adult denervated retinorecipient nuclei in which they form well defined terminal arbors that may persist for long periods of time. In addition, these studies provide the anatomical correlate for our previous functional study on the re-establishment of the pupillary light reflex in this experimental paradigm.

Axon regeneration in organotypic slice cultures from the mammalian auditory system is topographic and functional

In vitro models have frequently been employed to investigate the specificity of the formation of axonal projections during both development and regeneration. Such studies demonstrated pathway, target, and laminar specificity, yet they did not tackle the problem of topography. Here, we addressed the issue of regeneration of spatial specificity at the topographic level by lesioning a precisely organized projection from the auditory system of neonatal rats in organotypic slice culture and by analyzing regeneration capacity. Lesioning had no effect on the survival of axotomized neurons or the structure of the auditory nuclei. Anterograde and retrograde biocytin tracing demonstrated that the projection regenerated topographically at the supracellular level. Whole-cell patch-clamp recordings revealed that the regenerated projection was functional. Topographic regeneration was not impaired by blocking spike activity with tetrodotoxin or glycinergic transmission with strychnine. However, if lesioning was performed after the slices had been incubated for 1 week, regeneration capacity was lost despite good survival of neurons. The loss of the regeneration capacity in vitro occurs at a developmental stage that corresponds to the age when the capacity for axonal reorganization is lost in vivo. We conclude that the developmental processes occurring in vivo and in vitro are comparable in this system, which is why we think that essential aspects of the loss of regeneration capacity may be addressed with our culture model in the future.

Retinal axon regeneration in peripheral nerve, tectal, and muscle grafts in adult rats

This study examined whether prior regenerative growth through peripheral nerve (PN) bridging grafts influenced the specificity with which lesioned adult rat retinal ganglion cell (RGC) axons grew into co-grafts of developing target tissue (fetal superior colliculus). Growth into nontarget (muscle) tissue was also examined. Autologous PN was grafted onto the transected optic nerve. After 14 days, the distal ends of the PNs were placed next to, or inserted into, embryonic tectal tissue or into autologous muscle grafts placed in frontal cortex cavities. Host retinal projections were examined 3-8 months later using anterograde and retrograde tracing techniques. In rats in which there was good apposition between PN and tectal tissue, small numbers of RGC axons were observed growing into the tectal grafts (maximum distance of 180 microm). No evidence of specific innervation of appropriate target regions within tectal grafts was detected, even though such regions (identified by acetylcholinesterase histochemistry) were often located close to the PN grafts. In rats with PN/muscle co-grafts, the extent of retinal axon outgrowth was greater (up to 465 microm from the PN tip) and labelled profiles that resembled motor endplates were seen contacting muscle fibres. Previous studies have shown that spontaneously regenerating RGC axons consistently and selectively innervate appropriate target areas in fetal tectal tissue grafted directly into optic tract lesion cavities. Together, the data suggest that exposure to a PN environment may have reduced the extent of adult retinal axon growth into fetal tectal transplants and affected the way regenerating axons responded to specific developmental cues expressed by target cells in the co-grafted tissue.

Recovery of visual behaviors in adult hamsters with the peripheral nerve graft to the sectioned optic nerve

In adult hamsters, the autologous peripheral nerve (PN) was grafted to the sectioned optic nerve to make a bridge to the superior colliculus (SC). Three behavioral tasks were used to test functional recovery of the restored retinocollicular pathway. First, change of spontaneous ambulating activity to a decrease in environmental luminance was examined in an open field. PN-grafted hamsters showed a significant increase to 186% in ambulating activity just after light off, though it was lower than that in normal hamsters (489%). Second, a classical conditioning of total body movements was tested using an increase in luminance as a conditioned stimulus (CS) paired with foot shocks. In normal hamsters the magnitude of movements during CS increased in the acquisition period and then decreased in the extinction period in both the second and the third sessions, while the magnitude remained unchanged in a blind control. PN-grafted hamsters showed an increase in the magnitude only in the third session, although it was statistically barely significant (P = 0.0619). Following section of the grafted nerve, the conditioned response disappeared completely. And third, a shuttle-box avoidance task was examined using a flickering light as CS. Normal hamsters showed improved avoidance scores, while blind controls did not. PN-grafted hamsters showed a slight increase in the score, which was similar to that in the one-eyed control. Anterogradely transported labeling of WGA-HRP, injected into the vitreous body of the grafted eye, was observed in the graft and the superficial layers of SC. These results confirm and extend our previous finding that PN-grafted hamsters can restore some visual function and further suggest that the extent of recovered visual function is as good as in one-eyed animals.

Spontaneous regeneration of severed optic axons restores mapped visual responses to the adult rat superior colliculus

To test whether a spontaneous and functional regeneration of severed axons could occur within the adult mammalian central nervous system, a long-term recovery of microelectrode-mapped visual response was sought in the superior colliculus (SC) after its total or near-total abolition by a precise guillotine cut of the retinocollicular pathway. Recoveries were found 3 weeks or later in 15 of the 36 animals studied; in 10 of these recoveries, half or more of the width of the SC was involved. The recovered responses were often activated from within a normally small area of the visual field. Appropriate retinotopic maps were restored. Intraocular horseradish peroxidase tracing revealed a variety of novel optic trajectories, passing around lesions even of totally cut pathways, which eventually terminated in normally retinorecipient layers of those recovered SCs. Such detours could not be explained by a mechanical reorientation of brain structures. When exactly comparable lesions were examined within a few days, there were no detours: severed optic axons faced the cuts. In long-term animals where responsiveness remained absent, optic axonal reorientations were observed near lesions but the SC was not innervated. Extensive long-term recoveries were in marked contrast to the occasional rapid ones, found within a few days postlesion, which involved only an outermost silenced border of SC. These were attributed to a rapid reversal of conduction failure in spared, bordering, axons of this topographically organized pathway. The findings support the conclusion that, after they are cut, numbers of optic axons can regenerate to the SC and restore appropriate circuitry therein.

Re-establishment of visual circuitry after optic nerve regeneration

In mammals there are a few circumstances in which axotomised ganglion cell axons can regenerate. For instance, in vitro explants of retina can be encouraged to regenerate axons into appropriate culture media. Similarly, axotomised ganglion cells can regenerate into a peripheral nerve graft surgically connected to the optic nerve head, and during early development axons are able to regenerate across the retina to re-enter the optic nerve. This is certainly encouraging, but we are a long way from applying these observations to clinical practice. We need to know whether regenerating axons also retain a functional capacity for navigation. We must ask whether a regenerated projection is likely to be topographic rather than disordered. In this brief review we will look at some selected models of ganglion cell regeneration in order to examine this question of navigation in more detail. This is an important issue: the capacity to re-establish appropriate rather than random connections after ganglion cell regeneration would most likely be necessary for any meaningful return of visual function.

Cellular and molecular correlates of the regeneration of adult mammalian CNS axons into peripheral nerve grafts

Studies of the regeneration of CNS axons into peripheral nerve grafts have provided information crucial to our understanding of the regenerative potential of CNS neurons. Injured axons in the thalamus and corpus striatum produce regenerative sprouts within a few days of graft implantation, apparently in response to living cells in the grafts. The regenerating axons often grow directly towards the grafts, and enter Schwann cell columns where they elongate surrounded by Schwann cell processes. The regenerating CNS axons, and the Schwann cell processes along which they grow, initially express the cell adhesion molecules NCAM, and L1. The axons also express polysialic acid and, unlike regenerating peripheral axons, bind tenascin-C derived from Schwann cells. Wherever peripheral nerve grafts are implanted into the CNS they appear to promote the differential regeneration of CNS axons. Most of the axons which grow into grafts in the thalamus are derived from the thalamic reticular nucleus (TRN), whereas grafts in the striatum promote regeneration of axons from the substantia nigra pars compacta (SNpc) and grafts in the cerebellum promote regeneration from deep cerebellar nuclei (DCN) and brainstem precerebellar neurons. In contrast most thalamocortical projection neurons, striatal projection neurons and Purkinje cells in the cerebellar cortex are poor at regenerating. There are patterns to the expression of regeneration-related molecules by axons injured by nerve grafts in the CNS. Most neurons which regenerate well (e.g. TRN and DCN neurons) upregulate GAP-43, L1 and the transcription factor c-jun in response to a graft, whereas those neurons which do not regenerate well (e.g. Purkinje cells, thalamocortical and striatal projection neurons) do not upregulate these molecules. These observations suggest that some classes of CNS neurons may be intrinsically unable to regenerate axons and the repair of injuries in the brain and spinal cord may consequently require some form of gene therapy for axotomised neurons.

Implantable bioelectric interfaces for lost nerve functions

Neuronal cells are unique within the organism. In addition to forming long-distance connections with other nerve cells and non-neuronal targets, they lose the ability to regenerate their neurites and to divide during maturation. Consequently, external violations like trauma or disease frequently lead to their disappearance and replacement by non-neuronal, and thus not properly functioning cells. The advent of microtechnology and construction of artificial implants prompted to create particular devices for specialised regions of the nervous system, in order to compensate for the loss of function. The scope of the present work is to review the current devices in connection with their applicability and functional perspectives. (1) Successful implants like the cochlea implant and peripherally implantable stimulators are discussed. (2) Less developed and not yet applicable devices like retinal or cortical implants are introduced, with particular emphasis given to the reasons for their failure to replace very complex functions like vision. (3) Material research is presented both from the technological aspect and from their biocompatibility as prerequisite of any implantation. (4) Finally, basic studies are presented, which deal with methods of shaping the implants, procedures of testing biocompatibility and modification of improving the interfaces between a technical device and the biological environment. The review ends by pointing to future perspectives in neuroimplantation and restoration of interrupted neuronal pathways.

Re-establishment of direct synaptic connections between sensory axons and motoneurons after lesions of neonatal opossum CNS (Monodelphis domestica) in culture

For functional recovery after spinal cord injury, regenerating fibres need to grow and to reform appropriate connections with their targets. The isolated central nervous system of neonatal opossums aged 1-9 days has been used to analyse the precision with which neurons become reconnected during regeneration. In culture these preparations maintain their electrical activity and show rapid outgrowth through spinal cord crushes or cuts. By recording electrically and by staining with horseradish peroxidase, we first demonstrated that direct reflex connections were already present at birth between sensory fibres in one segment and motoneurons in the same segment and in adjacent segments. As in previous experiments, 5 days after the spinal cord had been crushed, labelled sensory fibres grew across the lesion to reach the next segment (Woodward et al. (1993) J. Exp. Biol., 176, 77-88; Varga et al. (1995a) Eur. J. Neurosci., 7, 2119-2129, Varga et al. (1995b) Proc. Natl. Acad. Sci. USA, 92, 10959-10963). Beyond the lesion the labelled axons abruptly changed direction, traversed the spinal cord and terminated on labelled motoneurons in the ventral horn. In preparations that had regenerated dorsal root stimulation once again initiated ventral root reflexes. Electron micrographs revealed synapses made by labelled sensory axons on motoneurons. Double staining of growing sensory axons and radial glial fibres showed close association, suggesting guidance. These results indicate that the original pathway is re-established during repair and that appropriate connections are reformed after injury.

Regeneration and transplantation of the optic nerve: developing a clinical strategy

Three separate experimental models of optic nerve regeneration have been presented--along the existing pathway in the presence of antibodies to neutralise inhibitory molecules, along peripheral nerve grafts and from retinal transplants. Each offers a theoretical clinical strategy for restoration of vision, if the mechanism of re-establishment of maps and reconnection to appropriate targets during regeneration can be determined. This is the process of axon guidance, and underlines the importance of our research into the molecular determinants that guide normal development of the visual system.

Functional recovery of vision in regenerated optic nerve fibers

Retinal ganglion cells (RGCs) of adult mammals normally suffer from retrograde cell death after optic nerve section. However, with transplantation of a segment of peripheral nerve (PN), their axons can regenerate and regrow through the graft. When properly guided, the regenerated axons make functional synapses with the target cells in the superior colliculus. Two months after PN graft we studied the number and morphology of RGCs with regenerated axons in adult cats. Number of regenerated RGCs was a few percent of the total population and, among various RGC types, alpha cells revealed the greatest ability for axonal regeneration and ON-center RGCs tended to regenerate better than OFF-center cells. While dendritic field dimension of RGCs with regenerated axons was mostly preserved, their regenerated axons were thinner than normal optic axons and mostly unmyelinated. The RGCs with regenerated axons revealed normal physiological properties in response to visual stimuli, and were classifiable into Y, X or W cells. In accordance with morphological results, Y cells (morphological alpha cells) were most frequently sampled. In hamsters and rats it has been shown that the animals with reconstructed retinocollicular pathway by the PN graft reveal behavioral recovery of visual function. However, in the cat, trials are still in progress to reconstruct the retinogeniculate pathway. The present status of researches on optic nerve regeneration of adult mammals using the PN graft is reviewed, and some future directions discussed.