Large-gap peripheral nerve repair using xenogeneic transplants in rhesus macaques

Surgical intervention is required to successfully treat severe, large-gap (≥4 cm) peripheral nerve injuries. However, all existing treatments have shortcomings and an alternative to the use of autologous nerves is needed. Human and porcine nerves are physiologically similar, with comparable dimensions and architecture, presence and distribution of Schwann cells, and conserved features of the extracellular matrix (ECM). We report the repair of fully transected radial nerves in 10 Rhesus Macaques using viable, whole sciatic nerve from genetically engineered (GalT-KO), designated pathogen free (DPF) porcine donors. This resulted in the regeneration of the transected nerve, and importantly, recovery of wrist extension function, distal muscle reinnervation, and recovery of nerve conduction velocities and compound muscle action potentials similar to autologous controls. We also demonstrate the absence of immune rejection, systemic porcine cell migration, and detectable residual porcine material. Our preliminary findings support the safety and efficacy of viable porcine nerve transplants, suggest the interchangeable therapeutic use of cross-species cells, and highlight the broader clinical potential of xenotransplantation.

Preclinical nerve conduction: Nerve battery options for primate studies

Electrophysiological neurodiagnostic tests of nerve conduction (NC) are key assays included in preclinical safety and toxicology programs to assess the peripheral neuropathy (PN) liability of a new drug. Despite their increased use, standardization of nerve conduction studies (NCS) is lacking in the preclinical space, with limited regulatory guidelines stipulating type and number of nerves or minimum combinations appropriate for each stage of drug development or indication. Detection of subtle peripheral toxicities depends on choosing appropriate nerve targets for testing, especially when functional changes remain above the lower limit of normal values. To support robust preclinical toxicology study designs, the current short communication provides options and recommendations for selecting peripheral nerves for clinically translatable nerve conduction batteries applicable to toxicology and gene therapy, with a focus on clinically translatable primate models. A comprehensive compilation of accessible nerve locations is offered including lower and upper extremity motor nerves, and sensory nerves with origin at multiple DRG levels. Rankings of technique difficulty and repeatability across serial collections are presented for each assay informed by serial nerve conduction from 500 adult primates. The goal of this communication is to support the standardization and preclinical implementation of this important assay.

Characterization of AAV-mediated dorsal root ganglionopathy

Recent studies in non-human primates administered recombinant adeno-associated viruses (rAAVs) have shown lesions in the dorsal root ganglia (DRG) of unknown pathogenesis. In this study, rAAV9s manufactured using different purification methods alongside a non-expressing Null AAV9 vector was administered to groups of cynomolgus monkeys followed by neuropathological evaluation after 4 weeks. Lesions, including neuronal degeneration, increased cellularity, and nerve fiber degeneration, were observed in the DRG, regardless of purification methods. Animals did not develop any neurological signs throughout the study, and there was no loss of function observed in neuro-electrophysiological endpoints or clear effects on intraepidermal nerve fiber density. However, magnetic resonance imaging (MRI) of animals with axonopathy showed an increase in short tau inversion recovery (STIR) intensity and decrease in fractional anisotropy. In animals administered the Null AAV9 vector, DRG lesions were not observed despite vector DNA being detected in the DRG at levels equivalent to or greater than rAAV9-treated animals. This study further supports that DRG toxicity is associated with transgene overexpression in DRGs, with particular sensitivity at the lumbar and lumbosacral level. The data from this study also showed that the nerve fiber degeneration did not correlate with any functional effect on nerve conduction but was detectable by MRI.

Evaluation of respiratory function in freely moving Beagle dogs using implanted impedance technology

INTRODUCTION

The Safety Pharmacology ICH S7A guidelines mandate the preclinical evaluation of drug effects on respiratory function. Chronic measurements of potential drug effects are commonly performed in rodents due to lack of a viable alternative in large animals. Presently, although the value and validity of these standard methods cannot be refuted, each method presents inherent limitations; such as the introduction of restraint stress (e.g. head-out rodent plethysmography and the pneumotachograph-equipped dog face mask), or sensitivity issues (e.g. whole body plethysmography). Since these approaches may limit the number of time points tested or affect respiratory parameters, new and accurate methods are needed for assessing respiratory function in conscious, freely moving animals.

METHODS

We evaluated a new surgically implanted telemetry device, which adds an impedance sensor for the chronic measurement of respiratory parameters to the standard device used for safety pharmacology cardiovascular studies. The feasibility of the implantable device was assessed based on concordance of respiratory data with pneumotachograph-recorded parameters in conscious Beagle dogs following intravenous administration of a positive control (4 mg/kg doxapram).

RESULTS

Linear regression analysis of data collected under restrained conditions showed a high correlation (R(2) 0.95) between impedance-derived respiratory parameters (tidal volume and respiratory frequency) and direct measurements of respiration via pneumotachograph. The correlation was reproduced when animals were challenged under the same dosing regimen. Volume changes similar to those obtained during the restrained collection were observed during the ambulatory collection following doxapram administration. Calibration of impedance-based values was adequate using both individual and population-based baseline conversion factors, both approximating actual mean respiratory variables collected with the pneumotachograph.

DISCUSSION

The benefit of this model is the accurate, continuous measurement of respiratory endpoints in restrained, as well as ambulatory settings. Assessment of multiple physiological parameters collected concurrently and the use of population-based calibrations may enable the maximization of resources and shortened timelines in drug development.