Abstract

Functional recovery is poor after peripheral nerve injury and delayed surgical repair or when nerves must regenerate over long distances to reinnervate distant targets. A reduced capacity of Schwann cells (SCs) in chronically denervated distal nerve stumps to support and interact with regenerating axons may account for the poor outcome. In an in vitro system, we examined the capacity of adult, long-term denervated rat SCs to proliferate and to myelinate neurites in co-cultures with fetal dorsal root ganglion (DRG) neurons. Non-neuronal cells were counted immediately after their isolation from the distal sciatic nerve stumps that were subjected to acute denervation of 7 days or chronic denervation of either 7 weeks or 17 months. Thereafter, equal numbers of the non-neural cells were co-cultured with purified dissociated DRG neurons for 5 days. The co-cultures were then treated with 3H-Thymidine for 24 h to quantitate SC proliferation with S100 immunostaining and autoradiography. After a 24-day period of co-culture, Sudan Black staining was used to visualize and count myelin segments that were elaborated around DRG neurites by the SCs. Isolated non-neural cells from 7-week chronically denervated nerve stumps increased 2.5-fold in number compared to ~2 million in 7 day acutely denervated stumps. There were only <0.2 million cells in the 17-week chronically denervated stumps. Nonetheless, these chronically denervated SCs maintained their proliferative capacity although the capacity was reduced to 30% in the 17-month chronically denervated distal nerve stumps. Moreover, the chronically denervated SCs retained their capacity to myelinate DRG neurites: there was extensive myelination of the neurites by the acutely and chronically denervated SCs after 24 days co-culture. There were no significant differences in the extent of myelination. We conclude that the low numbers of surviving SCs in chronically denervated distal nerve stumps retain their ability to respond to axonal signals to divide and to elaborate myelin. However, their low numbers consequent to their poor survival and their reduced capacity to proliferate account, at least in part, for the poor functional recovery after delayed surgical repair of injured nerve and/or the repair of injured nerves far from their target organs.

Highlights

  • The Schwann cells (SCs) in the peripheral nervous system support nerve regeneration after nerve injury in contrast to the oligodendrocytes in the central nervous system that do not (Cajal, 1928; Bunge, 1994; Fenrich and Gordon, 2004; Toy and Namgung, 2013)

  • The bright staining of cell nuclei allowed the unambiguous recognition of cells even when the suspensions were heavily laden with myelin debris

  • In the cultures of dorsal root ganglion (DRG) neurons to which non-neuronal cells were added, many elongated Sudan black-positive profiles were observed (Figures 4C–E). These profiles exhibited the well characterized structure of myelin sheathes. These findings demonstrate that the SCs that remain in chronically denervated nerve stumps retain their capacity to form myelin sheaths around neurites

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Summary

Introduction

The Schwann cells (SCs) in the peripheral nervous system support nerve regeneration after nerve injury in contrast to the oligodendrocytes in the central nervous system that do not (Cajal, 1928; Bunge, 1994; Fenrich and Gordon, 2004; Toy and Namgung, 2013). The prevailing view is that this failure in recovery is due to the irreversible degeneration of chronically denervated muscles and their replacement with fat during nerve regeneration (Sunderland, 1978; Kline and Hudson, 1995) This is despite the early conclusions by Holmes and Young (1942) that there are ‘‘various factors, in addition to atrophy of the end-organs, which are likely to reduce the effectiveness of recovery when suture is made after a long delay’’ and the later conclusion that ‘‘Most likely, multiple mechanisms contribute to this phenomenon’’ (of diminished recovery of muscle mass and integrated motor function), ‘‘which is sometimes referred to as ‘irreversible denervation atrophy’’’ (Kobayashi et al, 1997). Changes in the microenvironment of the chronically denervated nerve stumps provide, at least in part, the explanation for the progressive failure of axonal regeneration through the nerve stumps and to the denervated muscles

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