Abstract

BackgroundChronic inflammatory demyelinating polyneuropathy (CIDP) is often associated with chronic disability, which can be accounted to incomplete regeneration of injured axons. We hypothesized that Schwann cell support for regenerating axons may be altered in CIDP, which may account for the poor clinical recovery seen in many patients.MethodsWe exposed human and rodent Schwann cells to sera from CIDP patients and controls. In a model of chronic nerve denervation, we transplanted these conditioned Schwann cells intraneurally and assessed their capacity to support axonal regeneration by electrophysiology and morphometry.ResultsCIDP-conditioned Schwann cells were less growth supportive for regenerating axons as compared to Schwann cells exposed to control sera. The loss of Schwann cell support was associated with lower levels of granulocyte-macrophage colony-stimulating factor (GM-CSF) in CIDP sera and correlated with altered expression of c-Jun and p57kip2 in Schwann cells. The inactivation of these regulatory factors resulted in an altered expression of neurotrophins including BDNF, GDNF, and NGF in CIDP-conditioned Schwann cells in vitro.ConclusionsOur study provides evidence that pro-regenerative functions of Schwann cells are affected in CIDP. It thereby offers a possible explanation for the clinical observation that in many CIDP patients recovery is incomplete despite sufficient immunosuppressive treatment.Electronic supplementary materialThe online version of this article (doi:10.1186/s12974-016-0711-7) contains supplementary material, which is available to authorized users.

Highlights

  • Chronic inflammatory demyelinating polyneuropathy (CIDP) is often associated with chronic disability, which can be accounted to incomplete regeneration of injured axons

  • Chronic inflammatory demyelinating polyneuropathy (CIDP) is an immune-mediated peripheral neuropathy that is pathologically characterized by endoneural inflammation, segmental demyelination, and axonal degeneration

  • Low granulocyte-macrophage colony-stimulating factor (GM-CSF) levels in CIDP sera are associated with reduced c-Jun and p57kip2 expression in Schwann cells Since our results indicate that a soluble serum factor alters the expression of p57kip2 and c-Jun in Schwann cells, we further investigated the levels of a total of 31 soluble cytokines in CIDP sera

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Summary

Introduction

Chronic inflammatory demyelinating polyneuropathy (CIDP) is often associated with chronic disability, which can be accounted to incomplete regeneration of injured axons. We hypothesized that Schwann cell support for regenerating axons may be altered in CIDP, which may account for the poor clinical recovery seen in many patients. Thereby, Schwann cells change their morphology, down-regulate myelin genes and, at the same time, up-regulate genes that are responsible for promoting axon growth, neuronal survival, and macrophage invasion [6, 7]. Those include various neurotrophins like brain-derived neurotrophic factor (BDNF), glial cell line-derived nerve growth factor (GDNF), and nerve growth factor (NGF) [8]. This phenotypic switch of Schwann cells is controlled by a set of regulatory factors including positive regulators of myelination like Krox-20, Oct-6, Sox-10, and negative regulators like c-Jun, p57kip, and Sox-2 [9,10,11,12]

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