Cellular Repopulation Research Articles

3662 Cellular repopulation of myocardial infarction in patients with sex-mismatched heart transplantation

3662 Cellular repopulation of myocardial infarction in patients with sex-mismatched heart transplantation

Late-stage immature neocortical neurons reconstruct interhemispheric connections and form synaptic contacts with increased efficiency in adult mouse cortex undergoing targeted neurodegeneration.

In the neocortex, the effectiveness of potential cellular repopulation therapies for diseases involving neuronal loss may depend critically on whether newly incorporated cells can differentiate appropriately into precisely the right kind of neuron, re-establish precise long-distance connections, and reconstruct complex functional circuitry. Here, we test the hypothesis that increased efficiency of connectivity could be achieved if precursors could be more fully differentiated toward desired phenotypes. We compared embryonic neuroblasts and immature murine neurons subregionally dissected from either embryonic day 17 (E17) (Shin et al., 2000) or E19 primary somatosensory (S1) cortex and postnatal day 3 (P3) purified callosal projection neurons (CPNs) with regard to neurotransmitter and receptor phenotype and afferent synapse formation after transplantation into adult mouse S1 cortex undergoing targeted apoptotic degeneration of layer II/III and V CPNs. Two weeks after transplantation, neurons from all developmental stages were found dispersed within layers II/III and V, many with morphological features typical of large pyramidal neurons. Retrograde labeling with FluoroGold revealed that 42 +/- 2% of transplanted E19 immature S1 neurons formed connections with the contralateral S1 cortex by 12 weeks after transplantation, compared with 23 +/- 7% of E17 neurons. A greater percentage of E19-derived neurons received synapses (77 +/- 1%) compared with E17-derived neurons (67 +/- 2%). Similar percentages of both E17 and E19 donor-derived neurons expressed neurotransmitters and receptors [glutamate, aspartate, GABA, GABA receptor (GABA-R), NMDA-R, AMPA-R, and kainate-R] appropriate for endogenous adult CPNs progressively over a period of 2-12 weeks after transplantation. Although P3 fluorescence-activated cell sorting-purified neurons also expressed these mature phenotypic markers after transplantation, their survival in vivo was poor. We conclude that later-stage and region-specific immature neurons develop a mature CPN phenotype and make appropriate connections with recipient circuitry with increased efficiency. However, at postnatal stages of development, limitations in survival outweigh this increased efficiency. These results suggest that efforts to direct the differentiation of earlier precursors precisely along specific desired neuronal lineages could potentially make possible the highly efficient reconstruction of complex neocortical and other CNS circuitry.

Late-Stage Immature Neocortical Neurons Reconstruct Interhemispheric Connections and Form Synaptic Contacts with Increased Efficiency in Adult Mouse Cortex Undergoing Targeted Neurodegeneration

In the neocortex, the effectiveness of potential cellular repopulation therapies for diseases involving neuronal loss may depend critically on whether newly incorporated cells can differentiate appropriately into precisely the right kind of neuron, re-establish precise long-distance connections, and reconstruct complex functional circuitry. Here, we test the hypothesis that increased efficiency of connectivity could be achieved if precursors could be more fully differentiated toward desired phenotypes. We compared embryonic neuroblasts and immature murine neurons subregionally dissected from either embryonic day 17 (E17) (Shin et al., 2000) or E19 primary somatosensory (S1) cortex and postnatal day 3 (P3) purified callosal projection neurons (CPNs) with regard to neurotransmitter and receptor phenotype and afferent synapse formation after transplantation into adult mouse S1 cortex undergoing targeted apoptotic degeneration of layer II/III and V CPNs.Two weeks after transplantation, neurons from all developmental stages were found dispersed within layers II/III and V, many with morphological features typical of large pyramidal neurons. Retrograde labeling with FluoroGold revealed that 42 ± 2% of transplanted E19 immature S1 neurons formed connections with the contralateral S1 cortex by 12 weeks after transplantation, compared with 23 ± 7% of E17 neurons. A greater percentage of E19-derived neurons received synapses (77 ± 1%) compared with E17-derived neurons (67 ± 2%). Similar percentages of both E17 and E19 donor-derived neurons expressed neurotransmitters and receptors [glutamate, aspartate, GABA, GABA receptor (GABA-R), NMDA-R, AMPA-R, and kainate-R] appropriate for endogenous adult CPNs progressively over a period of 2–12 weeks after transplantation. Although P3 fluorescence-activated cell sorting-purified neurons also expressed these mature phenotypic markers after transplantation, their survivalin vivowas poor.We conclude that later-stage and region-specific immature neurons develop a mature CPN phenotype and make appropriate connections with recipient circuitry with increased efficiency. However, at postnatal stages of development, limitations in survival outweigh this increased efficiency. These results suggest that efforts to direct the differentiation of earlier precursors precisely along specific desired neuronal lineages could potentially make possible the highly efficient reconstruction of complex neocortical and other CNS circuitry.

Meniscus transplantation in the rabbit knee joint using a deep frozen meniscus allograft-pathohistologi- cal picture

The aim of the study was to assess the clinical, radiological and histological characteristics of deep frozen meniscal allograft for the rabbit knee. Eighteen (18) New Zealand white rabbits were operated on both knees and evaluated at three time intervals: after 2 weeks (first group), 8 weeks (second group) and 36 weeks (third group). Left knees without meniscal transplantation, served as the controls. Meniscal grafts obtained from other rabbits were stored in a deep freeze at -17 °C when required deep frozen menisci were thawed in sterile saline and transplanted in the place of the removed right medial meniscus of the experimental animal. The general condition, operated knees and X-ray pictures were monitored. After sacrifice the meniscal allografts were histologically analyzed. There were no adverse clinical and radiological pathological findings after transplantation, while in the control group changes were noted. At histological evaluation, 2 weeks after transplantation the collagen fibers were not oriented and there was a low cell population. Vascularity was observed in the second group, with cell repopulation and young immature collagen fibers. In the third group at 36 weeks the collagen tissue was more mature, with significant cell repopulation. We may conclude that deep frozen meniscal allografts show significant collagen remodeling and cellular repopulation. New menisci protect the underlying cartilage. Thus this procedure appears beneficial in cases where there is no possibility to reconstruct the meniscal lesion.

22 week assessment of bladder acellular matrix as a bladder augmentation material in a porcine model

Previous studies on the reconstruction of porcine bladder using bladder acellular matrix allograft (BAMA) have indicated positive preliminary results with respect to graft shrinkage and cellular repopulation. The current study was conducted to investigate the feasibility of using BAMA in a similar model of bladder reconstruction out to longer time frames (22 weeks). At predetermined time points, the macroscopic, histological and mechanical properties of explanted native and BAMA tissues were evaluated and compared. Macroscopically, contracture of the BAMA was observed. The peripheral regions of the grafts experienced extensive cellular repopulation. Towards the centre however, all grafts were consistently devoid of organized smooth muscle bundles and a well-developed urothelium. An alteration in both the amount and organization of collagen was also observed within this region. Significant differences ( p<0.05) in the rupture strain and the elastic modulus of the BAMA compared to native bladder tissue appear to correlate with macroscopic graft contracture as well as the fibroproliferative tissue response of the matrix.

Meniscal tissue regeneration using a collagenous biomaterial derived from porcine small intestine submucosa

Purpose: The present investigation is a preliminary study designed to evaluate the use of a collagen-based biomaterial, chemically unaltered porcine small intestine submucosa (SIS), as a scaffold for meniscal tissue regeneration. Type of Study: Basic research. Methods: Surgical defects were created in the lateral menisci of 12 mature New Zealand white rabbits. The defects were repaired with a similarly shaped and sized wedge of a new collagenous biomaterial (SIS) and sutured in place. The opposite knees served as controls by creating a defect in the lateral meniscus without filling with SIS graft. Full cage activity was allowed until the animals were killed at 4, 12, and 24 weeks. Results: At 4 weeks, the graft material retained its physical position and grossly appeared soft and translucent. Histologically, cellular elements had infiltrated between the laminates of the graft. At 12 weeks, the graft grossly appeared more solid and opaque. Histologically, the host meniscal fibrochondrocytes were seen streaming into the peripheral margin of the graft. Early repopulation of the graft with apparently differentiated meniscal tissue was observed. At 24 weeks, the meniscus defect was grossly healed across and looked virtually normal: the normal meniscal shape, contour, consistency, and color had been replicated. Histologically, the healing tissue showed infiltration of what appeared to be meniscal fibrochondrocytes and connective tissue resembling the host meniscal tissue. The graft was nearly totally replaced by host tissue. Conclusions: This pilot animal study demonstrates that the multilaminated collagenous graft is conducive for cellular repopulation with host meniscal elements, and, by 24 weeks, is capable of supporting complete healing of a large meniscal defect.Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 17, No 2 (February), 2001: pp 151–159

Transplanted Neuroblasts Differentiate Appropriately into Projection Neurons with Correct Neurotransmitter and Receptor Phenotype in Neocortex Undergoing Targeted Projection Neuron Degeneration

Reconstruction of complex neocortical and other CNS circuitry may be possible via transplantation of appropriate neural precursors, guided by cellular and molecular controls. Although cellular repopulation and complex circuitry repair may make possible new avenues of treatment for degenerative, developmental, or acquired CNS diseases, functional integration may depend critically on specificity of neuronal synaptic integration and appropriate neurotransmitter/receptor phenotype. The current study investigated neurotransmitter and receptor phenotypes of newly incorporated neurons after transplantation in regions of targeted neuronal degeneration of cortical callosal projection neurons (CPNs). Donor neuroblasts were compared to the population of normal endogenous CPNs in their expression of appropriate neurotransmitters (glutamate, aspartate, and GABA) and receptors (kainate-R, AMPA-R, NMDA-R. and GABA-R), and the time course over which this phenotype developed after transplantation. Transplanted immature neuroblasts from embryonic day 17 (E17) primary somatosensory (S1) cortex migrated to cortical layers undergoing degeneration, differentiated to a mature CPN phenotype, and received synaptic input from other neurons. In addition, 23.1 +/- 13.6% of the donor-derived neurons extended appropriate long-distance callosal projections to the contralateral S1 cortex. The percentage of donor-derived neurons expressing appropriate neurotransmitters and receptors showed a steady increase with time, reaching numbers equivalent to adult endogenous CPNs by 4-16 weeks after transplantation. These results suggest that previously demonstrated changes in gene expression induced by synchronous apoptotic degeneration of adult CPNs create a cellular and molecular environment that is both permissive and instructive for the specific and appropriate maturation of transplanted neuroblasts. These experiments demonstrate, for the first time, that newly repopulating neurons can undergo directed differentiation with high fidelity of their neurotransmitter and receptor phenotype, toward reconstruction of complex CNS circuitry.

Cellular Repair of Complex Cortical Circuitry

The mammalian neocortex is a highly complex structure that consists of a large number of distinct cell types and connections unparalleled throughout the rest of the mammalian central nervous system (CNS). The neocortex is responsible for high-level functions including sensorimotor integration, associative behavior, and cognition. Although many studies demonstrate that embryonic tissue or precursor cells transplanted into the embryonic or neonatal cortex can integrate and connect with a wide variety of targets, such connectivity in most studies using adult recipients has been quite limited (1, 2). In contrast, relatively recent advances in transplantation paradigms from our laboratory and other laboratories have made apparent the possibility of successful reconstruction of complex cortical circuitry in the adult mammalian brain by transplantation or by manipulation of endogenous precursors in situ. These advances include the ability to isolate increasingly specific populations of immature neurons and precursors from donor animals, and the establishment of a highly selective model of targeted degeneration in the neocortex (3-10, Leavitt, unpublished observations). Such advances now allow both the transplantation of more defined and specific populations of immature neocortical neuroblasts and precursors, and also make it possible to study the cellular, anatomic, and functional efficacy of both transplantation and manipulation of endogenous precursors in situ (9, 11) in increasingly refined models of neocortical degeneration. The neocortex has become a model system for studying circuitry formation, regional specification, cell specification, and cell autonomous versus environmental influences on neuronal development and function in the CNS. Although neocortical transplantation paradigms have proven very useful for elucidating how complex circuits and CNS cytoarchitecture evolve in the mammalian brain, more recent work using cell transplantation has made apparent the possibility of cell replacement and complex circuit repair in the neocortex. Our most recent results (9, 11) suggest that neuronal replacement therapies for neurodegenerative disease and other CNS injury may even some day be possible via molecular manipulation of endogenous neural precursors in situ, without transplantation. Although only fanciful just several years ago, it now appears that studies of cellular repopulation and circuitry reconstruction in the neocortex may provide a foundation toward developing cellular therapies for degenerative or acquired disease in neocortex and other regions of the CNS.

REGENERATION OF FUNCTIONAL BLADDER SUBSTITUTES USING LARGE SEGMENT ACELLULAR MATRIX ALLOGRAFTS IN A PORCINE MODEL

REGENERATION OF FUNCTIONAL BLADDER SUBSTITUTES USING LARGE SEGMENT ACELLULAR MATRIX ALLOGRAFTS IN A PORCINE MODEL

Regeneration of functional bladder substitutes using large segment acellular matrix allografts in a porcine model.

We previously reported on the short-term (4 weeks) morphometric analysis of a large bladder acellular matrix allograft used as a bladder bioprosthesis (average size 24 cm.2). We demonstrated cellular repopulation through the entire thickness of the graft. We now present the long-term (12 weeks) morphometric results of graft regenerated porcine bladders using segments measuring an average of 40 cm.2. Bladders harvested from pigs were subjected to detergent and enzymatic extractions to render them acellular. Partial cystectomy was performed in 21 pigs and the defect was repaired with a bladder acellular matrix allograft (average size 40.52 cm.2). Of the animals 8 were sacrificed at 1, 2 and 4 weeks and 13 were sacrificed at 8 and 12 weeks. To evaluate cellular repopulation and matrix reorganization the native bladder and graft were analyzed using standard histological and immunofluorescent techniques. To evaluate for calcium deposits in the grafts a radiological evaluation of the graft was performed after explantation. All animals survived the surgical procedure and there were no significant urinary leaks. No stones were noted in any of the bladders. At 1 week there was a diffuse infiltration with acute inflammatory cells. At 2 weeks the luminal surface of the graft was lined with a single layer of urothelium, and there was stromal infiltration with unorganized smooth muscle cells and angiogenesis. At 4 weeks the urothelium was multilayered with organizing groups of smooth muscle cells and angiogenesis. At 8 and 12 weeks there was repopulation throughout the bladder acellular matrix allograft implant with all native cellular components participating. We present evidence that large patch bladder acellular matrix allograft implantation is technically feasible and may prove to be a viable surgical alternative to bladder augmentation with intestinal segments. Its advantages may include the potential for complete and functional regeneration of a bladder substitute.

Histological analysis of human meniscal allografts. A preliminary report.

Little is known about the biology of meniscal allograft transplantation in humans. In particular, little information is available about the phenotype of the cells that repopulate the allograft, whether an immune response is elicited against the graft, and whether the repopulating cells synthesize normal extracellular matrix components. A small biopsy specimen of the meniscal allograft (twenty-eight menisci in twenty-five patients) and the adjacent synovial membrane (sixteen patients) was harvested during follow-up arthroscopy in patients who had undergone meniscal allograft transplantation at a mean of sixteen months earlier. Seventeen patients had undergone concomitant reconstruction of the anterior cruciate ligament with an allograft. Normal menisci (unimplanted allografts) and synovial specimens from age-matched controls were examined as well. All twenty-eight meniscal allografts were examined histologically. Immunohistochemical analysis was carried out on ten menisci and nine synovial specimens with use of monoclonal antibodies to class-I and class-II major histocompatibility complex antigens, CD-8, CD-11b, and CD-19 epitopes, as well as other epitopes, to demonstrate immunogenic macromolecules, cytotoxic T-lymphocytes, activated macrophages, and B-lymphocytes. Most of the specimens demonstrated incomplete repopulation with viable cells. The repopulating cells stained positively with phenotype markers for both synovial cells and fibroblasts. Polarized light microscopy demonstrated evidence of active remodeling of the matrix. The cells in frozen, unimplanted menisci stained positively for class-I and class-II human leukocyte antigens, indicating immunogenicity at the time of transplantation. Overall, nine of twelve specimens contained immunoreactive cells (B-lymphocytes or cytotoxic T-cells) in the meniscus or synovial tissue. However, only a small number of these cells was present. There was no evidence of frank immunological rejection. The clinical outcome (success or failure of the transplant) was not related to the overall histological score or to the presence of an immune response in the meniscal or synovial biopsy specimen. Human meniscal allograft transplants are repopulated with cells that appear to be derived from the synovial membrane; these cells appear to actively remodel the matrix. Although there is histological evidence of an immune response directed against the transplant, this response does not appear to affect the clinical outcome. The presence of histocompatibility antigens on the meniscal surface at the time of transplantation (even after freezing) indicates the potential for an immune response against the transplant. Despite the absence of frank immunological rejection, a subtle immune reaction may affect the healing, incorporation, and revascularization of the graft. It is possible that the structural remodeling associated with cellular repopulation may render the meniscus more susceptible to injury.

Acellular bladder matrix allografts in the regeneration of functional bladders: evaluation of large-segment (> 24 cm) substitution in a porcine model.

To evaluate the use of a large-segment (> 24 cm2) bladder substitution with porcine bladder acellular matrix allograft (BAMA) in a large animal model. Materials and methods Bladders were harvested from pigs at the time of necropsy and subjected to detergent and enzymatic extractions to render them acellular. The BAMA produced had the surgical handling and suture-retaining properties of normal bladder tissue. Six pigs had BAMA segments implanted under general anaesthesia, through a low midline abdominal incision and after partial cystectomy. The defect was repaired with a BAMA patch (mean size 43.88 cm2, range 12-72), with no urinary diversion. Two animals each were then killed at 9, 16 and 30 days and the bladders explanted. The native bladder and BAMA patch were analysed morphometrically to evaluate cellular re-population and matrix re-organization. All animals survived surgery; there were no urinary leaks and no stones detected in any of the bladders. At 9 days there was a diffuse infiltration with acute inflammatory cells, but no areas of necrosis. There were isolated areas of smooth muscle cell (SMC) infiltration of the BAMA. At 16 days the luminal surface was lined with a single layer of urothelium, there was stromal infiltration with disorganized SMC and angiogenesis, with mature vessels in the BAMA patch. At 30 days the urothelium was multilayered with organizing groups of SMCs and angiogenesis. The highest cell density was at the periphery of the repopulated BAMA patch, decreasing towards the centre. The implantation of large patches of BAMA is technically feasible and may prove to be a viable surgical alternative to bladder augmentation with intestinal segments. The advantages of BAMA include the potential for complete and functional regeneration of a bladder substitute. This model provides a tool with which to obtain a better understanding of the cellular and molecular aspects of matrix re-population.

The dose–response relationship for cancer incidence in a two-stage radiation carcinogenesis model incorporating cellular repopulation

Purpose : To investigate the role of cellular repopulation in the dose–response relationship for radiation carcinogenesis resulting from high doses of radiation. Method : A two-stage mathematical model of radiation carcinogenesis was developed and used to explore the effects of differing assumptions about repopulation by surviving normal stem cells and by one-stage mutants. Results : Characteristically, cancer incidence at any fixed time after irradiation increases with radiation dose, reaches a peak and then declines with dose (the decline reflecting radiation cell-killing). The optimal dose for cancer incidence, and the incidence level at this dose, are strongly influenced by repopulation kinetics. If repopulation does not occur, or is impaired owing to radiation damage to tissues, the highest value of cancer incidence is reduced, and this value occurs at a lower dose than if repopulation had been complete. A similar result is found if repopulation by one-stage mutants is impaired relative to unmutated cells, or if tissue recovery is assisted by immigration of unirradiated cells. Conclusions : Differing repopulation kinetics can account for differing dose–response relationships after large doses of radiation. These findings are relevant to the occurrence of ’second tumours‚ following radiotherapy and to the interaction of radiation with other agents.

Continuous, hyperfractionated, accelerated radiotherapy (CHART) versus conventional radiotherapy in non-small cell lung cancer: mature data from the randomised multicentre trial

Background and method: A randomised controlled trial in locally advanced non-small cell lung cancer (NSCLC), compared CHART which employs 36 fractions of 1.5 Gy 3 times per day to give 54 Gy in 12 consecutive days with conventional radiotherapy–30 fractions of 2 Gy to a total dose of 60 Gy in 6 weeks. A total of 563 patients were entered between April 1990 and April 1995. This report is based upon the data updated to 1 April 1998.Results: The analysis of the mature data shows that the benefits previously reported have been maintained. Overall there was a 22% reduction in the relative risk of death, which is equivalent to an absolute improvement in 2 year survival of 9% from 20 to 29% (P=0.008) and a 21% reduction in the relative risk of local progression (P=0.033). In the large subgroup of patients with squamous cell cancer which accounted for 81% of the cases, there was a 30% reduction in the relative risk of death, which is equivalent to an absolute improvement in 2 year survival of 13% from 20 to 33% (P=0.0007) and a 27% reduction in the relative risk of local progression (P=0.012). Furthermore, in squamous carcinoma there was a 25% reduction in the relative risk of local and/or distant progression (P=0.025) and 24% reduction in the relative risk of metastasis (P=0.043). There was no evidence that CHART gave more or less benefit in any other subgroup.Conclusion: This analysis of mature data confirms that CHART is superior to conventional radiotherapy in achieving local tumour control and survival in locally advanced NSCLC. This demonstrates the importance of cellular repopulation as a cause of failure in the radiotherapy of NSCLC. The reduction in the risk of metastasis confirms that improved local tumour control, even in lung cancer, can reduce the incidence of metastasis. This trial shows that control of local tumour can lead to an improvement in long term survival.

Maximizing therapeutic gain with gemcitabine and fractionated radiation

Purpose/Objective: The nucleoside analogue gemcitabine inhibits cellular repair and repopulation, induces apoptosis, causes tumor growth delay, and enhances radiation-induced growth delay. After single doses of drug and radiation, maximum enhancement of tumor response was obtained when gemcitabine preceded radiation by at least 24 h. Conversely, the cellular radioresponse of the normal gastrointestinal epithelium was slightly protected when gemcitabine and radiation were separated by 24 h. This differential response created a time frame within which therapeutic gain could be maximized. In our present investigation, we sought to define the most therapeutically beneficial scheme of gemcitabine administration when combined with fractionated radiotherapy. Methods and Materials: C3Hf/Kam mice were given identical drug and radiation schedules of administration, and both normal tissue (jejunal mucosa) and tumor (Sa-NH) responses were measured. Irradiation was given once per day for 5 days in normal tissue and tumor growth delay studies and twice per day for the tumor cure endpoint. A total dose of 25 mg/kg gemcitabine was given i.p. in 1 of 3 schedules: a single dose of 25 mg/kg 24 h before the start of fractionated irradiation, 12.5 mg/kg 24 h before the first and third radiation doses, or 24 h before each of 5 radiation doses. Groups of mice bearing 7- or 8-mm diameter tumors were treated with gemcitabine alone or in combination with fractionated irradiation under ambient or hypoxic conditions. The survival response of the jejunal mucosa was quantified by the microcolony assay and histologically by quantifying apoptosis, mitosis, S-phase fraction, and crypt cellularity. Results: For tumor growth delay, dose-modifying factors (DMFs) were similar (1.34–1.46) for all 3 schedules of drug administration. In contrast, the response of the jejunum was strongly dependent on the schedule of gemcitabine administration. A single dose of gemcitabine before the start of fractionated radiotherapy resulted in slight radioprotection (DMF 0.96). Two doses and 5 daily doses of gemcitabine enhanced radiation response by factors of 1.09 and 1.23, respectively. Major factors affecting the response of the jejunal mucosa were apoptotic death of S-phase cells exposed to gemcitabine and cell cycle synchrony of surviving cells. Tumor reoxygenation was found to be a major mechanism for tumor radioenhancement, in addition to those reported earlier. Conclusion: All 3 schedules of drug administration produced therapeutic gain; however, when gemcitabine was given more than once in a 5-fraction radiation treatment schedule, normal tissue toxicity increased. The highest therapeutic gain (1.4) was achieved by giving a single dose of gemcitabine (25 mg/kg) 24 h before the start of fractionated radiotherapy.

Meniscal substitutes--animal experience.

Animal studies have shown that meniscus allografts and tendon autografts generally heal to the capsule, are revascularized and repopulated with host cells. In animals, neither meniscal allografts nor tendon or fat autografts gain the properties of a normal meniscus. Meniscus allografts and tendon autografts are promising as both seem to offer some protection to the cartilage of the tibial plateau. There is no evidence that meniscal transplantation can prevent cartilage degenerative changes, and the long-term effect of meniscal transplantation on articular cartilage remains unknown. Whether cellular repopulation of the meniscal allograft is sufficient to restore its biomechanical properties is unknown. Collagen scaffolds and tissue engineered grafts are still under investigation, showing promising results especially for the former. Viable meniscal allografts should be implanted within 1 to 2 weeks after harvesting, as the production of proteoglycans decreases after 2 weeks.

Mature Astrocytes Transform into Transitional Radial Glia within Adult Mouse Neocortex That Supports Directed Migration of Transplanted Immature Neurons

Neuronal migration is an essential step in normal mammalian neocortical development, and the expression of defined cellular and molecular signals within the developing cortical microenvironment is likely crucial to this process. Therapy via transplanted or manipulated endogenous precursors for diseases which involve neuronal loss may depend critically on whether newly incorporated cells can actively migrate to repopulate areas of neuronal loss within the adult brain. Previous studies demonstrated that embryonic neurons and multipotent precursors transplanted into the neocortex of adult mice undergoing targeted apoptosis of pyramidal neurons migrate long distances into neuron-deficient regions, undergo directed differentiation, accept afferent synaptic input, and make appropriate long-distance projections. The experiments presented here: (1) use time-lapse digital confocal imaging of neuronal migration in living slice cultures to assess cellular mechanisms utilized by immature neurons during such long distance migration, and (2) identify changes within the host cortical astroglial population that may contribute to this migration. Prelabeled embryonic day 17 mouse neocortical neurons were transplanted into adult mouse primary somatosensory cortex undergoing targeted apoptotic degeneration of callosal projection neurons. Four to 7 days following transplantation, living slice cultures containing the region of transplanted cells were prepared and observed. Sequential time-lapse images were recorded using a video-based digital confocal microscope. Transplanted cells displayed bipolar morphologies characteristic of migrating neuroblasts and moved in a saltatory manner with mean rates of up to 14 μm/h. To investigate whether a permissive glial phenotype may provide a potential substrate for this directed form of neuronal migration, slice cultures were immunostained with the RC2 monoclonal antibody, which identifies radial glia that act as a substrate for neuronal migration during corticogenesis. RC2 does not label mature stellate astrocytes, which express glial fibrillary acidic protein (GFAP). RC2 expression was observed in glial cells closely apposed to migrating donor neurons within the slice cultures. The timing and specificity of RC2 expression was examined immunocytochemically at various times following transplantation. RC2 immunostaining within regions of neuronal degeneration was transient, with peak staining between 3 and 7 days following transplantation. Strongly RC2-immunoreactive cells that did not express GFAP were found within these regions, but not in distant cortical regions or within control brains. RC2-positive cells were identified in recipient transgenic mice which express β-galactosidase under a glial specific promoter. Coexpression of RC2 and β-galactosidase identified these cells as host astroglia. These results demonstrate that adult cortical astrocytes retain the capacity to reexpress an earlier developmental phenotype that may partially underlie the observed active migration of transplanted neurons and neural precursors. Further understanding of these processes could allow directed migration of transplanted or endogenous precursors toward therapeutic cellular repopulation and complex circuit reconstruction in neocortex and other CNS regions.

Cortical interneurons upregulate neurotrophins in vivo in response to targeted apoptotic degeneration of neighboring pyramidal neurons.

Intercellular signals provided by growth and neurotrophic factors play a critical role during neurogenesis and as part of cellular repopulation strategies directed toward reconstruction of complex CNS circuitry. Local signals influence the differentiation of transplanted and endogenous neurons and neural precursors, but the cellular sources and control over expression of these molecules remain unclear. We have previously examined microenvironmental control in neocortex over neuron and neural precursor migration and differentiation following transplantation, using an approach of targeted apoptotic neuronal degeneration to specific neuronal populations in vivo. Prior results suggested the hypothesis that upregulated or reexpressed developmental signal molecules, produced by degenerating pyramidal neurons and/or by neighboring neurons or nonneuronal cells, may be responsible for observed events of directed migration, differentiation, and connectivity by transplanted immature neurons and precursors. To directly investigate this hypothesis, we analyzed the gene expression of candidate and control neurotrophins, growth factors, and receptors within regions of targeted neuronal cell death, first by quantitative Northern blot analysis and then by in situ hybridization combined with immunocytochemical analysis. The genes for BDNF, NT-4/5, trkB receptors, and to a lesser extent NT-3 were upregulated specifically within the regions of neocortex undergoing targeted neuronal degeneration and specifically during the period of ongoing pyramidal neuron apoptosis. Upregulation occurred during the same 3-week period as the previously investigated cellular events of directed migration, differentiation, and integration. No upregulation was seen in panels of control neurotrophins, growth factors, and receptors that are not as developmentally regulated in cortex or that are thought to have primary actions in other CNS regions. In situ hybridization and immunocytochemistry revealed that BDNF mRNA expression was upregulated specifically by local interneurons adjacent to degenerating pyramidal neurons. These findings suggest specific effects of targeted apoptosis on neurotrophin and other gene expression via mechanisms, including intercellular signaling between degenerating pyramidal neurons and surrounding interneurons. Further understanding of these and other controls over neocortical projection neuron differentiation may provide insight regarding normal neocortical development, intercellular signaling induced by apoptosis, and toward reconstruction and cellular repopulation of complex neocortical and other CNS circuitry.

Accelerated radiotherapy with carbogen and nicotinamide (ARCON) for laryngeal cancer

Background and purpose: Tumor hypoxia and tumor cell repopulation are known factors determining radiation response. Accelerated radiotherapy as a method to counteract cellular repopulation was combined with carbogen (95% O 2+5% CO 2) breathing and oral administration of nicotinamide as a means to improve tumor perfusion and oxygenation. The feasibility, toxicity and clinical effectiveness of this approach as a voice-preserving treatment for carcinoma of the larynx was assessed in a prospective study. Patients and methods: Sixty-two patients with stage III–IV laryngeal carcinoma were treated with a schedule of accelerated radiotherapy. The total radiation dose to the primary tumor was 64 Gy and that to the metastatic nodes was 68 Gy delivered in fractions of 2 Gy over 35–37 days. Radiotherapy was combined with carbogen breathing in the initial 11 patients and with both carbogen and nicotinamide administration in the subsequent 51 patients. Results: After a median follow-up of 24 months, the actuarial local control rate at 2 years was 92%. This is higher than any previous report in the literature for this category of patients. Five patients had a local tumor recurrence and underwent laryngectomy. There was one regional recurrence. Including salvage surgery the loco-regional control rate was 100%. Four patients developed distant metastases and died. The actuarial overall survival rate at 2 years was 85%. Toxicity was increased relative to conventional radiotherapy but was considered as acceptable. One patient underwent laryngectomy for radiation-induced cartilage necrosis. Conclusion: These preliminary results indicate that advanced laryngeal cancer can be controlled in a high proportion of patients when treated with accelerated radiotherapy combined with carbogen and nicotinamide. This approach offers excellent possibilities for larynx preservation.

Effect of alignment of the transplanted graft extracellular matrix on cellular repopulation and newly synthesized collagen

This study examines the effect of alignment of the transplanted graft extracellular matrix on cellular repopulation and new collagen synthesis. The lateral half of the patellar tendon was harvested as a tendon graft from Lewis rats and frozen at -80 degrees C. In order to maintain the original alignment of the graft extracellular matrix, the graft was transplanted to a same size defect in the patellar tendon of other Lewis rats (group I). For controls, the graft was transplanted in a lax condition after excision of only the distal half of the lateral side of a patellar tendon (group II). After transplantation, six animals in each group were killed at 3, 7, 14, and 28 days. Cellular repopulation was assessed by using fibrillar-actin (F-actin) labeling with rhodamine-phalloidin, and new collagen synthesis was detected by means of a polyclonal antibody against type III collagen aminopropeptide (pN collagen III). Collagen fibril profiles were observed under the transmission electron microscope. On the 3rd day after transplantation, no specific fluorescence was detected in either group. Specific labeling for F-actin and pN collagen III, however, was observed at both ends of the graft in both groups at 1 week and throughout the graft at 2 weeks after transplantation. Consistent with the actin bundles' orientation, pN collagen III was aligned parallel to the longitudinal axis of the graft in group I. Collagen fibrils with a smaller diameter, mixed evenly and everywhere with a larger diameter, increased gradually in group I. However, smaller collagen fibrils in group II increased more slowly and were distributed unevenly. In summary, the dense collagen arrangement in the native patellar tendon determined the alignment of the repopulating cells, and the distribution of newly synthesized collagen might be affected by the actin cytoskeleton within the repopulating cells.