Myelin Diseases Research Articles

Rescue of Congenital Hypomyelination by Progenitor Cell Transplantation

Replacement of myelin-forming cells is an attractive but unproven therapy for inherited and acquired myelin diseases. In this issue of Cell Stem Cell, Windrem et al. (2008) describe the first progenitor cell transplantation paradigm that rescues the neurological phenotypes and increases life spans of mice with inherited myelin disease.

Oligodendroglial impact on axonal function and survival – a hypothesis

Although multiple sclerosis is considered the prototype of a primary autoimmune disease in the central nervous system, there is emerging evidence that primary oligodendrocyte dysfunctions can suffice to trigger a secondary immune response in the nervous system. This short review focuses on the possible primary role of oligodendrocytes in axon loss and inflammatory demyelination. The analysis of natural and engineered mouse mutants has provided unexpected insight into oligodendrocyte function beyond that of axonal myelination for rapid impulse propagation. Specifically, mutations in some genes thought to be required for myelin assembly revealed an additional role of oligodendrocytes in supporting long-term axonal function and survival. Other mutations have been reported that cause both central nervous system demyelination and neuroinflammation, with pathological features known from human leukodystrophy patients. In human multiple sclerosis, demyelination leads invariably to axon loss, but the underling pathomechanisms may not be restricted to that of a primary immune-mediated disorder. Collectively, experimental and pathological findings point to a primary role of myelinating glia in long-term axonal support and suggest that defects of lipid metabolism in oligodendrocytes contribute to inflammatory myelin diseases.

Multiple Sklerose

Multiple sclerosis is the most common chronic inflammatory disease of myelin with interspersed lesions in the white matter of the central nervous system. Magnetic resonance imaging (MRI) plays a key role in the diagnosis and monitoring of white matter diseases. This article focuses on key findings in multiple sclerosis as detected by MRI.

Generation and potential biomedical applications of embryonic stem cell-derived glial precursors

Recent progress in embryonic and adult stem cell research has opened new perspectives for generating large numbers of different neural cell types in vitro and using them for nervous system repair. Several lines of arguments suggest that myelin diseases represent particularly attractive targets for cell-based therapies. First, in contrast to neuronal cell replacement, a single and uniform cell type, the oligodendrocyte progenitor, suffices for therapeutic remyelination in all areas of the CNS, with no need for complex circuit integration. Second, there is an increasing understanding of the mechanisms regulating the recruitment of stem and progenitor cells into CNS lesions. Third, stem cells represent excellent vehicles for cell-mediated gene transfer, enabling novel approaches, which combine classic cell replacement with the delivery of therapeutic factors. Among the various donor sources, embryonic stem (ES) cells stand out as a population featuring pluripotency, unlimited self-renewal and amenability to gene targeting. Here we discuss the advantages, challenges and perspectives of bringing this unique cell type closer to a clinical application for treating myelin diseases and other neurological disorders.

The role of SVZ-derived neural precursors in demyelinating diseases: From animal models to multiple sclerosis

We will review the role of endogenous neural stem cells in myelin repair both in animal models of demyelination and multiple sclerosis. The mammalian sub-ventricular zone (SVZ) is the largest germinative zone of the adult brain, which contains a well characterized stem cell niche. While most studies highlight the neurogenic potential of SVZ progenitors, recent data indicate that SVZ cells become reactived in response to different pathological cues, like trauma, ischemia, neurodegeneration, inflammation and demyelination. Experimental models of demyelination in rodent demonstrate enhanced proliferation and recruitment of SVZ progenitors into myelin lesions, in response to demyelination. Moreover, cell lineage tracing experiments showed that SVZ progenitor cells can give rise to oligodendrocytes in demyelinated lesions, that could potentially contribute to remyelination. To examine the relevance of these studies in myelin diseases, we recently examined the human SVZ in post-mortem MS brains. The human SVZ is characterized by a ribbon of SVZ astrocytes lining the ependymal border of the lateral ventricles and which behave as multipotential progenitors in vitro. We showed that cellular density and proliferation were enhanced in MS SVZ compared to non-neurological controls. This high cellular density was correlated with the increased number of progenitor cells in MS SVZ, as well as in sub-ventricular lesions. Interestingly, some of these progenitors expressed transcription factors involved in oligodendrogenesis, such as Sox9, Olig2 and Sox10. These data indicate that gliogenesis occurs also in MS SVZ and suggest the recruitment of SVZ-derived oligodendrocyte precursors to peri-ventricular demyelinated lesions. Further investigation of adult neural stem cells and their progenitors in the brain of rodents and non-human primates should help to gain insights in their process of activation in response to demyelination and their role in myelin repair.

Myelin deficiencies visualized in vivo: Visually evoked potentials and T2‐weighted magnetic resonance images of shiverer mutant and wild‐type mice

Visually evoked potentials (VEPs) and micro magnetic resonance imaging (micro MRI) are widely used as noninvasive techniques for diagnosis of central nervous system (CNS) diseases, especially myelin diseases, such as multiple sclerosis. Here we use these techniques in tandem to validate the in vivo data in mouse models. We used the shiverer mutant mouse, which has little or no CNS myelin, as a test model. These data show that shiverer (MBP(shi)/MBP(shi)) has a VEP latency that is 30% longer than that of its wild-type sibling. Surprisingly, the heterozygous (MBP(shi)/+) mouse, with apparently normal myelin, nevertheless has a 7% increase in its VEP latency vs. wild type. The micro MRIs of the same animals show that myelinated white matter is hypointense compared with gray matter as a result of the shorter T2 in myelinated regions of the CNS. T2-weighted images of wild-type and heterozygous shiverer mice show regions of hypointensity corresponding to the major myelinated tracts, including the optic nerve and the optic tract of the CNS, whereas shiverer mice have no regions of low intensity and therefore no detectable myelinated areas. In shiverer mice, micro MRI can discern hypomyelination throughout the brain, including the optic tract, and these changes correlate with longer VEP latencies. In addition, VEPs can also detect changes in the molecular make up of myelin that are not discernible with histology or micro MR. These data show the potential of using micro MRI in combination with VEPs to follow changes in both the quality and the quantity of myelin in vivo. These combined methods would be useful for longitudinal studies and therapy testing.

Subtle myelin defects in PLP‐null mice

This study explores subtle defects in the myelin of proteolipid protein (PLP)-null mice that could potentially underlie the functional losses and axon damage known to occur in this mutant and in myelin diseases including multiple sclerosis. We have compared PLP-null central nervous system (CNS) myelin with normal myelin using ultrastructural methods designed to emphasize fine differences. In the PLP-null CNS, axons large enough to be myelinated often lack myelin entirely or are surrounded by abnormally thin sheaths. Short stretches of cytoplasm persist in many myelin lamellae. Most strikingly, compaction is incomplete in this mutant as shown by the widespread presence of patent interlamellar spaces of variable width that can be labeled with ferricyanide, acting as an aqueous extracellular tracer. In thinly myelinated fibers, interlamellar spaces are filled across the full width of the sheaths. In thick myelin sheaths, they appear filled irregularly but diffusely. These patent spaces constitute a spiral pathway through which ions and other extracellular agents may penetrate gradually, possibly contributing to the axon damage known to occur in this mutant, especially in thinly myelinated fibers, where the spiral path length is shortest and most consistently labeled. We show also that the "radial component" of myelin is distorted in the mutant ("diagonal component"), extending across the sheaths at 45 degrees instead of 90 degrees. These observations indicate a direct or indirect role for PLP in maintaining myelin compaction along the external surfaces of the lamellae and to a limited extent, along the cytoplasmic surfaces as well and also in maintaining the normal alignment of the radial component.

A genetic screen identifies genes essential for development of myelinated axons in zebrafish

The myelin sheath insulates axons in the vertebrate nervous system, allowing rapid propagation of action potentials via saltatory conduction. Specialized glial cells, termed Schwann cells in the PNS and oligodendrocytes in the CNS, wrap axons to form myelin, a compacted, multilayered sheath comprising specific proteins and lipids. Disruption of myelinated axons causes human diseases, including multiple sclerosis and Charcot–Marie–Tooth peripheral neuropathies. Despite the progress in identifying human disease genes and other mutations disrupting glial development and myelination, many important unanswered questions remain about the mechanisms that coordinate the development of myelinated axons. To address these questions, we began a genetic dissection of myelination in zebrafish. Here we report a genetic screen that identified 13 mutations, which define 10 genes, disrupting the development of myelinated axons. We present the initial characterization of seven of these mutations, defining six different genes, along with additional characterization of mutations that we have described previously. The different mutations affect the PNS, the CNS, or both, and phenotypic analyses indicate that the genes affect a wide range of steps in glial development, from fate specification through terminal differentiation. The analysis of these mutations will advance our understanding of myelination, and the mutants will serve as models of human diseases of myelin.

Spreading of autoimmunity from central to peripheral myelin: two cases of clinical association between multiple sclerosis and chronic inflammatory demyelinating polyneuropathy

Demyelinating inflammatory diseases of central and peripheral myelin share similar aetiopathogenesis but rarely occur simultaneously in the same individual. Here we report two clinical cases of temporal association between multiple sclerosis (MS) and chronic inflammatory demyelinating polyneuropathy (CIDP). Our finding supports the hypothesis that clinically manifested central and peripheral demyelinating diseases could result from a common pathogenic event characterised by T-cell autoimmunity spreading from central to peripheral myelin.

Enhancing Central Nervous System Remyelination in Multiple Sclerosis

Recent studies on adult neural stem cells and the developmental biology of myelination have generated the expectation that neural precursors can repair the damaged central nervous system of multiple sclerosis patients where the endogenous remyelination process has failed. As a result, many laboratories are engaged in translational studies in which the goal is to design ways to promote remyelination and repair. Here we raise issues highlighted by prior experimental and human work that should be considered lest these studies become "lost in translation."

Symposium S08: Mechanisms of axonal degeneration in myelin diseases

Journal of NeurochemistryVolume 94, Issue s1 p. 115-115 Free Access Symposium S08: Mechanisms of axonal degeneration in myelin diseases B. Trapp, B. TrappSearch for more papers by this author B. Trapp, B. TrappSearch for more papers by this author First published: 15 July 2008 https://doi.org/10.1111/j.1474-1644.2005.03231_3.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Volume94, Issues1June 2005Pages 115-115 RelatedInformation

Stem Cell Therapy for Myelin Diseases

Advances in cell biology have encouraged the hope that stem cell-based therapy can be used to heal central nervous system (CNS) diseases. Here, we will review the potential application of neural cell transplantation for the treatment of multiple sclerosis (MS) and other demyelinating disorders, mention some problematic issues that still face this therapeutic approach, and describe novel noninvasive methods for in vivo tracking of transplanted cells.

Efficient myelin repair in the macaque spinal cord by autologous grafts of Schwann cells

Experimental transplantation in rodent models of CNS demyelination has led to the idea that Schwann cells may be candidates for cell therapy in human myelin diseases. Here we investigated the ability of Schwann cells autografts to generate myelin in the demyelinated monkey spinal cord. We report that monkey Schwann cells derived from adult peripheral nerve biopsies retain, after growth factor expansion and transduction with a lentiviral vector encoding green fluorescent protein, the ability to differentiate in vitro into promyelinating cells. When transplanted in the demyelinated nude mouse spinal cord, they promoted functional and anatomical repair of the lesions (n = 12). Furthermore, we obtained evidence by immunohistochemistry (n = 2) and electron microscopy (n = 4) that autologous transplantation of expanded monkey Schwann cells in acute lesions of the monkey spinal cord results in the repair of large areas of demyelination; up to 55% of the axons were remyelinated by donor Schwann cells, the remaining ones being remyelinated by oligodendrocytes. Autologous grafts of Schwann cells may thus be of therapeutic value for myelin repair in the adult CNS.

MYELIN BIOLOGY AND ITS DISORDERS: TWO-VOLUME SET * Edited by Robert A. Lazzarini 2004. San Diego: Elsevier Academic Press Price 340.00. ISBN 0-12-439510-4

‘The third element’ ![Graphic][1] It is the title of this fine book that stirs the blood. It is neither a dusty dry tome on myelin, nor a clinicians' handbook on myelin diseases: it bestrides science and medicine and proclaims that these must not be divorced, but remain joined together in sickness and in health. There is surely no other area in medical neuroscience—arguably in all of clinical science—where science and medicine have been so closely intertwined. Why is this? How does the biology of the neural cell filter through to, and so dictate myelin order and disorder? It is not such a tortuous path to the answer. Originally, the brain was held to contain two cell types— neurons , whose function Cajal first proposed, and neuroglia , originally described by Virchow in the mid 19th century. He attributed to the latter, two activities: the mechanical support of nerve cells and the repair of tissues. Three further activities were proposed before the turn of that century: the nutritional support of neurons (by Golgi), the engulfment of cellular debris (Bevan Lewis) and the isolation of nervous conduction (probably first suggested by Santiago Ramon y Cajal's younger brother Pedro). Whilst broadly all true, the further recognition of cell types within the neuroglia allowed a division of these labours in the first few decades of the 20th century. Cajal (the elder) described in 1913 the ‘third element’ of the nervous system, a cell population separate from neurons and neuroglia (otherwise termed astroglia ). It fell predominantly to Pio del Rio Hortega to distinguish not one but two cell types within the third element. Microglia make up one-fifth of the CNS glial population and are of haemopoetic (mesodermal) origin—as indeed originally suggested by del Rio Hortega. Oligodendrocytes, which elaborate and maintain myelin membranes around axons in order … [1]: /embed/inline-graphic-1.gif

Dysmyelinated lower motor neurons retract and regenerate dysfunctional synaptic terminals.

Axonal degeneration is the major cause of permanent neurological disability in individuals with inherited diseases of myelin. Axonal and neuronal changes that precede axonal degeneration, however, are not well characterized. We show here that dysmyelinated lower motor neurons retract and regenerate dysfunctional presynaptic terminals, leading to severe neurological disability before axonal degeneration. In addition, dysmyelination led to a decreased synaptic quantal content, an indicator of synaptic dysfunction. The amplitude and rise time of miniature endplate potentials were also increased, but these changes were primarily consistent with an increase in the passive membrane properties of the transgenic muscle fibers. Maintenance of synaptic connections should be considered as a therapeutic target for slowing progression of neurological disability in primary diseases of myelin.

Oral Presentations OP02: Myelin and Diseases of Myelin. NPP2, A matricellular protein expressed during myelination, actively modulates oligodendrocyte adhesion

NPP2, also known as phosphodiesterase‐I alpha/autotaxin, is a type‐II membrane protein that belongs to the nucleotide pyrophosphatase/phosphodiesterase family (NPP). We have recently demonstrated that NPP2 is expressed and released by differentiating oligodendrocytes during the critical stages of CNS myelination. The structural domains of this secreted macromolecule suggest a functional role in the regulation of oligodendrocyte adhesion. Here, we present data that demonstrates that NPP2 interferes with the ability of oligodendroglial cells to adhere to known CNS adhesion molecules present during the onset of myelination, such as fibronection, vitronectin, and merosin (laminin2). Responses to NPP2 appear to be regulated by a different mechanism depending on the developmental stage of the oligodendrocyte. Although the exact mechanisms for NPP2 mediated counter‐adhesion are unknown, our studies have implicated that an active signalling mechanism involving heterotrimeric G proteins is responsible for adhesion modulation. These studies clearly define a role of NPP2 as a matricellular protein modulating oligodendrocyte adhesion and suggest that NPP2 function may represent the first step of oligodendrocyte remodelling when differentiating oligodendrocytes are actively involved in the formation of the myelin sheath.

Poster Sessions BP03: Myelin, Demyelination and Diseases of Myelin. Myelin and myelination in PLP‐null mice

The myelin proteolipid protein (PLP) is the major structural protein of CNS myelin, accounting for approximately half of total myelin protein. We studied synthesis and accumulation of myelin components for two months postnatally in PLP‐null mice and age‐matched controls. Accumulation of myelin, as assayed by levels of whole brain cerebroside and myelin basic protein, was normal in the knockout mice. The rate of cerebroside synthesis in the knockout mice was also normal. Myelin was isolated at several ages during development, using a standard subcellular fractionation protocol. The yield of ‘purified myelin’ isolated from a large particle (crude mitochondrial) fraction was reduced in PLP‐null mice, but increased amounts of ‘myelin’ were obtained in the small particle (crude microsomal) fraction. This ‘myelin’ in the crude microsomal fraction was identified as such by flotation on 0.85 m sucrose and the myelin‐characteristic 2 : 1 molar ratio of cholesterol to cerebroside. This suggests myelin from PLP‐null mice is physically more fragile than normal myelin, and that during tissue dispersion, much more PLP‐null myelin is fragmented into small vesicles than is the case for normal myelin. Three hours after intracranial injection of tritiated acetate into PLP‐null mice, cerebroside in myelin isolated from the large particle fraction was at a similar specific radioactivity to that isolated from the small particle (crude microsomal) fraction, suggesting that the most recently deposited PLP‐null myelin is not preferentially unstable. The increased fragility evident during tissue dispersion is indicative of an underlying structural abnormality in PLP‐null myelin. Whether this inherent structural instability affects myelin metabolism is under investigation.Acknowledgements: Supported by USPHS & NMSS grants.

Mutations of peripheral myelin protein 22 result in defective trafficking through mechanisms which may be common to diseases involving tetraspan membrane proteins.

Phenotypes of several heritable disorders including forms of hearing loss, myelin diseases, hypomagnesemia, and cataracts are linked to missense mutations in single alleles encoding membrane proteins having four transmembrane spans. In some cases, the mutant proteins exhibit dominant negative or gain-of-function behavior whereby heterozygous coexpression of mutant and wild-type genes leads to more serious pathology than is the case for individuals in which only a single wild-type allele is expressed. An example is found in the relationship of peripheral myelin protein 22 (PMP22) to Charcot-Marie-Tooth disease (CMTD) type 1A. A number of disease-linked PMP22 mutants fail to undergo normal trafficking beyond the endoplasmic reticulum or intermediate compartment to reach the cell surface. Moreover, recent evidence suggests that pathology resulting from this mistrafficking-based loss of function may also be augmented by the ability of some mutants to disrupt normal trafficking of the product of the wild-type PMP22 allele. The basis for this phenomenon appears to be the heterodimerization of trafficking-incompetent mutants with wild-type PMP22, such that both the wild-type protein and the mutant forms are retained early in the secretory pathway. The full cellular and structural biological details of these observations remain to be elucidated. However, the model suggested by the existing data regarding the relationship of PMP22 to CMTD may be useful to explain phenotypes of several other diseases involving other tetraspan membrane proteins and to facilitate predictions regarding previously undetected disease-protein linkages.

Attractin/mahogany/zitter plays a critical role in myelination of the central nervous system.

The rat zitter (zi) mutation induces hypomyelination and vacuolation in the central nervous system (CNS), which result in early-onset tremor and progressive flaccid paresis. By positional cloning, we found a marked decrease in Attractin (Atrn) mRNA in the brain of the zi/zi rat and identified zi as an 8-bp deletion at a splice donor site of Atrn. Atrn has been known to play multiple roles in regulating physiological processes that are involved in monocyte-T cell interaction, agouti-related hair pigmentation, and control of energy homeostasis. Rat Atrn gene encoded two isoforms, a secreted and a membrane form, as a result of alternative splicing. The zi mutation at the Atrn locus darkened coat color when introduced into agouti rats, as also described in mahogany (mg) mice, carrying the homozygous mutation at the Atrn locus. Transgenic rescue experiments showed that the membrane-type Atrn complemented both neurological alteration and abnormal pigmentation in zi/zi rats, but that the secreted-type Atrn complemented neither mutant phenotype. Furthermore, we discovered that mg mice exhibited hypomyelination and vacuolation in the CNS associated with body tremor. We conclude from these results that the membrane Atrn has a critical role in normal myelination in the CNS and would provide insights into the physiology of myelination as well as the etiology of myelin diseases.

Transection of dysmyelinated optic nerve axons in adult rats lacking myelin basic protein.

Injury to myelin or oligodendrocytes may manifest as dysmyelinating or demyelinating conditions of the CNS. Previous studies using dysmyelinated animal models (myelin basic protein mutants) suggest possible axonal dysfunction with complete loss of myelin. In this present study, we evaluated retinal ganglion cell survival after axotomy in MBP mutants to determine if prolonged dysmyelination of CNS axons exerted a detrimental effect on neuronal survival. We demonstrated that the survival of retinal ganglion cells with dysmyelinated axons is identical to retinal ganglion cells with myelinated axons after survival times up to 180 days. In myelin diseases where axon transection is a consistent consequence of demyelination resulting in progressive neurological deterioration, the absence of myelin does not accelerate neuronal death.