Introduction: Our laboratory demonstrated that monkeys treated after cortical injury with extracellular vesicles (EVs) derived from Mesenchymal Stem Cell (MSC) had enhanced recovery compared to controls. To identify the EV-mediated neuroplastic changes involved in improved recovery, we assessed markers of myelin damage and plasticity in brain and cerebrospinal fluid (CSF) of monkeys treated with EVs or vehicle. Hypothesis: MSC derived EVs enhance behavioral plasticity by reducing the post injury cascade of myelin damage and stimulating remyelination. Methods: Monkeys were given a unilateral cortical injury in the hand representation of M1. EVs were delivered IV 24 hours and 14 days later. Monkeys were tested on motor tasks for 14 weeks, and brains were harvested at completion. To quantify myelinated axons, we first used Spectral Confocal Reflectance (SCoRe) microscopy. To assess myelin damage, we measured accumulation of Myelin Basic Protein (MBP) in CSF from 24 hours to 14 weeks after injury. To assess myelin related gene expression changes, we used qPCR to assess MBP, BCAS1 as a marker of oligodendroglia engaged in new myelination, and Myelin Regulatory Factor (MyRF) a marker of oligodendrocyte regulation and differentiation. Additionally, we used IHC and stereology to quantify densities of BCAS1 and CC1 positive oligodendroglia. Results: Preliminary results show that EV treatment is associated with greater density of myelinated axons. In addition, longitudinal MBP levels in CSF gradually declined over 6 weeks, suggesting that EV treatment limited ongoing damage . PCR studies of perilesional brain tissue demonstrated a 4-fold increase in MyRF, as well as a 1.5-fold increase for BCAS1 and MBP in EV-treated monkeys relative to vehicle. Finally, increased densities of CC1+ and BCAS1+ cells approached significance in EV treated subjects. Conclusions and Future Directions: Our data suggests that MSC-EVs likely reduce the post injury cascade of myelin damage and promote remyelination, thus enhancing plasticity. (Supported by R21-NS102991 & R21-NS111174).
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