Patrizia Procacci

Cytokine Modulation is Necessary for Efficacious Treatment of Experimental Neuropathic Pain

Neuropathic pain originates from a damage or disease affecting the somatosensory system. Its treatment is unsatisfactory as it appears refractory to most analgesics. Animal models of neuropathic pain are now available that help to clarify the underlying mechanisms. Recently it has been recognized that inflammatory and immune mechanisms in the peripheral and in the central nervous system play a role in the onset and the maintenance of pain. In response to nervous tissue damage, activation of resident or recruited immune cells leads to the production of inflammatory mediators, as cytokines. In models of neuropathic pain, such as nerve injury and diabetes induced neuropathy, the time course of the expression of the proinflammatory cytokines TNF-α,IL-1β and IL-6 and of the antiinflammatory cytokine IL-10 has been well characterized both in the peripheral (sciatic nerve, dorsal root ganglia) and the central (spinal cord) nervous system. These cytokines appear activated/modulated in the nervous tissue in parallel with the occurrence of painful behaviour, i.e. allodynia and hyperalgesia. Novel therapeutic approaches efficacious to reduce painful symptoms, for example treatments with the non specific purinergic antagonist PPADS, the phytoestrogen genistein and a cell stem therapy with murine adult neural stem cells also re-established a balance between pro and antinflammatory mediators in the peripheral and central nervous system. These data suggest a pivotal role of immune system and inflammation in neuropathic pain. The modulation of inflammatory molecules appears to be a common trait accomplished throughout different mechanisms by different drugs that might converge in neuropathic pain modulation.

Comparative proteomic profile of rat sciatic nerve and gastrocnemius muscle tissues in ageing by 2-D DIGE

Ageing induces a progressive morphological change and functional decline in muscles and in nerves. Light and electron microscopy, 2‐D DIGE and MS, were applied to profile the qualitative and quantitative differences in the proteome and morphology of rat gastrocnemius muscle and sciatic nerve, in healthy 22‐month‐old rats. At muscle level, morphological changes are associated to fibre atrophy accompanied by myofibrillar loss and degeneration, disappearance of sarcomeres and sarcoplasmic reticulum dilatation, internal migration of nuclei, longitudinal fibre splitting, increment of subsarcolemmal mitochondria aggregates and increment of lipofuscin granules. Sciatic nerve shows myelin abnormalities like enfoldings, invaginations, onion bulbs, breakdowns and side axonal atrophy. Proteomic analysis identified changes correlated to morphological abnormalities in metabolic, contractile and cytoskeletal proteins, deregulation of iron homeostasis, change of Ca2+ balance and stress response proteins, accompanied by a deregulation of myelin membrane adhesion protein and proteins regulating the neuronal caliber. By comparing proteomic results from the two tissues, 16 protein isoforms showed the same up and down regulation trend suggesting that there are changes implying a general process which may act as a signal event of degeneration. Only β enolase and tropomyosin 1α were differentially expressed in the tissues.

Intravenous neural stem cells abolish nociceptive hypersensitivity and trigger nerve regeneration in experimental neuropathy

Summary In experimental neuropathic pain, intravenous neural stem cells induce a rapid remission of hyperalgesia and allodynia, followed by improvement in nerve morphology. Abstract A nonphysiological repair of the lesioned nerve leading to the formation of neurinomas, altered nerve conduction, and spontaneous firing is considered the main cause of the events underlying neuropathic pain. It was investigated whether neural stem cell (NSCs) administration could lead to a physiological nerve repair, thus to a reduction of neuropathic pain symptoms such as hyperalgesia and allodynia in a well‐established model of this pain (sciatic nerve chronic constriction injury [CCI]). Moreover, since we and others showed that the peripheral nerve lesion starts a cascade of neuroinflammation‐related events that may maintain and worsen the original lesion, the effect of NSCs on sciatic nerve pro‐ and antiinflammatory cytokines in CCI mice was investigated. NSCs injected intravenously, when the pathology was already established, induced a significant reduction in allodynia and hyperalgesia already 3 days after administration, demonstrating a therapeutic effect that lasted for at least 28 days. Responses changed with the number of administered NSCs, and the effect on hyperalgesia could be boosted by a new NSC administration. Treatment significantly decreased proinflammatory, activated antiinflammatory cytokines in the sciatic nerve, and reduced spinal cord Fos expression in laminae I‐VI. Moreover, in NSC‐treated animals, a reparative process and an improvement of nerve morphology is present at a later time. Since NSC effect on pain symptoms preceded nerve repair and was maintained after cells had disappeared from the lesion site, we suggest that regenerative, behavioral, and immune NSC effects are largely due to microenvironmental changes they might induce at the lesion site.

Altered peripheral myelination in mice lacking GABAB receptors

Emerging evidence implicates gamma-aminobutyric acid type B (GABA(B)) receptors in peripheral nervous system (PNS) functions. In order to elucidate which biochemical, morphological and functional parameters of peripheral nerve fibers depend on GABA(B) receptors we studied GABA(B1)-deficient mice, which are devoid of functional GABA(B) receptors. Here, we show that GABA(B1)-deficient mice exhibit morphological and molecular changes in peripheral myelin, including an increase in the number of irregular fibers and increases in the expression levels of the myelin proteins PMP22 and P0. Moreover, the number of small myelinated fibers and small neurons of the lumbar dorsal root ganglia is higher in GABA(B1)-deficient mice than in wild-type littermates. We further show that GABA(B1)-deficient mice exhibit gait alterations and reduced allodynia. In summary, our findings implicate GABA(B) receptors in the PNS myelination process and raise the possibility that PNS alterations contribute to the sensory phenotypes of GABA(B1)-deficient mice.

Biological performance of a novel biodegradable polyamidoamine hydrogel as guide for peripheral nerve regeneration.

Polyamidoamines (PAAs) are a well-known family of synthetic biocompatible and biodegradable polymers, which can be prepared as soft hydrogels characterized by low interfacial tension and tunable elasticity. For the first time we report here on the in vivo performance of a PAA hydrogel implant as scaffold for tissue engineering. In particular, an amphoteric agmatine-deriving PAA hydrogel shaped as small tubing was obtained by radical polymerization of a soluble functional oligomeric precursor and used as conduit for nerve regeneration in a rat sciatic nerve cut model. The animals were analyzed at 30, 90, and 180 days post-surgery. PAA tubing proved to facilitate nerve regeneration. Good surgical outcomes were achieved with no signs of inflammation or neuroma. Moreover, nerve regeneration was morphologically sound and the quality of functional recovery satisfactory. In conclusion, PAA hydrogel scaffolds may represent a novel and promising material for peripheral nerve regeneration.

GABA synthesis in Schwann cells is induced by the neuroactive steroid allopregnanolone

J. Neurochem. (2009) 112, 980–990.

Ultrastructural localization of NGF receptors in satellite cells of the rat spinal ganglia.

Data on the presence of NGF receptors in the satellite cells of spinal ganglia are scanty and contradictory. In the present study we used immunocytochemistry to examine the distribution of these receptors in spinal ganglia of the adult rat by light and electron microscopy. We found that (1) all satellite cells were immmunoreactive to p75 and the mean density of gold particles (mean number per μm2) was significantly greater in the satellite cell sheath than in the nerve cell body; (2) numerous satellite cells were immunoreactive for trkA with a mean density of gold particles slightly greater in the satellite cell sheath than in the nerve cell body, although the difference was not statistically significant; (3) both p75 and trkA immunoreactivity were confined to the cytoplasm. We suggest that the p75 receptor may be involved in the NGF-induced outgrowth of slender projections from the nerve cell body surface. With regard to the trkA receptor, satellite cells might be supported trophically by NGF released from the neuron with which they are associated; alternatively, satellite cells might internalize NGF to constitute a reservoir for later release to the neuron.

Age-related reduction of the satellite cell sheath around spinal ganglion neurons in the rabbit

SummaryThe volumes of the nerve cell bodies and those of the enveloping satellite cell sheaths from spinal ganglia of young adult and aged rabbits were determined by morphometric methods using the electron microscope. The mean volume of the nerve cell bodies was greater in the old rabbits than in young adults; this is probably related to the larger body size of the old animals. The mean volume of the satellite cell sheaths was, however, smaller in the aged rabbits than in the young adults. Consequently the volume ratio between the satellite cell sheaths and the related nerve cell bodies was significantly smaller in the aged animals. Since satellite cells play an important role in the support of the neuron, the reduction in volume of the perineuronal sheath could be associated with a decrease in the trophic activity of satellite cells towards the enveloped neuron with consequences for neuronal activity. Furthermore, in the satellite cell sheaths of old rabbits, the number and extension of gaps that leave the neuronal surface directly exposed to the basal lamina were significantly increased. Since spinal ganglia lack a blood-nervous tissue barrier, only the satellite cell sheath controls the traffic of material to the nerve cell body. Because the neuronal surface unprotected by the satellite cell envelopment is significantly more extensive in the spinal ganglia of old rabbits than in those of young adults, the nerve cells of the former are more exposed to potential damage by harmful substances. A dense undercoating was seen very frequently beneath the portions of the neuronal plasma membrane not covered by satellite cells.

Perineuronal satellite cells in mouse spinal ganglia express the gap junction protein connexin43 throughout life with decline in old age

Satellite glial cells that envelope the bodies of sensory neurons in spinal ganglia are connected to each other by gap junctions and exhibit dye coupling. These junctions may endow perineuronal satellite cells with the coordination necessary for the efficient performance of functions such as buffering of K(+) in the perineuronal microenvironment, provision of metabolic support to ganglionic neurons, and neuroprotection. Our knowledge of gap junctions has increased considerably in recent years, but little information is available on the connexins that form these junctions in spinal ganglia. In the present study we set out to determine whether the perineuronal satellite cells of mouse spinal ganglia express the connexins that are mainly present in neuroglial cells (Cx32 and Cx43). In young (3 months) mice, PCR showed the presence of both Cx32 and Cx43 transcripts. By immunocytochemistry, we localized Cx32 to axon-ensheathing Schwann cells, but not to other parts of the ganglion. We found Cx43 positivity in the perineuronal satellite cells, which were identified by their immunoreactivity to S100 protein and to glutamine synthetase. PCR showed Cx43 transcripts also in the spinal ganglia of adult (8 months) and old (24 months) animals. Cx43 immunostaining was present in satellite cells surrounding all nerve cell bodies, irrespective of size. The mean number of Cx43-immunoreactive puncta was significantly lower in the perineuronal satellite cells of aged mice compared to young and adult animals. This latter finding is consistent with observations in non-nervous tissues, and the hypothesis that a prominent decrease in Cx43 is a marker of senescence.

Scanning electron-microscope observations of the perikaryal projections of rabbit spinal ganglion neurons after enzymatic removal of connective tissue and satellite cells

SummaryThe true surface of rabbit spinal ganglion neurons has been made directly accessible to scanning electronmicroscope observation after removal of both the connective tissue and satellite cells that normally cover it. The neuronal surface is characterized by a profusion of slender projections whose shapes have been determined and whose length and width have been quantified. Controls carried out with transmission electron microscopy demonstrate that the procedure employed in this study satisfactorily preserves neuronal structure.