The transplantation of primary Schwann cells (SC) has been shown to improve nerve regeneration. However, to monitor the survival of transplanted cells within the host, a stable labelling method is required. The in vitro characteristics of green fluorescent protein labelled SC (GFP SC) and their effects in an in vivo peripheral nerve injury model were investigated.   The GFP-SC were readily visualised ex vivo and stimulated significantly better axonal regeneration compared to controls. Clinical use of autologous SC for the treatment of nerve injuries is of limited use due to difficulty in obtaining clinically useful numbers. However, bone marrow mesenchymal stem cells (MSC) can trans-differentiate into SC like cells (dMSC). The in vitro and in vivo differentiation of MSC was explored, and the study extended to include the easily-accessible adipose stem cells (ASC).  In vitro, glial growth factor stimulated MSC express S100, a SC marker, and its expression is maintained following in vivo transplantation.  Similarly, untreated MSC transplanted in vivo also expressed S100, which indicates glial differentiation in response to local cytokines and growth factors. Using an in vitro model, comprising dMSC or dASC co-cultured with adult dorsal root ganglia (DRG) neurons, the capacity of the dMSC and SC like differentiated ASC (dASC) to promote axon myelination was verified: both cell types expressed transcripts for protein zero, peripheral myelin protein-22 and myelin basic protein. The potential of stem cells in nerve repair may be limited by innate cellular senescence or donor age affecting cell functionality thus it was essential to determine the effects of donor age on morphology and functionality of stem cells.  The proliferation rates, expression of senescence markers (p38 and p53) and the stimulation of neurite outgrowth from DRG neurons by stem cells isolated from neonatal, young or old rats were very similar. However, the distribution and ultrastructure of mitochondria in dMSC and dASC from young and old rats were quite different, and seem to indicate physiological senescence of the aged cells.  Given the wide-ranging influence of Notch signalling in cell differentiation, including the neural crest to a glial cell type switch, and self-renewal in mammals, its role in the differentiation of stem cells to SC was investigated. The mRNA for notch-1 and -2 receptors were expressed in the dASC, blockage of notch signaling did not affect the neurotrophic and myelination potential of dASC.  In conclusion, these findings show that GFP labelling has no deleterious effect on SC survival and function. MSC and ASC differentiated into glial-type cells acquire SC morphology, and express characteristic SC markers, and the differentiation process was independent of the Notch signaling pathway. Also, following transplantation into a nerve gap injury dMSC improve regeneration. This study established that following co-culture with DRG neurons, dMSC and dASC were able to express peripheral myelin proteins.  Also, the functional bioactivity of these cells is independent of the donor animal age. Finally, although the glial lineage differentiated aged cells characterized in this study expressed markers typical of senescence they retained the potential to support axon regeneration.

Orientador: Antonio Carlos Alessi / Banca: Rosemeri de Oliveira Vasconcelos / Banca: Roberta Ferro de Godoy / Resumo: Lesões no Sistema Nervoso Periférico (SNP) são relativamente freqüentes. Apesar do SNP apresentar capacidade regenerativa em muitas situações não ocorre regeneração nervosa adequada levando a perdas funcionais. A Catuama é a associação de quatro extratos hidroalcoólicos obtidos de plantas brasileiras (Paullinia cupana, Trichilia catigua, Ptychopetalum olacoides e Zingiber officinale) com conhecida ação neuroprotetora, antiinflamatória, anti-oxidante e antidepressiva. O bilobalide é um componente extraído das folhas de Ginkgo biloba que tem demonstrada ação neuroprotetora nos sistemas nervosos central e periférico. O presente estudo avaliou a ação da Catuama e do bilobalide na regeneração nervosa periférica de ratos submetidos à secção do nervo isquiático e reparação com implante de tubo de silicone preenchido por colágeno deixando um intervalo entre os segmentos nervosos de 10mm. A Catuama foi administrada por via oral nos primeiros 28 dias de pós-operatório, nas doses de 100, 200 e 400mg/kg e comparada ao bilobalide na dose de 200μM adicionado ao colágeno líquido do implante e ao grupo controle. Os animais foram avaliados na primeira, quinta e décima semana de pós-operatório pelo teste de marcha e na décima semana pela avaliação eletrofiosiológica e pelas análises quantitativa e qualitativa dos cortes histológicos de amostras do nervo isquiático e do músculo gastrocnêmio. Em todas as análises utilizadas não foi encontrada diferença (P>0,05) entre os grupos experimentais o que indica que a Catuama e o bilobalide não interferiram na regeneração nervosa periférica nas condições experimentais. / Abstract: Peripheral nerve lesions are common. Functional recovery after peripheral nerve injuries is frequently poor, despite the capacity for axonal regeneration, resulting in most cases in a functional loss of the nerve. The Catuama is composed of four brasilian plants extracts (Paullinia cupana, Trichilia catigua, Ptychopetalum olacoides e Zingiber officinale). The Catuama is known as having neuroprotector, antinflamatory, antioxidant and antidepressive effects. Bilobalide, extraction of the leaves of Ginkgo biloba, is known by it's neuroprotector effect in the central and peripheral nervous system. The present study evaluates the effect of Catuama and bilobalide on peripheral nerve regeneration in rats following a sciatic nerve section. Sciatic nerve of adult rats was transected with a 10-mm gap and the proximal and distal nerve stumps were fixed in a silicone tube filled with collagen. The Catuama was oral administered along 28 days after the surgery. Three different treatment groups using doses of 100, 200 and 400mg/kg of Catuama were compared with one group using 200μM bilobalide associated with the liquid collagen in the silicone tube and the control group. Animals evaluations were done by a walk test on the first, fifth and tenth week after the surgery. Eletrophysiologic stimulation and quantitative and qualitative hystologic analysis of the sciatic nerve and gastrocnemius muscle were also realized on the tenth week after the surgery. No statistical difference was found in these variables between the five groups (P >0.05). These results suggest that there was no effect of Catuama or bilobalide on peripheral nerve regeneration regeneration. / Mestre

This project focused on the design of a cellular scaffold applicable for the promotion of peripheral nerve regeneration. Firstly, we established a correlation between the organization of HA/PEG co-polymeric networks to their mechanical and degradability properties; cell adhesion was conferred to all gels by the incorporation of RGD peptides. Three families of hydrogels were produced using different procedures to permit an increasing physical incorporation of HA into a PEGDA-based network. From a comparative study of rheological properties and enzymatic degradability, co-networks obtained using thiolated HA as chain transfer agent during PEGDA photo-polymerization were selected for further biological investigations, aiming to link the cellular response of L929 murine fibroblasts (phenotype, proliferation rate, metabolic activity) to the composition and the consistency of selected hydrogels. Our findings showed that there is a clear relation between increasing hardness and increasing cell spreading/proliferation rate. This study illustrated the possibility to fine tune cell/material interactions with appropriate reactive processing techniques. As a spin-off of this study, we become interested in the interplay of cellular interactions in the use of materials that contain both HA and RGD peptides, which can bind at the same time to HA receptors such as CD44 and av integrins. We focused on soluble HA derivatives, with or without dandling RGD peptides. The kinetics and the mechanistic details of both HA and HA-RGD internalization were studied in a phagocytic model (J774.2 murine macrophages). HA-RGD showed a form of synergic binding to integrins and CD44 (HA receptor), whereas its uptake remained solely regulated by CD44 dwell-time on the cell membrane. This study demonstrated that the knowledge of the rate-determining steps of the uptake of a carrier is necessary for assessing its efficiency. In this case, the presence of multiple ligands on a carrier was beneficial in some respect, but may not be optimal to overcome internalization limitations that arise from the slow turnover of the determining receptor. Finally, we studied the relation between the regulation of the expression of CD44 / RHAMM (HA receptor mediated motility) and the motility of Schwann cells (peripheral glial cells) and stem cells differentiated into a glial phenotype. Rt-PCR and immuno-assay experiments suggested that RHAMM up-regulation is associated with glial differentiation and we speculate that in the future this HA receptor could be considered as a differentiation marker. We also illustrated the importance of HA / RHAMM interaction for the motility of glial cells. These results indicate the importance of HA in mediating glial cell function during peripheral nerve regeneration and have implications for therapeutic repair strategies.

The use of autografts is the gold standard for peripheral nerve regeneration (PNR) while biomedical engineering made some contributions to improve PNR. A next generation of nerve guidance conduits (NGC) is required to transmit topographical and biochemical signals towards severed nerves. In this thesis, the gelatin hydrolyzate Collagel® (COL) and anhydride-containing cross-linkers (oPNMA, oPDMA) were used to fabricate crosslinked hydrogels (cGEL) for PNR. At first, established cGEL formulations were adjusted towards an injection-molding tool with static mixer. Therefore, the gelation kinetic was modified by variation of the gelation base. Hence, high reactive oPNMA was available for fabrication of robust cGEL based NGC. Secondly, novel cGEL and molding technique were adapted towards the fabrication of cGEL-based filler for polymer-derived braided NGC. Shear-thinning filler was developed that allowed direct application inside the conduit lumen with minimal mechanical stiffness but sufficient scaffolding properties. Besides pristine filler, chemically modified filler was designed with a small mimetic of the nerve growth factor, LM11A-31, that was grafted to oPNMA. In a rat sciatic nerve model, the performance of this derivatized filler was comparable to the control and underlined the potential of chemical cues in PNR. A number of small diamines were further integrated into oPNMA and oPDMA to modify cGEL bulk. In addition to chemical feasibility, the cytocompatibility and cellular response were tested on L929 mouse fibroblasts and human adipose-derived stem cells. The functionalization showed an impact on the cell behavior with differences in cell proliferation, migration and spreading. Finally, modified oPNMA-derived hydrogels were tested on neonatale Schwann cells. The cell viability and extension was maintained in all hydrogels while the impact of LM11A-31 was not as pronounced. This thesis emphasizes the potential of cGEL hydrogels in nerve implants as fillers or conduits and, thus, is a promising building block for a new generation of NGC.

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第19398号 / 医博第4049号 / 新制||医||1012(附属図書館) / 32423 / 京都大学大学院医学研究科医学専攻 / (主査)教授 戸口田 淳也, 教授 妻木 範行, 教授 井上 治久 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Keratins are a family of structural proteins that can be extracted from a variety of sources including wool, nails, skin, hooves, and hair. Keratin can be processed into different constructs such as coatings, scaffolds, and hydrogels, and has shown favorable results when placed in in vitro and in vivo settings for different tissue regeneration applications. Over three decades, keratin extraction technology has been continuously modified, and these differences in extraction processes have distinct effects on the characteristics of the end product. In this work, we examine the effect of keratin aggregation during a widely-used purification step, dialysis ultra-filtration, on material characteristics of the final keratin product when fabricated into a hydrogel. Two distinct dialysis procedures were applied during the extraction of oxidized keratin (keratose): one promoting protein aggregation and the other mitigating it. Analyses of material properties such as mechanical and enzymatic stability were conducted in addition to observing the differences in solution behavior between products. Data revealed that protein aggregation during the extraction process has a profound effect on keratose hydrogel material properties. After determination of the effect of protein aggregation during extraction on keratose hydrogels, investigation of how a blended material comprised of said keratose and type I collagen was undertaken. It was hypothesized that a blend would result in mixing at the molecular level, resulting in improved properties compared to either pure material alone. A protocol was created to make stable keratose/type I collagen blends and material characterization techniques were applied to determine the inherent properties of samples with differing ratios. Crosslinking density, mechanical properties, enzymatic degradation properties, water uptake capacity, structural architecture, and thermal properties were all assessed. In addition, the ability of this material to maintain cell viability was conducted. Results showed that the addition of type I collagen has a significant effect on the properties of hydrogel blends with keratose compared to the pure keratose system. This was mostly evident with hydrogel mechanical stability and material architecture. Finally, the ability to use this hybrid material as a luminal filler for a nerve conduit during peripheral nerve regeneration was explored in an in vitro setting. The ability of this blend to promote Schwann cell viability was assessed in addition to determining the ability of these cells to attach and migrate through the material matrix. These experiments demonstrate proof-of-concept for the application of using keratose/type I collagen matrices as a luminal filler in peripheral nerve guidance conduits. / Doctor of Philosophy / Keratins are a family of structural proteins that can be extracted from wool, skin, nails, and hair, and that have been investigated in the field of tissue regeneration. Humans make several types of keratins, so it has a natural acceptance by the body and its inflammatory and immune systems. However, keratins can be hard to make and process into useful products. Many methods for producing keratin biomaterials have been developed over the past 30 years, but most of them are not ideal. This work sought to explore a production method that addresses a particular problem, that of protein aggregation during purification. In so doing, methods can be optimized to create more useful keratin biomaterials. Experiments comparing preparation methods that maximize and minimize protein aggregation were compared. Data showed that minimizing aggregation leads to better biomaterial characteristics, thus demonstrating the potential impact of targeting this processing step. However, even after optimization of purification, keratins still have limitations. Most notably their mechanical strength is not as great as some other materials. A typical approach to address this in other systems has been by blending. In the present work, we explored a blend made from keratin and type 1 collagen. A method was developed to effectively blend keratin and collagen and create stable mixtures that yielded protein-to-protein coordination. Such interactions typically yield beneficial material characteristics such as increased strength. Data showed that intimate mixing of the two proteins was achieved, and resulting characteristics were improved compared to either pure material. Finally, studies were conducted to assess the potential for keratin/collagen blends to be used to regenerate injured nerves. A common method is to enclose the ends of a cut nerve into a tube and let the nerve re-grow through the tube to its target muscle. An important characteristic is an ability for cells to populate the interior of the tube and help the nerve fibers grow. In the present study, we investigated the behavior of a particularly important cell, the Schwann cell, to attach, move and grow through a keratin/collagen biomaterial. Data showed good cell behavior, suggesting that the material could be used in a medical product for nerve repair.

This study examines the prospects of using the electrospinning process to fabricate tissue engineering scaffolds targeting a variety of regenerative applications, with a primary focus on the production of nerve guides for the treatment of long-defect nerve injuries in the peripheral nervous system. A basic overview of the conventional electrospinning process is provided, and the utility of this fabrication scheme in the production of collagen-based tissue engineering scaffolds is demonstrated. Next, a novel modification of the basic electrospinning process is presented. This process, called two pole air gap electrospinning, was developed to produce nerve guides that exhibit an anisotropic structure that mimics the extracellular matrix of native peripheral nerve tissue. This electrospinning process makes it possible to produce macroscopic nerve guides that are cylindrical in shape and composed of dense arrays of nano- to micron-scale diameter fibers. Unlike, conventional hollow core nerve guides, these electrospun constructs lack a central lumen, hence the designation 3D (for three-dimensional) nerve guide. The fibers are nearly exclusively arrayed in parallel with the long axis of the construct. This architectural feature provides thousands of individual channels, and aligned fibers that provide guidance cues that are designed to drive regenerating axons to grow in a highly directed fashion down the longitudinal axis of the guide. To supplement the structural cues provided by the fibrillar arrays of the electrospun 3D nerve guides, an alginate-based platform designed to deliver therapeutic reagents was developed and characterized. This platform makes it possible to fabricate gradients of therapeutic reagents within the fibrillar arrays of an electrospun nerve guide. Functional and structural analyses of these constructs supplemented with or without a gradient of NGF, in a long-defect nerve injury in the rodent sciatic nerve indicate that the 3D design is superior to the gold standard treatment, the autologous nerve graft. Animals treated with the 3D grafts recovered motor and sensory function faster and exhibited far higher nerve-to-nerve and nerve-to-muscle signal amplitudes in electrophysiological studies than animals treated with autologous grafts or conventional hollow core cylindrical grafts.

Made available in DSpace on 2014-06-11T19:23:43Z (GMT). No. of bitstreams: 0 Previous issue date: 2008-11-24Bitstream added on 2014-06-13T18:19:53Z : No. of bitstreams: 1 pereira_rn_me_jabo.pdf: 471924 bytes, checksum: 4ffda866a6bffc48af4632f12c8dd08f (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Lesões no Sistema Nervoso Periférico (SNP) são relativamente freqüentes. Apesar do SNP apresentar capacidade regenerativa em muitas situações não ocorre regeneração nervosa adequada levando a perdas funcionais. A Catuama é a associação de quatro extratos hidroalcoólicos obtidos de plantas brasileiras (Paullinia cupana, Trichilia catigua, Ptychopetalum olacoides e Zingiber officinale) com conhecida ação neuroprotetora, antiinflamatória, anti-oxidante e antidepressiva. O bilobalide é um componente extraído das folhas de Ginkgo biloba que tem demonstrada ação neuroprotetora nos sistemas nervosos central e periférico. O presente estudo avaliou a ação da Catuama e do bilobalide na regeneração nervosa periférica de ratos submetidos à secção do nervo isquiático e reparação com implante de tubo de silicone preenchido por colágeno deixando um intervalo entre os segmentos nervosos de 10mm. A Catuama foi administrada por via oral nos primeiros 28 dias de pós-operatório, nas doses de 100, 200 e 400mg/kg e comparada ao bilobalide na dose de 200μM adicionado ao colágeno líquido do implante e ao grupo controle. Os animais foram avaliados na primeira, quinta e décima semana de pós-operatório pelo teste de marcha e na décima semana pela avaliação eletrofiosiológica e pelas análises quantitativa e qualitativa dos cortes histológicos de amostras do nervo isquiático e do músculo gastrocnêmio. Em todas as análises utilizadas não foi encontrada diferença (P>0,05) entre os grupos experimentais o que indica que a Catuama e o bilobalide não interferiram na regeneração nervosa periférica nas condições experimentais. / Peripheral nerve lesions are common. Functional recovery after peripheral nerve injuries is frequently poor, despite the capacity for axonal regeneration, resulting in most cases in a functional loss of the nerve. The Catuama is composed of four brasilian plants extracts (Paullinia cupana, Trichilia catigua, Ptychopetalum olacoides e Zingiber officinale). The Catuama is known as having neuroprotector, antinflamatory, antioxidant and antidepressive effects. Bilobalide, extraction of the leaves of Ginkgo biloba, is known by it´s neuroprotector effect in the central and peripheral nervous system. The present study evaluates the effect of Catuama and bilobalide on peripheral nerve regeneration in rats following a sciatic nerve section. Sciatic nerve of adult rats was transected with a 10-mm gap and the proximal and distal nerve stumps were fixed in a silicone tube filled with collagen. The Catuama was oral administered along 28 days after the surgery. Three different treatment groups using doses of 100, 200 and 400mg/kg of Catuama were compared with one group using 200μM bilobalide associated with the liquid collagen in the silicone tube and the control group. Animals evaluations were done by a walk test on the first, fifth and tenth week after the surgery. Eletrophysiologic stimulation and quantitative and qualitative hystologic analysis of the sciatic nerve and gastrocnemius muscle were also realized on the tenth week after the surgery. No statistical difference was found in these variables between the five groups (P >0.05). These results suggest that there was no effect of Catuama or bilobalide on peripheral nerve regeneration regeneration.

Traumatic injuries resulting in peripheral nerve lesions often require a graft to bridge the gap. Although autologous nerve graft is still the first choice strategy in reconstructions, it has the severe disadvantage of the sacrifice of a functional nerve. Cell transplantation in a bioartificial conduit is an alternative strategy to create a favourable environment for nerve regeneration. Among adult stem cells, adipose-derived stem cells (ASC) are a useful tool in regenerative medicine as they can be induced towards multiple mesodermal and nonmesodermal lineages, being recently differentiated into cells showing Schwann cell-like morphology, glial cell markers and increased neurotrophic potential. The first two chapters of this work describe in vivo applications of Schwann cell-like differentiated ASC (dASC), seeded into biodegradable nerve guides made of fibrin, investigating both brief (2 weeks) and long (4 months) term effects on the regenerating nerves. Comparison was carried out with similarly differentiated bone marrow mesenchymal stem cells (dMSC), Schwann cells (SC)and empty fibrin conduits, as well as with autologous nerve grafts. Regeneration was evaluated in a 1cm gap total axotomy sciatic nerve injury model on rats. Results showed that dASC could improve regeneration distance in a similar manner to other regenerative cells inthe brief term. This effect was maintained and strengthened in the long term, where nerve morphology, spinal motoneurons regeneration, protection from muscle atrophy and electrophysiological performances of regenerated nerves were analysed. dASC positive effects lasted in the long term with functional results comparable to the autologous nerve grafts, which served as controls. The third chapter focuses on the possibility to further improve dASC regenerative performances using fibronectin and laminin, two key extracellular matrix (ECM) molecules involved in nerve regeneration, with the future aim to optimize cell host, directional cues and neurotrophism of tissue engineered conduits. Fibronectin and laminin protected dASC from stress-induced cell death in vitro, significantly increasing cell adhesion and viability. Laminin significantly improved neurotrophic properties of dASC enhancing neurite outgrowth of both primary sensory neurons and NG108-15 neurons co-cultured with dASC, suggesting a further activation of the neurotrophic effect of dASC by ECM molecules. These improved effects were increased when a direct contact was established between the laminin substrate, dASC and neurons, suggesting a primary role of laminin in contact signalling, finally boosting the neurotrophic potential of dASC. Further studies will be needed to clarify the interactions between dASC and the complexniche of peripheral nerve regeneration, including the ECM molecules. However, the neurotrophic potential of dASC expressed in both in vitro and in vivo experiments opens wide perspectives in tissue engineering applications among new methods to enhance peripheral nerve repair.

京都大学 / 新制・課程博士 / 博士(人間健康科学) / 甲第23426号 / 人健博第93号 / 新制||人健||6(附属図書館) / 京都大学大学院医学研究科人間健康科学系専攻 / (主査)教授 山田 重人, 教授 林 悠, 教授 森本 尚樹 / 学位規則第4条第1項該当 / Doctor of Human Health Sciences / Kyoto University / DFAM