Effects of different neurotrophic factors on the survival of retinal ganglion cells after a complete intraorbital nerve crush injury: A quantitative in vivo study

We examined in adult Sprague Dawley rats the loss of retinal ganglion cells (RGCs) induced by complete intraorbital optic nerve crush (IONC) as well as the effects of several neurotrophic factors to prevent IONC-induced RGC loss. Completeness of the IONC lesion was assessed by investigating the orthograde and retrograde transport of neuronal tracers applied to the origin and termination of the retinotectal pathway. RGC survival after IONC alone or combined with intraocular injection of the neurotrophic factors NT-4, BDNF or CNTF was quantified at survival intervals ranging from 5 to 12 days post-lesion (dpl) by identifying RGCs that had been pre-labelled with fluorogold (FG). RGC loss first appeared at 7 dpl and by 12 dpl only 32% of the RGC population remained in the retina. Intraocular administration of NT-4, BDNF or CNTF resulted in almost a complete protection against IONC-induced RGC loss by 7 dpl, and the protection remained significant by 12 dpl only for NT-4 and BDNF. We have analyzed these results taking into account our previous studies on the loss of RGCs induced by intraorbital optic nerve transection (IONT) and concluded that RGC loss induced by IONC is slower and less severe than that following IONT. Moreover, as for IONT-induced RGC loss, IONC-induced RGC loss may also be prevented with administration of NT-4, BDNF or CNTF, though for NT-4 and CNTF their neuroprotective effects differ depending on the injury type. Overall this data underscore the importance of the type of ON injury on the pattern of RGC degeneration as well as in their response to neuroprotective treatments.     

视神经挫伤后视网膜形态学和Bcl-2/Bax表达

目的 研究大鼠视神经夹挫伤后视网膜神经节细胞（RGC）形态学改变及Bcl-2／Bax蛋白表达的变化，为了解视神经损伤的病理机制提供一定的依据。方法 建立大鼠视神经夹挫伤动物模型，伤后1d、3d、5d、7d、9d、2周、4周处死，HE染色观察RGC的动态变化，免疫组化方法检测RGC表达Bcl-2及Bax的水平。结果 视神经伤后RGC数目严重下降，2周内RGC快速减少，2周以后缓慢减少；伤后Bcl-2及Bax表达随时间而有不同程度的增加，Bax对损伤的反应较Bcl-2稍晚，两者表达均呈现先升后降的趋势，并维持一定的时间。Bcl-2和Bax蛋白表达比与RGC存活数目有一定的相关性。结论 视神经损伤后RGC数目减少是其视功能下降的病理基础之一，Bcl-2和Bax在RGC死亡机制中起重要作用，Bcl-2／Bax比率与RGC的减少呈一定的相关性。     

大鼠视神经部分损伤后视神经纤维再生的形态学观察

目的探讨大鼠视神经不同程度损伤后视网膜神经节细胞（RGC）和轴突的变化规律及神经再生能力。方法用夹持力为148g的反向镊夹持大鼠视神经3、6、12、30、60S建立不同程度视神经损伤的动物模型,计数视神经损伤后0．5、1、2、3、7个月RGC和损伤后1、2、3个月轴突随时间的变化规律,透射电镜观察损伤的再生反应,在银染的视神经纵切片上计数后计算视神经横断面上纤维数目,根据横断面的纤维数目计算损伤视神经的再生指数以衡量不同程度视神经损伤后的再生能力。再生指数的计算为（损伤点后0．5mm纤维数-损伤点后2．5唧纤维数）／（球后0．5唧纤维数-损伤点后2．5mm纤维数）。结果视神经部分损伤后RGC和轴突持续丢失,这种丢失可分为伤后2周内的急性丢失和其后的缓慢丢失两个时期,并呈指数形式下降。随着致伤程度的加重,RGC的丢失率上升而存活率降低,RGC和轴突的丢失率随致伤程度的加重而增高,轻度损伤时这种继发损伤具有自限性。视神经损伤后,有大量丛状聚集、区域化分布的无髓再生纤维。视神经夹持损伤3、6、12、30、60s后,再生指数分别为1．409、1．490、0．916、1．119、1．224（χ^2=281．2,P〈0．01）,不同程度损伤后神经的再生能力可能不同,轻度损伤的再生能力较强。结论不同程度视神经部分损伤后继发反应和再生能力不同,轻度损伤后的继发损伤具有自限性并具有更强的再生能力,在一定程度的损伤下修复与损伤可能达到某种平衡而导致成功再生。     

Citicoline and lithium rescue retinal ganglion cells following partial optic nerve crush in the rat

Citicoline and lithium (Li(-)) have been shown to support retinal ganglion cell (RGC) survival and axon regeneration in vitro. Optic nerve crush (ONC) is a model of both brain axonal injury and certain aspects of the glaucomatous degeneration of RGC. We have used this model to quantify protection offered to RGC by these drugs and to determine whether their effects are mediated by enhanced expression of the antiapoptotic protein Bcl-2. Adult rats (6-12 per group) were subjected to ONC accompanied by a contralateral sham operation. Animals were treated intraperitoneally with either vehicle, citicoline sodium (1g/kg daily for up to 7 days and 300 mg/kg daily afterwards), lithium chloride (30 mg/kg daily), or both drugs combined. Fluorogold was injected bilaterally into superior colliculi 1, 5 or 19 days after ONC. Labeled cells were counted under a fluorescence microscope 2 days after tracer injection. In a separate set of experiments the effects of treatments on expression of Bcl-2 in retinas were evaluated by immunohistochemistry. In vehicle-treated animals there was a progressive decrease of RGC density after crush. This decrease was attenuated in citicoline-treated animals 1 week and 3 weeks after the crush. In the lithium-treated group protection was even more pronounced. In animals treated with both drugs RGC protection was similar to that achieved by lithium alone. Bcl-2 immunoreactivity was seen predominantly in retinal ganglion cells. Its increase was recorded in the lithium and citicoline group as well as in animals treated with the combination of both drugs. Both citicoline and lithium protect RGC and their axons in vivo against delayed degeneration triggered by the ONC. Retinoprotective action of both drugs may involve an increase in Bcl-2 expression.     

Mechanism of retinal ganglion cells death in secondary degeneration of the optic nerve

In central nervous system injury, the secondary degeneration process is known to play a major role in determining the final extent of impairment. Here, we investigated the mechanism of retinal ganglion cell (RGC) death in secondary degeneration of the optic nerve using a unique model that allows morphological separation between primary and secondary degeneration. A partial transection model was applied unilaterally in 110 Wistar rat eyes. The rate of apoptosis was evaluated in primary and secondary degeneration over a period of 6 months using the Hoechst staining technique. The involvement of caspase 3 and members of the Bcl-2 family (Bax, Bad, Bcl-2 and Bcl-xl) was evaluated at multiple time points for 6 months after the injury by immunohistochemistry and RT-PCR. We found that in secondary degeneration of the optic nerve, RGCs died by apoptosis from day 3-6 months following the injury, peaking at 3 months (16.3% ± 2.5% apoptotic cells, p < 0.01). Both primary and secondary degeneration of the optic nerve resulted in caspase 3 activation, which was longer and more intense in the former. Similarly, both primary and secondary degeneration led to significant (p < 0.05) downregulation of the pro-survival genes Bcl-2 and Bcl-x-L and up-regulation of the pro-apoptotic genes Bax and Bad (p < 0.05), with a suggested delay in secondary degeneration. Thus, secondary degeneration of the optic nerve leads to RGC apoptosis over long periods in a similar mechanism as in primary degeneration.     

大鼠视神经挫伤视网膜形态功能变化的动态研究

目的观察视神经夹挫伤后视网膜形态学和视功能动态变化,为视功能评价和视神经保护研究提供依据。方法大鼠视神经夹挫伤后1d、3d、5d7、d、9d、2周4、周8、周1、2周,光镜观察视网膜神经节细胞(RGC)改变,闪光视觉诱发电位(F-VEP)检测视功能状况。结果视神经部分损伤后3d到1周内视网膜神经节细胞快速减少,2周以后缓慢减少,4周几乎无明显变化;视神经损伤1d,F-VEP波形变得低而宽,前2周呈进行性下降期,4周后变化平稳,并显示恢复迹象。结论神经节细胞继发性损伤是视功能进行性下降的重要原因,一定数量存活的视网膜节细胞是视功能恢复的基础;神经损伤变化和视功能变化与时间具有一定的相关性,这些对于正确评价视功能状况和预后有极重要的意义。     

Neuroprotection and regeneration after traumatic lesion of the optic nerve

BACKGROUND: After a traumatic lesion of the optic nerve, retinal ganglion cells (RGC) undergo massive degeneration by apoptosis, which leads to loss of vision in the affected eye. Like other neurones in the central nervous system, RGC are not able to regenerate their damaged axons spontaneously. We used special surgical methods and pharmacological measures to achieve enhanced survival and regeneration of damaged RGC. MATERIALS AND METHODS: Studies were performed using the model of RGC degeneration induced by severing the optic nerve of adult rats. RGC were loaded with a fluorescent dye, and several drugs were applied intravitreally. The effects were evaluated after two weeks by counting the surviving RGC. For regeneration studies, an autologous peripheral nerve graft was sutured to the stump of the cut optic nerve, or the ends of the cut optic nerve were re-sutured. Recovery of RGC function was assessed by VEP measurements. RESULTS: The number of RGC surviving an axotomy increased significantly after intravitreal injections of aurintricarboxylic acid, cortisol, a caspase inhibitor, brimonidine or microglia-targeted substances. Regeneration of cut axons was enhanced by aurintricarboxylic acid or cortisol. In addition, considerable neuroprotective and regenerative effects including partial restoration of VEP were induced by lens injury, which results in a gradual release of crystallins into the vitreous, or by intravitreal injection of purified crystallins. CONCLUSION: The loss of vision after an optic nerve trauma can be reduced in this animal model by suitable neuroprotective measures, which raises hope for the treatment of patients.     

转基因荧光小鼠视神经轴索钝性损伤后退行性病变观察

目的 建立单侧眼视神经轴索钝性损伤模型,观察视神经轴突退行性病变过程和小胶质细胞的变化.方法 将标记神经轴突的YFP小鼠和标记小胶质细胞的GFP小鼠分为手术组和正常对照组,并于视神经轴索钝性损伤手术后4h、1d、3d、5d、10d分离视神经,以激光共聚焦显微镜观察神经轴突受损程度及小胶质细胞的变化.结果 与对正常对照组比较,YFP小鼠术后4h损伤处视神经轴突断裂;术后1d视神经轴突开始出现念珠化;术后3d视神经轴突大部分念珠化;术后5d视神经轴突开始从念珠状转变为碎片状;术后10 d视神经轴突形成大量碎片.GFP小鼠与正常对照组相比,术后4h形成胶质瘢痕,静息态小胶质细胞开始大量出现;术后1d激活态小胶质细胞大量增多并开始覆盖受损区域;术后3d大量的激活态小胶质细胞基本覆盖了受损区域;术后5d、10 d虽然视神经的退行性病变持续恶化,但是小胶质细胞的数量基本保持稳定.结论 小鼠视神经受损后轴突发生不可逆的退行性病变,同时并伴随着小胶质细胞的激活和增多,说明小胶质细胞与视神经的退行性病变密切关联.     

钙通道抑制介导轴突稳定对视神经损伤修复作用的研究进展

视神经损伤是常见的神经性疾病,其基本的病理特征为轴突变性和视网膜神经节细胞(RGCs)凋亡,从而导致视觉功能障碍等症状的出现。轴突变性是神经发育、轴突重塑和损伤反应的重要过程,包括轴突选择性退化、轴突横断诱导的Wallerian变性和凋亡诱导的轴突变性(轴突凋亡)。轴突变性是许多创伤性神经系统疾病的初始步骤之一,损伤的轴突一般无法再生,从而进一步导致神经元胞体凋亡。神经元凋亡导致胞体和轴突两者的退化,在发育过程中广泛发生并且应对神经元的各种损伤。近年来有研究证实,钙是轴突变性的主要调控因子。在视神经挤压伤(ONC)发生后,通过钙通道抑制剂阻止钙离子涌入轴突,可以减弱急性轴突变性(AAD)的程度,提高RGCs的存活率以及促进轴突的再生。     

地塞米松对兔视神经钳夹伤后视网膜神经节细胞存活及Nogo-A表达的影响

目的观察地塞米松对家兔视神经钳夹伤后视网膜神经节细胞(retinal ganglion cell,RGC)存活的影响及损伤视神经、视网膜Nogo-A表达的变化。方法采用兔球后视神经钳夹伤模型,健康成年家兔分为正常对照组、损伤组、治疗组。分别于损伤后3d、7d、14d处死动物,观察单位面积RGC存活数量及损伤后Nogo-A在视神经、视网膜的表达变化。结果视神经损伤后,治疗组RGC的存活数高于损伤组及对照组(P<0.01)。对照组、损伤组损伤后3d、7d、14d视神经、视网膜Nogo-A表达增强,至损伤后7d达高峰;治疗组视神经、视网膜表达亦增强,各时间点均弱于损伤组、对照组,差异有显著统计学意义(P<0·01)。结论视神经损伤后,地塞米松能够增加RGC的存活数量,能够下调No-go-A的表达,这可能是地塞米松治疗作用机制之一。     

CNTF和Ad-BDNF对视神经夹伤后视网膜神经节细胞存活的影响

目的:观察大鼠视神经夹伤后玻璃体腔内注射睫状神经营养因子(CNTF)和腺病毒介导脑源性神经营养因子(Ad-BDNF)对视神经损伤后视网膜神经节细胞(RGC)存活的影响。方法:制作大鼠视神经定量夹伤模型,玻璃体腔内注射CNTF和Ad-BDNF,经上丘荧光金(FG)逆行标记RGC,计数视网膜铺片上的RGC并行统计学分析。结果:正常SD大鼠视网膜上RGC密度为2155±265个/mm2(n=12),视神经夹伤后RGC在1~2wk内下降速率最快,到3,4wk时RGC细胞数量虽仍有减少但下降速度已经明显减慢。CNTF组在视神经夹伤后1wk时视网膜RGC数显著高于对照组,但2~4wk的结果和对照组比较差异不明显。Ad-BDNF组视神经夹伤后1~4wk视网膜RGC数均显著高于对照组。结论:CNTF治疗组玻璃体腔内一次性注射CNTF可以在损伤早期2wk内为损伤的RGC提供神经营养因子,减少RGC的早期死亡。Ad-BDNF治疗组的这种保护作用可以持续到损伤后4wk,能够为RGC提供长时间地营养支持,但这种作用比较局限,可能与单一营养因子作用有关。     

小胶质细胞极化在青光眼视神经损伤发病机制及治疗中的研究进展

青光眼是多因素介导的以视网膜神经节细胞凋亡、视神经萎缩和视野缺损为特征的神经退行性眼病,发病机制尚不明确.小胶质细胞是视网膜内常驻的免疫细胞,它可分为经典激活M1型和替代激活M2型,随着眼压改变以及视网膜神经节细胞损伤修复过程的进展,小胶质细胞的极性呈现动态变化,可产生多种具有神经毒性或神经保护作用的细胞因子.近年来,...     

Autophagy in axonal degeneration in glaucomatous optic neuropathy

The role of autophagy in retinal ganglion cell (RGC) death is still controversial. Several studies focused on RGC body death, although the axonal degeneration pathway in the optic nerve has not been well documented in spite of evidence that the mechanisms of degeneration of neuronal cell bodies and their axons differ. Axonal degeneration of RGCs is a hallmark of glaucoma, and a pattern of localized retinal nerve fiber layer defects in glaucoma patients indicates that axonal degeneration may precede RGC body death in this condition. As models of preceding axonal degeneration, both the tumor necrosis factor (TNF) injection model and hypertensive glaucoma model may be useful in understanding the mechanism of axonal degeneration of RGCs, and the concept of axonal protection can be an attractive approach to the prevention of neurodegenerative optic nerve disease. Since mitochondria play crucial roles in glaucomatous optic neuropathy and can themselves serve as a part of the autophagosome, it seems that mitochondrial function may alter autophagy machinery. Like other neurodegenerative diseases, optic nerve degeneration may exhibit autophagic flux impairment resulting from elevated intraocular pressure, TNF, traumatic injury, ischemia, oxidative stress, and aging. As a model of aging, we used senescence-accelerated mice to provide new insights. In this review, we attempt to describe the relationship between autophagy and recently reported noteworthy factors including Nmnat, ROCK, and SIRT1 in the degeneration of RGCs and their axons and propose possible mechanisms of axonal protection via modulation of autophagy machinery.     

Nogo在视神经损伤后再生中的研究进展

哺乳动物外周神经损伤后轴突能再生很长距离。在一定条件下,中枢神经系统受损后也能部分再生。Nogo是一种已经被证实的髓鞘相关抑制因子,中枢神经损伤后Nogo释放增加、表达增强,启动神经元凋亡过程,导致神经元死亡。我们从Nogo-A,Nogo-66,可溶性NgR片段、RhoA酶与Rho-A/Rho激酶信号通道、钙离子几个方面综述Nogo的作用机制,并探讨其在视神经损伤后神经再生中的应用前景。     

Optic nerve transection in monkeys may result in secondary degeneration of retinal ganglion cells

PURPOSE: Interest in neuroprotection for optic neuropathies is, in part, based on the assumption that retinal ganglion cells (RGCs) die, not only as a result of direct (primary) injury, but also indirectly as a result of negative effects from neighboring dying RGCs (secondary degeneration). This experiment was designed to test whether secondary RGC degeneration occurs after orbital optic nerve injury in monkeys. METHODS: The superior one third of the orbital optic nerve on one side was transected in eight cynomolgus monkeys (Macaca fascicularis). Twelve weeks after the partial transection, the number of RGC bodies in the superior and inferior halves of the retina of the experimental and control eyes and the number and diameter of axons in the optic nerve were compared by detailed histomorphometry. Vitreous was obtained for amino acid analysis. A sham operation was performed in three additional monkeys. RESULTS: Transection caused loss of 55% +/- 13% of RGC bodies in the superior retina of experimental compared with fellow control eyes (mean +/- SD, t-test, P < 0.00,001, n = 7). Inferior RGCs, not directly injured by transection, decreased by 22% +/- 10% (P = 0.002). The loss of superior optic nerve axons was 83% +/- 12% (mean +/- SD, t-test, P = 0.0008, n = 5) whereas, the inferior loss was 34% +/- 20% (P = 0.02, n = 5). Intravitreal levels of glutamate and other amino acids in eyes with transected nerves were not different from levels in control eyes 12 weeks after injury. Fundus examination, fluorescein angiography, and histologic evaluation confirmed that there was no vascular compromise to retinal tissues by the transection procedure. CONCLUSIONS: This experiment suggests that primary RGC death due to optic nerve injury is associated with secondary death of surrounding RGCs that are not directly injured.     

碱性成纤维生长因子对大鼠视神经损伤的保护作用

目的 探讨碱性成纤维生长因子（ｂＦＧＦ）对视神经损伤的保护作用。方法 用精确校准方法在成年鼠造成部分视神经损伤模型,球后注射生理盐水,ＶＢ１２,ｂＦＧＦ。伤后１ｈ和４ｗｋ测量闪光视神经诱发电位（Ｆ－ＶＥＰ）。结果 伤后１ｈ,Ｆ－ＶＥＰ潜伏期延长且电位幅值降低,与正常比较有明显差异,伤后４ｗｋ时生理盐水和ＶＢ１２组对刺激没有应答,ｂＦＧＦ组Ｆ－ＶＥＰ接近正常。结论 ｂＦＧＦ对视神经损伤后视神经节细胞     

甲泼尼龙冲击治疗视神经损伤的效果及时效关系

目的观察甲泼尼龙(methylprednisolone,MP)治疗视神经损伤的效果及时效关系。方法 144只Wistar大鼠,随机分为正常对照组、损伤对照组、6个MP治疗组。后7组制作视神经损伤模型,6个MP治疗组分别在伤后2h、4h、6h、8h、12h、24h应用MP治疗,首次30.0mg·kg-1尾静脉注射,以后按5.4mg·kg-1·h-1给药,直至伤后48h。伤后4d、7d和14d:光镜下观察各组视神经和视网膜的组织病理学变化、视网膜神经节细胞(retinal ganglion cell,RGC)计数、观察F-VEP波形变化。结果与损伤对照组比较,伤后6h、24h应用MP治疗组伤后4d、7d、14d视神经和视网膜的病理损害均较轻;伤后2h、4h、6h、8h、12h应用MP治疗组伤后4d、7d和14dRGC计数分别为28.87±1.23、25.54±2.62、21.37±2.30,28.60±1.46、24.60±1.84、20.60±2.31,27.34±1.41、25.34±1.80、20.50±1.93,27.40±1.47、22.07±1.34、16.82±1.11,27.64±1.59、22.16±1.02、16.77±1.20,均显著高于损伤对照组(25.14±1.42、19.14±1.43、12.14±1.55),差异均有统计学意义(均为P<0.05),伤后24h应用MP治疗组伤后4d和7d RGC计数为25.16±1.14、19.20±1.07,与损伤对照组比较,差异均无统计学意义(均为P>0.05),14d(14.21±1.13)高于损伤对照组,差异有统计学意义(P<0.05)。伤后2h、4h、6h、8h和12h应用MP治疗组伤后4d、7d和14dP波潜伏期延迟和波幅降低,与正常对照组比较,差异均有统计学意义(均为P<0.05);伤后2h、4h和6h应用MP治疗组伤后7d和14d与伤后8h、12h、24h应用MP治疗组比较,差异均有统计学意义(均为P<0.05)。结论视神经损伤后12h内开始给予MP冲击治疗,可以明显减轻视神经损伤程度和促进恢复,6h内开始治疗效果更好,24h仍有效。     

兔视神经损伤后视网膜神经节细胞MDA/SOD的变化

目的:观察兔视神经损伤后视网膜神经节细胞(retinal ganglion cell,RGC)丙二醛(malondialdehyde,MDA)/超氧化物歧化酶(superoxide dismutase,SOD)的变化。方法:选用新西兰白兔32只,分为对照组和损伤组,损伤组再根据损伤后不同时间分为3,7,14d组,每组8只16眼。采用硫代戊巴比妥酸法和黄嘌呤氧化法分别测定视网膜MDA/SOD含量。结果:损伤实验组MDA含量分别为5.95±0.78,7.67±0.64和8.29±1.02μmol/g,均明显高于正常对照组(3.82±0.54μmol/g);实验各组SOD含量分别为510±44,415±29和398±36μkat/g,均明显低于正常对照组(727±52μkat/g)。结论:自由基代谢在兔视神经损伤后RGC凋亡中起着重要作用,MDA/SOD含量测定在RGC凋亡的研究中有一定的意义。     

视神经损伤后发生非折叠蛋白反应的超微证据

目的:探索视神经损伤后视网膜节细胞(retinal ganglion cell,RGC)及其纤维渐进性死亡机制。方法:利用包埋前与包埋后免疫金细胞化学标记技术结合电镜观察研究大鼠(n=15)视神经钳夹损伤后RGC与视神经干少突胶质细胞内的非折叠蛋白反应(unfolding protein response,UPR)。结果:视神经钳夹后,需肌醇酶1(inositol requiring enzyme 1,IRE1)在RGC与少突胶质细胞内胶体金标记数目增多,在钳夹0.5d后RGC内即有显著地增加(18.4±5.1～30.4±7.2个,P<0.05),随损伤时间延长,增多更为明显,在钳夹3d后达高峰(48.5±9.7个),IRE1在视神经干上的少突胶质细胞内增多时程变化与在RGC内相似。IRE1在RGC与少突胶质细胞内胶体金标记颗粒分布部位距离ER管腔距离增加为特征,在钳夹0.5d内神经干少突胶质细胞以及视网膜RGC内均表现非常明显的距离增加。结论:视神经钳夹导致损伤细胞触发UPR,UPR可能参与视神经损伤后RGC及其纤维渐进性死亡机制。