1 Department of Neurosciences, MetroHealth Medical Centre, Case Western Reserve University, Cleveland, Ohio.
2 King's College London, Regeneration Group, The Wolfson Centre for Age-Related Diseases, Guy's Campus, London Bridge, London, United Kingdom.
J Neurotrauma. 2019 Jun 15;36(12):1985-1999. doi: 10.1089/neu.2018.6186. Epub 2019 Feb 19.
Severe midcervical contusion injury causes profound deficits throughout the respiratory motor system that last from acute to chronic time points post-injury. We use chondroitinase ABC (ChABC) to digest chondroitin sulphate proteoglycans within the extracellular matrix (ECM) surrounding the respiratory system at both acute and chronic time points post-injury to explore whether augmentation of plasticity can recover normal motor function. We demonstrate that, regardless of time post-injury or treatment application, the lesion cavity remains consistent, showing little regeneration or neuroprotection within our model. Through electromyography (EMG) recordings of multiple inspiratory muscles, however, we show that application of the enzyme at chronic time points post-injury initiates the recovery of normal breathing in previously paralyzed respiratory muscles. This reduced the need for compensatory activity throughout the motor system. Application of ChABC at acute time points recovered only modest amounts of respiratory function. To further understand this effect, we assessed the anatomical mechanism of this recovery. Increased EMG activity in previously paralyzed muscles was brought about by activation of spared bulbospinal pathways through the site of injury and/or sprouting of spared serotonergic fibers from the contralateral side of the cord. Accordingly, we demonstrate that alterations to the ECM and augmentation of plasticity at chronic time points post-cervical contusion can cause functional recovery of the respiratory motor system and reveal mechanistic evidence of the pathways that govern this effect.
严重的颈中段挫伤会导致呼吸系统运动系统的严重损伤,这种损伤会持续从损伤后的急性期到慢性期。我们使用软骨素酶 ABC(ChABC)在损伤后的急性和慢性时期,消化呼吸系统周围细胞外基质(ECM)中的软骨素硫酸盐蛋白聚糖,以探索增强可塑性是否可以恢复正常的运动功能。我们的研究表明,无论损伤后的时间或治疗应用如何,病变腔都保持不变,在我们的模型中几乎没有再生或神经保护作用。然而,通过对多个吸气肌进行肌电图(EMG)记录,我们发现,即使在慢性损伤后,该酶的应用也能启动先前瘫痪的呼吸肌恢复正常呼吸功能。这减少了运动系统中代偿活动的需要。ChABC 在急性时间点的应用仅恢复了少量的呼吸功能。为了进一步了解这种影响,我们评估了这种恢复的解剖学机制。通过损伤部位的损伤处保留的延髓脊髓通路上的激活,以及/或来自脊髓对侧的保留的 5-羟色胺能纤维的发芽,使先前瘫痪的肌肉中的 EMG 活性增加。因此,我们证明,在颈段挫伤后的慢性时间点,细胞外基质的改变和可塑性的增强会导致呼吸运动系统的功能恢复,并揭示了支配这种效应的途径的机制证据。