Understanding the neural repair-promoting properties of olfactory ensheathing cells

Understanding the neural repair-promoting properties of olfactory ensheathing cells

YEXNR-11731; No. of pages: 16; 4C: Experimental Neurology xxx (2014) xxx–xxx Contents lists available at ScienceDirect Experimental Neurology journa...

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YEXNR-11731; No. of pages: 16; 4C: Experimental Neurology xxx (2014) xxx–xxx

Contents lists available at ScienceDirect

Experimental Neurology journal homepage: www.elsevier.com/locate/yexnr

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Review

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Kasper C.D. Roet a,⁎, Joost Verhaagen a,b,⁎⁎ a

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Article history: Received 19 March 2014 Revised 2 May 2014 Accepted 6 May 2014 Available online xxxx

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Keywords: Olfactory ensheathing Clinical Transplantation Neural repair Molecular mechanisms Axon regeneration Tissue repair Screen Bioinformatics Functional genomics

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Olfactory ensheathing glial cells (OECs) are a specialized type of glia that form a continuously aligned cellular pathway that actively supports unprecedented regeneration of primary olfactory axons from the periphery into the central nervous system. Implantation of OECs stimulates neural repair in experimental models of spinal cord, brain and peripheral nerve injury and delays disease progression in animal models for neurodegenerative diseases like amyotrophic lateral sclerosis. OECs implanted in the injured spinal cord display a plethora of pro-regenerative effects; they promote axonal regeneration, reorganize the glial scar, remyelinate axons, stimulate blood vessel formation, have phagocytic properties and modulate the immune response. Recently genome wide transcriptional profiling and proteomics analysis combined with classical or larger scale “medium-throughput” bioassays have provided novel insights into the molecular mechanism that endow OECs with their pro-regenerative properties. Here we review these studies and show that the gaps that existed in our understanding of the molecular basis of the reparative properties of OECs are narrowing. OECs express functionally connected sets of genes that can be linked to at least 10 distinct processes directly relevant to neural repair. The data indicate that OECs exhibit a range of synergistic cellular activities, including active and passive stimulation of axon regeneration (by secretion of growth factors, axon guidance molecules and basement membrane components) and critical aspects of tissue repair (by structural remodeling and support, modulation of the immune system, enhancement of neurotrophic and antigenic stimuli and by metabolizing toxic macromolecules). Future experimentation will have to further explore the newly acquired knowledge to enhance the therapeutic potential of OECs. © 2014 Published by Elsevier Inc.

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Contents

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Historical perspective on OEC: from discovery to therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The discovery of olfactory ensheathing cells . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Abbreviations: ADAMTS1, ADAM metallopeptidase with thrombospondin type 1 motif, 1; ATP, adenosine triphosphate; APP, amyloid beta precursor protein; ANGPT2, angiopoietin 2; Ara-C, arabinosylcytosine; GBA, beta-glucocerebrosidase; BDNF, brain derived neurotrophic factor; L1CAM, cell adhesion molecule L1; CNTFRalpha, ciliary neurotrophic factor receptor; CNTF, ciliary neurotrophic growth factor; COX-2, cyclo-oxygenase-2; CYR61, cysteine-rich, angiogenic inducer; ENTPD2, ectonucleoside triphosphate diphosphohydrolase 2; ESM1, endothelial cell-specific molecule 1; EGFR, epidermal growth factor; FGF2, fibroblast growth factor 2; CX3CL1, fractalkine; FZD1, frizzled class receptor 1; GAL-C, galactosylceramidase; GFRA1, glial cell line derived neurotrophic factor family receptor alpha 1; GFAP, glial fibrillary acidic protein; GDNF, glial-derived neurotrophic factor; GRO, growth-regulated oncogene; IL6, interleukin-6; LEPRE1, leprecan; LIPR, leukemia inhibitory factor receptor; LPL, lipoprotein lipase; P75/NGFR, low affinity nerve growth factor receptor; MBP, myelin basic protein; MMP2, matrix metalloproteinase 2; MSLN, mesothelin; MAP, microtubule-associated protein; CDH2, N-cadherin; NGF, nerve growth factor; NEFL, neurofilament, light polypeptide; NCAM1, neuronal cell adhesion molecule 1; NRP1, neuropilin 1; NT4/5, neurotrophin 4/5; NID2, nidogen 2; NFKB, nuclear factor KappaB; SERPINE1, plasminogen activator inhibitor-1; ON, olfactory nerve; ONF, olfactory nerve fibroblast; PAMP, pathogen-associated molecular pattern; PAR1, proteinase-activated receptor-1; P2X, purinergic receptor P2X, ligand-gated ion channel; P2Y, purinergic receptor P2Y, G-protein coupled; RHOA, ras homolog family member A; RARA, retinoic acid receptor, alpha; ROCK, Rho-associated protein kinase; RND1, Rho family GTPase 1; S100, S100 calcium binding protein; SCARB2, scavenger receptor class B, member 2; SPARC, secreted protein acidic rich in cysteine; SEMA, semaphorin; SMAD7, SMAD family member 7; THBD, thrombomodulin; TIMP2, TIMP metallopeptidase inhibitor 2; PLAT/tPA, tissue-type plasminogen activator; TGF, transforming growth factor; TNF, tumor necrosis factor alpha; TNFRSF1A, tumor necrosis factor receptor superfamily, member 1A; TH, tyrosine hydroxylase; VEGF, vascular endothelial growth factor; VAV1, vav 1 guanine nucleotide exchange factor. ⁎ Correspondence to: K.C.D. Roet, Boston Children's Hospital, F.M. Kirby Neurobiology Center, Center for Life Sciences, 3 Blackfan Circle, Boston, MA 02115, USA. ⁎⁎ Correspondence to: J. Verhaagen, Department of Neuroregeneration, Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Meibergdreef 47, 1105BA Amsterdam, The Netherlands. E-mail addresses: [email protected] (K.C.D. Roet), [email protected] (J. Verhaagen).

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Department of Neuroregeneration, Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Meibergdreef 47, 1105BA Amsterdam, The Netherlands b Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Neuroscience Campus Amsterdam, VU University, Boelelaan 1085, Amsterdam 1081HV, The Netherlands

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Understanding the neural repair-promoting properties of olfactory ensheathing cells

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http://dx.doi.org/10.1016/j.expneurol.2014.05.007 0014-4886/© 2014 Published by Elsevier Inc.

Please cite this article as: Roet, K.C.D., Verhaagen, J., Understanding the neural repair-promoting properties of olfactory ensheathing cells, Exp. Neurol. (2014), http://dx.doi.org/10.1016/j.expneurol.2014.05.007

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Introduction

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Historical perspective on OEC: from discovery to therapy

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The discovery of olfactory ensheathing cells The profound regenerative capacity of the mammalian primary olfactory system is unique. After damage to the neurons in the olfactory neuroepithelium or to the primary olfactory nerve fibers that form the olfactory nerve new primary olfactory neurons are generated from basal cells in the olfactory epithelium (Graziadei and Graziadei, 1979). The axons of these newly formed neurons grow through the lamina propria into the olfactory nerve layer (ONL) of the olfactory bulb and make new synaptic contacts in the glomeruli on dendrites of mitral, tufted and juxtaglomerular cells (Costanzo, 1985; Doucette et al., 1983; Farbman, 1992; Harding et al., 1977). When nerves from the periphery enter the central nervous system, the PNS–CNS transition zone is normally marked by astrocytes that form the glia limitans (Doucette, 1991). In 1991 it was discovered that the olfactory nerve differs from other nerves that enter the CNS in that this transition zone contains a specialized type of glial cell, the olfactory ensheathing glial cell (OEC) which originate from the neural crest (Barraud et al., 2010; Doucette, 1991). After a lesion, OECs guide the olfactory axons of the newly formed olfactory neurons through the lamina propria towards the ONL and into the glomeruli where they reinnervate their target cells (Doucette, 1990, 1991; Raisman, 1985). Thus OECs form a continuously aligned cellular substrate or pathway that actively supports regeneration of primary olfactory axons from the periphery into the CNS (Li et al., 2005b, 2012). In this review we will refer to OECs derived from the ONL of the olfactory bulb as OB-OECs and OECs derived from the lamina propria as LP-OECs when appropriate. Although these two cell types have many properties in common, some important cellular and molecular differences have been noted (Table 1). If we use the abbreviation OEC the text refers to both subtypes of OECs.

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(Ramon-Cueto and Nieto-Sampedro, 1994). In the following years, a large number of studies demonstrated that OB-OEC and LP-OEC implants do promote axonal regeneration after various spinal cord lesions (Franssen et al., 2007; Li et al., 1997; Raisman, 2007; Ramon-Cueto, 2011; Ramon-Cueto et al., 2000; Richter and Roskams, 2008; Ruitenberg and Vukovic, 2008; Tetzlaff et al., 2011; Toft et al., 2013), including a chronic spinal cord lesion (Munoz-Quiles et al., 2009). Implanted OECs not only promote axonal regeneration in the lesioned spinal cord and brain, but these cells also promote functional reconnection of injured axons (Takeoka et al., 2011; Ziegler et al., 2011) remyelinate axons, stimulate blood vessel formation, reorganize the glial scar, have phagocytic properties and modulate the immune response (Barbour et al., 2013; Franklin et al., 1996; Imaizumi et al., 2000a; Li et al., 1997, 2005b, 2012; Plant et al., 2011; Raisman et al., 2012; Ramer et al., 2004; Ramon-Cueto et al., 1998; Roet et al., 2011; Smale et al., 1996; Wewetzer et al., 2005).

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OECs also have beneficial effects in other nervous system injuries or diseases In the last decade, an increasing number of studies have reported improved functional recovery and/or fiber tract regeneration following implantation of OECs in a variety of animal models for neurodegenerative diseases and non-spinal cord pathologies, including amyotrophic lateral sclerosis (ALS), Parkinson's disease and stroke. Here we briefly highlight some of these findings. Firstly, adult OB-OECs improved functional recovery in rodent models for Parkinson's disease when cotransplanted with dopaminergic cells (Agrawal et al., 2004; Johansson et al., 2005; Shukla et al., 2009). Secondly, postnatal OB-OECs promoted survival of rats in a rat model for ALS through neuroprotection and remyelination (Li et al., 2011, 2013). Thirdly, adult OB-OECs enhanced recovery of learning and memory in a rat model for cognitive dysfunction (Srivastava et al., 2009). In this study OECs were implanted with neural progenitor cells in the lesioned hippocampus where they apparently provided neurotrophic support. Fourthly, human derived LP-OECs mixed with olfactory fibroblasts promoted neural plasticity and decreased neurological deficits in murine models for stroke (Shyu et al., 2008). Moreover, postnatal OB-OECs increased myelination and reduced infarct size in a rat model for stroke (Shi et al., 2010; Shyu et al., 2008). Finally, both LP- and OB-OECs improved functional laryngeal reinnervation (de Corgnol et al., 2011; Paviot et al., 2011) and OB-OECs stimulated regeneration of adult rat optic nerve and sciatic nerve axons after a lesion (Guerout et al., 2011; Li et al., 2003; You et al., 2011). Taken together, following transplantation in various peripheral

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Implantation of OECs in spinal cord lesion paradigms . . . . . . . . . . . . OECs also have beneficial effects in other nervous system injuries or diseases . The first clinical studies show that implantation of OECs is safe . . . . . . . . Challenges for successful OEC based therapeutic strategies . . . . . . . . . . The neural repair promoting properties of OECs . . . . . . . . . . . . . . . . . . . . Classical molecular and cellular characterization of OECs . . . . . . . . . . . . . . Microarray and large scale proteomic studies . . . . . . . . . . . . . . . . . . . Bioinformatics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . High throughput and high-content cellular screening . . . . . . . . . . . . . . . Lipid presentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . Balanced ligand and receptor expression to regulate axon growth and guidance Modulation of the extracellular matrix . . . . . . . . . . . . . . . . . . . Formation of a structural cellular pathway . . . . . . . . . . . . . . . . . Stimulation of angiogenesis . . . . . . . . . . . . . . . . . . . . . . . . Amelioration of the immune system . . . . . . . . . . . . . . . . . . . . ATP hydrolysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Loss of function versus gain of function cellular screening . . . . . . . . . . . . . . Animal studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . From bioassay to in vivo study: a big step with many uncertainties . . . . . . . . . Perspective on OEC research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Implantation of OECs in spinal cord lesion paradigms The unique anatomical position and function of OECs in the primary olfactory system prompted Ramon-Cueto and Nieto-Sampedro in 1994 to purify these cells and to examine their regenerative properties as cell implants after rhizotomy of the dorsal root in rats. Implanted OECs, derived from the adult olfactory bulb (OB-OECs), stimulated regeneration of injured dorsal root ganglion axons into the spinal cord in all eight experimental animals, while in contrast, no axonal growth beyond the lesion was found in the spinal cords of any of the control animals

Please cite this article as: Roet, K.C.D., Verhaagen, J., Understanding the neural repair-promoting properties of olfactory ensheathing cells, Exp. Neurol. (2014), http://dx.doi.org/10.1016/j.expneurol.2014.05.007

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Challenges for successful OEC based therapeutic strategies As discussed above, an impressive number of studies have reported enhanced neural repair after implantation of OECs in a variety of animal models for nervous system pathologies. However, approximately 20% of the studies investigating OECs in spinal cord lesion paradigms reported minimal or no beneficial effects (Franssen et al., 2007). Since investigators tend to not publish negative results this may be an underestimation of studies that failed to show efficacy. The reported discrepancies can partially be explained by differences in the timing of OEC implantation and the type of lesion used. However, two other factors are probably of critical importance. First, a number of studies that investigated the survival of OECs implanted in the contused rat spinal cord, using fluorescent labels or a Y-chromosome specific probe, reported very low survival rates, which varied from approximately 1 to 3% (Barakat et al., 2005; Li et al., 2010b; Pearse et al., 2007). These disappointing

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Classical molecular and cellular characterization of OECs

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Since the discovery of OECs, researchers have searched for the molecules that govern their pro-regenerative properties. In culture, OECs appear to switch to an axon growth promoting state and this process is dependent on external cues. Cultured adult OB-OECs express P75/ NGFR (Ramon-Cueto et al., 1993) and this receptor is also induced in OECs in the ONL after deafferentation of the OB (Turner and PerezPolo, 1993). Interestingly, olfactory neurites also express P75/NGFR and grow preferentially on P75/NGFR positive OECs. When the axons are ensheathed by OECs, P75/NGFR expression in both the axons and the OECs becomes undetectable. Laminin is abundantly present in the olfactory pathway (Doucette, 1996; Tisay and Key, 1999). Laminin also regulates spreading and migration of postnatal LP-OECs in culture and increases their neurite outgrowth promoting capacity (Tisay and Key, 1999). Postnatal OB-OECs express CNTF and its α-receptor subunit (Wewetzer et al., 2001). Interestingly, the expression of these molecules can be regulated by treatment with forskolin which is known to increase intracellular cAMP levels and can also induce expression of GFAP (Doucette and Devon, 1995; Wewetzer et al., 2001). Classical immunochemistry, in situ hybridization, biochemical analysis and quantitative PCR, revealed that OECs express a wide variety of signaling molecules that are involved in neural repair. These include neurotrophic factors such as NGF, BDNF, NT4/5, and GDNF (Boruch et al., 2001; Lipson et al., 2003; Woodhall et al., 2001) and several growth factor receptors (Wewetzer et al., 2001; Woodhall et al., 2001), as well as axon growth-promoting cell adhesion and extracellular matrix molecules, including CDH2, NCAM1 and L1CAM (Doucette,

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The first clinical studies show that implantation of OECs is safe The promising results obtained with implantation of OECs in animal models for spinal cord lesions or neurodegenerative diseases have stimulated researchers to investigate the therapeutic potential of OECs in human pathologies. In Australia, a phase I/IIa clinical study was initiated to examine the effects of implantation of human OECs for treatment of chronic spinal cord injury (Feron et al., 2005; Mackay-Sim et al., 2008). Three male paraplegic patients with complete thoracic injuries received autologous implantation of OECs that were isolated and purified from nasal biopsies. A control group was included that did not receive surgery. After three years, no adverse effects were detected. However, there were also no significant functional improvements. Another trial with LP-OECs in Poland, including six patients suffering from chronic thoracic paraplegia, showed no adverse effects of both the mucosa biopsy and the transplantation of the LP-OECs after one year (Tabakow et al., 2013). In this trial the 3 patients receiving OEC transplants did show functional improvements with two patients improving from American Spinal Injury Association class A (ASIA-A) to ASIA-B and ASIA-C. The third patient remained in ASIA-A, but showed improved motor and sensory function in the spinal cord below the injury. No improvements were observed in the control group. To assess the importance of these promising observations a larger group size is required. Safety and possible efficacy were also shown in six patients with complete chronic spinal cord injuries in China which received fetal OB-OEC transplants (Rao et al., 2013). A Spanish group has investigated the therapeutic potential of implantation of LP-OECs or autologous mesenchymal stromal cells in patients suffering from amyotrophic lateral sclerosis (Gamez et al., 2010). They concluded that although no significant side effects were found, progression of the disease was not altered. It should be noted that three of these four studies were conducted with LP-OECs and one with fetal OB-OECs. At this moment, the safety and efficacy of adult OB-OECs have not yet been adequately tested in patients. In China, fetal OB-OECs were implanted in hundreds of patients suffering from chronic spinal cord injuries or neurodegenerative diseases including amyotrophic lateral sclerosis, cerebral palsy and multiple sclerosis (Huang et al., 2009). Although beneficial effects were claimed, in most cases/studies, no proper control group was included and there was only minimal follow-up of the patients. This complicates the interpretation of the results. Other studies that examined the neuropathology or disease progression in a relatively small number of ALS patients that received fetal OEC implantations in China report no beneficial effects (Giordana et al., 2010; Piepers and van den Berg, 2010). Overall, implantation of LP-OECs and fetal OB-OECs in humans appears to be safe and well-tolerated and promising results have been obtained. However, future clinical trials with adequate group sizes have yet to show beneficial effects of OEC implants in patients with spinal cord injury or ALS.

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survival rates have recently been corroborated using non-invasive longitudinal bioluminescence imaging of adult OB-OECs transplanted in a spinal hemisection lesion (Roet et al., 2012). This indicates that OECs mainly exert beneficial effects during a relatively short postlesion period and only a relatively small number of cells continue to promote neural repair over an extended period of time. Secondly, OECs can have different pro-regenerative molecular profiles that have distinct effects on neural repair. These molecular profiles have been shown to depend on the OB-OEC donor species (Wewetzer et al., 2011), the OEC subtype (olfactory mucosa versus olfactory bulb) (Guerout et al., 2010) and OB-OEC purification methods (Novikova et al., 2011). To maximize neural repair, it is therefore necessary to select or genetically engineer OECs with a molecular profile that is most favorable for repair. For example, the gene expression profile of OB-OECs shows a predominant activation of genes involved in nervous system development whereas the genes that are activated in LP-OECs appear to be more involved in wound healing processes (Guerout et al., 2010). After implantation in the crushed dorsolateral funiculus of the rat spinal cord both postnatal OEC subtypes promote angiogenesis, endogenous Schwann cell infiltration, and axonal sprouting (Richter et al., 2005). However, implantation of LP-OECs results in increased growth of TH positive axons and a significant increase in autotomy while OB-OECs increase growth of substance-P positive axons (Richter et al., 2005). A study that compared implantation of OB-OECs versus LP-OECs in the lesioned rat vagus nerve reported only functional recovery after implantation of OB-OECs (Paviot et al., 2011) and only OB-OECs and not LP-OECs enabled axon regeneration and restoration of forepaw grasping in a rat rhizotomy paradigm (Ibrahim et al., 2013). It has been reported that in contrast to OB-OECs, LP-OECs require sufficient levels of purification before implantation to stimulate neural repair (Mayeur et al., 2013). Taken together, in our view the future success of OEC-based therapies for treatment of nervous system pathologies will depend on a much more profound understanding of the molecular machinery that determines their survival and pro-regenerative properties in the primary olfactory system and following transplantation in the CNS.

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Please cite this article as: Roet, K.C.D., Verhaagen, J., Understanding the neural repair-promoting properties of olfactory ensheathing cells, Exp. Neurol. (2014), http://dx.doi.org/10.1016/j.expneurol.2014.05.007

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Table 1 The literature references that are discussed in the current article and that describe studies on OECs. If clearly indicated in the specific reference, the following is presented: the subtype of OECs that is studied, the type and age of the OEC donor species, the OEC purification method and the main finding for each reference. Reference

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Main findingsa

Agrawal et al. (2004)

OB-OEC

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Au et al. (2007)

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Anti-Thy 1.1-mediated lysis

Babiarz et al. (2011)

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P75 immunopanning

Barakat et al. (2005)

OB-OEC

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Adult

P75 immunopanning

Barbour et al. (2013)

OB-OEC

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Adult

P75 immunoaffinity

Barraud et al. (2010) Boruch et al. (2001)

N/A nOEC (homogeneous clonal cell line)

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Devon and Doucette (1992)

OB-OEC

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Embryonic

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Doucette and Devon (1995)

OB-OEC

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Embryonic

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Doucette (1990) Doucette (1991)

OB-OEC N/A

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Adult

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Doucette (1996)

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Adult

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Fairless et al. (2005)

OB-OEC

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Postnatal

Field et al. (2003)

LP-OEC

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Adult

Franklin et al. (1996)

OB-OEC cell line

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Postnatal

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Franklin et al. (1996)

OB-OEC

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Postnatal

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Franssen et al. (2008)

OB-OEC

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Adult

P75 immunopanning

Franssen et al. (2009)

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Co-transplantation of OB-OECs with ventral mesencephalic cells restores functional deficits in rat model of Parkinson's disease SPARC from LP-OECs stimulates Schwann cells to promote neurite outgrowth and enhances spinal cord repair. Juvenile and adult OB-OECs bundle and myelinate dorsal root ganglion axons in culture. 2.3 +/− 1.4% Of the transplanted OB-OEC survived after 3 months. OB-OEC treated rats showed significant numbers of raphe projecting axons reaching at least 8 mm distal from the injury site OECs originate from the neural crest. nOECs express mRNA for NGF, BDNF, NT-4/5, and neuregulins, but not for NT-3 or CNTF. In addition, nOECs secrete NGF, BDNF, and neuregulin, but retain NT-4/5 intracellularly. LP-OECs improve functional laryngeal reinnervation in a rat model of nonselective vagus nerve section and anastomosis OB-OECs myelinate dorsal root ganglion neurites in vitro. Elevated intracellular levels of cAMP induce OECs to express GAL-C and GFAP but not MBP. OECs express L1/Ng-CAM and NCAM. The olfactory bulb contains a specialized type of glial cell, the OB-OEC. Laminin, fibronectin and collagen type IV are expressed in the lesioned adult ON layer. N-cadherin differentially determines Schwann cell and OEC adhesion and migration responses upon contact with astrocytes. LP-OECs have a rounded outer surface enclosed in a continuous single basal lamina, overlapping processes enwrap interweaving territories of tightly apposed aligned axons. Schwann cell-like myelination following transplantation of an OB-OEC cell line into areas of demyelination in the adult CNS. OB-OECs are able to produce peripheral-type myelin sheaths around axons of the appropriate diameter Gene expression profiling of OB-OECs and Schwann cells indicates distinct tissue repair chAra-Cteristics of OB-OECs. OB-OECs do intermingle with meningeal fibroblasts while Schwann cells do not. No significant adverse events or changes in the decline compared with the disease' s natural history were observed Neuropathologic analysis does not support a beneficial effect of fetal OEC implantation into the frontal lobes of ALS patients OB-OECs and LP-OECs fundamentally differ in their gene expression pattern. P75 high OB-OECs overexpress genes implicated in modulation of extracellular matrix and cell sorting, whereas P75Low OB-OECs overexpress genes involved in the inflammatory response and axonal guidance. OECs transplantation into brain and spinal cord is feasible and safe. RhoA–ROCK–myosin pathway regulates morphological plasticity of cultured OB-OECs. OB-OECs and not LP-OECs enabled axon regeneration and restoration of forepaw grasping, a difference most probably caused by differences in OEC yields (50% versus 5%) Transplanted OB-OECs remyelinate and enhance axonal conduction in the demyelinated dorsal columns of the rat spinal cord.

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t1:12

C

E

t1:19

t1:21

C

t1:23

t1:24

Honore et al. (2012)

OB-OEC/LP-OEC

U

Guerout et al. (2010) t1:26

N

Giordana et al. (2010) t1:25

O

t1:22

OB-OEC

R

t1:20

Rat

O4-positive galactocerebrosidenegative (FACS)

T

t1:17

t1:18

D

E

t1:16

P

t1:13 t1:14 t1:15

F

t1:8

N/A

P75 immunoaffinity (beads) Differential cell adhesion/FACS (P75 low and P75 high)

t1:27

Huang et al. (2009)

Human

Fetal Adult

Differential cell adhesion

Postnatal

None

t1:28

Huang et al. (2011)

OB-OEC

Rat

Ibrahim et al. (2013)

OB-OEC/LP-OEC

Rat

Imaizumi et al. (1998)

OB-OEC

Rat

t1:29

t1:30

t1:31

Please cite this article as: Roet, K.C.D., Verhaagen, J., Understanding the neural repair-promoting properties of olfactory ensheathing cells, Exp. Neurol. (2014), http://dx.doi.org/10.1016/j.expneurol.2014.05.007

K.C.D. Roet, J. Verhaagen / Experimental Neurology xxx (2014) xxx–xxx

5

Table 1 (continued) Age of donor species

Main findingsa

Reference

OEC subtype

Donor species

Purification method

Imaizumi et al. (2000a)

OB-OEC

Pig

Imaizumi et al. (2000b)

OB-OEC

Pig

Johansson et al. (2005)

OB-OEC

Rat

Adult

Differential cell adhesion

Lakatos et al. (2000)

OB-OEC

Rat

Postnatal

Lakatos et al. (2003)

OB-OEC

Rat

Postnatal

O4-positive galactocerebrosidenegative (FACS) O4-positive galactocerebrosidenegative (FACS)

Lamond and Barnett (2013)

OB-OEC

Rat

Postnatal

P75 immunoaffinity

Leaver et al. (2006)

OB-OEC

Rat

Adult

P75 immunoaffinity

Leung et al. (2008)

LP-OEC + OB-OEC

Rat

Postnatal

Ara-C

Li et al. (1997)

OB-OEC

Rat

Adult

None

Li et al. (2003)

mix of OB-OEC and ONF OEC surrounding the olfactory nerves

Rat

Adult

None

Rat

Adult

N/A

t1:33

None

t1:34

t1:36

O

t1:35

t1:40

t1:42

Li et al. (2005b)

D

t1:41

t1:43

Li et al. (2010b) b

P

t1:39

R O

t1:37

t1:38

t1:44

E

Rat

OB-OEC

Rat

Postnatal

Li et al. (2013)

OB-OEC

Rat

Postnatal

Stimulation with NT-3

Lipson et al. (2003)

OB-OEC

Rat

Adult

N80% P75/S100beta positive

Liu et al. (2010)

OB-OEC

Rat

Postnatal

Ara-C + differential cell adhesion

Lopez-Vales et al. (2004)

OB-OEC

Rat

Adult

P75 immunoaffinity (beads)

LP-OEC

Human

Adult

Stimulation with NT-3

OB-OEC/LP-OEC

Rat

Postnatal

Differential cell adhesion (OB-OEC)/stimulation with TGFalpha (LP-OEC)

Rat

Postnatal

N90% P75 positive (OB-OEC)

Munoz-Quiles et al. (2009)

OB-OEC/immortalized OB-OEC OB-OEC

Rat

Adult

P75 immunopanning

Nan et al. (2001)

LP-OEC

Mouse

Adult

N/A

Novikova et al. (2011)

OB-OEC

Rat

Adult

Differential cell adhesion/P75 immunoaffinity (beads)

Pastrana et al. (2006)

OB-OEC/TEG3 (immortalized)

Rat

Postnatal

None

T

Li et al. (2011)

C

t1:45

t1:49

Mackay-Sim et al. (2008) t1:50

U

Mayeur et al. (2013)

t1:51

Moreno-Flores et al. (2003) t1:52

R

N C O

t1:48

R

t1:47

E

t1:46

Stimulation with NT-3

t1:53 t1:54

t1:55

t1:56

Xenotransplantation of transgenic pig OB-OECs promotes axonal regeneration in rat spinal cord. Xenotransplantation of myelin-forming OB-OECs from pigs genetically altered to reduce the hyperacute response in humans are able to induce elongative axonal regeneration and remyelination Co-transplantation of OB-OECs with dopamineneuron-rich ventral mesencephalic tissue improves functional recovery in rats with 6-OHDA lesions OB-OECs will migrate into an area containing astrocytes while Schwann cells do not. OB-OECs induce less host astrocyte response and chondroitin sulfate proteoglycan expression than Schwann cells following transplantation into adult CNS white matter. Schwann cells but not OB-OECs inhibit CNS myelination via the secretion of connective tissue growth factor. OB-OECs promote the long-distance growth of adult retinal ganglion cell neurites in vitro. OECs are attracted to, and can endocytose, bacteria Transplantation of OB-OECs enhances repair of adult rat corticospinal tract Transplanted OB-OECs and ONFs promote regeneration of cut adult rat optic nerve axons. OECs and ONFs maintain continuous open channels for regrowth of olfactory nerve fibers and OECs phagocyte axonal debris b1% of implanted OECs survived and this number is related to the motor function recovery of the contused cord. Transplantation of OB-OECs into spinal cord prolongs the survival of mutant SOD1(G93A) ALS rats through neuroprotection and remyelination. Intracranial OB-OEC transplant protects both upper and lower motor neurons in amyotrophic lateral sclerosis. OB-OECs express NGF, BDNF, GDNF, and CNTF mRNA, while NT3 and NT4 mRNA were not detectable. The identification of four hundred and seventy nonredundant plasma membrane proteins and 168 extracellular matrix proteins in OB-OECs. OB-OECs promote functional and morphological preservation of the spinal cord after photochemical injury and increase neoangiogenesis and up-regulation of COX-2 and VEGF expression in astrocytes. Transplantation of autologous LP-OECs into the injured spinal cord is feasible and is safe up to 3 years of post-implantation. OB-OECs and LP-OECs induce electrophysiological and functional recovery, reduce astrocyte reactivity and glial scar formation and improve axonal regrowth. However, LP-OEC transplants require purification. High level of APP expression in neuritepromoting OB-OECs and immortalized OECs. Rats with complete spinal cord injury that were transplanted with OB-OECs 4 months after injury exhibited progressive improvement in motor function and axonal regeneration. LIFR, IL-6, and IL-6R are upregulated in LP-OECs 3 days after bulbectomy. The age of OB-OECs in culture and the method of cell purification could affect the efficacy of OB-OECs to support neuronal survival and regeneration after spinal cord injury. Genes associated with adult axon regeneration promoted by OECs: a new role for matrix metalloproteinase 2.

F

t1:32

(continued on next page)

Please cite this article as: Roet, K.C.D., Verhaagen, J., Understanding the neural repair-promoting properties of olfactory ensheathing cells, Exp. Neurol. (2014), http://dx.doi.org/10.1016/j.expneurol.2014.05.007

6

K.C.D. Roet, J. Verhaagen / Experimental Neurology xxx (2014) xxx–xxx

Table 1 (continued) Reference

OEC subtype

Donor species

Age of donor species

Paviot et al. (2011)

LP- and OB-OEC

Rat

Pearse et al. (2007)

OB-OEC

Rat

Adult

Human

Fetal

Purification method

Main findingsa

None

Efficiency of laryngeal motor nerve repair is greater with OB-OECs than with LP-OECs Transplantation of Schwann cells and/or OB-OECs into the contused spinal cord: Survival, migration, axon association, and functional recovery. No indications that implantation of OECs is beneficial for treatment of ALS. Purified OB-OECs fail to myelinate dorsal root ganglion axons. Remyelination of the nonhuman primate spinal cord by transplantation of H-transferase transgenic adult pig OB-OECs. LP-OECs reduce scar and cavity formation, promote angiogenesis and promote regeneration after spinal cord injury. Immunocytochemical properties of pure OB-OEC cultures. OB-OEC transplants promote regeneration of transected dorsal root axons into the spinal cord. In vitro enfolding of olfactory neurites by p75 NGF receptor positive OB-OECs. OB-OECs promote long-distance axonal regeneration in the transected adult rat spinal cord. OB-OEC transplants enhance functional recovery of paraplegic rats and motor axon regeneration in their spinal cords. OEC transplantation in spinal cord injury appears clinically safe after 24 months. LP-OECs and OB-OECs exhibit differential integration and migration and promote differential axon sprouting in the lesioned spinal cord. Bioluminiscence established to follow OB-OEC cell survival in rats; the bioluminescent signal of OB-OECs was b0.3% after 98 days. A multilevel screening strategy defines a molecular fingerprint of OB-OECs and identifies SCARB2, a protein that improves regenerative sprouting of injured sensory spinal axons. Genetic engineering of OB-OECs can result in more effective axonal outgrowth and can lead to enhanced recovery after injury. CX3CL1/fractalkine regulates branching and migration of monocyte-derived cells in the mouse olfactory epithelium. Mouse OB-OEC enhance axon outgrowth of dorsal root ganglion neurons on a myelin substrate in vitro. FGF/heparin differentially regulates Schwann cell and OB-OEC interactions with astrocytes: a role in astrocytosis. Transplated OB-OECs reduced the infarct volume, decreased mortality, and improved neurological deficits in a focal ischemia model in the rat. Survival and function of neural stem cells-derived dopaminergic neurons is enhanced by cotransplantation of OB-OECs in parkinsonian rats. Implantation of LP-OECs and ONFs promotes neuroplasticity in murine models of stroke. OB-OEC expressed plasminogen activator inhibitor-1 promotes axonal regeneration. Labeled OB-OECs were observed only within the graft after implantation following fimbria-fornix transection and not in the adjacent neural tissue. OB-OECs are effective promoters of retinal ganglion cell neurite outgrowth in coculture. OB-OECs provide neurotrophic support for co-transplanted neural progenitor cells resulting in improved recovery of cognitive dysfunction. Reactive astrocytes in glial scar attract OB-OEC migration by secreted TNF-alpha in spinal cord lesion of rat. Transplantations of autologous LP-OECs were safe, feasible and potentially beneficial.

t1:58

P75 immunopanning

t1:60

Piepers and Van Den Berg (2010) Plant et al. (2002)

OB-OEC

Rat

Adult

P75 immunopanning

Radtke et al. (2004)

OB-OEC

Pig

Postnatal

N98% P75 positive

Ramer et al. (2004)

LP-OEC

Mouse

Postnatal

Anti-Thy 1.1-mediated lysis

Ramon-Cueto and Nieto-Sampedro (1992) Ramon-Cueto and Nieto-Sampedro (1994) Ramon-Cueto et al. (1993)

OB-OEC

Rat

Adult

N/A

OB-OEC

Rat

Adult

P75 immunopanning

OB-OEC

Rat

Adult

N/A

Ramon-Cueto et al. (1998)

OB-OEC

Rat

Adult

P75 immunopanning

Ramon-Cueto et al. (2000)

OB-OEC

Rat

Adult

P75 immunopanning

Rao et al. (2013)

OB-OEC

Human

Fetal

None

Richter et al. (2005)

OB-OEC/LP-OEC

Rat

Postnatal

Anti-Thy 1.1-mediated lysis (LP-OEC)/P75 immunopanning (OB-OEC)

Roet et al. (2012)

OB-OEC

Rat

Adult

Roet et al. (2013)

OB-OEC

Rat

Adult

Ruitenberg et al. (2003)

OB-OEC

Rat

Adult

P75 immunopanning

Ruitenberg et al. (2008)

LP-OEC

Mouse

Adult

N/A

Runyan and Phelps (2009)

OB-OEC

Mouse

Adult

P75 Immunopanning

Santos-Silva et al. (2007)

OB-OEC

Rat

Postnatal

O4-positive galactocerebrosidenegative (FACS)

Shi et al. (2010)

OB-OEC

Rat

Postnatal

Stimulation with NT-3

N

t1:59

Rat

Adult

Differential cell adhesion

Human

Adult

None

Human

Young/adult

N99% S100beta + GFAP positive

Smale et al. (1996)

mix of LP-OEC and ONF OB-OEC (immortalized) OB-OEC

Rat

Fetal

Sonigra et al. (1999)

OB-OEC

Rat

Adult

None

Srivastava et al. (2009)

OB-OEC

Rat

Adult

None

Su et al. (2009)

OB-OEC

Rat

Adult

N95% S100beta positive

Tabakow et al. (2013)

LP-OEC

Human

Adult

None

t1:61

t1:62

t1:65 t1:66

P

t1:67

R O

t1:64

O

t1:63

t1:68

D

t1:69

R

t1:73

t1:77

Shukla et al. (2009)

OB-OEC

Shyu et al. (2008) Simon et al. (2011) t1:80

U

t1:78 t1:79

R

C

t1:76

O

t1:75

T

E

t1:72

t1:74

P75 immunopanning

C

t1:71

E

t1:70

P75 immunopanning

t1:81 t1:82

t1:83

t1:84 t1:85

F

t1:57

Please cite this article as: Roet, K.C.D., Verhaagen, J., Understanding the neural repair-promoting properties of olfactory ensheathing cells, Exp. Neurol. (2014), http://dx.doi.org/10.1016/j.expneurol.2014.05.007

K.C.D. Roet, J. Verhaagen / Experimental Neurology xxx (2014) xxx–xxx

7

Table 1 (continued) t1:86

Reference

OEC subtype

Donor species

Age of donor species

Purification method

Main findingsa

Takeoka et al. (2011)

OB-OEC

Rat

Adult

P75 immunopanning

Tisay and Key (1999)

LP-OEC

Rat

Postnatal

None

Toft et al. (2013)

OB-OEC

Rat

Postnatal

P75 FACS sorting

Turner and Perez-Polo (1993)

N/A

Rat

Adult

N/A

Vincent et al. (2005)

LP-OEC + OB-OEC

Rat

Postnatal

Ara-C

Vincent et al. (2007)

LP-OEC + OB-OEC

Rat

Postnatal

Ara-C

Wang et al. (2008)

OB-OEC

Mouse

Postnatal

N/A

Wewetzer et al. (2001)

OB-OEC

Rat

Postnatal

N95% P75 positive

Wewetzer et al. (2005)

OB-OEC

Rat

Postnatal

O4 and p75 immunoaffinity

Wewetzer et al. (2011)

OB-OEC

Dog

Adult

P75 immunoaffinity (beads)

Windus et al. (2007)

LP-OEC

Mouse

Postnatal

S100beta labeling

Windus et al. (2011)

LP-OEC

Mouse

Witheford et al. (2013)

LP-OEC

Rat

Postnatal

Axon regeneration can facilitate or suppress hindlimb function after OB-OEC transplantation. Laminin and matrigel enhanced the spreading and migration of olfactory ensheathing cells and increased their neurite outgrowth-promoting activity. OB-OECs promoted greater axonal regeneration than OB-derived fibroblasts. Peripheral lesioning dramatically reduced expression of glomerular p75NGFR while inducing expression of p75NGFR in the ON layer. Genetic expression profile of OECs is distinct from that of Schwann cells and astrocytes. Bacteria and PAMPs activate nuclear factor kappaB and Gro production in a subset of OECs and astrocytes but not in Schwann cells. A specialized subgroup of OB-OECs activate the Wnt/beta-catenin signaling reporter in the developing mouse olfactory nerve layer. OB-OECs express CNTF and its alpha receptor subunit. Phagocytosis of O4+ axonal fragments in vitro by p75 negative OB-OECs. CNPase is a novel marker for in situ detection of canine but not rat OECs. Motile membrane protrusions regulate cell–cell adhesion and migration of LP-OECs. Stimulation of LP-OEC motility enhances olfactory axon growth. LP-OECs promote corticospinal axonal outgrowth by a L1-CAM-dependent mechanism.

Woodhall et al. (2001)

OB-OEC

Rat

Postnatal

Wu et al. (2011a)

LP-OEC

Rat

Adult

You et al. (2011)

OB-OEC

Rat

Postnatal

t1:87

t1:88 t1:89

t1:90

F

t1:91

t1:93 t1:94 t1:95

P

t1:96 t1:97

S100beta labeling

D

t1:98

C

t1:101

t1:102

288 289 290 291 292 293 294 295 296 297 298 299 300 301 302 303 304 305 306 307 308 309

N95% P75 positive

OB-OECs express NGF, BDNF, GDNF and their receptors. Delayed OB-OEC transplants reduce nociception after dorsal root injury. OB-OECs enhance Schwann cell-mediated anatomical and functional repair after sciatic nerve injury.

E R

1990; Fairless et al., 2005; Witheford et al., 2013). OECs also express a number of other proteins that can promote axon growth or regeneration such as SERPINE1 (Simon et al., 2011) and cytokines, including IL6 and CX3CL1 (Nan et al., 2001; Ruitenberg et al., 2008). Several of the beneficial effects of OEC implants have been productively studied in vitro. The use of bioassays has provided the opportunity to examine the role of specific molecules and cellular interactions that underlie important aspects of the pro-regenerative functions of OECs, including their axon-growth promoting properties, their interaction with astrocytes, their immuno-modulatory and phagocytic properties and their capacity to myelinate axons. Co-cultures of OB-OECs with neurons have shown that these cells stimulate axon growth in a variety of neurons and that the stimulating effect on axon extension is not restricted to primary olfactory neurons (Leaver et al., 2006; Runyan and Phelps, 2009; Sonigra et al., 1999). OB-OECs intermingle much better with host scar cells than Schwann cells after implantation in the lesioned spinal cord (Pearse et al., 2007). This was studied in co-culture and confrontation assays. Cultured OB-OECs do migrate into an area with astrocytes or intermingle with meningeal fibroblasts while Schwann cells do not (Franssen et al., 2009; Lakatos et al., 2000). This difference between OB-OECs and Schwann cells is at least partly mediated by a differential regulation of N-Cadherin (Fairless et al., 2005). OB-OECs also induce a less severe host astrocyte response after implantation in the spinal cord than Schwann cells (Lakatos et al., 2003). This effect has been reproduced in culture: astrocytes become reactive when they encounter Schwann cells, in contrast astrocytes maintain a more benign phenotype when they encounter OB-OECs (Lakatos et al.,

R

286 287

Adopted from reference titles and abstracts. Article in Chinese.

N C O

284 285

b

U

283

a

T

t1:100

Anti-Thy 1.1-mediated lysis (LP-OEC)/P75 immunopanning (OB-OEC) Bovine pituitary extract enrichment Stimulation with NT-3

E

t1:99

t1:103 t1:104

R O

O

t1:92

2000; Santos-Silva et al., 2007). A molecular analysis provided strong indications that heparan sulfate proteoglycans and members of the fibroblast growth factor family are involved in this differential induction of the astrocyte stress response (Santos-Silva et al., 2007). Important aspects of the phagocytosis and immune function of LP-OECs and OBOECs have also successfully been studied in vitro (Chuah et al., 2011; Leung et al., 2008; Wewetzer et al., 2005). In a mixed population of OB-OECs and LP-OECS, exposed to Escherichia coli or lipopolysaccharide, the inflammatory transcription factor, NFKB, translocates to the nucleus and this leads to a functional activation of the OECs (Vincent et al., 2007). Finally, implanted OB-OECs can remyelinate spinal cord axons (Franklin et al., 1996; Imaizumi et al., 1998, 2000b; Radtke et al., 2004) and can myelinate dorsal root ganglion neurites in vitro (Babiarz et al., 2011; Devon and Doucette, 1992), although this has been disputed (Plant et al., 2002). In contrast to OB-OECs, the higher expression of CTGF in Schwann cells has been shown to inhibit CNS myelination (Lamond and Barnett, 2013).

310

Microarray and large scale proteomic studies

327

Genome wide transcriptional profiling and large scale proteomics combined with gene ontology and molecular pathway analysis have provided novel opportunities to study the molecular composition of OECs. These screening techniques have given us an unbiased and unprecedented insight in the molecular characteristics of OECs. Six genome wide microarray studies (Franssen et al., 2008; Guerout et al., 2010; Honore et al., 2012; Pastrana et al., 2006; Roet et al., 2011,

328 329

Please cite this article as: Roet, K.C.D., Verhaagen, J., Understanding the neural repair-promoting properties of olfactory ensheathing cells, Exp. Neurol. (2014), http://dx.doi.org/10.1016/j.expneurol.2014.05.007

311 312 313 314 315 316 317 318 319 320 321 322 323 324 325 326

330 331 332 333 334

360 361 362 363 364 365

370 371 372 373 374 375 376 377 378 379 380 381 382 383 384 385 386 387 388 389 390 391 392 393 394 395 396 397 398

C

358 359

E

356 357

R

354 355

R

352 353

O

350 Q7 351

C

348 349

N

346 347

U

344 345

High throughput and high-content cellular screening

439

Gene-ontology and pathway analysis tools are essential to uncover patterns in gene expression data sets that point to the presence of interesting functionally linked molecular pathways or networks. However, the number of genes indicated by means of these bioinformatics approaches is usually still far too large to be tested in classical cellular assays and/or labor-intensive preclinical animal models for neural transplantation and repair. Therefore it is of great importance to further define the potentially most important genes for in vivo studies. In recent years, huge advances have been made in the fields of microscopy, robotics and with techniques to interfere with gene function at a large scale. This has resulted in the development of fully integrated and automated cell culture and high throughput automated microscope systems that are combined with sophisticated morphometric analysis software such as the Cellomics KineticScan HCS reader and PerkinElmer's Opera High Content Screening System. This allows gain or loss of function studies on large numbers of genes in cellular bioassays that are tailored to detect effects of a gene on cell survival/death, proliferation, cytoskeletal changes, neurite outgrowth or synapse formation. This so-called “cellomics” approach yields information on sets of target genes that are functionally linked to a biological parameter of interest, for instance neuronal survival or neurite outgrowth. Recent studies have employed “cellomics” to screen genes, initially identified by microarray, for their role in the process of neurite outgrowth (Blackmore, 2012; Blackmore

440 441

F

The microarray and proteomics studies have identified large cohorts of genes that are highly expressed in OECs and that are potentially functionally connected. The functional dissection of these broad molecular signatures poses a significant challenge. The selection of “interesting” genes from microarray datasets, including those prepared of cultured OEC, was initially based on relatively arbitrary criteria because investigators typically tend to select a gene for further study based on what is already known about its function. For instance, MMP2 was selected for functional and immunohistochemical analysis from the genes that were higher expressed in short term cultured OB-OECs rather than long term cultured OECs. Loss and gain of function bioassays revealed the importance of MMP2 for the neurite outgrowth promoting properties of OECs (Pastrana et al., 2006). Based on the same microarray data, this research group later also investigated the role of SERPINE1, PAR1 and THBD as regulators of OB-OEC-dependent axonal regeneration (Simon et al., 2011). SPARC was selected from the proteome analysis of conditioned medium of LP-OECs after 2 and 6 passages based on high expression levels (Au et al., 2007). Functional analysis showed that SPARC expression in LP-OECs is important for axonal regeneration and that it can modulate the activation state of Schwann cells. Although the study of the function of selected molecules has resulted in important new insights into the molecular biology of OECs, it is now essential to move from individual molecules to an understanding of how multiple genes function in the context of molecular pathways, and how these pathways interact in OECs to promote successful regeneration (Geschwind and Konopka, 2009). The Gene Ontology project (GO, http:// www.geneontology.org/) and the Kyoto Encyclopedia for Genes and Genomes (KEGG, http://www.genenome.jp/kegg/) categorize genes into biologically meaningful gene groups based on their functional annotation (Guerout et al., 2010; Liu et al., 2010; Ogata et al., 1999). Genes are grouped in hierarchical classes that fall in one of three main categories:

342 343

O

368 369

341

R O

Bioinformatics

339 340

399 400

P

367

337 338

“biological process”, “cellular component” and “molecular function”. The application of these web-based bioinformatics tools revealed that OB-OECs express significantly more genes involved in tissue repair than Schwann cells (Franssen et al., 2008) and OECs from the ONL express more genes involved in nervous system development than OECs from the olfactory mucosa (Guerout et al., 2010). A limitation of the GO-based analysis of microarray data sets, namely the lack of insight in direct functional interactions of genes or proteins, is at least partially resolved by pathway or molecular network analysis tools, including Ingenuity Pathway Analysis (IPA) and Agilent's GeneSpring. IPA is an interactive database that allows the investigator to identify specific previously identified pathways and to build new pathways based on genes detected in a particular microarray experiments. A meta-analysis on publicly available micro array datasets on early passage OB-OECs revealed highly significant overrepresentation of neurite outgrowth, blood vessel development, migration and immune regulatory associated molecules and their molecular interaction networks as well as a the possible importance of OB-OEC ecto-ATPase activity (Roet et al., 2011). The proteins that have multiple functional connections with other molecules in a pathway or network are usually defined as “Hub” genes. These Hub genes can belong to a variety of functional classes and are likely to serve key regulatory functions in specific biological processes. For instance, the transcription regulator SMAD7 was identified as a Hub gene that may be important for the stimulation of blood vessel development by OB-OECs, whereas the cell surface protein APP was identified as a possible Hub gene for the stimulation of neurite outgrowth (Roet et al., 2011). The growth factors, FGF2, EGFR and TGF have been identified as Hub genes in the wound healing pathways in OB-OECs (Guerout et al., 2010). The current bioinformatics databases are continuously upgraded as new information about individual gene and protein interactions and their function becomes available. Therefore we predict that, as these databases are filled with more and more information, a re-analysis of the existing OEC-microarray datasets will allow the discovery of novel as yet hidden molecular characteristics of OEC. Furthermore novel computational tools to study gene regulation are emerging, such as algorithms to detect transcription factor binding site overrepresentation analysis, which can lead to the identification of transcription factors that coordinate the activation of specific sets of repair promoting genes (Geeven et al., 2011).

T

366

2013; Vincent et al., 2005) and two large scale proteomic studies (Au et al., 2007; Liu et al., 2010) have investigated the transcriptome and proteome of various preparations of cultured OECs (reviewed in (Roet et al., 2011)). The microarray studies have shown that OB-OECs or a mixture of LP-OECs and OB-OECs not only has many similarities with Schwann cells [as shown previously by using more classical analysis techniques (Wewetzer et al., 2002)] but also displays molecular characteristics that are distinct from Schwann cells (Franssen et al., 2008; Vincent et al., 2005), early passage OB-OECs have a stronger proregenerative phenotype than late passage OECs (Pastrana et al., 2006), OB-OECs have a distinct gene expression profile from LP-OECs (Guerout et al., 2010), OB-OECs with relatively low P75/NGFR expression overexpress more genes involved in axon guidance (Honore et al., 2012) and OB-OECs in the ONL increase the expression of many neurite growth promoting molecules during regeneration of olfactory axons (Roet et al., 2013). One of the proteomics studies pointed to proteins that appear to make conditioned medium of LP-OECs after two passages superior with regard to their capacity to stimulate neurite outgrowth than conditioned medium of OECs after 6 passages in culture (Au et al., 2007). The other proteomics study revealed the proteins that are in OB-OEC conditioned medium and in the plasma membrane of OECs and that may be important for OEC self-renewal and for their capacity to enhance spinal cord regeneration (Liu et al., 2010). In general, the large scale molecular screens demonstrated that OECs not only express many genes that potentially support neurite outgrowth, but also revealed that the transcriptome of OECs is enriched in genes involved in tissue repair/wound healing, blood vessel formation, myelination, phagocytosis, immune function and regulation of oxidative stress. These distinct molecular signatures are in strong support of the idea that OECs are cells that positively affect multiple tissue repairassociated processes that go beyond their capacity to stimulate of axon outgrowth per se.

D

335 336

K.C.D. Roet, J. Verhaagen / Experimental Neurology xxx (2014) xxx–xxx

E

8

Please cite this article as: Roet, K.C.D., Verhaagen, J., Understanding the neural repair-promoting properties of olfactory ensheathing cells, Exp. Neurol. (2014), http://dx.doi.org/10.1016/j.expneurol.2014.05.007

401 402 Q8 403 404 405 406 407 408 409 410 411 412 413 414 415 416 417 418 419 420 421 422 423 424 425 426 427 428 429 430 431 432 433 434 435 436 437 438

442 443 444 445 446 447 448 449 450 451 452 453 454 455 456 457 458 459 460 461 462

K.C.D. Roet, J. Verhaagen / Experimental Neurology xxx (2014) xxx–xxx

T

E

D

P

R O

O

F

479

C

472 473

Lipid presentation The identification of SCARB2 as a protein that improves regenerative sprouting of injured sensory spinal axons was the main finding of the “Cellomics” screen on the neurite growth promoting properties of OB-OECs. SCARB2 is a protein which mediates the uptake of cholesterol

E

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on published microarray datasets provided a number of molecular and functional insights into the neural repair-promoting properties of OB-OECs. Fig. 1 provides a summary of the molecular basis of established and recently proposed synergistic neural repair promoting properties of OECs.

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et al., 2010; MacGillavry et al., 2009; Moore et al., 2009). By using a “Cellomics” approach we have successfully identified 19 genes expressed by OB-OECs that affect neurite outgrowth of neurons cocultured with OB-OECs (Roet et al., 2013). This screen was performed with adult primary P75 positive OB-OECs plated in a 96-well plate format and transfected with siRNA pools to specifically knockdown a gene of interest. After 72 h, dissociated embryonic DRG were cocultured with these OECs for up to 8 h after which the neurite length was measured automatically in the Cellomics reader to allow assessment of the relevance of the targeted gene for OB-OEC promoted neurite growth. The hits in this screen together with the meta-analysis

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Fig. 1. The established and proposed synergistic neural repair properties of olfactory ensheathing cells. 1. ATP is released from necrotic and apoptotic cells at high levels which has a toxic effect on cells that express the ATP receptor P2X7. OECs express the ecto-ATPase ENTPD2 which hydrolyzes toxic extracellular ATP and releases ADP. 2. OECs produce and reutilize lipids such as cholesterol obtained from cellular debris. Neurotrophic lipids are secreted in vesicles and are used for rapid axon biosynthesis through interaction with the low density lipid receptor (LDLR). 3. OECs reduce astrocyte reactivity. 4. OECs (re)myelinate regenerating axons. 5. OECs promote angiogenesis by secretion of molecules like ESM1, CTGF and CYR61. 6. OECs produce neurotrophic factors, including NGF and BDNF. 7. OECs phagocyte cellular debris and reutilize obtained lipids which are presented to regenerating axons. 8. OECs modify the extracellular matrix by secretion of growth promoting matrix molecules such as laminin and by secretion of proteolytic enzymes such as ADAMTS1 which cleaves versican, a neurite growth inhibitory molecule. 9. OECs form a structural pathway for regenerating axons. 10. OECs ameliorate the immune system by secretion of molecules that reduce microglia activation such as CX3CL1.

Please cite this article as: Roet, K.C.D., Verhaagen, J., Understanding the neural repair-promoting properties of olfactory ensheathing cells, Exp. Neurol. (2014), http://dx.doi.org/10.1016/j.expneurol.2014.05.007

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Balanced ligand and receptor expression to regulate axon growth and guidance Axonal growth is normally tightly regulated by axon guidance molecules. OB-OECs express the Wnt and VEGF/SEMA receptors FZD1 and NRP1 respectively (Kolodkin et al., 1997; Roet et al., 2013; Soker et al., 1998; Takagi et al., 1995). Knockdown of FZD1 and NRP1 in OB-OECs reduced the neurite growth of co-cultured DRG neurons (Roet et al., 2013). Their expression in OECs may function as a scavenging mechanism for the neurite growth inhibitors WNT1 and SEMA3A respectively, which are both expressed in the spinal cord after a lesion (De Winter et al., 2002; Liu et al., 2008; Niclou et al., 2003). During development the canonical WNT signaling pathway is activated in a subpopulation of OECs which are involved in the formation of glomeruli (Wang et al., 2008). Several WNT proteins, including WNT1 are expressed in the ONL, and activation of the canonical WNT signaling pathway is necessary for olfactory axon target innervation in the forebrain (Petrova et al., 2014; Wang et al., 2008; Zaghetto et al., 2007). In addition to NRP1 and FZD1, NRP2 and most members of the FZD family are also expressed above background in OB-OECs together with all class 3 SEMAs and almost all WNTs (NCBI GEO dataset GSE19250). The coexpression of NRP1 and its ligand SEMA3A in motor neurons has been shown to be a controlling mechanism for the guidance of axonal regeneration (Kolodkin et al., 1997; Moret et al., 2007). OB-OECs do express not only many neurotropic and growth factors but also many of their receptors, such as the low affinity nerve growth factor receptor (P75/NGFR), CNTFRaplha, GFRA1, TGFB2 and TrkB (Ramon-Cueto et al., 1993; Roet et al., 2013; Wewetzer et al., 2001; Woodhall et al., 2001). P75/NGFR is induced in OECs in the ONL after deafferentation of the OB (Turner and Perez-Polo, 1993) and as mentioned before, olfactory neurites grow preferentially on P75/NGFR positive OBOECs (Ramon-Cueto et al., 1993). When the axons are ensheathed by OECs, P75/NGFR expression in both the axons and the OECs becomes undetectable. Downregulation of GFRA1 and TGFB2 in cultured OBOECs reduced the neurite length of embryonic DRG neurons (Roet et al., 2013). GDNF has been shown to mediate LP-OEC migration and thereby axon motility (Jing et al., 1996; Windus et al., 2011; Woodhall et al., 2001).

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Modulation of the extracellular matrix The composition of the extracellular matrix regulates many processes important for neural repair, including axon growth and guidance, the immune response and angiogenesis. OECs regulate the matrix composition by secreting extracellular matrix proteins, matrix proteases, matrix protease inhibitors and matricellular proteins. In the primary olfactory pathway, layers of interconnected OECs form a permissive pathway for growing olfactory axons (Field et al., 2003; Li et al., 2005a,b, 2012). OECs express a number of neurite growth supporting molecular components of the basement membrane, i.e., collagen type IV, fibronectin and laminin (Doucette, 1996; Kafitz and Greer, 1997; Laurie et al., 1983; Lein and Higgins, 1991; Ramon-Cueto and Nieto-Sampedro, 1992). We have recently identified LEPRE1, a leucine-proline enriched proteoglycan, and NID2, and adhesive protein that binds collagen types I, IV and laminin, (Fox et al., 2008; Kohfeldt et al., 1998; Mayer et al., 1998; Roet et al., 2013; Wassenhove-McCarthy and McCarthy, 1999) as two other basement membrane proteins expressed in OB-OECs and important for neurite growth (Roet et al., 2013). Knockdown of LEPRE1 and NID2 in OBOECs in our “Cellomics” screen reduced their neurite growth promoting capacity whereas overexpression of LEPRE1 in skin fibroblasts significantly increased the neurite length of adult DRG neurons. The gene expression profiling studies have shown that OB-OECs express many matrix proteases and matrix protease inhibitors (Franssen et al., 2008; Pastrana et al., 2006). Matrix proteases can digest and neutralize non-permissive matrix molecules and thereby also remove attached axon growth inhibitory molecules. Matrix protease inhibitors can protect permissive substrates by blocking the function of matrix proteases or they can help guide axonal growth by protecting non-permissive substrates. MMP2 and ADAMTS1, two matrix metalloproteases are important for the outgrowth promoting properties of OB-OECs (Pastrana et al., 2006; Roet et al., 2013). ADAMTS1 activity can release the repulsive axon guidance molecule SEMA3C, an inhibitory protein present in the neural scar, from the extracellular matrix (De Winter et al., 2002; Esselens et al., 2010; Russell et al., 2003; Steup et al., 2000). Overexpression of the matrix metalloprotease 2 (MMP2) inhibitor TIMP2 in skin fibroblasts inhibited neurite outgrowth (Roet et al., 2013). OB-OECs also express at least 6 members of the serine protease inhibitor gene family (SERPINB6b, SERPINE1, SERPINF1, SERPING1, SERPINH1, SERPINI1) (Franssen et al., 2008; Simon et al., 2011). Knockdown of SERPINI1 and SERPINF1 decreases neurite outgrowth of co-cultured DRG neurons (Roet et al., 2013). SERPINI1 is an inhibitor of PLAT/tPA which is expressed in neurons and glia, plays a prominent role in regulating neuroplasticity and synaptogenesis (Gveric et al., 2003; Miranda and Lomas, 2006; Samson and Medcalf, 2006) and which together with several other members of the fibrinolysis system, SERPINE1, SERPINF1, PAR1 and THBD, has been implicated in neural repair (Roet et al., 2013; Simon et al., 2011; Tanimoto et al., 2006; Yamagishi et al., 2009). In summary, the gene expression profiles observed in OB-OECs clearly indicate that these cells organize the extracellular matrix. The net-effect of the action of proteases and their inhibitors on neural repair will be very much dependent on the composition of the extracellular substrate and the presence and localization of additional signaling molecules. Since these components are also strongly influenced by neighboring cell types, including fibroblasts, astrocytes and blood-borne cells that are present at a neural injury site, translatable functional

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The co-expression of axon guidance molecule receptors, axon guidance molecules and neurotrophic/growth factors and their receptors allows for autocrine and paracrine signaling. The examples presented above indicate the importance of this balanced expression for neural repair and suggest that their repair-promoting properties can be regulated by their own signaling molecules as well as by those from neighboring OECs or other cells.

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to cells as well as cholesterol efflux by high affinity binding of high density lipoprotein (HDL) (Eckhardt et al., 2004; Ji et al., 1997; Kozarsky et al., 1997; Mulcahy et al., 2004) and which transports GBA from the endoplasmic reticulum to the lysosome (Reczek et al., 2007). SCARB2 expression is upregulated in the ONL immediately after a lesion, and remains high during the ingrowth of newly formed axons, knockdown of SCARB2 in OB-OECs decreases neurite growth of co-cultured embryonic DRG neurons and overexpression of SCARB2 in skin fibroblasts increases neurite outgrowth of adult DRG neurons in vitro (Roet et al., 2013). Although the mode of action of SCARB2 still needs to be determined, considering SCARB2's known functions, it is most likely related to lipid transfer mechanisms. Such mechanisms are important for rapid axon membrane biosynthesis during regeneration after a nerve injury (Boyles et al., 1989; Jurevics et al., 1998; Li et al., 2010a) and cholesterol-containing lipoproteins secreted by glia can strongly enhance neurite outgrowth and synapse formation of cultured retinal ganglion cells and dorsal root ganglion neurons (Handelmann et al., 1992; Hayashi et al., 2004; Mauch et al., 2001), a process which is mediated through the low density lipid receptor family on the neuronal processes. It is known that damage to the peripheral or central nervous system leads to the synthesis of proteins involved in lipid and cholesterol metabolism (Dawson et al., 1986; Ignatius et al., 1986; Mahley, 1988; Seitz et al., 2003) and that pharmacological or genetic interference with local cholesterol reutilization decreases axonal outgrowth (Goodrum et al., 2000). Since OECs normally guide and stimulate regrowing olfactory axons towards their targets, they are perfectly positioned to provide lipids necessary for this growth and it is therefore likely that there are molecular mechanisms in OECs that regulate this process.

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Please cite this article as: Roet, K.C.D., Verhaagen, J., Understanding the neural repair-promoting properties of olfactory ensheathing cells, Exp. Neurol. (2014), http://dx.doi.org/10.1016/j.expneurol.2014.05.007

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613 insights will require the studies in relevant in vivo lesion paradigms (see 614 Q10 Animal studies).

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Stimulation of angiogenesis Several studies have reported increased angiogenesis in vivo after transplantation of LP-OECs or OB-OECs (Lopez-Vales et al., 2004; Ramer et al., 2004; Richter et al., 2005). To date, the molecules responsible for these effects have not been identified in functional studies. However, 55 genes were identified that have been linked to blood vessel development and that are differentially regulated in OB-OECs in ≥3 microarray datasets (Roet et al., 2011). SMAD7 was identified as a HUB gene in the blood vessel development molecular interaction network and was directly functionally connected to 8 other genes in this network. Of particular interest are also ESM1, CYR61 and ANGPT2, which showed an average 38.7, 7.2, and 5.4 fold higher expression in OBOECs respectively. ESM1 mediates VEGF-A induced angiogenesis (Roudnicky et al., 2013) and CYR61 is a secreted protein and potent stimulator of angiogenesis that acts directly on endothelial cells (Brigstock, 2002). ANGPT2 promotes neovascularization (Asahara et al., 1998) and increased expression of ANGPT2 has been reported in GFAP and NG2 positive cells after a spinal cord injury and these expression levels were positively correlated with improved locomotor function (Durham-Lee et al., 2012). Amelioration of the immune system Two secreted and by OEC expressed immune-modulatory proteins, CX3CL1 and S100A9 (Roet et al., 2013; Ruitenberg et al., 2008), stimulated outgrowth of DRG neurons and knockdown of a third immunemodulatory protein, TGFB2, resulted in decreased neurite length in the “Cellomics” screen, suggesting that it supports neurite extension. CX3CL1, a cytokine also known as fractalkine, is predominantly expressed by neurons (Verge et al., 2004) and its receptor, CX3CR1, is expressed by microglia and astrocytes as well as in several types of neurons (Hughes et al., 2002; Meucci et al., 1998; Verge et al., 2004). There are strong indications that CX3CR1 expression in microglia protects against microglial and macrophage neurotoxicity (Cardona et al., 2006; Holmes et al., 2008) and CX3CL1 expressed by OECs can therefore have a direct or indirect protective effect on neurons. TNF is functionally connected to 13 of the 19 genes that affect neurite outgrowth in the “Cellomics” screen. This suggests a central role for TNF in the repair promoting molecular properties of OB-OECs. TNF can induce the expression of ADAMTS1, CX3CL1, MSLN, NCAM1,

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ATP hydrolysis The ecto-ATPase ENTPD2 is highly expressed in early passage OBOECs in 5 published microarray datasets (Roet et al., 2011). This expression has been confirmed by ICC and IHC (unpublished data). EctoATPases are membrane-associated enzymes that hydrolyse extracellular ATP and have a role in extracellular ATP homeostasis. High levels of ATP released from cells in following tissue damage leads to an increase of calcium in the cytosol and cell death (Verderio and Matteoli, 2001; Wang et al., 2004). Ecto-ATPases are upregulated after damage to the nervous system and decrease toxic ATP levels which, depending on the specificity of the Ecto-ATPase, can result in an increase of neuroprotective ADP (Abbracchio et al., 2009; Braun et al., 1998; Schubert and Kreutzberg, 1993). ENTPD2 preferentially hydrolyzes ATP, not ADP (Braun et al., 1998). Therefore the detection of ENTPD2 in the metaanalysis has led to the hypothesis that ENTPD2 expression by OB-OECs could have a significant impact on cell survival and tissue repair observed following transplantation of these cells in the brain and spinal cord. There are two major classes of ATP receptors, P2X (ion channels; 7 subtypes) and P2Y (G protein-coupled; 8 subtypes) receptors (Abbracchio et al., 2006; Burnstock and Kennedy, 1985; Erlinge and Burnstock, 2008). These ATP-receptor variants are found on a number of different cell types, including neurons, astrocytes, microglia, epithelial cells, immune cells and platelets and are involved in several processes, such as neurotransmission, inflammation, proliferation, apoptosis and migration (Burnstock, 2008). Application of antagonists for the ATP P2X7 receptor can improve behavioral recovery, reduce gliosis and diminish the immune response after a spinal cord injury (Peng et al., 2009). Moreover, administration of P2X3/X2X3, P2X4 and P2X7 antagonists has been shown to reduce nociceptive signaling (Chu et al., 2010; Inoue et al., 2005; Jarvis et al., 2002). A reduction in nociception was also observed after implantation of LP-OECs in a dorsal root injury model (Wu et al., 2011a). There are also a number of studies that link ATP signaling to ALS. P2X7 receptor expression is increased in activated microglial/macrophage like cells in human disease affected dorsolateral white matter regions (Yiangou et al., 2006). Astrocytes derived from SOD1G93A rats (ALS model) are toxic for motor neurons, however, pharmacological inhibition of the P2X7 receptors on these astrocytes abolishes this toxicity whereas stimulation of the P2X7 receptor induces a neurotoxic state in wild type astrocytes which induces death of motor neurons (Gandelman et al., 2010). Another study on SOD1G93A rats reported a strong increase of the ATP receptor P2X4 in degenerating motor neurons in the ventral horn of the spinal cord (Casanovas et al., 2008). These neurons appeared to recruit activated microglia and showed a

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NRP1, RND1 and TGFB2 (Ahn et al., 2004; Giraudo et al., 1998; Hatipoglu et al., 2009; Scotto d'Abusco et al., 2007; Sivasubramanian et al., 2001; Vargas et al., 1994; Zer et al., 2007) and it suppresses the expression of LPL, RARA, SERPINF1 and TIMP2 (Geier et al., 2005; Halin et al., 2010; Kawasaki et al., 2010; Watari et al., 1999). Moreover, TNF induces NFKB, which interacts with VAV1 (Houlard et al., 2002; Yu et al., 2008) and S100A9/S100A8 dimers induce TNF secretion which can lead to enhanced NGF secretion by fibroblasts (Hattori et al., 1993; Sunahori et al., 2006). Our microarray data shows that several TNF receptors including TNFRSF1A are expressed in cultured OB-OECs and are upregulated in the ONL directly after lesion (data not shown). TNF is secreted by reactive astrocytes after a spinal cord lesion and can stimulate OEC migration in a dose depending manner (Su et al., 2009). Blocking TNFRSF1A in vitro or in the lesioned spinal cord has been shown to attenuate OB-OEC migration (Su et al., 2009). The data presented in this study together with the available literature suggests that TNF signaling not only enhances OEC migration but also can activate a number of genes in OECs that promote neurite outgrowth. This may help to ameliorate the well-documented negative effects of TNF after a spinal cord lesion (Beattie et al., 2010; Esposito and Cuzzocrea, 2011).

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Formation of a structural cellular pathway The formation of the fascicle-like cellular tunnels formed by OECs in the olfactory nerve provides a permissive pathway for axon growth (Boyd et al., 2005; Raisman and Li, 2007; Windus et al., 2007) and requires reorganization of the cytoskeleton. It has been shown that the persistence of these cellular protrusions is dependent on the activity of the actin regulating RHOA pathway (Huang et al., 2011). Two of the proteins that were identified in the “Cellomics” screen, RND1 and VAV1 (Roet et al., 2013), are also proteins that regulate cytoskeletal remodeling (Hornstein et al., 2004; Riou et al., 2010) and the formation of cellular protrusions (Ishikawa et al., 2003; Spurrell et al., 2009). VAV1 is an important component of a signaling pathway that regulates focal adhesion kinase (FAK) (Spurrell et al., 2009), and ITGA7, another hit in the knock-down screen, also interacts with FAK (Chernousov et al., 2007). The cell adhesion molecules ITGA7 and MSLN (Roet et al., 2013) may also play a role in reorganization of the glial scar. OB-OECs express several other genes with well-defined roles in cytoskeletal (re)organization, process formation and cell motility, including MAP1B, MAP2, NEFL and APP (Moreno-Flores et al., 2003; Roet et al., 2011). APP has also been identified as a HUB gene in a molecular network of neurite outgrowth associated molecules (Roet et al., 2011) and these findings emphasize the importance of the cytoskeletal organization for neural repair.

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Please cite this article as: Roet, K.C.D., Verhaagen, J., Understanding the neural repair-promoting properties of olfactory ensheathing cells, Exp. Neurol. (2014), http://dx.doi.org/10.1016/j.expneurol.2014.05.007

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Gene expression profiling and proteomics followed by gene ontology and/or pathway analysis and high content cellular screening will narrow down the most promising set of molecular targets involved in OECmediated repair. To establish the function and therapeutic value of a gene in the OEC-mediated neural repair process it is still necessary to examine this in-vivo in an animal model for a nervous system pathology and neural transplantation. These studies may include transgenic animals, viral-vector mediated gene delivery and/or systemic or local administration of specific agonists or antagonists or compounds. The function of SPARC (identified in a proteomics screen discussed above) was studied in vivo by isolating and transplanting LP-OECs from SPARC null mutant mice and wild-type mice (Au et al., 2007). The mice that received LP-OECs deficient in SPARC showed a reduction in

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In total, the role of 102 genes was examined with a loss of function approach in co-cultures of OB-OECs and embryonic DRG in the “Cellomics” screen (Roet et al., 2013). Ten of the 19 genes that significantly affected neurite length were selected for gain of function studies in fibroblast-adult DRG co-culture assays. Of these 10 genes, overexpression of 5 genes significantly increased neurite length. In addition, 13 genes that did not affect neurite length in the loss of function assays were selected for the gain of function assays based on pre-existing knowledge about their function and their regulation after peripheral deafferentation of the olfactory nerve layer. Of these 13 genes, only 1 gene significantly increased neurite length. Thus, 50% of the genes detected in the loss-of-function screen had also an effect on neurite outgrowth in the gain-of function screen, while only 8% of the genes that had no effect on neurite length after knockdown in OECs showed an increase of neurite length after overexpression in fibroblasts. These data suggest that selecting candidate genes for the overexpression screen via a large knock-down screen increased the success rate of the gain of function screen approximately six fold. Although the success rate in the overexpression screen was higher when candidate genes were chosen based on the loss of function screen, half of the genes that had an effect in the loss of function screen had no effect on neurite outgrowth in the gain of function bioassays. We noticed this for ADAMTS1, BM385941, MSLN, RND1 and VAV1. There are several factors that may explain this (Holtmaat et al., 1998). First, different cell types were used for the loss and gain of function assays. It is possible that a number of the genes we investigated act on neurite outgrowth in a cell specific molecular pathways in either the OECs or the target neurons. For instance, it is known that DRG neurons become sensitive for myelin inhibition between postnatal days 1 and 5 and that this change coincides with a drop in intracellular cAMP levels (Cai et al., 2001; Mukhopadhyay et al., 1994). Second, the mechanism by which a gene can stimulate neurite outgrowth may be dependent on coexpression of other genes. Absence of a gene will then affect neurite outgrowth more strongly than overexpression (Feldman and Randolph, 1991). Third, the endogenous expression level of the gene may have already reached a maximum effect on neurite outgrowth so that overexpression is not effective anymore.

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From bioassay to in vivo study: a big step with many uncertainties

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In our multi-level screening study, the function of S100A9, SCARB2 and SERPINI1 was selected for functional validation in the lesioned rat dorsal column (Roet et al., 2013). These genes were selected because they had strong effects on neurite outgrowth in both the loss of function and gain of function bioassays. Overexpression of these 3 genes in fibroblasts resulted in a robust increase of neurite length of cultured adult DRG neurons. Ex vivo gene delivery of SCARB2 resulted in a significant increase of regenerating dorsal column fibers in vivo but overexpression of S100A9 and SERPINI1 did not. There are several possible reasons for the absence of an effect of S100A9 and SERPINI1. The circumstances in the in vivo situation are very different from those in the bioassay used to identify these genes. A spinal cord injury site constitutes a complex cellular microenvironment that contains many molecular signals not present in the simplified bioassay. Reactive astrocytes, activated microglia, infiltrating macrophages and endogenous SCs could change the molecular profile of the implanted fibroblasts or may modify the signaling pathways in the regenerating axons (Leal-Filho, 2011; Schwab et al., 2006; Thuret et al., 2006; Wu et al., 2011b). In the bioassay the fibroblasts were in direct contact with the cell bodies and the axons of the DRG neurons while in the spinal cord the transduced fibroblast was transplanted in the vicinity of the transected axons. Finally, the overexpressed proteins can also have unintentional effects on cells in the lesioned spinal cord. For instance, S100A9 is involved in a variety of inflammatory processes and can stimulate cytokine production in macrophages (Averill et al., 2011; Gebhardt et al., 2006; Sunahori et al., 2006). Taken together, our results highlight the challenge to translate observations made in bioassays to the actual situation in the injured nervous system in vivo.

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OECs are cells that harness an impressive neural repair-promoting potential that can be useful to promote repair in a number of neuropathological conditions. By using the technical advances that have been made in transcriptome and proteome analysis, bioinformatics, highthroughput microscopy, image analysis and robotics, a much more profound understanding of the specific molecular mechanisms that form the basis of the synergistic pro-regenerative properties of OECs can now be realized. Although many cell types may promote axon growth, and/or stimulate angiogenesis, and/or have phagocytic properties and/ or secrete growth factors, the uniqueness of OECs appears to be that the molecular pathways for many of these processes are present and act in a coordinated fashion in one cell type, that is the OEC (Fig. 1). A profound understanding of the different molecular pathways that are present in OECs and the accompanying functional phenotypes will

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outgrowth of specific subsets of axons and a decrease in the number of ED1 positive macrophages at the lesion site when compared to those that received wild-type OECs. OB-OECs normally express brain derived neurotrophic factor in small amounts (Woodhall et al., 2001). However, adult OB-OECs genetically modified to over-express brain derived neurotrophic factor showed enhanced regenerative sprouting of the rubrospinal tract and improved functional recovery after implantation in the lesioned rat dorsolateral funiculus (Ruitenberg et al., 2003). SCARB2 was identified as an important factor for the neurite growth promoting properties of OB-OECs in the multi-step screening approach discussed above (Roet et al., 2013). Implantation of skin fibroblasts that overexpress SCARB2 in rats concomitant a dorsal funiculus lesion resulted in enhanced neuronal sprouting towards the lesion center. These results suggest that at least part of the pro-regenerative properties of OECs can be transferred to less permissive cellular substrates. These studies demonstrate that it is possible to investigate the role of specific molecules in the pro-regenerative properties of OECs in the complex physiological context of a spinal cord injury.

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downregulation of the neuronal marker NeuN. It has been shown that implantation of OECs in the spinal cord of this same rat model increases the survival of the animals through neuroprotection and by increasing remyelination (Li et al., 2011). These effects may partly be mediated by hydrolysis of extracellular ATP which would decrease P2X4 signaling in motor neurons and P2X7 signaling in astrocytes and microglia. Taken together, the hydrolysis of high levels of toxic extracellular ATP by the ecto-ATPase ENTPD2 expressed by OB-OECs may be an important newly discovered neuro-protective property of OECs which can be relevant for treatment of spinal cord injuries and ALS.

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also be important for the selection of the appropriate OEC subtype (e.g. OB- or LP-OECs) for specific clinical applications. The hypotheses that will and have already resulted from this emerging integrated biological analysis can be tested in vivo e.g. by investigating the efficacy of modified OEC or other cellular implants in spinal lesions or other neuropathologies. We predict that this will lead to 1. Important new molecular insights in the mechanisms that govern successful regeneration; 2. Methods to further enhance the therapeutic potential of OECs perhaps to a level that is sufficient to merit further clinic application; and 3. The possibility to transfer certain neural repair promoting properties of OECs to other cell types and tissues (e.g. Schwann cells or bone marrow stromal cells) that are used to promote neural repair.

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Please cite this article as: Roet, K.C.D., Verhaagen, J., Understanding the neural repair-promoting properties of olfactory ensheathing cells, Exp. Neurol. (2014), http://dx.doi.org/10.1016/j.expneurol.2014.05.007

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Please cite this article as: Roet, K.C.D., Verhaagen, J., Understanding the neural repair-promoting properties of olfactory ensheathing cells, Exp. Neurol. (2014), http://dx.doi.org/10.1016/j.expneurol.2014.05.007

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