A multi-mutant herpes simplex virus vector has minimal cytotoxic effects on the distribution of filamentous actin, alpha-actinin 2 and a glutamate receptor in differentiated PC12 cells.

To develop effective gene therapy techniques that target populations of neurons in the spinal cord, suitable vectors must be developed that will undergo efficient, retrograde transport from an appropriate peripheral site and will not be cytotoxic. Our previous work (LeVatte et al, 1998a) has demonstrated that a replication defective herpes simplex virus vector 14Hdelta3vhsZ, that has been substantially detoxified, is retrogradely transported from peripheral sites and can infect large numbers of the targeted spinal neurons. We plan to develop targeted gene therapy approaches designed to modulate the excitatory glutamatergic methyl-D-aspartate (NMDA) receptor in spinal cord neurons as a means of ameliorating a form of episodic high blood pressure that occurs after spinal cord injury. In this report, we demonstrate that, in differentiated PC12 cells, a neuronal-like cell line, the virus vector does not appear to alter aspects of the cytoskeletal architecture important to the proper distribution of the NMDA receptor. In turn, the distribution of endogenous NMDA receptor 1 subunit protein (NMDAR1) or a transfected NMDAR1-green fluorescent fusion protein was also found to be unaltered after vector infection. However, whereas endogenous NMDAR1 distribution was maintained, vector infection did tend to reduce the level of its expression. This drop in endogenous NMDAR1 expression coincided with the expression of the HSV immediate early genes ICP0 and ICP27 over the first 24-48 h. These results indicate that the 14Hdelta3vhsZ herpes simplex virus vector is suitable to use in future strategies to alter the level of gene expression in targeted populations of spinal cord neurons.

Was Kent a Hahnemannian?

This article voices concern at the trend among an influential section of homeopaths the world over, to jettison Hahnemann's similimum principle and replace it with Kent's almost exclusive concentration on mental and psychic symptoms. This concern raises the question whether Kent was a true Hahnemannian. In order to discuss this question, two schools of thoughts are investigated. The first argues that Hahnemann's theories were scientific whereas Kent's were metaphysical. The second criticises Kent's more severely for being metaphysical. At the same time, it accuses Hahnemann himself of increasingly losing his way, with increasing age, into metaphysical homeopathy. The author believes there was no break in Hahnemann's thinking as alleged, but a gradual development with increasing experience, together with judicious use of rational insight, when scientific explanation was not yet available. The yardstick used to accuse Hahnemann of being metaphysical is crudely empirical and long outdated.

Co-localization of substance P and dopamine beta-hydroxylase with growth-associated protein-43 is lost caudal to a spinal cord transection.

After spinal cord injury, abnormal responses of spinal cord neurons to sensory input lead to conditions such as autonomic dysreflexia, urinary bladder dyssynergia, muscle spasticity and chronic pain syndromes. These responses suggest that the spinal cord undergoes marked reorganization after an injury. In previous studies, we demonstrated changes in individual patterns of immunoreactivity for growth-associated protein-43, dopamine beta-hydroxylase and substance P that suggest growth and/or changes in expression of neurotransmitter enzymes and peptides in the cord caudal to a transection injury. In the present study we determined whether (i) growth-associated protein-43 and dopamine beta-hydroxylase or substance P were co-expressed in the same neurons prior to cord injury, and (ii) these patterns of expression changed after injury. A change in co-localization patterns caudal to an injury would suggest diversity in responses of different populations of spinal neurons. We used double-labelling immunocytochemistry to determine whether either dopamine beta-hydroxylase or substance P was co-localized with growth-associated protein-43 in control rats and in rats one, two or six weeks after spinal cord transection. We focused on the intermediate gray matter, especially the sympathetic intermediolateral cell column. In control rats, fibres travelling in a stereotyped ladder-like pattern in the thoracic gray matter contained growth-associated protein-43 co-localized with dopamine beta-hydroxylase or substance P. In spinal rats, such co-localization was also observed in spinal cord segments rostral to the cord transection. In contrast, caudal to the transection, substance P and growth-associated protein-43 were found in separate reticular networks. Immunoreactivity for dopamine beta-hydroxylase disappeared in fibres during this time, but was clearly present in somata. Immunoreactivity for growth-associated protein-43 was also found in somata, but never co-localized with that for dopamine beta-hydroxylase. These observations demonstrated co-localization of growth-associated protein-43 with dopamine beta-hydroxylase and substance P in descending spinal cord pathways. Caudal to a cord transection, this co-localization was no longer found, although each substance was present either in an abundant neural network or in somata. One population of spinal neurons responded to cord injury by expressing the growth-associated protein, whereas two others changed in the intensity of their expression of neurotransmitter peptides or enzymes or in the abundance of fibres expressing them. Thus, three populations of spinal neurons had distinct responses to cord injury, two of them increasing their potential input to spinal sensory, sympathetic or motor neurons. Such responses would enhance transmission through spinal pathways after cord injury.

Was Kent a Hahnemannian?

This article voices concern at the trend among an influential section of homeopaths the world over, to jettison Hahnemann's similimum principle and replace it with Kent's almost exclusive concentration on mental and psychic symptoms. This concern raises the question whether Kent was a true Hahnemannian. In order to discuss... (AU)

Analysis of a multi-mutant herpes simplex virus type 1 for gene transfer into sympathetic preganglionic neurons and a comparison to adenovirus vectors.

A non-replicating triple-mutant herpes simplex virus (14H delta 3vhsZ) expressing the bacterial marker enzyme beta-galactosidase, was assessed for neurotropism and cytopathic effects as a vector for gene transfer into differentiated phaeochromocytoma 12 cells in vitro and into spinal sympathetic neurons in vivo. In the in vivo study, the 14H delta 3vhsZ was injected into the adrenal gland of hamsters. For comparison, an evaluation of two adenovirus vectors, AdCA17lacZ and AdCA36lacZ, was performed. Infection of the differentiated phaeochromocytoma 12 cells by 14H delta 3vhsZ resulted in intense beta-galactosidase staining in 80-90% of the cells without changes in cell morphology, detected by light microscopy, after a period of four days. No cytoskeletal disruption was detected by immunocytochemistry for the neurofilament protein and no apoptosis was demonstrated by the Hoescht stain for nuclear chromatin in virus-infected cells in comparison to mock-infected control cells. Twoto three days after adrenal inoculation with 14H delta 3vhsZ, beta-galactosidase was detected in 240 preganglionic neurons per hamster (n = 8), a number equal to about 25% of the population of targeted neurons. The beta-galactosidase reaction product extended throughout the normal kite-shaped neuronal somata and extensive dendritic arbour. The number decreased to 120 by five days (n = 3) and to two by eight days (n = 4). This decrease was presumably due to loss of expression of the marker gene and not to cell death because, at eight days, the number of sympathetic pregnanglionic neurons in the nucleus intermediolateralis, pars principalis, that were immunoreactive for the neurotransmitter enzyme choline acetyltransferase, and demonstrated nicotinamide adenine dinucleotide phosphate-diaphorase activity, were the same on the infected left side of the cord as on the uninfected right side. Inflammatory cells surrounded some of the infected neurons at five days but by eight days the infiltrate was reduced. Infection of differentiated phaeochromocytoma 12 cells by AdCA17lacZ and AdCA36lacZ also resulted in marker gene expression in a large proportion of the cells (80-90%) in the absence of cytopathic effects. In contrast, four days after adrenal injection of AdCA17lacZ or AdCA36lacZ (n = 5 for each) only an average of three preganglionic neurons per hamster expressed beta-galactosidase activity, despite clear adrenal infection. AdCA17lacZ and AdCA36lacZ both produced light patches of staining confined to the neuronal soma. These neurons had normal morphology but sometimes were surrounded by an inflammatory infiltrate. In conclusion, the non-replicating herpes simplex virus, 14H delta 3vhsZ, had minimal cytotoxic effects in neurons, in vitro or in vivo, and was efficiently transported from the adrenal gland to infect many sympathoadrenal pregnanglionic neurons. In contrast, very few neurons demonstrated beta-galactosidase activity after injection into the adrenal gland of AdCA17lacZ and AdCA36lacZ. Therefore, 14H delta 3vhsZ is a more suitable vector than either of the adenovirus vectors tested for eliciting short-term changes in preganglionic neuron gene expression.

Glutamate- and GABA-immunoreactive synapses on sympathetic preganglionic neurons caudal to a spinal cord transection in rats.

Spinal cord injury destroys bulbospinal amino acid-containing pathways to sympathetic preganglionic neurons and severely disrupts blood pressure control, resulting in resting or postural hypotension and episodic hypertension. Almost all immunoreactivity for the excitatory amino acid L-glutamate has been reported to disappear from autonomic areas of the cord caudal to a transection, apparently depriving autonomic neurons of their major excitatory input. However, the magnitude of the neurogenic episodic hypertension after cord injury suggests that excitatory inputs to sympathetic preganglionic neurons must still be present. Moreover, the hypotension associated with high spinal injuries may reflect a enhanced role for inhibitory transmitters, such as GABA. This apparent contradiction regarding the presence of glutamate and lack of information about GABA prompted the present investigation. In rats seven days after spinal cord transection, we examined identified sympathetic preganglionic neurons caudal to the injury for the presence of synapses or direct contacts from varicosities that were immunoreactive for the amino acids, L-glutamate and GABA. Adrenal sympathetic preganglionic neurons were retrogradely labelled with cholera toxin B subunit and amino acid immunoreactivity was revealed with post-embedding immunogold labelling. In single ultrathin sections, 46% (98/212) of the synapses or direct contacts on adrenal sympathetic preganglionic neurons were immunoreactive for glutamate and 39% (83/214) were immunoreactive for GABA. Analysis of inputs with the physical disector yielded similar results for the two amino acids. The proportions of glutamatergic or GABAergic synapses on cell bodies and dendrites were similar. When alternate ultrathin sections were stained to reveal glutamate or GABA immunoreactivity, either one or the other amino acid occurred in 78.4% (116/148) of inputs; 4.1% (6/148) of inputs contained both amino acids and 17.5% (26/148) of inputs contained neither. These results demonstrate that nerve fibres immunoreactive for the neurotransmitter amino acids, glutamate and GABA, provide most of the input to sympathetic preganglionic neurons caudal to a spinal cord transection. Synapses containing glutamate and GABA could provide the anatomical substrate for the exaggerated sympathetic reflexes and the low sympathetic tone that result from spinal cord injury.

Changes in immunoreactivity for growth associated protein-43 suggest reorganization of synapses on spinal sympathetic neurons after cord transection.

Cervical or high thoracic spinal cord injury often results in autonomic dysreflexia, a condition characterized by exaggerated spinal reflexes and episodic hypertension, that may be caused by reorganization of synapses on sympathetic preganglionic neurons after loss of supraspinal input. To assess remodelling of synaptic input to identified preganglionic neurons, immunoreactivity for growth associated protein-43 was examined by fluorescent and electron microscopy in control rats with intact spinal cords and in rats seven to 30 days after midthoracic cord transection. This protein is found in mature bulbospinal axons that supply spinal sympathetic nuclei and it is also known to be up-regulated in growing or sprouting axons. In the thoracic cord of control rats, fibres containing growth associated protein-43 surrounded histochemically- or retrogradely-labelled preganglionic neurons and formed a ladder-like pattern in the gray matter. Fibres travelled rostrocaudally along the lateral horn and, at approximately regular intervals, they coursed mediolaterally to form "rungs" of a ladder. Electron microscopy revealed concentrated growth associated protein-43 in many intervaricose axon segments in the intermediolateral cell column. Less frequently, faint immunoreactivity for this protein was found in varicosities, some of which synapsed on retrogradely-labelled sympathoadrenal preganglionic neurons. Electron microscopy of conventionally processed tissue was used to determine the time-course of degeneration of severed axon terminals in the intermediolateral cell column. In spinal rats, terminals with ultrastructural signs of degeneration were numerous in the intermediolateral cell column three days after transection, but were rare at seven days and absent at 14 days. Degenerating terminals were never found in this region in control rats. Thus virtually all supraspinal inputs to preganglionic neurons had been eliminated by seven days after transection. At longer times after injury, terminals containing immunoreactivity for growth associated protein-43 must therefore arise from intraspinal neurons. The distribution of fibres immunoreactive for growth associated protein-43 changed markedly in the first 30 days after cord transection. By 14 days, the ladder-like pattern was distorted rostral to the transection by enlarged masses of immunoreactive fibres surrounding preganglionic neurons, suggesting sprouting of bulbospinal or intraspinal axons or accumulation of this protein in their terminals after the parent axon had been severed. Caudal to the transection, the ladder-like arrangement of fibres was completely replaced by a reticular network of immunoreactive fibres that extended throughout the intermediate gray matter and increased in density between 14 and 30 days. In the intermediolateral cell column, at fourteen days after transection, axons with the ultrastructural features of growth cones contained intense growth associated protein-43 immunoreactivity. Although varicosities of bulbospinal axons containing this protein had degenerated by 14 days, weak immunoreactivity was still found in varicosities that synapsed on labelled sympathoadrenal neurons. Furthermore, immunoreactivity appeared in numerous somata of presumed interneurons throughout the intermediate gray matter by 14 days and the number of somata increased by 30 days. These interneurons may be the source of this protein in the reticular network, and in growth cones and synapses. The loss of supraspinal inputs by seven days after cord transection, and the new intraspinal network of immunoreactive fibres, synapses and cells are consistent with new synapse formation on preganglionic neurons. New synpases on preganglionic neurons may be crucial for the development of autonomic dysreflexia.

Catecholamine enzymes and neuropeptides are expressed in fibres and somata in the intermediate gray matter in chronic spinal rats.

Spinal cord injury disrupts control of sympathetic preganglionic neurons because bulbospinal input has been lost and the remaining regulation is accomplished by spinal circuits consisting of dorsal root afferent and spinal neurons. Moreover, an initial retraction and regrowth of dendrites of preganglionic neurons in response to deafferentation creates the potential for remodelling of spinal circuits that control them. Although catecholamines and neuropeptide Y are found in descending inputs to the preganglionic neurons, their presence in spinal circuits has not been established. Spinal circuits controlling preganglionic neurons contain substance P but participation of these peptidergic neurons in remodelling responses has not been examined. Therefore, we compared immunoreactivity for the catecholamine-synthesizing enzyme dopamine beta-hydroxylase, for neuropeptide Y and for substance P in the intermediate gray matter of the spinal cord in control rats and in rats seven or fourteen days after transection at the fourth thoracic cord segment. Sympathetic preganglionic neurons were retrogradely labelled by intraperitoneal injection of the tracer FluoroGold. These experiments yielded three original findings. 1) At one and two weeks after cord transection, fibres and terminals immunoreactive for dopamine beta-hydroxylase and neuropeptide Y were consistently found in the intermediolateral cell column in segments caudal to the transection. The area of fibres and terminals containing these immunoreactivities was markedly reduced compared to control rats or to segments rostral to the transection in the spinal rats. 2) Immunoreactivity for substance P was increased after cord transection and the distribution of fibres immunoreactive for this peptide in segments caudal to the transection extended more widely through the intermediate gray matter. These reactions demonstrated a plastic reaction to cord transection by spinal neurons expressing substance P. 3) Dopamine beta-hydroxylase expression was up-regulated in somata within the intermediate gray matter of spinal segments caudal to the transection. The numbers of somata immunoreactive for this enzyme increased six-fold by 14 days after cord transection, compared to the few somata counted in control rats. In conclusion, the presence of a catecholamine synthesizing enzyme and neuropeptides in fibres surrounding sympathetic preganglionic neurons caudal to a cord transection suggests a source of catecholamines and these peptides within spinal circuits in the chronic spinal rat. The presence of dopamine beta-hydroxylase in a markedly greater number of neuronal somata after cord transection reflects significant up-regulation of gene expression and may indicate a switch by these neurons to an adrenergic phenotype, revealing a plastic response to injury within the spinal cord.