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Alterations in gastrointestinal (GI) nerve morphology and density have caught the attention of gastroenterologists and pathologists for a long time, but their relevance for the pathophysiology of GI diseases remains unknown1-3. Indeed, several highly common GI disorders such as gastritis, reflux esophagitis, colitis, diverticulitis, and appendicitis are associated with increased innervation density in inflamed tissue areas1. However, no genuine attention has so far been paid to the mechanisms and meaning of neuroplasticity in the GI tract. Do morphologically altered GI nerves differ from normal GI nerves, i.e. the normal state of the enteric nervous system, in terms of their function? What are the implications of altered neuropeptide/neurotransmitter content in plastic enteric nerves? Does peripheral neuroplasticity always entail altered signaling to the central nervous system? And where are the central projections of plastic extrinsic GI neural pathways? A long series of such key questions can easily be generated when looking at the paucity of our knowledge on the functional aspects of GI neuroplasticity.
The study of GI neuroplasticity at functional level requires valid, reproducible and still easily applicable experimental models. In an era of increasing popularity and acceptance of genetically engineered conditional mouse models (GECoMM), such in vivo settings bear the potential to elucidate previously unknown facets of GI neuroplasticity in a realistic fashion1. However, the design and production of GECoMM remains costly, labor-intensive and, especially, time-consuming. Furthermore, they require the a priori selection of the target to be conditionally modulated in the genetically altered mouse (e.g. transgenic overexpression of nerve growth factor/NGF in enteric epithelial cells). Hence, for the design of a successful GECoMM, researchers need some indicators (e.g. previous experimental data) of a worthwhile target, i.e. that the molecule of interest (here NGF) can at least be expected to exert some biologically relevant effects on GI nerves.
Such indicators can easily be derived from adequate in vitro models in which isolated cell subtypes from the complex microenvironment of an in vivo system can be selectively cocultured in a heterotypic manner4-7. The modulation of molecular targets in such a heterotypic culture setting is on average technically less cumbersome, faster, and can therefore aid in the prefiltering of worthwhile targets for verification in in vivo studies.
Recently, we presented an in vitro neuroplasticity assay which was designed to simulate the increased neural density and hypertrophy of intrapancreatic nerves in human pancreatic cancer (PCa) and chronic pancreatitis (CP) tissues. Here, neurons derived from newborn rat dorsal root ganglia (DRG) or myenteric plexus (MP) were exposed to tissue extracts from surgically resected PCa or CP tissues specimens and compared to those cultured in normal human pancreas (NP) tissue extracts5. Instead of tissue extracts, one can also use cell line supernatants to study the impact of selected cell types on neuroplasticity. When combined with a standardized morphometric measurement, the presented neuroplasticity assay allows valid and reproducible assessment of neuronal plasticity in response to different pancreatic microenvironments. Particularly, it allows the simulation of 1) morphological neuroplasticity, i.e. the changes in the neurite outgrowth, branching pattern and neuronal size, and 2) functional neuroplasticity, i.e. alterations in the excitability of peripheral neurons. Moreover, not only peripheral (i.e. enteric), but also central (e.g. DRG or second order spinal) neurons can be included in the present assay to assess their morphological and functional reaction to different GI tissue contents. In the present video tutorial, we demonstrate the technical protocol for the performance of this assay and discuss its advantages and weaknesses. Moreover, we draw attention to the applicability of the basic notion of this assay to the study of neuroplasticity in any GI organ.