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A number of animal models have been developed to study MS, most recognizably the experimental autoimmune encephalomyelitis (EAE) model. In EAE, rodents are immunized against a fragment of a myelin peptide and undergo inflammatory lesion development manifesting in ascending paralysis. While this model has been useful for pre-clinical testing of immunomodulatory MS drugs, it is not ideal for studying remyelination for three main reasons: Firstly, the location of inflammatory lesions is somewhat random, and locating lesions when processing tissue for semi- or ultrathin sections can be challenging. The second is that remyelination occurs over a specific time course, and the exact age of a single EAE lesion cannot be known without continual non-invasive magnetic resonance imaging. The third is that remyelination is a naturally occurring phenomenon in rodents, and evidence of remyelination following drug treatment in EAE may not be a primary result of the drug, but instead a secondary phenomenon of reducing inflammation.
Another common method of producing demyelination is achieved by introducing the copper chelator cuprizone in the diet. This results in widespread demyelination, most notably in the corpus callosum. There are limitations in studying the corpus callosum as a site of remyelination for the following reasons: Firstly, axon diameters (and thus myelin thickness) are smaller than other CNS regions, and thus thinly remyelinated sheaths can be indistinguishable from those that were never demyelinated. Secondly, because the mouse corpus callosum contains >70% unmyelinated axons16, it can be unclear whether a remyelinated segment is true repair of damaged myelin or de novo myelin synthesis in the adult, which occurs normally17.
It is of our belief that the best model for studying remyelination is the direct injection of toxins, either lysolecithin, ethidium bromide, or others, into the caudal cerebral peduncles18 or the spinal cord white matter. The former location is achieved only by precise 3-dimension stereotactic injection, and is limited to larger rodents (rats) due to the small size of the cerebellar peduncles. This excludes the extensive resource of transgenic mice in studying de- and remyelination. The spinal cord, however, contains many large white matter tracts that are easily accessible surgically. Spaces between vertebrae in the rostral thoracic segment allows for exposure of the spinal cord without the need for a laminectomy, which is a necessary step in caudal thoracic surgical procedures. An advantage of specifically targeting the ventral white matter is that the axons are uniformly larger than the dorsal white matter, making quantification of remyelination a less ambiguous task—similar to the challenges associated with the corpus callosum. Additionally, the ventral white matter makes up a much larger target area to inject; several hundred microns laterally in the dorsal region would place the capillary outside the column, while the same deviation ventrally would still produce a prominent demyelinating lesion. Some protocols inject lysolecithin into both the dorsal and ventral columns of the same animal19. This can increase both the likelihood of proper capillary placement and the number of quantifiable lesions in fewer animals. While the current data presented is from 8-10 week old animals at time of operation, we have also had success using the same procedure on 8-10 month old mice, where remyelination is described as being markedly slower4.
Quantification of remyelination is not a trivial undertaking. A central dogma posits that remyelinated segments are shorter in length and thinner on average than their healthy counterparts, and thus g-ratio calculations (axon diameter divided by axon + myelin diameter) of cross-sectional semi- or ultrathin sections have become standard procedure. However, it is known that remyelinated segments thicken over time2 and a recent study using a transgenic reporter of remyelinating oligodendrocytes suggests that many internodes eventually become indistinguishable from control20. Quantifying the number of mature oligodendrocytes within the lesion is an indirect way to measure repair, as oligodendrocytes are capable of making a wide number of internodes, and a significant proportion of remyelination—depending on the model used—can occur from Schwann cells3. Of course, as remyelination has been linked to restoration of saltatory conduction21, the ultimate metric of repair would be functional recovery of neurological deficits. While remyelination has been linked to recovery of function in some species22,23, it has not become a standard procedure in murine lysolecithin studies. This is likely due to a lack of overt observable deficits from either dorsal or ventral lesions, compared to more robust demyelination models such as EAE and even cuprizone. We believe that functional deficits resulting from lysolecithin injection, and subsequent recovery with remyelination, will only be observable using sensitive tests of fine sensorimotor functioning.
A PubMed search of “remyelination” alongside either of the animal models listed above, albeit a brusque methodological approach, shows fewer search hits for lysolecithin (109) compared to EAE (188) and cuprizone (197). If our argument that lysolecithin demyelination is the superior approach for studying remyelination, why is it the least discussed? Perhaps an apprehension for using this method derives from a belief of technical difficulty in performing the surgical operation. In actuality, this procedure is fast, cost-effective, and is no more difficult than routine tissue dissection, requiring materials that are all commercially available. It is our hope that this protocol proves useful for those that wish to add this powerful model to their repertoire for studying the exciting and expanding field of myelin repair.