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A variety of studies have sought to enhance CNS axon regeneration after the injuries of the spinal cord or brain. Inflammatory reactions, inevitably accompanying the injuries in the nervous system, are traditionally thought to participate in secondary pathological processes leading to the deleterious outcomes1,2. Indeed, methylprednisolone that can suppress inflammatory reactions is the only approved therapy for acute spinal cord injury3. However, more recent studies have provided evidence that macrophages, a representative inflammatory cell type, can participate in the regeneration or repair of injured nervous system4,5,6. For example, infiltrating macrophages following a lens injury produce pro-regenerative molecules to promote the regeneration of the retinal ganglion neurons7,8. In addition, transplanted DRG neurons increased axon growth up the region where macrophages were activated by zymosan9. Moreover, the macrophages at the lesion site can create a growth-permissive milieu for injured peripheral nerves10.
Our work also provided strong evidence that macrophages can contribute to the capacity of axon regeneration in adjacent neurons. We have shown that the activation of macrophages in the dorsal root ganglia (DRG) were essential in the enhanced regenerative capacity of DRG sensory neurons following a preconditioning peripheral nerve injury11. Similar research was independently reported from another laboratory12. We also showed that intraganglionic injection of dibutyryl cyclic AMP (db-cAMP), which is a well-known molecule to enhance the capacity of axon regeneration13, induced the activation of macrophages. The deactivation of macrophages abolished the effects of db-cAMP on neurite outgrowth activity. Subsequent works identified injury-induced expression of CCL2 in neurons as a signal to stimulate macrophages with a pro-regenerative phenotype14,15.
Based on the above experimental results, we have established an in vitro model resembling molecular events that occur in the DRGs following a preconditioning injury model11,14. In this model, db-cAMP is applied to the neuron-macrophage co-cultures eliciting intercellular signaling that leads to the activation of macrophages with a pro-regenerative phenotype. Here, we describe detailed protocols by which we can generate macrophages that secrete molecular factors promoting neurite outgrowth (Figure 1). This experimental model illustrates a concept that macrophages can be stimulated or induced to support axon regeneration following the injuries to nervous system. Our model will also be useful in studying mechanisms in intercellular signaling that leads to the activation of pro-regenerative macrophages.