There are several critical steps for the generation of this co-culture system. It is important to ensure that the mouse DRG neurons and peritoneal macrophages are prepared fresh and healthy. We have experienced diminished neurite outgrowth activity of the CM when the dissection of all the DRGs took more than 30 min. In addition, the contamination of blood components in peritoneal macrophages also led to a decrease of neurite outgrowth activity in the CM. In order to elicit robust neuron-macrophage interaction by db-cAMP, thorough washing would also be a critical step to ensure complete removal of tissue debris and elimination of potentially remaining cytotoxic components, such as collagenase or RBC lysis buffer. Another point to be reiterated is that the roots attached to DRGs should be removed as much as possible. Remaining stubs of roots would increase the contamination of Schwann cells in DRG neuron culture. Schwann cells can produce high amount of neurotrophic factors in culture that might confuse the results.
In this protocol, dissociated macrophages were plated on a cell culture insert separated from the DRG neurons plated on the bottom of the well plate. Our previous study did not show significant difference in the extent of neurite outgrowth activity between the CMs collected from direct co-cultures (allowing physical contacts between the two cell types) and the co-cultures with the two cell types separated by a cell culture insert11. This result indicated that neurons and macrophages are communicating with each other via soluble molecules released from either cell type, not by direct physical contacts. It was shown that CCL2, secreted from DRG neurons, is responsible for activating macrophages into a pro-regenerative phenotype in this co-culture model14. Thus, our co-culture system will allow the elucidation of more detailed intercellular signaling that mediates the activation of pro-regenerative macrophages.
The culture was precisely restricted to 15 h during the neurite outgrowth assay in this protocol. In pilot experiments, we examined several different culture time and found that with a minimal extent of neurite outgrowth in control condition (15 h), highly robust neurite outgrowth was achieved with the CM treated with db-cAMP. Mouse DRG neurons, if not preconditioned, do not grow any significant neurites within this time frame. If DRG neurons are cultured longer than 15 h, however, they start to show some degree of neurite outgrowth even in control, not preconditioned condition, which would obscure any effect of the db-cAMP-treated CM on neurite outgrowth. Similar result was reported in the neurite outgrowth assay using rat DRG neurons in a previous study16.
Some previous studies used zymosan, a yeast cell wall preparation, to activate macrophages with a pro-regenerative phenotype7,9. However, the macrophages stimulated by zymosan released not only pro-regenerative molecules but also cytotoxic factors. When the protein components in macrophage CM treated with zymosan were separated by gel-filtration chromatography, macrophage-derived factors ≥ 30 kDa were cytotoxic while factors ≤ 30 kDa promoted axon regeneration7. In addition, zymosan injection to the spinal cord can lead to overt death of neurons and axons9. In comparison, our protocol to generate pro-regenerative macrophages has shown to be more physiologic than the previous one using zymosan. In fact, db-cAMP injection to the DRG neurons enhanced their capacity to growth axons following an injury to the central branch without any report on cellular damages17,18. Throughout a series of our experiments, we have never observed any significant decrease of the DRG neuron density in the culture following application of the db-cAMP-treated CM. We speculate that our protocol allows us to produce solely pro-regenerative macrophages without concurrent neurotoxicity. Therefore, the protocol and experimental model reported here would be useful to identify molecular signatures of pro-regenerative macrophages and to understand by what mechanisms the pro-regenerative phenotype is evolved.