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The Journal of Neuroscience, August 15, 2001, 21(16):6136-6146
Glial Cell Line-Derived Neurotrophic Factor Administration
in Postnatal Life Results in Motor Unit Enlargement and Continuous
Synaptic Remodeling at the Neuromuscular Junction
Cynthia R.
Keller-Peck1,
Guoping
Feng1,
Joshua R.
Sanes1,
Qiao
Yan3,
Jeff W.
Lichtman1, and
William D.
Snider2
1 Department of Anatomy and Neurobiology, Washington
University School of Medicine, St. Louis, Missouri 63110, 2 Neuroscience Center, University of North Carolina School
of Medicine, Chapel Hill, North Carolina 27599, and
3 Neurobiology, Amgen, Inc., Thousand Oaks, California
91320
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ABSTRACT |
Overexpression of glial cell line-derived neurotrophic factor
(GDNF) in embryonic muscle fibers causes dramatic hyperinnervation of
neuromuscular junctions. However, it is not known whether GDNF induces the extra innervation by regulation of axonal branching and/or
synaptic maintenance. To address this issue, high levels of circulating
GDNF were established by administering subcutaneous injections starting
either at birth or later and continuing for up to 40 d. Treatment
with exogenous GDNF beginning in the first week, but not later,
increased the number of axons converging at neuromuscular junctions.
The effect of GDNF on the branching pattern of individual motor axons
was determined by reconstructing labeled axonal arbors from transgenic
mice expressing yellow fluorescent protein in subsets of motor
neurons. Whereas, at postnatal day 8 (P8) individual axons in control
animals branched to sporadically innervate junctions within
circumscribed regions of the muscle, motor units from GDNF injected
animals had significantly more axonal branches and exhibited a high
degree of localized arborization such that adjacent muscle fibers were
often innervated by the same axon. Administration beginning at P0 and
continuing through P40 prolonged multiple innervation of most fibers
throughout the period of injection. Between P30 and P40 there was no
net change in multiple innervation, although there was evidence of
retraction bulbs, suggesting that axon extension and retraction were in
equilibrium. We conclude that GDNF has a developmentally regulated
effect on presynaptic branching and that sustained administration of
GDNF induces a state of continuous synaptic remodeling.
Key words:
GDNF; motor unit; motor neuron; growth factor; neuromuscular junction; synapse elimination; sprouting
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INTRODUCTION |
A number of recent studies have
demonstrated that neuronal growth factors influence synapses in many
parts of the nervous system. For example, in autonomic ganglia,
brain-derived neurotrophic factor (BDNF) has been shown to alter
synaptic density, suggesting that growth factor levels regulate
synaptogenesis (Causing et al., 1997 ). Activity-mediated synaptic
rearrangements in the CNS are also influenced by BDNF and NT-4/5
(Cabelli et al., 1995 , 1997 ). At the neuromuscular junction (NMJ),
several trophic factors influence developmental synaptic rearrangements
(English and Schwartz, 1995 ; Kwon et al., 1995 ; Jordan, 1996 ; Kwon and
Gurney, 1996 ). Because evidence suggests that neuronal growth factors
both influence synaptic activity and in turn can be regulated by neural
activity, these factors may be mediators of activity-dependent synaptic plasticity (Ghosh et al., 1994 ; Li et al., 1998 ; Berninger et al.,
1999 ; Kang and Schuman, 2000 ) (for review, see Snider and Lichtman,
1996 ; Schuman, 1999 ).
The actions of growth factors on synaptic connections could be
indirect, because of effects on the degree of axon branching or
on the number of axons (for example by preventing neuronal cell death).
Alternatively, growth factors could directly influence synapse
formation, maintenance, competition, or some combination. Deciding
between these alternatives is complicated in the CNS, where both
presynaptic and postsynaptic components may express receptors for the
same trophic factor (McAllister et al., 1995 , 1997 ).
Developing neuromuscular junctions undergo a stereotypical alteration
in synaptic connections known as synapse elimination (Brown et al.,
1976 ; Balice-Gordon et al., 1993 ), which seems analogous to central
rearrangements, but is far easier to analyze. At the NMJ, transgenic
overexpression of glial cell line-derived neurotrophic factor
(GDNF), the most potent trophic factor yet described for motor
neurons, leads to a dramatic increase in the number of motor axons
innervating muscle fibers at a time when axons are ordinarily being
eliminated (Nguyen et al., 1998 ). This effect suggested that GDNF might
be an important regulator of synapse elimination. However, the
interpretation of the mode of action of GDNF is ambiguous
because transgenic GDNF expression began before the period of
programmed cell death [approximately embryonic day 9.5 (~E9.5)]
(Cheng et al., 1992 ), allowing GDNF to alter the number or behavior of
motor axons while they are in the process of growing to targets.
Because the effects of transgenic GDNF on NMJ innervation are so
dramatic and because an increased understanding of this effect may shed
light on the regulation of synapses by growth factors, we thought it
important to investigate the mechanism by which GDNF alters NMJ
innervation. A pharmacological approach might provide useful
information because exogenous administration can be used to control the
amount, onset, and duration of GDNF exposure. We thus could ask if
higher levels of circulating GDNF could maintain multiple innervation
at the NMJ indefinitely, which did not occur in the transgenic animals
expressing lower and uncontrolled levels of GDNF (Nguyen et al., 1998 ).
We also could easily test whether GDNF-related molecules such as
neurturin (NTN) (Kotzbauer et al., 1996 ; Klein et al., 1997 ; Milbrandt
et al., 1998 ) had similar effects.
Here, we report that early postnatal subcutaneous injection of GDNF
(but not NTN) induces sustained multiple innervation, but GDNF
injections begun after the first postnatal week were without effect.
Moreover, if GDNF administration is begun early, and continued into
adulthood, multiple innervation persists. In these adult animals, there
is evidence of ongoing synapse elimination despite the retention of
multiple innervation. Morphological analysis of single labeled motor
axons reveals that the hyperinnervation is quantitatively explained by
an increase in motor unit size, not motor neuron number. Our results
demonstrate that GDNF promotes axon branching and synapse formation at
NMJs in postnatal life and, if applied during a developmentally
restricted time, GDNF may induce a continuous state of synaptic remodeling.
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MATERIALS AND METHODS |
Protocol for injection of factors. Human recombinant
(hr) GDNF was obtained from Amgen (Thousand Oaks, CA), and rat
recombinant NTN was kindly supplied by G. Johnson (Washington
University, St. Louis, MO). Both growth factors were diluted to a
working concentration of 2.5 mg/ml in sterile PBS, pH 7.4. GDNF
was stored at 70°C until dilution, after which it was kept for a
maximum of 4 d at 4°C. Before injection, the skin was sterilized
by wiping with 70% alcohol. Subcutaneous injections were done twice
daily with a 10 µl Hamilton syringe at a dose of 0.5 µg/gm or 2.0 µg/gm in the back of the neck beginning on either postnatal day 0 (P0) or P10. The volume of injection ranged from 0.2 to 20 µl.
Injections continued until P8, P23, P30, or P40. Control injections
were done identically to experimental injections, using PBS alone.
Animals. Timed pregnant CF-1 strain females were obtained
from Charles River (Wilmington, MA). Thy1-YFP transgenic
mice were produced at Washington University (St. Louis, MO) (Feng et
al., 2000 ). The day of birth was considered postnatal day 0. On the day
of the terminal experiment, mice were deeply anesthetized with sodium
pentobarbital (0.65 mg/gm body weight) and perfused transcardially with
heparin in PBS, pH 7.4, followed by 2% paraformaldehyde in 0.1 M phosphate buffer, pH 7.4. Sternomastoid and
spinotrapezius muscles were carefully dissected and post-fixed in
paraformaldehyde for ~2 hr. The connective tissue surrounding the
muscle was then removed, and the tissue was incubated overnight in PBS
with 0.1 M glycine.
Tissue staining. Sternomastoid muscles from CF1 and
spinotrapezius muscles from thy1-YFP mice were incubated for
30 min at room temperature in 5 µg/ml
tetramethylrhodamine-conjugated -bungarotoxin (Molecular
Probes, Eugene, OR) that was diluted in 1% bovine serum albumin (BSA)
in sterile lactated Ringer's solution. The muscles were then rinsed 3 hr in PBS. Thy1-YFP spinotrapezius muscles were then mounted
on glass slides in Vectashield mounting medium (Vector Laboratories,
Burlingame, CA) for imaging. CF1 sternomastoid muscles were
immunostained by blocking in 4% BSA and 0.5% Triton X-100 in
PBS overnight at 4°C. The next day, muscles were incubated in mouse
anti-phosphoneurofilament antibody SMI312 (Sternberger Monoclonals,
Lutherville, MD) diluted 1:500 and the mouse synaptic vesicle antibody
SV2 (Developmental Studies Hybridoma Bank, The University of Iowa, Department of Biological Sciences, IA City, IA)
diluted 1:10 in blocking solution. After washing 5 hr in 1.0% Triton
X-100 in PBS, the tissue was incubated overnight in a 1:200 dilution of goat anti-mouse antibody conjugated to the fluorescent label Alexa 488 (Molecular Probes). Immunostained muscles were also
mounted in Vectashield on glass slides.
Muscles to be stained for Ret or GFR -1 were dissected from unfixed
animals, embedded in OCT (Tissue-Tek, Miles Inc., Elkhart, IN),
and quick frozen with liquid nitrogen. Twenty micrometer sections
through the endplate band were cut on a cryostat and thaw-mounted on
glass slides for immunohistochemistry. Rabbit anti-Ret (R & D Systems,
Minneapolis, MN) and goat anti-GFR -1 (KMI Diagnostics, Minneapolis,
MN) were diluted 1:200 and 1:150, respectively, in blocking solution
(see above). Tissue was incubated overnight at 4°C. After washing in
PBS, sections were incubated 3 hr with either anti-rabbit or anti-goat
secondary antibodies conjugated to Alexa 488 (Molecular Probes). After
rinsing, slides were coverslipped with Vectashield (Vector
Laboratories) and imaged.
Data collection. For each time period and each dose of
growth factor, a minimum of two animals (four sternomastoid muscles) was examined. An approximately even distribution of male and female pups was used. When muscles from different animals in the same experimental condition were used, we first determined whether there
were statistically significant differences within the group before
combining data. In no case did muscles within an experimental group
differ significantly from each other; therefore, "n " in the text refers to the number of NMJs counted. Approximately 50 junctions per muscle were counted to determine the percent multiple innervation and the mean number of axons per receptor plaque. Data are
expressed as the mean number of axons per muscle fiber ± the SD,
unless otherwise noted.
A Nikon Optiphot microscope with a 50× water immersion lens was used
to examine and count the number of axons per junction. Thy1-YFP single motor units (and Ret/GFR -1-labeled tissue
sections) were imaged on an Olympus Optical (Tokyo, Japan) (BX50WI)
microscope using a laser-scanning confocal microscope (model 1024;
Bio-Rad, Hercules, CA). Images were obtained with a 40× (1.35 NA) oil
objective. Z-stacks were flattened with Confocal Assistant, and
montages of collapsed image stacks were assembled using Adobe Photoshop.
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RESULTS |
Initially, we tested daily subcutaneous doses of GDNF in newborn
pups at 2.5 µg/gm and higher, but the animals rarely survived the
first postnatal week. Therefore, to examine the effects of GDNF on
neuromuscular junctions in postnatal life, we injected either 2.0 or
0.5 µg/gm GDNF twice daily into CF1 pups for periods (8-40 d)
beginning at various time points after birth. Subcutaneous injection of
either 2.0 or 0.5 µg/gm GDNF beginning at birth rapidly produced
weight loss, and several days later tail kinks and tremors were evident
(Fig. 1). These same characteristics were
observed at birth in transgenic animals expressing GDNF in muscles
(Nguyen et al., 1998 ). Animals injected twice daily with 2.0 µg/gm
GDNF for the first 7 d after birth weighed an average of 21% less
than their PBS-injected littermate controls, and pups injected with 0.5 µg/gm for the same time period weighed an average of 2% less than
controls. When the high dose GDNF injections were continued into later
life (P0-P40), animals were 17% smaller than control P40 mice. The
magnitude of tremor was higher and persisted longer in the mice
injected with the higher dose of GDNF. Injection of the related factor,
NTN, at doses of 3.0 or 0.5 µg/gm twice daily produced no external
phenotypic changes.

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Figure 1.
GDNF injection results in tail kinks, weight loss,
and tremor. Three postnatal day 10 CF1 littermate pups are shown. Each
pup was injected with PBS (left), 0.5 µg/gm GDNF
(middle), or 2.0 µg/gm GDNF (right)
beginning at birth. There is a dose-dependent increase in tremor, as
noted in the insets (time lapse: 1 sec exposure).
A, PBS; B, 0.5 µg/gm GDNF;
C, 2.0 µg/gm GDNF.
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Effects of GDNF and NTN on neuromuscular innervation at P8
In pups injected twice daily with saline from P0 through P8, 37%
of the sternomastoid muscle fibers were multiply innervated at P8
(mean = 1.4 ± 0.5 axons per NMJ; n = 411).
This number was significantly higher in pups injected from birth with
2.0 µg/gm GDNF; 99% of junctions at P8 were multiply innervated
(mean = 3.3 ± 1.1; n = 199;
p < 0.000001; Student's t test) (Table
1, Fig.
2B). However, after
treatment many of the axons were of unusually small caliber, and when
adjacent to other axons, difficult to resolve, suggesting that we may
have underestimated their number. In animals treated with the low, 0.5 µg/gm, GDNF dose, the incidence of multiple innervation (93%) and
average number of axons per NMJ (mean = 2.9 ± 1.0;
n = 318) was also significantly greater than controls
(p < 0.000001; Student's t test).
The effect of the low dose of GDNF was however, significantly less than
the effects of the high dose of GDNF (p = 0.0002; Student's t test). We surveyed several other
muscles in the GDNF-treated animals, including two in the hindlimb
(gastrocnemius and soleus), and found similar effects on multiple
innervation.

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Figure 2.
Postnatal GDNF injection produces
hyperinnervation of neuromuscular junctions in sternomastoid muscle.
A, B, Confocal reconstructions of part of
the endplate band from a P8 mouse after twice-daily PBS
(A) or 2.0 µg/gm GDNF (B)
injections beginning at birth. C, D,
Higher magnification confocal reconstructions of a single neuromuscular
junction in control (C) and GDNF-exposed
(D) sternomastoid muscles at P8. Four different
axons innervate the junction in the GDNF-exposed mouse
(D, arrows), whereas only one axon
innervates the control junction (C). Note that in
the GDNF-exposed junction (D), axon number 4 is
relatively small compared with the other three inputs. Axons are
labeled with anti-neurofilament antibodies
(green), and postsynaptic acetylcholine
receptors are labeled with tetramethylrhodamine- -bungarotoxin
(red).
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Injection of the related factor neurturin at 0.5 µg/gm had no effect
on the number of axons innervating muscle fibers, and injection of 3.0 µg/gm produced no significant increase in NMJ innervation at P8
(1.5 ± 0.5; n = 122) (Table 1). These results show that augmenting GDNF levels, but not NTN, in postnatal animals had
comparable effects to transgenic GDNF expression beginning in embryonic life.
Interestingly, the number of axons per junction in P8 pups after GDNF
injection of 2.0 or 0.5 µg/gm is >2.1 axons per junction estimated
from electrophysiological studies of wild-type sternomastoid muscle at
P0 (Balice-Gordon and Lichtman, 1993 ), suggesting that GDNF is able to
induce presynaptic branching.
Presynaptic branching
To directly assess the effect of GDNF on motor neuron morphology,
we examined the entire branching pattern of single motor units in P8
muscles after twice-daily injections of 2.0 µg/gm GDNF beginning at
birth. To analyze individual motor units, we used a line of transgenic
mice (thy1-YFP) that expresses yellow fluorescent protein
(YFP) in only a few motor neurons per motor pool during postnatal life
(Feng et al., 2000 ) (our unpublished observations). For this
study, we chose the spinotrapezius muscle because it is a thin muscle
(unlike the sternomastoid, which was used previously) that is ideal for
imaging the entire arbor of individual motor axons. In control muscles,
each motor axon enters the muscle rostrally and sends off branches as
it courses caudally (Fig. 3A).
At P8, labeled motor units in control animals contact an average of
55 ± 15 (n = 5) muscle fibers. After GDNF
injection, the size of single motor units more than doubled, with each
axon contacting an average of 112 ± 18 muscle fibers at P8
(n = 2; p = 0.008) (Fig.
3B,C). Thus, GDNF exposure in postnatal life leads to a
large-scale increase in the size of motor units.

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Figure 3.
Completely reconstructed motor units in postnatal
day 8 spinotrapezius muscle show a twofold increase in branching after
GDNF injection. Montages of confocal reconstructions from postnatal day
8 transgenic mice (thy1-YFP) reveal single motor axons
that express yellow fluorescent protein. Axons appear
green, and acetylcholine receptors are labeled with
rhodamine- -bungarotoxin (red). The expanse of each
motor unit is shown in the small diagram to the
right of each photomontage. The pink
patches in the diagrams are areas where
neuromuscular junctions are clustered. A, Control motor
units, such as the one shown, are relatively simple. B,
C, In contrast, GDNF-exposed motor units (2.0 µg/gm
GDNF) are more complicated. The control motor unit in A
formed 57 neuromuscular contacts. The GDNF motor unit in
B formed 99 neuromuscular contacts, and the motor unit
in C formed 124.
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To determine if the degree of expansion of GDNF-injected motor units
was consistent with the degree of multiple innervation in
spinotrapezius muscle, we analyzed individual junctions from single
motor units in GDNF-injected and control animals. The YFP-labeled axon
occupies all the acetylcholine receptors in junctions that are singly
innervated. In contrast, junctions that have not completed synapse
elimination are only partially occupied by the labeled axon (our
unpublished observations). Thus, by analyzing the degree of
receptor occupation, it is possible to determine the percentage of
endplates that are still multiply innervated in a motor unit. In the
control muscles at P8, ~75% of spinotrapezius neuromuscular junctions had completed synapse elimination and were singly innervated. In the GDNF-treated muscles, 15% of the NMJs were singly innervated (p < 0.001; z test). If the
remaining 85% of multiply innervated junctions had just two axons
innervating them, there would be an average of 1.75 axons per junction.
This number is consistent with the approximately twofold increase in
the size of motor units.
We also analyzed the particular branching patterns of individual motor
axons after GDNF injection (Fig. 4). To
do this, we began by counting the number of axonal branch points
between the cell body and each NMJ. In control animals, each
neuromuscular contact in a motor unit was an average of 11.12 branch
points from the cell body. Each NMJ in GDNF-injected animals was an
average of 11.48 branch points from the cell body. Furthermore, the
most distal NMJ in controls was found 26 branch points from the cell body (mean = 19), whereas the most distal NMJs in GDNF motor units were found up to 22 branch points from the cell body (mean = 19). Thus, GDNF exposure affects the branching of motor units in such a way
that uniform expansion of the motor unit is produced.

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Figure 4.
Branching diagrams for two motor units after GDNF
injection show expansion of the motor unit around the cell body
(A is the motor unit shown in Fig. 3B,
and B is the motor unit shown in Fig.
3C). The number of branch points between each
neuromuscular junction and the cell body (MN) is
shown to the left of each diagram. The junctions are
color-coded so that singly innervated NMJs (i.e., those that have
completed synapse elimination) are red, and junctions
that are partially occupied, and therefore multiply innervated, are
green. Gray circles indicate
junctions that were oriented such that we could not determine whether
or not they had completed synapse elimination.
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One way this uniform effect could occur is if GDNF caused terminal axon
branches (those branches directly contacting endplates) to bifurcate.
In contrast to controls, terminal branches in the GDNF-exposed animals
often innervated multiple neighboring muscle fibers. For example,
within a single 60 µm2 field of view
from a GDNF-treated P8 mouse, in which at least one labeled terminal
branch was present, two or three NMJs innervated by the same labeled
motor axon could be visualized 20 or 12% of the time, respectively. In
PBS-injected motor units, two NMJs were infrequently observed in a
single field of view (8%), and three were never observed. The increase
in the number of double- and triple-labeled neuromuscular junctions
within a single field of view after GDNF exposure was significant
(p < 0.001 in both instances). To control for
the possibility that more labeled endplates were visible in a single
field of view because the muscle fibers were smaller after GDNF
injection, we counted the total number of receptor plaques in each
field of view. Per field, the total number of endplates was not
significantly different between GDNF and the control (1.7 vs 1.8, respectively). Taken together, these data suggest that the increase in
motor unit size after GDNF injection occurs by increased terminal branching.
Synaptic maintenance
For the reasons described above, the larger motor units seen in
GDNF-treated mice seem to be attributable at least in part to an
induction of axonal branching. However, it is also plausible that GDNF
alters synapse survival and thereby allows more of the initially formed
branches to be maintained during the period of synapse elimination. One
objective of this study was therefore to determine whether sufficiently
high concentrations of GDNF could maintain multiple innervation. We
injected GDNF at 2.0 or 0.5 µg/gm from P0 until P23, P30, or P40. The
results are shown in Table 1.
Despite the twice-daily dose of injected GDNF, the number of axons per
fiber decreased as the animal matured. Furthermore, even at postnatal
day 8, the first time period examined, some branches of a motor unit
had completed synapse elimination (Fig. 4). These results suggest that
GDNF by itself is unable to maintain the high level of multiple
innervation observed during the first postnatal week, and therefore
GDNF cannot prevent synapse elimination from occurring. However, when
compared with control animals, significantly more multiple innervation
was evident in mice injected with GDNF (2.0 µg/gm) through P40
(1.8 ± 0.8; n = 184) compared with uninjected mice (1.0 ± 0; n = 81; p < 0.000001; Student's t test). In the presence of a continual
supply of GDNF, a plateau was reached at P30, because there was no
significant difference between the number of axons per fiber at P30
(1.7 ± 0.7; n = 245) and P40 (1.8 ± 0.8;
n = 184; p > 0.09; Student's
t test). Despite no change in the number of multiply
innervated fibers from P30 to P40, chronic GDNF exposure starting at
birth was still affecting neuromuscular junction innervation at these
late ages because discontinuation of GDNF administration at P30 caused
the number of multiply innervated neuromuscular junctions to drop to an
average of 1.4 ± 0.8 (n = 87) by the age of P40.
This result is interesting because GDNF treatments begun after P10 had
no effects on neuromuscular innervation at any age (see below).
In chronically treated mice, multiple innervation of junctions always
decreased after withdrawal of GDNF (Fig.
5). For example, stopping GDNF injections
at P10 resulted in a 30% decrease in the number of axons per NMJ at
P23 compared with continual injection from P0 to P23. Moreover, this
decrease was statistically significant (p < 0.000001; Student's t test). Discontinuing GDNF injection at P10 and examining junctions at P30 also produced a significant (30%) decrease in the number of axons per junction compared with continual injection (p < 0.000001; Student's
t test). Finally, when GDNF injection is discontinued at P10
and the number of axons per junction counted at P40, the level of
multiple innervation begins to approach that of control, PBS-injected
muscles (i.e., 1.0 ± 0). Specifically, at P40, 38% fewer axons
innervate NMJs when GDNF is stopped at P10 than when GDNF is not
stopped until examination (p < 0.000001;
Student's t test). These data indicate that a continual
supply of GDNF is required to exert long-term effects on neuromuscular
innervation.

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Figure 5.
Continual GDNF injection is required to
maintain multiple innervation. Graph showing the effects of
discontinuing GDNF injection at postnatal day 10 (hatched
bars) compared with continual injection (black
bars). We injected 2.0 µg/gm GDNF in all animals beginning at
birth. When GDNF is discontinued at postnatal day 10 (hatched
bars), synapse elimination rapidly proceeds, and by postnatal
day 40 (far right, hatched bar) the number of
axons per junction has almost reached control levels (1.0 axons/NMJ).
In animals receiving GDNF injection from P0 to P10,
n = 203, 199, and 150 at P23, P30, and P40,
respectively. In animals receiving GDNF injection from P0 until
examination, n = 309, 244, and 183 at P23, P30, and
P40, respectively. Asterisks indicate statistically
significant differences (see Materials and Methods). Error bars
indicate mean ± SE.
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Continuous branch remodeling is induced by GDNF
To better understand how GDNF caused persistent multiple
innervation, we examined confocal images of labeled sternomastoid and
spinotrapezius preparations from P8 to P40 for the presence of
retraction bulbs (very thin axons with bulbous endings) and sprouts, in
mice treated with GDNF from birth. As expected, given the decrease in
the number of axons per junction after the first postnatal week, many
retraction bulbs were observed in GDNF-treated animals. Interestingly,
numerous retraction bulbs were present at both P30 and P40 (Fig.
6B), despite the fact
that the number of axons per fiber did not decrease during this period,
implying that axons may have been both retracting and re-growing.
Consistent with this view, terminal and nodal sprouts were present
throughout postnatal life after GDNF administration (Fig.
6C-H). These results suggest that a dynamic state of
active axon growth and retraction may be occurring in the presence of
GDNF.

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Figure 6.
GDNF induces a dynamic state of axonal branching.
A, Confocal reconstruction of a neuromuscular junction
from control sternomastoid muscle at P40 shows that the junctions are
large, singly innervated, and have a complicated pattern of receptor
branches that accurately mirrors the branching pattern of the overlying
terminal axon, which possesses no sprouts. B,
C, In contrast, after 40 d of continual exposure to 2.0 µg/gm GDNF, junctions are often multiply innervated
(C), smaller in area, and somewhat less complex
than controls. Furthermore, many thin axons, terminating in bulbs, were
evident (arrow, B). These structures are
identical in appearance to "retraction bulbs" seen during naturally
occurring synapse elimination in the first 2 postnatal weeks (Bernstein
and Lichtman, 1999 ). Additionally, axons that ended in structures that
resembled growth cones were observed in GDNF-exposed muscles
(C, and enlargement shown in D).
E, F, Also observed at P40 in
GDNF-treated muscles were terminal sprouts that either connected nearby
junctions (E) or exited neuromuscular junctions
but ended blindly (F). G, H, Such
sprouting was also seen at earlier ages. Shown here
(G) is a blindly ending sprout off a YFP-labeled
axon from a P8 spinotrapezius muscle in a mouse treated with GDNF since
birth and a neuromuscular junction with three terminal sprouts
(H) from the same animal, suggesting that
throughout the duration of GDNF exposure axons were sending out new
processes in the muscle. Scale bar shown in A is the
same for B and C. In A-F,
axons are labeled with anti-neurofilament antibodies
(green), and postsynaptic acetylcholine receptors
are labeled with rhodamine- -bungarotoxin
(red).
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While examining the innervation of junctions in GDNF injected pups, we
also noted that many of the receptor sites appeared morphologically
abnormal compared with littermate controls. In neonatal pups <2 weeks
of age, acetylcholine receptors (AChRs) tend to be clustered in smooth,
oval plaques. As the animal matures, these plaques increase in size and
become perforated, transforming the plaque into a "pretzel-like"
morphology (Marques et al., 2000 ). At P8, AChR plaques from
GDNF-treated mice (2.0 µg/gm) were significantly larger in both area
(30%; p < 0.001) and length (20%; p < 0.001) (Fig. 7A). This
increase in size occurred despite the fact that the mice are smaller at
P8 than control (see above). Interestingly, by postnatal day 30, the
effect had reversed. After injection of 2.0 µg/gm GDNF, AChR clusters
were now significantly smaller and much simpler than the age-matched
controls. In the 2.0 µg/gm-injected animals at P30, receptor plaques
were 23% smaller in area (p < 0.001) and 20%
smaller in length (p < 0.001) than the control (Fig. 7B-D). In addition, the number of AChR-containing
branches within a neuromuscular junction was fourfold lower in the
GDNF-treated animals (mean 3.2 ± 1.6 branches) than in controls
(mean 11.8 ± 2.0 branches) at P30. In the low-dose animals, the
receptors were 12% smaller in area and 19% smaller in length. Thus,
despite the ability of GDNF to induce hyperinnervation and larger
postsynaptic AChR sites in early postnatal life, prolonged synaptic
remodeling seemed to ultimately have deleterious effects on the AChR
areas. Perhaps repeated volleys of synaptic withdrawal, induced by
GDNF, caused an exaggeration of the naturally occurring AChR loss seen during the period of naturally occurring synapse elimination in early
postnatal life (for review, see Lichtman and Colman, 2000 ).

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|
Figure 7.
Acetylcholine receptor plaques are abnormal in
GDNF-injected animals. A, Average area
(left) or length (right) of acetylcholine
receptor plaques at P8 after continual exposure to either GDNF
(white bars) or PBS (black bars). The
small inset in A, left, shows the size
frequency histogram of acetylcholine receptor area in P8 GDNF-exposed
animals (white bars) compared with control (black
bars). At P8, receptor plaques are larger
(p < 0.001) and longer
(p < 0.001) after GDNF injection than in
control muscles. B, Average area (left)
or length (right) of acetylcholine receptor plaques at
P30 after continual exposure to either GDNF (white bars)
or PBS (black bars). At P30, AChR plaques in
GDNF-injected sternomastoid muscles are now significantly smaller than
controls in area (p < 0.001) and length
(p < 0.001) and are also less complex (see
below). C, D, Photomicrographs of P30
receptor plaques. C, AChRs in control junctions show
many small perforations and bifurcations. D, High doses
(2.0 µg/gm) of GDNF decrease the complexity and size of the receptor
area. One of every six junctions (n = 30) that were
photographed is shown from least complex to most complex
(left to right). Error bars indicate
mean ± SE.
|
|
Developmentally restricted responses to GDNF
To determine whether motor neurons were equally responsive to GDNF
at all ages, GDNF was injected twice daily starting at P10 rather than
at P0, and the number of axons per NMJ was examined at P23.
Surprisingly, injections begun at P10 resulted in no polyneuronal innervation (1.0 ± 0; n = 205), and in fact the
NMJs were indistinguishable from those in animals injected with PBS
alone. Moreover, tail kinks and tremor were not observed when
injections were begun at P10. The inability of motor neurons to respond
to GDNF injection after P10 thus marks the end of a critical period of
susceptibility in motor neuron development that approximates the end of
naturally occurring synapse elimination. This implies that continual
exposure to GDNF from birth prevents motor axons from maturing
appropriately, and therefore permits axons to maintain their
responsiveness to GDNF.
One possible explanation for the decreased ability of GDNF to induce
branching after postnatal day 10 is that axonal responsiveness to GDNF
diminishes, perhaps because GDNF receptor components are no longer
present on axons after the first postnatal week. Substantial evidence
exists that motor neuron cell bodies continue to express both the Ret
and GFR -1 components of the GDNF receptor into adulthood (Golden et
al., 1998 ). Nonetheless, it is unknown whether these receptors are also
present on axons in adulthood. To test the possibility that GDNF
receptors are excluded from intramuscular axon branches after the first
postnatal week, we immunostained P2, P14, and adult sternomastoid
muscles for both Ret and GFR -1. Strong Ret label was detected at the
neuromuscular junctions at all ages studied. The labeling appeared
presynaptic, although terminal Schwann cell staining could not be
excluded. Weak labeling of the intramuscular nerves was also observed
at all ages. The result was similar for GFR -1; labeling was detected
at the neuromuscular junction at all ages (although it was
substantially weaker than the Ret staining). Strong GFR -1 staining
was found in the intramuscular nerves at the same three ages. These
results suggest that the components for functional GDNF receptors
persist in motor axons as the animals mature, and therefore the lack of
responsiveness of motor neurons to exogenously applied GDNF after
postnatal day 10 is unlikely to be explained by receptor redistribution.
 |
DISCUSSION |
The GDNF family of polypeptide growth factors has multiple
regulatory roles during neural development in many ways analogous to
those of the neurotrophins (for review, see Baloh et al., 2000 ). GDNF
is the most potent neuronal growth factor described for developing motor neurons both in vitro (Henderson et al., 1994 ) and
in vivo (Li et al., 1995 ; Oppenheim et al., 1995 ; Yan et
al., 1995 ). The biological action of GDNF is mediated by a
two-component receptor complex that consists of a ligand binding
glycosylphosphatidylinositol-linked cell surface protein,
GFR -1 (Jing et al., 1996 ; Treanor et al., 1996 ), and a receptor
tyrosine kinase encoded by the c-Ret proto-oncogene (Ret; Durbec et
al., 1996 ; Trupp et al., 1996 ). Consistent with its trophic effects on
motor neurons, GDNF is expressed in developing nerves and skeletal
muscle at the time axons project to, and branch in, muscle fibers
(Trupp et al., 1995 ; Nosrat et al., 1996 ). Additionally, motor neurons
express the two-component GDNF receptor complex (Pachnis et
al., 1993 ; Tsuzuki et al., 1995 ; Naveilhan et al., 1997 ; Trupp et al.,
1997 ), including the ligand-binding component GFR -1 (Jing et al.,
1996 ; Treanor et al., 1996 ) and the signal-transducing component Ret
tyrosine kinase (Durbec et al., 1996 ; Trupp et al., 1996 ). The
expression of GDNF and its receptors strongly suggests that GDNF is an
important target-derived factor for spinal neuron survival,
differentiation, and/or synaptic remodeling.
In this study, we have shown that augmentation of GDNF levels by
subcutaneous injection in the postnatal period results in hyperinnervation of neuromuscular junctions. This effect is quite similar to that obtained by target mediated delivery of GDNF (Nguyen et
al., 1998 ), indicating that a localized postsynaptic target supply of
growth factor is not required for its effects on synapses. We have
found that the hyperinnervation is entirely explained by an increase in
the overall size of single motor units, such that they are twice as
large as control motor units at P8. Therefore, these results show that
in addition to the effects of GDNF on motor neuron survival in
embryonic life (Oppenheim et al., 2000 ), GDNF also has potent effects
on axonal arbors in postnatal life. Continued administration of
GDNF is required to maintain the multiple innervation at later ages.
Nevertheless, synapse elimination still proceeds to some degree even in
the presence of high levels of GDNF, suggesting that GDNF likely
plays a minimal role in maintaining synapses. Moreover, analysis of
morphological changes in both the axon and the receptor area suggests
that a dynamic remodeling of neuromuscular junctions occurs in the
presence of exogenous GDNF. Finally, we have shown that this effect of
GDNF is developmentally restricted, because even very high doses of
exogenous GDNF do not produce multiple innervation if administration is
begun after P10.
GDNF injections also altered the animal's external appearance. When
GDNF was begun in the first postnatal week, tail kinks and tremor were
observed but not when injections were begun later. These outward signs
correlated with the morphological changes in axon branching (i.e.,
higher doses of GDNF produced more multiple innervation at P8, and also
a greater degree of tremor). It is possible that both the tremor and
the tail kinks are attributable to the larger size of motor units
produced by GDNF. Each motor unit, because of its increased size, would
cause significantly more noticeable muscle twitching when the motor
axon was stimulated, leading to a tremor. The tail kinks may derive
from unbalanced muscle tone because of a greater number of muscle
fibers activated by some motor neurons innervating tail musculature.
GDNF and synaptic rearrangements
In previous work, a significant effect of transgenically supplied
GDNF on the number axons innervating the NMJ was shown (Nguyen et al.,
1998 ). In Myo-GDNF mice the transition from multiple
innervation to single innervation was delayed by ~2 weeks. One
interpretation of this work is that neuronal growth factors somehow
stabilize synapses and prevent the rearrangements that would ordinarily occur. The present results suggest however that the effect is predominantly by induction of axonal branches.
Two quantitative and three morphological lines of evidence support this
view. First, the degree of multiple innervation induced by GDNF at P8
is greater than the degree of multiple innervation at P0, as determined
by physiological methods (Balice-Gordon and Lichtman, 1993 ).
Furthermore, because of the small caliber and tight fasciculation of
axons at P8, we undoubtedly underestimated the degree of multiple
innervation induced by GDNF. Second, even in the face of high levels of
circulating GDNF, the number of axons per receptor plaque declined
almost 50% as the animal matured (from 3.3 at P8 to 1.8 at P40). These
data suggest that GDNF is unable to maintain synaptic connections.
There is also a significant amount of morphological evidence that
synapse elimination is continuing in the presence of GDNF. First,
endplates were markedly smaller than normal at P30, suggesting that
synaptic remodeling was ongoing, because synapse loss has been
associated with AChR loss (Lichtman and Colman, 2000 ). Second, in
1-month-old animals exposed to GDNF from birth, retraction bulbs,
structures that are specifically associated with synaptic withdrawal
during the period of normal synapse elimination (Bernstein and
Lichtman, 1999 ), were frequently encountered in the endplate band. At
normal adult NMJs there is no evidence of synaptic rearrangement. Third, sprouts, and other larger caliber axons not contacting endplates, were sometimes found in mature muscles after GDNF exposure. The combination of both presynaptic and postsynaptic changes suggests that the effect of GDNF is to induce a continual state of sprouting and
elimination that results in a situation in which some fraction of the
endplates are multiply innervated at every observation.
Specificity and temporal responses to GDNF
The specificity of morphological changes for GDNF is an
interesting feature of our results. Motor neurons express receptors for
multiple neurotrophins, GDNF family, cytokine, and other growth factors
(Henderson et al., 1998 ). However, our results here show that
subcutaneous injection of the GDNF family member neurturin at 3.0 µg/gm does not produce multiple innervation, and it has been
previously shown that transgenically oversupplied NT-3 and NT-4 were
also ineffective (Nguyen et al., 1998 ). Furthermore, the use of
adenoviruses to deliver truncated trk receptors to scavenge
neurotrophins has shown primary effects on muscle fibers and Schwann
cells, rather than direct effects on motor axons (Gonzalez et al.,
1999 ). In vitro, GDNF has shown more robust growth-promoting effects on motor axons than any other factor (Henderson et al., 1994 ;
Ho et al., 2000 ). At the moment there is no clear-cut explanation for
the specificity of the morphological responses to GDNF. These results
suggest that that Ret (and not the trks) activates signal transduction
mediators specifically linked to morphological responses in motor
neurons. One of the effects of the neurotrophins at the neuromuscular
junction may be to regulate assembly of postsynaptic receptors (Yan et
al., 1995 ; Gonzalez et al., 1999 ).
Whereas GDNF induced extensive growth of axons, these increased
branches were constrained to the endplate band. A possible explanation
of this lack of widespread exuberant growth is that the motor axon
branches may be restricted to grow along Schwann cells and that the
growth effect does not encourage axons to escape from their glial
sheaths (Son and Thompson, 1995a ,b ). These morphological responses
raise the issue of the role of GDNF in regeneration. After axotomy
there is a dramatic upregulation of GDNF by Schwann cells and muscle
(Trupp et al., 1995 , 1997 ; Naveilhan et al., 1997 ). Furthermore,
injection of the GDNF gene in individual muscle fibers produces
considerable motor axon growth and branching (Bernstein et al., 1998 ;
our unpublished observations). These data are consistent with
the idea that GDNF promotes a more rapid regenerative response (Naveilhan et al., 1997 ). However, our results raise the possibility that GDNF regulation of regeneration is more related to terminal branching than to extension of axons down a damaged nerve.
The branching pattern of motor axons observed in GDNF-treated mice
suggested that the effect of GDNF was primarily on terminal branches.
If GDNF had caused motor axons to undergo a greater number of proximal
bifurcations, then the number of branch points between each endplate
and the cell body would have been increased. However, the average
number of branch points remained the same (although the total number of
NMJs contacted by the motor axon increased twofold). Thus, the added
neuromuscular junctions must have come from terminal branches.
The temporal restriction of GDNF effects is also of considerable
interest. We saw no effect on motor axon branching if GDNF was first
administered after postnatal day 10. Adult motor neurons continue to
express Ret and should in theory respond to GDNF (Golden et al., 1998 ).
A spatial exclusion of Ret from axon terminal regions is a plausible
explanation for the loss of axon responsiveness. However, we have found
that there is no detectable difference in the expression of GDNF
receptors in the intramuscular branches of motor axons between P2 and
adulthood. Presumably the difference in GDNF responsiveness with age is
downstream of the receptor per se. Thus, the change in GDNF reactivity
may reflect a broader downregulation of axon growth potential as
neurons mature. In this regard it should be noted that sensory neurons
when initially plated in culture do not respond with axon elongation
unless they have been previously axotomized (Smith and Skene, 1997 ). In
other work we have shown that axotomy restores the ability of motor axons to respond with growth and branching to GDNF (Bernstein et al.,
1998 ; our unpublished observations). This may explain why GDNF
has persistent effects after P8 when started early: axons may remain in
a growth state in its presence and thus remain sensitive to the factor.
Conclusions
Here, we sought to maintain high levels of GDNF through
pharmacological means to test the premise that competition for a growth factor in limited supply would be inhibited by excess growth factor, and therefore a powerful motor neuron growth factor might prevent synapse elimination. However, our results suggest that the role of GDNF
is in growth and branching, and therefore synapse loss may more likely
be regulated by other kinds of signals such as those that maintain and
disrupt the adhesion of the nerve to the postsynaptic site.
Nonetheless, GDNF appears to have extremely potent effects on axonal
branching and synapse formation in early postnatal life, and these
effects can persist into adult life when GDNF exposure is maintained.
 |
FOOTNOTES |
Received Jan. 5, 2001; revised May 11, 2001; accepted May 24, 2001.
This work was supported by Grant R01 NS37873 from the National
Institutes of Health.
Correspondence should be addressed to Dr. William Snider,
Director, University of North Carolina Neuroscience Center, CB 7250, UNC School of Medicine, Chapel Hill, NC 27599. E-mail:
wsnider{at}med.unc.edu.
G. Feng's present address: Department of Neurobiology, Duke School of
Medicine, Durham, NC 27710.
 |
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