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The Journal of Neuroscience, June 15, 2002, 22(12):4942-4954
Lentivirally Delivered Glial Cell Line-Derived Neurotrophic
Factor Increases the Number of Striatal Dopaminergic Neurons in Primate
Models of Nigrostriatal Degeneration
Stephane
Palfi1, 2, *,
Liza
Leventhal1, *,
Yaping
Chu1,
Shuang Y.
Ma1,
Marina
Emborg1,
Roy
Bakay5,
Nicole
Déglon3, 4,
Philippe
Hantraye2,
Patrick
Aebischer3, 4, and
Jeffrey H.
Kordower1
1 Department of Neurological Sciences,
Rush-Presbyterian-St. Luke's Medical Center, Chicago,
Illinois 60612, 2 Commissariat à l'Energie Atomique,
Centre National de la Recherche Scientifique, and Unité de
Recherche Associée, 2210 Service Hospitalier Frederic Joliot, and
Commissariat à l'Energie Atomique, 94000 Orsay Cedex,
France, 3 Division of Surgical Research and Gene
Therapy Center, Lausanne University Medical School, 1015 Lausanne,
Switzerland, 4 The Neurosciences Institute, Swiss
Federal Institute of Technology, 1015 Lausanne, Switzerland, and
5 Department of Neurosurgery, Emory University, Atlanta,
Georgia 30322
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ABSTRACT |
The primate striatum contains tyrosine hydroxylase
(TH)-immunoreactive (ir) neurons, the numbers of which are augmented
after dopamine depletion. Glial cell line-derived neurotrophic factor (GDNF) strongly modulates the viability and phenotypic expression of
dopamine ventral mesencephalic neurons. The effect of GDNF on
TH-ir neurons intrinsic to the striatum has yet to be investigated. In
the present study, stereological counts of TH-ir striatal neurons in
aged and parkinsonian nonhuman primates revealed that GDNF delivered
via a lentiviral vector (lenti-) further increased the number of these
cells. Aged monkeys treated with lenti-GDNF displayed an eightfold
increase in TH-ir neurons relative to
lenti- -galactosidase-treated monkeys. Unilateral
1-methyl-4-phenyl- 1,2,3,6-tetrahydropyridine treatment alone in young monkeys resulted in a bilateral eightfold increase in TH-ir striatal cells. This effect was further magnified sevenfold on the side of lenti-GDNF treatment. These cells
colocalized with the neuronal marker neuronal-specific nuclear
protein. Some of these cells colocalized with GDNF-ir,
indicating that an alteration in phenotype may occur by the direct
actions of this trophic factor. Thus, GDNF may mediate plasticity in
the dopamine-depleted primate brain, which may serve to compensate for
cell loss by converting striatal neurons to a dopaminergic phenotype.
Key words:
striatum; dopaminergic neurons; Parkinson's disease; primates; GDNF gene therapy; lentivirus
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INTRODUCTION |
In contrast to lower species, the
primate striatum contains a population of tyrosine hydroxylase
(TH)-immunoreactive (ir) neurons whose function currently remains
elusive. In this regard, few studies have focused on the role of
intrinsic dopaminergic neurons within the adult primate striatum.
Striatal TH-ir neurons are a subtype of interneurons distributed
preferentially to the peripheral regions of the striatum. They were
initially described in the nonhuman primate striatum by Dubach et al.
(1987) and have been identified in the human striatum as well (Porritt
et al., 2000 ). Their numbers have been reported to increase up to
threefold in monkeys after dopaminergic denervation secondary to
1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) toxicity (Betarbet
et al., 1997 ). Double-label immunofluorescence studies revealed that
this population of TH-ir neurons colocalizes with glutamic acid
decarboxylase (GAD), the rate-limiting enzyme for GABA. These
TH-ir-positive cells are also immunoreactive for the dopamine
transporter (DAT), indicating that they may be equipped for functional
dopaminergic neurotransmission (Betarbet et al., 1997 ). Confirming
these experimental data, a recent clinicopathological investigation
demonstrated that TH-ir and DAT-ir striatal neurons are increased in
number in Parkinson's disease (PD) (Porritt et al., 2000 ). Increases
in the number of TH-ir striatal neurons in PD and after MPTP
intoxication may be a means by which the adult striatum compensates for
dopaminergic striatal denervation (Bezard and Gross, 1998 ). This
suggests that the TH gene that is normally quiescent
in striatal neurons may be triggered under specific pathological
conditions (Du et al., 1995 ).
If alterations in dopaminergic tone modulate striatal TH-ir neuronal
number, factors known to influence nigrostriatal circuitry may produce
similar effects. Unequivocally, glial cell line-derived neurotrophic
factor (GDNF), a member of the transforming growth factor-
superfamily, produces dramatic effects on dopaminergic nigrostriatal
neurons (Lin et al., 1993 ; for review, see Collier and Sortwell, 1999 ).
GDNF promotes the viability of, enhances the morphological
differentiation of, and increases dopamine uptake by mesencephalic
neurons in vitro and in vivo (Beck et al., 1995 ; Tomac et al., 1995 ; Choi-Lundberg et al., 1997 ; Collier and Sortwell, 1999 ). In addition, increased levels of GDNF produced by injections, infusions, or gene delivery promote cell viability and induce phenotypic changes in dopaminergic midbrain neurons of rats with 6-OHDA
lesions as well as aged rhesus monkeys and monkeys treated with MPTP
(Gash et al., 1996 ; Lapchak et al., 1997 ; Tseng et al., 1997 ; Kordower
et al., 2000 ). These trophic effects appear to be selective for
specific neuronal populations, because the viability and phenotypic
expression of serotonergic or GABAergic neurons are not affected by GDNF.
To date, the role of GDNF on primate TH-ir striatal neurons has not
been investigated in vivo. We published a study recently that examined the structural and functional effects of GDNF in primate
models of dopamine insufficiency (Kordower et al., 2000 ). This study
provided the opportunity to examine these unique tissues and to
evaluate the effects of GDNF on striatal TH-ir neurons. The present
study assessed whether gene delivery of this trophic factor could
augment the number of dopaminergic striatal neurons in primate models
of nigrostriatal degeneration. First, we confirmed that dopamine
depletion in MPTP-treated nonhuman primates enhances the number of
TH-ir striatal neurons. Then we found that in vivo gene
delivery of GDNF using a lentiviral vector increased the number of
TH-ir and DAT-ir striatal neurons in aged monkeys. Finally, gene
delivery of GDNF dramatically increased the number of TH-ir striatal
neurons in MPTP-treated monkeys.
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MATERIALS AND METHODS |
Experiment 1: effect of
1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine on striatal tyrosine
hydroxylase-immunoreactive cells. This experiment was performed to
confirm previous findings now using stereological counting procedures
to show that MPTP-treated monkeys have increased numbers of TH-ir
striatal neurons (Betarbet et al., 1997 ). Four rhesus monkeys (4-5
years of age) received two unilateral intracarotid injections of MPTP
separated by 1 month according to a protocol described
previously (Kordower et al., 2000 ) (Table
1). Briefly, animals were tranquilized
with ketamine (10 mg/kg, i.m.) and then maintained on an anesthetic plane with isoflurane (1-2%). The animals were put in the supine position. For each injection, a right-sided incision was made along the
medial edge of the sternocleidomastoid muscle. The carotid sheath was
opened and the common carotid artery, internal jugular vein, and vagus
nerves were identified. The common carotid was exposed below the
carotid bifurcation. The external carotid artery was then ligated. A 27 gauge butterfly needle was inserted into the common carotid artery in a
direction retrograde to blood flow; for each injection, 20 ml of saline
containing 3 mg of MPTP-HCl was infused at a rate of 1.33 ml/min (15 min). After the infusion was completed, 3 ml of saline was delivered,
and then the incision was closed. Two additional untreated rhesus
monkeys served as unoperated controls.
Experiment 2: lentiviral delivery of glial cell line-derived
neurotrophic factor to aged monkeys. This experiment investigated the effects of in vivo GDNF gene delivery on the number of
striatal TH-ir cells in aged rhesus monkeys. The details of procedures performed on these monkeys have been reported previously (Kordower et
al., 2000 ). In this experiment, four aged rhesus monkeys (24-27 years
of age) received intrastriatal injections of lentivirus encoding for
GDNF, and three monkeys received control injections of lentivirus
encoding for -galactosidase ( -gal) (Table 1). All animals
received six lentivirus injections targeted for the caudate nucleus
(n = 2 injections; 5 and 10 µl), putamen
(n = 3; 10, 10, and 5 µl), and substantia nigra
(n = 1; 5 µl). Coordinates were based on magnetic
resonance imaging as described previously (Kordower et al.,
2000 ). Monkeys were killed 3 months after the surgery. The construction
of the vectors has been described previously (Kordower et al., 1999 ,
2000 ; Deglon et al., 2000 ). Three months after the lentivirus
treatment, all animals were killed.
Experiment 3: lentiviral delivery of glial cell line-derived
neurotrophic factor to monkeys treated with
1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine. This experiment
tested the hypothesis that GDNF delivered via a lentiviral vector would
increase the number of TH-ir striatal neurons in MPTP-treated monkeys.
Eight monkeys comprised this experiment, the methodological details of
which have been reported previously (Kordower et al., 2000 ). Briefly,
monkeys received a single injection of MPTP (3 mg) into the right
carotid artery followed 1 week later by injections of GDNF delivered by
a lentiviral vector (lenti-) (n = 4) or lenti- -gal
(n = 4) into the right caudate nucleus, putamen, and
substantia nigra. The injection scheme was identical to that described
above for aged monkeys. Three months after the lentivirus treatment,
all animals were killed.
Preparation of tissues. Rhesus monkeys were killed with an
overdose of pentobarbital, perfused transcardially with saline, and
postfixed with 4% paraformaldehyde solution in phosphate buffer (0.1 M), pH 7.4, at 4°C. The brains were removed
immediately and cut into coronal blocks for postfixation. Tissue blocks
were then washed in a series of cold graded sucroses and sectioned (40 µm) in the coronal plane on a freezing microtome.
Immunohistochemistry. Sections through the forebrain and
midbrain were processed for the visualization of TH, DAT, or GDNF immunoreactivity using modifications of procedures published previously (Kordower et al., 1999 , 2000 ). Briefly, endogenous peroxidase activity
was eliminated with a 20 min incubation in 0.1 M
sodium periodate. Background staining was then inhibited by a 1 hr
incubation in 3% normal serum and 2% bovine serum albumin (BSA),
after which the tissue was incubated for 48 hr in the primary antibody.
The concentrations of the primary antibodies were as follows: TH
(1:20,000; Chemicon, Temecula, CA), DAT (1:500; generously
provided by Dr. Alan Levey, Emory University, Atlanta, GA), or
GDNF (1:250; Transduction Laboratories, Lexington, KY). Using a labeled
antibody procedure, sections were then sequentially incubated in
the appropriate biotinylated IgG (1:200; Vector Laboratories,
Burlingame, CA) for 1 hr, washed in a Tris-buffered saline solution
containing 0.05% Triton X-100, and incubated in "Elite"
avidin-biotin complex (ABC) (1:1000; ABC kits; Vector Laboratories)
for 75 min. The chromogen solution that completed the reaction
consisted of 0.05% diaminobenzidine and 0.005%
H2O2. For the GDNF
staining, the immunohistochemical reaction product was intensified by
adding 2.5% nickel II sulfate to the chromogen solution. Sections were
mounted on gelatin-coated slides, dehydrated through graded alcohols
(70, 95, and 99%), cleared in xylenes, and coverslipped with
Permount (Fisher Scientific, Pittsburgh, PA). Additional
sections were processed simultaneously in an identical manner except
for the deletion of the primary antibody or substitution of the primary
antibody with an irrelevant IgG matched for protein concentration. No
specific immunoreactivity was seen for any stain under these conditions.
Histological analysis. In experiment 1, stereological counts
of striatal TH-ir neurons were performed bilaterally on MPTP-treated animals and unilaterally in control animals. In experiments 2 and 3, stereological counts of TH-ir, GDNF-ir, or DAT-ir neurons were
performed unilaterally on the side of the lenti-GDNF or lenti- -gal infusions. For all experiments, stereological counts were performed using a computerized optical disector system. This method allows for an
unbiased stereological quantification of a defined portion of a
structure independent of its size, shape, orientation, tissue shrinkage, or anatomical level (Emborg et al., 1998 ). The computerized optical disector system consists of a computer-assisted image analysis,
a microscope, a computer-controlled x, y, z motorized stage,
a stereological software program (MicroBrightField Inc., Colchester,
VT), and a high-sensitivity video camera. Before each series of
measurements, the instrumentation was calibrated. The striatum was
outlined under low magnification (1.25×). Five percent of the outlined
region was quantified using a disector counting frame and a systematic
random-sampling design. The average section thickness for each section
and the antibody penetration throughout the entire tissue section were
determined empirically. The total number of striatal neurons was
quantified using a high magnification (100×) planapo oil
immersion objective with a 1.4 numerical aperture. Under the disector
principle, at least 200 striatal neurons were identified in each case.
Once the top of the section was in focus, the z-plane was
lowered 1-2 µm. Care was taken to ensure that the top and bottom
forbidden planes were not included in the analysis. The total number of
TH-ir striatal neurons (N) was calculated using the
following formula: N = NV × VStriatum, where
NV is the numerical density and
VStriatum is the volume of the
striatum as determined by the Cavalieri principle (1966).
Confocal double immunofluorescence of tyrosine hydroxylase with
neuronal-specific nuclear protein. Based on
tissue availability, double-immunofluorescence experiments were
performed with tissue from experiment 2 to determine whether the TH-ir
striatal cells coexpressed the neuronal marker neuronal-specific
nuclear protein (NeuN) or the trophic factor GDNF. Sections
were first incubated in a blocking solution (5% normal goat serum, 2%
BSA, and 0.3% Triton X-100 in TBS, pH 7.4) for 1 hr to inhibit
background staining. Then sections were incubated in primary rabbit
polyclonal anti-TH (1:1000; Chemicon) for 24 hr at 4°C. After three
washes, sections were incubated in secondary goat anti-rabbit IgG
coupled to the fluorescent marker Cy2 (1:200; Jackson ImmunoResearch,
West Grove, PA) for 1 hr. After completion of the reaction, sections
were washed and background staining was inhibited by incubating the sections in a blocking solution containing 5% normal horse serum, 2%
BSA, and 0.3% Triton X-100 in TBS, pH 7.4. Then sections were incubated in mouse monoclonal anti-NeuN (1:1000; Chemicon) for 24 hr at
4°C followed by incubation in goat anti-mouse IgG coupled to the
fluorescent marker rhodamine (1:200, Jackson ImmunoResearch) for 1 hr
at room temperature.
Confocal double immunofluorescence of tyrosine hydroxylase with
glial cell line-derived neurotrophic factor. To assess double labeling of TH-ir cells with the neurotrophic marker GDNF, sections were immersed in the blocking solution as described above for 1 hr and
then incubated in primary mouse monoclonal anti-TH (1:10,000; Incstar,
Stillwater, MN) for 24 hr at 4°C. After three washes, sections were
incubated in secondary goat anti-mouse IgG coupled to the fluorescent
marker Texas Red (1:200; Jackson ImmunoResearch) for 1 hr at room
temperature. Then sections were blocked with 5% normal horse serum,
2% BSA, and 0.3% Triton X-100 in TBS, pH 7.4, and incubated in goat
polyclonal anti-GDNF (1:200; Chemicon) for 24 hr at 4°C and in
biotinylated secondary donkey anti-goat IgG (1:200; Vector
Laboratories) coupled to the fluorescent marker Cy2 for 1 hr at room
temperature. Statistical analysis. The data were
analyzed using a two-way ANOVA followed by a Fisher's PLSD post hoc test when there was a significant overall ANOVA
(Statview 4.0; Abacus Concepts, Calabasas, CA).
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RESULTS |
Experiment 1: effect of
1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine on striatal tyrosine
hydroxylase-immunoreactive cell number
In all animals, numerous TH-ir neurons were distributed within the
nonhuman primate caudate nucleus and putamen. In normal control
animals, these cells were preferentially distributed around the
periphery of the striatum, just interior to surrounding white matter.
In MPTP-treated monkeys, TH-ir striatal neurons were also distributed
along the periphery of the striatum. However, unlike normal controls,
they were abundantly distributed throughout the central portions of the
caudate nucleus and putamen as well.
Greater numbers of TH-ir neurons were
seen in MPTP-treated monkeys
relative to normal controls (Figs. 1A-C,
2). In present study, we performed
stereological counts to confirm previous findings (Betarbet et al.,
1997 ) using nonstereological counting procedures. Stereological counts
in the present study demonstrated that MPTP-treated monkeys have
increased numbers of TH-ir striatal neurons. Statistical analyses
revealed significant differences in TH-ir striatal neurons between
treatment groups (factorial ANOVA;
F(2,7) = 21.2; p < 0.001) (Fig. 2). Monkeys with intracarotid MPTP injections displayed significant increases in the number of TH-ir cells ipsilateral to the
MPTP injection (mean ± SD, 1,557,526 ± 137,769) compared with untreated controls (453,528 ± 137,769; p < 0.004). Interestingly although the MPTP treatment was unilateral, the
number of TH-ir-positive striatal cells was also augmented on the side
contralateral to MPTP treatment (1,834,752 ± 129,477). This
number of TH-ir striatal neurons was statistically greater than that
seen in control animals (453,528 ± 137,769; p < 0.001) (Fig. 2) and similar in magnitude to that seen on the side
ipsilateral to MPTP treatment (p = 0.90).

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Figure 1.
TH-immunostained sections through the
striatum of a rhesus monkey receiving a unilateral intracarotid
injection of MPTP (A, B) and a normal control
(C). A, TH-ir neurons within the
striatum on the side ipsilateral to the MPTP infusion.
B, TH-ir neurons within the striatum on the side
contralateral to the MPTP infusion. C, TH-ir neurons in
an untreated rhesus monkey. Scale bar, 30 µm.
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Figure 2.
Histogram illustrating that the number of
TH-ir-positive cells was significantly elevated ipsilateral and
contralateral to the MPTP injection in monkeys receiving a unilateral
intracarotid MPTP injection compared with the control nontreated
animals. *p < 0.004.
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Experiment 2: lentiviral delivery of glial cell line-derived
neurotrophic factor in aged monkeys
Lentiviral delivery of GDNF to aged
monkeys resulted in a significant
increase in striatal TH-ir and DAT-ir
neurons compared with -gal-treated control animals (Figs. 3, 4, 5,
6). The increase in the number of TH-ir
striatal neurons was seen at every level of the striatum (Fig.
4B,D,F). In lenti- -gal-treated animals, TH-ir striatal neurons were scattered in the striatum but again were
preferentially located within the lateral aspects of the caudate
nucleus and putamen (Fig. 4A,C,E). In contrast,
numerous TH-ir striatal neurons were distributed through the center
core of this structure in lenti-GDNF-treated animals (Fig. 4).
Stereological counts through the striatum of aged monkeys receiving
lentivirus encoding for GDNF revealed that the number of TH-ir-labeled
neurons was significantly augmented compared with lenti- -gal-treated cohorts (factorial ANOVA; F(1,5) = 137.4; p < 0.0001) (Fig. 5A). Lenti-GDNF-treated aged monkeys displayed 2,851,744 ± 179,249 TH-ir cells compared with 350,009 ± 28,105 TH-ir striatal neurons in lenti- -gal-treated animals. This represents a more than eightfold increase in the number of TH-ir cells (Fig. 5A). Similar
significant increases mediated by lenti-GDNF were seen in DAT-ir
neurons (F(1,5) = 155.2;
p < 0.0001) (Figs. 5C, 6). In
lenti-GDNF-treated monkeys, 2,550,508 ± 143,991 DAT-ir cells were
seen in the striatum on the side ipsilateral to the lentivirus/MPTP
infusion. In contrast, only 379,625 ± 43,649 DAT-ir striatal
neurons were seen in Parkinsonian monkeys treated with lenti- -gal
(Fig. 5C). This represents a 6.7-fold increase in the number
of TH-ir neurons.

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Figure 3.
Photomicrographs of
TH-immunostained sections through the striatum of aged monkeys
receiving lentivirus encoding for GDNF (A) or
-gal (B). Note that large and numerous TH-ir
cells were observed in animals receiving lenti-GDNF compared with
lenti- -gal. Scale bar, 30 µm.
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Figure 4.
Distribution of TH-ir cells in the
striatum of aged monkeys. Representative sections through the primate
brain show the distribution of TH-ir cells throughout the
precommissural (A, B), commissural (C,
D), and postcommissural (E, F) striatum
of aged primates receiving intrastriatal injections of lentivirus
encoding for -gal (A, C, E) or GDNF (B, D,
F). Note that numerous TH-ir cells are distributed
throughout the striatum in the lenti-GDNF-treated monkey compared with
the lenti- -gal-treated animal.
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Figure 5.
Histograms showing the number of TH-ir
(A), GDNF-ir (B), and
DAT-ir (C) cells in the striatum of aged monkeys
receiving lentivirus encoding for GDNF or -gal. A significant
increase of TH-ir (A), GDNF-ir
(B), and DAT-ir (C) cells
was observed in animals receiving lenti-GDNF compared with the
lenti- -gal-treated cohorts. The correlation between the number of
TH-ir/GDNF-ir, TH-ir/DAT-ir, and DAT-ir/GDNF-ir cells in aged monkeys
receiving lentivirus encoding for GDNF or -gal is shown in
D, E, and F, respectively.
In all cases, a significant correlation between cell types was observed
(p < 0.0001). *p < 0.05.
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Figure 6.
Photomicrographs of DAT-ir
staining through the striatum of aged monkeys receiving lenti-GDNF
(A) or lenti- -gal (B).
Note that large and numerous DAT-ir cells were observed in animals
receiving lenti-GDNF compared with those receiving lenti- -gal. Scale
bar, 30 µm.
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GDNF-ir neurons were observed in aged monkeys treated with lenti-GDNF
(Fig. 7A) but not in aged
moneys treated with lenti- -gal (Fig. 7B). Stereological
counts of GDNF-ir neurons were also performed (Fig. 5B). No
GDNF-ir striatal neurons were seen in lenti- -gal-treated animals,
indicating that the injection schema used did not induce an
upregulation of endogenous GDNF to within detectable levels. In
contrast, 825,836 ± 13,466 GDNF-ir neurons were seen within the
striatum of lenti-GDNF-treated animals. Morphologically, the location
of GDNF-ir cells varied depending on the site of lentiviral vector
injections. In the penumbra of the injection site, GDNF-ir-positive cells appeared to be of similar size and displayed a similar morphology to that normally displayed by medium-sized spiny neurons. Additional tissues were not available to perform colocalization experiments to
confirm that these cells are indeed medium spiny neurons. Robust extracellular GDNF staining was also observed in the penumbra of the
injection site. In contrast, ovoid GDNF-ir-positive cells were
distributed primarily throughout the periphery of the injection area
(Fig. 7A). Similarly, ovoid TH-ir- and DAT-ir-positive cells were located in the same regions of the striatum as the ovoid GDNF-ir
cells.

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Figure 7.
Photomicrographs of GDNF-ir in the
striatum of aged monkeys receiving lenti-GDNF (A)
or lenti- -gal (B). Note that numerous GDNF-ir
cells were observed in animals receiving lenti-GDNF, but no
GDNF-ir-positive elements were seen in animals receiving lenti- -gal.
Scale bar, 30 µm.
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Correlations were performed to examine whether a significant
association existed between GDNF-induced alterations of TH-ir, GDNF-ir,
and DAT-ir striatal cells. Significant correlations were observed
between the various cell types: TH-ir/GDNF-ir (r = 0.98; p < 0.0001), TH-ir/DAT-ir (r = 0.98; p < 0.0001), and GDNF-ir/DAT-ir (r = 0.98; p < 0.0001) (Fig. 5).
Immunofluorescence
Double-immunofluorescence experiments were performed to determine
whether the TH-ir striatal cells coexpressed the neuronal marker NeuN
or the trophic factor GDNF. Laser confocal microscopic images through
the striatum of lenti-GDNF-treated monkeys confirmed that virtually all
of the TH-ir cells colocalized with the neuronal marker NeuN (Fig.
8). These double-labeled cells were
medium-sized and located in the penumbra of the lenti-GDNF injection
sites. Laser confocal microscopic images throughout the striatum of
lenti-GDNF-treated monkeys indicated that numerous medium-sized neurons
were immunopositive for GDNF and that the degree of colocalization
between TH and GDNF was regionally specific. Few GDNF-ir cells located
within the core of the injection site were immunoreactive for TH (Fig. 9). In contrast, many TH-ir-positive
cells coexpressed GDNF-ir in regions distal to the transfection site.
These double-labeled cells displayed an ovoid shape. Again, no GDNF-ir
immunofluorescence was observed in -gal-treated animals.

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Figure 8.
Laser confocal microscopic images
through a series of focal planes through the caudate nucleus of an aged
monkey treated with lenti-GDNF and stained for TH
(A) and NeuN (B).
C, The merged image. The yellow cells in
C signify that cells coexpress both TH and NeuN
(arrow). The arrows depict the same cell in
A and B as well as the merged image in
C. Scale bar, 15 µm.
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Figure 9.
Laser confocal microscopic images
through the caudate nucleus from an aged monkey treated with
lenti-GDNF. Green represents GDNF-ir; red
represents TH-ir. Note the yellow cell in
C, signifying that cells coexpress both GDNF and TH.
Scale bar, 15 µm.
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Experiment 3: lentiviral delivery of glial cell line-derived
neurotrophic factor in monkeys treated with
1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine
In monkeys rendered parkinsonian with MPTP, lenti-GDNF augmented
the number of TH-ir striatal neurons by more than sevenfold relative to
lenti- -gal-treated animals (Fig.
10). In lenti- -gal-treated animals,
stereological counts of TH-ir neurons revealed 121,380 ± 19,600 positive cells on the treated side. In contrast, the striata of
lenti-GDNF-treated animals contained 786,387 ± 406,682 TH-ir-positive neurons. This difference in the number of TH-ir striatal
neurons between lenti- -gal- and lenti-GDNF-treated animals was
statistically significant (t(1,6) = 3.267; p < 0.017).

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Figure 10.
Histogram illustrating the dramatic increase in
the number of TH-ir cells in the striatum of MPTP-treated monkeys
receiving lenti-GDNF or lenti- -gal. **p < 0.017.
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DISCUSSION |
The present series of experiments demonstrated that the
number of TH-ir striatal cells in nonhuman primates increases in
response to dopaminergic depletion; this effect is enhanced by the
lentiviral delivery of GDNF. Double-labeling studies in
lentivirus-treated animals revealed that these TH-ir cells
coexpressed NeuN-ir, indicating that cells expressing this
dopaminergic marker were neurons. In addition, TH-ir neurons
coexpressed GDNF-ir, indicating that the induction of the TH phenotype
may be occurring via an autotrophic mechanism. It should be noted that
the increase in DAT-ir cells after GDNF treatment was similar to that
observed for TH-ir and that the numbers of TH-ir and DAT-ir cells were
strongly correlated. These data suggest that the effects of dopamine
depletion and GDNF administration provide concomitant influences on the
genes responsible for TH and DAT expression.
A previous study found increases in TH-ir striatal neurons after the
unilateral or bilateral nigrostriatal lesions engendered by MPTP in
nonhuman primates (Betarbet et al., 1997 ). This study quantified TH-ir
neurons in four anatomically matched sections and did not have tissue
prepared in a manner that was compatible with a stereological analysis.
Stereological counts of TH-ir neurons in the present study confirmed
the increase in neuronal number after MPTP-induced dopaminergic
denervation. Indeed, in the study by Betarbet et al. (1997) , bilateral
increases in TH-ir striatal neurons were observed after unilateral MPTP
injections. Stereological analyses in the present study confirmed this
surprising effect as well. The fact that an increase in TH-ir striatal
neurons was observed on the "intact side" strongly indicates that
the increases seen on the side with lesions were authentic and not
attributable to the fact that they were easier to identify and count
after removal of the TH-ir striatal neuropil. However, it cannot be ruled out that the increase in TH-ir striatal neurons seen on the
intact side may have resulted from a small loss of nigrostriatal neurons that occurred as a result of MPTP crossing over to the contralateral side after the unilateral intracarotid injection of MPTP.
In this regard, a small loss of TH-ir has been reported previously in
monkeys on the side contralateral to the MPTP injection (Bankiewicz et
al., 1999 ). If MPTP crossover mediated the increase in TH-ir neurons on
the intact side, this would suggest that just a small loss of striatal
dopamine is capable of eliciting this plasticity response.
It should be noted that the number of TH-ir striatal neurons in the
control MPTP/lenti- -gal-treated animals in experiment 3 was less
than what was observed in experiment 1, in which monkeys were treated
with MPTP alone. There are a number of factors that could have
contributed to this difference in neuronal number. In experiment 1, the
monkeys were exposed to multiple MPTP injections and were killed 5 months after surgery, whereas the monkeys in experiment 3 received a
single MPTP injection and were killed 3 months postoperatively. Thus,
repetitive injections combined with a longer postoperative time course
could be responsible for this discrepancy, In addition, technical
issues could have played a role in this difference. In each of the
three experiments, tissue from control and experimental animals was
histochemically processed together. However, tissues from the different
experiments were processed independently, using different lots of
antibody and different reagents. The intensity of staining was much
greater in general through all dopaminergic regions in the tissues
processed in experiments 1 and 2 compared with experiment 3; this
likely contributed to the differences in absolute numbers. The
critical comparisons to be concerned with in this study are the
differences between conditions within an experiment rather than the
absolute number of neurons responding to dopamine depletion and
lenti-GDNF treatment.
The molecular mechanism underlying this plasticity response remains to
be elucidated. Endogenous trophic factor release by glia in response to
MPTP treatment has been reported as one potential stimulator of the
normally quiescent TH gene (Francis et al., 1995 ) and may account for
the increase in TH-ir cells. Regardless of whether this mechanism is in
effect, the present data suggest that the increase of TH-ir cells is a
compensatory response to striatal dopamine depletion. However, the fact
that nonhuman primates become symptomatic so quickly after intracarotid
MPTP administration suggests that this response is insufficient to
sustain functional effects in these animals.
In this study, lenti-GDNF dramatically increased the number of
TH-ir striatal neurons in both aged monkeys and monkeys rendered parkinsonian via MPTP. Aged rhesus monkeys undergo phenotypic losses of
nigrostriatal dopaminergic markers, as evidenced by the fact
that 50% of nigral neurons fail to express TH and 30% fail to express
DAT (Emborg et al., 1998 ). Intracarotid injection of MPTP induces a
more robust and frank degeneration of nigrostriatal neurons, in which
often up to 90% of nigrostriatal neurons are lost (Bankiewicz et al.,
1999 ). It is interesting that lenti-GDNF treatment was equipotent in
increasing the number of TH-ir striatal neurons in MPTP-treated
animals, in which the lesion was more severe relative to aged monkeys;
in aged monkeys the lesion is more modest and does not produce frank
neuronal degeneration. This suggests that the underlying status of the
host system does not influence the ability of lenti-GDNF to modify the
expression of TH-ir striatal neurons.
The mechanism by which GDNF increases the number of TH-ir
neurons is not yet known. In the nigrostriatal dopaminergic system, GDNF has been shown to signal through a multireceptor complex composed
of a novel glycosylphosphatidylinositol-anchored GDNF receptor and the
receptor tyrosine kinase product of the c-ret proto-oncogene (Durbec et
al., 1996 ; Trupp et al., 1996 ). The expression of this receptor complex
is maximal during early postnatal development but it is at very low
levels in the adult striatum (Trupp et al., 1997 ). As stated
previously, the vast majority of TH-ir cells coexpressed GDNF-ir,
suggesting that this trophic factor functioned in an autotrophic
manner. Interestingly, there appears to be specificity in this
response, because not all cells that were successfully transfected with
the lentivirus expressed TH-ir. Unfortunately, sufficient tissue
sections were not available to analyze the expression of ret and GDNF
receptor after GDNF delivery and to address some of these issues of
mechanisms. Such studies are fertile ground for further investigation.
Some potential mechanisms that mediate the augmentation of striatal
TH-ir neurons have been proposed. One hypothesis is that existing
GABAergic striatal interneurons are converted to a TH-ir phenotype
(Betarbet et al., 1997 ). This theory is based on a morphology analysis
and colocalization of TH-ir with GAD-ir in the MPTP primate model of
PD. In the present experiment, double labeling of TH-ir and GAD-ir were
inconclusive (data not shown). One other potential mechanism may
involve neural stem cells that migrate and differentiate to
TH-ir-positive neurons that result from dopamine depletion and/or
trophic factor release (Svendsen and Smith, 1999 ). This later
hypothesis has important implications for neural plasticity, but it
needs to be confirmed experimentally.
In summary, the present study revealed that the number of
TH-ir striatal cells in nonhuman primates increased in response to
dopaminergic depletion; this effect was further magnified by GDNF
treatment. In aged monkeys receiving lentivirus encoding for GDNF, many
TH-ir cells coexpressed GDNF-ir and NeuN-ir staining, indicating that
these neurons are converted to a phenotype directly by the trophic
effects of GDNF. In both aged and MPTP-treated monkeys,
lenti-GDNF increases the number of TH-ir neurons by more than
sevenfold, illustrating the potency of this trophic factor for
dopaminergic neurons other than those arising from the ventral midbrain. In this role, GDNF may mediate plasticity in the
dopamine-depleted primate brain and may serve to compensate for cell
loss by converting striatal neurons to a dopaminergic phenotype.
Additional studies are needed to determine whether these TH-ir striatal
cells are extant striatal neurons or are generated from differentiated
progenitor cells, and whether TH-ir cells are capable of producing
dopamine and exerting functional effects.
 |
FOOTNOTES |
Received Dec. 4, 2001; revised March 21, 2002; accepted March 28, 2002.
*
S.P. and L.L. contributed equally to this work.
This work was supported by a grant from the Department of Defense, a
grant from the Parkinson's Foundation of the National Capital Area,
and the Charles and M. V. Shapiro Foundation. We thank Theodora Kladis
for expert histological assistance.
Correspondence should be addressed to Dr. Jeffrey H. Kordower,
Department of Neurological Sciences, Rush Presbyterian Medical Center,
2242 West Harrison Street, Chicago, IL 60612. E-mail: jkordowe{at}rush.edu.
 |
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