Traumatic injury to the adult central nervous system (CNS) is associated with multiple different types of damage, all of which pose substantial challenges to attempts to carry out tissue repair. Promoting regenerative growth of severed motor and sensory axons requires the provision of appropriate substrates and/or the overriding of a variety of inhibitors that prevent axon regeneration. The expression of molecular inhibitors of axon growth has been extensively characterized in fibrotic, glial scar tissue [
1-
4] and in CNS myelin [
5-
7]. In particular, adult astrocytes at sites of injury have been shown to express proteoglycans that inhibit axon growth [
4,
8,
9] and have a major role in the formation of misaligned scar tissue [
10], which lacks the linear organization of adult CNS white matter thought to be required for rapid, long-distance axon growth [
11-
14].
A wide range of approaches have now been applied following CNS injury to promote regenerative growth of both sensory and motor axons, with a particular focus on the transplantation of a variety of cell types, often in combination with other therapies. Cell-based transplantation strategies for promoting axon growth across spinal cord injuries [
15] have included the use of neural stem cells, neonatal brain astrocytes, fibroblasts, bone-marrow derived cells and peripheral nervous system glia such as Schwann cells and olfactory ensheathing cells. Although transplants of some cell types have provided more benefit than others, the general lack of significant axon regeneration beyond sites of injury has led to the combination of cellular transplant strategies with delivery of neurotrophic factors, treatments designed to override or degrade the scar, and/or with the use of biomaterials to offer both potential substrates and organized tissue structures [
16,
17]. Such combinations have resulted in varying degrees of successful axon regeneration.
We have been interested in the possibility that repair of adult CNS injuries might be particularly enhanced with the introduction of cells from the immature CNS, a tissue that has a far greater regenerative capacity than the adult CNS (reviewed in [
18]). One possible approach is to transplant embryonic stem cells or neural progenitor cells. Although these cells have been shown to promote limited behavioral recovery via remyelination of host axons [
19-
22], their transplantation directly into or adjacent to traumatic spinal cord injuries has not resulted in the regeneration of significant numbers of endogenous axons across the site of injury [
21,
23-
25]. This may be due to the failure of the majority of these cells to differentiate [
26] or because the inflammatory environment of adult CNS injuries directs undifferentiated neural stem cells or glial progenitors to a 'scar astrocyte'-like phenotype [
27] that is poorly supportive of axon growth [
8,
28].
An alternative to allowing the lesion environment to regulate differentiation of stem or progenitor cells is to transplant a cell type from the immature CNS that is known to be supportive of axon growth. In this regard, embryonic astrocytes have long been thought of as an attractive cell type for repair of the adult CNS [
29]. Establishing astrocytic cultures directly from the embryonic CNS, however, generates cell populations containing mixed astrocytic phenotypes contaminated with glial progenitors and microglia, and such populations have yielded relatively modest success in promoting axon regeneration after transplantation to adult CNS injuries [
30,
31]. Isolating embryonic astrocytes directly from the embryonic CNS is also very challenging, owing to the relatively low abundance of these cells
in vivo. The generation of postnatal astrocytic cultures is normally associated with prolonged growth in conditions
in vitro that allow aging of these cells to a less supportive phenotype [
32], which has also resulted in minimal axon growth after their transplantation to adult spinal cord injuries [
33].
To address the above problems, we have explored the alternative approach of pre-differentiating embryonic glial precursors to specific astrocytes
in vitro, a technique that permits the rapid generation of sufficiently large, homogeneous populations of embryonic astrocytes of a desired phenotype for transplantation to adult CNS injuries. In applying this approach, we have generated pure populations of astrocytes directly from glial-restricted precursor (GRP) cells [
34-
36], the earliest arising progenitor cell population restricted to the generation of glia. Astrocytes were generated by exposing GRP cells to bone morphogenetic protein-4 (BMP-4), which induces astrocyte generation from embryonic neural precursor cells and GRP cells both
in vitro and
in vivo [
34,
37] and is thought to have important roles in regulating glial differentiation
in vivo [
38]. GRP-derived astrocytes (GDAs) generated by BMP exposure fall within the population of cells defined by their antigenic phenotype as type-1 astrocytes. Studies
in vitro of type-1 astrocytes purified from the postnatal CNS have shown that they promote extensive neurite growth from a variety of neurons [
39,
40], express high levels of molecules that support axon growth, such as laminin and fibronectin [
41] and nerve growth factor (NGF) or neurotrophin-3 (NT-3) [
42] and also show minimal immunoreactivity to chondroitin sulfate proteoglycans (CSPG) [
41]. Moreover, the directed generation of astrocytes from embryonic GRP cells may provide cells that show the beneficial axon-growth-promoting properties that characterize the early CNS.
Our study shows that transplantation of GDAs into acute spinal cord injuries promotes levels of tissue reorganization, axon regeneration and locomotor recovery that previously have been achieved only by combining cell transplantation with multiple therapeutic approaches. We also show, in identical lesions, that transplanted GRP cells are not supportive of axon growth or functional recovery, thus demonstrating the critical importance of pre-differentiating progenitor cells before transplantation to the injured adult CNS.