Here we report that exogenous LIF delivery to the adult mouse CNS can be used to enhance the endogenous progenitor cell response and promote remyelination following cuprizone-induced demyelination. A key finding of this study is that exogenous LIF stimulates OPC proliferation, as demonstrated by an increase in BrdU incorporation in OPCs. This increase in proliferation is observed both early (2–5 days) as well as 3 weeks after Ad-LIF delivery, indicating that the continuous delivery of LIF from adenovirus-infected ependymal cells results in a sustained response that expands the OPC population. Because LIF and other gp130 cytokines enhance the survival of OL lineage cells in vivo and in vitro, it is possible that the pro-survival effect of LIF also contributes to the expansion of the OPC pool and subsequently increased OL generation. Indeed, sustained LIF exposure appears to support the survival of supra-physiological numbers of Olig2+, OL lineage cells (see ), most notably in regions adjacent to the ventricles where LIF levels are presumably the highest. Therefore, LIF not only stimulates OPC proliferation but may further support the expansion of OL lineage cells by enhancing their survival.
The finding that LIF expands the population of pre-labeled YFP
+ OPCs in
PDGFRa-CreER;ROSA-YFP mice also strongly suggests that LIF mediates this expansion by acting primarily upon pre-existing, parenchymal OPCs rather than by enhancing the production of new OPCs from SVZ progenitors, since fate tracing in these mice specifically labels OPCs and their progeny but does not label SVZ NSCs (
Rivers et al., 2008). This conclusion is further supported by our previous experiment showing that these proliferating parenchymal progenitors were not labeled by the injection of a GFP-encoding retrovirus into the SVZ (
Bauer and Patterson, 2006). Given that OPCs are very abundant and widely disseminated throughout the CNS, they represent an ideal target population for therapeutic approaches aimed at promoting the generation of new OLs.
Our finding that ablation of
gp130 in OL lineage cells dramatically reduces their proliferative response to LIF suggests that LIF stimulates their proliferation directly. Alternatively, LIF might stimulate OPCs by inducing the expression of additional gp130 cytokines. Regardless, we demonstrate that activation of gp130 signaling within OPCs is necessary for their proliferative response to exogenous LIF. Thus, gp130 cytokine-based strategies aimed at promoting myelin repair would require direct action on OPCs. Whether this can be achieved without direct delivery to the CNS requires further study. LIF can cross the blood-brain barrier (BBB) through a saturable transport mechanism (
Pan et al., 2000) that is enhanced by neuroinflammation (
Pan et al., 2008), raising the possibility that systemically delivered LIF may be sufficient to mediate the effects on OPCs, especially at sites of inflammatory demyelination. Indeed, Butzkueven
et al. were able to detect systemically injected LIF in the CNS of mice with experimental autoimmune encephalomyelitis (EAE) but not in non-EAE controls (2002). Notably, daily systemic LIF administration did not increase the number of Ng2
+ OPCs in the CC after 4 weeks of cuprizone (
Marriott et al., 2008), a finding that might be explained by the lack of a direct effect of systemically delivered LIF on OPCs, or by the dramatic, spontaneous increase in OPCs that is present after 4 weeks of cuprizone treatment, which may have masked an effect of LIF on OPC expansion.
Interestingly, inactivation of
gp130 in the OL lineage does not affect the basal rate of OPC proliferation in control mice, suggesting that endogenous gp130 cytokine signaling does not contribute substantially to the rate of cycling of these cells under normal physiological conditions. Likewise, neither
gp130ΔNG2 mice, or
Nes-Cre+;gp130fl/fl mice, in which gp130 signaling is ablated embryonically in nearly all neural cells, has an obvious postnatal hypomyelination phenotype (B. E. Deverman, unpublished data). These findings imply that the loss of gp130 signaling either specifically in OL lineage cells, or in all neural cells, does not have significant consequences for developmental myelination. Given that both LIF and CNTF KOs have delayed OL generation in the optic nerve (
Barres et al., 1996;
Ishibashi et al., 2009), the loss of these cytokines may affect the timing of OL development indirectly. Whether endogenous LIF and/or other gp130 cytokines contribute to the enhancement of OPC proliferation that occurs in response to pathological demyelination is not clear. In support of this possibility, compared with wild-type mice, OPC proliferation is reduced in
Cntf−/− mice late during the course of EAE (
Linker et al., 2002). In contrast, the spontaneous expansion of OPCs that occurs by 4 weeks of cuprizone treatment is not influenced by the loss of LIF (
Marriott et al., 2008).
Our finding that sustained exogenous LIF expression enhances both OPC proliferation and the generation of myelinating OLs is consistent with
in vitro studies, but is surprising when considered in the context of studies of other factors such as PDGF and FGF2, which enhance OPC proliferation at the expense of differentiation (
Goddard et al., 2001;
Armstrong et al., 2002;
Woodruff et al., 2004;
Armstrong et al., 2006). How LIF stimulates both OPC proliferation and OL differentiation is unclear. Since LIF, like CNTF, is not mitogenic for OPCs
per se, but only expands the number of OPCs in the presence of PDGF (
Barres et al., 1996), one hypothesis is that LIF-induced gp130 signaling may “activate” OPCs thereby enhancing both their response to mitogens when present, and to differentiation signals, such as those from demyelinated axons, when mitogens become limiting. Alternatively, LIF may promote OL differentiation indirectly by increasing the density of OPCs, which is known to promote their differentiation, at least when seeded on DGR neurons in culture (
Rosenberg et al., 2008), or through an intrinsic timer mechanism that may limit the number of OPC divisions that can occur before the OPCs differentiate (
Temple and Raff, 1986;
Dugas et al., 2007). Irrespective of the mechanism, we demonstrate that exogenous LIF delivery can be used to stimulate the otherwise largely dormant OPC population to proliferate and generate new OLs that contribute to remyelination. Importantly, these beneficial effects of LIF on OL generation and remyelination cannot simply be attributed to the well-described, pro-survival action of LIF on OLs since we delivered LIF to cuprizone-treated mice at a time when mature OLs are severely depleted.
The need for remyelination-enhancing therapeutics is great. Significant progress toward developing such therapies has been made by injecting exogenous progenitors, from a variety of sources that are capable of generating myelinating OLs. Progenitor transplantation appears especially promising for the treatment of the congenital hypomyelinating diseases (
Windrem et al., 2008) and localized traumatic injury (
Cao et al., 2005;
Keirstead et al., 2005;
Lowry et al., 2008), but its efficacy for inducing remyelination in adult demyelinating disorders with disseminated lesions such as MS is less certain. For these disorders, enhancing repair by stimulating OL generation from endogenous progenitor cells is an attractive option. However, progress demonstrating the efficacy of targeting endogenous OPCs as well as NSCs with factors to promote remyelination has been slow, with only a few factors showing therapeutic promise (
Warrington et al., 2007;
Harsan et al., 2008). This is due only in part to our incomplete understanding of the factors that influence OL lineage cells and remyelination
in vivo. Progress has also been hindered by challenges associated with available animal models, most of which are poorly suited for demonstrating the efficacy of, and mechanism behind, any potential remyelination-promoting agents. This is largely because of the relative efficiency of remyelination in rodents. Indeed, even after a 12-week course of cuprizone treatment, which has been reported to induce a chronic state of demyelination, we observe significant spontaneous remyelination in the medial CC, which masks any increase in remyelination that may occur in response to Ad-LIF treatment. We therefore focused our study on the hippocampus, where the spontaneous remyelination of axons within several layers is incomplete.
In MS, the widespread incidence of gray matter (GM) demyelination (
Brownell and Hughes, 1962;
Kidd et al., 1999;
Bo et al., 2003;
Geurts et al., 2005) and abnormalities (
Rovaris et al., 2000;
Ge et al., 2002;
Vrenken et al., 2006) is now broadly appreciated, and GM changes correlate with the cognitive impairment that is common in MS patients (
Rovaris et al., 2000;
Vrenken et al., 2006;
Amato et al., 2007). GM lesions are present throughout the cortex and hippocampus (
Pirko et al., 2007;
Geurts et al., 2008). Indeed, demyelinated hippocampal lesions were found in 15 of 19 MS cases (
Geurts et al., 2007), and hippocampal lesions were seen in 14 out of 16 randomly selected, relapse-remitting (RR) and secondary progressive (SP) patients (
Roosendaal et al., 2008). In addition, hippocampal atrophy that exceeds global brain atrophy was observed in RR and SP patients, and this atrophy correlated with declining performance on a word-list learning task (
Sicotte et al., 2008). Thus, cuprizone-induced demyelination of the hippocampus is an attractive model of GM demyelination and remyelination, which has not been well characterized in other animal models.
In sum, we find that exogenous delivery of the neuropoietic cytokine LIF to the CNS stimulates the proliferation of parenchymal OPCs. LIF-induced OPC proliferation is dramatically reduced when
gp130 is ablated from the OL lineage, suggesting that their proliferation requires LIF-induced gp130 signaling in these cells. Importantly, the effect of LIF on OPC proliferation can be harnessed to restore the number of mature OLs, enhance myelin protein expression and reform nodes of Ranvier in the chronically demyelinated hippocampus of cuprizone-treated mice. Thus, LIF has repair-promoting activities that could be beneficial for disorders and injuries in which demyelination contributes to ongoing disability. Taken together with previous studies showing that LIF can ameliorate EAE (
Butzkueven et al., 2002;
Slaets et al., 2010;
Cao et al., 2011) and improve OL survival and motor symptoms following spinal cord injury (
Zang and Cheema, 2003;
Kerr and Patterson, 2005), our findings should reinforce interest in the further exploration of LIF, and other gp130 cytokines, as therapeutic agents for demyelinating disorders.