Three Strategies to Induce Neurotrophic Keratitis and Nerve Regeneration in Murine Cornea

Summary

Here, we propose three different methods of damaging the sensory fibres innervating the cornea. These methods facilitate the study of axon regeneration in mice. These three methods, which are adaptable to other animal models, are ideal for the study of corneal innervation physiology and regeneration.

Abstract

The cornea is a transparent tissue that covers the eye and is crucial for clear vision. It is the most innervated tissue in the body. This innervation provides sensation and trophic function to the eye and contributes to preserving corneal integrity. The pathological disruption of this innervation is termed neurotrophic keratitis. This can be triggered by injury to the eye, surgery, or disease. In this study, we propose three different protocols for inflicting damage on the innervation in ways that recapitulate the three types of cases generally encountered in the clinic.

The first method consists in making an abrasion of the epithelium with an ophthalmic burr. This involves the removal of the epithelial layer, the free nerve endings, and the subbasal plexus in a manner similar to the photorefractive keratectomy surgery performed in the clinic. The second method only targets the innervation by sectioning it at the periphery with a biopsy punch, maintaining the integrity of the epithelium. This method is similar to the first steps of lamellar keratoplasty and leads to a degeneration of the innervation followed by regrowth of the axons in the central cornea. The last method damages the innervation of a transgenic mouse model using a multiphoton microscope, which specifically localizes the site of cauterization of the fluorescent nerve fibers. This method inflicts the same damage as photokeratitis, an overexposure to UV light.

This study describes different options for investigating the physiopathology of corneal innervation, particularly the degeneration and regeneration of the axons. Promoting regeneration is crucial for avoiding such complications as epithelium defects or even perforation of the cornea. The proposed models can help test new pharmacological molecules or gene therapy that enhance nerve regeneration and limit disease progression.

Introduction

The cornea, which is the transparent surface of the eye, is composed of three distinct layers: the epithelium, the stroma, and the endothelium. This organ has the highest density of innervation in the body and is composed mainly of sensory fibers (types Aδ and C) originating from the ophthalmic branch of the trigeminal ganglion. Sensory fibers penetrate the periphery of the cornea in the mid-stroma in the form of big bundles that branch out to cover the surface. They then bifurcate to pierce the Bowmann's membrane and form the subbasal plexus, which is easily recognizable by the formation of a vortex in the center of the cornea. Those fibers terminate as free....

Protocol

All experiments were approved by the National Animal Experiment Board.

1. Preparations

1. Prepare an anesthetic solution of ketamine-xylazine for anesthesia. Inject ketamine at 80 mg/kg and xylazine at 10 mg/kg by diluting 200 µL of ketamine (100 mg/mL) and 125 µL of xylazine (20 mg/mL) in 2,175 mL of sterile 0.9% NaCl.
2. Prepare 0.02 mg/mL buprenorphine solution as an analgesic solution by adding 100 µL of 0.3 mg/mL buprenorphine to 1,400 mL of.......

Discussion

Neurotrophic keratitis is considered a rare disease, affecting 5 in 10,000 individuals. However, people suffering from NK due to a physical injury such as chemical burns, or syndromes such as diabetes or multiple sclerosis are not included in those statistics³. Furthermore, this condition remains significantly underdiagnosed²², and the prevalence of the disease is underestimated. There is a strong need for new treatments and therapy that would promote axon regeneration as a.......

Materials

Name	Company	Catalog Number	Comments
0.2 µm seringe filter	CLEARLINE	51733
0.5 mm rust ring remover	Alger Equipment Company	BU-5S
2 mL plastic tubes	Eppendrof	30120094
Algerbrush burr, Complete instrument	Alger Equipment Company	BR2-5
Anti-beta III Tubulin antibody	Abcam	ab18207
Antigenfix	Diapath	P0016
Artificial tear	Larmes artificielles Martinet	N/A
Buprecare	Animalcare	N/A
Cotton swab	Any provider	N/A
Dissecting tools	Fine Science Tools	N/A
Fluorescein	Merck	103887
Gelatin from cold water fish skin	Sigma	G7765
Goat serum	Merck	S26
Head Holder	Narishige	SGM 4
Heated plate	BIOSEB LAB instruments	BIO-HE002
Hoechst 33342	Thermo Fisher Scientific	H3570
Imalgene 1000	BOEHRINGER INGELHEIM ANIMAL HEALTH France	N/A	French marketing authorization numbre: FR/V/0167433 4/1992
LAS X software	Leica	N/A	Large volume computational clearing (LVCC) process
Laser Chameleon Ultra II	Coherent	N/A
Laser power meter	Coherent	N/A
Leica Thunder Imager Tissue microscope	Leica	N/A
Multi-photon Zeiss LSM 7MP upright microscope	Zeiss	N/A
Ocry-gel	TVM lab	N/A
Parametric oscillator	Coherent	N/A
Penlights with blue cobalt filtercap	Bernell	ALPEN
Petri dish	Thermo Scientific	150318	Axotomy protocol
Petridish	Thermo Scientific	150288	Cornea whole-mount processing
Rompun 2%	Elanco	N/A	French marketing authorization numbre: FR/V/8146715 2/1980
Sterile biopsy punch 2.5 mm	LCH medical	LCH-PUK-25
Triton X-100	VWR	0694
Vectashield	EuroBioSciences	H-1000	Mounting medium