The limb blastemal cells of an adult salamander regenerate the structures distal to the level of amputation, and the surface protein Prod 1 is a critical determinant of their proximodistal identity. The anterior gradient protein family member nAG is a secreted ligand for Prod 1 and a growth factor for cultured newt blastemal cells. nAG is sequentially expressed after amputation in the regenerating nerve and the wound epidermis-the key tissues of the stem cell niche-and its expression in both locations is abrogated by denervation. The local expression of nAG after electroporation is sufficient to rescue a denervated blastema and regenerate the distal structures. Our analysis brings together the positional identity of the blastema and the classical nerve dependence of limb regeneration.

Most but not all phyla include examples of species that are able to regenerate large sections of the body plan. The mechanisms underlying regeneration on this scale are currently being studied in a variety of contexts in both vertebrates and invertebrates. Regeneration generally involves the formation of a wound epithelium after transection or injury, followed by the generation of regenerative progenitor cells and morphogenesis to give the regenerate. Common mechanisms may exist in relation to each of these aspects. For example, the initial proliferation of progenitor cells often depends on the nerve supply, whereas morphogenesis reflects the generation of positional disparity between adjacent cells-the principle of intercalation. These mechanisms are reviewed here across a range of contexts. We also consider the evolutionary origins of regeneration and how regeneration may relate to both agametic reproduction and to ontogeny.

The regeneration of complex structures in adult salamanders depends on mechanisms that offer pointers for regenerative medicine. These include the plasticity of differentiated cells and the retention in regenerative cells of local cues such as positional identity. Limb regeneration proceeds by the local formation of a blastema, a growth zone of mesenchymal stem cells on the stump. The blastema can regenerate autonomously as a self-organizing system over variable linear dimensions. Here we consider the prospects for limb regeneration in mammals from this viewpoint.T he goal of regenerative medicine is to restore cells, tissues, and structures that are lost or damaged after disease, injury, or aging. The current approaches are influenced by our understanding of embryonic development, of tissue turnover and replacement in adult animals (1-3), and by tissue engineering and stem cell biology (4). The regeneration of organs and appendages after injury occurs in diverse animal groups and provides another important viewpoint, in addition to the demonstration that complex adult tissues can be rebuilt. The lessons of biological regeneration have not been extensively assimilated, in part because this attribute appears remote and exceptional from a mammalian perspective. This Review is concerned principally with lessons from regeneration in salamanders, the species of adult vertebrates that possesses the most extensive abilities (5, 6). We identify three properties of regeneration in salamandersautonomy, scaling, and plasticity-and discuss some of the cellular and molecular mechanisms underlying them. It may be desirable to implement these properties in the context of mammalian regeneration.Regenerative medicine currently uses three approaches ( Fig. 1) (4): the implantation of stem cells to build new structures, the implantation of cells pre-primed to develop in a given direction, and the stimulation of endogenous cells to replace missing structures. Each of the different aspects identified in the first two examples-the generation of an appropriate cohort of regenerative cells, their regulated division and differentiation, and the restoration of the appropriate part of the structure-must be evoked from endogenous cells in the third approach. These processes operate in adult animals that regenerate, and in addition, the regenerative response must be initiated by signals responsive to tissue injury or removal. One candidate signal in salamanders is the local activation of thrombin, a regulator of hemostasis and other aspects of the response to injury, as well as an activator of S phase (the phase of chromosome replication) reentry in differentiated cells (7-9).A salamander can regenerate its limbs and tail, upper and lower jaws, ocular tissues such as the lens and retina, the intestine, and small sections of the heart (10-13). The various contexts for regeneration do not present an equivalent degree of difficulty. To restore the intricate and discontinuous pattern of the vertebrate limb is a different proposition from replac...

Many regeneration contexts require the presence of regenerating nerves as a transient component of the progenitor cell niche. Here we review nerve involvement in regeneration of various structures in vertebrates and invertebrates. Nerves are also implicated as persistent determinants in the niche of certain stem cells in mammals, as well as in Drosophila. We consider our present understanding of the cellular and molecular mechanisms underlying nerve dependence, including evidence of critical interactions with glia and non-neural cell types. The example of the salamander aneurogenic limb illustrates that developmental interactions between the limb bud and its innervation can be determinative for adult regeneration. These phenomena provide a different perspective on nerve cells to that based on chemical and electrical excitability.

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Salamanders exhibit an extraordinary ability among vertebrates to regenerate complex body parts. However, scarce genomic resources have limited our understanding of regeneration in adult salamanders. Here, we present the ~20 Gb genome and transcriptome of the Iberian ribbed newt Pleurodeles waltl, a tractable species suitable for laboratory research. We find that embryonic stem cell-specific miRNAs mir-93b and mir-427/430/302, as well as Harbinger DNA transposons carrying the Myb-like proto-oncogene have expanded dramatically in the Pleurodeles waltl genome and are co-expressed during limb regeneration. Moreover, we find that a family of salamander methyltransferases is expressed specifically in adult appendages. Using CRISPR/Cas9 technology to perturb transcription factors, we demonstrate that, unlike the axolotl, Pax3 is present and necessary for development and that contrary to mammals, muscle regeneration is normal without functional Pax7 gene. Our data provide a foundation for comparative genomic studies that generate models for the uneven distribution of regenerative capacities among vertebrates.

To identify novel targets for neuropathic pain, 3097 mouse knockout lines were tested in acute and persistent pain behavior assays. One of the lines from this screen, which contained a null allele of the adapter protein-2 associated kinase 1 (AAK1) gene, had a normal response in acute pain assays (hot plate, phase I formalin), but a markedly reduced response to persistent pain in phase II formalin. AAK1 knockout mice also failed to develop tactile allodynia following the Chung procedure of spinal nerve ligation (SNL). Based on these findings, potent, small-molecule inhibitors of AAK1 were identified. Studies in mice showed that one such inhibitor, LP-935509, caused a reduced pain response in phase II formalin and reversed fully established pain behavior following the SNL procedure. Further studies showed that the inhibitor also reduced evoked pain responses in the rat chronic constriction injury (CCI) model and the rat streptozotocin model of diabetic peripheral neuropathy. Using a nonbrain-penetrant AAK1 inhibitor and local administration of an AAK1 inhibitor, the relevant pool of AAK1 for antineuropathic action was found to be in the spinal cord. Consistent with these results, AAK1 inhibitors dose-dependently reduced the increased spontaneous neural activity in the spinal cord caused by CCI and blocked the development of windup induced by repeated electrical stimulation of the paw. The mechanism of AAK1 antinociception was further investigated with inhibitors of α2 adrenergic and opioid receptors. These studies showed that α2 adrenergic receptor inhibitors, but not opioid receptor inhibitors, not only prevented AAK1 inhibitor antineuropathic action in behavioral assays, but also blocked the AAK1 inhibitor–induced reduction in spinal neural activity in the rat CCI model. Hence, AAK1 inhibitors are a novel therapeutic approach to neuropathic pain with activity in animal models that is mechanistically linked (behaviorally and electrophysiologically) to α2 adrenergic signaling, a pathway known to be antinociceptive in humans.

Adult urodele amphibians, such as the newt, can regenerate their limbs and various other structures. This is the result of the plasticity and reprogramming of residual differentiated cells, rather than the existence of a 'reserve-cell' mechanism. The recent demonstrations of plasticity in mouse myotubes should facilitate comparative studies of the pathways that underlie the regenerative response, as well as proposing new approaches to promote mammalian regeneration.