Charcot-Marie-Tooth disease (CMT) is the most common hereditary peripheral neuropathy, affecting 1 in 2,500 people. The only treatment currently available is rehabilitation or corrective surgery. The most frequent form of the disease, CMT-1A, involves abnormal myelination of the peripheral nerves. Here we used a mouse model of CMT-1A to test the ability of ascorbic acid, a known promoter of myelination, to correct the CMT-1A phenotype. Ascorbic acid treatment resulted in substantial amelioration of the CMT-1A phenotype, and reduced the expression of PMP22 to a level below what is necessary to induce the disease phenotype. As ascorbic acid has already been approved by the FDA for other clinical indications, it offers an immediate therapeutic possibility for patients with the disease.

Charcot-Marie-Tooth (CMT) disease is the most frequent hereditary peripheral neuropathy in humans. Its prevalence is about one in 2500. A subform, CMT1A, is transmitted as an autosomal dominant trait. An estimated 75% of patients are affected. This disorder has been shown to be associated with the duplication of a 1.5 Mb region of the short arm of chromosome 17, in which the PMP22 gene has been mapped. We have constructed a murine model of CMT1A by inserting into the murine genome a human YAC containing peripheral myelin protein 22 (PMP22) and its flanking controlling elements. We describe the behaviour of the C22 line (seven copies of YAC, 2.1 times PMP22 overexpression) during the myelination process. Electron microscopy, morphometry, electrophysiology, nerve conduction and expression of specific markers (e.g. Krox20) in normal and pathological Schwann cells demonstrated that PMP22 overexpression leads to a defect in the myelination of axons. The largest axons are the most affected. Only a few demyelination/remyelination processes were observed. Moreover, PMP22 overexpression probably enhances collagen synthesis by fibroblasts, before myelination, demonstrating that structures other than Schwann cells are affected by PMP22 overexpression. Classically, CMT1A was thought to be induced by a demyelination process following a phase of normal myelination, yet our data suggest that dysmyelination should be considered as a major factor for the disease.

The development of the gonadal primitive medulla in embryonic chick gonads was studied with the light microscope, using serial longitudinal sections from 72 h to 108 h of incubation. The sex of embryos was established from karyotypes. At 72 h, the germinal epithelium in the genital ridges was thickened. The nephrogenic cord was not differentiated into nephrons underneath, although the surrounding mesonephros displayed renal corpuscles and tubules. Clusters and trabeculae of mobilized mesonephric cells piled up under the germinal epithelium, forming the rudiment of the primitive medulla. From 78 h onwards, nephrotome-like structures existed in the mesenchyme underlying the germinal epithelium. Mesonephric cells became detached from their ventral walls and incorporated into the rudiment of the medulla. Finally, at 90 h, when the gonads were constituted, the primitive medulla was definitively formed without any contribution of the germinal epithelium. Adrenal cortical cells, also originating from the mesonephric blastema, showed tight relationships with the gonadal medullarian structures. Our observations support the concept of the mesonephric origin of the gonadal components having male potentialities in birds.