The past decade or so has seen rapid progress in our understanding of how left-right (LR) asymmetry is generated in vertebrate embryos. However, many important questions about this process remain unanswered. Although a leftward flow of extra-embryonic fluid in the node cavity (nodal flow) is likely to be the symmetry-breaking event, at least in the mouse embryo, it is not yet known how this flow functions or how the asymmetric signal generated in the node is transferred to the lateral plate. The final step in left-right patterning -translation of the asymmetric signal into morphology -is also little understood.
IntroductionThere are two key steps that contribute to the early establishment of left-right (LR) patterning in the mouse. The first step is the symmetry-breaking event that takes place in the node around embryonic day (E) 7.5 of mouse development (Fig. 1). In this step, an asymmetric signal(s) that is generated in the node is transferred preferentially towards the left side of the lateral plate mesoderm (LPM). (This mesoderm is located in the lateral region of the earlysomite-stage mouse embryo and later contributes to the mesenchyme of various visceral organs.) The transfer of this signal results in the second step: the asymmetric expression of the gene Nodal in the left LPM (see Fig. 1A,B). Cells in the left LPM that receive Nodal signaling contribute to various visceral organs, such as the lung and heart, that develop left side-specific morphologies.In this review, we discuss our current understanding of the mechanism of left-right (LR) patterning during development. In particular, we focus on genetic data from the mouse; we do not discuss finding from studies in other vertebrates, except where specifically mentioned. [For recent reviews of the similarities and differences in LR patterning between the mouse and other vertebrates, see Levin and Tabin (Levin, 2005;Tabin, 2005).]
Leftward fluid flow breaks LR symmetryAlthough there is some controversy concerning the initiation of LR asymmetry in other vertebrates (see Tabin, 2005), at least in the mouse, the breaking of LR symmetry is most likely to be achieved by the unidirectional flow of extra-embryonic fluid in the node (the node is an embryonic structure that is located at the midline, at the anterior tip of the primitive streak in mouse embryos, see Fig. 1B and Fig. 2A). This fluid flow is referred to as nodal flow (Nonaka et al., 1998). This leftward laminar flow of extra-embryonic fluid in the node cavity occurs at a speed (visualized with fluorescent beads, see Fig. 2D) of ~15 to 20 m/second and is generated by the rotational movement of 9+0 monocilia (these are cilia that have nine doublets of microtubules but that lack a pair of central microtubles), which protrude from cells located on the ventral side of the node into the node cavity (Sulik et al., 1994) (Fig. 2C). These 200-300 cilia rotate in the same direction (clockwise, as viewed from the ventral side) at a speed of 600 rpm (Nonaka et al., 1998). Nodal flow takes place for only a short ...