REVIEWS RETINOID SIGNALLING IN THE DEVELOPMENT OF THE CENTRAL NERVOUS SYSTEM Malcolm Maden Retinoids — a family of molecules that are derived from vitamin A — have been implicated in many developmental processes. In the embryonic vertebrate central nervous system (CNS), retinoic acid (RA) has a role in patterning both the anteroposterior and dorsoventral axes. Initially, RA was thought to be involved in generating the entire anteroposterior extent of the CNS, but more recent experiments have identified its main sites of action as the hindbrain and anterior spinal cord. RA also regulates interneuron and motor neuron development along the dorsoventral axis. This review describes the studies that led to these conclusions, and discusses how understanding the mechanisms of RA action in the developing CNS might provide insights into neurological disease. XEROPHTHALMIA An excessive dryness of the conjunctiva and cornea. HYDROCEPHALUS A condition, marked by an expansion of the cerebral ventricles and a compression of neural structures, that is caused by a block in the flow of cerebral spinal fluid or by its overproduction. SPINA BIFIDA Failure of neural tube closure at the posterior neuropore, which causes the spinal cord tissue to protrude through the vertebral column. MRC Centre for Developmental Neurobiology, 4th Floor New Hunt’s House, King’s College London, Guy’s Campus, London Bridge, London SE1 1UL, UK. e-mail: malcolm.maden@kcl.ac.uk doi:10.1038/nrn963 Vitamin A was discovered as an essential dietary component at the beginning of the twentieth century. Deprivation studies soon revealed that, in its absence, the adult animal shows characteristic changes, including widespread keratinization of epithelia, decreased immune function, anaemia, XEROPHTHALMIA and blindness1. Interestingly, from the point of view of this review, there were occasional reports of nerve degeneration in the spinal cord2,3, which resulted in a loss of coordination and apparent symptoms of motor neuron disease in pigs and chickens. Following the observation that the deprivation of vitamin A in pregnant pigs resulted in the birth of a litter without eyeballs4, it became clear that such a dietary deficiency generated characteristic congenital malformations of the embryo. In the central nervous system (CNS), the reported malformations were HYDROCEPHALUS, SPINA BIFIDA, ANOPHTHALMIA and MICROPHTHALMIA, but these superficial descriptions of abnormalities included no further anatomical details. Only recently have such details been described in deprivation studies using quail and rat embryos, which have generated precise and interesting CNS patterning abnormalities, as described in detail below. The opposite type of experiment, in which an excess of vitamin A is administered to embryos, did not begin NATURE REVIEWS | NEUROSCIENCE until 1953, when the metabolic pathway of vitamin A had been established and retinoic acid (RA) was identified as the compound that acts within cells. RA — but not vitamin A itself — was highly teratogenic when administered in excess to pregnant mammals, and it affected multiple systems of the body, including the CNS, causing EXENCEPHALY, ENCEPHALOCOEL, MICROCEPHALY, microphthalmia and spina bifida5–7. Important though they were from the teratological point of view, these observations did not really indicate what RA was doing in terms of altering the patterning of the CNS. These discoveries came only recently, after the cloning of genes (for example, the Hox genes) that could serve as markers of different axial regions of the CNS. The absence or duplication of these gene-expression domains gave precise patterning information, as described below. Perhaps the most interesting teratological observation from the perspective of the CNS is that embryos treated with RA at TAIL BUD stages produce ectopic neural tubes within the tail bud8,9. Therefore, RA can induce neural tissue from mesoderm. Similar results had been generated in abundance using embryonal carcinoma (EC) cells. When RA was added to the cultures, neurons and glia were induced to differentiate10,11. This type of result has been observed consistently with various EC cell strains, and with TERATOCARCINOMA CELLS, stem cells VOLUME 3 | NOVEMBER 2002 | 8 4 3 © 2002 Nature Publishing Group REVIEWS a Vitamin A (retinol) Alcohol dehydrogenases/ retinol dehydrogenases Retinal Retinaldehyde dehydrogenases all-trans-RA, 9-cis-RA CYP26A1, CYP26B1 4-oxo-RA, 4-OH-RA, 5,8-epoxy-RA b CRBP RA Retinol RoDH Retinol RA RXR RAR RALDH CRABP Retinal ANOPHTHALMIA Absence of the eyeballs. MICROPHTHALMIA RARE Figure 1 | Pathways for the synthesis and mechanism of action of RA. a | The metabolic pathway that converts vitamin A (retinol) into the various forms of retinoic acid (RA), which involves three classes of enzymes. b | The cellular mechanism of retinoid action. Retinol is taken up from the blood and bound to CRBP (cellular retinol-binding protein) in the cytoplasm. The retinol dehydrogenase (RoDH) enzymes metabolize retinol to retinal, then retinal is metabolized to RA by the retinaldehyde dehydrogenases (RALDHs). RA is bound in the cytoplasm by CRABP (cellular RA-binding protein). RA enters the nucleus and binds to the RA receptors (RARs) and the retinoid X receptors (RXRs), which themselves heterodimerize and bind to a sequence of DNA known as the RARE (RA-response element). This activates transcription of the target gene. A reduction in the size of the eyeballs. A blastema-like structure at the posterior end of the embryo that gives rise to all the structures of the sacrocaudal body region: neural tube, notochord, paraxial mesoderm and gut endoderm. and NEUROBLASTOMA CELLS from both mouse and human12. RA also affects neurons at various stages of differentiation; for example, in dissociated embryonic neurons or explants of neural tissue, RA causes outgrowth of more and longer neurites than would normally be observed. Hundreds of genes have now been shown to be regulated by RA during the processes of neuronal differentiation and neurite outgrowth, including transcription factors, structural proteins, enzymes, cell-surface glycoproteins, extracellular proteins, neurotransmitters, neuropeptide hormones, growth factors and cell-surface receptors12. We would therefore expect RA to be involved in neuronal differentiation in vivo. This is indeed the case, as we shall see. In addition, RA is involved in the patterning of the neuraxis along both the anteroposterior (AP) and dorsoventral (DV) axes. Before describing these data, we will first consider how RA acts in cells. TERATOCARCINOMA CELLS What is RA and how does it act? A cell line derived from a malignant germ-cell tumour, which arises from the ovary or testis and is composed of embryonal carcinoma cells. RA is the most biologically active naturally occurring member of a family of molecules called retinoids, all of which are derived from vitamin A. Retinoids are obtained from the diet in the form of retinyl esters from animal meat or β-carotene from plants. Cells in the embryo or adult that require RA obtain it from the blood, where it circulates as retinol bound to retinolbinding protein. Inside the cell, the sequestered retinol is EXENCEPHALY Failure of the cranial component of the neural tube to close. ENCEPHALOCOEL A neural tube defect that causes the herniation of brain tissue. MICROCEPHALY An abnormally small head, caused by reduced growth of the brain or skull. TAIL BUD NEUROBLASTOMA CELLS An immortalized cell line derived from tumours that arise from the neural crest. 844 | NOVEMBER 2002 | VOLUME 3 enzymatically converted, first to retinal by the retinol or alcohol dehydrogenases (RoDHs or ADHs), and then to RA by the retinaldehyde dehydrogenases (RALDHs)13 (FIG. 1a). There are several members of each of these enzyme classes, and the most important RALDHs for the embryo are RALDH1, RALDH2 and RALDH3. RA is further metabolized by two cytochrome P450 enzymes — CYP26A1 and CYP26B1 — to supposedly inactive products such as 4-oxo-RA, 4-OH-RA, 18-OH-RA and 5,8-epoxy-RA14–16, and is then excreted. Some of these products have recently been shown to be biologically active, and can even induce neural tissue17. However, the lethal phenotype of the Cyp26a1 mutant mouse, which mimics the effects of excess RA administration, is rescued by the heterozygous disruption of Raldh2, which simply reduces the amount of RA that is synthesized in the embryo18. This indicates that the products of CYP catabolism are not used by the embryo. There are two isomers of RA, all-trans-RA and 9-cis-RA, which act through different receptors. It is not known whether they are produced by separate enzymatic pathways — from all-trans-retinol and 9-cis-retinol, respectively — or whether they can be interconverted by isomerization. Cells that require RA also contain cytoplasmic retinoid-binding proteins. As their names imply, the cellular retinol-binding proteins (CRBP1 and CRBP2) bind retinol, whereas the cellular RA-binding proteins (CRABP1 and CRABP2) bind RA (FIG. 1b). Once RA has been synthesized, it enters the nucleus and influences gene activity by binding to ligandactivated nuclear transcription factors. There are two classes of these transcription factors — the RA receptors (RARs) and the retinoid X receptors (RXRs). In human, rat and mouse, there are three RARs (RARα, RARβ and RARγ)19 and three RXRs (RXRα, RXRβ and RXRγ)20. Each of these molecules has several isoforms. The RARs and RXRs act as heterodimers (for example, RARα–RXRβ), and they recognize consensus sequences known as RA-response elements (RAREs) in the control elements of RA-responsive genes (FIG. 1b). So, there are several points at which a cell’s response to RA could be regulated: the uptake of retinol from the blood; the presence of the enzymes to convert retinol to RA; the presence of the RARs and RXRs; and the presence of further co-regulators/co-repressors that interact with the RARs and RXRs. Primary neuron differentiation The first neurons to differentiate within the neuroepithelium of fish and amphibians are known as primary neurons. The function of these early-developing neurons is to coordinate escape movements, which are crucial for survival after hatching. In Xenopus, they develop in three parallel rows along either side of the midline, from the posterior hindbrain backwards (FIG. 2a). The three rows form ventral motor neurons (nearest to the midline), interneurons and dorsal sensory neurons (the most lateral). They express N-tubulin and islet 1, and there are about 120 of them on each side of the embryo21. The number of primary neurons is controlled by RA signalling. The addition of RA to the embryo increases www.nature.com/reviews/neuro © 2002 Nature Publishing Group REVIEWS a b m c m i s i s Figure 2 | Primary neurons in Xenopus and the effect of altered RA signalling. a | Schematic showing normal primary neurons at the neurula stage, as revealed by N-tubulin staining. There are three lines of neurons on either side of the midline. The most medial ones, marked ‘m’, are primary motor neurons. The middle lines, marked ‘i’, are interneurons. The lateral lines, marked ‘s’, are sensory neurons. b | The effect of excess retinoic acid (RA) on primary neurons. There are far more neurons, and the three discrete lines have fused into one. In addition, the neurons are also found at the anterior end of the embryo. c | The effect of decreasing RA signalling by treating embryos with a retinoid receptor antagonist. The anterior border of expression has moved posteriorly and there are far fewer neurons. Adapted, with permission, from REF. 22 © 1999 Company of Biologists. ANIMAL CAPS An explant cut from an amphibian embryo at the blastula stage, comprising a ‘cap’ of about 60° that is centred on the animal pole. These explants consist of uncommitted ectodermal tissue, and they are often used to test the activities of putative neuralizing factors. their numbers, so that they spread into the anterior part of the embryo and the three stripes merge21–23 (FIG. 2b). Similarly, increasing RA signalling, by injecting synthetic messenger RNA that encodes Xenopus RARα2 and RXRβ into one cell of the two-cell embryo, increases their number21,24. The additional primary neurons still form within the boundaries of the neural plate by filling in the gaps between the three stripes; the neural plate is not expanded laterally to accommodate these extra numbers (FIG. 2b). Conversely, the administration of citral (a competitive inhibitor of RA synthesis) decreases the number of primary neurons21,25. As a result, the embryos no longer respond to physical stimulation. Similarly, decreasing RA signalling, by the injection of dominant-negative RARα2 or by using the RARα–RARβ antagonist Ro 41-5253, reduces their numbers (FIG. 2c), and again the embryos are unresponsive to touch22,24–26. These methods of increasing or decreasing the numbers of primary neurons act directly on the neuroepithelium, and not through the mesoderm. This has been shown by duplicating the above results on isolated ANIMAL CAPS. The amphibian animal cap normally receives signals from the mesoderm, which comes to underlie it after GASTRULATION. These signals turn the animal cap into neural plate, but if the cap is isolated before receiving these signals, only epidermis is formed. When isolated animal caps that have been injected with noggin and/or XASH-3 to neuralize the tissue (this does not promote primary neuron formation) are treated with RA and/or injected with RARα–RXR, tubulin expression is promoted21,23. Studies of the neural genes that are altered by increases or decreases in RA signalling have been very revealing. The process of primary neurogenesis is under the control of PRONEURAL GENES27, most of which have been cloned as homologues of Drosophila genes in vertebrates. There is no RA signalling in Drosophila, but several of the proneural genes — including XASH-3, X-ngnr-1 (neurogenin-related protein), X-delta-1, Xiro2, X-MyT1, Gli3, Zic2 and X-shh (sonic hedgehog)22,25,28 — have been found to be controlled by RA in vertebrates, indicating that they must have come under the control of RA as the vertebrates evolved. Studies of the relationship between these genes, and where RA fits into the cascade of PREPATTERN GENES, proneural genes, neurogenic genes and differentiation genes, have placed RA upstream of all of them22. So, RA seems to be responsible for upregulating the prepattern genes (X-ngnr-1, X-MyT1) and the neurogenic genes (X-delta-1), and for downregulating the genes that inhibit neurogenesis (Zic2, X-shh). RA is thought to act after neural tissue has been induced by noggin, follistatin and chordin (FIG. 3). Naive ectoderm Neural inducers: noggin, chordin, follistatin Anterior neural tissue GASTRULATION RA, FGFs, Wnts The process by which the embryo becomes regionalized into three layers: ectoderm, mesoderm and endoderm. Neurogenesis AP patterning RA PRONEURAL GENES Genes that encode transcription factors of the basic helix–loop–helix class that specify neural progenitor cells and promote their differentiation. PREPATTERN GENES Also known as pre-proneural genes, these genes seem to provide a link between the patterning of the nervous system and the specification of neurons. Downregulate: Zic2 and X-shh Upregulate: X-ngnr-1, X-MyT1, X-delta-1 and N-tubulin Downregulation of anterior genes: Otx2, XCG-1, XAG-1, XA-1, Emx1, Emx2, Dlx1 and XINK-2 Upregulation of posterior genes: Krox20, Wnt1, En, Pax2, XIF-3, Xlim-1, and Hox genes Posterior hindbrain, anterior spinal cord Figure 3 | Chart to show where RA fits into the scheme of neural development. Naive ectoderm is induced to form neural tissue by the neural inducers, but this tissue is of anterior character. Retinoic acid (RA), along with fibroblast growth factors (FGFs) and Wnts, simultaneously induces neurogenesis and sets up the anteroposterior (AP) pattern of the central nervous system. In the right-hand pathway, RA upregulates a series of posterior genes and downregulates a series of anterior genes, thereby generating pattern in the posterior hindbrain and anterior spinal cord. In the left-hand pathway, RA acts to induce neurogenesis by downregulating and upregulating several identified genes. NATURE REVIEWS | NEUROSCIENCE VOLUME 3 | NOVEMBER 2002 | 8 4 5 © 2002 Nature Publishing Group REVIEWS a b fb Anteroposterior patterning c As the above studies show, RA regulates the cascade of genes that ultimately leads to neuronal differentiation, but this neuronal differentiation must be patterned along both the AP and DV axes. AP patterning takes place concurrently with neuronal differentiation, and it transpires that RA also switches on genes that are responsible for the patterning of the neural plate along the AP axis (FIG. 3). This can readily be appreciated by looking at the Xenopus primary neurons, which stretch posteriorly from the posterior hindbrain and are not present at the anterior end of the embryo (FIG. 2a). Excess RA causes the primary neurons not only to fill in the gaps between the three lateral stripes, but also to expand into the anterior end of the embryo (FIG. 2b). Conversely, decreasing signalling causes the border of primary neuron differentiation to move posteriorly (FIG. 2c). So, which part of the neural tube does RA pattern? As we shall see, initial experiments implied that RA acts throughout the AP extent of the neural tube through its posteriorizing activity, but subsequent experiments have instead focused on a more localized role of RA in the hindbrain and anterior spinal cord. mb Eye mb hb 1 2 3 4 5 6 7 d sc e Endogenous gradient of RA RA concentration Increased signalling Decreased signalling fb mb hb sc Anterior BLASTULA An embryo before the gastrulation stage, consisting of a hollow ball of epithelial cells that surround a fluid-filled cavity. NEURULA The stage of development that follows gastrulation, when the neural plate starts to develop from the ectoderm. PRIMITIVE STREAK An elongated depression of reptile, bird and mammalian embryos, through which mesodermal and endodermal cells migrate into the interior of the embryo. The most anterior tip of the primitive streak forms Hensen’s node. The streak is functionally homologous to the amphibian blastopore. 846 Posterior Figure 4 | The effects of altered RA signalling on Xenopus embryos. a | The normal central nervous system (CNS) of an embryo, showing the main subdivisions. 1–7, rhombomeres 1–7; fb, forebrain; hb, hindbrain; mb, midbrain; sc, spinal cord. b | The effect of retinoic acid (RA) treatment on Xenopus embryos. The eyes, forebrain and most of the midbrain are missing, and the remaining hindbrain and spinal cord are enlarged. c | The effect of injecting a dominant-negative RA receptor (RARα1; decreased signalling) into the left cell of a two-cell embryo. At the neural plate stage, the right (control) side shows the normal expression domains of neural markers, including Otx2 (brown; forebrain), En2 (blue; midbrain–hindbrain border), Krox20 (green; two stripes, one in rhombomere 3 (r3) and the other in r5) and Hoxb9 (red; spinal cord). On the left side of the embryo, decreased signalling has resulted in the posterior expansion of Otx2 and En2, loss of the posterior stripe of Krox20, and downregulation of Hoxb9. d | The effect of injecting a constitutively active RARα1 (increased signalling) into the left cell of a two-cell embryo. At the neural plate stage, the right (control) side shows the normal expression domains of neural markers, as in c. On the left side of the embryo, increased signalling has resulted in the anterior compression of the Otx2, En2 and Krox20 domains, with no change in Hoxb9. e | Explanation of the effects of increasing and decreasing RA signalling, based on an endogenous whole-body gradient of RA with a high point at the posterior end. Different parts of the CNS develop at different concentration thresholds. When signalling levels are changed, parts of the CNS are deleted because the thresholds are too low (red line) or are expanded (green line). | NOVEMBER 2002 | VOLUME 3 Effects of RA on the whole neuraxis. If whole embryos are treated with an excess of RA, anterior structures such as the forebrain and eyes are lost, and the hindbrain and spinal cord seem to expand to compensate (FIG. 4a,b). This has been observed most commonly in Xenopus when RA is administered at late BLASTULA /early NEURULA stages29–42, but it also occurs in urodeles43 and zebrafish44, and when RA is administered at mid/late PRIMITIVE STREAK stages in rat and mouse45–47. In addition to the loss of anterior structures, anterior genes, such as Otx2, XCG-1, Emx1 and Dlx1, are repressed. At the same time, more posterior structures, such as hindbrain and spinal cord, are expanded, and posterior genes such as Krox20, Pax2 and various Hox genes are upregulated. The cells at the anterior end of the embryo do not just die after RA treatment, but are respecified48, which explains why the remaining hindbrain and spinal cord seem to be enlarged31 (FIG. 4b). As in the case of the induction of excess primary motor neurons, RA acts directly on the neuroepithelium rather than through the mesoderm to cause this effect23,35,49–52. Alteration of RA signalling produces the same phenotypes as excess RA in Xenopus. RAR- and RXRselective ligands cause anteriorization and upregulation of posterior genes. Injection of a dominant-negative RARα1 enlarges anterior structures, shortens the tail and reduces the overall length of the embryos, and also results in an expansion of the anterior gene-expression domains26 (FIG. 4c, left side versus right side). Conversely, a constitutively active RARα1 reduces anterior structures, and the anterior gene-expression domains become compressed26 (FIG. 4d, left side versus right side). Overexpression of Xenopus CRABP produces abnormalities that are typical of excess RA administration; namely, reduced eyes, reduced forebrain and midbrain, and enhancement of Hoxb4 and Hoxb8 expression53. www.nature.com/reviews/neuro © 2002 Nature Publishing Group REVIEWS a b c fb fb d e fb fb fb mb mb mb Eye mb mb 4 hb 1 2 3 4 5 6 7 1 4 ‘5’ 4 5 6 7 5 1 2 3 1 2 3 4 5 sc Figure 5 | The effects of increasing and decreasing RA signalling on the hindbrain of chick and mouse embryos. a | Normal embryonic central nervous system (CNS). 1–7, rhombomeres 1–7; fb, forebrain; hb, hindbrain; mb, midbrain; sc, spinal cord. b | Typical effect of an excess of retinoic acid (RA) on a mouse embryo. The anterior hindbrain is deleted, leaving behind one large rhombomere (r4), with a loss of segmentation in the posterior rhombomeres. c | Typical effect of a lower dose of RA than that used in b on a mouse embryo. Here, r2 is transformed to a r4 identity, and r3 is partially transformed to r5. d | Typical effect of removing all RA from quail or rat embryos. The hindbrain region now comprises only the anterior three rhombomeres, each of which is enlarged. This effect is also seen in retinaldehyde dehydrogenase 2 (Raldh2)-knockout mice, RA receptor (RAR)-antagonist-treated mice and chicks, and RARα/RARγ double-knockout mice. e | The hindbrain in a RARα/RARβ double-knockout mouse. The r6–r7 border has gone, and r5 is expanded. The concept that emerged to explain these findings is that there is an endogenous gradient of RA within the developing CNS with a high point at the posterior end (FIG. 4e). Shifting the gradient anteriorly (increasing signalling) eliminates the forebrain and midbrain, whereas shifting it posteriorly (decreasing signalling) enlarges the forebrain and midbrain (FIG. 4e). OTOCYST An ectodermal invagination that constitutes the primordium of the internal ear. Effects of RA on the hindbrain. The whole-neuraxis gradient model fits well with the experimental data above. However, several other Xenopus experiments in which RA signalling was altered produced results in which only the hindbrain was affected. For example, CRABP overexpression caused loss of segmentation in the hindbrain53, and a dominant-negative RARβ that was injected into Xenopus resulted in a shorter and thicker hindbrain, with no rhombomere boundaries and increased numbers of Mauthner neurons (the neurons that regulate the escape response) in the posterior hindbrain54. As Mauthner neurons are normally present only in rhombomere 4 (r4), and Krox20 (which is normally expressed in r3 and r5) was ectopically expressed in r4, r6 and r7, it seemed that the posterior hindbrain had been partially anteriorized. Ectopic expression of Cyp26a1 (FIG. 1a) in Xenopus induces an anterior hindbrain duplication, which is reflected in a duplicated trigeminal ganglion and a posterior shift of Krox20, Pax6 and Hoxb3 expression55. NATURE REVIEWS | NEUROSCIENCE Another example of the effects of RA signalling on the hindbrain came from studies by Godsave et al.56, who showed that there was a concentration-dependent effect of excess RA on rhombomere-specific gene markers. Anterior rhombomere markers were induced at low concentrations, and more posterior markers required progressively higher concentrations of RA for their induction. Spinal cord genes, on the other hand, were virtually unresponsive. This rhombomere-specific effect of high levels of excess RA was already well established in mammalian embryos. Embryos that have been treated in this way have a shortened preotic hindbrain, which is reflected externally in an abnormally rostral position of the OTOCYST. It results from the loss of a section of CNS tissue from the anterior hindbrain, as well as a loss of posterior rhombomere segmentation (FIG. 5b). Most vertebrate embryos show this phenotype, from zebrafish44,57 through Xenopus58,59 and chick58,60, to rat and mouse46,47,61–65. The effect on Hox gene expression was used to establish what tissue had been lost. After RA treatment, it was shown that there is an anterior spread of the Hox-geneexpression domains into the anterior hindbrain and midbrain, followed by a retraction, leaving behind an aberrant expression pattern66. The interpretation that is most consistent with the gene-expression data65 and the neuronal architecture67 is that the single large rhombomere is r4, so r1, r2 and r3 have been lost, in addition to the posterior boundaries (FIG. 5a,b). Another effect of excess RA on the hindbrain is striking, because it involves not a loss of tissue, but a transformation of anterior hindbrain rhombomeres from one state to another. It occurs with a lower dose of RA, or by treating with RA at a slightly later stage47,61,65,68, and it has been characterized mainly in zebrafish and mouse57,69, although it also occurs in Xenopus 70. In the mouse, Hoxb1–lacZ transgenic embryos were generated, which showed the restriction of Hoxb1 to r4 and the facial nerve that derives from it. After treatment of late-streak-stage embryos with a relatively low dose of RA, the expression of Hoxb1 shifted anteriorly and then became restricted to two stripes, rather than the normal single stripe. The second stripe is in r2, and the nerve that usually emerges from r2 — the trigeminal nerve — comes to resemble the facial nerve of r4 (REFS 69,71). Rhombomere 3 changes in some of its neuronal characteristics to resemble r5, but not in terms of its Hox-gene-expression profile. So, two rhombomeres are at least partially transformed by the RA treatment (FIG. 5c). So, excess RA signalling seems to eliminate or alter the anterior hindbrain. Conversely, decreased signalling, as we shall now see, eliminates or alters the posterior hindbrain. Decreased RA signalling and the hindbrain. A decrease in RA signalling can be brought about in several ways; for example, by removing RA from the diet, by treating embryos with RAR antagonists, by knocking out the RARs or by knocking out the enzymes that make RA. The overall effect of decreased signalling is a sequential VOLUME 3 | NOVEMBER 2002 | 8 4 7 © 2002 Nature Publishing Group REVIEWS a b c d e f 1 1 1 1 1 1 2 2 2 2 2 2 3 3 3 3 3 4 4 4 4 5 5 5 3 6 6 7 No RA Full RA RA concentration g Figure 6 | The hindbrain structure after gradually decreasing RA signalling. a–f | Retinoic acid (RA) signalling is decreased from normal (f) to no RA signalling at all (a). At each decreased level, one rhombomere boundary is lost. g | Graphical representation of the level of RA signalling at each of these stages. This data was gathered by decreasing the levels of RA, by treating with a RA receptor antagonist at successively earlier stages, or by decreasing RA signalling. NODE A major organizing centre in primitive-streak-stage embryos that regulates pattern formation. It is known as Hensen’s node in chick and the Spemann organizer in frog. 848 loss of posterior rhombomeres. After removing RA from quail embryos by dietary deficiency, the posterior hindbrain fails to develop. Rhombomeres 4, 5, 6 and 7 are missing, and the remaining rhombomeres (r1, r2 and r3) expand in size to compensate72,73 (FIG. 5d). This outcome was assessed by the use of various hindbrain markers, including Hoxb1, Fgf3, MafB and Krox20, and by examining the structure of the hindbrain, which now consisted of three distinct rhombomeres attached to a spinal-cord-like structure (FIG. 5d). Essentially the same result was seen in RA-deficient rat embryos74,75, although as this spinal-cord-like tissue expressed Hoxb1, it was interpreted as being an enlarged r4. Decreasing signalling by knocking out RALDH2, one of the enzymes that synthesizes RA (FIG. 1a), produces the same phenotype; namely, two or three rhombomeres that are expanded in size and attached to a thinner spinal-cord-like structure76,77. A similar repertoire of markers, including Hoxb1 and other Hox genes, MafB, Wnt8c and Eph (ephrin receptor) genes, was used to reach this conclusion. However, a zebrafish mutation in Raldh2 only has a very mild hindbrain phenotype, possibly because of the recent genome duplication that has occurred in the fish lineage, which means that there might still be one perfect copy of Raldh2 (REFS 78,79). These all-or-nothing experiments showed that the entire posterior hindbrain segment (the myelencephalon) depends on RA for its development. So, the next question is, what happens when RA signalling is decreased gradually rather than removed entirely? | NOVEMBER 2002 | VOLUME 3 This question was addressed by studying receptorknockout embryos, and by using a pan-RAR antagonist. Culturing chick embryos in high concentrations of a pan-RAR antagonist caused the loss of posterior rhombomeres, with r1, r2 and r3 remaining attached to a smooth neural tube, the anterior portion of which was again interpreted as being an enlarged r4 due to its expression of Hoxb1 (REF. 80). Gradually decreasing signalling (increasing concentrations of the antagonist), or treating with a high concentration of antagonist at successively earlier stages (from stage 10 to stage 5), produced a sequential loss of posterior rhombomeres. Each loss was preceded by a rhombomere boundary loss and then by an expansion of that domain in the following order: first, the r7–r8 border was lost and r7 was expanded; then the r6–r7 border was lost and r6 and r7 were expanded then lost; then the r5–r6 border was lost and r5 was expanded then lost. Then, the r4–r5 border was lost and r4 was expanded. The fact that the rhombomere boundaries are lost one by one as RA signalling is experimentally decreased indicates that RA might function in the sequential formation of these boundaries. Receptor-knockout mice also show loss-of-boundary phenotypes. Although embryos in which a single RA receptor is knocked out have normal hindbrains, RARα–RARβ double knockouts have fused r6 and r7 (due to loss of the r6–r7 boundary) and an expanded r5 (REF. 81) (FIG. 5e). RARα–RARγ double-knockout embryos have a similar phenotype to RA-deficient embryos and Raldh2-knockout embryos, with missing posterior rhombomeres and expanded anterior rhombomeres82 (FIG. 5d). Both of these defects can be mimicked by the use of a pan-RAR antagonist. Treating mouse embryos at day 7 with the antagonist phenocopies the RARα–RARγ phenotype (FIG. 5d), and treating at day 8 phenocopies the RARα–RARβ phenotype, which consists of an expanded r5 and fused r6–r7 (FIG. 5e). This indicates that RARα and/or RARβ function later to form the r6–r7 border, after RARα and/or RARγ have acted to form the r3–r4, r4–r5 and r5–r6 boundaries. From these findings, we can propose a model for the function of RA in building the posterior hindbrain (FIG. 6). Similar ideas have recently been described by Gavalas83. The ground state in the absence of RA is enlarged r1, r2 and r3 (FIG. 6a). RA could be released from a source that is posterior to the developing hindbrain, forming a gradient that decreases in concentration towards the anterior end of the hindbrain. Alternatively, RA could be generated in a population of cells akin to a NODE, the progress zone of the limb bud, or a root tip of a plant, and when cells leave this population they no longer receive RA signals. Earlier-leaving cells would have received a lower level of RA signalling than later-leaving cells. The sequence of concentrationdependent RA-induced events (low-concentrations events first, high-concentration events last) would then be as follows. First, make a r3–r4 border (FIG. 6b). Then, make a r4–r5 border (FIG. 6c); make a r5–r6 border (FIG. 6d); make a r6–r7 border (FIG. 6e); and finally, make a r7–r8 border (FIG. 6f). www.nature.com/reviews/neuro © 2002 Nature Publishing Group REVIEWS Does endogenous RA fit either theory? PARAXIAL MESENCHYME So, we have two ideas about how RA might organize AP patterning. One is that there is a head-to-tail gradient that extends over the whole neuraxis, with a high point at the posterior end (FIG. 4e). The second is that there is a localized source of RA at the posterior end of the hindbrain that is responsible for patterning the posterior hindbrain (FIG. 6g). Do endogenous measurements provide support for either of these ideas? Endogenous measurements of RA in Xenopus have been contradictory. Some data support the idea of an AP gradient at the neural plate stage, with a high point at the posterior end84, but other measurements have found higher levels at the anterior end of the embryo36. A region of the mesoderm adjacent to the notochord, which becomes segmented rostrocaudally to give rise to the somites early in development. Hensen’s node b c RA concentration a fb d fb mb mb hb hb sc sc Neural plate Mesoderm Anterior Posterior fb e mb 1–3 Neural plate Mesoderm Anterior Posterior fb mb 1–3 Neural plate Mesoderm Anterior Posterior fb mb 1–3 Neural plate Mesoderm Anterior Posterior Figure 7 | Endogenous RA in the chick and mouse embryo. a | Stage 4 chick embryo, showing that retinoic acid (RA) can be detected in the posterior region (red area), behind Hensen’s node. This mirrors the distribution of retinaldehyde dehydrogenase 2 (Raldh2) expression at this early stage. b | Double in situ hybridization of a stage 6 chick embryo, showing the expression of the cytochrome P450 Cyp26a1 at the anterior end (green) and Raldh2 (red) at the posterior end. In between is the region that is fated to form the hindbrain, which is 100–200 µm in size. c | Graphical representation of the levels of RA in the embryo in b, generated by Raldh2 and catabolized by Cyp26a1. fb, forebrain; mb, midbrain; hb, hindbrain; sc, spinal cord. d | Diagram to show where the RA in b and c is actually present in the embryo. Raldh2 is expressed in the posterior mesoderm, whereas Cyp26a1 is expressed in the anterior neural plate, which is fated to form the forebrain and midbrain. Therefore, RA has to diffuse up into the neural plate and then turn towards the Cyp26a1 sink. e | An alternative explanation for the part that RA might play in the generation of the posterior hindbrain. Here, the RA does not form a gradient, but it signals sequentially to the neural plate above it. As the neural plate grows anteriorly (or the Raldh2expressing posterior mesenchyme moves posteriorly), successively more posterior hindbrain tissue is exposed to RA. 1–3, rhombomeres 1–3. NATURE REVIEWS | NEUROSCIENCE However, in mouse and chick embryos, using a variety of techniques, including HPLC (high-performance liquid chromatography)85,86, LacZ reporter cells86–89 or LacZ transgenic mouse embryos90–94, the consistent finding has been that the early forebrain, midbrain and hindbrain have low or undetectable levels of RA, but that the spinal cord has very high levels. There is a sharp on–off boundary of RA at the hindbrain–spinal cord border, which is at the level of the first somite (FIG. 7a). This distribution does not support the idea of a whole-body gradient of RA. The distribution of endogenous RA is validated by studies of the distribution of the enzyme RALDH2. From very early stages (stage 4 in the chick), it is expressed in a butterfly shape (FIG. 7a), with a sharp border where the head and trunk meet, which will later be at the level of the first somite95,96. At the same stage, CYP26A1 — one of the enzymes that metabolize RA — is expressed at the anterior end of the embryo. A double in situ hybridization using Cyp26a1 and Raldh2 probes revealed a gap between the two domains, and this is the region where the hindbrain will develop96,97 (FIG. 7b). Clearly, there is the potential for a gradient to form between the presumptive spinal cord (source) and the presumptive midbrain (sink), which would be responsible for the formation of rhombomere boundaries and domains of Hox gene expression (FIG. 7c). The size of the gap at stage 6 (FIG. 7b) is 100–200 µm — an ideal distance over which this gradient could form, and indeed, such a gradient has been proposed previously to explain how the expression pattern of the posterior hindbrain gene MafB might develop98. The expression of Cyp26b1 begins somewhat later than these presomite-stage events, and is found in r3 and r5, at least in the mouse99. If it is involved, this form of CYP would serve to sharpen the proposed gradient. However, a complicating factor is that Raldh2 is expressed not in the developing spinal cord, but in the adjacent PARAXIAL MESENCHYME. Cyp26a1, on the other hand, is expressed in the anterior neuroepithelium95,96,100. Therefore, the proposed gradient would have to go from the paraxial mesenchyme (which subsequently forms the somites) into the neuroepithelium above, and then turn at right angles to enter the anterior neuroepithelium (FIG. 7d). Arguments against this idea include the view that this mechanism is asking rather a lot of the cellular machinery, and that the neural tube itself can generate RA86,101, and can activate RAR and RXR reporters102, although the enzyme involved is not known. However, evidence to support the idea has come from the many experiments showing that, when cervical somites are grafted rostrally, adjacent to the hindbrain, the expression patterns of Hoxb4, Hoxa3, CEK8 and MafB are altered 98,103,104, and that this effect can be mimicked by the implantation of RA-soaked beads98 and can be inhibited by disulphiram treatment of the somites105 (disulphiram is an inhibitor of RA synthesis). In addition, the Raldh2 zebrafish mutant called neckless, which has a mild hindbrain phenotype, can be rescued by the transplantation of wild-type mesodermal cells78. Finally, the gradual loss VOLUME 3 | NOVEMBER 2002 | 8 4 9 © 2002 Nature Publishing Group REVIEWS of this inductive ability of the first four somites from the two-somite stage to the ten-somite stage104 correlates precisely with the loss of Ralhd2 expression in the same somites. So, the diffusion of RA from the paraxial mesoderm into the neural tube to generate the posterior hindbrain seems to be well supported by the experimental data. But is a gradient of RA required? Does the RA that comes from the paraxial mesoderm actually need to form a gradient across the presumptive hindbrain (FIG. 7c)? There are two arguments against the gradient hypothesis. First, it has been exceedingly difficult to demonstrate the existence of an RA gradient. Second, it is difficult to imagine how rescuing RA-deficient embryos by systemically administering RA could result in the recreation of a gradient72,76,106. Third, as CYP26A1 functions as the sink to break down the RA that is generated by RALDH2, knocking it out should destroy the gradient and produce the same phenotypes as an excess of RA (loss of anterior hindbrain and the transformation of anterior rhombomeres). However, although Cyp26a1-knockout embryos were found to have severe posterior (tail bud) abnormalities, no significant growth or segmentation abnormalities in the hindbrain were reported107,108. The only minor abnormalities in the hindbrain were in the expression domains of Hoxb1 (slightly larger), Meis2 (slightly smaller) and Krox20 (slightly smaller). An alternative to a gradient would be a constant supply of RA from the paraxial mesoderm over time, but where the neuroepithelium grows and moves away from the source of RA. More posterior rhombomeres and rhombomere boundaries that develop later than the more anterior ones would have been exposed to more total RA, so more posterior genes (requiring a higher concentration of RA) would be induced (FIG. 7e). A similar conclusion regarding RA activity has recently been presented83. a rp D b BMPs V0 V1 V2 mn V3 c Shh fp d LMCs RALDH2 850 | NOVEMBER 2002 | VOLUME 3 Dorsoventral patterning Two experiments have provided evidence for further roles for RA in the CNS, and these both concern neuronal populations along the DV axis of the spinal cord (FIG. 8a). In the first experiment, naive neural plate tissue was cultured in the presence of retinol. As a result, certain subsets of interneurons, which were characterized by the expression of the homeobox genes Dbx1, Dbx2, Evx1, Evx2 and En, were induced109. This is consistent with studies of the DV expression domains in the spinal cord of the RA-deficient quail embryo, in which these populations of interneurons are missing (L. J. Wilson and M.M., unpublished data). In this work, other populations along the DV axis were also studied. Ventral populations (Shh, Nkx6.1) had expanded at the expense of dorsal populations (Bmp4, Bmp7, Pax3 and Wnt1), which had shrunk, and the interneuron populations in the middle were abolished (FIG. 8b,c). This indicates a role for RA in repressing ventral neuronal genes and inducing dorsal genes, so that interneurons can develop in the centre of the spinal cord. Interestingly, these DV abnormalities were only present at the anterior spinal cord level, and not at posterior levels, which accords perfectly with the proposed role of RA in anterior spinal cord determination110. This also indicates that specification of the DV axis occurs at the same time as that of the AP axis in this region. As no RALDHs have been identified in the early neural tube, the source of RA for this inductive/repressive action must once again be the somites. Cyp26a1 is expressed in the dorsal third of the neural tube96, so this might act as a sink. A second and later event in the DV axis of the spinal cord concerns the appearance of subsets of motor neurons. The enzyme RALDH2 begins to be expressed in the motor neurons of the spinal cord at the limb levels at stage 19 in the chick and at day 12.5 in the mouse95,111,112. These limb levels of the spinal cord had previously been identified as ‘hot spots’ of RA synthesis along the AP axis113. Here, there is a special class of Figure 8 | Role of RA in the dorsoventral axis of the spinal cord. a | Classes of neurons that can be identified along the dorsoventral (DV) axis of the normal embryonic spinal cord. D, dorsal sensory neurons; fp, floor plate; mn, motor neurons; rp, roof plate; V0, V1, V2, interneurons; V3, ventral neurons. These classes of neurons are distinguished by their unique gene-expression profiles, many of which are characterized by combinations of homeobox transcription factors. b | Dorsal patterning is controlled by a gradient of bone morphogenetic proteins (BMPs) that arises from the dorsal roof plate, and ventral patterning is controlled by a gradient of sonic hedgehog (Shh) that arises from the floor plate. c | The pattern of dorsal and ventral genes in the retinoic acid (RA)-depleted quail spinal cord indicates that there is increased ventral signalling and decreased dorsal signalling. d | The role of RA in generating a subset of motor neurons in the spinal cord. Retinaldehyde dehydrogenase 2 (Raldh2) is expressed in motor neurons at limb levels (red circles). A subset of motor neurons known as lateral motor column neurons (LMCs) originates close to the midline of the cord (green circles) and then migrates through the Raldh2-expressing motor neurons to differentiate at the edge of the cord (arrow). During this journey, these cells are exposed to RA released by the motor neurons (red circles), and as a result, are induced to form LMCs. www.nature.com/reviews/neuro © 2002 Nature Publishing Group REVIEWS BRACHIAL At the level of the forelimbs. LUMBAR At the level of the lower back. SUBSTANTIA NIGRA A part of the midbrain that contains dopamine-producing neurons, the axons of which innervate the striatum and thereby control body movements. MORRIS WATER MAZE A learning task in which an animal is placed in a pool filled with opaque water and has to learn to escape to a hidden platform that is placed at a constant position. The animal must learn to use distal cues, and the spatial relationship between them and the platform. Learning in this task involves the hippocampus. motor neurons — the lateral motor column neurons (LMCs) — which are induced earlier in development by the presence of BRACHIAL somites (at the brachial eminence) and LUMBAR somites (at the lumbar eminence). When these somites were grafted up or down the spinal cord, ectopic LMCs were induced114, and a similar result was obtained when Raldh2 was virally misexpressed at thoracic non-limb levels112. Furthermore, the specific LMCs that were generated by this viral misexpression were not from cells that expressed Raldh2 themselves, but from adjacent cells that migrated through the Raldh2-expressing cells to a lateral location forming the lateral LMCs (FIG. 8d). This indicates that there is a paracrine inductive event, in which one cell generates RA from RALDH2, and an adjacent cell is induced to form a specific type of motor neuron (FIG. 8d). Implications for neurological disease Do these concepts have any relevance for postnatal life or in understanding the causes of neurological disease? As RA is a necessary component of the adult diet, it is highly likely that RA signalling also occurs in the adult CNS. Indeed, the signalling components — namely, RALDH1, RALDH2, RA, the RARs, the RXRs, CRABP and CRBP — are all present in the adult nervous system115–118. A failure to function of any one of these components, such as an enzyme malfunction or a receptor mutation, would be expected to lead to the malfunction or degeneration of the neuron or group of neurons concerned. Do the expression domains of these signalling components give us any indication as to which groups of neurons might be susceptible to such a malfunction? There are at least four examples that can be put forward. First, RALDH1 is expressed specifically by the neurons of the SUBSTANTIA NIGRA119. The neurons with which they synapse in the striatum have dopamine receptors, and the levels of these receptors are controlled by RA120–122. Double-null mutant mice for the RARβ and RXRβ or RXRγ genes have reduced levels of dopamine receptors, in addition to locomotor deficits123. It is easy to imagine, therefore, that the malfunctioning of RALDH1 could lead to decreased levels of RA, a failure of dopamine signalling and death of the nigral neurons, as could malfunctioning of RARβ or the RXRs in the striatum. In other words, a failure of RA signalling might lead to a movement disorder, such as Parkinson’s disease. Second, as RALDH2 is required for LMC development at limb levels112, it is possible that, in the adult, the failure of RA signalling might lead to degeneration of limb motor neurons, leading to motor neuron disease. Indeed, early studies in which adult pigs and chickens were deprived of vitamin A resulted in animals with degeneration of spinal cord motor neurons, loss of coordination and spasms2,3. We have recently shown that this is also the case in adult rats, and that there are defects in the retinoid signalling pathway in human cases of motor neuron disease124,125. Third, RARβ- and RXRγ-null mutant mice have severely impaired abilities in the MORRIS WATER MAZE, which is a test of spatial learning and memory126. This is reflected in the virtual elimination of long-term potentiation or NATURE REVIEWS | NEUROSCIENCE long-term depression in the hippocampus. So, a gradual failure of RA signalling could be responsible for the gradual decline in these abilities with age. Finally, another neurological disease that might be related to defects in retinoid metabolism is schizophrenia106,127,128. The evidence for this came from the observation that genes that have been implicated in schizophrenia are co-localized on the chromosomes with the major retinoid genes. Also, dysfunction of the dopaminergic system has been seen in patients with schizophrenia, and as discussed above, dopamine receptors are regulated by RA. In addition, schizophrenia is a disease that affects the forebrain, and certain aspects of forebrain development are under the control of RA synthesized by RALDH3 (REF. 129). We do not know the causes of Parkinson’s disease, motor neuron disease, schizophrenia or the decline in mental abilities with age, but these considerations raise the possibility of investigating a failure of retinoid signalling as one potential cause. If a failure to generate RA itself underlies any of these diseases, then the potential for a cure by administering this small lipophilic molecule is an exciting prospect. Summary and conjectures Retinoid signalling is involved in several aspects of the development of the CNS. In lower vertebrates, it is required for generating the correct numbers of primary neurons, and for their correct positioning. RA signalling is also responsible for aspects of AP patterning. It was originally thought to be involved in the organization of patterning along the whole AP axis of the early CNS, through the action of a gradient of RA with a high point at the posterior end. Integration of more recent data indicates that the hindbrain and anterior spinal cord are the foci for the action of RA. Experiments in which RA signalling has been decreased have revealed that RA seems to add posterior rhombomeres (r4–r7), one by one, from a three-rhombomere ground state (r1–r3) by generating rhombomere territories. The presence of a gradient of RA across the developing hindbrain, with a high point at the posterior end, is implied by the distribution of Raldh2 and Cyp26a1 expression, but the proposed gradient has proved to be difficult to measure and does not accord with the Cyp26a1-knockout phenotype. A gradient might not be necessary, as a constant source supplied over time to a growing system could generate the same result. Last, on the DV axis, RA signalling is required for interneuron development, and it is also required for the later development of a subset of motor neurons, the LMCs. What is now required is a greater understanding of RA and RA-like molecules in the CNS: how and where are they synthesized and what are their endogenous distributions? For example, it will be interesting to find out whether there are novel retinoids in the CNS that are not found elsewhere in the body. 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Online links DATABASES The following terms in this article are linked online to: LocusLink: http://www.ncbi.nlm.nih.gov/LocusLink/ ADHs | CRABP1 | CRABP2 | CRBP1 | CRBP2 | CYP26A1 | CYP26B1 | Eph | MafB | Meis2 | RALDH1 | RALDH2 | RALDH3 | RARα | RARβ | RARγ | RoDHs | RXRα | RXRβ | RXRγ OMIM: http://www.ncbi.nlm.nih.gov/Omim/ Parkinson’s disease | schizophrenia Swiss-Prot: http://ca.expasy.org/sprot/ CEK8 | chordin | En2 | follistatin | Gli3 | Hoxb3 | Hoxb4 | Hoxb9 | Krox20 | noggin | Otx2 | Pax2 | Pax6 | XASH-3 | X-delta-1 | X-MyT1 | X-ngnr-1 | X-shh | Zic2 FURTHER INFORMATION Encyclopedia of Life Sciences: http://www.els.net/ vertebrate central nervous system: pattern formation Access to this interactive links box is free online. VOLUME 3 | NOVEMBER 2002 | 8 5 3 © 2002 Nature Publishing Group