Periodic Reporting for period 2 - NeurO-GI (In vivo gut-brain optogenetic endomicroscopy for digestive disorders management)
Berichtszeitraum: 2023-05-01 bis 2024-10-31
Moreover, proper functioning of the brain is also connected to the health of the gut via the gut-brain axis (GBA). The gut-brain axis is a complex, multi-systems network of physiological interactions that enables our brain to integrate stimuli and coordinate responses to and from the gastrointestinal tract. The global impact of the gut-brain axis on health is exemplified by the relatively recent identification of its implication in diseases of the nervous system such as Parkinson’s disease, Alzheimer’s disease, Autism spectrum disorders and amyotrophic lateral sclerosis. In the case of Parkinson’s disease, the direct link between the gut and the brain has been made more evident by the discovery that GI symptoms precede those in the central nervous system and that GI symptom severity is predictive of cognitive decline.
Despite the importance of the status of the gut in efficient diagnosis and treatment of digestive and neurological disorders, it is still not well understood. One of the limiting factors is the lack of tools enabling in-vivo and minimally invasive investigations of the enteric nervous system’s involvement in diseases. Novel treatment methods have mainly targeted the gut microbiota, whose dysbiosis directly affects the GBA. However, ENS activity, whose role is crucial in coordinating gut homeostasis, remains mostly unexplored in these contexts. To provide insights into the functional dynamics of the gut and advance our understanding of its involvement and possible therapeutic potential in the GBA, we are developing an endoscope relying on optical and electrical signals to stimulate and monitor status of the gut. Since this entails the development of a new technology and methodology for the investigation of physiological phenomena that are not well understood, the project’s impact will affect both the device and biological knowledge landscapes surrounding the ENS and gut-brain axis.
To define design inputs for the new technology involving optical and electrical recording, as well as optogenetic stimulation, we first developed a methodology for ex-vivo imaging of large segments of the gut with the advanced microscopy platform at the Wyss Center. This approach gave unprecedent qualitative and quantitative information about the network of neurons and others cells involved in physiological function of the gut in mice (healthy and with Parkinson disease) and in human samples at the network level in 3D volumes. Measurements of neuron distribution in the distal colon were used to refine the design of the endoscope’s design for high-resolution intraluminal opto-electrical recording. By applying this method to tissue samples from healthy and disease animals, we could observe morphological remodeling of the network.
Building on the vast experience in electrical recording of brain at the Wyss Center, in August 2023 we achieved the first preliminary in-vivo recording of colon activity. We found spontaneous activity consisting of regular 10~20s trains of neurogenic spikes, repeating every 30~40s. We reliably modulated this activity with pharmacological stimulation of neuronal cholinergic conductance. This led to the development of the NeurO-GI ephys endoscope to map activity over 3 cm of the gut in-vivo. In parallel, we developed a custom endoscopic OCT system, compatible with the ephys endoscope, with specific scanning protocols to support visualization of enteric neuronal ganglia morphology in-vivo. We successfully collected high-quality OCT data in 5 animals and most recently acquired the first simultaneous OCT and ephys recording in-vivo. We also used the same opto-electrical endoscope for intraluminal optogenetic activation. To test the concept, we first achieved the complicated task of customizing an optogenetic mouse line to our experimental needs, choosing the ReaChR-mCitrine transgenic model expressing a red-shifted opsin sensitive to stimulation and inducing the expression of a fluorescent GCaMP reporter of neuronal activity. To target expression in the ENS we injected custom viral vectors produced by a subcontractor. We successfully delivered opsin-activating light to the gut in living animals and effectuated stimulation. We confirmed homogeneous expression of the opsin in the tissue with our ex-vivo imaging methodology. Overall, this novel neurotechnology has the potential to address the needs of neurogastroenterology research and was guided by our knowledge of neurobiology of the gut obtained with ex-vivo imaging.
Since the beginning of the action, we presented our approach and results to key opinion leaders from fields including neurology, gastroenterology, biomedical research and business development at venture capitals. The proposed mindset of neurobiology-driven device development to achieve a minimally invasive approach to understand, diagnose and possibly treat disorders in the gut and the brain has been extremely well received with a lot of interest in scientific collaboration and suggestions for translation to the clinical use. Apart from providing a completely novel research device for small animal investigations, we believe that this approach will allow for expansion to large animal models and ultimately humans.
According to a key expert in the field, a major weakness in neurogastroenterology has been the absence of any technology to record in high resolution the activity from the gastrointestinal (GI) tract of live rodents. The ability of our proposed technology to measure the dynamic changes in electrical activity from the gut with morphological confirmation in live mice intraluminally offers biomedical science a unique opportunity to study transgenic animals and hence manipulate specific genes of interest to determine function in-vivo. Commonly, optical and electrical read/write approaches are plagued by crosstalk artifacts and competing engineering requirements. However, by bringing extended experience of the PI in endoscopic optical catheters with expertise in electrophysiology and neurotechnology of the Wyss Center, we were able to create a novel multimodal device showing that the high risk / high gain idea at the basis of this action is feasible.
The first groundbreaking results obtained with our prototypes of electrical and optical endoscopes showed great potential for the development of a robust tool to advance understanding of the gut-brain axis. To demonstrate this tool’s potential impact, we will apply it in longitudinal studies in small mammals with various sources of GI dysfunction and stimulate at the gut and the brain sites. With the ultimate goal of transferring our findings into the clinic, we will be focused on defining modalities and biomarkers that can be used in the early diagnosis of gut-brain axis disorders in humans.
 
           
        