Animals
Adult male Sprague Dawley (SD) rats weighing 100-125g body weight (Charles River Laboratories, Wilmington, MA) were used. Animals were housed individually in a room maintained at constant temperature (22 ± 0.5°C) and relative humidity (60 ± 15%) with an alternating 12h light-dark cycle. Animals were provided access to water and food ad libitum throughout the experiment, and all efforts were made to minimize suffering. All survival surgeries were completed in a sterile environment under a surgical microscope in animals anesthetized with isoflurane (2–5%). For tissue harvest euthanasia, animals were deeply anesthetized by isoflurane followed by decapitation with a well-maintained guillotine. The estimated numbers of animals needed were derived from our previous experience with similar experiments 14,17 and a power analysis was not performed. The numbers of rats used were detailed in the relevant sections or figure legends of the experiments.
Molecular cloning and AAV constructs
AAV vectors encoding a dual promoter and bidirectional transgene cassette, in which a U6 promoter drives Piezo1-shRNA or a scramble RNA as control (SC) and GFP (for in vivo tracing) transcribed by a hybrid CMV enhancer/chicken β-actin (CBA) promoter, was constructed. Two shRNAs against rat Piezo1 (NM_001077200.2) were designed using Invivogen siRNA Wizard Software (https://www.invivogen.com). Piezo1-shRNA1: GCCGGCCATCTTGTTTGTTTATCAAGAGTAAACAAACAAGATGGCCGGC and 2: GCTGGAGGAGGATGACATAGATCAAGAGTCTATGTCATCCTCCTCCAGC (loop sequence underlined). The DNA sequences of U6-Piezo1-shRNAs were synthesized and subcloned into the Mlu I site by Genscript (Piscataway, NJ) that resides upstream of the CBA promoter of a single-strand AAV expressing plasmid pAAV-CBA-GFP, as we described previously.18 This generated pAAV-CBA-GFP-U6-Piezo1-shRNAs (pAAV-PZ1shRNAs). The plasmid of pAAV-CBA-GFP-U6-SC, designed as we previously described,19 was used as the control. The above plasmids were subsequently used to produce AAVs packed by capsid AAVolig001 by Packgene (Worcester, MA). A purified AAVolig001-CBA-GFP was provided by Myrtelle (https://myrtellegtx.com), and AAV6-CBA-GFP was produced and purified in our laboratory by previously established methods.20 Total four AAVs were used in the experiments, including 1) AAVolig001-CBA-GFP (AAVolig001-GFP, 1x1013GC/mL), 2) AAVolig001-PZ1shRNA-GFP (AAVolig001-PZ1shRNA, 1.2x1013GC/mL), 3) AAVolig001-scramble-GFP (AAVolig001-SC, 2x1013GC/mL), and 4) AAV6-CBA-GFP (AAV6-GFP, 2x1013GC/mL).
Primary cell culture and cell lines
Primary Schwann cell cultures were performed as previously described.14 In brief, SCs were isolated by digesting the dissected sciatic nerve with 0.25% trypsin (Sigma-Aldrich) for a short time (10–20 s) to obtain > 80% pure SCs, as determined by immunocytochemistry (ICC) with S100, a Schwann cell marker. NG108-15 (NG108) cells were obtained from ATCC (Manassas, VA). N2A cells stably expressing CRISPR Cas9 nuclease (Cas9N2A) were obtained from Genecopoeia (Rockville, MD). These cells were cultured by a standard protocol using Dulbecco's modified Eagle's medium (DMED) supplemented with 10% FBS and antibiotics (ThermoFisher, Rockford, IL) and were grown at 37°C and in 5% CO2 in a humidified incubator.
Microfluorimetric Ca2+ imaging
Determination of intracellular calcium (Cai2+) was performed using Fura2-based microfluorimetry and imaging analysis, as we previously described.21 Cells were imaged to monitor Cai2+ responses to Yoda1 superfusion (1 min) and total DMSO concentration was kept equal to and below 1% for all tested Yoda1 concentrations. The Cai2+ was measured as the ratio of emission in response to excitation at 340 and 380 nm, expressed as the 340/380 nm fluorescence emission ratio (R340/380) that is directly correlated to the amount of Cai2+.22 A ≥ 30% increase in R340/380 from baseline after superfusion with Yoda1 was considered a positive response for all cells recorded.14,23
AAV sciatic nerve injection
AAV was injected into the sciatic nerve using a procedure similar to that as we described for DRG injection using a microprocessor-controlled injector (Nanoliter 2000, World Precision Instruments, Sarasota, FL, USA),24 and comparable to a protocol described for sciatic nerve injection in mice.25 Briefly, after appropriate anesthesia was obtained by inhalation of 2% isoflurane, the right sciatic nerve was exposed through a lateral incision of the middle thighs and division of the superficial fascia and muscle, and the sciatic nerve was exposed at a point proximal to the bifurcation. Rats will receive sciatic nerve injection of AAV injection, in a dose of 2x1011 GC (~ 20µL) containing 0.1% Fast Green (0.1µL) in the viral vector solution to visualize the injected solution. AAV was injected directly into subepineural space (beneath the clear fascia surrounding the nerve but outside the perineurium) with a pulled glass capillary tip (40–60µm diameter) inserted into the sciatic nerve (~ 10mm) forming an angle with the longitudinal axis of the sciatic nerve. Once penetration was achieved, the injector was backed off until the compression of the tissue was not evident, to lessen tissue pressure on the pipette aperture. Injection was at a rate of 2µL/min over a 10-min period using a microprocessor-controlled injection system employing direct piston displacement mounted on a micromanipulator. Removal of the glass pipette was delayed for an additional 5 min to minimize the extrusion of the injectate. Following the injection and closure of overlying muscle and skin, the animals were returned to their housing where they remained as the designed experiments required. Saline (20µL) was injected as the control for the comparative evaluation of sensory behavior of injection and AAV.
Animal pain model and behavior testing
Tibial nerve injury (TNI) and common peroneal nerve injury (CPNI). Animals were anesthetized using isoflurane at 4% for induction and 2% for maintenance. Under anesthesia, the right sciatic nerve was exposed under aseptic surgical conditions by blunt dissection of the femoral biceps muscle. The sciatic nerve and its three branches (sural, common peroneal, and tibial nerves) were isolated. For TNI, the tibial nerve was then tightly ligated and transected distal to the ligation.17 CPNI surgery was performed using a method with minor modification, as previously validated in rats.26 Specifically, after exposure of the sciatic nerve and its three branches, the CPN was then tightly ligated and transected distal to the ligation (leaving the tibial and sural nerve intact). The overlying muscle and skin were then sutured following surgery. Sham-operated rats were subjected to all preceding procedures without nerve ligation or transection.
Sensory behavioral evaluation
Behavioral tests were conducted between 9:00 AM and 1:00 PM. Animals were habituated in individual test compartments for at least one hour before each test. Behavior tests were carried out as previously described, 24 and were performed by personnel blind to treatments. Stimuli were applied to the hindpaw plantar skin in the tibial nerve innervating area for CPNI and in the sural nerve innervating area for TNI.
1) Mild mechanical stimulation (von Frey). The withdrawal threshold was determined using calibrated monofilaments (Patterson Medical, Bolingbrook, Illinois) with forces of 0.3, 0.5, 0.8, 1.0, 2.8, 5, 9, 14, and 24g, applied in an up-down fashion, allowing calculation of the 50% withdrawal threshold.27 Beginning with the 2.8g filament, filaments were applied to the plantar skin with just enough force to bend the fiber and held for 1 s. If a response was observed, the next smaller filament was applied, and if no response was observed, the next larger was applied, until a reversal occurred, defined as a withdrawal after a previous lack of withdrawal, or vice versa. Following a reversal event, four more stimulations were performed following the same pattern. The forces of the filaments before and after the reversal, and the four filaments applied following the reversal, were used to calculate the von Frey threshold. Rats not responding to any filament were assigned a score of 25g.
2) Noxious mechanical stimulation (Pin). A point of 22g spinal anesthesia needle was gently applied 5 times to the plantar surface of hindpaw with enough force to indent but not puncture the skin. Five applications were separated by at least 10s, which was repeated after 2 min, making a total of 10 touches. For each application, this evokes either a simple withdrawal response with immediate return of the foot to the cage floor or a response characterized by sustained elevation with grooming (e.g., licking or chewing the toes) and possibly shaking, lasting at least 1 s. This latter behavior was referred to as hyperalgesia behavior. This hyperalgesia response has been associated specifically with an aversive experience.28
3) Heat stimulation. This was performed using a device designed to identify heat sensitivity (Paw Thermal Stimulator System, University Anesthesia Research & Development Group, San Diego, CA). Rats were placed on a temperature-regulated glass platform heated to 30°C and the lateral plantar surface of hindpaw was stimulated with a radiant heat source (50W halogen bulb) directed through an aperture. The time elapsed from the initiation of the stimulus until withdrawal (withdrawal latency) as detected by a series of photocells was measured. Each hindpaw was tested four times, and the withdrawal latency values were averaged.
4) Cold stimulation. Acetone was applied from a syringe attached to PE220 tubing to make a meniscus that was touched to the plantar surface of hindpaw, such that the drop spread out on the plantar surface of the paw without contact of the tubing to the skin. Each hindpaw was tested 3 times in alternating fashion. Any withdrawal was considered a positive response. The frequency of withdrawal from the stimulus was recorded.
Validation of Piezo1 antibody in CRISPR/Cas9-mediated Piezo1 knockout cells
Lentiviral (LV) expression plasmid pWPT-mCherry was used to express dual CRISPR guide RNAs (gRNAs) specific to mouse/rat Piezo1 (gRNA1: 5’-AGCATTGAAGCGTAACAGGG-3’, gRNA2: 5’-AGAGAGCATTGAAGCGTAAC-3’), as described previously.14 LVs expressing mCherry (control) or dual Piezo1 gRNAs were packaged using pWPT-mCherry and pWPT-mCherry-PZ1gRNAs with packaging plasmid pCMVDR8.74 and envelop plasmid pVSV-g, and products titrated in the range of 1x106 to 1x107 transduction unit/mL, as previously reported. 14 Cultured Cas9N2A cells grown to 50% confluence were infected by LV-mCherry-PZ1gRNAs or LV-mCherry (control) in the presence of 8µg of polybrene (Sigma-Aldrich) per mL at an optimized multiplicity of infection 5.
Tissue harvest for immunohistochemistry (IHC) and immunoblots
The rats were ~ 4 months old when tissues were harvested. After transcardial perfusion with cold 100mL PBS, lumbar (L) 4 and 5 DRG, lumbar spinal cord, and sciatic nerve segments proximal to the sciatic bifurcation and terminal branches were dissected, and fixed in Richard-Allan Scientific™ Buffered Zinc Formalin (ThermoFisher) overnight, followed by processing for paraffin embedment. The previously described histological protocol was adopted.17
Immunocytochemistry (ICC) and IHC
ICC on cultured cells and IHC on tissue sections were performed according to standard procedures. 29 Non-specific binding was reduced by incubating the sections for 30 min with a solution of 5% BSA in PBS plus 0.05% Tween20 (PBST). Cells and tissue sections were immunolabeled with the selected primary antibodies: mouse Piezo1 (1:400, Novus, NBP2-75617), rabbit GFP (1:500, Cell Signaling, CS, 2555S), rabbit mCherry (1:400, CS, 43590), rabbit GAP43 (1:400, CS, 8945), rabbit p75NTR (1:400, CS, 8238), rabbit MPZ (1:1000, CS, 57518s), rabbit S100 (1:1000, CS, 13018), goat MBP (1:1000, SCB, sc13912), rabbit NF200 (1:1000, CS, 30564), and rabbit Tubb3 (1:1000, CS, 5586), rabbit NeuN (1:400, CS, 24307s), and rabbit GFAP (1:1000, Dako, Z0334); in a humid atmosphere overnight at 4°C. The fluorophore-conjugated (Alexa 488 or Alexa 594, 1:2000) secondary antibodies (Jackson ImmunoResearch, West Grove, PA) were used to reveal immune complexes. The immunostaining was examined, and images were captured using a Nikon TE2000-S fluorescence microscope (El Segundo, CA) with filters suitable for selectively detecting the green and red fluorescence using a QuantiFire digital camera (Optronics, Ontario, NY). NIH ImageJ software (http://rsbweb.nih.gov/ij/) was used for analysis. For double-label colocalization, images from the same specimen but showing different antigen signals were overlaid by digitally merging the captured images. Positive immunostaining was defined as fluorescence intensity greater than average background fluorescence plus 2 standard deviations of the cells in an adjacent section in the same slide of negative control (the first antibody omitted) under identical acquisition parameters (n = 10 for different markers).29
Immunoblots
Immunoblots of cell lysates were performed as described previously.17 Immunoreactive proteins were detected by Pierce enhanced chemiluminescence (ThermoFisher) on a ChemiDoc Imaging system (Bio-Rad, Hercules, CA) after incubation with HRP-conjugated second antibodies (1:5000, Bio-Rad). The densitometry of the selected bands was analyzed by NIH Image J software.
Statistics
Statistical analysis was performed with GraphPad PRISM 9 (GraphPad Software, San Diego, CA). The numbers of biological replicates (e.g., animals, cells, and immunoblot samples) are provided in the corresponding figures and legends. No data points were excluded. Mechanical allodynia (vF), hyperalgesia (Pin), and thermal (heat and cold) changes after sciatic nerve injection were compared to pre-injection baseline (BL) with repeated measures of two-way ANOVA and Tukey post hoc for vF and heat, and Friedman's tests and Dunn post hoc for Pin and cold. The area under the curves (AUC) was compared among groups by one-way ANOVA and student’s t-test, where appropriate. Results are reported as mean and standard deviation of the mean (SEM). Differences were considered to be significant for values at p < 0.05.