Schwann cells produce myelin sheath around peripheral nerve axons. Myelination is critical for rapid propagation of action potentials, as illustrated by the large number of acquired and hereditary
peripheral neuropathies, such as
diabetic neuropathy or Charcot-Marie-
Tooth diseases, that are commonly associated with a process of
demyelination. However, the early molecular events that trigger the
demyelination program in these diseases remain unknown. Here, we used virally delivered
fluorescent probes and in vivo time-lapse imaging in a mouse model of
demyelination to investigate the underlying mechanisms of the
demyelination process. We demonstrated that mitochondrial
calcium released by
voltage-dependent anion channel 1 (VDAC1) after sciatic nerve injury triggers Schwann cell
demyelination via ERK1/2, p38, JNK, and c-JUN activation. In diabetic mice, VDAC1 activity was altered, resulting in a mitochondrial
calcium leak in Schwann cell cytoplasm, thereby priming the cell for
demyelination. Moreover, reduction of mitochondrial
calcium release, either by
shRNA-mediated VDAC1 silencing or pharmacological inhibition, prevented
demyelination, leading to nerve conduction and neuromuscular performance recovery in rodent models of
diabetic neuropathy and Charcot-Marie-
Tooth diseases. Therefore, this study identifies mitochondria as the early key factor in the molecular mechanism of peripheral
demyelination and opens a potential opportunity for the treatment of demyelinating
peripheral neuropathies.