A view from the ending: Axonal dieback and regeneration following SCI

Following spinal cord injury (SCI), most axons fail to regenerate and instead form large, swollen endings generically called 'retraction bulbs.' These endings form and persist after SCI even under experimental therapeutic conditions where significant CNS regeneration occurs. Although retraction bulbs can arise from either activation of degenerative processes or deficits in regenerative processes, they are typically grouped as a single type of axonal ending. To facilitate the targeting of axonal endings for SCI repair, this review focuses on dissecting the different types of axonal endings present following injury by examining them in the context of the temporal, degenerative and regenerative changes that occur following injury. The stages of axonal dieback (also known as axonal retraction) and the steps necessary for successful axonal regeneration are outlined. The types of axonal endings that can arise as an axon successfully or unsuccessfully mounts a regenerative response are examined, with an emphasis on retraction bulbs, growth cones, and collapsed growth cones. Retraction bulbs are subdivided into those that arise from a failure to form a growth cone (endbulbs) and those that stall in response to inhibitory gradients (dystrophic axonal endings). The current understanding of the mechanisms that lead to the development of different types of axonal endings, how different experimental therapeutic interventions may act on different types of axonal endings, the current gaps in understanding the sites of action of some pro-regenerative therapies, and some of the methodological challenges to studying different types of axonal endings are discussed.