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Taketani T, Oyama C, Mihara A, Tanabe Y, Abe M, Hirade T, Yamamoto S, Bo R, Kanai R, Tadenuma T, Michibata Y, Yamamoto S, Hattori M, Katsube Y, Ohnishi H, Sasao M, Oda Y, Hattori K, Yuba S, Ohgushi H, Yamaguchi S. Ex Vivo Expanded Allogeneic Mesenchymal Stem Cells with Bone Marrow Transplantation Improved Osteogenesis in Infants with Severe Hypophosphatasia. Cell Transplant 2015; 24:1931-43. [DOI: 10.3727/096368914x685410] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Patients with severe hypophosphatasia (HPP) develop osteogenic impairment with extremely low alkaline phosphatase (ALP) activity, resulting in a fatal course during infancy. Mesenchymal stem cells (MSCs) differentiate into various mesenchymal lineages, including bone and cartilage. The efficacy of allogeneic hematopoietic stem cell transplantation for congenital skeletal and storage disorders is limited, and therefore we focused on MSCs for the treatment of HPP. To determine the effect of MSCs on osteogenesis, we performed multiple infusions of ex vivo expanded allogeneic MSCs for two patients with severe HPP who had undergone bone marrow transplantation (BMT) from asymptomatic relatives harboring the heterozygous mutation. There were improvements in not only bone mineralization but also muscle mass, respiratory function, and mental development, resulting in the patients being alive at the age of 3. After the infusion of MSCs, chimerism analysis of the mesenchymal cell fraction isolated from bone marrow in the patients demonstrated that donor-derived DNA sequences existed. Adverse events of BMT were tolerated, whereas those of MSC infusion did not occur. However, restoration of ALP activity was limited, and normal bony architecture could not be achieved. Our data suggest that multiple MSC infusions, following BMT, were effective and brought about clinical benefits for patients with lethal HPP. Allogeneic MSC-based therapy would be useful for patients with other congenital bone diseases and tissue disorders if the curative strategy to restore clinically normal features, including bony architecture, can be established.
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Affiliation(s)
- Takeshi Taketani
- Division of Blood Transfusion, Shimane University Hospital, Izumo, Shimane, Japan
- Department of Pediatrics, Shimane University School of Medicine, Izumo, Shimane, Japan
| | - Chigusa Oyama
- Department of Pediatrics, Shimane University School of Medicine, Izumo, Shimane, Japan
| | - Aya Mihara
- Department of Pediatrics, Shimane University School of Medicine, Izumo, Shimane, Japan
| | - Yuka Tanabe
- Department of Pediatrics, Shimane University School of Medicine, Izumo, Shimane, Japan
| | - Mariko Abe
- Department of Pediatrics, Shimane University School of Medicine, Izumo, Shimane, Japan
| | - Tomohiro Hirade
- Department of Pediatrics, Shimane University School of Medicine, Izumo, Shimane, Japan
| | - Satoshi Yamamoto
- Department of Pediatrics, Shimane University School of Medicine, Izumo, Shimane, Japan
| | - Ryosuke Bo
- Department of Pediatrics, Shimane University School of Medicine, Izumo, Shimane, Japan
| | - Rie Kanai
- Department of Pediatrics, Shimane University School of Medicine, Izumo, Shimane, Japan
| | - Taku Tadenuma
- Division of Rehabilitation, Shimane University Hospital, Izumo, Shimane, Japan
| | - Yuko Michibata
- Division of Rehabilitation, Shimane University Hospital, Izumo, Shimane, Japan
| | - Soichiro Yamamoto
- Department of Orthopedics, Shimane University School of Medicine, Izumo, Shimane, Japan
| | - Miho Hattori
- Division of Blood Transfusion, Shimane University Hospital, Izumo, Shimane, Japan
| | - Yoshihiro Katsube
- Department of Life Science and Biotechnology, National Institute of Advanced Industrial Science and Technology, Amagasaki, Hyogo, Japan
| | - Hiroe Ohnishi
- Department of Life Science and Biotechnology, National Institute of Advanced Industrial Science and Technology, Amagasaki, Hyogo, Japan
| | - Mari Sasao
- Department of Life Science and Biotechnology, National Institute of Advanced Industrial Science and Technology, Amagasaki, Hyogo, Japan
| | - Yasuaki Oda
- Department of Life Science and Biotechnology, National Institute of Advanced Industrial Science and Technology, Amagasaki, Hyogo, Japan
| | - Koji Hattori
- Department of Life Science and Biotechnology, National Institute of Advanced Industrial Science and Technology, Amagasaki, Hyogo, Japan
| | - Shunsuke Yuba
- Department of Life Science and Biotechnology, National Institute of Advanced Industrial Science and Technology, Amagasaki, Hyogo, Japan
| | - Hajime Ohgushi
- Department of Life Science and Biotechnology, National Institute of Advanced Industrial Science and Technology, Amagasaki, Hyogo, Japan
| | - Seiji Yamaguchi
- Department of Pediatrics, Shimane University School of Medicine, Izumo, Shimane, Japan
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Coimbra LS, Steffens JP, Alsadun S, Albiero ML, Rossa C, Pignolo RJ, Spolidorio LC, Graves DT. Clopidogrel Enhances Mesenchymal Stem Cell Proliferation Following Periodontitis. J Dent Res 2015. [PMID: 26220958 DOI: 10.1177/0022034515598273] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Bone formation is dependent on the differentiation of osteoblasts from mesenchymal stem cells (MSCs). In addition to serving as progenitors, MSCs reduce inflammation and produce factors that stimulate tissue formation. Upon injury, MSCs migrate to the periodontium, where they contribute to regeneration. We examined the effect of clopidogrel and aspirin on MSCs following induction of periodontitis in rats by placement of ligatures. We showed that after the removal of ligatures, which induces resolution of periodontal inflammation, clopidogrel had a significant effect on reducing the inflammatory infiltrate. It also increased the number of osteoblasts and MSCs. Mechanistically, the latter was linked to increased proliferation of MSCs in vivo and in vitro. When given prior to inducing periodontitis, clopidogrel had little effect on MSC or osteoblasts numbers. Applying aspirin before or after induction of periodontitis did not have a significant effect on the parameters measured. These results suggest that clopidogrel may have a positive effect on MSCs in conditions where a reparative process has been initiated.
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Affiliation(s)
- L S Coimbra
- Department of Physiology and Pathology, Faculdade de Odontologia de Araraquara, UNESP-Univ Estadual Paulista-Araraquara, São Paulo, Brazil
| | - J P Steffens
- Department of Physiology and Pathology, Faculdade de Odontologia de Araraquara, UNESP-Univ Estadual Paulista-Araraquara, São Paulo, Brazil
| | - S Alsadun
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - M L Albiero
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - C Rossa
- Department of Diagnosis and Surgery, Faculdade de Odontologia de Araraquara, UNESP-Univ Estadual Paulista-Araraquara, São Paulo, Brazil
| | - R J Pignolo
- Department of Medicine and Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - L C Spolidorio
- Department of Physiology and Pathology, Faculdade de Odontologia de Araraquara, UNESP-Univ Estadual Paulista-Araraquara, São Paulo, Brazil
| | - D T Graves
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Alshayeb HM, Josephson MA, Sprague SM. CKD-mineral and bone disorder management in kidney transplant recipients. Am J Kidney Dis 2012; 61:310-25. [PMID: 23102732 DOI: 10.1053/j.ajkd.2012.07.022] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Accepted: 07/09/2012] [Indexed: 12/11/2022]
Abstract
Kidney transplantation, the most effective treatment for the metabolic abnormalities of chronic kidney disease (CKD), only partially corrects CKD-mineral and bone disorders. Posttransplantation bone disease, one of the major complications of kidney transplantation, is characterized by accelerated loss of bone mineral density and increased risk of fractures and osteonecrosis. The pathogenesis of posttransplantation bone disease is multifactorial and includes the persistent manifestations of pretransplantation CKD-mineral and bone disorder, peritransplantation changes in the fibroblast growth factor 23-parathyroid hormone-vitamin D axis, metabolic perturbations such as persistent hypophosphatemia and hypercalcemia, and the effects of immunosuppressive therapies. Posttransplantation fractures occur more commonly at peripheral than central sites. Although there is significant loss of bone density after transplantation, the evidence linking posttransplantation bone loss and subsequent fracture risk is circumstantial. Presently, there are no prospective clinical trials that define the optimal therapy for posttransplantation bone disease. Combined pharmacologic therapy that targets multiple components of the disordered pathways has been used. Although bisphosphonate or calcitriol therapy can preserve bone mineral density after transplantation, there is no evidence that these agents decrease fracture risk. Moreover, bisphosphonates pose potential risks for adynamic bone disease.
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Affiliation(s)
- Hala M Alshayeb
- Department of Medicine, Section of Nephrology, University of Chicago, Chicago, IL, USA
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