1
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Metheny L, Eid S, Wuttisarnwattana P, Auletta JJ, Liu C, Van Dervort A, Paez C, Lee Z, Wilson D, Lazarus HM, Deans R, Vant Hof W, Ktena Y, Cooke KR. Human multipotent adult progenitor cells effectively reduce graft-vs-host disease while preserving graft-vs-leukemia activity. STEM CELLS (DAYTON, OHIO) 2021; 39:1506-1519. [PMID: 34255899 PMCID: PMC8596993 DOI: 10.1002/stem.3434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 05/24/2021] [Indexed: 11/13/2022]
Abstract
Graft‐vs‐host disease (GvHD) limits successful outcomes following allogeneic blood and marrow transplantation (allo‐BMT). We examined whether the administration of human, bone marrow‐derived, multipotent adult progenitor cells (MAPCs™) could regulate experimental GvHD. The immunoregulatory capacity of MAPC cells was evaluated in vivo using established murine GvHD models. Injection of MAPC cells on day +1 (D1) and +4 (D4) significantly reduced T‐cell expansion and the numbers of donor‐derived, Tumor Necrosis Factor Alpha (TNFα) and Interferon Gamma (IFNγ)‐producing, CD4+ and CD8+ cells by D10 compared with untreated controls. These findings were associated with reductions in serum levels of TNFα and IFNγ, intestinal and hepatic inflammation and systemic GvHD as measured by survival and clinical score. Biodistribution studies showed that MAPC cells tracked from the lung and to the liver, spleen, and mesenteric nodes within 24 hours after injection. MAPC cells inhibited mouse T‐cell proliferation in vitro and this effect was associated with reduced T‐cell activation and inflammatory cytokine secretion and robust increases in the concentrations of Prostaglandin E2 (PGE2) and Transforming Growth Factor Beta (TGFβ). Indomethacin and E‐prostanoid 2 (EP2) receptor antagonism both reversed while EP2 agonism restored MAPC cell‐mediated in vitro T‐cell suppression, confirming the role for PGE2. Furthermore, cyclo‐oxygenase inhibition following allo‐BMT abrogated the protective effects of MAPC cells. Importantly, MAPC cells had no effect on the generation cytotoxic T lymphocyte activity in vitro, and the administration of MAPC cells in the setting of leukemic challenge resulted in superior leukemia‐free survival. Collectively, these data provide valuable information regarding the biodistribution and regulatory capacity of MAPC cells, which may inform future clinical trial design.
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Affiliation(s)
- Leland Metheny
- University Hospitals Seidman Cancer CenterClevelandOhioUSA
- Case Comprehensive Cancer CenterClevelandOhioUSA
| | - Saada Eid
- Department of PediatricsCase Western Reserve UniversityClevelandOhioUSA
| | - Patiwet Wuttisarnwattana
- Department of Computer EngineeringChiang Mai UniversityChiang MaiThailand
- Department of Biomedical Engineering CenterChiang Mai UniversityChiang MaiThailand
| | - Jeffery J. Auletta
- Host Defense Program, Hematology, Oncology, and Infectious DiseasesNationwide Children's HospitalColumbusOhioUSA
| | - Chen Liu
- Department of PathologyYale School of MedicineNew HavenConnecticutUSA
| | - Alana Van Dervort
- Department of PediatricsCase Western Reserve UniversityClevelandOhioUSA
| | - Conner Paez
- Department of PediatricsCase Western Reserve UniversityClevelandOhioUSA
| | - ZhengHong Lee
- Department of Biomedical EngineeringCase Western Reserve UniversityClevelandOhioUSA
| | - David Wilson
- Department of Biomedical EngineeringCase Western Reserve UniversityClevelandOhioUSA
| | | | | | | | - Yiouli Ktena
- Department of OncologyJohns Hopkins Sidney Kimmel Comprehensive Cancer CenterBaltimoreMarylandUSA
| | - Kenneth R. Cooke
- Department of OncologyJohns Hopkins Sidney Kimmel Comprehensive Cancer CenterBaltimoreMarylandUSA
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2
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Atkinson SP. A preview of selected articles. Stem Cells Transl Med 2020; 10:1-4. [PMID: 33373498 PMCID: PMC8022272 DOI: 10.1002/sctm.20-0519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 11/28/2020] [Indexed: 01/19/2023] Open
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3
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Gussenhoven R, Ophelders DRMG, Dudink J, Pieterman K, Lammens M, Mays RW, Zimmermann LJ, Kramer BW, Wolfs TGAM, Jellema RK. Systemic multipotent adult progenitor cells protect the cerebellum after asphyxia in fetal sheep. Stem Cells Transl Med 2020; 10:57-67. [PMID: 32985793 PMCID: PMC7780812 DOI: 10.1002/sctm.19-0157] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 06/29/2020] [Accepted: 08/09/2020] [Indexed: 12/30/2022] Open
Abstract
Involvement of the cerebellum in the pathophysiology of hypoxic‐ischemic encephalopathy (HIE) in preterm infants is increasingly recognized. We aimed to assess the neuroprotective potential of intravenously administered multipotent adult progenitor cells (MAPCs) in the preterm cerebellum. Instrumented preterm ovine fetuses were subjected to transient global hypoxia‐ischemia (HI) by 25 minutes of umbilical cord occlusion at 0.7 of gestation. After reperfusion, two doses of MAPCs were administered intravenously. MAPCs are a plastic adherent bone‐marrow‐derived population of adult progenitor cells with neuroprotective potency in experimental and clinical studies. Global HI caused marked cortical injury in the cerebellum, histologically indicated by disruption of cortical strata, impeded Purkinje cell development, and decreased dendritic arborization. Furthermore, global HI induced histopathological microgliosis, hypomyelination, and disruption of white matter organization. MAPC treatment significantly prevented cortical injury and region‐specifically attenuated white matter injury in the cerebellum following global HI. Diffusion tensor imaging (DTI) detected HI‐induced injury and MAPC neuroprotection in the preterm cerebellum. This study has demonstrated in a preclinical large animal model that early systemic MAPC therapy improved structural injury of the preterm cerebellum following global HI. Microstructural improvement was detectable with DTI. These findings support the potential of MAPC therapy for the treatment of HIE and the added clinical value of DTI for the detection of cerebellar injury and the evaluation of cell‐based therapy.
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Affiliation(s)
- Ruth Gussenhoven
- Department of Pediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands.,School of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Daan R M G Ophelders
- Department of Pediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands.,School of Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Jeroen Dudink
- Department of Neonatology, Wilhelmina Children's Hospital and Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Kay Pieterman
- Biomedical Imaging Group Rotterdam, Department of Radiology and Medical Informatics, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Martin Lammens
- Department of Pathology, Antwerp University Hospital and University of Antwerp, Edegem, Belgium
| | - Robert W Mays
- Regenerative Medicine, Athersys, Inc., Cleveland, Ohio, USA
| | - Luc J Zimmermann
- Department of Pediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands.,School of Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Boris W Kramer
- Department of Pediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands.,School of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.,School of Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Tim G A M Wolfs
- Department of Pediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands.,School of Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Reint K Jellema
- Department of Pediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands
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4
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Walker ND, Mourad Y, Liu K, Buxhoeveden M, Schoenberg C, Eloy JD, Wilson DJ, Brown LG, Botea A, Chaudhry F, Greco SJ, Ponzio NM, Pyrsopoulos N, Koneru B, Gubenko Y, Rameshwar P. Steroid-Mediated Decrease in Blood Mesenchymal Stem Cells in Liver Transplant could Impact Long-Term Recovery. Stem Cell Rev Rep 2018; 13:644-658. [PMID: 28733800 DOI: 10.1007/s12015-017-9751-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Orthotopic liver transplant (OLT) remains the standard of care for end stage liver disease. To circumvent allo-rejection, OLT subjects receive gluococorticoids (GC). We investigated the effects of GC on endogenous mesenchymal stem (stromal) cells (MSCs) in OLT. This question is relevant because MSCs have regenerative potential and immune suppressor function. Phenotypic analyses of blood samples from 12 OLT recipients, at pre-anhepatic, anhepatic and post-transplant (2 h, Days 1 and 5) indicated a significant decrease in MSCs after GC injection. The MSCs showed better recovery in the blood from subjects who started with relatively low MSCs as compared to those with high levels at the prehepatic phase. This drop in MSCs appeared to be linked to GC since similar change was not observed in liver resection subjects. In order to understand the effects of GC on decrease MSC migration, in vitro studies were performed in transwell cultures. Untreated MSCs could not migrate towards the GC-exposed liver tissue, despite CXCR4 expression and the production of inflammatory cytokines from the liver cells. GC-treated MSCs were inefficient with respect to migration towards CXCL12, and this correlated with retracted cytoskeleton and motility. These dysfunctions were partly explained by decreases in the CXCL12/receptor axis. GC-associated decrease in MSCs in OLT recipients recovered post-transplant, despite poor migratory ability towards GC-exposed liver. In total, the study indicated that GC usage in transplant needs to be examined to determine if this could be reduced or avoided with adjuvant cell therapy.
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Affiliation(s)
- Nykia D Walker
- Department of Medicine, Division of Hematology/Oncology, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA.,Rutgers Graduate School of Biomedical Sciences, Newark, NJ, USA
| | - Yasmine Mourad
- Rutgers Graduate School of Biomedical Sciences, Newark, NJ, USA
| | - Katherine Liu
- Department of Anesthesiology, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
| | - Michael Buxhoeveden
- Department of Anesthesiology, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
| | - Catherine Schoenberg
- Department of Anesthesiology, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
| | - Jean D Eloy
- Department of Anesthesiology, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
| | - Dorian J Wilson
- Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Lloyd G Brown
- Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Andrei Botea
- Department of Anesthesiology, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
| | - Faraz Chaudhry
- Department of Anesthesiology, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
| | - Steven J Greco
- Department of Medicine, Division of Hematology/Oncology, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
| | - Nicholas M Ponzio
- Department of Pathology and Laboratory Medicine, Rutgers, New Jersey Medical School, Newark, NJ, USA
| | - Nikolaos Pyrsopoulos
- Department of Medicine, Division of Hematology/Oncology, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
| | - Baburao Koneru
- Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Yuriy Gubenko
- Department of Anesthesiology, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA.
| | - Pranela Rameshwar
- Department of Medicine, Division of Hematology/Oncology, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA. .,Rutgers Graduate School of Biomedical Sciences, Newark, NJ, USA.
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5
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Human Mesenchymal Stromal Cell Sheet Enhances Allograft Repair in a Mouse Model. Sci Rep 2017; 7:7982. [PMID: 28801687 PMCID: PMC5554246 DOI: 10.1038/s41598-017-08804-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 07/12/2017] [Indexed: 12/02/2022] Open
Abstract
To determine whether cell sheets generated with long-term passaged (P10) aging human mesenchymal stromal cells (MSCs) could be used for bone tissue regeneration as tissue engineered periosteum in a femoral allograft mouse model similar to fresh passaged (P3) young MSCs. At 3 weeks after transplantation of MSC sheets, results showed more bony callus formed between allograft and host bone ends in both young P3 MSC and aged P10 MSC sheet-wrapped groups when compared to allograft alone. At 6 weeks, while both MSC sheet-wrapped allografts showed more bony callus formation when compared to allograft alone groups, the bony callus size in aged P10 MSC sheet groups was significantly less than young P3 MSC sheet groups. Biomechanical testing confirmed that P3 MSC sheet-grafted femurs had the highest biomechanical strength in the three groups. Histology sections showed that the area of the chondriod callus in the aged P10 MSC sheet groups was significantly larger than in P3 MSC sheet groups. Finally, a significant increase of chondro-osteoclast activity was observed in the P3 MSC sheet-grafted femur. Our data demonstrates that extensive long-term culture-induced MSC aging impaired their osteogenic ability and subsequent bony callus formation, and could be used to induce cartilaginous callus formation.
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Jellema RK, Ophelders DRMG, Zwanenburg A, Nikiforou M, Delhaas T, Andriessen P, Mays RW, Deans R, Germeraad WTV, Wolfs TGAM, Kramer BW. Multipotent adult progenitor cells for hypoxic-ischemic injury in the preterm brain. J Neuroinflammation 2015; 12:241. [PMID: 26700169 PMCID: PMC4690228 DOI: 10.1186/s12974-015-0459-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 12/16/2015] [Indexed: 12/02/2022] Open
Abstract
Background Preterm infants are at risk for hypoxic-ischemic encephalopathy. No therapy exists to treat this brain injury and subsequent long-term sequelae. We have previously shown in a well-established pre-clinical model of global hypoxia-ischemia (HI) that mesenchymal stem cells are a promising candidate for the treatment of hypoxic-ischemic brain injury. In the current study, we investigated the neuroprotective capacity of multipotent adult progenitor cells (MAPC®), which are adherent bone marrow-derived cells of an earlier developmental stage than mesenchymal stem cells and exhibiting more potent anti-inflammatory and regenerative properties. Methods Instrumented preterm sheep fetuses were subjected to global hypoxia-ischemia by 25 min of umbilical cord occlusion at a gestational age of 106 (term ~147) days. During a 7-day reperfusion period, vital parameters (e.g., blood pressure and heart rate; baroreceptor reflex) and (amplitude-integrated) electroencephalogram were recorded. At the end of the experiment, the preterm brain was studied by histology. Results Systemic administration of MAPC therapy reduced the number and duration of seizures and prevented decrease in baroreflex sensitivity after global HI. In addition, MAPC cells prevented HI-induced microglial proliferation in the preterm brain. These anti-inflammatory effects were associated with MAPC-induced prevention of hypomyelination after global HI. Besides attenuation of the cerebral inflammatory response, our findings showed that MAPC cells modulated the peripheral splenic inflammatory response, which has been implicated in the etiology of hypoxic-ischemic injury in the preterm brain. Conclusions In a pre-clinical animal model MAPC cell therapy improved the functional and structural outcome of the preterm brain after global HI. Future studies should establish the mechanism and long-term therapeutic effects of neuroprotection established by MAPC cells in the developing preterm brain exposed to HI. Our study may form the basis for future clinical trials, which will evaluate whether MAPC therapy is capable of reducing neurological sequelae in preterm infants with hypoxic-ischemic encephalopathy.
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Affiliation(s)
- Reint K Jellema
- School of Mental Health and Neuroscience (MHENS), Maastricht University, Universiteitssingel 40, Maastricht, 6229, ER, The Netherlands. .,Department of Pediatrics, Maastricht University Medical Center, PO Box 5800, Maastricht, 6202, AZ, The Netherlands. .,Department of Pediatrics, Máxima Medical Center, PO Box 90052, 5600, PD, Veldhoven, The Netherlands.
| | - Daan R M G Ophelders
- School of Mental Health and Neuroscience (MHENS), Maastricht University, Universiteitssingel 40, Maastricht, 6229, ER, The Netherlands. .,Department of Pediatrics, Maastricht University Medical Center, PO Box 5800, Maastricht, 6202, AZ, The Netherlands.
| | - Alex Zwanenburg
- Department of Pediatrics, Maastricht University Medical Center, PO Box 5800, Maastricht, 6202, AZ, The Netherlands. .,Department of Biomedical Engineering, Maastricht University, PO Box 616, Maastricht, 6200, MD, The Netherlands.
| | - Maria Nikiforou
- School of Mental Health and Neuroscience (MHENS), Maastricht University, Universiteitssingel 40, Maastricht, 6229, ER, The Netherlands. .,Department of Pediatrics, Maastricht University Medical Center, PO Box 5800, Maastricht, 6202, AZ, The Netherlands.
| | - Tammo Delhaas
- Department of Pediatrics, Maastricht University Medical Center, PO Box 5800, Maastricht, 6202, AZ, The Netherlands. .,Department of Biomedical Engineering, Maastricht University, PO Box 616, Maastricht, 6200, MD, The Netherlands. .,School for Cardiovascular Diseases (CARIM), Maastricht University, PO Box 616, Maastricht, 6200, MD, The Netherlands.
| | - Peter Andriessen
- Department of Pediatrics, Máxima Medical Center, PO Box 90052, 5600, PD, Veldhoven, The Netherlands.
| | - Robert W Mays
- Regenerative Medicine, Athersys, Inc., 3201 Carnegie Avenue, Cleveland, OH, 44115-2634, USA.
| | - Robert Deans
- Regenerative Medicine, Athersys, Inc., 3201 Carnegie Avenue, Cleveland, OH, 44115-2634, USA.
| | - Wilfred T V Germeraad
- School of Oncology and Developmental Biology (GROW), Maastricht University, Universiteitssingel 50, Maastricht, 6229, ER, The Netherlands. .,Department of Internal Medicine, Division of Hematology, Maastricht University Medical Center, PO Box 5800, Maastricht, 6202, AZ, The Netherlands.
| | - Tim G A M Wolfs
- Department of Pediatrics, Maastricht University Medical Center, PO Box 5800, Maastricht, 6202, AZ, The Netherlands. .,School of Oncology and Developmental Biology (GROW), Maastricht University, Universiteitssingel 50, Maastricht, 6229, ER, The Netherlands.
| | - Boris W Kramer
- School of Mental Health and Neuroscience (MHENS), Maastricht University, Universiteitssingel 40, Maastricht, 6229, ER, The Netherlands. .,Department of Pediatrics, Maastricht University Medical Center, PO Box 5800, Maastricht, 6202, AZ, The Netherlands. .,School of Oncology and Developmental Biology (GROW), Maastricht University, Universiteitssingel 50, Maastricht, 6229, ER, The Netherlands.
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7
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Burrows GG, Van't Hof W, Reddy AP, Wilmarth PA, David LL, Raber A, Bogaerts A, Timmerman L, Pinxteren J, Roobrouck VD, Deans RJ, Maziarz RT. Solution-Phase Crosstalk and Regulatory Interactions Between Multipotent Adult Progenitor Cells and Peripheral Blood Mononuclear Cells. Stem Cells Transl Med 2015; 4:1436-49. [PMID: 26494783 PMCID: PMC4675500 DOI: 10.5966/sctm.2014-0225] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2014] [Accepted: 08/03/2015] [Indexed: 02/06/2023] Open
Abstract
UNLABELLED Multipotent adult progenitor cells (MAPCs) are adult adherent stromal stem cells currently being assessed in clinical trials for acute graft versus host disease with demonstrated immunomodulatory capabilities and the potential to ameliorate detrimental autoimmune and inflammation-related processes. Anti-CD3/anti-CD28 (3/28) activation of T cells within the peripheral blood mononuclear cell (PBMC) compartment was performed in the presence or absence of MAPCs. Liquid chromatography-coupled tandem mass spectrometry was used to characterize the differential secretion of proteins, and transcriptional profiling was used to monitor mRNA expression changes in both cell populations. Overall, 239 secreted and/or ectodomain-shed proteins were detected in the secretomes of PBMCs and MAPCs. In addition, 3/28 activation of PBMCs induced differential expression of 2,925 genes, and 22% of these transcripts were differentially expressed on exposure to MAPCs in Transwell. MAPCs exposed to 3/28-activated PBMCs showed differential expression of 1,247 MAPC genes. Crosstalk was demonstrated by reciprocal transcriptional regulation. Secretome proteins and transcriptional signatures were used to predict molecular activities by which MAPCs could dampen local and systemic inflammatory responses. These data support the hypothesis that MAPCs block PBMC proliferation via cell cycle arrest coupled to metabolic stress in the form of tryptophan depletion, resulting in GCN2 kinase activation, downstream signaling, and inhibition of cyclin D1 translation. These data also provide a plausible explanation for the immune privilege reported with administration of donor MAPCs. Although most components of the major histocompatibility complex class II antigen presentation pathway were markedly transcriptionally upregulated, cell surface expression of human leukocyte antigen-DR is minimal on MAPCs exposed to 3/28-activated PBMCs. SIGNIFICANCE This study documents experiments quantifying solution-phase crosstalk between multipotent adult progenitor cells (MAPCs) and peripheral blood mononuclear cells. The secretome and transcriptional changes quantified suggest mechanisms by which MAPCs are hypothesized to provide both local and systemic immunoregulation of inflammation. The potential impact of these studies includes development of a robust experimental framework to be used for preclinical evaluation of the specific mechanisms by which beneficial effects are obtained after treatment of patients with MAPCs.
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Affiliation(s)
- Gregory G Burrows
- Center for Hematologic Malignancies, Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon, USA Department of Neurology, Oregon Health and Science University, Portland, Oregon, USA Department of Biochemistry and Molecular Biology, Oregon Health and Science University, Portland, Oregon, USA
| | - Wouter Van't Hof
- Regenerative Medicine Program, Athersys Inc., Cleveland, Ohio, USA National Center for Regenerative Medicine, Cleveland, Ohio, USA
| | - Ashok P Reddy
- Department of Biochemistry and Molecular Biology, Oregon Health and Science University, Portland, Oregon, USA
| | - Phillip A Wilmarth
- Department of Biochemistry and Molecular Biology, Oregon Health and Science University, Portland, Oregon, USA
| | - Larry L David
- Department of Biochemistry and Molecular Biology, Oregon Health and Science University, Portland, Oregon, USA
| | - Amy Raber
- Regenerative Medicine Program, Athersys Inc., Cleveland, Ohio, USA
| | | | | | | | | | - Robert J Deans
- Regenerative Medicine Program, Athersys Inc., Cleveland, Ohio, USA National Center for Regenerative Medicine, Cleveland, Ohio, USA ReGenesys, Inc., Leuven, Belgium
| | - Richard T Maziarz
- Center for Hematologic Malignancies, Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon, USA
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8
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Therapeutic possibility of human fetal cartilage-derived progenitor cells in rat arthritis model. Tissue Eng Regen Med 2015. [DOI: 10.1007/s13770-015-0441-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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9
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Soeder Y, Loss M, Johnson CL, Hutchinson JA, Haarer J, Ahrens N, Offner R, Deans RJ, Van Bokkelen G, Geissler EK, Schlitt HJ, Dahlke MH. First-in-Human Case Study: Multipotent Adult Progenitor Cells for Immunomodulation After Liver Transplantation. Stem Cells Transl Med 2015; 4:899-904. [PMID: 26041737 DOI: 10.5966/sctm.2015-0002] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 04/13/2015] [Indexed: 12/16/2022] Open
Abstract
Mesenchymal stem cells and multipotent adult progenitor cells (MAPCs) have been proposed as novel therapeutics for solid organ transplant recipients with the aim of reducing exposure to pharmacological immunosuppression and its side effects. In the present study, we describe the clinical course of the first patient of the phase I, dose-escalation safety and feasibility study, MiSOT-I (Mesenchymal Stem Cells in Solid Organ Transplantation Phase I). After receiving a living-related liver graft, the patient was given one intraportal injection and one intravenous infusion of third-party MAPC in a low-dose pharmacological immunosuppressive background. Cell administration was found to be technically feasible; importantly, we found no evidence of acute toxicity associated with MAPC infusions.
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Affiliation(s)
- Yorick Soeder
- Department of Surgery and Institute for Clinical Chemistry, Laboratory Medicine, and Transfusion Medicine, University Hospital Regensburg, Regensburg, Germany; Athersys Inc., Cleveland, Ohio, USA
| | - Martin Loss
- Department of Surgery and Institute for Clinical Chemistry, Laboratory Medicine, and Transfusion Medicine, University Hospital Regensburg, Regensburg, Germany; Athersys Inc., Cleveland, Ohio, USA
| | - Christian L Johnson
- Department of Surgery and Institute for Clinical Chemistry, Laboratory Medicine, and Transfusion Medicine, University Hospital Regensburg, Regensburg, Germany; Athersys Inc., Cleveland, Ohio, USA
| | - James A Hutchinson
- Department of Surgery and Institute for Clinical Chemistry, Laboratory Medicine, and Transfusion Medicine, University Hospital Regensburg, Regensburg, Germany; Athersys Inc., Cleveland, Ohio, USA
| | - Jan Haarer
- Department of Surgery and Institute for Clinical Chemistry, Laboratory Medicine, and Transfusion Medicine, University Hospital Regensburg, Regensburg, Germany; Athersys Inc., Cleveland, Ohio, USA
| | - Norbert Ahrens
- Department of Surgery and Institute for Clinical Chemistry, Laboratory Medicine, and Transfusion Medicine, University Hospital Regensburg, Regensburg, Germany; Athersys Inc., Cleveland, Ohio, USA
| | - Robert Offner
- Department of Surgery and Institute for Clinical Chemistry, Laboratory Medicine, and Transfusion Medicine, University Hospital Regensburg, Regensburg, Germany; Athersys Inc., Cleveland, Ohio, USA
| | - Robert J Deans
- Department of Surgery and Institute for Clinical Chemistry, Laboratory Medicine, and Transfusion Medicine, University Hospital Regensburg, Regensburg, Germany; Athersys Inc., Cleveland, Ohio, USA
| | - Gil Van Bokkelen
- Department of Surgery and Institute for Clinical Chemistry, Laboratory Medicine, and Transfusion Medicine, University Hospital Regensburg, Regensburg, Germany; Athersys Inc., Cleveland, Ohio, USA
| | - Edward K Geissler
- Department of Surgery and Institute for Clinical Chemistry, Laboratory Medicine, and Transfusion Medicine, University Hospital Regensburg, Regensburg, Germany; Athersys Inc., Cleveland, Ohio, USA
| | - Hans J Schlitt
- Department of Surgery and Institute for Clinical Chemistry, Laboratory Medicine, and Transfusion Medicine, University Hospital Regensburg, Regensburg, Germany; Athersys Inc., Cleveland, Ohio, USA
| | - Marc H Dahlke
- Department of Surgery and Institute for Clinical Chemistry, Laboratory Medicine, and Transfusion Medicine, University Hospital Regensburg, Regensburg, Germany; Athersys Inc., Cleveland, Ohio, USA
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Maziarz RT, Devos T, Bachier CR, Goldstein SC, Leis JF, Devine SM, Meyers G, Gajewski JL, Maertens J, Deans RJ, Van't Hof W, Lazarus HM. Single and multiple dose MultiStem (multipotent adult progenitor cell) therapy prophylaxis of acute graft-versus-host disease in myeloablative allogeneic hematopoietic cell transplantation: a phase 1 trial. Biol Blood Marrow Transplant 2014; 21:720-8. [PMID: 25555450 DOI: 10.1016/j.bbmt.2014.12.025] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 12/22/2014] [Indexed: 01/19/2023]
Abstract
We conducted a multicenter, phase 1 dose escalation study evaluating the safety of the allogeneic multipotent adult progenitor cell (MAPC, MultiStem, Athersys, Inc., Cleveland, OH) stromal product administered as an adjunct therapy to 36 patients after myeloablative allogeneic hematopoietic cell transplantation (HCT). Patients received increasing doses of MAPC (1, 5, or 10 million cells per kilogram recipient weight) as a single i.v. dose on day +2 after HCT (n = 18), or once weekly for up to 5 doses (1 or 5 million cells per kilogram; n = 18). Infusional and regimen-related toxicities were assessed for 30 days after the last MAPC dose. Of 36 allogeneic HCT donors (17 related and 19 unrelated), 35 were 6/6 HLA matched. MAPC infusions were well tolerated without associated infusional toxicity, graft failure, or increased incidence of infection. Median times to neutrophil (n = 36) and platelet (n = 31) engraftment were 15 (range, 11 to 25) and 16 (range, 11 to 41) days, respectively. The overall cumulative incidences of grades II to IV and III and IV acute graft-versus-host disease (GVHD) at day 100 were 37% and 14%, respectively (n = 36). In the group that received the highest single MAPC dose (10 million cells/kg), day 100 incidence of grade II to IV GVHD was 11.1% (1 of 9) with no observed cases of grade III and IV GVHD. We found no evidence for MHC class II allogeneic antibody induction, although some patients showed an increase in serum anticlass I titers compared with baseline. MAPC contribution to blood chimerism was negligible. These phase I data support the safety of stromal stem cell therapy and suggest that MAPC should be tested prospectively as a novel therapeutic option for GVHD prophylaxis after HCT.
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Affiliation(s)
- Richard T Maziarz
- Knight Cancer Institute, Center for Hematologic Malignancies, Oregon Health and Science University, Portland, Oregon.
| | - Timothy Devos
- Department of Microbiology & Immunology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Carlos R Bachier
- Adult Blood & Marrow Stem Cell Transplant Program, Texas Transplant Institute, San Antonio, Texas
| | | | - Jose F Leis
- Internal Medicine, Bone Marrow Transplant Program, Mayo Clinic Hospital, Phoenix, Arizona
| | - Steven M Devine
- Internal Medicine, Bone Marrow Transplant Program, Ohio State University, Columbus, Ohio
| | - Gabrielle Meyers
- Knight Cancer Institute, Center for Hematologic Malignancies, Oregon Health and Science University, Portland, Oregon
| | - James L Gajewski
- Knight Cancer Institute, Center for Hematologic Malignancies, Oregon Health and Science University, Portland, Oregon
| | - Johan Maertens
- Department of Microbiology & Immunology, Katholieke Universiteit Leuven, Leuven, Belgium
| | | | | | - Hillard M Lazarus
- University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio
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Leten C, Roobrouck VD, Struys T, Burns TC, Dresselaers T, Vande Velde G, Santermans J, Lo Nigro A, Ibrahimi A, Gijsbers R, Eggermont K, Lambrichts I, Verfaillie CM, Himmelreich U. Controlling and Monitoring Stem Cell Safety In Vivo in an Experimental Rodent Model. Stem Cells 2014; 32:2833-44. [DOI: 10.1002/stem.1819] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 05/13/2014] [Accepted: 06/23/2014] [Indexed: 01/12/2023]
Affiliation(s)
- Cindy Leten
- Biomedical MRI, Department of Imaging and Pathology; KU Leuven; Belgium
- Molecular Small Animal Imaging Center; KU Leuven; Belgium
| | - Valerie D. Roobrouck
- Department of Development and Regeneration, Stem Cell Institute Leuven; KU Leuven; Belgium
| | - Tom Struys
- Biomedical MRI, Department of Imaging and Pathology; KU Leuven; Belgium
- Biomedical Research Institute, Lab of Histology; University of Hasselt; Belgium
| | - Terry C. Burns
- Department of Neurosurgery; Stanford University; California USA
| | - Tom Dresselaers
- Biomedical MRI, Department of Imaging and Pathology; KU Leuven; Belgium
- Molecular Small Animal Imaging Center; KU Leuven; Belgium
| | - G. Vande Velde
- Biomedical MRI, Department of Imaging and Pathology; KU Leuven; Belgium
- Molecular Small Animal Imaging Center; KU Leuven; Belgium
| | - Jeanine Santermans
- Biomedical Research Institute, Lab of Histology; University of Hasselt; Belgium
| | - Antonio Lo Nigro
- Department of Development and Regeneration, Stem Cell Institute Leuven; KU Leuven; Belgium
| | - Abdelilah Ibrahimi
- Laboratory for Molecular Virology and Gene Therapy; KU Leuven; Belgium
- Leuven Viral Vector Core; KU Leuven; Belgium
| | - Rik Gijsbers
- Laboratory for Molecular Virology and Gene Therapy; KU Leuven; Belgium
- Leuven Viral Vector Core; KU Leuven; Belgium
| | - Kristel Eggermont
- Department of Development and Regeneration, Stem Cell Institute Leuven; KU Leuven; Belgium
| | - Ivo Lambrichts
- Biomedical Research Institute, Lab of Histology; University of Hasselt; Belgium
| | | | - Uwe Himmelreich
- Biomedical MRI, Department of Imaging and Pathology; KU Leuven; Belgium
- Molecular Small Animal Imaging Center; KU Leuven; Belgium
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12
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Rationale and prospects of mesenchymal stem cell therapy for liver transplantation. Curr Opin Organ Transplant 2014; 19:60-4. [DOI: 10.1097/mot.0000000000000031] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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13
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Human multipotent adult progenitor cells transcriptionally regulate fucosyltransferase VII. Cytotherapy 2013; 16:566-75. [PMID: 24176542 DOI: 10.1016/j.jcyt.2013.08.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 07/09/2013] [Accepted: 08/09/2013] [Indexed: 01/13/2023]
Abstract
BACKGROUND AIMS Targeted recruitment of leukocytes to sites of inflammation is a crucial event in normal host defense against pathogens, and attachment to and rolling on activated endothelial cells is a prerequisite first step for eventual leukocyte extravasation into sites of inflammation. These key events are mediated by interactions between glycosylated ligands expressed on leukocytes and selectins expressed on activated endothelium. Cell surface expression of selectin ligands on leukocytes is regulated by the rate-limiting enzyme fucosyltransferase VII (Fut7), and in its absence extravasation of leukocytes is severely inhibited. Multipotent adult progenitor cells (MAPCs) are an adherent cell population isolated from adult bone marrow. Intravenous administration of MAPCs provided functional improvement in multiple pre-clinical models of injury or disease, but the mechanisms by which these outcomes were achieved remain poorly understood. METHODS In vitro cell analysis studies including fluorescence-activated cell sorting, messenger RNA analysis, T-cell proliferation assays and endothelial cell binding assays were performed. RESULTS The in vitro cell analysis studies characterized the ability of MAPCs to secrete factors that transcriptionally attenuate expression of Fut7 in T cells, blocking the terminal fucosylation event in the biosynthesis of selectin ligands and reducing T-cell binding to endothelial cells. CONCLUSIONS This study presents the first example of a distinct regulatory mechanism involving transcriptional down-regulation of Fut7 by MAPCs that could modulate the trafficking behavior of T cells in vivo.
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Burrows GG, Van't Hof W, Newell LF, Reddy A, Wilmarth PA, David LL, Raber A, Bogaerts A, Pinxteren J, Deans RJ, Maziarz RT. Dissection of the human multipotent adult progenitor cell secretome by proteomic analysis. Stem Cells Transl Med 2013; 2:745-57. [PMID: 23981727 DOI: 10.5966/sctm.2013-0031] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Multipotent adult progenitor cells (MAPCs) are adult adherent stromal stem cells currently being assessed in acute graft versus host disease clinical trials with demonstrated immunomodulatory capabilities and the potential to ameliorate detrimental autoimmune and inflammation-related processes. Our previous studies documented that MAPCs secrete factors that play a role in regulating T-cell activity. Here we expand our studies using a proteomics approach to characterize and quantify MAPC secretome components secreted over 72 hours in vitro under steady-state conditions and in the presence of the inflammatory triggers interferon-γ and lipopolysaccharide, or a tolerogenic CD74 ligand, RTL1000. MAPCs differentially responded to each of the tested stimuli, secreting molecules that regulate the biological activity of the extracellular matrix (ECM), including proteins that make up the ECM itself, proteins that regulate its construction/deconstruction, and proteins that serve to attach and detach growth factors from ECM components for redistribution upon appropriate stimulation. MAPCs secreted a wide array of proteases, some detectable in their zymogen forms. MAPCs also secreted protease inhibitors that would regulate protease activity. MAPCs secreted chemokines and cytokines that could provide molecular guidance cues to various cell types, including neutrophils, macrophages, and T cells. In addition, MAPCs secreted factors involved in maintenance of a homeostatic environment, regulating such diverse programs as innate immunity, angiogenesis/angiostasis, targeted delivery of growth factors, and the matrix-metalloprotease cascade.
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Bravery CA, Carmen J, Fong T, Oprea W, Hoogendoorn KH, Woda J, Burger SR, Rowley JA, Bonyhadi ML, Van't Hof W. Potency assay development for cellular therapy products: an ISCT review of the requirements and experiences in the industry. Cytotherapy 2013; 15:9-19. [PMID: 23260082 DOI: 10.1016/j.jcyt.2012.10.008] [Citation(s) in RCA: 122] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Accepted: 08/09/2012] [Indexed: 10/27/2022]
Abstract
The evaluation of potency plays a key role in defining the quality of cellular therapy products (CTPs). Potency can be defined as a quantitative measure of relevant biologic function based on the attributes that are linked to relevant biologic properties. To achieve an adequate assessment of CTP potency, appropriate in vitro or in vivo laboratory assays and properly controlled clinical data need to be created. The primary objective of a potency assay is to provide a mechanism by which the manufacturing process and the final product for batch release are scrutinized for quality, consistency and stability. A potency assay also provides the basis for comparability assessment after process changes, such as scale-up, site transfer and new starting materials (e.g., a new donor). Potency assays should be in place for early clinical development, and validated assays are required for pivotal clinical trials. Potency is based on the individual characteristics of each individual CTP, and the adequacy of potency assays will be evaluated on a case-by-case basis by regulatory agencies. We provide an overview of the expectations and challenges in development of potency assays specific for CTPs; several real-life experiences from the cellular therapy industry are presented as illustrations. The key observation and message is that aggressive early investment in a solid potency evaluation strategy can greatly enhance eventual CTP deployment because it can mitigate the risk of costly product failure in late-stage development.
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Immunological characteristics of human mesenchymal stem cells and multipotent adult progenitor cells. Immunol Cell Biol 2013; 91:32-9. [PMID: 23295415 PMCID: PMC3540326 DOI: 10.1038/icb.2012.64] [Citation(s) in RCA: 158] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Somatic, also termed adult, stem cells are highly attractive biomedical cell candidates because of their extensive replication potential and functional multilineage differentiation capacity. They can be used for drug and toxicity screenings in preclinical studies, as in vitro model to study differentiation or for regenerative medicine to aid in the repair of tissues or replace tissues that are lost upon disease, injury or ageing. Multipotent adult progenitor cells (MAPCs) and mesenchymal stem cells (MSCs) are two types of adult stem cells derived from bone marrow that are currently being used clinically for tissue regeneration and for their immunomodulatory and trophic effects. This review will give an overview of the phenotypic and functional differences between human MAPCs and MSCs, with a strong emphasis on their immunological characteristics. Finally, we will discuss the clinical studies in which MSCs and MAPCs are already used.
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Kim N, Im KI, Lim JY, Jeon EJ, Nam YS, Kim EJ, Cho SG. Mesenchymal stem cells for the treatment and prevention of graft-versus-host disease: experiments and practice. Ann Hematol 2013; 92:1295-308. [DOI: 10.1007/s00277-013-1796-z] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Accepted: 05/14/2013] [Indexed: 12/13/2022]
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Reading JL, Yang JHM, Sabbah S, Skowera A, Knight RR, Pinxteren J, Vaes B, Allsopp T, Ting AE, Busch S, Raber A, Deans R, Tree TIM. Clinical-Grade Multipotent Adult Progenitor Cells Durably Control Pathogenic T Cell Responses in Human Models of Transplantation and Autoimmunity. THE JOURNAL OF IMMUNOLOGY 2013; 190:4542-52. [DOI: 10.4049/jimmunol.1202710] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Vaes B, Van’t Hof W, Deans R, Pinxteren J. Application of MultiStem(®) Allogeneic Cells for Immunomodulatory Therapy: Clinical Progress and Pre-Clinical Challenges in Prophylaxis for Graft Versus Host Disease. Front Immunol 2012; 3:345. [PMID: 23205020 PMCID: PMC3506828 DOI: 10.3389/fimmu.2012.00345] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Accepted: 10/30/2012] [Indexed: 12/30/2022] Open
Abstract
The last decade has seen much progress in adjunctive cell therapy for immune disorders. Both corporate and institutional Phase III studies have been run using mesenchymal stromal cells (MSC) for treatment of Graft versus Host Disease (GvHD), and product approval has been achieved for treatment of pediatric GvHD in Canada and New Zealand (Prochymal(®); Osiris Therapeutics). This effectiveness has prompted the prophylactic use of adherent stem cells at the time of allogeneic hematopoietic stem cell transplantation (HSCT) to prevent occurrence of GvHD and possibly provide stromal support for hematopoietic recovery. The MultiStem(®) product is an adult adherent stem cell product derived from bone marrow which has significant clinical exposure. MultiStem cells are currently in phase II clinical studies for treatment of ischemic stroke and ulcerative colitis, with Phase I studies completed in acute myocardial infarction and for GvHD prophylaxis in allogeneic HSCT, demonstrating that MultiStem administration was well tolerated while the incidence and severity of GvHD was reduced. In advancing this clinical approach, it is important to recognize that alternate models exist based on clinical manufacturing strategies. Corporate sponsors exploit the universal donor properties of adherent stem cells and manufacture at large scale, with many products obtained from one or limited donors and used across many patients. In Europe, institutional sponsors often produce allogeneic product in a patient designated context. For this approach, disposable bioreactors producing <10 products/donor in a closed system manner are very well suited. In this review, the use of adherent stem cells for GvHD prophylaxis is summarized and the suitability of disposable bioreactors for MultiStem production is presented, with an emphasis on quality control parameters, which are critical with a multiple donor approach for manufacturing.
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Affiliation(s)
| | | | - Robert Deans
- Regenerative Medicine, Athersys, Inc.Cleveland, OH, USA
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Walker PA, Bedi SS, Shah SK, Jimenez F, Xue H, Hamilton JA, Smith P, Thomas CP, Mays RW, Pati S, Cox CS. Intravenous multipotent adult progenitor cell therapy after traumatic brain injury: modulation of the resident microglia population. J Neuroinflammation 2012; 9:228. [PMID: 23020860 PMCID: PMC3546881 DOI: 10.1186/1742-2094-9-228] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2012] [Accepted: 09/06/2012] [Indexed: 11/16/2022] Open
Abstract
Introduction We have demonstrated previously that the intravenous delivery of multipotent adult progenitor cells (MAPC) after traumatic brain injury affords neuroprotection via interaction with splenocytes, leading to an increase in systemic anti-inflammatory cytokines. We hypothesize that the observed modulation of the systemic inflammatory milieu is related to T regulatory cells and a subsequent increase in the locoregional neuroprotective M2 macrophage population. Methods C57B6 mice were injected with intravenous MAPC 2 and 24 hours after controlled cortical impact injury. Animals were euthanized 24, 48, 72, and 120 hours after injury. In vivo, the proportion of CD4+/CD25+/FOXP3+ T-regulatory cells were measured in the splenocyte population and plasma. In addition, the brain CD86+ M1 and CD206+ M2 macrophage populations were quantified. A series of in vitro co-cultures were completed to investigate the need for direct MAPC:splenocyte contact as well as the effect of MAPC therapy on M1 and M2 macrophage subtype apoptosis and proliferation. Results Significant increases in the splenocyte and plasma T regulatory cell populations were observed with MAPC therapy at 24 and 48 hours, respectively. In addition, MAPC therapy was associated with an increase in the brain M2/M1 macrophage ratio at 24, 48 and 120 hours after cortical injury. In vitro cultures of activated microglia with supernatant derived from MAPC:splenocyte co-cultures also demonstrated an increase in the M2/M1 ratio. The observed changes were secondary to an increase in M1 macrophage apoptosis. Conclusions The data show that the intravenous delivery of MAPC after cortical injury results in increases in T regulatory cells in splenocytes and plasma with a concordant increase in the locoregional M2/M1 macrophage ratio. Direct contact between the MAPC and splenocytes is required to modulate activated microglia, adding further evidence to the central role of the spleen in MAPC-mediated neuroprotection.
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Affiliation(s)
- Peter A Walker
- Department of Surgery, University of Texas Medical School at Houston, 6431 Fannin Street, MSB 5.236, Houston, TX 77030, USA
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Lehman N, Cutrone R, Raber A, Perry R, Van't Hof W, Deans R, Ting AE, Woda J. Development of a surrogate angiogenic potency assay for clinical-grade stem cell production. Cytotherapy 2012; 14:994-1004. [PMID: 22687190 DOI: 10.3109/14653249.2012.688945] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND AIMS Clinical results from acute myocardial infarction (AMI) patients treated with MultiStem®, a large-scale expanded adherent multipotent progenitor cell population (MAPC), have demonstrated a strong safety and benefit profile for these cells. The mechanism of benefit with MAPC treatment is a result, in part, of its ability to induce neovascularization through trophic support. Production of clinical-grade stem cell products requires the development of lot-release criteria based on potency assays that directly reflect the fundamental mechanistic pathway underlying the therapeutic response to verify manufacturing process consistency and product potency. METHODS AND RESULTS Using an in vitro endothelial tube formation assay, a potency assay has been developed that reflects MAPC pro-angiogenic activity. Serum-free conditioned media collected from MAPC culture induced endothelial tube formation. A proteomic survey of angiogenic factors produced by the cells in vitro revealed candidate factors linked to angiogenic potency. Three cytokines, chemokine (C-X-C motif) ligand 5 (CXCL5), interleukin 8 (IL-8) and vascular endothelial growth factor (VEGF), were required for this angiogenic activity. Depletion of any of these factors from the media prevented tube formation, while adding back increasing amounts of these cytokines into the depleted serum-free conditioned media established the lower limits of each of the cytokines required to induce angiogenesis. CONCLUSIONS A necessary threshold of angiogenic factor expression was established using an in vitro angiogenesis assay. By correlating the levels of the cytokines required to induce tube formation in vitro with levels of the factors found in the spent media from manufacturing production runs, detection of these factors was identified as a surrogate potency assay with defined pass/fail criteria.
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Affiliation(s)
- Nicholas Lehman
- Athersys Inc., Regenerative Medicine Program, Cleveland, Ohio 44115, USA
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Sharpe ME, Morton D, Rossi A. Nonclinical safety strategies for stem cell therapies. Toxicol Appl Pharmacol 2012; 262:223-31. [PMID: 22617430 DOI: 10.1016/j.taap.2012.05.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2012] [Revised: 05/02/2012] [Accepted: 05/11/2012] [Indexed: 01/07/2023]
Abstract
Recent breakthroughs in stem cell biology, especially the development of the induced pluripotent stem cell techniques, have generated tremendous enthusiasm and efforts to explore the therapeutic potential of stem cells in regenerative medicine. Stem cell therapies are being considered for the treatment of degenerative diseases, inflammatory conditions, cancer and repair of damaged tissue. The safety of a stem cell therapy depends on many factors including the type of cell therapy, the differentiation status and proliferation capacity of the cells, the route of administration, the intended clinical location, long term survival of the product and/or engraftment, the need for repeated administration, the disease to be treated and the age of the population. Understanding the product profile of the intended therapy is crucial to the development of the nonclinical safety study design.
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Affiliation(s)
- Michaela E Sharpe
- Investigative Toxicology, Drug Safety Research and Development, Pfizer Ltd, Ramsgate Road, Sandwich, CT13 9NJ, UK.
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23
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Penn MS, Ellis S, Gandhi S, Greenbaum A, Hodes Z, Mendelsohn FO, Strasser D, Ting AE, Sherman W. Adventitial delivery of an allogeneic bone marrow-derived adherent stem cell in acute myocardial infarction: phase I clinical study. Circ Res 2011; 110:304-11. [PMID: 22052917 DOI: 10.1161/circresaha.111.253427] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
RATIONALE MultiStem is an allogeneic bone marrow-derived adherent adult stem cell product that has shown efficacy in preclinical models of acute myocardial infarction (AMI). In this phase I clinical trial in patients with first ST-elevation-myocardial infarction (STEMI), we combine first-in-man delivery of MultiStem with a first-in-coronary adventitial delivery system to determine the effects of this system on left ventricular function at 4 months after AMI. OBJECTIVE Test the effects of adventitial delivery of Multistem in the peri-infarct period in patients with first STEMI. METHODS AND RESULTS This study was a phase I, open-label, dose-escalating registry control group study. Nineteen patients received MultiStem (20 million, n=6; 50 million, n=7; or 100 million, n=6) and 6 subjects were assigned to the registry control group. Two to 5 days after AMI, we delivered MultiStem to the adventitia of the infarct-related vessel in patients with first-time STEMI. All patients underwent primary percutaneous coronary intervention with resulting Thrombolysis In Myocardial Infarction grade 3 flow and with ejection fraction (EF) ≤45% as determined by echocardiogram or left ventriculogram within 12 hours of primary percutaneous coronary intervention. The cell product (20 million, 50 million, or 100 million) was well tolerated, and no serious adverse events were deemed related to MultiStem. There was no increase in creatine kinase-MB or troponin associated with the adventitial delivery of MultiStem. In patients with EF determined to be ≤45% by a core laboratory within 24 hours before the MultiStem injection, we observed a 0.9 (n=4), 3.9 (n=4), 13.5 (n=5), and 10.9 (n=2) percent absolute increases in EF in the registry, 20 million, 50 million, and 100 million dose groups, respectively. The increases in EF in the 50 million and 100 million groups were accompanied by 25.4 and 8.4 mL increases in left ventricular stroke volume. CONCLUSIONS In this study, the delivery of MultiStem to the myocardium in patients with recent STEMI was well tolerated and safe. In patients who exhibited significant myocardial damage, the delivery of ≥50 million MultiStem resulted in improved EF and stroke volume 4 months later. These findings support further development of MultiStem in patients with AMI and they validate the potential of a system for delivery of adult stem cells at any time after primary percutaneous coronary intervention.
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Affiliation(s)
- Marc S Penn
- Summa Cardiovascular Institute, 525 E. Market St., Akron, OH 44309, USA.
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Medicetty S, Wiktor D, Lehman N, Raber A, Popovic ZB, Deans R, Ting AE, Penn MS. Percutaneous adventitial delivery of allogeneic bone marrow-derived stem cells via infarct-related artery improves long-term ventricular function in acute myocardial infarction. Cell Transplant 2011; 21:1109-20. [PMID: 22004910 DOI: 10.3727/096368911x603657] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Acute myocardial infarction (AMI) results in ischemic damage and death of cardiomyocytes and loss of vasculature. Stem cell therapy has emerged as a potentially promising strategy for maximizing cardiac function following ischemic injury. Issues of cell source, delivery, and quantification of response have challenged development of clinically viable strategies. In this study we investigate the effects of a well-defined bone marrow-derived allogeneic cell product delivered by catheter directly to the myocardium via the infarct-related vessel on global and regional measures of left ventricular (LV) function in a porcine model of anterior wall myocardial infarction. Multipotent adult progenitor cells (MAPCs) were derived and expanded from the bone marrow of a donor Yorkshire pig. Anterior wall myocardial infarction (AMI) was induced by 90 min of mid-LAD occlusion using a balloon catheter. Two days after AMI was induced, either vehicle (Plasma Lyte-A, n = 7), low-dose (20 million, n = 6), or high-dose (200 million, n = 6) MAPCs were delivered directly to the myocardium via the infarct-related vessel using a transarterial microsyringe catheter-based delivery system. Echocardiography was used to measure LV function as a function of time after AMI. Animals that received low-dose cell treatment showed significant improvement in regional and global LV function and remodeling compared to the high-dose or control animals. Direct myocardial delivery of allogeneic MAPCs 2 days following AMI through the vessel wall of the infarct-related vessel is safe and results in delivery of cells throughout the infarct zone and improved cardiac function despite lack of long-term cell survival. These data further support the hypothesis of cell-based myocardial tissue repair by a paracrine mechanism and suggest a clinically translatable strategy for delivering cells at any time after AMI to modulate cardiac remodeling and function.
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Affiliation(s)
- Satish Medicetty
- Regenerative Medicine Department, Athersys, Inc., Cleveland, OH 44309, USA
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Eggenhofer E, Renner P, Soeder Y, Popp FC, Hoogduijn MJ, Geissler EK, Schlitt HJ, Dahlke MH. Features of synergism between mesenchymal stem cells and immunosuppressive drugs in a murine heart transplantation model. Transpl Immunol 2011; 25:141-7. [DOI: 10.1016/j.trim.2011.06.002] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2011] [Revised: 06/08/2011] [Accepted: 06/08/2011] [Indexed: 02/07/2023]
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Mays RW, Borlongan CV, Yasuhara T, Hara K, Maki M, Carroll JE, Deans RJ, Hess DC. Development of an allogeneic adherent stem cell therapy for treatment of ischemic stroke. ACTA ACUST UNITED AC 2010. [DOI: 10.6030/1939-067x-3.1.34] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Safety Evaluation of Human Fibroblasts in Mice: Tumorigenicity, 13-week Toxicity and Distribution Studies. Lab Anim Res 2010. [DOI: 10.5625/lar.2010.26.2.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Auletta JJ, Cooke KR, Solchaga LA, Deans RJ, van't Hof W. Regenerative stromal cell therapy in allogeneic hematopoietic stem cell transplantation: current impact and future directions. Biol Blood Marrow Transplant 2009; 16:891-906. [PMID: 20018250 DOI: 10.1016/j.bbmt.2009.12.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2009] [Accepted: 12/03/2009] [Indexed: 02/07/2023]
Abstract
Regenerative stromal cell therapy (RSCT) has the potential to become a novel therapy for preventing and treating acute graft-versus-host disease (GVHD) in the allogeneic hematopoietic stem cell transplant (HSCT) recipient. However, enthusiasm for using RSCT in allogeneic HSCT has been tempered by limited clinical data and poorly defined in vivo mechanisms of action. As a result, the full clinical potential of RSCT in supporting hematopoietic reconstitution and as treatment for GVHD remains to be determined. This manuscript reviews the immunomodulatory activity of regenerative stromal cells in preclinical models of allogeneic HSCT, and emphasizes an emerging literature suggesting that microenvironment influences RSC activation and function. Understanding this key finding may ultimately define the proper niche for RSCT in allogeneic HSCT. In particular, mechanistic studies are needed to delineate the in vivo effects of RSCT in response to inflammation and injury associated with allogeneic HSCT, and to define the relevant sites of RSC interaction with immune cells in the transplant recipient. Furthermore, development of in vivo imaging technology to correlate biodistribution patterns, desired RSC effect, and clinical outcome will be crucial to establishing dose-response effects and minimal biologic dose thresholds needed to advance translational treatment strategies for complications like GVHD.
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Bone marrow transplantation: new approaches to immunosuppression and management of acute graft-versus-host disease. Curr Opin Pediatr 2009; 21:30-8. [PMID: 19242239 DOI: 10.1097/mop.0b013e3283207b2f] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE OF REVIEW Acute graft-versus-host disease (GVHD) significantly limits the application and the success of allogeneic hematopoietic stem cell transplantation (HSCT). Novel therapies that target the aberrant immune response underlying GVHD are reviewed with particular emphasis on immunomodulatory agents currently incorporated into clinical trials. In addition, regenerative stromal cellular therapy (RSCT) is discussed as an emerging form of novel GVHD therapy. RECENT FINDINGS Knowledge for transplant immunology, particularly as it relates to underlying pathophysiology of GVHD, has dramatically increased over the last decade. As a result, new immunomodulatory therapies have been used to treat steroid-refractory GVHD. However, their success has been limited by their lack of clinical experience during HSCT as well as by their associated toxicity profiles. RSCT uniquely offers the potential to enhance donor-derived hematopoiesis and immunity and to ameliorate adverse sequelae associated with GVHD. SUMMARY An exciting era incorporating the use of cellular therapeutics during HSCT has arrived. As the experience and understanding for cellular therapies, in general, and RSCT, in particular, increases, so too will their success in benefiting the HSCT recipient beyond limitations of current pharmaceutical agents.
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Kovacsovics-Bankowski M, Streeter PR, Mauch KA, Frey MR, Raber A, van't Hof W, Deans R, Maziarz RT. Clinical scale expanded adult pluripotent stem cells prevent graft-versus-host disease. Cell Immunol 2008; 255:55-60. [PMID: 19022422 DOI: 10.1016/j.cellimm.2008.10.004] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2008] [Revised: 09/18/2008] [Accepted: 10/09/2008] [Indexed: 12/29/2022]
Abstract
Adherent bone marrow adult stem cells have been used in the treatment of GVHD. In this study, we investigate the capacity of a newly characterized population of stem cells, the Multipotent Adult Progenitor Cells (MAPC), to modulate acute GVHD. These cells were derived from bone marrow cells and grown extensively without evidence for replicative senescence or loss of differentiating capacity. MAPC significantly decreased mortality of acute GVHD. Moreover, they were non immunogenic and they were not sensitive to NK-lysis. When these cells were added to a mixed lymphocyte reaction (MLR), a dose-dependent suppression of T cell proliferation was observed that was non-MHC restricted, was reversible upon removal of MAPC from culture and was mediated by soluble factors. These data show that in vitro expanded adult stem cells can efficiently control an allo-reactive response associated with acute GVHD, that they are immuno-privileged and present strong immunosuppressive properties.
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