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Cohen S, Partouche S, Gurevich M, Tennak V, Mezhybovsky V, Azarov D, Soffer-Hirschberg S, Hovav B, Niv-Drori H, Weiss C, Borovich A, Cohen G, Wertheimer A, Shukrun G, Israeli M, Yahalom V, Leshem-Lev D, Perl L, Kornowski R, Wiznitzer A, Tobar A, Feinmesser M, Mor E, Atar E, Nesher E. Generation of vascular chimerism within donor organs. Sci Rep 2021; 11:13437. [PMID: 34183759 PMCID: PMC8238957 DOI: 10.1038/s41598-021-92823-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 06/16/2021] [Indexed: 01/22/2023] Open
Abstract
Whole organ perfusion decellularization has been proposed as a promising method to generate non-immunogenic organs from allogeneic and xenogeneic donors. However, the ability to recellularize organ scaffolds with multiple patient-specific cells in a spatially controlled manner remains challenging. Here, we propose that replacing donor endothelial cells alone, while keeping the rest of the organ viable and functional, is more technically feasible, and may offer a significant shortcut in the efforts to engineer transplantable organs. Vascular decellularization was achieved ex vivo, under controlled machine perfusion conditions, in various rat and porcine organs, including the kidneys, liver, lungs, heart, aorta, hind limbs, and pancreas. In addition, vascular decellularization of selected organs was performed in situ, within the donor body, achieving better control over the perfusion process. Human placenta-derived endothelial progenitor cells (EPCs) were used as immunologically-acceptable human cells to repopulate the luminal surface of de-endothelialized aorta (in vitro), kidneys, lungs and hind limbs (ex vivo). This study provides evidence that artificially generating vascular chimerism is feasible and could potentially pave the way for crossing the immunological barrier to xenotransplantation, as well as reducing the immunological burden of allogeneic grafts.
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Affiliation(s)
- Shahar Cohen
- Laboratory for Organ Bioengineering, Rabin Medical Center, Petah Tikva, Israel.
| | - Shirly Partouche
- Laboratory for Organ Bioengineering, Rabin Medical Center, Petah Tikva, Israel.,Felsenstien Medical Research Center, Rabin Medical Center, Petah Tikva, Israel
| | - Michael Gurevich
- Department of Organ Transplantation, Rabin Medical Center, Petah Tikva, Israel
| | - Vladimir Tennak
- Department of Organ Transplantation, Rabin Medical Center, Petah Tikva, Israel
| | - Vadym Mezhybovsky
- Department of Organ Transplantation, Rabin Medical Center, Petah Tikva, Israel
| | - Dmitry Azarov
- Experimental Surgery Unit, Rabin Medical Center, Petah Tikva, Israel
| | | | - Benny Hovav
- Department of Radiology, Rabin Medical Center, Petah Tikva, Israel
| | - Hagit Niv-Drori
- Department of Pathology, Rabin Medical Center, Petah Tikva, Israel
| | - Chana Weiss
- Department of Pathology, Rabin Medical Center, Petah Tikva, Israel
| | - Adi Borovich
- Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Guy Cohen
- Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel
| | - Avital Wertheimer
- Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Golan Shukrun
- Division of Pediatric Cardiothoracic Surgery, Schneider Children's Medical Center, Petah Tikva, Israel.,Department of Cardiothoracic Surgery, Rabin Medical Center, Petah Tikva, Israel
| | - Moshe Israeli
- Tissue Typing Laboratory, Rabin Medical Center, Petah Tikva, Israel.,Zefat Academic College, Zefat, Israel
| | - Vered Yahalom
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Blood Services and Apheresis Institute, Rabin Medical Center, Petah Tikva, Israel
| | - Dorit Leshem-Lev
- Felsenstien Medical Research Center, Rabin Medical Center, Petah Tikva, Israel.,Department of Cardiology, Rabin Medical Center, Petah Tikva, Israel
| | - Leor Perl
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Cardiology, Rabin Medical Center, Petah Tikva, Israel
| | - Ran Kornowski
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Cardiology, Rabin Medical Center, Petah Tikva, Israel
| | - Arnon Wiznitzer
- Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ana Tobar
- Department of Pathology, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Meora Feinmesser
- Department of Pathology, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eytan Mor
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Transplantation Unit, Department of Surgery B, Sheba Medical Center, Ramat Gan, Israel
| | - Eli Atar
- Department of Radiology, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eviatar Nesher
- Department of Organ Transplantation, Rabin Medical Center, Petah Tikva, Israel
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Abstract
Human kidney tissue can now be generated via the directed differentiation of human pluripotent stem cells. This advance is anticipated to facilitate the modeling of human kidney diseases, provide platforms for nephrotoxicity screening, enable cellular therapy, and potentially generate tissue for renal replacement. All such applications will rely upon the accuracy and reliability of the model and the capacity for stem cell-derived kidney tissue to recapitulate both normal and diseased states. In this review, we discuss the models available, how well they recapitulate the human kidney, and how far we are from application of these cells for use in cellular therapies.
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Affiliation(s)
- Melissa H Little
- Murdoch Children's Research Institute, Parkville, Victoria 3052, Australia; .,Department of Paediatrics, University of Melbourne, Victoria 3010, Australia.,Department of Anatomy and Neuroscience, University of Melbourne, Victoria 3010, Australia
| | - Lorna J Hale
- Murdoch Children's Research Institute, Parkville, Victoria 3052, Australia;
| | - Sara E Howden
- Murdoch Children's Research Institute, Parkville, Victoria 3052, Australia; .,Department of Paediatrics, University of Melbourne, Victoria 3010, Australia
| | - Santhosh V Kumar
- Murdoch Children's Research Institute, Parkville, Victoria 3052, Australia; .,Department of Paediatrics, University of Melbourne, Victoria 3010, Australia
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Vining KH, Lombaert IMA, Patel VN, Kibbey SE, Pradhan-Bhatt S, Witt RL, Hoffman MP. Neurturin-containing laminin matrices support innervated branching epithelium from adult epithelial salispheres. Biomaterials 2019; 216:119245. [PMID: 31200143 DOI: 10.1016/j.biomaterials.2019.119245] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 05/30/2019] [Accepted: 06/01/2019] [Indexed: 01/05/2023]
Abstract
Cell transplantation of autologous adult biopsies, grown ex vivo as epithelial organoids or expanded as spheroids, are proposed treatments to regenerate damaged branching organs. However, it is not clear whether transplantation of adult organoids or spheroids alone is sufficient to initiate a fetal-like program of branching morphogenesis in which coordinated branching of multiple cell types including nerves, mesenchyme and blood vessels occurs. Yet this is an essential concept for the regeneration of branching organs such as lung, pancreas, and lacrimal and salivary glands. Here, we used factors identified from fetal organogenesis to maintain and expand adult murine and human epithelial salivary gland progenitors in non-adherent spheroid cultures, called salispheres. These factors stimulated critical developmental pathways, and increased expression of epithelial progenitor markers such as Keratin5, Keratin14, FGFR2b and KIT. Moreover, physical recombination of adult salispheres in a laminin-111 extracellular matrix with fetal salivary mesenchyme, containing endothelial and neuronal cells, only induced branching morphogenesis when neurturin, a neurotrophic factor, was added to the matrix. Neurturin was essential to improve neuronal survival, axon outgrowth, innervation of the salispheres, and resulted in the formation of branching structures with a proximal-distal axis that mimicked fetal branching morphogenesis, thus recapitulating organogenesis. Epithelial progenitors were also maintained, and developmental differentiation programs were initiated, showing that the fetal microenvironment provides a template for adult epithelial progenitors to initiate branching and differentiation. Further delineation of secreted and physical cues from the fetal niche will be useful to develop novel regenerative therapies that instruct adult salispheres to resume a developmental-like program in vitro and to regenerate branching organs in vivo.
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Affiliation(s)
- K H Vining
- Matrix and Morphogenesis Section, National Institute of Dental and Craniofacial Research, NIH, Bethesda, MD, 20842, USA; Medical Research Scholars Program, Office of Clinical Research Training and Medical Education, Clinical Center, NIH, Bethesda, MD, 20842, USA; University of Minnesota School of Dentistry, Minneapolis, MN 55455, USA; Current Address: John A. Paulson School of Engineering and Applied Sciences and Wyss Institute for Biologically Inspired Engineering, Harvard University, Cambridge, MA, 02138. USA
| | - I M A Lombaert
- Matrix and Morphogenesis Section, National Institute of Dental and Craniofacial Research, NIH, Bethesda, MD, 20842, USA; Current Address: Biointerfaces Institute, University of Michigan, School of Dentistry, North Campus Research Center, 2800 Plymouth Rd, Ann Arbor, MI 48104, USA
| | - V N Patel
- Matrix and Morphogenesis Section, National Institute of Dental and Craniofacial Research, NIH, Bethesda, MD, 20842, USA
| | - S E Kibbey
- Matrix and Morphogenesis Section, National Institute of Dental and Craniofacial Research, NIH, Bethesda, MD, 20842, USA
| | - S Pradhan-Bhatt
- Department of Biological Sciences, University of Delaware, Newark, DE, 19716, USA; Center for Translational Cancer Research, University of Delaware, Newark, DE, 19716, USA; Helen F. Graham Cancer Center, Christiana Care Health System, Newark, DE, 19713, USA
| | - R L Witt
- Department of Biological Sciences, University of Delaware, Newark, DE, 19716, USA; Center for Translational Cancer Research, University of Delaware, Newark, DE, 19716, USA; Helen F. Graham Cancer Center, Christiana Care Health System, Newark, DE, 19713, USA; Otolaryngology - Head & Neck Surgery, Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - M P Hoffman
- Matrix and Morphogenesis Section, National Institute of Dental and Craniofacial Research, NIH, Bethesda, MD, 20842, USA.
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Recapitulating kidney development: Progress and challenges. Semin Cell Dev Biol 2018; 91:153-168. [PMID: 30184476 DOI: 10.1016/j.semcdb.2018.08.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 08/22/2018] [Accepted: 08/28/2018] [Indexed: 12/14/2022]
Abstract
Decades of research into the molecular and cellular regulation of kidney morphogenesis in rodent models, particularly the mouse, has provided both an atlas of the mammalian kidney and a roadmap for recreating kidney cell types with potential applications for the treatment of kidney disease. With advances in both our capacity to maintain nephron progenitors in culture, reprogram to kidney cell types and direct the differentiation of human pluripotent stem cells to kidney endpoints, renal regeneration via cellular therapy or tissue engineering may be possible. Human kidney models also have potential for disease modelling and drug screening. Such applications will rely upon the accuracy of the model at the cellular level and the capacity for stem-cell derived kidney tissue to recapitulate both normal and diseased kidney tissue. In this review, we will discuss the available cell sources, how well they model the human kidney and how far we are from application either as models or for tissue engineering.
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Renal primordia activate kidney regenerative events in a rat model of progressive renal disease. PLoS One 2015; 10:e0120235. [PMID: 25811887 PMCID: PMC4374877 DOI: 10.1371/journal.pone.0120235] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 01/22/2015] [Indexed: 11/19/2022] Open
Abstract
New intervention tools for severely damaged kidneys are in great demand to provide patients with a valid alternative to whole organ replacement. For repairing or replacing injured tissues, emerging approaches focus on using stem and progenitor cells. Embryonic kidneys represent an interesting option because, when transplanted to sites such as the renal capsule of healthy animals, they originate new renal structures. Here, we studied whether metanephroi possess developmental capacity when transplanted under the kidney capsule of MWF male rats, a model of spontaneous nephropathy. We found that six weeks post-transplantation, renal primordia developed glomeruli and tubuli able to filter blood and to produce urine in cyst-like structures. Newly developed metanephroi were able to initiate a regenerative-like process in host renal tissues adjacent to the graft in MWF male rats as indicated by an increase in cell proliferation and vascular density, accompanied by mRNA and protein upregulation of VEGF, FGF2, HGF, IGF-1 and Pax-2. The expression of SMP30 and NCAM was induced in tubular cells. Oxidative stress and apoptosis markedly decreased. Our study shows that embryonic kidneys generate functional nephrons when transplanted into animals with severe renal disease and at the same time activate events at least partly mimicking those observed in kidney tissues during renal regeneration.
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Abstract
PURPOSE OF REVIEW Here, we review the rationale for the use of organs from embryonic donors, antecedent investigations and recent work from our own laboratory, exploring the utility for transplantation of embryonic kidney and pancreas as an organ replacement therapy. RECENT FINDINGS Ultrastructurally precise kidneys differentiate in situ in rats following xenotransplantation in mesentery of embryonic pig renal primordia. The developing organ attracts its blood supply from the host. Engraftment of pig renal primordia requires host immune suppression. However, beta cells originating from embryonic pig pancreas obtained very early following initiation of organogenesis [embryonic day 28 (E28)] engraft long term in nonimmune-suppressed diabetic rats or rhesus macaques. Engraftment of morphologically similar cells originating from adult porcine islets of Langerhans occurs in animals previously transplanted with E28 pig pancreatic primordia. SUMMARY Organ primordia engraft, attract a host vasculature and differentiate following transplantation to ectopic sites. Attempts have been made to exploit these characteristics to achieve clinically relevant endpoints for end-stage renal disease and diabetes mellitus using animal models. We and others have focused on use of the embryonic pig as a donor.
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Relevance of ureteric bud development and branching to tissue engineering, regeneration and repair in acute and chronic kidney disease. Curr Opin Organ Transplant 2014; 19:153-61. [DOI: 10.1097/mot.0000000000000053] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Nigam SK. Concise review: can the intrinsic power of branching morphogenesis be used for engineering epithelial tissues and organs? Stem Cells Transl Med 2013; 2:993-1000. [PMID: 24191267 DOI: 10.5966/sctm.2013-0076] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Branching morphogenesis is critical to the development of organs such as kidney, lung, mammary gland, prostate, pancreas, and salivary gland. Essentially, an epithelial bud becomes an iterative tip-stalk generator (ITSG) able to form a tree of branching ducts and/or tubules. In different organs, branching morphogenesis is governed by similar sets of genes. Epithelial branching has been recapitulated in vitro (or ex vivo) using three-dimensional cell culture and partial organ culture systems, and several such systems relevant to kidney tissue engineering are discussed here. By adapting systems like these it may be possible to harness the power inherent in the ITSG program to propagate and engineer epithelial tissues and organs. It is also possible to conceive of a universal ITSG capable of propagation that may, by recombination with organ-specific mesenchymal cells, be used for engineering many organ-like tissues similar to the organ from which the mesenchyme cells were derived, or toward which they are differentiated (from stem cells). The three-dimensional (3D) branched epithelial structure could act as a dynamic branching cellular scaffold to establish the architecture for the rest of the tissue. Another strategy-that of recombining propagated organ-specific ITSGs in 3D culture with undifferentiated mesenchymal stem cells-is also worth exploring. If feasible, such engineered tissues may be useful for the ex vivo study of drug toxicity, developmental biology, and physiology in the laboratory. Over the long term, they have potential clinical applications in the general fields of transplantation, regenerative medicine, and bioartificial medical devices to aid in the treatment of chronic kidney disease, diabetes, and other diseases.
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Affiliation(s)
- Sanjay K Nigam
- Departments of Pediatrics, Medicine, Cellular and Molecular Medicine, and Bioengineering, University of California San Diego, La Jolla, California, USA
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Hammerman MR. Engraftment of insulin-producing cells from porcine islets in non-immune-suppressed rats or nonhuman primates transplanted previously with embryonic pig pancreas. J Transplant 2011; 2011:261352. [PMID: 21969909 PMCID: PMC3182564 DOI: 10.1155/2011/261352] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Revised: 07/02/2011] [Accepted: 07/02/2011] [Indexed: 11/30/2022] Open
Abstract
Transplantation therapy for diabetes is limited by unavailability of donor organs and outcomes complicated by immunosuppressive drug toxicity. Xenotransplantation is a strategy to overcome supply problems. Implantation of tissue obtained early during embryogenesis is a way to reduce transplant immunogenicity. Insulin-producing cells originating from embryonic pig pancreas obtained very early following pancreatic primordium formation (embryonic day 28 (E28)) engraft long-term in non-immune, suppressed diabetic rats or rhesus macaques. Morphologically, similar cells originating from adult porcine islets of Langerhans (islets) engraft in non-immune-suppressed rats or rhesus macaques previously transplanted with E28 pig pancreatic primordia. Our data are consistent with induction of tolerance to an endocrine cell component of porcine islets induced by previous transplantation of embryonic pig pancreas, a novel finding we designate organogenetic tolerance. The potential exists for its use to enable the use of pigs as islet cell donors for humans with no immune suppression requirement.
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Affiliation(s)
- Marc R. Hammerman
- George M. O'Brien Center for Kidney Disease Research, Departments of Medicine, and Cell Biology and Physiology, The Washington University School of Medicine, St. Louis, MO 63110, USA
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Schneider MKJ, Seebach JD. Xenotransplantation literature update, January-February 2011. Xenotransplantation 2011; 18:147-50. [PMID: 21496121 DOI: 10.1111/j.1399-3089.2011.00630.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Mårten K J Schneider
- Laboratory of Vascular Immunology, Division of Internal Medicine, University Hospital Zurich, Zurich, Switzerland.
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Hubbard WJ, Dashti N. Aging and transplantation - a topic for biomedicine or bioethics? Aging Dis 2011; 2:181-185. [PMID: 22396872 PMCID: PMC3295047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2011] [Revised: 02/18/2011] [Accepted: 02/21/2011] [Indexed: 05/31/2023] Open
Abstract
The aged patient stands at the nexus of significant biomedical and bioethical issues in transplantation. This in itself can be seen as a microcosm of an imminent global tempest, stemming from expanding numbers and longer lives of the aged population. As a candidate for receiving organ and tissue transplants, the geriatric patient is challenging because they present unique physiology for medical management. As organ and tissue donors, the aged are perceived of as providing "marginal" organs, which drives the fear that the graft will fail before the recipient. Such difficulties lead inexorably to several unique bioethical considerations for transplantation with this population. The thorny conundrums for society hinge on fairness versus discrimination based on age, played out under the enormous and probably intractable problem of severe donor organ shortages. Fortunately, recent findings offer some rather unexpected new and favorable prospects. Notably, aged donors can provide organs with good, lifesaving function, even though there are nonetheless age-related compromises present. On the other side of the coin, there is less doubt that recipients can have their lives extended with high quality through transplantation. Here they benefit from some (counterintuitively) positive attributes for aging, such as reduced immune function, making immunosuppression less rigorous. Finally, the pressure of organ and tissue shortages plus the lifting of bans on embryonic stem cell research have portents for an explosive alternative to transplantation of adult organs. Stem cells also lend credibility to prospects for realizing regenerative medicine, assuming ethical and religious concerns can be satisfied.
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Affiliation(s)
- William J. Hubbard
- University of Alabama at Birmingham, Department of Surgery, Center for Surgical Research and
| | - Nassrin Dashti
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care
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