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Conese M, Napolitano O, Laselva O, Di Gioia S, Nappi L, Trabace L, Matteo M. The Oncogenic Theory of Preeclampsia: Is Amniotic Mesenchymal Stem Cells-Derived PLAC1 Involved? Int J Mol Sci 2023; 24:ijms24043612. [PMID: 36835024 PMCID: PMC9962629 DOI: 10.3390/ijms24043612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/04/2023] [Accepted: 02/07/2023] [Indexed: 02/15/2023] Open
Abstract
The pathomechanisms of preeclampsia (PE), a complication of late pregnancy characterized by hypertension and proteinuria, and due to improper placentation, are not well known. Mesenchymal stem cells derived from the amniotic membrane (AMSCs) may play a role in PE pathogenesis as placental homeostasis regulators. PLACenta-specific protein 1 (PLAC1) is a transmembrane antigen involved in trophoblast proliferation that is found to be associated with cancer progression. We studied PLAC1 in human AMSCs obtained from control subjects (n = 4) and PE patients (n = 7), measuring the levels of mRNA expression (RT-PCR) and secreted protein (ELISA on conditioned medium). Lower levels of PLAC1 mRNA expression were observed in PE AMSCs as compared with Caco2 cells (positive controls), but not in non-PE AMSCs. PLAC1 antigen was detectable in conditioned medium obtained from PE AMSCs, whereas it was undetectable in that obtained from non-PE AMSCs. Our data suggest that abnormal shedding of PLAC1 from AMSC plasma membranes, likely by metalloproteinases, may contribute to trophoblast proliferation, supporting its role in the oncogenic theory of PE.
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Affiliation(s)
- Massimo Conese
- Department of Clinical and Experimental Medicine, University of Foggia, Via Napoli 121, 71122 Foggia, Italy
- Correspondence:
| | - Ottavio Napolitano
- Department of Clinical and Experimental Medicine, University of Foggia, Via Napoli 121, 71122 Foggia, Italy
| | - Onofrio Laselva
- Department of Clinical and Experimental Medicine, University of Foggia, Via Napoli 121, 71122 Foggia, Italy
| | - Sante Di Gioia
- Department of Clinical and Experimental Medicine, University of Foggia, Via Napoli 121, 71122 Foggia, Italy
| | - Luigi Nappi
- Department of Medical and Surgical Sciences, University of Foggia, Via Napoli 121, 71122 Foggia, Italy
| | - Luigia Trabace
- Department of Clinical and Experimental Medicine, University of Foggia, Via Napoli 121, 71122 Foggia, Italy
| | - Maria Matteo
- Department of Medical and Surgical Sciences, University of Foggia, Via Napoli 121, 71122 Foggia, Italy
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2
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Mao Y, Yang Y, Sun C, Zou Y, Zhang Y, Wu B, Li C, Huang J, Zhang W, Wang J. Human amniotic mesenchymal stem cells promote endometrium regeneration in a rat model of intrauterine adhesion. Cell Biol Int 2023; 47:75-85. [PMID: 36317446 DOI: 10.1002/cbin.11951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 08/20/2022] [Accepted: 08/26/2022] [Indexed: 11/08/2022]
Abstract
Human amniotic transplantation has been proposed to improve the therapeutic efficacy of intrauterine adhesions (IUAs). Human amniotic mesenchymal stem stromal cells (hAMSCs) can differentiate into multiple tissue types. This study aimed to investigate the mechanism by which hAMSCs transplantation promotes endometrial regeneration. The rat models with IUA were established through mechanical and infective methods, and PKH26-labeled hAMSCs were transplanted through the tail vein (combined with/without estrogen). Under three different conditions, hAMSCs differentiated into endometrium-like cells. HE and Mason staining assays, and immunohistochemistry were used to compare the changes in rat models treated with hAMSCs and/or estrogen transplantation. To define the induction of hAMSCs to endometrium-like cells in vitro, an induction medium (cytokines, estrogen) was used to investigate the differentiation of hAMSCs into endometrium-like cells. qRT-polymerase chain reaction (PCR) and western blotting were performed to detect the differentiation of hAMSCs into endometrium-like cells. A greater number of glands, fewer endometrial fibrotic areas, and stronger expression of vascular endothelial growth factor and cytokeratin in the combined group (hAMSCs transplantation combined with estrogen) than in the other treatment groups were observed. hAMSCs could be induced into endometrium-like cells by cytokine treatment (TGF-β1, EGF, and PDGF-BB). Transplantation of hAMSCs is an effective alternative for endometrial regeneration after injury in rats. The differentiation protocol for hAMSCs will be useful for further studies on human endometrial regeneration.
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Affiliation(s)
- Yanhua Mao
- Department of Obstetrics and Gynecology, The University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Yuan Yang
- Department of Obstetrics and Gynecology, Shanghai Jiading Maternal Child Health Hospital, Shanghai, China
| | - Congcong Sun
- Department of Obstetrics and Gynecology, The University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Yulong Zou
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yingfeng Zhang
- Department of Obstetrics and Gynecology, The University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Benyuan Wu
- Department of Obstetrics and Gynecology, The University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Changjiang Li
- Department of Obstetrics and Gynecology, The University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Jinglin Huang
- Department of Obstetrics and Gynecology, The University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Wenwen Zhang
- Department of Obstetrics and Gynecology, The University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Jia Wang
- Department of Obstetrics and Gynecology, The University-Town Hospital of Chongqing Medical University, Chongqing, China
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3
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Aslan A, Yuka SA. Stem Cell-Based Therapeutic Approaches in Genetic Diseases. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1436:19-53. [PMID: 36735185 DOI: 10.1007/5584_2023_761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Stem cells, which can self-renew and differentiate into different cell types, have become the keystone of regenerative medicine due to these properties. With the achievement of superior clinical results in the therapeutic approaches of different diseases, the applications of these cells in the treatment of genetic diseases have also come to the fore. Foremost, conventional approaches of stem cells to genetic diseases are the first approaches in this manner, and they have brought safety issues due to immune reactions caused by allogeneic transplantation. To eliminate these safety issues and phenotypic abnormalities caused by genetic defects, firstly, basic genetic engineering practices such as vectors or RNA modulators were combined with stem cell-based therapeutic approaches. However, due to challenges such as immune reactions and inability to target cells effectively in these applications, advanced molecular methods have been adopted in ZFN, TALEN, and CRISPR/Cas genome editing nucleases, which allow modular designs in stem cell-based genetic diseases' therapeutic approaches. Current studies in genetic diseases are in the direction of creating permanent treatment regimens by genomic manipulation of stem cells with differentiation potential through genome editing tools. In this chapter, the stem cell-based therapeutic approaches of various vital genetic diseases were addressed wide range from conventional applications to genome editing tools.
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Affiliation(s)
- Ayça Aslan
- Department of Bioengineering, Yildiz Technical University, Istanbul, Turkey
| | - Selcen Arı Yuka
- Department of Bioengineering, Yildiz Technical University, Istanbul, Turkey.
- Health Biotechnology Joint Research and Application Center of Excellence, Istanbul, Turkey.
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4
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Human Amniotic Mesenchymal Stem Cells and Fibroblasts Accelerate Wound Repair of Cystic Fibrosis Epithelium. Life (Basel) 2022; 12:life12050756. [PMID: 35629422 PMCID: PMC9144497 DOI: 10.3390/life12050756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/12/2022] [Accepted: 05/16/2022] [Indexed: 12/19/2022] Open
Abstract
Cystic fibrosis (CF) airways are affected by a deranged repair of the damaged epithelium resulting in altered regeneration and differentiation. Previously, we showed that human amniotic mesenchymal stem cells (hAMSCs) corrected base defects of CF airway epithelial cells via connexin (CX)43-intercellular gap junction formation. In this scenario, it is unknown whether hAMSCs, or fibroblasts sharing some common characteristics with MSCs, can operate a faster repair of a damaged airway epithelium. A tip-based scratch assay was employed to study wound repair in monolayers of CFBE14o- cells (CFBE, homozygous for the F508del mutation). hAMSCs were either co-cultured with CFBE cells before the wound or added to the wounded monolayers. NIH-3T3 fibroblasts (CX43+) were added to wounded cells. HeLa cells (CX43-) were used as controls. γ-irradiation was optimized to block CFBE cell proliferation. A specific siRNA was employed to downregulate CX43 expression in CFBE cells. CFBE cells showed a delayed repair as compared with wt-CFTR cells (16HBE41o-). hAMSCs enhanced the wound repair rate of wounded CFBE cell monolayers, especially when added post wounding. hAMSCs and NIH-3T3 fibroblasts, but not HeLa cells, increased wound closure of irradiated CFBE monolayers. CX43 downregulation accelerated CFBE wound repair rate without affecting cell proliferation. We conclude that hAMSCs and fibroblasts enhance the repair of a wounded CF airway epithelium, likely through a CX43-mediated mechanism mainly involving cell migration.
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Pathophysiology of Lung Disease and Wound Repair in Cystic Fibrosis. PATHOPHYSIOLOGY 2021; 28:155-188. [PMID: 35366275 PMCID: PMC8830450 DOI: 10.3390/pathophysiology28010011] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/08/2021] [Accepted: 03/08/2021] [Indexed: 12/11/2022] Open
Abstract
Cystic fibrosis (CF) is an autosomal recessive, life-threatening condition affecting many organs and tissues, the lung disease being the chief cause of morbidity and mortality. Mutations affecting the CF Transmembrane Conductance Regulator (CFTR) gene determine the expression of a dysfunctional protein that, in turn, triggers a pathophysiological cascade, leading to airway epithelium injury and remodeling. In vitro and in vivo studies point to a dysregulated regeneration and wound repair in CF airways, to be traced back to epithelial CFTR lack/dysfunction. Subsequent altered ion/fluid fluxes and/or signaling result in reduced cell migration and proliferation. Furthermore, the epithelial-mesenchymal transition appears to be partially triggered in CF, contributing to wound closure alteration. Finally, we pose our attention to diverse approaches to tackle this defect, discussing the therapeutic role of protease inhibitors, CFTR modulators and mesenchymal stem cells. Although the pathophysiology of wound repair in CF has been disclosed in some mechanisms, further studies are warranted to understand the cellular and molecular events in more details and to better address therapeutic interventions.
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Cell-Based Therapeutic Approaches for Cystic Fibrosis. Int J Mol Sci 2020; 21:ijms21155219. [PMID: 32718005 PMCID: PMC7432606 DOI: 10.3390/ijms21155219] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/20/2020] [Accepted: 07/20/2020] [Indexed: 01/01/2023] Open
Abstract
Cystic Fibrosis (CF) is a chronic autosomal recessive disease caused by defects in the cystic fibrosis transmembrane conductance regulator gene (CFTR). Cystic Fibrosis affects multiple organs but progressive remodeling of the airways, mucus accumulation, and chronic inflammation in the lung, result in lung disease as the major cause of morbidity and mortality. While advances in management of CF symptoms have increased the life expectancy of this devastating disease, and there is tremendous excitement about the potential of new agents targeting the CFTR molecule itself, there is still no curative treatment. With the recent advances in the identification of endogenous airway progenitor cells and in directed differentiation of pluripotent cell sources, cell-based therapeutic approaches for CF have become a plausible treatment method with the potential to ultimately cure the disease. In this review, we highlight the current state of cell therapy in the CF field focusing on the relevant autologous and allogeneic cell populations under investigation and the challenges associated with their use. In addition, we present advances in induced pluripotent stem (iPS) cell approaches and emerging new genetic engineering methods, which have the capacity to overcome the current limitations hindering cell therapy approaches.
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7
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Ghamari SH, Abbasi-Kangevari M, Tayebi T, Bahrami S, Niknejad H. The Bottlenecks in Translating Placenta-Derived Amniotic Epithelial and Mesenchymal Stromal Cells Into the Clinic: Current Discrepancies in Marker Reports. Front Bioeng Biotechnol 2020; 8:180. [PMID: 32232037 PMCID: PMC7083014 DOI: 10.3389/fbioe.2020.00180] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 02/24/2020] [Indexed: 12/23/2022] Open
Abstract
Placenta-derived amniotic cells have prominent features for application in regenerative medicine. However, there are still discrepancies in the characterization of human amniotic epithelial and mesenchymal stromal cells. It seems crucial that the characterization of human amniotic membrane cells be investigated to determine whether there are currently discrepancies in their characterization reports. In addition, possible causes for the witnessed discrepancies need to be addressed toward paving the way for further clinical application and safer practices. The objective of this review is to investigate the marker characterization as well as the potential causes of the discrepancies in the previous reports on placenta-derived amniotic epithelial and mesenchymal stromal cells. The current discrepancies could be potentially due to reasons including passage number and epithelial to mesenchymal transition (EMT), cell heterogeneity, isolation protocols and cross-contamination, the region of cell isolation on placental disk, measuring methods, and gestational age.
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Affiliation(s)
- Seyyed-Hadi Ghamari
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohsen Abbasi-Kangevari
- Student Research Committee, Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Tahereh Tayebi
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soheyl Bahrami
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology in AUVA Research Center, Vienna, Austria
| | - Hassan Niknejad
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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8
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Effect of Mother’s Age and Pathology on Functional Behavior of Amniotic Mesenchymal Stromal Cells—Hints for Bone Regeneration. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9173471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Human amnion-derived mesenchymal stromal cells (hAMSCs) are used increasingly in regenerative medicine applications, including dentistry. The aim of this study was to evaluate if hAMSCs from aged and pathological mothers could be affected in their phenotype and functional behavior. hAMSCs were isolated from placentas of women aged younger than 40 years (Group 1, n = 7), older than 40 years (Group 2, n = 6), and with pre-eclampsia (Group 3, n = 5). Cell yield and viability were assessed at isolation (p0). Cell proliferation was evaluated from p0 to p5. Passage 2 was used to determine the phenotype, the differentiation capacity, and the adhesion to machined and sandblasted titanium disks. hAMSCs recovered from Group 3 were fewer than in Group 1. Viability and doubling time were not different among the three groups. Percentages of CD29+ cells were significantly lower in Group 3, while percentages of CD73+ cells were significantly lower in Groups 2 and 3 as compared with Group 1. hAMSCs from Group 2 showed a significant lower differentiation capacity towards chondrogenic and osteogenic lineages. hAMSCs from Group 3 adhered less to titanium surfaces. In conclusion, pathology can affect hAMSCs in phenotype and functional behavior and may alter bone regeneration capacities.
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9
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Lim R. Concise Review: Fetal Membranes in Regenerative Medicine: New Tricks from an Old Dog? Stem Cells Transl Med 2019; 6:1767-1776. [PMID: 28834402 PMCID: PMC5689753 DOI: 10.1002/sctm.16-0447] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 06/16/2017] [Indexed: 12/11/2022] Open
Abstract
The clinical application of the fetal membranes dates back to nearly a century. Their use has ranged from superficial skin dressings to surgical wound closure. The applications of the fetal membranes are constantly evolving, and key to this is the uncovering of multiple populations of stem and stem-like cells, each with unique properties that can be exploited for regenerative medicine. In addition to pro-angiogenic and immunomodulatory properties of the stem and stem-like cells arising from the fetal membranes, the dehydrated and/or decellularized forms of the fetal membranes have been used to support the growth and function of other cells and tissues, including adipose-derived mesenchymal stem cells. This concise review explores the biological origin of the fetal membranes, a history of their use in medicine, and recent developments in the use of fetal membranes and their derived stem and stem-like cells in regenerative medicine. Stem Cells Translational Medicine 2017;6:1767-1776.
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Affiliation(s)
- Rebecca Lim
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, Victoria, Australia.,Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia
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10
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Kitala D, Klama-Baryła A, Misiuga M, Łabuś W, Kraut M, Szapski M, Lesiak M, Krakowian D, Sieroń AL, Łos MJ, Kucharzewski M. Heterogeneous Mixture of Amniotic Cells is Likely a Better Source of Stem Cells than Adipose Tissue. Arch Immunol Ther Exp (Warsz) 2019; 67:189-196. [PMID: 30989240 PMCID: PMC6509077 DOI: 10.1007/s00005-019-00538-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 03/14/2019] [Indexed: 01/22/2023]
Abstract
Stem cells are increasingly being used in the course of burn treatment. As several different types of stem cells are available for the purposes, it is important to chose the most efficient and the most practicable stem cell type. The aim of this study was to compare the potential of heterogeneous amnion cell mixture with the presently used standard therapy, the adipose tissue-derived stem cells. The placenta was collected during a Cesarean section procedure. Adipose tissue tissue-derived cells were isolated using the Cytori’s Celution® System. Cells were tested for fulfillment of the minimum criteria for stem cells. The efficiency of cell cultures was tested by an analysis of population doubling, cell proliferation, cell cycle and cell migration. Amniotic cells presented a higher ability for differentiation to chondrocytes and osteocytes than adipose-derived regenerative cells but a lower ability for differentiation toward adipocytes. Additionally, in vitro experiments have demonstrated a higher applicability of amniotic cells than adipose tissue-derived stem cells. Amniotic cells show several advantages: easy access to placenta, low costs and a lack of ethical dilemmas related to stem cell harvesting. The main disadvantage is, however, their availability, as isogenic treatment would only be possible for women around children-bearing age, unless personalized banks for amniotic cells would be established.
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Affiliation(s)
- Diana Kitala
- Stanislaw Sakiel, MD Center for Burn Treatment, Jana Pawła II 2, 41-100, Siemianowice Śląskie, Poland.,Higher School of a Strategic Planning, Dabrowa Gornicza, Poland.,Silesian Medical School in Katowice, Katowice, Poland
| | - Agnieszka Klama-Baryła
- Stanislaw Sakiel, MD Center for Burn Treatment, Jana Pawła II 2, 41-100, Siemianowice Śląskie, Poland. .,Silesian Medical School in Katowice, Katowice, Poland.
| | - Marcelina Misiuga
- Stanislaw Sakiel, MD Center for Burn Treatment, Jana Pawła II 2, 41-100, Siemianowice Śląskie, Poland
| | - Wojciech Łabuś
- Stanislaw Sakiel, MD Center for Burn Treatment, Jana Pawła II 2, 41-100, Siemianowice Śląskie, Poland.,Higher School of a Strategic Planning, Dabrowa Gornicza, Poland
| | - Małgorzata Kraut
- Stanislaw Sakiel, MD Center for Burn Treatment, Jana Pawła II 2, 41-100, Siemianowice Śląskie, Poland
| | - Michał Szapski
- Stanislaw Sakiel, MD Center for Burn Treatment, Jana Pawła II 2, 41-100, Siemianowice Śląskie, Poland
| | - Marta Lesiak
- Department of General, Molecular Biology and Genetics, Medical University of Silesia, Katowice, Poland
| | - Daniel Krakowian
- Department of General, Molecular Biology and Genetics, Medical University of Silesia, Katowice, Poland
| | - Aleksander L Sieroń
- Department of General, Molecular Biology and Genetics, Medical University of Silesia, Katowice, Poland
| | - Marek J Łos
- LinkoCare Life Sciences AB, Linköping, Sweden. .,Biotechnology Centre, Silesian University of Technology, Chrobrego 8, 44-100, Gliwice, Poland.
| | - Marek Kucharzewski
- Chair and Department of Descriptive and Topographic Anatomy, School of Medicine, Division of Dentistry in Zabrze, Medical University of Silesia, Zabrze Rokitnica, Poland
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Amniotic cells share clusters of differentiation of fibroblasts and keratinocytes, influencing their ability to proliferate and aid in wound healing while impairing their angiogenesis capability. Eur J Pharmacol 2019; 854:167-178. [PMID: 30826324 DOI: 10.1016/j.ejphar.2019.02.043] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 02/22/2019] [Accepted: 02/26/2019] [Indexed: 12/19/2022]
Abstract
An alternative to cultured skin cell grafts usage in burn treatment is the graft of allogenic stem cells. We verified whether amniotic stem cells are better than the present therapeutic standard: grafts of autologous keratinocytes and fibroblasts along with autologous adipose-derived stem cells, and whether amniotic stem cells can support the growth of autologous keratinocytes and fibroblasts in the culture. The study was performed on the material from 18 amnia. Skin cells were obtained from 3 patients. In order to assess the influence of stem cells on keratinocytes and fibroblasts, the following experiments were performed: impact on viability and cell cycle, wound healing capability, angiogenesis capability, influence on the proliferation speed and capability to differentiate into skin cells. We demonstrated that human amniotic membrane-derived mesenchymal stem cells (hAMMSCs) share amniotic proteins with skin cells. Amniotic stem cells may replace skin fibroblasts in grafts due to the close similarity in their surface antigens, with significantly larger proliferative potential and ability to stimulate wound healing. It was shown that adding amniotic cells to both keratinocytes and fibroblast cultures accelerates directional migration by ≥ 40%. We confirmed in this study the influence of amniotic cells on the proliferation and cell cycle of fibroblasts and keratinocytes. Amniotic stem cells can be successfully used not only as a first choice graft but also to replace 3T3 line cells, supporting the proliferation of the cells during the culturing, as well as a supplementary graft supporting an autologous graft of keratinocytes and fibroblasts.
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12
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Conese M, Beccia E, Carbone A, Castellani S, Di Gioia S, Corti F, Angiolillo A, Colombo C. The role of stem cells in cystic fibrosis disease modeling and drug discovery. Expert Opin Orphan Drugs 2018. [DOI: 10.1080/21678707.2018.1549480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Massimo Conese
- Laboratory of Experimental and Regenerative Medicine, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Elisa Beccia
- Laboratory of Experimental and Regenerative Medicine, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, Campobasso, Italy
| | - Annalucia Carbone
- Division of Internal Medicine and Chronobiology Unit, IRCCS “Casa Sollievo della Sofferenza”, San Giovanni Rotondo (FG), Italy
| | - Stefano Castellani
- Laboratory of Experimental and Regenerative Medicine, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Sante Di Gioia
- Laboratory of Experimental and Regenerative Medicine, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Fabiola Corti
- Department of Pathophysiology and Transplantation, Cystic Fibrosis Center, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Antonella Angiolillo
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, Campobasso, Italy
| | - Carla Colombo
- Department of Pathophysiology and Transplantation, Cystic Fibrosis Center, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
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13
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Matuz-Mares D, Hernández-Vázquez A, Riveros-Rosas H, Guinzberg R, Quesada-López T, Cárabez-Trejo A, Mora O, Piña E. β- Adrenoceptors activate hepatic glutathione efflux through an unreported pathway. Arch Biochem Biophys 2018; 644:47-56. [PMID: 29496543 DOI: 10.1016/j.abb.2018.02.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 02/24/2018] [Accepted: 02/24/2018] [Indexed: 12/15/2022]
Abstract
The physiological regulation of hepatic glutathione efflux by catecholamines is poorly understood. The purpose of this work was to review the role of adrenergic receptors (AR) on total glutathione (GT) efflux in rat liver. Two models were used: isolated hepatocytes and perfused livers. In hepatocytes 10 μM adrenaline (Adr), but not isoproterenol (Iso) a β-AR agonist, or phenylephrine (Phe) an α1-AR agonist, (in a Krebs-Henseleit buffer (KHB) enriched with Ca2+ and some aminoacids) increased in 13% GT efflux. In livers perfused with KHB, Adr or Iso at 1 μmolar doses (but not Phe) stimulated 11-fold initial velocity of GT release, but only during the first 2 min of perfusion. This immediate response progressively disappeared during the following 15 min of perfusion. A second phase of GT efflux, observed between 2 and 14 min of perfusion, mimics the one reported earlier in isolated hepatocytes. The ED50 for Adr and Iso activation are in the range of 320 nM and 10 nM, respectively. Iso-mediated GT release requires Ca2+ to work, and was prevented by H89, glibenclamide, cystic fibrosis transmembrane regulator (CFTR) antibodies, and a direct CFTR inhibitor. This short-lived GT release system is associated to PKA activation and probably operates through CFTR.
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Affiliation(s)
- Deyamira Matuz-Mares
- Departamento de Bioquímica, Facultad de Medicina, Universidad Nacional Autónoma de México. Cd. Universitaria, Coyoacán. México, Cd. Mx., 04510, Mexico.
| | - Alain Hernández-Vázquez
- Departamento de Bioquímica, Facultad de Medicina, Universidad Nacional Autónoma de México. Cd. Universitaria, Coyoacán. México, Cd. Mx., 04510, Mexico
| | - Héctor Riveros-Rosas
- Departamento de Bioquímica, Facultad de Medicina, Universidad Nacional Autónoma de México. Cd. Universitaria, Coyoacán. México, Cd. Mx., 04510, Mexico
| | - Raquel Guinzberg
- Departamento de Bioquímica, Facultad de Medicina, Universidad Nacional Autónoma de México. Cd. Universitaria, Coyoacán. México, Cd. Mx., 04510, Mexico
| | - Tania Quesada-López
- Laboratorio de Rumiología y Metabolismo Nutricional, Facultad de Estudios Superiores Cuautitlán, Universidad Nacional Autónoma de México, Blvd. B. Quintana 514-D, Col. Arboledas, 76140, Querétaro, Qro., Mexico
| | - Alfonso Cárabez-Trejo
- Instituto de Neurobiología, Universidad Nacional Autónoma de México, Querétaro, Qro., Mexico
| | - Ofelia Mora
- Laboratorio de Rumiología y Metabolismo Nutricional, Facultad de Estudios Superiores Cuautitlán, Universidad Nacional Autónoma de México, Blvd. B. Quintana 514-D, Col. Arboledas, 76140, Querétaro, Qro., Mexico
| | - Enrique Piña
- Departamento de Bioquímica, Facultad de Medicina, Universidad Nacional Autónoma de México. Cd. Universitaria, Coyoacán. México, Cd. Mx., 04510, Mexico.
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14
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Conese M, Beccia E, Castellani S, Di Gioia S, Colombo C, Angiolillo A, Carbone A. The long and winding road: stem cells for cystic fibrosis. Expert Opin Biol Ther 2017; 18:281-292. [PMID: 29216777 DOI: 10.1080/14712598.2018.1413087] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Cystic fibrosis (CF) is a genetic syndrome with a high mortality rate due to severe lung disease. Despite having several drugs targeting specific mutated CFTR proteins already in clinical trials, new therapies, based on stem cells, are also emerging to treat those patients. AREAS COVERED The authors review the main sources of stem cells, including embryonic stem cells (ESCs), induced-pluripotent stem cells (iPSCs), gestational stem cells, and adult stem cells, such as mesenchymal stem cells (MSCs) in the context of CF. Furthermore, they describe the main animal and human models of lung physiology and pathology, involved in the optimization of these stem cell-applied therapies in CF. EXPERT OPINION ESCs and iPSCs are emerging sources for disease modeling and drug discovery purposes. The allogeneic transplant of healthy MSCs, that acts independently to specific mutations, is under intense scrutiny due to their secretory, immunomodulatory, anti-inflammatory and anti-bacterial properties. The main challenge for future developments will be to get exogenous stem cells into the appropriate lung location, where they can regenerate endogenous stem cells and act as inflammatory modulators. The clinical application of stem cells for the treatment of CF certainly warrants further insight into pre-clinical models, including large animals, organoids, decellularized organs and lung bioengineering.
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Affiliation(s)
- Massimo Conese
- a Laboratory of Experimental and Regenerative Medicine, Department of Medical and Surgical Sciences , University of Foggia , Foggia , Italy
| | - Elisa Beccia
- a Laboratory of Experimental and Regenerative Medicine, Department of Medical and Surgical Sciences , University of Foggia , Foggia , Italy.,b Department of Medicine and Health Sciences 'V. Tiberio' , University of Molise , Campobasso , Italy
| | - Stefano Castellani
- a Laboratory of Experimental and Regenerative Medicine, Department of Medical and Surgical Sciences , University of Foggia , Foggia , Italy
| | - Sante Di Gioia
- a Laboratory of Experimental and Regenerative Medicine, Department of Medical and Surgical Sciences , University of Foggia , Foggia , Italy
| | - Carla Colombo
- c Cystic Fibrosis Center, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Department of Pathophysiology and Transplantation , University of Milan , Milan , Italy
| | - Antonella Angiolillo
- b Department of Medicine and Health Sciences 'V. Tiberio' , University of Molise , Campobasso , Italy
| | - Annalucia Carbone
- d Division of Internal Medicine and Chronobiology Unit , IRCCS 'Casa Sollievo della Sofferenza' , San Giovanni Rotondo (FG) , Italy
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15
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Kitala D, Kawecki M, Klama-Baryła A, Łabuś W, Glik J, Kraut M, Misiuga M, Nowak M. The Isolation and Production of the Ready-to-Use Product (the Amniotic Stem Cell Culture) in Accordance with Good Manufacturing Practice Regulations. Stem Cells Dev 2017; 26:694-707. [PMID: 28117628 DOI: 10.1089/scd.2016.0198] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
According to the Committee for Advanced Therapies, amniotic stem cells were classified as an advanced therapy medicinal product. This work aims to standardize the isolation of amniotic stem cells and the selection of the optimal time of transplantation and cell application methods in burn patients according to the guidelines of the Good Manufacturing Practice. The placenta used in the study was sourced during a Cesarean section. The remnants of the amnion preparation were placed in a sterile container and transferred to a class B environment, where the primary cultures began. The highest average number of cells was obtained by tissue homogenization and culture growth on the AmnioGrow medium. The isolation of the pure monoculture should be performed using the antibodies against CD105. On the basis of an analysis of population doubling, the aging of a population, the cells' viability, and the severity of injury, the cells should be used between passages 3 and 6. Significant differences were found in the number and viability of cells that were transferred as a full sheet, depending on the transfer method. To sum up, amniotic cells are a promising source in the treatment of burns and can be used as a hospital exemption.
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Affiliation(s)
- Diana Kitala
- 1 Dr. Stanislaw Sakiel Burn Treatment Centre , Siemianowice Śląskie, Poland
| | - Marek Kawecki
- 1 Dr. Stanislaw Sakiel Burn Treatment Centre , Siemianowice Śląskie, Poland .,2 Department of Emergency Medicine, School of Health Sciences, University in Bielsko-Biała , Bielsko-Biała, Poland
| | | | - Wojciech Łabuś
- 1 Dr. Stanislaw Sakiel Burn Treatment Centre , Siemianowice Śląskie, Poland
| | - Justyna Glik
- 1 Dr. Stanislaw Sakiel Burn Treatment Centre , Siemianowice Śląskie, Poland .,3 Department of Chronic Wounds Management Organization, School of Health Sciences, Medical University of Silesia , Siemianowice Śląskie, Poland
| | - Małgorzata Kraut
- 1 Dr. Stanislaw Sakiel Burn Treatment Centre , Siemianowice Śląskie, Poland
| | - Marcelina Misiuga
- 1 Dr. Stanislaw Sakiel Burn Treatment Centre , Siemianowice Śląskie, Poland
| | - Mariusz Nowak
- 1 Dr. Stanislaw Sakiel Burn Treatment Centre , Siemianowice Śląskie, Poland
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16
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Duchesneau P, Besla R, Derouet MF, Guo L, Karoubi G, Silberberg A, Wong AP, Waddell TK. Partial Restoration of CFTR Function in cftr-Null Mice following Targeted Cell Replacement Therapy. Mol Ther 2017; 25:654-665. [PMID: 28187947 DOI: 10.1016/j.ymthe.2016.11.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 11/10/2016] [Accepted: 11/27/2016] [Indexed: 01/22/2023] Open
Abstract
Cystic fibrosis (CF) is a fatal recessive genetic disorder caused by a mutation in the gene encoding CF transmembrane conductance regulator (CFTR) protein. Alteration in CFTR leads to thick airway mucus and bacterial infection. Cell therapy has been proposed for CFTR restoration, but efficacy has been limited by low engraftment levels. In our previous studies, we have shown that using a pre-conditioning regimen in combination with optimization of cell number and time of delivery, we could obtain greater bone marrow cell (BMC) retention in the lung. Here, we found that optimized delivery of wild-type (WT) BMC contributed to apical CFTR expression in airway epithelium and restoration of select ceramide species and fatty acids in CFTR-/- mice. Importantly, WT BMC delivery delayed Pseudomonas aeruginosa lung infection and increased survival of CFTR-/- recipients. Only WT BMCs had a beneficial effect beyond 6 months, suggesting a dual mechanism of BMC benefit: a non-specific effect early after cell delivery, possibly due to the recruitment of macrophages and neutrophils, and a late beneficial effect dependent on long-term CFTR expression. Taken together, our results suggest that BMC can improve overall lung function and may have potential therapeutic benefit for the treatment of CF.
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Affiliation(s)
- Pascal Duchesneau
- Latner Thoracic Surgery Research Laboratories and McEwen Centre for Regenerative Medicine, Toronto General Hospital Research Institute, University of Toronto, Toronto, ON M5G 2C4, Canada
| | - Rickvinder Besla
- Latner Thoracic Surgery Research Laboratories and McEwen Centre for Regenerative Medicine, Toronto General Hospital Research Institute, University of Toronto, Toronto, ON M5G 2C4, Canada
| | - Mathieu F Derouet
- Latner Thoracic Surgery Research Laboratories and McEwen Centre for Regenerative Medicine, Toronto General Hospital Research Institute, University of Toronto, Toronto, ON M5G 2C4, Canada
| | - Li Guo
- Latner Thoracic Surgery Research Laboratories and McEwen Centre for Regenerative Medicine, Toronto General Hospital Research Institute, University of Toronto, Toronto, ON M5G 2C4, Canada
| | - Golnaz Karoubi
- Latner Thoracic Surgery Research Laboratories and McEwen Centre for Regenerative Medicine, Toronto General Hospital Research Institute, University of Toronto, Toronto, ON M5G 2C4, Canada
| | - Amanda Silberberg
- Latner Thoracic Surgery Research Laboratories and McEwen Centre for Regenerative Medicine, Toronto General Hospital Research Institute, University of Toronto, Toronto, ON M5G 2C4, Canada
| | - Amy P Wong
- Program in Developmental and Stem Cell Biology, Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Thomas K Waddell
- Latner Thoracic Surgery Research Laboratories and McEwen Centre for Regenerative Medicine, Toronto General Hospital Research Institute, University of Toronto, Toronto, ON M5G 2C4, Canada.
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17
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Kim SY, Burgess JK, Wang Y, Kable EP, Weiss DJ, Chan HK, Chrzanowski W. Atomized Human Amniotic Mesenchymal Stromal Cells for Direct Delivery to the Airway for Treatment of Lung Injury. J Aerosol Med Pulm Drug Deliv 2016; 29:514-524. [DOI: 10.1089/jamp.2016.1289] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Sally Yunsun Kim
- Faculty of Pharmacy, The University of Sydney, Sydney, Australia
| | - Janette K. Burgess
- Department Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Respiratory Cellular and Molecular Biology, Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia
- Discipline of Pharmacology, The University of Sydney, Sydney, Australia
| | - Yiwei Wang
- ANZAC Research Institute, The University of Sydney, Concord, Australia
| | - Eleanor P.W. Kable
- Australian Centre for Microscopy & Microanalysis, The University of Sydney, Sydney, Australia
| | - Daniel J. Weiss
- College of Medicine, University of Vermont College of Medicine, Burlington, Vermont
| | - Hak-Kim Chan
- Faculty of Pharmacy, The University of Sydney, Sydney, Australia
| | - Wojciech Chrzanowski
- Faculty of Pharmacy, The University of Sydney, Sydney, Australia
- Australian Institute of Nanoscale Science and Technology, The University of Sydney, Sydney, NSW 2006, Australia
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18
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Bajek A, Olkowska J, Walentowicz-Sadłecka M, Walentowicz P, Sadłecki P, Grabiec M, Bodnar M, Marszałek A, Dębski R, Porowińska D, Czarnecka J, Kaźmierski Ł, Drewa T. High Quality Independent From a Donor: Human Amniotic Fluid Derived Stem Cells-A Practical Analysis Based on 165 Clinical Cases. J Cell Biochem 2016; 118:116-126. [DOI: 10.1002/jcb.25618] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 06/03/2016] [Indexed: 12/30/2022]
Affiliation(s)
- Anna Bajek
- Department of Tissue Engineering; Nicolaus Copernicus University; Bydgoszcz 85-092 Poland
| | - Joanna Olkowska
- Department of Tissue Engineering; Nicolaus Copernicus University; Bydgoszcz 85-092 Poland
| | | | - Paweł Walentowicz
- Department of Obstetrics and Gynecology; Nicolaus Copernicus University; Bydgoszcz 85-168 Poland
| | - Paweł Sadłecki
- Department of Obstetrics and Gynecology; Nicolaus Copernicus University; Bydgoszcz 85-168 Poland
| | - Marek Grabiec
- Department of Obstetrics and Gynecology; Nicolaus Copernicus University; Bydgoszcz 85-168 Poland
| | - Magdalena Bodnar
- Department of Clinical Pathomorphology; Nicolaus Copernicus University; Bydgoszcz 85-094 Poland
| | - Andrzej Marszałek
- Department of Clinical Pathomorphology; Nicolaus Copernicus University; Bydgoszcz 85-094 Poland
| | - Robert Dębski
- Department of Experimental Oncology; Nicolaus Copernicus University; Bydgoszcz 85-094 Poland
| | - Dorota Porowińska
- Department of Biochemistry; Nicolaus Copernicus University; Toruń 87-100 Poland
| | - Joanna Czarnecka
- Department of Biochemistry; Nicolaus Copernicus University; Toruń 87-100 Poland
| | - Łukasz Kaźmierski
- Department of Tissue Engineering; Nicolaus Copernicus University; Bydgoszcz 85-092 Poland
| | - Tomasz Drewa
- Department of Tissue Engineering; Nicolaus Copernicus University; Bydgoszcz 85-092 Poland
- Department of Urology; Nicolaus Copernicus Hospital; Toruń 87-100 Poland
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19
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Mamede AC, Guerra S, Laranjo M, Carvalho MJ, Oliveira RC, Gonçalves AC, Alves R, Prado Castro L, Sarmento-Ribeiro AB, Moura P, Abrantes AM, Maia CJ, Botelho MF. Selective cytotoxicity and cell death induced by human amniotic membrane in hepatocellular carcinoma. Med Oncol 2015; 32:257. [PMID: 26507652 DOI: 10.1007/s12032-015-0702-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 10/12/2015] [Indexed: 12/20/2022]
Abstract
Hepatocellular carcinoma (HCC) has a worldwide high incidence and mortality. For this reason, it is essential to invest in new therapies for this type of cancer. Our team already proved that human amniotic membrane (hAM) is able to inhibit the metabolic activity of several human cancer cell lines, including HCC cell lines. Taking into account the previously performed work, this experimental study aimed to investigate the pathways by which hAM protein extracts (hAMPEs) act on HCC. Our results showed that hAMPE reduce the metabolic activity, protein content and DNA content in a dose- and time-dependent manner in all HCC cell lines. This therapy presents selective cytotoxicity, since it was not able to inhibit a non-tumorigenic human cell line. In addition, hAMPE induced cell morphology alterations in all HCC cell lines, but death type is cell line dependent, as proved by in vitro and in vivo studies. In conclusion, hAMPE have a promising role in HCC therapy, since it is capable of inducing HCC cytotoxicity and cell death.
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Affiliation(s)
- A C Mamede
- Biophysics Unit, Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba - Celas, 3000-548, Coimbra, Portugal. .,CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal. .,CIMAGO, Faculty of Medicine, University of Coimbra, Coimbra, Portugal. .,CNC.IBILI, University of Coimbra, Coimbra, Portugal.
| | - S Guerra
- Biophysics Unit, Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba - Celas, 3000-548, Coimbra, Portugal.
| | - M Laranjo
- Biophysics Unit, Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba - Celas, 3000-548, Coimbra, Portugal.,CIMAGO, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal
| | - M J Carvalho
- Biophysics Unit, Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba - Celas, 3000-548, Coimbra, Portugal.,CIMAGO, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal.,Obstetrics Service, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - R C Oliveira
- Biophysics Unit, Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba - Celas, 3000-548, Coimbra, Portugal.,Anatomic Pathology Service, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - A C Gonçalves
- CIMAGO, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal.,Applied Molecular Biology and Hematology Group, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - R Alves
- CNC.IBILI, University of Coimbra, Coimbra, Portugal.,Applied Molecular Biology and Hematology Group, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - L Prado Castro
- Anatomic Pathology Service, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - A B Sarmento-Ribeiro
- CIMAGO, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal.,Applied Molecular Biology and Hematology Group, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - P Moura
- Obstetrics Service, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - A M Abrantes
- Biophysics Unit, Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba - Celas, 3000-548, Coimbra, Portugal.,CIMAGO, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal
| | - C J Maia
- CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - M F Botelho
- Biophysics Unit, Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba - Celas, 3000-548, Coimbra, Portugal.,CIMAGO, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal
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20
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Hu C, Li L. In vitro culture of isolated primary hepatocytes and stem cell-derived hepatocyte-like cells for liver regeneration. Protein Cell 2015; 6:562-74. [PMID: 26088193 PMCID: PMC4506286 DOI: 10.1007/s13238-015-0180-2] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 05/25/2015] [Indexed: 02/07/2023] Open
Abstract
Various liver diseases result in terminal hepatic failure, and liver transplantation, cell transplantation and artificial liver support systems are emerging as effective therapies for severe hepatic disease. However, all of these treatments are limited by organ or cell resources, so developing a sufficient number of functional hepatocytes for liver regeneration is a priority. Liver regeneration is a complex process regulated by growth factors (GFs), cytokines, transcription factors (TFs), hormones, oxidative stress products, metabolic networks, and microRNA. It is well-known that the function of isolated primary hepatocytes is hard to maintain; when cultured in vitro, these cells readily undergo dedifferentiation, causing them to lose hepatocyte function. For this reason, most studies focus on inducing stem cells, such as embryonic stem cells (ESCs), induced pluripotent stem cells (iPSCs), hepatic progenitor cells (HPCs), and mesenchymal stem cells (MSCs), to differentiate into hepatocyte-like cells (HLCs) in vitro. In this review, we mainly focus on the nature of the liver regeneration process and discuss how to maintain and enhance in vitro hepatic function of isolated primary hepatocytes or stem cell-derived HLCs for liver regeneration. In this way, hepatocytes or HLCs may be applied for clinical use for the treatment of terminal liver diseases and may prolong the survival time of patients in the near future.
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Affiliation(s)
- Chenxia Hu
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, School of Medicine, First Affiliated Hospital, Zhejiang University, Hangzhou, 310006, China
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21
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Syva SH, Ampon K, Lasimbang H, Fatimah SS. Microenvironmental factors involved in human amnion mesenchymal stem cells fate decisions. J Tissue Eng Regen Med 2015; 11:311-320. [PMID: 26073746 DOI: 10.1002/term.2043] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Revised: 04/12/2015] [Accepted: 04/29/2015] [Indexed: 12/28/2022]
Abstract
Human amnion mesenchymal stem cells (HAMCs) show great differentiation and proliferation potential and also other remarkable features that could serve as an outstanding alternative source of stem cells in regenerative medicine. Recent reports have demonstrated various kinds of effective artificial niche that mimic the microenvironment of different types of stem cell to maintain and control their fate and function. The components of the stem cell microenvironment consist mainly of soluble and insoluble factors responsible for regulating stem cell differentiation and self-renewal. Extensive studies have been made on regulating HAMCs differentiation into specific phenotypes; however, the understanding of relevant factors in directing stem cell fate decisions in HAMCs remain underexplored. In this review, we have therefore identified soluble and insoluble factors, including mechanical stimuli and cues from the other supporting cells that are involved in directing HAMCs fate decisions. In order to strengthen the significance of understanding on the relevant factors involved in stem cell fate decisions, recent technologies developed to specifically mimic the microenvironments of specific cell lineages are also reviewed. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
| | - Kamaruzaman Ampon
- Biotechnology Research Institute, Universiti Malaysia Sabah, Malaysia
| | - Helen Lasimbang
- Faculty of Medicine and Health Science, Universiti Malaysia Sabah, Malaysia
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22
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Chopra R, Paul L, Manickam R, Aronow WS, Maguire GP. Efficacy and adverse effects of drugs used to treat adult cystic fibrosis. Expert Opin Drug Saf 2015; 14:401-11. [PMID: 25604518 DOI: 10.1517/14740338.2015.994503] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Cystic fibrosis (CF) is an autosomal recessive disease and is the most commonly seen monogenetic disease in Caucasians. The disease has various manifestations resulting from the abnormal thick secretions, most common being chronic lung infection and airway obstruction. Many new promising drugs have appeared on the horizon over the years. This review here is an attempt to bring together the various treatments being used to prolong and enhance the quality of life of CF patients. AREAS COVERED A literature review of published as well as ongoing clinical trials, meta-analysis and systematic reviews regarding the drugs used in CF management was carried out using PubMed and Ovid databases. EXPERT OPINION New concepts have been formed and some positive results in this direction have already led to the approval of cystic fibrosis transmembrane conductance regulator potentiator drug. Gene therapy and stem cell therapy are under development. The current therapies such as dornase alfa and pancreatic enzymes targeting the symptoms continue to evolve as they play an important complementary role. Development of new simple and cost-effective markers, which help assess the efficacy and safety of these constantly emerging new drugs, is also being investigated.
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Affiliation(s)
- Ravi Chopra
- New York Medical College/Westchester Medical Center, Division of Pulmonary, Critical Care and Sleep Medicine , 100 Woods Road, Valhalla, NY 10595 , USA +1 914 493 7518 ; +1 914 493 8130 ;
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23
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Stem cells, cell therapies, and bioengineering in lung biology and diseases. Comprehensive review of the recent literature 2010-2012. Ann Am Thorac Soc 2014; 10:S45-97. [PMID: 23869446 DOI: 10.1513/annalsats.201304-090aw] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
A conference, "Stem Cells and Cell Therapies in Lung Biology and Lung Diseases," was held July 25 to 28, 2011 at the University of Vermont to review the current understanding of the role of stem and progenitor cells in lung repair after injury and to review the current status of cell therapy and ex vivo bioengineering approaches for lung diseases. These are rapidly expanding areas of study that provide further insight into and challenge traditional views of mechanisms of lung repair after injury and pathogenesis of several lung diseases. The goals of the conference were to summarize the current state of the field, to discuss and debate current controversies, and to identify future research directions and opportunities for basic and translational research in cell-based therapies for lung diseases. The goal of this article, which accompanies the formal conference report, is to provide a comprehensive review of the published literature in lung regenerative medicine from the last conference report through December 2012.
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24
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Carbone A, Castellani S, Favia M, Diana A, Paracchini V, Di Gioia S, Seia M, Casavola V, Colombo C, Conese M. Correction of defective CFTR/ENaC function and tightness of cystic fibrosis airway epithelium by amniotic mesenchymal stromal (stem) cells. J Cell Mol Med 2014; 18:1631-43. [PMID: 24894806 PMCID: PMC4190909 DOI: 10.1111/jcmm.12303] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Accepted: 03/24/2014] [Indexed: 12/16/2022] Open
Abstract
Cystic fibrosis (CF) is caused by mutations in the CF transmembrane conductance regulator (CFTR) gene, with most of the mortality given by the lung disease. Human amniotic mesenchymal stromal (stem) cells (hAMSCs) hold great promise for regenerative medicine in the field of lung disease; however, their potential as therapeutics for CF lung disease has not been fully explored. In the present study, hAMSCs were analysed in co-cultures on Transwell filters with CF immortalized airway epithelial cells (CFBE41o- line) at different ratios to exploit their potency to resume basic defects associated with CF. The results show that F-actin content was increased in co-cultures as compared with CF cells and actin was reorganized to form stress fibres. Confocal microscopy studies revealed that co-cultures had a tendency of increased expression of occludin and ZO-1 at the intercellular borders, paralleled by a decrease in dextran permeability, suggestive of more organized tight junctions (TJs). Spectrofluorometric analysis of CFTR function demonstrated that hAMSC-CFBE co-cultures resumed chloride transport, in line with the appearance of the mature Band C of CFTR protein by Western blotting. Moreover, hAMSC-CFBE co-cultures, at a 1:5 ratio, showed a decrease in fluid absorption, as opposed to CFBE cell monolayers that displayed a great rate of fluid resorption from the apical side. Our data show that human amniotic MSCs can be used in co-culture with CF respiratory epithelial cells to model their engraftment into the airways and have the potential to resume a tight epithelium with partial correction of the CF phenotype.
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Affiliation(s)
- Annalucia Carbone
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Medical Genetics Laboratory, Milan, Italy; Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
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25
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Duarte IGL, Duval-Araujo I. Amniotic membrane as a biological dressing in infected wound healing in rabbits. Acta Cir Bras 2014; 29:334-9. [DOI: 10.1590/s0102-86502014000500008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Accepted: 03/19/2014] [Indexed: 02/05/2023] Open
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26
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Sha X, Wen Y, Liu Z, Song L, Peng J, Xie L. Inhibition of α-Smooth Muscle Actin Expression and Migration of Pterygium Fibroblasts by Coculture with Amniotic Mesenchymal Stem Cells. Curr Eye Res 2014; 39:1081-9. [DOI: 10.3109/02713683.2014.900806] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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27
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Paschos NK, Brown WE, Eswaramoorthy R, Hu JC, Athanasiou KA. Advances in tissue engineering through stem cell-based co-culture. J Tissue Eng Regen Med 2014; 9:488-503. [PMID: 24493315 DOI: 10.1002/term.1870] [Citation(s) in RCA: 128] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Revised: 12/19/2013] [Accepted: 01/03/2014] [Indexed: 12/13/2022]
Abstract
Stem cells are the future in tissue engineering and regeneration. In a co-culture, stem cells not only provide a target cell source with multipotent differentiation capacity, but can also act as assisting cells that promote tissue homeostasis, metabolism, growth and repair. Their incorporation into co-culture systems seems to be important in the creation of complex tissues or organs. In this review, critical aspects of stem cell use in co-culture systems are discussed. Direct and indirect co-culture methodologies used in tissue engineering are described, along with various characteristics of cellular interactions in these systems. Direct cell-cell contact, cell-extracellular matrix interaction and signalling via soluble factors are presented. The advantages of stem cell co-culture strategies and their applications in tissue engineering and regenerative medicine are portrayed through specific examples for several tissues, including orthopaedic soft tissues, bone, heart, vasculature, lung, kidney, liver and nerve. A concise review of the progress and the lessons learned are provided, with a focus on recent developments and their implications. It is hoped that knowledge developed from one tissue can be translated to other tissues. Finally, we address challenges in tissue engineering and regenerative medicine that can potentially be overcome via employing strategies for stem cell co-culture use.
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Affiliation(s)
- Nikolaos K Paschos
- Department of Biomedical Engineering and Orthopedic Surgery, University of California at Davis, CA, 95616, USA
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The Potential of Wharton’s Jelly Derived Mesenchymal Stem Cells in Treating Patients with Cystic Fibrosis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2014; 833:23-9. [DOI: 10.1007/5584_2014_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Miki T, Grubbs B. Therapeutic potential of placenta-derived stem cells for liver diseases: current status and perspectives. J Obstet Gynaecol Res 2013; 40:360-8. [PMID: 24245961 DOI: 10.1111/jog.12213] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Accepted: 06/17/2013] [Indexed: 12/15/2022]
Abstract
Over the last decade, there has been a growing interest in the human placenta as a unique source of stem cells. The placenta is a fetal organ that is normally discarded following delivery. Therefore, it is readily available as a source of cells without the ethical concerns normally associated with embryonic stem cells. These cells also carry less risk for age- and environmental-related DNA damage. In addition to these practical advantages of placenta-derived cells, amniotic epithelial cells possess unique stem cell-like biological characteristics. In contrast to other parts of the placenta, cells from the amniotic epithelium are derived from pluripotent epiblasts and possess the ability to differentiate into all three germ layers. From a translational perspective, amnion-derived stem cells are very attractive candidates for clinical application. These cells are genetically stable and do not demonstrate tumorigenicity upon transplantation, and may be endowed with immunomodulatory and/or anti-inflammatory properties. These unique characteristics have made amniotic epithelial cells attractive for use as stem cell-based therapies for liver disease. Human and rodent amniotic epithelial cells have already demonstrated their therapeutic efficacy in multiple animal models. Although the detailed mechanism by which the transplanted cells generate a therapeutic effect is not yet totally understood, these dramatic results have generated significant interest for consideration of these amnion-derived stem cells for clinical applications. This review covers recent findings of the therapeutic potential of amnion-derived stem cells for liver diseases, and provides perspectives for future developments.
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Affiliation(s)
- Toshio Miki
- Department of Biochemistry and Molecular Biology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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Francisco JC, Cunha RC, Simeoni RB, Guarita-Souza LC, Ferreira RJ, Irioda AC, Souza CMCO, Srikanth GVN, Nityanand S, Chachques JC, de Carvalho KAT. Amniotic membrane as a potent source of stem cells and a matrix for engineering heart tissue. ACTA ACUST UNITED AC 2013. [DOI: 10.4236/jbise.2013.612147] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Lindenmair A, Hatlapatka T, Kollwig G, Hennerbichler S, Gabriel C, Wolbank S, Redl H, Kasper C. Mesenchymal stem or stromal cells from amnion and umbilical cord tissue and their potential for clinical applications. Cells 2012; 1:1061-88. [PMID: 24710543 PMCID: PMC3901122 DOI: 10.3390/cells1041061] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Revised: 10/29/2012] [Accepted: 11/05/2012] [Indexed: 01/08/2023] Open
Abstract
Mesenchymal stem or stromal cells (MSC) have proven to offer great promise for cell-based therapies and tissue engineering applications, as these cells are capable of extensive self-renewal and display a multilineage differentiation potential. Furthermore, MSC were shown to exhibit immunomodulatory properties and display supportive functions through parakrine effects. Besides bone marrow (BM), still today the most common source of MSC, these cells were found to be present in a variety of postnatal and extraembryonic tissues and organs as well as in a large variety of fetal tissues. Over the last decade, the human umbilical cord and human amnion have been found to be a rich and valuable source of MSC that is bio-equivalent to BM-MSC. Since these tissues are discarded after birth, the cells are easily accessible without ethical concerns.
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Affiliation(s)
- Andrea Lindenmair
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Vienna/Linz 1200, Austria.
| | - Tim Hatlapatka
- Department of Biotechnology, University of Natural Resources and Life Sciences, Vienna 1190, Austria.
| | - Gregor Kollwig
- Department of Biotechnology, University of Natural Resources and Life Sciences, Vienna 1190, Austria.
| | | | | | - Susanne Wolbank
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Vienna/Linz 1200, Austria.
| | - Heinz Redl
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Vienna/Linz 1200, Austria.
| | - Cornelia Kasper
- Department of Biotechnology, University of Natural Resources and Life Sciences, Vienna 1190, Austria.
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Human amnion epithelial cells induced to express functional cystic fibrosis transmembrane conductance regulator. PLoS One 2012; 7:e46533. [PMID: 23029546 PMCID: PMC3460882 DOI: 10.1371/journal.pone.0046533] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Accepted: 09/05/2012] [Indexed: 11/19/2022] Open
Abstract
Cystic fibrosis, an autosomal recessive disorder caused by a mutation in a gene encoding the cystic fibrosis transmembrane conductance regulator (CFTR), remains a leading cause of childhood respiratory morbidity and mortality. The respiratory consequences of cystic fibrosis include the generation of thick, tenacious mucus that impairs lung clearance, predisposing the individual to repeated and persistent infections, progressive lung damage and shortened lifespan. Currently there is no cure for cystic fibrosis. With this in mind, we investigated the ability of human amnion epithelial cells (hAECs) to express functional CFTR. We found that hAECs formed 3-dimensional structures and expressed the CFTR gene and protein after culture in Small Airway Growth Medium (SAGM). We also observed a polarized CFTR distribution on the membrane of hAECs cultured in SAGM, similar to that observed in polarized airway cells in vivo. Further, hAECs induced to express CFTR possessed functional iodide/chloride (I−/Cl−) ion channels that were inhibited by the CFTR-inhibitor CFTR-172, indicating the presence of functional CFTR ion channels. These data suggest that hAECs may be a promising source for the development of a cellular therapy for cystic fibrosis.
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Molinski S, Eckford PDW, Pasyk S, Ahmadi S, Chin S, Bear CE. Functional Rescue of F508del-CFTR Using Small Molecule Correctors. Front Pharmacol 2012; 3:160. [PMID: 23055971 PMCID: PMC3458236 DOI: 10.3389/fphar.2012.00160] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Accepted: 08/17/2012] [Indexed: 01/21/2023] Open
Abstract
High-throughput screens for small molecules that are effective in “correcting” the functional expression of F508del-CFTR have yielded several promising hits. Two such compounds are currently in clinical trial. Despite this success, it is clear that further advances will be required in order to restore 50% or greater of wild-type CFTR function to the airways of patients harboring the F508del-CFTR protein. Progress will be enhanced by our better understanding of the molecular and cellular defects caused by the F508del mutation, present in 90% of CF patients. The goal of this chapter is to review the current understanding of defects caused by F508del in the CFTR protein and in CFTR-mediated interactions important for its biosynthesis, trafficking, channel function, and stability at the cell surface. Finally, we will discuss the gaps in our knowledge regarding the mechanism of action of existing correctors, the unmet need to discover compounds which restore proper CFTR structure and function in CF affected tissues and new strategies for therapy development.
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Affiliation(s)
- Steven Molinski
- Programme in Molecular Structure and Function, Research Institute, Hospital for Sick Children Toronto, ON, Canada ; Department of Biochemistry, University of Toronto Toronto, ON, Canada
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Kang NH, Hwang KA, Kim SU, Kim YB, Hyun SH, Jeung EB, Choi KC. Potential antitumor therapeutic strategies of human amniotic membrane and amniotic fluid-derived stem cells. Cancer Gene Ther 2012; 19:517-22. [PMID: 22653384 DOI: 10.1038/cgt.2012.30] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
As stem cells are capable of self-renewal and can generate differentiated progenies for organ development, they are considered as potential source for regenerative medicine and tissue replacement after injury or disease. Along with this capacity, stem cells have the therapeutic potential for treating human diseases including cancers. According to the origins, stem cells are broadly classified into two types: embryonic stem cells (ESCs) and adult stem cells. In terms of differentiation potential, ESCs are pluripotent and adult stem cells are multipotent. Amnion, which is a membranous sac that contains the fetus and amniotic fluid and functions in protecting the developing embryo during gestation, is another stem cell source. Amnion-derived stem cells are classified as human amniotic membrane-derived epithelial stem cells, human amniotic membrane-derived mesenchymal stem cells and human amniotic fluid-derived stem cells. They are in an intermediate stage between pluripotent ESCs and lineage-restricted adult stem cells, non-tumorigenic, and contribute to low immunogenicity and anti-inflammation. Furthermore, they are easily available and do not cause any controversial issues in their recovery and applications. Not only are amnion-derived stem cells applicable in regenerative medicine, they have anticancer capacity. In non-engineered stem cells transplantation strategies, amnion-derived stem cells effectively target the tumor and suppressed the tumor growth by expressing cytotoxic cytokines. Additionally, they also have a potential as novel delivery vehicles transferring therapeutic genes to the cancer formation sites in gene-directed enzyme/prodrug combination therapy. Owing to their own advantageous properties, amnion-derived stem cells are emerging as a new candidate in anticancer therapy.
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Affiliation(s)
- N-H Kang
- Laboratory of Veterinary Biochemistry and Immunology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
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Burns JS, Safwat A, Grisendi G, Kassem M, Dominici M. Sarcomas as a mise en abyme of mesenchymal stem cells: exploiting interrelationships for cell mediated anticancer therapy. Cancer Lett 2012; 325:1-10. [PMID: 22659735 DOI: 10.1016/j.canlet.2012.05.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Revised: 05/22/2012] [Accepted: 05/24/2012] [Indexed: 12/24/2022]
Abstract
Mise en abyme meaning "placed into abyss or infinite recurrence" is an apt paradigm for the relentless growth of sarcoma cells. Its alternative meaning, "self-reflexive embedding" fits the central role attributed to cancer stem cells (CSCs). Diversely sourced and defined, mesenchymal stem cells (MSCs) may be the cells of sarcoma origin, evolve a CSC phenotype and/or contribute to tumor growth through inherent qualities for homing, neovascularization, paracrine cross-feeding, microvesicle secretion, cell fusion, entosis and immune modulation. Exploiting these qualities, MSC expressing modified forms of the TNF-related apoptosis-inducing ligand (Apo2L/TRAIL) are being developed to complement more conventional radiation and chemotherapy.
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Affiliation(s)
- Jorge S Burns
- Laboratory of Cell Biology and Advanced Cancer Therapies, Department of Oncology, Hematology and Respiratory Disease, University Hospital of Modena and Reggio Emilia, Modena, Italy.
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