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Lightner AL, Irving PM, Lord GM, Betancourt A. Stem Cells and Stem Cell-Derived Factors for the Treatment of Inflammatory Bowel Disease with a Particular Focus on Perianal Fistulizing Disease: A Minireview on Future Perspectives. BioDrugs 2024; 38:527-539. [PMID: 38914783 PMCID: PMC11247053 DOI: 10.1007/s40259-024-00661-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2024] [Indexed: 06/26/2024]
Abstract
Inflammatory bowel disease remains a difficult disease to effectively treat, especially fistulizing Crohn's disease. Perianal fistulas in the setting of Crohn's disease remain an area of unmet need with significant morbidity in this patient population. Up to one third of Crohn's patients will have perianal fistulizing disease and current medical and surgical interventions are of limited efficacy. Thus, most patients experience significant morbidity, narcotic use, and loss of employment and end up with multiple surgical interventions. Mesenchymal stem cells (MSCs) have shown efficacy in phase 3 clinical trials, but considerable infrastructure challenges make MSCs limited with regard to scalability in clinical practice. Extracellular vesicles, being derived from MSCs and capturing the secretome functionality of MSCs, offer similar physiological utility regarding mechanism, while also providing an off the shelf regenerative medicine product that could be widely used in daily clinical practice.
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Affiliation(s)
- Amy L Lightner
- Surgery, Scripps Clinic, 10667 N Torrey Pines Rd, La Jolla, CA, 92037, USA.
- Molecular Medicine, Scripps Research Institute, La Jolla, USA.
| | - Peter M Irving
- Guy's and St Thomas' Hospital, London, UK
- King's College London, London, UK
| | | | - Aline Betancourt
- Vitabolus Inc, San Diego, CA, USA
- Medicine, Tulane University School of Medicine, New Orleans, LA, USA
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2
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Yu YQ, Wang H. Imbalance of Th1 and Th2 Cytokines and Stem Cell Therapy in Pathological Pain. CNS & NEUROLOGICAL DISORDERS DRUG TARGETS 2024; 23:88-101. [PMID: 36573059 DOI: 10.2174/1871527322666221226145828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 11/05/2022] [Accepted: 11/12/2022] [Indexed: 12/28/2022]
Abstract
The pathophysiological importance of T helper 1 (Th1) and Th2 cell cytokines in pathological pain has been highly debated in recent decades. However, the analgesic strategy targeting individual cytokines still has a long way to go for clinical application. In this review, we focus on the contributions of Th1 cytokines (TNF-α, IFN-γ, and IL-2) and Th2 cytokines (IL-4, IL-5, IL-10, and IL-13) in rodent pain models and human pain-related diseases. A large number of studies have shown that Th1 and Th2 cytokines have opposing effects on pain modulation. The imbalance of Th1 and Th2 cytokines might determine the final effect of pain generation or inhibition. However, increasing evidence indicates that targeting the individual cytokine is not sufficient for the treatment of pathological pain. It is practical to suggest a promising therapeutic strategy against the combined effects of Th1 and Th2 cytokines. We summarize the current advances in stem cell therapy for pain-related diseases. Preclinical and clinical studies show that stem cells inhibit proinflammatory cytokines and release enormous Th2 cytokines that exhibit a strong analgesic effect. Therefore, a shift of the imbalance of Th1 and Th2 cytokines induced by stem cells will provide a novel therapeutic strategy against intractable pain. It is extremely important to reveal the cellular and molecular mechanisms of stem cell-mediated analgesia. The efficiency and safety of stem cell therapy should be carefully evaluated in animal models and patients with pathological pain.
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Affiliation(s)
- Yao-Qing Yu
- Institute for Biomedical Sciences of Pain, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China
| | - Huan Wang
- Department of Dermatology, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China
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de Góes HAN, Sarafan M, do Amaral JB, dos Anjos Almeida J, Voegels RL, de la Cruz LT, Thamboo A, Gomes LF, Pezato R. Differential Angiogenic Induction Impacts Nasal Polyp Tissue Growth. Indian J Otolaryngol Head Neck Surg 2023; 75:893-900. [PMID: 37206760 PMCID: PMC10188751 DOI: 10.1007/s12070-023-03469-y] [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: 10/24/2022] [Accepted: 01/02/2023] [Indexed: 01/22/2023] Open
Abstract
In chronic rhinosinusitis with nasal polyps, inflammatory edema drives tissue remodeling favoring anomalous growth of the nasal mucosa, but a proangiogenic contribution of nasal polyp in support of tissue growth is still controversial. The chorioallantoic membrane of chicken embryo model was employed to address the potentiality of nasal tissue fragments to modulate angiogenesis. Fifty-seven fertilized eggs were implanted with polyp or healthy nasal mucosa tissue or were kept as non-implanted controls. The embryos' size, length, and development stage, and chorioallantoic membrane vasculature morphology were evaluated after 48 h. Quantitative computer vision techniques applied to digital chorioallantoic membrane images automatically calculated the branching index as the ratio between the areas of the convex polygon surrounding the vascular tree and the vessels' area. Ethics approval and consent to participate: the study was approved by the Human Research Ethics Committee of the Federal University of São Paulo (CAAE number: 80763117.1.0000.5505) and by the Animal Research Ethics Committee of University of São Paulo (nº CEUA 602-2019). Mucosal, but not polyp tissue implants, hampered embryo development and induced underdeveloped chorioallantoic membranes with anastomosed, interrupted, and regressive vessels. Vessels' areas and branching indexes were higher among the chorioallantoic membranes with polyp implants and controls than among those with healthy mucosa implants. Nasal polyp presents differential angiogenic induction that impacts tissue growth.
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Affiliation(s)
- Hallyson Andre Nascimento de Góes
- ENT Research Lab, Department of Otorhinolaryngology – Head and Neck Surgery, Federal University of São Paulo – UNIFESP, São Paulo, SP Brazil
| | - Masih Sarafan
- Centre of Heart Lung Innovation, University of British Columbia, Vancouver, BC Canada
| | - Jônatas Bussador do Amaral
- ENT Research Lab, Department of Otorhinolaryngology – Head and Neck Surgery, Federal University of São Paulo – UNIFESP, São Paulo, SP Brazil
| | - Joyce dos Anjos Almeida
- General Physics Department, Institute of Physics, Faculty of Pharmaceutical Sciences, University of São Paulo – USP, São Paulo, SP Brazil
| | - Richard Louis Voegels
- Department of Ophthalmology and Otorhinolaryngology, University of São Paulo – USP, São Paulo, SP Brazil
| | - Leandro Ticlia de la Cruz
- Marine Biology Department – Oceanographic Institute, University of São Paulo – USP, São Paulo, SP Brazil
| | - Andrew Thamboo
- Centre of Heart Lung Innovation, University of British Columbia, Vancouver, BC Canada
| | - Lígia Ferreira Gomes
- General Physics Department, Institute of Physics, Faculty of Pharmaceutical Sciences, University of São Paulo – USP, São Paulo, SP Brazil
| | - Rogério Pezato
- ENT Research Lab, Department of Otorhinolaryngology – Head and Neck Surgery, Federal University of São Paulo – UNIFESP, São Paulo, SP Brazil
- Centre of Heart Lung Innovation, University of British Columbia, Vancouver, BC Canada
- Department of Ophthalmology and Otorhinolaryngology, University of São Paulo – USP, São Paulo, SP Brazil
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4
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Dozois EJ, Lightner AL, Dietz AB, Fletcher JG, Lee YS, Friton JJ, Faubion WA. Durable Response in Patients With Refractory Fistulizing Perianal Crohn's Disease Using Autologous Mesenchymal Stem Cells on a Dissolvable Matrix: Results from the Phase I Stem Cell on Matrix Plug Trial. Dis Colon Rectum 2023; 66:243-252. [PMID: 36538706 DOI: 10.1097/dcr.0000000000002579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Refractory perianal Crohn's disease remains notoriously difficult to treat. We developed a novel technology using a commercially available bioabsorbable fistula plug to deliver autologous adipose-derived mesenchymal stem cells. OBJECTIVE This study aimed to assess therapeutic safety and feasibility in the completed STOMP (stem cells on matrix plugs) phase 1 clinical trial. DESIGN Prospective single-arm phase I clinical trial. SETTING Tertiary academic medical center. PATIENTS Adults (aged 18-65 y) with complex single-tract Crohn's disease perianal fistula who have failed conventional therapy were included in this study. INTERVENTION Autologous adipose-derived mesenchymal stem cells were isolated, ex vivo culture expanded, and seeded onto a commercially available bioabsorbable fistula plug. Six weeks later, patients returned to the operating room for removal of the seton and placement of the stem cell-loaded plug. MAIN OUTCOME MEASURES Patients were followed up for a total of 8 visits through 12 months. Safety was the primary end point; clinical healing and MRI response were secondary end points. RESULTS Twenty patients (12 females; mean age 36 y) were treated with the stem cell-loaded plug. Of the 20 patients enrolled, 3 were not included in the 12-month analysis because of study withdrawal. Through 12 months, no patient experienced a serious adverse event related to the stem cell-loaded plug. Four patients experienced 7 serious adverse events and 12 patients experienced 22 adverse events. Complete clinical healing occurred in 14 of 18 patients at 6 months and 13 of 17 patients at 12 months. MRI response was observed in 12 of 18 patients at 6 months. LIMITATIONS The main limitations were the small sample size and restrictive inclusion criteria. CONCLUSIONS A stem cell-loaded plug can safely and effectively deliver cell-based therapy for patients with single-tract fistulizing perianal Crohn's disease. See Video Abstract at http://links.lww.com/DCR/C70 . RESPUESTA DURADERA OBSERVADA EN PACIENTES CON ENFERMEDAD DE CROHN PERIANAL FISTULIZANTE REFRACTARIA MEDIANTE EL USO DE CLULAS MADRE MESENQUIMALES AUTLOGAS EN UNA MATRIZ DISOLUBLE RESULTADOS DEL ENSAYO DE FASE I STEM CELL ON MATRIX PLUG ANTECEDENTES:La enfermedad de Crohn perianal refractaria sigue siendo notoriamente difícil de tratar. Desarrollamos una tecnología novedosa utilizando un tapón de fístula bioabsorbible disponible comercialmente para administrar células madre mesenquimales derivadas de tejido adiposo autólogo.OBJETIVO:Evaluar la seguridad y viabilidad terapéutica en el ensayo finalizado STOMP.DISEÑO:Ensayo clínico prospectivo de fase I de un solo brazo.AJUSTE:Centro médico académico terciario.PACIENTES:Adultos (18-65) con fístula perianal compleja de la enfermedad de Crohn de un solo tracto que han fracasado con la terapia convencional.INTERVENCIÓN:Se aislaron células madre mesenquimales derivadas de tejido adiposo autólogo, se expandieron en cultivo ex vivo y se sembraron en un tapón de fístula bioabsorbible disponible comercialmente. Seis semanas después, los pacientes regresaron al quirófano para retirar el setón y colocar el tapón cargado de células madre.PRINCIPALES MEDIDAS DE RESULTADO:Los pacientes fueron seguidos durante un total de 8 visitas durante 12 meses. La seguridad fue el criterio principal de valoración; la curación clínica y la respuesta a la resonancia magnética fueron criterios de valoración secundarios.RESULTADOS:Veinte pacientes (12 mujeres, edad media 36 años) fueron tratados con el tapón cargado de células madre. De los 20 pacientes inscritos, tres no se incluyeron en el análisis de 12 meses porque se retiraron del estudio. A lo largo de 12 meses, ningún paciente experimentó un evento adverso grave relacionado con el tapón cargado de células madre. Cuatro pacientes experimentaron 7 eventos adversos graves y 12 pacientes experimentaron 22 eventos adversos. La curación clínica completa ocurrió en 14 de 18 pacientes a los 6 meses y en 13 de 17 pacientes a los 12 meses. La respuesta a la resonancia magnética se observó en 12 de 18 pacientes a los 6 meses.LIMITACIONES:Las principales limitaciones son el tamaño pequeño de la muestra y los criterios de inclusión restrictivos.CONCLUSIONES:Un tapón cargado de células madre se puede administrar de manera segura y efectiva, una terapia basada en células para pacientes con enfermedad de Crohn perianal fistulizante de un solo tracto. Consule Video Resumen en http://links.lww.com/DCR/C70 . (Traducción- Dr. Yesenia Rojas-Khalil ).
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Affiliation(s)
- Eric J Dozois
- Department of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota
| | - Amy L Lightner
- Department of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota
| | - Allan B Dietz
- Department of Laboratory Medicine, Mayo Clinic, Rochester, Minnesota
| | | | - Yong S Lee
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - Jessica J Friton
- Department of Gastroenterology, Mayo Clinic, Rochester Minnesota
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5
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Lightner AL, Dadgar N, Matyas C, Elliott K, Fulmer C, Khaitan N, Ream J, Nachand D, Steele SR. A phase IB/IIA study of remestemcel-L, an allogeneic bone marrow-derived mesenchymal stem cell product, for the treatment of medically refractory ulcerative colitis: an interim analysis. Colorectal Dis 2022; 24:1358-1370. [PMID: 35767384 PMCID: PMC9795998 DOI: 10.1111/codi.16239] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 05/27/2022] [Accepted: 06/24/2022] [Indexed: 12/30/2022]
Abstract
AIM There have been no studies into the direct injection of mesenchymal stem cells (MSCs) for luminal ulcerative colitis (UC). Our aim was to investigate the efficacy of MSCs delivered locally via endoscopic delivery, as is done in the setting of perianal disease, to treat the local site of inflammation directly. METHOD A phase IB/IIA randomized control clinical trial of remestemcel-L, an ex vivo expanded allogeneic bone marrow-derived MSC product, at a dose of 150 million MSCs versus placebo (2:1 fashion) delivered via direct injection using a 23-gauge sclerotherapy needle at the time of colonoscopy was designed to assess the safety and efficacy of endoscopic delivery of MSCs for UC. The main outcome measures were adverse events, Mayo score and Mayo endoscopic severity score at 2 weeks, 6 weeks and 3 months post-MSC delivery. RESULTS Six patients were enrolled and treated; four received MSCs and two placebo. All had been on prior anti-tumour necrosis factor or anti-integrin therapy. There were no adverse events related to MSCs. In the treatment group (n = 4), the Mayo endoscopic severity score decreased in all patients by 2 weeks after MSC delivery. At 3 months, all patients were extremely satisfied or satisfied with their MSC treatment based on the inflammatory bowel disease patient-reported treatment impact (IBD-PRTI), and treatment response was described as excellent or good in all patients. In the control group (n = 2), the Mayo endoscopic severity score did not increase as a result of being off alternative therapy. At 3 months, patients were dissatisfied according to the IBD-PRTI, and treatment response was poor or unchanged. CONCLUSION MSCs may offer a safe therapeutic option for the treatment of medically refractory UC. Early data suggest improved clinical and endoscopic scores by 2 weeks after MSC delivery.
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Affiliation(s)
- Amy L. Lightner
- Department of Colorectal SurgeryDigestive Disease and Surgery Institute, Cleveland ClinicClevelandOhioUSA,Department of Inflammation and ImmunityLerner Research Institute, Cleveland ClinicClevelandOhioUSA
| | - Neda Dadgar
- Department of Inflammation and ImmunityLerner Research Institute, Cleveland ClinicClevelandOhioUSA
| | - Caroline Matyas
- Department of Colorectal SurgeryDigestive Disease and Surgery Institute, Cleveland ClinicClevelandOhioUSA
| | - Kavita Elliott
- Department of Colorectal SurgeryDigestive Disease and Surgery Institute, Cleveland ClinicClevelandOhioUSA
| | - Clifton Fulmer
- Department of PathologyRobert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland ClinicClevelandOhioUSA
| | - Neha Khaitan
- Department of PathologyRobert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland ClinicClevelandOhioUSA
| | - Justin Ream
- Department of RadiologyImaging Institute, Cleveland ClinicClevelandOhioUSA
| | - Douglas Nachand
- Department of RadiologyImaging Institute, Cleveland ClinicClevelandOhioUSA
| | - Scott R. Steele
- Department of Colorectal SurgeryDigestive Disease and Surgery Institute, Cleveland ClinicClevelandOhioUSA
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Merrill T, Kanaan A. Managing Chronic Rhinosinusitis with Nasal Polyps in the Elderly: Challenges and Solutions. Clin Interv Aging 2022; 17:685-698. [PMID: 35535364 PMCID: PMC9077011 DOI: 10.2147/cia.s279765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 04/20/2022] [Indexed: 11/23/2022] Open
Abstract
The proportion of the population over 65 years old continues to grow. Chronic rhinosinusitis is common in this population and causes a reduction in quality of life and an increase in health care utilization. Diagnosis of chronic rhinosinusitis with nasal polyps follows the same principles for elderly patients as in the general population, but the elderly population presents some diagnostic challenges worth considering. Presbynasalis, the anatomic and functional changes of the nose and paranasal sinuses associated with aging must be accounted for when caring for these patients. In addition, polypharmacy and other medical issues that can cause similar symptoms must be considered. Medical therapy is generally similar to the general population but with additional concerns given the propensity for geriatric patients to be on multiple medications and to suffer from multiple medical issues. Sinus surgery should be considered following the same indications as in the general population. While some authors have found higher complication rates in endoscopic sinus surgery, others have found higher rates of success. As always, the risks of surgery must be considered with the possible benefits on a patient-to-patient basis.
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Affiliation(s)
- Tyler Merrill
- University of Arkansas for Medical Sciences, Department of Otolaryngology – Head and Neck Surgery, Little Rock, AR, USA
- Correspondence: Tyler Merrill, University of Arkansas for Medical Sciences, Department of Otolaryngology – Head and Neck Surgery, 4301 W. Markham Street, #543, Little Rock, AR, 72205, USA, Tel +1 (501) 686 5140; +1 (330) 285 1750, Fax +1 (501) 686 8029, Email
| | - Alissa Kanaan
- University of Arkansas for Medical Sciences, Department of Otolaryngology – Head and Neck Surgery, Little Rock, AR, USA
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Lino WVS, Bachi ALL, Neto JAM, Caetani G, Amaral JBD, Pezato R. CD133, a Progenitor Cell Marker, is Reduced in Nasal Polyposis and Showed Significant Correlations with TGF-β1 and IL-8. Int Arch Otorhinolaryngol 2021; 26:e091-e096. [PMID: 35096164 PMCID: PMC8789493 DOI: 10.1055/s-0041-1726043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 11/30/2020] [Indexed: 11/29/2022] Open
Abstract
Introduction
Combination of chronic inflammation and an altered tissue remodeling process are involved in the development of Chronic Rhinosinusitis with Nasal Polyps (CRSwNP). Studies demonstrated that mesenchymal stem cells expressing the progenitor gene
CD133
were involved in a significant reduction of the chronic inflammatory process in the polypoid tissue.
Objective
To evaluate the levels of CD133 (Prominin-1) in nasal polypoid tissue and its correlation with interleukin-8 (IL-8) and transforming growth factor β1 (TGF-β1).
Methods
A total of 74 subjects were divided in the following groups: control group (
n
= 35); chronic rhinosinusitis with nasal polyps nonpresenting comorbid asthma and aspirin intolerance (CRSwNPnonAI) group (
n
= 27); and chronic rhinosinusitis with nasal polyps presenting comorbid asthma and aspirin intolerance (CRSwNPAI) group (
n
= 12). Histologic analysis and also evaluation of the concentration of CD133, IL-8, and TGF-β1 by enzyme-linked immunosorbent assay (ELISA) kits were performed in nasal tissue obtained from nasal polypectomy or from middle turbinate tissue.
Results
Higher eosinophilic infiltration was found in both CRSwNP groups by histologic analysis. Lower levels of TGF-β1 and IL-8 were observed in both CRSwNP groups when compared with the control group, whereas the CD133 levels were significantly reduced only in the CRSwNPnonAI group compared with the control group.
Conclusion
It was demonstrated that the nasal mucosa presenting polyposis showed a significant reduction of CD133 levels, and also that this reduction was significantly correlated with the reduction of TGF-β1 levels, but not with IL-8 levels. Therefore, these findings may be involved in the altered inflammatory and remodeling processes observed in the nasal polyposis.
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Affiliation(s)
- Wagner Vargas Souza Lino
- Department of Otorhinolaryngology – Head and Neck Surgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - André Luis Lacerda Bachi
- Department of Otorhinolaryngology – Head and Neck Surgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil
- Instituto Brasileiro Ensino/Pesquisa em Imunologia Pulmonar, São Paulo, SP, Brazil
- Postgraduation Program in Health Science, Universidade Santo Amaro), Sao Paulo, SP, Brazil
| | - José Arruda Mendes Neto
- Department of Otorhinolaryngology – Head and Neck Surgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Gabriel Caetani
- Hospital Universitário Gafree e Guinle, Universidade Federal do Estado do Rio de Janeiro,, Rio de Janeiro, RJ, Brazil
| | - Jônatas Bussador do Amaral
- Department of Otorhinolaryngology – Head and Neck Surgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Rogério Pezato
- Department of Otorhinolaryngology – Head and Neck Surgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil
- Hospital Universitário Gafree e Guinle, Universidade Federal do Estado do Rio de Janeiro,, Rio de Janeiro, RJ, Brazil
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Trombitaș VE, Nagy AA, Berce C, Pall E, Tăbăran F, Ilea A, Albu S. The Role of Mesenchymal Stem Cells in the Treatment of a Chronic Rhinosinusitis-An In Vivo Mouse Model. Microorganisms 2021; 9:microorganisms9061182. [PMID: 34070848 PMCID: PMC8226609 DOI: 10.3390/microorganisms9061182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 12/11/2022] Open
Abstract
Objectives/Hypothesis: It is acknowledged that the treatment of chronic rhinosinusitis (CRS) represents an important challenge for rhinology and for social and economic life. At present, one of the most common treatments for CRS is represented by local corticosteroids followed by endoscopic sinus surgery (ESS). Starting from the example of the mesenchymal stem cell’s (MSC) capacity to migrate and to modulate a real response in the nasal mucosa of an allergic rhinitis mouse model, we try to obtain a response in a CRS mouse model, using MSC derived by adipose tissue. The aim of this study is to demonstrate that the MSC can be used in CRS treatment and could change its priorities. Methods: Seventy female mice (6 MSC donor mice) were randomized in two stages of study, 32 Aspergillus fumigatus (Af) exposure mice (20 for histological comparison to 1st control mice and 12 for MSC administration, to CRS/MCS model) and 32 control mice (20 for histological comparison to CRS model and 12 for MSC administration and histological control to MSC model); in the first stage, the Aspergillus fumigatus (Af) CRS mouse model was targeted, in this section were included 64 (n = 32) mice (treated and control group). In order to assess the inflammation level (histological analysis), the animals were euthanized; in the second stage MSCs (1 × 106/animal) were administered intravenously to a total of 24 (n = 24) mice (12 mice from the exposed group and 12 mice from the second control group). Results: After 12 weeks of Af intranasal instillation, the inflammation parameters evaluated indicated a severe diffuse chronic inflammation, associated with diffuse severe hyperplasia and mature diffuse squamous metaplasia. The MSCs’ injection via the ophthalmic vein induced important histopathological changes in the CRS experimental group, starting with the presence of MSCs in all samples and continuing with the important degenerative character of inflammation. Conclusions: MSC administration demonstrated a real improvement of CRS evolution on the CRS mouse model.
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Affiliation(s)
- Veronica-Elena Trombitaș
- II-nd Department of Otolaryngology, Iuliu Hațieganu University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania; (A.A.N.); (S.A.)
- Correspondence:
| | - Alina Anda Nagy
- II-nd Department of Otolaryngology, Iuliu Hațieganu University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania; (A.A.N.); (S.A.)
| | - Cristian Berce
- Department of Experimental Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania;
| | - Emoke Pall
- Department of Reproduction, Obstetrics and Veterinary Gynecology, Faculty of Veterinary Medicine, University of Agricultural Science and Veterinary Medicine, 400372 Cluj-Napoca, Romania;
| | - Flaviu Tăbăran
- Department of Anatomic Pathology, Necropsy and Forensic Medicine, Faculty of Veterinary Medicine, University of Agricultural Science and Veterinary Medicine, 400372 Cluj-Napoca, Romania;
| | - Aranka Ilea
- Department of Oral Rehabilitation, Oral Health and Dental Office Management, Iuliu Hațieganu University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania;
| | - Silviu Albu
- II-nd Department of Otolaryngology, Iuliu Hațieganu University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania; (A.A.N.); (S.A.)
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Lucas BR, Voegels RL, do Amaral JB, Bachi ALL, Pezato R. BMP-7, MMP-9, and TGF-β tissue remodeling proteins and their correlations with interleukins 6 and 10 in chronic rhinosinusitis. Eur Arch Otorhinolaryngol 2021; 278:4335-4343. [PMID: 33715043 DOI: 10.1007/s00405-021-06722-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 02/23/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Chronic rhinosinusitis without nasal polyposis (CRSsNP) and Chronic rhinosinusitis with nasal polyposis (CRSwNP) present distinct tissue remodeling processes. The proteins involved in the process of tissue remodeling have their production and activity related to the inflammatory environment they are. This study aimed to evaluate the protein expression of BMP-7, MMP-9, TGF-β in chronic sinusitis with and without nasal polyposis and their relations with IL-6 and IL-10. METHODS Cross-sectional observational study with 86 participants was divided into three groups: patients with CRSwNP (n = 34), patients with CRSsNP (n = 26), and a control group (CG) without inflammatory disease of the nasal mucosa (n = 26). The primary outcomes were the concentrations of BMP-7, MMP-9, TGF-β, IL-6, and IL-10. Secondary outcomes were the correlations of these markers. RESULTS The TGF-β dosage was elevated in the CRSsNP group and reduced in the CSwNP group. The dosage of IL-6 was higher in the CSwNP group, and the IL-10 dosage lower in the groups with sinusitis, and IL-10 was positively correlated with BMP-7 in all groups. There was a negative correlation between IL-6 and IL-10 in all groups observed. The correlation between MMP-9 and interleukins was lost in the CRSsNP group. There was a positive correlation between TGF-β and IL-6 in the CG, and negative in the CRSsNP group. CONCLUSION An inflammation shown in rhinosinusitis with an increase in IL-6 and decrease in IL-10 when compared with the control group; only TGF-β was altered in the tissue remodeling process when compared with BMP-7 and MMP-9 in rhinosinusitis. There is a loss of correlation between tissue remodeling proteins and interleukins studied in CRSsNP.
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Affiliation(s)
- Bernardo Relvas Lucas
- ENT Research Lab, Department of Otorhinolaryngology-Head and Neck Surgery, Federal University of São Paulo, São Paulo, SP, Brazil
| | | | - Jônatas Bussador do Amaral
- ENT Research Lab, Department of Otorhinolaryngology-Head and Neck Surgery, Federal University of São Paulo, São Paulo, SP, Brazil
| | - André Luis Lacerda Bachi
- ENT Research Lab, Department of Otorhinolaryngology-Head and Neck Surgery, Federal University of São Paulo, São Paulo, SP, Brazil
- Post-graduation Program in Health Science, Santo Amaro University (UNISA), São Paulo, SP, Brazil
| | - Rogério Pezato
- ENT Research Lab, Department of Otorhinolaryngology-Head and Neck Surgery, Federal University of São Paulo, São Paulo, SP, Brazil.
- Otorhinolaryngology Department, São Paulo University, São Paulo, SP, Brazil.
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10
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Ryu JS, Jeong EJ, Kim JY, Park SJ, Ju WS, Kim CH, Kim JS, Choo YK. Application of Mesenchymal Stem Cells in Inflammatory and Fibrotic Diseases. Int J Mol Sci 2020; 21:ijms21218366. [PMID: 33171878 PMCID: PMC7664655 DOI: 10.3390/ijms21218366] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 10/29/2020] [Accepted: 11/05/2020] [Indexed: 02/07/2023] Open
Abstract
Mesenchymal stem cells (MSCs) are multipotent stem cells that can be isolated from various tissues in the adult body. MSCs should be characterized by three criteria for regenerative medicine. MSCs must (1) adhere to plastic surfaces, (2) express specific surface antigens, and (3) differentiate into mesodermal lineages, including chondrocytes, osteoblasts, and adipocytes, in vitro. Interestingly, MSCs have immunomodulatory features and secrete trophic factors and immune receptors that regulate the microenvironment in host tissue. These specific and unique therapeutic properties make MSCs ideal as therapeutic agents in vivo. Specifically, pre-clinical and clinical investigators generated inflammatory and fibrotic diseases models, and then transplantation of MSCs into diseases models for therapeutic effects investigation. In this review, we characterize MSCs from various tissues and describe their applications for treating various inflammation and fibrotic diseases.
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Affiliation(s)
- Jae-Sung Ryu
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Konyang University, Daejeon 35365, Korea; (J.-S.R.); (J.-Y.K.)
- Department of Biomedical Informatics, College of Medicine, Konyang University, Daejeon 35365, Korea
| | - Eun-Jeong Jeong
- Department of Biological Science, College of Natural Sciences, Wonkwang University, Iksan 54538, Korea; (E.-J.J.); (S.J.P.); (W.S.J.)
- Biotherapeutics Translational Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon 34141, Korea;
| | - Jong-Yeup Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Konyang University, Daejeon 35365, Korea; (J.-S.R.); (J.-Y.K.)
- Department of Biomedical Informatics, College of Medicine, Konyang University, Daejeon 35365, Korea
| | - Soon Ju Park
- Department of Biological Science, College of Natural Sciences, Wonkwang University, Iksan 54538, Korea; (E.-J.J.); (S.J.P.); (W.S.J.)
- Institute for Glycoscience, Wonkwang University, Iksan 54538, Korea
| | - Won Seok Ju
- Department of Biological Science, College of Natural Sciences, Wonkwang University, Iksan 54538, Korea; (E.-J.J.); (S.J.P.); (W.S.J.)
- Institute for Glycoscience, Wonkwang University, Iksan 54538, Korea
| | - Chang-Hyun Kim
- College of Medicine, Dongguk University, Goyang 10326, Korea;
| | - Jang-Seong Kim
- Biotherapeutics Translational Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon 34141, Korea;
- Department of Functional Genomics, University of Science and Technology (UST), Daejeon 34141, Korea
| | - Young-Kug Choo
- Department of Biological Science, College of Natural Sciences, Wonkwang University, Iksan 54538, Korea; (E.-J.J.); (S.J.P.); (W.S.J.)
- Institute for Glycoscience, Wonkwang University, Iksan 54538, Korea
- Correspondence:
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11
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Chiarella E, Lombardo N, Lobello N, Aloisio A, Aragona T, Pelaia C, Scicchitano S, Bond HM, Mesuraca M. Nasal Polyposis: Insights in Epithelial-Mesenchymal Transition and Differentiation of Polyp Mesenchymal Stem Cells. Int J Mol Sci 2020; 21:E6878. [PMID: 32961745 PMCID: PMC7555226 DOI: 10.3390/ijms21186878] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/11/2020] [Accepted: 09/17/2020] [Indexed: 12/17/2022] Open
Abstract
Chronic rhinosinusitis is a common inflammatory disease of paranasal sinuses, which causes rhinorrhea, nasal congestion, and hyposmia. The genetic predisposition or the exposure to irritants can sustain the inflammatory response and the development of nasal polyposis. Nasal polyps are benign and teardrop-shaped growths that project in the nasal cavities, and originate from the ethmoid sinuses. This inflammatory process is associated with high expression of IL-4, IL-5 and IL-13 and IgE. Antibodies targeting these cytokines or receptors represent a therapeutic strategy in the treatment of nasal polyposis in combination with corticosteroids. The molecular pathogenesis of nasal polyps in chronic rhinosinusitis (CRS) patients is associated with remodeling transition, a process in which epithelial cells lose their typical phenotype, acquiring a mesenchymal-like aspect. TGFβ/SMAD, ERK, and Wnt/β-catenin pathways are altered during the nasal tissue remodeling. miRNA and inhibitor molecules targeting these signaling pathways are able to interfere with the process; which could lead to alternative therapies. Nasal polyps are an alternative source of mesenchymal stem cells, which can be isolated from surgical biopsies. A molecular understanding of the biology of PO-MSCs will contribute to the delineating inflammatory process underlying the development of nasal polyps.
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Affiliation(s)
- Emanuela Chiarella
- Laboratory of Molecular Haematopoiesis and Stem Cell Biology, Department of Experimental and Clinical Medicine, University “Magna Græcia”, 88100 Catanzaro, Italy; (E.C.); (A.A.); (S.S.)
| | - Nicola Lombardo
- Otolaryngology Head and Neck Surgery, Department Medical and Surgical Sciences, University “Magna Græcia”, 88100 Catanzaro, Italy; (N.L.); (N.L.)
| | - Nadia Lobello
- Otolaryngology Head and Neck Surgery, Department Medical and Surgical Sciences, University “Magna Græcia”, 88100 Catanzaro, Italy; (N.L.); (N.L.)
| | - Annamaria Aloisio
- Laboratory of Molecular Haematopoiesis and Stem Cell Biology, Department of Experimental and Clinical Medicine, University “Magna Græcia”, 88100 Catanzaro, Italy; (E.C.); (A.A.); (S.S.)
| | - Teodoro Aragona
- Otolaryngology, A.O.U. Ospedali Riuniti, 60123 Ancona, Italy;
| | - Corrado Pelaia
- Department of Health Sciences, University “Magna Græcia” of Catanzaro, 88100 Catanzaro, Italy;
| | - Stefania Scicchitano
- Laboratory of Molecular Haematopoiesis and Stem Cell Biology, Department of Experimental and Clinical Medicine, University “Magna Græcia”, 88100 Catanzaro, Italy; (E.C.); (A.A.); (S.S.)
| | - Heather Mandy Bond
- Laboratory of Molecular Haematopoiesis and Stem Cell Biology, Department of Experimental and Clinical Medicine, University “Magna Græcia”, 88100 Catanzaro, Italy; (E.C.); (A.A.); (S.S.)
| | - Maria Mesuraca
- Laboratory of Molecular Haematopoiesis and Stem Cell Biology, Department of Experimental and Clinical Medicine, University “Magna Græcia”, 88100 Catanzaro, Italy; (E.C.); (A.A.); (S.S.)
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12
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Stem cell therapy for perianal Crohn's. Curr Opin Gastroenterol 2019; 35:311-320. [PMID: 33216484 DOI: 10.1097/mog.0000000000000545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
PURPOSE OF REVIEW Perianal Crohn's disease is a morbid and disabling condition, notoriously difficult to successfully treat with conventional medical and surgical therapies. Mesenchymal stem cells (MSCs) are an emerging novel therapy for perianal Crohn's disease. RECENT FINDINGS Over 300 patients with perianal Crohn's disease have now been treated with MSCs in the context of clinical trials. All trials have demonstrated safety, and efficacy superior to conventional therapy with biologics and surgical intervention. This was consistent despite the heterogeneity in study protocols including variability in cell dosing, mode of delivery, repeat dosing, and allogeneic versus autologous donors. Sustained healing to 1 year has also been demonstrated in a recent extension of the largest phase III study confirming superior efficacy of MSCs to placebo at 1-year follow-up. However, several outstanding questions regarding the use of MSCs for perianal Crohn's disease remain, which, if answered, could enhance MSCs' treatment efficacy. These include defining the optimal MSC donor, optimal MSC source (e.g., bone marrow versus adipose tissue), investigating a potential alloimmune response following allogeneic cellular delivery, and determining the optimal mode for MSC delivery. In addition to these unanswered questions, significant challenges in the required infrastructure and cost required for cell-based therapies may drive future research toward identifying novel acellular therapies. SUMMARY Novel regenerative therapies offer promising new treatment options for perianal Crohn's disease, without the risk of opportunistic infection seen with biologics and incontinence with surgical techniques. Future research will help define the optimal MSC product and treatment protocol, and may even expand our horizon of regenerative medicine into acellular therapy as well as cell-based therapies.
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13
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Lightner AL. The Present State and Future Direction of Regenerative Medicine for Perianal Crohn's Disease. Gastroenterology 2019; 156:2128-2130.e4. [PMID: 31034831 DOI: 10.1053/j.gastro.2019.04.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Amy L Lightner
- Department of Colon and Rectal Surgery, Cleveland Clinic, Cleveland, Ohio.
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14
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Durand N, Russell A, Zubair AC. Effect of Comedications and Endotoxins on Mesenchymal Stem Cell Secretomes, Migratory and Immunomodulatory Capacity. J Clin Med 2019; 8:jcm8040497. [PMID: 30979082 PMCID: PMC6517980 DOI: 10.3390/jcm8040497] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 04/04/2019] [Accepted: 04/08/2019] [Indexed: 02/06/2023] Open
Abstract
Mesenchymal stem cells (MSCs) are becoming an increasingly popular therapeutic option among patients with a broad range of ailments to modulate immunity and induce regeneration. The majority of patients receiving these MSC therapies are on concurrent medication or have ongoing infection. In the present study, we examined the effect of immunosuppressive drugs and lipopolysaccharides (LPS)/endotoxins on the secretory profile, migration towards site of injury, and suppression of lymphocyte proliferation of bone marrow-derived MSCs (BMSCs). Generally, LPS coculture augmented the secretory capacity of BMSCs while exposure to immunosuppressive drugs resulted primarily in no change or attenuated secretion, with some cases of increased secretion, dependent on the cytokine assayed. Among the immunosuppressants evaluated, Hydrocortisone had the most widespread inhibitory effect, while LPS from E. coli O111:B4 had the most potent stimulatory effect. In addition, we also showed that Hydrocortisone or LPS from E. coli O111:B4 affected the migratory and immunosuppressive capacity of BMSCs. Following simulation with Hydrocortisone, BMSC migration was attenuated, and immunosuppressive capacity against T cell proliferation was enhanced, however, the opposite effects were seen with LPS from E. coli O111:B4. Our data suggests that the clinical outcomes of MSC-based therapy are affected by the use of immunosuppressive medication or the presence of endotoxemia in patients.
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Affiliation(s)
- Nisha Durand
- Transfusion Medicine, Department of Laboratory Medicine and Pathology and Center for Regenerative Medicine, Mayo Clinic, Jacksonville, FL 32224, USA.
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15
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Pezato R, Voegels RL, Pignatari S, Gregório LC, Pinto Bezerra TF, Gregorio L, Balsalobre L, Tepedino MS, Coronel N, Pinna FDR, Mendes Neto J, Oliveira P, Macoto E, Stefanini R, Figueiredo C, Haddad F, Pilan R, Bezerra Soter A, Melo NA, Candido DA, Amaral JD, Santos RDP, Van Zele T, Fujita R, Dreyfuss JL, Chamon W, Alencar AM, Perez-Novo C, Stamm AC. Nasal Polyposis: More than a Chronic Inflammatory Disorder-A Disease of Mechanical Dysfunction-The São Paulo Position. Int Arch Otorhinolaryngol 2019; 23:241-249. [PMID: 30956711 PMCID: PMC6449132 DOI: 10.1055/s-0038-1676659] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 10/21/2018] [Indexed: 01/02/2023] Open
Abstract
Introduction The importance of our study lies in the fact that we have demonstrated the occurrence of mechanical dysfunction within polypoid tissues, which promotes the development of polyps in the nasal cavity. Objective To change the paradigm of nasal polyposis (NP). In this new conception, the chronic nasal inflammatory process that occurs in response to allergies, to pollution, to changes in the epithelial barrier, or to other factors is merely the trigger of the development of the disease in individuals with a genetic predisposition to an abnormal tissue remodeling process, which leads to a derangement of the mechanical properties of the nasal mucosa and, consequently, allows it to grow unchecked. Data Synthesis We propose a fundamentally new approach to intervening in the pathological process of NP, addressing biomechanical properties, fluid dynamics, and the concept of surface tension. Conclusion The incorporation of biomechanical knowledge into our understanding of NP provides a new perspective to help elucidate the physiology and the pathology of nasal polyps, and new avenues for the treatment and cure of NP.
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Affiliation(s)
- Rogerio Pezato
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | | | - Shirley Pignatari
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | - Luiz Carlos Gregório
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | | | - Luciano Gregorio
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | - Leonardo Balsalobre
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | | | - Nathália Coronel
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | | | - José Mendes Neto
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | - Pedro Oliveira
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | - Eduardo Macoto
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | - Renato Stefanini
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | - Claudia Figueiredo
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | - Fernanda Haddad
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | - Renata Pilan
- Department of Otolaryngology, USP, São Paulo, SP, Brazil
| | | | | | | | - Jonatas do Amaral
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | | | - Thibaut Van Zele
- Ear, Nose and Throat Department,, University of Ghent, Ghent, Belgium
| | - Reginaldo Fujita
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
| | | | - Wallace Chamon
- Department of Ophthalmology and Visual Sciences, Unifesp, São Paulo, SP, Brazil
- Department of Ophthalmology and Visual Sciences, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Adriano Mesquita Alencar
- Laboratory of Microrheology and Molecular Physiology, Institute of Physics, USP, São Paulo, SP, Brazil
| | - Claudina Perez-Novo
- Proteinscience, Proteomics and Epigenetic Signaling, Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Aldo Cassol Stamm
- Department of Otolaryngology – Head and Neck Surgery, Unifesp, São Paulo, SP, Brazil
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16
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Balsalobre L, Pezato R, Mangussi-Gomes J, Gregorio L, Haddad FLM, Gregorio LC, Fujita R. What is the Impact of Positive Airway Pressure in Nasal Polyposis? An Experimental Study. Int Arch Otorhinolaryngol 2019; 23:147-151. [PMID: 30956697 PMCID: PMC6449137 DOI: 10.1055/s-0038-1676095] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 10/06/2018] [Indexed: 11/21/2022] Open
Abstract
Introduction
It has been hypothesized that increasing the interstitial hydrostatic pressure within the sinonasal mucosa of patients with nasal polyposis (NP) might decrease the size of nasal polyps.
Objective
To evaluate the effects of positive airway pressure, delivered by a continuous positive airway pressure (CPAP) device, in patients with NP and in control subjects.
Methods
Twelve patients with NP and 27 healthy subjects were exposed to CPAP (20 cm H2O) for 2 hours. Visual analog scale (VAS), Nasal Obstruction Symptom Evaluation (NOSE) scale, acoustic rhinometry (AR), peak nasal inspiratory flow (PNIF) and nasal endoscopy (NE—Meltzer polyp grading system) were performed before and after the intervention, for all patients.
Results
The control group showed a significant worsening in nasal obstruction symptoms, as measured by VAS and NOSE (
p
< 0.01), and a significant decrease in nasal patency, as measured by the PNIF and AR (
p
< 0.01). For the NP group, VAS, NOSE, and AR did not differ significantly (
p
= 0.72,
p
= 0.73, and
p
= 0.17, respectively), but PNIF values worsened (
p
= 0.04) after exposure to CPAP. There was a statistically significant reduction in the nasal polyps' size (
p
= 0.04).
Conclusions
Positive pressure worsened the nasal obstruction symptoms and decreased objective parameters of nasal patency in control subjects. In patients with NP, exposure to CPAP reduced the nasal polyps' size, and the nasal patency, as measured by PNIF. However, it had no significant effects in AR and in nasal obstruction symptoms.
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Affiliation(s)
- Leonardo Balsalobre
- ENT Research Laboratory, Department of Otolaryngology and Head and Neck Surgery, Universidade Federal de São Paulo, SP, Brazil
| | - Rogerio Pezato
- ENT Research Laboratory, Department of Otolaryngology and Head and Neck Surgery, Universidade Federal de São Paulo, SP, Brazil
| | - Joao Mangussi-Gomes
- ENT Research Laboratory, Department of Otolaryngology and Head and Neck Surgery, Universidade Federal de São Paulo, SP, Brazil
| | - Luciano Gregorio
- ENT Research Laboratory, Department of Otolaryngology and Head and Neck Surgery, Universidade Federal de São Paulo, SP, Brazil
| | - Fernanda Louise Martinho Haddad
- ENT Research Laboratory, Department of Otolaryngology and Head and Neck Surgery, Universidade Federal de São Paulo, SP, Brazil
| | - Luiz Carlos Gregorio
- ENT Research Laboratory, Department of Otolaryngology and Head and Neck Surgery, Universidade Federal de São Paulo, SP, Brazil
| | - Reginaldo Fujita
- ENT Research Laboratory, Department of Otolaryngology and Head and Neck Surgery, Universidade Federal de São Paulo, SP, Brazil
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17
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Klimek L, Koennecke M, Mullol J, Hellings PW, Wang D, Fokkens W, Gevaert P, Wollenberg B. A possible role of stem cells in nasal polyposis. Allergy 2017; 72:1868-1873. [PMID: 28599061 DOI: 10.1111/all.13221] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2017] [Indexed: 12/21/2022]
Abstract
Since its discovery, the understanding of stem/progenitor cells raised dramatically in the last decade. Their regenerative potential is important to develop new therapeutic applications, but the identification advanced much faster than our understanding of stem/progenitor cells. In nasal polyposis, little is known about stem cells/progenitor cells and their ability. However, the further characterization of stem cells/progenitor cells may provide new treatment options for combating nasal polyposis. This review highlights the knowledge of the current literature about stem cells/progenitor cells in nasal polyposis and how this may be exploited in the development of novel treatment strategies.
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Affiliation(s)
- L. Klimek
- Center for Rhinology and Allergology; Wiesbaden Germany
| | - M. Koennecke
- Department of Otorhinolaryngology; University Hospital Schleswig-Holstein; Lübeck Germany
| | - J. Mullol
- Rhinology Unit and Smell Clinic; Department of Otorhinolaryngology; Hospital Clinic; IDIBAPS; Universitat de Barcelona, CIBERES; Barcelona Catalonia Spain
| | - P. W. Hellings
- Department of Otorhinolaryngology; University Hospitals Leuven; Leuven Belgium
- Department of Otorhinolaryngology; Academic Medical Centre; Amsterdam The Netherlands
| | - D.Y. Wang
- Department of Otolaryngology; National University of Singapore; Singapore
| | - W. Fokkens
- Department of Otorhinolaryngology; Academic Medical Centre; Amsterdam The Netherlands
| | - P. Gevaert
- Department of Otorhinolaryngology; Ghent University; Ghent Belgium
| | - B. Wollenberg
- Department of Otorhinolaryngology; University Hospital Schleswig-Holstein; Lübeck Germany
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18
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Dendritic cell subset expression in severe chronic rhinosinusitis with nasal polyps. Curr Opin Allergy Clin Immunol 2017; 17:1-4. [PMID: 27870663 DOI: 10.1097/aci.0000000000000328] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE OF REVIEW Two main pillars are implicated in nasal polyposis development: a severe imbalance in immunomodulation and a mechanical dysfunction because of an abnormal remodeling process. Dendritic cells play a crucial role in the link between innate and adaptive immune response and orchestrating the T-cell response and are implicated in the severe inflammatory process found in nasal polypoid tissue. This review summarizes the existent knowledge about dendritic cells in nasal polyposis. RECENT FINDINGS Dendritic cells are found increased in nasal polyposis, regardless of subset. Of interest, plasmacytoid dendritic cells are decreased in patients with a more severe Th2 profile, suggesting an important role of the cytokines milieu in their functional response or that plasmacytoid dendritic cell could act mitigating the inflamed process found in polypoid tissue. SUMMARY Understanding the dendritic cell subset expression in different environments, as well as the effect of these subsets on T-cell differentiation will greatly improve the development of new therapies in nasal polyposis.
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Gregório L, Pezato R, Felici RS, Kosugi EM. Fibrotic Tissue and Middle Turbinate Exhibit Similar Mechanical Properties. Is Fibrosis a Solution in Nasal Polyposis? Int Arch Otorhinolaryngol 2017; 21:122-125. [PMID: 28382117 PMCID: PMC5375701 DOI: 10.1055/s-0036-1593728] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 09/06/2016] [Indexed: 10/31/2022] Open
Abstract
Introduction Nasal polyposis (NP) is a chronic inflammatory condition of the upper airway characterized by overgrowth of nasal mucosa. Recent studies have shown a mechanical dysfunction in the nasal polyp tissue. Objective This study aims to evaluate the mechanical properties of nasal fibrotic tissue. Method This study was an institutional review board approved translational study in 20 participants (8 patients with NP, 7 patients with nasal synechiae, and 5 subjects without sinus disease (control group). We used Controlled Disc Stimulation equipment to compare the curve Pressure/Volume created during the saline solution infusion. Results The increase of pressure in response to solution injection was lower in the nasal polyp group when compared with control middle turbinate group and fibrotic group. No significant difference was found in the pressure response during solution injection between fibrotic group and control middle turbinate group. Inferior turbinate group showed significant difference when compared with control middle turbinate group. Conclusion The mechanical dysfunction found in the nasal mucosa of patients with NP provides new insight into this condition. These data allow the belief that the fibrosis has a potential role in increasing interstitial hydrostatic pressure and, consequently, mitigating edema formation in NP.
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Affiliation(s)
- Luciano Gregório
- ENT Research Laboratory, Department of ENT, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Rogério Pezato
- ENT Research Laboratory, Department of ENT, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Rafael Souza Felici
- ENT Research Laboratory, Department of ENT, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Eduardo Macoto Kosugi
- ENT Research Laboratory, Department of ENT, Universidade Federal de São Paulo, São Paulo, SP, Brazil
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20
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Koennecke M, Böscke R, Pfannerstill AC, Reers S, Elsner M, Fell B, Richter A, Bruchhage KL, Schumann S, Pries R, Klimek L, Wollenberg B. Neuronal Differentiation Capability of Nasal Polyps of Chronic Rhinosinusitis. Arch Immunol Ther Exp (Warsz) 2017; 65:431-443. [PMID: 28280847 DOI: 10.1007/s00005-017-0456-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 12/16/2016] [Indexed: 12/20/2022]
Abstract
Chronic rhinosinusitis with nasal polyps is considered a subgroup of chronic rhinosinusitis and a significant health problem, but the pathogenesis remains unclear to date. Therefore, we investigated the stemness to determine the role of stem cells in nasal polyps, with additional analysis of the neuronal differentiation potential of nasal polyp cells. We determined gene and protein expression profiles of stem cells in nasal polyp tissues, using whole genome microarray, quantitative real-time PCR (qPCR), immunohistochemistry, and flow cytometry. To evaluate the neuronal differentiation potential of nasal polyp cells, we used an efficient xenogeneic co-culture model with unsliced adult rat brain biopsies, followed by qPCR, immunohistochemistry, and growth factor antibody arrays. During gene expression analysis and immunohistochemistry, we were able to detect different stem cell markers, like Oct-4, Sox2, Klf4, c-Myc, ABCG2, Nanog, CD133, and Nestin, which confirmed the existence of stem cell like cells within nasal polyps. In addition, co-culture experiments give evidence for a guided differentiation into the neuronal lineage by overexpression of Nestin, Neurofilament, and GM-CSF. Our study demonstrated the expression of stem cell-related markers in nasal polyps. Furthermore, we characterized, for the first time, the stemness and neuronal differentiation potential of nasal polyp cells. These results gave new insights into the pathogenesis of nasal polyps and its therapeutic effectiveness could represent a promising strategy in the future.
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Affiliation(s)
- Michael Koennecke
- Department of Otorhinolaryngology, University Medical Center Schleswig-Holstein, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
| | - Robert Böscke
- Department of Otorhinolaryngology, University Medical Center Schleswig-Holstein, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - Ann-Christin Pfannerstill
- Department of Otorhinolaryngology, University Medical Center Schleswig-Holstein, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - Stefan Reers
- Department of Otorhinolaryngology, University Medical Center Schleswig-Holstein, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - Martina Elsner
- Fraunhofer Research Institution for Marine Biotechnology, EMB, Lübeck, Germany
| | - Benjamin Fell
- Fraunhofer Research Institution for Marine Biotechnology, EMB, Lübeck, Germany
| | - Anja Richter
- Fraunhofer Research Institution for Marine Biotechnology, EMB, Lübeck, Germany
| | - Karl-Ludwig Bruchhage
- Department of Otorhinolaryngology, University Medical Center Schleswig-Holstein, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - Sandra Schumann
- Fraunhofer Research Institution for Marine Biotechnology, EMB, Lübeck, Germany
| | - Ralph Pries
- Department of Otorhinolaryngology, University Medical Center Schleswig-Holstein, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - Ludger Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - Barbara Wollenberg
- Department of Otorhinolaryngology, University Medical Center Schleswig-Holstein, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
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de Oliveira PWB, Pezato R, Agudelo JSH, Perez-Novo CA, Berghe WV, Câmara NO, de Almeida DC, Gregorio LC. Nasal Polyp-Derived Mesenchymal Stromal Cells Exhibit Lack of Immune-Associated Molecules and High Levels of Stem/Progenitor Cells Markers. Front Immunol 2017; 8:39. [PMID: 28194153 PMCID: PMC5276864 DOI: 10.3389/fimmu.2017.00039] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 01/10/2017] [Indexed: 12/26/2022] Open
Abstract
Mesenchymal stromal cells (MSCs) are considered adult progenitor stem cells and have been studied in a multitude of tissues. In this context, the microenvironment of nasal polyp tissue has several inflammatory cells, but their stroma compartment remains little elucidated. Hence, we isolated MSCs from nasal polyps Polyp-MSCs (PO-MSCs) and compared their molecular features and gene expression pattern with bone marrow-derived MSCs (BM-MSCs). Initially, both PO-MSCs and BM-MSCs were isolated, cultivated, and submitted to morphologic, differentiation, phenotypic, immunosuppressive, and gene expression assays. Compared to BM-MSCs, PO-MSCs showed normal morphology and similar osteogenic/adipogenic differentiation potential, but their immunophenotyping showed lack of immune-associated molecules (e.g., CD117, HLA-DR, PDL-1, and PDL-2), which was linked with less immunoregulatory abilities such as (i) inhibition of lymphocytes proliferation and (ii) regulatory T cell expansion. Furthermore, we detected in the PO-MSCs a distinct gene expression profile in comparison with BM-MSCs. PO-MSC expressed higher levels of progenitor stem cells specific markers (e.g., CD133 and ABCB1), while BM-MSCs showed elevated expression of cytokines and growth factors (e.g., FGF10, KDR, and GDF6). The gene ontology analysis showed that the differentially modulated genes in PO-MSC were related with matrix remodeling process and hexose and glucose transport. For BM-MSCs, the highly expressed genes were associated with behavior, angiogenesis, blood vessel morphogenesis, cell–cell signaling, and regulation of response to external stimulus. Thus, these results suggest that PO-MSCs, while sharing similar aspects with BM-MSCs, express a different profile of molecules, which presumably can be implicated in the development of nasal polyp tissue.
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Affiliation(s)
- Pedro Wey Barbosa de Oliveira
- ENT Research Laboratory, Department of Otolaryngology-Head and Neck Surgery, Federal University of São Paulo , São Paulo , Brazil
| | - Rogério Pezato
- ENT Research Laboratory, Department of Otolaryngology-Head and Neck Surgery, Federal University of São Paulo , São Paulo , Brazil
| | - Juan Sebastian Henao Agudelo
- ENT Research Laboratory, Department of Otolaryngology-Head and Neck Surgery, Federal University of São Paulo , São Paulo , Brazil
| | - Claudina Angela Perez-Novo
- Department Biomedical Sciences, University of Antwerp, PPES Lab Proteinchemistry, Proteomics Epigenetic Signaling , Wilrijk , Belgium
| | - Wim Vanden Berghe
- Department Biomedical Sciences, University of Antwerp, PPES Lab Proteinchemistry, Proteomics Epigenetic Signaling , Wilrijk , Belgium
| | - Niels Olsen Câmara
- Department of Medicine, Nephrology Division, Federal University of São Paulo, São Paulo, Brazil; Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Danilo Candido de Almeida
- Department Biomedical Sciences, University of Antwerp, PPES Lab Proteinchemistry, Proteomics Epigenetic Signaling , Wilrijk , Belgium
| | - Luís Carlos Gregorio
- ENT Research Laboratory, Department of Otolaryngology-Head and Neck Surgery, Federal University of São Paulo , São Paulo , Brazil
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Chen G, Yue A, Ruan Z, Yin Y, Wang R, Ren Y, Zhu L. Comparison of biological characteristics of mesenchymal stem cells derived from maternal-origin placenta and Wharton's jelly. Stem Cell Res Ther 2015; 6:228. [PMID: 26607396 PMCID: PMC4660673 DOI: 10.1186/s13287-015-0219-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 10/21/2015] [Accepted: 10/29/2015] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Although mesenchymal stem cells (MSCs) from different sources share many similar characteristics, they also exhibit individual properties. In this study, we compared MSCs derived from Wharton's jelly in the umbilical cord with those derived from the decidual basalis in the maternal part of the placenta to better understand the similarities and differences between these two cell types. METHOD The morphology, immunophenotype (as assessed using flow cytometry), and multi-lineage differentiation potential were analyzed. Karyotype analysis was carried out to determine the origin of the MSCs. Growth kinetics were evaluated using analysis of the population doubling time and cell cycle. Immunosuppressive function was analyzed using mixed lymphocyte culture. RESULTS MSCs from Wharton's jelly and the decidua basalis exhibited similar morphology, immunophenotype, and differentiation potential to osteogenesis and adipogenesis. The percentage of MSCs in the G0/G1 phase was higher in the case of Wharton's jelly than in the case of the decidua basalis (P < 0.05). Decidual MSCs displayed more remarkable immunosuppressive effects on phytohemagglutinin-stimulated T-cell proliferation (P < 0.05). CONCLUSION MSCs from both sources had similar basic biological properties, but decidual MSCs had slower proliferation and stronger immunosuppressive function.
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Affiliation(s)
- Gecai Chen
- Department of Cardiology, Taizhou Renmin Hospital, Taizhou, Jiangsu Province, China.
| | - Aihuan Yue
- Stem Cell Research Center, Taizhou, Jiangsu Province, China.
| | - Zhongbao Ruan
- Department of Cardiology, Taizhou Renmin Hospital, Taizhou, Jiangsu Province, China.
| | - Yigang Yin
- Department of Cardiology, Taizhou Renmin Hospital, Taizhou, Jiangsu Province, China.
| | - Ruzhu Wang
- Department of Cardiology, Taizhou Renmin Hospital, Taizhou, Jiangsu Province, China.
| | - Yin Ren
- Department of Cardiology, Taizhou Renmin Hospital, Taizhou, Jiangsu Province, China.
| | - Li Zhu
- Department of Cardiology, Taizhou Renmin Hospital, Taizhou, Jiangsu Province, China.
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