1
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Lear BP, Moore DL. Moving CNS axon growth and regeneration research into human model systems. Front Neurosci 2023; 17:1198041. [PMID: 37425013 PMCID: PMC10324669 DOI: 10.3389/fnins.2023.1198041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 05/25/2023] [Indexed: 07/11/2023] Open
Abstract
Axon regeneration is limited in the adult mammalian central nervous system (CNS) due to both intrinsic and extrinsic factors. Rodent studies have shown that developmental age can drive differences in intrinsic axon growth ability, such that embryonic rodent CNS neurons extend long axons while postnatal and adult CNS neurons do not. In recent decades, scientists have identified several intrinsic developmental regulators in rodents that modulate growth. However, whether this developmentally programmed decline in CNS axon growth is conserved in humans is not yet known. Until recently, there have been limited human neuronal model systems, and even fewer age-specific human models. Human in vitro models range from pluripotent stem cell-derived neurons to directly reprogrammed (transdifferentiated) neurons derived from human somatic cells. In this review, we discuss the advantages and disadvantages of each system, and how studying axon growth in human neurons can provide species-specific knowledge in the field of CNS axon regeneration with the goal of bridging basic science studies to clinical trials. Additionally, with the increased availability and quality of 'omics datasets of human cortical tissue across development and lifespan, scientists can mine these datasets for developmentally regulated pathways and genes. As there has been little research performed in human neurons to study modulators of axon growth, here we provide a summary of approaches to begin to shift the field of CNS axon growth and regeneration into human model systems to uncover novel drivers of axon growth.
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Affiliation(s)
| | - Darcie L. Moore
- Department of Neuroscience, University of Wisconsin-Madison, Madison, WI, United States
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2
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Sucha R, Kubickova M, Cervenka J, Hruska-Plochan M, Bohaciakova D, Vodickova Kepkova K, Novakova T, Budkova K, Susor A, Marsala M, Motlik J, Kovarova H, Vodicka P. Targeted mass spectrometry for monitoring of neural differentiation. Biol Open 2021; 10:271174. [PMID: 34357391 PMCID: PMC8353267 DOI: 10.1242/bio.058727] [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: 03/26/2021] [Accepted: 06/28/2021] [Indexed: 12/25/2022] Open
Abstract
Human multipotent neural stem cells could effectively be used for the treatment of a variety of neurological disorders. However, a defining signature of neural stem cell lines that would be expandable, non-tumorigenic, and differentiate into desirable neuronal/glial phenotype after in vivo grafting is not yet defined. Employing a mass spectrometry approach, based on selected reaction monitoring, we tested a panel of well-described culture conditions, and measured levels of protein markers routinely used to probe neural differentiation, i.e. POU5F1 (OCT4), SOX2, NES, DCX, TUBB3, MAP2, S100B, GFAP, GALC, and OLIG1. Our multiplexed assay enabled us to simultaneously identify the presence of pluripotent, multipotent, and lineage-committed neural cells, thus representing a powerful tool to optimize novel and highly specific propagation and differentiation protocols. The multiplexing capacity of this method permits the addition of other newly identified cell type-specific markers to further increase the specificity and quantitative accuracy in detecting targeted cell populations. Such an expandable assay may gain the advantage over traditional antibody-based assays, and represents a method of choice for quality control of neural stem cell lines intended for clinical use.
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Affiliation(s)
- Rita Sucha
- Laboratory of Applied Proteome Analyses and Research Center PIGMOD, Institute of Animal Physiology and Genetics of The Czech Academy of Sciences, Rumburska 89, Libechov CZ-27721, Czech Republic
| | - Martina Kubickova
- Laboratory of Applied Proteome Analyses and Research Center PIGMOD, Institute of Animal Physiology and Genetics of The Czech Academy of Sciences, Rumburska 89, Libechov CZ-27721, Czech Republic.,Department of Cell Biology, Faculty of Science, Charles University, Albertov 6, Prague CZ-12843, Czech Republic
| | - Jakub Cervenka
- Laboratory of Applied Proteome Analyses and Research Center PIGMOD, Institute of Animal Physiology and Genetics of The Czech Academy of Sciences, Rumburska 89, Libechov CZ-27721, Czech Republic.,Department of Cell Biology, Faculty of Science, Charles University, Albertov 6, Prague CZ-12843, Czech Republic
| | - Marian Hruska-Plochan
- Department of Quantitative Biomedicine, University of Zurich, Winterthurerstrasse 190, Zürich CH-8057, Switzerland
| | - Dasa Bohaciakova
- Department of Histology and Embryology, Faculty of Medicine, Masaryk University, Kamenice 753/5, Brno CZ-62500, Czech Republic
| | - Katerina Vodickova Kepkova
- Laboratory of Applied Proteome Analyses and Research Center PIGMOD, Institute of Animal Physiology and Genetics of The Czech Academy of Sciences, Rumburska 89, Libechov CZ-27721, Czech Republic
| | - Tereza Novakova
- Laboratory of Applied Proteome Analyses and Research Center PIGMOD, Institute of Animal Physiology and Genetics of The Czech Academy of Sciences, Rumburska 89, Libechov CZ-27721, Czech Republic.,Department of Cell Biology, Faculty of Science, Charles University, Albertov 6, Prague CZ-12843, Czech Republic
| | - Katerina Budkova
- Laboratory of Applied Proteome Analyses and Research Center PIGMOD, Institute of Animal Physiology and Genetics of The Czech Academy of Sciences, Rumburska 89, Libechov CZ-27721, Czech Republic.,Department of Cell Biology, Faculty of Science, Charles University, Albertov 6, Prague CZ-12843, Czech Republic
| | - Andrej Susor
- Laboratory of Biochemistry and Molecular Biology of Germ Cells, Institute of Animal Physiology and Genetics of The Czech Academy of Sciences, Rumburska 89, Libechov CZ-27721, Czech Republic
| | - Martin Marsala
- Neuroregeneration Laboratory, Sanford Consortium for Regenerative Medicine, Department of Anesthesiology, University of California, San Diego, 2880 Torrey Pines Scenic Dr., La Jolla, CA 92037, USA
| | - Jan Motlik
- Laboratory of Cell Regeneration and Plasticity and Research Center PIGMOD, Institute of Animal Physiology and Genetics of The Czech Academy of Sciences, Rumburska 89, Libechov CZ-27721, Czech Republic
| | - Hana Kovarova
- Laboratory of Applied Proteome Analyses and Research Center PIGMOD, Institute of Animal Physiology and Genetics of The Czech Academy of Sciences, Rumburska 89, Libechov CZ-27721, Czech Republic
| | - Petr Vodicka
- Laboratory of Applied Proteome Analyses and Research Center PIGMOD, Institute of Animal Physiology and Genetics of The Czech Academy of Sciences, Rumburska 89, Libechov CZ-27721, Czech Republic
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3
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Jiao Y, Liu YW, Chen WG, Liu J. Neuroregeneration and functional recovery after stroke: advancing neural stem cell therapy toward clinical application. Neural Regen Res 2021; 16:80-92. [PMID: 32788451 PMCID: PMC7818886 DOI: 10.4103/1673-5374.286955] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Stroke is a main cause of death and disability worldwide. The ability of the brain to self-repair in the acute and chronic phases after stroke is minimal; however, promising stem cell-based interventions are emerging that may give substantial and possibly complete recovery of brain function after stroke. Many animal models and clinical trials have demonstrated that neural stem cells (NSCs) in the central nervous system can orchestrate neurological repair through nerve regeneration, neuron polarization, axon pruning, neurite outgrowth, repair of myelin, and remodeling of the microenvironment and brain networks. Compared with other types of stem cells, NSCs have unique advantages in cell replacement, paracrine action, inflammatory regulation and neuroprotection. Our review summarizes NSC origins, characteristics, therapeutic mechanisms and repair processes, then highlights current research findings and clinical evidence for NSC therapy. These results may be helpful to inform the direction of future stroke research and to guide clinical decision-making.
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Affiliation(s)
- Yang Jiao
- Stem Cell Clinical Research Center, National Joint Engineering Laboratory, Regenerative Medicine Center, The First Affiliated Hospital of Dalian Medical University; Dalian Innovation Institute of Stem Cells and Precision Medicine, Dalian, Liaoning Province, China
| | - Yu-Wan Liu
- Stem Cell Clinical Research Center, National Joint Engineering Laboratory, Regenerative Medicine Center, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
| | - Wei-Gong Chen
- Stem Cell Clinical Research Center, National Joint Engineering Laboratory, Regenerative Medicine Center, The First Affiliated Hospital of Dalian Medical University; Dalian Innovation Institute of Stem Cells and Precision Medicine, Dalian, Liaoning Province, China
| | - Jing Liu
- Stem Cell Clinical Research Center, National Joint Engineering Laboratory, Regenerative Medicine Center, The First Affiliated Hospital of Dalian Medical University; Dalian Innovation Institute of Stem Cells and Precision Medicine, Dalian, Liaoning Province, China
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4
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Bravo-Hernandez M, Tadokoro T, Navarro MR, Platoshyn O, Kobayashi Y, Marsala S, Miyanohara A, Juhas S, Juhasova J, Skalnikova H, Tomori Z, Vanicky I, Studenovska H, Proks V, Chen P, Govea-Perez N, Ditsworth D, Ciacci JD, Gao S, Zhu W, Ahrens ET, Driscoll SP, Glenn TD, McAlonis-Downes M, Da Cruz S, Pfaff SL, Kaspar BK, Cleveland DW, Marsala M. Spinal subpial delivery of AAV9 enables widespread gene silencing and blocks motoneuron degeneration in ALS. Nat Med 2019; 26:118-130. [PMID: 31873312 DOI: 10.1038/s41591-019-0674-1] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 10/30/2019] [Indexed: 11/09/2022]
Abstract
Gene silencing with virally delivered shRNA represents a promising approach for treatment of inherited neurodegenerative disorders. In the present study we develop a subpial technique, which we show in adult animals successfully delivers adeno-associated virus (AAV) throughout the cervical, thoracic and lumbar spinal cord, as well as brain motor centers. One-time injection at cervical and lumbar levels just before disease onset in mice expressing a familial amyotrophic lateral sclerosis (ALS)-causing mutant SOD1 produces long-term suppression of motoneuron disease, including near-complete preservation of spinal α-motoneurons and muscle innervation. Treatment after disease onset potently blocks progression of disease and further α-motoneuron degeneration. A single subpial AAV9 injection in adult pigs or non-human primates using a newly designed device produces homogeneous delivery throughout the cervical spinal cord white and gray matter and brain motor centers. Thus, spinal subpial delivery in adult animals is highly effective for AAV-mediated gene delivery throughout the spinal cord and supraspinal motor centers.
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Affiliation(s)
- Mariana Bravo-Hernandez
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California San Diego, La Jolla, CA, USA
| | - Takahiro Tadokoro
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California San Diego, La Jolla, CA, USA.,Department of Anesthesiology, University of the Ryukyus, Okinawa, Japan
| | - Michael R Navarro
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California San Diego, La Jolla, CA, USA
| | - Oleksandr Platoshyn
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California San Diego, La Jolla, CA, USA
| | - Yoshiomi Kobayashi
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California San Diego, La Jolla, CA, USA
| | - Silvia Marsala
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California San Diego, La Jolla, CA, USA
| | - Atsushi Miyanohara
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California San Diego, La Jolla, CA, USA.,Vector Core Laboratory, University of California San Diego, La Jolla, CA, USA
| | - Stefan Juhas
- Institute of Animal Physiology and Genetics, AS CR v.v.i., Liběchov, Czech Republic
| | - Jana Juhasova
- Institute of Animal Physiology and Genetics, AS CR v.v.i., Liběchov, Czech Republic
| | - Helena Skalnikova
- Institute of Animal Physiology and Genetics, AS CR v.v.i., Liběchov, Czech Republic
| | - Zoltan Tomori
- Dept. of Biophysics, Institute of Experimental Physics, Slovak Academy of Sciences, Kosice, Slovakia
| | - Ivo Vanicky
- Institute of Neurobiology, Slovak Academy of Sciences, Kosice, Slovakia
| | - Hana Studenovska
- Department of Biomaterials and Bioanalogous System, Institute of Macromolecular Chemistry, Czech Academy of Sciences, Prague, Czech Republic
| | - Vladimir Proks
- Department of Biomaterials and Bioanalogous System, Institute of Macromolecular Chemistry, Czech Academy of Sciences, Prague, Czech Republic
| | - PeiXi Chen
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California San Diego, La Jolla, CA, USA
| | - Noe Govea-Perez
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California San Diego, La Jolla, CA, USA.,Ludwig Institute for Cancer Research and Department of Cellular and Molecular Medicine, University of California San Diego, La Jolla, CA, USA
| | - Dara Ditsworth
- Ludwig Institute for Cancer Research and Department of Cellular and Molecular Medicine, University of California San Diego, La Jolla, CA, USA
| | - Joseph D Ciacci
- Department of Neurosurgery, University of California San Diego, La Jolla, CA, USA
| | - Shang Gao
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Wenlian Zhu
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Eric T Ahrens
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Shawn P Driscoll
- Gene Expression Laboratory and the Howard Hughes Medical Institute, Salk Institute for Biological Studies, La Jolla, CA, USA
| | - Thomas D Glenn
- Gene Expression Laboratory and the Howard Hughes Medical Institute, Salk Institute for Biological Studies, La Jolla, CA, USA
| | - Melissa McAlonis-Downes
- Ludwig Institute for Cancer Research and Department of Cellular and Molecular Medicine, University of California San Diego, La Jolla, CA, USA
| | - Sandrine Da Cruz
- Ludwig Institute for Cancer Research and Department of Cellular and Molecular Medicine, University of California San Diego, La Jolla, CA, USA
| | - Samuel L Pfaff
- Gene Expression Laboratory and the Howard Hughes Medical Institute, Salk Institute for Biological Studies, La Jolla, CA, USA
| | | | - Don W Cleveland
- Ludwig Institute for Cancer Research and Department of Cellular and Molecular Medicine, University of California San Diego, La Jolla, CA, USA
| | - Martin Marsala
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California San Diego, La Jolla, CA, USA. .,Institute of Neurobiology, Slovak Academy of Sciences, Kosice, Slovakia.
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5
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Marsala M, Kamizato K, Tadokoro T, Navarro M, Juhas S, Juhasova J, Marsala S, Studenovska H, Proks V, Hazel T, Johe K, Kakinohana M, Driscoll S, Glenn T, Pfaff S, Ciacci J. Spinal parenchymal occupation by neural stem cells after subpial delivery in adult immunodeficient rats. Stem Cells Transl Med 2019; 9:177-188. [PMID: 31800978 PMCID: PMC6988771 DOI: 10.1002/sctm.19-0156] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 09/19/2019] [Indexed: 02/01/2023] Open
Abstract
Neural precursor cells (NSCs) hold great potential to treat a variety of neurodegenerative diseases and injuries to the spinal cord. However, current delivery techniques require an invasive approach in which an injection needle is advanced into the spinal parenchyma to deliver cells of interest. As such, this approach is associated with an inherent risk of spinal injury, as well as a limited delivery of cells into multiple spinal segments. Here, we characterize the use of a novel cell delivery technique that employs single bolus cell injections into the spinal subpial space. In immunodeficient rats, two subpial injections of human NSCs were performed in the cervical and lumbar spinal cord, respectively. The survival, distribution, and phenotype of transplanted cells were assessed 6-8 months after injection. Immunofluorescence staining and mRNA sequencing analysis demonstrated a near-complete occupation of the spinal cord by injected cells, in which transplanted human NSCs (hNSCs) preferentially acquired glial phenotypes, expressing oligodendrocyte (Olig2, APC) or astrocyte (GFAP) markers. In the outermost layer of the spinal cord, injected hNSCs differentiated into glia limitans-forming astrocytes and expressed human-specific superoxide dismutase and laminin. All animals showed normal neurological function for the duration of the analysis. These data show that the subpial cell delivery technique is highly effective in populating the entire spinal cord with injected NSCs, and has a potential for clinical use in cell replacement therapies for the treatment of ALS, multiple sclerosis, or spinal cord injury.
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Affiliation(s)
- Martin Marsala
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California, San Diego, La Jolla, California
| | - Kota Kamizato
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California, San Diego, La Jolla, California.,Department of Anesthesia, University of Ryukyus, Okinawa, Japan
| | - Takahiro Tadokoro
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California, San Diego, La Jolla, California.,Department of Anesthesia, University of Ryukyus, Okinawa, Japan
| | - Michael Navarro
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California, San Diego, La Jolla, California
| | - Stefan Juhas
- Institute of Animal Physiology and Genetics, Czech Academy of Sciences, Libechov, Czech Republic
| | - Jana Juhasova
- Institute of Animal Physiology and Genetics, Czech Academy of Sciences, Libechov, Czech Republic
| | - Silvia Marsala
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California, San Diego, La Jolla, California
| | - Hana Studenovska
- Department of Biomaterials and Bioanalogous Systems, Institute of Macromolecular Chemistry, Czech Academy of Sciences, Prague, Czech Republic
| | - Vladimir Proks
- Department of Biomaterials and Bioanalogous Systems, Institute of Macromolecular Chemistry, Czech Academy of Sciences, Prague, Czech Republic
| | - Tom Hazel
- Neuralstem Inc., Germantown, Maryland
| | - Karl Johe
- Neuralstem Inc., Germantown, Maryland
| | | | - Shawn Driscoll
- Gene Expression Laboratory, Howard Hughes Medical Institute, Salk Institute for Biological Studies, La Jolla, California
| | - Thomas Glenn
- Gene Expression Laboratory, Howard Hughes Medical Institute, Salk Institute for Biological Studies, La Jolla, California
| | - Samuel Pfaff
- Gene Expression Laboratory, Howard Hughes Medical Institute, Salk Institute for Biological Studies, La Jolla, California
| | - Joseph Ciacci
- Department of Neurosurgery, University of California, San Diego, La Jolla, California
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6
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A First-in-Human, Phase I Study of Neural Stem Cell Transplantation for Chronic Spinal Cord Injury. Cell Stem Cell 2019; 22:941-950.e6. [PMID: 29859175 DOI: 10.1016/j.stem.2018.05.014] [Citation(s) in RCA: 194] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 04/25/2018] [Accepted: 05/14/2018] [Indexed: 12/14/2022]
Abstract
We tested the feasibility and safety of human-spinal-cord-derived neural stem cell (NSI-566) transplantation for the treatment of chronic spinal cord injury (SCI). In this clinical trial, four subjects with T2-T12 SCI received treatment consisting of removal of spinal instrumentation, laminectomy, and durotomy, followed by six midline bilateral stereotactic injections of NSI-566 cells. All subjects tolerated the procedure well and there have been no serious adverse events to date (18-27 months post-grafting). In two subjects, one to two levels of neurological improvement were detected using ISNCSCI motor and sensory scores. Our results support the safety of NSI-566 transplantation into the SCI site and early signs of potential efficacy in three of the subjects warrant further exploration of NSI-566 cells in dose escalation studies. Despite these encouraging secondary data, we emphasize that this safety trial lacks statistical power or a control group needed to evaluate functional changes resulting from cell grafting.
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7
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Zhang G, Li Y, Reuss JL, Liu N, Wu C, Li J, Xu S, Wang F, Hazel TG, Cunningham M, Zhang H, Dai Y, Hong P, Zhang P, He J, Feng H, Lu X, Ulmer JL, Johe KK, Xu R. Stable Intracerebral Transplantation of Neural Stem Cells for the Treatment of Paralysis Due to Ischemic Stroke. Stem Cells Transl Med 2019; 8:999-1007. [PMID: 31241246 PMCID: PMC6766600 DOI: 10.1002/sctm.18-0220] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 05/10/2019] [Indexed: 12/14/2022] Open
Abstract
NSI‐566 is a stable, primary adherent neural stem cell line derived from a single human fetal spinal cord and expanded epigenetically with no genetic modification. This cell line is being tested in clinical trials in the U.S. for treatment of amyotrophic lateral sclerosis and spinal cord injury. In a single‐site, phase I study, we evaluated the feasibility and safety of NSI‐566 transplantation for the treatment of hemiparesis due to chronic motor stroke and determined the maximum tolerated dose for future trials. Three cohorts (n = 3 per cohort) were transplanted with one‐time intracerebral injections of 1.2 × 107, 2.4 × 107, or 7.2 × 107 cells. Immunosuppression therapy with tacrolimus was maintained for 28 days. All subjects had sustained chronic motor strokes, verified by magnetic resonance imaging (MRI), initiated between 5 and 24 months prior to surgery with modified Rankin Scores [MRSs] of 2, 3, or 4 and Fugl‐Meyer Motor Scores of 55 or less. At the 12‐month visit, the mean Fugl‐Meyer Motor Score (FMMS, total score of 100) for the nine participants showed 16 points of improvement (p = .0078), the mean MRS showed 0.8 points of improvement (p = .031), and the mean National Institutes of Health Stroke Scale showed 3.1 points of improvement (p = .020). For six participants who were followed up for 24 months, these mean changes remained stable. The treatment was well tolerated at all doses. Longitudinal MRI studies showed evidence indicating cavity‐filling by new neural tissue formation in all nine patients. Although this was a small, one‐arm study of feasibility, the results are encouraging to warrant further studies. stem cells translational medicine2019;8:999–1007
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Affiliation(s)
- Guangzhu Zhang
- Affiliated BaYi Brain Hospital, Army General Hospital of PLA, Beijing, People's Republic of China
| | - Ying Li
- Neurology Department, Army General Hospital of PLA, Beijing, People's Republic of China
| | - James L Reuss
- Prism Clinical Imaging, Inc., Milwaukee, Wisconsin, USA
| | - Nan Liu
- Neurology Department, Army General Hospital of PLA, Beijing, People's Republic of China
| | - Cuiying Wu
- Affiliated BaYi Brain Hospital, Army General Hospital of PLA, Beijing, People's Republic of China
| | - Jingpo Li
- Suzhou Neuralstem Biopharmaceutical Co., Ltd., Suzhou, People's Republic of China
| | - Shuangshuang Xu
- Suzhou Neuralstem Biopharmaceutical Co., Ltd., Suzhou, People's Republic of China
| | - Feng Wang
- Suzhou Neuralstem Biopharmaceutical Co., Ltd., Suzhou, People's Republic of China
| | | | - Miles Cunningham
- Laboratory for Neural Reconstruction, McLean Hospital, Harvard Medical School, Belmont, Massachusetts, USA
| | - Hongtian Zhang
- Affiliated BaYi Brain Hospital, Army General Hospital of PLA, Beijing, People's Republic of China
| | - Yiwu Dai
- Affiliated BaYi Brain Hospital, Army General Hospital of PLA, Beijing, People's Republic of China
| | - Peng Hong
- Affiliated BaYi Brain Hospital, Army General Hospital of PLA, Beijing, People's Republic of China
| | - Ping Zhang
- Affiliated BaYi Brain Hospital, Army General Hospital of PLA, Beijing, People's Republic of China
| | - Jianghong He
- Affiliated BaYi Brain Hospital, Army General Hospital of PLA, Beijing, People's Republic of China
| | - Huiru Feng
- Department of Nuclear Medicine, Army General Hospital of PLA, Beijing, People's Republic of China
| | - Xiangdong Lu
- Department of Nuclear Medicine, Army General Hospital of PLA, Beijing, People's Republic of China
| | - John L Ulmer
- Department of Neuroradiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | | | - Ruxiang Xu
- Affiliated BaYi Brain Hospital, Army General Hospital of PLA, Beijing, People's Republic of China
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8
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Chen KS, McGinley LM, Kashlan ON, Hayes JM, Bruno ES, Chang JS, Mendelson FE, Tabbey MA, Johe K, Sakowski SA, Feldman EL. Targeted intraspinal injections to assess therapies in rodent models of neurological disorders. Nat Protoc 2019; 14:331-349. [PMID: 30610242 DOI: 10.1038/s41596-018-0095-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Despite decades of research, pharmacological therapies for spinal cord motor pathologies are limited. Alternatives using macromolecular, viral, or cell-based therapies show early promise. However, introducing these substances into the spinal cord, past the blood-brain barrier, without causing injury is challenging. We describe a technique for intraspinal injection targeting the lumbar ventral horn in rodents. This technique preserves motor performance and has a proven track record of translation into phase 1 and 2 clinical trials in amyotrophic lateral sclerosis (ALS) patients. The procedure, in brief, involves exposure of the thoracolumbar spine and dissection of paraspinous muscles over the target vertebrae. Following laminectomy, the spine is affixed to a stereotactic frame, permitting precise and reproducible injection throughout the lumbar spine. We have used this protocol to inject various stem cell types, primarily human spinal stem cells (HSSCs); however, the injection is adaptable to any candidate therapeutic cell, virus, or macromolecule product. In addition to a detailed procedure, we provide stereotactic coordinates that assist in targeting of the lumbar spine and instructional videos. The protocol takes ~2 h per animal.
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Affiliation(s)
- Kevin S Chen
- Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA
| | - Lisa M McGinley
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Osama N Kashlan
- Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA
| | - John M Hayes
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | | | - Josh S Chang
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Faye E Mendelson
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Maegan A Tabbey
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | | | | | - Eva L Feldman
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA.
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9
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Züchner M, Lervik A, Kondratskaya E, Bettembourg V, Zhang L, Haga HA, Boulland JL. Development of a Multimodal Apparatus to Generate Biomechanically Reproducible Spinal Cord Injuries in Large Animals. Front Neurol 2019; 10:223. [PMID: 30941086 PMCID: PMC6433700 DOI: 10.3389/fneur.2019.00223] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 02/21/2019] [Indexed: 01/08/2023] Open
Abstract
Rodents are widespread animal models in spinal cord injury (SCI) research. They have contributed to obtaining important information. However, some treatments only tested in rodents did not prove efficient in clinical trials. This is probably a result of significant differences in the physiology, anatomy, and complexity between humans and rodents. To bridge this gap in a better way, a few research groups use pig models for SCI. Here we report the development of an apparatus to perform biomechanically reproducible SCI in large animals, including pigs. We present the iterative process of engineering, starting with a weight-drop system to ultimately produce a spring-load impactor. This device allows a graded combination of a contusion and a compression injury. We further engineered a device to entrap the spinal cord and prevent it from escaping at the moment of the impact. In addition, it provides identical resistance around the cord, thereby, optimizing the inter-animal reproducibility. We also present other tools to straighten the vertebral column and to ease the surgery. Sensors mounted on the impactor provide information to assess the inter-animal reproducibility of the impacts. Further evaluation of the injury strength using neurophysiological recordings, MRI scans, and histology shows consistency between impacts. We conclude that this apparatus provides biomechanically reproducible spinal cord injuries in pigs.
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Affiliation(s)
- Mark Züchner
- Department of Neurosurgery, Oslo University Hospital, Oslo, Norway.,Norwegian Center for Stem Cell Research, Oslo University Hospital, Oslo, Norway
| | - Andreas Lervik
- Department of Companion Animal Clinical Sciences, Norwegian University of Life Sciences, Oslo, Norway
| | - Elena Kondratskaya
- Norwegian Center for Stem Cell Research, Oslo University Hospital, Oslo, Norway
| | - Vanessa Bettembourg
- Department of Companion Animal Clinical Sciences, Norwegian University of Life Sciences, Oslo, Norway
| | - Lili Zhang
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Henning A Haga
- Department of Companion Animal Clinical Sciences, Norwegian University of Life Sciences, Oslo, Norway
| | - Jean-Luc Boulland
- Norwegian Center for Stem Cell Research, Oslo University Hospital, Oslo, Norway
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10
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Bohaciakova D, Hruska-Plochan M, Tsunemoto R, Gifford WD, Driscoll SP, Glenn TD, Wu S, Marsala S, Navarro M, Tadokoro T, Juhas S, Juhasova J, Platoshyn O, Piper D, Sheckler V, Ditsworth D, Pfaff SL, Marsala M. A scalable solution for isolating human multipotent clinical-grade neural stem cells from ES precursors. Stem Cell Res Ther 2019; 10:83. [PMID: 30867054 PMCID: PMC6417180 DOI: 10.1186/s13287-019-1163-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 01/13/2019] [Accepted: 02/04/2019] [Indexed: 12/14/2022] Open
Abstract
Background A well-characterized method has not yet been established to reproducibly, efficiently, and safely isolate large numbers of clinical-grade multipotent human neural stem cells (hNSCs) from embryonic stem cells (hESCs). Consequently, the transplantation of neurogenic/gliogenic precursors into the CNS for the purpose of cell replacement or neuroprotection in humans with injury or disease has not achieved widespread testing and implementation. Methods Here, we establish an approach for the in vitro isolation of a highly expandable population of hNSCs using the manual selection of neural precursors based on their colony morphology (CoMo-NSC). The purity and NSC properties of established and extensively expanded CoMo-NSC were validated by expression of NSC markers (flow cytometry, mRNA sequencing), lack of pluripotent markers and by their tumorigenic/differentiation profile after in vivo spinal grafting in three different animal models, including (i) immunodeficient rats, (ii) immunosuppressed ALS rats (SOD1G93A), or (iii) spinally injured immunosuppressed minipigs. Results In vitro analysis of established CoMo-NSCs showed a consistent expression of NSC markers (Sox1, Sox2, Nestin, CD24) with lack of pluripotent markers (Nanog) and stable karyotype for more than 15 passages. Gene profiling and histology revealed that spinally grafted CoMo-NSCs differentiate into neurons, astrocytes, and oligodendrocytes over a 2–6-month period in vivo without forming neoplastic derivatives or abnormal structures. Moreover, transplanted CoMo-NSCs formed neurons with synaptic contacts and glia in a variety of host environments including immunodeficient rats, immunosuppressed ALS rats (SOD1G93A), or spinally injured minipigs, indicating these cells have favorable safety and differentiation characteristics. Conclusions These data demonstrate that manually selected CoMo-NSCs represent a safe and expandable NSC population which can effectively be used in prospective human clinical cell replacement trials for the treatment of a variety of neurodegenerative disorders, including ALS, stroke, spinal traumatic, or spinal ischemic injury. Electronic supplementary material The online version of this article (10.1186/s13287-019-1163-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Dasa Bohaciakova
- Department of Anesthesiology, University of California San Diego School of Medicine, La Jolla, CA, 92093, USA.,Department of Histology and Embryology, Faculty of Medicine, Masaryk University Brno, Kamenice 3, 62500, Brno, Czech Republic
| | - Marian Hruska-Plochan
- Department of Anesthesiology, University of California San Diego School of Medicine, La Jolla, CA, 92093, USA
| | - Rachel Tsunemoto
- Gene Expression Laboratory, Howard Hughes Medical Institute and Salk Institute for Biological Studies, 10010 North Torrey Pines Rd, La Jolla, CA, 92037, USA.,Department of Cellular and Molecular Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Wesley D Gifford
- Gene Expression Laboratory, Howard Hughes Medical Institute and Salk Institute for Biological Studies, 10010 North Torrey Pines Rd, La Jolla, CA, 92037, USA
| | - Shawn P Driscoll
- Gene Expression Laboratory, Howard Hughes Medical Institute and Salk Institute for Biological Studies, 10010 North Torrey Pines Rd, La Jolla, CA, 92037, USA
| | - Thomas D Glenn
- Gene Expression Laboratory, Howard Hughes Medical Institute and Salk Institute for Biological Studies, 10010 North Torrey Pines Rd, La Jolla, CA, 92037, USA
| | - Stephanie Wu
- Department of Anesthesiology, University of California San Diego School of Medicine, La Jolla, CA, 92093, USA
| | - Silvia Marsala
- Department of Anesthesiology, University of California San Diego School of Medicine, La Jolla, CA, 92093, USA
| | - Michael Navarro
- Department of Anesthesiology, University of California San Diego School of Medicine, La Jolla, CA, 92093, USA
| | - Takahiro Tadokoro
- Department of Anesthesiology, University of California San Diego School of Medicine, La Jolla, CA, 92093, USA
| | - Stefan Juhas
- Institute of Animal Physiology and Genetics, v.v.i., AS CR, Liběchov, Czech Republic
| | - Jana Juhasova
- Institute of Animal Physiology and Genetics, v.v.i., AS CR, Liběchov, Czech Republic
| | - Oleksandr Platoshyn
- Department of Anesthesiology, University of California San Diego School of Medicine, La Jolla, CA, 92093, USA
| | - David Piper
- Primary and Stem Cell Systems, Life Technologies (Thermo Fisher Scientific), 501 Charmany Drive, Madison, WI, 53719, USA
| | - Vickie Sheckler
- Sanford Stem Cell Clinical Center, University of California San Diego, La Jolla, CA, 92093, USA
| | - Dara Ditsworth
- Department of Cellular and Molecular Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Samuel L Pfaff
- Gene Expression Laboratory, Howard Hughes Medical Institute and Salk Institute for Biological Studies, 10010 North Torrey Pines Rd, La Jolla, CA, 92037, USA.
| | - Martin Marsala
- Department of Anesthesiology, University of California San Diego School of Medicine, La Jolla, CA, 92093, USA. .,Sanford Consortium for Regenerative Medicine, University of California San Diego, 2880 Torrey Pines Scenic Drive, La Jolla, CA, 92037, USA.
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11
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Bravo-Hernández M, Tadokoro T, Marsala M. Subpial AAV Delivery for Spinal Parenchymal Gene Regulation in Adult Mammals. Methods Mol Biol 2019; 1950:209-233. [PMID: 30783976 DOI: 10.1007/978-1-4939-9139-6_12] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The use of adeno-associated virus (AAV) vectors has become an attractive method for treatment of a variety of neurodegenerative disorders by permitting targeted gene upregulation or silencing in the CNS. Systemic and intrathecal infusion, while preferable routes of vector delivery, have shown encouraging but variable efficacy due to the poor permeability of AAV into spinal cord and brain parenchyma in adult mammals. Recently we have developed a novel and relatively noninvasive technique of spinal subpial vector delivery. This technique confers widespread transgene expression throughout the spinal parenchyma, including both white and gray matter. We have demonstrated that this technique can be performed safely, with a high level of accuracy, and is effective in both small (mouse or rat) and large preclinical (adult pig or nonhuman primate) animal models. In this chapter we provide a comprehensive description of the subpial vector delivery technique in adult rodents (mouse and rat) and large preclinical animals (adult pig and nonhuman primates).
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Affiliation(s)
- Mariana Bravo-Hernández
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California, San Diego, La Jolla, CA, USA
| | - Takahiro Tadokoro
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California, San Diego, La Jolla, CA, USA
| | - Martin Marsala
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California, San Diego, La Jolla, CA, USA.
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12
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Strnadel J, Carromeu C, Bardy C, Navarro M, Platoshyn O, Glud AN, Marsala S, Kafka J, Miyanohara A, Kato T, Tadokoro T, Hefferan MP, Kamizato K, Yoshizumi T, Juhas S, Juhasova J, Ho CS, Kheradmand T, Chen P, Bohaciakova D, Hruska-Plochan M, Todd AJ, Driscoll SP, Glenn TD, Pfaff SL, Klima J, Ciacci J, Curtis E, Gage FH, Bui J, Yamada K, Muotri AR, Marsala M. Survival of syngeneic and allogeneic iPSC–derived neural precursors after spinal grafting in minipigs. Sci Transl Med 2018; 10:10/440/eaam6651. [DOI: 10.1126/scitranslmed.aam6651] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2016] [Revised: 11/17/2017] [Accepted: 04/19/2018] [Indexed: 12/15/2022]
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13
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Goutman SA, Brown MB, Glass JD, Boulis NM, Johe K, Hazel T, Cudkowicz M, Atassi N, Borges L, Patil PG, Sakowski SA, Feldman EL. Long-term Phase 1/2 intraspinal stem cell transplantation outcomes in ALS. Ann Clin Transl Neurol 2018; 5:730-740. [PMID: 29928656 PMCID: PMC5989736 DOI: 10.1002/acn3.567] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 03/25/2018] [Indexed: 12/12/2022] Open
Abstract
Objective Intraspinal human spinal cord‐derived neural stem cell (HSSC) transplantation is a potential therapy for amyotrophic lateral sclerosis (ALS); however, previous trials lack controls. This post hoc analysis compared ambulatory limb‐onset ALS participants in Phase 1 and 2 (Ph1/2) open‐label intraspinal HSSC transplantation studies up to 3 years after transplant to matched participants in Pooled Resource Open‐Access ALS Clinical Trials (PRO‐ACT) and ceftriaxone datasets to provide required analyses to inform future clinical trial designs. Methods Survival, ALSFRS‐R, and a composite statistic (ALS/SURV) combining survival and ALS Functional Rating Scale revised (ALSFRS‐R) functional status were assessed for matched participant subsets: PRO‐ACT n = 1108, Ph1/2 n = 21 and ceftriaxone n = 177, Ph1/2 n = 20. Results Survival did not differ significantly between cohorts: Ph1/2 median survival 4.7 years, 95% CI (1.2, ∞) versus PRO‐ACT 2.3 years (1.9, 2.5), P = 1.0; Ph1/2 3.0 years (1.2, 5.6) versus ceftriaxone 2.3 years (1.8, 2.8), P = 0.88. Mean ALSFRS‐R at 24 months significantly differed between Ph1/2 and both comparison cohorts (Ph1/2 30.1 ± 8.6 vs. PRO‐ACT 24.0 ± 10.2, P = 0.048; Ph1/2 30.7 ± 8.8 vs. ceftriaxone 19.2 ± 9.5, P = 0.0023). Using ALS/SURV, median PRO‐ACT and ceftriaxone participants died by 24 months, whereas median Ph1/2 participant ALSFRS‐Rs were 23 (P = 0.0038) and 19 (P = 0.14) in PRO‐ACT and ceftriaxone comparisons at 24 months, respectively, supporting improved functional outcomes in the Ph1/2 study. Interpretation Comparison of Ph1/2 studies to historical datasets revealed significantly improved survival and function using ALS/SURV versus PRO‐ACT controls. While results are encouraging, comparison against historical populations demonstrate limitations in noncontrolled studies. These findings support continued evaluation of HSSC transplantation in ALS, support the benefit of control populations, and enable necessary power calculations to design a randomized, sham surgery‐controlled efficacy study.
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Affiliation(s)
- Stephen A Goutman
- Department of Neurology University of Michigan 109 Zina Pitcher Place 5017 AAT-BSRB Ann Arbor Michigan 48109
| | - Morton B Brown
- Department of Biostatistics University of Michigan 1415 Washington Heights M4039 SPH II Ann Arbor Michigan 48109
| | - Jonathan D Glass
- Department of Neurology Emory University School of Medicine 101 Woodruff Circle Atlanta Georgia 30322
| | - Nicholas M Boulis
- Department of Neurosurgery Emory University School of Medicine 101 Woodruff Circle WMB Room 6309 Atlanta Georgia
| | - Karl Johe
- Neuralstem, Inc. 20271 Goldenrod Lane Suite 2033 Germantown Maryland 20876
| | - Tom Hazel
- Neuralstem, Inc. 20271 Goldenrod Lane Suite 2033 Germantown Maryland 20876
| | - Merit Cudkowicz
- Department of Neurology Massachusetts General Hospital Harvard Medical School 165 Cambridge Street Boston Massachusetts 02114
| | - Nazem Atassi
- Department of Neurology Massachusetts General Hospital Harvard Medical School 165 Cambridge Street Boston Massachusetts 02114
| | - Lawrence Borges
- Department of Neurosurgery Massachusetts General Hospital Harvard Medical School 15 Parkman Street Wand ACC 745 Boston Massachusetts 02114
| | - Parag G Patil
- Department of Neurology University of Michigan 109 Zina Pitcher Place 5017 AAT-BSRB Ann Arbor Michigan 48109.,Department of Neurosurgery University of Michigan 1500 E. Medical Center Drive SPC 5338 Ann Arbor Michigan 48109
| | - Stacey A Sakowski
- Program for Neurology Research and Discovery University of Michigan 109 Zina Pitcher Place 5017 AAT-BSRB Ann Arbor Michigan 48109
| | - Eva L Feldman
- Department of Neurology University of Michigan 109 Zina Pitcher Place 5017 AAT-BSRB Ann Arbor Michigan 48109.,Program for Neurology Research and Discovery University of Michigan 109 Zina Pitcher Place 5017 AAT-BSRB Ann Arbor Michigan 48109
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14
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Amer MH, Rose FRAJ, Shakesheff KM, Modo M, White LJ. Translational considerations in injectable cell-based therapeutics for neurological applications: concepts, progress and challenges. NPJ Regen Med 2017; 2:23. [PMID: 29302358 PMCID: PMC5677964 DOI: 10.1038/s41536-017-0028-x] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 06/27/2017] [Accepted: 07/12/2017] [Indexed: 12/11/2022] Open
Abstract
Significant progress has been made during the past decade towards the clinical adoption of cell-based therapeutics. However, existing cell-delivery approaches have shown limited success, with numerous studies showing fewer than 5% of injected cells persisting at the site of injection within days of transplantation. Although consideration is being increasingly given to clinical trial design, little emphasis has been given to tools and protocols used to administer cells. The different behaviours of various cell types, dosing accuracy, precise delivery, and cell retention and viability post-injection are some of the obstacles facing clinical translation. For efficient injectable cell transplantation, accurate characterisation of cellular health post-injection and the development of standardised administration protocols are required. This review provides an overview of the challenges facing effective delivery of cell therapies, examines key studies that have been carried out to investigate injectable cell delivery, and outlines opportunities for translating these findings into more effective cell-therapy interventions.
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Affiliation(s)
- Mahetab H. Amer
- School of Pharmacy, University of Nottingham, Nottingham, NG7 2RD UK
| | | | | | - Michel Modo
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA USA
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA USA
| | - Lisa J. White
- School of Pharmacy, University of Nottingham, Nottingham, NG7 2RD UK
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15
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Choi SS, Yoon SB, Lee SR, Kim SU, Cha YJ, Lee D, Kim SU, Chang KT, Lee HJ. Establishment and Characterization of Immortalized Minipig Neural Stem Cell Line. Cell Transplant 2017; 26:271-281. [PMID: 27524466 DOI: 10.3727/096368916x692852] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Despite the increasing importance of minipigs in biomedical research, there has been relatively little research concerning minipig-derived adult stem cells as a promising research tool that could be used to develop stem cell-based therapies. We first generated immortalized neural stem cells (iNSCs) from primary minipig olfactory bulb cells (pmpOBCs) and defined the characteristics of the cell line. Primary neural cells were prepared from minipig neonate olfactory bulbs and immortalized by infection with retrovirus carrying the v-myc gene. The minipig iNSCs (mpiNSCs) had normal karyotypes and expressed NSC-specific markers, including nestin, vimentin, Musashi1, and SOX2, suggesting a similarity to human NSCs. On the basis of the global gene expression profiles from the microarray analysis, neurogenesis-associated transcript levels were predominantly altered in mpiNSCs compared with pmpOBCs. These findings increase our understanding of minipig stem cells and contribute to the utility of mpiNSCs as resources for immortalized stem cell experiments.
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16
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Miyanohara A, Kamizato K, Juhas S, Juhasova J, Navarro M, Marsala S, Lukacova N, Hruska-Plochan M, Curtis E, Gabel B, Ciacci J, Ahrens ET, Kaspar BK, Cleveland D, Marsala M. Potent spinal parenchymal AAV9-mediated gene delivery by subpial injection in adult rats and pigs. MOLECULAR THERAPY-METHODS & CLINICAL DEVELOPMENT 2016; 3:16046. [PMID: 27462649 PMCID: PMC4943453 DOI: 10.1038/mtm.2016.46] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 05/14/2016] [Indexed: 12/30/2022]
Abstract
Effective in vivo use of adeno-associated virus (AAV)-based vectors to achieve gene-specific silencing or upregulation in the central nervous system has been limited by the inability to provide more than limited deep parenchymal expression in adult animals using delivery routes with the most clinical relevance (intravenous or intrathecal). Here, we demonstrate that the spinal pia membrane represents the primary barrier limiting effective AAV9 penetration into the spinal parenchyma after intrathecal AAV9 delivery. We develop a novel subpial AAV9 delivery technique and AAV9-dextran formulation. We use these in adult rats and pigs to show (i) potent spinal parenchymal transgene expression in white and gray matter including neurons, glial and endothelial cells after single bolus subpial AAV9 delivery; (ii) delivery to almost all apparent descending motor axons throughout the length of the spinal cord after cervical or thoracic subpial AAV9 injection; (iii) potent retrograde transgene expression in brain motor centers (motor cortex and brain stem); and (iv) the relative safety of this approach by defining normal neurological function for up to 6 months after AAV9 delivery. Thus, subpial delivery of AAV9 enables gene-based therapies with a wide range of potential experimental and clinical utilizations in adult animals and human patients.
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Affiliation(s)
- Atsushi Miyanohara
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California , San Diego, California, USA
| | - Kota Kamizato
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California , San Diego, California, USA
| | - Stefan Juhas
- Institute of Animal Physiology and Genetics, Czech Academy of Sciences , Libechov, Czech Republic
| | - Jana Juhasova
- Institute of Animal Physiology and Genetics, Czech Academy of Sciences , Libechov, Czech Republic
| | - Michael Navarro
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California , San Diego, California, USA
| | - Silvia Marsala
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California , San Diego, California, USA
| | - Nada Lukacova
- Institute of Neurobiology, Slovak Academy of Sciences , Kosice, Slovak Republic
| | | | - Erik Curtis
- Department of Neurosurgery, University of California , San Diego, California, USA
| | - Brandon Gabel
- Department of Neurosurgery, University of California , San Diego, California, USA
| | - Joseph Ciacci
- Department of Neurosurgery, University of California , San Diego, California, USA
| | - Eric T Ahrens
- Department of Radiology, University of California , San Diego, California, USA
| | - Brian K Kaspar
- Department of Pediatrics, The Ohio State University, The Research Institute at Nationwide Children's Hospital , Columbus, Ohio, USA
| | - Don Cleveland
- Ludwig Institute and Department of Cellular and Molecular Medicine, University of California, San Diego, California, USA; Ludwig Institute and Department of Neurosciences, University of California, San Diego, California, USA
| | - Martin Marsala
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California, San Diego, California, USA; Institute of Neurobiology, Slovak Academy of Sciences, Kosice, Slovak Republic
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17
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Lunn JS, Sakowski SA, McGinley LM, Pacut C, Hazel TG, Johe K, Feldman EL. Autocrine production of IGF-I increases stem cell-mediated neuroprotection. Stem Cells 2016; 33:1480-9. [PMID: 25532472 DOI: 10.1002/stem.1933] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 12/01/2014] [Indexed: 12/12/2022]
Abstract
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disorder resulting in motor neuron (MN) loss. There are currently no effective therapies; however, cellular therapies using neural progenitor cells protect MNs and attenuate disease progression in G93A-SOD1 ALS rats. Recently, we completed a phase I clinical trial examining intraspinal human spinal stem cell (HSSC) transplantation in ALS patients which demonstrated our approach was safe and feasible, supporting the phase II trial currently in progress. In parallel, efforts focused on understanding the mechanisms underlying the preclinical benefit of HSSCs in vitro and in animal models of ALS led us to investigate how insulin-like growth factor-I (IGF-I) production contributes to cellular therapy neuroprotection. IGF-I is a potent growth factor with proven efficacy in preclinical ALS studies, and we contend that autocrine IGF-I production may enhance the salutary effects of HSSCs. By comparing the biological properties of HSSCs to HSSCs expressing sixfold higher levels of IGF-I, we demonstrate that IGF-I production augments the production of glial-derived neurotrophic factor and accelerates neurite outgrowth without adversely affecting HSSC proliferation or terminal differentiation. Furthermore, we demonstrate that increased IGF-I induces more potent MN protection from excitotoxicity via both indirect and direct mechanisms, as demonstrated using hanging inserts with primary MNs or by culturing with organotypic spinal cord slices, respectively. These findings support our theory that combining autocrine growth factor production with HSSC transplantation may offer a novel means to achieve additive neuroprotection in ALS.
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18
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Chen KS, Sakowski SA, Feldman EL. Intraspinal stem cell transplantation for amyotrophic lateral sclerosis. Ann Neurol 2016; 79:342-53. [PMID: 26696091 DOI: 10.1002/ana.24584] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 12/18/2015] [Accepted: 12/18/2015] [Indexed: 12/11/2022]
Abstract
Amyotrophic lateral sclerosis (ALS) is a devastating neurodegenerative disorder in which the loss of upper and lower motor neurons produces progressive weakness and eventually death. In the decades since the approval of riluzole, the only US Food and Drug Administration-approved medication to moderately slow progression of ALS, no new therapeutics have arisen to alter the course of the disease. This is partly due to our incomplete understanding of the complex pathogenesis of motor neuron degeneration. Stem cells have emerged as an attractive option in treating ALS, because they come armed with equally complex cellular machinery and may modulate the local microenvironment in many ways to rescue diseased motor neurons. Various stem cell types are being evaluated in preclinical and early clinical applications; here, we review the preclinical strategies and advances supporting the recent clinical translation of neural progenitor cell therapy for ALS. Specifically, we focus on the use of spinal cord neural progenitor cells and the pipeline starting from preclinical studies to the designs of phase I and IIa clinical trials involving direct intraspinal transplantation in humans.
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Affiliation(s)
- Kevin S Chen
- Department of Neurosurgery, University of Michigan, Ann Arbor, MI
| | - Stacey A Sakowski
- A. Alfred Taubman Medical Research Institute, University of Michigan, Ann Arbor, MI
| | - Eva L Feldman
- A. Alfred Taubman Medical Research Institute and Department of Neurology, University of Michigan, Ann Arbor, MI
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19
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Ma Z, Zhang YP, Liu W, Yan G, Li Y, Shields LBE, Walker M, Chen K, Huang W, Kong M, Lu Y, Brommer B, Chen X, Xu XM, Shields CB. A controlled spinal cord contusion for the rhesus macaque monkey. Exp Neurol 2016; 279:261-273. [PMID: 26875994 DOI: 10.1016/j.expneurol.2016.02.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 02/07/2016] [Accepted: 02/09/2016] [Indexed: 01/23/2023]
Abstract
Most in vivo spinal cord injury (SCI) experimental models use rodents. Due to the anatomical and functional differences between rodents and humans, reliable large animal models, such as non-human primates, of SCI are critically needed to facilitate translation of laboratory discoveries to clinical applications. Here we report the establishment of a controlled spinal contusion model that produces severity-dependent functional and histological deficits in non-human primates. Six adult male rhesus macaque monkeys underwent mild to moderate contusive SCI using 1.0 and 1.5mm tissue displacement injuries at T9 or sham laminectomy (n=2/group). Multiple assessments including motor-evoked potential (MEP), somatosensory-evoked potential (SSEP), MR imaging, and monkey hindlimb score (MHS) were performed. Monkeys were sacrificed at 6 months post-injury, and the lesion area was examined for cavitation, axons, myelin, and astrocytic responses. The MHS demonstrated that both the 1.0 and 1.5mm displacement injuries created discriminative neurological deficits which were severity-dependent. The MEP response rate was depressed after a 1.0mm injury and was abolished after a 1.5mm injury. The SSEP response rate was slightly decreased following both the 1.0 and 1.5mm SCI. MRI imaging demonstrated an increase in T2 signal at the lesion site at 3 and 6months, and diffusion tensor imaging (DTI) tractography showed interrupted fiber tracts at the lesion site at 4h and at 6 months post-SCI. Histologically, severity-dependent spinal cord atrophy, axonal degeneration, and myelin loss were found after both injury severities. Notably, strong astrocytic gliosis was not observed at the lesion penumbra in the monkey. In summary, we describe the development of a clinically-relevant contusive SCI model that produces severity-dependent anatomical and functional deficits in non-human primates. Such a model may advance the translation of novel SCI repair strategies to the clinic.
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Affiliation(s)
- Zhengwen Ma
- Department of Laboratory Animal Sciences, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, PR China
| | - Yi Ping Zhang
- Norton Neuroscience Institute, Norton Healthcare, Louisville, KY 40202, USA
| | - Wei Liu
- Department of Laboratory Animal Sciences, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, PR China
| | - Guofeng Yan
- Department of Laboratory Animal Sciences, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, PR China
| | - Yao Li
- Department of Laboratory Animal Sciences, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, PR China
| | - Lisa B E Shields
- Norton Neuroscience Institute, Norton Healthcare, Louisville, KY 40202, USA
| | - Melissa Walker
- Spinal Cord and Brain Injury Research Group, Stark Neurosciences Research Institute, Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Kemin Chen
- Department of Radiology, Ruijing Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, PR China
| | - Wei Huang
- Department of Radiology, Ruijing Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, PR China
| | - Maiying Kong
- Department of Bioinformatics and Biostatistics, SPHIS, University of Louisville School of Medicine, Louisville, KY 40292, USA
| | - Yi Lu
- Department of Neurosurgery, Harvard Medical School, Boston, MA 02115, USA
| | - Benedikt Brommer
- Department of Neurology, Harvard Medical School, Boston, MA 02115, USA
| | - Xuejin Chen
- Department of Laboratory Animal Sciences, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, PR China.
| | - Xiao-Ming Xu
- Department of Laboratory Animal Sciences, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, PR China; Spinal Cord and Brain Injury Research Group, Stark Neurosciences Research Institute, Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
| | - Christopher B Shields
- Norton Neuroscience Institute, Norton Healthcare, Louisville, KY 40202, USA; Department of Anatomical Sciences and Neurobiology, University of Louisville School of Medicine, Louisville, KY 40292, USA.
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20
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Time course of spinal doublecortin expression in developing rat and porcine spinal cord: implication in in vivo neural precursor grafting studies. Cell Mol Neurobiol 2014; 35:57-70. [PMID: 25487013 DOI: 10.1007/s10571-014-0145-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 11/19/2014] [Indexed: 12/13/2022]
Abstract
Expression of doublecortin (DCX), a 43-53 kDa microtubule binding protein, is frequently used as (i) an early neuronal marker to identify the stage of neuronal maturation of in vivo grafted neuronal precursors (NSCs), and (ii) a neuronal fate marker transiently expressed by immature neurons during development. Reliable identification of the origin of DCX-immunoreactive cells (i.e., host vs. graft) requires detailed spatial and temporal mapping of endogenous DCX expression at graft-targeted brain or spinal cord regions. Accordingly, in the present study, we analyzed (i) the time course of DCX expression in pre- and postnatal rat and porcine spinal cord, and (ii) the DCX expression in spinally grafted porcine-induced pluripotent stem cells (iPS)-derived NSCs and human embryonic stem cell (ES)-derived NSCs. In addition, complementary temporospatial GFAP expression study in porcine spinal cord was also performed. In 21-day-old rat fetuses, an intense DCX immunoreactivity distributed between the dorsal horn (DH) and ventral horn was seen and was still present in the DH neurons on postnatal day 20. In animals older than 8 weeks, no DCX immunoreactivity was seen at any spinal cord laminae. In contrast to rat, in porcine spinal cord (gestational period 113-114 days), DCX was only expressed during the pre-natal period (up to 100 days) but was no longer present in newborn piglets or in adult animals. Immunohistochemical analysis was confirmed with a comparable expression profile by western blot analysis. Contrary, the expression of porcine GFAP started within 70-80 days of the pre-natal period. Spinally grafted porcine iPS-NSCs and human ES-NSCs showed clear DCX expression at 3-4 weeks postgrafting. These data indicate that in spinal grafting studies which employ postnatal or adult porcine models, the expression of DCX can be used as a reliable marker of grafted neurons. In contrast, if grafted neurons are to be analyzed during the first 4 postnatal weeks in the rat spinal cord, additional markers or grafted cell-specific labeling techniques need to be employed to reliably identify grafted early postmitotic neurons and to differentiate the DCX expression from the neurons of the host.
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Pomeshchik Y, Puttonen KA, Kidin I, Ruponen M, Lehtonen S, Malm T, Åkesson E, Hovatta O, Koistinaho J. Transplanted Human Induced Pluripotent Stem Cell-Derived Neural Progenitor Cells Do Not Promote Functional Recovery of Pharmacologically Immunosuppressed Mice With Contusion Spinal Cord Injury. Cell Transplant 2014; 24:1799-812. [PMID: 25203632 DOI: 10.3727/096368914x684079] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Improved functional recovery after spinal cord injury by transplantation of induced pluripotent stem cell-derived neural stem/progenitor cells (iPSC-NPCs) has been reported. However, beneficial effects of iPSC-based therapy have so far been produced mostly using genetically immunodeficient rodents. Because of the long time required for generation and characterization of iPSCs, the use of autologous iPSCs for treating patients with acute spinal cord injury (SCI) is not feasible. Therefore, it is of utmost importance to investigate the effect of iPSC-based therapy on functional recovery after SCI using pharmacologically immunosuppressed, immunocompetent animal models. Here we studied the functional outcome following subacute transplantation of human iPSC-derived NPCs into contused mouse spinal cord when tacrolimus was used as an immunosuppressive agent. We show that human iPSC-derived NPCs transplanted into pharmacologically immunosuppressed C57BL/6J mice exhibited poor long-term survival and failed to improve functional recovery after SCI as measured by Basso Mouse Scale (BMS) for locomotion and CatWalk gait analysis when compared to vehicle-treated animals. The scarce effect of iPSC-based therapy observed in the current study may be attributable to insufficient immunosuppressive effect, provided by monotherapy with tacrolimus in combination with immunogenicity of transplanted cells and complex microenvironment of the injured spinal cord. Our results highlight the importance of extensive preclinical studies of transplanted cells before the clinical application of iPSC-based cell therapy is achieved.
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Affiliation(s)
- Yuriy Pomeshchik
- Department of Neurobiology, A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
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Dolezalova D, Hruska-Plochan M, Bjarkam CR, Sørensen JCH, Cunningham M, Weingarten D, Ciacci JD, Juhas S, Juhasova J, Motlik J, Hefferan MP, Hazel T, Johe K, Carromeu C, Muotri A, Bui J, Strnadel J, Marsala M. Pig models of neurodegenerative disorders: Utilization in cell replacement-based preclinical safety and efficacy studies. J Comp Neurol 2014; 522:2784-801. [DOI: 10.1002/cne.23575] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2013] [Revised: 02/13/2014] [Accepted: 02/14/2014] [Indexed: 12/12/2022]
Affiliation(s)
- Dasa Dolezalova
- Department of Anesthesiology; University of California; San Diego La Jolla CA USA
| | | | - Carsten R. Bjarkam
- Department of Neurosurgery; Aalborg University Hospital; Aalborg Denmark
- Department of Biomedicine; Institute of Anatomy, University of Aarhus; Aarhus Denmark
| | | | - Miles Cunningham
- MRC 312, McLean Hospital, Harvard Medical School; Belmont MA 02478 USA
| | - David Weingarten
- UCSD Division of Neurosurgery; University of California; San Diego CA USA
| | - Joseph D. Ciacci
- UCSD Division of Neurosurgery; University of California; San Diego CA USA
| | - Stefan Juhas
- Institute of Animal Physiology and Genetics, Czech Academy of Sciences; 277 21 Libechov Czech Republic
| | - Jana Juhasova
- Institute of Animal Physiology and Genetics, Czech Academy of Sciences; 277 21 Libechov Czech Republic
| | - Jan Motlik
- Institute of Animal Physiology and Genetics, Czech Academy of Sciences; 277 21 Libechov Czech Republic
| | | | | | | | - Cassiano Carromeu
- Department of Cellular and Molecular Medicine; University of California; San Diego CA USA
| | - Alysson Muotri
- Department of Cellular and Molecular Medicine; University of California; San Diego CA USA
| | - Jack Bui
- Department of Pathology; University of California; San Diego CA USA
| | - Jan Strnadel
- Department of Pathology; University of California; San Diego CA USA
| | - Martin Marsala
- Department of Anesthesiology; University of California; San Diego La Jolla CA USA
- Institute of Neurobiology, Slovak Academy of Sciences; Kosice Slovakia
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Tajiri N, Quach DM, Kaneko Y, Wu S, Lee D, Lam T, Hayama KL, Hazel TG, Johe K, Wu MC, Borlongan CV. Behavioral and histopathological assessment of adult ischemic rat brains after intracerebral transplantation of NSI-566RSC cell lines. PLoS One 2014; 9:e91408. [PMID: 24614895 PMCID: PMC3948841 DOI: 10.1371/journal.pone.0091408] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Accepted: 02/10/2014] [Indexed: 02/06/2023] Open
Abstract
Stroke is a major cause of death and disability, with very limited treatment option. Cell-based therapies have emerged as potential treatments for stroke. Indeed, studies have shown that transplantation of neural stem cells (NSCs) exerts functional benefits in stroke models. However, graft survival and integration with the host remain pressing concerns with cell-based treatments. The current study set out to investigate those very issues using a human NSC line, NSI-566RSC, in a rat model of ischemic stroke induced by transient occlusion of the middle cerebral artery. Seven days after stroke surgery, those animals that showed significant motor and neurological impairments were randomly assigned to receive NSI-566RSC intracerebral transplants at two sites within the striatum at three different doses: group A (0 cells/µl), group B (5,000 cells/µl), group C (10,000 cells/µl), and group D (20,000 cells/µl). Weekly behavioral tests, starting at seven days and continued up to 8 weeks after transplantation, revealed dose-dependent recovery from both motor and neurological deficits in transplanted stroke animals. Eight weeks after cell transplantation, immunohistochemical investigations via hematoxylin and eosin staining revealed infarct size was similar across all groups. To identify the cell graft, and estimate volume, immunohistochemistry was performed using two human-specific antibodies: one to detect all human nuclei (HuNu), and another to detect human neuron-specific enolase (hNSE). Surviving cell grafts were confirmed in 10/10 animals of group B, 9/10 group C, and 9/10 in group D. hNSE and HuNu staining revealed similar graft volume estimates in transplanted stroke animals. hNSE-immunoreactive fibers were also present within the corpus callosum, coursing in parallel with host tracts, suggesting a propensity to follow established neuroanatomical features. Despite absence of reduction in infarct volume, NSI-566RSC transplantation produced behavioral improvements possibly via robust engraftment and neuronal differentiation, supporting the use of this NSC line for stroke therapy.
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Affiliation(s)
- Naoki Tajiri
- Center of Excellence for Aging & Brain Repair, Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, Tampa, Florida, United States of America
| | - David M. Quach
- Neuralstem, Inc., Rockville, Maryland, United States of America
| | - Yuji Kaneko
- Center of Excellence for Aging & Brain Repair, Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, Tampa, Florida, United States of America
| | - Stephanie Wu
- Neuralstem, Inc., Rockville, Maryland, United States of America
| | - David Lee
- Neuralstem, Inc., Rockville, Maryland, United States of America
| | - Tina Lam
- Neuralstem, Inc., Rockville, Maryland, United States of America
| | - Ken L. Hayama
- Neuralstem, Inc., Rockville, Maryland, United States of America
| | - Thomas G. Hazel
- Neuralstem, Inc., Rockville, Maryland, United States of America
| | - Karl Johe
- Neuralstem, Inc., Rockville, Maryland, United States of America
| | - Michael C. Wu
- Neurodigitech, LLC., San Diego, California, United States of America
| | - Cesar V. Borlongan
- Center of Excellence for Aging & Brain Repair, Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, Tampa, Florida, United States of America
- * E-mail:
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Sevc J, Goldberg D, van Gorp S, Leerink M, Juhas S, Juhasova J, Marsala S, Hruska-Plochan M, Hefferan MP, Motlik J, Rypacek F, Machova L, Kakinohana O, Santucci C, Johe K, Lukacova N, Yamada K, Bui JD, Marsala M. Effective long-term immunosuppression in rats by subcutaneously implanted sustained-release tacrolimus pellet: Effect on spinally grafted human neural precursor survival. Exp Neurol 2013; 248:85-99. [DOI: 10.1016/j.expneurol.2013.05.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Revised: 05/21/2013] [Accepted: 05/26/2013] [Indexed: 01/14/2023]
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Acharya MM, Christie LA, Hazel TG, Johe KK, Limoli CL. Transplantation of human fetal-derived neural stem cells improves cognitive function following cranial irradiation. Cell Transplant 2013; 23:1255-66. [PMID: 23866792 DOI: 10.3727/096368913x670200] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Treatment of central nervous system (CNS) malignancies typically involves radiotherapy to forestall tumor growth and recurrence following surgical resection. Despite the many benefits of cranial radiotherapy, survivors often suffer from a wide range of debilitating and progressive cognitive deficits. Thus, while patients afflicted with primary and secondary malignancies of the CNS now experience longer local regional control and progression-free survival, there remains no clinical recourse for the unintended neurocognitive sequelae associated with their cancer treatments. Multiple mechanisms contribute to disrupted cognition following irradiation, including the depletion of radiosensitive populations of stem and progenitor cells in the hippocampus. We have explored the potential of using intrahippocampal transplantation of human stem cells to ameliorate radiation-induced cognitive dysfunction. Past studies demonstrated the capability of cranially transplanted human embryonic (hESCs) and neural (hNSCs) stem cells to functionally restore cognition in rats 1 and 4 months after cranial irradiation. The present study employed an FDA-approved fetal-derived hNSC line capable of large scale-up under good manufacturing practice (GMP). Animals receiving cranial transplantation of these cells 1 month following irradiation showed improved hippocampal spatial memory and contextual fear conditioning performance compared to irradiated, sham surgery controls. Significant newly born (doublecortin positive) neurons and a smaller fraction of glial subtypes were observed within and nearby the transplantation core. Engrafted cells migrated and differentiated into neuronal and glial subtypes throughout the CA1 and CA3 subfields of the host hippocampus. These studies expand our prior findings to demonstrate that transplantation of fetal-derived hNSCs improves cognitive deficits in irradiated animals, as assessed by two separate cognitive tasks.
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Affiliation(s)
- Munjal M Acharya
- Department of Radiation Oncology, University of California, Irvine, CA, USA
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van Gorp S, Leerink M, Kakinohana O, Platoshyn O, Santucci C, Galik J, Joosten EA, Hruska-Plochan M, Goldberg D, Marsala S, Johe K, Ciacci JD, Marsala M. Amelioration of motor/sensory dysfunction and spasticity in a rat model of acute lumbar spinal cord injury by human neural stem cell transplantation. Stem Cell Res Ther 2013; 4:57. [PMID: 23710605 PMCID: PMC3706882 DOI: 10.1186/scrt209] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Accepted: 04/25/2013] [Indexed: 12/15/2022] Open
Abstract
Introduction Intraspinal grafting of human neural stem cells represents a promising approach to promote recovery of function after spinal trauma. Such a treatment may serve to: I) provide trophic support to improve survival of host neurons; II) improve the structural integrity of the spinal parenchyma by reducing syringomyelia and scarring in trauma-injured regions; and III) provide neuronal populations to potentially form relays with host axons, segmental interneurons, and/or α-motoneurons. Here we characterized the effect of intraspinal grafting of clinical grade human fetal spinal cord-derived neural stem cells (HSSC) on the recovery of neurological function in a rat model of acute lumbar (L3) compression injury. Methods Three-month-old female Sprague–Dawley rats received L3 spinal compression injury. Three days post-injury, animals were randomized and received intraspinal injections of either HSSC, media-only, or no injections. All animals were immunosuppressed with tacrolimus, mycophenolate mofetil, and methylprednisolone acetate from the day of cell grafting and survived for eight weeks. Motor and sensory dysfunction were periodically assessed using open field locomotion scoring, thermal/tactile pain/escape thresholds and myogenic motor evoked potentials. The presence of spasticity was measured by gastrocnemius muscle resistance and electromyography response during computer-controlled ankle rotation. At the end-point, gait (CatWalk), ladder climbing, and single frame analyses were also assessed. Syrinx size, spinal cord dimensions, and extent of scarring were measured by magnetic resonance imaging. Differentiation and integration of grafted cells in the host tissue were validated with immunofluorescence staining using human-specific antibodies. Results Intraspinal grafting of HSSC led to a progressive and significant improvement in lower extremity paw placement, amelioration of spasticity, and normalization in thermal and tactile pain/escape thresholds at eight weeks post-grafting. No significant differences were detected in other CatWalk parameters, motor evoked potentials, open field locomotor (Basso, Beattie, and Bresnahan locomotion score (BBB)) score or ladder climbing test. Magnetic resonance imaging volume reconstruction and immunofluorescence analysis of grafted cell survival showed near complete injury-cavity-filling by grafted cells and development of putative GABA-ergic synapses between grafted and host neurons. Conclusions Peri-acute intraspinal grafting of HSSC can represent an effective therapy which ameliorates motor and sensory deficits after traumatic spinal cord injury.
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Federici T, Hurtig CV, Burks KL, Riley JP, Krishna V, Miller BA, Sribnick EA, Miller JH, Grin N, Lamanna JJ, Boulis NM. Surgical technique for spinal cord delivery of therapies: demonstration of procedure in gottingen minipigs. J Vis Exp 2012:e4371. [PMID: 23242422 DOI: 10.3791/4371] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
This is a compact visual description of a combination of surgical technique and device for the delivery of (gene and cell) therapies into the spinal cord. While the technique is demonstrated in the animal, the procedure is FDA-approved and currently being used for stem cell transplantation into the spinal cords of patients with ALS. While the FDA has recognized proof-of-principle data on therapeutic efficacy in highly characterized rodent models, the use of large animals is considered critical for validating the combination of a surgical procedure, a device, and the safety of a final therapy for human use. The size, anatomy, and general vulnerability of the spine and spinal cord of the swine are recognized to better model the human. Moreover, the surgical process of exposing and manipulating the spinal cord as well as closing the wound in the pig is virtually indistinguishable from the human. We believe that the healthy pig model represents a critical first step in the study of procedural safety.
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Kakinohana O, Juhasova J, Juhas S, Motlik J, Platoshyn O, Galik J, Hefferan M, Yuan SH, Vidal JG, Carson CT, Van Gorp S, Goldberg D, Leerink M, Lazar P, Marsala S, Miyanohara A, Keshavarzi S, Ciacci JD, Marsala M. Survival and Differentiation of Human Embryonic Stem Cell-Derived Neural Precursors Grafted Spinally in Spinal Ischemia-Injured Rats or in Naive Immunosuppressed Minipigs: A Qualitative and Quantitative Study. Cell Transplant 2012; 21:2603-19. [DOI: 10.3727/096368912x653200] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
In previous studies, we have demonstrated that spinal grafting of human or rat fetal spinal neural precursors leads to amelioration of spasticity and improvement in ambulatory function in rats with spinal ischemic injury. In the current study, we characterize the survival and maturation of three different human embryonic stem (ES) cell line-derived neural precursors (hNPCs) once grafted into ischemia-injured lumbar spinal cord in rats or in naive immunosuppressed minipigs. Proliferating HUES-2, HUES-7, or HUES-9 colonies were induced to form embryoid bodies. During the nestin-positive stage, the rosettes were removed and CD184+/CD271-/CD44-/CD24+ population of ES-hNPCs FAC-sorted and expanded. Male Sprague–Dawley rats with spinal ischemic injury or naive immunosuppressed Gottingen–Minnesota minipigs received 10 bilateral injections of ES-NPCs into the L2–L5 gray matter. After cell grafting, animals survived for 2 weeks to 4.5 months, and the presence of grafted cells was confirmed after staining spinal cord sections with a combination of human-specific (hNUMA, HO14, hNSE, hSYN) or nonspecific (DCX, MAP2, CHAT, GFAP, APC) antibodies. In the majority of grafted animals, hNUMA-positive grafted cells were identified. At 2–4 weeks after grafting, double-labeled hNUMA/ DCX-immunoreactive neurons were seen with extensive DCX+ processes. At survival intervals of 4–8 weeks, hNSE+ neurons and expression of hSYN was identified. Some hSYN-positive terminals formed putative synapses with the host neurons. Quantitative analysis of hNUMA+ cells at 2 months after grafting showed comparable cell survival for all three cell lines. In the presence of low-level immunosuppression, no grafted cell survival was seen at 4.5 months after grafting. Spinal grafting of proliferating pluripotent HUES-7 cells led to consistent teratoma formation at 2–6 weeks after cell transplantation. These data show that ES-derived, FAC-sorted NPCs can represent an effective source of human NPCs to be used in CNS cell replacement therapies.
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Affiliation(s)
- O. Kakinohana
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California, San Diego, La Jolla, CA, USA
| | - J. Juhasova
- Institute of Animal Physiology and Genetics, AS CR, Liběchov, Czech Republic
| | - S. Juhas
- Institute of Animal Physiology and Genetics, AS CR, Liběchov, Czech Republic
| | - J. Motlik
- Institute of Animal Physiology and Genetics, AS CR, Liběchov, Czech Republic
| | - O. Platoshyn
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California, San Diego, La Jolla, CA, USA
| | - J. Galik
- Institute of Neurobiology, Slovak Academy of Sciences, Košice, Slovakia
- Institute of Biology and Ecology, Faculty of Science, Pavol Jozef Safarik University, Košice, Slovakia
| | - M. Hefferan
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California, San Diego, La Jolla, CA, USA
| | - S. H. Yuan
- Howard Hughes Medical Institute and Department of Cellular and Molecular Medicine, School of Medicine, University of California, San Diego, La Jolla, CA, USA
- Department of Neurosciences, School of Medicine, University of California, San Diego, La Jolla, CA, USA
| | | | | | - S. Van Gorp
- Department of Anesthesiology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - D. Goldberg
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California, San Diego, La Jolla, CA, USA
| | - M. Leerink
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California, San Diego, La Jolla, CA, USA
| | - P. Lazar
- University of Veterinary Medicine and Pharmacy, Department of Breeding and Diseases of Game and Fish, Košice, Slovakia
| | - S. Marsala
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California, San Diego, La Jolla, CA, USA
| | - A. Miyanohara
- Vector Core Laboratory, Department of Pediatrics, University of California, San Diego, La Jolla, CA, USA
| | - S. Keshavarzi
- Division of Neurosurgery, University of California, San Diego, La Jolla, CA, USA
| | - J. D. Ciacci
- Division of Neurosurgery, University of California, San Diego, La Jolla, CA, USA
| | - M. Marsala
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California, San Diego, La Jolla, CA, USA
- Institute of Neurobiology, Slovak Academy of Sciences, Košice, Slovakia
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Paspala SA, Vishwakarma SK, Murthy TV, Rao TN, Khan AA. Potential role of stem cells in severe spinal cord injury: current perspectives and clinical data. STEM CELLS AND CLONING-ADVANCES AND APPLICATIONS 2012; 5:15-27. [PMID: 24198535 PMCID: PMC3781762 DOI: 10.2147/sccaa.s28477] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Stem cell transplantation for spinal cord injury (SCI) along with new pharmacotherapy research offers the potential to restore function and ease the associated social and economic burden in the years ahead. Various sources of stem cells have been used in the treatment of SCI, but the most convincing results have been obtained with neural progenitor cells in preclinical models. Although the use of cell-based transplantation strategies for the repair of chronic SCI remains the long sought after holy grail, these approaches have been to date the most successful when applied in the subacute phase of injury. Application of cell-based strategies for the repair and regeneration of the chronically injured spinal cord will require a combinational strategy that may need to include approaches to overcome the effects of the glial scar, inhibitory molecules, and use of tissue engineering strategies to bridge the lesion. Nonetheless, cell transplantation strategies are promising, and it is anticipated that the Phase I clinical trials of some form of neural stem cell-based approach in SCI will commence very soon.
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Affiliation(s)
- Syed Ab Paspala
- PAN Research Foundation, CARE, Hyderabad, India ; The Institute of Medical Sciences, Hyderabad, India
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Riley J, Hurtig CV, Boulis N. Translating cellular therapies from bench to bedside for amyotrophic lateral sclerosis. Per Med 2012; 9:645-655. [DOI: 10.2217/pme.12.74] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The last decade has witnessed an increasing number of biologic (e.g., cell- or viral vector-based) therapeutics supported by preclinical efficacy data for the treatment of afflictions to the CNS. While some international investigators have undertaken preliminary clinical safety studies, published literature indicate varying degrees of rigor with respect to study design and technical approach. To our knowledge, ours is the first group to have systematically generated preclinical validation data for a delivery approach and translated this into a Phase I trial attempting to covalidate the safety of a direct, targeted delivery approach, as well as a cell-based therapeutic. This article discusses the rationale for cell-based therapy in amyotrophic lateral sclerosis and several of the unique considerations encountered during this process.
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Affiliation(s)
- Jonathan Riley
- Department of Neurosurgery, Emory University, 1365-B Clifton Road Northeast, Suite B6200, Atlanta, GA 30322, USA
| | - Carl V Hurtig
- Department of Neurosurgery, Emory University, 1365-B Clifton Road Northeast, Suite B6200, Atlanta, GA 30322, USA
| | - Nicholas Boulis
- Department of Neurosurgery, Emory University, 1365-B Clifton Road Northeast, Suite B6200, Atlanta, GA 30322, USA
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Eaton MJ, Berrocal Y, Wolfe SQ, Widerström-Noga E. Review of the history and current status of cell-transplant approaches for the management of neuropathic pain. PAIN RESEARCH AND TREATMENT 2012; 2012:263972. [PMID: 22745903 PMCID: PMC3382629 DOI: 10.1155/2012/263972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Accepted: 04/09/2012] [Indexed: 11/18/2022]
Abstract
Treatment of sensory neuropathies, whether inherited or caused by trauma, the progress of diabetes, or other disease states, are among the most difficult problems in modern clinical practice. Cell therapy to release antinociceptive agents near the injured spinal cord would be the logical next step in the development of treatment modalities. But few clinical trials, especially for chronic pain, have tested the transplant of cells or a cell line to treat human disease. The history of the research and development of useful cell-transplant-based approaches offers an understanding of the advantages and problems associated with these technologies, but as an adjuvant or replacement for current pharmacological treatments, cell therapy is a likely near future clinical tool for improved health care.
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Affiliation(s)
- Mary J. Eaton
- Miami VA Health System Center, D806C, 1201 NW 16th Street, Miami, FL 33125, USA
| | - Yerko Berrocal
- Department of Cellular Biology and Pharmacology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA
| | - Stacey Q. Wolfe
- Department of Neurosurgery, Tripler Army Medical Center, 1 Jarrett White Road, Honolulu, HI 96859, USA
| | - Eva Widerström-Noga
- Miami VA Health System Center, D806C, 1201 NW 16th Street, Miami, FL 33125, USA
- The Miami Project to Cure Paralysis, Miller School of Medicine at the University of Miami, Miami, FL 33136, USA
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Cellular and molecular approaches to motor neuron therapy in amyotrophic lateral sclerosis and spinal muscular atrophy. Neurosci Lett 2012; 527:78-84. [PMID: 22579818 DOI: 10.1016/j.neulet.2012.04.079] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Accepted: 04/29/2012] [Indexed: 12/12/2022]
Abstract
Amyotrophic lateral sclerosis (ALS) and spinal muscular atrophy (SMA) are progressive fatal neurodegenerative diseases. They differ in their disease development but have in common a loss of motor neuron as they progress. Research is ongoing to further understand the origin of these diseases but this common thread of motor neuron loss has provided a target for the development of therapies for both ALS and SMA. It is the linked fields of gene and cell therapy that are providing some of the most interesting therapeutic possibilities.
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33
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Eaton MJ, Berrocal Y, Wolfe SQ. Potential for Cell-Transplant Therapy with Human Neuronal Precursors to Treat Neuropathic Pain in Models of PNS and CNS Injury: Comparison of hNT2.17 and hNT2.19 Cell Lines. PAIN RESEARCH AND TREATMENT 2012; 2012:356412. [PMID: 22619713 PMCID: PMC3348681 DOI: 10.1155/2012/356412] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Accepted: 01/15/2012] [Indexed: 01/07/2023]
Abstract
Effective treatment of sensory neuropathies in peripheral neuropathies and spinal cord injury (SCI) is one of the most difficult problems in modern clinical practice. Cell therapy to release antinociceptive agents near the injured spinal cord is a logical next step in the development of treatment modalities. But few clinical trials, especially for chronic pain, have tested the potential of transplant of cells to treat chronic pain. Cell lines derived from the human neuronal NT2 cell line parentage, the hNT2.17 and hNT2.19 lines, which synthesize and release the neurotransmitters gamma-aminobutyric acid (GABA) and serotonin (5HT), respectively, have been used to evaluate the potential of cell-based release of antinociceptive agents near the lumbar dorsal (horn) spinal sensory cell centers to relieve neuropathic pain after PNS (partial nerve and diabetes-related injury) and CNS (spinal cord injury) damage in rat models. Both cell lines transplants potently and permanently reverse behavioral hypersensitivity without inducing tumors or other complications after grafting. Functioning as cellular minipumps for antinociception, human neuronal precursors, like these NT2-derived cell lines, would likely provide a useful adjuvant or replacement for current pharmacological treatments for neuropathic pain.
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Affiliation(s)
- Mary J. Eaton
- Miami VA Health System Center, D806C, 1201 NW 16th Street, Miami, FL 33199, USA
| | - Yerko Berrocal
- Department of Cellular Biology and Pharmacology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Stacey Q. Wolfe
- Department of Neurosurgery, Tripler Army Medical Center, 1 Jarrett White Road, Honolulu, HI 96859-5000, USA
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Nout YS, Rosenzweig ES, Brock JH, Strand SC, Moseanko R, Hawbecker S, Zdunowski S, Nielson JL, Roy RR, Courtine G, Ferguson AR, Edgerton VR, Beattie MS, Bresnahan JC, Tuszynski MH. Animal models of neurologic disorders: a nonhuman primate model of spinal cord injury. Neurotherapeutics 2012; 9:380-92. [PMID: 22427157 PMCID: PMC3337011 DOI: 10.1007/s13311-012-0114-0] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Primates are an important and unique animal resource. We have developed a nonhuman primate model of spinal cord injury (SCI) to expand our knowledge of normal primate motor function, to assess the impact of disease and injury on sensory and motor function, and to test candidate therapies before they are applied to human patients. The lesion model consists of a lateral spinal cord hemisection at the C7 spinal level with subsequent examination of behavioral, electrophysiological, and anatomical outcomes. Results to date have revealed significant neuroanatomical and functional differences between rodents and primates that impact the development of candidate therapies. Moreover, these findings suggest the importance of testing some therapeutic approaches in nonhuman primates prior to the use of invasive approaches in human clinical trials. Our primate model is intended to: 1) lend greater positive predictive value to human translatable therapies, 2) develop appropriate methods for human translation, 3) lead to basic discoveries that might not be identified in rodent models and are relevant to human translation, and 4) identify new avenues of basic research to "reverse-translate" important questions back to rodent models.
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Affiliation(s)
- Yvette S. Nout
- />Department of Animal and Veterinary Sciences, College of Agriculture, California State Polytechnic University, Pomona, CA USA
| | - Ephron S. Rosenzweig
- />Department of Neurosciences, University of California, La Jolla, San Diego, CA USA
| | - John H. Brock
- />Department of Neurosciences, University of California, La Jolla, San Diego, CA USA
| | - Sarah C. Strand
- />California National Primate Research Center, University of California, Davis, CA USA
| | - Rod Moseanko
- />California National Primate Research Center, University of California, Davis, CA USA
| | - Stephanie Hawbecker
- />California National Primate Research Center, University of California, Davis, CA USA
| | - Sharon Zdunowski
- />Department of Integrative Biology and Physiology, Los Angeles, CA USA
- />Brain Research Institute, University of California, Los Angeles, CA USA
| | - Jessica L. Nielson
- />Brain and Spinal Injury Center, Department of Neurological Surgery, University of California, San Francisco, CA USA
| | - Roland R. Roy
- />Department of Integrative Biology and Physiology, Los Angeles, CA USA
- />Brain Research Institute, University of California, Los Angeles, CA USA
| | - Gregoire Courtine
- />Experimental Neurorehabilitation, Department of Neurology, Universität Zurich, Zurich, Switzerland
| | - Adam R. Ferguson
- />Brain and Spinal Injury Center, Department of Neurological Surgery, University of California, San Francisco, CA USA
| | - V. Reggie Edgerton
- />Department of Integrative Biology and Physiology, Los Angeles, CA USA
- />Departments of Neurobiology and Neurosurgery, Los Angeles, CA USA
- />Brain Research Institute, University of California, Los Angeles, CA USA
| | - Michael S. Beattie
- />Brain and Spinal Injury Center, Department of Neurological Surgery, University of California, San Francisco, CA USA
| | - Jacqueline C. Bresnahan
- />Brain and Spinal Injury Center, Department of Neurological Surgery, University of California, San Francisco, CA USA
| | - Mark H. Tuszynski
- />Department of Neurosciences, University of California, La Jolla, San Diego, CA USA
- />Veterans Administration Medical Center, La Jolla, CA USA
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Leung L. Cellular therapies for treating pain associated with spinal cord injury. J Transl Med 2012; 10:37. [PMID: 22394650 PMCID: PMC3320547 DOI: 10.1186/1479-5876-10-37] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2011] [Accepted: 03/06/2012] [Indexed: 12/21/2022] Open
Abstract
Spinal cord injury leads to immense disability and loss of quality of life in human with no satisfactory clinical cure. Cell-based or cell-related therapies have emerged as promising therapeutic potentials both in regeneration of spinal cord and mitigation of neuropathic pain due to spinal cord injury. This article reviews the various options and their latest developments with an update on their therapeutic potentials and clinical trialing.
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Affiliation(s)
- Lawrence Leung
- Centre of Neurosciences Study, Queen's University, 18 Stuart Street, Kingston, ON K7L 3N6, Canada.
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Kakinohana O, Hefferan MP, Miyanohara A, Nejime T, Marsala S, Juhas S, Juhasova J, Motlik J, Kucharova K, Strnadel J, Platoshyn O, Lazar P, Galik J, Vinay L, Marsala M. Combinational spinal GAD65 gene delivery and systemic GABA-mimetic treatment for modulation of spasticity. PLoS One 2012; 7:e30561. [PMID: 22291989 PMCID: PMC3264568 DOI: 10.1371/journal.pone.0030561] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2011] [Accepted: 12/19/2011] [Indexed: 01/08/2023] Open
Abstract
Background Loss of GABA-mediated pre-synaptic inhibition after spinal injury plays a key role in the progressive increase in spinal reflexes and the appearance of spasticity. Clinical studies show that the use of baclofen (GABAB receptor agonist), while effective in modulating spasticity is associated with major side effects such as general sedation and progressive tolerance development. The goal of the present study was to assess if a combined therapy composed of spinal segment-specific upregulation of GAD65 (glutamate decarboxylase) gene once combined with systemic treatment with tiagabine (GABA uptake inhibitor) will lead to an antispasticity effect and whether such an effect will only be present in GAD65 gene over-expressing spinal segments. Methods/Principal Findings Adult Sprague-Dawley (SD) rats were exposed to transient spinal ischemia (10 min) to induce muscle spasticity. Animals then received lumbar injection of HIV1-CMV-GAD65 lentivirus (LVs) targeting ventral α-motoneuronal pools. At 2–3 weeks after lentivirus delivery animals were treated systemically with tiagabine (4, 10, 20 or 40 mg/kg or vehicle) and the degree of spasticity response measured. In a separate experiment the expression of GAD65 gene after spinal parenchymal delivery of GAD65-lentivirus in naive minipigs was studied. Spastic SD rats receiving spinal injections of the GAD65 gene and treated with systemic tiagabine showed potent and tiagabine-dose-dependent alleviation of spasticity. Neither treatment alone (i.e., GAD65-LVs injection only or tiagabine treatment only) had any significant antispasticity effect nor had any detectable side effect. Measured antispasticity effect correlated with increase in spinal parenchymal GABA synthesis and was restricted to spinal segments overexpressing GAD65 gene. Conclusions/Significance These data show that treatment with orally bioavailable GABA-mimetic drugs if combined with spinal-segment-specific GAD65 gene overexpression can represent a novel and highly effective anti-spasticity treatment which is associated with minimal side effects and is restricted to GAD65-gene over-expressing spinal segments.
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Affiliation(s)
- Osamu Kakinohana
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California San Diego, La Jolla, California, United States of America
| | - Michael P. Hefferan
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California San Diego, La Jolla, California, United States of America
| | - Atsushi Miyanohara
- Gene Therapy Program and Department of Pediatrics, University of California San Diego, La Jolla, California, United States of America
| | - Tetsuya Nejime
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California San Diego, La Jolla, California, United States of America
| | - Silvia Marsala
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California San Diego, La Jolla, California, United States of America
| | - Stefan Juhas
- Institute of Animal Physiology and Genetics, AS CR, Liběchov, Czech Republic
| | - Jana Juhasova
- Institute of Animal Physiology and Genetics, AS CR, Liběchov, Czech Republic
| | - Jan Motlik
- Institute of Animal Physiology and Genetics, AS CR, Liběchov, Czech Republic
| | - Karolina Kucharova
- Sanford-Burnham Medical Research Institute, La Jolla, California, United States of America
| | - Jan Strnadel
- Institute of Animal Physiology and Genetics, AS CR, Liběchov, Czech Republic
| | - Oleksandr Platoshyn
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California San Diego, La Jolla, California, United States of America
| | - Peter Lazar
- Department of Breeding and Diseases of Game and Fish, University of Veterinary Medicine and Pharmacy, Komenskeho, Košice, Slovakia
| | - Jan Galik
- Institute of Neurobiology, Slovak Academy of Sciences, Košice, Slovakia
- Faculty of Science, Institute of Biology and Ecology, Pavol Jozef Safarik University, Košice, Slovakia
| | - Laurent Vinay
- Laboratoire Plasticité et Physio-Pathologie de la Motricité (UMR6196), Centre National de la Recherche Scientifique (CNRS) and Aix-Marseille Université, Marseille, France
| | - Martin Marsala
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California San Diego, La Jolla, California, United States of America
- Institute of Neurobiology, Slovak Academy of Sciences, Košice, Slovakia
- * E-mail:
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37
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Navarro R, Juhas S, Keshavarzi S, Juhasova J, Motlik J, Johe K, Marsala S, Scadeng M, Lazar P, Tomori Z, Schulteis G, Beattie M, Ciacci JD, Marsala M. Chronic spinal compression model in minipigs: a systematic behavioral, qualitative, and quantitative neuropathological study. J Neurotrauma 2012; 29:499-513. [PMID: 22029501 DOI: 10.1089/neu.2011.2076] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The goal of the present study was to develop a porcine spinal cord injury (SCI) model, and to describe the neurological outcome and characterize the corresponding quantitative and qualitative histological changes at 4-9 months after injury. Adult Gottingen-Minnesota minipigs were anesthetized and placed in a spine immobilization frame. The exposed T12 spinal segment was compressed in a dorso-ventral direction using a 5-mm-diameter circular bar with a progressively increasing peak force (1.5, 2.0, or 2.5 kg) at a velocity of 3 cm/sec. During recovery, motor and sensory function were periodically monitored. After survival, the animals were perfusion fixed and the extent of local SCI was analyzed by (1) post-mortem MRI analysis of dissected spinal cords, (2) qualitative and quantitative analysis of axonal survival at the epicenter of injury, and (3) defining the presence of local inflammatory changes, astrocytosis, and schwannosis. Following 2.5-kg spinal cord compression the animals demonstrated a near complete loss of motor and sensory function with no recovery over the next 4-9 months. Those that underwent spinal cord compression with 2 kg force developed an incomplete injury with progressive partial neurological recovery characterized by a restricted ability to stand and walk. Animals injured with a spinal compression force of 1.5 kg showed near normal ambulation 10 days after injury. In fully paralyzed animals (2.5 kg), MRI analysis demonstrated a loss of spinal white matter integrity and extensive septal cavitations. A significant correlation between the magnitude of loss of small and medium-sized myelinated axons in the ventral funiculus and neurological deficits was identified. These data, demonstrating stable neurological deficits in severely injured animals, similarities of spinal pathology to humans, and relatively good post-injury tolerance of this strain of minipigs to spinal trauma, suggest that this model can successfully be used to study therapeutic interventions targeting both acute and chronic stages of SCI.
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Affiliation(s)
- Roman Navarro
- Neuroregeneration Laboratory, Department of Anesthesiology, University of California, San Diego (UCSD), San Diego, California, USA
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Abstract
Effective treatments are urgently needed for amyotrophic lateral sclerosis (ALS), a fatal neurodegenerative disease characterized by the loss of motor neurons. In 2009, the FDA approved the first phase I safety trial of direct intraspinal transplantation of neural stem cells into patients with ALS, which is currently in progress. Stem cell technologies represent a promising approach for treating ALS, but several issues must be addressed when translating promising experimental ALS therapies to patients. This article highlights the key research that supports the use of stem cells as a therapy for ALS, and discusses the rationale behind and approach to the phase I trial. Completion of the trial could pave the way for continued advances in stem cell therapy for ALS and other neurodegenerative diseases.
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39
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Abstract
Over the past 20 years, stem cell technologies have become an increasingly attractive option to investigate and treat neurodegenerative diseases. In the current review, we discuss the process of extending basic stem cell research into translational therapies for patients suffering from neurodegenerative diseases. We begin with a discussion of the burden of these diseases on society, emphasizing the need for increased attention toward advancing stem cell therapies. We then explain the various types of stem cells utilized in neurodegenerative disease research, and outline important issues to consider in the transition of stem cell therapy from bench to bedside. Finally, we detail the current progress regarding the applications of stem cell therapies to specific neurodegenerative diseases, focusing on Parkinson disease, Huntington disease, Alzheimer disease, amyotrophic lateral sclerosis, and spinal muscular atrophy. With a greater understanding of the capacity of stem cell technologies, there is growing public hope that stem cell therapies will continue to progress into realistic and efficacious treatments for neurodegenerative diseases.
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Affiliation(s)
- J Simon Lunn
- Department of Neurology, University of Michigan, Ann Arbor, MI 48109-2200, USA
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40
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Abstract
More than 1 million people in the United States live with a spinal cord injury (SCI). Despite medical advances, many patients with SCIs still experience substantial neurological disability, with loss of motor, sensory, and autonomic function. Cell therapy is ideally suited to address the multifactorial nature of the secondary events following SCI. Remarkable advances in our understanding of the pathophysiology of SCI, structural and functional magnetic resonance imaging, image-guided micro-neurosurgical techniques, and transplantable cell biology have enabled the use of cell-based regenerative techniques in the clinic. It is important to note that there are more than a dozen recently completed, ongoing, or recruiting cell therapy clinical trials for SCI that reflect the views of many key stakeholders. The field of regenerative neuroscience has reached a stage in which the clinical trials are scientifically and ethically justified. Although experimental models and analysis methods and techniques continue to evolve, no model will completely replicate the human condition. It is recognized that more work with cervical models of contusive/compressive SCI are required in parallel with clinical trials. It is also important that the clinical translation of advances made through well-established and validated experimental approaches in animal models move forward to meet the compelling needs of individuals with SCI and to advance the field of regenerative neuroscience. However, it is imperative that such efforts at translation be done in the most rigorous and informed fashion to determine safety and possible efficacy, and to provide key information to clinicians and basic scientists, which will allow improvements in regenerative techniques and the validation and refinement of existing preclinical animal models and research approaches. The field of regenerative neuroscience should not be stalled at the animal model stage, but instead the clinical trials need to be focused, safe, and ethical, backed up by a robust, translationally relevant preclinical research strategy.
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Affiliation(s)
- Michael G. Fehlings
- University Health Network, Toronto Western Hospital, Toronto, ON M5T 2S8 Canada
| | - Reaz Vawda
- University Health Network, Toronto Western Hospital, Toronto, ON M5T 2S8 Canada
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41
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Lunn JS, Sakowski SA, Federici T, Glass JD, Boulis NM, Feldman EL. Stem cell technology for the study and treatment of motor neuron diseases. Regen Med 2011; 6:201-13. [PMID: 21391854 DOI: 10.2217/rme.11.6] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Amyotrophic lateral sclerosis and spinal muscular atrophy are devastating neurodegenerative diseases that lead to the specific loss of motor neurons. Recently, stem cell technologies have been developed for the investigation and treatment of both diseases. Here we discuss the different stem cells currently being studied for mechanistic discovery and therapeutic development, including embryonic, adult and induced pluripotent stem cells. We also present supporting evidence for the utilization of stem cell technology in the treatment of amyotrophic lateral sclerosis and spinal muscular atrophy, and describe key issues that must be considered for the transition of stem cell therapies for motor neuron diseases from bench to bedside. Finally, we discuss the first-in-human Phase I trial currently underway examining the safety and feasibility of intraspinal stem cell injections in amyotrophic lateral sclerosis patients as a foundation for translating stem cell therapies for various neurological diseases.
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Affiliation(s)
- J Simon Lunn
- University of Michigan Department of Neurology, 109 Zina Pitcher Place, Ann Arbor, MI 48109, USA
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42
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Yuan SH, Martin J, Elia J, Flippin J, Paramban RI, Hefferan MP, Vidal JG, Mu Y, Killian RL, Israel MA, Emre N, Marsala S, Marsala M, Gage FH, Goldstein LSB, Carson CT. Cell-surface marker signatures for the isolation of neural stem cells, glia and neurons derived from human pluripotent stem cells. PLoS One 2011; 6:e17540. [PMID: 21407814 PMCID: PMC3047583 DOI: 10.1371/journal.pone.0017540] [Citation(s) in RCA: 288] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Accepted: 02/08/2011] [Indexed: 12/22/2022] Open
Abstract
Background Neural induction of human pluripotent stem cells often yields heterogeneous cell populations that can hamper quantitative and comparative analyses. There is a need for improved differentiation and enrichment procedures that generate highly pure populations of neural stem cells (NSC), glia and neurons. One way to address this problem is to identify cell-surface signatures that enable the isolation of these cell types from heterogeneous cell populations by fluorescence activated cell sorting (FACS). Methodology/Principal Findings We performed an unbiased FACS- and image-based immunophenotyping analysis using 190 antibodies to cell surface markers on naïve human embryonic stem cells (hESC) and cell derivatives from neural differentiation cultures. From this analysis we identified prospective cell surface signatures for the isolation of NSC, glia and neurons. We isolated a population of NSC that was CD184+/CD271−/CD44−/CD24+ from neural induction cultures of hESC and human induced pluripotent stem cells (hiPSC). Sorted NSC could be propagated for many passages and could differentiate to mixed cultures of neurons and glia in vitro and in vivo. A population of neurons that was CD184−/CD44−/CD15LOW/CD24+ and a population of glia that was CD184+/CD44+ were subsequently purified from cultures of differentiating NSC. Purified neurons were viable, expressed mature and subtype-specific neuronal markers, and could fire action potentials. Purified glia were mitotic and could mature to GFAP-expressing astrocytes in vitro and in vivo. Conclusions/Significance These findings illustrate the utility of immunophenotyping screens for the identification of cell surface signatures of neural cells derived from human pluripotent stem cells. These signatures can be used for isolating highly pure populations of viable NSC, glia and neurons by FACS. The methods described here will enable downstream studies that require consistent and defined neural cell populations.
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Affiliation(s)
- Shauna H. Yuan
- Howard Hughes Medical Institute and Department of Cellular and Molecular Medicine, School of Medicine, University of California San Diego, La Jolla, California, United States of America
- Department of Neurosciences, School of Medicine, University of California San Diego, La Jolla, California, United States of America
| | - Jody Martin
- BD Biosciences, La Jolla, California, United States of America
| | - Jeanne Elia
- BD Biosciences, La Jolla, California, United States of America
| | - Jessica Flippin
- Howard Hughes Medical Institute and Department of Cellular and Molecular Medicine, School of Medicine, University of California San Diego, La Jolla, California, United States of America
| | | | - Mike P. Hefferan
- Anesthesiology Research Laboratory, Department of Anesthesiology, University of California San Diego, La Jolla, California, United States of America
| | - Jason G. Vidal
- BD Biosciences, La Jolla, California, United States of America
| | - Yangling Mu
- Laboratory of Genetics, The Salk Institute for Biological Studies, La Jolla, California, United States of America
| | - Rhiannon L. Killian
- Howard Hughes Medical Institute and Department of Cellular and Molecular Medicine, School of Medicine, University of California San Diego, La Jolla, California, United States of America
- Biomedical Sciences Graduate Program, University of California San Diego, La Jolla, California, United States of America
| | - Mason A. Israel
- Howard Hughes Medical Institute and Department of Cellular and Molecular Medicine, School of Medicine, University of California San Diego, La Jolla, California, United States of America
- Biomedical Sciences Graduate Program, University of California San Diego, La Jolla, California, United States of America
| | - Nil Emre
- BD Biosciences, La Jolla, California, United States of America
| | - Silvia Marsala
- Anesthesiology Research Laboratory, Department of Anesthesiology, University of California San Diego, La Jolla, California, United States of America
| | - Martin Marsala
- Anesthesiology Research Laboratory, Department of Anesthesiology, University of California San Diego, La Jolla, California, United States of America
- Institute of Neurobiology, Slovak Academy of Sciences, Košice, Slovakia
| | - Fred H. Gage
- Laboratory of Genetics, The Salk Institute for Biological Studies, La Jolla, California, United States of America
| | - Lawrence S. B. Goldstein
- Howard Hughes Medical Institute and Department of Cellular and Molecular Medicine, School of Medicine, University of California San Diego, La Jolla, California, United States of America
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Guest J, Benavides F, Padgett K, Mendez E, Tovar D. Technical aspects of spinal cord injections for cell transplantation. Clinical and translational considerations. Brain Res Bull 2011; 84:267-79. [DOI: 10.1016/j.brainresbull.2010.11.007] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2010] [Revised: 09/20/2010] [Accepted: 11/08/2010] [Indexed: 12/13/2022]
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