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Zhang MM, Hu Y, Xu J, Liu L, Lv LL. The Impact of Cellular Therapies on Gastrointestinal Diseases: Applications and Challenges. THE TURKISH JOURNAL OF GASTROENTEROLOGY : THE OFFICIAL JOURNAL OF TURKISH SOCIETY OF GASTROENTEROLOGY 2023; 34:782-794. [PMID: 37485563 PMCID: PMC10544052 DOI: 10.5152/tjg.2023.23137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/09/2023] [Indexed: 07/25/2023]
Abstract
Gastrointestinal diseases are highly prevalent, and their burden significantly impacts the quality of life of affected individuals. Inflammatory and immune-mediated intestinal diseases usually have a chronic course without adequate therapeutic modalities. Although much has been reported to comprehend these diseases, many remain resistant and refractory to conventional treatment approaches. Therefore, recent approaches to cellular therapy using stem cells, like hematopoietic stem cells and mesenchymal stem cells, and other cellular immunosuppressive modalities, like T-regulatory cells, were introduced and investigated in treating gastrointestinal diseases. We aimed to conduct a literature review to discuss the applications and challenges of cellular therapeutics in gastrointestinal diseases. Evidence from published clinical trials supports the safety and efficacy of cellular treatment in different immune-mediated and inflammatory gastrointestinal diseases. They can offer a longer duration of remission, being able to adjust the dysregulated immune system. However, there are various challenges to be considered by future trials, including the limitations of current clinical trials, challenges in retrieval and application of these therapeutics, and their mutagenesis potential.
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Affiliation(s)
- Meng-Meng Zhang
- Department of Gastroenterology, Hangzhou Shangcheng District People’s Hospital, Hangzhou, Zhejiang Province, China
- Department of Gastroenterology, The Second Affiliated Hospital, Zhejiang University Faculty of Medicine, Hangzhou, Zhejiang Province, China
| | - Yan Hu
- Department of Gastroenterology, Hangzhou Shangcheng District People’s Hospital, Hangzhou, Zhejiang Province, China
- Department of Gastroenterology, The Second Affiliated Hospital, Zhejiang University Faculty of Medicine, Hangzhou, Zhejiang Province, China
| | - Jing Xu
- Department of Gastroenterology, Hangzhou Shangcheng District People’s Hospital, Hangzhou, Zhejiang Province, China
- Department of Gastroenterology, The Second Affiliated Hospital, Zhejiang University Faculty of Medicine, Hangzhou, Zhejiang Province, China
| | - Ling Liu
- Department of Gastroenterology, Hangzhou Shangcheng District People’s Hospital, Hangzhou, Zhejiang Province, China
- Department of Gastroenterology, The Second Affiliated Hospital, Zhejiang University Faculty of Medicine, Hangzhou, Zhejiang Province, China
| | - Lu-Lu Lv
- Department of Gastroenterology, Shengzhou People’s Hospital (the First Affiliated Hospital of Zhejiang University Shengzhou Branch), Zhejiang University, Shengzhou, Zhejiang Province, China
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Collier CA, Mendiondo C, Raghavan S. Tissue engineering of the gastrointestinal tract: the historic path to translation. J Biol Eng 2022; 16:9. [PMID: 35379299 PMCID: PMC8981633 DOI: 10.1186/s13036-022-00289-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/08/2022] [Indexed: 11/15/2022] Open
Abstract
The gastrointestinal (GI) tract is imperative for multiple functions including digestion, nutrient absorption, and timely waste disposal. The central feature of the gut is peristalsis, intestinal motility, which facilitates all of its functions. Disruptions in GI motility lead to sub-optimal GI function, resulting in a lower quality of life in many functional GI disorders. Over the last two decades, tissue engineering research directed towards the intestine has progressed rapidly due to advances in cell and stem-cell biology, integrative physiology, bioengineering and biomaterials. Newer biomedical tools (including optical tools, machine learning, and nuanced regenerative engineering approaches) have expanded our understanding of the complex cellular communication within the GI tract that lead to its orchestrated physiological function. Bioengineering therefore can be utilized towards several translational aspects: (i) regenerative medicine to remedy/restore GI physiological function; (ii) in vitro model building to mimic the complex physiology for drug and pharmacology testing; (iii) tool development to continue to unravel multi-cell communication networks to integrate cell and organ-level physiology. Despite the significant strides made historically in GI tissue engineering, fundamental challenges remain including the quest for identifying autologous human cell sources, enhanced scaffolding biomaterials to increase biocompatibility while matching viscoelastic properties of the underlying tissue, and overall biomanufacturing. This review provides historic perspectives for how bioengineering has advanced over time, highlights newer advances in bioengineering strategies, and provides a realistic perspective on the path to translation.
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Affiliation(s)
- Claudia A Collier
- Department of Biomedical Engineering, Texas A&M University, Emerging Technologies Building, 3120 TAMU, College Station, TX, 77843, USA
| | - Christian Mendiondo
- Department of Biomedical Engineering, Texas A&M University, Emerging Technologies Building, 3120 TAMU, College Station, TX, 77843, USA
| | - Shreya Raghavan
- Department of Biomedical Engineering, Texas A&M University, Emerging Technologies Building, 3120 TAMU, College Station, TX, 77843, USA. .,Department of Nanomedicine, Houston Methodist Research Institute, Houston, TX, USA.
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Choi J, Kang S, Kim B, So S, Han J, Kim GN, Lee MY, Roh S, Lee JY, Oh SJ, Sung YH, Lee Y, Kim SH, Kang E. Efficient hepatic differentiation and regeneration potential under xeno-free conditions using mass-producible amnion-derived mesenchymal stem cells. Stem Cell Res Ther 2021; 12:569. [PMID: 34772451 PMCID: PMC8588618 DOI: 10.1186/s13287-021-02470-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 06/22/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Amnion-derived mesenchymal stem cells (AM-MSCs) are an attractive source of stem cell therapy for patients with irreversible liver disease. However, there are obstacles to their use due to low efficiency and xeno-contamination for hepatic differentiation. METHODS We established an efficient protocol for differentiating AM-MSCs into hepatic progenitor cells (HPCs) by analyzing transcriptome-sequencing data. Furthermore, to generate the xeno-free conditioned differentiation protocol, we replaced fetal bovine serum (FBS) with polyvinyl alcohol (PVA). We investigated the hepatocyte functions with the expression of mRNA and protein, secretion of albumin, and activity of CYP3A4. Finally, to test the transplantable potential of HPCs, we transferred AM-MSCs along with hepatic progenitors after differentiated days 11, 12, and 13 based on the expression of hepatocyte-related genes and mitochondrial function. Further, we established a mouse model of acute liver failure using a thioacetamide (TAA) and cyclophosphamide monohydrate (CTX) and transplanted AM-HPCs in the mouse model through splenic injection. RESULTS We analyzed gene expression from RNA sequencing data in AM-MSCs and detected downregulation of hepatic development-associated genes including GATA6, KIT, AFP, c-MET, FGF2, EGF, and c-JUN, and upregulation of GSK3. Based on this result, we established an efficient hepatic differentiation protocol using the GSK3 inhibitor, CHIR99021. Replacing FBS with PVA resulted in improved differentiation ability, such as upregulation of hepatic maturation markers. The differentiated hepatocyte-like cells (HLCs) not only synthesized and secreted albumin, but also metabolized drugs by the CYP3A4 enzyme. The best time for translation of AM-HPCs was 12 days from the start of differentiation. When the AM-HPCs were transplanted into the liver failure mouse model, they settled in the damaged livers and differentiated into hepatocytes. CONCLUSION This study offers an efficient and xeno-free conditioned hepatic differentiation protocol and shows that AM-HPCs could be used as transplantable therapeutic materials. Thus, we suggest that AM-MSC-derived HPCs are promising cells for treating liver disease.
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Affiliation(s)
- Jiwan Choi
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology (AMIST), University of Ulsan College of Medicine, Asan Medical Center, Seoul, 05505, South Korea
- Stem Cell Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, 05505, South Korea
- Present Address: Center for Embryo & Stem Cell Research, CHA Advanced Research Institute and Department of Biomedical Science, CHA University, Pocheon-si, Gyeonggi, 13488, South Korea
| | - Seoon Kang
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology (AMIST), University of Ulsan College of Medicine, Asan Medical Center, Seoul, 05505, South Korea
- Stem Cell Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, 05505, South Korea
- Present Address: Center for Embryo & Stem Cell Research, CHA Advanced Research Institute and Department of Biomedical Science, CHA University, Pocheon-si, Gyeonggi, 13488, South Korea
| | - Bitnara Kim
- Stem Cell Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, 05505, South Korea
- Present Address: Center for Embryo & Stem Cell Research, CHA Advanced Research Institute and Department of Biomedical Science, CHA University, Pocheon-si, Gyeonggi, 13488, South Korea
| | - Seongjun So
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology (AMIST), University of Ulsan College of Medicine, Asan Medical Center, Seoul, 05505, South Korea
- Stem Cell Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, 05505, South Korea
| | - Jongsuk Han
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology (AMIST), University of Ulsan College of Medicine, Asan Medical Center, Seoul, 05505, South Korea
- Stem Cell Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, 05505, South Korea
- Present Address: Center for Embryo & Stem Cell Research, CHA Advanced Research Institute and Department of Biomedical Science, CHA University, Pocheon-si, Gyeonggi, 13488, South Korea
| | - Gyeong-Nam Kim
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology (AMIST), University of Ulsan College of Medicine, Asan Medical Center, Seoul, 05505, South Korea
- Convergence Medicine Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, 05505, South Korea
| | - Mi-Young Lee
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, 05505, South Korea
| | - Seonae Roh
- Stem Cell Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, 05505, South Korea
| | - Ji-Yoon Lee
- Asan Institute for Life Sciences, Asan Medical Center and Department of Convergence Medicine, College of Medicine, University of Ulsan, Seoul, 05505, South Korea
| | - Soo Jin Oh
- Asan Institute for Life Sciences, Asan Medical Center and Department of Convergence Medicine, College of Medicine, University of Ulsan, Seoul, 05505, South Korea
| | - Young Hoon Sung
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology (AMIST), University of Ulsan College of Medicine, Asan Medical Center, Seoul, 05505, South Korea
- Convergence Medicine Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, 05505, South Korea
| | - Yeonmi Lee
- Stem Cell Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, 05505, South Korea
- Present Address: Center for Embryo & Stem Cell Research, CHA Advanced Research Institute and Department of Biomedical Science, CHA University, Pocheon-si, Gyeonggi, 13488, South Korea
| | - Sung Hoon Kim
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, 05505, South Korea.
| | - Eunju Kang
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology (AMIST), University of Ulsan College of Medicine, Asan Medical Center, Seoul, 05505, South Korea.
- Stem Cell Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, 05505, South Korea.
- Present Address: Center for Embryo & Stem Cell Research, CHA Advanced Research Institute and Department of Biomedical Science, CHA University, Pocheon-si, Gyeonggi, 13488, South Korea.
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Adas G, Koc B, Adas M, Duruksu G, Subasi C, Kemik O, Kemik A, Sakiz D, Kalayci M, Purisa S, Unal S, Karaoz E. Effects of mesenchymal stem cells and VEGF on liver regeneration following major resection. Langenbecks Arch Surg 2016; 401:725-40. [PMID: 27094936 DOI: 10.1007/s00423-016-1380-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Accepted: 02/08/2016] [Indexed: 12/17/2022]
Abstract
PURPOSE The study aims to determine the effects of mesenchymal stem cell (MSC) therapy and a combination therapy of MSCs transfected with vascular endothelial growth factor (VEGF) for liver regeneration after major resection. METHODS Thirty-eight rats were divided into four groups: group 1: control (sham operation); group 2: control (70 % hepatic resection); group 3: 70 % hepatic resection + systemically transplanted MSCs; and group 4: 70 % hepatic resection + systemically transplanted MSCs transfected with the VEGF gene. MSCs were injected via the portal vein route in study groups 3 and 4. Expression levels of VEGF, fibroblast growth factor (FGF), platelet-derived growth factor (PDGF), epidermal growth factor (EGF), transforming growth factor (TGF), hepatocyte growth factor (HGF), and augmenter of liver regeneration (ALR) were analyzed in the remnant liver tissue. We investigated the levels of angiogenic factors, VEGF-receptor, angiopoietin-1 (Angpt1) and Angpt2. Biochemical parameters of liver function in blood samples were measured and a histologic assessment of the livers was performed. The postoperative liver weight and volume of each rat were measured 14 days after surgery. RESULTS The expression levels of all measured growth factors were significantly increased in groups 3 and 4 compared to the control groups. The levels of Angpt1 and Angpt2 correlated with levels of VEGF and thus were also significantly higher in the study groups. There were significant differences between the estimated liver weights and volumes of group 4 and the resected controls in group 2. With the exception of portal inflammation, levels of all histological parameters were observed to be higher in MSC-treated groups when compared with the resected controls in group 2. CONCLUSIONS Transplanted stem cells and MSCs transfected with VEGF significantly accelerated many parameters of the healing process following major hepatic resection. After the injection of MSCs and VEGF-transfected MSCs into the portal vein following liver resection, they were engrafted in the liver. They increased bile duct and liver hepatocyte proliferation, and secreted many growth factors including HGF, TGFβ, VEGF, PDGF, EGF, and FGF via paracrine effects. These effects support liver function, regeneration, and liver volume/weight.
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Affiliation(s)
- Gokhan Adas
- Department of Surgery, Bakirkoy Dr.Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Bora Koc
- Faculty of Medicine, Istanbul Training Hospital, Department of Surgery, Baskent University, Oymaci Sok. No:7, 34662, Altunizade Uskudar, Istanbul, Turkey.
| | - Mine Adas
- Department of Endocrinology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Gokhan Duruksu
- Center for Stem Cell and Gene Therapies Research and Practice, Institute of Health Sciences, Stem Cell Department, Kocaeli University, Izmit, Kocaeli, Turkey
| | - Cansu Subasi
- Center for Stem Cell and Gene Therapies Research and Practice, Institute of Health Sciences, Stem Cell Department, Kocaeli University, Izmit, Kocaeli, Turkey
| | - Ozgur Kemik
- Department of Surgery, Bakirkoy Dr.Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Ahu Kemik
- Faculty of Medicine, Department of Biochemistry, Istanbul University, Istanbul, Turkey
| | - Damlanur Sakiz
- Department of Pathology, Bakirköy Dr.Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Mustafa Kalayci
- Department of Surgery, Bakirkoy Dr.Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Sevim Purisa
- Faculty of Medicine, Department of Statistics, Istanbul University, Istanbul, Turkey
| | - Seda Unal
- Center for Stem Cell and Gene Therapies Research and Practice, Institute of Health Sciences, Stem Cell Department, Kocaeli University, Izmit, Kocaeli, Turkey
| | - Erdal Karaoz
- Center for Regenerative Medicine and Stem Cell Research and Manufacturing (LivMedCell), Liv Hospital, Istanbul, Turkey
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Kim R, Lee JM, Shin CI, Lee ES, Yoon JH, Joo I, Kim SH, Hwang I, Han JK, Choi BI. Differentiation of intrahepatic mass-forming cholangiocarcinoma from hepatocellular carcinoma on gadoxetic acid-enhanced liver MR imaging. Eur Radiol 2015; 26:1808-17. [PMID: 26373763 DOI: 10.1007/s00330-015-4005-8] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 08/16/2015] [Accepted: 09/02/2015] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To determine the different imaging features of intrahepatic mass-forming cholangiocarcinoma (IMCC) from hepatocellular carcinoma (HCC) on gadoxetic acid-enhanced magnetic resonance imaging (MRI). METHODS This retrospective study was institutional review board approved and the requirement for informed consent was waived. Patients who underwent gadoxetic acid-enhanced MRI with histologically confirmed IMCCs (n = 46) or HCCs (n = 58) were included. Imaging features of IMCCs and HCCs on gadoxetic acid-enhanced MRI including T2- and T1-weighted, diffusion weighted images, dynamic study and hepatobiliary phase (HBP) images were analyzed. Univariate and multivariate logistic regression analyses were performed to identify relevant differentiating features between IMCCs and HCCs. RESULTS Multivariate analysis revealed heterogeneous T2 signal intensity and a hypointense rim on the HBP as suggestive findings of IMCCs and the wash-in and "portal wash-out" enhancement pattern as well as focal T1 high signal intensity foci as indicative of HCCs (all, p < 0.05). When we combined any three of the above four imaging features, we were able to diagnose IMCCs with 94 % (43/46) sensitivity and 86 % (50/58) specificity. CONCLUSIONS Combined interpretation of enhancement characteristics including HBP images, morphologic features, and strict application of the "portal wash-out" pattern helped more accurate discrimination of IMCCs from HCCs. KEY POINTS • Analysis of enhancement characteristics helped accurate discrimination of IMCCs from HCCs. • Wash-out should be determined on the PVP of gadoxetic acid-enhanced MRI. • A hypointense rim on the HBP was a significant finding of IMCCs.
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Affiliation(s)
- Rihyeon Kim
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, Korea
| | - Jeong Min Lee
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, Korea. .,Institute of Radiation Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, Korea.
| | - Cheong-Il Shin
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, Korea
| | - Eun Sun Lee
- Department of Radiology, Chung-Ang University Hospital, 102, Heukseok-ro, Dongjak-gu, Seoul, Korea
| | - Jeong Hee Yoon
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, Korea
| | - Ijin Joo
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, Korea
| | - Seong Ho Kim
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, Korea
| | - Inpyeong Hwang
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, Korea
| | - Joon Koo Han
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, Korea.,Institute of Radiation Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, Korea
| | - Byung Ihn Choi
- Department of Radiology, Chung-Ang University Hospital, 102, Heukseok-ro, Dongjak-gu, Seoul, Korea
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Diepeveen LA, Watson ME, McSpadden SB, Strauss RP, Callus BA, Yeoh GC. Epigenetic Modulators Enhance Constitutive and Liver-Specific Reporter Expression in Murine Liver Progenitor Cell Lines. Tissue Eng Part C Methods 2015; 21:1080-7. [PMID: 25997084 DOI: 10.1089/ten.tec.2015.0131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Stem cells expressing reporter constructs are extremely useful for their tracking in vivo or for determining cell lineage fate in vivo and in vitro. We generated liver progenitor cell (LPC) lines from actin-EGFP and TAT-GRE-lacZ mice. LPCs from the actin-EGFP mouse facilitate cell tracing following transplant as the reporter is constitutively expressed. LPCs from the TAT-GRE-lacZ mouse express β-galactosidase under the control of the tyrosine aminotransferase (TAT) promoter and are only active in mature hepatocytes. We found that the utility of such LPC lines becomes severely limited by downregulation of transgene expression following extended culture. We show that epigenetic mechanisms are responsible for suppressing expression of both transgenes. Enhancement of transgene expression in both LPC lines was achieved by treating the cell lines with either the histone acetylating agent sodium butyrate or the DNA demethylating agent 5-azacytidine.
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Affiliation(s)
- Luke Aris Diepeveen
- 1 The Centre for Medical Research, Harry Perkins Institute of Medical Research , Nedlands, WA, Australia
| | - Michel Elyse Watson
- 1 The Centre for Medical Research, Harry Perkins Institute of Medical Research , Nedlands, WA, Australia .,2 Center for Cell Therapy and Regenerative Medicine, School of Medicine and Pharmacology, Crawley, WA, Australia
| | - Sarah Beth McSpadden
- 3 School of Chemistry and Biochemistry, University of Western Australia , Crawley, WA, Australia
| | - Robyn Patricia Strauss
- 3 School of Chemistry and Biochemistry, University of Western Australia , Crawley, WA, Australia
| | - Bernard Andrew Callus
- 3 School of Chemistry and Biochemistry, University of Western Australia , Crawley, WA, Australia
| | - George Cheng Yeoh
- 1 The Centre for Medical Research, Harry Perkins Institute of Medical Research , Nedlands, WA, Australia .,2 Center for Cell Therapy and Regenerative Medicine, School of Medicine and Pharmacology, Crawley, WA, Australia .,3 School of Chemistry and Biochemistry, University of Western Australia , Crawley, WA, Australia
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7
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Banerjee A, Bizzaro D, Burra P, Di Liddo R, Pathak S, Arcidiacono D, Cappon A, Bo P, Conconi MT, Crescenzi M, Pinna CMA, Parnigotto PP, Alison MR, Sturniolo GC, D'Incà R, Russo FP. Umbilical cord mesenchymal stem cells modulate dextran sulfate sodium induced acute colitis in immunodeficient mice. Stem Cell Res Ther 2015; 6:79. [PMID: 25890182 PMCID: PMC4455709 DOI: 10.1186/s13287-015-0073-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 09/26/2014] [Accepted: 04/01/2015] [Indexed: 01/14/2023] Open
Abstract
Introduction Inflammatory bowel diseases (IBD) are complex multi-factorial diseases with increasing incidence worldwide but their treatment is far from satisfactory. Unconventional strategies have consequently been investigated, proposing the use of cells as an effective alternative approach to IBD. In the present study we examined the protective potential of exogenously administered human umbilical cord derived mesenchymal stem cells (UCMSCs) against Dextran Sulfate Sodium (DSS) induced acute colitis in immunodeficient NOD.CB17-Prkdcscid/J mice with particular attention to endoplasmic reticulum (ER) stress. Methods UCMSCs were injected in NOD.CB17-Prkdcscid/J via the tail vein at day 1 and 4 after DSS administration. To verify attenuation of DSS induced damage by UCMSCs, Disease Activity Index (DAI) and body weight changes was monitored daily. Moreover, colon length, histological changes, myeloperoxidase and catalase activities, metalloproteinase (MMP) 2 and 9 expression and endoplasmic reticulum (ER) stress related proteins were evaluated on day 7. Results UCMSCs administration to immunodeficient NOD.CB17-Prkdcscid/J mice after DSS damage significantly reduced DAI (1.45 ± 0.16 vs 2.08 ± 0.18, p < 0.05), attenuating the presence of bloody stools, weight loss, colon shortening (8.95 ± 0.33 cm vs 6.8 ± 0.20 cm, p < 0.01) and histological score (1.97 ± 0.13 vs 3.27 ± 0.13, p < 0.001). Decrease in neutrophil infiltration was evident from lower MPO levels (78.2 ± 9.7 vs 168.9 ± 18.2 U/g, p < 0.01). DSS treatment enhanced MMP2 and MMP9 activities (>3-fold), which were significantly reduced in mice receiving UCMSCs. Moreover, positive modulation in ER stress related proteins was observed after UCMSCs administration. Conclusions Our results demonstrated that UCMSCs are able to prevent DSS-induced colitis in immunodeficient mice. Using these mice we demonstrated that our UCMSCs have a direct preventive effect other than the T-cell immunomodulatory properties which are already known. Moreover we demonstrated a key function of MMPs and ER stress in the establishment of colitis suggesting them to be potential therapeutic targets in IBD treatment.
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Affiliation(s)
- Antara Banerjee
- Department of Surgery, Oncology and Gastroenterology, Gastroenterology/Multivisceral Transplant Unit, University Hospital Padova, Via Giustiniani 2, Padova, 35128, Italy.
| | - Debora Bizzaro
- Department of Surgery, Oncology and Gastroenterology, Gastroenterology/Multivisceral Transplant Unit, University Hospital Padova, Via Giustiniani 2, Padova, 35128, Italy.
| | - Patrizia Burra
- Department of Surgery, Oncology and Gastroenterology, Gastroenterology/Multivisceral Transplant Unit, University Hospital Padova, Via Giustiniani 2, Padova, 35128, Italy.
| | - Rosa Di Liddo
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Via Marzolo 5, 35131, Padova, Italy.
| | - Surajit Pathak
- Department of Surgery, Oncology and Gastroenterology, Gastroenterology/Multivisceral Transplant Unit, University Hospital Padova, Via Giustiniani 2, Padova, 35128, Italy.
| | - Diletta Arcidiacono
- Department of Surgery, Oncology and Gastroenterology, Gastroenterology/Multivisceral Transplant Unit, University Hospital Padova, Via Giustiniani 2, Padova, 35128, Italy. .,Venetian Institute of Molecular Medicine (VIMM), Via Orus, 2 35129, Padova, Italy.
| | - Andrea Cappon
- Department of Surgery, Oncology and Gastroenterology, Gastroenterology/Multivisceral Transplant Unit, University Hospital Padova, Via Giustiniani 2, Padova, 35128, Italy.
| | - Patrizio Bo
- Obstetrics and Gynecology Unit, Cittadella Hospital, via Casa di ricovero, 40 35013 Cittadella, Padova, Italy.
| | - Maria Teresa Conconi
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Via Marzolo 5, 35131, Padova, Italy.
| | - Marika Crescenzi
- Department of Surgery, Oncology and Gastroenterology, Gastroenterology/Multivisceral Transplant Unit, University Hospital Padova, Via Giustiniani 2, Padova, 35128, Italy.
| | - Claudia Maria Assunta Pinna
- Department of Surgery, Oncology and Gastroenterology, Gastroenterology/Multivisceral Transplant Unit, University Hospital Padova, Via Giustiniani 2, Padova, 35128, Italy.
| | - Pier Paolo Parnigotto
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Via Marzolo 5, 35131, Padova, Italy.
| | - Malcolm R Alison
- Centre for Tumour Biology, Barts Cancer Institute, Charterhouse Square, London, EC1M 6BQ, UK.
| | - Giacomo Carlo Sturniolo
- Department of Surgery, Oncology and Gastroenterology, Gastroenterology/Multivisceral Transplant Unit, University Hospital Padova, Via Giustiniani 2, Padova, 35128, Italy.
| | - Renata D'Incà
- Department of Surgery, Oncology and Gastroenterology, Gastroenterology/Multivisceral Transplant Unit, University Hospital Padova, Via Giustiniani 2, Padova, 35128, Italy.
| | - Francesco Paolo Russo
- Department of Surgery, Oncology and Gastroenterology, Gastroenterology/Multivisceral Transplant Unit, University Hospital Padova, Via Giustiniani 2, Padova, 35128, Italy.
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Hermerén G. Human stem-cell research in gastroenterology: experimental treatment, tourism and biobanking. Best Pract Res Clin Gastroenterol 2014; 28:257-68. [PMID: 24810187 DOI: 10.1016/j.bpg.2014.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 02/11/2014] [Accepted: 02/21/2014] [Indexed: 01/31/2023]
Abstract
The growing interest in the possibility of applying stem-cell therapies to gastroenterological diseases is outlined. Some promising results have been reported, but more research is needed in view of the uncertainties and knowledge gaps that still exist. The ethical issues raised by this kind of research are then indicated and classified. Three problematic kinds of situation are outlined: experimental treatments, stem-cell tourism and biobanking. A four-question approach - which is not to be confused with the well-known four-principle approach introduced by Beauchamp and Childress - is described and applied to these three challenging situations. In conclusion, it is pointed out that the analysis of these situations illustrates the interplay between definitions, empirical research and ethics. They are interrelated and need to be integrated.
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Affiliation(s)
- Göran Hermerén
- Dept. of Medical Ethics, Lund University, Biomedical Center BMC I 12, 22184 Lund, Sweden.
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Massumi M, Hoveizi E, Baktash P, Hooti A, Ghazizadeh L, Nadri S, Pourasgari F, Hajarizadeh A, Soleimani M, Nabiuni M, Khorramizadeh MR. Efficient programming of human eye conjunctiva-derived induced pluripotent stem (ECiPS) cells into definitive endoderm-like cells. Exp Cell Res 2014; 322:51-61. [DOI: 10.1016/j.yexcr.2014.01.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2013] [Revised: 12/15/2013] [Accepted: 01/06/2014] [Indexed: 01/08/2023]
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Sasikala M, Rao GV, Tandan M, Reddy DN. Gastro Intestinal Stem Cells. Regen Med 2013. [DOI: 10.1007/978-94-007-5690-8_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Desreumaux P, Foussat A, Allez M, Beaugerie L, Hébuterne X, Bouhnik Y, Nachury M, Brun V, Bastian H, Belmonte N, Ticchioni M, Duchange A, Morel-Mandrino P, Neveu V, Clerget-Chossat N, Forte M, Colombel JF. Safety and efficacy of antigen-specific regulatory T-cell therapy for patients with refractory Crohn's disease. Gastroenterology 2012; 143:1207-1217.e2. [PMID: 22885333 DOI: 10.1053/j.gastro.2012.07.116] [Citation(s) in RCA: 261] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Revised: 07/23/2012] [Accepted: 07/30/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS New therapeutic strategies are needed for patients with refractory Crohn's disease (CD). We evaluated data from the Crohn's And Treg Cells Study (CATS1) to determine the safety and efficacy of antigen-specific T-regulatory (Treg) cells for treatment of patients with refractory CD. METHODS We performed a 12-week, open-label, multicenter, single-injection, escalating-dose, phase 1/2a clinical study in 20 patients with refractory CD. Ovalbumin-specific Treg cells (ova-Tregs) were isolated from patients' peripheral blood mononuclear cells (PBMCs), exposed to ovalbumin, and administrated intravenously. Safety and efficacy were assessed using clinical and laboratory parameters. We evaluated proliferation of PBMCs in response to ovalbumin. RESULTS Injections of ova-Tregs were well tolerated, with 54 adverse events (2 related to the test reagent) and 11 serious adverse events (3 related to the test reagent, all recovered). Overall, a response, based on a reduction in Crohn's Disease Activity Index (CDAI) of 100 points, was observed in 40% of patients at weeks 5 and 8. Six of the 8 patients (75%) who received doses of 10(6) cells had a response at weeks 5 and 8, with a statistically significant reduction in CDAI. In this group, remission (based on CDAI ≤150) was observed in 3 of 8 patients (38%) at week 5 and 2 of 8 patients (25%) at week 8. CONCLUSIONS Administration of antigen-specific Tregs to patients with refractory CD (CATS1) was well tolerated and had dose-related efficacy. The ovalbumin-specific immune response correlated with clinical response, supporting immune-suppressive mechanisms of ova-Tregs. The consistency of results among different assessment methods supports the efficacy of ova-Tregs; this immune therapy approach warrants further clinical and mechanistic studies in refractory CD. Eudract, Number: 2006-004712-44.
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Affiliation(s)
- Pierre Desreumaux
- Department of Hepatogastroenterology and Centre d'Investigation Clinique, Huriez Hospital, Lille, France
| | | | - Matthieu Allez
- Gastroenterology and Centre d'Investigation Clinique, Saint-Louis Hospital, Paris, France
| | - Laurent Beaugerie
- Gastroenterology and Centre d'Investigation Clinique, St Antoine Hospital, Paris, France
| | - Xavier Hébuterne
- Gastroenterology and Unité de Recherche Clinique, L'Archet 2 Hospital, Nice, France
| | | | - Maria Nachury
- Gastroenterology and Centre d'Investigation Clinique, Jean Minjoz Hospital, Besançon, France
| | | | | | | | | | | | | | | | | | | | - Jean-Frédéric Colombel
- Department of Hepatogastroenterology and Centre d'Investigation Clinique, Huriez Hospital, Lille, France.
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Therapeutic strategies against ischemia-reperfusion injury: stem cell therapy and beyond. Crit Care Med 2012; 40:1381-2. [PMID: 22425855 DOI: 10.1097/ccm.0b013e31824316c9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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