Mesenchymal Stem Cells Flashcards

1
Q

What are MSCs?

A
  • → Non-haematopoetic stem-like cells that can be isolated from most mesenchymal tissues such as bone marrow, fat, blood vessels and umbilical cord
  • In culture, MSCs defined as plastic-adherant, fibroblasts-like cells which are able to self-renew and differentiate into bone, adipose and cartilage

Nomenclature:
• Marrow stromal cells, mesenchymal stem cells etc… nomenclature still controversial

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2
Q

How were MSCs first described

A

• Freidenstein 1974
• Identified cells in the stroma of the bone marrow that could form bone, fat and cartilage cells
• Cells demonstrated:
− tight adherence to tissue culture plastic
− multipotent differentiation in culture and in vivo
− spindle-like morphology
− single cell-derived colonies
• Described them initially as CFU-fibroblastic

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3
Q

What was the early understanding of MSCs?

A

Owen and Freidenstein, 1988: Stromal cells , marrow derived osteogenic precursors
• Evidence for stromal stem cells present in the soft connective tissue associated with marrow and bone surfaces
• Able to give rise to a number of different cell lines
• Fibroblastic colonies formed when marrow cells cultured in vivo
• CFU-F assays demonstrated that some CFU-F have high ability for self-renewal and multipotency whereas some have more limited potential
• Different stromal cell lines can be promoted under different culture conditions → more specific markers for the different lines required

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4
Q

Where do we find MSCs?

A

• Stem cell niche → stem cell niche controls MSC function
• Niches vary from tissue to tissue but generally:
− MSCs surrounded by stromal cells
− Cell-cell adhesion, receptor ligand binding and gap junctions will mediate interaction
− Niche also has ECM that provides structural support
− Soluble factors provide trophic support

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5
Q

Why are MSCs important?

A
  1. Regulation of HSCs
    − CAR cells (CXCL12 abundant reticular cells) thought to be progeny of MSCs
    − Endosteal niche – CAR cells secrete factors responsible for mainternance of HSCs:
    − Differentiation of osteoblasts (which give support for HSCs)
    − Differentiation of adipocytes (which negatively regulate HSCs)
    − Quiescence, retention and maintenance of HSCs
    − Perivascular niche – CAR cells secrete factors responsible for activation of HSCs:
    − Activation, division, differentiation and mobilisation of HSCs
  2. Tissue repair:
    • In vivo, the classic paradigm always been that activation and mobilization of MSCs, fibroblasts and cells of the immune system repair an injured tissue by MSC integration and differentiation.
    • We are now increasingly finding cell empowerment → MSCs are trophic factories, produce molecules that stimulate other cells.
    − In response to cells of the immune system, tissue damage, high cytokine levels, hypoxia etc… get activation of MSCs to produce immunosuppressive factors, GFs to stimulate fibroblasts to produce new tissue, GFs that stimulate endothelial cells for angiogenesis, and factors that stimulate progenitor cells of that particular tissue to differentiate and repair – rather than MSCs being the ones to differentiate.
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6
Q

What is the differentiation potential of MSCs?

A

• Multipotent differentiation potential towards mesenchymal lineages
− Bone, cartilage, muscle, marrow, ligaments, adipose, connective tissue
• In vivo, we particularly see osteocytes and adipocytes
• Don’t really see much chondrocytes (cartilate) – isn’t a direct blood supply to articular cartilage. But can see this in the lab.
• We also have potential transdifferentiation to different germ lineages, but this is controversial, especially in vivo.

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7
Q

What processes can be affected by MSC secreted factors?

A

− Immunomodulation → HL, TGF-B, PGE-2, LIF…
− Anti-apoptosis → VEGF, HGF, IGF, TGF-b, GM-CSF…
− Angiogenesis → VEGF, PIGF, IL-6, bFGF
− Chemoattraction → CCLs and CXCLs
− Anti-scarring → HGF, bFGF, ADM
− Support of growth and differentiation of stem and progenitor cells →SCF, LIF, M-CSF, SDF-1

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8
Q

What are isolation procedures for MSCs from bone marrow and adipose

A

From bone marrow:
• Bone marrow taken from patients undergoing hip replacement therapy
• Put bone marrow in density gradient centrifugation → seperates marrow into plasma, mononuclear cells, granulocytes and RBCs.
− From MSCs we are interested in the mononuclear layer
• Put the mononuclear layer in culture → the cells that elongate and adhere are MSCs

From adipose (liposuction)
• Centrifuge the solution
• Adipose end up at the bottom, plate these out

→ Quite crude methods, to be more specific use FACS

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9
Q

What are the minimal criteria for MSCs?

A

• Established in 2006 by the International Society for Cellular Therapy
• Isolated on the basis of:
− Mononuclear cells
− Adherance – plastic adherent and grow as a monolayer
− Positive/negative expression of cell surface markers
➢ CD271 and Stro-1 quite specific and only expressed by small subset
➢ 100% of MSC prep may fit the minimal criteria. Within that, could look for expression of specific CD markers
➢ May find CD271 expressed on 0.01% of those cells, those are a subset
➢ Can do the same with Stro-1
➢ These subsets may have a different differentiation capacity → Stro-1 more oestogenic, CD271 more chondrogenic.
− Differentiation capacity towards adipocytes, chondrocytes, and osteoblast (as the minimum)
• MSCs still relatively poorly defined

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10
Q

What are differences between BM and AD MSCs?

A
Bone marrow MSCs
Positive markers:
•	CD29
•	CD44
•	CD105

Negative markers:
• CD14
• CD45

Adipose derived MSCs
•	Easy to isolate
•	More abundant that bone marrow MSCs
•	Higher proliferation rate
•	Differences in CD profile:
−	AD-MSCs → CD34, high CD30, CD36
−	BM-MSCs → no CD34, lower CD30, , no CD36
•	Differences in differentiation:
−	Osteogenesis very similar
−	Chondrogenesis very different → adipose derived stem cells don’t make chondrocytes well
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11
Q

What GFs influence MSCs?

A

• AD-MSCs proliferate faster, BM-MSCs undergo better chondrogenesis
• AD-MSCs may lack TGF receptor, thus BMP6 might improve differentiation
− Indeed, paper published → Reduced Chondrogenic Potential of Adipose Tissue Derived Stromal Cells Correlated with an Altered TGF-B Receptor and BMP Profile is Overcome by BMP-6.

GFs and Effects
• TGF-B & BMP-2 → increases proliferation and cartilaginous ECM production, downregulates collagen type I expression
• BMP-4 → accelerates the progression of cartilage differentiation
• GDF-5 → increases cartilaginous ECM production
• FGF-2 → increases proliferation, increases proteoglycan production

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12
Q

What TFs control MSC differentiation?

A

Adipocyte differentiation:
• PPARy → from committed progenitor to mature preadipocyte
• C/EBPb → commited progenitor and early preadipocyte
• FABPs → mature preadipocyte and adipocyte
• Lipids → mature preadipocyte and adipocyte

Osteocyte differentiation:
• Runx2 → committed progenitor to preosteoblast. Master regulator of osteogensis
• Osterix → Preosteoblast
• Alkaline phosphatase → preosteoblast to early osteoblast
• Osteocalcin → mature osteoblast
• Osteopontin → mature osteoblast

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13
Q

What is the model for chondrogenesis in vivo

A

Key TFs in osteogenesis and chondrogenesis are Runx2 vs SOX-9

  1. From the multipotent mesenchymal progenitors (Notch, Runx2) some will become osteochondro progenitor cells (Col1, CD44, N-cadherin)
  2. From these we get mesenchymal condensation and expression of Sox-9
  3. SOX-9 is the master regulator of chondrogenesis → directly linked to expression of type 2 collagen
  4. Proliferating chondrocytes will either give cells that will upregulate type 2 collagen and aggrecan, or hypertrophic chondrocytes that upregulate Runx2
  5. Hypertrophied chondrocytes either die, or through maintained Runx2 expression, can transfer to osteogenic lineage
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14
Q

What is the model for chondrogenesis in vitro?

A

• Recreate the 3D microenvironment → use alginate beads. Keeps them rounded and held within a matrix
• Use of a differentiating media → dexamethasone and TFG-B
• Promotes chondrogenesis:
− Rounded morphology
− Upregulation of Sox-9, type II collagen and aggrecan
− First demonstrated by Johnstone et al, 1998
• 2D culture → Sox-9 overexpression required to induce MSC chondrogenesis in a monolayer, but we don’t get aggregan expression and also get type I collagen.
• 3D culture → complete differentiation – sustained upregulation of SOX-9, type 2 collagen and aggrecan

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15
Q

How does donor age of MSCs affect differentiation?

A
  • Mean telomere length decreases with age
  • Total population doublings decrease with age
  • Differentiation is negatively effected by age
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16
Q

What is a timeline of MSCs as trophic factories?

A
  • 1970 → MSCs reported
  • 1998/2002 → immunosuppressive property of MSCs in vitro/in vivo reported
  • 2004 → first report of MSCs to treat patients with GvHD
  • 2009 → GvHD trials fail at phase II
  • 2010 → pro-inflammatory MSC1 and anti-inflammatory MSC2 cells identified
  • 2013 → International Society for Cellular Therapy suggests assaying immunmodulatory ability of MSCs in clinical application
  • 2014 → inflammatory status is shown to dictate the immunoregulation property of MSCs
17
Q

What are MSCs therapeutic potential in GvHD

A

• MSCs can accumulate in an allograft as a result of inflammation due to transplantation
• Here they contribute to immunosuppression and help reduce rejection
− Inhibit T cell activation by secreting MMPs
− Promote Treg cell actiation by secreting IL-10 and TGF-B

18
Q

How can MSCs act as trophic factories

A

• Secrete growth factors and anti-inflammatory cytokines that regulate repair.
− Secrete these in response to anti-inflammatory cytokines IFN-y, TNF-a, IL-1B, LPS
• Also interact with macrophages during inflammation
− MSCs secrete enzymes (COX2 and IDO) which promotes repolarization of macrophages from pro-inflammatory M1 to anti-inflammatory M2
− M2 macrophages prevent neutrophil invasion and T cell stimulaton, while inducing T regs
• MSCs can also
− Suppress DC maturation
− Reduce B cell activation and proliferation
− Inhibit the cytotoxicity of NK cells

19
Q

How can MSCs be used as therapy for cardiac and brain disorders?

A

Cardiac protection
• MSCs enhance tissue repair without significant enhancement
• MSCS intravenously infused trap in lungs
• MSCs in lungs secrete anti-inflammatory factors, eg TSG-6
− Decreased inflammation
− Reduced infarct size
− Improved cardiac function

Neural Transdifferentiation and Neuroprotective Effects:
• Inhibition of astrocyte proliferation
• Inhibition of microglia activation
• Induction of microglia phenotype switch
• Induction of endogenous neurogenesis
• Inhibition of neuronal apoptosis

MSCs being tested for therapeutic potential in experimental forms of:
•	Stroek
•	MS
•	Brain ischaemia
•	Spinal cord injury
20
Q

MSCs - Misconceptions and Evolving Concepts

A
  1. MSCs isolated from different tissues are equivalent
  2. MSCs can be defined by their surface epitopes → we have a minimal criteria, but there are lots of potential molecules and different populations express certain ones and have different potency
  3. Cloning MSCs provides homogenous preparations of cells → again, all cells are different, and some may be more primed to form cells of a certain lineage
  4. Mouse MSCs can be isolated and expanded under the same conditions
  5. The properties of MSCs in culture reflect their properties in vivo → can undergo transdifferentiation in vitro
  6. MSCs should not be tested in clinical trials until their mechanism of action to produce therapeutically beneficial effects are fully defined → most clinical trials havent defined the mechanism.
21
Q

Describe the stamina foundation story

A

• 2009: Stamina foundation founded
− Private organization in Italy
− Founded by Davide Vannino (not trained as a scientist)
− Used MSCs to treat parkinsons
− No published evidence to support the claims, or clinical trials evidence
− Claims to have peformed >80 successful operations, mainly on children
• 2012: Italian Medicine Agency shuts down Stamina due to safety concerns (public protests)
• March 2013: IMA allows treatments to continue (stem cell scientists protest)
• May 2013: Government agrees to sponsor clinical trial of stamina product
• July 2013: Data in patent application found to be flawed
• Oct 2013: Trial halted after problems with protocol identified
• Dec 2013: Italian health minister reveals 36 patients not improved
• 2014: Prosecutor accuses Vannoni and others of attempted fraud