Genetic Engineering as a Strategy to Improve the Therapeutic Efficacy of Mesenchymal Stem/Stromal Cells in Regenerative Medicine

Mesenchymal stem/stromal cells (MSCs) have been widely studied in the field of regenerative medicine for applications in the treatment of several disease settings. The therapeutic potential of MSCs has been evaluated in studies in vitro and in vivo, especially based on their anti-inflammatory and pro-regenerative action, through the secretion of soluble mediators. In many cases, however, insufficient engraftment and limited beneficial effects of MSCs indicate the need of approaches to enhance their survival, migration and therapeutic potential. Genetic engineering emerges as a means to induce the expression of different proteins and soluble factors with a wide range of applications, such as growth factors, cytokines, chemokines, transcription factors, enzymes and microRNAs. Distinct strategies have been applied to induce genetic modifications with the goal to enhance the potential of MCSs. This review aims to contribute to the update of the different genetically engineered tools employed for MSCs modification, as well as the factors investigated in different fields in which genetically engineered MSCs have been tested

Combination stem cell therapy for heart failure

Patients with congestive heart failure (CHF) that are not eligible for transplantation have limited therapeutic options. Stem cell therapy such as autologous bone marrow, mobilized peripheral blood, or purified cells thereof has been used clinically since 2001. To date over 1000 patients have received cellular therapy as part of randomized trials, with the general consensus being that a moderate but statistically significant benefit occurs. Therefore, one of the important next steps in the field is optimization. In this paper we discuss three ways to approach this issue: a) increasing stem cell migration to the heart; b) augmenting stem cell activity; and c) combining existing stem cell therapies to recapitulate a "therapeutic niche". We conclude by describing a case report of a heart failure patient treated with a combination stem cell protocol in an attempt to augment beneficial aspects of cord blood CD34 cells and mesenchymal-like stem cells

Lysophosphatidic acid enhances survival of human CD34(+) cells in ischemic conditions

Several clinical trials are exploring therapeutic effect of human CD34(+) cells in ischemic diseases, including myocardial infarction. Unfortunately, most of the cells die few days after delivery. Herein we show that lysophosphatidic acid (LPA)-treated human umbilical cord blood-derived CD34(+) cells cultured under hypoxic and serum-deprived conditions present 2.2-fold and 1.3-fold higher survival relatively to non-treated cells and prostaglandin E2-treated cells, respectively. The pro-survival effect of LPA is concentration- and time-dependent and it is mediated by the activation of peroxisome proliferator-activator receptor γ (PPARγ) and downstream, by the activation of pro-survival ERK and Akt signaling pathways and the inhibition of mitochondrial apoptotic pathway. In hypoxia and serum-deprived culture conditions, LPA induces CD34(+) cell proliferation without maintaining the their undifferentiating state, and enhances IL-8, IL-6 and G-CSF secretion during the first 12 h compared to non-treated cells. LPA-treated CD34(+) cells delivered in fibrin gels have enhanced survival and improved cardiac fractional shortening at 2 weeks on rat infarcted hearts as compared to hearts treated with placebo. We have developed a new platform to enhance the survival of CD34(+) cells using a natural and cost-effective ligand and demonstrated its utility in the preservation of the functionality of the heart after infarction.info:eu-repo/semantics/publishedVersio

Priming adult stem cells by hypoxic pretreatments for applications in regenerative medicine

The efficiency of regenerative medicine can be ameliorated by improving the biological performances of stem cells before their transplantation. Several ex-vivo protocols of non-damaging cell hypoxia have been demonstrated to significantly increase survival, proliferation and post-engraftment differentiation potential of stem cells. The best results for priming cultured stem cells against a following, otherwise lethal, ischemic stress have been obtained with brief intermittent episodes of hypoxia, or anoxia, and reoxygenation in accordance with the extraordinary protection afforded by the conventional maneuver of ischemic preconditioning in severely ischemic organs. These protocols of hypoxic preconditioning can be rather easily reproduced in a laboratory; however, more suitable pharmacological interventions inducing stem cell responses similar to those activated in hypoxia are considered among the most promising solutions for future applications in cell therapy. Here we want to offer an up-to-date review of the molecular mechanisms translating hypoxia into beneficial events for regenerative medicine. To this aim the involvement of epigenetic modifications, microRNAs, and oxidative stress, mainly activated by hypoxia inducible factors, will be discussed. Stem cell adaptation to their natural hypoxic microenvironments (niche) in healthy and neoplastic tissues will be also considered

Human bone marrow-derived mesenchymal stem cells

Mesenchymal stem cells (MSCs) have elicited a great clinical interest, particularly in the areas of regenerative medicine and induction of tolerance in allogeneic transplantation. Previous reports demonstrated the feasibility of transplanting MSCs, which generates new prospects in cellular therapy. Recently, injection of MSCs induced remission of steroid-resistant acute graft-versus-host disease (GVHD). This review summarizes the knowledge and possible future clinical uses of MSCs

In vivo experience with natural scaffolds for myocardial infarction : the times they are a-changin'

Altres ajuts: La Marató de TV3 (12/2232)Treating a myocardial infarction (MI), the most frequent cause of death worldwide, remains one of the most exciting medical challenges in the 21st century. Cardiac tissue engineering, a novel emerging treatment, involves the use of therapeutic cells supported by a scaffold for regenerating the infarcted area. It is essential to select the appropriate scaffold material; the ideal one should provide a suitable cellular microenvironment, mimic the native myocardium, and allow mechanical and electrical coupling with host tissues. Among available scaffold materials, natural scaffolds are preferable for achieving these purposes because they possess myocardial extracellular matrix properties and structures. Here, we review several natural scaffolds for applications in MI management, with a focus on pre-clinical studies and clinical trials performed to date. We also evaluate scaffolds combined with different cell types and proteins for their ability to promote improved heart function, contractility and neovascularization, and attenuate adverse ventricular remodeling. Although further refinement is necessary in the coming years, promising results indicate that natural scaffolds may be a valuable translational therapeutic option with clinical impact in MI repair

Characterization of key mechanisms involved in transmigration and invasion of mesenchymal stem cells

Stem cell therapy using human adult mesenchymal stem cells (MSCs) has emerged as a novel strategy for the treatment of a variety of damaged tissues. For a successful systemic stem cell therapy MSCs have to exit the blood circulation by transmigrating across the endothelium and invading into the target tissue. Elevating our knowledge on these core processes might help to optimize stem cell based therapies. The first part of the present study provides insights into key mechanisms involved in the transmigration and invasion of MSCs. Different model systems as well as in vivo studies revealed that MSCs quickly come into contact with the endothelium and subsequently exit the blood circulation by (1) integrating into the endothelium, (2) transmigrating across the endothelial barrier via the insertion of plasmic podia, (3) penetrating the basement membrane and subsequently invading the surrounding tissue. Additionally, it was proven that transmigration of human MSCs not only requires the interaction of very late antigen-4 (VLA-4) and its most important ligand vascular cell adhesion molecule-1 (VCAM-1), but also triggers a clustering of beta 1 integrins. Furthermore, upon invading into cardiac tissue MSCs secrete active matrix metalloproteinase (MMP)-2, but not MMP-9. This study also demonstrates that both the time course and the morphological aspects of MSC transmigration differ depending on the endothelial phenotype, thus indicating, that a variable capacity for transendothelial migration exists within the vasculature. Furthermore, addition of cytokines, mainly vascular endothelial growth factor (VEGF) and erythropoietin (EPO), accelerate the transmigration of MSCs at early stages. Moreover, nitric oxide (NO) and reactive oxygen species (ROS) are released by MSCs upon contact with endothelial cells; manipulating the NO and ROS system by donors and inhibitors resulted in alterations of the transmigratory capacity of MSCs. The second part of the study deals with two possible strategies to enhance the transmigration of MSCs and thereby their therapeutic effectiveness. First, the results demonstrate that genetic modification of MSCs using adenoviral overexpression of the chemokine receptor CXCR4 does not lead to an increase in the transmigration efficiency. Second, focussed pretreatment of the endothelium by a novel and non-invasive technique using ultrasound-mediated microbubble stimulation (UMS) induces a targeted improvement of MSC attraction, transmigration and invasion into non-ischemic as well as into ischemic myocardium. This effect was most likely due to the release of nitric oxide, cytokines and the regional activation of proteases. Thus, UMS represents a forward-looking possibility to increase the efficiency of MSC engraftment by modulating the process of transmigration in a targeted and non-invasive manner