Division of Pediatric Surgery, Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles; Division of Pediatric Surgery, Department of Surgery, School of Medicine, Stanford University.
Division of Pediatric Surgery, Department of Surgery, School of Medicine, Stanford University.
J Pediatr Surg. 2020 Jan;55(1):194-200. doi: 10.1016/j.jpedsurg.2019.09.075. Epub 2019 Oct 24.
Hirschprung's disease is characterized by aganglionic bowel and often requires surgical resection. Cell-based therapies have been investigated as potential alternatives to restore functioning neurons. Skin-derived precursor cells (SKPs) differentiate into neural and glial cells in vitro and generate ganglion-like structures in rodents. In this report, we aimed to translate this approach into a large animal model of aganglionosis using autologous transplantation of SKPs.
Juvenile pigs underwent skin procurement from the shoulder and simultaneous chemical denervation of an isolated colonic segment. Skin cells were cultured in neuroglial-selective medium and labeled with fluorescent dye for later identification. The cultured SKPs were then injected into the aganglionic segments of colon, and the specimens were retrieved within seven days after transplantation. SKPs in vitro and in vivo were assessed with histologic samples for various immunofluorescent markers of multipotency and differentiation. SKPs from the time of harvest were compared to those at the time of injection using PCR.
Prior to transplantation, 72% of SKPs stained positive for nestin and S100b, markers of neural and glial precursor cells of neural crest origin, respectively. Markers of differentiated neurons and gliocytes, TUJ1 and GFAP, were detected in 47% of cultured SKPs. After transplantation, SKPs were identified in both myenteric and submucosal plexuses of the treated colon. Nestin co-expression was detected in the SKPs within the aganglionic colon in vivo. Injected SKPs appeared to migrate and express early neuroglial differentiation markers.
Autologous SKPs implanted into aganglionic bowel demonstrated immunophenotypes of neuroglial progenitors. Our results suggest that autologous SKPs may be potentially useful for cell-based therapy for patients with enteric nervous system disorders.
Basic science.
先天性巨结肠症的特征是无神经节的肠段,通常需要手术切除。细胞疗法已被研究为恢复功能神经元的潜在替代方法。皮肤衍生前体细胞(SKP)在体外分化为神经和神经胶质细胞,并在啮齿动物中产生类似神经节的结构。在本报告中,我们旨在使用 SKP 的自体移植将这种方法转化为巨结肠症的大型动物模型。
幼年猪从肩部采集皮肤,并对分离的结肠段进行化学去神经支配。皮肤细胞在神经胶质选择性培养基中培养,并标记荧光染料以便后续鉴定。然后将培养的 SKP 注射到无神经节的结肠段中,并在移植后七天内取回标本。通过组织学样本评估 SKP 在体外和体内的多能性和分化的各种免疫荧光标记物。使用 PCR 比较 SKP 在收获时和注射时的情况。
在移植前,72%的 SKP 对巢蛋白和 S100b 呈阳性染色,分别为神经嵴起源的神经前体细胞和神经胶质前体细胞的标志物。培养的 SKP 中检测到神经元和神经胶质细胞的分化标志物 TUJ1 和 GFAP,占 47%。移植后,在处理结肠的肌间和黏膜下神经丛中均鉴定出 SKP。在体内无神经节的结肠中检测到 SKP 中的巢蛋白共表达。注射的 SKP 似乎迁移并表达早期神经胶质分化标志物。
植入无神经节肠段的自体 SKP 表现出神经胶质祖细胞的免疫表型。我们的结果表明,自体 SKP 可能对治疗肠神经系统疾病的患者具有潜在的细胞治疗作用。
基础科学。