Department of Orthopedics, UHealth Sports Medicine Institute, University of Miami Miller School of Medicine, Miami, Florida, USA; Diabetes Research Institute & Cell Transplant Center, University of Miami Miller School of Medicine, Miami, Florida, USA.
Department of Orthopedics, UHealth Sports Medicine Institute, University of Miami Miller School of Medicine, Miami, Florida, USA; Diabetes Research Institute & Cell Transplant Center, University of Miami Miller School of Medicine, Miami, Florida, USA; Department of Biomedical Engineering, University of Miami College of Engineering, Miami, Florida, USA.
Cytotherapy. 2020 Nov;22(11):677-689. doi: 10.1016/j.jcyt.2020.06.007. Epub 2020 Jul 26.
Mesenchymal stem/stromal cell (MSC)-based therapies have gained attention as potential alternatives for multiple musculoskeletal indications based on their trophic and immunomodulatory properties. The infrapatellar fat pad (IFP) serves as a reservoir of MSCs, which play crucial roles modulating inflammatory and fibrotic events at the IFP and its neighboring tissue, the synovium. In an effort to comply with the existing regulatory framework regarding cell-based product manufacturing, we interrogated the in vitro immunomodulatory capacity of human-derived IFP-MSCs processed under different conditions, including a regulatory-compliant protocol, in addition to their response to the inflammatory and fibrotic environments often present in joint disease.
Immunophenotype, telomere length, transcriptional and secretory immunomodulatory profiles and functional immunopotency assay were assessed in IFP-MSCs expanded in regular fetal bovine serum (FBS)-supplemented medium and side-by-side compared with same-donor cells processed with two media alternatives (i.e., regulatory-compliant pooled human platelet lysate [hPL] and a chemically reinforced/serum-reduced [Ch-R] formulation). Finally, to assess the effects of such formulations on the ability of the cells to respond to pro-inflammatory and pro-fibrotic conditions, all three groups were stimulated ex vivo (i.e., cell priming) with a cocktail containing TNFα, IFNγ and connective tissue growth factor (tumor-initiating cells) and compared with non-induced cohorts assessing the same outcomes.
Non-induced and primed IFP-MSCs expanded in either hPL or Ch-R showed distinct morphology in vitro, similar telomere dynamics and distinct phenotypical and molecular profiles when compared with cohorts grown in FBS. Gene expression of IL-8, CD10 and granulocyte colony-stimulating factor was highly enriched in similarly processed IFP-MSCs. Cell surface markers related to the immunomodulatory capacity, including CD146 and CD10, were highly expressed, and secretion of immunomodulatory and pro-angiogenic factors was significantly enhanced with both hPL and Ch-R formulations. Upon priming, the immunomodulatory phenotype was enhanced, resulting in further increase in CD146 and CD10, significant CXCR4 presence and reduction in TLR3. Similarly, transcriptional and secretory profiles were enriched and more pronounced in IFP-MSCs expanded in either hPL or Ch-R, suggesting a synergistic effect between these formulations and inflammatory/fibrotic priming conditions. Collectively, increased indoleamine-2,3-dioxygenase activity and prostaglandin E2 secretion for hPL- and Ch-R-expanded IFP-MSCs were functionally reflected by their robust T-cell proliferation suppression capacity in vitro compared with IFP-MSCs expanded in FBS, even after priming.
Compared with processing using an FBS-supplemented medium, processing IFP-MSCs with either hPL or Ch-R similarly enhances their immunomodulatory properties, which are further increased after exposure to an inflammatory/fibrotic priming environment. This evidence supports the adoption of regulatory-compliant practices during the manufacturing of a cell-based product based on IFP-MSCs and anticipates a further enhanced response once the cells face the pathological environment after intra-articular administration. Mechanistically, the resulting functionally enhanced cell-based product has potential utilization as a novel, minimally invasive cell therapy for joint disease through modulation of local immune and inflammatory events.
间充质干细胞(MSC)疗法因其营养和免疫调节特性,已成为多种肌肉骨骼疾病潜在的替代疗法。髌下脂肪垫(IFP)是 MSC 的储存库,在调节 IFP 及其相邻组织(滑膜)的炎症和纤维化事件中发挥着关键作用。为了遵守现有的细胞产品制造监管框架,我们研究了不同条件下处理的人源性 IFP-MSC 的体外免疫调节能力,包括符合监管要求的方案,以及它们对关节疾病中常见的炎症和纤维化环境的反应。
在常规胎牛血清(FBS)补充培养基中扩增 IFP-MSC,并与相同供体的细胞进行比较,评估其免疫表型、端粒长度、转录和分泌免疫调节谱以及功能免疫原性测定。此外,为了评估这些制剂对细胞响应促炎和促纤维化条件的能力,所有三组细胞均在体外用含有 TNFα、IFNγ 和结缔组织生长因子(肿瘤起始细胞)的鸡尾酒进行刺激(即细胞预刺激),并与未诱导的队列进行比较,以评估相同的结果。
非诱导和预刺激的 IFP-MSC 在 hPL 或 Ch-R 中扩增,表现出独特的体外形态,端粒动力学相似,表型和分子特征与在 FBS 中扩增的细胞明显不同。白细胞介素 8、CD10 和粒细胞集落刺激因子的基因表达在类似处理的 IFP-MSC 中高度富集。与免疫调节能力相关的细胞表面标志物,包括 CD146 和 CD10,高度表达,hPL 和 Ch-R 制剂均显著增强了免疫调节和促血管生成因子的分泌。在预刺激后,免疫调节表型增强,导致 CD146 和 CD10 的进一步增加,CXCR4 的显著存在以及 TLR3 的减少。同样,IFP-MSC 在 hPL 或 Ch-R 中扩增时,转录和分泌谱更加丰富和明显,表明这些制剂与炎症/纤维化预刺激条件之间存在协同作用。总的来说,与在 FBS 中扩增的 IFP-MSC 相比,hPL 和 Ch-R 扩增的 IFP-MSC 的吲哚胺 2,3-双加氧酶活性和前列腺素 E2 分泌增加,在体外对 T 细胞增殖的抑制能力更强,即使在预刺激后也是如此。
与使用 FBS 补充培养基的处理相比,使用 hPL 或 Ch-R 处理 IFP-MSC 同样增强了它们的免疫调节特性,在暴露于炎症/纤维化预刺激环境后,这些特性进一步增强。这一证据支持在基于 IFP-MSC 的细胞产品制造过程中采用符合监管要求的实践,并预期一旦细胞在关节内给药后面临病理环境,就会有进一步增强的反应。从机制上讲,这种功能增强的细胞产品具有作为一种新型微创细胞疗法的潜力,通过调节局部免疫和炎症事件,用于关节疾病。