A terapia celular representa uma abordagem promissora para o tratamento de cardiopatia isquêmica, porém aspectos-chave dessa estratégia permanecem incertos. Neste trabalho avaliamos a eficiência da retenção cardíaca de células da medula óssea marcadas com tecnécio (99m Tc-CMO) transplantadas, de acordo com o tempo após o infarto (1, 2, 3 e 7 dias) e a via de administração dessas células (intravenosa [IV], intraventricular [IC], intracoronariana [ICO] e intramiocárdica [IM]), em ratos submetidos à isquemia-reperfusão cardíaca [I&R]. Após 24 horas, a retenção cardíaca de 99m Tc-CMO foi maior na via IM comparada com a média alcançada pelas demais (6,79% do total injetado vs. 0,53%). O uso de fibrina como veículo para a injeção de células incrementou a retenção em 2.5 vezes (17,12 vs. 6,84%) na via IM. Curiosamente, quando administradas após 7 dias, a retenção de células na via IM alcançou valores próximos dos observados com da matriz de fibrina injetadas 24 h após a I&R (16,55 vs. 17,12%), enquanto que para as demais vias as mudanças foram insignificantes. Nos animais em que as CMO foram administradas por via intramiocárdica 24 horas após a I&R, com ou sem fibrina, observou-se melhora significante do desempenho cardíaco frente ao estresse farmacológico com fenilefrina quando comparados aos controles. Em conjunto, os dados mostram a biodistribuição das células injetadas após a I&R por 4 diferentes vias e 4 intervalos de tempo pós-lesão e indicam que a via IM é a que produz maior retenção cardíaca. O uso do biopolímero de fibrina aumenta a retenção das células e a eficácia deste efeito sobre a função cardíaca e mortalidade dos animais em longo prazo, além de 30 dias pós I&R, merecerá ser investigada no futuro. / Cell therapy represents a promising approach for ischemic cardiac disease, but key aspects of this strategy remain unclear. We examined the effects of timing and route of administration of bone marrow cells (BMCs) after myocardial ischemia/reperfusion injury (I&R). 99mTc-labeled BMCs were injected by 4 different routes: intravenous (IV), left ventricular cavity (LV), left ventricular cavity with temporal aorta occlusion (LV+) and intramyocardial (IM). The injections were performed 1, 2, 3, or 7 days after infarction. Cardiac retention was higher following the IM route compared to the average values obtained by all other routes (6.79% of the total radioactivity injected vs. 0.53%). Use of a fibrin biopolymer as vehicle during IM injection led to a 2.5-fold increase in cardiac cell accumulation (17.12 vs. 6.84%). Interestingly, the retention of cells administered with culture medium at day 7 post-MI by the IM route was similar to that observed when cells were injected 24 h post-IM using fibrin (16.55 vs 17.12%), whereas no significant changes were observed for the other routes. Cell therapy 24 hs post MI by IM injection, with or without fibrin, resulted in comparable improvement in cardiac function under pharmacological stress compared to control animals. Together, we provide evidence for the biodistribution of 99mTc-labeled BMCs injected post MI by 4 different routes and times post-injury, which shows that the IM rout is the most effective for cardiac cell retention. The use of a fibrin biopolymer further increased cardiac cell retention and its potential long term benefits, beyond 30, on reducing mortality and improving cardiac function deserve to be explored in the future.

La transplantation d’hépatocytes dans le foie est un procédé séduisant pour corriger la fonction hépatique et permettre peut-être d’éviter la transplantation d’organe. Actuellement, la greffe de cellules hépatiques a été envisagée pour corriger le déficit métabolique des patients ayant une maladie hépatique métabolique héréditaire, dont le foie est par ailleurs normal. Les résultats des essais cliniques d’allotransplantation ou d’autotransplantation d'hépatocytes génétiquement modifiés montrent une prise de greffe insuffisante et, dans la plupart des études, un effet thérapeutique transitoire. Ces résultats ont incité à développer des modèles animaux précliniques pour tester des procédés facilitant la prise de greffe. L’intégration des hépatocytes dans les travées hépatocytaires et leur prolifération permet de préparer le foie à greffer par stimulation de la régénération hépatique. Ces deux procédés sont aujourd'hui utilisés en routine dans ces modéles expérimentaux: l’hépatectomie partielle ou l’embolisation portale. Néanmoins, ces deux techniques de stimulation de la régénération hépatique sont difficilement applicables à la pratique clinique car la résection chirurgicale du foie comporte des risques majeurs et l’embolisation portale "classique", c’est-à-dire l’obstruction des grosses veines sectorielles du foie, est responsable d'une embolisation anatomique avec une atrophie ou une destruction partielle de la partie du foie embolisé. Par ces procédés, certes la régénération est stimulée à hauteur de 20% mais seulement sur une partie du volume hépatique (environ 50%) avec diminution du volume accessible à la greffe sans compter les risques liés à l'atrophie ou à la resection chirurgicale du reste du foie.Nous avons donc proposé une nouvelle approche de stimulation de la régénération hépatique chez la souris. Nous avons utilisé une embolisation portale volumétrique à l’aide de microbilles allant très loin dans tout le foie. Il s’agit donc de l’embolisation d'un pourcentage du volume global hépatique sans altération anatomique (lobe) du foie. Ainsi, les traumatismes nécessaires à la préparation du foie pour augmenter la prolifération seront mieux répartis dans la totalité du foie et devraient avoir moins de conséquences sur la fonction hépatique, contrairement à l’embolisation partielle dite anatomique. Un autre effet serait la préservation de l’accessibilité à tout le volume du foie des cellules à greffer et non plus à la partie non embolisée du foie ce qui devrait d’augmenter le nombre de cellules injectées donc transplantées par une même préparation.Nous devons encore évaluer les repercutions hépatiques à long terme (>J21) des conditions d'embolisation volumétrique à plus fort taux de régénération mais qui implique des lésions de nécrose hépatique. Avant de passer sur des modéles cliniques, une évaluation de l’embolisation volumétrique sur un animal plus gros (rat ou maquaque) avec déficit métabolique est nécéssaire. Par ailleurs, cette nouvelle préparation du foie doit être optimisée pour une application clinique à moyen terme avec des injections séquentielles de microsphères et l’utilisation de microsphères résorbables, ce qui permettrait d’obstruer plus de sinusoïdes sans accumulation du matériel dans les branches portales, et ainsi augmenter le signal de régénération.Si ces résultats se confirment, notamment chez l’animal, ce nouveau procédé permettrait d’améliorer la prise de greffe de façon significative dans l’ensemble du parenchyme hépatique et de pouvoir transplanter un plus grand nombre de cellules. L’intérêt de cette technique peu invasive la rend d’autant plus applicable chez l’homme car l’architecture du foie est préservée. De réels progrès dans la thérapie cellulaire hépatique devront permettre dans le futur de mieux traiter les patients atteints de maladies métaboliques héréditaires. / Hepatocyte transplantation has been proposed as an alternative to orthotopic liver transplantation to treat metabolic liver diseases. This approach requires preconditioning of the host liver to enhance engraftment of transplanted hepatocytes. Different methods are currently used in preclinical models: partial hepatectomy, portal ligature or embolization, and radiotherapy or chemotherapeutic drugs. However, these methods carry high risks of complications and are problematic for use in clinical practice. Here, we developed an innovative method called volumetric (distal, partial and random) portal embolization (EPV), which preserves total liver volume.METHODS: Embolization was performed in the portal trunk of C57BL6 adult mice with polyester microspheres, to ensure a bilateral and distal distribution. The repartition of microspheres was studied by angiographic and histological analysis. Liver regeneration was evaluated by Ki67 labeling. Optimal conditions for EPV were determined and the resulting regeneration was compared with that following partial hepatectomy (70%). Labeled adult hepatocytes were then transplanted and engraftment was compared between embolized (n=19) and non embolized mice (n=8). Engraftment was assessed in vivo and histologically by tracking labeled cells at day 5. RESULTS: The best volumetric embolization conditions, which resulted in the regeneration of 5% of total liver, were 8x106 10µm microspheres infused with a 29 G needle directly into the portal trunk at 3.3ml/s. In these conditions, transplanted hepatocytes engraftment was significantly higher than in control conditions (3 vs 0.65%). CONCLUSIONS: EPV is a new, minimally invasive and efficient technique to prepare the host liver for cell transplantation.

La dystrophie Facio-Scapulo-Humérale est caractérisée par une faiblesse musculaire progressive et asymétrique. Elle affecte principalement les muscles faciaux, scapulaires et huméraux. L’association de plusieurs évènements épigénétiques à trois facteurs génétiques de la région subtélomérique du chromosome 4 résulte en un changement dans l’organisation chromatinienne la rendant permissive à l’expression aberrante des gènes de la région 4q35. Les myoblastes DFSH présentent des défauts de différenciation in vitro et des dérégulations dans des voies majeures comme celle de la réponse cellulaire au stress oxydant et de la différenciation myogénique. L’enjeu génétique et épigénétique complexe dans la DFSH et les limitations de la thérapie cellulaire dans son contexte laissent la DFSH jusque-là incurable. Toutefois les avancées dans les thérapies cellulaires et génétiques des myopathies ouvrent des horizons pour de futures applications dans le cadre de la DFSH.Le travail de thèse s’articule autour de trois thématiques. Premièrement, nous démontrons la faisabilité de la correction phénotypique et fonctionnelle des myotubes DFSH in vitro par la fusion de 50% de myoblastes normaux avec des myoblastes DFSH. Ensuite, nous évaluons deux approches d’édition génomique. Dans la première approche, nous ciblons le site de rattachement du chromosome 4 à la matrice nucléaire, FR-MAR avec la protéine CTCF à l’aide du système CRISPR/dCas9 en vue du rétablissement de l’organisation chromatinienne et de la fonction isolatrice de FR-MAR. Dans la deuxième, nous échangeons par translocation les régions homologues 4q35 et 10q26 dans le but de corriger les myoblastes DFSH comme les trois facteurs génétiques du locus 4q35 ne sont pathogéniques que sur un fond génétique lié au chromosome 4. Finalement, nous étudions le rôle du stress oxydant dans la DFSH. / Facio-Scapulo-Humeral dystrophy is characterized by progressive and asymmetrical muscle weakness. It mainly affects the facial, scapular and humeral muscles. The association of several epigenetic events with three genetic factors of the subtelomeric region of chromosome 4 results in a chromatin organization modification making it permissive to the aberrant expression of genes in the 4q35 region. FSHD myoblasts exhibit differentiation defects in vitro and dysregulations in major pathways such as the cellular response to oxidative stress and myogenic differentiation. The limitations of cell therapy and the complex genetic and epigenetic interplay in FSHD leave it, till now, incurable. However advances in cellular and genetic therapies of myopathies open up new horizons for future applications in the FSHD context. The thesis work is structured around three themes. First, we demonstrate the feasibility of phenotypic and functional correction of FSHD myotubes in vitro by fusing 50% of normal myoblasts with FSHD myoblasts. Next, we evaluate two genomic editing approaches. In the first one, we target the site of attachment of chromosome 4 to the nuclear matrix, FR-MAR with the CTCF protein using the CRISPR / dCas9 system for the purpose of restoring the chromatin organization and the insulating function of FR-MAR. In the second one, we exchange the homologous regions 4q35 and 10q26 by translocation in order to correct the FSHD myoblasts as the three genetic factors of the 4q35 locus are pathogenic only on a genetic background linked to chromosome 4. Finally, we study the role of the oxidative stress in the FSHD.

Eine Vielzahl präklinischer Schlaganfallstudien zeigte die neuroprotektive und neuroregenerative Wirkung des hämatopoetischen Wachstumsfaktors G-CSF (Granulozyten-Kolonie stimulierender Faktor). Ein Wirkungsmechanismus des G-CSF ist die Mobilisation von protektiven Knochen-markzellen in die ischämische Läsion, wobei diese zeitverzögert nach G-CSF-Gabe stattfindet. Eine zusätzliche frühzeitige Transplantation mononukleärer Knochenmarkzellen (BM MNC) könnte diese therapeutische Lücke füllen. Ziel der vorliegenden Studie war es, die Wirksamkeit dieser Kombinations-therapie in einem Schlaganfallmodell der spontan hypertensiven Ratte (SHR) zu testen. Syngene BM MNC wurden aus dem Knochenmark von SHRs durch immunmagnetische Depletion der Granulozyten isoliert. Nach Verschluss der Arteria cerebri media wurde den Tieren über insgesamt 5 Tage G-CSF verabreicht und zusätzlich zu einem frühen (6h nach Schlaganfall) oder späteren (48h nach Schlaganfall) Zeitpunkt BM MNC intravenös appliziert. Unbehandelte Schlaganfalltiere sowie Tiere mit alleiniger G-CSF-Therapie dienten als Kontrolle. Das Infarktvolumen wurde weder durch die alleinige G-CSF-Gabe noch durch die zusätzliche Zelltherapie verändert. Dennoch wiesen Tiere mit G-CSF-Einzeltherapie eine anhaltende funktionelle Verbesserung des sensomotorischen Defizites auf. Während die zusätzliche frühzeitige Zelltransplantation (6h) keinen weiteren Therapieeffekt zeigte, führte die Zelltransplantation nach 48h zu einer Aufhebung des protektiven G-CSF Effektes. Die G-CSF-Therapie bewirkte erwartungsgemäß einen deutlichen Anstieg der zirkulierenden Leukozyten. Interessanterweise wurde der Granulozytengehalt im Blut und in der Milz durch die einmalige Zelltherapie nach 48h signifikant erhöht. Ein Großteil der transplantierten BM MNC (48h) konnte in der Milz nachgewiesen werden und führte dort vermutlich zu einer kompetitiven Hemmung des Granulozytenabbaus. Dies hatte sowohl den Anstieg der zirkulierenden Granulozyten als auch deren vermehrte Infiltration in das ischämische Hirngewebe zur Folge und könnte schließlich den negativen Einfluss auf die funktionelle Verbesserung erklären. Die beobachteten Interaktionsmechanismen werfen ein interessantes Licht auf die mögliche Wirkungsweise von Zelltherapien und unterstreichen die entscheidende Rolle des Immunsystems in der Pathophysiologie des Schlaganfalls.

Stem cell therapy may present an effective treatment for metastatic brain cancer and glioblastoma. Here we posit the critical role of a leaky blood-brain barrier (BBB) as a key element for the development of brain metastases, specifically melanoma. By reviewing the immunological and inflammatory responses associated with BBB damage secondary to tumoral activity, we identify the involvement of this pathological process in the growth and formation of metastatic brain cancers. Likewise, we evaluate the hypothesis of regenerating impaired endothelial cells of the BBB and alleviating the damaged neurovascular unit to attenuate brain metastasis, using the endothelial progenitor cell (EPC) phenotype of bone marrow-derived mesenchymal stem cells. Specifically, there is a need to evaluate the efficacy for stem cell therapy to repair disruptions in the BBB and reduce inflammation in the brain, thereby causing attenuation of metastatic brain cancers. To establish the viability of stem cell therapy for the prevention and treatment of metastatic brain tumors, it is crucial to demonstrate BBB repair through augmentation of vasculogenesis and angiogenesis. BBB disruption is strongly linked to metastatic melanoma, worsens neuroinflammation during metastasis, and negatively influences the prognosis of metastatic brain cancer. Using stem cell therapy to interrupt inflammation secondary to this leaky BBB represents a paradigm-shifting approach for brain cancer treatment. In this review article, we critically assess the advantages and disadvantages of using stem cell therapy for brain metastases and glioblastoma. / National Institutes of Health / Revisión por pares

Stem cell transplantation with rehabilitation therapy presents an effective stroke treatment. Here, we discuss current breakthroughs in stem cell research along with rehabilitation strategies that may have a synergistic outcome when combined together after stroke. Indeed, stem cell transplantation offers a promising new approach and may add to current rehabilitation therapies. By reviewing the pathophysiology of stroke and the mechanisms by which stem cells and rehabilitation attenuate this inflammatory process, we hypothesize that a combined therapy will provide better functional outcomes for patients. Using current preclinical data, we explore the prominent types of stem cells, the existing theories for stem cell repair, rehabilitation treatments inside the brain, rehabilitation modalities outside the brain, and evidence pertaining to the benefits of combined therapy. In this review article, we assess the advantages and disadvantages of using stem cell transplantation with rehabilitation to mitigate the devastating effects of stroke. / Revisión por pares

No description available.

<p> Cell therapy for Parkinson's disease will greatly benefit from progress in methods aimed at visualizing the dopamine system and cell replacement techniques. Currently, cell therapy has been met with varied success, in part due to differences in cell sources, transplantation procedures, and our lack of understanding of cell fate post-transplantation. The standardization of transplantation procedures will enhance our ability to draw comparisons between studies and improve cell therapy outcomes. We developed a method to label neural stem/progenitor cells (NSPCs) with technetium-99m and then visualize the cells with single photon emission computed tomography (SPECT) subsequent to grafting in the brain. This labeling method permitted a high uptake of the tracer into the cells without causing damage to the DNA or altering cell viability. The labeling caused a significant decrease (75%) in the proliferative capacity of the SPCs and caused a trend towards an increase in neuronal differentiation. Using this technique paves the way to standardize the location of the transplant and quantify the number transplanted cells while increasing the production of neurons.</p> <p> Experiments were performed to visualize the dopamine system with [(123)I]altropane at pre-and post-transplant time points in the 6-0HDA rat model of Parkinson's disease. [(123)I]altropane binding correlated with the content of dopamine in the stria tum. However, [(123)I]altropane binding was not correlated with dopamine content in the substantia nigra and did not show a correlation with the amphetamine rotations. However, there was a significant correlation with the cylinder test and the postural instability test. When the data was assessed using linear regression, the r^2 value of the linear relationship was low indicating that [(123)I]altropane SPECT is not a good predictor of behavioural outcome due to a weak linear relationship. Our data indicates that [(123)I]altropane predicts the integrity of the striatal dopamine nerve terminals, but does not predict the integrity of the nigrostriatal system. The results are discussed in relation to the use of [(123)I]altropane in comparison to other dopamine SPECT and PET agents. </p> / Thesis / Doctor of Philosophy (PhD)

A major obstacle in the implementation of adoptive cell therapy (ACT) for solid tumors is CD8+ T cell quantity and functional quality. In order to address this issue, the ACT field has directed considerable effort toward the generation of less-differentiated memory T cells (Tm), which demonstrate superior effector function and engraftment over effector T cells. An obstacle in using Tm for ACT is their requirement for in vivo activation before full effector function can be acquired. We sought to determine if a rhabdovirus expressing a defined tumor antigen (i.e. a rhabdoviral oncolytic vaccine) could activate adoptively-transferred Tm in vivo and eliminate established tumors. We used ex vivo cultured DUC18 TCR-transgenic Tm combined with a rhabdoviral oncolytic vaccine to target established CMS5 fibrosarcomas in both balb/c and NRG mice, and we compared the efficacy of the combination treatment versus monotherapies. Our data demonstrate that the rhabdoviral oncolytic vaccine was capable of expanding adoptively-transferred Tm in order to eliminate established tumors. Furthermore, synergy between ACT and oncolytic vaccination was required for optimal therapeutic outcome. Interestingly, we observed a population of endogenous, tumor-primed lymphocytes which appeared to be required for complete tumor elimination and subsequent memory formation. This was in contrast to the current consensus in the ACT field which is that endogenous lymphocytes are detrimental to therapeutic outcome, thus necessitating lymphodepletion prior to the commencement of therapy. Our data suggest that endogenous lymphocytes may be a beneficial cell population which is overlooked by current approaches to ACT. / Thesis / Master of Science (MSc) / Current approaches to the T cell therapy of cancer are hindered by poor cell quality. It is simple to grow higher quality T cells, but it is difficult to grow very large numbers of them. Furthermore, higher quality T cells need a signal in order to “switch on” before they can start killing cancer cells. Here, we use a cancer-targeting virus as a signal for these cells to activate, grow to very large numbers in the patient, and destroy their tumor. Our vaccine also switches on other immune cells in the patient, which help guarantee the destruction of the tumor. The significance of this work is that it will improve T cell therapy for cancer by opening the possibility of using higher-quality T cells which are much better at killing cancer than the currently used type of T cells.

Background: Regenerative therapies based on autologous mesenchymal stem cells (MSC) as well as stem cells in general are still facing an unmet need for non-invasive sampling, availability, and scalability. The only known adult source of autologous MSCs permanently available with no pain, discomfort, or infection risk is the outer root sheath of the hair follicle (ORS). Methods: This study presents a non-invasively-based method for isolating and expanding MSCs from the ORS (MSCORS) by means of cell migration and expansion in air–liquid culture. Results: The method yielded 5 million cells of pure MSCORS cultured in 35 days, thereby superseding prior art methods of culturing MSCs from hair follicles. MSCORS features corresponded to the International Society for Cell Therapy characterization panel for MSCs: adherence to plastic, proliferation, colony forming, expression of MSC-markers, and adipo-, osteo-, and chondro-differentiation capacity. Additionally, MSCORS displayed facilitated random-oriented migration and high proliferation, pronounced marker expression, extended endothelial and smooth muscle differentiation capacity, as well as a paracrine immunomodulatory effect on monocytes. MSCORS matched or even exceeded control adipose-derived MSCs in most of the assessed qualities. Conclusions: MSCORS qualify for a variety of autologous regenerative treatments of chronic disorders and prophylactic cryopreservation for purposes of acute treatments in personalized medicine.