Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 5 uppsatser.

A engenharia de tecido ósseo associando células-tronco mesenquimais (CTMs) a biomateriais tem sido proposta como tratamento potencial para o reparo de defeitos ósseos, constituindo uma abordagem nova na área da medicina regenerativa e de amplo interesse para as áreas de cirurgia buco-maxilo-facial e ortopedia. A seleção das CTMs mais adequadas e o método utilizado para carreá-las nos sítios de defeitos ósseos são fatores importantes para o sucesso do tratamento. Como a osteoporose reduz a capacidade de regeneração dos ossos, seria de grande importância que a engenharia do tecido ósseo pudesse ser aplicada com sucesso nessa patologia. Assim, foi avaliado o potencial das CTMs de medula óssea (CTMs-MO) e de tecido adiposo (CTMs-TA) associadas ao arcabouço de vitrocerâmica BioS-2P ou a membrana de P(VDF-TrFE)/BT no reparo de defeitos ósseos em ratas osteoporóticas. A osteoporose foi induzida por ovariectomia e comprovada pela análise microtomográfica dos fêmures. Nas ratas osteoporóticas foram criados defeitos ósseos nas calvárias que foram tratados com implantação de BioS-2P associado à CTMs-MO e CTMs-TA ou com a implantação de membrana de P(VDF-TrFE)/BT combinada com a injeção de CTMs-MO e CTMs-TA. Ao final de 4 semanas, as análises microtomográficas e histológica mostraram que não houve formação óssea nos defeitos sem qualquer tratamento, mas nos defeitos tratados com implantação de BioS-2P ou membrana de P(VDF-TrFE)/BT houve formação óssea independente da presença de CTMs. Apenas os defeitos tratados com membrana de P(VDF-TrFE)/BT e injeção de CTMs-MO apresentaram maior formação óssea, mas não ocorreu a regeneração. / Bone tissue engineering based on the combination of mesenchymal stem cells (MSCs) and biomaterials, has been proposed as a potential treatment for the repair of bone defects, constituting a new approach in the field of regenerative medicine and of interest to the areas of oral and maxillofacial surgery and orthopedics. To select the most suitable MSCs and an efficient method to carry them to the bone defects are the key for the successful treatment. Considering that osteoporosis represents a challenge situation, it would be of the utmost importance that bone tissue engineering could be used in this pathological condition. Thus, the aim of this study was to evaluate the potential of MSCs harvested from bone marrow (MSCs-BM) and from adipose tissue (MSCs-AT) associated to a vitreous scaffold (BioS-2P) or to a membrane of P(VDF-TrFE)/BT in regenerate bone defects created in osteoporotic rats. Osteoporosis was induced by ovariectomy and confirmed by microtomography of the femurs. Defects created in calvaria of osteoporotic rats were implanted with either Bios-2P seeded with MSCs-BM and MSCs-AT or a membrane of P(VDF-TrFE)/BT combined with injection of MSCs-BM and MSCs-AT. After 4 weeks, microtomography and histological analyses showed that there was no bone formation in untreated defects but in those treated with BioS-2P or membrane of P(VDF-TrFE)/BT there was bone formation irrespective of the presence of MSCs. Only defects treated with membrane of P(VDF-TrFE)/BT and MSCs-BM injection resulted in greater bone formation but there was not full bone regeneration.

A crescente demanda clínica para regeneração óssea tem dirigido esforços significativos para o desenvolvimento de novos biomateriais, incluindo aqueles aplicados em terapias baseadas em engenharia de tecidos. Neste contexto, os biovidros são considerados uma boa alternativa mas as suas propriedades mecânicas têm limitado a sua aplicação. Para melhorar tais propriedades sem afetar a biocompatibilidade, um novo material vitrocerâmico bioativo do sistema P2O5-Na2O-CaO-SiO2, chamado Biosilicato® com duas fases cristalinas (BioS-2P) foi desenvolvido. No entanto, os efeitos da adição das fases cristalinas sobre o comportamento biológico do BioS-2P ainda não foram estudados. Assim, os objetivos deste estudo foram investigar a capacidade do BioS-2P em induzir, in vitro, a diferenciação osteoblástica de células-tronco mesenquimais (CTMs); a capacidade do BioS-2P em aumentar, in vitro, a atividade dos osteoblastos em fase inicial de diferenciação (OBs) e osteoblastos da linhagem UMR-106 (UMRs); e a capacidade do BioS-2P em conduzir e induzir a neoformação óssea, in vivo, associado ou não a células. Células derivadas da medula óssea obtidas de fêmures de ratos foram cultivadas em meio de crescimento para obtenção de CTMs ou em meio osteogênico para obtenção de OBs. Essas células e UMRs foram cultivadas sobre discos de BioS-2P, Bioglass® 45S5 (45S5) e plástico de cultura (Controle) e utilizadas nas avaliações in vitro. Para as avaliações in vivo, defeitos de 5 mm criados em calotas de ratos foram implantados somente com arcabouços de BioS-2P ou com arcabouços de BioS-2P associados às CTMs ou aos OBs. Os dados foram comparados por teste não paramétrico de Kruskal-Wallis seguido pelo teste de Student Newman-Keuls, e o nível de significância adotado foi de 5%. As CTMs foram caracterizadas por apresentarem alta porcentagem de células expressando os marcadores de superfície CD29 e CD90 e baixa porcentagem expressando CD31, CD34, CD45 e CD106. A diferenciação osteoblástica das CTMs foi confirmada pela expressão dos genes marcadores da diferenciação osteoblástica fosfatase alcalina (ALP), runt-related transcriptor factor-2 (RUNX2), sialoproteína óssea (BSP) e osteocalcina (OC). CTMs cultivadas sobre discos de BioS-2P em meio não-osteogênico apresentaram diminuição da proliferação e aumento da atividade de ALP e da expressão dos genes marcadores da diferenciação osteoblástica ALP, RUNX2, osterix (OSX), proteína óssea morfogenética-4 (BMP-4), osteopontina (OPN) e OC, comprovando seu potencial osteoindutor similar ao 45S5. O BioS-2P foi capaz de aumentar a atividade de OBs e UMRs de maneira similar àqueles cultivados sobre o 45S5. OBs apresentaram diminuição na proliferação e aumento da atividade da ALP e da expressão dos genes marcadores da diferenciação osteoblástica RUNX2, OSX, BMP-4, OPN e OC. A análise em larga escala da expressão de mais de 23.000 genes mostrou que o BioS-2P induziu a sobre-expressão de genes envolvidos no aumento da atividade osteoblástica e a repressão de genes envolvidos na diminuição dessa atividade, em comparação com o Controle. Ao menos em parte, esse aumento da atividade osteoblástica foi atribuído à modulação das vias de sinalização proteíno-quinases ativadas por mitógenos (MAPK) e Wnt Canônica, e à modulação da expressão de microRNAs. UMRs crescidos sobre o BioS-2P corroboraram esses achados, pela capacidade em formar matriz mineralizada e por apresentarem aumento na expressão das proteínas ALP, RUNX2, dentin matrix protein-1 (DMP-1) e OPN. Arcabouços de BioS-2P (5 mm de diâmetro e 2 mm de altura com porosidade de 76 ± 5% e com tamanhos de poros variando entre 100 e 800 µm) implantados em defeitos na calota de ratos estimularam a formação de tecido ósseo, que ocorreu tanto na periferia como no interior dos defeitos e em íntimo contato com o material. A morfometria por microtomografia computadorizada não evidenciou qualquer diferença entre os parâmetros volume ósseo, volume ósseo/volume total, superfície óssea, superfície/volume ósseo, número de trabéculas, separação trabecular e espessura trabecular, avaliados na 4a, 8a e 12a semanas de implantação. As CTMs e os OBs foram carreados para os arcabouços de BioS- 2P (com eficiência de 90% e 81%, respectivamente) e essas células permaneceram nos defeitos por 14 dias. A combinação de arcabouços de BioS-2P com CTMs ou OBs, implantados por 8 semanas, resultou no mesmo padrão de formação óssea daquele observado para o arcabouço sem células. No entanto, essa combinação não resultou em aumento na quantidade de osso formado. Os resultados evidenciaram a capacidade do BioS-2P em induzir a diferenciação osteoblástica de CTMs e estimular a atividade osteoblástica de OBs, o que resultaria na neoformação óssea observada in vivo. No entanto, a combinação de BioS-2P com CTMs e OBs não foi capaz de aumentar a formação óssea e induzir o reparo dos defeitos ósseos. / The increasing clinical demand for bone regeneration has driven significant efforts to develop new biomaterials including those for tissue engineeringbased therapies. In this context, bioglasses emerges as a good alternative, but their use has been limited mainly due their poor mechanical properties. To improve these mechanical properties without affecting biocompatibility, a novel bioactive glass-ceramic of the P2O5-Na2O-CaO-SiO2 system, named Biosilicate® with two cristallyne phases (BioS-2P) was developed. However, the effects of these two phases on BioS- 2P biological behavior have not yet been evaluated. Thus, the aims of this study were to investigate the BioS-2P capability of inducing in vitro mesenquimal stem cell differentiation (MSC) towards osteoblasts; the BioS-2P capability to increase in vitro activity of osteoblasts derived from rat bone marrow at early stages of differentiation (OBs) and osteoblasts from rat cell line UMR- 106 (UMRs); and the BioS-2P capability to drive and induce bone formation in vivo, associated or not with cells. Bone marrow cells harvested from rat femurs were cultured either in growth media to obtain MSCs or in osteogenic media to obtain OBs. MSCs, OBs and UMRs were cultured on discs of BioS-2P, Bioglass® 45S5 (45S5) and tissue culture polystyrene (Control). For in vivo evaluations, 5-mm rat calvarial surgical defects were filled with BioS-2P with or without MSCs or OBs. Data were compared by non-parametric Kruskal-Wallis test followed by Student Newman- Keuls test and the significance level was set at 5%. MSCs were characterized by presenting high percentage of CD29 and CD90 surface markers and low percentage of CD31, CD34, CD45 and CD106 surface markers. Osteoblastic differentiation of MSCs was detected by gene expression of bone markers alkaline phosphatase (ALP), runt-related transcritption factor 2 (RUNX2), bone sialoprotein (BSP) and osteocalcin (OC). MSCs cultured on Bios-2P discs under non-osteogenic conditions exhibited a decrease on cell proliferation and an increase on ALP activity and gene expression of bone markers ALP, RUNX2, osterix (OSX), bone morphogenetic protein-4 (BMP-4), osteopontin (OPN) and OC, confirming its osteoinductive potential similar to 45S5. Also, BioS-2P increased the OBs and UMRs activity, similar to 45S5. OBs cultured on Bios-2P discs presented a decrease in cell proliferation and an increase on ALP activity and gene expression of bone markers RUNX2, OSX, BMP-4, OPN and OC. The large-scale analysis of over 23,000 genes showed that the BioS-2P induced overexpression of genes positively related to osteoblastic activity and repression of genes negatively related with its activity, compared with control. At least in part, the increase on OBs activity was associated to the modulation of two main signaling pathways, the mitogen activated protein kinases (MAPK) and the Canonical Wnt, and the modulation of microRNAs expression. These findings were corroborated by UMRs grown on BioS-2P, which produced mineralized matrix and exhibited increased expression of the ALP, RUNX2, dentin matrix protein-1 (DMP-1) and OPN proteins, than on control. BioS-2P scaffolds (5 mm diameter and 2 mm heigh, presenting 76 ± 5% of total porosity, with poros size ranging from 100 to 800 µm) implanted in calvarial defects promoted new bone formation in close contatc to BioS-2P, both on periphery and in the center of the defect. The computed microtomography morphometry showed no difference between the evaluated parameters bone volume, bone volume / total volume, bone surface, surface / bone volume, number of trabeculae, trabecular separation and trabecular thickness, measured at 4, 8 and 12 weeks. MSCs and OBs were seeded into the scaffold (with efficiency of incorporation 90% e 81%, respectively) and they remained on the defects for 14 days. After 8 weeks, the same pattern of bone formation was observed, however, the combination of BioS-2P with cells did not increase the amount of new bone. The results showed the BioS-2P ability to induce osteoblastic differentiation of MSCs and to stimulate osteoblastic activity, resulting in new bone formation in vivo. However, the combination of BioS-2P with MSCs and OBs was not able to increase bone formation and induce the repair of bone defects.

A desnutrição proteico-energética (DPE) altera a hemopoese e, portanto, a geração de células imunológicas, bem como compromete o sistema imune. Desta forma, indivíduos desnutridos apresentam maior susceptibilidade a infecções. As células tronco mesenquimais (CTMs) possuem propriedades imunomodulatórias e são importantes na formação do estroma medular que sustenta a hemopoese. Visto que a L-glutamina (GLUT) é o aminoácido condicionalmente essencial mais consumido por CTMs, e que também apresenta capacidade imunomoduladora, investigou-se, neste trabalho, se a GLUT exerceria efeito sobre aspectos imunomodulatórios das CTMs em um modelo experimental de DPE. Para tanto, utilizou-se camundongos da linhagem BALB/c, os quais receberam rações normoproteica ou hipoproteica isocalóricas contendo, respectivamente, 12% e 2% de proteína por um período de 5 semanas. Após o isolamento e a caracterização de CTMs provenientes dos grupos controle (CTMct) e desnutrido (CTMdesn), cultivou-se essas células em 0, 0,6, 2 e 10mM GLUT, a fim de determinar a influência deste aminoácido sobre a expressão de fatores de transcrição e produção de citocinas por CTMct e CTMdesn. Adicionalmente, avaliou-se o efeito dos sobrenadantes das culturas de CTMct e CTMdesn sobre a proliferação e produção de citocinas por macrófagos e linfócitos esplênicos. Os animais desnutridos apresentaram anemia, leucopenia, hipoplasia medular e diminuição na concentração de proteínas séricas, albumina e préa-lbumina. A DPE não modificou a morfologia e o fenótipo das CTMs, bem como não alterou a expressão de proteínas reguladoras do ciclo celular. Por outro lado, a expressão de NFkB e STAT-3 e a produção de IL-1β, IL-6, IL-10 e TGF-β por CTMs foram alteradas pela DPE e variaram de acordo com as concentrações de GLUT testadas. O aumento na concentração de GLUT diminuiu a expressão de NFkB e induziu a expressão de STAT-3 por CTMs obtidas de ambos os grupos. Quanto a produção de citocinas por essas células, observou-se uma diminuição nos níveis de IL-β e IL-6 e uma elevação nos níveis de IL-10 e TGF-β com o aumento na concentração de GLUT. Variações na concentração desse aminoácido não alteraram a produção de IL-17 ou IFN-γ por CTMct e CTMdesn. Ademais, a concentração de GLUT alterou, de forma diretamente proporcional, a taxa de proliferação das CTMs. Os meios condicionados de CTMct e CTMdesn diminuíram a proliferação de macrófagos e linfócitos esplênicos estimulados com LPS, induziram aumento na produção da citocina antiinflamatória IL-10 por ambos os tipos celulares e diminuíram a produção das citocinas pró-inflamatórias IL-12 e TNF-α por macrófagos e IL-17 por linfócitos. Portanto, conclui-se que a GLUT possui efeito sobre a proliferação das CTMs, bem como a capacidade de imunomodular estas células. / Protein-energy malnutrition (PEM) alters hemopoiesis and, therefore, the generation of immune cells, and compromises the immune system. In this way, malnourished individuals are more susceptible to infections. Mesenchymal stem cells (MSCs) have immunomodulatory properties and are important in the formation of bone marrow stroma that supports hemopoiesis. Since L-glutamine (GLUT) is a conditionally essential amino acid, which is most consumed by MSCs, and present immunomodulatory capacity, this work investigated whether GLUT would have an effect on immunomodulatory aspects of MSCs in a PEM experimental model. For this purpose, BALB/c mice were used, which received isocaloric normoproteic or hypoproteic diets, containing respectively, 12% and 2% of protein for a period of 5 weeks. After isolation and characterization of MSCs from control (MSCct) and malnourished (MSCmaln) groups, these cells were cultured with 0, 0.6, 2 and GLUT 10mM in order to determine the influence of this amino acid on the expression of transcription factors and cytokine production by MSCct and MSCmaln. Besides that, the effect of MSCct and MSCmaln culture supernatants on proliferation and cytokine production by macrophages and splenic lymphocytes was evaluated. Malnourished animals presented anemia, leucopenia, marrow hypoplasia and decreased concentration of serum proteins, albumin and prealbumin. PEM did not change morphology and phenotype of MSCs or altered the expression of cell cycle regulatory proteins. On the other hand, the expression of NFkB and STAT-3 and the production of IL-1β, IL-6, IL-10 and TGF-β by MSCs were modified by PEM and varied according to the tested GLUT concentrations. An increase in GLUT concentration decreased NFkB expression and induced STAT-3 expression by MSCs obtained from both groups. Regarding the production of cytokines by these cells, an increase in GLUT concentration resulted in decreased IL-1β and IL-6 levels and increased IL- 10 and TGF-β levels. Changes in the concentration of this aminoacid did not alter IL- 17 or IFN-γ production by MSCct and MSCmaln. Furthermore, the concentration of GLUT changed, in direct proportion, the proliferation of MSCs. The conditioned media MSCct and MSCmaln decreased the proliferation of macrophages and splenic lymphocytes stimulated with LPS, induced an increase in the production of the antiinflammatory cytokine IL-10 by both cell types, and decreased the production of proinflammatory cytokines IL-12 and TNF-α by macrophages and IL-17 by lymphocytes. Therefore, it can be concluded that GLUT has an effect on the proliferation of MSCs and it has the capacity to immunomodulate these cells.

There are approximately 600,000 cases of delayed or aberrant fracture healing in people each year, with a small subset of these fractures experiencing disunion. Dietary phosphate deficiency has been shown to impair oxidative phosphorylation and decrease BMP-2 mediated chondrogenic differentiation during fracture healing. Prior studies using pre-committed chondro-progenitor ATDC5 cell line grown in phosphate deficient media showed that energy consumption was linked to protein production and collagen hydroxylation but inversely related to matrix mineralization. The goal of this study was to further define the relationship between energy consumption and BMP-2 mediated stem cell chondrogenic differentiation and further examine how dietary phosphate, and promotion of collagen hydroxylation via ascorbate availability effected these processes. C3H10T1/2 murine cells, a multi-potential cell line, were expanded in pre-differentiation growth medium (DMEM with 10% FBS and 1% Pen/Strep). Once cells reached 60% confluence (day 0), they were grown in differentiating media (α-MEM with 5% FBS and 1X insulin-transferrin-selenium) containing either 100% (1mM) or 25% (0.25mM) inorganic phosphate (Pi), ± 200ng/mL BMP-2(BMP), and ±0.2 mM L-ascorbic acid (AA). In total, there were 8 groups with varying combinations of these three substances. Intracellular lipid, total DNA, protein, and hydroxyproline (HP) content were examined. Chondrocyte gene expression (Col2a1, Acan, ColXa1) and adipocyte gene expression (Pparg, Plin1, Ucp1) were measured to check for cell lineage commitment and specific differentiation of the C3H10T1/2. All measurements were acquired at day 8. The +BMP differentiation media groups contained significantly less DNA content and more protein content than the –BMP differentiation media groups (both p<0.0001). There was also a significant interaction between phosphate and ascorbic acid treatment (p=0.0296), with 25% Pi +AA groups producing significantly more protein than 100% Pi +AA groups. Hydroxyproline production was not different in 100% Pi or 25% Pi conditions (p=0.2951). AA presence in culture media led to greater HP production than culture media lacking AA (p=0.0035) There was a trend of an interaction between phosphate content and AA availability (p=0.0744). 100% Pi ±AA groups produced significantly different amounts of HP while 25% Pi ±AA groups did not produce significantly different amount of HP. Col2a1, Acan, and ColXa1 expression were all increased in +BMP groups. Ascorbic acid treatment groups expressed significantly more Col2a1and Acan than –AA groups. 100% Pi media led to greater Acan expression over 25% Pi groups (p=0.0009), whereas 25% Pi media trended to lead to greater ColXa1 expression over 100% Pi groups (p=0.0734). Pparg and Plin1 expression were increased in the 25% Pi condition. There were no significant differences in expression of Ucp1. C3H10T1/2 cells were significantly affected by phosphate concentration, BMP-2 treatment, and ascorbic acid supplementation. Phosphate deficiency hindered maturation of early chondrocytes into proliferating chondrocytes while also promoting MSC differentiation into the adipocyte cell lineage. Hypertrophic chondrocyte expression was decreased in phosphate deficient media, which may coincide with increased protein production observed in low phosphate conditions. BMP-2 promoted chondrogenesis which resulted in increased protein production. Whereas, lack of ascorbic acid in cell culture media led to decreased hydroxyproline production.

Mesenchymale Stammzellen bieten eine interessante Option in der regenerativen Medizin, da sie praktisch unlimitiert verfügbar sind. Um das Verhalten von humanen MSC zu studieren, werden Untersuchungen momentan an immundefizienten Mäusen durchgeführt, deren Verwendung kostenintensiv und aufwendig ist. Fra-gestellung war, ob durch Immunisolation (Alginat, Dialyseschlauch, Diffusionskammer) die Knorpel erhaltenden -, bzw. bildenden Eigenschaften von MSC-Konstrukten ebenso gut in immunkompetenten Mäusen untersucht werden können. Gleichzeitig sollte geprüft werden, ob die mit einer Immunabschirmung einhergehende Reduktion der Zellversorgung und damit die Annäherung an die Gelenksituation ihre Mineralisierung vermindern kann und ob Mauszellen für eine Veränderung der vordifferenzierten Knorpelpellets verantwortlich sind. Hierzu wurden hBMSC chondrogen differenziert. Die Zellpellets wurden mit Alginat, dem Dialyseschlauch oder der Diffusionskammer verkapselt und parallel zu unver-kapselten Kontrollpellets subkutan in immundefiziente SCID-Mäuse sowie in immunkompetente BDF1-Mäuse implantiert. Die Explantate wurden mit Alzianblau-, Alizarinrot-, Kollagen Typ II-Färbungen, sowie einer ALU in-situ Hybridisierung mar-kiert und mittels Histologiescore doppelt blind bewertet (MannWhitneyU). Überra-schenderweise zeigten die unverkapselten Kontrollen in den BDF1-Mäusen weder Zeichen von Inflammation noch von Destruktion und 4/5 der Pellets waren auf Kol-lagen Typ-II und Alzianblau positiv. Gleichzeitig war der Grad der Mineralisierung in den BDF1-Mäusen gegenüber SCID-Mäusen reduziert (p = 0,03). Durch Alginat wurde die Mineralisierung in den BDF1 Mäusen (0/8) völlig verhindert, während in den SCID-Mäusen noch 7/8 der Pellets Kalzifizierung zeigten (p = 0,001). Die Verkapselung mit Alginat verglichen mit der Kontrolle führte in beiden Mausstämmen zu höheren Scores für Kollagen Typ II (SCID: p = 0,013, BDF1: p = 0,042) und zeigte gleichzeitig eine Reduktion der Mineralisierung (SCID: p = 0,018, BDF1: p = 0,031). In SCID-Mäusen war außerdem der Alzianblau-Wert gegenüber den Kontrollen erhöht (p = 0,003). Die Diffusionskammer erwies sich als ungeeignet, da die Pellets ihre knorpeligen Eigenschaften verloren. Durch die Verwendung des Dialyseschlauches konnte lediglich in der SCID-Maus eine Erhöhung der Kollagen Typ II (p = 0,03) und eine Reduktion der Kalzifizierung (p = 0,004) erreicht werden. Sowohl im Alginatbead in der BDF1-Maus (1/3 Spendern), als auch im Dialyseschlauch mit Kollagenmembran (2/3 Spendern) konnte eine erfolgreiche in vivo Chondrogenese durchgeführt werden. Zur Untersuchung der in vivo Stabilität knorpeliger MSC-basierter Konstrukte stellt die BDF1-Maus eine attraktive, kostengünstige Alternative mit einer gegenüber der SCID-Maus verringerten Mineralisierungsrate dar. Die in vitro gebildete knorpelige Extrazellulärmatrix erzeugt dabei bereits eine Immunisolation, welche die Transplantatdestruktion verhindert. Ob ein intaktes lymphozytäres System die Knorpelstabilität gegenüber defizienten Immunsystemen begünstigt, muss durch die Untersuchung weiterer Ansätze belegt werden. Im Gegensatz zur Diffusionskammer bietet Alginat das richtige Maß an Versorgungsreduktion, um die Stabilisierung des Knorpelphänotyps der Konstrukte zu ermöglichen.

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

No description available.

No description available.

<p>Hemophilia B patients may have frequent, spontaneous and life-threatening bleeds that are currently managed by an invasive and expensive treatment. Mesenchymal stem cells (MSCs) are increasingly being applied to clinically therapeutic strategies and lentiviral gene vectors have been shown to be safe and efficient tools for modifying stem cells for long-term expression of high levels of transgenes. In this study, MSCs were engineered with a lentivirus to express sustained and therapeutic levels of human FIX protein <em>in vitro </em>and in mice. The modified MSCs secreted human FIX protein at levels exceeding 4 μg/10⁶ MSCs/24 h with high FIX coagulant activity of greater than 2.5 mIU/10⁶ MSCs/24 h for 6 week <em>in vitro. </em>Functional FIX transgene was continually expressed by these cells when they were induced to differentiate into adipocyte, osteoblast and chondrocyte lineages <em>in vitro</em>. However, the modified MSCs transplanted via tail vein into NOD-SCID-γ mice expressed low levels of FIX <em>in vivo</em>. The transplantation procedure had an increased risk of death that was more pronounced in mice that received cell doses exceeding 2 million cells. Organ examinations suggested the deaths resulted from entrapment of MSCs in pulmonary capillaries. Modified MSCs encapsulated in alginate-PLL microcapsules and transplanted into the peritoneal cavity of both NOD-SCID-γ and hemophilia B mice at 9 million cells/mouse resulted in therapeutic expression around 100 ng of human FIX/mL of plasma only for a few days <em>in vivo</em> as human FIX expression quickly decreased to basal values by the end of the first week. Cultured <em>ex vivo</em>, human FIX expression by retrieved capsules indicated an innate immune response to the encapsulated cells prevented sustained expression of FIX. These investigations demonstrate that lentivirally modified MSCs have the potential to express therapeutic human FIX for sustained periods <em>in vitro</em>, even after their differentiation. However, they also highlight the challenges to overcome to optimize cell engraftment and survival following transplantation, and to minimize the immune responses associated with the xenogeneic translational<em> </em>models used.</p> / Doctor of Philosophy (PhD)