The heart does not regenerate new functional tissue when myocardium dies following coronary artery occlusion, or is defective. Ventricular restoration involves excising the infarct and replacing it with a cardiac patch to restore the heart to a more efficient condition. The goal of this study was to design and develop a myocardial patch to replace myocardial infarctions. A basic design was developed that is composed of 3D microfibrous mats that house mesenchymal stem cells (MSCs) from umbilical cord matrix (Wharton&rsquo / s Jelly) aligned parallel to each other, and biodegradable macroporous tubings to supply growth media into the structure. Poly(glycerol sebacate) (PGS) prepolimer was synthesized and blended with P(L-D,L)LA and/or PHBV, to produce aligned microfiber (dia 1.16 - 1.37 &amp / #956 / m) mats and macroporous tubings. Hydrophilicity and softness of the polymer blends were found to be improved as a result of PGS introduction. The Wharton&rsquo / s Jelly (WJ) MSCs were characterized by determination of their cell surface antigens with flow cytometry and by differentiating them into cells of mesodermal lineage (osteoblasts, adipocytes, chondrocytes). Cardiomyogenic differentiation potential of WJ MSCs in presence of differentiation factors was studied with RT-PCR and immunocytochemistry. WJ MSCs expressed cardiomyogenic transcription factors even in their undifferentiated state. Expression of a ventricular sarcomeric protein was observed upon differentiation. The electrospun, aligned microfibrous mats of PHBV-P(L-D,L)LA-PGS blends allowed penetration of WJ MSCs and improved cell proliferation. To obtain the 3D myocardial graft, the WJ MSCs were seeded on the mats, which were then wrapped around macroporous tubings. The 3D construct (4 mm x 3.5 cm x 2 mm) was incubated in a bioreactor and maintained the uniform distribution of aligned cells for 2 weeks. The positive effect of nutrient flow within the 3D structure was significant. This study represents an important step towards obtaining a thick, autologous myocardial patch, with structure similar to native tissue and capability to grow, for ventricular restoration.

Non-healing bone defects have a significant socioeconomic impact in the U.S. with approximately 600,000 bone grafting procedures performed annually. Autografts and allografts are clinically the most common treatments; however, autologous donor bone is in limited supply, and allografts often have poor mechanical properties. Therefore, tissue engineering and regenerative medicine strategies are being developed to address issues with clinical bone grafting. The overall objective of this work was to develop bone tissue engineering strategies that enhance healing of orthotopic defects by targeting specific osteogenic cell signaling pathways. The general approach included the investigation of two different tissue engineering strategies, which both focused on directed osteoblastic differentiation to promote bone formation. In the first cell-based strategy, we hypothesized that constitutive overexpression of the osteoblast-specific transcription factor, Runx2, in bone marrow stromal cells (BMSCs) would promote orthotopic bone formation in vivo. We tested this hypothesis by delivering Runx2-modified BMSCs on synthetic scaffolds to critically-sized defects in rats. We found that Runx2-modified BMSCs significantly increased orthotopic bone formation compared to empty defects, cell-free scaffolds and unmodified BMSCs. This gene therapy approach to bone regeneration provides a mineralizing cell source which has clinical relevance. In the second biomaterial-based strategy, we hypothesized that incorporation of the collagen-mimetic peptide, GFOGER, into synthetic bone scaffolds would promote orthotopic bone formation in vivo without the use of cells or growth factors. We tested this hypothesis by passively adsorbing GFOGER onto poly-caprolactone (PCL) scaffolds and implanting them into critically-sized orthotopic defects in rats. We found that GFOGER-coated scaffolds significantly increased bone formation compared to uncoated scaffolds in a dose dependent manner. Development of this cell-free strategy for bone tissue engineering provides an inexpensive therapeutic alternative to clinical bone defect healing, which could be implemented as a point of care application. Both strategies developed in this work take advantage of specific osteoblastic signaling pathways involved in bone healing. Further development of these tissue engineering strategies for bone regeneration will provide clinically-relevant treatment options for healing large bone defects in humans by employing well-controlled signals to promote bone formation and eliminating the need for donor bone.

Ligament/tendon tissue engineering has the potential to provide therapies that overcome the limitations of incomplete natural healing responses and inadequate graft materials. While ligament/tendon fibroblasts are an obvious choice of cell type for these applications, difficulties associated with finding a suitable cell source have limited their utility. Mesenchymal stem cells/marrow stromal cells (MSCs) are seen as a viable alternative since they can be harvested through routine medical procedures and can be differentiated toward a ligament/tendon fibroblast lineage. Further study is needed to create an optimal biomaterial/biomechanical environment for ligament/tendon fibroblastic differentiation of MSCs. The overall goal of this dissertation was to improve the understanding of the role that biomechanical stimulation and the biomaterial environment play, both independently and combined, on human MSC (hMSC) differentiation toward a ligament/tendon fibroblast phenotype. Specifically, the effects of cyclic tensile stimuli were studied in a biomaterial environment that provided controlled presentation of biological moieties. The influence of an enzymatically-degradable biomaterial environment on hMSC differentiation was investigated by creating biomaterials containing enzymatically-cleavable moieties. The role that preculture may play in tensile responses of hMSCs was also explored. Together, these studies provided insights into the contributions of the biomaterial and biomechanical environment to hMSC differentiation toward a ligament/tendon fibroblast phenotype.

Mesenchymal stem cells (MSCs) are bone marrow derived multipotent cells with the ability to self-renew and differentiate into multiple connective cell lineages. In vivo, MSCs travel from the bone-marrow to the inflammatory sites and actively participate in remodeling and regeneration process under the influence of soluble growth factors. Due to these inherent properties, MSCs have emerged as an ideal candidate for diverse regenerative therapeutic applications. The development of MSC-based therapies requires in vitro expansion of MSCs; however, MSC expansion results in phenotypical changes that have limited its efficacy upon reintroduction in vivo. In order to increase the efficacy of MSC-based therapeutics, it is critical for us to improve the current understanding of MSC interactions with its niche specific factors and explore new methods to enhance MSC function in vivo. We used tumor conditioned media, which contains soluble factors secreted by tumor cells in culture (TCM), and inflammatory niche-specific soluble factors, such as platelet derived growth factor (PDGF) and transforming growth factor-β1 (TGF-β1), to characterize the mechanical response of MSCs. The intracellular mechanical properties of MSCs were dramatically altered in response to soluble factors and MSCs displayed cytosolic stiffening in response to TCM and TGF-β1. Although PDGF treated cells did not elicit any mechanical response, blocking PDGF signaling with a small molecule inhibitor reversed the stiffening response in TGF-β1 treated cells, indicating crosstalk between these two pathways is essential in TGF-β1 mediated cell stiffening. Furthermore, a genome-wide microarray analysis revealed TGF-β1 dependent regulation of cytoskeletal actin-binding protein (ABP) genes. Actin crosslinking and bundling protein genes, which regulate cytosolic rheology through changes in semiflexible actin polymer meshworks, were upregulated with TGF-β1 treatment. Since TGF-β1 treatment profoundly altered the MSC phenotype after relatively short exposure times, we sought to understand if pretreated cells could sustain these enhanced characteristics leading to higher efficacy in vivo. We found that MSCs pretreated with TGF-β1 displayed enhanced adhesive properties while maintaining the expression profile of surface adhesion molecules even after removal of stimulus. Additionally, pretreated MSCs exposed to lineage specific induction media, demonstrated superior differentiation potential along multiple lineages. Based on the large number of sustained changes, TGF-β1 pretreated cells were used to treat full thickness skin wounds for in vivo wound healing model to determine their therapeutic efficacy. TGF-β1 pretreated MSCs increased wound closure rate and displayed enhanced migration of MSCs towards the center of the wound compared to the control cells. In conclusion, soluble factor pretreated MSCs with altered mechanical properties displayed significantly improved cell functions leading to highly efficient tissue regeneration in vivo. Mechanical priming of MSCs with niche specific factors prior to transplantation can become a viable strategy to maximize their therapeutic potential.

No description available.

Mesenchymal stromal cells (MSC) are bone marrow-derived, non-hematopoietic progenitors that are amenable to genetic engineering, making them attractive delivery vehicles for therapeutic proteins. However, limited transplanted cell survival compromises the efficacy of MSC-based gene therapy. We hypothesized that co-implantation of insulin-like growth factor-1 (IGF-I)-overexpressing MSC (MSC-IGF) would improve MSC-based therapy of anemia by providing paracrine support to erythropoietin (EPO)-secreting MSC (MSC-EPO). Murine MSC were found to express the IGF-I receptor and be responsive to IGF-I stimulation. IGF-I also improved MSC survival in vitro. MSC were admixed in a bovine collagen matrix and implanted by subcutaneous injection in a murine model of chronic renal failure. Mice receiving MSC-EPO co-implanted with MSC-IGF experienced a greater and significantly sustained elevation in hematocrit compared to controls; heart function was also improved. Co-implantation of MSC-IGF therefore represents a promising new strategy for enhancing implanted cell survival, and improving cell-based gene therapy of renal anemia.

The amniotic membrane and the amniotic fluid are one of life's most complex and delicate tissues and fluids, respectively. What was known about this tissue and fluid prior to the 20th century was extremely limited scientifically, but was significantly defined by beliefs entrenched in mysticism, folklore, and superstitions. A comprehensive literature review of the amniotic membrane tissue and amniotic fluid reveals the many unique and complex characteristics and biological properties that been heavily investigated since the turn of the 20th century and continues to surge into the 21st century. The historical perspectives, evolution, derivation, histology, structure, and composition of the amniotic membrane; and historical perspectives, volume and regulation, and cellular and non-cellular composition of the amniotic fluid are discussed here and are coalesced for an easy and comprehensible resource. Lastly, future perspectives regarding research and application of the amniotic membrane and amniotic fluid, including stem cells are discussed.

Durante as duas últimas décadas, têm ocorrido progressos substanciais a respeito do entendimento da fisiopatologia da cicatrização de feridas, e novas terapias tem sido desenvolvidas. Contudo, acelerar o processo de reparo continua sendo um desafio no campo da cirurgia plástica reconstrutiva. Tratamentos inovadores para melhorar a cicatrização e a regeneração cutânea são necessários e é nesse âmbito que as pesquisas com as células-troncos mesenquimais (MSCs) vêm ganhando espaço na última década. As MSCs foram estudadas em diversas áreas no que diz respeito ao seu efeito sobre a cicatrização de lesões e suas aplicações clínicas. Relatos apontam que tanto as MSCs originárias da medula óssea influenciam beneficamente a cicatrização de feridas, quanto originárias do tecido adiposo (ADSCs). A vantagem das ADSCs está na facilidade de serem coletadas, baixas taxas de morbidade e pelo alto rendimento de MSCs por coleta. Estudos demonstram que a eletroacupuntura (passagem de eletricidade através de agulhas de acupuntura inseridas na pele) pode exercer efeito cicatrizante em feridas cutâneas experimentalmente induzidas por meio do aumento da proliferação e da migração de células epiteliais e do tecido conjuntivo envolvidos no reparo de feridas. Dessa forma, este trabalho tem como objetivo avaliar o efeito da terapia com ADSCs no processo da cicatrização de feridas cutâneas em coelhos induzidas experimentalmente. Além disso, avaliar se a eletroacupuntura (EA) é capaz de causar efeito sobre a terapia com ADSCs no reparo de lesões cutâneas experimentais. Para tanto, foram utilizados 32 coelhos divididos em quatro grupos: GCTAD (ADSCs), GCTADE (ADSCs associado a EA), GE (EA) e GC (controle) o período de avaliação das lesões foi de 15 dias. As feridas induzidas cirurgicamente foram avaliadas por observações clinicas e análises histológicas. Os animais do GCTAD apresentaram uma velocidade cicatricial superior aos demais grupos até a quinta avaliação. Já na sétima avaliação o GE passa a ter a melhor taxa de contração cicatricial superando o GCTAD (p=0,039) e o GC (p=0,05). O GCTAD apresentou as maiores médias nas variáveis histológicas: proliferação vascular (p=0,059), proliferação fibroblástica (p=0,05) e Ki67. Nas variáveis reepitelização e colagenização as médias foram maiores que a dos outros grupos, mas semelhantes ao GE e a presença de queratina, da mesma forma, semelhante ao GCTADE. O GCTADE se destaca pela presença de folículos pilosos (p=0,026) e pelas maiores médias encontradas para as células mononucleares e polimorfonucleares, mas esses valores não configuram diferença estatística significativa. Por meio desse experimento, demostrou-se que o GCTAD melhora a cicatrização de feridas, acelerando a fase proliferativa do processo cicatricial. A associação dos tratamentos EA e ADSCs só foi considerada superior aos outros tratamentos na avaliação da presença de folículos pilosos. Talvez, o beneficio dessa associação seja mais evidente se o estudo for feito por um período superior aos 15 dias, ou seja, durante a fase de remodelamento da cicatrização, onde pode ser que se verifique um aspecto cosmético mais favorável da cicatriz. / The pathophysiology understanding of wound healing has been substantial progress during the last two decades, and new therapies have been developed. However, to accelerate the repair process remains a challenge in the field of reconstructive plastic surgery. Innovative treatments to enhance wound healing and cutaneous regeneration are necessary and in this context the research with mesenchymal stem cells (MSCs) are getting space in the last decade. MSCs have been studied in several areas with regard to its effect on the healing of lesions and their clinical applications. Reports indicate that both MSCs from bone marrow beneficially influence wound healing, as originating from adipose tissue (ADSCs). The advantage of ADSCs is because they can be easily collected, with low rates of morbidity and the high yield of MSCs per collection. Studies show that electro acupuncture (passing electricity through the acupuncture needles inserted into the skin) can have a healing effect on experimentally induced skin wounds by increasing the proliferation and migration of epithelial cells and connective tissue involved in wound repair. Thus, this study aims to evaluate the effect of therapy with ADSCs in the process of skin wound healing in rabbits that were experimentally induced. Moreover, to evaluate whether electro acupuncture (EA) is capable to causing effect on ADSCs therapy in the repair of experimental skin lesions. Therefore, it was used 32 rabbits divided into four groups: GCTAD (ADSCs), GCTADE (ADSCs associated with EA), GE (EA) and CG (control) the evaluation period of the lesions was 15 days. The surgically induced wounds were evaluated by clinical observations and histological analysis. The GCTAD animals showed an accelerated wound healing than the other groups until the fifth assessment. In the seventh evaluation GE replaced by the best healing rate than GCTAD (p = 0.039) and CG (p = 0.05). The GCTAD had the highest averages in the histological variables: vascular proliferation (p = 0.059), fibroblast proliferation (p = 0.05) and Ki67. Reepithelialization and collagen variables the averages were higher than other groups, but similar to GE and the presence of keratin, the same way, similar to GCTADE. The GCTADE stands by the presence of hair follicles (p = 0.026) and by the major averages found for the mononuclear and polymorph nuclear cells, but these values are not statistically significant. Through this experiment, we show that the GCTAD improves wound healing by accelerating the proliferation phase of healing. The combination of EA and ADSCs treatments were not considered superior to other treatments in assessing the presence of hair follicles. Perhaps the benefit of this association is more evident if the study is done for a period exceeding 15 days, during the remodeling phase of healing, it could be ascertained a more favorable cosmetic appearance of the scar.

A regeneração óssea alveolar tem sido um dos principais alvos de estudo na odontologia, tanto humana como veterinária, principalmente na implantodontia e nas cirurgias periodontais e buco-maxilo-faciais. Em função disto, este trabalho foi realizado com o objetivo de avaliar a regeneração óssea alveolar, utilizando como enxerto osso liofilizado e células-tronco mesenquimais (MSCs), oriundas da polpa dentária de um doador macho para enxerto alogênico. Foram utilizados 57 coelhas, Nova Zelândia, sendo um coelho doador das MSCs, distribuídos em sete grupos: controle (G1), osso liofilizado (G2), Matrigel (G3), Matrigel e MSC (G4), osso liofilizado e Matrigel (G5), Osso liofilizado, Matrigel e MSC (G6) e somente MSC (G7). Após a exodontia do incisivo inferior esquerdo, o alvéolo recebia o implante de acordo com cada grupo e avaliados em sete dias. As amostras foram coletadas para análise microscópica, desmineralizadas e não desmineralizadas, PCR, além de terem sido submetidas à análise radiográfica, a qual também era realizada no pré e no pós-operatório imediato. Macroscopicamente, foi observado espessamento do ramo mandibular dos animais dos grupos que receberam Matrigel e aceleração do crescimento dos dentes incisivos remanescentes nos animais que receberam terapia celular. Na análise microscópica, constatou-se que, todos os grupos que receberam como enxerto o osso liofilizado, o tempo de regeneração foi menor, embora o grupo controle tenha apresentado melhor organização na regeneração óssea, sendo que o tratamento com Matrigel resultou ainda em uma reação inflamatória exacerbada, dado este confirmado também nas amostras não desmineralizadas. As radiografias periapicais também apontaram que os grupos que foram tratados com osso liofilizado apresentavam maior área de radiopacidade, sugerindo aceleração do processo de regeneração. Porém, o teste de PCR não detectou a presença do cromossomo Y do doador nas fêmeas receptoras das MSCs. Os resultados sugerem que o uso da terapia celular diminui o tempo de regeneração óssea alveolar e, quando aliada ao osso liofilizado, acelera este processo. Entretanto, decorridos sete dias da aplicação do Matrigel, houve aumento da espessura do ramo mandibular no alvéolo onde foi aplicado, necessitando maior tempo de avaliação para melhor elucidar seu uso clínico. / The alveolar bone regeneration has been a major focus of study in dentistry, both human and veterinary medicine, especially in implant and periodontal surgery and in the bucco-maxillo facial. Because of this, this study was to evaluate alveolar bone regeneration, using lyophilized bone and implant as mesenchymal stem cells (MSCs) derived from the dental pulp of a male donor for allogeneic graft. We used 57 female New Zealand rabbits, one rabbit MSCs from donor, divided into seven groups: control (G1), lyophilized bone (G2), Matrigel (G3), Matrigel and MSC (G4), lyophilized bone and Matrigel(G5), lyophilized bone, MSC and Matrigel (G6) and MSC only (G7). After extraction of the left lower incisor, the socket receiving the implant according to each group and evaluated in seven days. The samples were collected for microscopic analysis, demineralized and non-demineralized, PCR, and they have been subjected to X-ray analysis, which was also held in pre-and postoperatively. Grossly, there was thickening of the mandibular branch of animals that received and accelerate growth of the incisor teeth remaining in the Matrigel animals that received cell therapy. Under microscopic analysis, we found that all groups that received the bone graft as lyophilized, regeneration time was lower, although the control group had a better organization in bone regeneration, and treatment with still resulted in a Matrigel exaggerated inflammatory response, since this is also confirmed in samples not demineralized. The periapical radiographs also showed that the groups were treated with lyophilized bone had a greater area of radiopacity, suggesting acceleration of the regeneration process. However, the PCR test failed to detect the presence of Y chromosome in female recipients of the donor of MSCs. The results suggest that the use of cell therapy reduces the duration and alveolar bone regeneration when combined with lyophilized bone, accelerates this process. However, Matrigel, there was increased thickness after seven days of applying of the mandibular alveolus in which it was applied, requiring longer evaluation to elucidate its clinical use.

Glicocorticoides e outras drogas imunossupressoras são comumente utilizados para o tratamento de condições inflamatórias, como as Doenças Inflamatórias Intestinais (DIIs). Apesar dos avanços na terapia medicamentosa, a remissão da doença ainda é difícil de ser mantida. Devido às suas propriedades imunomodulatórias, as Células-Tronco Mesenquimais (MSCs – Mesenchymal Stem Cells) têm emergido como reguladoras da resposta imune, e sua viabilidade e propriedades migratórias são essenciais para o sucesso da terapia celular. Entretanto, pouco se conhece sobre os efeitos das drogas convencionalmente utilizadas no tratamento das DIIs no comportamento das MSCs. Portanto, o objetivo deste estudo foi avaliar a viabilidade, a morfometria nuclear, a polaridade celular, a distribuição da actina-F e da FAK (Focal Adhesion Kinase), e o comportamento migratório das MSCs na presença das drogas Azatioprina (AZA) e Dexametasona (DEXA). As células foram isoladas de membranas coriônicas humanas e caracterizadas pela diferenciação em adipócitos e osteócitos, bem como pela expressão de um painel de marcadores de superfície. As MSCs foram previamente tratadas com AZA ou DEXA por 24h ou 7d nas concentrações de 1μM ou 10μM, respectivamente. Ambas as drogas não afetaram a viabilidade celular analisada por MTT (3-(4,5-dimethyltiazol-2-yl)-2,5- diphenyltetrazolium bromide) e morfometria nuclear. Entretanto, a análise do índice de polaridade resultou em uma morfologia mais alongada após o tratamento com AZA, enquanto células mais arredondadas foram observadas na presença de DEXA. Os filamentos de actina foram marcados por Rodamina-Faloidina e sua análise mostrou que a AZA preservou parcialmente a formação de lamelipódios e aumentou a presença de fibras de estresse ventrais, enquanto que a DEXA inibiu a formação de lamelipódios, evidenciou uma maior presença de fibras de estresse ventrais e diminuiu a estabilidade das protrusões de membrana, observadas em vídeo. Através da análise de microscopia de série temporal, foi observado que as células sob o efeito da AZA por 7d migraram por maiores distâncias e tiveram um aumento em sua velocidade de migração (24,35%; P < 0,05; n = 4), ao passo que a DEXA diminuiu a velocidade migratória em 24h e 7d (-28,69% e -25,37%, respectivamente; P < 0.05; n = 4) e diminuiu a distância alcançada pelas células. Em conclusão, nossos dados sugerem que as drogas AZA e DEXA podem afetar diferentemente a morfologia e o comportamento migratório das MSCs, possivelmente afetando o resultado da terapia celular. O protocolo de migração celular utilizado neste estudo foi estabelecido por nosso grupo de pesquisa, sendo que um artigo científico contendo todas as etapas do protocolo foi escrito para que outros laboratórios possam utilizá-lo de maneira simples e eficaz. / Glucocorticoids and other immunosuppressive drugs are commonly used to treat inflammatory disorders, such as Inflammatory Bowel Disease (IBD) and, despite few improvements, the remission of IBD is still difficult to maintain. Due to its immunomodulatory properties, Mesenchymal Stem Cells (MSCs) have emerged as regulators of immune response, and its viability and activation of migratory properties are essential for a successful cell therapy. However, little is known about the effects of immunosuppressant drugs used on IBD treatment on MSCs behavior. In this way, the aim of this study was to evaluate MSCs viability, nuclear morphometry, cell polarity, F-actin and FAK (Focal Adhesion Kinase) distribution and cell migration properties in the presence of the immunosuppressive drugs Azathioprine (AZA) or Dexamethasone (DEX). MSCs were isolated from human chorionic membranes and characterized through adipogenic and osteogenic differentiations, as well as a panel of surface markers. Cells were previously treated with AZA or DEX for 24 hrs or 7 days at 1μM and 10μM, respectively. Both drugs had no effects on cell viability analyzed through MTT (3-(4,5- dimethyltiazol-2-yl)-2,5-diphenyltetrazolium bromide) and nuclear morphometry. However, polarity index analysis showed that AZA treatment induced a more elongated cell shape while a greater presence of rounded cells was observed under DEX exposure. F-actin was stained by Rhodamine-Phalloidin and showed that AZA could partially preserve lamellipodia formation and increase the presence of ventral actin stress fibers, while DEX inhibited lamellipodia formation and increased the presence of ventral actin stress fibers while decreasing protrusion stability, observed in video. Through time-lapse microscopy, it was observed that after 7 days of treatment, AZA improved cell the spatial trajectory (ST) and increased migration speed (24.35%, P < 0.05, n = 4) while DEX impaired ST and migration speed after 24 hrs and 7 days treatment (- 28.69% and -25.37%, respectively; P < 0.05, n = 4). In conclusion our data suggests these immunosuppressive drugs can differently affect MSCs morphology and migration capacity, possibly impacting the success of cell therapy. The migration protocol used in this study was successfully established by our group, leading to the writing of a protocol paper to facilitate the usage of this technique by other laboratories in a simple and efficient manner.