Pulmonary arterial hypertension (PAH) is a devastating lung disease characterized by arterial pruning, occlusive vascular remodeling, and inflammation contributing to increased pulmonary vascular resistance with resultant right heart failure. Endothelial cell (EC) injury and apoptosis are commonly considered triggers for PAH, the mechanisms leading from injury to complex arterial remodeling are incompletely understood. While current therapies can improving symptoms, with the exception of parenteral prostacyclin, they do not significantly prolong transplant free survival. As well, there are no therapies that can regenerate the damaged lung short of transplantation. In this project, I sought to both advance the understanding of disease pathogenesis and explore regenerative therapeutic options for PAH. To this end, I first employed single cell RNA sequencing (scRNA-seq) at multiple time points during the Sugen 5416 (SU) – chronic hypoxia (CH) model of PAH, to provide new insights into PAH pathogenesis both during onset and progression of disease. We also employed microCT analysis to visualize and quantify the arterial pruning associated with PH and found significant loss up to 65% of the healthy arteriolar volume in this model. Through scRNA-seq analysis performed at four timepoints spanning the onset and progression of disease, two disease-specific EC cell types emerged as key drivers of PAH pathogenesis. The first was the emergence of capillary ECs with a de-differentiated gene expression profile, which we termed dedifferentiated capillary (dCap) ECs, with enrichment for the Cd74 gene. Interestingly, RNA velocity analysis suggested that these cells may be undergoing endothelial to mesenchymal transition during PAH development. At later times, a second arterial EC population became apparent, which we termed activated arterial ECs (aAECs), since it uniquely exhibited persistently elevated levels of differential gene expression consistent with a migratory, invasive and proliferative state. Interestingly, the aAECs together with the smooth muscle (SM)-like pericytes, a population which was also greatly expanded in PAH, expressed Tm4sf1, a gene previously associated with a number of cancers and abnormal cell growth. Furthermore, by immunostaining, TM4SF1 was found to be spatially localized to sites of complex and occlusive arterial remodeling, associated with both endothelial cells and pericytes in these lesions, suggesting an important role for the aAECs and SM-like pericytes in arterial remodeling and PH progression. Together, these findings suggest that aAECs, dCap ECs, and SM-like pericytes are emerging cell populations responsible for lung arterial remodeling in PAH, which drives disease progression, and that TM4SF1 may be a novel therapeutic target for this disease. As a first step in trying to develop approaches to regenerate lung arterial bed that is lost in PAH, we investigated the potential role of endothelial colony forming cells (ECFCs) and mesenchymal stromal cell (MSC) derived extracellular vesicles (EVs) as novel therapeutics, on the premise that these stem/progenitor cells would stimulate lung regeneration by mainly paracrine mechanisms. Additionally, we used biomaterials to microencapsulate cells and EVs to improve their local delivery and retention. While ECFCs were found to be ineffective in treating the monocrotaline model on their own, they were poorly retained in the lung and microencapsulation of ECFCs led to enhanced lung delivery within the first 72 hours, with resultant hemodynamic improvements in this model of PAH. MSCs are well known to be immunomodulatory and proangiogenic, largely acting through paracrine mechanisms, including by the release of EVs. Yet, following intravenous administration, nano sized EVs are rapidly cleared from circulation, potentially limiting their therapeutic potential. I adapted our microencapsulation strategy for EVs, and demonstrated significantly greater retention of microgel-loaded EVs were within the lung, resulting in enhanced local cell uptake. Interestingly, the hydrogel used for microencapsulation induced a local immune response which made it unsuitable for testing any potential therapeutic benefits of MSC-EVs in this study. Nonetheless, this work demonstrated proof-of-principle for the utility of microencapsulation as a strategy to enhance EV lung delivery. Overall, this work has identified novel lung cell populations (aAECs, dCap ECs, SM-like pericytes) driving arterial remodeling associated with PH progression, demonstrated the potential of ECFCs as a regenerative cell for the treatment of PAH, and illustrated the utility of microencapsulation as a tool to enhance lung targeting of both cells and EVs.

<p> Mesenchymal stromal cells (MSC) are a multipotent stromal population of interest as cancer therapeutics for their inherent tropism towards cancer sites. This renders them a potential cellular vehicle for delivering anti-tumor therapies. A limitation to their broader use is a plasticity in their biological roles, which depending on the context, may potentiate opposite roles in tumor modulation. Therefore, strategies to “guide” these cells towards a desired functional role are of high interest in the field of cancer therapeutics. In this dissertation, the functional polarization paradigm via stimulation with toll-like receptor ligands (poly I:C or LPS), previously described in bone-marrow derived MSC (BM-MSC), was evaluated in MSC sourced from adipose tissues (ASC). ASC provide several advantages over BM-MSC, such as the relative ease of acquisition of clinically relevant cellular doses via <em>in vitro </em>expansion. Findings in our studies in prostate cancer models <em>in vitro</em> suggested that a generation of phenotypically and functionally distinct ASC populations could be achieved via differential pre-stimulation approaches on ASC. We observed significant effects on the migratory and immunomodulatory capability of ASC, demonstrated via <em>in vitro </em>assays. Upon administration of these cells <em>in vivo </em>in a mouse model of prostate cancer, poly I:C-primed (or pre-conditioned) ASC were found to accelerate tumor growth progression. While unprimed and LPS-primed ASC did not exert a significant effect on tumor growth at the macroscopic level, gene expression analyses suggested that all treatments promoted distinct modulatory effects in the tumor microenvironment, including altered modulation of angiogenesis, and immune response processes, however, only in the case of poly I:C-primed ASC these effects translated to a significant effect in the tumor growth rate in the mouse model examined.  </p>

Doctor of Philosophy / Department of Anatomy and Physiology / Mark L. Weiss / Graft Versus Host Disease (GVHD) is the major complication following hematopoietic stem cell transplantation. GVHD is activated by immunocompetent T cells presented in the donor grafted tissue. Due to the increased use of bone marrow transplantation to treat diverse malignancies, the incidence of GVHD has shown a notable increase. Depending of the degree of immunological mismatch between donor and host, 50-70% of patients develop GVHD after allogeneic Bone Marrow Transplantation (BMT). Once GVHD develops, mortality reaches up to 50% in humans. Several studies using Mesenchymal Stromal Cells (MSCs) to prevent and treat GVHD have produced controversial results. It is thought that distinct MSCs sources used in those studies might be an important factor that produces different outcomes. For cellular therapy, the most attractive characteristics of MSCs are their reduced immunogenic potential, and their abilities to modulate immune responses. This dissertation addressed the hypothesis that Wharton’s jelly cells (WJCs) would prevent the pathology and death associated with GVHD after BMT. To accomplish this, I created a clinically relevant model of GVHD by transplanting allogeneic bone marrow across minor histocompatibility antigen (HA) barriers in the rat. To enhance alloreactive T-cell stimulation, bone marrow (BM) was co-administered with a fraction of CD8[superscript]+ cells magnetically selected from spleen to induce GVHD. Bone marrow tissue was isolated from a donor rat Fischer 344 (F344, RT1lv) and transplanted into lethally irradiated (10 Gray) Lewis rat (LEW, RT1l). Once GVHD was induced, MSCs derived from umbilical cord WJCs were either co-transplanted at day 0 with bone marrow, or given on day 2 post-BMT intravenously. The prophylactic potential of WJCs in an in vivo GVHD model was assessed as survival time, clinical symptomatology occurrence, and histopathology injuries in target tissues. Results indicate that while co-administration of WJCs with hematopoietic cells on day 0 failed to alleviate GVHD associated symptomatology and mortality. WJCs administered on day 2 post-induction ameliorated GVHD-associated symptomatology, improved engraftment and survival.

Master of Science / Department of Clinical Sciences / Mary Lynn Higginbotham / Objectives – To isolate and maintain canine Wharton’s jelly mesenchymal stromal cells (WJMSCs) in culture, to determine the effects of micellar nanoparticles containing doxorubicin (DOX) on WJMSCs and canine osteosarcoma (OSA) D17 cell viability, and to determine the effects of conditioned media from WJMSCs loaded with micellar nanoparticles containing DOX on OSA D17 cell viability. Sample Population – Canine WJMSCs containing various concentrations of DOX micelles and canine OSA D17 cells. Procedures – WJMSCs were isolated from canine umbilical cords. Micellar nanoparticles containing DOX were prepared and added to culture plates containing canine OSA D17 cells to determine micelle effects on cell growth and viability. Conditioned media from culture plates containing canine WJMSCs incubated with various DOX micelle concentrations was added to OSA D17 cells for conditioned media experiments. A 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay was performed to assess OSA D17 cell viability. A trypan blue stain was also utilized to perform cell counts to determine the effect of the DOX micelles on stromal cell growth. Results – WJMSCs were successfully isolated and maintained in culture. Micellar nanoparticles containing DOX decreased OSA D17 cell viability. OSA D17 cell viability was also decreased following incubation with conditioned media from canine WJMSCs loaded with micellar nanoparticles containing DOX. Significant decreases with the conditioned media of canine WJMSCs loaded with 10μM micelles occurred at 48 hours (p < 0.005) and at 72 and 96 hours (p < 0.0001). Significant decreases were also observed with the 1 μM DOX micelles at 72 hours (p < 0.005) and 96 hours (p < 0.0001). WJMSC numbers decreased in a dose dependent manner following incubation with DOX micelles. Changes in WJMSC number was not caused by increased cell death as all variables produced similar percentages of dead cells. Conclusions – Canine WJMSCs were successfully isolated and maintained in culture. Stromal cells containing DOX micellar nanoparticles induced OSA D17 cell cytotoxicity while inducing an anti-proliferative, rather than cytotoxic effect, on the WJMSC. These data support future in vivo experiments utilizing canine WJMSCs and micellar nanoparticles.

INTRODUÇÃO: As células-tronco mesenquimais são capazes de regenerar diferentes tipos de tecidos, no entanto, a maioria dos métodos para sua obtenção são invasivos. Recentemente, foi descoberta a existência destas células no sangue menstrual. OBJETIVO: Padronizar as técnicas de coleta e transporte do fluido menstrual, bem como a caracterização, isolamento, expansão e criopreservação de células-tronco do fluido menstrual e avaliar a disponibilidade de células tronco mesenquimais no fluido menstrual. MÉTODOS: No período de agosto de 2011 a março de 2012 foram selecionadas 20 voluntárias com ciclo menstrual regular, sem doença ginecológica. O fluido menstrual foi coletado no dia de maior fluxo e submetido a imunofenotipagem e cultivo celular. Foram realizadas duas passagens em meio de cultura até atingir semi-confluência das células-tronco, as quais foram, em seguida, criopreservadas. RESULTADOS: Os parâmetros analisados apresentaram os seguintes valores médios: volume de fluido menstrual 6,90±5,60mL; tempo de transporte 17,20±5,50h; número de células totais 3,95 x106±3,88 x106 com 76,05%±24,57 de células viáveis. Após a cultura, as células mesenquimais aumentaram de 0,14%±0,26 para 96,19%±2,14. Na primeira passagem de cultura, após 15 a 21 dias, as colônias formaram grupos que atingiram a confluência, que a partir da segunda passagem ocorreu em cerca de 3 dias. As células-tronco mesenquimais criopreservadas eram viáveis. CONCLUSÃO: As células-tronco do fluido menstrual podem ser obtidas sem métodos invasivos. O fluido menstrual pode ser transportado em condições ideais de temperatura até 24 horas após a coleta. As células tronco mesenquimais podem ser caracterizadas por imunofenotipagem, isoladas, cultivadas e expandidas e, em seguida, criopreservadas. O fluido menstrual contém células tronco mesenquimais viáveis e apropriadas para cultivo / INTRODUCTION: Mesenchymal stem cells may renovate different tissues, but techniques to obtain these cells are invasive. Recently, those cells were detected in menstrual blood. OBJECTIVE: Patterning techniques of collection, transportation, characterization, isolation, expansion and cryopreservation of stem cells in menstrual fluid. METHODS: From August 2011 to March 2012 twenty volunteers were selected with regular menstrual cycle without gynecological diseases. They collected menstrual fluid on the most intense flux day to analysis by immunophenotyping and cellular culture. Culture was made in 2 stages until reached semi-confluence of stem cells and these cells were cryopreserved. RESULTS: Average of menstrual fluid volume was 6,90±5,60mL, transportation time was 17,20±5,50h, and total number of cells was 3,95 x106±3,88 x106 witch 76,05%±24,57 were viables. After culture, mesenchymal stem cells increased from 0,14%±0,26 to 96,19%±2,14. After 15 to 21 days of culture in first passage, colonies formed clusters that reached confluence. In second passage, it happens after 3 days of culture and stem cells were cryopreserved. CONCLUSION: Stem cells of menstrual fluid may be easily obtained without invasive methods. Menstrual fluid can be transported in good conditions of temperature up to 24 hours of collection. Mesenchymal stem cells of menstrual fluid may be characterized by immunophenotyping, as well as it is possible to isolated, cultivate and cryopreserved them. Menstrual fluid has viable and proper for culture mesenchymal stem cells

Células reticulares fibroblásticas (FRCs, gp38+ e CD31-) e células duplo negativas (DNCs, gp38- e CD31-) são células estromais encontradas em órgãos linfoides secundários, como linfonodos. Enquanto as FRCs têm sido amplamente estudadas, pouco se sabe ainda sobre DNCs. Apesar da função estrutural das FRCs nos linfonodos já estar bem estabelecida, estudos recentes indicam que as FRCs também desempenham um papel fundamental em processos imunológicos, por exemplo, migração celular, ativação e qualidade da resposta imune, além da participação na tolerância periférica. Outra célula estromal em constante estudo são as células-tronco mesenquimais (CTMs), principalmente encontradas na medula óssea. Estas células compartilham similaridades, como por exemplo; são células estromais encontradas em órgãos linfoides, apresentam morfologia e características semelhantes quando cultivadas in vitro e estão envolvidas na resposta imune por mecanismos semelhantes. As CTMs são provenientes de um órgão linfoide primário, cuja função principal não está relacionada à resposta imunológica, entretanto, de acordo com inúmeros trabalhos, estas células possuem capacidade de interferir na ativação de várias células do sistema imunológico. Portanto, nossa hipótese é de que as FRCs e DNCs, que se encontram em um órgão linfoide secundário, cuja função principal remete a resposta imunológica, apresentem também um papel regulador, descrito na literatura como tolerância periférica e contração de uma resposta imunológica já estabelecida. Em nosso estudo mostramos que FRCs e DNCs foram isoladas a partir de linfonodos humanos e devidamente caraterizadas. Evidenciamos que FRCs e DNCs atendem todos os critérios mínimos propostos pela sociedade internacional de terapia celular para serem consideradas células-tronco estromais. Além disso, mostramos que FRCs e DNCs influênciam a proliferação e a expressão de moléculas de homing em linfócitos alogênicos in vitro. Portanto, contribuimos de forma inédita para o entendimento funcional das FRCs e DNCs, visto que estudos em humanos envolvendo estas células são escassos / Fibroblastic reticular cells (FRCs, gp38+ e CD31-) and double-negative cells (DNCs, gp38- e CD31-) are stromal cells found in secondary lymphoid organs, such as lymph nodes. While the FRCs has been widely studied, little is known about DNCs. Despite the structural function of FRCs on lymph nodes is well established, recent studies indicate that FRCs also play a key role in immunological processes, for example, cell migration, immune response activation and quality, beyond their involvement in peripheral tolerance. Another stromal cell type in constant study are mesenchymal stem cells (MSCs), mainly found in bone marrow. These cells share similarities with FRCs and DNCs, for example; they are estromal cells found in lymphoid organs, they present similar morphology and characteristics when cultured in vitro and they are involved in the immune response by similar mechanisms. MSCs are derived from a primary lymphoid organ which the major function is not related to immune response, but according to numerous studies these cells have the capacity of the interfere on activation of various immune cells. Consequently, our hypothesis is that FRCs and DNCs, usually found in secondary lymphoid organ, display immune regulatory roles, which were described in the literature as peripheral tolerance and immune response contraction. In our study we showed that FRCs and DNCs were isolated from human lymph nodes and adequately characterized. We evidenced that FRCs and DNCs meet all minimum criteria proposed by the International Society of Cell Therapy to be considerate a stromal stem cell. Therefore, we contributed in an unpublished manner to the functional understanding of FRCs and DNCs, since human studies involving these cells are scarce

A heterogeneidade entre as células tumorais e o suporte a elas proporcionado pelos componentes do microambiente tumoral (TME) são os dois principais responsáveis pela progressão do câncer e por tornar essas doenças essencialmente incuráveis. Assim, identificar as principais dependências das células malignas, sejam elas internas ou advindas do meio extracelular, é fundamental para entender seu comportamento e propor terapias mais eficientes. Nesta tese, abordamos aspectos destas duas questões separadamente. Em um primeiro trabalho, investigamos as interações de células tumorais com células-tronco mesenquimais (MSCs), um dos principais componentes do TME. MSCs participam ativamente do nicho tumoral, especialmente por serem capazes de liberar uma vasta gama de moléculas que, via sinalização parácrina, podem modular as células ao seu redor. No entanto, os principais mediadores e respectivos efeitos do secretoma dessas células nos tumores ainda precisam ser melhor elucidados. Ao investigar esses efeitos em glioblastomas (GBM), um dos tumores primários mais agressivos em adultos, mostramos que o secretoma de células-tronco mesenquimais derivadas de tecido adiposo humano (hADSCs) foi capaz de bloquear a autofagia das células malignas. Nossos dados revelaram que o secretoma de hADSCs ativou a via de sinalização de mTORC1 e reduziu a translocação nuclear de TFEB, um fator de transcrição chave que regula a autofagia e a a função lisossomal, nas células de GBM, impedindo que o fluxo autofágico fosse completado. Já em um segundo trabalho, no contexto da heterogeneidade celular em tumores, propusemos uma abordagem para análise de dados de céulas únicas focada em outliers. Minorias celulares com níveis anormalmente elevados, ou reduzidos, de expressão de determinados genes ou proteínas são em muitos casos responsáveis por resistir aos tratamentos e levar à recidiva da doença, ao mesmo tempo que, por serem outliers, são muitas vezes ignoradas ou excluídas das análises de dados. Assim, decidimos utilizar métodos estatísticos em dados de expressão de células únicas para detectar e analisar células outliers, comparando o seu comportamento com as demais células não-outliers. Denominamos essa abordagem de Single Cell OUTlier analysis (SCOUT) e a testamos em dados de células tumorais avaliadas por citometria de massas e por sequenciamento de RNA de células únicas (sc-RNA-seq). Como resultado, pudemos confirmar que, especialmente diante de determinados tratamentos, células outliers podem se comportar de maneira distinta de não-outliers, revelando informações potencialmente relevantes ao desenvolvimento de estretégias terapêuticas. Por fim, desenvolvemos uma ferramenta para automatizar a detecção e seleção de outliers em dados de célula única a fim de facilitar o estudo dessas células em diversos aspectos na pesquisa do câncer. / Intratumoral heterogeneity and the support provided by components of the tumor microenvironment (TME) to malignant cells are major contributors to cancer progression, and the two main factors that make this disease essentially incurable. Thus, identifying malignant cells dependencies, either in the intra- or extracellular environment, is fundamental to understand their behavior and propose more efficient therapies. In this thesis, we approached aspects of these two issues separately. In a first work, we investigated interactions between tumors and mesenchymal stem cells (MSCs), one of the main components in the TME. MSCs actively participate in the tumor niche, especially due to their capacity of releasing a wide range of molecules that can modulate cells in their surroundings. However, little is known about the effects of MSCs-derived molecules in tumor cells behavior. In investigating these effects on glioblastomas (GBM), one of the most aggressive primary tumors in adults, we found out that the secretome of human adipose-derived stromal cells (hADSCs) was able to block autophagy in malignant cells. Our data revealed that hADSCs secretome activated mTORC1 signaling pathway and reduced nuclear translocation of TFEB, a master transcription factor that regulates autophagy and lysosomal function, in GBM cells, preventing autophagic flux from being completed. In a second work, we addressed intratumoral heterogeneity by proposing an approach to analyze outliers in single cell data. Cellular minorities with abnormally high, or low, expression levels of certain genes or proteins are in many cases responsible for resisting treatments and lead to disease relapse, while for being outliers they are also frequently ignored or excluded from data analysis. Thus, we decided to apply statistical methods on single cell expression data to detect outliers and analyze them, comparing their behavior with the remaining non-outlier cells. We called this approach Single Cell OUTlier analysis (SCOUT) and tested it on tumor cell datasets obtained from mass cytometry and single cell RNA sequencing (scRNA-seq) experiments. Using SCOUT we were able to confirm that, especially upon specific treatments, outlier cells may behave differently from non-outliers, revealing potentially relevant information to aid in the development of novel therapeutic strategies. Finally, we developed a tool to automate detection and selection of outliers in single cell data with the aim to facilitate the study of these cells under different contexts in cancer research.

La myélofibrose primitive (MFP) est un néoplasme myéloprolifératif chromosome Philadelphie négatif rare, mais de pronostic sévère. Elle se caractérise par une prolifération clonale et une mobilisation des cellules souches et progéniteurs hématopoïétiques (CSH/PH) de la moelle osseuse vers la rate et le foie. Cette anomalie de l’hématopoïèse est associée à une pathologie du stroma (myélofibrose, ostéosclérose et néoangiogenèse). L’existence d’anomalies moléculaires de la CSH/PH telles que les mutations de Jak2, Mpl, TET2 ou CALR ne permet pas à elle seule d’expliquer la physiopathologie de la maladie. Les résultats obtenus dans le laboratoire suggèrent que le microenvironnement médullaire au sein des niches hématopoïétiques et en particulier les cellules stromales mésenchymateuses (CSM), participe vraisemblablement à cette dérégulation de l’hématopoïèse, favorisant le développement du clone pathologique. Cependant, aucune preuve tangible d’une altération des CSM médullaires n’a été jusqu’à présent apportée.Dans ce travail, nous avons isolé les CSM de la moelle de patients atteints de MFP et réalisé une caractérisation « complète » de ces cellules : prolifération, phénotype, soutien de l’hématopoïèse, sécrétome, transcriptome, miRNome et capacités de différenciation. Nos résultats ont permis de dégager un faisceau d’arguments en faveur d’une dérégulation de leur différenciation ostéoblastique (DOB). (i) Les cytokines BMP2, RANTES, PDGF, TGF-β1, VEGF et Il-6 sont significativement produites en plus grande quantité par ces cellules. (ii) L’étude du transcriptome a révélé une expression significativement différente d’un ensemble de gènes impliqués dans la DOB tels que RUNX2, DLX5, TWIST1 et NOGGIN. (iii) De nombreux micro-ARN, dont certains sont connus pour être impliqués dans la DOB comme miR-210 ou dans le nichage des cellules souches hématopoïétiques comme miR-34a, sont dérégulés à l’état basal et au cours de cette DOB. (iv) Enfin, l’étude de leurs capacités de différenciation ostéoblastique in vitro et in vivo chez la souris immunodéprimée est en faveur d’une augmentation de ces capacités. Nous avons étudié l’impact du TGF- β1 dans cette DOB. Nous avons mis en évidence que les CSM de malades présentent un état basal d'activation de la voie de signalisation pSmad significativement augmenté, confirmant l’expression endogène de TGF-β1. En utilisant des inhibiteurs spécifiques du récepteur de type I au TGF- β, nous avons montré l’implication de cette cytokine dans les altérations de la DOB. En conclusion, notre travail montre pour la première fois que les CSM des malades de MFP sont anormales et ce indépendamment de la stimulation par le clone hématopoïétique pathologique, suggérant la présence d'anomalies constitutives ou acquises. Ces anomalies impliquent deux acteurs majeurs de la pathologie : le TGF-β1 et l'ostéogenèse. / Primary myelofibrosis (PMF) is a Philadelphia-negative myeloproliferative neoplasm, rare but associated with a poor prognosis. Its features are a clonal proliferation and an egress of hematopoietic stem cells (HSC) from bone marrow to spleen. These abnormalities of hematopoiesis are in relation with a pathological stroma (myelofibrosis, osteosclerosis and neoangiogenesis). Molecular abnormalities present in HSC partially explain the physiopathology of the disease. Results from our lab suggest that the bone marrow micro-environnement, especially mesenchymal stromal cells (MSC), are involved in the deregulation of hematopoiesis, promoting the clonal cells. However, there is no strong evidence of bone marrow MSC alterations reported for now.In our study, we isolated MSC from bone marrow of patients suffering from PMF and performed a broad characterization: proliferation, phenotype, hematopoiesis supporting capacities, secretome, transcriptome and miRNome analysis. Our results highlight arguments in favor of a deregulation of their osteogenic capacities. (i) Cytokines NMP2, RANTES, PDGF, TGF-β1, VEGF and Il-6 were significantly overproduced by MSCs. (ii) Transcriptome analysis revealed a specific signature involving genes participating in osteogenic differentiation such as RUNX2, DLX5, TWIST1 and NOGGIN. (iii) Many micro-RNAs, some know to be involved in osteogenic differentiation regulation, as mir-34a, are deregulated in MSCs and in MSC-derived osteoblasts. (iv) Finally, study of their osteogenic potency in vitro and in vivo in nude mice showed an increasing of their osteogenic potency. We studied the impact of TGF-β1 in this process and showed that PMF MSCs showed a basal expression of Smad pathway significantly increased as compared to control. Using specific inhibitor of TGF-β1 receptor, we demonstrated the implication of this cytokine in the osteogenic impairment.To summarize, our work shows for the first time that MSCs from PMF patients are abnormal, independently from stimulation by clonal cells, suggesting intrinsic abnormalities. These abnormalities involve two main factor of the disease: TGF-β1 and osteogenesis.

Hui, Fan Fong. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2009. / Includes bibliographical references (leaves 153-181). / Abstract also in Chinese. / Acknowledgements --- p.ii / Abstract --- p.iii / Abbreviations --- p.vii / Table of Contents --- p.ix / List of Tables --- p.xv / List of Tables --- p.xv / List of Figures --- p.xvi / Major Conference Presentations --- p.xix / Publications in Preparation --- p.xxii / Chapter Chapter 1 --- Study Background --- p.1 / Chapter 1. --- Introduction --- p.2 / Chapter 1.1. --- Spinal Deformities --- p.2 / Chapter 1.1.1. --- Treatment --- p.2 / Chapter 1.2. --- Spinal fusion --- p.4 / Chapter 1.2.1. --- Gold Standard of Spinal Fusion --- p.4 / Chapter 1.2.2. --- Decortication in Spinal Fusion --- p.4 / Chapter 1.2.3. --- Autograft in Spinal Fusion --- p.4 / Chapter 1.2.4. --- Local Factors Influencing Spinal Fusion --- p.5 / Chapter 1.2.5. --- Ultimate Goals of Spinal Fusion --- p.7 / Chapter 1.2.6. --- Limitations of Spinal fusion --- p.7 / Chapter 1.3. --- Alternatives of Different Components for Enhancing Spinal Fusion / Chapter 1.3.1. --- Bone Graft Substitute --- p.9 / Chapter 1.3.2. --- Bioactive Factors --- p.15 / Chapter 1.4. --- Limitations of the Alternative Methods in Spinal Fusion Enhancement --- p.19 / Chapter 1.4.1. --- BMPs --- p.19 / Chapter 1.4.2. --- Gene Therapy --- p.20 / Chapter 1.4.3. --- Biophysical Stimulation --- p.20 / Chapter 1.5. --- Recent Methods in Enhancing Spinal Fusion --- p.21 / Chapter 1.5.1. --- Low Intensity Pulsed Ultrasound --- p.21 / Chapter 1.5.2. --- Mesenchymal Stem Cells in Spinal Fusion --- p.24 / Chapter 1.6. --- Conclusion --- p.26 / Chapter Chapter 2 --- "Hypothesis, Objectives and Plan of Study" --- p.29 / Chapter 2. --- "Hypothesis, Objectives and Plan of Study" --- p.30 / Chapter 2.1 --- Study Hypothesis --- p.31 / Chapter 2.2 --- Study Objectives --- p.31 / Chapter 2.3 --- Plan of Study --- p.32 / Chapter 2.3.1 --- For First Objective --- p.32 / Chapter 2.3.2 --- For Second Objective --- p.32 / Chapter 2.3.3 --- For Third Objective --- p.33 / Chapter Chapter 3 --- In vitro Study of Effect of Low Intensity Pulsed Ultrasound on Mesenchymal Stem Cells --- p.34 / Chapter 3.1. --- Introduction --- p.35 / Chapter 3.2. --- Materials and Methods --- p.36 / Chapter 3.2.1. --- Experimental Animal --- p.36 / Chapter 3.2.2. --- Materials and Reagents --- p.36 / Chapter 3.2.2.1. --- Dulbecco，s Modified Eagle Medium (DMEM) --- p.36 / Chapter 3.2.2.2. --- Phosphate Buffered Saline (PBS) --- p.37 / Chapter 3.2.2.3. --- Osteogenic Medium (OS) --- p.37 / Chapter 3.2.2.4. --- Alkaline Phosphatase (ALP) Buffer --- p.37 / Chapter 3.2.2.5. --- ALP Substrate Buffer --- p.38 / Chapter 3.2.2.6. --- MTT Stock Solution --- p.38 / Chapter 3.2.2.7. --- MTT Working Solution --- p.38 / Chapter 3.2.2.8. --- Lysis buffer --- p.38 / Chapter 3.2.2.9. --- Alkaline Phosphatase (ALP) Working Reagents --- p.39 / Chapter 3.2.3. --- Isolation of Bone Marrow Derived Mesenchymal Stem Cells (BM derived MSCs) --- p.39 / Chapter 3.2.4. --- In vitro Low Intensity Pulsed Ultrasound Treatment --- p.40 / Chapter 3.2.4.1. --- In vitro LIPUS Devices --- p.40 / Chapter 3.2.4.2. --- Treatment Procedure and Experimantal Groupings --- p.40 / Chapter 3.2.5. --- Effect of LIPUS on Cell Viability and Osteogenesis in bone marrow derived-MSCs --- p.41 / Chapter 3.2.5.1. --- Cell Viability Assay --- p.41 / Chapter 3.2.5.2. --- Alkaline Phosphatase (ALP) Enzyme Activity --- p.42 / Chapter 3.2.5.3. --- Cell Morphology and Alkaline Phosphatase Cytochemistry --- p.42 / Chapter 3.2.6. --- Statistical Analysis --- p.43 / Chapter 3.3. --- Results --- p.43 / Chapter 3.3.1. --- Morphology --- p.43 / Chapter 3.3.2. --- Total Number of Viable Cells --- p.44 / Chapter 3.3.3. --- ALP Activity Absorbance --- p.44 / Chapter 3.3.4. --- ALP staining --- p.45 / Chapter 3.3.5. --- Qualitative Analysis --- p.45 / Chapter 3.3.6. --- Quantitative Analysis --- p.46 / Chapter 3.4. --- Discussion --- p.46 / Chapter 3.4.1. --- LIPUS have No Enhancing Effect on Proliferation of MSCs in Basal Medium Nor Osteogenic Medium --- p.47 / Chapter 3.4.2. --- LIPUS Stimulate Proliferation of MSCs in Early Period --- p.49 / Chapter 3.4.3. --- LIPUS Further Enhanced Osteogenesis of MSCs in Osteogenic Medium --- p.49 / Chapter 3.4.4. --- 10 mins LIPUS treatment for 7 days can positively enhance osteogenic differentiation --- p.50 / Chapter 3.4.5. --- Optimum Conditions of LIPUS was Cell Type Dependent --- p.51 / Chapter 3.4.6. --- LIPUS Promoted Osteogenesis in MSCs through Accelerated Mineralization --- p.52 / Chapter Chapter 4 --- Enhancement of Posterior Spinal Fusion The Effect of Tissue-Engineered MSC and Calcium Phosphate Ceramic composite treated with LIPUS in Vivo --- p.68 / Chapter 4.1. --- Introduction --- p.69 / Chapter 4.1.1. --- TCP Biomaterials --- p.70 / Chapter 4.2. --- Materials and Methods --- p.71 / Chapter 4.2.1. --- Materials and Reagents --- p.71 / Chapter 4.2.2. --- Preparation of MSC Derived Osteogenic Cells-tricalcium Phosphate Ceramics Composite --- p.73 / Chapter 4.2.3. --- Posterior Spinal Fusion Surgery --- p.74 / Chapter 4.2.4. --- In vivo LIPUS treatment --- p.75 / Chapter 4.2.5. --- Assessment of Fusion Mass --- p.76 / Chapter 4.2.6. --- Histology --- p.77 / Chapter 4.2.7. --- Statistical Analysis --- p.79 / Chapter 4.3. --- Results --- p.79 / Chapter 4.3.1. --- Fusion by Manual Palpation --- p.79 / Chapter 4.3.2. --- pQCT Analysis --- p.80 / Chapter 4.3.3. --- Histological Analysis --- p.81 / Chapter 4.4. --- Discussion --- p.85 / Chapter 4.4.1. --- Summary of the Findings from Different Assessment Methods --- p.85 / Chapter 4.4.2. --- Addition of MSCs to TCP ceramic in Spinal Fusion --- p.87 / Chapter 4.4.3. --- The Needs of Differentiated MSC in Spinal Fusion --- p.89 / Chapter 4.4.4. --- bFGF Masked the Effect of OS in MSC --- p.91 / Chapter 4.4.5. --- LIPUS Enhanced Bone Formation --- p.95 / Chapter 4.4.6. --- LIPUS Enhanced Bone Formation through Mineralization --- p.96 / Chapter 4.4.7. --- LIPUS Enhanced Spinal Fusion through Bone Remodeling-induced Fusion Mass --- p.97 / Chapter 4.4.8. --- LIPUS Enhanced Bone Formation through Endochondral Ossification --- p.99 / Chapter Chapter 5 --- In Vivo Monitoring of Spinal Fusion in Animal Model with High-resolution Peripheral Quantitative Computed Tomography-A New Pilot Study --- p.122 / Chapter 5.1. --- Introduction --- p.123 / Chapter 5.2. --- Materials and Methods --- p.124 / Chapter 5.2.1. --- Animal Groupings --- p.124 / Chapter 5.2.2. --- Preparation of MSC Derived Osteogenic Cells-tricalcium Phosphate Ceramics Composite --- p.124 / Chapter 5.2.3. --- Posterior Spinal Fusion Operation Procedures --- p.125 / Chapter 5.2.4. --- LIPUS treatment --- p.125 / Chapter 5.2.5. --- High-resolution Peripheral Quantitative Computed Tomography …- --- p.125 / Chapter 5.2.6. --- Analysis with HR-pQCT --- p.126 / Chapter 5.3. --- Result --- p.128 / Chapter 5.3.1. --- Qualitative Observations from HR-pQCT Images --- p.128 / Chapter 5.3.2. --- Quantitative Analysis --- p.129 / Chapter 5.4. --- Discussion --- p.130 / Chapter Chapter 6 --- "Overall Summary, Discussion and Conclusion" --- p.140 / Chapter 6.1. --- Overall Summary and Discussion --- p.141 / Chapter 6.2. --- Limitations and Further Studies --- p.145 / Chapter 6.3. --- Conclusions --- p.147 / Chapter 6.4. --- Summary Flowchart of the whole thesis --- p.148 / References --- p.153

Smad7作為轉化生長因數-β信號通路中的負性調節因子為人所知，異常的Smad7表達通常會引發癌症及組織纖維化等疾病。而目前對於其在骨重建及其相關疾病中的作用尚未有研究。本研究利用Smad7部分敲除小鼠來探索Smad7在骨重建，骨質疏鬆以及間充質幹細胞分化等方面的作用。 / 本研究所用的Smad7部分敲除小鼠模型來源於已有報導過的Smad7ΔE1(KO)小鼠。該小鼠體內Smad7基因組外顯子I的翻譯區被替換，導致部分蛋白失及其功能破壞。研究結果表明，KO小鼠在6、12、24周齡時股骨遠端幹骺端均有不同程度下降的骨小梁數目、厚度，骨礦化率，骨密度，骨體積分數，及其上升的骨小梁間隙和破骨細胞表面。骨髓來源間充質幹細胞的多向分化實驗表明，KO組呈現出抑制性的成骨能力，表現為鈣結節形成減少，鹼性磷酸酶活性下降，早晚期成骨標記基因表達下降。該組亦表現出促進性的成脂能力，有較多及較早的脂滴形成，成脂標記基因表達上升。而對於骨髓來源巨噬細胞的體外破骨誘導實驗表明，KO組有更多且更大的破骨細胞形成，較大的骨吸收面積，以及上升的破骨標記基因表達。卵巢切除小鼠模型的研究表明，術後4、8、16周，KO组的股骨遠端幹骺端对比野生组有更大程度下降的骨形态学参数，以及明顯升高的破骨細胞融合標記蛋白的表達。體外實驗表明KO组有更多且更大的破骨細胞形成，以及更大面積的骨吸收。積雪草酸曾被證實在肝纖維化模型中誘導Smad7 基因的表達，也在本實驗中用以研究對骨質疏鬆疾病的作用。卵巢切除動物模型連續給藥8周後，骨質疏鬆的現象有明顯逆轉，表現為升高的骨形态学参数，及下降的股骨內破骨細胞融合標記蛋白的表達。 / 總結，本研究證實了Smad7在骨骼發育重建及骨疾病的病理機理等方面的研究提供了突破性的見解。部分敲除Smad7可以導致抑制性的成骨能力，促進性的破骨能力，以及損傷性的骨重建，亦會加速骨質疏鬆的進程，并可作為全新的藥物治療靶點，提示Smad7 本身對於骨重建及骨代謝的保護性作用，為代謝性骨疾病的研究及其臨床藥物開發提供了更廣泛的前景。 / Smad7 has been well documented as a negative regulator of TGF-β signaling, and its altered expression often leads to human diseases such as cancer and fibrosis. However, the role of Smad7 in regulating bone remodeling and related diseases remains unclear. We performed both in vivo and in vitro experiments as well as disease model and drug therapy studies using both wild-type (WT) and Smad7ΔE1 (KO) mice to investigate the functional role of Smad7 in bone remodeling, osteoporosis, and MSCs differentiation. / The Smad7ΔE1 mice were generated by replacing part of the exon1 of Smad7 gene as reported, which resulted in truncated protein and partial loss of Smad7 function. Mice were genotyped by PCR. The μ-CT, histological assays and bone histomorphometric assays in metaphysic region of the femurs showed lower trabecular number (TbN), trabecular thickness (TbTh), mineral apposition rate (MAR), higher trabecular separation (TbSp) and Osteoclast Surface (Oc.S/BS & Oc.N/BS) in the KO mice at 6, 12, to 24 weeks old; as well as lower bone mineral density (BMD) and bone volume fraction (BV/TV) at 24 weeks old in the KO mice. The in vitro BM-MSCs multi-lineage differentiation studies showed the suppressed osteogenic potential in the KO group with fewer mineralized nodules, lower ALP activity and expression of Col1A1, Runx2 and OCN; while the adipogenic potential was elevated with more lipid droplets formation and higher expression of Adipsin and C/EBPα. The osteoclastogenic potential of KO mice BMMs was also elevated, showing higher osteoclasts activity and larger resorptive areas, as well as elevated expression of TRAP and CTR. Both in vivo and in vitro studies of the osteoporotic models showed that the KO mice had lower BMD, TbTh, and higher TbSp compared to the WT mice at 4, 8, 16 weeks after OVX, similar results of lower BV/TV and TbN were observed at 4 weeks after OVX in the KO mice. The RANKL-induced osteoclastogenesis potential was elevated compared to WT mice, with more and bigger osteoclasts, larger resorptive areas, as well as elevated expression of TRAP and CTR. The osteoclastic cell fusion was also enhanced. Treatment of Asiatic acid (one traditional Chinese medicine that has been proved to induce the expression of Smad7 as reported) in the OVX mice reversed the osteoporotic process with increase BMD, BV/TV, TbN, TbTh, and decreased TbSp compared to the untreated group. The osteoclastic cell fusion was suppressed after AA treatment. / Partial loss of Smad7 function leads to impaired bone remodeling in vivo, reduced osteogenesis and enhanced osteoclastogenesis in vitro, and also accelerates the osteoporotic development and osteoclastic cell fusion. Asiatic acid may be a novel potential drug for prevention of osteoporosis. Our findings provide new evidences for a better understanding of the biological functions of Smad7 in bone remodeling and its therapeutic potential for metabolic bone diseases. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Li, Nan. / Thesis (Ph.D.) Chinese University of Hong Kong, 2014. / Includes bibliographical references (leaves 131-153). / Abstracts also in Chinese.