The use of allograft bone is effective in the treatment of large bone loss following tumour removal or surgery. However, it is not osteogenic due to a lack of viable osteogenic cells and the remaining marrow material is potentially harmful to the recipient. Sterilisation techniques, such as gamma irradiation, are routinely used to improve the safety of these grafts; however this fails to remove the immunogenic material and may diminish the bones innate properties. Thus, wash techniques are being developed to remove the deleterious marrow, whilst retaining the native properties of the bone so that through tissue engineering, pre-osteogenic cells may be added to aid osseointegration. To this end, this study utilised a novel wash process (developed by the National Health Service Blood and Transplant Tissue services (NHSBT)) on whole human femoral heads, to assess the resulting material’s suitability as a biological scaffold for bone tissue engineering (BTE). Following the wash process, marrow removal efficiency was analysed by biochemical testing and histological assessment, and biocompatibility of fresh-frozen and washed human bone was assessed using extract cytotoxicity assays with BM-MSCs. The results showed a marrow removal efficiency of 99.5%, leaving a material with only 16.7 ng DNA/100mg of dry material, and which histologically displayed minimal cellular content demonstrating that this was an efficient wash process producing an acellular biological scaffold material (<50ng DNA/100mg bone). Extract cytotoxicity testing indicated the material was biocompatible. Uniaxial compression to failure was performed on 1cm3 cubes using bone samples from mirrored location of bilaterally halved femoral heads, with one half washed, whilst the other was fresh-frozen. A random orientated “clinical” model was also utilised, with samples processed as fresh-frozen, washed and irradiated for comparative assessment. There was no significant change in the mechanical strength of the washed material compared to fresh-frozen samples or between sterilisation types, suggesting the washed bone was mechanically comparable to existing bone allograft stock. BM-MSCs from both young (≤50 years) and old donors (≥70 years) were seeded on washed bone cubes from young and old donors, and cultured in standard or osteogenic media. Samples were analysed at 0, 14 and 28 day timepoints for cell viability, osteogenic gene expression, alkaline phosphatase activity and histological analysis. Results indicated significant fold increases in cell metabolism at day 14 and 28, in both medium types compared to day 0 (p≤0.001). QRT-PCR data showed increased expression of osteogenic markers RUNX2 (p≤0.001), osteopontin (p≤0.001) and osteocalcin (p≤0.001) in both standard and osteogenic media with significantly higher RUNX2 and osteocalcin in osteogenic medium samples at day 28. Expression of osteogenic genes was significantly higher in young donor cells seeded on the washed bone compared to old donor cells, as was expression in BM-MSCs cultured on old donor bone compared to young bone. This implies that the washed bone was able to induce osteogenic differentiation in BM-MSCs, that young donor cells were better able to differentiate than old, and that old donor bone was better able to induce osteogenic activity. Additionally, patient-matched BM-MSCs and ASCs, and BM-MSCs and BM-MNCs were seeded onto washed bone cubes and cultured for 28 days in standard or osteogenic media, with gene expression and metabolic activity assessed. The washed bone was able to induce osteogenic differentiation of ASCs. Moreover, BM-MNCs when cultured on washed bone also expressed osteogenic genes, indicative of osteogenic differentiation. These results indicate the efficacy of a novel wash process in producing a biological acellular scaffold suitable for bone tissue engineering. Interestingly, data also suggests that the age of the cell donor and bone donor may effect osteogenic differentiation of seeded cells which has significant implications clinically.

Intervertebral disc (IVD) degeneration is associated with low back pain (LBP). It has been suggested that changes in the IVD physio-chemical microenvironment (i.e. hypoxia, reduced nutrient and acidic conditions) may lead to disc degeneration. Studying the response of human nucleus pulposus (NP) cells to these conditions could establish the causal relationship between IVD microenvironment and aberrant cellular behaviour, characteristic of disc degeneration. Human bone marrow mesenchymal stem cells (BM-MSCs) are a promising cell population for disc regeneration. However, knowledge of their survival and functioning in the microenvironment of the IVD is still lacking. Moreover, in vitro co-culture model studies that are used to study MSC/disc cell interaction, also need to consider the effect of the microenvironment on cellular responses. BM-MSCs and degenerate NP cells were cultured alone or co-cultured in monolayer under hypoxia (2%O2), reduced nutritional (2% serum or/and 5mM glucose) and acidic (moderate pH 6.8 or severe pH 6.5) conditions alone or in combination for 7 days. Cell viability, proliferation, gene and protein expression was assessed. Degenerate NP cells and BM-MSCs maintained good cell viability under all conditions. Both cell types demonstrated overall similar proliferation and gene and protein responses under the majority of the conditions and combinations studied. Hypoxia promoted aggrecan and versican matrix biosynthesis in both cell types. Nutrient deprived and moderate acidic conditions (pH 6.8) inhibited proliferation of both cell types. Interestingly the combination of hypoxia with these conditions showed a protective effect in modulating cell proliferation. These results imply that hypoxia may be beneficial in some instances. Nutrient deprived conditions had a relatively minor effect on degenerate NP cell gene and protein expression but these conditions specifically inhibited VCAN expression in BM-MSCs. The combination of hypoxia with these conditions increased or restored VCAN expression. Interestingly the combination of hypoxia with reduced glucose conditions increased aggrecan and versican matrix biosynthesis in both NP cells and BM-MSCs. The combination of hypoxia and complete nutrient deprived conditions (both reduced serum and reduced glucose) impaired ACAN, VCAN and PAX-1 gene and aggrecan and versican protein expression in degenerate NP cells implicating disc hypoxia and complete nutrient deprived combined microenvironment in accelerating degenerate changes in NP cells. In contrast, these conditions showed no such detrimental effects on BM-MSC gene and protein expression. pH 6.5 was critical for both cell types proliferation and ACAN and VCAN gene expression suggesting that severe acidic conditions may exacerbate degenerative changes and be inhibitory for implanted MSCs. Finally, a combination of hypoxia, complete nutrient deprived and moderate acidic conditions, reduced cell proliferation without affecting the gene expression profile of both cell types. IVD-like physio-chemical microenvironmental conditions also appeared to influence differentiation of BM-MSC and modulation of degenerate NP cell phenotype observed during co-culture. Noticeably hypoxia, reduced serum or reduced glucose conditions stimulated BM-MSC differentiation and modulation of degenerate NP cell phenotype. Hypoxia also increased or recovered changes at gene expression level in both BM-MSCs and degenerate NP cells under nutrient deprived (reduced serum or/and reduced glucose) conditions during co-culture. Degenerate NP cell and BM-MSC co-culture also showed noticeable increase in aggrecan and versican biosynthesis under hypoxia and reduced glucose combine conditions, implicating these in improving the co-culture responses. Severe pH condition alone, pH 6.8 in combination with hypoxia and finally all IVD-like physio-chemical conditions together compromised co-culture responses. Such results imply that IVD-like physio-chemical microenvironmental conditions may influence MSC based regenerative outcomes. This work has increased our understanding about the influence of disc harsh microenvironment on degeneration and regeneration processes.

As distrofias musculares progressivas (DMP) são um grupo de doenças genéticas hereditárias caracterizadas pela degeneração progressiva e irreversível da musculatura esquelética. A distrofia muscular de Duchenne (DMD) é a forma mais comum e mais grave de DMP, com prevalência de 1 a cada 3500 a 5000 meninos. Em geral, a perda da ambulação ocorre entre 9 a 12 anos e complicações respiratórias e cardíacas podem levar ao óbito a partir da segunda década. A pesquisa em terapia celular iniciou-se com o objetivo de reverter ou diminuir a progressão do processo distrófico através do repovoamento do músculo com células normais. Atualmente, acredita-se em um benefício terapêutico com base nas propriedades anti-inflamatórias, anti-fibróticas e imunomodulatórias das células tronco adultas (CTA). As CTAs mesenquimais são bastante heterogêneas quanto à sua composição celular o que ocasiona inconsistência de resultados. Por isso, a caracterização e separação de sub-populações através de marcadores específicos e o enriquecimento de culturas de CTA com um subtipo celular de interesse pode aumentar a robustez e o efeito das terapias. Uma dessas subpopulações é o pericito que, ao contrário das CTAs mesenquimais, foi bem descrito quanto à sua localização e função in vivo. Além disso, pericitos derivados de tecido adiposo humano aumentaram a sobrevida de camundongos duplo mutantes para distrofina e utrofina (dko). Dessa forma, este trabalho pretendeu comparar o potencial terapêutico de CTAs mesenquimais e pericitos de um mesmo tecido adiposo em camundongos dko. Conseguimos confirmar o resultado anterior, mostrando que os pericitos tendem a melhorar a sobrevida de animais tratados, sendo ainda melhores do que células mesenquimais, mas a melhora perdura somente durante o tratamento. A sobrevida é maior no começo do tratamento, sugerindo que o quanto antes o tratamento for iniciado, com animais mais jovens e sintomas mais leves, melhor poderá ser o resultado. Outras perguntas a serem pesquisadas na tentativa de melhorar o efeito terapêutico da terapia celular com pericitos são: número de injeções, quantidade de células a serem injetadas, tempo de tratamento e idade das células \"doadoras\" / Progressive muscular dystrophies (PMD) are inherited genetic diseases characterized by progressive muscle loss and weakness. Duchenne muscular dystrophy (DMD) is the most common and aggressive form of PMD, with incidence of 1 in every 3500-5000 boys. In general, patients with DMD are confined to wheelchairs around 9-12 years of age and death occurs due to respiratory and heart dysfunction after the second decade. Cell therapy research at first aimed to recover or slow down the dystrophic process by repopulating the patient\'s muscle with normal cells. However, nowadays it is believed also that therapeutic benefits occur by the anti-inflammatory, anti-fibrotic and immunomodulation properties of mesenchymal stem cells (MSC). MSC are constituted by an heterogeneous cell population and therefore, cell sorting of the subpopulation cell of interest is being done routinely. By doing this enrichment, the effect can be more robust and powerful. One of the cell populations of interest for research is pericyte, which are cells well defined regarding their in vivo function and location, as opposed to MSC. Besides that, pericytes derived from adipose tissue were successful in increasing survival of double knockout mice for dystrophin and utrophin (dko). The present work aimed to compare the therapeutic potential of MSC and pericytes derived from the same adipose tissue sample in the dko mouse model. We confirmed our previous results, showing that pericytes tend to improve the survival of treated mice, and are even better than MSC from the same source but the trend was statistically significant only during the treatment period. Additionally, we also observed that the survival was better in the beginning of treatment, suggesting that earlier treatment may lead to a better therapeutic effect. In an attempt to increase the therapeutic effect of these procedure other questions to be asked are: the number of injections and number of cells per injection, the duration of the treatment and the \"age\" of the donor cells

Células-tronco mesenquimais (CTM) apresentam tropismo a tumores, sendo importantes componentes do estroma tumoral. No cérebro, o nicho perivascular é uma importante fonte de CTM, as quais podem contribuir direta e/ou indiretamente para o desenvolvimento de tumores, embora os mecanismos envolvidos sejam pouco conhecidos. No presente trabalho, investigou-se a influência de CTM sobre a proliferação, capacidade invasiva e tumorigenicidade de células de Glioblastoma (GBM) humano. Sabe-se que CTM produzem TGFB1, uma citocina multifuncional envolvida em imunomodulação, proliferação, migração e transição epitelial-mesenquimal de células tumorais. Experimentos in vitro, realizados com meios condicionados de CTM de cordão umbilical humano com silenciamento permanente do gene TGFB1, demonstraram que o TGFB1 secretado por CTM é capaz de aumentar significativamente a proliferação e viabilidade de células de GBM humano da linhagem U87FP635. Esses resultados revelam uma importante ação parácrina dessa citocina regulatória, quando produzida por outros tipos celulares contidos no microambiente tumoral. Entretanto, sob condições experimentais que melhor mimetizam o microambiente tumoral, detectou-se que CTM também afetam o comportamento de células tumorais por um mecanismo alternativo, dependente de contato celular, mas independente dos níveis de TGFB1 secretados pelas CTM. Sob condições de cocultivo celular, envolvendo contato físico entre CTM e células de GBM U87FP635, detectou-se um aumento significativo na quantidade de células tumorais viáveis. Quando cultivadas na forma de esferoides tumorais, o contato com CTM aumentou a capacidade invasiva das células U87FP635. Finalmente, em modelo in vivo ectópico de GBM, células U87FP635 geraram tumores mais desenvolvidos quando coinjetadas com CTM. Esses efeitos pró-tumorigênicos foram observados tanto em contato com CTM controles, quanto com CTM contendo o gene TGFB1 permanentemente silenciado. Assim, esses achados indicam que CTM podem exercer efeitos pró-tumorigênicos por dois mecanismos alternativos e independentes: ação parácrina de TGFB1 secretado por CTM e ação mediada por contato célula-célula. Nas condições experimentais testadas, o mecanismo dependente de contato célula-célula demonstrou ser predominante. O estudo proteômico do secretoma dessas células identificou 126 proteínas diferencialmente expressas além de 10 proteínas exclusivamente detectadas em meios condicionados de cocultivos de CTM com células de GBM U87FP635. Cerca de 80% dessas proteínas exclusivamente secretadas pelo contato célula-célula são componentes de exossomos e estão envolvidas em proliferação celular e desenvolvimento tecidual. Esses resultados apontam uma interação dinâmica de comunicação entre CTM e células tumorais, e revelam algumas proteínas interessantes potencialmente envolvidas em uma ação pró-tumorigênica de CTM mediada por contato celular / Mesenchymal stem cells (MSC) display tropism to tumors, being recruited to its microenvironment where they comprise the tumor stroma. In brain, perivascular niche is a substantial source of MSC. Although mechanisms involved are poorly understood, MSC may directly and/or indirectly contribute to tumor development. Herein, the influence of MSC on the proliferation, invasiveness and tumorigenicity of human glioblastoma cells (GBM) was investigated. Moreover, since MSC releases TGFB1, a multifunctional cytokine with roles in immunomodulation, proliferation, migration and epithelial-mesenchymal transition of tumor cells, we analyzed if MSC-secreted TGFB1 affects GBM behavior. In vitro studies performed in the presence of conditioned media from human umbilical cord MSC with a stable TGFB1 gene expression knockdown showed that MSC-secreted TGFB1 is able to significantly increase the proliferation and viability of a GBM cell line (U87FP635). These results revealed an important paracrine effect of this regulatory cytokine when secreted by other cell types in tumor microenvironment. However, under experimental conditions that better mimic the tumor microenvironment, it was found that MSC also affect tumor cell behavior by an alternative mechanism dependent on cell-cell contact, but independent of TGFB1 levels secreted by MSC. The cell-cell contact between MSC and GBM U87FP635 significantly enhaced tumor viable cells. Additionally, the spheroid tumor cell culture with MSC cell contact increased the invasiveness of U87FP635 cells. Finally, in vivo ectopic implantation model showed more developed tumors when GBM U87FP635 cells were coinjected with MSC. These pro-tumorigenic effects were found both in cell-cell contact with control MSC, as with MSC containing TGFB1 gene expression knockdown. Thus, these findings indicate that MSC can exert pro-tumorigenic effects by two alternative and independent mechanisms: paracrine action of TGFB1 secreted by MSC and action mediated by cell-cell contact. In the present experimental conditions, the cell-cell contact-dependent mechanism was predominant. The secretome proteomic study of those cells identified 126 differentially expressed proteins as well as 10 proteins exclusively detected in conditioned media from GBM U87FP635 cell cocultures with MSC. About 80% of proteins uniquely secreted by cell-cell contact are exosomes components and are involved in cell proliferation and tissue development. These results indicate a dynamic interaction of communication between MSC and tumor cells and reveal some interesting proteins potentially involved in a MSC pro-tumorigenic action mediated by cell contact

Fissura de lábio com ou sem fissura de palato não-sindrômica (FL/P NS) é uma malformação craniofacial frequente, com modelo de herança multifatorial, onde fatores de risco genéticos e ambientais atuam na manifestação da doença. Variações nos níveis de expressão gênica têm sido apontadas como um importante mecanismo de susceptibilidade a doenças complexas, e variantes no DNA que regulam esses níveis de expressão (eQTL) têm sido combinadas a estudos de associação para auxiliar no entendimento da etiologia de algumas doenças. No presente trabalho, integramos eQTLs e estudo de associação para 1) verificar se variantes já associadas com FL/P NS possuem um papel regulatório em células-tronco de músculo orbicular do lábio (OOMMSC, um tecido afetado em FL/P NS), e 2) verificar se eQTLs mapeados em OOMMSC teriam associação com a mesma. Para o primeiro objetivo, verificamos a correlação entre os genótipos das variantes rs642961 e rs590223 e os níveis de expressão de IRF6, e também entre rs987525 e os níveis de expressão de MYC. Não encontramos correlação para nenhuma das três variantes testadas. É possível que essas variantes possuam um papel funcional em algum momento específico da embriogênese, ou mesmo que não tenhamos detectado essa correlação devido ao número amostral analisado (N=46). Para o segundo objetivo, realizamos um estudo de associação do tipo caso-controle dos eQTLs rs5011163, rs1505443, rs4793213, rs4793229 e rs1242500. Não encontramos associação entre nenhuma das cinco variantes e FL/P NS. Uma possível explicação para a associação negativa seria a significância marginal dessas variantes como eQTLs em OOMMSC. Além disso, estudos com baixo poder, como o mapeamento de eQTLs em OOMMSC realizado em outro projeto pelo nosso grupo, geralmente detectam os eQTLs de maior efeito, sendo esses frequentemente compartilhados entre tecidos, e, assim, podem não ter relevância para a doença em si. Outros eQTLs de OOMMSC, selecionados por critérios diferentes do presente estudo, estão sendo testados para associação com FL/P NS, o que nos permitirá avaliar a relevância dessa abordagem para detectar variantes de susceptibilidade a FL/P NS / Nonsyndromic cleft lip with or without cleft palate (NSCL/P) is a frequent craniofacial malformation, with a multifactorial model of inheritance, in which genetic and environmental risk factors act in disease manifestation. Variation of gene expression has been pointed as an important susceptibility mechanism to complex diseases, and DNA variants that regulate expression levels (eQTLs) have been combined with association studies to help elucidate the etiology of some diseases. In the present work, we integrate eQTL and association studies to 1) verify if variants associated with NSCL/P have a regulatory role in orbicularis oris muscle mesenchymal stem cells (OOMMSC, a tissue affected by NSCL/P); and 2) verify if eQTLs mapped in OOMMSC are associated with the disease. For the first goal, we verified the correlation of the rs642961 and rs590223 genotype variants with IRF6 expression levels, and also between the rs987525 genotype and MYC expression levels. We did not find correlation for any of the three variants tested. Possibly, these variants have a functional role in specific moments of embryogenesis, or sample size (N=46) was insufficient to detect correlation. For the second goal, we did a case-control association study for eQTLs rs5011163, rs1505443, rs4793213, rs4793229 and rs1242500. We did not find association between these variants and NSCL/P. The negative association could be explained by the marginal significance of these variants as eQTLs in OOMMSC. Besides, low-power studies, as the OOMMSC eQTL mapping performed in another project by our group, usually detect eQTLs of larger effect, which are frequently shared among tissues; therefore, they may not be relevant for the disease itself. Other eQTLs, selected under different criteria, are currently being tested for association with NSCL/P, which will enable us to evaluate the relevance of this approach to detect susceptibility variants for NSCL/P

A fissura lábio-palatina não-sindrômica (FLP NS) é uma doença multifatorial, determinada pela interação entre fatores genéticos e ambientais e sua incidência é estimada entre 0,34 e 2,29 a cada 1000 nascimentos. Trata-se de uma embriopatia causada por erros durante a morfogênese orofacial, a qual depende de uma fina regulação de mecanismos como proliferação celular, remodelagem de matriz extracelular, e transição epitélio-mesenquimal. Apesar de intensos esforços para se determinar fatores genéticos e ambientais de susceptibilidade, a etiologia desta malformação permanece pouco compreendida. Vários loci associados às FLP NS vêm sendo identificados por meio de estudos de mapeamento gênico convencionais, entretanto, a grande maioria dos resultados não se replica em diferentes estudos, e não há clareza acerca do efeito funcional das variantes detectadas. Neste contexto, uma abordagem interessante para investigar a etiologia da doença é a análise de expressão gênica, que pode ser utilizada para identificar alterações de vias biológicas que convergem na manifestação do quadro clínico. Em vista disso, neste trabalho nós utilizamos a análise do transcriptoma de células-tronco de polpa dental de pacientes portadores de FLP NS, com o intuito de identificar padrões de expressão relacionados a mecanismos biológicos relevantes para a embriopatogênese da doença. Obtivemos padrões de expressão que sugerem desregulação de mecanismos associados à remodelagem de matriz extracelular e à transição epitélio-mesenquimal. Além disso, ao utilizarmos diferentes condições de cultura celular, verificamos em uma nova amostra de pacientes a desregulação de vias biológicas relacionadas ao reparo de DNA e checkpoint do ciclo celular. Nossos dados revelam a aplicabilidade das células-tronco de polpa dental para este tipo de abordagem, e indicam que tais perfis de expressão podem levar ao acometimento da morfogênese lábio-palatina. Além disso, mostramos pela primeira vez uma conexão entre desregulação de expressão gênica e a documentada maior incidência de formas esporádicas de câncer em famílias segregando a FLP NS. Nossos resultados abrem novas possibilidades para a investigação da etiologia das FLP NS, e ajudarão na compreensão dos eventos embrionários que predispõem a essa malformação. / Non-syndromic cleft lip and palate (NSCL/P) is a multifactorial disease determined by the interplay between genetic and environmental factors, with a variable incidence of 0.34-2.29:1000 births. This malformation arises from errors during lip and palate morphogenesis, which requires tight regulation of biological mechanisms such as cellular proliferation, extracellular matrix remodelling, and epithelial-mesenchymal transition. Albeit much effort has been put into determining the genetic and environmental factors underlying disease susceptibility, the aetiology of NSCL/P remains obscure. Many candidate loci have been identified through conventional gene mapping strategies, however, there is a general lack of reproducibility across studies, and there is no consensus with regard to the functional implications of the identified genetic variants. In this context, an alternative approach resides in assessing differential expression patterns to identify alterations in biological networks that could lead to phenotype manifestation. Here, we analysed the transcriptome of dental pulp stem cells from NSCL/P patients in order to pinpoint dysregulated pathways involved in the embryopathogenesis of the disease. We encountered expression patterns related to dysregulation of extracellular matrix remodelling and epithelial mesenchymal transition. Moreover, by subjecting a novel NSCL/P sample to differential cell culture conditions, we observed abnormal transcription of genes partaking in DNA repair and cell cycle checkpoint pathways. Our results show the applicability of dental pulp stem cells to this strategy and suggest that the observed expression patterns could lead to impairment of lip and palate morphogenesis. Moreover, we described for the first time a connection between abnormal gene expression in these individuals and the elevated occurrence of sporadic cancer types in NSCL/P families. Our results open new possibilities to investigate the aetiology of NSCL/P and provide further insight into the ontogenetic events underlying disease predisposition.

La grande originalité de mon projet réside dans la génération de cellules stromales mésenchymateuses (MSCs) à partir de cellules souches pluripotentes induites humaines (iPS). Je rappellerai les propriétés phénotypiques, de multipotence et immunosuppressives des MSCs et m’attarderai sur leurs différents mécanismes immunomodulateurs. Cependant, leur nombre limité et leur isolation difficile limitent leur utilisation thérapeutique nécessitant une autre source de cellules.Mon travail a donc été de générer et de caractériser des MSCs issues d’iPS (huiPS-MSCs). L'avantage des huiPS-MSCs réside dans leur plus grande disponibilité et la possibilité d'en avoir à volonté. Encore faut-il valider l’intérêt thérapeutique potentiel de ces huiPS-MSCs. Premièrement, mes résultats in vitro montrent que les huiPS-MSCs présentent une activité immunosuppressive sur les lymphocytes T (LT) activés conduisant à une induction de LT régulateurs FoxP3+ fonctionnels. Deuxièmement, dans une approche plus axée sur la thérapie, j’ai analysé in vivo l’activité́ immunosuppressive des huiPS-MSCs dans un modèle de réaction xénogénique de greffon contre l'hôte (souris immunodéficientes NSG injectées avec des LT humains). Je montre clairement, après traitement avec les huiPS-MSCs, une réduction de la proportion de LT humains producteurs de cytokines inflammatoires (IFNγ et TNFα) typiques de la pathologie et l’apparition concomitante de LT présentant un phénotype régulateur (production d’IL10 et expression de FoxP3). La fin de mon travail a été de caractériser moléculairement la régulation de l’expression de PD-L1, une molécule immuno-régulatrice puissante, entre les MSCs issues de la moelle osseuse (BM-MSCs) de donneurs sains et nos huiPS- MSCs. Les huiPS-MSCs ont une expression constitutive de PD-L1, qui est absente sur les BM-MSCs. J’ai analysé les microARNs susceptibles de limiter l’expression de PD-L1, j’ai pu en identifier plusieurs. En mesurant leur expression dans les différentes MSCs à notre disposition, je montre que cette expression est inverse par rapport à celle de PD-L1. J’ai ainsi pu démontrer l’activité immunosuppressive de nos huiPS-MSCs in vitro et in vivo avec une perspective d’induction de tolérance immune, et caractériser la régulation de l’expression de PD-L1, molécule immunosuppressive exprimée par les huiPS-MSCs. / The mesenchymal stromal cells (MSCs) present many features that render attractive as therapeutic cells. Their phenotype, multipotency and immunosuppressive properties are well described. Nevertheless, major restriction for their clinical use is due to the limited in vitro expansion and low quantity of cells that can be collected from adult tissues. The originality of my project consisted in the generation of mesenchymal stromal cells (MSCs) from human induced pluripotent stem cells (iPS). These huiPS-MSCs could fulfill some of the specification required to improve MSCs use in therapeutic approaches: welldefined and unlimited number of cells with reproducible functional characteristics. In a first approach, I characterized the huiPS-MSCs generated in the laboratory. My results highlight the immunosuppressive activity in vitro of the huiPS-MSCs on T-cell stimulation that induces a switch in T-cell cytokine polarization toward the generation of Treg cells. Secondly, in a more therapy-oriented approach, I analyzed in vivo immunosuppressive activity of huiPS-MSCs in a xenogeneic graft versus host model (NSG immunodeficient mice injected with human T lymphocytes). My data showed significantly reduced percentages of human-differentiated T cells producing Th1 inflammatory cytokines (IFNγ and TNFα). By contrast, T cells producing IL-10 and FoxP3+ Treg cells, absent in nontreated animals, were detected in huiPS-MSCs treated mice, confirming the in vitro results of a tolerizing process. The end of my work was to characterize the molecular regulation of the expression of PDL1, an immunoregulatory molecule expressed by the MSCs. Comparing bone marrow MSCs (BM-MSCs) from healthy donors and our huiPS-MSCs, I showed that the huiPSMSCs have a constitutive expression of PD-L1, which is absent on BM-MSCs. Analysing microRNAs that could limit the expression of PD-L1, I could identify several microRNAs which expression is inverse to the expression of PD-L1. For the first time, my results highlight the immunosuppressive activity of huiPS-MSCs on human T-cell stimulation with a concomitant generation of human Treg cells in vivo and characterize the regulation of PD-L1 expression, an immunosuppressive molecule expressed by the MSCs. They may favor the development of new tools and strategies based on the use of huiPS cells and their derivatives for the induction of immune tolerance.

As Distrofias Musculares Progressivas constituem um grupo de doenças genéticas caracterizadas por uma degeneração progressiva e irreversível da musculatura esquelética. As diferentes abordagens terapêuticas propostas para esse grupo de doenças têm como enfoque restaurar a proteína muscular deficiente por meio da terapia celular ou terapia gênica, ou o tratamento dos sinais e sintomas patológicos do músculo pela administração de fármacos e/ou fatores de crescimento. A combinação de diferentes estratégias pode aumentar a eficiência do reparo muscular. Deste modo, este trabalho tem como objetivo principal avaliar o potencial terapêutico das célulastronco mesenquimais (MSCs) associadas ao fator de crescimento semelhante à insulina (IGF-1) para diferentes tipos de distrofias musculares. Inicialmente avaliamos o potencial miogênico de MSCs humanas de cordão umbilical in vitro. Nossos resultados demonstraram que os fatores solúveis liberados pelo músculo distrófico de camundongos mdx foram capazes de induzir a diferenciação miogênica terminal das células-tronco. Além disso, verificamos que o IGF-1, por si só, é capaz de promover a miogênese de MSCs, com mais eficiência que os protocolos de indução padrões. Ainda nos estudos in vitro, demonstramos que MSCs são capazes de interagir com células musculares de pacientes com Distrofia Muscular de Duchenne (DMD) e restaurar a expressão de distrofina, quando cultivadas em meios suplementados com IGF-1. Frente a estes resultados, prosseguimos com os estudos em modelos animais, in vivo, e demonstramos que as MSCs humanas de cordão umbilical e IGF-1, quando administrados conjuntamente por via sistêmica, são capazes de modular a inflamação, reduzir a fibrose, aumentar o reparo muscular e, consequentemente, promover uma melhora clínica significativa do músculo de camundongos LAMA2dy/2j - modelo murino de Distrofia Muscular Congênita. Cabe ressaltar que as células humanas não foram rejeitadas após administração sistêmica em modelos animais não imunossuprimidos. Esses resultados suportam o potencial uso combinado de MSCs de cordão umbilical humano e IGF-1 no tratamento de distrofias musculares. Contudo, a confirmação destes dados em um modelo animal de grande porte, como os modelos caninos de distrofia muscular, é de extrema importância visando o entendimento dos mecanismos envolvidos no reparo muscular e avaliação de eventuais efeitos adversos, o que pode representar um passo importante para o início dos testes clínicos em pacientes / Progressive muscular dystrophies are a clinically and genetically heterogeneous group of disorders caused by the deficiency or abnormal muscle proteins, resulting in progressive degeneration and loss of skeletal muscle function. Strategies for the development of a muscular dystrophy therapy have focused on the possibility of restoring the defective muscle protein by cell therapy or on delivery of growth factors to treat or ameliorate muscular pathology symptoms. Combining both strategies could be a very useful approach to enhance the efficiency of muscle repair. The aim of this study is to evaluate the therapeutic potential of human mesenchymal stem cells (MSCs) from umbilical cord tissue combined with IGF-1 for muscle regeneration. Firstly, we verified the myogenic potential of these cells in vitro. Our results demonstrated that the soluble factors released from mdx dystrophic muscle were able to promote the myogenic differentiation of MSCs. Moreover, we showed that IGF-1 is capable of enhancing considerably the myogenesis of human MSCs from UC in vitro. More interestingly, we showed that IGF-1 enhances the interaction of MSCs and DMD muscle cells in coculture and the restoration of dystrophin expression. Subsequently, our in vivo studies revealed that the association of IGF-1 and MSCs markedly reduced muscle inflammation and fibrosis, and significantly improved muscle strength in LAMA2dy/2j mice, a murine model for congenital muscular dystrophy. It is important to point out that human cells are not rejected even in xenotransplants without immunosuppression. In summary, our results suggest that a combinatorial strategy of both IGF-1 and MSCs could enhance the efficiency of muscle repair and, therefore, should be further tested as a potential therapeutic approach in muscular dystrophies. However it is important to repeat the experiments on canine dystrophic model (GRMD; Golden Retriever Muscular Dystrophy) - in order to enhance our knowledge about the mechanism involved in muscle repair and monitor any eventual long-term side effects, which could represent an important point to start the clinical trial in patients

A síndrome mielodisplásica (SMD) é uma doença hematológica heterogênea, caracterizada por hematopoese anormal, displasia e instabilidade genômica, portanto, a análise citogenética é determinante no diagnóstico, prognóstico e acompanhamento evolutivo da doença. Considerando que as células hematopoéticas (CHs) e as estromais mesenquimais multipotentes (CTMs) estão em estreita associação, estudos que visem à caracterização destas poderão contribuir para elucidar os mecanismos que governam a progressão tumoral e identificar novos alvos terapêuticos. Objetivo: Caracterizar e comparar as CHs e CTMs derivadas de pacientes através da citogenética convencional e molecular para os genes aurora cinase A e B. Avaliar as propriedades biológicas das CTMs derivadas de SMD e controles saudáveis. Métodos: o estudo iniciou-se com a avaliação clinica de 25 pacientes e 8 controles saudáveis doo HCFMRP-USP e HAC-Jaú. Em seguida, foi realizada a análise cariótipica das CHs e CTMs da medula óssea pelo bandamento G e por FISH para os genes aurora A e B e o perfil imunofenotípico, bem como potencial de diferenciação em adipócito e osteócito das CTMs de pacientes portadores de SMD e controles saudáveis. Resultados: A avaliação clínica mostrou plaquetopenia (76%), neutropenia (100%), hemoglobina baixa (16%). A análise citogenética das CHs revelou cariótipo alterado em 13 pacientes (52%), com cariótipo complexo resultando em alterações numéricas e estruturais. Ao contrário, nas CTMs, o cariótipo se mostrou alterado em sete pacientes (28%) e um padrão de menor complexidade, apenas quatro pacientes apresentaram alterações nas duas populações celulares, porém, diferentes. Foram encontradas apenas alterações numéricas (sendo 86% monossomia e 14% ganho de cromossomo). As CHs e CTMs dos controles apresentaram cariótipos 100% normais. Na análise de FISH não foi evidenciada amplificação dos genes AURKA e AURKB. As CTMs dos pacientes e controles apresentaram-se semelhantes quanto à morfologia e potencial de diferenciação. Entretanto, as CTMs de pacientes mostraram-se alteradas para dois antígenos de superfície, CD90 e CD146, os quais mostraram níveis de expressão mais elevados nas amostras dos pacientes (p= 0,04, p = 0,001 respectivamente). Conclusão: Observou-se que as CTMs se encontram alteradas embora em menor frequência e diferindo das alterações encontradas nas CHs. Esses dados sugerem que as CTMs devem exercer importante papel na progressão tumoral e devem ser consideradas como alvos na busca de novas terapias e melhor esclarecimento dos mecanismos que governam a progressão tumoral. Apesar de não ter evidenciado amplificação dos genes AURKA e AURKB em SMD, estudos futuros que visem avaliar o nível de expressão dessas enzimas em pacientes portadores ou não de alterações citogenéticas poderão contribuir para a compreensão do envolvimento ou não desse gene com a evolução da doença. Além disso, não foi evidenciada associação de anemia profunda e citogenética alterada. / The myelodysplastic syndrome (MDS) is a heterogeneous hematologic disease characterized by abnormal hematopoiesis, dysplasia and genomic instability, therefore, cytogenetic analysis is crucial in the diagnosis, prognosis and monitoring of disease evolution. Whereas hematopoietic cells (CHs) and stromal multipotent mesenchymal (MSCs) are in close association studies aimed at the characterization of these may help to elucidate the mechanisms that govern tumor progression and identify novel therapeutic targets. Objective: To characterize and compare the CHs and MSCs derived from patients by conventional cytogenetics and molecular genes aurora kinase A and B. To evaluate the biological properties of MSCs derived from MDS and healthy controls. Methods: The study began with the clinical evaluation of 25 patients and eight healthy controls HCFMRP dooUSP and CH-Jau. Next, we performed a karyotypic analysis of CHs and MSCs from bone marrow by G-banding and FISH for aurora A and B genes and immunophenotypic profile and potential to differentiate into adipocytes and osteocytes of MSCs in patients with MDS and controls healthy. Results: The clinical evaluation showed thrombocytopenia (76%), neutropenia (100%), low hemoglobin (16%). The cytogenetic analysis revealed karyotype of CHs changed in 13 patients (52%), resulting in complex karyotype with numerical and structural changes. In contrast, in MSC, the karyotype was abnormal in seven patients (28%) and a pattern of lower complexity, only four patients had changes in both cell populations, however, different. Were found only numerical changes (monosomy being 86% and 14% gain in chromosome). The CHs and MSCs controls showed 100% normal karyotypes. In FISH analysis there was no evidence of gene amplification and AURKA AURKB. The MSCs of patients and controls were similar regarding the morphology and differentiation potential. However, the CTMs of patients proved to be changed to two surface antigens, CD90 and CD146, which showed higher expression levels in samples of patients (p = 0.04, p = 0.001 respectively). Conclusion: Furthermore, it was observed that the MSCs are changed although less frequently and differing from changes found in CHs. These data suggest that MSCs should play an important role in tumor progression and should be considered as targets in the search for new therapies and better explain the mechanisms that govern tumor progression. Although not shown AURKA amplification of genes in MDS and AURKB, future studies aimed at assessing the level of expression of these enzymes in patients with or without cytogenetic alterations may contribute to the understanding of the involvement or not of this gene with the disease. This study can not associate with profound anemia cytogenetic changes.

Orientador: Dimas Tadeu Covas / Banca: José Orlando Bordin / Banca: Carmino Antônio de Souza / Banca: Orlando Castro e Silva Júnior / Banca: Aparecida Maria Fontes / Resumo: Alguns trabalhos realizados recentemente relatam que as células-tronco mesenquimais (CTM) podem ser induzidas à aquisição de marcadores hepatocíticos pelo transplante em modelos animais de dano hepático, ou pelo cultivo in vitro com fatores de crescimento e citocinas. O presente trabalho teve por objetivo avaliar o comportamento das CTM frente à indução da diferenciação hepatocítica. As CTM foram isoladas da medula óssea de quatro doadores saudáveis, caracterizadas e submetidas ao protocolo de indução à diferenciação hepatocítica in vitro e in vivo. As células induzidas in vitro apresentaram mudanças na sua morfologia, mostrando a morfologia semelhante à do hepatócito, porém, o perfil imunofenotípico não foi modificado. As células induzidas também não apresentaram o aumento dos transcritos de albumina, citoqueratina 18 e citoqueratina 19 quando analisadas por RT-PCR em tempo real, e não alteraram a expressão de albumina, citoqueratina 18 e alfafetoproteína como demonstrado por imunofluorescência. Quando analisadas in vivo, as CTM demonstraram o potencial migratório para o tecido hepático danificado de camundongos imunodeficientes. Em conjunto, os resultados sugerem que as CTM da medula óssea não são capazes de se diferenciar em hepatócitos quando estimuladas in vitro pela metodologia utilizado neste trabalho, mas são capazes de migrar para o tecido hepático danificado in vivo, o que sugere o seu papel no reparo do fígado. A contribuição para o reparo pode estar associada com o efeito parácrino dessas células. / Abstract: Some recently works have been reported that mesenchymal stem cells (MSC) can be induced to the acquisition of hepatocytic markers for the transplant in animal models of liver damage, or for the in vitro culture with growth factors and cytokines. The present work aim is to evaluate the behavior of the MSC in front of the induction of the hepatocytic differentiation. The MSC was isolated from the bone morrow of 4 normal donators, characterized and submitted to the protocol of in vitro and in vivo induction of hepatocytic differentiation. The in vitro induced cells showed morphology changes acquiring hepatocytes-like morphology. However, the immunophenotypic profile of those cells was not modified. The induced cells did not present increase of the albumin, cytokeratin 18 and cytokeratin 19 transcripts, when analyzed by real time RTPCR. The expression of albumin, cytokeratin 18 and alpha foetoprotein was also not modified as demonstrated by immunofluorescence. In vivo, the MSC have demonstrated the migratory potential for the damaged liver of immunodeficient mice. Together, the results suggest that the bone morrow MSC are not capable of in vitro hepatocytic differentiating according to the approach in this work, but are capable to homming into damaged hepatic tissue in vivo. This migration capacity suggests their role in the repair mechanisms. / Doutor