Immunosuppressive drugs have been used for many years for the treatment of autoimmune diseases and post-transplantation treatment. While these drugs have a lot of advantages, they also show several undesirable side effects. The most common side effects are higher blood pressure, lowered renal function and susceptibility to infections. Therefore, in recent years there has been a demand for other medical approaches that do not exhibit the above-mentioned adverse effects. Among one of the newly tested approaches is the application of mesenchymal stem cells (MSCs), which possess several advantages such as immunomodulatory abilities, safety and relatively easy isolation, however, stem cell use alone has not yet provided sufficiently strong immunomodulation. Only a small part of research of MSCs is focused on their use in the combination with immunosuppressive therapy. Therefore, in my thesis I focused on the model which allows to reduce the dose of immunosuppressive drugs in the combination with MSCs. Combined therapy is more advantageous than both monotherapies thanks to lower dosages of these drugs used. It enables to decrease negative side effects of immunosuppressive drugs, when combined with MSCs to provide sufficient immunomodulation in comparison to classical therapy. The aim of my work was to...

Metastasizing is responsible for 90% of death in cancer patients. Metastatic tumour cells have several strategies that they use to invade surrounding tissues - they can migrate together or individually. When individual cells migrate, tumour cells adopt two different morphologies. They are either elongated and migrate using the proteolytically active mesenchymal mode, or they are rounded and migrate in the amoeboid mode. Metastatic tumour cells can switch between these modes, which complicates the development of effective migrastatics. In this work, we focused on the effect of inflammatory signalling on metastatic cell migration. We worked with cell lines of malignant human melanoma, which adopt a mixed morphology and show both amoeboid and mesenchymal phenotype during migration. Upon stimulation of melanoma human cells with interferon beta, a mesenchymal to amoeboid transition occurs. Interferon beta appears to induce amoeboid morphology by maintaining high levels of the ISGF3 complex, which is composed of the heterodimer of STAT 1 and STAT 2 proteins and the IRF9 protein. Upon blocking of Jak / Stat signalling pathway by negative regulators, human melanoma cells return to mesenchymal morphology. Key words - invasiveness, mesenchymal-ameboid transition, interferons, inflammation, migration, metastases

Maintaining of homeostasis is essential for the survival of the organism. Stress disturbs the homeostasis and prepares the organism for mental or physical stress. During the stress situation, the endogenous stress factors are released. Through these factors stress affects tissue regeneration, the immune system and other metabolic processes. Chronic stress impacts many parts of body and mind and has a negative effect on these processes. Acute stress has the opposite effect. Mesenchymal stem cells (MSCs) participate in regenerative processes and modulate the immune system. Therefore, it can be assumed that stress will affect on MSCs. The aim of this study was to investigate the effect of stress factors, norepinephrine and corticosterone on the properties and function of MSCs in acute and chronic stress model. In our study, stress factors did not affect the morphology, vitality and differentiation of MSCs. However, the metabolic activity of MSCs was reduced regardless of the duration of their action. The action of stress factors also affected the production of some immunologically relevant molecules and proteins. Unfortunately, the results did not show a clear effect of stress factors on the lymphocyte modulation by MSCs. Key words: mesenchymal stem cells, catecholamines, adrenergic receptors,...

Infectious diseases are the worldwide leading cause of morbidity and mortality. Sepsis is the major cause of death in infectious diseases. It is one of the most serious and also one of the most difficult treatable conditions of contemporary medicine. Sepsis is the main cause of death in intensive care units. Causal therapy of sepsis does not yet exist. With a far better understanding of patho/physiological mechanism of sepsis, it is possible to model new preclinical experiments to verify the efficiency and security of new therapeutic procedures. Large animal experiments in progressive sepsis, with the use of domestic porcine, play a vital role. Long-standing experience with this model and similarity to human facilitate the realization of more complex experiments with potential for the relevant translation of results into the subsequent clinical studies on human subjects. The objective of this doctoral dissertation was to assess on the clinically relevant model: 1) the efficiency and security of extracorporeal membrane oxygenation in the event of vasoplegic septic shock; and 2) the benefit of two innovative therapeutic approaches to treatment of sepsis: a) the intravenous administration of mesenchymal stem cells; and b) the activation of the neuro-inflammatory reflex through the vagus nerve stimulation.

Regenerative treatment of focal hyaline cartilage defects could prevent or delay the development of secondary osteoarthritis. Current surgical techniques result partly in i) the formation of mechanically inferior fibrous cartilage or ii) present the disadvantage of the donor site morbidity from harvesting cartilage biopsy as well as iii) the dedifferentiation of chondrocytes due to in vitro expansion and iv) the reduced re-differentiation potential of in vitro expanded chondrocytes. The self-healing capacities of injured and degenerated articular cartilage revealed a promising target cell population for a regenerative, autologous treatment of these defects using mesenchymal stromal cells (MSCs). Several case studies, randomized and controlled clinical studies showed the general ability of autologous, bone marrow-derived, expanded MSC transplantation to regenerate articular cartilage lesions [1]. However, these two-stage approaches are based on time- and cost-consuming expansion of MSCs under good manufacturing practice (GMP) conditions and hold a risk of contamination during this process. In 2010, CD271, the low-affinity nerve growth factor receptor, was described as a suitable surface marker to enrich MSCs from human bone marrow aspirate intraoperatively [2]. The aim of the present dissertation was to investigate the feasibility of generating cartilage grafts from either ovine (study no. 1) and human (study no. 2) non-expanded CD271+ bone marrow cells in a collagen type I hydrogel. Study no. 1 (“Point-of-care treatment of focal cartilage defects with selected chondrogenic mesenchymal stromal cells - An in vitro proof-of-concept study”) investigated several surface marker candidates for the prospective MSC separation and examined their potential of resulting colony-forming units, respective their yield of potent MSCs [3]. This study was conducted with ovine bone marrow samples. CD271 was the most effective surface marker to isolate the target cell population. Subsequently, CD271+, CD271- and unseparated mononuclear cells (MNCs), containing the MSCs, were used to generate cartilage grafts without an expansion of these cells in monolayer culture. It could be proven, that ovine CD271+ cells were able to generate a potent hyaline cartilage graft. Study no. 2 (“Single-stage preparation of human cartilage grafts generated from bone marrow-derived CD271+ mononuclear cells”) was performed as the final translational step from animal-derived bone marrow to human donor material and is therefore strengthening the therapeutically focus of the entire work [4]. Briefly, eight bone marrow aspirates were used for MNC isolation and subsequent magnetic cell separation (MACS). The resulting CD271+ and CD271- MNCs were compared to unseparated MNCs. Subsequently, they were seeded in a clinically approved collagen type I hydrogel and cultivated for up to 5 weeks to investigate the progression of the chondrogenic differentiation processes. Graft analysis included cell viability visualization by live/dead staining, determination of the DNA and the secreted sulphated glycosaminoglycan (sGAG) content as well as the immunohistochemical staining for typical chondrogenic differentiation markers and the extracellular matrix molecules aggrecan and collagen type II. A proliferation of cells in the generated grafts was shown of CD271+ and unsep, but not CD271- MNCs. Hence, the cell number was 2.8-fold higher after 35 days compared to the first day for CD271+ MNCs grafts, while CD271- MNCs did not proliferate in the grafts and unsep MNCs showed only a slight increase in cell number. The chondrogenic potential was measured by quantification of freshly produced sGAGs and the expression of chondrogenic markers. In grafts with CD271+ MNCs, sGAG production increased over time and reached its maximum at day 35, whereas grafts with CD271- MNCs showed no measurable sGAG deposition. The amount of sGAG in unsep MNC grafts increased only slightly over the whole cultivation period. Aggrecan and collagen type II staining varied considerably between the MNCs donors. Collagen type II positive staining was observed in CD271+ MNC grafts (5/8 donors) and unsep MNC (2/8) grafts. In comparison to macroscopically healthy cartilage, three-dimensional grafts of the CD271+ group yielded a proceeding extracellular matrix production. In summary, CD271+ MNCs showed the highest proliferation rate, cell viability, sGAG deposition and cartilage marker expression compared to the CD271- or unseparated MNC fractions in in vitro generated three-dimensional cartilage grafts. Therefore, the presented work demonstrated the feasibility of generating a cartilage graft from CD271+ bone marrow-derived MNCs in a clinically approved collagen type I hydrogel without a previous monolayer expansion of these cells. This will enable the intraoperative purification of CD271+ MNCs, which contain the majority of colony-forming MSCs, by MACS technology. The clinical application will be possible with currently available and clinical approved cell separation devices. Providing a cartilage graft with non-expanded CD271+ MNCs by a fast and simple intraoperative therapeutic approach fulfils the need for a “single-step, tissue-engineered solution to focal cartilage defects, and elimination of the morbidity of the donor defect” as requested by the editors of the journal Arthroscopy [5]. References of the summary 1. Filardo G, et al. (2016). Stem cells in articular cartilage regeneration. J Orthop Surg Res 11:42. 2. Jones E, et al. (2010). Large-scale extraction and characterization of CD271+ multipotential stromal cells from trabecular bone in health and osteoarthritis: implications for bone regeneration strategies based on uncultured or minimally cultured multipotential stromal cells. Arthritis Rheum. 62:1944–1954. 3. Petters O, et al. (2018). Point-of-care treatment of focal cartilage defects with selected chondrogenic mesenchymal stromal cells-An in vitro proof-of-concept study. J Tissue Eng Regen Med. 4. Petters O, et al. (2018). Single-Stage Preparation of Human Cartilage Grafts Generated from Bone Marrow-Derived CD271+ Mononuclear Cells. Stem Cells Dev 27:545–555. 5. Lubowitz JH and GG Poehling. (2009). Saving our cells: Advances in tissue engineering for focal cartilage defects. Arthroscopy: the journal of arthroscopic & related surgery: official publication of the Arthroscopy Association of North America and the International Arthroscopy Association 25:115–116.:1 Introduction 1 1.1 Articular cartilage 1 1.2 Cartilage lesions 2 1.3 Self-healing capability of articular cartilage 3 1.4 Treatment option for cartilage lesions 4 1.5 Mesenchymal stromal cells in cartilage regeneration 6 2 Rationale 8 3 Publication manuscripts 9 Point-of-care treatment of focal cartilage defects with selected chondrogenic mesenchymal stromal cells - An in vitro proof-of-concept study 9 Single-stage preparation of human cartilage grafts generated from bone marrow-derived CD271+ mononuclear cells 21 4 Summary 33 5 References 35 6 Appendix 42 7 Declaration of Authorship 47 8 Curriculum vitae 48 9 Publications 49 10 Acknowledgements 49

Cells can release lipid bilayer vesicles of endosomal and plasma membrane origin, which are known as exosomes or extracellular vesicles (EVs). EVs contain diverse shuttling lipids, RNA and transmembrane proteins, and play an important role in communicating between neighboring or distant cells. Breast cancer is the most commonly diagnosed malignancy, with over 2 million new cases in 2018, and is the leading cause of cancer mortality in women all over the world. Some observational studies have suggested that breast cancer is more likely to develop among women who have type 2 diabetes; the association is clear in postmenopausal women. Moreover, women with type 2 diabetes diagnosed before, at the same time, or after breast cancer diagnosis, have decreased overall survival compared to women without diabetes. The most recent medical studies provide more clues as to why breast cancer is more common and has poorer prognosis in type 2 diabetes patients, by pointing out the role of insulin-resistant adipocytes in the etiopathology. Here, we demonstrate how insulin-resistant adipocytes engage crosstalk with breast cancer cells through EVs in the microenvironment and drive the tumor cells to be more metastatic and aggressive. These progression mechanisms and the effects of insulin-resistant adipocytes on breast cancer cells require Bromodomain and ExtraTerminal (BET) proteins – an important epigenetic pathway. Targeting this pathway may help reduce morbidity and mortality of women with breast cancer and type 2 diabetes.

Orientador: Rogério Martins Amorim / Coorientador: Ana Liz Garcia Alves / Banca: Rui Seabra Ferreira Junior / Banca: Fernanda da Cruz Landim / Resumo: Estudos demonstram o grande potencial do uso das células estromais mesenquimais multipotentes (MSCs) como terapia celular. Seu uso em lesões neurológicas, que usualmente apresentam difícil regeneração, tem sido estudado pelo fato das MSCs apresentarem baixa imunogenicidade efeitos imunomoduladores e neuroregenerativos. Nesse contexto, o presente estudo avaliou a viabilidade e a segurança do transplante de MSCs alogênicas provenientes do tecido adiposo, medula óssea e cordão umbilical de equinos, pela via intratecal através do espaço intervertebral C1-C2, por meio de exame neurológico seriado, análises hematológicas e determinação dos níveis séricos de proteínas de fase aguda. Foram utilizados 16 equinos saudáveis, divididos em quatro grupos: grupo SHAM (SHAM) que recebeu o transplante de salina tamponada com fosfato (PBS); grupo tecido adiposo (GTA), recebeu MSCs de origem do tecido adiposo; grupo medula óssea (GMO), recebeu MSCs de origem da medula óssea; e grupo cordão umbilical (GCU), recebeu células de origem da matriz do cordão umbilical. Foram realizadas três aplicações com intervalo de 30 dias em cada grupo, e coletou-se amostras de sangue, nos momentos que antecederam os transplantes, M0, M30 e M60 e 24 horas, após o transplante, M1, M31, M61. E por último foi realizada uma coleta 30 dias após M60, caracterizando M90. Não foram observadas alterações do exame clinico, hematológico e nas proteínas de fase aguda relacionadas aos sucessivos transplantes intratecais de MSC... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Studies demonstrate the great potential of using multipotent mesenchymal stromal cells (MSCs) as cell therapy. Its use in neurological lesions, which usually present difficult regeneration, has been studied because MSCs have low immunogenicity and immunoregulatory and neuroregenerative effects. In this context, the present study evaluated the viability and safety of transplantation of allogeneic MSCs from the adipose tissue, bone marrow and umbilical cord of horses, through the intrathecal route through the C1-C2 intervertebral space, through serial neurological examination, hematological analyzes and determination of serum levels of acute phase proteins. Sixteen healthy horses were used, divided into four groups: SHAM group (SHAM) that received phosphate buffered saline (PBS) transplantation; adipose tissue group (GTA), received adipose tissue MSCs; bone marrow group (GMO), received MSCs from bone marrow origin; and umbilical cord (UGC) group, received cells from the umbilical cord array. M0, M30 and M60 were collected at the time of the transplantation, M1, M31 and M61 and 24 hours after transplantation. And finally a collection was performed 30 days after M60, characterizing M90. There were no changes in the clinical, hematological and acute phase-related proteins related to successive intrathecal transplantations of MSCs, nor were there alterations that contra indicated the use of any of the cellular sources, demonstrating that the protocol used, as well as any of cellula... (Complete abstract click electronic access below) / Mestre

Due to their immunomodulatory and regenerative potential, mesenchymal stem cells (MSCs) represent a promising therapeutic tool for cell-based therapy, organ transplantation or tissue engineering. To improve clinical applicability of MSCs, new methods to increase their delivery and efficacy have been tested in the latest years but the mechanism of observed alterations has not yet been described. In the present project we focused on studying the effect of several factors that can significantly affect the therapeutic success of MSC-based treatment. Initially, we analysed the therapeutic effect of MSCs applied locally on nanofiber scaffold with incorporated cyclosporine A (CsA) in a mouse model of allogeneic skin transplantation. Our results indicate that application of MSCs in the presence of CsA direct M1/M2 macrophage polarization towards regulatory phenotype. This phenotype switching is accompanied by decreased production of nitric oxide (NO) and interferon  (IFN-) and increase production of interleukin 10 (IL-10), and may result in suppression of the local inflammatory reaction. The next goal of proposed study was to analyse the effect of the treatment based on MSCs combined with immunosuppressive drugs with different mechanism of action on the balance among distinct T cell subpopulations. We...

This article provides a brief review of the pathophysiology of osteoarthritis and the ontogeny of chondrocytes and details how physical exercise improves the health of osteoarthritic joints and enhances the potential of autologous chondrocyte implants, matrix-induced autologous chondrocyte implants, and mesenchymal stem cell implants for the successful treatment of damaged articular cartilage and subchondral bone. In response to exercise, articular chondrocytes increase their production of glycosaminoglycans, bone morphogenic proteins, and anti-inflammatory cytokines and decrease their production of proinflammatory cytokines and matrix-degrading metalloproteinases. These changes are associated with improvements in cartilage organization and reductions in cartilage degeneration. Studies in humans indicate that exercise enhances joint recruitment of bone marrow-derived mesenchymal stem cells and upregulates their expression of osteogenic and chondrogenic genes, osteogenic microRNAs, and osteogenic growth factors. Rodent experiments demonstrate that exercise enhances the osteogenic potential of bone marrow-derived mesenchymal stem cells while diminishing their adipogenic potential, and that exercise done after stem cell implantation may benefit stem cell transplant viability. Physical exercise also exerts a beneficial effect on the skeletal system by decreasing immune cell production of osteoclastogenic cytokines interleukin-1β, tumor necrosis factor-α, and interferon-γ, while increasing their production of antiosteoclastogenic cytokines interleukin-10 and transforming growth factor-β. In conclusion, physical exercise done both by bone marrow-derived mesenchymal stem cell donors and recipients and by autologous chondrocyte donor recipients may improve the outcome of osteochondral regeneration therapy and improve skeletal health by downregulating osteoclastogenic cytokine production and upregulating antiosteoclastogenic cytokine production by circulating immune cells.

Breast cancer remains the most common malignant disease in women worldwide. Despite the advantages of early detection and improved treatments, studies into the mechanisms that initiate and drive breast cancer progression are still required. Recent studies have identified RUNX1, which is an essential transcription factor for hematopoiesis, is one of the most frequently mutated genes in breast cancer patients. However, the role of RUNX1 in the mammary gland is understudied. In this dissertation, we examined the role of RUNX1 in both normal mammary epithelial and breast cancer cells. Our in vitro studies demonstrated that RUNX1 inhibits epithelial to mesenchymal transition (EMT), migration, and invasion, reflecting its tumor suppressor activity, which was confirmed in vivo. Moreover, RUNX1 also contributes significantly to inhibition of the phenotypes of breast cancer stem cells (CSC), which is responsible for metastasis and tumor relapse. We showed that Runx1 overexpression reduces the tumorsphere formation and cancer stem cell population. Overall, our studies provide mechanistic evidence for RUNX1 repression of EMT in mammary cells, anti-tumor activity in vivo and regulation of CSC-like properties in breast cancer. Our results highlight crucial roles for RUNX1 in preventing epithelial to mesenchymal transition and tumor progression in breast cancer. This RUNX1 mediated mechanism points to novel intervention strategies for early stage breast cancer.