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京都大学 / 新制・課程博士 / 博士(医学) / 甲第23770号 / 医博第4816号 / 新制||医||1056(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 長船 健二, 教授 安達 泰治, 教授 遊佐 宏介 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Yes / Beneficial effects have been observed following the transplant of lipoaspirates containing adipose-derived stem cells into chronic wounds caused by oncologic radiotherapy. It is not yet certain whether adipose-derived stem cells are resistant to radiation exposure. Therefore, the aims of this study were to isolate stromal vascular fraction from human breast tissue exposed to radiotherapy and determine the presence of adipose-derived stem cells. Stromal vascular fraction from irradiated donor tissue was compared to commercially sourced pre-adipocytes. Immunocytochemistry was used to determine the presence of adipose-derived stem cell markers. Conditioned media from stromal vascular fraction isolated from irradiated donors was used as a treatment in a scratch wound assay of dermal fibroblasts also isolated from irradiated donors and compared to pre-adipocyte conditioned media and serum free control. This is the first report of human stromal vascular fraction being cultured from previously irradiated breast tissue. Stromal vascular fraction conditioned media from irradiated donors had a similar effect in increasing the migration of dermal fibroblasts from irradiated skin to pre-adipocyte conditioned media from healthy donors. Therefore, the ability of adipose-derived stem cells in the stromal vascular fraction to stimulate dermal fibroblasts in wound healing appears to be preserved following radiotherapy. This study demonstrates that stromal vascular fraction from irradiated patients is viable, functional and may have potential for regenerative medicine techniques following radiotherapy. / This research was funded by a Bradford City FC Supporters Fellowship for L.V.T. administered through the Plastic Surgery and Burns Research Unit, University of Bradford. / Research Development Fund Publication Prize Award winner, Mar 2023.

京都大学 / 新制・課程博士 / 博士(医学) / 甲第25197号 / 医博第5083号 / 新制||医||1072(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 齋藤 潤, 教授 斎藤 通紀, 教授 長船 健二 / 学位規則第4条第1項該当 / Doctor of Agricultural Science / Kyoto University / DFAM

The development of a vasculature within a tissue-engineered construct is one of the largest hurdles to successful bone regeneration. This thesis investigates methods to increase vasculature of such transplanted constructs, based on in vivo transplant studies and in vitro analysis of cell behaviors. A syngeneic mouse model in immunocompetent mice was developed and analyzed for both osteogenesis and hematopoiesis. This study demonstrates that syngeneic bone marrow stromal cells (BMSCs) are not rejected by the host, provided the strain of mice is sufficiently inbred. Additionally, an effective protocol was developed for the isolation of endothelial cells (ECs) from the bone marrow of mice. Two different sets of materials for this study were analyzed, both collagen based, and the GelfoamTM scaffold was found to possess advantages over synthesized collagen or collagen/hydroxyapatite composites, although only for mouse and not human bone transplantation. In order to gain rapid and integrated vasculature formation within the transplant, attempts were made to increase both (de novo) vasculogenesis and angiogenesis (ingrowth) from the surrounding tissue. For the former, transplant studies were combined with in vitro osteogenic calcification studies. Direct co-culture of the BMSCs and ECs increased osteogenic calcification and was monitored by using both alizarin red S quantification and quantitative polymerase chain reaction. Angiogenesis (as assessed by cell migration) was studied by various motility and chemotaxis assays in vitro, as well as through use of a directed in vivo angiogenesis assay. Growth factors, particularly TGF-β1 and BMP-4, were found to increase cell movement in these systems. In conclusion, we show that although much work remains to be done in order to increase the vasculature in bone transplants, systematic combination of in vivo and in vitro assays can elucidate the nature behind this crucial process in this context.

Ischaemic heart disease (IHD) is the leading cause of death worldwide. Currently, even optimal medical therapies do not attenuate deterioration of the left ventricular (LV) function completely. Stem cell therapies, and recently cardiac stem cell therapies, have emerged as potential novel treatments for IHD. However, clinical evidence from randomised controlled studies has shown mixed results. Thus understanding what patient-related factors may affect the therapeutic performance of the cells may help improving treatment outcomes. The studies described in this thesis aim to understand how cardiac progenitor cells (CPCs) can re-vascularise ischaemic myocardium and promote functional repair of the heart. Resident CPCs were isolated and expanded from the right atrial appendage of 68 patients following the ‘cardiosphere’ method (cardiosphere-derived cells or CDCs). They resemble mesenchymal progenitors as they lack the expression of endothelial and haematopoietic cell surface markers but express mesenchymal progenitor cell markers (e.g. CD105, CD90). Cell function was evaluated by support of angiogenesis, mesenchymal lineage differentiation potential in vitro, and improvement in heart function in vivo. Notably in vitro, CDC from different patients differed in their angiogenic supportive and differentiation potentials. In a rodent model of myocardial infarction (MI), transplantation of CDC reduced infarct size significantly (p<0.05). However, only those CDCs with a robust pro-angiogenic ability in vitro improved vessel density and heart systolic function (p<0.05) in vivo. A multiple regression model, which accounted for 51% of the variability observed, identified New York Heart Association (NYHA) class, smoking, hypertension, type of ischaemic disease and diseased vessel as independent predictors of angiogenesis. In addition, gene expression analyses revealed that differential gene expression of several extracellular matrix components (e.g. CUX1, COL1A2, BMP1 genes and microRNA-29b) could explain the differences observed in CDC’s vascular supportive function. In summary, this is the first description of variability in the pro-angiogenic and differentiation potential of CDCs and its correlation with their therapeutic potential. This study indicates that patient stratification may need to be included in the design of future trials to improve the efficacy of cell-based therapies.