C. Huselstein

Stem Cells and Regenerative Medicine: Myth or Reality of the 21th Century

Since the 1960s and the therapeutic use of hematopoietic stem cells of bone marrow origin, there has been an increasing interest in the study of undifferentiated progenitors that have the ability to proliferate and differentiate into various tissues. Stem cells (SC) with different potency can be isolated and characterised. Despite the promise of embryonic stem cells, in many cases, adult or even fetal stem cells provide a more interesting approach for clinical applications. It is undeniable that mesenchymal stem cells (MSC) from bone marrow, adipose tissue, or Whartons Jelly are of potential interest for clinical applications in regenerative medicine because they are easily available without ethical problems for their uses. During the last 10 years, these multipotent cells have generated considerable interest and have particularly been shown to escape to allogeneic immune response and be capable of immunomodulatory activity. These properties may be of a great interest for regenerative medicine. Different clinical applications are under study (cardiac insufficiency, atherosclerosis, stroke, bone and cartilage deterioration, diabetes, urology, liver, ophthalmology, and organs reconstruction). This review focuses mainly on tissue and organ regeneration using SC and in particular MSC.

Phenotypic analysis of cell surface markers and gene expression of human mesenchymal stem cells and chondrocytes during monolayer expansion

Both chondrocytes and mensenchymal stem cells (MSCs) are the most used cell sources for cartilage tissue engineering. However, monolayer expansion to obtain sufficient cells leads to a rapid chondrocyte dedifferentiation and a subsequent ancillary reduced ability of MSCs to differentiate into chondrocytes, thus limiting their application in cartilage repair. The aim of this study was to investigate the influence of the monolayer expansion on the immunophenotype and the gene expression profile of both cell types, and to find the appropriate compromise between monolayer expansion and the remaining chondrogenic characteristics. To this end, human chondrocytes, isolated enzymatically from femoral head slice, and human MSCs, derived from bone marrow, were maintained in monolayer culture up to passage 5. The respective expressions of cell surface markers (CD34, CD45, CD73, CD90, CD105, CD166) and several chondrogenic-related genes for each passage (P0-P5) of those cells were then analyzed using flow cytometry and quantitative real-time PCR, respectively. Flow cytometry analyses showed that, during the monolayer expansion, some qualitative and quantitative regulations occur for the expression of cell surface markers. A rapid increase in mRNA expression of type 1 collagen occurs whereas a significant decrease of type 2 collagen and Sox 9 was observed in chondrocytes through the successive passages. On the other hand, the expansion did not induced obvious change in MSCs gene expression. In conclusion, our results suggest that passage 1 might be the up-limit for chondrocytes in order to achieve their subsequent redifferentiation in 3D scaffold. Nevertheless, MSCs could be expanded in monolayer until passage 5 without loosing their undifferentiated phenotypes.

Designing a three-dimensional alginate hydrogel by spraying method for cartilage tissue engineering

Cartilage tissue engineering strategies generally result in homogeneous tissue structures with little resemblance to native zonal organization of articular cartilage. The main objective of our work concerns the buildup of complex biomaterials aimed at reconstructing biological tissue with three dimensional cells construction for mimicking cartilage architecture. n In this first step, our strategy is based on structure formation by simple and progressive spraying of mixed alginate and chondrocytes at different pressures. We report the first demonstration of spraying effect on chondrocytes inside an alginate hydrogel at short (i) and long terms (ii) and the mechanical behavior of a sprayed hydrogel by biomechanical tests (plane strain compression tests). n Our results indicate clearly that during the first days of culture the cells were influenced by the construction method (spraying or molding, control method) with low viability and higher production levels of nitrite. From day 7, the cell behaviors become similar for both methods. Indeed after 28 days of culture, type II collagen was observed, showing the cartilage gene expression, then a similar behavior for all methods. Finally, we conclude that the mechanical performances of sprayed hydrogels was enhanced compared to the controls. n We report here, for the first time, that it is possible to spray mixed alginate and chondrocytes with little damage for cells. Therefore, the sprayed hydrogel keeps not only the mechanical properties needed for cells, but also maintains the chondrocyte phenotype to induce cartilage.

Chondrogenic induction of mesenchymal stromal/stem cells from Wharton's jelly embedded in alginate hydrogel and without added growth factor: an alternative stem cell source for cartilage tissue engineering

BackgroundDue to their intrinsic properties, stem cells are promising tools for new developments in tissue engineering and particularly for cartilage tissue regeneration. Although mesenchymal stromal/stem cells from bone marrow (BM-MSC) have long been the most used stem cell source in cartilage tissue engineering, they have certain limits. Thanks to their properties such as low immunogenicity and particularly chondrogenic differentiation potential, mesenchymal stromal/stem cells from Wharton’s jelly (WJ-MSC) promise to be an interesting source of MSC for cartilage tissue engineering.MethodsIn this study, we propose to evaluate chondrogenic potential of WJ-MSC embedded in alginate/hyaluronic acid hydrogel over 28xa0days. Hydrogels were constructed by the original spraying method. Our main objective was to evaluate chondrogenic differentiation of WJ-MSC on three-dimensional scaffolds, without adding growth factors, at transcript and protein levels. We compared the results to those obtained from standard BM-MSC.ResultsAfter 3xa0days of culture, WJ-MSC seemed to be adapted to their new three-dimensional environment without any detectable damage. From day 14 and up to 28xa0days, the proportion of WJ-MSC CD73+, CD90+, CD105+ and CD166+ decreased significantly compared to monolayer marker expression. Moreover, WJ-MSC and BM-MSC showed different phenotype profiles. After 28xa0days of scaffold culture, our results showed strong upregulation of cartilage-specific transcript expression. WJ-MSC exhibited greater type II collagen synthesis than BM-MSC at both transcript and protein levels. Furthermore, our work highlighted a relevant result showing that WJ-MSC expressed Runx2 and type X collagen at lower levels than BM-MSC.ConclusionsOnce seeded in the hydrogel scaffold, WJ-MSC and BM-MSC have different profiles of chondrogenic differentiation at both the phenotypic level and matrix synthesis. After 4xa0weeks, WJ-MSC, embedded in a three-dimensional environment, were able to adapt to their environment and express specific cartilage-related genes and matrix proteins. Today, WJ-MSC represent a real alternative source of stem cells for cartilage tissue engineering.

Construction of nerve guide conduits from cellulose/soy protein composite membranes combined with Schwann cells and pyrroloquinoline quinone for the repair of peripheral nerve defect.

Regeneration and functional reconstruction of peripheral nerve defects remained a significant clinical challenge. Nerve guide conduits, with seed cells or neurotrophic factors (NTFs), had been widely used to improve the repair and regeneration of injured peripheral nerve. Pyrroloquinoline quinone (PQQ) was an antioxidant that can stimulate nerve growth factors (NGFs) synthesis and accelerate the Schwann cells (SCs) proliferation and growth. In present study, three kinds of nerve guide conduits were constructed: one from cellulose/SPI hollow tube (CSC), another from CSC combined with SCs (CSSC), and the third one from CSSC combined with PQQ (CSSPC), respectively. And then they were applied to bridge and repair the sciatic nerve defect in rats, using autograft as control. Effects of different nerve guide conduits on the nerve regeneration were comparatively evaluated by general analysis, sciatic function index (SFI) and histological analysis (HE and TEM). Newly-formed regenerative nerve fibers were observed and running through the transparent nerve guide conduits 12 weeks after surgery. SFI results indicated that the reconstruction of motor function in CSSPC group was better than that in CSSC and CSC groups. HE images from the cross-sections and longitudinal-sections of the harvested regenerative nerve indicated that regenerative nerve fibers had been formed and accompanied with new blood vessels and matrix materials in the conduits. TEM images also showed that lots of fresh myelinated and non-myelinated nerve fibers had been formed. Parts of vacuolar, swollen and abnormal axons occurred in CSC and CSSC groups, while the vacuolization and swell of axons was the least serious in CSSPC group. These results indicated that CSSPC group had the most ability to repair and reconstruct the nerve structure and functions due to the comprehensive contributions from hollow CSC tube, SCs and PQQ. As a result, the CSSPC may have the potential for the applications as nerve guide conduits in the field of nerve tissue engineering.

Mesenchymal stem cells derived from Wharton's jelly: Comparative phenotype analysis between tissue and in vitro expansion

Mesenchymal stem cells (MSCs) are useful multipotent stem cells that are found in many tissues. While MSCs can usually be isolated from adults via bone marrow aspiration (BM-MSCs), MSCs derived from the discarded umbilical cord, more precisely from Whartons jelly (WJ), offer a low-cost and pain-free collection method of MSCs that may be cryogenically stored, and are considered extremely favorable for tissue engineering purpose. The aim of this study was to analyze the harvested number of cells per centimeter of human umbilical cord (UC) and carry out the phenotype of these WJ-MSCs after explant or enzymatic methods. Fresh UCs were obtained from full-term births, and processed within 6 hours from partum to obtain the WJ-MSCs. UC sections were analyzed in confocal microscopy to analyze cells phenotype in situ. Others UC components were treated either by enzymatic method or by explant method to obtain isolated cells and to analyze cells phenotype until the end of the first passage. We have successfully generated MSCs from UC by using explant and enzymatic methods. Using microscopy confocal, we identified the expression of some MSCs markers in situ of Whartons jelly tissue as well as in perivascular region. Our comparative study, between explant and enzymatic digestion, indicated, that WJ expressed most of MSCs markers in both conditions, but a remarkable variation of cell phenotype expression was distinguished after primary culture comparing to directly isolated cells by enzymatic digestion. We also studied the expression of CD271, which showed to be weakly expressed in situ on fresh fragment of WJ.

Mesenchymal stem cells for cartilage engineering.

Injuries to articular cartilage are one of the most challenging issues of musculoskeletal medicine due to the poor intrinsic ability of this tissue for repair. Despite progress in orthopaedic surgery, cell-based surgical therapies such as autologous chondrocyte transplantation (ACT) have been in clinical use for cartilage repair for over a decade but this approach has shown mixed results. Moreover, the lack of efficient modalities of treatment for large chondral defects has prompted research on tissue engineering combining chondrogenic cells, scaffold materials and environmental factors.This paper focuses on the main parameters in tissue engineering and on the potential of mesenchymal stem cells (MSCs) as an alternative to cells derived from patient tissues in autologous transplantation and tissue engineering. Here we discuss the prospects of using autologous chondrocytes or MSCs in regenerative medicine and summarize the advantages and disadvantages of these cells in articular cartilage engineering.

Hypoxic Culture Conditions for Mesenchymal Stromal/Stem Cells from Wharton’s Jelly: A Critical Parameter to Consider in a Therapeutic Context

Mesenchymal Stromal/Stem Cells from human Whartons jelly (WJ-MSC) are an abundant and interesting source of stem cells for applications in cell and tissue engineering. Their fetal origin confers specific characteristics compared to Mesenchymal Stromal/Stem Cells isolated from human bone marrow (BM-MSC). The aim of this work was to optimize WJ-MSC culture conditions for their subsequent clinical use. We focused on the influence of oxygen concentration during monolayer expansion on several parameters to characterize MSC. Our work distinguished WJ-MSC from BM-MSC in terms of proliferation, telomerase activity and adipogenic differentiation. We also showed that hypoxia had a beneficial effect on proliferation potential, clonogenic capacity and to a lesser extent, on HLA-G expression of WJ-MSC during their expansion. Moreover, we reported for the first time an increase in chondrogenic differentiation when WJ-MSC were expanded under hypoxia. In an allogeneic therapeutic context, production of clinical batches requires generating high numbers of MSC whilst maintaining the cells properties. Considering our results, hypoxia will be an important parameter to take into account. In addition, the clinical use of WJ-MSC would provide significant numbers of cells with maintenance of their proliferation and differentiation potential, particularly their chondrogenic potential. Due to their chondrogenic differentiation potential, WJ-MSC promise to be an interesting source of MSC for cell therapy or tissue engineering for cartilage repair and/or regeneration.

Original approach for cartilage tissue engineering with mesenchymal stem cells.

Cartilage tissue engineering gives the ability to product adaptable neocartilage to lesion with autologous cells. Our work aimed to develop a stratified scaffold with a simple and progressive spraying build-up to mimic articular cartilage environment. An Alginate/Hyaluronic Acid (Alg/HA) hydrogel seeded with human Mesenchymal Stem Cells (hMSC) was construct by spray. First, cells repartition and actin organization were study with confocal microscopy. Then, we analyzed cells viability and finally, metabolic activity. Our results indicated a homogenous cells repartition in the hydrogel and a pericellular actin repartition. After 3 days of culture, we observed about 52% of viable cells in the scaffold. Then, from day 7 until the end of culture (D28), the proportion of living cells and their metabolic activity increased, what indicates that culture conditions are not harmful for the cells. We report here that sprayed method allowed to product a scaffold with hMSCs that confer a favorable environment for neocartilage construction: 3D conformation and ability of cells to increase their metabolic activity, therefore with few impact on hMSCs.

Fabrication and evaluation of physical properties and cytotoxicity of zein-based polyurethanes.

Polyurethane prepolymer (PUP) was first synthesized from polycaprolactone diol and isophorone diisocyanate; and then a series of zein-based polyurethane (ZEPU) sheets was fabricated from PUP and zein (ZE) using a hot press and moulding process without addition of other additives. Effects of ZE content (WZE) on the structure and properties of the resultant ZEPU sheets were investigated by Fourier transform infrared spectroscopy, scanning electron microscopy, dynamic mechanical analysis, tensile testing, and dissolubility testing in alcohol. The results indicated that cross-linking and grafting reactions occurred between ZE and PUP to form new polyurethane showing a higher thermal stability, flexibility, and alcohol-resistance than the neat ZE sheets. For example, the elongation at break of ZEPU with 50xa0% WZE was 211.2xa0%, which was 47 times higher than that of neat ZE sheet. ZE molecules acted as both cross-linkers and polymer fillers in ZEPU sheets. The cytotoxicity and cytocompatibility of ZEPU sheets were evaluated by cell culture in vitro. The ZEPU sheets showed non- or low-cytotoxicity, and L929 cells grew and expanded well on the surfaces of the sheets with WZE over 50xa0%. Undoubtedly, the fabrication of ZE-based polyurethanes without toxic additives such as catalysts, cross-linkers and chain extenders improved the physical properties and cytocompatibility of zein, thus widening the possible range of applications for zein-based biomaterials.