Deepak A. Lamba

Efficient generation of retinal progenitor cells from human embryonic stem cells.

The retina is subject to degenerative conditions, leading to blindness. Although retinal regeneration is robust in lower vertebrates, regeneration does not occur in the adult mammalian retina. Thus, we have developed efficient methods for deriving retinal neurons from human embryonic stem (hES) cells. Under appropriate culture conditions, up to 80% of the H1 line can be directed to the retinal progenitor fate, and express a gene expression profile similar to progenitors derived from human fetal retina. The hES cell-derived progenitors differentiate primarily into inner retinal neurons (ganglion and amacrine cells), with functional glutamate receptors. Upon coculture with retinas derived from a mouse model of retinal degeneration, the hES cell derived retinal progenitors integrate with the degenerated mouse retina and increase in their expression of photoreceptor-specific markers. These results demonstrate that human ES cells can be selectively directed to a neural retinal cell fate and thus may be useful in the treatment of retinal degenerations.

Transplantation of Human Embryonic Stem Cell-Derived Photoreceptors Restores Some Visual Function in Crx-Deficient Mice

Some of the most common causes of blindness involve the degeneration of photoreceptors in the neural retina; photoreceptor replacement therapy might restore some vision in these individuals. Embryonic stem cells (ESCs) could, in principle, provide a source of photoreceptors to repair the retina. We have previously shown that retinal progenitors can be efficiently derived from human ESCs. We now show that retinal cells derived from human ESCs will migrate into mouse retinas following intraocular injection, settle into the appropriate layers, and express markers for differentiated cells, including both rod and cone photoreceptor cells. After transplantation of the cells into the subretinal space of adult Crx(-/-) mice (a model of Lebers Congenital Amaurosis), the hESC-derived retinal cells differentiate into functional photoreceptors and restore light responses to the animals. These results demonstrate that hESCs can, in principle, be used for photoreceptor replacement therapies.

Generation, Purification and Transplantation of Photoreceptors Derived from Human Induced Pluripotent Stem Cells

Background Inherited and acquired retinal degenerations are frequent causes of visual impairment and photoreceptor cell replacement therapy may restore visual function to these individuals. To provide a source of new retinal neurons for cell based therapies, we developed methods to derive retinal progenitors from human ES cells. Methodology/Physical Findings In this report we have used a similar method to direct induced pluripotent stem cells (iPS) from human fibroblasts to a retinal progenitor fate, competent to generate photoreceptors. We also found we could purify the photoreceptors derived from the iPS cells using fluorescence activated cell sorting (FACS) after labeling photoreceptors with a lentivirus driving GFP from the IRBP cis-regulatory sequences. Moreover, we found that when we transplanted the FACS purified iPSC derived photoreceptors, they were able to integrate into a normal mouse retina and express photoreceptor markers. Conclusions This report provides evidence that enriched populations of human photoreceptors can be derived from iPS cells.

Neural Regeneration and Cell Replacement: A View from the Eye

Neuronal degenerations in the retina are leading causes of blindness. Like most other areas of the CNS, the neurons of the mammalian retina are not replaced following degeneration. However, in nonmammalian vertebrates, endogenous repair processes restore neurons very efficiently, even after complete loss of the retina. We describe the phenomenon of retinal regeneration in nonmammalian vertebrates and attempts made in recent years to stimulate similar regenerative processes in the mammalian retina. In addition, we review the various strategies employed to replace lost neurons in the retina and the recent use of stem cell technologies to address problems of retinal repair.

Histone deacetylase inhibition elicits an evolutionarily conserved self-renewal program in embryonic stem cells.

Recent evidence indicates that mouse and human embryonic stem cells (ESCs) are fixed at different developmental stages, with the former positioned earlier. We show that a narrow concentration of the naturally occurring short-chain fatty acid, sodium butyrate, supports the extensive self-renewal of mouse and human ESCs, while promoting their convergence toward an intermediate stem cell state. In response to butyrate, human ESCs regress to an earlier developmental stage characterized by a gene expression profile resembling that of mouse ESCs, preventing precocious Xist expression while retaining the ability to form complex teratomas in vivo. Other histone deacetylase inhibitors (HDACi) also support human ESC self-renewal. Our results indicate that HDACi can promote ESC self-renewal across species, and demonstrate that ESCs can toggle between alternative states in response to environmental factors.

Blimp1 controls photoreceptor versus bipolar cell fate choice during retinal development.

Photoreceptors, rods and cones are the most abundant cell type in the mammalian retina. However, the molecules that control their development are not fully understood. In studies of photoreceptor fate determination, we found that Blimp1 (Prdm1) is expressed transiently in developing photoreceptors. We analyzed the function of Blimp1 in the mouse retina using a conditional deletion approach. Developmental analysis of mutants showed that Otx2+ photoreceptor precursors ectopically express the bipolar cell markers Chx10 (Vsx2) and Vsx1, adopting bipolar instead of photoreceptor fate. However, this fate shift did not occur until the time when bipolar cells are normally specified during development. Most of the excess bipolar cells died around the time of bipolar cell maturation. Our results suggest that Blimp1 expression stabilizes immature photoreceptors by preventing bipolar cell induction. We conclude that Blimp1 regulates the decision between photoreceptor and bipolar cell fates in the Otx2+ cell population during retinal development.

Strategies for retinal repair: cell replacement and regeneration.

The retina, like most other regions of the central nervous system, is subject to degeneration from both genetic and acquired causes. Once the photoreceptors or inner retinal neurons have degenerated, they are not spontaneously replaced in mammals. In this review, we provide an overview of retinal development and regeneration with emphasis on endogenous repair and replacement seen in lower vertebrates and recent work on induced mammalian retinal regeneration from Müller glia. Additionally, recent studies demonstrating the potential for cellular replacement using postmitotic photoreceptors and embryonic stem cells are also reviewed.

Hypoxia induces re-entry of committed cells into pluripotency.

Adult stem cells reside in hypoxic niches, and embryonic stem cells (ESCs) are derived from a low oxygen environment. However, it is not clear whether hypoxia is critical for stem cell fate since for example human ESCs (hESCs) are able to self‐renew in atmospheric oxygen concentrations as well. We now show that hypoxia can govern cell fate decisions since hypoxia alone can revert hESC‐ or iPSC‐derived differentiated cells back to a stem cell‐like state, as evidenced by re‐activation of an Oct4‐promoter reporter. Hypoxia‐induced “de‐differentiated” cells also mimic hESCs in their morphology, long‐term self‐renewal capacity, genome‐wide mRNA and miRNA profiles, Oct4 promoter methylation state, cell surface markers TRA1–60 and SSEA4 expression, and capacity to form teratomas. These data demonstrate that hypoxia can influence cell fate decisions and could elucidate hypoxic niche function. Stem Cells 2013;31:1737‐1748

Genome-wide analysis of Müller glial differentiation reveals a requirement for Notch signaling in postmitotic cells to maintain the glial fate.

Previous studies have shown that Müller glia are closely related to retinal progenitors; these two cell types express many of the same genes and after damage to the retina, Müller glia can serve as a source for new neurons, particularly in non-mammalian vertebrates. We investigated the period of postnatal retinal development when progenitors are differentiating into Müller glia to better understand this transition. FACS purified retinal progenitors and Müller glia from various ages of Hes5-GFP mice were analyzed by Affymetrix cDNA microarrays. We found that genes known to be enriched/expressed by Müller glia steadily increase over the first three postnatal weeks, while genes associated with the mitotic cell cycle are rapidly downregulated from P0 to P7. Interestingly, progenitor genes not directly associated with the mitotic cell cycle, like the proneural genes Ascl1 and Neurog2, decline more slowly over the first 10–14 days of postnatal development, and there is a peak in Notch signaling several days after the presumptive Müller glia have been generated. To confirm that Notch signaling continues in the postmitotic Müller glia, we performed in situ hybridization, immunolocalization for the active form of Notch, and immunofluorescence for BrdU. Using genetic and pharmacological approaches, we found that sustained Notch signaling in the postmitotic Müller glia is necessary for their maturation and the stabilization of the glial identity for almost a week after the cells have exited the mitotic cell cycle.

Immune modulation by MANF promotes tissue repair and regenerative success in the retina

INTRODUCTION Regenerative therapies based on cell replacement hold promise for the treatment of a range of age-related degenerative diseases but are limited by unfavorable microenvironments in degenerating tissues. A promising strategy to improve success is to harness endogenous repair mechanisms that promote tissue integrity and function. Innate immune cells are central to such repair mechanisms because they coordinate local and systemic responses to tissue injury by secreting inflammatory and anti-inflammatory signals in a context-dependent manner. A proper balance between these opposing phenotypes of innate immune cells is essential for efficient tissue repair, and immune modulation may be an effective way to promote repair and enhance regenerative therapies. Here, we identified a new evolutionarily conserved immune modulatory function for mesencephalic astrocyte-derived neurotrophic factor (MANF) that biases immune cells toward an anti-inflammatory phenotype, thereby promoting tissue repair in both vertebrates and invertebrates and enhancing retinal regenerative therapy. RATIONALE In Drosophila, interactions between damaged tissues and hemocytes are essential for tissue repair. We used this model to identify immune cell–derived factors with immune modulatory activity that promote tissue repair after retinal injury. The identification of MANF as such a factor prompted us to test its role in mammalian retinal repair and ask whether its immune modulatory activity helped cell replacement therapies in degenerating retinas. RESULTS Using a combination of transcriptome analysis and genetic studies, we identified MANF as a hemocyte-derived factor that is induced by platelet-derived growth factor (PDGF)– and vascular endothelial growth factor (VEGF)–related factor 1 (Pvf-1)/PDGF- and VEGF-receptor related (PvR) signaling. MANF was necessary and sufficient to promote retinal repair after ultraviolet-light–induced retinal injury in Drosophila. MANF also had an autocrine immune-modulatory function in fly hemocytes, which was necessary for its tissue repair–promoting activity. This regulation and function of MANF was evolutionarily conserved: Mouse photoreceptors expressed PDGF-A (a Pvf-1 homolog) in response to damage signals, which promoted MANF expression in innate immune cells. This PDGF-A/MANF signaling cascade was required to limit photoreceptor apoptosis in the retina. Exogenously supplied recombinant MANF protected photoreceptors in several paradigms of retinal injury and degeneration. As in flies, this prorepair function was associated with alternative activation of macrophages and microglia in the retina. Ablation of CD11b+ immune cells and deletion of Cx3Cr1, a chemokine receptor required for MANF-induced alternative activation, prevented MANF-induced repair. Thus, the protective effects of MANF in retinal injury rely on its immune modulatory activity. Finally, MANF supplementation to photoreceptors transplanted into congenitally blind mice increased integration efficiency and accelerated and improved visual function recovery. CONCLUSION Combining genetic studies in invertebrates and vertebrates has rapidly identified factors with promising therapeutic potential. Immune modulation is a promising strategy to optimize regenerative therapies. With its conserved immune modulatory function, MANF is a particularly promising molecule that is likely to be useful for the treatment of inflammatory conditions in many different disease contexts. MANF in retinal repair. In Drosophila (left) or mouse (right), the damaged retina secretes Pvf-1/PDGF-A, which acts on innate immune cells. MANF derived from innate immune cells (and other sources) promotes phenotypic changes in immune cells as part of a mechanism required for tissue repair. Therapeutically, MANF supplementation can delay retinal degeneration and improve the success of cell-replacement regenerative therapies in the retina. Regenerative therapies are limited by unfavorable environments in aging and diseased tissues. A promising strategy to improve success is to balance inflammatory and anti-inflammatory signals and enhance endogenous tissue repair mechanisms. Here, we identified a conserved immune modulatory mechanism that governs the interaction between damaged retinal cells and immune cells to promote tissue repair. In damaged retina of flies and mice, platelet-derived growth factor (PDGF)–like signaling induced mesencephalic astrocyte-derived neurotrophic factor (MANF) in innate immune cells. MANF promoted alternative activation of innate immune cells, enhanced neuroprotection and tissue repair, and improved the success of photoreceptor replacement therapies. Thus, immune modulation is required during tissue repair and regeneration. This approach may improve the efficacy of stem-cell–based regenerative therapies.