Fabio Triolo

Efficient human fetal liver cell isolation protocol based on vascular perfusion for liver cell–based therapy and case report on cell transplantation

Although hepatic cell transplantation (CT) holds the promise of bridging patients with end‐stage chronic liver failure to whole liver transplantation, suitable cell populations are under debate. In addition to hepatic cells, mesenchymal stem cells (MSCs) and hematopoietic stem cells (HSCs) are being considered as alternative cell sources for initial clinical cell work. Fetal liver (FL) tissue contains potential progenitors for all these cell lineages. Based on the collagenase incubation of tissue fragments, traditional isolation techniques yield only a fraction of the number of available cells. We report a 5‐step method in which a portal vein in situ perfusion technique is used for tissue from the late second trimester. This method results in the high viabilities known for adult liver vascular perfusion, addresses the low cell yields of conventional digestion methods, and reduces the exposure of the tissue to collagenase 4‐fold. We used donated tissue from gestational weeks 18 to 22, which yielded 1.8 ± 0.7 × 109 cells with an average viability of 78%. Because HSC transplantation and MSC transplantation are of interest for the treatment of hepatic failure, we phenotypically confirmed that in addition to hepatic progenitors, the resulting cell preparation contained cells expressing typical MSC and HSC markers. The percentage of FL cells expressing proliferation markers was 45 times greater than the percentage of adult hepatocytes expressing these markers and was comparable to the percentage of immortalized HepG2 liver hepatocellular carcinoma cells; this indicated the strong proliferative capacity of fetal cells. We report a case of human FL CT with the described liver cell population for clinical end‐stage chronic liver failure. The patients Model for End‐Stage Liver Disease (MELD) score improved from 15 to 10 within the first 18 months of observation. In conclusion, this human FL cell isolation protocol may be of interest for further clinical translation work on the development of liver cell–based therapies. Liver Transpl 18:226–237, 2012.

Treatment of Severe Adult Traumatic Brain Injury Using Bone Marrow Mononuclear Cells

Preclinical studies using bone marrow derived cells to treat traumatic brain injury have demonstrated efficacy in terms of blood–brain barrier preservation, neurogenesis, and functional outcomes. Phase 1 clinical trials using bone marrow mononuclear cells infused intravenously in children with severe traumatic brain injury demonstrated safety and potentially a central nervous system structural preservation treatment effect. This study sought to confirm the safety, logistic feasibility, and potential treatment effect size of structural preservation/inflammatory biomarker mitigation in adults to guide Phase 2 clinical trial design. Adults with severe traumatic brain injury (Glasgow Coma Scale 5–8) and without signs of irreversible brain injury were evaluated for entry into the trial. A dose escalation format was performed in 25 patients: 5 controls, followed 5 patients in each dosing cohort (6, 9, 12 ×106 cells/kg body weight), then 5 more controls. Bone marrow harvest, cell processing to isolate the mononuclear fraction, and re‐infusion occurred within 48 hours after injury. Patients were monitored for harvest‐related hemodynamic changes, infusional toxicity, and adverse events. Outcome measures included magnetic resonance imaging‐based measurements of supratentorial and corpus callosal volumes as well as diffusion tensor imaging‐based measurements of fractional anisotropy and mean diffusivity of the corpus callosum and the corticospinal tract at the level of the brainstem at 1 month and 6 months postinjury. Functional and neurocognitive outcomes were measured and correlated with imaging data. Inflammatory cytokine arrays were measured in the plasma pretreatment, posttreatment, and at 1 and 6 month follow‐up. There were no serious adverse events. There was a mild pulmonary toxicity of the highest dose that was not clinically significant. Despite the treatment group having greater injury severity, there was structural preservation of critical regions of interest that correlated with functional outcomes. Key inflammatory cytokines were downregulated. Treatment of severe, adult traumatic brain injury using an intravenously delivered autologous bone marrow mononuclear cell infusion is safe and logistically feasible. There appears to be a treatment signal as evidenced by central nervous system structural preservation, consistent with previous pediatric trial data. Inflammatory biomarkers are downregulated after cell infusion. Stem Cells 2016

A Quality Risk Management Model Approach for Cell Therapy Manufacturing

International regulatory authorities view risk management as an essential production need for the development of innovative, somatic cell-based therapies in regenerative medicine. The available risk management guidelines, however, provide little guidance on specific risk analysis approaches and procedures applicable in clinical cell therapy manufacturing. This raises a number of problems. Cell manufacturing is a poorly automated process, prone to operator-introduced variations, and affected by heterogeneity of the processed organs/tissues and lot-dependent variability of reagent (e.g., collagenase) efficiency. In this study, the principal challenges faced in a cell-based product manufacturing context (i.e., high dependence on human intervention and absence of reference standards for acceptable risk levels) are identified and addressed, and a risk management model approach applicable to manufacturing of cells for clinical use is described for the first time. The use of the heuristic and pseudo-quantitative failure mode and effect analysis/failure mode and critical effect analysis risk analysis technique associated with direct estimation of severity, occurrence, and detection is, in this specific context, as effective as, but more efficient than, the analytic hierarchy process. Moreover, a severity/occurrence matrix and Pareto analysis can be successfully adopted to identify priority failure modes on which to act to mitigate risks. The application of this approach to clinical cell therapy manufacturing in regenerative medicine is also discussed.

Fractal approach in petrology: combining ultra small angle, small angle and intermediate angle neutron scattering

Ultra small angle neutron scattering (USANS) instruments have recently covered the gap between the size resolution available with conventional intermediate angle neutron scattering and small angle neutron scattering (SANS) instruments on one side and optical microscopy on the other side. New fields of investigations are now open and important areas of material science (ceramics, glass fibers, natural materials) and fundamental physics (phase transition, phase separation and critical phenomena) can be studied in bulk samples with an accuracy previously unobtainable owing to a combination of favourable features of the neutron-matter interaction: high penetrability of neutrons, even cold neutrons, ability to easily manipulate local scattering amplitudes by means of isotopic substitution methods, small absorption for most nuclei and hardly any radiation damage. In particular, neutrons see rocks as two-phase systems, and therefore the data analysis is enormously simplified. Rocks showing fractal behavior in over two decades of momentum transfer and seven orders of magnitude of intensity are examined and fractal parameters are extracted from the combined USANS, SANS and intermediate angle neutron scattering curves.

Organometallic Complexes with Biological Molecules. XIV. Biological Activity of Dialkyl and Trialkyltin(IV) (Meso-tetra(4-carboxy- phenyl)porphinate) Derivatives

Molecules. XIV. Biological Activity of Dialkyl and Trialkyltin(IV) [Meso-tetra(4-carboxyphenyl)porphinate] Derivatives C. Mansueto, E. Puccia, F. Maggio, R. Di Stefano, T. Fiore, C. Pellerito, F. Triolo and L. Pellerito* Dipartimento di Biologia Animale, Universita di Palermo, Via Archirafi 18, 90123 Palermo, Italy Dipartimento di Chimica Inorganica, Universita di Palermo, Viale delle Scienze, Parco d’Orleans, 90128 Palermo, Italy

Experimental evaluation of the efficacy of sanitation procedures in operating rooms.

BACKGROUND There remains much debate on how to define an adequate sanitation protocol in hospital environments. METHODS The efficacy of a sanitation protocol in the operating room (OR) of a modern hospital was evaluated by measuring bacterial load on different types of finishing materials of all internal surfaces (ie, walls, floors, and furnishings). Samples were obtained before cleaning and over the subsequent 24 hours. A total of 2124 microbiological samples were collected using RODAC plates and sterile swabs. RESULTS The data demonstrate a very significant postsanitation reduction of bacterial load on floors and furnishings; however, no significant data on walls were obtained, because of the low levels of initial contamination (1.50 to 5.98 cfu/100 cm2). The increase in postsanitation bacterial load over time was greater on smooth materials than on porous materials, on which a further reduction in contamination was seen. The study outcomes were confirmed by simulation experiments in which different materials were contaminated with a predetermined bacterial load and then subjected to the sanitation protocol. These simulation experiments were carried out both in vitro and in an eddy-flux testing room that simulated a full-scale OR similar (in terms of architectonic systems) to a real setting. CONCLUSION Our data demonstrate that the spatial (vertical/horizontal) disposition of materials affects the initial contamination level, which is always much lower on vertical surfaces than on horizontal ones. Moreover, postsanitation bacterial load recovery is dependent on the physical properties of the surface.

Organometallic complexes with biological molecules: XII. Solid‐state and solution studies on dialkyltin(IV)– and trialkyltin(IV)–thiaminepyrophosphate derivatives

Dialkyltin(IV) and trialkyltin(IV) derivatives of the coenzyme thiaminepyrophosphate (H2TPP) have been synthesized with general formula R2Sn(HTPP)2·nH2O (Alk = Me, n = 2; Alk = Bu, n = 4) and R3SnHTPP·nH2O (R=Me, n = 2; R = Bu, n = 1), respectively. The solid-state structure of the complexes has been investigated through infrared and Mossbauer spectroscopy. The infrared data suggest the involvement of only phosphate oxygen atoms in the coordination of both dialkyl- and trialkyl-tin(IV) moieties, with phosphate anions behaving as monoanionic bidentate bridging or chelating groups, with the tin(IV) involved in six- and five-fold coordination geometries, respectively, in R2Sn(HTPP)2·nH2O (R = Me, n = 2; R = Bu, n = 4) and R3SnHTPP·nH2O (R = Me, n = 2; R = Bu, n = 1). The 119Sn Mossbauer data, and in particular rationalization of the experimental nuclear quadrupole splittings, Δ, through the point-charge model formalism, suggests the occurrence of an octahedral trans-R2 structure in R2Sn(HTPP)2·nH2O (R = Me, n = 2; R = Bu, n = 4) and a trigonal-bipyramidal structure in R3SnHTPP·nH2O (R = Me, n = 2; R = Bu, n = 1). 1H and 13C NMR spectra, in D2O, suggested that the soluble derivatives, at room temperature, in solution, maintained the solid-state structure. The interactions of dibutyltin(IV)–thiaminepyrophosphate (DBTPP) and tributyltin(IV)–thiaminepyrophosphate (TBTPP) complexes with Bluescript KS(+) plasmid and immortalized 3T3 fibroblasts were studied. Both compounds have a clear inhibitory effect on the growth of immortalized mouse embryonal fibroblasts (NIH-3T3), TBTPP being the much more active. No evidence was found, however, for DNA cleavage by the compounds at molar ratios as high as 1:10 (DBTPP, TBTPP/DNA base pairs). According to our observations, the cytotoxicity of TBTPP does not seem to be based on direct interaction with DNA, but in the presence of TBTPP (1:10, TBTPP/DNA bp), plasmid DNA seems to be more susceptible to cleavage by UV. Copyright

End-stage organ failure: will regenerative medicine keep its promise?

End-stage organ failure is a major cause of death worldwide that can occur in patients of all ages and transplantation is the current standard of care for chronic end-stage disease of many organs. Despite the success of organ transplantation, it is becoming clear that there will never be enough organs made available through donation to meet the increasing demand. The past decades rapid advancement in stem cell biology and tissue engineering generated an explosive outburst of reports that gave rise to regenerative medicine, a new field that promises to “fix” damaged organs through regeneration provided by transplanted cells, stimulation of endogenous repair mechanisms, or implantation of bioengineered tissue. Whether, and if so when, regenerative medicine will keep its promise is uncertain. As we continue to strive to find new effective solutions, alternative approaches based on the development of targeted, preventive interventions aimed at maintaining normal organ function, instead of repairing organ damage, should also be pursued.

Prostaglandin E2 Indicates Therapeutic Efficacy of Mesenchymal Stem Cells in Experimental Traumatic Brain Injury

Traumatic brain injury (TBI) is soon predicted to become the third leading cause of death and disability worldwide. After the primary injury, a complex set of secondary injuries develops hours and days later with prolonged neuroinflammation playing a key role. TBI and other inflammatory conditions are currently being treated in preclinical and clinical trials by a number of cellular therapies. Mesenchymal stem cells (MSC) are of great interest due to their widespread usage, safety, and relative ease to isolate and culture. However, there has been a wide range in efficacy reported using MSC clinically and in preclinical models, likely due to differences in cell preparations and a significant amount of donor variability. In this study, we seek to find a correlation between in vitro activity and in vivo efficacy. We designed assays to explore the responsiveness of MSC to immunological cues to address the immunomodulatory properties of MSC, one of their primary modes of therapeutic activity in TBI. Our results showed intrinsic differences in the immunomodulatory capacity of MSC preparations from different bone marrow and amniotic fluid donors. This difference mirrored the therapeutic capacity of the MSC in an experimental model of TBI, an effect confirmed using siRNA knockdown of COX2 followed by overexpressing COX2. Among the immunomodulatory factors assessed, the therapeutic benefit correlated with the secretion of prostaglandin E2 (PGE2) by MSC prior to treatment, suggesting that measurement of PGE2 could be a very useful potency marker to create an index of predicted efficacy for preparations of MSC to treat TBI. Stem Cells 2017;35:1416–1430

Critical micellisation density: a SAS structural study of the unimer-aggregate transition of block-copolymers in supercritical CO2

In this paper we report a SANS investigation of micelle formation by fluorocarbon-hydrocarbon block copolymers in supercritical CO, (scCO,) at 313K. A sharp unimer-micelle transition is obtained due to the tuning of the solvating ability of scCO 2 by profiling pressure. At high pressure the copolymer is in a monomeric state with a random coil structure. By lowering the pressure aggregates are formed with the hydrocarbon segments forming the core and the fluorocarbon segments forming the corona of spherical aggregates. This aggregate-unimer transition is driven by the gradual penetration of CO 2 molecules toward the core of the aggregate and is critically related to the density of the solvent, thus suggesting the definition of a critical micellisation density (CMD).