U.S. patent application number 10/608997 was filed with the patent office on 2004-05-13 for isolated stromal cells for use in the treatment of diseases of the central nervous system.
This patent application is currently assigned to Philadelphia Health & Education Corporation. Invention is credited to Azizi, S. Ausim, Prockop, Darwin J., Stokes, David G..
Application Number | 20040091464 10/608997 |
Document ID | / |
Family ID | 21843237 |
Filed Date | 2004-05-13 |
United States Patent
Application |
20040091464 |
Kind Code |
A1 |
Prockop, Darwin J. ; et
al. |
May 13, 2004 |
Isolated stromal cells for use in the treatment of diseases of the
central nervous system
Abstract
Methods of treating a human patient having a disease, disorder
or condition of the central nervous system are disclosed. The
methods include obtaining a bone marrow sample from a human donor,
isolating stromal cells from the bone marrow sample, and
administering the isolated stromal cells to the central nervous
system of the human patient, wherein the presence of the isolated
stromal cells in the brain effects treatment of the disease,
disorder or condition. Stromal cells which are isolated may be
cultured in vitro, they may be genetically engineered to produce
therapeutic compounds, and/or they may be pre-differentiated prior
to administration into the central nervous system.
Inventors: |
Prockop, Darwin J.; (New
Orleans, LA) ; Stokes, David G.; (Willow Grove,
PA) ; Azizi, S. Ausim; (Philadelphia, PA) |
Correspondence
Address: |
MORGAN, LEWIS & BOCKIUS LLP
1701 MARKET STREET
PHILADELPHIA
PA
19103-2921
US
|
Assignee: |
Philadelphia Health & Education
Corporation
|
Family ID: |
21843237 |
Appl. No.: |
10/608997 |
Filed: |
June 27, 2003 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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10608997 |
Jun 27, 2003 |
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09028395 |
Feb 24, 1998 |
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6653134 |
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09028395 |
Feb 24, 1998 |
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PCT/US96/04407 |
Mar 28, 1996 |
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PCT/US96/04407 |
Mar 28, 1996 |
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08412066 |
Mar 28, 1995 |
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5716616 |
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Current U.S.
Class: |
424/93.21 ;
435/368 |
Current CPC
Class: |
A61K 38/2264 20130101;
A61K 48/00 20130101; A61P 25/28 20180101; C12N 2502/1311 20130101;
C12N 5/0663 20130101; A61K 38/2264 20130101; A61K 35/28 20130101;
C07K 16/2845 20130101; A61K 35/28 20130101; A61K 38/177 20130101;
A61P 25/16 20180101; C12Y 114/16002 20130101; C07K 14/4702
20130101; C07K 14/61 20130101; A61P 25/00 20180101; C12N 2799/027
20130101; A61K 38/177 20130101; A61K 38/44 20130101; C12N 5/0622
20130101; C12Y 304/21022 20130101; C07K 14/745 20130101; A61K 38/00
20130101; A61K 38/44 20130101; A61K 38/4846 20130101; C07K 14/78
20130101; A61P 35/00 20180101; C12N 2501/135 20130101; C12N 2502/08
20130101; A61K 38/4846 20130101; C12N 2506/1353 20130101; A61P
11/00 20180101; A61K 2300/00 20130101; A61K 2300/00 20130101; A61P
43/00 20180101; A61K 2300/00 20130101; A61K 2300/00 20130101; A61K
2300/00 20130101 |
Class at
Publication: |
424/093.21 ;
435/368 |
International
Class: |
A61K 048/00; C12N
005/08 |
Goverment Interests
[0002] This work was supported in part by U.S. Government funds
(National Institutes of Health, Grant No. AR44210), and the U.S.
Government may therefore have certain rights in the invention.
Claims
What is claimed is:
1. A method of treating a human patient having a disease, disorder
or condition of the central nervous system, the method comprising
obtaining a bone marrow sample from a human donor, isolating
stromal cells from said bone marrow sample, and administering said
isolated stromal cells to the central nervous system of said human
patient, wherein the presence of said isolated stromal cells in
said central nervous system effects treatment of said disease,
disorder or condition.
2. The method of claim 1, wherein said human donor is not suffering
from a disease, disorder or condition of the central nervous system
and wherein said human donor is synergeneic with said patient.
3. The method of claim 1, wherein said human donor is said human
patient.
4. The method of claim 1, wherein said disease, disorder or
condition of the central nervous system is selected from the group
consisting of a genetic disease, a tumor, trauma and stroke.
5. The method of claim 4, wherein said disease, disorder or
condition is injury to the tissues or cells of said central nervous
system.
6. The method of claim 4, wherein said disease, disorder or
condition is a brain tumor.
7. The method of claim 1, wherein said isolated stromal cells
administered to said central nervous system remain present or
replicate in said central nervous system.
8. The method of claim 1, wherein prior to administering said
isolated stromal cells, said cells are cultured in vitro.
9. The method of claim 1, wherein prior to administering said
isolated stromal cells, said isolated stromal cells are transfected
with an isolated nucleic acid encoding a therapeutic protein,
wherein when said protein is expressed in said cells said protein
serves to effect treatment of said disease, disorder or
condition.
10. The method of claim 9, wherein said therapeutic protein is
selected from the group consisting of a cytokine, a chemokine and a
neurotrophin.
11. The method of claim 1, wherein prior to administering said
isolated stromal cells, said isolated stromal cells are transfected
with an isolated nucleic acid encoding a therapeutic protein
wherein when such protein is secreted by said cells said protein
serves to effect treatment of said disease, disorder or
condition.
12. The method of claim 11, wherein said isolated nucleic acid is
operably linked to a promoter/regulatory sequence.
13. The method of claim 11, wherein said therapeutic protein is
selected from the group consisting of a cytokine, a chemokine and a
neurotrophin.
14. The method of claim 9, wherein said isolated nucleic acid is a
wild type copy of a mutated, non-functioning or under-expressed
gene, wherein said isolated nucleic acid is operably linked to a
promoter/regulatory sequence and is expressed in said isolated
stromal cells.
15. The method of claim 11, wherein said isolated nucleic acid is a
wild type copy of a mutated, non-functioning or under-expressed
gene, wherein said isolated nucleic acid is operably linked to a
promoter/regulatory sequence and is expressed in to generate a
protein which is secreted from said isolated stromal cells.
16. The method of claim 1, wherein prior to administrating said
stromal cells, said cells are pre-differentiated by coculturing
said stromal cells in the presence of a substantially homogeneous
population of differentiated cells, whereby said stromal cells
differentiate and acquire the phenotypic characteristics of said
differentiated cells.
17. The method of claim 1, wherein prior to administration of said
isolated stromal cells at least one of the steps of culturing said
cells in vitro, introducing isolated nucleic acid into said cells,
and pre-differentiating said cells, is performed.
18. The method of claim 1, wherein said isolated stromal cells are
immunologically isolated.
19. A method of directing the differentiation of an isolated
stromal cell comprising culturing said isolated stromal cell in the
presence of a substantially homogeneous population of
differentiated cells whereby said isolated stromal cell
differentiates and acquires the phenotypic characteristics of said
differentiated cells.
20. The method of claim 19, wherein said differentiated cells are
astrocytes.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] The present application is a continuation-in-part of PCT
Application No. US/PCT96/04407, filed on Mar. 28, 1996, which is a
continuation of U.S. application Ser. No. 08/412,066, filed on Mar.
28, 1995, and which is also entitled to priority under 35 U.S.C.
119(e) to U.S. Provisional Application No. 60/006,627, filed on
Nov. 13, 1995.
FIELD OF THE INVENTION
[0003] The invention relates to compositions and methods of
treating a mammal suffering from a disease, disorder or a condition
associated with the central nervous system, using isolated stromal
cells.
BACKGROUND OF THE INVENTION
[0004] Neurological damage in a mammal having as its genesis
trauma, tumor formation or a genetic or other component, is very
difficult to treat and/or reverse in the mammal. One treatment for
neurological damage to the central nervous system is
neurotransplantation. Over the last few decades,
neurotransplantation has been used to explore the development,
plasticity, and regeneration of the central nervous system (McKay,
1997, Science 276:66-71). Also, neurotransplantation has been used
to effect the repair and functional restoration of diseased and
damaged nervous tissues (Bjorklund, 1993, Nature 362:414-415;
Olson, 1997, Nature Med. 3:1329-1335; Spencer et al., 1992, N.
Engl. J. Med. 327:1541-1548: Freed et al., 1992, N. Engl. J. Med
327:1549-1555; Kordower et al., 1995, N. Engl. J. Med.
332:1118-1124; Defer et al., 1996, Brain 119:41-50; Lopez-Lozano et
al., 1997, Transp. Proc. 29:977-980; Rosenstein, 1995, Exp. Neurol.
33:106; Turner et al., 1993, Neurosurg. 33:1031-1037; Kang et al.,
1993, J. Neurosci. 13:5203-5211; Andersson et al., 1993, Int. J.
Dev. Neurosci. 11:555-568; Sanberg et al., 1997, Nature Med.
3:1129-1132). In particular, a series of human patients with
Parkinson's disease have been treated by neurotransplantation of
mesencephalic cells obtained from 6 to 9 week old abortuses of
human fetuses (Spencer et al., 1992, N. Engl. J. Med.
327:1541-1548: Freed et al., 1992, N. Engl. J. Med 327:1549-1555;
Kordower et al., 1995, N. Engl. J. Med. 332:1118-1124; Defer et
al., 1996, Brain 119:41-50; Lopez-Lozano et al., 1997, Transp.
Proc. 29:977-980). Some of the patients exhibited significant
improvement both in clinical symptoms and in the synthesis of
dopamine, as assessed by fluorodopa uptake using positron-emission
tomography (Spencer et al., 1992, N. Engl. J. Med. 327:1541-1548:
Freed et al., 1992, N. Engl. J. Med 327:1549-1555; Kordower et al.,
1995, N. Engl. J. Med. 332:1118-1124; Defer et al., 1996, Brain
119:41-50). However, the process of obtaining fetal tissue for
therapeutic uses has presented major logistic and ethical barriers
(Rosenstein, 1995, Exp. Neurol. 33:106; Turner et al., 1993,
Neurosurg. 33:1031-1037). Also, only about 5 to 10% of dopaminergic
neurons survive, apparently because of adverse immune reaction to
the same (Lopez-Lozano et al., 1997, Transp. Proc. 29:977-980) and
because the fetal tissue is primarily dependent on lipid instead
glycolytic metabolism (Rosenstein, 1995, Exp. Neurol. 33:106). For
these reasons, attempts have been made to develop alternative cells
such as fibroblasts (Kang et al., 1993, J. Neurosci. 13:5203-5211),
fetal astrocytes (Andersson et al., 1993, Int. J. Dev. Neurosci.
11:555-568), and sertoli cells (Sanberg et al., 1997, Nature Med.
3:1129-1132) which are suitable for neurotransplantation.
[0005] In order to treat diseases, disorders, or conditions of the
central nervous system, such as for example brain tumors, brain
trauma, Huntington's disease, Alzheimer's disease, Parkinson's
disease, and spinal cord injury, by transplantation, donor cells
should be easily available, capable of rapid expansion in culture,
immunologically inert, capable of long term survival and
integration in the host brain tissue, and amenable to stable
transfection and long-term expression of exogenous genes
(Bjorklund, 1993, Nature 362:414-415; Olson, 1997, Nature Med.
3:1329-1335). Donor cells meeting these criteria are not currently
available.
[0006] In addition to the hematopoietic stem cells, bone marrow
contains stem-like precursors for non-hematopoietic cells, such as
osteoblasts, chondrocytes, adipocytes and myoblasts (Owen et al.,
1988, in Cell and Molecular Biology of Vertebrate Hard Tissues,
Ciba Foundation Symposium 136, Chichester, UK, pp. 42-60; Caplan,
1991, J. Orthop. Res. 9:641-650; Prockop, 1997, Science 276:71-74).
Non-hematopoietic precursors of the bone marrow have been variously
referred to as colony-forming-unit-fibrob- lasts, mesenchymal stem
cells, and marrow stromal cells (MSCs).
[0007] MSCs are mesenchymal precursor cells (Friedenstein et al.,
1976, Exp. Hemat. 4:267-274) that are characterized by their
adherence properties when bone marrow cells are removed from a
mammal and are transferred to plastic dishes. Within about four
hours, MSCs adhere to the plastic and can thus be isolated by
removing non-adherent cells from the dishes. Bone marrow cells,
i.e., MSCs, that tightly adhere to plastic have been studied
extensively (Castro-Malaspina et al., 1980, Blood 56:289-30125;
Piersma et al., 1985, Exp. Hematol 13:237-243; Simmons et al.,
1991, Blood 78:55-62; Beresf ord et al., 1992, J. Cell. Sci.
102:341- 3 51; Liesveld et al., 1989, Blood 73:1794-1800; Liesveld
et al., Exp. Hematol 19:63-70; Bennett et al., 1991, J. Cell. Sci.
99:131-139). The terms "MSCs" and "stromal cells" are used
interchangeably herein.
[0008] Stromal cells are believed to participate in the creation of
the microenvironment within the bone marrow in vivo. When isolated,
stromal cells are initially quiescent but eventually begin dividing
so that they can be cultured in vitro. Expanded numbers of stromal
cells can be established and maintained. Stromal cells have been
used to generate colonies of fibroblastic adipocytic and osteogenic
cells when cultured under appropriate conditions. They can also be
made to differentiate into cartilage cells and myoblasts. If the
adherent cells are cultured in the presence of hydrocortisone or
other selective conditions, populations enriched for hematopoietic
precursors or osteogenic cells are obtained (Carter et al., 1992,
Blood 79:356-364 and Bienzle et al., 1994, Proc. Natl. Acad. Sci
USA, 91:350-354).
[0009] There are several examples of the use of stromal cells for
treatment of disease. For example, European Patent EP 0,381,490,
discloses gene therapy using stromal cells. In particular, a method
of treating hemophilia is disclosed. Stromal cells have been used
to produce fibrous tissue, bone or cartilage when implanted into
selective tissues in vivo (Ohgushi et al., 1989, Acte. Orthop.
Scand. 60:334-339; Nakahara et al., 1992, J. Orthop. Res.
9:465-476; Niedzwiedski et al., 1993, Biomaterials 14:115-121; and
Wakitani et al., 1994, J. Bone & Surg. 76A:579-592). In some
reports, stromal cells have been used to generate bone or cartilage
in vivo when implanted subcutaneously with a porous ceramic
(Ohgushi, et al., 1989, Acta. Orthop. Scand. 60:334-339),
intraperitoneally in a diffusion chamber (Nakahara et al., 1991, J.
Orthop. Res. 9:465-476), percutaneously into a surgically induced
bone defect (Niedzwiedski, et al., 1993, Biomaterials 14: 115-121),
or transplanted within a collagen gel to repair a surgical defect
in a joint cartilage (Wakitani et al., 1994, J. Bone Surg. 76A:
579-592). Piersma et al. (1983, Brit. J. Hematol. 94:285-290)
disclose that after intravenous bone marrow transplantation, the
fibroblast colony-forming cells which make up the hemopoietic
stroma lodge and remain in the host bone marrow. Stewart et al.
(1993, Blood 81:2566-2571) recently observed that unusually large
and repeated administrations of whole marrow cells produced
long-term engraftment of hematopoietic precursors into mice that
had not undergone marrow ablation. Also, Bienzle et al. (1994,
Proc. Natl. Acad. Sci. USA, 91:350-354) successfully used long-term
bone marrow cultures as donor cells to permanently populate
hematopoietic cells in dogs without marrow ablation. In some
reports, stromal cells were used either as cells that established a
microenvironment for the culture of hematopoietic precursors
(Anklesaria, 1987, PNAS USA 84:7681-7685) or as a source of an
enriched population of hematopoietic stem cells (Kiefer, 1991,
Blood 78(10):2577-2582).
[0010] Given the paucity of successful treatments for diseases,
disorders and conditions of the central nervous system, there
remains a need for additional methods of treating patients affected
by a disease, disorder, or condition of the central nervous system.
The present invention satisfies this need and overcomes the
deficiencies of prior art treatments.
SUMMARY OF THE INVENTION
[0011] The invention relates to a method of treating a human
patient having a disease, disorder or condition of the central
nervous system. The method comprises obtaining a bone marrow sample
from a human donor, isolating stromal cells from the bone marrow
sample, and administering the isolated stromal cells to the central
nervous system of the human patient, wherein the presence of the
isolated stromal cells in the central nervous system effects
treatment of the disease, disorder or condition.
[0012] In one aspect, the human donor is not suffering from a
disease, disorder or condition of the central nervous system and
the human donor is synergeneic with the patient.
[0013] In another aspect, the human donor is the human patient.
[0014] In yet another aspect, the disease, disorder or condition of
the central nervous system is selected from the group consisting of
a genetic disease, a tumor, trauma and stroke.
[0015] In a preferred embodiment, the disease, disorder or
condition is injury to the tissues or cells of the central nervous
system. In another preferred embodiment, the disease, disorder or
condition is a brain tumor.
[0016] In another aspect, the isolated stromal cells administered
to the central nervous system remain present or replicate in the
central nervous system.
[0017] In a further aspect, prior to administering the isolated
stromal cells, the cells are cultured in vitro.
[0018] In yet a further aspect, prior to administering the isolated
stromal cells, the isolated stromal cells are transfected with an
isolated nucleic acid encoding a therapeutic protein, wherein when
the protein is expressed in the cells the protein serves to effect
treatment of the disease, disorder or condition.
[0019] In a preferred embodiment, the therapeutic protein is
selected from the group consisting of a cytokine, a chemokine and a
neurotrophin.
[0020] In yet another aspect, prior to administering the isolated
stromal cells, the isolated stromal cells are transfected with an
isolated nucleic acid encoding a therapeutic protein wherein when
such protein is secreted by the cells the protein serves to effect
treatment of the disease, disorder or condition.
[0021] In a preferred embodiment, the isolated nucleic acid is
operably linked to a promoter/regulatory sequence. In yet another
preferred embodiment, the therapeutic protein is selected from the
group consisting of a cytokine, a chemokine and a neurotrophin.
And, in a further preferred embodiment, the isolated nucleic acid
is a wild type copy of a mutated, non-functioning or
under-expressed gene, wherein the isolated nucleic acid is operably
linked to a promoter/regulatory sequence and is expressed in the
isolated stromal cells.
[0022] In yet another preferred embodiment, the isolated nucleic
acid is a wild type copy of a mutated, non-functioning or
under-expressed gene, wherein the isolated nucleic acid is operably
linked to a promoter/regulatory sequence and is expressed in to
generate a protein which is secreted from the isolated stromal
cells.
[0023] In another aspect of this aspect of the invention, prior to
administrating the stromal cells, the cells are pre-differentiated
by coculturing the stromal cells in the presence of a substantially
homogeneous population of differentiated cells, whereby the stromal
cells differentiate and acquire the phenotypic characteristics of
the differentiated cells.
[0024] In yet another aspect, prior to administration of the
isolated stromal cells at least one of the steps of culturing the
cells in vitro, introducing isolated nucleic acid into the cells,
and pre-differentiating the cells, is performed.
[0025] In another aspect, the isolated stromal cells are
immunologically isolated.
[0026] The invention also relates to a method of directing the
differentiation of an isolated stromal cell comprising culturing
the isolated stromal cell in the presence of a substantially
homogeneous population of differentiated cells whereby the isolated
stromal cell differentiates and acquires the phenotypic
characteristics of the differentiated cells.
[0027] In one aspect of this aspect of the invention, the
differentiated cells are astrocytes.
BRIEF DESCRIPTION OF THE DRAWINGS
[0028] FIG. 1 is a schematic of the retroviral constructs pCMV-lac
Z, pCOL1-lac Z, and pCOL2-lac Z. The cassettes of the gene
constructs are: LTR-Neo-promoter-Lac Z30 LTR.
[0029] FIG. 2 is a schematic illustration of a diffusion
chamber.
[0030] FIG. 3 is a graph depicting the effect of PDGF-AA on the
growth of human of MSCs. The following symbols are represented:
.diamond-solid., control; .tangle-solidup., _ng/ml PDGF;
.quadrature., _ng/ml PDGF; .box-solid., _ng/ml PDGF.
[0031] FIG. 4 comprising Panels A-F, is an image of
photomicrographs illustrating the morphological characteristics of
MSCs and astrocytes in culture. Panel A and Panel B depict two
types of human MSCs: flat and elongated. Panel C depicts rat MSCs.
Panel D depicts fluorescent labeled nuclei of human MSCs prior to
implantation. Panels E and F depict indirect immunofluorescent
staining of astrocytes with antibodies against vimentin and glial
fibrillary acidic protein.
[0032] FIG. 5 comprising Panels a-f, is an image of
photomicrographs depicting the site of implantation of bone marrow
stromal cells in the striatum of adult rats. Panel a depicts the
site of implantation of human MSCs after 14 days. Panel b depicts
an adjacent section to that shown in a, wherein human MSCs were
stained with antibodies to HLA-ABC. Panel c depicts an adjacent
section to that in a, wherein cells were examined for nuclear
fluorescence of human MSCs. Panel d depicts the site of
implantation of human MSCs after 72 days. Panel e depicts the same
site of implantation as in Panel d of human MSCs after 30 days.
Panel f depicts the site of implantation of human MSCs after 14
days. These cells were examined by nuclear fluorescence.
[0033] FIG. 6 is a series of line drawings of rat forebrain,
illustrating the migration of MSCs through the brain. The drawing
is a composite from brains examined at 4, 14, 30 and 72 days after
cell infusion. The pattern of implantation and migration of human
MSCs is similar to that of rat astrocytes. The outlying cells,
located in the temporal cortex and areas of corpus callosum
farthest from the injection sites, were first to disappear. The
following symbols are represented: .circle-solid., human MSCs;
.largecircle., rat astrocytes.
[0034] FIG. 7 comprising Panels a-c, is an image of
photomicrographs depicting antibody staining to collagen I and
fibronectin. Panel a depicts human MSCs stained with antibodies to
collagen I prior to implantation. Panel b depicts human MSCs
stained with antibodies to fibronectin. Panel c depicts a section
of a rat brain stained for fibronectin 5 days after implantation of
human MSCs.
DETAILED DESCRIPTION OF THE INVENTION
[0035] The invention includes compositions and methods for treating
patients affected by a disease, disorder, or condition of the
central nervous system. The composition is isolated marrow cells
which may or may not be genetically altered using recombinant DNA
technology. The method comprises the steps of obtaining a bone
marrow sample from a donor, isolating stromal cells from the bone
marrow sample and administering the isolated stromal cells directly
into the central nervous system of the patient.
Definitions
[0036] As used herein, "central nervous system" should be construed
to include brain and/or the spinal cord of a mammal. The term may
also include the eye and optic nerve in some instances.
[0037] As used herein, "stromal cells", "colony forming
fibroblasts", "marrow stromal cells", "adherent cells" and "MSCs"
are used interchangeably and are meant to refer to the small
fraction of cells in bone marrow which can serve as stem cell like
precursors of osteocytes, chondrocytes, and adipocytes and which
can be isolated from bone marrow by their ability adhere to plastic
dishes. Stromal cells may be derived from any animal. In some
embodiments, stromal cells are derived from primates, preferably
humans.
[0038] As used herein, the term "adherent cells" is meant to refer
to stromal cells.
[0039] The term "non-adherent cells" as used herein, is meant to
refer to hematopoietic precursor cells.
[0040] As used herein, the term "disease, disorder or condition of
the central nervous system" is meant to refer to a disease,
disorder or a condition which is caused by a genetic mutation in a
gene that is expressed by cells of the central nervous system such
that one of the effects of such a mutation is manifested by
abnormal structure and/or function of the central nervous system,
such as, for example, neurodegenerative disease or primary tumor
formation. Such genetic defects may be the result of a mutated,
non-functional or under-expressed gene in a cell of the central
nervous system. The term should also be construed to encompass
other pathologies in the central nervous system which are not the
result of a genetic defect per se in cells of the central nervous
system, but rather are the result of infiltration of the central
nervous system by cells which do not originate in the central
nervous system, for example, metastatic tumor formation in the
central nervous system. The term should also be construed to
include trauma to the central nervous system induced by direct
injury to the tissues of the central nervous system.
[0041] As used herein, "a disease, disorder or condition
characterized by a gene defect" is meant to refer to a disease,
disorder and condition in which a defective gene and/or
insufficient gene expression is causally linked to the disease,
disorder or condition. Individual who have any of several well
known diseases, disorders and conditions characterized by a gene
defect can be identified by those having ordinary skill in the
art.
[0042] As used herein, "a disease, disorder or condition
characterized by a defect in a gene which encodes a secreted
protein" is meant to refer to a disease, disorder or condition
characterized by a gene defect in which the gene that is defective
or insufficiently expressed encodes a protein that is abnormally
secreted from the cell.
[0043] By the term "abnormal secretion" is meant that the protein
is processed in the cell in a manner which differs from the normal,
i.e., wild type, non-defective protein. For example, the normal
protein may be secreted from the cell in a particular structural
configuration; abnormal secretion of this protein may occur when
the protein is secreted in a different configuration. Further by
way of example, when the normal protein is normally secreted from
the cell, abnormal secretion of the protein may occur if the
protein is not secreted from the cell, or is secreted from the cell
at a level which differs markedly, i.e., is higher or lower, from
the normal level of secretion of the normal protein.
[0044] As used herein, "a disease, disorder or condition which can
be treated with a beneficial protein" is meant to refer to a
disease, disorder or condition that can be treated or prevented by
the presence of a protein which alleviates, reduces, prevents or
causes to be alleviated, reduced or prevented, the causes and/or
symptoms that characterize the disease, disorder or condition.
Diseases, disorders and conditions which can be treated with a
beneficial protein include diseases, disorders and conditions
characterized by a gene defect as well as those which are not
characterized by a gene defect but which nonetheless can be treated
or prevented by the presence of a protein which alleviates,
reduces, prevents or causes to be alleviated, reduced or prevented,
the causes and/or symptoms that characterize the disease, disorder
or condition.
[0045] As used herein, "beneficial protein" and "heterologous
protein" are interchangeable and are meant to refer to a protein
which can compensate for the protein encoded by a defective gene
and/or insufficient gene expression that is causally linked to the
disease or symptoms of the disease, disorder or condition
characterized by a gene defect. The presence of the protein
alleviates, reduces, prevents or causes to be alleviated, reduced
or prevented, the causes and/or symptoms that characterize the
disease, disorder or condition.
[0046] As used herein, "injury to the tissues or cells of the
central nervous system caused by a tumor," is meant to refer to a
disease, disorder or a condition of the central nervous system,
wherein new growth of tissue occurs, usually in the brain and
includes multiplication of cells which is uncontrollable and
progressive. The cells which multiply may originate from, or may
not originate from the central nervous tissue.
[0047] As used herein, "immunologically isolated", "immunologically
protected", "immunologically neutralized", and "a manner that
physically isolates cells from the recipient's immune system" are
meant to refer to the encapsulation, containment or other physical
separation of an implanted cell from the body into which it is
implanted such that the cell is not exposed to and cannot be
eliminated by the immune system of the body, such that cells which
are immunologically isolated are administered in a manner that
physically isolates them from the recipient's immune system.
Examples of immunological isolation methods include, but are not
limited to, well known technologies and devices such as
microencapsulation, biocompatible matrices, diffusion chambers,
implantable cartridges, implant devices with membrane assemblies
and other containers with membranes. It is preferred that cells are
immunologically isolated by maintaining them in the body within an
implant device.
[0048] The term "isolated nucleic acid" should be construed to
refer to a nucleic acid sequence, or segment, or fragment which has
been purified from the sequences which flank it in a naturally
occurring state, e.g., a DNA fragment which has been removed from
the sequences which are normally adjacent to the fragment e.g., the
sequences adjacent to the fragment in a genome in which it
naturally occurs. The term also applies to nucleic acids which have
been substantially purified from other components which naturally
accompany the nucleic acid, e.g., RNA or DNA or proteins which
naturally accompany it in the cell.
[0049] As used herein, "an isolated nucleic acid molecule" may be
one which either is not present in stromal cells or is not
expressed as a protein in sufficiently high levels in stromal cells
until it is introduced into the cell by means such as, but not
limited to, classical transfection (calcium phosphate or DEAE
dextran-mediated transfection), electroporation, microinjection,
liposome-mediated transfer, chemical-mediated transfer, ligand
mediated transfer or recombinant viral vector transfer.
[0050] As used herein, "gene construct" is meant to refer to an
isolated nucleic acid molecule which includes coding sequences that
encode a beneficial protein operably linked to a
promoter/regulatory sequence having elements sufficient for
expression of the coding sequence in stromal cells.
[0051] As used herein, "promoter/regulatory sequence" means a DNA
sequence which is required for specific expression of a gene
operably linked to the promoter/regulator sequence. In some
instances, this sequence may be the core promoter sequence and in
other instances, this sequence may also include an enhancer
sequence and other regulatory elements which are required for
expression of the gene in a tissue-specific or otherwise inducible
or constitutive manner.
[0052] By describing two nucleic acid sequences as "operably
linked" as used herein, is meant that a single-stranded or
double-stranded nucleic acid moiety comprises each of the two
nucleic acid sequences and that the two sequences are arranged
within the nucleic acid moiety in such a manner that at least one
of the two nucleic acid sequences is able to exert a physiological
effect by which it is characterized upon the other.
[0053] As used herein, "heterologous gene" is meant to refer to the
coding sequence of the gene construct.
[0054] A "heterologous protein" as used herein, is one which is
encoded by a heterologous gene.
[0055] As used herein, the terms "recombinant genetic material" and
"recombinant gene" are used interchangeably and meant to refer to
genomic DNA, cDNA, synthetic DNA and RNA, mRNA and antisense DNA
and RNA which is introduced into the stromal cell. The recombinant
genetic material may be heterologous genetic material or may be an
additional copy or copies of genetic material normally found in the
individual or animal. When cells are used as a component of a
pharmaceutical composition in a method for treating a human
disease, disorder or condition, the recombinant genetic material
that is used to transform the cells may encode a protein selected
as a therapeutic used to treat the individual and/or to render the
cells more amenable to transplantation.
[0056] As used herein, "transfected stromal cells" is meant to
refer to stromal cells to which a gene construct has been provided
using any technology used to introduce nucleic acid molecules into
cells such as, but not limited to, classical transfection (calcium
phosphate or DEAE dextran mediated transfection), electroporation,
microinjection, liposome-mediated transfer, chemical-mediated
transfer, ligand mediated transfer or recombinant viral vector
transfer.
[0057] As used herein, the term "pre-differentiated" should be
construed to mean isolated stromal cells which are cocultured with
a substantially homogeneous population of differentiate cells such
that the isolated stromal cells differentiate and acquire
phenotypic characteristics of the differentiated cells.
[0058] As used herein, the term "phenotypic characteristics" should
be construed to mean at least one of the following characteristics:
morphological appearance, the expression of a specific protein, a
staining pattern, and the ability to be stained with a
substance.
[0059] The phrase "substantially homogeneous population of
differentiated cells" as used herein should be construed to mean a
population of cells wherein at least 75% of the cells exhibit the
same differentiated phenotype.
[0060] The phrase "directing differentiation" as used herein,
should be construed to mean the induction of a differentiated
phenotype in an undifferentiated cell by coculturing the
undifferentiated cell in the presence of a substantially
homogeneous population of differentiated cells.
Description
[0061] The present invention is based on the discovery that MSCs
which are isolated by adhesion to plastic and are infused into
mammal brain, engraft, migrate, and differentiate into cells of the
central nervous system, while other cells remain as precursor cells
which throw off daughter cells that differentiate into cells of the
central nervous system. This discovery allows for the successful
treatment of an individual, i.e., a mammal and preferably, a human
patient, suffering from a disease, disorder or a condition
associated with the central nervous system, by either providing the
individual with stromal cells obtained from a normal, matched
syngeneic donor, or by isolating stromal cells from the individual,
culturing the cells and genetically modifying them to correct
whatever genetic defect is responsible for the disease, disorder or
condition associated with the defect in the central nervous
system.
[0062] In a preferred embodiment of the invention, stromal cells
obtained from a matched donor are administered to an individual
suffering from a disease, disorder or condition involving the
central nervous system, in order to augment or replace the diseased
and damaged nervous cells. Stromal cells are preferably
administered to a human. Stromal cells are further preferably
administered to the brain of the human. In some instances, the
cells are administered to the corpus striatum portion of the human
brain. The precise site of administration of the stromal cells will
depend on any number of factors, including but not limited to, the
site of the lesion to be treated, the type of disease being
treated, the age of the human and the severity of the disease, and
the like. Determination of the site of administration is well
within the skill of the artisan versed in the administration of
such cells.
[0063] The mode of administration of the stromal cells to the
central nervous system of the human may vary depending on several
factors including the type of disease being treated, the age of the
human, whether the stromal cells are differentiated or not, whether
the stromal calls have heterologous DNA introduced therein, and the
like. An example of administration of stromal cells directly into
brain tissue is provided herein in the experimental details
section. In that example, cells are introduced into the brain of a
mammal be first creating a hole in the cranium through which the
cells are then passed into the brain tissue. Cells may be
introduced by direct injection, by using a shunt, or by any other
means used in the art for the introduction of compounds into the
central nervous system.
[0064] There are several ways in which stromal cells may be used in
a mammal, preferably, a human, to treat diseases of the central
nervous system. For example, stromal cells may be used as precursor
cells that differentiate following introduction the central nervous
system or as cells which have been differentiated into neural cells
prior to introduction into the central nervous system. In either
situation, as the data presented herein establishes, the cells
become permanent residents of the central nervous system. These
cells may therefore replace cells in the central nervous system
which have been lost as a result of a genetic disease, trauma, or
other injury. In addition, prior to introduction into the central
nervous system, stromal cells may be genetically engineered to
produce molecules such as cytokines, neurotrophins, and the like,
which will beneficially influence cells which are already present
in the central nervous system. For example, genetically engineered
stromal cells which are then introduced into the central nervous
system may be used to repair any central nrevous system damage,
and/or to combat tumors of the central nervous system.
[0065] The data presented herein establish that human stromal cells
which are cocultured with rat astrocytes become positive for glial
fibrillary acidic protein, a marker for early astrocytes. In other
words, it is possible to direct the differentiation of stromal
cells by coculture of stromal cells with a desired cell type. Thus,
it is possible, according to the data presented herein, to
pre-differentiate isolated stromal cells to evolve into a desired
phenotype prior to their introduction into the central nervous
tissue. It is further possible that isolated stromal cells which
are introduced into the central nervous system can differentiate in
brain tissue or in spinal cord tissue into oligodendrocytes, Schwan
cells and neurons.
[0066] Based on these considerations, the types of diseases which
are treatable using isolated stromal cells which are introduced
directly into the central nervous system are many. For example,
among neonates and children, the cells may be used for treatment of
a number of genetic diseases of the central nervous system,
including, but not limited to, Tay-Sachs disease and he related
Sandhoff's disease, Hurler's syndrome and related
mucopolysaccharidoses and Krabbe's disease. To varying extents,
these diseases also produce lesions in the spinal cord and
peripheral nerves and they also have non-neurological effects.
While the non-neurological effects of these diseases may be
treatable by bone marrow transplantation, the central nervous
system effects do not improve despite bone marrow transplantation.
The method of the present invention may therefore be used to
address the central nervous system effects of these types of
diseases. In addition, in neonates and children, treatment of head
trauma during birth or following birth is treatable by introducing
stromal cells directly into the central nervous system of the
children. Central nervous system tumor formation in children is
also treatable using the methods of the present invention.
[0067] With respect to adult diseases of the central nervous
system, isolated stromal cells are useful for treatment of
Parkinson's disease, Alzheimer's disease, spinal cord injury,
stroke, trauma, tumors, degenerative diseases of the spinal cord
such as amyotropic lateral sclerosis, Huntington's disease and
epilepsy. Treatment of multiple sclerosis may also be possible.
[0068] Treatment of spinal cord injuries is possible using the
method of the present invention. Some prior art methods of treating
spinal cord injuries involve using fibroblast cells to deliver of
neurotrophins to the site of spinal cord lesions in animals. The
neurotrophins delivered in this manner serve to reduce the lesion
or otherwise treat the injury. However, unlike stromal cells,
fibroblasts continue to produce large amounts of collagen which
causes fibrosis at the site of the lesion, thereby negating the
beneficial effects of the treatment. Thus, delivery of
neurotrophins to spinal cord lesions using genetically engineered
stromal cells has significant advantages over prior art methods
because stromal cells do not produce large amounts of collagen and
therefore will not cause fibrosis.
[0069] Although the data presented herein establish that the direct
introduction of stromal cells into the central nervous system is
useful for treatment of diseases of the central nervous system, in
certain instances, isolated stromal cells may also be useful for
treatment of diseases or injury associated with the eye. Stromal
cells, when injected directly into the eye may differentiate into
retinal pigmented epithelium, i.e., the cells that line the
posterior surface of the retina and that appear to serve as
nutrient cells for cones and rods in the eye. Alternatively, it may
be possible to pre-differentiate isolated stromal cells into
retinal pigmented epithelium by coculturing stromal cells with
cells of the eye. That stem cells give rise to cells of the eye has
been observed in fish. Fish eyes continue to grow throughout the
life of the fish. In that instance, there are stem cells in the
anterior edges of the eye that differentiate into both retinal
pigmented epithelium and the light sensitive cells of the retina.
Isolated stromal cells may be used to treat a variety of
degenerative diseases of the eye, including degenerative diseases
of the optic nerve retinal pigmented epithelial cells. The diseases
include, but are not limited to, macular degeneration, a process of
unknown origin which leads to a central visual loss in the elderly.
Also included is blindness resulting from diabetes or arterial
sclerosis, i.e., diseases of the eye which are the result of
lesions in the vascular supply of the retina. In addition, rare
diseases such as, for example, Laber's congenital amaurosis, may
also be treatable using the methods of the invention.
[0070] In some aspects of the invention, an individual suffering
from a disease, disorder, or a condition that affects the central
nervous system and that is characterized by a genetic defect may be
treated by supplementing, augmenting and/or replacing defective or
deficient neurological cells with cells that correctly express a
normal neurological cell gene. The cells which are to be introduced
into the individual may be derived from stromal cells obtained from
a normal matched donor or they may be stromal cells obtained from
the individual to be treated. The cells may also be genetically
modified to correct the defect. But this is not the only instance
where the cells can be genetically modified.
[0071] In another embodiment of the invention, an individual
suffering from a disease, disorder or a condition that affects the
central nervous system and that is characterized by a genetic
defect can be treated by supplementing, augmenting and/or replacing
defective cells with cells that correctly express a normal gene.
The cells may be derived from stromal cells obtained from a normal
matched donor or stromal cells obtained from the individual to be
treated. The cells may also be genetically modified to correct the
defect.
[0072] An example of a disease, disorder or a condition that
affects the central nervous system and that is characterized by a
genetic defect is a brain tumor. An individual suffering from a
brain tumor may be administered stromal cells obtained from a
normal matched donor, which stromal cells differentiate into normal
brain cells that may be used to replace or supplement the brain
cells in the individual which has the tumor cells. The normal cells
will compensate for the defective cells in the brain.
[0073] In an alternative embodiment, stromal cells are isolated
from an individual suffering from a brain tumor and a gene capable
of killing or otherwise arresting the replication of the tumor
cells is inserted into the isolated stromal cells. The transfected
cells are then reintroduced into the individual. The growth and/or
replication of the tumor cells is arrested and/or apoptosis of the
tumor cells is induced.
[0074] In one aspect of the invention, an individual suffering from
a disease, disorder or a condition of the central nervous system
can be treated as follows. Isolated stromal cells are obtained,
they are expanded and are systemically administered to the
individual. Some of the isolated/expanded stromal cells will
develop into normal brain cells. Normal stromal cells expand more
quickly than defective stromal cells and the expanded rejuvenated
population will reflect a greater proportion of normal cells. Thus,
repopulation of the central nervous system tissue with an expanded
and rejuvenated population of stromal cells serves to provide a
population of normal central nervous system cells which facilitate
correction of the defect in the central nervous system tissue.
Also, stromal cells may be pre-differentiated into, for example,
astrocytes, by following the protocols provided herein, prior to
administration of the stromal cells to the central nervous
system.
[0075] In addition to replacing defective cells with repaired cells
or normal cells from matched donors, the method of the invention
may also be used to facilitate expression of a desired protein that
when secreted in the central nervous system, has a beneficial
effect. That is, stromal cells may be isolated, furnished with a
gene encoding a desired protein and introduced into the central
nervous system tissue of an individual. Expression of the desired
protein in the central nervous system of the individual exerts a
therapeutic effect in the individual. This aspect of the invention
relates to gene therapy in which therapeutic proteins are
administered to an individual.
[0076] According to some aspects of the present invention,
immunologically isolated transfected stromal cells may be used as
cell therapeutics to treat a disease, disorder or a condition
characterized by a gene defect and/or a disease, disorder or a
condition which can be treated using a recombinant protein in a
gene therapy approach. In particular, a gene construct that
comprises a heterologous gene which encodes a beneficial protein is
introduced into stromal cells. The transfected stromal cells are
then immunologically isolated and implanted into an individual who
will benefit when the protein is expressed and secreted by the cell
into the tissue of the central nervous system, preferably the
brain.
[0077] Immunologically isolated stromal cells are particularly
useful in cell therapeutic compositions, because in addition to
being suitable hosts for expressing heterologous genes and
producing heterologous proteins, stromal cells perform favorably
when they are immunologically isolated. Immunologically isolated
stromal cells have a very high viability when implanted in
locations that lack a direct vascular blood supply. Moreover,
stromal cells can be easily and readily obtained, they rapidly
expand in culture making them a good source of an adequate supply
of useful cells for immunologically isolated cell therapeutics.
[0078] According to the present invention, gene constructs which
comprise nucleotide sequences that encode heterologous proteins are
introduced into stromal cells. That is, the cells are genetically
altered to introduce a gene whose expression has therapeutic effect
on the individual. According to some aspects of the invention,
stromal cells obtained from the same individual to be treated or
from another individual, or from a non-human animal, may be
genetically altered to replace a defective gene and/or to introduce
a gene whose expression has therapeutic effect on the
individual.
[0079] Further, according to the present invention, stromal cells
are useful to prepare transfected cells that can be immunologically
isolated and express heterologous beneficial proteins thereby
providing a means to correct genetic defects and/or to produce
therapeutic proteins in the individual. Stromal cells may be
isolated with relative ease and isolated stromal cells may be
cultured to increase the number of cells available. Stromal cells
can be transfected, immunologically isolated and implanted with a
high degree of viability into locations that lack direct blood
supply such as subcutaneous locations.
[0080] In some embodiments, stromal cells may be immortalized, such
as by using SV40 virus, a retrovirus, an adenovirus or other
transforming virus, or by using proteins having transforming
properties. In some aspects of the invention, an individual
suffering from a disease, disorder or a condition may be treated by
supplementing, augmenting and/or replacing defective or deficient
genes by providing immunologically isolated stromal cells
containing gene constructs that include normal, functioning copies
of the deficient gene. This aspect of the invention relates to gene
therapy in which the individual is provided with genes for which
they are deficient in presence and/or function. The gene provided
by the cell compensates for the defective gene of the individual,
because, when the gene is expressed in the central nervous system
tissue, a protein is produced which serves to alleviate or
otherwise treat the disease, disorder or condition in the
individual. Such genes preferably encode proteins that are
secreted.
[0081] The stromal cells are transfected and are administered to
the central nervous system of the individual "as is" or in an
immunologically isolated form. In some embodiments, stromal cells
are transfected with genes for which the individual to be treated
suffers from a complete absence of a non-mutated copy of the gene,
or suffers from an absence or insufficient expression of a
nonmutated form of the protein. Stromal cells are transfected with
a non-mutated copy of the gene in an expressible form. That is, the
protein encoded by the transfected gene will be expressed by the
stromal cells, preferably as a secreted protein.
[0082] In addition to replacing defective genes with functional
genes, the invention may also be used to express desired secreted
proteins which exert a biologically active therapeutic or
prophylactic effect. Such proteins are preferably secreted by the
cells. That is, stromal cells may be isolated, furnished with a
gene encoding a desired protein, they may then be administered to
the individual as is, or in an immunologically isolated form, and
the desired protein is expressed therein. According to this aspect
of the invention, the isolated stromal cells serve as vectors for
introducing therapeutic genes into the individual as well as hosts
for such genes when the cells are administered to the
individual.
[0083] In such embodiments, stromal cells are transfected with
genes that encode proteins which have a therapeutic effect when
expressed in the individual to be treated. Rather than
administering the therapeutic protein directly to the individual
which may require repeated administrations, the present invention
provides a means of administering a therapeutic protein to the
individual in a continuous manner by administering to the
individual cells which produce the protein. Stromal cells are
transfected with a gene that encodes the protein in an expressible
form. That is, the protein encoded by the transfected gene will be
expressed in the stromal cells, preferably as a secreted protein.
Thus, the invention includes a method of treating a disease,
disorder or condition of the central nervous system wherein stromal
cells that are transfected with genes that encode a protein are
administered to the individual. The protein is expressed and has a
therapeutic effect. Examples of therapeutic proteins include, but
are not limited to cytokines, chemokines, neurotrophins, and the
like.
[0084] In all cases in which a gene construct is transfected into a
stromal cell, the heterologous gene is operably linked to an
appropriate promoter/regulatory sequence which is required to
achieve expression of the gene in the stromal cell. Such
promoter/regulatory sequences include but are not limited to,
constitutive and inducible and/or tissue specific and
differentiation specific promoters. Constitutive promoters include,
but are not limited to, the cytomegalovirus immediate early
promoter and the Rous sarcoma virus promoter. In addition,
housekeeping promoters such as those which regulate expression of
housekeeping genes may also be used. Other promoters include those
which are preferentially expressed in cells of the central nervous
system, such as, but not limited the promoter for the gene encoding
glial fibrillary acidic protein. In addition, promoter/regulatory
elements may be selected such that gene expression is inducible.
For example, a tetracycline inducible promoter may be used
(Freundlich et al., 1997, Meth. Enzymol. 283:159-173).
[0085] The gene construct is preferably provided as an expression
vector which includes the coding sequence of a heterologous protein
operably linked to essential promoter/regulatory sequences such
that when the vector is transfected into the cell, the coding
sequence is expressed by the cell. The coding sequence is operably
linked to the promoter/regulatory elements necessary for expression
of the sequence in the cells. The nucleotide sequence that encodes
the protein may be cDNA, genomic DNA, synthesized DNA or a hybrid
thereof or an RNA molecule such as mRNA.
[0086] The gene construct, which includes the nucleotide sequence
encoding the beneficial protein operably linked to the
promoter/regulatory elements, may remain present in the cell as a
functioning episomal molecule or it may integrate into the
chromosomal DNA of the cell. Genetic material may be introduced
into cells where it remains as separate genetic material in the
form of a plasmid. Alternatively, linear DNA which can integrate
into a host cell chromosome may be introduced into the cell. When
introducing DNA into the cell, reagents which promote DNA
integration into chromosomes may be added. DNA sequences which are
useful to promote integration may also be included in the DNA
molecule. Alternatively, RNA may be introduced into the cell.
[0087] The elements in the promoter/regulatory sequences that are
necessary for gene expression include: a promoter, an initiation
codon, a stop codon, and a polyadenylation signal. It is necessary
that these elements be operable in the stromal cells or in cells
that arise from the stromal cells after infusion of the cells into
an individual. Moreover, it is necessary that these elements be
operably linked to the nucleotide sequence that encodes a protein
such that the nucleotide sequence can be expressed in the stromal
cells and thus the protein can be produced. Initiation codons and
stop codon are generally considered to be part of a nucleotide
sequence that encodes the protein. However, it is necessary that
these elements are functional in the stromal cells or cells that
arise from stromal cells. Similarly, the promoters and
polyadenylation signals used must be functional within the stromal
cells or cells that arise from stromal cells.
[0088] Examples of promoter/regulatory sequences useful to practice
the present invention include but are not limited to
promoter/regulatory sequences that are active in many cells such as
the cytomegalovirus promoter, the SV40 promoter and many retroviral
promoters. Other examples of promoter/regulatory sequences useful
to practice the present invention include but are not limited to
tissue-specific promoter/regulatory sequences, i.e.
promoter/regulatory sequences that function in some tissues but not
in others; also, promoter/regulatory sequences of genes normally
expressed in stromal cells with or without specific or general
enhancer sequences. In some embodiments, promoter/regulatory
sequences are used which constitutively express genes in stromal
cells with or without enhancer sequences. Enhancer sequences are
provided in some embodiments when appropriate or desirable.
[0089] Examples of polyadenylation signals useful to practice the
present invention include but are not limited to the human collagen
I polyadenylation signal, the human collagen II polyadenylation
signal, and the SV40 polyadenylation signal.
[0090] In order for genetic material in an expression vector to be
expressed, the promoter/regulatory elements must be operably linked
to the nucleotide sequence that encodes the protein. In order to
maximize protein production, promoter/regulatory sequences may be
selected which are well suited for gene expression in the desired
cells. Moreover, codons may be selected which are most efficiently
transcribed in the cell. One having ordinary skill in the art can
produce recombinant genetic material as expression vectors which
are functional in the desired cells.
[0091] It is also contemplated that promoter/regulatory elements
may be selected to facilitate tissue specific expression of the
protein. Thus, for example, specific promoter/regulatory sequences
may be provided such that the heterologous gene will only be
expressed in the tissue where the immunologically isolated stromal
cells are implanted. In addition, promoter/regulatory elements may
be selected such that gene expression is inducible. For example, a
tetracycline inducible promoter may be used (Freundlich et al.,
1997, Meth. Enzymol. 283:159-173).
[0092] The heterologous protein preferably includes a signal
sequence which directs the transport and secretion of the
heterologous protein in the stromal cell. The signal sequence is
generally processed and removed upon secretion of the mature
protein from the cell.
[0093] In addition to providing cells with recombinant genetic
material that either corrects a genetic defect in the cells, that
encodes a protein which is otherwise not present in sufficient
quantities and/or functional condition so that the genetic material
corrects a genetic defect in the individual, and/or that encodes a
protein which is useful as a therapeutic in the treatment or
prevention of a particular disease, disorder or condition
associated therewith, genetic material may also be introduced into
the stromal cells used in the present invention to provide a means
for selectively terminating such cells should such termination
become desirable. Such means for targeting cells for destruction
may be introduced into stromal cells which are to be otherwise
genetically modified as well as those to which no other recombinant
genetic material is to be introduced.
[0094] According to the invention, isolated stromal cells are
furnished with genetic material which renders them specifically
susceptible to destruction. For example, stromal cells may be
provided with a gene that encodes a receptor that can be
specifically targeted with a cytotoxic agent. An expressible form
of a gene that can be used to induce selective cell death can be
introduced into the cells. In such a system, cells expressing the
protein encoded by the gene are susceptible to targeted killing
under specific conditions or in, the presence or absence of
specific agents. For example, an expressible form of a herpes virus
thymidine kinase (herpes tk) gene can be introduced into the cells
and used to induce selective cell death. When the introduced
genetic material that includes the herpes tk gene is introduced
into the individual, herpes tk will be produced. If it is desirable
or necessary to kill the implanted cells, the drug gangcyclovir can
be administered to the individual which will cause the selective
killing of any cell producing herpes tk. Thus, a system can be
provided which allows for the selective destruction of implanted
cells.
[0095] Stromal cells may be obtained by removing bone marrow cells
from a donor and placing the cells in a sterile container with a
plastic surface or other appropriate surface that the cells come
into contact with. The stromal cells will adhere to the plastic
surface within 30 minutes to about 3 days. After at least 30
minutes, preferably about four hours, the non-adhered cells may be
removed and discarded. The adhered cells are stromal cells which
are initially non-dividing. However, after about 2-4 days, the
cells begin to proliferate and can be cultured to increase their
numbers using standard cell culture techniques.
[0096] According to preferred embodiments, stromal cells are
cultured in medium supplemented with 2-20% fetal calf serum or
serum-free medium with or without additional supplements. Isolated
stromal cells may be transfected using well known techniques
readily available to those having ordinary skill in the art.
Foreign genes may be introduced into stromal cells using standard
methods which are employed for introducing a gene construct into
cells which express the protein encoded by the gene. In some
embodiments, cells are transfected by calcium phosphate
precipitation transfection, DEAE dextran transfection,
electroporation, microinjection, liposome-mediated transfer,
chemical-mediated transfer, ligand mediated transfer or recombinant
viral vector transfer.
[0097] In some embodiments, recombinant adenovirus vectors are used
to introduce DNA having a desired sequence into the stromal cell.
In some embodiments, recombinant retrovirus vectors are used to
introduce DNA having a desired sequence into the stromal cell. In
some embodiments, standard calcium phosphate, DEAE dextran or lipid
carrier mediated transfection techniques are employed to
incorporate a desired DNA into dividing cells. Standard antibiotic
resistance selection techniques can be used to identify and select
transfected cells. In some embodiments, DNA is introduced directly
into cells by microinjection. Similarly, well known electroporation
or particle bombardment techniques can be used to introduce foreign
DNA into isolated stromal cells. A second gene is usually
co-transfected or linked to the therapeutic gene. The second gene
is frequently a selectable antibiotic-resistance gene. Transfected
cells can be selected by growing the cells in an antibiotic that
kills cells that do not take up the selectable gene. In most cases
where the two genes are unlinked and co-transfected, the cells that
survive the antibiotic treatment contain and express both
genes.
[0098] After isolating the stromal cells, the cells can be
administered to the human upon isolation or following a period of
in vitro culture. Isolated stromal cells may be administered upon
isolation, or may be administered within about one hour after
isolation. Generally, stromal cells may be administered immediately
upon isolation in situations in which the donor is large and the
recipient is an infant. It is preferred that stromal cells are
cultured prior to administration. Isolated stromal cells can be
cultured from 1 hour to up to over a year. In some preferred
embodiments, the isolated stromal are cultured prior to
administration for a period of time sufficient to allow them to
convert from non-cycling to replicating cells. In some embodiments,
the isolated stromal cells are cultured for 3-30 days, preferably,
5-14 days, more preferably, 7-10 days. In other embodiments, the
isolated stromal cells are cultured for 4 weeks to a year,
preferably, 6 weeks to 10 months, more preferably, 3-6 months.
[0099] In other embodiments, the isolated stromal cells are
cocultured so that they differentiate into astrocytes or other
neural cells prior to administration of the central nervous
system.
[0100] If the cells are to be transfected, either isolated,
non-cycling stromal cells are first transfected and then are
administered as non-cycling cells; isolated, non-cycling stromal
cells are first transfected, then cultured for a period of time
sufficient to convert them from non-cycling to replicating cells
and then are administered; isolated, non-cycling stromal cells are
first cultured for a period of time sufficient to convert them from
non-cycling to replicating cells, they are then transfected, and
then are administered; or isolated, non-cycling stromal cells are
first cultured for a period of time sufficient to convert them from
non-cycling to replicating cells, they are then transfected, they
are then cultured and then administered to the human. In some
embodiments, stromal cells are isolated, transfected and
immediately administered to the human.
[0101] It is preferred that stromal cells are cultured prior to
transfection and/or administration. Isolated stromal cells can be
cultured from cultured for 3-30 days, in some embodiments, 5-14
days, in other embodiments, 7-10 days prior to transfection.
Transfected stromal cells can be cultured for 3-30 days, in some
embodiments, 5-14 days, in some embodiments, 7-10 days prior to
administration. Isolated stromal cells can be cultured from 3-30
days, in some embodiments, 5-14 days, in some embodiments, 7-10
days prior to transfection, and upon transfection, additionally
cultured for 3-30 days, in some embodiments, 5-14 days, in some
embodiments, 7-10 days prior to administration. In some
embodiments, the isolated stromal cells are cultured for 4 weeks to
a year, in some embodiments, 6 weeks to 10 months, in some
embodiments, 3-6 months prior to transfection. Transfected stromal
cells can be cultured for 4 weeks to a year, in some embodiments, 6
weeks to 10 months, in some embodiments, 3-6 months prior to
administration. In some embodiments, the isolated stromal cells are
cultured for 4 weeks to a year, in some embodiments, 6 weeks to 10
months, in some embodiments, 3-6 months prior to transfection and
upon transfection, further cultured for 4 weeks to a year, in some
embodiments, 6 weeks to 10 months, in some embodiments, 3-6 months
prior to administration.
[0102] For administration of stromal cells to the human, the
isolated stromal cells are removed from culture dishes, washed with
saline, centrifuged to a pellet and resuspended in a glucose
solution which is infused into the patient. In some embodiments,
bone marrow ablation is undertaken prior to infusion in order to
make space in the bone for introduced cells. Bone marrow ablation
may be accomplished by X-radiating the individual to be treated,
administering drugs such as cyclophosphamide or by a combination of
X-radiation and drug administration. In some embodiments, bone
marrow ablation is produced by administration of radioisotopes
known to kill metastatic bone cells such as, for example,
radioactive strontium, .sup.135Samarium or .sup.166Holmium (see
Applebaum et al., 1992, Blood 80(6):1608-1613).
[0103] If bone marrow ablation precedes administration of stromal
cells, the administration of stromal cells must be accompanied by
the administration of non-adherent cells which comprise blood cell
precursors necessary for survival. Such non-adherent cells may be
saved from the same sample used as starting materials in the
isolation of stromal cells and stored or they can be derived from a
different sample. In some preferred embodiments, the non-adherent
cells are provided by the recipient/patient. Prior to procedures
which generate bone marrow ablation, a sample of the
patient/recipients bone marrow is obtained and stored. The entire
sample may be used or the non-adherent cells may be isolated and
used to administer in conjunction with isolated stromal cells.
Non-adherent cells administered in conjunction with administration
of stromal cells may be administered separately before or after
stromal cell administration or may be mixed with isolated stromal
cells prior to administration.
[0104] In some embodiments, isolated stromal cells are administered
to the brain by direct infusion as described herein in the
experimental examples section. In other embodiments, isolated
stromal cells are administered to the central nervous system, i.e.,
the spinal cord, by simple injection, etc.
[0105] Between about 10.sup.5 and about 10.sup.13 cells per 100 kg
person are administered per infusion. In some embodiments, between
about 1.5.times.10.sup.6 and about 1.5.times.10.sup.12 cells are
infused intravenously per 100 kg person. In some embodiments,
between about 1.times.10.sup.9 and about 5.times.10.sup.11 cells
are infused intravenously per 100 kg person. In some embodiments,
between about 4.times.10.sup.9 and about 2.times.10.sup.11 cells
are infused per 100 kg person. In some embodiments, between about
5.times.10.sup.8 cells and about 1.times.10.sup.1 cells are infused
per 100 kg person.
[0106] In some embodiments, a single administration of cells is
provided. In some embodiments, multiple administrations are
provided. In some embodiments, multiple administrations are
provided over the course of 3-7 consecutive days. In some
embodiments, 3-7 administrations are provided over the course of
3-7 consecutive days. In some embodiments, 5 administrations are
provided over the course of 5 consecutive days.
[0107] In some embodiments, a single administration of between
about 10.sup.5 and about 10.sup.13 cells per 100 kg person is
provided. In some embodiments, a single administration of between
about 1.5.times.10.sup.8 and about 1.5.times.10.sup.12 cells per
100 kg person is provided. In some embodiments, a single
administration of between about 1.times.10.sup.9 and about
5.times.10.sup.11 cells per 100 kg person is provided. In some
embodiments, a single administration of about 5.times.10.sup.10
cells per 100 kg person is provided. In some embodiments, a single
administration of 1.times.10.sup.10 cells per 100 kg person is
provided.
[0108] In some embodiments, multiple administrations of between
about 10.sup.5 and about 10.sup.13 cells per 100 kg person are
provided. In some embodiments, multiple administrations of between
about 1.5.times.10.sup.8 and about 1.5.times.10.sup.12 cells per
100 kg person are provided. In some embodiments, multiple
administrations of between about 1.times.10.sup.9 and about
5.times.10.sup.11 cells per 100 kg person are provided over the
course of 3-7 consecutive days. In some embodiments, multiple
administrations of about 4.times.10.sup.9 cells per 100 kg person
are provided over the course of 3-7 consecutive days. In some
embodiments, multiple administrations of about 2.times.10.sup.11
cells per 100 kg person are provided over the course of 3-7
consecutive days. In some embodiments, 5 administrations of about
3.5.times.10.sup.9 cells are provided over the course of 5
consecutive days. In some embodiments, 5 administrations of about
4.times.10.sup.9 cells are provided over the course of 5
consecutive days. In some embodiments, 5 administrations of about
1.3.times.10.sup.11 cells are provided over the course of 5
consecutive days. In some embodiments, 5 administrations of about
2.times.10.sup.11 cells are provided over the course of 5
consecutive days.
[0109] Stromal cells in diffusion chambers are described in
Benayahu et al., 1989, J. Cell Physiol. 140:1-7; Mardon et al.,
1987, Cell Tissue Res. 250:157-165. After introducing the gene
construct into the stromal cells, the cells can be immunologically
isolated immediately or following a period of in vitro culture.
Stromal cells can be implanted after they are immunologically
isolated. Stromal cells may be immunologically isolated using any
number of well known methods using readily available starting
materials and/or devices. Stromal cells may be microencapsulated
using many such microencapsulation protocols including those
disclosed, for example, in U.S. Pat. No. 4,391,909, U.S. Pat. No.
4,806,355, U.S. Pat. No. 4,942,129, and U.S. Pat. No.
5,334,640.
[0110] Stromal cells may be administered to an individual in
chambers using diffusible membranes or they may be encapsulated in
microbeads. In another embodiment, the stromal cells are contained
in hollow fibers such as those available from Amicon, Inc. (Beverly
Mass.). These fibers are used for example to make cartridges for
dialysis. One end can be pulled out from under the skin and reduced
in size if dosages of the protein made by the cells are to be
reduced. The surface area of the fibers is very high. Further,
cells in the fiber can be flushed out and replaced periodically.
Hollow fibers are described on pages 50-51 of Amicon, Inc.
Publication No. 323.
[0111] Similarly, incorporation of transfected stromal cells in
biocompatible matrices facilitates secretion of a beneficial
protein to the individual while maintaining the cells in an
immunologically isolated condition. Examples of biocompatible
matrices are disclosed, for example, in U.S. Pat. No. 4,902,295 and
U.S. Pat. No. 4,997,443. In some embodiments, transfected stromal
cells are immunologically isolated by encasing them within tissue
implant systems that are membrane assemblies. That is, cells are
maintained in containers that include at least one porous membrane.
The cells within the membrane assembly are immunologically isolated
while beneficial proteins may be made available to the individuals
by passing through the membrane. Implant devices which are membrane
assemblies, include, but are not limited to, those described in
U.S. Pat. No. 5,314,471 and U.S. Pat. No. 5,344,454. According to
one embodiment of the invention, an implant device is provided
which comprises two ten ring assembles. Each ring assembly
comprises a circular plastic ring and a 0.3 micron millipore
membrane covering the area of the circle. Transfected stromal cells
are disposed between the two ring assembly which are connected to
each other at the circumference. The constructed implant device is
preferably implanted subcutaneously.
[0112] In some preferred implant devices, about 10.sup.5 to about
10.sup.13 cells are provided. Preferred ranges of cells to be
administered when immunologically isolated are as described herein
when the cells are not immunologically isolated. Immunologically
isolated cells may be implanted into the ventricles of the subdural
space, or into the subarachnoid space of the brain and spinal
column.
[0113] It is preferred that stromal cells are cultured prior to
immunological isolation. Stromal cells can be cultured from 1 hour
to over a year. In some preferred embodiments, the stromal cells
are cultured for a period of time sufficient to allow them to
convert from non-cycling to replicating cells. In some embodiments,
the stromal cells are cultured for 3-30 days, preferably 5-14 days,
more preferably 7-10 days. In some embodiments, the stromal cells
are cultured for 4 weeks to a year, preferably 6 weeks to 10
months, more preferably 3-6 months. In preferred embodiments, cells
are either isolated, non-cycling stromal cells that are first
transfected and then immunologically isolated, then implanted as
noncycling cells; isolated, non-cycling stromal cells that are
first transfected, then cultured for a period of time sufficient to
convert from non-cycling to replicating cells, then immunologically
isolated and then implanted; isolated, non-cycling stromal cells
that are first cultured for a period of time sufficient to convert
from non-cycling to replicating cells, then transfected, then
immunologically isolated and then implanted; or isolated,
non-cycling stromal cells that are first cultured for a period of
time sufficient to convert from non-cycling to replicating cells,
then transfected, then cultured, then immunologically isolated and
then implanted. In some embodiments, stromal cells are isolated,
transfected, immunologically isolated and implanted. It is
preferred that stromal cells are cultured prior to and after
transfection, prior to immunological isolation. Isolated stromal
cells can be cultured from 3-30 days, in some embodiments, 5-14
days, in some embodiments, 7-10 days prior to transfection.
Transfected stromal cells can be cultured from 3-30 days, in some
embodiments, 5-14 days, in some embodiments, 7-10 days prior to
administration. Isolated stromal cells can be cultured from 3-30
days, in some embodiments, 5-14 days, in some embodiments, 7-10
days prior to transfection and upon transfection, additionally
cultured for 3-30 days, in some embodiments, 5-14 days, in some
embodiments, 7-10 days prior to administration. In some
embodiments, the isolated stromal cells are cultured for 4 weeks to
a year, in some embodiments, 6 weeks to 10 months, in some
embodiments, 3-6 months prior to transfection. Transfected stromal
cells can be cultured for 4 weeks to a year, in some embodiments, 6
weeks to 10 months, in some embodiments, 3-6 months prior to
implantation.
[0114] The invention will be further described by reference to the
following experimental examples. These examples are provided for
the purposes of illustration only and are not intended to be
limiting unless otherwise specified. Thus, the invention shall in
no way be construed as being limited to the following examples, but
rather, shall be construed to encompass any and all variations
which become evident as a result of the teaching provided
herein.
EXAMPLES
Example 1
Stromal Cells as Precursor Cells of Connective Tissues
[0115] Cells from a transgenic mouse line that expresses a human
mini-gene for collagen I in a tissue-specific manner were used to
determine whether precursor mesenchymal cells from marrow that are
expanded in culture can serve as long-term precursors of bone and
other connective tissues after intravenous infusion into irradiated
mice. The marker gene consisted of an internally deleted mini-gene
encoding the human pro.alpha.1 (I) chain of procollagen I that
causes synthesis of shortened pro.alpha.1 (I) chains (Khillan et
al., 1991, J. Biol. Chem. 266:23373-23379; Pereira et al., 1983, J.
Clin. Invest. 91:709-716; and Sokolov et al., 1993, Biochemistry
32:9242-9249). Cells expressing the gene were obtained from a line
of transgenic mice in which the copy number of the human mini-gene
relative to the endogenous mouse gene was about 100 to 1, and the
steady-state levels of mRNA expressed by the human mini-gene
relative to mRNA expressed by the endogenous mouse gene was about
0.5:1 in most tissues.
[0116] Donor cells obtained from marrow partially enriched for
mesenchymal precursors were prepared using standard protocols
(Friedenstein et al., 1976, Exp. Hemat. 4:267-274; Castro-Malaspina
et al., 1980, Blood 56:289-301; Piersma et al., 1985, Exp. Hematol
13:237-243; Simmons et al., 1991, Blood 78:55-62; Beresford et al.,
1992, J. Cell. Sci.102:341-351; Liesveld et al., 1989, Blood
73:1794-1800; Liesveld et al., 1990, Exp. Hematot. 19:63-70;
Bennett et al., 1991, J. Cell. Sci. 99:131-139). Briefly, the ends
of long bones from the transgenic mice were cut, and the marrow was
extracted with a pressurized syringe filled with .alpha.-MEM
(Sigma) containing 10% fetal bovine serum (Atlanta Biologicals).
About 10.sup.7 nucleated cells were plated onto 175 cm.sup.2
plastic culture flasks in 25 ml of .alpha.-MEM containing 10% fetal
bovine serum. After 4 hours, the non-adherent cells were discarded
by replacing the medium. Foci containing two to four
fibroblast-like cells appeared in 2 to 3 days, and the foci grew to
near-confluent colonies in about 1 week. The yield was about
10.sup.7 cells per flask after trypsin digestion. Most of the cells
were fibroblast-like, but a few macrophages and adipocytes were
also seen when the cells were examined under phase contrast
microscopy.
[0117] About 10.sup.5 of the cultured adherent cells were mixed
with 6.times.10.sup.5 non-adherent cells obtained by incubation of
marrow from normal mice for 4 hours on 175 cm.sup.2 flasks under
the same conditions used for the initial isolation of the adherent
cells. The mixture of about 7.times.10.sup.5 cells in 0.2 to 0.4 ml
of .alpha.-MEM and 10% fetal bovine serum was injected into the
tail vein of each recipient mouse.
[0118] Eight-week old mice from the same inbred FVB/N line were
prepared to receive the donor cells by irradiation with a
.sup.137Cu irradiator (Atomic Energy of Canada, Ltd.). The unit had
a dose rate of 116 cG/min with a parallel opposed beam
configuration. Each animal received 9.0 Gy in two fractions with a
4 hour interval (4.5 Gy+4.5 Gy) (O'Hara et al., 1991, Exp. Hemat.
19:878-881). One to 2 hours after the second radiation fraction,
the mixture of marked adherent cells and normal non-adherent cells
was injected intravenously. Control irradiated mice that did not
receive a cell infusion died after 10 to 13 days of marrow
failure.
[0119] To follow the fate of the donor cells, two PCR assays for
the human COL1A1 mini-gene and the mouse endogenous COL1A1 gene
were developed. Using a two-primer assay, the values for the ratio
of the human to mouse genes were linear over a range of 10.sup.-4
to about 10.sup.+1 and, therefore, resulted in about 10.sup.-6 to
10.sup.-1 donor cells per recipient cell. Using the three-primer
assay, the values were linear over a range of about 10.sup.-3 to
10.sup.+2 and, therefore, resulted in about 10.sup.-5 to 1 donor
cell per recipient call.
[0120] Assays of irradiated mice after one day indicated only trace
amounts of the donor cells in marrow, spleen, bone, lung or brain
(Table 1). Slightly higher levels were seen at seven days. At 30
days and 150 days, progeny of the donor cells accounted for 2.0 to
12% of the cells in marrow, spleen, bone and lung (Table 1). At 150
days, they also accounted for 1.5 to 5.0% of the cells in xiphoid
cartilage that was dissected free of any mineralized or fibrous
tissue under a microscope. Although the mean values appeared to
show a decrease between 1 and 5 months, there was no statistically
significant decrease in the combined values for marrow, spleen,
bone and lung between these two time periods (Table 1). Assays of
non-irradiated mice revealed only very low levels of the donor
cells at the same time points (<0.0001 to 0.05%). PCR in situ
assay of tissue sections of lung demonstrated that progeny of the
donor cells were evenly distributed in the parenchyma of both
alveoli and bronchi.
[0121] To confirm that progeny of the donor cells were present in
cartilage, chondrocytes were isolated from xiphoid and articular
cartilage by digestion at 37.degree. C. overnight with 0.5 mg/ml
bacterial collagenase (Sigma) in DMEM. PCR assays indicated that
progeny of the donor cells accounted for 2.5% of the isolated
chondrocytes.
[0122] To determine whether the donor cells became functional
mesenchymal cells in the tissues they populated, tissues obtained
the recipient mice were assayed by RT-PCR for expression of the
human mini-gene for collagen I contained in the donor cells. In
three mice assayed at 150 days, the mini-gene was expressed in
bone, a tissue in which over half the protein synthesized in
collagen I. The expression in bone was confirmed using a similar
assay on bone cells isolated from femur and cultured for 1 week.
Expression of the mini-gene for collagen I was more variable in
marrow, spleen and lung, tissues in which the rate of collagen I
synthesis is less than in bone. As expected, the mini-gene was not
expressed in cartilage, a tissue in which about half the protein is
synthesized in collagen II but in which there is no synthesis of
collagen 1. The mini-gene for collagen I was also not expressed in
cultures of chondrocytes obtained from the recipient mice that
contained the marker gene and that synthesize collagen II but not
collagen I.
[0123] The results presented herein demonstrate that after
intravenous injection into irradiated mice, the expanded cultures
of adherent cells efficiently populate several connective tissues.
The results also demonstrate that the cells serve as true precursor
cells for these tissues, since they expressed the marker gene for
collagen I in a tissue-specific manner, and they were diffusely
incorporated into the mesenchymal parenchyma of lung.
Example 2
Conditions for Isolation and Culture of MSCs
[0124] Conditions for culture of MSCs so that they expand but
retain the stem-cell-like phenotype were examined. Table I provides
data which establishes that co-culture of MSCs with pieces of bone
increased the number of cells obtained after 1 week. At the same
time, co-culturing with bone decreased the alkaline phosphatase
(APase) levels in the cells, an observation which suggests that the
cells did not differentiate into osteoblasts. Also, there was a
decrease in the levels of tartrate-resistant acid phosphatase
(TRAP), an observation which suggests that the cells did not
differentiate into osteoclasts. Similar effects were observed with
secondary cultures of the MSCs. Therefore, the results suggest that
co-culturing of MSCs with pieces of bone may provide improved
conditions for expansion of MSCs. Also, the medium of cultured bone
pieces may be an important source of cytokines and growth factors
for expansion of MSCs in culture.
[0125] In related experiments, it has been found that secondary
cultures of MSCs can be maintained for long periods of time. MSCs
can be passed in culture for over 4 months by trypsinization and
re-plating. The cells are remarkably stable in stationary phase
cultures. In one experiment, stationary cultures remained viable
for over 4 months with re-feeding about once per week. In another
experiment, the cells remained viable when, through an oversight,
they were left in an incubator without re-feeding for 1 month.
Stable Transfection of MSCs with a Retrovirus Vector
[0126] To obtain virus for infection of MSCs, the LNCZ retroviral
vector (Miller et al., 1989, BioTechniques 7:980-990) was modified
so that the promoter for cytomegalovirus (pCMV) drove expression of
the lacZ gene (FIG. 1). The vector was stably transfected into an
amphotropic murine packaging cell line (PA317). Constitutive virus
producer clones were isolated by G418 selection, and supernatant
obtained from the clones was used for infection of MSCs. Primary
cultures of MSCs (3 days old) were infected for three successive
days with fresh supernatant obtained from the producer line with
the highest titer. Staining of the cells 5 days later indicated
that about 15-20% of the cells typically expressed the lacZ gene.
Several cultures of the infected cells were placed under selection
with G418 (0.44 .mu.g/ml active concentration) for 5 days. Most of
the cells that recovered continued to express the lacZ gene.
Modifications of LNCZ were also constructed so that expression of
the lacZ gene was driven by the promoter of the COL A1 gene and the
promoter of the COL2 A1 gene (pCOL2A1). Expression of the lacZ gene
was successfully obtained in primary cultures of MSCs using both
constructs.
Replacement of Bone Cells with Normal MSCs in Transgenic Mice
[0127] MSCs obtained from normal mice were infused into transgenic
mice that expressed high levels of the mutated COL1 A1 gene
osteoimperfecta (OI) mice (Tables 2 and 3). One month after the
infusion of normal MSCs into the mice, progeny of the donor cells
accounted for 10 to 45% of the bone cells in recipient mice that
had been irradiated with a maximally tolerated dose of X-ray (700
centi-Gray or cGy) Similar values were obtained in mice irradiated
with one-half of the maximally tolerated dose of X-ray (350 cGy).
However, reducing the dose to one-quarter (175 cGy) reduced these
values in four mice to 0%, 5%, 10% and 40%. Similar results were
obtained when OI transgenic mice were infused with large numbers of
whole marrow cells from which MSCs were not removed (Table 3).
[0128] In five recipient mice in which the synthesis of pro.alpha.1
(1) chains was examined (Tables 2 and 3), the replacement of the
recipient's bone cells by normal donor MSCs was accompanied by an
increase in the ratio of normal pro.alpha.1 (1) chains to mutated
pro.alpha.1 (1) chains in bone. Hence, the replacement by normal
cells was accompanied by the expected changes at the protein
level.
Example 3
Long-term Expression of Human Genes Using hGH, Factor IX or Ob in
Stably Transfected MSCs
[0129] MSCs are isolated from mice and cultured under the
conditions described in Pereira et al., 1995, Proc. Natl. Acad.
Sci. USA 92:4857-4861, which is incorporated herein by reference.
MSCs are infected with retroviral vectors or transfected with naked
DNA to obtain clones that express the genes for human growth
hormone (hGH), the human obesity protein (Ob), or the gene for
human factor IX. Because a lacZ gene has been successfully
introduced into mouse MSCs with a retroviral vector, variants of
the same vector are used. At the same time, MSCs are stably
transfected with electroporation (Andreason et al., 1988,
BioTechniques 6:650-660; (Toneguzzo et al., 1986, Mol. Call. Biol.
6:703-706), lipofectamine and nuclear injection (Mercer et al.,
1992, In: Antisense Strategies, Ann. IV. Y. Acad. Sci. Biol.
660:209-218) so that larger endogenous genes can be used. Further,
some of the potential disadvantages of retroviruses are avoided
using alternative introduction methodology.
[0130] Standard conditions for isolation and culture are: Whole
marrow is obtained from the tibias and femurs of 6- to 10-week old
FVB/N mice by cutting the ends of the bones and extruding the
marrow with a syringe that contains 1 to 2 ml of ice-cold
.alpha.-MEM and 10% fetal bovine serum (FBS). The pooled marrow
cells are dispersed by gentle shaking and counted in an automatic
counter (Coulter model ZM). From 5.times.10.sup.6 to
5.times.10.sup.7 nucleated cells in 25 ml of .alpha.-MEM and 10%
FBS are plated onto 75-cm.sup.2 culture flasks. After 4 hours or 3
days, the non-adherent cells are removed by replacing the medium.
The adherent cells are expanded as primary cultures for 10 to 12
days with a refeeding about every 4 days. The cells are recovered
by digestion with 0.25% trypsin and 1 to 5 mM EDTA for 5 minutes at
37.degree. C. followed by gentle scraping. The cells are diluted
with .alpha.-MEM with 10% FBS and replated at a density of from
3.times.10.sup.4 to 1.times.10.sup.5 cells per 9.5 cm.sup.2 in
6-well plates. Under these conditions, the doubling time of the
cells is 19 to 22 hours. The secondary cultures are re-fed about
every 4 days, and passed by trypsinization and replating under the
same conditions.
Preparation of Gene Constructs
[0131] The retrovirus vector LNCX is used as the parent construct.
Convenient cloning sites in the construct are used to prepare the
modified constructs pRSV-lacZ, pCMV-lacZ, pCOL1/lacZ and pCOL2-lacZ
(FIG. 1). The pCOL1 promoter is a 1.4 kb fragment that contains 476
bp of the promoter, the first exon and most of the first intron of
the human COL1A1 gene. The promoter has been shown in transgenic
mice to express a promoterless form of the COL2A1 gene in a highly
tissue specific and developmental specific manner (Sokolov et al.,
1995, J. Biol. Chem. 270:9622-9629). The COL2A1 promoter is a 1 kb
fragment from the human COL2A1 gene (Ala-Kokko et al., 1991, J.
Biol. Chem. 266:14175-14178) that confers tissue-specificity of
expression (Bradham et al., 1994, J. Cell Physiol.158:61-68). The
lacZ gene is replaced with the hGH gene (Nichols Laboratories); the
OB gene (Considine et al., 1995, J. Clin. Invest. 95:2986-2988) or
the human factor IX gene (Genetic Therapy, Inc.).
Use of the Retrovirus Vector
[0132] Retrovirus Producer Cell Lines
[0133] To establish producer cell lines, amphotrophic retrovirus
packaging murine cells PA317 were used. The cells were transfected
at 20% confluency in 100 mm dishes by the calcium phosphate
precipitation procedure (Promega) using 15 .mu.g of plasmid DNA
that was linearized by digestion with ScaI that cuts in the pBR322
region of the retrovirus vector. One day post-transfection G418
(GIBCO/BRL) was added to the medium at an active concentration of 1
mg/ml. Neomycin-resistant colonies appeared at 7 to 10 days of
selection and were isolated by cloning with mechanical rings. The
clones were expanded and individual clones were tested for the
ability to express lacZ by direct staining of duplicate wells. The
titer of the virus produced by the positive cells was assayed by
single addition of 50 .mu.l of medium to HT-1080 human tumor cells
grown to 20% confluency in 6-well microliter plates with 3 ml
medium per well and in the presence of 4 .mu.g/ml of polybrene. The
titer was assayed by determining the number of HT-1080 cells that
stained positively for expression of the lacZ gene. Typically, the
titer was 1.times.10.sup.5 to 1.times.10.sup.6.
[0134] Retrovirus Infection of Mouse MSCs
[0135] Primary cultures of mouse MSCs were prepared as described
above. After 3 days, the non-adherent marrow cells were discarded
and fresh medium was added. The cells were then infected with the
retrovirus in the presence of 4 .mu.g/ml of polybrene by addition
of 1/4 volume of fresh supernate medium from stably transfected
producer cells that had the highest titer of virus production. The
infection was repeated on two additional successive days. The cells
were then either stained directly for lacZ expression or were
divided into larger dishes and placed under selection with 0.4
mg/ml of G418 (active concentration). About 15 to 20% of primary
cultures were positive for lacZ and most of the cells that survived
G418 selection were positive for lacZ.
[0136] Lipofectamine Transfection
[0137] Primary cultures of MSCs were grown for 10 days in
.alpha.-MEM containing 10% FBS. After trypsinization and light
scraping, the cells were seeded in a 6-well plate at a density of
10.sup.5 cells per well. The cells were grown for 2 days, then
washed 2 times with PBS and incubated with a DNA-lipofectamine
complex. The DNA-lipofectamine complex was prepared as follows: 6
.mu.l of lipofectamine (GIBCO/BRL) were mixed with 1 .mu.g of LNCZ
DNA in 200 .mu.l of .alpha.-MEM, incubated at room temperature for
30 min, and added to one well of a 6-well plate containing MSCs in
800 microliter .alpha.-MEM. After 6 hour incubation at 37.degree.
C., the DNA-lipofectamine complex was replaced with 2 ml of
.alpha.-MEM containing 10% FBS. The cells were stained for lacZ or
placed under G418 selection after 18 hour incubation in
FBS-containing medium. Positive clones were obtained, but they grew
slowly, apparently because the cell density was too low after the
G418 selection. To circumvent this situation, three different
strategies can be used: cells are plated at higher densities;
co-culture cell culture inserts are placed over surviving clones
early in the selection process and fresh MSCs or pieces of bone in
the inserts are placed (see Table 1) on a daily basis to provide
the necessary cell factors to stimulate growth; at the time that
selection with G418 has killed many of the non-transfected cells,
the cultures are reseeded with MSCs that have been infected with a
variant of the retrovirus LNCX (FIG. 1) in which the lacZ gene is
replaced with a selectable gene for thymidine kinase. Therefore,
the MSCs stably transfected with retrovirus are used to provide the
necessary cytokines, growth factors, and cell interactions required
for the initial growth of the transfected MSCs during selection in
G418. The cells infected with the retrovirus may be then removed by
negative selection with gangcyclovir.
Delivery Methods
[0138] Nuclear Injections
[0139] Nuclear injections are highly efficient as a means of
transfecting some cells. Cells were plated in 60-mm dishes
containing a 22.times.22 mm coverslip marked with a circle to
delineate the area for microinjection. Cells were incubated in
medium containing 0.1% CS for 5 days to induce growth arrest before
microinjection. Under these conditions between 8 and 15% of the
cells incorporated [.sup.3H] thymidine during continuous labeling
for 24 hours between days 5 and 6. Microinjection was performed
using a Zeiss Axiovert inverted-microscope equipped with an
Eppendorf microinjector and micromanipulator using commercially
purchased glass-capillary femtotips (Eppendorf). All cells within a
delineated area of the coverslip (usually 150-200) were
microinjected into the nucleus with DNA at concentrations ranging
from 0.01-10 .mu.g/.mu.l in 10 mM Tris buffer (pH 7.6). The
injected cells are then expanded and assayed as described
above.
[0140] Electroporation
[0141] MSCs are treated with 0.25% trypsin and 1 to 5 mM EDTA for 5
minutes at room temperature and then harvested by scraping. The
cells are pelletted by centrifugation at 4,000.times.g for 10
minutes, and then are washed twice by resuspending the pellet in
ice cold PBS (pH 7.4). MSCs are resuspended at 2.times.10.sup.6
cells per 0.8 ml and aliquoted into an electroporation cuvette (0.4
cm gap). The cells are incubated for 10 minutes on ice, DNA is
added to the suspension (5-50 .mu.g), and the cells are chilled for
an additional 10 minutes. The cell suspension is then
electroporated using a commercial instrument (BioRad Gene Pulser;
model 1652076) at an empirically determined field strength which
yields the greatest percentage of cells that retain the exogenously
added DNA. To determine the appropriate field strength for MSCs,
titrations have been performed ranging from 0.25-2.5 kv/cm.
Electroporation efficiency was monitored by introducing a lacZ gene
(LNCZ vector) and then staining cells 48 to 72 hours after
electroporation.
Assays
[0142] hGH
[0143] Expression of the hGH gene is monitored by assaying medium
from clones of cells grown in 6-well microliter plates with an
enzyme linked immunoabsorbent assay with a commercially available
kit (GIBCO/BRL). In this assay, 0.1 ml of 2.times. diluent buffer
is added per well of a microtiter plate. After 5 minutes, 0.1 ml of
test sample is added and the plate is incubated at 37.degree. C.
for 30 minutes. The wells are washed 5 times and 0.2 ml of primary
antibody is added per well. The samples are incubated at 37.degree.
C. for 30 minutes, and washed 5 times. Then 0.2 ml of substrate
buffer containing 0-phenylenediamine substrate is added. Samples
are incubated at room temperature for 30 minutes and the reaction
is stopped by addition of 0.1 ml of 2 N sulfuric acid. The
absorbance of the sample is assayed at 490 nm.
[0144] Ob Protein
[0145] Cells are assayed for expression of the OB gene using a
protein radioimmunoassay of cell medium. The primary antibody for
human OB protein was raised in rabbits against recombinant protein
synthesized in an E. coli expression system and purified to
homogeneity. The human protein is highly homologous to the mouse
and, therefore, anti-human antibodies should cross-react with the
mouse protein. If they do not, the short mouse cDNA (619 nt) is
expressed in E. coli, the protein is purified and antibodies are
prepared. Alternatively, synthetic peptides having the mouse
sequence are purchased and these are used to prepare antibodies.
For the assay, recombinant human Ob protein was radiolabeled with
.sup.125Iodine by the BoltonHunter method followed by gel
filtration purification using Sephadex G-25. The specific activity
obtained was 30 .mu.Ci/.mu.g. Samples for assay (0.2 ml) were
preincubated with primary antiserum (1:2000 dilution) in phosphate
buffered saline containing 0.1% Triton X-100 for 16 hours at
4.degree. C. in a total volume of 0.4 ml. .sup.125I -Ob protein
(30,000 cpm carried in 100 .mu.l) was then added and the incubation
was continued for an additional 24 h. The bound Ob protein
(12.+-.1%; nonspecific binding 1.4.+-.0.1%) was immunoprecipitated
by the addition of 0.1 ml sheep anti-rabbit IgG serum (Antibodies,
Inc., Davis, Calif.), 0.1 ml normal rabbit serum (GIBCO/BRL,
Gaithersburg, Md.), and 0.1 ml of 10% polyethylene glycol. The
tubes were centrifuged for 15 minutes (2200 rpm), unbound label was
decanted and the radioactivity in the pellet was counted in a
Packard 5000 gamma counter (Downers Grove, Ill.). The concentration
of Ob protein in unknown samples was calculated using Rodbard's
unweighted four parametric logistic model. The limit of detection
of this assay is 0.39 ng/ml. The intraassay variance is 11.6% at 12
ng/ml with an interassay variance of 20.8% at 13.1 ng/ml.
[0146] Human Factor IX
[0147] Expression of the gene encoding factor IX is assayed using a
commercially available ELISA (American Bioproducts Company) under
conditions similar to those used in the hGH assay (above). The
standard curve ranged from 1-50 ng/ml.sup.-1 and the limit of
sensitivity was 1 ng/ml.sup.-1. The assay did not cross-react with
mouse factor IX.
Example 4
Sustained Expression of the Three Genes at Physiologically
Important Levels by Systemic Infusion of Stably Transfected MSCs
into Mice
[0148] Experiments with the OI transgenic mice (Tables 2 and 3)
have demonstrated that cultured MSCs can serve as stem-cell-like
precursors of bone, cartilage and other mesenchymal tissues after
systemic infusion. Therefore, MSCs expressing hGH, the Ob protein
or factor IX are infused into irradiated and nonirradiated mice to
evaluate sustained expression of the genes in vivo.
[0149] Infusion of MSCs
[0150] Initially, MSCs are infused into mice under conditions such
as those described in Table 2 (3-week old mice: 300 or 700 Gray
irradiation; intraperitoneal injection; 1.times.10.sup.6 MSCs; and
2.times.10.sup.8 whole marrow cells). In addition, intravenous
infusion is compared to intraperitoneal; and lower levels of X-ray
irradiation are employed. Also, the cells are infused into embryos
by Cesarean section. In preliminary trials, 50 .mu.l of
5.times.10.sup.4 ES were injected into the amnion of seven 13-day
embryos; 6 of 7 were delivered as viable pups. Therefore,
intrauterine injection of MSCs is feasible.
[0151] Growth Curves
[0152] Effective in vivo expression of hGH should increase the
growth rate of mice and expression of the Ob protein should induce
starvation. Therefore, the weight and size of the treated mice and
of control littermates are monitored.
[0153] Assays for Gene Expression
[0154] Blood is obtained from the retro-orbital plexus of mice at 1
week, 1 month, 3 months, 5 months, 10 months, and 20 months after
infusion of the MSCs. hGH and factor IX are assayed by ELISA, and
the Ob protein is assayed with a radioimmune assays. In addition,
if measurable increases in human factor IX are obtained with ELISA,
the procedure described in Smith et al. (1993) Mature Genet.
5:397-402, to assay biologically active human Factor IX. In this
procedure, human Factor IX was first captured in a microtiter well
with the monoclonal antibody, BGIX1, and then activated by Factor
Xla. The active Factor IX, in combination with Factor VIII,
converted Factor X to Xa. Factor Xa cleaved the chromogenic
substrate, S2765, yielding a yellow product. BGIX1-coated
microliter plates and Factor VIII were purchased from Elcatech,
Inc. (Winston-Salem, N.C.). Factor Xia was purchased from Enzyme
Research Labs, Inc. (South Bend, Ind.).
[0155] Factor X, phospholipid solution, S-2765, and the thrombin
inhibitor, 1-2581, were purchased from Kabi Pharmacia Hepar, Inc.
(Franklin, Ohio). Four buffers were prepared: A, 50 mM Tris, 150 mM
NaCl, 1% BSA, pH 7.5; B, 150 mM Tris, 5 mM CaCl.sub.2, 10 mg/ml
gelatin, pH 7.6; C, 50 mM Tris, 10 mM CaCl.sub.2, pH 7.5; D, 50 mM
Tris, 15 OmM NaCl, pH 8.4. The Factor VIII/X reaction mix was
prepared fresh by mixing equal quantities of the following stocks:
Factor VIII, 5 U/ml in buffer A; Factor X, 1 U/ml in buffers;
1-2581, 34 .mu.g/ml in buffer A; CaCl.sub.2, 25 mM in water; and
phospholipid. Plasma samples were diluted in buffer A and 100 .mu.l
was added to each microtiter well. The plate was incubated for 90
minutes at room temperature and then washed five times with buffer
B. 100 .mu.l of Factor Xla (2 .mu.g/ml in buffer C) was added to
each well. After 30 minutes at 37.degree. C., 100 .mu.l of S2765
(0.5 mM in buffer D) was added to each well and the plate was
incubated for 10 minutes at room temperature before the reaction
was stopped by adding acetic acid to a final concentration of 10%.
Absorbances at 405 nm were determined using a Bio-Rad microplate
reader. The standard curve, prepared with dilutions of human normal
pooled plasma, was linear from 3-25 ng/ml. The assay did not cross
react with mouse Factor IX. Factor IX, levels of 250 ng/ml or 5% of
normal are generally considered therapeutic and 100 to 150 ng/ml
are considered beneficial.
Example 5
Sustained Expression of the Genes at Physiologically Important
Levels By Placing the MSCs in Subcutaneous Diffusion Chambers
[0156] Cells implanted in subcutaneous diffusion chambers have at
least two distinct advantages for use in therapy of human patients:
Immune responses are circumvented; and when implanted in capsules
in mice (Benayahu, 1989, J. Cell Physiol.140:1-7), rats (Mardon et
al., 1987, Cell Tissue Res. 250:157-165) or rabbits (Friedenstein
et al., 1987, Cell Tissue Kinet. 20:263-272), they survive for at
least 6 weeks (Wakitani, 1994, J. Bone and J. T. Surgery
76A:579-592), apparently because they persist as bone, fibrous
tissue or cartilage that does not require vascularization (Benayahu
et al., 1989, Supra; Mardon, et al., 1987, Supra; Owen et al.,
1988, In: Cell and Molecular Biology of Invertebrate Hard Tissues,
Wiley Chicester, CIBA Foundation Symposium, 136:42-60; Friedenstein
et al., 1987, Supra).
[0157] Preparation of Chambers
[0158] Diffusion chambers are assembled from commercially available
components (Millipore Corp.) and used as described in previous
reports (Benayahu et al., 1989, Supra; Mardon et al., 1987, Supra).
Briefly, membrane filters with pore size are glued to one side of
each of two plastic rings with acryloid glue. The two rings are
then glued together to form a chamber, the dimensions are 9 mm
inner diameter and 2 mm thick with a volume of about 127 mm.sup.3.
From 10.sup.4 to 10.sup.7 MSCs are inoculated into the chambers
through a hole in one ring and the hole is sealed with a tapered
plastic plug coated with glue. The chambers are implanted into mice
either subcutaneously on the back or intraperitoneally under
anesthesia. Initially, one or more chambers are inserted into
freshly weaned mice (3 weeks). Subsequently, chambers are inserted
in 1 week old mice. For the experiments with the 1 week old mice,
smaller chambers are prepared from discs (5 mm, inner diameter) cut
from plastic tips for micropipettes.
[0159] Assays
[0160] Blood is obtained from the retro-orbital plexus at 1 week, 1
month, 3 months, 5 months, 10 months and 20 months after
implantation of the chambers. The plasma is assayed for hGH, Ob
protein and factor IX as described above.
Example 6
[0161] Referring to FIG. 2, the diffusion chamber (1) may have a
chamber barrel (3) having two ends, a first end (5) and a second
end (7). The barrel may be comprised of one or more rings secured
together by non-toxic means. The chamber is fitted at each end with
a filter, a first filter (9) and a second filter (11). The filters
are porous to factors, for example, proteins, such that the factors
may pass between the chamber and the mammal. The filter pores size
may be about 0.25 .mu.m or smaller, preferably about 0.1 .mu.m. The
filters may be made of plastic, teflon, polyester, or any inert
material which is strong, flexible and able to withstand chemical
treatments. The filters may be secured in position with rubber
gaskets which may also provide a tighter seal. Optionally, the
barrel portion of the chamber may have an opening (13) which may be
covered by a cap (not shown). The cap may be a screw on type of
self sealing rubber and fitted to the opening. Inserting cells into
the chamber contents may thus be performed by accessing the opening
by removing the cap and inserting cells using an ordinary needle
and syringe. The chamber may be made of any substance, such as but
not limited to, plastic, teflon, lucite, titanium, or any inert
material, which is non-toxic to, and well tolerated by, mammals. In
addition, the chambers should be able to survive sterilization.
[0162] The chamber may be implanted in the following nonlimiting
ways: subcutaneously or intraperitoneally, for example. The chamber
may be removed about 24 to about 30 hours after implantation.
Alternatively, a refillable chamber may be employed such that the
chamber may be re-used for treatments and emptied following
treatments.
Example 7
Administration of Isolated MSCs Directly into Rat Brains
[0163] Preparation of Donor MSCs and Astrocytes
[0164] Human MSCs (Owen et al., 1988, in Cell and Molecular Biology
of Vertebrate Hard Tissues, Ciba Foundation Symposium 136,
Chichester, UK, pp. 42-60; Caplan, 1991, J. Orthop. Res. 9:641-650;
Prockop, 1997, Science 276:71-74; Pereira et al., 1995, Proc. Natl.
Acad. Sci. 92:4857-4861; Pereira et al., 1998, Proc. Natl. Acad.
Sci. 95:1142-1147) were grown from aspirates taken from the iliac
crest of normal male and female volunteers, aged 19 to 46 years
old. Aspirates were diluted 1:1 with .alpha.-MEM/10% FBS and were
centrifuged through a density gradient (Ficoll-Paque Plus; 1.077
g/ml, Pharmacia, LKB Biotechnology Inc., Piscataway, N.J.) for 30
minutes at 1000.times.g. After the supernatant and the interface
were combined, the mixture was diluted to about 40 ml with
.alpha.-MEM/10% FBS, and was again centrifuged. The nucleated
cells, i.e., the MSCs, were suspended at a concentration of
1.times.10.sup.7/ml in .alpha.-MEM/10% FBS and the cells were
plated at 3.times.10.sup.6/cm.sup.2 in 25 cm.sup.2 culture dishes.
The MSCs were incubated for 3 days and the non-adherent cells were
removed by replacing the medium in the culture. After the MSC
cultures reached confluency, the MSCs were lifted from the plates
by incubation with 0.25% trypsin and 1 mM EDTA at 37.degree. C. for
3 to 4 minutes. The MSCs were diluted 1:2 or 1:3 and the procedure
for preparing the MSCs was repeated for 3 to 5 passages. Beginning
with the second passage, 5 ng/ml of platelet derived growth factor
(PDGF-AA; GIBCO/BRL, Grand Island, N.Y.) was added to the
medium.
[0165] For the isolation of rat MSCs, tibias and femurs obtained
from 8-12 week old Lewis/SsNHsd female rats were dissected (Harlan
Sprauge Dawley, Ind.). The ends of the bones were cut, and the
marrow was extruded using 5 ml of DMEM (GIBCO/BRL, Grand Island,
N.Y.) using a needle and syringe. Between 100-200.times.10.sup.6
whole marrow cells were plated on a 175 cm.sup.2 tissue culture
flask in DMEM/10% FBS. After 24 hours, the non-adherent cells were
removed by replacing the medium. The medium was replaced every 2 to
3 days as the cells were grown to confluency. The cells were lifted
as before by incubation in the presence of 0.25% trypsin and 1 mM
EDTA, following which the cells were passed three or four times and
were then stored frozen until use.
[0166] Primary cultures of astrocytes (Azizi, 1996, Ann. Neurol.
(suppl) 121:T236) were obtained from the brains of albino
Sprague-Dawley adult rats (Harlan Sprague Dawley). After the heads
of the mice were decapitated, the brains were removed under aseptic
conditions and were floated in cold PBS over ice. The meninges and
the brain stem were removed and discarded. The forebrain was
mechanically dissociated into small pieces of tissue and the
tissues were incubated at 37.degree. C. for 30 minutes in 2.4
units/ml of dispase (GIBCO/BRL, Grand Island, N.Y.). At 10 minute
intervals, the tissues were dissociated by flushing them through a
large bore pipette. The dissociated tissues were centrifuged and
the supernatant was discarded.. The residue from each brain was
suspended in .alpha.-MEM and was plated in two 175 cm.sup.2 culture
flasks, each in a medium of .alpha.-MEM/10% FBS. The non-adherent
cells and the debris were removed by changing the medium after 48
hours, and then changing the medium every 4 days for about 2 weeks
until the cultures were confluent. To remove loosely adherent
cells, the confluent cultures were treated with 2.4 units/ml
dispase for 15 minutes at 37.degree. C., and the cultures were
shaken on a rotary shaker at 120 rpm for 2 hours. The detached
cells were discarded. Fresh medium was added to the adherent cells
and the cultures were reincubated for 24 to 48 hours. Treatment
with dispase to remove loosely adherent cells was repeated three
times over a period of about 1 week.
[0167] For antibody staining, the cells were lifted from the plates
by incubation with 0.25% trypsin for 1 to 3 minutes. The cells were
then subcultured in chambered slides. To label the nuclei
fluorescently, the MSCs and the astrocytes were incubated in the
presence of 1 .mu.g/ml bis-benzamide (Sigma Chemical Company, St.
Louis, Mo.) for 24 hours prior to implantation. At one to two hours
prior to implantation, the cultures were washed three times with
sterile buffered saline and were lifted from the plates by
incubation with 0.25% trypsin for 1 to 3 minutes. The trypsin was
neutralized by adding medium containing 20% serum, and the cells
were isolated by centrifugation. The cells were suspended as a
slurry of about 10,000 cells/liter in .alpha.-MEM without
serum.
[0168] Neurotransplantation of Cells
[0169] Adult Sprague-Dawley albino rats (weighing 200 to 300 grams
each) were anesthetized in a sealed chamber using 3% halothane in
oxygen. Anesthesia was maintained by intramuscular injection of a
mixture of 6 mg/kg xylozine and 60 mg/kg ketamine. The animals were
transferred to a sterotaxic apparatus in a clean field. A 2 to 5 mm
incision was made in the scalp, 2 mm lateral to the bregma. A burr
hole was made in the bone at a position 3 mm lateral to the bregma
using a dental drill. About 10 .mu.l of the cell suspension was
slowly injected over 30 minutes into the striatum at a depth of 4
to 5 mm deep from the surface of the brain. The wound was closed
with interrupted surgical sutures, and the animals were treated
with 0.6 mg/kg of xylozine and 6 mg/kg of ketamine. At 5, 14, 30
and 72 day intervals, the rats were sacrificed by intracardiac
perfusion under deep anesthesia using xylozine and ketamine.
Perfusion was performed using ice-cold phosphate buffered saline,
followed by 3% buffered paraformaldehyde, and then followed by 10%
sucrose. The brains were removed, the forebrains were trimmed, and
samples comprising sections of the brain were frozen
immediately.
[0170] Immunohistology of Implanted Cells.
[0171] Ten micron tissue sections were prepared using a cryostat.
The transplant site in the brain was located by microscopically
identifying the fluorescently labeled cells in the tissue sections.
Frozen sections were attached to the gelatin coated slides and were
quickly immersed in cold acetone for 5 minutes and stored at
-20.degree. C. for further processing. The cells in the chambered
slides were fixed with acetone for 5 minutes. Immunocytochemistry
was performed at room temperature. The cells and the tissue
sections were treated with blocking antibodies comprising 2% goat
serum and 5% fetal bovine serum for 30 minutes. In experiments
requiring the labeling of collagen and vimentin, the cells were
further treated with Triton X-100 for 30 minutes and were then were
rinsed in PBS. Primary antibodies were applied (Table 4) for 1 to 2
hours to cells in the chambered slides. These antibodies were
applied for 24 hours in the case of tissue sections. The secondary
antibodies used were species-specific IgGs coupled to either FITC
or rhodamine.
[0172] Fluorescently labeled cells were visualized and photographed
using a fluorescent microscope. The number of fluorescently labeled
nuclei were counted in eight to ten tissue sections, cut from
rostral to caudal limits of the striatum. This procedure was
repeated on each brain by two individuals, who used alternate
sections. Only the clearly labeled nuclei were counted. Dead and
lysed cells left a bluish hue in the surrounding tissue and no
clear nuclear staining. The observed numbers were extrapolated to
the total number of sections in order to estimate the number of
surviving engrafted cells.
[0173] Donor MSCs and Astrocytes Precursors
[0174] MSCs obtained from human bone marrow were isolated by their
adherence to plastic and were grown for 3 to 5 passages. As
indicated in FIG. 3, the addition of PDGF-AA increased the growth
rate of the cells. Therefore, PDGF-AA was added to cells at
passages 2 to 5 in order to obtain adequate numbers of human MSCs.
However, rat MSCs grew adequately without the addition of PDGF-AA.
Astrocytes were also isolated because of their tight adherence to
plastic cultures dishes. Astrocytes were harvested after primary
culture for about 3 weeks.
[0175] As indicated in Table 4, human MSCs stained heavily for
fibronectin, collagen I and human HLA-ABC. Human MSCs stained
faintly for vimentin and were negative for glial fibrillary acidic
protein, whereas rat astrocytes were positive for both. Rat
astrocytes stained poorly for fibronectin and were negative for
collagen I and human HLA-ABC. Rat astrocytes were also negative for
von Willebrand factor and galactocerebrosidase C.
[0176] It has been previously described that human MSCs become
relatively homogeneous in appearance as these cells are passaged in
culture (Bruder et al., 1997, J. Cell Biochem. 64:278-294).
However, in the present study, two distinct populations were seen.
These included a population of large flattened cells and a
population of relatively elongated or spindle shaped cells (FIG. 4,
Panels A and B). In rat MSCs, two distinct populations of cells
having similar morphologies were also seen (FIG. 4, Panel C). The
rat brain astrocytes were more dendritic in appearance (FIG. 4,
Panels E and F).
[0177] Survival of Cells after Injection in the Striatum
[0178] The MSCs and the astrocytes were injected in the corpus
striatum of rat brains using minimal perfusion pressure. Five to 72
days later, the rats were killed and sections of their brains were
obtained. Examination of sections stained with hematoxylin and
eosin indicated that there was no significant gliosis around the
implantation site of either the rat astrocytes or the MSCs (FIG. 5,
Panel a). Fluorescently labeled cells were readily detected in the
brain sections. Rat astrocytes, as previously shown in the prior
art, readily engrafted (Andersson et al., 1993, Int. J. Dev.
Neurosci. 11:555-568; Azizi, 1996, Ann. Neurol. (suppl) 121:T236;
Zhou et al., 1992, J. Comp. Neurol. 317:145-155). Similar results
were obtained using rat MSCs (FIG. 5, Panel f) and human MSCs
(FIGS. 5, Panels b-e). As indicated in Table 5, from about 20,000
to 42,000 cells were present in the recovered brains. Since the
number of the cells injected varied from 100,000 to 120,000, about
20% of the infused human MSCs were recovered after 5 to 72 days.
Moreover, there appeared to be a decrease in the number of the
infused human MSCs recovered between days 30 and 72. In the case of
rat MSCs, 33,000 cells or about 30% were recovered 14 days after
infusion (FIG. 5f).
[0179] Migration of the Implanted Cells
[0180] It has been previously described that implanted rat
astrocytes migrate through layers of the brain (Andersson et al.,
1993, Int. J. Dev. Neurosci. 11:555-568; Zhou et al., 1992, J.
Comp. Neurol. 317:145-155) in a manner similar to the migration
seen with implanted neural stem cell or with a transformed line of
the neural stem cells (McKay, 1997, Science 276:66-71). In the
present invention it has been discovered that MSCs migrated in a
similar fashion. Donor cells were found in multiple areas of the
brain, including the contralateral cortex (FIG. 6). The cells
persisted in the sites to which they migrated. The heaviest
concentration of cells was found around the rostrocaudal axis in
the striatum and along the corpus callosum. There were fewer cells
in the cerebral cortex. Clusters of labeled cells were consistently
observed in the temporal lobe regions at all time points examined.
At day 72, fewer cells were found in the outlying cortical regions,
an observation consistent with the apparent decrease in cell number
between day 30 and 72 (Table 5).
[0181] Immunohistology of Implanted Cells
[0182] Immunostaining of sections demonstrated that engrafted human
MSCs were also detected throughout the brain (FIG. 6) when
antibodies to HLA-ABC were used (FIG. 5, Panel b). Although human
MSCs stained with antibodies to collagen I prior to implantation
(FIG. 7, Panel a), no staining with the same antibodies was seen
after implantation. Thus, the MSCs ceased synthesis of type I
collagen after integration into brain tissue. Staining of the cells
with antibodies specific for fibronectin was observed prior to
implantation (FIG. 7, Panel b) and was also observed 5 days after
implantation (FIG. 7, Panel c).
[0183] The results of neurotransplantation experiments establish
that human MSCs infused into rat brain can engraft, migrate, and
survive in a manner similar to engraftment, migration and survival
of rat astrocytes. Rat MSCs behaved in a similar manner to rat
astrocytes. Thus, the rat and human cells behave in a similar
manner. The data presented herein has established that at least a
subset of cells that are isolated from the bone marrow by their
adherence characteristics to plastic culture dishes, may also
participate in the same pathway as astrocytes. The results
establish that MSCs are therefore useful vehicles for both cell and
gene therapy for treatment of a variety of diseases in humans. In
addition, since the transplanted MSCs ceased synthesis of collagen
type I, these cells are much more suitable for neurotransplantation
than are fibroblasts which are known to continue to produce large
amounts of collagen following transplantation and which therefore
induce fibrosis at the site of transplantation.
[0184] MSCs have several advantages as cells for
neurotransplantation. In particular, they can be readily obtained
from bone marrow and expanded in culture. Also, a patient's own
MSCs can be employed for the therapy, thus circumventing any
attending problems of host immunity and graft versus host disease.
In addition, the cells may be genetically engineered for treatment
of diseases in human.
Example 8
Coculture of MSCs with Astrocytes: Differentiation of MSCs into
Astrocytes
[0185] Human MSCcs at a concentration of 2.times.10.sup.5 cells
were cocultured with rat astrocytes at a concentration of
1.times.10.sup.5 cells in 10 ml of medium that consisted of MEM
plus 30% FBS Sigma). The human cells were fluorescently labeled
with .alpha.-human HLA-ABC prior to coculture. Following 5 days of
coculture, about 2% of the human cells also stained positive for
glial fibrillary acidic protein. Since glial fibrillary acidic
protein is a marker for early astrocytes, these results demonstrate
that a fraction of the human MSCs had differentiated into
astrocytes during coculture with rat astrocytes.
1TABLE 1 Conditions for Growth of Primary and Secondary Cultures of
MSCs Cells per APase.sup.a TRAP.sup.a Well .times. (mmol (mmol MSCs
Culture Conditions 10.sup.5 min/mg) min/mg) Primary Standard.sup.a
2.0 42.6 144 Co-cultured.sup.b 6.41 22.3 102 Co-cultured.sup.c 6.94
42.0 105 (Matrigel) Secondary.sup.d Standard 1.33 2,052 72
Co-cultured 7.40 362 60.6 Co-cultured (Matrigel) 5.08 506 59.2
.sup.aWhole marrow cells (20 .times. 10.sup.6) from 6-week old mice
were cultured in individual 9.5 cm.sup.2 wells in a 2 ml of 10% FCS
and .alpha.-MEM. Non-adherent cells were removed on day 3 and the
incubation was continued in fresh medium until day 7. APase and
TRAP were assayed. .sup.bCo-cultured with pieces of bone (one-half
femur and one-half tibia) in cell culture inserts (23 mm; 3 .mu.m
pore size; Becton Dickinson). .sup.cSame as .sup.b, with inserts
coated with Matrigel. .sup.dPrimary cultures on day 10 were
detached with 0.25% trypsin and 1 mM EDTA for 5 minutes at
37.degree. C. followed by gentle scraping. Cells from one well (2
.times. 10.sup.5) were diluted 1:4 and cultured in 9.5 cm.sup.2
wells for 7 days with changes of medium on day 3 and day 6.
.sup.eAPase and TRAP activities were per mg total protein.
[0186]
2TABLE 2 Experiments with (a) Transgenic Mice as Recipients; (b)
Normal MSCs as Donor Cells; and (c) Decreasing X-Ray Done Donor
Cells Bone Recipient X-ray Whole replacement at mice (cG) MSCs
marrow 1 month (%).sup.c Transgenic 700 0.7 .times. 10.sup.6 15
.times. 10.sup.6 10 to 45% (3 weeks) (N).sup.a (TG).sup.ab (n = 3)
Transgenic 350 1.2 .times. 10.sup.6 2 .times. 10.sup.6 28 to 60% (3
weeks) (N) (TG) (n = 4) Transgenic 175 1.2 .times. 10.sup.6 2
.times. 10.sup.6 0 to 40% (3 weeks) (N) (TG) (n = 4) .sup.a(N),
normal; (TG), transgenic. .sup.bMSCs removed from whole marrow
cells before infusion by incubation on plastic culture dish for 4
hours at 37.degree. C. .sup.cValues obtained using a
semi-quantitative assay.
[0187]
3TABLE 3 Experiments with (a) Transgenic Mice as Recipients; (b)
10-Fold Increase in Whole Marrow Cells as Donor Cells; and (c)
Decreasing X-Ray Dose Donor Cells.sup.a Bone Recipient X-ray Whole
replacement at mice (cG) MSCs marrow 1 month (%).sup.b Transgenic
700 5 .times. 10.sup.6 20 to 38% (3 weeks) (N).sup.a (n = 3)
Transgenic 350 16 .times. 10.sup.6 50 to 78% 93 weeks) (N) (n = 4)
(n = 3) Transgenic 350 5 .times. 10.sup.6 22 to 45% (3 weeks) (N)
(n = 4) .sup.a(N) whole marrow from normal mice without any
treatment to remove MSCs. .sup.bValues obtained using a
semi-quantitative PCR assay.
[0188]
4TABLE 4 Immunostaining of Human MSCs and Rat Astrocytes Human Rat
Antibodies Dilution MSCs astrocytes Fibronectin (Sigma) 1:400 +++ -
Collagen I (Biodesign) 1:10 ++ - HLA-ABC (Pharmingen) 1:100 ++ -
Vimentin (Sigma) 1:40 +/- +++ Glial Fibrillary Acidic Protein
(Sigma) 1:20 - ++ Galactocerebrosidase C (Sigma) 1:50 NA.sup.a -
von Willebrand Factor (Sigma) 1:200 NA - .sup.aNA, not assayed
[0189]
5TABLE 5 Recovery of Fluorescently Labeled Human MSCs from Rat
Brain Days after infusion Labeled cells per brain 5 27,300.sup.a 14
30,200 30 41,800 72 19,900 .sup.aTotal counts on alternative
sections by two different observers differed by less than 20%.
[0190] The disclosures of each and every patent, patent application
and publication cited herein are hereby incorporated herein by
reference in their entirety.
[0191] While this invention has been disclosed with reference to
specific embodiments, it is apparent that other embodiments and
variations of this invention may be devised by others skilled in
the art without departing from the true spirit and scope of the
invention. The appended claims are intended to be construed to
include all such embodiments and equivalent variations.
* * * * *