U.S. patent application number 12/991367 was filed with the patent office on 2011-07-07 for ameliorating nervous systems disorders.
Invention is credited to Arturo Alvarez-Buylla, Scott C. Baraban, Arnold Kriegstein, John L.R. Rubenstein.
Application Number | 20110165129 12/991367 |
Document ID | / |
Family ID | 41265359 |
Filed Date | 2011-07-07 |
United States Patent
Application |
20110165129 |
Kind Code |
A1 |
Kriegstein; Arnold ; et
al. |
July 7, 2011 |
Ameliorating Nervous Systems Disorders
Abstract
The present disclosure provides methods for the treatment of a
mammal having a neurological condition, disease, or injury. The
methods involve increasing the number of functional GABAergic
interneurons at or near the site of the neurological disease,
injury, or condition.
Inventors: |
Kriegstein; Arnold; (Mill
Valley, CA) ; Rubenstein; John L.R.; (San Francisco,
CA) ; Baraban; Scott C.; (Novato, CA) ;
Alvarez-Buylla; Arturo; (Woodside, CA) |
Family ID: |
41265359 |
Appl. No.: |
12/991367 |
Filed: |
May 5, 2009 |
PCT Filed: |
May 5, 2009 |
PCT NO: |
PCT/US2009/042914 |
371 Date: |
March 18, 2011 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
61050980 |
May 6, 2008 |
|
|
|
Current U.S.
Class: |
424/93.7 |
Current CPC
Class: |
A61K 35/30 20130101;
A61P 25/02 20180101; C12N 2506/02 20130101; G01N 2800/2842
20130101; A61K 9/0085 20130101; C12N 5/0618 20130101; C12N 5/0622
20130101; G01N 2800/2835 20130101; A61K 9/0019 20130101; G01N
2800/28 20130101; A61P 25/14 20180101; A61P 25/00 20180101 |
Class at
Publication: |
424/93.7 |
International
Class: |
A61K 35/12 20060101
A61K035/12; A61P 25/00 20060101 A61P025/00 |
Goverment Interests
STATEMENT AS TO FEDERALLY SPONSORED RESEARCH
[0002] This invention was made with the support of the United
States government under Contract number 5R01NS048528-04 by National
Institutes of Health. The government has certain rights in the
invention.
Claims
1. A method for the treatment of a mammal having a neurological
condition, disease, or injury comprising: increasing the number of
functional GABAergic interneurons at or near the site of the
neurological disease, injury, or condition, wherein said functional
GABAergic interneurons functionally integrate with endogenous
neurons and restore balance to neuronal circuitry that is
dysregulated in neurological conditions, diseases, or injuries.
2. The method of claim 1, wherein the increase in said functional
GABAergic interneurons is by transplantation comprising the
injection of MGE (medial ganglionic eminence) precursor cells.
3. The method of claim 2, wherein the MGE precursor cells are able
to migrate at least 0.5 mm from the transplantation site.
4. The method of claim 1, wherein the neurological condition,
disease, or injury is a degenerative disease, genetic disease,
acute injury, or chronic injury.
5. The method of claim 4, wherein the neurological condition,
disease, or injury comprises Parkinson's disease, epilepsy,
spasticity, multiple sclerosis, stroke, spinal cord injury, brain
injury, or chronic pain disorders.
6. The method of claim 3, wherein the MGE precursor cells express a
therapeutic protein or peptide, or neurotransmitter.
7. The method of claim 6, wherein the therapeutic protein or
peptide comprises a neurotrophin, a neuropoietic cytokine, a
fibroblast growth factors (e.g., acidic and basic FGF), an
inhibitory growth factor, or a cytokine useful in the treatment of
infectious disease, brain tumors, or brain metastases.
8. The method of claim 4, wherein the neurological condition is
epilepsy, wherein transplantation of MGE precursor cells result in
at least a 10% reduction in spontaneous electrographic seizure
activity.
9. The method of claim 4, wherein the neurological condition is
epilepsy, wherein transplantation of MGE precursor cells result in
at least a 10% reduction in seizure duration.
10. The method of claim 4, wherein the neurological condition is
epilepsy, wherein transplantation of MGE precursor cells result in
at least a 10% reduction in seizure frequency.
11. The method of claim 4, wherein the neurological condition is
epilepsy, wherein transplantation of MGE precursor cells result in
at least a 10% reduction in required antiepileptic drug use.
12. The method of claim 4, wherein the neurological disease is
Parkinson's disease, wherein transplantation of MGE precursor cells
result in at least a 10% reduction in required antiParkinsonian
drug use.
13. The method of claim 4, wherein the neurological disease is
Parkinson's disease, wherein transplantation of MGE precursor cells
result in at least a 10% reduction in tremor at rest, rigidity,
akinesia, bradykinesia, postural instability, flexed posture and/or
freezing.
14. The method of claim 4, wherein the neurological disease is
Parkinson's disease, wherein the MGE cells transplanted into the
striatum survive for at least 6 months.
15. The method of claim 4, wherein the neurological condition is
spasticity, wherein transplantation of MGE precursor cells obviates
the need for intrathecal medication or surgery.
16. The method of claim 4, wherein the neurological condition is
spasticity, wherein transplantation of MGE precursor cells result
in at least a 10% reduction in required antispasmodic drug use.
17. The method of claim 2, wherein the MGE precursor cells are
injected into the striatum, basal ganglia, dorsal ganglia, ventral
horn, or lumbar theca.
18. The method as in claim 2, wherein the mammal does not require
immunosuppressive therapy following transplantation.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application claims priority benefit to U.S. provisional
application Ser. No. 61/050,980 filed on May 6, 2008, which
application is incorporated herein by reference in its
entirety.
INTRODUCTION
[0003] Clinical management of conditions, diseases and injuries of
the central and peripheral nervous system usually focus of the
prevention of further neurological damage or injury rather than on
the repair or replacement of the damaged neurological tissue (e.g.,
neurons). For example, treatment of spinal cord injury includes the
prevention of additional spinal cord injury by physically
stabilizing the spine through surgical and non-surgical procedures
and by inhibiting the inflammatory response with steroidal therapy.
Thus, there remains a pressing need for improved and effective
treatments of the central and peripheral nervous system that are
able to repair or replace damaged or injured neural tissue.
SUMMARY
[0004] In some embodiments, a method is provided for the treatment
of a mammal having a neurological condition, disease, or injury
comprising increasing the number of functional GABAergic
interneurons at or near the site of the neurological disease,
injury, or condition, wherein the functional GABAergic interneurons
functionally integrate with endogenous neurons and restore balance
to neuronal circuitry that is dysregulated in neurological
conditions, diseases, or injuries. In some embodiments, the
increase in the functional GABAergic interneurons is by
transplantation using injections of MGE (medial ganglionic
eminence) precursor cells. In some embodiments, the MGE precursor
cells are able to migrate at least 0.5 mm from the transplantation
site.
[0005] In some embodiments, the neurological condition, disease, or
injury is a degenerative disease, genetic disease, acute injury, or
chronic injury. In some embodiments, the neurological condition,
disease, or injury comprises Parkinson's disease, epilepsy,
spasticity, multiple sclerosis, stroke, spinal cord injury, brain
injury, or chronic pain disorders.
[0006] In some embodiments, the neurological condition is epilepsy,
wherein transplantation of MGE precursor cells result in at least a
10% reduction in spontaneous electrographic seizure activity. In
some embodiments, the neurological condition is epilepsy, wherein
transplantation of MGE precursor cells result in at least a 10%
reduction in seizure duration. In some embodiments, the
neurological condition is epilepsy, wherein transplantation of MGE
precursor cells result in at least a 10% reduction in seizure
frequency. In some embodiments, the neurological condition is
epilepsy, wherein transplantation of MGE precursor cells result in
at least a 10% reduction in required antiepileptic drug use.
[0007] In some embodiments, the neurological disease is Parkinson's
disease, wherein transplantation of MGE precursor cells result in
at least a 10% reduction in required anti-Parkinsonian drug use. In
some embodiments, the neurological disease is Parkinson's disease,
wherein transplantation of MGE precursor cells result in at least a
10% reduction in tremor at rest, rigidity, akinesia, bradykinesia,
postural instability, flexed posture and/or freezing. In some
embodiments, the neurological disease is Parkinson's disease,
wherein the MGE cells transplanted into the striatum survive for at
least 6 months.
[0008] In some embodiments, the neurological condition is
spasticity, wherein transplantation of MGE precursor cells
mitigates or obviates the need for intrathecal medication or
surgery. In some embodiments, the neurological condition is
spasticity, wherein transplantation of MGE precursor cells result
in at least a 10% reduction in required antispasmodic drug use
[0009] In some embodiments, the MGE precursor cells express a
therapeutic protein or peptide, or neurotransmitter. In some
embodiments, the therapeutic protein or peptide comprises a
neurotrophin, a neuropoietic cytokine, a fibroblast growth factor
(e.g., acidic and basic FGF), an inhibitory growth factor, or a
cytokine useful in the treatment of infectious disease, brain
tumors, or brain metastases.
[0010] In some embodiments, the MGE precursor cells are injected
into the striatum, basal ganglia, dorsal ganglia, ventral horn, or
lumbar theca. In some embodiments, the mammal does not require
immunosuppressive therapy following transplantation.
[0011] All publications and patent applications mentioned in this
specification are herein incorporated by reference to the same
extent as if each individual publication or patent application was
specifically and individually indicated to be incorporated by
reference. Nothing cited herein is to be construed as an admission
that the invention is not entitled to antedate such disclosure by
virtue of prior invention.
BRIEF DESCRIPTION OF THE DRAWINGS
[0012] FIG. 1 is a collection of schematics as follows: Panel A.
Experimental design. 6-OHDA-surgery was performed on day 1 and
behavioral tests on weeks 3 and 5. If the rat showed parkinsonian
behavior, it was injected with MGE cells on week 6. The behavioral
tests were repeated on weeks 9, 11, 14 and 18. Panel B. Unilateral
lesion of the rat nigrostriatal projection. Tyrosine hydroxylase
(TH) labels dopaminegic cells. The ipsilateral side to the
injection did not show any stain for TH, while the contralateral
side had numerous TH+ cells in the SNc, after 2 weeks. Panel C.
Drug-induced rotations were measured in an automated rotometer
bowl. After intraperitoneal injection of apomorphine, the animals
were fitted with a jacket that was attached via a cable to a
rotation sensor, the animals were placed into the test bowl and the
number of clockwise or counterclockwise rotations was recorded over
a test period of 40 minutes. Panel D. Rats were placed into a
runway. The floor of the runway was covered with paper. The rats
were trained to run down the runway. At the start of each test, the
animals' feet were dipped in black ink before being placed at the
beginning of the runway. Panel E. The length of stride was measure
for each test. 6-OHDA length of stride was shorter than that of
controls. Panel F. 6-OHDA rats tended to wander from side to side
as they walked down the runway rather than follow a straight path.
Scale bar: A=30 .mu.m.
[0013] FIG. 2 is a collection of images as follows: Panel A.
Striatum 4 weeks after transplant. The transplanted GFP-MGE cells
migrated 2 to 2.5 mm in all the directions from the site of
injection. The cells covered the whole span of the striatum but
never migrated outside it. Panel B. Transplanted cells 8 weeks
after transplant had a fully mature appearance, an oblong body
shape and numerous processes that extended up to 50 .mu.m, and
occupied the whole striatum even in areas far away from cellular
GFP-MGE somas. The processes intermingled and seemed to contact one
another. Scale bars: A=0.5 mm; B=25 .mu.m.
[0014] FIG. 3 is a collection of images as follow, illustrating
that most (3:1) MGE cells showed interneuronal fate when
transplanted into the adult striatum. Four weeks after transplant,
MGE-cells expressed the mature neuronal markers NeuN+ (A,
75.+-.6%), GAD (B, 60.+-.11%), GABA+ (C, 75.+-.4%), GAT (D,
50.+-.9%), CB (E, 24.+-.7%), CR (F, 8.3.+-.0.5%), Substance P (G,
6.+-.2%), CNPase (H, 25%.+-.4), Somatostatin (I, 1.+-.0.5%) and
Chat. Scale bars: B1=10 .mu.m and applies to Panels A1, C1, D1, E1,
F1, G1, H1, I1, and J1; A3=30 .mu.m and applies to Panels A2, B1,
B2, C1, C2, D1, D2, E1, E2, F1, F2, G1, G2, H1, H2, I1, I2, J1, and
J2.
[0015] FIG. 4 is a collection of graphs and images showing that MGE
cells transplanted into the striatum retain the basic membrane
properties that are characteristics of cortical interneurons Panel
A. 67% of the MGE cells expressed synaptophysin in their processes
(white arrows). Panel B. Alexa-594 was included in the fill
solution of the glass microelectrode to determine whether the
obtained whole-cell recordings were from the targeted
GFP-expressing MGE transplant cells. Panel C. MGE cells fired
repetitive non-accommodating action potentials with large after
hyperpolarizations when stimulated with a series of depolarizing
currents, as is common for MGE derived interneurons. Panel D. Some
of the transplanted MGE cells (n=2/13) did not possess neuronal
membrane properties and did not fire action potentials. Panel E.
MGE transplant cells fired spontaneous action potentials, and Panel
F. exhibited spontaneous synaptic currents at a frequency of 1.1
psc/s, which was similar to that recorded from host cells (1.0
psc/s). Scale bars: A=3 .mu.m; B=5 .mu.m.
[0016] FIG. 5 is a collection of graphs as follows: Panel A.
Rotation test. 6-OHDA rats (n=21) performed far more rotations than
control rats (n=16) before receiving an MGE cell transplant. Upon
transplantation, however, they started performing significantly
fewer contra-lateral turns than non-transplanted 6-OHDA controls
(n=12). This trend continued until the last time point (week 18).
Sham-transplanted 6-OHDA rats (n=11) performed similarly to
non-transplanted 6-OHDA rats (n=12). Panel B. Length of stride
test. 6-OHDA rats (n=12) had an average stride length of
13.2.+-.0.2 cm, significantly shorter than the average stride
length of control rats (15.1.+-.0.3, n=16). Upon MGE cells
transplantation, the stride length of 6-OHDA rats increased and
eventually reached the same value as in control rats (15.5.+-.0.4
cm, n=21). The stride length of 6-OHDA rats that had received a
sham transplant (n=11) was not significantly different from that of
6-OHDA rats (n=12). Panel C. Width of path test. 6-OHDA rats had a
width of path of 3.4.+-.0.3 cm (n=12), significantly different from
the 2.5.+-.0.3 cm width of path of control rats (n=16). Upon MGE
cells transplantation, the path width decreased and eventually
reached control value (n=16). The path width of sham transplanted
6-OHDA rats (n=11) was not significantly different from that of
6-OHDA rats (n=12).
[0017] FIG. 6 is a collection of images showing MGE transplanted
cells expressed Dopamine Receptors 1 (DR1, A1-A2) and Dopamine
Receptor 2 (DR2, B1-B2). DR1 and DR2 are present in somatic
membrane and processes of MGE cells. Panels A2 and A3. High
magnification images of MGE cells that expressed DR1 (A2) and DR2
(B2). Panel A1=30 .mu.m and applies to Panel B1; Panel A2=3 .mu.m
and applies to Panel B2.
[0018] FIG. 7 is a collection of graphs showing the following:
Panel A. The length of stride was significantly higher in control
rats injected with MGE cells (n=6) than in control rats (n=16).
Panel B. Open field test show an increase activity in wild-type MGE
transplanted rats compared to control rats. Panel C. Representative
open field zone map. Wild-type MGE transplanted rat has a major
level of motor activity when compared to a control rat.
[0019] FIG. 8 is a collection of images showing MGE cells
transplanted into the STN survived but did not migrate from the
site of injection (Panel A). None of the MGE cells in the STN
expressed the neuronal marker NeuN (Panel B), the inhibitory
interneuron markers GABA (Panel E) or GAD (Panel G), or the calcium
sequestering proteins CR (Panel H) or CB (Panel I). MGE cells
transplanted STN expressed GFAP (75.+-.5%, Panels C and J) or the
oligodendrocyte marker CNPase (30.+-.9%, Panels D and K). A small
percentage of MGE cells in the STN expressed the GABA transporter
GAT1 (13.+-.5%, Panel F). Scale bars: A=25 .mu.m; I=25 .mu.m and
applies to Panels B, C, D, E, F, G and H; K=5 .mu.m and applies to
J.
[0020] FIG. 9 is a collection of schematics and images showing the
following: Panel A generally illustrates the transplantation of MGE
cells from E13.5 embryonic GFP+ transgenic donor into mice
expressing green fluorescent protein (GFP) on postnatal day 2 (P2);
bilateral injections were made. MGE cells are then analyzed 30 days
after transplantation (30 DAT). Panel B illustrates transplanted
MGE cells, harvested from mice expressing GFP at 30 DAT and
co-labeled with antibodies to GABA, GAD67, calretinin (CR),
parvalbumin (PV), neuropeptide Y (NPY), and somatostatin (SOM).
Panels C and D illustrate that the MGE-GFP neurons exhibit firing
properties similar to endogenous interneuron sub-types such as
fast-spiking (FS), regular-spiking non-pyramidal cells (RSNP), and
stuttering (STUT). The plot in 1d summarizes all GFP-positive cells
that were recorded; one cell had non-firing properties similar to
an astrocyte (astro).
[0021] FIG. 10 is a collection of graphs and images as follows:
Panel A shows an interneuron, identified by their oval and often
multi-polar morphologies under IR-DIC. Panel B confirms post hoc
that the interneurons were correctly identified with biocytin
labeling. Panel C shows GABA-mediated current from control
(un-transplanted) and grafted interneurons that were
voltage-clamped in bath solution containing glutamate receptor
antagonists (DNQX and APV). Panels D-F show no significant
differences in GABA-mediated inhibition onto endogenous
interneurons between control and grafted mice at 30 DAT using IPSC
analysis.
[0022] FIG. 11 shows that white matter stimulation elicited IPSCs
on Layer II/III pyramidal neurons in regions containing GFP+ cells
with kinetic properties that were not different between control and
grafted animals. An exemplary graph is shown in Panel A, and the
data presented in graphic form in Panel B.
[0023] FIG. 12 is a collection of images and graphs as follows:
Panel A, subpanels 1-4 show that early postnatal bilateral
transplantation of MGE-GFP progenitors generated new
GFP-immunoreactive (IR) cells in host neocortex with distributions
between 0.75 and 5 mm from injection site. Panel A, subpanel 5 show
that a threshold of .about.40,000 GFP-IR cells per animal, with
migration.gtoreq.0.5 mm from the injection site, was defined as a
successful graft. Panel B illustrates confirmation of
high-amplitude synchronous electrographic seizure activity using
scalp electroencephalographic (EEG) recording. Panel C, graph 1
shows the percentage observed for behavioral seizure manifestations
including forelimb clonus (Stage 3, S3) in control mice and in mice
with phenobarbital (PB), carbamezepine (CBZ), MGE, and phenyloin
(PHT). For mice grafted with MGE cells at P2, the percentage of
animals exhibiting S3 seizures was reduced to .about.50%. Panel C,
graph 2 shows the latency to first seizure behavior for control
mice and in mice with phenobarbital (PB), carbamezepine (CBZ), MGE,
and phenyloin (PHT). For mice grafted with MGE cells at P2, the
latency to first seizure behavior was unchanged from that of the
control mice.
[0024] FIG. 13 is a collection of graphs as follows: Panel A shows
video-electroencephalography (EEG) used to examine MGE transplant
effects on spontaneous seizures in mice epilepsy model. Panel B
shows the duration of the spontaneous seizures in mice epilepsy
models with MGE transplants. Panel C shows the frequency of the
spontaneous seizures in mice epilepsy models with MGE transplants.
Panel D shows the Kaplan-Maier survival plots for postnatal days.
Panel E shows the percentage of mice that survive at P55. Panel F
shows new GFP cell density per brain in Kv1.1-/- mice that survive
at P57.
DETAILED DESCRIPTION
[0025] While exemplary embodiments of the present invention have
been shown and described herein, it will be obvious to those
skilled in the art that such embodiments are provided by way of
example only. Numerous variations, changes, and substitutions will
now occur to those skilled in the art without departing from the
invention. It should be understood that various alternatives to the
embodiments of the invention described herein may be employed in
practicing the invention. It is intended that the following claims
define the scope of the invention and that methods and structures
within the scope of these claims and their equivalents be covered
thereby.
[0026] The practice of the present methods will employ, unless
otherwise indicated, conventional techniques of cell biology, cell
culture, molecular biology, transgenic biology, microbiology,
recombinant DNA, and immunology, which are within the skill of the
art. Such techniques are described in the literature. See, for
example, Molecular Cloning A Laboratory Manual, 2nd Ed., ed. by
Sambrook, Fritsch and Maniatis (Cold Spring Harbor Laboratory
Press: 1989); DNA Cloning, Volumes I and II (D. N. Glover ed.,
1985); Oligonucleotide Synthesis (M. J. Gait ed., 1984); Mullis et
al. U.S. Pat. No. 4,683,195; Nucleic Acid Hybridization (B. D.
Hames & S. J. Higgins eds. 1984); Transcription And Translation
(B. D. Hames & S. J. Higgins eds. 1984); Culture Of Animal
Cells (R. I. Freshney, Alan R. Liss, Inc., 1987); Immobilized Cells
And Enzymes (IRL Press, 1986); B. Perbal, A Practical Guide To
Molecular Cloning (1984); the treatise, Methods In Enzymology
(Academic Press, Inc., N.Y.); Gene Transfer Vectors For Mammalian
Cells (J. H. Miller and M. P. Calos eds., 1987, Cold Spring Harbor
Laboratory); Methods In Enzymology, Vols. 154 and 155 (Wu et al.
eds.), Immunochemical Methods In Cell And Molecular Biology (Mayer
and Walker, eds., Academic Press, London, 1987); Handbook Of
Experimental Immunology, Volumes I-IV (D. M. Weir and C. C.
Blackwell, eds., 1986); Manipulating the Mouse Embryo, (Cold Spring
Harbor Laboratory Press, Cold Spring Harbor, N.Y., 1986).
[0027] It must be noted that as used herein and in the appended
claims, the singular forms "a," "an," and "the" include plural
reference unless the context clearly dictates otherwise. Thus, for
example, a reference to "a cell" includes a plurality of such cells
and so forth. Unless defined otherwise, all technical and
scientific terms used herein have the same meanings as commonly
understood by one of ordinary skill in the art to which this
invention belongs. Although any materials and methods similar or
equivalent to those described herein can be used to practice or
test the present invention, exemplary materials and methods are now
described.
[0028] As common methods of administering the MGE precursor cells
of the present disclosure to animals, particularly humans, which
are described in detail herein, include injection or implantation
of the MGE precursors cells into target sites in the animals, the
cells of the disclosure can be inserted into a delivery device
which facilitates introduction by, injection or implantation, of
the cells into the animals. Such delivery devices include tubes,
eg., catheters, for injecting cells and fluids into the body of a
recipient animal. In a preferred embodiment, the tubes additionally
have a needle, eg., a syringe, through which the cells can be
introduced into the animal at a desired location. The MGE precursor
cells can be inserted into such a delivery device, eg., a syringe,
in different forms. For example, the cells can be suspended in a
solution or embedded in a support matrix when contained in such a
delivery device. As used herein, the term "solution" includes a
pharmaceutically acceptable carrier or diluent in which the cells
remain viable. Pharmaceutically acceptable carriers and diluents
include saline, aqueous buffer solutions, solvents and/or
dispersion media. The use of such carriers and diluents is well
known in the art. The solution is preferably sterile and fluid to
the extent that easy syringability exists. Preferably, the solution
is stable under the conditions of manufacture and storage and
preserved against the contaminating action of microorganisms such
as bacteria and fungi through the use of, for example, parabens,
chlorobutanol, phenol, ascorbic acid, thimerosal, and the like.
Solutions of the present disclosure can be prepared as described
herein in as a pharmaceutically acceptable carrier or diluent and,
as required, other ingredients enumerated above, followed by filter
sterilization.
[0029] The present disclosure also provides substantially pure MGE
precursor cells that can be used therapeutically for treatment of
various disorders. To illustrate, the MGE precursors of the
disclosure can be used in the treatment or prophylaxis of a variety
of conditions, diseases, or disorders. For instance, the MGE
precursors can be used to produce populations of differentiated
neurons for repair, replacement, or amelioration of damaged nervous
system tissue for the treatment or prophylaxis of Parkinson's
disease, epilepsy, schizophrenia, chronic pain disorders,
neuropathic pain, multiple sclerosis, neuropathy, damage from
traumatic injury, stroke, or ischemia and the like.
[0030] The invention will now be further described by way of
reference only to the following non-limiting examples. It should be
understood, however, that the examples following are illustrative
only, and should not be taken in any way as a restriction on the
generality of the invention described above. In particular, while
the methods and compositions of the present disclosure are
described in detail in relation to the use of mouse and rat cells,
it will be clearly understood that the findings herein are not
limited to these-types of cells, but would be useful growing any
MGE precursor cell from any animal, including humans.
[0031] When the cells are implanted into the brain, stereotaxic
methods will generally be used as described in Leksell and
Jernberg, Acta Neurochir., 52:1-7 (1980) and Leksell et al., J.
Neurosurg., 66:626-629 (1987), both of which are incorporated
herein by reference. Localization of target regions will generally
include pre-implantation MRI as described in Leksell et al., J.
Neurol. Neurosurg. Psychiatry, 48:14-18 (1985), incorporated herein
by reference. Target coordinates will be determined from the
pre-implantation MRI.
[0032] Prior to implantation, the viability of the cells may be
assessed as described by Brundin et al., Brain Res., 331:251-259
(1985), incorporated herein by reference. Briefly, sample aliquots
of the cell suspension (1-4 .mu.l) are mixed on a glass slide with
10 .mu.l of a mixture of acridine orange and ethidium bromide (3.4
g/ml of each component in 0.9% saline; Sigma). The suspension is
transferred to a hemocytometer, and viable and non-viable cells
were visually counted using a fluorescence microscope under
epi-illumination at 390 nm combined with white light
trans-illumination to visualize the counting chamber grid. Acridine
orange stains live nuclei green, whereas ethidium bromide will
enter dead cells resulting in orange-red fluorescence. Cell
suspensions should generally contain more than about 98% viable
cells.
[0033] In humans, injections will generally be made with sterilized
10 .mu.l Hamilton syringes having 23-27 gauge needles. The syringe,
loaded with cells, is mounted directly into the head of a
stereotaxic frame. The injection needle is lowered to predetermined
coordinates through small burr holes in the cranium, 40-50 .mu.l of
suspension are deposited at the rate of about 1-2 .mu.l/minute and
a further 2-5 minutes are allowed for diffusion prior to slow
retraction of the needle. Frequently, two or more separate deposits
will be made, separated by 1-3 mm, along the same needle
penetration, and up to 5 deposits scattered over the target area
can readily be made in the same operation. The injection may be
performed manually or by an infusion pump. At the completion of
surgery following retraction of the needle, the patient is removed
from the frame and the wound is sutured. Prophylactic antibiotics
or immunosuppressive therapy may be administered as needed.
[0034] In some embodiments of the present disclosure, the implanted
cells may be transfected with a DNA sequence encoding a peptide.
The peptide may be an enzyme which catalyzes the production of a
therapeutic compound including the production of a
neurotransmitter, e.g., the DNA could encode tyrosine hydroxylase
which catalyzes the synthesis of dopamine that is effective in the
treatment of Parkinsonism. The DNA may also encode a neurotrophic
factor. Useful neurotrophic factors include the neurotrophins
(e.g., NGF; brain-derived neurotrophic factor, BDNF; and
neurotrophins NT-3 and NT-4/5); the neuropoietic cytokines (e.g.,
ciliary neurotrophic factor, CNTF); and the fibroblast growth
factors (e.g., acidic and basic FGF). The DNA may also encode an
inhibitory growth factor, or a cytokine useful in the treatment of
infectious disease, brain tumors, or brain metastases.
[0035] Generally, the DNA sequence will be operably linked to a
transcriptional promoter and a transcriptional terminator. The DNA
sequence may also be linked to a transcriptional enhancer.
Expression of the DNA in the implanted cells may be constitutive or
inducible. A variety of expression vectors having these
characteristics may carry the DNA for transfection of the cells,
such as plasmid vectors pTK2, pHyg, and pRSVneo, simian virus 40
vectors, bovine papillomavirus vectors or Epstein-Barr virus
vectors, as described in Sambrook et al., Molecular Cloning, A
Laboratory Manual, Cold Spring Harbor Press, 1988, previously
incorporated herein by reference. The vectors may be introduced
into the cells by standard methods, such as electroporation,
calcium phosphate-mediated transfection, polybrene transfection,
and the like.
[0036] In some embodiments, the present disclosure is useful in the
treatment of degenerative diseases. A degenerative disease is a
disease in which the decline (e.g., function, structure,
biochemistry) of particular cell type, e.g., neuronal, results in
an adverse clinical condition. For example, Parkinson's disease is
a degenerative disease in the central nervous system, e.g., basal
ganglia, which is characterized by rhythmical muscular tremors,
rigidity of movement, festination, droopy posture and masklike
facies. Degenerative diseases that can be treated with the
substantially homogenous cell populations of the present disclosure
include, for example, Parkinson's disease, multiple sclerosis,
epilepsy, Huntington's, dystonia, (dystonia musculmusculorum
deformans) and choreoathetosis.
[0037] In some embodiments, the present disclosure is useful in the
treatment of conditions caused by an acute injury. An acute injury
condition is a condition in which an event or multiple events
results in an adverse clinical condition. The event which results
in the acute injury condition can be an external event such as
blunt force or compression or an internal event such as sudden
ischemia (e.g., stroke or heart attack). Acute injury conditions
that can be treated with the substantially homogenous cell
populations of the present disclosure include, for example, spinal
cord injury, traumatic brain injury, brain damage resulting from
myocardial infarction and stroke.
[0038] In some embodiments, the present disclosure provides methods
of treating a human suffering from a neurological condition,
comprising the step of administering to the human a substantially
homogenous cell population of the present disclosure. "A
neurological condition," as used herein, refers to any state of the
nervous system (central or peripheral nervous system) which
deviates in any manner from a normal nervous system or nervous
system of a mammal, e.g., human, not affected by a neurological
condition. The neurological condition can be a condition of the
central (brain or spinal cord) or peripheral nervous system. The
neurological condition can be, for example, the result or
consequence of a disease, e.g., Parkinson's disease or multiple
sclerosis, acute injury condition, e.g., stroke, brain injury,
spinal cord injury, or a combination of disease and acute injury
condition. Other neurological conditions which can be treated with
the substantially homogenous population of cells of the present
disclosure include, for example, chronic or intractable pain,
primary brain tumors, or metastasizes.
[0039] In some embodiments, the administered cells comprise a
substantially homogenous population. In some embodiments, the
substantially homogenous population comprises cells wherein at
least 25% of the cells become GABA expressing cells. In some
embodiments, the substantially homogenous population comprises
cells wherein at least 30%, 40%, 50%, 60%, 70%, 80%, 90%, 95%, or
99% of the cells become GABA expressing cells. In some embodiments,
at least 25% of the cells comprising the substantially homogenous
population of cells migrate at least 0.5 mm from the injection
site. In some embodiments, at least 30%, 40%, 50%, 60%, 70%, 80%,
90%, 95%, or 99% of the cells comprising the substantially
homogenous population of cells migrate at least 0.5 mm from the
injection site. In some embodiments, the majority of the cells
comprising the substantially homogenous population of cells migrate
at least 1.0, 1.5, 2.0, 3.0, 4.0, or 5.0 mm from the injection
site. In some embodiments, at least 25% of the substantially
homogenous population of cells becomes functionally GABAergic
interneurons. In some embodiments, at least 30%, 40%, 50%, 60%,
70%, 80%, 90%, 95%, or 99% of the cells become functionally
GABAergic interneurons. In some embodiments, at least 25% of the
substantially homogenous population of cells becomes functionally
GABAergic interneurons that integrate with endogenous neurons. In
some embodiments, at least 30%, 40%, 50%, 60%, 70%, 80%, 90%, 95%,
or 99% of the substantially homogenous population of cells become
functionally GABAergic interneurons that integrate with endogenous
neurons.
[0040] In some embodiments, the substantially homogeneous
population of cells becomes functional GABAergic interneurons and
express one or more of the following: parvalbumin, calbindin,
somatostatin, calretinin, neuropeptide Y, nitric oxide synthase,
ChAT, NADPH diaphorase.
[0041] In some embodiments, the implanted functionally GABAergic
interneurons increase the overall level of GABA-mediated synaptic
inhibition in the host brain by at least 5%. In some embodiments,
the implanted functionally GABAergic interneurons increase overall
level of GABA-mediated synaptic inhibition in the host brain by at
least 10%, 15%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, or 95%. The
increased inhibition can be monitored in patients by assaying for
GABA levels in regions containing transplanted MGE cells.
[0042] In some embodiments, the functionally integrated
transplanted interneurons represent at least 1% of the total number
of the native striatal interneurons. In some embodiments, the
functionally integrated transplanted interneurons represent at
least 2%, 3%, 4%, 5%, 6%, 7%, 8%, 9%, 10%, 12%, 15%, 20%, 25%, or
30% of the total number of the striatal interneurons.
[0043] In some embodiments, the substantially homogenous cells
secrete at least one neurotransmitter, therapeutic factor, cytokine
and/or trophic factor. In some embodiments, the synthesis and
secretion of at least one therapeutic factor, cytokine and/or
trophic factor from the substantially homogenous population of
cells of the present disclosure can protect surrounding cells near
or distant from the site of transplantation from further damage as
a consequence of the degenerative, acute injury or neurological
condition. In some embodiments, the synthesis and secretion of at
least one therapeutic factor, cytokine and/or trophic factor from
the substantially homogenous population of cells of the present
disclosure can also, or alternatively, promote regeneration of
cells and tissues of the host, e.g., human suffering from a
degenerative condition, acute injury, or neurological
condition.
[0044] In some embodiments, the cell populations of the present
disclosure have the capacity to respond to intrinsic signals, e.g.,
at the sites of transplantation, during migration, or at final
migratory location, and exogenous cues to differentiate into
neurons. The cell populations of the present disclosure can provide
a readily available source of cells for use in treating animals,
preferably mammals, and most preferably humans.
[0045] "MGE progenitor cell" or "MGE precursor cell," as used
herein, refers to a cell obtained from a source, e.g., embryonic
medial ganglionic eminence, umbilical cord blood, adult bone
marrow, fat, skin, etc., that has substantially similar
characteristics of a cell isolated from the MGE of E13.5 mouse
fetuses, E14.5 rat fetuses, or develops into a cell with the
substantially similar characteristics of a cell isolated from the
MGE of E14.5 mouse fetuses. MGE progenitor cells can be isolated
from human fetuses at 12-14 gestational weeks. A MGE progenitor
cell can be a cell isolated from central nervous system tissue that
is substantially similar to the MGE of E13.5 mice fetus or E14.5
rat fetus, a primary culture of cells grown from cells isolated
from central nervous system tissue that is substantially similar to
the MGE of E13.5 mice, E14.5 rat, or cells generated from other
sources such as cell lines derived from embryonic or adult stem
cells that are further differentiated to have substantially similar
characteristics of cells isolated from the MGE of E13.5 mice or
E14.5 rat.
[0046] In some embodiments, the cell line is produced by regulating
the production of telomerase. In some embodiments, telomerase
expression is forced by the expression of exogenous hTERT as
detailed in Ouellette, M. M. et al. The establishment of
telomerase-immortalized cell lines representing human chromosome
instability syndromes. Human Molecular Genetics, 9:403-411, 2000.
In some embodiments, the cell line is derived from pluripotent stem
cells that are derived following reprogramming of adult somatic
cells by somatic cell nuclear transfer as detailed by I. Wilmut, et
al. Nature, 385, 810, 1997. In some embodiments, the cell line is
derived from pluripotent stem cells that were derived following
reprogramming of adult somatic cells by fusion with embryonic stem
cells as described by Cowan, C. et al. Nuclear reprogramming of
somatic cells after fusion with human embryonic stem cells.
Science, 309, 1369-1372, 2005. In some embodiments, the cell line
is derived from pluripotent stem cells that were derived following
reprogramming of adult somatic cells by exposure to a defined set
of reprogramming factors. In some embodiments, the reprogramming
factors are OCT4, SOX2, NANOG, and LIN28 as detailed by Yu, J., et
al. Induced pluripotent stem cell lines derived from human somatic
cells. Science, 318, 1917-1920, 2007. In some embodiments, the
reprogramming factors are Oct3/4, Sox2, Klf4, and c-Myc as detailed
by Takahashi, K., et al. Induction of pluripotent stem cells from
adult human fibroblasts. Cell, 131, 861-871, 2007.
[0047] Selected cells can be used directly from cultures or stored
for future use, e.g., by cryopreserving in liquid nitrogen. If
cyropreserved, MGE precursors must be initially thawed before
placing the MGE precursors in a transplantation medium. Methods of
freezing and thawing cryopreserved materials such that they are
active after the thawing process are well-known to those of
ordinary skill in the art.
[0048] In some embodiments, the present disclosure includes a
pharmaceutical composition comprising a substantially homogeneous
cell population of MGE precursors. In some embodiments, the
pharmaceutical composition has at least about 10.sup.5
substantially homogeneous cells. In some embodiments, the
pharmaceutical composition has at least about 10.sup.6, 10.sup.7,
10.sup.8, 10.sup.9, or 10.sup.10 substantially homogeneous cells.
The cells comprising the pharmaceutical composition can also
express at least one neurotransmitter, neurotrophic factor,
inhibitory factor, or cytokine.
[0049] The cells of the present disclosure can be, for example,
transplanted or placed in the central, e.g., brain or spinal cord,
or peripheral nervous system. The site of placement in the nervous
system for the cells of the present disclosure is determined based
on the particular neurological condition, e.g., direct injection
into the lesioned striatum, spinal cord parenchyma, or dorsal
ganglia. For example, cells of the present disclosure can be placed
in or near the striatum of patients suffering from Parkinson's
disease. Similarly, cells of the present disclosure can be placed
in or near the spinal cord (e.g., cervical, thoracic, lumbar or
sacral) of patients suffering from a spinal cord injury. One
skilled in the art would be able to determine the manner (e.g.,
needle injection or placement, more invasive surgery) most suitable
for placement of the cells depending upon the location of the
neurological condition and the medical condition of the
patient.
[0050] The substantially homogenous cells of the present disclosure
can be administered alone or as admixtures with conventional
excipients, for example, pharmaceutically, or physiologically,
acceptable organic, or inorganic carrier substances suitable for
enteral or parenteral application which do not deleteriously react
with the cells of the present disclosure. Suitable pharmaceutically
acceptable carriers include water, salt solutions (such as Ringer's
solution), alcohols, oils, gelatins and carbohydrates such as
lactose, amylose or starch, fatty acid esters,
hydroxymethycellulose, and polyvinyl pyrrolidine. Such preparations
can be sterilized and, if desired, mixed with auxiliary agents such
as lubricants, preservatives, stabilizers, wetting agents,
emulsifiers, salts for influencing osmotic pressure, buffers,
coloring, and/or aromatic substances and the like which do not
deleteriously react with the cells of the present disclosure.
[0051] When parenteral application is needed or desired,
particularly suitable admixtures for the cells are injectable,
sterile solutions, preferably oily or aqueous solutions, as well as
suspensions, emulsions, or implants. In particular, carriers for
parenteral administration include aqueous solutions of dextrose,
saline, pure water, ethanol, glycerol, propylene glycol, peanut
oil, sesame oil and polyoxyethylene-block polymers. Pharmaceutical
admixtures suitable for use in the present disclosure are
well-known to those of skill in the art and are described, for
example, in Pharmaceutical Sciences (17th Ed., Mack Pub. Co.,
Easton, Pa.) and WO 96/05309 the teachings of both of which are
hereby incorporated by reference.
[0052] The substantially homogenous population of cells can be used
alone or in combination with other therapies when administered to a
human suffering from a neurological condition. For example,
steroids or pharmaceutical synthetic drugs can be co-administered
with the cells of the present disclosure. Likewise, treatment of
spinal cord injury can include the administration/transplantation
of the cells of the present disclosure in a human whose spine has
been physically stabilized.
[0053] The dosage and frequency (single or multiple doses) of the
administration or transplantation of the cells to a human,
including the actual number of cells transplanted into the human,
can vary depending upon a variety of factors, including the
particular condition being treated, e.g., degenerative condition,
acute injury, neurological condition; size; age; sex; health; body
weight; body mass index; diet; nature and extent of symptoms of the
neurological condition being treated, e.g., early onset Parkinson's
disease versus advanced Parkinson's disease; spinal cord trauma
versus partial or complete severing of the spinal cord); kind of
concurrent treatment, e.g., steroids; complications from the
neurological condition; extent of tolerance to the treatment or
other health-related problems. Humans with a degenerative
condition, acute injury, or neurological condition can be treated
of once or repeatedly with cells of the present disclosure, e.g.,
about 10.sup.6 cells, at the same or different site. Treatment can
be performed monthly, every six months, yearly, biannually, every
5, 10, or 15 years, or any other appropriate time period as deemed
medically necessary.
[0054] The methods of the present disclosure can be employed to
treat neurological conditions in mammals other than human mammals.
For example, a non-human mammal in need of veterinary treatment,
e.g., companion animals (e.g., dogs, cats), farm animals (e.g.,
cows, sheep, pigs, horses) and laboratory animals (e.g., rats,
mice, guinea pigs).
Parkinson's Disease
[0055] Parkinson's disease (PD) affects approximately 150 per
100,000 people in the United States and Europe. PD is characterized
by motor impairment as well as cognitive and autonomic dysfunction
and disturbances in mood. Four cardinal features of PD can be
grouped under the acronym TRAP: Tremor at rest, Rigidity, Akinesia
(or bradykinesia) and Postural instability. In addition, flexed
posture and freezing (motor blocks) have been included among
classic features of parkinsonism, with PD as the most common form.
Existing treatments can attenuate the symptoms of PD but there is
no cure. The motor symptoms of PD result primarily from the loss of
dopamine containing neurons in the substantia nigra compacta (SNc)
that extend axonal projections to the striatum and release dopamine
(for review see (Litvan et al., 2007). The SNc and the striatum
belong to the basal ganglia, a network of nuclei which integrate
inhibitory and excitatory signals to control movement. Loss of SNc
cells in PD reduces the amount of dopamine release into the
striatum, producing a neurotransmitter imbalance that inhibits the
output of the basal ganglia and produces hypokinetic signs (for
review (DeLong and Wichmann, 2007).
[0056] The striatum is composed of three classes of neurons. Medium
spiny neurons are the projection neurons of the striatum and
account for 95% of the total number of striatal neurons. The medium
spiny neurons are GABAergic, express calbindin and substance P,
give rise to nearly all outputs from the striatum, and receive
nearly all the synapses from brain structures that project into the
striatum (Tepper and Bolam, 2004). A second class of neuron is the
large cholinergic neuron or large spiny neuron that is an
excitatory striatal interneuron that expresses the marker
cholineacetyltransferase (Chat). Cholinergic interneurons modulate
the sub- and supra-threshold responses of the medium spiny neurons
to cortical and/or thalamic inputs (Tepper and Bolam, 2004). The
third class of striatal neuron is the GABAergic inhibitory
interneuron or small spiny neuron of the striatum. These cells
account for approximately 1-2% of the total number of striatal
neurons. There are three subtypes of GABAergic inhibitory
interneuron, and each subtype can be identified by the
co-expression of specific markers: GABAergic interneurons that
express calretinin (CR); GABAergic interneurons that express
parvalbumin (PV); and GABAergic interneurons that express
somatostatin, NADPH-diaphorase, and NOS (Kawaguchi et al., 1995;
Tepper and Bolam, 2004). The GABAergic interneurons are the main
source of inhibition of medium spiny neurons (Koos and Tepper,
1999; Koos et al., 2004; Plenz and Kitai, 1998). Each of the three
types of GABAergic interneurons produce a strong inhibitory
postsynaptic potential in medium spiny neurons, the function of
which is to influence the precise timing of action potential firing
in either individual or ensembles of medium spiny neurons. Both
excitatory and inhibitory striatal interneurons are important sites
of action for neuromodulators in the neostriatum, and act in
different but complementary ways to modify the activity of the
medium spiny projection neurons (Tepper and Bolam, 2004).
[0057] Striatal projection neurons and interneurons originate from
the embryonic primordium of the basal ganglia, the ganglionic
eminences. Inhibitory projection neurons are believed to derive
from the medial ganglionic eminence (MGE, (Anderson et al., 1997;
Deacon et al., 1994; Olsson et al., 1995), and the cholinergic
excitatory projection neurons are thought to derive from the
lateral ganglionic eminence (LGE) (Olsson et al., 1998). Previous
data indicate that the GABAergic interneurons may have mixed
origins. The CR+ subclass of interneurons derives mostly from MGE,
but as many as ten percent may be derived from the LGE (Marin et
al., 2000). The PV+ subclass of interneurons is thought to derive
entirely from MGE (Marin et al., 2000). Transplantation studies
suggest that Som+ interneurons may originate from both the LGE and
MGE (Olsson et al., 1998), although the expression pattern of the
transcription factor Nkx2.1, which is required for the
specification of MGE derivates, suggests that Som+ cells are
derived only from the MGE (Marin et al., 2000). The embryonic MGE
also produces a substantial number of neocortical interneurons that
migrate long distances over a tangential pathway to the dorsal
neocortex, where they mature into local circuit GABAergic
interneurons (Anderson et al., 1999; Lavdas et al., 1999; Wichterle
et al., 1999). MGE cells retain the capacity for dispersal and
integration when grafted heterochronically into neonatal or adult
brain (Grasbon-Frodl et al., 1997; Olsson et al., 1997; Wichterle
et al., 1999), develop into mature neurons when re-transplanted
into the embryonic MGE (Butt et al., 2005), and can significantly
increase the levels of inhibition exerted on neocortical projection
neurons when grafted into the neocortex (Alvarez-Dolado et al.,
2006).
[0058] The most widely used treatment for PD is administration of
the dopamine precursor, levodopa, which improves motor behavior but
also produces undesirable side effects including dyskinesias.
Surgical approaches have been developed that involve electrical
stimulation or ablation of the motor thalamus, the subthalamic
nucleus, or the globus pallidus. Additional therapeutic strategies
have been based on restoring or increasing concentrations of
dopamine in the basal ganglia through transplantation of adult or
embryonic dopamine-releasing tissues or stem cells.
[0059] To treat the motor symptoms of Parkinson's disease produced
by a reduction of dopaminergic input, a non-dopamine based strategy
that modified the circuit activity in the basal ganglia was
employed. MGE cells were transplanted into the striatum of rats
treated with 6-hydroxydopamine (6-OHDA), a well-established model
of PD. This treatment relies on the ability of MGE cells to
migrate, functionally integrate, and increase levels of inhibition
in the host brain after transplantation. Transplanted MGE cells
migrated from the site of injection and dispersed throughout the
host striatum. Most MGE transplant cells acquired a mature neuronal
phenotype and expressed neuronal and GABAergic markers. In
addition, the transplanted cells expressed a variety of markers
that are characteristic of striatal GABAergic interneurons such as
CB, CR, CB, and Som. Finally, the MGE transplant cells became
physiologically mature, integrated into the host circuitry, and
improved the motor symptoms of PD in the rat 6-OHDA model. These
results indicate that the transplantation of GABAergic interneurons
restores balance to neuronal circuitry that has been affected by
neurodegenerative diseases such as PD.
Example 1
Materials And Methods
[0060] Experimental design 6-OHDA lesions were induced on
experimental day 1 and performed behavioral tests on weeks 3 and 5.
In rats selected for grafting, MGE cells were transplanted on week
6, and behavioral tests were repeated on weeks 9, 11, 14 and 18
(FIG. 1, Panel A). All animals were treated in accordance with
protocols approved by the Institutional Animal Care and Use
Committee at UCSF.
[0061] 6-OHDA-model Unilateral lesions of the nigrostriatal
projection in rats, using 6-OHDA, leads to the loss of dopaminergic
cells in the SNc through retrograde transport, and loss of
dopaminergic terminals in the striatum through axonal disruption
(Berger et al., 1991). As a consequence, the distribution of D1 and
D2 receptors is altered. Unilateral damage can result in bilateral
changes in the SNc (Berger et al., 1991). Damage of the
nigrostriatal pathway in rats is accompanied by a compensatory
increase in the synthesis and release of dopamine from the
dopaminegic terminals that remain (Zigmond et al., 1984). To
evaluate the success of surgery, a subset of animals (n=5) were
perfused 4 weeks after lesion and the SNc stained for tyrosine
hydroxylase immunoreactivity (TH-IR), a limiting enzyme in the
synthesis of dopamine, in order to label dopaminegic cells. In
successful surgeries, the side of the SNc ipsilateral to the 6-OHDA
injection did not show TH-IR, while the contralateral side had
numerous TH+ cells (FIG. 1, Panel B). To evaluate the 6-OHDA
surgeries in vivo, behavioral testing was performed (described
below).
[0062] 6-OHDA-surgery Adult female rats were anesthetized with
ketamine (90 mg/Kg) and xylazine (7 mg/Kg), and when insensitive to
pain, immobilized within a stereotaxic frame in flat skull
position. A two-centimeter mid-sagittal skin incision was made on
the scalp to expose the skull. The coordinates for the
nigrostriatal bundle were determined based on the Paxinos and
Watson adult rat brain atlas (Paxinos and Watson, 1982). A hole was
drilled through the skull at the appropriate coordinates, and a
glass capillary micropipette stereotaxically advanced so that the
internal tip of the pipette was located within the nigro-striatal
pathway. The micropipette had a 50 .mu.m diameter tip and was
filled with a solution of 6-OHDA, 12 gr/3 .mu.l in 0.1% ascorbic
acid-saline. The 6-OHDA was injected into the right nigro-striatal
pathway at a rate of 1 .mu.l/minute. The micropipette was kept at
the site for an additional 4 minutes before being slowly withdrawn.
The skin incision was closed with stainless steel wound clips. Each
animal was injected with 6-OHDA on the right side only, producing
hemi-Parkinsonian rats.
[0063] MGE transplant surgery Adult pregnant rats that carried the
green fluorescent protein (EGFP) under the chick-beta actin
promoter (Wistar-TgN (CAG-GFP, 184Ys, Rat Resource and Research
Center) were anesthetized as described above. Fetuses were removed
from the uterus at E14.5 and brains dissected under a microscope.
The MGE was dissected from the forebrain in oxygenated artificial
cerebrospinal fluid (aCSF, in mm: NaCl, 125; KCl, 2.5; MgCl2, 1;
CaCl2, 2; NaPO4, 1.25; NaHCO3, 25; and glucose, 25; Sigma). Eight
MGEs were used to prepare dissociated cells for each surgery. The
MGE tissue was mechanically dissociated in the presence of 1% DNAse
I in aCSF. Cells were centrifuged at 2.times. gravity for 2
minutes, and pellets dissociated in 5 .mu.l of aCSF. Cells were
injected immediately after dissociation. Three injections were
performed along the rostro-caudal axis of the striatum, and cells
were deposited at three delivery sites along the dorsal-ventral
axis at each injection site, starting with the most ventral site
first and then withdrawing the injection pipette dorsally to
perform the second and third injections. 400 nl of cell suspension
was injected at each delivery site, and a total of 3.6 .mu.l of MGE
cell suspension was injected in each striatum. One 300 nl injection
was performed into the STN. The total number of transplanted cells
were 252,390.+-.7729 (n=3 rats).
[0064] Immunocytochemistry Rats were anesthetized as described
above and perfused intracardially with 0.1M phosphate buffer saline
(PBS) followed by 4% paraformaldehyde in PBS. The brains were
removed and post-fixed 24 hours in the same paraformaldehyde at
4.degree. C. Coronal 50 .mu.m slices were prepared on a vibratome
(Leica). Free-floating sections were blocked in 10% donkey serum
(Gibco, Calif., USA), 0.1% triton X-100 (Sigma, Mo., USA) and 0.2%
gelatin (Sigma, Mo., USA). Sections were incubated 24 hours in
primary antibodies at room temperature. The primary antibodies
were: anti-neuronal specific nuclear protein (mouse anti-NeuN,
Chemicon), Gamma Aminobutryic Acid (rabbit anti-GABA (1:1000,
Sigma), Glutamic Acid Descarboxylase 67 (mouse anti-GAD, 1:1000,
Abcam), GABA Transporter 1 (rabbit anti-GAT, 1:300, Abcam), CNPase
(mouse anti-1:500, Abcam), Glial Fibrillary Acidic Protein (rabbit
anti-GFAP, 1:1000; Sigma), Substance P (rabbit anti-SP, 1:2000,
Chemicon), Somatostatin (mouse anti-Som, 1:100, Abcam), Nitric
Oxide Synthase (rabbit anti-NOS, 1:100, Abcam), Choline
Acetyltransferase (goat anti-Chat, 1:100; Chemicon), Tyrosine
Hydroxylase (mouse anti-TH, 1:1000, Boehringer Mannheim
Biochemica), Parvalbumin (mouse anti-PV, 1:1000, Chemicon),
Calretinin (mouse anti-CR, 1:1000; Chemicon), Calbindin (mouse
anti-CB, 1:2000; Swant, Bellinzona, Switzerland), Synaptophysin
(mouse anti-Synaptophysin, 1:200, Sigma), Dopamine- and
cAMP-regulated Protein (rabbit anti-DARPP 32, 1:50, Abcam),
Dopamine Transporter (rat anti-DAT, 1:500, Abcam), Vesicular
Monoamine Transporter 2 (rabbit anti-VMAT, 1:1000, Abcam), Dopamine
Receptor 1 (rabbit anti-DR1, 1:2000, Abcam), Dopamine Receptor 2
(rabbit anti-DR2, 1:500, Abcam), and green fluorescent protein
(chicken anti-GFP, 1:1000, Abcam). Sections were rinsed and
incubated in the appropriate secondary antibody: Cy2, Cy3 or Cy5
conjugated polyclonal anti-mouse/goat/rabbit antibodies (1:100,
Jackson Laboratories, ME, USA). Tissue was rinsed and mounted on
coated glass slides and cover-slipped with an aqueous mounting
medium (Aquamount; Lerner, Pa., USA). Confocal microscopy was
performed on an Olympus Fluoview confocal laser scanning microscope
and analysis performed in Fluoview v.3.3 (Olympus). The first
antibody was omitted as a control for each immunostaining
experiment.
[0065] Cell quantification The survival of MGE cells after
transplantation, and the percentage of transplanted MGE cells that
expressed cell specific markers were quantified through confocal
microscopy. Brains were perfused as described above at three days,
one week, two weeks, three weeks, four weeks, eight weeks and 12
weeks after transplantation. Brains were cut into 50 thick coronal
sections as described above. The number of MGE cells that survived
transplantation was estimated by quantifying the number of cells in
every third 50 .mu.m thick section throughout the rostro-caudal
axes of the brain, and multiplying this number by three. The
percentage of MGE transplanted cells that expressed cell-type
specific markers was calculated using at least three animals for
each marker (n=27 total animals analyzed). MGE cells were counted
in three coronal sections: one section at the level of a MGE cell
transplantation, a second section 300 .mu.m rostral to the
injection, and a third section 300 .mu.m caudal to the site of
injection. The total number of GFP+ MGE cells in each section were
counted and the percent that were positive for NeuN, GABA, GAD,
GAT, CR, CB, PV, Som, Substance P, NOS, Chat, CNPase, and
synaptophysin were quantified at three time points after
transplantation (four, eight and 12 weeks).
[0066] Electrophysiology Coronal slices for electrophysiological
recordings of GFP+ MGE transplanted cells were prepared as
described previously (Noctor et al., 2008). Briefly, brains were
sectioned at 400 .mu.m with a vibratome (Leica) in ice-chilled
artificial cerebrospinal fluid (aCSF) bubbled continuously with
95/5% O2/CO2. containing (in mM): NaCl 125, KCl 5, NaH2PO4 1.25,
MgSO4 1, CaCl2 2, NaHCO3 25, and glucose 20, pH 7.4, at 25.degree.
C., 310 mOsm/l. Tissue slices were allowed to rest for one hour
before recording. Slices were transferred to a recording chamber on
an Olympus BX50WI upright microscope and were perfused with aerated
aCSF. GFP+ cells were identified under epifluorescence and
recordings performed using an EPC-9 patch-clamp amplifier (Heka
Electronics) controlled by an Apple computer running Pulse v8.0
(Heka). Glass recording electrodes (7-10 M.OMEGA.) were filled with
(in mM): KCl 130, NaCl 5, CaCl2 0.4, MgCl2 1, HEPES 10, pH 7.3,
EGTA 1.1, to which 500 .mu.M Alexa 594-conjugated biocytin
(Molecular Probes) was added to identify recorded cells.
Epifluorescent images of the recorded cells were collected using
Scion Image, and arranged using Photoshop. Electrophysiological
responses were measured and analyzed using Pulse, and traces were
arranged using Igor Pro (Wavemetrics), and Freehand
(Macromedia).
[0067] Behavioral tests Behavioral tests were performed 3 and 5
weeks after 6-OHDA surgery and 3, 5, 8 and 12 weeks after MGE cell
transplants. All animals were cared for according to protocols
approved by the Institutional Animal Care and Use Committee at
UCSF.
[0068] Rotational behavior: Each rat was injected with the dopamine
agonist apomorphine (0.05 mg/kg, IP) to produce contralateral
rotational behavior in 6-OHDA treated rats. Drug-induced rotations
were measured in an automated rotometer bowl 28 cm in
diameter.times.36 cm high (Columbus Instruments, Ohio, Brain
Research, 1970, 24:485-493). After intraperitoneal injection of
apomorphine, the animals were fitted with a jacket that was
attached via a cable to a rotation sensor. The animals were placed
in the test bowl and the number and direction of rotations was
recorded over a test period of 40 minutes. This test was
administered to each rat to verify and quantify the efficacy of the
intracranial 6-OHDA-infusion (FIG. 1, Panel C). Apomorphine
stimulates dopaminergic receptors directly, preferentially on the
denervated side due to denervation induced dopamine receptor
supersensitivity, causing contralateral rotation (Creese et al.,
1977; Ungerstedt, 1971; Ungerstedt and Arbuthnott, 1970). There is
a threshold of SNc damage that must be reached in order to produce
maximal rotation behavior after apomorphine administration (Hudson
et al., 1993). The abnormal behavior of hemi-Parkinsonian rats is
directly related to the amount of DA cell loss. When there is less
than 50% dopamine depletion in the striatuma significant change in
rotation behavior after apomorphine injection was not observed, due
to compensatory mechanisms in the striatum. For the grafting
experiment only those 6-OHDA rats that rotated at least four times
more to the contralateral than to the ipsilateral side of the
injection were selected.
[0069] Stride test: The test animal was placed on a runway 1 m long
and 33 cm wide with walls 50 cm high on either side. The runway was
open on the top, and was situated in a well-lit room. A dark
enclosure was placed at one end of the runway, and rats were free
to enter the enclosure after traversing the runway. Rats were
trained to run down the runway by placing them on the runway at the
end opposite to the dark enclosure. The practice runs were repeated
until each rat ran the length of the runway immediately upon
placement in the runway. The floor of the runway was covered with
paper. At the start of each test, the animals' rear feet were
dipped in black ink before being placed at the beginning of the
runway. The test twice was repeated for each rat and the length of
stride for each test was measured to obtain an average stride
length for each rat. The average stride length was compared across
groups. 6-OHDA rats display impairments in the posture and movement
of the contralateral limbs. They compensate by supporting
themselves mainly on their ipsilateral limbs, using the
contralateral limb and tail for balance, and by disproportional
reliance on their good limbs to walk. The good limbs are
responsible for both postural adjustments and forward movements and
they shift the body forward and laterally (Miklyaeva, 1995). The
bad limb produces little forward movement, and as a consequence the
length of step is shorter in 6-OHDA rats than in control rats (FIG.
1, Panels D, E).
[0070] Width of the path test: Normal control rats ran straight
down the runway to the enclosure at the end. In 6-OHDA rats,
however, the limb impairment produced a wandering path that
zig-zagged from side to side, and as a consequence the pathway
followed by the 6-OHDA rats was wider than normal. The maximum
width of the path for control and experimental groups were compared
(FIG. 1, Panel F).
[0071] Open Field Test: An Open Field 16.times.16 Photobeam System
with Flex-Field software (SD Instruments) was used to record the
complete coordinates of a rat's movements within an acrylic
enclosure (40 cm wide, 40 cm deep and 37.5 cm high). Each animal
was placed in the center of the enclosure at the start of the test
and allowed to freely explore the apparatus for 5 minutes. The
movement of the rat interrupts the laser photobeams. The Flex-Field
software recorded units of movement, which were represented by the
number of entries into each of the 256 square zones of the open
field, and the amount of time spent at each point. At the end of
the experiment the movement of each rat during the 5 minutes period
was represented as units of movement, and by a zone map that traced
the path followed by the rat in the open field.
Results
[0072] MGE Cells Survived Up to One Year after Transplant into the
Adult Striatum
[0073] To determine if MGE cells survive in the adult striatum,
6-OHDA rats transplanted into the striatum with MGE cells carrying
the GFP reporter gene were sacrificed at various times after
transplant. Of the approximately 250,000 cells injected, most died
during the first 3 weeks after transplant. By week 4, approximately
1% (2,613.+-.156) of the transplanted cells were present. These
cells, however, persisted, and the number of surviving transplanted
cells did not decrease further at 8 and 12 weeks and for up to one
year after transplantation. To determine if the transplanted MGE
cells continue to proliferate after transplantation the fixed
tissue was labeled with Ki67, a marker expressed by dividing cells.
Ki67+ MGE cells were not found at four, eight and 12 weeks after
transplantation, indicating that even if the MGE cells were
initially proliferative, they had ceased dividing within four weeks
after transplantation.
Transplanted MGE Cells Migrate Throughout the Striatum
[0074] The GFP reporter gene expression in the MGE transplant cells
allowed for the examination of the morphology and behavior of the
surviving MGE cells. At 3 and 7 days post-transplant, GFP+ cells
had the classical morphology of migrating neurons, including a
simple bipolar shape and a leading process. At two weeks post
transplant many of the transplanted cells had migrated up to 2.0 to
2.5 mm in all the directions from the site of transplantation, and
some of the transplanted cells had migrated up to 3.5 mm. At two
weeks post transplant the cells appeared more mature and displayed
abundant neuritic processes. The vast majority, if not all GFP+
cells migrated within the striatum and did not migrate outside its
borders (FIG. 2, Panel A).
[0075] After 4 weeks, the transplanted MGE cells had a fully mature
appearance. Most of them had an oblong cell body and numerous
processes that extended at least 50 .uparw.m. Each process
extending from the transplanted cell gave rise to second, third and
fourth order processes. Eight and 12 weeks after transplantation
most GFP+ cells were found within 2.5 mm of the injection. Grafted
cells had very extensive and ramified processes that could be
observed as GFP+ fibers or puncta throughout the transplanted
striatum. Therefore, GFP+ transplant cell processes appear to
occupy the entire striatum, including areas remote from the
injection sites. (FIG. 2, Panel B).
Most Transplanted MGE Cells Transformed into Inhibitory GABA+
Cells
[0076] The fate of the transplanted MGE cells was examined by
quantifying the percentage of MGE cells that expressed
cell-specific markers at four, eight, and 12 weeks after
transplant. At four weeks after transplantation, the majority of
the transplanted MGE cells had differentiated into neurons since
75% expressed the mature neuronal marker NeuN+ (75.+-.6%, n=676).
Most of the transplanted cells also expressed markers of GABAergic
neurons, including GABA (75.+-.4%, n=294), the GABA synthesizing
enzyme GAD (60.+-.11%, n=382), and the GABA transporter GAT
(50.+-.9%, n=380, see FIG. 3). These data indicate that the
majority of MGE transplanted cells became GABAergic neurons.
[0077] Next, the transplanted cells were examined for the
expression of additional markers that are typical of striatal
neurons in the adult brain. Some of the GFP+ cells expressed
markers of striatal interneuron subtypes such as the calcium
binding protein calretinin (CR, 8.3.+-.0.5%, n=473) and parvalbumin
(PV, 0.5.+-.0.5%, n=320), Som (1.+-.0.5%, n=300), or NOS
(1.+-.0.7%, n=337). A small percentage of the transplanted MGE
cells expressed the cholinergic interneuron marker Chat, which is
expressed by striatal excitatory interneurons. Some of the
transplanted GFP+ MGE cells expressed markers that are typical of
striatal inhibitory projection neurons such as CB (24.+-.7%, n=300)
and Substance P (6.+-.2%, n=193) (for review (Tepper and Bolam,
2004) (FIG. 3).
[0078] Transplanted cells were also examined for expression of
markers that are related with dopamine synthesis, but none of the
observe transplanted cells expressed VMAT or DAT. Additionally,
DARPP 32 expression, a marker of adult medium spiny projection
neurons, was not expressed by MGE cells. Together these data
indicate that most MGE cells transplanted into adult striatum
differentiate into local GABAergic interneurons and express a range
of cell specific markers that are normally expressed in the adult
rat striatum.
[0079] The pattern of marker expression of grafted cells was
largely preserved at 8 and 12 weeks, except for the number of Som
expressing cells that rose slightly at 12 weeks after
transplantation (10.+-.3%, n=343). In contrast, by 12 weeks after
transplantation, the number of MGE cells that expressed the calcium
binding proteins was reduced (CR, 2.+-.1%, n=258; CB, 2.+-.1.5%
n=270; PV, 0%, n=136). Interestingly, the transplantation of the
MGE cells temporarily induced strong expression of CR and CB by
host cells surrounding the injection site. The strong expression at
four weeks after transplantation, was not present at 8 or 12 weeks.
Host cells in the control animals that received only vehicle did
not express CR or CB, indicating that the expression was likely due
to presence of the grafted cells.
[0080] Approximately, one fourth of the grafted MGE cells
(25.+-.4%) were NeuN-negative. These cells stained positive for the
myelin protein, CNPase, indicating that a subpopulation of the
grafted cells differentiated into oligodendrocytes. None of the
cells transplanted into the striatum expressed GFAP suggesting that
grafted cells did not differentiate into astrocytes. The ratio of
neuronal to glial cells (3:1) was maintained at 8 and 12 weeks post
transplantation.
MGE Transplanted Cells Integrated into Striatal Circuitry
[0081] The MGE transplanted cells were examined for the
establishment of synaptic connections in the striatum and
functionally integratation. At four weeks after transplantation,
67.+-.3% of the GFP+ MGE cells (n=193) expressed synaptophysin
puncta along their processes, indicating the presence of synapses
(FIG. 4, Panel A). Electrophysiological recordings provided further
evidence that the MGE cells became functionally integrated into the
host striatum. Whole-cell patch-clamp recordings were obtained from
GFP+ MGE cells 20 weeks after transplantation to examine their
basic membrane properties (n=13 cells). Alexa-594 dye was included
in the patch electrodes to confirm that recordings were obtained
from targeted GFP-expressing transplant cells (FIG. 4, Panel B).
The recordings demonstrated that most of the transplanted MGE cells
became functionally mature neurons (11/13 cells). The neuronal
cells had a resting membrane potential of 65.9.+-.5.1 mV. In
voltage clamp recordings, a series of depolarizing voltage steps
elicited voltage gated inward currents characteristic of neurons
(FIG. 4, Panel C). In current clamp recordings, a series of
depolarizing current steps elicited mature action potentials (APs)
with a spike amplitude of 69.1.+-.4.6 mV, and large
after-hyperpolarizations of 14.5.+-.2.9 mV (FIG. 4, Panel D). In
addition, the transplanted MGE cells fired repetitive
non-accommodating APs, (FIG. 4, Panel D) and trains of spontaneous
APs (FIG. 4, Panel F). The membrane properties of the transplanted
cells were consistent with that of MGE derived interneurons in the
cerebral cortex (Alvarez-Dolado et al., 2006; Butt et al., 2005),
and with the membrane properties recorded from host striatal
interneurons (Kawaguchi, 1993).
[0082] Indeed, some of the transplanted MGE cells fired APs at
frequencies greater than 100 Hz, indicating a fast-spiking
interneuron phenotype. The transplanted MGE cells also displayed
evidence that they were receiving synaptic inputs. In voltage clamp
recordings the GFP+ neurons exhibited spontaneous synaptic currents
at a frequency of 1.1.+-.0.2 Hz (FIG. 4, Panel G), which was
similar to the frequency observed in recordings obtained from
control host striatal cells (1.0.+-.0.3 Hz, n=5 host cells). These
results are consistent with those of Alvarez-Dolado et al.
(Alvarez-Dolado et al., 2006), who showed that transplanted MGE
cells increased the amount of GABAergic inhibition on host
neocortical projection neurons. Two of the recorded GFP+ cells did
not express voltage-dependent inward currents, and did not fire
action potentials when stimulated with a series of depolarizing
currents (FIG. 4, Panel E). These recordings were most likely
obtained from the non-neuronal, CNPase+ population of transplanted
cells, and are consistent with the membrane properties of mature
glial cells in the cortex. Together these data support the
conclusion that most transplanted MGE cells become inhibitory
interneurons and are synaptically integrated into the host striatal
circuitry.
MGE Cell Striatal Grafts Ameliorated the Behavioral Symptoms of
6-OHDA Lesioned Rats
[0083] The behavioral effect of MGE cells on 6-OHDA lesioned rats
was examined using three behavioral tests performed before and
after transplantation (FIG. 5).
[0084] Rotation under apomorphine As previously shown, upon
apomorphine administration, unilaterally 6-OHDA lesioned rats
rotated significantly more to the contralateral side (with respect
to the lesioned side) than the ipsilateral side compared to control
rats that rotated approximately equally in both directions. After
transplantation, there was a significant reduction in the number of
contra-lateral turns in the MGE transplanted 6-OHDA lesioned rats
(n=21) compared to non-transplanted 6-OHDA controls (n=12). This
effect was observed at all experimental times beginning with week 9
(p<0.05) and continued until the last time point, 18 weeks
(p<0.05). The performance of sham-transplanted 6-OHDA rats
(n=11) was undistinguishable from non-transplanted 6-OHDA rats
(n=12), indicating that the MGE cells, and not the transplantation
procedure, were responsible for the motor improvement of
MGE-transplanted 6-OHDA rats. (FIG. 5, Panel a).
[0085] Apomorphine binds to dopamine receptors expressed by host
striatal neurons, which causes rotation in the 6-OHDA rat
(Ungerstedt and Arbuthnott, 1970). Apomorphine-induced rotational
behavior was significantly reduced after MGE transplantation
suggesting that the transplanted MGE cells express dopamine
receptors and are directly responsible for the observed reduction
in rotational behavior. This hypothesis was confirmed by performing
fluorescence immunostaining for dopamine receptor 1 (DR1) and 2
(DR2). Both were detected in somatic membrane and processes of MGE
cells 12 weeks after transplantation (FIG. 6). These data
demonstrate that apomorphine directly stimulates MGE inhibitory
interneurons, altering the balance of excitation/inhibition in the
striatum and modifying rotational behavior.
[0086] Length of stride 6-OHDA rats (n=12) had a stride length of
13.2.+-.0.2 cm, significantly shorter than the stride length of
control rats, 15.1.+-.0.3 cm (p<0.001, n=16). After MGE cell
transplantation, the stride length of the 6-OHDA rats (n=21)
increased and by week 9 reached values similar to those of control
rats (15.5.+-.0.4 cm, n=16). The increase in the length of stride
was maintained after 11 and 14 weeks. The stride length of 6-OHDA
rats that received a sham transplant (n=11) did not change, and was
not significantly different from that of 6-OHDA rats that received
no treatment (n=12) (FIG. 5, Panel b).
[0087] Width of path The maximum path width of all rats was
measured as they ran down the runway (FIG. 1, Panel e). 6-OHDA
animals (n=12) had a path width that was 3.4.+-.0.3 cm, which was
significantly wider than the value of 2.5.+-.0.3 cm for control
rats (p<0.05, n=16). The path width of 6-OHDA rats that received
MGE cell transplants decreased and by week 11 matched (2.7.+-.0.3
cm, n=21) that of the unlesioned control animals (n=16). The path
of sham transplanted 6-OHDA rats (n=11) was not significantly
different from that of 6-OHDA rats (n=12). These data indicate that
MGE transplantation resulted in a substantial improvement in the
gait of 6-OHDA lesioned rats (FIG. 5, Panel c).
MGE Cell Striatal Transplants Alter the Motor Performance of
Wild-Type Rats
[0088] MGE cells were grafted into intact rats to examine the
effect of MGE cells on unlesioned animals using the behavior assays
described above. The path width and the rotations under apomorphine
were not significantly different in rats injected with MGE cells
compared to non-transplanted controls. Interestingly, the stride
length of wild-type rats that received MGE grafts was significantly
longer than that of control untreated rats (p<0.001, n=6) (FIG.
7, Panel a). This was believed due to an increase in motor activity
after MGE-transplantation. To confirm this hypothesis an open field
activity test was performed on wild-type control, 6-OHDA injected
and MGE-transplanted wild-type rats using a five minute test period
(FIG. 7, Panel b). Surprisingly, MGE-cells transplanted into
control rats (no 6-OHDA treatment) produced a significantly higher
level of motor activity (1101.+-.39 UM) than in untreated control
rats (912.+-.104 UM). 6-OHDA injected rats, as expected, had lower
motor activity levels than control rats (453.+-.69 UM). The
increase of motor activity in wild-type rats versus control rats is
reflected in the open field zone map (FIG. 7, Panel c).
[0089] MGE Cells Transplanted in the Subthalamic Nucleus Survived,
but Did not Migrate, and Transformed into Glial Cells
[0090] The results observed after MGE cell transplantation into the
striatum suggests that increased GABAergic inhibition in the
striatum significantly ameliorates motor symptoms in
hemi-Parkinsonian rats. It has been suggested that increasing
inhibition in the subthalamic nucleus (STN) could also have
beneficial effects in Parkinson's disease (Benabid et al., 2000;
During et al., 2001). Therefore, the survival and differentiation
of grafted MGE cells were tested in this nucleus. The behavior and
phenotype of MGE cells, however, was strikingly different after
transplant into the STN. In contrast to MGE cells that migrated
substantial distances after transplant into the striatum, MGE cells
transplanted into the STN did not migrate from the site of
injection (n=6, FIG. 8, Panel A). Moreover, the MGE cells in the
STN did not become neurons. None of the MGE cells in the STN
expressed the neuronal marker NeuN (n=231). In contrast, a small
number of MGE cells located outside the boundary of the STN did
express NeuN (FIG. 8, Panel B). Furthermore, none of the grafted
MGE cells in the STN expressed the calcium sequestering proteins CR
or CB, or the inhibitory interneuron markers GAD or GABA (FIG. 8,
Panels E, G, H, I). While none of grafted MGE cells in the striatum
expressed the astrocyte marker GFAP, the majority of MGE cells in
the STN expressed GFAP (75.+-.5%, n=151). Roughly one third of MGE
cells also expressed the oligodendrocyte marker CNPase (30.+-.9%,
n=132, FIG. 8, Panels C, D, J, K) A small percentage of MGE cells
in the STN expressed the GABA transporter GAT1 (13.+-.5%, n=94,
FIG. 8, Panel F). The GAT expressing cells were most likely
astrocytes or oligodendrocytes which have been shown to express the
GAT1 GABA transporter (Pow et al., 2005). These data indicate that,
in contrast to the striatum where MGE grafted cells integrate and
differentiate into neurons, most grafted MGE cells in STN
differentiate into glial cells.
Example 2
[0091] In this study, MGE cell transplantation was tested as a
means to add inhibitory GABAergic interneurons to the striatum.
Additionally, MGE cell transplantation was tested to see if it
would beneficially improve the motor behavior of hemi-Parkinsonian
rats. These studies utilized MGE cells from E14.5 GFP rats that
were transplanted into the striatum of adult rats. A small
population of these transplanted cells, migrated, survived and
differentiated into GABAergic neurons that became synaptically
integrated into the striatal circuitry. MGE cells that were grafted
into the striatum of 6-OHDA lesioned rats alleviated motor symptoms
of PD. Fetal MGE grafts in the striatum also impacted the behavior
of normal untreated rats; the transplanted MGE cells increased
several measures of motor activity in the control animals. The
ability of MGE cells to differentiate into interneurons appears to
be dependent on the host environment since transplanted MGE cells
into the STN differentiated into astrocytes or oligodendrocytes
rather than neurons. These data indicate that injection of MGE
cells into the striatum is a new modality to modulate hyperactive
neurons in the striatum and therefore alleviate motor symptoms in
PD.
[0092] MGE Cells Transplanted into the Adult Striatum Transform
into Inhibitory Interneurons and Integrate into the Striatal
Circuit
[0093] MGE cells transplanted into the striatum survived at least
one year, migrated from the site of injection, and were widely
distributed throughout the striatum. This study demonstrated that
MGE cells transplanted into the adult striatum acquire a mature
morphological phenotype and differentiate into GABAergic neurons
that express markers common to neostriatal interneurons. Although a
small percentage of the MGE transplanted cells survived after 3
months, the ability of these cells to impact behavior depends on
their number in relation to the number of host interneurons.
Stereological based studies estimate that the number of striatal
interneurons in the adult rat is approximately 49,000: 13,000
CR+interneurons (Rymar et al., 2004), 15,000 PV+ interneurons
(Larsson et al., 2001; Luk and Sadikot, 2001) and 21,000 SOM+
interneurons (West et al., 1996). Therefore, the average number of
transplanted MGE cells that survived in the current experiments
(2613.+-.156, n=3) represents approximately 5% of the total number
of native striatal interneurons. In addition, the MGE cells
extended numerous processes throughout the striatum, indicating
their potential for interacting widely with host cells. The number
of surviving MGE cells are sufficient to produce motor behavioral
changes, both in 6-OHDA treated, and untreated control animals. MGE
cells unexpected demonstrated the generally effect of increasing
motor speed of all treated animals, including the unlesioned,
control animals. The transplantation of a higher number of MGE
cells is anticipated to result in a greater number of surviving
interneurons in the host striatum.
[0094] The embryonic MGE produces both striatal and neocortical
interneurons, and both populations share the expression of many of
the same sets of markers (Defelipe et al., 1999; Kawaguchi, 1997;
Kubota et al., 1994). Thus, it is likely that the dissociated
embryonic MGE cells that were injected into the striatum included a
mixture of cells destined to populate both the striatum and the
neocortex, and these cells retained their normal molecular
expression characteristics after transplantation. However, the
pattern of cell markers expressed by MGE cells was influenced by
their post transplantation environment as most MGE cells that
survived in the adult STN nucleus expressed GFAP and none expressed
neuronal markers.
[0095] GFP+ processes were not detected outside of the striatum in
the transplanted animals, indicating that the transplanted MGE
cells did not project outside of the striatum as do GABAergic
projection neurons. Thus, the MGE cells integrated in the circuitry
of the striatum and the behavioral changes observed in transplanted
rats were due to modification of activity of synapses and/or
neurons within the striatum by the transplanted cells. This
integration modulated the activity level of host GABAergic
interneurons and/or projection neurons and produced a remarkable
improvement in the behavioral deficits.
Transplanted MGE Cells Ameliorate Behavioral and Movement Deficits
in 6-OHDA Rats
[0096] 6-OHDA lesioned rats that received MGE cell grafts exhibited
behavioral improvements including improvement in the apomorphine
rotational test, an increase on the length of stride, and a
normalized gait. These behavioral and movement changes indicate a
general improvement of the motor symptoms of PD animals after MGE
transplantation.
[0097] MGE cells were transplanted six weeks after the induction of
6-OHDA lesions. The MGE cells differentiated into GABA+
interneurons within 4 weeks after transplant and notably improved
motor symptoms of PD. These results demonstrate that, in addition
to the protective effect described previously, GABA also improve PD
symptoms once the disease is established. The ability of MGE cells
to disperse in the striatum, mature, remain functionally active,
and synaptically integrate into basal ganglia circuitry is
responsible for the observed behavioral modifications. MGE cells
can also carry trophic factors or neurotransmitter synthesizing
enzymes to further ameliorate symptoms produced by dysfunctional
circuits in the striatum. Useful neurotrophic factors include the
neurotrophins (e.g., NGF; brain-derived neurotrophic factor, BDNF;
and neurotrophins NT-3 and NT-4/5); the neuropoietic cytokines
(e.g., ciliary neurotrophic factor, CNTF); and the fibroblast
growth factors (e.g., acidic and basic FGF). Useful
neurotransmitters include acetylcholine, epinephrine,
norepinephrine, dopamine, serotonin, melatonin, glutamic acid,
gamma aminobutyric acid (GABA), aspartic acid, and glycine.
[0098] The increase in motor behavior observed after
transplantation of fetal MGE cells into the striatum of control
rats, indicates that MGE cells are ideal for achieving a change in
the balance of excitatory and inhibitory signals in the striatum,
and thus represent a powerful strategy for altering output of the
striatum in disease conditions.
Therapeutic Advantages
[0099] The approach of the methods of the present disclosure is to
inject dissociated cells from the embryonic MGE into the adult
basal ganglia of a subject having or suspected of having PD,
epilepsy or other neurological condition amenable to treatment
according to the methods disclosed herein. The advantage of MGE
cell transplants over other cell types is their capacity for
dispersal throughout the striatum. For example, mesencephalic cells
show very little migration after transplantion into the striatum
and remain in clumps within the basal ganglia. These clusters are
thought to be responsible for some of the serious side effects that
result from transplantation of dopaminergic precursors for PD
(Bhattacharya et al., 2004). In contrast, the MGE cells have the
surprising ability to disperse widely after transplantation and
integrate into the host striatum in a homogenous manner that
lessens PD symptoms without undesired side effects seen in other
therapies. MGE grafts do not produce tumors or cause aberrant
tissue organization. Striatum grafted MGE cells increase motor
activity levels, demonstrating that MGE cells change the balance of
excitatory and inhibitory activity. In some embodiments, MGE grafts
reduce one or more TRAP features of PD and/or reduce flexed posture
and freezing by at least 10% compared to controls or the previous
untreated state. In some embodiments, MGE grafts reduce one or more
TRAP features of PD and/or reduce flexed posture and freezing by at
least 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, or 95% compared to
controls or the previous untreated state. In some embodiments, MGE
grafts reduce the amount of required drug by at least 10% compared
to controls or the previously untreated state. In some embodiments,
MGE grafts reduce the amount of required drug by at least 20%, 30%,
40%, 50%, 60%, 70%, 80%, 90%, or 95% compared to controls or the
previously untreated state. In some embodiments, MGE cells
transplanted into the striatum survive for at least 6 months, In
some embodiments, MGE cells transplanted into the striatum survive
for at least 1, 2, 3, 4, 5, 7, or 10 years. In some embodiments,
treatment of patients suffering from bradykinesia is preferred. In
some embodiments, before and after treatment success is measure
under at least one of the following criteria, the unified
Parkinson's disease rating scale (UPDRS), motor "off" (off
medication) scores, OFF time and dyskinesias, and dose of
L-Dopa.
Example 3
Epilepsy
[0100] Transplanted MGE cells, harvested from mice expressing green
fluorescent protein (GFP), co-label with antibodies to GABA, GAD67,
calretinin, parvalbumin, neuropeptide Y or somatostatin at 30 days
after transplantation (30 DAT) (FIG. 9, Panels A, B). In
neocortical tissue slices from 30 DAT grafted animals, MGE-GFP
neurons primarily exhibit firing properties similar to endogenous
interneuron sub-types: (i) fast-spiking, (ii) regular-spiking
non-pyramidal cells and (iii) burst-spiking non-pyramidal (FIG. 9,
Panels C-D). Consistent with previous observations of graft-derived
cells with immature and "migratory" anatomical profiles immediately
following transplantation (Wichterle 1999; Alvarez-Dolado 2006),
current-clamp recordings at 7 to 10 DAT revealed GFP+ neurons with
immature intrinsic membrane properties e.g., small and broad width
action potentials, depolarizing resting membrane potential and high
input resistance (data not shown). As expected at 30 DAT
(Alvarez-Dolado 2006), GABA-mediated input to pyramidal neurons in
the host brain, measured as inhibitory postsynaptic current (IPSC)
frequency, increased by nearly 300% in mice receiving MGE grafts
(control: 0.6.+-.0.1 Hz, n=8; MGE: 2.3.+-.0.3 Hz, n=7).
[0101] MGE progenitors were examined for their ability to generate
interneurons that would innervate native interneurons and alter the
activity of the endogenous interneurons, an undesirable side
effect. To determine whether GABA-mediated inhibition onto
endogenous interneurons was altered, the spontaneous IPSCs in the
host neocortex of grafted mice were examined. Interneurons were
identified by their oval, often multi-polar morphologies under
IR-DIC (FIG. 10, Panel a), confirmed post hoc with biocytin
labeling (FIG. 10, Panel b) and voltage-clamped in bath solution
containing glutamate receptor antagonists (DNQX and APV; FIG. 10,
Panel C) to isolate GABA-mediated current. IPSC analysis failed to
identify significant differences between control (un-transplanted)
and grafted mice at 30 DAT (FIG. 10, Panels d-f).
[0102] Enhanced inhibition in grafted animals could also lead to
homeostatic changes in postsynaptic GABAA receptors (Mody 2005; Xu
2007). Analysis of evoked IPSC kinetics, decay time constants in
particular (Soltesz; MV Jones), would reflect potential changes in
postsynaptic GABA receptor subunit expression and were examined in
neocortical slices (30 DAT). White matter stimulation elicited
IPSCs on Layer ii/III pyramidal neurons in regions containing GFP+
cells with kinetic properties that were not different between
control and grafted animals (FIG. 11, Panels A and B). Together,
these data further support the MGE transplantation protocol as an
effective strategy to selectively enhance inhibition of principal
neurons in postnatal brain.
[0103] Because some available antiepileptic drugs (AEDs) enhance
GABA-mediated synaptic transmission and enhanced inhibition could
be therapeutic (MacDonald 1989), MGE transplants were examined for
their ability to reduce acute seizures. Early postnatal bilateral
transplantation of MGE-GFP progenitors generated new
GFP-immunoreactive (IR) cells in host neocortex with distributions
between 0.75 and 5 mm from the injection site (FIG. 12, Panels
a1-4; also see Alvarez-Dolado 2006). New interneuron density was
confirmed for all animals used in acute seizure studies and a
threshold of approximately 40,000 GFP-IR cells per animal, with
migration .E-backward.0.5 mm from the injection site, was defined
as a successful graft (FIG. 12, Panel a5). Pilocarpine, a
muscarinic acetylcholine receptor antagonist and common convulsant
agent, was administered to adult wild-type mice at a concentration
(300 mg/kg, i.p.) chosen to maximize the number of animals that
would experience tonic-clonic seizures (Winawer et al. 2007).
High-amplitude synchronous electrographic seizure activity was
confirmed using scalp electroencephalographic (EEG) recording and
dual digital cameras (FIG. 12, Panel B). Behavioral seizure
manifestations including forelimb clonus (Stage III, S3; Racine
1972; Jones 2002) were observed in -75% of control mice at this
pilocarpine concentration; the latency to first behavioral seizure
was between 10 and 15 minutes post-injection, as reported
previously (Hamani 2004). In mice grafted with MGE cells at P2, the
percentage of animals exhibiting S3 seizures was reduced to
approximately 50% (FIG. 12, Panel c1); latency to first seizure
behavior was unchanged (FIG. 12, Panel c2). This level of "seizure
protection" was comparable to that observed with phenobarbital (20
mg/kg) or carbamazepine (50 mg/kg) pre-treatment, and better than
phenyloin (200 mg/kg), an AED previously shown to exacerbate
pilocarpine-induced seizures (Sofia et al., 2003)(FIG. 12, Panel
d2).
[0104] MGE transplants were then tested for their ability to reduce
seizures in a mouse epilepsy model. Spontaneous tonic-clonic
seizures were reported in humans with a dominant-negative missense
mutation in KCNA1 (Zuberi 1999) or mice with a recessive knockout
of Kv1.1/Kcna1 (Smart 1999). To monitor spontaneous seizures in
these mice, prolonged video-electroencephalography (EEG; see
Methods for full description of electrographic phenotypes) was
performed. The EEG of Kv1.1-1-mice showed severe, generalized
electrographic seizures lasting 10-340 s (Grade IV; FIG. 13, Panel
A) and occurring more than once per hour (1.5.+-.0.5 seizure/hr;
FIG. 13, Panel C); electrographic seizures or high voltage spiking
were never observed in age-matched wild-type siblings (FIG. 13,
Panel A). Video monitoring confirmed tonic-clonic, S4 seizure
behavior (e.g., tonic arching, tail extension, followed by forelimb
clonus, and then synchronous forelimb and hindlimb clonus) during
ictal seizure episodes. As reported (Smart 1999; Wenzel 2007;
Glasscock 2007), Kv1.1-1-mice exhibit frequent spontaneous seizures
starting during the second-to-third postnatal week and do not
survive beyond the 8th postnatal week (FIG. 13, Panels a-e); sudden
death is likely due to cardio-respiratory failure associated with
status epilepticus. In contrast, Kv1.1-1-mice grafted with MGE
progenitors on P2 survive well past postnatal week 10 and exhibit a
surprising and striking reduction in electrographic seizure
activity. Only brief episodes (10-48 s) of synchronized high
amplitude spiking were observed in transplanted Kv1.1-1-mice (FIG.
13, Panels a, b). The frequency of these events was rare compared
to un-transplanted mice (FIG. 13, Panel c) and 43% of grafted
animals only exhibit interictal spiking (Grade II; Table 1).
Kaplan-Maier survival plots show a clear, and statistically
significant, rightward shift for Kv1.1 mutant mice receiving
successful MGE grafts (FIG. 13, Panel d); new GFP cell density was
confirmed as .E-backward.40,000 cells per brain in Kv1.1-1-mice
that survived to P57 (FIG. 13, Panels e-f).
[0105] Embryonic neural progenitor cells derived from the medial
ganglionic eminence generate new interneurons. These cells
differentiate into functional interneuron sub-types and selectively
enhance GABA-mediated inhibition in the host brain. Newly-generated
interneurons demonstrate a surprising protective effect against
acute seizures that was comparable to that observed with
commercially available AEDs. In some embodiments, MGE progenitor
cell transplantation results in a reduction of required AED dose of
at least 10% compared to untreated controls or to the individual's
previously untreated state. In some embodiments, MGE progenitor
cell transplantation results in a reduction of required AED dose of
at least 20%, 30%, 40%, 50%, 60%, 70%, 80%, 95%, or 99%, compared
to untreated controls or to the individual's previously untreated
state. Significant suppression of spontaneous seizures was observed
in a mouse model of generalized epilepsy. Decreased seizure
activity in these animals was also associated with a delay in
sudden death and significantly prolonged life-span.
[0106] Immortalized cells engineered to produce GABA attenuate
stimulation-induced electrical after discharge in a rat (Thompson
2000; 2005). Attenuation of after discharge duration has also been
achieved with embryonic precursor cells modified to release
adenosine (Li 2007) or viral vectors engineered to produce
glial-cell line-derived neurotrophic factor (Kanter-Schlifke 2007),
neuropeptide Y (Richichi 2004) or galanin (Haberman 2003; McCown
2006). While promising, none of these procedures was associated
with migration (or transfection) of cells outside the injection
site, functional evidence for modification of synaptic transmission
in the host brain or significant suppression of spontaneous
electrographic seizures. Systemically injected human neural stem
cells modestly reduce behavioral seizures in a rat pilocarpine
model and hippocampal field recordings suggest an effect on
synaptic inhibition (Chu 2004). These studies, and the demonstrated
differentiation of hippocampal neural stem cells into neurons
(including GABAergic interneurons) in a rat model of temporal lobe
epilepsy (Shetty, 2005), suggest that interneuron generation and
enhancement of GABAergic neurotransmission (as shown here in
single-cell recordings) may be antiepileptic. Although interneuron
loss has been reported in epilepsy (de Lanerolle 1989; Spreafico
1998; Golarai 2001), and GABA-enhancing AEDs are used clinically
(MacDonald 1986, 1989), a procedure to modify host brain circuits
via the addition of new interneurons to existing circuits, either
normal or pathological, has never been demonstrated.
[0107] MGE cell grafts were shown to produce a dramatic and
remarkable reduction in spontaneous electrographic seizure activity
in a mouse Shaker-like K+ channel mutant mimicking a human epilepsy
phenotype (Kuberi; Noebels). In some embodiments, at least a 10%
reduction in spontaneous electrographic seizure activity is
achieved. In some embodiments, at least a 20%, 30%, 40%, 50%, 60%,
70%, 80%, 95%, or 99% reduction in spontaneous electrographic
seizure activity is achieved. In some embodiments, at least a 10%
reduction in the duration of seizures is achieved. In some
embodiments, at least a 20%, 30%, 40%, 50%, 60%, 70%, 80%, 95%, or
99% reduction in the duration of seizures is achieved. In some
embodiments, at least a 10% reduction in the frequency of
spontaneous electrographic seizures is achieved. In some
embodiments, at least a 20%, 30%, 40%, 50%, 60%, 70%, 80%, 95%, or
99% reduction in the frequency of spontaneous electrographic
seizures is achieved. In some embodiments, at least a 10% reduction
in high voltage spiking is achieved. In some embodiments, at least
a 20%, 30%, 40%, 50%, 60%, 70%, 80%, 95%, or 99% reduction in high
voltage spiking is achieved. This result is consistent with a
long-standing hypothesis that synaptic inhibition constrains
seizure discharge (Kandel, Dichter, Trevelyan). Moreover, the
described transplantation protocol to generate enriched populations
of GABAergic interneurons with the unique ability to migrate and
functionally integrate in host brain provides a significant
advancement in cell therapy development for the treatment of
intractable epilepsy.
Methods
[0108] Tissue dissection and cell dissociation. Ventricular and
subventricular layers of the GE germinal region were dissected from
E13.5 embryonic GFP+ transgenic mice. The MGE is a transient
structure, and at E14 the MGE is well developed but still separated
from LGE. Bordering tissue between adjacent regions was discarded
during dissections to avoid contamination. Explants were
mechanically dissociated by repeated pipetting through 200 .mu.l
yellow plastic pipette tip (10-20 times). Dissociated cells were
washed with 1 ml of L-15 medium containing DNase 1 (10-100
.mu.g/ml) and pelleted by centrifugation (2 minutes, 800 g).
[0109] Transplantation. Highly concentrated cell suspension
(.about.8.times.105 cells/.mu.l in 3-5 .mu.l of L-15 medium) were
front-loaded into beveled glass micropipettes (.about.50 .mu.m
diameter) that pre-filled with mineral oil and mounted on a
microinjector. Cells were allowed to settle inside the pipette and
the excess cell-free medium will be expelled. Two-three day old
mice were anesthetized by exposure to -4.degree. C. until pedal
reflex was abolished. Anesthesia was maintained by performing
surgery on a cold aluminum plate. 5.times.105 cells/mouse were
injected in deep layers of cortex.
[0110] Immunostaining. Animals were transcardially perfused with 4%
paraformaldehyde. Brains were immediately removed, postfixed
overnight, and sectioned coronally (50 .mu.m). Floating sections
were immunostained with commercially available antibodies.
Secondary antibodies were used: cy3-conjugated donkey anti-mouse,
cy3-conjugated donkey anti-rabbit, cy2-conjugated donkey
anti-rabbit, and biotin-conjugated donkey anti-mouse (all from
Jackson ImmunoResearch, PA). Sections were washed in PBS, blocked
for 1 h in PBS containing 10% donkey serum and 0.1% Triton X-100,
then incubated overnight at -4.degree. C. in primary antibodies
diluted in PBS containing 10% donkey serum and 0.1% Triton X-100,
washed 3.times. in PBS and incubated with secondary antibodies for
1-2 hours at room temperature in the dark. Fluorescent images were
obtained using a cooled-CCD camera (Princeton Instruments) and
Metamorph software (Universal Imaging).
[0111] Electrophysiology. Acute neocortical slices were prepared
from male or female mice, as described previously (Alvarez-Dolado
et al. 2005). Resulting slices were immediately transferred to a
holding chamber where they remained submerged in oxygenated
recording medium (ACSF) consisting of (in mM) 124 NaCl, 3 KCl, 1.25
NaH2PO4, 2 MgO4, 26 NaHCO3, 2 CaCl2, 10 dextrose (295-305 mOsm);
37.degree. C. for 45 min and then at room temperature. For each
experiment an individual slice is gently transferred to a recording
chamber and continuously perfused with oxygenated recording medium
at room temperature. Whole cell voltage-clamp pipette recordings
were obtained from visually identified neurons using an infrared
differential interference contrast (IR-DIC) video microscopy
system. Intracellular patch solution for whole-cell IPSC current
recordings contained (in mM) 120 Cs-gluconate, 10 HEPES, 11 EGTA,
11 CsCl2, 1 MgCl2, 1.25 QX314, 2 Na2-ATP, 0.5 Na2-GTP, (pH 7.25;
285-290 mOsm). To isolate GABAergic synaptic currents, slices were
perfused with nACSF containing 20 .mu.M
6,7-dinitroquinoxaline-2,3-dione (DNQX) and 50 .mu.M
d-(-)-2-amino-5-phosphonovaleric acid (D-APV). IPSCs were recorded
at the reversal potential for glutamatergic currents (holding
potential, 0 mV; room temperature) where IPSC events exhibit a
large amplitude and prominent decay (Otis and Mody 1992).
Intracellular patch pipette solution for current-clamp recordings
contained (in mm) 120 KMeGluconate, 10 KCl, 1 MgCl2, 0.025 CaCl2,
10 HEPES, 0.2 EGTA, 2 Mg-ATP, 0.2 Na-GTP, pH 7.2, (285-290 mOsm).
For analysis of intrinsic firing properties, recordings were
obtained from GFP+ cells in the neocortex an IR-DIC microscope
equipped with epifluorescence (Olympus). Current and voltage were
recorded with an Axopatch 1D amplifier (Axon Instruments) and
monitored on an oscilloscope. Cells were depolarized and
hyperpolarized, via direct current injection (5-1000 ms, duration).
Whole-cell access resistance was carefully monitored throughout the
recording and cells were rejected if values changed by more than
25% (or exceeded 20.OMEGA.); only recordings with stable series
resistance of <20 M.OMEGA. will be used for IPSC analysis (at
least 100 events were analyzed per cell).
[0112] Video-EEG monitoring. Behavioral and electroencephalographic
(EEG) observations were made using a time-locked, dual video
digital EEG monitoring system (Pinnacle Technologies, Lawrence,
Kans.). For EEG recordings, mice were surgically implanted in the
left and right frontoparietal cortex with electrodes. Each mouse
was anesthetized with ketamine and xylazine (10 mg/kg and 1 mg/kg,
i.p. respectively) so that there was no limb withdrawal response to
a noxious foot pinch. Sterile stainless steel recording electrodes
were placed epidurally through burr holes in the skull (one
electrode on either side of the sagittal suture, approximately
halfway between bregman and lambdoid sutures and .about.1 mm from
the midline). Electrodes were cemented in place with a fast-acting
adhesive and dental acrylic, and electrode leads were attached to a
microplug that is also cemented to the head of the animal. Animals
were allowed to recover for 5 days before experiments are
initiated. Experimental animals were monitored for between 5-10
days (6-12 hr/day, 5 days/week; at least 30 hr per animal). A total
of 165 hours of recording was analyzed for Kv1.1-1-mice (n=4) and
242 hours for Kv1.1-1-+MGE mice (n=7). Control mice (n=4) were
administered pilocarpine (300 mg/kg, i.p.) at the conclusion of the
last recording session to obtain a "baseline" electrographic
seizure sample. All monitoring data was coded and scored "blind"
for changes in behavior and EEG by four independent investigators.
Electrographic seizures were defined as follows (modified from Dube
2006; Wong 2007; Henshall 2002): Grade I, basic background, no
epileptiform spikes; Grade II, mostly normal background, some high
voltage spikes; Grade III, mostly abnormal background with low
frequency high voltage spiking and Grade IV, high frequency, high
voltage synchronized poly-spike or paroxysmal sharp-waves with
amplitude>2-fold background that last .E-backward.6 seconds.
Electrographic EEG seizures were analyzed using SireniaScore
software (Pinnacle) and confirmed by off-line review of behavioral
video recordings obtained at two different monitoring angles.
Behavior was scored, between Stage 1 (S1) and S4, on a modified
Racine scale (Racine; Jones). All animals were sacrificed at the
conclusion of EEG monitoring and processed for GFP
immunohistochemistry and cell counting.
[0113] In some embodiments, patients with temporal lobe epilepsy,
the most common form of the disease, are likely candidates for MGE
therapy as it is well documented that interneuron loss contributes
to the diseased state (de Lanerolle et al. 1989). In some
embodiments, patients with epilepsy associated with a focal
cortical dysplasia are also known to lose interneuron and/or
exhibit reduced GABA-mediated inhibition (Spreafico et al. 1998;
Calcagnotto et al. 2005) and are also good candidates for MGE
therapy. In some embodiments, clinical neuron-imaging studies (PET,
MRI, etc.) in combination with video-EEG monitoring are used to
identify candidate patients. In some embodiments, video-EEG
monitoring and/or seizure self-reporting by patients is used to
measure outcome of the MGE transplantation procedure. In some
embodiments, MGE progenitor therapy success is quantified by a
reduction in seizure frequency or duration in treated patients. In
some embodiments, MGE progenitor therapy success is quantified by a
reduction in dosages or the need for co-treatment with prescribed
antiepileptic medications.
[0114] Note for figure legend: Kv1.1 is not the dominant Shaker
family transcript expressed in vascular tissue (Cox et al. 2001).
Kv1.1-containing potassium channels are predominantly expressed in
axons of the hippocampus and cerebellum (Wang et al. 1993; Rhodes
et al. 1997)
TABLE-US-00001 TABLE 1 Analysis of EEG data Duration Frequency
Highest seizure Animal (sec) (per hr) score Kv1.1 KO #307 38.6 .+-.
3.7 0.6 .+-. 0.2 Grade IV #419 57.5*16.4 0.8 .+-. 0.3 Grade IV #461
59.0 .+-. 9.3 2.5 .+-. 0.1 Grade IV #466 58.0 .+-. 7.4 2.1 .+-. 0.6
Grade IV Kv1.1 KO + MGE #428 24.7 .+-. 2.2 0.1 .+-. 0.05 Grade IV
#492 0 0 Grade II #525 0 0 Grade II #533 0 0 Grade II #544 23.7
.+-. 4.2 0.2 .+-. 0.15 Grade IV #573 27.5 .+-. 4.4 0.2 .+-. 0.07
Grade IV #575 28.0 .+-. 2.1 0.1 .+-. 0.08 Grade IV
Spasticity
[0115] Spasticity is a common disorder in patients with injury of
the brain and spinal cord. The prevalence is approximately 65-78%
of patients with spinal cord injury (Maynard et al. 1990), and
around 35% in stroke patients with persistent hemiplegia
(Sommerfeld et al. 2004). Reflex hyperexcitability develops over
several months following human spinal cord injuries in segments
caudal to the lesion site. Intractable spasticity is also a common
source of disability in patients with multiple sclerosis. Symptoms
include hypertonia, clonus, spasms and hyperreflexia.
[0116] There are numerous medicines that treat the general effects
of spasticity. These drugs act on multiple muscle groups in the
body. Tizanidine (Zanaflex Capsules.TM.), temporarily reduces
spasticity by blocking nerve impulses. Baclofen acts on the central
nervous system to relax muscles. It also decreases the rate of
muscle spasms, pain, tightness and improves range of motion.
Benzodiazepines (Valium.RTM. and Klonopin.RTM.) act on the central
nervous system to relax muscles and temporarily decrease
spasticity. Dantrolene sodium (Dantrium.RTM.) acts directly on the
muscle by blocking the signals that cause muscles to contract.
Dantrolene use can lessen muscle tone. Injections of botulinum
toxin (Botox.RTM. or Myobloc.RTM.) relax stiff muscles, but the
shots only target specific limbs or muscle groups affected by
spasticity. In more extreme cases, intrathecal baclofen or surgery
is used to relieve spasticity.
[0117] While the precise mechanisms responsible for the development
of spasticity are not fully understood, a role for reduction of
inhibition is most likely involved. For example, inhibitory
interneurons are particularly vulnerable to spinal cord ischemic
injury, and are often selectively lost following spinal cord
injury. This may contribute to the changes in inhibitory circuits
observed following spinal injury such as reduction in reciprocal
inhibition as well as attenuation of inhibition normally mediated
by segmental inhibitory interneurons that synapse directly onto
motoneurons.
[0118] The treatment of spasticity is treated by grafting
inhibitory interneurons (MGE cells) into the affected segments of
the injured spinal cord. The GABAergic cells derived from the
median ganglionic eminence (MGE) will down-regulate the hyperactive
local spinal circuitry. In the developing brain, MGE cells gives
rise to inhibitory neurons, and this particular class of neuron has
a remarkable ability to migrate and integrate in adult brain
tissue. MGE cells will integrate in the spinal cord and produce
factors that will inhibit local circuit activity and reduce
post-lesion spasticity. This strategy can also be used to relieve
spasticity in a variety of other conditions including multiple
sclerosis, stroke, and brain injury.
Example 5
Prophetic
Generation of a Spinal Cord Injury in Mice
[0119] Genetically modified and wild-type mice are anesthetized
with Avertin supplemented with isoflurane or isoflurane only. The
skin over the middle of the back is shaved. The shaved area is
disinfected with Clinidine. All surgical tools are soaked overnight
in Cidex prior to their use. Lubricating ophthalmic ointment is
placed in each eye. Animals are placed on a warming blanket to
maintain temperature at 37.degree. C. A dorsal midline incision,
approximately 1 cm in length is made using a scalpel blade. The
spinous process and lamina of T9 are identified and removed. A
circular region of dura, approximately 2.4 mm in diameter, is
exposed. At this point the animal is transferred to the spinal cord
injury device that is about 5 feet from the surgical area. Small
surgical clamps are placed on a spine rostral and a spine caudal to
laminectomy site to stabilize the vertebral column. Thereafter, a
2-3 g weight is dropped 5.0 cm onto the exposed dura. This produces
a moderate level of spinal cord injury. Immediately after injury,
the animal is removed from the injury device and returned to the
surgical area. A small, sterile suture is placed in the
paravertebral musculature to mark the site of injury. The skin is
then closed with wound clips and the animal recovered from the
anesthesia. The entire surgical procedure is completed within 45 to
60 minute.
Assessment of Motor Function in Mice
[0120] Spinal cord injured mice are euthanized at 1 hour to 42 days
after injury. In those animals that survive 42 days, locomotor
ability is evaluated as follows:
[0121] Open field testing. This involves testing animals at 3 days
and weekly thereafter until time of euthanasia at 42 days.
Locomotor testing consists of evaluating how animals locomote in an
open field. This open field walking score measures recovery of
hindlimb movements in animals during free open field locomotion as
described by Basso et al. A score of 0 is given if there is no
spontaneous movement, a score of 21 indicate normal locomotion.
Plantar stepping with full weight support and complete
forelimb-hindlimb coordination is reached when an animal shows a
score of 14 points. We use a modified version of the BBB score if
the sequence of recovering motor features is not the same as
described in the original score. If this is observed, points for
the single features are added independently. For example, a mouse
showing incomplete toe clearance, enhanced foot rotation and
already a `tail-up` position, one additional point are added to the
score for the tail position.
[0122] The mice are tested preoperatively in an open field, which
was an 80.times.130-cm transparent plexiglass box, with walls of 30
cm and a pasteboard covered non-slippery floor. In postoperative
sessions two people, blinded to the treatments, will observe each
animal for a period of 4 min. Animals that exhibit coordinated
movement, based upon open field testing, are subjected to
additional tests of motor function as follows.
[0123] Grid walking. Deficits in descending motor control are
examined by assessing the ability of the animals to navigate across
a 1 m long runway with irregularly assigned gaps (0.5-5 cm) between
round metal bars. The bar distances are randomly changed from one
testing session to the next. The animals are tested over a period
of 5 days, beginning 1 to 2 weeks prior to euthanasia.
[0124] Crossing this runway requires that animals accurately place
their limbs on the bars. In baseline training and postoperative
testing, every animal will cross the grid for at least three times.
The number of footfalls (errors) are counted in each crossing and a
mean error rate is calculated. If an animal is not able to move the
hindlimbs, a maximum of 20 errors are given. The numbers of errors
counted are also rated in a non-parametric grid walk score: 0-1
error is rated as 3 points, 2-5 as 2 points, 6-9 as 1 point and
10-20 footfalls as 0 points.
[0125] Foot placement. Footprint placement analysis is modified
from De Medinaceli et al. The animal's hind paws are inked, for
example, with watercolor paint that can easily be washed off, and
footprints are made on paper covering a narrow runway of 1 m length
and 7 cm width as the animals traverse the runway. This ensures
that the direction of each step is standardized in line. A series
of at least eight sequential steps are used to determine the mean
values for each measurement of limb rotation, stride length and
base of support. The base of support are determined by measuring
the core to core distance of the central pads of the hind paws. The
limb rotation are defined by the angle formed by the intersection
of the line through the print of the third digit and the print
representing the metatarsophalangeal joint and the line through the
central pad parallel to the walking direction. Stride length are
measured between the central pads of two consecutive prints on each
side.
[0126] To include animals with incomplete weight support in early
postoperative testing sessions, a 4-point scoring system is also
used: 0 points is given for constant dorsal stepping or hindlimb
dragging, i.e. no footprint was visible; 1 point is counted if the
animal had visible toe prints of at least three toes in at least
three footprints; 2 points are given if the animal showed exo- or
endo-rotation of the feet of more than double values as compared to
its own baseline values; 3 points are recorded if the animal showed
no signs of toe dragging but foot rotation; 4 points are rated if
the animal showed no signs of exo- or endo-rotation (less than
twice the angle of the baseline values). These animals are tested
over a period of 5 days, beginning 1 to 2 weeks prior to
euthanasia.
[0127] Beam balance. Animals are placed on a narrow beam, and the
ability to maintain balance and/or traverse the beam is evaluated.
These animals are tested over a period of 5 days, beginning 1 to 2
weeks prior to euthanasia. The narrow beat test is performed
according to the descriptions of Hicks and D'Amato. Three types of
beams are used as narrow pathways: a rectangular 2.3 cm wide bean,
a rectangular 1.2 cm wide beam and a round dowel with 2.5 cm
diameter. All beams are 1 m long and elevated 30 cm from the
ground. After training, normal rats are expected to be able to
traverse the horizontal beams with less than three footfalls. When
occasionally their feet slipped off the beam, the animals are
retrieved and repositioned precisely.
[0128] A scoring system is used to assess the ability of the
animals to traverse the beams: 0 is counted as complete inability
to walk on the bean (the animals fall down immediately), 0.5 is
scored if the animal was able to traverse half of the beam, 1 point
is given for traversing the whole length, 1.5 points when stepping
with the hindlimbs is partially possible, and 2 points is noted for
normal weight support and accurate foot placement. If the scores of
all three beams are added, a maximum of 6 points can be
reached.
[0129] Inclined plane. Animals are placed on a platform that can be
raised to varying angles. The ability to maintain position at a
given angle is determined. These animals are tested over a period
of 5 days, beginning 1 to 2 weeks prior to euthanasia. Animals are
placed on an adjustable inclined plane constructed as described
(Rivlin and Tator, 1977). The slope is progressively increased
every 20 s noting the angle at which the mouse could not maintain
its position for 5 s. The test is repeated twice for each mouse and
the average angle is recorded. In the inclined-plane test, recovery
from motor disturbance is assessed before, and again at 1, 7, 14,
and 21 d after the injury. The maximum inclination of the plane on
which the rats could maintain themselves for 5 sec without falling
is recorded.
[0130] Each of these tests described above takes less than 5
minutes. These various tests are designed such that if animals fall
from the testing apparatus, they either land on padded flooring or
the distance fallen is sufficiently limited (less than 6 inches)
that the animals are not be harmed.
Generation of a Spinal Cord Injury in Rats
[0131] MGE cells are implanted into the uninjured cord of rats to
assess their integration into the local circuitry (n=10) and also
into contused (n=10) and transected (n=10) spinal cords. Both
contusion and transection are studied in order to assess mild
(contusion) and moderate (transection) levels of spasticity.
[0132] Rats are anesthetized with Avertin supplemented with
isoflurane or isoflurane only. The skin over the middle of the back
is shaved. The shaved area is disinfected with Clinidine. All
surgical tools are soaked overnight in Cidex prior to their use.
Lubricating ophthalmic ointment is placed in each eye. Animals are
placed on a warming blanket to maintain temperature at 37.degree.
C. A dorsal midline incision, approximately 1 cm in length is made
using a scalpel blade. The spinous process and lamina of T9 are
identified and removed. A circular region of dura, approximately
2.4 mm in diameter, is exposed.
[0133] To produce a contusion injury, a circular region of dura,
approximately 3.0 mm in diameter, is exposed. At this point the
animal is transferred to the spinal cord injury device that is
about 5 feet from the surgical area. Small surgical clamps are
placed on a spine rostral and a spine caudal to laminectomy site to
stabilize the vertebral column. Thereafter, a 10 g weight is
dropped 5 cm onto the exposed dura. This produces a moderate level
of spinal cord injury. To produce a transection injury, the
procedure to expose the cord is similar to that for the contusion
injury except a surgical blade is used to completely transect the
spinal cord.
[0134] Immediately after contusion or transection injury, the
animal is removed from the injury device and returned to the
surgical area. A small, sterile suture is placed in the
paravertebral musculature to mark the site of injury. The skin is
then closed with wound clips and the animal recovered from the
anesthesia. The entire surgical procedure is completed within 45 to
60 minutes.
Spinal Cord Implantation of MGE Cells in Rats
[0135] The first surgery produces either a contusion or transection
spinal cord injury as described. Spasticity is initially seen at
seven days after injury. A second surgery on day 7 is used to
inject MGE cells into the injured spinal cord. The delay in MGE
implantation allows the ability to measure reductions in spasticity
over time.
[0136] Seven days after either transection or contusion, animal are
re-anesthetized with isoflurane, the exposed cord is visualized and
two additional laminectomies are made caudal to the original
laminectomy. Using a stereotaxic device, MGE cells, are injected
into each of the ventral horns. An uninjured control group is also
be injected with cells. A sterile suture is positioned in the
paravertebral musculature to mark the surgical site. The skin is
then closed with wound clips and the animal is recovered from the
anesthesia. This transplantation procedure is completed in
approximately 60 minutes. Spinal cord injured and control rats are
anesthetized and perfused with fixative at 1 to 6 weeks after
transplantation of cells.
Assessment of Motor Function in Rats
[0137] After recovery from surgery, these animals may be assessed
for function 1-2 times weekly:
[0138] Locomotor assessment. Locomotor testing consists of
evaluating how animals locomote in an open field. One day
postinjury (p.i.) and 1 to 2 times weekly thereafter, behavioral
analysis is performed by two observers blinded to the treatments,
using a battery of tests to rate open-field locomotion by the
Basso-Beattie-Bresnahan (BBB) scale. This open field walking score
measures recovery of hindlimb movements in rats during free open
field locomotion as described by Basso et al. A score of 0 is given
if there is no spontaneous movement, a score of 21 indicate normal
locomotion. Plantar stepping with full weight support and complete
forelimb-hindlimb coordination is reached when an animal shows a
score of 14 points. We will use a modified version of the BBB score
if the sequence of recovering motor features is not the same as
described in the original score. If this is observed, points for
the single features are added independently. For example, a rat
showing incomplete toe clearance, enhanced foot rotation and
already a `tail-up` position, one additional point are added to the
score for the tail position.
[0139] The rats are tested preoperatively in an open field, which
was an 80.times.130-cm transparent plexiglass box, with walls of 30
cm and a pasteboard covered non-slippery floor. In postoperative
sessions two people, blinded to the treatments, will observe each
animal for a period of 4 min. Animals that exhibit coordinated
movement, based upon open field testing, are subjected to
additional tests of motor function as follows.
[0140] Grid walking. Deficits in descending motor control are
examined by assessing the ability of the animals to navigate across
a 1 m long runway with irregularly assigned gaps (0.5-5 cm) between
round metal bars. The bar distances are randomly changed from one
testing session to the next. The animals are tested 1 to 2 times
weekly postinjury. Crossing this runway requires that animals
accurately place their limbs on the bars. In baseline training and
postoperative testing, every animal will cross the grid for at
least three times. The number of footfalls (errors) are counted in
each crossing and a mean error rate is calculated. If an animal is
not able to move the hindlimbs, a maximum of 20 errors are given.
The numbers of errors counted are also rated in a non-parametric
grid walk score: 0-1 error is rated as 3 points, 2-5 as 2 points,
6-9 as 1 point and 10-20 footfalls as 0 points.
[0141] Foot placement. Footprint placement analysis is modified
from De Medinaceli et al. The animal's hind paws are inked, for
example, with watercolor paint that can easily be washed off, and
footprints are made on paper covering a narrow runway of 1 m length
and 7 cm width as the animals traverse the runway. This ensures
that the direction of each step is standardized in line. A series
of at least eight sequential steps are used to determine the mean
values for each measurement of limb rotation, stride length and
base of support. The base of support are determined by measuring
the core to core distance of the central pads of the hind paws. The
limb rotation are defined by the angle formed by the intersection
of the line through the print of the third digit and the print
representing the metatarsophalangeal joint and the line through the
central pad parallel to the walking direction. Stride length are
measured between the central pads of two consecutive prints on each
side.
[0142] To include animals with incomplete weight support in early
postoperative testing sessions, a 4-point scoring system is also
used: 0 points is given for constant dorsal stepping or hindlimb
dragging, i.e. no footprint was visible; 1 point is counted if the
animal had visible toe prints of at least three toes in at least
three footprints; 2 points are given if the animal showed exo- or
endo-rotation of the feet of more than double values as compared to
its own baseline values; 3 points are recorded if the animal showed
no signs of toe dragging but foot rotation; 4 points are rated if
the animal showed no signs of exo- or endo-rotation (less than
twice the angle of the baseline values).
[0143] Beam balance. Animals are placed on a narrow beam, and the
ability to maintain balance and/or traverse the beam is evaluated.
The narrow beat test is performed according to the descriptions of
Hicks and D'Amato. Three types of beams are used as narrow
pathways: a rectangular 2.3 cm wide bean, a rectangular 1.2 cm wide
beam and Three types of beams are used as narrow pathways: a
rectangular 2.3 cm wide bean, a rectangular 1.2 cm wide beam and a
round dowel with 2.5 cm diameter. All beams are 1 m long and
elevated 30 cm from the ground. After training, normal rats are
expected to be able to traverse the horizontal beams with less than
three footfalls. When occasionally their feet slipped off the beam,
the animals are retrieved and repositioned precisely.
[0144] A scoring system is used to assess the ability of the
animals to traverse the beams: 0 is counted as complete inability
to walk on the bean (the animals fell down immediately), 0.5 is
scored if the animal was able to traverse half of the beam, 1 point
is given for traversing the whole length, 1.5 points when stepping
with the hindlimbs is partially possible, and 2 points is noted for
normal weight support and accurate foot placement. If the scores of
all three beams are added, a maximum of 6 points can be
reached.
[0145] Inclined plane. Animals are placed on a platform that can be
raised to varying angles. The ability to maintain position at a
given angle is determined.
[0146] Animals are placed on an adjustable inclined plane
constructed as described (Rivlin and Tator, 1977). The slope is
progressively increased every 20 s noting the angle at which the
mouse could not maintain its position for 5 s. The test is repeated
twice for each mouse and the average angle is recorded. In the
inclined-plane test, recovery from motor disturbance is assessed
before, and again at 1, 7, 14, and 21 d after the injury. The
maximum inclination of the plane on which the rats could maintain
themselves for 5 sec without falling is recorded.
[0147] Each of these tests described above takes less than 5
minutes. These various tests are designed such that if animals fall
from the testing apparatus, they either land on padded flooring or
the distance fallen is sufficiently limited (less than 6 inches)
that the animals are not harmed.
[0148] Transplantation of MGE progenitor cells can be used in
methods of the present disclosure reduce spasticity (e.g., as seen
in multiple sclerosis, stroke, and brain injury) by at least 10%
compared to controls, or the individual's previously untreated
stated. In some embodiments, transplantation of MGE progenitor
cells reduces spasticity by at least 20%, 30%, 40%, 50%, 60%, 70%,
80%, 90%, or 95% compared to controls, or the individual's
previously untreated stated. In some embodiments, transplantation
of MGE progenitor cells reduces the need for medication by at least
10% compared to controls, or the individual's previously untreated
stated. In some embodiments, transplantation of MGE progenitor
cells reduces the need for medication by at least 20%, 30%, 40%,
50%, 60%, 70%, 80%, 90%, or 95% compared to controls, or the
individual's previously untreated stated. In some embodiments,
transplantation of MGE progenitor cells obviates the need for
intrathecal medication or surgery.
In Vitro Expansion of MGE Progenitor Cells (Prophetic Example)
[0149] The practical and ethical problems associated with embryonic
and fetal tissue transplantation is overcome through the use of in
vitro expansion of a small amount of embryonic or fetal CNS tissue
as floating cell aggregates called neurospheres using the technique
developed by Reynolds, B. A., and Weiss, S., Generation of neurons
and astrocytes from isolated cells of adult mammalian central
nervous system. Science 255: 1707-1710, 1992.
Primary Cultures and Passaging Procedures
[0150] Adult pregnant rats are anesthetized with ketamine (90
mg/Kg) and xylazine (7 mg/Kg). Fetuses are removed from the uterus
at E14.5 and brains dissected under a microscope. The MGE is
dissected from the forebrain in oxygenated artificial cerebrospinal
fluid (aCSF, in mm: NaCl, 125; KCl, 2.5; MgCl2, 1; CaCl2, 2; NaPO4,
1.25; NaHCO3, 25; and glucose, 25; Sigma). Twelve to 15 MGEs are
dissected and prepared as described in Reynolds and Weiss. The
culture medium is DMEM/F12 supplemented with the hormone mixture
used by Reynolds and Weiss along with human recombinant fibroblast
growth factor-2 (FGF-2; 20 ng/ml; Prepro Tech, Inc., Rocky Hill,
N.J.). Fresh FGF-2 is added every 2 days. Cells are passages once
per week. The passage of cells obtained from one pregnant rat
(12-15 fetuses) three times will produce enough immature neural
progenitor cells for the transplantation of at least 450 rats.
Thus, the in vitro expansion of embryonic or fetus-derived MGE
progenitor cells using the above methodology or other methodology
known to one of skill in the artis a useful source for
transplantable material with which to treat neurological
conditions, disease, or injury, including Parkinson's disease,
epilepsy, and spinal cord injury.
Generation of an Immortalized Cell Line that is Substantially
Similar to MGE cells isolated from E13.5 mouse fetus (Prophetic
Example)
[0151] Normal human somatic cells have a defined life span and
enter senescence after a limited number of cell divisions. At
senescence, cells are viable but no longer divide. This limitation
on cell proliferation represents an obstacle in the scale up and
production of large quantities of MGE progenitor cells required for
transplantation. The establishment of permanent cell lines will
circumvent this problem. Many immortalized tumor cell lines are
known and normal human somatic cells can be transformed in vitro
with oncogenes to establish permanent cell lines. While valuable
for research, transformed cells derived from normal human cells are
unacceptable for therapeutic use owing to their alterations in cell
cycle, loss of contact inhibition, aneuploidy, spontaneous
hypermutability and other characteristics associated with cancerous
cells.
[0152] Fortunately, the recognition that replicative senescence is
controlled by the shortening of the telomeres allows for the
production of immortalized cell lines through methodologies that
modulate or control the regulation of telemerase. One of the number
of ways known in the art to immortalize cells is by the forced
expression of exogenous hTERT in normal human cells. This produces
telomerase activity and prevent the erosion of telomeres and
resultant senescence. MGE progenitor cells immortalized with hTERT
have normal cell cycle controls, functional p53 and pRB
checkpoints, are contact inhibited, are anchorage dependent,
require growth factors for proliferation and possess a normal
karyotype. Thus MGE progenitor cells that express exogenous hTERT
have extended life spans that allow for the production of useful
quantities of MGE progenitor cells for transplantation.
Methods and Materials
[0153] Telomerase is introduced into MGE progenitors using the
techniques of Ouellette, M. M. et al. The establishment of
telomerase-immortalized cell lines representing human chromosome
instability syndromes. Human Molecular Genetics, 9:403-411, 2000.
Briefly, retroviral supernatants is obtained from PA317 packaging
cells stably expressing hTERT cloned into the pBabepuro vector.
Cells are infected and then selected for 2 weeks using puromycin at
750 ng/ml.
[0154] Cells are grown at 37.degree. C. in 5% CO.sub.2
Neurobasal.TM. Medium (Invitrogen, Purchase, N.Y.) and Gentamicin
(25 .mu.g/ml). For hygromycin B sensitivity, cells were grown at
various doses for 7 days, stained for viability and counted.
[0155] Telomerase activity is determined using the TRAP assay
(TRAPeze kit, Intergen, Purchase, N.Y.). PCR products are
electrophoresed on 10% polyacrylamide gels and quantified using the
Phosphorimaging system and IMAGEQUANT (Molecular Dynamics, Amersham
Pharmacia Biotech, Piscataway, N.J.). Quantitation of telomerase
activity is done by determining the ratio of the 36 bp internal
standard to the telomerase ladder.
[0156] Total genomic DNA is isolated as described in Ouellette, M.
M., et al. Telomerase activity does not always imply telomere
maintenance. Biochem. Biophys. Res. Commun., 254:795-803, 1999. The
DNA is digested with a battery of six enzymes (HinfI, RsaI, CfoI,
AluI, HaeIII, MspI) and resolved on a 1% agarose gel. The gel is
denatured and dried, neutralized and the signal detected in situ
using a telomeric probe end-labeled with [.gamma.-.sup.32P]ATP.
[0157] The immortalized MGE progenitor cell line is compared with
uninfected MGE progenitor cells to demonstrate: (i) the presence of
telomerase activity; (ii) the capacity to maintain extended
telomere size; and (iii) the ability to grow beyond the number of
population doublings of uninfected control MGE progenitor cells.
Using the telomere repeat amplification protocol (TRAP) assay,
telomerase activity should be found to be absent from all
uninfected samples, but present in samples that are infected with
the hTERT vector. Preferably, the level of activity detected in the
infected cells should be comparable with that detected in a human
lung cancer cell line, H1299, with telomere size larger in the
immortalized MGE progenitor cells than in their uninfected
counterpart, indicating the exogenous telomerase activity is able
to elongate telomeres. All samples are continuously passaged to
determine cellular life span. Uninfected samples would be expected
to enter senescence after approximately 60 population doublings,
and thus the presence of exogenous telomerase preferably should
extend the life span of MGE progenitor cells by at least three-fold
compared to the uninfected cultures.
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[0159] While this invention has been particularly shown and
described with references to preferred embodiments thereof, it will
be understood by those skilled in the art that various changes in
form and details may be made therein without departing from the
scope of the invention encompassed by the appended claims.
* * * * *