U.S. patent application number 14/518304 was filed with the patent office on 2015-02-05 for biomatrix composition and methods of biomatrix seeding.
This patent application is currently assigned to Board of Regents of the University of Texas System. The applicant listed for this patent is Eckhard U. Alt, Michael E. Coleman, Ron Stubbers. Invention is credited to Eckhard U. Alt, Michael E. Coleman, Ron Stubbers.
Application Number | 20150037387 14/518304 |
Document ID | / |
Family ID | 42172221 |
Filed Date | 2015-02-05 |
United States Patent
Application |
20150037387 |
Kind Code |
A1 |
Coleman; Michael E. ; et
al. |
February 5, 2015 |
Biomatrix Composition and Methods of Biomatrix Seeding
Abstract
Apparatus and methods are described for generating autologous
tissue grafts, the apparatus including a point of care SVF
isolation unit that includes a tissue digestion chamber in fluid
communication with a lipid separating chamber, whereby SVF cells
are isolated without centrifugation; and a cell seeding chamber in
fluid communication with the SVF isolation unit, said cell seeding
chamber adapted to support a cell scaffold. Methods and materials
for cell seeding, including through the provision of micro rough
scaffold surfaces, are also provided.
Inventors: |
Coleman; Michael E.; (The
Woodlands, TX) ; Alt; Eckhard U.; (Houston, TX)
; Stubbers; Ron; (Houston, TX) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Coleman; Michael E.
Alt; Eckhard U.
Stubbers; Ron |
The Woodlands
Houston
Houston |
TX
TX
TX |
US
US
US |
|
|
Assignee: |
Board of Regents of the University
of Texas System
Austin
TX
Ingeneron, Inc.
Houston
TX
|
Family ID: |
42172221 |
Appl. No.: |
14/518304 |
Filed: |
October 20, 2014 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
12619977 |
Nov 17, 2009 |
8865199 |
|
|
14518304 |
|
|
|
|
61115457 |
Nov 17, 2008 |
|
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|
Current U.S.
Class: |
424/423 ;
424/93.7 |
Current CPC
Class: |
A61P 19/00 20180101;
A61L 2430/40 20130101; A61K 35/33 20130101; A61L 2430/20 20130101;
A61L 27/3804 20130101; A61P 17/02 20180101; A61L 27/56
20130101 |
Class at
Publication: |
424/423 ;
424/93.7 |
International
Class: |
A61L 27/38 20060101
A61L027/38; A61L 27/56 20060101 A61L027/56 |
Claims
1. A cell-seeded tissue graft comprising a reparative cell
preparation seeded onto a porous scaffold, wherein the tissue graft
is prepared by: isolating a fresh stromal vascular fraction (SVF)
from an adipose tissue of a patient by a process including
enzymatically digesting the adipose tissue; applying the fresh SVF
cells to the porous scaffold without subjecting the fresh SVF cells
to plastic adherence; and rinsing the porous scaffold to eliminate
cells that are unbound by the porous scaffold, thereby generating a
tissue graft comprising a reparative cell preparation in less than
about 4 hours from removal of the adipose tissue from the
patient.
2. The cell-seeded tissue graft of claim 1, wherein the porous
scaffold is characterized by a micro-rough cell attachment surface
that has surface irregularities at a periodicity of 1-20 .mu.m.
3. The cell-seeded tissue graft of claim 1, wherein the cell-seeded
tissue graft is generated at a point-of-care and is implanted into
the patient without culturing the cell-seeded tissue graft.
4. The cell-seeded tissue graft of claim 1, wherein the cell-seeded
tissue graft is cultured to expand populations of cells seeded on
the graft prior to implanting into the patient.
5. The cell-seeded tissue graft of claim 1, wherein the SVF cells
are pushed into contact with the porous scaffold by pressure.
6. The cell-seeded tissue graft of claim 1, wherein the SVF cells
are pushed into contact with the porous scaffold by a partial
vacuum.
7. The cell-seeded tissue graft of claim 1, wherein the SVF cells
are incubated with an inductive media before, during or after being
applied to the porous scaffold.
8. The cell-seeded tissue graft of claim 7, wherein the inductive
media is adapted for generation of one or more of adipocytes,
chondrocytes, endothelial cells, hepatocytes, myoblasts, neurons,
and osteoblasts.
9. The cell-seeded tissue graft of claim 1, wherein the porous
scaffold is comprised of a biocompatible or a biodegradable
material.
10. The cell-seeded tissue graft of claim 9, wherein the
biocompatible material is selected from the group consisting of:
polytetrafluoroethylene, woven polyester, spun silicone, open foam
silicone encased in microporous expanded PTFE, stainless steel,
polypropylene, polyurethane, polycarbonate, nickel titanium shape
memory alloys and cobalt-chromium-nickel alloys, and combinations
thereof.
11. The cell-seeded tissue graft of claim 10, wherein the
biodegradable material is selected from the group consisting of:
silk fibroin-chitosan, acellular dermal matrices, collagen,
polyglactin, hyaluronic acid, and resorbable silica gel matrix.
12. The cell-seeded tissue graft of claim 2, wherein the surface
irregularities of the porous scaffold are created by treatment of
at least one cell attachment surface of the scaffold by one or more
of embossing, blasting, plasma etching, by controlling
polymerization or drying processes, by heat application, by
chemical etching, and by coating or printing.
13. The cell-seeded tissue graft of claim 2, wherein at least one
surface of the porous scaffold is characterized by a spongy texture
formed by subjecting the nascent scaffold material to a partial
vacuum during polymerization or drying.
14. The cell-seeded tissue graft of claim 1, wherein the
cell-seeded tissue graft is adapted and configured to treat one or
more of: wound healing, burns, bone fractures, cosmetic defects,
cartilage damage, tendon damage, ulcers, fistulas, hernias, retinal
degeneration, treatment of ischemic disease, nerve injury,
aneurysms, bladder wall repair, intestinal injury, and vascular
vessel repair.
15. The cell-seeded tissue graft of claim 1, wherein an adherence
agent selected to promote adherence of desired cell types is
applied to the porous scaffold prior to cell-seeding.
16. The cell-seeded tissue graft of claim 15, wherein the adherence
agent is selected from the group consisting of: autologous plasma
or serum and components thereof, cold insoluble globulin,
carboxymethyl dextran, iron dextran, and hyaluronic acid and
polymers thereof.
17. A cell-seeded tissue graft comprising a reparative cell
preparation seeded onto a porous scaffold, wherein the tissue graft
is prepared by: isolating a fresh stromal vascular fraction (SVF)
from extraction fluid of a lipoaspirate from a patient; applying
the fresh SVF cells to the porous scaffold without subjecting the
fresh SVF cells to plastic adherence; and rinsing the porous
scaffold to eliminate cells that are unbound by the porous
scaffold, thereby generating a tissue graft comprising a reparative
cell preparation in less than about 4 hours from removal of the
adipose tissue from the patient.
Description
CROSS REFERENCE TO RELATED APPLICATIONS
[0001] This application is a divisional of, and claims priority to,
U.S. application Ser. No. 12/619,977, filed Nov. 17, 2009 and
issued Oct. 21, 2014 as U.S. Pat. No. 8,865,199, which in turn
claims priority to U.S. Provisional Application Ser. No. 61/115,457
filed Nov. 17, 2008, which is incorporated herein by reference.
FIELD OF THE INVENTION
[0002] This invention relates generally to apparatus, compositions
and methods for the generation of implantable matrices seeded with
reparative cell populations.
BACKGROUND OF THE INVENTION
[0003] The present invention relates generally to tissue scaffolds
seeded with reparative cell populations for tissue repair,
including myocardial repair. Without limiting the scope of the
invention, its background is described in connection with existing
methods and compositions of implantable materials for treating
physical defects and wound healing.
[0004] Roughly 1% of humans are born with an atrial septal defect
(ASD) which permits a shunt between the right and left atrium.
Other deficiencies include ventricular septum defects and patent
foramen ovale (PFO). Each of these defects are amenable to
treatment by occlusion either by direct surgical techniques in
suturing a patch or by placement of an occluder non-invasively.
Current occluders and patch materials include non-absorbable but
biocompatible materials such as polytetrafluroethylene (PTFE or
Teflon.RTM. patches such as the GORE HELEX.RTM. Septal Occluder),
woven polyester (Dacron.RTM. fabric disk devices such as
CardioSEAL.RTM. and STARFlex.RTM.), stainless steel and
polyurethane (i.e. the Sideris buttoned devices), nickel titanium
shape memory alloys (i.e. the Amplatzer septal occluder constructed
of a mesh of Nitinol wires) or cobalt-chromium-nickel alloys
(Elgiloy). Although the synthetic patches are not absorbed, they
act as a scaffold onto which normal tissue can grow and cover the
defect, which is essentially "scarred" into place after about 3-6
months depending on the conditions of the defect.
[0005] For wound healing and reconstructive surgery, existing
materials include the use of synthetic materials as well as
biomaterials generated from human and other animal tissues, such as
for example the acellular dermal matrices (ADM) derived from normal
human skin (i.e. Alloderm.RTM. ADMs, also detailed in U.S. Pat. No.
7,358,284). Synthesized biodegradable scaffolds for tissue repair
have been introduced for potential applications including tissue
formation, expansion of host bone cells, cell transplantation, and
bioactive molecule delivery. Preformed biodegradable scaffolds
composed of polyglycolic acid (PGA) and poly L-lactic acid (PLLA)
have been FDA-approved (i.e. Vicryl.RTM. polyglactin woven mesh).
The biodegradable graft material, Dermagraft.RTM., which has been
approved for treatment of diabetic foot ulcers, is manufactured by
seeding a polyglactin mesh with human fibroblasts which proliferate
and coat the mesh with dermal collagen, matrix proteins, and growth
factors before the mesh is cryopreserved.
[0006] The field of regenerative medicine has been extensively
studying the potential of cell therapy for repair of injured or
diseased tissue. To date, cells from multiple sources including
embryonic stem cells, bone marrow derived mesenchymal stem cells,
peripheral blood derived endothelial progenitor cells and
mesenchymal stem cells, and selected adipose derived cells have
been demonstrated to enhance tissue repair in one or more
experimental models. Translation of these preclinical findings into
a practical therapy is the subject of significant research. Since
these research efforts are largely based on the premise that a
single cell type, for example a pluripotent or totipotent stem
cell, is the best choice for cell therapy, significant effort has
been focused on identifying and then obtaining the target cell
type.
[0007] It has been suggested that the post-graft mechanical
behavior of ADM could be enhanced by cell seeding prior to
implantation. (Erdag G, Sheridan R L. "Fibroblasts improve
performance of cultured composite skin substitutes on athymic
mice." Burns 30(4) (2004) 322e8; Fuchs J R, et al. "Diaphragmatic
reconstruction with autologous tendon engineered from mesenchymal
amniocytes" J Pediatr Surg 39(6) (2004) 834-8). Tissue engineering
involving the delivery of autologous stem cells and progenitor
cells seeded on scaffolds is currently at the animal discovery
stage and involves the seeding of scaffolds followed by in vitro
culture to produce relatively large pieces of tissue prior to
implantation. Such pre-seeded and cultured scaffolds have been
shown to be of value for tissue repair in animal models.
[0008] Recent research in the inventor's laboratories has proven
that a mixture of early mesenchymal, multi-potent, lineage
committed and lineage uncommitted stem/progenitor cells and fully
differentiated cells can be obtained from many body tissue areas.
The early mesenchymal uncommitted cells originate from the
microvessels within the tissues. For practical reasons, adipose
tissue is a source that is available in most animal and human
species without disrupting the physiological functions of the body.
It has been reported that adipose derived stromal cells seeded onto
carrier bioprosthetics facilitated formation of new bone in an
animal model. (Cowan C M, et al. "Adipose-derived adult stromal
cells heal critical-size mouse calvarial defects" Nat Biotechnol
22(5) (2004) 560e7).
[0009] Typically, cells for matrix or scaffold seeding are isolated
from donor tissue and cultured for an extended period of time. For
example, the FDA approved Apligraf.RTM. skin grafts available from
Organogenesis (Canton, Mass.) are manufactured by first forming a
bovine collagen matrix which is plated with cultured human dermal
fibroblasts isolated from human donor skin. Certain aspects of the
manufacturing process are disclosed in Bell, U.S. Pat. No.
5,800,537. The donor fibroblasts are cultured on the collagen
matrix for 6 days to form a dermal matrix. Next the dermal matrix
is plated with cultured human keratinocytes to promote development
of a stratum corneum layer. The entire process takes from 20 to 27
days prior to packaging. While useful, such a process does not
utilize pluripotent cells and is clearly not amendable to a point
of care process employing the patient's own (autologous) cells.
Additionally, recent findings suggest that the cells do not survive
long term and engraft in the recipient patient thus limiting the
utility of this allogenic cell product (Griffiths M, et al,
"Survival of Apligraf in acute human wounds" Tissue Eng 10(7-8)
(2004) 1180).
[0010] Alternatively, in research applications, bone marrow
aspirate cells have been obtained from patients and the cells have
been held in place or physically "trapped" on the matrix by an
artificial means such as by a thrombin induced clot for holding
bone marrow aspirate onto an osteogenic matrix. While these methods
may have some utility, they require a prolonged treatment program
including several surgical interventions.
[0011] Methods and compositions for the generation of point-of-care
cell seeded matrices have not been heretofore available and there
continues to be an unmet need for implantable cell seeded matrices
that maybe generated in a single procedure. Also needed are methods
and apparatus that permit the isolation of reparative cell
populations that are suitable for direct seeding on to
biocompatible matrices.
[0012] The present invention provides methods and materials for the
focal application of reparative cell populations, for example for
repair of damaged neurons, muscle, tendons, joints and bone
structures, repair of parenchymal organs such as liver, kidney,
heart, or brain, and for repair of skin tissues including in the
treatment of burns, hernias, and non-healing wounds. Methods and
materials are provided to retain desirable cell populations on
biocompatible scaffolds and to most effectively use the scaffold in
conjunction with a fresh cellular preparation, which avoids a need
to culture the cells.
BRIEF SUMMARY OF THE INVENTION
[0013] The invention described provides novel methods and apparatus
for point-of-care isolation of reparative cell populations that
does not rely on a cell property of being strongly adherent, as
well as biocompatible matrices that are suitable for loading with
the reparative cell populations and implanted without the need for
prolonged culturing of the cells or without the need for
preselecting cells by plastic adherence.
[0014] In one embodiment of the invention, a graft is provided that
includes a biomaterial that is resorbable and is seeded with
reparative cell population that allows a natural healing including
by differentiation of cells from the population into different
lineages depending on pretreatment of the cells and/or placement of
the seeded biomaterial in specialized tissues that influence the
differentiation pathway. For one non-limiting example, when
implanted into the heart, certain of the pluripotent stem cells in
the population may turn into fibroblasts while others may
differentiate into specialized cells such as cardiomyocytes and
endothelial cells, thus enabling an accelerated healing and
remodeling process that most closely resembles a natural
process.
[0015] In one embodiment, a method of generating tissue grafts is
provided including the steps of: isolating stromal vascular
fraction (SVF) cells from adipose tissue of a mammal, said SVF
cells isolated by enzymatically digesting adipose tissue and
separating out lipid containing cells by floatation, followed by
collecting the SVF cells without centrifugation; applying the SVF
cells to a first scaffold; incubating the SVF cells with the
scaffold for less than 2 hours; and removing unbound SVF cells from
the scaffold, thereby generating a cell seeded tissue graft. In one
such embodiment, the cell seeded tissue graft is generated at a
point-of-care and is implanted into the mammal without culturing
the tissue graft whereas in alternative embodiments, the cell
seeded tissue graft is cultured to expand populations of cells
seeded on the graft prior to implanting into the mammal. In one
embodiment of the aforementioned seeding step, the SVF cells are
pushed into contact with the scaffold by pressure or by a partial
vacuum. The methods and apparatus of the present invention are
particularly useful in providing autologous tissue grafts.
[0016] If desired, a series of seeding steps may be employed
wherein the unbound cells from a first seeding step are applied to
second scaffold, wherein the second scaffold is adapted for binding
of a different population of cells than the first scaffold, thereby
generating at least two tissue grafts, each seeded with a different
subpopulation of cells. By different subpopulations it is meant
populations that exhibited different affinity for the two
substrates at the time they were applied although it is understood
that the different subpopulations may both contain at least some
cells having similar or identical phenotypic markers.
[0017] In certain embodiments, the SVF cells are incubated with
inductive media before, during or after being applied to the
scaffold. For example, the inductive media may be adapted for
generation of one or more of adipocytes, chondrocytes, endothelial
cells, hepatocytes, myoblasts, neurons, and osteoblasts.
[0018] Preferably, the scaffolds to be seeded are comprised of a
biocompatible or a biodegradable material. Suitable biocompatible
materials include but are not limited to polytetrafluoroethylene,
woven polyester, spun silicone, open foam silicone encased in
microporous expanded PTFE, stainless steel, polypropylene,
polyurethane, polycarbonate, nickel titanium shape memory alloys
and cobalt-chromium-nickel alloys, and combinations thereof.
Suitable biodegradable materials include but are not limited to
silk fibroin-chitosan, acellular dermal matrices, collagen,
polyglactin, and hyaluronic acid.
[0019] In certain embodiments, a cell attachment surface of the
scaffold material is characterized by surface irregularities at a
periodicity of 1-100 .mu.m. In other embodiments, the surface
feature micro surface irregularities at a periodicity of 5-20
.mu.m. The surface irregularities may be created by treatment of at
least one cell attachment surface of the scaffold by one or more of
mechanical processes including by embossing, blasting, plasma
etching, by controlling polymerization or drying processes, by heat
application, by chemical etching, and by coating or printing. In
one embodiment, at least one surface of the scaffold is
characterized by a spongy texture formed by subjecting the nascent
scaffold material to a partial vacuum during polymerization or
drying.
[0020] The cell seeded tissue grafts disclosed herein may be
utilized to treat one or more of: wound healing, burns, bone
fractures, cosmetic defects, cartilage damage, tendon damage,
ulcers, fistulas, hernias, retinal degeneration, treatment of
ischemic disease, nerve injury, aneurysms, bladder wall repair,
intestinal injury, and repair and reconstruction of vessels.
[0021] In one embodiment of the invention, one or more adherence
agents selected to promote adherence of desired cell types to the
scaffold are introduced into the seeding chamber before or during
cell seeding. For example, the adherence agent may be selected from
autologous plasma or serum and components thereof, cold insoluble
globulin, carboxymethyl dextran, iron dextran, and hyaluronic acid
and polymers thereof.
[0022] Also provided herein are apparatus for generating tissue
grafts, said apparatus including a point of care SVF isolation unit
that includes a tissue digestion chamber in fluid communication
with a lipid separating chamber, whereby SVF cells are isolated
without centrifugation; and a cell seeding chamber in fluid
communication with the SVF isolation unit, said cell seeding
chamber adapted to support a cell scaffold. In one embodiment, the
cell seeding chamber is a dedicated chamber having an upper portion
and a lower portion separated by a support member for the scaffold
and further comprising at least one inlet port on the upper portion
and at least one exit port on the lower portion. The exit port may
in some embodiments be adapted for attachment to a vacuum or a pump
whereby the SVF cells can be pulled from the upper portion to the
lower portion across the scaffold. In some embodiments, the cell
seeding chamber further includes a drain port in the upper portion.
In other embodiments a plurality of seeding chambers are provided,
linked in seriatim through a fluid conduit.
[0023] In one embodiment of the invention, a tissue graft is
provided that includes a freshly isolated reparative cell
preparation seeded onto a biomaterial, wherein the reparative cell
preparation is seeded onto the biomaterial in an integrated
apparatus that is employed to first isolate the reparative cell
preparation and then seed the reparative cell preparation onto the
biomaterial.
[0024] In one method of the invention, a method of generating a
cell-seeded, biocompatible matrix at the point of care is provided
including: isolating a population of cells at the point of care,
said cells including multi-potent progenitor cells, endothelial
cells, and fibroblasts; conveying the isolated population of cells
onto a biocompatible matrix in a seeding chamber; allowing the
cells to adhere to the biocompatible matrix at the point of care;
and removing cells that are unbound to the matrix, thereby
generating a cell-seeded, biocompatible matrix suitable for
implantation into a patient at the point of care. By point of care
it is meant at or near to the site of patient care, such as for
example, in or near the operating suite or bedside. In an example
of a point of care procedure, donor tissue is harvested from a
patient, desired cell populations isolated, and a tissue graft
prepared and implanted into the patient, all such steps occurring
at or near to the site of patient care and at one clinic or
hospital visit. In one embodiment of the method, a cell-seeded,
biocompatible matrix is provided in less than about 4 hours in an
integrated process at the point of care, wherein the process
includes isolation of a heterogeneous reparative cell population
and immediately seeding the heterogeneous reparative cell
population onto the biocompatible matrix for implantation.
[0025] In one embodiment of the invention, a method of producing a
cell-seeded, biocompatible matrix at the point of care is provided
that includes: providing a biocompatible matrix that is modified to
promote cell adherence; seeding the biocompatible matrix with a
freshly isolated heterogeneous reparative cell population that
contains cells having a plastic-adherent property as well as cells
that lack a property of plastic adherence; forcing the freshly
isolated heterogeneous reparative cell population into contact with
the biocompatible matrix by applied pressure, vacuum or electric
field. The biocompatible matrix may be optionally modified to
promote cell adherence via chemical or physical modification of the
matrix, or coating of the matrix with a biodegradable coating. For
example, the modification may include treatment of at least one
cell attachment surface of the scaffold by one or more of
embossing, blasting, plasma etching, by controlling polymerization
processes, by heat application, by chemical etching, and by coating
or printing. Alternatively, or in addition, the modification may
include coating with an adherence agent selected from the group
consisting of: autologous plasma or serum and components thereof,
cold insoluble globulin, carboxymethyl dextran, iron dextran, and
hyaluronic acid and polymers thereof.
BRIEF DESCRIPTION OF THE DRAWINGS
[0026] For a more complete understanding of the present invention,
including features and advantages, reference is now made to the
detailed description of the invention along with the accompanying
figures:
[0027] FIG. 1 is a flow chart of a reparative cell isolation method
according to one embodiment of the present invention.
[0028] FIGS. 2A and B represent characterization data for
reparative cell populations isolated according to the process
depicted in FIG. 1.
[0029] FIG. 3 represents characterization data for freshly isolated
reparative cell populations that have not been separated into
adherent and non-adherent populations.
[0030] FIGS. 4 and 5 represent characterization data for freshly
isolated reparative cell populations.
[0031] FIG. 6 is a figurative diagram of one embodiment of a cell
separation apparatus.
[0032] FIGS. 7 and 8 are flow charts depicting seeding methods
according to two embodiments of the invention. In FIG. 8 a series
of selective seeding chambers are utilized in serial fashion for
positive or negative selection or a combination thereof.
[0033] FIGS. 9A and B represent two alternative embodiments of cell
seeding chambers.
[0034] FIG. 10 depicts removal of a scaffold from a seeding chamber
in accordance with one embodiment of the invention.
[0035] FIG. 11 is a Scanning Electron Micrograph (SEM) of an
unseeded Acellular Dermal Matrix (ADM) at 100.times.
magnification.
[0036] FIG. 12 is a SEM of an ADM seeded with adipose derived
stromal cells (ADSC) at 100.times. magnification.
[0037] FIG. 13 is a SEM of an unseeded ADM at 1000.times.
magnification.
[0038] FIG. 14 is a SEM of an ADM seeded with ADSC at 1000.times.
magnification.
[0039] FIG. 15 is a SEM of a silk fibroin-chitosan scaffold (SFCS)
seeded with adipose derived stromal cells (ADSC) at 100.times.
magnification.
[0040] FIG. 16 is a SEM of a SFCS seeded with ADSC at 1000.times.
magnification.
[0041] FIG. 17 is a SEM of a SFCS seeded with freshly isolated SVF
cells at 1000.times. magnification.
DETAILED DESCRIPTION OF THE INVENTION
[0042] While the making and using of various embodiments of the
present invention are discussed in detail below, it should be
appreciated that the present invention provides many applicable
inventive concepts that can be employed in a wide variety of
specific contexts. The specific embodiments discussed herein are
merely illustrative of specific ways to make and use the invention
and do not delimit the scope of the invention.
[0043] To facilitate the understanding of this invention, a number
of terms are defined below. Terms defined herein have meanings as
commonly understood by a person of ordinary skill in the areas
relevant to the present invention. Terms such as "a", "an" and
"the" are not intended to refer to only a singular entity, but
include the general class of which a specific example may be used
for illustration. The terminology herein is used to describe
specific embodiments of the invention, but their usage does not
delimit the invention, except as outlined in the claims.
[0044] Increasing evidence suggests that stem cells are residents
of a micro-vascular niche, on stand-by for tissue repair as needed.
However, with extensive tissue damage, the local pool of stem cells
available for repair is considered insufficient to fully correct
the deficiency. Discarded adipose tissue obtained from liposuction
procedures contains a significant number of mesenchymal stem cells
accessed via a relatively low-risk surgical intervention. Adipose
tissue is highly vascularized and is thus a source of endothelial
cells, smooth muscle cells, its progenitors and of early
multipotent mesenchymal stem cells.
[0045] Adipose tissue is characterized by the presence of mature
adipocytes bound in a connective tissue framework termed the
"stroma." In the present invention, "stromal cells" generally
refers to cells resident in the connective tissue of an organ or
tissue. Non-limiting examples of such cells include fibroblasts,
macrophages, monocytes, pericytes, endothelial cells, inflammatory
cells, progenitors and early undifferentiated mesenchymal stem
cells. Such cells also participate in tissue maintenance and
repair, typically as supportive cells. The stroma of adipose tissue
includes an array of cells that do not include the lipid inclusions
that characterize adipocytes. These include preadipocytes,
fibroblasts, vascular smooth muscle cells, endothelial cells,
monocyte/macrophages and lymphocytes.
[0046] When the connective tissue of adipose tissue is digested,
such as with collagenase, the lipid containing adipocytes can be
separated from the other cell types. In 1964, Rodbell reported the
use of collagenase to dissociate adipose tissue into a cellular
suspension that could then be fractionated by centrifugation into
an upper, lipid-filled adipocyte fraction, and a cell pellet
comprised of non lipid-filled cells. The pelleted non-adipocyte
fraction of cells isolated from adipose tissue by enzyme digestion
has been termed the "stromal vascular cell" or SVF population.
(Rodbell M. "Metabolism of isolated fat cells: Effects of hormones
on glucose metabolism and lipolysis" J. Biol. Chem. 239 (1964)
375-380).
[0047] Heretofore, adipocytes have been separated from the SVF by
centrifugation wherein the adipocytes float and the cells of the
SVF pellet. Typically however, the SVF is subject to further
processing and selection, including plastic adherence. Cells from
the stromal vascular fraction that have been subject to plastic
adherence are typically referred to as cultured stromal vascular
cells or "adipose tissue-derived stromal cells" (ADSC). Not
withstanding other definitions that may exist in the art, as used
herein, the term "stromal vascular fraction cells" refers to all of
the constituent cells of adipose tissue after enzyme digestion and
removal of adipocytes and are not limited to plastic adherent
cells.
[0048] Researchers have studied the makeup of the stromal vascular
fraction of adipose tissue across a range of disciplines.
Typically, the stromal vascular fraction cells that are adherent
have comprised the population that has been studied in culture. In
addition to fibroblasts, the stromal vascular fraction of adipose
tissue has been shown to contain, among other cell types,
microvessel endothelial cells, vascular progenitor cells, adipocyte
progenitor cells (preadipocytes), and multipotent progenitor cells.
Subsequent to Rodbell's original isolation, others, using in vitro
and in vivo models, identified cells within the SVF that could
differentiate into adipocytes. These cells were termed
preadipocytes and were identified as plastic adherent cells within
the SVF. (Hollenberg C H and Vost A. "Regulation of DNA synthesis
in fat cells and stromal elements from rat adipose tissue" J. Clin.
Invest. 47 (1968) 2485-2498; Van R L R, Bayliss C E, and Roncari D
A K "Cytological and enzymological characterization of adult human
adipocyte precursors in culture" J. Clin. Invest. 58 (1976)
699-704.
[0049] Using the basic methodology of Rodbell, but capturing
endothelial cell clusters on a 30 .mu.m filter versus collection of
the entire stromal vascular pellet, it was demonstrated beginning
in the 1970's that microvascular endothelial cells could be
prepared from human adipose tissue. (Wagner R C and Matthews M A.
"The isolation and culture of capillary endothelium from epidymal
fat" Microvasc. Res. 10 (1975) 286-297). Interestingly, the so
described "microvascular endothelial cells" from adipose tissue,
unlike microvascular endothelial cells from other tissues, were
observed to be adherent to plastic and as such could be easily
cultured. See e.g. Kern P A, Knedler A, and Eckel R H. "Isolation
and culture of microvascular endothelium from adipose tissue" J.
Clin. Invest. 71 (1983) 1822-1829; Hewett P W, et al "Isolation and
characterization of microvessel endothelial cells from human
mammary adipose tissue" In Vitro Cell. Dev. Biol. 29 (1992)
325-331.
[0050] Caplan and Haynesworth (Osiris U.S. Pat. No. 5,486,359)
described isolation of pluripotent mesenchymal stem cells from bone
marrow using Percoll gradient separation and plating of the lowest
density fraction on plastic. The isolated mesenchymal stem cells
were plastic adherent and had fibroblast-like morphology. A panel
of monoclonal antibodies was developed to these cells and including
antibodies termed SH2, SH3 and SH4. These antibodies now have the
following correlated CD markers: SH2 (CD105), SH3 and SH4 (CD73).
Davis-Sproul et al. (Osiris U.S. Pat. No. 6,387,367) described
isolation of pluripotent mesenchymal stem cells from bone marrow or
blood using density gradient separation and collection of the light
density cells followed by immunomagnetic bead separation of CD45+
cells. These cells were also positive for SH3 (a.k.a. CD 73) or SH2
(a.k.a. CD 105) and could be pre-selected for these markers.
[0051] Yuan-di Halvorsen (Artecel U.S. Pat. No. 6,391,297) used the
SVC isolation technique of Rodbell, to wit, collagenase digestion
and centrifugation, followed by plastic adherence to isolate
stromal cells from adipose tissue. The stromal cells were cultured
and induced to differentiate into either adipocytes by the bone
marrow stem cell differentiation method of Hauner, which involved
culture in a serum free medium supplemented with triiodothyronine,
insulin and glucocorticoid (J. Clin. Invest. 84 (1989) 1663), or
into osteoblasts using osteoplast differentiation medium which
critically included .beta.-glycerophosphate and
ascorbate-2-phosphate. Later, Yuan-di Halvorsen described that
stromal cells isolated from adipose tissue by collagenase digestion
and centrifugation followed by plastic adherence could be induced
to differentiate into preadipocytes by culture in a medium that
critically included thiazolidinedione followed by culture in a
medium critically including glucose, insulin and glucocorticoid.
(Zen-Bio, U.S. Pat. No. 6,153,432, filed Jan. 29, 1999). Yuan-di
Halvorsen et al (Artecel U.S. Pat. No. 6,429,013) later used the
stromal vascular cell isolation technique of the above referenced
U.S. Pat. No. 6,153,432, to isolate adipose-derived stromal cells
that were induced to differentiate into chondrocytes by culture
with a differentiation medium that included a glucocorticoid such
as dexamethasone and a member of the TGF-.beta. superfamily.
[0052] The ability of plastic adherent SVF cells to differentiate
into multiple lineages fit the criteria of multipotent mesenchymal
stem cells. (See review by Zuk et al "Human Adipose Tissue is a
Source of Multipotent Stem Cells" Mol. Biol. Cell 13 (2002)
4279-95). In 2005, the International Society for Cellular Therapy
(ISCT) stated that the currently recommended term for
plastic-adherent cells isolated from bone marrow and other tissues
is multipotent mesenchymal stromal cells (MSC) in lieu of the prior
"stem cell" term.
[0053] As used herein the term Mesenchymal Stromal Cell (MSC) means
the definition adopted by the International Society for Cellular
Therapy and published in a position paper by Dominici et al,
Cytotherapy 8 (2006) 315. In accordance with the position paper,
MSC must exhibit: [0054] 1) adherence to plastic in standard
culture conditions using tissue culture flasks; [0055] 2) a
specific surface antigen (Ag) phenotype as follows: [0056] positive
(.gtoreq.95%+) for CD105 (endoglin, formerly identified by MoAb
SH2), CD73 (ecto 5'nucleotidase, formerly identified by binding of
MoAbs SH3 and SH4), CD90 (Thy-1), and [0057] negative 2%+) for CD14
or CH11b (monocyte and macrophage marker), CD34 (primitive
hematopoietic progenitor and endothelial cell marker), CD45
(pan-leukocyte marker), CD79.alpha. or CD19 (B cells), and HLA-DR
(unless stimulated with IFN-.gamma.); and [0058] 3) tri-lineage
mesenchymal differentiation capacity: able to differentiate in
vitro into osteoblasts, adipocytes and chondrocytes in inductive
media.
[0059] MSC have been traditionally defined as spindle-shaped or
fibroblast-like plastic adherent cells. Although originally
isolated from bone marrow, MSC have now been isolated from a
variety of tissues including bone periosteum, trabecular bone,
adipose tissue, synovium, skeletal muscle, dental pulp and cord
blood.
[0060] Adipose-derived stem cells (ADSCs) have been reported to
confer benefits in vivo including as angiogenic agents and in
promoting multi-lineage restoration of soft tissue defects. See
Altman A M, et al. "Dermal matrix as a carrier for in vivo delivery
of human adipose-derived stem cells." Biomaterials 29(10) (2008)
1431-1442; Kim W S et al. "Wound healing effect of adipose-derived
stem cells: A critical role of secretory factors on human dermal
fibroblasts." J Dermatol Sci 48(1) (2007) 15-24; and Kim Y, et al.
"Direct comparison of human mesenchymal stem cells derived from
adipose tissues and bone marrow in mediating neovascularization in
response to vascular ischemia." Cell Physiol Biochem 20(6) (2007)
867-876.
[0061] However, it has been shown that the phenotype of plastic
adherent adipose derived cells changes with cell culture and is
influenced by culture conditions. (Gimble J and Guilak F
"Adipose-derived adult stem cells: isolation, characterization, and
differentiation potential" Cytotherapy 5(5) (2003) 362-369; Boquest
A C, et al "Isolation and transcription profiling of purified
uncultured human stromal stem cells: Alteration of gene expression
after in vitro cell culture" Mol. Biol. Cell 16(3) (2005)
1131-1141).
[0062] As used herein, "reparative cell population" refers to a
mixture of cells that includes "tissue engrafting cells" that are
herein defined to include MSC as well as cells such as fibroblasts
and endothelial cells that are able to proliferate and engraft a
target tissue when returned to the body. The reparative cell
population may also include one or more "supportive cell"
populations. Supportive cells are herein defined as cells that do
not permanently engraft in the target tissue but may aid in the
tissue remodeling process that is essential to healing of damaged
tissue. These may include, for example, lymphocytes and
macrophages. As used herein the term "reparative cell population"
is not limited to plastic adherent cells and may be the same as
adipose stromal vascular fraction cells under some
circumstances.
[0063] Advantageously, such reparative cell preparations can be
utilized for cell therapy without prior expansion in cell culture.
Prerequisite for such a procedure is the requirement to obtain a
sufficient number of cells for therapeutic use without expanding
the cells in culture. Subcutaneous tissue may provide as many as
300,000 reparative cells per gram, which have an appropriate cell
type composition. In contrast to the prevailing view that a single
cell type is optimal for cell therapy, the present inventors
believe that multiple cell types are able to act in a coordinated
manner to achieve healing and/or repair. Thus, in one embodiment a
heterogeneous reparative cell population is provided to mediate a
tissue healing and repair process that emulates endogenous
repair.
[0064] In the present invention, "progenitor cells" generally refer
to uncommitted mesenchymal stem cells in various mesenchymal
tissues, such as muscle, bone, cartilage and adipose tissue and
vascular progenitor cells that can be differentiated into vascular
cell types. Such cells are generally believed to constitute a
cellular reserve fraction and function as target engrafting
cells.
[0065] The present invention may be utilized in a process for the
isolation of cell populations without loss of cells that would
otherwise be useful but lack a property of being strongly adherent
when first removed from the body. For example, when plated onto
plastic, adherence of non-fibroblast cells in a fresh cell
preparation may require several hours to more than one day. Culture
of the fresh cell preparation changes two characteristics. First,
monolayer culture enhances certain cell populations resulting in a
cell preparation that is distinct from the fresh isolate. Second,
culture in an adherent monolayer selects and conditions the cells
for adherence, so that upon passaging and replating the resulting
cell populations adhere much more rapidly (i.e., <30 min).
Isolation of MSC involves plastic adherence by definition and
eliminates non-adherent and weakly adherent cells in spite of their
beneficial properties.
[0066] To have clinical utility as a point of care product, the
present inventors believe that cell seeding onto a matrix or
scaffold for implantation would be preferably accomplished in <
about 2 hours and more preferably in < about 1 hours. In other
embodiments, matrices are provided that are adapted to provide
rapid, adherence or incorporation of select constituent
subpopulations of reparative cells such that cell selection can be
performed at the point-of care.
[0067] In one embodiment of the invention a method of modifying the
surface of a biocompatible matrix or scaffold is provided to enable
selective, rapid adherence of freshly prepared reparative cells,
stem cells, or progenitor cells. In one embodiment the selective
adherence occurs in an incubation time frame of < about 2 hours.
If desired, following incubation, non-adherent, undesirable cells
are removed with a wash step prior to implantation of the seeded
matrix. In one embodiment of the invention, modifications such as
coating of matrices and/or chemical or physical modifications are
undertaken such that the matrix has increased selectivity for
freshly isolated reparative cells over a contact time of .ltoreq.1
hour. If desired, unbound cells may be removed by washing. In one
embodiment of the invention, a method is provided that includes
assembling a biocompatible matrix to create a three dimensional
topology that enhances selective, rapid adherence of freshly
prepared reparative cells, stem cells, or progenitor cells. Rapid
adherence is herein defined as adherence occurring in a time frame
of < about 2 hours.
[0068] In one embodiment of the invention, the biocompatible matrix
comprises one of more of: collagen, PLGA, PGA, silk fibroin,
chitosan, polypropylene, acellular skin preparations of human or
other animal origin, and hyaluronic acid polymers (i.e.
HYAFF.RTM.-11 sponges). The matrices may be used without coating or
may have surface modifications including coating with specific cell
adhesion compounds such as hyaluronic acid, fibrin, collagen,
fibronectin, antibodies, aptamers, or thioaptamers, chemical
etching such as with NaOH, coatings such as iridium oxide, and/or
manufacturing processes that alter the surface topology of existing
matrices to increase surface roughness or textural structure.
[0069] The following examples are included for the sake of
completeness of disclosure and to illustrate the methods of making
the compositions and composites of the present invention as well as
to present certain characteristics of the compositions. In no way
are these examples intended to limit the scope or teaching of this
disclosure.
[0070] Isolation of Reparative Cells from Adipose Tissue:
[0071] In contrast to prior isolation methods, the present
invention provides for isolation of reparative cell populations
without the use of centrifugation or plastic adherence, and which
is suitable for use at the point of care. In one embodiment of the
invention, population of cells for cell transplantation is prepared
by dissociating a sample of donor adipose tissue into individual
cells and small clusters of cells until the dissociated cells and
clusters of cells are reduced in diameter to about 1000 microns or
less, phase separating the individual cells and small clusters of
cells into an aqueous cellular layer and a lipid layer without
centrifugation, and collecting cells for cell transplantation from
the aqueous cellular layer.
[0072] In one embodiment of the invention the phase separation is
undertaken by introducing the dissociated cells, including
adipocytes, into a lipid separating unit in an aqueous medium. The
lipid and lipid containing adipocytes float upward, thus forming a
top lipid layer in the lipid separating unit while the non-lipid
containing or non-adipocyte cells float downward under the
influence of normal gravity and are withdrawn from under the top
lipid layer. In accordance with this method, non-adipocytes can be
separated from lipid containing cells without centrifugation.
[0073] In one particular embodiment of the invention, as
figuratively depicted in the flow chart of FIG. 1, adipose tissue
is introduced into a digestion chamber that includes a digestion
fluid and an internal digestion mesh and the tissues and digested
cells are recirculated across the digestion mesh until the tissue
is separated into a digestion mixture that includes individual
cells and small cell clusters, followed by phase separating the
digestion mixture through an aqueous medium disposed in a lipid
separation unit. After the phase separation separates the
constituent cells of the digestion mixture on the basis of density
in an aqueous medium, desired cell populations are collected from
select regions within the lipid separation unit. Isolation of
desired cell populations is preferably accomplished in a unitary
device without a need for centrifugation. In further embodiments,
the digestion mixture is filtered over at least one dispersing
filter prior to phase separating. In certain embodiments the
digestion mixture is finally conveyed through a dispersing head
that is disposed within and forms an entry port to the lipid
separating unit. The dispersing head further divides clumps of
cells within the digestion mixture as the digestion mixture enters
the lipid separation unit. The method is particularly suitable
isolation of cells from adipose-containing tissues of human,
equine, canine, feline, simian, caprine, and ovine origin.
[0074] Various embodiments of the present invention provide a
reparative cell preparation for cell therapy, wherein the cell
preparation comprises a heterogeneous mixture of tissue engrafting
cells and supportive cells that is derived without prior expansion
in cell culture. Once derived, cell preparations of the present
invention can optionally undergo further treatment prior to use for
cell therapy. For instance, in one example, leukocytes within the
cell preparation may be removed. In further examples, cell
preparations of the present invention are seeded (i.e., applied)
onto a biocompatible matrix and are then suitable for implantation
at the point-of-care. Such biocompatible matrices can include
without limitation scaffolds, grafts, sponges, and other well known
materials that may be surgically implanted into the subject.
Example 1
Reparative Cell Collection Apparatus
[0075] FIG. 6 is a schematic depiction of one embodiment of a
unitary apparatus for isolation of stromal vascular cells, wherein
the cells are collected without centrifugation. Apparatus 100
includes a digestion chamber 105 and a fat separation chamber
(a.k.a. lipid separation unit) 140. Digestion chamber 105 generally
refers to a housing that can receive and treat a biological sample
and can have various shapes and structures. The depicted digestion
chamber 105 includes at least two compartments, predigestion
chamber 102 and post digestion chamber 103, separated by digestion
mesh 101. The digestion chamber may optionally include a vent 116
that may include a filter 118 to preserve sterility such as, for
example, an ACRODISC brand syringe filter (Pall Scientific). In the
depicted embodiment, the digestion chamber 105 is cylindrical and
the pre and post digestion chambers are formed by placement of an
inner mesh cylinder 101 disposed within the digestion chamber. The
porosity of the digestion chamber mesh is selected based on various
desired properties including but not limited to a size sufficient
for small clusters of digested tissue to pass through the mesh
without rate limiting clogging of the mesh. In one embodiment the
digestion mesh has a plurality of holes or pores having an opening
size of approximately 2-0.5 mm. In one embodiment found to be
effective, the mesh is a nylon mesh having an average pore size of
approximately 1 mm.
[0076] Adipose tissue in extraction fluid or tumescent is
introduced via entry port 110 into predigestion chamber 102. The
extraction fluid or tumescent is able to drain through mesh 101 and
out drain port 127 and ultimately to waste port 115 for discard.
Valves 137 and/or clamps (not shown) control the pattern of flow,
as well as the action of pump 510. After draining of the extraction
fluid and optional washing if desired, a digestion buffer is added
to the predigestion chamber via a fill port such as fill port 112
and a digestion enzyme or cocktail of enzymes is added to the
predigestion chamber. The enzyme can be added together with the
digestion buffer if desired. In one embodiment found to be
effective, the buffer solution utilized was a lactated Ringer's
solution, however other physiologic buffers are suitable and are
readily envisioned by one of skill in the art. In the depicted
embodiment, the enzyme may be added through a dedicated port such
as fill port 112, which may be constructed in any number of ways
including for example as a valvable opening or as a self-sealing
septum. Optionally, a compound such as a poloxamer may be added to
improve flow and as an aid in maintaining cell viability. For
example, poloxamer 188 may be used at concentrations ranging from
about 0.05% (w/v) to about 5% (w/v). Further, heparin or low
molecular weight heparin may be added at concentration ranging from
1-100 U/ml, preferably between 10-30 U/ml, to reduce formation of
clot like clumps and recovery of a unicellular suspension.
[0077] A digestion period is then begun wherein the digestion
mixture is recirculated, typically through the action of a pump
such as for example roller or peristaltic pump 510. The direction
of flow is from predigestion chamber 102 through digestion mesh
101, into post digestion chamber 103, out drain port 127, and back
around into the predigestion chamber through recirculation port
113. This configuration provides ample volume for both chambers
and, as can be seen by the depicted arrows, the digestion mixture
is able to circulate around as well as through the digestion mesh
101.
[0078] As part of the recirculation loop the digestion mixture may
be passed through a heat exchanger loop 136 by the action of pump
510. In a preferred embodiment, equipment such as pump 510 and
heating element 520, shown surrounded by dashed lines, are adapted
to be operably attached to apparatus 100 via tubing but are part of
a reusable base unit that constitutes capital equipment in contrast
to apparatus 100, which is designed for clinical use to be a
disposable unit that does not require any electrically operable
components and can be supplied as a presterilized single use unit.
The heat exchanger loop 136 is heated by heating element 520 which
provides controlled heating to the heat exchanger loop for optimum
enzyme activity. As digestion continues an increasing greater
proportion of the adipose tissue is able to cross the digestion
mesh 101. In a preferred embodiment, the apparatus 100 is agitated
by shaking during the digestion period. After the adipose tissue is
sufficiently digested, the recirculation loop is ceased and the
digestion mixture is directed to fat or lipid separation unit 140.
In alternative embodiments, modulation of processing temperatures,
for example to control the activity of digestion enzymes, is
provided by enclosing the processing apparatus in a thermally
controlled chamber. Such a thermally controlled chamber may be used
together with, or in lieu of, use of one or more heat exchanger
loops.
[0079] In one embodiment, prior to allowing the digestion mixture
to enter the lipid separating unit, the unit is prefilled with a
separation buffer. In further embodiments of the present invention,
various compositions may be introduced into a lipid separating unit
to aid in phase separation. For instance, the separation buffer may
comprise separation facilitating compounds that may be introduced
into lipid separating unit 140.
[0080] The separation buffer may be added through various
mechanisms. In the depicted embodiment, a fill port 112 is provided
for separation buffer addition. In the lipid separation unit 140,
phase separation occurs and the lipid and lipid containing cells
float up through the separation buffer as depicted by the upward
directed thick dashed arrow and ultimately form a floating lipid
phase. The non-lipid containing cells, including a reparative cell
population, settle down. After a desired period wherein the lipids
have had time to migrate to the top of the chamber, the underlying
phase is removed via collection port 172. In the embodiment
provided in FIG. 6 flow patterns are depicted with the
recirculation of tissue during digestion depicted in solid lined
arrows while the digested mixture is depicted in dashed lined
arrows. In the depicted embodiment, apparatus 100 further includes
a dispersing head 168 having a plurality of pores 169 as the entry
port of fat or lipid separating chamber 140. In one embodiment, the
average pore size of the dispersing head is in the range of about
0.3 mm (300 microns) to about 1 mm (1000 microns), while in another
embodiment the average pore size is from about 0.4 mm (400 microns)
to about 0.6 mm (600 microns). In one embodiment, the dispersing
head has an average pore size of about 0.5 mm (500 microns).
[0081] In the depicted embodiment of FIG. 6, dispersing head 168 is
a substantially rigid structure designed to be located relatively
close to the bottom of the lipid separating unit 140. As depicted,
the dispersing head can be directed with its exit openings or pores
169 facing downward such that the fluid flow entering lipid
separating unit 140 is in the opposite direction of the buoyancy of
lipid-filled cells and thus further reduces clumps and releases
reparative cells trapped together with lipid-filled adipose cells.
Use of the dispersing head has been shown by the present inventors
to result in greater yield of reparative cells.
[0082] In the embodiment depicted in FIG. 6, a further dispersing
filter chamber 165 including dispersing filter 170 is included
in-line prior to the dispersing head 168 and is adapted to further
divide clumps of cells and to protect the dispersing head from
clogging. In one embodiment, the dispersing filter is dimensioned
to have a pore size ranging from about 0.2 mm (200 microns) to
about 0.3 mm (300 microns). In yet another embodiment, the
dispersing filter has an average pore size of about 0.25 mm (250
microns). However, one of ordinary skill in the art will recognize
other suitable filter sizes that can be used in the present
invention. Furthermore, one of ordinary skill in the art will
recognize that dispersing filter 170 can be in other forms or may,
in some embodiments, be eliminated entirely depending on the
configuration of the apparatus.
[0083] Likewise, one of ordinary skill in the art will recognize
that container 105 can have various other shapes and arrangements.
As with other embodiments, digestion chamber 105 is in fluid
communication with the lipid separating unit 140, and any
intervening filters, via a tubing network. The pattern of flow is
controlled by one or more valves 137 and/or clamps 138 as well as
the action of the pump. The embodiment depicted in FIG. 6 includes
a separate waste line 115.
[0084] As depicted in FIG. 6, the upper most portion 164 of the
lipid separating unit may have a greater diameter than the lower
portion to accommodate the floating fat layer. The embodiment
depicted in FIG. 6 also includes an optional seeding chamber 180,
which may include a cell seeding substrate or scaffold 185. Such a
seeding chamber may serve various functions. In one embodiment, the
chamber can contain the aforementioned substrate or scaffold on
which cells might be seeded as liquid is drained from the lipid
separating unit. In operation, reparative cells collected using the
apparatus can be directly disposed onto the cell seeding substrate
and either implanted on the patient or removed to an incubator for
further cellular expansion. In another embodiment, the chamber
might be adapted to allow buffer exchange. In further embodiments
of the present invention, chamber 180 may be entirely absent or may
be provided as a separate apparatus. In some of such embodiments,
lipid separating unit 140 may have a port and/or an opening for
passage of separated material.
[0085] In another embodiment, various chamber and compartment of
the apparatus might contain materials such as antibodies or
aptamers or thioaptamers that could be used to negatively select
for materials to be removed from the processed material for further
purification. Cell selection agents that may be introduced into
containers of the present invention generally refer to one or more
compounds for positive cell selection or negative cell selection.
For negative cell selection, such cell selection agents may aid in
the depletion of various cells from a biological sample, such as
the depletion of leukocytes and/or erythrocytes in one embodiment.
For positive cell selection, the cell selection agents may
specifically bind a desired cell type for isolation. Cell selection
agents suitable for use in the present invention may include,
without limitation, an antibody (see U.S. Pat. Nos. 6,491,918,
6,482,926, 6,342,344, 6,306,575, 6,117,985, 5,877,299, and
5,837,539), an aptamer (see U.S. Pat. No. 5,756,291), and/or a
thioaptamer (see U.S. Pat. No. 6,867,289), for example, all of
which are incorporated herein by reference in their entirety. In
some embodiments, the cell selection agents may also be immobilized
on the matrix or scaffold 185.
[0086] As depicted in FIG. 6, the lipid separating unit may
optionally include fill port 112 and a vent port 116 with sterility
filter 118. An additional collected cell filter 175 may be
optionally included prior to the seeding chamber 180 and may be
adapted to optionally provide for purification and sizing of
desired cells as well as to prevent clogging of downstream
components. Collected cell filter 175 is generally a circular
structure in the present example, though a person of ordinary skill
in the art could envision other shapes and structures.
[0087] In the example shown in FIG. 6, collected cell filter 175 is
desirably a filter with a pore size of less than about 250 microns.
However, in other embodiments, collected cell filter 175 can have a
pore size ranging from about 0.01 mm (10 microns) to about 0.1 mm
(100 microns). In another embodiment, collected cell filter 175 can
have a pore size ranging from about 0.03 mm (30 microns) to about
0.05 mm (50 microns). In a further embodiment, the average pore
size in collected cell filter 175 is about 0.037 mm (37 microns).
In additional embodiments, the collected cell filter may be
entirely absent.
Example 2
[0088] In one example, a reparative cell population was isolated as
follows. Lipoaspirate was collected under informed consent in the
operating room directly into a unitary purification apparatus by
standard suction assisted lipoplasty with tumescent. The apparatus
including tumescent fill was transported to the laboratory and
processed within 2 hours of collection. In practice however, it is
anticipated that the purification apparatus will be suitable for,
and will be used, in the operating suite. The digestion chamber of
the apparatus as depicted in Example 1 included a predigestion
chamber and an inner postdigestion chamber separated by a nylon
mesh having a pore size of approximately 1 mm. The tumescent was
drained and a volume of approximately 100 ml of drained
lipoaspirate was washed by draining the predigestion chamber and
refilling with a solution of lactated Ringer's solution, which was
prewarmed to 37.degree. C. containing a proteolytic enzyme
combination comprised of collagenase IV (60,000 U) and dispase (120
U). An additional 150 ml of lactated Ringer's was added to the
lipid separating unit. The digestion recirculation loop was
implemented by a pump actuated flow path from the predigestion
chamber into the postdigestion chamber and including passage across
a heat exchanger that maintains the digestion mixture at
approximately 37.degree. C. Recirculation was continued for
approximately 30 to about 60 minutes or until greater than 90% of
the cellular volume of the predigestion chamber was able to pass
the 1 mm mesh into the post digestion chamber. The design of the
pre and post digestion chambers, separated by the nylon mesh across
which the recirculation flow path passes repeatedly, provided
trapping of connective and other debris tissue on the digestion
mesh. After digestion was sufficiently complete, the digestion
mixture was pumped tangentially over a nylon dispersing filter
having a pore size of 250 .mu.m. The filtered digestion mixture was
then pumped into a columnar lipid separating chamber that was
integral to the apparatus. As previously mentioned, the lipid
separating chamber was prefilled with a volume of 150 ml lactated
Ringer's solution prior to introduction of the digestion mixture
such that when the filtered digestion mixture entered the chamber,
any clusters of cells including lipids or adipocytes, were subject
to fluid shear as the lipid moieties float upward in the aqueous
solution. The filtered digestion mixture entered the lipid
separating chamber through a dispersing head having a plurality of
downwardly directed pores with a pore size of 500 .mu.m and
disposed proximally to a bottom inner surface of the lipid
separating unit. The design was adapted for forcibly flowing the
cell mixture against an inner surface within the lipid separating
unit and thereby further disrupting cell clusters within the cell
mixture prior to fluid phase separation. Fluid phase separation was
allowed to proceed at room temperature for about 5 to about 30
minutes prior to collection of the stromal vascular fraction from
the bottom of the lipid separating chamber.
Example 3
[0089] After processing tissue in the device, cell viability and
cell number were determined. In one processing run, the collected
cells were plated at a density of approximately 7.times.10.sup.5
cells/cm.sup.2 into a T185 flask in MEM, 20% (v/v) FBS including
and antibiotic/antimycotic and cultured overnight at 37.degree. C.
in a humidified 95% O.sub.2, 5% CO.sub.2 atmosphere. After
overnight, non-adherent cells were harvested by aspiration, and
adherent cells were harvested by trypsinization. Immediately after
harvest, cells were processed for flow cytometry. Numbers represent
the net percentage positive cells after subtraction of background
(2' Ab only) and gating to remove debris. FIGS. 2A and B represent
data from two processing runs.
[0090] Cells collected as described in Example 2 have also been
characterized by direct analysis without separation into adherent
and non-adherent populations. The results are depicted in FIG.
3.
[0091] In comparing the cells isolated as disclosed herein with
mesenchymal stromal cells isolated using centrifugation and plastic
adherence in accordance with conventional preparation methods,
several notable differences are apparent. Mesenchymal stromal cells
have been classically isolated from adipose tissue using enzymatic
digestion, centrifugation to remove lipid filled cells and plastic
adherence with culture in vitro. These cells show a fibroblast-like
morphology. Although the cells are initially heterogeneous, the
phenotype of population changes in culture including loss of CD31+,
CD34+, CD45+ cells, and an increase in CD105 and other cell
adhesion type molecules. Generally, <10% of the cells express
markers associated with stemness (e.g., CXCR4, sca-1, SSEA-4) and a
substantial fraction differentiates into adipocytes in inductive
media. A lesser fraction differentiates into other lineages (bone,
cartilage, nerve) in inductive media.
[0092] The reparative cell population isolated as disclosed herein
without centrifugation or plastic adherence is also a heterogenous
population and generally <10% express markers associated with
stemness (e.g., CXCR4, Sca-1, SSEA-1, SSEA-4, VEGFr2, CD117, CD146,
Oct4). However, a substantial fraction of the early multipotent
stem cells are not plastic adherent. Importantly, a substantial
fraction of cells expressing markers of stemness, endothelial cell
lineages and/or exhibiting a small diameter 6 mm) are not adherent
and are lost using conventional isolation methods that rely on
plastic adherence or centrifugation.
Example 4
[0093] Cells were collected as essentially described in Example 2.
Digestion with warming, agitation, and recirculation was conducted
for 30 minutes. The resulting slurry was then pumped through a 250
.mu.M filter and into the lipid separating unit. After a 10 minute
static hold, the lower aqueous phase was collected, and cells from
this phase were concentrated by centrifugation at 400.times.g
before characterization. Cell yield was determined by counting with
a hemacytometer. Cell viability was assessed by two assays, trypan
blue exclusion using phase contrast microscopy and the Live/Dead
assay (InVitrogen, Inc) using a Coulter Epics XL-MCL cytometer.
[0094] Collected cells were characterized by cytometry using cell
surface markers CD31, 34, 44, 45, 71, 73, 90, 105, 117, 146,
SSEA-4, and Sca-1. All assays were performed using a Coulter Epics
XL-MCL cytometer. Cell preparations were plated in standard growth
medium and cultured overnight in a humidified, 37.degree. C., 95%
O.sub.2, 5% CO.sub.2 environment. Non-adherent cells were removed
by pipette, and adherent cells were detached by trypsinization.
Cells were layered onto ficoll and centrifuged at 1000.times.g to
remove erythrocytes prior to incubation with primary antibody.
Adherent and non-adherent cell populations were analyzed
separately, and then an estimate for surface marker profile in the
total population was calculated from cell counts and surface marker
profiles in the adherent and non-adherent populations. All assays
were performed with murine anti human antibody specific for the
target in question and FITC conjugated goat anti murine secondary
antibody.
[0095] Culture characteristic assays were performed as follows. For
determination of doubling time, 1.times.10.sup.6 adherent cells
from overnight culture were seeded in a 75 cm.sup.2 flask and
cultured for 4.about.5 days with medium changed every 2 days. Cells
were harvested by trypsinization and counted with a hemacytometer.
Doubling time was calculated based on cell count versus the number
of cells plated. For determination of colony forming units (CFU),
3.1.times.10.sup.5 cells were suspended in 3.1 ml growth media
(MEM, 20% FBS, antibiotic/antimycotic). Duplicate dilutions of
cells were prepared and plated at approximately
2.8.times.10.sup.4/cm.sup.2, 0.5.times.10.sup.4/cm.sup.2, and
0.1.times.10.sup.4/cm.sup.2 in 6 well plates. Cells were maintained
in a humidified 37.degree. C., 95% O.sub.2, 5% CO.sub.2
environment, and media was changed 2.times./week. Colony forming
units were scored after 7-14 days in culture. Cells were fixed and
stained with hematoxylin and pictures were taken under the
microscope from 5 fields per well at 25.times. magnification for
quantitation. Colonies with at least 10 fibroblast-like fusiform
cells clustered or piled together were counted. For colonies on the
edges of a microscopic field, only those that were judged to be
more than 50% within the field were included in the calculations.
Percent colony forming units was calculated from the number of
colonies relative to the total number of cells plated and averaged
across the three dilutions.
[0096] Results for subject demographics, cell yield, doubling time
and CFU are presented in FIG. 4. Mean total cell yield was
30.times.10.sup.6 cells from the 8 tissue samples processed in the
device described in Example 1. Cell yield for the two samples from
male subjects averaged 13.5.times.10.sup.6 whereas cell yield from
the 6 female subjects averaged 36.9.times.10.sup.6. Mean cell
viability was 82 and 83 percent for the two respective assays. Mean
percent CFU was 12%, ranging from 6.6 to 15.4.
[0097] Results for surface markers are presented in FIG. 5. Surface
markers for endothelial cells (CD31), hematopoietic progenitor
cells (CD34), leukocytes (CD45), mesenchymal stromal cells (CD44,
CD73, CD90) and progenitor cells (CD117, CD146, Sca-1, and SSEA-4)
were observed in all specimens. The high yield and viability of the
diverse population is considered by the inventors to be important
contributions provided by the method and apparatus of the
invention.
Scaffolds
[0098] In one embodiment of the invention, reparative cells are
localized onto a scaffold such that upon implantation a locally
high concentration of reparative cells, including stem cells, is
retained at the implantation site. A number of biocompatible
materials including biodegradable materials are known. Available
biocompatible materials include polytetrafluoroethylene (PFTE),
woven polyester (i.e. Dacron.RTM. fabric), open foam silicone
encased in microporous expanded PTFE (Evera Medical), stainless
steel, polypropylene, polyurethanes, polycarbonates, nickel
titanium shape memory alloys (i.e. Nitinol) and
cobalt-chromium-nickel alloys (Elgiloy). Although the synthetic
patches are not absorbed, they act as a scaffold onto which normal
tissue can grow and cover the defect, which is essentially
"scarred" into place after about 3-6 months depending on the
conditions of the defect. In addition to non-absorbable
biocompatible materials, there is a whole range of degradable and
bio-absorbable biomaterials that are suitable.
[0099] In one embodiment, biomaterials are seeded including, for
example, silk fibroin-chitosan, acellular dermal matrices (ADM)
derived from normal human skin, preformed biodegradable scaffolds
composed of polyglycolic acid (PGA) and poly L-lactic acid (PLLA)
(i.e. Vicryl.RTM. polyglactin woven mesh), and bioabsorbable
scaffolds coated with extracellular matrix (i.e. Dermagraft.RTM.
polyglactin woven mesh coated with extracellular matrix (ECM) laid
down by fibroblasts prior to cryopreservation). In one embodiment
of the invention, a bioabsorbable three-dimensional scaffold
composed of ECM is used as the cell scaffold for the freshly
isolated reparative cells of the invention.
[0100] Treatment of the surface of the scaffold, such as with the
above NaOH etching, can increase the adherence of stem cells. It
has been determined by the present inventors that a local
micro-roughness and the creation of niches increases not only the
adhesion but also enhances the three dimension incorporation of
stem cells into the material. The micro-roughness of the surface
structure can be increased by mechanical processes including by
embossing, blasting, such as particle blasting, or by plasma
etching, controlling the polymerization processes, heat
application, by chemical etching, and including by printing such as
by inkjet printing.
[0101] Where it is desired to increase the surface roughness of the
matrix, a micro-rough surface is generated wherein three
dimensional mounds of scaffold material or peaks, valleys and voids
are arrayed to provide surface irregularities at a periodicity of
1-100 .mu.m. In one embodiment the three dimensional mounds are
formed as ridges while in other embodiments the three dimensional
mounds are hemispherical. In other embodiments a pattern of ridges
and hemispherical mounds is formed. Alternatively, or in addition,
a spongy surface characterized by voids is provided.
[0102] In one embodiment of the invention, scaffolds are provided
that are characterized by a spongy texture formed by subjecting the
nascent scaffold material to a partial vacuum during polymerization
or drying. Desolved gases in the uncured scaffold solution expand
and form bubbles that are induced to rupture just as curing is
completed thus forming a plurality of voids and pockets that
together result in a sponge like composition having a vastly
increased surface area. In one embodiment, the formation of bubbles
is enhanced by inclusion of a frothing agent into the uncured
scaffold material such that bubble formation is enhanced by
application of the vacuum.
[0103] In the case of printing such as with inkjet type printing,
an array can be deposited according to a programmed pattern
including patterns forming a plurality of surface structures. In
other embodiments, printing such as with inkjet type printing is
further utilized to apply a plurality of different substrate
materials and/or growth factors arrayed on the surface thus
promoting the growth of disparate cell types in a virtual tissue
pattern.
[0104] Collagen:
[0105] Collagen is another biomaterial that is suitable for use
with mixed reparative cell populations, both for the process for
the selection and adhesion of stem cells, and as a local carrier
and matrix or as an adhesion matrix when coated onto other
materials. FDA approved Type 1 collagen products, such as those
available from Collagen Matrix, Inc., Franklin Lakes, N.J., are
commercially available. Such collagens are especially useful for
external application such as non-healing wounds and burns, soft
tissue defects, cosmetic surgery, and for nerve repair wherein a
collagen sleeve serves as a conduit between the interrupted nerve
ends.
[0106] Bioresorbable Silica Gel Matrix:
[0107] In another embodiment, a very recently developed
bioresorbable silica gel matrix is seeded with fresh reparative
cells. The matrix of silica gel fibers, developed by Dr. Jorn
Probst and Dipl.-Ing. Walther Glaubitt at the Fraunhofer Institute
for Silicate Research ISC in Wurzburg, is shape-stable, pH-neutral
and 100 percent bioresorbable. The fibers are produced by means of
wet-chemical sol-gel process in which a transparent, honey-like gel
is produced from tetraethoxysilane (TEOS), ethanol and water in a
multi-stage, acidically catalyzed synthesis process. The gel is
processed in a spinning tower which produces fine endless threads
which are collected on a traversing table and spun in a specific
pattern to produce a multi-layer textile web which can be cut to
desired size and sterilized prior to loading into a seeding
chamber.
[0108] Highly pliable biomaterials loaded with reparative cells can
be locally wrapped around the tissue or inserted into a tissue
defect where it is desirable to localize cells for repair at an
increased local concentration. This is especially useful where the
scaffold can be integrated surgically into the defect when carrying
cells for nerve repair, wrapping around non-healing bone fractures,
ruptures or injuries to tendons, which normally show a very slow
rate of healing, applications in repair of cartilage defects in
joints or of scars and injuries to skin and the underlying tissue
and also for plastic, cosmetic, aesthetic repair. In addition, a
repair such as an entubulation, or a wrapping around of venous
structures, lymphatic vessels, and nerves is also a target of the
cell loaded scaffolds disclosed herein.
[0109] Acellular Dermal Matrix Scaffolds:
[0110] In one embodiment of the invention, acellular dermal matrix
(ADM) pre-seeded with reparative cells prior to implantation is
provided for treatment of soft tissue injuries including abdominal
wall compromise and soft tissue loss secondary to traumatic and
oncologic processes. Human acellular dermal matrix (ADM) has become
widely used in plastic surgery because it is non-immunogenic,
mechanically robust and has favorable handling characteristics.
Recent reports have suggested that the post-engraftment mechanical
behavior could be enhanced by cell seeding. (Erdag G, Sheridan R L.
"Fibroblasts improve performance of cultured composite skin
substitutes on athymic mice" Burns 30(4) (2004) 322e8; Fuchs J R,
et al. "Diaphragmatic reconstruction with autologous tendon
engineered from mesenchymal amniocytes" J Pediatr Surg 39(6) (2004)
834e8). Additionally, others have shown that seeding
adipose-derived stromal cells on a carrier bioprosthetic material
facilitated new bone formation in the treatment of a bony defect.
(Cowan C M, Shi Y Y, Aalami O O, Chou Y F, Mari C, Thomas R, et al.
"Adipose-derived adult stromal cells heal critical-size mouse
calvarial defects" Nat Biotechnol 22(5) (2004) 560e7). Thus, a
cell-seeded matrix is believed to offer some benefits for
introducing cells to the local environment as it provides a
framework for the support of their regenerative capacity. ADM
provides a three-dimensional scaffold into which seeded cells could
incorporate and help to build the foundation for the integration of
local tissue with the graft.
Example 5
[0111] Human adipose tissue was obtained from elective body
contouring procedures and the tissue digested with a solution of
0.07% Blendzyme 3 (F. Hoffman-La Roche Ltd, Basel, Switzerland)
with mild agitation at 37.degree. C. for 60 minutes. The digest was
passed through a 100 .mu.m filter, then through a 40 .mu.m filter
and finally though a 10 .mu.m filter. The filtered material was
centrifuged at 1500 RPM for 10 minutes and resuspended in
1.times.PBS. Following a second centrifugation the cells were
resuspended in MEM containing 20% FBS, 2 mM L-glutamine, 100 U/ml
penicillin, and 100 .mu.g/ml streptomycin and selected based on
adherence to T75 tissue culture flasks for 24 hours after which
non-adherent cells and debris were discarded by aspiration.
Adherent cells were incubated in a 5% CO.sub.2-containing chamber
at 37.degree. C. with medium changed every 3 days. ADSCs between
passages 1 and 6 were used for all experiments.
[0112] For seeding of the grafts, six-mm diameter ADM pieces
(Alloderm.RTM. Lifecell) having a thickness of 0.53-0.76 mm were
placed completely covering the well bottom in 96-well plates with
the papillary dermal surface facing up and the grafts were covered
with 200 .mu.l aliquots of medium alone in the ADM group and with
equal volume of cell suspension containing 1.times.10.sup.5 ADSC in
ADSC-ADM group. Grafts were incubated under standard culture
conditions for 24 hours after which overlying medium or cell
suspension was aspirated. The grafts were flipped to place the
opposite reticular dermal surface facing up, and the corresponding
medium or cell suspension solution was placed on the other side.
Grafts were then incubated for 24 hours and transferred to the
operating suite for surgical engraftment.
[0113] FIG. 11 is a scanning electron micrograph (SEM) of unseeded
ADM at a magnification of 100.times.. As can be seen in FIG. 11,
the ADM is characterized by a surface having three dimensional
mounds and ridges at a periodicity of 10-100 .mu.m. FIG. 12 is a
SEM of the ADM seeded with ADSC. As can be seen in FIG. 12, the
seeded cells spread out on the rough surface. FIG. 13 represents a
1,000.times. magnification of unseeded ADM, wherein it can be seen
that the ADM not only presents a surface having three dimensional
mounds and ridges at a periodicity of 10-100 .mu.m but also
presents surface irregularity on a scale of 1-10 .mu.m. FIG. 14
represents the ADM at 1000.times. magnification now seeded with
ADSC where it can be seen that the ADSC are spread out and adherent
to the surface of the matrix.
[0114] Once on the operative field, grafts were transferred to a
sterile 6-well plate and washed gently in 2.times.500 .mu.l
aliquots of PBS to remove any non-adherent cells or medium. For the
main study groups of seven athymic nude mice were randomized to one
of three treatment groups: no graft, ADM alone or ADSC-ADM. Animals
in each group received one 6 mm punch lesion and a graft-based
repair depending on group randomization.
[0115] Human adipose-derived stem cells have been well
characterized with regard to profile of expressed surface cluster
of differentiation (CD) markers. The ADSCs were negative for the
pan-leukocyte marker CD45, separating them from the hematopoietic
lineage. They were also negative for the integrin CD11b (alpha-M
chain), an adhesion molecule characteristically found on
macrophages and leukocytes. The ADSCs were positive for CD44
(99.+-.1%), CD90 (98.+-.3%), CD105 (98.+-.2%).
[0116] Analysis of wound healing rates (rate of wound contraction)
was defined as the gross epithelialization of the wound bed. A
statistically significant increased rate of epithelialization in
the ADSC-ADM group compared to the no-graft and ADM groups was
noted at postoperative day 7. Percent wound closure at post-op day
7 was 56.+-.21% in the no-graft control group, 57.+-.21% in the ADM
group and 77.+-.4% in the ADSC-ADM group (p.ltoreq.0.05). Closure
of wounds in the ADSC-ADM group still was significantly greater
than in the no-graft group at post-op day 10, although the
differences between the three groups diminished over time as would
be expected. Because the ADSC were transfected with a vector
expressing Green Fluorescent protein (GFP) prior to seeding of the
grafts, the status of the ADSC could be monitored during wound
healing. It was found that the ADSC actively proliferated post
transplantation and could be detected in the graft at 28 days,
almost two weeks after complete wound closure. Certain of the ADSCs
engrafted into the cutaneous wound milieu via the ADSC-ADM
construct demonstrated a microvascular endothelial phenotype by 2
weeks postoperatively, contributing directly to the establishment
of a vascular network in the context of tissue regeneration. No GFP
expressing cells were detectable at locations 2 cm from the graft,
nor in the spleen, liver or kidneys, indicating that the
transplanted cells were locally persistent to the site of
engraftment.
[0117] The findings demonstrated that a construct created by the
seeding of adipose-derived stem cells upon human dermal matrix
could be used as an effective delivery vehicle in vivo.
Furthermore, the use of an AD SC-seeded ADM construct significantly
enhanced the rate of wound healing at postoperative day 7. Finally,
it was demonstrated that human adipose-derived mesenchymal stem
cells delivered via an ADSC-ADM construct persist locally and do
not distribute systemically, providing anatomically directed
support to tissue regeneration at the desired site of surgical
engraftment.
[0118] As an important finding of this study, it was shown that
human adipose-derived stem cells delivered via dermal matrix
differentiated into derivatives of two germ layers in the setting
of this murine cutaneous wound healing model. Ectoderm derivatives
were noted at 4 weeks at which time GFP positive stem cells were
seen to co-localize with stain against cytokeratin 19, an element
of epidermal epithelium, indicating differentiation into epidermal
epithelial cells. Spontaneous mesoderm-derivative differentiation
patterns were evidenced by GFP-positive ADSCs co-staining with
HSP47, an indicator of a fibroblastic differentiation fate. Further
evidence of mesodermal differentiation paths was observed with the
identification of smooth muscle actin (SMA)-positive and von
Willebrand Factor-positive engrafted GFP cells, appearing
structurally integral to and associated with neo-vascular
structures. This finding is consistent with the recent report by Wu
and colleagues on the ability of 1.times.10.sup.6 mesenchymal stem
cells delivered to the cutaneous wound to differentiate into
various dermal appendages. (Wu Y, et al. "Mesenchymal stem cells
enhance wound healing through differentiation and angiogenesis"
Stem Cells 25(10) (2007) 2648-59).
[0119] Consistent with the observed enhanced rate of wound healing,
a circumferential halo of hyperemia was noted at the margins of the
healing wounds in the ADSC-ADM group, observed most prominently at
postoperative day 7, which was not seen in the no-graft or ADM
groups. Kim and colleagues recently reported on markedly enhanced
rates of gross wound closure in athymic mice treated locally with a
dose of 1.times.10.sup.6 ADSCs. (Kim W S, et al. "Wound healing
effect of adipose-derived stem cells: a critical role of secretory
factors on human dermal fibroblasts" J Dermatol Sci 48(1) (2007)
15-24). The present study indicates that with the use of a carrier
system a therapeutic effect is facilitated with only a fifth of the
cells (2.times.10.sup.5).
[0120] Silk-Chitosan Scaffolds:
[0121] In one embodiment of the invention, a particularly treated
blend of silk fibroin and chitosan is provided that is pre-seeded
with reparative cells prior to implantation. The fibers of silkworm
silk consist of two main proteins, fibroin, which is the structural
center of the silk fiber and sericin, which is the sticky material
surrounding the fibroin. Silk fibroin is a .beta.-keratin material
known to be a reliable suture material with mid-range degradation
kinetics and solid mechanical strength. Silk fibroin which has
unique biocompatibility features including its degradation
products. Silk fibroin degrades to amino acids, which are natural
to the body.
[0122] Chitosan is a naturally occurring polysaccharide composed of
alternating acetylated and deacetylated D-glucosamine residues. The
polysaccharide is derived from the deacetylation of the exoskeleton
of crustaceans and having the chemical formula
Poly-(1-4)-2-Amino-2-deoxy-.beta.-D-Glucan as reflected in the
following structure:
##STR00001##
[0123] Chitosan has been used clinically in hemostatic wound
dressings and is emerging as a promising constituent of novel
biocompatible matrices in tissue engineering. (Khor E, Lim L Y.
"Implantable applications of chitin and chitosan." Biomaterials
24(13) (2003) 2339-2349). Chitosan degrades to sugars, also part of
the body's metabolism and easily incorporated into other metabolic
products. Since the degradation of the product does not change the
local pH, there is no adverse effect such as observed with
polyglucolic or polylactic acids, whose degradation reduces the
local pH and causes a sterile inflammatory response.
[0124] Silk fibroin combined with chitosan has been found to be
useful in repair of tissue defects. See e.g. Gobin A S, Butler C E,
and Mathur A B. "Repair and regeneration of the abdominal wall
musculofascial defect using silk fibroin-chitosan blend." Tissue
Eng 12(12) (2006) 3383-3394. Silk fibroin can be blended with
chitosan at different ratios including 25:75, 50:50, 60:40, or
75:25, with the different ratios providing different physical
characteristics.
Example 6
[0125] Silk fibroin-chitosan scaffolds were prepared in a series of
steps. The sericin coating of raw silk fiber was removed via
degumming. Solutions of 0.25% (w/v) sodium dodecyl sulfate
(Sigma-Aldrich, St. Louis, Mo.) and 0.25% (w/v) sodium carbonate
(Sigma-Aldrich) were dissolved and heated to 100.degree. C. Silk
was added at 1:100 w/v, heated for 1 hour, followed by draining of
the alkaline soap solution. Degummed silk was rinsed in running
distilled water, air-dried, and then dissolved in calcium nitrate
tetrahydrate-methanol (molar ratio 1:4:2 calcium:water:methyl
alcohol) at 65.degree. C. The silk fibroin (SF) was dissolved at
10% (w/v) concentration over a 3-h period with continuous
stirring.
[0126] Chitosan (CS) solution was prepared by 2% acetic acid
dissolution of high-molecular-weight chitosan (82.7% deacetylation;
Sigma-Aldrich). Under continuous stirring, SF and CS solutions were
combined for preparation of 75:25 (v/v) SF:CS blend, followed by
mixing for 30 minutes, and then dialysis (molecular weight cutoff,
6-8 kDa) for 4 days against deionized water.
[0127] Forty ml of SFCS blend solution was added to a glass Petri
dish and then non-directionally frozen overnight at -80.degree. C.,
followed by 2-day lyophilization. Dry samples were treated in a
50:50 (v/v) methanol:1N sodium hydroxide (NaOH) solution for 15
minutes for SF crystallization and CS neutralization. Methanol:NaOH
was then replaced by 1 N NaOH for 12-18 hours. NaOH was removed by
dilution in phosphate-buffered saline (PBS, 1.times.) with
sequential changes of solution hourly for 4 hours and then
quarter-hourly until pH equilibration at 7.0. Samples were
sterilized with 70% ethanol immersion for 12-18 hours, and
subsequently rinsed in sterile PBS prior to in vitro cell seeding
and subsequent in vivo engraftment. Final scaffold thickness was
1.5 mm.
[0128] In other embodiments, thin sections of SFCS were fabricated
using a 75:25 SFCS blend. One ml of a 75:25 SFCS blend was added to
a flexiperm mold adhered to a glass slide and oven dried at
.about.60.degree. C. overnight. The SFCS film was treated with
50:50 (v/v) methanol:1N NaOH for 15 minutes for SF crystallization
and CS neutralization. The methanol:NaOH was replaced by 1 N NaOH
for 12-18 hrs and the NaOH removed by dilution in PBS 2-3.times.
for 30 minutes until the pH equilibrated at 7.0. Again the SFCS
film was sterilized by 70% ethanol immersion for 12-18 hours. After
rinsing with sterile PBS the SFCS scaffold was ready for
seeding.
[0129] In an experiment to test the functionality of pre-seeded
silk-fibroin grafts made as described above versus unseeded grafts,
human ADSC-seeded SFCS were tested as a cyto-prosthetic hybrid for
reconstructive support in a murine cutaneous wound healing model.
ADSC-SFCS were found to support the delivery and engraftment of
stem cells as well as differentiation into fibrovascular and
epithelial components. Human adipose tissue was obtained from
elective body contouring procedures and the tissue digested with a
solution of 0.07% Blendzyme 3 (F. Hoffman-La Roche Ltd, Basel,
Switzerland) with mild agitation at 37.degree. C. for 60 minutes,
passed through a 40 .mu.m filter and finally selected based on
adherence to T75 tissue culture flasks at 24 hours. Cells were
grown in alpha MEM medium supplemented with 20% fetal bovine serum,
2 mM L-glutamine, 100 U/ml penicillin, and 100 .mu.g/ml
streptomycin. Cells were incubated in a 5% CO.sub.2-containing
chamber at 37.degree. C. with medium changed every 3 days. ADSCs
between passages 1 and 8 were used for all experiments. ADSCs used
in these experiments have been previously characterized and the
multi-lineage differentiation potential of these cells
demonstrated. (Bai X, et al. "Electrophysiological Properties of
Human Adipose Tissue-Derived Stem Cells." Am J Physiol Cell Physiol
293(5) (2007) C1539-50).
[0130] For seeding of the grafts, six-mm diameter SFCS grafts were
placed completely covering the well bottom in 96-well plates and
the grafts were covered with 200 .mu.l aliquots of medium alone in
the SFCS group and with equal volume of cell suspension containing
1.times.10.sup.5 ADSCs/cm.sup.2 in the ADSC-SFCS group. Grafts were
incubated under standard culture conditions for 24 hours after
which overlying medium or cell suspension was aspirated. The grafts
were flipped to place the opposite surface facing up, and the
corresponding medium or cell suspension solution was placed on the
other side. Grafts were then incubated for 24 hours and transferred
to the operating suite for surgical engraftment. Once on the
operative field, grafts were transferred to a sterile 6-well plate
and washed gently in 2.times.500 .mu.l aliquots of PBS to remove
any non-adherent cells or medium. For the main study ten animals
were randomized to one of three treatment groups: no graft, SFCS
alone or ADSC-SFCS. Animals in each group received one 6 mm punch
lesion and a graft-based repair depending on group
randomization.
[0131] Wound closure was measured by planimetric analysis and
revealed a wound closure at post-op day 6 of 46.+-.15% in the
control group receiving no graft, 58.+-.9% in the SFCS group and
72.+-.5% in the ADSC-SFCS group (p.ltoreq.0.05). Post-op day 8
values were 55.+-.17% in the no graft group, 75.+-.11% in the SFCS
group and 90.+-.3% in the ADSC-SFCS group (p.ltoreq.0.05). Wound
bed analysis of fresh tissue mounts demonstrated a markedly
enhanced extent of wound closure in the ADSC-SFCS group in
comparison to both the SFCS and no-graft control groups at post-op
day 9. Close inspection of images under intense illumination
revealed an apparent more robust invasion of vascular tissue,
characterized by hyperemia, in the SFCS and ADSC-SFCS groups versus
no-graft controls. Furthermore, the extent of vascular infiltration
of the surrounding tissue in the region of the operative site was
greater in qualitative magnitude in the ADSC-SFCS group versus the
SFCS group (data not shown). Mean micro-vessel density in the
ADSC-SFCS group at 2 weeks post-op was 7.5.+-.1.1 vessels/high
power field, while density in the SFCS group at two weeks was
5.1.+-.1.0 vessels/high power field (p.ltoreq.0.05). There was no
evident inflammatory infiltrate (no polymorphonuclear cell
infiltration, no giant cells noted) on any H&E stains of wound
bed biopsies at two weeks, indicating excellent biocompatibility of
engrafted SFCS. FIGS. 13 and 14 are scanning electron micrographs
of SFCS seeded with ADSC. As can be seen in the images, the ADSC
preferentially adhere to regions having surface structure or
micro-roughness.
[0132] This study showed that a 75:25 silk fibroin-chitosan blend
acts as a scaffold for the seeding and in vivo delivery of human
adipose-derived stem cells and confers the physiologic benefits of
accelerated wound closure. Histological analysis showed that the
ADSCs engraft, proliferate and differentiate into fibroblastic,
vascular, and epithelial phenotypes in their new microenvironment
and that such seeded grafts potentiate local vascular ingrowth. The
culture-expanded ADSCs were shown to adhere to a SFCS substrate in
the range of 75% adhesion by one hour post-seeding, with adherent
stem cells occupying both surface and three-dimensional elements of
the scaffold. The clear engraftment of ADSCs into regenerating
tissue in this study differs from previous reports where the
engraftment of therapeutically introduced mesenchymal stem cells
has been either un-observable or observable only at low levels.
(Prockop D J. "`Stemness` does not explain the repair of many
tissues by mesenchymal stem/multipotent stromal cells (MSCs)" Clin
Pharmacol Ther. 82(3) (2007) 241-243).
[0133] Successful seeding of grafts has been conducted with fresh
SVF cells as well and provides the further benefits of larger
numbers of cells loaded on the graft and a greater population
diversity as well.
Seeding of the Matrices
[0134] Cells for regenerative medicine can be delivered as a
suspension, including delivery of suspensions of cells to specific
target compartments. For example, one of the present inventors has
disclosed a process for repairing tissue by delivering stem cells
to a site of the tissue to be repaired through the vascular tree or
the pre-existing distribution trees in the body and that such focal
application of cells is beneficial, for example for repair of a
patient's heart, brain, liver, kidney, pancreas, lungs, nerves, and
muscles. (Alt, E., U.S. Pat. No. 6,805,860 and related CIP
application issuing as U.S. Pat. No. 7,452,532).
[0135] While delivery of cell suspensions may be indicated in
certain tissue repair or regeneration applications, in other
indications it may be desirable to localize the cells in high
concentration on a matrix or scaffold in order to provide a locally
enriched population of desired cells and to retain their presence
at the site of desired action until healing is well underway.
Provided herein are methods and compositions that are able to seed
and retain cells of interest on a biocompatible scaffold. Also
provided are methods to most effectively use the scaffold in
conjunction with a freshly isolated cellular preparation that
avoids a need for culturing of the cells. In other embodiments,
methods and compositions are provided to selectively enrich for
cells that are desired in specific tissue regeneration applications
based on their adherence to different biomaterials, while removing
cells that may be detrimental to the tissue repair or regeneration
process.
[0136] In one embodiment of the invention, the reparative cell
population is isolated as above and immediately seeded onto a
biocompatible matrix. In other embodiments, the stromal vascular
fraction is isolated and subject to culture to isolate the adherent
cells that have been characterized as mesenchymal stromal cells.
The adherent cells are seeded onto scaffolds and, as further shown
herein, will adhere to the scaffold within 2 hours and preferably
within one hour.
[0137] In one embodiment of the invention, the reparative cell
isolation apparatus such as that depicted in FIG. 6 includes an
in-line seeding chamber 180. For example, as described in FIG. 7,
the SVF fraction is removed from under the lipid containing layer
in the lipid separating chamber 140 and the SVF cells are pulled or
pushed into the seeding chamber 180 by the action of a pump (not
shown) that can be place up or downstream of the seeding chamber.
For example, where a porous scaffold is used, the cells can be
forced into rapid contact with the surface of the scaffold when the
fluid medium containing the cells is pulled through the scaffold.
After a contact time whereby a desired % of the desired cells have
adhered to the scaffold, nonadherent cells and debris are removed
through nonadherent conduit 187. In other embodiments, the seeding
chamber 180 is a separate apparatus or unit from the isolation
apparatus 100.
[0138] Optionally, a porous cell retentive membrane having pore
size between 0.2 and 5 .mu.m, preferably between 1 and 3 .mu.m is
situated immediately beneath the porous cell scaffold. The cells
are forced into rapid contact with the surface of the scaffold when
the fluid medium containing the cells is pulled through the
scaffold and retained in contact or close proximity to the porous
cell scaffold by the porous cell retentive membrane. Media to
enhance cell adherence of desired reparative cells to the membrane
may be introduced at this time. Media may include, but not be
limited to, cell culture media supplemented with the patient's own
plasma or serum, carbohydrates such as carboxymethyl dextran or
iron dextran, or cold insoluble globulin. After a contact time of 5
minutes to 2 hours, non-retained cells and debris are removed
through conduit 187. Media or porous membrane composition that may
further support cell survival following implantation in situ may
also be incorporated for example inclusion of local oxygen delivery
component (U.S. Pat. No. 7,160,553). In other embodiments, the
seeding chamber 180 is a separate apparatus or unit from the
isolation apparatus 100.
[0139] In one embodiment, the seeding chamber 180 is a disposable
unit that is loaded with the scaffold 185 before the cell isolation
begins. The shape and size of this scaffold is adaptable to its
intended clinical use, including shape and dimension and two or
three dimensional configuration.
[0140] In one embodiment, as depicted in FIG. 7, procedural steps
in use of a seeding chamber include the following: SVF or MSC are
conveyed to a seeding chamber which is adapted for use depending on
a configuration and cell selection criteria tailored to the tissue
to be repaired. The cells are introduced into the seeding chamber
in a way that promotes physical interaction between the cells and
the matrix material of the scaffold and a certain contact time
between 15 and 120 minutes is allowed for desired cells to attach
and/or migrate into structure of the scaffold, following which
cells that have not adhered to the scaffold are evacuated or washed
from the seeding chamber.
[0141] In one embodiment of the invention as depicted in FIG. 8, a
series of selective seeding chambers are utilized in serial
fashion. For example, SVF cells are isolated and directed into
selective seeding chamber A wherein scaffold A is adapted to
selectively bind a population of cells on the basis of an "A"
ligand. Non-adherent cells lacking the "A" ligand are washed from
the A chamber and directed to selective seeding chamber B, which
contains selective scaffold B, which is adapted to selectively bind
a population of cells on the basis of a "B" ligand. Non-adherent
cells lacking both the "A" and "B" ligand are washed from chamber B
and collected. Adherent cells in chambers A and/or B may be
collected after release from the scaffolds. The selective seeding
chambers may be used for either positive or negative selection in
the generation of specific cell populations.
[0142] In one embodiment of the invention, introduction of the
reparative cells onto the scaffold is facilitated by pulling the
cells through a porous scaffold in such a way that physical contact
between the cells and the surface of the scaffold is promoted. For
example, the seeding can be enhanced by vacuum or other physical
force applied to the cells to force the cells into physical contact
with the matrix or scaffold. In one embodiment of a seeding chamber
and method of use thereof, the cells are introduced to the chamber
prior to an attachment period of less than 2 hours. For use, the
scaffold is removed from the seeding chamber and applied to or
implanted at the target site on a human or animal patient.
[0143] FIG. 9A depicts one embodiment of a seeding chamber 180
wherein cells to be seeded onto scaffold 185 are introduced into
seeding chamber 180 through inlet 181. In the depicted embodiment,
scaffold 185 is mounted in the chamber in such a way that a fluid
entering the chamber from inlet 181 may not leave through outlet
186 without passing through the scaffold 185. In the depicted
embodiment, the scaffold 185 is supported by porous support 190.
The chamber is designed so that no fluids can pass to outlet 186
without going through the scaffold 185. In this way, a pump or
other partial vacuum source (not shown) disposed in fluid
communication with outlet 186 is able to pull fluids through the
scaffold and any cells entering the chamber will be rapidly pulled
into contact with the scaffold. In the embodiment depicted in FIG.
9A, the top of the chamber includes a plurality of ribs 194 that
are arrayed to convey fluid entering the chamber down channels 192
such that cells are relatively evenly dispersed over the scaffold
surface. The top and bottom aspects of the chamber are connected by
a resealable closure such as threaded closure 195, which enables
ready opening of the chamber for insertion of the scaffold as well
as removal of the cell seeded scaffold.
[0144] FIG. 9B depicts an alternative embodiment of a seeding
chamber 180. Again cells to be seeded onto scaffold 185 are
introduced into seeding chamber 180 through inlet 181. In the
depicted embodiment, the upper portion of the chamber includes a
port 187 whereby media can be exchanged, additive introduced, and
cells that do not adhere to the scaffold can be drawn off after an
incubation period. In the embodiment depicted in FIG. 9B, cells are
relatively evenly distributed over the scaffold by a plurality of
channels 192 that are manufactured into the lid or top of the
chamber. Also in the depicted embodiment, the scaffold 185 is
supported by a plurality of supports 196. Porous support 190 may
not be necessary or desired. In one embodiment, the supports 196
represent the upper aspect of a grid or spiral or labyrinthine form
having a plurality of drainage holes. The flow of fluid through the
scaffold is essentially perpendicular to the plan of the scaffold
as depicted by the arrows.
[0145] FIG. 10 depicts a seeding chamber according to one
embodiment of the invention. Cells to be seeded onto porous
scaffold 185 are introduced into seeding chamber 180 through inlet
181. In the depicted embodiment, porous scaffold 185 is mounted in
the chamber in such a way that a fluid entering the chamber from
inlet 181 may not leave through outlet 186 without passing through
the scaffold 185. In one embodiment, a sealing ring 182 insures
that no fluids can pass to outlet 186 without going through the
scaffold 185. In this way, a pump or other partial vacuum source
(not shown) disposed in fluid communication with outlet 186 is able
to pull fluids through the scaffold and any cells entering the
chamber will be rapidly pulled into contact with the scaffold.
[0146] After a predetermined attachment period, wash outlet 187 is
opened and non-adherent cells and debris are pulled out of the
chamber. If desired, a selective red blood cell lysis can be
undertaken in the chamber, using for example hypotonic solutions,
surfactants, ammonium chloride (155 mM NH.sub.4Cl, 10 mM
KHCO.sub.3), carbamates (U.S. Pat. No. 7,300,797) etc., without
compromising the viability of the nucleated cells.
[0147] Typically, as depicted in FIG. 10 the chamber 180 is
constructed such that it can be opened after cells have been
deposited on the scaffold and the scaffold removed for implantation
or further processing.
Example 7
[0148] In one embodiment of the invention, the reparative cell
population is contacted with the scaffold for less than about 90
minutes while in other embodiments, a contact time of approximately
60 minutes or even less is sufficient. A relatively short contact
time was found to be effective in inducing the adherence of greater
than 90% of adipose derived stem cells to a bioabsorbable ADM
matrix. ADSCs were isolated from discarded adipose tissue obtained
at body contouring procedures according to standard methodology for
isolating mesenchymal stromal cells. Briefly, lipoaspirate was
washed with sterile phosphate-buffered saline (PBS). Washed
aspirates were treated with a mixture of collagenase and neutral
protease in PBS for 30 min at 37.degree. C. with agitation. The
enzyme was inactivated with an equal volume of DMEM/10% fetal
bovine serum (FBS) and the cells were collected by centrifugation
for 10 min at low speed. The cellular pellet was resuspended in
DMEM/10% FBS and filtered through a 100 .mu.m mesh filter to remove
debris. The filtrate was centrifuged as before and plated onto
conventional tissue culture plates DMEM/20% FBS for culture.
Non-adherent cells were removed after 24 hours by aspiration and
the adherent cells were expanded in culture with media changes at 3
day intervals. Cells at passage 1-8 were used for experiments.
[0149] ADM of thickness 0.4 to 0.8 mm was obtained (AlloDerm.RTM.,
LifeCell, Branchburg, N.J. and FlexHD.TM., MTF, Edison, N.J.).
Passage 1-5 cell suspensions in growth medium were seeded into
multi-well plates covered with ADM with the papillary dermis side
facing up at a density of 5.0.times.10.sup.4 cells/cm.sup.2 for
histology, 7.5.times.10.sup.4 cells/cm.sup.2 for quantitative
studies, and 1.0.times.10.sup.6 cells/cm.sup.2 for scanning
electron microscopy (SEM).
[0150] Adherence was quantified by fluorescent cell counts at 15,
30, 60 and 120 minutes. Specimens for histology and SEM were seeded
and incubated under standard culture conditions for 24 hours.
Specimens were hematoxylin and eosin (H&E) stained. SEM was
performed using adaptations of established methodology.
[0151] The ADSCs were negative for the leukocyte markers CD45 and
CD11b, and positive for the intermediate filament nestin, CD44,
CD90, and CD105. Quantitative adhesion experiments revealed very
rapid adherence of ASC to the ADM. It was found that 543.+-.62
cells/mm.sup.2 adhered at 15 minutes (71%), 688.+-.69
cells/mm.sup.2 adhered at 30 minutes (92%), 713.+-.63
cells/mm.sup.2 adhered at 60 minutes (94%), and 727.+-.54
cells/mm.sup.2 adhered at 120 minutes (96%). H&E and SEM
analysis confirmed stem cell adhesion to ADM.
[0152] This experiment showed that the AdSC components of the
reparative cell mixture are able to rapidly bind to a bioabsorbable
ADM matrix. Thus, the ADSC present in the reparative cell mixture
can be seeded onto a matrix and be available for implantation in
one operative procedure. The observation that ADSCs adhere to ADM
at high rates within a two-hour time frame is significant.
Furthermore, SEM identified active attachment of stem cells to ADM
with the extension of microvilli and lamellopodia acting as focal
anchorage points.
Example 8
[0153] The rapid seeding of SFCS scaffolds was also tested to
confirm the feasibility of point of care seeding of scaffolds. ADSC
were isolated as described in Example 5 and seeded onto SFCS
scaffolds produced as described in Example 4. For adhesion studies,
cells were transfected with green fluorescent protein as described
by Zhang et al. "Transduction of bone-marrow derived mesenchymal
stem cells by using lentivirus vectors pseudotypes with modified
RD114 envelope glycoprotains" J. Virol. 78 (2004) 1219-29.
Adherence was qualified by direct triplicate counts of adherent GFP
positive cells.
[0154] It was shown that 75% of a population of ADSC would bind to
a SFCS scaffold within 60 minutes. Specifically, in one experiment
the numbers of adherent ADSCs to SFCS with time were as
follows:
[0155] 369.+-.53.16 adherent cells/field (49.20.+-.7.09% of seeded
cells) at 15 minutes
[0156] 365.+-.81.30 adherent cells/field (48.78.+-.10.84% of seeded
cells) at 30 minutes
[0157] 566.+-.75.05 adherent cells/field (75.46.+-.10.01% of seeded
cells) at 60 minutes
[0158] 572.+-.131.33 adherent cells/field (76.30.+-.17.51% of
seeded cells) at 120 minutes
[0159] SEM findings provided qualitative confirmation of the above
adhesion data that was based on GFP fluorescent counts. A scatter
distribution of adherent stem cells was observed at 15 minutes
post-seeding, with adherent cells focused on the parallel sheet
edge and around fiber projections of the surface. Cell spreading
was noted by 30 minutes and by 60 minutes cells were beginning to
adhere to the flat and smooth regions of the SFCS sheet that were
initially minimally populated. By 120 minutes a full blanketing was
observed with progressive spreading of cells on flat regions and
the dense occupation of fiber convolutions and micro-enclaves at
the junctions of fibers and sheets. The results obtained with ADC
isolated with a step including plastic adherence were confirmed
with freshly isolated cells. FIG. 17 presents a SEM image of
freshly isolated SVF cells adhering to SFCS after 15 minutes of
incubation. As can be seen, many of the cells have elaborated
microvilli and lamellopodia by such time.
[0160] The results showed a preference of the cells for adherence
to rough topography and pointed to this preferential structural
character of particularly desirable scaffolds. Thus, in one
embodiment of the invention a method of inducing adherence of
reparative cell populations to tissue scaffolds includes generation
of a rough surface topography to the scaffold wherein the surface
is characterized by surface irregularities occurring on a scale of
one to one hundred .mu.m.
Preorientation of ADC and SVF:
[0161] In one embodiment of the invention, adherent cells from
human lipoaspirate isolated in accordance with Example 1 and 2 are
exposed to select induction media to preorient responsive cells
into a desired differentiation track prior to administration into
the patient. The following are non-limiting examples of induction
media that are known to drive the differentiation of cells into
particular lineages by prolonged culture in the media.
[0162] Examples of Media for Cell Pre-Orientation
TABLE-US-00001 Lineage Component Conc. Adipogenic DMEM, low glucose
Fetal bovine serum (FBS) 10% L-glutamine 2 mM
Penicillin/Streptomycin L-Ascorbic acid 100 .mu.M
1-methyl-3-isobutylxanthine, 0.5 mM (IBMX) Dexamethasone 1 .mu.M
Indomethacin 100 .mu.M Insulin human recombinant 10 .mu.g/ml Assess
subsequent adipogenesis by Oil Red O staining
TABLE-US-00002 Lineage Component Conc. Chondrogenic DMEM, high
glucose FBS 10% Dexamethasone 0.1 .mu.M Ascorbate-2-phosphate 25
ug/ml Insulin, bovine 10 .mu.g/ml TGF.beta.-3 (R&D) 10 .mu.g/ml
Sodium pyruvate 1 mM Non-essential amino acids Proline 0.M
Transferrin 5.5 .mu.g/ml Sodium selenite 5 ng/ml Linoleic Acid 4.7
ng/ml Bovine Serum Albumen 0.5 mg/ml (BSA) Assess chondrogeneis by
expression of proteoglycan or collagen II using histochemistry or
immunohistochemistry staining.
TABLE-US-00003 Lineage Component Conc. Endothelial DMEM, (low
glucose) FBS 2% Penicillin 10 U/ml Streptomycin 100 ug/ml VEGF 50
ng/ml L-glutamine 2 mM Assess endothelial like cells by detection
of vWF by immunohistochemistry.
TABLE-US-00004 Lineage Component Conc. Hepatogeneic DMEM, (1 g/L
glucose) FBS 1% bFGF (Chemicon) 10 ng/ml aFGF (Chemicon) 20 ng/ml
EGF 10 ng/ml HGF (R&D) 20 ng/ml Insulin-transferrin-selenious
acid 1% (ITS-BD Biosciences) Oncostatin M (OSM) 10 ng/ml Assess
hepatogenesis by detection of albumin by immunofluorescence.
TABLE-US-00005 Lineage Component Conc. Myogenic DMEM, (low glucose)
FBS 10% Horse Serum (HS) 5% Penicillin/streptomycin 1%
Hydrocortisone 50 .mu.M Assess myogenesis by detection of myosin by
immunofluorescence.
TABLE-US-00006 Lineage Component Conc. Neurogenic DMEM, F12 FBS 1%
B27 (Invitrogen) 2% L-ascorbic acid 50 .mu.M Insulin 5 .mu.g/ml
bFGF (Chemicon) 10 ng/ml bEGF 10 ng/ml NGF (R&D) 10 ng/ml
2-mercaptoethanol 1 mM forskolin 10 .mu.M cAMP 2 mM
1-methyl-3-isobutylxanthine, 0.5 mM (IBMX) indomethacin 200 .mu.M
Assess neurogenesis by detection of microtubule-associated
protein-2 (MAP-2) by immunofluorescence.
TABLE-US-00007 Lineage Component Conc. Osteogenic FBS 10%
Dexamethasone 0.1 .mu.M L-Ascorbic acid 0.2 mM .beta.-glycerol
phosphate 10 mM Assess subsequent mineralization by calcium deposit
by staining with Alizarin Rd S
Applications
[0163] The cellular preparations of the present invention including
the different biocapatable matricies can be applied to subjects for
various cell therapeutic purposes. Such cell therapies generally
refer to the regeneration and/or repair of injured or diseased
tissue. Non-limiting examples include wound healing (infected and
non-infected), bone fracture healing, treatment of non-healing
ulcers, hernia repair, tendon repair, plastic surgical indications
including skin grafting, cartilage regeneration, including
cartilage of the nose and pinna of the ear, engraftment after
chemotherapy, rescue of retinal degeneration, treatment of ischemic
disease (e.g., ischemic heart disease and peripheral arterial
disease), treatment of nerve injury, filling of heart aneurysms and
of the atrial appendage, creation of an artificial bladder and
bladder wall repair, repair and reconstruction of intestines, and
repair and reconstruction of vessels and associated structures.
[0164] Cardiac Applications: In one embodiment, reparative
populations are seeded onto biomaterial matrices for the treatment
of various physical defects of the heart including the roughly 1%
of the population with an atrial septal defect which enables a
shunt between the right and left atrium. Other deficiencies are
ventricular septum defect and patent foramen ovale (PFO) that are
amenable by occlusion either by direct surgical techniques in
suturing a cell seeded patch or by non-invasive correction in
placing a cell seeded occluder. While all current occluders and
materials to close such a patch are considered to be of
non-absorbable materials such as Teflon.RTM., Dacron.RTM.,
stainless steel, Elgiloy.RTM. or Nitinol.TM., the present invention
provides biomaterials which are absorbable and coated with stem
cells which allows a natural healing as certain of the included
multipotent cells differentiate into fibroblasts as well as
cardiomyocytes.
[0165] Another application for the biomaterial is to occlude the
left auricle of the left atrium from which a good deal of
thrombotic events can occur and previous experience has shown that
the occlusion of such an auricle can reduce the formation of
thrombus and prevent the embolic events. In another embodiment,
reparative cell coated biomaterial is used for repair of aneurysms
of the vascular structures, including aneurysms of the aorta and
arteries. Placement can optionally be made from inside the vessel
in the form of a covered stent, which would be a combination of a
scaffold and a coated biomaterial membrane.
[0166] All publications, patents and patent applications cited
herein are hereby incorporated by reference as if set forth in
their entirety herein. While this invention has been described with
reference to illustrative embodiments, this description is not
intended to be construed in a limiting sense. Various modifications
and combinations of illustrative embodiments, as well as other
embodiments of the invention, will be apparent to persons skilled
in the art upon reference to the description. It is therefore
intended that the appended claims encompass such modifications and
enhancements.
* * * * *