U.S. patent application number 15/378102 was filed with the patent office on 2017-04-06 for methods of generating corneal cells and cell populations comprising same.
This patent application is currently assigned to TECHNION RESEARCH & DEVELOPMENT FOUNDATION LTD.. The applicant listed for this patent is Daniel ABERDAM, Joseph ITSKOVITZ-ELDOR, Ruby SHALOM-FEUERSTEIN. Invention is credited to Daniel ABERDAM, Joseph ITSKOVITZ-ELDOR, Ruby SHALOM-FEUERSTEIN.
Application Number | 20170095513 15/378102 |
Document ID | / |
Family ID | 46171264 |
Filed Date | 2017-04-06 |
United States Patent
Application |
20170095513 |
Kind Code |
A1 |
ITSKOVITZ-ELDOR; Joseph ; et
al. |
April 6, 2017 |
METHODS OF GENERATING CORNEAL CELLS AND CELL POPULATIONS COMPRISING
SAME
Abstract
A method of generating a population of corneal epithelial cells
is disclosed. The method comprises culturing human pluripotent stem
cells in corneal fibroblast-conditioned medium on a solid surface
comprising an extracellular matrix component thereby generating the
population of corneal epithelial cells. Isolated cell populations
and corneal tissues are also disclosed, as well as uses
thereof.
Inventors: |
ITSKOVITZ-ELDOR; Joseph;
(Haifa, IL) ; ABERDAM; Daniel; (Nice, FR) ;
SHALOM-FEUERSTEIN; Ruby; (Binyamina, IL) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
ITSKOVITZ-ELDOR; Joseph
ABERDAM; Daniel
SHALOM-FEUERSTEIN; Ruby |
Haifa
Nice
Binyamina |
|
IL
FR
IL |
|
|
Assignee: |
TECHNION RESEARCH & DEVELOPMENT
FOUNDATION LTD.
Haifa
IL
INSTITUT NATIONAL DE LA SANTE ET DE LA RECHERCHE
MEDICALE
Paris
FR
|
Family ID: |
46171264 |
Appl. No.: |
15/378102 |
Filed: |
December 14, 2016 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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13991172 |
Jun 3, 2013 |
9574171 |
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PCT/IL2011/000914 |
Dec 1, 2011 |
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15378102 |
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61418915 |
Dec 2, 2010 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
C12N 2533/54 20130101;
C12N 2501/33 20130101; A61P 27/02 20180101; C12N 2533/90 20130101;
G01N 33/53 20130101; G01N 33/5073 20130101; C12N 2502/085 20130101;
C12N 2501/11 20130101; G01N 33/5058 20130101; C12N 2533/52
20130101; G01N 33/5026 20130101; C12N 2506/02 20130101; G01N
33/5023 20130101; C12N 2506/45 20130101; C12N 5/0062 20130101; C12N
2501/155 20130101; A61K 35/30 20130101; C12N 2502/1323 20130101;
C12N 5/0621 20130101 |
International
Class: |
A61K 35/30 20060101
A61K035/30; G01N 33/50 20060101 G01N033/50; C12N 5/079 20060101
C12N005/079 |
Claims
1-31. (canceled)
32. A method of treating an eye disorder in a subject in need
thereof, the method comprising transplanting to the subject a
therapeutically effective amount of human corneal epithelial cells
generated according to a method of generating a population of human
corneal epithelial cells which comprises culturing human
pluripotent stem cells in corneal fibroblast-conditioned medium on
a solid surface comprising an extracellular matrix component
thereby generating the population of human corneal epithelial
cells, wherein said corneal fibroblast-conditioned medium is
produced from human corneal fibroblasts which are not contaminated
with limbal fibroblasts and comprises insulin, hydrocortisone and
epidermal growth factor (EGF).
33. The method according to claim 32, wherein said corneal
fibroblast-conditioned medium further comprises bone morphogenetic
protein-4 (BMP-4).
34. The method according to claim 32, wherein said extracellular
matrix component is selected from the group consisting of collagen
IV, laminin, fibronectin and Matrigel.RTM..
35. The method according to claim 32, wherein said population of
human corneal epithelial cells does not comprise skin cells.
36. The method according to claim 32, wherein at least 70% of the
cells of said population of human corneal epithelial cells
co-express K3 and Pax6.
37. The method according to claim 32, wherein wherein less than 10%
of the cells of said population of human corneal epithelial cells
express nanog and Oct4.
38. A method of treating an eye disorder in a subject in need
thereof, the method comprising transplanting to the subject a
therapeutically effective amount of human corneal tissue generated
according to a method of generating human corneal tissue which
comprises: (a) culturing human pluripotent stem cells in corneal
fibroblast-conditioned medium on a solid surface comprising an
extracellular matrix component, thereby generating a population of
human corneal epithelial cells, wherein said corneal
fibroblast-conditioned medium is produced from human corneal
fibroblasts which are not contaminated with limbal fibroblasts and
comprises insulin, hydrocortisone and epidermal growth factor
(EGF); (b) dissociating the generated population of human corneal
epithelial cells to generate a population of dissociated human
corneal epithelial cells; and (c) culturing said dissociated human
corneal epithelial cells on a scaffold under conditions that
generate human corneal tissue.
39. The method according to claim 38, wherein said corneal
fibroblast-conditioned medium further comprises bone morphogenetic
protein-4 (BMP-4).
41. The method according to claim 38, wherein said extracellular
matrix component is selected from the group consisting of collagen
IV, laminin, fibronectin and Matrigel.RTM..
42. The method according to claim 38, wherein said population of
human corneal epithelial cells does not comprise skin cells.
43. The method according to claim 38, wherein at least 70% of the
cells of said population of human corneal epithelial cells
co-express K3 and Pax6.
44. The method according to claim 38, wherein wherein less than 10%
of the cells of said population of human corneal epithelial cells
express nanog and Oct4.
45. A method of screening for an agent which enhances
differentiation towards a human corneal epithelial lineage, the
method comprising: (a) culturing human pluripotent stem cells in
corneal fibroblast-conditioned medium, wherein said corneal
fibroblast-conditioned medium is produced from human corneal
fibroblasts which are not contaminated with limbal fibroblasts and
comprises insulin, hydrocortisone and epidermal growth factor
(EGF), on a solid surface comprising an extracellular matrix
component in a presence of said agent; and (b) analyzing a
differentiation status of said human pluripotent stem cells,
wherein an increase in differentiation compared to a
differentiation in an absence of said agent is indicative of an
agent which enhances differentiation towards a human corneal
epithelial lineage.
46. The method of claim 45, wherein said pluripotent stem cells
comprise iPS cells.
47. The method of claim 45, wherein said iPS cells are derived from
healthy patients.
48. The method of claim 45, wherein said iPS cells are derived from
diseased patients.
49. The method of claim 45, wherein said corneal
fibroblast-conditioned medium further comprises bone morphogenetic
protein-4 (BMP-4).
Description
FIELD AND BACKGROUND OF THE INVENTION
[0001] The present invention, in some embodiments thereof, relates
to methods of generating corneal cells from pluripotent stem cells
and cell populations comprising same.
[0002] The cornea is a unique, transparent structure that covers
the iris, pupil, and anterior chamber, providing most of the eye's
optical power. Together with the lens, the cornea refracts light
and, as a result, aids in focusing. The cornea contributes more to
the total refraction than the lens does, but, whereas the curvature
of the lens can be adjusted to "tune" focus, the curvature of the
cornea is fixed. The cornea has no blood vessels, its nourishment
is obtained via diffusion from the tear fluid, the aqueous humor,
and neurotrophins supplied by nerve fibers that innervate it. Thus,
for example, disturbances in circulation of these fluids or
inflammatory processes play a large role in the pathogenesis of
corneal abnormalities.
[0003] The cornea is composed mostly of dense connective tissue.
However, the collagen fibers are arranged in a parallel pattern,
allowing light waves to constructively interfere, thus letting
light pass through relatively uninhibited.
[0004] The corneal tissue is arranged in five basic layers:
epithelium, Bowman's layer, stroma, Descemet's membrane and
endothelium, each having a separate function. The epithelium is the
outermost layer of the cornea, comprising about 10% of the tissue's
thickness. The epithelium functions primarily to: (1) block passage
of foreign materials, such as dust, water, and bacteria, into the
eye and other layers of the cornea; and (2) provide a smooth
surface that absorbs oxygen and cell nutrients from tears, then
distributes these nutrients to the rest of the cornea. The corneal
epithelium is maintained by stein cells (SCs) located at the
periphery of the cornea, in a region known as the limbus. The
corneal epithelium itself is devoid of its own stem cells. Limbal
fibroblasts form the major cellular component of the limbal stroma
upon which the LSCs reside, and they produce specific cytokines
that promote corneal epithelial wound healing by the LSCS.
[0005] The changes associated with aging of the cornea include
increased opacity, increased anterior surface curvatures, and
possibly changes in refractive index distribution. Various
refractive eye surgery techniques change the shape of the cornea in
order to reduce the need for corrective lenses or otherwise improve
the refractive state of the eye. In many techniques, reshaping of
the cornea is performed by photoablation using an eximer laser.
[0006] If the corneal stroma develops visually significant opacity,
irregularity, or edema, a cadaveric donor cornea can be
transplanted.
[0007] Limbal auto-grafts have been applied to patients with a
relatively high degree of success. In severe cases such as total
limbal stem cell deficiency, allo-grafts may be obtained from
patient's relatives or from post mortem donors. However, limbal
tissue is highly immunogenic and the rate of graft rejection
exceeds 35%, 5 years post transplantation. This method is further
limited due to a shortage of donors. Further, living donors are at
risk of developing limbal stem cell deficiency. To reduce this
risk, a smaller limbal tissue may be grafted from donor and
expanded ex vivo prior to transplantation. This technology does not
allow treating patient immediately following injury, since it
requires the cultivation of the cells for several weeks prior to
grafting. Moreover, allogenic limbal stem cell transplantations to
a patient are eventually rejected.
[0008] Synthetic corneas also exist (keratoprotheses), however,
these are typically plastic inserts or may be composed of
biocompatible synthetic materials that encourage tissue in-growth
into the synthetic cornea, thereby promoting biointegration.
Alternatively, orthokeratology offers the use of specialized hard
or rigid gas-permeable contact lenses to transiently reshape the
cornea in order to improve the refractive state of the eye or
reduce the need for eyeglasses and contact lenses.
[0009] Homma et al. [Invest Ophthalmol Vis Sci. 2004 December;
45(12):4320-6] teach corneal epithelial differentiation of murine
embryonic bodies on collagen IV-coated dishes.
[0010] Sajjad et al. [Stem Cells. 2007 May; 25(5):1145-55] teach
generation of corneal epithelial-like cells by seeding human
embryonic stem cells on collagen IV-coated dishes in the presence
of medium that was conditioned by limbal fibroblasts. The resulting
corneal epithelial cells were contaminated with skin cells.
SUMMARY OF THE INVENTION
[0011] According to an aspect of some embodiments of the present
invention there is provided a method of generating a population of
corneal epithelial cells comprising culturing human pluripotent
stem cells in corneal fibroblast-conditioned medium on a solid
surface comprising an extracellular matrix component thereby
generating the population of corneal epithelial cells.
[0012] According to some embodiments of the invention, the corneal
fibroblast-conditioned medium comprises bone morphogenetic
protein-4 (BMP-4).
[0013] According to some embodiments of the invention, the human
pluripotent stem cells comprise human embryonic stem cells (hESCs)
or human induced pluripotent stem cells (hlPSCs).
[0014] According to some embodiments of the invention, the corneal
fibroblast-conditioned medium comprises at least one agent selected
from the group consisting of insulin, hydrocortisone and epidermal
growth factor (EGF). According to some embodiments of the
invention, the corneal fibroblast-conditioned medium comprises
insulin, hydrocortisone and epidermal growth factor (EGF).
[0015] According to some embodiments of the invention, the
extracellular matrix component is selected from the group
consisting of collagen IV, laminin, fibronectin and
Matrigel.sup.RTM.
[0016] According to some embodiments of the invention, the method
further comprises analyzing the population of corneal epithelial
cells for at least one marker selected from the group consisting of
keratin 3 (K3), keratin 12 (K12), paired box gene 6 (pax6), keratin
18 (K18) and Connexin 43.
[0017] According to some embodiments of the invention, the corneal
fibroblast-conditioned medium is devoid of limbal fibroblasts.
[0018] According to some embodiments of the invention, there is
provided an isolated population of human corneal epithelial cells
generated according to the method of the present invention.
[0019] According to some embodiments of the invention, the isolated
population of corneal epithelial cells does not comprise skin
cells.
[0020] According to some embodiments of the invention, at least 70%
of the cells of the population co-express K3 and Pax6.
[0021] According to some embodiments of the invention, less than
10% of the cells of the population express nanog and Oct4.
[0022] According to some embodiments of the invention, the isolated
population of corneal epithelial cells is for use in treating an
eye disorder.
[0023] According to some embodiments of the invention, there is
provided a method of treating an eye disorder in a subject in need
thereof, the method comprising transplanting to the subject a
therapeutically effective amount of corneal epithelial cells
generated according to the method of the present invention, thereby
treating the eye disorder in the subject.
[0024] According to some embodiments of the invention, there is
provided qa pharmaceutical composition comprising the isolated
population of corneal epithelial cells of the present invention and
a pharmaceutically acceptable carrier.
[0025] According to some embodiments of the invention, there is
provided a method of generating corneal tissue, the method
comprising: [0026] (a) dissociating the isolated population of
human corneal epithelial cells of the present invention to generate
a population of dissociated human corneal epithelial cells; and
[0027] (b) culturing the dissociated human corneal epithelial cells
on a scaffold under conditions that generate corneal tissue.
[0028] According to some embodiments of the invention, the scaffold
comprises Matrigel.RTM. and collagen I.
[0029] According to some embodiments of the invention, the scaffold
comprises a human amniotic membrane.
[0030] According to some embodiments of the invention, there is
provided an isolated human corneal tissue generated according to
the method of the present invention.
[0031] According to some embodiments of the invention, there is
provided a human corneal tissue for use in treating an eye
disorder.
[0032] According to some embodiments of the invention, there is
provided a method of treating an eye disorder in a subject in need
thereof, the method comprising transplanting to the subject a
therapeutically effective amount of corneal tissue generated
according to the method of the present invention, thereby treating
the eye disorder in the subject.
[0033] According to some embodiments of the invention, there is
provided a pharmaceutical composition comprising the isolated
corneal tissue of the present invention and a pharmaceutically
acceptable carrier.
[0034] According to an aspect of some embodiments of the present
invention there is provided a method of screening for an agent
which enhances differentiation towards a corneal epithelial
lineage, the method comprising:
[0035] (a) culturing human pluripotent stem cells in corneal
fibroblast-conditioned medium on a solid surface comprising an
extracellular matrix component in a presence of said agent; and
[0036] (b) analyzing a differentiation status of said human
pluripotent stem cells, wherein an increase in differentiation
compared to a differentiation in an absence of said agent is
indicative of an agent which enhances differentiation towards a
corneal epithelial lineage.
[0037] According to some embodiments of the invention, the
pluripotent stem cells comprise iPS cells.
[0038] According to some embodiments of the invention, the iPS
cells are derived from healthy patients.
[0039] According to some embodiments of the invention, the iPS
cells are derived from diseased patients.
[0040] According to some embodiments of the invention, the medium
further comprises BMP-4.
[0041] According to some embodiments of the invention, the diseased
patients are ectrodactyly--ectodermal dysplasia--cleft syndrome
(EEC) patients.
[0042] According to some embodiments of the invention, the
analyzing is effected by analyzing a morphology of said pluripotent
stem cells.
[0043] According to some embodiments of the invention, the
analyzing is effected by analyzing an expression of a corneal cell
marker in said pluripotent stem cells.
[0044] According to some embodiments of the invention, the corneal
cell marker is Pax6 or K3/K12.
[0045] Unless otherwise defined, all technical and/or scientific
terms used herein have the same meaning as commonly understood by
one of ordinary skill in the art to which the invention pertains.
Although methods and materials similar or equivalent to those
described herein can be used in the practice or testing of
embodiments of the invention, exemplary methods and/or materials
are described below. In case of conflict, the patent specification,
including definitions, will control. In addition, the materials,
methods, and examples are illustrative only and are not intended to
be necessarily limiting.
BRIEF DESCRIPTION OF THE DRAWINGS
[0046] In the drawings:
[0047] FIGS. 1A-G illustrate corneal commitment of human embryonic
stem (huES) cells. (A). Morphology of a confluent human ES cell
population after 10 days of corneal differentiation. (B-E) Kinetic
analysis of corneal and pluripotent markers at different days of
corneal differentiation of huES cells. Cells, RNA and protein
extracts were collected at different times of commitment for
qRT-PCR (B), Western blot (C), immunofluorescence (D) and FACS (E)
analysis, showing efficient production of cornea-specific marker
(pax-6, K12, K3, connexin 43) and disappearance of
pluripotent-specific markers (oct-4 and nanog). (F and G)
Specificity of the corneal differentiation of huES cells. (F)
Corneal-specific DNA construct carrying the fluorescent GFP gene
under the K12 promoter was transfected into several cell lines and
human ES cells during corneal commitment and quantification was
done by FACS analysis of GFP-positive cells. The corneal K12
promoter was active in human corneal epithelial control cells (HCE)
and in huES committed cells at D6 and D12 and not in
undifferentiated ES cells or non corneal epithelial cell lines
(Hela, HaCaT). (G) Differentiated epidermal-specific markers K1,
K10 and involucrin were not expressed by undifferentiated (D0) or
huES cells committed into corneal differentiation (D6, D12 and
D17), as compared to normal huma, keratinocytes (NHK), used as
positive control.
[0048] FIGS. 2A-C illustrate production of corneal epithelium from
human ES cells. Corneal fibroblasts were embedded in collagen type
1 gel to produce a corneal stroma equivalent (A). After a week,
huES-derived corneal cells were seeded on the top of the gel for
one week to allow proliferation. Then, the culture was lifted up at
the air-liquid interface to induce stratification (B). (C)
Immunofluoresence analysis demonstrated that the resulting corneal
epithelia were positive for K3 (red) and pax-6 (green; dapi in
blue).
[0049] FIGS. 3A-C are photographs illustrating production of
corneal epithelial tissue using amniotic membrane as a
scaffold.
[0050] FIGS. 4A-C are graphs illustrating differentiation of iPSC
cells into corneal epithelial lineage. iPSC colonies were seeded on
collagen IV-coated dishes in the presence of epithelial-medium that
was conditioned by corneal fibroblasts. (A). RNA preparations
obtained in the indicated days of corneal differentiation were
subjected to real time PCR analysis of the indicated genes. The
mRNA expression levels were normalized to GAPDH. Data represents
the relative fold change of each transcript as compared to its
levels as recorded in undifferentiated hES cells. (B). Test of
BMP-4. (C). Corneal commitment of hair follicle-derived iPSCs
(HF2-iPS), fibroblast-derived iPSCs (DF1 and DF2-iPS) and human ES
cells quantified by real time qRT-PCR analysis for K18, pax6,
DNp63, K14 and K3 genes.
[0051] FIGS. 5A-B are photographs illustrating corneal commitment
of iPS cell lines.
[0052] FIGS. 6A-B are photographs and graphs illustrating impaired
corneal differentiation of EEC-iPS cells.
DESCRIPTION OF SPECIFIC EMBODIMENTS OF THE INVENTION
[0053] The present invention, in some embodiments thereof, relates
to methods of generating corneal cells from pluripotent stem cells
and cell populations comprising same.
[0054] Before explaining at least one embodiment of the invention
in detail, it is to be understood that the invention is not
necessarily limited in its application to the details set forth in
the following description or exemplified by the Examples. The
invention is capable of other embodiments or of being practiced or
carried out in various ways.
[0055] When a cornea becomes cloudy due to disease or injury, light
cannot penetrate the eye to reach the light-sensitive retina. Poor
vision or blindness may result. Corneal transplant surgery involves
the removal of the central portion of the cloudy cornea and
replacing it with a clear cornea, usually donated through an eye
bank. This technique is hampered by a scarcity of donors and graft
rejection.
[0056] Limbal auto-grafts have been applied to patients with
disorders of the cornea with a relatively high degree of success.
In severe cases such as total limbal stem cell deficiency,
allo-grafts may be obtained from patient's relatives or from post
mortem donors. However, limbal tissue is highly immunogenic and the
rate of graft rejection exceeds 35%, 5 years post transplantation.
This method is further limited due to a shortage of donors.
Further, living donors are at risk of developing limbal stem cell
deficiency. To reduce this risk, a smaller limbal tissue may be
grafted from donor and expanded ex vivo prior to transplantation.
This technology does not allow treating patient immediately
following injury, since it requires the cultivation of the cells
for several weeks prior to grafting. Moreover, allogenic limbal
stem cell transplantations to a patient are eventually
rejected.
[0057] In order to overcome these problems, the present inventors
devised a technique whereby they generated corneal epithelial cell
populations from pluripotent stem cells. The differentiation
protocol relies on the use of corneal fibroblast-conditioned
medium.
[0058] As illustrated in FIGS. 1A-G, the generated corneal
epithelial cell population was homogeneous, the cells expressing
K3, K12, pax6 and Connexin43. Furthermore, the present inventors
noted that the cell population was devoid of cells expressing
epidermal markers such as K1, K10 and Involucrin (see FIG. 1G).
[0059] The present inventors further showed that 3D culture of such
cells resulted in the generation of corneal tissue equivalents
(FIG. 2). This procedure allows the production of ready to use
tissues for corneal transplantation, thereby resolving the need of
donors.
[0060] Thus, according to one aspect of the present invention there
is provided a method of generating a population of corneal
epithelial cells comprising culturing human pluripotent stem cells
in corneal fibroblast-conditioned medium on a solid surface
comprising an extracellular matrix component thereby generating the
population of corneal epithelial cells.
[0061] The method of the present invention is initially effected by
obtaining pluripotent stem cells and culturing them.
[0062] As used herein, the phrase "stem cells" refers to cells
which are capable of remaining in an undifferentiated state (e.g.,
pluripotent or multipotent stem cells) for extended periods of time
in culture until induced to differentiate into other cell types
having a particular, specialized function (e.g., fully
differentiated cells). The phrase "pluripotent stem cells"
encompasses embryonic stem cells (ESCs) and induced pluripotent
stem cells (iPS. The stem cells are typically mammalian pluripotent
cells, such as for example human pluripotent stem cells.
[0063] The phrase "embryonic stern cells" refers to embryonic cells
which are capable of differentiating into cells of all three
embryonic germ layers (i.e., endoderm, ectoderm and mesoderm), or
remaining in an undifferentiated state. The phrase "embryonic stem
cells" may comprise cells which are obtained from the embryonic
tissue formed after gestation (e.g., blastocyst) before
implantation of the embryo (i.e., a pre-implantation blastocyst),
extended blastocyst cells (EBCs) which are obtained from a
post-implantation/pre-gastrulation stage blastocyst (see
WO2006/040763) and embryonic germ (EG) cells which are obtained
from the genital tissue of a fetus any time during gestation,
preferably before 10 weeks of gestation.
[0064] Induced pluripotent stem cells (iPS; embryonic-like stem
cells), are cells obtained by de-differentiation of adult somatic
cells which are endowed with pluripotency (i.e., being capable of
differentiating into the three embryonic germ cell layers, i.e.,
endoderm, ectoderm and mesoderm). According to some embodiments of
the invention, such cells are obtained from a differentiated tissue
(e.g., a somatic tissue such as skin or hair) and undergo
de-differentiation by genetic manipulation which re-program the
cell to acquire embryonic stem cells characteristics. According to
some embodiments of the invention, the induced pluripotent stem
cells are formed by inducing the expression of Oct-4, Sox2, Kfl4
and c-Myc in a somatic stem cell.
[0065] The embryonic stem cells of the present invention can be
obtained using well-known cell-culture methods. For example, human
embryonic stem cells can be isolated from human blastocysts. Human
blastocysts are typically obtained from human in vivo
preimplantation embryos or from in vitro fertilized (IVF) embryos.
Alternatively, a single cell human embryo can he expanded to the
blastocyst stage. For the isolation of human ES cells the zona
pellucida is removed from the blastocyst and the inner cell mass
(ICM) is isolated by immunosurgery, in which the trophectoderm
cells are lysed and removed from the intact ICM by gentle
pipetting. The ICM is then plated in a tissue culture flask
containing the appropriate medium which enables its outgrowth.
Following 9 to 15 days, the ICM derived outgrowth is dissociated
into clumps either by a mechanical dissociation or by an enzymatic
degradation and the cells are then re-plated on a fresh tissue
culture medium. Colonies demonstrating undifferentiated morphology
are individually selected by micropipette, mechanically dissociated
into clumps, and re-plated. Resulting ES cells are then routinely
split every 4-7 days. For further details on methods of preparation
human ES cells see Thomson et al., [U.S. Pat. No. 5,843,780;
Science 282: 1145, 1998; Curr. Top. Dev. Biol. 38: 133, 1998; Proc.
Natl. Acad. Sci. USA 92: 7844, 1995]; Bongso et al., [Hum Reprod 4:
706, 1989]; and Gardner et al., [Fertil. Steril. 69: 84, 1998].
[0066] It will be appreciated that commercially available stem
cells can also be used with this aspect of the present invention.
Human ES cells can be purchased from the NIH human embryonic stem
cells registry (www.escr.nih.gov). Non-limiting examples of
commercially available embryonic stem cell lines are BG01, BG02,
BG03, BG04, CY12, CY30, CY92, CY10, 1E03 and 1E32.
[0067] In addition, ES cells can be obtained from other species as
well, including mouse (Mills and Bradley, 2001), golden hamster
[Doetschman et al., 1988, Dev Biol. 127: 224-7], rat [Iannaccone et
al., 1994, Dev Biol. 163: 288-92] rabbit [Giles et al. 1993, Mol
Reprod Dev. 36: 130-8; Graves & Moreadith, 1993, Mol Reprod
Dev. 1993, 36: 424-33], several domestic animal species [Notarianni
et al., 1991, J Reprod Fertil Suppl. 43: 255-60; Wheeler 1994,
Reprod Fertil Dev. 6: 563-8; Mitalipova et al., 2001, Cloning. 3:
59-67] and non-human primate species (Rhesus monkey and marmoset)
[Thomson et al., 1995, Proc Natl Acad Sci U S A. 92: 7844-8;
Thomson et al., 1996, Biol Reprod. 55: 254-9].
[0068] Extended blastocyst cells (EBCs) can be obtained from a
blastocyst of at least nine days post fertilization at a stage
prior to gastrulation. Prior to culturing the blastocyst, the zona
pellucida is digested [for example by Tyrode's acidic solution
(Sigma Aldrich, St Louis, Mo., USA)] so as to expose the inner cell
mass. The blastocysts are then cultured as whole embryos for at
least nine and no more than fourteen days post fertilization (i.e.,
prior to the gastrulation event) in vitro using standard embryonic
stem cell culturing methods.
[0069] EG cells are prepared from the primordial germ cells
obtained from fetuses of about 8-11 weeks of gestation (in the case
of a human fetus) using laboratory techniques known to anyone
skilled in the arts. The genital ridges are dissociated and cut
into small chunks which are thereafter disaggregated into cells by
mechanical dissociation. The EG cells are then grown in tissue
culture flasks with the appropriate medium. The cells are cultured
with daily replacement of medium until a cell morphology consistent
with EG cells is observed, typically after 7-30 days or 1-4
passages. For additional details on methods of preparation human EG
cells see Shamblott et al., [Proc. Natl. Acad. Sci. USA 95: 13726,
1998] and U.S. Pat. No. 6,090,622.
[0070] Induced pluripotent stem cells (iPS) (embryonic-like stem
cells) can be generated from somatic cells by genetic manipulation
of somatic cells, e.g., by retroviral transduction of somatic cells
such as fibroblasts, hepatocytes, gastric epithelial cells with
transcription factors such as Oct-3/4, Sox2, c-Myc, and KLF4
[Yamanaka S, Cell Stem Cell. 2007, 1(1):39-49; Aoi T, et al.,
Generation of Pluripotent Stem Cells from Adult Mouse Liver and
Stomach Cells. Science. 2008 Feb 14. (Epub ahead of print); IH
Park, Zhao R, West JA, et al. Reprogramming of human somatic cells
to pluripotency with defined factors. Nature 2008;451:141-146; K
Takahashi, Tanabe K, Ohnuki M, et al. Induction of pluripotent stem
cells from adult human fibroblasts by defined factors. Cell
2007;131:861-872]. Other embryonic-like stem cells can be generated
by nuclear transfer to oocytes, fusion with embryonic stem cells or
nuclear transfer into zygotes if the recipient cells are arrested
in mitosis.
[0071] It will be appreciated that undifferentiated stem cells are
of a distinct morphology, which is clearly distinguishable from
differentiated cells of embryo or adult origin by the skilled in
the art. Typically, undifferentiated stem cells have high
nuclear/cytoplasmic ratios, prominent nucleoli and compact colony
formation with poorly discernable cell junctions. Additional
features of undifferentiated stem cells are further described
hereinunder.
[0072] Currently practiced ES culturing methods are mainly based on
the use of feeder cell layers which secrete factors needed for stem
cell proliferation, while at the same time, inhibit their
differentiation. Feeder cell free systems have also been used in ES
cell culturing, such systems utilize matrices supplemented with
serum, cytokines and growth factors as a replacement for the feeder
cell layer.
[0073] In order to induce differentiation of the pluripotent stem
cells to the corneal epithelial lineage, the pluripotent stem cells
are cultured in corneal fibroblast-conditioned medium.
[0074] Corneal fibroblasts may be obtained from cadavers or living
donors. According to one embodiment, the corneal fibroblasts are
obtained from humans. Typically corneal fibroblasts are isolated by
incubation of the cornea with a dispersing agent (e.g. Dispase II,
typsin or collagenase for about 1-18 hours at 37.degree. C.). The
epithelial sheet may then be removed with forceps. Care should be
taken to avoid contamination of the corneal sample with limbal
tissue, such that the cells used to generate the conditioned medium
are not contaminated with limbal fibroblasts.
[0075] Conditioned medium is the growth medium of a monolayer cell
culture (i.e., feeder cells) present following a certain culturing
period. The conditioned medium includes growth factors and
cytokines secreted by the monolayer cells in the culture.
[0076] In order to produce corneal fibroblast conditioned medium,
the isolated fibroblasts may initially be expanded by culturing in
a suitable medium (e.g. dulbeco's modified eagle medium (DMEM)
supplemented with 10% new born calf serum). When the fibroblast
cell population reaches about 80%-100% density (see FIG. 2A), cell
proliferation is stopped, e.g. by incubation in mitomycin C (8
.mu.g/ml) for about three hours. The mitomycinized cells are then
incubated in a suitable growth medium.
[0077] Conditioned medium is collected from the corneal fibroblasts
forming monolayers in culture.
[0078] The growth medium can be any medium suitable for culturing
the corneal fibroblasts. The growth medium can be supplemented with
nutritional factors, such as amino acids, (e.g., L-glutamine),
anti-oxidants (e.g., beta-mercaptoethanol) and growth factors,
which benefit corneal fibroblast cell growth.
[0079] According to one embodiment bone morphogenetic protein-4
(BMP-4) may be added during the culture period. The BMP-4 may be
added for the entire length of the culturing period or at a
particular stage of the culturing period (e.g. for the first three
days of the culturing period).
[0080] An exemplary concentration of BMP-4 is between about 0.1-10
nM, more preferably between 0.1 - 5 nM, more preferably between
about 0.1 and 1 nM (for example 0.5 nM).
[0081] According to one embodiment, the growth medium comprises at
least one of the following agents--insulin (e.g. 5 .mu.g/ml),
hydrocortisone (e.g. 0.5 .mu.g/ml) and EGF e.g. (10 ng/ml).
[0082] According to another embodiment the growth medium comprises
insulin, hydrocortisone and EGF.
[0083] An exemplary medium is epithelial medium ((DMEM 60%, HamF12
30%, FCII 10%, insulin 5 .mu.g/ml, hydrocortisone 0.5 EGF 10 ng/ml,
0.2 mM Adenine, 10 nM Cholera toxin).
[0084] The epithelial fibroblast cells are cultured in the growth
medium for sufficient time to allow adequate accumulation of
secreted factors to support stem cell differentiation towards the
corneal epithelial cell lineage. Typically, the medium is
conditioned by culturing for 4 hours at 37.degree. C. to 24
hours.
[0085] However, the culturing period can be scaled by assessing the
effect of the conditioned medium on stem cell differentiation.
[0086] Selection of culture apparatus for conditioning the medium
is based on the scale and purpose of the conditioned medium.
Large-scale production preferably involves the use of dedicated
devices. Continuous cell culture systems are reviewed in Furey
(2000) Genetic Eng. News 20:10.
[0087] Following accumulation of adequate factors in the medium,
growth medium (i.e., conditioned medium) is separated from the
corneal fibroblasts and collected. It will be appreciated that the
corneal fibroblasts can be used repeatedly to condition further
batches of medium over additional culture periods, provided that
the cells retain their ability to condition the medium.
[0088] According to one embodiment, the medium is collected every
day and replaced by fresh media for up to 10 days.
[0089] Preferably, the conditioned medium is sterilized (e.g.,
filtration using a 20 .mu.M filter) prior to use. The conditioned
medium of some embodiments of the invention may be applied directly
on stem cells or extracted to concentrate the effective factor such
as by salt filtration. For future use, conditioned medium is
preferably stored frozen at -80.degree. C.
[0090] Culturing in corneal fibroblast-conditioned medium is
typically effected on a solid surface which comprises an
extracellular matrix component. Examples of extracellular matrix
components include but are not limited to collagen IV, laminin,
fibronectin and Matrigel.RTM..
[0091] Methods of coating culture dishes with extraceullar matrix
components are well known in the art and further described in the
Examples section herein below.
[0092] The pluripotent stem cells are cultured under suitable
conditions to allow differentiation. According to one embodiment,
the cells are cultured for about 5 days, 7 days or about 10
days.
[0093] The differentiation status of the cells may be determined by
analyzing marker expression thereof. Thus for example the following
markers may be analyzed: cytokeratin 3 (K3), cytokeratin 12 (K12),
paired box gene 6 (pax6), cytokeratin 18 (K18) and Connexin 43.
Expression of the above described markers in at least 50%, at least
60%, at least 70%, at least 80%, at least 90% of the generated cell
population may be used as an indication that the cell population is
differentiated towards the corneal epithelial lineage.
[0094] According to a particular embodiment, the population of
cells is selected wherein at least 70%, 80% or 90% of the cells of
the population co-express K3 and Pax6.
[0095] Alternatively, or additionally, the differentiation status
of the cells may be determined by analyzing markers of
undifferentiated stem cells, such as Oct4 or nanog. Expression of
the above described markers in less than 40%, less than 30%, less
than 20%, less than 10%, less than 5% of the generated cell
population may be used as an indication that the cell population
comprises differentiated cells.
[0096] Preferably the generated population of cells does not
comprise skin cells. Accordingly, the population of cells may be
analyzed for skin cell markers (e.g. K1, K10 and Involucrin) and
only cell populations which do not express such markers (e.g. less
than 10% of the cells express or less than 5% of the cells express)
are selected.
[0097] Methods for analyzing cells for particular markers are well
known in the art and include for Example Western Blot Analysis,
flow cytometry and reverse transcriptase PCR analysis (RT-PCR).
Immunohistochemistry techniques may be used to ascertain whether a
particular cell co-expresses two or more markers.
[0098] Antibodies for K3, K12, Pax6, K18, K1, K10, involucrin and
connexin 43 are commercially available from Companies such as Santa
Cruz Biotechnology and Chemicon.
[0099] Exemplary primer sequences which may be used to analyze the
differentiation status of the cells are provided herein below.
TABLE-US-00001 Pax-6 (forward): (SEQ ID NO: 1) gCTTggTggTgTCTTTgTCA
Pax-6 (reverse): (SEQ ID NO: 2) TCACACAACCgTTggATACC connexin 43
(forward): (SEQ ID NO: 3) gCTgAgCCCTgCCAAAgAC connexin 43
(reverse): (SEQ ID NO: 4) gAggAgCAgCCATTgAAATAA
[0100] The differentiation status of the cells may also be
determined by analyzing promoter activity for a particular gene
known to be expressed in differentiated cells. Example 1 of the
Examples section herein below details how the activity of the k12
promoter (a corneal specific promoter) may be analyzed in the
differentiated cell populations.
[0101] The above described differentiation protocol may be used to
screen for agents which enhance differentiation towards a corneal
epithelial lineage.
[0102] Thus, according to another aspect of the present invention,
there is provided a method of screening for an agent which enhances
differentiation towards a corneal epithelial lineage, the method
comprising:
[0103] (a) culturing human pluripotent stem cells in corneal
fibroblast-conditioned medium on a solid surface comprising an
extracellular matrix component in a presence of said agent; and
[0104] (b) analyzing a differentiation status of the human
pluripotent stem cells, wherein an increase in differentiation
compared to a differentiation in an absence of the agent is
indicative of an agent which enhances differentiation towards a
corneal epithelial lineage.
[0105] Analyzing the differentiation status of the cells has been
described herein above.
[0106] The pluripotent stem cells may be embryonic stem cells or
induced pluripotent stem cells (iPS cells). The iPS cells may be
derived from healthy subjects or patients who have a disease which
affects corneal epithelial cells - for example,
ectrodactyly--ectodermal dysplasia--cleft syndrome (EEC) patients.
The present inventors have shown that iPS cells derived from such
patients do not undergo differentiation to corneal epithelial cells
to the same extent as iPS cells derived from healthy subjects.
Thus, the present protocol may be used to screen for a drug that
enhances corneal epithelial cell differentiation for the treatment
of a particular disease.
[0107] Examples of agents that may be screened include polypeptide
agents, polynucleotide agents, small molecule agents and other
chemicals.
[0108] The isolated cell populations generated according to the
method of this aspect of the present invention may be used for
various applications including transplantation thereof for the
treatment of diseases or disorders of the cornea, as further
described herein below. In addition, the isolated cell populations
may be used as a cellular model for drug discovery and cell
toxicity tests. The reproducibility of identical cells from the
same source will allow comparative and standardizes studies, which
is an important criteria for industrials of cosmetology and
pharmacology.
[0109] Alternatively, the isolated cell populations (e.g. ones that
have been initially differentiated for 1-2 weeks in the corneal
fibroblast conditioned medium) may be further differentiated on a
3D scaffold to generate corneal tissue.
[0110] According to one embodiment, the corneal tissue is
stratified.
[0111] According to another embodiment, the corneal tissue
comprises at least 3 layers of corneal epithelial tissue.
[0112] According to another embodiment the corneal tissue is devoid
of squamous cells.
[0113] A method of generating corneal tissue on a scaffold is
described in Example 2 of the Examples section below and
illustrated in FIGS. 3A-I.
[0114] According to one embodiment the 3D scaffold comprises a gel
composed of Matrigel.sup.RTM and collagen I.
[0115] According to another embodiment, the scaffold comprises a
human amniotic membrane.
[0116] Such techniques are described in Koizumi et al.,
Investigative Ophthalmology & Visual Science, August 2000, Vol.
41, No. 9; Gaggioli et al., Nature cell biology volume 9, number
12, 2007 and Larouch et al., Chapter 15, Stem Cells in Regenerative
Medicine: Methods and Protocols, vol. 482, 2009), the contents of
each being incorporated by reference.
[0117] Typically, the cell populations are differentiated on the
scaffold for about 1-2 weeks to induce differentiation of corneal
tissue.
[0118] As mentioned, the isolated corneal epithelial cell
populations (and the corneal tissue differentiated therefrom) may
be used to treat diseases and disorders of the cornea.
[0119] Disorders affecting the cornea include, but are not limited
to, allergies, conjunctivitis, corneal infections, dry eye, Fuchs'
dystrophy, herpes zoster, iridocorneal endothelial syndrome,
keratoconus, lattice dystrophy, map-dot-fingerprint dystrophy,
ocular herpes, Stevens-Johnson syndrome, pterygium, keratitis,
corneal ulcer, corneal abrasion, snow blindness, arc eye,
Thygeson's superficial puncate keratopathy, and
keratpconjunctivitis sicca.
[0120] In corneal transplant surgery, the surgeon typically removes
the central portion of the diseased or injured cornea and replaces
it with a clear cornea. The new cornea or corneal cells are placed
in the opening and is sutured to the eye (see, e.g., Rapuano et al.
Anterior Segment, The Requisites (Requisites in Ophthalmology),
1999, Mosby, Inc., Philadelphia, Pa.). Typically about
1-2.times.10.sup.6 cells/eye are transplanted to the damaged
cornea.
[0121] In one embodiment, a method for replacement of a cornea of
an eye using the synthetic cornea of the present invention includes
surgically excising the cornea from the eye, inserting the
synthetic cornea into the area of the removed cornea, and allowing
the synthetic cornea to interface with tissue underlying the
excision to anchor the synthetic cornea to the eye.
[0122] In a related aspect, the method includes separating a
portion of the outer surface of a cornea thereby forming a corneal
flap and a corneal bed, the corneal flap having an anterior surface
and a posterior surface, the corneal bed having a shaped anterior
surface, implanting the synthetic cornea on the corneal bed, the
cornea having an anterior surface and a posterior surface, and
replacing the portion of the cornea that was separated.
[0123] Careful histological and immunohistochemical analysis should
be performed at different times following grafting by using
specific markers. The number of goblet cells on the corneal surface
should be evaluated with impression cytology to evaluate the
presence of limbal deficiency. The rejection index, the mean
survival time, and the rejection rates may be calculated for each
group.
[0124] As mentioned hereinabove, the corneal cells or tissue of the
present invention can be derived from either autologous sources
(induced pluripotent stem cells) or from allogeneic sources such as
embryonic stem cells. Since non-autologous cells are likely to
induce an immune reaction when administered to the body several
approaches have been developed to reduce the likelihood of
rejection of non-autologous cells. For example, prior to
transplantation, the histo-compatibility of the subject may be
tested such that only histo-compatible corneal grafts may be
transplanted.
[0125] Other approaches include either suppressing the recipient
immune system or encapsulating the non-autologous cells in
immunoisolating, semipermeable membranes before
transplantation.
[0126] Encapsulation techniques are generally classified as
microencapsulation, involving small spherical vehicles and
macroencapsulation, involving larger flat-sheet and hollow-fiber
membranes (Uludag, H. et al. Technology of mammalian cell
encapsulation. Adv Drug Deliv Rev. 2000; 42: 29-64).
[0127] Methods of preparing microcapsules are known in the arts and
include for example those disclosed by Lu MZ, et al., Cell
encapsulation with alginate and
alpha-phenoxycinnamylidene-acetylated poly(allylamine). Biotechnol
Bioeng. 2000, 70: 479-83, Chang T M and Prakash S. Procedures for
microencapsulation of enzymes, cells and genetically engineered
microorganisms. Mol Biotechnol. 2001, 17: 249-60, and Lu M Z, et
al., A novel cell encapsulation method using photosensitive
poly(allylamine alpha-cyanocinnamylideneacetate). J Microencapsul.
2000, 17: 245-51.
[0128] For example, microcapsules are prepared by complexing
modified collagen with a ter-polymer shell of 2-hydroxyethyl
methylacrylate (HEMA), methacrylic acid (MAA) and methyl
methacrylate (MMA), resulting in a capsule thickness of 2-5 .mu.m.
Such microcapsules can be further encapsulated with additional 2-5
.mu.m ter-polymer shells in order to impart a negatively charged
smooth surface and to minimize plasma protein absorption (Chia, S.
M. et al. Multi-layered microcapsules for cell encapsulation
Biomaterials. 2002 23: 849-56).
[0129] Other microcapsules are based on alginate, a marine
polysaccharide (Sambanis, A. Encapsulated islets in diabetes
treatment. Diabetes Thechnol. Ther. 2003, 5: 665-8) or its
derivatives. For example, microcapsules can be prepared by the
polyelectrolyte complexation between the polyanions sodium alginate
and sodium cellulose sulphate with the polycation
poly(methylene-co-guanidine) hydrochloride in the presence of
calcium chloride.
[0130] It will be appreciated that cell encapsulation is improved
when smaller capsules are used. Thus, the quality control,
mechanical stability, diffusion properties, and in vitro activities
of encapsulated cells improved when the capsule size was reduced
from 1 mm to 400 .mu.m (Canaple L. et al., Improving cell
encapsulation through size control. J Biomater Sci Polym Ed.
2002;13:783-96). Moreover, nanoporous biocapsules with
well-controlled pore size as small as 7 nm, tailored surface
chemistries and precise microarchitectures were found to
successfully immunoisolate microenvironments for cells (Williams D.
Small is beautiful: microparticle and nanoparticle technology in
medical devices. Med Device Technol. 1999, 10: 6-9; Desai, T. A.
Microfabrication technology for pancreatic cell encapsulation.
Expert Opin Biol Ther. 2002, 2: 633-46).
[0131] Examples of immunosuppressive agents include, but are not
limited to, methotrexate, cyclophosphamide, cyclosporine,
cyclosporin A, chloroquine, hydroxychloroquine, sulfasalazine
(sulphasalazopyrine), gold salts, D-penicillamine, leflunomide,
azathioprine, anakinra, infliximab (REMICADE.sup.R), etanercept,
TNF.alpha. blockers, a biological agent that targets an
inflammatory cytokine, and Non-Steroidal Anti-Inflammatory Drug
(NSAIDs). Examples of NSAIDs include, but are not limited to acetyl
salicylic acid, choline magnesium salicylate, diflunisal, magnesium
salicylate, salsalate, sodium salicylate, diclofenac, etodolac,
fenoprofen, flurbiprofen, indomethacin, ketoprofen, ketorolac,
meclofenamate, naproxen, nabumetone, phenylbutazone, piroxicam,
sulindac, tolmetin, acetaminophen, ibuprofen, Cox-2 inhibitors and
tramadol.
[0132] If appropriate, the patient can be further treated with
pharmaceutical agents or bioactives that facilitate the survival
and function of the transplanted cells. These agents may include,
for example, insulin, members of the TGF-beta family, including
TGF-beta1, 2, and 3, bone morphogenic proteins (BMP-2, -3, -4, -5,
-6, -7, -11, -12, and -13), fibroblast growth factors-1 and -2,
platelet-derived growth factor-AA, and -BB, platelet rich plasma,
insulin growth factor (IGF-I, II) growth differentiation factor
(GDF-5, -6, -7, -8, -10, -15), vascular endothelial cell-derived
growth factor (VEGF), pleiotrophin, endothelin, among others. Other
pharmaceutical compounds can include, for example, nicotinamide,
glucagon like peptide-I (GLP-1) and II, GLP-1 and 2 mimetibody,
Exendin-4, retinoic acid, parathyroid hormone, MAPK inhibitors,
such as, for example, compounds disclosed in U.S. Published
Application 2004/0209901 and U.S. Published Application
2004/0132729.
[0133] The cells or tissue of the present invention may be
transplanted to a human subject per se, or in a pharmaceutical
composition where it is mixed with suitable carriers or
excipients.
[0134] As used herein a "pharmaceutical composition" refers to a
preparation of one or more of the cell populations described herein
with other chemical components such as physiologically suitable
carriers and excipients. The purpose of a pharmaceutical
composition is to facilitate administration of a compound to an
organism.
[0135] Hereinafter, the phrases "physiologically acceptable
carrier" and "pharmaceutically acceptable carrier" which may be
interchangeably used refer to a carrier or a diluent that does not
cause significant irritation to an organism and does not abrogate
the biological activity and properties of the administered
compound. An adjuvant is included under these phrases.
[0136] Herein the term "excipient" refers to an inert substance
added to a pharmaceutical composition to further facilitate
administration of an active ingredient. Examples, without
limitation, of excipients include calcium carbonate, calcium
phosphate, various sugars and types of starch, cellulose
derivatives, gelatin, vegetable oils and polyethylene glycols.
[0137] Pharmaceutical compositions of the present invention may be
manufactured by processes well known in the art, e.g., by means of
conventional mixing, dissolving, granulating, dragee-making,
levigating, emulsifying, encapsulating, entrapping or lyophilizing
processes.
[0138] Pharmaceutical compositions for use in accordance with the
present invention thus may be formulated in conventional manner
using one or more physiologically acceptable carriers comprising
excipients and auxiliaries, which facilitate processing of the
active ingredients into preparations which, can be used
pharmaceutically. Proper formulation is dependent upon the route of
administration chosen.
[0139] For injection, the active ingredients of the pharmaceutical
composition may be formulated in aqueous solutions, preferably in
physiologically compatible buffers such as Hank's solution,
Ringer's solution, or physiological salt buffer.
[0140] Pharmaceutical compositions suitable for use in context of
the present invention include compositions wherein the active
ingredients are contained in an amount effective to achieve the
intended purpose. More specifically, a therapeutically effective
amount means an amount of active ingredients (corneal cells)
effective to prevent, alleviate or ameliorate symptoms of a
disorder.
[0141] Determination of a therapeutically effective amount is well
within the capability of those skilled in the art, especially in
light of the detailed disclosure provided herein.
[0142] For any preparation used in the methods of the invention,
the therapeutically effective amount or dose can be estimated from
animal models to achieve a desired concentration or titer. Such
information can be used to more accurately determine useful doses
in humans.
[0143] Toxicity and therapeutic efficacy of the active ingredients
described herein can be determined by standard pharmaceutical
procedures in experimental animals. The data obtained from these
animal studies can be used in formulating a range of dosage for use
in human. The dosage may vary depending upon the dosage form
employed and the route of administration utilized. The exact
formulation, route of administration and dosage can be chosen by
the individual physician in view of the patient's condition. (See
e.g., Fingl, et al., 1975, in "The Pharmacological Basis of
Therapeutics", Ch. 1 p. 1).
[0144] Dosage amount and interval may be adjusted individually to
provide cell numbers sufficient to induce repair or improve sight
(minimal effective concentration, MEC). The MEC will vary for each
preparation, but can be estimated from in vitro data. Dosages
necessary to achieve the MEC will depend on individual
characteristics and route of administration. Detection assays can
be used to determine plasma concentrations.
[0145] The amount of a composition to be administered will, of
course, be dependent on the subject being treated, the severity of
the affliction, the manner of administration, the judgment of the
prescribing physician, etc.
[0146] Compositions of the present invention may, if desired, be
presented in a pack or dispenser device, such as an FDA approved
kit, which may contain one or more unit dosage forms containing the
active ingredient. The pack may, for example, comprise metal or
plastic foil, such as a blister pack. The pack or dispenser device
may be accompanied by instructions for administration. The pack or
dispenser may also be accommodated by a notice associated with the
container in a form prescribed by a governmental agency regulating
the manufacture, use or sale of pharmaceuticals, which notice is
reflective of approval by the agency of the form of the
compositions or human or veterinary administration. Such notice,
for example, may be of labeling approved by the U.S. Food and Drug
Administration for prescription drugs or of an approved product
insert. Compositions comprising a preparation of the invention
formulated in a compatible pharmaceutical carrier may also be
prepared, placed in an appropriate container, and labeled for
treatment of an indicated condition, as if further detailed
above.
[0147] As used herein the term "about" refers to .+-.10%.
[0148] The terms "comprises", "comprising", "includes",
"including", "having" and their conjugates mean "including but not
limited to".
[0149] The term "consisting of means "including and limited
to".
[0150] The term "consisting essentially of" means that the
composition, method or structure may include additional
ingredients, steps and/or parts, but only if the additional
ingredients, steps and/or parts do not materially alter the basic
and novel characteristics of the claimed composition, method or
structure.
[0151] Whenever a numerical range is indicated herein, it is meant
to include any cited numeral (fractional or integral) within the
indicated range. The phrases "ranging/ranges between" a first
indicate number and a second indicate number and "ranging/ranges
from" a first indicate number "to" a second indicate number are
used herein interchangeably and are meant to include the first and
second indicated numbers and all the fractional and integral
numerals therebetween.
[0152] As used herein the term "method" refers to manners, means,
techniques and procedures for accomplishing a given task including,
but not limited to, those manners, means, techniques and procedures
either known to, or readily developed from known manners, means,
techniques and procedures by practitioners of the chemical,
pharmacological, biological, biochemical and medical arts.
[0153] As used herein, the term "treating" includes abrogating,
substantially inhibiting, slowing or reversing the progression of a
condition, substantially ameliorating clinical or aesthetical
symptoms of a condition or substantially preventing the appearance
of clinical or aesthetical symptoms of a condition.
[0154] It is appreciated that certain features of the invention,
which are, for clarity, described in the context of separate
embodiments, may also be provided in combination in a single
embodiment. Conversely, various features of the invention, which
are, for brevity, described in the context of a single embodiment,
may also be provided separately or in any suitable subcombination
or as suitable in any other described embodiment of the invention.
Certain features described in the context of various embodiments
are not to be considered essential features of those embodiments,
unless the embodiment is inoperative without those elements.
[0155] Various embodiments and aspects of the present invention as
delineated hereinabove and as claimed in the claims section below
find experimental support in the following examples.
EXAMPLES
[0156] Reference is now made to the following examples, which
together with the above descriptions illustrate some embodiments of
the invention in a non limiting fashion.
[0157] Generally, the nomenclature used herein and the laboratory
procedures utilized in the present invention include molecular,
biochemical, microbiological and recombinant DNA techniques. Such
techniques are thoroughly explained in the literature. See, for
example, "Molecular Cloning: A laboratory Manual" Sambrook et al.,
(1989); "Current Protocols in Molecular Biology" Volumes I-III
Ausubel, R. M., ed. (1994); Ausubel et al., "Current Protocols in
Molecular Biology", John Wiley and Sons, Baltimore, Md. (1989);
Perbal, "A Practical Guide to Molecular Cloning", John Wiley &
Sons, New York (1988); Watson et al., "Recombinant DNA", Scientific
American Books, New York; Birren et al. (eds) "Genome Analysis: A
Laboratory Manual Series", Vols. 1-4, Cold Spring Harbor Laboratory
Press, New York (1998); methodologies as set forth in U.S. Pat.
Nos. 4,666,828; 4,683,202; 4,801,531; 5,192,659 and 5,272,057;
"Cell Biology: A Laboratory Handbook", Volumes I-III Cellis, J. E.,
ed. (1994); "Culture of Animal Cells--A Manual of Basic Technique"
by Freshney, Wiley-Liss, N. Y. (1994), Third Edition; "Current
Protocols in Immunology" Volumes I-III Coligan J. E., ed. (1994);
Stites et al. (eds), "Basic and Clinical Immunology" (8th Edition),
Appleton & Lange, Norwalk, Conn. (1994); Mishell and Shiigi
(eds), "Selected Methods in Cellular Immunology", W. H. Freeman and
Co., New York (1980); available immunoassays are extensively
described in the patent and scientific literature, see, for
example, U.S. Pat. Nos. 3,791,932; 3,839,153; 3,850,752; 3,850,578;
3,853,987; 3,867,517; 3,879,262; 3,901,654; 3,935,074; 3,984,533;
3,996,345; 4,034,074; 4,098,876; 4,879,219; 5,011,771 and
5,281,521; "Oligonucleotide Synthesis" Gait, M. J., ed. (1984);
"Nucleic Acid Hybridization" Hames, B. D., and Higgins S. J., eds.
(1985); "Transcription and Translation" Hames, B. D., and Higgins
S. J., eds. (1984); "Animal Cell Culture" Freshney, R. I., ed.
(1986); "Immobilized Cells and Enzymes" IRL Press, (1986); "A
Practical Guide to Molecular Cloning" Perbal, B., (1984) and
"Methods in Enzymology" Vol. 1-317, Academic Press; "PCR Protocols:
A Guide To Methods And Applications", Academic Press, San Diego,
Calif. (1990); Marshak et al., "Strategies for Protein Purification
and Characterization--A Laboratory Course Manual" CSHL Press
(1996); all of which are incorporated by reference as if fully set
forth herein. Other general references are provided throughout this
document. The procedures therein are believed to be well known in
the art and are provided for the convenience of the reader. All the
information contained therein is incorporated herein by
reference.
Example 1
Differentiation of Human Embryonic Stem Cells to Corneal Cells
[0158] I. Preparation of corneal fibroblasts conditioned epithelial
medium: To prepare conditioned media, primary corneal fibroblasts
were extracted from human cornea that is not suitable for
transplantation by incubation of the cornea with Dispase II (2
mg/ml) overnight at 37.degree. C. The epithelial sheet was removed
and the fibroblasts were cultured in culture dishes in dulbeco's
modified eagle medium (DMEM) supplemented with 10% new born calf
serum. When the fibroblast cell population reached 80%-100% density
(see FIG. 2A), cell proliferation was stopped by incubating in
mitomycin C (8 .mu.g/ml) for three hours. To obtain conditioned
media, the mitomycinized cells were incubated with epithelial media
((DMEM 60%, HamF12 30%, FCII 10%, insulin 5 .mu.g/ml,
hydrocortisone 0.5 EGF 10 ng/ml, 0.2 mM Adenine, 10 nM Cholera
toxin). The medium was collected every day and replaced by fresh
media for up to 10 days. The medium was filtered and stored at
-20.degree. C. until use. II. Coating of culture dishes: Culture
dishes were incubated with collagen IV (0.5 mg/ml) or matrigel
(0.25 mg/ml) at 37.degree. C. for 4 hours and then washed
extensively with phosphate buffered saline.
[0159] III. Differentiation of pluripotent stem cells into corneal
epithelial lineage: Pluripotent stem cell cells were incubated with
collagenase (2 mg/ml) for 1 hour and then colonies were seeded on
collagen IV or matrigel-coated dishes. Medium was replaced every
second day by fresh corneal fibroblast conditioned epithelial media
for about two weeks.
[0160] Real-time PCR analysis: RNA extractions of cells during
different time point of corneal differentiation were analyzed by
real-time PCR analysis of K18, K12, pax6, GAPDH.
[0161] Western blot analysis: we used anti K3/K12 Ab, anti pax6 Ab,
anti K18 Ab, anti Connexin 43 Ab, anti Nanog Ab, anti Oct4 Ab.
[0162] FACS analysis: FACS analysis was performed using anti K18
Ab, anti K3/K12 Ab and anti pax6 Ab.
[0163] Transfection of cells with GFP under a K12 promoter:
Embryonic stem cells-derived corneal cells (at Day 10 of
differentiation), and cells that were used as positive (Human
corneal epithelial (HCE) immortalized cell line) or negative
(HaCaT, Hela, undifferentiated ES cells) controls were transfected
with a GFP-encoding plasmid that is under K12-corneal specific
promoter, using Fugene reagent according the manufacturer
instructions. After 48 hours, the percentage of cells with GFP
fluorescence was examined by FACS analysis.
Results
[0164] The morphology of the differentiated cells appeared
relatively homogenous at day 9, as shown in FIG. 1A. Corneal
differentiation was evaluated by quantitative real time polymerase
chain reaction (qPCR) of corneal epithelial markers (FIG. 1B).
Elevated levels of the ectodermal marker K18 (and K8, not shown),
and of pax6, a key factor in eye and corneal development, were
recorded in early culture days. The mRNA levels of corneal specific
cytokeratins, namely K12 and K3 were increased at late culture days
(FIG. 1B).
[0165] Western blot analysis demonstrated that the protein levels
of known corneal-epithelial markers (namely, pax6, K3, K12 and
Connexin43) increased gradually at late differentiation stages
while embryonic stem cell markers (Nanog and Oct4) became
undetectable within 6-8 days (FIG. 1C), suggesting that this
protocol induces efficient corneal differentiation of ES cells.
[0166] The co-expression of K18 and pax6 hallmarks the `lens
placode`, a structure that emerges at day 9.5 of mouse
embryogenesis (E9.5), from which the corneal epithelium is derived.
At later embryonic stages, the corneal epithelium maintains
pax6-expression and begins to express K12 and K3. Notably, the
majority of the cells at day 4 of ES differentiation expressed K18
or co-expressed K18 and pax6 (FIG. 1D, left panel), while, at day
10 of ES differentiation, the majority of cells co-expressed K3 and
pax6 (FIG. 1D), suggesting that ES cells differentiate into corneal
precursors in a manner that reminiscent of corneal
embryogenesis.
[0167] To further assess corneal epithelial fate, differentiated
cells were subjected to FACS analysis of K18, pax6 and K3. As shown
in FIG. 1E, most of the cells expressed K18 and pax6 at day 6,
while the vast majority of the cells expressed K3 and pax6
(>90%) at day 12. Furthermore, the encoding sequence for green
fluorescent protein (GFP) was cloned under the corneal-specific
promoter of K12 gene, which is the most specific amongst corneal
markers. The specificity of this construct to corneal epithelial
cells was confirmed by the transfection of various non-corneal cell
lines as negative controls (Hela, HaCaT, ES) or of a human corneal
epithelial cell line (HCE) as positive control (FIG. 1F). While
non-corneal cells did not express any significant amount of GFP,
78% of HCE and 71% of ES-derived corneal epithelial-like (ES-EC)
cells displayed a strong K12-promoter activity (FIG. 1F). Finally,
no epidermal differentiation markers (namely K1, K10 and
Involucrin, see FIG. 1G) were detected, suggesting that highly
enriched population of ES-CE cells were obtained that was not
contaminated with epidermal-like cells.
Example 2
Generation of Corneal Tissue from Embryonic Stem Cells
[0168] Materials and Methods
[0169] After 1-2 weeks of differentiation of pluripotent stem cells
on collagen IV or matrigel in the presence of conditioned media,
cells were collected by dispase or trypsin and reseeded onto a
corneal stroma equivalent gels in a 3D organotypic reconstitution
assay: primary human corneal fibroblast cells were embedded in gels
that were composed of matrigel and collagen I, and hES-derived
corneal cells were seeded on top of these gels in epithelial media.
Corneal stratification was induced by air-liquid interphase as
illustrated in FIGS. 2A-C and further exemplified in Gaggioli et
al., Nature cell biology volume 9, number 12, 2007. Then air liquid
interface was induced by reducing media inside the inserts and
cells were allowed to stratify for 1-2 weeks, while medium was
replaced every day. Alternatively, differentiated cells were seeded
on human amniotic membrane and lifted from the culture (as
described for instance in Koizumi et al., Investigative
Ophthalmology & Visual Science, August 2000, Vol. 41, No.
9).
Example 3
Differentiation of Human Induced Pluripotent Stem (iPS) Cells to
Corneal Cells
[0170] I. Preparation of corneal fibroblasts conditioned epithelial
medium: as described in Example 1.
[0171] II. Coating of culture dishes: as described in Example
1.
[0172] III. Differentiation of iPS cells into corneal epithelial
lineage: iPS derived from human hair follicle cells or dermal
fibroblasts were seeded on collagen IV or matrigel-coated dishes.
Medium was replaced every second day by fresh corneal fibroblast
conditioned epithelial media for about two weeks. On days 3, 8 and
14, BMP-4 was added to the medium.
[0173] Real-time PCR analysis: RNA extractions of cells during
different time point of corneal differentiation were analyzed by
real-time PCR analysis of K3, K14, K12, K18, pax6 and DNp63.
[0174] FACS analysis: FACS analysis was performed using anti K14
Ab, anti K3/K12 Ab and anti pax6 Ab.
[0175] Results
[0176] Addition of BMP-4 during the first three days significantly
enhanced corneal differentiation, as illustrated by increased
expression of DNp63, K14 and K12 (FIG. 4A). This effect was
inhibited by LDN, a specific antagonist of BMP-4. To follow corneal
commitment, messenger RNA levels of corneal epithelial lineage
genes were recorded at different time points in the course of iPSCs
differentiation by qPCR (FIG. 4B). Elevation in ectodermal marker
K18 (and K8, not shown) appeared already within 2-4 culture days
(FIG. 4B), along with the expression of pax6, an early marker of
neuroectodermal cell fate and a key regulator of eye development.
Early epithelial commitment was detected at days 6-8 by the
expression of limbal markers, p63 and K14, while markers of mature
corneal epithelium (K3, K12) and Connexin 43 (not shown) appeared
within 10-14 days (FIG. 4B). Simultaneous expression of K18 and
pax6 at early stage recapitulated the in vivo co-expression in the
lens placode at E9.5, was followed by co-expression of pax6 and K3
which are hallmark of mature corneal cells. The robustness of
corneal epithelial-like cell production was evaluated at day 12 by
FACS analysis. The vast majority of the cells expressed K3
(>90%) while 20% of the cells remained K14-positive cells.
Finally, although epidermal marker K10 increased at the mRNA
levels, no K10 protein could be detected (not shown). Similar
results were obtained with iPSCs derived from human fibroblasts or
huESCs (FIG. 4C).
Example 4
Differentiation of Diseased iPS Cells Towards a Corneal Fate
[0177] EEC patients suffer from visual morbidity due to impaired
cornea associated with limbal stem cell deficiency. iPSC lines were
induced to corneal fate as described in Example 3. As illustrated
by real-time qRT-PCR analysis, human iPSC lines underwent
sequential differentiation into ectodermal precursors
(K8/K18+/Pax6.sup.+) at day 4, limbal (K14/K5/Pax6.sup.+/p63.sup.+)
at day 8 and corneal epithelial (Pax-6.sup.+/K3/K12.sup.+) cells at
day 14 (FIG. 5A). Remarkably, at day 14, most of the cells became
corneal epithelial cells, as detected by immunofluorescent staining
(FIG. 5B) and FACS analysis (data not shown). Since EEC patients
suffer from limbal stem cell deficiency, iPS.sup.EEC cells were
challenged for their ability to undergo proper corneal epithelial
commitment as compared to the iPSC.sup.ctl. Immunofluorescent
staining analysis was performed at day 10 with antibodies raised
against K18, E-cadherin and K14 (FIG. 6A). Similar production of
ectodermal progenitors (K18.sup.+/E-cadherin.sup.+) was observed at
day 10 for iPSC.sup.ctl, iPSC.sup.204W and iPSC.sup.304W. However,
the absence of K14 and K3 staining revealed the inability of
iPSC.sup.EEC to undergo further commitment for the production of
limbal cells and corneal cells, respectively, as compared to
iPSC.sup.ctl. In parallel, gene expression of known p63-target
genes was evaluated at day 10 of commitment by real-time qRT-PCR
(FIG. 6B). Most of the genes were less expressed in mutated cells
as compared to control cells.
[0178] Although the invention has been described in conjunction
with specific embodiments thereof, it is evident that many
alternatives, modifications and variations will be apparent to
those skilled in the art. Accordingly, it is intended to embrace
all such alternatives, modifications and variations that fall
within the spirit and broad scope of the appended claims.
[0179] All publications, patents and patent applications mentioned
in this specification are herein incorporated in their entirety by
reference into the specification, to the same extent as if each
individual publication, patent or patent application was
specifically and individually indicated to be incorporated herein
by reference. In addition, citation or identification of any
reference in this application shall not be construed as an
admission that such reference is available as prior art to the
present invention. To the extent that section headings are used,
they should not be construed as necessarily limiting.
Sequence CWU 1
1
4120DNAArtificial SequenceSingle strand DNA oligonucleotide
1gcttggtggt gtctttgtca 20220DNAArtificial SequenceSingle strand DNA
oligonucleotide 2tcacacaacc gttggatacc 20319DNAArtificial
SequenceSingle strans DNA oligonucleotide 3gctgagccct gccaaagac
19421DNAArtificial SequenceSingle strand DNA oligonucleotide
4gaggagcagc cattgaaata a 21
* * * * *