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Mantovani MDC, Gabanyi I, Pantanali CA, Santos VR, Corrêa-Giannella MLC, Sogayar MC. Islet transplantation: overcoming the organ shortage. Diabetol Metab Syndr 2023; 15:144. [PMID: 37391848 DOI: 10.1186/s13098-023-01089-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 05/13/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND Type 1 diabetes mellitus (T1D) is a condition resulting from autoimmune destruction of pancreatic β cells, leading patients to require lifelong insulin therapy, which, most often, does not avoid the most common complications of this disease. Transplantation of isolated pancreatic islets from heart-beating organ donors is a promising alternative treatment for T1D, however, this approach is severely limited by the shortage of pancreata maintained under adequate conditions. METHODS In order to analyze whether and how this problem could be overcome, we undertook a retrospective study from January 2007 to January 2010, evaluating the profile of brain-dead human pancreas donors offered to our Cell and Molecular Therapy NUCEL Center ( www.usp.br/nucel ) and the basis for organ refusal. RESULTS During this time period, 558 pancreata were offered by the São Paulo State Transplantation Central, 512 of which were refused and 46 were accepted for islet isolation and transplantation. Due to the elevated number of refused organs, we decided to analyze the main reasons for refusal in order to evaluate the possibility of improving the organ acceptance rate. The data indicate that hyperglycemia, technical issues, age, positive serology and hyperamylasemia are the top five main causes for declination of a pancreas offer. CONCLUSIONS This study underlines the main reasons to decline a pancreas offer in Sao Paulo-Brazil and provides some guidance to ameliorate the rate of eligible pancreas donors, aiming at improving the islet isolation and transplantation outcome. TRIAL REGISTRATION Protocol CAPPesq number 0742/02/CONEP 9230.
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Affiliation(s)
- Marluce da Cunha Mantovani
- Cell and Molecular Therapy NUCEL Group, School of Medicine, University of São Paulo, Avenida Dr. Arnaldo, 455, São Paulo, 01246-903, SP, Brasil
- Technical Division for Teaching, Research and Innovation Support - DTAPEPI Biotechnology and Innovation Facility, School of Medicine, University of São Paulo Medical School, São Paulo, 01246-903, SP, Brazil
| | - Ilana Gabanyi
- Cell and Molecular Therapy NUCEL Group, School of Medicine, University of São Paulo, Avenida Dr. Arnaldo, 455, São Paulo, 01246-903, SP, Brasil
| | - Carlos Andrés Pantanali
- Gastroenterology Department, School of Medicine, University of São Paulo, São Paulo, 01246-903, SP, Brazil
| | - Vinícius Rocha Santos
- Gastroenterology Department, School of Medicine, University of São Paulo, São Paulo, 01246-903, SP, Brazil
| | - Maria Lúcia Cardillo Corrêa-Giannella
- Cell and Molecular Therapy NUCEL Group, School of Medicine, University of São Paulo, Avenida Dr. Arnaldo, 455, São Paulo, 01246-903, SP, Brasil
- Medical Sciences Department, Laboratory of Carbohydrates and Radioimmunoassay (LIM-18) HCFMUSP, Medical School, University of São Paulo, São Paulo, 01246-903, SP, Brazil
| | - Mari Cleide Sogayar
- Cell and Molecular Therapy NUCEL Group, School of Medicine, University of São Paulo, Avenida Dr. Arnaldo, 455, São Paulo, 01246-903, SP, Brasil.
- Technical Division for Teaching, Research and Innovation Support - DTAPEPI Biotechnology and Innovation Facility, School of Medicine, University of São Paulo Medical School, São Paulo, 01246-903, SP, Brazil.
- Biochemistry Department, Chemistry Institute, University of São Paulo, São Paulo, 05508-000, Brazil.
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Lojudice FH, Fernandes RAB, Innocenti F, Franciozi CE, Cristovam P, Maia M, Sogayar MC, Junior RB. In vitro differentiation of cGMP-grade retinal pigmented epithelium from human embryonic stem cells. Int J Retina Vitreous 2019; 5:45. [PMID: 31646003 PMCID: PMC6802162 DOI: 10.1186/s40942-019-0194-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 10/10/2019] [Indexed: 11/15/2022] Open
Abstract
Background The World Health Organization (WHO) estimates that the number of individuals who lose their vision due to retinal degeneration is expected to reach 6 million annually in 2020. The retinal degenerative diseases affect the macula, which is responsible for central and detailed vision. Most macular degeneration, i.e., age-related macular degeneration (AMD) develops in the elderly; however, certain hereditary diseases, such as the Stargardt disease, also affect young people. This degeneration begins with loss of retinal pigmented epithelium (RPE) due to formation of drusen (atrophic) or abnormal vessels (exudative). In wet AMD, numerous drugs are available to successful treat the disease; however, no proven therapy currently is available to treat dry AMD or Stargardt. Since its discovery, human embryonic stem cells (hESCs) have been considered a valuable therapeutic tool. Some evidence has shown that transplantation of RPEs differentiated from hESCs cells can result in recovery of both RPE and photoreceptors and prevent visual loss. Methods The human embryonic WA-09 stem cell lineage was cultured under current Good Manufacturing Practices (cGMP) conditions using serum-free media and supplements. The colonies were isolated manually and allowed to spontaneously differentiate into RPE cells. Results This simple and effective protocol required minimal manipulation and yielded more than 10e8 RPE cells by the end of the differentiation and enrichment processes, with cells exhibiting a cobblestone morphology and displaying cellular markers and a gene expression profile typical of mature RPE cells. Moreover, the differentiated cells displayed phagocytic activity and only a small percentage of the total cells remained positive for the Octamer-binding transcriptions factor 4 (OCT-4) pluripotency cell marker. Conclusions These results showed that functional RPE cells can be produced efficiently and suggested the possibility of scaling-up to aim at therapeutic protocols for retinal diseases associated with RPE degeneration.
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Affiliation(s)
- Fernando H Lojudice
- 1Department of Ophthalmology and Visual Sciences, Federal University of São Paulo, CEP 04021-001 São Paulo, Brazil.,2Cell and Molecular Therapy Center (NUCEL), Medical School, University of São Paulo, São Paulo, SP 05360-130 Brazil
| | - Rodrigo A Brant Fernandes
- 1Department of Ophthalmology and Visual Sciences, Federal University of São Paulo, CEP 04021-001 São Paulo, Brazil
| | - Francesco Innocenti
- 1Department of Ophthalmology and Visual Sciences, Federal University of São Paulo, CEP 04021-001 São Paulo, Brazil.,2Cell and Molecular Therapy Center (NUCEL), Medical School, University of São Paulo, São Paulo, SP 05360-130 Brazil
| | - Carlos E Franciozi
- 4Department of Orthopedics and Traumatology, Federal University of São Paulo, São Paulo, 04038-032 Brazil
| | - Priscila Cristovam
- 1Department of Ophthalmology and Visual Sciences, Federal University of São Paulo, CEP 04021-001 São Paulo, Brazil.,2Cell and Molecular Therapy Center (NUCEL), Medical School, University of São Paulo, São Paulo, SP 05360-130 Brazil
| | - Maurício Maia
- 1Department of Ophthalmology and Visual Sciences, Federal University of São Paulo, CEP 04021-001 São Paulo, Brazil
| | - Mari C Sogayar
- 2Cell and Molecular Therapy Center (NUCEL), Medical School, University of São Paulo, São Paulo, SP 05360-130 Brazil.,3Department of Biochemistry, Chemistry Institute, University of São Paulo, São Paulo, SP 05508-000 Brazil
| | - Rubens Belfort Junior
- 1Department of Ophthalmology and Visual Sciences, Federal University of São Paulo, CEP 04021-001 São Paulo, Brazil
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Ceresoli V, Mainieri D, Del Fabbro M, Weinstein R, Pedrazzini E. A Fusion between Domains of the Human Bone Morphogenetic Protein-2 and Maize 27 kD γ-Zein Accumulates to High Levels in the Endoplasmic Reticulum without Forming Protein Bodies in Transgenic Tobacco. FRONTIERS IN PLANT SCIENCE 2016; 7:358. [PMID: 27047526 PMCID: PMC4805588 DOI: 10.3389/fpls.2016.00358] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 03/07/2016] [Indexed: 05/12/2023]
Abstract
Human Bone Morphogenetic Protein-2 (hBMP2) is an osteoinductive agent physiologically involved in bone remodeling processes. A commercialized recombinant hBMP2 produced in mammalian cell lines is available in different clinical applications where bone regeneration is needed, but widespread use has been hindered due to an unfavorable cost/effective ratio. Protein bodies are very large insoluble protein polymers that originate within the endoplasmic reticulum by prolamine accumulation during the cereal seed development. The N-terminal domain of the maize prolamin 27 kD γ-zein is able to promote protein body biogenesis when fused to other proteins. To produce high yield of recombinant hBMP2 active domain (ad) in stably transformed tobacco plants we have fused it to the γ-zein domain. We show that this zein-hBMP2ad fusion is retained in the endoplasmic reticulum without forming insoluble protein bodies. The accumulation levels are above 1% of total soluble leaf proteins, indicating that it could be a rapid and suitable strategy to produce hBMP2ad at affordable costs.
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Affiliation(s)
- Valentina Ceresoli
- Istituto di Biologia e Biotecnologia Agraria, Consiglio Nazionale Delle RicercheMilano, Italy
- Dipartimento Scienze Biomediche, Chirurgiche e Odontoiatriche, Università Degli Studi di MilanoMilano, Italy
- IRCCS Istituto Ortopedico GaleazziMilano, Italy
| | - Davide Mainieri
- Istituto di Biologia e Biotecnologia Agraria, Consiglio Nazionale Delle RicercheMilano, Italy
| | - Massimo Del Fabbro
- Dipartimento Scienze Biomediche, Chirurgiche e Odontoiatriche, Università Degli Studi di MilanoMilano, Italy
- IRCCS Istituto Ortopedico GaleazziMilano, Italy
| | - Roberto Weinstein
- Dipartimento Scienze Biomediche, Chirurgiche e Odontoiatriche, Università Degli Studi di MilanoMilano, Italy
- IRCCS Istituto Ortopedico GaleazziMilano, Italy
| | - Emanuela Pedrazzini
- Istituto di Biologia e Biotecnologia Agraria, Consiglio Nazionale Delle RicercheMilano, Italy
- *Correspondence: Emanuela Pedrazzini
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Carreira AC, Lojudice FH, Halcsik E, Navarro RD, Sogayar MC, Granjeiro JM. Bone morphogenetic proteins: facts, challenges, and future perspectives. J Dent Res 2014; 93:335-45. [PMID: 24389809 DOI: 10.1177/0022034513518561] [Citation(s) in RCA: 229] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Bone morphogenetic proteins (BMPs) are members of the TGF-β superfamily, acting as potent regulators during embryogenesis and bone and cartilage formation and repair. Cell and molecular biology approaches have unveiled the great complexity of BMP action, later confirmed by transgenic animal studies. Genetic engineering allows for the production of large amounts of BMPs for clinical use, but they have systematically been associated with a delivery system, such as type I collagen and calcium phosphate ceramics, to ensure controlled release and to maximize their biological activity at the surgical site, avoiding systemic diffusion. Clinical orthopedic studies have shown the benefits of FDA-approved recombinant human BMPs (rhBMPs) 2 and 7, but side effects, such as swelling, seroma, and increased cancer risk, have been reported, probably due to high BMP dosage. Several studies have supported the use of BMPs in periodontal regeneration, sinus lift bone-grafting, and non-unions in oral surgery. However, the clinical use of BMPs is growing mainly in off-label applications, with robust evidence to ascertain rhBMPs' safety and efficacy through well-designed, randomized, and double-blind clinical trials. Here we review and discuss the critical data on BMP structure, mechanisms of action, and possible clinical applications.
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Affiliation(s)
- A C Carreira
- Biochemistry Department, Chemistry Institute, and Cell and Molecular Therapy Center NUCEL-NETCEM, School of Medicine, University of São Paulo, São Paulo, SP, Brazil
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