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Allenby MC, Okutsu N, Brailey K, Guasch J, Zhang Q, Panoskaltsis N, Mantalaris A. A spatiotemporal microenvironment model to improve design of a 3D bioreactor for red cell production. Tissue Eng Part A 2021; 28:38-53. [PMID: 34130508 DOI: 10.1089/ten.tea.2021.0028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Cellular microenvironments provide stimuli including paracrine and autocrine growth factors and physico-chemical cues, which support efficient in vivo cell production unmatched by current in vitro biomanufacturing platforms. While three-dimensional (3D) culture systems aim to recapitulate niche architecture and function of the target tissue/organ, they are limited in accessing spatiotemporal information to evaluate and optimize in situ cell/tissue process development. Herein, a mathematical modelling framework is parameterized by single-cell phenotypic imaging and multiplexed biochemical assays to simulate the non-uniform tissue distribution of nutrients/metabolites and growth factors in cell niche environments. This model is applied to a bone marrow mimicry 3D perfusion bioreactor containing dense stromal and hematopoietic tissue with limited red blood cell (RBC) egress. The model characterized an imbalance between endogenous cytokine production and nutrient starvation within the microenvironmental niches, and recommended increased cell inoculum density and enhanced medium exchange, guiding the development of a miniaturized prototype bioreactor. The second-generation prototype improved the distribution of nutrients and growth factors and supported a 50-fold increase in RBC production efficiency. This image-informed bioprocess modelling framework leverages spatiotemporal niche information to enhance biochemical factor utilization and improve cell manufacturing in 3D systems.
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Affiliation(s)
- Mark Colin Allenby
- Queensland University of Technology, 1969, Institute of Health and Biomedical Innovation (IHBI), Kelvin Grove, Queensland, Australia.,Imperial College London, 4615, Department of Chemical Engineering, London, London, United Kingdom of Great Britain and Northern Ireland;
| | - Naoki Okutsu
- Imperial College London, 4615, Department of Chemical Engineering, London, London, United Kingdom of Great Britain and Northern Ireland;
| | - Kate Brailey
- Imperial College London, 4615, Department of Chemical Engineering, London, London, United Kingdom of Great Britain and Northern Ireland;
| | - Joana Guasch
- Imperial College London, 4615, Department of Chemical Engineering, London, London, United Kingdom of Great Britain and Northern Ireland;
| | - Qiming Zhang
- Imperial College London, 4615, Department of Chemical Engineering, London, London, United Kingdom of Great Britain and Northern Ireland;
| | - Nicki Panoskaltsis
- Emory University, 1371, Winship Cancer Institute, Department of Hematology & Medical Oncology, Atlanta, Georgia, United States.,Imperial College London, 4615, Department of Haematology, London, London, United Kingdom of Great Britain and Northern Ireland;
| | - Athanasios Mantalaris
- Georgia Institute of Technology, 1372, BME, Atlanta, Georgia, United States.,Imperial College London, 4615, Department of Chemical Engineering, London, London, United Kingdom of Great Britain and Northern Ireland;
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Jiang M, Bi X, Duan X, Pang N, Wang H, Yuan H, Zhang R, Cui L. Adipose tissue-derived stem cells modulate immune function in vivo and promote long-term hematopoiesis in vitro using the aGVHD model. Exp Ther Med 2020; 19:1725-1732. [PMID: 32104226 PMCID: PMC7027076 DOI: 10.3892/etm.2020.8430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 11/06/2019] [Indexed: 11/05/2022] Open
Abstract
The present study was designed to investigate the effect of adipose-derived stem cells (ADSCs) on acute graft vs. host disease (aGVHD) and hematopoietic recovery after allogeneic hematopoietic stem cell transplantation. ADSCs, bone marrow-derived stem cells (BMSCs) and fibroblasts were cultured. ADSCs were cocultured with hematopoietic stem/progenitor cells. Then, ADSCs were infused into the aGVHD rat model. The survival of the rats was recorded. Livers and small intestines were obtained from sacrificed rats for pathological examinations. Expression of the Sry gene in recipient rats that survived longer than 21 days was examined by real-time PCR to detect the presence of donor Y chromosome. Expression of serum interferon (INF)-γ and interleukin (IL)-4 was detected by ELISA at 0, 7, 14, 21 and 50 days after transplantation. Transplantation of ADSCs improved the survival of aGVHD rats. Survived ADSCs participated in hematopoietic reconstitution in aGVHD rats. ADSCs decreased aGVHD severity by immunomodulation. ADSCs support the proliferation of hematopoietic stem/progenitor cells in vitro. The present study demonstrated that ADSCs may reduce aGVHD by influencing the balance of IL-4 and INF-γ and can promote long-term hematopoiesis.
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Affiliation(s)
- Ming Jiang
- Hematologic Disease Center, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang Uygur Autonomous Region Research Institute of Hematology, Urumqi, Xinjiang Uygur Autonomous Region 830054, P.R. China.,State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medicine Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region 830054, P.R. China
| | - Xiaojuan Bi
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medicine Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region 830054, P.R. China
| | - Xianlin Duan
- Hematologic Disease Center, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang Uygur Autonomous Region Research Institute of Hematology, Urumqi, Xinjiang Uygur Autonomous Region 830054, P.R. China
| | - Nannan Pang
- Hematologic Disease Center, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang Uygur Autonomous Region Research Institute of Hematology, Urumqi, Xinjiang Uygur Autonomous Region 830054, P.R. China
| | - Hongbo Wang
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medicine Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region 830054, P.R. China
| | - Hailong Yuan
- Hematologic Disease Center, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang Uygur Autonomous Region Research Institute of Hematology, Urumqi, Xinjiang Uygur Autonomous Region 830054, P.R. China
| | - Rongyao Zhang
- Hematologic Disease Center, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang Uygur Autonomous Region Research Institute of Hematology, Urumqi, Xinjiang Uygur Autonomous Region 830054, P.R. China
| | - Lei Cui
- Hematologic Disease Center, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang Uygur Autonomous Region Research Institute of Hematology, Urumqi, Xinjiang Uygur Autonomous Region 830054, P.R. China.,School of Medicine, Tongji University, Shanghai 200092, P.R. China
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Central metabolism of functionally heterogeneous mesenchymal stromal cells. Sci Rep 2019; 9:15420. [PMID: 31659213 PMCID: PMC6817850 DOI: 10.1038/s41598-019-51937-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 10/08/2019] [Indexed: 12/16/2022] Open
Abstract
Metabolism and mitochondrial biology have gained a prominent role as determinants of stem cell fate and function. In the context of regenerative medicine, innovative parameters predictive of therapeutic efficacy could be drawn from the association of metabolic or mitochondrial parameters to different degrees of stemness and differentiation potentials. Herein, this possibility was addressed in human mesenchymal stromal/stem cells (hMSC) previously shown to differ in lifespan and telomere length. First, these hMSC were shown to possess significantly distinct proliferation rate, senescence status and differentiation capacity. More potential hMSC were associated to higher mitochondrial (mt) DNA copy number and lower mtDNA methylation. In addition, they showed higher expression levels of oxidative phosphorylation subunits. Consistently, they exhibited higher coupled oxygen consumption rate and lower transcription of glycolysis-related genes, glucose consumption and lactate production. All these data pointed at oxidative phosphorylation-based central metabolism as a feature of higher stemness-associated hMSC phenotypes. Consistently, reduction of mitochondrial activity by complex I and III inhibitors in higher stemness-associated hMSC triggered senescence. Finally, functionally higher stemness-associated hMSC showed metabolic plasticity when challenged by glucose or glutamine shortage, which mimic bioenergetics switches that hMSC must undergo after transplantation or during self-renewal and differentiation. Altogether, these results hint at metabolic and mitochondrial parameters that could be implemented to identify stem cells endowed with superior growth and differentiation potential.
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Liu Y, Yi L, Wang L, Chen L, Chen X, Wang Y. Ginsenoside Rg1 protects human umbilical cord blood-derived stromal cells against tert-Butyl hydroperoxide-induced apoptosis through Akt-FoxO3a-Bim signaling pathway. Mol Cell Biochem 2016; 421:75-87. [PMID: 27522666 DOI: 10.1007/s11010-016-2786-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 08/05/2016] [Indexed: 12/22/2022]
Abstract
Human umbilical cord blood-derived stromal cells (hUCBDSCs) possess strong capability of supporting hematopoiesis and immune regulation, whereas some stress conditions cause reactive oxygen species (ROS) accumulation and then lead to oxidative injury and cell apoptosis. Ginsenoside Rg1 (G-Rg1) has been demonstrated to exert antioxidative and prosurvival effects in many cell types. In this study, the tert-Butyl hydroperoxide (t-BHP), an analog of hydroperoxide, was utilized to mimic the oxidative damage to hUCBDSCs. We aimed to investigate the effects of Ginsenoside Rg1 on protecting hUCBDSCs from t-BHP-induced oxidative injury and apoptosis, as well as the possible signaling pathway involved. It was shown that the treatment of hUCBDSCs with G-Rg1 markedly restored the t-BHP-induced cell viability loss, promoted the CFU-F formation, and inhibited cell apoptosis. G-Rg1 also caused a reduced production of LDH and MDA while significantly enhancing the activity of SOD. Mechanistically, G-Rg1 promoted the phosphorylation of Akt and FoxO3a and led to the cytoplasmic translocation of FoxO3a, which in turn suppressed FoxO3a-modulated expression of proapoptotic Bim and elevated the ratio of Bcl-2 to Bax. All these results suggest that G-Rg1 enhances the survival of t-BHP-induced hUCBDSCs and protects them against apoptosis at least partially through Akt-FoxO3a-Bim signaling pathway.
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Affiliation(s)
- Ying Liu
- Department of Histology and Embryology, Laboratory of Stem Cells and Tissue Engineering, Chongqing Medical University, Chongqing, People's Republic of China
| | - Long Yi
- Research Center for Nutrition and Food Safety, Institute of Military Preventive Medicine, Third Military Medical University, Chongqing, People's Republic of China
| | - Lu Wang
- Department of Histology and Embryology, Laboratory of Stem Cells and Tissue Engineering, Chongqing Medical University, Chongqing, People's Republic of China
| | - Linbo Chen
- Department of Histology and Embryology, Laboratory of Stem Cells and Tissue Engineering, Chongqing Medical University, Chongqing, People's Republic of China
| | - Xiongbin Chen
- Department of Histology and Embryology, Laboratory of Stem Cells and Tissue Engineering, Chongqing Medical University, Chongqing, People's Republic of China
| | - Yaping Wang
- Department of Histology and Embryology, Laboratory of Stem Cells and Tissue Engineering, Chongqing Medical University, Chongqing, People's Republic of China.
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Molaeipour Z, Shamsasanjan K, Movassaghpour AA, Akbarzadehlaleh P, Sabaghi F, Saleh M. The Effect of Bone Marrow Mesenchymal Stem Cells on Vitamin D3 Induced Monocytic Differentiation of U937 Cells. Adv Pharm Bull 2016; 6:23-9. [PMID: 27123414 DOI: 10.15171/apb.2016.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 12/27/2015] [Accepted: 01/07/2016] [Indexed: 12/30/2022] Open
Abstract
PURPOSE Mesenchymal stem cells (MSCs) are key components of the hematopoietic stem cells (HSCs) niche. They control the process of hematopoiesis by secreting regulatory cytokines, growth factors and expression of important cell adhesion molecules for cell-tocell interactions. In this research, we have investigated the effect of bone marrow derived MSCs on monocytic differentiation of U937 cells line. METHODS U937 cells were cultured in both direct co-culture with MSCs and MSCs conditioned medium (C.M) driven. This study used 1,25-dihydroxyvitamin D3(VitD3) as inductor of monocytic differentiation and U937 cells treated with VitD3 morphology was examined by Wright Giemsa staining. CD14 monocytic differentiation marker was measured by flow cytometry and monocytic gene expression was assessed by real time polymerase chain reaction (RT PCR). RESULTS The results of flow cytometric analysis showed that CD14 expression of U937 increased. The higher effect of MSCs co-culture on CD14 expression in U937 cells was observed, compared to the conditioned medium. Among ten monocytic related genes which were screened that was observed increase in 5 genes in which CXCR4 and CSF2RA showed significant increase. CONCLUSION The results obtained show that MSCs have supportive effect on the monocytic differentiation of U937 cells. However, a distinct mechanism of that remains unclear.
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Affiliation(s)
- Zahra Molaeipour
- Hematology Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Karim Shamsasanjan
- Hematology Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Parvin Akbarzadehlaleh
- Pharmaceutical Biotechnology Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Sabaghi
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Mahshid Saleh
- Hematology Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Molaeipour Z, Shamsasanjan K, Movassaghpour AA, Akbarzadehlaleh P, Sabaghi F, Saleh M. The Effect of Bone Marrow Mesenchymal Stem Cells on Vitamin D3 Induced Monocytic Differentiation of U937 Cells. Adv Pharm Bull 2016; 6:23-29. [PMID: 27123414 PMCID: PMC4845548 DOI: 10.15171/apb.2016.05] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 12/27/2015] [Accepted: 01/07/2016] [Indexed: 08/05/2023] Open
Abstract
PURPOSE Mesenchymal stem cells (MSCs) are key components of the hematopoietic stem cells (HSCs) niche. They control the process of hematopoiesis by secreting regulatory cytokines, growth factors and expression of important cell adhesion molecules for cell-tocell interactions. In this research, we have investigated the effect of bone marrow derived MSCs on monocytic differentiation of U937 cells line. METHODS U937 cells were cultured in both direct co-culture with MSCs and MSCs conditioned medium (C.M) driven. This study used 1,25-dihydroxyvitamin D3(VitD3) as inductor of monocytic differentiation and U937 cells treated with VitD3 morphology was examined by Wright Giemsa staining. CD14 monocytic differentiation marker was measured by flow cytometry and monocytic gene expression was assessed by real time polymerase chain reaction (RT PCR). RESULTS The results of flow cytometric analysis showed that CD14 expression of U937 increased. The higher effect of MSCs co-culture on CD14 expression in U937 cells was observed, compared to the conditioned medium. Among ten monocytic related genes which were screened that was observed increase in 5 genes in which CXCR4 and CSF2RA showed significant increase. CONCLUSION The results obtained show that MSCs have supportive effect on the monocytic differentiation of U937 cells. However, a distinct mechanism of that remains unclear.
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Affiliation(s)
- Zahra Molaeipour
- Hematology Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Karim Shamsasanjan
- Hematology Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Parvin Akbarzadehlaleh
- Pharmaceutical Biotechnology Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Sabaghi
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Mahshid Saleh
- Hematology Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Barilani M, Lavazza C, Viganò M, Montemurro T, Boldrin V, Parazzi V, Montelatici E, Crosti M, Moro M, Giordano R, Lazzari L. Dissection of the cord blood stromal component reveals predictive parameters for culture outcome. Stem Cells Dev 2015; 24:104-14. [PMID: 25046283 DOI: 10.1089/scd.2014.0160] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
In regenerative medicine, human cord blood-derived multipotent mesenchymal stromal cells (CBMSCs) stand out for their biological peculiarities demonstrated in in vitro and in vivo preclinical studies. Here, we present our 9-year experience for the consistent isolation of CBMSCs. Although nearly one CB unit out of two retains the potential to give rise to MSC colonies, only 46% of them can be cultured till low passages (P≥4), but one-fourth of those reaches even higher passages (P≥8). Subsequent characterization for morphological, clonal, differentiation, and proliferation properties revealed two divergent CBMSC behaviors. In particular, a cumulative population doublings cut-off (CPD=15) was identified that undoubtedly distinguishes two growth curves, and different degrees of commitment toward osteogenesis were observed. These data clearly show the existence of at least two distinct CBMSC subsets: one mainly short-living and less proliferative (SL-CBMSCs), the other long-living, with higher growth rate, and, very importantly, with significantly (P≤0.01) longer telomere (LL-CBMSCs). Moreover, significant differences in the immunoprofile before seeding were found among CB units giving rise to LL-CBMSCs or SL-CBMSCs or showing no colony formation. Finally, all the aforementioned results provided a peculiar and useful set of parameters potentially predictive for CBMSC culture outcome.
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Affiliation(s)
- Mario Barilani
- 1 Cell Factory, Unit of Cell Therapy and Cryobiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milano, Italy
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Yao Y, Song Q, Chu Y, Gong H, Li N, Hu Q, Xu X. Infusion of allogeneic umbilical cord blood hematopoietic stem cells in patients with chemotherapy-related myelosuppression. Exp Ther Med 2014; 8:1946-1950. [PMID: 25371761 PMCID: PMC4218683 DOI: 10.3892/etm.2014.2022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 09/29/2014] [Indexed: 11/05/2022] Open
Abstract
Chemotherapy-induced myelosuppression is one of the main problems in the treatment of cancer. In the present study, the effects of allogeneic umbilical cord blood hematopoietic stem cell (UCB-HSC) infusion were investigated on the treatment of chemotherapy-related myelosuppression. In total, 65 patients (male, 42; female, 23) diagnosed with chemotherapy-related myelosuppression were included in the study. The majority of the patients were classified with stage II myelosupression at enrolment, and an average concentration of 7.07×109/l UCB-HSCs were transfused through the peripheral vein. The minimum values of the white blood cell (WBC) count, hemoglobin (Hb) level, platelet (PLT) count and Karnofsky performance status (KPS) scores were recorded prior to and between days 7 and 14 following UCB-HSC infusion. When assessing the overall data, the results revealed that the mean WBC and PLT counts increased significantly following UCB-HSC infusion. However, the subgroup analyses based on gender and KPS score revealed that UCB-HSC infusion was more successful in male patients and those with a higher KPS score. Spearman's correlation analysis revealed a linear correlation between the number of transfused UCB-HSCs and the changes in the WBC and PLT counts following treatment. In conclusion, the results indicated that peripheral vein infusion of non-human leukocyte antigen matched UCB-HSCs can markedly improve chemotherapy-related myelosuppression in a safe and effective manner.
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Affiliation(s)
- Yi Yao
- Cancer Center, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Qibin Song
- Cancer Center, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Yuxin Chu
- Cancer Center, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Hongyun Gong
- Cancer Center, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Na Li
- Cancer Center, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Qinyong Hu
- Cancer Center, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Xiaotao Xu
- Cancer Center, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
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Liu SS, Zhang C, Zhang X, Chen XH. Human umbilical cord blood-derived stromal cells: A new source of stromal cells in hematopoietic stem cell transplantation. Crit Rev Oncol Hematol 2013; 90:93-8. [PMID: 24411588 DOI: 10.1016/j.critrevonc.2013.12.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Revised: 10/21/2013] [Accepted: 12/03/2013] [Indexed: 01/14/2023] Open
Abstract
The hematopoietic inductive microenvironment (HIM), which is composed of stromal cells, extracellular matrix and cytokines, plays a vital role in hematopoietic stem cell transplantation (HSCT). Bone marrow stromal cells (BMSCs), as the main component of HIM, have been well studied. However, the highly invasive procedure of bone marrow (BM) collection limits the clinical application of BMSCs. Human umbilical cord blood-derived stromal cells (hUCBDSCs) isolated and cultured in our laboratory have attracted much attention for their ease collection and low probability of pathophoresis. Previous research demonstrated that hUCBDSCs have numerous functions that are identical to those of BMSCs, for example, hUCBDSCs can support the growth of hematopoietic stem and progenitor cells, especially during the expansion of megakaryocyte colony-forming units (CFU-Mk), promote engraftment after hematopoietic stem cell transplantation (HSCT), exert immunosuppressive effects on xenogenic T cells in vitro and suppress acute graft-versus-host disease (aGVHD) in vivo. Although hUCBDSCs, as new stromal cells, have not been used in clinical practice, they have great practical significance because of their superiority in hematopoiesis and the regulation of immunity.
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Affiliation(s)
- Shan-Shan Liu
- Department of Hematology, Xinqiao Hospital, The Third Military Medical University, Chongqing 400037, People's Republic of China
| | - Cheng Zhang
- Department of Hematology, Xinqiao Hospital, The Third Military Medical University, Chongqing 400037, People's Republic of China
| | - Xi Zhang
- Department of Hematology, Xinqiao Hospital, The Third Military Medical University, Chongqing 400037, People's Republic of China
| | - Xing-Hua Chen
- Department of Hematology, Xinqiao Hospital, The Third Military Medical University, Chongqing 400037, People's Republic of China.
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