The viability and regeneration of artificial cell microencapsulated rat hepatocyte xenograft transplants in mice

Secretion of Erythropoietin from Microencapsulated Rat Kidney Cells: Preliminary Results

Rat kidney epithelial cells were microencapsulated within alginate-poly(L)lysinealginate membrane. The microencapsulated cells were incubated using a culture media containing cobalt and another without cobalt. The viability was measured by trypan blue exclusion test. Secretion of erythropoietin (EPO) was measured by radioimmunoassay (RIA). Viability of free cells was 53%. The viability of microencapsulated cells increased to 72% after 12 days of incubation and remained at this level. Samples of the culture media were collected every 2 days for RIA. Samples within the microcapsules were collected by breaking the microcapsules open. RIA of these samples showed the following for the media containing cobalt. Between day 16 and day 32 the concentrations of EPO were 5.3 mU/ml inside and 18.3 mU/ml outside the microcapsule. The medium from the same number of free cells contained 21.2 mU/ml of EPO. Culture media without cobalt collected during the same period contained 1.8 mU/ml inside and 9.9 mU/ml outside the microcapsules. The free cell culture with this media during the same period contained 8.3 mU/ml.

Effect of Donor Strains and Age of the Recipient in the Use of Microencapsulated Hepatocytes to Control Hyperbilirubinemia in the Gunn Rat

Hepatocytes of certain rat strains are spontaneously accepted when they are implanted in the peritoneal cavity. Therefore to evaluate if microcapsules are able to immunoisolate the hepatocytes, it is necessary to find the strain of rat whose free hepatocytes are rejected. Hepatocytes were collected from Buffalo rats and were implanted intraperitoneally in one year old Gunn rats. During the first two weeks both groups of Gunn rats which received free and encapsulated hepatocytes showed a reduction in the bilirubin level relative to the control. After 15 days, the bilirubin levels increased in the group which received free hepatocytes. This suggests that an acute rejection had taken place. Bilirubin continued to stay high until the end of the experiment and there was no difference between this group and the control. As the animal ages, there is a significant accumulation of bilirubin in the tissues which affects the net reduction of serum bilirubin since once bilirubin is conjugated by the transplanted hepatocytes and eliminated, some of the bilirubin deposited in the tissues diffuses into the blood preventing a major drop in serum bilirubin levels. The findings that UDP-glucuronosyltransferase (UDPGT) activity of Buffalo rat hepatocytes is the same as the UDPGT activity of Wistar rat hepatocytes, imply that the age of the animal is a very critical factor in determining how great the depression of serum bilirubin will be after implantation of hepatocytes.

Extracorporeal Artificial Liver: The Influence of a Second Cell Layer on the Morphology and Function of Immobilized Human Hepatocytes

Hepatocytes in long-term cultures represent a promising approach to preserve liver function under standard culture conditions. Hepatocyte cultures as the key components in an extracorporeal artificial liver (EAL) in the treatment of hepatic insufficiency, would be a great advantage. However, one of the numerous unsolved problems is the limitation of the surface area of a future EAL. To decrease the dimensions of same, we modified the cell immobilization technique by placing a second layer of immobilized human hepatocytes onto a layer of pre-immobilized hepatocytes creating a “sandwich immobilization” (SI) system. Immobilization and sandwich immobilization were compared over an investigation period of 30 days: functional performance mirrored by cholinesterase (CHE) and albumin secretion showed remarkable differences only in the course of the first week, whereas we found almost no differences from day 8 on. The total DNA-values on days 0, 1, 7, 14, 21 and 30 varied strongly after the first week but were very similar up to day 30. Finally, it appears disadvantageous to enlarge number/cm2 of (human) hepatocytes in long-term cultures or for application in an EAL by means of sandwich immobilization.

Repeated Transplantation of Microencapsulated Hepatocytes for Sustained Correction of Hyperbilirubinemia in Gunn Rats

In previous studies we demonstrated that transplantation of microencapsulated hepatocytes could correct congenital hyperbilirubinemia in Gunn rats for 4 to 6 wks. Reduction in hyperbilirubinemia followed a single transplantation of isolated encapsulated hepatocytes (IEH). After 4 to 6 wks of transplantation IEH gradually lose their functionality. To sustain long-term supplementation of liver function we have investigated the efficacy of monthly IEH transplantations for 6 mo. Hepatocytes, isolated from young Wistar rats, were microencapsulated with a collagen matrix within an alginate-poly L-lysine composite membrane. We transplanted IEH intraperitoneally into homozygous Gunn rats at monthly (4-wk) intervals for 6 mo. Control Gunn rats received intraperitoneal transplantations of empty microcapsules. Total serum bilirubin was measured in the IEH-transplanted and control Gunn rats at weekly intervals for the duration of the 6-month study. A significant (p < 0.01) and sustained decrease (by nearly 50%) in total serum bilirubin levels was observed following monthly IEH transplantations in Gunn rats for the duration of the study. No such decrease in total serum bilirubin levels was seen in the controls. The Gunn rats exhibited good tolerance for the multiple IEH transplantations. Thus, repeated IEH transplantations may be one strategy for providing long-term supplementation of liver function in congenital metabolic liver disease.

Microencapsulation for the Therapeutic Delivery of Drugs, Live Mammalian and Bacterial Cells, and Other Biopharmaceutics: Current Status and Future Directions

Microencapsulation is a technology that has shown significant promise in biotherapeutics, and other applications. It has been proven useful in the immobilization of drugs, live mammalian and bacterial cells and other cells, and other biopharmaceutics molecules, as it can provide material structuration, protection of the enclosed product, and controlled release of the encapsulated contents, all of which can ensure efficient and safe therapeutic effects. This paper is a comprehensive review of microencapsulation and its latest developments in the field. It provides a comprehensive overview of the technology and primary goals of microencapsulation and discusses various processes and techniques involved in microencapsulation including physical, chemical, physicochemical, and other methods involved. It also summarizes the state-of-the-art successes of microencapsulation, specifically with regard to the encapsulation of microorganisms, mammalian cells, drugs, and other biopharmaceutics in various diseases. The limitations and future directions of microencapsulation technologies are also discussed.

Improving cell encapsulation through size control

Capsules based on 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 have previously shown important advantages for cell encapsulation. However, in vivo long-term applications require capsule features that are well suited for the functionality of encapsulated cells. These should be targeted to the site of implantation with an appropriate size, a relative stability, and suitable diffusion properties. This study shows the effect of capsule size reduction, from 1 mm to 400 microm, on capsule quality control, mechanical stability, diffusion properties, and in vitro activities of the encapsulated cells. Following a controlled preparation, it was determined that the capsule mechanical stability was largely dependent on the volume ratio of the capsule over the membrane. The molecule diffusion time was related to the surface/volume ratio of the capsule even for the capsules exhibiting an identical cut-off towards the proteins and the dextran molecules. Finally, the in vitro cellular activities, for both primary cultures of rat islets and murine hepatocytes, were improved for cells encapsulated into the 400 microm capsules compared with those in the 1 mm capsules. All of these findings suggest that the smaller capsules present better properties for future clinical applications, at the same time widening the choice of implantation site, and strengthen the notion that slight changes in the capsular morphological parameters can largely influence the graft function in vivo.

Generating intestinal tissue from stem cells: potential for research and therapy

Intestinal resection and malformations in adult and pediatric patients result in devastating consequences. Unfortunately, allogeneic transplantation of intestinal tissue into patients has not been met with the same measure of success as the transplantation of other organs. Attempts to engineer intestinal tissue in vitro include disaggregation of adult rat intestine into subunits called organoids, harvesting native adult stem cells from mouse intestine and spontaneous generation of intestinal tissue from embryoid bodies. Recently, by utilizing principles gained from the study of developmental biology, human pluripotent stem cells have been demonstrated to be capable of directed differentiation into intestinal tissue in vitro. Pluripotent stem cells offer a unique and promising means to generate intestinal tissue for the purposes of modeling intestinal disease, understanding embryonic development and providing a source of material for therapeutic transplantation.

Characterization of viability and proliferation of alginate-poly-L-lysine-alginate encapsulated myoblasts using flow cytometry

Genetically modified cells encapsulated in alginate-poly-L-lysine-alginate (APA) are being developed to deliver therapeutic products to treat a variety of diseases. The characterization of the encapsulated cells thus becomes paramount. This study reports a novel method to assess the viability, granularity and proliferation of encapsulated cells based on flow cytometry. The in vitro viability of encapsulated G8 murine myoblasts secreting canine FVIII (cFVIII) measured by flow cytometry was comparable to the traditional trypan blue exclusion method and both correlated with cFVIII secretion levels. In contrast, after implantation into mice, only viability measured by flow cytometry correlated with cFVIII secretion. Further, flow cytometry analysis of encapsulated cells maintained in vitro and in vivo revealed a greater fraction of granular cells compared to free cells, suggesting that encapsulation influences the morphology (cytoplasmic composition) of cells within APA microcapsules. Interestingly, the proliferation study showed that encapsulated cells proliferate faster, on average, and were more heterogeneous in vivo compared to in vitro culture conditions, suggesting that encapsulated cell proliferation is complex and environment-dependent. In conclusion, we show that flow cytometry analysis allows for a more consistent and comprehensive examination of encapsulated cells to aid in the development of cell therapy protocols.

Artificial cell microencapsulated stem cells in regenerative medicine, tissue engineering and cell therapy

Adult stem cells, especially isolated from bone marrow, have been extensively investigated in recent years. Studies focus on their multiple plasticity oftransdifferentiating into various cell lineages and on their potential in cellular therapy in regenerative medicine. In many cases, there is the need for tissue engineering manipulation. Among the different approaches of stem cells tissue engineering, microencapsulation can immobilize stem cells to provide a favorable microenvironment for stem cells survival and functioning. Furthermore, microencapsulated stem cells are immunoisolated after transplantation. We show that one intraperitoneal injection of microencapsulated bone marrow stem cells can prolong the survival of liver failure rat models with 90% of the liver removed surgically. In addition to transdifferentiation, bone marrow stem cells can act as feeder cells. For example, when coencapsulated with hepatocytes, stem cells can increase the viability and function of the hepatocytes in vitro and in vivo.

Mechanical properties of alginate beads hosting hepatocytes in a fluidized bed bioreactor

Fluidized bed bioartificial liver has been proposed as a temporary support to bridge patients suffering from acute liver failure to transplantation. In such a bioreactor, alginate beads hosting hepatocytes are in continuous motion during at least six hours. After having shown in vitro the functionality of such a device, the present study aims at analyzing the potential mechanical alterations of the beads in the bioreactor, perfused by different surrounding media. Compression experiments are performed and coupled for analysis with Hertz theory. They provide qualitative and quantitative data. The average value of the shear modulus, calculated for the different cases studied varied from 2.4 to 10.4 kPa, and could therefore be considered as a quantitative measure of the beads mechanical properties. From the compression experiments and the estimated values of the shear modulus, we could now evaluate the effect of different operating conditions (fluidization, presence of cells, surrounding medium) on the mechanical behavior of alginate beads. On the one hand, the motion during six hours in the bioreactor does not alter the beads significantly. On the other hand, the presence of different substances in the fluid phase might change their mechanical strength. These results can be considered as new encouragements to use such a device as a bioartificial organ.

Co-transplantation of encapsulated HepG2 and rat Sertoli cells improves outcome in a thioacetamide induced rat model of acute hepatic failure

Hepatocyte transplantation offers therapeutic opportunities in liver disease. Xenogeneic hepatocytes are a potential resource, but rejection presents a major problem. We combined cell encapsulation with modulation by local generation of an immunosuppressant by co-encapsulating Sertoli cells with HepG2 cells. We assessed in vitro rat leukocyte proliferative responses and HepG2 cell survival after intraperitoneal injection in rats. Empty beads, and beads containing HepG2 cells or HepG2/Sertoli cells were injected intra-peritoneally into rats and survival of implanted cells followed over 4 weeks; in some animals acute hepatic failure (AHF) using thioacetamide (TAA) was also induced. The marked proliferative response of rat leukocytes to HepG2 cells and HepG2-containing beads was reduced by Sertoli cell-conditioned medium and HepG2/Sertoli encapsulates. After intra-peritoneal transplantation, Sertoli cells co-encapsulation protected the HepG2 cells in normal and AHF animals. Combined encapsulation and locally generated immuno-suppression may be a valuable strategy in hepatocyte transplantation.

Therapeutic applications of polymeric artificial cells

Polymeric artificial cells have the potential to be used for a wide variety of therapeutic applications, such as the encapsulation of transplanted islet cells to treat diabetic patients. Recent advances in biotechnology, molecular biology, nanotechnology and polymer chemistry are now opening up further exciting possibilities in this field. However, it is also recognized that there are several key obstacles to overcome in bringing such approaches into routine clinical use. This review describes the historical development and principles behind polymeric artificial cells, the present state of the art in their therapeutic application, and the promises and challenges for the future.

Cellular therapies for liver replacement

Insufficient donor organs for orthotopic liver transplantation worldwide have urgently increased the requirement for new therapies for acute and chronic liver disease. Whilst none are yet clinically proven there are at least two different approaches for which there is extensive experimental data, some human anecdotal evidence and some data emerging from Phase 1 clinical trials. Both approaches involve bio-engineering. In vivo tissue engineering involves isolated liver cell transplantation into the liver and/or other ectopic sites and in vitro tissue engineering, using an extracorporeal hepatic support system or bioartificial liver. Some questions are common to both these approaches, such as the best cell source and the therapeutic mass required, and are discussed. Others are specific to each approach. For cell transplantation in vivo the initial engraftment and repopulation will make a critical difference to the outcome, and development of markers for transplanted cells has enabled significant advances in understanding, and therefore manipulating, the process. Moreover, the role of immunosuppression is also important and novel approaches to natural immunosuppression are discussed. For use in a bioartificial liver, the ability for hepatocytes to perform ex vivo at in vivo levels is critical. Three dimensional culture improves cell performance over monolayer cultures. Alginate encapsulated cells offer a suitable 3-D environment for a bioartificial liver since they are both easily manipulatable and cryopreservable. The use of cells derived from stem cells or foetal rather than adult liver cells is also emerging as a potential human cell source which may overcome problems associated with xenogeneic cells.

Artificial cell bioencapsulation in macro, micro, nano, and molecular dimensions: keynote lecture

Artificial cells now ranges from macro-dimensions, to micron-dimensions, to nano-dimensions, and to molecular dimensions. Those in the macro-dimensions are suitable for use in the bioencapsulation of cells, tissues, microorganisms, and bioreactants. Those in the micron-dimensions are suitable for the bioencapsulation of enzymes, microorganisms, peptides, drugs, vaccine, and other materials. Those in the nano-dimension are being used for blood substitutes and carriers for enzymes, peptides, drugs, etc. Those in the molecular-dimensions are used as blood substitutes, crosslinked enzymes etc.

Artificial Cells for Cell and Organ Replacements

The artificial cell is a Canadian invention (Chang, Science, 1964). This principle is being actively investigated for use in cell and organ replacements. The earliest routine clinical use of artificial cells is in the form of coated activated charcoal for hemoperfusion for use in the removal of drugs, and toxins and waste in uremia and liver failure. Encapsulated cells are being studied for the treatment of diabetes, liver failure, and kidney failure, and the use of encapsulated genetically-engineered cells is being investigated for gene therapy. Blood substitutes based on modified hemoglobin are already in Phase III clinical trials in patients, with as much as 20 units being infused into each patient during trauma surgery. Artificial cells containing enzymes are being developed for clinical trial in hereditary enzyme deficiency diseases and other diseases. The artificial cell is also being investigated for drug delivery and for other uses in biotechnology, chemical engineering, and medicine.

Artificial cells for replacement of metabolic organ functions

Artificial cells are being actively investigated for use in the replacement of cell and organ functions, especially related to metabolic functions. The earliest routine clinical use of artificial cells is in the form of coated activated charcoal for hemoperfusion. Implantation of encapsulated cells are being studied for the treatment of diabetes, liver failure, kidney failure and the use of encapsulated genetically engineered cells for gene therapy. Blood substitutes based on modified hemoglobin are already in Phase III clinical trials in patients with as much as 20 units infused into each patient during trauma surgery. Artificial cells containing enzymes are being developed for clinical trial in hereditary enzyme deficiency diseases and other diseases. Artificial cell is also being investigated for drug delivery and for other uses in biotechnology, chemical engineering and medicine.

Increased viability of transplanted hepatocytes when hepatocytes are co-encapsulated with bone marrow stem cells using a novel method

This study is to investigate the viability of hepatocytes when transplanted into Wistar rats using co-encapsulated hepatocytes and bone marrow stem cells. Hepatocytes and bone marrow stem cells, isolated from Wistar rats, are co-encapsulated using either the standard single-step method or a novel two-step cell encapsulation method (www.artcell.mcgill.ca). After intraperitoneal transplantation into Wistar rats, the histology, fate of recovered microcapsules and viability of encapsulated hepatocytes are studied. When prepared using the standard method, there is excellent viability but only for up to 3 weeks. After this, there is extensive fibrous coating and severe fibrous adhesion and no microcapsules can be recovered. On the other hand, using the new two-step encapsulation method, the viability of the encapsulated hepatocytes can be followed for more than 4 months after transplantation. Even up to 4 months, there is significantly less host reaction when using the two-step encapsulation method and 50% of the microcapsules can be recovered. Co-encapsulated with bone marrow stem cells resulted in further increase in viability of the hepatocytes when followed up to 4 months after transplantation. This new approach may improve the potential feasibility of using co-encapsulation of hepatocytes and bone marrow stem cells in bio-artificial liver support for the treatment of liver failure, especially for acute liver failure.

Development of a coculture model of encapsulated cells

In the whole animal, metabolic regulations are set by reciprocal interactions between various organs, via the blood circulation. At present, analyses of such interactions require numerous and uneasily controlled in vivo experiments. In a search for an alternative to in vivo experiments, our work aims at developing a coculture system in which different cell types are isolated in polymer capsules and grown in a common environment. The signals exchanged between cells from various origins are, thus, reproducing the in vivo intertissular communications. With this perspective, we evaluated a new encapsulation system as an artificial housing for liver cells on the one hand and adipocytes on the other hand. Murine hepatocytes were encapsulated with specially designed multicomponent capsules formed by polyelectrolyte complexation between sodium alginate, cellulose sulphate and poly(methylene-coguanidine) hydrochloride, of which the permeability has been characterized. We demonstrated the absence of cytotoxicity and the excellent biocompatibility of these capsules towards primary culture of murine hepatocytes. Encapsulated hepatocytes retain their specific functions--transaminase activity, urea synthesis, and protein secretion--during the first four days of culture in minimum medium. Mature adipocytes, isolated from mouse epidydimal fat, were embedded in alginate beads. Measurement of protein secretion shows an identical profile between free and embedded adipocytes. We finally assessed the properties of encapsulated hepatocytes, cryopreserved over a periods of up to four months. The perspective of using encapsulated cells in coculture are discussed, since this system may represent a promising tool for fundamental research, such as analyses of drug metabolism, intercellular regulations, and metabolic pathways, as well as for the establishment of a tissue bank for storage and supply of murine hepatocytes.

Improved survival and ammonia metabolism by intraperitoneal transplantation of microencapsulated hepatocytes in totally hepatectomized rats

BACKGROUND

We evaluated the effects of intraperitoneal transplantation of microencapsulated hepatocytes in a 3-stage total hepatectomy rat model.

METHODS

A new model of total hepatectomy was created as follows. First, the infrahepatic inferior vena cava was ligated just above the right renal vein. Seven days later, the portal vein was ligated and a portacaval shunt was established using a Teflon catheter over a venipuncture needle. Another 7 days later, total hepatectomy was completed by ligating and dividing the suprahepatic inferior vena cava, the hepatic artery, and the bile duct. Next, 4 x 10(7) hepatocytes (4% of the normal liver hepatocyte mass) isolated from male Wistar rats were microencapsulated within a collagen matrix enveloped by a 3-layer membrane of sodium alginate-poly-L-lysine-sodium alginate copolymer. Capsules containing hepatocytes (diameter, 500-800 microm) and empty capsules (control) were transplanted intraperitoneally 4 days before the total hepatectomy. Survival time and selected blood chemistry concentrations after the total hepatectomy were measured. The capsules were also examined histologically with hematoxylin and eosin staining and modified Gmelin's stain for bile pigments.

RESULTS

The survival time was greater in the rats given the microencapsulated hepatocytes than in the control rats (17.3 +/- 3 vs 3.7 +/- 0.1 hours; P <.01). The blood ammonia concentrations increased soon after total hepatectomy but remained significantly lower in the rats with microencapsulated hepatocytes (P <.05). The microcapsules contained numerous viable hepatocytes with abundant bile pigments and no lymphocytic infiltration.

CONCLUSIONS

Microencapsulated hepatocytes with an ultrathin polymer layer that protects them from inflammatory and lymphocytic reactions may facilitate their ability to function. In this study, 4 x 10(7) hepatocytes significantly prolonged the survival of rats that underwent hepatectomy and supported ammonia metabolism. Further development of this technique may permit its use in patients with hepatic failure.

Maintenance of primary murine hepatocyte functions in multicomponent polymer capsules--in vitro cryopreservation studies

BACKGROUND/AIMS

The potential of a new encapsulation system has been evaluated as an artificial housing for liver cells.

METHODS

Murine hepatocytes were encapsulated in specially designed multicomponent capsules formed by polyelectrolyte complexation of sodium alginate, cellulose sulphate and poly(methylene-co-guanidine) hydrochloride, the permeability of which has previously been characterised.

RESULTS

We demonstrate here the absence of cytotoxicity and the excellent biocompatibility of these capsules towards primary culture of murine hepatocytes. Experimental results demonstrated that the encapsulated hepatocytes retained their specific functions--transaminase activity, urea synthesis and protein secretion--over the first 4 days of culture in minimum medium. The cryopreservation of encapsulated hepatocytes, for periods of up to 4 months, did not alter their functional capacities, as no major differences were observed between unfrozen and frozen encapsulated cells for the functions tested.

CONCLUSIONS

Because of the absence of cytotoxicity, and the ease of handling and cryopreservation, while maintaining liver specific functions, the described system appears to be valuable for murine liver cell encapsulation. It is also a promising tool for fundamental research into drug metabolism, intercellular regulation, metabolic pathways, and the establishment of banks for the supply and storage of murine hepatocytes.

Agarose enhances the viability of intraperitoneally implanted microencapsulated L929 fibroblasts

To achieve immunoisolation, mouse L929 fibroblasts were encapsulated in approximately 400 microm poly(hydroxyethyl methacrylate-co-methyl methacrylate) (HEMA-MMA) microcapsules and were subsequently implanted in the peritoneal cavity of syngeneic C3H mice. As a baseline for the use of genetically engineered cells in cell encapsulation therapy, the L929 cells were transfected to express a secreted form of human alkaline phosphatase (SEAP). Implantation of empty microcapsules in a PBS suspension resulted in deformation, aggregation, and poor retrievability of the microcapsules. Incubation of microcapsules with medium containing xenogeneic horse serum prior to implantation increased the thickness of the fibrous tissue surrounding the microcapsules. However, immobilization of the microcapsules in a 4% (w/v) SeaPlaque agarose gel prior to implantation allowed complete recovery of the microcapsules and prevented their aggregation and deformation. As a result, approximately 50% of the encapsulated cells remained viable 21 days postimplantation. Moreover, once the viable cells were released from retrieved microcapsules and regrown as monolayers, they expressed SEAP at a level similar to their encapsulated but nonimplanted counterparts.

Non-invasive evaluation of the location, the functional integrity and the oxygen supply of implants: 19F nuclear magnetic resonance imaging of perfluorocarbon-loaded Ba2+-alginate beads

19F nuclear magnetic resonance imaging (MRI) can be used as a non-invasive tool to simultaneously determine the location, the integrity and the oxygen supply of Ba2+-alginate implants. This requires that the beads (implants) are pre-loaded with the perfluorocarbon compound F-44E. Implantation of solid 19F-labelled beads into the peritoneum, below the kidney capsule or into the muscle of Wistar WU rats demonstrated that these beads could be detected by 19F-MRI for up to 18 months after implantation. This indicated that F-44E is not considerably released from the beads during implantation. The signal to noise ratio of liquid-core beads was higher by a factor of 4 than the signal to noise ratio of solid beads, but liquid-core beads were more fragile and also too large for implantation under the kidney capsule and into the intramuscular tissue. Quantitative 2-dimensional 19F-T1 maps (resolution 0.5 x 0.5 mm) could be deduced from 19F-MRI measurements. These T1-maps correlated to the local pO2-values. The partial oxygen pressure estimated in F-44E-loaded Ba2+-alginate beads showed that the oxygen supply inside the beads was very poor when they were implanted below the kidney capsule or into the peritoneal cavity. These low pO2-values obtained for the renal subcapsular site and the peritoneum may explain the failure of previous immunoisolated islet transplantation studies using these locations.

Encapsulated xenogeneic hepatocytes remain functional after peritoneal implantation despite immunization of the host

BACKGROUND/AIMS

Xenogeneic hepatocytes encapsulated in semipermeable membranes could be used in the future for the treatment of acute liver failure and congenital liver defects. However, host immune response could affect the viability and function of transplanted cells. The purpose of this study was to investigate the immunological consequences of intraperitoneal implantation of encapsulated xenogeneic hepatocytes and their effects.

METHODS

Recipient Lewis rats received 2 x 10(7) human hepatocytes encapsulated in semipermeable hydrogel-based hollow fibers, 2 x 10(7) free human hepatocytes or 2 x 10(7) encapsulated Lewis rat hepatocytes. The presence of human albumin in rat sera was assessed by Western blot and the presence of anti-human hepatocytes and anti-human albumin antibodies by ELISA.

RESULTS

Anti-hepatocyte antibodies were detected on the 7th day, and their level increased progressively on days 21 and 28 in rats grafted with encapsulated or free human hepatocytes. Anti-albumin antibodies were detected on day 7 and increased progressively in rats grafted with encapsulated human hepatocytes, but were not detected in the other groups. No immune complexes or complement components of donor origin were detected by immunofluorescence in the recipients' tissues. Despite immunization of the host, encapsulated xenogeneic hepatocytes survived and produced albumin, whereas free hepatocytes had been lysed.

CONCLUSION

Transplantation of encapsulated xenogeneic hepatocytes resulted in immunization of the host with production of anti-hepatocyte and anti-albumin antibodies. However, hepatocytes could be efficiently protected by the membrane and remained viable and functional during the study.

Artificial cells with emphasis on bioencapsulation in biotechnology

The most common use of artificial cells is for bioencapsulation of biologically active materials. Each artificial cell can contain combinations of materials. The permeability, composition and shape of an artificial cell membrane can be varied using different types of synthetic or biological materials. These possible variations in contents and membranes allow for large variations in the properties and functions of artificial cells. Artificial cells containing adsorbents have been a routine form of treatment in hemoperfusion for patients. This includes acute poisoning, high blood aluminum and iron, and supplement to dialysis in kidney failure. Artificial red blood cell substitutes based on modified hemoglobin are already in Phase I and Phase II clinical trials in patients. Artificial cell encapsulated cell cultures are being studied for the treatment of diabetes, liver failure, gene therapy and other conditions. Research on artificial cells containing enzymes includes their use for treatment in hereditary enzyme deficiency diseases and other diseases. Recent demonstration of extensive enterorecirculation of amino acids in the intestine has allowed oral administration to deplete specific amino acids. One example is phenylketonuria, an inborn error or metabolism resulting in high systemic phenylalanine levels. Preliminary clinical studies in patients using bioencapsulation of cells or enzymes have started. Artificial cells containing complex enzyme systems convert wastes like urea and ammonia into essential amino acids. Artificial cells are being used for the production of monoclonal antibodies, interferon and other biotechnological products. Other areas of biotechnological uses include drug delivery, and other areas of biotechnology, chemical engineering and medicine.

[Intraperitoneal transplantation of isolated hepatocytes of the pig: the implantable bioartificial liver]

The general aim is to prepare a bioartificial liver to treat acute hepatic failure using allo- and xenogeneic hepatocytes, immunoprotected by macroencapsulation and transplanted into the peritoneal cavity. The goal of this study was to prepare a large amount of isolated porcine hepatocytes, to encapsulate them within biocompatible membranes for transplant in allo- and xenogeneic combinations and to examine the viability and functionality of the cells 6 weeks later. Hepatocyte isolation was performed in 12 kg pigs (n = 15) by dissociation of the liver with collagenase D (1 g) without oxygenation. Encapsulation of the hepatocyte suspension (10(7)/mL) was performed in hydrogel membranes AN69; hollow fibers (2 m x 0.8 mm) and flaskes (1.8 cm), and transplanted to Yucatan pigs (n = 4) and Lewis rats (n = 12). Six weeks later, they were removed to study the cell viability by histological examination, and the production of albumin by immunonephelometry. The rate of isolated hepatocytes was 38 +/- 5 x 10(9)/mL by liver of pig and the mean viability was 93 +/- 2%. Six weeks after transplantation, hepatocytes were viable, organized in lobules, and showed conserved albumin production. The same results were observed for allogenic and xenogeneic combinations. In conclusion, this method of liver dissociation allowed for preparation of a large amount of isolated hepatocytes from a single pig liver, theoretically sufficient to treat a patient with acute liver failure. Hydrogel membranes were well tolerated and allowed immunoprotection without immunosuppression. Transplanted hepatocytes remained functional. This work is an important step in progress toward clinical application.

Artificial cells and bioencapsulation in bioartificial organs

The most common use of artificial cells is for bioencapsulation of biologically active materials. Many combination of materials can be bioencapsulated. The permeability, composition and configurations of artificial cell membrane can be varied using different types of synthetic or biological materials. These possible variations in contents and membranes allow for large variations in the properties and functions of artificial cells.

Evidence for survival and metabolic activity of encapsulated xenogeneic hepatocytes transplanted without immunosuppression in Gunn rats

BACKGROUND

Hepatocyte transplantation could be an alternative to whole organ transplantation to correct enzymatic disorders. To this end, it would be of major importance to use xenogeneic cells without immunosuppression. The aim of this study was to investigate the survival and metabolic activity of encapsulated xenogeneic hepatocytes in the absence of immunosuppression. For this purpose, we used Gunn rats genetically incapable of bilirubin conjugation.

METHODS

Xenogeneic (from guinea pigs) and allogeneic (from Lewis rats) hepatocytes (2x10(7)) were isolated, macroencapsulated in hydrogel hollow fibers made with an acrylonitrile-sodium methallyl-sulfonate copolymer, and transplanted into the peritoneum of Gunn rats without any immunosuppression. Plasma bilirubin levels were evaluated weekly. Bilirubin conjugates in bile and cell morphology were studied after 5 and 12 weeks, respectively.

RESULTS

In Gunn rats transplanted with xenogeneic hepatocytes, a significant decrease in the serum bilirubin level was observed between 3 and 9 weeks after transplantation when compared with controls transplanted with empty hollow fibers: it fell to 62% of the initial level at weeks 5-7 (P < 0.01). A comparable result was observed in Gunn rats transplanted with encapsulated allogeneic cells. Bilirubin conjugates were observed in bile samples of rats transplanted with encapsulated hepatocytes. After explantation, hollow fibers appeared intact with minimal fibrosis. Cell viability and hepatocyte morphology were preserved.

CONCLUSIONS

These results indicate that macroencapsulated xenogeneic hepatocytes can survive and remain functional for more than 2 months when transplanted in vivo in the absence of any immunosuppression.

Transplantation of microencapsulated hepatocytes for liver function replacement

Recent advances in cell biology and biotechnology have lead the way for a greater understanding of cell function and the potential therapeutic use of transplanted cells for treating a wide array of illnesses. Treatment of disease by transplantation of normal healthy cells, for the replacement of specific biological deficiencies or as a form of auxiliary support for a failing organ, offers important therapeutic applications and also serves as a model for assessing cellular physiology. In the long-term, cell transplantation may also have potential in the development of artificial organ support systems for sustaining patients with severe and chronic diseases such as diabetes, liver failure, endocrine and exocrine disorders, neurological abnormalities, and congenital metabolic defects. Several groups have demonstrated the feasibility and efficacy of cell transplantation in providing specific function in various experimental animal models of human disease. However, without adequate immunosuppression, complications due to tissue rejection remain a significant problem. Microencapsulation of cells within a synthetic semipermeable membrane, prior to transplantation, has been proposed for circumventing immunological complications following transplantation. The microcapsule's semipermeable membrane allows permeant molecules to freely diffuse across while preventing the microencapsulated cells from escaping. This membrane also keeps unwanted substances, such as cells and antibodies, from entering the microcapsule. Thus, microencapsulation provides an innovative and unique technique for the transplantation of foreign tissue and cells without the need for immunosuppression.

Artificial liver support: state of the art

Severe liver disease is very often life-threatening and dramatically diminishes quality of life. Liver support systems based on detoxification alone have proven ineffective because they cannot correct biochemical disorders. An effective artificial liver support system should be capable of carrying out the liver's essential processes such as synthetic and metabolic functions, detoxification, and excretion. It should be capable of sustaining patients with fulminant hepatic failure, preparing patients for liver transplantation when a donor liver is not readily available (i.e., bridge to transplantation), and improving the survival and quality of life for patients for whom transplantation is not a therapeutic option. Recent advances in cell biology, tissue culture techniques, and biotechnology have led the way for the potential use of isolated hepatocytes in treating an array of liver disorders. Isolated hepatocytes may be transplanted to replace liver-specific deficiencies or as an important element of an auxiliary hybrid, bioartificial extracorporeal liver support device, which are important therapeutic applications for treating severe liver disease. Although several hepatocyte-based liver support systems have been proposed, there is no current consensus on its eventual design configuration. Furthermore, application of tissue engineering technology, based on cell-surface interaction studies proposed by our group and others, has enhanced interest in the development of highly efficient hybrid, bioartificial, liver support devices.

Permeability and biocompatibility of a new hydrogel used for encapsulation of hepatocytes

A new high-water-content (83%) and highly permeable anionic polyelectrolyte hydrogel was obtained by phase inversion of a polymer solution containing 6% polyacrylonitrile-sodium methallylsulphonate, 91% dimethylsulphoxide and 3% physiological saline solution. Hydrogel-based hollow fibres (HFs) were fabricated with a co-extrusion apparatus in collaboration with Hospal (France). HFs have an internal diameter of 800 microns and a wall thickness of 100 microns. Experimental results demonstrated that hydrogel-based HFs were permeable to albumin (mol. wt 69,000) and human immunoglobulin G (150,000), but were impermeable to immunoglobulins A (170,000) and M (900,000) after 24 h of diffusion. In vitro, the viability of isolated rat hepatocytes injected into the HFs was 64 +/- 6% after 10 d versus 30 +/- 5% for hepatocytes cultured in Petri dishes (P = 0.0001). Under these conditions, the amount of albumin released by encapsulated hepatocytes was 12 +/- 3 micrograms/24 h/10(6) cells at day 10, whereas at that time no albumin was released by hepatocytes cultured in Petri dishes. In vivo, histological study of hydrogel HFs implanted up to 6 wk in the peritoneum of rats revealed a low inflammatory tissue reaction without giant multinucleate cells in the foreign tissue, which decreased after the third week. The survival rate of encapsulated hepatocytes was over 85% 45 d after transplantation in the peritoneum of syngeneic Lewis rats. Therefore, this hydrogel demonstrates highly favourable properties for encapsulation of hepatocytes with regard to its biocompatibility, permeability and ability to maintain hepatocytes in a functional state for prolonged periods.

Kinetic analysis of UDP-glucuronosyltransferase in bilirubin conjugation by encapsulated hepatocytes for transplantation into Gunn rats

Kinetic analysis of the enzyme UDP-glucuronosyltransferase (UDPGT), responsible for the conjugation of bilirubin, suggests that it is a multisubunit enzyme in which there is cooperative binding of the substrate to the subunits. The binding of bilirubin to UDPGT shows positive cooperativity with an apparent Hill coefficient of 2.9. The binding of UDP-glucuronic acid (UDPGA) exhibits kinetics with mixed cooperativity with an apparent Hill coefficient of 4.028. Homogenized rat hepatocytes, intact hepatocytes, and hepatocytes encapsulated in alginate-polylysine-alginate artificial cells, when incubated with bilirubin (1.6 mM) and UDPGA (20 mM), can form monoconjugated and diconjugated bilirubin. However, the presence of the artificial membrane offers some mass transfer resistance. The intraperitoneal transplantation into the Gunn rat of free and microencapsulated Wistar rat hepatocytes shows that both are equally effective in lowering the serum bilirubin. Thus, the membrane did not contribute to a lowering of efficacy after transplantation.

Transplantation of isolated hepatocytes and their role in extrahepatic life support systems

Transplantation of isolated hepatocytes for the replacement of liver function and the use of isolated hepatocytes as a bridge-to-transplantation in extrahepatic bioartificial liver support devices offer important therapeutic advances for treating severe liver disease. Progress in cell biology, tissue culture techniques and biotechnology have led the way for the potential therapeutic use of isolated hepatocytes in a wide array of liver disorders. Transplanted hepatocytes show considerable promise of performing the full range of liver functions in several animal models of liver disease, ranging from fulminant hepatic failure to congenital metabolic liver disease. Recently, several interesting designs for extrahepatic liver support systems have been proposed. Although there is no current consensus on its eventual design configuration, the hollow fiber hepatocyte bioreactor design has the greatest potential for therapeutic benefit.

Hollow fibers for hepatocyte encapsulation and transplantation: studies of survival and function in rats

In this study, the feasibility of transplanting hepatocytes using hollow fibers (HF) was investigated. Experiments were carried out in vitro and in vivo to determine the viability and function of hepatocytes encapsulated in four different types of commercially available HF: regenerated cellulose HF (RCHF), polysulfone HF of two different sizes (PSHF-1 and PSHF-2), and polyvinylidine HF (PVDF). Hepatocytes remained viable in all types of HF for at least 1 wk in vitro as measured by light microscopy and their ability to synthesize protein and secrete albumin. However, the levels of protein synthesis and albumin secretion in these cells varied significantly between different HF (RCHF > PSHF-2 > PVDF approximately PSHF-1) and appeared to be inversely related to their internal diameters (215, 500, 1000, and 1100 microns for RCHF, PSHF-2, PVDF, and PSHF-1, respectively). While PSHF-2, PVDF, and PSHF-1 did not support long term viability in vivo, hepatocytes in RCHF survived after implantation in the mesentery. After 24 h in vivo, the hepatocytes appeared morphologically intact and exhibited a similar rate of protein synthesis when compared with cells cultured in parallel. The hepatocytes in RCHF also maintained the ability to synthesize protein after 7 days in vivo. These results suggest that HF of appropriate size may be useful for hepatocyte transplantation applications in which prevascularization is not possible.

Performance of plasma-perfused, microencapsulated hepatocytes: prospects for extracorporeal liver support

The growing success of liver transplantation and the shortage of donor livers has turned attention to the possibility of utilizing hepatocytes within artificial liver support systems to allow time for donor livers to become available and to improve the condition of patients with hepatic failure. This study evaluated encapsulated hepatocytes, a technology which might allow the possibility of using xenogenic or human hepatoma cells. Rabbit hepatocytes were encapsulated using the ionic polysaccharides carboxymethylcellulose, chondroitin sulfate A, chitosan, and polygalacturonic acid. Encapsulated cells were maintained in perfusion culture for at least 6 days in heparinized, normal human plasma or in a defined culture medium. Parallel cultures of plated hepatocytes were also conducted. The metabolic capability of the cells was evaluated by following the rates of urea, albumin, and transferrin synthesis and the transformation rate of the drug antipyrine. Protein synthesis and ureogenesis in plasma were depressed from the levels expressed in defined culture medium. Drug detoxification as measured by antipyrine metabolism appeared to be enhanced in plasma. We conclude that encapsulated rabbit hepatocytes retain significant levels of function for at least 6 days of perfusion with human plasma, suggesting the feasibility of this technology as a potential method of short-term liver support.

Interfacial photopolymerization of poly(ethylene glycol)-based hydrogels upon alginate-poly(l-lysine) microcapsules for enhanced biocompatibility

The biocompatibility of microcapsules made by the co-acervation of alginate and poly(l-lysine) (PLL) was enhanced by coating the surface of these microcapsules with a poly(ethylene glycol) (PEG)-based hydrogel. The hydrogel was formed by an interfacial photopolymerization technique using visible light from an argon ion laser. The light absorbing chromophore, eosin Y, was immobilized on the microcapsule surface. This restricted the formation of the PEG hydrogel to the surface of the microcapsule. The presence of the PEG gel on the surface was confirmed by fluorescent dextran entrapment, by direct visualization after dissolution of the underlying membrane and by electron spectroscopy for chemical analysis. The biological response of such microcapsules was evaluated by intraperitoneal implantation in mice. The PEG-coated microcapsules were found to be less inflammatory and were seen not to elicit a fibrotic response, as was the case with alginate-PLL microcapsules.

A morphological and functional evaluation of transplanted isolated encapsulated hepatocytes following long-term transplantation in Gunn rats

In this study we investigated the fate of microencapsulated hepatocytes following long-term (6 months) transplantation in Gunn rats. Isolated hepatocytes were microencapsulated with a collagen matrix within an alginate-poly L-lysine composite membrane. Isolated, encapsulated hepatocytes (IEH) or free (unencapsulated) isolated hepatocytes were intraperitoneally transplanted into homozygous Gunn rats that exhibit congenital hyperbilirubinemia. Control Gunn rats received empty microcapsules. Total serum bilirubin was measured at weekly intervals for one month post-IEH transplantation, every two weeks for the next month, and monthly thereafter for up to six months. IEH samples were biopsied from the Gunn rats at monthly intervals and analyzed by light and electron microscopy. A significant (p < 0.01) decrease in total serum bilirubin was observed in IEH transplanted animals during the first month of transplantation. Thereafter, total serum bilirubin levels gradually returned to pre-transplantation levels. A mild, transient decrease in total serum bilirubin was seen in animals transplanted with free (unencapsulated) hepatocytes. No decrease in total serum bilirubin levels was seen in the Gunn rats transplanted with control (empty) microcapsules. Transplanted IEH retained its normal ultrastructure for up to one month and intact microcapsules showed no evidence of hepatocyte rejection, at this time. Degenerative changes observed in the IEH beginning at 2 months post-transplantation, suggests that repeated transplantations may be necessary for long-term effectiveness of IEH therapy.

Polydisperse dextran as a diffusing test solute to study the membrane permeability of alginate polylysine microcapsules

Applications of alginate polylysine (APL) microcapsules in cell culture engineering and hybrid artificial organs require strict control of membrane permeability. For example, hybrid artificial organs must permit the diffusion of smaller molecules including peptides and proteins and the exclusion of leucocytes and immunoglobulins (MW > 150,000). Single molecular weight solutes such as proteins have been used to study the molecular weight cut-off of the membrane. A new approach that uses a heterogenous mixture of dextrans of different molecular weights: -MW 10,000-500,000 as a test solute in diffusion experiments is described. Intra/extra capsular changes in concentration and molecular weight distribution of the heterogenous dextran mixture are monitored and determined by high performance gel chromatography. MW can then be related to diffusional Stokes radius, a more useful parameter when comparing permeability of cell membrane to different test solutes.

In vitro study of multicellular hepatocyte spheroids formed in microcapsules

To make highly differentiated encapsulated hepatocytes, we formed hepatocyte spheroids in microcapsules in cultures. Hepatocytes isolated from rats were encapsulated in alginate-poly-L-lysine artificial cells and cultured under different medium conditions. When high molecular weight poly-L-lysine was used to make the capsule membrane, the hepatocytes aggregated and formed spheroids inside microcapsules within 48 hs. We studied the viability and function of encapsulated hepatocyte spheroids; free hepatocyte spheroids; nonaggregated encapsulated hepatocytes; and free hepatocyte monolayers. Cell viability and protein-producing ability were monitored for up to 30 days. Hepatocyte spheroids in the encapsulated or free form remained viable and continued to secrete proteins throughout the 30 days of observation. The viability and function of nonaggregated hepatocytes in the encapsulated or free form declined rapidly. These results suggest that the tridimensional structure of the spheroids may be important in maintaining the viability and function of encapsulated hepatocytes.