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Luce E, Steichen C, Allouche M, Messina A, Heslan JM, Lambert T, Weber A, Nguyen TH, Christophe O, Dubart-Kupperschmitt A. In vitro recovery of FIX clotting activity as a marker of highly functional hepatocytes in a hemophilia B iPSC model. Hepatology 2022; 75:866-880. [PMID: 34687060 PMCID: PMC9299628 DOI: 10.1002/hep.32211] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/13/2021] [Accepted: 10/13/2021] [Indexed: 12/08/2022]
Abstract
BACKGROUND AND AIMS Pluripotent stem cell-derived hepatocytes differentiated in monolayer culture are known to have more fetal than adult hepatocyte characteristics. If numerous studies tend to show that this immature phenotype might not necessarily be an obstacle to their use in transplantation, other applications such as drug screening, toxicological studies, or bioartificial livers are reliant on hepatocyte functionality and require full differentiation of hepatocytes. New technologies have been used to improve the differentiation process in recent years, usually evaluated by measuring the albumin production and CYP450 activity. Here we used the complex production and most importantly the activity of the coagulation factor IX (FIX) produced by mature hepatocytes to assess the differentiation of hemophilia B (HB) patient's induced pluripotent stem cells (iPSCs) in both monolayer culture and organoids. APPROACH AND RESULTS Indeed, HB is an X-linked monogenic disease due to an impaired activity of FIX synthesized by hepatocytes in the liver. We have developed an in vitro model of HB hepatocytes using iPSCs generated from fibroblasts of a severe HB patient. We used CRISPR/Cas9 technology to target the genomic insertion of a coagulation factor 9 minigene bearing the Padua mutation to enhance FIX activity. Noncorrected and corrected iPSCs were differentiated into hepatocytes under both two-dimensional and three-dimensional differentiation protocols and deciphered the production of active FIX in vitro. Finally, we assessed the therapeutic efficacy of this approach in vivo using a mouse model of HB. CONCLUSIONS Functional FIX, whose post-translational modifications only occur in fully mature hepatocytes, was only produced in corrected iPSCs differentiated in organoids. Immunohistochemistry analyses of mouse livers indicated a good cell engraftment, and the FIX activity detected in the plasma of transplanted animals confirmed rescue of the bleeding phenotype.
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Affiliation(s)
- Eléanor Luce
- INSERM Université Paris-SaclayUnité Mixte de Recherche 1193VillejuifFrance.,Féderation Hospitalo-Universitaire Hépatinov, Hôpital Paul BrousseVillejuifFrance
| | - Clara Steichen
- INSERM Université Paris-SaclayUnité Mixte de Recherche 1193VillejuifFrance.,Féderation Hospitalo-Universitaire Hépatinov, Hôpital Paul BrousseVillejuifFrance
| | - Mickaël Allouche
- INSERM Université Paris-SaclayUnité Mixte de Recherche 1193VillejuifFrance.,Féderation Hospitalo-Universitaire Hépatinov, Hôpital Paul BrousseVillejuifFrance
| | - Antonietta Messina
- INSERM Université Paris-SaclayUnité Mixte de Recherche 1193VillejuifFrance.,Féderation Hospitalo-Universitaire Hépatinov, Hôpital Paul BrousseVillejuifFrance
| | | | - Thierry Lambert
- Centre de Référence pour le Traitement des HémophilesHôpital de BicêtreFrance
| | - Anne Weber
- INSERM Université Paris-SaclayUnité Mixte de Recherche 1193VillejuifFrance.,Féderation Hospitalo-Universitaire Hépatinov, Hôpital Paul BrousseVillejuifFrance
| | - Tuan Huy Nguyen
- INSERM Unité Mixte de Recherche 1064CHU Hôtel DieuNantesFrance
| | - Olivier Christophe
- INSERM Unité Mixte de Recherche 1176Hôpital de BicêtreKremlin-BicêtreFrance
| | - Anne Dubart-Kupperschmitt
- INSERM Université Paris-SaclayUnité Mixte de Recherche 1193VillejuifFrance.,Féderation Hospitalo-Universitaire Hépatinov, Hôpital Paul BrousseVillejuifFrance
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Messina A, Luce E, Benzoubir N, Pasqua M, Pereira U, Humbert L, Eguether T, Rainteau D, Duclos-Vallée JC, Legallais C, Dubart-Kupperschmitt A. Evidence of Adult Features and Functions of Hepatocytes Differentiated from Human Induced Pluripotent Stem Cells and Self-Organized as Organoids. Cells 2022; 11:cells11030537. [PMID: 35159346 PMCID: PMC8834365 DOI: 10.3390/cells11030537] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 01/27/2022] [Accepted: 01/29/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Human-induced pluripotent stem cell-derived hepatocytes (iHeps) have been shown to have considerable potential in liver diseases, toxicity, and pharmacological studies. However, there is a growing need to obtain iHeps that are truly similar to primary adult hepatocytes in terms of morphological features and functions. We generated such human iHeps, self-assembled as organoids (iHep-Orgs). Methods: iPSC-derived hepatoblasts were self-assembled into spheroids and differentiated into mature hepatocytes modulating final step of differentiation. Results: In about four weeks of culture, the albumin secretion levels and the complete disappearance of α-fetoprotein from iHep-Orgs suggested the acquisition of a greater degree of maturation than those previously reported. The expression of apical transporters and bile acid secretion evidenced the acquisition of complex hepatocyte polarity as well as the development of a functional and well-defined bile canalicular network confirmed by computational analysis. Activities recorded for CYP450, UGT1A1, and alcohol dehydrogenase, response to hormonal stimulation, and glucose metabolism were also remarkable. Finally, iHep-Orgs displayed a considerable ability to detoxify pathological concentrations of lactate and ammonia. Conclusions: With features similar to those of primary adult hepatocytes, the iHep-Orgs thus produced could be considered as a valuable tool for the development and optimization of preclinical and clinical applications.
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Affiliation(s)
- Antonietta Messina
- UMR_S 1193, INSERM/Université Paris-Saclay, F-94800 Villejuif, France; (E.L.); (N.B.); (J.-C.D.-V.)
- Centre Hépatobiliaire, Fédération Hospitalo-Universitaire (FHU) Hépatinov, AP-HP, Hôpital Paul Brousse, F-94800 Villejuif, France; (M.P.); (U.P.); (C.L.)
- Correspondence: (A.M.); (A.D.-K.)
| | - Eléanor Luce
- UMR_S 1193, INSERM/Université Paris-Saclay, F-94800 Villejuif, France; (E.L.); (N.B.); (J.-C.D.-V.)
- Centre Hépatobiliaire, Fédération Hospitalo-Universitaire (FHU) Hépatinov, AP-HP, Hôpital Paul Brousse, F-94800 Villejuif, France; (M.P.); (U.P.); (C.L.)
| | - Nassima Benzoubir
- UMR_S 1193, INSERM/Université Paris-Saclay, F-94800 Villejuif, France; (E.L.); (N.B.); (J.-C.D.-V.)
- Centre Hépatobiliaire, Fédération Hospitalo-Universitaire (FHU) Hépatinov, AP-HP, Hôpital Paul Brousse, F-94800 Villejuif, France; (M.P.); (U.P.); (C.L.)
| | - Mattia Pasqua
- Centre Hépatobiliaire, Fédération Hospitalo-Universitaire (FHU) Hépatinov, AP-HP, Hôpital Paul Brousse, F-94800 Villejuif, France; (M.P.); (U.P.); (C.L.)
- UMR CNRS 7338 Biomechanics & Bioengineering, Université de Technologie de Compiègne, Sorbonne Universités, 60203 Compiegne, France
| | - Ulysse Pereira
- Centre Hépatobiliaire, Fédération Hospitalo-Universitaire (FHU) Hépatinov, AP-HP, Hôpital Paul Brousse, F-94800 Villejuif, France; (M.P.); (U.P.); (C.L.)
- UMR CNRS 7338 Biomechanics & Bioengineering, Université de Technologie de Compiègne, Sorbonne Universités, 60203 Compiegne, France
| | - Lydie Humbert
- Centre de Recherche Saint-Antoine, Sorbonne Université, INSERM, CRSA, AP-HP, Hôpital Saint Antoine, Metomics, 75012 Paris, France; (L.H.); (T.E.); (D.R.)
| | - Thibaut Eguether
- Centre de Recherche Saint-Antoine, Sorbonne Université, INSERM, CRSA, AP-HP, Hôpital Saint Antoine, Metomics, 75012 Paris, France; (L.H.); (T.E.); (D.R.)
| | - Dominique Rainteau
- Centre de Recherche Saint-Antoine, Sorbonne Université, INSERM, CRSA, AP-HP, Hôpital Saint Antoine, Metomics, 75012 Paris, France; (L.H.); (T.E.); (D.R.)
| | - Jean-Charles Duclos-Vallée
- UMR_S 1193, INSERM/Université Paris-Saclay, F-94800 Villejuif, France; (E.L.); (N.B.); (J.-C.D.-V.)
- Centre Hépatobiliaire, Fédération Hospitalo-Universitaire (FHU) Hépatinov, AP-HP, Hôpital Paul Brousse, F-94800 Villejuif, France; (M.P.); (U.P.); (C.L.)
| | - Cécile Legallais
- Centre Hépatobiliaire, Fédération Hospitalo-Universitaire (FHU) Hépatinov, AP-HP, Hôpital Paul Brousse, F-94800 Villejuif, France; (M.P.); (U.P.); (C.L.)
- UMR CNRS 7338 Biomechanics & Bioengineering, Université de Technologie de Compiègne, Sorbonne Universités, 60203 Compiegne, France
| | - Anne Dubart-Kupperschmitt
- UMR_S 1193, INSERM/Université Paris-Saclay, F-94800 Villejuif, France; (E.L.); (N.B.); (J.-C.D.-V.)
- Centre Hépatobiliaire, Fédération Hospitalo-Universitaire (FHU) Hépatinov, AP-HP, Hôpital Paul Brousse, F-94800 Villejuif, France; (M.P.); (U.P.); (C.L.)
- Correspondence: (A.M.); (A.D.-K.)
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Luce E, Messina A, Caillaud A, Si-Tayeb K, Cariou B, Bur E, Dubart-Kupperschmitt A, Duclos-Vallée JC. [Hepatic organoids: What are the challenges?]. Med Sci (Paris) 2021; 37:902-909. [PMID: 34647879 DOI: 10.1051/medsci/2021119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The study and understanding of liver organogenesis have allowed the development of protocols for pluripotent stem cells differentiation to overcome the lack of primary cells, providing an almost unlimited source of liver cells. However, as their differentiation in conventional 2D culture systems has shown serious limits, hepatic organoids derived from human pluripotent stem cells represent a promising alternative. These complex and organized structures, containing one or more cell types, make it possible to recapitulate in vitro some of the organ functions, thus enabling numerous applications such as the study of the liver development, the mass production of functional liver cells for transplantation or the development of bioartificial livers, as well as the in vitro modeling of hepatic pathologies allowing high throughput applications in drug screening or toxicity studies. Economic and ethical issues must also be taken into account before using these organoids in therapeutic applications.
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Affiliation(s)
- Eléanor Luce
- Inserm UMRS 1193, Université Paris-Saclay, 12-14 avenue Paul Vaillant Couturier, F-94800 Villejuif, France - Fédération hospitalo-universitaire Hépatinov, hôpital Paul Brousse, F-94800 Villejuif, France
| | - Antonietta Messina
- Inserm UMRS 1193, Université Paris-Saclay, 12-14 avenue Paul Vaillant Couturier, F-94800 Villejuif, France - Fédération hospitalo-universitaire Hépatinov, hôpital Paul Brousse, F-94800 Villejuif, France
| | - Amandine Caillaud
- Université de Nantes, CHU Nantes, CNRS, Inserm, Institut du thorax, F-44000 Nantes, France
| | - Karim Si-Tayeb
- Université de Nantes, CHU Nantes, CNRS, Inserm, Institut du thorax, F-44000 Nantes, France
| | - Bertrand Cariou
- Université de Nantes, CHU Nantes, CNRS, Inserm, Institut du thorax, F-44000 Nantes, France
| | - Etienne Bur
- Fédération hospitalo-universitaire Hépatinov, hôpital Paul Brousse, F-94800 Villejuif, France - Institut français de BioFabrication, hôpital Paul Brousse, F-94800 Villejuif, France
| | - Anne Dubart-Kupperschmitt
- Inserm UMRS 1193, Université Paris-Saclay, 12-14 avenue Paul Vaillant Couturier, F-94800 Villejuif, France - Fédération hospitalo-universitaire Hépatinov, hôpital Paul Brousse, F-94800 Villejuif, France - Institut français de BioFabrication, hôpital Paul Brousse, F-94800 Villejuif, France
| | - Jean-Charles Duclos-Vallée
- Inserm UMRS 1193, Université Paris-Saclay, 12-14 avenue Paul Vaillant Couturier, F-94800 Villejuif, France - Fédération hospitalo-universitaire Hépatinov, hôpital Paul Brousse, F-94800 Villejuif, France - Institut français de BioFabrication, hôpital Paul Brousse, F-94800 Villejuif, France
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Luce E, Messina A, Duclos-Vallée JC, Dubart-Kupperschmitt A. Advanced Techniques and Awaited Clinical Applications for Human Pluripotent Stem Cell Differentiation into Hepatocytes. Hepatology 2021; 74:1101-1116. [PMID: 33420753 PMCID: PMC8457237 DOI: 10.1002/hep.31705] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 11/16/2020] [Accepted: 12/19/2020] [Indexed: 12/22/2022]
Abstract
Liver transplantation is currently the only curative treatment for several liver diseases such as acute liver failure, end-stage liver disorders, primary liver cancers, and certain genetic conditions. Unfortunately, despite improvements to transplantation techniques, including live donor transplantation, the number of organs available remains insufficient to meet patient needs. Hepatocyte transplantation has enabled some encouraging results as an alternative to organ transplantation, but primary hepatocytes are little available and cannot be amplified using traditional two-dimensional culture systems. Indeed, although recent studies have tended to show that three-dimensional culture enables long-term hepatocyte culture, it is still agreed that, like most adult primary cell types, hepatocytes remain refractory to in vitro expansion. Because of their exceptional properties, human pluripotent stem cells (hPSCs) can be amplified indefinitely and differentiated into any cell type, including liver cells. While many teams have worked on hepatocyte differentiation, there has been a consensus that cells obtained after hPSC differentiation have more fetal than adult hepatocyte characteristics. New technologies have been used to improve the differentiation process in recent years. This review discusses the technical improvements made to hepatocyte differentiation protocols and the clinical approaches developed to date and anticipated in the near future.
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Affiliation(s)
- Eléanor Luce
- INSERMUniversité Paris-SaclayUnité Mixte de Recherche (UMR_S) 1193VillejuifFrance.,Fédération Hospitalo-Universitaire HépatinovHôpital Paul-BrousseVillejuifFrance
| | - Antonietta Messina
- INSERMUniversité Paris-SaclayUnité Mixte de Recherche (UMR_S) 1193VillejuifFrance.,Fédération Hospitalo-Universitaire HépatinovHôpital Paul-BrousseVillejuifFrance
| | - Jean-Charles Duclos-Vallée
- INSERMUniversité Paris-SaclayUnité Mixte de Recherche (UMR_S) 1193VillejuifFrance.,Fédération Hospitalo-Universitaire HépatinovHôpital Paul-BrousseVillejuifFrance
| | - Anne Dubart-Kupperschmitt
- INSERMUniversité Paris-SaclayUnité Mixte de Recherche (UMR_S) 1193VillejuifFrance.,Fédération Hospitalo-Universitaire HépatinovHôpital Paul-BrousseVillejuifFrance
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Abstract
The development of protocols for pluripotent stem cell (PSC) differentiation into cholangiocytes and cholangiocyte organoids in three-dimensional structures represent a huge advance in both research and medical fields because of the limited access to primary human cholangiocytes and the potential bias induced by animal models used to study cholangiopathies in vivo. PSC-derived cholangiocyte organoids consisting of either cysts with luminal space or branching tubular structures are composed of cells with apico-basal polarity that can fulfill cholangiocyte functions like the transport of bile salts. Several protocols of PSC differentiation have already been published but we added to the detailed protocol we describe here some notes or advice to facilitate its handling by new users. We also propose detailed protocols to carry out some of the characterization analyses using immunofluorescence to study the expression of specific markers and a functionality test to visualize bile acid transport using cholyl-lysyl-fluorescein (CLF).
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Affiliation(s)
- Eléanor Luce
- INSERM Unité Mixte de Recherche (UMR_S) 1193, Villejuif, France; UMR_S 1193, Université Paris-Sud/Paris-Saclay, Villejuif, France; Département Hospitalo-Universitaire Hepatinov, Villejuif, France.
| | - Anne Dubart-Kupperschmitt
- INSERM Unité Mixte de Recherche (UMR_S) 1193, Villejuif, France; UMR_S 1193, Université Paris-Sud/Paris-Saclay, Villejuif, France; Département Hospitalo-Universitaire Hepatinov, Villejuif, France
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Messina A, Luce E, Hussein M, Dubart-Kupperschmitt A. Pluripotent-Stem-Cell-Derived Hepatic Cells: Hepatocytes and Organoids for Liver Therapy and Regeneration. Cells 2020; 9:cells9020420. [PMID: 32059501 PMCID: PMC7072243 DOI: 10.3390/cells9020420] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 02/04/2020] [Accepted: 02/10/2020] [Indexed: 12/19/2022] Open
Abstract
The liver is a very complex organ that ensures numerous functions; it is thus susceptible to multiple types of damage and dysfunction. Since 1983, orthotopic liver transplantation (OLT) has been considered the only medical solution available to patients when most of their liver function is lost. Unfortunately, the number of patients waiting for OLT is worryingly increasing, and extracorporeal liver support devices are not yet able to counteract the problem. In this review, the current and expected methodologies in liver regeneration are briefly analyzed. In particular, human pluripotent stem cells (hPSCs) as a source of hepatic cells for liver therapy and regeneration are discussed. Principles of hPSC differentiation into hepatocytes are explored, along with the current limitations that have led to the development of 3D culture systems and organoid production. Expected applications of these organoids are discussed with particular attention paid to bio artificial liver (BAL) devices and liver bio-fabrication.
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Affiliation(s)
- Antonietta Messina
- INSERM unité mixte de recherche (UMR_S) 1193, F-94800 Villejuif, France; (A.M.)
- UMR_S 1193, Université Paris-Sud/Paris-Saclay, F-94800 Villejuif, France
- Département Hospitalo-Universitaire (DHU) Hépatinov, F-94800 Villejuif, France
| | - Eléanor Luce
- INSERM unité mixte de recherche (UMR_S) 1193, F-94800 Villejuif, France; (A.M.)
- UMR_S 1193, Université Paris-Sud/Paris-Saclay, F-94800 Villejuif, France
- Département Hospitalo-Universitaire (DHU) Hépatinov, F-94800 Villejuif, France
| | - Marwa Hussein
- INSERM unité mixte de recherche (UMR_S) 1193, F-94800 Villejuif, France; (A.M.)
- UMR_S 1193, Université Paris-Sud/Paris-Saclay, F-94800 Villejuif, France
- Département Hospitalo-Universitaire (DHU) Hépatinov, F-94800 Villejuif, France
| | - Anne Dubart-Kupperschmitt
- INSERM unité mixte de recherche (UMR_S) 1193, F-94800 Villejuif, France; (A.M.)
- UMR_S 1193, Université Paris-Sud/Paris-Saclay, F-94800 Villejuif, France
- Département Hospitalo-Universitaire (DHU) Hépatinov, F-94800 Villejuif, France
- Correspondence: ; Tel.: +33-145595138
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Steichen C, Hannoun Z, Luce E, Hauet T, Dubart-Kupperschmitt A. Genomic integrity of human induced pluripotent stem cells: Reprogramming, differentiation and applications. World J Stem Cells 2019; 11:729-747. [PMID: 31692979 PMCID: PMC6828592 DOI: 10.4252/wjsc.v11.i10.729] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 06/13/2019] [Accepted: 07/30/2019] [Indexed: 02/06/2023] Open
Abstract
Ten years after the initial generation of induced pluripotent stem cells (hiPSCs) from human tissues, their potential is no longer questioned, with over 15000 publications listed on PubMed, covering various fields of research; including disease modeling, cell therapy strategies, pharmacology/toxicology screening and 3D organoid systems. However, despite evidences that the presence of mutations in hiPSCs should be a concern, publications addressing genomic integrity of these cells represent less than 1% of the literature. After a first overview of the mutation types currently reported in hiPSCs, including karyotype abnormalities, copy number variations, single point mutation as well as uniparental disomy, this review will discuss the impact of reprogramming parameters such as starting cell type and reprogramming method on the maintenance of the cellular genomic integrity. Then, a specific focus will be placed on culture conditions and subsequent differentiation protocols and how their may also trigger genomic aberrations within the cell population of interest. Finally, in a last section, the impact of genomic alterations on the possible usages of hiPSCs and their derivatives will also be exemplified and discussed. We will also discuss which techniques or combination of techniques should be used to screen for genomic abnormalities with a particular focus on the necessary quality controls and the potential alternatives.
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Affiliation(s)
- Clara Steichen
- INSERM U1082 IRTOMIT, CHU de Poitiers, Poitiers F-86021, France
- Université de Poitiers, Faculté de Médecine et Pharmacie, Bâtiment D1, 6 rue de la milétrie, TSA 51115, 86073 Poitiers Cedex 9, France
| | - Zara Hannoun
- INSERM U1193, Hôpital Paul Brousse, Villejuif F-94800, France
- UMR_S1193, Université Paris-Saclay, Hôpital Paul Brousse, Villejuif F-94800, France
- The Jenner Institute, University of Oxford, Oxford OX3 7DQ, United Kingdom
| | - Eléanor Luce
- INSERM U1193, Hôpital Paul Brousse, Villejuif F-94800, France
- UMR_S1193, Université Paris-Saclay, Hôpital Paul Brousse, Villejuif F-94800, France
- Département Hospitalo-Universitaire Hepatinov, Hôpital Paul Brousse, Villejuif F-94807, France
| | - Thierry Hauet
- INSERM U1082 IRTOMIT, CHU de Poitiers, Poitiers F-86021, France
- Université de Poitiers, Faculté de Médecine et Pharmacie, Bâtiment D1, 6 rue de la milétrie, TSA 51115, 86073 Poitiers Cedex 9, France
- Service de Biochimie, Pôle Biospharm, CHU de Poitiers, Poitiers F-86021, France
- Fédération Hospitalo-Universitaire SUPORT, CHU de Poitiers, Poitiers F-86021, France
| | - Anne Dubart-Kupperschmitt
- INSERM U1193, Hôpital Paul Brousse, Villejuif F-94800, France
- UMR_S1193, Université Paris-Saclay, Hôpital Paul Brousse, Villejuif F-94800, France
- Département Hospitalo-Universitaire Hepatinov, Hôpital Paul Brousse, Villejuif F-94807, France
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Caron J, Pène V, Tolosa L, Villaret M, Luce E, Fourrier A, Heslan JM, Saheb S, Bruckert E, Gómez-Lechón MJ, Nguyen TH, Rosenberg AR, Weber A, Dubart-Kupperschmitt A. Low-density lipoprotein receptor-deficient hepatocytes differentiated from induced pluripotent stem cells allow familial hypercholesterolemia modeling, CRISPR/Cas-mediated genetic correction, and productive hepatitis C virus infection. Stem Cell Res Ther 2019; 10:221. [PMID: 31358055 PMCID: PMC6664765 DOI: 10.1186/s13287-019-1342-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 07/03/2019] [Accepted: 07/14/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Familial hypercholesterolemia type IIA (FH) is due to mutations in the low-density lipoprotein receptor (LDLR) resulting in elevated levels of low-density lipoprotein cholesterol (LDL-c) in plasma and in premature cardiovascular diseases. As hepatocytes are the only cells capable of metabolizing cholesterol, they are therefore the target cells for cell/gene therapy approaches in the treatment of lipid metabolism disorders. Furthermore, the LDLR has been reported to be involved in hepatitis C virus (HCV) entry into hepatocytes; however, its role in the virus infection cycle is still disputed. METHODS We generated induced pluripotent stem cells (iPSCs) from a homozygous LDLR-null FH-patient (FH-iPSCs). We constructed a correction cassette bearing LDLR cDNA under the control of human hepatic apolipoprotein A2 promoter that targets the adeno-associated virus integration site AAVS1. We differentiated both FH-iPSCs and corrected FH-iPSCs (corr-FH-iPSCs) into hepatocytes to study statin-mediated regulation of genes involved in cholesterol metabolism. Upon HCV particle inoculation, viral replication and production were quantified in these cells. RESULTS We showed that FH-iPSCs displayed the disease phenotype. Using homologous recombination mediated by the CRISPR/Cas9 system, FH-iPSCs were genetically corrected by the targeted integration of a correction cassette at the AAVS1 locus. Both FH-iPSCs and corr-FH-iPSCs were then differentiated into functional polarized hepatocytes using a stepwise differentiation approach (FH-iHeps and corr-FH-iHeps). The correct insertion and expression of the correction cassette resulted in restoration of LDLR expression and function (LDL-c uptake) in corr-FH-iHeps. We next demonstrated that pravastatin treatment increased the expression of genes involved in cholesterol metabolism in both cell models. Moreover, LDLR expression and function were also enhanced in corr-FH-iHeps after pravastatin treatment. Finally, we demonstrated that both FH-iHeps and corr-FH-iHeps were as permissive to viral infection as primary human hepatocytes but that virus production in FH-iHeps was significantly decreased compared to corr-FH-iHeps, suggesting a role of the LDLR in HCV morphogenesis. CONCLUSIONS Our work provides the first LDLR-null FH cell model and its corrected counterpart to study the regulation of cholesterol metabolism and host determinants of HCV life cycle, and a platform to screen drugs for treating dyslipidemia and HCV infection.
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Affiliation(s)
- Jérôme Caron
- INSERM UMR_S1193, Hôpital Paul Brousse, Villejuif, France; UMR-S1193, Université Paris-Saclay, Hôpital Paul Brousse, Villejuif, France; DHU Hepatinov, Hôpital Paul Brousse, Villejuif, France
| | | | - Laia Tolosa
- Unidad de Hepatología Experimental, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | | | - Eléanor Luce
- INSERM UMR_S1193, Hôpital Paul Brousse, Villejuif, France; UMR-S1193, Université Paris-Saclay, Hôpital Paul Brousse, Villejuif, France; DHU Hepatinov, Hôpital Paul Brousse, Villejuif, France
| | - Angélique Fourrier
- Centre de Recherche en Transplantation et Immunologie UMR1064, INSERM, Université de Nantes, Nantes, France
| | - Jean-Marie Heslan
- Centre de Recherche en Transplantation et Immunologie UMR1064, INSERM, Université de Nantes, Nantes, France
| | - Samir Saheb
- Service d'Endocrinologie Métabolisme, Hôpital Pitié-Salpêtrière, Paris, France
| | - Eric Bruckert
- Service d'Endocrinologie Métabolisme, Hôpital Pitié-Salpêtrière, Paris, France
| | - María José Gómez-Lechón
- Unidad de Hepatología Experimental, Instituto de Investigación Sanitaria La Fe, Valencia, Spain.,CIBERehd, FIS, Barcelona, Spain
| | - Tuan Huy Nguyen
- Centre de Recherche en Transplantation et Immunologie UMR1064, INSERM, Université de Nantes, Nantes, France
| | - Arielle R Rosenberg
- Université Paris Descartes, EA4474, Paris, France.,AP-HP, Hôpital Cochin, Service de Virologie, Paris, France
| | - Anne Weber
- INSERM UMR_S1193, Hôpital Paul Brousse, Villejuif, France; UMR-S1193, Université Paris-Saclay, Hôpital Paul Brousse, Villejuif, France; DHU Hepatinov, Hôpital Paul Brousse, Villejuif, France
| | - Anne Dubart-Kupperschmitt
- INSERM UMR_S1193, Hôpital Paul Brousse, Villejuif, France; UMR-S1193, Université Paris-Saclay, Hôpital Paul Brousse, Villejuif, France; DHU Hepatinov, Hôpital Paul Brousse, Villejuif, France.
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9
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Martorell L, Luce E, Vazquez JL, Richaud-Patin Y, Jimenez-Delgado S, Corrales I, Borras N, Casacuberta-Serra S, Weber A, Parra R, Altisent C, Follenzi A, Dubart-Kupperschmitt A, Raya A, Vidal F, Barquinero J. Advanced cell-based modeling of the royal disease: characterization of the mutated F9 mRNA. J Thromb Haemost 2017; 15:2188-2197. [PMID: 28834196 DOI: 10.1111/jth.13808] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Indexed: 11/28/2022]
Abstract
Essentials The Royal disease (RD) is a form of hemophilia B predicted to be caused by a splicing mutation. We generated an iPSC-based model of the disease allowing mechanistic studies at the RNA level. F9 mRNA analysis in iPSC-derived hepatocyte-like cells showed the predicted abnormal splicing. Mutated F9 mRNA level was very low but we also found traces of wild type transcripts. SUMMARY Background The royal disease is a form of hemophilia B (HB) that affected many descendants of Queen Victoria in the 19th and 20th centuries. It was found to be caused by the mutation F9 c.278-3A>G. Objective To generate a physiological cell model of the disease and to study F9 expression at the RNA level. Methods Using fibroblasts from skin biopsies of a previously identified hemophilic patient bearing the F9 c.278-3A>G mutation and his mother, we generated induced pluripotent stem cells (iPSCs). Both the patient's and mother's iPSCs were differentiated into hepatocyte-like cells (HLCs) and their F9 mRNA was analyzed using next-generation sequencing (NGS). Results and Conclusion We demonstrated the previously predicted aberrant splicing of the F9 transcript as a result of an intronic nucleotide substitution leading to a frameshift and the generation of a premature termination codon (PTC). The F9 mRNA level in the patient's HLCs was significantly reduced compared with that of his mother, suggesting that mutated transcripts undergo nonsense-mediated decay (NMD), a cellular mechanism that degrades PTC-containing mRNAs. We also detected small proportions of correctly spliced transcripts in the patient's HLCs, which, combined with genetic variability in splicing and NMD machineries, could partially explain some clinical variability among affected members of the European royal families who had lifespans above the average. This work allowed the demonstration of the pathologic consequences of an intronic mutation in the F9 gene and represents the first bona fide cellular model of HB allowing the study of rare mutations at the RNA level.
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Affiliation(s)
- L Martorell
- Gene and Cell Therapy Laboratory, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
- Congenital Coagulopathies Laboratory, Blood and Tissue Bank (BST), Barcelona, Spain
- Molecular Diagnosis and Therapy Unit, VHIR-UAB, Barcelona, Spain
| | - E Luce
- INSERM Unité Mixte de Recherche (UMR_S) 1193, Villejuif, France
- Université Paris-Sud, Villejuif, France
- Département Hospitalo-Universitaire Hepatinov, Paul Brousse Hospital, Villejuif, France
| | - J L Vazquez
- Center of Regenerative Medicine in Barcelona (CMRB), Barcelona, Spain
| | - Y Richaud-Patin
- Center of Regenerative Medicine in Barcelona (CMRB), Barcelona, Spain
| | - S Jimenez-Delgado
- Center of Regenerative Medicine in Barcelona (CMRB), Barcelona, Spain
| | - I Corrales
- Congenital Coagulopathies Laboratory, Blood and Tissue Bank (BST), Barcelona, Spain
| | - N Borras
- Congenital Coagulopathies Laboratory, Blood and Tissue Bank (BST), Barcelona, Spain
| | - S Casacuberta-Serra
- Gene and Cell Therapy Laboratory, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Weber
- INSERM Unité Mixte de Recherche (UMR_S) 1193, Villejuif, France
- Université Paris-Sud, Villejuif, France
- Département Hospitalo-Universitaire Hepatinov, Paul Brousse Hospital, Villejuif, France
| | - R Parra
- Molecular Diagnosis and Therapy Unit, VHIR-UAB, Barcelona, Spain
- Hemophilia Unit, Vall d'Hebron University Hospital, Barcelona, Spain
| | - C Altisent
- Hemophilia Unit, Vall d'Hebron University Hospital, Barcelona, Spain
| | - A Follenzi
- University of Piemonte Orientale, Novara, Italy
| | - A Dubart-Kupperschmitt
- INSERM Unité Mixte de Recherche (UMR_S) 1193, Villejuif, France
- Université Paris-Sud, Villejuif, France
- Département Hospitalo-Universitaire Hepatinov, Paul Brousse Hospital, Villejuif, France
| | - A Raya
- Center of Regenerative Medicine in Barcelona (CMRB), Barcelona, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
- Biomedical Research Networking Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - F Vidal
- Congenital Coagulopathies Laboratory, Blood and Tissue Bank (BST), Barcelona, Spain
- Molecular Diagnosis and Therapy Unit, VHIR-UAB, Barcelona, Spain
- Biomedical Research Networking Center on Cardiovascular Diseases, Madrid, Spain
| | - J Barquinero
- Gene and Cell Therapy Laboratory, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
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10
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Steichen C, Maluenda J, Tosca L, Luce E, Pineau D, Dianat N, Hannoun Z, Tachdjian G, Melki J, Dubart-Kupperschmitt A. An atypical human induced pluripotent stem cell line with a complex, stable, and balanced genomic rearrangement including a large de novo 1q uniparental disomy. Stem Cells Transl Med 2015; 4:224-9. [PMID: 25650439 DOI: 10.5966/sctm.2014-0186] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Human induced pluripotent stem cells (hiPSCs) hold great promise for cell therapy through their use as vital tools for regenerative and personalized medicine. However, the genomic integrity of hiPSCs still raises some concern and is one of the barriers limiting their use in clinical applications. Numerous articles have reported the occurrence of aneuploidies, copy number variations, or single point mutations in hiPSCs, and nonintegrative reprogramming strategies have been developed to minimize the impact of the reprogramming process on the hiPSC genome. Here, we report the characterization of an hiPSC line generated by daily transfections of modified messenger RNAs, displaying several genomic abnormalities. Karyotype analysis showed a complex genomic rearrangement, which remained stable during long-term culture. Fluorescent in situ hybridization analyses were performed on the hiPSC line showing that this karyotype is balanced. Interestingly, single-nucleotide polymorphism analysis revealed the presence of a large 1q region of uniparental disomy (UPD), demonstrating for the first time that UPD can occur in a noncompensatory context during nonintegrative reprogramming of normal fibroblasts.
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Affiliation(s)
- Clara Steichen
- INSERM U972 and Unité Mixte de Recherche (UMR) S972, Université Paris-Sud, Paul Brousse Hospital, Villejuif, France; Département Hospitalo-universitaire Hepatinov, Paul Brousse Hospital, Villejuif, France
| | - Jérôme Maluenda
- INSERM UMR S986, Institut Fédératif de Recherche 93, Bicêtre Hospital, Kremlin-Bicêtre, France
| | - Lucie Tosca
- Department of Cytogenetics, Béclère Hospital, Clamart, France
| | - Eléanor Luce
- INSERM U972 and Unité Mixte de Recherche (UMR) S972, Université Paris-Sud, Paul Brousse Hospital, Villejuif, France; Département Hospitalo-universitaire Hepatinov, Paul Brousse Hospital, Villejuif, France
| | | | - Noushin Dianat
- INSERM U972 and Unité Mixte de Recherche (UMR) S972, Université Paris-Sud, Paul Brousse Hospital, Villejuif, France; Département Hospitalo-universitaire Hepatinov, Paul Brousse Hospital, Villejuif, France
| | - Zara Hannoun
- INSERM U972 and Unité Mixte de Recherche (UMR) S972, Université Paris-Sud, Paul Brousse Hospital, Villejuif, France; Département Hospitalo-universitaire Hepatinov, Paul Brousse Hospital, Villejuif, France
| | | | - Judith Melki
- INSERM UMR S986, Institut Fédératif de Recherche 93, Bicêtre Hospital, Kremlin-Bicêtre, France
| | - Anne Dubart-Kupperschmitt
- INSERM U972 and Unité Mixte de Recherche (UMR) S972, Université Paris-Sud, Paul Brousse Hospital, Villejuif, France; Département Hospitalo-universitaire Hepatinov, Paul Brousse Hospital, Villejuif, France;
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11
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Steichen C, Luce E, Maluenda J, Tosca L, Moreno-Gimeno I, Desterke C, Dianat N, Goulinet-Mainot S, Awan-Toor S, Burks D, Marie J, Weber A, Tachdjian G, Melki J, Dubart-Kupperschmitt A. Messenger RNA- versus retrovirus-based induced pluripotent stem cell reprogramming strategies: analysis of genomic integrity. Stem Cells Transl Med 2014; 3:686-91. [PMID: 24736403 DOI: 10.5966/sctm.2013-0158] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
The use of synthetic messenger RNAs to generate human induced pluripotent stem cells (iPSCs) is particularly appealing for potential regenerative medicine applications, because it overcomes the common drawbacks of DNA-based or virus-based reprogramming strategies, including transgene integration in particular. We compared the genomic integrity of mRNA-derived iPSCs with that of retrovirus-derived iPSCs generated in strictly comparable conditions, by single-nucleotide polymorphism (SNP) and copy number variation (CNV) analyses. We showed that mRNA-derived iPSCs do not differ significantly from the parental fibroblasts in SNP analysis, whereas retrovirus-derived iPSCs do. We found that the number of CNVs seemed independent of the reprogramming method, instead appearing to be clone-dependent. Furthermore, differentiation studies indicated that mRNA-derived iPSCs differentiated efficiently into hepatoblasts and that these cells did not load additional CNVs during differentiation. The integration-free hepatoblasts that were generated constitute a new tool for the study of diseased hepatocytes derived from patients' iPSCs and their use in the context of stem cell-derived hepatocyte transplantation. Our findings also highlight the need to conduct careful studies on genome integrity for the selection of iPSC lines before using them for further applications.
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Affiliation(s)
- Clara Steichen
- INSERM Unité Mixte de Recherche S972, Université Paris-Sud, Unité Mixte de Recherche S972, and Département Hospitalo-Universitaire Hepatinov, Paul Brousse Hospital, Villejuif, France; INSERM Unité Mixte de Recherche S986, Institut Fédératif de Recherche 93, Bicêtre Hospital, Kremlin-Bicêtre, France; Department of Cytogenetics, INSERM U935, Béclère Hospital, Clamart, France; Centros de Investigación Biomédica en Red de Diabetes y Obesidad, Centro de Investigación Principe Felipe, Eduardo Primo Yúfera 3, Valencia, Spain; Molecular Genetics Center, Centre National de la Recherche Scientifique, Unité Propre de Recherche 3404, Gif-sur-Yvette, Université Paris-Sud, Orsay, France
| | - Eléanor Luce
- INSERM Unité Mixte de Recherche S972, Université Paris-Sud, Unité Mixte de Recherche S972, and Département Hospitalo-Universitaire Hepatinov, Paul Brousse Hospital, Villejuif, France; INSERM Unité Mixte de Recherche S986, Institut Fédératif de Recherche 93, Bicêtre Hospital, Kremlin-Bicêtre, France; Department of Cytogenetics, INSERM U935, Béclère Hospital, Clamart, France; Centros de Investigación Biomédica en Red de Diabetes y Obesidad, Centro de Investigación Principe Felipe, Eduardo Primo Yúfera 3, Valencia, Spain; Molecular Genetics Center, Centre National de la Recherche Scientifique, Unité Propre de Recherche 3404, Gif-sur-Yvette, Université Paris-Sud, Orsay, France
| | - Jérôme Maluenda
- INSERM Unité Mixte de Recherche S972, Université Paris-Sud, Unité Mixte de Recherche S972, and Département Hospitalo-Universitaire Hepatinov, Paul Brousse Hospital, Villejuif, France; INSERM Unité Mixte de Recherche S986, Institut Fédératif de Recherche 93, Bicêtre Hospital, Kremlin-Bicêtre, France; Department of Cytogenetics, INSERM U935, Béclère Hospital, Clamart, France; Centros de Investigación Biomédica en Red de Diabetes y Obesidad, Centro de Investigación Principe Felipe, Eduardo Primo Yúfera 3, Valencia, Spain; Molecular Genetics Center, Centre National de la Recherche Scientifique, Unité Propre de Recherche 3404, Gif-sur-Yvette, Université Paris-Sud, Orsay, France
| | - Lucie Tosca
- INSERM Unité Mixte de Recherche S972, Université Paris-Sud, Unité Mixte de Recherche S972, and Département Hospitalo-Universitaire Hepatinov, Paul Brousse Hospital, Villejuif, France; INSERM Unité Mixte de Recherche S986, Institut Fédératif de Recherche 93, Bicêtre Hospital, Kremlin-Bicêtre, France; Department of Cytogenetics, INSERM U935, Béclère Hospital, Clamart, France; Centros de Investigación Biomédica en Red de Diabetes y Obesidad, Centro de Investigación Principe Felipe, Eduardo Primo Yúfera 3, Valencia, Spain; Molecular Genetics Center, Centre National de la Recherche Scientifique, Unité Propre de Recherche 3404, Gif-sur-Yvette, Université Paris-Sud, Orsay, France
| | - Inmaculada Moreno-Gimeno
- INSERM Unité Mixte de Recherche S972, Université Paris-Sud, Unité Mixte de Recherche S972, and Département Hospitalo-Universitaire Hepatinov, Paul Brousse Hospital, Villejuif, France; INSERM Unité Mixte de Recherche S986, Institut Fédératif de Recherche 93, Bicêtre Hospital, Kremlin-Bicêtre, France; Department of Cytogenetics, INSERM U935, Béclère Hospital, Clamart, France; Centros de Investigación Biomédica en Red de Diabetes y Obesidad, Centro de Investigación Principe Felipe, Eduardo Primo Yúfera 3, Valencia, Spain; Molecular Genetics Center, Centre National de la Recherche Scientifique, Unité Propre de Recherche 3404, Gif-sur-Yvette, Université Paris-Sud, Orsay, France
| | - Christophe Desterke
- INSERM Unité Mixte de Recherche S972, Université Paris-Sud, Unité Mixte de Recherche S972, and Département Hospitalo-Universitaire Hepatinov, Paul Brousse Hospital, Villejuif, France; INSERM Unité Mixte de Recherche S986, Institut Fédératif de Recherche 93, Bicêtre Hospital, Kremlin-Bicêtre, France; Department of Cytogenetics, INSERM U935, Béclère Hospital, Clamart, France; Centros de Investigación Biomédica en Red de Diabetes y Obesidad, Centro de Investigación Principe Felipe, Eduardo Primo Yúfera 3, Valencia, Spain; Molecular Genetics Center, Centre National de la Recherche Scientifique, Unité Propre de Recherche 3404, Gif-sur-Yvette, Université Paris-Sud, Orsay, France
| | - Noushin Dianat
- INSERM Unité Mixte de Recherche S972, Université Paris-Sud, Unité Mixte de Recherche S972, and Département Hospitalo-Universitaire Hepatinov, Paul Brousse Hospital, Villejuif, France; INSERM Unité Mixte de Recherche S986, Institut Fédératif de Recherche 93, Bicêtre Hospital, Kremlin-Bicêtre, France; Department of Cytogenetics, INSERM U935, Béclère Hospital, Clamart, France; Centros de Investigación Biomédica en Red de Diabetes y Obesidad, Centro de Investigación Principe Felipe, Eduardo Primo Yúfera 3, Valencia, Spain; Molecular Genetics Center, Centre National de la Recherche Scientifique, Unité Propre de Recherche 3404, Gif-sur-Yvette, Université Paris-Sud, Orsay, France
| | - Sylvie Goulinet-Mainot
- INSERM Unité Mixte de Recherche S972, Université Paris-Sud, Unité Mixte de Recherche S972, and Département Hospitalo-Universitaire Hepatinov, Paul Brousse Hospital, Villejuif, France; INSERM Unité Mixte de Recherche S986, Institut Fédératif de Recherche 93, Bicêtre Hospital, Kremlin-Bicêtre, France; Department of Cytogenetics, INSERM U935, Béclère Hospital, Clamart, France; Centros de Investigación Biomédica en Red de Diabetes y Obesidad, Centro de Investigación Principe Felipe, Eduardo Primo Yúfera 3, Valencia, Spain; Molecular Genetics Center, Centre National de la Recherche Scientifique, Unité Propre de Recherche 3404, Gif-sur-Yvette, Université Paris-Sud, Orsay, France
| | - Sarah Awan-Toor
- INSERM Unité Mixte de Recherche S972, Université Paris-Sud, Unité Mixte de Recherche S972, and Département Hospitalo-Universitaire Hepatinov, Paul Brousse Hospital, Villejuif, France; INSERM Unité Mixte de Recherche S986, Institut Fédératif de Recherche 93, Bicêtre Hospital, Kremlin-Bicêtre, France; Department of Cytogenetics, INSERM U935, Béclère Hospital, Clamart, France; Centros de Investigación Biomédica en Red de Diabetes y Obesidad, Centro de Investigación Principe Felipe, Eduardo Primo Yúfera 3, Valencia, Spain; Molecular Genetics Center, Centre National de la Recherche Scientifique, Unité Propre de Recherche 3404, Gif-sur-Yvette, Université Paris-Sud, Orsay, France
| | - Deborah Burks
- INSERM Unité Mixte de Recherche S972, Université Paris-Sud, Unité Mixte de Recherche S972, and Département Hospitalo-Universitaire Hepatinov, Paul Brousse Hospital, Villejuif, France; INSERM Unité Mixte de Recherche S986, Institut Fédératif de Recherche 93, Bicêtre Hospital, Kremlin-Bicêtre, France; Department of Cytogenetics, INSERM U935, Béclère Hospital, Clamart, France; Centros de Investigación Biomédica en Red de Diabetes y Obesidad, Centro de Investigación Principe Felipe, Eduardo Primo Yúfera 3, Valencia, Spain; Molecular Genetics Center, Centre National de la Recherche Scientifique, Unité Propre de Recherche 3404, Gif-sur-Yvette, Université Paris-Sud, Orsay, France
| | - Joëlle Marie
- INSERM Unité Mixte de Recherche S972, Université Paris-Sud, Unité Mixte de Recherche S972, and Département Hospitalo-Universitaire Hepatinov, Paul Brousse Hospital, Villejuif, France; INSERM Unité Mixte de Recherche S986, Institut Fédératif de Recherche 93, Bicêtre Hospital, Kremlin-Bicêtre, France; Department of Cytogenetics, INSERM U935, Béclère Hospital, Clamart, France; Centros de Investigación Biomédica en Red de Diabetes y Obesidad, Centro de Investigación Principe Felipe, Eduardo Primo Yúfera 3, Valencia, Spain; Molecular Genetics Center, Centre National de la Recherche Scientifique, Unité Propre de Recherche 3404, Gif-sur-Yvette, Université Paris-Sud, Orsay, France
| | - Anne Weber
- INSERM Unité Mixte de Recherche S972, Université Paris-Sud, Unité Mixte de Recherche S972, and Département Hospitalo-Universitaire Hepatinov, Paul Brousse Hospital, Villejuif, France; INSERM Unité Mixte de Recherche S986, Institut Fédératif de Recherche 93, Bicêtre Hospital, Kremlin-Bicêtre, France; Department of Cytogenetics, INSERM U935, Béclère Hospital, Clamart, France; Centros de Investigación Biomédica en Red de Diabetes y Obesidad, Centro de Investigación Principe Felipe, Eduardo Primo Yúfera 3, Valencia, Spain; Molecular Genetics Center, Centre National de la Recherche Scientifique, Unité Propre de Recherche 3404, Gif-sur-Yvette, Université Paris-Sud, Orsay, France
| | - Gérard Tachdjian
- INSERM Unité Mixte de Recherche S972, Université Paris-Sud, Unité Mixte de Recherche S972, and Département Hospitalo-Universitaire Hepatinov, Paul Brousse Hospital, Villejuif, France; INSERM Unité Mixte de Recherche S986, Institut Fédératif de Recherche 93, Bicêtre Hospital, Kremlin-Bicêtre, France; Department of Cytogenetics, INSERM U935, Béclère Hospital, Clamart, France; Centros de Investigación Biomédica en Red de Diabetes y Obesidad, Centro de Investigación Principe Felipe, Eduardo Primo Yúfera 3, Valencia, Spain; Molecular Genetics Center, Centre National de la Recherche Scientifique, Unité Propre de Recherche 3404, Gif-sur-Yvette, Université Paris-Sud, Orsay, France
| | - Judith Melki
- INSERM Unité Mixte de Recherche S972, Université Paris-Sud, Unité Mixte de Recherche S972, and Département Hospitalo-Universitaire Hepatinov, Paul Brousse Hospital, Villejuif, France; INSERM Unité Mixte de Recherche S986, Institut Fédératif de Recherche 93, Bicêtre Hospital, Kremlin-Bicêtre, France; Department of Cytogenetics, INSERM U935, Béclère Hospital, Clamart, France; Centros de Investigación Biomédica en Red de Diabetes y Obesidad, Centro de Investigación Principe Felipe, Eduardo Primo Yúfera 3, Valencia, Spain; Molecular Genetics Center, Centre National de la Recherche Scientifique, Unité Propre de Recherche 3404, Gif-sur-Yvette, Université Paris-Sud, Orsay, France
| | - Anne Dubart-Kupperschmitt
- INSERM Unité Mixte de Recherche S972, Université Paris-Sud, Unité Mixte de Recherche S972, and Département Hospitalo-Universitaire Hepatinov, Paul Brousse Hospital, Villejuif, France; INSERM Unité Mixte de Recherche S986, Institut Fédératif de Recherche 93, Bicêtre Hospital, Kremlin-Bicêtre, France; Department of Cytogenetics, INSERM U935, Béclère Hospital, Clamart, France; Centros de Investigación Biomédica en Red de Diabetes y Obesidad, Centro de Investigación Principe Felipe, Eduardo Primo Yúfera 3, Valencia, Spain; Molecular Genetics Center, Centre National de la Recherche Scientifique, Unité Propre de Recherche 3404, Gif-sur-Yvette, Université Paris-Sud, Orsay, France
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14
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Phillips B, Luce E. Sleep apnea. The University of Kentucky experience. J Ky Med Assoc 1984; 82:567-72. [PMID: 6512385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Abstract
This report summarizes our experience during a four-year period with the repair of 8 thoracic cage and 3 diaphragmatic defects requiring reinforcement with prosthetic material. Defects as large as the entire left hemidiaphragm or the right anterior chest wall including ribs two through six from the midsternum to the midaxillary line were adequately repaired. The technical approach utilized to obtain a secure, nonmobile thoracic cage involved the placement of sutures through drill holes or around ribs, rather than through the periosteum or pericostal soft tissues. Successful diaphragmatic repair was dependent on proper anchoring of the medial border of the prosthesis, placing sutures in the pericardium as necessary. Skin coverage for thoracic cage defects was achieved with widely undermined and advanced local tissue or previously delayed pedicle flaps. All patients had good evidence of chest wall stabilization after operation, and all were removed from mechanical ventilation within three days. One patient died of myocardial infarction twenty days after operation, and a second patient died later of metastatic disease. On the basis of our experience, we conclude that the range of chest wall lesions that can be surgically corrected or palliated is increased by the use of prosthetics implanted with techniques described here.
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16
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Griffith GL, Meeker WR, McMahan A, Luce E. Management of carcinoma of the larynx. J Ky Med Assoc 1979; 77:169-72. [PMID: 479678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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17
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Abstract
The response of the human thoracoabdominal system to whole-body, vertical, sinusoidal vibration has been studied. Peak acceleration of the shake table was held constant (±0.5 G), and frequency varied between 2 and 10 cycles/sec. Subjects were seated with trunk axes parallel with the direction of acceleration. The amplitude of forced airflow oscillation increased with frequency to an average 1,368 cm3/sec at 6 cycles/sec and then decreased. The maximum average volume of air forced in or out of the lung with vibration was 46 cm3 at 5 cycles/sec. Transpulmonary pressure fluctuation exhibited a peak average amplitude of 5.44 cm H2O at 5 cycles/sec. The response to square-wave table motion was also investigated. The transient flow oscillation produced by the step function had an average frequency of 5.6 cycles/sec. Measurements of the logarithmic decrement of transient flow oscillation indicate the total thoracoabdominal system is underdamped (hV = 0.1–0.2). The calculated damping for the lung subsystem indicates very high damping (hL = 4.5). Measurements of abdominal deformation produced by the step function suggest the transient flow oscillations result from close coupling of the lung to other components of the thoracoabdominal system. Note: (With the Technical Assistance of Tom Sharp, Roger Shannon, and Judith White) whole-body vibration; periodic vertical acceleration; vibration-induced changes in respiration; oscillation; mechanics of thoracoabdominal system Submitted on February 14, 1964
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