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Grönroos P, Mörö A, Puistola P, Hopia K, Huuskonen M, Viheriälä T, Ilmarinen T, Skottman H. Bioprinting of human pluripotent stem cell derived corneal endothelial cells with hydrazone crosslinked hyaluronic acid bioink. Stem Cell Res Ther 2024; 15:81. [PMID: 38486306 PMCID: PMC10941625 DOI: 10.1186/s13287-024-03672-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 02/20/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Human corneal endothelial cells lack regenerative capacity through cell division in vivo. Consequently, in the case of trauma or dystrophy, the only available treatment modality is corneal tissue or primary corneal endothelial cell transplantation from cadaveric donor which faces a high global shortage. Our ultimate goal is to use the state-of-the-art 3D-bioprint technology for automated production of human partial and full-thickness corneal tissues using human stem cells and functional bioinks. In this study, we explore the feasibility of bioprinting the corneal endothelium using human pluripotent stem cell derived corneal endothelial cells and hydrazone crosslinked hyaluronic acid bioink. METHODS Corneal endothelial cells differentiated from human pluripotent stem cells were bioprinted using optimized hydrazone crosslinked hyaluronic acid based bioink. Before the bioprinting process, the biocompatibility of the bioink with cells was first analyzed with transplantation on ex vivo denuded rat and porcine corneas as well as on denuded human Descemet membrane. Subsequently, the bioprinting was proceeded and the viability of human pluripotent stem cell derived corneal endothelial cells were verified with live/dead stainings. Histological and immunofluorescence stainings involving ZO1, Na+/K+-ATPase and CD166 were used to confirm corneal endothelial cell phenotype in all experiments. Additionally, STEM121 marker was used to identify human cells from the ex vivo rat and porcine corneas. RESULTS The bioink, modified for human pluripotent stem cell derived corneal endothelial cells successfully supported both the viability and printability of the cells. Following up to 10 days of ex vivo transplantations, STEM121 positive cells were confirmed on the Descemet membrane of rat and porcine cornea demonstrating the biocompatibility of the bioink. Furthermore, biocompatibility was validated on denuded human Descemet membrane showing corneal endothelial -like characteristics. Seven days post bioprinting, the corneal endothelial -like cells were viable and showed polygonal morphology with expression and native-like localization of ZO-1, Na+/K+-ATPase and CD166. However, mesenchymal-like cells were observed in certain areas of the cultures, spreading beneath the corneal endothelial-like cell layer. CONCLUSIONS Our results demonstrate the successful printing of human pluripotent stem cell derived corneal endothelial cells using covalently crosslinked hyaluronic acid bioink. This approach not only holds promise for a corneal endothelium transplants but also presents potential applications in the broader mission of bioprinting the full-thickness human cornea.
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Affiliation(s)
- Pyry Grönroos
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön Katu 34, 33520, Tampere, Finland
| | - Anni Mörö
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön Katu 34, 33520, Tampere, Finland
| | - Paula Puistola
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön Katu 34, 33520, Tampere, Finland
| | - Karoliina Hopia
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön Katu 34, 33520, Tampere, Finland
| | - Maija Huuskonen
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön Katu 34, 33520, Tampere, Finland
- Tays Eye Centre, Tampere University Hospital, Tampere, Finland
| | - Taina Viheriälä
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön Katu 34, 33520, Tampere, Finland
| | - Tanja Ilmarinen
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön Katu 34, 33520, Tampere, Finland
| | - Heli Skottman
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön Katu 34, 33520, Tampere, Finland.
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Ilmarinen T, Vattulainen M, Kandhavelu J, Bremond-Gignac D, Aberdam D, Skottman H. Production and Limbal Lineage Commitment of Aniridia Patient-Derived Induced Pluripotent Stem Cells. Stem Cells 2023; 41:1133-1141. [PMID: 37632794 DOI: 10.1093/stmcls/sxad067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 08/16/2023] [Indexed: 08/28/2023]
Abstract
Congenital aniridia is caused by heterozygous mutations on the PAX6 gene leading to reduced amount of PAX6 protein (haploinsufficiency), abnormal eye development, and aniridia-associated keratopathy (AAK). This progressive corneal opacification resembles late-onset limbal stem cell (LSC) deficiency, leading to disrupted corneal epithelial renewal. The factors leading to AAK are not known and defects in native LSC differentiation and/or features leading to ocular surface dysfunction like inflammation and loss of innervation could contribute to development of AAK. Here, we produced induced pluripotent stem cells (hiPSC) from 3 AAK patients and examined whether PAX6 haploinsufficiency affects LSC lineage commitment. During LSC differentiation, characterization of the AAK lines showed lowered PAX6 expression as compared to wild type (WT) controls and expression peak of PAX6 during early phase of differentiation was detected only in the WT hiPSC lines. Whether it reflects developmental regulation remains to be studied further. Nevertheless, the AAK-hiPSCs successfully differentiated toward LSC lineage, in line with the presence of LSCs in young patients before cell loss later in life. In addition, patient-specific LSCs showed similar wound healing capacity as WT cells. However, extensive batch-related variation in the LSC marker expression and wound healing efficacy was detected without clear correlation to AAK. As development and maintenance of corneal epithelium involves an interplay between LSCs and their environment, the AAK-hiPSCs generated here can be further used to study the crosstalk between LSCs and limbal niche including, eg, corneal immune cells, stroma cells, and neurons.
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Affiliation(s)
- Tanja Ilmarinen
- BioMediTech, Faculty of Medicine and Health technology, Tampere University, Tampere, Finland
| | - Meri Vattulainen
- BioMediTech, Faculty of Medicine and Health technology, Tampere University, Tampere, Finland
| | - Jeyalakshmi Kandhavelu
- BioMediTech, Faculty of Medicine and Health technology, Tampere University, Tampere, Finland
| | - Dominique Bremond-Gignac
- Ophthalmology Department, Necker-Enfants Malades University Hospital, AP-HP, Paris, France
- INSERM UMRS U1138, T17, Sorbonne Paris Cité University, Centre des Cordeliers, Paris, France
| | - Daniel Aberdam
- INSERM UMRS U1138, T17, Sorbonne Paris Cité University, Centre des Cordeliers, Paris, France
- Paris Cité University, Paris, France
| | - Heli Skottman
- BioMediTech, Faculty of Medicine and Health technology, Tampere University, Tampere, Finland
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Kauppila M, Mörö A, Valle-Delgado JJ, Ihalainen T, Sukki L, Puistola P, Kallio P, Ilmarinen T, Österberg M, Skottman H. Toward Corneal Limbus In Vitro Model: Regulation of hPSC-LSC Phenotype by Matrix Stiffness and Topography During Cell Differentiation Process. Adv Healthc Mater 2023; 12:e2301396. [PMID: 37449943 DOI: 10.1002/adhm.202301396] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/29/2023] [Accepted: 07/10/2023] [Indexed: 07/18/2023]
Abstract
A functional limbal epithelial stem cells (LSC) niche is a vital element in the regular renewal of the corneal epithelium by LSCs and maintenance of good vision. However, little is known about its unique structure and mechanical properties on LSC regulation, creating a significant gap in development of LSC-based therapies. Herein, the effect of mechanical and architectural elements of the niche on human pluripotent derived LSCs (hPSC-LSC) phenotype and growth is investigated in vitro. Specifically, three formulations of polyacrylamide gels with different controlled stiffnesses are used for culture and characterization of hPSC-LSCs from different stages of differentiation. In addition, limbal mimicking topography in polydimethylsiloxane is utilized for culturing hPSC-LSCs at early time point of differentiation. For comparison, the expression of selected key proteins of the corneal cells is analyzed in their native environment through whole mount staining of human donor corneas. The results suggest that mechanical response and substrate preference of the cells is highly dependent on their developmental stage. In addition, data indicate that cells may carry possible mechanical memory from previous culture matrix, both highlighting the importance of mechanical design of a functional in vitro limbus model.
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Affiliation(s)
- Maija Kauppila
- Faculty of Medicine and Health Technology, Tampere University, Tampere, 33520, Finland
| | - Anni Mörö
- Faculty of Medicine and Health Technology, Tampere University, Tampere, 33520, Finland
| | - Juan José Valle-Delgado
- Department of Bioproducts and Biosystems, School of Chemical Engineering, Aalto University, Espoo, 02150, Finland
| | - Teemu Ihalainen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, 33520, Finland
| | - Lassi Sukki
- Faculty of Medicine and Health Technology, Tampere University, Tampere, 33520, Finland
| | - Paula Puistola
- Faculty of Medicine and Health Technology, Tampere University, Tampere, 33520, Finland
| | - Pasi Kallio
- Faculty of Medicine and Health Technology, Tampere University, Tampere, 33520, Finland
| | - Tanja Ilmarinen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, 33520, Finland
| | - Monika Österberg
- Department of Bioproducts and Biosystems, School of Chemical Engineering, Aalto University, Espoo, 02150, Finland
| | - Heli Skottman
- Faculty of Medicine and Health Technology, Tampere University, Tampere, 33520, Finland
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Viheriälä T, Hongisto H, Sorvari J, Skottman H, Nymark S, Ilmarinen T. Cell maturation influences the ability of hESC-RPE to tolerate cellular stress. Stem Cell Res Ther 2022; 13:30. [PMID: 35073969 PMCID: PMC8785579 DOI: 10.1186/s13287-022-02712-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 01/10/2022] [Indexed: 11/15/2022] Open
Abstract
Background Transplantation of human pluripotent stem cell-derived retinal pigment epithelium (RPE) is an urgently needed treatment for the cure of degenerative diseases of the retina. The transplanted cells must tolerate cellular stress caused by various sources such as retinal inflammation and regain their functions rapidly after the transplantation. We have previously shown the maturation level of the cultured human embryonic stem cell-derived RPE (hESC-RPE) cells to influence for example their calcium (Ca2+) signaling properties. Yet, no comparison of the ability of hESC-RPE at different maturity levels to tolerate cellular stress has been reported. Methods Here, we analyzed the ability of the hESC-RPE populations with early (3 weeks) and late (12 weeks) maturation status to tolerate cellular stress caused by chemical cell stressors protease inhibitor (MG132) or hydrogen peroxide (H2O2). After the treatments, the functionality of the RPE cells was studied by transepithelial resistance, immunostainings of key RPE proteins, phagocytosis, mitochondrial membrane potential, Ca2+ signaling, and cytokine secretion. Results The hESC-RPE population with late maturation status consistently showed improved tolerance to cellular stress in comparison to the population with early maturity. After the treatments, the early maturation status of hESC-RPE monolayer showed impaired barrier properties. The hESC-RPE with early maturity status also exhibited reduced phagocytic and Ca2+ signaling properties, especially after MG132 treatment. Conclusions Our results suggest that due to better tolerance to cellular stress, the late maturation status of hESC-RPE population is superior compared to monolayers with early maturation status in the transplantation therapy settings. Supplementary Information The online version contains supplementary material available at 10.1186/s13287-022-02712-7.
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Affiliation(s)
- Taina Viheriälä
- BioMediTech, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Heidi Hongisto
- BioMediTech, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Ophthalmology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Juhana Sorvari
- BioMediTech, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Heli Skottman
- BioMediTech, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Soile Nymark
- BioMediTech, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Tanja Ilmarinen
- BioMediTech, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland. .,BioMediTech, Faculty of Medicine and Life Sciences, Tampere University, Arvo Ylpön katu 34, 33520, Tampere, Finland.
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Vattulainen M, Ilmarinen T, Viheriälä T, Jokinen V, Skottman H. Corneal epithelial differentiation of human pluripotent stem cells generates ABCB5 + and ∆Np63α + cells with limbal cell characteristics and high wound healing capacity. Stem Cell Res Ther 2021; 12:609. [PMID: 34930437 PMCID: PMC8691049 DOI: 10.1186/s13287-021-02673-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/06/2021] [Indexed: 01/13/2023] Open
Abstract
Background Differentiation of functional limbal stem cells (LSCs) from human pluripotent stem cells (hPSCs) is an important objective which can provide novel treatment solutions for patients suffering from limbal stem cell deficiency (LSCD). Yet, further characterization is needed to better evaluate their immunogenicity and regenerative potential before clinical applications. Methods Human PSCs were differentiated towards corneal fate and cryopreserved using a clinically applicable protocol. Resulting hPSC-LSC populations were examined at days 10–11 and 24–25 during differentiation as well as at passage 1 post-thaw. Expression of cornea-associated markers including PAX6, ABCG2, ∆Np63α, CK15, CK14, CK12 and ABCB5 as well as human leukocyte antigens (HLAs) was analyzed using immunofluorescence and flow cytometry. Wound healing properties of the post-thaw hPSC-LSCs were assessed via calcium imaging and scratch assay. Human and porcine tissue-derived cultured LSCs were used as controls for marker expression analysis and scratch assays at passage 1. Results The day 24–25 and post-thaw hPSC-LSCs displayed a similar marker profile with the tissue-derived LSCs, showing abundant expression of PAX6, ∆Np63α, CK15, CK14 and ABCB5 and low expression of ABCG2. In contrast, day 10–11 hPSC-LSCs had lower expression of ABCB5 and ∆Np63α, but high expression of ABCG2. A small portion of the day 10–11 cells coexpressed ABCG2 and ABCB5. The expression of class I HLAs increased during hPSC-LSCs differentiation and was uniform in post-thaw hPSC-LSCs, however the intensity was lower in comparison to tissue-derived LSCs. The calcium imaging revealed that the post-thaw hPSC-LSCs generated a robust response towards epithelial wound healing signaling mediator ATP. Further, scratch assay revealed that post-thaw hPSC-LSCs had higher wound healing capacity in comparison to tissue-derived LSCs. Conclusions Clinically relevant LSC-like cells can be efficiently differentiated from hPSCs. The post-thaw hPSC-LSCs possess functional potency in calcium responses towards injury associated signals and in wound closure. The developmental trajectory observed during hPSC-LSC differentiation, giving rise to ABCG2+ population and further to ABCB5+ and ∆Np63α+ cells with limbal characteristics, indicates hPSC-derived cells can be utilized as a valuable cell source for the treatment of patients afflicted corneal blindness due to LSCD. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13287-021-02673-3.
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Affiliation(s)
- Meri Vattulainen
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, 33520, Tampere, Finland
| | - Tanja Ilmarinen
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, 33520, Tampere, Finland
| | - Taina Viheriälä
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, 33520, Tampere, Finland
| | - Vilma Jokinen
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, 33520, Tampere, Finland
| | - Heli Skottman
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, 33520, Tampere, Finland.
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Tan GSW, Liu Z, Ilmarinen T, Barathi VA, Chee CK, Lingam G, Su X, Stanzel BV. Hints for Gentle Submacular Injection in Non-Human Primates Based on Intraoperative OCT Guidance. Transl Vis Sci Technol 2021; 10:10. [PMID: 33510949 PMCID: PMC7804573 DOI: 10.1167/tvst.10.1.10] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 11/02/2020] [Indexed: 02/07/2023] Open
Abstract
Purpose Delivery of Advanced Therapy Medicinal Products to the submacular space is increasingly evolving into a therapeutic modality. Cell replacement for age-related macular degeneration (AMD) and gene therapy for RPE65 are recent successful examples. Herein, a nonhuman primate (NHP) model was used to investigate surgical means to detach the macula. Methods Sixteen eyes of 13 healthy macaques underwent a 25-gauge vitrectomy and subretinal injection of balanced salt solution monitored by microscope-integrated intraoperative optical coherence tomography (miOCT). The animals were followed with OCT and histology. Results The miOCT monitoring allowed a more precise definition of surgical trauma ranging from an initial full-thickness foveal tear, or induction of a cystoid macular edema (CME), until no foveal defect was discernible, as the technique improved. However, as the subretinal fluid wave detached the fovea, the aforementioned lesions formed, whereas persistent retinal adhesion reproducibly proved to remain in the distal parafoveal semi-annulus. Measures to reduce foveal trauma during submacular fluid injection included reducing intraocular pressure, injection volume, and velocity, as well as the retinal location for bleb initiation, use of a vitreous tamponade, and a dual-bore subretinal cannula. Conclusions A stable very low intraocular pressure and careful subretinal injection may avoid tangential macular stretching or mechanical CME formation, while vitreous tamponade may facilitate a more lamellar subretinal flow, all thereby reducing foveal trauma during submacular injection in NHP. Translational Relevance These results can be relevant to any submacular surgery procedure used today, as they synergistically reduce the risk of compromising foveal integrity.
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Affiliation(s)
- Gavin S W Tan
- Singapore National Eye Centre, Singapore, Singapore.,Singapore Eye Research Institute, Singapore, Singapore.,Ophthalmology Academic Clinical Research Program, DUKE-NUS Medical School, Singapore, Singapore
| | - Zengping Liu
- Singapore Eye Research Institute, Singapore, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Institute of Molecular and Cell Biology, ASTAR (Agency for Science, Technology and Research), Singapore, Singapore
| | - Tanja Ilmarinen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Veluchamy A Barathi
- Singapore Eye Research Institute, Singapore, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Ophthalmology Academic Clinical Research Program, DUKE-NUS Medical School, Singapore, Singapore
| | - Caroline K Chee
- Singapore Eye Research Institute, Singapore, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Ophthalmology, National University Hospital, Singapore, Singapore
| | - Gopal Lingam
- Singapore Eye Research Institute, Singapore, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Ophthalmology, National University Hospital, Singapore, Singapore
| | - Xinyi Su
- Singapore Eye Research Institute, Singapore, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Institute of Molecular and Cell Biology, ASTAR (Agency for Science, Technology and Research), Singapore, Singapore.,Department of Ophthalmology, National University Hospital, Singapore, Singapore
| | - Boris V Stanzel
- Singapore National Eye Centre, Singapore, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Eye Clinic Sulzbach, Knappschaft Hospital Saar, Sulzbach, Saar, Germany
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Ramsay E, Raviña M, Sarkhel S, Hehir S, Cameron NR, Ilmarinen T, Skottman H, Kjems J, Urtti A, Ruponen M, Subrizi A. Avoiding the Pitfalls of siRNA Delivery to the Retinal Pigment Epithelium with Physiologically Relevant Cell Models. Pharmaceutics 2020; 12:pharmaceutics12070667. [PMID: 32708811 PMCID: PMC7407886 DOI: 10.3390/pharmaceutics12070667] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/03/2020] [Accepted: 07/14/2020] [Indexed: 12/17/2022] Open
Abstract
Inflammation is involved in the pathogenesis of several age-related ocular diseases, such as macular degeneration (AMD), diabetic retinopathy, and glaucoma. The delivery of anti-inflammatory siRNA to the retinal pigment epithelium (RPE) may become a promising therapeutic option for the treatment of inflammation, if the efficient delivery of siRNA to target cells is accomplished. Unfortunately, so far, the siRNA delivery system selection performed in dividing RPE cells in vitro has been a poor predictor of the in vivo efficacy. Our study evaluates the silencing efficiency of polyplexes, lipoplexes, and lipidoid-siRNA complexes in dividing RPE cells as well as in physiologically relevant RPE cell models. We find that RPE cell differentiation alters their endocytic activity and causes a decrease in the uptake of siRNA complexes. In addition, we determine that melanosomal sequestration is another significant and previously unexplored barrier to gene silencing in pigmented cells. In summary, this study highlights the importance of choosing a physiologically relevant RPE cell model for the selection of siRNA delivery systems. Such cell models are expected to enable the identification of carriers with a high probability of success in vivo, and thus propel the development of siRNA therapeutics for ocular disease.
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Affiliation(s)
- Eva Ramsay
- Drug Research Program, Division of Pharmaceutical Biosciences, Faculty of Pharmacy, University of Helsinki, 00014 Helsinki, Finland; (E.R.); (M.R.); (S.S.); (A.U.)
| | - Manuela Raviña
- Drug Research Program, Division of Pharmaceutical Biosciences, Faculty of Pharmacy, University of Helsinki, 00014 Helsinki, Finland; (E.R.); (M.R.); (S.S.); (A.U.)
| | - Sanjay Sarkhel
- Drug Research Program, Division of Pharmaceutical Biosciences, Faculty of Pharmacy, University of Helsinki, 00014 Helsinki, Finland; (E.R.); (M.R.); (S.S.); (A.U.)
| | - Sarah Hehir
- Department of Life Sciences, Institute of Technology Sligo, F91 YW50 Sligo, Ireland;
| | - Neil R. Cameron
- School of Engineering, University of Warwick, Coventry CV4 7AL, UK;
- Department of Materials Science and Engineering, Monash University, Clayton, VIC 3800, Australia
| | - Tanja Ilmarinen
- Faculty of Medicine and Health Technology, BioMediTech, Tampere University, 33014 Tampere, Finland; (T.I.); (H.S.)
| | - Heli Skottman
- Faculty of Medicine and Health Technology, BioMediTech, Tampere University, 33014 Tampere, Finland; (T.I.); (H.S.)
| | - Jørgen Kjems
- Interdisciplinary Nanoscience Center (iNANO), Aarhus University, 8000 Aarhus C, Denmark;
| | - Arto Urtti
- Drug Research Program, Division of Pharmaceutical Biosciences, Faculty of Pharmacy, University of Helsinki, 00014 Helsinki, Finland; (E.R.); (M.R.); (S.S.); (A.U.)
- Laboratory of Biohybrid Technologies, Institute of Chemistry, St. Petersburg State University, 198504 Peterhoff, Russia
- School of Pharmacy, University of Eastern Finland, 70210 Kuopio, Finland;
| | - Marika Ruponen
- School of Pharmacy, University of Eastern Finland, 70210 Kuopio, Finland;
| | - Astrid Subrizi
- Interdisciplinary Nanoscience Center (iNANO), Aarhus University, 8000 Aarhus C, Denmark;
- School of Pharmacy, University of Eastern Finland, 70210 Kuopio, Finland;
- Correspondence: ; Tel.: +358-40-016-3407
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Koivusalo L, Kauppila M, Samanta S, Parihar VS, Ilmarinen T, Miettinen S, Oommen OP, Skottman H. Tissue adhesive hyaluronic acid hydrogels for sutureless stem cell delivery and regeneration of corneal epithelium and stroma. Biomaterials 2019; 225:119516. [PMID: 31574405 DOI: 10.1016/j.biomaterials.2019.119516] [Citation(s) in RCA: 93] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 09/21/2019] [Indexed: 01/05/2023]
Abstract
Regeneration of a severely damaged cornea necessitates the delivery of both epithelium-renewing limbal epithelial stem cells (LESCs) and stroma-repairing cells, such as human adipose-derived stem cells (hASCs). Currently, limited strategies exist for the delivery of these therapeutic cells with tissue-like cellular organization. With the added risks related to suturing of corneal implants, there is a pressing need to develop new tissue adhesive biomaterials for corneal regeneration. To address these issues, we grafted dopamine moieties into hydrazone-crosslinked hyaluronic acid (HA-DOPA) hydrogels to impart tissue adhesive properties and facilitate covalent surface modification of the gels with basement membrane proteins or peptides. We achieved tissue-like cellular compartmentalization in the implants by encapsulating hASCs inside the hydrogels, with subsequent conjugation of thiolated collagen IV or laminin peptides and LESC seeding on the hydrogel surface. The encapsulated hASCs in HA-DOPA gels exhibited good proliferation and cell elongation, while the LESCs expressed typical limbal epithelial progenitor markers. Importantly, the compartmentalized HA-DOPA implants displayed excellent tissue adhesion upon implantation in a porcine corneal organ culture model. These results encourage sutureless implantation of functional stem cells as the next generation of corneal regeneration.
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Affiliation(s)
- Laura Koivusalo
- Eye Regeneration Group, Faculty of Medicine and Health Technology and BioMediTech Institute, Tampere University, Tampere, 33520, Finland
| | - Maija Kauppila
- Eye Regeneration Group, Faculty of Medicine and Health Technology and BioMediTech Institute, Tampere University, Tampere, 33520, Finland
| | - Sumanta Samanta
- Bioengineering and Nanomedicine Lab, Faculty of Medicine and Health Technology and BioMediTech Institute, Tampere University, Tampere, 33720, Finland
| | - Vijay Singh Parihar
- Bioengineering and Nanomedicine Lab, Faculty of Medicine and Health Technology and BioMediTech Institute, Tampere University, Tampere, 33720, Finland
| | - Tanja Ilmarinen
- Eye Regeneration Group, Faculty of Medicine and Health Technology and BioMediTech Institute, Tampere University, Tampere, 33520, Finland
| | - Susanna Miettinen
- Adult Stem Cell Group, Faculty of Medicine and Health Technology and BioMediTech Institute, Tampere University, Finland & Research, Development and Innovation Centre, Tampere University Hospital, Tampere, 33520, Finland
| | - Oommen P Oommen
- Bioengineering and Nanomedicine Lab, Faculty of Medicine and Health Technology and BioMediTech Institute, Tampere University, Tampere, 33720, Finland.
| | - Heli Skottman
- Eye Regeneration Group, Faculty of Medicine and Health Technology and BioMediTech Institute, Tampere University, Tampere, 33520, Finland.
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Vattulainen M, Ilmarinen T, Koivusalo L, Viiri K, Hongisto H, Skottman H. Modulation of Wnt/BMP pathways during corneal differentiation of hPSC maintains ABCG2-positive LSC population that demonstrates increased regenerative potential. Stem Cell Res Ther 2019; 10:236. [PMID: 31383008 PMCID: PMC6683518 DOI: 10.1186/s13287-019-1354-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 07/19/2019] [Accepted: 07/22/2019] [Indexed: 12/20/2022] Open
Abstract
Background The differentiation of corneal limbal stem cells (LSCs) from human pluripotent stem cells (hPSCs) has great power as a novel treatment for ocular surface reconstruction and for modeling corneal epithelial renewal. However, the lack of profound understanding of the true LSC population identity and the regulation of LSC homeostasis is hindering the full therapeutic potential of hPSC-derived LSCs as well as primary LSCs. Methods The differentiation trajectory of two distinct hPSC lines towards LSCs was characterized extensively using immunofluorescence labeling against pluripotency, putative LSC, and mature corneal epithelium markers. Cell counting, flow cytometry, and qRT-PCR were used to quantify the differences between distinct populations observed at day 11 and day 24 time points. Initial differentiation conditions were thereafter modified to support the maintenance and expansion of the earlier population expressing ABCG2. Immunofluorescence, qRT-PCR, population doubling analyses, and transplantation into an ex vivo porcine cornea model were used to analyze the phenotype and functionality of the cell populations cultured in different conditions. Results The detailed characterization of the hPSC differentiation towards LSCs revealed only transient expression of a cell population marked by the universal stemness marker and proposed LSC marker ABCG2. Within the ABCG2-positive population, we further identified two distinct subpopulations of quiescent ∆Np63α-negative and proliferative ∆Np63α-positive cells, the latter of which also expressed the acknowledged intestinal stem cell marker and suggested LSC marker LGR5. These populations that appeared early during the differentiation process had stem cell phenotypes distinct from the later arising ABCG2-negative, ∆Np63α-positive third cell population. Importantly, novel culture conditions modulating the Wnt and BMP signaling pathways allowed efficient maintenance and expansion of the ABCG2-positive populations. In comparison to ∆Np63α-positive hPSC-LSCs cultured in the initial culture conditions, ABCG2-positive hPSC-LSCs in the novel maintenance condition contained quiescent stem cells marked by p27, demonstrated notably higher population doubling capabilities and clonal growth in an in vitro colony-forming assay, and increased regenerative potential in the ex vivo transplantation model. Conclusions The distinct cell populations identified during the hPSC-LSC differentiation and ABCG2-positive LSC maintenance may represent functionally different limbal stem/progenitor cells with implications for regenerative efficacy. Electronic supplementary material The online version of this article (10.1186/s13287-019-1354-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Meri Vattulainen
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, 33520, Tampere, Finland
| | - Tanja Ilmarinen
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, 33520, Tampere, Finland
| | - Laura Koivusalo
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, 33520, Tampere, Finland
| | - Keijo Viiri
- Tampere Center for Child Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Heidi Hongisto
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, 33520, Tampere, Finland.,Department of Ophthalmology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Heli Skottman
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, 33520, Tampere, Finland.
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10
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Ilmarinen T, Thieltges F, Hongisto H, Juuti‐Uusitalo K, Koistinen A, Kaarniranta K, Brinken R, Braun N, Holz FG, Skottman H, Stanzel BV. Survival and functionality of xeno-free human embryonic stem cell-derived retinal pigment epithelial cells on polyester substrate after transplantation in rabbits. Acta Ophthalmol 2019; 97:e688-e699. [PMID: 30593729 DOI: 10.1111/aos.14004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 11/21/2018] [Indexed: 01/08/2023]
Abstract
PURPOSE To study immunogenic properties of human embryonic stem cell-derived retinal pigment epithelium (hESC-RPE) and to evaluate subretinal xenotransplantation of hESC-RPE on porous polyethylene terephthalate (PET) in rabbits. METHODS Human ESC-RPE cells were characterized by morphology, transepithelial electrical resistance (TER), protein expression and photoreceptor outer segment phagocytosis in vitro. Expression of major histocompatibility complex (MHC) proteins was assessed in conventionally or xeno-free produced hESC-RPE ± interferon-gamma (IFN-γ) stimulation (n = 1). Xeno-free hESC-RPE on PET with TER < 200 Ω·cm2 > or PET alone were transplanted into 18 rabbits with short-term triamcinolone ± extended tacrolimus immunosuppression. Rabbits were monitored by spectral domain optical coherence tomography. After 4 weeks, the eyes were processed for histology and transmission electron microscopy. RESULTS Upon in vitro IFN-γ stimulation, xeno-free hESC-RPE expressed lower level of MHC-II proteins compared to the conventional cells. Outer nuclear layer (ONL) atrophy was observed over the graft in most cases 4 weeks post-transplantation. In 3/4 animals with high TER hESC-RPE, but only in 1/3 animals with low TER hESC-RPE, ONL atrophy was observed already within 1 week. Retinal cell infiltrations were more frequent in animals with high TER hESC-RPE. However, the difference was not statistically significant. In three animals, preservation of ONL was observed. Weekly intravitreal tacrolimus did not affect ONL preservation. In all animals, hESC-RPE cells survived for 4 weeks, but without tacrolimus, enlarged vacuoles accumulated in hESC-RPE (n = 1). CONCLUSIONS Xenografted xeno-free hESC-RPE monolayers can survive and retain some functionality for 4 weeks following short-term immunosuppression. The preliminary findings of this study suggest that further investigations to improve transplantation success of hESC-RPE xenografts in rabbits should be addressed especially toward the roles of hESC-RPE maturation stage and extended intravitreal immunosuppression.
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Affiliation(s)
- Tanja Ilmarinen
- BioMediTech Institute Faculty of Medicine and Life Sciences University of Tampere Tampere Finland
| | | | - Heidi Hongisto
- BioMediTech Institute Faculty of Medicine and Life Sciences University of Tampere Tampere Finland
- Department of Ophthalmology Institute of Clinical Medicine University of Eastern Finland Kuopio Finland
| | - Kati Juuti‐Uusitalo
- BioMediTech Institute Faculty of Medicine and Life Sciences University of Tampere Tampere Finland
| | | | - Kai Kaarniranta
- Department of Ophthalmology Institute of Clinical Medicine University of Eastern Finland Kuopio Finland
- Department of Ophthalmology Kuopio University Hospital Kuopio Finland
| | - Ralf Brinken
- Department of Ophthalmology University of Bonn Bonn Germany
| | | | - Frank G. Holz
- Department of Ophthalmology University of Bonn Bonn Germany
| | - Heli Skottman
- BioMediTech Institute Faculty of Medicine and Life Sciences University of Tampere Tampere Finland
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11
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Szatmári-Tóth M, Ilmarinen T, Mikhailova A, Skottman H, Kauppinen A, Kaarniranta K, Kristóf E, Lytvynchuk L, Veréb Z, Fésüs L, Petrovski G. Human Embryonic Stem Cell-Derived Retinal Pigment Epithelium-Role in Dead Cell Clearance and Inflammation. Int J Mol Sci 2019; 20:ijms20040926. [PMID: 30791639 PMCID: PMC6412543 DOI: 10.3390/ijms20040926] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 11/07/2018] [Revised: 12/19/2018] [Accepted: 02/13/2019] [Indexed: 12/19/2022] Open
Abstract
Inefficient removal of dying retinal pigment epithelial (RPE) cells by professional phagocytes can result in debris formation and development of age-related macular degeneration (AMD). Chronic oxidative stress and inflammation play an important role in AMD pathogenesis. Only a few well-established in vitro phagocytosis assay models exist. We propose human embryonic stem cell-derived-RPE cells as a new model for studying RPE cell removal by professional phagocytes. The characteristics of human embryonic stem cells-derived RPE (hESC-RPE) are similar to native RPEs based on their gene and protein expression profile, integrity, and barrier properties or regarding drug transport. However, no data exist about RPE death modalities and how efficiently dying hESC-RPEs are taken upby macrophages, and whether this process triggers an inflammatory responses. This study demonstrates hESC-RPEs can be induced to undergo anoikis or autophagy-associated cell death due to extracellular matrix detachment or serum deprivation and hydrogen-peroxide co-treatment, respectively, similar to primary human RPEs. Dying hESC-RPEs are efficiently engulfed by macrophages which results in high amounts of IL-6 and IL-8 cytokine release. These findings suggest that the clearance of anoikic and autophagy-associated dying hESC-RPEs can be used as a new model for investigating AMD pathogenesis or for testing the in vivo potential of these cells in stem cell therapy.
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Affiliation(s)
- Mária Szatmári-Tóth
- Department of Biochemistry and Molecular Biology, University of Debrecen, Faculty of Medicine, 4032 Debrecen, Hungary.
| | - Tanja Ilmarinen
- Tampere University, Faculty of Medicine and Health Technology, 33014 Tampere, Finland.
| | - Alexandra Mikhailova
- Tampere University, Faculty of Medicine and Health Technology, 33014 Tampere, Finland.
| | - Heli Skottman
- Tampere University, Faculty of Medicine and Health Technology, 33014 Tampere, Finland.
| | - Anu Kauppinen
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, 70211 Kuopio, Finland.
| | - Kai Kaarniranta
- Department of Ophthalmology, Institute of Clinical Medicine, University of Eastern Finland, 70211 Kuopio, Finland.
- Department of Ophthalmology, Kuopio University Hospital, 70029 Kuopio, Finland.
| | - Endre Kristóf
- Department of Biochemistry and Molecular Biology, University of Debrecen, Faculty of Medicine, 4032 Debrecen, Hungary.
| | - Lyubomyr Lytvynchuk
- Department of Ophthalmology, Justus-Liebig-University Giessen, Eye Clinic, University Hospital Giessen and Marburg GmbH, Campus Giessen, 35390 Giessen, Germany.
| | - Zoltán Veréb
- Department of Ophthalmology, Faculty of Medicine, University of Szeged, 6720 Szeged, Hungary.
| | - László Fésüs
- Department of Biochemistry and Molecular Biology, University of Debrecen, Faculty of Medicine, 4032 Debrecen, Hungary.
| | - Goran Petrovski
- Department of Biochemistry and Molecular Biology, University of Debrecen, Faculty of Medicine, 4032 Debrecen, Hungary.
- Department of Ophthalmology, Faculty of Medicine, University of Szeged, 6720 Szeged, Hungary.
- Center for Eye Research, Department of Ophthalmology, Oslo University Hospital and University of Oslo, Kirkeveien 166, 0450 Oslo, Norway.
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12
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Hongisto H, Vattulainen M, Ilmarinen T, Mikhailova A, Skottman H. Efficient and Scalable Directed Differentiation of Clinically Compatible Corneal Limbal Epithelial Stem Cells from Human Pluripotent Stem Cells. J Vis Exp 2018. [PMID: 30417867 DOI: 10.3791/58279] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Corneal limbal epithelial stem cells (LESCs) are responsible for continuously renewing the corneal epithelium, and thus maintaining corneal homeostasis and visual clarity. Human pluripotent stem cell (hPSC)-derived LESCs provide a promising cell source for corneal cell replacement therapy. Undefined, xenogeneic culture and differentiation conditions cause variation in research results and impede the clinical translation of hPSC-derived therapeutics. This protocol provides a reproducible and efficient method for hPSC-LESC differentiation under xeno- and feeder cell-free conditions. Firstly, monolayer culture of undifferentiated hPSC on recombinant laminin-521 (LN-521) and defined hPSC medium serves as a foundation for robust production of high-quality starting material for differentiations. Secondly, a rapid and simple hPSC-LESC differentiation method yields LESC populations in only 24 days. This method includes a four-day surface ectodermal induction in suspension with small molecules, followed by adherent culture phase on LN-521/collagen IV combination matrix in defined corneal epithelial differentiation medium. Cryostoring and extended differentiation further purifies the cell population and enables banking of the cells in large quantities for cell therapy products. The resulting high-quality hPSC-LESCs provide a potential novel treatment strategy for corneal surface reconstruction to treat limbal stem cell deficiency (LSCD).
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Affiliation(s)
- Heidi Hongisto
- BioMediTech Institute, Faculty of Medicine and Life Sciences, University of Tampere;
| | - Meri Vattulainen
- BioMediTech Institute, Faculty of Medicine and Life Sciences, University of Tampere
| | - Tanja Ilmarinen
- BioMediTech Institute, Faculty of Medicine and Life Sciences, University of Tampere
| | - Alexandra Mikhailova
- Department of Ophthalmology, SILK, Faculty of Medicine and Life Sciences, University of Tampere
| | - Heli Skottman
- BioMediTech Institute, Faculty of Medicine and Life Sciences, University of Tampere
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13
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Koivusalo L, Karvinen J, Sorsa E, Jönkkäri I, Väliaho J, Kallio P, Ilmarinen T, Miettinen S, Skottman H, Kellomäki M. Hydrazone crosslinked hyaluronan-based hydrogels for therapeutic delivery of adipose stem cells to treat corneal defects. Materials Science and Engineering: C 2018; 85:68-78. [DOI: 10.1016/j.msec.2017.12.013] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 08/22/2017] [Accepted: 12/07/2017] [Indexed: 01/22/2023]
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14
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Calejo MT, Ilmarinen T, Skottman H, Kellomäki M. Breath figures in tissue engineering and drug delivery: State-of-the-art and future perspectives. Acta Biomater 2018; 66:44-66. [PMID: 29183847 DOI: 10.1016/j.actbio.2017.11.043] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [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: 06/29/2017] [Revised: 11/09/2017] [Accepted: 11/22/2017] [Indexed: 12/11/2022]
Abstract
The breath figure (BF) method is an easy, low-cost method to prepare films with a highly organized honeycomb-like porous surface. The particular surface topography and porous nature of these materials makes them valuable substrates for studying the complex effects of topography on cell fate, and to produce biomimetic materials with high performance in tissue engineering. Numerous researchers over the last two decades have studied the effects of the honeycomb topography on a variety of primary and immortalized cell lines, and drew important conclusions that can be translated to the construction of optimal biomaterials for cell culture. The literature also encouragingly shows the potential of honeycomb films to induce differentiation of stem cells down a specific lineage without the need for biochemical stimuli. Here, we review the main studies where BF honeycomb films are used as substrates for tissue engineering applications. Furthermore, we highlight the numerous advantages of the porous nature of the films, such as the enhanced, spatially controlled adsorption of proteins, the topographical cues influencing cellular behavior, and the enhanced permeability which is essential both in vitro and in vivo. Finally, this review highlights the elegant use of honeycomb films as drug-eluting biomaterials or as reservoirs for distinct drug delivery systems. STATEMENT OF SIGNIFICANCE Combining biocompatible surfaces and 3D nano/microscale topographies, such as pores or grooves, is an effective strategy for manufacturing tissue engineering scaffolds. The breath figure (BF) method is an easy technique to prepare cell culture substrates with an organized, honeycomb-like porous surface. These surface features make these scaffolds valuable for studying how the cells interact with the biomaterials. Their unique surface topography can also resemble the natural environment of the tissues in the human body. For that reason, numerous studies, using different cell types, have shown that honeycomb films can constitute high performance substrates for cell culture. Here, we review those studies, we highlight the advantages of honeycomb films in tissue engineering and we discuss their potential as unique drug-eluting systems.
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Affiliation(s)
- Maria Teresa Calejo
- BioMediTech Institute and Faculty of Biomedical Sciences and Engineering, Tampere University of Technology, Tampere, Finland.
| | - Tanja Ilmarinen
- BioMediTech Institute and Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Heli Skottman
- BioMediTech Institute and Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Minna Kellomäki
- BioMediTech Institute and Faculty of Biomedical Sciences and Engineering, Tampere University of Technology, Tampere, Finland; BioMediTech Institute and Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
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15
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Hongisto H, Ilmarinen T, Vattulainen M, Mikhailova A, Skottman H. Xeno- and feeder-free differentiation of human pluripotent stem cells to two distinct ocular epithelial cell types using simple modifications of one method. Stem Cell Res Ther 2017; 8:291. [PMID: 29284513 PMCID: PMC5747074 DOI: 10.1186/s13287-017-0738-4] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 11/13/2017] [Accepted: 11/28/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Human pluripotent stem cells (hPSCs) provide a promising cell source for ocular cell replacement therapy, but often lack standardized and xenogeneic-free culture and differentiation protocols. We aimed to develop a xeno- and feeder cell-free culture system for undifferentiated hPSCs along with efficient methods to derive ocular therapy target cells: retinal pigment epithelial (RPE) cells and corneal limbal epithelial stem cells (LESCs). METHODS Multiple genetically distinct hPSC lines were adapted to a defined, xeno-, and feeder-free culture system of Essential 8™ medium and laminin-521 matrix. Thereafter, two-stage differentiation methods toward ocular epithelial cells were established utilizing xeno-free media and a combination of extracellular matrix proteins. Both differentiation methods shared the same basal elements, using only minor inductive modifications during early differentiation towards desired cell lineages. The resulting RPE cells and LESCs were characterized after several independent differentiation experiments and recovery after xeno-free cryopreservation. RESULTS The defined, xeno-, and feeder-free culture system provided a robust means to generate high-quality hPSCs with chromosomal stability limited to early passages. Inductive cues introduced during the first week of differentiation had a substantial effect on lineage specification, cell survival, and even mature RPE properties. Derivative RPE formed functional epithelial monolayers with mature tight junctions and expression of RPE genes and proteins, as well as phagocytosis and key growth factor secretion capacity after 9 weeks of maturation on inserts. Efficient LESC differentiation led to cell populations expressing LESC markers such as p40/p63α by day 24. Finally, we established xeno-free cryobanking protocols for pluripotent hPSCs, hPSC-RPE cells, and hPSC-LESCs, and demonstrated successful recovery after thawing. CONCLUSIONS We propose methods for efficient and scalable, directed differentiation of high-quality RPE cells and LESCs. The two clinically relevant cell types are generated with simple inductive modification of the same basal method, followed by adherent culture, passaging, and cryobanking.
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Affiliation(s)
- Heidi Hongisto
- BioMediTech Institute, Faculty of Medicine and Life Sciences, University of Tampere, Arvo Ylpön katu 34, 33520, Tampere, Finland.
| | - Tanja Ilmarinen
- BioMediTech Institute, Faculty of Medicine and Life Sciences, University of Tampere, Arvo Ylpön katu 34, 33520, Tampere, Finland
| | - Meri Vattulainen
- BioMediTech Institute, Faculty of Medicine and Life Sciences, University of Tampere, Arvo Ylpön katu 34, 33520, Tampere, Finland
| | - Alexandra Mikhailova
- Department of Ophthalmology, SILK, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.,Finnish Federation of the Visually Impaired, Helsinki, Finland
| | - Heli Skottman
- BioMediTech Institute, Faculty of Medicine and Life Sciences, University of Tampere, Arvo Ylpön katu 34, 33520, Tampere, Finland
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16
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Hongisto H, Jylhä A, Nättinen J, Rieck J, Ilmarinen T, Veréb Z, Aapola U, Beuerman R, Petrovski G, Uusitalo H, Skottman H. Proteomic tools for studying RPE functions. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.02174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- H. Hongisto
- Faculty of Medicine and Life Sciences; University of Tampere; Tampere Finland
| | - A. Jylhä
- Faculty of Medicine and Life Sciences; University of Tampere; Tampere Finland
| | - J. Nättinen
- Faculty of Medicine and Life Sciences; University of Tampere; Tampere Finland
| | - J. Rieck
- Faculty of Medicine and Life Sciences; University of Tampere; Tampere Finland
| | - T. Ilmarinen
- Faculty of Medicine and Life Sciences; University of Tampere; Tampere Finland
| | - Z. Veréb
- Stem Cells and Eye Research Laboratory-Faculty of Medicine; University of Szeged; Szeged Hungary
| | - U. Aapola
- Faculty of Medicine and Life Sciences; University of Tampere; Tampere Finland
| | - R. Beuerman
- Faculty of Medicine and Life Sciences; Singapore Eye Research Institute and Duke-NUS School of Medicine-Singapore and University of Tampere; Tampere Finland
| | - G. Petrovski
- Center for Eye Research-Department of Ophthalmology; Oslo University Hospital and University of Oslo; Oslo Norway
| | - H. Uusitalo
- Faculty of Medicine and Life Sciences and Tampere University Hospital Eye Center; University of Tampere; Tampere Finland
| | - H. Skottman
- Faculty of Medicine and Life Sciences; University of Tampere; Tampere Finland
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17
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Hongisto H, Jylhä A, Nättinen J, Rieck J, Ilmarinen T, Veréb Z, Aapola U, Beuerman R, Petrovski G, Uusitalo H, Skottman H. Comparative proteomic analysis of human embryonic stem cell-derived and primary human retinal pigment epithelium. Sci Rep 2017; 7:6016. [PMID: 28729539 PMCID: PMC5519552 DOI: 10.1038/s41598-017-06233-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 06/12/2017] [Indexed: 01/28/2023] Open
Abstract
Human embryonic stem cell-derived retinal pigment epithelial cells (hESC-RPE) provide an unlimited cell source for retinal cell replacement therapies. Clinical trials using hESC-RPE to treat diseases such as age-related macular degeneration (AMD) are currently underway. Human ESC-RPE cells have been thoroughly characterized at the gene level but their protein expression profile has not been studied at larger scale. In this study, proteomic analysis was used to compare hESC-RPE cells differentiated from two independent hESC lines, to primary human RPE (hRPE) using Isobaric tags for relative quantitation (iTRAQ). 1041 common proteins were present in both hESC-RPE cells and native hRPE with majority of the proteins similarly regulated. The hESC-RPE proteome reflected that of normal hRPE with a large number of metabolic, mitochondrial, cytoskeletal, and transport proteins expressed. No signs of increased stress, apoptosis, immune response, proliferation, or retinal degeneration related changes were noted in hESC-RPE, while important RPE specific proteins involved in key RPE functions such as visual cycle and phagocytosis, could be detected in the hESC-RPE. Overall, the results indicated that the proteome of the hESC-RPE cells closely resembled that of their native counterparts.
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Affiliation(s)
- Heidi Hongisto
- BioMediTech Institute, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.
| | - Antti Jylhä
- Department of Ophthalmology, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Janika Nättinen
- BioMediTech Institute, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.,Department of Ophthalmology, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Jochen Rieck
- BioMediTech Institute, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Tanja Ilmarinen
- BioMediTech Institute, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Zoltán Veréb
- Stem Cells and Eye Research Laboratory, Department of Ophthalmology, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Ulla Aapola
- Department of Ophthalmology, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Roger Beuerman
- Department of Ophthalmology, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.,Singapore Eye Research Institute and Duke-NUS School of Medicine, Singapore, Singapore
| | - Goran Petrovski
- Stem Cells and Eye Research Laboratory, Department of Ophthalmology, Faculty of Medicine, University of Szeged, Szeged, Hungary.,Center for Eye Research, Department of Ophthalmology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Hannu Uusitalo
- Department of Ophthalmology, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.,Tampere University Hospital Eye Center, University of Tampere, Tampere, Finland
| | - Heli Skottman
- BioMediTech Institute, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
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18
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Calejo MT, Ilmarinen T, Vuorimaa-Laukkanen E, Talvitie E, Hakola HM, Skottman H, Kellomäki M. Langmuir-Schaefer film deposition onto honeycomb porous films for retinal tissue engineering. Acta Biomater 2017; 54:138-149. [PMID: 28223209 DOI: 10.1016/j.actbio.2017.02.035] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [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: 09/13/2016] [Revised: 01/31/2017] [Accepted: 02/16/2017] [Indexed: 12/15/2022]
Abstract
Age-related macular degeneration (AMD) is the leading cause of vision loss in senior citizens in the developed world. The disease is characterised by the degeneration of a specific cell layer at the back of the eye - the retinal pigment epithelium (RPE), which is essential in retinal function. The most promising therapeutic option to restore the lost vision is considered to be RPE cell transplantation. This work focuses on the development of biodegradable biomaterials with similar properties to the native Bruch's membrane as carriers for RPE cells. In particular, the breath figure (BF) method was used to create semi-permeable microporous films, which were thereafter used as the substrate for the consecutive Langmuir-Schaefer (LS) deposition of highly organised layers of collagen type I and collagen type IV. The newly developed biomaterials were further characterised in terms of surface porosity, roughness, hydrophilicity, collagen distribution, diffusion properties and hydrolytic stability. Human embryonic stem cell-derived RPE cells (hESC-RPE) cultured on the biomaterials showed good adhesion, spreading and morphology, as well as the expression of specific protein markers. Cell function was additionally confirmed by the assessment of the phagocytic capacity of hESC-RPE. Throughout the study, microporous films consistently showed better results as cell culture materials for hESC-RPE than dip-coated controls. This work demonstrates the potential of the BF-LS combined technologies to create biomimetic prosthetic Bruch's membranes for hESC-RPE transplantation. STATEMENT OF SIGNIFICANCE Age-related macular degeneration (AMD) is a leading cause of central blindness in developed countries, associated with the degeneration of the retinal pigment epithelium (RPE), a specific cell layer at the back of the eye. Transplantation of RPE cells derived from stem cells is considered the best option to treat these patients. In this work, we developed a cell carrier for human embryonic stem cell-derived RPE that resembled the upper layers of the membrane that naturally supports the RPE cells in the retina. The new combination of technologies employed in this study resulted in very promising materials as confirmed by our studies on cell proliferation, morphology and function.
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Affiliation(s)
- Maria Teresa Calejo
- Faculty of Biomedical Sciences and Engineering, and BioMediTech Institute, Tampere University of Technology, Tampere, Finland.
| | - Tanja Ilmarinen
- Faculty of Medicine and Life Sciences, and BioMediTech Institute, University of Tampere, Tampere, Finland
| | | | - Elina Talvitie
- Faculty of Biomedical Sciences and Engineering, and BioMediTech Institute, Tampere University of Technology, Tampere, Finland
| | - Hanna M Hakola
- Laboratory of Chemistry and Bioengineering, Tampere University of Technology, Tampere, Finland
| | - Heli Skottman
- Faculty of Medicine and Life Sciences, and BioMediTech Institute, University of Tampere, Tampere, Finland
| | - Minna Kellomäki
- Faculty of Biomedical Sciences and Engineering, and BioMediTech Institute, Tampere University of Technology, Tampere, Finland
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Calejo MT, Ilmarinen T, Jongprasitkul H, Skottman H, Kellomäki M. Honeycomb porous films as permeable scaffold materials for human embryonic stem cell-derived retinal pigment epithelium. J Biomed Mater Res A 2016; 104:1646-56. [PMID: 26914698 DOI: 10.1002/jbm.a.35690] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 01/29/2016] [Accepted: 02/16/2016] [Indexed: 01/29/2023]
Abstract
Age-related macular degeneration (AMD) is a leading cause of blindness in developed countries, characterised by the degeneration of the retinal pigment epithelium (RPE), a pigmented cell monolayer that closely interacts with the photoreceptors. RPE transplantation is thus considered a very promising therapeutic option to treat this disease. In this work, porous honeycomb-like films are for the first time investigated as scaffold materials for human embryonic stem cell-derived retinal pigment epithelium (hESC-RPE). By changing the conditions during film preparation, it was possible to produce films with homogeneous pore distribution and adequate pore size (∼3-5 µm), that is large enough to ensure high permeability but small enough to enable cell adherence and spreading. A brief dip-coating procedure with collagen type IV enabled the homogeneous adsorption of the protein to the walls and bottom of pores, increasing the hydrophilicity of the surface. hESC-RPE adhered and proliferated on all the collagen-coated materials, regardless of small differences in pore size. The differentiation of hESC-RPE was confirmed by the detection of specific RPE protein markers. These results suggest that the porous honeycomb films can be promising candidates for hESC-RPE tissue engineering, importantly enabling the free flow of ions and molecules across the material. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 1646-1656, 2016.
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Affiliation(s)
- Maria Teresa Calejo
- BioMediTech, Department of Electronics and Communications Engineering, Tampere University of Technology, Tampere, Finland
| | | | - Hatai Jongprasitkul
- BioMediTech, Department of Electronics and Communications Engineering, Tampere University of Technology, Tampere, Finland
| | - Heli Skottman
- BioMediTech, University of Tampere, Tampere, Finland
| | - Minna Kellomäki
- BioMediTech, Department of Electronics and Communications Engineering, Tampere University of Technology, Tampere, Finland
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20
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San Giorgi MRM, van den Heuvel ER, Tjon Pian Gi REA, Brunings JW, Chirila M, Friedrich G, Golusinski W, Graupp M, Horcasitas Pous RA, Ilmarinen T, Jackowska J, Koelmel JC, Ferran Vilà F, Weichbold V, Wierzbicka M, Dikkers FG. Age of onset of recurrent respiratory papillomatosis: a distribution analysis. Clin Otolaryngol 2016; 41:448-53. [PMID: 26460806 DOI: 10.1111/coa.12565] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2015] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Distribution of age of onset of recurrent respiratory papillomatosis (RRP) is generally described to be bimodal, with peaks at approximately 5 years and 30 years. This assumption has never been scientifically confirmed, and authors tend to refer to an article that does not describe distribution. Knowledge of the distribution of age of onset is important for virological and epidemiological comprehension. The objective of this study was to determine the distribution of age of onset of RRP in a large international sample. DESIGN Cross-sectional distribution analysis. PARTICIPANTS Laryngologists from 12 European hospitals provided information on date of birth and date of onset of all their RRP patients treated between 1998 and 2012. Centers that exclusively treated either patients with juvenile onset RRP or patients with adult onset RRP, or were less accessible for one of these groups, were excluded to prevent skewness. MAIN OUTCOME MEASURES A mixture model was implemented to describe distribution of age of onset. The best fitting model was selected using the Bayesian information criterion. RESULTS Six hundred and thirty-nine patients were included in the analysis. Age of onset was described by a three component mixture distribution with lognormally distributed components. Recurrent respiratory papillomatosis starts at three median ages 7, 35 and 64 years. CONCLUSIONS Distribution of age of onset of RRP shows three peaks. In addition to the already adopted idea of age peaks at paediatric and adult age, there is an additional peak around the age of 64.
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Affiliation(s)
- M R M San Giorgi
- Department of Otorhinolaryngology/Head & Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Cancer Research Center Groningen, University of Groningen, Groningen, The Netherlands
| | - E R van den Heuvel
- Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - R E A Tjon Pian Gi
- Department of Otorhinolaryngology/Head & Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Cancer Research Center Groningen, University of Groningen, Groningen, The Netherlands
| | - J W Brunings
- Department of Otorhinolaryngology/Head & Neck Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - M Chirila
- Department of Otorhinolaryngology/Head & Neck Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - G Friedrich
- Department of Phoniatrics, Speech and Swallowing, Ear, Nose and Throat University Hospital, Medical University of Graz, Graz, Austria
| | - W Golusinski
- Department of Otorhinolaryngology, Greater Poland Cancer Centre, Poznań, Poland
| | - M Graupp
- Department of Phoniatrics, Speech and Swallowing, Ear, Nose and Throat University Hospital, Medical University of Graz, Graz, Austria
| | - R A Horcasitas Pous
- Pediatric Otolaryngology, Hospital Infantil del Estado de Chihuahua, Chihuahua, Mexico
| | - T Ilmarinen
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - J Jackowska
- Department of Otolaryngology - Head and Neck Surgery, Poznań University of Medical Sciences, Poznań, Poland
| | - J C Koelmel
- Klinik für Hals-, Nasen-, Ohrenkrankheiten, Plastische Operationen, Klinikum-Stuttgart, Stuttgart, Germany
| | - F Ferran Vilà
- Consulta d'ORL, foniatria i logopèdia, Hosp. Gral de Catalunya (Sant Cugat del Vallès), Barcelona, Spain
| | - V Weichbold
- Department for Hearing Speech and Voice Disorders, Medical University Innsbruck, Innsbruck, Austria
| | - M Wierzbicka
- Department of Otolaryngology - Head and Neck Surgery, Poznań University of Medical Sciences, Poznań, Poland
| | - F G Dikkers
- Department of Otorhinolaryngology/Head & Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. .,Cancer Research Center Groningen, University of Groningen, Groningen, The Netherlands.
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21
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Ilmarinen T, Hiidenmaa H, Kööbi P, Nymark S, Sorkio A, Wang JH, Stanzel BV, Thieltges F, Alajuuma P, Oksala O, Kataja M, Uusitalo H, Skottman H. Ultrathin Polyimide Membrane as Cell Carrier for Subretinal Transplantation of Human Embryonic Stem Cell Derived Retinal Pigment Epithelium. PLoS One 2015; 10:e0143669. [PMID: 26606532 PMCID: PMC4659637 DOI: 10.1371/journal.pone.0143669] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [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: 09/02/2015] [Accepted: 11/06/2015] [Indexed: 12/11/2022] Open
Abstract
In this study, we investigated the suitability of ultrathin and porous polyimide (PI) membrane as a carrier for subretinal transplantation of human embryonic stem cell (hESC) -derived retinal pigment epithelial (RPE) cells in rabbits. The in vivo effects of hESC-RPE cells were analyzed by subretinal suspension injection into Royal College of Surgeons (RCS) rats. Rat eyes were analyzed with electroretinography (ERG) and histology. After analyzing the surface and permeability properties of PI, subretinal PI membrane transplantations with and without hESC-RPE were performed in rabbits. The rabbits were followed for three months and eyes analyzed with fundus photography, ERG, optical coherence tomography (OCT), and histology. Animals were immunosuppressed with cyclosporine the entire follow-up time. In dystrophic RCS rats, ERG and outer nuclear layer (ONL) thickness showed some rescue after hESC-RPE injection. Cells positive for human antigen were found in clusters under the retina 41 days post-injection but not anymore after 105 days. In rabbits, OCT showed good placement of the PI. However, there was loss of pigmentation on the hESC-RPE-PI over time. In the eyes with PI alone, no obvious signs of inflammation or retinal atrophy were observed. In the presence of hESC-RPE, mononuclear cell infiltration and retinal atrophy were observed around the membranes. The porous ultrathin PI membrane was well-tolerated in the subretinal space and is a promising scaffold for RPE transplantation. However, the rejection of the transplanted cells seems to be a major problem and the given immunosuppression was insufficient for reduction of xenograft induced inflammation.
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Affiliation(s)
- Tanja Ilmarinen
- BioMediTech, University of Tampere, Tampere, Finland
- * E-mail:
| | | | - Peeter Kööbi
- Department of Ophthalmology, SILK, University of Tampere and Tays Eye Center, Tampere, Finland
| | - Soile Nymark
- Department of Electronics and Communications Engineering and BioMediTech, Tampere University of Technology, Tampere, Finland
| | - Anni Sorkio
- BioMediTech, University of Tampere, Tampere, Finland
| | - Jing-Huan Wang
- Department of Ophthalmology, SILK, University of Tampere and Tays Eye Center, Tampere, Finland
| | | | | | | | | | | | - Hannu Uusitalo
- Department of Ophthalmology, SILK, University of Tampere and Tays Eye Center, Tampere, Finland
| | - Heli Skottman
- BioMediTech, University of Tampere, Tampere, Finland
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22
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Mikhailova A, Jylhä A, Rieck J, Nättinen J, Ilmarinen T, Veréb Z, Aapola U, Beuerman R, Petrovski G, Uusitalo H, Skottman H. Comparative proteomics reveals human pluripotent stem cell-derived limbal epithelial stem cells are similar to native ocular surface epithelial cells. Sci Rep 2015; 5:14684. [PMID: 26423138 PMCID: PMC4589773 DOI: 10.1038/srep14684] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 09/08/2015] [Indexed: 12/13/2022] Open
Abstract
Limbal epithelial stem cells (LESCs) are tissue-specific stem cells responsible for renewing the corneal epithelium. Acute trauma or chronic disease affecting LESCs may disrupt corneal epithelial renewal, causing vision threatening and painful ocular surface disorders, collectively referred to as LESC deficiency (LESCD). These disorders cannot be treated with traditional corneal transplantation and therefore alternative cell sources for successful cell-based therapy are needed. LESCs derived from human pluripotent stem cells (hPSCs) are a prospective source for ocular surface reconstruction, yet critical evaluation of these cells is crucial before considering clinical applications. In order to quantitatively evaluate hPSC-derived LESCs, we compared protein expression in native human corneal cells to that in hPSC-derived LESCs using isobaric tag for relative and absolute quantitation (iTRAQ) technology. We identified 860 unique proteins present in all samples, including proteins involved in cell cycling, proliferation, differentiation and apoptosis, various LESC niche components, and limbal and corneal epithelial markers. Protein expression profiles were nearly identical in LESCs derived from two different hPSC lines, indicating that the differentiation protocol is reproducible, yielding homogeneous cell populations. Their protein expression profile suggests that hPSC-derived LESCs are similar to the human ocular surface epithelial cells, and possess LESC-like characteristics.
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Affiliation(s)
| | - Antti Jylhä
- Department of Ophthalmology, School of Medicine, University of Tampere, Finland
| | | | - Janika Nättinen
- Department of Ophthalmology, School of Medicine, University of Tampere, Finland
| | | | - Zoltán Veréb
- Stem Cells and Eye Research Laboratory, Department of Ophthalmology, Faculty of Medicine, University of Szeged, Hungary
| | - Ulla Aapola
- Department of Ophthalmology, School of Medicine, University of Tampere, Finland
| | - Roger Beuerman
- Department of Ophthalmology, School of Medicine, University of Tampere, Finland.,Singapore Eye Research Institute and School of Medicine, Singapore
| | - Goran Petrovski
- Stem Cells and Eye Research Laboratory, Department of Ophthalmology, Faculty of Medicine, University of Szeged, Hungary
| | - Hannu Uusitalo
- Department of Ophthalmology, School of Medicine, University of Tampere, Finland.,Tampere University Hospital Eye Center, University of Tampere, Finland
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23
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Polinati PP, Ilmarinen T, Trokovic R, Hyotylainen T, Otonkoski T, Suomalainen A, Skottman H, Tyni T. Patient-Specific Induced Pluripotent Stem Cell-Derived RPE Cells: Understanding the Pathogenesis of Retinopathy in Long-Chain 3-Hydroxyacyl-CoA Dehydrogenase Deficiency. Invest Ophthalmol Vis Sci 2015; 56:3371-82. [PMID: 26024122 DOI: 10.1167/iovs.14-14007] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Retinopathy is an important manifestation of trifunctional protein (TFP) deficiencies but not of other defects of fatty acid oxidation. The common homozygous mutation in the TFP α-subunit gene HADHA (hydroxyacyl-CoA dehydrogenase), c.1528G>C, affects the long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD) activity of TFP and blindness in infancy. The pathogenesis of the retinopathy is unknown. This study aimed to utilize human induced pluripotent stem cell (hiPSC) technology to create a disease model for the disorder, and to derive clues for retinopathy pathogenesis. METHODS We implemented hiPSC technology to generate LCHAD deficiency (LCHADD) patient-specific retinal pigment epithelial (RPE) monolayers. These patient and control RPEs were extensively characterized for function and structure, as well as for lipid composition by mass spectrometry. RESULTS The hiPSC-derived RPE monolayers of patients and controls were functional, as they both were able to phagocytose the photoreceptor outer segments in vitro. Interestingly, the patient RPEs had intense cytoplasmic neutral lipid accumulation, and lipidomic analysis revealed an increased triglyceride accumulation. Further, patient RPEs were small and irregular in shape, and their tight junctions were disorganized. Their ultrastructure showed decreased pigmentation, few melanosomes, and more melanolysosomes. CONCLUSIONS We demonstrate that the RPE cell model reveals novel early pathogenic changes in LCHADD retinopathy, with robust lipid accumulation, inefficient pigmentation that is evident soon after differentiation, and a defect in forming tight junctions inducing apoptosis. We propose that LCHADD-RPEs are an important model for mitochondrial TFP retinopathy, and that their early pathogenic changes contribute to infantile blindness of LCHADD.
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Affiliation(s)
- Padmini P Polinati
- Research Program of Molecular Neurology, Biomedicum 1, University of Helsinki, Helsinki, Finland
| | - Tanja Ilmarinen
- Institute of Biomedical Technology, University of Tampere, Tampere, Finland 3BioMediTech, Tampere, Finland
| | - Ras Trokovic
- Research Program of Molecular Neurology, Biomedicum 1, University of Helsinki, Helsinki, Finland
| | - Tuulia Hyotylainen
- Valtion Teknillinen Tutkimuskeskus (VTT) Technical Research Centre of Finland, Tietotie 2, Espoo, Finland
| | - Timo Otonkoski
- Research Program of Molecular Neurology, Biomedicum 1, University of Helsinki, Helsinki, Finland 5Children's Hospital, Helsinki University Central Hospital, Helsinki, Finland
| | - Anu Suomalainen
- Research Program of Molecular Neurology, Biomedicum 1, University of Helsinki, Helsinki, Finland 5Children's Hospital, Helsinki University Central Hospital, Helsinki, Finland
| | - Heli Skottman
- Institute of Biomedical Technology, University of Tampere, Tampere, Finland 3BioMediTech, Tampere, Finland
| | - Tiina Tyni
- Research Program of Molecular Neurology, Biomedicum 1, University of Helsinki, Helsinki, Finland 5Children's Hospital, Helsinki University Central Hospital, Helsinki, Finland
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24
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Ilmarinen T, Laine J, Juuti-Uusitalo K, Numminen J, Seppänen-Suuronen R, Uusitalo H, Skottman H. Towards a defined, serum- and feeder-free culture of stratified human oral mucosal epithelium for ocular surface reconstruction. Acta Ophthalmol 2013; 91:744-50. [PMID: 22963401 DOI: 10.1111/j.1755-3768.2012.02523.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [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: 11/28/2022]
Abstract
PURPOSE Ocular surface reconstruction with cultivated oral mucosal epithelial transplantation technique is a viable treatment option for severe ocular surface injuries and diseases with limbal stem cell deficiency. Currently, this technique is based on utilization of xenogenic, allogenic or undefined components such as murine 3T3 feeders, serum and amniotic membrane. In this study, we aimed to find a more defined culture method to generate stratified human oral mucosal epithelium. METHODS In this study, we have examined the formation of stratified cell sheets from human oral mucosal epithelial cells under serum-free culture environment both in the absence and presence of fibroblast-conditioned culture medium and elevated epidermal growth factor (EGF) concentration. RESULTS In all examined culture conditions, the cultivated oral epithelial cells formed a stratified tissue, which was positive for keratins K3/12, K4 and K13. The tissue-engineered oral epithelia also expressed proliferation and progenitor markers Ki67 and p63 in the basal layer of the cell sheets, suggesting that the epithelia still had regenerative capacity. The cultures presented expression of tight junction proteins ZO-1 and occludin and high transepithelial electrical resistance values. CONCLUSION In this culture method, we have been able to produce stratified cell sheets successfully without serum, conditioning of the medium or increased EGF concentration. We provide a novel protocol to produce tight multi-layered epithelium with proliferative potential, which can be easily adapted for cultivated oral mucosal epithelial transplantation.
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Affiliation(s)
- Tanja Ilmarinen
- Institute of Biomedical Technology, University of Tampere, Tampere, FinlandBioMediTech, Tampere, FinlandDepartment of Eye, Ear, and Oral Diseases, Tampere University Hospital, Tampere, FinlandSILK, Department of Ophthalmology, University of Tampere, Tampere, FinlandEye Center, Tampere University Hospital, Tampere, Finland
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25
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Tjon Pian Gi REA, Ilmarinen T, van den Heuvel ER, Aaltonen LM, Andersen J, Brunings JW, Chirila M, Dietz A, Ferran Vilà F, Friedrich G, de Gier HHW, Golusinski W, Graupp M, Hantzakos A, Horcasitas R, Jackowska J, Koelmel JC, Lawson G, Lindner F, Remacle M, Sittel C, Weichbold V, Wierzbicka M, Dikkers FG. Safety of intralesional cidofovir in patients with recurrent respiratory papillomatosis: an international retrospective study on 635 RRP patients. Eur Arch Otorhinolaryngol 2013; 270:1679-87. [PMID: 23377227 DOI: 10.1007/s00405-013-2358-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Accepted: 01/10/2013] [Indexed: 12/27/2022]
Abstract
Intralesional use of cidofovir (Vistide(®)) has been one of the mainstays of adjuvant therapy in patients with recurrent respiratory papillomatosis (RRP) since 1998. In 2011, a communication provided by the producer of cidofovir addressed very serious side effects concerning its off-label use. As this was a general warning, it was inconclusive whether this would account for its use in RRP. The aim of this study is to determine whether nephrotoxic, neutropenic, or oncogenic side effects have occurred after intralesional use of cidofovir in patients with RRP. Update of recent developments in RRP, a multicentre questionnaire and a multicentre retrospective chart review. Sixteen hospitals from eleven countries worldwide submitted records of 635 RRP patients, of whom 275 were treated with cidofovir. RRP patients received a median of three intralesional injections (interquartile range 2-6). There were no statistical differences in occurrence of neutropenia or renal dysfunction before and after cidofovir. There was no statistical difference in occurrence of upper airway and tracheal malignancies between the cidofovir and the non-cidofovir group. In this retrospective patient chart review, no clinical evidence was found for more long-term nephrotoxicity, neutropenia or laryngeal malignancies after the administration of intralesional cidofovir in RRP patients.
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Affiliation(s)
- R E A Tjon Pian Gi
- Department of Otorhinolaryngology Head and Neck Surgery, University of Groningen, University Medical Center Groningen, PO box 30001, 9700 RB Groningen, The Netherlands.
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26
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Toivonen S, Ojala M, Hyysalo A, Ilmarinen T, Rajala K, Pekkanen-Mattila M, Äänismaa R, Lundin K, Palgi J, Weltner J, Trokovic R, Silvennoinen O, Skottman H, Narkilahti S, Aalto-Setälä K, Otonkoski T. Comparative analysis of targeted differentiation of human induced pluripotent stem cells (hiPSCs) and human embryonic stem cells reveals variability associated with incomplete transgene silencing in retrovirally derived hiPSC lines. Stem Cells Transl Med 2013; 2:83-93. [PMID: 23341440 DOI: 10.5966/sctm.2012-0047] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Functional hepatocytes, cardiomyocytes, neurons, and retinal pigment epithelial (RPE) cells derived from human embryonic stem cells (hESCs) or human induced pluripotent stem cells (hiPSCs) could provide a defined and renewable source of human cells relevant for cell replacement therapies, drug discovery, toxicology testing, and disease modeling. In this study, we investigated the differences between the differentiation potentials of three hESC lines, four retrovirally derived hiPSC lines, and one hiPSC line derived with the nonintegrating Sendai virus technology. Four independent protocols were used for hepatocyte, cardiomyocyte, neuronal, and RPE cell differentiation. Overall, cells differentiated from hESCs and hiPSCs showed functional similarities and similar expression of genes characteristic of specific cell types, and differences between individual cell lines were also detected. Reactivation of transgenic OCT4 was detected specifically during RPE differentiation in the retrovirally derived lines, which may have affected the outcome of differentiation with these hiPSCs. One of the hiPSC lines was inferior in all directions, and it failed to produce hepatocytes. Exogenous KLF4 was incompletely silenced in this cell line. No transgene expression was detected in the Sendai virus-derived hiPSC line. These findings highlight the problems related to transgene expression in retrovirally derived hiPSC lines.
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Affiliation(s)
- Sanna Toivonen
- Research Programs Unit, Molecular Neurology, Biomedicum Stem Cell Center, University of Helsinki, Helsinki, Finland
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Hongisto H, Mikhailova A, Hiidenmaa H, Ilmarinen T, Skottman H. Low level of activin A secreted by fibroblast feeder cells accelerates early stage differentiation of retinal pigment epithelial cells from human pluripotent stem cells. ACTA ACUST UNITED AC 2012. [DOI: 10.4236/scd.2012.24022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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28
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Vaajasaari H, Ilmarinen T, Juuti-Uusitalo K, Rajala K, Onnela N, Narkilahti S, Suuronen R, Hyttinen J, Uusitalo H, Skottman H. Toward the defined and xeno-free differentiation of functional human pluripotent stem cell-derived retinal pigment epithelial cells. Mol Vis 2011; 17:558-75. [PMID: 21364903 PMCID: PMC3044694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2010] [Accepted: 02/17/2011] [Indexed: 11/02/2022] Open
Abstract
PURPOSE The production of functional retinal pigment epithelium (RPE) cells from human embryonic (hESCs) and human induced pluripotent stem cells (hiPSCs) in defined and xeno-free conditions is highly desirable, especially for their use in cell therapy for retinal diseases. In addition, differentiated RPE cells provide an individualized disease model and drug discovery tool. In this study, we report the differentiation of functional RPE-like cells from several hESC lines and one hiPSC line in culture conditions, enabling easy translation to clinical quality cell production under Good Manufacturing Practice regulations. METHODS Pluripotent stem cells were cultured on human fibroblast feeder cells in serum-free medium. The differentiation toward RPE was induced by removing basic fibroblast growth factor and feeder cells from the serum-free conditions. RPE differentiation was also achieved using xeno-free and defined culture conditions. The RPE cell morphology and pigmentation of the cells were analyzed and the expression of genes and proteins characteristic for RPE cells was evaluated. In vitro functionality of the cells was analyzed using ELISA measurements for pigment epithelium derived factor (PEDF) secretion and phagocytosis of photoreceptor outer segments (POS). The integrity of the generated RPE layers was analyzed using transepithelial electric resistance measurements. RESULTS We generated putative RPE cells with typical pigmented cobblestone-like morphology. The expression of RPE-specific markers was confirmed at the gene and protein level. The differentiated cells were able to phagocytose POS and secrete PEDF characteristic of native RPE cells. In addition, cultured cells formed a polarized epithelium with high integrity and exhibited excellent transepithelial electric resistance values, indicating well established, tight junctions. Moreover, we introduced an improved method to generate functional putative RPE cells without xeno-components under defined conditions. CONCLUSIONS We have developed a progressive differentiation protocol for the production of functional RPE-like cells from hESCs and hiPSCs. Our results demonstrate that putative hESC-RPE and hiPSC-RPE express genes and proteins characteristic for RPE cells, as well as being able to phagocytose POS and secrete PEDF. Furthermore, our results show that RPE-like cells can be differentiated in xeno-free and defined culture conditions, which is mandatory for Good Manufacturing Practice-production of these cells for clinical use.
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Affiliation(s)
- Hanna Vaajasaari
- Regea - Institute for Regenerative Medicine, University of Tampere, Tampere, Finland
| | - Tanja Ilmarinen
- Regea - Institute for Regenerative Medicine, University of Tampere, Tampere, Finland
| | - Kati Juuti-Uusitalo
- Regea - Institute for Regenerative Medicine, University of Tampere, Tampere, Finland
| | - Kristiina Rajala
- Regea - Institute for Regenerative Medicine, University of Tampere, Tampere, Finland
| | - Niina Onnela
- Department of Biomedical Engineering, Tampere University of Technology, Tampere, Finland
| | - Susanna Narkilahti
- Regea - Institute for Regenerative Medicine, University of Tampere, Tampere, Finland
| | - Riitta Suuronen
- Regea - Institute for Regenerative Medicine, University of Tampere, Tampere, Finland,Department of Eye, Ear, and Oral Diseases, Tampere University Hospital, Tampere, Finland,SILK, Department of Ophthalmology, University of Tampere, Tampere, Finland
| | - Jari Hyttinen
- Department of Biomedical Engineering, Tampere University of Technology, Tampere, Finland
| | - Hannu Uusitalo
- Department of Eye, Ear, and Oral Diseases, Tampere University Hospital, Tampere, Finland,SILK, Department of Ophthalmology, University of Tampere, Tampere, Finland
| | - Heli Skottman
- Regea - Institute for Regenerative Medicine, University of Tampere, Tampere, Finland
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Tonooka A, Kubo T, Ichimiya S, Tamura Y, Ilmarinen T, Ulmanen I, Kimura S, Yokoyama S, Takano Y, Kikuchi T, Sato N. Wild-type AIRE cooperates with p63 in HLA class II expression of medullary thymic stromal cells. Biochem Biophys Res Commun 2009; 379:765-70. [PMID: 19124002 DOI: 10.1016/j.bbrc.2008.12.123] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2008] [Accepted: 12/20/2008] [Indexed: 01/03/2023]
Abstract
During T cell development in the thymus, autoreactive T cells are deleted through a mechanism that is actively supported by medullary epithelial cells. These epithelial cells possess particular transcription factors including autoimmune regulator (AIRE), which is responsible for regulating expression of self-antigens, as well as p63, a p53-like molecule. Here we present evidence suggesting interaction of AIRE with p63 through a SAND domain and a transactivation domain, respectively. Interestingly an AIRE molecule with a mutated SAND domain of G228W, whose genetic alteration is inherited in an autosomal dominant manner, could not establish a complex with p63 as indicated by immunoprecipitation and molecular modeling analyses. Further in vitro study indicated that the G228W mutation led to downregulation of the transcription levels of CIITA and, accordingly, the cell surface expression of HLA class II molecules in thymic epithelial cells with p63. This indicates novel involvement of AIRE and p63 in the regulation of HLA class II, and suggests that defects in the AIRE-p63 interaction may lead to malfunction of HLA-based selection of self-reactive helper CD4(+) T cells in the thymus.
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Affiliation(s)
- Akiko Tonooka
- Department of Pathology, Sapporo Medical University School of Medicine, South-1, West-17, Chuo-ku, Sapporo, Japan
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Nöjd N, Ilmarinen T, Lehtonen L, Skottman H, Suuronen R, Hyttinen J. Using MEA system in verifying the functionality of retinal pigment epithelium cells differentiated from human embryonic stem cells. IFMBE Proceedings 2009. [DOI: 10.1007/978-3-540-89208-3_547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Ilmarinen T, Kangas H, Kytömaa T, Eskelin P, Saharinen J, Seeler JS, Tanhuanpää K, Chan FYL, Slattery RM, Alakurtti K, Palvimo JJ, Ulmanen I. Functional interaction of AIRE with PIAS1 in transcriptional regulation. Mol Immunol 2008; 45:1847-62. [PMID: 18083234 DOI: 10.1016/j.molimm.2007.10.045] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2007] [Accepted: 10/31/2007] [Indexed: 10/22/2022]
Abstract
AIRE (autoimmune regulator) promotes the establishment of self-tolerance by regulating gene expression in the thymus. Mutations in AIRE lead to an autoimmune disease, APECED. Here we have identified PIAS proteins as novel AIRE interaction partners. Although PIAS proteins function as E3 SUMO ligases, AIRE is not sumoylated. We expressed AIRE, wt PIAS1, and PIAS1 mutants with deleted SP-RING domain or SUMO interaction motif (SIM) in different cell lines and demonstrate that AIRE and PIAS1 localize to adjacent nuclear bodies (NBs). The expression of AIRE enhances the formation of PIAS1 NBs. The ability of PIAS1 to localize into NBs and interconnect with AIRE is neither dependent on the SP-RING domain nor the SIM. Further, we show that PIAS1 is able to attract AIRE into SUMO1-containing complexes and that the process is dependent on the SIM of PIAS1. PIAS1 and AIRE concurrently activate the human insulin promoter, a known target gene of AIRE, and the SP-RING is required for this activation. Moreover, AIRE represses and PIAS1 activates the CSTB promoter, used as a model for a housekeeping promoter, and both the SP-RING and SIM are needed for its activation by PIAS1. Collectively, our data suggest that AIRE and PIAS1 interact functionally to regulate the activities of the target genes of AIRE.
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Affiliation(s)
- Tanja Ilmarinen
- Department of Molecular Medicine, National Public Health Institute, Biomedicum Helsinki, Haartmaninkatu 8, 00290 Helsinki, Finland
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Dominguez M, Crushell E, Ilmarinen T, McGovern E, Collins S, Chang B, Fleming P, Irvine AD, Brosnahan D, Ulmanen I, Murphy N, Costigan C. Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) in the Irish population. J Pediatr Endocrinol Metab 2006; 19:1343-52. [PMID: 17220063 DOI: 10.1515/jpem.2006.19.11.1343] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To determine the Irish prevalence of autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED), the AIRE mutations involved and clinical features of this population. METHODS All patients were identified through paediatricians and endocrinologists in Ireland. Patients were invited to attend a multidisciplinary clinic. RESULTS Thirty-one patients (2-56 years), 18 female, were identified from 19 families giving an Irish prevalence of 1:130,000. Twenty-six patients had hypoparathyroidism, 21 had adrenal insufficiency (AI) and 10 of 16 had ovarian failure. Three affected patients have died. Many with hypoparathyroidism were resistant to 1-alpha-vitamin D. Two needed daily PTH injections. Mineralocorticoid deficiency as the first manifestation of AI was common. Chronic intra-oral candidiasis affected 25 patients and three had leukoplakia. Two had keratoconjuntivitis. Of 22 with AIRE gene analysis, three different mutations were identified, one of which is novel. CONCLUSION APECED is rare in Ireland. We saw a significant amount of non-endocrine disease but no ectodermal dystrophy. AIRE gene analysis reassured many siblings and identified individuals with APECED prior to any symptoms.
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Affiliation(s)
- Maria Dominguez
- Department of Endocrinology, Our Lady's Hospital for Sick Children, Crumlin, Dublin, Ireland
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Turunen JA, Wessman M, Forsblom C, Kilpikari R, Parkkonen M, Pöntynen N, Ilmarinen T, Ulmanen I, Peltonen L, Groop PH. Association analysis of the AIRE and insulin genes in Finnish type 1 diabetic patients. Immunogenetics 2006; 58:331-8. [PMID: 16552513 DOI: 10.1007/s00251-006-0088-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2005] [Accepted: 01/11/2006] [Indexed: 11/28/2022]
Abstract
Mutations in the autoimmune regulator (AIRE) gene cause a recessive Mendelian disorder autoimmune polyendocrinopathy syndrome type 1 (APS-1 or autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy). APS-1 patients develop multiorgan autoimmune diseases including type 1 diabetes (prevalence 12%). The AIRE protein controls the central tolerance induction in the thymus by regulating the expression levels of tissue-specific peripheral antigens, such as insulin. We hypothesized that the insulin gene (INS) polymorphisms together with the AIRE variations may predispose individuals to diabetes. The role of the AIRE gene was tested both independently and on the condition of the INS risk genotype in the Finnish type 1 diabetes sample. A total of 733 type 1 diabetic cases and 735 age- and sex-matched healthy controls were used in the analysis. Five common single nucleotide polymorphisms (SNPs) in the AIRE gene were selected from the public database (dbSNP). The -23HphI polymorphism was used as a surrogate marker for the INS gene promoter repeat. The five genotyped SNPs in the AIRE gene showed no evidence of association with type 1 diabetes. As expected, the INS gene polymorphism -23HphI was significantly associated with susceptibility to type 1 diabetes (P=6.8 x 10(-12), chi(2) test). When the subclass of patients carrying the homozygote genotype of the INS gene was used in the analysis, the AIRE polymorphisms showed no association with the disease. In conclusion, the AIRE gene does not seem to contribute to disease susceptibility in Finnish type 1 diabetic patients, whereas the insulin gene represents a notable risk factor for disease in this population.
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Affiliation(s)
- Joni A Turunen
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki (C318b), University of Helsinki, P.O. Box 63, Haartmaninkatu 8, 00014, Helsinki, Finland
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Collins SM, Dominguez M, Ilmarinen T, Costigan C, Irvine AD. Dermatological manifestations of autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy syndrome. Br J Dermatol 2006; 154:1088-93. [PMID: 16704638 DOI: 10.1111/j.1365-2133.2006.07166.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy syndrome (APECED; OMIM 240300) is a rare autosomal recessive disorder defined by a variable combination of endocrine failure, chronic mucocutaneous candidiasis (CMC), and dystrophy of the dental enamel and nails. APECED is caused by mutations in the autoimmune regulator gene (AIRE). Alopecia areata (AA) and vitiligo are diseases with autoimmune pathogeneses, and have been recognized as part of the APECED complex. There are rare reports of other cutaneous manifestations. OBJECTIVES We sought to delineate the dermatological features of APECED in an Irish case series with emphasis on timing of their appearance and association with disease severity. Furthermore, we looked for evidence of genotype: phenotype correlation. Finally, we wanted to determine if the ectodermal changes described represent a primary ectodermal dysplasia or whether the ectodermal manifestations are secondary phenomena. METHODS Irish patients with APECED were invited to attend a multidisciplinary clinic (Dermatology, Endocrinology, Dentistry and Ophthalmology) held in Our Lady's Hospital for Sick Children, Dublin. Clinical data were compiled from case notes and questionnaires. All patients had a detailed cutaneous examination. Blood samples were obtained for mutational analysis. RESULTS Eighteen patients (seven males and 11 females) from 15 families were interviewed and examined. The mean age at diagnosis was 6 years (range 8 months-18 years). All patients had evidence of CMC, 13 (72%) had candidal onychomycosis or paronychia, six (33%) had AA and two had vitiligo. In the case of two patients the diagnosis was made on recognition of dermatological manifestations and confirmed by mutational analysis. Both patients developed Addison's disease on follow-up. CMC was an early feature, often predating diagnosis (10 of 18). AA and vitiligo presented later, and may reflect more severe disease in these cases. There was no correlation between the AIRE mutations identified on mutational analysis and the clinical presentation. We found no evidence of an isolated nail dystrophy or features consistent with a primary ectodermal dysplasia. CONCLUSIONS APECED is a rare but complex and potentially life-threatening autoimmune disease. CMC is a common and early feature; diagnosis at this stage may pre-empt life-threatening endocrinological crises. It is important for dermatologists to be aware of this association as they are likely to be the earliest clinicians who encounter these children. AA and vitiligo in our series occurred in the setting of established disease. The term "ectodermal dystrophy" is misleading as the ectodermal features described in our series and in the literature are most likely to be secondary phenomena.
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Affiliation(s)
- S M Collins
- Department of Paediatric Endocrinology, Our Lady's Hospital for Sick Children, Crumlin, Dublin 12, Ireland
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Ilmarinen T, Melén K, Kangas H, Julkunen I, Ulmanen I, Eskelin P. The monopartite nuclear localization signal of autoimmune regulator mediates its nuclear import and interaction with multiple importin alpha molecules. FEBS J 2006; 273:315-24. [PMID: 16403019 DOI: 10.1111/j.1742-4658.2005.05065.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Autoimmune regulator (AIRE) is a transcriptional regulator involved in establishing immunological self-tolerance. Mutations in the AIRE gene lead to the development of the autosomal, recessively inherited, organ-specific autoimmune disease, autoimmune polyendocrinopathy candidiasis ectodermal dystrophy (APECED). The AIRE protein is mainly localized in the cell nucleus where it is associated with nuclear bodies. The N-terminal part of AIRE has been previously shown to mediate nuclear localization of the protein. However, the functional nuclear localization signal (NLS) and nuclear import mechanisms of AIRE have not been identified. We show that, although the amino-acid sequence of AIRE contains a potential bipartite NLS consisting of amino acids 110-114 and 131-133, only the latter part constitutes a functional NLS. Furthermore, we show by in vitro binding assays that AIRE interacts with multiple members of the nuclear transport receptor importin alpha family, mainly alpha1, alpha3, and alpha5, and that these interactions depend on the intactness of the Arg-Lys-rich NLS of AIRE. In addition, we found that AIRE binds to the 'minor' NLS-binding site of importin alpha3 and alpha5 proteins consisting of the C-terminal armadillo repeats 7-9. Our findings strongly suggest that the nuclear import of AIRE is mediated by the classical importin alpha/beta pathway through binding to several importin alpha family members.
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Affiliation(s)
- Tanja Ilmarinen
- Department of Molecular Medicine, National Public Health Institute, Helsinki, Finland.
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Ulmanen I, Halonen M, Ilmarinen T, Peltonen L. Monogenic autoimmune diseases — lessons of self-tolerance. Curr Opin Immunol 2005; 17:609-15. [PMID: 16226439 DOI: 10.1016/j.coi.2005.09.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2005] [Accepted: 09/20/2005] [Indexed: 12/21/2022]
Abstract
The molecular defects recently identified in the rare monogenic autoimmune diseases (AIDs) have pinpointed critical steps in the pathways that contribute to the development of normal immune responses and self-tolerance. Recent studies of autoimmune polyendocrinopathy syndrome type 1, autoimmune lymphoproliferative syndrome, immunodysregulation, polyendocrinopathy and enteropathy, X-linked, IL-2 receptor alpha-chain deficiency, and, in particular, their corresponding mouse models, have revealed the details of the molecular mechanisms of normal immune tolerance, and exposed how defects in these mechanisms result in human autoimmunity. In addition to a deeper understanding of the immune system, detailed molecular characterization of monogenic AIDs will help us to understand the mechanisms behind common polygenic AIDs and, furthermore, to develop novel therapies and intervention strategies to treat them.
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Affiliation(s)
- Ismo Ulmanen
- National Public Health Institute, Department of Molecular Medicine, Biomedicum, Helsinki, Finland
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Ilmarinen T, Eskelin P, Halonen M, Rüppell T, Kilpikari R, Torres GD, Kangas H, Ulmanen I. Functional analysis of SAND mutations in AIRE supports dominant inheritance of the G228W mutation. Hum Mutat 2005; 26:322-31. [PMID: 16114041 DOI: 10.1002/humu.20224] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Autoimmune polyendocrinopathy candidiasis ectodermal dystrophy (APECED) is a rare disorder caused by mutations in the autoimmune regulator gene (AIRE) and characterized by a variable combination of organ-specific autoimmune diseases. Studies on AIRE-deficient mice suggest that AIRE is an important factor in the establishment and maintenance of self-tolerance. The AIRE protein contains several structural domains often found in transcriptional regulators and functions as a transcriptional transactivator in vitro. To date, more than 50 patient mutations have been identified in the coding region of the AIRE gene. So far, APECED has been reported to be inherited in an autosomal recessive manner. However, in contrast to all other AIRE mutations, a novel mutation c.682T>G (p.G228W) in the DNA-binding and/or multimerization domain SAND was recently described to be inherited in a dominant fashion. We analyzed the effects of mutant AIRE proteins containing the patient mutations c.682T>G (p.G228W) and c.755C>T (p.P252L) located in the SAND domain on the properties of the wild-type AIRE in a heterozygous situation in vitro. In addition to the patient mutations, we analyzed the effects of a double mutation [c.727A>G;c.728A>C;c.739C>G;c740G>C] (p.K243A;R247A) of positively charged amino acids in the SAND domain. Of the mutants studied, only c.682T>G (p.G228W) mutant changed the subcellular localization and in addition severely disrupted the transactivating capacity of the wild-type AIRE. Our results indicate that the c.682T>G (p.G228W) mutant AIRE protein acts with a dominant negative effect by binding to the wild-type AIRE, thus preventing the protein from forming the complexes needed for transactivation.
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Affiliation(s)
- Tanja Ilmarinen
- Department of Molecular Medicine, National Public Health Institute, Helsinki, Finland.
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Halonen M, Kangas H, Rüppell T, Ilmarinen T, Ollila J, Kolmer M, Vihinen M, Palvimo J, Saarela J, Ulmanen I, Eskelin P. APECED-causing mutations in AIRE reveal the functional domains of the protein. Hum Mutat 2004; 23:245-57. [PMID: 14974083 DOI: 10.1002/humu.20003] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
A defective form of the AIRE protein causes autoimmune destruction of target organs by disturbing the immunological tolerance of patients with a rare monogenic disease, autoimmune polyendocrinopathy (APE)-candidiasis (C)-ectodermal dystrophy (ED), APECED. Recently, experiments on knockout mice revealed that AIRE controls autoimmunity by regulating the transcription of peripheral tissue-restricted antigens in thymic medullary epithelial cells. Thus, AIRE provides a unique model for molecular studies of organ-specific autoimmunity. In order to analyze the molecular and cellular consequences of 16 disease-causing mutations in vitro, we studied the subcellular localization, transactivation capacity, homomultimerization, and complex formation of several mutant AIRE polypeptides. Most of the mutations altered the nucleus-cytoplasm distribution of AIRE and disturbed its association with nuclear dots and cytoplasmic filaments. While the PHD zinc fingers were necessary for the transactivation capacity of AIRE, other regions of AIRE also modulated this function. Consequently, most of the mutations decreased transactivation. The HSR domain was responsible for the homomultimerization activity of AIRE; all the missense mutations of the HSR and the SAND domains decreased this activity, but those in other domains did not. The AIRE protein was present in soluble high-molecular-weight complexes. Mutations in the HSR domain and deletion of PHD zinc fingers disturbed the formation of these complexes. In conclusion, we propose an in vitro model in which AIRE transactivates transcription through heteromeric molecular interactions that are regulated by homomultimerization and conditional localization of AIRE in the nucleus or in the cytoplasm.
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Affiliation(s)
- Maria Halonen
- Department of Molecular Medicine, National Public Health Institute, Helsinki, Finland.
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