Long-term Tumorgenicity of Induced Pluripotent Stem Cells


A paper from the Okano laboratory has shown that implantation of neural stem cells made from induced pluripotent stem cells can still form tumors ever after a long period of time.

This paper is an important contribution to the safety issues surrounding induced pluripotent stem cells (iPSCs). As noted in previous posts, iPSCs are made from adult cells by means of genetic engineering and cell culture techniques. In short, by introducing four different genes into adult cells and then culturing them in a special culture medium, a fraction of these cells will de-differentiate into cells that resemble embryonic stem cells in many ways, but are not exactly like them.

The Okano laboratory made iPSCs using viruses that integrate into the genome of the host cell, which is not the safest option. However, because in the four-gene cocktail that is normally used to reprogram these cells (Oct-4, Klf-4, Sox2, and c-Myc), the c-Myc gene is often thought to be the main cause of tumor formation. Okano and his collaborators made their iPSCs without the c-Myc gene, but only used the three-gene cocktail of Oct-4, Klf-4, and Sox2. Such a cocktail is much less efficient that the four-gene cocktail, but it supposed to make iPSCs that are altogether safer.

These iPSCs were differentiated into neural stem cells that grew as tiny spheres of cells, and these “neurospheres” were transplanted into the spinal cords of mice that had suffered a spinal cord injury. The implanted cells differentiated into neurons and glial cells and restored some neural function to these mice. However, the mice were observed for a long period of time after the implantations to assess the long-term safety of these implanted cells.

After 105 days, the implanted mice began to show deterioration of their neural function and their spinal cords showed tumors. It is clear that the Oct-4 gene that was used in the reprogramming procedure was the reason for the tumor transformation.

Graphical Abstract 20141213

This experiment, once again, calls into question the safety of any method for iPSC generation that leaves the transfected genes in the reprogrammed cells. I reported in a previous post that skin cells made from iPSCs that had their transgenes left in them were good at causing tumors and not as good as forming skin cells, but iPSCs without their reprogramming transgenes were safer and more effective tools for regenerative medicine.  This experiment also shows that c-Myc is not the only concern with iPSCs.  Any of the transgenes used for reprogramming can cause problems, and they must be removed if iPSCs are going to produce safe, differentiated cells.  Finally, this experiment pretty much shows that the use of retrovirus tools to introduce genes into cells for the sake of reprogramming is a bad idea if those cells are going to be used for regenerative medicine.  Non-integrating tools are much safer and preferable in these cases.

The Okano paper appeared in Stem Cell Reports.

Infertility Treatment with Stem Cells is Unlikely


Because several laboratories have managed to differentiate embryonic stem cells into cells that look very much like human eggs and sperm, many have predicted that infertility will be treated with stem cell treatments (see Volarevic V, et al., Biomed Res Int. 2014;2014:507234). However, new work from the University of Gothenburg and Karolinska Institute has cast doubt on this hope.

At about 24 days of life, large, spherical sex cells are recognizable among the endodermal cells of the umbilical vesicle close to the allantois. These cells are the primordial germ cells and they are the progenitor cells of the sperm in men and eggs in women. As the embryo folds during about the late 4th week, the dorsal portion of the umbilical vesicle is incorporated into the embryo. This incorporation of the umbilical vesicle occur concurrently with the migration of these primordial germ cells along the dorsal mesentery of the hindgut to the gonadal ridges. During the 6th week of life, the primordial germ cells enter the underlying mesenchyme and are incorporated into the gonadal cords. Primordial germ cell migration is mainly regulated by three genes: Stella, Fragilis, and BMP-4.

PGC migration

These primordial germ cells divide as they migrate, and by five months of gestation, embryonic ovaries contain about six to seven million oogonia. Most of these oogonia experience cell death before birth, but the remaining oogonia begin meiosis toward the end of gestation. At this time, the oogonia are called primary oocytes. Meiosis is arrested in prophase of the first meiotic division, and this is the same stage at which spermatogenesis in the male is blocked. Primary oocytes decrease in number throughout a woman’s life. The ovaries of a newborn girl contain about two million primary oocytes and these are all the gametes she will ever have. Each primary oocyte is contained within a hollow ball of cells called the ovarian follicle. By the time a woman reaches puberty, that number of primary oocytes has been reduced to 400,000. Only about 400 of these cells will ovulate during a woman’s reproductive years. The rest will die by means of programmed cell death. Once all the primary oocytes are gone, ovulation stops and the woman undergoes menopause.

Kui Liu from the University of Gothenburg said: “Ever since 2004, the studies on stem cell research and infertility have been surrounded by hype. There has been a great amount of media interest in this, and the message has been that the treatment of infertility with stem cells is about to happen. However, many researchers, including my research group, have tried to replicate these studies and not succeeded. This creates uncertainty about whether it is all possible to create new eggs with the help of stem cells.”

In collaboration with Outi-Hovatta’s laboratory at the Karolinska Institute and Jan-Åke Gustafsson’ research team at the university of Houston in the US, Lui’s research team carried out experiments on mice that failed to demonstrate that functional gametes could be formed from pluripotent stem cells. Essentially, the only gametes that could that the female mice had were the ones they were born with.

In Liu’s opinion, fertility clinics should place their attention on using the eggs that women still have in order to treat infertility.

Teaching Old Cells New Tricks


The laboratory of Helen Blau at Stanford University has devised a technique to lengthen the sequences that cap the ends of chromosomes in skin cells. This treatment enlivens the cells and makes them behave as though they were younger.

In order to properly protect linear chromosomes from loosing DNA at their ends, chromosomes have a special set of sequences called “telomeres” at their ends. Telomeres consists of short sequences that are repeated many times. A special enzyme called the telomerase replicates the telomeres and maintains them. As we age, telomerase activity wanes and the telomeres shorten. This threatens the genetic integrity of the chromosomes, since a loss of genes from the ends of chromosomes can be deleterious for cells. In young humans, the telomeres may be 8,000 to 10,000 bases long. When the telomeres shorten to a particular length, growth stops and the cells become quiescent.

Human telomeres

Embryonic stem cells have long telomeres at the ends of their chromosomes and they also have robust telomerase activity. Adult stem cells have varied telomerase activity and telomere length, but it seems that the length of the telomeres and the activity of the telomerase correlates with the vitality of the stem cell population and its capacity to heal (see H. Saeed and M. Iqtedar (2013). J. Biosci. 38, 641–649). As we age our stem cell quality decreases as their telomeres shorten.

Blau and her colleagues used a modified type of RNA to lengthen the telomeres of large numbers of cells. According to Blau: “Now we have found a way to lengthen human telomeres by as much as 1,000 nucleotides, turning back the internal clock in these cells by the equivalent of many years of human life. This greatly increases the number of cells available for studies such as drug testing or disease modeling.”

In these experiments, Blau and her coworkers used chemically modified messenger RNA molecules that code for TERT, which is the protein component of the telomerase. The expression of these messenger RNAs in human cells greatly increased the levels of telomerase activity.

This technique devised by Blau and her team have distinct advantages of previously described protocols. First, this technique boosts telomerase activity temporarily. The modified messenger RNA sticks around for several hours and is translated into TERT protein, but this protein only lasts for about 48 hours, after which its activity dissipates. After the telomerase have lengthened the telomeres, they will shorten again after each cell division as before.

“This new approach paves the way toward preventing or treating diseases of aging,” said Blau. “There are also highly debilitating genetic diseases associated with telomere shortening that could benefit from such a potential treatment.”

Blau and her team are testing their technique in other cell types besides skin cells.

A Way to Get Stem Cells to Make Living Heart Valve Tissue?


What a benefit it would be to be able to replace diseased and defective heart valves with new heart valves. Thus, living tissue engineered heart valves (TEHV) would be a boon to children who require replacement heart valves that have the capacity to grow with the child and completely integrate into the child’s heart tissue. A persistent challenge for TEHV is accessible human cell source(s) that have the ability to mimic native valve cell phenotypes and possess matrix remodeling characteristics that are essential for long-term function.

Mesenchymal stem cells derived from bone marrow (BMMSC) or adipose tissue (ADMSC) are intriguing cell sources for TEHV. Unfortunately, they have not been compared to pediatric human aortic valve interstitial cells (pHAVIC) in relevant 3-dimensional culture environments.

In a recent study, Bin Duan from the Biomedical Engineering department at Cornell University compared the spontaneous and induced multipotency of ADMSC and BMMSC to that of pHAVIC using different induction culture systems within three-dimensional (3D) bioactive hybrid hydrogels that have similar material properties to those of aortic heart valve leaflets. pHAVICs possessed some multi-lineage differentiation capacity in response to induction media, but these cells were limited to the earliest stages and their differentiation capacity were less potent than either ADMSCs or BMMSCs. ADMSCs expressed cell phenotype markers that were similar to pHAVICs when they were grown in HAVIC growth media spiked with a growth factor called basic fibroblast growth factor (bFGF). BMMSCs generally expressed extra cellular matrix remodeling characteristics similar to pHAVICs.

Duan and his colleagues then chemically attached bFGF to components of the 3D hybrid hydrogels in order to further immobilize them. The immobilized bFGF upregulated vimentin expression and promoted the fibroblastic differentiation of pHAVIC, ADMSC and BMMSC. Since fibroblasts help make heart valves, these changes in gene expression might presage the ability of these cells to form new heart living heart valve tissue.

Thus, these findings show that even though mesenchymal stem cells retain a heightened capacity to form bone in 3D culture, this tendency can be shifted fibroblast cell fates by tethering bFGF to the 3-D matrix. Such a strategy is probably rather important for utilizing stem cell sources in heart valve tissue engineering applications.

This is an important finding.  Even though the production of TEHVs are some ways off, Duan’s findings might provide a strategy to begin cells on the path to making TEHVs.

Gestational Diabetes Affects the Quality of Umbilical Cord Mesenchymal Stromal Cells


The laboratories of Drs. Jene Choi and Chong Jai Kim from the University of Ulsan College of Medicine in Seoul, South Korea have collaboratively shown that the therapeutic quality of umbilical cord mesenchymal stem cells is profoundly affected by gestational diabetes. Their work was published in a recent issue of the journal Stem Cells and Development and has profound implications for regenerative medicine.

Choi and Kim and their coworkers collected umbilical cords from mothers who had been given birth by Cesarian section and had also been diagnosed with gestational diabetes and mothers who had also just given birth by Cesarian section and showed normal blood sugar control. These umbilical cord tissues were processed and the mesenchymal stem cells from the cord tissue were isolated and cultured. These cells were grown and then subjected to a rather extensive battery of tests. These tests were a reflection of the ability of these to perform in regenerative treatments.

First umbilical cord mesenchymal stem cells (UCMSCs) from mothers with gestational diabetes (GD) did not grow as well as UCMSCs from mother who did not have GD.  As you can see in the graphs below, these are not small growth differences.  The UCMSCs from non-GD mothers (on the left) grow substantially better than those from GD mothers.  This result is also consistent for different cell lines.  This also means that transplanted cells would not grow very well if they were used for therapeutic purposes.

Umbilical cord mesenchymal stromal cells (UC-MSCs) derived from gestational diabetes mellitus (GDM) patients exhibit retarded growth proliferation. The growth of 7.5×103 UC-MSCs isolated from patients with normal pregnancies (A) and GDM (B) was monitored over a period of 12 days. GDM-UC-MSCs consistently showed decreased proliferation compared with normal pregnant women (N-UC-MSCs). Points represent the mean values from three independent experiments; bars denote standard deviation (SD).

Umbilical cord mesenchymal stromal cells (UC-MSCs) derived from gestational diabetes mellitus (GDM) patients exhibit retarded growth proliferation. The growth of 7.5×103 UC-MSCs isolated from patients with normal pregnancies (A) and GDM (B) was monitored over a period of 12 days. GDM-UC-MSCs consistently showed decreased proliferation compared with normal pregnant women (N-UC-MSCs). Points represent the mean values from three independent experiments; bars denote standard deviation (SD).

Secondly, UCMSCs from GD mothers showed a greater tendency to undergo premature senescence.  When MSCs are grown in culture, they usually grow rather well for several days and then the cells go to sleep and they stop growing.  This is called culture senescence and it is due to intrinsic properties of the cells.  When the cells go into senescence tends to be a cell line-specific property, but one thing is certain; the sooner cells become senescent, the few cells they will generate in culture.  The UCMSCs from GD mothers go into senescence early and easily and this is one of the reasons they grow so poorly relative to normal cells – because they are running to their beds to take a nap (so to speak).  Such cells are usually not good candidates for regenerative medicine.

Third, UCMSCs from GD mothers show poor lineage-specific differentiation.  MSCs have the ability to differentiate into fat cells, bone cells, and cartilage cells if particular well-established protocols are used.  However, UCMSCs from GD mothers showed inefficient differentiation and that is one of the things that MSCs must do if they are to repair bone or cartilage problems or if they are to help make smooth muscle for new blood vessels formation. 

Stem cell differentiation potentials are largely different between normal and GDM-affected UC-MSCs. Three different cell lines of normal and GDM-affected pregnancies were cultured in a control medium or induction medium for 5 days. Upregulation of the expression of the adipogenic-specific gene PPARγ (A) and the osteogenic genes alkaline phosphatase (ALP) (B), osteocalcin (OC) (C), and collagen type 1 alpha 1 (Col1α1) (D) was evaluated by real-time RT-PCR and normalized to GAPDH. All assays were performed in triplicate; bars denote SD (*P<0.05).

Stem cell differentiation potentials are largely different between normal and GDM-affected UC-MSCs. Three different cell lines of normal and GDM-affected pregnancies were cultured in a control medium or induction medium for 5 days. Upregulation of the expression of the adipogenic-specific gene PPARγ (A) and the osteogenic genes alkaline phosphatase (ALP) (B), osteocalcin (OC) (C), and collagen type 1 alpha 1 (Col1α1) (D) was evaluated by real-time RT-PCR and normalized to GAPDH. All assays were performed in triplicate; bars denote SD (*P<0.05).

The figure above shows the disparity between these established UCMSC cell lines.  The dark, solid bars indicate non-induced cells that were grown in normal culture media, and the striped bars are cells grown in media that designed to induce the differentiation of these cells into either bone, fat, or cartilage cells.  The cell lines with “N” in their name are from non-GD mothers and those with “D” in their designations are from GD mothers.  These assays are for genes known to be strongly induced when cells begin to differentiate into fat (PPARgamma), bone (ALP or osteocalcin or collagen 1 alpha 1).  As you can clearly see, the Ns outdo the Ds every time.

Finally, when the mitochondria, the compartments in cells that generate energy, from these two cell populations were examined it was exceedingly clear that UCMSCs from GD mothers had mitochondria that were abnormal and did not make every very well.  Mitochondria from UCMSCs taken from GD mothers showed decreased expression of the energy-making components.  Thus the energy-making pathways in these cell compartments were sub-par from a structural perspective.  Functional assays for mitochondria showed that mitochondria from UCMSCs from GD mothers consistently underperformed those from UCMSCs taken from non-GD mothers.  Also, when markers of mitochondrial dysfunction were measured (reactive oxygen species and indicators of mitochondrial damage from reactive oxygen species), such markers were consistently higher in mitochondria from UCMSCs from GD mothers relative to those from non-GD mothers.  This shows that the energy-making or powerhouses of the cells are dysfunctional in UCMSCs from GD mothers.  Without the ability to properly make energy from food molecules, the cells have a diminished capacity to heal damaged tissues and organs.

Several studies have established a positive link between mitochondrial dysfunction and accelerated aging.  Therefore, these cells, because they have more extensive indications of mitochondrial damage, may show profound accumulation of mitochondrial damage and accelerated aging.

In summary, this study shows that integral biological properties of human UC-MSCs differ according to obstetrical conditions.  These data also stress the importance of maternal–fetal conditions in biological studies of hUC-MSCs and the development of future therapeutic strategies using hUC-MSCs.

Discovery of New Stem Cell Class Might Accelerate Research


An international team of scientists has discovered a new class of stem cell. This project consisted of a massive collaboration between over 50 scientists on four continents, that has been affectionately named, “Project Grandiose.” This new class of stem cells, known as a F-class cell, opens new and exciting avenues for generating designer cells that could be safer and more efficiently used in therapy.

Andras Nagy, Ph.D., from the University of Toronto’s Institute of Medical Sciences led this group in conducting a high-resolution characterization of the molecular events that are required for the reprogramming of stem cells. In particular, Nagy and his colleagues were interested in ways to control the path to pluripotency. In this analysis, they discovered an alternative reprogrammed cell, which they called F-class stem cells.

It has been known for many years that when mature, adult cells are reprogrammed into induced pluripotent stem cells (iPSCs) by means forcing expression of key transcription factors (Oct4, Klf4, Sox2, and c-Myc), some cells will stably not express the pluripotency gene Nanog, and fail to acquire full pluripotency, even though these cells look like embryonic stem cells (see Fussner, E. et al. EMBO J. 30, 1778–1789 (2011); Sridharan, R. et al. Cell 136, 364–377 (2009); and Chen, J. et al. Nature Genet. 45, 34–42 (2013)). These partially reprogrammed cells seem to indicate that there are other cell types that can be formed by reprogramming that are not fully pluripotent. Strangely, some labs have reported that treating partially pluripotent cells with vitamin C can reprogram to cells to full pluripotency (Esteban, M. A. et al. Cell Stem Cell 6, 71–79 (2009)).

Nagy and his colleagues used a whole battery of tests to take detailed snapshots of every stage of reprogramming, and in the process, revealed an alternative state of pluripotency. They discovered that high levels of expression of the four reprogramming factors generates cells that do not form typical ESC-like colonies in culture, but are still pluripotent. These are the F-type cells.  F-type cells derived their name from the fuzzy boundaries they form when they grow in culture.

When F-type cells were compared to embryonic-like stem cells, the F-type cells are easier to make, less expensive, and faster to grow. Thus F-class stem cells can be produced more economically in large quantities and this should accelerate drug-screening efforts, disease modeling, and eventually the development of treatments for different illnesses.

Direct Reprogramming Cells with Recombinant Proteins


In my opinion, for what it’s worth, we will probably see direct reprogramming take a prominent place in regenerative medicine in the future. It will not be in the near future, but as direct reprogramming becomes better understood and more feasible, it will probably become a central part of the discussion of regenerative medical strategies.

Direct reprogramming, which is also known as lineage conversion, uses cell type-specific transcription factors to convert a mature, adult cell into a different type of mature, adult cell. The cell does not pass through a pluripotent intermediate, and becomes a wholly different type of cell.

Of course, forcing the expression of lineage-specific transcription factors in cells requires that they be treated with recombinant viruses or other such tools. These genetic manipulations present problems for regenerative medicine, since such viruses can cause mutations or cause the introduced genes to be constantly activated, both of which can cause cells to die to grow uncontrollably. Genetically engineering cells needs to be done in a “kinder and gentler” way (to quote George HW Bush).

To that end Dennis Clegg and his colleagues from the Center for Stem Cell Biology and Engineering at UC Santa Barbara have used specially designed proteins to directly cultured retinal pigmented epithelial cells to neurons.

Newly discovered C-end rule (CendR) cell- and tissue-penetrating peptides have a arginine-rich sequence at the end of proteins that allows them to bind particular cell receptors and be internalized into the cell. These CendR peptides bind to the NRP-1 protein and are internalized. Several laboratories have used CendR peptides to increase the efficacy of anti-cancer drugs in experimental cases (see Alberici L, et al (2013) Cancer Res 73:804–812; Sugahara KN, et al. (2010) Science 328:1031–1035; Sugahara KN, et al. (2009) Cancer Cell 16:510–520; and Roth L,, et al. (2012) Oncogene 31:3754–3763).

By tacking a CendR peptide to the end of the Sox2 protein, Clegg and others were able to convert retinal pigmented epithelial (RPEs) cells to neurons. The Sox2 protein is highly expressed in neural progenitor cells. Other studies have shown that Sox2 can reprogram mouse and human fibroblasts to neural stem cells (Ring KL, et al. (2012) Cell Stem Cell 11:100–109). Thus, Sox2 should do the trick.

Making cultured RPE cells from embryonic stem cells is relatively easy to do. Therefore, Clegg and his coworkers made cultured RPEs and then treated them with viruses that expressed Sox2. The cultured RPEs showed conversion to neurons and the expression of neuron-specific genes.

Since they had established that Sox2 could convert RPEs to neurons, they tried recombinant Sox2 protein with the CendR peptide RPARPAR at the end of the protein. After 60 days in culture, the cells expressed a host of neuron-specific genes, and were capable of taking up a dye that only active neurons can take up (FM1-43).

Reprogramming human fetal RPE (hfRPE) cells to neurons using recombinant SOX2 proteins. (A): Efficiency of hfRPE cells to be reprogrammed to neuron-like cells after recombinant proteins was added to the media every 24 hours for 30 days. (B): Efficiency of hfRPE cells to be reprogrammed by adding SOX2-RPARPAR recombinant protein every 48 hours for different time courses. (C): Representative images of hfRPE (fRPE1914) cells during reprogramming to neuron-like cells after 30, 40, and 50 days in culture with SOX2-RPARPAR protein. Scale bars = 100 μm. (D): Representative images of hfRPE (fRPE1914) cells reprogrammed to neuron-like cells expressing neuronal markers, but not an RPE marker (PAX6), using SOX2-RPARPAR protein. Scale bars = 50 μm. Abbreviations: D, days; RPE, retinal pigmented epithelial cells.

Reprogramming human fetal RPE (hfRPE) cells to neurons using recombinant SOX2 proteins. (A): Efficiency of hfRPE cells to be reprogrammed to neuron-like cells after recombinant proteins was added to the media every 24 hours for 30 days. (B): Efficiency of hfRPE cells to be reprogrammed by adding SOX2-RPARPAR recombinant protein every 48 hours for different time courses. (C): Representative images of hfRPE (fRPE1914) cells during reprogramming to neuron-like cells after 30, 40, and 50 days in culture with SOX2-RPARPAR protein. Scale bars = 100 μm. (D): Representative images of hfRPE (fRPE1914) cells reprogrammed to neuron-like cells expressing neuronal markers, but not an RPE marker (PAX6), using SOX2-RPARPAR protein. Scale bars = 50 μm. Abbreviations: D, days; RPE, retinal pigmented epithelial cells.

The efficiency for this experiment was lousy (0.3%) as opposed to the efficiency for the use of recombinant viruses (11%). Nevertheless, this experiment shows that it is possible to directly reprogram cells without using recombinant viruses.