Stem Cell-Extracted Proteins Promote Bone Regrowth

Scientists from the Gladstone Institutes have found a new technique to regrow bone by using the protein signals produced by stem cells. This new technology could potentially help treat victims who have experienced major trauma to a limb, such as soldiers wounded in combat or casualties of a natural disaster. This new protocol improves older therapies by providing a sustainable source for fresh tissue that also reduces the risk of tumor formation that can arise with stem cell transplants.

This study was published in a journal called Scientific Reports, and it is the first study that successfully extracted bone-producing growth factors from stem cells and showed that these proteins are sufficient to create new bone. This stem cell-based approach was as effective as the current standard treatment in terms of the amount of bone created.

“This proof-of-principle work establishes a novel bone formation therapy that exploits the regenerative potential of stem cells,” says senior author Todd McDevitt, PhD, a senior investigator at the Gladstone Institutes. “With this technique, we can produce new tissue that is completely stem cell-derived and that performs similarly with the gold standard in the field.”

Rather than using stem cells, the Gladstone scientists extracted the proteins that the stem cells secrete, such as a protein called bone morphogenetic protein (BMP). By extracting these proteins, they hoped to harness their regenerative power. McDevitt and his colleagues treated stem cells with a chemical that helped drove them to begin to differentiate into early bone cells. Then they analyzed the secreted factors produced by these cells that signal to other cells to regenerate new tissue. Afterwards, they took these isolated proteins and injected then into mouse muscle tissue to facilitate new bone growth.

Currently, laboratory technicians grind up old bones and extract the available proteins and growth factors that can induce the growth of new bone. Unfortunately, this approach relies on bones taken from cadavers, which are highly variable when it comes to the quality of the available tissue and how much of the necessary signals they still produce. Also, cadaver tissue is not always available.

“These limitations motivate the need for more consistent and reproducible source material for tissue regeneration,” says Dr. McDevitt, who conducted the research while he was a professor at the Georgia Institute of Technology. “As a renewable resource that is both scalable and consistent in manufacturing, pluripotent stem cells are an ideal solution.”

BMP-2 Release By Synthetic Coacervates Improves Bone Making Ability of Muscle Stem Cells

Johnny Huard and his co-workers from the McGowan Institute for Regenerative Medicine at the University of Pittsburgh have isolated a slowly-adherent stem cell population from skeletal muscle called muscle-derived stem cells or MDSCs (see Deasy et al Blood Cells Mol Dis 2001 27: 924-933). These stem cells can form bone and cartilage tissue in culture when induced properly, but more importantly when MDSCs are engineered to express the growth factor Bone Morphogen Protein-2 (BMP-2), they make better bone and do a better job of healing bone lesions than other engineered muscle-derived cells (Gates et al., J Am Acad Orthop Surg 2008 16: 68-76).

In most experiments, MDSCs are infected with genetically engineered viruses to deliver the BMP-2 genes, but the use of viruses is not preferred if such a technique is to come to the clinic. Viruses elicit and immune response and can also introduce mutations into stem cells. Therefore a new way to introduce BMP-2 into stem cells is preferable.

To that end, Huard and his colleagues devised an ingenious technique to feed BMP-2 to implanted MDSCs without using viruses. They utilized a particle composed of heparin (a component of blood vessels) and a synthetic molecule called poly(ethylene arginylaspartate diglyceride), which is mercifully abbreviated PEAD. The PEAD-heparin delivery system formed a so-called “coacervate,” which is a tiny spherical droplet that is held together by internal forces and composed of organic molecules. These PEAD-heparin coacervates could be loaded with BMP-2 protein and they released slowly and steadily to provide the proper stimulus to the MDSCs to form bone.

When tested in culture dishes, the BMP-2-loaded coacervates more than tripled the amount of bone made by the MDSCs, but when they were implanted in living rodents the presence of the BMP-2-loaded coacervates quadrupled the amount of bone made by the MDSCs.

This technique provides a way to continuously deliver BMP-2 to MDSCs without using viral vectors to infect them. These carriers do inhibit the growth or function of the MDSCs and activate their production of bone.

This paper used a “heterotropic bone formation assay” which is to say that cells were injected into the middle of muscle and they formed ectopic bone. The real test is to see if these cells can repair actual bone lesions with this system.

Converting Mesenchymal Stem Cells to Bone Makers

Within human bone, cells called osteoblasts make new bone and without the constant activity of osteoblasts, bone becomes thin and fragile. Osteoblasts are derived from mesenchymal stem cells in the bone marrow. When bones break, orthopedic surgeons try to use growth factors to push more mesenchymal stems and their progeny to become osteoblasts. The growth factor in question is bone morphogen protein (BMP). BMP, however, does not work consistently, and it has some rather nasty side effects (cancer, The specific complications that are drawing the most concern include swelling in the neck and throat, radiating leg pain, and male sterility). Therefore, an alternative method for converting mesenchymal stem cells into osteoblasts is highly desirable.

Kurt Hankenson from the University of Pennsylvania School of Veterinary Medicine has worked on this very problem and described the situation this way, “In the field, we’re always searching for new ways for progenitor cells to become osteoblasts so we became interested in the Notch signaling pathway.” When it comes to BMP, Hankenson said, “it has become clear that BMPs have some issues with safety and efficacy.”

Is there a better way to make bone? There seems to be. A protein called Jagged-1 has been shown by Hankenson’s team to be highly expressed in bone. Jagged-1 is a component of the widely used Notch signaling pathway, which is found in the nervous system and in many other cells as well.

In mouse stem cells, introducing Jagged-1 blocks the progression of mesenchymal stem cells to osteoblasts. This finding has actually hampered osteoblast research for the last two years. Hankenson again, “That had been our operating dogma for a year or two.”

However, as is so often the case in science, you never truly know the result of an experiment until you actually do it. When Jagged-1 was added to human mesenchymal stem cells, the results were very different. Hankenson said, “It was remarkable to find that just putting the cells onto the Jagged-1 ligand seemed sufficient for driving the formation of bone-producing cells.”

From a developmental genetics perspective, this makes perfect sense, since mutations in the Jagged-1 gene cause an inherited disease known as Alagille syndrome which causes liver problems, abnormal metabolisms, and fragile bones that break easily. Also, genome-wide association studies have shown that particular versions of the Jagged-1 gene cause low bone density.

Hankenson and his collaborators are examining ways to manipulate the levels of the Jagged-1 protein in patients with bone problems. To that end, Hankenson is collaborating with Kathleen Loomes of Penn’s Perelman School of Medicine and the Children’s Hospital of Pennsylvania to study pediatric patients with Alagille syndrome to determine if bone abnormalities in these patients are indeed connected to Jagged-1 malfunctions.

Hankenson and his former graduate student Mike Dishowitz started a company called Skelegen through the University of Pennsylvania’s Center for Technology Transfer (CTT) UPstart program. The goal of Skelegen is to develop and improve a system for delivering Jagged-1 to sites that require new bone growth in the hopes of treating bone fractures and other skeletal problems.

See Fengchang Zhu et al., “Pkcdelta is required for Jagged-1 induction of hMSC osteogenic differentiation.” Stem Cells 2013; DOI 10.1002/stem.1353.