Targeting Mitochondrial Dynamics via EV Delivery in Regenerative Cardiology: Mechanistic and Therapeutic Perspectives

Besides being powerhouses of the cell, mitochondria released into extracellular space act as intercellular signaling. Mitochondria and their components mediate cell-to-cell communication in free form or embedded in a carrier. The pathogenesis of cardiovascular disease is complex, which shows close relationship with inflammation and metabolic abnormalities. Since mitochondria sustain optimal function of the heart, extracellular mitochondria are emerging as a key regulator in the development of cardiovascular disease. In this review, we provide recent findings in the presence and forms of mitochondria transfer between cells, as well as the effects of these mitochondria on vascular inflammation and ischemic myocardium. Mitochondrial transplantation is a novel treatment paradigm for patients suffering from acute cardiovascular accident and challenges the traditional methods of mitochondria isolation.

Extracellular vesicles: A promising therapy against SARS-CoV-2 infection

Extracellular Vesicles - A Versatile Biomaterial.

Although pioneering preclinical research on the use of cell therapy for cardiac regeneration was conducted in the last quarter of the 20th century,1,2 a preponderance of advances have occurred in the 21st century, making this a relatively young field. In the first important clinical trial of cardiac cell therapy, begun in 2001, Menasche et al3 implanted autologous skeletal myoblasts into postinfarct scar at the time of coronary artery bypass surgery. Although the transplanted cells remained viable and exhibited contraction, they formed the nidus for serious ventricular tachyarrhythmias, which led to premature discontinuation of the trial. Despite this outcome, the trial energized the field, accelerating both preclinical and clinical research, albeit not with skeletal myoblasts. The extensive progress in cardiac regeneration is reviewed in this Compendium, and as occurs frequently in science, important observations have led to more questions and challenges (Table). View this table: Table. Important Challenges to Cell Therapy for Cardiac Regeneration Many cell types have been evaluated as candidates for cardiac regeneration. Among the earliest clinical trials, Zeiher’s group infused autologous bone marrow-derived progenitor cells into the coronary arteries of patients with acute,4 as well as healed myocardial infarction (MI)5 and reported improvements in left ventricular (LV) function. However, these results have not been fully confirmed by later studies, as pointed out in the review in the Compendium by Banarjee, Bolli, and Hare.6 Pittenger et al7 were among the first to direct attention to bone marrow-derived (stromal) mesenchymal stem cells (MSCs), emphasizing that these cells proliferated extensively in culture and suggesting that they could be attractive candidates for transplantation. In 2004, Chen et al8 reported that intracoronary infusion of autologous bone marrow-derived MSCs improved cardiac function. Zimmet and Hare pointed out that MSCs lack histocompatibility type II markers and elude rejection by …

Synovial Mesenchymal Stem Cell-Derived EV-Packaged miR-31 Downregulates Histone Demethylase KDM2A to Prevent Knee Osteoarthritis

Renal artery stenosis (RAS) is the leading cause of secondary hypertension worldwide. However, current medical and surgical treatment modalities provide minimal benefits for kidney injury. Recent preclinical RAS models have demonstrated promising potential of human mesenchymal stem cells (MSC) and their daughter extracellular vesicles (EV) in improving murine renal function and attenuating inflammation. However, the extent and mechanisms underlying immune rejection of xenogeneic MSCs or EVs are yet undetermined. Therefore, adipose tissue was harvested from adult healthy patients. Adipose-derived MSCs were extracted and cultured, and EVs were isolated from their supernatants via ultra-centrifugation. Then, mice randomly assigned to RAS or sham surgery were divided into 6 groups: sham surgery, RAS, sham + MSC, RAS + MSC, sham + EV, and RAS + EV. Two weeks after intra-aortic injection of MSCs (5 × 105) or EVs (20 µg protein), we compared the intrarenal T-cell and macrophage accumulation, splenic B-cell numbers, circulating cytokines and anti-human antibodies levels among the groups. MSCs and EVs did not influence intrarenal immune cell infiltrations. However, MSCs significantly increased circulating anti-human antibodies. In the spleen, RAS + EV mice showed higher memory IgM+ B-cells but reduced CD19+ B-cells compared to RAS + MSC. In vitro T-cell recall assay showed that both MSCs and EVs exhibited reduced IFN-γ release upon re-stimulation, indicating an immunosuppressive effect. Therefore, xenogeneic MSCs induced a greater humoral response in mice, while EVs triggered a splenic cellular response, but neither elicits discernible kidney rejection. Our results provide key insights into the immunomodulatory mechanisms of MSCs and EVs and immune mechanisms underlying xenograft rejection.

Second International Pulmonary Hypertension/Heart Failure Symposium—Structural heart disease, right ventricular dysfunction, and stem cell therapy: The European Pediatric Pulmonary Vascular Disease Network

Introduction: Mesenchymal Stem Cell (MSC)-derived Extracellular Vesicles (EVs) are an emerging regenerative therapy for treatment of ischemic cardiomyopathy. In this study, we determine the efficacy of MSC-EV therapy in a shear-thinning hydrogel (STG) delivered via intramyocardial injection to the border zone of rat hearts following myocardial infarction (MI). Hypothesis: MSC EV-loaded STGs will preserve hemodynamic function and minimize ventricular scar formation in a rat model of acute MI. Methods: EVs were isolated from MSCs by PEG precipitation, and the EV proteome was characterized by MaxQuant 1.5.1.2 and Metacore analysis software. Varying concentrations of EVs were administered to rats following induction of acute MI by ligation of the left anterior descending artery. EVs were delivered in either sterile phosphate buffered saline (PBS) or STG for sustained EV release. Chronic injury was assessed at 4 weeks post-MI through transthoracic echocardiography, intraventricular pressure-volume loop displacement, and histology. Results: MSC EV proteomic analysis highlighted upregulation of VEGF angiogenic cascades and ILK-mediated proliferative pathways. The mean left ventricle ejection fraction (LVEF) for each treatment group at four weeks is displayed in Table 1. A 20 ug dose of MSC EVs in STG improved LVEF by 19.12% (p<0.05) compared to PBS, with a 90 ug dose of MSC EVs in STG increasing LVEF by 23.56% (p<0.01) (Fig. 1). Conclusions: Intramyocardial injection of MSC EVs in STG post-MI showed concentration dependent improvements in hemodynamics. These findings show that high doses of MSC EV in STG may have potential as a therapy for ischemic cardiomyopathy. Proteomic analysis revealed that angiogenesis, recruitment of cardiac progenitor cells, and immune modulation may be mechanistic drivers of MSC-EV therapy.

Mesenchymal cells were described for their potency to interact with human immune cells and to modulate thereby immune responses. Besides mesenchymal stromal cells (MSC) from diverse tissue sources, like bone marrow and umbilical cord, also mesenchymal adherent cells within the heart tissue were able to attenuate and modulate induced immune cell activation or inflammatory processes. Mechanistic studies with MSC support the hypothesis, that mainly paracrine acting molecules, in particular extracellular vesicles (EVs), are responsible for the observed functional effects. EVs are known as potent intercellular communicators by delivering proteins, lipids, RNA and other small signaling molecules to a recipient cell. They can be discriminated by their size and biogenesis into the subsets of apoptotic bodies (diameter > 1μm), microvesicles (diameter range = 1 - 0.1 μm) and exosomes (diameter < 0.1 μm). While microvesicles and apoptotic bodies are shedded from the plasma membrane, exosomes originate from intracellular located multivesicular bodies, which have to fuse with the plasma membrane for their release into the extracellular space. Crosstalk of EVs from MSCs with immune cells is a secured fact, but the way of up-take into the target cells and especially the mechanism of immune modulation are not entirely understood. In our study, we isolated and characterized EVs from a human mesenchymal cardiac cell type regarding their potential to modulate induced immune responses in vitro. The presence of typical EV surface markers like tetraspanins (CD9, CD63, CD81) was confirmed as well as their low expression of HLA-molecules, which indicates a general low immunogenicity. Furthermore, EVs were able to attenuate triggered T cell proliferation accompanied by significantly reduced levels of pro-inflammatory cytokines (IFNγ, TNFα), which was highly dependent on the presence of CD14-positive cells. Interestingly, the EVs of cardiac mesenchymal cells induced a changed phenotype on these myeloid cells; most prominently a reduced HLA-DR and CD86 expression, but enhanced levels for CD206 and PD-L1. Future studies have to identify key molecular pathways involved in EVs` crosstalk with immune cells and to estimate the benefits but also the risks of this new therapeutic based on mesenchymal cells.

Extracellular vesicles are released by all cell types and contain proteins, microRNAs, mRNAs, and other bioactive molecules. Extracellular vesicles play an important role in intercellular communication and in the modulation of the immune system and neuroinflammation. The cargo of extracellular vesicles (e.g., proteins and microRNAs) is altered in pathological situations. Extracellular vesicles contribute to the pathogenesis of many pathologies associated with sustained inflammation and neuroinflammation, including cancer, diabetes, hyperammonemia and hepatic encephalopathy, and other neurological and neurodegenerative diseases. Extracellular vesicles may cross the blood-brain barrier and transfer pathological signals from the periphery to the brain. This contributes to inducing neuroinflammation and cognitive and motor impairment in hyperammonemia and hepatic encephalopathy and in neurodegenerative diseases. The mechanisms involved are beginning to be understood. For example, increased tumor necrosis factor α in extracellular vesicles from plasma of hyperammonemic rats induces neuroinflammation and motor impairment when injected into normal rats. Identifying the mechanisms by which extracellular vesicles contribute to the pathogenesis of these diseases will help to develop new treatments and diagnostic tools for their easy and early detection. In contrast, extracellular vesicles from mesenchymal stem cells have therapeutic utility in many of the above pathologies, by reducing inflammation and neuroinflammation and improving cognitive and motor function. These extracellular vesicles recapitulate the beneficial effects of mesenchymal stem cells and have advantages as therapeutic tools: they are less immunogenic, may not differentiate to malignant cells, cross the blood-brain barrier, and may reach more easily target organs. Extracellular vesicles from mesenchymal stem cells have beneficial effects in models of ischemic brain injury, Alzheimer’s and Parkinson’s diseases, hyperammonemia, and hepatic encephalopathy. Extracellular vesicles from mesenchymal stem cells modulate the immune system, promoting the shift from a pro-inflammatory to an anti-inflammatory state. For example, extracellular vesicles from mesenchymal stem cells modulate the Th17/Treg balance, promoting the anti-inflammatory Treg. Extracellular vesicles from mesenchymal stem cells may also act directly in the brain to modulate microglia activation, promoting a shift from a pro-inflammatory to an anti-inflammatory state. This reduces neuroinflammation and improves cognitive and motor function. Two main components of extracellular vesicles from mesenchymal stem cells which contribute to these beneficial effects are transforming growth factor-β and miR-124. Identifying the mechanisms by which extracellular vesicles from mesenchymal stem cells induce the beneficial effects and the main molecules (e.g., proteins and mRNAs) involved may help to improve their therapeutic utility. The aims of this review are to summarize the knowledge of the pathological effects of extracellular vesicles in different pathologies, the therapeutic potential of extracellular vesicles from mesenchymal stem cells to recover cognitive and motor function and the molecular mechanisms for these beneficial effects on neurological function.

Tumor Microenvironment and Clonal Monocytes of Chronic Myelomonocytic Leukemia Induce a Procoagulant Climate within the Tumor Niche

Comparative analysis of extracellular vesicles isolated from human mesenchymal stem cells by different isolation methods and visualisation of their uptake

Cancer-associated fibroblasts are critical to tumor progression. There exists a dynamic crosstalk between cancer and stromal compartments, which maintains a permissive tumor microenvironment. Extracellular vesicles (EVs) play a significant role in this intercellular communication. Colorectal cancer (CRC) cells can be categorized according to epithelial-mesenchymal transition (EMT) status, and therefore metastatic capacity. We aimed to investigate the effect of EMT on EV-mediated cancer-fibroblast signaling. CRC cell lines (DLD-1, HCT116, SW620 and SW480) were characterized by western blotting to determine EMT status. EVs were isolated from conditioned media by serial centrifugation and validated by transmission electron microscopy, western blotting and nanoparticle tracking analysis. Fluorescently labeled EVs and cells were detected and evaluated by flow cytometry and fluorescence microscopy. Increasing concentrations of EVs from CRC cells were co-cultured with fibroblasts for 24h. Activation/inhibition of signaling pathways was examined by western blotting. EV microRNA (miRNA) profiles were obtained, validated by qPCR and submitted for target and pathway analysis. DLD-1, HCT116 and SW620 cells express E-cadherin and are considered epithelial, whereas SW480 lacks E-cadherin, expresses ZEB-1, and is considered mesenchymal. EVs were spherical, enriched in ALIX, TSG101, CD63 and had a mean diameter of 90nm. EVs from CRC cells were shown to transfer directly to primary ex vivo patient-derived fibroblasts and fibroblast cell lines. Transfer of EVs from epithelial CRC cells abrogated ERK activity in fibroblasts, even at the lowest concentration, and was associated with reduced fibroblast proliferation, whereas EVs from mesenchymal cells had no effect. MiRNA profiling of EVs from epithelial and mesenchymal CRC cells showed a 10-fold upregulation of miR-143-3p in epithelial compared to mesenchymal EVs. MiRNA target analysis and experimental validation show that miR-143-3p directly targets KRAS and HRAS, providing a potential miRNA-orchestrated mechanism of action for the downregulation of fibroblast ERK activity in the tumor microenvironment. Importantly, CRC cellular ERK activity is not reflected in fibroblasts treated with CRC EVs, suggesting that EVs do not directly transmit ERK protein or mRNA. However, miRNAs are the most stable EV cargo, and we show that epithelial but not mesenchymal CRC EVs contain upregulated miRNAs, which target critical components of the ERK pathway. Downregulation of ERK activity has been shown to induce fibroblast senescence, a phenotype linked to cancer progression. We hypothesize that differential regulation occurs because epithelial CRC cells are juxtaposed with fibroblasts in the tumor core, where senescent cancer associated fibroblasts are frequently observed, whereas mesenchymal CRC cells are at the invasive front or in the circulation. Citation Format: Rahul Bhome, Louise M. House, Tilman Sanchez-Elsner, Stephen M. Thirdborough, Emre Sayan, Alex H. Mirnezami. Metastatic and non-metastatic colorectal cancer cells differentially regulate fibroblast cell cycle via extracellular vesicles [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 2982. doi:10.1158/1538-7445.AM2017-2982

Functionally engineered extracellular vesicles improve bone regeneration

BackgroundOver the past decade, mesenchymal stromal cells have been increasingly investigated for their therapeutic potential in several different illnesses. However, cell therapy can be limited by potentially serious adverse events including cell embolus formation and tumorigenesis. Importantly, the protective effects of mesenchymal stromal cells are largely mediated by paracrine mechanisms including release of extracellular vesicles. This systematic review intends to synthesize the current knowledge of mesenchymal stromal cell-derived extracellular vesicles as a therapeutic option for preclinical models of disease, inflammation, or injury.MethodsA systematic literature search of MEDLINE, Embase, and BIOSIS databases will be conducted. Interventional preclinical in vivo studies using extracellular vesicles derived from any tissue source of mesenchymal stromal cells will be included. Studies will be screened by abstract, and full-text by two independent reviewers. Eligible studies will undergo data extraction with subcategorization into domains based on disease. Methods utilized for extracellular vesicle characterization and isolation will be collected, as well as information on interventional traits, such as tissue source of mesenchymal stromal cells, dosage regimen, and vesicle modifications. Reported outcomes will be collected to determine which diseases studied may be impacted most from treatment with mesenchymal stromal cell-derived extracellular vesicles.DiscussionThis systematic review will summarize preclinical studies investigating the therapeutic efficacy of both small and large extracellular vesicles derived by mesenchymal stromal cells. Extracellular vesicles represent a possibility to harness the benefits of mesenchymal stromal cells with added benefits of reduced manufacturing costs and an improved safety profile. Hence, there has been an exponential increase in interest for developing this cell-free therapy with hundreds of preclinical studies published to date. However, a vast amount of heterogeneity between groups relates to methods of extracellular vesicle isolation, characterization, and study design. This review will capture this heterogeneity and identify the most commonly used and optimal approaches to evaluate mesenchymal stromal cell-derived extracellular vesicle treatment. A meta-analysis of outcomes within each disease domain will help elucidate which fields of research demonstrate promise for developing extracellular vesicles as a novel cell-free therapy. Summarizing this robust information on extracellular vesicles as an intervention can provide guidance for designing preclinical studies with hopes of future clinical translation.