Thermoreversible Hyaluronan Hydrogels Support Mesenchymal Stem Cells Discogenic Differentiation in Vitro and Ex Vivo

Abstract

Introduction Hyaluronan is a proteoglycan widely present in the nucleus pulposus (NP) of the intervertebral disk (IVD). Recently, thermoreversible hyaluronan (HA) based hydrogels, which are injectable, minimally invasive, allow for encapsulation and maintenance of viable cells and promote re-differentiation of NP cells, have been developed.1 While it is known that hyaluronan is recognized by mesenchymal stem cells (MSCs)2 and can induce anabolic pathways, growth factors may further support MSC differentiation in HA-based hydrogels. Therefore, the objectives of the present work were: (i) to assess whether the addition of growth factors3 could support MSC differentiation towards the disk cell phenotype in HA based hydrogels and (ii) to determine if MSC preconditioning (culture under “chondrogenic” conditions) would improve the survival rate and differentiation potential of MSC supplemented to an IVD cultured ex vivo. Materials and Methods Hydrogel Thermoreversible HA-based hydrogels were prepared by grafting a thermoreversible segment poly (N-isopropylacrylamide) (pNIPAM) on a functionalized HA backbone, as previously described.1 In vitro Human bone marrow-derived MSCs (P2-P4) were cultured for 7 days in HA-pNIPAM hydrogel under hypoxic conditions (5% O2) in chondrogenic medium, with or without recombinant human growth and differentiation factor-5 (rhGDF-5) supplementation. Cell viability, DNA, and glycosaminoglycans (GAG) content were quantified by Live-dead, Picogreen, and 1,9 dimethylmethylene blue assays, respectively. Gene expression analysis was performed to assess the disc-like differentiation of MSCs. The expression of collagen type I and II (COL1 and COL2) aggrecan (ACAN), cytokeratin-19, sox-9, cluster of differentiation 24 (CD24), hyaluronan synthase I and II (HAS1 and HAS2), forkhead box protein F1 (FOXF1) and carbonic anhydrase 12 (CA12) was analyzed with 18s as endogenous control. Ex Vivo Bovine caudal IVDs were excised and nucleotomy performed through the endplate (Fig. 1A,B). MSCs were either suspended in HA-pNIPAM and directly supplied to the IVDs or precultured (under hypoxic conditions and with supplementation of GDF-5) for 1 week in HA-pNIPAM and then supplied to the IVDs. After 1 week of culture, gene expression analyses were performed using the same markers as for the in vitro study. Statistics After confirming the normality of the data distribution, one-way analysis of variance with Bonferroni posthoc was performed ( p < 0.05). Results MSC viability was maintained>90% over 1 week of culture in the HA-pNIPAM hydrogel both in vitro and ex vivo. DNA and GAG did not show significant variation over the 7 days of in vitro culture. Gene expression revealed 10–100-fold upregulation of the transcription factor SOX9 and 100–1000, fold upregulation of COL2, while COL1 was only slightly enhanced. The expression of the potential NP cell marker KRT19 was also increased. With the addition of rhGDF-5, an improved COL2/COL1 expression ratio was found. No significant differences were found for the other genes. Ex vivo cultures of nucleotomized discs supplemented with MSCs in HA-pNIPAM confirmed the positive effect of the hydrogel and the IVD environment on MSC differentiation towards the disc-like phenotype (Fig. 1C), with upregulation of collagen type II ( p < 0.05), CD24, and FOX-F1. No significant differences were found for the other genes. Preculture of MSCs before the supplementation in the IVD did not enhance MSC differentiation. Figure 1 Bovine IVD after nucleotomy: (A) top view and (B) view of the nucleotomized area. (C) Gene expression of human MSCs after 1 week of culture in bovine IVDs normalized to the mRNA levels at day 0 of culture: human MSCs were either suspended in HA-pNIPAM and directly supplied to bovine IVDs (white bars) or precultured for 1 week in HA-pNIPAM hydrogel and then supplied to bovine IVDs (grey bars);* p < 0.05, outliers. Conclusion The thermoreversible hyaluronan-based hydrogel was able to induce human MSC differentiation toward a “disc-like” phenotype without the addition of growth factors, although GDF-5 supplementation resulted in an improved gene expression profile. Preculture of MSCs before the supplementation in the IVD is not required with the thermoreversible hyaluronan-based hydrogel. Therefore, this type of hydrogel could be an appropriate carrier for MSCs supplementation to compromised discs. Investigations are ongoing to evaluate its biomechanical behavior under loading. Acknowledgements This study was partially supported by a NASS Research Grant. I confirm having declared any potential conflict of interest for all authors listed on this abstract Yes Disclosure of Interest None declared Peroglio M, et al. European Spine Journal (Epub ahead of print) Zhu H et al. Stem cells 2006; 24:928–935 Gantenbein-Ritter B, et al. European Spine Journal 2011;20(6):962–971