Clinical Application Of iPSCs Research Articles

A clinical-grade HLA haplobank of human induced pluripotent stem cells matching approximately 40% of the Japanese population

Human induced pluripotent stem cells (iPSCs) are expected to be useful for regenerative medicine for many diseases. Many researchers have focused on and enabled the generation of differentiated cells or tissue-like structures, including organoids, which help to ameliorate target diseases. To promote such cell therapies, we established a clinically applicable iPSC haplobank matching as many people as possible in Japan. Through cooperation with several organizations, we recruited donors whose human leukocyte antigens (HLAs) involved in immunorejection were homozygous. The peripheral or umbilical cord blood collected from the donors was used for iPSC production by electroporation of episomal vectors. These iPSC lines were then subjected to testing, including genome analyses and sterility, to maximize safety. We constructed a clinical-grade haplobank of 27 iPSC lines from 7 donors according to good manufacturing practice regulations. However, reasons to avoid using iPSC lines include the presence of residual episomal vectors or genetic mutations in cancer-related genes. This haplobank provides HLA-matched iPSC lines for approximately 40% of the Japanese population. Since the haplobank's release in 2015, these iPSC lines have been used in more than 10 clinical trials. The establishment of this haplobank is an important step toward the clinical application of iPSCs in cell therapies. This study was supported by a research center network for therealization of regenerative medicine of the Japan Agency for Medical Research and Development (AMED) under grant number JP20bm0104001h0108.

Improved and Flexible HDR Editing by Targeting Introns in iPSCs

Highly efficient gene knockout (KO) editing of CRISPR–Cas9 has been achieved in iPSCs, whereas homology-directed repair (HDR)-mediated precise gene knock-in (KI) and high-level expression are still bottlenecks for the clinical applications of iPSCs. Here, we developed a novel editing strategy that targets introns. By targeting the intron before the stop codon, this approach tolerates reading frameshift mutations caused by nonhomologous end-joining (NHEJ)-mediated indels, thereby maintaining gene integrity without damaging the non-HDR-edited allele. Furthermore, to increase the flexibility and screen for the best intron-targeting sgRNA, we designed an HDR donor with an artificial intron in place of the endogenous intron. The presence of artificial introns, particularly an intron that carries an enhancer element, significantly increased the reporter expression levels in iPSCs compared to the intron-deleted control. In addition, a combination of the small molecules M3814 and trichostatin A (TSA) significantly improves HDR efficiency by inhibiting NHEJ. These results should find applications in gene therapy and basic research, such as creating reporter cell lines.

Clinical Applications of Induced Pluripotent Stem Cells - Stato Attuale.

In an adult human body, somatic stem cells are present in small amounts in almost all organs with the function of general maintenance and prevention of premature aging. But, these stem cells are not pluripotent and are unable to regenerate large cellular loss caused by infarctions or fractures especially in cells with limited replicative ability such as neurons and cardiomyocytes. These limitations gave rise to the idea of inducing pluripotency to adult somatic cells and thereby restoring their regeneration, replication and plasticity. Though many trials and research were focused on inducing pluripotency, a solid breakthrough was achieved by Yamanaka in 2006. Yamanaka's research identified 4 genes (OCT-4, SOX-2, KLF-4 and c-MYC) as the key requisite for inducing pluripotency in any somatic cells (iPSCs). Our study, reviews the major methods used for inducing pluripotency, differentiation into specific cell types and their application in both cell regeneration and disease modelling. We have also highlighted the current status of iPSCs in clinical applications by analysing the registered clinical trials. We believe that this review will assist the researchers to decide the parameters such as induction method and focus their efforts towards clinical application of iPSCs.

IPSC-based treatment of age-related macular degeneration (AMD): The path to success requires more than blind faith

Induced pluripotent stem cells (iPSCs) hold great promise for the treatment of human diseases. Two recent first-of-its-kind clinical case reports on the iPSC-based treatment of age-related macular degeneration (AMD) highlight the hopes and challenges associated with the clinical application of iPSCs.

Induced pluripotent stem cells in dermatology: potentials, advances, and limitations.

The discovery of methods for reprogramming adult somatic cells into induced pluripotent stem cells (iPSCs) has raised the possibility of producing truly personalized treatment options for numerous diseases. Similar to embryonic stem cells (ESCs), iPSCs can give rise to any cell type in the body and are amenable to genetic correction by homologous recombination. These ESC properties of iPSCs allow for the development of permanent corrective therapies for many currently incurable disorders, including inherited skin diseases, without using embryonic tissues or oocytes. Here, we review recent progress and limitations of iPSC research with a focus on clinical applications of iPSCs and using iPSCs to model human diseases for drug discovery in the field of dermatology.

Current Perspectives on Cardiac Regenerative Therapy with Human Induced Pluripotent Stem Cells

Heart failure (HF) is the leading cause of death in developed countries. Heart transplantation is the only radical treatment of severe HF; however, donor shortage remains an unsolved problem. Induced pluripotent stem cell (iPSC) generation is a revolutionary technology as an infinite cell source for cardiomyocytes (CM). Therefore regenerative medicine with iPSCs has promised to fulfill this unmet medical need. However, clinical application of iPSCs needs to be achieved step by step. The establishment of safe iPSCs in xeno-free condition must be a first step, while genome integration-free and oncogene-free reprogramming is necessary.

Footprint-Free Human Induced Pluripotent Stem Cells From Articular Cartilage With Redifferentiation Capacity: A First Step Toward a Clinical-Grade Cell Source

Human induced pluripotent stem cells (iPSCs) are potential cell sources for regenerative medicine; however, clinical applications of iPSCs are restricted because of undesired genomic modifications associated with most reprogramming protocols. We show, for the first time, that chondrocytes from autologous chondrocyte implantation (ACI) donors can be efficiently reprogrammed into iPSCs using a nonintegrating method based on mRNA delivery, resulting in footprint-free iPSCs (no genome-sequence modifications), devoid of viral factors or remaining reprogramming molecules. The search for universal allogeneic cell sources for the ACI regenerative treatment has been difficult because making chondrocytes with high matrix-forming capacity from pluripotent human embryonic stem cells has proven challenging and human mesenchymal stem cells have a predisposition to form hypertrophic cartilage and bone. We show that chondrocyte-derived iPSCs can be redifferentiated in vitro into cartilage matrix-producing cells better than fibroblast-derived iPSCs and on par with the donor chondrocytes, suggesting the existence of a differentiation bias toward the somatic cell origin and making chondrocyte-derived iPSCs a promising candidate universal cell source for ACI. Whole-genome single nucleotide polymorphism array and karyotyping were used to verify the genomic integrity and stability of the established iPSC lines. Our results suggest that RNA-based technology eliminates the risk of genomic integrations or aberrations, an important step toward a clinical-grade cell source for regenerative medicine such as treatment of cartilage defects and osteoarthritis.

Future Prospects for Regenerated Heart Using Induced Pluripotent Stem Cells

Induced pluripotent stem cell (iPSC) generation is an epoch-making technology. The potential applications for iPSCs are wide-ranging from in vitro disease models to drug discovery. For regenerative medicine in particular, the technology provides great hope for patients with incurable diseases or potentially fatal disorders such as heart failure (HF). However, the true realization of that promise for HF remains uncertain and moving toward the clinical application of iPSCs needs to be stepwise and careful. The establishment of "safe" iPSCs must be a major premise, while genome integration-free and oncogene-free reprogramming is also necessary. Teratoma formation also remains a risk with undifferentiated iPSCs, but it must not happen in patients' bodies. Thus, regardless of the target organ, the differentiated cells from iPSCs must be purified to exclude any possibility of tumorigenicity. The transplantation strategies used for iPSC-derived cells are very important for the recovery of lost cardiac function. Longer engraftment of transplanted iPSCs-derived cardiomyocytes is essential particularly because their survival could be hampered by ischemia, inflammation, apoptosis, immunological rejection, and other cardiac phenomena. Providing these multistep solutions will open the new frontier of regenerative therapies with iPSCs for patients with severe HF.

Induced pluripotent stem cell (iPSCs) and their application in immunotherapy

The ever-improving technology to generate induced pluripotent stem cells (iPSCs) has increased their potential use as novel candidates for disease modeling, drug screening, regenerative medicine and cell therapy. Indeed, iPSCs offer extensive capacity for self-renewal without the ethical concerns faced by embryonic stem cells (ESCs). With respect to potential applications in the immune system, many studies provide evidence to support that there are exclusive advantages to using iPSCs over other systems. Both hematopoietic stem cells and several types of mature immune cells have successfully been reprogrammed to iPSCs and vice versa, paving a path toward our ability to effectively model patient-specific diseases and provide potentially alternative cell sources for transfusion medicine. Despite these potential advances, some limitations regarding the use of iPSCs in the clinic still remain, including the immunogenicity of iPSCs and their derivatives, which is currently under debate in the field. In this review, we mainly focus on discussing the recent progress being made in the latest differentiation methods and clinical implications of iPSCs with respect to the immune system. Additionally, current issues regarding the clinical application of iPSCs are addressed, especially the controversy surrounding immunogenicity, along with various other perspectives.

Abstract 2564: Characterization of dysgerminoma-like cells emerged in the process of iPSC generation from common Marmoset fibroblasts

Abstract Recent generation of induced pluripotent stem cells (iPSCs) has made a great impact on the field of regenerative medicine. Before the clinical application of iPSCs, preclinical testing of the safety and usefulness of them must be performed using reliable animal models of various diseases. The Common Marmoset (CM, callithrix jacchus), has recently been considered one of the most useful experimental animals for medical research because of close phylogenetic similarity to humans. To generate iPSCs from CM cells, we transduced reprogramming factors including Oct3/4, Klf4, Sox2 and c-Myc into CM fibroblasts. We found that several round-shaped colonies similar to embryonic stem cells (ESCs) were formed. These cells expressed ES markers such as SSEA4 and TRA-1-60, and showed alkaline phosphatase activity. Moreover RT-PCR revealed that the cells were also positive for other ES markers such as LIN28, SALL1 and DPPA4, suggesting that these cells have been reprogrammed. Next we performed karyotype analysis, and found that these cells contained 46, X, del(4q),+mar. Although parental CM fibroblasts had abnormal chromosome called mar, majority of chromosomes were intact, indicating that chromosome 4q was lost in the process of reprogramming. We called these reprogrammed cells abnormally reprogrammed cells (ARCs). We next injected one million cells of ARCs into the testis of SCID mice. Tumors were formed approximately 6 weeks after the injection, and HE staining showed that the tumor was composed of nests and sheets of uniform round or polygonal cells with abundant, clear to faintly eosinophilic cytoplasm with well-demarcated cytoplasmic borders. In addition, immunohistochemical analysis demonstrated that the tumor cells were focally and weakly immunopositive for vimentin, and immunonegative for cytokeratin, S100, Desmin, α-smooth muscle actin and Neuron-specific enolase, and the tumor tissue appeared to be c-kit+/CD30-/CD45- by quantitative RT-PCR, all of which were characteristics of human dysgerminoma. Thus we called the tumor common marmoset dysgerminoma (CM DGs). Next we tried to culture CM DGs in vitro, and found that they could proliferate in a semifloating condition. Western blotting revealed that these tumor cells showed continuous expression of exogenous reprogramming factors. We also examined the sensitivity of CM DGs to irradiation and DNA damage agents such as mitomicin C and cisplatin, and found that they were highly sensitive to all the DNA damage treatments tested compared to the parental cells. We also found that knockdown of Sox2 or c-Myc inhibited the proliferation of CM DGs due to the increase of cell death. These results indicate that irradiation, chemotherapy using DNA damaging agents or targeting reprogramming factors such as Sox2 and c-Myc might be effective for unexpected tumors accidentally found in patients treated with the functional cells derived from iPSCs. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 2564. doi:1538-7445.AM2012-2564