Background: Recently, pig induced pluripotent stem cells (iPSCs) have been produced by by ectopic expression of four human transcriptional factors, OCT4, SOX2, KLF4, and cMYC in pig fetal fibroblasts through a lentiviral vector. The pig iPSCs showed pluripotency via in vitro differentiation assays and teratoma testing. However, these cells have failed to differentiate into beating myocytes in vitro. To determine whether in vivo conditions would drive iPSC differentiation into myocytes, we performed allogeneic transplantation of the pig iPSCs into areas of chronically ischemic myocardium. Methods: Pig iPSCs were expanded by standard ES cell culture method, and allogeneically transplanted into chronically ischemic myocardium of eight Yorkshire pigs by direct intramyocardial injection (four 10-cm culture dishes, total of 10-16 million cells, suspended in 2.5 ml of saline, with 25 injection sites). Cohorts of two animals were sacrificed at 2, 4, 8 wks and 3 months after injection to study the differentiation of the injected cells. Results: After transplantation, there were no signs of adverse side effects or graft versus host disease at any time point. Two weeks after injection, clusters of SSEA-4 positive cells were detected in the frozen sections of the injected area using immunofluorescent staining. Four to 8 weeks later, these clusters of cells started to proliferate, within the injected area, into spherical shaped small tumors surrounded by thin capsules. The cells inside these tumors showed homogeneous phenotype with no signs of differentiation into any lineage. Three months after the injection, no such small tumors were found; instead, similar SSEA-4 positive cell clusters were found in the injected area but in smaller numbers. By immunofluorescent staining, few smooth muscle actin or vWF positive cells were found inside the cell clusters, but no positive desmin cells were found, and by RT-PCR, the expression of VEGF, FGF, ANRT were significantly higher in the injected myocardium compared with none injected, suggesting that injected iPSCs were not differentiated into myocytes and might contribute to the formation of some new vessels. Conclusions: Allogeneic transplantation of iPSCs can be safely used to test the lineage differentiation of stem cells for the future iPSC-based therapy. Despite an ischemic environment, pig iPSCs continue to proliferate in vivo for three months after injection. However the proliferation ability of the iPSCs was limited within the immunoconpetent hosts. For future cell-based therapy, iPSCs with pro-myocyte differentiation will be needed to study their potential for myocardial regeneration.
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