All Things Stem Cell

“STEM CELL REVOLUTIONS” is an informative and engaging documentary recently distributed by the Scottish Documentary Institute. It’s a very useful film to see if you want to learn more about the history of stem cells, and where the clinical, cutting-edge technology is at currently. The documentary gives an overview of international stem cell history, starting with the discovery of stem cells and ending with the newest members of the ever-growing stem cell family. To summarize such a wealth of research, research that has been going on for over half a century, the film tells the story of a few key stem cell discoveries and applications. Each story is described through interviews with stem cell researchers who were directly involved or appeared on the scene later but can knowledgably discuss the event’s impact. The first group of stories is related to adult stem cells (although this is not explicitly stated or explained): the discovery of stem cells during WWII, the amazing rescue of two boys in the early 1980s using stem cell-based skin grafts, and the present-day treatment of blind patients in a stem cell clinic in India. The final group of stories is related to pluripotent stem cells: the discovery of embryonic stem cells (ESCs) in mice in 1981 by Martin Evans (it was a treat to see Evans, who won the Nobel Prize in 2007 for the research he discusses in the film!) and of human ESCs (hESCs) in 1998 by Jamie Thomson, present-day use of hESCs to treat patients with retinal disorders in London (although I shuddered a little when Pete Coffee handled a flask of cells without gloves on!), and the creation of induced pluripotent stem cells (iPSCs) by Shinya Yamanaka in 2006.

The science presented in the film is well-explained and even though the focus of the film is on medical breakthroughs accomplished using stem cells, the scientists interviewed do not try to over-hype current stem cell applications. Most helpful in making the technical information accessible are several short, accurate, and intriguing animations (made by Cameron Duguid). During a segment on Yamanaka’s research, one of these animations is particularly useful in explaining how chromatin regulation of gene expression is different in different types of tissues. However, it is repeatedly jarring when the interviews with down-to-earth stem cell scientists, who mostly do not over-hype their research, are bookended by interviews with Margaret Atwood (a writer who is confusingly repeatedly interviewed in a laboratory setting). She makes repeated references to The Fountain of Youth – at odds with the scientists’ messages. Similarly, repeatedly interspersed videos of a topless man doing what looked to be the Brazilian martial art of Capoeira seemed out of place.

Perhaps the only shortcoming of the film, if a bit minor, is that it shies away from getting into some of the nitty-gritty of why iPSCs may be better than hESCs or vice versa, but instead falls back upon the standard argument that hESCs are surrounded by ethical concerns. For a 71-minute-long film, it only makes sense that some issues be simplified, but additional details may have helped viewers better understand this important and hotly-debated topic. Specifically, a lot of the ethical arguments against hESCs are outdated or ill-founded. Probably most importantly, in 2006, Irina Klimanskaya and colleagues found how to isolate hESCs while leaving the donor embryo intact and potentially able to develop normally, weakening the argument against the generation of hESC lines on the grounds that they require the destruction of a potential embryo. Additionally, many researchers use blastocysts that would have been discarded by the in vitro fertilization clinic because the embryos were damaged in some way and would never develop properly. However, a significant strike against using hESCs in treatments, which the film does not touch upon, is the potential for immune rejection. Human iPSCs, on the other hand, are very appealing because they potentially may not have immune rejection problems in treatments, as mentioned in the film. However, human iPSCs are much newer to the stem cell scene and have similarities with cancer cells that researchers should probably better understand before iPSCs are widely used clinically. It is also a little surprising that Jamie Thomson is not mentioned in the human iPSC segment, as his group independently created human iPSCs at the same time as Yamanaka’s group.

The researchers interviewed in the film emphasize the importance of striking a balance between regulation and progress, but then the film seems to not take its own advice and gets bogged down in the regulation of stem cells in the very last segment of the film, when it may have been more useful to focus on the near-future applications of these cells. There’s a surprising focus on the hypothetical ethical arguments that would arise should human iPSCs be made into function eggs and sperm (which has not been done yet, and may not even be possible). However, it may be more useful to first focus on whether human iPSCs can even be successfully used in the clinic before diverting attention to this hypothetical ethical argument, which is much further down the road. It would also have been nice to see a mention of direct reprogramming, the latest stem cell technology that may one day make even iPSCs obsolete.

While there are amazing advances being made with stem cell technology, the film rightly cautions viewers about the dangers of going to a stem cell clinic abroad. A great resource for those considering stem cell treatments abroad is A Closer Look at Stem Cell Treatments, a website made by the reputable International Society for Stem Cell Research.

Overall, “STEM CELL REVOLUTIONS” is a great film for anyone wanting to learn more about the history of stem cells, hear legendary researchers talk about their ground-breaking work and patients talk about how stem cell therapies have changed their lives, and still get a down-to-earth idea of what is realistically being accomplished with these cells.

admin Bioengineering, Embryonic Stem Cells, Hematopoietic Stem Cells, Reprogramming, Review adult, clinical trials, embryonic, history, regenerative medicine, review © 2012. Teisha Rowland. All rights reserved.

It’s known that stem cells, the key players in regenerative processes in the body, play a key role in continually making new hair. This role created interest in studying hair follicle stem cells to better understand androgenetic alopecia (AGA), or male pattern baldness, the most frequent type of hair loss among men. Naturally, the hair follicle stem cells were the prime suspects for causing AGA. However, earlier this month a study by George Cotsarelis at the University of Pennsylvania School of Medicine and colleagues published in The Journal of Clinical Investigation (Garza et al., 2011) revealed that patients with AGA actually had had a normal amount of follicle stem cells in their scalps. Surprisingly, it was found that different progenitor cell populations, suspected to be derived from the hair follicle stem cells, were in fact the ones playing the key roles in causing AGA. (Progenitor cells are like stem cells in that they can differentiate into different cell types, but progenitors’ fates are more limited and they can replicate only a restricted number of times.) By better understanding the exact cell types involved, it may help researchers devise better therapies for treating AGA.

A Hair’s Life-Cycle: In order to understand AGA and the newly discovered key role of these progenitor cells in it, it’s helpful to first review the normal life of a hair. In the skin, every hair sits inside a hair follicle, a little cavity that goes down through the dermis layer and has connected sebaceous glands (which lubricate the hair by secreting an oily substance) an arrector pili (a small bundle of muscles that can make the hair stand on end) (see Hair Follicle figure). Each hair carries out its own life-cycle. The first lifecycle phase is called anagen, a growing period that about 85 percent of the hairs on a person’s head are in at any given time. During anagen, which can last two to six years for one hair, the hair grows at the rate of about five inches a year. After anagen, the hair enters catagen, a transitional one- to two week-long stage when the hair follicle and root both shrink. The hair then enters the last stage, telogen, which is a resting phase that lasts about five to six weeks, during which time the old hair does not grow. At the end of telogen the hair follicle re-enters anagen, the growth phase, and often a new hair will push the old one out, starting the growth cycle over again (Furdon & Clark, 2003; Garza et al., 2011).

Every hair sits inside a hair follicle, which goes down through the epidermis and dermis of the skin. Connected to the follicle are sebaceous glands, which release oils onto the hair, and arrector pili muscles, which can cause hairs to stand on end. The bulge is where the majority of the hair follicle stem cells reside, and these can give rise to multipotent progenitor cells.

Androgenetic Alopecia: Normally, the new hair will grow similar to how the last one did. However, with AGA this isn’t the case. In AGA, hair follicles get smaller over time, and consequently make smaller and smaller, eventually microscopic, hairs. How is this caused? It’s not that well understood; it’s known that testosterone is necessary for this miniaturization (as inhibiting testosterone conversion to its active form can delay AGA progression), but not much else is known about what causes AGA (Garza et al., 2011).

But even if it’s not known what happens to cause AGA, researchers have done a lot of work to figure out what stem cells are normally active in the hair follicle. Within a hair follicle, there are stem cells that reside in an area called the hair follicle “bulge,” which is a small compartment located where the outer root sheath meets the arrector pili muscle (see Hair Follicle figure). The stem cells in the bulge are multipotent epithelial stem cells, and can become, or differentiate into, all the epithelial cell types in the follicle (including hair follicles, epidermis, and sebaceous glands) (Oshima et al., 2001). They’re intimately involved in the hair follicle lifecycle. Given this, it shouldn’t come as a surprise that if these stem cells are destroyed, so is the hair follicle (Ohyama et al., 2006; Ohyama 2007).
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admin Hair Stem Cells adult, regenerative medicine © 2012. Teisha Rowland. All rights reserved.

One of the major hurdles that needs to be overcome in the field of regenerative medicine is the issue of immune rejection, or preventing a patient’s body from
rejecting a tissue transplant from a foreign donor. Consequently, researchers have increasingly focused on ways to regenerate damaged or diseased tissues in a patient by using the patient’s own tissues, which should not trigger an immune response. At this point in time, there are primarily two types of stem cells that hold the greatest promise for use in regenerative medicine where immune rejection is a significant concern: human induced pluripotent stem cells (iPSCs) and cells made through a process called somatic cell nuclear transfer (SCNT). This article will focus on recent SCNT improvements, but we’ll re-visit iPSCs briefly for comparison’s sake.

Applying Somatic Cell Nuclear Transfer in the Creation of Dolly the Cloned Sheep. Dolly the sheep was cloned through somatic cell nuclear transfer (SCNT). An adult cell from the mammary gland of a Finn-Dorset ewe acted as the nuclear donor; it was fused with an enucleated egg from a Scottish Blackface ewe, which acted as the cytoplasmic (or egg) donor. An electrical pulse acted to fuse the cells and activate the oocyte after injection into the surrogate mother ewe. A successfully implanted oocyte developed into the lamb Dolly, a clone of the nuclear donor, the Finn-Dorset ewe. SCNT may also be used to create patient-specific stem cells with great therapeutic potential.

Human induced pluripotent stem cells: The history and biology of human iPSCs were explored previously in “Induced Pluripotent Stem Cells: A New Stem Cell Line with a Long History.” In essence, iPSCs, which were first created with mouse cells in 2006 (Takahashi and Yamanaka, 2006) and then with human cells in 2007 (Yu et al., 2007; Takahashi et al., 2007), are adult cells that have been “reprogrammed” to an embryonic stem cell (ESC) state. This reprogramming is done by forcing adult cells to express proteins that are essential to the ESC identity (by transducing the adult cells with a retrovirus vector that contains the DNA for the key proteins). Consequently, human iPSCs look and behave nearly indistinguishably from hESCs. Like hESCs, iPSCs are pluripotent (they can become any cell type) and proliferate virtually indefinitely, both features which are important for use in regenerative medicine.

However, while great improvements have been made to make this technology closer to the clinic (such as multiple approaches to create iPSCs that do not have the reprogramming genes randomly integrated into their genomes [Yu et al., 2009; Zhou et al., 2009]), and it may someday be used to generate patient-specific ESC-like cells, the technology is not quite there yet. (Other similar technologies, such as “direct reprogramming,” are also being explored for the generation of patient-specific cells, but, again, this approach also has a ways to go.)

Somatic cell nuclear transfer: SCNT technology significantly predates iPSCs, and in many ways formed the basis for the idea of iPSCs. In SCNT, the nucleus from a somatic cell (an adult cell that is not a sperm or egg, i.e. not the gametes) is implanted into an egg, which already had its own nucleus removed. The egg amazingly reprograms the nucleus to become embryonic again; it’s been found that SCNT causes some 10,000 to 12,000 genes to be expressed (turned into protein) that are normally associated only with embryonic development (Niemann et al., 2008). The newly formed embryo (technically called a blastocyst) can then be implanted into a surrogate mother, and potentially become an adult organism. The organism is a clone of the animal that donated the nucleus. Although nuclear transfer studies have been conducted since the late 1930s (primarily in amphibians using nuclei donated from embryos, not adult tissues) (Spemann, 1938), it wasn’t until 1997 that the first widely-accepted successful use of SCNT was reported: Dolly the sheep was born, and she was the first cloned animal from an adult cell, and the first cloned mammal (Wilmut et al., 1997). Since Dolly, several other animals have been successfully cloned, though many problems still remain (the frequency of successful development is relatively low, as SCNT-derived embryos usually result in about 0 to 10% live births) (Wilmut et al., 1997; Wakayama et al., 1998; Solter, 1998; McKinnell and Di Bernardino, 1999; Gurdon and Byrne, 2003, Beyhan and Cibelli, 2008).

Therapeutic cloning: While SCNT has been long-explored for its ability to create cloned animals like Dolly and others (a practice called “reproductive cloning”), SCNT has other very appealing applications that do not involve the creation of an entire animal, such as “therapeutic cloning.” The goal of therapeutic cloning is to use SCNT technology to create patient-specific embryonic stem cells for medical therapies. These much sought-after cells are being labeled nuclear transfer stem cells (NTSCs), but they are essentially ESCs. While using SCNT to clone an entire animal has been fraught with developmental challenges, using SCNT to create NTSCs may be less difficult because it only requires a very early stage embryo, a blastocyst, to be formed (and NTSCs from a blastocyst may be less compromised by developmental abnormalities than an entire animal would be) (Beyhan and Cibelli, 2008). NTSCs have now been created from many different model animals.

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A recently published paper showed that mice with colon cancer can be “vaccinated” with human embryonic stem cells and have a significant immune response against the cancer (Li et al., 2009). This study relates to a big hurdle that needs to be overcome in order to better fight cancer: immune tolerance. The immune system usually fails to detect and attack cancerous tumors, and consequently many cancer treatments are currently being developed that stimulate the immune system to fight back (e.g. the growing field of cancer vaccines).

Cancerous tumors and embryonic tissues have been found to share many of the same antigens, which are detected by the immune system through antibodies. This group of antigens is called oncofetal antigens. Consequently, animals can be vaccinated with embryonic tissues/cells (most recently done with human embryonic stem cells) and develop an immune response against cancer.

Interestingly, this state of immune tolerance is similar to what happens during pregnancy, and, more specifically, it’s been found that the body’s response to a tumor is very similar to its response to embryonic tissues. While much recent research has not been published in this area, there is actually a long history of studies that show: (1) there is a significant number of antigens shared between tumors and embryonic tissues (called “oncofetal antigens”) and, consequently, antibodies made against tumors can also recognize embryonic tissues, and vice versa; (2) pregnancy confers some immunity against cancer (accompanied by antibody production against oncofetal antigens), not only against its occurrence but also against its growth; (3) similar to pregnancy, an immune response against cancer can be generated by vaccinating animals with embryonic tissues. These studies and the recent re-visitation will be explored below (for a more detailed review, see Brewer et al., 2009).

The first published suggestion that tumors may have an embryonic nature came in the early 1800s (Muller, 1838). Tumors were suspected to be tissues that had been triggered to become embryonic-like again, and it is now generally accepted that tumors are indeed more “embryonic” than the tissues they are derived from, due to the re-expression of embryonic-related genes. By the late 1800s, researchers understood cancer enough to realize that they must better understand normal development in order to better combat cancerous tumors and their embryonic-like cells (Brewer et al., 2009). In the 1880s, these studies shifted focus; the field of immunology was born (from research conducted by Louis Pasteur, at the University of Strasbourg, and Robert Koch, as a medical officer in Poland) and many researchers focused on creating vaccines to cure diseases. Cancer was no exception.
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admin Cancer Stem Cells, Embryonic Stem Cells, Induced Pluripotent Stem Cells cancer, embryonic, history, news © 2012. Teisha Rowland. All rights reserved.

A goal of regenerative medicine has been to be able to take any cell from a person’s body and turn it in to any other cell type that may be desired (such as insulin-producing beta-cells for treating diabetes, or creating neurons to treat a neurodegenerative disease). This would eliminate several donor-compatibility problems, and potentially eliminate the need for a donor (who isn’t the patient) altogether. In 2007, human induced pluripotent stem cells (iPSCs) were created and this goal seemed a bit closer (Yu et al., 2007; Takahashi et al., 2007). iPSCs are cells that can be take from adult tissue and “reprogrammed” into embryonic stem cell (ESC)-like cells. Because iPSCs are pluripotent, these cells can then differentiate into (or become) any cell type (for more information, see the All Things Stem Cell article on “Induced Pluripotent Stem Cells: A New Stem Cell Line with a Long History”).

But is it possible to get rid of the iPSC-middle man? Is it possible to take any cell in the adult body and directly reprogram it, skipping the iPSC state, into the final desired cell type? There have been several studies over the last few decades that show this is quite possible, though it still has a ways to go before it can be regularly used in the clinic.

Reprogramming of cells to a different cell type is usually done by either somatic cell nuclear transfer (SCNT) or by using transcription factors. This post will focus on work done with transcription factors (for more information on using SCNT, see the “Induced Pluripotent Stem Cells…” post). Transcription factors are expressed (or made) at different levels in different cell types, and control what genes are expressed in every cell, making sure, for example, that a liver cell remains a liver cell and does not become a neuron. A famous example of how transcription factor expression can be used to alter a cell’s identity is the creation of iPSCs, where adult cells were forced to express transcription factors normally expressed in ESCs, which made the adult cells express genes specific to ESCs, and consequently become nearly identical to ESCs.

There are many degrees of direct reprogramming that have been reported over the last few decades. Several progenitor cells, cells that appear to be committed to their fate but not yet fully differentiated, have been shown to be capable of dedifferentiating into a different cell type; this process is called transdetermination. However, in a few cases it has been shown that a fully differentiated cell can actually become a different cell type; this process is called transdifferentiation (Graf and Enver, 2009). Over the last few decades, much progress has been made in direct reprogramming with muscle, blood, the pancreas, and neurons.

Muscle

In the 1980s, the first reprogramming experiments using transcription factors took place. In 1987, a group reported using MyoD to make fibroblasts become muscle cells (Davis et al., 1987). Fibroblasts are cells important for wound healing (they secrete essential extracellular matrix proteins) and are common in connective tissues. The specific fibroblasts used were embryonic mouse fibroblasts. Because they were embryonic, this process is called transdetermination; the embryonic fibroblasts could probably differentiate more easily than adult fibroblasts (Graf and Enver, 2009). To convert the fibroblasts into muscle cells, the researchers transfected the fibroblasts with the cDNA of MyoD, forcing the cells to express MyoD (Davis et al., 1987). MyoD is normally only expressed in skeletal muscle, and it was later found to be a transcription factor involved in the differentiation of muscle cells and also a very early marker of muscle cell fate commitment.

Because of its success with the fibroblasts, MyoD was subsequently used in many other reprogramming studies to see what other cells it could make into muscle. It was found that while MyoD could indeed convert many different cell types into muscle, including fibroblasts in the dermal layer of skin, immature chondrocytes (cells in cartilage), smooth muscle, and retinal cells (Choi et al., 1990), MyoD could not turn any cell type into muscle; it was found incapable of making muscle out of hepatocytes (cells in the liver) (Schäfer et al., 1990).

Blood

In the 1990s, another key direct reprogramming factor was discovered, specifically involved in hematopoiesis. Hematopoiesis is the process by which the different types of blood cells are generated in the body (the term literally means “to make blood”). (For information on hematopoietic stem cells, see the All Things Stem Cell article “Hematopoietic Stem Cells: A Long History in Brief”). The central hematopoiesis-regulating factor discovered was the transcription factor GATA-1.

In 1995, a group reported that when GATA-1 was added to or removed from avian monocyte precursors, it could turn them into erythrocytes, megakaryocytes, and eosinophils (Kulessa et al., 1995). To understand the significance of these findings an inspection of hematopoiesis is required (see Figure). During hematopoiesis, hematopoietic stem cells (HSCs) (also called hemocytoblasts) give rise to all the different types of blood cells. Specifically, HSCs can first differentiate into either a common myeloid progenitor cell or a common lymphoid progenitor cell; either progenitor then further differentiates into specific blood cell types.

Direct Reprogramming in the Hematopoietic System. Several different transcription factors have been found that can directly reprogram one type of blood cell into another. Changing the expression levels of GATA-1 in monocytes (red) can make them differentiate into eosinophils, erythrocytes, or megakaryocytes. Making B-cells (B lymphocytes) express C/EBP transcription factors (blue) can cause them to differentiate into macrophages. Lastly, C/EBPs can also inhibit the function of the transcription factor Pax5; when Pax5 is deleted in B-cells they differentiate into T-cells (T lymphocytes), though they first dedifferentiate into a common lymphoid progenitor.

admin Embryonic Stem Cells, Induced Pluripotent Stem Cells, Reprogramming adult, cancer, developmental, embryonic, hematopoietic, history, news, potency, regenerative medicine © 2012. Teisha Rowland. All rights reserved.