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Lamas et al. Arthritis Research & Therapy (2019) 21:112 https://doi.org/10.1186/s13075-019-1894-y RESEARCH ARTICLE Open Access RNA sequencing of mesenchymal stem cells reveals a blocking of differentiation and immunomodulatory activities under inflammatory conditions in rheumatoid arthritis patients Jose Ramon Lamas1, Benjamin Fernandez-Gutierrez1* , Arkaitz Mucientes1, Fernando Marco2, Yaiza Lopiz2, Juan Angel Jover1, Lydia Abasolo1 and Luis Rodríguez-Rodríguez1 Abstract Introduction: Mesenchymal stem cells (MSCs) have the ability to differentiate into different types of cells of the mesenchymal lineage, such as osteocytes, chondrocytes, and adipocytes. It is also known that under inflammatory stimuli or in the appropriate experimental conditions, they can also act as regulators of inflammation. Thus, in addition to their regenerating potential, their interest has been extended to their possible use in cell therapy strategies for treatment of immune disorders. Objective: To analyze, by RNA-seq analysis, the transcriptome profiling of allogenic MSCs under RA lymphocyte activation. Methods: We identified the differentially expressed genes in bone marrow mesenchymal stem cells after exposure to an inflammatory environment. The transcriptome profiling was evaluated by means of the precise measurement of transcripts provided by the RNA-Seq technology. Results: Our results evidenced the existence of blocking of both regenerative (differentiation) and immunomodulatory phenotypes under inflammatory conditions characterized by an upregulation of genes involved in immune processes and a simultaneous downregulation of genes mainly involved in regenerative or cell differentiation functions. Conclusions: We conclude that the two main functions of MSCs (immunomodulation and differentiation) are blocked, at least while the inflammation is being resolved. Inflammation, at least partially mediated by gamma-interferon, drives MSCs to a cellular distress adopting a defensive state. This knowledge could be of particular interest in cases where the damage to be repaired has an important immune-mediated component. Keywords: Mesenchymal stem cells, Rheumatoid arthritis, RNA-seq, Immunomodulation * Correspondence: [email protected] 1Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), UGC de Reumatología, Hospital Clínico San Carlos, Madrid, Spain Full list of author information is available at the end of the article © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Lamas et al. Arthritis Research & Therapy (2019) 21:112 Page 2 of 10 Introduction knowledge is fundamental for a better understanding of the Rheumatoid arthritis (RA) is a chronic, systemic inflamma- biological interactions between MSCs and the immune sys- tory disease with a wide spectrum of clinical manifesta- tem and to progress toward clinical application of MSCs in tions, varying from mild to very severe [1, 2]. In order to regenerative medicine and cell therapy strategies. prevent serious long-term complications, such as joint de- struction, functional loss, and preterm mortality, disease Materials and methods remission is the current treatment goal for this condition Patients and donors [3]. However, most patients do not achieve this state [4, 5], Demographic and clinical characteristics BM-MSCs do- despite the use of new drugs, such as biologic agents. nors and of the RA patients are shown in Additional file 1: Therefore, new therapies are needed to reduce the burden Table S1 and Additional file 2: Table S2, respectively. of this condition. Bone marrow (BM)-derived mesenchymal stem cells Bone marrow mesenchymal stem cells (MSCs) are plastic adherent and self-replicating adult stem/ Mesenchymal stem cells (MSCs) were obtained from bone progenitor cells with multipotential capacities. MSCs were marrow (BM) aspirates collected from the iliac crests of initially identified in bone marrow but are present virtually three donors, following informed consent. We included sub- in any tissue. The most common sources, besides bone jects older than 18 years old, with no previous diagnosis of marrow, are adipose tissue, umbilical cord and cord blood, autoimmune disease or lymphoproliferative/neoplastic con- synovial tissue, and dental pulp [6]. ditions. Briefly, aspirates were diluted in an equal volume MSCs can be easily isolated and are capable to undergo with saline and centrifuged over a Ficoll layer at 2000×g for osteogenic, chondrogenic, and adipogenic differentiation in 20 min. Cellular fraction recovered was washed two times in vitro. More recently, it has been also described in vitro the Dulbecco’s modified Eagles medium (DMEM) (Lonza). The potential of MSCs to interact with immune cells and dis- cell pellet obtained was suspended in 5 ml with complete play immunomodulatory and anti-inflammatory properties. culture medium (DMEM supplemented with 2 mM glutam- Thus, the use of MSCs as therapeutic agents has been ex- ine, 0.06% penicillin, 0.02% streptomycin, and 10% FBS). panded offering new perspectives beyond their regenerative Cultures were incubated at 37 °C in a 5% CO2 humidified at- potential becoming optimal candidates for the treatment of mosphere in 25-cm2 flasks. After several days, non-adherent immune-mediated diseases [6]. cells were removed and fresh medium was added. The Interactions between MSCs and immune cells are charac- medium was exchanged every 4 days of culture. When cul- terized by the existence of a bi-directional crosstalk which tured cells reached 80–90% confluence, adherent cells were influences the final outcome. It is mediated by a combin- trypsinized (0.05% trypsin/1.0 mM EDTA), harvested, and ation of cell-to-cell interactions and by paracrine secretion expanded in 25-cm2 flasks. MSC characterization was per- of different soluble factors [7, 8]. These include the formed according to the minimal criteria recommended by interleukin-10 (IL-10) [9], the inducible nitric oxide syn- the ISCT (International Society for Cellular Therapy) de- thase (iNOS), the cyclooxygenase-2 (COX-2 [10, 11]), the scribedbyDominicietal[16]. Cells in the fourth passage transforming growth factor-β (TGF-β)[12], the prostaglan- were used in the experimental analysis. dinE2(PGE2),thenitricoxide(NO),andtheindoleamine Bone marrow aspirates and blood were obtained in 2,3,dioxygenase (IDO), among others [13]. accordance with Good Clinical Practices and the princi- Altogether, these combined effects determine the trigger- ples expressed in the Declaration of Helsinki. The study ing of several immune functions after stimulation by proin- was approved by our institutional Ethics Committee flammatory mediators, including the polarization of (Comité Ético de Investigación Clínica Hospital Clínico macrophage pro-inflammatory phenotype M1 to the im- San Carlos—Madrid). munoregulatory M2 phenotype [14]. M2 polarization, in turn, increases the Th2 response (Treg upregulation, im- Isolation of PBMCs from RA patients munosuppression, and tissue remodeling). Additionally, Five consecutive patients diagnosed with RA according to MSCs also can enhance angiogenesis promoting the VEGF the 2010 ACR/EULAR criteria, attending the Hospital and angiopoietin-1 production [15]. Rheumatology Outpatient Clinic, were included in this We used RNA sequencing (RNA-Seq) as an experimental study. Patients were over the age of 18 at disease onset and approach to perform a precise measurement of transcripts had no previous history of any other chronic disease such generated by BM-MSCs interacting with activated or inacti- as diabetes, chronic kidney disease, and/or lymphoprolifera- vated peripheral blood mononuclear cells (PBMCs); more- tive/neoplastic conditions. We excluded from the study over, we classified the highly regulated genes from both those patients receiving more than 10 mg/day of prednis- groups according to functional gene ontologies (GOs) in one or equivalent, those who had received any intramuscu- order to gain insight into the changes these cells undergo lar dose of corticosteroids in the previous 2 months, or when exposed to an inflammatory environment. This those treated with drugs that can affect lymphocyte Lamas et al. Arthritis Research & Therapy (2019) 21:112 Page 3 of 10 activation, such as calcium antagonists or statins. At inclu- Bioinformatic analyses sion, demographic and clinical data were collected, and a Raw sequence quality control was performed using FastQC fasting venous blood sample was extracted on EDTA as [17] (Babraham Bioinformatics). The raw sequence reads anticoagulant. PBMCs were separated by centrifugation on (FASTQ format) were aligned to the cDNA sequences of a Ficoll-Hypaque gradient at 900×g,for20minat25°C. thehumanGRCh37referenceassemblyavailableinUCSC Genome Browser (http://hgdownload.soe.ucsc.edu/golden- In vitro BM-MSC–PBMC co-cultures Path/hg19/bigZips/hg19.2bit), using the Rsubread Biocon- BM-MSCs (2 × 105 cells) were cultured alone for 24 h in ductor package v1.20.3
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