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Iv Copyright by Tiziana Corsello 2017 Copyright by Tiziana Corsello 2017 iv The Dissertation Committee for Tiziana Corsello Certifies that this is the approved version of the following dissertation: HUMAN WHARTON’S JELLY MESENCHYMAL STEM CELLS (WJ-MSCs): CHARACTERIZATION AND PROPERTIES Committee: Cristiana Rastellini, M.D., Supervisor Luca Cicalese, M.D. Ella Englander, Ph.D. Giulio Taglialatela, Ph.D. Giampiero La Rocca, Ph.D. _______________________________ Dean, Graduate School iv HUMAN WHARTON’S JELLY MESENCHYMAL STEM CELLS (WJ-MSCs): CHARACTERIZATION AND PROPERTIES by Tiziana Corsello, PhD Dissertation Presented to the Faculty of the Graduate School of The University of Texas Medical Branch in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy The University of Texas Medical Branch March, 2017 v Dedication Dedicated to my wonderful love, my family and all people that supported me during this journey. Their love and effort have been precious and infinite. v Acknowledgements I wish to express my sincere gratitude to my mentor Dr. Cristiana Rastellini, to the members of my dissertation committee: Drs. Luca Cicalese, Giulio Taglialatela, Ella Englander, and Giampiero La Rocca. Despite their tremendously busy schedule, their helpful suggestions and valuable comments were essential to this work. I huge and unique thank-you goes to the people that supported me in this path, without whose continuous encouragement and guidance, the achievement of this work would have been impossible. v HUMAN WHARTON’S JELLY MESENCHYMAL STEM CELLS (WJ-MSCs): CHARACTERIZATION AND PROPERTIES Publication No._____________ Tiziana Corsello, PhD The University of Texas Medical Branch, 2017 Supervisor: Cristiana Rastellini, MD In recent years, mesenchymal stem cells (MSCs) have attracted researchers’ attention because of their promising prospective and potential application in regenerative medicine. MSCs are defined as immature cells with the ability to self- renew and differentiate into specialized cells belonging to different lineages. Due to their high proliferative potential, MSCs can be rapidly expanded in vitro when growing in adhesive plastic dishes containing a classical culture medium. In addition, they are able to differentiate into mature cell-types. Various parts of the umbilical cord (UC) have been considered a promising source of MSCs because they can be isolated in relatively high numbers when compared to other mesenchymal sources and they can be easily cultured or cryopreserved. Many other properties make UC cells a comparatively more desirable therapeutic agent. However, more research is needed in order to elucidate the biological features and specific markers expressed by specific UC MSCs named Wharton jelly mesenchymal stem cells (WJ- MSCs). WJ-MSCs are multipotent stem cells with many advantages as a potential source of MSCs; the tissue is readily available, cells are easy to grow in culture, they can be cryopreserved, and have great expansion capacity in vitro. In this study, we vi have shown that WJ-MSCs possess MSC features and therefore can be considered as an alternative MSC source in regenerative medicine applications. Following isolation, culture (self-renewal ability), characterization and differentiation of WJ- MSCs according to three different cell phenotypes, we have investigated other stem markers and the immune-modulatory/anti-inflammatory properties of WJ-MSCs. This last investigation introduces a new concept in the utilization of WJ-MSCs in regenerative medicine where instead of replacing function of cells/tissue, stem cells could be used as adjuvant when co-transplanted with other cells, tissue or organs. The results of this research will give us a better understanding of typical MSCs markers from WJ-originated cells and additional peculiar markers still unknown. vii TABLE OF CONTENTS ABSTRACT vi LIST OF TABLES xii LIST OF FIGURES xiii LIST OF ABBREVIATIONS xv CHAPTER 1 BACK GROUND AND SIGNIFICANCE 1 STEM CELLS 1 EMBRYONIC STEM CELLS 3 ADULT STEM CELLS 3 MESENCHYMAL STEM CELLS 4 OTHER SOURCES OF STEM CELL 5 PLACENTA DERIVED STEM CELLS (PDSCs) 5 UMBILICAL CORD BLOOD (UCB) 5 AMNIOTIC FLUID (AF) 6 THE FEATURES OF HUMAN UMBILICAL CORD (UC) 7 WHARTON’S JELLY: STRUCTURE AND FUNCTION 9 OVERALL SIGNIFICANCE 9 CHAPTER 2 MATERIAL AND METHODS 11 WHARTON’S JELLY MESENCHYMAL STEM CELLS ISOLATION 11 CELL CULTURING AND PASSAGING 12 viii IMMUNOCYTOCHEMISTRY ANALYSIS 12 FLOW CYTOMETRY 15 PROTEIN EXTRACTION AND WESTERN BLOT ANALYSIS 17 OSTEOGENIC DIFFERENTIATION 17 ADIPOGENIC DIFFERENTIATION 18 CHONDROGENIC DIFFERENTIATION 18 ANIMALS 19 DIABETES INDUCTION 19 ISLET ISOLATION 19 20 ISLET TRANSPLANT BLOOD GLUCOSE LEVEL (BGL) AND INTRA-PERITONEAL GLUCOSE TOLERANCE TEST (IPGTT): ENGRAFTMENT AND 20 FUNCTIONALITY ASSESSMENT STATISTICS 21 ix CHAPTER 3 WJ-MSCs : ISOLATION, PHENOTYPICAL 22 CHARACTERIZATION AND POTENCY INTRODUCTION AND BACKGROUND 22 METHODS 26 RESULTS 26 Morphological features of Wharton’s jelly Mesenchymal stem cells 26 Phenotypical characterization of Wharton’s jelly Mesenchymal stem 29 cells for the expression of classical MSC markers and standard differentiation Phenotypical characterization of Wharton’s jelly Mesenchymal stem 32 cells: additional markers Neuronal markers and glial factor expression of Wharton’s jelly Mesenchymal stem cells 38 DISCUSSION 42 CHAPTER 4 IMMUNO-MODULATORY AND IMMUNE 43 RELATED MOLECULES EXPRESSION IN WJ-MSCs ABSTRACT 43 INTRODUCTION 44 METHODS 45 RESULTS 45 Immunomodulatory and immune related molecules expression in WJ- 45 MSCs by immunohistochemistry, immunocytochemistry and flow cytometry Immunomodulatory expression of Wharton’s jelly Mesenchymal stem 53 cells by western blot DISCUSSION 55 x CHAPTER 5 WJ-MSCs IN PANCREATIC ISLET 56 TRANSPLANTATION ABSTRACT 56 INTRODUCTION 57 METHODS 70 RESULTS 70 Pilot study for the feasibility of co-transplantation of WJ-MSCs and 70 pancreatic islets 73 IPGTT results 74 Islets engraftment under kidney capsule (H&E and Insulin staining) DISCUSSION 76 CHAPTER 6 CONCLUSION 77 BIBLIOGRAPHY 79 VITA 90 xi LIST OF TABLES Table n 1: Criteria of the collected umbilical cords……………………………...11 Table n 2: List of antibodies used in the present study…………………………..14 Table n 3: List of antibodies used in the present study………..............................16 Table n 4: Group of animals transplanted…………………………………….......20 Table n 5: Human embryonic development stages……………………………….64 xii LIST OF FIGURES Figure 1.1: Stem cells differentiation ability 2 Figure 1.2: Umbilical cord 8 Figure 1.3: Umbilical cord H&E section 8 Figure 3.1: Demonstration of umbilical cord and WJC morphology 27 Figure 3.2: Flow cytometry analysis of standard MSC markers 29 expression in WJ-MSCs Figure 3.3: Demonstration of the tri-lineage differentiation by WJ-MSCs 30 Figure 3.4: Representative panels of immunohistochemical detection of 34 various markers in umbilical cord specimens Figure 3.5: Representative panels of immunocytochemical detection of 35 various markers in umbilical cord specimens Figure 3.6: Representative panels of immunohistochemical detection of 36 various markers in umbilical cord specimens Figure 3.7: Representative panels of immunocytochemical detection of 37 various markers in umbilical cord specimens Figure 3.8: Representative panels of immunocytochemical detection of 40 neural markers in WJ-MSCs Figure 3.9: Western blotting analysis of GDNF expression in mouse 41 tissues and WJ-MSCs Figure 4.1: Representative panels of 47 immunohistochemical/immunocytochemical detection of immune- related molecules in umbilical cord specimens and paired cultured cells Figure 4.2: Flow cytometry analysis of the levels of expression of 48 immune-related and immunomodulatory molecules in WJ-MSCs Figure 4.3: Representative panels of immunohistochemical detection of 50 various markers in umbilical cord specimens Figure 4.4: Representative panels of 51 xiii immunohistochemical/immunocytochemical detection of B7-H3 in umbilical cord specimens and paired cultured cells Figure 4.5: Representative panels of 52 immunohistochemical/immunocytochemical detection of immune- related molecules in umbilical cord specimens and paired cultured cells Figure 4.6: Panel of western blotting analyses for the expression of 54 immunomodulatory molecules in WJ-MSCs Figure 5.1: Pancreas anatomy 59 Figure 5.2: Pancreatic ductal anatomy 60 Figure 5.3: Islet of Langerhans 61 Figure 5.4: Transcription factor network of human pancreas 65 development Figure 5.5: Graph depicting the blood glucose levels (BGL) of the 71 animals following co-transplantation of pancreatic islets and WJ-MSCs Figure 5.6: Graph reporting body weight 72 Figure 5.7: Graph depicting the results of IPGT test for the two mice of 73 the experimental group performed after three months Figure 5.8: Localization of islets transplanted under the kidney capsule 75 of mice receiving co-transplantation of WJ-MSCs xiv LIST OF ABBREVIATIONS AF Amniotic fluid bFGF Basic fibroblast growth factor BGL Blood glucose level BM-MSCs Bone marrow mesenchymal stem cells BMP Bone morphogenetic protein CCE Cornified cell envelope CD Cluster of differentiation CK Cytokeratin COMP Cartilage oligomeric matrix protein CS Carnegie stages cTnT Cardiac troponin T Cx-43 Connexin-43 DC Dendritic cell xv DMSO Dimetylsulfoxide ECs Endothelial cells EGF Epidermal growth factor EPF Early pregnancy factor ESCs Embryonic stem cells FGF Fibroblast growth factor G-CSF Granulocyte colony stimulating factor GAGs Glycosaminoglycan rich substance GDNF Glial-derived neutrophic factor GFAP Glial fibrillar acidic
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