Transplantation of neural stem cells: cellular & gene therapy for hypoxic-ischemic brain injury

We have tracked the response of host and transplanted neural progenitors or stem cells to hypoxic-ischemic (HI) brain injury, and explored the therapeutic potential of neural stem cells (NSCs) injected into mice brains subjected to focal HI injury. Such cells may integrace appropriately into the degenerating central nervous system (CNS), and showed robust engraftment and foreign gene expression within the region of HI inury. They appeared to have migrated preferentially to the site of ischemia, experienced limited proliferation, and differentiated into neural cells lost to injury, trying to repopulate the damaged brain area. The transplantation of exogenous NSCs may, in fact, augment a natural self-repair process in which the damaged CNS "attempts" to mobilize its own pool of stem cells. Providing additional NSCs and trophic factors may optimize this response. Therefore, NSCs may provide a novel approach to reconstituting brains damaged by HI brain injury. Preliminary data in animal models of stroke lends support to these hypotheses.     

神经干细胞分化调控机制的研究进展

神经干细胞（NSCs）是一类具有自我更新和多方向分化潜能的干细胞,可以分化为神经元,星形胶质细胞和少突胶质细胞。自从1992年Reynolds等从小鼠纹状体中分离到神经干细胞之后,相关的研究已经取得了很大的进展。然而由于中枢神经系统内神经干细胞数量较少,而神经系统损伤后移植的外源的神经干细胞大多分化为神经胶质细胞,进而形成瘢痕组织,限制了神经系统的恢复。因此,如何实现神经干细胞的定向诱导分化成为当前该领域的核心问题。     

Proliferation and differentiation of neural stem cells within the subependymal layer of lateral brain ventricles in response to the neurodegenerative process in the striatum

It is known that the subependymal layer (SEL) of the lateral brain ventricles' wall is a source of neural stem cells (NSCs) of adult mammalian brain including the human brain. The NSCs in relation to the striatum differentiate only into glial phenotype. Therefore we focused on proliferative activity of NSCs and precursors in the SEL and on the course of their differentiation into the astrocytes in reaction to the neurodegenerative process in the striatum like in Huntington's disease. Increased gliogenesis, differentiation of newly generated cells and their ability to migrate into the striatum were evaluated in two groups of the rats surviving 1 and 3 months after the application of the neurotoxic (ibotenic) acid into the striatum. For evaluation of the proliferative activity we compared the results obtained using two proliferative markers--Bromodeoxyuridine (BrdU) and Ki-67. Characterization of newly generated cells and of their differentiation was based on the detection using the following antibodies: Nestin (a marker for NSCs and precursors), GFAP (detection of astrocytes), also the double-staining method with BrdU and GFAP.     

Stem cell strategies for neuroreplacement therapy in Alzheimer's disease

The existence of neural stem cells (NSCs) in the adult human brain provides impetus for investigating possible neuroreplacement therapies for neurodegenerative disease. Due to recent advances in techniques affording isolation and maintenance of NSCs using non-serum culture media, these cells have become exciting candidates for therapeutic strategies. We are able to expand NSCs by mitogenic growth factors in vitro and in defined conditions, NSCs differentiate into each of the diverse brain cell types: neurons, astrocytes and oligodendrocytes. This article addresses the involvement of amyloid-beta precursor protein and the presenilins in NSCs' biology and possible application of NSCs for therapeutic approaches in Alzheimer's disease. Ongoing studies in our laboratory, and recent findings by others using human neural progenitors, serve as the conceptual frame for this article.     

Neural stem cells

Neural stem cells (NSCs) have the ability to self-renew, and are capable of differentiating into neurones, astrocytes and oligodendrocytes. Such cells have been isolated from the developing brain and more recently from the adult central nervous system. This review aims to provide an overview of the current research in this evolving area. There is now increasing knowledge of the factors controlling the division and differentiation of NSCs during normal brain development. In addition, the cues for differentiation in vitro, and the possibility of transdifferentiation are reviewed. The discovery of these cells in the adult brain has encouraged research into their role during neurogenesis in the normal mature brain and after injury. Lastly other sources of neural precursors are discussed, and the potential for stem cells to be used in cell replacement therapy for brain injury or degenerative brain diseases with a particular emphasis on cerebral ischaemia and Parkinson's disease.     

Human neural stem and progenitor cells: in vitro and in vivo properties,and potential for gene therapy and cell replacement in the CNS

The generation of unlimited quantities of neural stem and/or progenitor cells derived from the human brain holds great interest for basic and applied neuroscience. In this article we critically review the origins and recent developments of procedures developed for the expansion, perpetuation, identification, and isolation of human neural precursors, as well as their attributes. Factors influencing their in vitro properties, both under division and after differentiation conditions, are evaluated, with the aim of identifying properties common to the different culture systems reported. This analysis suggests that different culture procedures result in cells with different properties, or even in different cells being isolated. With respect to in vivo performance, present evidence obtained in rodents indicate that cultured human neural precursors, in general, are endowed with excellent integrative properties. Differentiation of the implanted cells, in particular in the case of adult recipients, seems not to be complete, and functionality still needs to be demonstrated. In relation to gene transfer and therapy, aspects currently underexplored, initial data support the view that human neural stem and progenitor cells may serve a role as a platform cell for the delivery of bioactive substances to the diseased CNS. Although a large deal of basic research remains to be done, available data illustrate the enormous potential that human neural precursors isolated, expanded, and characterized in vitro hold for therapeutic applications. In spite of this potential, maintaining a critical view on many unresolved questions will surely help to drive this research field to a good end, that is, the development of real therapies for diseases of the human nervous system.     

大鼠胚胎脑组织神经干细胞的培养和鉴定

目的探讨从不同胎龄的大鼠脑组织中分离,培养神经干细胞(NSC)并对其鉴定,了解生物特性。方法通过采用机械分离和消化分离相结合的方法分离不同胎龄大鼠脑NSC。在无血清DMEM/F12(含20ng/m lbFGF,20ng/m lEGF及B27辅助培养液)中培养、传代和鉴定。诱导分化后采用SABC法对分化的细胞进行神经元特异烯醇化酶(NSE)、胶质纤维酸性蛋白(GFAP)检测作细胞鉴定。结果从不同胎龄的胎鼠脑组织中成功培养出神经干细胞,胎龄为12.5天的胎鼠提取的神经干细胞集落最多,在上述条件下培养及传代的细胞不断分裂增殖,形成悬浮生长的呈巢素蛋白(nestin)阳性的神经球;用血清诱导分化为大量表达NSE阳性的神经元和GFAP阳性的星形胶质细胞。结论胎龄为12.5天胎鼠大脑皮质培养出的神经干细胞数量最多,可分化为神经元、神经胶质细胞及少突胶质细胞。     

内皮细胞对神经干细胞增殖与分化的影响

已经确定神经干细胞在脑中不是随意分布,而是集中在血管周围的。尽管神经干细胞存在于血管周围,但是对于其与血管组成细胞之间的关系还不是很清楚。据报道,内皮细胞释放的可溶性因子可以刺激神经干细胞自我增殖,抑制其分化,并且提高神经元的比例。将内皮细胞与神经干细胞共同培养可以激活Notch途径来促进神经干细胞自我增殖。另外,血管内皮生长因子对神经细胞的生长也起着非常重要的作用,它促进了中枢神经系统星形胶质细胞的生长与分化。因此,内皮细胞不仅是传统意义上血管的组成部分,还是神经干细胞所在区域的重要成分,并且可以通过大脑产生的神经营养性分泌物来提高神经元的发生。     

成年小鼠神经干细胞体外培养、鉴定及分化

目的:建立一种简便易行的从成年小鼠脑组织分离、培养和鉴定神经干细胞(neural stem cells,NSCs)的方法,为相关研究提供新的研究手段。方法:采用机械分离和酶消化结合方法分离成年昆明种小鼠的脑组织,用无血清培养基悬浮培养;倒置相差显微镜观察细胞形态;MTT法(四甲基偶氮唑盐微量酶反应比色法)观察NSCs的自我增殖能力;免疫荧光细胞化学技术检测NSCs标志物巢蛋白(Nestin)的表达;多聚赖氨酸铺板和撤除培养基中FGF和EGF的条件下,给予5%血清和1μm维甲酸诱导NSCs分化,免疫荧光细胞化学技术检测GFAP(标记胶质细胞),β-tubulin Ⅲ(标记神经元)蛋白的表达来测定NSCs的分化能力。结果:从成年小鼠脑组织分离的细胞,在无血清培养液中可形成神经球,并可在体外扩增和连续传代,免疫荧光细胞化学表明神经球Nestin阳性表达,在给予血清和维甲酸条件下神经球可表达GFAP和β-tubulin Ⅲ。结论:本研究成功建立了体外培养成年小鼠脑组织分离和培养NSCs的方法,培养的NSCs具有自我更新、增殖及多向分化潜能。此方法是一个稳定、简便易行的方法,可广泛用于神经干细胞相关的基础和应用研究。     

Neural stem cells as tools for understanding retroviral neuropathogenesis

The discovery within the past decade that neural stem cells (NSCs) from the developing and adult mammalian brain can be propagated, cloned, and genetically manipulated ex vivo for ultimate transfer back into the CNS has opened the door to a novel means for modifying the CNS environment for experimental and therapeutic purposes. While a great deal of interest has been focused on the properties and promise of this new technology, especially in regard to cellular replacement and gene therapy, this minireview will focus on the recent use of NSCs to study the neuropathogenesis of the murine oncornaviruses. In brief, the use of this NSC-based approach has provided a means for selective reconstitution within the brain, of specific retroviral life cycle events, in order to consider their contribution to the induction of neurodegeneration. Furthermore, by virtue of their ability to disseminate virus within the brain, NSCs have provided a reliable means for assessing the true neurovirulence potential of murine oncornaviruses by directly circumventing a restriction to virus entry into the CNS. Importantly, these experiments have demonstrated that the neurovirulence of oncornaviruses requires late virus life cycle events occurring specifically within microglia, the resident macrophages of the brain. This initial application of NSC biology to the analysis of oncornavirus-CNS interactions may serve as an example for how other questions in viral neuropathogenesis might be addressed in the future.     

神经干细胞与脊髓损伤的修复研究现状与展望

神经干细胞在哺乳动物中枢神经许多区域存在,已经从胚胎、胎儿和成人脑组织的不同部位,包 括海马、脑室/室管膜以及从皮质分离出来,能够在体外或体内扩增、分化为神经元和神经胶质。利用神经干 细胞进行细胞替代治疗和基因治疗有很好的临床应用前景,为治疗和修复脊髓损伤带来了希望。移植神经干 细胞或它们的分化产物至宿主脑,继而分化为内生干细胞是很多神经退行性变疾病的潜在治疗方法。     

Evaluation of Bone Marrow- and Brain-Derived Neural Stem Cells in Therapy of Central Nervous System Autoimmunity

Adult subventricular zone (SVZ)-derived neural stem cells (NSCs) have therapeutic effects in experimental autoimmune encephalomyelitis, an animal model of multiple sclerosis. However, SVZ precursor cells as a source of NSCs are not readily accessible for clinical application. In the present study, we demonstrate that NSCs derived from bone marrow (BM) cells exhibit comparable morphological properties as those derived from SVZ cells and possess a similar ability to differentiate into neurons, astrocytes, and oligodendrocytes both in vitro and in vivo. Importantly, both types of NSCs suppressed chronic experimental autoimmune encephalomyelitis to a comparable extent on transplantation. Mechanisms underlying the therapeutic effects of NSCs include immunomodulation in the periphery and the central nervous system (CNS), neuron/oligodendrocyte repopulation by transplanted cells, and enhanced endogenous remyelination and axonal recovery. Furthermore, we provide evidence for the trans-differentiation of transplanted BM-NSCs into neural cells in the CNS, while no fusion of these cells with host neural cells was detected. This is the first study that directly compares SVZ- versus BM-NSCs with regard to in vivo neural differentiation and anti-inflammatory and therapeutic effects on CNS inflammatory demyelination. Their virtually identical therapeutic potential, greater accessibility, and autologous properties make BM-NSCs a novel and highly applicable substitute for SVZ-NSCs in cell-based multiple sclerosis therapies.Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease resulting from an autoimmune response against central nervous system (CNS) myelin. Inflammatory infiltration and demyelination of the CNS are hallmarks of MS and its animal model, experimental autoimmune encephalomyelitis (EAE).^1–3 MS begins when peripherally activated myelin-reactive T cells infiltrate into the CNS, followed closely by other immune cells, including naïve myelin-reactive T cells, polyclonal T cells, macrophages, dendritic cells, B cells, and neutrophils.^1–4 Once in the CNS, myelin-reactive T cells are presented with myelin antigens, and become activated/reactivated, thereby triggering an immunological cascade that results in myelin damage. This process occurs in the initial phase of the disease and continues to some extent during the chronic and relapse phases.^2,5 Despite extensive research aimed at developing pharmacotherapeutic agents to reduce myelin damage, only a few therapies are available (eg, interferon [IFN]-β, glatiramer acetate, and mitoxantrone), all with potential side effects and only modest to moderate efficacy.^1,6Recent studies have shown the therapeutic potential of neural stem cells (NSCs) in EAE.^7–11 NSCs exhibit stem cell properties, including self-renewal, production of a large number of progeny and differentiation into the three primary CNS phenotypes: neurons, astrocytes, and oligodendrocytes. Because NSCs have the ability to support neurogenesis throughout adulthood and exert immunomodulatory properties, they have been evaluated as a renewable source of neural precursors for regenerative transplantation in various CNS diseases, including degenerative disorders, injury, and cancers.^12,13Although NSCs can be isolated from the subventricular zone (SVZ) of adult mammalian CNS, this source of NSCs is hardly accessible for clinical application. This problem led us to search for alternative sources for SVZ-NSCs. Recently it has been shown that cells resembling NSCs can be generated from adult rodent bone marrow (BM). These BM-derived NSCs (BM-NSCs) have similar morphological properties and cellular markers as SVZ-NSCs,^14,15 and are thus potentially a clinically feasible alternative to SVZ-NSCs for therapy of MS.In the present study, we compared the biological and functional properties of NSCs from BM and SVZ in vitro and in vivo. Transplantation of BM-NSCs suppressed EAE to a similar extent as SVZ-NSCs and BM-NSCs had a similar capacity to differentiate into neural cells in vitro and in vivo. The availability of autologous BM-NSCs, ie, the patient him/herself being the donor, represents a great advantage of this approach over other alternatives, such as NSCs derived from cord blood. Equal therapeutic efficacy of BM-NSCs, together with easy accessibility of BM cells and absence of ethical issues, provide a rationale for considering BM-NSCs advantageous to SVZ-NSCs in MS therapy.     

Manipulation of endogenous neural stem cells following ischemic brain injury

The use of cell-based therapy is a valid therapeutic approach to ischemic brain injury. Endogenous neural stem cells (NSCs) have been identified in the central nervous system where they reside largely in the subventricular zone and in the subgranular zone of the hippocampus. Endogenous NSCs are capable of self-renewal and differentiation into functional brain cells. This paper summarizes the evidence recently gathered in support of a therapeutic role for endogenous NSCs in acute experimental stroke.     

To be or not to be accepted: the role of immunogenicity of neural stem cells following transplantation into the brain in animal and human studies

Grafting of neural stem cells into the mammalian central nervous system (CNS) has been performed for some decades now, both in basic research and clinical applications for neurological disorders such as Parkinson's and Huntington's disease, stroke, and spinal cord injuries. Albeit the “proof of principle” status that neural grafts can reinstate functional deficits and rebuild damaged neuronal circuitries, many critical scientific questions are still open. Among them are the manifold immunological aspects that are encountered during the graft–host interaction in vivo. For example, the experience with allografted cells in absence of immunosuppressant drugs has raised serious doubts about an immunological privileged site within the CNS as compared to other engraftment sites in the body. This review discusses recent experimental and clinical findings demonstrating that neural stem cells have unique characteristics that help them modulate the host immunological defense, but, under some conditions, may still trigger a rejection process. Implications of these findings on neural grafting and potential new therapeutic applications are discussed.     

Effect of monolayer cells on sphere cells--two types of cells that emerge during the neural differentiation of mouse embryonic stem cells

Embryonic stem (ES) cells represent a valuable resource for transplantation and tissue engineering applications. For derivation of neural cells, a five-stage differentiation protocol has been widely applied, which involves the propagation of ES cells, formation of embryoid bodies (EBs), selection of neural stem cells (NSCs), expansion of NSCs, and further maturation of NSCs to neurons. During the expansion stage (the fourth stage), two types of cells with distinct morphologies normally emerge, with one type being monolayer cells and the other sphere-like aggregates growing on top of the monolayer cells. In this study, we focus on how the monolayer cells may affect different aspects of aggregate cells, which may have important implications for regenerative medicine. We find that monolayer cells can support the proliferation and decrease the apoptosis rate of sphere cells, as well as facilitate the production of Tuj1-positive cells from sphere cells. In addition, transplantation of monolayer cells into nude mice does not result in tumor formation nor affects the tumorigenicity of sphere cells, when grafted together with monolayer cells.     

Directing the differentiation of embryonic stem cells to neural stem cells.

Embryonic stem cells (ESCs) are a potential source of neural derivatives that can be used in stem cell-based therapies designed to treat neurological disorders. The derivation of specific neuronal or glial cell types from ESCs invariably includes the production of neural stem cells (NSCs). We describe the basic mechanisms of neural induction during vertebrate embryogenesis and how this information helped formulate several protocols used to generate NSCs from ESCs. We highlight the advantages and disadvantages of each approach and review what has been learned about the intermediate stages in the transition from ESC to NSC. Recent data describing how specific growth factors and signaling molecules regulate production of NSCs are described and a model synthesizing this information is presented.