脐血CD34+CD38-早期造血祖细胞的体外增殖和凋亡

为了从适龄产妇脐血中分离出CD34^ CD38^-细胞，在体外较长时间培养后观察分析CD34^ CD38^-细胞分裂增殖、凋亡以及干细胞因子对CD34^ CD38^-细胞增殖的影响，用流式细胞仪从10例健康产妇脐血中分选出CD34^ 和CD38^-标记的脐血原始细胞．在添加IL-3、IL-6、GM—CSF、EPO、IGF—1和SCF6种混合因子的干细胞培养基中培养6个月，观察细胞并绘制生长曲线，用单细胞凝胶电泳检测干细胞因子对CD34^ CD38^-细胞生长的影响和用流式细胞仪检测CD34’CD38细胞凋亡情况。结果表明：脐血CD34^ CD38^-细胞可在体外较长时间培养增殖，无异常或过度的细胞凋亡发生。结论：通过控制培养条件，脐血CD34^ CD38^-早期造血祖细胞可在体外较长时间培养增殖，以作为大量脐血原始细胞移植的细胞来源.     

人胎盘造血干/祖细胞的增殖分化能力

近年来有研究表明，人胎盘组织富含造血干细胞，而且其CD34^＋CD38^-、CD34^＋CD38^＋造血干／祖细胞（HSPC）的百分率明显高于脐血。但有关人胎盘组织CD34^＋HSPC亚群的增殖分化能力的研究却未见报道。我们采用免疫磁珠分选人胎盘组织CD34^＋CD38^-和CD34^＋CD38^＋HSPC亚群，并用不同培养体系进行血细胞集落培养，以评价其增殖分化能力。     

脐血造血干／祖细胞研究进展

脐血和骨髓均富含造血干／祖细胞，但二者在造血干／祖细胞的含量上存在差别。脐血中各CD34^ 细胞亚群有着独特的免疫表型。脐血造血干／祖细胞能在体外扩增，扩增后的CD34^ 细胞能在SCID小鼠体内造血，由脐血CD34^ 细胞可以生成淋巴细胞和内皮细胞。脐血造血干／祖细胞移植与骨髓造血干／祖细胞移植在患者的生存率、复发率及移植免疫排斥等方面均具有可比性，有着极大的潜在价值。     

人脐血CD34+CD38-细胞免疫表型和染色体核型特征分析

目的 分离脐血干／祖细胞(CD34^ CD38)进行体外长期培养，观察分析其增殖、细胞表面分子标志和染色体核型的特征。方法 用流式细胞仪分选CD34-FITC和CD38-PE标记的CD34^ CD38脐血原始细胞，在含细胞生长因子IL-3、IL-6、GM-CSF、EPO、SCF和胰岛素样生长因子的干细胞培养基中培养6个月，用流式细胞术检测体外培养30d的干／祖细胞表面标记，并用G显带方法分析其染色体核型。结果 在一定培养条件下，经7～12d培养，脐血干／祖细胞(CD34^ CD38)开始增殖。培养6个月后，每孔接种1个细胞，细胞数增殖至250～350个；每孔接种10个细胞，细胞数可增殖至400～500个。每孔接种1个细胞其细胞增殖峰持续时间(8～9代)比接种10个细胞(6～7代)长：经体外长期培养增殖，细胞仍强烈显示十／祖细胞表面分子标记(CD34^ CD38^-)；细胞染色体数目、结构未见异常。结论 脐血干／祖细胞(CD34^ CD38^ )经体外特异性培养增殖，可为大量脐血干／祖细胞移植提供细胞来源。     

microRNA在人脐血CD34^＋CD38^-、CD34^＋CD38^＋细胞中的差异性表达

为进一步探讨microRNA（miRNA）在造血调控中的作用奠定基础,比较了miRNA在人脐血CD34^＋CD38^-、CD34^＋CD38^＋细胞中的差异性表达。从人脐血中分离单个核细胞（MNC）,应用FACSVantage分选流式细胞仪分选CD34^＋CD38^-、CD34^＋CD38^＋细胞;抽提miRNA后与miRNA芯片杂交,应用生物信息学技术分析miRNA芯片的表达结果。结果发现,miRNA在人脐血CD34^＋CD38^＋细胞的表达水平比在CD34^＋CD38^-细胞的表达水平降低至1／2以下者共11个,表达水平升高至2倍以上者共73个,以上84个miRNA被称为“干细胞性”miRNA。经比较Georgantas等和芯片表达结果,发现有12个（14、29％,12／84）相同的miRNA。部分miRNA经历了类似于CD34在造血细胞表面的发展历程。应用生物信息学技术可寻找到新的与造血调控相关的miRNA簇及miRNA的下游靶基因。结论：“干细胞性”miRNA在正常造血中发挥着重要作用,即miRNA的系统表达模式一造血干／祖细胞基因表达谱一造血干／祖细胞的自我更新和系列定向分化。     

阵发性睡眠性血红蛋白尿症患者骨髓造血干/祖细胞体外单个细胞培养

目的 研究阵发性睡眠性血红蛋白尿症（PNH）患者单个不同表型骨髓造血干／祖细胞体外生长特性。方法 用免疫磁珠富集C34^ 细胞，用流式细胞仪自动分选系统将患者CD34^ CD59^ 和CD34^ CD59^-造血干／祖细胞单个分选入96孔培养板，进行单个细胞培养，观察不同细胞各个生长指标，并与正常对照细胞比较。结果 ①单个细胞培养条件下，患者CD34^ CD59^-细胞在细胞发生分裂（细胞数≥2个）的比率、形成集落（细胞数≥50）的比率及扩增的总数（所有细胞发生分裂的孔的细胞数的总和）都超过了其CD34^ CD59^ 细胞（P＜0．05）。②PNH CD34^ CD59^-细胞单个细胞扩增的数目及细胞扩增的总数代于正常对照（P＜0．05）。③PNH CD34^ CD59^ 细胞在较大集落（细胞数≥500）形成、单个细胞扩增的数目及细胞扩增总数均低于正常对照（P＜0．01）。④患者异常与正常表型细胞单个细胞次级集落的形成能力差异无显著性（P＞0．05），但都明显低于正常对照。（P＜0．001）。结论 在单个细胞培养条件下，患者异常表型的造血干／祖细胞较其正常表型的造血干／祖细胞具有一定的生长优势。但它们与正常骨髓细胞相比，都存在一定的生长缺陷，正常表型细胞的缺陷尤为明显。     

脐血造血干/祖细胞端粒酶相关蛋白基因hTERT和TEP1的表达及意义

目的：探讨造血／干细胞端粒酶相关蛋白基因hTERT和TEP1在造血过程中对端粒酶活性的调节作用。方法：用RT-PCR和TRAP法分别测定脐血干／祖细胞中hTERT、TEP1mRNA及端粒酶的活性。结果：在新分离的脐血单个核细胞（MNC）和CD34^-细胞中检测不到端粒酶的活性，hTERTmRNA表达阴性；CD34^ 细胞中端粒酶活性低，hTERTmRNA阳性；而TEP1mRNA在MNC、CD34^－细胞和CD34^ 细胞中均为阳性，表达水平差异无显著性。在不同细胞因子组合条件下，CD34^ 细胞体外培养7d，细胞端粒酶活性和hTERTmRNA表达增高，之后随着细胞的分化成熟，二者表达降低，在整个培养过程中，TWEP1mRNA表达无明显变化。结论在脐血造血干／祖细胞中，hTERT基因表达水平与端粒酶活性一致，hTERT基因表达水平对端粒酶的活性起关键作用，TEP1基因作用较弱。     

人脐血及骨髓淋巴细胞免疫表型的比较及其意义

为比较脐血和骨髓淋巴细胞及祖细胞分化抗原，通过流式细胞术（FCM）双标法对38份脐血及10份骨髓免疫细胞表型进行了分析研究。研究发现：（1）脐血及骨髓淋巴细胞中均测到稚淋巴细胞（CD3^-CD4^ )，且前中含量较多，但脐血细胞毒T细胞含量（CTL，CD3^ CD16^ 56^ )低于骨髓；（2）脐血中NK细胞（CD3^-CD16^ 56^ )比例高于骨髓；（3）脐血有核细胞中CD34^ 细胞的比值接近于骨髓，但脐血CD34^ 细胞中髓系祖细胞（CD34^ CD13^ ,CD34^ HLA-DR^ )及淋巴系祖细胞（CD34^ CD19^ )含量均低于骨髓，结论：（1）脐血免疫细胞具有不成熟性，这估计是脐血移植后GVHD程度轻的主要原因；（2）脐血淋巴细胞中NK细胞含量较高，推测脐血移植后移植物抗白血病效应（GVL）并不会降低；（3）脐血CD34^ 细胞中髓系祖细胞及淋巴系祖细胞比例均低于骨髓，可能是脐血移植后造血及免疫重建速度较慢的原因之一。     

脐血造血干／祖细胞的密度分离实验研究

目的：为建立脐血造血细胞库,减少脐血储存空间,探讨脐血造血干／祖细胞的密度分离效果。方法：选用五种不同比密的Ficoll分离液（1.084、1.077、1.072、1.064、1.054g/L）分离脐血细胞,采用流式细胞技术（FCM）和全自动血细胞分析仪分析了41例脐血造血干／祖细胞和有核细胞（NC）的回收率并作了对比研究。结果：1.064g/L Ficoll分离脐血有核细胞回收率3.6％,淋巴细胞去除率为86.6％;所分离的单个核细胞(MNC）中CD34^ 细胞平均纯度为10.3％,最高可高达46.6％;所分离的细胞体外易形成CFU－GM及BFU－E。结论：不同比密分离脐血造血干／祖细胞具有不同影响。其中1.064g/L Ficoll分离脐血造血干／祖细胞是一种方便、实用、有效的方法。所分离的细胞体外有较强的增殖能力。     

脐血造血干/祖细胞研究进展

脐血和骨髓均富含造血干/祖细胞,但二者在造血干/祖细胞的含量上存在差别。脐血中各CD34~+细胞亚群有着独特的免疫表型。脐血造血干/祖细胞能在体外扩增,扩增后的CD34~+细胞能在SCID小鼠体内重建造血。由脐血CD34~+细胞可以生成淋巴细胞和内皮细胞。脐血造血干/祖细胞移植与骨髓造血干/祖细胞移植在患者的生存率、复发率及移植免疫排斥等方面均具有可比性,有着极大的潜在价值。     

Tpo、IL-11基因修饰的基质细胞对CD34+CD38-早期造血祖细胞扩增的影响

目的　观察经Tpo、IL 11基因修饰的基质细胞对脐血CD3 4 + CD3 8-细胞体外扩增的影响。方法　用载有Tpo、IL 11基因的重组逆转录病毒感染成纤维样基质细胞HFCL ,通过Northernblot法检测基因修饰的HFCL细胞Tpo、IL 11基因的表达。以未经基因修饰的HFCL细胞作为对照 ,将脐血CD3 4 + 造血干 /祖细胞在这种基因修饰的HFCL细胞支持下 ,进行 7d体外扩增后 ,用锥虫蓝拒染法计数活细胞总数 ,并用流式细胞仪分析扩增细胞中CD3 4 + 细胞以及CD3 4 + CD3 8-细胞的比例。结果　在Tpo基因修饰的HFCL细胞、IL 11基因修饰的HFCL细胞和Tpo +IL 11基因共同修饰的HFCL细胞的支持下 ,扩增后CD3 4 + CD3 8-早期造血祖细胞的比例分别为 (1.8± 0 .2 4 ) %、(1.6 2± 0 .2 3) %、(2 .4 5±0 2 8) % ,细胞扩增倍数为 4 .2倍、3.6倍、6 .9倍 ,高于对照组的 (0 .80± 0 .2 3) %和 1.5倍 ,同时扩增细胞总数和CD3 4 + 细胞比例亦高于未经基因修饰的HFCL细胞所支持的扩增体系。结论　Tpo、IL 11基因修饰的基质细胞可有效促进脐血CD3 4 + 造血干 /祖细胞体外扩增 ,同时能有效维持扩增体系中的CD3 4 + CD3 8-细胞以及促进其扩增。     

Tumor necrosis factor alpha is a potent synergistic factor for the proliferation of primitive human hematopoietic progenitor cells and induces resistance to transforming growth factor beta but not to interferon gamma

Since tumor necrosis factor (TNF)-alpha, interferon (IFN)-gamma, and transforming growth factor (TGF)-beta have all been shown to be specific inhibitors of early human hematopoiesis, we wanted to investigate the interactions of these three cytokines on very primitive human adult bone marrow CD34++CD38- hematopoietic progenitor cells, using a pre-colony-forming cell (pre-CFC) assay, which detects the effects of these cytokines on the initial phases of the differentiation of these primitive progenitors, which are unresponsive to interleukin (IL) 3 alone. Surprisingly, TNF-alpha was a very potent stimulator of the proliferation of CD34++CD38- cells and was the most potent synergistic factor for the IL-3-induced proliferation of these cells of all cytokines tested (IL-1, IL-6, granulocyte colony-stimulating factor, kit ligand). TNF-alpha was the only cytokine that, as a single added factor, induced substantial proliferation in CD34++CD38- cells in the presence of IL-3, except for kit ligand, which induced very limited proliferation. TNF-alpha, moreover, induced a high degree of resistance to the inhibitory effects of TGF-beta in a dose-dependent way. The inhibitory effects of IFN-gamma, however, were not affected by the presence of TNF-alpha. We hypothesize that in situations of the hematopoietic stress, TNF-alpha may abrogate the inhibitory effect of ambient TGF-beta in the bone marrow microenvironment to allow primitive stem cells to proliferate and differentiate in response to an increased demand for mature blood cells.     

阵发性睡眠性血红蛋白尿症患者骨髓CD34+CD59+细胞与CD34+CD59-细胞生物学性能的研究

目的 探讨阵发性睡眠性血红蛋白尿症(PNH)患CD34^ CD59^ 细胞的特性及PNH克隆呈优势造血的可能原因，以探索PNH发病的内在机制。方法 用免疫磁珠吸附法富集纯化CD34^ 细胞，再用流式细胞仪分选出PNH患的CD34^ CD59^ 细胞、CD34^ CD59^ 细胞及正常对照CD34^ 细胞。分别进行体外扩增液体培养2周，并对扩增前、后的细胞进行半固体培养。结果 ①PNH患CD34^ CD59^ 细胞与正常对照CD34^ 细胞形成集落形成单位(CFU)均在第7天达到扩增高峰，并且扩增后的细胞仍能保持CD59抗原，无GPI锚连蛋白的丢失。②正常对照的CD34^ 细胞在生存、增殖、形成CFU及扩增能力上均明显强于FHN患的CD34^ CD59^ 细胞及CD34^ CD59^-细胞.③PNH患CD34^ CD59^ 细胞及CD34^ CD59^ 细胞体外半固体培养，其形成CFU的能力无明显差异。④PNH患CD34^ CD59^ 细胞及CD34^ CD59^ 细胞在SCF IL3 IL6 FL Tpo及SCF IL3 IL6 FL Tpo Epo组合下液体培养，其生存、增殖、扩增等能力上均无明显差异。但在SCF IL3 IL6 FL Tpo Epo GM-CSF组合下液体培养，CD34^ CD59^ 细胞的生存、增殖、扩增能力均明显强于CD34^ CD59^ 细胞。结论 ①正常对照的CD34^ 细胞在生存、增殖、形成CFU及扩增能力上均明显强于PNH患的CD34^ CD59^ 细胞。②PNH患CD34^ CD59^ 细胞及CD34^ CD59^ 细胞体外半固体培养，以及在SCF IL3 IL6 LF Tpo及SCF IL3 IL6 FL Tpo Ep组合下液体培养，其生存、增殖、扩增等能力上均无明显差异，说明CD34^ CD59^ 细胞在造血能力上并无内在的优势。GM—CSF或许是使PNH克隆呈造血优势的原因之一。     

脐血CD34+细胞与单个核细胞的体外扩增特性研究

目的　探讨CD34+ 富集细胞和单个核细胞 (MNC)的体外扩增特性。方法　利用Min iMACS系统富集CD34+ 细胞 ,在相同条件下与同批MNC进行对照培养 ;观察了再次富选和MNC培养上清 (MNC SN)对CD34+ 富集细胞扩增的影响 ;并尝试了MNCCD34- 细胞的培养。结果　虽然CD34+ 富集细胞具有很高的扩增潜力 ,但在培养过程中 ,其集落密度和CD34 + 细胞含量却始终呈下降趋势 ,而MNC在培养中却出现了一个上升的趋势 ,集落密度和CD34+ 细胞含量分别由第 0天的 (4 12± 16 7) 10 5细胞和 (1.12± 0 .4 2 ) %增至第 7天的 (116 2± 5 6 6 ) 10 5细胞和 (4 .17± 1.4 4 ) % ;再次富选可以使培养过的CD34+ 富集细胞的总细胞和CD34+ 细胞扩增能力大大提高 ;MNCCD34- 细胞具有集落形成和转化为CD34+ 细胞的能力 ;MNC SN对CD34+ 富集细胞的集落形成有促进作用 ,而同时又对CD34+ 细胞有促分化作用。结论　CD34+ 富集细胞在体外大量扩增的同时存在大量分化 ,其在培养过程中产生的CD34-细胞对CD34+ 细胞的扩增有抑制作用 ;脐血MNC中大量的CD34- 细胞含有造血干 祖细胞 ,其分泌的细胞因子有促进CD34+ 细胞向较为成熟的集落形成祖细胞分化的作用。     

人胎盘造血干/祖细胞及淋巴细胞亚群表型的研究

目的　探讨人胎盘组织中是否含有造血干 祖细胞 (HSPC) ,并分析其淋巴细胞亚群的表型特征。方法　将新鲜胎盘制成单个细胞悬液 ,用流式细胞仪分析其有核细胞中HSPC、淋巴细胞及其亚群的表型特征 ,并用流式细胞术 (FCM)或MiniMACS分选胎盘CD34 细胞。结果　胎盘CD34 细胞百分率是脐带血的 8.8倍 ,CD34 CD38- 细胞和CD34 CD38 细胞百分率分别为脐带血的 4 .6倍和 11.9倍 ;FCM分选胎盘CD34 细胞的回收率和纯度分别为 (6 3.0 5± 10 .14 ) %和 (86 .39± 11.2 7) % ;胎盘中的淋巴细胞总数、T细胞 (CD3 CD2 )、B细胞 (CD1 9 )、Th(CD3 CD4 )细胞及Th Ts比值均明显低于脐带血 ,而CD8 CD2 8- T抑制细胞则明显高于脐带血。结论　人胎盘富含HSPC ,在胎儿期具有重要的造血功能 ,可望成为HSPC移植的重要资源。CD8 CD2 8- T抑制细胞可能在胎 母免疫耐受中起重要作用。     

人脐血造血细胞扩增后表面标志的动态研究

目的 探讨脐血造血细胞体外扩增及其移植的最佳时机。方法 用粒细胞集落刺激因子、粒－巨噬细胞集落刺激因子、重组人白细胞介素３、重组白细胞介素６、干细胞因子和红细胞生成素长期培养脐血造血细胞,并对其表面标志及细胞增殖周期进行动态分析。结果 脐血中ＣＤ３＾＋细胞、ＣＤ４＾＋／ＣＤ４５ＲＯ＾＋和ＣＤ８＾＋／ＣＤ４５ＲＯ＾＋细胞培养３ｄ稍有增加,培养７ｄ达高峰,１４ｄ显下降,培养２１ｄ时处于更低水平。ＣＤ     

Cytokines increase human hemopoietic cell adhesiveness by activation of very late antigen (VLA)-4 and VLA-5 integrins

Cytokines are known to be important regulators of normal hemopoiesis, acting in concert with components of the bone marrow microenvironment. Interactions with this microenvironment are known to regulate the proliferation, differentiation, and homing of hemopoietic progenitor (CD34+) cells. Adhesive interactions with the extracellular matrix retain CD34+ cells in close proximity to cytokines, but may also provide important costimulatory signals. Thus, the functional states of adhesion receptors are critical properties of CD34+ cells, but the physiological mechanisms responsible for regulating functional properties of cell adhesion receptors on primitive hemopoietic cells are still unknown. We confirm that the integrins very late antigen (VLA)-4 and VLA-5 are expressed on the CD34+ cell lines MO7e, TF1, and on normal bone marrow CD34+ progenitor cells, but in a low affinity state, conferring on them a weak adhesive phenotype on fibronectin (Fn). Herein, we show that the cytokines interleukin (IL)-3, granulocyte-macrophage CSF (GM-CSF), and KIT ligand (KL) are physiological activators of VLA-4 and VLA-5 expressed by MO7e, TF1, and normal bone marrow CD34+ progenitor cells. Cytokine-stimulated adhesion on Fn is dose dependent and transient, reaching a maximum between 15 and 30 min and returning to basal levels after 2 h. This cytokine- dependent activation is specific for VLA-4 and VLA-5, since activation of other beta 1 integrins was not observed. The addition of second messenger antagonists staurosporine and W7 abolished all cytokine- stimulated adhesion to Fn. In contrast, genistein inhibited KL- stimulated adhesion, but failed to inhibit GM-CSF- and IL-3-stimulated adhesion. Our data suggest that cytokines GM-CSF and IL-3 specifically stimulate beta 1 integrin function via an "inside-out" mechanism involving protein kinase activity, while KL stimulates integrin activity through a similar, but initially distinct, pathway via the KIT tyrosine-kinase. Thus, in addition to promoting the survival, proliferation, and development of hemopoietic progenitors, cytokines also regulate adhesive interactions between progenitor cells and the bone marrow microenvironment by modifying the functional states of specific integrins. These data are of importance in understanding the fundamental processes of beta 1 integrin activation and cellular response to mitogenic cytokines as well as on the clinical setting where cytokines induce therapeutic mobilization of hematopoietic progenitors.     

In vitro self-renewal division of hematopoietic stem cells

Little is known about how hematopoietic stem cells (HSCs) self-renew. We studied the regeneration of HSCs in culture. Effects of various cytokines on cell division of CD34(-/low) c-Kit(+)Sca-1(+) lineage marker-negative (CD34(-)KSL) bone marrow cells of the mouse were first evaluated in serum-free single cell culture. We then performed a competitive repopulation assay on divided cells to ask if such cell division involved self-renewal of HSCs.In the presence of stem cell factor (SCF), thrombopoietin (TPO) induced a first cell division of CD34(-)KSL cells more efficiently than did interleukin (IL)-3 or IL-6. Multilineage repopulating cells were detected in a significant proportion of cells derived from single cells in culture with TPO and SCF, although this culture condition led to a substantial decrease in HSC number. These regenerated repopulating cells could be further transplanted into secondary recipients. When paired daughter cells were separately studied, one of a pair gave rise to repopulating cells with self-renewal potential, suggesting asymmetric self-renewal division. This study provides evidence that one HSC regenerates at least one HSC in culture.     

Optimization of gene transfer into primitive human hematopoietic cells of granulocyte-colony stimulating factor-mobilized peripheral blood using low-dose cytokines and comparison of a gibbon ape leukemia virus versus an RD114-pseudotyped retroviral vector

Primitive human hematopoietic cells in granulocyte-colony stimulating factor (G-CSF)-mobilized peripheral blood (MPB) are more difficult to transduce compared to cells from umbilical cord blood. Based on the hypothesis that MPB cells may require different stimulation for efficient retroviral infection, we compared several culture conditions known to induce cycling of primitive hematopoietic cells. MPB-derived CD34(+) cells were stimulated in the presence or absence of the murine fetal liver cell line AFT024 in trans-wells with G-CSF, stem cell factor (SCF), and thrombopoietin (TPO) (G/S/T; 100 ng/ml) or Flt3-L, SCF, interleukin (IL)-7, and TPO (F/S/7/T; 10-20 ng/ml), and transduced using a GaLV-pseudotyped retroviral vector expressing the enhanced green fluorescence protein (eGFP). Compared to cultures without stroma, the presence of AFT024 increased the number of transduced colony-forming cells (CFC) by 3.5-fold (with G/S/T), long-term culture-initiating cells (LTC-IC) by 4.6-fold (with F/S/7/T), and nonobese diabetic/severe immunodeficiency disease (NOD/SCID)-repopulating cells (SRC) by 6.8-fold (with F/S/7/T). Similar numbers of long-term culture-initiating cells (LTC-IC) and SRC could be transduced using AFT024-conditioned medium (AFT-CM) or a defined medium that had been supplemented with factors identified in AFT-CM. Finally, using our best condition based on transduction with the gibbon ape leukemia virus (GaLV)-pseudotyped vector, we demonstrate a 33-fold higher level of gene transfer (p < 0.001) in SRC using an RD114-pseudotyped vector. In summary, using an optimized protocol with low doses of cytokines, and transduction with an RD114 compared to a GaLV-pseudotyped retroviral vector, the overall number of transduced cells in NOD/SCID mice could be improved 144-fold, with a gene-transfer efficiency in SRC of 16.3% (13.3-19.9; n = 6).