Amniotic fluid (AF) possesses anti-inflammatory, anti-microbial and regenerative properties that make it attractive for use in clinical applications. The goals of this study were to assess the feasibility of collecting AF from full-term pregnancies and to evaluate non-cellular and cellular properties of AF for clinical applications. Donor informed consent and medical histories were obtained from pregnant women scheduled for C-sections and infectious disease testing was performed the day of collection. AFs were evaluated for total volume, fluid chemistries, total protein, and hyaluronic acid (HA) levels. AF was also assessed with quantitative antibody arrays, cellular content and for an ability to support angiogenesis. Thirty-six pregnant women consented and passed donor screening to give birth tissue. AF was successfully collected from 17 individuals. Median AF volumes were 70 mL (range 10-815 mL; n = 17). Fluid chemistries were similar, but some differences were noted in HA levels and cytokine profiles. Cytokine arrays revealed that an average of 304 ± 20 of 400 proteins tested were present in AF with a majority of cytokines associated with host defense. AF supported angiogenesis. Epithelioid cells were the major cell type in AF with only a minor population of lymphoid cells. Cultures revealed a highly proliferative population of adherent cells capable of producing therapeutic doses of mesenchymal stromal cells (MSCs). These findings showed that significant volumes of AF were routinely collected from full-term births. AF contained a number of bioactive proteins and only a rare population of MSCs. Variations noted in components present in different AFs, warrant further investigations to determine their relevance for specific clinical applications.
Background
Efforts are underway to eliminate fetal bovine serum (FBS) from mammalian cell cultures for clinical use. An emerging viable replacement option for FBS is human platelet lysate (PL) either as a plasma (PL-P) or serum (PL-S) based product.
Study Design and Methods
Nine industrial scale PL-S manufacturing runs (i.e. lots) were performed that consisted of an average volume of 24.6±2.2 liters of pooled platelet-rich-plasma (PRP) units that were obtained from apheresis donors. Manufactured lots were compared by evaluating various biochemical and functional test results. Comprehensive cytokine profiles of PL lots and product stability testing was performed. Global gene expression profiles of Mesenchymal Stromal Cells (MSCs) when cultured with PL-S or PL-P were compared with FBS.
Results
Electrolyte and protein levels were relatively consistent among all PL-S lots with only slight variations in glucose and calcium levels. All nine lots were as good as or better than FBS in expanding MSCs. PL-S stored at −80°C remained stable over two years. Quantitative cytokine arrays showed similarities as well as dissimilarities in the proteins present in PL-S. Greater differences in MSC gene expression profiles were attributable to the starting cell source than as to whether PL or FBS were used as culture supplements.
Conclusion
Using a large-scale standardized method, lot-to-lot variations were noted for industrial scale preparations of PL-S. However, all lots were as good as or better than FBS in supporting MSC growth. Together these data indicate that off-the-shelf PL is a feasible substitute for FBS in MSC cultures.
Mobilization failure rates were <5% across all thresholds. Mobilization costs were comparable. Conclusion: We demonstrate that a liberal strategy for plerixafor administration correlates with fewer apheresis days while having similar mobilization costs. There were 26 fewer days of collection per 100 mobilization attempts with a pCD34 threshold of 40/μL compared to 15/μL at our institution. More patients completed collection in one day, and more reached an optimal collection yield.
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