Brain pericytes play important roles in the formation and maintenance of the neurovascular unit (NVU), and their dysfunction has been implicated in central nervous system disorders. While human pluripotent stem cells (hPSCs) have been used to model other NVU cell types, including brain microvascular endothelial cells (BMECs), astrocytes, and neurons, hPSC-derived brain pericyte–like cells have not been integrated into these models. In this study, we generated neural crest stem cells (NCSCs), the embryonic precursor to forebrain pericytes, from hPSCs and subsequently differentiated NCSCs to brain pericyte–like cells. These cells closely resembled primary human brain pericytes and self-assembled with endothelial cells. The brain pericyte–like cells induced blood-brain barrier properties in BMECs, including barrier enhancement and reduced transcytosis. Last, brain pericyte–like cells were incorporated with iPSC-derived BMECs, astrocytes, and neurons to form an isogenic human model that should prove useful for the study of the NVU.

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Initially thought of as primarily a respiratory infection, SARS-CoV-2 is now implicated in substantial central nervous system (CNS) pathology [1][2][3] . CNS symptoms include ischemic strokes, hemorrhages, seizures, encephalopathy, encephalitis/meningitis, anosmia, postinfectious syndromes and neurovasculopathy, collectively described in up to 85% of intensive care unit patients [4][5][6][7] . Several reports appear to meet established criteria for infectious encephalitis 8 . SARS-CoV-2 can utilize angiotensin-converting enzyme 2 (ACE2) as a receptor, although other receptors have been proposed 9,10 . Recent studies on single-cell RNA sequencing (scRNA-seq) datasets indicated low levels of ACE2 expression in brain cells; however, expression is relatively high in some neurovascular unit (NVU) components, particularly in brain pericytes [11][12][13][14] . Autopsy series have suggested the potential for SARS-CoV-2 to spread throughout the brain, especially within vascular and immune cells. They note ischemic brain lesions accompanied by widespread activation of astrocytes and cell death 1,15 . The potential for a SARS-CoV-2 elicited neurovasculopathy supports the development of new models to study tropism and pathology.Brain pericytes are derived from neural crest stem cells (NCSCs) and are uniquely positioned in the NVU, physically linking endothelial and astrocytic cells 16 . Embedded within the basement membrane, pericytes connect, coordinate and regulate signals from neighboring cells to generate responses critical for CNS function in both healthy and disease states, including blood-brain barrier permeability, neuroinflammation, neuronal differentiation and neurogenesis in the adult brain [17][18][19] . Results SARS-CoV-2 productively infects PLCs.We found that green fluorescent protein (GFP) + PLCs generated in vitro from human pluripotent stem cell (hPSC)-derived NCSCs expressed the standard pericyte markers NG2 and PDGFR-β (Fig. 1a,b) 20 . We detected appreciable ACE2 messenger RNA and protein in PLCs cultured two-dimensionally compared with cultured human neural precursors (Extended Data Fig. 1a-d) 14,21 . To assess SARS-CoV-2 PLC tropism, we exposed PLCs to authentic SARS-CoV-2 at a multiplicity of infection (MOI) of 0.5, then collected the supernatant and cells daily (Fig. 1c). We found that the percentage of SARS-CoV-2 nucleocapsid protein + cells and viral RNA as measured by quantitative PCR with reverse transcription (RT-qPCR) increased daily up to 72 h postinfection, from 0 to 65% SARS-CoV-2 nucleocapsid protein + , with viral RNA load increasing up to approximately 1,000-fold (Fig. 1d,e). Plaque assay from the PLC supernatants on Vero E6 cells showed approximately 100-fold increased infectious virus production at 24 h postinfection with increased viral RNA as well as viral titers compared to baseline, suggesting viral production by PLCs (Fig. 1f-h) 22 . Furthermore, we found that ACE2 receptor-blocking antibody partially prevented SARS-CoV-2 infection of PLCs (Extended Data Fig. 2a-e) 23 .PCCO generat...

The brain vasculature maintains brain homeostasis by tightly regulating ionic, molecular, and cellular transport between the blood and the brain parenchyma. These blood-brain barrier (BBB) properties are impediments to brain drug delivery, and brain vascular dysfunction accompanies many neurological disorders. The molecular constituents of brain microvascular endothelial cells (BMECs) and pericytes, which share a basement membrane and comprise the microvessel structure, remain incompletely characterized, particularly in humans. To improve the molecular database of these cell types, we performed RNA sequencing on brain microvessel preparations isolated from snap-frozen human and mouse tissues by laser capture microdissection (LCM). The resulting transcriptome datasets from LCM microvessels were enriched in known brain endothelial and pericyte markers, and global comparison identified previously unknown microvessel-enriched genes. We used these datasets to identify mouse-human species differences in microvessel-associated gene expression that may have relevance to BBB regulation and drug delivery. Further, by comparison of human LCM microvessel data with existing human BMEC transcriptomic datasets, we identified novel putative markers of human brain pericytes. Together, these data improve the molecular definition of BMECs and brain pericytes, and are a resource for rational development of new brain-penetrant therapeutics and for advancing understanding of brain vascular function and dysfunction. The blood-brain barrier (BBB) regulates blood flow, supplies the brain with nutrients, and facilitates clearance of a variety of substances. The BBB is comprised of brain microvascular endothelial cells (BMECs), the principal barrier-forming cell. BMECs are also intimately associated with brain pericytes, mural cells that line the outside of microvessels and are linked to endothelial cells by a shared vascular basement membrane 1. The BBB is required to maintain brain homeostasis, but also prevents clinically relevant doses of many therapeutics from entering the brain 2,3. Brain vascular dysfunction plays a role in several neurological disorders, including some with cellautonomous defects in BMEC or pericyte function 4-7. Due to its role in neurological disorders and important implications for brain drug delivery, the brain vasculature has been the subject of intense research, often focused on identifying mechanisms underlying its unique behavior. Our understanding of brain vascular development, function, dysfunction, and molecular constituents, however, has been advanced largely by mouse models. The scarcity of human brain tissue and low abundance of brain vascular cells has limited molecular profiling of the human brain vasculature. Improved molecular understanding of human BMECs and pericytes could aid in the development of new BBB-penetrant therapeutics and advance new hypotheses about mechanisms of brain vascular dysfunction in disease. Mouse brain vascular cells have previously been isolated and transcriptionally prof...

The blood-brain barrier (BBB) regulates the transport of ions, nutrients, and metabolites to help maintain proper brain function. This restrictive interface formed by brain microvascular endothelial cells excludes the majority of small and large molecule drugs from entering the brain, and blood-brain barrier dysfunction is a signature of many neurological diseases. Thus, models of the BBB based on brain endothelial cells have been developed to facilitate screening drugs for BBB permeability. However, while brain endothelial cells form the main interface, they work in concert with other brain-resident cells such as neural progenitor cells, pericytes, astrocytes, and neurons to form the neurovascular unit (NVU). Importantly, non-endothelial cells of the NVU play key roles in eliciting BBB phenotypes and in regulating the dynamic responses of the BBB to brain activity and disease. As a result, emerging BBB models have incorporated these NVU cell types in addition to endothelial cells. These multicellular BBB or NVU models have found increasing application not only in drug screening, but also in studying complex cellular and molecular mechanisms underlying BBB biology and disease.

Brain pericytes play an important role in the formation and maintenance of the neurovascular unit (NVU), and their dysfunction has been implicated in central nervous system (CNS) disorders. While human pluripotent stem cells (hPSCs) have been used to model other components of the NVU including brain microvascular endothelial cells (BMECs), astrocytes, and neurons, cells having brain pericyte-like phenotypes have not been described. In this study, we generated neural crest stem cells (NCSCs), the embryonic precursor to forebrain pericytes, from human pluripotent stem cells (hPSCs) and subsequently differentiated NCSCs to brain pericyte-like cells. The brain pericyte-like cells expressed marker profiles that closely resembled primary human brain pericytes, and they self-assembled with endothelial cells to support vascular tube formation. Importantly, the brain pericyte-like cells induced blood-brain barrier (BBB) properties in BMECs, including barrier enhancement and reduction of transcytosis. Finally, brain pericyte-like cells were incorporated with iPSC-derived BMECs, astrocytes, and neurons to form an isogenic human NVU model that should prove useful for the study of the BBB in CNS health, disease, and therapy.

Background: Brain microvascular endothelial cells (BMECs) astrocytes, neurons, and pericytes form the neurovascular unit (NVU). Interactions with NVU cells endow BMECs with extremely tight barriers via the expression of tight junction proteins, a host of active efflux and nutrient transporters, and reduced transcellular transport. To recreate the BMEC-enhancing functions of NVU cells, we combined BMECs, astrocytes, neurons, and brain pericyte-like cells. Methods: BMECs, neurons, astrocytes, and brain like pericytes were differentiated from human induced pluripotent stem cells (iPSCs) and placed in a Transwell-type NVU model. BMECs were placed in co-culture with neurons, astrocytes, and/or pericytes alone or in varying combinations and critical barrier properties were monitored. Results: Co-culture with pericytes followed by a mixture of neurons and astrocytes (1:3) induced the greatest barrier tightening in BMECs, supported by a significant increase in junctional localization of occludin. BMECs also expressed active P-glycoprotein (PGP) efflux transporters under baseline BMEC monoculture conditions and continued to express baseline active PGP efflux transporters regardless of co-culture conditions. Finally, brain-like pericyte co-culture significantly reduced the rate of non-specific transcytosis across BMECs. Conclusions: Importantly, each cell type in the NVU model was differentiated from the same donor iPSC source, yielding an isogenic model that could prove enabling for enhanced personalized modeling of the NVU in human health and disease.

Summary We describe the extended endothelial cell culture method (EECM) for the differentiation of human pluripotent stem cells (hPSCs) into brain microvascular endothelial cell (BMEC)-like cells. EECM-BMEC-like cells resemble primary human BMECs in morphology, molecular junctional architecture, and diffusion barrier characteristics. A mature immune phenotype with proper endothelial adhesion molecule expression makes this model distinct from any other hPSC-derived in vitro blood-brain barrier (BBB) model and suitable to study immune cell migration across the BBB in a disease relevant and personalized fashion. For complete details on the use and execution of this protocol, please refer to Lian et al. (2014) , Nishihara et al. (2020a) .