Summary Embryonic stem cells (ESCs) of mice and humans have distinct molecular and biological characteristics, raising the question whether an earlier ‘naive’ state of pluripotency may exist in humans. Here we took a systematic approach to identify small molecules that support self-renewal of naive human ESCs based on maintenance of endogenous OCT4 distal enhancer activity, a molecular signature of ground state pluripotency. Iterative chemical screening identified a combination of five kinase inhibitors that induces and maintains OCT4 distal enhancer activity when applied directly to conventional human ESCs. These inhibitors generate human pluripotent cells in which transcription factors associated with the ground state of pluripotency are highly upregulated and bivalent chromatin domains are depleted. Comparison with previously reported naive human ESCs indicates that our conditions capture a distinct pluripotent state in humans that closely resembles mouse ESCs. This study presents a framework for defining the culture requirements of naive human pluripotent cells.

EpCAM was found to be overexpressed on epithelial progenitors, carcinomas and cancer-initiating cells. The role of EpCAM in proliferation, and its association with cancer is poorly explained by proposed cell adhesion functions. Here we show that regulated intramembrane proteolysis activates EpCAM as a mitogenic signal transducer in vitro and in vivo. This involves shedding of its ectodomain EpEX and nuclear translocation of its intracellular domain EpICD. Cleavage of EpCAM is sequentially catalysed by TACE and presenilin-2. Pharmacological inhibition or genetic silencing of either protease impairs growth-promoting signalling by EpCAM, which is compensated for by EpICD. Released EpICD associates with FHL2, beta-catenin and Lef-1 to form a nuclear complex that contacts DNA at Lef-1 consensus sites, induces gene transcription and is oncogenic in immunodeficient mice. In patients, EpICD was found in nuclei of colon carcinoma but not of normal tissue. Nuclear signalling of EpCAM explains how EpCAM functions in cell proliferation.

Direct reprogramming of human fibroblasts to induced pluripotent stem cells (iPS) has been achieved by ectopic expression of defined transcription factors. Derivation of human fibroblasts however is a time consuming process and requires punch biopsies or isolation of patient foreskin. Here we use a polycistronic vector encoding Oct4, Klf4, Sox2 and c-Myc to generate iPS cells from from frozen peripheral blood of several donors. Genomic DNA analyses indicated that iPS cells were derived from mature T cells as well as myeloid donor cells. Inducing pluripotency in peripheral blood would allow utilization of easy to get samples from the adult and, more importantly, provide convenient access to numerous patient samples stored in blood banks. The latter is of major interest as frozen blood samples, when reprogrammed to iPS cells, would allow the retrospective molecular analyses of rare diseases.

SUMMARY Autophagy dysfunction has been implicated in misfolded protein accumulation and cellular toxicity in several diseases. Whether alterations in autophagy also contribute to the pathology of lipid storage disorders is not clear. Here we show defective autophagy in Niemann-Pick type C1 (NPC1) disease associated with cholesterol accumulation, where maturation of autophagosomes is impaired due to defective amphisome formation caused by failure in SNARE machinery, whilst the lysosomal proteolytic function remains unaffected. Expression of functional NPC1 protein rescues this defect. Inhibition of autophagy also causes cholesterol accumulation. Compromised autophagy was seen in disease-affected organs of Npc1 mutant mice. Of potential therapeutic relevance is that HP-β-cyclodextrin, which is used for cholesterol depletion treatment, impedes autophagy, whereas stimulating autophagy restores its function independent of amphisome formation. Our data suggest that a low dose of HP-β-cyclodextrin that does not perturb autophagy, coupled with an autophagy inducer, may provide a rational treatment strategy for NPC1 disease.