Mesenchymal stem cells (MSCs) represent a great therapeutic promise in pre-clinical models of osteoarthritis (OA), but many questions remain as to their therapeutic mechanism of action: engraftment versus paracrine action. Encapsulation of human MSCs (hMSCs) in sodium alginate microspheres allowed for the paracrine signaling properties of these cells to be isolated and studied independently of direct cellular engraftment. The objective of the present study was to quantitatively assess the efficacy of encapsulated hMSCs as a disease-modifying therapeutic for OA, using a medial meniscal tear (MMT) rat model. It was hypothesized that encapsulated hMSCs would have a therapeutic effect, through paracrine-mediated action, on early OA development.Lewis rats underwent MMT surgery to induce OA. 1 d post-surgery, rats received intra-articular injections of encapsulated hMSCs or controls (i.e., saline, empty capsules, non-encapsulated hMSCs). Microstructural changes in the knee joint were quantified using equilibrium partitioning of a ionic contrast agent based micro-computed tomography (EPIC-μCT) at 3 weeks post-surgery, an established time point for early OA.Encapsulated hMSCs significantly attenuated MMT-induced increases in articular cartilage swelling and surface roughness and augmented cartilaginous and mineralized osteophyte volumes.Cellular encapsulation allowed to isolate the hMSC paracrine signaling effects and demonstrated that hMSCs could exert a chondroprotective therapeutic role on early stage OA through paracrine signaling alone. In addition to this chondroprotective role, encapsulated hMSCs augmented the compensatory increases in osteophyte formation. The latter should be taken into strong consideration as many clinical trials using MSCs for OA are currently ongoing.
Neutrophil extracellular traps (NETs) are implicated in autoimmune, thrombotic, malignant, and inflammatory diseases; however, little is known of their endogenous regulation under basal conditions. Inflammatory effects of neutrophils are modulated by extracellular purines such as adenosine (ADO) that is inhibitory or ATP that generally up‐regulates effector functions. In order to evaluate the effects of ADO on NETs, human neutrophils were isolated from peripheral venous blood from healthy donors and stimulated to make NETs. Treatment with ADO inhibited NET production as quantified by 2 methods: SYTOX green fluorescence and human neutrophil elastase (HNE)‐DNA ELISA assay. Specific ADO receptor agonist and antagonist were tested for their effects on NET production. The ADO 2A receptor (A2AR) agonist CSG21680 inhibited NETs to a similar degree as ADO, whereas the A2AR antagonist ZM241385 prevented ADO's NET‐inhibitory effects. Additionally, CD73 is a membrane bound ectonucleotidase expressed on mesenchymal stromal cells (MSCs) that allows manipulation of extracellular purines in tissues such as bone marrow. The effects of MSCs on NET formation were evaluated in coculture. MSCs reduced NET formation in a CD73‐dependent manner. These results imply that extracellular purine balance may locally regulate NETosis and may be actively modulated by stromal cells to maintain tissue homeostasis.
Functional lymphatic drainage inherently modulates cardiac function by maintaining the immune response and tissue-fluid homeostasis. During cardiac transplantation, the lymphatic collecting vessels are severed at the time of heart excision and not surgically reconstructed in the recipient. The consequence resulting from impaired lymphatic drainage in transplanted hearts is unknown. We hypothesize disruption of lymphatic drainage potentiates chronic inflammation by impeding the egress of immune cells and pro-inflammatory cytokines out of the myocardium exacerbating transplant rejection. Methods: Banked human allograft biopsies were utilized to retrospectively evaluate lymphatic differences between patients that did and did not develop chronic transplant rejection from 1 week to 5 years after surgery. Immunofluorescence staining permitted quantification of normalized lymphatic vessel number and area throughout the lifespan of each cardiac allograft (n=24). Autopsy patients with non-cardiac related fatalities served as controls to delineate normal cardiac lymphatic distribution (n=6). Results: Patients without chronic rejection displayed an initial presence of lymphatic vasculature that steadily declined (n=12), while patients with chronic rejection exhibited a delayed increase in lymphatic development (n=12). Conclusions: These data show significant differences in lymphatic area between patients with and without chronic transplant rejection at critical timepoints, suggesting delayed lymphangiogenesis may correlate with rejection. Translational Impact: These preliminary human data support further investigation into lymphatic-modifying therapeutics to prolong the life of cardiac allografts.
Lymphatic drainage inherently modulates cardiac function by maintaining the immune response and tissue-fluid homeostasis. During cardiac transplantation, the lymphatic collecting vessels are severed at the time of donor heart excision and not surgically reconstructed in the recipient. We hypothesize severed cardiac lymphatics contribute to transplant rejection and reduced cardiac function by influencing myocardial edema and immune cell transit. Methods: A heterotopic abdominal heart transplant (HAHT) rodent model permitted the immunologic evaluation of transplant rejection as supported in past literature. Echocardiography confirmed allograft survival via active contraction, while histologic quantification of lymphatic vessels and fibrosis were obtained for native and transplanted rodent hearts (n=3). Lymphatic drainage was assessed via intramyocardial injection of fluorescein isothiocyanate (FITC)-dextran. Results: Electrocardiographic impulses detected during the echocardiograms revealed additional QRS complexes attributed to contractions of the transplanted hearts. Histologic analysis of fibrosis in rodent allografts at an early timepoint exhibited increases in total tissue accumulation (1.48 – 5.15 fold) and significant increases in various focal regions (left ventricle, ***p < 0.001; interventricular septum, ****p < 0.0001) compared to the native hearts. Furthermore, large amounts of cellular infiltrate and marginal increases in cardiac diameter (1.10 – 1.42 fold) were observed in the transplants. While the scarcity of immunofluorescence signal for lymphatic markers has caused cardiac lymphatic quantification to be inconclusive, evaluation of lymphatic transport revealed fluctuating time-dependent circulating FITC levels (0.002 - 0.010 mg/mL; *p < 0.05) suggesting multi-teared compartmental release properties between the microcirculatory system, lymphatic system, and cardiac tissue. Conclusion: The HAHT rodent model provides a promising modality to assess both lymphatic transport and transplant rejection. Moreover, these studies will progress understanding of transplant rejection’s pathological intricacies and provide the groundwork for lymphangiogenic-based therapeutic intervention.
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