Oncofertility: Fertility Preservation and Restoration Progress Toward an Ovarian Bioprosthesis

Transcription

1 Oncofertility: Fertility Preservation and Restoration Progress Toward an Ovarian Bioprosthesis

2 Fertility Needs in Pediatric Cancer Patients Acute Lymphoblastic Leukemia Cells in ovarian cortical tissue Ovarian cortical tissue from NPC participants; Scale bar = 50 um Laronda, et al. (2015) Biomaterials Modified from: Cordeiro, Kim, Woodruff. Cancer Treatment and the Ovary (2015) Patient Sample 4 y.o.; scale bar = 100 mm; National Physicians Cooperative

3 Fertility Needs in Pediatric Cancer Patients Follicle maturation High fidelity oocyte maturation Endocrine hormone production Pubertal transition Cyclical hormones to support systemic health 3

4 Encapsulated In Vitro Follicle Growth (eivfg) Lonnie Shea, Ph.D. Shea and Woodruff, 2000-present

5 Hydrogel-based eivfg Supports Cellular Differentiation Follicles have different cell types Follicles produce steroid hormones DNA StAR Theca-like DNA Inhibin a Granulosa cells Xu, unpublished Xu et al, Tiss. Eng Xu et al, Human Repro Nature Medicine Breakthrough of the Decade ( )

6 In Vitro Ovulation and Luteinization Skory, Xu, Shea and Woodruff, Human Reprod. 2015

7 96% rupture (n=70)

8 Skory, R, unpublished In Vitro Ovulation and Luteinization

9 Skory, R, unpublished In Vitro Ovulation and Luteinization

10 Skory, R, unpublished Mechanisms of Ovulation

11 Inhibin A (pg/ml) Inhibin B (pg/ml) Estradiol (pg/ml) Progesterone (ng/ml) Follicular and Luteal Phase Hormone Secretion over 28 Day Cycle - EVATAR Follicular phase Estradiol Progesterone Luteal phase hcg Draper Laboratories, Cambridge, MA 0 day Follicular phase Inhibin A Inhibin B Luteal phase hcg day Shuo Xiao, Ph.D. Xiao et al, unpublished

12 eivfg Supports Live Birth and EVATAR Ovulates and Produces MII eggs Mom NUBorn NUAge Shea and Woodruff, Tiss Eng 2006 Nature Medicine Breakthrough of the Decade ( ) Xiao, unpublished

13 Human Tissue for Long Term Storage and Research Shea and Woodruff, Human Reproduction, 2009

14 ...exploring and expanding options for the reproductive future of cancer survivors

15

16 eivfg Matured Human Oocytes 44 patients; 65 follicles; 4 MII National Center for Translational Research in Infertility NICHD P50 Xiao, et al Sci Reports, 2015

17 Fundamental Role of Architecture and the Environment in Follicle Development Fundamental Roles of Hormones, Architecture and Environment in Follicle Development Biomaterial Environment (alginate, fibrin-alginate IPN, PEG) Animal Environment (age, metabolic status, and weight studies) Physical Environment (rigidity, PCOS, and primordial follicles) Cellular Environment (stroma/ theca cells and other follicles) In vitro Environment (translation to human) alginate bead Human Environment (policy, law, religion) Shea and Woodruff, 2000-present

18 What Makes a Good Egg? Duncan Woodruff, Aging Cell, 2012 Hornick, Duncan, Marko, Woodruff, JARG, 2014 Tingen Woodruff, Science 2013

19 What Makes a Good Egg? Tom O Halloran, Ph.D. Morrison Professor of Chemistry Northwestern University Kim, Bernhardt, Kong, Duncan, Que, Zhang, Chang Nature Chemistry, Nature Chemical Biology, Chemistry and Biology, Nature Scientific Reports (2009-present)

20 Fertility Needs in Pediatric Cancer Patients Follicle maturation High fidelity oocyte maturation Endocrine hormone production Pubertal transition Cyclical hormones to support systemic health 20

21 Components of an Engineered Ovary oocyte granulosa ESTRADIOL ECM 3D-Printed theca ipscs igcs Specialized cells: Granulosa/Theca Cells & Oocytes isolated or cultured from patient tissue, derived from human stem cells Bioactive Scaffold patient, donor, engineered Laronda, et al. (2013) Stem Cell Research & Therapy; Laronda, et al. (2014) JARG

22 In In vivo In follicle Vivo Follicle maturation Maturation (retrieved for in vitro fertilization) Cryopreserve ovarian tissue (in 5 mm cubes) Isolate follicles Encapsulated in nondegradable material F-actin α-tubulin Nuclei Merged Shikanov, Woodruff, Shea, Tiss Eng. 2014

23 Degradable Hydrogel-Follicle Transplant Minimizes Cancer Transplant (results in live birth) Kniazeva Woodruff, Jeruss, Shea, Sci Rep. 2015

24 Decellularized Ovary for Bio-active Scaffold Monica Laronda, Ph.D. Burroughs Wellcome Career Awardee Laronda, et al. Biomaterials, 2015

25 Decellularized Ovary for Bio-active Scaffold Scale bar = 5 mm Laronda, et al. (2015) Biomaterials

26 Puberty Was Initiated in Ovariectomized Mice with Recellularized Grafts Scale bar = 500 μm; 50 μm >30 day transplant Laronda, et al. Biomaterials, 2016

27 Bioinspired Scaffold Design Hormones Architecture - Environment oocyte granulosa theca Follicle on Ovary Paper Sutured to soft tissues Scaffold Criteria: Mechanically rigid to handle during transplant Mimic a 3D architecture Open pores for nutrient flow, growth and ovulation Bioactive, Gelatin scaffold bio-safe with a microporous architecture material TZP, Susan Barrett (Nature Medicine Cover); False-colored SEM Follicle on Ovary Paper, Laronda, Rashedi,. Jakus (Shah Lab); 3D Printing by A. Rutz (Shah Lab)

28 Bioinspired Scaffold Design calcein / rhodamine vinculin / dapi Scale bar = 50 mm Rutz & Laronda, unpublished

29 Microtubules / DNA Bioinspired Scaffold Design Follicle Development and Oocyte Maturation basement membrane stroma / cytoskeleton / DNA oocyte 30º; D8 Scale bar = 50 mm Rutz & Laronda, unpublished

30 Bioinspired Scaffold Design Soft Tissue Transplant Bioprosthesis in bursa fat GFP+ follicles vessel oviduct PECAM / DNA Rutz & Laronda, unpublished

31 Bioinspired Scaffold Design Soft Tissue Transplant CL Large follicles Primary follicle Secondary follicles Uterine horn Bioprosthesis 8wks post-surgery Scale bar = 200 and 50 mm vessel Bioprosthesis 3wks post-surgery Rutz & Laronda, unpublished

32 Live Birth from Ovarian Bioprothesetic Transplant (first soft organ transplant) Females with Ovary Bioprosthesis: Cycling (vaginal histology) 3 had pups from transplant Supported pups with milk until wean Transplant recipient (EGFP-) with EGFP+ pup EGFP+ pup with CD1 pup from different litter Pups produced tissue grand-pups Rutz & Laronda, unpublished

33 Fertility Needs in Pediatric Cancer Patients Follicle maturation High fidelity oocyte maturation Endocrine hormone production Pubertal transition Cyclical hormones to support systemic health On the Horizon. 33

34 Chemotherapy and Radiation Target Cancer and Other Susceptible Sites Cancer cells Germ cells So-youn Kim, Ph.D. Research Assistant Professor Northwestern University

35 DNA damage response in Mammalian Oocytes TAp63-independent apoptosis TAp63-dependent apoptotic pathway TAp63-independent apoptosis Prophase arrest Ovarian Reserve Chemotherapy Radiation Therapy Recombination (DNA breaks by Spo11) TAp63 E7.5 E13.5 E16 E18.5 ATM, ATR --KU55933, BEZ Spo11 CHK --Chk2 inhibitor ATM c-abl --Imatinib DMC1 Apoptotic TAp63 BRCA1 Pathway JNK, p38 --JNK, p38 inhibitors H2AX PUMA NOXA BAX BAK Low ATM and Chk ATR (unknown)

36 Summary of In vitro Mitigation Test CONTROL CISPLATIN RADIATION Targets Inhibitors Protection from CDDP Protection from Radiation ABL kinase Imatinib Yes No GNF2 Yes No Dasatinib Nilotinib Yes No Dasatinib Yes No Regorafenib Yes No Chk2 Chk2 hydrate Yes Yes KU PI3K pathway NVP-BEZ235 Yes No PP121 No No MK-2206 No No PD5 mouse Ovary In vitro culture SB Chk2 Inhibitor MAPK pathway SB Yes Yes SP Yes Yes Selumetinib Yes No p53 Pifithrin-a No No ATM Pifithrin-u KU55933 No Yes No Yes Kim, SY, et al, (2016, in preparation)

37 Oncofertility 2036 Better Cancer Control and Tx Higher Selectivity of Patients Neo-adjuvant Fertoprotectives In Vitro Follicle Maturation Designer Ovarian Bioprosthetics Eliminate the Field

38 Thank you! Funded by: Oncofertility Consortium NIH/NICHD: P50HD Microfluidic Menstrual Cycle NCATS/ORWH/NIEHS: UH3TR Woodruff Lab, 2015 Zinc Spark NIGMS: R01GM115848; Keck Foundation; Argonne National Laboratories Lonnie Shea, PhD, Tom O Halloran, Ph.D, Visit us at: John Marko, Ph.D., Ramille Shah, Ph.D.

39 Visit us at: