Stem Cells and The Endometrium. Director, Division of Reproductive Endocrinology and infertility

Transcription

1 Stem Cells and The Endometrium Hugh S. Taylor, M.D. Director, Division of Reproductive Endocrinology and infertility

2 Nothing to disclose

3 Stem Cells Cells that are capable of both self-renewal and have broad potential to differentiate into multiple adult cell types. These cells may be derived from the inner cell mass or may be found in the adult. Bone marrow is one source of mutipotent adult stem cells.

4 Endometrium The endometrium, is known for its remarkable regenerative capacity as it undergoes dynamic changes each menstrual cycle. Need for stem cells to replenish the endometrium.

5 Endometrial Progenitor Stem Cells C.E. Gargett et al. Molecular and Cellular Endocrinology 288 (2008) 22 29

6 In the last 20 years, multipotent stem cells have been isolated multiple tissues. They are few in number. About 1 stem cell found in 100,000 cells circulating in the blood. Furthermore they resemble the other Furthermore, they resemble the other cells that surround them.

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8 Can Bone Marrow Derived Cells Differentiate Into Endometrium?

9 Subjects Four bone marrow transplant recipients HLA type that allowed determination of the origin any cell Age Rx Chemotherapy and TBI

10 Methods Endometrial biopsy RT-PCR for HLA Immunohistochemistry for HLA and CD45

11 RT-PCR amplifying HLA AA11A11 Taylor HS, JAMA. 2004;292(1):81-5

12 Taylor HS, JAMA. 2004;292(1):81-5

13 Serial IHC for HLA and CD45 Taylor HS, JAMA. 2004;292(1):81-5

14 Marker of Differentiation Calcitonin HLA Merge Taylor HS, JAMA. 2004;292(1):81-5

15 Do Stem Cells Contribute to Endometrium in a murine model?

16 Identification of bone marrow-derived cells in murine-endometrium Transplant of Male bone marrow into female mice. Assessment of SRY gene expression and Y chromosome by FISH Du, H. and Taylor H. Stem Cells 2007;25:

17 Stem cell origin of endometrium in mouse Du, H. and Taylor H. Stem Cells 2007;25:

18 Male CD45 Cytokeritin

19 Stem Cells and Disease Can Stem Cells Contribute to Endometriosis i?

20 Support of Sampson s theory Dependent distribution Common occurrence of retrograde menstruation High incidence with outflow tract obstruction Tubal patency common Risk factors that include frequent menstruation and early menarchy. Animal models involving peritoneal transplant

21 Sampson s Theory does not explain the presence of endometriosis i outside of the peritoneal cavity or in men.

22 A Novel Origin of Endometriosis Do stem cells contribute to murine endometriosis?

23 Methods Wild Type and LacZ transgenic mice Hysterectomy Uterine transplant to ectopic location Beta-Galactosidase activity and Beta Galactosidase activity and expression

24 IHC using anti Beta-galacotosidase antibody Wt control LacZ transgenic Wt transplanted to LacZ transgenic Du, H. and Taylor H. Stem Cells 2007;25:

25 IHC using anti Beta-galactosidase Stromal Cells

26 X-GAL staining of Beta-Galactosidase activity Glandular cell Stromal Cell

27 Novel mechanism of disease- Ectopic transdifferentiation of stem cells.

28 Bone Marrow and Endometrial Stem Cells Potential for endometrial repair after disease. Explains failure of ablative therapies for abnormal bleeding. Novel mechanism of disease- Ectopic transdifferentiation of stem cells.

29 Does the Endometrium Contain Stem Cells that can Differentiate into Non- endometrial Cell Types?

30 Methods Reproductive aged women Endometrial biopsy Endometrial stromal cell culture Differentiation protocols

31 Chondrocytes Wolff E. and Taylor H Reproductive Sciences 2007

32

33 Type II Collagen

34 Neurogenic Differentiation

35 Flow cytometry: Human Endometrial Derived Stem Cells CD45 + (0.3%) CD31 + (1.4%) CD90 + (99.6%) Leukocyte Endothelial cell Stromal cell PDGFRß + (99.7%) CD146 + (99.7%) Wolff E et al JCMM 2010

36 in vitro to Control Endometrial Stromal Cells Neurogenic Differentiated 50 um 50 um Wolff E et al JCMM 2010

37 in vitro Nestin Expression 50 um 50 um 50 um DIC Immunofluorescence Merge Wolff E et al, JCMM 2010

38 in vitro Tyrosine Hydroxylase Expression Merge Wolff E et al, JCMM 2010

39 in vitro Dopamine Synthesis: Metabolites Present in Media Control Neurogenic DOPAC (Dihydroxyphenylacetic acid) ) 0.2 pg/ml 1.2 pg/ml Wolff E et al, JCMM 2010

40 Ba 2+ sensitive K + currents: GIRK2 Channels Undifferentiated HEDSC Neurogenic Baseline Wolff E et al, JCMM 2010

41 Parkinson s s Disease (PD) Model PD is a degenerative disorder of the central nervous system that impairs movement and speech PD is caused by deficiency of Dopamine production in the Substantia Nigra of the brain MPTP (1-methyl 4-phenyl 1,2,3,6- tetrahydropyridine) is a neurotoxin of dopamine producing cells MPTP induces a permanent model of PD

42 Human Endometrial Derived Stem Cells (HEDSC) Transplantation ti MPTP Parkinson's Disease PBS HEDSC

43 HEDSC Engraftment t PCR for Human DNA in Transplanted Brains

44 HEDSC Engraftment Human Nestin Antibody Wolff E et al, JCMM 2010

45 EDSC Neurotransplantation Engraft in mice brains PCR detects human DNA Engraft in mice brains Striatum t (transplant t site) Migrate & Differentiate morphologically in vivo Substantia nigra (lesion site)

46 ESC Neurotransplantation Rescues dopamine concentrations * *all p< * *

47 Pancreatic Beta Cells From Endometrial Stem Cells

48 Methods: Human endometrial tissue from subjects undergoing hysteroscopy/hysterectomy at P2-P5 (n=7) Differentiation following a 3 step-protocol SCID mouse model

49 β-pancreatic Gene Expression During Development Chandra V et al. Stem Cells2009 Aug;27(8):

50 Differentiation Protocol Standard protocol: In ECM gel Step 1: H-DMEM+10%FBS+10-6 M RA for 24 hours, H- DMEM+10%FBS for 48 hours Step 2: L-DMEM+10%FBS+10mmol/L nicotinamide+ 20ng/mL EGF for 7 days Step 3: L-DMEM+10%FBS+10 nmol/l exendin 4 for 7 days

51 Gene expression using standard protocol

52 In vitro differentiation Undifferentiated Step 2 Step 3

53 Ctrl S1 S2 S3 Pancreas PDX-1 Insulin β-actin

54 Modified Protocol Step 3

55 Immunofluorescence Insulin DAPI Undifferentiated Differentiated

56 Insulin Secretion et (ELISA)

57 Diabetes Animal Model Streptozotocin (200mg/kg ip) No transplantation 5 STZ 10 7 Undifferentiated endometrial cells Renal subcapsular transplantation 10 7 differentiated cells 4 Control 8 Cases SCID Female Mice

58 Control (undifferentiated tx) Treatment (differentiated cell Tx)

59 Endometrial Stem Cells Potential source of HLA identical stem cells in women Easily Obtainable bl Renewable e abe Can treat animal models of Parkinson s disease and diabetes.

60 Conclusions: Cell trafficking into the uterus likely contributes to uterine tissue regeneration and repair. Stem cells are a novel etiology of endometriosis The endometrium is a source of multipotent mesenchymal stem cells. These cells have a vast capacity for differentiation into multiple cell types useful in tissue repair and regenerative medicine.

61 Acknowledgements Stem Cell Group: o g g u Hongling Du NIH R01 HD NIH R01 ES Erin Wolff NIH U54 HD Xavier Santamaria Effi Massasa Yuping Zhou Collaborators: Xiao-Bing Gao Tamas Horvath