Exosomes/tricalcium phosphate combination scaffolds can enhance bone regeneration by activating the PI3K/Akt signalling pathway

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Exosomes/tricalcium phosphate combination scaffolds can enhance bone regeneration by activating the PI3K/Akt signalling pathway Jieyuan Zhang, Xiaolin Liu, Haiyan Li, Chunyuan Chen, Bin Hu, Xin Niu, Qing Li, Bizeng Zhao, Zongping Xie and Yang Wang 1

Background Effective reconstruction of bone defects challenging Most widely used treatments: autologous and allogenic bone grafting Negatives: autologous: limited availability extra damage to harvest site need for a second operation allogenic: significant failure rates poor mechanical stability immunological rejection 2

Background Bioactive materials provide an alternative -> Tricalcium phosphate (β-tcp) same ions as bone well characterized osteoconducitve biomaterial already in clinical use for repair and regeneration Lack of osteoinductive activity 3

human induced Pluripotent Stem- Mesenchymal Stromal Cells (hips-mscs) MSCs- Positive effects on tissue repair due to stimulation of the tissue resident recipient cells via paracrine mechanisms Exosomes as nanocarriers no apparent adverse effects ips-mscs showed bone regenerating ability when directly transplanted into calvarial defects in immuno-compromised mice hips-mscs-exos -> To improve the osteogenesis ability of the β-tcp 4

The PI3K/Akt signaling pathway 5

Methods Generation and characterization of hips-mscs hips were cultured and expanded on ESC-Qualified BD Matrigel in six-well plates in mtesr1 When 90% confluent, mtesr1 replaced by low-glucose Dulbecco s modified Eagle medium containing 10% fetal bovine serum and 2mM L-Glu After 14 days in culture, into 0,1% gelatin-precoated dishes until 80-90% confluency MSC cell surface identification via flow cytormetry 6

Fig. S1 Characterization of hips-mscs: (A) Flow cytometry analysis of the cell surface markers in hips-mscs. (B) The qrt-pcr results for OCN, Sox9, and LPL after 7 days in culture with osteo-, chondro-, and adipogenic mediun. (ANOVA, *p < 0.05 compared with the control group) 7

Methods Isolation and identification of hips-msc-exos 48h cultivation in MGro-500 chemically defined serum-free MSC medium Centrifuged to remove dead cells and cellular debris The supernatant was filtered through 0.22-μm filter sterilizer to remove the residual cellular debris Supernatant was centrifuged at 4000 x g to about 200μL by ultra filtration in a 15mL Amicon Ultra -15 Centrifugal Filter Unit, washed twice with PBS and re-ultra-filtrated For exosome purification the liquid was overlaid onto a 30% sucrose-d 2 O cushion in a sterile Ultra-Clear tube and ultra-centrifuged at 100,000 g for 2 h to pellet the small vesicles that correspond to exosomes The pelleted exosomes were resuspended in 15 ml PBS and centrifuged at 4000 g in Centrifugal Filter Units until the final volume was reduced to approximately 200 μl. All procedures were performed at 4 C. Exosomes were stored at 80 C or used for downstream experiments. Transmission electron microscopy (TEM), tunable resistive pulse sensing (TRPS) analysis, and western blotting were used to identify hips-msc-exos. 8

In vivo animal experiments Surgical procedures β-tcp scaffolds with a dimension of 5 mm in diameter and 2 mm in depth with an average pore size of 500 μm and 75 % porosity were used as exosome carriers in the in vivo studies Five 10 11 particles/ml or 1 10 12 particles/ml of exosomes (100 μl) or an equal volume PBS were blotted onto each β-tcp scaffold and left for 4 h for the exosomes to be totally absorbed Sprague Dawley rats got two critical-sized calvarial defects with a diameter of 5 mm on each side of the cranium using dental trephine followed by implantation of the scaffolds into the defects. 9

In vivo experimental animal experiments At 2,4, and 6 weeks after the operation the rats were injected with tetracycline, alizarin red and calcein for fluorescent labeling 8 weeks after the OP rats were sacrifized The craniums were scanned by micro-ct and new bone volume was calculated Histological analysis with the fluorochromes using CLSM and van Gieson s staining osteogenesis was evaluated by IHC analysis for Osteocalcin 10

In vitro studies Exosome release from β-tcp (1day and 5days) Cell proliferation assay Migration assay (using a scratch wound healing assay) hbmscs with Exosomes 5 10 11 or 1 10 12 particles/ml Gene expression profiling and bioinformatics analysis by using the GeneChip PrimeView Human Gene Expression Array hbmscs with Exosomes 5 10 11 particles/ml qrt-pcr Western Blot analysis PI3K/Akt signaling inhibition to confirm the involment Alkaline phosphatase (ALP) assay and Alizarin red S (ARS) staining 11

Results Characterization suggest that the vast majority of the nanocarriers derived from hips-mscs were exosomes In vivo experiment showed a dose-dependent increase in new bone formation DiO-labeled exosomes can be found in the perinuclear region of hbmscs which surround β-tcp Exosomes enhanced the hbmscs proliferation Scratch wound assay showed that, after being cultured with exosomes, the migration ability of hbmscs was remarkably enhanced 12

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Genexpression and PI3K/Akt pathway Significant differential expression of 1447 candidate genes Among these 293 genes were upregulated and 1154 genes were downregulated with exosome treatment Multiple pathways were prominently enriched PI3K/Akt-pathway ECM-receptor interaction focal adhesion The PI3K/Akt signaling pathway positive effector genes upregulated negative effector genes downregulated Control with LY294002 = PI3K-Inhibitor 17

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Discussion Currently a growing body of evidence indicates that MSC paracrine action may be applied as a novel strategy for tissue repair The exosome/β-tcp combination scaffolds can be potentially used as a promising graft for bone defect repair exosomes in perinuclear regions of hbmscs indicate that the exosomes are released by the exosome/β-tcp scaffold and then be internalized by hbmscs, which stimulates their proliferation, migration osteogenic differentiation PI3K-inhibitor markedly, but not completely, abolished the pro-osteogenic effect of hips-msc-exos -> exosome induced effect not fully attributed to PI3K/Akt 20

Conclusions hips-mscs-exos- functionalized β-tcp scaffold can effectively promote bone repair and regeneration in a rat model bone regeneration through activation of endogenous BMSCs in the bone defect site The PI3K/Akt signaling pathway plays a critical role in the pro-osteogenesis effects of the exosome/β-tcp scaffold on BMSCs Further studies are needed to assess the long-term effects 21

Thank you for your attention 22