Mesenchymal Stem Cells and Cancer: Their Interplay

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Mesenchymal Stem Cells and Cancer: Their Interplay Gang Li, MBBS, DPhil (Oxon) Stem Cell and Regeneration Program School of Biomedical Sciences Li Ka Shing Institute of Health Sciences Department of Orthopaedics and Traumatology The Chinese University Hong Kong

Cancers Are Major Healthcare Challenges (Campbell-Walsh Urology, 9th ed, 2007, Saunder )

The disadvantages of traditional therapies Surgical therapy Radiotherapy Chemotherapy Problems of specific targeting? Gene therapy, et al 3

Gene therapy methods are well established As of January 2007, there were a total of 1,260 gene therapy clinical trials approved worldwide, with approximately 90 new trials submitted for approval each year, most of which in the USA and Europe. Nearly half of all trials use one of two viral-based gene transfer vectors, adenovirus and retrovirus. Specific homing/targeting is still the challenge.

Mesenchymal Stem Cells

Bone Marrow Mesenchymal Stem Cells Self renew ability Easy to collect and expand Low immunogenicity Low tumorigenic/transformation rate Can be gene modified without affecting their phenotype Home to injury tissues and tumours/cancer

MSCs Can Home to Injury Tissues MSCs home to a variety of tissues, particularly after tissue injury and ischemia. Miyahara Y, Nagaya N, Kataoka M,et al. Monolayered mesenchymal stem cells repair scarred myocardium after myocardial infarction. Nat Med. 2006 Apr;12(4):459-65. Carvalho KA, Guarita-Souza LC, Hansen P,et al. Cell Transplantation After The Coculture of Skeletal Myoblasts and Mesenchymal Stem Cells in the Regeneration of the Myocardium Scar: An Experimental Study in Rats. Transplant Proc. 2006 Jun;38(5):1596-1602. Gnecchi M, He H, Noiseux N,et al. Evidence supporting paracrine hypothesis for Akt-modified mesenchymal stem cell-mediated cardiac protection and functional improvement. FASEB J. 2006 Apr;20(6):661-9. Kraitchman DL, Tatsumi M, Gilson WD, et al. Dynamic imaging of allogeneic mesenchymal stem cells trafficking to myocardial infarction. Circulation. 2005 Sep 6;112(10):1451-61.

Systemically Administrated MSCs Specially Home to the Tumours Journal of the National Cancer Institute, Vol. 97, No. 7, 2005

Our hypothesis Similarities Between Tissue Repair and Tumour Development Tumour development shares many common characteristics of wound healing; Tumours are regarded as wounds that never heal. Rapid cell proliferation and differentiation Angiogenesis Immuno-suppresive nature Main Difference: Tissue Remodeling: Apoptosis

MSCs and Tumour Stroma Where do the tumour stroma orginiate? Local Circulating cells MSCs form tumour stroma. Tumor mcroenvironment select MSC engraftment.

The tumour environment recruits MSCs

MSCs-like cells increased in patient with chondrosarcoma, PBMNCs culture; 7 days; 40x

MSCs-like cells increased in patient with osteosarcoma, PBMNCs culture; 14 days; 40x Flow cytometric analysis demonstrated an >9-fold increase in the number of cells with MSC-like phenotypes CD34(-)CD45(-)CD105(+) in patients with bone sarcomas compared with control subjects (p<0.05). Bian, et al. Increased number of mesenchymal stem cell-like cells in peripheral blood of patients with bone sarcomas. Arch Med Res. 2009 Apr;40(3):163-8

Numbers of cells migrated throμgh transwell membranes CM stimulate BMSCs migration toward tumor cell lines before and after tumor condition medium stimulation PC3 DU145 MCF-7 RIF-1

BMSCs response to tumor cells in close contact

Percentage of the Starting distance Wound healing assay of BMSCs in tumor cells condition media 0h 12h 24h

The changes of CXCR4 and MMP-2 expression were confirmed by Western blot

RIF-1 Numbers of cells migrated throμgh transwell membranes MCF-7 DU145 PC3 BMSCs migration towards to tumor cells before and after treating with CXCR4 and MMP2 inhibitor Tumor cell only AMD3100 MMP2 Inhibitor Medium control

MSCs as carrier for anti-tumour/cancer therapy Significance Systemic release Cytokines BM-MSCs Tumours Cancers Cell delivery Systemic delivery Genetic modification Implications for clinical practice Gene Therapy

IVIS 200 Imaging System: Tracing Stem Cells in vivo In vitro GFP Rat Luc-CMV Mouse Luc-BMP-4 Mouse 3D reconstruction In vivo bioluminescence Coregistration with X-Ray with PET & SPECT In vivo fluorescence with MRI & CT Chemiluminescence

Cell numbers 500 1000 2000 4000 8000 16000 32000 64000 Luciferase gene was stably transduced into BMSCs and tumour cell lines

Good correlations were found between cell numbers and bioluminescence in all cells

Study MSCs Homing to Tumours TUMOUR CELLS SUBCUTANEOUS IMPLANTATION Luciferase labelled MSCs Tumour xenograft model Luciferin injection In-vivo imaging

MSCs distribution in PC3 tumor bearing mice Day 3 Day 6 Day 9 Day 12

Study MSCs Homing to Tumours TUMOUR CELLS SYSTEMIC INJECTION Luciferase labelled tumour cells Tumour metastasis model Luciferin injection In-vivo imaging

Day 1 Day 3 Day 5 Day 7 Day 9 Day 12 Day 14 Day 20 MSCs distribution in PC3 lung tumor model from day 1 to day30. The cells mainly stay in lung where the tumor located. Proved by histology. Day 30

MSCs mainly home to tumours following systemic administration

The engraftment of BMSCs in the tumour parenchyma was confirmed by immunostaining of GFP positive cells

Cell proliferation as multiple of day 1 BMSCs did not favor tumour growth in short term co-culture

BMSCs favour PC3 tumour growth in vivo Tumour size mm 3

TK (Thymidine Kinase)/GCV (Ganciclovir) System Herpes simplex virus 1 (HSV-1) TK enzyme is not expressed in normal cells. HSV-TK converts GCV to triphosphate GCV (GCV-TP), which is cytotoxic. GCV-TP causes cell death by apoptosis

293FT OR 293T producer cell line Stem cells for gene therapy Stem cells as gene delivery vehicles TK gene was tranfected into MSCs using Lentiviral system 48h after C3H10T1/2 cells transfected with Lenti- CMV-luciferase-GFP virus.

The phenotype of Lenti-Luciferase-TK transduced BMSCs did not change Negative Control CD45 CD 31 PE PE CD90 CD44 GFP

Numbers of cells migrated through the transwell membrane TK transduced BMSCs respond to GCV in 24 h TK expression 102bp GAPDH 89bp In presence of GCV

Anti-tumour effect of systemically administered TK- MSCs in the presence of GCV in tumour bearing mice.

TK MSCs + GCV TK MSCs Only GCV Only

Systemic administration of TK-MSCs and GCV significantly inhibited metastatic tumour growth

Gross Sample of RIF-1 tumor in lung day 27

Percentage of BMSCs in the lung compared to total BMSCs in the body

Using Mesenchymal Stem Cells as Vehicles for Anti-cancer Therapy Homing Delivery

MSCs as anti-tumour gene therapy vehicle Transduction of the HSV-TK gene into BMSCs did not change their MSCs phenotype and tumour homing potential. Potent cytotoxic effects of TK-BMSCs/GCV was proved on tumour cells in vitro. TK-BMSCs together with GCV can greatly inhibit tumour growth in both local and metastasis tumour models in vivo. Campus of Chinese University of Hong Kong

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