Isolation and trilineage differentiation of mouse bone marrow MSCs. (a)–(d) Representative flow cytometry cell sorting plots show sequential selection of cell populations as indicated by a red arrow: total adherent cells subjected to sorting (a), singlets (b), CD11b-, CD14-, CD19-, CD31-, CD34-, and CD45-cells (c), and Sca-1+ cells (d). (e)–(h) Trilineage differentiation of mouse bone marrow MSCs: Nondifferentiated MSCs in culture (e); black arrows indicate Oil Red O staining of lipid droplets within differentiated adipocytes (f); white arrows indicate staining of Collagen type II (red) produced by differentiated chondrocytes (g); and empty arrows indicate Alizarin Red staining of calcium deposit of differentiated osteocytes (h).

Isolation and trilineage differentiation of mouse bone marrow MSCs. (a)–(d) Representative flow cytometry cell sorting plots show sequential selection of cell populations as indicated by a red arrow: total adherent cells subjected to sorting (a), singlets (b), CD11b-, CD14-, CD19-, CD31-, CD34-, and CD45-cells (c), and Sca-1+ cells (d). (e)–(h) Trilineage differentiation of mouse bone marrow MSCs: Nondifferentiated MSCs in culture (e); black arrows indicate Oil Red O staining of lipid droplets within differentiated adipocytes (f); white arrows indicate staining of Collagen type II (red) produced by differentiated chondrocytes (g); and empty arrows indicate Alizarin Red staining of calcium deposit of differentiated osteocytes (h).

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Obliterative bronchiolitis (OB) remains the most significant cause of death in long-term survival of lung transplantation. Using an established murine heterotopic tracheal allograft model, the effects of different routes of administration of bone marrow-derived multipotent stromal cells (MSCs) on the development of OB were evaluated. Tracheas from...

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The single most important cause of late mortality after lung transplantation is chronic lung allograft dysfunction (CLAD). However, the pathological development of CLAD was not as simple as previously presumed and subclassification phenotypes, bronchiolitis obliterans syndrome (BOS) and restrictive CLAD (rCLAD), have been introduced. We want to re-...
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... It is believed that chronic non-immunological and immunological injury to the lung is central to causing pathological distal airway fibroproliferation, leading to the irreversible lung damage related to CLAD [42,86,91,92]. Encouragingly, in mouse tracheal transplantation models, MSC therapy has successfully prevented airway obliteration, possibly by modulating immune responses [61][62][63][64]. ...
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Lung transplantation is often the only viable treatment option for a patient with end-stage lung disease. Lung transplant results have improved substantially over time, but ischemia-reperfusion injury, primary graft dysfunction, acute rejection, and chronic lung allograft dysfunction (CLAD) continue to be significant problems. Mesenchymal stromal cells (MSC) are pluripotent cells that have anti-inflammatory and protective paracrine effects and may be beneficial in solid organ transplantation. Here, we review the experimental studies where MSCs have been used to protect the donor lung against ischemia-reperfusion injury and alloimmune responses, as well as the experimental and clinical studies using MSCs to prevent or treat CLAD. In addition, we outline ex vivo lung perfusion (EVLP) as an optimal platform for donor lung MSC delivery, as well as how the therapeutic potential of MSCs could be further leveraged with genetic engineering.
... However, they can also have profibrotic effects. ere are multiple studies with animal models using MSCs to treat BOS [94][95][96][97][98]. Cao et al. showed that in seven patients with BOS and respiratory failure, six of them presented with lung function improvement 6 months after they were given i.v. ...
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Bronchiolitis obliterans (BO) is a rare, chronic form of obstructive lung disease, often initiated with injury of the bronchiolar epithelium followed by an inflammatory response and progressive fibrosis of small airways resulting in nonuniform luminal obliteration or narrowing. The term BO comprises a group of diseases with different underlying etiologies, courses, and characteristics. Among the better recognized inciting stimuli leading to BO are airway pathogens such as adenovirus and mycoplasma, which, in a small percentage of infected children, will result in progressive fixed airflow obstruction, an entity referred to as postinfectious bronchiolitis obliterans (PIBO). The present knowledge on BO in general is reasonably well developed, in part because of the relatively high incidence in patients who have undergone lung transplantation or bone marrow transplant recipients who have had graft-versus-host disease in the posttransplant period. The cellular and molecular pathways involved in PIBO, while assumed to be similar, have not been adequately elucidated. Since 2016, an international consortium of experts with an interest in PIBO assembles on a regular basis in Geisenheim, Germany, to discuss key areas in PIBO which include diagnostic workup, treatment strategies, and research fields.
... The degree to which the benefits of cell-seeded grafts are due to direct cell engraftment and retention versus the effect of the release of both free and exosome-contained chemotactic and trophic factors [112] from these cells remains unclear. In a subcutaneous heterotopic tracheal allograft model, it has been reported that repeated doses of MSCs might be effective in reducing both fibrosis and the extent of immune infiltrate, despite the failure of MSCs to persist long term within the scaffolds following implantation [113]. In these circumstances, signals might provide a stimulus for regeneration through immune modulation or by host cell recruitment. ...
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Purpose of Review There is no consensus on the best technology to be employed for tracheal replacement. One particularly promising approach is based upon tissue engineering and involves applying autologous cells to transplantable scaffolds. Here, we present the reported pre-clinical and clinical data exploring the various options for achieving such seeding. Recent Findings Various cell combinations, delivery strategies, and outcome measures are described. Mesenchymal stem cells (MSCs) are the most widely employed cell type in tracheal bioengineering. Airway epithelial cell luminal seeding is also widely employed, alone or in combination with other cell types. Combinations have thus far shown the greatest promise. Chondrocytes may improve mechanical outcomes in pre-clinical models, but have not been clinically tested. Rapid or pre-vascularization of scaffolds is an important consideration. Overall, there are few published objective measures of post-seeding cell viability, survival, or overall efficacy. Summary There is no clear consensus on the optimal cell-scaffold combination and mechanisms for seeding. Systematic in vivo work is required to assess differences between tracheal grafts seeded with combinations of clinically deliverable cell types using objective outcome measures, including those for functionality and host immune response. Electronic supplementary material The online version of this article (10.1007/s40778-017-0108-2) contains supplementary material, which is available to authorized users.
... These favorable characteristics have recently been translated into proven efficacy in human renal transplantation [6]. Several preclinical studies now suggest that MSC treatment will be effective in CLAD [7][8][9][10]. However, despite these studies, safety concerns remain since MSCs have the capacity to differentiate into fibroblastlike cells and were found in bronchoalveolar lavage fluid obtained from patients with CLAD, potentially implicating them in the pathogenesis of allograft fibrosis [11]. ...
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Chronic lung transplant rejection (termed chronic lung allograft dysfunction [CLAD]) is the main impediment to long-term survival after lung transplantation. Bone marrow-derived mesenchymal stromal cells (MSCs) represent an attractive cell therapy in inflammatory diseases, including organ rejection, given their relative immune privilege and immunosuppressive and tolerogenic properties. Preclinical studies in models of obliterative bronchiolitis and human trials in graft versus host disease and renal transplantation suggest potential efficacy in CLAD. The purpose of this phase 1, single-arm study was to explore the feasibility and safety of intravenous delivery of allogeneic MSCs to patients with advanced CLAD. MSCs from unrelated donors were isolated from bone marrow, expanded and cryopreserved in a GMP-compliant facility. Patients had deteriorating CLAD and were bronchiolitis obliterans (BOS) grade ≥ 2 or grade 1 with risk factors for rapid progression. MSCs (2 x 106 cells per kilogram patient weight) were infused via a peripheral vein twice weekly for 2 weeks, with 52 weeks follow-up. Ten Patients (5 male, 8 bilateral, median [interquartile range] age 40 [30–59] years, 3 BOS2, 7 BOS3) participated. MSC treatment was well tolerated with all patients receiving the full dosing schedule without any procedure-related serious adverse events. The rate of decline in forced expiratory volume in one second slowed after the MSC infusions (120 ml/month preinfusion vs. 30 ml/month postinfusion, p = .08). Two patients died at 152 and 270 days post-MSC treatment, both from progressive CLAD. In conclusion, infusion of allogeneic bone marrow-derived MSCs is feasible and safe even in patients with advanced CLAD. © Stem Cells Translational Medicine 2017.
... 13,14 To increase the biocompatibility of the synthesized graft we applied bone marrow stromal cells (BMSCs) that were previously shown to enhance bladder regeneration. 15,16 BMSCs have immunosuppressive effects, [17][18][19] high proliferative potential and the ability to differentiate into different tissue lines [20][21][22] including cells of the urothelium. [23][24][25] For stem cell tracking in the graft, BMSCs were labeled with superparamagnetic iron oxide nanoparticles (SPIONs) which, due to their superparamagnetic behavior, can be applied as contrast agents for magnetic resonance imaging (MRI). ...
... 33 To date, several cell sources have been suggested including pluripotent stem cells, human umbilical mesenchymal stem cells, urothelial, and smooth muscle cells. [34][35][36][37] In our studies for enhancing the integrative properties of grafts, we applied allogenic BMSCs which have immunosuppressive action [17][18][19] and are able to differentiate in different directions. [20][21][22] The data obtained clearly demonstrate the efficacy and safety of a two-layer scaffold (PL-SF) seeded with allogenic BMSCs in the reconstruction of the bladder wall in a model of partial cystectomy in rabbits. ...
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Natalia M Yudintceva,1 Yulia A Nashchekina,1,2 Miralda I Blinova,1 Nadezhda V Orlova,3 Alexandr N Muraviov,3 Tatiana I Vinogradova,3 Magomed G Sheykhov,3 Elena Y Shapkova,3 Dmitriy V Emeljannikov,3 Petr K Yablonskii,3,4 Igor A Samusenko,5 Anastasiya L Mikhrina,6 Artem V Pakhomov,7 Maxim A Shevtsov1,7,8 1Department of Cell Culture, Institute of Cytology of the Russian Academy of Sciences (RAS), 2Nanotechnology and Telecommunications, Institute of Physics, Peter the Great St Petersburg Polytechnic University, 3Department of Urology, Federal State Institution Saint Petersburg Research Institute of Phthisiopulmonology, Ministry of Health of Russia, 4Faculty of Medicine, Federal State Budgetary Institute, 5Department of Pathology, Federal State Budgetary Institute “Nikiforov Russian Centre of Emergency and Radiation Medicine” of the Ministry of Health of Russia, 6Department of Pathomorphology, I.M. Sechenov Institute of Evolutionary Physiology and Biochemistry of the Russian Academy of Science, 7Department of Radiology, Federal Almazov North-West Medical Research Center, 8Department of Experimental Medicine, First I.P. Pavlov State Medical University of St Petersburg, St Petersburg, Russia Abstract: In the present study, a poly-L-lactide/silk fibroin (PL-SF) bilayer scaffold seeded with allogenic bone marrow stromal cells (BMSCs) was investigated as a potential approach for bladder tissue engineering in a model of partial bladder wall cystectomy in rabbits. The inner porous layer of the scaffold produced from silk fibroin was designed to promote cell proliferation and the outer layer produced from poly-L-lactic acid to serve as a waterproof barrier. To compare the feasibility and efficacy of BMSC application in the reconstruction of bladder defects, 12 adult male rabbits were divided into experimental and control groups (six animals each) that received a scaffold seeded with BMSCs or an acellular one, respectively. For BMSC tracking in the graft in in vivo studies using magnetic resonance imaging, cells were labeled with superparamagnetic iron oxide nanoparticles. In vitro studies demonstrated high intracellular incorporation of nanoparticles and the absence of a toxic influence on BMSC viability and proliferation. Following implantation of the graft with BMSCs into the bladder, we observed integration of the scaffold with surrounding bladder tissues (as detected by magnetic resonance imaging). During the follow-up period of 12 weeks, labeled BMSCs resided in the implanted scaffold. The functional activity of the reconstructed bladder was confirmed by electromyo­graphy. Subsequent histological assay demonstrated enhanced biointegrative properties of the PL-SF scaffold with cells in comparison to the control graft, as related to complete regener­ation of the smooth muscle and urothelium tissues in the implant. Confocal microscopy studies confirmed the presence of the superparamagnetic iron oxide nanoparticle-labeled BMSCs in newly formed bladder layers, thus indicating the role of stem cells in bladder regeneration. The results of this study demonstrate that application of a PL-SF scaffold seeded with allogenic BMSCs can enhance biointegration of the graft in vivo and support bladder tissue regeneration and function. Keywords: bladder, bone marrow stromal cells, scaffold, superparamagnetic iron oxide nanoparticles, tissue engineering, stem cells
... Mesenchymal stem cells (MSCs) have been isolated from various species, including humans [Boura et al., 2014], mouse [Casey et al., 2014], rat [Wang et al., 2014a], swine [Brückner et al., 2013], bovine [Dueñas et al., 2014], ovine [Adamzyk et al., 2013], and chicken [Khatri et al., 2009]. MSCs from these species have been used as research models for tissue engineering and repair, disease treatment, and handling of cell differentiation for the development of biotechnology tools. ...
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... This production is then associated with elevations of IL-6-inducible reactants C-reactive protein and lipopolysaccharide-binding protein. 124 An observational study of preterm infants who developed sepsis noted that these infants had decreased monocyte class II antigen, again suggesting that the adaptive immune system is delayed. 125 This has led to the hypothesis that there is a later set point for coupling adaptive and innate immunity. ...
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Introduction Bronchiolitis obliterans (BO) is the most common expression of chronic allograft dysfunction in lung transplantation. Moreover, BO represents the major cause of death in the long-term after this procedure. On the other hand, mesenchymal stem cells have been tested in animal models of BO aiming to interfere in its development. The aim of this experimental study is to explore the role of bone-marrow derived stem cells (BMSCs) as a preventive intervention of BO occurrence. Materials and methods This an experimental randomized study. A bronchiolitis obliterans animal model in rats was reproduced: heterotopical tracheal transplant model in lung parenchyma. Five of these animals were used as control group. After setting up the model, individuals were divided in 3 groups of treatment (n = 15), in which BMSCs were administered in 3 different time points after the tracheal transplant (tracheal transplantation and BMSCs administration occurred the same day, group G0; after 7 days, group G7; after 14 days, group G14. In addition, within each group, BMSCs were administered through 3 different routes: endotracheally, endovascular and topically in the lung parenchyma). Animals were sacrificed at 21 days. Histology, fluorescence in situ hybridization and immunohistochemistry techniques were performed for identifying stem cells. Results Compared to control group, animals receiving BMSCs showed large neovessels in a loose fibrous matrix. Group G7 showed less fibrosis (p < 0.033) and edema (p < 0.028). Moreover, G7 animals receiving stem cells endotracheally showed no fibrosis (p < 0.008). Alveolar-like patches of tissue were observed among all groups (53.4%, 46.7% and 40% in G0, G7 and G14 respectively), consisting of cells expressing both stem and alveolar cells biomarkers. Conclusion BMSCs modify the course of bronchiolitis obliterans and differentiate into alveolar cells. Endotracheal administration of BMSCs 7 days after the heterotopical tracheal transplant might be considered an effective way to prevent BO in this animal model.
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Introduction: Bronchiolitis obliterans (BO) is the most common expression of chronic allograft dysfunction in lung transplantation. Moreover, BO represents the major cause of death in the long-term after this procedure. On the other hand, mesenchymal stem cells have been tested in animal models of BO aiming to interfere in its development. The aim of this experimental study is to explore the role of bone-marrow derived stem cells (BMSCs) as a preventive intervention of BO occurrence. Materials and methods: This an experimental randomized study. A bronchiolitis obliterans animal model in rats was reproduced: heterotopical tracheal transplant model in lung parenchyma. Five of these animals were used as control group. After setting up the model, individuals were divided in 3 groups of treatment (n=15), in which BMSCs were administered in 3 different time points after the tracheal transplant (tracheal transplantation and BMSCs administration occurred the same day, group G0; after 7 days, group G7; after 14 days, group G14. In addition, within each group, BMSCs were administered through 3 different routes: endotracheally, endovascular and topically in the lung parenchyma). Animals were sacrificed at 21 days. Histology, fluorescence in situ hybridization and immunohistochemistry techniques were performed for identifying stem cells. Results: Compared to control group, animals receiving BMSCs showed large neovessels in a loose fibrous matrix. Group G7 showed less fibrosis (p<0.033) and edema (p<0.028). Moreover, G7 animals receiving stem cells endotracheally showed no fibrosis (p<0.008). Alveolar-like patches of tissue were observed among all groups (53.4%, 46.7% and 40% in G0, G7 and G14 respectively), consisting of cells expressing both stem and alveolar cells biomarkers. Conclusion: BMSCs modify the course of bronchiolitis obliterans and differentiate into alveolar cells. Endotracheal administration of BMSCs 7 days after the heterotopical tracheal transplant might be considered an effective way to prevent BO in this animal model.
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Costimulatory molecules, such as the programmed death ligand (PD-L1), might exert differential effects on T-cell function, depending on the clinical setting and/or immunological environment. Given the impact of T cells on bronchiolitis obliterans (BO) in lung transplantation, we used an established tracheal transplant model inducing BO-like lesions to investigate the impact of PD-L1 on alloimmune responses and histopathological outcome in BO. In contrast to other transplant models in which PD-L1 generally shows protective functions, we demonstrated that PD-L1 has divergent effects depending on its location in donor versus recipient tissue. Although PD-L1 deficiency in donor tissue worsened histopathological outcome, and increased systemic inflammatory response, recipient PD-L1 deficiency induced opposite effects. Mechanistic studies revealed PD-L1-deficient recipients were hyporesponsive toward alloantigen, despite increased numbers of CD8(+) effector T cells. The function of PD-L1 on T cells after unspecific stimulation was dependent on both cell type and strength of stimulation. This novel function of recipient PD-L1 may result from the high degree of T-cell activation within the highly immunogenic milieu of the transplanted tissue. In this model, both decreased T-cell alloimmune responses and the reduction of BO in PD-L1-deficient recipients suggest a potential therapeutic role of selectively blocking PD-L1 in the recipient. Further investigation is warranted to determine the impact of this finding embedded in the complex pathophysiological context of BO.