We are grateful to Mr. Poddar and Mr. Ludwig for generous funding support via Hackensack UMC Foundation. We appreciate Laura Zhao for English editing.

The protocol follows the guidelines of institutional human research ethics committee at Center for Discovery and Innovation, Hackensack Meridian Health. Human buffy coat blood units were purchased from the New York Blood Center (New York, NY). Human umbilical cord blood units were collected from healthy donors and purchased from Cryo-Cell International blood bank (Oldsmar, FL). Both New York Blood Center and Cryo-Cell have received all accreditations for blood collections and distributions, with IRB approval and signed C...

<ol>
	<li>Zhao, Y. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Stem+cell+educator+therapy+and+induction+of+immune+balance.">Stem cell educator therapy and induction of immune balance.</a> Current Diabetes Reports. 12 (5), 517-523 (2012).</li><li>Zhao, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Reversal+of+type+1+diabetes+via+islet+beta+cell+regeneration+following+immune+modulation+by+cord+blood-derived+multipotent+stem+cells.">Reversal of type 1 diabetes via islet beta cell regeneration following immune modulation by cord blood-derived multipotent stem cells.</a> BMC Medicine. 10 (1), 3 (2012).</li><li>Zhao, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Targeting+insulin+resistance+in+type+2+diabetes+via+immune+modulation+of+cord+blood-derived+multipotent+stem+cells+(CB-SCs)+in+stem+cell+educator+therapy:+phase+I/II+clinical+trial.">Targeting insulin resistance in type 2 diabetes via immune modulation of cord blood-derived multipotent stem cells (CB-SCs) in stem cell educator therapy: phase I/II clinical trial.</a> BMC Medicine. 11, 160 (2013).</li><li>Delgado, E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Modulation+of+autoimmune+T-cell+memory+by+stem+cell+educator+therapy:+phase+1/2+clinical+trial.">Modulation of autoimmune T-cell memory by stem cell educator therapy: phase 1/2 clinical trial.</a> EBioMedicine. 2 (12), 2024-2036 (2015).</li><li>Li, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Hair+regrowth+in+alopecia+areata+patients+following+Stem+Cell+Educator+therapy+BMC.">Hair regrowth in alopecia areata patients following Stem Cell Educator therapy BMC.</a> Medicine. 13 (1), 87 (2015).</li><li>Colombo, M., Raposo, G., Thery, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Biogenesis,+secretion,+and+intercellular+interactions+of+exosomes+and+other+extracellular+vesicles.">Biogenesis, secretion, and intercellular interactions of exosomes and other extracellular vesicles.</a> Annual Review of Cell And Developmental Biology. 30, 255-289 (2014).</li><li>Abak, A., Abhari, A., Rahimzadeh, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Exosomes+in+cancer:+small+vesicular+transporters+for+cancer+progression+and+metastasis,+biomarkers+in+cancer+therapeutics.">Exosomes in cancer: small vesicular transporters for cancer progression and metastasis, biomarkers in cancer therapeutics.</a> PeerJ. 6, 4763 (2018).</li><li>Adamiak, M., Sahoo, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Exosomes+in+myocardial+repair:+advances+and+challenges+in+the+development+of+next-generation+therapeutics.">Exosomes in myocardial repair: advances and challenges in the development of next-generation therapeutics.</a> Molecular Therapy. 26 (7), 1635-1643 (2018).</li><li>Akyurekli, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+systematic+review+of+preclinical+studies+on+the+therapeutic+potential+of+mesenchymal+stromal+cell-derived+microvesicles.">A systematic review of preclinical studies on the therapeutic potential of mesenchymal stromal cell-derived microvesicles.</a> Stem Cell Review and Report. 11 (1), 150-160 (2015).</li><li>Hu, W., Song, X., Yu, H., Sun, J., Zhao, Y. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Released+exosomes+contribute+to+the+immune+modulation+of+cord+blood-derived+stem+cells+(CB-SC).">Released exosomes contribute to the immune modulation of cord blood-derived stem cells (CB-SC).</a> Frontiers in Immunology. (11), 165 (2020).</li><li>Jacobson, G., K&#229;rsn&#228;s, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Important+parameters+in+semi-dry+electrophoretic+transfer.">Important parameters in semi-dry electrophoretic transfer.</a> Electrophoresis. 11 (1), 46-52 (1990).</li><li>Dykstra, M. J., Reuss, L. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Biological Electron Microscopy: Theory, Techniques, and Troubleshooting. , (2011).</li><li>Konoshenko, M. Y., Lekchnov, E. A., Vlassov, A. V., Laktionov, P. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Isolation+of+extracellular+vesicles:+general+methodologies+and+latest+trends.">Isolation of extracellular vesicles: general methodologies and latest trends.</a> BioMed Research International. 2018, 8545347 (2018).</li><li>Witwer, K. W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Standardization+of+sample+collection,+isolation+and+analysis+methods+in+extracellular+vesicle+research.">Standardization of sample collection, isolation and analysis methods in extracellular vesicle research.</a> Journal of Extracellular Vesicles. 2, (2013).</li><li>Orecchioni, M., Ghosheh, Y., Pramod, A. B., Ley, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Macrophage+polarization:+different+gene+signatures+in+M1(LPS+)+vs.+classically+and+M2(LPS-)+vs.+alternatively+activated+macrophages.">Macrophage polarization: different gene signatures in M1(LPS+) vs. classically and M2(LPS-) vs. alternatively activated macrophages.</a> Frontiers in Immunology. 10, 1084 (2019).</li></ol>

Dr. Zhao is a founder of Tianhe Stem Cell Biotechnology Inc. Dr. Zhao is an inventor of Stem Cell Educator technology. All other authors have no financial interests that may be relevant to the submitted work.

Application of exosomes is an emerging field for clinical diagnosis, drug developments and regenerative medicine. Here, we present a detailed protocol regarding the preparation of CB-SC-derived exosomes and the functional study of exosomes on the differentiation of human monocytes. The current protocol demonstrated that functional CB-SC-derived exosomes are isolated by sequential centrifugation and ultracentrifugation with high purity and exhibiting the immune modulation on monocytes.
As compa...

Cord blood stem cells (CB-SC) are unique type of stem cells identified from human cord blood and are distinguished from other known types of stem cells such as mesenchymal stem cells (MSC) and hematopoietic stem cells (HSC)1. Based on their unique properties of immune modulation and their ability to tightly adhere to the surface of Petri dishes, we developed a new technology designated as Stem Cell Educator (SCE) therapy in clinical trials2,3. During SCE therapy, a patient&#8217;s peripheral blood mononuclear cells (PBMC) are collected and circulated through a cell separator and co-cultured with adherent CB-SC in vitro. These &#8220;educated&#8221; cells (CB-SC-treated PBMC) are then returned to the patient&#8217;s circulation in a closed-loop system. Clinical trials have already demonstrated the clinical safety and efficacy of SCE therapy for the treatment of autoimmune diseases including type 1 diabetes (T1D)2,4 and alopecia areata (AA)5.
Exosomes are a family of nanoparticles with diameters ranging 30&#8210;150 nm and exist in all biofluid and cell culture media6. Exosomes are enriched with many bioactive molecules including lipids, mRNAs, proteins, and microRNAs (miRNA), and play an important role in cell-to-cell communications. Of late, exosomes have become more attractive for researchers and pharmaceutical companies due to their therapeutic potentials in clinics7,8,9. Recently, our mechanistic studies demonstrated that CB-SC-released exosomes contribute to the immune modulation of SCE therapy10.
Here, we describe the protocol to explore the mechanism of SCE therapy targeting monocytes by CB-SC-released exosomes. First, CB-SC-released exosomes were isolated from CB-SC-derived conditioned media using ultracentrifugation methods and validated by flow cytometry, western blot (WB) and dynamic light scattering (DLS). Second, CB-SC-derived exosomes were labeled with a green fluorescent lipophilic dye: Dio. Third, they were co-cultured with PBMC to examine the positive percentages of Dio-labeled CB-SC-derived exosomes at the different subpopulations of PBMC by flow cytometry. This protocol provides guidance to study the action of exosomes underlying the immune modulation of stem cells.

<table>
	<tbody>
		<tr>
			<td>1.5 ml Microcentrifuge tube</td>
			<td>Fisher Scientific</td>
			<td>05-408-129</td>
			<td></td>
		</tr>
		<tr>
			<td>15 ml conical tube</td>
			<td>Falcon</td>
			<td>352196</td>
			<td></td>
		</tr>
		<tr>
			<td>24-well plate</td>
			<td>Falcon</td>
			<td>351147</td>
			<td>Non-tissue culture 
			plate</td>
		</tr>
		<tr>
			<td>3,3&#39;-Diostadecyloxacarbocyanine perchlorate(Dio)</td>
			<td>Millipore sigma</td>
			<td>D4292-20MG</td>
			<td>Store at 4 &#176;C</td>
		</tr>
		<tr>
			<td>300 Mesh Grids</td>
			<td>Ted Pella</td>
			<td>1GC300</td>
			<td></td>
		</tr>
		<tr>
			<td>50 mL conical tube</td>
			<td>Falcon</td>
			<td>352070</td>
			<td></td>
		</tr>
		<tr>
			<td>6-well plate</td>
			<td>Falcon</td>
			<td>353046</td>
			<td>Tissue culture plate</td>
		</tr>
		<tr>
			<td>96-well plate</td>
			<td>Falcon</td>
			<td>353072</td>
			<td>Tissue culture plate</td>
		</tr>
		<tr>
			<td>ACK Lysis Buffer</td>
			<td>Lonza</td>
			<td>10-548E</td>
			<td>100 ml</td>
		</tr>
		<tr>
			<td>Amicon-15 10kDa Centrifuge Fliter Unit</td>
			<td>Millipore sigma</td>
			<td>UFC901024</td>
			<td></td>
		</tr>
		<tr>
			<td>Anti-Human Alix</td>
			<td>Biolegend</td>
			<td>634501</td>
			<td>store at 4 &#176;C, RRID: AB_2268110</td>
		</tr>
		<tr>
			<td>Anti-Human Calnexin</td>
			<td>Biolegend</td>
			<td>699401</td>
			<td>store at 4 &#176;C, RRID: AB_2728519</td>
		</tr>
		<tr>
			<td>Anti-Human CD11c antibody, Pe-Cy7</td>
			<td>BD Bioscience</td>
			<td>561356</td>
			<td>store at 4 &#176;C, RRID: AB_10611859</td>
		</tr>
		<tr>
			<td>Anti-Human CD14 antibody, Karma Orange</td>
			<td>Beckman Coulter</td>
			<td>B36294</td>
			<td>store at 4 &#176;C, RRID: AB_2728099</td>
		</tr>
		<tr>
			<td>Anti-Human CD163 antibody, PE</td>
			<td>BD Bioscience</td>
			<td>556018</td>
			<td>store at 4 &#176;C, RRID: AB_396296</td>
		</tr>
		<tr>
			<td>Anti-Human CD19 antibody, PC5</td>
			<td>Beckman Coulter</td>
			<td>IM2643U</td>
			<td>store at 4 &#176;C, RRID: AB_131160</td>
		</tr>
		<tr>
			<td>Anti-Human CD206 antibody, FITC</td>
			<td>BD Bioscience</td>
			<td>551135</td>
			<td>store at 4 &#176;C, RRID: AB_394065</td>
		</tr>
		<tr>
			<td>Anti-Human CD209 antibody, Brilliant Violet 421</td>
			<td>BD Bioscience</td>
			<td>564127</td>
			<td>store at 4 &#176;C, RRID: AB_2738610</td>
		</tr>
		<tr>
			<td>Anti-Human CD270 antibody, PE</td>
			<td>Biolegend</td>
			<td>318806</td>
			<td>store at 4 &#176;C, RRID: AB_2203703</td>
		</tr>
		<tr>
			<td>Anti-Human CD3 antibody, Pacfic Blue</td>
			<td>Biolegend</td>
			<td>300431</td>
			<td>store at 4 &#176;C, RRID: AB_1595437</td>
		</tr>
		<tr>
			<td>Anti-Human CD34 antibody, APC</td>
			<td>Beckman Coulter</td>
			<td>IM2427U</td>
			<td>store at 4 &#176;C, RRID: N/A</td>
		</tr>
		<tr>
			<td>Anti-Human CD4 antibody, APC</td>
			<td>BD Bioscience</td>
			<td>555349</td>
			<td>store at 4 &#176;C, RRID: AB_398593</td>
		</tr>
		<tr>
			<td>Anti-Human CD45 antibody, Pe-Cy7</td>
			<td>Beckman Coulter</td>
			<td>IM3548U</td>
			<td>store at 4 &#176;C, RRID: AB_1575969</td>
		</tr>
		<tr>
			<td>Anti-Human CD56 antibody, PE</td>
			<td>Beckman Coulter</td>
			<td>IM2073U</td>
			<td>store at 4 &#176;C, RRID: AB_131195</td>
		</tr>
		<tr>
			<td>Anti-Human CD63 antibody,PE</td>
			<td>BD Bioscience</td>
			<td>561925</td>
			<td>store at 4 &#176;C, RRID: AB_10896821</td>
		</tr>
		<tr>
			<td>Anti-Human CD8 antibody, APC-Alexa Fluor 750</td>
			<td>Beckman Coulter</td>
			<td>A94686</td>
			<td>store at 4 &#176;C, RRID: N/A</td>
		</tr>
		<tr>
			<td>Anti-Human CD80 antibody, APC</td>
			<td>Beckman Coulter</td>
			<td>B30642</td>
			<td>store at 4 &#176;C, RRID: N/A</td>
		</tr>
		<tr>
			<td>Anti-Human CD81 antibody, FITC</td>
			<td>BD Bioscience</td>
			<td>561956</td>
			<td>store at 4 &#176;C, RRID: AB_394049</td>
		</tr>
		<tr>
			<td>Anti-Human CD86 antibody, APC-Alexa Fluor 750</td>
			<td>Beckman Coulter</td>
			<td>B30646</td>
			<td>store at 4 &#176;C, RRID: N/A</td>
		</tr>
		<tr>
			<td>Anti-Human CD9 antibody, FITC</td>
			<td>ThermoScientic</td>
			<td>MA5-16860</td>
			<td>store at 4 &#176;C, RRID: AB_2538339</td>
		</tr>
		<tr>
			<td>Anti-Human Galectin 9 antibody, Brilliant Violet 421</td>
			<td>Biolegend</td>
			<td>348919</td>
			<td>store at 4 &#176;C, RRID: AB_2716134</td>
		</tr>
		<tr>
			<td>Anti-Human OCT3/4 antibody, eFluor660</td>
			<td>ThermoScientic</td>
			<td>50-5841-82</td>
			<td>store at 4 &#176;C, RRID: AB_11218882</td>
		</tr>
		<tr>
			<td>Anti-Human SOX2 antibody, Alexa Fluor 488</td>
			<td>ThermoScientic</td>
			<td>53-9811-82</td>
			<td>store at 4 &#176;C, RRID: AB_2574479</td>
		</tr>
		<tr>
			<td>BCA Protein Assay Kit</td>
			<td>ThermoFisher Scientific</td>
			<td>23227</td>
			<td></td>
		</tr>
		<tr>
			<td>Bovine Serum Albumin</td>
			<td>Millipore Sigma</td>
			<td>A1933</td>
			<td></td>
		</tr>
		<tr>
			<td>Buffy coat</td>
			<td>New York Blood Center</td>
			<td></td>
			<td>40-60 ml/unit</td>
		</tr>
		<tr>
			<td>Cell scraper</td>
			<td>Falcon</td>
			<td>353085</td>
			<td></td>
		</tr>
		<tr>
			<td>Disposable semi-micro cuvette</td>
			<td>VWR</td>
			<td>97000590</td>
			<td></td>
		</tr>
		<tr>
			<td>Dissociation buffer</td>
			<td>Gibco</td>
			<td>131510014</td>
			<td>100 ml</td>
		</tr>
		<tr>
			<td>Dual-Chanber cell counting slides</td>
			<td>Bio-Rad</td>
			<td>1450015</td>
			<td></td>
		</tr>
		<tr>
			<td>Exosome-Human CD63 Detection reagent</td>
			<td>ThermoFisher Scientific</td>
			<td>10606D</td>
			<td>store at 4 &#176;C</td>
		</tr>
		<tr>
			<td>Ficoll-Paque PLUS density grandient media</td>
			<td>GE Health</td>
			<td>17-1440-03</td>
			<td>500 ml</td>
		</tr>
		<tr>
			<td>Fixed-Angle Rotor(25&#176;)</td>
			<td>Thermo Scientifc</td>
			<td>75003698</td>
			<td>Maxium 24,700 x g</td>
		</tr>
		<tr>
			<td>Gallios flow cytometer</td>
			<td>Beckman Coulter</td>
			<td></td>
			<td>3 lasers 
			10 Color Max</td>
		</tr>
		<tr>
			<td>Human cord blood</td>
			<td>Cryo-Cell International</td>
			<td></td>
			<td>40-100 ml/unit</td>
		</tr>
		<tr>
			<td>Human Fc Block</td>
			<td>BD Bioscience</td>
			<td>564220</td>
			<td>store at 4 &#176;C</td>
		</tr>
		<tr>
			<td>Immun-Blot PVDF membrane</td>
			<td>Bio-Rad</td>
			<td>1620177</td>
			<td></td>
		</tr>
		<tr>
			<td>Millex-GP Syringe Filter Unit, 0.22 &#181;m</td>
			<td>Millipore Sigma</td>
			<td>SLGP033RS</td>
			<td></td>
		</tr>
		<tr>
			<td>Optima XE-90 Ultracentriguge</td>
			<td>Beckman Coulter</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Orbital Shaker MP4</td>
			<td>BioExpress</td>
			<td>S-3500-1</td>
			<td></td>
		</tr>
		<tr>
			<td>PBS</td>
			<td>ThermoFisher Scientific</td>
			<td>10010049</td>
			<td>500 ml</td>
		</tr>
		<tr>
			<td>Propidium Iodide</td>
			<td>BD Bioscience</td>
			<td>56-66211E</td>
			<td>store at 4 &#176;C</td>
		</tr>
		<tr>
			<td>Nikon Eclipse Ti2 microscope</td>
			<td>Nikon instruments Inc</td>
			<td>Eclipse Ti2</td>
			<td>NIS-Elements software version 5.11.02</td>
		</tr>
		<tr>
			<td>Hochest 33342</td>
			<td>Thermo Scientifc</td>
			<td>62249</td>
			<td>5 ml</td>
		</tr>
		<tr>
			<td>Revert microsopy</td>
			<td>Fisher scientific</td>
			<td>12563518</td>
			<td></td>
		</tr>
		<tr>
			<td>Rotor 41 Ti</td>
			<td>Beckman Coulter</td>
			<td>331362</td>
			<td>Maxium 41,000 rpm</td>
		</tr>
		<tr>
			<td>Sorvall St 16R Centrifuge</td>
			<td>Thermo Scientifc</td>
			<td>75004381</td>
			<td></td>
		</tr>
		<tr>
			<td>Swinging Bucket Rotor</td>
			<td>Thermo Scientifc</td>
			<td>75003655</td>
			<td></td>
		</tr>
		<tr>
			<td>TC-20 cell counter</td>
			<td>Bio-Rad</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>ThermoScientific Forma 380 Steri Cycle CO2 Incubator</td>
			<td>ThermoFisher Scientific</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Transmission electron microscopy</td>
			<td>JEOL</td>
			<td>JEM-2100 PLUS</td>
			<td></td>
		</tr>
		<tr>
			<td>Ultracentrifuge tube</td>
			<td>Beckman Coulter</td>
			<td>331372</td>
			<td></td>
		</tr>
		<tr>
			<td>X&#39;VIVO 15 Serum-free medium</td>
			<td>Lonza</td>
			<td>BEBP04-744Q</td>
			<td>1000 ml Culture medium, store at 4 &#176;C</td>
		</tr>
	</tbody>
</table>

differentiation of monocytes into phenotypically distinct macrophages after treatment with human cord blood stem cell (cb-sc)-derived exosomes

Stem Cell Educator (SCE) therapy is a novel clinical approach for the treatment of type 1 diabetes and other autoimmune diseases. SCE therapy circulates the isolated patient&#8217;s blood mononuclear cells (e.g., lymphocytes and monocytes) through an apheresis machine, co-cultures the patient&#8217;s blood mononuclear cells with adherent cord blood-derived stem cells (CB-SC) in the SCE device, and then returns these &#8220;educated&#8221; immune cells to the patient&#8217;s blood. Exosomes are nano-sized extracellular vesicles between 30&#8210;150 nm existing in all biofluid and cell culture media. To further explore molecular mechanisms underlying SCE therapy and determine the actions of exosomes released from CB-SC, we investigate which cells phagocytize these exosomes during the treatment with CB-SC. By co-culturing Dio-labeled CB-SC-derived exosomes with human peripheral blood mononuclear cells (PBMC), we found that CB-SC-derived exosomes were predominantly taken up by human CD14-positive monocytes, leading to the differentiation of monocytes into type 2 macrophages (M2), with spindle-like morphology and expression of M2-associated surface molecular markers. Here, we present a protocol for the isolation and characterization of CB-SC-derived exosomes and the protocol for the co-culture of CB-SC-derived exosomes with human monocytes and the monitoring of M2 differentiation.

Initially, the phenotype and purity of CB-SC were examined by flow cytometry with CB-SC-associated markers such as leukocyte common antigen CD45, ES cell-specific transcription factors OCT3/4, and SOX2. CB-SC display high levels of CD45, OCT3/4, SOX2, CD270, and galectin 9 expression, but no expression of CD34 (Figure 1A). Flow cytometry analysis confirmed the expression of exosome-specific markers including CD9, CD81, and CD63 were on CB-SC-derived exosomes (Figure 1B</...

Watch this Scientific Journal Video about Differentiation of Monocytes into Phenotypically Distinct Macrophages After Treatment with Human Cord Blood Stem Cell CB-SC-Derived Exosomes at JoVE.com

Differentiation of Monocytes into Phenotypically Distinct Macrophages After Treatment with Human Cord Blood Stem Cell CB-SC-Derived Exosomes

Exosome application is an emerging tool for drug development and regenerative medicine. We establish an exosome isolation protocol with high purity to isolate exosomes from novel identified stem cells called CB-SC for mechanistic studies. We also coculture CB-SC-derived exosomes with human monocytes, leading to their differentiation into phenotypically distinct macrophages.

Differentiation of Monocytes into Phenotypically Distinct Macrophages After Treatment with Human Cord Blood Stem Cell (CB-SC)-Derived Exosomes

Stem Cell Educator (SCE) therapy is a novel clinical approach for the treatment of type 1 diabetes and other autoimmune diseases. SCE therapy circulates ...

The Stem Cell Educator therapy was developed to treat type I diabetes and the other autoimmune disease. This method was developed to explore the molecule mechanism underlying immune moderation of Stem Cell Educator therapy through CB-SC released exosomes. This protocol provide guidance on how to purify exosomes from a human cord blood stem cells cultures and determine their immune modulation of monocytes.Demonstrating the procedure will be Wei Hu, a PhD student, from my lab. To begin, centrifuge the CB-SC-derived conditioned medium three times as described in the text manuscript, collecting the supernatant into a new 50 milliliter conical tube after each centrifugation. After the third centrifugation, filter the obtained supernatant with a 0.22 microliter filter and transfer 15 milliliters of media to each 10 kilodalton centrifugal filter unit.Centrifuges at 4, 000 x g for 30 minutes to isolate the concentrated exosome media. Transfer the concentrated exosomes to an ultracentrifuge tube. Then pellet the exosomes at 100, 000 x g for 80 minutes at four degrees Celsius.Then discard the supernatant and resuspend the pelleted exosomes in 10 milliliters of PBS. Perform a final ultracentrifugation to collect the exome pellet and resuspend it in 200 microliters of PBS. Add 30 million human PBMCs to a 15 milliliter tube and centrifuge at 300 x g for 10 minutes at four degrees Celsius.Resuspend the cells in 300 microliters of cold PBS and add 60 microliters of CD14 microbeads. Mix well and incubate the cells on ice for 15 minutes. Add six more milliliters of cold PBS and centrifuge at 300 x g for 10 minutes at four degrees Celsius.Then resuspend the pelleted cells in 500 microliters of cold running buffer. Place the separation column in the magnet separator and wash it three times with two milliliters of cold running buffer. Transfer the resuspended cells into the separation column and let them pass.Again, wash the column three times with two milliliters of running buffer per wash. Then lift the column from the magnet separator and place it over a 15 milliliter centrifuge tube on ice. Elute the CD14 positive cells with two milliliters of cold running buffer and centrifuged at 300 x g for 10 minutes at four degrees Celsius to pellet the cells.Resuspend the pellet in two milliliters of cold chemical defined serum medium and transfer 50 microliters of it into a 1.5 milliliter tube. Stain the obtained cells with 10 microliters of Krome Orange-conjugated anti-human CD14 monoclonal antibodies for 20 minutes. Add one milliliter of PBS and centrifuge at 300 x g for 10 minutes to pellet the cells.Resuspend the cell pellet in 200 microliters of PBS and transfer it into a five milliliter tube. Determine the purity of CD14+monocytes by flow cytometry. Seed one million of the obtained purified monocytes in a tissue culture treated six-well plate and incubate for two hours at 37 degrees Celsius under 5%carbon dioxide.After incubation discard the supernatant and gently add two milliliters of 37 degree pre-warmed chemical defined serum-free culture medium, then add 80 micrograms of the CB-SC-derived exosomes to the monocyte culture in the six-well plate with a total volume of two milliliters. Incubate the plate at 37 degrees Celsius under 5%carbon dioxide for three to four days. Then image the cell morphology using an inverted microscope at 200X magnification.Add one milliliter of PBS-based cell dissociation buffer to detach the cells by pipetting up and down and harvest the remaining cells with a cell scraper. Collect the cells by centrifuging at 1, 690 x g for five minutes and resuspend them in 200 microliters of PBS. Add five microliters of FC blocker to block the non-specific binding, then add the antibodies.Incubate the cells at room temperature for 30 minutes. Add one milliliter of PBS to the incubated cells and centrifuge them at 300 x g for 10 minutes. Resuspend the pellet in 200 microliters of PBS and add five microliters of propidium iodide per sample.Transfer the cells to a new five milliliter flow tube and perform flow cytometry to evaluate the levels of CD14, CD80, CD86, CD163, CD206, and CD209 expression. The phenotype and purity of CB-SCs were examined by flow cytometry with CB-SC associated markers. The analysis showed high levels of CD45, OCT3/4, SOX2, CD270 and galectin 9 expression but no expression of CD34 was observed.Flow cytometry analysis also confirm the expression of exome specific markers, CD9, CD 81, and CD63 on CB-SC-derived exosomes. The size morphology of exosomes was characterized by TEM and the size distribution was determined by DLS. Western blot further prove the expression of the exome associated marker Alix without expression of the ER associated marker, calnexin.The direct interaction of Dio-labeled CB-SC-Exo with PBMC was observed using fluorescence microscopy. To better define which cell population interacted with the dial labeled CB-SC-Exo, different cell compartments were gated with cell specific markers, such as CD3 for T cells, CD11C for myeloid dendritic cells, CD14 for monocytes, CD19 for B cells, and CD56 for NK cells. Monocytes were primarily targeted by the CB-SC-derived exosomes as they exhibited higher median fluorescence intensities than those of other immune cells.The exosome treated monocytes successfully differentiated into spindle-like morphologies. There was an upregulation in the level of M2 associated markers, such as CD163, CD206, and CD209 after the treatment with CB-SC-derived exosomes. Phenotypic comparison between conventional M2 macrophages and the CB-SC exome-induced M2 macrophages showed no significant differences.The key step in this protocol is adding CB-SC-derived exosomes to the monocyte of culture in six-well plate and incubate it for three to four days, which needed to the cell's differentiation to other type 2 macrophages with spindle-like morphology. Next, we are going to explore the molecule components inside of CB-SC-derived exosomes that contributed to the induction of differentiation of monocyte into type 2 macrophages.

differentiation-monocytes-into-phenotypically-distinct-macrophages

Research

JoVE Journal

Immunology and Infection

5.6K vistas.  Hackensack Meridian Health Center. La terapia de educador de células madre fue desarrollada para tratar la diabetes tipo I y la otra enfermedad autoinmune. Este método fue desarrollado para explorar el mecanismo de molécula subyacente a la moderación inmune de la terapia de educador de células madre a través de EXOsomas liberados CB-SC. Este protocolo proporciona orientación sobre cómo purificar exosomas de cultivos de células madre de sangre de cordón umbilical humano y determinar su modulación inmune de monocitos....