Name: ultrasound-guided intracardiac injection of human mesenchymal stem cells to increase homing to the intestine for use in murine models of experimental inflammatory bowel diseases
Uploaded: 2017-09-01T12:30:00
Description: Watch this Scientific Journal Video about Ultrasound-guided Intracardiac Injection of Human Mesenchymal Stem Cells to Increase Homing to the Intestine for Use in Murine Models of Experimental Inflamma

Maneesh Dave is supported by Department of Defense grant PR141774 and the Crohn's and Colitis Foundation of America Career Development Award. The laboratory of Fabio Cominelli is supported by NIH grants DK042191 (F.C.), DK055812 (F.C.), DK091222 (F.C.), and DK07948 (F.C.). The laboratory of Arnold Caplan is supported in part by the L. David and E. Virginia Baldwin Foundation. The funding agencies had no role in the study analysis or writing of the manuscript. Its contents are solely the responsibility of the authors.

All mice experiments and procedures in the study were approved by Case Western Reserve University&#39;s Institutional Animal Care and Use Committee. The procedures were conducted in Association for Assessment and Accreditation of Laboratory Animal Care (AAALAC) accredited facility. The BM was aspirated under a University Hospitals Institutional Review Board-approved protocol at the stem cell core facility at Case Western Reserve University after informed consent.
1. Culture and Transduction of H...

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This study describes a novel technique for the ultrasound-guided intracardiac injection of hMSCs in a small-intestinal mouse model of experimental CD. This technique has very high rate of survival and success, as the trajectory of the needle can be adjusted based on real-time, high-resolution images of the mouse left ventricle, provided by the ultrasound. The advantage of delivery to the left ventricle is that hMSCs are then distributed intra-arterially and bypass venous circulation, thus avoiding the aggregation of cell...

Crohn&#39;s disease (CD) is a common chronic inflammatory disease of the small and large intestines and is thought to result from an inappropriate response of the host immune system to intestinal microbes7,8. Recent studies have shown that both murine and human mesenchymal stem cells (MSCs) can suppress inflammation in mouse models of intestinal inflammation1,3,4,5. There are multiple ongoing clinical trials that use human MSCs derived from bone marrow or adipose tissue to treat patients with inflammatory bowel disease (IBD), which includes CD9. Two routes for MSC therapy have been used in these clinical trials: one involves the systemic infusion (i.e., intravenously) of MSCs for luminal IBD (including CD), and the other involves the localized application/injection of stem cells in the fistula tract of patients with perianal CD. In a recent meta-analysis of MSC therapy for IBD, systemic (i.e., intravenous) MSC therapy for luminal IBD (including CD) was efficacious in up to 40% (95% CI: 7 - 79%) of patients, whereas the efficacy was much higher, at 61% (95% CI: 36 - 85%), when the MSCs were injected locally into the diseased CD fistula9. A recent phase III multicenter randomized placebo controlled trial of allogeneic adipose stem cells injected directly into the perianal fistula of CD patients showed statistically significant clinical and radiological evidence of perianal fistulae healing, corroborating the findings of the meta-analysis10. The reasons for the low efficacy of MSC therapy given intravenously for luminal CD has been inadequately investigated, but one reason may be the inadequate homing of MSCs to the site of inflammation. Murine studies in models of colonic inflammation have demonstrated that only a small percentage of MSCs (1 - 5%) injected intravenously reach the inflamed colon; the remaining MSCs are filtered by the lungs (first-pass effect)1,2,5,11,12. Multiple murine research studies have therefore used the intraperitoneal route (i.p.) for MSC administration in animal models of colitis4. However, they have also demonstrated that only a small fraction of cells reach and engraft the colon and that the efficacy is related to the secretion of soluble paracrine factors, like tumor necrosis factor-inducible gene 6 protein (TSG-6)2. The MSC mechanism of immunosuppression and healing involves a multipronged approach that involves paracrine; cell proximity-independent factors, like TSG-6; and cell proximity-dependent factors, like programmed death-ligand 1 (PD-L1); or Jagged 1. Therefore, MSC localization to the site of inflammation may result in increased efficacy9,13. In fact, a recent study showed that MSCs directly implanted at the site of colonic injury resulted in healing by secreting angiogenesis-promoting vascular endothelial growth factor (VEGF). On the other hand, a minimal healing effect was noted after intravenous injection5. To increase their localization to the site of inflammation (i.e., the small intestine in SAMP mice), this ultrasound-guided intracardiac injection technique for MSC administration in the left ventricle was developed. Image-guided injection ensures an accurate injection, which leads to a higher rate of success and to decreased morbidity and mortality rates. Moreover, the injection of MSCs into the left ventricle delivers them to arterial circulation, where they can reach the inflamed small intestine before becoming trapped in the lungs.
In this study, human bone marrow-derived MSCs (hMSCs) were used for injection in the SAMP-1/YitFc (SAMP) murine model of CD14. SAMP is a well-characterized spontaneous murine model of chronic inflammation that develops small-intestinal inflammation with nearly 100% penetrance14. The inflammation develops in response to microflora in the absence of any chemical, immunological, or genetic manipulation and closely resembles human CD11. Sex- and age-matched inflammation-free AKR/J (AKR) mice, the parental control mice of SAMP, were used in this study.
The hMSCs were isolated and expanded in the laboratory from bone marrow (BM) samples obtained from normal, unidentified donors after informed consent using validated and previously published protocols15,16. After isolation and expansion, the MSC ability in osteogenic, adipogenic, and chondrogenic differentiation was evaluated in the laboratory by multiple assays15. The osteogenic functional assay was performed by implanting ceramic cubes of hydroxyapatite/tricalcium phosphate matrix containing hMSCs subcutaneously in immunocompromised CB17-Prkdc SCID mice17. The cube assay demonstrates osteogenesis and chondrogenesis potential and is considered the ultimate test for evaluating individual MSC preparations17. To visualize hMSCs in vivo after injection, lentivirus was used to transduce hMSCs with triple reporter gene construct that consists of firefly luciferase (fl), monomeric red fluorescent protein (mRFP), and herpes simplex viral thymidine kinase (ttk), driven by a modified myeloproliferative sarcoma virus (mnd) promoter18. The firefly luciferase in the triple reporter is an enzyme that coverts injected luciferin to oxyluciferin in hMSCs and produces photons/white light. This is detected by the sensitive charge-coupled device (CCD) camera (bioluminescence) in an in vivo optical imaging system, enabling the visualization of live hMSCs in mice. Bioluminescence imaging (BLI) is a sensitive technique that can be used serially for tracking cells and for ex vivo analysis. The use of a strong mnd promoter drives the continuous expression of the triple fusion reporter gene construct and allows for the imaging of injected hMSCs for more than 16 weeks19. The hMSCs are difficult to transduce and have a low transduction efficiency. Using an optimized protocol, the hMSCs transduction efficiency was improved and the transgene expression was enhanced18. Using mRFP expression (one of the triple reporter genes) on flow cytometry, the ability to transduce hMSCs with a high efficiency of up to 83% was demonstrated. Differentiation assays and in vivo cube assays demonstrated the ability of the transduced hMSCs to differentiate into chondrocytes, adipocytes, and osteocytes17.

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			<td>Fisher Scientific</td>
			<td>FB0875711A</td>
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			<td height="21" style="height:21px;">SAMP mice</td>
			<td>Cleveland Digestive Disease Research Core Centre</td>
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			<td height="21" style="height:21px;">AKR mice</td>
			<td>Cleveland Digestive Disease Research Core Centre</td>
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			<td height="21" style="height:21px;">Triple reporter</td>
			<td colspan="2">Kindly provided by Dr. Zheng- Hong Lee, CWRU, (citation 19)</td>
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</table>

ultrasound-guided intracardiac injection of human mesenchymal stem cells to increase homing to the intestine for use in murine models of experimental inflammatory bowel diseases

Crohn&#39;s disease (CD) is a common chronic inflammatory disease of the small and large intestines. Murine and human mesenchymal stem cells (MSCs) have immunosuppressive potential and have been shown to suppress inflammation in mouse models of intestinal inflammation, even though the route of administration can limit their homing and effectiveness 1,3,4,5. Local application of MSCs to colonic injury models has shown greater efficacy at ameliorating inflammation in the colon. However, there is paucity of data on techniques to enhance the localization of human bone marrow-derived MSCs (hMSCs) to the small intestine, the site of inflammation in the SAMP-1/YitFc (SAMP) model of experimental Crohn&#39;s disease. This work describes a novel technique for the ultrasound-guided intracardiac injection of hMSCs in SAMP mice, a well-characterized spontaneous model of chronic intestinal inflammation. Sex- and age-matched, inflammation-free AKR/J (AKR) mice were used as controls. To analyze the biodistribution and the localization, hMSCs were transduced with a lentivirus containing a triple reporter. The triple reporter consisted of firefly luciferase (fl), for bioluminescent imaging; monomeric red fluorescent protein (mrfp), for cell sorting; and truncated herpes simplex virus thymidine kinase (ttk), for positron emission tomography (PET) imaging. The results of this study show that 24 h after the intracardiac administration, hMSCs localize in the small intestine of SAMP mice as opposed to inflammation-free AKR mice. This novel, ultrasound-guided injection of hMSCs in the left ventricle of SAMP mice ensures a high success rate of cell delivery, allowing for the rapid recovery of mice with minimal morbidity and mortality. This technique could be a useful method for the enhanced localization of MSCs in other models of small-intestinal inflammation, such as TNF&#916;RE6. Future studies will determine if the increased localization of hMSCs by intra-arterial delivery can lead to increased therapeutic efficacy.

Figure 1 shows that hMSCs can be transduced with the triple reporter at a high efficiency, preserving their stem cell properties. Transduced hMSCs can be visualized in real time by BLI (Figure 1C, Figure 3). This novel, ultrasound-guided injection of hMSCs into the left ventricle of SAMP mice ensures a very high success rate of injection, allowing for the rapid recovery of the mice with minimal morbi...

Watch this Scientific Journal Video about Ultrasound-guided Intracardiac Injection of Human Mesenchymal Stem Cells to Increase Homing to the Intestine for Use in Murine Models of Experimental Inflamma

Ultrasound-guided Intracardiac Injection of Human Mesenchymal Stem Cells to Increase Homing to the Intestine for Use in Murine Models of Experimental Inflammatory Bowel Diseases

Murine studies in models of colonic inflammation have demonstrated that a small percentage (1 - 5%) of mesenchymal stem cells (MSC) injected intravenously or intraperitoneally home to the inflamed colon1,2. This study shows that ultrasound-guided intracardiac injections of MSCs result in increased localization to the intestine.

Crohn&#39;s disease (CD) is a common chronic inflammatory disease of the small and large intestines. Murine and human mesenchymal stem cells (MSCs) have ...

The overall goal of this procedure is to use ultrasound-guided intracardiac human bone marrow derived mesenchymal stem cell or HMSC injection in a mouse model of experimental crohn's disease, to observe HMSC homing to the intestine. This method can help answer the key questions in the inflammatory bowel disease field, about the need for increased localisations of HMSC to small intestine during inflammation. The main advantage of this technique is that it facilitates a high HMSC delivery success rate with minimal mouse mobility and mortality.Generally, individuals new to this method can have trouble because multiple variables, they can affect the procedure outcome. Requiring a lot of trainee understanding of human mesenchymal stem cell biology. Demonstrating the procedures will be Paola Menghini, a post doc from our laboratory.In a specific pathogen free facility, set up the mouse echocardiogram ultrasound imaging system protocol and initialize the 30 megahertz transducer. Next, confirm the appropriate level of sedation by toe pinch and apply ointment to the animal's eyes. Use depilatory cream to remove the hair over the thorax and place the animal on the 37 degree celsius imaging table in the supine position.Tape the limbs to prevent movement during the procedure and disinfect the exposed skin of the thorax with 10%povidone iodine and 70%ethanol. Apply a thick layer of 37 degree celsius ultrasound gel to the skin and mount the transducer in the holder, adjusting the position of the transducer until the left ventricle is clearly visible in the field of view. Next, gently re-suspend 2 x 10 to the sixth transduced human mesenchymal stem cells in 150 microliters of sterile PBS to generate a homogenous cell suspension and load the cells into a one milliliter syringe equipped with a 28 gauge needle.Inject less than 150 microliters of cell suspension per mouse to avoid a volume overload and death. Secure the syringe in a syringe holder. Then, advance the syringe towards the mouse thorax using the ultrasound guidance to adjust the needle trajectory as necessary and penetrate the needle tip through the intercostal space into the left ventricle.Adequate visualization of the needle on the ultrasonographic image is critical for ensuring a proper trajectory and insertion of the needle into the left ventricle, a successful injection and the avoidance of cardiac dampening and death. The tip should be clearly visible within the left ventricle and proper placement can be further confirmed by fresh arterial blood outflow into the syringe. Apply a gentle pressure to the plunger to slowly inject the HMSC suspension over a period of two minutes.When all the cells have been injected, gently withdraw the needle and place the animal in a clean cage on a preheated pad with monitoring until full recovery. 24 hours after the injection, initialize the bioluminescence imaging system and open a new study in the in-vivo imaging software. To set the imaging parameters in the control panel, click the sequence set up.In the imaging mode, select luminescent and photograph. Set the exposure times from 0.5 seconds to 10 minutes, the bidding to medium and the f/stop to one. Set the excitation filter to block, the emission filter to open and the field of view to see for two mice.Then click on the acquisition control panel to add the sequence set up to the image wizard. Next, inject the first mouse with 300 microliters of d-luciferin. Apply ointment to the animals'eyes and transfer the mouse to the in-vivo imaging chamber.10 minutes after the d-luciferin injection, click acquire, to begin the image acquisition. After all the mice have been imaged, harvest the whole gastrointestinal tract, mesenteric lymph nodes, lungs, spleen and liver from each animal. Then image the organs as just demonstrated, for whole animal bioluminescence imaging.HMSC can be transduced with the triple reporter at a high efficiency preserving the stem cell properties and allowing their visualization in real time by bioluminescence imaging. Ex-vivo analysis of the intracardiac delivered stem cells, confirms that this root of administration facilitates HMSC homing to the inflamed small intestines of the experimental crohn's disease mice. HMSC is injected into control, inflammation free animals however, do not accumulate in the small intestine.Once mastered, this technique can be completed in less than 15 minutes per mouse if it is performed properly. While attempting this procedure, it's important to remember to use the ultrasound image to adjust the needle trajectory. A poor technique and an incorrect trajectory can lead to cardiac tamponade from hemorrhagic pericardial effusion and death.Following this procedure, other methods like histology and 3D studio microscopy can be performed to answer additional questions such as, does an increased homing of HMSC to the small intestine augment that therapeutic efficacy. This technique will allow researchers in the field of experimental IBD to explore all their mouse models like TNF trajectory, can be injected with HMSCs to enhance homing to the small intestine. After watching this video, you should have a good understanding of how to perform ultrasound guided intracardiac injection of HMSC in mice and of how to use bioluminescent imaging to analyze a bad distribution and homing.Don't forget that working with human MSCs can be hazardous and that precautions such as, using gloves and a face mask with a shield, should always be taken while performing this procedure.

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Research

JoVE Journal

Medicine

The Measurement and Treatment of Suppression in Amblyopia

Amblyopia, a developmental disorder of the visual cortex, is one of the leading causes of visual dysfunction in the working age population. Current estimates put the prevalence of amblyopia at approximately 1-3%1-3, the majority of cases being monocular2. Amblyopia is most frequently caused by ocular misalignment (strabismus), blur induced by unequal refractive error (anisometropia), and in some cases by form deprivation.
Although amblyopia is initially caused by abnormal visual input in infancy, once established, the visual deficit often remains when normal visual input has been restored using surgery and/or refractive correction. This is because amblyopia is the result of abnormal visual cortex development rather than a problem with the amblyopic eye itself4,5 . Amblyopia is characterized by both monocular and binocular deficits6,7 which include impaired visual acuity and poor or absent stereopsis respectively. The visual dysfunction in amblyopia is often associated with a strong suppression of the inputs from the amblyopic eye under binocular viewing conditions8. Recent work has indicated that suppression may play a central role in both the monocular and binocular deficits associated with amblyopia9,10 .
Current clinical tests for suppression tend to verify the presence or absence of suppression rather than giving a quantitative measurement of the degree of suppression. Here we describe a technique for measuring amblyopic suppression with a compact, portable device11,12 . The device consists of a laptop computer connected to a pair of virtual reality goggles. The novelty of the technique lies in the way we present visual stimuli to measure suppression. Stimuli are shown to the amblyopic eye at high contrast while the contrast of the stimuli shown to the non-amblyopic eye are varied. Patients perform a simple signal/noise task that allows for a precise measurement of the strength of excitatory binocular interactions. The contrast offset at which neither eye has a performance advantage is a measure of the "balance point" and is a direct measure of suppression. This technique has been validated psychophysically both in control13,14 and patient6,9,11 populations.
In addition to measuring suppression this technique also forms the basis of a novel form of treatment to decrease suppression over time and improve binocular and often monocular function in adult patients with amblyopia12,15,16 . This new treatment approach can be deployed either on the goggle system described above or on a specially modified iPod touch device15.

Amblyopia is a developmental disorder of the visual cortex that is often accompanied by strong suppression of one eye. We present a new technique for measuring and treating interocular suppression in patients with amblyopia that can be deployed using virtual reality goggles or a portable iPod Touch device.

Amblyopia, a developmental disorder of the visual cortex, is one of the leading causes of visual dysfunction in the working age population. Current ...

The Use of Primary Human Fibroblasts for Monitoring Mitochondrial Phenotypes in the Field of Parkinson's Disease

Parkinson's disease (PD) is the second most common movement disorder and affects 1% of people over the age of 60 1. Because ageing is the most important risk factor, cases of PD will increase during the next decades 2. Next to pathological protein folding and impaired protein degradation pathways, alterations of mitochondrial function and morphology were pointed out as further hallmark of neurodegeneration in PD 3-11.
After years of research in murine and human cancer cells as in vitro models to dissect molecular pathways of Parkinsonism, the use of human fibroblasts from patients and appropriate controls as ex vivo models has become a valuable research tool, if potential caveats are considered. Other than immortalized, rather artificial cell models, primary fibroblasts from patients carrying disease-associated mutations apparently reflect important pathological features of the human disease.
Here we delineate the procedure of taking skin biopsies, culturing human fibroblasts and using detailed protocols for essential microscopic techniques to define mitochondrial phenotypes. These were used to investigate different features associated with PD that are relevant to mitochondrial function and dynamics. Ex vivo, mitochondria can be analyzed in terms of their function, morphology, colocalization with lysosomes (the organelles degrading dysfunctional mitochondria) and degradation via the lysosomal pathway. These phenotypes are highly relevant for the identification of early signs of PD and may precede clinical motor symptoms in human disease-gene carriers. Hence, the assays presented here can be utilized as valuable tools to identify pathological features of neurodegeneration and help to define new therapeutic strategies in PD.

The Use of Primary Human Fibroblasts for Monitoring Mitochondrial Phenotypes in the Field of Parkinson&#039;s Disease

Fibroblasts from patients carrying mutations in Parkinson's disease-causing genes represent an easily accessible ex vivo model to study disease-associated phenotypes. Live cell imaging gives the opportunity to study morphological and functional parameters in living cells. Here we describe the preparation of human fibroblasts and subsequent monitoring of mitochondrial phenotypes.

Parkinson's disease (PD) is the second most  common movement disorder and affects 1% of people over the age of 60 1. Because ageing is  the most important ...

Subretinal Injection of Gene Therapy Vectors and Stem Cells in the Perinatal Mouse Eye

The loss of sight affects approximately 3.4 million people in the United States and is expected to increase in the upcoming years.1 Recently, gene therapy and stem cell transplantations have become key therapeutic tools for treating blindness resulting from retinal degenerative diseases. Several forms of autologous transplantation for age-related macular degeneration (AMD), such as iris pigment epithelial cell transplantation, have generated encouraging results, and human clinical trials have begun for other forms of gene and stem cell therapies.2 These include RPE65 gene replacement therapy in patients with Leber's congenital amaurosis and an RPE cell transplantation using human embryonic stem (ES) cells in Stargardt's disease.3-4 Now that there are gene therapy vectors and stem cells available for treating patients with retinal diseases, it is important to verify these potential therapies in animal models before applying them in human studies. The mouse has become an important scientific model for testing the therapeutic efficacy of gene therapy vectors and stem cell transplantation in the eye.5-8 In this video article, we present a technique to inject gene therapy vectors or stem cells into the subretinal space of the mouse eye while minimizing damage to the surrounding tissue.

This surgical technique illustrates the injection of gene therapy vectors and stem cells into the subretinal space of the mouse eye.

The loss of sight affects approximately 3.4 million people in the United States and is expected to increase in the upcoming years.1 Recently, gene therapy ...

DNBS/TNBS Colitis Models: Providing Insights Into Inflammatory Bowel Disease and Effects of Dietary Fat

Inflammatory Bowel Diseases (IBD), including Crohn&#39;s Disease and Ulcerative Colitis, have long been associated with a genetic basis, and more recently host immune responses to microbial and environmental agents. Dinitrobenzene sulfonic acid (DNBS)-induced colitis allows one to study the pathogenesis of IBD associated environmental triggers such as stress and diet, the effects of potential therapies, and the mechanisms underlying intestinal inflammation and mucosal injury. In this paper, we investigated the effects of dietary n-3 and n-6 fatty acids on the colonic mucosal inflammatory response to DNBS-induced colitis in rats. All rats were fed identical diets with the exception of different types of fatty acids [safflower oil (SO), canola oil (CO), or fish oil (FO)] for three&#160;weeks prior to exposure to intrarectal DNBS. Control rats given intrarectal ethanol continued gaining weight over the 5 day study, whereas, DNBS-treated rats fed lipid diets all lost weight with FO and CO fed rats demonstrating significant weight loss by 48&#160;hr and rats fed SO by 72&#160;hr. Weight gain resumed after 72&#160;hr post DNBS, and by 5 days post DNBS, the FO group had a higher body weight than SO or CO groups. Colonic sections collected 5&#160;days post DNBS-treatment showed focal ulceration, crypt destruction, goblet cell depletion, and mucosal infiltration of both acute and chronic inflammatory cells that differed in severity among diet groups. The SO fed group showed the most severe damage followed by the CO, and FO fed groups that showed the mildest degree of tissue injury. Similarly, colonic myeloperoxidase (MPO) activity, a marker of neutrophil activity was significantly higher in SO followed by CO fed rats, with FO fed rats having significantly lower MPO activity. These results demonstrate the use of DNBS-induced colitis, as outlined in this protocol, to determine the impact of diet in the pathogenesis of IBD.

DNBS/TNBS induced colitis offers an alternative and inexpensive method to study the pathobiology of inflammatory bowel disease. The protocol discussed in this paper outlines the successful application of DNBS to induce colitis in mice and rats and allows one to thoroughly study host-mediated intestinal responses.

Inflammatory Bowel Diseases (IBD), including Crohn&#39;s Disease and Ulcerative Colitis, have long been associated with a genetic basis, and more recently ...

Ultrasound-guided Transthoracic Intramyocardial Injection in Mice

Murine models of cardiovascular disease are important for investigating pathophysiological mechanisms and exploring potential regenerative therapies. Experiments involving myocardial injection are currently performed by direct surgical access through a thoracotomy. While convenient when performed at the time of another experimental manipulation such as coronary artery ligation, the need for an invasive procedure for intramyocardial delivery limits potential experimental designs. With ever improving ultrasound resolution and advanced noninvasive imaging modalities, it is now feasible to routinely perform ultrasound-guided, percutaneous intramyocardial injection. This modality efficiently and reliably delivers agents to a targeted region of myocardium. Advantages of this technique include the avoidance of surgical morbidity, the facility to target regions of myocardium selectively under ultrasound guidance, and the opportunity to deliver injectate to the myocardium at multiple, predetermined time intervals. With practiced technique, complications from intramyocardial injection are rare, and mice quickly return to normal activity on recovery from anesthetic. Following the steps outlined in this protocol, the operator with basic echocardiography experience can quickly become competent in this versatile, minimally invasive technique.

Echocardiography-guided percutaneous intramyocardial injection represents an efficient, reliable, and targetable modality for the delivery of gene transfer agents or cells into the murine heart. Following the steps outlined in this protocol, the operator can quickly become competent in this versatile, minimally invasive technique.

Murine models of cardiovascular disease are important for investigating pathophysiological mechanisms and exploring potential regenerative therapies. ...

Studying Pancreatic Cancer Stem Cell Characteristics for Developing New Treatment Strategies

Pancreatic ductal adenocarcinoma (PDAC) contains a subset of exclusively tumorigenic cancer stem cells (CSCs) which have been shown to drive tumor initiation, metastasis and resistance to radio- and chemotherapy. Here we describe a specific methodology for culturing primary human pancreatic CSCs as tumor spheres in anchorage-independent conditions. Cells are grown in serum-free, non-adherent conditions in order to enrich for CSCs while their more differentiated progenies do not survive and proliferate during the initial phase following seeding of single cells. This assay can be used to estimate the percentage of CSCs present in a population of tumor cells. Both size (which can range from 35 to 250 micrometers) and number of tumor spheres formed represents CSC activity harbored in either bulk populations of cultured cancer cells or freshly harvested and digested tumors 1,2. Using this assay, we recently found that metformin selectively ablates pancreatic CSCs; a finding that was subsequently further corroborated by demonstrating diminished expression of pluripotency-associated genes/surface markers and reduced in vivo tumorigenicity of metformin-treated cells. As the final step for preclinical development we treated mice bearing established tumors with metformin and found significantly prolonged survival. Clinical studies testing the use of metformin in patients with PDAC are currently underway (e.g., NCT01210911, NCT01167738, and NCT01488552). Mechanistically, we found that metformin induces a fatal energy crisis in CSCs by enhancing reactive oxygen species (ROS) production and reducing mitochondrial transmembrane potential. In contrast, non-CSCs were not eliminated by metformin treatment, but rather underwent reversible cell cycle arrest. Therefore, our study serves as a successful example for the potential of in vitro sphere formation as a screening tool to identify compounds that potentially target CSCs, but this technique will require further in vitro and in vivo validation to eliminate false discoveries.

Pancreatic cancer stem cells (CSCs) can be expanded in vitro using the anchorage-independent sphere culture technique, which represents a powerful tool to study CSC biology and can serve as the first step to develop novel CSC-targeting therapies. Here the methodology for expanding, analyzing and targeting of pancreatic CSCs is provided.

Pancreatic ductal adenocarcinoma (PDAC) contains a subset of exclusively tumorigenic cancer stem cells (CSCs) which have been shown to drive tumor ...

Injection of Syngeneic Murine Melanoma Cells to Determine Their Metastatic Potential in the Lungs

Approximately 90% of human cancer deaths are linked to metastasis. Despite the prevalence and relative harm of metastasis, therapeutics for treatment or prevention are lacking. We report a method for the establishment of pulmonary metastases in mice, useful for the study of this phenomenon. Tail vein injection of B57BL/6J mice with B16-BL6 is among the most used models for melanoma metastases. Some of the circulating tumor cells establish themselves in the lungs of the mouse, creating "experimental" metastatic foci. With this model it is possible to measure the relative effects of therapeutic agents on the development of cancer metastasis. The difference in enumerated lung foci between treated and untreated mice indicates the efficacy of metastases neutralization. However, prior to the investigation of a therapeutic agent, it is necessary to determine an optimal number of injected B16-BL6 cells for the quantitative analysis of metastatic foci. Injection of too many cells may result in an overabundance of metastatic foci, impairing proper quantification and overwhelming the effects of anti-cancer therapies, while injection of too few cells will hinder the comparison between treated and controls.

Metastasis plays a profound role in the virulence of cancer, accounting for an estimated 90% of deaths. We report a protocol for a metastatic melanoma model in mice that is useful for determining the efficacy of therapeutic agents against this clinical phenomenon.

Approximately 90% of human cancer deaths are linked to metastasis.  Despite the prevalence and relative harm of metastasis, therapeutics for treatment or ...

Standardized Tuina Manipulation for Knee Osteoarthritis in Rats

Tuina Manipulation to Reduce Inflammation and Cartilage Loss in Knee Osteoarthritis Rats

Clinical trials suggest that Tuina manipulation is effective in treating knee osteoarthritis (KOA), while further studies are required to discover its mechanism. Therefore, the manipulation of animal models of knee osteoarthritis is critical. This protocol provides a standard process for Tuina manipulation on KOA rats and a preliminary exploration of the mechanism of Tuina for KOA. The press and kneading manipulation method (a kind of Tuina manipulation that refers to pressing and kneading the specific area of the body surface) is applied on 5 acupoints around the knee joint of rats. The force and frequency of the manipulation were standardized by finger pressure recordings, and the position of the rat during manipulation is described in detail in the protocol. The effect of manipulation can be measured by pain behavior tests and microscopic findings in synovial and cartilage. KOA rats showed significant improvement in pain behavior. The synovial tissue inflammatory infiltration was reduced in the Tuina group, and the expression of tumor necrosis factor (TNF)-&#945; was significantly lower. Compared to the control group, chondrocyte apoptosis was less in the Tuina group. This study provides a standardized protocol for Tuina manipulation on KOA rats and preliminary proof that the therapeutic effects of Tuina may be related to reducing synovial inflammation and delayed chondrocyte apoptosis.

Author Spotlight: Understanding the Mechanism of Tuina Manipulation in Rats 

We present a protocol for Tuina manipulation performed on plaster-immobilized-induced knee osteoarthritis rats. Based on the preliminary results, it suggested that the efficacy of the method relied on the reduction of inflammation and cartilage loss.

Clinical trials suggest that Tuina manipulation is effective in treating knee osteoarthritis (KOA), while further studies are required to discover its ...

Standardized Tuina Protocol for Rat DRG Compression Model

Analgesic Effect of Tuina on Rat Models with Compression of the Dorsal Root Ganglion Pain

Neuropathic pain is a prevalent condition that affects 6.9%-10% of the population and results from nerve damage due to various etiologies, such as lumbar disc herniation, spinal canal stenosis, and intervertebral foramen stenosis. Although Tuina, a traditional Chinese manual therapy, has shown analgesic effects in clinical practice for the treatment of neuropathic pain, its underlying neurobiological mechanisms remain unclear. Animal models are essential for elucidating the basic principles of Tuina. In this study, we propose a standardized Tuina protocol for rats with compression of the dorsal root ganglion (DRG), which involves inducing DRG compression by inserting a stainless steel rod into the intervertebral foramen, performing Tuina manipulation with specific parameters of location, intensity, and frequency in a controlled environment, and assessing the behavioral and histopathological outcomes of Tuina treatment. This article also discusses the potential clinical implications and limitations of the study and suggests directions for future research on Tuina.

Author Spotlight: Analgesic Effect of Tuina on Rat Models with Compression of the Dorsal Root Ganglion Pain  

This article presents a manipulation for treating chronic compression of the dorsal root ganglion in rats using Tuina therapy, along with a method for evaluating its effectiveness based on pain behavior and histopathological results.

Neuropathic pain is a prevalent condition that affects 6.9%-10% of the population and results from nerve damage due to various etiologies, such as lumbar ...

Advancing Cryostorage of Human Stem Cell-Derived Retinal Pigment Epithelial Cells

Cryopreservation of Human Embryonic Stem Cell-Derived Retinal Pigment Epithelial Cells at the Optimal Stage

Retinal pigment epithelial&#160;(RPE) cells derived from human embryonic stem cells (hESCs) are superior cell sources for cell replacement therapy in individuals with retinal degenerative diseases; however, studies on the stable and secure banking of these therapeutic cells are scarce. Highly variable cell viability and functional recovery of&#160;RPE cells after cryopreservation are the most commonly encountered issues. In the present protocol, we aimed to achieve the best cell recovery rate after thawing by selecting the optimal cell phase for freezing based on the original experimental conditions. Cells were frozen in the exponential phase determined by using the 5-ethynyl-2&#8242;-deoxyuridine labeling assay, which improved cell viability and recovery rate after thawing. Stable and functional cells were obtained shortly after thawing, independent of a long differentiation process. The methods described here allow the simple, efficient, and inexpensive preservation and thawing of hESC-derived RPE cells. Although this protocol focuses on RPE cells, this freezing strategy may be applied to many other types of differentiated cells.

Author Spotlight: Development of an Efficient and Feasible Method of Retinal Pigment Epithelial Cell Freezing

This study provides a detailed protocol for the efficient cryopreservation of human stem cell-derived retinal pigment epithelial cells.

Retinal pigment epithelial&#160;(RPE) cells derived from human embryonic stem cells (hESCs) are superior cell sources for cell replacement therapy in ...