# Patent

## Title
Isolation of spore-like cells from tissues exposed to extreme conditions

## Abstract

Highly undifferentiated spore-like cells can be isolated from many different tissues and bodily fluids after those tissues and fluids have been exposed to extreme conditions. The spore-like cells can be used to treat a wide variety of disorders.

## Background
CROSS-REFERENCE TO RELATED APPLICATION
This is a continuation of application Ser. No. 10/020,778, filed Oct. 30, 2001, now abandoned.
This application claims priority to U.S. Ser. No. 60/244,347, filed Oct. 30, 2000.


TECHNICAL FIELD
The invention relates to compositions and methods for tissue engineering and cell therapies.
BACKGROUND
Every year, millions of people suffer tissue loss or end-stage organ failure (see, e.g., Langer and Vacanti, Science 260:920–926, 1993). When possible, physicians treat this loss or failure by transplanting organs from one individual to another, performing surgical reconstruction, or using mechanical devices such as kidney dialyzers. Although these therapies have saved and improved countless lives, they are imperfect solutions. Transplantation is severely limited by critical donor shortages, which worsen every year, and surgical reconstruction can cause long-term problems. For example, colon cancers often develop after surgical treatment of incontinence that directs urine into the colon. Mechanical devices are inconvenient for the patient, and their performance to date cannot match that of an intact organ. Few, if any, of these treatments can restore the tissue lost or prevent progression of the underlying disorder.
An alternative to the measures described above is tissue engineering, an interdisciplinary science that applies engineering and physiological principles to the development of biological substitutes that maintain, improve, or restore tissue function (Tissue Engineering, R. Skalak and C. F. Fox, Eds., Alan R. Liss, New York, N.Y., 1988; Nerem, Ann. Biomed. Eng. 19:529, 1991). Three general strategies have been adopted for the creation of new tissue. The first employs isolated cells or cell substitutes. This approach avoids the complications of surgery, allows replacement of only those cells that supply the needed function, and permits manipulation of cells before they are administered to a patient. However, the cells do not always maintain their function in the recipient, and they can evoke an immune response that results in their destruction. The second approach employs tissue-inducing substances. For this approach to succeed, appropriate signal molecules, such as growth factors, must be purified and appropriately targeted to the affected tissue. The third approach employs cells placed on or within matrices. In closed systems, these cells are isolated from the body by a membrane that is permeable to nutrients and wastes, but impermeable to harmful agents such as antibodies and immune cells. Closed systems can be implanted or used as extra-corporeal devices. In open systems, cell-containing matrices are implanted and become incorporated into the body. The matrices are fashioned from natural materials such as collagen or from synthetic polymers. Immunological rejection may be prevented by immunosuppressive drugs or by the use of autologous cells.
SUMMARY
The present invention is based, in part, on the discovery that highly undifferentiated cells remain viable within, and can be isolated from, tissue that has been exposed to extreme conditions. Because these cells are highly undifferentiated and have other unusual characteristics, some of which are reminiscent of spores, the cells are called spore-like cells. Spore-like cells are “undifferentiated” in that, when first isolated, they have the characteristics described herein regardless of the tissue type from which they were isolated. The cells can lie dormant in many tissues (they have been found in all tissues examined to date and seem to be ubiquitous), and they are also present in bodily fluids such as the blood. In addition, they are small, have an outer membrane that is rich in glycolipids (or glycogen) and/or mucopolysaccharides, and an unusual cytoarchitecture. They are also multipotent, and they can survive in extreme conditions (e.g., conditions in which differentiated cells would die). Finally, spore-like cells fail to demonstrate activity in a microtetrazolium assay (all known living cells demonstrate redox activity in this assay). These characteristics are discussed in more detail below.
Some of the methods of the invention are based on spore-like cells' remarkable ability to survive under conditions that would kill differentiated cells or known multipotent stem cells (such as those found within the bone marrow, nervous system, and pancreas). For example, spore-like cells are tolerant of oxygen-deprivation. As shown in the Examples below, spore-like cells can survive in oxygen-poor (including essentially oxygen-free) environments, such as those that exist within the tissues of a deceased animal (including tissues that have been frozen for an extended period of time), or within a capped container of phosphate-buffered saline (PBS) for many hours (e.g., four, six, ten, twelve, or 24 hours or more). Differentiated or partially differentiated cells (e.g., stem cells) are able to survive oxygen deprivation for variable, but much more limited, periods of time than spore-like cells can survive the same deprivation. Differentiated neurons are particularly sensitive, surviving in an animal for only about 4–15 minutes after oxygen deprivation (caused by, for example, heart failure, cardiac or respiratory arrest, or a cerebrovascular accident). Cartilage withstands oxygen deprivation better than most other tissues. With refrigeration, cartilage can remain viable for a month or so. But neither differentiated cells nor stem cells can withstand oxygen deprivation to the same extent spore-like cells can. The spore-like cells within a tissue (or within the blood) can outlive the differentiated or partially differentiated cells of that tissue (or within that blood sample) when the tissue (or blood sample) is oxygen-deprived or exposed to another of the extreme conditions described herein. Accordingly, one method of obtaining (or isolating) spore-like cells includes exposing a tissue to conditions that kill the differentiated or partially differentiated cells, but do not kill the spore-like cells therein. The tissue can be any biological tissue, including an intact tissue, a tissue that has been disrupted in some way (by, for example, physical dissociation), or a tissue remnant (e.g., a remnant of skin left at the scene of an accident or epithelial cells that have been naturally shed).
Moreover, spore-like cells can survive (i.e., remain alive after) oxygen deprivation or other harsh conditions (i.e., conditions that would kill a differentiated or partially differentiated cell) without special preservatives. For example, hepatocytes can survive ex vivo for approximately two days if they are specially preserved, but spore-like cells from the liver can survive for the same period (and much longer) without special preservatives.
Spore-like cells can also survive exposure to temperatures higher or lower than temperatures in which differentiated or partially differentiated cells can survive. For example, spore-like cells can survive exposure to temperatures higher or lower than body temperature (e.g., average body temperature, elevated body temperature (as occurs, for example, with fever), or depressed body temperature (as occurs, for example, with hypothermia)). For example, spore-like cells remain viable within (and can be isolated from) tissues that are stored at about 4° C. for a prolonged period of time (e.g., one, three, five, seven, or more days). They also remain viable at temperatures that vary even further from a physiological body temperature. For example, substantially pure populations of spore-like cells (e.g., spore-like cells isolated from a mammal) and spore-like cells within tissues (e.g., spore-like cells within mammalian tissues) can survive freezing or heating to more than 5° C. in excess of a physiological body temperature. That is, viable spore-like cells survive (e.g., within tissues) exposure to temperatures of 0° C., or below, or 43° C. or above (e.g., 45, 50, 55, 58, 60, 75, 90, 95, or 100° C.). As with oxygen-deprivation, spore-like cells can survive exposure to these conditions without special treatment (e.g., they can survive exposure to freezing temperatures even without treatment with a cryopreservative). Viable spore-like cells can also be isolated from tissues that have been thoroughly dried (e.g., by placement in a dessicator for approximately 4, 8, 12, or 24 hours or more).
Because spore-like cells can survive exposure to extreme conditions, they can be isolated from tissues that have been exposed to any one of those conditions (the differentiated or partially differentiated cells having been destroyed by the condition). For example, spore-like cells can be isolated from an animal (including a human) that has been dead for many hours, for several days, or longer. The precise time is not critical. What is important is that the conditions be such that spore-like cells in the tissue of interest survive after the differentiated or partially differentiated cells have died (that is not to say that every spore-like cell that was in the living animal or tissue sample need survive; any number of spore-like cells can survive where no differentiated or partially differentiated cells survive). As indicated above, differentiated cells within oxygen-sensitive tissues, such as the brain, are not viable after only short periods of oxygen deprivation. Thus, the precise conditions required vary depending on the tissue type used for the isolation procedure; the extent of the treatment (e.g., the time the tissue must be oxygen-deprived) need only be sufficient to kill the differentiated or partially differentiated cells in the tissue used.
Spore-like cells can also be isolated from tissues that have been frozen without a cryopreservative. Thus, spore-like cells can be isolated from any tissue (be it intact or processed or manipulated in some way) that has been placed in a freezer without first being treated with a cryopreservative (as noted above, the time period of exposure need only be sufficient to kill the differentiated or partially differentiated cells in the animal, tissue, or bodily fluid). Similarly, spore-like cells can be isolated from animals that have died in the wild in frigid climates and, quite probably, from animals that have been frozen for many, many years. Similarly, because spore-like cells remain viable even after exposure to heat, they can also be recovered from animals that have died in fires, arid landscapes, or in warm springs. Some of the animals from which spore-like cells can be isolated may now be extinct.
Although spore-like cells can be isolated from tissue that has been frozen (or boiled), methods of isolating spore-like cells can be carried out at temperatures above freezing (or below boiling). Here again, the temperature must only be low enough or high enough to kill differentiated or partially differentiated cells.
Spore-like cells can be used to analyze fundamental aspects of cellular differentiation and to treat many types of disorders. For example, spore-like cells can be used to reengineer damaged or diseased tissue, to augment existing tissue, to create new tissue, or to otherwise improve the condition of a patient who is suffering from a disorder that is amenable to treatment by a cell- or gene-based therapy. For example, spore-like cells that differentiate into various types of skin cells can be used to repair skin damaged by physical, thermal, or chemical trauma. Similarly, spore-like cells that differentiate into insulin-secreting cells can be used to treat diabetes; spore-like cells that differentiate into α-galactosidase A-expressing cells can be used to treat Fabry disease; and spore-like cells that differentiate into cells that express angiogenesis inhibiting factors, such as an endostatin, or other anti-tumor agents (e.g., tumor necrosis factor), can be used to treat cancer. These are merely examples of the ways in which spore-like cells can be used. Alternatively, or in addition, one can use spore-like cells that are engineered to secrete substances such as those described above. The cells can be made to express a wide variety of substances by genetic manipulation or exposure to factors that alter their course of differentiation. Spore-like cells can also be used to treat patients who have an infection. It is believed that spore-like cells are so primitive that they remain unaltered by exposure to agents that infect differentiated cells. For example, a patient who has hepatitis can be treated by harvesting a portion of the liver, isolating spore-like cells from that tissue sample, and using the spore-like cells to reengineer mature liver cells and tissues. All or a portion of the infected liver can be ablated before the reengineering process. Similarly, one can treat patients who have cancer using spore-like cells. For example, spore-like cells can be isolated from a patient who has a type of leukemia before the patient undergoes chemotherapy or any other therapy for the cancer. Following therapy, spore-like cells, which may have been induced to differentiate ex vivo, can be administered to the patient to reconstitute a healthy cadre of blood cells. There is no evidence that spore-like cells are susceptible to the processes that result in malignancy, and the therapy administered can be very aggressive (and thereby more likely to kill malignant blood cells and thus, succeed in eradicating the cancer). The methods of the present invention may also be useful in forensic science. For example, one can isolate spore-like cells from a deceased person or from a sample (e.g., a blood sample) found at a crime scene and use the cells to identify the person that was their source. For example, one can place the spore-like cells in culture, allow them to differentiate, and analyze their genetic material by standard techniques.
As noted above, spore-like cells can be isolated from a tissue, including a tissue that has been exposed to any condition that is extreme enough to kill the differentiated or partially differentiated cells within the tissue. For example, the tissue can be exposed to an oxygen deficient environment, a non-physiological temperature, an insufficiently moist environment (as in, for example, a dessicator), or a toxin or any other substance (e.g., a salt or improperly buffered solution) or event (e.g., radiation) that kills differentiated or partially differentiated cells. In particular embodiments, spore-like cells can be isolated from a tissue that was harvested from an animal whose heart ceased beating at least four minutes ago (i.e., an animal that has been dead for at least 4, 10, 20, or 30 minutes; at least 1, 2, 4, 10 or 24 hours; at least 2, 4, 7, 10 or 30 days; at least 5, 10, 20 or 40 weeks; or at least 1, 2, 4, 10 or 100 years). Generally, differentiated cells will not survive unless they are within 200 μm of an oxygen supply (such as a blood vessel carrying oxygenated blood), but spore-like cells can survive even if they are more than 200 μum away from such an oxygen supply.
In other embodiments, spore-like cells can be isolated from a tissue that was (or has been) exposed (e.g., placed in a bath of hot or cold water, a cold room, freezer, or the like) to a temperature that is more than 42° C. or less than 0° C. without first being treated with a protective agent (e.g. a cryopreservative such as glycerol). The isolation procedure following exposure to any extreme condition can be carried out very simply. For example, a biological sample that contains cells such as tissue cells or a bodily fluid that has been exposed to a condition extreme enough to kill differentiated or partially differentiated cells can simply be placed in a tissue culture vessel (e.g., a plate or flask). The dead cells can then be washed away after the spore-like cells adhere to the vessel. If desired, the tissue can be disrupted (by, e.g., cutting, shredding, or scraping it with a blunt instrument) either before or after it is placed in culture or before or after exposure to an extreme condition. Given spore-like cells' ability to survive in extreme conditions, there is no reason to expect that they would not survive in culture under most, if not all, of the conditions used to culture differentiated cells. Alternatively, or in addition, spore-like cells can be isolated by passing a tissue, bodily fluid, or cell culture medium that contains them through a series of devices (e.g., size-exclusion devices such as pipettes or filters) having progressively smaller apertures (the smallest of which can be approximately 15 μ). Smaller diameters (i.e., diameters smaller than 15 μ) can also be used when more aggressive isolation is desired (i.e., when one desires fewer differentiated cells in the resulting culture). More aggressive isolation may be desired when one wishes to maintain the spore-like cells in their highly undifferentiated state. As described below, the conditions in which the cells are cultured can be such that their proliferation is encouraged and their differentiation is discouraged.
The ability to survive after being exposed to a condition that kills differentiated or partially differentiated cells is only one of the unusual characteristics that can be exploited to identify and isolate spore-like cells. They can also be identified and isolated on the basis of their size alone. Although there is some variation in the size of spore-like cells (see below), it is clear that many spore-like cells are smaller than any other known biological cell. Accordingly, one can isolate spore-like cells by isolating the smallest cells in a tissue or bodily fluid. The isolation can be carried out by any method known in the art (e.g., flow cytometry). Alternatively, the method can be carried out using a size-exclusion device, such as the pipettes and filters described above.
In another aspect, the invention features isolated cells that are non-terminally differentiated progeny of spore-like cells that were isolated from non-neural and non-pancreatic tissues and that develop into mature non-neural and non-pancreatic cells.
One way to distinguish the cells of the present invention from previously described cell types is to isolate the present cells from tissues where no stem cells are known to exist. For example, conventional wisdom dictates that there are no stem cells in the liver or the heart. Therefore, any cell isolated from the liver or heart that is a dividing, non-mature cell is a spore-like cell of the present invention or a non-terminally differentiated progeny thereof.
Spore-like cells can be administered alone, with other cell types, or in conjunction with tissue engineering constructs (i.e.,tissue that includes materials or devices used to reengineer damaged, diseased, or otherwise unhealthy tissue). These constructs can include support structures, such as a mesh, or a hydrogel. Together, the hydrogel and the spore-like cells of the invention form a hydrogel-spore-like cell composition. Similarly, a hydrogel combined with a progenitor cell forms a hydrogel-progenitor cell composition. Thus, the invention features methods for generating an artificial tissue by, for example, combining hydrogel with a spore-like cell or the progeny of a spore-like cell. The hydrogel-cell compositions can also be delivered into a permeable, biocompatible support structure and used to treat damaged tissue (e.g., a hydrogel-spore-like cell composition can be applied to the damaged tissue).
In addition to methods for generating and repairing tissue, the invention features methods of treating patients who have a disorder, such as a skin disorder, a tumor, or a disease, such as diabetes. These methods are carried out, for example, by administering a spore-like cell or its progeny to the damaged region (e.g., the damaged region of the patient's skin, the area from which the tumor was ablated, or the pancreas). Systemic administration is also possible. The methods of the invention can be used to treat a patient who has a deficiency of functional cells in any of a wide variety of tissues or systems, including the retina (or other structures associated with vision), auditory system, nasal epithelium, alimentary canal, pancreas, gallbladder, bladder, kidney, liver, heart, lung (including respiratory support structures such as the trachea and smaller airways), nervous system, reproductive system, endocrine system, immune system, bone, muscle, tooth, nail, or skin (including the hair follicles).
Spore-like cells and their progeny must originally be isolated from their natural environment (i.e., removed from a place where they reside within an animal) to fall within the present invention. Spore-like cells can be isolated from tissues that are derived from the endoderm, mesoderm, or ectoderm. Similarly, spore-like cells can differentiate into tissues that derive from the endoerm, mesoderm, or ectoderm. The germ layers, and the tissues they give rise to, are well known in the art. An “isolated” spore-like cell can be one that is placed in cell culture, even temporarily. The term covers single, isolated spore-like cells and their progeny, as well as cultures of spore-like cells (and their progeny) that have been significantly enriched (i.e., cultures in which less than about 10% of the cells are differentiated or partially differentiated cells).
The term “disorder” encompasses medical disorders, conditions, syndromes, illnesses, and diseases, regardless of their etiology. For example, a disorder amenable to treatment with the compositions and methods described herein can be caused by trauma, a genetic defect, an infection, substance abuse, uncontrolled cellular proliferation, or a degenerative process (e.g., neural degeneration or muscular atrophy). A given disorder is treated when the symptoms of the disorder are alleviated or the underlying cause is eliminated or counteracted, either completely or partially.
A “hydrogel” is a substance formed when an organic polymer, which can be natural or synthetic, is set or solidified to create a three-dimensional, open-lattice structure that entraps molecules of water or other solutions to form a gel. Solidification can occur by aggregation, coagulation, hydrophobic interactions, cross-linking, or similar means. Preferably, the hydrogels used in conjunction with spore-like cells solidify so rapidly that the majority of the spore-like cells are retained at the application site. This retention enhances new cell growth at the application site. However, those of ordinary skill in the art will recognize that cellular retention is not always necessary. For example, retention is not necessary when treating a systemic disorder. The hydrogels are also biocompatible (e.g., they are not toxic to cells). The “hydrogel-cell composition” referred to herein is a suspension that includes a hydrogel and a spore-like cell or its progeny.
There are many advantages to using spore-like cells. For example, they can be used to produce sufficient biological material for tissue engineering. This is not always possible when fully differentiated cells are used as the starting material. In addition, spore-like cells can differentiate into a greater variety of cell types than previously identified progenitor cells isolated from adult mammals. Thus,.spore-like cells can be used to maintain or repair many, if not all, tissues and organs, including those (such as the retina) that have not been considered likely candidates for tissue engineering. The pluripotent nature of spore-like cells also allows more histologically complete development of any given tissue. For example, spore-like cells can be used to engineer skin that is pigmented and that contains adnexal structures (i.e., accessory structures or appendages such as hair follicles, sweat glands, sebaceous glands, nail beds, and specialized sensory receptors that allow us to sense pain, pressure, temperature, position, etc). The pigmentation and adnexal structures render the skin replacement a more visually appealing and functional replacement for natural, undamaged skin. Of course, disorders affecting the skin are only one of the many types of disorders that can be treated with spore-like cells. Analogous benefits will be apparent when systemic disorders or disorders affecting other organs (e.g., the pancreas, liver, heart or lung) are treated. The use of spore-like cells may also obviate the need to obtain cells or tissues from embryonic or fetal tissue and may therefore diffuse the emotional and political debate that currently surrounds the research and treatments that rely on embryonic or fetal tissue.
Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. Although methods and materials similar or equivalent to those described herein can be used in the practice or testing of the present invention, useful methods and materials are described below. All publications, patent applications, patents, and other references mentioned herein are incorporated by reference in their entirety. In case of conflicting subject matter, the present specification, including definitions, will control. In addition, the materials, methods, and examples are illustrative only and not intended to be limiting.
Other features and advantages of the invention will be apparent from the following detailed description, and from the claims.



BRIEF DESCRIPTION OF THE DRAWINGS
FIGS. 1A–1C are scanning electron micrographs of spore-like cells obtained from the liver of an adult rat. The cells are magnified 5,000× in FIGS. 1A and 1B, and 10,000× in FIG. 1C. The scale bars represent 1.0 μ.
FIGS. 2A–2D are transmission electron micrographs of spore-like cells obtained from the liver of an adult rat and placed in culture for 12 days. The magnification in FIGS. 2A–2D is 25,000×, 39,000×, 17,000×, and 90,000× respectively.
FIGS. 3A–3C are photographs of cells isolated from an adult rat heart and placed in culture. The newly isolated cells shown in FIG. 3A include undifferentiated spore-like cells (magnified 100×). After three days in culture, early myocardial cells can be seen (FIG. 3B). After two weeks in culture, Purkinje-like structures can be seen (FIG. 3C).
FIGS. 4A–4C are photographs of cells isolated from the small intestine of an adult rat. The newly isolated cells shown in FIG. 4A include undifferentiated spore-like cells. After three days in culture, clusters of small intestinal cells (FIG. 4B) and autonomic neurons (FIG. 4C) can be seen. FIGS. 4A–4C are shown at a magnification of 200×.
FIGS. 5A and 5B are photographs of cells isolated from the bladder of an adult rat. The newly isolated cells shown in FIG. 5A include undifferentiated spore-like cells (magnification at 100×). After two days in culture, the isolated spore-like cells, or their progeny, appear to be differentiating (FIG. 5B; magnification at 200×).
FIGS. 6A and 6B are photographs of cells isolated from the kidney of an adult rat. The newly isolated cells shown in FIG. 6A include undifferentiated spore-like cells (magnification at 100×). After three days in culture, aggregates of cells resembling kidney structures can be (FIG. 6B; magnification at 200×).
FIGS. 7A–7E are photographs of cells isolated from the liver of an adult rat. The newly isolated cells shown in FIGS. 7A and 7C include undifferentiated spore-like cells (magnification at 100×). After three days in culture, an aggregate of cells resembling a differentiating liver structure can be seen (FIG. 7B; magnification at 200×). After seven days in culture, cells resembling hepatocytes can be seen (FIG. 7D). After 12 days in culture, many cells isolated from the liver express bile, as evidenced by a Hall's stain (FIG. 7E; 400×).
FIGS. 8A–8C are photographs of cells isolated from the lung of an adult rat; FIG. 8D is a photograph of cells in a culture initiated by spore-like cells obtained from an adult sheep lung; and FIG. 8E is a photograph of a semi-thin section of a feline lung. The newly isolated cells shown in FIG. 8A include undifferentiated spore-like cells. After six weeks in culture, alveolar-like cells can be seen (FIGS. 8B and 8C). After 30 days in culture, spore-like cells have formed alveolar-like structures (FIG. 8D) similar to those seen in the lungs of adult mammals (FIG. 8E).
FIGS. 9A–9D are photographs of cells isolated from the adrenal-gland of an adult rat. Undifferentiated spore-like cells can be seen at Day 0 (see the arrows in FIGS. 9A (200×) and 9B (400×)). After two days in culture, primitive adrenal cells can be seen (FIGS. 9C (200×) and 9D (400×)).
FIGS. 10A–10C are photographs of islet-like structures. These structures formed in cultures of spore-like cells that were isolated from pancreatic tissue that contained no islets (the islets were harvested prior to the isolation of spore-like cells). After six days in culture, more than 100 islet-like structures were present per field (at 100× magnification; FIGS. 10A and 10B). The islet-like structures were immunostained, which revealed insulin expression (FIG. 10C).
FIG. 11 is a photograph of a culture that includes undifferentiated spore-like cells isolated from adult human blood.
FIGS. 12A and 12B are photographs of cultured cells. The cultures were established seven days earlier and, as shown by phase contrast microscopy, contained spore-like cells isolated from adult human blood (FIG. 12A). Immunofluorescent staining was then performed and, some of the cells expressed nestin (FIG. 12B).
FIG. 13 is a schematic of a permeable support structure filled with a hydrogel-spore-like cell composition.



DETAILED DESCRIPTION
The present invention provides compositions and methods for repairing, replacing, or generating tissue or another biologically useful substance (e.g., a hormone, an enzyme, an anti-angiogenic factor, a cytokine, a growth factor, or other biologically active molecules, including chimeric molecules (e.g., a polypeptide that contains a detectable marker)). The compositions include spore-like cells (e.g., mammalian spore-like cells), and can be used to study cellular differentiation, to detect a compound that has an adverse effect on differentiation (and therefore a possible adverse effect on development) or administered to a patient either by the methods described below or by way of existing tissue engineering or cell therapy procedures known to those of ordinary skill in the art. For example, to screen compounds for possible adverse effects on development, one can expose spore-like cells to the compound(s) and follow their course of differentiation. If the compound inhibits or alters cellular differentiation (relative to an appropriate control, such as a spore-like cell or population of spore-like cells that have been similarly treated but not exposed to the compound), then the compound may have an adverse effect on development (e.g., fetal development) and should be tested further.
When spore-like cells are fused in cell therapies, they can be administered just as more differentiated cells have been administered. For example, when spore-like cells are used to treat diabetes, they can be administered just as mature insulin-expressing cells have been administered (e.g., by implantation under the renal capsule or within various implantable or extracorporeal devices). Spore-like cells can also be placed within a containment device and implanted, for example, within a patient's abdomen to treat a variety of disorders. This method of administration is particularly well suited for treating systemic disorders, such as those caused by an enzymatic imbalance. Implantation by way of containment devices is also useful when cells require protection from the patient's immune system (however, a particular advantage of administering spore-like cells is that they do not require such protection—they may be harvested from the patient to whom they are subsequently administered or they may be so primitive that they fail to evoke an immune response).
Alternatively, as described below, spore-like cells can be combined with a liquid hydrogel that can be placed into a permeable, biocompatible support structure that is delivered to a patient (either before or after it is filled with the hydrogel-cell composition). As the hydrogel-cell composition fills the support structure, it assumes the structure's shape. When spore-like cells proliferate and differentiate to such an extent that they form new tissue, the support structure guides the shape of the developing tissue. For example, the support structure can be shaped as a bone (or a fragment thereof), a meniscus within a joint, an ear, an internal organ (or a portion thereof), or other tissue (e.g., the skin). However, the support structure need not be strictly fashioned after naturally occurring tissue in every case. For example, the support structure can be shaped in a way that simply facilitates delivery of spore-like cells to a patient. For example, the support structure can be shaped to fit under the renal capsule or within some other organ or cavity (e.g. the support structure can be shaped to lie within a portion of the gastrointestinal tract or to fill a space once occupied by tissue, such as the spaces created when a tumor is surgically removed or when a tissue has been destroyed following trauma, ischemia, or an autoimmune response).
In some instances, including instances where spore-like cells are administered in the course of cell or gene therapy, spore-like cells can be administered without containment devices, hydrogels, or support structures. It is well within the ability of one of ordinary skill in the art to determine when spore-like cells should be confined within a space dictated by a support structure and when they should not. For example, one of ordinary skill in the art would recognize that when treating respiratory distress syndrome (RDS) with spore-like cells that are made to secrete surfactant, or that differentiate into cells that secrete surfactant, the substance that reduces surface tension within the alveoli, they must be supplied locally.
Spore-like cells, and their progeny, and exemplary methods for their isolation and administration, are described below.
Spore-Like Cells
As noted above, spore-like cells were so named because they have characteristics reminiscent of those of spores. More specifically, spore-like cells have one-or more of the following characteristics. First, they are widely distributed throughout the body. They have been isolated from every tissue examined to date, and they have been isolated from bodily fluids as well. Thus, they can be isolated from a wide variety of tissues (e.g., cardiac, smooth and skeletal muscle, intestine, bladder, kidney, liver, lung, adrenal gland, skin, retina, nasal epithelium, brain, spinal cord, periosteum, perichondrium, fascia, and pancreas) and bodily fluids (e.g., blood, cerebrospinal fluid, urine, and saliva). Stated more generally, spore-like cells can be isolated from tissues that are generated from the endoderm, mesoderm, or ectoderm.
Second, spore-like cells are multipotent, i.e., they can differentiate into two or more (e.g., two, three, four, five, or more) cell types. For example, multipotent spore-like cells can differentiate into epithelial cell, keratinocytes, and melanocytes. They can also self-replicate. That is, a spore-like cell can divide to produce either one or two new spore-like cells. Spore-like cells can differentiate into the cell types of the tissue from which they were isolated (e.g., spore-like cells isolated from the pancreas can differentiate into insulin-producing islet cells or glucagon-producing islet cells) or into the cell types of another tissue. For example, spore-like cells isolated from the blood can differentiate into insulin-producing islet cells, and spore-like cells isolated from cartilage or periosteum can differentiate into neurons.
Third, spore-like cells are small. Most spore-like cells have a diameter of approximately one to seven microns (e.g., a diameter of one to two, two to four, three to five, about five, or five to ten microns). However, spore-like cells having a diameter of less than approximately one micron in diameter (e.g., one-tenth, one-fifth, one-third, or one-half of a micron) have also been observed). The diameter of the spore-like cells may increase somewhat as they adhere to a tissue culture vessel and “sit down.” Cell size is discussed further below.
Fourth, spore-like cells appear to be membrane-bound, as biological cells typically are, but within the membrane or associated with the membrane, spore-like cells have an unusually high content of glycolipids (or glycogen) and/or mucopolysaccharides. In fact, there are sufficient glycolipids (or glycogen) and/or mucopolysaccharides that the cells appear to have one or more dark stripes when viewed under a powerful microscope (by, e.g., transmission electron microscopy). When the cells are exceedingly small (e.g., less than about one or two microns), the stripes are not as obvious, but they can, even in some of the exceedingly small cells, be seen with a trained eye. While it is not presently known, glycolipids (or glycogen) and/or mucopolysaccharides may help protect spore-like cells and thus better equip them to survive harsh conditions, such as those described herein.
Fifth, spore-like cells have-an unusual cytoarchitecture. Electron micrographs and histological stains for nucleic acids reveal that a large portion (e.g., at least about 50% and up to about 90% or more) of the volume of a spore-like cell is comprised of nucleic acids. Mitochondria have also been observed.
Sixth, spore-like cells can survive in extreme conditions (i.e., conditions in which differentiated or partially differentiated cells would die). For example, spore-like cells are tolerant of oxygen-deprivation. As shown in the Examples below, spore-like cells can survive in low-oxygen environments, such as those that exist within the tissues of a deceased animal, for many hours (e.g., four, six, ten, twelve, or 24 hours or more).
Spore-like cells can be obtained by the methods of the present invention from many different types of donors (e.g., a member of an avian, reptilian, amphibian, or mammalian class). For example, mammalian spore-like cells can be isolated from a rodent, a rabbit, a cow, a pig, a horse, a goat, a sheep, a dog, a cat, a non-human primate, or, preferably, a human. Spore-like cells can be obtained from an animal even after it has reached adulthood. Because spore-like cells tolerate oxygen deprivation and exposure to extreme temperatures better than differentiated cells, viable spore-like cells can also be isolated from deceased animals, including animals that have been deceased for many days, if not weeks, months, or years (e.g., animals that have been deceased for 1,000 years or more).
In addition, spore-like cells can be obtained from a variety of sources within a given donor. For example, spore-like cells can be obtained from bodily fluids (e.g., blood, saliva, cerebrospinal fluid, or urine), and most, if not all, functional organs and mucous membranes. Moreover, spore-like cells can be obtained from the patient who will be subsequently treated with those cells, from another person, or from an animal of a different species. In other words, autologous, allogenic, and xenogeneic spore-like cells can be obtained and used to treat human patients.
Regardless of the source from which they are obtained, spore-like cells can be placed in culture, and cell lines derived from spore-like cells can be developed. Given the unique characteristics of spore-like cells, it is entirely reasonable to think they are immortal (i.e., they can be cultured indefinitely). However, if this is not the case, they can be immortalized using techniques routinely practiced by those of ordinary skill in the art. Thus, cultured spore-like cells and cell lines derived from spore-like cells can also be used to treat human patients.
Spore-like cells can differentiate into many different cell types. For example, as shown below, spore-like cells can be isolated from adult mammalian liver, lung, heart, bladder, kidney, and intestine, and can differentiate into hepatocytes, alveolar cells, cardiac myocytes, bladder cells, renal cells, and autonomic neurons, respectively. Spore-like cells obtained from the retina can differentiate into cells having morphologies similar to that of rods and cones. Spore-like cells obtained from the spinal cord can differentiate into cells having morphologies similar to that of neurons, astrocytes and oligodendrocytes.
Spore-like cells can also be isolated from readily obtainable bodily fluids, such as the blood. Given the variety of known sources for spore-like cells, it is reasonable to expect that these cells can be found in most, if not all, tissues and bodily fluids. Similarly, given the number of differentiated phenotypes already observed, it is reasonable to expect that spore-like cells can differentiate into most, if not all, types of cells.
As noted above, spore-like cells are generally spherical, especially when first isolated, and are typically small. Many cells in a culture of newly isolated spore-like cells are approximately 1 to 3 μ in diameter. However, larger and smaller spore-like cells have been identified (e.g., using electron microscopy; see Example 2). Given that spore-like cells can differentiate into a variety of mature cell types, and that differentiation is a gradual process, it is difficult to define the precise upper size limit of spore-like cells. However, spore-like cells 4 to 5, as well as 7 to 10, μ in diameter have been identified in scanning electron micrographs. Occasionally, even larger cells (e.g., cells as large as 12 to 18 μ or more) have been observed. The larger cells may have in fact been cells on the verge of cell division (structures resembling mitotic clefts are often visible). Alternatively, the larger cells may really be conglomerates of several spore-like cells.
The lower size limit of the spore-like cells is more definite and is certainly unique. Spore-like cells that are only about one-third of a micron in diameter have been observed in scanning electron micrographs and some cells may be as small as one-tenth of a micron. This extremely small size may reflect the unique composition of spore-like cells. Newly isolated spore-like cells contain a great deal of nuclear material and relatively little cytoplasm. In most differentiated cells, the nucleus consumes approximately 10–20% of the cells' volume. However, approximately 50% and up to approximately 90% of the volume of a spore-like cell is consumed with nuclear material. The nuclear material appears to be surrounded by a coat containing glycolipids and/or mucopolysaccharides.
Without limiting the invention to spore-like cells that arise by any particular mechanism, it is believed that spore-like cells may arise when essential DNA fragments (which may represent compressed DNA) are shed from mature cells (e.g., those undergoing cell death by apoptosis or other means) and re-packaged in a glycolipid-rich coat. Indeed, the concept of a minimal genome is beginning to emerge. This concept is exemplified by a mycoplasma that contains 517 genes but only requires 265 to 350 of these genes to survive (Hutchison et al. Science 286:2165–2169, 1999). If one considers the exquisite simplicity of DNA and the genetic code, it seems plausible that the complex information stored in DNA could be compressed considerably.
The unique size and composition of newly-isolated spore-like cell is perhaps best appreciated by viewing the cells with an electron microscope (e.g., see FIGS. 1A–1C and 2A–2D).
Functionally, spore-like cells are unique in at least three ways. First, even though they are present in mature animals (e.g., post-natal, adolescent, or adult animals), they can differentiate into a wide variety of different cell types. Second, spore-like cells tolerate (i.e., survive following exposure to) conditions that kill differentiated or partially differentiated cells (e.g., oxygen-deprivation and exposure to temperatures that are either much higher or much lower than normal body temperature (which, for warm-blooded mammals, is 37° C.)). Experiments have demonstrated that spore-like cells can tolerate essentially complete oxygen deprivation for at least five days (cells were viable despite oxygen deprivation for either four hours, 24 hours, or five days). Thus, spore-like cells can tolerate prolonged oxygen deprivation for at least five days or longer. In addition, spore-like cells have a greater capacity to proliferate than terminally differentiated cells isolated from specialized tissues. Proliferative capacity is an important attribute because tissue engineering, cell therapies, and gene-based therapies are often hampered by physicians' inability to obtain sufficient numbers of cells to administer to a patient.
To obtain spore-like cells, a sample is obtained from an animal, such as a human. One of the easiest samples to obtain is a sample of whole blood. Those of ordinary skill in the art will appreciate that the isolation method may vary slightly depending on the type of tissue used as the starting material. For example, in the event the sample is a blood sample, it can be placed in a tube containing an anti-coagulant. After collection, tissue samples, whether they are samples of bodily fluids, organs, tissues, or cell suspensions thereof, can be stored. Moreover, spore-like cells can be recovered from bodily fluids or other samples that have been stored under conditions in which differentiated cells or known stem cells (e.g., hematopoietic stem cells) cannot survive (e.g., frozen storage without a cryopreservative).
Either immediately after collection or after storage (e.g., under normal cell storage conditions, but also in an oxygen-poor environment or at a temperature more than 42° C. or at or below freezing), the cells can be centrifuged for a time and at a speed sufficient to pellet them in the bottom of the centrifuge tube. The resulting pellet is resuspended in a suitable medium (e.g., DMEM/F-12 medium supplemented with glucose, transferrin, insulin, putricine, selenium, progesterone, epidermal growth factor (EGF) and basic fibroblast growth factor (bFGF; see the Examples, below. Other media have been used and have worked as well as that just described for the growth, proliferation, and differentiation of spore-like cells. After collection, the tissue sample can be intentionally exposed to harsh conditions, for example, those described herein, to kill differentiated cells.
The suspended cells are then transferred to a tissue culture vessel and incubated (obviously, the incubation temperature is not critical, but most incubators are kept at or near 37° C.). Initially, when the sample is a blood sample, the culture flasks contain primarily hematopoietic cells. However, after several days in culture, the red blood cells lyse and degenerate so that the culture contains primarily, if not exclusively, spore-like cells. When spore-like cells are isolated from solid tissues, the differentiated cells can be lysed by triturating the sample with a series of pipettes, each having a smaller bore diameter than the one before. For example, the last pipette used can have a bore diameter of approximately 15 μ (methods in which spore-like cells are isolated after exposure to an extreme condition and methods in which spore-like cells are isolated based on another characteristic, such as size, or their ability to withstand infectious agents, can be carried out separately or in combination). After several additional days in culture, the spore-like cells multiply and can coalesce to form clusters of cells. Over time, usually on the order of approximately 7 days, their number can increase greatly. Typically, more than 90% of the spore-like cells are viable according to Trypan blue exclusion studies when isolated as described above.
Those of ordinary skill in the art will recognize that trituration through reduced bore pipettes is not the only way to isolate spore-like cells from larger, differentiated cells. For example, flow cytometry can also be used. Alternatively, a suspension containing spore-like cells and differentiated cells can be passed through a filter having pores of a particular size. The size of the pores within the filter (and, similarly, the diameter of the pipette used for trituration) can be varied, depending on how stringent one wishes the isolation procedure to be. Generally, the smaller the pores within the filter, or the smaller the diameter of the pipette used for trituration, the fewer the number of differentiated cells that will survive the isolation procedure.
At the time of isolation, spore-like cells may not express the receptors or other cellular components that make differentiated cells susceptible to attack by infectious agents. This is another characteristic that can be exploited to identify and isolate spore-like cells. For example, one can infect a tissue or cell culture with an infectious agent and then separate the live spore-like cells from the differentiated cells that were killed by the infectious agent.
The features and characteristics described above can be used to distinguish spore-like cells from previously identified cell types. For example, the spore-like cells of the invention can be identified by their ability to differentiate into a variety of terminally differentiated cell types found in mature animals (such as those illustrated in the Examples below), their typical spherical shape, small size (as small as 0.1–0.3 μ in diameter and generally 1.0 to 3.0 μ in diameter), and cytoarchitecture (which includes relatively large amounts of nuclear material, relatively small amounts of cytoplasm, and a glycolipid- or mucopolysaccharide-rich coat), their ability to survive in environments in which other cell types would die (e.g., environments in which there is a low, or even non-existent, oxygen supply, environments in which the temperature is higher or lower than other cells can tolerate (without special protective measures), environments containing toxins, non-physiological salt concentrations, acids, bases, or radioenergy that other cells cannot tolerate).
When cultured as described in the Examples below, spore-like cells proliferate more rapidly and into more types of differentiated cells than do terminally differentiated cells or mesenchymal stem cells. Cell viability can be assessed using standard techniques, including visual observation with light or scanning electron microscopes and Trypan blue exclusion.
Spore-like cells have been isolated from body fluids (e.g., the blood) as well as from solid functional organs such as the liver, but it is not clear that they originate exclusively in either of these places. It may be that tissues and organs are the primary sources for spore-like cells, which appear in body fluids only secondarily, for example, when the cells are “washed out” of those tissues. However, it is also possible that spore-like cells originate in bodily fluids or from the same source as other cells that are present in bodily fluids (e.g., spore-like cells may originate in the bone marrow). If so, spore-like cells could then be subsequently delivered from those fluids to specific tissues. Moreover, delivery may be upregulated when the tissue is affected by, for example, a disorder, a regenerative process, or wound healing.
Without limiting the invention to spore-like cells that differentiate by a particular mechanism, it is believed that the rate and nature of spore-like cell differentiation can be influenced by altering the number and type of mature cells that come into contact (physical or functional contact) with spore-like cells. A mature cell is infunctional contact with a spore-like cell when the mature cell emits a chemical signal (e.g. a growth factor, cytokine, or neurotransmitter) that is detected by the spore-like cell. For example, when isolating spore-like cells from the liver, the more mature hepatocytes that remain in the culture of spore-like cells, the more quickly the spore-like cells will differentiate and the more likely it is that they will differentiate into hepatocytes. Thus, it is believed that spore-like cells proliferate and differentiate in response to agents (e.g., growth factors or hormones) within tissue, including tissue that has been injured or that is otherwise associated with a medical disorder. These agents guide differentiation so that the spore-like cells or their progeny come to express some or all of the same phenotypic markers expressed by mature cells normally present in the tissue in which they have been placed. Spore-like cells can be influenced by agents within tissues regardless of their origin (i.e., regardless of whether the spore-like cells originate in the blood, another body fluid, the bone marrow, or a solid, functional tissue or organ).
Spore-like cells can be used to maintain the integrity and function of a wide variety of tissues as well as to reengineer, repair, or otherwise improve tissue associated with a medical disorder. For example, spore-like cells can be used to maintain or reengineer: bone; bone marrow; muscle (e.g., smooth, skeletal, or cardiac muscle); connective tissue (e.g., cartilage, ligaments, tendons, pleura, or fibrous tissues); epithelial and mucous membranes; lung tissue; vascular tissue; nervous tissue (e.g., neurons and glial cells in the central or peripheral nervous systems), glandular tissue (e.g., tissue of the thyroid gland, adrenal gland, or sweat or sebaceous glands); epithelial cells, keratinocytes, or other components of the skin; lymph nodes; the immune system; reproductive organs; or any of the internal organs (e.g., liver, kidney, pancreas, stomach, bladder, or any portion of the alimentary canal). This list is intended to illustrate, not limit, the types of cells and tissues that can benefit from administration of spore-like cells. For example, life-like artificial skin can be produced by culturing spore-like cells and allowing them, when applied to a living body or used in conjunction with present skin replacement methods, to differentiate into epidermal and dermal cells (including melanocytes) as well as into hair follicles, sweat glands, sebaceous glands, ganglia, and similar adnexal structures. Those of ordinary skill in the art will recognize many other therapeutic uses for spore-like cells.
Spore-Like Cell Differentiation
Spore-like cells or their progeny can differentiate into a number of different cell types. For example, spore-like cells can differentiate into epithelial cells, keratinocytes, melanocytes, adipocytes, myocytes, chondrocytes, osteocytes, alveolar cells, hepatocytes, renal cells, adrenal cells, endothelial cells, islet cells (e.g., alpha cells, delta cells, PP cells, and beta cells), blood cells (e.g., leukocytes, erythrocytes, macrophages, and lymphocytes) retinal cells (and other cells involved in sensory perception, such as those that form hair cells in the ear or taste buds on the tongue), and fibroblasts or other cell types present in organs and connective tissues.
Spore-like cells and their progeny can be induced to differentiate in a variety of ways and may or may not be committed to a particular differentiation pathway. One method of inducing differentiation is to allow spore-like cells or their progeny to establish contact (e.g., physical contact) with a solid support. For example, spore-like cells can differentiate when they establish contact with (e.g., adhere to) a glass or plastic surface, a mesh, or other substrate suitable for use in tissue culture or administration to a patient.
Spore-like cells can also differentiate when they establish contact with a tissue within a patient's body or are sufficiently close to a tissue to be influenced by substances (e.g., growth factors, enzymes, or hormones) released from the tissue. Thus, differentiation of a spore-like cell can be influenced by virtue of signals the cell receives from the surrounding tissue. Such signaling would occur, for example, when a receptor on the surface of a spore-like cell, or on the surface of a cell descended from a spore-like cell, bound and transduced a signal from a molecule such as a growth factor, enzyme, neurotransmitter, or hormone that was released by a tissue within the patient.
Alternatively, or in addition, spore-like cells can be induced to differentiate by adding a substance (e.g., a growth factor, enzyme, hormone, or other signaling molecule) to the cell's environment. For example, a substance can be added to a culture dish containing spore-like cells, to a mesh or other substrate suitable for applying spore-like cells to a tissue, or to a tissue within a patient's body. When a substance that induces spore-like cells to differentiate is administered, either systemically or locally, it can be administered according to pharmaceutically accepted methods. For example, proteins, polypeptides, or oligonucleotides can be administered in a physiologically compatible buffer, with or without a carrier or excipient. Of course, either the cells within a patient's body or the cells being administered (here, spore-like cells or their progeny) can be made to express particular factors following genetic manipulation. For example, spore-like cells can be made to express hormones, such as insulin, by transfecting them with gene constructs that include sequences that encode these factors. Thus, spore-like cells or their progeny can differentiate either in culture or in a patient's body, and may do so following contact with a solid support or exposure to substances that are either naturally expressed, exogenously administered, or expressed as a result of genetic manipulation. Regardless of the stimulus for differentiation, spore-like cells that have differentiated, or that will do so, sufficiently to aid in the maintenance or repair of tissue, can be administered to a patient (e.g., at the site of a burn or other traumatized area of skin, a bone fracture, a torn ligament, an-atrophied muscle, a malfunctioning gland, or an area adversely affected by a neurodegenerative process (or trauma or ischemia, as occurs with a cerebrovascular accident) or autoimmune response). Based on simple observation, it appears that when spore-like cells come into contact with each other, they orchestrate their own development. It appears that once contact is initiated, a developmental pattern is set into motion.
Another way to promote proliferation without differentiation is to expose the spore-like cells, particularly those isolated from the skin, to agonists of Notch function, as described in U.S. Pat. No. 5,780,300. Agonists of Notch include, but are not limited to, proteins such as Delta or Serrate or Jagged (Lindsell et al., Cell 80:909–917, 1995) or biologically active fragments thereof. These proteins or protein fragments mediate binding to Notch and thereby activate the Notch pathway. Spore-like cells isolated from the skin can be contacted in culture with agonists of Notch or can be transfected with genes that encode Notch agonists. As described above, the techniques required to transfect cells in culture are routinely practiced by those of ordinary skill in the art. Spore-like cells that remain undifferentiated in culture can differentiate when administered to a patient; their differentiation being orchestrated by the microenvironment they encounter within the patient.
As described in Example 7, below, many cells isolated as spore-like cells from the liver express bile after 12 days in culture. Bile expression can be seen following staining by Hall's technique using Fouchet's reagent (FIG. 7E). Bile pigments can also be identified by at least two other standard histological stains, the Gmelin test, and Stein's method. Similarly, there are a number of standard assays for glycolipids, which are carbohydrate and lipid compounds that contain 1 mole each of a fatty acid, sphingosine, and hexose. Common reactions for carbohydrates include the periodic acid-Schiff (PAS) reaction, diastase, alcian blue staining, colloidal iron, and hyaluronidase. Spore-like cells isolated from adult liver are stained by PAS and mucicarmine stains, which indicates that these cells are coated with mucopolysaccharids and glycolipids.
While spore-like cells or their progeny may eventually become fully differentiated, and while this is desirable in some circumstances (e.g., where the cells are used to essentially recreate a histologically mature and complete tissue), fully differentiated cells are not always necessary for successful treatment; spore-like cells or their progeny need only differentiate to a point sufficient to treat the patient. For example, spore-like cells used to treat diabetes need not ever differentiate into cells that are indistinguishable from fully differentiated p cells within the islets of Langerhans. To the contrary, spore-like cells or their progeny need only differentiate to the point where they express sufficient insulin to treat the diabetic patient.
Excluded from the invention are cells having characteristics that render them indistinguishable from previously identified stem cells (e.g., mesenchymal stem cells), precursor cells (e.g., the islet cell precursors described by Cornelius et al. (Horn. Metab. Res. 29:271–277 (1997)), or the progenitors from central nervous tissue described by Shihabuddin et al. (Exp. Neurol. 148:577–586 (1997)) or Weiss et al. (J. Neurosci. 16:7599–7609 (1996)) or terminally differentiated cells. These characteristics can be assessed by those of ordinary skill in the art in numerous ways (e.g., by histological, biochemical, or, preferably, electron microscopic analysis).
Methods of Treatment
A. Administration of Spore-like Cells and Their Progeny Via Hydrogel
The novel cell types described herein can be administered to a patient by way of a composition that includes spore-like cells, or their progeny, and a liquid hydrogel. This cell-hydrogel mixture can be applied directly to a tissue that has been damaged. For example, as described in U.S. Ser. No. 08/747,036, a hydrogel-cell mixture can simply be brushed, dripped, or sprayed onto a desired surface or poured or otherwise made to fill a desired cavity or device. The hydrogel provides a thin matrix or scaffold within which the spore-like cells adhere and grow. These methods of administration may be especially well suited when the tissue associated with a patient's disorder has an irregular shape or when the cells are applied at a distant site (e.g., when spore-like cells are placed beneath the renal capsule to treat diabetes).
Alternatively, the hydrogel-cell mixture can be introduced into a permeable, biocompatible support structure so that the mixture essentially fills the support structure and, as it solidifies, assumes the support structure's shape. Thus, the support structure can guide the development and shape of the tissue that matures from spore-like cells, or their progeny, that are placed within it. As described further below, the support structure can be provided to a patient either before or after being filled with the hydrogel-cell mixture. For example, the support structure can be placed within a tissue (e.g., a damaged area of the skin, the liver, or the skeletal system) and subsequently filled with the hydrogel-cell composition using a syringe, catheter, or other suitable device. When desirable, the shape of the support structure can be made to conform to the shape of the damaged tissue. In the following subsections, suitable support structures, hydrogels, and delivery methods are described (cells suitable for use are described above).
1. Hydrogels
The hydrogels used to practice this invention should be biocompatible, biodegradable, capable of sustaining living cells, and, preferably, capable of solidifying rapidly in vivo (e.g., in about five minutes after being delivered to the support structure). Large numbers of spore-like cells can be distributed evenly within a hydrogel; a hydrogel can support approximately 5×106 cells/ml. Hydrogels also enable diffusion so that nutrients reach the cells and waste products can be carried away.
A variety of different hydrogels can be used to practice the invention. These include, but are not limited to: (1) temperature dependent hydrogels that solidify or set at body temperature (e.g., PLURONICSTM); (2) hydrogels cross-linked by ions (e.g., sodium alginate); (3) hydrogels set by exposure to either visible or ultraviolet light, (e.g., polyethylene glycol polylactic acid copolymers with acrylate end groups); and (4) hydrogels that are set or solidified upon a change in pH (e.g., TETRONICSTM).
Materials that can be used to form these different hydrogels include, but are not limited to, polysaccharides such as alginate, polyphosphazenes, and polyacrylates, which are cross-linked ionically, block copolymers such as PLURONICSTM (also known as POLOXAMERSTM), which are poly(oxyethylene)-poly(oxypropylene) block polymers solidified by changes in temperature, TETRONICSTM (also known as POLOXAMINESTM), which are poly(oxyethylene)-poly(oxypropylene) block polymers of ethylene diamine solidified by changes in pH.
Ionic Hydrogels
Ionic polysaccharides, such as alginates or chitosan, can also be used to suspend living cells, including spore-like cells and their progeny. These hydrogels can be produced by cross-linking the anionic salt of alginic acid, a carbohydrate polymer isolated from seaweed, with ions, such as calcium cations. The strength of the hydrogel increases with either increasing concentrations of calcium ions or alginate. U.S. Pat. No. 4,352,883 describes the ionic cross-linking of alginate with divalent cations, in water, at room temperature, to form a hydrogel matrix.
Spore-like cells are mixed with an alginate solution, the solution is delivered to an already implanted support structure, which then-solidifies in a short time due to the presence of physiological concentrations of calcium ions in vivo. Alternatively, the solution is delivered to the support structure prior to implantation and solidified in an external solution containing calcium ions.
In general, these polymers are at least partially soluble in aqueous solutions (e.g., water, aqueous alcohol solutions that have charged side groups, or monovalent ionic salts thereof). There are many examples of polymers with acidic side groups that can be reacted with cations (e.g., poly(phosphazenes), poly(acrylic acids), and poly(methacrylic acids)). Examples of acidic groups include carboxylic acid groups, sulfonic acid groups, and halogenated (preferably fluorinated) alcohol groups. Examples of polymers with basic side groups that can react with anions are poly(vinyl amines), poly(vinyl pyridine), and poly(vinyl imidazole).
Polyphosphazenes are polymers with backbones consisting of nitrogen and phosphorous atoms separated by alternating single and double bonds. Each phosphorous atom is covalently bonded to two side chains. Polyphosphazenes that can be used have a majority of side chains that are acidic and capable of forming salt bridges with di- or trivalent cations. Examples of acidic side chains are carboxylic acid groups and sulfonic acid groups.
Bioerodible polyphosphazenes have at least two different types of side chains: acidic side chains capable of forming salt bridges with multivalent cations, and side chains that hydrolyze in vivo (e.g., imidazole groups, amino acid esters, glycerol, and glucosyl). Bioerodible or biodegradable polymers (i.e., polymers that dissolve or degrade within a period that is acceptable in the desired application (usually in vivo therapy), will degrade in less than about five years and most preferably in less than about one year, once exposed to a physiological solution of pH 6–8 having a temperature of between about 25° C. and 38° C. Hydrolysis of the side chain results in erosion of the polymer. Examples of hydrolyzing side chains are unsubstituted and substituted imidizoles and amino acid esters in which the side chain is bonded to the phosphorous atom through an amino linkage.
Methods for synthesis and the analysis of various types of polyphosphazenes are described in U.S. Pat. Nos. 4,440,921, 4,495,174, and 4,880,622. Methods for the synthesis of the other polymers described above are known to those of ordinary skill in the art. See, for example Concise Encyclopedia of Polymer Science and Engineering, J. I. Kroschwitz, Ed., John Wiley and Sons, New York, N.Y., 1990. Many polymers, such as poly(acrylic acid), alginates, and PLURONICSTM are commercially available.
Water soluble polymers with charged side groups are cross-linked by reacting the polymer with an aqueous solution containing multivalent ions of the opposite charge, either multivalent cations if the polymer has acidic side groups, or multivalent anions if the polymer has basic side groups. Cations for cross-linking the polymers with acidic side groups to form a hydrogel include divalent and trivalent cations such as copper, calcium, aluminum, magnesium, and strontium. Aqueous solutions of the salts of these cations are added to the polymers to form soft, highly swollen hydrogels.
Anions for cross-linking the polymers to form a hydrogel include divalent and trivalent anions such as low molecular weight dicarboxylate ions, terepthalate ions, sulfate ions, and carbonate ions. Aqueous solutions of the salts of these anions are added to the polymers to form soft, highly swollen hydrogels, as described with respect to cations.
For purposes of preventing the passage of antibodies into the hydrogel, but allowing the entry of nutrients, a useful polymer size in the hydrogel is in the range of between 10 and 18.5 kDa. Smaller polymers result in gels of higher density with smaller pores.
Temperature-Dependent Hydrogels
Temperature-dependent, or thermosensitive, hydrogels can also be used in the methods of the invention. These hydrogels have so-called “reverse gelation” properties, i.e., they are liquids at or below room temperature, and gel when warmed to higher temperatures (e.g., body temperature). Thus, these hydrogels can be easily applied at or below room temperature as a liquid and automatically form a semi-solid gel when warmed to body temperature. As a result, these gels are especially useful when the support structure is first implanted into a patient, and then filled with the hydrogel-cell composition. Examples of such temperature-dependent hydrogels are PLURONICSTM (BASF-Wyandotte), such as polyoxyethylene-polyoxypropylene F-108, F-68, and F-127, poly (N-isopropylacrylamide), and N-isopropylacrylamide copolymers.
These copolymers can be manipulated by standard techniques to affect their physical properties such as porosity, rate of degradation, transition temperature, and degree of rigidity. For example, the addition of low molecular weight saccharides in the presence and absence of salts affects the lower critical solution temperature (LCST) of typical thermosensitive polymers. In addition, when these gels are prepared at concentrations ranging between 5 and 25% (WNV) by dispersion at 4° C., the. viscosity and the gel-sol transition temperature are affected, the gel-sol transition temperature being inversely related to the concentration. These gels have diffusion characteristics capable of allowing spore-like cells and their progeny to survive and be nourished.
U.S. Pat. No. 4,188,373 describes using PLURONICTM polyols in aqueous compositions to provide thermal gelling aqueous systems. U.S. Pat. Nos. 4,474,751, '752, '753, and 4,478,822 describe drug delivery systems that utilize thermosetting polyoxyalkylene gels. With these systems, both the gel transition temperature and/or the rigidity of the gel can be modified by adjustment of the pH and/or the ionic strength, as well as by the concentration of the polymer.
pH-Dependent Hydrogels
Other hydrogels suitable for use in the methods of the invention are pH-dependent. These hydrogels are liquids at, below, or above specific pH values, and gel when exposed to specific pHs, for example, 7.35 to 7.45, the normal pH range of extracellular fluids within the human body. Thus, these hydrogels can be easily delivered to an implanted support structure as a liquid and automatically form a semi-solid gel when exposed to body pH. Examples of such pH-dependent hydrogels are TETRONICSTM (BASF-Wyandotte) polyoxyethylene-polyoxypropylene polymers of ethylene diamine, poly(diethyl aminoethyl methacrylate-g-ethylene glycol), and poly(2-hydroxymethyl methacrylate). These copolymers can be manipulated by standard techniques to affect their physical properties.
Light Solidified Hydrogels
Other hydrogels that can be used to administer spore-like cells or their progeny are solidified by either visible or ultraviolet light. These hydrogels are made of macromers including a water soluble region, a biodegradable region, and at least two polymerizable regions (see, e.g., U.S. Pat. No. 5,410,016). For example, the hydrogel can begin with a biodegradable, polymerizable macromer including a core, an extension on each end of the core, and an end cap on each extension. The core is a hydrophilic polymer, the extensions are biodegradable polymers, and the end caps are oligomers capable of cross-linking the macromers upon exposure to visible or ultraviolet light, for example, long wavelength ultraviolet light.
Examples of such light solidified hydrogels include polyethylene oxide block copolymers, polyethylene glycol polylactic acid copolymers with acrylate end groups, and 10K polyethylene glycol-glycolide copolymer capped by an acrylate at both ends. As with the PLURONICTM hydrogels, the copolymers comprising these hydrogels can be manipulated by standard techniques to modify their physical properties such as rate of degradation, differences in crystallinity, and degree of rigidity.
Thus, a variety of hydrogels can be used to practice the present invention. They include, but are not limited to: (1) temperature dependent hydrogels that solidify or set at body temperature, e.g., PLURONICSTM; (2) hydrogels cross-linked by ions, e.g., sodium alginate; (3) hydrogels set by exposure to either visible or ultraviolet light, e.g., polyethylene glycol polylactic acid copolymers with acrylate end groups; and (4) hydrogels that are set or solidified upon a change in pH, e.g., TETRONICSTM.
The materials that can be used to form these various hydrogels include polysaccharides such as alginate, polyphosphazenes, and polyacrylates, which are cross-linked ionically, or block copolymers such as PLURONICSTM (also known as POLOXAMERSTM), which are poly(oxyethylene)-poly(oxypropylene) block polymers solidified by changes in temperature, or TETRONICSTM (also known as POLOXAMINESTM), which are poly(oxyethylene)-poly(oxypropylene) block polymers of ethylene diamine solidified by changes in pH.
2. Preparation of Hydrogel-Cell Mixtures
Once a hydrogel of choice (e.g., a thermosensitive polymer at between 5 and 25% (W/V), or an ionic hydrogel such as alginate dissolved in an aqueous solution (e.g., a 0.1 M potassium phosphate solution, at physiological pH, to a concentration between 0.5% to 2% by weight) is prepared, isolated spore-like cells or their progeny are suspended in the polymer solution. If desired, the concentration of the cells can mimic that of the tissue to be generated. For example, the concentration of cells can range between 10 and 100 million cells/ml (e.g., between 20 and 50 million cells/ml or between 50 and 80 million cells/ml). Of course, the optimal concentration of cells to be delivered into the support structure may be determined on a case by case basis, and may vary depending on cell type and the region of the patient's body into which the support structure is implanted or onto which it is applied. To optimize the procedure (i.e., to provide optimal viscosity and cell number), one need only vary the concentrations of the cells or the hydrogel.
3. Support Structures
The support structure is a permeable structure having pore-like cavities or interstices that shape and support the hydrogel-cell mixture. For example, the support structure can be a porous polymer mesh, or a natural or synthetic sponge. The porosity of the support structure should be such that nutrients can diffuse into the structure, thereby effectively reaching the cells inside, and waste products produced by the cells can diffuse out of the structure.
The support structure can be shaped to conform to the space in which new tissue is desired. For example, the support structure can be shaped to conform to the shape of an area of the skin that has been burned or the portion of cartilage or bone that has been lost. Depending on the material from which it is made, the support structure can be shaped by cutting, molding, casting, or any other method that produces a desired shape (as described below, in some instances, the support structure can be shaped by hand). Moreover, the shaping process can occur either before or after the support structure is filled with the hydrogel-cell mixture. For example, a support structure can be filled with a hydrogel-cell mixture and, as the hydrogel hardens, molded into a desired shape by hand.
As the hydrogel solidifies, it will adopt the flexibility and resiliency of the support structure, which is important for accommodation of compressive and tensile forces. Thus, for example, replaced skin could accommodate tensile forces associated with pulling and stretching, as well as compressive forces associated with weight bearing, as occurs, for example, on the soles of the feet. The flexibility and resiliency of the support structure also provides greater ease of administration. For example, in many currently available skin replacement methods, the tissue is extremely delicate and must be handled with the utmost care.
The support structure is also biocompatible (i.e., it is not toxic to the spore-like cells suspended therein) and can be biodegradable. Thus, the support structure can be formed from a synthetic polymer such as a polyanhydride, polyorthoester, or polyglycolic acid. The polymer should provide the support structure with an adequate shape and promote cell growth and proliferation by allowing nutrients to reach the cells by diffusion. Additional factors, such as growth factors, other factors that induce differentiation or dedifferentiation, secretion products, immunomodulators, anti-inflammatory agents, regression factors, biologically active compounds that promote innervation or enhance the lymphatic network, and drugs, can be incorporated into the polymer support structure.
An example of a suitable polymer is polyglactin, which is a 90:10 copolymer of glycolide and lactide, and is manufactured as VICRYLTM braided absorbable suture (Ethicon Co., Somerville, N.J.). Polymer fibers (such as VICRYLTM), can be woven or compressed into a felt-like polymer sheet, which can then be cut into any desired shape. Alternatively, the polymer fibers can be compressed together in a mold that casts them into the shape desired for the support structure. In some cases, additional polymer can be added to the polymer fibers as they are molded to revise or impart additional structure to the fiber mesh.
For example, a polylactic acid solution can be added to this sheet of polyglycolic fiber mesh, and the combination can be molded together to form a porous support structure. The polylactic acid binds the crosslinks of the polyglycolic acid fibers, thereby coating these individual fibers and fixing the shape of the molded fibers. The polylactic acid also fills in the spaces between the fibers. Thus, porosity can be varied according to the amount of polylactic acid introduced into the support. The pressure required to mold the fiber mesh into a desirable shape can be quite moderate. All that is required is that the fibers are held in place long enough for the binding and coating action of polylactic acid to take effect.
Alternatively, or in addition, the support structure can include other types of polymer fibers or polymer structures produced by techniques known in the art. For example, thin polymer films can be obtained by evaporating solvent from a polymer solution. These films can be cast into a desired shaped if the polymer solution is evaporated from a mold having the relief pattern of the desired shape. Polymer gels can also be molded into thin, permeable polymer structures using compression molding techniques known in the art.
Many other types of support structures are also possible. For example, the support structure can be formed from sponges, foams, corals, or biocompatible inorganic structures having internal pores, or mesh sheets of interwoven polymer fibers. These support structures can be prepared using known methods.
4. Application of the Support Structure
Any of the liquid hydrogel-cell mixtures described above can be placed in any of the permeable support structures (also described above). FIG. 13 is a schematic of a filled support structure in cross-section. This structure is suitable for application of spore-like cells or their progeny to the skin. The support structure 10 is formed from a bilayered mesh of interwoven polymer fibers 12 having epidermal layer 12a and dermal layer 12b. The spaces between the fibers form interconnected pores 14 that are filled with liquid hydrogel-cell mixture. Within a short time of placing the mixture in the support structure (e.g., in approximately three to five minutes), hydrogel 16 solidifies, thereby keeping the suspended cells 18 within the pores 14 of support structure 10. The solidified hydrogel 16 helps maintain the viability of the cells by allowing diffusion of nutrients (including growth and differentiation factors) and waste products through the interconnected pores of the support structure. The ultimate result being the growth of new skin and its engraftment to the patient's body.
The liquid hydrogel-cell mixture can be delivered to the shaped support structure either before or after the support structure is implanted in or applied to a patient. The specific method of delivery will depend on whether the support structure is sufficiently “sponge-like” for the given viscosity of the hydrogel-cell composition, i.e., whether the support structure easily retains the liquid hydrogel-cell mixture before it solidifies. Sponge-like support structures can be immersed within, and saturated with, the liquid hydrogel-cell mixture, and subsequently removed from the mixture. The hydrogel is then allowed to solidify within the support structure. The hydrogel-cell-containing support structure is then implanted in or otherwise administered to the patient.
The support structure can also be applied to the patient before the hydrogel completely solidifies. Alternatively, a sponge-like support structure can be injected with the liquid hydrogel-cell mixture, either before or after the support structure is implanted in or otherwise administered to the patient. The hydrogel-cell mixture is then allowed to solidify.
The volume of the liquid hydrogel-cell mixture injected into the support structure is typically less than, but somewhat comparable to, the volume of the support structure, i.e., the volume of the desired tissue to be grown.
Support structures that do not easily retain the liquid composition require somewhat different methods. In those cases, for example, the support structure is immersed within and saturated with the liquid hydrogel-cell mixture, which is then allowed to partially solidify. Once the cell-containing hydrogel has solidified to the point where the support structure can retain the hydrogel, the support structure is removed from the partially solidified hydrogel, and, if necessary, partially solidified hydrogel that remains attached to the outside of the support structure is removed (e.g., scraped off the structure).
Alternatively, the liquid hydrogel-cell mixture can be delivered into a mold containing the support structure. For example, the liquid hydrogel-cell mixture can be injected into an otherwise fluid-tight mold that contains the support structure and matches its outer shape and size. The hydrogel is then solidified within the mold, for example, by heating, cooling, light-exposure, or pH adjustment, after which, the hydrogel-cell-containing support structure can be removed from the mold in a form that is ready for administration to a patient.
In other embodiments, the support structure is implanted in or otherwise administered to the patient (e.g., placed over the site of a burn or other wound, placed beneath the renal capsule, or within a region of the body damaged by ischemia), and the liquid hydrogel-cell mixture is then delivered to the support structure. The hydrogel-cell mixture can be delivered to the support using any simple device, such as a syringe or catheter, or merely by pouring or brushing a liquid gel onto a support structure (e.g., a sheet-like structure).
Here again, the volume of hydrogel-cell composition added to the support structure should approximate the size of the support structure (i.e., the volume displaced by the desired tissue to be grown). The support structure provides space and a structural template for the injected liquid hydrogel-cell mixture. As described above, some of the hydrogel-cell mixture may leak from the support structure prior to solidifying. However, in this event, existing tissue beneath or surrounding the support structure would sufficiently constrain the liquid hydrogel-cell mixture until it gels.
In any of the above cases, the hydrogel is solidified using a method that corresponds to the particular hydrogel used (e.g., gently heating a composition including a PLURONICTM temperature-sensitive hydrogel).
To apply or implant the support structure, the implantation site within the patient can be prepared (e.g., in the event the support structure is applied to the skin, the area can be prepared by debridement), and the support structure can be implanted or otherwise applied directly at that site. If necessary, during implantation, the site can be cleared of bodily fluids such as blood (e.g., with a burst of air or suction).
EXAMPLES
The present invention will be further understood by reference to the following non-limiting examples.
Example 1
Spore-like cells were isolated from human blood as follows. Five cc's of whole blood were acquired from an adult human and placed in a tube containing an anti-coagulant. The blood sample was then centrifuged at 1200 rpm for approximately five minutes. The supernatant was removed, and the resulting pellet was resuspended in 15 cc's of DMEM/F-12 medium supplemented with a combination of the following hormones and nutrients: glucose (23 mM), transferrin (10 mg/ml), insulin (20 mg/ml), putricine (10 mM), selenium (100 nM), progesterone (10 nM) (Life Technologies, Baltimore, Md.), EGF (20 ng/ml), and bFGF (20 ng/ml) (Collaborative Biomedical Products, Chicago, Ill.). The resulting suspension was transferred to 75 cm2 tissue culture flasks and incubated in 5% CO2 at 37° C. The media were changed every 3–4 days. Cells were passaged every 7–9 days. Initially, these culture flasks appeared to contain many hematopoeitic cells (e.g., red blood cells), but over time (usually, a matter of several days), these cells disappeared, leaving only spore-like cells. After several days in culture, the spore-like cells multiplied and coalesced to form clusters of cells. Trypan blue exclusion revealed cell viability to be greater than 90%. FIGS. 11 and 12A are photographs of cultures that include undifferentiated spore-like cells isolated from adult human blood. The cells shown in FIG. 12A were isolated seven days earlier and are viewed with phase contrast microscopy. Immunofluorescent staining was then performed. At this time, some of the cells expressed nestin (see FIG. 12B).
Example 2
Spore-like cells were isolated from the skin of an adult rodent as follows. Excisional biopsies of the skin of adult Fisher rats were made under sterile conditions. The biopsied tissue, which included the dermis and epidermis, was placed in a petri dish containing cold phosphate buffered saline (PBS) and antibiotics (penicillin (50 mU/ml) and streptomycin (90 mg/ml)). The epidermis was scraped with, a #11 scalpel to disassociate epidermal cells, and the tissue was then transferred to a second petri dish (also containing cold PBS and antibiotics) where the dermis was scraped with a #11 scalpel. The cells that were dissociated were then centrifuged at 1200 rpm (GLC-2B, Sorvall, Wilmington, Del.) for five minutes and resuspended in 10 ml of 0.05% trypsin (Life Technologies, Baltimore, Md.). Following resuspension in trypsin, the tissue was incubated at 37° C. for five minutes. Ten ml of Dulbecco's Modified Eagle Medium (DMEM)/F-12 containing 10% heat inactivated fetal bovine serum (FBS) (Life Technologies, Baltimore, Md.) was added to deactivate the trypsin.
The tissue was then triturated, first with a normal bore Pasteur pipette and subsequently with a series of fire polished pipettes having bores reduced to about 15 μm. The number of pipettes required can vary depending upon how frequently they become clogged with tissue. Trituration was carried out until the tissue was dispersed as a fine suspension. The suspension was then centrifuged at 1200 rpm (GLC-2B, Sorvall, Wilmington, Del.) for five minutes. The supernatant was removed and the pellet was resuspended in 15 ml of DMEM/F-12 medium supplemented with a hormone mixture containing glucose (23 mM), transferrin (10 mg/ml), insulin (20 mg/ml), putricine (10 mM), selenium (100 nM), progesterone (10 nM) (Life Technologies, Baltimore, Md.), EGF (20 ng/ml) and bFGF (20 ng/ml) (Collaborative Biomedical Products, Chicago, Ill.). The suspension was transferred to 75 cm2 tissue culture flasks (Collaborative Biomedical Products, Chicago, Ill.) and incubated at 37° C. in 5% CO2. The media was changed every three days, and the cells were passaged every 7–9 days. The cells that attached to the tissue culture flask appeared to differentiate more readily.
Spore-like cells isolated from the skin will differentiate upon exposure to the processes and basal nutrient media described in U.S. Pat. No. 5,292,655. Alternatively, growth factors that cause spore-like cells to mitose (e.g., epidermal growth factor (EGF), basic fibroblast growth factor (bFGF) and other cytokines) can be applied to help maintain the cells in an undifferentiated state. For example, the isolated cells can be cultured in Dulbecco's Modified Eagle's Medium (DMEM) supplemented with a hormone mixture containing glucose, transferrin, insulin, putricine, selenium, progesterone, EGF, and bFGF.
Spore-like cells were also isolated from excisional biopsies of the skin of adult pigs according to the same protocol described here for the adult rat.
Example 3
Spore-like cells were isolated from adult rat heart according to the protocol described in Example 2. The newly isolated cells, which are shown in FIG. 3A, include undifferentiated spore-like cells. After three days in culture, early myocardial cells can be seen (FIG. 3B), and after two weeks in culture, Purkinje-like structures can be seen (FIG. 3C).
Example 4
Spore-like cells were isolated from adult rat intestine according to the protocol described in Example 2. The newly isolated cells, as shown in FIG. 4A, include undifferentiated spore-like cells. After three days in culture, clusters of small intestinal cells (FIG. 4B) and autonomic neurons (FIG. 4C) can be seen.
Example 5
Spore-like cells were isolated from an adult rat bladder according to the protocol described in Example 2. The newly isolated cells, which are shown in FIG. 5A, include undifferentiated spore-like cells. After two days in culture, the isolated spore-like cells, or their progeny, appear to be differentiating into mature bladder cells (FIG. 5B).
Example 6
Spore-like cells were isolated from an adult rat kidney according to the protocol described in Example 2. Cells newly isolated from the kidney of an adult rat, which are shown in FIG. 6A, include undifferentiated spore-like cells. After three days in culture, aggregates of cells resembling kidney structures can be seen (FIG. 6B).
Example 7
Spore-like cells were isolated from an adult rat liver according to the protocol described in Example 2. Because the liver is highly vascularized, the intact tissue was washed with PBS. Cells newly isolated from the liver of an adult rat, which are shown in FIGS. 7A and 7C, include undifferentiated spore-like cells. After three days in culture, an aggregate of cells resembling a differentiating liver structure can be seen (FIG. 7B). After seven days in culture, cells resembling hepatocytes can be seen (FIG. 7D).
Example 8
Spore-like cells were isolated from adult mammalian lungs according to the protocol described in Example 2. Spore-like cells were isolated from the lungs of adult rats (see FIGS. 8A–8C) and sheep (see FIG. 8D). The newly isolated cells shown in FIG. 8A include undifferentiated spore-like cells. After six weeks in culture, alveolar-like cells can be seen (FIGS. 8B and 8C). After 30 days in culture, spore-like cells isolated from an adult sheep have formed alveolar-like structures (FIG. 8D) similar to those seen in the lungs of adult cats (FIG. 8E; Histology, F. Hammersen, Ed., Urban & Schwarzenberg, Baltimore-Munich, 1980, FIG. 321).
Example 9
Spore-like cells were isolated from adult rat adrenal glands according to the protocol described in Example 2. Undifferentiated spore-like cells isolated from the adrenal gland of an adult rat can be seen at Day 0 in FIGS. 9A and 9B (see the arrows). After two days in culture, primitive adrenal cells can be seen (FIGS. 9C and 9D).
Example 10
Spore-like cells were isolated from the pancreas of an adult human and from the pancreas of an adult rat. The dissections were carried out in 10% cold fetal serum albumin according to the protocol described in Example 2. Significantly, spore-like cells have been isolated from a portion of the rat pancreas that remained after the islets were removed by ductal injection of collagenase (as described, for example, by Sutton et al., Transplantation, 42:689–691, 1986).
Islet-like structures that formed in cultures of spore-like cells isolated from islet-free pancreatic tissue are shown in FIGS. 10A–10C. After six days in culture, more than 100 islet-like structures were present per field (see FIGS. 10A and 10B), even though the spore-like cells first placed in culture were isolated from a tissue from which the islets had been removed. When the islet-like structures that nevertheless developed were immunostained, insulin expression can be seen (FIG. 10C).
Example 11
Due in part to the unusual appearance of spore-like cells under the light microscope, the cells were examined under an electron microscope. Scanning and electron microscopy was performed according to standard protocols. The electron micrographs revealed several interesting features. For example, the range of spore-like cell sizes may be greater than first appreciated with the light microscope. Some of the spore-like cells shown in FIG. 1A have a diameter of approximately 0.3 microns. The unique cytoarchitecture of the spore-like cell is apparent when viewed with transmission electron microscopy (see FIGS. 2A–2D) or following nuclear staining (such as the 4′6-diamidino-2-phenylindole (DAPI) stain described in Example 12). The interior of the cell is consumed largely with diffuse nuclear material and the cell is surrounded by a “zebra” coating, which is associated with deposits of glycolipids (i.e., carbohydrate and fat). For example, zebra bodies (so-called because of their striped appearance) are associated with mucopolysaccharidoses, such as Hurler's syndrome or with Fabry's disease, in which glycolipids accumulate due to an enzyme deficiency. Spore-like cells thus appear, during at least one stage of their existence, to be unique packets of DNA.
Example 12
A massive accumulation of nuclear material is also apparent when spore-like cells are stained for nucleic acids by methods known to those of ordinary skill in the art. For example, DNA can be stained with either 4′6,-diamidino-2-phenylindole (DAPI) for total DNA staining or with propidium iodide for staining of double-stranded DNA and RNA. DAPI and propidium iodide can be added directly to anti-fade mounting medium (e.g., 90% glycerol, 1× PBS, and 2.5% 1,4-diazabicyclo[2,2,2]octane (DABCO) (Sigma Chemical Co., St. Louis, Mo.). Spore-like cells stained with DAPI contained a great deal of nuclear material; the ratio of nuclear to cytoplasmic material was much higher in spore-like cells than one would expect in most fully differentiated cell types.
Example 13
Four tissues (lung, liver, fascia, and spinal cord) were obtained from three animals (Fisher rats) and kept in cold storage for five days. More specifically, each tissue type was removed from an animal less than two hours after the animals was killed and placed in a 50 cc centrifuge tube (Fisher Scientific, Pittsburg, Pa.) filled with PBS. The tubes were stored at 4° C. without supplemental oxygen for five days. Spore-like cells were then isolated as follows. After excision from the animal, and using sterile technique, the selected tissue was placed in cold PBS containing penicillin (50 mU/ml) and streptomycin (90 mg/ml) (Gibco, Grand Island, N.Y.). The tissue was then manually disassociated with a #11 scalpel, and the disassociated cells were collected by centrifugation at 1200 rpm for five minutes. The tissue was then resuspended in ten ml of 0.05% trypsin (w/v) for five minutes at 37° C. The trypsin was inactivated by adding 10 ml of DMEM/F-12 medium (Gibco) supplemented with 10% heat-inactivated fetal bovine serum (FBS) (Gibco). The cells were then dispersed by trituration using progressively narrower fire-polished, reduced-bore pasteur pipettes. While the aperatures are not measured, the opening of the smallest-bore pipette was approximately 15 μm. The dispersed cells were collected by centrifugation at 1200 rpm for five minutes. The resulting pellet was resuspended in 10 ml of DMEM/F-12 medium containing 33 mM glucose (Sigma Chemical Co., St. Louis, Mo.), 10 mg/ml transferrin (Sigma), 20 mg/ml insulin (Sigma), 10 mM putrescine (Sigma), 100 nM selenium (Sigma), 10 nM progesterone (Sigma), 20 ng/ml EGF (Peprotech, Rocky Hill, N.J.), and 20 ng/ml bFGF (Collaborative Biomedical, Raynham, Mass.). The primary cell suspension was incubated at 37° C. in 5% CO2, and the media were changed every 3 days. Cells were passaged every 7–9 days by collecting the nonadherent cell aggregates, centrifuging them at 1200 rpm for five minutes and removing the media. Cells were resuspended in fresh media, triturated using narrow fire polished reduced bore pasteur pipettes. The cell suspension was then divided into two suspensions and placed into two new culture dishes.
The technique described above was slightly modified to isolate hepatic tissue: hepatic tissue was washed with cold PBS prior to disassociation.
Standard hematoxalin and eosin (H&E) staining was performed on tissue fixed with 10% formalin. A simple Hall's stain was performed on liver-derived spore-like cells for the presence of bile. Standard stains for mucicarmine and periodic acid-Schiff were also performed.
To assess cellular proliferation, the time that was required for a population of cells to double its number was estimated using periodic phase microscopy field counts (10 fields counted and averaged at 100×) or viable cell counts using trypan blue with a hemocytometer.
Based on the exclusion of trypan blue, approximately 50% of the spore-like cells within each of the four tissues that were exposed to 4° C., without supplemental oxygen, for five days, remained viable at the end of that period. Moreover, the spore-like cells isolated from lung, liver, fascia, and spinal cord retained their ability to proliferate and differentiate into tissue-specific structures.
Example 14
After being killed, whole animals (Fisher rats) were placed in plastic bags and stored in a freezer at −86° C. After being frozen for either two or eight weeks, the animals were removed from the freezer and placed in a 37° C. water bath until their tissues thawed. Four tissues (lung, liver, fascia, and spinal cord) were then harvested, and spore-like cells were isolated as described in Example 13 and assessed by trypan blue exclusion for viability. Spore-like cells could be obtained from oxygen-deprived and deeply frozen tissue just as they were from oxygen-deprived and chilled tissue. Approximately 50% of the spore-like cells within each of the four tissues that were exposed to −86° C., without supplemental oxygen, for two or eight weeks, remained viable at the end of those periods. Moreover, the spore-like cells isolated from lung, liver, fascia, and spinal cord retained their ability to proliferate and differentiate into tissue-specific structures.
Example 15
Four tissues (lung, liver, fascia, and spinal cord) were obtained from three animals (Fisher rats) and heated to 85° C. for 30 minutes. More specifically, each tissue type was removed from an animal less than two hours after the animals was killed and placed in a 50 cc centrifuge tube (Fisher Scientific, Pittsburg, Pa.) filled with PBS. The tubes were then placed in a heated water bath as the temperature of the bath was raised to 85° C. The temperature was monitored with sterile thermometers, which were placed within each tube. The tubes were left in the water bath for 45 minutes after the temperature reached 85° C. The tissue was then allowed to cool to room temperature, and spore-like cells were isolated as described in Example 13.
Based on the exclusion of trypan blue, approximately 50% of the spore-like cells within each of the four tissues that were heated to 85° C. for 30 minutes remained viable at the end of that period. Moreover, the spore-like cells isolated from lung, liver, fascia, and spinal cord retained their ability to proliferate and differentiate into tissue-specific structures.
Example 16
Spore-like cells isolated from the central nervous system fail to show activity in a microculture tetrazolium assay (conducted as described in Marshall et al. (Growth Regulation 5:69–84, 1995)), but do so when they differentiate into cells with more usual and recognizable characteristics. This assay tests for redox activity and, when negative, indicates that no cells are present. This assay therefore provides further evidence that spore-like cells are unique from known cell types and that they exist in a dormant state without apparent metabolic activity.
Example 17
Blood from a patient who developed type I diabetes eight years earlier was collected in a standard tube with anticoagulant and subsequently frozen at −85° C. without preparation (i.e., without treatment with a cryopreservative or other substance) for up to 26 weeks. Spore-like cells were successfully isolated from this blood sample after up to four freeze-thaw cycles. No other intact cells were observed (as was expected as no known cell types are known to survive these conditions).
More specifically, after each thaw cycle, one cc of blood was added to 20 ccs of complete medium (DMEM/F12 with progesterone, b-FGF, and EGF) After the cells were added, the medium was triturated with a pasteur pipette and reduced-bore pasteur pipettes and filtered through, first, a 100 micron filter and then a 40 micron filter. The cells were then placed in a 175 cm2 flask and incubated at 37° C. with 5% CO2. Initially, a few intact spore-like cells were suspended in the media with gel-like properties, with 3–5 cc of fresh media added every 3 to 5 days. The media then assumed a liquid quality, with rapid spore-like cell replication (ten doublings in 5 days). At about day 12, the spore-like cells formed small clusters. At this point, 0.5 cc of 30% glucose was added to the culture flask, raising the concentration of glucose from about 100 mg/dl to 500 mg/dl (a hyperglycemic condition). In response, the clusters enlarged, and frequent nucleated cells could be seen within 5 days. Insulin production was demonstrated by both standard immunofluorescent assays and by RT-PCR for insulin mRNA.
OTHER EMBODIMENTS
One of ordinary skill in the art will appreciate that the spore-like cells described herein can be administered in connection with existing tissue engineering methods, in lieu of differentiated cells in cell-based therapies, and in lieu of cells presently administered following genetic manipulation.
It is to be understood that while the invention has been described in conjunction with the detailed description thereof, that the foregoing description is intended to illustrate and not limit the scope of the invention, which is defined by the scope of the appended claims.
Other aspects, advantages, and modifications are within the scope of the following claims.

## Claims

1. A method for isolating a spore-like cell population from a mammalian biological tissue or cell containing fluid, the method comprising (a) obtaining a mammalian tissue or cell containing fluid and exposing the mammalian tissue or cell containing fluid to an environment in which differentiated or partially differentiated cells in the tissue or fluid die, wherein the environment includes one or more conditions selected from the group consisting of temperature of 42° C. or greater, freezing, non-physiological salt concentration, essential absence of oxygen for at least four hours, size separation and passaging in cell culture, treatment with acid or base, radiation and drying, and (b) separating the population of viable spore-like cells from the dead differentiated or partially differentiated cells.

2. The method of claim 1, further comprising disrupting the tissue or fluid either before or after step (a) and separating the viable spore-like cell from the dead differentiated or partially differentiated cells by size separation.

3. The method of claim 1 wherein the spore-like cell population fails to demonstrate activity in a microtetrazolium assay.

4. The method of claim 1 wherein the spore-like cells contain between approximately 50 and 90% by volume nuclear material.

5. The method of claim 1 wherein the spore-like cells have a diameter of approximately 15 microns or less.

6. The method of claim 1, wherein the spore-like cells have a diameter of between 0.1 and 3.0 microns.

7. The method of claim 1 wherein the tissue or fluid is treated with salt, acid or base and the spore-like cells isolated.

8. The method of claim 1, wherein the biological tissue comprises a tissue that originates from the endoderm.

9. The method of claim 1, wherein the biological tissue comprises a tissue that originates from the mesoderm.

10. The method of claim 1, wherein the biological tissue comprises a tissue that originates from the ectoderm.

11. The method of claim 1, wherein the biological fluid comprises blood, urine, or saliva.

12. The method of claim 1, wherein the biological fluid is cerebrospinal fluid.

13. The method of claim 1, wherein the environment is an oxygen-poor environment.

14. The method of claim 1, wherein the environment is one in which the temperature is above or below the range of temperatures in which differentiated or partially differentiated cells can survive.

15. The method of claim 1, wherein the environment contains a toxin or infectious agent that kills differentiated or partially differentiated cells.

16. The method of claim 1 wherein the environment contains radiation or is dessicating.

17. The method of claim 1 further comprising placing the cell population into a matrix for implantation into a site for tissue repair, augmentation or regeneration.

18. The method of claim 17, further comprising implanting the matrix into a site for tissue repair, augmentation or regeneration.

19. The method of claim 1 further comprising culturing the spore-like cell population.

20. The method of claim 18 further comprising implanting the matrix into a tissue selected from the group consisting of the visual system, auditory system, nasal epithelium, alimentary canal, pancreas, gallbladder, bladder, kidney, liver, heart, respiratory system, nervous system, reproductive system, endocrine system, immune system, bone, muscle, tooth, nail, and skin.

21. The method of claim 17 wherein the matrix is a hydrogel.

22. The method of claim 1 wherein the tissue is selected from the group consisting of cardiac, smooth and skeletal muscle, intestine, bladder, kidney, liver, lung, adrenal gland, skin, retina, nasal epithelium, brain, spinal cord, periosteum, perichondrium, fascia, and pancreas.

23. The method of claim 1 wherein the spore-like cell population is frozen after isolation.

24. The method of claim 1 further comprising inducing the isolated spore-like cells in the population to differentiate.

25. The method of claim 21 wherein the spore-like cells in the population are introduced into a support structure.

26. The method of claim 17 wherein the matrix is a porous polymer mesh, suture, film or sponge.

27. The method of claim 1, wherein the biological fluid is cerebrospinal fluid.