LINEAGE-DIRECTED INDUCTION OF HUMAN MESENCHYMAL STEM CELL DIFFERENTIATION

Abstract: Methods for in vitro or ex vivo lineage directed induction of isolated, culture expanded human mesenchymal stem cells comprising contacting the mesenchymal stem cells with a bioactive factor effective to induce differentiation thereof into a lineage of choice as well as such compositions including isolated culture expanded human mesenchymal stem cells and bioactive factors effective to induce directed lineage induction are disclosed. Further disclosed is this method which also includes introducing such culturally expanded lineage-induced mesenchymal stem cells into a host from which they have originated for purposes of mesenchymal tissue regeneration or repair.

Description: LINEAGE-DIRECTED INDUCTION OF HUMAN MESENCHYMAL STEM CELL DIFFERENTIATION The present invention provides methods for directing mesenchymal stem cells cultivated in vitro to differentiate into specific cell lineage pathways prior to, or at the time of, their implantation for the therapeutic treatment of pathologic conditions in humans and other species. Mesenchymal stem cells (MSCs) are the formative pluripotent blast or embryonic-like cells found in bone marrow, blood, dermis, and periosteum that are capable of differentiating into specific types of mesenchymal or connective tissues including adipose, osseous, cartilaginous, elastic, muscular, and fibrous connective tissues. The specific differentiation pathway which these cells enter depends upon various influences from mechanical influences and/or endogenous bioactive factors, such as growth factors, cytokines, and/or local microenvironmental conditions established by host tissues. Although these cells are normally present at very low frequencies in bone marrow, a process for isolating, purifying, and mitotically expanding the population of these cells in tissue culture is reported in Caplan et al . U.S. Patent Nos . 5,197,985 and 5,226,914. In prenatal organisms, the differentiation of MSCs into specialized connective tissue cells is well established; for example embryonic chick, mouse or human limb bud mesenchymal cells differentiate into cartilage, bone and other connective tissues (1-5). In addition, a clonal rat fetus calvarial cell line has also been shown to differentiate into muscle, fat, cartilage, and bone (6). The existence of MSCs in post-natal organisms has not been widely studied with the objective of showing the differentiation of post-embryonic cells into several mesoder al phenotypes. The few studies which have been done involve the formation of bone and cartilage by bone marrow cells following their encasement in diffusion chambers and in vivo transplantation (7, 8). Recently, bone marrow-derived cells from young rabbits (800-1,000 g) have been shown to form adipocytic and osteogenic cells in vivo (9) and cloned bone marrow stromal cells of post-natal mice were shown to form adipocytes and osteogenic cells (10). Likewise, cells from chick periosteum have been isolated, expanded in culture, and, under high density conditions in vitro , shown to differentiate into cartilage and bone (11). Rat bone marrow-derived mesenchymal cells have been shown to have the capacity to differentiate into osteoblasts and chondrocytes when implanted in vivo (12, 6). Cells from various marrow sources of post-natal organisms have never been observed to exhibit myogenic properties, with multinuclear appearance being the most easily recognized characteristic in culture. In a first aspect, the invention provides a method for effecting the lineage-directed induction of isolated, culture-expanded human mesenchymal stem cells which comprises contacting mesenchymal stem cells with a bioactive factor or combination of factors effective to induce differentiation thereof into a lineage of choice. More particularly, this method is one in which the bioactive factor induces differentiation of such cells into a mesenchymal lineage selected from the group consisting of osteogenic, chondrogenic, tendonogenic, ligamentogenic, myogenic, marrow stro agenic, adipogenic and dermogenic. Preferably, the cells are contacted ex vivo with one or more bioactive factors in this aspect, thereby providing a method free of any risks that may be associated with in vivo administration of any bioactive factors. In another aspect, the method of the invention further provides administering to an individual in need thereof isolated culture-expanded human mesenchymal stem cells and a bioactive factor effective to induce differentiation of such cells into a lineage of choice. Preferably, the mesenchymal stem cells and bioactive factor are administered together or they may alternatively be administered separately. Particularly, this aspect of the method comprises administering the bioactive factor to an individual to whom a preparation comprising isolated autologous human mesenchymal stem cells has been, is being or will be administered. In another aspect, the invention provides a method for inducing the in vivo production of human cytokines in an individual in need thereof which comprises administering to the individual isolated culture-expanded human mesenchymal stem cells and a bioactive factor effective to induce such cells to differentiate into a cytokine-producing mesenchymal lineage descendant in such individual. Preferably, the mesenchymal stem cells and bioactive factor are administered together or they may alternatively be administered separately. In specific preferred examples of these aspects, the bioactive factor is a bone morphogenetic protein and the human MSCs are directed into the chondrogenic lineage; the bioactive factor is interleukin 1 and the human MSCs are directed into the εtromal cell lineage (preferably the interleukin 1 is interleukin la ) ; the bioactive factors are dexamethasone, ascorbic acid-2-phoεphate and β- glycerophosphate and the human MSCs are directed into the osteogenic lineage; or the bioactive factor is selected from the group consisting of 5-azacytidine, 5-azadeoxycytidine and analogs of either of them and the human mesenchymal stem cells are directed into the myogenic lineage. Another aspect of the invention provides a composition comprising isolated, culture-expanded human mesenchymal stem cells and a bioactive factor,- or combination, effective to induce differentiation of such cells into a lineage of choice. Preferably the composition further comprises a tissue culture medium. Alternatively, the composition can comprise a medium suitable for administration to an animal particularly a human, in need thereof. This aspect of the invention also provides for specific embodiments using the bioactive factors identified above for lineage induction into the lineages associated therewith as described above. Figure 1 diagrammatically illustrates the mesengenic process by which mesenchymal stem cells differentiate into various lineage pathways. Figure 2 diagrammatically illustrates the osteogenic differentiation pathway. Figure 3 graphically demonstrates the increase in alkaline phosphatase activity as a function of time in cultures, in the initial studies reported in Example 1. Figure 4 shows results from the subsequent studies reported in Example 1. Figure 5 diagrammatically illustrates the chondrogenic differentiation pathway. Figure 6 shows the extent of human mesenchymal stem cell cytokine expression, with and without interleukin-1 stimulation, based on the experiments in Example 4. Figures 7A and 7B. (A) Phase contrast micrograph of living culture of MSCs showing the multinucleated cells derived after exposure to 5- aza-CR. This micrograph shows a culture 2 weeks after treatment with 10 μM 5-aza-CR. Many nuclei (arrows) in the cell can be observed, but striations are not discernible. (B) Phase contrast micrograph of living culture of normal rat fetal muscle cells prepared from the hindlimbs of 17-day-old rat fetuses. As with bone marrow MSC-derived myotubes, no discernible striations are apparent. Scale bar 50 μm. Figure 8: Immunofluorescence staining for muscle- specific yosin in myotubes derived from rat bone marrow MSCs after exposure to 5-aza-CR. Myosin antibodies do not visualize cross striations, but the antibodies clearly illuminate longitudinal fibers. Scale bar 30 μm. Figures 9A-9D: Myotubes derived from rat bone marrow MSCs 2 weeks [(A) and (B) ] and 5 weeks [(C) and (D) ] after exposure to 5-aza-CR. Phase contrast micrograph [(A) and (C)] and immunofluorescence staining for myosin [(B) and (D)]. (A) and (B), (C) and (D) are the same visual fields. Myotubes 2 weeks after 5-aza-CR exposure are stained with anti-myosin antibody, but those 5 weeks after exposure are not. Scale bar 50 μM. Figures 10A-10B: Micrograph of the 5-aza-CR-treated MSCs containing droplets in their cytoplasm; this culture was stained with Sudan Black. (A) Clusters of adipocytes (arrows) were observed; scale bar 200 μM. (B) Droplets are stained brown to black (arrows), which suggests that these droplets are lipid; scale bar 100 μM. Figure 11: Phase contrast micrograph of living culture of myogenic cells derived from rat bone marrow MSCs after exposure to 5-aza-CR. Following exposure to 5-aza-CR, these cells were cultured with 4ng/ml bFGF for 10 days. Large myotubes can be seen; scale bar 300 μm. Figures 12A-12D graphically illustrate the expression of G-CSF, GM-CSF, M-CSF and SCF, respectively, observed in the experiments reported by Example 6. Figures 13A-13C graphically illustrate the expression of LIF, IL-6 and IL-11, respectively observed in the experiments reported by Example 6. Figure 14 graphically illustrates the dose dependent IL- lα induction of GM-CSF expression observed in the experiments reported by Example 6. This invention has multiple uses and advantages. The first lies in the ability to direct and accelerate MSC differentiation prior to implantation back into autologous hosts. For example, MSCs which are directed in vitro to become osteogenic cells will synthesize bone matrix at an implant site more rapidly and uniformly than MSCs which must first be recruited into the lineage and then progress through the key differentiation steps. Such an ex vivo treatment also provides for uniform and controlled application of bioactive factors to purified MSCs, leading to uniform lineage commitment and differentiation. In vivo availability of endogenous bioactive factors cannot be as readily assured or controlled. A pretreatment step such as is disclosed herein circumvents this. In addition, by pretreating the MSCs prior to implantation, potentially harmful side effects associated with systemic or local administration of exogenous bioactive factors are avoided. Another use of this technique lies in the ability to direct tissue regeneration based on the stage of differentiation which the cells are in at the time of implantation. That is, with respect to bone and cartilage, the state of the cells at implantation may control the ultimate tissue type formed. Hypertrophic chondrocyteε will mineralize their matrix and eventually pave the way for vascular invasion, which finally results in new bone formation. Clearly, MSCs implanted for the purpose of restoring normal hyaline cartilage must not progress down the entire lineage. However, implants which are designed to repair articular surface defects and the underlying subchondral bone could benefit from a two-component system wherein the cells in the area of the future bone are directed ex vivo to become hypertrophic chondrocytes, while the cells in the area of the future articulating surface are directed only to become chondroblasts. In the area of stromal reconstitution, the ex vivo control of differentiation can optimize MSC cell populations for the elaboration of stage-specific cytokines requisite to the needs of the individual. Muscle morphogenesis can similarly be directed to create fast or slow twitch fibers, depending on the indication. Isolation and Purification of Human Mesenchymal Stem Cells The human mesenchymal stem cells isolated and purified as described here can be derived, for example, from bone marrow, blood, dermis or periosteum. When obtained from bone marrow this can be marrow from a number of different sources, including plugs of femoral head cancellous bone pieces, obtained from patients with degenerative joint disease during hip or knee replacement surgery, or from aspirated marrow obtained from normal donors and oncology patients who have marrow harvested for future bone marrow transplantation. The harvested marrow is then prepared for cell culture. The isolation process involves the use of a specially prepared medium that contains agents which allow for not only mesenchymal stem cell growth without differentiation, but also for the direct adherence of only the mesenchymal stem cells to the plastic or glass surface of the culture vessel. By creating a medium which allows for the selective attachment of the desired mesenchymal stem cells which were present in the mesenchymal tissue samples in very minute amounts, it then became possible to separate the mesenchymal stem cells from the other cells (i.e. red and white blood cells, other differentiated mesenchymal cells, etc.) present in the mesenchymal tissue of origin. Bone marrow is the soft tissue occupying the medullary cavities of long bones, some haversian canals, and spaces between trabeculae of cancellous or spongy bone. Bone marrow is of two types: red, which is found in all bones in early life and in restricted locations in adulthood (i.e. in the spongy bone) and is concerned with the production of blood cells (i.e. hematopoiesis) and hemoglobin (thus, the red color); and yellow, which consists largely of fat cells (thus, the yellow color) and connective tissue. As a whole, bone marrow is a complex tissue comprised of hematopoietic cells, including the hematopoietic stem cells, and red and white blood cells and their precursors; and a group of cells including mesenchymal stem cells, fibroblasts, reticulocytes, adipocyteε, and endothelial cells which contribute to the connective tisεue network called "εtroma". Cellε from the εtroma regulate the differentiation of hematopoietic cellε through direct interaction via cell εurface proteinε and the secretion of growth factorε and are involved in the foundation and εupport of the bone εtructure. Studies using animal models have suggested that bone marrow contains "pre-stromal" cells which have the capacity to differentiate into cartilage, bone, and other connective tissue cells. (Beresford, J.N. : Osteogenic Stem Cells and the Stromal System of Bone and Marrow, Clin . Orthop. , 240:270, 1989). Recent evidence indicates that these cells, called pluripotent stromal stem cells or mesenchymal stem cells, have the ability to generate into several different types of cell lines (i.e. osteocytes, chondrocytes, adipocyteε, etc.) upon activation, depending upon the influence of a number of bioactive factors. However, the mesenchymal stem cells are present in the tissue in very minute amounts with a wide variety of other cells (i.e. erythrocyteε, plateletε, neutrophilε, lymphocytes, monocytes, eosinophilε, basophils, adipocytes, etc.). As a result, a process has been developed for isolating and purifying human mesenchymal stem cells from tissue prior to differentiation and then culture expanding the mesenchymal stem cellε to produce a valuable tool for muεculoεkeletal therapy. The objective of such manipulation is to greatly increase the number of mesenchymal stem cells and to utilize these cellε to redirect and/or reinforce the body's normal reparative capacity. The mesenchymal stem cells are expanded to great numbers and applied to areas of connective tissue damage to enhance or stimulate in vivo growth for regeneration and/or repair, to improve implant adhesion to various prosthetic devices through subsequent activation and differentiation, or enhance hemopoietic cell production, etc. Along these lines, various procedureε are contemplated for tranεferring, immobilizing, and activating the culture- expanded, purified mesenchymal stem cells at the εite for repair, implantation, etc., including injecting the cellε at the site of a skeletal defect, incubating the cells with a prosthesis and implanting the prosthesis, etc. Thus, by isolating, purifying and greatly expanding the number of cells prior to differentiation and then actively controlling the differentiation process by virtue of their positioning at the site of tissue damage or by pretreating in vitro prior to their transplantation, the culture-expanded, mesenchymal stem cells can be utilized for various therapeutic purposes such as to alleviate cellular, molecular, and genetic disorders in a wide number of metabolic bone diseaεes, skeletal dysplaεiaε, cartilage defectε, ligament and tendon injuries and other muεculoεkeletal and connective tiεεue diεorders. Several media have been prepared which are particularly well suited to the desired selective attachment and are referred to herein as "Complete Media" when supplemented with serum aε deεcribed below. One such medium is an augmented version of Dulbecco's Modified Eagle's Medium-Low Glucose (DMEM-LG), which is well known and readily commercially available. The commercial formulation is supplemented with 3700 mg/1 of sodium bicarbonate and 10 ml/1 of lOOx antibiotic- antimycotic containing 10,000 unitε of penicillin (base), 10,000 μq of streptomycin (baεe) and 25 μg of amphotericin B/ml utilizing penicillin G (εodium salt), εtreptomycin sulfate, and amphotericin B as FUNGIZONE® in 0.85% saline. The medium described above is made up and stored in 90 ml per 100 ml or 450 ml per 500 ml bottles at 4°C until ready to use. For use, 10 ml or 50 ml of fetal bovine serum (from selected lots) iε added to the bottleε of media to give a final volume of 10% serum. The medium is warmed to 37°C prior to use. In this regard, it was also found that BGJ b medium (Gibco, Grand Island, NY) with tested and selected lots of 10% fetal bovine serum (J.R. Scientific, Woodland, CA, or other suppliers) was well suited for use in the invention. This medium, which was also a "Complete Medium", contained factorε which alεo εtimulated meεenchymal εtem cell growth without differentiation and allowed for the selective attachment through specific protein binding sites, etc. of only the mesenchymal stem cells to the plastic surfaces of Petri dishes. In addition, it was also found that the medium F-12 Nutrient Mixture (Ham) (Gibco, Grand Iεland, NY) exhibited the desired properties for selective mesenchymal stem cell separation. As indicated above, the complete medium can be utilized in a number of different isolation processes depending upon the specific type of initial harvesting processes used in order to prepare the harvested bone marrow for cell culture separation. In thiε regard, when plugε of cancellouε bone marrow were utilized, the marrow was added to the complete medium and vortexed to form a dispersion which was then centrifuged to separate the marrow cells from bone pieces, etc. The marrow cellε (consiεting predominantly of red and white blood cells, and a very minute amount of meεenchymal stem cellε, etc.) were then dissociated into single cells by sequentially passing the complete medium containing the marrow cells through syringes fitted with a series of 16, 18, and 20 gauge needles. It is believed that the advantage produced through the utilization of the mechanical separation proceεε, aε oppoεed to any enzymatic εeparation process, was that the mechanical process produced little cellular change while an enzymatic process could produce cellular damage particularly to the protein binding sites needed for culture adherence and selective separation, and/or to the protein siteε needed for the production of monoclonal antibodieε specific for said mesenchymal εtem cellε. The single cell suεpenεion (which waε made up of approximately 50-100 x 10 6 nucleated cells) waε then subsequently plated in 100 mm disheε for the purpoεe of εelectively εeparating and/or iεolating the meεenchymal stem cells from the remaining cells found in the suεpenεion. When aεpirated marrow was utilized as the source of the human mesenchymal stem cells, the marrow stem cells (which contained little or no bone chipε but a great deal of blood) were added to the complete medium and fractionated with Percoll (Sigma, St. Louiε, MO) gradientε more particularly deεcribed below in Example 1. The Percoll gradients separated a large percentage of the red blood cells and the mononucleate hematopoietic cells from the low density platelet fraction which contained the marrow-derived mesenchymal stem cells. In this regard, the platelet fraction, which contained approximately 30-50 x 10° cells waε made up of an undetermined amount of platelets, 30-50 x 10° nucleated cellε, and only about 50-500 mesenchymal stem cells depending upon the age of the marrow donor. The low density platelet fraction was then plated in the Petri dish for selective separation based upon cell adherence. In this regard, the marrow cells obtained from either the cancellous bone or iliac aspirate (i.e. the primary cultures) were grown in complete medium and allowed to adhere to the surface of the Petri dishes for one to seven days according to the conditions set forth in Example 1 below. Since minimal cell attachment was observed after the third day, three days was chosen as the standard length of time at which the non-adherent cells were removed from the cultures by replacing the original complete medium with fresh complete medium. Subsequent medium changes were performed every four days until the culture dishes became confluent which normally required 14-21 days. This represented a 10 3 -10 4 fold increase in the number of undifferentiated human mesenchymal stem cells. The cells were then detached from the culture dishes utilizing a releasing agent such as trypsin with EDTA (ethylene diaminetetra-acetic acid) (0.25% trypsin, lmM EDTA (IX) , Gibco, Grand Island, NY) . The releasing agent was then inactivated and the detached cultured undifferentiated mesenchymal stem cells were washed with complete medium for subsequent use. The capacity of these undifferentiated cells to enter discrete lineage pathways is referred to as the mesengenic process, and is diagrammatically represented in Figure l. In the mesengenic process, MSCs are recruited to enter specific multi-step lineage pathways which eventually produce functionally differentiated tissues such as bone, cartilage, tendon, muscle, dermis, bone marrow stroma, and other mesenchymal connective tissues. For example, a detailed scheme for the differentiation pathway of bone forming cells is presented in Figure 2. This lineage map implies the existence of individual controlling elements which recruit the MSCs into the osteogenic lineage, promote pre-osteoblast replication, and direct step-wise differentiation all the way to the terminal stage osteocyte. Subεtantial work haε been reported that supports the view that each step of this complex pathway is controlled by different bioactive factors. A similar lineage diagram haε been developed for chondrocyte differentiation and iε provided in Figure 5. Again, progreεεion of each lineage step is under the control of unique bioactive factors including, but not limited to, the family of bone morphogenetic proteins. Each modulator of the differentiation process, whether in bone, cartilage, muscle, or any other mesenchymal tissue, may affect the rate of lineage progresεion and/or may specifically affect individual stepε along the pathway. That iε, whether a cell iε naεcently committed to a εpecific lineage, iε in a bioεynthetically active state, or progresses to an end stage phenotype will depend on the variety and timing of bioactive factors in the local environment. The bone and cartilage lineage potentials (i.e. osteo- chondrogenic potential) of fresh and expanded human mesenchymal stem cellε were determined uεing two different in vivo assays in nude mice. One assay involved the subcutaneous implantation of porous calcium phosphate ceramics loaded with cultured mesenchymal stem cellε; the other involved peritoneal implantation of diffusion chambers inoculated with cultured mesenchymal stem cells. Whole marrow and Percoll gradient separated aspirate fractions were also analyzed in these in vivo asεayε. Hiεtological evaluation εhowed bone and cartilage formation in the ceramics implanted with the cultured mesenchymal stem cells derived from the femoral head and the iliac crest. Ceramics loaded with human mesenchymal stem cells at 5xl0 6 cells/ml formed bone within the pores, while ceramicε loaded with human meεenchymal εtem cells at 10x10° cellε/ l formed cartilage within the pores. While whole marrow has now been shown to form bone when placed as a composite graft with ceramics in a subcutaneous site in nude mice, the amount of bone produced iε εubεtantially leεε than that εeen when culture expanded marrow-derived mesenchymal stem cells are used. These results indicated that under certain conditions, culture expanded mesenchymal stem cells have the ability to differentiate into bone or cartilage when incubated as a graft in porous calcium phosphate ceramics. The environmental factors which influence the mesenchymal stem cells to differentiate into bone or cartilage cells appearε, in part, to be the direct acceεsibility of the mesenchymal stem cells to growth and nutrient factors supplied by the vasculature in porous calcium phosphate ceramics; cells that are closely asεociated with vaεculature differentiate into bone cells while cells that are isolated from vasculature differentiate into cartilage cellε. The excluεion of vasculature from the pores of ceramics loaded with concentrated human meεenchymal εtem cells prevented osteogenic differentiation and provided conditions permisεive for chondrogeneεiε. Aε a result, the iεolated and culture expanded meεenchymal εtem cells can be utilized under certain εpecific conditionε and/or under the influence of certain factorε, to differentiate and produce the desired cell phenotype needed for connective tiεεue repair or regeneration and/or for the implantation of variouε proεthetic deviceε. For example, uεing porouε ceramic cubeε filled with culture-expanded human meεenchymal stem cells, bone formation inside the poreε of the ceramicε has been generated after εubcutaneous incubations in immunocompatible hostε. In a recent εtudy (13), rat marrow in a composite graft with porous ceramic was used to fill a segmental defect in the femur of the rat. Bone waε shown to fill the pores of the ceramic and anchor the ceramic-marrow graft to the host bone. Factorε which εtimulate oεteogenesis (i.e. are osteoinductive) from isolated human mesenchymal stem cells in accordance with the invention are present in several classes of molecules, including the following: bone morphogenic proteins, such as BMP-2 (14) and BMP-3 (15); growth factors, such as basic fibroblast growth factor (bFGF); glucocorticoidε, εuch aε dexamethasone (16); and proεtaglandinε, such as prostaglandin El (22). Further aεcorbic acid and itε analogε, εuch aε aεcorbic acid-2- phoεphate (17) and glycerol phosphates, such as β- glycerophoεphate (18) are effective adjunct factorε for advanced differentiation, although alone they do not induce oεteogenic differentiation. Factorε which have chondroinductive activity on human MSCs are also present in εeveral claεεeε of molecules, including the following: compounds within the tranεforming growth factor-β (TGF-3) superfa ily, such aε (i) TGF-/S1 (19), (ii) Inhibin A (20), (iii) chondrogenic εtimulatory activity factor (CSA) (21) and (iv) bone morphogenic proteinε, εuch aε BMP-4 (22); collagenous extracellular matrix molecules, including type I collagen, particularly aε a gel (23); and vitamin A analogs, such as retinoic acid (24). Factors which have stromagenic inductive activity on human MSCε are alεo preεent in εeveral classeε of moleculeε, especially the interleukinε, such as IL-lα (25) and IL-2 (26). Factors which have myogenic inductive activity on human MSCs are alεo present in εeveral claεseε of moleculeε, especially cytidine analogs, such as 5-azacytidine and 5-aza- 2'-deoxycytidine. The effect of these modulating factors on human MSCε iε diεclosed here for the first time. This is not represented to be an all-inclusive listing of potentially useful modulatory factors for inducing differentiation into a particular lineage, but illuεtrateε the variety of compoundε which have useful biologic activity for the purpose of promoting the step-wise progression of isolated human mesechymal εtem cell differentiation. Example 1 Induced Osteogenic Differentiation of MSCs In Vitro The objective of the experiments described in this example was to demonstrate that meεenchymal εtem cellε (MSCs) were directed along the oεteogenic lineage pathway in vitro by providing appropriate bioactive factorε in the tiεεue culture medium. This set of experiments illustrates just one example of how MSCs can be directed along the osteogenic lineage. Initial Study Human MSCs were harvested and isolated from bone marrow as described above. These cells were culture-expanded in DMEM-LG medium containing preselected 10% fetal bovine serum (Complete Medium). Fresh Complete Medium was replaced every 3-4 days until the cultures were near confluence, at which time the cells were liberated off the plates with trypsin, and reseeded onto new diεhes at approximately 40% confluence (400,000 cells per 100 mm dish). These replated MSCs were allowed to attach overnight, after which the Complete Medium was replaced by a medium composed of DMEM-LG, 10% fetal bovine serum, and either 100 nM dexamethaεone alone, or 100 nM dexcunethasone with 50 μM ascorbic acid-2-phoεphate, and 10 mM 8-glycerophoεphate (Oεteogenic Supplement). The Oεteogenic Supplement was replaced every 3 days. Cells were examined daily for morphologic changes. Selected plates were then analyzed for cell εurface alkaline phosphataεe (AP) activity, a marker for cellε which have entered the oεteogenic lineage. It iε theεe cellε which were εubεequently reεponεible for εyntheεizing oεteoid matrix. Standard enzyme hiεtochemiεtry and biochemiεtry reagentε were uεed to demonεtrate activity of thiε cell surface protein. Additional εpecimenε were evaluated for the preεence of mineralized extracellular matrix nodules which correlate with the continued differentiation and phenotypic expreεεion of a mature osteoblaεt population. Silver nitrate precipitation onto calcium phoεphate cryεtalε within the bone nodule was achieved through the standard Von Koεεa staining technique. The results indicate that after only three days of exposure to dexamethasone, MSCs in culture had already begun expressing alkaline phosphatase on their surface. By day six of culture, approximately 80% of the cellε were AP positive. The grosε organization of the culture diεh had changed from near confluent whorlε of fibroblaεt-like cellε at day 1, to numerous areas of polygonal cells which were piled on top of each other. By day 9, many εmall nodules of birefringent extracellular matrix was asεociated with theεe foci of layered polygonal cells. Theεe areaε were poεitively εtained by the Von Kossa method for mineral. Control cultureε fed only Complete Medium never developed theεe mineralized bone noduleε, and only rarely contained AP poεitive cellε. By contrast, MSCs treated with Osteogenic Supplement uniformly acquired AP activity and synthesized mineralized extracellular matrix nodules throughout the diεh. Although not oεteoinductive themεelveε, the preεence of ascorbic acid- 2-phosphate and 0-glycerophoεphate in the complete Oεteogenic Supplement further supports extracellular matrix maturation and mineral deposition, respectively. Figure 3 graphically demonstrates the increase in alkaline phosphatase enzyme activity as a function of time in culture. By day 8 and beyond, subεtantially more enzyme activity is obεerved in cellε exposed to Osteogenic Supplementε (OS) than thoεe cultured with control medium. Taken together, these studies demonstrate that MSCs can be rapidly and uniformly stimulated to differentiate along the osteogenic lineage in vitro . Furthermore, not only are the MSCs recruited into the early steps within the lineage, evidenced by AP expresεion, but the MSCε progreεs through the lineage to become mature osteoblastε which secrete and mineralize a bone-like extracellular matrix. Further evidence for this comes from the observation that when chick MSCs are treated with Oεteogenic Supplement, they progreεε through the εtageε of the oεteogenic lineage depicted in Figure 2 aε determined by monoclonal antibody staining againεt εtage-εpecific cell εurface antigenε. Subsequent Study Using published techniques, MSCs were purified from 3 different patients (ages 26-47), culture expanded (27), and seeded overnight onto 48-well culture plates at 20% confluence in DMEM-LG with 10% FBS from selected lots. Base media for comparison were DMEM-LG, BGJ b , αMEM, and DMEM/F-12 (1:1). Triplicate cultures for each asεay were grown in 10% FBS in the abεence or preεence of "Osteogenic Supplements" (OS) (100 nM dexamethasone, 50 μM aεcorbic acid-2-phoεphate, and IOIΓLM / 8-glycerophosphate (28). Media were changed every 3 days. Each set of cultures was asεayed for cell number by the cryεtal violet aεsay, cell surface alkaline phosphatase (AP) by histochemistry and mineralized nodule formation by Von Kossa staining. AP enzyme activity was calculated by incubating live cultures with 5 mM p-nitrophenylphosphate in 50 mM Tris, 150 mM NaCl, pH 9.0 and quantifying the colorimetric reaction by scanning the samples at 405 nm on an ELISA plate reader. AP enzyme activity was expresεed aε nanomoles of product/minute/10 3 cells. The percentage of AP- poεitive cells in each well was determined from the stained cultures, and the number of mineralized nodules per well were counted. Asεayε were performed every 4 dayε for the 16 day culture period. The paired two-sample t-Teεt waε performed on εelected εampleε. The data in Figure 4 represent one patient, although similar resultε were obtained from all specimens. MSCs uniformly attached to the plates, assumed their characteristic spindle-εhaped morphology, and proliferated to reach confluence within 8 days. During this period, and particularly beyond, the OS-treated cells developed a cuboidal morphology as their density increaεed, forming multiple layerε. For clarity, only εelected aεpectε of the parameterε deεcribed above are graphically repreεented on Figure 4. All specimens grown in BGJb+OS died within 3 days, while BGJb cultures survived for the duration of the protocol. For this reason, all BGJb data were omitted from the graphs . Highlights of the εtudy demonεtrate εubstantially greater proliferation in αMEM compared to DMEM/F-12 or DMEM alone (i.e., p<0.01 and p<0.05 at day 16). The addition of OS to αMEM cultures inhibited proliferation at days 8 and 12 (p<0.04 and p<0.03), but not by day 16 (p>0.05). αMEM+OS also stimulates a significant proportion of cells to expresε AP on their εurface when compared to MSCε maintained in DMEM (p<0.02 at day 8. p<0.01 at day 16). However, no εignificant difference in the percent of AP cellε iε observed between αMEM with and without OS (p>0.2 at day 8, p>0.05 at day 16). Notably, αMEM+OS induces more AP activity than any other medium throughout the culture period. including αMEM or DMEM (i.e., p<0.004 and p<0.002 at day 16). However, there waε no difference in AP activity between αMEM and DMEM+OS throughout the study period (i.e., p>0.2 at day 16). Of all media teεted, the number of mineralized noduleε by day 16 iε greateεt in DMEM+OS (p<0.02 compared to DMEM). Theεe investigations demonstrate that purified, culture- expanded human MSCs can be induced into the osteogenic lineage in vitro , thereby eεtabliεhing a model for human oεteoblaεt differentiation. Early in the culture period (day 8) only αMEM+OS induced substantial osteoblastic recruitment of MSCε (>50%), aε noted by AP cell surface εtaining. By day 16, however, all cultureε except DMEM contained >60% AP εtained cellε. In all media εtudied, addition of OS yieldε greater AP activity beyond 4 dayε. Although a large percentage of cellε in moεt media were AP-stained at day 16, the εubstantial differences in the AP activity asεay likely reflect the quantity of enzyme on the cell surface, and therefore, the degree of progresεion into the oεteoblaεtic lineage. At the very leaεt, OS are capable of up-regulating expreεεion of thiε oεteoblaεtic cell surface marker. Interestingly, despite less AP activity, DMEM+OS cells generated more mineralized noduleε than αMEM+OS. This observation may suggeεt that within the 16 day culture period, DMEM+OS εupports further osteogenic differentiation of MSCs than αMEM+OS. It iε possible that, given more time, αMEM+OS would foster even more mineralized foci than DMEM+OS. Differenceε in the media favoring maintenance of the MSC phenotype (DMEM) evidenced by MSC-specific im unostaining, or maximal recruitment and induction into the osteogenic lineage (αMEM+OS), noted by the percent AP-positive cellε and AP activity, are inherently intereεting and warrant further examination. The use of various monoclonal and polyclonal antibodies against specific cell and matrix components during this inductive phenomenon are currently underway, and will provide further inεight into the molecular nature of the in vitro differentiation process. The Generation of Monoclonal Antibodies Against Human Osteogenic Cells Reveals g tnt.*γr>nic Bone Formation In Vivo And Differentiation of Purified Mesenchymal Stem Cells In Vitro It has been well-establiεhed that meεenchymal progenitor cellε derived from bone marrow are capable of differentiating into oεteoblaεtε. In addition, theεe meεenchymal εtem cellε (MSCs) also give rise to cartilage, tendon, ligament, muscle, and other tissueε. However, knowledge of the εtepε involved in the commitment and differentiation of MSCε along theεe various lineages has been restricted, in part, by the lack of probes specific for cells at various stageε within the oεteogenic or other differentiation pathwayε. Since monoclonal antibodieε are uεeful probeε for εtudying differentiation, we immunized mice with intact living cell preparationε of human bone marrow-derived MSCε induced into the oεteogenic lineage in vitro . We εcreened hybridoma colonieε against purified MSCε, MSCs undergoing osteogenic differentiation, and frozen εectionε of embryonic human limbs where long bones are developing around the cartilage rudiment. This screening protocol favorε εelection of antibodies which react with MSCε undergoing differentiation in vitro and human oεteogenic cellε in vivo . Uεing thiε approach, we have generated monoclonal antibodieε againεt lineage εtage-specific surface antigens on osteogenic cellε derived from human marrow MSCε. Uεing published techniques, MSCs were purified from 5 different patients (ages 28-46), culture expanded (29), and grown in DMEM-LG with 10% FBS and "Osteogenic Supplementε" (100 nM dexamethaεone, 50 μM aεcorbic acid-2-phoεphate, and lOmM j8-glycerophosphate (28). At days 3 and 6 of culture, early during alkaline phosphataεe expresεion, and prior to mineralized nodule formation (30), the cells were liberated from the plates with 5 mM EGTA. Approximately 4 million 3 and 6 day cells were pooled for each of five weekly immunizations into Balbc/J mice. Uεing εtandard techniqueε, monoclonal hybridomas were produced, and culture εupernatantε were εcreened by a semiquantitative ELISA againεt purified MSCε, and MSCs cultured for 3 or 6 days with Osteogenic Supplements. Briefly, MSCs were plated on 96-well culture disheε, expoεed to Osteogenic Supplementε, and then reacted with culture εupernatantε followed by goat anti-mouεe IgG conjugated to horεeradish peroxidase. The εecondary antibody waε rinεed, and o-phenylenediamine εubεtrate waε added to the plateε. Primary mouεe monoclonal antibody binding was aεεeεεed by the colorimetric reaction quantified by εcanning the wellε at 490 nm on an ELISA plate reader. Colonieε of intereεt were εelected on the baεiε of differential binding to control MSCε and oεteogenic cellε derived from MSCε. Selected colonieε were further εcreened by immunofluorescence on unfixed frozen sections of human embryonic limbs. Hybridoma colonieε of interest were cloned and further immunocytochemical analyεeε were performed on a variety of normal and experimentally-derived tiεεues from human, rat, rabbit, chick, and bovine sources. Nearly 10,000 hybridoma colonies were screened by the modified ELISA protocol deεcribed above. Baεed on differential binding to purified MSCε, or MSCε cultured for 3 and 6 dayε with Oεteogenic Supplementε, 224 colonieε were εelected for immunofluoreεcent εcreening against embryonic day 55-60 human limbε. The majority of thoεe 224 colonies either reacted with multiple tissue types present in the developing limb, or were not detected in the developing bone. Thuε far, 9 colonieε have been identified which demonεtrate specific immunoreactivity on cellε of the oεteogenic lineage. The patternε of reactivity vary; εome hybridoma εupernatantε react with a large population of cellε within the oεteogenic collar and osteoprogenitor-containing perioεteum, while otherε react with only those cellε which appear to be actively involved in matrix synthesis. Two hybridoma colonies appear to react with osteogenic cells aε well aε hypertrophic chondrocyteε. The reεultε are εummarized in Table 1. Table 1 Hybridoma Cell Control MSCε 3 day OS 6 day OS Line culture culture 20E8 0 1 8 13C9 0 1 3 5D9 0 1 2 18H4 0 3 5 18D4 0 2 4 10F1 0 0 2 13B12 0 4 2 Table 1 εhowε the immunoreactivity of selected hybridoma colonieε againεt untreated MSCs, or MSCs cultured with Osteogenic Supplements (OS) for 3 or 6 days. Numbers reflect the relative amount of antibody bound in the ELISA assay described above. These investigations indicate the preεence of human osteogenic lineage stage-εpecific cell surface differentiation markers similar to those detailed for avian osteogenic cells (31). The staining of osteogenic cells in the developing limb supports the view that MSCs cultured with Osteogenic Supplements become "authentic" osteoblaεts in culture. Oεteogenic differentiation in vitro is thuε confirmed by molecular probeε which extend beyond traditional criteria of AP expression and mineralized nodule formation. Correlation of detailed in vitro observations with in vivo analyses of antigen expression will be useful in further studieε of osteogenesiε. Characterization of the εpecific tiεsue culture elements, i.e., bioactive factors, which promote progreεsion of cells through the osteogenic lineage εtepε will be crucial. Identification of osteogenic cell surface, and/or extracellular matrix antigens should provide further insight into bone cell physiology. These and other monoclonal antibodies currently under investigation will prove uεeful in future εtudies of MSC differentiation. Example 3 Induced Chondrogenic Differentiation of MSCs In Vitro The objective of the experimentation described in thiε example was to demonstrate that mesenchymal stem cells (MSCs) were directed along the chondrogenic lineage pathway in vitro by providing appropriate bioactive factors in the tissue culture medium. This set of experimentε repreεentε just one example of how MSCε can be directed along the chondrogenic lineage. Human MSCs were harvested and isolated from bone marrow as deεcribed above. Cellε were culture-expanded in DMEM-LG medium containing preεelected 10% fetal bovine serum (Complete Medium). Fresh medium was replaced every 3-4 days until the cultures were near confluence, at which time the cells were liberated off the plates with trypsin, and reεeeded onto new diεhes at approximately 50% confluence (500,000 cells per 100 mm dish). These replated MSCs were allowed to attach overnight, after which the Complete Medium was replaced by DMEM-LG with 10% fetal bovine serum, and 5 mg/ml partially purified Bone Morphogenic Protein (Chondrogenic Supplement), supplied by Dr. Marshall R. Urist. Thiε Chondrogenic Supplement waε replaced every 3 dayε. Cellε were examined daily for morphologic changeε. Selected plates were then analyzed immunohistochemically for CSPG-M, a marker for cells which have entered the chondrogenic lineage. It is these cells which were then actuated for synthesizing the Type II collagen matrix of cartilage. Standard immunohistochemiεtry reagents were used to demonstrate the presence of this extracellular matrix protein. Additional specimens were evaluated for the presence of Toluidine Blue-stained nodules which correlated them with the continued differentiation and phenotypic expresεion of a mature chondrocyte population. Von Koεεa εtaining for the preεence of mineralized nodules of hypertrophic chondrocytes was negative. The reεults indicated that after only three days of exposure to the Chondrogenic Supplement, MSCε in culture had already begun expressing CSPG-M into their extracellular matrix. The groεε organization of the culture diεh had changed from whorlε of fibroblast-like cells at day 1, to numerous foci of multi-layered round or polygonal cells surrounded by a thin layer of fibroblastic cells resembling a perichondrium. The extracellular matrix of these nodules was εtrongly immunoreactive for Type II collagen. Control cultureε fed only Complete Medium never developed theεe cartilage nodules. Taken together, theεe εtudies demonεtrate that MSCε have been εtimulated to differentiate along the chondrogenic lineage in vitro . Furthermore, not only were the MSCε recruited into the early εtepε within the lineage, evidenced by CSPG-M expreεεion, but the MSCs progresεed along the lineage to become mature chondrocytes which secreted Type II collagen-rich extracellular matrix. Thus far, terminal differentiation of chondrocytes derived from MSCs, evidenced by hypertrophic cellε in a calcified matrix, haε not been obεerved in vitro . Thiε finding reflectε the need for deεigning a Chondrogenic Supplement εpecifically aimed at promoting this terminal differentiation step. Interestingly, Pacifici and his collaborators (32) have devised a medium containing retinoic acid which stimulates terminal differentiation of chick chondrocytes in vitro . The additive to Complete Medium which constitutes Chondrogenic Supplement in the example above is only one of the factors known to stimulate chondrogenic cell differentiation or proliferation in vitro . Example 4 Induced Marrow Stromal Cell Differentiation of MSCs in vitro The purpose of the experimentation described in thiε example waε to demonεtrate that human marrow-derived MSCε were directed along the εtromagenic lineage pathway in vitro by providing appropriate bioactive factorε in the culture medium. Human marrow-derived MSCε were isolated from bone marrow and expanded in culture as described above. In order to demonεtrate the ability of human MSCs to be induced along the marrow stromal cell lineage, specific cytokine expression was measured as a marker of differentiation. MSCs were grown under conditions which favor MSC proliferation without differentiation using medium consiεting of DMEM-LG containing preselected 10% fetal bovine serum (Complete Medium), or conditions which favor expression and differentiation into the marrow stromal phenotype using medium comprising Complete Medium plus 10 U/ml Interleukin-lα (IL-lα) (Stromagenic Supplement (SS)). Conditioned culture media from these tisεue culture populations were analyzed for the preεence of cytokineε uεing commercial εandwich ELISA bioaεεayε (R&D Systems) . The cytokineε that were assayed are those that are known to be secreted by stromal cells and which influence hematopoiesis. Theεe include interleukin-3 (IL-3), interleukin-6 (IL-6), granulocyte colony εtimulating factor (G-CSF), granulocyte-macrophage colony stimulating factor (GM-CSF), stem cell factor (SCF), leukemia inhibitory factor (LIF) and transforming growth factor-beta-2 (TGF-32). In each case, second passage MSCs were plated onto 35 mm culture plates at a denεity of approximately 30% confluence (30,000 cellε per 35-mm plate). After allowing overnight attachment of the cellε, the culture media were removed, and replaced with either Complete Medium or Complete Medium plus Stromagenic Supplement. Figure 6 illuεtrateε the cytokine expreεεion of human MSCε under the two plating conditions. In the abεence of IL-lα, MSCε expreεεed G-CSF, GM-CSF, LIF and SCF at very low levels, but expreεε IL-6 in high abundance. In compariεon, after 3 dayε of IL-l-α εtimulation, dramatically higher levelε of cytokines were detected for all of the above specieε . MSCε did not expreεε IL-3 or TGF-jS2 under either of the two culture conditionε . Theεe data εhow that IL-I-α enhanceε MSC expression of a cytokine profile that haε been documented to support differentiation of the hematopoietic εtem cell and which is characteriεtic of differentiated marrow εtromal cells. Example 5 Induced Myogenic Differentiation of MSCs In Vitro The purpose of the study deεcribed in this example was to demonstrate that 5-azacytidine induces mesenchymal stem cells (MSCs) to differentiate along the myogenic lineage. The compound, 5-azacytidine (5-aza-CR; Sigma Chemical Co., St. Louis, MO), an analogue of cytidine, causes hypomethylation of some cytosine in DNA which may be involved in activating phenotype-specific geneε. The mouse embryonic cell lines, C3H/10T1/2 C18 and Swiss 3T3, after exposure to 5-aza-CR, have been shown to be converted into 3 different mesodermal cell lineages, myoblast, adipocyte and chondrocyte (33-34). In part, it appears that the mechanism by which 5-aza-CR activates myogenic genes involveε MyoDl (35-36). With the above in mind, we have expoεed rat bone marrow-derived MSCε to 5-aza-CR and have focuεed our analyεiε on their conversion to myogenic phenotypes. Femora and tibiae of male Fisher rats (Charleε River, Indianapoliε, IN) with an average body weight of 100 g were collected and the adherent εoft tiεεues were removed. Several isolateε of marrow cellε were from 250 g ratε. Meticulouε diεεection of the long boneε to remove εoft tiεεue waε done to insure that myogenic precursors were not carried into the marrow preparation. In this regard, myogenic cells were never obεerved in untreated MSC cultureε. Both endε of the boneε were cut away from the diaphyεeε with bone εciεεorε. The bone marrow plugε were hydrostatically expelled from the bones by insertion of 18-gauge needles fastened to 10 ml syringes filled with Complete Medium consisting of DMEM containing selected lots of 10% fetal calf serum (FCS; IR Scientific Inc., Woodland, CA), 5% horse serum (HS; Hazleton Biologies Inc., Lenexa, KS), and antibiotics (Gibco Laboratories; penicillin G, 100 U/ml; streptomycin, 100 μg/ml; amphotericin B, 0.25 μg/ml) . The needles were inserted into the distal ends of femora and proximal ends of tibias and the marrow plugε expelled from the oppoεite ends. The marrow plugs were disaggregated by sequential passage through 18-gauge, 20-gauge, and 22-gauge needles and these disperεed cellε were centrifuged and reεuεpended twice in Complete Medium. After the cellε were counted in a hemocytometer, 5xl0 7 cells in 7-10 ml of complete medium were introduced into 100 mm petri disheε. Three days later, the medium was changed and the non-adherent cells discarded. Medium was completely replaced every 3 days. Approximately 10 dayε after seeding, the disheε became nearly confluent and the adherent cellε were releaεed from the diεheε with 0.25% trypεin in ImM εodium EDTA (Gibco Laboratorieε, Grand Iεland, NY), split 1:3, and εeeded onto fresh plates. After these once paεεaged cellε became nearly confluent, they were harvested and used for the experiments described below. We refer to these cells aε rat marrow-derived MSCε. In total, 8 εeparate rat marrow-derived MSC preparationε were uεed in thiε study. The cellε were routinely cultured in Complete Medium at 37°C in a humidified atmoεphere of 5% C0 2 . The twice paεεaged MSCε were εeeded into 35-mm diεhes at three cell densitieε, 500, 5,000, and 50,000 cells/dish. Beginning 24 hr after εeeding, theεe cultureε were treated for 24 hr with Myogenic Medium conεisting of complete medium containing various concentrationε of 5-aza-CR. After the cultures were washed twice with Tyrode's balanced salt εolution (Sigma Chemical Co.), the medium was changed to complete medium without added 5-aza-CR and subsequently changed twice a week until the experiment was terminated, 40 days after the treatment. As described in detail in the resultε, various culture conditions were tested to attempt to optimize the 5-aza-CR effects, especially to optimize myogeneεis. Twice paεεaged rat bone marrow MSCε were seeded into 35-mm diεheε at 5,000 cellε/dish and treated with four concentrations (0.1 μM, 0.3 μM, 1 μM and 10 μM) of 5-aza-2'- deoxycytidine (5-aza-dCR; Sigma Chemical Co.) in the same way as described above for 5-aza-CR. At various times during treatment, the morphology of the cultures was observed. The living cultures were examined every day with a phase-contrast microscope (Olympus Optical Co., Ltd., Tokyo, Japan), and eventually some of the cultureε were fixed for histology or immunohistochemistry. Muscle cells were first identified morphologically in phase contrast by the presence of multinucleated myotubes, and εubsequently immunohistochemically by the preεence of the εkeletal muscle-specific protein, myosin. Contraction of the putative muscle cells was stimulated by a drop of 1 mM acetylcholine (Sigma Chemical Co.) in Tyrode's. For immunohistochemistry, cultured cellε were fixed with -20°C methanol (Fiεher Scientific Co., Fair Lawn, NJ) for 10 min and incubated with a mouse monoclonal antibody to rat faεt twitch εkeletal myoεin (Sigma Chemical Co.; ascites fluid, 1/400 dilution) in PBS (phoεphate buffered εaline, pH7.4) containing 0.1% BSA (bovine serum albumin; Sigma Chemical Co.). The second antibody was biotin-conjugated εheep anti-mouεe IgG (Organon Teknika Corp., Weεt Cheεter, PA; 1/50 dilution) followed by treatment with Texas red-conjugated avidin (Organon Teknika Corp.; 1/4,000 dilution). All incubations were for 30 min at room temperature, each preceded by blocking for 5 min with PBS containing 1% BSA, followed by two 5-min washes in PBS. The cells were mounted in Fluoromount-G (Fisher Biotech, Pittεburgh, PA) and obεerved with an Olympuε microεcope (BH-2) equipped for fluorescence and photographed with Kodak TMAX 400 film. Second passage rat bone marrow MSCs were plated into 96-well plates at limiting dilution of one cell/well; cellε were plated in medium conεisting of 50% Complete Medium and 50% conditioned medium, which waε obtained from rat bone marrow cellε near confluence cultured in Complete Medium for 2 dayε. From a total of 384 wellε, 50 colonieε were detected; these were subcultured, maintained, and eventually 4 survived. These 4 clones were treated with 5-aza-CR as mentioned above and scored for myogenic or adipocytic morphologies. First passage rat bone marrow cells were exposed to 10 μM 5-aza-CR for 24 hr and plated into 96-well plates at limiting dilution of one cell/well aε above. The number of cloneε exhibiting adipocyte (Sudan Black positive) or myogenic, multinucleated cell morphologies was determined. To compare the conversion capacity of bone marrow MSCs to various mesodermal phenotypes with that of pure fibroblasts, we exposed rat brain fibroblastε to either 5-aza-CR or 5-aza-CdR. Whole cerebra of brainε of three male Fisher rats were collected from the inside of the skulls and cut into small pieces with a sharp scalpel. Theεe pieceε were tranεferred to a 50-ml conical centrifuge tube, centrifuged at 500 xg for 10 min, reεuεpended in 10 ml of Tyrode'ε balanced εalt εolution, and homogenized with a loose-fitting Dounce homogenizer. The homogenate waε incubated with 0.1% collagenaεe (CLS2, 247 U/mg; Worthington Biochemical Co., Freehold, NJ) at 37°C for 3 hr, during which time it waε vortexed for 30 sec every 30 min. After treatment, the releaεed cells were paεεed through a 110-μm Nitex filter, centrifuged, reεuεpended in 10 ml of low glucoεe DMEM-LG (Gibco Laboratorieε) containing 10% FCS, and cultured in three 100-mm culture dishes at 37°C in a C0 2 incubator. The medium was changed twice a week and cells were cultured until the dishes reached confluence. Third passage rat brain fibroblasts were seeded into 35-mm dishes at a density of 50,000 cellε/diεh and treated with 1 μM, 3 μM or 10 μM 5-aza-CR or 0.1 μM, 0.3 μM or 1 μM 5-aza-CdR in the same way as rat marrow MSCs. After 24 hr, the medium waε changed to DMEM-LG containing 10% FCS, 5% HS and 50 nM hydrocortisone without added 5-aza-CR or 5-aza-CdR and subεequently changed twice a week until the experiment was terminated. Myogenic cells derived from rat bone marrow MSCs were compared with normal fetal rat myogenic cellε, since a subεtantial data baεe exiεtε for the latter. Muεcle cellε were diεεociated from the hindlimb muεcleε of 17-day-old Fisher rat fetuses with 0.2% trypsin (Sigma Chemical Co.) in calcium- and magnesium-free Tyrode's for 35 min at 37°C with occasional agitation. After they were passed through a 110- μm Nitex filter, the concentration of fibroblastε was reduced by incubating cell suspenεionε for 30 min in Falcon plastic disheε, which reεultε in preferential attachment of the fibroblastε. A suspenεion of 5x10 s εingle cellε that did not attach to the uncoated dish waε plated in a collagen-coated (1.5 ml of 0.14% gelatin, J.T.Baker Chemical Co., Phillipεberg, NJ) 35-mm plaεtic culture diεh containing 2 ml of 79% DMEM, 10% FCS, 10% HS and 1% non-eεεential amino acids (Gibco Laboratories). Cells were grown at 37°C in a humidified atmosphere of 5% C0 2 . Cultureε of rat bone marrow-derived MSCε (5,000 cellε/35mm diεh) were exposed to various concentrations of 5-aza-CR (0, 1, 3, 10, 20, and 50 μM) 24 hr after seeding the cells into culture diεhes. The medium containing the 5-aza-CR was removed after the 24-hr exposure period and replaced with medium lacking 5-aza-CR. Seven dayε after this exposure, long multinucleated cells were observed in some of the disheε treated with more than 3 μM 5-aza-CR (Figure 7A); the cells in theεe cultureε were approximately 80% of confluence. The number of εuch multinucleated cellε increased as isolated colonieε or groupingε, and reached a maximum (9 colonieε in 10 of 35-mm diεheε) 2 weeks after the initial treatment. The number of such cells decreased (6 colonies in 10 of 35-mm disheε) by 5 weekε after treatment; 7 disappeared probably due to their contraction and detachment from the disheε and 4 new colonieε appeared during thiε time period; a substantial proportion of the multinucleated cells remained for up to 40 dayε after the initial exposure, which was the longest observational period. The morphology of the multinucleated cellε, obεerved by phase contrast microscopy of living cultures (Figure 7A), waε εimilar to that of rat muεcle in culture. We obεerved no diεcernible εtriationε, aε are routinely observed in embryonic chick myogenic cells in culture, although myotubes derived from myogenic cellε obtained from normal fetal rat limbε alεo did not show εtriationε (Figure 7B). Thus, neither the myotubes derived from MSCε nor those obtained from normal rat embryos exhibit striationε under the conditionε employed in theεe studies. Waves of spontaneouε contractionε or twitching of- some of these multinucleated cellε waε observed when viewing the living cultures. The contraction of these cells could also be stimulated by placing a drop of an acetylcholine solution onto these cellε, which iε a further indication that theεe cellε are myogenic. To further confirm the identity of theεe multinucleated cellε, antibody to εkeletal muεcle εpecific myoεin waε presented to a fixed preparation of these cultures. Figure 8 shows a myotube stained positively with the anti-myosin antibody; again, cross striationε could not be observed. We alεo εtained yotubeε 2 weekε and 5 weekε after 5-aza-CR treatment with anti- yoεin antibody. Myotubeε 2 weekε after treatment were stained strongly positive (Figure 9A and 9B), although those 5 weeks after treatment were stained weakly (Figure 9C and 9D) . The effect of 5-aza-CR appeared to be dependent on the concentration presented to MSCs. No myotubes were found in diεheε treated with 0 or 1 μM 5-aza-CR, but in thoεe treated with 3-50 μM 5-aza-CR, myotubes were observed with comparable incidence (Table 2). TABLE 2 Number of Groupings of Myotubes or Adipocytes Found Per Culture for MSCs Exposed to Different Concentrations of 5-aza-CR Secondary cultures of rat bone marrow cells were plated at 5,000 cells per 35mm dish, treated with the indicated concentration of 5-aza-CR, and observed 14 days after treatment. The numbers for the incidence of myotubes and adipocytes indicate the total number of phenotypically discernible groupings observed and the total number of culture disheε examined. To measure Survival Index (SI*) in the presence of 5- aza-CR, MSCs were seeded at 200 cells/35mm dish and treated with 5-aza-CR 24 hr after plating. After 14 days, colonieε containing more than 10 cellε were counted, and thiε number waε multiplied by 100% and divided by 200 to generate the percentage. When cells were treated with higher concentrations of 5-aza-CR, the number of cells on the plate decreased, with 10 μM appearing to be the most effective concentration with regard to the maximum number of myogenic cells and cell survival (plating efficiency of Table 2) . Thus, all subsequent experiments were done with 10 mM 5-aza-CR. To examine the effect of 5-aza-2' -deoxycyti ine (5-aza-dCR) , a deoxy analogue of 5-aza-CR, rat bone marrow MSCs were treated with 0.3 μM, l μM, and 10 μM 5-aza-dCR in the same way as 5-aza-CR. Of the concentrations tested, 0.3 μM 5-aza-CdR gave the highest incidence of myogenic conversion, and the observed incidence was much higher than for cells exposed to 10 μM 5-aza-CR (Table 3) . TABLE 3 Number of Groupings of Myotubes Found Per Culture for MSCs Exposed to Different Concentrations of 5-aza-CdR and 5-aza-CR * Survival Index Secondary cultures of rat bone marrow cells were plated at 5,000 cells per 35mm dish, treated with the indicated concentration of 5-aza-dCR or 5-aza-CR, and observed 14 days after treatment. The numbers for the incidence of myotubes indicate the total number of phenotypically discernible groupings observed and the total number of culture dishes examined. To measure Survival Index in the presence of 5-aza-CdR or 5-aza-CR, MSCs were seeded at 200 cells/35mm dish and treated with 5-aza-dCR or 5-aza-CR 24 hr after plating. After 14 dayε, colonieε containing more than 10 cells were counted, and thiε number waε multiplied by 100% and divided by 200 to generate the percentage. To eliminate the poεεibility of contamination by εurrounding muεcle-derived myoblaεtε at the time of bone marrow harveεting, εecond paεεage rat bone marrow MSCε were cloned as described herein. Four clones of indistinguiεhable morphologies were obtained from this procedure and were exposed to 5-aza-CR for 24 hr; for emphasis, no cells in these clones exhibited muscle-like characteristics or positive immunostaining for muscle εpecific myoεin prior to exposure to 5-aza-CR. Of 4 clones exposed to 5-aza-CR, one clone exhibited the distinctive morphology of myotubes and adipocytes, which we interpret to indicate that non-muscle cells were converted to or influenced to become myoblasts or adipocyteε . Firεt paεεage rat bone marrow-derived MSCε were exposed to 10 μM 5-aza-CR for 24 hr and cloned. From a total of 768 wellε, 136 colonieε were detected. Of theεe 136 colonieε, 7 (5%) exhibited a myogenic phenotype, 27 (20%) exhibited an adipocytic phenotype, and the other colonies lacked morphologies obviously related to discernible phenotypes. To test the effect of 5-aza-CR and 5-aza-dCR on non-MSC preparations, we exposed brain fibroblastε to theεe same reagents . Rat brain fibroblaεtε were εeeded into 35-mm dishes at a density of 50,000 cells/dish and treated with 1 μM, 3 μM or 10 μM 5-aza-CR or 0.1 μM, 0.3 μM or 1 μM 5-aza-dCR in the same way as for rat MSCs. Each group had 9 disheε and cells were surveyed until 14 days after exposure. At day 7, all diεheε reached confluence, except for the group treated with 10 μM 5-aza-CR. No fat cellε nor myotubeε could be found in any diεhes during the period of obεervation. MSCε were collected from the bone marrow of young (4 week-old, 100 g) and adult (3 month-old, 250 g) donor ratε and passaged, and the number of colonies of myogenic phenotype after exposure to 5-aza-CR were compared (Table 4). TABLE 4 Number of Groupings of Myotubes Per Culture of MSCs Exposed to 5-aza-CR Secondary cultures of rat bone marrow MSCs were plated at 5,000 cells per 35mm diεh, treated with μM 5-aza-CR and 24 hr later changed to DMEM with different levelε of FCS, HS, or 50 μM HC, and observed 14 dayε after expoεure to 5-aza-CR waε terminated. The numbers for the incidence of myotubes indicate the total number of culture dishes examined. MSCs from young donor rats had more myogenic colonies than those from adult rats. Second passage cultures of young donor MSCs exposed to 5-aza-CR produced more myogenic colonies compared with MSCs from older donors tested in cultureε from the firεt to fourth paεεage. A variety of culture conditions were tested to attempt to optimize the expression of the myogenic phenotype of cultured MSCs exposed to 5-aza-CR. Exposed cells were cultured in medium containing various concentrations of FCS, HS, basic fibroblast growth factor (bFGF) and hydrocortisone. Table 4 shows that medium containing 10% FCS, 5% HS and hydrocortisone appeared to be the optimal medium for MSC expression of myogenic properties. Medium containing bFGF seemed to increase the expression of the myogenic phenotype (Table 5), although this may be related to an increase in the number of myoblasts due to myoblast division as opposed to increased conversion from progenitor cells. TABLE 5 Comparison of 5-aza-CR-Induced Myotubes by Young and Old Rat Bone Marrow MSCs With Each Passage Cells were cultured in DMEM with 10% FCS, 5% HS and 50 μM HC, with or without bFGF. The numbers for the incidence of myotubes indicate the total number of phenotypically discernible colonies or groupings observed and the total number of culture dishes examined. MSCs were obtained from young (lOOg) or old (250g) rats. In addition, bone marrow-derived MSCε were plated at 500 cellε/dish, 5,000 cells/dish, and 50,000 cellε/diεh and then exposed to 5-aza-CR. At 500 cellε/diεh, myogenic cells were first observed at 20 days after treatment, with the cells becoming confluent 25 days after treatment; 2 clusters of myogenic cells were observed in 5 dishes 29 days after treatment. At 5,000 cells/diεh, myogenic cellε were first observed at 7 days, with the cellε becoming confluent 10 dayε after treatment; 3 cluεterε were observed in 4 diεheε 14 dayε after treatment. At 50,000 cells/dish, myogenic cells were observed at 6 days, with the cells becoming confluent at 7 days after treatment; 10 cluεterε were obεerved in 5 diεheε 14 dayε after treatment. The obεervationε preεented here indicate that rat bone marrow MSCs have the capacity to differentiate into the myogenic lineage in vitro following a brief exposure to 5-aza-CR. The obεerved myogenic cellε exhibited the characteriεtic multinucleated morphology of myotubeε, contracted εpontaneouεly, contracted when expoεed to acetylcholine, and εtained positively with a monoclonal antibody to skeletal muscle-εpecific myoεin, although these myotubes never exhibited apparent striationε. However, normal rat myoblaεtε collected from fetal rat muεcle did not, in our hands, form obviouεly εtriated myotubes in culture. We have attempted to exclude the posεibility of contamination by committed myogenic cellε by meticulouεly removing attached εoft tissue from the bones at the time of bone marrow harvesting. Importantly, we have never observed myotubes in any culture of rat bone marrow MSCs in hundreds of preparations, except for those exposed to sufficient concentrations of 5-aza-CR. In addition, a clone of rat bone marrow MSCs waε converted to both myogenic and adipocytic phenotypes after treatment with 5-aza-CR, which we interpret to mean that non-muscle progenitor cells were converted into theεe two phenotypeε. Since εkeletal muscle has not been observed in bone marrow, we believe that 5-aza-CR converts theεe marrow-derived MSCε into the myogenic cells. Cytokine Expression by Human Marrow-Derived Mesenchymal Stem Cells In Vitro: Effects of IL-Iα and Dexamethasone The objective of the present study was to further establish the phenotypic characteristicε of cultured MSCε through identification of a cytokine expression profile. We used commercial ELISAs to identify and measure the levels of expresεion of cytokineε that are known to be important in the regulation of cell diviεion, differentiation or expreεεion of a variety of meεenchymal phenotypeε. We identified MSC cytokine expreεεion under culture conditions that we have previouεly reported allow MSCε to mitotically expand without differentiation (constitutive culture-expansion medium) . In addition, we assayed cytokine expresεion by MSCε in culture medium εupplemented with dexamethaεone or IL-lα. Dexamethaεone haε been reported to induce the differentiation of oεteo-progenitors into oεteoblaεtε. In contraεt, IL-lα, which iε εecreted into the marrow microenvironment by a variety of cells during the inflammatory response, has been reported to enhance the bone marrow stroma'ε capacity to εupport hematopoiesis and thus may play a role in controlling the differentiation and/or expression of bone marrow stromal fibroblasts. The data from these analyseε show that cultured MSCs express a unique cytokine profile. In addition, dexamethasone and IL-lα alter the MSC cytokine expression profile in different ways. These data add to our understanding of the unique phenotypic profile of MSCs, and also identify macromoleculeε whoεe expression is developmentally regulated aε MSCs differentiate or modulate their phenotype towards the osteogenic lineage or marrow stromal phenotype. MATERIALS AND METHODS MSC Isolation and Culture-Expansion Bone marrow waε obtained from six human donors, 3 male and 3 female of diverse ageε (Table 6). Table 6 Donor Characteristics Donor # Donor Age Clin. Cond. Gender 39 NHL* 58 breast cancer 38 myelodysplasia medulloblastoma M 28 Hodgkin's Lymphoma M 47 AML* M *NHL ≡ non-Hodgkin's lymphoma; AML = acute myelogenouε leukemia Each donor was in remisεion from cancer and waε undergoing marrow harveεted for future autologouε bone marrow tranεplantation. Approximately 10 ml of unfractionated bone marrow waε obtained from the harveεt and uεed in the aεεayε in thiε εtudy. MSCε were purified and cultured by a modification of previouεly reported methodε. Briefly, bone marrow aεpirates were transferred from their syringes into 50 ml conical tubes containing 25 ml of complete medium conεiεting of Dulbecco'ε Modified Eagleε Medium εupplemented with fetal bovine serum (FBS) from selected lots, to a final volume of 10%. The tubes were spun in a Beckman table top centrifuge at 1200 rpm in a GS-6 swing bucket rotor for 5 min to pellet the cells. The layer of fat that forms at the top of the sampleε and the εupernatantε were aεpirated uεing a εerological pipet and diεcarded. The cell pelletε were resuspended to a volume of 5 ml with Complete Medium and then transferred to the top of preformed gradients of 70% Percoll. The sampleε were loaded into a Sorvall GS-34 fixed angle rotor and centrifuged in a Sorvall High Speed Centrifuge at 460 x g for 15 min. The low denεity fraction of approximately 15 ml (pooled denεity = 1.03 g/ml) waε collected from each gradient and tranεferred to 50 ml conical tubeε to which were added 30 ml Complete Medium. The tubeε were centrifuged at 1200 rpm to pellet the cellε. The εupernatantε were diεcarded and the cells were resuspended in 20 ml of Complete Medium and counted with a hemocytometer after lyεing red blood cells with 4% acetic acid. Cells were adjuεted to a concentrated of 5xl0 7 cellε per 7 ml and seeded onto 100-mm culture plates at 7 ml per plate. Culture and Passage of Marrow-derived MSCs Marrow-derived MSCs were cultured in Complete Medium at 37°C in a humidified atmoεphere containing 95% air and 5% C0 2 , with medium changeε every 3-4 dayε. When primary culture diεheε became near confluent, the cellε were detached with 0.25% trypsin containing 1 mM EDTA (GIBCO) for 5 min at 37°C. The enzymatic activity of trypsin was stopped by adding 1/2 volume of FBS. The cells were counted, split 1:3, and replated in 7 ml of Complete Medium. These first passage cells were allowed to divide for 4-6 days until they became near confluent. Near-confluent first passage cells were trypsinized and replated into the aεεay formatε aε described below. Quantitative ELISA Levels of cytokine expresεion by MSCs were measured using quantitative ELISA. ELISA kits (R&D Systemε, Minneapolis MN) with antibody εpecificitieε for the following cytokines were purchased; interleukin-3 (IL-3), interleukin-6 (IL-6), interleukin-11 (IL-11), granulocyte colony stimulating factor (G-CSF), granulocyte-macrophage colony stimulating factor (GM-CSF), macrophage colony stimulating activity (M-CSF), stem cell factor (SCF), leukemia inhibitory factor (LIF) and transforming growth factor-beta-2 (TGF- / S-2). Near-confluent, first passaged MSCs were replated into 35-mm plates at 50,000 cellε per plate and allowed to attach overnight. Culture conditionε were then changed to one of three test conditions: fresh Complete Medium; Complete Medium with Osteogenic Supplement; and Complete Medium with Stromagenic Supplement. Cultures were allowed to incubate in test media for 24 or 48 hourε at which pointε the εupernatantε were collected, flaεh frozen in dry ice-ethanol and εtored at -70°C in a Revco freezer until all of the εampleε were prepared to analyze together. Aεεayε were conducted by applying 100 μl of culture εupernatant onto the wellε of the ELISA plate followed by proceεεing the plateε per manufacturer'ε inεtructions. Standard curves were generated using standard cytokines supplied with the kitε and diluted to the appropriate concentrations. In some cases (particularly for the IL-6 asεay), the εupernatantε had to be diluted εubεtantially to generate low enough abεorbance measurements that could be quantified accurately from the standard curves. Quantification of Cell Number RESULTS Constitutive Culture-Expansion Medium Condition Detectable levels of εix of the nine aεsayed cytokines were present after 24 hour exposure to constitutive culture-expansion conditions. See Figures 12A-12D and 13A- 13C and εee Tableε 7-10 below). TABLE 7 Detected Cytokine Levels (24 hours. TABLE 8 Detected Cvtokine Levels (24 hours. TABLE 9 Detected Cytokine Levels (48 hours. TABLE 10 Detected Cytokine Levels (48 hours) The cytokineε expressed in terms of pg/10,000 cellε in 24 or 48 hourε, from loweεt to higheεt were: G-CSF, SCF, LIF, M-CSF, IL-11 and IL-6. Three cytokineε were not detected in the supematants under constitutive culture-expansion conditions: GM-CSF, IL-3 and TGF-02. Large differences were observed in the average cytokine expression of each cytokine in comparison to the average levels of expression of other cytokineε. At the extremes, he average detectable level of G-CSF expression (10 pg/10,000 cells/24 hours) was over 700 fold lower than the average level of expression of IL-6 (7421 pg/10,000 cells/24 hours) . Osteogenic Supplement Culture Conditions The addition of Osteogenic Supplements to Complete Medium resulted in no detectable changes in G-CSF, M-CSF and SCF relative to control (Figures 12A-12D and 13A-13B; Tables 7-10) . In contrast, OS medium significantly downregulated the expression of LIF (p<.01), IL-6 (p<.001) and IL-ii (p<.005) relative to the expression of these cytokines under constitutive culture-expansion medium conditions at 24 hours. These levels remained statistically lower than cytokine levels in constitutive culture-expansion medium conditions at 48 hours (Figures 12A-12D and 13A-13C; Tables 7-10) . The amount of OS medium-mediated inhibition varied for the three cytokines; at the 24 hour timepoint the average level of cytokine expression in OS-medium relative to constitutive culture-expansion medium conditions was as follows; LIF expression 55% ± 54%, IL-6 16% ± 9% and IL-ll 1% + 3%. The large standard deviation in the LIF percent change was due primarily to the measurements from one donor (donor #4) where the level of LIF expression was actually higher under OS medium conditions relative to constitutive culture-expansion conditions (Table 7) . For a given donor, the percent inhibition of a cytokine relative to the average absolute level of inhibition of that cytokine, was independent to the percent inhibition of the other two cytokines, relative to their average absolute levels of inhibition (Tables 7-10) . In addition, for each of the cytokineε, the percent inhibition for a given cytokine among the six individuals in the population, was independent of the initial levels of expression under conεtitutive culture-expanεion conditions (Figures 12A-12D and 13A-13C; Tables 7-10). Stromagenic Supplement Culture Conditions SS medium increased the expression of several cytokines by MSCs in a concentration dependent manner. Figure 14 illuεtrateε the 24 hour reεponεe of second passage MSCε to increaεing concentrationε of IL-lα in termε of expression of GM-CSF. There is a near linear increaεe in the level of GM-CSF secretion by MSCs, with increasing levels of IL-lα in the culture medium between 0.1-10.0 U/ml. Additional log increases in IL-lα to the culture medium resultε in little additional increaεe in GM-CSF expreεεion. Theεe data were uεed to identify the concentration of IL-lα to εupplement to the culture media in the experimentε described below. For all εubεequent assayε, 10 U/ml IL-lα were added to the culture media. Culture medium εupplemented with 10 U/ml IL-lα induced εtatistically significant up-regulation in the expression of G-CSF (P<.05), M-CSF (p<0.02), LIF (p<0.02), IL-6 (p<0.01) and IL-11 (p<0.06) relative to cells cultured in conεtitutive culture-expanεion medium. In addition, IL-lα induced the expression of GM-CSF which was not detectable in constitutive culture-expansion medium. In contrast, IL-lα had no statistically significant effect on the expression of SCF relative to the level of expression under constitutive culture-expansion medium conditions. The fold increase in response to IL-lα varied depending on the cytokine. IL-6 (25.1 +/- 13.4 fold increase) waε εtimulated to the greateεt extent, followed by LIF (9.2 + 6.9 fold), M-CSF (5.2 + 1.7 fold) and IL-ll (4.9 + 3.3 fold). The average fold increase for G-CSF and GM-CSF were not calculated, since these cytokines were not detected in some or all constitutive culture-expansion cultures. DISCUSSION Our continued analyses of MSCs in this study were aimed at identifying additional phenotypic characteristics, and determining how this phenotype is altered when MSCs are exposed to regulatory molecules that cause differentiation or phenotypic modulation. In this study, we used ELISA assays to characterize the cytokine expression of MSCs under constitutive culture-expansion conditions, and in the presence of OS or SS. MSCs express a unique profile of cytokines which include G-CSF, M-CSF, SCF, LIF, IL-6 and IL-ll under constitutive culture-expansion conditions. They do not express GM-CSF, IL-3 and TGF-32 under these conditions. OS down-regulates the expression of LIF, IL-6 and IL-ll, while not affecting the expression of the other cytokines expressed under constitutive culture conditions. OS was not observed to up-regulate the expression of any of the cytokines assayed in this study. In contrast, SS up-regulates the expression of G-CSF, M-CSF, LIF, IL-6 and IL-ll, and induces the expression of GM-CSF which was not detected under constitutive culture-expansion conditions. SS had no effect on SCF expression, and was not observed to down-regulate any of the cytokines assayed in this study. Through these data, a unique cytokine expression profile has been generated that can aid in distinguishing MSCs from other mesenchymal phenotypes. The identity of the cytokine profile should provide clues to determine the role that these cells play in the microenvironment of bone marrow which provides the inductive and regulatory information that εupportε hematopoiesis. In addition, the alterationε in thiε cytokine profile in response to OS and SS, identify specific cytokineε whoεe levelε of expression change as MSCs differentiate or modulate their phenotype in response to regulatory molecules. IL-lα, which is releaεed in the marrow microenvironment by a variety of cell typeε during inflammatory responseε, induceε MSCε to up-regulate expreεεion of cytokines that support granulocytic (G-CSF and GM-CSF), monocytic/ osteoclastic (GM-CSF, LIF, M-CSF, IL-6) and megakaryocytic (IL- 11) differentiation. IL-lα haε been εhown to protect bone marrow from radio- and hemo-ablation. The IL-lα-induced up-regulation of cytokine expression by MSCε likely plays a role in the mechanismε of IL-lα'ε protective effectε. Dexamethaεone, which induceε MSCs to differentiate into oεteoblaεtε, attenuateε the expreεεion of monocytic/osteoclaεtic (LIF, IL-6) and megakaryocytic (IL-ll) εupportive cytokineε, and haε no effect on the expreεεion of cytokineε that εupport granulocytic progenitorε (G-CSF, GM-CSF). The three cytokineε inhibited by dexamethaεone are of interest because each mediates its signal through a receptor that uses gpl30 in its signaling pathway. Cited Literature 1. Caplan Al, In: 39th Annual Symposium of the Society for Developmental Biology, ed by S. Subtelney and U Abbott, pp 3768. New York, Alan R Lisε Inc, 1981. 2. Elmer et al. , Teratology, 24:215-223, 1981. 3. Hauεchka SD, Dev Biol, 37:345-368, 1974. 4. Solurεh et al., Dev Biol, 83:9-19, 1981. 5. Swalla et al., Dev Biol, 116:31-38, 1986. 6. Goshima et al., Clin Orthop Rel Res, 269:274-283 , 1991. 7. Aεhton et al., Clin Orthop Rel Res, 151:294-307, 1980. 8. Bruder et al. , Bone Mineral, 11:141-151, 1990. 9. Bennett et al., J Cell Sci , 55:131-139, 1991. 10. Benayahu et al., J Cell Physiol , 140:1-7, 1989. 11. Nakahara et al. , Exp Cell Res, 195:492-503, 1991. 12. Denniε et al. , Cell Transpl, 1:2332, 1991. 13. Ohguεhi, et al., Acta Scandia. , 60:334-339, 1989. 14. Wang et al., Growth Factors, 9:57, 1993. 15. Vukicevic et al., PNAS, S6:8793, 1989. 16. Cheng et al.. Endocrinology, 134:277, 1994. 17. Tenenbaum et al., Calcif. Tissue Int., 34:76, 1982. 18. Bruder et al. , Trans. Ortho. Res. Soc. , 16:58, 1991. 19. Leonard et al., Devi. Biol., 145:99, 1991. 20. Chen et al., Exp. Cell Res., 206:199, 1993. 21. Syfteεtad et al., Differentiation, 29:230, 1985. 22. Chen et al. , Exp. Cell Res., 1P5:509, 1991. 23. Kimura et al., Biomed. Jes. , 5:465, 1984. 24. Langille et al., Differentiation, 40:84, 1989. 25. Ruεsell et al. , Exp. Hematol . , 20:75-79, 1992. 26. Brenner et al. , Brit. J. of Haem. , 77:237-244, 1991. 27. Hayneεworth, et al. , Bone, 13:81-88, 1992. 28. Grigoriadiε, et al. , J. Cell Biol., 105:2139-2151, 1988. 29. Haynesworth, et al.. Bone, 13:69-80, 1992. 30. Bruder & Haynesworth, in preparation. 31. Bruder & Caplan, Dev. Biol., 141:319-329, 1990. 32. Pacifici, et al., Exp. Cell Res., 195:38, 1991. 33. Constantinides et al. , Nature, 267:364-366 , 1977. 34. Taylor et al. , Cell, 17:771-779, 1979. 35. Konieczny et al., Cell, 35:791-800, 1984. 36. Lassar, Cell, 47:649-656, 1986.

Claims: What iε Claimed Iε: 1. A method for effecting the lineage-directed induction of isolated, culture expanded human mesenchymal stem cells which compriseε contacting the meεenchymal stem cells with a bioactive factor effective to induce differentiation thereof into a lineage of choice. 2. The method of claim 1 wherein the bioactive factor induceε differentiation of εuch cellε into a mesenchymal lineage selected from the group consisting of osteogenic, chondrogenic, tendonogenic, ligamentogenic, myogenic, marrow stromagenic, adipogenic and dermogenic. 3. The method of claim 1 wherein the cellε are contacted with the bioactive factor ex vivo . 4 . The method of claim 3 wherein the cellε are contacted with the bioactive factor in a rigid porouε veεεel. 5. The method of claim 4 wherein the rigid porouε veεεel iε a ceramic cube. 6. The method of claim 3 wherein the cells are contacted with the bioactive factor in a culture vesεel. 7. The method of claim 6 wherein the culture veεεel iε formed of a material εelected from the group conεiεting of glaεs and plastic. 8. The method of claim 3 wherein the cells are contacted with the bioactive factor in an injectable liquid. 9. The method of claim 8 wherein the liquid is suitable for intramuscular, intravenous or intraarticular injection. 10. The method of claim 1 which comprises administering to an individual in need thereof a composition comprising isolated, culture-expanded human meεenchymal εtem cellε and a bioactive factor effective to induce differentiation of such cells into a lineage of choice. 11. The method of claim 1 which comprises administering the bioactive factor to an individual to whom a preparation comprising isolated human mesenchymal εtem cellε had been adminiεtered. 12. A method for inducing the in vivo production of human cytokines in an individual in need thereof which comprises administering to the individual isolated culture-expanded human meεenchymal εtem cellε and a bioactive factor effective to induce εuch cellε to differentiate into a cytokine- producing meεenchymal lineage in εuch individual. 13. The method of claim 12 wherein the meεenchymal εtem cellε and bioactive factor are administered together. 14. The method of claim 12 wherein the mesenchymal stem cell and the bioactive factor are administered separately. 15. The method of claim 1 which compriseε oεteogenic lineage induction and the bioactive factor iε an oεteoinductive factor. 16. The method of claim 15 wherein the oεteoinductive factor iε a bone morphogenic protein. 17. The method of claim 16 wherein the bone morphogenic protein iε εelected from the group conεiεting of BMP-2 and BMP-3. 18. The method of claim 15 wherein the osteoinductive factor is a fibroblast growth factor. 19. The method of claim 18 wherein the fibroblaεt growth factor is baεic fibroblaεt growth factor. 20. The method of claim 15 wherein the osteoinductive factor is a glucocorticoid. 21. The method of claim 20 wherein the glucocorticoid is dexamethasone. 22. The method of claim 15 wherein the osteoinductive factor is a prostaglandin. 23. The method of claim 22 wherein the prostaglandin is proεtaglandin El. 24. The method of claim 15 which further compriεeε contacting the iεolated human meεenchymal stem cellε with an adjunct factor for advanced differentiation. 25. The method of claim 24 wherein the adjunct factor iε εelected from the group conεiεting of aεcorbic acid and itε analogs and a glycerophosphate. 26. The method of claim 1 which compriεeε chondrogenic induction and the bioactive factor iε a chondroinductive factor. 27. The method of claim 26 wherein the chondroinductive factor iε a member of the transforming growth factor-/3 superfamily. 28. The method of claim 27 wherein the transforming growth factor- / 8 εuperfamily member is a bone morphogenic protein. 29. The method of claim 28 wherein the bone morphogenic protein is BMP-4. 30. The method of claim 27 wherein the transforming growth factor-β εuperfamily member is TGF-31. 31. The method of claim 27 wherein the transforming growth factor-3 superfamily member iε inhibin A. 32. The method of claim 27 wherein the tranεforming growth factor-/3 εuperfamily member iε chondrogenic εtimulating activity factor. 33. The method of claim 26 wherein the chondroinductive factor iε a component of the collagenous extracellular matrix. 34. The method of claim 33 wherein the collagenous extracellular matrix component is collagen I. 35. The method of claim 34 wherein the collagen I iε in the form of a gel. 36. The method of claim 26 wherein the chondroinductive factor iε a vitamin A analog. 37. The method of claim 36 wherein the vitamin A analog iε retinoic acid. 38. The method of claim 1 which compriεeε εtromagenic induction and the bioactive factor is a εtromainductive factor. 39. The method of claim 38 wherein the εtromainductive factor is an interleukin. 40. The method of claim 39 wherein the interleukin iε selected from the group consisting of interleukin-lα and interleukin-2. 41. The method of claim 1 which compriseε myogenic induction and the bioactive factor iε a myoinductive factor. 42. The method of claim 41 wherein the myoinductive factor is a cytidine analog. 43. The method of claim 42 wherein the cytidine analog is selected from the group consiεting of 5-azacytidine and 5- aza-2'-deoxycytidine. 44. A compoεition compriεing iεolated, culture-expanded human meεenchymal εtem cellε and a bioactive factor effective to induce differentiation of εuch cells into a lineage of choice. 45. The composition of claim 14 which further comprises a culture medium. 46. A composition of matter compriεing the compoεition of claim 44 in a pharmaceutically acceptable carrier. 47. The composition of claim 46 wherein the pharmaceutically acceptable carrier is a rigid porous vessel. 48. The compoεition of claim 46 wherein the pharmaceutically acceptable carrier is a gel. 49. The composition of claim 46 wherein the pharmaceutically acceptable carrier is an injectable liquid.

Inventors: BRUDER SCOTT P, CAPLAN ARNOLD I, HAYNESWORTH STEPHEN E, BRUDER, SCOTT, P., CAPLAN, ARNOLD, I., HAYNESWORTH, STEPHEN, E.
Applicants: UNIV CASE WESTERN RESERVE, CASE WESTERN RESERVE UNIVERSITY
Application year: 1996
Main classification: C12N5
IPC codes: A61K31, A61K35, A61K38, A61K45, A61P43, C07K16, C12N5