Morteza Abouzaripour1, Parichehr Pasbakhsh1, Nader Atlasi1, Abdol Hossein Shahverdi2, Reza Mahmoudi3, Iraj Ragerdi Kashani1. 1. Department of Anatomical Sciences, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2. Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Medicine, ACECR, Tehran, Iran. 3. Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran.
Abstract
OBJECTIVE: Bone marrow has recently been recognized as a novel source of stem cells for the treatment of wide range of diseases. A number of studies on murine bone mar- row have shown a homogenous population of rare stage-specific embryonic antigen 1 (SSEA-1) positive cells that express markers of pluripotent stem cells. This study focuses on SSEA-1 positive cells isolated from murine bone marrow in an attempt to differentiate them into insulin-secreting cells (ISCs) in order to investigate their differentiation potential for future use in cell therapy. MATERIALS AND METHODS: This study is an experimental research. Mouse SSEA-1 positive cells were isolated by Magnetic-activated cell sorting (MACS) followed by characteriza- tion with flow cytometry. Induced SSEA-1 positive cells were differentiated into ISCs with specific differentiation media. In order to evaluate differentiation quality and analysis, dithizone (DTZ) staining was use, followed by reverse transcription polymerase chain reaction (RT-PCR), immunocytochemistry and insulin secretion assay. Statistical results were analyzed by one-way ANOVA. RESULTS: The results achieved in this study reveal that mouse bone marrow contains a population of SSEA-1 positive cells that expresses pluripotent stem cells markers such as SSEA-1, octamer-binding transcription factor 4 (OCT-4) detected by immunocytochem- istry and C-X-C chemokine receptor type 4 (CXCR4) and stem cell antigen-1 (SCA-1) detected by flow cytometric analysis. SSEA-1 positive cells can differentiate into ISCs cell clusters as evidenced by their DTZ positive staining and expression of genes such as Pdx1 (pancreatic transcription factors), Ngn3 (endocrine progenitor marker), Insulin1 and Insulin2 (pancreaticβ-cell markers). Additionally, our results demonstrate expression of Pdx1 and Glut2 protein and insulin secretion in response to a glucose challenge in the differentiated cells. CONCLUSION: Our study clearly demonstrates the potential of SSEA-1 positive cells to differentiate into insulin secreting cells in defined culture conditions for clinical ap- plications.
OBJECTIVE: Bone marrow has recently been recognized as a novel source of stem cells for the treatment of wide range of diseases. A number of studies on murine bone mar- row have shown a homogenous population of rare stage-specific embryonic antigen 1 (SSEA-1) positive cells that express markers of pluripotent stem cells. This study focuses on SSEA-1 positive cells isolated from murine bone marrow in an attempt to differentiate them into insulin-secreting cells (ISCs) in order to investigate their differentiation potential for future use in cell therapy. MATERIALS AND METHODS: This study is an experimental research. MouseSSEA-1 positive cells were isolated by Magnetic-activated cell sorting (MACS) followed by characteriza- tion with flow cytometry. Induced SSEA-1 positive cells were differentiated into ISCs with specific differentiation media. In order to evaluate differentiation quality and analysis, dithizone (DTZ) staining was use, followed by reverse transcription polymerase chain reaction (RT-PCR), immunocytochemistry and insulin secretion assay. Statistical results were analyzed by one-way ANOVA. RESULTS: The results achieved in this study reveal that mouse bone marrow contains a population of SSEA-1 positive cells that expresses pluripotent stem cells markers such as SSEA-1, octamer-binding transcription factor 4 (OCT-4) detected by immunocytochem- istry and C-X-C chemokine receptor type 4 (CXCR4) and stem cell antigen-1 (SCA-1) detected by flow cytometric analysis. SSEA-1 positive cells can differentiate into ISCs cell clusters as evidenced by their DTZ positive staining and expression of genes such as Pdx1 (pancreatic transcription factors), Ngn3 (endocrine progenitor marker), Insulin1 and Insulin2 (pancreaticβ-cell markers). Additionally, our results demonstrate expression of Pdx1 and Glut2 protein and insulin secretion in response to a glucose challenge in the differentiated cells. CONCLUSION: Our study clearly demonstrates the potential of SSEA-1 positive cells to differentiate into insulin secreting cells in defined culture conditions for clinical ap- plications.
Diabetes is a global health problemand one of
the leading causes of morbidity and mortality in
many countries, and its frequency has beensteadily
increasing worldwide (1). Transplantation of islet
cells can replenish those destroyed in patients with
type I diabetes and can restore normoglycemic
levels, but donor organs are very limited and thus
waiting time is long (2). For this reason, a great
deal of attention has been focused on the potential
of bioengineered insulin secretingcells (ISCs) (3).
Recent study have revealed the feasibility of generating
ISCs obtained from embryonic stem cells;
however, results are not yet satisfactory and some
obstacles remain unsolved, such as immune rejection,
tumor formation, source limitation, and ethical
concerns about use (1).A number of studies have suggested that bone
mesenchymal stem cells (BMSCs) can differentiate
into insulin secreting cells in Dulbecco’s
Modified Eagle Medium (DMEM) supplemented
with certain growth factors and inducer
agents (1, 2). However, despite BMSCs potential
to differentiate, applications using BMSCs have
not been successful due to the lesser number
of nucleated cells obtained from large samples
and a decreased maximum lifespan after differentiation
into insulin secreting cells (4). Recently,
using murine bone marrow, Kuica et al.
(5) have identified a homogenous population of
rare stage-specific embryonic antigen 1 (SSEA-
1) positive cells. Using reverse transcription
polymerase chain reaction (RQ-PCR) and immunohistochemistry
these cells were shown to
express marker of pluripotent stem cells such
as C-X-C chemokine receptor type 4 (CXCR4),
stem cell antigen-1 (SCA-1), octamer-binding
transcription factor 4 (OCT-4) and NANOG.However, experimental evidence from several
studies indicates that the contribution of bone
marrow derived stem cells to organ/tissue regeneration
may be explained not by BMSCs but
rather by the presence of SSEA-1 positive stem
cells in bone marrow (5, 6). This study takes
advantage of SSEA-1 positive cells isolated
from murine bone marrow in an attempt to differentiate
them into ISCs and investigate their
differentiation potential. It will also determine
whether the method might have potential as viable
and effective method of cell therapy in the
future.
Materials and Methods
Isolation of stage-specific embryonic antigen 1
positive cells from bone marrow
This study is an experimental research. All
animals were treated according to guidelines,
approved by Tehran University of Medical Sciences
Ethics Committee under the code number
90-03-33-15668. Bone marrow aspirate was
collected from the femur and tibia of 2–4 weeks
old C57BL/6 mice (Pasteur Institute, Iran) by
vigorous flushing with DMEM (Invitrogen,
CA). Erythrocytes were eliminated using erythrocyte
lysing solution (Dako, Denmark). Magneticactivated
cell sorting (MACS, Abcam, USA) was
used to separate the suspension of bone marrow
mononuclear cells (BMMNCs) according to the
expressed cell surface marker SSEA-1. BMMNCs
were resuspended in cold MACS buffer (Miltenyi
Biotec, Germany) and incubated with microbeadconjugated
anti-SSEA-1 antibody (Miltenyi Biotec,
Germany) for 45 minutes at 4˚C on a plateshaker.
The cells were then washed three times
with MACS buffer.For the sorting of labeled SSEA-1 positive
cells, were loaded on to a sterile LS column
(Miltenyi Biotec, Germany) installed in a magnetic
field (Miltenyi Biotec, Germany). The column
was rinsed several times with MACS buffer
and negative unlabelled cells (flow-through
or negative fraction) were passed through and
collected. Trapped cells (positive or labelled
fraction) were washed with MACS buffer after
removal of the column from the magnetic
field. To achieve higher purity, the positive
fraction was reloaded on a second column and
the positive selection repeated, with the sample
finally being collected by centrifugation.
Viability and purity of the isolated SSEA-1
positive cells were evaluated by Trypan Blue
(Sigma-Aldrich, USA) exclusion and flow cytometry
analysis (FACSCalibur TM, Becton
Dickinson, CA, USA) respectively. For flow
cytometry analysis, SSEA-1 positive cells were
washed with phosphate buffered saline (PBS, Sigma-Aldrich, Germany) and resuspended in
PBS plus 2 % fetal calf serum (FCS, Sigma-
Aldrich, Germany). The antibody staining
was performed following standard protocols.
250,000 cells were washed, incubated for 45-
60 minutes with primary conjugated antibodies,
washed three times, and analyzed using Becton-
Dickinson flow cytometer (FACScan BD FACS
Calibur, Becton-Dickinson, USA). For every
sample at least 20,000 events were counted and
the acquired data analysed using WinMDI 2.9
software. The following antibodies were used:
anti-CXCR4 (Burlingame, CA), anti– SCA-1
(Abcam, UK) and and anti-cluster determinant
45 (CD45, BioLegend, UK). Primary antibodies
were directly conjugated with fluorescein isothiocyanate
(FITC, Sigma-Aldrich, Germany).
Expansion and differentiation of stage-specific
embryonic antigen 1 positive cells
Undifferentiated SSEA-1 positive cells were
cultured on a feeder layer of mouse embryonic
fibroblasts (MEF, Pasteur Institute, Iran) in
DMEM with a low concentration of fetal bovine
serum (FBS, Sigma-Aldrich, Germany).
The expansion of SSEA-1 positive cellswas
continued for 9 dayswith a change of medium
every 3-4 days. Following expansion, cells
were trypsinized and expanded SSEA-1 positive
cellswere isolated from MEF cells by flow
cytometry. SSEA-1 positive cellswere seeded at
1×106 cells per well to gelatin (Sigma-Aldrich,
Germany) coated plates in DMEM/F-12 medium
supplemented with 4 mM L-glutamine (Sigma-
Aldrich, Germany), 4.5 g/l glucose (Sigma-
Aldrich, Germany), 1% heat-inactivated FBS
and 50 ng/ml of recombinant human Activin A
(RDMEM/F12 medium with 4 mM
L-glutamine, 4.5 g/l glucose, 5% heat-inactivated
FBS in the presence of N2 supplement (Sigma-
Aldrich, Germany), B27 supplement and 10
mM Nicotinamide (Sigma-Aldrich, Germany).
Medium was changed every second day. Isletlike
clusters appeared after 21days of culture.
Dithizone (DTZ) staining
DTZ (Sigma-Aldrich, Germany) stock solution
was prepared by dissolving 100 mg of DTZ
in 5 ml of dimethyl sulfoxide (DMSO, Sigma-
Aldrich, Germany). Cells induced for 21days
were washed with PBS buffer twice. Next 1 mL
PBS buffer and 10 μL DTZ stock solutions were
added and the cells were stored a 37˚C incubator
for 15 minutes. The crimson-red-stained
clusters were examined with a phase-contrast
microscope (CKX41, Olympus, Japan).
RNA isolation and reverse transcription polymerase
chain reaction (RT–PCR) analysis
SSEA-1 positive cells and new produced
ISCs were washed and immediately transferred
to micro tubes containing TRIzolj reagent (Qiagen,
Germany). Tubes were vortexed to lyse
the cells and kept at -20˚C until analysis. Total
RNA was extracted using a Nucleospin RNAII
kit (Macherey-Nagel, Germany). DNase treatment
applied to clean up any possible genomic
DNA contamination. cDNA synthesis was
undertaken with Revert AidTMH Minus First
Strand cDNA Synthesi Kit (Fermentas, Germany).
A sample of 2.5 ml of cDNA, 16PCR
buffer (AMS TM, Sinagen), 200 mM dNTPs,
1.5 mM MgCl2, 0.5 mM each of forward and
reverse primers and 1 unit Taq DNA polymerase
(Fermentas, Germany) was used to
prepare reactionmixtures for PCR. PCR was
performed with an optimized programme for
each primer. Amplified DNA fragments were
electrophoresed on 2% agarose gel. The gels
were stained with ethidiumbromide (10 mg/
ml) and the amplified fragments photographed
under Ultraviolet (UV) transilluminator (Uvidoc,
UK). β-actin amplification was used as an
internalgene control. RNA from mouseinsulinoma
cell line (MIN6B1) was used as positive
control. Negative controls were mock RT with
diethyl pyrocarbonate (DEPC, Fermentas, Germany)
treated water instead of RNA or cDNA
samples. In table 1, the primer pairs used for
amplification of following genes are listed:
Pdx1 (pancreatic transcription factors), Ngn3
(endocrine progenitor marker), glucagon, Amylase
(exocrine pancreas marker), Insulin1 and
Insulin2 (pancreatic β-cell markers).Primers used for reverse transcription polymerase chain reaction (RT-PCR) analysis
Immunocytochemistry
SSEA-1 positive cells that had differentiated
into insulin secreting cells were cytospinned
on to glass slides and allowed to dry
for 15 minutes. Cells were then washed with
PBS and fixed with 4% icecold paraformaldehyde
for 10 minutes.The next step in the case
of intracellular markers, was permeabilization
by 0.4% Triton X-100 (Sigma-Aldrich, Germany).
Non-specific binding sites were blocked
by incubation of cells with 10% serum containing
secondary antibody species. After two more
washes in PBS, cells were incubated with optimal
dilutions of primary antibodies overnight
and with secondary antibodies for 1 hour. Briefly
the SSEA-1 positive cells were stained with
antibodies to SSEA-1 (1:400, anti-SSEA-1, BD
Pharmingen, USA), OCT-4 (1:500, anti-OCT-4;
Abcam, USA). SSEA-1 positive cells induced
into ISCs were incubated with rabbit polyclonal
anti-pancreatic-duodenal homeobox 1 (Pdx1,
1:400 dilution, Abcam, USA) and anti-Glucose
Transporter2 (Glut2, 1:400 dilution, Abcam,
USA) primary antibodies overnight at 4˚C. After
five sequential three minute washes in PBS,
appropriate secondary antibodies, FITCconjugated
anti-goat IgG (1:500, Abcam, USA) and
PE-conjugated anti-rabbit IgG (1:300, Abcam,
USA) were used. After three washes with PBS,
nuclei were counterstained with 4´, 6-diamidino-
2-phenylindole (DAPI, Roche, Germany).
Slides were mounted with 50% (v/v) glycerol
in PBS and checked under an Olympus BX 60
fluorescent microscope.
Measurement of insulin secretion
Differentiated cells were seeded at 1×106 cells
per well in a 24 well culture plate, incubated
overnight in culture media and grown for 3 hours
in DMEM-low glucose (5.6 mM glucose). After
3 hours, the medium was removed and stored at
–20˚C. Cells were then washed three times with
PBS and incubated for 3 hours in DMEM-highglucose
(25 mM glucose). Thereafter, the medium
was stored at –20˚C. The stored media were
then analyzed for insulin content using a direct
mouseinsulin enzyme-linked immunosorbent
assay kit (ELISA, Invitrogen, CA) according to the manufacturer’s instructions. Non-induced
SSEA-1 positive cells were used as a control.
Statistical analysis
Data are expressed as mean ± SD. Comparisons
between groups were carried out with one-way
ANOVA. P<0.05 was considered statistically significant.
Results
Bone marrow as a home of pluripotent stage-specific
embryonic antigen 1 positive cells
In the current study, SSEA-1 positive cells were
isolated from bone marrow mononuclear cell suspension
derived from 2-4 weeks old C57BL/6 mice
using anti-SSEA-1 antibody and MACS. Immunofluorescence
staining showed that SSEA-1 positive
cells expressed embryonic stem cell markers
OCT-4 (Fig .1A) and SSEA-1 at the protein level
(Fig .1B).The purity of the isolated cells was determined
by flow cytometery using SSEA-1, CXCR4
and SCA-1 as a surface markers of pluripotent
stem cells and CD45 as a common leukocyte antigen.
The flow cytometric analysis revealed that
63.45 ± 2.2% of sorted cells expressed SSEA-1,
82.65 ± 1.8% expressed CXCR4 and 53.28 ± 1.7%
expressed SCA-1 but 0.53 ± 0.1% expressed CD45
(Fig .1C).
Fig.1
Immunostaining of pluripotency markers in bone marrow derived SSEA-1 positive cells. Expression of A. OCT-4, B. SSEA-1 in purified
bone marrow derived SSEA-1 positive cells evaluated by immunofluorescence staining. Nuclei were counterstained with DAPI and C. Flow
cytometric analysis of bone marrow derived SSEA-1 positive cells show that they expressed SSEA-1, CXCR4 and SCA-1 but expression of
CD45 was much lower or undetectable.
Immunostaining of pluripotency markers in bone marrow derived SSEA-1 positive cells. Expression of A. OCT-4, B. SSEA-1 in purified
bone marrow derived SSEA-1 positive cells evaluated by immunofluorescence staining. Nuclei were counterstained with DAPI and C. Flow
cytometric analysis of bone marrow derived SSEA-1 positive cells show that they expressed SSEA-1, CXCR4 and SCA-1 but expression of
CD45 was much lower or undetectable.SSEA-1; Stage-specific embryonic antigen 1, OCT-4; Octamer-binding transcription factor 4, DAPI; 4´, 6-diamidino-2-phenylindole, CXCR4;
C-X-C chemokine receptor type 4 and SCA-1; Stem cells antigen-1.
Morphology and dithizone staining during the
differentiation
SSEA-1 positive cells at passages 3-5 were treated
with differentiated medium and their morphologic
characteristics were detected every day. Undifferentiated
SSEA-1 positive cells were spherical
in shape (Fig .2A). Over 14 days of induction in
induction group, accumulated together and formed
colony-like structures (Fig .2B). The cells aggregated
in clusters and islet-like cell clusters were
formed at 21 days. Derived clusters proved to be
DTZ positive (Fig .2C). DTZ can specifically stain
insulin granules in insulin secreting cells.
Fig.2
Identification of bone marrow derived SSEA-1 positive cells differentiated into insulin producing cells. A. Primary explant cultures
of bone marrow derived SSEA-1 positive cells. Undifferentiated SSEA-1 positive cells were spherical in shape, B. Colony of purified SSEA-1
positive cells after culturing on MEF-coated dishes and C. Dithizone staining of insulin secreting cellsderived from bone marrow derived
SSEA-1 positive cells.
SSEA-1; Stage-specific embryonic antigen 1 and MEF; Mouse embryonic fibroblasts.
Reverse transcription polymerase chain reaction
analysis of gene expression in insulin producing
cells
To determine whether the SSEA-1 positive
cells had differentiated into insulin producing
cells, the expression of genes related to the pancreatic
endocrine development and function was
examined by RT-PCR analysis. As a positive
control, the expression of β-actin was detected
indicating our experimental system being was
intact. As shown in figure 3, the results indicated
that differentiated mouseSSEA-1 positive
cells expressed Pdx1, Ngn3, glucagon, Amylase,
Insulin1 and Insulin2. However, glucagon
and Amylase genes expression became silent in
the cells that expressed of Pdx1, Ngn3, Insulin1
and Insulin2 indicating more differentiated
beta-like precursor cells. These results indicate
that SSEA-1 positive cells derived clusters possess
the potential to differentiate into functional
insulin-producing cells.
Fig.3
Electropherograms of RT-PCR product of mRNA extracted from bone marrow derived SSEA-1 positive cells induced into insulin secreting
cells (lane 2), undifferentiated bone marrow derived SSEA-1 positive cells (lane 3) and pancreatic β-cells as a positive control (lane
4). The leftmost lane represents the DNA ladder and distilled H2O (lane 1) was used as a negative control. β-actin amplification served as
an internal control. A. Pdx1, B. Ngn3, C. glucagon, D. Amylase, E. Insulin1, F. Insulin2 and G. β-actin.
To examine the efficiency of pancreatic progenitor
formation, Pdx1 and Glut2 expression was
examined by immunofluorescence staining, represented
as green dots in the immunofluorescence
assay.Immunofluorescence staining showed that
the Pdx1 and Glut2 expression was positive
(Fig .4).
Fig.4
Immunofluorescence reveals bone marrow derived SSEA-1 positive cells differentiated into insulin secreting cells in vitro. The insulin
secreting cells at days 24 were fixed and stained with antibodies against Pdx1 and Glut2 and visualized with secondary antibody
(FITC). 4′, 6-diamidino-2-phenylindole (DAPI) was used to counter-stain DNA (blue) (scale bar; 50 μm).
A. AntiPdx1 immunofluorescence, B. Nuclear counterstain with DAPI, C. Merged image of A and B, D. AntiGlut2 immunofluorescence,
E. Nuclear counterstain with DAPI and F. Merged image of D and E. SSEA-1; Stage-specific embryonic antigen 1.
Identification of bone marrow derived SSEA-1 positive cells differentiated into insulin producing cells. A. Primary explant cultures
of bone marrow derived SSEA-1 positive cells. Undifferentiated SSEA-1 positive cells were spherical in shape, B. Colony of purified SSEA-1
positive cells after culturing on MEF-coated dishes and C. Dithizone staining of insulin secreting cellsderived from bone marrow derived
SSEA-1 positive cells.SSEA-1; Stage-specific embryonic antigen 1 and MEF; Mouse embryonic fibroblasts.Electropherograms of RT-PCR product of mRNA extracted from bone marrow derived SSEA-1 positive cells induced into insulin secreting
cells (lane 2), undifferentiated bone marrow derived SSEA-1 positive cells (lane 3) and pancreatic β-cells as a positive control (lane
4). The leftmost lane represents the DNA ladder and distilled H2O (lane 1) was used as a negative control. β-actin amplification served as
an internal control. A. Pdx1, B. Ngn3, C. glucagon, D. Amylase, E. Insulin1, F. Insulin2 and G. β-actin.RT-PCR; Reverse transcription polymerase chain reaction and SSEA-1; Stage-specific embryonic antigen 1.Immunofluorescence reveals bone marrow derived SSEA-1 positive cells differentiated into insulin secreting cells in vitro. The insulin
secreting cells at days 24 were fixed and stained with antibodies against Pdx1 and Glut2 and visualized with secondary antibody
(FITC). 4′, 6-diamidino-2-phenylindole (DAPI) was used to counter-stain DNA (blue) (scale bar; 50 μm).A. AntiPdx1 immunofluorescence, B. Nuclear counterstain with DAPI, C. Merged image of A and B, D. AntiGlut2 immunofluorescence,
E. Nuclear counterstain with DAPI and F. Merged image of D and E. SSEA-1; Stage-specific embryonic antigen 1.
Insulin content
To determine whether the SSEA-1 positive cells
induced into insulin secreting cells were capable of
insulin secretion, we incubated them with DMEMlow
glucose (5.6 mM glucose) or high (25 mM
glucose) glucose and assayed culture supernatants
for mouseinsulin, as described earlier. As shown
in figure 5, SSEA-1 positive cells induced into insulin
secreting cells secreted insulin in response to
glucose stimulation.
Fig.5
Insulin released in response to low glucose (5.6 mM) and
high glucose (25 mM) stimulation in culture medium of insulinsecreting
cells generated from bone marrow derived SSEA-1+ SCs
(day 24) was measured. Undifferentiated bone marrow derived
SSEA-1 positive cells were used as a control. Each value represents
mean ± SD of three experiments. Statistical significance
was tested by a Student’s t test. *; P<0.05 when compared with
control and SSEA-1; Stage-specific embryonic antigen 1.
Insulin released in response to low glucose (5.6 mM) and
high glucose (25 mM) stimulation in culture medium of insulinsecreting
cells generated from bone marrow derived SSEA-1+ SCs
(day 24) was measured. Undifferentiated bone marrow derived
SSEA-1 positive cells were used as a control. Each value represents
mean ± SD of three experiments. Statistical significance
was tested by a Student’s t test. *; P<0.05 when compared with
control and SSEA-1; Stage-specific embryonic antigen 1.
Discussion
In vitro generation of ISCs, responsible for insulin
synthesis, storage and release, from adult stem
cells is an important advance for use in future therapies
for diabetes mellitus (7). Here we demonstrate
the existence of a distinct population of stem
cells within murine bone marrow that expressed
higher levels of the pluripotent stem cell markers,
OCT-4, SSEA-1, CXCR4 and SCA-1, and have a
capacity for differentiation into ISCs in vitro.Previous studies demonstrate that adult tissues
contain a population of stem cells that express embryonic
stem cells markers, such as SSEA-1 (8,
9). The presence of these stem cells in adult tissues
including bone marrow supports the hypothesis
that adult bone marrow contains pluripotent
stem cells deposited in embryogenesis during gastrulation
(9). In this study we show that SSEA-1
positive cells could successfully differentiate into
ISCs and the resultant cells were morphologically
similar to pancreatic islet cells. In addition, they
could also express insulin as confirmed by DTZ
staining. Furthermore, using RT-PCR analyses, we
observed that they expressed transcriptions factors
related to pancreatic endocrine development and
function, including pancreatic transcription factors
Previous studies demonstrate that embryonic stem
cells (ESCs) (3) and MSCs (1, 2, 4) could successfully
differentiate into ISCs and the resultant cells
were morphologically similar to pancreatic islet
cells. In addition, they could also express insulin
that was confirmed by DTZ staining. Furthermore,
using RT-PCR analyses, we observed that they expressed
transcriptions factors related to pancreatic
endocrine development and function including
Pdx1, Ngn3, Insulin1 and Insulin2.Three different protocols for differentiating
ESCs into ISCs have been published during the
past decade (10-12). Lumelsky et al. (10) proposed
a five step protocol to differentiate mouse ESCs
into ISCs. The protocol is based on the similarities
between the pancreas and brain. Microarray
analysis revealed that cells differentiated following
this protocol failed to demonstrate increased
expression of β-cell specific functional genes such
as islet amyloid polypeptide, Insulin1 and Insulin2
(13). In the Hori protocol 10-30% of ESCs expressed
Insulin, 10-20% expressed c-peptide and
the remaining ESCs expressed glucagon which
might serve as a negative marker of β-cells (11).
Blysckuk et al. (12) published a protocol in which
the total duration of differentiation was 48 days.
All of these protocols were based on the formation
of embryoid bodies’ in hanging drop culture (13).Here, we tested a two-step differentiation protocol
(14) in which mouseSSEA-1 positive cells
were first cultured with activin A to favor formation
of definitive endoderm in monolayer culture.
Secondly this monolayer endoderm was induced
to differentiate into ISCs using nicotinamide, N2
supplement and B27 supplement. This protocol
is a simple modification of complex protocols for
ESCs differentiation into ISCs. Using activin A to
induce the differentiation of ES cells into endoderm
is an important element common to almost
all of the methods (15). Activin A is a dimeric glycoprotein showing high sequence homology
with transforming growth factor-beta (TGF-beta)
which has been shown to induce definitive endoderm
cells dependent on concentration, culture
conditions and time of application (14). In most recent
studies, addition of activin A at the beginning
of in vitro ESCs differentiation can cause further
differentiation into definitive endodermal cells
(16). Differentiation of ESCs in activin A containing
medium resulted in upregulation of Pdx1,
a marker of pancreatic progenitors, whereas medium
without activin A induced ectoderm-specific
Pdx1 and Sox1 expression (14). The transcription
factor Pdx1 is critical to both β-cell development
and function (17). Pdx1 regulates the expression
of a number of β-cell genes including insulin, the
β-cell Glut2 and glucokinase (18).Nicotinamide is the precursor for the coenzyme
β-nicotinamide adenine dinucleotide (NAD+). It is
important for the genesis of nicotinamide adenine
dinucleotide phosphate (19) and plays a significant
role during the enhancement of cell survival as well
as cell longevity (20). Nicotinamide, in addition to
governing intrinsic cellular integrity, regulates cellular
lifespan (19). Liu and Lee (16) showed that
nicotinamide enhances the in vitro differentiation
of cultured humanpancreatic cells, favoring the
expression of INSULIN and SOMATOSTATIN.Previous reports have shown that the addition of
N2 and B27 supplement to cultured medium, in
addition to essential growth factors, play an important
role in promoting sphere formation and
sustaining the propagation of spheres (21). In addition,
Qin et al. (22) demonstrated that N2 and
B27 supplements contain many antioxidants that can
help reduce the free radicals produced by oxygen
and thus reduce the stress on stem cells induced by
oxygen (23). Nicotinamide, activin-A, N2 and B27
supplements can promote fetal Insulin secreting cell
differentiation and increase β-cell quantity (24).Our results revealed that Pdx1 was expressed
in differentiated cells both at mRNA and protein
levels. Pdx1 is a transcription factor necessary for
ISC maturation (25): developing ISCs co-express
Pdx1 and Insulin, a process that results in the silencing
of V-maf musculo aponeurotic fibrosarcoma
oncogene homolog B (MafB) and the expression
of MafA a necessary switch in maturation of
ISCs (26). Pdx1 appears also to play a role in the
fate of endocrine cells, encoding for insulin and
somatostatin, two pancreatic endocrine products,
while repressing glucagon. Thus, Pdx1 expression
apparently favors the production of ISCs rather
than glucagon secreting cells (27). In addition to
roles in ISCs differentiation, Pdx1 is required for
ISCs survival. Cells with reduced Pdx1 have an
increased rate of apoptotic programmed cell death
(28).We also detected the expression of Glut2 in
cells after 21 days of induction, using immunofluorescence.
Glut2, a glucose transporter with
the lowest affinity and the highest capacity for
glucose, is expressed in pancreatic β-cell (29).
Glut2 catalyzes glucose uptake by β-cells. This
is the first step in signaling a cascade, leading to
glucose-stimulated insulin secretion (30). Glut2
is present in β-cell, but not in the other islet endocrine
cells (31).These findings suggested that SSEA-1 positive
cells might have the ability to secrete insulin in response
to glucose. We tested this latter prediction
by analyzing the secretion of insulin in response to
glucose stimulation, which is an important indicator
of functional pancreatic β-cells. Therefore, it was
demonstrated that SSEA-1 positive cells derived
ISCs are able to respond to glucose concentration
and behave as matured insulin producing cells.
Conclusion
Our study clearly demonstrates the potential of
SSEA-1 positive cells to differentiate into insulin
secreting cells in defined culture conditions. This
finding has the potential for clinical application in
the form of a new procedure for diabetes stem cell
therapy. However, further research is needed to test
the differentiated cells we obtained in an in vivo
evaluation of glucose levels in a diabetic model.
Table 1
Primers used for reverse transcription polymerase chain reaction (RT-PCR) analysis
Authors: James D Johnson; Noreen T Ahmed; Dan S Luciani; Zhiqiang Han; Hung Tran; Jun Fujita; Stanley Misler; Helena Edlund; Kenneth S Polonsky Journal: J Clin Invest Date: 2003-04 Impact factor: 14.808
Authors: Dario Gerace; Rosetta Martiniello-Wilks; Najah Therese Nassif; Sara Lal; Raymond Steptoe; Ann Margaret Simpson Journal: Stem Cell Res Ther Date: 2017-03-09 Impact factor: 6.832