Title: Adipose Tissue derived Mesenchymal Stem Cells’ Influence on Monocytes’ Differentiation into Dendritic Cells and Maturation of these Project period: 25th of April 2012 – 29th of May 2012 Department of Health Science and Technology Medicine and Medicine with Industrial Specialization Fredrik Bajers Vej 7D2 DK- 9220 Aalborg Phone 99 40 99 40 Fax 98 15 40 08 Project group: 412 Members: ___________________________________ Anne Frederiksen ___________________________________ Ida Brix ___________________________________ Jesper Lütkemeyer Kjeldsen ___________________________________ Michael Sloth Trabjerg ___________________________________ Mike Sæderup Astorp ___________________________________ Sofie Pagter Supervisor: Romana Maric Pages: 26 Appendix: 5 papers Finished on the: 29th of May 2012 Abstract: Bone marrow mesenchymal stem cells (BM-MSCs) have proven to be immunosuppressive. The purpose of this study is to obtain more knowledge of the immunosuppressive effect of adipose tissue-derived mesenchymal stem cells (AD-MSCs) regarding their effect on differentiation from monocytes into dendritic cells (DCs) and the maturation of these. The study constitutes three separate trials investigating different aspects of the immunosuppression under various influences of ADMSCs. Monocytes were isolated from buffycoat and were stimulated with granulocyte-macrophage colony stimulating factor (GM-CSF) and interleukin 4 (IL-4) to induce differentiation into immature DCs. The aspects explored were the effect of conditioned medium from AD-MSCs investigating the cytokines secreted, cell-to-cell contact with co-culture of monocytes and AD-MSCs, and the effect of soluble factors using transwell inserts. Lipopolysaccharide (LPS) was added in all three experiments to induce maturation of the DCs, and furthermore, addition of antibodies (CD80-PE-Cy5, CD14-PE-Cy7, HLA-DRAPC-Cy7, CD86-PE and CD83-APC) for the use of flow cytometry. The data obtained suggest the immunosuppressive effect of the AD-MSCs to be minimal compared to earlier studies. The control cells (HEK293) used seemed to be more immunosuppressive compared to the AD-MSCs. Further, the transwell inserts used (Sigma-Aldrich) seemed to have an immunosuppressive effect on individually cultured monocytes. Page 1 of 41 TABLE OF CONTENTS Introduction ............................................................................................................................... 4 Dendritic Cells ....................................................................................................................... 4 Definition of Dendritic Cells .............................................................................................. 4 Differentiation of Monocytes into Dendritic Cells ............................................................ 4 Function of Dendritic Cells ................................................................................................ 5 Mesenchymal stem cells ....................................................................................................... 5 Description of Mesenchymal Stem Cells .......................................................................... 5 Isolation of Mesenchymal Stem Cells ............................................................................... 5 Immunomodulatory Properties of Mesenchymal Stem Cells........................................... 5 Clinical Applications of Mesenchymal Stem Cells............................................................. 6 Bone Marrow derived Mesenchymal Stem Cells .................................................................. 6 The effect of Bone Marrow derived Mesenchymal Stem Cells on the immune system .. 6 The Effect of Bone Marrow derived Mesenchymal Stem Cells on Dendritic Cells ........... 6 The Effect of Bone Marrow derived Mesenchymal Stem Cells on Dendritic Cells in Transwell Inserts ............................................................................................................... 7 Comparison of Bone Marrow derived Mesenchymal Stem Cells and Adipose Tissue derived Mesenchymal Stem Cells ......................................................................................... 7 Description and Purpose of the Experiment ........................................................................... 10 Conditioned Medium Setup ................................................................................................ 10 Cell-to-Cell Contact Setup ................................................................................................... 11 Transwell Inserts Setup ....................................................................................................... 11 Data Analysis ....................................................................................................................... 11 Method .................................................................................................................................... 12 Monocytes .......................................................................................................................... 12 Adipose Tissue Derived Mesenchymal Stem Cells .............................................................. 12 Human Embryonic Kidney Cells .......................................................................................... 12 Control Wells ....................................................................................................................... 13 Flow Cytometry ................................................................................................................... 13 Overview Table ................................................................................................................... 14 Sources of Interference .......................................................................................................... 15 Seeding of the Cells......................................................................................................... 15 Environmental Conditions during Purification of Monocytes ........................................ 15 Centrifugation with Lymphoprep ................................................................................... 15 KM10 Medium as Buffer-System .................................................................................... 15 No Use of Flow Cytometry .............................................................................................. 15 Suggestions for Improvements ....................................................................................... 15 Page 2 of 41 The Second Experiment ...................................................................................................... 15 Buffycoat ......................................................................................................................... 16 Flow cytometry ............................................................................................................... 16 Sterile filtration ............................................................................................................... 16 Results ..................................................................................................................................... 16 Microscope Images ............................................................................................................. 17 Flow Cytometry Data .......................................................................................................... 18 Discussion ................................................................................................................................ 23 Adipose tissue derived mesenchymal stem cells ................................................................ 23 Human Embryonic Kidney cells ........................................................................................... 23 Dendritic Cell Controls ........................................................................................................ 23 A Critical View on the Results ............................................................................................. 24 Immunosuppression in the Conditioned Medium Trial.................................................. 24 Impossible to distinguish AD-MSC and HEK-cells ........................................................... 24 Unspecific Bindings of Isotypes ...................................................................................... 24 pH Change ....................................................................................................................... 24 Transwells’ Supression of Dendritic Cell Control ............................................................ 25 Subpopulations ............................................................................................................... 25 Ratio ................................................................................................................................ 25 Summary ............................................................................................................................. 25 Future Perspectives ................................................................................................................. 25 References ............................................................................................................................... 26 Appendix.................................................................................................................................. 29 Page 3 of 41 INTRODUCTION Mesenchymal stem cells (MSCs) are of high interest in the scientific environment today, as they are able to perform selfrenewal and multi-directional differentiation when injected into an allogen host. The research within MSCs seems to be going in four directions: Tissue regeneration, a delivery method for genetic therapy, enhancement of hematopoietic stem cell engraftment and treatments of immune diseases (Yi & Song, 2012). However, there are currently several difficulties connected to working with MSCs in vitro in regard to isolation and proliferation. Adipose derived MSCs (AD-MSCs) have shown to be easier attainable as well as easier to work with in vitro compared to bone marrow derived MSCs (BM-MSCs). The AD-MSCs can be hard to distinguish from the BM-MSCs as their phenotypes are very similar (Puissant et al., 2005). Even so, there seems to be a great variance in their functionality concerning their ability to differentiate into different kinds of tissue (Al-Nbaheen et al., 2012). This Study tries to clarify the role of ADMSCs in differentiation of monocytes into dendritic cells (DCs). This has previously been tested with BM-MSCs, where it seemed that these cells had an inhibitory effect on this differentiation process (Yi & Song, 2012). It is investigated whether this is the case for AD-MSCs as well. DENDRITIC CELLS DEFINITION OF DENDRITIC CELLS DCs are a part of the immune system, and they are the most potent antigenpresenting cells, in other words the principle initiator of adaptive immune responses both in vivo and in vitro assays (O’Neill, 2007). All DCs originate from hematopoietic stem cell. There have been found different kinds of DCs from both myeloid, lymphoid as well as a third progenitor cell type, that does not have any myeloid or lymfoid potential. One type of DC is the DC2, which originates from the plasmacytoid cells of the blood. Another kind is the interstitial DC1 developed from monocytes. These are found in the connective tissue in many kinds of organs (Agger, 2007; O’Neill, 2007). This study maintains a focus upon the DC1 type. A monocyte is a progenitor cell which can differentiate into either a DC or a macrophage (Randolph, 1998). A monocyte stimulated by granulocytemacrophage colony stimulating factor (GM-CSF) and interleukin-4 (IL-4) for several days will differentiate into an immature DC with the phenotype CD14and CD83-, meaning that they do not express CD14 and CD83 (O’Neill, 2007). Because there has not been found an unambiguous marker specific for DCs, they are often defined by their lack of markers, for example CD14 expressed on the surface of monocytes and macrophages but not on DCs (Agger, 2007). DIFFERENTIATION OF MONOCYTES INTO DENDRITIC CELLS Two steps of differentiation characterize DCs. Recently developed unstimulated DCs are called immature DCs and express relatively high numbers of MHC I- and to a lesser extend MHC II-molecules on their surface (Agger, 2007). In this stage they are able to actively gather antigens in their environment (O’Neill, 2007). If they are subjected to an appropriate stimulus, for example lipopolysaccharides (LPS) from a gram-negative bacteria or by proinflammatory cytokines, such as tumor necrosis factor α (TNF-α), they will differentiate into mature dendritic cells Page 4 of 41 expressing a greater amount of MHC Imolecules, a much greater number of MHC II-molecules and furthermore CD80, CD83 and CD86 (Agger, 2007; O’Neill, 2007). FUNCTION OF DENDRITIC CELLS One of the important functions of the DCs is, as already mentioned, their ability as antigen-presenting cells. They are able to initiate the immune response through activation of naive T-cells (Agger, 2007). More specific, antigen-presenting DCs activate naive T-cells. The response is dependent on the antigen dose and the state of maturation of the DCs (O’Neill, 2007). The DC is capable of activating several types of T-cells. The most important in relation to this experiment is however the differentiation of naïve Tcells into T-helper cells. This is the fundamental reaction in the adaptive immune response, because T-helper cells are necessary for other immune cells to expand and differentiate. An example of this is activation of B-lymphocytes by help of Th2 cells. This gives the B-cells the ability to produce antibodies against foreign molecules (Agger, 2007). Since the DCs are the principal initiator of the adaptive immune response, it is of high interest to clarify the influence of MSC on them. In the following section MSC is described in a general perspective. MESENCHYMAL STEM CELLS DESCRIPTION OF MESENCHYMAL STEM CELLS MSCs are adult stem cells from various types of tissues (Yi & Song, 2012). According to the Mesenchymal and Tissue Stem Cell Committee of the International Society for Cellular Therapy, a MSC must conform to the following criteria: When maintained in standard culture conditions, a MSC must be plastic-adherent. A MSC must express CD105, CD73 and CD90. A MSC must lack expression of CD45, CD34, CD14 or CD11b, CD79a or CD19 and HLA-DR surface molecules. A MSC must be able to differentiate into osteoblasts, adipocytes and chondroblasts in vitro. (Dominici et al., 2006) ISOLATION OF MESENCHYMAL STEM CELLS Isolation of MSC is not an easy task. One of the key problems in this isolation process is that no unique MSC surface markers have yet been identified. Furthermore, it is difficult to distinguish subpopulations of MSCs (Yi & Song, 2012). In the isolating process, mononuclear cells are fractionated from the remaining tissue by a density gradient (Yi & Song, 2012). Despite the massive effort to gain a pure sample of MSC, this has not yet been achieved. The isolation process gives rise to the probability, that true MSCs will get lost in the specter of mononuclear cells living up to the criteria for MSCs (Yi & Song, 2012). IMMUNOMODULATORY PROPERTIES OF MESENCHYMAL STEM CELLS MSCs have a general immunosuppressive effect, which functions via paracrine activity by cytokines, and via cell-to-cell contact (Yi & Song, 2012). This effect is a result of the ability of MSCs to stop the differentiation and possibly also the maturation of DCs. (Jiang et al., 2005) This means that the activation of T-cells, which are required for activation of the adaptive immune response, will not occur. Thereby the immunosuppressive effect can be acquired by using MSCs in vivo. Page 5 of 41 CLINICAL APPLICATIONS OF MESENCHYMAL STEM CELLS Regarding the clinical applications, MSCs have been shown to have a tissue regenerative effect, as well as the ability to differentiate into bone-, cartilage-, muscle-, tendon- and neural cells. There is however, still doubt about the exact mechanism involved. Furthermore, MSCs have been shown to enhance the hematopoietic stem cell engraftment, and show promise in gene therapy. Moreover, studies of the effect of MSCs on autoimmune diseases such as multiple sclerosis and type II diabetes have been investigated (Yi & Song, 2012). BONE MARROW DERIVED MESENCHYMAL STEM CELLS In the 1970ies, Friedenstein first identified BM-MSC as an adherent fibroblast-like population, which was able to differentiate into bone. Later studies show that these cells fulfill stem cell criteria, which are self-renewal and multilineage differentiation capacity. Since MSCs from bone marrow were the first to be discovered, BM-MSCs have been object of a range of studies, including investigations of their immunomodulatory effect (Nauta, Fibbe, & Dc, 2012a). THE EFFECT OF BONE MARROW DERIVED MESENCHYMAL STEM CELLS ON THE IMMUNE SYSTEM BM-MSCs have a suppressive effect on the immune system, and are likely to be involved in the induction of immune tolerance (Aggarwal & Pittenger, 2005). The immunomodulatory properties of BM-MSCs include suppression of T-cell proliferation, suppression of B-cell proliferation and their terminal differentiation, effect on the maturation and function of DCs, and immune modulation of other immune cells such as the natural killer (NK) cells (Yi & Song, 2012). When BM-MSCs are co-cultured with purified subcultures of immune cells, experiments have shown that they change the cytokine secretion profile of DCs, NKcells and T-cells, both the effector and naive T-cells. This change induces a more anti-inflammatory or tolerant phenotype. The BM-MSCs cause the mature DC1s to decrease their secretion of tumor necrosis factor- (TNF-), a proinflammatory cytokine, and they cause DC2s to increase the secretion of the anti-inflammatory cytokine interleukin-10 (IL-10). Levels of prostaglandin E2 (PGE2) are elevated, and inhibitors of PGE2 production weaken the BM-MSC-mediated immune modulation (Aggarwal & Pittenger, 2005). However, Puissant found that PGE2 is not a major soluble inhibitory factor released by BMMSC (Puissant et al., 2005; Agger, 2007; Bortesi et al., 2009). THE EFFECT OF BONE MARROW DERIVED MESENCHYMAL STEM CELLS ON DENDRITIC CELLS As mentioned, the BM-MSCs have an effect on the differentiation, maturation and function of the DCs. When coculturing MSC and monocytes with GMCSF and IL-4, the differentiation of monocytes into DCs was strongly inhibited. Monocytes cultured with BMMSCs developed macrophage morphology. The cells retained the same amount of CD14 without acquisition of CD1a or up-regulation of CD80, CD83 and CD86, in contrast to monocytes cultured without BM-MSCs (Jiang et al., 2005). The monocytes were blocked from entering the G1 phase of the cell cycle, resulting in an accumulation of cells in the G0 phase with an impaired antigen-presenting ability (Ramasamy et al., 2007). An altered cytokine production pattern of the MSCinfluenced DCs was observed, showing a Page 6 of 41 decreased production of TNF-α , INF- and IL-12, and an increased production of the anti-inflammatory cytokine IL-10 (Nauta, Fibbe, & Dc, 2012b). It shows that the ratio between MSCs and monocytes have an influence on the inhibitory effect observed (Jiang et al., 2005). At a BMMSC/monocyte ratio higher than 1:10, the suppressive effect was observed even without intercellular contact. With intercellular contact, the blockage of the differentiation of monocytes into DCs first became minor when the BMMSC/monocyte ratio was as low as 1:200. This indicates a very strong BM-MSCmediated inhibition of the differentiation of monocytes into DCs (Jiang et al., 2005) When co-culturing mature DCs with BMMSC, the expression of CD83, MHC II, CD80 and CD86 were reduced, and the secretion of IL-12 was down regulated (Jiang et al., 2005). THE EFFECT OF BONE MARROW DERIVED MESENCHYMAL STEM CELLS ON DENDRITIC CELLS IN TRANSWELL INSERTS In the same study with co-culture of BMMSC with monocytes, a transwell insert was used to determine whether intercellular contact between monocytes and BM-MSCs was necessary for the inhibitory effect of monocytes into DCs (Jiang et al., 2005). At a higher BMMCS/monocyte ratio of 1:10, the differentiation of monocytes into DCs was completely blocked. At a ratio of 1:20 and 1:50, the monocytes were able to differentiate into immature DCs when cultured with GM-CSF and IL-4. These immature cells had down-regulated CD14, but also an up-regulated CD1a expression. When stimulated with LPS, the immature DCs underwent maturation even though the BM-MSCs were present. These results pointed toward that BM-MSCs are capable of suppressing the generation of DCs through secretion of cytokines at a higher BM-MSC/monocyte ratio. At lower ratios however, the suppression occurs mainly through intercellular contact (Jiang et al., 2005). To determine whether the suppressive factors were constitutively secreted from the MSCs, supernatant from these cell cultures were added to monocytes. This showed no inhibitory effect, unless the MSCs had been co-cultured with lymphocytes. This indicated, that the MSCs required a dynamic cross talk with T-lymphocytes to secrete inhibitory factors (Nauta, Fibbe, & Dc, 2012a). In 2001 Zuk et al. found adipose tissue to be an alternatively source of MSCs with great advantages, since the cells were obtainable in larger quantities than in the bone marrow. Furthermore, the medical procedure of cell acquisition could be done under local anesthesia with minimal discomfort for the patient (Zuk et al., 2001). COMPARISON OF BONE MARROW DERIVED MESENCHYMAL STEM CELLS AND ADIPOSE TISSUE DERIVED MESENCHYMAL STEM CELLS Earlier studies with focus on BM-MSCs have provided a good amount of knowledge regarding their abilities (Puissant et al., 2005). In recent years, there has been an increased focus on the extraction and use of AD-MSC instead of BM-MSC, based on similarities and easier attainability of these (Al-Nbaheen et al., 2012). This section will make a comparison between the BM-MSCs and AD-MSCs. Interestingly, the phenotypes of BM-MSCs and AD-MSCs are nearly similar according to Puissant et al. However, studies show discrepancy between the expression of Page 7 of 41 CD34 (Al-Nbaheen et al., 2012; Puissant et al., 2005). Puissant and colleagues concluded that AD-MSC expressed CD34, whereas Al-Nbaheen et al. did not find any expression of CD34 on AD-MSCs (AlNbaheen et al., 2012; Puissant et al., 2005). Both sources agreed that BM-MSC did not express CD34 (Al-Nbaheen et al., 2012; Puissant et al., 2005). Though, their phenotype seems nearly identically, it seems that their abilities vary from one another. Larger amounts of MSCs are possible to extract from adipose tissue compared to bone marrow (Puissant et al., 2005). In vitro experiments reveal that AD-MSCs have a greater proliferation potential than that of BM-MSCs. This makes them very suitable for culturing (Puissant et al., 2005). A study performed by Al-Nbaheen and colleagues indicates a difference in the MSCs’ ability to differentiate into specific tissues. BM-MSCs seem to evolve more easily into osteoblast, while ADMSCs evolve more easily into adipocytes (Al-Nbaheen et al., 2012). Also, it seems that the AD-MSCs have a higher ability to induce angiogenesis than the BM-MSCs (Petit JY, 2012). A recent study concludes there to be a significant difference between BM-MSCs and AD-MSCs, in their ability to suppress differentiation from monocytes to DCs (Ivanova-Todorova et al., 2009). The study showed that AD-MSCs are more potent suppressors than BM-MSCs. This was expressed by an experiment carried out by Ivanova-Todorova and colleagues were this effect was tested. Monocytes were isolated and cultured. The description of their experiment was as follows: “Peripheral blood mononuclear cells (PBMC) were passed through a column with magnetic beads coated with antiCD14 anti-body and the CD14+ cells were isolated and cultured independently or co-cultured with different types of human MSCs in the presence of cytokines (IL-4, GM-CSF) to induce their differentiation into dendritic cells and their further maturation induction by LPS added on day 6th of culture.” (Ivanova-Todorova et al., 2009, page 39). They tested the cells for the following CD markers: CD14, CD80, CD83, CD86 and HLA-DR. The experiment showed that of the independently cultured CD14 positive cells, only 1.3% of them remained CD14 positive. Compared to those co-cultured with BM-MSCs, 53.2% remained CD14 positive, and for AD-MSCs, 69.8% remained CD14 positive. The same was tested with CD83, where 76% of the independently cultured cells showed to be positive. Compared to those co-cultured with BM-MSCs, 23.6% were positive for CD83, and for AD-MSCs, 21.5% showed a positive result. These results indicate that AD-MSCs have a more powerful ability to suppress the differentiation of monocytes into dendritic cells compared to BM-MSC. Furthermore, the study indicated that ADMSCs were more potent in stimulating the secretion of IL-10 than the BM-MSCs (Ivanova-Todorova et al., 2009). Although, co-culture studies have already been conducted with AD-MSCs and monocytes there are yet undefined elements in this field of study. These earlier studies have shown that AD-MSCs inhibited differentiation of monocytes into DCs. However, these earlier studies have investigated the role of cell-to-cell contact in the AD-MSC induced inhibition of monocytes differentiation. For future perspectives it is of great relevance to investigate how the AD-MSCs will act when not in direct contact with the monocytes. This is to find out if it is their secreted product, which induce the immunosuppressive effect or not. Thus, in this study it is investigated whether direct cell-cell contact is necessary for AD-MSC Page 8 of 41 induced inhibition of monocyte differentiation, or whether potential soluble factors released into the surroundings by AD-MSCs are involved in this inhibitory effect. Page 9 of 41 DESCRIPTION AND PURPOSE OF THE EXPERIMENT Based on the results and research presented in the introduction (by IvanovaTodorova et al., 2009 & Jiang et al., 2005) this experiment has been designed to gain a broader knowledge on the area of ADMSCs’ immune-modulatory effects on DCs. It is expected to verify the results gained by Ivanova-Todorova and colleagues. These results showed an immune-suppressive effect of AD-MSCs on the differentiation of monocytes into DCs. In this experiment, monocytes, AD-MSCs and control cells (human embryonic kidney cells (HEK293-cells)) will be cultured with different setups. It is divided into three parts each investigating different aspects of cell differentiation of monocytes into DCs under various influences of AD-MSCs. One setup will be exploring the effect of conditioned medium from AD-MSCs on the differentiation. Another will explore the influence on differentiation when cell-tocell contact between AD-MSCs and monocytes is present. A third will explore the effect of AD-MSCs on the differentiation through transwell inserts, thus without physical cell-cell contact. These three setups will make it possible to determine if a potential reaction will be caused by cytokines (conditioned medium setup), physical contact between the cells (cell-to-cell contact setup) or short lived cytokines (transwell inserts setup). Additionally it will be investigated if the same methods of interaction between non-MSCs (HEK-cells) and monocytes will have a similar effect as the AD-MSCs. CONDITIONED MEDIUM SETUP This trial will explore if conditioned medium from AD-MSCs and HEK-cells introduced to monocytes will have an immunoregulatory effect. Conditioned medium is defined by being the medium, in which the cells have lived for a period likely to contain cytokines produced by the AD-MSCs and HEK-cells. If a suppression of differentiation within the monocyte population is observed, these cytokines are likely to be the cause. See figure 1. of time. The conditioned medium will be Page 10 of 41 CELL-TO-CELL CONTACT SETUP In this trial AD-MSCs and HEK-cells are cocultured with monocytes with cell-to-cell contact. This will make it possible to determine if direct contact between the AD-MSCs and monocytes will influence the differentiation of the monocytes into DCs. The same will be investigated for HEK-cells. It is possible that cell-to-cell contact is necessary for the AD-MSCs to influence the dif-ferentiation. This kind of requirement for cell-to-cell contact, to initiate internal cell processes, is known from immunology; exemplified in the necessity for cell-to-cell contact in T-cell activation by an antigen-presenting cell. See figure 2. TRANSWELL INSERTS SETUP The third trial will explore the influence of AD-MSCs and HEK-cells influence the differentiation process of monocytes when co-cultured, but physically separated by a transwell inserts. When the AD-MSCs and monocytes are cultured together, but denied cell-to-cell contact, it is possible to determine if short-lived cytokines may be able to induce an immunosuppressive effect on the differentiation process. See figure 3. DATA ANALYSIS Cells will be analyzed by flow cytometry which will provide information about the specific phenotypes. Based on the data obtained, it will be possible to conclude if the AD-MSCs and HEK-cells have had an immunomodulatory effect on the monocytes. Page 11 of 41 METHOD This study was conducted by three separate project groups each investigating one aspect of the above mentioned. This study will only describe the protocol for the transwell insert trial. MONOCYTES Peripheral blood mononuclear cells (PBMCs) are isolated by density gradient centrifugation from buffycoat, donated by the Blood Bank, Aalborg Sygehus Nord with Lymphoprep (Axel-Shield). Monocytes are isolated from PBMCs by adherence to bottom of 6-well plates according to the protocol (see appendix 2) Buffycoat is diluted 1:4 in 0.9% NaCl, added Lymphoprep and centrifuged (380xg 20min) to isolate PBMCs, which are found in the interphase after density gradient centrifugation. PBMCs have a density of 1.077g/ml as Lymphoprep and cannot migrate through the medium, whereas erythrocytes and granulocytes have larger densities, and fall to the bottom. PBMCs are washed 3 times with PBS+1mM EDTA by centrifugation 2x 300xg and 1x 200xg to wash away any thrombocytes. It is important that washing is performed at 4oC as monocytes stick to plastic surfaces at room temperature. PBMCs are counted with methyl violet supplemented with acetic acid. Methyl violet stains leucocytes and acetic acid kills erythrocytes. Cells are sown in 6-well cell culture plates (Costar; Corning Incorporated) at a concentration of 3.4x106 cell/mL in each well. After 3 hours at 37oC in a CO2-incubator, cells are washed with warm KM10 medium consisting of RPMI 1640 medium supplemented with L-Glutamine, Penicillin/Streptomycin and 10% fetal calf serum (FCS). During the 3 hour incubation, it is expected that monocytes, which make up approximately 15% of PBMCs, will adhere to the bottom of the wells, while the rest of the cells will not adhere and therefore will be washed away. The cells are grown in KM10 media supplemented with 100ng/ml GM-CSF and 20ng/ml IL-4 (Perprotech) for 6 days. These cytokine are used to drive the differentiation of monocytes into immature DCs. On day 6, 10ng/ml LPS is added to induce maturation of DCs. LPS are large molecules consisting of lipids and polysaccharides and are found in the outer membrane of gram-negative bacteria. On day 7 cells are analyzed and photographed in a reverse phase contrast microscope. Furthermore the differentiation and maturation state is analyzed by flow cytometry. ADIPOSE TISSUE DERIVED MESENCHYMAL STEM CELLS AD-MSCs are isolated by lipectomy. Cells are initially grown in alfa-MEM, but have been adjusted stepwise to RPMI 1640 (Lifetechnologies) media before use. This is because AD-MSCs are more robust than monocytes, and are easier adjusted to new media than monocytes (Trine Fink, associate professor) AD-MSCs are harvested at day one by trypsinization using trypsin/EDTA which breaks the integrins and cadherins between the ADMSCs and the wells. Cells are sown into two transwell inserts (Sigma-Aldrich) at a density of 25000 cell per well. This number was calculated to get a ratio of 1:20 (AD-MSC:monocytes). HUMAN EMBRYONIC KIDNEY CELLS HEK293-cells originate from a human embryonic kidney and were obtained in the 1970ies. As AD-MSCs, HEK-cells are initially grown in alfa-MEM, and slowly adjusted to RPMI 1640 (Lifetech-nologies) media before use. Cells are harvested at Page 12 of 41 day 1 by trypsinization using trypsin/EDTA. Cells are sown in two transwell inserts (Sigma-Aldrich) at a density of 25000 cell per well. CONTROL WELLS The last two wells function as control for normal monocyte differentiation. This means, that no cells were added in the transwell inserts, only KM10 media. (Sigma-Aldrich). FLOW CYTOMETRY Flow cytometry is a method used to analyze a range of parameters of individually cells in a heterogenic population. It is for instance applied for immunophenotyping and cell counting, which both can be illustrated graphically and analyzed statistically (Flowcytometry, n.d.). cells from the bottom of all the wells are collected in RPMI 1640, centrifuged (300xg for 10 min.) and resuspended in PBS supplemented with 0.5% BSA and 0.01% sodium azid at a pH of 7.4. BSA is a stabilizer and deliver nutrients and binds free radicals. Furthermore, it prevents the targeted cells from adhering to the tubes. Sodium azid prevents bacterial growth of gram-negative bacteria. Cells are counted with trypan blue (Sifma) in a microscope, which dyes the dead cells blue. Cells were incubated with anti-CD80-PE-Cy5, antiHLA-DR, anti-CD86-PE, anti-CD83-APC (Beckton Dickinson) and anti-CD14-PE-Cy7 (BD Pharmingen) and their corresponding isotypes for 30 minutes at 4oC in darkness. Exposure to light will compromise the activity of the antibodies. After washing the cells twice with PBS supplemented with 0.5% BSA and 0.01% sodium azid by centrifugation (300xg for 5 min.), the cells are resuspended in 300μl PBS with 1% formaldehyde for preservation. The samples are analyzed on a FACSCanto and thereafter by FACSDiva. Subsequently the results are edited with FlowJo. In this study flow cytometry is used to analyze the differentiation and maturation state of the DCs. On day 7, Page 13 of 41 OVERVIEW TABLE This table is produced to give a further overview of the experiment Monocytes Day -5 Day -3 Day 0 Day 1 The cells are purified from buffycoat and seeded into the 6 wells KM10, GM-CSF and IL-4 are added to the medium in the wells The cells are washed and added new KM10, GM-CSF and IL-4 Day 3 Other The new medium contains 50% alpha-mem and 50% RPMI 1640 The medium is changed to contain 25% alpha-mem and 75% RPMI 1640 The medium is again changed. It does now consist of 100% RPMI 1640 The cells are seeded into transwell systems in four wells, two of each cell type The transwells are put into all 6 wells All wells are added fresh KM10, GM-CSF and IL-4 All wells are added fresh KM10, GM-CSF and IL-4 LPS is added to all wells and the cells will afterwards be incubated at 37o C Day 5 Day 6 Day 7 AD-MSCs and HEK-cells The cells are separately counted and seeded in new containers with new medium The monocytes are harvested and counted with trypan blue The monocytes are prepared for flow cytometry The monocytes were analyzed using flow cytometry. Page 14 of 41 SOURCES OF INTERFERENCE The first experiment failed to show any results, why the purpose of this chapter is to clarify the possible errors. Before the cells were harvested on day 7, they were observed using a microscope. Also the control wells, without any other cells than DCs, contained very few cells. The possible errors are listed below. SEEDING OF THE CELLS When seeding the cells in a specific concentration, it is of great importance that the resuspention of cells is carefully mixed before a portion is seeded into a well. If not, it is possible that the cells precipitate. This would make the concentration in the resuspention too low to provide any useful data. This could explain the small amount of cells observed in each well. ENVIRONMENTAL CONDITIONS DURING PURIFICATION OF MONOCYTES When the monocytes were purified from the buffycoat, they were outside the 37°C CO2-incubator for many hours. These conditions could cause cell death or make them adhere to the plastic during preparation, and thus fewer cells were seeded out in the wells. Cells should be kept at 4oC, in between handling. CENTRIFUGATION WITH LYMPHOPREP During purification of monocytes from the buffycoat, Lymphoprep was used as density gradient to isolate the PBMCs. It was discovered that the centrifugation was conducted at too great a force, which possibly would have interfered with the results by possibly causing cell death. KM10 MEDIUM AS BUFFER-SYSTEM At the end of the experiment the KM10 medium changed colour, indicating a change in pH value, thereby providing a disadvantageous environment for the cells. This could inactivate the cytokines, why the monocytes possibly were not stimulated to develop into DCs. Whether or not the change in pH had an effect on the cytokines or the cells depends on how acidic or alkaline the medium had become. This was not investigated further. NO USE OF FLOW CYTOMETRY By using flow cytometry it would have been possible to determine the phenotype of the cell cultures. This was not done and therefore it was not possible to detect if the cells had differentiated as well as matured successfully. SUGGESTIONS FOR IMPROVEMENTS It would be useful to observe the cells regularly using a microscope to determine potential errors in the process as they occurred. The KM10 medium contained a bicarbonate-buffer system, which is a major physiologic buffer maintaining the pH value at 7.0-7.4. It would be beneficial to add HEPES-buffer to provide a pH value of 7.2-7.6. This addition would give the medium a better buffer capacity when working long periods outside the CO2incubator (“Life Technologies Co.,” n.d.). THE SECOND EXPERIMENT A second identical experiment was conducted to avoid previously suspected interference sources in an attempt to achieve useful results. This trial was conducted by the supervising PhD. student Romana Maric, and laboratory technician Brita Holst Jensen. Hence it Page 15 of 41 became possible to minimize some sources of interference. Previously, the lack of the practitioners’ laboratory experience was suspect to the errors experienced. The second experiment obtained the same low amount of cells as the previous one. From here it can be concluded that the method was conducted in a correct manner. The focus must be applied elsewhere. BUFFYCOAT The attention could be directed towards the buffycoat (Ralf Agger, associate professor). Buffycoat is isolated from a blood sample that has been kept overnight. Pre-buffycoat is isolated from a fresh blood sample. Buffycoat was used in this experiment. Hence both trials failed to achieve optimal results, even in the hands of skilled professionals, it seems rational to suspect the buffycoat. If a new trial was to be conducted, it would be of great interest to apply pre-buffycoat or full blood instead. cytometry. They were indistin-guishable resulting in inaccurate data. The AD-MSCs could have been added antibodies giving them the same green emission as that of the HEK-cells. This makes it possible to discard any data collected on cells having this specific emission. Thereby the DCs or monocytes could have been isolated in the data obtained. A flow cytometry testing the five antibodies on the ADMSCs and HEK-cells should have been conducted. This would clarify if the ADMSCs and HEK-cells have any surface markers in common with monocytes or DCs. 10.000 events were preferred when performing the flow cytometry test. The material available for the test was though insufficient, which resulted in an acceptance of 2000 – 10.000 events instead. In addition, a flow cytometry test of the HEK-cells without antibodies and isotypes would clear the suspicion if the cells’ autofluorescence could have had an impact on the data collected. FLOW CYTOMETRY STERILE FILTRATION When analyzing the results gained from flow cytometry, it was in this case not possible to distinguish the cell populations from each other. The AD-MSCs and the HEK-cells could have been dyed with the same fluorescent colour, whereby these populations could have been ignored, and the data obtained would only represent the potential DCs and monocytes. In the conditioned medium trial, there were AD-MSCs and HEK-cells present in the medium transferred to the wells. This could have been avoided if the conditioned medium was sterile filtrated during the transfer. Further, CD14-PE-Cy7 should have been tested on the monocytes to establish a point of reference to compare the obtained data from the experiment. IL-4 and GM-CSF were added to differentiate monocytes into DCs. LPS was added to induce the maturation process. The AD-MSCs and HEK-cells were cultured with monocytes in different trials to investigate their influence on the differentiation and maturation. In the experiment HEK-cells and AD-MSCs influenced the obtained data from flow RESULTS Page 16 of 41 MICROSCOPE IMAGES Before harvesting the cells, pictures were taken to estimate the state of the cells. All photos were taken at 20x optics. Photo 1: DC in conditioned medium extracted from ADMSCs. Photo 2: DC from AD-MSC co-culture. Photo 3: DC from well with transwell insert, containing AD-MSCs. Photo 4: DCs and HEK-cells in conditioned medium from HEK-cells. Photo 5: DCs and HEKcells in co-culture. Photo 6: DCs from well with transwell insert containing HEK-cells. Photo 7: DCs in control well. Photo 8: DCs in control well. Photo 9: DCs in control well with transwell insert. Since DCs were observed in all the trials, it was relevant to do a flow cytometry test. Fluorescent antibodies were added to the three different cell suspensions to distinguish between different surface markers. In each trial three FACS tubes, each containing a single cell suspension, were added following antibodies; CD80PE-Cy5, HLA-DR-APC-Cy7, CD86-PE, CD83APC. Furthermore, in each trial, their corresponding isotypes were added to three different FACS tubes, each containing one of the single cell suspensions. Page 17 of 41 FLOW CYTOMETRY DATA Data 1 - Data from flow cytometry of cells in conditioned medium from AD-MSCs. A) 2D scatter plot of the cell population showing the morphologic gating. B) Histogram showing antibody CD80-PE-Cy7 and isotype CD80-PE-Cy7. C) Histogram showing antibody CD83-APC and isotype CD83-APC. D) Histogram showing antibody CD86-PE and isotype CD86-PE. E) Histogram showing antibody CD14-PE-Cy7 and isotype CD14-PE-Cy7. F) Histogram showing antibody HLA-DR-APC-Cy7 and isotype HLA-DR-APC-Cy7. Page 18 of 41 Data 2 - Data from flow cytometry of cells co-cultured with AD-MSCs. A) 2D scatter plot of the cell population showing the morphologic gating. B) Histogram showing antibody CD80-PE-Cy7 and isotype CD80-PE-Cy7. C) Histogram showing antibody CD83-APC and isotype CD83-APC. D) Histogram showing antibody CD86-PE and isotype CD86-PE. E) Histogram showing antibody CD14-PE-Cy7 and isotype CD14-PE-Cy7. F) Histogram showing antibody HLA-DR-APC-Cy7 and isotype HLA-DR-APC-Cy7. Data 3 - Data from flow cytometry of cells co-cultured with AD-MSC separated by transwell insert. A) 2D scatter plot of the cell population showing the morphologic gating. B) Histogram showing antibody CD80-PE-Cy7 and isotype CD80-PE-Cy7. C) Histogram showing antibody CD83-APC and isotype CD83-APC. D) Histogram showing antibody CD86-PE and isotype CD86-PE. E) Histogram showing antibody CD14-PE-Cy7 and isotype CD14-PE-Cy7. F) Histogram showing antibody HLA-DR-APC-Cy7 and isotype HLA-DR-APC-Cy7. Page 19 of 41 Data 4 - Data from flow cytometry of cells in conditioned medium from HEK-cells. A) 2D scatter plot of the cell population showing the morphologic gating. B) Histogram showing antibody CD80-PE-Cy7 and isotype CD80-PE-Cy7. C) Histogram showing antibody CD83-APC and isotype CD83-APC. D) Histogram showing antibody CD86-PE and isotype CD86-PE. E) Histogram showing antibody CD14-PE-Cy7 and isotype CD14-PE-Cy7. F) Histogram showing antibody HLA-DR-APC-Cy7 and isotype HLA-DR-APC-Cy7. Data 5 - Data from flow cytometry of cells co-cultured with HEK-cells. A) 2D scatter plot of the cell population showing the morphologic gating. B) Histogram showing antibody CD80-PE-Cy7 and isotype CD80-PE-Cy7. C) Histogram showing antibody CD83-APC and isotype CD83-APC. D) Histogram showing antibody CD86-PE and isotype CD86-PE. E) Histogram showing antibody CD14-PE-Cy7 and isotype CD14-PE-Cy7. F) Histogram showing antibody HLA-DR-APC-Cy7 and isotype HLA-DR-APC-Cy7. Page 20 of 41 Data 6 - Data from flow cytometry of cells co-cultured with HEK-cells separated by transwell insert. A) 2D scatter plot of the cell population showing the morphologic gating. B) Histogram showing antibody CD80-PE-Cy7 and isotype CD80-PE-Cy7. C) Histogram showing antibody CD83-APC and isotype CD83-APC. D) Histogram showing antibody CD86-PE and isotype CD86-PE. E) Histogram showing antibody CD14-PE-Cy7 and isotype CD14-PE-Cy7. F) Histogram showing antibody HLA-DR-APC-Cy7 and isotype HLA-DR-APC-Cy7. Data 7 - Data from flow cytometry of control cells in KM10 medium from the setup with conditioned medium. A) 2D scatter plot of the cell population showing the morphologic gating. B) Histogram showing antibody CD80-PE-Cy7 and isotype CD80-PE-Cy7. C) Histogram showing antibody CD83-APC and isotype CD83-APC. D) Histogram showing antibody CD86-PE and isotype CD86-PE. E) Histogram showing antibody CD14-PE-Cy7 and isotype CD14-PE-Cy7. F) Histogram showing antibody HLA-DR-APC-Cy7 and isotype HLA-DR-APC-Cy7. Page 21 of 41 Data 8 - Data from flow cytometry of control cells in KM10 medium from the setup with coculturing. A) 2D scatter plot of the cell population showing the morphologic gating. B) Histogram showing antibody CD80-PE-Cy7 and isotype CD80-PE-Cy7. C) Histogram showing antibody CD83-APC and isotype CD83-APC. D) Histogram showing antibody CD86-PE and isotype CD86-PE. E) Histogram showing antibody CD14-PE-Cy7 and isotype CD14-PE-Cy7. F) Histogram showing antibody HLA-DR-APC-Cy7 and isotype HLA-DR-APC-Cy7. Data 9 - Data from flow cytometry of control cells in KM10 medium from the setup with transwell inserts. A) 2D scatter plot of the cell population showing the morphologic gating. B) Histogram showing antibody CD80-PE-Cy7 and isotype CD80-PE-Cy7. C) Histogram showing antibody CD83-APC and isotype CD83-APC. D) Histogram showing antibody CD86-PE and isotype CD86-PE. E) Histogram showing antibody CD14-PE-Cy7 and isotype CD14-PE-Cy7. F) Histogram showing antibody HLA-DR-APC-Cy7 and isotype HLA-DR-APC-Cy7. Page 22 of 41 DISCUSSION Whether AD-MSCs have had an effect on the differentiation of the monocytes will now be discussed. To detect if the observed cells are DCs, this study will use the expression of CD80 and CD86 as an indicator of this. If the potentially observed DCs are mature or immature DCs will be decided by the amount of HLA-DR and CD83 expressed. Also the expression of CD14 among the cell populations is used to say if the potentially non-DCs are monocytes or macrophages. ADIPOSE TISSUE DERIVED MESENCHYMAL STEM CELLS The results obtained in this study indicate that the AD-MSCs have had an immunosuppressive effect. This effect is however doubtful as none of the data collected was as conclusive as that of Ivanova-Todorova (Ivanova-Todorova et al., 2009). The largest suppression was observed for the AD-MSCs in the cell-tocell contact trial. A subpopulation here was suspected to be suppressed monocytes. Despite this potential suppression, many DCs were still observed. The second inhibitoriest effect of the AD-MSCs was detected in the trial using conditioned medium. A smaller subpopulation suspected to be suppressed monocytes was observed in this trial as well. Also many DCs were detected. The least, and seemingly noninhibited monocytes, grown with ADMSCs, were observed in the data from the transwell insert trial. Here no cell differentiation seemed to have been inhibited. The subpopulation for the cell-to-cell contact trial seems to be more suppressed than those of the conditioned medium trial, whereas the monocytes from the transwell insert trial seems to have all differentiated into mature DCs. However this study will not conclude whether an actual immunosuppressive effect, has been present. HUMAN EMBRYONIC KIDNEY CELLS The results obtained from the HEK-cells indicated that these cells had a more immunosuppressive effect than the one observed for the AD-MSCs. The HEK-cells had a strong suppressive effect on the monocytes in both the conditioned medium trial as well as the cell-to-cell contact trial. In each, a smaller subpopulation was observed and suspected to be DCs. The primary population in those two trials was believed to be the HEK-cells themselves, since the population was overall negative in all tests. The largest amount of DCs seemed to be present in the transwell insert trial, although only a small amount was detected here. The HEK-cells seems to be most immunosuppressive when there is cell-tocell contact compared to the conditioned medium trial. The ones cultured in transwell inserts do not seem to be as suppressive as in the other trials. Also, it seems that the HEK-cells have a stronger immunosuppressive ability than that of the AD-MSCs. DENDRITIC CELL CONTROLS The data from the conditioned medium trial and the cell-to-cell contact trial showed almost the same result. This was expected as they were cultured using the same protocol. The transwell insert trial gave results indicating suppression. This is remarkable as the only difference from the other two trials was the presence of Page 23 of 41 the transwell insert. This could indicate something interesting, which will be discussed later. A CRITICAL VIEW ON THE RESULTS The results obtained in this study must however be viewed in a critical context. IMMUNOSUPPRESSION IN THE CONDITIONED MEDIUM TRIAL The conditioned medium contained HEKcells and AD-MSCs, which could have interfered with the differentiation of monocytes into DCs and the maturation of these. There could be several reasons for this interference. The HEK-cells and AD-MSCs could have emptied the KM10 medium for nutrients, possibly causing cell death. Furthermore, no studies have been conducted regarding whether HEKcells have the ability to suppress the differentiation of monocytes into DCs. Also the ratio between the conditioned and non-conditioned medium (KM10) could be of great importance. In the coculture with HEK-cells and DCs, the suppression observed could also be caused by the HEK-cells potentially being immunosuppressive. IMPOSSIBLE TO DISTINGUISH AD-MSC AND HEK-CELLS It is complex to distinguish the presence of HEK-cells and AD-MSCs from the monocytes and DCs, due to the lack of specific markers targeting HEK-cells and AD-MSCs in this experiment. Additionally, it is unknown if the cells expressing HLADR could be HEK-cells, since it is known that AD-MSCs do not express this surface marker. UNSPECIFIC BINDINGS OF ISOTYPES In the different trials the CD14-PE-Cy7 isotype marker binds as strongly as the CD14-PE-Cy7 antibody marker. The CD14PE-Cy7 isotype test showed that it bound unspecific, even in the control containing only monocytes and DCs. An explanation of this could be that the isotype is able to bind to the monocytes or DCs themselves. The CD14-PE-Cy7 isotype therefore proved to be a poor isotype to use. Because of this, the data obtained for CD14 was analyzed with a skeptical view. In the trials using HEK-cells, both in the conditioned medium trial and the cell-tocell contact trial, the CD86-PE isotype bound unspecific. This was not the case in the transwell insert trial. This indicates that CD86-PE possibly binds unspecific to HEK-cells, since these were present in both the cell suspension from the coculture setup and the setup with conditioned medium and not in the transwell trial. For the HLA-DR-APC-Cy7 isotype marker the same tendency occurred as with the CD14-PE-Cy7 isotype marker. Though the antibody marker showed to have a higher affinity for HLA-DR than the isotype’s affinity for its unknown receptors, possibly being Fc-receptors. This makes it possible to use the results in the analysis. In an experiment, executed by Beavis and Pennline, investigating this tandem dye combined of APC and Cy7, as used in this experiment, it was shown that monocytes are able to bind APC-Cy7 non-specifically (Beavis & Pennline, 1996). Though this was minimal, it might still have influenced the data obtained. PH CHANGE It was observed that the KM10 medium had changed pH. The wells containing HEK-cells became alkaline (orange), whereas the wells containing AD-MSCs and the wells only containing DCs became acidic (pink). The changes in pH could Page 24 of 41 have interfered with the differentiation of monocytes into DCs. TRANSWELLS’ SUPRESSION OF DENDRITIC CELL CONTROL The transwell inserts seemed to have a suppressive effect on the differentiation of monocytes compared to the other DC controls. This could indicate that the transwell inserts may contain the cytokines, which would suppress the differentiation. Furthermore, it is possible that the transwell inserts consist of some substances inhibiting the differentiation of monocytes into DCs. SUBPOPULATIONS Subpopulations were detected in most of the data gained from the experiment. An explanation could be that some of the cells were not expressing the surface markers of interest. This indicates that the subpopulations observed were not DCs. The data obtained for CD14 was inconclusive, and therefore it was not possible to distinguish these cell types from each other. Therefore, in the trials containing both AD-MSCs and HEK-cells, the subpopulations could represent either one of those, monocytes or macrophages. The reason for this problem, in relation to the conditioned medium trials, was caused by the fact that this medium contained cells. RATIO In the experiment AD-MSCs and monocytes were cultured in a 1:20 ratio. Since no clear immunosuppression was observed and monocytes had differentiated into DCs, it could indicate that the ratio used might have been too low. This is seen on the graphs for the conditioned medium trial and cell-to-cell contact trial (Data 1, Data 2). A suppression seems to be present in both, but stronger in the one with the highest ratio. An earlier study from Jiang et al. show an immunosuppressive effect when BMMSCs and monocytes are co-cultured using transwell inserts with a ratio of 1:10. As the ratio was lowered to 1:20 and even 1:50, the monocytes became able to differentiate into DCs (Jiang et al., 2005). It would therefore be relevant to consider an alteration of the ratio in the experiment to find a more suitable ratio. SUMMARY The results of this experiment indicate that AD-MSCs have a decreased inhibitory effect on the differentiation of DCs compared to the results obtained by Ivanova-Todorova and colleagues. Based on the results obtained in this experiment, it is not possible to draw any conclusions. However, indications have been observed and noted. The results indicate AD-MSCs to be immunosuppressive, although not in a degree formerly observed in other studies. Also, the HEK-cells used seem to be more suppressive than AD-MSCs, and finally, the data indicates the transwell inserts themselves to have an inhibitory effect on the monocytes differentiation into DCs. FUTURE PERSPECTIVES Whether or not the AD-MSCs have an immunosuppressive ability was not properly clarified. There are still aspects that need to be investigated further. It would be ideal to correct the issues discussed in the source of interference chapter. Thereby the experiment might result in useful data, which potentially could show the immunosuppressive effect of the AD-MSCs, previously indicated by Page 25 of 41 Ivanova-Todorova et al. An essential correction to the experiment could be the ratio between monocytes and AD-MSCs. In the experiment by Jiang et al., they used a BM-MSC/monocyte ratio of 1:10 compared to the AD-MSC/monocyte ratio of 1:20 in this study. It could be of interest to conduct further studies, investigating the influence of different ratios. This also applies for ratio of conditioned medium in the trials regarding this. Another consideration for future perspectives is whether to use HEK-cells as control cells. Because of the lack of knowledge regarding HEK-cells’ effect on monocytes, it could be beneficial to try with cancer cells. Cancer cells have previously shown a tendency of immunosuppression (Pinzon-Charry, Maxwell, & López, 2005). In other words, the use of cancer cells would make it possible to compare their known immunosuppressive effect versus the presumable effect of the AD-MSCs. Remarkably the HEK-cells showed an immunosuppression. 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Tissue engineering, 7(2), 211-28. doi:10.1089/107632701300062859 Page 27 of 41 Title: Neurogenic Induction of Human Adipose Der Project period: 26th of April 2011 – 1st of June 2011 Project group: 402 Members: Cecilie Weiersøe Skovholm Danny Klindt Josephsen Heidi Kasten Malene Cording Christensen Marie Gerstrøm Supervisor: Meg Duroux Print run: 7 Pages: 42 Appendices: 4 Finished on the 1st of June 2011 The contents of this report is freely accessible, but re be done in agreement with the authors 1 APPENDIX Title: Neurogenic Induction of Human Adipose Der List of Contents: Project period: 26th of April 2011 – 1st of June 2011 Project group: 402 1 – CD-List Members: 2 – Protocol Cecilie Weiersøe Skovholm 3 – Catalog and Materials Danny Klindt Josephsen 4 – Cell Surface Markers 5 – APV Heidi Kasten Malene Cording Christensen Marie Gerstrøm Supervisor: Meg Duroux Print run: 7 Pages: 42 Appendices: 4 Finished on the 1st of June 2011 The contents of this report is freely accessible, but re be done in agreement with the authors 1 APPENDIX 1: CD LIST Title: Neurogenic Induction of Human Adipose Der Cluster of Differentiation CD1a CD11b CD14 CD19 CD34 CD45 CD73 CD80 CD83 CD86 CD90 CD105 Others IL-4 IL-10 IL-12 TNF-α TNF-γ Project period: 26th of April 2011 – 1st of June 2011 Projectbygroup: 402 These surface markers are especially expressed cells that are specialized for antigen presentation. Expressed on myoloide and NK-cells. It is known mediate leukocyte Members: adhesion. This CD is mainly expressed by macrophages and monocytes and to lesser extent dendritic cells. It is also able to recognize pathogen-associated molecular patterns. Cecilie Weiersøe Skovholm B-lymphocyte antigen - this CD can only be located B-lymphocytes. This CD can be found on the surface of hematopoietic cells. CD34 is equally important for adhesion and T-cell migration into lymph notes. Klindt Josephsen This CD is specific for mesenchymal stem Danny cells compared to hem poetic stem cells which do not possess CD45. Is found on T- and B-cell subsets. Heidi Kastencells and to a lesser Is especially found on the surface of mature dendritic extent on the B-cell and monocytes. CD80 is also important in regards to T-cell activation. Is found on the mature dendritic cell. ButMalene also on B-cells and langerhans Cording Christensen cells. Is found on the mature dendrictic cell, monocytes and active b-cells. Marie Gerstrøm Supervisor: Meg Duroux Printactivation run: 7 by IL-4, Th2 cells Is a cytokine that activates naive t-cells. Upon subsequently produce additional IL-4. ThePages: cell that 42initially produces IL-4 has not been lidentified. It has many biological roles, including the Appendices: 4 stimulation of activated B-cell and T-cell proliferation, and the differentiation of CD4+ T-cells into Th2 cells. It is a key regulator Finished on the 1st of in June 2011 humoral and adaptive immunity. IL-4 decreases the production of Th1 cells, macrophages, IFN-gamma, and dendritic cell IL-12. Further more IL-4 stimulates monocytes to differentiate into immature dendritic cells under the influence of GM-CSF. IL-10 inhibits the synthesis of proinflammatory cytokines such as TNF-alfa The contents of this report is freely accessible, but re and INF-gamma. There by inhibiting APC. be done in agreement with the authors IL-12 is involved in the maturation of a naive T-cell into a Th1/Th2-cell. This cytokin is primarily produced by macrophages, NK- and T-cells. It is proinflamatoric and induce apoptose. 1 TNF-γ is the most important mediator of acute inflammation in response to Gram-negative bacteria and other infectious microbes. It mediates the PGE-2 MHC-1 recruitment of polymorphonuclear leukocytes and monocytes to the site of infection. It’s been proposed for a longer time that it is involved in the Title: Neurogenic Induction of Human Adipose Der immunosupression during example given burns and other serverer Project period: 26th of April 2011 – 1st of June 2011 injuries. Their function is to display fragments of proteins within Project from group: 402the cell to T cells; healthy cells will be ignored, while cells containing foreign proteins will be attacked by the immune system. Members: Class I MHC molecules bind peptides generated mainly from degradation of cytosolic proteins by the proteasome. MHC-2 (HLA-DR Cecilie Weiersøe Skovholm Major Histocompability Complex (Called HLA in humans) is used to present antigens to the imunosystem. TCR Stands for T-celle-receptor. It is for important in Klindt the process of T-cell Danny Josephsen activition. GM-CSF is a cytokine that functions as a white blood cell growth factor. GM-CSF stimulates Monocytes whereupon theyKasten mature Heidi into macrophages and dendritic cells. GM-CSF Malene Cording Christensen Marie Gerstrøm Supervisor: Meg Duroux Print run: 7 Pages: 42 Appendices: 4 Finished on the 1st of June 2011 The contents of this report is freely accessible, but re be done in agreement with the authors 1 Title: Neurogenic Induction of Human Adipose Der Project period: 26th of April 2011 – 1st of June 2011 APPENDIX 2: PROTOCOL Project group: 402 DYRKNING AF HUMANE DC VED ADHÆRENS Members: (GRUPPE III: CO-KULTUR I TRANSWELL INSERTS) Cecilie Weiersøe Skovholm KORT OVERSIGT OVER FORSØGETS OPSÆTNING: Dag 0 Oprensning af PBMC fra buffycoat Danny Klindt Josephsen Monocyt oprensning ved adhærens Afvask af lymfocytter Heidi Kasten Tilsætning af KM10 medium + cytokiner Dag 1 Afvask af lymfocytter Malene Cording Christensen Tilsætning af KM10 medium + cytokiner Marie Gerstrøm Tilsætning af stamceller og HEK celler i Transwell inserts Dag 3 Tilsætning af KM10 medium + cytokiner Dag 5 Tilsætning af KM10 medium + cytokiner Dag 6 Modning Dag 7 Høst af celler + flowcytometri Supervisor: Meg Duroux Print run: 7 Pages: 42 Appendices: 4 Finished on the 1st of June 2011 The contents of this report is freely accessible, but re be done in agreement with the authors 1 MATERIALER: Title: Neurogenic Induction of Human Adipose Der Project period: 26th of April 2011 – 1st of June 2011 Kemikalier Plast Buffycoat group: 402 50ml TPP Project rør 0.9% NaCl (sterilt) 15ml TPP rør Lymfoprep (sterilt) Sterile engangs-plast pipetter PBS pH 7.4 + 1mM EDTA Celledyrknings 6-brøndsplader Members: FACS rør Cecilie Weiersøe Skovholm Methylviolet-eddikesyre Sterilfiltre Trypan blåt 0,4 % Sprøjte Danny Klindt Josephsen RPMI 1640 (- glutamin) Lang kanyle L-Glutamin , stock 200mM Heidi Kasten Penicillin/Streptomycin, stock Føtalt kalveserum (varmeinaktiveret ved 56°C) GM-CSF, stock: 100μg/ml (50μl aliquot) Malene Cording Christensen Marie Gerstrøm IL-4, stock: 100μg/ml (10/20μl aliquot) LPS, stock: 10μg/ml Supervisor: Meg Duroux PBS + 0,5% BSA + 0,01% natriumazid Print run: 7 PBS + 1% formaldehyd Pages: 42 Appendices: 4 Finished on the 1st of June 2011 The contents of this report is freely accessible, but re be done in agreement with the authors 1 FØLGENDE LAVES INDEN FORSØG PÅBEGYNDES Title: Neurogenic Induction of Human Adipose Der KM10 medium med 10% føtalt kalveserum (FCS) Project period: 26th of April 2011 – 1st of June 2011 Fremstilles af Project group: 402 RPMI 1640 Members: 2 mM Glutamin (tilsættes ud fra stockopløsning på 200mM) 1% Penicillin/Streptomycin (af en stockopløsning på P:10000U/ml og S:10000µg/ml) 10% FCS (varmeinaktiveret ved 56°C) Cecilie Weiersøe Skovholm - Mediet steril-filtreres inden brug og holdes sterilt. Hældes på 50ml rør, idet det holder sig bedst i disse rør (O2-mætningen) Danny Klindt Josephsen PBS + 1mM EDTA -Steril-filtreres inden brug og holdes sterilt Heidi Kasten NaCl 0.9% -Steril-filtreres inden brug og holdes sterilt Malene Cording Christensen PBS + 0,5% BSA + 0,01% sodium azid -Steril-filtreres inden brug (pga. flowcytometer kørsel) Marie Gerstrøm Supervisor: Meg Duroux Print run: 7 Pages: 42 Appendices: 4 Finished on the 1st of June 2011 The contents of this report is freely accessible, but re be done in agreement with the authors 1 DAG 0 Oprensing af PBMC fra buffycoat Title: Neurogenic Induction of Human Adipose Der 1. Fortynd buffycoat 1:4 i 0.9% NaCl. Project period: 26th of April 2011 – 1st of June 2011 - Der bruges ca. ___20___ml buffycoat Project group: 402 2. Fordel det fortyndede buffycoat på 50ml TPP rør (ca.15-20ml pr rør) og lejr FORSIGTIGT Lymfoprep under buffycoated med en lang kanyle. 3. Centrifuger cellerne i 20min, 180xg, 18-20oC, bremse 0. Members: 4. Sug FORSIGTIGT ca. 7.8 ml supernat fra med en lang pipette. 5. Centrifuger cellerne i 20min, 380xg, 18-20oC. bremse 0. 6. Høst interfasen med en engang plast-pipette, og saml to Cecilie interfaser i et 50ml TPP rør indeholdende 10-15ml kold Weiersøe Skovholm PBS+1mM EDTA. Fyld op med kold PBS+1mM EDTA til 25ml. Danny Klindt Josephsen 7. Vask cellerne 3 gange i kold PBS+1mM EDTA- efter vask to pooles alle cellerne i ét 15ml TPP rør. Vask: 1. 300xg, 4oC, 10min, bremse 0 2. 300xg, 4oC, 10min, bremse 2 Kasten Heidi o 3. 200xg, 4 C, 10 min, bremse 2 8. Efter 3. vask resuspender cellerne i KM10 medium. - Der resuspenderes i ____3____ml Malene Cording Christensen 9. Tæl cellerne i methylviolet (90μl methylviolet + 10μl celler) (Dette gøres ved at overføre 10μl celler fortyndet i methylviolet på et tællekammer, og dernæst tælles celler indtil der er talt min. 100 celler (se figur) og cellekoncentrationen udregnes) Marie Gerstrøm Supervisor: Meg Duroux Print run: 7 Pages: 42 Appendices: 4 Finished on the 1st of June 2011 The contents of this report is freely accessible, but re be done in agreement with the authors 1 Talt antal celler= _____350______ Celletal (C)= antal talte celler * fortyndingen af celler*104 / antal kamre talt Title: Neurogenic Induction of Human Adipose Der 350 celler ⦁10 mL ⦁ 10^4 𝐶= 1 ↔ Project period: 26th of April 2011 – 1st of June 2011 Project group: 402 𝐶 = 35⦁106 𝑐𝑒𝑙𝑙𝑒𝑟/𝑚𝐿 Indstil cellerne på 3,4x106 celler/ml i KM10 medium Members: Oprensning af monocytter ved adhærens 1. Udså i hver brønd i en 6-brøndsbakke 3,4x106 celler, dvs. 1 ml cellesuspension. 2. Tilsæt yderligere 2 ml KM10 medie pr. brønd. Cecilie Weiersøe Skovholm 3. Sæt bakken i CO2-inkubator i 3 timer, hvorved monocytterne vil adhærere til bunden af brøndene. 4. Efter 3 timer sug supernatanten fra (indeholdende non-adhærente celler), og skyl Danny Klindt Josephsen efterfølgende hver brønd 2 gange med ca. 1ml varmt cytokinfrit KM10 medium. Gør dette ved at holde bakken skrå, så mediet blot løber ned over bundende af brøndene (gentages 2-3 gange med samme medium). Gentag proceduren fra den Heidi Kasten modsatte af bakken med nyt skyllemedium (gentages 2-3 gange med samme medium) 5. PBMC’er indeholder ca. 15% monocytter, resten adhærerer ikke og skylles derfor Malene Cording Christensen fra. Tilsæt KM10 medium med cytokiner (se nedenfor) Tilsætning af KM10 medium og cytokiner til adhærente celler Marie Gerstrøm 6. Optø og slyng cytokinerne (GM-CSF + IL-4). Cytokinerne antages for friske i op til 5 o dage ved 4 C efter optøning. 7. Tilsæt 3 ml KM10 medium med cytokiner til hver brønd. Tilsæt følgende mængde Supervisor: Meg Duroux cytokiner til mediet: - GM-CSF: slut-koncentration 100ng/ml Print run: 7 - IL-4: slut-koncentration 20ng/ml Pages: 42 KM10: ____3_____ml Appendices: 4 GM-CSF: ____3_____μl Finished on the 1st of June 2011 IL-4: ____0,6______μl 8. Inkuber cellerne i 37oC CO2-inkubator 16-18 timer. The contents of this report is freely accessible, but re be done in agreement with the authors 1 DAG 1 Afvask af lymfocyter + tilsætning af stamceller og HEK celler i Transwell inserts + cytokiner 9. Efter ca. 16-18 timers inkubation, sug supernatanten fra brøndende og skyl Title: medium Neurogenic Inductioni of Human Adipose Der brøndene 2 gange med ca. 1ml varmt cytokinfrit KM10 som beskrevet punkt 4. Project period: 26th of April 2011 – 1st of June 2011 10. Der tilsættes 1,5 ml KM10 medium pr. brønd med cytokiner til alle 6 brønde (NB db. Project group: 402 konc. i forhold til nedenstående koncentrationer). Indsæt Transwell inserts med stamceller i 1,5 ml KM10 (ca. 5x105celler) til brønde 1 + 2, og transwell inserts med HEK celler i 1,5 ml KM10 (ca. 5x105celler) til brønde 3 + 4. Til brønd 5 + 6 tilsættes Members: Transwells med 1,5 ml KM10 medium. Slutvolumen i alle brønde er så 3 ml, slutkonc. af cytokiner i alle brønde er følgende: - GM-CSF: 100ng/ml Cecilie Weiersøe Skovholm - IL-4: 20ng/ml KM10 indeholdende celler: ___1,5______ml Danny Klindt Josephsen GM-CSF: ____3_____μl IL-4: ____0,6_____μl Heidi Kasten Malene Cording Christensen Marie Gerstrøm Supervisor: Meg Duroux o 11. Stil cellerne i 37 C CO2-inkubator. Print run: 7 DAG 3 Tilsætning af medium + cytokiner Pages: 42 Appendices: 4 Finished on the 1st of June 2011 12. Tilsæt 0.5ml frisk cytokin-indeholdigt KM10 medium til hver brønd. - GM-CSF: slut-koncentration 100ng/ml - IL-4: slut-koncentration 20ng/ml KM10: _____0,5____ml GM-CSF: ____0,5_____μl The contents of this report is freely accessible, but re be done in agreement with the authors IL-4: ____0,1_____μl 13. Stil cellerne i 37oC CO2-inkubator 1 DAG 5 Tilsætning af medium + cytokiner Title: Neurogenic Induction of Human Adipose Der 14. Tilsæt 1 ml cytokin-holdigt KM10 medium til hver brønd, Project period: 26th of April 2011 – 1st of June 2011 - GM-CSF: slut-koncentration 100ng/ml IL-4: slut-koncentration 20ng/ml KM10: _____1____ml Project group: 402 Members: GM-CSF: ____1_____μl IL-4: ____0,2_____μl Cecilie Weiersøe Skovholm o 15. Stil cellerne i 37 C CO2-inkubator. DAG 6 Danny Klindt Josephsen Modning Heidi Kasten 10ng/ml, kl 09.00 16. Til alle brønde tilsæt LPS (modningstimulus) i slut-koncentration Medium: _____4,5____ml/brønd LPS stock: _____4,5____µl/brønd Malene Cording Christensen 17. Stil cellerne i 37oC CO2-inkubator DAG 7 Marie Gerstrøm Høst af celler + flowcytometri Supervisor: Meg Duroux 18. Kig på cellerne i mikroskopet, noter hvad der observeres, og tag billeder Print run: 7 19. Høst alle celler ved at suge væsken fra med pipette. For at høste de ”semiPages: 42 adhærente” celler, spul hver brønd flere gange med koldt RPMI 1640. (Dette kan Appendices: tage op til 5min pr brønd). Der tages billeder af hver brønd efter4høst, for at se hvor meget der er høstet. Finished on the 1st of June 2011 20. Centrifuger cellerne i 10min, 300xg, 22oC, bremse 2. 21. Resuspender AD-MSC cellerne i _270 __μl PBS + 0.5% BSA + 0,01% sodium azid. 22. Resuspender HEK cellerne i ___370____ μl PBS + 0.5% BSA + 0,01% sodium azid. The contents of this report is freely accessible, but re be done in agreement with the authors 23. Resuspender medieceller i _310 _ μl PBS + 0.5% BSA + 0,01% sodium azid. 24. Tæl cellerne i trypanblåt (fortyndes 1:2) 1 AD-MSC Celletal (1 + 2): __6,1 *105celler/mL _____ HEK Celletal (3 + 4): ____6,75 *105celler/mL___ Medie Celletal (5 + 6): __6,1 *105celler/mL _____ Title: Neurogenic Induction of Human Adipose Der 6 25. Indstil cellerne på 2-10 x10 celler/ml i PBS +0.1% BSA. Hvis der er for få celler, indstil Project period: 26th6 of April 2011 – 1st of June 2011 så det passer med det antal rør der skal analyseres, dog mindst 0.1x10 celler pr Project group: 402 FACS rør. 26. Gør 6 FACS rør klar med følgende antistoffer samt isotype kontroller for de Members: forskellige markører (se skema): Rør 1 Rør 2 Cecilie Weiersøe Skovholm CD80-PE-Cy5 20μl CD80-PE-Cy5 isotype HLA-DR-APCCy7 5μl HLA-DR5μl Danny Klindt APC-Cy7 isotype CD86-PE 20μl CD86-PE 20μl Heidi Kasten isotype CD83-APC 20μl CD83-APC 20μl isotype Malene Cording Christensen CD14-PE-Cy7 5μl CD14-PE-Cy7 isotype 20μl Josephsen 5μl Marie Gerstrøm Supervisor: Meg Duroux 1. Overfør 100μl cellesuspension fra hver brønd til ét FACS rør indeholdende Print run: 7 antistoffer og til ét rør indeholdende isotype kontroller. 2. Inkuber rørene ½ time ved 4oC under sølvpapir Pages: 42 Appendices: 4 3. Tilsæt 2 ml PBS + 0,5% BSA + 0,01% sodium azid pr. rør Finished on the 1st of June 2011 4. Centrifuger rørene i 5min, 300xg, 20oC, bremse 2 5. Hæld supernatanten fra og resuspender pellet i 2 ml PBS + 0,5% BSA + 0,01% sodium azid pr. rør 6. Centrifuger rørene i 5min, 300xg, 20oC, bremse 2The contents of this report is freely accessible, but re be done in agreement with the authors 7. Hæld supernatanten fra og resuspender pellet i300μl PBS + 1%formaldehyd og vortex (NB! Formaldehyd er kræftfremkaldende, stå i stinkskab under tilførslen, og luk FACS rør med prop). Hvis cellerne skal analyseres samme dage, kan pellet resuspenderes i300μl PBS. 1 8. Analysér på flowcytometer eller gem ved 4oC indtil analyse (inden 7 dage) Title: Neurogenic Induction of Human Adipose Der Project period: 26th of April 2011 – 1st of June 2011 APPENDIX 3: CATALOG ANDProject MATERIALS group: 402 Produkt RPMI 1640 Lymfoprep PBS EDTA L-Glutamin Penicillin/Streptomycin GM-CSF IL-4 LPS BSA Transwell Trypan Blå CD80-PE-Cy5 HLA-DR-APC-Cy7 CD86-PE CD83-APC CD14-PE-Cy7 NaCl Firma Lifetechnologies Medinor/Axis-Shield Lifetechnologies Sigma-Aldrich Perprotech Sigma-Alrich Sigma-Aldrich Sifma Beckton Dickinson Beckton Dickinson Beckton Dickinson Beckton Dickinson Beckton Dickinson Sigma Members: Katalognummer 31870-074 1114545 Cecilie70011-051 Weiersøe Skovholm Danny P4333 Klindt Josephsen 200-04 Heidi Kasten A2153 CLS3412-24EA 93595 Malene559370 Cording Christensen 335831 555658 551073 Marie Gerstrøm 557742 S9888 Supervisor: Meg Duroux Print run: 7 Pages: 42 Appendices: 4 Finished on the 1st of June 2011 The contents of this report is freely accessible, but re be done in agreement with the authors 1 APPENDIX 4: SURFACE MARKERS Title: Neurogenic Induction of Human Adipose Der Project period: 26th of April 2011 – 1st of June 2011 Project group: 402 Members: Cecilie Weiersøe Skovholm Danny Klindt Josephsen Heidi Kasten Malene Cording Christensen Marie Gerstrøm Supervisor: Meg Duroux Print run: 7 Pages: 42 Appendices: 4 Finished on the 1st of June 2011 The contents of this report is freely accessible, but re be done in agreement with the authors 1