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COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD Centro di Ricerca E.Menni, Fondazione Poliambulanza, Brescia, Italy 20-27 August, 2010

COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

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Page 1: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

COMPUTATIONAL CHALLENGES in

REGENERATIVE MEDICINE

CCIS, Sao Paolo, Brazil

Ornella Parolini, PhD

Centro di Ricerca E.Menni, Fondazione Poliambulanza, Brescia, Italy

20-27 August, 2010

Page 2: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

Talking in front of experts in

computation…..

……

I believe I will find many collaborations

for solving the problems of a biologist….

Page 3: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

Introduction on regenerative medicine tissue

engineering and stem cells

And needs for computational applications

Why an interest in cells derived from human

term placenta?

In vitro studies using placenta derived cells

In vivo studies using placenta derived cells

Page 4: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

1954: FIRST ORGAN TRANSPLANTATION

TODAY, Increasing problem:

Tissue and Organ shortage and rejection

Page 5: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm
Page 6: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

The end goal:

To create products that improve tissue

function or heal tissue defects. Replace

diseased or damaged tissue

Because……

- Donor tissues and organs are in short supply

- We want to minimize immune system response

by using our own cells or novel ways to protect

transplant.

Page 7: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

Regenerate, repair and replace

• Regenerate

– Identify the cues that allow for regeneration, i.e. transplant cells that could differentiate

• Repair

– Stimulate the tissue at a cell or molecular level, even at level of DNA, to repair itself.

• Replace

– A biological substitute is created in the lab that can be implanted to replace the tissue or organ of interest

Page 8: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

Cell-based therapies

Aimed at certain diseases

Uses mostly only cells and no materials

Type I diabetes transplant of new pancreas cells

Adult stem cells for heart disease

Neuronal transplants for Parkinson’s disease

Bone marrow transplant for various blood cancers

Muscular dystrophy

Page 9: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

Tissue Engineering

Using well designed scaffolds and optimized cell growth, we can create tissues such as: Skin

Bone

Cartilage

Intestine

These have been successfully engineered to some extent

Page 10: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

More complex organs

Not very far in development

Complex metabolic functions

Require multiple types of cells and

intricate scaffolds

Liver

Heart

Lung

Kidney

Page 11: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

Tissue-engineered products contain

mixtures of the following:

Biological components--cells

Can be genetically modified to behave a

specific way

Chemicals

that tell the tissue to regenerate

A non-biological component

Polymer scaffold

Fibers, plastic, other natural components

Gels

Page 12: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

Scaffolds Various textures and materials

Encourage cells to grow

Allow nutrients to permeate

Won’t harm the patient

Page 13: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

Transplants that match the patient

- Isolate cells from patient

- Identify a matched compatible donor

- Grow in culture with or without

biomaterials

- Give appropriate “factors” to make

cells do what is needed

- Replace into patient

Page 14: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

Multidisciplinary Nature of

Tissue Engineering/Regenerative Medicine

Construct for

transplantation

Cellular biology Material

science

Surgery

EngineeringPharmacology

COMPUTATION CHALLENGES

Page 15: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

So which are the challenges:…

Page 16: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm
Page 17: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

Need to:

-monitor the course of experimental

procedures;

-gather, smooth, and record data and signals;

-provide an effective medium though which

data can be analyzed, visualized,

communicated, and disseminated widely by

means of databases connected to electronic

networks.

Page 18: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

Digital procedures that will somehow monitor,

collate, and manage the explosion of online databases

across genomics, proteomics, organisms, cell lines, and

tissue projects, allowing researchers to identify and

extract data essential to targeted needs.

A related challenge is the need for data mining

procedures able to “drill down” into the layers of

catalogued information and extract key discoveries

otherwise buried among terabytes of compiled results.

Page 19: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

Microarray technologies22 march2010

Page 20: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

Microarray technologies22 march2010

Page 21: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm
Page 22: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

Biostatistics and bioinformatics

Genome variability

Page 23: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

Computational Modeling

• Structural and functional modeling of

biological processes

• Computational and experimental frameworks

for real-time mapping of biological processes

• i.e. In tissue engineering the ability to apply accurate

modelling and new cell simulation techniques can

provide information and answer key questions

regarding cell, tissue, and ultimately organ behavior.

Page 24: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

Cell biology

Visualization of cells (Flow Cytometry, image

analysis)

Analysis of cells and tissue ( follow cell cyle,

cell divisions, etc..)

Molecular biology

Gene expression analysis (DNA microarray)

Protein expression

Biochemical analysis

Signalling Pathways

Page 25: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

Let me tell something about

stem cells…..

Page 26: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm
Page 27: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm
Page 28: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm
Page 29: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

HOW IS CELL HOMEOSTASIS

MAINTAINED?

STEM CELLS WITHIN

THE DIFFERENT TISSUES

Page 30: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

WHAT ARE THE UNIQUE PROPERTIES

OF ALL STEM CELLS

• Stem cells differ from other kinds of cells in the body.

• All stem cells—regardless of their source—have three general properties:

– they are capable of dividing and renewing themselves for long periods;

– they are unspecialized;

– they can give rise to specialized cell types.

Centro di Ricerca E. Menni

Page 31: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm
Page 32: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm
Page 33: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm
Page 34: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

Amnion Smooth chorion

False

knot

Fetal surface

of placenta

Umbilical cord

Centro di Ricerca E. Menni

Page 35: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

Why an interest in human

placenta?

• Identify stem cells for cell therapy

approaches:

– Stem cell potential

– No transplant rejection

• Placenta may combine these two essential

features on the basis of:

– Embryological origin

– Immunological characteristics

Centro di Ricerca E. Menni

Page 36: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

Embryological Origin

Page 37: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

Fetal membranes

Umbilical cord

Uterus wall

trophoblast

FETAL MATERNAL TOLERANCE:

Pregnancy is a unique

event in which a

genetically and

immunologically

foreign fetus

survives to full term

without rejection by

the mother's immune

system.

Page 38: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

In vitro studies

Page 39: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

Fetal sideMaternal side

Umbilical cord

chorionamnion

trophoblast

Umbilical

cord

Amniotic derived cells isolation

Page 40: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

Amnion

Epithelium

Basal Membrane

Compact

Layer

Cellular

Layer

Spongy

Layer

Amniotic Epithelial CellAmniotic Mesenchymal Cell400 x EE

200 x EE

Amnion

ChorionChorionic

Mesoderm

Chorionic

Trofoblast

Chorion mesenchymal cell

Chorion Trofoblastic cell nuclei

Reflected fetal membranes

AmnionChorion

Page 41: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

AEC

AMSC

Amnion

Enzymes:

Dispase

Collagenase + Dnase

Trypsin

AMSC

AEC

AEC= amniotic ephitelial cells

AMSC= amniotic mesenchymal stromal cells

Amniotic membrane enzymatic digestion

Page 42: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

ADIPOGENIC

LINEAGE

(oil red staining)

CHONDROGENIC

LINEAGE

(toluidine blue

staining)

AMC CMC control

Differentiation Potential of AMC and CMC

OSTEOGENIC

LINEAGE

(alizarin red staining)

Soncini M. et al J TERM 2007

Page 43: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

IMMUNOMODULATORY FEATURES OF

AMNIOTIC DERIVED CELLS

Page 44: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

0

5000

10000

15000

20000

R R+S* R+A*

cpm

***A

0

5000

10000

15000

a Pig+hC*(CD45-Gly

-)Pig+hPBMC* Pig+hA*Pig

** **

cpm

**

pPBMC pPBMC

+

hPBMC*

pPBMC

+

hA*

pPBMC

+

hC(CD45-GlyA-)*

**B

R: PBMNC from subject A

S*: PBMNC from subject B after irradiation

A: Amnion derived cells

Page 45: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

AMSC effect on lymphocyte proliferation

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Contact Transwell

cpm no AMC

plus AMC

T cells + PBMC*

AMSC inihibit lymphocyte proliferation induced

in a mixed lymphocyte reaction

No AMSC

+AMSC

Page 46: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

PBMC+ allo PBMC* PBMC+ allo PBMC* + AMSC

AMSC effect on lymphocyte proliferation

Page 47: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

In vivo studies:

Transplant and engraftment

potential of fetal membrane cells

Page 48: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

Murine model of lung fibrosis induced by

intra-tracheal bleomycin instillation

Intratracheal instillation of bleomycin induces:

• LUNG INJURY - alveolar epithelial cell injury

• INFLAMMATION - migration of inflammatory

cells

- FIBROSIS - fibroblast proliferation and extensive

accumulation of collagen

Page 49: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

INFLAMMATION

day 3 day 7 day 14

a1 a2 a350 mm 50 mm 50 mm

b1 b2 b350 mm 50 mm 50 mm

FIBROSIS

Centro di Ricerca E. MenniCargnoni et al, Cell Transplantation 2009

BLEOMYCIN

Page 50: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

XENO-TRANSPLANTATION

ALLO-TRANSPLANTATION

BALB/c mice C57BL/6 mice

GFP miceC57BL/6 mice

C57BL/6 mice

Page 51: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

day 3 day 7 day 14

Ble

om

yci

nB

leom

yci

n +

all

o-

tra

nsp

lan

tati

on

FIBROSIS

Page 52: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

a1 a2

Allo-transplantation Xeno-transplantation

Intr

a-t

rach

eal

del

iver

y

Intr

a-p

erit

on

eal

del

iver

y

a3 a4

Centro di Ricerca E. MenniCargnoni et al, Cell Transplantation 2009

Page 53: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

INFLAMMATION SCORE

• Inflammation severity

- type of inflammatory cells

- number of inflammatory cells

- edema presence

•Inflammation extent

- represents the lung area involved in the process

FIBROSIS SCORE

• Fibrosis severity

- Fibroblast proliferation

- Collagen deposition

• Fibrosis extent

- represents the lung area involved in the process

Centro di Ricerca E. Menni

Page 54: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

day 14

Infl

am

mati

on

sev

eri

ty

(sc

ore

un

its

)

Infla

mm

atio

n e

xte

nt

(% o

f are

a in

vo

lve

d)

0

1

2

3

4

5

6

7

0

25

50

75

100

n=19 n=8

n=3

n=3

n=7

“Bleo” “Bleo+Cells” “Cells”

IP route IT route IP route IT route

day 14

*

*Fib

rosis

sev

eri

ty

(sc

ore

un

its

)

Fib

rosis

exte

nt

(% o

f are

a in

vo

lve

d)

0

1

2

3

4

5

0

25

50

75

100

n=19

n=8

n=3 n=3

n=7

**

Allo-transplantation

Centro di Ricerca E. MenniCargnoni et al, Cell Transplantation 2009

Page 55: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

Xeno-transplantation

day 14

Infl

am

mati

on

sev

eri

ty

(sc

ore

un

its

)

Infla

mm

atio

n e

xte

nt

(% o

f are

a in

vo

lve

d)

0

1

2

3

4

5

6

7

0

25

50

75

100

n=19

n=8

n=4

n=3

n=7

“Bleo” “Bleo+Cells” “Cells”

IP route IT route IP route IT route

day 14 *

0

1

2

3

4

5

0

25

50

75

100

Fib

rosis

sev

eri

ty

(sc

ore

un

its

)

Fib

rosis

exte

nt

(% o

f are

a in

vo

lve

d)

n=19

n=8

n=4 n=3

n=7

**

Centro di Ricerca E. Menni Cargnoni et al, Cell Transplantation 2009

Page 56: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

Pulmonary fibrosis

Bleomycin-induced lung fibrosis in miceDISEASE MODEL:

Xenogeneic cell transplantTREATMENT:

Allogeneic cell transplant

TREATMENT

ROUTE:

Systemic delivery= IP injection

Local delivery= IT injection

Placenta-derived cell transplantation

significantly reduced bleomycin-

induced lung fibrosis

Page 57: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

Effects of placenta-derived cells and

amniotic membrane on cardiac injury

induced by coronary ligation in rats

Reduction of post-ischemic cardiac dimensional alterations

and improvement of myocardial function

for up to at least 60 days after ischemia induction.

Page 58: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

Experimental design

Time (days):0 7 30 60 90

Isch

emia

induct

ion

Isch

emia

induct

ion +

amnio

n a

ppli

cati

on

Ech

oca

rdio

gra

phy

Ech

oca

rdio

gra

phy

Ech

oca

rdio

gra

phy

Ech

oca

rdio

gra

phy

Sac

rifi

ce

EXPERIMENTAL GROUPS:

Failure Group (n=14)

Amnion Group (n=16)

Control Group (n=8)

Sel

ecti

on

of

rats

sho

win

g i

nfa

rct

size

>1

0%

Sca

r si

ze

Page 59: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

A lateral thoracotomy was performed at level of

4th-5th intercostal space

Page 60: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

Heart was exteriorised from the thorax

Page 61: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

A 5-0 silk suture was passed under the LAD artery

Page 62: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

The heart was replaced into the thoracic cavity

Page 63: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

The suture was tightened around the LAD coronary

Page 64: COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE · COMPUTATIONAL CHALLENGES in REGENERATIVE MEDICINE CCIS, Sao Paolo, Brazil Ornella Parolini, PhD ... Amnion Chorion Chorionic Mesoderm

The ischaemic cardiac area was whitening

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10. Thorax closure, in case of ischaemic untreated rats

In case of ischaemic treated rats

Amniotic membrane application

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The membrane was softly applied on the left ventricle with the

mesenchymal side in contact with epicardial surface

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Echocardiographic analysis

Healthy rat heart

Ischemic rat heart

Ischemic rat heart + amnion

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Cardiac dimensions: left ventricle diameter

6

7

8

9

10

11

p>0.05

Systolic diameter (mm)

4

5

6

7

8

9

p<0.05

Diastolic diameter (mm)

9060307Days

9060307Days

Control Group Ischemia Group Ischemia+amnion Group

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Cardiac dimensions: left ventricle wall thickness

Systolic LV wall thickness (mm) Diastolic LV wall thickness (mm)

9060307Days

9060307Days

p<0.050.0

0.5

1.0

1.5

2.0

2.5

3.0

0.0

0.5

1.0

1.5

2.0

2.5

3.0

p<0.05

Control Group Ischemia Group Ischemia+amnion Group

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Cardiac function parameters

Fractional shortening (%)

9060307Days

Control Group Ischemia Group Ischemia+amnion Group

Ejection fraction (%)

20

25

30

35

40

p<0.01

P<0.01

9060307Days

40

50

60

70

80

p<0.01

P<0.01

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Myocardial ischemia

Myocardial ischemia induced

by coronary ligation in ratsDISEASE MODEL:

TREATMENT: Amniotic membrane application

Amniotic membrane application

significantly improved cardiac

functions in ischemic rat hearts for

at least 2 months post-injury

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Which other models of fibrosis….

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Bile duct ligation rat model

LIVER

Common

Bile Duct

Intestine

Bile Secretion

Ligation

Fibrotic LIVER

Normal Liver BDL model

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Common Bile duct

Exposed

Bile duct

Double LigatedBile duct

Cut between ligatures

Surgery: Assessing BDL Model

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Study Groups

Amniotic Membrane

Sacrifice:

2,4,6 weeks

Sacrifice:

2,4,6 weeks

BDL Group BDL+AM Group

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AM fragment was

inserted under the

liver lobes

The extremities

were raised…

…and fixed

to cover the

whole liver surface

Surgery: AM application

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Evaluation of Fibrosis

Amniotic Membrane

HISTOLOGY HISTOLOGY

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CV

CV

PT

SCORE: 0 SCORE: 1

SCORE: 3 SCORE: 4

A B

B C

MASSON STAIN: Knodel* scoring patterns for liver fibrosis

Periportal area

is

morphologically

normal

Portal tract is

enlarged by

the accumulation

of collagen

Collagen infiltration

forms

bridging septa

between

portal tracts

Collagen deposition

infiltrates lobular

parenchyma

Sample

Fields

Portal Tracts

Central Vein

CV

PT

CV

PT

PT

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Results: Knodel semiquantitative fibrosis scroing system

UNPUBLISHED DATA

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Liver fibrosis

liver fibrosis induced by bile

duct ligation (BDL) in ratsDISEASE MODEL:

TREATMENT: Amniotic membrane application

Amniotic membrane application

significantly reduced liver

fibrosis induced in rats by BDL

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Steps toward clinical application of

placenta : “in vivo” experiments

Pulmonary fibrosis

Myocardial ischemia

Liver fibrosis

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Fetal membrane-derived cells

Which treatment was applied in

these disease models?

Pulmonary fibrosis

Myocardial ischemia

Liver fibrosis

Amniotic membrane

application

Amniotic membrane

application

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Placenta-derived cell

transplantation significantly

reduced bleomycin-induced

lung fibrosis

What results were obtained?

Pulmonary fibrosis

Myocardial ischemia

Liver fibrosis

Amniotic membrane application

significantly improved cardiac

functions in ischemic rat hearts

for at least 2 months post-injury

Amniotic membrane application

significantly reduced liver

fibrosis induced in rats by BDL

(Cargnoni A. et al. Cell Transplant; 2009)

(Cargnoni A. et al. Cell Transplant; 2009)

(Sant`Anna Barros L. et al. submitted)

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Microarray technologies22 march2010

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Database for the precise description of the experimental plan and the correlation between the parameters in the set up and the results

Network of databases to compare results: using different stem cells for the same clinical application.... and different application with the same cell type.

Image analysis system to quantify different type and properties of cells

Evaluation systems that are not only analysing a single slide/section, but the entire organ

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REGENERATION versus REPAIR

In vivo studies demonstrate mainly the

ability of amniotic cells/amniotic membrane to modify the environment and exert paracrine effects that improve local surrounding tissue favouring repair from the host cells

Centro di Ricerca E. Menni

NEW WAY TO CONSIDER CELL THERAPY?

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Marta Magatti Luciana Barros Sant`Anna

Silvia De Munari

Patrizia Bonassi

Elsa Vertua

Daniele Rossi

Anna Cargnoni

Lorenzo Ressel

Emanuele Ricci

Animal Facilities: Istituto Zooprofilattico Brescia

Università di Milano Dept. Veterinaria

CENTRO DI RICERCA E.MENNI

FONDAZIONE POLIAMBULANZA