EP2964237A2 - Verfahren zur bewahrung der population von therapeutischen zellen an der behandlungsstelle einer person für eine zelltherapie - Google Patents

Verfahren zur bewahrung der population von therapeutischen zellen an der behandlungsstelle einer person für eine zelltherapie

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Publication number
EP2964237A2
EP2964237A2 EP14751247.9A EP14751247A EP2964237A2 EP 2964237 A2 EP2964237 A2 EP 2964237A2 EP 14751247 A EP14751247 A EP 14751247A EP 2964237 A2 EP2964237 A2 EP 2964237A2
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EP
European Patent Office
Prior art keywords
cells
stem cells
hyaluronic acid
therapeutic
kda
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP14751247.9A
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English (en)
French (fr)
Other versions
EP2964237A4 (de
Inventor
Patrick Ching-Ho HSIEH
Chia-Yun Lai
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
National Cheng Kung University NCKU
DCB USA LLC
Original Assignee
National Cheng Kung University NCKU
DCB USA LLC
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Application filed by National Cheng Kung University NCKU, DCB USA LLC filed Critical National Cheng Kung University NCKU
Publication of EP2964237A2 publication Critical patent/EP2964237A2/de
Publication of EP2964237A4 publication Critical patent/EP2964237A4/de
Withdrawn legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K35/00—Medicinal preparations containing materials or reaction products thereof with undetermined constitution
    • A61K35/12—Materials from mammals; Compositions comprising non-specified tissues or cells; Compositions comprising non-embryonic stem cells; Genetically modified cells
    • A61K35/48—Reproductive organs
    • A61K35/54—Ovaries; Ova; Ovules; Embryos; Foetal cells; Germ cells
    • A61K35/545—Embryonic stem cells; Pluripotent stem cells; Induced pluripotent stem cells; Uncharacterised stem cells
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/70—Carbohydrates; Sugars; Derivatives thereof
    • A61K31/715—Polysaccharides, i.e. having more than five saccharide radicals attached to each other by glycosidic linkages; Derivatives thereof, e.g. ethers, esters
    • A61K31/726—Glycosaminoglycans, i.e. mucopolysaccharides
    • A61K31/728—Hyaluronic acid
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K35/00—Medicinal preparations containing materials or reaction products thereof with undetermined constitution
    • A61K35/12—Materials from mammals; Compositions comprising non-specified tissues or cells; Compositions comprising non-embryonic stem cells; Genetically modified cells
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K35/00—Medicinal preparations containing materials or reaction products thereof with undetermined constitution
    • A61K35/12—Materials from mammals; Compositions comprising non-specified tissues or cells; Compositions comprising non-embryonic stem cells; Genetically modified cells
    • A61K35/28—Bone marrow; Haematopoietic stem cells; Mesenchymal stem cells of any origin, e.g. adipose-derived stem cells
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K35/00—Medicinal preparations containing materials or reaction products thereof with undetermined constitution
    • A61K35/12—Materials from mammals; Compositions comprising non-specified tissues or cells; Compositions comprising non-embryonic stem cells; Genetically modified cells
    • A61K35/32—Bones; Osteocytes; Osteoblasts; Tendons; Tenocytes; Teeth; Odontoblasts; Cartilage; Chondrocytes; Synovial membrane
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K35/00—Medicinal preparations containing materials or reaction products thereof with undetermined constitution
    • A61K35/12—Materials from mammals; Compositions comprising non-specified tissues or cells; Compositions comprising non-embryonic stem cells; Genetically modified cells
    • A61K35/34—Muscles; Smooth muscle cells; Heart; Cardiac stem cells; Myoblasts; Myocytes; Cardiomyocytes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K35/00—Medicinal preparations containing materials or reaction products thereof with undetermined constitution
    • A61K35/12—Materials from mammals; Compositions comprising non-specified tissues or cells; Compositions comprising non-embryonic stem cells; Genetically modified cells
    • A61K35/35—Fat tissue; Adipocytes; Stromal cells; Connective tissues
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K35/00—Medicinal preparations containing materials or reaction products thereof with undetermined constitution
    • A61K35/12—Materials from mammals; Compositions comprising non-specified tissues or cells; Compositions comprising non-embryonic stem cells; Genetically modified cells
    • A61K35/36—Skin; Hair; Nails; Sebaceous glands; Cerumen; Epidermis; Epithelial cells; Keratinocytes; Langerhans cells; Ectodermal cells
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K35/00—Medicinal preparations containing materials or reaction products thereof with undetermined constitution
    • A61K35/12—Materials from mammals; Compositions comprising non-specified tissues or cells; Compositions comprising non-embryonic stem cells; Genetically modified cells
    • A61K35/48—Reproductive organs
    • A61K35/50—Placenta; Placental stem cells; Amniotic fluid; Amnion; Amniotic stem cells
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K35/00—Medicinal preparations containing materials or reaction products thereof with undetermined constitution
    • A61K35/12—Materials from mammals; Compositions comprising non-specified tissues or cells; Compositions comprising non-embryonic stem cells; Genetically modified cells
    • A61K35/48—Reproductive organs
    • A61K35/51—Umbilical cord; Umbilical cord blood; Umbilical stem cells

Definitions

  • the present disclosure relates to cell therapies. More particularly, the disclosed invention relates to improving the therapeutic efficacy of cell therapies using at least one hyaluronan compound.
  • somatic cell therapy is the prevention, treatment, cure, diagnosis, or mitigation of diseases or injuries in humans by the administration of autologous, allogeneic or xenogeneic cells that have been manipulated or altered ex vivo.
  • said manipulation and alteration include the propagation, expansion, selection, and/or pharmacological treatment of the cells.
  • HEMACORD hematopoietic progenitor cell
  • the related art has attempted to address the a bove-identified issues by using biodegrada ble materials, with the goal of controlling the timespan of cell retention in vivo.
  • the in vivo duration of the biodegrada ble material should be sufficiently long for the cells to adhere to the surrounding microenvironment but not so long that the biodegrada ble material may result in undesira ble responses. Better therapeutic outcomes may thus be reached once the critical time point for cell adhesion and function is known.
  • the present disclosure is directed to a method for maintaining a population of therapeutic cells administered to a treatment site in a su bject for a period of time. In another aspect, the present disclosure is directed to a method for treating a subject in need of cell therapy.
  • the method comprises the steps of, administering a therapeutically-effective amount of therapeutic cells to the treatment site; and administering an effective amount of a biodegrada ble material comprising a hyaluronan compound to the treatment site.
  • the biodegrada ble material has an in vivo degradation profile similar to that of a hyaluronic acid having a molecular weight of 20 kDa to 2,000 kDa.
  • the therapeutic cells may be stem cells, induced pluripotent cells, functionally differentiated cells, recom binant cells, or a combination thereof.
  • stem cells includes but are not limited to, embryonic stem cells, hematopoietic stem cells, vascular stem cells, neural stem cells, mesenchymal stem cells, cardiac stem cells, adipose stem cells, muscular stem cells, dental stem cells, skeletal stem cells, cartilage stem cells, periosteal stem cells, mammary stem cells, uterus stem cells, endothelial stem cells, skin stem cells, placental stem cells, umbilical cord blood stem cells, yolk sac stem cells, and amniotic fluid stem cells.
  • Exemplary functionally differentiated cells include fibroblasts, chondrocytes, osteoblasts, osteocytes, adipocytes, epithelial cells, keratinocytes, retinal cells, dental cells, renal cells, pancreatic islet cells, hepatocytes, neuronal cells, immune cells, muscle cells, and blood cells.
  • the hyaluronan compound is any of the following compounds: hyaluronic acid, partial or total esters of hyaluronic acid, adipic dihydrazide-modified hyaluronan, amides of hyaluronan, crosslinked hyaluronic acid, hemiesters of succinic acid, heavy metal salts of hyaluronic acid, sulphated hyaluronic acid, N-sulphated hyaluronic acid, amine- modified hyaluronic acid, diamine-modified hyaluronic acid, and a composite of hyaluronic acid and silk.
  • the in vivo degradation profile of the biodegrada ble material is similar to that of a hyaluronic acid having a molecular weight of 50 kDa to 1,600 kDa; preferably, 200 kDa to 800 kDa.
  • the population of therapeutic cells at the treatment site is maintained for at least 7 days; preferably at least 14 days; and more preferably, at least 28 days.
  • the biodegradable material has an in vivo half-life of 4 hours to 28 days; alternatively, the in vivo half-life of the biodegradable material is 8 hours to 7 days, 12 hours to 5 days or 1-3 days after the administration.
  • the biodegradable material further comprises at least one biopolymer; examples of which include, but are not limited to, collagen, gelatin, alginate, chitosan, fibronectin, and fibrin glue.
  • the population of the therapeutic cells at the treatment site, at 3-10 days after the administration is substantially the same as or greater than the population of the therapeutic cells initially administered.
  • the therapeutic cells are administered prior to, concurrently with, or after the administration of the biodegradable material.
  • the therapeutic cells and the biodegradable material may be formulated as a single composition or in separate compositions.
  • the therapeutic cells and the biodegradable material are administered by direct application, catheter-assisted delivery, endoscope-assisted delivery, robotic-assisted delivery, device-assisted delivery, or imaging device-guided delivery, respectively or concomitantly.
  • the therapeutically-effective amount of the therapeutic cells is lxlO 4 to lxlO 8 cells/kg body weight of the subject. In these cases, or in other embodiments, the effective amount of the hyaluronan compound is 0.01 to 10 mg/kg body weight of the subject.
  • SA Alexa Fluor 700 streptavidin
  • hMSCs Ds-Red expressing human mesenchymal stem cells
  • Figure 3 provides images collected by in vivo imaging system (IVIS) using the corresponding filter sets for the Alexa Fluor 700 streptavidin (SA) and Ds-Red expressing hMSCs; the upper two IVIS images were collected before mixing SA and hMSCs and the lower two images were collected after mixing. Although not visible in these figures, the fluorescent signals were yellow to red and regions of interest (ROIs) were blue line-enclosed.
  • 570/620 the excitation/emission filter set for the hMSCs.
  • 675/720 the filter set for the Alexa Fluor 700 SA.
  • Figure 4 provides bar graphs demonstrating the statistical analysis of the fluorescence intensity of the streptavidin (left) and hMSCs (right) before and after mixing. Neither the Alexa Fluor 700 streptavidin nor Ds-Red expressing hMSCs exhibited significantly different fluorescence in unmixed or mixed states.
  • Figures 5-7 are line graphs demonstrating the fluorescent intensity of each of the three molecular-weight variants of HA with (gray lines) or without (black lines) mixing with the hMSCs.
  • Figure 8 provides IVIS images of mouse hindlimbs after a hyaluronic acid (HA)-200 injection.
  • Figure 9 is a line graph demonstrating the fluorescent signal of an injection with streptavidin alone.
  • Figure 10 is a line graph demonstrating the degradation patterns of HA of three molecular weights, as indicated by the fluorescent signals of Alexa Fluor 700.
  • Figure 11 shows the coefficients a and b, obtained from an exponential regression analysis ⁇ «* ⁇ ⁇ **).
  • Figure 12 demonstrates the half-lives of HA-200, HA-800, and HA-1640.
  • Figure 13 is a line graph demonstrating the hMSC fluorescent intensities in mixtures with each molecular-weight variant of HA.
  • Figure 14 provides images of the immunofluorescence staining of the proliferation marker Ki-67. Representative images are shown for the three treatment groups, stained for Ds-Red and Ki-67 and with DAPI. Scale bar: 100 ⁇ . Ki-67 and Ds-Red double-stained cells are indicated by arrows.
  • Figure 15 is a bar graph demonstrating the percentage of Ki-67-positive cells among the Ki-67 and Ds-Red double-positive cells.
  • Figure 16 provides images demonstrating results from a TUN EL assay double-stained with Ds-Red. Representative images are shown for each of the three treatment groups, stained for Ds-Red and apoptotic hMSCs and with DAPI. Scale bar: 100 ⁇ . The TUN EL and Ds-Red double-stained cells are indicated by arrows.
  • Figure 17 is a bar graph demonstrating the percentage of apoptotic hMSCs among the Ds-Red positive cells.
  • Figure 18 to Figure 20 demonstrate that a close relationship existed between hMSCs and different molecular weights of the HA at the early times.
  • Figure 22 is a bar graph demonstrating the statistical analysis of the retained hMSC stained in Figure 21.
  • Figure 23 provides representative images of mouse ischemic hindlimbs after treatment.
  • Figure 24 is a bar graph demonstrating that injections of HA-200, HA-800, or HA-1640 along with the hMSCs increased blood flow in the ischemic hindlimbs.
  • the blood flow at days 0, 1, 7, 14, 21 and 28 in each experimental group was measured by laser Doppler flowmetry (*** P ⁇ 0.001 vs. PBS-treated group; ### P ⁇ 0.001, # P ⁇ 0.05 vs. HA-800/hMSC group; +++ P ⁇ 0.001, ++ P ⁇ 0.01, + P ⁇ 0.05 vs. HA-1640/hMSC group).
  • Figure 25 is a line graph demonstrating the clinical scores of mice 7 to 28 days after the induction of hindlimb ischemia (### P ⁇ 0.001 vs. PBS-treated, hMSC alone, HA-200 alone, HA-800 alone, HA-1640 alone, and HA-1640/h MSC groups; * * * P ⁇ 0.001,
  • Figure 26 provides representative immunofluorescence images of isolectin demonstrating the capillary at the mid-thigh level for different treatment groups: sham (Group a), PBS (Group b), hMSCs (Group c), HA-200 (Group d), HA-800 (Group e),
  • HA-1640 (Group f), HA-200/h MSC (Group g), HA-800/hMSC (Group h) and
  • HA-1640/hMSC (Group i).
  • the capillaries were labeled with anti-isolectin, the skeletal muscles were labeled with anti-tropomyosin, and the nuclei with stained with DAPI.
  • Figure 27 is a bar graph demonstrating the quantification of the capillary density at the peri-injury region. * * * P ⁇ 0.001 vs. all other treatment groups.
  • Figure 28 provides representative immunofluorescence images of smooth muscle 22a showing the arterioles at the mid-thigh level : sham (Group a), PBS (Group b), h MSCs (Group c), HA-200 (Group d), HA-800 (Group e), HA-1640 (Group f), HA-200/h MSC
  • HA-800/hMSC Group h
  • HA-1640/h MSC Group i
  • the arterioles were labeled with anti-smooth muscle 22a, the skeletal muscles were la beled with anti-tropomyosin, and the nuclei with stained with DAPI. Scale bar: 100 ⁇ . Arrows indicate arterioles stained against smooth muscle 22a.
  • Figure 29 is a bar graph demonstrating the quantification of the arteriole density at the peri-injury region. * * * P ⁇ 0.001 vs. HA-800/h MSC group; * * P ⁇ 0.01 vs.
  • therapeutic cell refers to cellular material to be introduced into and/or in the vicinity of a treatment site.
  • Therapeutic cells vary with respect to characteristics such as formulation (including com bination with a scaffold or other non-cellular component), the genetic relationship of the cells to the patient (autologous, allogeneic, xenogeneic), and the cell source.
  • formulation including com bination with a scaffold or other non-cellular component
  • genetic relationship of the cells to the patient autologous, allogeneic, xenogeneic
  • the in vivo biological activity and safety profile of the therapeutic cell are influenced by cell origin (donor source, tissue source), as well as the level of manipulation and stage of differentiation at the time of administration.
  • cell population refers to the num ber of therapeutic cells to be administered to the treatment site or the total number of therapeutic cells residing at the treatment site and cells proliferated from these residing therapeutic cells.
  • treatment site is meant to refer to a desired site for administration of therapeutic cells and the biodegrada ble material of the present invention.
  • Treatment site is thus meant to include, although is not necessarily limited to, a subcutaneous, intravenous, intrathecal, intraorbital, intraocular, intraaural, intratympanic, intramuscular, intra-arterial, intra-articular, intracavitary, intraductal, intraglandular, intravascular, intranasal, intraperitoneal, intraspinal, epidural, intracranial, intracardial, intrapericardial, peritumoral, or intratumoral (i.e., within a cancerous growth) site within a su bject.
  • Treatment site thus also encompasses intracavitary sites, e.g., sites within or near a selected organ or tissue (e.g., central nervous system (e.g., spinal fluid), kidney, liver, pancreas, heart (e.g., intrapericardial), lung, eye, inner ear, middle ear, cochlea, lymph nodes, breast, prostate, ovaries, testicles, thyroid, spleen, etc.), into arteries that feed a selected organ to tissue, or at a site associated with a microbial infection (e.g., bacterial, viral, parasitic or fungal infection).
  • a selected organ or tissue e.g., central nervous system (e.g., spinal fluid), kidney, liver, pancreas, heart (e.g., intrapericardial), lung, eye, inner ear, middle ear, cochlea, lymph nodes, breast, prostate, ovaries, testicles, thyroid, spleen, etc.
  • a microbial infection e
  • treatment are used herein broadly to include a preventative (e.g., prophylactic), curative, or palliative measure that results in a desired pharmaceutical and/or physiological effect.
  • treatment and treating refer to application of the present method to a su bject in need of cell therapy, with the purpose to partially or completely alleviate, ameliorate, relieve, delay onset of, inhibit progression of, reduce severity of, and/or reduce incidence of one or more symptoms or features of a disease or condition.
  • a “treatment” includes not just the improvement of symptoms or decrease of markers of the disease, but also a cessation or slowing of progress or worsening of a symptom that would be expected in a bsence of treatment.
  • effective amount refers to the quantity of a component (e.g., the biodegradable material) which is sufficient to yield a desired response (such as, maintaining the cell population and/or enhancing the therapeutic efficacy). Effective amount may be expressed, for example, in grams, milligrams or micrograms or as milligrams per kilogram of body weight (mg/kg). The term also refers to an amount of a pharmaceutical composition containing an active component or combination of components.
  • the specific effective or sufficient amount will vary with such factors as the particular condition being treated, the physical condition of the patient (e.g., the patient's body mass, age, or gender), the type of mammal or animal being treated, the duration of the treatment, the nature of concurrent therapy (if any), and the specific formulations employed and the structure of the compounds or its derivatives.
  • the term "therapeutically effective amount” refers to the quantity of an active component which is sufficient to yield a desired therapeutic response.
  • a therapeutically effective amount is also one in which any toxic or detrimental effects of the compound or composition are outweighed by the therapeutically beneficial effects.
  • the term "subject” refers to a mammal including the human species that is treata ble with the present method.
  • the term “su bject” is intended to refer to both the male and female gender unless one gender is specifically indicated.
  • the present invention is based, at least, on the finding that biodegrada ble materials with specific degradation profiles are capa ble of augmenting cell retention and viability at the treatment site, thereby enhancing the therapeutic efficacy of cell therapies. Therefore, the present invention is directed to methods which apply the degradation characteristics of a biomaterial to optimize the retention of transplanted cells in vivo in order to maximize the therapeutic efficacy of the transplanted cells.
  • the present disclosure is directed to a method for maintaining a population of therapeutic cells administered to a treatment site in a su bject for a period of time. Said method is particular useful for su bjects in need of cell therapies; and hence, the present disclosure also contemplates a method for treating a su bject in need of cell therapy.
  • the method for maintaining a population of therapeutic cells administered to a treatment site in a subject for a period of time or the method for treating a subject in need of cell therapy comprises the steps of (a) administering a therapeutically-effective amount of therapeutic cells to the treatment site; and ( b) administering an effective amount of a biodegradable material comprising a hyaluronan compound to the treatment site.
  • the biodegrada ble material has an in vivo degradation profile similar to that of a hyaluronic acid having a molecular weight of 20 kDa to 2,000 kDa.
  • the step (a) is performed before, at the same time with, or after the step (b).
  • the therapeutic cells and the biodegradable material may be formulated as a single composition or in separate compositions.
  • the composition biodegradable material is up to about 5% by weight of the composition; such as 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 4.5, or 5% by weight.
  • the amount of therapeutic cells is about lxlO 4 to about lxlO 8 cells in a single dosage volume of about 100 to about 2,000 ⁇ .
  • the composition according to the present disclosure may further comprise a pharmaceutically acceptable carrier or diluent.
  • pharmaceutically acceptable carrier is one that is suitable for use with the subjects without undue adverse side effects (such as toxicity, irritation, and allergic response) commensurate with a reasonable benefit/risk ratio.
  • each carrier must be "acceptable” in the sense of being compatible with the other ingredients of the pharmaceutical composition.
  • Preferred but not exclusive carrier suitable for use in the present composition can be in the form of a solid, semi-solid, or liquid diluent.
  • the composition may also comprise other additives such as growth factors, cytokines, chemokines, antitumor agents, antibacterial agents and antifungal agents, isotonic and absorption delaying agents and the like.
  • steps (a) and/or (b) may be performed by directly applying, for example, during a surgery or for treatment sites locating at externally accessible area of the body, the therapeutic cells and/or the biodegradable material or compositions comprising the same to the treatment site, with or without an applicator (e.g., a dropper and the like).
  • the direct injection also comprises injection of therapeutic cells and/or the biodegrada ble material or compositions comprising the same to the treatment site without the aid or assistance of other surgical or imaging devices.
  • the direct injection may comprise intradermal, su bcutaneous, intramuscular, intravenous, intraosseous, intraperitoneal, intrathecal, epidural, intracardiac, intraarticular, intracavernous, or intravitreal injection.
  • the therapeutic cells and/or the biodegrada ble material or compositions comprising the same may be delivered with the aid of surgical or imaging devices.
  • the steps (a) and/or (b) may be performed during the open surgery, catheterization surgery, endoscopic surgery or robotic surgery.
  • Imaging techniques suitable for use in the present method include, but are not limited to ultrasound, X-ray, computed tomography (CT), M RI, fluorescent and nuclear imaging (e.g., single-photon emission computed tomography (SPECT) and positron emission tomography (PET)).
  • CT computed tomography
  • M RI fluorescent and nuclear imaging
  • SPECT single-photon emission computed tomography
  • PET positron emission tomography
  • the therapeutic cells suita ble for use in the cell therapy may be stem cells, induced pluripotent cells, functionally differentiated cells or recombinant cells, or a combination thereof.
  • Tissue sources of stem cells include: adult (e.g., hematopoietic, vascular, neural, mesenchymal, cardiac, adipose, muscular, dental, skeletal, cartilage, periosteal, mammary, uterus, skin); perinatal (e.g., placental, um bilical cord blood); fetal (e.g., amniotic fluid, yolk sac, neural, skin); and em bryonic.
  • Stem cells or cell products derived therefrom are characterized by a varia ble capacity for self-renewing replication through cycles of cell division and the capacity for differentiation into a variety of cell types with specialized properties/functions. Such differentiation and replication are primarily controlled by the physiologic milieu of the host in which the cells reside following in vivo administration.
  • Functionally differentiated cells may be obtained from adult human donors (autologous or allogeneic) or from animal sources (xenogeneic).
  • Source cells can include fibroblasts, chondrocytes, osteoblasts, osteocytes, adipocytes, epithelial cells, keratinocytes, retinal cells, dental cells, renal cells, pancreatic islet cells, hepatocytes, neuronal cells, immune cells, muscle cells, and blood cells.
  • Functionally differentiated cells or cell products derived therefrom typically do not possess the property of self-renewing proliferation and the capacity to differentiate into multiple cell types; however, they may retain some cellular characteristics of their tissue of origin. Additionally, their characteristics may change after in vivo administration, based on specific extracellular cues.
  • iPS cells Induced pluripotent cells are cells that have been induced, either genetically or chemically, from differentiated somatic cells or stem/progenitor cells to cells having characteristics of higher potency cells, such as embryonic stem cells. iPS cells exhibit morphological, functional and growth properties similar to embryonic stem cells.
  • Recombinant cells are cells into which a recombinant gene has been introduced.
  • the therapeutic cells may be recombinant CD31+, CD34+, CD45+, CD133+, c-kit+, sca-l+ or isl-l+ cells.
  • the hyaluronan compound may be hyaluronic acid or a derivative thereof.
  • Hyaluronic acid (HA) is an anionic, non-sulfated glycosaminoglycan consisting of repeating disaccharide units of N-acetylglucosamine and D-glucuronic acid.
  • HA is an essential component of the extracellular matrix and considered to be an immuno-neutral polysaccharide; hence, it has been widely used in biomedical applications for decades.
  • Derivatives of hyaluronic acid include, but are not limited to, partial or total esters of hyaluronic acid, adipic dihydrazide-modified hyaluronan, amides of hyaluronan, crosslinked hyaluronic acid, hemiesters of succinic acid, heavy metal salts of hyaluronic acid, sulphated hyaluronic acid, N-sulphated hyaluronic acid, amine- modified hyaluronic acid, and diamine-modified hyaluronic acid.
  • Hyaluronan compounds also include composites of hyaluronan and silk, hyaluronic acids cross-linked with other natural or synthetic materials.
  • Derivatives or composites of hyaluronic acid can be obtained by chemically modifying one or more functional groups (e.g., carboxylic acid group, hydroxyl group, reducing end group, N-acetyl group) of hyaluronic acid and/or crosslinking hyaluronan with other molecules using methods known in the art.
  • the biodegradable material consists of hyaluronic acid having a molecular weight of 20-2,000 kDa; preferably, 50-1,200 kDa; and more preferably, 200-800 kDa.
  • the molecular weight of the hyaluronan compound is 20, 30, 40, 50, 60, 70, 80, 90, 100, 110, 120, 130, 140, 150, 160, 170, 180, 190, 200, 200, 250, 300, 350, 400, 450, 500, 550, 600, 650, 700, 750, 800, 850, 900, 950, 1,000, 1, 100, 1,200, 1,300, 1,400, 1,500, 1,600, 1,640, 1,700, 1,800, 1,900, 2,000, 2, 100, 2,200, 2,300, 2,400, 2,500, 2,600, 2,700, 2,800, 2,900, 3,000, 3, 100, 3,200, 3,300, 3,400, 3,500, 3,600, 3,700, 3,800, 3,900, 4,000, 4,100, 4,200, 4,300, 4,400, 4,500, 4,600, 4,700, 4,800, 4,900 or 5,000 kDa.
  • the biodegrada ble material may comprise two or more hyaluronan compounds.
  • the biodegradable material may optionally comprise at least one biopolymer; examples of which include, but are not limited to, collagen, gelatin, alginate, chitosan, fibronectin, and fibrin glue.
  • the overall in vivo degradation profile of the biodegradable material should be similar to that of a hyaluronic acid having any of the above-identified molecular weights.
  • the biodegrada ble material has an in vivo half-life of 4 hours to 28 days; alternatively, the in vivo half-life of the biodegrada ble material is 8 hours to 7 days, 12 hours to 5 days or 1-3 days after the administration.
  • the in vivo half-life may be 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, or 23 hours, or 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27 or 28 days.
  • the therapeutic cells once ministered to the therapeutic cells may be degraded; however, the experimental data provided hereinbelow demonstrates that the administration of the present biodegradable material may slow down the removal of therapeutic cells, thereby retaining a higher percentage of the therapeutic cells residing at the treatment site. Moreover, the experimental data also suggest that the biodegrada ble material may prevent cell apoptosis and promote cell proliferation in vivo. Accordingly, the administration of the present biodegrada ble material facilitates the maintenance of the cell population at the treatment site at least by retarding cell degradation and promoting cell proliferation.
  • the population of therapeutic cells at the treatment site is maintained for at least 7 days; preferably at least 14 days; and more preferably, at least 28 days. Put it in another way, there are therapeutically-effective amount of therapeutic cells at the treatment sites at 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, or 28 days after the administration.
  • the present invention is also advantageous in that the method provides a greater amount of therapeutic cells during the early period (e.g., the first 10 days) of cell therapy.
  • the cell population at the treatment site may remain substantially the same or greater with respect to the initially administered therapeutic cells, at 3, 4, 5, 6, 7, 8, 9, or 10 days after the administration.
  • the therapeutically-effective amount of the therapeutic cells is lxlO 4 to lxlO 8 cells/kg body weight of a subject.
  • the effective amount of the hyaluronan compound is 0.01 to 10 mg/kg body weight of the subject.
  • the subject is an adult human weighted between 45-80 kg.
  • Equivalent doses for children or other mammals could be estimated by conversions formulae known in the art; such as those provided in FDA's "Guidance for Industry: Estimating the Maximum Safe Starting Dose in Initial Clinical Trials for Therapeutics in Adult Healthy Volunteers.”
  • the present method is suitable for use in the treatment of various diseases or conditions treatable by cell therapy.
  • the subject may suffer from a damaged or infected tissue, a degenerative disease, or a cardiovascular disease such as coronary artery disease, cardiomyopathy, myocardial infarction, atherosclerosis, heart failure, a congenital heart disease, a peripheral artery occlusive disease, a valvular heart disease, Raynaud's phenomenon, Berger's disease and other connective tissue disorder associated vascular inflammation or damage, peripheral arterial disease, and an ischemic heart disease.
  • a cardiovascular disease such as coronary artery disease, cardiomyopathy, myocardial infarction, atherosclerosis, heart failure, a congenital heart disease, a peripheral artery occlusive disease, a valvular heart disease, Raynaud's phenomenon, Berger's disease and other connective tissue disorder associated vascular inflammation or damage, peripheral arterial disease, and an ischemic heart disease.
  • the present method may be applicable in the treatment of diseases or conditions associated with bone, cartilage, muscle, eye, retina, nose, ear, thyroid gland, parathyroid gland, skin, muscle, bone, tooth, gingiva, wound, brain, spinal cord, breast, uterus, ovary, testis, liver, pancreas, or kidney.
  • the present method may be adapted to the field of cosmetic or reconstructive medicine.
  • Hyaluronic Acid (HA). Biotinylated hyaluronic acids of 200 kDa, HA 800 kDa and HA 1640 kDa were purchased from Creative PEGworks, Winston-Salem, NC, USA and stored at 4°C.
  • hMSC Human mesenchymal stem cells Culture. hMSCs were cultured in minimum essential alpha medium (aMEM) containing 20% fetal bovine serum (FBS) and 4 ng/ml human fibroblast growth factor-basic (bFGF; Invitrogen, Grand Island, NY, USA). hMSCs were maintained at 37 °C and an atmosphere of 5% C0 2 in air on culture dishes. Cells were trypsinized and counted under light microscopy before transplantation.
  • aMEM minimum essential alpha medium
  • FBS fetal bovine serum
  • bFGF human fibroblast growth factor-basic
  • hMSCs were cultured on 10-cm culture dishes and maintained at 37°C under an atmosphere of 5% CO2 in air. A total of 4x10 s hMSCs were mixed with 200 ⁇ of aMEM culture medium or 1% HA and then injected into the ischemic muscles of mice. Immediately and at various intervals after the injection, the mice were imaged using a Xenogen IVIS ® Spectrum device and the corresponding filter sets. The fluorescent intensity was determined by calculating the number of photons within the manually drawn ROI, and the intensity was adjusted to exclude tissue autofluorescence. [0089] Animal Model of Hindlimb Ischemia and Treatment.
  • the overall surgical mortality rate was 0%.
  • the left femoral artery and iliac artery in mice were ligated and then cut to induce hindlimb ischemia.
  • 200 ⁇ of PBS, 4x10 s hMSC (suspended in culture medium), 1% solutions of the three molecular weight HAs, or 1% solutions of the three molecular weight HAs mixed with 4x10 s hMSC were injected intramuscularly. The injections were delivered into 4 sites at the ischemic site (50 ⁇ for each site).
  • DAPI Sigma-Aldrich, St. Louis, MO, USA
  • sections were mounted and observed under a fluorescence microscope.
  • the capillary and arteriole densities at the border zone were measured and images were taken from 8 randomly-selected ischemic sites (200x magnification) in each sample and quantification was performed by manually counting each section; the 8 values were averaged.
  • a platform to simultaneously quantify biomaterial degradation and stem-cell retention was designed to evaluate the impact of material degradation kinetics on stem-cell retention.
  • Alexa Fluor 700 la beled hyaluronan and Discosoma sp. Red (Ds-Red)-expressing hMSCs were used along with a non-invasive imaging system (IVIS; Perkin Elmer, Waltham, MA, USA) to reduce animal consumption and experimental variance while still revealing material retained in vivo.
  • IVIS non-invasive imaging system
  • Alexa Fluor 700 la beled streptavidin and Ds-Red expressing hMSCs were separately allocated in two microcentrifuge tu bes (Eppendorf, Hamburg, Germany), and their original emission fluorescent signals were detected by the respective filter sets 675/720 (excitation/emission) for Alexa Fluor 700 and 570/620 for Ds-Red.
  • Regions of interest were drawn to evaluate the fluorescent intensities before and after mixing the streptavidin and hMSCs together. There was no significant difference in the signal emitted by the unmixed or mixed streptavidin and hMSC samples, indicating that the spectra of Alexa Fluor 700 and Ds-Red did not interfere with each other ( Figure 4). This concept was further confirmed by injecting HA or HA/hMSCs into a mouse hindlimb; the fluorescent signals adhered to the same HA degradation patterns with or without addition of hMSCs ( Figures 5-7).
  • a murine model of hindlimb ischemia was employed to investigate the effects of various cell-retention profiles on mitigating peripheral arterial disease.
  • biotinylated hyaluronan with fluorescently labeled streptavidin and Ds-Red-expressing hMSCs were used.
  • MSCs Mesenchymal stem cells
  • hMSCs Mesenchymal stem cells
  • hMSCs human MSCs
  • the disease model used herein is murine hindlimb ischemia, representing peripheral arterial occlusive disease, which as many as 10 million people in the United States suffer from.
  • the transplanted hMSCs likely underwent three stages: depletion, sedimentation, and proliferation.
  • the h MSCs were depleted from the HA, as indicated by the decreasing trend of the fluorescent signal.
  • the hMSCs started to attach to the surrounding microenvironment, as indicated by sta ble fluorescence signals.
  • the last stage occurred 72 hours after transplantation, when the cells began to proliferate, as evidenced by the elevated fluorescence signals even in the a bsence of HA.
  • the accompanying biomaterial should remain in the in vivo system for at least 48 hours. Otherwise, this material may not properly assist the cells in remaining at the site of injury.
  • peripheral arterial occlusive disease can cause leg pain and severe morbidity, such as amputation. Alleviating the discomfort and preserving the lim b at the same time are primary clinical goals for medication. As provided herein, the gross examination of the distal mouse thigh and calf muscles 1 day, 2 weeks, and 4 weeks after surgical excision of the left femoral artery allowed the direct observation of the level of limb salvage.
  • the ischemic hindlim bs exhibited no remarkable therapeutic outcomes compared to the PBS-treated control group, which experienced severe limb gangrene and necessary amputation.
  • Another clinical index used to examine the therapeutic effects was the blood-flow recovery in the ischemic region. The blood flow in the mouse hindlimb was recorded by laser Doppler flowmetry (moorLDI; Moor Instrument, UK) every week after the injection to compare the recovery of blood flow between the different treatment groups ( Figure 24).

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