EP3773489A1 - Verfahren zur differenzierung von stammzellen in hormonproduzierende zellen - Google Patents

Verfahren zur differenzierung von stammzellen in hormonproduzierende zellen

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Publication number
EP3773489A1
EP3773489A1 EP19781961.8A EP19781961A EP3773489A1 EP 3773489 A1 EP3773489 A1 EP 3773489A1 EP 19781961 A EP19781961 A EP 19781961A EP 3773489 A1 EP3773489 A1 EP 3773489A1
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Prior art keywords
cells
type
fsh
function
patient
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Ceased
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EP19781961.8A
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English (en)
French (fr)
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EP3773489A4 (de
Inventor
Craig S. Atwood
Sivan Vidakkadath Meethal
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Jangobio LLC
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Jangobio LLC
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Priority claimed from US15/947,304 external-priority patent/US11439668B2/en
Application filed by Jangobio LLC filed Critical Jangobio LLC
Publication of EP3773489A1 publication Critical patent/EP3773489A1/de
Publication of EP3773489A4 publication Critical patent/EP3773489A4/de
Ceased legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P15/00—Drugs for genital or sexual disorders; Contraceptives
    • A61P15/08—Drugs for genital or sexual disorders; Contraceptives for gonadal disorders or for enhancing fertility, e.g. inducers of ovulation or of spermatogenesis
    • 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
    • A61K35/14—Blood; Artificial blood
    • A61K35/15—Cells of the myeloid line, e.g. granulocytes, basophils, eosinophils, neutrophils, leucocytes, monocytes, macrophages or mast cells; Myeloid precursor cells; Antigen-presenting cells, e.g. dendritic 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
    • A61K35/52—Sperm; Prostate; Seminal fluid; Leydig cells of testes
    • 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
    • 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
    • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
    • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12N—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
    • C12N5/00—Undifferentiated human, animal or plant cells, e.g. cell lines; Tissues; Cultivation or maintenance thereof; Culture media therefor
    • C12N5/06—Animal cells or tissues; Human cells or tissues
    • C12N5/0602—Vertebrate cells
    • C12N5/0652—Cells of skeletal and connective tissues; Mesenchyme
    • C12N5/0662—Stem cells
    • C12N5/0663—Bone marrow mesenchymal stem cells (BM-MSC)
    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12N—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
    • C12N5/00—Undifferentiated human, animal or plant cells, e.g. cell lines; Tissues; Cultivation or maintenance thereof; Culture media therefor
    • C12N5/06—Animal cells or tissues; Human cells or tissues
    • C12N5/0602—Vertebrate cells
    • C12N5/0681—Cells of the genital tract; Non-germinal cells from gonads
    • C12N5/0682—Cells of the female genital tract, e.g. endometrium; Non-germinal cells from ovaries, e.g. ovarian follicle cells
    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12N—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
    • C12N5/00—Undifferentiated human, animal or plant cells, e.g. cell lines; Tissues; Cultivation or maintenance thereof; Culture media therefor
    • C12N5/06—Animal cells or tissues; Human cells or tissues
    • C12N5/0602—Vertebrate cells
    • C12N5/0681—Cells of the genital tract; Non-germinal cells from gonads
    • C12N5/0683—Cells of the male genital tract, e.g. prostate, epididymis; Non-germinal cells from testis, e.g. Leydig cells, Sertoli cells
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/0012—Galenical forms characterised by the site of application
    • A61K9/0019—Injectable compositions; Intramuscular, intravenous, arterial, subcutaneous administration; Compositions to be administered through the skin in an invasive manner
    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12N—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
    • C12N2501/00—Active agents used in cell culture processes, e.g. differentation
    • C12N2501/01—Modulators of cAMP or cGMP, e.g. non-hydrolysable analogs, phosphodiesterase inhibitors, cholera toxin
    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
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    • C12N2501/00—Active agents used in cell culture processes, e.g. differentation
    • C12N2501/30—Hormones
    • C12N2501/31—Pituitary sex hormones, e.g. follicle-stimulating hormone [FSH], luteinising hormone [LH]; Chorionic gonadotropins
    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
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    • C12N2501/00—Active agents used in cell culture processes, e.g. differentation
    • C12N2501/999—Small molecules not provided for elsewhere
    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
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    • C12N2506/00—Differentiation of animal cells from one lineage to another; Differentiation of pluripotent cells
    • C12N2506/13—Differentiation of animal cells from one lineage to another; Differentiation of pluripotent cells from connective tissue cells, from mesenchymal cells
    • C12N2506/1346—Differentiation of animal cells from one lineage to another; Differentiation of pluripotent cells from connective tissue cells, from mesenchymal cells from mesenchymal stem cells
    • C12N2506/1353—Differentiation of animal cells from one lineage to another; Differentiation of pluripotent cells from connective tissue cells, from mesenchymal cells from mesenchymal stem cells from bone marrow mesenchymal stem cells (BM-MSC)
    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
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    • C12N2506/00—Differentiation of animal cells from one lineage to another; Differentiation of pluripotent cells
    • C12N2506/45—Differentiation of animal cells from one lineage to another; Differentiation of pluripotent cells from artificially induced pluripotent stem cells

Definitions

  • the present invention relates to drugs and methods to differentiate stem cells into sex hormone-producing cells. More particularly, the disclosure relates to specific compounds and combinations of these compounds for improving sex hormone production from cells differentiated using such treatments.
  • Stem cells have the potential to self-renew (divide) and differentiate into specialized cell types.
  • MSC Mesenchymal stem cells
  • phenotypic characteristics of multilineage mesoderm- type cells such as osteoblasts, adipocytes, and chondrocytes.
  • MSC have the capacity to differentiate into ectodermal and endodermal-type cellular lineages.
  • MSC have been isolated from many tissues sources such as bone marrow, adipose tissue, skin, cardiac muscle, skeletal muscle, umbilical cord blood, liver, lung, nasal septum, synovial membrane, and amniotic membrane.
  • Wilms tumor gene, Wtl. is abundantly expressed in testis Sertoli cells. Wtl is required for the lineage specification of both Sertoli and granulosa cells by repressing Sfl expression (Chen, et al. 2017). Developmentally, if Wtl expression is suppressed, the expression of Sfl drives somatic cells to differentiate into steroidogenic cells instead of supporting cells (Chen et al. 2017). However, SF-l is essential for Sertoli cell maturation and spermatogenesis, during post-natal testis development (Kato, et al. 2012).
  • Fetal Leydig cells synthesize only androstenedione as they lack Hsdl7b3 expression. Fetal Sertoli cells convert androstenedione to testosterone, whereas adult Leydig cells synthesize testosterone by themselves (Shima, et al. 2013).
  • the inventors have discovered compounds that differentiate stem cells into hormone-producing stem cells (Figure 1). These compounds induce the production of sex steroids, including progesterone, 17p-estradiol. and testosterone.
  • the present invention is a method for differentiating stem cells into multiple linages including Leydig-like and Sertoli-like cells (hormone-producing cells), comprising stimulating the stem cells via a NR5A transcription factor and WT-l expression. Furthermore, said method may comprise further stimulating the MSC by cAMP.
  • the inventors have discovered cocktails of compounds that result in markedly improved hormone production from stem cells differentiated with these compounds.
  • the stem cells can be MSCs derived from bone marrow of fat, or induced pluripotent stem cells.
  • the present invention is a method for producing hormone-producing cells, comprising generating hormone-producing cells by implementing said method in vitro.
  • the present invention is for stem cells obtained from humans or other animals.
  • Embodiments of the present disclosure are capable of utilizing said cells for balancing and maintaining in balance the hypothalamic-pituitary-gonadal (HPG) axis, at least to some extent.
  • HPG hypothalamic-pituitary-gonadal
  • An embodiment of the invention pertains to a method of treating a patient.
  • a HPG axis of the patient in need thereof is rebalanced by administering a therapeutically effective amount of hormone-producing cells.
  • Another embodiment of the invention relates to a method of reducing endocrine dyscrasia (dyosis) in a patient.
  • a HPG axis of the patient in need thereof is rebalanced by administering a therapeutically effective amount of hormone-producing cells.
  • Yet another embodiment of the invention pertains to a method of reducing rejection in a patient in need of a tissue-specific stem cell transplant.
  • a HPG axis of the patient in need thereof is rebalanced by administering a therapeutically effective amount of a hormone-producing cell and administering a second stem cell that is tissue-specific to the patient.
  • Yet another embodiment of the invention relates to a method of preventing or slowing dyosis in a patient.
  • a therapeutically effective amount of at least one physiological agent that regulates or increases the production of hormones produced by the gonads is administered to a patient.
  • the present invention provides an improved method for rapidly differentiating stem cells into hormone-producing cells.
  • the present invention also provides a significant improvement in production of multiple sex hormones from stem cells.
  • FIG. 1 Treatment of rat MSCs with SF-l agonists promotes progesterone production.
  • RJW100 1, 5, 10 or 20 pM
  • PE 20, 100 or 200 pM
  • E 2 100 or 400 nM
  • DPN 2, 10 or 20 pM
  • 4-HP 50, 200 or 400 nM
  • RSV (0.44, 1,76 or 3.52 pM
  • FIG. 2 Treatment of rat MSCs with SF-l agonists promotes testosterone production.
  • FIG. 3 Treatment of rat MSCs with SF-l agonists promotes testosterone production.
  • FIG. 3 Treatment of rat MSCs with SF-l agonists promotes testosterone production.
  • Rat MSCs Treatment of rat MSCs with a combination of SF-l agonists and the WT- 1 inverse agonist dramatically increases testosterone production.
  • FIG. 5 Treatment of human MSCs with an SF-l agonist increases testosterone production.
  • Human MSC pre-treated for 7 days with RJW100 (1, 5 and 10 pM), followed by treatment with dbcAMP for 3 days, increases testosterone production.
  • FIG. 6 Treatment of human iCell® MSCs (Cellular Dynamics International, Madison, WI) with SF-l agonists and a WT-l inverse agonist promotes testosterone production.
  • Human iCell® MSCs pre-treated for 7 days with specific combinations of 1) RJW100 (5 pM); 2) PE (20 pM), 3); E 2 (400 nM), 4) DPN (10 pM), 5) 4-HP (200 nM), and 6) RSV (3.52 pM), followed by treatment with N6, 2’-0-dibutyryladenosine 3’,5’-cyclic monophosphate sodium (dbcAMP) for 3 days, increases testosterone production.
  • dbcAMP monophosphate sodium
  • FIG. 7 Injection of educated MSCs into the rat testicle.
  • Rat MSCs pretreated for 7 days with the combination of RJW100 (5 pM), PE (20 pM), E 2 (400 nM), DPN (10 pM), 4- HP (200 nM) and RSV (3.52 pM) were injected into the testes (1 million cells/testicle) to increase circulating testosterone concentrations in 8.5 month old male rats.
  • the present disclosure relates to a method of differentiating stem and adult cells into hormone-producing cells (or‘steroidogenic cells’; SCs) for use in maintaining in balance or rebalancing, the HPG axis and preventing or reversing hypogonadism and accompanying symptoms and diseases.
  • SCs hormone-producing cells
  • the transcriptional factor SF-l is an inducing factor that is stimulated or blocked by various agonists, inverse agonists and antagonists in the present invention, is an orphan intranuclear receptor, which is expressed in genital and adrenal gland-type steroid hormone- producing cells, and has been known to control the transcription of steroid hormone producing- enzymes (Morohashi and Omura 1996; Parker and Schimmer 1997). Even if SF-l is derived from different animal species, SF-l binds to a common target DNA sequence in mesenchymal stem cells and the factor is expected to provide the same result.
  • the transcriptional factor Wilm s tumor protein (WT-l), is an inducing factor (Barrionuevo, et al. 2012; Chen et al. 2017) that is stimulated or blocked by various agonists, inverse agonists and antagonists in the present invention.
  • cAMP exists ubiquitously in all living organism, whose intra-cellular concentration is 10 to 10 M. cAMP participates in generation of specific enzymes and metabolic control in target cells and also participates in growth and differentiation of cells. cAMP is a second messenger of luteinizing hormone (LH) and adrenocorticotropic hormone (ACTH), which induces the expression of steroid hormone production-related enzymes in genital and adrenal glands and enhances the production of steroid hormones.
  • LH luteinizing hormone
  • ACTH adrenocorticotropic hormone
  • Stimulation of these transcription factors (SF1 and WT1) by cAMP may include the direct contact of these factors with cells or the use of a vector expressing these factors.
  • stem cells may be stimulated by an inducing factor in vitro.
  • mesenchymal stem cells may be cultured in a media containing serum or serum components in an incubator with 5% CCh at 37° C (see examples).
  • adult cells may be stimulated by an inducing factor in vitro.
  • fibroblasts may be cultured in a media containing serum or serum components in an incubator with 5% CCh at 37° C (see examples).
  • the method involves treating stem or adult cells cultured in appropriate medias with one of the following:
  • Phenylephrine (PE; (Favaretto, et al. 1988; Mayerhofer, et al. 1989); enhances hCG- mediated T secretion, alpha-adrenergic agonist)
  • An improved method involves treating stem cells (or iPS cells) cultured in appropriate medias with more than one of the following RJW100 (5 mM), PE (20 pM); E2 (400 nM); DPN (10 pM); 4-HP (200 nM), and RSV (3.52 pM).
  • RJW100 5 mM
  • PE 20 pM
  • E2 400 nM
  • DPN 10 pM
  • 4-HP 200 nM
  • RSV 3.52 pM
  • Sertoli cells The presence of Sertoli cells in these cultures provides factors that promote steroid production from neighboring Ley dig-like cells.
  • a variation to this method is to inject the transplanted patient with gonadotropin (hCG, LH and/or FSH) at doses sufficient to induce hormone production from the transplanted cells.
  • gonadotropin hCG, LH and/or FSH
  • Hormone-producing cells derived from stem cells include testicular Ley dig cells, testicular Sertoli cells, testicular macrophages, ovarian granulosa cells, ovarian capsular cells, ovarian thecal cells, ovarian macrophages, adrenal cortical cells, and others.
  • Embodiments of the present invention relates to a method for slowing, preventing or delaying senescence, preventing or treating a disease associated with senescence, and for increasing longevity.
  • This is achieved by delivering donor cells into the human or animal body to increase the production and secretion of sex hormones into the circulation to levels near young adult reproductive levels, thereby reinitiating negative feedback on the hypothalamus and pituitary to rebalance the HPG axis hormone synthesis and secretion to levels near young adult reproductive levels.
  • This in effect prevents dyotic (death) signaling that results from the dysregulation of the HPG axis (Atwood and Bowen 2011; Atwood, et al. 2017; Bowen and Atwood 2004).
  • This will prevent and treat hypogonadism, prevent and treat symptoms associated with female reproductive endocrine dyscrasia and symptoms associated with male reproductive endocrine dyscrasia, and prevent or delay the onset of age-related diseases and extend longevity.
  • the invention encompasses a method of preventing or reversing the dysregulation of the HPG axis by repopulating the ovaries with follicular cells, and the testes with Ley dig, Sertoli and other support cells. This will prevent and treat hypogonadism, prevent and treat symptoms associated with female reproductive endocrine dyscrasia and symptoms associated with male reproductive endocrine dyscrasia, and prevent and delay the onset of age- related diseases and extend longevity.
  • the invention encompasses a method of restoring the HPG axis to balance (young adult reproductive levels) by repopulating the ovaries with follicular cells, and the testes with Ley dig, Sertoli and other support cells. This will reverse hypogonadism, prevent and treat symptoms associated with female reproductive endocrine dyscrasia and symptoms associated with male reproductive endocrine dyscrasia, and prevent and delay the onset of age-related diseases and extend longevity.
  • the invention further encompasses a method of inhibiting inflammation such as decreasing the expression of tumor necrosis factor (TNF), in a subject, by administering donor cells that lead to a rebalancing of the HPG axis.
  • TNF tumor necrosis factor
  • the present invention encompasses reversing the degenerative serum hormonal milieu back to one that allows the appropriate growth and development of cells for the normal maintenance of tissue structure and function in the body.
  • Rebalancing the endocrine HPG axis will allow for the rebalancing of the tissue specific‘mini -HPG’ axes present in tissues throughout the body (Meethal et al. 2009b). This will rebalance reproductive hormone signaling to cells in all tissues of the body.
  • the present invention encompasses a method of maintaining HPG axis hormones in balance to extend longevity for purposes of extending longevity of animals with agricultural applications, such as increasing yields of wool, cashmere or other fibers per animal. Similar applications apply to egg and milk production. [0060] This can be achieved by injecting into a subject donor cells that can repopulate the gonads with cell types capable of producing reproductive hormones required to balance the HPG axis.
  • donor cells capable of differentiating into germ cells spermatogonia, spermatocytes, spermatids and spermatozoon
  • Sertoli cells myoid cells, Leydig cells, stromal cells, macrophage cells and/or epithelial cells and integrating into the tissue to restore function.
  • donor cells capable of differentiating into germ cells oogonial stem cells
  • granulosa cells cumulus cells
  • thecal cells stromal cells, epithelial cells, macrophage cells and/or oocyte cells, and integrating into the tissue to restore function.
  • the differentiation of donor cells into more than one gonadal cell type is required to allow complete rebalancing of the axis.
  • Leydig cells primarily produce androgens
  • Sertoli cells produce large quantities of inhibins, both of which are required for HPG axis rebalancing in males.
  • a combination of gonadal cells is optimal for complete rebalancing of the axis.
  • An embodiment of the present invention includes administering, to a subject, donor cells that decrease or regulate the blood levels, production, function or activity of gonadal hormone to be near the blood levels, production, function or activity occurring during fetal life or at or around the height of the subject’s reproductive period, which in humans usually corresponds to about 18 to 35 years of age.
  • the present invention encompasses administering, to a subject, donor cells that decrease or regulate the blood levels, production, function or activity of kisspeptin, GnRH, LH or FSH to be approximately as low as possible without significant adverse side effects, preferably to be undetectable or nearly undetectable by conventional detection techniques known in the art, which, at the present time, is less than 0.7 mlU/mL for both LH and FSH.
  • the present invention encompasses administering, to a subject, donor cells that regulate the function or activity of activin to be approximately as low as possible without significant adverse side effects, preferably to be undetectable or nearly undetectable by conventional detection techniques known in the art.
  • the present invention encompasses administering donor cells that increase or regulate the blood levels, production, function, or activity of inhibin, follistatin, myostatin or BMP4 to be approximately as high as possible without significant adverse side effects.
  • the blood levels, production, function or activity of gonadal hormones are continuously regulated, by monitoring the blood levels, production, function or activity and making adjustments to the donor cell or donor cells being administered via a feedback control system.
  • Embodiments of the present invention include administration of one or more stem or differentiated cell types that can be used to increase or regulate the blood and/or tissue levels, production, function or activity of gonadal hormones. Studies have shown that increasing the levels of circulating sex steroids and inhibins will result in significant decreases in GnRH, LH and FSH levels and a rebalancing of the HPG axis (Hayes, et al. 1998; Thomer et al. 1998; Ying 1988).
  • GnRH GnRH
  • FSH Follistatin
  • Embodiments of the present invention also encompass rebalancing of the HPG axis such that the axis and related hormonal concentrations are balanced for that person.
  • the production of sex hormones by donor cells is expected to be different for different individuals in order to reach optimal balancing of that person’s HPG axis.
  • the circulating and tissue concentrations of sex hormones in one person’s balanced HPG axis is expected to be different to that of another person whose axis is also balanced.
  • Embodiments of the present invention also encompass the minute-to-minute, hour-to-hour and day-to-day variations in HPG axis hormone production to allow the axis to remain in balance.
  • Embodiments of the present invention also encompass modulating the concentrations and ratios of hormones of the HPG axis at any stage of the life cycle, including the embryo, fetus, childhood, puberty, adulthood or during senescence. [0069] Embodiments of the present invention also encompass modulating the concentrations and ratios of hormones of the HPG axis during gender transition from male to female, or female to male.
  • Embodiments of the present invention also encompass returning the ratios of sex hormones back to near the ratios occurring during fetal life or at or near the time of greatest reproductive function of the subject.
  • the ratio of testosterone: FSH during the male reproductive period is ⁇ l l (6.5 ng/mL:0.6 ng/mL), while that during the post-reproductive period (post-menopause) is ⁇ l (2.3 ng/mL:2.3 ng/mL).
  • treatment would aim to return the ratio of these hormones back to 11.
  • Further embodiments to this invention would encompass returning all the sex hormone ratios back to those during fetal life or at the time of greatest reproductive function of the subject.
  • Embodiments of the present invention also encompass administration of purified and mixed donor cell populations derived from the tissues of an individual who will receive the donor cells.
  • Embodiments of the present invention also encompass administration to an individual purified and mixed donor cell populations derived from multiple tissues of one or more individuals.
  • Embodiments of the present invention encompass administration of autologous or allogenic donor cell populations into the gonads for the prevention or treatment of hypogonadism, hypergonadotropic hypogonadism, andropause, menopause and related conditions, and for the prevention and treatment of diseases associated with senescence and aging.
  • Embodiments of the present invention also encompass administration of donor cell populations into the gonads prior to administration of donor cell populations (e.g. stem cell therapy, iPS therapy, or implantation/injection of differentiated cells including stem cells that have been differentiated in vitro) into other tissues of the body.
  • donor cell populations e.g. stem cell therapy, iPS therapy, or implantation/injection of differentiated cells including stem cells that have been differentiated in vitro
  • Such a method allows for rebalancing the HPG axis so that the‘toxic environment of dyotic signaling’ is reversed in order to allow for donor cells transplanted into other tissues to differentiate appropriately, integrate into the tissue and restore function.
  • donor cell recipients may receive supplemental gonadal hormones, GnRH agonists/antagonists, an LH/FSH-inhibiting agent, an activin-inhibiting agent, an inhibin-promoting agent, and/or a follistatin-promoting agent.
  • administering can be oral or by injection, inhalation, patch, or other effective means.
  • the dosage of GnRH agonists/antagonists, LH/FSH-inhibiting agents, activin-inhibiting agents, inhibin-promoting agents, follistatin-promoting agents, or sex steroids, including those identified above, will be a therapeutically effective amount, sufficient to decrease or regulate the blood and/or tissue levels, production, function or activity of GnRH, LH or FSH, or to decrease or regulate the function or activity of activin or to increase or regulate the blood and/or tissue levels, production, function or activity of inhibin or follistatin, to the desired blood and/or tissue levels, production, function or activity.
  • administration of LH/FSH-inhibiting agents, activin-inhibiting agents, inhibin-promoting agents, follistatin-promoting agents, or sex steroids can be in a single dose, multiple doses, in a sustained release dosage form, in a pulsatile form, or in any other appropriate dosage form or amount.
  • Administration prior to treatment with cells is preferred, but can occur during or after administration of cells.
  • the duration of treatment could range from a few days or weeks to the remainder of the patient’s life.
  • GnRH agonists/antagonists In addition to treating neurodegenerative diseases, the administration of GnRH agonists/antagonists, LH/FSH-inhibiting agents, activin-inhibiting agents, inhibin-promoting agents, follistatin-promoting agents, sex steroids, or other agents that decrease dysregulated cell cycle signaling, as described above, is expected to be beneficial as a prophylactic or in the treatment of aging and diseases where cell replenishment is required in order to repopulate a tissue to regain function or establish a new function, in accordance with the present invention.
  • Example 1 General Overview of Stem Cell Education into Hormone-Producing Stem Cells
  • MSCs Mesenchymal stem cells
  • bone marrow stromal cells are pluripotent cells that have the ability to differentiate into cells of all three germ layers (Ratajczak, et al. 2008).
  • MSCs are isolated from 1) bone, the femur and/or tibia (Tub, et al. 2003a; Tub, et al. 2003b), 2) umbilical cord blood (Hayward, et al. 2013; Malgieri, et al. 2010), 3) Wharton's jelly (Hayward et al. 2013), 4) skin (Manini, et al. 2011) or 5) adipose tissue (Kuhbier, et al. 2010; Manini et al. 2011; Tholpady, et al. 2003; Zhu, et al. 2013; Zuk, et al. 2001).
  • Cells are then subjected to flow cytometry to isolate MSC that are then injected (10,000 - 1 billion cells/treatment) into the interstitium of one or both testes or ovaries of the donor.
  • cells can be injected into the seminal vesicle lobules, septa, tunica albuginea, straight tubule, rete testes, efferent ductile and/or epididymis.
  • cells can be injected into the ovarian cortex. If the number of isolated MSCs is insufficient, MSCs are expanded in culture first prior to injection into the gonads.
  • Stem cells and educated stem cells e.g. MSCs differentiated into hormone- producing stem cells
  • injected into the testes localize to the testicular interstitium and seminiferous tubules and differentiate into Leydig cells and spermatogonia/spermatocytes, respectively (Lo, et al. 2004; Yazawa et al. 2006).
  • Stem cells injected into the ovaries increase follicle numbers (Abd- internationale, et al. 2013).
  • Hormonal factors secreted within the gonads direct the differentiation and integration of such stem cells for the replenishment of germ cells, Leydig, Sertoli and other cells in the testes, and replenishment of follicular cells (germ cells, granulosa, thecal and other cells) in the ovaries. Hormones secreted by the transplanted cells and their progeny in turn rebalance the HPG axis.
  • This technique may be performed autologously, i.e. isolating cells from the same individual who will receive the cells; allogeneically, i.e. cells isolated from one individual are injected into another individual (human or animal); or both autologously and allogeneically, i.e. isolated cells from the recipient and from another individual(s) are injected into the recipient.
  • MCSs from which gonadal tissues are derived during embryogenesis, are purified from tissues other than the gonads and then injected into the gonads.
  • MSCs in a suitable buffer, or encapsulated in a hydrogel or other matrix (e.g. fibrin, collagen) prior to injection may be injected into the gonads (testes or ovaries). Injection may be via a catheter.
  • MSCs in this example are capable of differentiating into all relevant gonadal cell types upon injection into the gonads.
  • This technique can be used on humans, animals and plants with a reproductive hormone axis.
  • the patient can be treated with gonadotropins (hCG, LH and/or FSH) to induce further differentiation hormone production.
  • gonadotropins hCG, LH and/or FSH
  • the concentration of circulating reproductive hormones in the individual can be measured before and after the injection of cells to confirm that injected cells are producing hormones and rebalancing the HPG axis.
  • Tissue concentrations of reproductive hormones can be measured in tissues to confirm that the hormones of the‘mini -HPG- axis in that tissue have rebalanced (returned to young adult reproductive concentrations). If the HPG axis has not completely rebalanced, a second or subsequent injection can be given until such time as the HPG axis is balanced and dyotic signaling has decreased. This provides a preventative and treatment for hypogonadism (primary) and of age-related reproductive endocrine dyscrasia.
  • Example 2 MSC Education into Hormone-Producing Cells
  • MSCs or other stem cell populations are differentiated in vitro into discrete precursor or differentiated cell types including germ cells (spermatogonia, spermatocytes, spermatids and spermatozoon), Sertoli cells, myoid cells, Leydig cells, stromal cells, macrophage cells and/or epithelial cells in the case of the male; or germ cells (oogonial stem cells), granulosa cells, cumulus cells, thecal cells, stromal cells, epithelial cells, macrophage cells and/or oocyte cells, in the case of the female, and one or preferably more of these cell types are injected into the gonads and/or other tissues and circulating and tissue sex hormone concentrations measured as in the methods described in Example 1, for rebalancing of the HPG axis.
  • germ cells spermatogonia, spermatocytes, spermatids and spermatozoon
  • Sertoli cells myoid cells
  • Leydig cells strom
  • Bone marrow derived hMSC are grown to confluence in T75 flasks using Minimum Essential Medium (MEM) - Alpha 1, with Earle’s salts, Glutagro Supplement, L- alanyl-L-glutamine, MEM nonessential amino acids and HyClone fetal bovine serum prior to treatment with differentiation factors.
  • MEM Minimum Essential Medium
  • MSCs are differentiated into hormone-producing cells over 7-21 days in a water- jacketed CCh incubator (Thermo Electron Corporation, Waltham, MA) at 37°C with 5% CCh by treatment with RJW100 (5 mM), PE (20 pM); E 2 (400 nM); DPN (10 pM); 4-HP (200 nM), and RSV (3.52 pM).
  • CCh incubator Thermo Electron Corporation, Waltham, MA
  • Hormone production can be induced in educated cells by treatment with N6, 2’- O-dibutyryladenosine 3’,5’-cyclic monophosphate sodium (dbcAMP), or following treatment with LH, FSH and/or hCG, for 1-3 days in serum supplement-free media.
  • dbcAMP N6, 2’- O-dibutyryladenosine 3’,5’-cyclic monophosphate sodium
  • Sex steroid and protein hormone concentrations are measured in the media.
  • Cells are then injected into a patient, including the gonads or fat pad, and the patient can be treated with gonadotropins (LH, FSH and/or hCG) to aid in repopulation, cell differentiation and hormone production.
  • gonadotropins LH, FSH and/or hCG
  • Induced pluripotent stem (iPS) cells created from the recipient or another donor can be cultured to produce sufficient cell numbers to be injected into either one or both of the gonads, and/or injected into the circulation, and/or other tissues of the body and circulating and tissue sex hormone concentrations measured as described in Example 1 to rebalance the HPG axis.
  • Differentiated cells such as fibroblasts, umbilical cord fibroblasts stomach, hepatocytes, lymphocytes, prostatic cells and other adult differentiated cells can be obtained by various techniques known in the field and reprogrammed into iPS cells via the following techniques also known in the field.
  • iCell MSC Cellular Dynamics International, Madison, WI
  • iCell maintenance media that includes L- Ascorbic Acid, B-27 supplement minus vitamin A, recombinant human FGF -basic, bovine serum albumin, GlutaMAX supplement, Ham’s F-12 medium, Iscove’s Modified Dulbecco’s Medium, l-Thioglycerol, N-2 supplement, recombinant human PDGF-BB, and penicillin/streptomycin.
  • the iCell MSC are differentiated into hormone-producing cells over 7- 21 days in a water-jacketed CCh incubator (Thermo Electron Corporation, Waltham, MA) at 37°C with 5% CCh by treatment with RJW100 (5 mM), PE (20 pM); E 2 (400 nM); DPN (10 pM); 4-HP (200 nM), and RSV (3.52 pM).
  • Hormone production can be induced in educated cells by treatment with N6, 2’- O-dibutyryladenosine 3’,5’-cyclic monophosphate sodium (dbcAMP), or following treatment with LH, FSH and/or hCG, for 1-3 days in serum supplement-free media.
  • dbcAMP monophosphate sodium
  • Sex steroid and protein hormone concentrations are measured in the media.
  • Cells can be administered to patients as described in the examples above and below.
  • the above techniques can also be used to differentiate post-natal fibroblasts from foreskin or punch biopsies into Ley dig-like and Sertoli-like cells.
  • Testicular cells such as Leydig cells, Sertoli cells, and germ cells can be differentiated from MSCs following transfection with members of the nuclear receptor family, SF-l, liver receptor homolog-l (LRH-l), and/or Wilms tumor protein (WT1), and treatment with 8-bromoadenosine-cAMP ((Yazawa et al. 2006); WT1).
  • WT1 Wilms tumor protein
  • One or preferably both of these cell types are injected into the male gonads and/or other tissues neat or in matrices via methods described in Example 1 and circulating and tissue sex hormone concentrations measured as in the methods described in Example 1, for rebalancing of the HPG axis.
  • Cells may be autologous or allogeneic.
  • MSC or other cell types are treated with differentiation factors as described in Example 3, and injected within 24h into the testes via methods described in Example 1.
  • MSC or other cell types are imbedded in a matrix impregnated with differentiation factors and injected into the testes via methods described in Example 1.
  • FUW-tetO-lox- h02S Three plasmid vectors of lentiviral reprogramming: FUW-tetO-lox- h02S, FUW-tetO-lox-hM2K, and FUW-tetO-lox-hN2L are constructed.
  • Expression cassettes of human POU5F1 -internal ribosome entry site 2 (IRES2)-SOX2 (02S) and MYC-IRES2- KLF4 (M2K) of pEP4 E02S EM2K (Addgene, #20923) (Yu, et al. 2009) are used for the 02S and M2K cassettes.
  • Pseudovirus is produced in 293FT cells by transfection with each lentiviral vector (02S, M2K, N2L) and the reverse tetracycline transactivator expression plasmid, FUW- M2rtTA (Addgene, plasmid 20342) (Hockemeyer, et al. 2008) along with the VSV-G envelope (pMD2.G) and packaging vector (psPAX2) (Ezashi, et al. 2009). Two consecutive infections are introduced into the target cell or interest (1 c 10 5 cells) in the presence of 12 pg/ml hexadimethrine bromide (polybrene, Sigma, St. Louis, MO).
  • the cells are cultured for 48 h by adding a mixture of the four titered pseudoviruses (multiplicity of infection); 02S (30.8), M2K (17.5), N2L (18.2) and rtTA (20.7) to the culture medium.
  • 02S (30.8), M2K (17.5), N2L (18.2) and rtTA (20.7)
  • cells are dispersed with trypsin and then expanded. Cells are tested for pluripotency and can then be used for treatment.
  • Episomal vectors carrying the reprogramming genes SOX2, KLF4, POU5FJ LIN28, p53 and MYCL are electroporated into 1-6 x 10 5 cells using a Nucleofector II device (Lonza, Basel, Switzerland) and Amaxa NHDF Nucleofector kit (Lonza). After 20 days, colonies resembling human ESC are mechanically isolated and expanded in mTeSRl medium (Gallego, et al. 2010; Ludwig, et al. 2006; Porayette, et al. 2009) (StemCell Technologies, Vancouver, Canada) on a Matrigel (BD Bioscience, San Jose, CA) coated substratum. Cells are tested for pluripotency and can then be used for treatment.
  • Adult granulosa, cumulus, thecal and germ cells can be isolated from adult ovaries following tituration, percoll gradients and/or flow cytometry (Sittadjody, et al. 2013) and one or preferably more of these cell types, educated cell types, or bioengineered cell types as described in the above examples injected into the female gonads and/or other tissues and circulating and tissue sex hormone concentrations measured as in the methods described in Examples 1-4, for rebalancing of the HPG axis.
  • Example 7 This technique can be used on humans, animals and plants with a reproductive hormone axis.
  • the patient is pre-treated with agents to lower dyotic signaling, such as GnRH agonists/antagonists and/or sex steroid supplementation (e.g. testosterone in males; estradiol and progesterone in females), prior to treatment with donor cells as outlined in Examples 1-7 to aid in the repopulation of gonadal cells.
  • agents to lower dyotic signaling such as GnRH agonists/antagonists and/or sex steroid supplementation (e.g. testosterone in males; estradiol and progesterone in females), prior to treatment with donor cells as outlined in Examples 1-7 to aid in the repopulation of gonadal cells.
  • Pre-treatment of patients described above is performed prior to the injection of donor cells into non-gonadal tissues or the circulation, and tissue regeneration and function monitored.
  • Example 1 -8 can be utilized to rebalance the HPG axis and reverse or prevent dyotic signaling in tissues, thereby allowing for a more conducive environment for innate tissue regeneration or regeneration aided by treatment with donor cells.
  • the methods from Examples 1-8 can be performed on patients, circulating and tissue sex hormone concentrations measured to confirm the HPG axis is rebalanced and that dyotic signaling has decreased, prior to the injection of donor cells into specific tissues or the circulation, and tissue regeneration and function monitored.
  • the method of Example 1 can be used to decrease dyotic signaling to the brain, and donor cells (e.g. neural stem cells, iPS cells or differentiated neural cells) injected into a dysfunctioning region(s) of the brain.
  • donor cells e.g. neural stem cells, iPS cells or differentiated neural cells
  • hypogonadotropic hypogonadism secondary hypogonadism
  • FSH and LH gonadotropins
  • Pituitary cell types such as gonadotrophs, corticotrophs, thyrotrophs, lactotrophs and adipose generated by way of Examples 1-3, 5-7, and from pituitary tissue, can be cultured to produce sufficient cell numbers to be injected into the pituitary, and/or injected into the circulation, and/or other tissues of the body to rebalance the HPG axis as described m Examples 1-8 with or without pre treatment of patients described m Example 8. Circulating and tissue sex hormone concentrations measured as described in Example 1 are performed to confirm rebalancing of the HPG axis.
  • hypogonadism hypergonadotropic hypogonadism
  • Kallman syndrome isolated GnRH deficiency, isolated LH deficiency, Prader-Willi syndrome, Turner syndrome, and Laurence- Moon-Biedl syndrome
  • secondary acquired forms of hypogonadism pituitary tumors and infarct, trauma, mumps, traumatic brain injury, children bom to mothers who had ingested the endocrine disruptor diethylstilbestrol, opioid induced androgen deficiency (resulting from the prolonged use of opioid class drugs, e.g.
  • morphine oxycodone
  • methadone fentanyl
  • hydromorphone anabolic steroid-induced hypogonadism craniopharyngioma
  • hyperprolactemia (1° & 2°)
  • hemochromatosis and neurosarcoid.
  • the above techniques also can be used to treat other dysregulated hormone axes of the body, including conditions and diseases that dysregulate the hypothalamic- pituitary-adrenal axis (e.g. adrenal insufficiency, Cushing’s syndrome, Addison disease), alimentary system hormone axes, placental hormone axes, calcium regulatory axes, salt regulatory axes, thermoregulatory axes and thyroid hormone axes
  • hypothalamic- pituitary-adrenal axis e.g. adrenal insufficiency, Cushing’s syndrome, Addison disease
  • alimentary system hormone axes e.g. adrenal insufficiency, Cushing’s syndrome, Addison disease
  • placental hormone axes e.g., placental hormone axes
  • calcium regulatory axes e.g. calcium regulatory axes, salt regulatory axes, thermoregulatory axes and thyroid hormone axes
  • Examples 1-12 can be used to treat animals such as stud bulls or horses, pets and members of rare and endangered species in order to restore hormone balance and improve or maintain health and lifespan.
  • Sorrentino V 2011 Multi-potent progenitors in freshly isolated and cultured human mesenchymal stem cells: a comparison between adipose and dermal tissue. Cell and tissue research 344 85-95.

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