EP3908295A2 - Cellules stromales neonatales felines et leurs utilisations - Google Patents
Cellules stromales neonatales felines et leurs utilisationsInfo
- Publication number
- EP3908295A2 EP3908295A2 EP20700707.1A EP20700707A EP3908295A2 EP 3908295 A2 EP3908295 A2 EP 3908295A2 EP 20700707 A EP20700707 A EP 20700707A EP 3908295 A2 EP3908295 A2 EP 3908295A2
- Authority
- EP
- European Patent Office
- Prior art keywords
- feline
- cells
- csns
- population
- csn
- 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.)
- Pending
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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
- A61K35/28—Bone marrow; Haematopoietic stem cells; Mesenchymal stem cells of any origin, e.g. adipose-derived stem cells
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
- A61K47/50—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates
- A61K47/69—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the conjugate being characterised by physical or galenical forms, e.g. emulsion, particle, inclusion complex, stent or kit
- A61K47/6903—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the conjugate being characterised by physical or galenical forms, e.g. emulsion, particle, inclusion complex, stent or kit the form being semi-solid, e.g. an ointment, a gel, a hydrogel or a solidifying gel
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- 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
- A61P1/02—Stomatological preparations, e.g. drugs for caries, aphtae, periodontitis
-
- 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
- C12N5/0668—Mesenchymal stem cells from other natural sources
Definitions
- the invention relates to a population of feline neonatal stromal cells, a pharmaceutical composition and an injectable solution comprising said cells, as well as a process for obtaining this composition from neonatal tissues.
- the invention also relates to the use of these cells and compositions in cell therapy in the feline, in particular for the treatment of stomatitis.
- GSC feline chronic gingivostomatitis
- stomatitis chronic gingivostomatitis
- lympho-plasmocytic stomatitis granulomatous stomatitis
- GSC results in several symptoms such as mouth ulcers, inflammatory lesions, hyper salivation, loss of animal weight or bleeding. This debilitating disease is responsible for pain, stopping feeding, infectious complications and is the first cause of dental avulsion in cats. This operation is heavy and expensive and requires additional therapy in 69% of cases. Furthermore, among the subjects who underwent this avulsion, 32.6% of cats remained refractory to treatment (3) (Jennings et al., 2015). The etiology of GSC is still poorly understood, but it seems multifactorial and mainly underlies a local dysimmunity component (4). The strong presence of T cells at the lesion sites suggests an exacerbation of the host's immune response to the mucous membranes.
- a treatment consisting of a double administration of 20 ⁇ 10 6 feline stromal cells derived from adipose tissue at one month apart has shown an effectiveness of the order of 70% in the context of autologous therapies and of the order of 57% in the context of allogenic therapies (7; US20160199414A1) and this on pathological subjects not responding to conventional therapies.
- the cells used in these documents are fresh cells, that is to say cells which have not undergone a cryopreservation step or which are returned to culture after cryopreservation in the case of the second injection to the subject.
- feline stromal cells require the removal of adipose tissue from an individual and therefore surgical intervention is necessary limiting the industrializable nature of a therapy exploiting the properties of these cells.
- feline GSC When observing symptoms of feline GSC, very often all of the animal's teeth are extracted. In some cases, partial dental avulsion may be performed. For example, when oral lesions are not generalized, canines can be preserved. Likewise, when the inflammation is localized, it is possible that tooth extraction only concerns the teeth affected by the lesions.
- the invention aims to provide a product for the treatment of feline stomatitis, easy to use, available at any time and which can be industrialized.
- the invention also aims to provide a population of cells intended for cell therapy, in particular for allogenic therapeutic applications, and more particularly for the treatment of tissue damage to the mucous membranes in the feline such as feline stomatitis.
- Another objective of the invention is to provide a population of cells having a good proliferation capacity to be able to be produced on an industrial scale and which retains all of its biological properties following a cryopreservation step.
- Another objective is to provide a process for obtaining a pharmaceutical composition ready for use, comprising said cell population.
- Another objective is to provide a pharmaceutical composition comprising said cell population.
- Another objective of the invention is to develop a ready-to-use injectable solution which is directly usable for a therapeutic application, without the need to put the cells back in culture or to change the cellular medium before injection in the subject.
- feline neonatal stromal cells make it possible to treat oral inflammation of the mucous membranes in the feline in an effective and lasting manner, in an allogenic context, in particular by injecting a single dose to the subject treat.
- this cell population is capable of exerting a localized and / or global anti-inflammatory action making it possible to substantially reduce oral lesions.
- This anti-inflammatory activity is linked, among other things, to the immunomodulatory properties of feline neonatal stromal cells. These properties can be defined as the ability of feline neonatal stromal cells to inhibit the differentiation, proliferation and / or activity of immune cells that cause the inflammatory context of a tissue or when these immune cells are cultured in vitro.
- a first object of the present disclosure relates to a population of feline neonatal stromal cells (CSN).
- feline means any animal of the Félidés family, in particular any animal of the genus
- the feline according to the invention is a cat.
- neonatal stromal cells all cells having one, more or all of the characteristics of mesenchymal stem cells and having a neonatal origin.
- the term “neonatal” means that feline CSNs can be isolated from all tissue sources and / or biological fluids, from extra-embryonic appendages and which can be recovered during the parturition / cesarean phase or during the gestation period. .
- these neonatal tissue sources correspond to the umbilical cord and more particularly to the umbilical cord matrix such as Wharton jelly, the perivascular zone of the arteries and / or the umbilical vein.
- the neonatal tissues correspond to the amniotic membrane or more particularly to the epithelium of the amniotic membrane and / or of the amnion.
- the neonatal tissues correspond to the placenta which is of the endotheliochorial type or more particularly to the chorionic mesoderm / chorionic plate, to the chorionic trophoblast / trophoblast, to the chorionic villi, to the placental cotyledons, to the placental decidua and / or to the perivascular system of the placenta.
- the extra embryonic tissue is immediately transferred to a transport box containing for example a phosphate buffered saline solution from Dulbecco to be transported to the laboratory.
- the tissues of extra embryonic appendages can be recovered during the entire gestation period of the cat (on average lasting 64-69 days) in the context of an ovary.
- Hysterectomy of convenience which is a routine operation with an abortive and sterilizing aim.
- biological fluids fluids from extra embryonic appendages such as umbilical cord blood or amniotic fluid and / or placental blood.
- Umbilical cord blood can be recovered by puncturing the umbilical cord.
- amniotic fluid it can be recovered by puncturing the liquid contained in the amniotic sac or by piercing the amniotic sac and by pouring the amniotic fluid which it contains in a tube, a petri dish or any other container. adapted.
- said population of feline CSN comes from a neonatal tissue sample, in particular from one or more placentas and / or from one or more umbilical cords; or a sample of neonatal fluid, particularly blood from one or more umbilical cords or amniotic fluids.
- feline CSNs from these tissues and fluids have the advantage of having been only slightly exposed to exogenous stresses which can induce epigenetic changes.
- the feline CSNs are placental feline CSNs.
- the CSNs of placentas come from placentas recovered during the gestation period. In another embodiment, the CSNs of placentas come from placentas recovered at the end of gestation.
- the feline CSNs are characterized by the presence on their surface of the markers CD44 and CD29. In a particular embodiment, the feline CSNs are characterized by the absence on their surface of the markers CD8, CMH-I and CMH-II.
- the analysis of these markers can be done by protein and / or transcriptional analysis.
- markers CD44, CD29, CD8, CMH-I and / or CMH-II can be respectively analyzed by measuring the expression of the genes Cd44, Itgbl, C5arl and / or the family of "human leukocyte antigen gene complex" (HLA) genes HLA-DP, HLA-DM, HLA-DOA, HLA-DOB, HLA-DQ, and HLA-DR or the corresponding feline homologous genes such as "feline leukocyte antigen gene complex ”(FLA).
- HLA human leukocyte antigen gene complex
- FLA feline leukocyte antigen gene complex
- Analysis of the expression of the various genes can be carried out by techniques of final time PCR, RTqPCR, digital PCR and / or RNA microarray.
- the expression of these markers can be studied by the use of antibodies or antibody fragments (monoclonal or polyclonal) specifically directed against one or more epitopes of the proteins CD44, CD29, CD8, MHC- I and / or CMH-II.
- the techniques associated with these antibodies include, among others, cytometric analysis, Western blots, ELISA, immunofluorescence and / or immunohistochemistry.
- marker proteins such as ligands or inhibitors can be used as analytical tools.
- Other technologies using probe-labeled oligonucleotides can be used to assess this expression such as the use of aptamers, RNA probes and / or DNA probes.
- feline CSNs can be characterized by their biological characteristics.
- the feline CSN population is characterized in that at least 80% of the cells of said population have a capacity for consecutive cell doublings greater than 20 cumulative doublings.
- cell doubling capacity is meant that a population of feline CSNs is able to double in number, more than 20 times in total.
- feline CSNs have a capacity for consecutive cell doublings of between 20 and 50 cumulative doublings, in particular from 20 to 40, more particularly from 20 to 30.
- This significant proliferation capacity allows cell amplification of the scale up type / scale out and industrializes a manufacturing process using this population cellular.
- the significant proliferation capacity also means that the population of feline CSNs allows amplification over several passages ranging from 1 to more than 15 passages.
- Nb of doublings LOG (Nf / Ni) / LOG (2) (Nf: number of final cells and Ni: number of initial cells).
- the total number of cell doublings is equal to the sum of the number of doublings accumulated during each cell passage.
- mesenchymal stem / stromal cells derived from adult feline tissue may have limits to the industrializable nature of the invention because of a possible infection with a Foamy virus type virus, the prevalence of 20 to 80% of cats, as has been demonstrated for mesenchymal stem cells from adipose tissue (8; 9; 10).
- the latter limits cell proliferation by inducing premature cell death during the cell proliferation phase.
- the fact of using cells of neonatal origin makes it possible to limit the use of cells infected with this virus and thus to confer an advantage for the industrialization of cell culture.
- the fetal-maternal barrier has been shown to decrease the transmission of certain pathogens from mother to fetus (77).
- the feline CSNs have an adhesion capacity to the plastic.
- adhesion capacity on plastic support is meant that the population of CSN is characterized by its adhesion property on plastic support.
- the feline CSNs have a fibroblastic type morphology.
- fibroblastic type morphology is meant mononuclear cells having a spindle morphology; that is to say cells stretched in length in culture on a plastic support and the ends of which have cytoplasmic extensions. This morphology shows an ability for these cells to spread in order to ensure focal type adhesion on support and cell polarization. This aspect can be assessed by studying the maximum Feret diameter and minimum of the cells, of the surface occupied by the cells on 2D support and of the corresponding aspect ratio (minimum Feret / maximum Feret).
- the feline CSNs have an immunomodulatory potential.
- immunomodulatory potential is meant that in a specific embodiment, the population of feline CSN is characterized in that at least 80% of the cells of said population of feline CSN have an immunomodulatory potential.
- This immunomodulation property can be characterized by the ability of feline CSNs to express a set of immunomodulatory factors such as PGE2, IL-6, IL-10, TGF-b, IDO, iNOS, HGF, KGF , CCL2 and / or TSG-6.
- feline CSNs can modify their phenotype.
- the inflammatory context can be mimicked in vitro by stimulation of the cells by means of cytokines and / or growth factors such as IFN-g, IL-1, IL-6 and / or TNF-a.
- a change in the phenotype of feline CSNs results in the ability of feline CSNs to modify the transcriptional and / or protein expression of markers involved in immunomodulation.
- the immunomodulatory potential of feline CSNs can also be characterized by the antiproliferative effect of feline CSNs on peripheral blood mononuclear cells (PBMC) treated with a mitogenic agent such as phytohemagglutinin, concanavalin A and / or lipopolysaccharides. Immunomodulation of feline CSNs can also be assessed by the ability of feline CSNs to inhibit the proliferation, secretion of pro-inflammatory cytokines and / or differentiation of T, NK, B Lymphocytes, monocytes and / or macrophages.
- PBMC peripheral blood mononuclear cells
- the feline CSNs have a capacity for chondrogenic differentiation.
- capacity for chondrogenic differentiation it is meant that the CSNs have the capacity to be able to differentiate into chondrocytes.
- the expressions “chondrocyte differentiation” and “chondrocyte differentiation” can also be used interchangeably.
- This capacity for differentiation into chondrocytes can be evaluated by the protein and / or transcriptional study of specific markers of cartilage such as Collagen type II (COL2A1), SOX-9 (SOX9), aggrecan (ACAN), cartilage Oligomeric Matrix Protein (COMP), Collagen type IX (COL9A1), collagen type XI (COL11A1) collagen type IIB (COL2B) after induction of chondrogenesis.
- cartilage Oligomeric Matrix Protein COMP
- Collagen type IX (COL9A1)
- collagen type XI collagen type IIB
- visco-elastic properties of the extracellular matrix expressed by the differentiated CSNs, approaching the visco-elastic properties of cartilage, can serve as a characteristic for the evaluation of chondrogenesis.
- the CSNs are detached from their support by trypsination and used to form micromasses by gravitation in a drop of amplification medium such as for example DMEM (lg / L of glucose) supplemented with 10% FCS (vol: vol), 2 mM glutamine and 0 to 20 ng / ml fibroblastic growth factor (FGFb).
- amplification medium such as for example DMEM (lg / L of glucose) supplemented with 10% FCS (vol: vol), 2 mM glutamine and 0 to 20 ng / ml fibroblastic growth factor (FGFb).
- FGFb fibroblastic growth factor
- This micromass is recovered and placed in the presence, for 7 to 28 days, of a chondrocyte differentiation medium composed of DMEM with 4.5 g / L of glucose and supplemented with TGF- b3 or a combination TGF- bI / BMR -2, in particular 10 ng / ml of TGF ⁇ 3 or 10 ng / mlTGF-bI and 50 ng / ml of BMP-2.
- a chondrocyte differentiation medium composed of DMEM with 4.5 g / L of glucose and supplemented with TGF- b3 or a combination TGF- bI / BMR -2, in particular 10 ng / ml of TGF ⁇ 3 or 10 ng / mlTGF-bI and 50 ng / ml of BMP-2.
- an RNA or protein extraction is carried out in order to analyze the expression of specific markers of the chondrogenic lineage such as collagen type II, aggrecan, COMP, SO
- the feline CSN population is characterized in that at least 80% of the cells of said feline CSN population have a potential for osteogenic differentiation. We also talk about osteogenic differentiation potential or osteogenesis.
- This osteogenic differentiation potential can be assessed by the protein and / or transcriptional study of specific bone markers (ALPL, RUNX2 ...) or by analysis of calcium deposits after induction of osteogenesis in 7 to 15 days.
- This osteogenic induction can be carried out by culturing CSNs in a monolayer in the presence of an osteogenic differentiation medium containing a corticosteroid, such as dexamethasone (0.1-ImM), a reducing agent such as ascorbic acid 2-phosphate ( between 0 and 200 pg / ml) and b-glycerophosphate (0-50 mM).
- a corticosteroid such as dexamethasone (0.1-ImM)
- a reducing agent such as ascorbic acid 2-phosphate ( between 0 and 200 pg / ml) and b-glycerophosphate (0-50 mM).
- BMP-2 can for example replace dexamethasone.
- APL a protein and / or transcriptional study of specific markers of bone (ALPL, RUNX2) can be carried out.
- composition and injectable solution comprising feline CSNs
- Another aspect of the invention relates to a pharmaceutical composition
- a pharmaceutical composition comprising a population of feline CSNs as described above.
- the present invention also relates to a pharmaceutical composition
- a pharmaceutical composition comprising a population of feline CSNs as defined above and a pharmaceutically acceptable vehicle.
- the feline CSNs of said composition come from a sample of neonatal tissue, in particular from one or more placentas and / or from one or more umbilical cords, or from a sample neonatal biological fluid, in particular the blood of one or more umbilical cords or amniotic fluid.
- said pharmaceutical composition comprises a population of feline CSNs between 3 million and 20 million cells for 0.5 ml to 10 ml of solution, and more specifically between 5 and 15 million cells for 1 to 2 ml of solution, and even more specifically 10 million cells for 1.5 ml of solution.
- the pharmaceutical composition comprises between 3.10 5 and 4.10 7 cells / ml, in particular 2.5 ⁇ 10 6 and 1.5 ⁇ 10 7 cells / ml, more particularly 1.10 7 cells / ml.
- the pharmaceutical composition comprises between 5 and 15 million feline CSNs, in particular 10 million.
- the pharmaceutically acceptable vehicle of this composition and / or the packaging makes it possible to maintain this proportion of viable CSNs for a sufficient time and this in a frozen or thawed manner according to the following methods.
- the vehicle can be all types of liquids, gels, solid polymers capable of containing these CSNs without deteriorating their desired properties, in particular an aqueous saline solution, serum, culture medium, a cryopreservation medium.
- the packaging can be all types of receptacles, containers, medical devices capable of aseptically isolating pharmaceutical preparations from the external environment and / or the transport environment and / or the manipulator.
- the packaging makes it possible to maintain the integrity and the formulation of the pharmaceutical composition and / or to facilitate the distribution / transport of the pharmaceutical composition.
- the vehicle and / or the packaging can be used to improve the properties of feline CSNs for their therapeutic use.
- growth factors, cytokines, active principles can be incorporated into the vehicle or linked to the packaging and thus act on the properties of feline CSNs so as to improve them.
- the availability and / or release of these chemical and / or biological actors can be of kinetic nature.
- said pharmaceutically acceptable vehicle is a solution comprising a cryoprotective.
- the solution can be any solution allowing the freezing and / or thawing of cells while limiting the biological influence of these processes on cells such as the induction of cell death, differentiation, the induction of cell senescence , osmotic shocks, induction of membrane porosity, modification of the membrane composition and / or phenotypic changes.
- the solution corresponds to DPBS (Dulbecco's phosphate-buffered saline), DMEM (Dulbecco's Modified Eagle Medium), MEM (Minimum Essential Media), a solution comprising fetal calf serum ( SVF), a solution comprising animal serum, and / or any other isotonic solution.
- said solution comprises between 0 and 20% of FCS, more particularly between 5 and 20%, even more particularly 10%.
- cryopreservation solution in a particular embodiment, is free of animal product.
- cryopreservation solution can be used as an injectable solution for the treatments concerned by the pharmaceutical composition described in said invention.
- cryoprotective means any compound making it possible to perform the cryopreservation function.
- said cryoprotector is chosen from glycerol, dimethyl sulfoxide (DMSO), propylene glycol, proteogly canes, trehalose, "Bovine serum albumin” (BSA), gelatin, polyethylene glycol (PEG), polyacrylic-acid, poly-L-lysine, ethylene glycol or a combination of several of these cryoprotectors.
- said solution comprises from 0.5 to 30% of glycerol, from 0.5 to 30% of DMSO, from 0.5 to 30% propylene glycol or from 0.5 to 20% poly-L-lysine.
- said solution comprising a cryoprotective is a solution comprising from 2 to 10% of DMSO, more particularly 5% of DMSO.
- said solution comprising a cryoprotective is a solution comprising 2 to 20% of glycerol.
- one or more adjuvants can be added to the pharmaceutical composition such as ammonium chloride, Ringer's lactate or BSA.
- said solution comprising a cryoprotector is a DMEM solution comprising SVF, in particular from 5 to 20% of SVF and more particularly 10%, and comprising from 1 to 90% of DMSO, more particularly from 0.5 to 20%, more particularly from 5 to 10%, in particular 5%.
- said solution comprising a cryoprotector is a DMEM solution comprising SVF, in particular from 5 to 20% of SVF and more particularly 10%, and from 2 to 20% of glycerol.
- the pharmaceutical composition is characterized in that it is in frozen form.
- the pharmaceutical composition can be cryogenized with the use of a suitable cryoprotective, capable of guaranteeing the integrity and the formulation of the pharmaceutical composition.
- the pharmaceutical composition can then be stored at -196 ° C, for long-term storage (more than 12 months). To be used, it undergoes thawing, as described below.
- said composition is a ready-to-use composition.
- ready to use is meant that the pharmaceutical composition comprising feline CSNs is ready to be injected into the individual. Recultivation of cells before use in the individual is not necessary and the cells do not need to be resuspended in a physiological medium, even when they are formulated with a cryoprotector as described above .
- the expression “ready to use” means that only a thawing step is necessary when the composition is in frozen form, before injection into the patient.
- This pharmaceutical composition which can be frozen can thus be mobilized at any time.
- the latter has the advantage of making treatment available as soon as possible while limiting the human intervention necessary for its effectiveness and limiting the risk of contamination inherent in each manipulation by an operator. Thus, it is possible to separate the process for obtaining the pharmaceutical composition from its final clinical use.
- Another aspect of the invention relates to a ready-to-use injectable solution comprising a population of feline CSNs as described above and a cryoprotector as defined above.
- said ready-to-use injectable solution comprises a unit dose of 5 to 15 million CSN, more particularly 10 million, and a solution comprising a cryoprotector as defined above.
- cryoprotective in said injectable solution is DMSO.
- the solution comprises between 0.5 and 30% of DMSO, in particular between 2 and 10%, more particularly 5%.
- the injected solution ready for use at a volume between 1 and 5 ml, more particularly 1.5 ml.
- feline CSNs The characteristics of the feline CSNs described above, allow the use of these cells in cell therapy.
- cell therapy is meant a therapeutic treatment comprising G administration of cells capable of inducing a beneficial therapeutic effect in the feline.
- this cell therapy is likely to directly (cell differentiation) or indirectly (secretion of biological factors, activation or inhibition of environmental cells) recovery, homeostatic and / or immune balance of one or more tissues or organs in a feline individual awaiting such treatment.
- the present invention relates to a population of feline CSNs, a pharmaceutical composition or an injectable solution as described above for their use in cell therapy.
- This use in cell therapy can be an autologous, allogenic, syngeneic or xenogenic therapeutic use.
- the use in cell therapy is an allogeneic therapeutic use, also called heterologous.
- the use in cell therapy is a xenogenic therapeutic use.
- the present invention relates to a population of feline CSNs, a pharmaceutical composition or an injectable solution as described above for their use in the treatment of feline stomatitis.
- stomatitis means an inflammation of the oral cavity. Stomatitis is designated by different terms depending on the etiology, therapeutic approach and / or clinical signs observed. For example and in a non-exhaustive manner, the stomatitis are gingivitis, periodontitis, caudal stomatitis, buccostomatitis, chronic stomatitis, lympho-plasmocytic stomatitis or granulomatous stomatitis.
- the stomatitis can have an infectious (bacterial, fungal), autoimmune, inflammatory origin, following chemotherapy and / or radiotherapy and / or consecutive to organic, metabolic drug treatment.
- the pathological origin of the stomatitis is viral and in a non-exhaustive manner, generated following an infection by the feline Calicivirus, by the Herpes virus or by the feline immunodeficiency virus.
- feline stomatitis is chronic stomatitis, in particular chronic gingivostomatitis (GSC).
- 5.10 5 to 10.10 6 cells / kg more particularly 1.10 6 to 5.10 6 cells / kg are administered.
- 5.10 5 to 2.10 7 feline CSN in particular from 5.10 6 to 1.5.10 7 , more particularly 1.10 7 , or a composition or solution for injection comprising such a dose, are administered.
- the subject is treated with the administration of a single dose as defined above.
- a single dose of 3.10 6 to 2.10 7 Feline CSN, in particular from 5.10 6 to 1.5.10 7 , more particularly 1.10 7 is sufficient to treat the subject.
- treating the subject is meant that the subject to whom feline CSNs have been administered as described in the present application, shows a reduction in symptoms for a period of at least 2 months, in particular at least 4 months, especially at least 6 months. The subject's condition is then improved by the treatment. It is also understood that the subject to whom the feline CSNs have been administered presents an improvement in their condition in the sense that this allows a reduction in the frequency and / or the dose, or the total freedom from other known conventional therapeutic or analgesic solutions. by the skilled person.
- compositions known to those skilled in the art are meant, in a non-exhaustive manner, total or partial dental avulsion, ciclosporin, anti-inflammatory drugs of steroid or non-steroid type, antibiotics, Omega Interferon (IFN), corticosteroids, gabapentin, morphine and / or buprenophine.
- administration to the subject is carried out at least once to treat said subject.
- At least two administrations on the subject are carried out, two administrations being spaced at least 2 months from each other, in particular spaced from 2 months to 5 years, by 2 months at 4 years, from 2 months to 3 years, from 2 months to 2 years, from 2 months to 1 year, or from 2 months to 6 months.
- the CSNs can be administered locally or in a particular embodiment intravenously (IV).
- IV administration is meant administration of the CSNs directly into the venous system of the animal using a catheter or a needle or, for example, via an infusion bag or, for example, through the infusion set with a particular speed of administration.
- administration speed is understood to mean an infusion rate in a particular embodiment of 2.5 ⁇ 10 4 to 1.10 6 of CSN / min.
- the CSNs can be administered at the rate of 5.10 5 CSN / min.
- the administration is carried out intravenously, for example using an infusion.
- said population of feline CSNs or said pharmaceutical composition for the use as described above is characterized in that the administration is carried out in the form of a single dose of 5.10 5 to 2.10 7 Feline CSN, in particular from 5.10 6 to 1.5.10 7 , more particularly 1.10 7 , to treat the subject, in particular by intravenous route.
- this use can be combined with other types of treatment / interventions.
- it can be carried out following total dental avulsion; and / or during or following a drug treatment or during anesthesia.
- this use can be carried out in subjects who have not undergone dental avulsion or in subjects who have undergone partial dental avulsion.
- partial dental avulsion is meant any surgical operation aimed at extracting between 1 and 29 teeth, more particularly between 1 and 26 teeth, more particularly between 1 and 16 teeth.
- partial avulsion can represent the only extraction of teeth specifically affected by oral lesions or G extraction of all teeth except the canines.
- the present invention relates to feline CSNs, the pharmaceutical composition or the solution for injection as described above for their use in the treatment of feline stomatitis, in combination with the administration of one or more anti-inflammatory, analgesic, immunomodulatory, anti-infectious and / or antiviral treatments linked or not to stomatitis.
- the present invention relates to feline CSNs, the pharmaceutical composition or the solution for injection as described above for their use in the treatment of stomatitis in felines, in combination with the administration of a anti-inflammatory.
- This anti-inflammatory can be an anti-inflammatory of the steroid or non-steroid type.
- steroidal anti-inflammatory we can cite glucocorticoids and steroid corticoids.
- non-steroidal anti-inflammatory we can cite buprenorphine, aspirin, ibuprofen, ketoprofen, methylprednisolone acetate.
- As a therapeutic with an anti-inflammatory action we can also cite laser therapy.
- As analgesics we can cite morphine and alpha2-agonists.
- immunomodulator we can cite cyclosporins and rapamycin.
- anti-infective and antiviral we can cite recombinant antibiotics and interferons.
- the feline CSNs are administered for the treatment of feline stomatitis in subjects refractory to one or more of the therapeutic or analgesic solutions previously mentioned.
- refractory means any medical management of feline GSC which is not satisfactory, which has a lack of effectiveness, an upsurge of clinical signs, which generates unwanted side effects, which generates intolerance or an adverse immune reaction, inducing a lack of compliance, requiring use of a drug dose that is too high compared to conventional treatment and / or the use of too complex and unsuitable polypharmacy.
- feline CSNs allows at least clinical improvement or complete remission in more than 50%, more particularly 70%, more particularly 80% of animals suffering from GSC, having undergone dental avulsion total and / or refractory to conventional therapies.
- this evolution is observed without prior selection of cats based on their blood phenotype and more particularly without selection of the proportion of cells having a low level of expression of the CD8 marker (CD8 + low) within a population expressing this marker (CD8 + global).
- the effectiveness of the treatment can be evaluated in different ways.
- the effectiveness of the treatment is measured using an evaluation system established by a veterinarian, based on the GSC activity index (The Stomatitis Disease Activity Index: SD AI).
- SD AI score takes into account the following parameters: oral inflammation (maxillary and mandibular), gingival inflammation (maxillary and mandibular), inflammation in the palatal arch, inflammation of the salivary gland, oropharyngeal inflammation, lingual inflammation or sublingual.
- the evaluation of the SDAI can be carried out at the inclusion and then at different times after the infusion or injection of the pharmaceutical preparation.
- SDAI clinical score
- the recovery percentage is obtained by the formula ⁇ 1- (SDAI f / SDAL) ⁇ x 100 where SDAI f corresponds to the final SDAI obtained, and SD AL corresponds to the initial SDAI obtained.
- the effectiveness of the treatment can be assessed during a time interval by calculating a recovery percentage using as an analysis variable an SDAI at a given intermediate time (SDAI t ) instead of d 'an SDAI f and a formula of the type of (1- (SDAI t / SDAL) ⁇ xl00.
- a percentage greater than or equal to 15% is considered to be a clinical improvement not due to a placebo effect (13).
- clinical remission is meant, animals whose SD AI score is less than 2 at the time of the clinical evaluation (Dental Vêts, 2015).
- the effectiveness of the treatment can be evaluated by monitoring the progress of the symptoms linked to the disease.
- the treatment will thus be considered effective if it makes it possible to dispense with the other conventional therapeutic or analgesic solutions known by the person skilled in the art or to reduce the frequency of use or the dose thereof, if it contributes to reducing eating disorders (dysorexia) in animals with a symptom of undernutrition, if it allows gain in activity and weight gain in treated subjects with an initial loss of activity, if it allows the intensity of pain caused by the subject's medical status. All or part of these parameters can be monitored by the owners in monitoring forms (Example 2).
- the present invention also relates to a method of treatment of feline stomatitis comprising the administration of feline CSNs, of a pharmaceutical composition or of an injectable solution comprising feline CSNs as described above, to a subject.
- Another aspect of the invention relates to an in vitro process for obtaining a pharmaceutical composition according to the invention.
- the present invention also relates to an in vitro process for obtaining a ready-to-use pharmaceutical composition comprising feline CSNs as described above, said process comprising the following steps:
- step d at least one step of cryopreservation of the population of feline CSNs obtained following step b and / or c., to constitute a cell bank;
- step f optionally, a step of stimulation by a chemical and / or biological physical effector of the feline CSNs to increase their biological and therapeutic properties, during step f;
- step b. at least one step for verifying the biological properties of feline CSNs following step b., c., d., e., f., and / or g .;
- feline neonatal biological samples from which the feline CSNs may have been described have been described previously.
- isolation means the means used to extract the cells from their original source of tissue nature and / or biological fluid. Typically these means correspond to the mechanical dissection of the tissues making it possible to obtain tissue fractions which can be used in the laboratory. These tissue fractions are then cultured for explantation type isolation, thus exploiting the migration capacities of the resident cells.
- Another means of isolation is for example the use of digestion enzymes leading to the catabolism of the extracellular matrix and the release of the cells over a given time from 10 min to 16 h under controlled temperature. Among these digestion enzymes, it is possible to cite, in a non-exhaustive manner, collagenases, pronase, hyaluronidases and / or other matrix proteases.
- Another means of isolation, for biological liquid sources and / or cell suspensions obtained from enzymatic tissue digestion, consists in the use of cell purification by centrifugation on a density gradient of the Ficoll, Percol and / or glucose type. .
- the methods mentioned above can be used alone or in combination.
- the result of these isolation methods must favor the isolation of CSNs independently of cells. hematopoietic, blood cells or other contaminating cell types which do not correspond to CSNs or CSNs which do not have the abovementioned biological properties.
- a step of amplifying the cells by adhesion to the plastic can be carried out.
- a plastic support treated or not for cell adhesion, and / or in the presence or not of fibroblast growth factor (FGF, FGF-2, FGFb), dexamethasone and / or ascorbic acid 2 phosphate (A2P), and in a cell culture medium properly defined by those skilled in the art, is used.
- amplification step is meant any step allowing proliferation of CSNs on plastic or polymer support. This phase must be able to promote the presence of CSNs to the detriment of other cell types which do not meet the characteristics of CSNs. It must also ensure optimal proliferation of cells while limiting the phenomena of dedifferentiation, differentiation and / or senescence. This step involves conditions in a controlled atmosphere such that a person skilled in the art is able to establish, for example with 90% humidity and comprising 5% CO2.
- the amplification temperature must be constant and between 35-40 ° C, more precisely between 37-39 ° C.
- the culture media in a non-exhaustive manner, it is possible to cite the media of the Alpha-MEM, DMEM, RPMI, IMDM, Opti-MEM, EGM, EGM-2 type, synthetic media adapted to the culture of CSM lacking endotoxin and / or serum, synthetic media adapted to good manufacturing practices, whether or not supplemented with fetal calf serum (SVF) from 0.1% to 20%, platelet lysate, insulin-transferin-selenium , defined commercial supplements and / or other growth factors and / or molecules promoting the proliferation of CSNs while limiting their senescence such as FGF, EGF, VEGF, dexamethasone and / or A2P.
- SVF fetal calf serum
- This amplification phase can be carried out on different supports once the population of CSN is obtained following the isolation step.
- These different supports can be 2D or 3D in nature.
- amplification on 2D support is meant any cell culture method allowing amplification of feline CSNs on monolayer support and properly developed by those skilled in the art.
- the cells can be cultured in plastic culture dishes treated or not to promote cell adhesion, of flaccid type, with one or more stages and / or of multilayer type with or without continuous perfusion, with or without optimization of the flow of 'air.
- the CSNs can be amplified in shaking, axial and / or pendulum bioreactors, in wave shaking, in rotating bed shaking, in static and / or infused bioreactors.
- the biomaterials and / or microcarriers can be of several natures and according to particular embodiments can be of sizes between 50-500 ⁇ m in diameter, have a porosity of different nature, have a treated surface, charged or not negatively or positively charged, include growth factors or recombinant proteins of the integrin and / or extracellular matrix type or any other biological / chemical molecules promoting cell adhesion and / or cell proliferation.
- cell passage of the CSNs may be necessary and carried out by a method correctly developed by those skilled in the art.
- These cell passages can be carried out by detachment of the cells under the effect of mechanical action, enzymes and / or inhibitors such as, in a non-exhaustive manner, recombinant or animal trypsin, EDTA and / or accutase.
- a clonal selection can take place during the first passages from PI to P4 such (11) and result in a relatively stable population such as the clonogenicity of the population of CSN n 'evolves only weakly.
- these first passages can allow the isolation of a CSN population devoid of other contaminating cell types such as lymphocytes and other blood cells, macrophage, neutrophils, polynuclear cells, endothelial cells and / or fibroblasts.
- the cells are for example treated with trypsin-EDTA, then taken up in an amplification medium and centrifuged. After taking up in amplification medium, they are seeded at the level of 1500 to 5000 cells / cm 2 or 3D equivalent and cultivated in amplification medium with or without monitored monitoring of the microenvironment and / or culture atmosphere.
- the feline CSNs obtained are suspended with a pharmaceutically acceptable vehicle as defined above.
- the pharmaceutically acceptable vehicle is a solution comprising a cryoprotective.
- cryopreservation is meant the cell freezing and storage stage for a period ranging from 1 day to 5 years and more.
- the cell bank is conditioned to guarantee the integrity and biological properties of cell populations. Banks can be of several natures and play several roles. It is possible to cite in a non-exhaustive manner the cellular reserve banks (“master bank” or “seed unit”), cellular working banks (“working bank”), legal bank, retention bank and / or unit banks ready-to-use therapeutic products for therapeutic use. Note that this latter bank of therapeutic units may correspond to a pharmaceutical preparation described later.
- the cryopreservation step is carried out after the suspension of the CSNs in a solution comprising a cryoprotector.
- this freezing or cryopreservation step corresponds to a gradual descent of the temperature of the cell suspension (-1 ° C / minutes) to reach the storage temperature ranging from -70 ° C to - 195 ° C.
- the cells can be frozen at a freezing rate of between -0.3 ° C / minutes and -99 ° C / minutes.
- the same freezing protocol can include one or more different freezing speeds as in the case of a gradual increase in freezing speed.
- the cells are directly frozen without temperature control in a storage enclosure whose temperature is between -70 ° C and 195 ° C.
- Final storage can be in liquid phase (liquid nitrogen type) or gas phase (enclosure type -140 ° C, -80 ° C or nitrogen storage in gas phase).
- a thawing step is carried out following the freezing step, in the case where the CSNs used for the administration are in the form of units of bank. This thawing is carried out so as to pass from the stage of frozen cells to the stage of thawed cells during an embodiment limiting cell death by drying, mechanical damage to the plasma membrane, osmotic shock.
- the CSN units are heated by manual friction for less than 10 min.
- the CSN units are placed in a liquid or dry water bath, set at a temperature between 30 and 40 ° C for less than 10 min, in particular at 37 ° C for 3 to 5 min.
- the CSN units are placed in an automatic thawing apparatus.
- the CSN units are thawed at room temperature for less than 10 min if the cryoprotector used allows it.
- the thawed cells can be amplified. After thawing, the cells are then resuspended in washing medium (DPBS, DMEM or DMEM + SVF) or in cell amplification medium. In a particular embodiment, the volume of suspension is gradually adjusted in order to limit the osmotic shocks that the cells can undergo. The cells are then returned to culture in order to carry out a new amplification phase.
- washing medium DPBS, DMEM or DMEM + SVF
- cell amplification medium In a particular embodiment, the volume of suspension is gradually adjusted in order to limit the osmotic shocks that the cells can undergo.
- the feline CSNs can undergo an exogenous stimulation / modification step during the amplification phase by means of physical, biological and / or chemical effectors.
- exogenous stimulation also called “priming”
- treatment with cytokines in concentrations between 1 and 500 ng / ml of IFN-g, IL-Ib, 11-6 and / or TNF-a makes it possible to significantly increase expression molecules with immunomodulatory activity.
- mechanical stimulation and / or the induction of a chondrogenic predifferentiation can make it possible to favor the tissue reconstruction properties in vitro.
- At least one step of verifying the biological properties of the isolated feline CSNs is carried out.
- the presence of the markers CD29 and CD44 and the absence of the markers CD8, CMH-I and CMH-II are verified.
- the cell proliferation capacity comprised of at least 20 consecutive cell doublings, as described above, is verified.
- the capacity for chondrogenic differentiation of the feline CSNs is verified.
- FIG. IA shows the analysis of feline CSNs by flow cytometry according to the FSC-A / FSC-H parameters allowing the selection of single cells.
- An analysis according to the FSC-A / SSC-A parameters subsequently makes it possible to select the population of CSNs of interest.
- Figs. IB, IC, 1D, 1E, 1F represent the evaluation of the expression of the marker of interest by the population of feline CSNs by fluorescence analysis for the corresponding fluorochrome.
- the graph represents the results of the surface markers (in light gray, the specific marker of interest; in dark gray the corresponding isotype).
- the positivity threshold is placed using cells marked with the corresponding isotype.
- the table indicates the number of events analyzed as well as the median fluorescence of the CSN population.
- FIG. IB shows the positivity of the expression of the surface marker CD44.
- FIG. IC shows the positivity of the expression of the CD8 surface marker.
- FIG. 1D shows the positivity of the expression of the CMH-II surface marker.
- FIG. 1E shows the positivity of the expression of the surface marker CD29.
- FIG. IG shows the analysis of PBMC by flow cytometry according to the FSC-A / FSC-H parameters allowing the selection of single cells.
- An analysis according to the FSC-A / SSC-A parameters subsequently makes it possible to select lymphocytes.
- FIGS. 1H and II represent the evaluation of the expression of the marker of interest by the lymphocytes, by analysis of the fluorescence for the corresponding fluorochrome.
- the graph represents the results of the surface markers (in light gray, the specific marker of interest; in dark gray the corresponding isotype).
- the positivity threshold is placed using cells marked with the corresponding isotype.
- the table indicates the number of events analyzed as well as the median fluorescence of lymphocytes.
- FIG. 1H shows the validation of the specificity of the CMH-II marker on cat lymphocytes.
- FIG. II shows the validation of the specificity of the CMH-I marker on cat lymphocytes.
- FIG. 2 shows the proliferative activity illustrated by the accumulation of the number of cell doublings during the passages
- FIG. 3 shows a representative photograph of the MSCs cultivated for 2 weeks in osteogenic differentiation medium and marked with red alizarin. The presence of calcium deposits is highlighted by the red coloring;
- FIG. 4 shows a monitoring sheet completed by the owners of the animals included in the study
- FIG. 5 shows a photo of the mouth of a cat having undergone dental avulsion and treated by Feline CSNs. This photo shows the reduction in visible oral lesions before (photo on the left) and after treatment (photo on the right);
- FIG. 6 shows the evolution of the SD AI score of cats having undergone dental avulsion and treated with feline CSNs over time (days after infusion). The median is represented by a horizontal line in the center of the boxplot;
- FIG. 7 shows the evolution of the SD AI score over time presented for each cat included and followed, having undergone dental avulsion and treated by the feline CSNs;
- FIG. 8 shows the clinical recovery rate calculated at each follow-up visit (D60, D90, DI 80) for the 7 cats having undergone dental avulsion and treated by the feline CSNs of the study;
- FIG. 9 shows the proprietary score (/ 12) evaluated over time (injection D0, 15 days, 2 months, 3 months and 6 months) for each cat having undergone dental avulsion and treated with feline CSN.
- FIG. 10 shows a photo of the mouth of a cat with partial dental avulsion treated with Feline CSNs. This photo shows the reduction in visible oral lesions 15 days after treatment (photo on the left) and 1 month after treatment (photo on the right);
- FIG. 11 shows the evolution of the SD AI score of cats having undergone partial dental avulsion and treated with feline CSNs over time (days after infusion).
- Fig. 12 shows the evolution of the SD AI score of cats having undergone partial dental avulsion and treated with feline CSNs over time (days after infusion).
- FIG. 12 shows the clinical recovery rate calculated at each follow-up visit (D60, D90, DI 80) for the 2 cats having undergone partial dental avulsion and treated by the feline CSNs of the study;
- FIG. 13 shows the proprietary score (/ 12) evaluated over time (day of the infusion, 15 days, 2 months, 3 months and 6 months) for each cat having undergone partial dental avulsion and treated with Feline CSNs.
- Example 1 Obtaining and characterizing feline neonatal stromal cells (CSN)
- the extra feline embryonic appendages (placenta, umbilical cord) are removed aseptically during a suitable ovario-hysterectomy performed on cats during pregnancy.
- a suitable ovario-hysterectomy performed on cats during pregnancy.
- the uterus more or less the clamped ovarian ducts are placed in a transport box containing a buffered saline solution such as Dulbecco phosphate (D-PBS) to be sent to the temperature-controlled laboratory (4-12 ° C).
- D-PBS Dulbecco phosphate
- the processing of the extra embryonic tissue is carried out at most within 72 hours of the sample. All of the tissue processing steps are carried out in a controlled environment, under a microbiological safety station (PSM).
- PSM microbiological safety station
- the tissue is aseptically removed from its transport box and transferred to a 100 cm 2 petri dish.
- the amniotic sac containing the fetus is removed by dissection.
- the red placenta is transferred to a sterile beaker.
- the fabric is washed 3 to 5 times in successive D-PBS baths.
- the placental tissue is dissected into fragments of approximately 10-20 mm 2 then subjected to an enzymatic digestion by incubating the tissue fragments in a solution composed of DMEM (modified Eagle medium from Dulbecco) containing 0.5-4 mg / ml of type I collagenase, and more specifically a concentration of 1 mg / ml of type I collagenase.
- DMEM modified Eagle medium from Dulbecco
- the enzymatic digestion takes place at 37 ° C for 45 min but digestion between 15 min and 16 h can be carried out by reducing the incubation temperature (room temperature (18-22 ° C or 4 ° C).
- the enzymatic activity is stopped by dilution, by adding DMEM containing at least 10% of fetal calf serum (SVF) in an amount equivalent to the enzymatic digestion solution. filtered on a 70-100 ⁇ m sieve. The recovered cells are centrifuged at 800 g for 10 min. The cell pellet containing the neonatal stromal cells is rinsed with DMEM and again centrifuged at 800 g for 10 min. culture medium con containing DMEM, 10% FCS, 2 mM glutamine and 0 to 20 ng / ml of fibroblast growth factor (FGF).
- FGF fibroblast growth factor
- the cells are counted and seeded in culture dishes at a density of between 10 4 and 2.10 4 cells / cm 2 .
- the cells are then cultured in the culture medium described above in a controlled atmosphere at 37 ° C. and containing 5% of CO2.
- the medium is changed after 48 hours and then every 2-3 days.
- the cells are passed when the confluence reaches 70-80%.
- Culture medium consisting of DMEM, 10% FCS, 2 mM glutamine and 0 to 20 ng / ml of fibroblast growth factor (FGF) is added to the amniotic fluid at a minimum level of 50% of the volume sampled.
- the suspension can be rinsed with DPBS and centrifuged to centrifuged at 800 g for 10 min.
- the volume of liquid or cells re suspended in an equivalent volume in the culture medium is placed directly in the culture dish at a height of 100 to 300 m 300 per cm 2 .
- the culture dishes are then cultivated in the culture medium described above in a controlled atmosphere at 37 ° C. and containing 5% of CO2. The medium is changed after 48 hours and then every 2-3 days. After 1-2 weeks of cultures, the feline CSN colonies are passed to allow cell amplification.
- the cells undergo cell passage and optionally, an amplification procedure.
- the feline CSNs are rinsed with D-PBS and treated with 0.05% trypsin-EDTA for 2-5 min at 37 ° C. This helps detach the cells and form a population of isolated cells.
- the cells are then taken up with amplification medium consisting of DMEM, 10% of S VF, 2 mM glutamine and from 0 to 20 ng / ml of fibroblast growth factor (FGF) and centrifuged between 300-500 g for 5 to 10 minutes.
- the feline CSNs are taken up in amplification medium, and counted by manual counting (tryan blue and Malassez cells) or using an electronic counter.
- cells are then seeded at a height of 1500 to 5000 cells / cm 2 and cultivated on a plastic cell culture support in amplification medium and in a controlled atmosphere at 37 ° C. and containing 5% of CO2. During the amplification process, cells can undergo between 0 and 15 cell passages.
- the cells can be cryopreserved in cellular seed units.
- the feline CSNs are centrifuged between 300-500 g for 5 to 10 min and the cell pellet is taken up in freezing medium composed either of DMEM medium enriched with 5-20% of SVF and 5-10 % (vol: vol) of DMSO or in a commercial cryopreservation medium, whether or not containing a fraction of DMSO.
- the cell concentration is between 1.10 6 and 15.10 6 cells per ml of freezing medium.
- the cells are frozen under conditions of controlled temperature reduction, for example using a CoolCell® Cell Freezing Containers (BioCision) and following the freezing procedure as described by the manufacturer. Cells are then transferred for negative cold storage at temperatures such as -196 ° C for long-term storage (more than 1 year).
- the cell seed units are used to generate cell units for therapeutic purposes.
- the cellular seed units are thawed at 37 ° C for 3-6 min and amplified in vitro.
- the cells are seeded in culture medium at a density of 1500-3000 cells / cm 2 .
- the cells are amplified by successive passage in vitro. When a significant number of cells is produced (for example> 150 ⁇ 10 6 cells), the cells are frozen according to the protocol described above.
- the cells are distributed in hermetically sealed sealable bottles at a rate of 1.10 6 -1.5.10 7 cells / ml in freezing medium free of product of animal origin (such as, for example, the cryopreservation medium Recovery TM Cell culture freezing medium (Thermo Fisher), Cryostem TM freezing medium (Biological Industries), Cryostor TM (Biolife Solution).
- the vials are lowered in temperature according to a controlled temperature lowering protocol, at -l ° C / min to -80 ° C
- the bottles are then transferred to -80 ° C for storage for a maximum of 24 months.
- tests are carried out on aliquots of cells during amplification or after freezing / thawing of a seeding unit or of a therapeutic unit.
- feline CSN surface markers is carried out by flow cytometry using the following anti-feline antibodies: CD8 (vpg9; Biorad), CMH2 (vpg3; Biorad); and antibodies specific to other species and crossing with cats: CD44 (IM7; Biolegend); CD29 (TS2 / 16; Biolegend).
- CD8 vpg9; Biorad
- CMH2 vpg3; Biorad
- CD44 IM7; Biolegend
- CD29 TS2 / 16; Biolegend
- a secondary mouse anti-immunoglobulin (IgG) antibody coupled to allophycocyanin (APC) is used in a second step.
- Isotypic controls are used to adjust the background noise for each fluorochrome used: anti-mouse IgG2a (COL2002 / CQLI205C; Monoclonal Antibody Center); anti-mouse IgG1 coupled to PE (MOPC-21; Biolegend); anti-rat IgG2b coupled to APC (IM7, Biolegend).
- the feline CSNs in culture are detached from their plastic support by trypsination and are rinsed with D-PBS. The cells are divided into tubes at the rate of 10 5 -5.10 5 cells / tube.
- the cells are centrifuged (500 g / 5 min) and taken up in 25-100 m ⁇ of labeling buffer (D-PBS and of 0.5-1% (v / v) of bovine serum albumin (BSA) or of 0.5-2% (v / v) fetal calf serum).
- labeling buffer D-PBS and of 0.5-1% (v / v) of bovine serum albumin (BSA) or of 0.5-2% (v / v) fetal calf serum.
- BSA bovine serum albumin
- the optimal concentration of antibody used for labeling must be determined beforehand by a person skilled in the art.
- the incubation required for labeling must also be determined by a person skilled in the art and between 15 min and 10 h at 4 ° C. protected from light. In particular, the cells are incubated for 30 min at 4 ° C. protected from light.
- Labeling with a secondary antibody targeting the primary antibody can be carried out, after washing with D-PBS, in the case where the primary antibody is not directly coupled to a fluorochrome.
- the cells are washed twice in 1 ml of D-PBS and centrifuged (500 g / 5 min). The cell pellets are taken up in a volume of 100-500 m 3 of labeling buffer for reading with a flow cytometer (Accuri C6, BD Biosciences).
- FIGS. IA to III show a representative example of the results of cytometric analysis of the feline CSNs.
- the proliferation of feline CSNs is evaluated for 6 to 15 consecutive cell passages to determine the proliferative activity of the cells.
- the cells are detached from their culture support using 0.5% trypsin / EDTA for 2-3 min.
- Culture medium is added and the cells are centrifuged for 5 min / 300 g.
- the cell pellet is taken up in a defined volume of culture medium and the cells are counted by trypan blue exclusion technique using an electronic counter.
- the total number of cell doublings is equal to the sum of the number of doublings accumulated during each cell passage.
- FIG. 2 illustrates the number of doublings cumulated on 8 cell passages of a line of feline CSN.
- feline CSNs are capable of 30 consecutive doublings in the space of 7 weeks (at the rate of one passage per week).
- the feline CSNs are detached from their plastic support by trypsination and counted.
- the feline CSNs are seeded at a density of between 1500 and 5000 cells / cm 2 in a 6-well plate in amplification medium under a controlled atmosphere at 37 ° C. and containing 5% CO 2.
- the proliferation medium is removed and replaced by osteogenic differentiation medium composed of DMEM, 10% of SVF, 2 mM glutamine, 0.1 mM dexamethasone (Sigma), 50 mM acid. ascorbic 2-phosphate (Sigma) and 10 mM b-glycerophosphate (Sigma).
- the medium is renewed 2 times / week, for a period between 10 and 15 days.
- the wells are washed with D-PBS and the cells are fixed with, for example, a neutral buffered formalin solution 10% for at least 1 hour. Staining with a 1% Alizarin red solution (weight / volume) is carried out to demonstrate the presence of calcium deposits.
- the wells are then rinsed in H 2 0 and the coloration is analyzed under a microscope. The presence of calcium deposits allows us to conclude that we can differentiate our in the osteogenic lineage.
- FIG. 3 represents an example of feline CSN cultured for 14 days in osteogenic differentiation medium and stained with G red alizarin.
- Example 2 Evaluation of the clinical effect of a single injection of cryopreserved feline CSNs for the management of feline GSC refractory to conventional treatments and having undergone total dental avulsion or partial dental avulsion. [0191] A. Study program
- Inclusion criteria 1- Present specific inflammatory lesions of GSC (confirmed by a specialist in dentistry); 2- Having tried other ciclosporin-type treatments, NSAIDs, antibiotics, omega IFN without success; 3- Show persistence of clinical signs after 2 months of treatment; 4- Dental extraction (partial or total) required and dating back more than 3 months; 5- Stop IFN or corticosteroid treatments
- Non-inclusion criteria 1 - Informed consent not signed by the owner; 2- Gestation, progressive tumor process, systemic infectious process, intercurrent disease which may interfere with the evaluation of treatment; 3- Extreme physical impairment involving the life of the animal; 4- Administration of unauthorized treatment during the study period (IFN or corticosteroid therapy)
- Criteria for leaving the study 1 - Resumption of treatment including ciclosporin, IFN, corticoids, lactoferrin during the study period; 2-Deterioration of the general condition during the test leading to an extreme weakening involving the life of the animal; 3- Appearance of other intercurrent affections which can interfere with the follow-up of the evolution: evolutionary tumor process, systemic infectious process
- the animals included in the study are evaluated by a veterinarian who ranks the degree of severity of the pathology using the "stomatitis Disease Activity Index" (SD AI). This score gives a score of 0 (healthy animals) to 24 (severe GSC). Pictures of the cat's mouth are taken on D0 and at the end of the study (6 months (M)) to check the evolution of the lesions.
- SD AI stomatitis Disease Activity Index
- M median health of the cat's mouth
- M 6 months
- the owners of the animals included in the study receive a questionnaire to complete to assess the activity, appetite, behavior and comfort of their animal.
- the animals receive cell treatment on the day of inclusion.
- the follow-up of the animals is planned at 15 days, 2 months, 3 months and 6 months post-inclusion.
- animals are allowed to continue their nonsteroidal anti-inflammatory therapy (NSAIDs) at provided that the dose is specified in the study documents. Monitoring the doses and the frequency of administration of treatments during the study is an analysis criterion.
- Table 1 summarizes the schedule of the study and the different analyzes performed at each follow-up.
- the clinical evaluation is carried out by a veterinarian specialized in dentistry, holder of the specialist diploma of the European College (European Veterinary Dental College (EVDC)).
- EVDC European College
- Follow-ups are scheduled at 2 weeks, 2 months, 3 months and 6 months post-treatment.
- the veterinarian fills out a clinical follow-up sheet including the evaluation criteria detailed below, the weight, the treatments in progress.
- the main criterion for evaluating effectiveness is the improvement of clinical signs. This assessment is based on the GSC activity index (SDAI) taking into account different parameters:
- the owners are also asked to carry out an evaluation of their cat on the criteria of activity, appetite, behavior and comfort. Each parameter is scored from 0 to 3, resulting in a score of 12.
- FIG. 4 represents the monitoring sheet completed by the owners of the animals included in the study.
- a dose of feline CSN cryopreserved at -196 ° C. is thawed at 37 ° C. for 3-5 minutes in the laboratory the day before the administration of the treatment under conditions guaranteeing the asepsis of the product.
- An aliquot of the cell product is taken to verify the viability and the quantity of cells by the trypan blue exclusion technique.
- the specifications of the post-thaw product are as follows: viability greater than 80%, and total number of viable cells of at least 10 7 . The precise number of viable cells counted is presented in Table 2.
- Table 2 illustrates the results of the thaw cell viability tests.
- the cells conforming to the specifications are transferred to a sterile sealable bottle.
- the product packaged in its bottle is transferred to a temperature-controlled transport box (4-12 ° C).
- the treatment is sent to the veterinary clinic for administration to the patient on D + 1 or D + 2.
- the animal can be sedated to control the smooth running of the infusion.
- the veterinarian chooses the most suitable site to fix the venous route to the animal.
- An infusion bag (Ringer lactate) is used in combination with heparin. The bag is then homogenized by inversion then the veterinarian connects the infuser to the solution bag.
- the cellular product (between 1.0 ⁇ 10 7 and 1.4 ⁇ 10 7 viable cells for an average of 1.2 ⁇ 10 7 ) is removed from its packaging 15 min before the injection.
- the veterinarian homogenizes the cell suspension inside the bottle by rotation.
- a syringe of suitable volume with an 18 G-20 G (70 mm) needle is prepared to aspirate the cell suspension inside the vial.
- the syringe is then connected to the injection site at the bottom of the tubing.
- the veterinarian slowly pushes the plunger to expel approximately 0.2-0.5 ml of the suspension every 5 min.
- the entire feline CSN is administered in approximately 20-30 min.
- the animals are awakened and kept in the clinic for at least 4 hours to check their physiological parameters. Data analysis
- the main evaluation criterion is the SD AI clinical score defined by the veterinarian during each follow-up.
- the significance of the variability of the SD AI over time is compared with the score on inclusion in the study (OJ) using a non-parametric Friedman test.
- Table 3 details the characteristics of the animals included in the study with complete or partial dental avulsion.
- Table 4 summarizes the treatments administered by the owners of the cats during the 6 months of follow-up. [0223] [Table 4]
- FIG. 6 illustrates the evolution of the SD AI score over time.
- a non-significant decrease in SD AI was observed 15 days post-treatment (median score on D15: 9.5 [4; 14] vs median score on D0: 11 [9; 13]).
- FIG. 7 illustrates the evolution of SDAI per cat during the study. Complete resolution of clinical signs 2 months post administration in a cat (# 4 is observed. In this cat, a slight oropharyngeal inflammation is observed which reappears at 3 and 6 months (score 2/24). At follow-up at 3 months, a slight degradation in a cat (# 3, score goes from 5 to 9) is observed then the score decreases again to reach 7 to 6 months An improvement in the state of the other cats is also observed.
- FIG. 8 represents the clinical recovery rate of each animal having undergone total avulsion at the different follow-up times.
- the recovery rate corresponds to the difference (in percentage) between the SD AI score evaluated at a follow-up time (2 months, 3 months, 6 months) and the SD AI score on the inclusion of the same animal, divided by SD AI score at inclusion.
- This report takes into account the improvement that has occurred, if it takes place.
- One cat (# 4) shows complete recovery (clinical remission) at follow-up at 2 months.
- the owner evaluation is based on 4 main criteria: appetite, activity, comfort and behavior. Each criterion is noted on / 3, and therefore makes it possible to obtain a score / 12. The more the score decreases the more the behavior of the cat improves.
- Figure 10 shows a reduction in oral lesions at 1 month following the injection.
- FIG. 11 showing the evolution of the SD AI for the two cats having undergone a partial dental avulsion, shows an almost complete resolution of the clinical signs at 6 months post administration with a score of 3. While the cat # 1 showed rapid clinical improvement after two weeks, cat # 2 showed an increase in symptoms at 2 months which then diminished sharply.
- FIG. 12 represents the clinical recovery rate of each animal having undergone a partial avulsion at the different follow-up times. For the two cats, an improvement in the recovery rate is observable from 90 days.
- FIG. 13 shows the evolution of the owner score for the two cats with partial dental avulsion. Again, cat # 2 showed a transient decrease in symptoms to be considered healthy at 6 months after injection. Cat # 1's health improved quickly after two weeks to reach a home score of 2 to 6 months.
- Feline Foamy Virus Adversely Affects Feline Mesenchymal Stem Cell Culture and Expansion: Implications for Animal Model Development. Stem Cells Dev. 24, 814-823.
Abstract
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