WO2022014071A1 - 成熟脂肪細胞含有組成物の製造方法 - Google Patents
成熟脂肪細胞含有組成物の製造方法 Download PDFInfo
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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
- C12N2506/1384—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 adipose-derived stem cells [ADSC], from adipose stromal stem cells
Definitions
- the present invention relates to a method for producing a mature adipocyte-containing composition. More specifically, the production of a mature adipocyte-containing composition containing mature adipocytes and an acclimatized medium (eg, a supernatant of mature adipocytes) that enhances vascular regeneration of adipose tissue for transplantation and improves the engraftment rate of adipocytes. Regarding the method.
- an acclimatized medium eg, a supernatant of mature adipocytes
- Fat transplantation as a breast reconstruction technique performed after breast cancer resection is said to be safe without promoting cancer metastasis. For this reason, breast reconstruction is frequently performed in the areas of plastic surgery and cosmetic surgery. However, due to the large amount of tissue in the breast, only a survival rate of 30 to 45% could be obtained by transplanting a piece of adipose tissue that could simply suck the adipose tissue of the living body (Zhou et al. Non-patent literature). 1).
- adipose tissue pieces The main cause of poor survival of aspirated adipose tissue pieces in the recipient environment is the lack of vasa vasorum.
- the transplanted adipose tissue pieces are separated from the original vasa vasorum, resulting in malnutrition and necrosis. It is well known that adipose tissue pieces are recognized as foreign substances after transplantation, and absorption, cyst formation, and calcification occur.
- a method of transplanting adipose tissue together with adipose-derived stem cells (ASC) present in SVF (small vascular fraction) in the minute has been reported (cell-assisted lipotransfer cell-assisted fat transplant fat: CAL (Eto et al. Non-Patent Document 2).
- This method is a method in which aspirated adipose tissue is enzymatically treated to remove fat components to obtain cells around blood vessels, SVF adipose precursor stem cells, and transplanted together with aspirated adipose tissue.
- SVF has the ability to self-regenerate. Characterized to be highly versatile (Zuk PA. et al. Non-Patent Document 3).
- CAL Cell assisted liptransfer (Eto et al. Non-Patent Document 2) in breast cases had a higher incidence of complications than facial cases (p ⁇ 0.001).
- CAL utilizes adipose-derived stem cells (ASC) present in a group of interstitial vascular cells (SVF: small vascular fraction) obtained by enzymatically treating adipose tissue, and transplants both cells ASC that regenerate blood vessels and adipose tissue.
- ASC adipose-derived stem cells
- SSF small vascular fraction
- ASC adipose stem cells
- DFAT dedifferentiated adipocytes
- ASC is an adipose progenitor cell, it is a stem cell that not only differentiates into adipocytes but also has pluripotency into bone cells, muscle cells, chondrocytes, etc. (Zuk PA. et al. Non-Patent Document 3). Since it has been reported to promote cancer metastasis, it is not suitable for fat transplantation frequently performed in breast remodeling surgery after breast resection. In addition, ASC is not suitable for transplantation because it induces a large amount of TNF- ⁇ under hypoxia and may induce inflammation, and absorption due to inflammation induction after transplantation cannot be suppressed.
- a mature adipocyte-containing composition having high vascular regeneration ability was desired.
- a mature adipocyte-containing composition having a low possibility of causing inflammation was desired.
- vascular regeneration promoters containing such mature adipocyte-containing compositions, compositions used as a substitute for subcutaneous adipose tissue, and fats for use in breast enlargement, breast reconstruction, or tissue depression plasty.
- the containing agent was desired.
- adipose tissue is cut and filtered, microfat is cultured using a medium to obtain mature fat cells, and a composition including an acclimatized medium (culture supernatant) obtained during the culture is included.
- the substance is rich in chemokines / cytokines that promote angiogenesis such as IL-8, GRO, MCP-1 or VEGF (vascular endothelial cell proliferation factor), and it is said that breast regeneration, for example, was extremely successful with this composition.
- the first invention described herein relates to a method for producing a mature adipocyte-containing composition.
- This method includes a cutting filtration step, a microfat culture step, and a mature adipocyte-containing composition acquisition step.
- the cutting and filtering step is a step for cutting and filtering adipose tissue that has not been treated with an enzyme to obtain fine fat.
- the microfat culture step is a step for culturing the microfat using a culture medium after the cutting and filtering step to obtain mature adipocytes. Culture medium contains hydrocortisone and FGF-2.
- the mature adipocyte-containing composition acquisition step is a step for obtaining a mature adipocyte-containing composition containing the mature adipocyte and the conditioned medium obtained through the micro-adipocyte culture step.
- a preferable example of adipose tissue is that the aspirated fat is washed and then the blood component is removed.
- a preferred example of the cutting filtration step includes the step of performing centrifugation and removing the stromal vascular cell group (SVF) that precipitates.
- SVF stromal vascular cell group
- Preferred examples of mature adipocytes are cells that express the chemokines / cytokines IL-8, GRO, and MCP-1 four-fold or more (preferably 10-fold or more, more preferably 20-fold or more) than IL-6, respectively.
- the conditioned medium is preferably one containing these chemokines / cytokines.
- the conditioned medium preferably contains vascular endothelial growth factor (VEGF) 0.5 times or more and 1.5 times or less of IL-6.
- VEGF vascular endothelial growth factor
- a preferable use example of the mature adipocyte-containing composition is to use it as a substitute for subcutaneous adipose tissue.
- the mature adipocyte-containing composition may also be used in breast enlargement, breast reconstruction, or tissue depression plasty.
- the second invention described herein relates to a composition used as a substitute for subcutaneous adipose tissue.
- This composition is a mature adipocyte-containing composition produced by any of the above-mentioned methods for producing a mature adipocyte-containing composition, and is used as a substitute for subcutaneous adipose tissue.
- This composition is used, for example, in breast enlargement, breast reconstruction, or tissue depression plasty.
- the third invention described in this specification relates to an angiogenesis promoter.
- This angiogenesis-promoting agent includes, for example, a mature adipocyte-containing composition obtained by the method for producing any of the above-mentioned mature adipocyte-containing compositions.
- the mature adipocyte-containing composition comprises vascular endothelial growth factor receptor (VEGFR) 2, or positive cells and platelet-derived growth factor (PDGFR) ⁇ .
- VEGFR vascular endothelial growth factor receptor
- PDGFR platelet-derived growth factor
- the mature adipocyte-containing composition obtained by the first invention usually highly expresses IL-8, GRO, MCP-1 or VEGF having high angioplasty promoting ability. Therefore, this mature adipocyte-containing composition has a high ability to regenerate blood vessels.
- the mature adipocyte-containing composition obtained by the first invention highly expresses IL-8, GRO and MCP-1 that promote angiogenesis, while TNF- ⁇ , IL-1 ⁇ and INF- ⁇ . Is hardly expressed. Therefore, the mature adipocyte-containing composition obtained by the above method is unlikely to cause inflammation.
- the second invention contains a mature adipocyte-containing composition, it can be used as a substitute for subcutaneous adipose tissue, and is also used for breast enlargement surgery, breast reconstruction surgery, or tissue depression plasty. be able to.
- the mature adipocyte-containing composition can be used as an angiogenesis-promoting agent because it highly expresses IL-8, GRO and MCP-1 that promote angiogenesis.
- FIG. 1 is a photograph in place of a drawing showing a state in which microfat that has been shredded and crushed is placed in a culture flask.
- FIG. 2 is a phase-contrast micrograph that replaces the drawing showing mature adipocytes in culture.
- FIG. 3 is a photograph that replaces the drawing when mature adipocytes in culture were stained with Sudan III.
- FIG. 4 is a graph that replaces the drawing showing the results of cytokine / chemokine analysis in the conditioned medium.
- FIG. 5 is a photograph replacing the drawing showing an excised specimen 6 months after transplantation of a tissue in which a human sucked fat piece was independently transplanted into the abdomen of a nude mouse.
- FIG. 1 is a photograph in place of a drawing showing a state in which microfat that has been shredded and crushed is placed in a culture flask.
- FIG. 2 is a phase-contrast micrograph that replaces the drawing showing mature adipocytes in culture.
- FIG. 6 is a substitute for a drawing showing an excised specimen 6 months after transplantation in which human adipose tissue, cultured adipocytes, and acclimatized medium in the abdomen of a nude mouse were co-transplanted.
- FIG. 7 is a substitute for a drawing showing an excised specimen 6 months after transplantation in which human adipose tissue, cultured adipocytes, and acclimatized medium in the abdomen of a nude mouse were co-transplanted.
- FIG. 8 is a photograph that replaces the drawing showing an example of breast reconstruction surgery after surgery for left breast cancer.
- FIG. 9 is an alternative photograph showing the results of immunostaining of VEGFR2 and PDGFR ⁇ on cultured fat cell membranes.
- FIG. 10 is a graph that replaces the drawing showing the number of adipocytes that can be passaged and PDL.
- FIG. 11 is a photograph replacing the drawing showing the cultured adipocytes on the 4th day of the control P2 culture of ⁇ -MEM only.
- FIG. 12 is a photograph replacing the drawing showing the cultured adipocytes on the 4th day of the mesenchymal stem cell serum-free medium P2 culture.
- FIG. 13 is a substitute for a drawing showing cultured adipocytes in a medium supplemented with ⁇ -MEM + 10% fetal bovine serum (FCS).
- FCS fetal bovine serum
- the first invention described in this specification relates to a method for producing a mature adipocyte-containing composition.
- the mature adipocyte-containing composition is, for example, a composition containing mature adipocytes derived from humans.
- Japanese Patent No. 5991687 describes a method for isolating mature adipocytes.
- mature adipocytes are known.
- the size of the mature adipocyte (the length of the portion giving the maximum length) may be 60 to 100 ⁇ m, preferably 1 ⁇ m or more and 60 ⁇ m or less, and may be 5 ⁇ m or more and 40 ⁇ m or less.
- This method includes a cutting filtration step, a microfat culture step, and a mature adipocyte-containing composition acquisition step.
- the cutting and filtering step is a step for cutting and filtering adipose tissue that has not been treated with enzymes to obtain fine fat.
- a preferred example of adipose tissue is one in which the aspirated fat has been washed and then the blood components have been removed. The cells may be finely crushed by filtering the adipose tissue from which blood components have been removed after sterilization with an antibiotic.
- the cutting filtration step preferably includes a step of performing centrifugation and removing the stromal vascular cell group (SVF) that precipitates. In this case, only the fat component that floats on the upper part of the liquid phase obtained by centrifugation should be recovered to obtain microcells. For centrifugation, a known method may be appropriately adopted.
- the microfat culture step is a step for culturing microfat using a culture medium after a cutting and filtering step to obtain mature adipocytes. These mature adipocytes are included in the cultured cell group.
- the culture medium is a medium containing hydrocortisone and FGF-2.
- Preferred culture media are media containing autologous serum or media containing FBS, hydrocortisone and FGF-2.
- the culture medium may be a medium containing autologous serum, hydrocortisone and FGF-2.
- the medium of the present invention may be prepared by adding necessary elements to the basic medium as appropriate.
- basal medium examples include ⁇ -MEM medium, Eagle's basal medium, and DMEM.
- reagent a known reagent used for the medium may be appropriately added.
- reagents are bovine fetal serum (FBS), HC (hydrocortisone), FGF2, IGF (insulin-like growth factor), insulin, PDGF (steroid-delivered growth factor), ACTH (adrenocorticotropic hormone), LIF (leukemia inhibitor).
- a salt such as 2-phosphate may be added. It may be added to each medium so as to be 0.1 ng / mL or more and 20 ⁇ g / mL or less (or 0.2 ng / mL or more and 10 ⁇ g / mL or less). These may be appropriately adjusted and added according to the degree of purification and the required amount. Self-serum may be added instead of FBS. Alternatively, a serum-free medium may be used. In any case, it is preferable to add HC (hydrocortisone) and FGF-2 to the medium.
- HC hydrocortisone
- culture media examples include 1-10% fetal bovine serum (FBS), 20 ng / ml to 100 ng / ml hydrocortisone, 5 ng / ml to 20 ng / ml (or 50 ng / ml) in ⁇ -MEM medium.
- FGF2 Fibroblast Growth Factor 2
- FBS fetal bovine serum
- FBS and autologous serum may be contained in the medium at 0.1% to 20%.
- Microfat may be cultivated and propagated under normal culture conditions.
- the cell mass can range from around 10% to 100% confluent, and can also be cultured in a high-density, multi-layered state that exceeds 100% confluent.
- the patient may be transferred to hypoxia.
- hypoxic culture for example, a commercially available hypoxic incubator can be used by mixing commercially available nitrogen gas to reduce the oxygen partial pressure, or by blowing nitrogen gas into an appropriate space to reduce the oxygen partial pressure. May be cultured.
- the culture conditions are preferably 3% or more and 20% or less carbon dioxide gas, 1% or more and 10% or less oxygen gas, 5% or more and 20% or less carbon dioxide gas, and 2% or more and 10% or less oxygen gas. However, it may be under carbon dioxide gas of 8% or more and 12% or less, and oxygen gas of 3% or more and 7% or less.
- the mature adipocyte-containing composition acquisition step is a step for obtaining a mature adipocyte-containing composition containing a mature adipocyte and a conditioned medium obtained through a microadipocyte culture step. Is.
- the mature adipocyte-containing composition may include mature adipocytes and a culture supernatant.
- a preferred example of mature adipocytes is cells that express the chemokines / cytokines IL-8, GRO and MCP-1 four-fold or more than IL-6, respectively. Any one or two or more of IL-8, GRO and MCP-1 may be expressed 10 times or more more than IL-6, or may be expressed 20 times or more more than IL-6. Alternatively, it may be expressed 20 times or more than IL-6.
- the mature adipocyte-containing composition exerts high vascular promoting ability without causing inflammation when transplanted. Suitable for.
- the mature adipocyte-containing composition is particularly preferably one containing fat collected from a patient undergoing transplantation.
- a preferred example of mature adipocytes is one that expresses any or two or more of IL-8, GRO and MCP-1 10 times or more as compared with TNF- ⁇ , and 50 times or more as compared with TNF- ⁇ . Those that are expressed are preferable, those that are expressed 100 times or more as compared with TNF- ⁇ , and those that are expressed 500 times or more as compared with TNF- ⁇ are preferable.
- a preferred example of mature fat cells is one that expresses any or two or more of IL-8, GRO and MCP-1 10 times or more as compared with IL-1- ⁇ , and as compared with IL-1- ⁇ . It is preferably expressed 50 times or more, preferably 100 times or more as compared with IL-1- ⁇ , and preferably 500 times or more as compared with IL-1- ⁇ .
- a preferred example of mature adipocytes is one that expresses any or two or more of IL-8, GRO and MCP-1 10 times or more as compared with INF- ⁇ , and 50 times or more as compared with INF- ⁇ . Those that are expressed are preferable, those that are expressed 100 times or more as compared with INF- ⁇ , and those that are expressed 500 times or more as compared with INF- ⁇ are preferable.
- the mature adipocyte-containing composition may contain an appropriate amount of mature adipocytes or a conditioned medium (or culture supernatant) according to the purpose.
- this composition may be contained in a necessary container in the same manner as a normal composition so that it can be used as needed.
- the amount of mature adipocytes may be, for example, 1 ⁇ 10 4 cells or more and 1 ⁇ 10 10 cells per application, or 1 ⁇ 10 5 cells or more and 1 ⁇ 10 8 cells per application.
- Agents containing the culture supernatant as an active ingredient are known, for example, as disclosed in Japanese Patent Application Laid-Open No. 2013-18756, Japanese Patent No. 5139294, and Japanese Patent No. 5526320. Therefore, a composition containing a conditioned medium can be produced using a known method.
- Examples of the culture supernatant of mature fat cells are a processed product obtained by removing water from the culture supernatant obtained by solid-liquid separation of the culture supernatant by centrifugation and water removal by freeze-drying, an evaporator, etc.
- the supernatant obtained by culturing the mature fat cells of the present invention is centrifuged (for example, 1,000 ⁇ g, 10 minutes) and then fractionated with ammonium sulfate (for example, 65% saturated ammonium sulfate) to obtain a precipitate.
- ammonium sulfate for example, 65% saturated ammonium sulfate
- dialysis treatment may be performed and filtered through a syringe filter (for example, 0.2 ⁇ m) to obtain a sterile culture supernatant.
- the collected culture supernatant can be used as it is, or it can be cryopreserved and thawed at the time of use.
- a pharmaceutically acceptable carrier may be added and dispensed into a sterilized container so that the amount of liquid is easy to handle.
- the culture supernatant may be treated with a virus clearance filter or ultraviolet irradiation.
- the mature adipocyte-containing composition preferably contains 1 mL or more and 1,000 mL or less of the culture supernatant as one administration unit, and more preferably 30 mL or more and 300 mL or less.
- a preferable use example of the mature adipocyte-containing composition is to use it as a substitute for subcutaneous adipose tissue.
- the specification also provides a method for substituting subcutaneous adipose tissue, which comprises the step of administering a mature adipocyte-containing composition to a human patient.
- the mature adipocyte-containing composition preferably further contains the adipose tissue of this patient in addition to the mature adipocytes and the acclimatized medium.
- the mature adipocyte-containing composition may also be used in breast enlargement, breast reconstruction, or tissue depression plasty.
- breast reconstruction involves injecting a mature adipocyte-containing composition into a fat-deficient breast.
- the second invention described herein relates to a composition used as a substitute for subcutaneous adipose tissue.
- This composition is a mature adipocyte-containing composition produced by any of the above-mentioned methods for producing a mature adipocyte-containing composition, and is used as a substitute for subcutaneous adipose tissue.
- This composition is used, for example, in breast enlargement, breast reconstruction, or tissue depression plasty.
- the third invention described in this specification relates to an angiogenesis promoter.
- This angiogenesis-promoting agent includes, for example, a mature adipocyte-containing composition obtained by the method for producing any of the above-mentioned mature adipocyte-containing compositions. That is, this angiogenesis-promoting agent is the same as the above-mentioned mature adipocyte-containing composition.
- the angiogenesis promoter may be, for example, an injection.
- the above-mentioned mature adipocyte-containing composition may be contained in a syringe, mixed with the patient's tissue as necessary, and transplanted to the required location of the patient.
- Culture method Composition of culture medium of cultured adipose tissue was obtained, and adipose tissue was collected by suction from the abdomen, thigh, buttocks, and upper arm with a cannula having a diameter of 2 mm or less (the diameter is not limited).
- the fat collected by suction was washed to remove blood components. After sterilizing this tissue with an antibiotic, the tissue was finely filtered, the fat was crushed into small pieces, and the tissue was centrifuged to culture only the fat component floating above in the liquid phase. When the SVF was centrifuged, it settled as pellets in the lower layer and was removed.
- FIG. 1 is a photograph in place of a drawing showing a state in which microfat that has been shredded and crushed is placed in a culture flask. As shown in FIG. 1, SVF is removed and only the fat component remains. The amount of medium at the time of culturing was set to a small amount so that the tissue did not float. After 5 days of culturing, it was confirmed that cells adhering to the tissue pieces appeared, so the medium was added and the culturing was continued.
- the medium used was ⁇ -MEM medium supplemented with 5% fetal bovine serum (FBS: Fetal Bovine Serum), 40 ng / ml hydrocortisone, and 10 ng / ml FGF2 (Fibroblast Growth Factor 2).
- FBS Fetal Bovine Serum
- the culture conditions were 10% carbon dioxide gas and 5% oxygen gas.
- the 2 ⁇ 3 ⁇ 10 6 cells of the cultured cells were collected in a primary culture day 12. Some of these cells were frozen and the other cells were seeded at a density of 4-5 ⁇ 10 4 / cm 2 and cultured for 5 days. After 6 days, the cells were washed 3 times with PBS (-) and cultured for 2 days in a medium obtained by removing FBS from the above medium components. This medium was used for analysis as a conditioned medium.
- FIG. 2 is a phase-contrast micrograph instead of a drawing showing mature adipocytes in culture.
- adipocytes contained a large amount of fat granules.
- Sudan III staining was performed to confirm mature adipocytes in culture. Even in Sudan III, which is a special dyeing and weaving of fat, mature adipocytes are specifically dyed red.
- FIG. 3 is a photograph that replaces the drawing when mature adipocytes in culture were stained with Sudan III. As shown in FIG. 3, it can be seen that the medium contains a large amount of fat granules.
- Cytokine / chemokine analysis was performed on the conditioned medium (Conditioned Medium) of cultured mature adipocytes by the antibody solidified magnetic beads method (Antibody-Immobilized Magnetic Beads method).
- the supernatant obtained by centrifuging a Conditioned Medium sample at 13,000 G at 4 ° C for 5 minutes was used for measurement.
- Concentrations of 40 target proteins in Conditioned Medium were measured using the Luminex® system.
- the pretreated sample was used at 25 ⁇ L per well and measurements were taken 3 times.
- One standard solution was added based on the manual, seven 5-fold dilution series were prepared, and measurements were taken three times.
- the 40 target proteins are EGF, FGF-2, eotaxin, TGF- ⁇ , G-CSF, Flt-3L, GM-CSF, fractalkine, IFN ⁇ 2, IFN ⁇ , GRO, IL-10, MCP-3, IL-12P40.
- MDC MDC
- IL-12P70 PDGF-AA, IL-13, PDGF-AB / BB, IL-15, sCD40L, IL-17A, IL-1RA, IL-1 ⁇ , IL-9, IL-1 ⁇ , IL-2 , IL-3, IL-4, IL-5, IL-6, IL-7, IL-8, IP-10, MCP-1, MIP-1 ⁇ , MIP-1 ⁇ , RANTES, TNF ⁇ , TNF ⁇ , and VEGF there were.
- FIG. 4 is a graph that replaces the drawing showing the results of cytokine / chemokine analysis in Conditioned Medium. As shown in FIG. 4, it was proved that the conditioned medium of cultured mature adipocytes produced a large amount (ng / ml) of IL-8, GRO, and MCP-1, which are cytokines having high vascular regeneration ability. rice field. On the other hand, TNF- ⁇ , which increases and causes inflammation in adipose stem cells, and IL-1- ⁇ and INF- ⁇ , which have strong inflammation-inducing power, are hardly produced in these cells, so it was also shown to be safe.
- the bacteria were sterilized and sown by the same method as above.
- 2 ⁇ 10 6 cells of cultured adipocytes were collected. These cells were once cryopreserved. Before transplanting, the cells were thawed , seeded at a density of 5 ⁇ 10 4 cells / cm 2 , and cultured for 5 days.
- adipose cells harvested by enzymatic treatment with respect to fat 0.6 ⁇ 0.7 g of transplanting 3 ⁇ 10 6 cells were added and mixed, were implanted subcutaneously into the back of nude mice the next day. Only fat was transplanted to the control group of mice. It was excised 6 months after transplantation and subjected to tissue staining. Most of the adipose tissue was absorbed by the single transplantation of human adipose tissue alone, but the adipose tissue was completely left by the co-transplantation of cultured cells and human fat. Moreover, the formation of blood vessels was observed in the center.
- FIG. 5 is a photograph replacing the drawing showing an excised specimen 6 months after transplantation of a tissue in which a human sucked fat piece was independently transplanted into the abdomen of a nude mouse.
- the magnification of FIG. 5 is 100 times.
- the part where adipose tissue was formed is found in the periphery, but the central part is hollow in the part where fat was absorbed after transplantation. Scar tissue and some fat are formed around it.
- FIG. 6 is a substitute for a drawing showing an excised specimen 6 months after transplantation in which human adipose tissue, cultured adipocytes, and a conditioned medium (Conditioned Medium) were co-transplanted in the abdomen of a nude mouse.
- the magnification of FIG. 6 is 100 times. More than 95% of adipose tissue is formed in the entire specimen tissue. Vascular tissue was found inside.
- FIG. 7 is a photograph replacing a drawing showing an excised specimen 6 months after transplantation in which human adipose tissue, cultured adipocytes, and a conditioned medium (Conditioned Medium) were co-transplanted in the abdomen of a nude mouse. Adipose tissue is formed throughout the specimen tissue. Blood vessel-like tissue was also found inside.
- Example 4-1 Cultured mature adipocytes for breast reconstruction after surgery for left breast cancer, Conditioned Medium, and autologous fat transplantation-
- a tissue expander was placed in the chest at the time of breast cancer resection, and the subcutaneous tissue and pectoralis major muscle were expanded to create a bulge in the chest. After that, this method was planned at the request of the person. 2 cc of fat was collected by suction from the abdomen, sterilized, and seeded and cultured.
- Cultured adipocytes of 3 ⁇ 10 6 cells in primary culture day 14 were harvested. The cultured adipocytes were once cryopreserved.
- thawed cells Prior to transplantation, thawed cells were cultured in 12 flasks with a bottom area of 150 cm 2 for 6 days.
- the aspirated adipose tissue used for transplantation, mature cultured cells, and a conditioned medium were mixed and transplanted.
- the lumen and the flask eight total 258ml therearound (11.44 ⁇ 10 7 cells) was immediately implanted in the left chest subcutaneously when withdrawing the tissue expander after about 6 months.
- a medium for culturing the cells after primary culture and thawing a medium supplemented with 10% autologous serum, hydrocortisone 40 ng / ml and FGF 210 ng / ml was used. It was confirmed that the same substance could be obtained by using FBS instead of 10% autologous serum.
- FIG. 8 is a photograph that replaces the drawing showing an example of breast reconstruction surgery after surgery for left breast cancer.
- the screen is a horizontal section of MRI, and the findings are seen from below, and the papilla of mammary gland tissue is observed on the healthy side.
- the transplanted fat is not absorbed and is almost 100% engrafted.
- the brightness of the adipose tissue is white, and it can be seen that fat is formed in all layers.
- a large number of blood vessels are found running inside. No fat necrosis, cysts, calcifications, or lumps (induration) are observed. Stable fat formation was observed (same results were obtained in the other 10 cases).
- the healthy side is drooping because it was taken in the prone position.
- Example 4-2 Cultured mature fat cells for left breast cancer-preserving surgery and right breast atrophy hypoplasia, conditioned medium and autologous fat transplantation
- thawed cells Prior to transplantation, thawed cells were cultured in 15 flasks with a bottom area of 150 cm 2 for 7 days.
- a medium for culturing the cells after primary culture and thawing a medium supplemented with 10% autologous serum, hydrocortisone 40 ng / ml and FGF 210 ng / ml was used.
- the aspirated adipose tissue used for transplantation, cultured adipocytes, mature cultured cells, and Conditioned Medium were mixed and transplanted. Porting the total amount was 310ml (21.45 ⁇ 10 7 cells) .
- a total of 220 ml was injected and transplanted into the entire subcutaneous tissue in the left breast cancer-preserving area.
- Fat transplantation to humans (facial depression deformity plasty)
- Example 4-3 Cultured mature adipocytes for facial atrophy, Conditioned Medium, and autologous fat transplantation
- a 68-year-old female after surgery for left breast cancer showed recessed deformation due to right facial atrophy.
- it was difficult to collect normal fat because of liposuction of the abdomen and thighs at another clinic. This method was planned at the request of the person. 2cc of fat was collected by suction from the abdomen, sterilized, and seeded and cultured.
- Culture cells 4.4 ⁇ 10 6 cells in primary culture day 16 were harvested. The cultured cells were once cryopreserved.
- thawed cells Prior to transplantation, thawed cells were cultured in 5 flasks with a bottom area of 175 cm 2 for 7 days.
- a medium for culturing the cells after primary culture and thawing a medium supplemented with 10% autologous serum, hydrocortisone 40 ng / ml and FGF 210 ng / ml was used.
- the aspirated adipose tissue used for transplantation, cultured cells, mature cultured cells, and Conditioned medium were mixed and transplanted. Porting the total amount was 35ml (8.35X10 7 cells).
- the adipose tissue was not absorbed and the size was maintained, no lumps (induration) were observed, and the appearance was good.
- funnel chest is a depressed chest wall deformity of the chest, it can be considered to be medically highly depressed as in Example 4-2, and is therefore an indication for this method.
- the conventional concept was that SVF (ASC) containing adipose stem cells promotes angiogenesis, and when co-transplanted with fat, the survival rate of transplantation is improved.
- ASC Adipose derived stromal cells
- GRO has angioplasty in the literature (Caunt M, 1 Liang Hu, 1 Thomas Tang, 1 Peter C. Brooks, 2 Sherif (2004), 3 and Simon Karpatkin Growth-regulated Oncogene Is Pivotal in Thrombin-Induced Angiogenesis. Cancer Res 2006; 66 (8): 4125 -32, Keglowich1 L, Roth M, Philippova1 M, Resink T, Tjin G, Bronchial Smooth Muscle Cells of Asthmatics Promote Angiogenesis Through Elevated Secretion of CXC-chemokines (ENA-78, GRO- ⁇ , and IL-8) PLoS One.2013; 8 (12): e81494. Doi: 10.1371 / journal.pone.0081494).
- MCP-1 has been reported as an angiogenic chemokine and has an angiogenic ability in another document (6. Niu J, Azfer A, Zhelyabovska O, Fatma S, and Kolattukudy PE. Monocyte Chemotactic Protein (MCP) -1 Promotes Angiogenesis via. Novel Transcription Factor, MCP-1-induced Protein (MCPIP). J Biol Chem2008 May 23; 283 (21): 14542-51.doi: 10.1074 / jbc.M802139200). In addition, the literature (3. Hong KH, Ryu J, Han KH. Monocyte Chemoattractant protein-1-induced Angiogenesis Is Mediated by Vascular Endothelial Growth factor-A. Blood 2005; 105: 1405-1407 DOI: 10,1182 / blood-2004-08-3178). Macrophage mobilization is essential for angioplasty, and MCP-1 is an essential factor in doing so.
- VEGFR2 Vascular endothelial growth Immunostaining of factor receptor 2
- PDGFR ⁇ platelet-derived growth factor beta
- Anti-VEGFR2 polyclonal antibody (Funakoshi: bs-10412)
- Anti-PDGFRbeta polyclonal antiboby [Y92] -C-terminal (ab32570)
- Goat Anti-Rabbit IgG H & L (HRP) (ab205718)
- DAB substrate kit (Funakoshi: CSK- 4100, VEC).
- FIG. It was shown that both groups had cells that strongly expressed VEGFR2 and PDGFR ⁇ . Since VEGFR2 is expressed only in vascular endothelial cells and their progenitor cells by the primary responder of VEGF signal, it was shown that blood vessels are formed.
- PDGFR ⁇ is expressed when its PPAR ⁇ of adipose progenitor cells is stimulated by fatty acid or the like. Therefore, we obtained the result that adipose progenitor cells are also included. Since both cells are contained, it is considered that angiogenesis and fat formation are promoted at the same time after transplantation. In addition, since the previous blood vessel promoting factors (MCP-1, IL-8, GRO, VEGF) are also abundant, angiogenesis after transplantation becomes (both wheel ring: cell type + factor), and a very strong angiogenic effect. It turned out to have. It was also shown that VEGFR2 and PDGFR ⁇ were strongly expressed in the group in which mature adipocytes and aspirated fat were co-cultured.
- FIG. 10 is a graph that replaces the drawing showing the number of adipocytes that can be passaged and PDL. As shown in FIG. 10, it was confirmed that growth arrest due to aging occurred.
- FIG. 11 is a photograph replacing the drawing showing the cultured adipocytes on the 4th day of the control P2 culture of ⁇ -MEM only.
- FIG. 12 is a photograph replacing the drawing showing the cultured adipocytes on the 4th day of the serum-free medium (Lonza PT-3001) P3 culture.
- FIG. 13 is a substitute for a drawing showing cultured adipocytes in a medium supplemented with ⁇ -MEM + 10% fetal bovine serum (FCS). Table 1 shows the number of cells in each medium.
- This invention can be used in the field of medical devices and the like.
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Abstract
Description
裁断ろ過工程は,酵素処理をしていない脂肪組織を裁断ろ過し,微小脂肪を得るための工程である。
微小脂肪培養工程は,裁断ろ過工程後に,培養用培地を用いて前記微小脂肪を培養し,成熟脂肪細胞を得るための工程である。培養用培地は,ヒドロコルチゾン及びFGF-2を含む。
成熟脂肪細胞含有組成物取得工程は,前記成熟脂肪細胞と前記微小脂肪培養工程を経て得られる馴化培地(conditioned medium)とを含む成熟脂肪細胞含有組成物を得るための工程である。
裁断ろ過工程は,酵素処理をしていない脂肪組織を裁断ろ過し,微小脂肪を得るための工程である。脂肪組織の好ましい例は,吸引脂肪を洗浄後,血液成分を除去されたものである。血液成分を除去された脂肪組織を抗生物質で除菌後にろ過することで,細胞を細かく破砕してもよい。裁断ろ過工程は,遠心分離を行い,沈殿する間質血管細胞群(SVF)を除去する工程を含むものが好ましい。この場合,遠心分離により得られる液相の上部に浮き上がる脂肪成分のみを回収し,微小細胞を得ればよい。遠心分離は公知の方法を適宜採用すればよい。
微小脂肪培養工程は,裁断ろ過工程後に,培養用培地を用いて微小脂肪を培養し,成熟脂肪細胞を得るための工程である。この成熟脂肪細胞は,培養細胞群に含まれる。培養用培地は,ヒドロコルチゾン及びFGF-2を含む培地である。好ましい培養用培地は,自己血清を含む培地であるか,FBS,ヒドロコルチゾン及びFGF-2を含む培地である。培養用培地は,自己血清とヒドロコルチゾン及びFGF-2を含む培地であってもよい。
成熟脂肪細胞含有組成物取得工程は,成熟脂肪細胞と微小脂肪培養工程を経て得られる馴化培地(conditioned medium)とを含む成熟脂肪細胞含有組成物を得るための工程である。成熟脂肪細胞含有組成物は,成熟脂肪細胞と培養上清を含むものであってもよい。
インフォームドコンセントを得て,腹部,大腿部,臀部,上腕部より脂肪組織を径2mm以下(径は限定しない)のカニューラで吸引採取した。吸引採取した脂肪を洗浄し,血液成分を除去した。この組織を抗生物質で除菌後に細切濾過し,脂肪を細かく破砕し,遠心して液相に上部に浮き上がる脂肪成分のみを培養した.SVFは遠心すると下層にペレット(pellet)として沈殿するので除去した.
-マウスの移植実験と移植組織像の検討-
インフォームドコンセントを得て,腹部より脂肪組織を吸引採取した.上記と同様な方法で,除菌して播種した.初代培養12日目に2×106 cells の培養脂肪細胞を回収した.この細胞を一旦凍結保存した.移植前に細胞を解凍して,5×104 cells/cm2の密度で播種し,5日間培養した.移植する脂肪0.6~0.7gに対して酵素処理で回収した培養脂肪細胞を3×106 cells加えて混和し,翌日にヌードマウスの背部皮下に移植した.対照群のマウスには脂肪のみ移植した.移植後6か月目に摘出して,組織染色に供した.ヒト脂肪組織のみの単独移植では脂肪組織は殆ど吸収されていたが,培養細胞とヒト脂肪の共移植では完全に脂肪組織が残っていた.しかも中心に血管の形成が認められた.
実施例4-1:左乳癌術後の乳房再建への培養成熟脂肪細胞,馴化培地(Conditioned Medium)及び自家脂肪移植例-
左乳癌術後の46歳女性に対し,乳がん切除時に胸部に組織拡張器を留置して,皮下組織と大胸筋を拡張(expansion)して胸に膨らみを作製した。その後,本人の希望により本法を予定した。腹部より脂肪を2cc吸引採取し,除菌して播種培養を行った。初代培養14日目に3×106 cellsの培養脂肪細胞を回収した。 この培養脂肪細胞は一旦凍結保存した。 移植前に,解凍して細胞を,底面積150 cm2のフラスコ12枚に6日間培養した。移植に用いる吸引脂肪組織と成熟培養細胞と馴化培地(Conditioned Medium)を混和して移植した。1回目の移植は皮下組織拡張器の周囲に,合計252ml(17.16×107 cells)を左胸部皮下に直ぐに移植した.約6ヶ月後に組織拡張器を抜去する際に内腔とその周囲にフラスコ8枚合計258ml(11.44×107cells)を左胸部皮下に直ぐに移植した。
実施例4-2:左乳癌温存手術術後および右乳房萎縮低形成への培養成熟脂肪細胞,馴化培地(Conditioned Medium)及び自家脂肪移植例
左乳癌術後の44歳女性に対し,左乳がん温存手術後に著しい乳房陥凹変形(1/2以上の変形)を認め,右乳房は低形成と萎縮を認めた。本人の希望により本法を予定した。腹部より脂肪を2cc吸引採取し,除菌して播種培養を行った。初代培養14日目に3.4×106 cellsの培養細胞を回収した。 この培養細胞を一旦凍結保存した。 移植前に,解凍した細胞を,底面積150 cm2のフラスコ15枚に7日間培養した。初代培養及び解凍後の細胞を培養する際の培地として,10%自家血清,ヒドロコルチゾン40ng/ml及びFGF210ng/mlを添加した培地を用いた。移植に用いる吸引脂肪組織と培養脂肪細胞と成熟培養細胞と馴化培地(Conditioned Medium)を混和して移植した。移植総量は310ml(21.45×107 cells)であった。左乳がん温存部には皮下組織全体に合計220mlを注入移植した.右乳房萎縮低形成部には90mlを注入移植した.移植後1年,脂肪組織は吸収されずに大きさが維持され,しこり(硬結)など認めず、外貌形態は良好であった。
実施例4-3:顔面萎縮への培養成熟脂肪細胞,馴化培地(Conditioned Medium)及び自家脂肪移植例
左乳癌術後の68歳女性は右顔面萎縮のため陥凹変形を認めた。また,他医院で腹部,大腿などの脂肪吸引を受けているため通常の脂肪採取が難しい症例であった。本人の希望により本法を予定した。腹部より脂肪を2cc吸引採取し,除菌して播種培養を行った。初代培養16日目に4.4×106cellsの培養細胞を回収した。 この培養細胞は一旦凍結保存した。 移植前に,解凍して細胞を,底面積175 cm2のフラスコ5枚に7日間培養した。初代培養及び解凍後の細胞を培養する際の培地として,10%自家血清,ヒドロコルチゾン40ng/ml及びFGF210ng/mlを添加した培地を用いた。移植に用いる吸引脂肪組織と培養細胞と成熟培養細胞とConditioned medium を混和して移植した。移植総量は35ml(8.35X107 cells)であった。移植後1年,脂肪組織は吸収されずに大きさが維持され,しこり(硬結)など認めず,外貌形態は良好であった。
従来の概念では脂肪幹細胞を含むSVF(ASC)は血管新生を促すことにより、脂肪と共移植すると移植のsurvival rateが向上すると考えられていた。Animal study では移植片の生存可能領域は、縁から約1.5 0.5 mmであり、生存細胞内の脂肪細胞の60%が死んでいる。 Adipocytes にSVFに含まれるAdipose derived stromal cell (ASCs)を添加してもSurvival zoneは300μmよりすくないsurvival zone しか得られていない。またhuman studyではCell assisted lipotrasfer(CAL) といわれ、乳房の脂肪移植は 通常の脂肪移植と変わらない報告と、通常の脂肪移植が39%でCALは65%であったと報告した(Toyserkani MN., Quaade ML, and Sorensen. JA. Cell-Assisted Lipotransfer: A Systematic Review of Its Efficacy. Aesthetic Plast Surg.2016; 40:309-318)。乳房へのCALの survival rate は10の報告中の5報告で記載しており、51.8%、47%、40%~80%、54%、50%と安定していない(Cell assisted lipotransfer in breast augmentation and reconstruction: A systematic review of safety, efficacy, use of patient reported outcomes and study quality.Arshad Z, Karmen L, Choudhary R, Smith JA, Branford OABrindley DA, Pettitt D and Davies BM. JPRAS OPEN .2016 Dec;10:5-20)
Keglowich1 L, Roth M, Philippova1 M, Resink T, Tjin G, Bronchial Smooth Muscle Cells of Asthmatics Promote Angiogenesis Through Elevated Secretion of CXC-chemokines (ENA-78, GRO-α, and IL-8) PLoS One.2013 ;8(12):e81494. doi: 10.1371/journal.pone.0081494)で示されている。
使用薬品はAnti-VEGFR2 polyclonal antibody (フナコシ:bs-10412)Anti-PDGFRbeta polyclonal antiboby [Y92]-C-terminal (ab32570) Goat Anti-Rabbit IgG H&L (HRP) (ab205718) DAB substrate kit (フナコシ:CSK-4100, VEC)である.
得られた結果を図9に示す。2群はどちらもVEGFR2とPDGFRβが強く発現している細胞が存在することが示された.
VEGFR2はVEGF signalのprimary responderで血管内皮細胞とその前駆細胞にしか発現しないので,血管が造成することが示された.PDGFRβは脂肪前駆細胞のそのPPARγがFatty acid等に刺激される時に発現する。したがって、脂肪前駆細胞も含まれているという結果を得た.両者の細胞が含まれているので移植後に血管形成と脂肪形成が同時に促進されると考えたれた.また前回の血管促進因(MCP-1,IL-8,GRO,VEGF)も多量に出ているので移植後の血管形成が(両輪の輪:細胞種+因子)となり,非常に強い血管新生作用を持っていることがわかった.また,成熟脂肪細胞と吸引脂肪を共培養した群においてもVEGFR2とPDGFRβが強く発現していることが示された.
6名の培養脂肪細胞を3か月間培養して増殖停止するまでのPDL(CPD)を計測した。これらは,何回分裂したかを意味する。その結果を図10に示す。図10は,脂肪細胞の継代可能数とPDLを示す図面に代わるグラフである。図10に示される通り,Agingによる増殖停止が起こっていることが確認された。
P14=total 102 day culture:縦軸CDL(=PDL).
49歳(102日で停止),40歳(95日で停止),60歳(67日で停止),54歳(61日で停止)
52歳(62日で停止), 50歳(67日で停止)
基礎培地:
A: α-MEMのみ,血清は添加しない(control)
添加するHCとFGFの濃度は臨床と同じ
B: 間葉系幹細胞無血清培地(Lonza PT-3001)を添加したもの
C: α-MEM にウシ胎仔血清(FCS)を10%になるよう添加したもの(positive control)
以上を比較検討した。その結果を図11~図13に示す。図11は,α-MEMのみ(control)P2培養4日目の培養脂肪細胞を示す図面に代わる写真である。図12は,無血清培地(Lonza PT-3001)P3培養4日目の培養脂肪細胞を示す図面に代わる写真である。図13は,α-MEM+10%ウシ胎仔血清(FCS)添加培地の培養脂肪細胞を示す図面に代わる写真である。表1は,各培地における細胞数を示す。
Claims (9)
- 酵素処理をしていない脂肪組織を裁断ろ過し,微小脂肪を得る裁断ろ過工程と,
裁断ろ過工程後に,培養用培地を用いて前記微小脂肪を培養し,成熟脂肪細胞を得る微小脂肪培養工程と,
前記成熟脂肪細胞と前記微小脂肪培養工程を経て得られる馴化培地(conditioned medium)とを含む成熟脂肪細胞含有組成物を得る成熟脂肪細胞含有組成物取得工程とを含む,
成熟脂肪細胞含有組成物の製造方法であって,
前記裁断ろ過工程は,遠心分離を行い,沈殿する間質血管細胞群(SVF)を除去する工程を含み,
前記培養用培地は,
ヒドロコルチゾン及びFGF-2を含む培地である
成熟脂肪細胞含有組成物の製造方法。 - 請求項1に記載の成熟脂肪細胞含有組成物の製造方法であって,
前記脂肪組織は,吸引脂肪を洗浄後,血液成分を除去されたものである成熟脂肪細胞含有組成物の製造方法。 - 請求項2に記載の成熟脂肪細胞含有組成物の製造方法であって,
前記裁断ろ過工程は,遠心分離により得られる液相の上部に浮き上がる脂肪成分を回収し,前記微小細胞を得る工程をさらに含む,成熟脂肪細胞含有組成物の製造方法。 - 請求項3に記載の成熟脂肪細胞含有組成物の製造方法であって,
前記馴化培地(conditioned medium)は,IL-8,GRO及びMCP-1を,それぞれIL-6の4倍以上含む,成熟脂肪細胞含有組成物の製造方法。 - 請求項3に記載の成熟脂肪細胞含有組成物の製造方法であって,
前記馴化培地(conditioned medium)は,血管内皮細胞増殖因子(VEGF)を,IL-6の0.5倍以上1.5倍以下含む,成熟脂肪細胞含有組成物の製造方法。 - 請求項1~5のいずれかに記載の成熟脂肪細胞含有組成物の製造方法であって,前記成熟脂肪細胞含有組成物は,皮下脂肪組織の代用として用いられる成熟脂肪細胞含有組成物の製造方法。
- 請求項1~5のいずれかに記載の成熟脂肪細胞含有組成物の製造方法であって,前記成熟脂肪細胞含有組成物は,乳房増大術,乳房再建術,又は組織陥凹形成術に用いられる成熟脂肪細胞含有組成物の製造方法。
- 請求項1~5のいずれかに記載の成熟脂肪細胞含有組成物の製造方法によって得られた成熟脂肪細胞含有組成物を含む血管再生促進剤の製造方法。
- 請求項8に記載の血管再生促進剤の製造方法であって,前記成熟脂肪細胞含有組成物は,
血管内皮細胞増殖因子受容体(VEGFR)2、又は陽性細胞及び血小板由来成長因子(PDGFR)βを含む,方法。
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