The renoprotective efficacy and safety of genetically-engineered human bone marrow-derived mesenchymal stromal cells expressing anti-fibrotic cargo.
Mesenchymal Stem Cells
/ metabolism
Humans
Mesenchymal Stem Cell Transplantation
/ methods
Animals
Relaxin
/ genetics
Fibrosis
Male
Renal Insufficiency, Chronic
/ therapy
Cell Differentiation
Bone Marrow Cells
/ metabolism
Green Fluorescent Proteins
/ metabolism
Genetic Engineering
Kidney
/ pathology
Reperfusion Injury
/ metabolism
Mice
BM-MSCs
Chronic kidney disease
Fibrosis
Genetic engineering
Relaxin
Journal
Stem cell research & therapy
ISSN: 1757-6512
Titre abrégé: Stem Cell Res Ther
Pays: England
ID NLM: 101527581
Informations de publication
Date de publication:
23 Oct 2024
23 Oct 2024
Historique:
received:
06
08
2024
accepted:
09
10
2024
medline:
24
10
2024
pubmed:
24
10
2024
entrez:
24
10
2024
Statut:
epublish
Résumé
Kidney fibrosis is a hallmark of chronic kidney disease (CKD) and compromises the viability of transplanted human bone marrow-derived mesenchymal stromal cells (BM-MSCs). Hence, BM-MSCs were genetically-engineered to express the anti-fibrotic and renoprotective hormone, human relaxin-2 (RLX) and green fluorescent protein (BM-MSCs-eRLX + GFP), which enabled BM-MSCs-eRLX + GFP delivery via a single intravenous injection. BM-MSCs were lentiviral-transduced with human relaxin-2 cDNA and GFP, under a eukaryotic translation elongation factor-1α promoter (BM-MSCs-eRLX + GFP) or GFP alone (BM-MSCs-eGFP). The ability of BM-MSCs-eRLX + GFP to differentiate, proliferate, migrate, produce RLX and cytokines was evaluated in vitro, whilst BM-MSC-eRLX + GFP vs BM-MSCs-eGFP homing to the injured kidney and renoprotective effects were evaluated in preclinical models of ischemia reperfusion injury (IRI) and high salt (HS)-induced hypertensive CKD in vivo. The long-term safety of BM-MSCs-RLX + GFP was also determined 9-months after treatment cessation in vivo. When cultured for 3- or 7-days in vitro, 1 × 10 BM-MSCs-eRLX + GFP produced greater renoprotective and therapeutic efficacy over that of BM-MSCs-eGFP or ACE inhibition, and may represent a novel and safe treatment option for acute kidney injury and hypertensive CKD.
Sections du résumé
BACKGROUND
BACKGROUND
Kidney fibrosis is a hallmark of chronic kidney disease (CKD) and compromises the viability of transplanted human bone marrow-derived mesenchymal stromal cells (BM-MSCs). Hence, BM-MSCs were genetically-engineered to express the anti-fibrotic and renoprotective hormone, human relaxin-2 (RLX) and green fluorescent protein (BM-MSCs-eRLX + GFP), which enabled BM-MSCs-eRLX + GFP delivery via a single intravenous injection.
METHODS
METHODS
BM-MSCs were lentiviral-transduced with human relaxin-2 cDNA and GFP, under a eukaryotic translation elongation factor-1α promoter (BM-MSCs-eRLX + GFP) or GFP alone (BM-MSCs-eGFP). The ability of BM-MSCs-eRLX + GFP to differentiate, proliferate, migrate, produce RLX and cytokines was evaluated in vitro, whilst BM-MSC-eRLX + GFP vs BM-MSCs-eGFP homing to the injured kidney and renoprotective effects were evaluated in preclinical models of ischemia reperfusion injury (IRI) and high salt (HS)-induced hypertensive CKD in vivo. The long-term safety of BM-MSCs-RLX + GFP was also determined 9-months after treatment cessation in vivo.
RESULTS
RESULTS
When cultured for 3- or 7-days in vitro, 1 × 10
CONCLUSIONS
CONCLUSIONS
BM-MSCs-eRLX + GFP produced greater renoprotective and therapeutic efficacy over that of BM-MSCs-eGFP or ACE inhibition, and may represent a novel and safe treatment option for acute kidney injury and hypertensive CKD.
Identifiants
pubmed: 39443975
doi: 10.1186/s13287-024-03992-x
pii: 10.1186/s13287-024-03992-x
doi:
Substances chimiques
Relaxin
9002-69-1
Green Fluorescent Proteins
147336-22-9
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
375Subventions
Organisme : National Health and Medical Research Council
ID : GNT1156446
Organisme : National Health and Medical Research Council
ID : GNT2019014
Informations de copyright
© 2024. The Author(s).
Références
Levey AS, Eckardt K-U, Tsukamoto Y, Levin A, Coresh J, Rossert J, et al. Definition and classification of chronic kidney disease: a position statement from kidney disease: improving global outcomes (KDIGO). Kidney Int. 2005;67(6):2089–100.
pubmed: 15882252
doi: 10.1111/j.1523-1755.2005.00365.x
Zoccali C, Vanholder R, Massy ZA, Ortiz A, Sarafidis P, Dekker FW, et al. The systemic nature of CKD. Nat Rev Nephrol. 2017;13(6):344–58.
pubmed: 28435157
doi: 10.1038/nrneph.2017.52
Eddy AA. Overview of the cellular and molecular basis of kidney fibrosis. Kidney Int Suppl. 2014;4(1):2–8.
doi: 10.1038/kisup.2014.2
Klinkhammer BM, Goldschmeding R, Floege J, Boor P. Treatment of renal fibrosis - Turning challenges into opportunities. Adv Chronic Kidney Dis. 2017;24(2):117–29.
pubmed: 28284377
doi: 10.1053/j.ackd.2016.11.002
English K. Mechanisms of mesenchymal stromal cell immunomodulation. Immunol Cell Biol. 2013;91(1):19–26.
pubmed: 23090487
doi: 10.1038/icb.2012.56
Li Y, Ricardo SD, Samuel CS. Enhancing the therapeutic potential of mesenchymal stromal cell-based therapies with an anti-fibrotic agent for the treatment of chronic kidney disease. Int J Mol Sci. 2022;23(11):6035.
pubmed: 35682717
pmcid: 9181689
doi: 10.3390/ijms23116035
Perico N, Casiraghi F, Remuzzi G. Clinical translation of mesenchymal stromal cell therapies in nephrology. J Am Soc Nephrol. 2018;29(2):362–75.
pubmed: 29191959
doi: 10.1681/ASN.2017070781
Makhlough A, Shekarchian S, Moghadasali R, Einollahi B, Dastgheib M, Janbabaee G, et al. Bone marrow-mesenchymal stromal cell infusion in patients with chronic kidney disease: a safety study with 18 months of follow-up. Cytotherapy. 2018;20(5):660–9.
pubmed: 29580865
doi: 10.1016/j.jcyt.2018.02.368
Makhlough A, Shekarchian S, Moghadasali R, Einollahi B, Hosseini SE, Jaroughi N, et al. Safety and tolerability of autologous bone marrow mesenchymal stromal cells in ADPKD patients. Stem Cell Res Ther. 2017;8(1):116.
pubmed: 28535817
pmcid: 5442691
doi: 10.1186/s13287-017-0557-7
Skyler JS, Fonseca VA, Segal KR, Rosenstock J. Allogeneic mesenchymal precursor cells in type 2 diabetes: a randomized, placebo-controlled, dose-escalation safety and tolerability pilot study. Diabetes Care. 2015;38(9):1742–9.
pubmed: 26153271
pmcid: 4542273
doi: 10.2337/dc14-2830
Packham DK, Fraser IR, Kerr PG, Segal KR. Allogeneic mesenchymal precursor cells (MPC) in diabetic nephropathy: a randomized, placebo-controlled, dose escalation study. EBioMedicine. 2016;12:263–9.
pubmed: 27743903
pmcid: 5078602
doi: 10.1016/j.ebiom.2016.09.011
Wang B, Yao K, Huuskes BM, Shen HH, Zhuang J, Godson C, et al. Mesenchymal stem cells deliver exogenous microRNA-let7c via exosomes to attenuate renal fibrosis. Mol Therap. 2016;24(7):1290–301.
doi: 10.1038/mt.2016.90
Burchfield JS, Iwasaki M, Koyanagi M, Urbich C, Rosenthal N, Zeiher AM, et al. Interleukin-10 from transplanted bone marrow mononuclear cells contributes to cardiac protection after myocardial infarction. Circ Res. 2008;103(2):203–11.
pubmed: 18566343
doi: 10.1161/CIRCRESAHA.108.178475
Jin S, Li H, Han M, Ruan M, Liu Z, Zhang F, et al. Mesenchymal stem cells with enhanced Bcl-2 expression promote liver recovery in a rat model of hepatic cirrhosis. Cell Physiol Biochem. 2016;40(5):1117–28.
pubmed: 27960154
doi: 10.1159/000453166
Beckermann BM, Kallifatidis G, Groth A, Frommhold D, Apel A, Mattern J, et al. VEGF expression by mesenchymal stem cells contributes to angiogenesis in pancreatic carcinoma. Br J Cancer. 2008;99(4):622–31.
pubmed: 18665180
pmcid: 2527820
doi: 10.1038/sj.bjc.6604508
Samuel CS, Bennett RG. Relaxin as an anti-fibrotic treatment: perspectives, challenges and future directions. Biochem Pharmacol. 2022;197:114884.
pubmed: 34968489
doi: 10.1016/j.bcp.2021.114884
Garber SL, Mirochnik Y, Brecklin CS, Unemori EN, Singh AK, Slobodskoy L, et al. Relaxin decreases renal interstitial fibrosis and slows progression of renal disease. Kidney Int. 2001;59(3):876–82.
pubmed: 11231342
doi: 10.1046/j.1523-1755.2001.059003876.x
Garber G, Mirochnik Y, Brecklin CS, Slobodskoy L, Arruda JA, Dunea G. Effect of relaxin in two models of renal mass reduction. Am J Nephrol. 2003;23(1):8–12.
pubmed: 12373075
doi: 10.1159/000066302
McDonald GA, Sarkar P, Rennke H, Unemori E, Kalluri R, Sukhatme VP. Relaxin increases ubiquitin-dependent degradation of fibronectin in vitro and ameliorates renal fibrosis in vivo. Am J Physiol Renal Physiol. 2003;285(1):F59-67.
pubmed: 12820641
doi: 10.1152/ajprenal.00157.2002
Lekgabe ED, Kiriazis H, Zhao C, Xu Q, Moore SL, Su Y, et al. Relaxin reverses cardiac and renal fibrosis in spontaneously hypertensive rats. Hypertension. 2005;46(2):412–8.
pubmed: 15967869
doi: 10.1161/01.HYP.0000171930.00697.2f
Danielson LA, Welford A, Harris A. Relaxin improves renal function and histology in aging Munich Wistar rats. J Am Soc Nephrol. 2006;17(5):1325–33.
pubmed: 16597680
doi: 10.1681/ASN.2005121307
Hewitson TD, Ho WY, Samuel CS. Antifibrotic properties of relaxin: in vivo mechanism of action in experimental renal tubulointerstitial fibrosis. Endocrinology. 2010;151(10):4938–48.
pubmed: 20826562
doi: 10.1210/en.2010-0286
Sasser JM, Molnar M, Baylis C. Relaxin ameliorates hypertension and increases nitric oxide metabolite excretion in angiotensin II but not N(omega)-nitro-L-arginine methyl ester hypertensive rats. Hypertension. 2011;58(2):197–204.
pubmed: 21670419
doi: 10.1161/HYPERTENSIONAHA.110.164392
Yoshida T, Kumagai H, Kohsaka T, Ikegaya N. Relaxin protects against renal ischemia-reperfusion injury. Am J Physiol Renal Physiol. 2013;305(8):F1169–76.
pubmed: 23946288
doi: 10.1152/ajprenal.00654.2012
Yoshida T, Kumagai H, Kohsaka T, Ikegaya N. Protective effects of relaxin against cisplatin-induced nephrotoxicity in rats. Nephron Exp Nephrol. 2014;128(1–2):9–20.
pubmed: 25403022
doi: 10.1159/000365852
Wang D, Luo Y, Myakala K, Orlicky DJ, Dobrinskikh E, Wang X, et al. Serelaxin improves cardiac and renal function in DOCA-salt hypertensive rats. Sci Rep. 2017;7(1):9793.
pubmed: 28851937
pmcid: 5574886
doi: 10.1038/s41598-017-09470-0
Samuel CS, Bodaragama H, Chew JY, Widdop RE, Royce SG, Hewitson TD. Serelaxin is a more efficacious antifibrotic than enalapril in an experimental model of heart disease. Hypertension. 2014;64(2):315–22.
pubmed: 24866131
doi: 10.1161/HYPERTENSIONAHA.114.03594
Li Y, Shen M, Ferens D, Broughton BRS, Murthi P, Saini S, et al. Combining mesenchymal stem cells with serelaxin provides enhanced renoprotection against 1K/DOCA/salt-induced hypertension. Br J Pharmacol. 2021;178(5):1164–81.
pubmed: 33450051
doi: 10.1111/bph.15361
Huuskes BM, Wise AF, Cox AJ, Lim EX, Payne NL, Kelly DJ, et al. Combination therapy of mesenchymal stem cells and serelaxin effectively attenuates renal fibrosis in obstructive nephropathy. FASEB J. 2015;29(2):540–53.
pubmed: 25395452
doi: 10.1096/fj.14-254789
Seibold JR, Korn JH, Simms R, Clements PJ, Moreland LW, Mayes MD, et al. Recombinant human relaxin in the treatment of scleroderma. A randomized, double-blind, placebo-controlled trial. An Int Med. 2000;132(11):871–9.
doi: 10.7326/0003-4819-132-11-200006060-00004
Chen SA, Perlman AJ, Spanski N, Peterson CM, Sanders SW, Jaffe R, et al. The pharmacokinetics of recombinant human relaxin in nonpregnant women after intravenous. Intravag Intracerv Administr Pharm Res. 1993;10(6):834–8.
Dahlke M, Halabi A, Canadi J, Tsubouchi C, Machineni S, Pang Y. Pharmacokinetics of serelaxin in patients with severe renal impairment or end-stage renal disease requiring hemodialysis: A single-dose, open-label, parallel-group study. J Clin Pharmacol. 2016;56(4):474–83.
pubmed: 26239266
doi: 10.1002/jcph.607
Chawla LS, Eggers PW, Star RA, Kimmel PL. Acute kidney injury and chronic kidney disease as interconnected syndromes. New Eng J Med. 2014;371(1):58–66.
pubmed: 24988558
doi: 10.1056/NEJMra1214243
Wise AF, Williams TM, Kiewiet MB, Payne NL, Siatskas C, Samuel CS, et al. Human mesenchymal stem cells alter macrophage phenotype and promote regeneration via homing to the kidney following ischemia-reperfusion injury. Am J Physiol Renal Physiol. 2014;306(10):F1222-35.
pubmed: 24623144
doi: 10.1152/ajprenal.00675.2013
Badawi A, Jefferson OC, Huuskes BM, Ricardo SD, Kerr PG, Samuel CS, et al. A novel approach to enhance the regenerative potential of circulating endothelial progenitor cells in patients with end-stage kidney disease. Biomedicines. 2002;10(4):883.
doi: 10.3390/biomedicines10040883
Neugarten J, Golestaneh L. Influence of sex on the progression of chronic kidney disease. Mayo Clin Proc. 2019;94(7):1339–56.
pubmed: 31272577
doi: 10.1016/j.mayocp.2018.12.024
Samuel CS, Zhao C, Bathgate RAD, Bond CP, Burton MD, Parry LJ, et al. Relaxin deficiency in mice is associated with an age-related progression of pulmonary fibrosis. FASEB J. 2003;17(1):121–3.
pubmed: 12424226
doi: 10.1096/fj.02-0449fje
Beaini S, Saliba Y, Hajal J, Smayra V, Bakhos JJ, Joubran N, et al. VEGF-C attenuates renal damage in salt-sensitive hypertension. J Cell Physiol. 2019;234(6):9616–30.
pubmed: 30378108
doi: 10.1002/jcp.27648
Gao XM, Tsai A, Al-Sharea A, Su Y, Moore S, Han LP, et al. Inhibition of the renin-angiotensin system post myocardial infarction prevents inflammation-associated acute cardiac rupture. Cardiovascular Drugs Ther. 2017;31(2):145–56.
doi: 10.1007/s10557-017-6717-2
Alikhan MA, Jones CV, Williams TM, Beckhouse AG, Fletcher AL, Kett MM, et al. Colony-stimulating factor-1 promotes kidney growth and repair via alteration of macrophage responses. Am J Path. 2011;179(3):1243–56.
pubmed: 21762674
pmcid: 3157188
doi: 10.1016/j.ajpath.2011.05.037
Li Y, Chakraborty A, Broughton BRS, Ferens D, Widdop RE, Ricardo SD, et al. Comparing the renoprotective effects of BM-MSCs versus BM-MSC-exosomes, when combined with an anti-fibrotic drug, in hypertensive mice. Biomed Pharmacother. 2021;144:112256.
pubmed: 34607108
doi: 10.1016/j.biopha.2021.112256
Maric C, Sandberg K, Hinojosa-Laborde C. Glomerulosclerosis and tubulointerstitial fibrosis are attenuated with 17beta-estradiol in the aging Dahl salt sensitive rat. J Am Soc Nephrol. 2004;15(6):1546–56.
pubmed: 15153565
doi: 10.1097/01.ASN.0000128219.65330.EA
Woessner JF Jr. Quantification of matrix metalloproteinases in tissue samples. Methods Enzymol. 1995;248:510–28.
pubmed: 7674942
doi: 10.1016/0076-6879(95)48033-1
Dominici M, Le Blanc K, Mueller I, Slaper-Cortenbach I, Marini F, Krause D, et al. Minimal criteria for defining multipotent mesenchymal stromal cells. Int Soc Cell Therapy Posit Statem Cytother. 2006;8(4):315–7.
Unemori EN, Amento EP. Relaxin modulates synthesis and secretion of procollagenase and collagen by human dermal fibroblasts. J Biol Chem. 1990;265(18):10681–5.
pubmed: 2162358
doi: 10.1016/S0021-9258(18)87000-4
Unemori EN, Bauer EA, Amento EP. Relaxin alone and in conjunction with interferon-gamma decreases collagen synthesis by cultured human scleroderma fibroblasts. J Invest Dermatol. 1992;99(3):337–42.
pubmed: 1512471
doi: 10.1111/1523-1747.ep12616665
Unemori EN, Pickford LB, Salles AL, Piercy CE, Grove BH, Erikson ME, et al. Relaxin induces an extracellular matrix-degrading phenotype in human lung fibroblasts in vitro and inhibits lung fibrosis in a murine model in vivo. J Clin Invest. 1996;98(12):2739–45.
pubmed: 8981919
pmcid: 507738
doi: 10.1172/JCI119099
Bell RJ, Eddie LW, Lester AR, Wood EC, Johnston PD, Niall HD. Relaxin in human pregnancy serum measured with an homologous radioimmunoassay. Obstet Gynecol. 1987;69(4):585–9.
pubmed: 3822300
Teerlink JR, Metra M, Felker GM, Ponikowski P, Voors AA, Weatherley BD, et al. Relaxin for the treatment of patients with acute heart failure (Pre-RELAX-AHF): a multicentre, randomised, placebo-controlled, parallel-group, dose-finding phase IIb study. Lancet. 2009;373(9673):1429–39.
pubmed: 19329178
doi: 10.1016/S0140-6736(09)60622-X
Gallo G, Volpe M, Savoia C. Endothelial dysfunction in hypertension: Current concepts and clinical implications. Front Med (Lausanne). 2021;8:798958.
pubmed: 35127755
doi: 10.3389/fmed.2021.798958
Togel F, Yang Y, Zhang P, Hu Z, Westenfelder C. Bioluminescence imaging to monitor the in vivo distribution of administered mesenchymal stem cells in acute kidney injury. Am J Physiol Renal Physiol. 2008;295(1):F315-21.
pubmed: 18480180
pmcid: 4063418
doi: 10.1152/ajprenal.00098.2008
Sanchez-Diaz M, Quinones-Vico MI, Sanabria de la Torre R, Montero-Vilchez T, Sierra-Sanchez A, Molina-Leyva A, et al. Biodistribution of mesenchymal stromal cells after administration in animal models and humans: A systematic review. J Clin Med. 2021;10(13):2925.
pubmed: 34210026
pmcid: 8268414
doi: 10.3390/jcm10132925
Bennett RG, Heimann DG, Singh S, Simpson RL, Tuma DJ. Relaxin decreases the severity of established hepatic fibrosis in mice. Liver Int. 2014;34(3):416–26.
pubmed: 23870027
doi: 10.1111/liv.12247
Formigli L, Perna AM, Meacci E, Cinci L, Margheri M, Nistri S, et al. Paracrine effects of transplanted myoblasts and relaxin on post-infarction heart remodelling. J Cell Mol Med. 2007;115:1087–100.
doi: 10.1111/j.1582-4934.2007.00111.x
de Oliveira-Sales EB, Nishi EE, Boim MA, Dolnikoff MS, Bergamaschi CT, Campos RR. Upregulation of AT1R and iNOS in the rostral ventrolateral medulla (RVLM) is essential for the sympathetic hyperactivity and hypertension in the 2K–1C Wistar rat model. Am J Hypertens. 2010;23(7):708–15.
pubmed: 20360752
doi: 10.1038/ajh.2010.64
Gross O, Beirowski B, Koepke ML, Kuck J, Reiner M, Addicks K, et al. Preemptive ramipril therapy delays renal failure and reduces renal fibrosis in COL4A3-knockout mice with Alport syndrome. Kidney Int. 2003;63(2):438–46.
pubmed: 12631109
doi: 10.1046/j.1523-1755.2003.00779.x
Srivastava SP, Goodwin JE, Kanasaki K, Koya D. Inhibition of angiotensin-converting enzyme ameliorates renal fibrosis by mitigating DPP-4 level and restoring antifibrotic microRNAs. Genes (Basel). 2020;11(2):211.
pubmed: 32085655
pmcid: 7074526
doi: 10.3390/genes11020211
Royce SG, Miao YR, Lee M, Samuel CS, Treegar GW, Tang MLK. Relaxin reverses airway remodeling and airway dysfunction in allergic airways diseases. Endocrinology. 2009;150(6):2692–9.
pubmed: 19213838
doi: 10.1210/en.2008-1457
Patel KP, Giraud AS, Samuel CS, Royce SG. Combining an epithelial repair factor and anti-fibrotic with a corticosteroid offers optimal treatment for allergic airways disease. Br J Pharmacol. 2016;173(12):2016–29.
pubmed: 27060978
pmcid: 4882488
doi: 10.1111/bph.13494
Royce SG, Mao W, Lim R, Kelly K, Samuel CS. iPSC- and mesenchymoangioblast-derived mesenchymal stem cells provide greater protection against experimental chronic allergic airways disease compared with a clinically used corticosteroid. FASEB J. 2019;33(5):6402–11.
pubmed: 30768365
doi: 10.1096/fj.201802307R
Kuusniemi AM, Lapatto R, Holmberg C, Karikoski R, Rapola J, Jalanko H. Kidneys with heavy proteinuria show fibrosis, inflammation, and oxidative stress, but no tubular phenotypic change. Kidney Int. 2005;68(1):121–32.
pubmed: 15954901
doi: 10.1111/j.1523-1755.2005.00386.x
Sharma A, Sahasrabudhe V, Musib L, Zhang S, Younis I, Kanodia J. Time to rethink the current paradigm for assessing kidney function in drug development and beyond. Clin Pharmacol Ther. 2022;112(5):946–58.
pubmed: 34800044
doi: 10.1002/cpt.2489