CELL THERAPY FOR THE TREATMENT OF NEURODEGENERATION

Abstract

Methods are described for the isolation and selection of a heterogeneous bone marrow cell population, called NCS-01, that is effective at treating neurodegeneration. For example, NCS-01 cells are shown to treat neurodegeneration caused by ischemia. In vivo studies demonstrate that selected NCS-01 cell populations treat neurodegeneration in a standard rat middle cerebral artery occlusion (MCAO) animal model under conditions of transient or permanent total arterial occlusion. These studies also disclose that when the neurodegeneration is caused by ischemic stroke, combining the administration of a selected NCS-01 cell population with thrombolytic agents and/or mechanical methods of clot removal leads to a decrease in the volume of infarction caused by acute onset neurodegeneration. The disclosed cell therapy promises to make a significant clinical impact on patient survival after stroke.

Claims

1-63. (canceled)

64. A method of producing a heterogeneous subpopulation of bone marrow cells for the treatment of neurodegeneration caused by ischemia, comprising: a) obtaining a population of bone marrow cells from human unprocessed bone marrow; b) seeding the population of bone marrow cells at a low density of 10.sup.5-10.sup.6 cells/cm.sup.2 onto a plastic surface, c) washing the seeded cell population to remove non-adherent cells; d) culturing the adherent cells from the washed population of cells to confluence in serum containing media; e) serially passaging the cultured cells for no more than seven serial passages in the serum-containing media, wherein, at each passage, the cultured cells are seeded at low density of about 750 cells/cm.sup.2; f) obtaining said heterogeneous subpopulation of bone marrow cells, wherein said heterogeneous subpopulation of bone marrow cells treats neurodegeneration caused by ischemia.

65. The method according to claim 64, wherein the serum-containing media are bovine serum-containing media.

66. The method according to claim 64 or 65, wherein said unprocessed bone marrow is obtained from a subject that is not pre-treated with a chemotherapy agent.

67. The method according to claim 66, wherein said chemotherapy agent is 5-fluorouracil.

68. The method according to claim 66, wherein said population of bone marrow cells cannot be isolated by density fractionation or by ACK lysis.

69. The method according to claim 68, wherein said density fractionation requires a Ficoll™ or Percoll™ gradient.

70. The method according to claim 64, further comprising testing said heterogeneous subpopulation of bone marrow cells in an experimental model of neurodegeneration caused by ischemia, wherein only those populations that demonstrate the ability to treat neurodegeneration caused by ischemia are selected.

71. The method according to claim 70, wherein the experimental model of neurodegeneration caused by ischemia is an oxygen/glucose deprivation (OGD) cell culture model.

72. The method according to claim 70, wherein the experimental model of neurodegeneration caused by ischemia is a stroke animal model.

73. A method of optimizing an experimental protocol for the isolation of a cell population that treats neurodegeneration caused by ischemia, comprising the steps of: isolating a cell population according to the method according to claim 64, wherein neurodegeneration caused by ischemia in an experimental animal model of neurodegeneration caused by ischemia is treated by said cell population, and wherein the optimal parameters of each step of the method according to claim 64 are determined by testing the effect each parameter has on the efficacy of said isolated cell population to treat neurodegeneration caused by ischemia in the experimental animal model of neurodegeneration caused by ischemia.

74. The method according to claim 73, wherein said neurodegeneration caused by ischemia is caused by ischemic stroke.

75. The method according to claim 73, wherein said parameters comprise cell density at seeding, cell passage number, culture media composition or cell fractionation.

76. The method according to claim 73, wherein said experimental animal model of neurodegeneration caused by ischemia is an oxygen/glucose deprivation (OGD) cell culture model.

77. The method according to claim 73, wherein said experimental animal model of neurodegeneration caused by ischemia is a stroke animal model.

78. The method according to claim 73, wherein said experimental model of neurodegeneration caused by ischemia is a middle cerebral artery occlusion (MCAO) animal model.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0069] The skilled artisan will understand that the drawings, described below, are for illustration purposes only. The figures are not intended to limit the scope of the teachings in any way.

[0070] FIGS. 1A-1K depicts the results from the screening of candidate bone marrow-derived cell sub-populations using the in vitro OGD model (FIG. 1A, 1B, 1C, 1G, 1H, and 1I) and the in vivo MCAO rat model (FIG. 1D, 1E, 1F, 1J, and 1K).

[0071] FIGS. 1A, 1B, and 1C depict host cell survival and cytokine release (bFGF and IL-6) respectively in the in vitro OGD model in response to the presence or absence of 7 different candidate bone marrow-derived cell sub-populations.

[0072] FIGS. 1D, 1E, and 1F compares host cell survival, infarction volume and neurological function in the in vivo MCAO rat model in response to the NCS-01 bone marrow cell sub-population or saline injected either intravenously (IV) or intra-arterially (ICA).

[0073] FIGS. 1G, 1H, and 1I depicts host cell survival and cytokine release (bFGF and IL-6) in the in vitro OGD model in response to the presence or absence of the NCS-01 bone marrow cell sub-population.

[0074] FIGS. 1J and 1K shows changes in infarction volume and neurological function in the in vivo MCAO rat model in response to the injection of 3×10.sup.5, 10.sup.6 and 10.sup.7 NCS-01 bone marrow cells.

[0075] FIGS. 2A and 2B show changes in infarction volume (FIG. 2A) and neurological function (Panel B; as measured by the Modified Bederson Scale (0=normal to 3=most severe)) in a transient (60 minutes) or permanent MCAO rat model in response to the ICA injection of 1 ml of 7.5×10.sup.6 NCS-01 cells or saline solution.

[0076] FIG. 3 depicts a schematic diagram that describes the protocol used in the in vitro Oxygen Glucose Deprivation (OGD) assay.

[0077] FIGS. 4A and 4B shows the relative levels of secreted bFGF and IL-6 cytokines in the cell culture media of an OGD assay after addition of saline, Li cells or NCS-01 cells.

[0078] FIGS. 5A, 5B, and 5C depicts host cell survival, infarction volume and neurological function in the in vivo MCAO rat model in response to an injection of saline, Li cells and NCS-01 cells.

DETAILED DESCRIPTION

[0079] The practice of the invention employs, unless otherwise indicated, conventional molecular biological techniques within the skill of the art. Such techniques are well known to the skilled worker, and are explained fully in the literature. See, e.g., Ausubel, et al., ed., Current Protocols in Molecular Biology, John Wiley & Sons, Inc., NY, N.Y. (1987-2008), including all supplements; Sambrook, et al., Molecular Cloning: A Laboratory Manual, 2nd Edition, Cold Spring Harbor, N.Y. (1989).

[0080] Unless defined otherwise, all technical and scientific terms used herein have the same meaning as is commonly understood by one of skill in the art. The specification also provides definitions of terms to help interpret the disclosure and claims of this application. In the event a definition is not consistent with definitions elsewhere, the definition set forth in this application will control.

[0081] Bone marrow (BM) derived cells include a heterogeneous mixture of many different types of cells. Bone marrow is composed of two main cell systems that belong to two distinct lineages—the hematopoietic tissues and the associated supporting stroma. Thus, at least two distinct stem cells, namely hematopoietic stem cells (HSCs) and mesenchymal stem cells (MSCs), are known to co-exist in the bone marrow (Bianco, M. Riminucci, S. Gronthos, and P. G. Robey, “Bone marrow stromal stem cells: nature, biology, and potential applications,” Stem Cells, vol. 19, no. 3, pp. 180-192, 2001).

[0082] MSCs can be broadly defined both by cell-surface markers and by their ability to adhere to tissue/cell culture plastic. Thus, MSC populations are necessarily heterogeneous, i.e. not a clonal cell population. Even if MSC sub-populations share one or more common cell surface markers, they can nevertheless differ significantly in their biological activity depending on the manufacturing method used to isolate them. This disclosure describes a two-step screening protocol for the identification of a heterogeneous bone marrow cell population that is effective at treating neurodegeneration including acute onset neurodegeneration caused by ischemia.

[0083] In a first step, bone marrow subpopulations are screened for their ability to attenuate the effect of oxygen glucose deprivation (OGD) in co-cultures comprising candidate bone marrow subpopulations and neural cells. The activity of candidate bone marrow subpopulations to attenuate neurodegeneration is assessed by measuring the secretion of trophic factors (bFGF and IL6) in the culture media as well as determining host cell survival in the OGD assay.

[0084] In a second step, bone marrow derived cell populations having the strongest activity in the OGD assay are then further screened by testing in an in vivo MCAO rat model of neurodegeneration caused by ischemia. This screening procedure facilitates the identification of a heterogeneous bone marrow subpopulation, called NCS-01, that greatly attenuates neurodegeneration caused by ischemia, as defined herein.

[0085] Unprocessed bone marrow cells are readily available to one of ordinary skill in the art.

[0086] As used herein, the term “unprocessed bone marrow” refers to a human bone marrow aspirate without any additional processing, such as density fractionation or cell sorting.

[0087] In other embodiments, “unprocessed bone marrow” is obtained from subjects that are not pre-treated with any agent that interferes with normal cell growth and division, including, for example, chemotherapy agents such as anti-mitotic or anti-metabolite agents.

[0088] Examples of such agents can be found in Cancer Principles and Practice of Oncology by V. T. Devita and S. Hellman (editors), 6th edition (Feb. 15, 2001), Lippincott Williams & Wilkins Publishers.

[0089] An “anti-metabolite” agent, as used herein, relates to a compound which inhibits or disrupts the synthesis of DNA resulting in cell death. Examples of an anti-metabolite include, but are not limited to, 6-mercaptopurine; cytarabine; fludarabine; flexuridine; 5-fluorouracil; capecitabine; raltitrexed; methotrexate; cladribine; gemcitabine; gemcitabine hydrochloride; thioguanine; hydroxyurea; DNA de-methylating agents, such as 5-azacytidine and decitabine; edatrexate; and folic acid antagonists such as, but not limited to, pemetrexed.

[0090] As used herein, the term “density fractionation” refers to well-known laboratory procedures for the fractionation of bone marrow cells based on cell density using Ficoll-Paque™ or Percoll™ gradients. For example, Ficoll-Paque™ is placed at the bottom of a conical tube, and unprocessed bone marrow is then slowly layered on top of the Ficoll-Paque™. After centrifugation of the cells through the Ficoll gradient, the cells separate into layers according to density, from top to bottom: plasma and other constituents, a layer of mono-nuclear cells, called the buffy coat, comprising peripheral blood mononuclear cells (PBMCs) and mononuclear cells (MNCs) and erythrocytes and granulocytes in the pellet. This fractionation procedure separates erythrocytes from PBMCs. Ethylene diamine tetra-acetate (EDTA) and heparin are commonly used in conjunction with Ficoll-Paque™ to prevent clotting.

[0091] As used herein, the term “ACK lysis” refers to ammonium chloride potassium lysis buffer (ACK lysis buffer) for lysing of red blood cells in EDTA-anti-coagulated whole blood.

[0092] As used herein, the term “seeding the population of bone marrow cells at a low density” refers to the concentration of bone marrow cells added at the start of cell culture. In one aspect, the bone marrow cells are seeded at a density of about 10.sup.2 or about 10.sup.3 or about 10.sup.4 or about 10.sup.5 or about 10.sup.6 cells/cm.sup.2. In a preferred aspect, the bone marrow cells are seeded at a density of about 10.sup.5 to about 10.sup.6 cells/cm.sup.2.

[0093] As used herein, “neurodegeneration” refers to any pathological state that results in the progressive loss of structure or function of neural cells, including neural cell death. Thus, neurodegeneration is a pathological state caused by neurological disorders.

[0094] In one embodiment, the phrase “neural cell” includes both nerve cells (i.e., neurons, e.g., uni-, bi-, or multipolar neurons) and their precursors and glial cells (e.g., macroglia such as oligodendrocytes, Schwann cells, and astrocytes, or microglia) and their precursors.

[0095] In one embodiment, an “effective amount” refers to the optimal number of cells needed to elicit a clinically significant improvement in the symptoms and/or pathological state associated with neurodegeneration including slowing, stopping or reversing neurodegeneration, reducing a neurological deficit or improving a neurological response. In some embodiments, an effective amount of the NCS-01 cell population refers to the optimal number of cells needed to reduce the volume of infarction caused by the sudden onset of acute neurodegeneration after a stroke. An appropriate effective amount of the NCS-01 cell population for a particular organism may be determined by one of ordinary skill in the art using routine experimentation.

[0096] As used herein, “treating neurodegeneration” refers to the treatment of neurodegeneration by a NCS-01 cell population that results in a clinically significant improvement in the symptoms and/or pathological state associated with neurodegeneration including slowing, stopping or reversing neurodegeneration, reducing a neurological deficit or improving a neurological response.

[0097] As used herein, “thrombolytic agents” refers to drugs that are used in medicine to dissolve blood clots in a procedure termed thrombolysis. Non-limiting examples of thrombolytic drugs include tissue plasminogen tissue activator tPA, alteplase (Activase), reteplase (Retavase), tenecteplase (TNKase), anistreplase (Eminase), streptokinase (Kabikinase, Streptase) and urokinase (Abbokinase).

[0098] The following describes the procedures for isolating and characterizing a heterogeneous bone marrow cell sub population from whole, unprocessed bone marrow that is optimal for the treatment of neurodegeneration including the treatment of neurodegeneration caused by ischemia.

Isolation of Candidate Bone Marrow Cell Populations Effective for Treating Neurodegeneration Caused by Ischemia.

[0099] Whole, unprocessed bone marrow is harvested from a mammal that is not pre-treated with an anti-mitotic or anti-metabolite, such as 5-fluorouracil (5-FU).

[0100] The unprocessed bone marrow is then plated directly on to tissue/cell culture plastic and expanded by serial passaging in a serum containing media. At each passage, cells are seeded at very low cell density, i.e. approximately 750 cells/cm.sup.2 or less, and cultured to near confluence before additional passaging. Non-adherent cells are removed by washing. As the bone marrow is not processed by density fractionation, the starting whole bone marrow cell population includes hematopoietic and non-hematopoietic cells as well as both nucleated and non-nucleated bone marrow cells.

[0101] Master (MCB) and Working Cell Banks (WCB) are then established preferably at passages 3 and 5, respectively and cryopreserved.

When needed, WCB cells are seeded at very low density, e.g. approximately 750 cells/cm.sup.2 or less, and expanded in serum containing media before being harvested and cryopreserved using standard procedures.
A two-step Selection Protocol for Evaluating a Bone Marrow Cell Population'S Ability to Attenuate Neurodegeneration

[0102] ‘Candidate’ bone marrow cell populations can then be screened using a two-step procedure that selects the optimal bone marrow cell population for the treatment of neurodegeneration.

[0103] In the first step, candidate bone marrow cell populations are tested in an in vitro oxygen glucose deprivation assay where candidate bone marrow cell populations are co-cultured with neural cells under experimental conditions that mimic neurodegeneration. Cell populations that are shown to attenuate neurodegeneration in vitro are then screened for their ability to treat neurodegeneration in vivo.

[0104] In the second step, selected candidate bone marrow cell populations are evaluated in a rat MCAO model of neurodegeneration caused by ischemia. The candidate heterogeneous bone marrow cell population demonstrating the most activity to attenuate neurodegeneration in vivo is then selected.

[0105] The heterogeneous bone marrow cell population selected by this two-step screening procedure is called the NCS-01 cell population or NCS-01.

Identification of the Optimal Cell Culture Conditions for the Isolation of a Bone Marrow Cell Population with Neurodegeneration Attenuation Activity

[0106] The two-step screening protocol is also useful in identifying the optimal experimental conditions such as cell density at seeding, cell passage number, culture media composition or cell fractionation for the culture of bone marrow cell populations that are able to treat neurodegeneration.

[0107] Thus, using the two screening procedure, the optimal reseeding cell concentration is about 750 cells/cm.sup.2 or less at each passage. The optimal culture media is a serum containing media. NCS-01 cell populations can be passaged for no more than about 7, or about 6 or about 5 or about 4 or about 3 or about 2 passages from the initial plating of the whole, unprocessed bone marrow. Extended passaging i.e. beyond 7 passages from the initial plating of the whole, unprocessed bone marrow diminishes or abolishes NCS-01's ability to treat neurodegeneration in the OGD in vitro assay and in the MCAO rat model.

[0108] The OGD assay and the MCAO rat model of neurodegeneration are now described in detail below.

In Vitro Screening of Bone Marrow Cell Populations Capable of Treating Neurodegeneration

[0109] Candidate bone marrow cell populations are first screened for their ability to prevent neurodegeneration in a neuron-astrocyte co-culture after culture conditions of oxygen-glucose deprivation (OGD) that simulate neurodegeneration caused by ischemia.

[0110] Primary mixed cultures of rat or human neurons and astrocytes are first exposed to oxygen glucose deprivation (OGD) culture conditions (for example, 8% oxygen, glucose free media) for about 0.5 to 3 hours to induce neurodegeneration. Oxygen glucose deprivation of the cell culture is then discontinued and the OGD induced neural cells are cultured under physiological conditions for 2 hours and then co-cultured in the presence of a candidate bone marrow cell population for an additional 3 hours. Neurodegeneration is then assessed by measuring host cell viability either in the presence or absence of the candidate bone marrow cell population at 0 and from 5 hours after OGD. Host cell (neurons and astrocytes) viability can be assessed using, for example, trypan blue staining and/or the MTT (3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay.

[0111] An increase in cell viability in the presence of a candidate bone marrow cell population as compared to the cell viability of a control (without the addition of the candidate bone marrow cell population) by about 5% or about 10% or about 15% or about 20% or about 25% or more indicates the candidate bone marrow cell population can protect and rescue neuron/astrocyte co-cultures from neurodegeneration caused by oxygen and glucose deprivation.

[0112] In addition, the culture media of neuron/astrocyte cell cultures subjected to OGD conditions in the presence or absence of candidate bone marrow cell populations can also be assayed for the induced secretion of trophic factors, for example, bFGF and/or IL-6 using commercially available ELISA kits.

[0113] In certain embodiments, candidate bone marrow cell populations are selected according to their ability to induce an increase in the amount of secreted bFGF and/or IL-6 in the media of neuron-astrocyte co-cultures in response to oxygen glucose deprivation, but not in the absence of oxygen glucose deprivation.

[0114] In other embodiments candidate bone marrow cell populations are selected according to their ability to induce an at least two-fold or greater increase in the amount of secreted bFGF and/or IL-6 in the media of neuron-astrocyte co-cultures in response to oxygen glucose deprivation, but not in the absence of oxygen glucose deprivation.

[0115] Candidate bone marrow cell populations that decrease the incidence of OGD-induced cell death and induce an increase in the amount of secreted trophic factors (such as bFGF and/or IL-6) are then selected for screening in the in vivo the MCAO rat model (see below).

[0116] For example, candidate bone marrow cell populations can be selected for further screening if they decrease the incidence of OGD-induced cell death by more than about 25% and increase the amount of secreted trophic factors by at least 10% or more.

In Vivo Screening of Candidate Bone Marrow Cell Populations Capable of Treating Neurodegeneration

[0117] Candidate bone marrow cell populations, selected in the OGD assay screening step described above, are tested for their ability to treat neurodegeneration in vivo. For example, the candidate bone marrow cell populations can be tested for their ability to treat neurodegeneration in an experimental animal model of neurodegeneration including transgenic models of neurodegenerative diseases (see, for example, Harvey et al. Transgenic animal models of neurodegeneration based on human genetic studies J Neural Transm. (2011) 118(1): 27-45; Trancikova et al. Genetic mouse models of neurodegenerative diseases. Prog Mol Biol Transl Sci. (2011);100:419-82; Chan et al. Generation of transgenic monkeys with human inherited genetic disease Methods (2009) 49(1):78-84; Rockenstein et al. Transgenic animal models of neurodegenerative diseases and their application to treatment development Adv Drug Deliv Rev. (2007) 59(11):1093-102).

[0118] In one embodiment, the experimental animal model of neurodegeneration can be an animal model of stroke/cerebral ischemia (review by Graham et al. Comp Med. 2004 54(5):486-96), such as the MCAO rat model, where constriction of a surgically implanted ligature around a cerebral artery mimics the effect of ischemic stroke by limiting the blood flow to the brain and causes ischemia and subsequent neurodegeneration.

[0119] In the transient MCAO model, a candidate bone marrow cell population, selected in the OGD assay, is administered by constant rate infusion into the blood stream of a transient MCAO rat. One or ordinary skill in the art can determine suitable dosages that can range, for example, from 7.5×10.sup.4 to 3.75×10.sup.7 cells. The cells can be injected into, for example, either the jugular vein (IV) or the carotid artery (ICA). Controls consist of administration of an equivalent volume of cryopreservation media or saline solution. Cells within the candidate bone marrow population then migrate to the site of the infarct caused by the transient MCAO.

[0120] Neurologic function in the presence or absence of the OGD selected bone marrow cell populations is then evaluated using a modified Bederson Neurologic Test at various times post-infarction. The rats are then sacrificed and the volume of infarction and host cell survival are measured by hematoxylin and eosin (H&E) or Nissl staining of brain tissue sections from treated and untreated MCAO rats. Bone marrow cell populations are then selected according to their ability to improve neurologic function, increase host cell survival and decrease the volume of infarction as compared to control animals up to 28 days post-MCAO.

Combination Therapies for the Treatment Of Neurodegeneration Caused by Ischemic Stroke

[0121] Stopping blood flow through the middle cerebral artery for an extended period of time simulates permanent arterial occlusion with a blood clot. Transient occlusion, where blood flow through the cerebral artery is stopped for a limited period of time before being restored to allow reperfusion is intended to mimic therapies such as thrombolysis or mechanical clot removal that restore blood flow to the stroke penumbra immediately after arterial blockage caused by ischemic stroke.

[0122] In many respects, the administration of the NCS-01 cell population to transient MCAO rats simulates reperfusion of occluded arteries as a result of thrombolysis or mechanical removal of blood clots including angioplasty or surgical implantation of stents.

[0123] When neurodegeneration is cause by ischemic stroke, NCS-01 cell population can be combined with thrombolytic therapies for the treatment of neurodegeneration caused by ischemia. A description of thrombolytic agents and their administration can be found, for example, in U.S. Pat. Nos. 5,945,432 and 6,821,985.

[0124] Thrombolytic agents injected after an ischemic event can be administered either before, together or after the injection of the NCS-01 cell population.

[0125] Non-limiting examples of mechanical procedures to improve blood flow to a stroke penumbra that may be used in conjunction with the injection of the disclosed NCS-01 cell composition include angioplasty or the implantation of stents according to procedures that are well known in the art.

[0126] The present invention will be described in further detail with reference to the following examples.

EXAMPLES

[0127] The examples set forth methods for isolating, selecting and using subpopulations of bone marrow cells for treating neurodegeneration according to the present invention. It is understood that the steps of the methods described in these examples are not intended to be limiting. Further objectives and advantages of the present invention other than those set forth above will become apparent from the examples which are not intended to limit the scope of the present invention.

Example 1

Isolation of the NCS-01 Cell Population

1) Isolation of Candidate Bone Marrow Cell Populations

[0128] A heterogeneous bone marrow cell population was isolated by the following manufacturing process:

[0129] Human unprocessed bone marrow was harvested from pre-screened healthy donors of 50 years of age or younger by qualified commercial vendor. The bone marrow was harvested from a donor that was not pretreated with any anti-mitotic agent such 5-fluorouracil.

[0130] The bone marrow, whether processed or unprocessed, was then seeded at low density (10.sup.2-10.sup.6 cells/cm.sup.2) onto a tissue/cell culture plastic surface and cultured in the presence of serum-containing media;

[0131] after a few days to allow for cell adherence to the plastic, non-adherent cells were removed by washing; and

[0132] culturing the adherent cell population to near confluence in serum-containing media; serially passaging the population of cultured cells for no more than about 7 serial passages, wherein, at each passage, the cultured cells are seeded at a low density.

[0133] To select the optimal culture conditions for the isolation of a bone marrow cell population that can treat neurodegeneration, cell populations were initially grown under different culture conditions such as cell density at seeding, cell passage number, culture media composition or cell fractionation (see Table I).

[0134] Bone marrow cells from unprocessed bone marrow or after density fractionation or ACK lysis were seeded on to tissue/cell culture plastic in presence of α-MEM supplemented with 2 mM GlutaMax (Invitrogen) and 10% fetal bovine serum (FBS, HyClone or GIBCO) or α-MEM (Mediatech) with 2 mM GlutaMax (Invitrogen) and 10% fetal bovine serum (FBS, HyClone or GIBCO) or serum free media (StemPro). After washing to remove non-adherent cells, adherent cells were allowed to proliferate to near confluence. The cells were then serially passaged for a total of 3, 4, 5 or 6 passages.

[0135] Candidate bone marrow cell populations were then tested for their ability to treat neurodegeneration in the in vitro OGD assay and in vivo MCAO study.

TABLE-US-00001 TABLE I CELLS CELL FRACTION CULTURE MEDIA PASSAGES Cell 1 Unprocessed BM* αMEM + 10% FBS 3 Cell 2 Using Ficoll αMEM + 10% FBS 3 Cell 3 Using ACK lysis αMEM + 10% FBS 3 Cell 4 Using Ficoll Serum free media 6 (StemPro) Cell 5 Using ACK lysis Serum free media 5 (StemPro) Cell 6 Using Ficoll Serum free media 4 (StemPro) Call 7 Using ACK lysis Serum free media 4 (StemPro) *Bone marrow
2) Primary Screening using the In Vitro Oxygen/Glucose Deprivation (OGD) Protocol

[0136] Different parameters in the manufacturing process outlined above, such as bone marrow preparation in the presence or absence of density fractionation, seeding density, number of passages, culture media and/or their combination were evaluated using the in vitro oxygen/glucose deprivation (OGD) experimental protocol to determine the optimal procedure for the isolation of a candidate bone marrow cell population that can treat neurodegeneration.

[0137] The in vitro OGD model was chosen as an initial screen because it mimics neurodegeneration caused by ischemic stroke. Specifically, OGD tested whether or not a specific candidate bone marrow cell subpopulation can prevent neural cell death in culture and induce the secretion of neuroprotective trophic factors, such as bFGF and IL-6.

[0138] In the in vitro oxygen glucose deprivation (OGD) model, primary mixed cultures of rat neurons and astrocytes (at a 1:1 ratio) were exposed to OGD injury (8% oxygen; glucose-free Earle's balanced salt solution) for 90 minutes and returned to physiological conditions for 2 hours, after which, a candidate bone marrow cell populations was added to the OGD treated neuron-astrocyte co-culture for an additional 3 more hours. Neural cell viability was evaluated immediately after OGD and at 5 hours after OGD using standard trypan blue staining and MTT (3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) methodologies.

Cell Culture

[0139] Primary mixed cultures of rat neurons and astrocytes were maintained in culture following the supplier's protocol (CAMBREX, Md.). Immediately after thawing, cells (4×10.sup.4 cells/well) were seeded and grown in 96-well plates coated with poly-lysine in Neuro basal media (GIBCO, CA) containing 2 mM L-glutamine, 2% B27 (GIBCO, CA) and 50 U/ml penicillin and streptomycin for 7-10 days at 37° C. in humidified atmosphere containing 5% CO.sub.2. The purity of the neuronal and astrocytic cell populations was then evaluated using MAP2 and GFAP immunostaining, respectively, and found to be greater than 99%.

Oxygen-Glucose Deprivation (OGD) and Co-Culture with Candidate Bone Marrow Cell Populations

[0140] Cultured cells were exposed to the OGD injury model as described previously (Malagelada et al., Stroke (2004) 35(10):2396-2401) with few modifications. Briefly, culture medium was replaced by a glucose-free Earle's balanced salt solution (BSS) having the following composition: 116 mM NaCl, 5.4 mM KCl, 0.8 mM MgSO.sub.4, 1 mM NaH.sub.2PO.sub.4, 26.2 mM NaHCO.sub.3, 0.01 mM glycine, 1.8 mM CaCl.sub.2, and the pH was adjusted to 7.4. Cultured cells were placed in a humidified chamber to equilibrate with a continuous flow of 92% N.sub.2 and 8% O.sub.2 gas for 15 minutes. After equilibrium was achieved, the chamber was sealed and placed in an incubator at 37° C. for 90 minutes. After this time period, OGD was ended by adding glucose to the culture medium and returning the cultures to the standard 95% O.sub.2 and 5% CO.sub.2 incubator. A 2-hour period of ‘reperfusion’ in standard medium and normoxic conditions were then allowed, after which, a candidate bone marrow (BM) cell population was added to the OGD-treated mixed neuronal-glial culture for about 3 hours. The supernatant and the bone marrow cell population were then separated from the mixed culture by washing. Thereafter, cell viability and immunocytochemistry were performed on the cells and the amounts of secreted trophic factors were measured using commercially available ELISA assays as described below.

Cell Viability Assays

[0141] Cell viability was evaluated at two time points: immediately after OGD and 5 hours after OGD (i.e., 2 hours of reperfusion plus 3 hours of treatment with the selected bone marrow cell population). For the post-OGD viability assay, the supernatant containing the bone marrow derived cells was separated from the adherent mixed neural cell culture. Trypan blue staining method was conducted and mean viable cell counts were calculated in three randomly selected areas (0.2 mm.sup.2) in each well (n=5 per treatment condition) to reveal the cell viability for each treatment condition. In addition, Trypan blue staining was performed on subsets of bone marrow derived cells harvested as pellets from the supernatant.

ELISA Assays

[0142] Trophic factors such as bFGF and IL-6 as well as possible neurotrophic factors secreted by bone marrow-derived cells presumably participate in the treatment of neurodegeneration simulated by the OGD culture conditions. Thus, measuring the amount of these molecules secreted into the culture media provides criteria by which to evaluate candidate bone marrow cell populations that can treat neurodegeneration in vivo. Supernatants from co-cultures of neural cells and candidate bone marrow cell populations under standard culture conditions or exposed to OGD were collected and analyzed for the presence of trophic factor secretion using commercially available ELISA kits in accordance with the manufacturer's instructions.

[0143] The results of an OGD analysis of the bone marrow derived cell populations processed according to the parameters depicted in Table I above, are shown in FIGS. 1A, 1B, and 1C.

[0144] Based on the results depicted in FIGS. 1A, 1B, and 1C αMEM+10% FBS was chosen as the optimal cell culture medium and unprocessed bone marrow was found to be superior to bone marrow processed by density fractionation (such as Ficoll-Paque or Percoll) or by ACK lysis. The optimal passage number for unprocessed bone marrow cells in αMEM+10% FBS medium was found to be no more than 7 passages.

3) Secondary Screening and Selection of Candidate Bone Marrow Cell Populations Using the In Vivo Middle Cerebral Artery Occlusion Rat Model

[0145] Based on the results obtained with the initial screening in the in vitro OGD model, the biological activity of each candidate bone marrow cell population to treat neurodegeneration was evaluated by comparing the neurological deficit and the volume of infarction of MCAO rats treated with the candidate bone marrow cell population with MCAO rats treated receiving only saline solution.

Middle Cerebral Artery Occlusion (MCAO) Surgery

[0146] Animals were anesthetized using isoflurane (1.5%-2.5% with oxygen). The scalp skin was shaved and scrubbed with alcohol and chlorhexidine surgical scrub. The animal was then placed in a stereotaxic apparatus. Starting slightly behind the eyes, a midline sagittal incision about 2.5 cm long was made, and the skull area was exposed using the rounded end of a spatula. With the bregma as a reference point, baseline (i.e., prior to stroke surgery) laser Doppler recording was obtained from the following coordinates (AP: +2.0, ML: ±2.0). The skin on the ventral neck was shaved from the jaw to the manubrium and scrubbed with alcohol and chlorhexidine surgical scrub. The animal was then moved under the surgical microscope. A skin incision was made over the right carotid artery. The external carotid was isolated and ligated as far distally as possible. The occipital artery was cauterized. Occasionally there was another branch or two extending from the external carotid that may also need to be cauterized. A second ligature was placed proximally on the external carotid artery, which was then cut between the ligatures. The pterygopalatine artery was ligated. Following this, a temporary suture was placed around the common carotid to provide tension and restrict blood flow. The proximal stump of the external carotid was pulled back using the ligature, effectively straightening the carotid bifurcation. An incision using a pair of micro-scissors was made in the stump of the external carotid and a 4-0 nylon filament with a pre-fabricated end was inserted and passed up into the internal carotid until resistance was felt (approximately 15-17 mm). This effectively blocks the middle cerebral artery (MCA). The filament was secured in place with a ligature around the proximal stump of the external carotid. The contralateral common carotid was isolated and secured with a temporary ligature. The skin incision was closed with staples. The animal was then fixed to the stereotaxic apparatus for laser Doppler recording to reveal successful MCA occlusion. After five minutes, the ligature to the contralateral common carotid artery was removed. The isoflurane was discontinued and the animal was placed in a recovery cage over a warming blanket. After 60 minutes, the animal was anesthetized again with isoflurane and the incision was opened for testing in the transient model. The filament causing the occlusion was removed and the stump of the external carotid ligated close to the carotid bifurcation. The skin incision was closed with staples. The animal was again fixed to the stereotaxic apparatus for laser Doppler recording to reveal successful reperfusion. Finally, the animal was placed in a recovery cage over a warming blanket.

Neurological Function Tests

[0147] The well-recognized modified Bederson Neurologic Test was performed for each rat and involves obtaining a score from each of the following: [0148] contralateral hind limb retraction, which measures the ability of the animal to replace the hind limb after it was displaced laterally by 2-3 cm, graded from 0 (immediate replacement) to 3 (no replacement), [0149] beam walking ability, graded 0 for a rat that readily traverses a 2.4-cm-wide, 80-cm-long beam to 3 for a rat unable to stay on the beam for 10 seconds, and [0150] bilateral forepaw grasp, which measures the ability to hold onto a 2-mm-diameter steel rod, graded 0 for a rat with normal forepaw grasping behavior to 3 for a rat unable to grasp with the forepaws.

[0151] The scores from all 3 tests were assessed over a period of about 15 minutes on each assessment day. An average score was calculated from the 3 tests to provide a composite neurologic deficit score that ranges from 0 (normal neurological function) to a maximum of 3 (severe neurological deficit). Thus, the higher the score, the greater the neurological deficit.

[0152] Based on pilot studies, a score above about 2.5 indicates an animal has neurological deficits characteristic of stroke.

Histology

Brain Section Preparation

[0153] Brain section preparation is designed to identify regions of cerebral injury. At 7 days or 28 days after MCA occlusion, rats were euthanized, perfused by trans-cardiac perfusion with saline, followed by 4% paraformaldehyde. The brains were then fixed in 4% paraformaldehyde, and subsequently immersed in 25% sucrose. Each forebrain was cut into 30 μm thick coronal tissue sections with anterior-posterior coordinates corresponding from bregma 5.2 mm to bregma −8.8 mm per animal.

Measurements of Infarction Volume

[0154] At least 4 coronal tissue sections per brain were processed for hematoxylin and eosin (H&E) or Nissl staining. The indirect lesion area, in which the intact area of the ipsilateral hemisphere was subtracted from the area of the contralateral hemisphere was used to reveal cerebral infarction.

[0155] The lesion volume was presented as a volume percentage of the lesion compared to the contralateral hemisphere. Histological determination of the lesion volume was performed using hematoxylin and eosin (H&E) or Nissl staining, with representative images captured digitally and processed via NIH Image J software, and quantitative image analysis. The lesion volume was determined according to the following formula:

Thickness of the section×sum of the infarction area in all brain sections.

[0156] To minimize artifacts produced by post-ischemic edema in the infarcted area, the infarction area in the ipsilateral hemisphere was indirectly measured by subtracting the non-infarction area in the ipsilateral hemisphere from the total intact area of the contralateral hemisphere.

Measurements of Cell Survival in Ischemic Peri-Infarct Area

[0157] A randomly selected high power field corresponding to the cortical peri-infarct area was used to count cells surviving in this ischemic region (Yasuhara et al., Stem Cells and Dev, 2009). For an estimation of host neuronal cell viability within the ischemic cortical region, Nissl staining was performed using Crystal violet solution (Sigma, St. Louis, Mo.), and randomly selected visual fields of the cortical region and corresponding contralateral intact cortex in 3 sections were captured photographically (Carl Zeiss, Axiophot2), and cell numbers were determined by counting cells in randomly selected high power field views (28,800 μm2). The percentages of preserved neurons in damaged cortex relative to the intact side were calculated and used for statistical analyses. Brain sections were blind-coded and the total number of counted stained cells was corrected using the Abercrombie formula.

Screening of Candidate Bone Marrow Cell Populations Using the Mcao Stroke Animal Model

[0158] Groups of 3 (for IV administration) or 6 (for ICA administration) male rats/group were subjected to 1 hr. transient MCAO and then injected with 1 ml of injection medium containing either saline or 7.5×10.sup.6 bone marrow-derived cells (called NCS-01 cell population) isolated according to the protocol described above. Animals were followed for up to 7 days post cell administration.

[0159] FIGS. 1D, 1E and 1F shows that IV or ICA-administered NCS-01 bone marrow cell population provided substantial neurologic and pathologic benefit, when administered in rats with transient MCAO. Moreover, NCS-01 prevented host cell death by treating ischemia-induced neurodegeneration with consequent reduction in infarction volume and improvement of neurological deficit.

[0160] The primary in vitro and secondary in vivo screening procedures were repeated until the process reliably and reproducibly produced an optimal subpopulation of bone marrow derived cells (called NCS-01 cell population) that was able to treat neurodegeneration.

[0161] The optimized NCS-01 cell population was again tested in the in vitro OGD model to confirm anti-neurodegeneration activity in a co-culture of human neurons and astrocytes (see FIGS. 1G, 1H and 1I) and in the in vivo rat MCAO model (FIGS. 1J and 1K). The experiment depicted in FIGS. 1J and 1K also shows the ability of NCS-01 cell population to treat neurodegeneration is dose dependent.

Example 2

Standardized Manufacturing Procedure for the Product of the NCS-01 Cell Population that is Able to Treat Neurodegeneration

[0162] Whole, unprocessed bone marrow is harvested from a mammal that is not pre-treated with any anti-mitotic or anti-metaolite agent, such as 5-fluorouracil (5-FU). Because the bone marrow is not processed by density fractionation or ACK lysis, the starting whole bone marrow cell population can include hematopoietic and non-hematopoietic cells as well as both nucleated and non-nucleated bone marrow cells.

[0163] The above unprocessed bone marrow is diluted and seeded at low density (105-106 cells/cm2) onto a tissue/cell culture plastic surface and cultured in the presence of serum-containing media (α-MEM (phenol red free) supplemented with 2mM GlutaMax (Invitrogen) and 10% fetal bovine serum (FBS, HyClone or GIBCO) or α-MEM (Mediatech) with 2 mM GlutaMax (Invitrogen) and 10% fetal bovine serum (FBS, HyClone or GIBCO)). The cell cultures are then incubated at 37° C., 5% CO.sub.2, 80% RH (relative humidity) for 72 hours;

[0164] The cells are rinsed with D-PBS to remove non-adherent cells and RBCs from the cell culture plastic followed by a complete medium exchange with supplemented α-MEM, which is used for all subsequent feedings. Cell cultures (at passage 0 or p0) were then incubated at 37° C., 5% CO2, 80% RH.

[0165] For passage 1, the cells are rinsed with D-PBS and the plastic adherent cells are detached using a cell dissociation reagent. Dissociated cells are harvested by centrifugation at 300 g (˜1000 rpm) for 8-10 minutes. The pelleted cells are re-suspended with supplemented α-MEM and seeded at a density of approximately 750 cells/cm.sup.2 onto a tissue/cell culture plastic surface.

[0166] The cells are cultured to near confluence before additional passaging.

[0167] Cells are harvested and again seeded again at a density of approximately 750 cells/cm.sup.2 onto a tissue/cell culture plastic surface as described above for passage 2.

[0168] For passage 3, cells are harvested using a cell dissociation reagent and centrifuged as described above. The pelleted cells are then resuspended and pooled. Cells are resuspended in a cryopreservation media and 1 mL cell suspension aliquoted into Cryovials (Nunc). Vials are frozen using a control-rate freezer and once the freezing program is complete, transferred on dry ice for permanent storage in a vapor-phase Liquid Nitrogen freezer.

[0169] The vials containing cells at passage 3 (p3) constitute the MCB.

[0170] One vial of MCB is thawed and the recovered cells (passage 4 or P4) are seeded on to tissue/cell culture plastic at a density of approximately 750 cells/cm.sup.2 in α-MEM supplemented with 10% FBS and GlutaMAX™. The cells are then incubated at 37° C., 5% CO.sub.2, 80% RH.

[0171] For passage 4, the cells are cultured to near confluence before additional passaging. Cells are harvested and seeded onto new tissue/cell culture plastic surface as described above.

[0172] For passage 5, cells are harvested and frozen, following the methods described above for the MCB. Cells that are aliquoted into vials and cryopreserved at passage 5 (P5) constitute the WCB.

[0173] When needed, one vial of WCB is thawed and the recovered cells are seeded on to tissue/cell culture plastic at a density of approximately 750 cells/cm.sup.2 in α-MEM supplemented with 10% FBS and GlutaMAX™. The cells are then incubated at 37° C., 5% CO.sub.2, 80% RH.

[0174] For passage 6, the cells are cultured to near confluence before additional passaging. Cells are harvested and seeded onto new tissue/cell culture plastic surface as described above.

[0175] Culture media is changed in the middle of passage (WCB to passage 6 and passage 6 and passage 7).

[0176] For passage 7, cells are harvested and frozen, following the methods described above for the MCB.

Example 3

Treatment of Neurodegeneration Caused by Permanent versus Transient Middle Cerebral Artery Occlusion (MCAO) with NCS-01 Cells

[0177] The infarction volume and neurologic function of NCS-01 treated rats with permanent MCAO was compared to that of NCS-01 treated rats with transient (60 minutes) MCAO.

[0178] The transient MCAO simulates the treatment of arterial occlusion caused by stroke with now standard clinical procedures that restore blood flow to the stroke penumbra. These procedures include the administration of thrombolytic drugs as well as procedures such as angioplasty and/or vascular stenting that involve the mechanical removal of blood clots.

[0179] Groups of 3 or 6 rats were subjected to either permanent or transient MCAO (with reperfusion). Either saline or 7.5×10.sup.6 NCS-01 cells in 1 ml were then administered ICA 24 hours post-ischemia and rats were monitored for up to 28 days. Neurologic function was then evaluated using the modified Bederson Neurologic Test. The transient occlusion model mimics the situation in which a stroke patient was treated with tPA, or was subjected to clot removal.

[0180] The results in FIGS. 2A and 2B show significant histological (infarction volume; FIG. 2A) and clinical (modified Bederson Scale; FIG. 2B) benefit with NCS-01 cell population treatment in both MCAO paradigms. Benefit was 2- to 3-fold greater in the transient occlusion model than in the permanent occlusion model. The time course of the neurological response (Panel B) showed steady improvement up to 28 days post-infarction, averaging 11% over this interval for un-reperfused (permanent occlusion) and untreated controls to 67% for re-perfused (transient occlusion) and NCS-01 treated animals.

[0181] Unexpectedly, NCS-01 was more effective in treating symptoms in the transient occlusion model, suggesting that maximum efficacy may be obtained when NCS-01 was added in conjunction with clot removal, either after administration of a thrombolytic drug or removal of the clot using a mechanical device.

Example 4

Comparison between NCS-01 Cells and Other Bone Marrow Derived Cells

[0182] 1) Isolation of a Bone Marrow Cell Population according to Li et al.

[0183] A bone marrow cell population was prepared exactly as described in the publication by Li et al. Journal of Cerebral Blood Flow and Metabolism (2000) 20: 1311-1319 (hereafter called the Li bone marrow population).

[0184] Primary cultured bone marrow cells were obtained from adult mice that had received the anti-metabolite drug, 5-fluorouracil (5-FU, 150 mg/kg) intra-peritoneally 2 days before harvesting (Randall and Weissman, 1997). Using a 21-gauge needle connected to a 1 mL syringe with phosphate-buffered saline (PBS, 0.5 mL), fresh complete bone marrow was harvested aseptically from tibias and femurs. Bone marrow was mechanically dissociated until a milky homogenous single-cell suspension. Red blood cells were removed from bone marrow using 0.84% NH.sub.4Cl and the number of nucleated marrow cells was determined using a cytometer. 2×10.sup.6 nucleated cells were seeded into a tissue culture flask in Iscove's Modified Dulbecco's medium supplemented with fetal bovine serum (10%). After 3 days of incubation, cells tightly adhered to plastic and were resuspended in fresh Iscove's Modified Dulbecco's medium in new flasks and were grown for another three passages.

2) Comparison of the Li Cell Population with the NCS-01 Cell Population in the In Vitro OGD Assay

[0185] Two lots of NCS-01 manufactured from different WCBs of a same MCB and bone marrow were tested together with the Li cell population in the in vitro OGD model as outlined in FIG. 3.

[0186] As shown in FIGS. 4A and 4B, both lots of NCS-01 cells generated the same increase in the secretion of both IL-6 and bFGF. Hence, NCS-01 cell populations produced by the optimized manufacturing procedure described above consistently treated neurodegeneration in the in vitro OGD assay.

[0187] In contrast, the Li cell population, that was isolated exactly as described in the Li (2000) publication, produced 4-5× less bFGF and IL-6 than NCS-01 cell population in the OGD assay.

2) Comparison of the Li Cell Population with the NCS-01 Cell Population in the In Vivo MCAO Assay

[0188] The ability of the NCS-01 and Li cell populations to treat neurodegeneration in vivo was tested in vivo using the MCAO rat model. The effect of the cells on host cell viability, the volume of infarction and neurological deficit are shown in FIGS. 5A and 5B. Consistent with the studies described above, the NCS-01 cell population prevented host cell death (see FIG. 5A) by treating ischemia-induced neurodegeneration with consequent reduction in infarction volume and improvement of neurological deficit (see FIGS. 5B and 5C).

[0189] In contrast, the Li cell population failed to show any statistically significant activity on infarction volume or neurological function. These data therefore demonstrate that the ability of the NCS-01 population to treat neurodegeneration is defined by the manufacture process and that the NCS-01 cell population is distinct from the cell population described in the Li 2000 publication.

[0190] Any patent, patent application, publication, or other disclosure material identified in the specification is hereby incorporated by reference herein in its entirety. Any material, or portion thereof, that is said to be incorporated by reference herein, but which conflicts with existing definitions, statements, or other disclosure material set forth herein is only incorporated to the extent that no conflict arises between that incorporated material and the present disclosure material.