A panel of experts recently proposed three criteria to define MSCs, including adherence to plastic in standard culture conditions, expression of specific cell surface antigens and a lack of expression of certain other antigens, and finally their ability to differentiate into osteocytes, adipocytes and chondrocytes [
22]. In the present study we have devised a practical methodology that allowed us to persistently isolate MSCs from three different human ESC lines (H1, H7, and H9) without the use of any feeder-cell supporting layers. We defined these cells as MSCs by the combination of their adherence to plastic in standard culture conditions, their cell surface immunophenotype, and their functional properties of differentiation into osteogenic, adipogenic, and chondrogenic lineages
in vitro.
Although the generation of fibroblast-looking cells from human ESCs was originally reported a few years ago, those cells were not fully characterized as MSCs [
23-
25]. Barberi et al were the first to derive MSCs from human ESCs through co-culturing them with the OP9 murine BM stromal cell line for 40 days and characterize them according to accepted criteria for MSCs [
20]. Recently, we reported the generation of MSCs from human ESCs through co-culturing with OP9 cells but in a shortened 2 weeks period [
19]. Nevertheless, our intent in the current study was to move away from the use of murine OP9 feeder cells. Olivier et al. previously reported derivation of MSCs from human ESCs through a feeder free culture system [
17]. However, that methodology was based on culturing MSCs from human ESCs that were grown into a thick multilayer epithelium. More recently, Lian et al. reported generating MSCs from H1 and H9 human ESCs by culturing ESC colonies on gelatinized plates in knockout DMEM and supplemented with 10% serum replacement, FGF2 and PDGF AB followed by cell sorting for CD105+ and CD24- cells by FACS [
18], which is different from our method.
SSEA-4 is one of the markers expressed on undifferentiated human ESCs [
26]. Although there are major differences in our derivation methodology we can not explain why our MSCs were uniformly negative for SSEA-4 expression in contrast to the study of Olivier et al study [
17]. Interestingly, we only saw negligible amounts of cells that were double-positive for SSEA-4 and CD73 markers at any time point in our culture system (). The expression of SSEA-4 on adult human BM-derived MSCs is also disputed between different groups. For example, Wagner et al [
27] and Cheng et al [
28] reported that MSCs derived from human BM do not express SSEA-4 marker. However, Gang et al reported that SSEA-4 are expressed on human BM-derived MSCs [
29]. These differences might be due to differences in the derivation methodologies used by different groups; for example, Battula et al showed that culturing human placenta or BM-derived MSCs in serum-free bFGF-containing medium induces expression of SSEA-4 [
30]. Shibata et al. have shown that purging SSEA-4 positive cells from hematopoietic cells differentiated from cynomolgus monkey ESCs prevented teratoma formation when cells were subsequently transplanted into fetal animals, compared to transplantation of un-purged cells that resulted in teratoma formation in all animals tested [
31]. Thus, the lack of expression of SSEA-4 on our human ESC-derived MSCs, that otherwise possess all the other characteristics of adult BM-derived MSCs, makes our differentiation protocol of potential clinical value.
To our knowledge our report is the first on the
in vitro immunological properties of human ESC-derived MSCs. Similar to adult BM-derived MSCs, our human ESC-derived MSCs express HLA-ABC but do not express HLA-DR or co-stimulatory molecules such as CD40 and CD80 [
32]. Although treatment of human ESC-derived MSCs with IFN-γ could induce cell surface expression of HLA-DR, the expression of HLA-DR molecules on ESC-derived MSCs remained lower compared to BM-derived MSCs at day 3 and 5. It has also been shown that adult BM-derived MSCs do not elicit a proliferative response when co-cultured with allogeneic T-lymphocytes [
16,
33]. Similarly, our ESC-derived MSCs failed to induce proliferation of allogeneic T-lymphocytes when co-cultured with PB-MNCs. Thus, at least under these experimental conditions, human ESC-derived MSCs are not inherently immunogenic. Even after we cultured human ESC-MSCs with IFN-γ to induce surface expression of HLA-DR antigen they failed to induce proliferation of T-lymphocytes. Also, when we added human ESC-derived MSCs to MLR cultures they suppressed proliferation of responder T-lymphocytes. The suppressive effect of our ESC-derived MSCs persisted to a lesser degree, using semi-permeable membrane or MSC-CM. This suggests a role for secretary factors similar to the report by Di Nicola et al. [
33].
The extent of MSC contribution to generation of other tissues, their ultimate clinical significance, and the potential mechanisms of their activities are matters of strong debate [
34,
35]. Nevertheless, interest in MSCs has already moved from
in vitro and animal studies into actual clinical trials in patients [
36]. Several phase I-II clinical trials have already shown the safety and efficacy of BM-derived MSCs for enhancing the engraftment of co-transplanted HSCs in patients with hematologic and non-hematologic malignancies [
37,
38]. BM-derived MSCs have also shown promising results for the treatment of mesenchymal diseases such as osteogenesis imperfecta [
39] and congenital disorders such as metachromatic leukodystrophy [
40]. BM-derived MSCs have shown to be safe in phase-I trials in myocardial infarction patients [
41]. The immunological characteristics of BM-derived MSCs are another reason for the interest in the use of these cells for clinical applications [
13-
16]. Indeed, the use of third party ex vivo expanded HLA-mismatched MSCs in immune-dysregulation disorders such as graft versus host disease after allogeneic HSC transplantation and Crohn’s disease have generated encouraging results, and are currently into phase-III trials [
42-
44].
Human ESC-derived MSCs could provide a novel and unlimited universal source of MSCs for a variety of potential clinical applications such as repair of mesodermal tissues, contribution to repair of other tissues, and even potentially enhancement of engraftment of human ESC-derived HSCs. We have devised a reproducible and potentially clinically applicable method for deriving MSCs from human ESCs in vitro with morphologic, immunophenotypic, and in vitro functional and immunological characteristics very similar to adult BM-derived MSCs. These immunological properties of human ESC-derived MSCs could play a significant role in their eventual applications.