Encouraged by our recent findings in mouse cells
13, we explored in this study whether also human fibroblasts could be directly induced to become functional neurons. This was unclear given the differences in the gene regulatory networks governing human and rodent neural development
14–16. First, we sought to determine whether forced expression of transcription factors could induce a neuronal fate in human pluripotent cells. To that end, we infected undifferentiated human ES cells in chemically defined N3 media
17 with
Brn2,
Ascl1, and
Myt1l (BAM) using doxycycline (dox)-inducible lentiviral vectors together with an EGFP virus. The majority of ES cells were EGFP-positive 24 hours after addition of doxycycline (
Supplementary Fig. 1). Strikingly, as early as 3 days after dox treatment, we observed bipolar neuron-like cells surrounding nearly all ES cell colonies (;
Supplementary Fig. 1). By day 8, cells with more mature neuronal morphologies that expressed both β-III-tubulin (Tuj1) and MAP2 had migrated away from ES cell colonies and were present throughout the plate (). In contrast, after infection with EGFP virus alone, no neuronal cells were generated during the same timeframe, and nearly all ES cells had died due to the Ara-C treatment. We then determined the relative contribution of the three factors and found that
Ascl1 alone was sufficient to induce MAP2-positive cells (
Supplementary Fig. 2). The addition of
Brn2 or
Myt1l or both did not increase the efficiency of neuronal differentiation but induced more complex morphologies. Cells infected with all three factors together displayed the most mature neuronal morphologies (
Supplementary Fig. 2). Electrophysiological analysis surprisingly revealed that as early as 6 days after induction all recorded cells (n=16) generated action potentials (). At day 15 after dox, the average resting membrane potential of neuronal cells was −51±1.8 mV (mean±SEM, n=18) (,
Supplementary Table 1). These ES-iN cells exhibited prominent after-hyperpolarization potentials (AHPs) following action potentials (). Similar findings could be observed when human iPS cells were infected (
Supplementary Fig. 3). Thus, the BAM factors rapidly induce neuronal differentiation of human pluripotent stem cells.
Next, we asked whether also human fibroblasts could be directly converted into neurons. To this end, we derived three independent primary human fetal fibroblast lines (HFFs) (see methods) and performed an extensive characterization of these cultures in various growth conditions to confirm that they lack spontaneous neuronal differentiation potential and do not contain detectable amounts of neural crest stem cells (see
Supplementary Fig. 4). Strikingly, 7–10 days after infection with the BAM factors we could detect cells with immature neuronal morphologies. These cells expressed Tuj1 (
Supplementary Fig. 5a), but remained functionally immature as revealed by their inability to generate action potentials 20 days after dox treatment (
Supplementary Fig. 5b). Thus, the BAM factors appeared to induce neuronal features but were insufficient to generate functional neurons from human fetal fibroblasts under these conditions.
Therefore, we screened 20 additional factors that could improve the generation of neuronal cells in combination with the BAM pool. We observed that
NeuroD1, another basic helix-loop-helix transcription factor, improved the efficiency of generating Tuj1-positive neuronal cells 2–3 fold after 3 weeks (). To determine the relative contribution of
NeuroD1, we tested various combinations of these four factors.
NeuroD1 alone had no effect, but surprisingly in combination with
Brn2 it was sufficient to generate a similar number of Tuj1-positive neuronal cells compared to the BAN, BMN and BAMN pools (
Supplementary Fig. 6a). However, further morphological and functional characterization showed that the BAMN combination generated the most mature neuronal cells (
Supplementary Fig. 6b). We therefore decided to focus the further analysis on BAMN-iN cells.
Two weeks after induction, BAMN-iN cells exhibited neuronal morphologies and were labeled with pan-neuronal antibodies such as Tuj1, NeuN, PSA-NCAM and MAP2 (). After extended culture periods of 4–5 weeks, we could detect cells expressing neurofilaments (
Supplementary Fig. 7a), and rare neuronal processes decorated with punctate staining of synapsin and synaptotagmin, two synaptic vesicle proteins (,
Supplementary Fig. 7b). To ensure the co-expression of pan-neuronal and subtype specific markers, we performed single-cell gene-expression profiling of iN cells using Fluidigm™ dynamic RT-PCR arrays
18. We analyzed 54 single HFF-iN cells 34 days after dox from two independently infected cultures (
Supplementary Fig. 8). These data revealed robust co-expression of multiple pan-neuronal and synaptic markers in 50/54 HFF-iN cells (
β-III-tubulin, DCX, MAP2, NCAM, synapsin). Over half (29/54) of the iN cells analyzed expressed mRNAs typical for glutamatergic neurons, such as vGLUT1, vGLUT2 or both (). Only 2 iN cells expressed GAD67 in the absence of vGLUT1 or 2, and no iN cell expressed the inhibitory marker gene vGAT. Five cells expressed the catecholaminergic neuron marker tyrosine hydroxylase. Immunofluorescence analysis revealed that 5 weeks after infection 17±8% of iN cells expressed the forebrain marker Tbr1, 21±9 % expressed the marker of peripheral neurons Peripherin, while En1, a marker of midbrain neurons, serotonin and Cholinacetyltransferase were not detectable (
Supplementary Fig. 9).
To assess whether the iN cell state was stable without continued transgene expression, we monitored mRNA expression levels of endogenous and exogenous BAMN genes before and after dox induction and after dox withdrawal. While the exogenous transgenes were clearly dox dependent, the 4 corresponding endogenous genes were rapidly induced and exhibited increasing expression levels over time even after dox withdrawal (
Supplementary Fig. 10). Similarly, HFF-iN cells could be maintained in the absence of dox for 3 weeks (
Supplementary Fig. 11).
We next asked whether iN cells generated from HFFs exhibited active membrane properties. iN cells were identified by EGFP fluorescence () and whole-cell recordings were performed 14–35 days after dox. 14–25 days after addition of dox the average resting membrane potential of HFF-iN cells was −52.2 ± 2.2 mV (mean±SEM, n=41). When HFF-iN cells were step depolarized, action potentials could be detected in many iN cells at 14–25 days, and in all recorded iN cells at days 34–35 (,
Supplementary Figs. 7 & 12 and Table 1). Fast-activating and inactivating inward Na
+ currents as well as outward K
+ currents were also observed ().
To determine whether the BAMN factors were also capable of converting more mature human fibroblasts into iN cells, we derived primary human postnatal fibroblasts (HPFs) from 3 different perinatal foreskin resections. In all three HPF lines, expression of BAMN factors reproducibly generated neuron-like cells with co-expression of multiple pan-neuronal markers (). Intriguingly, the efficiencies of iN cell generation from fetal and postnatal fibroblasts were similar (2–4% of cells plated; ). Single-cell gene-expression profiling of iN cells revealed that 46/51 HPF iN cells co-expressed pan-neuronal and synaptic markers 42 days after infection; the majority of the HPF iN cells (37/51) appear to be glutamatergic neurons. Immunofluorescence analysis revealed that 6 weeks after infection, 81±17% of iN cells expressed Tbr1 above the levels of fibroblasts, 15.2±6.6% were peripherin-positive (
Supplementary Fig. 13). Unlike fetal fibroblasts, most postnatal fibroblasts showed weak but specific Tbr1 staining (
Supplementary Fig. 13a–d). Electrophysiological recordings demonstrated the presence of regenerative action potentials as well as voltage-dependent channel activities in the majority of cells analyzed from 2 lines (e.g. 17/18 cells from line HPF-B, ,
Supplementary Table 1). Furthermore, iN cells exhibiting active membrane properties could be generated from dermal fibroblasts derived from an 11-year-old human subject (
Supplementary Fig. 14).
Finally, we determined whether human iN cells can express functional neurotransmitter receptors and form functional synapses. Application of either GABA or
l-glutamate to HFF-iN cells induced current responses that could be blocked by picrotoxin and CNQX, respectively (
Supplementary Fig. 12e, f). We then dissociated HFFs 4–7 days after infection with the BAMN factors and EGFP and plated them onto previously established mouse cortical neuronal cultures. These co-cultures were maintained for up to 5 weeks thereafter. HFF-iN cells were identified by the EGFP expression (). Whole-cell recordings after 2 to 3 weeks of co-culture showed no synaptic activity (n=20) but after 4–5 weeks approximately half of human iN cells recorded exhibited spontaneous postsynaptic currents (PSCs) with variable kinetics (n=21, ,
Supplementary Table 1). Immunostaining with synapsin antibodies confirmed the presence of scattered synaptic puncta on the dendrites of EGFP-positive cells (). When the GABA
A receptor inhibitor picrotoxin was applied, the majority of the spontaneous PSCs were blocked, demonstrating that they were inhibitory (IPSCs) (). In the presence of picrotoxin, bursting of spontaneous excitatory postsynaptic currents (EPSCs) was revealed and could be blocked by the AMPA receptor blocker CNQX (). Focal stimulation evoked both IPSCs and EPSCs that could be blocked by picrotoxin and CNQX (). Importantly, PSCs could also be recorded from HPF-iN cells co-cultured with mouse cortical neurons 4 weeks after infection (
Supplementary Fig. 15). These results demonstrate that fetal and postnatal fibroblast-derived iN cells could form functional synapses and integrated into pre-existing neuronal networks.
In this report, we have identified a combination of transcription factors that are capable of directly converting human fibroblasts into neurons. Like mouse iN cells
13, ES cell
19–21 - and iPS cell-derived neurons
22,23, the human iN cells appear relatively immature, as indicated by their slightly depolarized membrane potentials and the relatively low-amplitude synaptic responses. Compared to mouse iN cells, human iN cells required longer culture periods to develop synaptic activity. Future studies will be necessary to thoroughly optimize conditions for human iN cell generation and maturation, which would facilitate applications of this method for the study of human neuronal development and disease.