Stem Cells in Kidney Disease: Where Are We Now?

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1 Stem Cells in Kidney Disease: Where Are We Now? Berliner Dialyseseminar 5. Dezember 2015 Albert Q. Lam, MD Associate Physician Brigham and Women s Hospital Harvard Medical School

2 None Disclosures

3 Cell transplantation Bioengineering Regenerative medicine Disease modeling Drug development Polycystic kidney disease Alport s syndrome FSGS

4 Bioengineering a Kidney Two basic components: Cells Starting substrate Stimulate regeneration Promote vascularization Biomaterials Natural or synthetic matrix Provide spatial environment to restore tissue structure and function Attract/suppport cells

5 Human Pluripotent Stem Cells Can differentiate into cells and tissues of all three germ layers of the embryo Ectoderm (nervous system, epidermal tissues) PSC Mesoderm (muscle, bone, blood, heart, kidneys) Endoderm (lungs, stomach, pancreas, GI tract) Types: Embryonic stem cells Induced pluripotent stem cells (ips cells) Embryonal carcinoma cells Embryonic germ cells

6 Embryonic Stem (ES) Cells Specialized cells: Cardiomyocytes Hepatocytes Pancreatic cells Intestinal cells Neurons Muscle cells Kidney cells Modified from Landry and Zucker J Clin Invest 2004

7 Induced Pluripotent Stem (ips) Cells OCT4 SOX2 KLF4 C-MYC

8 Human ips Cell Lines from Patients with Kidney Disease Lam, Freedman, and Bonventre Semin Nephrol 2014

9 Kidney Organogenesis The kidneys are derived from the mesoderm germ layer (intermediate mesoderm)

10 Metanephric mesenchyme SIX2+ nephron progenitor cells Kidney stem cells Ureteric bud

11 Origin of the Metanephric Mesenchyme Taguchi et al. Cell Stem Cell 2014

12 Human PSCs into Kidney Cells Schuldiner PNAS 2000 Batchelder Differentiation 2009 Lin Stem Cells Dev 2010 Song PLoS One 2012 Narayanan Kidney Int 2013 Mae Nat Commun 2013 Xia Nat Cell Biol 2013 Taguchi Cell Stem Cell 2013 Takasato Nat Cell Biol 2013 Lam JASN 2013 Araoka PLoS One 2014 Kang PLoS One 2014 Kandasamy Sci Rep 2015 Imberti Sci Rep 2015 Toyohara Stem Cells Transl Med 2015 Takasato Nature 2015 Freedman Nat Commun 2015 Morizane Nat Biotechnol 2015

13 Recapitulating Metanephric Development PSCs Late mid primitive streak Posterior intermediate mesoderm Metanephric mesenchyme

14 Defining the Origin of the Metanephric Mesenchyme To generate the primitive streak cells that will give rise to MM: Define the anteriorposterior position along the primitive streak (mid-streak) Define the timing of migration out of the primitive streak (late stage)

15 Extended treatment with high-dose CHIR99021 induces late mid-primitive streak Day 4 Morizane et al. Nat Biotechnol 2015

16 Activin induces posterior IM differentiation Day 7 Morizane et al. Nat Biotechnol 2015

17 FGF9 induces metanephric mesenchyme Day 9 Morizane et al. Nat Biotechnol 2015

18 SIX2 + NPCs spontaneously differentiate into renal vesicles Morizane et al. Nat Biotechnol 2015

19 FGF9 + CHIR induce renal vesicles Day 14 Morizane et al. Nat Biotechnol 2015

20 Renal vesicles spontaneously form nephron structures in 2D culture Day 21 Morizane et al. Nat Biotechnol 2015

21 Renal vesicles spontaneously form nephron structures in 2D culture Day 21 Morizane et al. Nat Biotechnol 2015

22 Das Bild kann zurzeit nicht angezeigt werden. Nephron structures in 2D culture Days Morizane et al. Nat Biotechnol 2015

23 Nephron progenitor cells form spherical aggregates in 3D suspension culture Morizane et al. Nat Biotechnol 2015

24 3D organoids contain multi-segmented nephron structures Morizane et al. Nat Biotechnol 2015

25 3D organoids contain multi-segmented nephron structures Morizane et al. Nat Biotechnol 2015

26 3D organoids contain multi-segmented nephron structures Morizane et al. Nat Biotechnol 2015

27 Electron microscopy of 3D nephron organoids 3D Organoids Human Kidney Morizane et al. Nat Biotechnol 2015

28 Modeling development with organoids 2D organoids Notch inhibition Morizane et al. Nat Biotechnol 2015

29 DAPT impairs proximal tubule formation 3D organoids DAPT Control Morizane et al. Nat Biotechnol 2015

30 Modeling kidney toxicity with organoids 3D organoid Gentamicin x 48 hours

31 Modeling kidney toxicity with organoids

32 Summary By mimicking the critical developmental stages of nephrogenesis, human PSCs can be efficiently differentiated into multipotent nephron progenitor cells (NPCs) NPCs can be induced to form renal vesicles that spontaneously form multi-segmented nephron structures in 2D and 3D organoids Nephron organoids can be used to model kidney development and toxicity

33 Human PSCs into Kidney Cells PAX2 + vimentin + cells WT1 + PAX2 + cells Proximal tubule-like cells Podocyte-like cells Intermediate mesoderm cells Ureteric bud progenitor cells Nephron progenitor cells 2D and 3D kidney organoids Applications Modeling kidney toxicity Modeling kidney development Modeling kidney disease Modeling kidney physiology Repair after AKI

34 Acknowledgements Brigham and Women s Hospital Joseph Bonventre, MD, PhD Ryuji Morizane, MD, PhD Todd Valerius, PhD Seiji Kishi, MD Vanesa Bijol, MD University of Washington Benjamin Freedman, PhD Northwestern University Jason Wertheim, MD, PhD