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Induced Pluripotent Stem Cells as an Alternative to Embryonic Stem Cells for the Treatment of Type 1 Diabetes A thesis submitted by Natalie Francis For the degree of Doctor of Philosophy from Imperial College London Beta Cell Physiology Group Department of Medicine Imperial College London Acknowledgements: Firstly, huge thanks to my NIBSC supervisor Chris, for all your help and support throughout my PhD. Thank you for staying positive even when experiments weren’t working! Thanks to all my colleagues at NIBSC, especially to Mel for all your practical help, and to my colleagues at the UK Stem Cell Bank for passing on their knowledge (and cells!) when I needed them. Thanks also to my supervisor Guy at Imperial College for your helpful advice. Finally, thank you to my husband Rob, who proved that getting married during a PhD is not always a bad idea, and for your continuous love and support. Declaration of originality: I declare that all work presented in this thesis is my own unless otherwise referenced. Copyright declaration: The copyright of this thesis rests with the author and is made available under a Creative Commons Attribution Non-Commercial No Derivatives licence. Researchers are free to copy, distribute or transmit the thesis on the condition that they attribute it, that they do not use it for commercial purposes and that they do not alter, transform or build upon it. For any reuse or redistribution, researchers must make clear to others the licence terms of this work. Abstract Type 1 diabetes mellitus (T1DM) results from auto-immune destruction of the insulin- secreting β-cells of the pancreas. The most common treatment is injection of exogenous insulin, but this allows only partial control over blood glucose levels, so other therapies are needed. Pancreatic islet transplantation has shown proof of principle for cell replacement therapy to treat T1DM. There are several sources of cells which could be used, but much of the focus has been on pluripotent stem cells, which are able to self-renew indefinitely in culture and give rise to any cell in the body. Insulin-expressing cells have successfully been produced from embryonic stem cells (ESCs) by recapitulating embryonic development in vitro. However, problems associated with the use of ESCs mean that an alternative cell source is needed. In 2006, it was discovered that 4 transcription factors can reprogram somatic cells into induced pluripotent stem cells (iPSCs). iPSCs provide an alternative source of pluripotent stem cells and can be derived in a patient-specific manner. iPSCs have been shown to differentiate in vitro into insulin-expressing cells, but it is unknown whether iPSCs are truly equivalent to ESCs. Important differences have been shown to exist between iPSCs and ESCs which may affect the ability of iPSCs to give rise to cells of a pancreatic lineage and therefore limit their usefulness for the treatment of T1DM. The aim of this project is to identify whether iPSCs are a viable alternative to ESCs for generating β-cells in vitro for cell replacement therapy to treat type 1 diabetes. The differentiation potential of iPSCs and ESCs to give rise to first definitive endoderm (the first stage in differentiation towards a pancreatic lineage) in vitro will be compared, and the involvement of miRNAs in differentiation of ESCs and iPSCs to definitive endoderm will be investigated. Table Of Contents Chapter 1. General Introduction...........................................................................................4 1.1 Diabetes Mellitus..............................................................................................................8 1.1.1 Type 1 Diabetes Mellitus (T1DM) .........................................................................8 1.1.2 Type 2 Diabetes Mellitus (T2DM) .........................................................................9 1.1.3 Other Types of Diabetes .......................................................................................10 1.2 Structure of the Pancreas ................................................................................................11 1.3 Developmental Biology of the Pancreas ........................................................................12 1.3.1 Formation of Definitive Endoderm....................................................................12 1.3.2 Pancreatic Specification .....................................................................................14 1.3.3 Human Pancreatic Development .......................................................................22 1.4 Insulin and Its Mechanisms of Action............................................................................23 1.4.1 Insulin Biosynthesis ............................................................................................23 1.4.2 Insulin Secretion..................................................................................................24 1.4.3 Insulin Action ......................................................................................................25 1.5 Treatment of Type 1 Diabetes ........................................................................................27 1.5.1 Insulin Replacement ..........................................................................................27 1.5.2 Pancreas Transplantation ...................................................................................29 1.5.3 Islet Transplantation ..........................................................................................29 1.5.4 Xenotransplantation ...........................................................................................31 1.6 Cell Replacement Therapy .............................................................................................33 1.6.1 Human β-cells .....................................................................................................33 1.6.2 Pancreatic Stem Cells ..........................................................................................35 1.6.3 Other Adult Stem Cells .......................................................................................38 1.7 Embryonic Stem Cells (ESCs) .......................................................................................43 1.7.1 Differentiation of ESCs into Pancreatic β-cells ....................................................45 1.8 Induced Pluripotent Stem Cells ......................................................................................55 1.8.1 Differentiation of iPSCs into Pancreatic β-cells ....................................................57 1.8.2 Considerations Prior to Clinical Application of iPSCs .........................................61 1.9 Differences Between iPSCs and ESCs ...........................................................................70 1.9.1 Gene Expression ...................................................................................................71 1.9.2 Genomic Stability.................................................................................................74 1.9.3 Epigenomic Stability ............................................................................................77 1.9.4 Epigenetic Memory ..............................................................................................78 1.9.5 miRNA Expression ..............................................................................................81 1.10 MicroRNA ....................................................................................................................82 1.10.1 Biosynthesis and Action of miRNAs ................................................................83 1.10.2 The Role of miRNAs in Pluripotency ...............................................................84 1.10.3 The Role of miRNAs in Differentiation............................................................88 1.11 Hypothesis & Aims ......................................................................................................95 Chapter 2: Materials & Methods…………………………………………………………..97 2.1 Generation of Induced Pluripotent Stem Cell (iPSC) Lines ........................................100 2.1.1 Preparation of Cell Lines ..................................................................................100 2.1.2 Preparation of pMX Plasmids ...........................................................................102 2.1.3 Reprogramming of Fibroblasts .........................................................................104 2.2. Maintenance of Pluripotent Stem Cells in Culture......................................................107 2.2.1 SNL Feeder Cell Culture & Inactivation ..........................................................107 2.2.2 Maintenance of Pluripotent Stem Cells on Feeder Cells ..................................109 2.2.3 Preparation of Matrigel™-Coated Plates ..........................................................110 2.2.4 Maintenance of Pluripotent Stem Cells on Matrigel™ .....................................111 2.2.5 Cryopreservation of Stem Cells ........................................................................111 2.3. In Vitro Differentiation of Stem Cells.........................................................................113 2.3.1 Differentiation to Definitive Endoderm ............................................................113 2.4. Characterisation of iPS Cells.......................................................................................114 2.4.1 Reverse Transcription-Polymerase Chain Reaction (RT-PCR) ........................114 2.4.2 Gel Electrophoresis ...........................................................................................118 2.4.3 Quantitative PCR (qRT-PCR) for Detection of mRNA Expression .................119 2.4.4 Immunocytochemistry.......................................................................................122 2.5 Investigation of microRNA Expression .......................................................................124 2.5.1 Microarray Analysis ..........................................................................................124 2.5.2 qRT-PCR for Detection of miRNA Expression ................................................129 2.5.3 Identification of Gene Targets of miRNAs .......................................................132 2.5.4 Luciferase Assay in 293FT Cells ......................................................................135 Chapter 3: Generation and characterisation of induced pluripotent stem cell lines.....141 3.1 Introduction ..................................................................................................................143 3.2 Methods ........................................................................................................................145 3.2.1 Generation of induced pluripotent stem cells....................................................145 3.2.2 Maintenance of pluripotent stem cells in culture ..............................................146 3.2.2 Characterisation of pluripotent stem cells .........................................................146 3.3 Results ..........................................................................................................................149 3.3.1 Generation of New iPS Cell Lines ....................................................................149 3.3.2 Characterisation of New iPSC Lines ................................................................152 3.4 Discussion ....................................................................................................................163 Chapter 4: Differentiation of pluripotent stem cells into definitive endoderm.………170 4.1 Introduction ..................................................................................................................171 4.2 Methods ........................................................................................................................173 4.2.1 Differentiation of Pluripotent Stem Cells into Definitive Endoderm .......................173 4.2.2. Characterisation of Differentiated Cells ...................................................................174 4.3 Results ..........................................................................................................................176 4.3.1 Comparison of Differentiation Protocols ..........................................................176 4.3.2 Comparison of Cell Lines .................................................................................181 4.4 Discussion ....................................................................................................................186 Chapter 5: Identification of miRNAs that play a role in the formation of definitive endoderm..............................................................................................................................194 5.1 Introduction ..................................................................................................................197 5.1.1 The role of miRNAs in Pluripotency and Differentiation .................................197 5.1.2 The Role of miRNAs in Definitive Endoderm Formation ................................200 5.1.3 Differences in miRNA Expression between ESCs and iPSCs ..........................200 Aims ...................................................................................................................................202 5.2 Methods ........................................................................................................................203 5.2.1. Choice of Cell Lines.........................................................................................203 5.2.2 In Vitro Differentiation of Pluripotent Stem Cells into Definitive Endoderm..203 5.2.3 Microarray Analysis ..........................................................................................203 5.2.4 qRT-PCR For miRNA Expression ....................................................................204 5.3 Results ..........................................................................................................................205 5.3.1 Analysis of Microarray Results .........................................................................205 5.3.2 Validation of Microarray Results by qRT-PCR ................................................222 5.4 Discussion ....................................................................................................................239 Chapter 6: Investigation of the function of miRNAs in differentiation to definitive endoderm……...............................................................................................................242 6.1 Introduction ..................................................................................................................247 6.2 Methods ........................................................................................................................249 6.2.1 Identification of Gene Targets of miRNAs .......................................................249 6.2.2 Luciferase Assay in 293FT Cells ......................................................................249 6.2.3 Manipulation of miRNA Expression ................................................................250 6.3 Results ..........................................................................................................................251 6.3.1 Identification of Gene Targets of miRNAs .......................................................251 6.3.2 Investigation of the Function of miR-375 in Definitive Endoderm Formation 251 6.3.3 Investigation of the Function of miR-151a-5p in Definitive Endoderm Formation ...................................................................................................................258 6.3.4 Manipulation of miRNA Expression in Pluripotent Stem Cells .......................262 6.4 Discussion ....................................................................................................................267 Chapter 7: General discussion .....................................................................................269 7.1 Generation and Characterisation of iPSCs ...................................................................273 7.2 Differentiation of Pluripotent Stem Cells into Definitive Endoderm ..........................275 7.3 Investigation of miRNA Expression in DE Formation ................................................278 7.4 Investigation of Differential miRNA Expression between ESCs and iPSCs ...............280 7.5 Investigation of the Function of miRNAs in DE Formation ........................................283 7.6 Concluding Remarks ....................................................................................................287 Bibliography……………………………..…………………….……….……………....…...290 Appendix 1: Supplementary miRNA tables………………………………....….…........…334 Appendix 2: miRNA target predictions………………………………..………………......344 Appendix 3: List of Materials…………………………………………...…………............350 List of Figures Figure 1.1. Structure of the pancreas ............................................................................. 11 Figure 1.2. Early development of the dorsal pancreas. .................................................. 14 Figure 1.3.Endocrine specification in the developing pancreas. .................................... 19 Figure 1.4. Approximate timescale of mouse and human pancreatic development ........ 22 Figure 1.5. Signal transduction in β-cells ...................................................................... 24 Figure 1.6. The insulin signalling pathway ................................................................... 26 Figure 1.7. Derivation of ESC lines from cleavage-stage embryos................................ 43 Figure 1.8. Differentiation of pluripotent stem cells toward insulin-producing β-cells in vitro recapitulates in vivo development ......................................................................... 48 Figure 1.9. Derivation of iPSCs & their applications in cell replacement therapy, disease modelling and gene therapy. .......................................................................................... 56 Figure 1.10 miRNA biogenesis ..................................................................................... 84 Figure 1.11. miRNAs expressed at the different stages of pancreatic development ....... 91 Figure 2.1. Overview of the process of reprogramming of somatic cells to induced pluripotent stem cells. .................................................................................................. 106 Figure 2.2. Passage of stem cell colonies.. .................................................................. 109 Figure 2.3. Amplification plot. .................................................................................... 121 Figure 2.4. Standard curve .......................................................................................... 121 Figure 2.5. Overview of microarray analysis of microRNA expression....................... 126 Figure 2.6. Typical electropherogram from an RNA 6000 Nano Bioanalyzer chip used to analyse RNA quantity and quality. .............................................................................. 127 Figure 2.7. Normalisation of data using Lowess normalisation. .................................. 128 Figure 2.8. Plasmid used in luciferase assays to determine miRNA-target relationships.. .................................................................................................................................... 137 Figure 2.9 miArrest™ lentiviral vector used to repress expression of miRNAs of interest. ........................................................................................................................ 137 Figure 2.10 miExpress™ lentiviral vector used to overexpress miRNAs of interest. ... 137 Figure 2.11. Overview of luciferase assay to detect miRNA-target interactions. ......... 139 Figure 3.1 GFP expression during reprogramming ...................................................... 150 Figure 3.2. Formation of stem cell-like colonies after transfection of HFF1 fibroblasts with reprogramming factors ......................................................................................... 150 Figure 3.3. Immunocytochemistry for TRA-1-60 expression using live cell stain. ...... 152 Figure 3.4. qRT-PCR showing expression levels of key pluripotency genes. .............. 153 Figure 3.5 Morphology of stem cell colonies. ............................................................. 154 Figure 3.6. Immunocytochemistry for TRA-1-60 expression. ..................................... 155 Figure 3.7. Alkaline phosphatase staining...................................................................155 Figure 3.8. Expression of pluripotency markers. ......................................................... 156 Figure 3.9. Expression of pluripotency markers. ......................................................... 156 Figure 3.10. Expression of pluripotency markers. ....................................................... 157 Figure 3.11 Expression of pluripotency markers ......................................................... 157 Figure 3.12. qRT-PCR showing expression levels of key pluripotency genes ............. 159 Figure 3.13. qRT-PCR showing expression levels of exogenous genes used in reprogramming. ........................................................................................................... 159 Figure 3.14. qRT-PCR data showing expression of marker genes characteristic of endoderm. .................................................................................................................... 161 Figure 3.15. qRT-PCR data showing expression of a marker gene characteristic of mesoderm .................................................................................................................... 161 Figure 3.16. qRT-PCR data showing expression of marker genes characteristic of ectoderm. ..................................................................................................................... 161 Figure 3.17 qRT-PCR data showing the expression of the pluripotency genes OCT4 and NANOG in two iPSC lines at several different passages. ............................................ 165 Figure 4.1.Immunocytochemistry for SOX17 expression. ........................................... 176 Figure 4.2.Expression of Sox17 assessed by qRT-PCR ............................................... 178 Figure 4.3. Expression of Cxcr4 assessed by qRT-PCR .............................................. 178

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However, problems associated with the use of ESCs mean that an alternative cell source is needed. Table 5.5. Top 10 miRNAs up- and down-regulated upon endoderm formation in the MRC5I cell line. By the end of gastrulation, at approximately E7.5, the DE consists of a flat sheet of cells with.
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