Precision Cancer Therapies Market Forecast Research Reports Offers Key Insights 2017 2025 – Space Market Research

Precision medicine (PM) can be defined as predictive, personalized, and preventive healthcare services delivery model. Precision cancer therapies is an additional option for patients suffering from cancer however it cannot completely replace the existing cancer treatments. Currently, researchers are making progress in the field of precision cancer therapies however many new and innovative drugs are currently in clinical trials. Precision cancer therapies include drugs or other substances which block the growth of cancer. Precision cancer therapies are also termed as molecular targeted therapy, or targeted molecular therapies, and precision medicines. Researchers are involved in developing anticancer drug developments via precision cancer therapies.

Precision Cancer Therapies Market: Segmentation

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Precision cancer therapies market can be segmented on the basis of the type of therapies, end users, and regions: Hormone Therapy Immunotherapies Targeted Therapy Monoclonal Antibody Therapy Gene Therapy

Precision cancer therapies market can be segmented on the basis of different end users in the market: Hospitals Diagnostic Centers Oncology Clinics Research Institutes

Precision Cancer Therapies Market: Dynamics

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Precision cancer therapies market is primarily driven by a few key factors such as the increasing prevalence of cancers, such as lung cancer, breast cancer, prostate cancer, melanoma and other types of cancers. The market is likely to grow owing to the increasing awareness regarding molecular diagnostic techniques which is expected to fuel the growth of precision cancer therapies market. The rising insurance coverage and growing healthcare expenditure by the government are among the factors which would aid the growth of precision cancer therapies market over the forecast years.

Precision cancer therapies market, however, faces various challenges such as the high cost of new and innovative therapies which prevent the wide prevention of these diseases. Precision cancer therapies market has various drugs which are still in various stages of clinical trials which refrain the products from the market. Precision cancer therapies market faces tremendous challenges due to the low awareness regarding the new diagnosis and treatment measures. Low-income countries and rising economies are coming forward to address such issues for precision cancer therapies market.

Precision Cancer Therapies Market: Region-wise Outlook

Based on geography, the precision cancer therapies market can be segmented into five major regions: North America, Europe, Asia-Pacific, Latin America and Middle East & Africa. At present, North America holds a leading position in the precision cancer therapies market due to the increasing incidence of cancer in the region which is followed by Europe. The major driving factors which have driven the growth of the precision cancer therapies market in this region is constant support of healthcare organizations in the development of new treatment methods, technological advancement in finding innovative treatment measures, and a rise in funding in public and private sector. Following North America, European countries are also anticipated to show steady growth in the precision cancer therapies market. Asia Pacific is expected to grow at the fastest CAGR because of increasing prevalence of different types of cancers in the region, thus boosting the market growth of precision cancer therapies market throughout the forecast period. The factors which would fuel the growth of precision cancer therapies market in Asia-Pacific are various multinational companies are setting up their operations in this region and aiming to gain huge revenue share from emerging countries, rising healthcare concerns, and improving healthcare scenario of the region. Precision cancer therapies market would evolve at a rapid rate across the regions. However, North America would maintain its position in the precision cancer therapies market, though, we are anticipating emerging economies such India, China, Brazil, Russia to have the highest growth in precision cancer therapies market.

Precision Cancer Therapies Market: Key Players

Precision cancer therapies market holds a huge number of players operating in the segment for years with expertise and experience. Various multinational companies are involved in the manufacturing of products which are utilized in the treatment of cancer. Such companies are Abbott Laboratories, Bayer HealthCare AG, GlaxoSmithKline plc, OncoGenex Pharmaceuticals Inc., Hospira Inc., Boehringer Ingelheim GmbH, AstraZeneca, Aveo Pharmaceuticals among others. Precision cancer therapies market has the presence of many regional players which have a huge market share in the emerging countries.

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Precision Cancer Therapies Market Forecast Research Reports Offers Key Insights 2017 2025 - Space Market Research

Health Repair Damaged or Diseased Tissue with Stem Cell Injections 10:38 AM, Sep 28, 2019 – WXYZ

Dr. Mansour identifies two defining properties of stem cells: First, they can self-regenerate, meaning they divide and give rise to more regenerative cells of the same kind. Second, stem cells can mature or differentiate into specialized cells which carry out a specific function in the skin, muscle, or blood.

A major breakthrough in modern medicine revolves around the use of Umbilical Cord Stem cells. These powerful cells are injected into damaged tissues, ligaments, muscles and tendons, arthritic joints, or other tissues in an attempt to stimulate and accelerate healing.

Regenerative Medicine from Umbilical Cord Stem Cells in Macomb County

We were the first clinic in Michigan to offer umbilical cord stem cell injections as a holistic alternative to pain management and cell regeneration.

Dr. Mansour conducts monthly educational seminars and offers free one on one consultation, during which he reviews all imaging studies to determine if the patient is a candidate for stem cell therapy. For those who qualify, he offers a customized plan that is specific to each patient.

There is a wide range of conditions which may be treated with stem cells, including:

Joint Pain

Arthritis

Ligament Tears

Cartilage Tears

Meniscus Tears

Nerve Damage

Back Pain

And So Much More!

A Better Approach with Revolution Wellness

Are you suffering from constant discomfort, or diagnosed with a specific condition only to be told that medication or surgery are your only options? At Revolution Wellness, we believe otherwise. We use the innovative technology of stem cell therapy to treat discomfort and serious physical ailments.

Call our office today for more information about how we can get you on your way to living with less pain!

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Health Repair Damaged or Diseased Tissue with Stem Cell Injections 10:38 AM, Sep 28, 2019 - WXYZ

Minnesota builds expertise in coaxing the body to heal itself – Star Tribune

An obsolete surgical balloon might not sound like a tool of cutting-edge health care, but doctors at Mayo Clinic are repurposing it as they expand the field of regenerative medicine beyond organ transplants and stem cells to new therapies that can coax the body to repair itself.

Mayo physicians are testing the balloon on unborn babies who have a defect that causes their lower organs to bunch up and choke lung growth. By threading the balloon into the womb and inflating it to block the babys throat, doctors can reverse chest pressure, pushing the organs back down and giving the lungs space to heal and grow on their own.

The technique illustrates how the states expertise has grown in five years under the Regenerative Medicine Minnesota program. The state-funded initiative has issued 162 grants worth $21.7 million to advance the knowledge and use of stem-cell therapies, but also to explore ways to help the body heal itself without transplanting these powerful but sometimes problematic cells.

We all thought regenerative medicine equaled stem cells, said Dr. Andre Terzic, director of Mayos Center for Regenerative Medicine, but if you go through the applications, especially those that have been breakthrough applications, you realize that there are new technologies that are going beyond stem cells.

Terzic and Dr. Jakub Tolar, former dean of the University of Minnesotas Medical School and director of the Us Stem Cell Institute, co-lead the state program, with the goal of turning Minnesota into the Silicon Valley of regenerative medicine. It receives $4 million per year from the states general fund that is divided into two-year grants for research and medical education.

Terzic said the range of grants shows the acceleration in regenerative medicine, a field that in many ways got its start in Minnesota, where the first islet transplant was performed at the U in 1974 to create new insulin supplies in patients with diabetes. Once focused on elderly patients and cancer, or chronic diseases such as diabetes, regenerative medicine is expanding as doctors learn how multiple organs have healing powers that can be activated, he said.

Many studies still focus on stem cells the bodys so-called master cells that can grow other cells and tissues with some testing them as therapies and others just aiming to understand how they can be activated in patients to accelerate healing, Tolar said.

Robert Tranquillo, a biomedical engineer at the U, for example, received grant funding to seed artificial blood vessels with stem cells so they can become suitable replacements for clogged arteries. Funding also supported 4-D printing by mechanical engineer Michael McAlpine, also at the U, to create cellular scaffolds that can harness and direct transplanted stem cells so they can regenerate damaged heart tissue.

A common goal of all the grants, including some awards to local biotech companies, is to hasten the transfer of research discoveries into clinical applications, Tolar said. The science is not enough. What really matters is what you get from the science, which is understanding.

Mayo received $500,000 to test the balloon placement, a procedure formally known as fetoscopic endoluminal tracheal occlusion, on 10 fetuses, and to join a half-dozen other U.S. institutions that are studying the treatment for an often-fatal birth complication.

A hole in his diaphragm

Alyse Ahern-Mittelsted was still grieving the loss of a daughter in utero when she discovered in the 20th week of her latest pregnancy last year that her fetus heart was out of place. His lungs had reached only 22% of expected growth due to a hole in his diaphragm that allowed lower abdominal organs to press up against them. For her, joining the study was an easy choice.

We had lost our daughter and then we found this out, said the Cresco, Iowa, woman. To me, it wasnt really a question. I wanted to do everything and anything that we could.

At the 27th week, Mayos Dr. Rodrigo Ruano lined up the baby so he could thread a balloon through the mothers abdomen and straight into his throat.

This surgical balloon was invented to stop bleeding in the brain, but other techniques now work better for that. It is not approved for the fetal procedure by the U.S. Food and Drug Administration, but Ruano said he is trying to prove its worth. Ruano had performed the procedure in Brazil before coming to Mayo.

During pregnancy, babies receive oxygen from their mothers umbilical cords. Their throats are filled with fluid, and the inflated balloons create a pressure change that pushes the fluid downward, creating space for the lungs.

Its the only mechanism we have so far to help promote lung growth in babies with this condition, he said.

By the time the balloon was deflated and removed from Ahern-Mittelsteds baby, at 34 weeks gestation, his lower organs had already receded to their expected locations and his lungs were growing. The baby, born last Nov. 20 and named Zane, still needed surgery to close the hole in his diaphragm, but he was breathing on his own.

I figured hed be born and hed turn blue because he couldnt breathe, his mother said, but when he came out his eyes were open and he made a little tiny peep.

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Minnesota builds expertise in coaxing the body to heal itself - Star Tribune

Better solutions for the replacement of joints – SciTech Europa

Orthopaedic Research focuses on finding solutions for regenerating parts of the musculoskeletal apparatus that often fail while ageing as they are constantly loaded. Hereby, it can be mentioned that the joints who are often involved are the knees with problems such as cartilage degeneration and/or meniscus degeneration, but also ruptures of the anterior cruciate ligament. Furthermore, the rotator-cuff joint of the shoulder and the intervertebral discs of the spine are potentially affected with a very poor self-healing capacity. These problems might arise by ageing but also due to post-trauma induced degeneration or genetic predisposition.

In terms of implants the most successful surgery for Orthopaedics remains the hip implant. Here, complication rates as low as 1-2% were reported. However, for all other joints no equally good solutions exist until now. Here, an improved understanding of the mechano-biology of joints and the tissue homeostasis is needed. Current solutions are often to replace the joint with a full implant. However, these natural joints possess six-degree-of-freedom for motion, e.g. the knee and the spine, but are also equipped with proprio-and mechano-receptors that provide important information about the actual position and movement/loading of the joint.

An increasing elderly population demands for an increased supply of joint substitutes or replacement parts. However, these are unmet clinical needs as implants do not often give back full range of motion and proprioception, which is important for certain movements. Thus, for the intervertebral discs of the spine, cartilage and meniscus, currently no good solutions exist in the clinics that provide long-time satisfaction. Here, tissue engineering is expected to unleash new solutions.

The Tissue Engineering, Orthopaedics & Mechanobiology (TOM) Group of the Department for BioMedical Research (DBMR),at the University of Bern conducts translational research at the intersection of tissue engineering, biology and applied clinical research. The group is experienced in musculoskeletal connective tissues, such as bone, cartilage, ligaments and tendons. The TOM research Group has established core competence how these tissues and/or cells can be targeted and cultured into various 3D systems from biomaterials to organoids.

The primary aims of the TOM group are on the one hand to investigate cell therapy options to regenerate the intervertebral disc (IVD) of the spine and on the other hand, to elucidate bone metabolism and signalling of the bone morphogenic proteins (BMPs) in order to improve patients outcome for spinal fusion. The third focus is the understanding of ruptures of the anterior cruciate ligament of the knee and its options to heal this structure. Here, the aim is to find superior solutions for the healing of the anterior cruciate ligament (ACL).

To achieve these goals, the group applies a broad spectrum of methods, such as cell targeting by sorting, 3D hydrogel culture, organ 3D culture and specialised bioreactors that maintain the joint tissues mechano-biological requirements. The common focus of the TOM group is to advance in vitro organ culture models, which match closely the human situation and where regenerative therapy strategies, such as novel biomaterials and cells, can be tested in a most authentic in vitro set-up.

In regenerative medicine, and especially in tissue engineering, several open questions still need to be tackled, such as which cells or which materials to take for healing and/or regeneration. It would be great if materials could be designed for the recruitment of cells on site-of-request with growth factors that would either induce cell migration or even lead to differentiation of progenitor cells into the correct cell type. In line of this research, many research teams have tried to develop novel smart biomaterials containing growth factors. Indeed, some of these approaches seem to carry potential for further optimisation.

For the IVD, growth and differentiation factor five and six (i.e., GDF5 and GDF6) are especially promising in this respect, as they were shown to be of central relevance for thriving mesenchymal stromal cells (MSCs) towards an IVD phenotype. In this project, silk scaffolds were produced by transduced Bombyx mori (silkworm) cultures with a cassette that contained the human growth factor GDF6.1.

Recent advancements in the field of engineering, such as electro-spinning and/or 3D printing might lead to new options and products. The group has been driving research in the fields of silk electro-spinning in collaboration with Ren Rossi and Guisepino Fortunato from the Empa, St. Gallen, Laboratory for Biomimetic Membranes and Textiles. With these collaborations new protocols were established to generate different scaffolds mimicking either the outer part of the disc, i.e. the annulus fibrosus (AF) with a parallel fibre orientation, using a rotating mandrill to collect the silk fibres in a parallel orientation.

To mimic the inner part a static collector to accumulate randomly oriented fibres, which mimics the centre of the IVD, and scaffolds were seeded with nucleopulpocytes. Here, the basic question was more on the production of fibres and their orientation and mechanical properties for IVD repair.

Furthermore, the group performed in vitro pre-clinical models using genetically engineered silk. This successful Gebert-Rf-founded project involved the collaboration of a German company that produced the silk (Spintec Engineering, GmbH, Aachen, Germany). The project was a collaboration with specific know-how on producing a GMP (general molecular practise)-compliant silk containing two of very promising growth factors for IVD repair.

The feasibility was then tested using in vitro 3D cell culture experiments seeding adult stem cells isolated from the bone-marrow aspirated from spinal surgery at the University Hospital of Bern. Prof Dr Lorin Benneker, head of Spine of the Insel University Hospital of Bern, from the Department of Traumatology and Orthopedics, was involved and provided valuable clinical tissue that allowed to assess the important question whether human primary IVD cells can be expanded with these materials and whether these cells can be stimulated towards.

The feasibility of IVD repair was tested in a 3d explant organ culture model. The team of Prof Dr Gantenbein could show that adult mesenchymal stromal cells from bone marrow could be differentiated towards more intervertebral-disc-like cells producing extra cellular matrix as expected of the so-called nucleopulpocytes.

In terms of repair for the centre of the IVD, the so-called nucleus pulposus, hydrogels are very attractive. Here, it was shown that the mechanical properties of such hydrogels are often not optimised for the orthopaedic application. For IVD and cartilage repair the stiffness of these materials should be adopted to better match the one of a native nucleus pulposus of the human lumbar disc. This increased stiffness could be achieved by incorporation of linkers into the hydrogels such as genipin. This has been tested successfully in the established bioreactor using live bovine IVD explants.

In a recently started European consortium H2020 project named iPSpine, Project number #825925, that is led by Prof Dr Marianna Tryfonidou of the University of Utrecht, the TOM group is contributing knowledge how to target a rare progenitor cell population from the centre of the disc that might be useful for regenerative purposes. The presented findings were related to their recently published work alongside supporting partners of the iPSpine consortium that compares cell sorting methods for bovine cells disc progenitors (Tissue Engineering part C Methods, June 2019). According to the TOM groups findings, Fluorescent Associated Cell Sorting (FACS) was the best isolation method for sorting the tissue specific progenitor cells and led to the most potent and functional cells. The aim is to apply soon this process for therapeutic purposes in humans.

Members of Prof Gantenbeins lab are working to build on these findings within the iPSpine consortium. Dr Julien Guerrero is working on a Standard Operational Protocol for the isolation of these progenitors cells from human intervertebral discs. These cells can then be further considered and employed for the purposes of the iPSpine consortium. Within this consortium it is foreseen to derive GMP-grade specialised cells (induced pluripotent stem cells; iPSCs).

These steps are all advancing the goals of iPSpine to develop an advanced cell therapy to soon ease the widespread health problems of people suffering from chronic low back pain, the most common cause of job-related disability and missed work.

Prof Dr Benjamin Gantenbein and Dr Julien Guerrero

Department for BioMedical Research (DBMR)

Tissue Engineering for Orthopaedics & Mechanobiology (TOM)

Department of Orthopaedics

& Traumatology

Insel University Hospital

University of Bern

+41 31 632 88 15

Benjamin.Gantenbein@dbmr.unibe.ch

Julien.Guerrero@dbmr.unibe.ch

http://www.tom-lab.com

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Better solutions for the replacement of joints - SciTech Europa

The Bright Future of Stem Cell Therapy: Part 2 – Green Valley News

Last month, we talked about using Mesenchymal Stem Cells (MSC) in Regenerative Medicine to heal degenerative joints and other tissues and organ systems.

When we inject MSCs into damaged areas, we augment the bodys regenerative capacity. MSCs heal damaged tissue by orchestrating the entire healing cascade, providing building blocks for new tissue as well as necessary messenger signaling molecules.

Harvesting cells from C-Section deliveries

Mesenchymal stem cells are harvested from full-term C-section deliveries after the donor has been screened for infectious diseases. The umbilical cord including Whartons Jelly along with the amniotic fluid and sac are harvested and carefully processed.

They are further tested to determine the number of MSCs, structural proteins, cytokines (IL-1, TGF-, TGF-), and growth factors the tissue in question contains. Then they are frozen in liquid nitrogen until needed.

Care is given to inject them in the desired joint or region of the body immediately upon thawing, to preserve viability and increase effectiveness.

Amniotic tissue has been described as fertilizer, while MSCs are new seed, and our tissues are like the soil. The healthier the soil, the better the outcome when new seed and fertilizer are introduced.

There is a bright future for stem cells in many aspects of healing and regeneration. An added benefit is much less recovery time than with surgical procedures.

For information about Nature Cures health programs and retreat, contact the Nature Cure Clinic in Green Valley at 520-399-9212.

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The Bright Future of Stem Cell Therapy: Part 2 - Green Valley News

Friday Frontline: Cancer Updates, Research and Education on September 27, 2019 – Curetoday.com

From a freezer failure that lost the stem cells of some patients with cancer to a documentary about one of the pioneers of immunotherapy, heres what is making headlines in the cancer space this week.

The freezers temperature sensors failed, and the safeguards put in place were insufficient, according to Childrens Hospital Los Angeles. The hospital apologized and sent letters to the families affected, as well as set up a phone line for people to call with questions.

We apologize for any distress or confusion that this has caused our patients and their families, the hospital said in a statement. No childs health is in jeopardy due to this incident, they added.

A documentary about immunotherapy pioneer Dr. Jim Allison premieres in certain theaters today. Jim Allison: Breakthrough will debut in New York and Los Angeles before expanding to other theaters across the country.

It tells the story of Allisons discovery on how the immune system can fight cancer. Allison is best known for his work in T-cell response mechanisms and his discovery that blocking the signaling of the immune checkpoint protein CTLA-4 improved responses. His research led to the development of Yervoy (ipilimumab), the first immune checkpoint inhibitor approved by the Food and Drug Administration in 2011.

Last year, Allison won the 2018 Nobel Prize in Physiology or Medicine alongside Dr. Tasuku Honjo.

The first-ever ZERO Cancer Day took place Tuesday to honor the prostate cancer community. ZERO The End of Prostate Cancer, a nonprofit organization, was behind the event.

It took place on its various social media channels to recognize the passion of prostate cancer survivors, patients and their families.

ZERO Cancer Day was inspired by the urgency and necessity of ending prostate cancer, according to a press release. More about the one-day event can be found on the groups Facebook page.

A 6-year-old cancer survivor learns dreams can come true. Linden Bradley got to open the gates to Disneyland thanks to the Make-A-Wish Foundation who provided the family with a weeklong trip.

He was also surprised with becoming the honorary mayor of the Haunted Mansion. Bradley received a stage 4 Burkitt lymphoma diagnosis in March but after four rounds of inpatient chemotherapy he was released in June. Bradley is now cancer-free.

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Friday Frontline: Cancer Updates, Research and Education on September 27, 2019 - Curetoday.com

Cell Conversions Transformed From Black Box Guesswork to Systematic Discovery – Technology Networks

The ability to reliably convert the phenotype of one cell to another would be a game-changer for regenerative medicine. However, predicting the reprogramming factors necessary to induce cell conversion has largely relied on trial and error, revealing the need for a more systematic approach.

In 2016, Rackham et al. presented a predictive system called Mogrify in a paper titled: "A predictive computational framework for direct reprogramming between human cell types, published in Nature Genetics.

Since then, the UK company has continued to work towards its goal of transforming the future development of cell therapies. This year, Mogrify has grown its team, appointedDr. Jane Osbourn (former Vice President for Research and Development and Site Leader at MedImmune (AstraZeneca)) as Chair of the Board, relocated to the Bio-Innovation Centre in Cambridge, and won Business Weekly's "Disruptive Technology" awardin March.

To learn more about Mogrify's approach to achieving cell conversion through transdifferentiation, we interviewed Pierre-Louis Joffrin, Corporate Development Executive at Mogrify.

Michele Wilson (MW): Transdifferentiation is the process of converting one cell type to another without going through a pluripotent state. Can you elaborate on our current ability to achieve cell conversion in this way?

Pierre-Louis Joffrin (PJ): Transdifferentiation is defined as the conversion of one cell type into another without going through pluripotency by the forced expression of cDNA encoding for transcription factors. The first example of transdifferentiation was reported in 1987 by Davis, Weintraub and Lassar, in a seminal study titled Expression of a single transfected cDNA converts fibroblasts to myoblasts.

Despite this discovery, the field of transdifferentiation was relatively on standby until 2006, when Yamanaka reported that pluripotent stem cells could be induced from mouse fibroblasts. Since then, many laboratories around the world have embarked on a journey to revisit the transdifferentiation concept published 20 years earlier. Soon after, combinations of transcription factors to convert human fibroblasts into neurons, cardiomyocytes and hepatocytes started to emerge.

Since 2010, over 400 scientific reports have been published reporting or validating transdifferentiation protocols, using different cell types as the source material. However, the success of a conversion depends on the exact identification of the combination of transcription factors amidst an infinitely large search space of >1022 possible combinations. Consequently, conversions have largely relied on a combination of educated guess and experimental trial and error, with little room for optimization. As a result, few conversions achieve the desired outcome of a functional mature cell.

MW: Mastering the technique of transdifferentiation would create many possibilities for regenerative medicine therapies. Can you paint a picture of what you hope the future will hold for this technique?PJ: Transdifferentiation has huge potential in regenerative medicine in two distinct ways. Firstly, conversions can be used to produce cells for autologous or allogeneic implantation in patients with diseases where the number of functional cells are diminished, such as chondrocytes in osteoarthritis. Autologous chondrocyte implantation (ACI) is an approved therapy for cartilage defects that could be enhanced by transdifferentiating a more scalable cell type, such as fibroblasts, to increase the number of chondrocytes for re-implantation.

Secondly, transdifferentiation could be used to reprogram cells in vivo, to convert an undesired cell type into a desired cell type at the affected site in the body. A potential example of this would be converting white adipose tissue into brown adipose tissue, to reduce obesity and to help maintain glucose homeostasis for type-2 diabetes patients. So far, there are no approved in vivo reprogramming therapies, but as an increasing number of cell conversions are discovered and delivery systems are developed, these therapies should draw more attention as they bypass the problem of immunogenicity associated with the allogeneic implantation of foreign cells.

MW: What are the main limitations that are holding back progress in reprogramming techniques and applications?

PJ:Many of the currently identified transdifferentiation protocols are inefficient, leading to the conversion of only a small subset of cells, sometimes <1%. As a result, several transdifferentiation protocols are not reproducible. This could be due to factors such as:

(1) the optimal transcription factor combination is yet to be identified(2) the delivery method for the transcription factors is not ideal, or(3) the culture conditions to enhance the conversion and maintenance of the desired cell type have not been discovered.

Cellular validation and bioequivalence are vital, especially in the context of regenerative medicine. The cellular phenotype of the generated cells must be assessed to determine bioequivalence with native cells. Yet, scientific data showing this is poor, in some cases, or absent altogether.

In several cases, cells resembling the desired target cell type are transiently generated, but fail to be maintained in culture. This could be because the combination of transcription factors fails to induce a self-sustaining endogenous gene expression change, or because the optimal culture conditions to capture this cellular state have not been identified.

MW: Can you tell us about Mogrifys system that predicts the reprogramming factors necessary to induce cell conversion?PJ:Mogrify has developed a proprietary cellular conversion technology, which makes it possible to transform any mature human cell type into any other, without having to go through a pluripotent stem cell- or progenitor-cell state. The platform takes a systematic big-data approach to identify the optimal transcription factors and/or small molecules needed to convert and culture any human cell type. This is achieved in three distinct steps.

Firstly, the gene expression levels of the source and target cell types are compared, using next-generation sequencing, gene regulatory and epigenetic network data, to determine the change in gene expression required to achieve the conversion. Secondly, all transcription factors are ranked according to their potential effect (both direct and indirect) on the differential gene expression identified previously. Lastly, the optimal combination of transcription factors is determined by obtaining maximal coverage of the differential gene expression (minimum of 98%), whilst avoiding overlap in effect from the different factors.

Mogrifys results have been experimentally validated, and can also predict the transcription factors used in known transdifferentiation experiments, serving as a directory of defined factors for any direct cell reprogramming.

MW: Mogrifys predictive algorithm considers gene expression data, as well as regulatory network information. Can you provide examples of regulatory network information that have been incorporated here?PJ:Regulatory networks are a way of representing causal interactions between transcription factors and their downstream gene targets, in order to calculate both direct and indirect effects on gene expression levels. These types of relationships can be inferred from different kinds of data such as DNA sequence, chromatin structure, gene or protein expression.

Mogrify incorporates data from two main databases: MARA, which models protein-DNA interactions and is representative of any potential direct effects on gene expression by transcription factor binding to promoter regions, and STRING, which models protein-protein interactions and is therefore representative of any potential indirect effects on gene expression through pathway cross-talk.

By capturing both of these regulatory network databases, Mogrify can rank the transcription factors, taking into account transcription factor-DNA binding motifs, gene promoter regions, gene expression and protein-protein interactions.

MW: To what extent do you expect Mogrify predictions to aid progress in the field of reprogramming?PJ: The process of transdifferentiation is still a black box. Thus far, all the combinations of factors required to convert one cell type into another have been identified using a trial and error approach and some educated guesses based on expert knowledge of a specific cell type. The Mogrify algorithm is designed to turn this black box into a predictable variable, identifying sets of transcription factors for direct cell conversion regardless of prior knowledge.

This will streamline the discovery of new transdifferentiation protocols, that can be used to generate cell conversions which exhibit safety, efficacy and scalable manufacturing profiles suitable for development as cell therapies for regenerative medicine and oncology. Mogrifys algorithm can also identify which genes are repressing cell-state conversionsa factor that has proven successful in enhancing conversion protocols in the past. Moreover, newer versions of the algorithm now include epigenetic data, which can be leveraged to predict growth factors and cytokines that are necessary for the maintenance of a specific cell type in culture.

MW: Can you tell us about any exciting upcoming or ongoing projects?PJ:The lead program at Mogrify is the development of chondrocyte conversions (via its subsidiary, Chondrogenix). As part of this program we are creating a scalable supply of chondrocytes from fibroblasts, which can be allogeneically implanted into the patient (without the need for gene editing, since cartilage is immune-privileged). This would effectively democratize the already approved ACI therapy, and make it considerably cheaper by transforming it into an off-the-shelf product. This initial program is currently entering pre-clinical testing. Were also working on converting osteoarthritic chondrocytes to healthy ones in vivo, in order to create the first disease-modifying therapy for osteoarthritis whereby the course of the disease is deterministically reversed.

Pierre-Louis Joffrin was speaking to Michele Wilson, Science Writer for Technology Networks.

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Cell Conversions Transformed From Black Box Guesswork to Systematic Discovery - Technology Networks

CytoDyn Treats First Patient in Phase 1b/2 Clinical Trial with Leronlimab (PRO 140) for Patients with Treatment-Nave, Metastatic Triple-Negative…

VANCOUVER, Washington, Sept. 27, 2019 (GLOBE NEWSWIRE) -- CytoDyn Inc. (OTC.QB: CYDY), (CytoDyn or the Company), a late stage biotechnology company developing leronlimab (PRO 140), a CCR5 antagonist with the potential for multiple therapeutic indications announced today the injection of the first patient in a Phase 1b/2 clinical protocol with treatment-nave metastatic triple-negative breast cancer (mTNBC).

The treatment of the first patient in mTNBC with leronlimab took place under the care of Dr. Jacob Lalezari, M.D. Dr Lalezari is a scientific advisor to CytoDyn and current Chief Executive Officer of Quest Clinical Research. Dr. Lalezari has authored more than 75 peer-reviewed articles and served as a principal investigator in over 200 clinical trials with a particular focus on first-in-man and proof of concept studies. Dr. Lalezari is also principle investigator for CytoDyns HIV monotherapy trial.

Results from this ongoing trial in mTNBC will dictate the Companys regulatory pathway, including the potential to seek Breakthrough Therapy Designation and accelerated approval with the U.S. Food and Drug Administration (FDA) for the use of leronlimab in mTNBC. Leronlimab has been granted Fast Track designation for mTNBC by the FDA based on a greater than 98% reduction of metastatic tumor volume in a murine xenograft model. Circulating Tumor Cells (CTC) will be evaluated in each patient every three weeks.

There is a growing body of evidence about the role of CCR5 in cancer and, in particular, how CCR5 blockade by a drug like leronlimab could have a multitude of anti-tumor effects including inhibition of immune inhibitory T-cells and promotion of anti-tumor activity by macrophages. These activities are synergistic with the exciting new class of immune-oncology drugs, stated Bruce Patterson, M.D., CEO of IncellDX.

Today marks a crucial milestone in our companys history, launching CytoDyn into clinical development in the oncology space, stated CytoDyn President and CEO, Nader Pourhassan, Ph.D. It is important to note that leronlimab has completed nine successful clinical trials and has been dosed in over 800 patients in our HIV programs, without a single drug-related serious adverse event (SAE), he continued. With this safety record and results from multiple pre-clinical trials in various cancer indications, including mTNBC, and other indications like NASH and GvHD, we are optimistic about the potential of leronlimab to provide a new therapeutic option for the roughly 37,000 women that are diagnosed with triple-negative breast cancer each year in the United States. We wish to thank the women who have agreed to participate in our trials and endeavor to provide each of them with clinical benefit. Along with our current mTNBC trial, CytoDyn will continue to enroll cancer patients under the expanded access program.

About Leronlimab (PRO 140)The U.S. Food and Drug Administration (FDA) have granted a Fast Track designation to CytoDyn for two potential indications of leronlimab for deadly diseases. The first as a combination therapy with highly active antiretroviral therapy (HAART) for HIV-infected patients and the second is for metastatic triple-negative breast cancer. Leronlimab is an investigational humanized IgG4 mAb that blocks CCR5, a cellular receptor that is important in HIV infection, tumor metastases, and other diseases including non-alcoholic steatohepatitis (NASH). Leronlimab has successfully completed nine clinical trials in over 800 people, including meeting its primary endpoints in a pivotal Phase 3 trial (leronlimab in combination with standard anti-retroviral therapies in HIV-infected treatment-experienced patients).

In the setting of HIV/AIDS, leronlimab is a viral-entry inhibitor; it masks CCR5, thus protecting healthy T cells from viral infection by blocking the predominant HIV (R5) subtype from entering those cells. Leronlimab has been the subject of nine clinical trials, each of which demonstrated that leronlimab can significantly reduce or control HIV viral load in humans. The leronlimab antibody appears to be a powerful antiviral agent leading to potentially fewer side effects and less frequent dosing requirements compared with daily drug therapies currently in use.

In the setting of cancer, research has shown that CCR5 plays an important role in tumor invasion and metastasis. Increased CCR5 expression is an indicator of disease status in several cancers. Published studies have shown that blocking CCR5 can reduce tumor metastases in laboratory and animal models of aggressive breast and prostate cancer. Leronlimab reduced human breast cancer metastasis by more than 98% in a murine xenograft model. CytoDyn is therefore conducting aPhase 2 human clinical trial in metastatic triple-negative breast cancer and was granted Fast Track designation in May 2019. Additional research is being conducted with leronlimab in the setting of cancer and NASH with plans to conduct additionalclinical studies when appropriate.

The CCR5 receptor appears to play a central role in modulating immune cell trafficking to sites of inflammation and may be important in the development of acute graft-versus-host disease (GvHD) and other inflammatory conditions. Clinical studies by others further support the concept that blocking CCR5 using a chemical inhibitor can reduce the clinical impact of acute GvHD without significantly affecting the engraftment of transplanted bone marrow stem cells. CytoDyn is currently conducting a Phase 2 clinical study with leronlimab to further support the concept that the CCR5 receptor on engrafted cells is critical for the development of acute GvHD and that blocking this receptor from recognizing certain immune signaling molecules is a viable approach to mitigating acute GvHD. The FDA has granted orphan drug designation to leronlimab for the prevention of GvHD.

About CytoDynCytoDyn is a biotechnology company developing innovative treatments for multiple therapeutic indications based on leronlimab, a novel humanized monoclonal antibody targeting the CCR5 receptor. CCR5 appears to play a key role in the ability of HIV to enter and infect healthy T-cells. The CCR5 receptor also appears to be implicated in tumor metastasis and in immune-mediated illnesses, such as GvHD and NASH. CytoDyn has successfully completed a Phase 3 pivotal trial with leronlimab in combination with standard anti-retroviral therapies in HIV-infected treatment-experienced patients. CytoDyn plans to seek FDA approval for leronlimab in combination therapy and plans to complete the filing of a Biologics License Application (BLA) in 2019 for that indication. CytoDyn is also conducting a Phase 3 investigative trial with leronlimab as a once-weekly monotherapy for HIV-infected patients and, plans to initiate a registration-directed study of leronlimab monotherapy indication, which if successful, could support a label extension. Clinical results to date from multiple trials have shown that leronlimab can significantly reduce viral burden in people infected with HIV with no reported drug-related serious adverse events (SAEs). Moreover, results from a Phase 2b clinical trial demonstrated that leronlimab monotherapy can prevent viral escape in HIV-infected patients, with some patients on leronlimab monotherapy remaining virally suppressed for more than four years. CytoDyn is also conducting a Phase 2 trial to evaluate leronlimab for the prevention of GvHD and has received clearance to initiate a clinical trial with leronlimab in metastatic triple-negative breast cancer. More information is at http://www.cytodyn.com.

Forward-Looking StatementsThis press releasecontains certain forward-looking statements that involve risks, uncertainties and assumptions that are difficult to predict. Words and expressions reflecting optimism, satisfaction or disappointment with current prospects, as well as words such as believes, hopes, intends, estimates, expects, projects, plans, anticipates and variations thereof, or the use of future tense, identify forward-looking statements, but their absence does not mean that a statement is not forward-looking. The Companys forward-looking statements are not guarantees of performance, and actual results could vary materially from those contained in or expressed by such statements due to risks and uncertainties including: (i)the sufficiency of the Companys cash position, (ii)the Companys ability to raise additional capital to fund its operations, (iii) the Companys ability to meet its debt obligations, if any, (iv)the Companys ability to enter into partnership or licensing arrangements with third parties, (v)the Companys ability to identify patients to enroll in its clinical trials in a timely fashion, (vi)the Companys ability to achieve approval of a marketable product, (vii)the design, implementation and conduct of the Companys clinical trials, (viii)the results of the Companys clinical trials, including the possibility of unfavorable clinical trial results, (ix)the market for, and marketability of, any product that is approved, (x)the existence or development of vaccines, drugs, or other treatments that are viewed by medical professionals or patients as superior to the Companys products, (xi)regulatory initiatives, compliance with governmental regulations and the regulatory approval process, (xii)general economic and business conditions, (xiii)changes in foreign, political, and social conditions, and (xiv)various other matters, many of which are beyond the Companys control. The Company urges investors to consider specifically the various risk factors identified in its most recent Form10-K, and any risk factors or cautionary statements included in any subsequent Form10-Q or Form8-K, filed with the Securities and Exchange Commission. Except as required by law, the Company does not undertake any responsibility to update any forward-looking statements to take into account events or circumstances that occur after the date of this press release.

CONTACTSInvestors:Nader Pourhassan, Ph.D.President & CEONPourhassan@CytoDyn.com

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CytoDyn Treats First Patient in Phase 1b/2 Clinical Trial with Leronlimab (PRO 140) for Patients with Treatment-Nave, Metastatic Triple-Negative...

Moving beyond hype: Could one-two treatment restore damaged heart muscle? – University of Wisconsin-Madison

Heart attacks can cause immediate death. But in survivors, the blockage of blood flow can kill so many heart muscle cells that heart failure can follow months or years afterwards. Heart disease is the leading cause of hospital admission and death in the United States.

A heart attack causes a loss of muscle and leaves the heart with a scar that does not contract and so impairs the hearts pumping function, says Tim Kamp, a professor of medicine who is co-leader of a new grant designed to attack two roadblocks that have stymied efforts to restore heart muscle with muscle cells grown from stem cells.

Kamp, who directs the Stem Cell and Regenerative Medicine Center at the University of WisconsinMadison, says, Everybody involved in treating these patients knows that this scarring often leads to a continual decline in heart function with heart failure and even death.

The UWMadison researchers used approved surgical devices to locate the damaged heart muscle, and then injected the supportive matrix and committed cardiac muscle cells. The circle outlines target zone established before surgery; black dots show the sites that were injected in this mouse study. Amish Raval, work performed at UWMadison in collaboration with Biologics Delivery Systems.

Sixteen percent of men, and 22 percent of women, develop heart failure after myocardial infarction heart attack. Coronary artery disease the category that includes stoppage of blood flow causes one in seven deaths in the United States.

Adult stem cell injections seemed a logical way to form new heart muscle cells and repair the damaged muscle. But in dozens of experiments, the cells either washed out of the heart or failed to develop into the specialized muscle cells the cardiomyocytes that power cardiac contractions. The benefits were mixed, modest at best, says Kamp.

After years of preliminary investigations, however, Kamp and Amish Raval, a professor of cardiology, researcher and entrepreneur, hope that a combination of two cutting-edge approaches would use a fabric-like material to prevent wash-out and successfully implant cardiomyocytes to damaged hearts.

Aided by a Regenerative Medicine Innovation Project grant from the National Heart, Lung, and Blood Institute, part of the National Institutes of Health, the two will lead a group to test that idea in pigs over two years.

Having committed cells could be a major advance, Raval says. The first stem-cells therapies started with cells that I call the model T. Now, we are moving to the Buick. The cells originate as induced pluripotent stem cells (iPSCs) a relative of embryonic stem cells that is based on reprogramming adult cells.

Two Madison-based businesses, and sources at the University of WisconsinMadison, also helped to fund the research. Fujifilm Cellular Dynamics Inc., one of the largest commercial sources of stem cell products, produces the committed cardiac progenitor cells that will be tested. These committed cells are ready to transform themselves into cardiomyocytes.

Fujifilm bought CDI, a company whose founders included Kamp and UWMadison stem cell pioneer James Thomson, but the operations remain in Madison. Kamp has no ownership position but is a consultant for the company.

Raval is a founder and board chair of the second commercial supporter, Cellular Logistics, Inc., which makes a freeze-dried matrix from the same proteins that naturally holds cardiomyocytes in place in the heart. The material is called extracellular matrix (ECM) because it scaffolds cells from the outside.

When the heart pumps, internal pressures often eject would-be replacement cells through lymph channels and blood vessels. Ravals group has already shown in mice that injecting extracellular matrix proteins along with new cells creates mechanical restraints that avoid the wash-out problem.

The extra-cellular matrix to be used in the NIH grant at UWMadison helped retain stem cells (yellow dots) in a pig heart. When similar cells (blue) were injected without the matrix, the cells spilled out of the heart muscle through the needle track and lymph channels.Eric Schmuck and Amish Raval, work performed at UWMadison. Eric Schmuck and Amish Raval, work performed at UWMadison

The injected scaffold may have another advantage for regenerating muscle after heart attack, Kamp notes. The ECM replenishes the scarred area to become more hospitable to the replacement cardiomyocytes. The effect may be based on chemical and mechanical signaling between the ECM and the regenerating cells.

Pigs hearts are quite close to human hearts in size and structure. The grant will cover tests on four groups of 12 pigs each following myocardial infarction:

If the combination is effective, Raval adds, We plan to proceed toward a Food and Drug Administration application for an investigational new drug, which would allow us to begin human trials.

With the passion and concern of a working cardiac surgeon, Raval says those trials would focus on patients who have not been helped by the best medical management we know today and they are not candidates for heart transplant or mechanical assist devices. The only other option is palliative or hospice care.

As Raval notes, More people are surviving heart attacks, and thats great. But many are left with a scar in the heart muscle a dead zone. That scar can enlarge, and the damage can spread. So we are seeing an increasing number of patients with heart failure. Thats why we are moving forward with this project.

This research is being funded by NIH grant 1U01HL148690-01.

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Moving beyond hype: Could one-two treatment restore damaged heart muscle? - University of Wisconsin-Madison

Conjugated polymers optically regulate the fate of endothelial colony-forming cells – Science Advances

Abstract

The control of stem and progenitor cell fate is emerging as a compelling urgency for regenerative medicine. Here, we propose a innovative strategy to gain optical control of endothelial colony-forming cell fate, which represents the only known truly endothelial precursor showing robust in vitro proliferation and overwhelming vessel formation in vivo. We combine conjugated polymers, used as photo-actuators, with the advantages offered by optical stimulation over current electromechanical and chemical stimulation approaches. Light modulation provides unprecedented spatial and temporal resolution, permitting at the same time lower invasiveness and higher selectivity. We demonstrate that polymer-mediated optical excitation induces a robust enhancement of proliferation and lumen formation in vitro. We identify the underlying biophysical pathway as due to light-induced activation of TRPV1 channel. Altogether, our results represent an effective way to induce angiogenesis in vitro, which represents the proof of principle to improve the outcome of autologous cell-based therapy in vivo.

In recent years, organic semiconductors have emerged as highly promising materials in biotechnology, thanks to several key-enabling features. Differently from silicon-based electronics, they support both electronic and ionic charge transport (1); they can be easily functionalized with specific excitation and sensing capabilities (24); and they are solution processable, soft, and conformable (5). They are highly biocompatible, being suitable for in vivo implantation and long-term operation, as recently reported for many different applications, including electrocorticography, precise delivery of neurotransmitters, electrocardiography, deep brain stimulation, and spinal cord injury (69). An important, distinctive feature of organic semiconductors is their sensitivity to the visible and near-infrared light. Recently, our and other groups have exploited it for optical modulation of cell electrophysiological activity, by using conjugated polymers and organic molecules as exogenous light-sensitive actuators (1012). Interesting applications have been reported in the field of artificial visual prosthesis (5), photothermal excitation or inhibition of cellular activity (13, 14), and modulation of animal behavior (15).

In this framework, the opportunity to use polymer-based phototransduction mechanisms to regulate the very early stages of living cell development has been very scarcely considered (16, 17). The possibility to selectively and precisely regulate a number of cell processes, such as adhesion, differentiation, proliferation, and migration, would be key to regenerative medicine and drug screening. The presently dominant approaches to reliably regulate stem and progenitor cell fate for regenerative purposes mainly rely on the use of chemical cues. However, irreversibility and lack of spatial selectivity represent important limitations of these methods. Whenever targeting in vivo applications, one must face the major, unsolved problem of diffusion of neurotrophic molecules by the conventional intravenous or oral routes. In addition, the therapeutic outcome of autologous cell-based therapy is often impaired by low engraftment, survival, and poor integration of stem cells within the environment of the targeted tissue. Other stimuli, mainly consisting of mechanical and electrical cues, were recently reported to have some notable effects, and recent advances in nanotechnology and material science enabled versatile, robust, and larger-scale modulation of the cell fate. In particular, carbon-based materials and conjugated polymers led to interesting results (18). However, their distinctive visible light absorption was never exploited in optically driven techniques.

Use of light actuation has been proposed either by viral transfer of light-sensitive proteins, by optogenetics tools, or by absorption of endogenously expressed light-sensitive moieties, based on low lightlevel therapies (1921). In the first case, interesting results were obtained (22); however, this approach bears all the drawbacks related to the need for viral gene transfer. Photobiomodulation led to interesting outputs as well, but overall efficiency is hampered by the limited absorption of light-responsive molecules endogenously expressed in living cells.

In this work, we propose to couple the use of conjugated polymers with visible light excitation to gain optical control of cell fate. We focus our attention on endothelial progenitor cells (EPCs) and, in particular, on endothelial colony-forming cells (ECFCs), which are currently considered the bona fide best surrogate of EPCs (23). ECFCs are mobilized from the bone marrow and vascular stem cell niche to reconstruct the vascular network destroyed by an ischemic insult and to restore local blood perfusion (24). ECFCs may be easily harvested from peripheral blood, display robust clonogenic potential, exhibit tube-forming capacity in vitro, and generate vessel-like structures in vivo (24, 25), thereby representing a promising candidate for autologous cell-based therapy of ischemic disorders (24). Manipulating the signaling pathways that drive ECFC proliferation, migration, differentiation, and tubulogenesis could represent a reliable strategy to improve the regenerative outcome of therapeutic angiogenesis in the harsh microenvironment of an ischemic tissue, such as the infarcted heart (24, 25). Intracellular Ca2+ signals play a crucial role in stimulating ECFC proliferation and tubulogenesis by promoting the nuclear translocation of the Ca2+-sensitive nuclear transcription factor B (NF-B) (2628). It has, therefore, been suggested that intracellular Ca2+ signaling could be targeted to boost the regenerative potential of autologous ECFCs for regenerative purposes (29). For the above-mentioned reasons, ECFCs represent a valuable test bed model for assessing the possibility to exploit the visible light sensitivity of conjugated polymers to gain touchless, optical modulation of cell proliferation and function.

In this framework, we demonstrate that polymer-mediated optical excitation during the first steps of ECFC growth leads to a robust enhancement of both proliferation and tubulogenesis through the optical modulation of the Ca2+-permeable transient receptor potential vanilloid 1 (TRPV1) channel and NF-Bmediated gene expression. Our results represent, to the best of our knowledge, the first report on the use of polymer photoexcitation for the in vitro modulation of ECFC fate and function, thereby representing the proof of principle to obtain direct control of progenitor cell fate.

Figure 1A shows a sketch of the bio/polymer interface developed for obtaining optical control of ECFC proliferation and network formation, together with the polymer chemical structure and the optical absorption spectrum. The material of choice for light absorption and phototransduction is a workhorse organic semiconductor, widely used in photovoltaic and photodetection applications, namely, regioregular poly(3-hexyl-thiophene) (P3HT) (6). It is characterized by a broad optical absorption spectrum, in the blue-green visible region, peaking at 520 nm. P3HT outstanding biocompatibility properties have been reported in a number of different systems, both in vitro and in vivo, including astrocytes (30), primary neurons and brain slices (14), and invertebrate models of Hydra vulgaris (15). Chronical implantation of P3HT-based devices in the rat subretinal space did not show substantial inflammatory reactions up to 6 months in vivo (10). Here, polymer thin films (approximate thickness, 150 nm) have been deposited by spin coating on top of polished glass substrates, as detailed in Materials and Methods. Both polymer-coated and glass substrates have been thermally sterilized (120C, 2 hours), coated with fibronectin, and, lastly, used as light-sensitive and control cell culturing substrates, respectively. ECFCs have been isolated from peripheral blood samples of human volunteers and seeded on top of polymer and glass substrates.

(A) P3HT polymer optical absorption spectrum. Insets show the chemical structure of the conjugated polymer and a sketch of the polymer device used for cell optical activation. ECFCs are cultured on top of P3HT thin films, deposited on glass substrates. (B) ECFC viability at fixed time points after plating (24, 48, and 72 hours). Cell cultures were kept in dark conditions at controlled temperature (37C) and fixed CO2 levels (5%). No statistically significant difference was observed between the glass and polymer substrates at any fixed time point (unpaired Students t test). (C) Experimental setup and optical excitation protocol for evaluation of polymer-mediated cell photoexcitation effects on cell fate. Polymer and control samples are positioned within a sterilized, home-designed petri holder. Light scattering effects are completely screened. The geometry and the photoexcitation protocol have been implemented to minimize overheating effects and to keep the overall extracellular bath temperature fairly unaltered. Thirty-millisecond-long green light pulses are followed by 70 ms in dark condition.

ECFC proliferation on polymer substrates has been primarily assessed in dark conditions at three different time points, namely, 24, 48, and 72 hours after plating (Fig. 1B). Polymer-coated samples, while showing from the very beginning a slightly lower number of cells as compared with control substrates, exhibit a proliferation rate fully similar to cells plated on glass substrates (slope of the linear fitting is 0.034 0.003, R2 = 0.99 and 0.034 0.005, R2 = 0.96 for control and P3HT polymer samples, respectively).

Once assessed that the P3HT polymer surface represents a nicely biocompatible substrate for ECFC seeding and proliferation in the dark, we moved to investigate the effect of polymer photoexcitation. In more detail, to evaluate the effect of optical stimulation on cell proliferation and network formation, we continuously shined light for the whole temporal window required for cell growth, and we realized an ad hoc system suitable for operation within the cell incubator. The experimental configuration and the excitation protocol are schematically represented in Fig. 1C. Optical excitation is provided by a light-emitting diode (LED) source, with maximum emission wavelength at 525 nm, incident from the substrate side. The choice of the protocol, continuously administered to the cell cultures during early seeding and proliferation stages, has been mainly dictated by the need to avoid overheating effects, with possible negative outcomes on the overall cell culture viability. On the basis of these considerations, we opted for a protocol based on 30-ms excitation pulses, followed by a 70-ms dark condition, at a photoexcitation density of 40 mW/cm2. The whole protocol is continuously repeated for a minimum of 4 up to 36 hours, depending on the type of functional assay, at controlled temperature (37C) and CO2 levels (5%).

The temporally precise and spatially localized measurement of the temperature variation upon polymer photoexcitation at the polymer/cell interface (i.e., within the cell cleft) is not straightforward because it requires the use of localized, submicrometer probes with a fast response time. However, according to the heat diffusion equation, we expect that dissipation occurs within a few milliseconds, following exponential decrease dynamics (14). Moreover, we used the well-known method of the calibrated pipette (31) to characterize the temperature variation dynamics within the extracellular bath volume, defined by the cylinder with the base area corresponding to the light spot size and the height of about 1 m. This choice is a good approximation of the overall volume occupied by a single ECFC cell; thus, it provides a realistic estimation of the average heating experienced by the cell (fig. S1A). We observe that temperature variation closely follows short optical pulse dynamics, reaching a maximum temperature at the end of the 30-ms illumination period, quickly followed by an almost complete thermal relaxation to the basal temperature during the 70-ms-long dark period. We conclude that our polymer-based system provides a highly spatially and temporally resolved method for optical excitation, making it possible, in perspective, to selectively target single cells and even cell subcompartments. Upon prolonged illumination (hours), one should also consider possible overheating effects of the whole extracellular medium volume. The average temperature of the bath for the entire duration of the long-term experiment was measured by a thermocouple immersed in the medium. Data show that an equilibrium situation is established after 5 hours and that the absolute temperature of the bath is increased by about 1.5 (fig. S1B). The adopted prolonged excitation protocol does not negatively affect overall cell culture viability (see below).

Figure 2 reports specific effects mediated by P3HT substrates and visible light stimulation on ECFC proliferation. ECFCs were plated in the presence of EGM-2 medium to facilitate the adhesion to the substrate. After 12 hours, the medium was switched to EBM-2 supplemented with 2% fetal bovine serum, and the cells were subjected to the long-term lighting protocol for 36 hours at controlled temperature (37C) and CO2 levels (5%). Under these conditions, ECFCs seeded on P3HT and subjected to light stimulation undergo a significant increase in proliferation rate, as compared with the control condition, i.e., to cells also seeded on P3HT polymer substrates but kept in dark conditions for the whole duration of the experiment (+158% versus P3HT dark; P < 0.05). No statistically significant difference in proliferation was observed among cells seeded on glass, whether they were subjected to optical excitation or not (Fig. 2A).

(A) Relative variation of the proliferation rate of ECFCs subjected to long-term optical excitation seeded on both bare glass and P3HT thin films, together with corresponding control samples kept in dark conditions. Cell proliferation was measured after 36 hours of culture in the presence of EBM-2 supplemented with 2% fetal calf serum. (B) Relative variation of the proliferation rate of ECFCs subjected to long-term optical excitation seeded on P3HT in the absence (CTRL) and presence of 10 M capsazepine (CPZ), 10 M ruthenium red (RR), 20 M RN-1734 (RN-1734), and 30 M BAPTA-AM (BAPTA). The results are represented as the means standard error of the mean (SEM) of three different experiments conducted on cells harvested from three different donors. The significance of differences was evaluated with one-way analysis of variance (ANOVA) coupled with Tukey (A) or Dunnetts (B) post hoc test. *P < 0.05.

Recent evidence demonstrated an interesting correlation between processes key to ECFC vascular regeneration, including proliferation and network formation, and activation of TRPV1 channels, which are expected to be endogenously expressed in ECFCs (32). In addition, we recently reported that polymer photoexcitation leads to selective TRPV1 activation in transfected human embryonic kidney (HEK) cell models (33). Therefore, we were prompted to evaluate whether the increase in cell proliferation is distinctively determined by a polymer-mediated photoactivation of the TRPV1 channel. To this goal, we preliminarily checked the actual expression of the TRPV1 channel in the ECFC models by carrying out electrophysiology experiments in patch-clamp configuration. Methods and results are extensively discussed in the Supplementary Materials (fig. S2 and related description). Briefly, the expression of the TRPV1 channel was confirmed, as well as the capability to selectively excite its activity through localized polymer excitation at high optical power density. To establish whether the TRPV1 channel also has a role in the observed increase in cell proliferation upon polymer excitation, we performed the experiments under light illumination upon administration of a highly specific TRPV1 antagonist [capsazepine (CPZ), 10 M], an aspecific TRPV channel inhibitor [ruthenium red (RR), 10 M], and a selective antagonist of a different temperature-sensitive channel, TRPV4, which is also endogenously expressed in ECFCs (RN-1734, 20 M) (34) (Fig. 2B). TRPV1 inactivation by CPZ and RR results in a relative, strong reduction in cell proliferation by 51 and 30%, respectively, as compared with untreated cells. Conversely, in the case of RN-1734 treatment, the proliferation increase due to polymer photoexcitation is completely unaltered.

As mentioned earlier, intracellular Ca2+ signaling has been reported to drive ECFC proliferation (26, 28). To further investigate whether TRPV1-mediated extracellular Ca2+ entry mediates the proangiogenic response to light illumination, we pretreated ECFCs with [1,2-Bis(2-aminophenoxy)ethane-N,N,N,N-tetraacetic acid tetrakis(acetoxymethyl ester) BAPTA-AM] (30 M), a membrane-permeable buffer of intracellular Ca2+ levels (26, 28). BAPTA-AM is widely used to prevent the increase in intracellular Ca2+ concentration ([Ca2+]i) induced by extracellular stimuli and inhibits the downstream Ca2+-dependent processes. For instance, BAPTA-AM represents the most suitable tool to prevent the activation of Ca2+-sensitive decoders residing within tens of nanometers from the inner pore of plasmalemmal Ca2+ channels (35). It was recently reported that, in the absence of Ca2+-mobilizing growth factors, it does not impair the low rate of ECFC growth (27). Here, however, BAPTA-AM clearly reduced the light-driven proliferation increase, thus confirming that TRPV1 stimulates ECFCs through an increase in [Ca2+]i (Fig. 2B).

We further examined the physiological outcome of chronic light stimulation by carrying out a tube formation assay within an extracellular matrix protein-based scaffold, which is a surrogate of the basement membrane extracellular matrix. This assay recapitulates many steps of the angiogenic process, including adhesion, migration, protease activity, and tubule formation (27, 28). ECFCs were plated in the presence of EBM-2 medium supplemented with 2% fetal calf serum and subjected to the long-term lighting protocol for 8 hours at controlled levels of temperature and CO2. Control experiments carried out in dark conditions, either onto glass (see Fig. 3A for a representative optical image) or onto polymer substrates (Fig. 3C), as well as control experiments carried out upon photoexcitation of cells seeded on glass substrates (Fig. 3B), do not show remarkable differences. Conversely, ECFC cultures subjected to polymer-mediated optical excitation clearly tend to assemble into an extended bidimensional capillary-like network (Fig. 3D). Cell cultures were monitored up to 24 hours after illumination onset, but results were comparable to observations reported here, after 8 hours of illumination. This qualitative observation is fully confirmed by quantitative morphological analysis (27). As depicted in the sketch of Fig. 3E, we quantitatively evaluated the main features typical of the capillary-like network formation and, in particular, the number of master segments (Fig. 3F), master junctions (Fig. 3G), and meshes (Fig. 3H). In all cases, a notable, statistically relevant difference is observed between cells subjected to polymer-mediated optical excitation and controls. Within the same considered temporal window, the combined use of polymer substrates and visible light stimuli does not lead to sizable toxicity effects or delays in cell proliferation. Conversely, it leads to enhanced cell proliferation (Fig. 2) and allows the achievement of the formation of a more extended and mature tubular network (Fig. 3).

(A to D) Representative images of in vitro tubular networks of ECFCs subjected to long-term optical excitation seeded on both bare glass and P3HT, as well as on corresponding control samples in dark conditions. Cultures were observed up to 24 hours, but their appearance did not substantially change after pictures were taken after 8-hour culture. Scale bars, 250 m. (E) Sketch representing the main features typical of the capillary-like network that were considered for the topologic analysis. Number of master segments (F), master junctions (G), and meshes (H) analyzed in the different conditions. The results are represented as the means SEM of three different experiments conducted on cells harvested from three different donors. The significance of differences was evaluated with one-way ANOVA coupled with Tukey post hoc test. **P < 0.01 and ***P < 0.001.

As evidenced for the proliferation rate, the TRPV1 channel activation emerges to play also a fundamental role in tubulogenesis (Fig. 4). The TRPV1 pharmacological blockade with the specific inhibitor CPZ deterministically leads to a marked reduction in network formation (Fig. 4A). Upon CPZ administration, a statistically significant decrease in the relative variation of the number of master segments (Fig. 4E), master junctions (Fig. 4F), and meshes (Fig. 4G) is observed. In line with the results shown in Figs. 2 and 3, RR administration resulted in a less marked but still sizable reduction in the tubular network (Fig. 4, B and E to G), probably due to the minor specificity toward TRPV1, while the protubular effect of light remained fully unaltered in the presence of the TRPV4 inhibitor RN-1734 (Fig. 4, C and E to G). Notably, the treatment with BAPTA-AM (30 M), which affected ECFC proliferation, was able to prevent also in vitro tubulogenesis, thus corroborating the key role of intracellular Ca2+ signaling in the proangiogenic response to light illumination (Fig. 4, D and E to G). Control measurements carried out in dark conditions on polymer substrates upon the considered pharmacological treatments do not show any relevant effect (fig. S4, A to C). Overall, this evidence supports the notion that TRPV1 stimulates ECFC proliferation and network formation and demonstrates that optical excitation, properly mediated by biocompatible polymer substrates, positively affects ECFC fate by spatially and temporally selective activation of the TRPV1 channel.

(A to D) Representative optical images of in vitro tubular network of ECFCs subjected to long-term optical excitation seeded either on bare glass or on P3HT thin films and treated respectively with CPZ (A), RR (B), RN-1734 (C), and BAPTA-AM (D). Scale bars, 250 m. (E to G) Relative variation of number of master segments (E), master junctions (F), and meshes (G) of ECFCs subjected to long-term optical excitation seeded on P3HT in the absence [control (CTRL)] and presence of 10 M CPZ, 10 M RR, 20 M RN-1734 (RN-1734), and 30 M BAPTA-AM (BAPTA). The results are represented as the means SEM of three different experiments conducted on cells harvested from three different donors. The significance of differences was evaluated with one-way ANOVA coupled with Dunnetts post hoc test. *P < 0.05 and **P < 0.01.

We now turn our attention to elucidating the possible mechanisms leading to optically enhanced tubulogenesis, through TRPV1 channel activation, upon prolonged polymer excitation.

Reliable optical modulation of the cell activity mediated by polymer photoexcitation has been reported in several, previous reports, both in vitro, at the level of single cells, and in vivo, at the level of the whole animal, as evidenced by behavioral studies on both invertebrate and vertebrate models. Three different photostimulation mechanisms, active at the polymer/cell interface, have been proposed so far. These include (i) the creation of an interface capacitance, i.e., of a localized electric field, possibly affecting the cell membrane potential (11); (ii) photothermal processes, establishing a localized temperature increase upon polymer photoexcitation (13, 36); and (iii) photoelectrochemical reactions, mainly oxygen reduction processes, leading to a local variation of extracellular and/or intracellular pH (33) and sizable production of reactive oxygen species (ROS), at a nontoxic concentration, and intracellular calcium modulation (37).

In electrophysiological experiments, carried out at a photoexcitation density higher than the one used in chronic stimulation by about two orders of magnitude, we clearly observe TRPV1 excitation, corresponding however to a small variation of the cell membrane potential, in the order of a few millivolts (Supplementary Materials). Thus, upon much lower light intensity, the effects of either direct photothermal channel activation and of photocapacitive charging are expected to be negligible. To further corroborate this hypothesis, we carry out control experiments aimed at disentangling photoelectrical from photothermal transduction processes.

First, we use a different material as a cell-seeding substrate, characterized by optical absorption and heat conductivity similar to the ones typical of P3HT (13) but fully electrically inert (i.e., unable to sustain electronic charge generation upon photoexcitation). The material of choice is a photoresist (MicroPosit S1813). S1813 thin films are realized by spin coating, and deposition parameters are optimized to obtain optical absorbance values similar to the semiconducting polymer samples at the considered excitation wavelength. The capability of photoresist substrates to sustain ECFC proliferation was successfully assessed in a control measurement, obtaining fully comparable results with respect to the P3HT substrates (Fig. 5A). The functional effect eventually driven by photoresist optical excitation on tubulogenesis was then investigated by using the same experimental conditions and analysis technique previously adopted for polymer and glass substrates (Fig. 5B). Data show that long-term photoresist excitation does not lead to sizable enhancement of the cellular network formation, thus pointing out that a purely photothermal effect does not play a major role in boosting the tubulogenesis process at variance with semiconducting polymer substrates. In a complementary experiment, we directly assessed the occurrence of photoelectrochemical reactions at the polymer/extracellular bath interface by measuring ROS production. We previously demonstrated that P3HT polymer thin films exposed to saline electrolytes sustain efficient light-triggered charge generation and charge transfer processes, giving rise to photoelectrochemical reactions (38, 39). Moreover, we also reported that P3HT nanoparticles are efficiently internalized within the cytosol of secondary line cell models (HEK-293) and that their photoexcitation leads to the production of ROS and subsequent intracellular calcium modulation (15, 37). However, the actual capability to sustain photoelectrochemical reactions in the specific experimental conditions used in this work (polymer film deposition conditions, sterilization process, prolonged exposure to specific cellular growth medium in an incubating environment, prolonged exposure to a light excitation protocol, light wavelength, pulses duty cycle, and power density) was never assessed. In particular, direct measurement of intracellular ROS was never carried out in the presence of polymer thin films. To this goal, we realized ECFC cultures on top of polymer and glass control substrates, and we exposed them to the same optical stimulation protocol previously used in the tubulogenesis assay. ROS production was then evaluated by means of a fluorescence experiment based on the use of the well-known ROS probe 2,7-dichlorodihydrofluorescein diacetate (H2DCF-DA) (Fig. 5C). Results show that light induces an increase in ROS production both on glass and polymer substrates. Relative percentage variation amounts to +34 and +200%, respectively, thus pointing out that polymer surface photocatalytic activity plays a major role in the phototransduction phenomenon.

(A) An electrically insulating, thermally conducting material (photoresist) is successfully used as an ECFC seeding substrate. (B) Photoresist long-term photoexcitation does not lead to sizable enhancement in tubulogenesis parameters. (C) Evaluation of intracellular ROS production following long-term photoexcitation protocol of ECFC cultures on polymer and glass substrates (glass dark, n = 629; glass light, n = 656; P3HT dark, n = 686; and P3HT light, n = 583). For each panel, the results are represented as the means SEM of three different experiments conducted on cells harvested from three different donors. The significance of differences was evaluated with unpaired Students t test (A and B) or one-way ANOVA coupled with Tukey post hoc test (C). ***P < 0.001.

Altogether, data in Fig. 5 indicate that photoelectrochemical reactions induced by light at the interface between the organic semiconducting polymer and the extracellular bath play a key role in triggering the observed enhancement in cell network formation through indirect activation of the TRPV1 channel. The occurrence of faradaic phenomena at the polymer/bath interface may give rise to material degradation effects. The photostability of the polymer substrates was carefully checked by optical absorption, photoluminescence, and Raman spectra measurements. By treating the samples with the same experimental protocol used for cell tubulogenesis assays (photoexcitation density, pulses frequency, overall exposure duration, temperature, and humidity levels), no sign of irreversible polymer degradation was observed, as compared with nonilluminated samples (fig. S5).

The Ca2+-sensitive transcription factor NF-B might provide the missing link between the influx of Ca2+ through TRPV1 and the increase in proliferation and tubulogenesis observed in ECFCs upon photostimulation (26). We therefore monitored the nuclear translocation of the cytoplasmic p65 NF-B subunit via immunofluorescence staining and mRNA levels of a number of genes induced during tubulogenesis in an NF-Bdependent manner (26, 40) (Fig. 6). Our data indicate that ECFCs seeded on polymer and subjected to light stimulation have a significantly enhanced p65 NF-B nuclear translocation compared with the control conditions consisting of cells also seeded on P3HT but kept in dark conditions (+35% versus P3HT dark; P < 0.05; Fig. 6, A and B), and seeded on bare glass (+28% versus glass dark; P < 0.05; Fig. 6B). No differences were observed between samples seeded on glass, whether they were subjected to optical excitation or not (fig. S6).

ECFCs seeded on P3HT samples and glass controls are subjected to long-term photostimulation protocol. Corresponding control samples are kept in dark conditions. After photostimulation, p65 NF-B nuclear translocation (A and B) and mRNA levels of tubulogenic/angiogenic genes that have been shown to be activated downstream of NF-B (C) are evaluated. (A) Representative images of immunofluorescence staining showing p65 NF-B (green) nuclear translocation. Cell nuclei are detected by 4,6-diamidino-2-phenylindole (DAPI) (blue). Scale bars, 50 m. (B) Quantitative evaluation of p65 NF-B nuclear translocation, as evidenced by colocalization experiments. Results are expressed as means SEM of the relative percentage of p65 nucleipositively stained cells to the total number of cells (glass dark, n = 151; glass light, n = 125; P3HT dark, n = 147; and P3HT light, n = 159). Ten fields per condition are analyzed. Data are obtained from two different experiments conducted on cells harvested from two different donors. (C) mRNA levels of intercellular adhesion molecule 1 (ICAM1), selectin E (SELE), and matrix metalloproteinases (MMP1, MMP2, and MMP9) are quantified by real-time polymerase chain reaction (PCR). Data are expressed as means SEM of percentage variation with respect to cells grown in the dark (n = 6). The significance of differences was evaluated with unpaired Students t test (C) or one-way ANOVA coupled with Tukey post hoc test (B). *P < 0.05 and **P < 0.01.

In addition, we have checked the expression of nine genes whose expression is known to be induced in endothelial cells during tubulogenesis/angiogenesis in an NF-Bdependent manner. We considered intercellular adhesion molecule 1 (ICAM1); vascular adhesion molecule 1 (VCAM1); selectin E (SELE), matrix metalloproteinases (MMPs) 1, 2, and 9; vascular endothelial growth factor A (VEGFA); cyclooxygenase 2 (COX2, PTGS2); and cyclin D1 (CCND1) (40). Of these, five are significantly up-regulated by light exposure in cells grown on P3HT substrates, namely, ICAM1 (+90% versus P3HT dark; P < 0.05), SELE (+1119%; P < 0.01), MMP1 (+242%; P < 0.01), MMP2 (+467%; P < 0.05), and MMP9 (+458%; P < 0.05) (Fig. 6C). Conversely, VCAM1, VEGFA, PTGS2, and CCND1 do not show relevant variation upon light stimulation (fig. S7A). Light excitation on cells grown on bare glass substrates does not show any significant effect as compared with control samples in dark conditions (fig. S7B).

Therapeutic angiogenesis via autologous EPC transplantation represents a promising strategy to preserve or, at least, partially restore cardiac function after myocardial infarction (24, 41). Nevertheless, the regenerative outcome of EPC-based therapies in preclinical studies was rather disappointing and did not lead to sufficient neovascularization of the ischemic heart (41). This led to the proposal to boost their angiogenic activity by using emerging technologies, including tissue engineering of vascular niches, pharmacological preconditioning, or genetic and epigenetic reprogramming (42). ECFCs are regarded among the most suitable EPC subtypes to induce therapeutic angiogenesis and cardiac regeneration due to their high clonal proliferative potential and ability to assemble into capillary-like structures (23, 24). In addition, they can be easily isolated and expanded from the peripheral blood of patients and healthy donors. It has recently been suggested that their angiogenic activity could be boosted by targeting the intracellular Ca2+ toolkit (29). Here, we target ECFCs by adopting a fully different approach, i.e., by exploiting visible light as a modulation trigger and by the use of a thiophene-based conjugated polymer as the exogenous, light-responsive actuator. We demonstrate that photoexcitation of the organic material deterministically leads to robustly enhanced proliferation and tubulogenesis. Pharmacological assays, supported by electrophysiology experiments, allow the identification of TRPV1 selective excitation as a key player in the molecular pathway leading to macroscopic outcomes, as observed by quantitative analysis of the angiogenic response.

All data unambiguously show that polymer photoexcitation leads to selective activation of the TRPV1 channel, which has recently been shown to be expressed and drive angiogenesis in human ECFCs (32). TRPV1 is a polymodal Ca2+-permeable channel that integrates multiple chemical and physical cues to sense major changes in the local microenvironment of most mammalian cells (43). TRPV1 is activated by either noxious heat (>42C) and acidic solutions (pH < 6.5), whereas mild acidification (pH 6.3) of the extracellular milieus sensitizes TRPV1 to heat stimulation and results in channel activation at temperature thresholds (30 to 32C) well below the normal one (43). ROS production is also expected to further contribute to TRPV1 activation, as previously reported in mouse coronary endothelial cells (44), in which hydrogen peroxide elicits a depolarizing inward current at negative holding potentials. Likewise, ROS may stimulate TRPV1 to depolarize the membrane potential, thereby triggering trains of action potentials in airway C fibers (45, 46).

On the basis of measurements carried out in cells seeded on the photoresist substrate, as well as on direct evaluation of a limited, local temperature increase upon light stimuli during the long-term photoexcitation protocol, we infer that the excitation of the TRPV1 channel through direct photothermal transduction is not the predominant process leading to enhanced tubulogenesis.

We have previously demonstrated that polymer photoexcitation leads to generation of faradaic current, to electron transfer reactions at the polymer/electrolyte interface, and to sizable intracellular enhancement of ROS (37, 38). Briefly, optical excitation of P3HT polymer thin films leads to photoexcited species (Eq. 1), namely, singlets and charge states, which react with the oxygen dissolved in the cell medium, thus reducing oxygen (Eq. 2)P3HT+hP3HT*(1)P3HT*+O2P3HT++O2(2)

The superoxide further evolves, leading to the generation of different ROS and, lastly, ending up with hydrogen peroxide production. It has been reported that extracellular H2O2 can cross the plasma membrane through aquaporin AQP3, thereby triggering intracellular ROS signaling (47, 48). In line with our previous results, we have demonstrated here that intracellular ROS enhancement does occur in ECFCs upon photoexcitation of polymer thin films, thus contributing to TRPV1 activation.

Altogether, the evidence supports the hypothesis of a transduction mechanism mainly governed by photoelectrochemical reactions. Moreover, these same observations could explain why TRPV4, which is also expressed in ECFCs (34), is not sensitive to optical modulation. Although TRPV4 is activated by moderate heat (24 to 38C), it is supposed to be inhibited by local pH variation, although this is still a matter of debate (49, 50).

On the one hand, the role attributed in the phototransduction mechanism to the capability of the polymer to generate and transport electronic charges, as well as to its photocatalytic activity in an aqueous environment, clearly implies the need for a biocompatible, visible lightresponsive, semiconducting material. This excludes any possible implementation of the reported technique by using a thermally conducting, electrically insulating plastic substrate. Suitable cell-seeding materials have to be selected and developed within the wide arena of organic semiconducting polymers. On the other hand, the key role played by ROS raises additional issues about material photostability, cell viability, and overall safety and reliability of the technique. We extensively verified that the main polymer optoelectronic properties are not substantially altered by the exposure to light and to incubating conditions. From the biological point of view, it is very well known that high ROS levels can induce highly toxic effects and, finally, lead to cell death. We notice, however, that the established photoactivation protocol (illuminator geometry and air flow, light photoexcitation density, duty cycle, and repetition rate) has been implemented to avoid any detrimental effect. Accordingly, no toxicity effects were detected for the overall duration of the experiments, as proven by the robust increase in ECFC proliferation and tubulogenesis exposed to light. This observation is consistent with the emerging notion that appropriate ROS levels can exert a signaling role and control angiogenesis in endothelial cells (51).

The biophysical mechanisms whereby the photoactivation of TRPV1 stimulates in vitro angiogenesis in ECFCs deserve a more detailed discussion as well. Earlier work showed that TRPV1 stimulates proliferation and tube formation in vascular endothelial cells by mediating extracellular Ca2+ entry. The following increase in intracellular Ca2+ concentration ([Ca2+]i) leads to the recruitment of several downstream Ca2+-dependent decoders, such as endothelial nitric oxide synthase and Ca2+/calmodulin-dependent protein kinase II (CaMKII) (52). Recently, TRPV1 was found to induce also proliferation and tube formation in ECFCs by mediating the uptake of the endocannabinoid anandamide (32). This study, however, did not investigate whether TRPV1 activation was per se able to stimulate ECFCs by engaging Ca2+-dependent pathways. Intracellular Ca2+ signaling is a crucial determinant of ECFC fate and behavior (2628). Accordingly, light-induced ECFC proliferation and tube formation were markedly reduced by the pharmacological blockade of TRPV1-mediated Ca2+ entry with CPZ and RR and by preventing the subsequent increase in [Ca2+]i with BAPTA-AM. This finding endorses the view that optical excitation stimulates ECFCs through TRPV1-mediated extracellular Ca2+ entry, and we suggest here that this occurs via downstream activation of transcriptional factor NF-B. NF-B has previously been shown to stimulate cell proliferation and tubulogenesis in endothelial cells (53, 54) and in hepatocytes (55). Our group has shown that NF-B triggers the transcriptional program underlying the angiogenic response to extracellular Ca2+ entry in ECFCs (26). Moreover, NF-B activation in response to extracellular stimulation and Ca2+ entry through TRPV1 has also been demonstrated (56, 57). Under resting conditions, NF-B is retained in the cytoplasm by the complex with the inhibitory protein IB. An increase in [Ca2+]i results in IB degradation by ubiquitination, which is triggered upon the Ca2+-dependent phosphorylation of IB. As a consequence, the p65 NF-B subunit is released from IB inhibition and translocates into the nucleus (58) where it induces the expression of multiple proangiogenic genes (40). Consistently, we found that optical excitation significantly boosted the nuclear translocation of p65 in ECFCs cultured on the conjugated polymer compared with those not exposed to light. Robust up-regulation of several angiogenic genes, such as ICAM, SELE, MMP1, MMP2, and MMP9, which are under NF-Bdependent transcriptional control, was also consequently observed. Intriguingly, NF-B also mediates VEGFA-induced gene expression and angiogenesis in vascular endothelial cells (59, 60) through an increase in [Ca2+]i (61). These observations strongly hint at NF-B as the Ca2+-sensitive decoder that translates optical excitation into an angiogenic response in human ECFCs interfaced with the light-sensitive conjugated polymer.

Overall, our findings represent the proof of principle that optical modulation may be successfully exploited to directly control the fate of a progenitor cell population, i.e., ECFCs, which has been shown to support revascularization of ischemic tissues. The in vitro activation of ECFC angiogenic activity is made possible by the use of a biocompatible, light-sensitive polymer as the phototransduction element.

The combined use of optical excitation and organic polymer technology can open interesting perspectives for several different reasons. First, the use of light modulation allows unprecedented spatial and temporal resolution to be achieved in a fully reversible way. Light temporal and spatial patterns can be specifically designed and adapted to different in vitro cell models, allowing ideally endless combinations of possibilities, to finely tune overall output in cell proliferation and network formation. The demonstrated technology is minimally invasive, allows for massive parallelization of experiments, and can be virtually implemented in any cell therapy model in a straightforward way. In addition, the use of different polymers, with lower energy gap and in the form of nanobeads, may pave the way to the optical enhancement of therapeutic angiogenesis in vivo. Further work is needed to understand whether the pattern and/or intensity of the illumination protocol may be adjusted to further boost the angiogenic response. For instance, the optical excitation protocol consisted of 30-ms-long light pulses that were delivered at 1 Hz for 4 (tubulogenesis) up to 36 (proliferation) hours. This is likely to result in oscillations in [Ca2+]i, which are known to deliver the most instructive signal for ECFCs to undergo angiogenesis by inducing the nuclear translocation of the p65 NF-B subunit (26). As the frequency of intracellular Ca2+ oscillations can be artificially manipulated to regulate NF-Bdependent gene expression in virtually any cell type (62), we envisage an additional layer of specificity and control that could be exploited to further improve the angiogenic response to optical excitation. Future work will also be devoted to assess the outcome of optical modulation on patient-derived ECFCs. One of the main hurdles associated to autologous cell-based therapy is the impairment of the angiogenic activity of EPCs, including ECFCs harvested from cardiovascular patients (29). The therapeutic translation of our findings will require the demonstration that light-induced TRPV1 activation boosts angiogenesis also in ECFCs derived from individuals affected by severe cardiovascular disorders, such as hypertension, atherosclerosis, and heart failure. In this view, the combination of organic semiconductors and genetic manipulation to increase endogenous TRPV1 expression could be sufficient to restore the reparative phenotype of autologous ECFCs from cardiovascular patients.

Regioregular P3HT (99.995% purity; Mn 54,000 to 75,000 molecular weight) was purchased from Sigma-Aldrich and used without any further purification. The samples for cell cultures were prepared by spin coating on a square 18 mm by 18 mm glass (VWR International) substrates carefully rinsed in subsequent ultrasonic baths of ultrapure water, acetone, and isopropanol. P3HT solution was prepared in chlorobenzene at a final P3HT concentration of 20 g/liter and spin coated on the cleaned substrates with a two-step recipe: (i) 3 s at 800 rpm and (ii) 60 s at 1600 rpm. Polymer film thickness is about 150 nm.

Microposit S1813 photoresist was purchased from Shipley and used without any further purification. Photoresist thin films were prepared by spin coating on cleaned substrates with a two-step recipe: (i) 3 min at 300 rpm and (ii) 30 s at 2600 rpm. Parameters were adjusted to obtain homogeneous films and similar optical absorbance to the one of the polymer thin films, at the same excitation wavelength used in the long-term stimulation protocol (see below). All films were thermally treated in an oven at 120C for 2 hours for annealing and sterilization. To promote adhesion, samples were coated with fibronectin (from bovine plasma; Sigma-Aldrich) at a concentration of 2 mg/ml in phosphate-buffered saline (PBS) for at least 30 min at 37C and then rinsed with PBS.

ECFCs were isolated from peripheral blood and expanded as shown elsewhere (26). Blood samples (40 ml) collected in EDTA-containing tubes were obtained from healthy male human volunteers aged from 28 to 38 years. The Institutional Review Board at Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo Foundation in Pavia approved all protocols and specifically approved this study. Informed written consent was obtained according to the Declaration of Helsinki of 1975 as revised in 2008. We focused on the so-called ECFCs, a subgroup of EPCs that are found in the CD34+ CD45 fraction of circulating mononuclear cells (MNCs), exhibit robust proliferative potential, and form capillary-like structures in vitro (23). To isolate ECFCs, MNCs were obtained from peripheral blood by density gradient centrifugation on lymphocyte separation medium for 30 min at 400g and washed twice in EBM-2 with 2% fetal calf serum. A median of 36 106 MNCs (range, 18 to 66) was plated on fibronectin-coated culture dishes (BD Biosciences) in the presence of the endothelial cell growth medium EGM-2 MV (Lonza) containing endothelial basal medium (EBM-2), 5% fetal bovine serum (FBS), recombinant human (rh) EGF, rhVEGF, recombinant human Fibroblast Growth Factor-Basic (rhFGF-B), recombinant human Insulin-like Growth Factor-1 (rhIGF-1), ascorbic acid, and heparin and maintained at 37C in 5% CO2 and humidified atmosphere. Nonadherent cells were discarded after 2 days, and thereafter, medium was changed three times a week. The outgrowth of ECFCs from adherent MNCs was characterized by the formation of a cluster of cobblestone-shaped cells. That ECFC-derived colonies belonged to the endothelial lineage was confirmed by staining with anti-CD31, anti-CD105, anti-CD144, anti-CD146, antivon Willebrand factor, anti-CD45, and anti-CD14 monoclonal antibodies and by assessment of capillary-like network formation in the in vitro tube formation assay.

For our experiments, we have mainly used endothelial cells obtained from early-passage ECFCs (P2-4, which roughly encompasses a 15- to 18-day period) with the purpose to avoid, or maximally reduce, any potential bias due to cell differentiation. However, to make sure that the phenotype of the cells did not change throughout the experiments, in the preliminary experiments, we tested the immunophenotype of ECFCs at different passages, and we found no differences. We also tested whether functional differences occurred when early (P2) and late (P6)passage ECFCs were used by testing the in vitro capacity of capillary network formation in a Cultrex assay and found no differences between early- and late-passage ECFC-derived cells (data not shown).

Electrophysiological recordings were performed using a patch-clamp setup (Axopatch 200B; Axon Instruments) coupled to an inverted microscope (Nikon Eclipse Ti). ECFCs were measured in whole-cell configuration with freshly pulled glass pipettes (3 to 6 M), filled with the following intracellular solution: 12 mM KCl, 125 mM K-gluconate, 1 mM MgCl2, 0.1 mM CaCl2, 10 mM EGTA, 10 mM Hepes, and 10 mM ATP (adenosine 5-triphosphate)Na2. The extracellular solution contained the following: 135 mM NaCl, 5.4 mM KCl, 5 mM Hepes, 10 mM glucose, 1.8 mM CaCl2, 1 mM MgCl2. Only single cells were selected for recordings. Acquisition was performed with the pCLAMP 10 software (Axon Instruments). Membrane currents were low pass filtered at 2 kHz and digitized with a sampling rate of 10 kHz (Digidata 1440 A; Molecular Devices). Data were analyzed with Clampfit (Axon Instruments) and Origin 8.0 (OriginLab Corporation).

For optical excitation of the polymer, a homemade petri cell culture illuminator, compatible with the use within the cell incubator, was designed and implemented. Its design included a black spacer made by fused filament fabrication, both to minimize overheating effects in the extracellular bath and to avoid unwanted light scattering/diffusion effects and cross-talk between different specimens. Optical excitation was provided by a green LED system, whose duty cycle, repetition rate, and intensity were set through a custom-made control circuit, comprising a microcontroller, a digital-to-analog converter, and an analog LED driver. The driver was connected to five green LEDs (SMB1N-525V-02; Roithner LaserTechnik GmbH, Vienna, Austria), with maximum emission wavelength at 525 nm, each carrying a collimator lens reducing the emission angle to 22. This way, up to five 3.5-cm petri dishes can be simultaneously treated with a homogeneous photoexcitation density of 40 mW/cm2. The long-term optical excitation protocol adopted for cell fate modulation consists of 30-ms-long pulses, followed by 70-ms-long dark conditions, continuously repeated for a minimum of 4 up to 36 hours in the case of tubulogenesis and proliferation assays, respectively.

Growth dynamics were evaluated by plating a total of 5 103 ECFC-derived cells into 10-mm fibronectin-treated cloning cylinders (5 104/cm2) in the presence of EGM-2 MV medium to facilitate the adhesion. After 12 hours, the medium was switched to EBM-2 supplemented with 2% fetal calf serum. For the pharmacological treatment, one of compounds was added to the medium: BAPTA (30 M), CPZ (10 M), RN-1734 (20 M), or RR (10 M). Cultures were incubated at 37C (in 5% CO2 and humidified atmosphere), and cell growth was assessed after 36 hours since the beginning of the long-term illumination protocol. At this point, cells were recovered by trypsinization from all the dishes, and the cell number was assessed by counting in a hemocytometer. Preliminary experiments showed no unspecific or toxic effect for each agent when used at these concentrations. Each assay was repeated in triplicate.

ECFC-derived cells from early-passage (P2 to P4) cultures were obtained by trypsinization and resuspended in EBM-2 supplemented with 2% FBS. EPC-derived cells (10 103) per well were plated in Cultrex basement membrane extract (Trevigen Inc., Gaithersburg, MD, USA) 10-mm fibronectin-treated cloning cylinders. Plates were then incubated at 37C, 5% CO2, and capillary network formation was assessed starting from 4 to 24 hours later. At least three different sets of cultures were performed every experimental point. Quantification of tubular structures was performed after 8 hours of incubation by measuring the total length of structures per field with the aid of the ImageJ software (National Institutes of Health, USA; http://rsbweb.nih.gov/ij/). To evaluate the role of TRPV1, the same protocol was repeated in the presence of the following drugs: BAPTA (30 M), CPZ (10 M), RN-1734 (20 M), or RR (10 M).

H2DCF-DA (Sigma-Aldrich) was used for the intracellular detection of ROS. ECFCs were seeded onto polymer and control substrates and subjected to the same photoexcitation protocol used for the in vitro tube formation assay. Immediately after the end of the protocol, cell cultures were incubated with the ROS probe for 30 min. After careful washout of the excess probe from the extracellular medium, the fluorescence of the probe was recorded (excitation/emission wavelengths, 490/520 nm; integration time, 70 ms for H2DCF-DA) with an inverted microscope (Nikon Eclipse Ti) equipped with an Analog-WDM Camera (CoolSNAP MYO, Teledyne Photometrics). To minimize the effects of the spectral overlap between the polymer absorption and emission spectra, and the probe emission, samples were turned upside down by using a homemade chamber with a 500-m-thick channel filled with extracellular medium. Variation of fluorescence intensity was evaluated over regions of interest covering single-cell areas, and reported values represent the average over multiple cells. See figure captions for additional details about statistical analysis. Image processing was carried out with ImageJ and subsequently analyzed with Origin 8.0.

Two sets of P3HT thin films (n = 12) were prepared as described above. The optical absorbance, the emission, and the Raman spectrum were measured immediately after fabrication. Then, all samples were exposed to ECFC growth medium (EBM-2 supplemented with 2% FBS) and incubated at 37C, 5% CO2 for 24 hours. The first set was taken in dark conditions (n = 6), and the second one was treated with the same optical excitation protocol used in the tubulogenesis assays (n = 6). After incubation, absorption, emission, and Raman spectrum were measured again in the same conditions as before. Absorption spectra were recorded by using a spectrophotometer (PerkinElmer Lambda 1040) in transmission mode. Photoluminescence spectra were acquired by using a Jobin-Yvon spectrofluorometer; the excitation wavelength was set at the polymer absorption peak wavelength (530 nm). Resonant Raman spectra were recorded by using visible light excitation at 532 nm (HORIBA Jobin-Yvon HR800 micro-Raman spectrometer system). Laser power intensity on the sample was kept at values lower than 0.03 mW to avoid laser-induced sample degradation. Spectra were typically recorded in the region 600 to 2000 cm1 and were calibrated against the 520.5 cm1 line of an internal silicon wafer. The signal-to-noise ratio was enhanced by repeated acquisitions (100). The measurements were conducted at room temperature (RT), and the resulting spectral resolution was 0.4 cm1.

To examine NF-B p65 subunit translocation into the nucleus in the individual ECFCs, the coverslips were fixed with 4% formaldehyde in PBS (20 min at RT) and permeabilized with 0.1% Triton X-100 in PBS (7 min at RT). Primary rabbit polyclonal anti-p65 antibody (Santa Cruz Biotechnology, catalog no. Sc-372) was applied at a final dilution of 1:100 for 1 hour at 37C in a humidified chamber. After three washes with PBS, secondary chicken anti-rabbit Alexa(488)-conjugated antibody (1:200; Invitrogen, catalog no. A-21441) was applied for 1 hour at RT. After washing (three times in PBS), nuclei were counterstained with 4,6-diamidino-2-phenylindole, dihydrochloride (DAPI; 1:5000 dilution in PBS; 20 min at RT; Invitrogen, catalog no. D1306). Last, the coverslips with cells were mounted on microscope glass slides using Fluoroshield mount medium (Sigma, catalog no. F6182). Fluorescence images were taken with the same fluorescence microscope used for the electrophysiology experiments, using standard DAPI and fluorescein isothiocyanate filters set for the acquisition of DAPI and Alexa(488) fluorescence emission, respectively.

Cells were lysed in 0.5 ml of TRI Reagent (Sigma, catalog no. T9424), and total RNA was extracted according to the manufacturers protocol. One microgram of total RNA was retrotranscribed using SensiFAST cDNA Synthesis Kit (Bioline, London, UK, catalog no. BIO-65054). Real-time polymerase chain reaction (PCR) was performed using iTaq qPCR master mix according to the manufacturers instructions (Bio-Rad, Segrate, Italy, catalog no. 1725124) on a SFX96 Real-Time System (Bio-Rad). As a control, S18 ribosomal subunit was used, whose expression did not change across the conditions. For each gene, Ct was calculated by using the formula Ct = 2^(Ct(gene) Ct(S18)). The data are expressed as a percentage variation between P3HT light and glass light conditions and P3HT dark and glass dark samples, respectively. Sequences of oligonucleotide primers are listed in table S1.

The significance of differences was evaluated with unpaired Students t test or one-way analysis of variance (ANOVA) coupled with Tukey or Dunnetts post hoc test, as appropriate. Data are represented as means standard error of the mean (SEM). P < 0.05 was considered statistically significant. Statistical analysis was performed using the GraphPad Prism 7 software (GraphPad Software Inc., La Jolla, CA).

Supplementary material for this article is available at http://advances.sciencemag.org/cgi/content/full/5/9/eaav4620/DC1

Fig. S1. Local and global evaluation of the extracellular bath temperature.

Fig. S2. TRPV1 is endogenously expressed in ECFCs, and it is efficiently activated by polymer photostimulation.

Fig. S3. Current clamp measurements in HEK-293 cells.

Fig. S4. Pharmacological study on ECFCs seeded on polymer substrates in the darkEvaluation of effect on tubulogenesis.

Fig. S5. Polymer photostability.

Fig. S6. p65 NF-B nuclear translocation is unaltered in ECFCs seeded on glass subjected to light-induced photostimulation.

Fig. S7. mRNA levels of proangiogenic genes downstream of NF-B signaling.

Table S1. List of oligonucleotide primers used for real-time PCR.

This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial license, which permits use, distribution, and reproduction in any medium, so long as the resultant use is not for commercial advantage and provided the original work is properly cited.

Acknowledgments: We gratefully thank I. Abdel Aziz for the characterization of the homemade petri cell culture illuminator used for long-term optical excitation and P. Falvo for the constructive criticism of the manuscript and the helpful scientific discussions. Funding: This work was jointly supported by the European Research Council (ERC) under the European Unions Horizon 2020 research and innovation program LINCE, grant agreement no. 803621 (M.R.A.), the EU Horizon 2020 FETOPEN-2018-2020 Programme LION-HEARTED, grant agreement no. 828984 (F.L., F.M., and M.R.A.), the Italian Ministry of Education, University and Research (MIUR): Dipartimenti di Eccellenza Program (20182022)Department of Biology and Biotechnology L. Spallanzani, University of Pavia (F.M.), and Fondo Ricerca Giovani from the University of Pavia (F.M.). Author contributions: F.L., F.M., and M.R.A. planned the experiments. F.L. carried out the experimental measurements (electrophysiology, short- and long-term photoexcitation, evaluation of effects on proliferation, tubulogenesis, and ROS production). V.R. provided the ECFC models, took care of the cell cultures, and contributed to the tubulogenesis and proliferation experiments. G.T. prepared the polymer samples. A.D. designed, realized, and optimized the experimental setup for the long-term photoexcitation. L.T. and D.L. carried out the immunofluorescence and real-time PCR assays. P.C. contributed to the methodological discussion about gene expression. F.L. and M.R.A. wrote the main manuscript, with help from F.M. All authors contributed to the data interpretation and approved the final manuscript. Competing interests: The authors declare that they have no competing interests. Data and materials availability: All data needed to evaluate the conclusions in the paper are present in the paper and/or the Supplementary Materials. Additional data related to this paper may be requested from the authors.

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