Means and methods for preventing or reversing aging

Abstract

The present disclosure provides a means of regenerating / restoring aged and / or damaged tissue or treating a medical condition by providing a circuit containing cells outside the body, including fibroblasts or dedifferentiated fibroblasts, in contact with plasma but not with blood cells, in a manner that allows for the exchange of factors between the subject and a cell mass present outside the body. The present disclosure provides a means to titrate factors produced by extracorporeal regenerative cell masses, thereby enabling regenerative effects.

Description

[Technical field]

[0001] This application claims priority to U.S. Provisional Patent Application No. 62 / 758,240, filed November 9, 2018, which is incorporated by reference herein in its entirety.

[0002] Embodiments of the present disclosure relate to at least the fields of cell biology, molecular biology, biology, immunology, and medicine. [Background technology]

[0003] Previous studies have demonstrated that circulatory connections between young and old animals can provide systemic anti-aging effects. For example, one study investigated the effects of systemic factors on aged progenitor cells from liver tissue by establishing a shared circulatory system between young and old mice (heterochronic parabiosis) and exposing old mice to factors present in young serum. Notably, this pairing restored the activation of Notch signaling, as well as the proliferation and regenerative capacity of aged satellite cells. Furthermore, exposure of satellite cells from old mice to young serum enhanced the expression of Notch ligand (Delta), enhanced Notch activation, and enhanced proliferation in vitro. Moreover, heterochronic parabiosis increased the proliferation of aged hepatocytes and restored cEBP-α complexes to levels seen in young animals. These results suggest that the age-related decline in progenitor cell activity may be regulated by systemic factors that change with age [1]. Another study found that young blood contains factors that induce vascular remodeling, which resulted in increased neurogenesis and improved olfactory discrimination in aged mice using a similar heterochronic parabiosis model. Identification of molecular factors associated with improved cerebral vascularity and neurogenesis revealed the role of a molecule called GDF11 [2].

[0004] Unfortunately, procedures for accessing the human circulation are extremely difficult and unethical, and therefore there is a need in the art to provide regenerative factors in a practical manner to subjects in need thereof. Summary of the Invention

[0005] The present disclosure is directed to systems, methods, and compositions for providing one or more regenerative factors to one or more subjects in need thereof. Aspects of the present disclosure provide systems, compositions, and methods in which the circulatory system of a subject having a medical condition and / or aging is exposed to one or more beneficial regenerative factors produced from specific cells; where the regenerative factors are produced upon exposure of the cells to blood or plasma from the subject. In other embodiments, the subject is exposed to the system to prevent or delay the onset of one or more symptoms of aging. In certain embodiments, cells in-line in the system with the subject produce one or more regenerative factors upon exposure to one or more degenerative factors originating from the subject's circulation, and the one or more regenerative factors are provided to the subject in-line in the system. Such regenerative factors then ameliorate at least one symptom of the medical condition and / or reduce at least partially one or more effects of aging.

[0006] In certain embodiments, the disclosure utilizes an extracorporeal circuit to provide one or more regenerative factors to one or more subjects in need. In certain embodiments, the extracorporeal circuit includes tubing connecting at least one subject and at least one bioreactor. In certain embodiments, the disclosure encompasses a circuit connecting a subject and a bioreactor, where one or more specific factors are shared between the subject and the bioreactor. In certain embodiments, the disclosure separates one or more cellular components of the subject from one or more cellular components of the one or more bioreactors. In certain embodiments, this separation occurs by using at least one semi-permeable membrane in the tubing (unless hollow fibers are utilized in certain embodiments), the subject, and / or at a location within the bioreactor. In some embodiments, the bioreactor includes cells that secrete one or more factors useful to the subject. In some embodiments, the bioreactor detects one or more factors from the subject. In certain embodiments, the bioreactor secretes the factors at a rate that is dependent on the rate at which the factors are detected from the subject.

[0007] In some embodiments, the subject in need is an individual with at least one medical condition requiring treatment, and / or an age requiring supplementation of one or more factors, and / or an age requiring reduction of at least one or more adverse factors. In at least some cases, the subject is an individual with abnormal levels of factors associated with aging. In other aspects, the subject is an individual with abnormal levels, for example, chronic or acute, of degenerative factors. In some embodiments, the subject is an organ. In at least some cases, the organ is derived from an individual with abnormal levels of one or more degenerative factors and / or one or more factors associated with aging. In other cases, the organ is derived from a donor, where regenerative factors provided by a bioreactor are useful to keep the organ fully viable; the organ may need to be used, for example, for transplantation. In certain embodiments, the subject is one or more tissues.

[0008] The present invention provides a means of producing and / or utilizing cells in a bioreactor. In some embodiments of the present disclosure, the cells produced and / or utilized are from a young subject or from a subject lacking one or more signs of aging. In certain embodiments of the present disclosure, the cells produced and / or utilized have one or more cell surface molecules. In certain embodiments, the cells produced and / or utilized lack one or more specific cell surface molecules. In certain embodiments of the present disclosure, the cells produced and / or utilized are cultured using methods that enhance the ability of the cells to secrete one or more regenerative factors and / or detect or respond to one or more degenerative factors. In at least some cases, the cells produced and / or utilized are further manipulated, such as by culture using one or more viral and / or one or more non-viral methods.

[0009] An embodiment of the present disclosure includes a system for treating a subject, the system comprising: at least one bioreactor containing cells; at least one selectively permeable membrane; and Tubing connecting the at least one bioreactor, the at least one selectively permeable membrane, and the subject for circulating fluid from the subject to the bioreactor. and in certain embodiments, a membrane is optional, provided that the tubing comprises hollow fibers. The system may further include blood or plasma from the subject, or may include organ preservation fluid. The cells may be regenerative cells that allow for cell or tissue regeneration, and in certain cases, the regenerative cells are fibroblasts, dedifferentiated fibroblasts, induced pluripotent cells, parthenogenic derived cells, mesenchymal stem cells, or hematopoietic stem cells, although the stem cells may be of any type. The regenerative cells may secrete one or more regenerative factors at a basal or inducible rate. Examples of regenerative factors are selected from the group consisting of AKT, BAMBI, BCL-2, BCL-2XL, BDNF, BIRC5 CDA, CXCR4, dominant negative CCL2, EGF, exosomes, FGF-2, GATA-4 GDF-11, GDNF, hCG, HGF, HIF-1α, HLA-G, HO-1, hTERT, IFN-b, IGF-1, IFT-1, LIGHT, miR-126, NK4, NUR77, OCT-4, PGE-1, SDF-1, STC-1, TERT, TRAIL, VEGF, WNT11, XIAP, and combinations thereof. The regenerative cells may produce one or more regenerative factors in response to one or more degenerative factors from the subject's blood or plasma. In some cases, the regenerative cells secrete the regenerative factors at a set rate upon detection of the degenerative factor. The rate of secretion of the regenerative factor from the cells may be a ratio to the rate of detection of the degenerative factor by the cells. In certain embodiments, the ratio of regenerative factor secretion rate to denatured factor detection rate is selected from the group consisting of 50:1, 25:1, 10:1, 5:1, 1:1, 1:5, 1:10, 1:25, 1:50, and any ratio therebetween.

[0010] In certain embodiments of the present disclosure, the selectively permeable membrane is disposed within the tubing, e.g., between the bioreactor and the subject; the tubing may be comprised of the selectively permeable membrane; and / or the bioreactor may be at least partially comprised of the selectively permeable membrane. In some cases, the selectively permeable membrane inhibits or reduces the passage of cellular material (whole cells or fragments thereof) between the subject and the bioreactor. One or more selectively permeable membranes may allow the passage of one or more regenerative factors and one or more denaturing factors.

[0011] The system may be applied to any subject, such as a living animal, or the subject may be an organ (any part of an organ, or any part of an organ system) or tissue from an animal, and the organ or tissue may be from a donor. Examples of organs include one or more selected from the group consisting of liver, pancreas, gallbladder, stomach, small intestine, large intestine, lung, kidney, heart, spleen, brain, eyeball, and combinations thereof.

[0012] If the object comprises an organ or tissue, the system may also comprise a container connected to at least one bioreactor and at least one selectively permeable membrane for enclosing the object. In certain embodiments, the object is an organ or tissue and the container is adapted to hold the object to allow transfer of organ preservation fluid or other fluids to the tubing.

[0013] Embodiments of the present disclosure include an extracorporeal method of producing regenerative factors, comprising subjecting a subject to a system encompassed by the present disclosure under conditions that allow secretion of one or more regenerative factors from cells in the system. The cells may be fibroblasts derived from tissues including skin, heart, blood vessels, bone marrow, skeletal muscle, liver, pancreas, brain, adipose tissue, placenta, and / or foreskin. The fibroblasts may have one or more surface markers selected from the group consisting of CD73, CD90, CD56, SSEA3, SSEA4, Tra-1-60, Tra-1-81, Tra-2-54, HLA class I, CD13, CD44, CD49b, CD105, aminopeptidase N, hyaluronic acid binding receptor, collagen / laminin binding integrin alpha 2, OCT4, NANOG, SOX-2, and combinations thereof. In certain embodiments, the fibroblasts lack one or more surface markers selected from the group consisting of CD14, CD34, CD45, HLA class II, and combinations thereof.

[0014] In certain embodiments of the method, the method includes culturing fibroblasts in an undifferentiated state for 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25 or more days, culturing the fibroblasts of step (a) in the presence of one or more factors selected from the group consisting of nerve growth factor, bFGF, dibutryl cAMP, IBMX, retinoic acid, exendin-4, and combinations thereof, and activating the fibroblasts. Activating the fibroblasts may include exposing the fibroblasts to one or more cytokines in a cell culture medium. Examples of cytokines are one or more selected from the group consisting of IL-1, IFNγ, and combinations thereof. The cytokines may be at a particular concentration, for example, the concentration of IL-1 may be 1-100 ng / mL, 5-100 ng / mL, 10-100 ng / mL, or 20-40 ng / mL, and the concentration of IL-1 may be 1 ng / mL, 5 ng / mL, 10 ng / mL, 20 ng / mL, 30 ng / mL, 40 ng / mL, 50 ng / mL, 60 ng / mL, 70 ng / mL, 80 ng / mL, 90 ng / mL, or 100 ng / mL. The concentration of IFNγ may be 1 to 1000 IU, 5 to 1000 IU, 10 to 1000 IU, 1 to 500 IU, 5 to 500 IU, 10 to 500 IU, 100 to 500 IU, or 250 IU, and the concentration of IFNγ may be 1 IU, 5 IU, 10 IU, 50 IU, 100 IU, 200 IU, 250 IU, 300 IU, 400 IU, 500 IU, 600 IU, 700 IU, 800 IU, 900 IU, or 1000 IU. These concentrations are merely examples.

[0015] In certain embodiments of the present disclosure, exposing fibroblasts to one or more cytokines induces increased expression of one or more complement inhibitory molecules from the fibroblasts. Exemplary complement inhibitory molecules are selected from the group consisting of CD35, CD46, C4BP, CD55, factor H, and combinations thereof. Activating the fibroblasts may include transfecting the fibroblasts with one or more viral and / or non-viral expression systems to induce expression of one or more regenerative factors. In specific embodiments, the regenerative factor is selected from the group consisting of AKT, BAMBI, BCL-2, BCL-2XL, BDN, BIRC5 CDA, CXCR4, dominant negative CCL2, EGF, exosomes, FGF-2, GATA-4 GDF-11, GDNF, hCG, HGF, HIF-1α, HLA-G, HO-1, hTERT, IFN-b, IFT-1, LIGHT, miR-126, NK4, NUR77, OCT-4, PGE-1, SDF-1, STC-1, TERT, TRAIL, VEGF, WNT11, XIAP, and combinations thereof.

[0016] Embodiments of the present disclosure include kits that include some or all of the systems encompassed herein.

[0017] The foregoing has outlined rather broadly the features and technical advantages of the present disclosure so that the detailed description that follows may be better understood. Additional features and advantages will be described below that form the subject of the claims herein. It should be understood by those skilled in the art that the conception and specific embodiments disclosed may be readily utilized as a basis for modifying or designing other structures for carrying out the same purposes of the present design. It should also be understood by those skilled in the art that such equivalent constructions do not depart from the spirit and scope as set forth in the appended claims. The novel features believed characteristic of the design disclosed herein, together with further objects and advantages, both as to the organization and method of operation, will be better understood from the following description when considered in connection with the accompanying drawings. It should be expressly understood, however, that each of the figures is provided for the purpose of illustration and description only and is not intended as a definition of the limits of the present disclosure. [Brief description of the drawings]

[0018] For a more complete understanding of the present disclosure, reference is now made to the following descriptions taken in conjunction with the accompanying drawings, in which:

[0019] [Figure 1] 1 is an example of a system of the present disclosure having a mammal as a subject.

[0020] [Diagram 2] 1 is an example of a system of the present disclosure having an organ or tissue as a target.

[0021] [Diagram 3] Figure 1 shows the assessment of senescence when foreskin fibroblasts were subjected to an accelerated senescence protocol induced by exposure to the indicated concentrations of H2O2 for 48 hours. Cells were cultured in control medium (RPMI) (left bar of group of 3 bars) or in 5% conditioned medium (middle bar of group of 3 bars) or in 10% conditioned medium (right bar of group of 3 bars). DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0022] [I. Definition example] Following long-standing patent law practice, the words "a" and "an," when used in conjunction with the words "comprises," mean "one or more," including in the claims, and some embodiments of the disclosure can consist of, or consist essentially of, one or more of the disclosed elements, method steps, and / or methods. It is contemplated that any method or composition described herein can be used with respect to any other method or composition described herein. As used herein, the term "about" or "approximately" refers to an amount, level, value, number, frequency, percentage, dimension, size, amount, weight, or length that differs from a reference amount, level, value, number, frequency, percentage, dimension, size, amount, weight, or length by 30, 25, 20, 25, 10, 9, 8, 7, 6, 5, 4, 3, 2, or 1%, and in certain embodiments, the term "about" or "approximately" is in front of a numerical value, which represents a value within a range of plus or minus 15%, 10%, 5%, or 1%. In the context of biological systems or processes, the term may mean within an order of magnitude, preferably within 5-fold, and more preferably within 2-fold, of a value. Unless otherwise specified, the term "about" means within an acceptable range of error for a particular numerical value.

[0023] As used herein, the term "aging" refers to a subject that begins to show signs of age-related degeneration, such as a decrease in telomere length, increased oxidative stress, formation of cellular tangles, development of taupathies in the central nervous system, and / or an increase in the number of misfolded proteins.

[0024] As used herein, the term "bioreactor" refers to a vessel or container that contains or can contain, for example, cells, cellular components, and / or other biological material. The bioreactor may be constructed of any suitable material. In some embodiments, the bioreactor comprises, at least in part, at least one semipermeable membrane as described herein. The bioreactor of the present disclosure may include an environment that allows for cell survival while perfusing tissue culture medium over viable cells in a manner that allows the tissue culture medium to remove growth factors and therapeutic agents from the cells growing in the environment. In one embodiment, the cells are perfused with plasma from the blood of an individual in need of treatment.

[0025] Throughout this specification, unless the context requires otherwise, the words "comprise", "include", and "comprising" are understood to mean the inclusion of the specified steps or elements, but not the exclusion of other steps or elements or elements. "Consisting of" means including and limited to what follows the phrase "consisting of". Thus, the phrase "consisting of" indicates that the recited elements are necessary or mandatory, and that there must be no other elements. The phrase "consisting essentially of" means including any elements recited after the phrase, and is limited to other elements that do not interfere with or contribute to the activity or action specified in the disclosure of the described element. The phrase "consisting essentially of" indicates that the recited elements are optional and may or may not be present depending on whether they affect the activity or action of the recited elements.

[0026] As used herein, the term "degeneration" or "degenerative factor" refers to one or more factors that are harmful to a subject. Such agents may be one or more aging-related factors, including at least one or more inflammatory molecules, such as inflammatory molecules selected from the group consisting of IL-1, TNF-α, IL-6, IL-17, IL33, and combinations thereof, or other factors known in the art.

[0027] Throughout this specification, references to "one embodiment," "an embodiment," "a particular embodiment," "a related embodiment," "a particular embodiment," "an additional embodiment," or "a further embodiment," or combinations thereof, mean that a particular feature, structure, or characteristic described in connection with an embodiment is included in at least one embodiment of the invention. Thus, the appearances of such phrases in various places throughout this specification are not necessarily all referring to the same embodiment. Furthermore, particular features, structures, or characteristics may be combined in any suitable manner in one or more embodiments.

[0028] As used herein, the term "factor" refers to a molecule such as a protein, lipid, nucleic acid, metabolite, hormone, biosynthetic product, or other molecule produced by the subject and / or bioreactor.

[0029] The terms "reduce," "inhibit," "reduce," "suppress," "reduce," "prevent," and grammatical equivalents (including "lower," "less," etc.), when referring to the occurrence of any symptom in a treated subject versus an untreated subject, mean that the amount and / or magnitude of the symptom in the treated subject is lower by any amount that would be recognized as clinically relevant by any medically trained person as compared to the untreated subject. In one embodiment, the amount and / or magnitude of the symptom in the treated subject is at least 10% lower, at least 25% lower, at least 50% lower, at least 75% lower, and / or at least 90% lower than the amount and / or magnitude of the symptom in the untreated subject.

[0030] As used herein, the term "regeneration" or "regenerative agent" refers to one or more agents that act to fully or partially restore a subject to a state prior to exposure to a degenerative stimulus. Such a regenerative stimulus can be said, for example, to act in opposition to the associated degenerative agent.

[0031] As used herein, the term "selectively permeable membrane" refers to one or more devices or materials that can selectively allow the passage of factors while restricting the passage of cells. In some embodiments, the selectively permeable membrane utilized is a hollow fiber membrane. A hollow fiber membrane is a semipermeable membrane consisting of long porous filaments with an inside and an outside, which can selectively allow certain compositions to pass from inside to outside or from outside to inside, while restricting such passage of other compositions. In some embodiments, the hollow fiber membrane allows the passage of factors while restricting the passage of cells. In certain embodiments, the membrane accomplishes two things:

[0032] In certain embodiments, the membrane does not allow blood cells from the individual to contact the cells in the bioreactor: and only plasma from the individual's blood contacts the regenerative cells in the bioreactor. In certain cases, the membrane does not allow cells from the bioreactor to leak into the individual's blood.

[0033] The term "cellular senescence" (or simply "senescence") is the stress-induced persistent cell cycle arrest of previously replicative cells.

[0034] "Treatment", "treat" or "treating" refers to a method of reducing the effects of a disease or condition. Treatment can also refer to a method of reducing the disease or condition itself, not just the symptoms. Treatment can be any reduction from pre-treatment levels, including but not limited to complete elimination of the disease, condition, or symptoms of the disease or condition. Thus, in the disclosed methods, "treatment" can refer to a 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, or 100% reduction in the severity of an established disease or disease progression, including a reduction in the severity of at least one symptom of the disease. For example, the disclosed methods for reducing the immunogenicity of a cell are considered to be therapeutic if there is a detectable reduction in the immunogenicity of the cell compared to pre-treatment levels in the same subject or control subject. Thus, the reduction can be a 10, 20, 30, 40, 50, 60, 70, 80, 90, 100% reduction, or any amount in between, compared to native or control levels. It is understood and contemplated herein that "treatment" does not necessarily refer to a cure of a disease or condition, but rather to an improvement in the outlook for a disease or condition. In certain embodiments, treatment refers to a decrease in the severity or extent of at least one symptom, and may alternatively or additionally refer to a delay in the onset of at least one symptom.

[0035] In some embodiments of the present disclosure, the cells generated and / or utilized are from a "young subject," which may be a subject that is less than 30, 29, 28, 27, 26, 25, 24, 23, 22, 21, 20, 19, 18, 17, 16, 15, 14, 13, 12, 11, 10, 9, 8, 7, 6, 5, 4, 3, 2 years old, or 1 year old.

[0036] In certain embodiments, a subject lacking one or more signs of aging may not be of a particular age, but may be less than 60, 59, 58, 57, 56, 55, 54, 53, 52, 51, 50, 49, 48, 47, 46, 45, 44, 43, 42, 41, 40, 39, 38, 37, 36, 35, 34, 33, 32, 31, 30, 29, 28, 27, 26, 25, 24, 23, 22, 21, 20, 19, 18, 17, 16, 15, 14, 13, 12, 11, 10, 9, 8, 7, 6, 5, 4, 3, 2 years old, or 1 year old.

[0037] [II. Extracorporeal System] In certain embodiments, the present disclosure describes a system capable of inducing one or more regenerative changes in a subject, for example, a system capable of inducing one or more regenerative changes systemically or locally in a subject. In some embodiments, the system generates a regenerative feedback proportional to the degree of the degenerative stimulus, and in certain aspects, can counteract one or more degenerative stimulus effects. In certain embodiments, the device produces, releases, or secretes one or more units of a regenerative factor for each one or more units of a degenerative factor detected by the system. In some cases, the degenerative stimulus includes a senescence-associated stimulus and / or a senescence-associated inflammation. More precisely, one or more of several inflammatory mediators are associated with various aspects of aging or degeneration. Without being bound by theory, certain embodiments of the system encompassed herein represent an exogenous bioreactor, where regenerative cells in the system are contacted with circulating factors from a subject connected to the bioreactor, and the cells in the system produce one or more regenerative factors in response to the circulating factors in the system. In some embodiments of the present disclosure, the circulating factors from the subject are age-related factors, such as inflammatory mediators. The purpose of the present invention is to create an artificial environment in which inflammatory or other degeneration can trigger the production of regenerative factors based on the body's needs. In some embodiments of the present disclosure, the regenerative factors include agents such as GDF-11, exosomes, or other agents related to regeneration, such as BDNF, EGF, hCG, VEGF, and IGF-1.

[0038] In some embodiments, the subject may be aging. Aging may be natural aging or accelerated aging, and aging may be a time-dependent decline in physiological function. In some embodiments, aging is associated with enhanced fibrosis, enhanced inflammation, and / or reduced telomere length, all compared to normal. In some embodiments, the subject may have abnormal levels of degenerative factors associated with a disease state. In some embodiments, the subject may have a particular trauma or injury or medical condition that alters the subject's levels of degenerative and / or regenerative factors.

[0039] In certain embodiments, the subject may be, for example, an organ from an individual that is aging or diseased or has trauma or injury. In other embodiments, the subject may be an organ used for transplantation. In the case of transplantation, the system is used to keep the organ viable. In further embodiments, the subject may be a tissue or set of tissues that are to be kept viable. In embodiments of the present disclosure in which the subject is an organ, the subject may be the liver, pancreas, gallbladder, stomach, small intestine, large intestine, lung, kidney, heart, spleen, brain, eye, omentum, small intestine mucosa, or other organ, or any part of an organ, or any part of an organ system.

[0040] Referring to FIG. 1 , system 100 illustrates an example of an extracorporeal system for preventing or reversing aging and / or treating a medical condition of a subject 101. In the example system, the circulatory system of the subject 101 is attached in-line to tubing 102 such that the tubing 102 can transport blood or plasma from the subject 101 to the outside of the body. The tubing 102 transports the blood or plasma from the subject 101 to a bioreactor 103 that contains cells that can detect the presence of one or more degenerative factors in the blood or plasma of the subject 101. When the cells in the bioreactor 103 are exposed to the blood or plasma from the subject 101 that has been transported through the tubing 102, the cells in the bioreactor 103 produce one or more regenerative factors. One or more regenerative factors from the cells in bioreactor 103 are then transported through tubing 104 into the blood or plasma and returned to subject 101 because tubing 104 is in-line with the system and attached to the circulatory system of subject 101. The semi-permeable membrane may be incorporated anywhere in the system, such as within or throughout tubing 102 and / or 104, or may at least partially comprise bioreactor 103.

[0041] Referring to FIG. 2, system 200 illustrates an example of an extracorporeal system for preventing or reversing aging of an organ or tissue 202 and / or treating a medical condition of an organ or tissue 201. In the example of the system, the circulatory system of the organ or tissue 201 is attached in-line to tubing 202 such that the tubing 202 can transport blood or plasma from the organ or tissue 201 to the outside of the organ or tissue. The organ or tissue may be contained within a container 205. The tubing 202 transports organ preservation fluid (commercially available) from the organ or tissue 201 to a bioreactor 203 that contains cells capable of detecting the presence of one or more degenerative factors in the blood or plasma from the organ or tissue 201. When the cells in the bioreactor 203 are exposed to the blood or plasma from the organ or tissue 201 transported through the tubing 202, the cells in the bioreactor 203 produce one or more regenerative factors. One or more regenerative factors from the cells in bioreactor 203 are then transported through tubing 204 into the blood or plasma and back to the organ or tissue 201 because tubing 204 is in-line with the system and attached to the circulatory system of the organ or tissue 201. The semi-permeable membrane may be incorporated anywhere in the system, such as within or throughout tubing 202 and / or 204, or may at least partially comprise bioreactor 203 and / or vessel 205.

[0042] In certain embodiments of the present disclosure, a bioreactor is provided that includes a compartment suitable for containing regenerative biological material including cells. In certain aspects, the bioreactor includes at least one selectively permeable membrane that can contact the cells. In certain embodiments, the bioreactor has at least one selectively permeable wall. In certain embodiments, the selectively permeable membrane can be a selectively permeable hollow fiber. The bioreactor can include a plurality of selectively permeable hollow fibers passing through the compartment, through which one or both of a gas and a fluid containing nutrients for the cells can pass. In certain embodiments, the bioreactor includes a plurality of selectively permeable hollow fibers passing through the bioreactor. In other embodiments, the selectively permeable membrane or the plurality of selectively permeable membranes are separate from the bioreactor. In certain embodiments, the membrane(s) are disposed within tubing that connects at least one of the bioreactors to a subject. The bioreactor and the selectively permeable membrane can be connected to the subject by tubing. The tubing can be made of any material that is flexible or rigid and biocompatible. In some embodiments, the tubing is connected to the subject's circulatory system at at least one point of the subject's circulatory system. In certain embodiments, the tubing is connected to a container that houses the subject (e.g., where the subject is a tissue or organ). In such embodiments, the tubing allows for circulation of fluid from the subject and / or allows for circulation of fluid around the subject. In certain embodiments, methods and / or devices are used to circulate fluid in tubing that connects the subject, the bioreactor, and the selectively permeable membrane.

[0043] The biological material contained in the bioreactor 1) senses a predetermined level of a degenerative factor, 2) produces an appropriate level of one or more appropriate counteracting regenerative factors, and 3) in some embodiments also releases a diagnostic marker that defines the extent of the degenerative factor produced by the subject. The biological material for use in the device can be any cell or cell material or cells that are effective for use in the bioreactor, and can be xenogeneic, syngeneic, allogeneic, or autologous with respect to the individual treated by use of the bioreactor. In certain embodiments where the biological material is a cell, the cell can detect the degenerative factor and secrete the regenerative factor at a rate commensurate with the rate of degenerative factor detection. The commensurate ratio can be the ratio of regenerative secretion to degenerative detection. This ratio can be, for example, 50:1, 10:1, 5:1, 1:1, 1:5, 1:10, 1:50, and any ratio therebetween.

[0044] In certain embodiments, the biological material comprises cells. In certain embodiments, the cells are cultured in a bioreactor. In other embodiments, the cells are cultured outside the bioreactor in a suitable cell culture vessel and then harvested for use in the bioreactor. In certain embodiments, the cells utilized are fibroblasts. The cells used, including when they may be fibroblasts, may have one or more surface markers selected from the group consisting of CD73, CD90, CD56, SSEA3, SSEA4, Tra-1-60, Tra-1-81, Tra-2-54, HLA class I, CD13, CD44, CD49b, CD105, aminopeptidase N, hyaluronic acid binding receptor, collagen / laminin binding integrin alpha 2, and combinations thereof. At least about 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99%, or about 100% of the cell population used in the present disclosure may express one or more specific surface markers. The cells used may also lack one or more surface markers (e.g., one or more selected from the group consisting of CD14, CD34, CD45, HLA class II, and combinations thereof). In certain embodiments of the present disclosure, the cells are capable of self-renewal in tissue culture, maintain euploidy for more than one year in culture, share markers with human ES cells, and / or differentiate into all three germ layers of the developing embryo. In certain embodiments, the cells are fibroblasts, which may be obtained in amniotic membranes harvested during the second trimester of human pregnancy. Fibroblasts comprise multiple morphologically distinguishable cell types, and it is known that a majority of the cells are prone to senescence and are lost from culture. In one embodiment, the cells are grown from fibroblast harvests from normal 16-18 week pregnancies using fibronectin-coated plates and culture conditions as described in U.S. Pat. No. 7,569,385 (incorporated herein by reference). In one embodiment, the cells of the present disclosure are of fetal origin and may have a normal diploid karyotype. Regenerative cells can be isolated from any mammal, including any primate (including humans), however, fibroblast regenerative cells may be isolated in a similar manner from other species.Examples of species that can be used to induce fibroblast regenerative cells include, but are not limited to, mammals, humans, primates, dogs, cats, goats, elephants, sheep, endangered species, cattle, horses, pigs, mice, rabbits, etc.

[0045] The cells used in the present disclosure may be recognized by specific cell surface proteins or by the presence and / or absence of specific cell proteins. Typically, specific cell types have specific cell surface proteins. These surface proteins may be used as markers to determine or confirm the specific cell type. Typically, these surface markers can be visualized using antibody-based techniques or other detection methods. In certain embodiments, the markers are selected from the group consisting of CD73, CD90, CD56, SSEA3, SSEA4, Tra-1-60, Tra-1-81, Tra-2-54, HLA class I, CD13, CD44, CD49b, CD105, aminopeptidase N, hyaluronic acid binding receptor, collagen / laminin binding integrin alpha 2, and combinations thereof.

[0046] In certain embodiments of the present disclosure, the cells are human stem cells that can be grown in continuous culture in an undifferentiated state for an indefinite period of time. The term "undifferentiated" refers to cells that have not become a specialized cell type. The cells are cultured in a nutrient medium. The nutrient medium can include any one or more of isotonic saline, buffer, amino acids, antibiotics, serum or serum replacements, and exogenously added factors in appropriate combinations. The cells can be grown in an undifferentiated state for a desired period of time and then cultured under specific conditions to progress to a differentiated or activated state. In some embodiments, the cells are cultured in an undifferentiated state for at least 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25 or more days before activating the cells. In certain embodiments, the cells are cultured in the presence of a factor(s) before activating the cells. In further embodiments, the cells are cultured in the presence of factors that may include nerve growth factor, bFGF, dibutryl cAMP, IBMX, retinoic acid, exendin-4, or other factors, alone or in combination, useful for producing the desired activated cells. By activated, the term refers to the process by which non-specialized cells acquire the characteristics of specialized cells, such as cells of the heart, liver, muscle, pancreas, or other organs or tissues. The cells in this disclosure can be activated into any cell type that can be used for the described system.

[0047] General methods regarding cell differentiation techniques that may be useful for differentiating the cells of the present disclosure can be found in general texts such as (EJ Robertson, ed., IRL Press Ltd. 1987); Guide to Techniques in Mouse Development (PM Wasserman et al. eds., Academic Press 1993); Embryonic Stem Cell Differentiation in vitro (MV Wiles, Meth. Enzymol. 225:900, 1993); Properties and uses of Embryonic Stem Cells: Prospects for Application to Human Biology and Gene Therapy (PD Rathjen et al., Reprod. Fertil. Dev. 10:31, 1998); and in Stem cell biology (LM Reid, Curr. Opinion Cell Biol. 2:121, 1990), each of which is incorporated herein by reference in its entirety.

[0048] In some embodiments of the present disclosure, the cells are cultured in the presence of one or more cytokines to activate the cells for use in the system. In certain embodiments, the cytokines used are IL-1, or IFNγ, or both, either simultaneously or sequentially. In some embodiments, the concentration of IL-1 provided to the cell culture can be, for example, 1-100 ng / mL, 5-100 ng / mL, 10-100 ng / mL, or 20-40 ng / mL. In other embodiments, the concentration of IL-1 can be, for example, 1 ng / mL, 5 ng / mL, 10 ng / mL, 20 ng / mL, 30 ng / mL, 40 ng / mL, 50 ng / mL, 60 ng / mL, 70 ng / mL, 80 ng / mL, 90 ng / mL, or 100 ng / mL. In certain embodiments, the concentration of IFNγ can be, for example, 1-1000 IU, 5-1000 IU, 10-1000 IU, 1-500 IU, 5-500 IU, 10-500 IU, 100-500 IU, or 250 IU. In further embodiments, the concentration of IFNγ can be, for example, 1 IU, 5 IU, 10 IU, 50 IU, 100 IU, 200 IU, 250 IU, 300 IU, 400 IU, 500 IU, 600 IU, 700 IU, 800 IU, 900 IU, or 1000 IU.

[0049] In certain embodiments, the cells may be cultured prior to use in the system. In certain cases, culturing the cells induces expression of complement inhibitory molecules. These molecules may include CD35, CD46, C4BP, CD55, Factor H, or other factors that reduce activation of the complement system.

[0050] In some embodiments of the present disclosure, cells are transfected to have enhanced regenerative properties. Transfection can be achieved by using one or more viral vectors (e.g., retrovirus, lentivirus, adenovirus, adeno-associated virus) or one or more non-viral vectors (e.g., plasmids). Means for performing transfection are well known in the art and are discussed in the following references [3-9]. Specific examples of genes include SDF-1 to promote stem cell homing, particularly hematopoietic stem cells

[10] , GDNF to treat Parkinson's disease in animal models

[11] , HGF to promote remyelination in brain injury models

[12] , akt to protect against pathological circulatory remodeling and necrosis of dead cells

[13] , TRAIL to induce apoptosis in tumor cells [14-17], PGE-1 synthase for cardioprotection

[18] , NUR77 to promote migration

[19] , BDNF to reduce ophthalmoplegia associated with hypertension

[20] , HIF-1α to stimulate bone formation

[21] , dominant-negative CCL2 to reduce pulmonary fibrosis

[22] , and interferon-β to inhibit tumor progression [

[23] , HLA-G to enhance immunosuppressive activity

[24] , hTERT to induce differentiation along the hepatocyte lineage

[25] , cytosine deaminase

[26] , OCT-4 to reduce senescence [27, 28], BAMBI to reduce TGF expression and tumorigenic effects

[29] , HO-1 for radioprotection

[30] , LIGHT to induce antitumor activity

[31] , miR-126 to promote angiogenesis [32, 33], bcl-2 to induce the generation of nucleus pulposus cells

[34] , telomerase to induce neurogenesis

[35] , CXCR4 to promote hematopoietic recovery

[36] , and reduce unwanted immunity

[37] , wnt11 to promote regenerative cytokine production

[38] , and the HGF antagonist NK4 to reduce cancer

[39] . Other factors known in the art to suppress degeneration or induce regeneration may also be used.

[0051] III. METHODS OF TREATING A MEDICAL CONDITION OR REVERSING OR SLOWING AGING The embodiments of the present disclosure include a method of treating a medical condition or reducing the effects of the natural process of aging. The medical condition may be a senescence-related disorder or age-related disorder or process. The individual may have cellular accumulation of damage and other deleterious changes, including loss of at least some cells and structures, compared to younger individuals. In certain cases, the individual has lost the ability of adult somatic cells to be transformed into partially reprogrammed cells or induced pluripotent stem cells for the individual.

[0052] In some embodiments of the present disclosure, the methods and systems include extending the lifespan of a cell and / or organism compared to an individual not subjected to the methods and systems of the present disclosure. In certain embodiments, the methods and systems of the present disclosure allow for the reversal or delay of cellular senescence and irreversible loss of replicative capacity in somatic cells. In certain cases, the methods and systems prevent or reduce telomere dysfunction and / or alterations in mitochondrial homeostasis associated with cellular senescence.

[0053] In certain embodiments, the medical condition is an aging-related disease, for example, a disease that increases in frequency as aging progresses and is the most frequent disease.In at least some cases, the aging-related disease is a complication resulting from aging.With a few rare exceptions, all adult animals age, but not all adult animals experience all age-related diseases, so in certain embodiments, the aging-related disease can be distinguished from the aging process itself.In certain cases, the aging-related disease includes neurodegenerative disease, atherosclerosis, cardiovascular disease, cancer, arthritis, cataracts, osteoporosis, type 2 diabetes, hypertension, Parkinson's disease, amyotrophic lateral sclerosis, and / or Alzheimer's disease. EXAMPLES

[0054] [IV. Working Example] The following examples are presented in order to more fully illustrate the preferred embodiments of the present disclosure, but they should in no way be construed as limiting the broad scope of the disclosure.

[0055] Example 1. Harvesting cells for use in the system Surface markers of isolated pluripotent amniotic fluid stem cells (MAFSC) cells derived from independently collected fibroblast samples were tested for a range of cell surface and other markers using monoclonal antibodies and FACS analysis. These cells can be characterized by the following cell surface markers: SSEA3, SSEA4, Tra-1-60, Tra-1-81, Tra-2-54. MAFSC cells can be distinguished from mouse ES cells in that they do not express the cell surface marker SSEA1. In addition, MAFSC express the stem cell transcription factor Oct-4. MAFSC cells can be recognized by the presence of at least one, or at least two, or at least three, or at least four, or at least five, or at least six, or all of the following cell markers SSEA3, SSEA4, Tra-1-60, Tra-1-81, Tra-2-54, and Oct-4.

[0056] MAFSC cultures express little or no SSEA-1 marker. In addition to the embryonic stem cell markers SSEA3, SSEA4, Tra1-60, Tra1-81, Tra2-54, and Oct-4, fibroblast regenerative cells expressed high levels of cell surface antigens typically found on human mesenchymal stem cells, but not on human embryonic stem cells. This set of markers includes CD13 (99.6%) aminopeptidase N, CD44 (99.7%) hyaluronan-binding receptor, CD49b (99.8%) collagen / laminin-binding integrin α2, and CD105 (97%) endoglin. The presence of both embryonic stem cell markers and hMSC markers in MAFSC cell cultures indicates that fibroblast-derived MAFSC cells grown and expanded as described herein represent a new class of human stem cells that combine characteristics of hES and hMSC cells.

[0057] To determine the quality of MAFSC cultures, flow cytometry was performed on all cultures to examine the surface expression of SH-2, SH-3, SH-4 MSC markers and the absence of contaminating CD14- and CD-45-positive cells. Cells were detached with 0.05% trypsin-EDTA, washed with DPBS+2% bovine albumin, fixed in 1% paraformaldehyde, blocked with 10% serum, and incubated separately with primary antibodies for SH-2, SH-3, and SH-4, followed by PE-conjugated anti-mouse IgG (H+L) antibody. 2 Confluent MSCs in flasks were washed with Tyrode's salt solution, incubated with Medium 199 (M199) for 60 min, and detached with 0.05% trypsin-EDTA (Gibco). Ten flasks of cells were detached at a time, and MSCs were resuspended in 40 ml of M199 + 1% human serum albumin (HSA; American Red Cross, Washington DC, USA). MSCs from each set of 10 flasks were stored at 4°C for up to 4 h and pooled at the end of the harvest. A total of 2–10 6 MSCs per kg were resuspended in M199 + 1% HSA and centrifuged at 460g for 10 min at 20°C. The cell pellet was resuspended in fresh M199 + 1% HSA medium and centrifuged at 460g for 10 min at 20°C for three more times. Total harvest time was 2–4 h based on MSC yield per flask and desired dose. Harvested MSCs were cryopreserved in Cryocyte (Baxter, Deerfield, IL, USA) freeze bags using a controlled rate freezer with a final concentration of 10% DMSO (Research Industries, Salt Lake City, UT, USA) and 5% HSA.

[0058] In one embodiment of the present disclosure, MAFSCs are allowed to adhere for 72 hours, after which the medium is changed every 3 to 4 days. Adherent cells are removed with 0.05% trypsin-EDTA and cultured at 175 cm 2 Hit 1'10 6The MAFSCs can be administered intravenously, or in a preferred embodiment, intrathecally, in patients suffering from radiation-associated neurodegenerative conditions. The dosage can be determined by one skilled in the art and will depend on various patient characteristics, but intravenous administration can be at a concentration ranging from 1 to 10 million MSCs / kilogram, with a preferred dosage being about 2 to 5 million cells / kilogram.

[0059] [Example 2. Examples of transfected cells for this system] In one embodiment of the present invention, MAFSCs are transfected with anti-apoptotic proteins to extend their life span in vivo. The present disclosure includes a method of using MAFSCs cultured under conditions that express an increased amount of at least one anti-apoptotic protein as a treatment for inhibiting or preventing apoptosis. In one embodiment, MAFSCs used as a treatment for inhibiting or preventing apoptosis are contacted with apoptotic cells. The present invention is based on the discovery that MAFSCs contacted with apoptotic cells express high levels of anti-apoptotic molecules. In some instances, MAFSCs contacted with apoptotic cells secrete high levels of at least one anti-apoptotic protein, including, but not limited to, STC-1, BCL-2, XIAP, survivin, and Bcl-2XL. Methods of transfecting MAFSCs with anti-apoptotic genes that can be applied to the present invention have been previously described, and the anti-apoptotic genes that can be utilized in the practice of the present invention include, but are not limited to, GATA-4

[40] , FGF-2

[41] , bcl-2 [34, 42], and HO-1

[43] . Based on the disclosure provided herein, MAFSCs can be obtained from any source. MAFSCs can be autologous (obtained from the same host) with respect to the subject and / or recipient, or allogeneic with respect to the subject and / or recipient. Furthermore, MAFSCs can be xenogeneic (obtained from a different species of animal) with respect to the subject and / or recipient. In one embodiment of the present invention, MAFSCs are pretreated with an agent to induce expression of anti-apoptotic genes, one example of which is pretreatment with exendin-4 as previously described

[44] . In a further non-limiting embodiment, MAFSCs used in the present invention can be isolated from the bone marrow of any species of mammal, including but not limited to human, mouse, rat, ape, gibbon, cow. In a non-limiting embodiment, MAFSCs are isolated from human, mouse, or rat. In another non-limiting embodiment, MAFSCs are isolated from human.

[0060] Example 3. Fibroblast conditioned medium reduces senescence. Foreskin fibroblasts were obtained from the American Type Culture Collection (ATCC) and cultured according to the manufacturer's instructions. To generate fibroblast conditioned medium, fibroblasts were isolated based on the expression of CD73 and cultured at a concentration of 1 million cells per 10 ml of RPMI medium containing 10% fetal bovine serum for 24 h, and the medium was used as conditioned medium.

[0061] To assess senescence, foreskin fibroblasts were incubated with the indicated concentrations of H 2 O 2 Cells were exposed to an accelerated senescence protocol induced by exposure to 5% RPMI for 48 h. Cells were cultured in control medium (RPMI) (left bar of group of three bars), 5% conditioned medium (middle bar of group of three bars), or 10% conditioned medium (right bar of group of three bars). Senescence was detected by fixing cells with 4% paraformaldehyde and staining with SA-β-Gal using a senescent cells histochemical staining kit (Sigma Aldrich, St Louis, MO, USA). Three images were collected per well, and SA-β-Gal stained cells were counted.

[0062] A decrease in senescence-associated β-galactosidase was observed in conditioned medium from CD73-selected fibroblasts.

[0063] Although the present disclosure and its advantages have been described in detail, it should be understood that various changes, substitutions, and alterations can be made herein without departing from the spirit and scope of the design as defined by the appended claims. Moreover, the scope of the present application is not intended to be limited to the particular embodiments of the processes, machines, manufacture, compositions of matter, means, methods, and steps described herein. As will be readily apparent from the present disclosure to those skilled in the art, any currently existing or later developed process, machine, manufacture, composition of matter, means, method, or step that performs substantially the same function or achieves substantially the same result as the corresponding embodiment described herein can be utilized in accordance with the present disclosure. Thus, it is intended that the appended claims include within their scope such processes, machines, manufacture, compositions of matter, means, methods, or steps.

[0064] [References] All patents and publications mentioned in this specification are indicative of the level of those skilled in the art to which this invention pertains. All patents and publications in this specification are incorporated by reference to the same extent as if each individual publication was specifically and individually indicated to be incorporated by reference in its entirety.

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Claims

1. 1. A system for treating a subject, comprising: (a) at least one bioreactor containing cells; (b) at least one selectively permeable membrane; and (c) tubing connecting at least one of the bioreactors, at least one of the selectively permeable membranes, and the subject, for circulating fluid from the subject to the bioreactors (provided that if the tubing comprises hollow fibers, the selectively permeable membrane is optionally included); the cells are amniotic fluid stem cells (MAFSCs) or fibroblasts; The system, wherein the MAFSCs are derived from fibroblasts, and the fibroblasts express CD73.

2. The system of claim 1 , further comprising blood or plasma from the subject, or comprising an organ preservation fluid.

3. The system of claim 1 , wherein the cells secrete one or more regenerative factors at a basal or inducible rate.

4. The system according to claim 3, wherein the regeneration factor is one or more factors selected from the group consisting of AKT, BAMBI, BCL-2, BCL-2XL, BDNF, BIRC5 CDA, CXCR4, dominant negative CCL2, EGF, exosomes, FGF-2, GATA-4 GDF-11, GDNF, hCG, HGF, HIF-1α, HLA-G, HO-1, hTERT, IFN-b, IGF-1, IFT-1, LIGHT, miR-126, NK4, NUR77, OCT-4, PGE-1, SDF-1, STC-1, TERT, TRAIL, VEGF, WNT11, XIAP, and combinations thereof.

5. The system of any one of claims 1 to 4, wherein the cells produce one or more regenerative factors in response to degenerative factors from the subject's blood or plasma.

6. The system according to any one of claims 1 to 5, wherein the cells secrete a regenerative factor at a rate determined by the detection of a degenerative factor.

7. The system of claim 6, wherein the ratio of the secretion rate of the regeneration factor to the detection rate of the denatured factor is selected from the group consisting of 50:1, 10:1, 5:1, 1:1, 1:5, 1:10, 1:50, and any ratio therebetween.

8. At least one of the selectively permeable membranes is disposed within the tubing between the bioreactor and the subject. the tubing is constructed from a selectively permeable membrane; and / or The system of any one of claims 1 to 7, wherein the bioreactor is at least partially composed of the selectively permeable membrane.

9. 10. The system of claim 8, wherein at least one of the selectively permeable membranes inhibits or reduces the passage of cellular material between the subject and the bioreactor.

10. The system according to any one of claims 1 to 9, wherein at least one of the selectively permeable membranes allows the passage of regenerative and denaturing factors.

11. The system according to any one of claims 1 to 10, wherein the subject is an animal.

12. The system according to any one of claims 1 to 10, wherein the target is an organ or tissue derived from an animal.

13. The system according to any one of claims 1 to 12, wherein the subject is an organ or tissue derived from a donor.

14. 14. The system according to claim 12 or 13, wherein the organ is selected from the group consisting of liver, pancreas, gallbladder, stomach, small intestine, large intestine, lung, kidney, heart, spleen, brain, eyeball, and combinations thereof.

15. The system according to any one of claims 12 to 14, wherein the object is any part of an organ or any part of an organ system.

16. The object is an organ or tissue, the system further comprising a vessel connected to at least one of the bioreactors and to at least one of the selectively permeable membranes for containing the subject; A system according to any one of claims 1 to 10 or 12 to 15.

17. The object is an organ or tissue, the container is adapted to hold the object so as to allow transfer of organ preservation fluid or other fluid to the tubing; 17. The system of claim 16.

18. 1. An ex vivo method for producing a regenerative factor, comprising:

20. A method comprising the step of subjecting the subject to a system according to any one of claims 1 to 17 under conditions that permit secretion of one or more regenerative factors from cells in the system, unless the subject is a human or is taken from a human and returned to the human from whom it was taken for therapeutic purposes.

19. 20. The method of claim 18, wherein the cells are fibroblasts derived from tissues including skin, heart, blood vessels, bone marrow, skeletal muscle, liver, pancreas, brain, adipose tissue, placenta, and / or foreskin.

20. 20. The method of claim 19, wherein the fibroblasts have one or more surface markers selected from the group consisting of CD73, CD90, CD56, SSEA3, SSEA4, Tra-1-60, Tra-1-81, Tra-2-54, HLA class I, CD13, CD44, CD49b, CD105, aminopeptidase N, hyaluronan binding receptor, collagen / laminin binding integrin alpha 2, OCT4, NANOG, SOX-2, and combinations thereof.

21. The method of any one of claims 17 to 19, wherein the fibroblasts lack one or more surface markers selected from the group consisting of CD14, CD34, CD45, HLA class II, and combinations thereof.

22. (a) culturing fibroblasts in an undifferentiated state for 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25 or more days; (b) culturing the fibroblasts from step (a) in the presence of one or more factors selected from the group consisting of nerve growth factor, bFGF, dibutryl cAMP, IBMX, retinoic acid, exendin-4, and combinations thereof; and (c) activating the fibroblasts from step (b); The method according to any one of claims 19 to 21, comprising:

23. 23. The method of claim 22, wherein activating the fibroblasts in step (c) comprises exposing the fibroblasts from step (b) to one or more cytokines in cell culture medium.

24. 24. The method of claim 23, wherein the cytokine is selected from the group consisting of IL-1, IFNγ, and combinations thereof.

25. 25. The method of claim 24, wherein the concentration of IL-1 is 1 to 100 ng / mL, 5 to 100 ng / mL, 10 to 100 ng / mL, or 20 to 40 ng / mL.

26. The method of claim 24 or 25, wherein the concentration of IL-1 is 1 ng / mL, 5 ng / mL, 10 ng / mL, 20 ng / mL, 30 ng / mL, 40 ng / mL, 50 ng / mL, 60 ng / mL, 70 ng / mL, 80 ng / mL, 90 ng / mL, or 100 ng / mL.

27. 25. The method of claim 24, wherein the concentration of IFNγ is 1 to 1000 IU, 5 to 1000 IU, 10 to 1000 IU, 1 to 500 IU, 5 to 500 IU, 10 to 500 IU, 100 to 500 IU, or 250 IU.

28. 28. The method of claim 24 or 27, wherein the concentration of IFNγ is 1 IU, 5 IU, 10 IU, 50 IU, 100 IU, 200 IU, 250 IU, 300 IU, 400 IU, 500 IU, 600 IU, 700 IU, 800 IU, 900 IU, or 1000 IU.

29. 29. The method of any one of claims 23 to 28, wherein exposing the fibroblasts to one or more cytokines induces increased expression of one or more complement inhibitory molecules from the fibroblasts.

30. 30. The method of claim 29, wherein the complement inhibitory molecule is selected from the group consisting of CD35, CD46, C4BP, CD55, Factor H, and combinations thereof.

31. 23. The method of claim 22, wherein activating the fibroblasts in step (c) comprises transfecting the fibroblasts from step (b) with one or more viral and / or non-viral expression systems to induce expression of one or more regenerative factors.

32. 32. The method of claim 31, wherein the regenerative factor is selected from the group consisting of AKT, BAMBI, BCL-2, BCL-2XL, BDN, BIRC5 CDA, CXCR4, dominant negative CCL2, EGF, exosomes, FGF-2, GATA-4 GDF-11, GDNF, hCG, HGF, HIF-1α, HLA-G, HO-1, hTERT, IFN-b, IFT-1, LIGHT, miR-126, NK4, NUR77, OCT-4, PGE-1, SDF-1, STC-1, TERT, TRAIL, VEGF, WNT11, XIAP, and combinations thereof.

33. A kit comprising the system according to any one of claims 1 to 17.

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