Endothelial and smooth muscle-like tissues produced from urinary cells and uses thereof

Abstract

The present disclosure relates to endothelial and smooth muscle-like vascular tissues produced from urine cells. In some embodiments, the present disclosure relates to a method for producing endothelial and smooth muscle-like vascular tissues by exposing urine-derived cells to ETV2 in a first growth medium under conditions that modify the cells to form a pool of cells that express increased levels of endothelial surface markers, and then exposing the cell pool to a second growth medium under conditions that modify the cells to form tissues that include cells that express increased levels of smooth muscle surface markers in addition to the endothelial surface markers. In some embodiments, the present disclosure relates to the use of the cells and tissues described herein for vascular, cardiac, and wound healing treatment applications.

Description

[Technical field]

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS This application claims the benefit of U.S. Provisional Application No. 62 / 903,154, filed September 20, 2019, the entirety of which is incorporated herein by reference.

[0002] STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH This invention was made with Federal support under DK108245, HL127759 and HL129511 awarded by the National Institutes of Health.

[0003] Incorporation by reference of documents submitted as text files via the Office's Electronic Filing System (EFS-WEB) The sequence listing for this application has been provided in text format in lieu of paper and is incorporated herein by reference. The text file containing the sequence listing is named 19161PCT_ST25.txt. The text file is 11 KB, was created on July 9, 2020, and will be submitted electronically via EFS-Web. [Background technology]

[0004] background Ischemic cardiovascular disease is a major cause of morbidity and mortality in developed countries. Risk factor management, pharmacological therapy, and surgical revascularization are current treatment options, but are not always effective when blood vessels are permanently compromised. Despite significant efforts over the past decades, treating patients with ischemic heart and vascular disease remains challenging. Thus, there is a great need to develop therapies that restore blood supply in host organs through neovascularization.

[0005] Endothelial cells (ECs) are a key component of the vasculature and are essential for the repair of damaged or ischemic tissues. Over the past few years, many attempts have been made to generate ECs for use in cell therapy. Despite initial interest, adult stem or progenitor cells have proven to have poor capacity for transdifferentiation into endothelium. Embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs) have emerged as promising alternatives. However, their clinical application has been limited due to issues such as tumorigenicity or inefficient cell productivity. There is therefore a need to find improvements.

[0006] Lee et al. report the reprogramming of human dermal fibroblasts into endothelial cells using ER71 / ETV2.

[0007] Veldman et al. report transdifferentiation of fast skeletal muscle into functional endothelium in vivo by the transcription factor Etv2. PLoS Biol, 2013, 11(6): e1001590.

[0008] Bharadwaj et al. reported pluripotent differentiation of human urinary stem cells. Stem Cells 2013, 31:1840-1856.

[0009] The documents cited herein are not admitted to be prior art. Summary of the Invention

[0010] overview The present disclosure relates to endothelial and smooth muscle-like vascular tissues made from urine cells.In some embodiments, the present disclosure relates to a method of making endothelial and smooth muscle-like vascular tissues by exposing urine-derived cells to ETV2 in a first growth medium under conditions that modify the cells to form a pool of cells that express increased levels of endothelial surface markers, and then exposing the cell pool to a second growth medium under conditions that modify the cells to form tissues that include cells that express increased levels of smooth muscle surface markers in addition to the endothelial surface markers.In some embodiments, the present disclosure relates to the use of the cells and tissues described herein for vascular, cardiac and wound healing treatment applications.

[0011] In some embodiments, the present disclosure relates to a method for producing endothelial and smooth muscle-like vascular tissue, comprising: i) concentrating urine cells from a subject; ii) replicating the concentrated urine cells in a first growth medium comprising a) EGF, b) hydrocortisone, c) epinephrine, and d) human or animal serum to provide purified concentrated urine-derived cells; iii) exposing the purified concentrated urine-derived cells to ETV2; iv) culturing the purified concentrated urine-derived cells in a first growth medium to provide endothelial-like urine-derived cells; v) culturing the endothelial-like urine-derived cells in a second growth medium comprising a) EGF, b) VEGFA, c) bFGF, d) heparin, e) L-ascorbic acid, and d) human or animal serum to provide endothelial and smooth muscle-like vascular tissue. In some embodiments, the human serum is derived from the subject to be treated with or transplanted with the vascular tissue.

[0012] In some embodiments, exposing the purified concentrated urine-derived cells to ETV2 is by mixing the purified concentrated urine-derived cells with a recombinant virus that infects the purified concentrated urine-derived cells, contains a gene encoding ETV2, and expresses ETV2 after infection. In some embodiments, the recombinant virus is an adenovirus or a lentivirus.

[0013] In some embodiments, the first or second growth medium comprises glucose, amino acids, and vitamins, glutamine, and sodium pyruvate.

[0014] In some embodiments, the methods disclosed herein further comprise folding the endothelial and smooth muscle-like vascular tissue into a three-dimensional structure. In some embodiments, the methods disclosed herein further comprise transplanting the endothelial and smooth muscle-like vascular tissue into a subject.

[0015] In some embodiments, transplanting the endothelial- and smooth muscle-like vascular tissue is by contacting the endothelial- and smooth muscle-like vascular tissue with a vein, an artery, a capillary, or myocardium.

[0016] In some embodiments, the disclosure relates to a method of making endothelial or endothelial-like cells comprising exposing amplified urinary cells comprising a recombinant vector encoding ETV2 in operable combination with a promoter to stimulation of the promoter under conditions such that ETV2 is produced in the cells and the amplified urinary cells are modified to form a pool of cells expressing increased levels of endothelial surface markers, thereby providing endothelial-like cells, wherein the surface markers are KDR and CDH5.

[0017] In some embodiments, the cell pool expresses increased levels of the surface markers KDR and CDH5. In some embodiments, the cell pool expresses increased levels of the surface markers PECAM1 and TEK.

[0018] In some embodiments, the urinary cells or amplified cells contain or do not contain a recombinant vector encoding ERG or FLI1, or contain or do not contain a recombinant vector encoding FOXC2, MEF2C, SOX17, NANOG, or HEY1.

[0019] In some embodiments, the urine cells or expanded urine-derived cells are contacted or not contacted with medium comprising a TGFβ inhibitor.

[0020] In some embodiments, the methods disclosed herein further comprise purifying the pool of purified urine-derived cells by selecting cells that express KDR to provide a pool of purified KDR urine-derived cells. In some embodiments, the methods disclosed herein further comprise purifying the pool of purified urine-derived cells by selecting cells that do not express KDR to provide a pool of purified KDR negative urine-derived cells.

[0021] In some embodiments, the present disclosure relates to a composition comprising cells produced by the methods disclosed herein.

[0022] In some embodiments, the methods disclosed herein further comprise the step of producing endothelial-like cells comprising contacting the cells produced herein with valproic acid.

[0023] In some embodiments, the methods disclosed herein further comprise the step of creating a pool of modified cells comprising contacting the cells produced in this disclosure with a promoter stimulus.

[0024] In some embodiments, the methods disclosed herein further comprise the step of creating a pool of modified cells comprising contacting the cells produced in the present disclosure with collagen.

[0025] In some embodiments, the present disclosure relates to a method of treating or preventing a skin condition, disease, injury, contusion, open wound, laceration, vascular condition, disease, cardiac condition, disease, atherosclerosis, coronary artery disease, or ischemia comprising administering to a subject in need thereof an effective amount of a cell or tissue produced in the present disclosure. [Brief description of the drawings]

[0026] [Figure 1]Figure 1 shows the method for the generation of vascular-like tissue. Human urinary cells are collected by centrifugation of urine. The cell pellet is suspended in growth medium (Growth medium for urinary cells: Dulbecco's modified Eagle's medium (DMEM) with 10% fetal bovine serum, DMEM / nutrient mixture F-12 (DMEM / F-12 does not contain proteins, lipids or growth factors)). Growth factors EGF, hydrocortisone and epinephrine are added. The cell suspension is incubated for 14 days in a 37°C, CO2 (5%) incubator. The cells are selected and allowed to replicate and form colonies. Reprogramming of the replicated urinary cells is initiated by infection with an adenovirus encoding ETV2. The urine-derived cells are allowed to grow for 24 hours. The medium is then changed to contain VEGFA, EGF, bFGF, heparin and vitamin C. [Diagram 2] FIG. 2 presents data showing that endothelial genes were significantly induced in ETV2-treated replicate urinary cells. [Diagram 3] FIG. 3 shows a tubular network structure in a blood vessel-like tissue. [Figure 4] FIG. 4 presents data showing that the non-EC population (KDR negative) is significantly enriched for smooth muscle cell-specific genes. [Diagram 5] FIG. 5 shows the generation of vascular-like tissue. [Figure 6] Figure 6 shows sequence comparison of ETV2 isoform 1 from human (H. sapiens, query, NCBI accession number NP_055024.2) and mouse (M. musculus, subject, NCBI accession number NP_031985.2): 232 / 344 (67% identical), 250 / 344 (73% positive), and 11 / 344 (3% gap). DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0027] Before describing the present disclosure in detail, it is to be understood that the present disclosure is not limited to particular embodiments described, which may, of course, vary. Moreover, it is to be understood that the terminology used herein is used for the purpose of describing particular embodiments only, and is not intended to be limiting, since the scope of the present disclosure may be limited only by the appended claims.

[0028] Unless otherwise defined, technical and scientific terms used herein have the same meaning as commonly understood by those skilled in the art to which this disclosure belongs. Preferred methods and materials are described below, but any methods and materials similar or equivalent to those described herein can also be used in the practice or testing of this disclosure.

[0029] All publications and patents cited herein are incorporated by reference as if each individual publication or patent was specifically and individually indicated to be incorporated by reference herein, and the publications are incorporated by reference herein to disclose and describe the methods and / or materials for which they are cited. The citation of any publication is for its disclosure prior to the filing date and should not be construed as an admission that the present disclosure is not entitled to antedate such publication by virtue of prior disclosure. Further, the publication dates provided may be different from the actual publication dates, which may require independent confirmation.

[0030] As will be apparent to those skilled in the art upon receipt of this disclosure, each individual embodiment described and illustrated herein has separate components and features which may be readily separated from or combined with the features of any of the other several embodiments without departing from the scope or spirit of the disclosure. Any described method may be carried out in the order of events described or in any other order that is logically possible.

[0031] Aspects of the present disclosure may employ, unless otherwise indicated, techniques of medicine, organic chemistry, biochemistry, molecular biology, pharmacology, and the like, within the skill of the art, such techniques being fully described in the literature.

[0032] It should be noted that in this specification and the claims, singular references include plural references unless the context clearly indicates otherwise. Thus, for example, the short form "support" includes plural support. In this specification and the appended claims, a number of terms may be used that are defined to have the following meanings unless a different intention is clear:

[0033] The terms "comprising" (and any variation of comprising, such as "comprises"), "having" (and any variation of comprising, such as "having"), "including" (and any variation of including, such as "including") or "containing" (and any variation of containing, such as "containing") used in this disclosure and claims have the meaning of the terms in U.S. Patent Law in that they are inclusive or open-ended and do not exclude additional unrecited elements or method steps. For example, the term "comprising" with respect to an oligonucleotide having a certain nucleic acid sequence refers to an oligonucleotide that may contain additional 5' (5'-end) or 3' (3'-end) nucleotides, i.e., the term is intended to include the oligonucleotide sequence within a larger nucleic acid. The terms "consisting essentially of" or "consisting of," and the like, when used in reference to methods and compositions contained in this disclosure, refer to compositions as disclosed herein that exclude certain prior art elements to provide the claimed inventive feature, but may include additional composition components or method steps, etc. that do not materially affect the basic novel characteristics of the composition or method as compared to the corresponding composition or method disclosed herein.

[0034] The term "serum" refers to a blood product obtained by clotting an animal's blood and separating the clot from the blood. Fetal bovine serum is obtained from the blood of fetal bovine animals extracted from slaughtered cattle.

[0035] As used herein, "growth medium" or "culture medium" refers to a composition containing components that promote cell maintenance and growth by protein biosynthesis, such as vitamins, amino acids, inorganic salts, buffers, and nutrients, such as acetate, succinate, sugars, and / or optionally nucleotides. Additionally, the growth medium may contain phenol red as a pH indicator. The components of the growth medium may be derived from blood serum, or the growth medium may be serum-free. The growth medium may optionally be supplemented with albumin, lipids, insulin, and / or zinc, transferrin or iron, selenium, ascorbic acid, and antioxidants, such as glutathione, 2-mercaptoethanol, or 1-thioglycerol. Other contemplated growth medium components include ammonium metavanadate, cupric sulfate, manganese dichloride, ethanolamine, and sodium pyruvate. Minimum essential medium (MEM) is a term used in the art to refer to a growth medium that contains calcium chloride, potassium chloride, magnesium sulfate, sodium chloride, sodium phosphate, and sodium bicarbonate, essential amino acids, and the vitamins thiamine (vitamin B1), riboflavin (vitamin B2), nicotinamide (vitamin B3), pantothenic acid (vitamin B5), pyridoxine (vitamin B6), folic acid (vitamin B9), choline, and myo-inositol (formerly called vitamin B8). A variety of growth media are known in the art. Dulbecco's Modified Eagle's Medium (DMEM) is a growth medium that contains additional components such as glycine, serine, and ferric nitrate, and is high in vitamins, amino acids, and glucose, as shown in Table 1 below.

[0036] [Table 1]

[0037] Ham's F-12 medium contains high levels of amino acids, vitamins, and other trace elements. Putrescine and linoleic acid are included in this formulation. See Table 2 below.

[0038] [Table 2]

[0039] In some embodiments, the present disclosure contemplates a growth medium disclosed herein using a mixture of DMEM and F-12 media, which is a 1:1 mixture of DMEM and Ham's F-12. The optimum carbon dioxide required is 10% for DMEM and 5% for F-12. Since this medium is a mixture, the optimum carbon dioxide concentration is typically 5% to 8%.

[0040] As used herein, "heparin" refers to an anticoagulant polymer with variably sulfated repeating disaccharide units, the majority of which consist of 2-O-sulfo-α-L-iduronic acid and 2-deoxy-2-sulfamido-α-D-glucopyranosyl-6-O-sulfate.

[0041] The terms "ETS translocation variant 2" and "ETV2" refer to a transcription factor involved in hematopoiesis and vascular development. ETV2 deficiency in mice leads to complete inhibition of hematopoiesis and angiogenesis and embryonic lethality. Human recombinant ETV2 is a protein of NCBI reference sequence NP_055024.2 (SEQ ID NO: 1) that is commercially available. Adenoviruses encoding ETV2 are also commercially available (see NCBI reference sequence NM_014209.4) that express ETV2 mRNA.

[0042] In some embodiments, the present disclosure contemplates exposing urine-derived cells to ETV2 under conditions such that ETV2 is produced as a fusion, optionally with a cell-penetrating peptide (CPP), such as polyarginine, at the C-terminus or N-terminus, i.e., contacting the urine-derived cells with the ETV2 fusion. Warren et al. report reprogramming human cells to pluripotency and directed differentiation with synthetic recombinant mRNA. Cell stem cell, 2010, 7:618-630. In some embodiments, the present disclosure contemplates exposing urine-derived cells to ETV2 mRNA, for example, by using electroporation, or by complexing the RNA with a cationic vehicle to promote endocytic uptake, and delivering the mRNA to the cells.

[0043] The terms "epidermal growth factor" and "EGF" refer to a protein of approximately 6 kDa. The human EGF gene encodes a preprotein that undergoes proteolytic processing to generate a peptide that functions to stimulate the division of epithelial and other cells. Human recombinant VEGFA is commercially available in the form of a 54 amino acid protein having the following sequence: MNSDSECPLSHDGYCLHDGVCMYIEALDKYACNCVVGYIGERCQYRDLKWWELR (SEQ ID NO: 3)

[0044] The term "vascular endothelial growth factor A" or "VEGFA" refers to a heparin-binding protein that exists as a disulfide-linked homodimer that induces proliferation and migration of vascular endothelial cells. Human recombinant VEGFA is commercially available in the form of a 165 amino acid protein having the following sequence: APMAEGGGQNHHEVVKFMDVYQRSYCHPIETLVDIFQEYPDEIEYIFKPSCVPLMRCGGCCNDEGLECVPTEESNITMQIMRIKPHQGQHIGEMSFLQHNKCECRPKDRARQENPCGPCSERRKHLFVQDPQTCKCSCKNTDSRCKARQLELNERTCRCDKPRR (SEQ ID NO: 4)

[0045] The term "basic fibroblast growth factor" or "bFGF" refers to a protein with a β-trefoil structure that binds to members of the FGF receptor (FGFR) family. Human recombinant bFGF is commercially available in the form of a 154 amino acid protein having the following sequence: AAGSITTLPALPEDGGSGAFPPGHFKDPKRLYCKNGGFFLRIHPDGRVDGVREKSDPHIKLQLQAEERGVVSIKGVCANRYLAMKEDGRLLASKCVTDECFFFERLESNNYNTYRSRKYTSWYVALKRTGQYKLGSKTGPGQKAILFLPMSAKS (SEQ ID NO: 5)

[0046] Variants of the proteins disclosed herein can be easily made by those skilled in the art. Computer modeling can be used to predict functional variants with structural similarity. Tests to confirm intrinsic activity can be performed using the literature and procedures described herein. Those skilled in the art can understand that a large number of functional variants can be made that are predicted to have desirable properties. The genes are known and the members have significant homology between species. The sequences are not identical, as shown by the difference between human and mouse sequences SEQ ID NO: 1 and SEQ ID NO: 2 in FIG. 6. Only 232 of 344 amino acids (67%) are identical. Some are conservative substitutions (indicated with +). Some are not conservative substitutions. To make functional variants, those skilled in the art do not blindly try random combinations, but instead can use computer programs to make stable substitutions. Those skilled in the art can know that certain conservative substitutions are desirable. Furthermore, those skilled in the art typically do not make changes to evolutionarily conserved positions. See Saldano et al. Evolutionary Conserved Positions Define Protein Conformational Diversity, PLoS Comput Biol. 2016, 12(3):e1004775.

[0047] How many amino acid residues can be replaced, inserted or deleted without losing biological activity can be determined by using computer programs in combination with publicly available databases well known in the art, such as RaptorX, ESyPred3D, HHpred, Homology Modeling Professional for HyperChem, DNAStar, SPARKS-X, EVfold, Phyre and Phyre2 software.See Kelley et al., the Phyre2 web portal for protein modelling, prediction and analysis. Nat Protoc. 2015, 10(6):845-58. See also Marks et al., Protein structure from sequence variation, Nat Biotechnol, 2012, 30(11):1072-80; Mackenzie et al. Curr Opin Struct Biol, 2017, 44:161-167; Mackenzie et al. Proc Natl Acad Sci US A. 113(47):E7438-E7447 (2016) and Wei et al. Int. J. Mol. Sci. 2016, 17(12), 2118.

[0048] The disclosure contemplates, in some embodiments, the use of variants of the polypeptide sequences disclosed herein that are more than 50%, 60%, 70%, 80%, 90%, 95% or more identical. "Sequence identity" refers to a measure of relatedness between two or more nucleic acids or proteins, typically expressed as a percentage over the entire length of comparison. Identity calculations take into account identical amino acid residues that are present in the same relative positions in each longer sequence. Identity calculations can be performed using algorithms contained in computer programs such as "GAP" (Genetics Computer Group, Madison, Wis.) and "ALIGN" (DNAStar, Madison, Wis.) with default parameters. In some embodiments, sequence "identity" refers to the number of exactly matching residues (expressed as a percentage) in a sequence alignment between two sequences. In some embodiments, the identity percentage of an alignment can be calculated by dividing the number of identical positions by the greater of the shortest sequence or the number of corresponding positions excluding overhangs (where gaps in the sequence are counted as corresponding positions). For example, the polypeptides GGGGGG (SEQ ID NO:6) and GGGGT (SEQ ID NO:7) share 4 / 5 or 80% sequence identity. For example, the polypeptides GGGPPP (SEQ ID NO:8) and GGGAPPP (SEQ ID NO:9) share 6 / 7 or 85% sequence identity.

[0049] In some embodiments, it is also contemplated that for any intended percentage of sequence identity, sequences may have sequence similarity of the same percentage or more. Percent "similarity" is used to quantify the degree of amino acid similarity between two sequences in an alignment, such as hydrophobicity, hydrogen bonding strength, and charge. This method is similar to determining identity, except that an amino acid does not have to be identical to match. In some embodiments, sequence similarity can be calculated using well-known computer programs with default parameters. Typically, amino acids are determined to match if they fall into groups of similar properties, such as those according to the following amino acid groups: aromatic-FYW; hydrophobic-AVIL; positively charged-RKH; negatively charged-DE; polar-STNQ.

[0050] "Subject" means any animal, but preferably a mammal, such as a human, monkey, mouse or rabbit.

[0051] As used herein, the terms "treat" and "treatment" are not limited to cases where a subject (e.g., a patient) is cured and the disease is cured. Rather, embodiments of the present disclosure also contemplate treatment that only relieves symptoms and / or delays disease progression.

[0052] The term "nucleic acid" refers to a polymer of nucleotides or a polynucleotide. The term is used to refer to a single molecule or a collection of molecules. A nucleic acid can be single-stranded or double-stranded and can contain a coding region and various regulatory elements, as described below.

[0053] The term "polynucleotide having a nucleotide sequence encoding a gene" or "nucleic acid sequence encoding" a particular polypeptide refers to a nucleic acid sequence that comprises the coding region of a gene, in other words, the nucleic acid sequence that encodes a gene product. The coding region may be present in either cDNA, genomic DNA or RNA form. If present in DNA form, the oligonucleotide, polynucleotide or nucleic acid may be single-stranded (i.e., the sense strand) or double-stranded. Appropriate regulatory elements, such as enhancers / promoters, splice junctions, polyadenylation signals, etc., may be located in close proximity to the coding region of the gene, as necessary to allow proper transcription initiation and / or accurate processing of the primary RNA transcript. Alternatively, the coding region used in the expression vectors of the invention may contain endogenous enhancers / promoters, splice junctions, intervening sequences, polyadenylation signals, etc., or a combination of both endogenous and exogenous regulatory elements.

[0054] The terms "in operable combination," "in operable order," and "operably linked" refer to nucleic acid sequences being linked in such a manner that a nucleic acid molecule is formed that is capable of directing the transcription of a given gene and / or the synthesis of a desired protein molecule. The terms also refer to amino acid sequences being linked in such a manner that a functional protein is produced.

[0055] The term "regulatory element" refers to a genetic element that regulates some aspect of the expression of a nucleic acid sequence. For example, a promoter is a regulatory element that facilitates the initiation of transcription of an operably linked coding region. Other regulatory elements are splicing signals, polyadenylation signals, termination signals, etc.

[0056] A promoter can be constitutive or regulatable. The term "constitutive" as used with respect to a promoter means that the promoter is capable of inducing the transcription of an operably linked nucleic acid sequence in the absence of a stimulus (e.g., heat shock, chemicals, light, etc.). Typically, a constitutive promoter can induce the expression of a transgene in virtually any cell and any tissue. In contrast, a "regulatable" or "inducible" promoter is one that can induce the transcription of an operably linked nucleic acid sequence in the presence of a stimulus (e.g., heat shock, chemicals, light, etc.) at a level that is different from that in the absence of the stimulus.

[0057] Enhancers and / or promoters can be "endogenous" or "foreign" or "heterologous". An "endogenous" enhancer or promoter is one that is naturally linked to a given gene in the genome. An "exogenous" or "heterologous" enhancer or promoter is one that is placed by genetic engineering (i.e., molecular biology techniques) near a gene such that it induces transcription of the gene to which it is linked. For example, an endogenous promoter that is operably associated with a first gene can be isolated, removed, and placed in operably associated with a second gene, thereby resulting in a "heterologous promoter" that is operably associated with the second gene. A variety of such combinations are contemplated, for example, the first and second genes can be from the same species or from different species.

[0058] Direct reprogramming of human urinary cells into reprogrammed vascular tissue (rVT) Ischemic cardiovascular diseases, including coronary artery disease (e.g., myocardial infarction) and peripheral artery disease (e.g., critical limb ischemia), are frequent causes of morbidity and mortality. The primary cause of these clinical outcomes is impaired blood vessels. Endothelial cells (ECs), as key components of the vasculature, are essential for repairing damaged or ischemic tissues. Several methods have been developed to generate ECs for use in cell therapy. One method to generate ECs is by direct lineage reprogramming using a single transcription factor (TF) ETV2 (a gene or gene product, including modified mRNA, protein, or protein-containing exosomes) that is specific and important for EC generation. This method has attracted attention due to potential advantages including a simple process and avoidance of the potential tumorigenicity that may be introduced when using pluripotent stem cells (PSCs) and induced pluripotent stem cells (iPSCs). The reprogramming method described herein may be applied to autologous cell therapy.

[0059] An improved reprogramming method has been developed that utilizes EC maturation in a short time to form vascular-like tissues including smooth muscle cells. Source cells are collected from patients in a non-invasive manner that can be used in clinical applications. The use of human urine cells can avoid the pain associated with biopsy source cell collection in the case of skin fibroblast collection. Urine cells are replicated and transformed into endothelial-like and smooth muscle-like tissues that are useful for treating diseases that require revascularization, including but not limited to coronary artery disease, myocardial infarction, heart failure, peripheral artery disease, critical limb ischemia, stroke, diabetic complications, and wound healing. Human urine cells are transformed into vascular-like tissues using a protocol that includes special culture conditions and ETV2 gene delivery into human urine cells.

[0060] The endogenous synthesis of a natural bio-scaffold or bio-matrix from autologous sources enhances the survival of transplanted cells in the target tissue. The natural ECM accumulates growth factors released by the therapeutic cells and provides a suitable microenvironment for the cells to initiate angiogenesis.

[0061] Natural biomatrix formed naturally from therapeutic cellular components provides an effective method of tissue formation, avoiding the complex processes required for the generation of individual cells and the formation of artificial tissues. Natural biomatrix is ​​more biocompatible because it is formed from autologous sources and its formation mechanism is largely free of the risk of pathogen invasion during the manufacturing process. Although cell-mediated matrix synthesis has not been substantially studied, studies have shown that VSMCs with a synthetic phenotype play an important role in natural matrix formation. Introduction of TGFB and PDGFB induced collagen synthesis. VSMCs significantly enhanced collagen synthesis even in lactate culture medium, indicating that glucose metabolism can affect cells with a synthetic phenotype. Administration of ascorbic acid stimulated collagen biosynthesis by VSMCs and dermal fibroblasts. Ascorbic acid, a cofactor for hydroxylproline and hydroxylysine, plays an important role in α-peptide cross-linking during collagen biosynthesis.

[0062] Derivation of urinary cells from human urine To obtain urine cells from the sample, urine is collected and centrifuged. Concentrated urine cells are collected and suspended in growth medium containing EGF, hydrocortisone, epinephrine and fetal bovine serum (FBS). The cell suspension is plated on a pre-gelatin-coated cell culture plate and cultured at 37°C and CO2 (5%) for 14 days. The urine cells from the colonies are maintained for further subculture as source cells for direct reprogramming. For clinical purposes, FBS can be replaced with patient-derived human serum to provide xeno-free conditions.

[0063] Reprogramming human urinary cells into vascular-like tissue / reprogrammed vascular tissue (rVT) To generate vascular-like tissue, human urinary cells are reprogrammed into endothelial cells by overexpression of ETV2 in specific culture conditions. Reprogramming of human urinary cells is initiated by infecting the cells with adenovirus expressing ETV2 for 24 hours in urinary cell growth medium. The endothelial reprogramming medium is then changed to contain VEGFA, EGF, bFGF, heparin and vitamin C (see FIG. 1). After ETV2 transduction, the morphology of urinary cells appears as corbelstone-shaped endothelial cells. The reprogramming process was monitored by changes in gene profile and protein expression compared to non-reprogrammed control urinary cells. To determine whether urinary cells were reprogrammed into endothelial cells, the mRNA levels of endothelial-specific genes, such as KDR, CDH5, PECAM1 and VWF, were measured by quantitative real-time PCR (FIG. 2). EC genes were significantly induced in ETV2-treated urinary cells. In addition to early endothelial genes, late mature endothelial genes such as PECAM1 and VWF were expressed (Figure 2). Thus, there was a rapid increase in induction of EC markers and a higher number of mature endothelial surface markers such as PECAM1, which does not occur in other source cell types such as dermal fibroblasts. Human dermal fibroblasts do not express such high levels of PECAM1 within the short reprogramming period of <14 days by ETV2 overexpression. Urine-derived cells were also transdifferentiated into several lineages, including smooth muscle-like cells.

[0064] During endothelial reprogramming, urinary cells formed specialized tube-like structures on the upper surface of the cell sheet. To test the functional properties, EC-specific acetic LDL uptake and UEA1 lectin binding were confirmed by fluorescent cytochemistry. The tissue was co-stained for EC and smooth muscle markers, such as CDH5, PECAM1, ACTA2, and CNN1. The reprogrammed tissue was enzymatically digested and separated into EC and non-EC populations using the EC-specific marker KDR. The populations separated by EC (ETV-VMT) and non-EC markers showed that the reprogrammed tissue was enriched in endothelial and smooth muscle-like cells, respectively (Figure 4). The reprogrammed tissue could be mechanically harvested and folded into vessel-like structures (Figure 5). The tissue contained 30-50% cells expressing EC markers, such as KDR, CDH5, and PECAM1. Compared with ETV2-induced reprogramming of human dermal fibroblasts, mature EC marker PECAM1 is significantly more abundant and efficiently induced in a shorter reprogramming period. Non-EC marker expressing cells (KDR negative) show high levels of smooth muscle markers such as SM22a, SMTN, ACTA2 and CNN1 (Figure 4). Tissues containing reprogrammed endothelial and smooth muscle-like cells were transplanted into mouse hindlimb ischemia model. The tissues were maintained in vivo for more than 3 months. Therefore, the tissues are more suitable for direct transplantation or injection into ischemic tissues, which require high maintenance and cell survival for treatment.

[0065] Endothelial cell generation using various other protocols, such as differentiation of PSCs and direct reprogramming of somatic cells, has not been reported to achieve sufficient numbers of functional endothelial cells within the desired time for clinical application. A major drawback in using reprogrammed ECs in clinical applications is the low maintenance efficiency of ECs injected into the ischemic target area of ​​patients. The method disclosed herein has several advantages compared to other EC generation methods. Urine provides an unlimited supply of source cells that can be obtained in a non-invasive manner. EC generation can be performed in a more timely manner compared to other methods. Both reprogrammed endothelial and smooth muscle cells can be obtained in a cell sheet structure that is well maintained in the ischemic area without heterologous biomaterials. The reprogrammed vascular-like tissues are applicable to autologous cell therapy of various ischemic diseases, such as PAD and MI. Aspects of the invention Aspects of the present invention are further described in the following sections: [Section 1] i) concentrating urine cells from a subject; ii) separating the concentrated urine cells; a) EGF, b) hydrocortisone, c) epinephrine, and d) Human or animal serum to provide purified concentrated urine-derived cells; iii) exposing the purified concentrated urine-derived cells to ETV2; iv) culturing the purified concentrated urine-derived cells in a first growth medium to provide endothelial-like urine-derived cells; v) subjecting said endothelial-like urine-derived cells to a) EGF, b) VEGFA; c) bFGF, d) heparin, e) L-ascorbic acid, and d) Human or animal serum to provide endothelial and smooth muscle-like vascular tissue; 2. A method for producing endothelial and smooth muscle-like vascular tissue, comprising: [Section 2] The method according to item 1 above, wherein the human serum is derived from a subject. [Section 3] The method according to item 1, wherein exposing the purified concentrated urine-derived cells to ETV2 is by mixing the purified concentrated urine-derived cells with a recombinant virus that infects the purified concentrated urine-derived cells, contains a gene encoding ETV2, and expresses ETV2 after infection. [Section 4] 4. The method according to item 3 above, wherein the recombinant virus is an adenovirus or a lentivirus. [Section 5] 2. The method according to claim 1, wherein the growth medium comprises glucose, amino acids and vitamins, glutamine and sodium pyruvate. [Section 6] Item 2. The method according to item 1, further comprising a step of folding the endothelial and smooth muscle-like vascular tissue into a three-dimensional structure. [Section 7] The method according to item 1, further comprising transplanting endothelial and smooth muscle-like vascular tissue into a subject. [Section 8] 8. The method according to item 7 above, wherein transplanting the endothelial and smooth muscle-like vascular tissue is by contacting the endothelial and smooth muscle-like vascular tissue with a vein, an artery, a capillary, myocardium, skin, lung, kidney or intestine.

Claims

1. i) concentrating urine cells from a subject; ii) separating the concentrated urine cells; a) EGF, b) hydrocortisone, c) epinephrine, and d) Human or animal serum to provide purified concentrated urine-derived cells; iii) exposing the purified concentrated urine-derived cells to ETV2; iv) culturing the purified concentrated urine-derived cells in a first growth medium to provide endothelial-like urine-derived cells; v) subjecting said endothelial-like urine-derived cells to a) EGF, b) VEGFA; c) bFGF; d) heparin, e) L-ascorbic acid, and d) Human or animal serum to provide endothelial and smooth muscle-like vascular tissue; A method for producing endothelial and smooth muscle-like vascular tissue, comprising:

2. The method of claim 1 , wherein the human serum is derived from a subject.

3. 2. The method of claim 1, wherein exposing the purified concentrated urine-derived cells to ETV2 is by mixing the purified concentrated urine-derived cells with a recombinant virus that infects the purified concentrated urine-derived cells, contains a gene encoding ETV2, and expresses ETV2 after infection.

4. The method of claim 3, wherein the recombinant virus is an adenovirus or a lentivirus.

5. 10. The method of claim 1, wherein the growth medium comprises glucose, amino acids and vitamins, glutamine, and sodium pyruvate.

6. i) concentrating urine cells from a subject; ii) separating the concentrated urine cells; a) EGF, b) hydrocortisone, c) epinephrine, and d) Human or animal serum to provide purified concentrated urine-derived cells; iii) exposing the purified concentrated urine-derived cells to ETV2; iv) culturing the purified concentrated urine-derived cells in a first growth medium to provide endothelial-like urine-derived cells; v) subjecting said endothelial-like urine-derived cells to a) EGF, b) VEGFA; c) bFGF; d) heparin, e) L-ascorbic acid, and d) Human or animal serum to provide endothelial and smooth muscle-like vascular tissue; vi) folding said endothelial and smooth muscle-like vascular tissue into a three-dimensional structure; A method for producing a three-dimensional structure of endothelial and smooth muscle-like vascular tissue, comprising:

7. A method according to any one of claims 1 to 6, wherein the endothelial and smooth muscle-like vascular-like tissue or the three-dimensional structure of the endothelial and smooth muscle-like vascular-like tissue is for transplantation into a subject.

8. The method according to claim 7, wherein the transplantation is carried out by contacting the endothelial and smooth muscle-like vascular-like tissue or the three-dimensional structure of the endothelial and smooth muscle-like vascular-like tissue with a vein, an artery, a capillary, myocardium, skin, lung, kidney or intestine.

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