Axial stem cells, method of generating them, and use

Abstract

The present invention relates to methods for generating axial stem cells (AxSCs), as well as AxSCs generated by such methods and uses thereof. The present invention further relates to Axial Stem Cells (AxSCs) that are not pluripotent cells, but are, for example, region-specific multipotent stem cells that can replicate themselves indefinitely.

Description

Technical Field

[0001] This application includes a sequence listing in computer-readable form, which is incorporated herein by reference.

[0002] Technical Field The present invention relates to a method for generating axial stem cells (AxSC), and to axial stem cells (AxSC) generated by such a method, for example, and their use. The present invention further relates to regionally specific differentiating pluripotent stem cells that are not pluripotent cells; can be obtained from pluripotent stem cells; cannot differentiate into cell types of all tissues of the embryo; can only differentiate into cell types that emerge from the region of the central body axis during embryogenesis (for example, somites, dermomyotomes and peripheral neurons); cannot form teratomas; can mimic the characteristics of precursors that give rise to axial region (for example, cells of motor neurons, peripheral neurons, peripheral nervous system neurons, sensory neurons, bone, cartilage, tendon, ligament and / or skeletal muscle); are not transient cells; can differentiate into precursors of motor neurons, peripheral neurons, muscle, cartilage or bone; can replicate (renew) stem cells without limitation; and can proliferate as clones. The present invention relates to axial stem cells (AxSC) having one or more of these characteristics.

Background Art

[0003] A prominent feature of mammalian development is the ability of embryonic cells to self-replicate for a defined period, producing daughter offspring that undergo differentiation into various tissue types while maintaining separate pools of stem cells. Identifying mechanisms that promote the proliferation and inhibit the differentiation of pluripotent, trophoblastic, and extraembryonic endoderm cells in mouse blastocysts has led to the informed design of cell culture environments that facilitate the induction of unrestrictedly replicating stem cell lines, designated ESC / PSC, TSC, and XEN, respectively (Martin, 1981; Evans and Kaufman, 1981; Tanaka et al., 1998; Niakan et al., 2013). Furthermore, pluripotent strains corresponding to pre- and post-transplant blastocysts, named naive / basal state and priming state, respectively, as well as the recently proposed formative pluripotency state (Smith, 2017), have been created by manipulating the signaling cascades that regulate each developmental stage (Nichols and Smith, 2009; Brons et al., 2007; Tesar, 2005). Notably, the fundamental modes of regulation for these stages are evolutionarily conserved and have led to the induction of human stem cell lines representing blastocyst lineages (differentiation series) (Thomson et al., 1998; Gafni et al., 2013; Guo et al., 2016; Takashima et al., 2014; Theunissen et al., 2014). The application of culture conditions that maintain PSCs and ectopically expressed pluripotent transcription factors has led to the induction of artificial (i)PSCs from a variety of mammalian species, including humans (Takahashi et al., 2007; Takahashi and Yamanaka, 2006; Yu et al., 2007; Liu et al., 2008). This leads to the conclusion that the repertoire of cell types present in blastocysts may be regenerated and maintained indefinitely as stem cell lines in culture. Since the regulation of proliferation and differentiation is also present in the later stages of embryonic development, this raises the question of whether it is possible to create further types of non-pluripotent stem cells representing specific embryonic regions.

[0004] One example of a post-blastocyst developmental stage involving extensive proliferation and differentiation is the process of axial elongation. It begins in the posterior region of the primitive streak and continues from the tail bud embryo until axial elongation is complete (Benazeraf and Pourquie, 2013). This process is driven by stem cell-like precursors that are initially formed in the primitive streak and present during axial elongation at the node-primitive streak border (NSB), caudal lateral epiblast (CLE), and chordoneural hinge (CNH) of the mouse embryo (Henrique et al., 2015). These so-called axial progenitors are thought to give rise to all peripheral neurons, sclerotone lineages, and cutaneous myotomyocyte lineages, such as motor neurons, peripheral neurons, peripheral nervous system neurons, sensory neurons, bone, cartilage, tendons, ligaments, and / or skeletal muscle cells (Cambray and Wilson, 2002, 2007; Garriock et al., 2015; Attardi et al., 2018), and transplantation experiments have shown that they possess a high degree of developmental plasticity (Cambray and Wilson, 2007; Tzouanacou et al., 2009; McGrew et al., 2008).

[0005] The identification and maintenance of the body axis precursor are driven by the interaction of Wnt / β-catenin signaling and FGF signaling (Henrique et al., 2015). A distinct feature of this process is the co-expression of TBXT and SOX2, which are generally considered to be the major non-overlapping regulators of mesoderm and neurogenesis, respectively (Delfino-Machin et al., 2005; Tsakiridis et al., 2014; Gouti et al., 2014; Koch et al., 2017). Based on this expression pattern, and their anatomical locations listed above as giving rise to peripheral neurons, sclerotolus lineages, and cutaneous muscularis plate lineages, they were classified as neuromesodermal progenitors (NMPs) (Gouti et al., 2014; Turner et al., 2014; Cambray and Wilson, 2007; Tzouanacou et al., 2009; Brown and Storey, 2000; Wilson et al., 2009; Olivera-Martinez et al., 2012). Notochord progenitors (Wilson and Beddington, 1996) and lateral plate mesoderm progenitors (LPMPs) of the anterior and trunk (Kinder et al., 1999; Smith et al., 1994; Taguchi et al., 2014) are further cell types located in the axial region. Recent global transcriptomics studies have shown that while all three axial progenitor cell types are clearly distinguishable, they share a great many gene expression patterns, making differentiation difficult in targeted approaches (Wymeersch et al., 2019). To date, the potential for functional development of axial precursors and whether they can be converted into stem cell lines remains an unresolved question.

[0006] Precursors mimicking the transcriptional phenotype of axial NMPs, including the expression of TBXT and SOX2, have been induced from mouse and human ESCs by activation of the Wnt and FGF pathways (Gouti et al., 2014; Turner et al., 2014; Lippmann et al., 2015; Tsakiridis and Wilson, 2015; Gouti et al., 2017; Denham et al., 2015; Verrier et al., 2018). However, their properties (identity), purity, and differentiation potential have been debated (Edri et al., 2018), and importantly, their long-term self-renewal has not been demonstrated.

[0007] Known methods for generating human axial offspring are labor-intensive, costly, and the resulting transient axial precursors are contaminated with numerous other cell types. Therefore, despite a detailed understanding of hypocotyl elongation in mammals, axial stem cells (AxSCs) have not been induced, and this stage remains inaccessible in human embryos. [Prior art documents] [Non-patent literature]

[0008] [Non-Patent Document 1] Martin, GR (1981) Proc Natl Acad Sci USA 78, 7634-7638. [Non-Patent Document 2] Evans, MJ, and Kaufman, MH (1981) Nature 292, 154-156 [Non-Patent Document 3] Tanaka, S., Kunath, T., Hadjantonakis, A.K., Nagy, A., and Rossant, J. (1998) Science 282, 2072-2075. [Non-Patent Document 4] Niakan, K.K., Schrode, N., Cho, L.T., and Hadjantonakis, A.K. (2013) Nat Protoc 8, 1028-1041. [Non-Patent Document 5] Smith, A. (2017) Development 144, 365 - 373

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Summary of the Invention

Means for Solving the Problems

[0009] The present invention relates to a method for generating (or inducing) axial stem cells (AxSCs) (or neuromuscular stem cells), comprising the step of providing pluripotent stem cells, embryonic stem cells, or induced pluripotent stem cells (e.g., human PSCs and / or ESCs and / or iPSCs, e.g., human ESC strain H9(WA09) or human iPSC strain HMGU#1), wherein, preferably prior to the induction / generation, the pluripotent cells are maintained in a suitable pluripotent cell medium (e.g., mTESR®1, or StemMACS® iPS-Brew XF, as described by Ludwig T, Thomson JA, Curr Protoc Stem Cell Biol. September 2007), and more preferably, the suitable pluripotent cell medium is supplemented with a vitamin A-containing or vitamin A-containing B27 supplement (e.g., Brewer GJ, Cotman CW., Brain Res.) for the induction / generation (i.e., prior to the induction / generation). The process is replaced by the steps described in 7 August 1989; 494(1):65-74, and the process is to activate the Wnt / β-catenin signaling pathway in the pluripotent stem cells, embryonic stem cells, or induced pluripotent stem cells (e.g., GO:0016055; for example, the Wnt / β-catenin signaling pathway is a series of molecular signals initiated by the binding of Wnt proteins to frizzled family receptors on the surface of target cells and ending with a change in cellular state (Huelsken J, Birchmeier W., New aspects of Wnt signalling pathways in higher vertebrates. Current Opinion in Genetics & Development). (October 2001;11(5):547-553), preferably the above activation is carried out by using an inhibitor of the GSK3-β protein (e.g., UniProtKB-P49841), more preferably the inhibitor is CHIR99021, more preferably the CHIR99021 inhibitor is used at a concentration of about 5 μM to about 10 μM, more preferably the CHIR99021 inhibitor is used for about 24 hours, and the cells derived from step (b) areThe process involves subculturing the cells under conditions of continuous activation of the Wnt / β-catenin signaling pathway during subculturing, preferably for at least 3 to 9 subculturings (e.g., 3, 4, 5, 6, 7, 8, or 9 subculturings), more preferably for continuous subculturings, and most preferably for subculturing the cells derived from step (b) to be reseeded at a lower density in fresh serum-free medium (e.g., RPMI1640 medium supplemented with or without vitamin A B27 supplement) (e.g., reseeding to single cells or cell clusters). The process comprises the dissociation of colonies and their plating, and preferably the continuous activation of the Wnt / β-catenin signaling pathway is carried out by using an inhibitor of the Wnt / β-catenin signaling pathway, more preferably the inhibitor is CHIR99021, and most preferably the CHIR99021 inhibitor is used at a concentration of at least about 5 μM (e.g., about 7.5 μM), and the cells derived from step (c) endogenously express the transcription factor SOX-2 (e.g., UniProtKB-P48431). (d1) The above-mentioned sequential activation of the Wnt / β-catenin signaling pathway from step (c) is carried out in the presence of a fibroblast growth factor 2 (e.g., UniProtKB-P09038) and / or a TGF-β (e.g., UniProtKB-P01137) inhibitor, preferably (d1) the above-mentioned sequential activation of the Wnt / β-catenin signaling pathway from step (c) is carried out using a CHIR99021 inhibitor at a concentration of approximately 5 μM, with the presence of a fibroblast growth factor 2 (e.g., UniProtKB-P09038) and a TGF-β (e.g., UniProtKB-P01137) inhibitor. The procedure is carried out in the presence of an inhibitor, more preferably the TGF-β inhibitor is SB-431542, more preferably the SB-431542 inhibitor is used at a concentration of about 10 μM, and more preferably the fibroblast growth factor 2 is used at a concentration of about 20 to about 100 ng / ml, and the cells derived from step (d1) are transcribed with transcription factor SOX-2 (e.g., UniProtKB-P48431), T-box transcription factor T (e.g., UniProtKB-O15178) and homeobox protein MIXL1 (e.g.,(d2) The following proteins endogenously express UniProtKB-Q9H2W2) but do not endogenously express the paired-box protein Pax-6 (e.g., UniProtKB-P26367), and optionally further endogenously express the homeobox protein CDX-2 (e.g., UniProtKB-Q99626), or the above sequential activation of Wnt / β-catenin signaling from step (c) is performed using a CHIR99021 inhibitor at a concentration of approximately 5 μM, preferably a TGF-β inhibitor (e.g., UniProtKB-P01137). The procedure is carried out in the presence of, more preferably, the TGF-β inhibitor is SB-431542, and most preferably, the SB-431542 inhibitor is used at a concentration of about 10 μM, and the cells derived from step (d2) endogenously express the transcription factor SOX-2 (e.g., UniProtKB-P48431) and the paired-box protein Pax-6 (e.g., UniProtKB-P26367), but also express the T-box transcription factor T (e.g., UniProtKB-O15178) and the homeobox protein MIXL1 (e.g., UniPro If tKB-Q9H2W2) and the homeobox protein CDX-2 (e.g., UniProtKB-Q99626) are not endogenously expressed, or if the above sequential activation of Wnt / β-catenin signaling from step (c) (d3) is carried out using a CHIR99021 inhibitor at a concentration of approximately 7.5 μM, preferably in the presence of a TGF-β (e.g., UniProtKB-P01137) inhibitor, more preferably the TGF-β inhibitor being SB-431542, and most preferably the SB-431542 inhibitor being used at a concentration of approximately 10 μM This invention relates to a method in which cells used and induced from step (d3) endogenously express the transcription factor SOX-2 (e.g., UniProtKB-P48431), T-box transcription factor T (e.g., UniProtKB-O15178), homeobox protein MIXL1 (e.g., UniProtKB-Q9H2W2), and paired-box protein Pax-6 (e.g., UniProtKB-P26367), and optionally further endogenously express the homeobox protein CDX-2 (e.g., UniProtKB-Q99626).

[0010] This application satisfies this requirement by providing a method for generating axial stem cells (AxSCs), as described below herein, characterized in the claims, and illustrated by the appended examples and drawings, as well as axial stem cells (AxSCs) generated by such a method, and their use. [Brief explanation of the drawing]

[0011] Sequence List Overview Sequence ID 1: DNA sequence of the GAPDH forward primer (for SYBR Green qPCR). Sequence ID 2: DNA sequence of the GAPDH reverse primer (for SYBR Green qPCR). Sequence ID 3: DNA sequence of the MNX1(HB9) forward primer (for SYBR Green qPCR). Sequence ID 4: This is the DNA sequence of the MNX1(HB9) reverse primer (for SYBR Green qPCR). Sequence ID 5: DNA sequence of the PRPH forward primer (for SYBR Green qPCR). Sequence ID 6: DNA sequence of the PRPH reverse primer (for SYBR Green qPCR). Sequence ID 7: This is the DNA sequence of the POU4F1 forward primer (for SYBR Green qPCR). Sequence ID 8: This is the DNA sequence of the POU4F1 reverse primer (for SYBR Green qPCR). Sequence ID 9: This is the DNA sequence of the RUNX2 forward primer (for SYBR Green qPCR). Sequence ID 10: DNA sequence of the RUNX2 reverse primer (for SYBR Green qPCR). Sequence ID 11: This is the DNA sequence of the BGLAP forward primer (for SYBR Green qPCR). Sequence ID 12: This is the DNA sequence of the BGLAP reverse primer (for SYBR Green qPCR). Sequence ID 13: This is the DNA sequence of the COL1A1 forward primer (for SYBR Green qPCR). Sequence ID 14: This is the DNA sequence of the COL1A1 reverse primer (for SYBR Green qPCR). Sequence ID 15: DNA sequence of NKX3-2 forward primer (for SYBR Green qPCR). Sequence ID 16: DNA sequence of the NKX3-2 reverse primer (for SYBR Green qPCR). Sequence ID 17: DNA sequence of the COMP forward primer (for SYBR Green qPCR). Sequence ID 18: DNA sequence of the COMP reverse primer (for SYBR Green qPCR). Sequence ID 19: DNA sequence of the ACAN forward primer (for SYBR Green qPCR). Sequence ID 20: DNA sequence of the ACAN reverse primer (for SYBR Green qPCR). Sequence ID 21 is, for example, an exemplary amino acid sequence of the human SOX-2 protein corresponding to UniProtKB acceptance number P48431. Sequence ID 22 is, for example, an exemplary amino acid sequence of the human POU5F1 protein (also known as OCT4) corresponding to UniProtKB acceptance number Q01860-1. Sequence ID 23 is, for example, an exemplary amino acid sequence of a human NANOG protein corresponding to UniProtKB acceptance number Q9H9S0-1. Sequence ID 24 is, for example, an exemplary amino acid sequence of the human TBXT protein corresponding to UniProtKB acceptance number O15178-1. Sequence ID 25 is, for example, an exemplary amino acid sequence of the human CDX2 protein corresponding to UniProtKB acceptance number Q99626-1. Sequence ID 26 is, for example, an exemplary amino acid sequence of the human MIXL1 protein corresponding to UniProtKB acceptance number Q9H2W2-1. Sequence ID 27 is, for example, an exemplary amino acid sequence of the human PAX6 protein corresponding to UniProtKB acceptance number P26367-1. Sequence ID 28 is, for example, an exemplary amino acid sequence of the human GSK3B protein corresponding to UniProtKB acceptance number P49841-1. Sequence ID 29 is, for example, an exemplary amino acid sequence of the human FGF2 protein corresponding to UniProtKB acceptance number P09038-4. Sequence ID 30 is, for example, an exemplary amino acid sequence of the human TGFB1 protein corresponding to UniProtKB acceptance number P01137-1. Sequence ID 31 is, for example, an exemplary amino acid sequence of the human LIN28B protein corresponding to UniProtKB acceptance number Q6ZN17-1. Sequence ID 32 is, for example, an exemplary amino acid sequence of the human MYCN protein corresponding to UniProtKB acceptance number P04198-1. Sequence ID 33 is, for example, an exemplary amino acid sequence of the human ZIC2 protein corresponding to UniProtKB acceptance number O95409-1. Sequence ID 34 is, for example, an exemplary amino acid sequence of the human IRX3 protein corresponding to UniProtKB acceptance number P78415-1. Sequence ID 35 is an exemplary amino acid sequence of the human SOX1 protein, corresponding, for example, to UniProtKB acceptance number O00570-1. Sequence ID 36 is an exemplary amino acid sequence of the human SOX11 protein, corresponding, for example, to UniProtKB acceptance number P35716-1. Sequence ID 37 is an exemplary amino acid sequence of the human homeobox protein Nkx-2.1, corresponding, for example, to UniProtKB acceptance number P43699-1. Sequence ID 38 is, for example, an exemplary amino acid sequence of the human E3 ubiquitin protein ligase TRIM71, corresponding to UniProtKB acceptance number Q2Q1W2-1. Sequence ID 39 is, for example, an exemplary amino acid sequence of human forkheadbox protein B1 corresponding to UniProtKB acceptance number Q99853-1.

[0012] [Figure 1A] Constitutive Wnt / β-catenin signaling and passaging promote stable expression of T and SOX2 in hESC offspring. Time-course analysis of T by qPCR comparing single and repeated treatment of hESCs with CHIR99021 (n=3, error bars - SEM; all other qPCR analyses below are also performed similarly). [Figure 1B] Constitutive Wnt / β-catenin signaling and passage promote stable expression of T and SOX2 in hESC offspring. Time-course RNA-seq (n=2) of constitutively active forms of β-catenin constitutively treated with CHIR99021 and overexpressed in hESCs. Principal component analysis. [Figure 1C] Constitutive Wnt / β-catenin signaling and passage promote stable expression of T and SOX2 in hESC offspring. Time-course RNA-seq (n=2) of constitutively active forms of β-catenin constitutively treated with CHIR99021 and overexpressed in hESCs. Panel of expression of primitive streak (T, MIXL1, EVX1, CDX2), gestational sclera (GSC), and paraxial mesoderm (TBX6) markers over time. [Figure 1D] Constitutive Wnt / β-catenin signaling and passage promote stable expression of T and SOX2 in hESC offspring. Time-course RNA-seq (n=2) of constitutively active forms of β-catenin constitutively treated with CHIR99021 and overexpressed β-catenin in hESCs. Venn diagram of upregulated genes at 72 hours compared with untreated cells (FC>2, padj≦0.05) and enriched tissue categories. [Figure 1E]Constitutive Wnt / β-catenin signaling and passage promote stable expression of T and SOX2 in hESC offspring. Time-course RNA-seq (n=2) of constitutively active forms of β-catenin constitutively treated with CHIR99021 and overexpressed in hESCs. Heatmap of upregulated genes assigned to the most enriched tissue categories from (D): ectoderm, mesoderm, neural tube and neural crest. [Figure 1F] Constitutive Wnt / β-catenin signaling and passaging promote stable expression of T and SOX2 in hESC offspring. Time-course RNA-seq (n=2) of constitutively active forms of β-catenin constitutively treated with CHIR99021 and overexpressed in hESCs. The most significantly enriched signaling cascade over time. [Figure 1G] Constitutive Wnt / β-catenin signaling and passage promote stable expression of T and SOX2 in hESC offspring. Time-course RNA-seq (n=2) of constitutively active forms of β-catenin constitutively treated with CHIR99021 and overexpressed β-catenin in hESCs. Changes in the expression fold of core pluripotency genes over time. [Figure 1H] Constitutive Wnt / β-catenin signaling and passaging promote stable expression of T and SOX2 in hESC offspring. Time-course RNA-seq of constitutively active forms of β-catenin overexpressed in hESCs constitutively treated with CHIR99021 (n=2). Analysis of core pluripotency genes and T by qPCR 24 hours after 10 μM CHIR99021 treatment and after passages 1, 3, and 5. Passaging medium was supplemented with either 5 μM CHIR99021 (5C) or 5 μM CHIR + 100 ng / ml FGF2 (5CF) (n=4). [Figure 2A]WNT and WNT / FGF2 promote the establishment of unrestricted, axial-like cell lines. The treatment scheme used to establish axial stem cell lines shows a gradient of CHIR99021 concentrations and the presence of FGF2 and the TGF-β pathway inhibitor SB431542. Colored sectors indicate conditions that resulted in successful induction of lines of 9 passages or more. The complete conditions matrix is ​​given in Figure S2. Based on more than three independent inductions using the H9 hESC line. [Figure 2B] WNT and WNT / FGF2 promote the establishment of unrestricted, axial-like cell lines. The treatment scheme used to establish axial stem cell lines shows a gradient of CHIR99021 concentrations and the presence of FGF2 and the TGF-β pathway inhibitor SB431542. Colored sectors indicate conditions that resulted in successful induction of lines of 9 passages or more. The complete conditions matrix is ​​given in Figure S2. Based on more than three independent inductions using the H9 hESC line. [Figure 2C] WNT and WNT / FGF2 promote the establishment of axial cell lines that replicate indefinitely. The upper panel shows representative phase-contrast micrographs (10x magnification) of cell lines established by the treatment shown in passage 25 (the inset is a high-density micrograph of the CHIR99021+FGF2+TGF-β inhibitor SB431542 cell line from the same passage). The lower panel shows representative immunofluorescence micrographs (40x magnification) of the corresponding cell lines, passages 26-28. Double staining with SOX2 and T, and single staining with CDX2 and PAX6, respectively (scale bar - 40 μm). [Figure 2D] WNT and WNT / FGF2 promote the establishment of unrestricted, axial-like cell lines. qPCR analysis of axial and neuronal genes in established cell lines at passages 5 and 9 is shown. Diagrammatic changes relative to undifferentiated H9 hESCs are shown (n=3, independently induced cell lines; NT - not tested, ND - not detected). [Figure 2E]WNT and WNT / FGF2 promote the establishment of unrestricted, axial-like cell lines. qPCR analysis of axial and neuronal genes in established cell lines at passage 26 is shown. Diagrammatic changes relative to undifferentiated H9 hESCs are shown (n=3, independently induced cell lines; NT - not tested, ND - not detected). [Figure 2F] WNT and WNT / FGF2 promote the establishment of axial cell lines that replicate indefinitely. Representative phase-contrast micrographs (10x magnification) of cell lines established in the presence of 7.5 μM CHIR99021 or CHIR99021 + TGF-β inhibitor SB431542 at passage 25 (high-density cultures are shown in the inset), and representative immunofluorescence micrographs of CHIR99021 + SB431542 samples at passage 28. [Figure 2G] WNT and WNT / FGF2 promote the establishment of axial cell lines that replicate unrestricted. qPCR analysis of cell lines established in the presence of 7.5 μM CHIR99021 or CHIR99021 + TGF-β inhibitor SB431542. qPCR analysis of mesoderm and neural genes in the above cell lines at passages 5 and 26 (n=3, independently induced cell lines). [Figure 3A] Directional differentiation of axial stem cells. A summary of successfully established cell lines exhibiting characteristic gene expression patterns and their presumed differentiation biases. [Figure 3B] Directional differentiation of axial stem cells. Venn diagrams showing upregulated and downregulated genes (log2FC≧2, FDR<0.05, 9-12 passages) in RNA sequencing datasets, comparing cell lines established with CHIR99021 alone, CHIR99021+SB43154, and CHIR99021+SB43154+FGF2 treatment with the undifferentiated H9 parental cell line. [Figure 3C] Directional differentiation of axial stem cells. Gene ontology analysis (molecular function) of significantly upregulated genes from each cell line. p-values ​​(Fisher test) are shown for all categories. [Figure 3D]Directional differentiation of axial stem cells. qPCR analysis of indicated genes during medium changes from the basal state (CHIR99021+SB43154+FGF2) to the priming state (CHIR99021+SB43154) and vice versa at 1, 2, and 3 weeks. Log2 factor changes relative to the undifferentiated parental cell line are shown. ND-Ct values ​​were not determined during qPCR. [Figure 3E] Directional differentiation of axial stem cells. Predicted differentiation capacity of axial stem cells along the major pathway. [Figure 3F] Directional differentiation of axial stem cells. CHIR+TGFi and CHIR+FGF2+TGFi cells differentiated into motor neurons for 15 and 28 days. Phase-contrast images and single immunofluorescence staining at 10x magnification for Tuj1, Isl1, and HB9 cells overlaid with DAPI (blue) are shown. Magnification - 40x for 15 days, 63x for 28 days; scale bars - 20 and 50 μm, respectively. [Figure 3G] Directional differentiation of axial stem cells. qPCR analysis of neuronal markers after differentiation at 15 and 26 days from CHIR+FGF2+TGFi and CHIR+TGFi cell lines. Log2 factor changes compared to undifferentiated parental cell lines are shown (n=3, NT- test not performed). [Figure 3H] Directional differentiation of axial stem cells. qPCR analysis of osteocytes derived from the specified conditions after 15 days of differentiation. Log2 factor change compared to the undifferentiated parental cell line is shown (n=3). [Figure 3I] Directional differentiation of axial stem cells. qPCR analysis of chondrocytes derived from the specified conditions after 15 days of differentiation. Log2 factor changes compared to the undifferentiated parental cell line are shown (n=3). [Figure 3J] Directional differentiation of axial stem cells. Alizarin red staining of CHIR+FGF2+TGFi and CHIR+TGFi strains after 15 days of osteogenic differentiation. Undifferentiated CHIR+TGFi control is shown side by side. [Figure 3K]Directional differentiation of axial stem cells. Alcian blue staining of CHIR+FGF2+TGFi and CHIR+TGFi strains after 15 days of chondrogenic differentiation. Undifferentiated CHIR+TGFi control is shown side by side. [Figure 4] A) Outline of ligand combinations used in maintenance media for inducing axial stem cells. The top row in μM indicates the CHIR99021 concentration. Green rectangles indicate successful cell line establishment (more than 9 passages). Rectangles marked with an "x" indicate unsuccessful induction terminated by cell death, lack of proliferation, and terminal differentiation. Gray rectangles indicate cell lines maintained beyond 9 passages but exhibiting unstable growth and prolonged spontaneous differentiation across passages. [Figure 5A] Gene expression based on quantitative PCR in 10 individually isolated clones from the CHIR-FGF2-SB431542 strain, which exhibits heterogeneity in CDX2 expression. Clones were induced from 27 passages of the parental strain and analyzed at 4 passages after isolation. Gene expression is expressed as a relative amount (relative to GAPDH). n=1. [Figure 5B] Immunofluorescence analysis of eight clones from A) for Cdx2 and TBXT expression. Representative image at 63x magnification. [Figure 6A] An overview of axial stem cell induction from human iPS cell line (HMGU#1). The μM concentration is for CHIR99021. The concentrations of FGF2 and SB-431542 were the same as those for induction from H9 hES cell line, at 100 ng / ml and 10 μM, respectively. [Figure 6B] Quantitative qPCR analysis of marker gene expression in iPS-derived axial stem cell lines at passage 9. Expression is normalized to GAPDH and plotted as a Log2 factor change relative to the undifferentiated parental iPS cell line. Error bars represent the standard error of the mean between biological replicates (inducers). n=1-6. [Figure 7A]RNA-seq analysis of Hox gene expression during CHIR99021 stimulation and β-catenin induction over time. Time points are 0 (unstimulated), 8 hours, 16 hours, 24 hours, 48 ​​hours, and 72 hours. All differentially expressed Hox genes (at any time point compared to 0 hours) are plotted (magnification change > 1.5, FDR < 0.05). Z-scores were calculated from normalized counts. [Figure 7B] RNA-seq analysis of Hox gene expression in established axial stem cell lines (log2 magnification change). Only Hox genes that were differentially expressed (any line relative to undifferentiated parental hES) are plotted (magnification change > 1.5, FDR < 0.05). [Figure 7C] Venn diagram showing the overlap in Hox gene expression between 72 hours after CHIR99021 stimulation and the established CHIR-FGF2-SB431542 axial stem cell line (only differentially expressed Hox genes are compared). Genes expressed only in the established line are listed on the right. [Figure 8A] Gene expression analysis revealing the axial identity of novel, unrestricted self-replicating cells. qPCR analysis of pluripotency genes, axial genes, neural genes, and mesodermal genes in cells induced for 24 hours by CHIR99021 at passages 1, 3, and 5, and in CHIR99021+FGF2+SB431542-driven cells (CFS) (magnification changes relative to undifferentiated H9 hESC, n=3, independently induced cell lines). [Figure 8B] qPCR analysis of pluripotency, axial, neural, and mesoderm genes in cells induced for 24 hours by CHIR99021 at passages 1, 2, 3, and 4, and in CHIR99021+SB431542-driven cells (CS) (magnification change relative to undifferentiated H9 hESC, n=3, independently induced cell lines). Error bars represent the mean standard error (SEM). [Figure 9A] UMAP visualization of single-cell sequencing of CFS and CS strains derived from hESCs (H9 and HUES6) and hiPSCs (HMGU1). [Figure 9B(1)]Expression of axial markers SOX2, TBXT, CDX2, and neuronal marker PAX6 at the single-cell level. [Figure 9B(2)] Expression of axial markers SOX2, TBXT, CDX2, and neuronal marker PAX6 at the single-cell level. [Figure 9C] A dot plot showing the average expression of lineage-specific markers. The dot size represents the percentage of cells expressing each gene, and the color intensity indicates the expression level. [Figure 9D] A dot plot showing the average expression of HOX genes. The dot size represents the percentage of cells expressing each gene, and the color intensity indicates the expression level. [Figure 9E] A dot plot showing the average expression of WNT genes and receptors involved in signaling pathways regulated through axial elongation and embryonic development. The dot size represents the percentage of cells expressing each gene, and the color intensity indicates the expression level. [Figure 9F] A dot plot showing the average expression of genes, FGF genes, and receptors involved in signaling pathways regulated through axial elongation and embryonic development. The dot size represents the percentage of cells expressing each gene, and the color intensity indicates the expression level. [Figure 9G] A dot plot showing the average expression of TGFb genes and receptors, which are involved in signaling pathways regulated through axial elongation and embryonic development. The dot size represents the percentage of cells expressing each gene, and the color intensity indicates the expression level. [Figure 9H] A dot plot showing the average expression of genes, NOTCH ligands, and receptors involved in signaling pathways regulated through axial elongation and embryonic development. The dot size represents the percentage of cells expressing each gene, and the color intensity indicates the expression level. [Figure 9I] A dot plot showing the average expression of retinoic acid receptors, genes involved in signaling pathways regulated through axial elongation and embryonic development. The dot size represents the percentage of cells expressing each gene, and the color intensity indicates the expression level. [Figure 9J] A dot plot showing the average expression of BMP genes and receptors involved in signaling pathways regulated through axial elongation and embryonic development. The dot size represents the percentage of cells expressing each gene, and the color intensity indicates the expression level. [Figure 10A] UMAP visualization of Louvain clustering in CS strains. [Figure 10B] A dot plot showing the average expression of lineage-specific markers in the CS cluster. The dot size represents the percentage of cells expressing each gene, and the color intensity indicates the expression level. [Figure 11A] UMAP visualization of Louvain clustering in CS strains. [Figure 11B] A dot plot showing the average expression of lineage-specific markers in the CS cluster. The dot size represents the percentage of cells expressing each gene, and the color intensity indicates the expression level. [Figure 12A] Neural differentiation of axial stem cells. Schematic diagram of the neural differentiation process and cytokines in the differentiation medium. [Figure 12B] Neural differentiation of axial stem cells. Representative phase-contrast micrographs (20x magnification) of CFS strains (upper panel) and CS strains (lower panel) at days 2 and 16 during differentiation. [Figure 12C] Neural differentiation of axial stem cells. qPCR analysis of neural markers at day 28 of differentiation from three CFS strains (P: parental cells, N: neural differentiation). Each symbol in each bar indicates a technical repeat. Error bars represent the mean standard error (SEM). Magnification changes are shown relative to undifferentiated H9 hESCs. [Figure 12D] Neural differentiation of axial stem cells. qPCR analysis of neural markers at day 28 of differentiation from three CS strains (P: parental cells, N: neural differentiation). Each symbol in each bar indicates a technical repeat. Error bars represent the standard error of the mean (SEM). Magnification changes are shown relative to undifferentiated H9 hESCs. [Figure 12E]Neural differentiation of axial stem cells. Immunofluorescence staining of motor neuron marker (MNX1, green), panneuronal marker (TUJ1, red), and DAPI (blue) at 63x magnification on day 28 of differentiation from CFS cells. [Figure 12F] Neural differentiation of axial stem cells. Immunofluorescence staining of motor neuron marker (MNX1, green), panneuronal marker (TUJ1, red), and DAPI (blue) at 63x magnification on day 14 after differentiation from CS strain. [Figure 13A] Skeletal muscle differentiation of axial stem cells. Schematic diagram of the skeletal muscle differentiation process (#1-4) and cytokines in the differentiation medium. [Figure 13B] Skeletal muscle differentiation of axial stem cells. Representative phase-contrast micrograph (20x magnification) at day 40 of differentiation from a CFS strain. Scale bar is 20 μm. [Figure 13C] Skeletal muscle differentiation of axial stem cells. Representative phase-contrast micrographs (20x magnification) of differentiation from three independently induced CS strains at day 6. Scale bar is 20 μm. [Figure 13D] Skeletal muscle differentiation of axial stem cells. qPCR analysis of stage-specific muscle development markers at day 40 of differentiation from CFS strains using the process shown (#1). Each symbol in each bar indicates a technical repeat (P: parental cell, N: neural differentiation). Error bars represent the mean standard error (SEM). Magnification changes are shown for undifferentiated H9 hESCs. [Figure 13E] Skeletal muscle differentiation of axial stem cells. qPCR analysis of stage-specific muscle development markers at day 40 of differentiation from CFS strains using the process shown (#2). Each symbol in each bar indicates a technical repeat (P: parental cell, N: neural differentiation). Error bars represent the standard error of the mean (SEM). Magnification changes are shown for undifferentiated H9 hESCs. [Figure 13F]Skeletal muscle differentiation of axial stem cells. qPCR analysis of stage-specific muscle development markers at day 40 of differentiation from CFS strains using the process shown (#3). Each symbol in each bar indicates a technical repeat (P: parental cell, N: neural differentiation). Error bars represent the mean standard error (SEM). Magnification changes are shown for undifferentiated H9 hESCs. [Figure 13G] Skeletal muscle differentiation of axial stem cells. qPCR analysis of stage-specific muscle development markers at day 40 of differentiation from CFS strains using the process shown (#4). Each symbol in each bar indicates a technical repeat (P: parental cell, N: neural differentiation). Error bars represent the mean standard error (SEM). Magnification changes are shown for undifferentiated H9 hESCs. [Figure 13H] Skeletal muscle differentiation of axial stem cells. Immunofluorescence staining of muscle markers MyoD (red), M-cadherin (green), and DAPI (blue) at day 40 of differentiation from CFS strains using the shown process, scale bar, magnification 63x. [Figure 13I] Skeletal muscle differentiation of axial stem cells. Immunofluorescence staining of muscle markers myogenin (red), M-cadherin (green), and DAPI (blue) at day 40 of differentiation from CFS strains using the shown process, scale bar, magnification 63x. [Figure 13J] Skeletal muscle differentiation of axial stem cells. Immunofluorescence staining of muscle markers MyHC (red) and DAPI (blue) at day 40 of differentiation from CFS strains using the shown process, scale bar, magnification 63x. [Figure 14A] Neuromuscular differentiation of CFS strains in 3D culture. Schematic diagram of the 3D differentiation process and cytokines in the differentiation medium. [Figure 14B] Neuromuscular differentiation of CFS strains in 3D culture. Representative phase-contrast micrograph (5x magnification) of 40-day-old organoids differentiated from CFS strains. Scale bar is 0.75 μm. [Figure 14D] Neuromuscular differentiation of CFS strains in 3D culture. qPCR analysis of neuronal markers (C) and muscle markers (D) in organoids at day 40. [Figure 14F] Neuromuscular differentiation of CFS strains in 3D culture. (E-F) Whole organoid immunofluorescence staining of motor neuron markers (MNX1, red; OLIG2, purple; ISL1, green) and DAPI (blue) (E) and muscle markers (MyHC, red; ACTA1, green) and DAPI (blue) in 40-day organoids differentiated from CFS strains. Scale bar - 100 μm. [Figure 15A] Injection of eGFP-tagged CFS strains into chicken embryos. Injection of eGFP+ CFS cells into the tail bud region of developing chicken embryos in the HH17 stage, indicated by the asterisk. [Figure 15B] Injection of eGFP-tagged CFS cell lines into chicken embryos. eGFP+ CFS cells in chicken embryos arrested at HH23-24. [Figure 15C] Injection of eGFP-tagged CFS cell strains into chicken embryos. Contribution of CFS cells to the neural tube (white arrow) and somites (red arrow) in cross-sections of GFP-stained HH23-24 stage embryos. [Figure 16A] A gene that is expressed in hAxSC but not in human NMP (Verrier et al., 2018 Development; Table S1) or mouse NMP (Gouti et al., Dev Cell. 2017). The figure shows the sequencing of next-generation single-cell global transcripts (all expressed genes) of human axial stem cells (AxCC) derived from three sources: priming: CS_H9: CS state derived from human ES cell line WA09(H9); priming: CS_HMGU1: CS state derived from human iPS cell line HMGU1; priming: CS_HUES6: CS state derived from human ES cell line HUES6; base: CFS_H9: CS state derived from human ES cell line WA09(H9); base: CFS_HMGU1: CS state derived from human iPS cell line HMGU1; base: CFS_HUES6: CS state derived from human ES cell line HUES6. The Uniform Manifold Approximation and Projection (UMAP) plot shows the degree of similarity between 28,700 individual cells. [Figure 16B]This gene is expressed in hAxSCs but not in human NMPs (Verrier et al., 2018 Development; Table S1) or mouse NMPs (Gouti et al., Dev Cell. 2017). The figure shows the sequencing of the next generation (all expressed genes) of single-cell comprehensive transcripts of human axial stem cells (AxCCs) from three sources: priming: CS_H9: CS state derived from human ES cell line WA09(H9); priming: CS_HMGU1: CS state derived from human iPS cell line HMGU1; priming: CS_HUES6: CS state derived from human ES cell line HUES6; base: CFS_H9: CS state derived from human ES cell line WA09(H9); base: CFS_HMGU1: CS state derived from human iPS cell line HMGU1; base: CFS_HUES6: CS state derived from human ES cell line HUES6. The panel consists of genes, namely MYCN, LIN28B, IRX3, SOX1, ZIC2, and SOX11, which are significantly expressed by AxSC (the basal AxSC (CS on the left) mainly expresses MYCN, LIN28B, ZIC2, and SOX11, while the priming AxSC (CFS on the right) mainly expresses MYCN, LIN28B, IRX3, SOX1, ZIC2, and SOX11), but are not expressed in human NMP derived from human and human ES cells (Verrier et al., 2018 Development) or mouse NMP derived from embryos (Gouti et al., Dev Cell. 2017). [Modes for carrying out the invention]

[0013] Despite a detailed understanding of hypocotyl elongation in mammals, axial stem cells (AxSCs) have not been induced, and this stage is inaccessible in human embryos. Therefore, the technical problem underlying the present invention may be formulated to suit the above-mentioned need. This technical problem has been solved by the means and methods described herein and set forth in the claims.

[0014] In some embodiments, the present invention relates to the induction of axial stem cells from human pluripotent stem cells. In particular, the present invention relates to a procedure for establishing region-specific differentiated pluripotent stem cells, i.e., axial stem cells, from pluripotent stem cells. In preferred embodiments, the present invention provides a procedure for inducing daughter stem cells from human pluripotent stem cells, embryonic stem cells, and induced pluripotent stem cells (e.g., ESCs and iPSCs) that mimic the properties of precursors that give rise to axial regions, including motor neurons, sensory neurons, bone, cartilage, and skeletal muscle cells.

[0015] In preferred embodiments, the axial stem cells of the present invention are not pluripotent and therefore cannot produce teratomas, which are a significant concern in cell therapy. More preferably, the axial stem cells of the present invention can generate differentiated offspring of higher purity (e.g., cells of the axial region including motor neurons, sensory neurons, bone, cartilage, and skeletal muscle cells) compared to the differentiation of human pluripotent stem cells that produce all cell types of the body. Most preferably, the axial stem cells of the present invention can dramatically shorten and simplify differentiation protocols for cell types of the axial region including motor neurons, sensory neurons, bone, cartilage, and skeletal muscle cells.

[0016] Advantageously, the method of the present invention enables, for example, the generation of an unlimited amount of the above-mentioned purer progeny types (e.g., axial region cells including motor neurons, sensory neurons, bone, cartilage, and skeletal muscle cells), making production feasible, lower cost, and safer the application of cells by transplantation.

[0017] definition As described herein, the UniProtKB acceptance number (available at http: / / www.uniprot.org / , for example, in UniProtKB Release 2020_01 published on February 26, 2020) is referenced.

[0018] As described herein, the Gene Ontology and GO Annotations database (https: / / www.ebi.ac.uk / QuickGO / ); GO version 2020-04-09; annotation sets created on 2020-04-06 are referenced.

[0019] As used herein, the term “Wnt / β-catenin signaling pathway” may be used interchangeably with the term “Wnt signaling pathway” (e.g., GO:0016055; for example, the Wnt / β-catenin signaling pathway is a series of molecular signals initiated by the binding of Wnt proteins to frizzled family receptors on the surface of target cells and ending with a change in cellular state; Huelsken J, Birchmeier W. New aspects of Wnt signaling pathways in higher vertebrates. Current Opinion in Genetics & Development. October 2001; 11(5):547-553).

[0020] As used herein, the term “axial stem cell” (or “AxSC”) may be used interchangeably with the term “neuromusculoskeletal stem cell” and may refer to cells produced by the method of the present invention, or cells having the characteristics of cells produced by the method of the present invention as described below herein.

[0021] As used herein, the term “pluripotent stem cell” (or “PSC”) may mean a cell that can differentiate into any type of tissue cell and can be obtained by means other than, for example, the destruction of an embryo (e.g., a human embryo) (e.g., Yu et al., 2007, Science. December 21, 2007; 318(5858):1917-20).

[0022] As used herein, the term “embryonic stem cell” (or “ESC”) may refer to embryonic pluripotent stem cells that may be generated without destroying an embryo (e.g., a human embryo) (e.g., Chung et al., Cell stem Cell, February 2008, Vol. 2, pp. 113–117).

[0023] As used herein, the term “induced pluripotent stem cells” (or “iPSCs”) may also refer to pluripotent stem cells that can be directly generated from adult cells (e.g., Yu et al., 2007), that is, they can be obtained without destroying the embryo, for example, they can be obtained from somatic cells (e.g., fibroblasts).

[0024] As used herein, the term “neuronal mesoderm precursor” (or NMp) may refer to an embryonic cell type that contributes to the development of both the spinal cord and paraxial mesoderm (e.g., Tzouanacou et al., 2009). However, NMPs cannot replicate themselves indefinitely, nor can they differentiate themselves into different stem cell subtypes (e.g., CFS and CS as used in this invention). Furthermore, NMPs are transient cells, meaning they cannot proliferate (e.g., more than 20 passages). In addition, NMPs express a different gene repertoire compared to the axial stem cells of this invention. For example, NMPs do not express the MYCN, LIN28B, IRX3, SOX1, ZIC2, and SOX11 proteins as defined herein.

[0025] As used herein, the term "induced neural stem cell" (or iNSC) may refer to somatic cell-derived neural stem cells that are self-renewing, pluripotent cells capable of differentiating into neurons, astrocytes, and oligodendrocytes.

[0026] As used herein, the term “substantially not expressed” may mean an expression level less than 10% (e.g., less than 7%, less than 4%, less than 1%, less than 0.5%, or less than 0.1%) of the expression level of a control (e.g., starting cells, e.g., undifferentiated cells, e.g., undifferentiated H9 hESCs).

[0027] In the course of this invention, it was found that continuous passage of human ESCs and iPSCs when TXBT / BRA and SOX2 are endogenously induced allows for the establishment of two states of morphologically compact stem cell lines that self-replicate indefinitely. Establishment under WNT / FGF produced the SOX2 / TBXT line, which resembles a precursor of neural mesoderm, while WNT alone produced the SOX2 / PAX6 line, which can also be induced from the first state, but not the other way around. Inhibition of TGF-β improved the induction process, clonal passage, and reduced spontaneous differentiation. Importantly, these two states readily differentiate into peripheral neuron types with peripheral and motor characteristics, and into sclerotiotomes and cutaneous muscular somites (dermomyotomesomitic mesoderms), but importantly, they are functionally similar, differentiate rapidly and uniformly into motor neurons, and do not form teratomas. Therefore, basal and priming human AxSCs can be induced from pluripotent cells and have the potential to serve as a basis for treating peripheral nerve degeneration and injury, as well as potentially becoming a benchmark for research on neurodegeneration, axial development, and evolution.

[0028] In the course of this invention, a process was developed for creating human stem cell lines that meet known criteria for body axis precursors. Since manipulating human embryos after transplantation and the onset of gastrulation is not permitted, this induction was based, for example, on human ESCs and iPSCs. The conditions for inducing endogenous expression of TBXT and SOX2 in hPSC offspring were initially defined, as these genes are some of the earliest markers characterizing body axis precursors in NSBs, CLEs, and CNHs. Surprisingly, continuous passaging was found to maintain the expression of SOX2, a transcription factor crucial for the self-renewal of pluripotent stem cells and neural stem cells (NSCs), and therefore continuous passaging was used to create cell lines. Wnt / β-catenin and FGF inducers, as well as TGF-β inhibitors, were studied because these pathways were activated in cells with upregulated TBXT. Cell line establishment was evident, for example, within 3–5 passages, and levels of key developmental genes remained stable across numerous passages. Furthermore, the use of TGF-β inhibitors minimized spontaneous differentiation of cell lines, enabling the inventors to produce single-cell clones. Notably, two developmental states were captured by these cell lines, which maintained SOX2 at the PSC level but were mutually exclusive in expressing PAX6 and TBXT in the presence of FGF2. In the course of this invention, it was possible to differentiate the newly established axial cell lines in vitro into peripheral neurons and mesodermal sclerotiota and cutaneous muscularis progeny. To test their teratogenic potential, all cell lines were injected into immunodeficient mice, but the mice did not show any signs of such tumors. Given the effects of previous induction of stem cell lines such as ESCs and NSCs, the presentation of human axial precursors in culture in the form of unrestricted replicating stem cell lines is intended to ignite the progress of novel basic and medical research. This may include, for example, novel applications in the regulation of axial development, neuromuscular disorders and evolution, and the treatment of peripheral nervous system diseases and injuries through the development of drug compounds and cell therapies.

[0029] The axial stem cells (AxSCs) of the present invention are not neural mesoderm precursors (NMPs). Therefore, it is known from the prior art that NMPs are transient cells, which means they cannot be proliferated, whereas the axial stem cells (AxSCs) of the present invention are not transient and can be proliferated (e.g., more than 20 passages).

[0030] Embodiments characterizing the present invention are described herein, shown in the drawings, illustrated in the examples, and reflected in the claims.

[0031] In this specification, the singular forms "a," "an," and "the" refer to multiple objects unless they are clearly inconsistent with the context. For example, a reference to "a reagent" includes one or more such different reagents, and a reference to "the method" includes an equivalent process and method known to those skilled in the art that can be used to modify or substitute the method described herein.

[0032] Unless otherwise specified, the term “at least” preceding a set of elements should be understood to refer to all elements of that set. Those skilled in the art will be able to recognize or confirm, by routine experimentation alone, many equivalents to the specific embodiments of the invention described herein. Such equivalents are intended to be incorporated into the invention.

[0033] As used herein, the term "and / or" includes the meanings of "and," "or," and "all or any other combination of the elements connected by that term."

[0034] As used herein, the terms “about” or “approximately” mean within 20%, preferably within 10%, and more preferably within 5% of a given value or range.

[0035] Throughout this specification and the accompanying claims, unless inconsistent with the context, the phrase "comprise," and variations such as "comprises" and "comprising," shall be understood to imply the inclusion of the described integer or process or group of integers or processes, and not the exclusion of any other integer or process or group of integers or processes. As used herein, the term "comprising" may be replaced by the term "containing" or "including," or, as used herein, by the term "having."

[0036] As used herein, "consisting of" excludes any element, process, or component not specified in the elements of the claim. As used herein, "essentially consisting of" does not exclude any material or process that does not substantially affect the basic and novel features of the claim.

[0037] In each of the foregoing, the terms “comprising,” “consisting essentially of,” and “consisting of” may be replaced with any of the other two terms.

[0038] In another embodiment, the present invention relates to a method for generating (or inducing) axial stem cells (AxSCs) (or neuromuscular stem cells), comprising the steps of providing pluripotent stem cells, embryonic stem cells, or induced pluripotent stem cells (e.g., human PSCs and / or ESCs and / or iPSCs, e.g., human ESC strain H9(WA09) or human iPSC strain HMGU#1), wherein, preferably prior to the induction / generation, the pluripotent cells are maintained in a suitable pluripotent cell medium (e.g., mTESR1 or iPS-Brew, etc.), and more preferably, the suitable pluripotent cell medium is used for the induction / generation. The steps include replacing the medium with RPMI1640 medium supplemented with a vitamin A-containing or vitamin A-free B27 supplement (i.e., before the induction / generation described above), and activating the Wnt / β-catenin signaling pathway in the pluripotent stem cells, embryonic stem cells, or induced pluripotent stem cells (e.g., GO:0016055; for example, the Wnt / β-catenin signaling pathway is a series of molecular signals initiated by the binding of Wnt proteins to frizzled family receptors on the surface of target cells and ending with a change in cellular state (Huelsken J, Birchmeier W., New aspects of Wnt signaling pathways in higher vertebrates. Current Opinion in Genetics & Development).2001 Oct;11(5):547-553)), preferably the activation is carried out by using an inhibitor of the GSK3b protein (e.g., UniProtKB-P49841), more preferably the inhibitor is CHIR99021, more preferably the CHIR99021 inhibitor is used at a concentration of about 5 μM to about 10 μM, more preferably the CHIR99021 inhibitor is used for about 24 hours, and the cells derived from step (b) are passaged under conditions of continuous activation of the Wnt / β-catenin signaling pathway in the cells during passage, preferably the passages are carried out at least about 3 to 9 times (e.g., 3, 4, 5, 6, 7, 8, or 9 times), more preferably the passages are continuous passages, and more preferably the passages are The process comprises, optionally, reseeding the cells derived from step (b) at a lower density in fresh serum-free medium (e.g., RPMI1640 medium supplemented with or without vitamin A B27 supplement) (e.g., reseeding is the dissociation of colonies into single cells or cell clusters and their plating), preferably, the continuous activation of the Wnt / β-catenin signaling pathway is carried out by using an inhibitor of the Wnt / β-catenin signaling pathway, more preferably, the inhibitor is CHIR99021, and most preferably, the CHIR99021 inhibitor is used at a concentration of at least about 5 μM (e.g., about 7.5 μM), and the cells derived from step (c) endogenously express the transcription factor SOX-2 (e.g., UniProtKB-P48431). (d) The above sequential activation of the Wnt / β-catenin signaling pathway from step (c) is carried out in the presence of fibroblast growth factor 2 (e.g., UniProtKB-P09038) and / or a TGF-β inhibitor (e.g., UniProtKB-P01137), preferably, (d1) The above-mentioned sequential activation of Wnt / β-catenin signaling from step (c) is carried out in the presence of fibroblast growth factor 2 (e.g., UniProtKB-P09038) and TGF-β (e.g., UniProtKB-P01137) inhibitors, with the CHIR99021 inhibitor at a concentration of approximately 5 μM, more preferably the TGF-β inhibitor being SB-431542, and most preferably the SB-431542 inhibitor being used at a concentration of approximately 10 μM, and most preferably the fibroblast growth factor 2 being used at a concentration of approximately 20 to approximately 100 ng / ml. The cells used and induced from step (d1) endogenously express the transcription factor SOX-2 (e.g., UniProtKB-P48431), the T-box transcription factor T (e.g., UniProtKB-O15178), and the homeobox protein MIXL1 (e.g., UniProtKB-Q9H2W2), but do not endogenously express the paired-box protein Pax-6 (e.g., UniProtKB-P26367), and optionally further endogenously express the homeobox protein CDX-2 (e.g., UniProtKB-Q99626), or (d2) The above-mentioned sequential activation of Wnt / β-catenin signaling from step (c) is carried out using a CHIR99021 inhibitor at a concentration of approximately 5 μM, preferably in the presence of a TGF-β (e.g., UniProtKB-P01137) inhibitor, more preferably the TGF-β inhibitor being SB-431542, and most preferably the SB-431542 inhibitor being used at a concentration of approximately 10 μM, and the cells derived from step (d2) are transcribed by the transcription factor SOX-2( For example, it may endogenously express UniProtKB-P48431) and paired-box protein Pax-6 (e.g., UniProtKB-P26367), but not endogenously express T-box transcription factor T (e.g., UniProtKB-O15178), homeobox protein MIXL1 (e.g., UniProtKB-Q9H2W2), and homeobox protein CDX-2 (e.g., UniProtKB-Q99626), or (d3) The above-mentioned sequential activation of Wnt / β-catenin signaling from step (c) is carried out using a CHIR99021 inhibitor at a concentration of approximately 7.5 μM, preferably in the presence of a TGF-β (e.g., UniProtKB-P01137) inhibitor, more preferably the TGF-β inhibitor being SB-431542, and most preferably the SB-431542 inhibitor being used at a concentration of approximately 10 μM, and the cells derived from step (d3) are transcribed by the transcription factor SOX-2 (e.g., UniProtKB-P48431), T-box transcription factor T (e.g., UniProtKB-O15178), homeobox protein MIXL1 (e.g., UniProtKB-Q9H2W2), and paired-box protein Pax-6 (e.g., UniProtKB-P26367) are endogenously expressed, and homeobox protein CDX-2 (e.g., UniProtKB-Q99626) is further endogenously expressed with optional selection. Provide a method.

[0039] Exemplary RPMI-1640 culture medium composition (For example, as described at https: / / www.sigmaaldrich.com / life-science / cell-culture / learning-center / media-formulations / rpmi-1640.html)

[0040] [Table 1(1)] [Table 1(2)]

[0041] Exemplary B27 composition and preparation protocol (as described, for example, by the Hanna Lab Protocol of the Weizmann Institute of Science, available at https: / / hannalabweb.weizmann.ac.il / )

[0042] We will create a stock of some of the ingredients for future reuse.

[0043] 3) Human insulin (Sigma or PROSPEC BIO CYT) (125 mg is needed per 800 ml of B27). Prepare a 25 mg / ml stock solution by dissolving 250 mg of insulin in 10 ml of 0.005 M HCl overnight or for an additional 2 days at 4°C. Store in 1 ml aliquots at -80°C (use 5 vials per 800 ml of B27).

[0044] 6) T3 (Sigma) (80 μg is required for 800 ml of B27). Prepare a 2 mg / ml stock solution by dissolving 100 mg of T3 in 1 ml of DMSO, and then in 49 ml of ethanol. Store in 40 μl individual aliquots at -80°C (use one vial per 800 ml of B27 supplement).

[0045] 11) Sodium selenite (Sigma, 1 mg) (500 μg is needed for 800 ml of B27). Prepare a 1 mg / ml stock by dissolving the above vial in 1 ml of dH2O. Add 500 μl per 800 ml of B27 supplement.

[0046] 12) Corticosterone (Sigma, 1 g) (800 μg is needed for 800 ml of B27). Prepare a 2 mg / ml stock by dissolving 0.1 g of corticosterone in 50 ml of ethanol. Prepare individual 400 μl aliquots (use one vial per 800 ml of B27). Store at -80°C.

[0047] 13) Linoleic acid (Sigma, 100 mg) (40 mg is needed for 800 ml of B27). Prepare a 100 mg / ml stock by adding 0.9 ml of ethanol. Prepare individual 400 μl aliquots (use one vial per 800 ml of B27). Store at -80°C.

[0048] 14) Linolenic acid (Sigma, 500 mg) (40 mg is needed for 800 ml of B27). Prepare a 100 mg / ml stock by adding 4.5 ml of ethanol. Prepare individual 400 μl aliquots (use one vial per 800 ml of B27). Store at -80°C.

[0049] 15) Progesterone (Sigma, 1 g) (0.252 mg is required per 800 ml of B27 stock). Prepare a 1 mg / ml stock by dissolving 10 mg of progesterone in 10 ml of ethanol. Store at -80°C. Prepare individual aliquots of 252 μl (use one vial per 800 ml of B27).

[0050] 16) Retinol acetate (Sigma, 1 g) (4 mg is required per 800 ml of B27 stock). Prepare a 20 mg / ml stock by dissolving the above vial in 50 ml of ethanol. Prepare individual 200 μl aliquots (use one vial per 800 ml of B27). Store at -80°C.

[0051] 17) DL-α-tocopherol (vitamin E) (Sigma, 5G) (40 mg is required per 800 ml of B27 stock). Prepare a 100 mg / ml stock by dissolving the above vial in 45 ml of ethanol. Prepare individual 400 μl aliquots (use one vial per 800 ml of B27). Store at -80°C.

[0052] 18) DL-α-tocopherol acetate (Sigma, 10G) (40 mg is required per 800 ml of B27). Prepare a 100 mg / ml stock by dissolving the above vial in 90 ml of ethanol. Prepare individual 400 μl aliquots (use one vial per 800 ml of B27). Store at -80°C.

[0053] 19) Oleic acid (Sigma, 1G) (40 mg is required per 800 ml of B27 stock). Prepare a 100 mg / ml stock by adding 9 ml of ethanol. Prepare individual 400 μl aliquots (use one vial per 800 ml of B27). Store at -80°C.

[0054] 20) Pipecolic acid (Sigma, 100 mg) (40 mg is needed per 800 ml of B27 stock). Prepare a 50 mg / ml stock by adding 2 ml of water. Prepare individual 800 μl aliquots (use one vial per 800 ml of B27). Store at -80°C.

[0055] For a total of 800 ml of B27 supplement, collect the following 22 ingredients (e.g., those made by Sigma-Aldrich) in 500 ml of Neurobasal medium (Invitrogen) as a base: 1) Place a total of 100g of BSA Fraction V IgG-free Fatty Acid Poor powder (Invitrogen) and 500ml of Neurobasal medium into an empty, sterile 1L glass vial (use the remaining 300ml of Neurobasal to dissolve some of the components listed below). 2) Dissolve biotin (1 unit of 100 mg, e.g., Sigma brand) in 10 ml of Neurobasal medium, add it, and mix. 3) Dissolve catalase (1 unit of 100 mg, e.g., Sigma) in 10 ml of Neurobasal medium, add it, and mix. 4) Dissolve all four units of superoxide dismutase in 10 ml of Neurobasal medium, add to the medium, and mix. 5) Weigh out 40 mg of glutathione and add it directly, then mix. 6) Dissolve all 2 units of holotransferinin in 10 ml of Neurobasal medium, add to the medium, and mix. 7) Weigh out 80 mg of L-carnitine and add it directly to the mixture and mix. 8) Weigh out 600 mg of D-galactose and add it directly, then mix. 9) Weigh out 644 mg of putrescine and add it directly to the mixture. 10) Add 40 μL of ethanolamine directly and mix. 11) Add and mix directly one vial of progesterone stock (dissolved in ethanol and frozen at -80°C). Progesterone stock preparation: Prepare a 1 mg / ml stock by dissolving 10 mg of progesterone in 10 ml of ethanol. Store at -80°C. Prepare individual aliquots of 252 μl (use one vial per 800 ml of B27). 12) Add and mix directly 5 vials of insulin stock (dissolved and frozen at -80°C). 13) Add one vial of T3 (dissolved in ethanol and frozen at -80°C) directly and mix. 14) Add and mix directly one vial of pipecolic acid stock (dissolved in water and frozen at -80°C). 15) Add and mix directly one vial of oleic acid stock (dissolved in ethanol and frozen at -80°C). 16) Add and mix directly one vial of linoleic acid stock (dissolved in ethanol and frozen at -80°C). 17) Add and mix directly one vial of linolenic acid stock (dissolved in ethanol and frozen at -80°C). 18) Add and mix directly one vial of retinol acetate stock (dissolved in ethanol and frozen at -80°C). To prepare a vitamin A-free B27 supplement, remove the retinol acetate from the composition. 19) Add and mix directly one vial of DL-α-tocopherol (vitamin E) stock (dissolved in ethanol and frozen at -80°C). 20) Add and mix directly one vial of DL-α-tocopherol acetate stock (dissolved in ethanol and frozen at -80°C). 21) Add and mix directly one vial of corticosterone stock (dissolved in ethanol and frozen at -80°C). 22) Add and mix directly one vial of sodium selenite stock (dissolved in ethanol and frozen at -80°C). 23) Add the remaining 300 ml of Neurobasal. Gently mix the bottle (no pipetting or vigorous shaking is necessary). Gently shake 10 times. Leave the bottle at 4°C for 12 hours (overnight) for optimal dissolution (without any shaking and protected from light). The next day, prepare 5 ml aliquots and store at -20°C protected from light. (Stable for 1 year at -20°C). Avoid repeated freezing and thawing. The mixture is too viscous to filter, but can be filtered later when added to the culture medium. For mouse PSCs, 5 ml (1 aliquot) of B27 can be used per 500 ml culture bottle. For human PSCs, 10 ml (2 aliquots) of B27 can be used per 500 ml culture bottle.

[0056] In further embodiments, the present invention relates to a method of the present invention in which the sequential activation of the Wnt / β-catenin signaling pathway from step (c) is carried out in the presence of a fibroblast growth factor 2 (e.g., UniProtKB-P09038) and / or a TGF-β (e.g., UniProtKB-P01137) inhibitor.

[0057] In further embodiments, the present invention is carried out in the presence of fibroblast growth factor 2 (e.g., UniProtKB-P09038) and TGF-β (e.g., UniProtKB-P01137) inhibitors, with the successive activation of Wnt / β-catenin signaling from step (c) using a CHIR99021 inhibitor at a concentration of about 5 μM, more preferably the TGF-β inhibitor being SB-431542, more preferably the SB-431542 inhibitor being used at a concentration of about 10 μM, and more preferably the fibroblast growth factor 2 being used at a concentration of about 20 to about 100 ng / ml. The present invention relates to a method wherein cells induced from the above step (d1) endogenously express the transcription factor SOX-2 (e.g., UniProtKB-P48431), the T-box transcription factor T (e.g., UniProtKB-O15178), and the homeobox protein MIXL1 (e.g., UniProtKB-Q9H2W2), but do not endogenously express the paired-box protein Pax-6 (e.g., UniProtKB-P26367), and optionally further endogenously express the homeobox protein CDX-2 (e.g., UniProtKB-Q99626).

[0058] In further embodiments, the present invention is carried out using a CHIR99021 inhibitor at a concentration of about 5 μM, preferably in the presence of a TGF-β (e.g., UniProtKB-P01137) inhibitor, more preferably the TGF-β inhibitor being SB-431542, and most preferably the SB-431542 inhibitor being used at a concentration of about 10 μM, and the cells derived from step (d2) are transcribed with the transcription factor SOX- The present invention relates to a method that endogenously expresses protein 2 (e.g., UniProtKB-P48431) and paired-box protein Pax-6 (e.g., UniProtKB-P26367), but does not endogenously express T-box transcription factor T (e.g., UniProtKB-O15178), homeobox protein MIXL1 (e.g., UniProtKB-Q9H2W2), and homeobox protein CDX-2 (e.g., UniProtKB-Q99626).

[0059] In further embodiments, the present invention is carried out using a CHIR99021 inhibitor at a concentration of about 7.5 μM, preferably in the presence of a TGF-β (e.g., UniProtKB-P01137) inhibitor, more preferably the TGF-β inhibitor being SB-431542, and most preferably the SB-431542 inhibitor being used at a concentration of about 10 μM, and the cells derived from step (d3) are transcribed by the transcription factor SOX-2( The present invention relates to a method that endogenously expresses, for example, UniProtKB-P48431), T-box transcription factor T (e.g., UniProtKB-O15178), homeobox protein MIXL1 (e.g., UniProtKB-Q9H2W2), and paired-box protein Pax-6 (e.g., UniProtKB-P26367), and optionally further endogenously expresses homeobox protein CDX-2 (e.g., UniProtKB-Q99626).

[0060] In further embodiments, the present invention relates to a method of the present invention comprising step (d).

[0061] In further embodiments, the present invention relates to a method of the present invention comprising step (d), and further comprising steps (d1), (d2), or (d3).

[0062] In further embodiments, the present invention relates to a method of the present invention that further comprises passage of cells derived from step (c) and / or step (d).

[0063] In further embodiments, the present invention relates to axial stem cells that express the transcription factor SOX-2 (e.g., UniProtKB-P48431); substantially do not express the OCT4 transcription factor (e.g., UniProtKB-Q01860); substantially do not express the homeobox protein NANOG (e.g., UniProtKB-Q9H9S0); are non-pluripotent, region-specific differentiated pluripotent stem cells; can be obtained from pluripotent stem cells, embryonic stem cells, or induced pluripotent stem cells (e.g., human PSCs and / or ESCs and / or iPSCs, e.g., human ESC strain H9(WA09) or human iPSC strain HMGU#1); are not capable of differentiating into all tissue types of the embryo; and embryogenesis. The present invention relates to one or more of the following characteristics: it can differentiate only into cell types that emerge from the centrosome axial region (e.g., sclerotiomyocytes, cutaneous muscularis cells, and peripheral neurons); it cannot form teratomas; it can mimic the characteristics of precursors that give rise to axial regions (e.g., motor neurons, peripheral neurons, peripheral nervous system neurons, sensory neurons, bone, cartilage, tendons, ligaments, and / or skeletal muscle cells); it is not a transient cell; it can differentiate into precursors of motor neurons, peripheral neurons, muscle, cartilage, or bone; it is a stem cell that replicates indefinitely; it can proliferate as a clone; and it is not a neuronal mesoderm precursor (NMp) and / or an artificial neural stem cell (iNSC).

[0064] In further embodiments, the present invention allows the axial stem cells of the present invention to replicate and differentiate indefinitely into, for example, (a) basal axial stem cells (for example, basal axial stem cells that replicate indefinitely may also be referred to herein as "CFS"), which basal axial stem cells are equipped with the transcription factor SOX-2 (e.g., UniProtKB-P48431), the T-box transcription factor T (e.g., UniProtKB-O15178), the homeobox protein CDX-2 (e.g., UniProtKB-Q99626), and the homeobox protein The present invention relates to a method of expressing the protein MIXL1 (e.g., UniProtKB-Q9H2W2) and / or (b) being able to replicate and differentiate indefinitely into priming axial stem cells (e.g., priming axial stem cells that replicate indefinitely may also be referred to herein as "CS"), wherein these priming axial stem cells express the transcription factor SOX-2 (e.g., UniProtKB-P48431) and the paired-box protein PAX-6 (e.g., UniProtKB-P26367).

[0065] In further embodiments, the present invention relates to a method of the present invention in which the axial stem cells are human axial stem cells.

[0066] In further embodiments, the present invention relates to axial stem cells generated by the method of the present invention.

[0067] In further embodiments, the present invention relates to axial stem cells (AxSCs) (e.g., isolated AxSCs) which express the transcription factor SOX-2 (e.g., UniProtKB-P48431); substantially do not express the OCT4 transcription factor (e.g., UniProtKB-Q01860); substantially do not express the homeobox protein NANOG (e.g., UniProtKB-Q9H9S0); the AxSCs are not pluripotent but region-specific differentiated pluripotent stem cells; can be obtained from pluripotent stem cells, embryonic stem cells or induced pluripotent stem cells (e.g., ESCs and / or iPSCs, e.g., human ESC strain H9(WA09) or human iPSC strain HMGU#1); and differentiate into all tissue cell types of the embryo. This relates to axial stem cells having one or more of the following characteristics: they are not capable of; they can differentiate only into cell types that emerge from the centrosome axial region during embryonic development (e.g., sclerotiomerus, cutaneous muscularis, and peripheral neurons); they cannot form teratomas; they can mimic the characteristics of precursors that give rise to axial regions (e.g., motor neurons, peripheral neurons, peripheral nervous system neurons, sensory neurons, bone, cartilage, tendons, ligaments, and / or skeletal muscle cells); they are not transient cells; they can differentiate into precursors of motor neurons, peripheral neurons, muscle, cartilage, or bone; they are stem cells that replicate indefinitely; they can proliferate as clones; they are not neural mesoderm precursors (NMp); and they are not artificial neural stem cells (iNSCs).

[0068] In further embodiments, the present invention allows the AxSC to replicate itself indefinitely and differentiate into, for example, (a) basal axial stem cells (for example, basal axial stem cells that replicate indefinitely may also be referred to herein as "CFS"), which basal axial stem cells may be synthesized by the transcription factor SOX-2 (e.g., UniProtKB-P48431); T-box transcription factor T (e.g., UniProtKB-O15178); homeobox protein CDX-2 (e.g., UniProtKB-Q99626); and homeo The present invention relates to axial stem cells that express the box protein MIXL1 (e.g., UniProtKB-Q9H2W2) and / or (b) differentiate into primed axial stem cells (e.g., primed axial stem cells that replicate indefinitely may also be referred to herein as "CS"), wherein these primed axial stem cells express the transcription factor SOX-2 (e.g., UniProtKB-P48431) and the paired box protein PAX-6 (e.g., UniProtKB-P26367).

[0069] In further embodiments, the present invention relates to axial stem cells of the present invention in which the above-mentioned AxSC endogenously expresses the transcription factor SOX-2 (e.g., UniProtKB-P48431), the T-box transcription factor T (e.g., UniProtKB-O15178), and the homeobox protein MIXL1 (e.g., UniProtKB-Q9H2W2), does not endogenously express the paired-box protein Pax-6 (e.g., UniProtKB-P26367), and optionally further endogenously expresses the homeobox protein CDX-2 (e.g., UniProtKB-Q99626).

[0070] In further embodiments, the present invention relates to axial stem cells of the present invention in which the above-mentioned AxSC endogenously expresses the transcription factor SOX-2 (e.g., UniProtKB-P48431) and the paired-box protein Pax-6 (e.g., UniProtKB-P26367), but does not endogenously express the T-box transcription factor T (e.g., UniProtKB-O15178), the homeobox protein MIXL1 (e.g., UniProtKB-Q9H2W2), and the homeobox protein CDX-2 (e.g., UniProtKB-Q99626).

[0071] In further embodiments, the present invention relates to axial stem cells of the present invention in which the above-mentioned AxSC endogenously expresses the transcription factor SOX-2 (e.g., UniProtKB-P48431), the T-box transcription factor T (e.g., UniProtKB-O15178), the homeobox protein MIXL1 (e.g., UniProtKB-G9H2W2), and the paired-box protein Pax-6 (e.g., UniProtKB-P26367), and optionally further endogenously expresses the homeobox protein CDX-2 (e.g., UniProtKB-C99626).

[0072] In further embodiments, the present invention relates to axial stem cells of the present invention, wherein the AxSC is a human axial stem cell (e.g., isolated).

[0073] In further embodiments, the present invention relates to compositions, preparations and / or kits comprising axial stem cells of the present invention.

[0074] In further embodiments, the compositions, preparations, and / or kits of the present invention are compositions, preparations, or kits for pharmaceutical and / or diagnostic purposes.

[0075] In further embodiments, the axial stem cells, compositions, preparations, and / or kits of the present invention are used as pharmaceuticals.

[0076] In further embodiments, the axial stem cells, compositions, preparations and / or kits of the present invention are used in one or more of the above-mentioned methods, which are in vitro, ex vivo, or in vivo methods, for the treatment, reduction, prevention and / or diagnosis of neurodegenerative diseases; for the treatment, reduction, prevention and / or diagnosis of bone and / or cartilage disorders; for the treatment, reduction, prevention and / or diagnosis of muscle disorders; for the regenerative therapy of cells, tissues, organs and / or bodies; for the screening of candidate compounds for activity against diseases (e.g., diseases of the peripheral nervous system or diseases related to axial stem cells, e.g., muscle-related, motor neuron-related, peripheral neuron-related, sensory neuron-related, cartilage-related, tendon-related (e.g., degenerative) diseases) and / or for neurotoxicity screening; for the treatment, reduction, prevention and / or diagnosis of diseases related to axial stem cells, e.g., muscle-related, motor neuron-related, peripheral neuron-related, sensory neuron-related, cartilage-related, tendon-related (e.g., degenerative) diseases.

[0077] In further embodiments, the present invention relates to a method for improving the condition of a required sample and / or subject, preferably one or more of the following: a method for treating, reducing, preventing and / or diagnosing neurodegenerative diseases; a method for treating, reducing, preventing and / or diagnosing bone and / or cartilage disorders; a method for treating, reducing, preventing and / or diagnosing muscle disorders; a method for regenerative therapy of cells, tissues, organs and / or bodies; and a method for screening candidate compounds for activity against diseases (e.g., diseases of the peripheral nervous system) and / or neurotoxicity screening, wherein the method comprises the steps of providing the axial stem cells, compositions, preparations and / or kits of the present invention to the sample and / or subject, and administering, for example, a therapeutically effective amount of the axial stem cells, compositions, preparations and / or kits to the sample and / or subject.

[0078] In further embodiments, the present invention relates to a method of the present invention which is an in vitro, ex vivo, or in vivo method.

[0079] In further embodiments, the present invention relates to the use of axial stem cells, compositions, preparations and / or kits of the present invention for one or more of the above uses, which are, for example, the treatment, reduction, prevention and / or diagnosis of neurodegenerative diseases; the treatment, reduction, prevention and / or diagnosis of bone and / or cartilage disorders; the treatment, reduction, prevention and / or diagnosis of muscle disorders; regenerative therapy of cells, tissues, organs and / or bodies; screening candidate compounds for activity against diseases (e.g., diseases of the peripheral nervous system) and / or neurotoxicity screening; and use of axial stem cells, compositions, preparations and / or kits of the present invention for one or more of the above uses, which are in vitro, exovivo or in vivo use.

[0080] Further embodiments relate to uses of the present invention that are in vitro, ex vivo, or in vivo, or a combination thereof.

[0081] In preferred embodiments, the methods of the present invention are carried out using the following starting cells (i.e., cells provided by the methods of the present invention), the starting cells being pluripotent cells, which may be either embryonic stem cells (ESCs) or induced pluripotent stem cells (iPSCs), preferably the starting cells being human-derived pluripotent cells (however, the present invention also includes primate cells or non-human-derived pluripotent cells such as mouse cells), the pluripotent cells being described in the literature and characterized, for example, by co-expression of the classical pluripotency factors POU5F1 (OCT4), NANOG, and SOX2, as well as the ability to self-replicate indefinitely in cell culture, and the ability to differentiate into endoderm, mesoderm, ectoderm, and extraembryonic tissue types.

[0082] In a more preferred embodiment, the method of the present invention includes the following induction steps applied to the starting cells to obtain final cells (axial stem cells), the first and second steps of which are described herein below.

[0083] The first step in inducing differentiated pluripotent axial stem cells is the induction of an early primitive streaky state in the pluripotent cells (this step is short, e.g., 24 hours, to ensure that the cells are given an impulse to differentiate into primitive streaky precursors, preferably this step is not long enough to completely downregulate the pluripotency genes POU5F1, NANOG and / or SOX2, and more preferably this step is carried out in a serum-free medium as defined in the present invention for cells growing at high density, e.g., in a 2D monolayer).

[0084] The second step is the actual generation of differentiated pluripotent axial stem cells. The rationale for this step is to maintain, in the primitive-like cells generated in the previous step, a) the ability to self-replicate and b) the characteristics of a pluripotent precursor that contributes to the elongation of the posterior-occipital axis in mammals. This step is carried out, for example, by re-seeding the induced cells at a much lower density in a prescribed serum-free medium containing a specific ligand. The success of generating a candidate stem cell line can be visually demonstrated by the formation of small, dense colonies that can further proliferate in the same (corresponding) medium. This axial stem cell line undergoes an empirical establishment phase of, for example, up to 9 passages (e.g., 3–9 passages). During this time, marker gene expression can be monitored for consistency. After establishment, the cells are considered "induced" and can be used for further differentiation into terminal somatic cell types, a) spinal motor neurons and b) sclerodendron derivatives (chondrocytes and osteocytes). These cells can also be converted into cutaneous muscle cell derivatives – skeletal muscle cells and adipocytes.

[0085] In a more preferred embodiment, the method of the present invention uses the following culture medium composition and / or ligand: In the first induction step, the cells can be transferred to a suitable medium consisting of, for example, RPMI1640 supplemented with a vitamin A-containing or vitamin B27 supplement, and CHIR99021 at a concentration of 10 μM can be added for 24 hours. In the second step, the induced cells can be re-seed into a suitable medium consisting of, for example, RPMI1640 supplemented with a vitamin A-containing or non-vitamin B27 supplement, and the following ligands can be added: 5 μM CHIR99021 with 100 ng / ml FGF2 and 10 μM TGF pathway inhibitor SB431542 to generate cell type A (may also be called "basal"); or 5 μM CHIR99021 with or without 10 μM SB431542 to generate cell type B (may also be called "primed"); or 7.5 μM CHIR99021 with or without 10 μM SB431542 to generate cell type C (may also be called "intermediate"). Preferably, these medium compositions can be maintained throughout the establishment period (e.g., 9 passages) and thereafter.

[0086] In a more preferred embodiment, the method and axial cells of the present invention have one or more of the following characteristics: after the first 24-hour induction period, the cells are characterized by induced expression in all or some of the markers of the early primitive streak, e.g., brachiuri (TBXT), MIXL1, GSC, CDX1, CDX2, EOMES, and / or EVX1. Preferably, at the same time, these cells do not express Pax6 (neuroectoderm) or Sox17 (endoderm). More preferably, at the same time, the pluripotency genes POU5F1, NANOG, and SOX2 do not show a significant decrease in expression. Most preferably, the differentiated pluripotent axial stem cells of the present invention have one or more of the following characteristics after passage 9: unlimited self-renewal capacity; the ability to proliferate as small to moderately densely formed colonies with epithelial-like morphology; and non-teratogenicity (i.e., not forming teratomas).

[0087] In a more preferred embodiment, the type A axial stem cells of the present invention co-express TBXT (Brachyuri) and SOX2, preferably MIXL1, more preferably CDX2, and most preferably most preferably most preferably most preferably most preferably most preferably least preferably most preferably least preferably least preferably least preferably least preferably least preferably least preferably least preferably least preferably least preferably less preferably preferably less preferably than less preferably less than or less than Pax6 or POU5F1, with NANOG expression being greatly downregulated.

[0088] In a more preferred embodiment, the type B axial stem cells of the present invention express most of the SOX2 and HOX cluster genes (e.g., A1-D9 / A10), preferably express Pax6 at a high level, and more preferably do not express TBXT (Brachyuri), MIXL1, and CDX2.

[0089] In a more preferred embodiment, the type C axial stem cells of the present invention express most of the HOX cluster genes (e.g., A1-D9 / A10), preferably co-expressing brachiuri (TBXT) and SOX2, and more preferably expressing Pax6 at a moderate level.

[0090] In a more preferred embodiment, all three axial cell types (A, B, and C) of the present invention can be further differentiated into spinal motor neurons, osteocytes, and chondrocytes. This neuronal differentiation is uniform and requires significantly less time compared to established protocols starting from pluripotent cells (e.g., conversion can be observed in 48–72 hours).

[0091] In a more preferred embodiment, the axial stem cells of the present invention are not neural mesoderm precursors (NMp).

[0092] In a more preferred embodiment, the method and use of the present invention do not generate neural mesoderm precursors (NMp).

[0093] In a more preferred embodiment, the axial stem cells, compositions, preparations, or kits of the present invention are used in a method of the present invention (for example, such a method is an in vivo, in vitro, or exo vivo method).

[0094] In a more preferred embodiment, the axial stem cells, compositions, preparations, kits, or methods of the present invention do not involve the destruction of an embryo (e.g., a human embryo), and can be obtained, for example, without the destruction of an embryo (e.g., a human embryo).

[0095] The present invention is not limited to the specific methodologies, protocols, and reagents described herein, and should therefore be understood to be subject to change. The terms used herein are for the sole purpose of describing specific embodiments and are not intended to limit the scope of the present invention as defined solely by the claims.

[0096] All publications and patents cited throughout this Specified (including all patents, patent applications, scientific publications, manufacturer specifications, instructions, etc.) are incorporated herein by reference in their entirety, notwithstanding the foregoing or the foregoing. Nothing in this Specified should be construed as acknowledging that the present invention has no prior rights to such disclosure by prior art. In the event that any material incorporated by reference is inconsistent with or contradicts this Specified, this Specified shall prevail over all such material.

[0097] The present invention can also be characterized by the following: 1. A method for generating (or inducing) axial stem cells (AxSCs) (or neuromuscular stem cells), a) A step of providing pluripotent stem cells, embryonic stem cells or induced pluripotent stem cells (e.g., human PSCs and / or ESCs and / or iPSCs, e.g., human ESC strain H9(WA09) or human iPSC strain HMGU#1), wherein, preferably, prior to the induction / generation, the pluripotent cells are maintained in a suitable pluripotent cell medium (e.g., mTESR1 or iPS-Brew, etc.), and more preferably, the suitable pluripotent cell medium is replaced for the induction / generation (i.e., prior to the induction / generation) with RPMI1640 medium supplemented with a vitamin A-containing or vitamin A-containing B27 supplement, b) A step of activating the Wnt / β-catenin signaling pathway in the above-mentioned pluripotent stem cells, embryonic stem cells, or induced pluripotent stem cells (e.g., GO:0016055; for example, the Wnt / β-catenin signaling pathway is a series of molecular signals initiated by the binding of Wnt proteins to frizzled family receptors on the surface of target cells and ending with a change in cellular state (Huelsken J, Birchmeier W. New aspects of Wnt signalling pathways in higher vertebrates. Current Opinion in Genetics & Development). (October 2001;11(5):547-553), preferably the above activation is carried out by using an inhibitor of the GSK3b protein (e.g., UniProtKB-P49841 or SEQ ID NO: 28), more preferably the inhibitor is CHIR99021, more preferably the CHIR99021 inhibitor is used at a concentration of about 5 μM to about 10 μM, and more preferably the CHIR99021 inhibitor is used for about 24 hours. c) Passaging the cells derived from step (b) under conditions of continuous activation of the Wnt / β-catenin signaling pathway in the cells during passaging, preferably the passaging is carried out at least about 3 to 9 times (e.g., 3, 4, 5, 6, 7, 8, or 9 times), more preferably the passaging is continuous passaging, and most preferably the passaging is reseeding the cells derived from step (b) at a lower density in fresh serum-free medium (e.g., RPMI1640 medium supplemented with or without vitamin A B27 supplement) (e.g., reseeding is unicellular or The process includes the dissociation of colonies into cell aggregates and their plating, and preferably the continuous activation of the Wnt / β-catenin signaling pathway is carried out by using an inhibitor of the Wnt / β-catenin signaling pathway, more preferably the inhibitor is CHIR99021, and most preferably the CHIR99021 inhibitor is used at a concentration of at least about 5 μM (e.g., about 7.5 μM), and the cells derived from step (c) endogenously express the transcription factor SOX-2 (e.g., UniProtKB-P48431 or SEQ ID NO: 21) Includes, d) Optionally, the sequential activation of the Wnt / β-catenin signaling pathway from step (c) is carried out in the presence of a fibroblast growth factor 2 (e.g., UniProtKB-P09038 or SEQ ID NO: 29) and / or a TGF-β (e.g., UniProtKB-P01137 or SEQ ID NO: 30) inhibitor, preferably, (d1) The above-mentioned sequential activation of Wnt / β-catenin signaling from step (c) is carried out using a CHIR99021 inhibitor at a concentration of approximately 5 μM in the presence of fibroblast growth factor 2 (e.g., UniProtKB-P09038 or SEQ ID NO: 29) and TGF-β (e.g., UniProtKB-P01137 or SEQ ID NO: 30) inhibitors, more preferably the TGF-β inhibitor being SB-431542, more preferably the SB-431542 inhibitor being used at a concentration of approximately 10 μM, and more preferably the fibroblast growth factor 2 being used at a concentration of approximately 20 to approximately 100 ng / ml, and is derived from step (d1). The cells endogenously express the transcription factor SOX-2 (e.g., UniProtKB-P48431 or SEQ ID NO: 21), the T-box transcription factor T (e.g., UniProtKB-O15178 or SEQ ID NO: 24), and the homeobox protein MIXL1 (e.g., UniProtKB-Q9H2W2 or SEQ ID NO: 26), but do not endogenously express the paired-box protein Pax-6 (e.g., UniProtKB-P26367 or SEQ ID NO: 27), and optionally further endogenously express the homeobox protein CDX-2 (e.g., UniProtKB-Q99626 or SEQ ID NO: 25), or (d2) The above-mentioned sequential activation of Wnt / β-catenin signaling from step (c) is carried out using a CHIR99021 inhibitor at a concentration of approximately 5 μM, preferably in the presence of a TGF-β inhibitor (e.g., UniProtKB-P01137 or SEQ ID NO: 30), more preferably the TGF-β inhibitor being SB-431542, and most preferably the SB-431542 inhibitor being used at a concentration of approximately 10 μM, and the cells induced from step (d2) are transcribed with the transcription factor SOX-2 (e.g., UniProtKB-P4843 They endogenously express the protein 1 or SEQ ID NO: 21) and the paired-box protein Pax-6 (e.g., UniProtKB-P26367 or SEQ ID NO: 27), but do not endogenously express the T-box transcription factor T (e.g., UniProtKB-O15178 or SEQ ID NO: 24), the homeobox protein MIXL1 (e.g., UniProtKB-Q9H2W2 or SEQ ID NO: 26), and the homeobox protein CDX-2 (e.g., UniProtKB-Q99626 or SEQ ID NO: 25), or (d3) The above-mentioned sequential activation of Wnt / β-catenin signaling from step (c) is carried out using a CHIR99021 inhibitor at a concentration of approximately 7.5 μM, preferably in the presence of a TGF-β inhibitor (e.g., UniProtKB-P01137 or SEQ ID NO: 30), more preferably the TGF-β inhibitor being SB-431542, and most preferably the SB-431542 inhibitor being used at a concentration of approximately 10 μM, and the cells derived from step (d3) are transcribed with the transcription factor SOX-2 (e.g., UniProtKB-P4843 It endogenously expresses the following proteins: 1 (or SEQ ID NO: 21), T-box transcription factor T (e.g., UniProtKB-O15178 or SEQ ID NO: 24), homeobox protein MIXL1 (e.g., UniProtKB-Q9H2W2 or SEQ ID NO: 26), and paired-box protein Pax-6 (e.g., UniProtKB-P26367 or SEQ ID NO: 27), and optionally further endogenously expresses homeobox protein CDX-2 (e.g., UniProtKB-Q99626 or SEQ ID NO: 25). method.

[0098] 2. A method for generating (or inducing) axial stem cells (or neuromuscular stem cells) as described in item 1, including step (d).

[0099] 3. A method for generating (or inducing) axial stem cells (or neuromuscular stem cells) according to item 1 or item 2, comprising step (d), and further comprising steps (d1), (d2), or (d3).

[0100] 4. A method for generating (or inducing) axial stem cells (or neuromuscular stem cells) according to any one of items 1 to 3, further comprising the step of passage the cells derived from step (c) and / or step (d).

[0101] 5. The above axial stem cells (or neuromuscular stem cells) i) Expressing the transcription factor SOX-2 (e.g., UniProtKB-P48431 or SEQ ID NO: 21), ii) Substantially does not express the OCT4 transcription factor (e.g., UniProtKB-Q01860 or SEQ ID NO: 22), iii) Substantially does not express the homeobox protein NANOG (e.g., UniProtKB-Q9H9S0 or SEQ ID NO: 23), iv) Not pluripotent, v) Region-specific differentiated pluripotent stem cells, vi) Can be obtained from pluripotent stem cells, embryonic stem cells, or induced pluripotent stem cells (e.g., human PSCs and / or ESCs and / or iPSCs, e.g., human ESC strain H9(WA09) or human iPSC strain HMGU#1), vii) Not all cells in the embryo can differentiate into all tissue types. viii) Cells that can differentiate only into cell types that emerge from the central axis region during embryonic development (e.g., sclerotioles, cutaneous muscularis, and peripheral neurons), ix) Unable to form teratomas, It is possible to mimic the properties of precursors that give rise to the x-axis region (e.g., motor neurons, peripheral neurons, peripheral nervous system neurons, sensory neurons, bone, cartilage, tendons, ligaments, and / or skeletal muscle cells). xi) Not a transient cell, xii) It can differentiate into motor neurons, peripheral neurons, muscle, cartilage, or bone precursors. xiii) Stem cells that can replicate indefinitely, xiv) It can be reproduced as a clone. xv) Not a neural mesoderm precursor (NMp), and / or xvi) Not artificial neural stem cells (iNSCs), A method for generating (or inducing) axial stem cells (or neuromuscular stem cells) described in any one of items 1 to 4, which have one or more of the characteristics of the above.

[0102] 6. A method for generating axial stem cells as described in any one of items 1 to 5, wherein the axial stem cells described above are not capable of differentiating into the cell types of all tissues of the embryo.

[0103] 7. A method for generating axial stem cells described in any one of items 1 to 6, wherein the axial stem cells described above can differentiate only into cell types that emerge from the central axial region during embryonic development.

[0104] 8. A method for generating axial stem cells described in any one of items 1 to 7, wherein the axial stem cells described above are incapable of forming teratomas.

[0105] 9. A method for generating axial stem cells described in any one of items 1 to 8, wherein the axial stem cells described above are not transient cells.

[0106] 10. A method for generating axial stem cells as described in any one of items 1 to 9, wherein the axial stem cells described above are stem cells that replicate indefinitely.

[0107] 11. A method for generating axial stem cells described in any one of items 1 to 10, which can proliferate as clones.

[0108] 12. A method for generating (or inducing) axial stem cells (or neuromuscular stem cells) described in any one of items 1 to 11, wherein the axial stem cells (or neuromuscular stem cells) described above are not neural mesoderm precursors (NMp).

[0109] 13. The above axial stem cells are not neural mesoderm precursors (NMp), but rather the following proteins: i) Preferably, N-myc proto-oncoprotein (MYCN) having UniProtKB-P04198 or SEQ ID NO: 32, ii) Preferably a protein lin-28 homolog B (LIN28B) having UniProtKB-Q6ZN17 or SEQ ID NO: 31, iii) Preferably, Iroquois class homeodomain protein IRX-3 (IRX3) having UniProtKB-P78415 or SEQ ID NO: 34, iv) Preferably a transcription factor SOX-1 (SOX1) having UniProtKB-O00570 or SEQ ID NO: 35, v) Preferably a zinc finger protein ZIC2 (ZIC2) having UniProtKB-O95409 or SEQ ID NO: 33, vi) Preferably a transcription factor SOX-11 (SOX11) having UniProtKB-P35716 or SEQ ID NO: 36, Expressing one or more of the following, vii) Preferably, the above AxSC is a ground state AxSC expressing MYCN, LIN28B, ZIC2 and SOX11 as defined in (i) to (vi), viii) Preferably, the AxSC is a priming state AxSC expressing MYCN, LIN28B, IRX3, SOX1, ZIC2, and SOX11 as defined in (i) to (vi), a method for generating axial stem cells according to any one of items 1 to 12.

[0110] 14. The above axial stem cells (or neuromuscular stem cells) i) Basal axial stem cells (for example, basal axial stem cells that replicate indefinitely, also referred to herein as "CFS"), which basal axial stem cells a) Transcription factor SOX-2 (e.g., UniProtKB-P48431 or SEQ ID NO: 21), b) T-box transcription factor T (e.g., UniProtKB-O15178 or SEQ ID NO: 24), c) Homeobox protein CDX-2 (e.g., UniProtKB-Q99626 or SEQ ID NO: 25), and d) Homeobox protein MIXL1 (e.g., UniProtKB-Q9H2W2 or SEQ ID NO: 26) It expresses, e) Preferably, the homeobox protein Nkx-2.1 (NKX2.1), for example UniProtKB-P43699 or SEQ ID NO: 37, is further expressed. f) Preferably, for example, a protein lin-28 homolog B (LIN28B) having UniProtKB-Q6ZN17 or SEQ ID NO: 31 is further expressed. g) Preferably, for example, an N-myc proto-oncoprotein (MYCN) having UniProtKB-P04198 or SEQ ID NO: 32 is further expressed. h) Preferably, for example, the E3 ubiquitin protein ligase TRIM71 (TRIM71) having UniProtKB-Q2Q1W2 or SEQ ID NO: 38 is further expressed. i) Preferably, for example, a forkheadbox protein B1 (FOXB1) having UniProtKB-Q99853 or SEQ ID NO: 39 is further expressed. In basal axial stem cells, ii) A primed axial stem cell (for example, a primed axial stem cell that replicates indefinitely, also referred to herein as "CS"), wherein the primed axial stem cell is j) Transcription factor SOX-2 (e.g., UniProtKB-P48431 or SEQ ID NO: 21), and k) Paired box protein PAX-6 (e.g., UniProtKB-P26367 or SEQ ID NO: 27) It expresses, l) Preferably, for example, a protein lin-28 homolog B (LIN28B) having UniProtKB-Q6ZN17 or SEQ ID NO: 31 is further expressed. m) Preferably, for example, an N-myc proto-oncoprotein (MYCN) having UniProtKB-P04198 or SEQ ID NO: 32 is further expressed. n) Preferably, for example, further express the E3 ubiquitin protein ligase TRIM71 (TRIM71) having UniProtKB-Q2Q1W2 or SEQ ID NO: 38, o) Preferably, for example, a forkheadbox protein B1 (FOXB1) having UniProtKB-Q99853 or SEQ ID NO: 39 is further expressed. In the priming state, axial stem cells A method for generating (or inducing) axial stem cells (or neuromuscular stem cells) described in any one of items 1 to 13 that can replicate and differentiate indefinitely.

[0111] 15. A method for generating (or inducing) axial stem cells (or neuromuscular stem cells) as described in any one of items 1 to 14, wherein the axial stem cells (or neuromuscular stem cells) described above are human axial stem cells (or human neuromuscular stem cells).

[0112] 16. Axial stem cells (or neuromuscular stem cells) generated by a method for generating (or inducing) axial stem cells (or neuromuscular stem cells) as described in any one of items 1 through 15.

[0113] 17. Isolated axial stem cells (AxSCs) (or neuromuscular stem cells) that express the transcription factor SOX-2 (e.g., UniProtKB-P48431 or SEQ ID NO: 21), substantially do not express the OCT4 transcription factor (e.g., UniProtKB-Q01860 or SEQ ID NO: 22), substantially do not express the homeobox protein NANOG (e.g., UniProtKB-Q9H9S0 or SEQ ID NO: 23), are not pluripotent, and have the following characteristics: i) Region-specific differentiated pluripotent stem cells, ii) Can be obtained from pluripotent stem cells, embryonic stem cells, or induced pluripotent stem cells (e.g., ESCs and / or iPSCs, e.g., human ESC strain H9(WA09) or human iPSC strain HMGU#1), iii) Not all cells in the embryo can differentiate into all tissue types. iv) Cells that can differentiate only into cell types that emerge from the central axis region during embryonic development (e.g., cleotids, cutaneous muscularis, and peripheral neurons), v) Unable to form a teratoma, vi) It is possible to mimic the properties of precursors that give rise to axial regions (e.g., motor neurons, peripheral neurons, peripheral nervous system neurons, sensory neurons, bone, cartilage, tendons, ligaments and / or skeletal muscle cells), vii) Not transient cells, viii) It can differentiate into motor neurons, peripheral neurons, muscle, cartilage, or bone precursors. ix) Stem cells that can replicate indefinitely, x) Can grow as a clone, xi) Not a neural mesoderm precursor (NMp), xii) Not artificial neural stem cells (iNSCs), Isolated axial stem cells (AxSCs) (or neuromuscular stem cells) further having one or more of the following.

[0114] 18. The axial stem cells (or neuromuscular stem cells) described in item 17 are not capable of differentiating into all tissue cell types of the embryo.

[0115] 19. The axial stem cells (or neuromuscular stem cells) described in item 17 or 18 are capable of differentiating only into cell types that emerge from the central axial region during embryonic development.

[0116] 20. The above axial stem cells (or neuromuscular stem cells) are those described in any one of items 17 to 19 that are incapable of forming teratomas.

[0117] 21. The above axial stem cells (or neuromuscular stem cells) are not transient cells and are axial stem cells (or neuromuscular stem cells) as described in any one of items 1 to 20.

[0118] 22. The above axial stem cells (or neuromuscular stem cells) are stem cells that replicate indefinitely, as described in any one of items 17 to 21.

[0119] 23. The above axial stem cells (or neuromuscular stem cells) are axial stem cells (or neuromuscular stem cells) described in any one of items 17 to 22 that can proliferate as clones.

[0120] 24. The above axial stem cells (or neuromuscular stem cells) are axial stem cells (or neuromuscular stem cells) described in any one of items 17 to 23, and are not neural mesoderm precursors (NMp).

[0121] 25. The above axial stem cells (or neuromuscular stem cells) are not neural mesoderm precursors (NMp), and the above axial stem cells are composed of the following proteins: i) Preferably, N-myc proto-oncoprotein (MYCN) having UniProtKB-P04198 or SEQ ID NO: 32, ii) Preferably a protein lin-28 homolog B (LIN28B) having UniProtKB-Q6ZN17 or SEQ ID NO: 31, iii) Preferably an Iroquois class homeodomain protein IRX-3 (IRX3) having UniProtKB-P78415 or SEQ ID NO: 34, iv) Preferably a transcription factor SOX-1 (SOX1) having UniProtKB-O00570 or SEQ ID NO: 35, v) Preferably a zinc finger protein ZIC2 (ZIC2) having UniProtKB-O95409 or SEQ ID NO: 33, vi) Preferably, a transcription factor SOX-11 (SOX11) having UniProtKB-P35716 or SEQ ID NO: 36. Expressing one or more of the following, vii) Preferably, the above AxSC is a ground state AxSC expressing MYCN, LIN28B, ZIC2 and SOX11 as defined in (i) to (vi), viii) Preferably, the AxSC is a priming state AxSC that expresses MYCN, LIN28B, IRX3, SOX1, ZIC2, and SOX11 as defined in (i) to (vi). Axial stem cells (or neuromuscular stem cells) as described in any one of items 17 through 24.

[0122] 26. The above axial stem cells (or neuromuscular stem cells) can replicate themselves indefinitely. i) Basal axial stem cells (for example, basal axial stem cells that replicate indefinitely, also referred to herein as "CFS"), which basal axial stem cells a) Transcription factor SOX-2 (e.g., UniProtKB-P48431 or SEQ ID NO: 21), b) T-box transcription factor T (e.g., UniProtKB-O15178 or SEQ ID NO: 24), c) Homeobox protein CDX-2 (e.g., UniProtKB-Q99626 or SEQ ID NO: 25), and d) Homeobox protein MIXL1 (e.g., UniProtKB-Q9H2W2 or SEQ ID NO: 26) It expresses, e) Preferably, the homeobox protein Nkx-2.1 (NKX2.1), for example UniProtKB-P43699 or SEQ ID NO: 37, is further expressed. f) Preferably, for example, a protein lin-28 homolog B (LIN28B) having UniProtKB-Q6ZN17 or SEQ ID NO: 31 is further expressed. g) Preferably, for example, an N-myc proto-oncoprotein (MYCN) having UniProtKB-P04198 or SEQ ID NO: 32 is further expressed. h) Preferably, for example, the E3 ubiquitin protein ligase TRIM71 (TRIM71) having UniProtKB-Q2Q1W2 or SEQ ID NO: 38 is further expressed. i) Preferably, for example, a forkheadbox protein B1 (FOXB1) having UniProtKB-Q99853 or SEQ ID NO: 39 is further expressed. In basal axial stem cells, ii) A primed axial stem cell (for example, a primed axial stem cell that replicates indefinitely, also referred to herein as "CS"), wherein the primed axial stem cell is j) Transcription factor SOX-2 (e.g., UniProtKB-P48431 or SEQ ID NO: 21), and k) Paired box protein PAX-6 (e.g., UniProtKB-P26367 or SEQ ID NO: 27) It expresses, l) Preferably, for example, a protein lin-28 homolog B (LIN28B) having UniProtKB-Q6ZN17 or SEQ ID NO: 31 is further expressed. m) Preferably, for example, an N-myc proto-oncoprotein (MYCN) having UniProtKB-P04198 or SEQ ID NO: 32 is further expressed. n) Preferably, for example, further express the E3 ubiquitin protein ligase TRIM71 (TRIM71) having UniProtKB-Q2Q1W2 or SEQ ID NO: 38, o) Preferably, for example, a forkheadbox protein B1 (FOXB1) having UniProtKB-Q99853 or SEQ ID NO: 39 is further expressed. In the priming state, axial stem cells Axial stem cells (or neuromuscular stem cells) described in any one of items 17 to 25 that can be differentiated.

[0123] 27. The axial stem cells (or neuromuscular stem cells) described above are human axial stem cells (or human neuromuscular stem cells) as described in any one of items 17 to 26.

[0124] 28. A method for generating (or inducing) axial stem cells (or neuromuscular stem cells) described in any one of items 1 to 27, wherein the axial stem cells (or neuromuscular stem cells) described in any one of items 1 to 27.

[0125] 29. Compositions, preparations, or kits comprising axial stem cells (or neuromuscular stem cells) as described in any one of items 16 through 27.

[0126] 30. The composition, preparation, or kit described above is a composition, preparation, or kit for pharmaceutical and / or diagnostic use as described in item 29.

[0127] 31. Axial stem cells, compositions, preparations, or kits described in any one of items 16 to 27 and 29 to 30, for use as pharmaceuticals.

[0128] 32. i) Methods for the treatment, reduction, prevention and / or diagnosis of neurodegenerative diseases, ii) Methods for the treatment, reduction, prevention, and / or diagnosis of bone and / or cartilage disorders, iii) Methods for the treatment, reduction, prevention and / or diagnosis of muscle disorders, iv) Methods for regenerative therapy of cells, tissues, organs and / or the body, v) A method for screening candidate compounds for activity against diseases (e.g., diseases of the peripheral nervous system or diseases related to axial stem cells, e.g., muscle-related, motor neuron-related, peripheral neuron-related, sensory neuron-related, cartilage-related, tendon-related (e.g., degenerative) diseases) and / or for neurotoxicity screening. vi) Methods for the treatment, reduction, prevention and / or diagnosis of diseases related to axial stem cells, such as muscle-related, motor neuron-related, peripheral neuron-related, sensory neuron-related, cartilage-related, and tendon-related (e.g., degenerative) diseases. vii) Any of (i) to (vi) methods, either in vitro, ex vivo, or in vivo. Axial stem cells (or neuromuscular stem cells), compositions, preparations, or kits described in any one of items 16 to 27 and 29 to 31 for use in one or more of the following:

[0129] 33. A method for improving the condition of a required sample or object, the method being as follows: i) Methods for the treatment, reduction, prevention and / or diagnosis of neurodegenerative diseases, ii) Methods for the treatment, reduction, prevention, and / or diagnosis of bone and / or cartilage disorders, iii) Methods for the treatment, reduction, prevention and / or diagnosis of muscle disorders, iv) Methods for regenerative therapy of cells, tissues, organs and / or the body, v) A method for screening candidate compounds for activity against diseases (e.g., diseases of the peripheral nervous system) and / or for neurotoxicity screening. One or more of the following: This method is a) A step of providing the above sample or subject with axial stem cells, compositions, preparations, or kits described in any one of items 16 to 27 and items 29 to 32, b) A step of administering a therapeutically effective amount of the above-mentioned axial stem cells, composition, preparation, or kit to the above-mentioned sample or subject. A method that includes this.

[0130] 34. The method described in item 33, wherein the method is in vitro, ex vivo, or in vivo.

[0131] 35. The following, i) Treatment, reduction, prevention and / or diagnosis of neurodegenerative diseases, ii) Treatment, reduction, prevention, and / or diagnosis of bone and / or cartilage disorders, iii) Treatment, reduction, prevention and / or diagnosis of muscle disorders, iv) Regenerative therapy of cells, tissues, organs and / or the body, v) Screening candidate compounds for activity against diseases (e.g., diseases of the peripheral nervous system) and / or for neurotoxicity screening. vi) In vitro, ex vivo, or in vivo use, any of (i) to (v) Use of axial stem cells, compositions, preparations and / or kits described in any one of items 16 to 27 and items 29 to 32 for one or more of the following:

[0132] The present invention is further illustrated by the following examples, but is not limited to these examples, nor is it limited by any particular embodiment of these examples. [Examples]

[0133] Examples of the present invention Materials and methods cell culture Human ESC strain H9 (WA09) and human iPSC strain HMGU#1 (Kunze et al., 2018) were grown on Matrigel-coated (BD Corning) plates in either mTesR1 (Stem Cell Technologies) or iPS Brew XP (Miltenyi Biotech) medium. Cells were divided in a 1:10 ratio using Passaging solution XF (Miltenyi Biotech) when confluence > 70%. H9 cells were used for 42–65 passages, and HMGU#1 for 21–34 passages. In all experiments, fresh medium was applied daily, and cells were cultured under 5% CO2.

[0134] In the time-course experiment, cells were dissociated using Accutase (Sigma) and seeded at a rate of 2.5 × 10⁵ cells per well in mTesR1 medium supplemented with 10 μM Y-27632 (R&D) in a 12-well plate. After 24 hours, the medium was replaced with differentiation medium, RPMI-1640 containing L-glutamine and 1 × B-27 supplement without insulin containing 10 μM CHIR99021 (Tocris). The procedure was the same except that in cases of β-catenin overexpression, CHIR99021 was replaced with 1 μg / ml doxycycline (Clontech). All cell culture medium components were obtained from Life Technologies unless otherwise specified.

[0135] Axial stem cell induction Cells were seeded as described above and treated with 10 μM CHIR for 24 hours. The cells were then divided in a 1:20–1:30 ratio into Matrigel-coated 6-well plates containing maintenance medium (RPMI-1640 supplemented with L-glutamine, 1× non-essential amino acids, 1× B-27 supplement without vitamin A, and their respective ligands (see Table 1)), and the cultures were incubated until confluent. Confluent cultures were divided in a 1:10–1:20 ratio using conventional methods until the end of the establishment period, defined as passage 9. Dividing was performed using either Passaging solution XF or Versene (Life Technologies). Fresh FGF2-containing medium was prepared weekly, and FGF2-free medium was prepared at least every two weeks. Manual colony harvesting or scraping of differentiated cells was not employed at any stage during cell line establishment.

[0136] [Table 2]

[0137] ΔN90 β-catenin hESC strain To generate tetracycline-inducible overexpression of constitutively active β-catenin (including deletion of the first 90 amino acids from the N-terminus), H9 cells were nucleofected with the PB-GFP-P2A-ΔNβCAT plasmid and the Piggybac transposase-coding plasmid using the P3 primary cell 4D nucleofector kit (Lonza). After 48 hours, the cells were divided into 10 cm dishes and selected for 2 weeks with 50 μg / ml hygromycin B (Life Technologies). Subsequently, polyclonal stable strains were grown in the presence of 25 μg / ml hygromycin B in the same manner as the parent H9 strain.

[0138] Directional differentiation Motor neuron differentiation: AxSC cells were dissociated with Accutase, and 1.5 × 10⁵ cells were seeded into one well of a 12-well plate coated with Matrigel containing their respective maintenance media supplemented with 10 μM Y-27632. The following day, the medium was replaced with a 1:1 ratio of DMEM / F12 and Neurobasal medium A containing neuronal differentiation medium, 1 × B-27 supplement, 1 × N2 supplement, 0.1 μM retinoic acid (Sigma), 100 ng / ml recombinant Sonic Hedgehog (R&D), 10 ng / ml BDNF (R&D), 10 ng / ml GDNF (R&D), 10 ng / ml IGF-1 (Peprotech), 0.1 μM compound E (Merck), and 100 μM cAMP (Sigma). The medium was changed daily for the first 5 days, and then every other day thereafter.

[0139] Osteocyte differentiation: The AxSC strain was seeded as described above, but at a higher density, with 2.5 × 10⁵ cells per well in a 12-well plate. The following day, the medium was replaced with RPMI-1640 containing L-glutamine and supplemented with 300 nM SAG (Sigma) and 20 ng / ml FGF₂ (Peprotech), and containing a vitamin A-free 1 × B-27 supplement. Two days later, the medium was replaced with OsteoDiff StemMACS medium (Miltenyi Biotech) for the remainder of differentiation. The medium was changed daily for the first 5 days, and then every other day thereafter.

[0140] Chondrocyte differentiation: Chondrocytes were differentiated from the AxCS strain using the same procedure as for osteocytes, except that the differentiation medium was ChondroDiff StemMACS (Miltenyi Biotech).

[0141] quantitative PCR Total RNA was isolated using the RNeasy Mini Kit (Qiagen). cDNA was synthesized from 0.2 - 1 μg of total RNA (normalized amount between samples within each experiment) using the Verso cDNA Synthesis Kit (Thermo Scientific) according to the manufacturer's instructions. 1 μl of cDNA (1:5 dilution) was used as template in a 10 μl qPCR reaction. PCR was set up using either pre-designed Taqman Gene Expression Assays (both from Thermo Scientific) together with Taqman Gene Expression Master Mix, or custom-designed primers together with Power SYBR Green master mix (Thermo Scientific). Details of all primers and Taqman probes are listed, for example, in Table 2. The primer concentration in the reaction was 250 nM for all primers. PCR was performed on a QuantStudio 12K Flex Real-Time PCR System (Thermo Scientific) using pre-specified cycling parameters. Two technical replicates were performed for each reaction. The Taqman assays and primers used are listed, for example, in Table 2. GAPDH served as a housekeeping gene in all experiments. Relative fold changes (FC) in gene expression were calculated using the ΔΔCt method (Livak and Schmittgen, 2001). Results are presented as mean ΔΔCt ± mean standard error between biological replicates, unless otherwise stated. Plots were created using the ggplot2 package (Wickham, 2009) in RStudio software running R version 3.5.1 (R Core Team, 2018).

[0142]

Table 3

[0143] Immunofluorescence analysis For immunofluorescence analysis, cells were seeded either on Matrigel-coated glass coverslips or on Matrigel-coated 4-well μ-slides (Ibidi). For IF on differentiated motor neurons, the AxCS strain was directly differentiated on coverslips. After fixation with 4% methanol-free formaldehyde (Thermo Scientific) in PBS for 15 min at room temperature (RT), cells were permeabilized with 0.2% Triton X-100 (Sigma-Aldrich) for 10 min and subsequently blocked with 5% goat serum (Sigma-Aldrich) in PBS / 0.05% Triton-X100 for 40 min at RT. The primary antibody dilutions in blocking buffer (e.g., Table 3) were added and incubated overnight at 4°C. The next day, cells were washed three times with PBS and incubated with secondary antibodies diluted in PBS for 1 h at RT. Coverslips were mounted using ProLong Gold mounting reagent containing DAPI. Images were obtained at a magnification of 63× using a Zeiss Axio Observer.ZI epifluorescence microscope (Zeiss) equipped with Apotome.2 and Zen software.

[0144]

Table 4

[0145] Staining of osteocytes and chondrocytes Differentiated cells were washed twice with PBS and fixed with 4% formaldehyde for 30 min at room temperature. After washing three times with distilled water, osteocytes were stained with 40 mM alizarin red solution (Sigma-Aldrich) for 30 min. Chondrocytes were stained with 1% alcian blue solution in 3% acetic acid, pH 2.5 for 1 h at room temperature. Alcian blue was washed once with 3% acetic acid and subsequently three times with distilled water, with each wash being performed for 15 min. The alizarin red washings were washed with distilled water, with each wash being performed for 15 min. Images of the wells were acquired at a magnification of 10× using a Leica ICC50HD color camera.

[0146] RNA sequencing 3 μg of total RNA was treated with TURBO DNase (Life Technologies) and purified using the RNeasy Minelute RNA Cleanup Kit (Qiagen). RNA quality was evaluated using microcapillary electrophoresis on an Agilent 2100 Bioanalyzer with the RNA Pico 6000 Kit (Agilent), and only RNA with a RIN value > 8 was further processed. For each RNA-seq library, 1 μg of DNase-treated RNA was treated with the RiboZero Gold (Human / Mouse / Rat) Kit (Illumina) to remove rRNA, and then RNA cleanup was performed using the RNeasy Minelute RNA Cleanup Kit. Sequencing libraries were prepared from an equal amount of rRNA-depleted RNA using the TruSeq Stranded total RNA LT Kit (Illumina) according to the manufacturer's instructions, with 11 cycles of enrichment PCR. Library quality was evaluated using the DNA 1000 Kit (Agilent) with an Agilent 2100 Bioanalyzer. Library concentration was measured using the Qubit dsDNA HS Assay Kit (Life Technologies). Library duplicatement was performed according to the manufacturer's instructions. Duplicated libraries from CHIR time-course experiments were sequenced using a NextSeq 500 (Illumina) to generate 75nt single-ended reads. The sequencing depth was 20-40 Mio reads per library. Libraries derived from the established AxCS strain were sequenced using a HiSeq2500 instrument to generate 50bp single-ended reads. The sequencing depth was 12-14 Mio reads per sample.

[0147] RNA sequencing data analysis For CHIR time-course experiments, reads were pseudo-aligned to a human transcriptome (Ensembl version GRChg38.86) using kallisto (version 0.43.0_3) (Bray et al., 2016). The abundance of the obtained estimated transcript levels was aggregated into counts per gene and exported using the Tximport (version 1.10.1) pipeline (Soneson et al., 2015). Differential gene expression analysis was performed by comparing gene expression at each stimulus time point with undifferentiated parental cell lines using the DESeq2 package in R (version 1.22.2) (Love et al., 2014). Normalized counts were extracted from the DESeq2 objects. PCA plots were constructed from the rlog-transformed raw counts.

[0148] For RNA sequencing of AxCS strains, genome alignment and read counting were performed using the Galaxy platform (Afgan et al., 2018). Briefly, reads were trimmed using Trimmomatic (Bolger et al., 2014) with default parameters and aligned to the hg38 human genome using HiSAT2 (Kim et al., 2015). Reads were counted from bam files using featureCounts (Liao et al., 2014). Differential gene expression analysis was achieved by comparing AxCS strains with undifferentiated parental cell lines using the DESeq2 package in R (version 1.22.2). Genes differentially expressed from each strain were analyzed for overexpression of GO ontology terms from the "biological process" category using the topGO package (Alexa and Rahnenfuhrer, 2018), and p-values ​​from Fisher's Exact Test for normalized gene counts were reported.

[0149] Overexpression pathways were analyzed using the Genomatix Pathway System (GePS) tool from the Genomatix software suite (http: / / www.genomatix.de) by providing significantly upregulated genes and stimuli as inputs from each time point in time.

[0150] The Enrichr tool (Kuleshov et al., 2016) and the JENSEN tissue expression database (https: / / tissues.jensenlab.org) were used to analyze the association between tissues and cell types. A list of genes associated with selected cell types was extracted, and their normalized expression values ​​(from DESeq2 analysis) were used to construct the heatmap shown in Figure 1E.

[0151] Example 1: Maintenance of TBXT and SOX2 expression in passaged offspring of hESCs To permanently capture human hypocotyl-like precursors in vitro, the inventors first attempted to establish conditions similar to those of SOX2 and TBXT / BRA expression. Since SOX2 is already highly expressed in undifferentiated hESCs, the inventors focused on inducing the most likely endogenous TBXT expression by activating the Wnt / β-catenin signaling pathway (Arnold et al., 2000) that regulates this gene in the early primitive streak. Using CHIR99021 as an agonist for this pathway, the inventors compared continuous Wnt / β-catenin activation with a 24-hour transient activation (Lian et al., 2012) that produces ectomesoderm precursors. The inventors noted that continuous 10 μM treatment maintained high levels of TBXT (e.g., Figure 1A). To characterize the differentiation stages under continuous WNT activation, the inventors performed time-series RNA sequencing (e.g., Figure 1B). The inventors focused on the rapid upward trend (e.g., Figures 1C-E) that plateaued within 48-72 hours for genes expressed in the primitive streak (TBXT, MIXL1, GSC, EVX1), as well as neural genes (ZIC1, CDH2, GBX2) and genes characteristic of the elongation axis (early and mid-stage members of the HOX gene cluster). Gene ontology analysis confirmed the relationship between the transcriptome and the development of mesoderm, ectoderm, and neurons at 72 hours after continuous CHIR99021 treatment (e.g., Figures 1D, E). This indicates that the body axis precursor and their autonomous regulation begin to form upon continuous inhibition of GSK-3β in the hESC.

[0152] To confirm that this axial gene signature represents direct activation of Wnt / β-catenin, we incorporated a constitutively active mutant of β-catenin into the genome of hESCs under the regulation of tetracycline-controlled transcriptional activation. Although constitutively active β-catenin resulted in the induction and higher expression of a broader gene cohort overall, continuous treatment of this strain with doxycycline revealed a similar tendency for upregulation of axial mesoderm genes and axial nerve genes, suggesting stronger induction of this pathway (e.g., Figures 1D, E). In summary, this indicates that continuous activation of the Wnt / β-catenin pathway generates precursors with axial characteristics, which are reasonable to assume have developmental potential encompassing paraxial mesoderm lineages and peripheral nerve offspring.

[0153] The inventors' next objective was to define the conditions that promote the replication of axial-like cells in culture during passaging. To investigate the signaling cascades that may be important for replication and differentiation, the inventors performed pathway analysis, which revealed endogenous FGF, TGF-β, and, to a lesser extent, BMP signaling, in addition to the externally activated Wnt / β-catenin pathway (e.g., Figure 1F). Since basic FGF (FGF2) is a potent mitogen for neural precursors (Kitchens et al., 1994) and mesoderm spread (Wilson et al., 2005), the inventors attempted to promote the replication of axial-like precursors by CHIR99021 treatment with and without FGF2. Even if the induction of axial markers did not reach peak levels after 24 hours (e.g., Figure 1C), the inventors initiated cell passaging at this time point because SOX2 levels were equivalent to those of the undifferentiated state (e.g., Figure 1G). Surprisingly, the inventors found that a passage campaign initiated at 24 hours in the presence of CHIR99021 produced offspring that stably expressed SOX2 at levels comparable to undifferentiated hESCs, accompanied by mild and potent downregulation of NANOG and OCT4, respectively, which are exclusive markers for pluripotency (e.g., Figure 1H). Surprisingly, although TBXT is a direct target of β-catenin, in these experiments its sustained expression required the presence of FGF2 (e.g., Figure 1H). Taken together, these results indicate that persistent activation of Wnt / β-catenin in hESCs and passage initiated at 24 hours promote the replication of cells that co-express the axial markers TBXT and SOX2, but do not express either NANOG or OCT4, which are essential pluripotency reprogramming factors for early development. Surprisingly, only steady-state Wnt / β-catenin activation sustained the cellular state that maintained only SOX2.

[0154] Example 2: Induction of stem cell lines exhibiting axial state characteristics Next, the inventors tested the induction of stem cell-like lines exhibiting two axial states. Depending on the maintenance of the SOX2 and TBXT states by Wnt / β-catenin and FGF signaling, or the maintenance of the SOX2 state by Wnt / β-catenin alone, the inventors screened concentration ranges of CHIR99021 with or without the addition of FGF2, as well as ligands and inhibitors of TGF-β and BMP signaling (e.g., Figure 4). The inventors investigated whether phenotypic stable lines could be established over several months of culture by applying these conditions after 24 hours of CHIR99021 treatment and continuous passaging (e.g., Figure 2A).

[0155] Results from three independent serial passage campaigns using hESCs as the starting population revealed that treatment with 5 μM or 7.5 μM CHIR99021 enabled the induction of lines exhibiting compact stem cell colony morphology in the presence or absence of FGF2 (e.g., Figures 2C and F). Furthermore, application of the TGF-β inhibitor SB-431542 generated more compact cells and denser colonies (e.g., insets in Figures 2C and F). In contrast, the addition of BMP4 or TGF-β completely prevented deviation from stable lineages (e.g., Figure 4). Finally, concentrations of CHIR99021 lower than 5 μM did not promote cell line formation, and 10 μM treatment was toxic to hESC conversion but not to iPSCs (e.g., Figures 2B, 4, and 5). Representative cell lines induced by the inventors from hESCs showed no obvious changes in proliferation rate, viability, or epithelial morphology, and were passaged at least 40 times and continuously cultured for a total of 8 months or more (e.g., Figure 2C). Thus, the inventors were able to induce self-replicating cell lines by persistent activation of Wnt / β-catenin with or without FGF2.

[0156] During the passage campaign, the expression of axial mesoderm and neural markers was monitored, thereby collectively defining two major states of the putative axial stem cell lines. Cell lines induced by treatment with 5 μM CHIR99021 with FGF2 showed high levels of SOX2, TBXT, CDX2, MIXL1, EOMES, and very low levels of PAX6 or no PAX6 (e.g., Figures 2C-E). Conversely, treatment with 5 μM CHIR99021 alone resulted in the formation of cell lines showing high levels of SOX2 along with PAX6, but no T, CDX2, MIXL1, or EOMES (e.g., Figures 2C-E). Using immunocytochemistry, we confirmed that SOX2 / TBXT / CDX2 and SOX2 / PAX6 are co-expressed in cell lines established with or without FGF2, respectively (e.g., Figure 2C). In particular, it was shown that cell lines with a very similar phenotype to those generated without FGF2 were formed when TGF-β was inhibited (e.g., Figures 2D, E), and that intermediate axial state cell lines could also be induced. Indeed, when the inventors induced cell lines by treatment with 7.5 μM CHIR99021, they observed a stable phenotype characterized by intermediate levels of TXBT and PAX6 (e.g., Figures 2F, G). In summary, this indicates that the terminals of the axial stem cell state regenerated in vitro by the inventors are characterized by the mutually exclusive expression of TBXT and PAX6. Importantly, the initial characterization of cell line states derived from human iPSCs under the same conditions revealed a similar phenotype, despite the fact that inhibition of TGF-β with 10 μM CHIR99021 was tolerated for the induction of SOX2 / TXBT axial cell lines (e.g., Figure 6). Finally, downregulation of NANOG and blockade of OCT4 were observed in all clones, which is consistent with the restriction of their expression to a pre-linear stage. Furthermore, we noted the increase in SOX2 over long passages (e.g., Figure 2E).

[0157] Importantly, the inventors noted that some SOX2 / TXBT axial cell lines exhibited heterologous expression of CDX2, with some colonies being uniformly positive and others negative. To further define the characteristics of CDX2-positive and CDX2-negative cells, the inventors created clones from single cells. The inventors noted that these clones were either CDX2-negative or contained mixed populations, and that high CDX2 expression correlated with high TBXT and MIXL1 expression (e.g., Figure 5). Interestingly, one clone expressed only PAX6. Taken together, these results indicate that the early stages in the hierarchy of axial states captured by the cell lines exhibit the expression of SOX2, TBXT, CDX2, and MIXL1, while the final stages are characterized by the expression of SOX2 and PAX6. The inventors named these respective states the ground state and the priming state, respectively. Notably, both states expressed a broad repertoire of HOX cluster-derived genes, including some of the late-stage HOX genes from the ground state.

[0158] Example 3: Axial stem cells are hierarchical and differentiate into peripheral neurons, sclerotioles, and cutaneous muscularis. To characterize the putative axial stem cell lines, the inventors first analyzed their hierarchy by switching between FGF2 treatment and non-treatment. The inventors noted that in the absence of FGF2, basal-like axial cell lines downregulated TBXT / CDX2 and upregulated PAX6, but the expression of SOX2 and PAX6 did not change after the addition of FGF2 to SOX2 / PAX6 axial cell lines (e.g., Figure 3A). This demonstrated the premise that SOX2 / TBXT axial cell lines represent precursors to the SOX2 / PAX6 stage. Next, the inventors analyzed the basal, intermediate, and primed axial stem cell states using comprehensive transcriptome analysis. Interestingly, despite the mutually exclusive expression of T / CDX2 and PAX6 in the basal and primed states, respectively, the inventors found that the cohort of upregulated genes in the primed state was almost entirely (approximately 90%) contained within the basal state (e.g., Figure 3B). This indicates that the regulation of the initial axial state involves a larger cohort of gene expression, likely mediated by TBXT / CDX2 / MIXL1 and / or FGF signaling. Furthermore, we found that the intermediate state exhibits upregulation of a unique cohort containing approximately 10% of the genes that did not overlap with the other states. Despite these differences, analysis of the enriched tissue categories showed that the developmental correspondences of the basal, priming, and intermediate states are similar and that they possess the potential to differentiate into neuronal and skeletal systems (e.g., Figure 3C).

[0159] Since axial stem cells represent a developmental stage beyond the induction of the primitive streaks, to access the neuronal potential of basal and priming cell lines, we skipped a first set of signals typically used to induce neuronal differentiation from the pluripotency stage, including dual Smad inhibition. Notably, when these cell lines were directly treated with motor neuron maturation medium containing RA, SHH, BDNF, and GDNF, morphological transformation was rapid, with cells developing neuronal cell morphology within 4 days in the basal state and within 2 days in the priming state. Within 15 days, an elaborate network of TUJ1-positive neurons was readily apparent (e.g., Figure 3D), and the motor neuron precursor marker OLIG2 was highly expressed (e.g., Figure 3E). Subsequently, OLIG2 was downregulated, while transcription factors expressed by terminally differentiated (highly differentiated) motor neurons, including ISL1 and HB9, as well as choline acetyltransferase (ChAT) and peripherin (PRPH), were upregulated (e.g., Figure 3E). In addition, BRN3A (POU4F1), a common marker for sensory neurons, was upregulated at the final stage of analysis in differentiated neurons derived from both basal and primed axial cell lines (e.g., Figure 3E). Overall, these data indicate that axial stem cell lines differentiate into mature peripheral neurons regardless of their state, and that basal and primed states may have different tendencies to differentiate into sensory and motor neurons, respectively. This was supported by the different morphologies of the resulting neuronal networks.

[0160] Under the same premise, skipping the initial stages of induction from the pluripotent state should allow axial stem cell lines to differentiate into the sclerotid lineage. Indeed, when we treated basal and priming axial stem cells with a sonic hedgehog pathway activator and a medium that promotes the maturation of osteocytes and chondrocytes, we found that differentiated cells from both states exhibited definitive characteristics of their respective cell types. This included upregulation of RUNX2 (Komori, 2010), a key transcription factor required for the identification of the osteoblast lineage, and its osteocyte-specific target genes—osteocalcin (BGLAP), osteopontin (SPP1), and collagen 1a1 (COL1A1) (e.g., Figure 3F). Similarly, we focused on upregulation of chondrocyte markers, including NKX3-2 (containing oligomeric substrate protein (COMP) and aggrecan (ACAN)), a transcription factor that activates genes expressed in cartilage tissue (e.g., Figure 3G). Notably, this upregulation is stronger for cells differentiated from the basal state line, indicating a higher tendency to produce cartilage in the basal state axial stem cell line. Finally, staining of calcium deposits with alizarin red and staining of sulfated proteoglycans with Alcian blue confirmed the differentiation of osteocytes and chondrocytes (e.g., Figures 3H-I). Therefore, we conclude that both states of axial stem cells are capable of producing sclerotium, but the tendency to differentiate differs depending on the developmental stage.

[0161] To induce cutaneous muscular lamina differentiation of skeletal muscle, the inventors applied a recently developed sensorimotor organoid protocol (Pereira et al., 2019, CellPress SneakPeek) and initiated the process using basal and priming axial cell lines. On day 16, the inventors observed significant upregulation of PAX3, PAX7, and MYOD1, which indicate skeletal muscle formation.

[0162] Finally, the inventors transplanted basal state and primed state axial stem cell lines into immunodeficient mice, and in contrast to undifferentiated hESCs, in 100% of the transplantation cases, the inventors detected no teratoma formation. Taken together, evidence of differentiation into peripheral neurons, somites and the dermomyotome, rather than teratomas, supports the classification of axial-like basal cell lines and primed state cell lines as equivalents to human embryonic axis region precursors.

[0163] Discussion SOX2 plays a crucial role in the maintenance of embryonic stem cells and neural stem cells (NSCs) (Boyer et al., 2005; Avilion et al., 2003; Graham et al., 2003; Pevny and Nicolis, 2010), and is also expressed in the diversifying precursors of the peripheral nervous system present in NSBs, CLEs, and CNHs, such as in the axial precursor (Henrique et al., 2015), or in the neural crest-derived sensory neuron precursor (Cimadamore et al., 2011). In this embodiment, we demonstrate that by continuously activating the Wnt / β-catenin pathway in conjunction with cell passage starting 24 hours after pathway activation, high SOX2 expression, as in human ESCs, can be maintained. This makes it possible to elucidate the roles of Wnt / β-catenin and FGF in regulating SOX2, PAX6, and TBXT in axial precursor differentiation. Despite the idea that TBXT forms a positive feedback loop between Wnt / β-catenin and FGF signaling, which are necessary for establishing and maintaining the body axis precursor (Garriock et al., 2015; Gouti et al., 2014; Koch et al., 2017; Turner et al., 2014; Martin and Kimelman, 2010), our results show that Wnt / β-catenin alone is sufficient to maintain SOX2 expression in the body axis precursor. Instead, both FGF and Wnt / β-catenin signaling are necessary for establishing and maintaining the state of the body axis precursor co-expressing TBXT and SOX2. Nevertheless, TBXT appears to be transiently expressed after Wnt / β-catenin activation and passage, and FGF appears to be endogenously produced (e.g., Figure 1F), indicating that TBXT and FGF are transiently involved in the establishment of all forms of the body axis precursor. This is supported by the unidirectional conversion of SOX2, TBXT→SOX2, and PAX6 axial states by Wnt / β-catenin alone. Importantly, if hPSCs are not passaged after Wnt / β-catenin stimulation, SOX2 is rapidly downregulated, which completely prevents the induction of the body axial precursor.Accordingly, we conclude that Wnt / β-catenin and passage promote the axial ground state of TBXT and SOX2 in the presence of bFGF, or the priming state (e.g., Figure 3K) in which SOX2 and PAX6 are co-expressed when only Wnt / β-catenin signaling is active.

[0164] PAX6 has been previously shown to be essential for neuroectoderm differentiation in human fetuses and human PSCs, juxtaposed with Sox1, the earliest marker in mouse neuroectoderm (Zhang et al., 2010). Based on axial precursor differentiation, our results indicate that PAX6 is the earliest neuronal factor in the precursor of human peripheral nervous system differentiation. Importantly, FGF2 has been previously shown to suppress PAX6 during the differentiation of human PSCs into neurons (Greber et al., 2011). Furthermore, MEK-ERK signaling is involved in mesoderm differentiation and TBXT expression (Yao et al., 2003). This suggests that FGF2 plays a dual role in inhibiting human axial precursor differentiation into a priming state (e.g., Figure 3K). Part of this mechanism may include switching the enhancer regulated in SOX2 from N1 in undifferentiated ESCs to a Wnt / FGF-dependent N2 enhancer in the axial state (Takemoto et al., 2006; Kondoh and Takemoto, 2012).

[0165] Beyond the mechanism of early differentiation, the inventors have for the first time induced self-renewing stem cell lines corresponding to the axial precursors at each stage, i.e., the basal state and the priming state, from both hESC and iPSC lines. These stem cell lines exhibited a stable undifferentiated phenotype for numerous passages, and the inventors noted that TGF-β inhibition with SB-431542 reduced spontaneous differentiation, maintaining the line as a more compact colony. Importantly, single-cell cloning of basal-state AxSC lines treated with SB-431542 produced mixed clones or CDX2 clones, indicating that AxSC expresses CDX2 in the root state. The clonal pattern of CDX2 may be due to heterogeneity in the expression of the late HOX gene HOXD13, which is known to negatively regulate CDX2 (Young et al., 2009; Amin et al., 2016). Finally, FGF8 may be replaced by FGF2 in the induction of AxSC strains (Lippmann et al., 2015). In summary, by passage human axial progenitor cells when SOX2 expression is consistent with TBXT after Wnt / β-catenin activation with or without FGF2, ground and priming AxSC strains can be generated by utilizing a pathway that regulates the differentiation of human axial progenitor cells.

[0166] This evaluation of the differentiation potential of basal and priming AxSC strains showed that both types rapidly differentiated into complex neural networks within just 48 hours. Therefore, despite the fact that AxSC required approximately 10 days to express high levels of peripheral and motor neuron markers, neural involvement represents the default differentiation pathway for AxSC, suggesting that peripheral neuron maturation and diversification may be accompanied by further signaling. Interestingly, the morphology of the neural networks differed between basal and priming AxSC strains. Higher PRPH expression in neurons derived from basal AxSC may indicate a greater tendency to generate sensory neurons compared to priming AxSC, which also produced a faster and denser neural network. The idea that neuronal differentiation is the default pathway for AxSC is supported by the fact that its cells require 15-day and 15-30-day protocols to become sclerotomy cells (i.e., chondrocytes and osteocytes), and cutaneous muscularis cells (i.e., muscle fibers), respectively. Despite other previously reported studies on the differentiation of human NMP precursors into motor neurons (Gouti et al., 2014; Lippmann et al., 2015; Denham et al., 2015; Verrier et al., 2018) and one study reporting the differentiation of early myocytes (Gouti et al., 2014), to the best of our knowledge, AxSC represents the first and only type of pluripotent clonal cell line capable of producing sclerotiodontium, cutaneous muscularis, and peripheral neurons.

[0167] The ordering of HOX gene expression along the body axis in mouse embryos and the regional activation of specific HOX genes in invertebrate body segments are thought to reflect a similar deterministic mode of HOX gene activation in mammals. Notably, we found that the repertoire of HOX genes expressed by the AxSC strain is very broad, including several late-stage posterior HOX genes in the basal state. This may indicate a permissive mode of ordering HOX genes along the body axis in mammals, acting by initially activating all or most of the HOX paralog genes in AxSC in parallel, and then fixing their positional identity through secondary signaling. In line with this explanation, there are recent findings by Gouti et al., who focused on the progressive activation of posterior HOX genes in transient NMPs derived from mouse embryos, and by Lippmann et al., who showed that retinoic acid fixes the positional identity of NMP offspring. The ability to generate single clones from ground-state AxSCs, and their differentiation into priming-state AxSCs that do not express late-stage HOX genes, provides an important platform for investigating the mechanisms underlying the positional accuracy of HOX gene patterns in mammals.

[0168] The generation of human AxSC strains may be highly advantageous for research and medical applications. Firstly, the application of such strains or their progeny may increase the safety of cell therapies in the peripheral nervous system, skeletal muscle, or skeletal tissue by avoiding the risk of cellular impurities. These may be residual undifferentiated PSCs that risk forming teratoma tumors (Drukker, 2012) or differentiated and intermediate cell types in other tissues. Importantly, we have found no evidence that basal or priming AxSCs can produce teratomas. Secondly, the a priori developmental limitation of AxSCs may make the induction of specific types of cells of interest, such as motor neurons, more coherent, uniform, and faster, resulting in less expensive and simpler production of therapeutic cells. Therefore, AxSCs can also be an easy-to-handle tool for creating cell models of diseases affecting the peripheral nervous system, such as amyotrophic lateral sclerosis (ALS), as well as for drug development and toxicity testing using AxSC progeny. Thirdly, AxSCs could serve as a benchmark for understanding the regulation of the development, function, and evolution of further cell types arising in the human peripheral nervous system and axial region. In this regard, we anticipate that induced (artificial) AxSCs (iAxSCs) can be directly induced from somatic cells by overexpression of key transcription factors described herein, just as in the case of induced (artificial) neurons and iPSCs.

[0169] knot The induction of NSCs from embryos and ESCs has ushered in a new era in central nervous system research and therapy. The induction of AxSC strains complements these crucial findings by providing a system for researching and creating treatments for diseases and injuries affecting the sensory and motor peripheral nervous system and skeletal muscle, including ALS and muscular dystrophy.

[0170] Example 4: Induction of stem cell lines exhibiting axial state characteristics CHIR+TGFi and CHIR+FGF2+TGFi treatments enabled the induction of stable cell lines; therefore, further induction was carried out by using these conditions to check the expression trends of the aforementioned marker genes during the first passages in the establishment process. Similar to previous results for passages 5, 9, and 26, axial precursor markers (SOX2, TBXT, and CDX2) were detected at high levels in the first passage by CHIR+FGF2+TGFi (CFS) treatment (Figure 8A), whereas CHIR+TGFi (CS) treatment resulted in a stepwise decrease in axial precursor markers, in contrast to the gradually increasing PAX6 (Figure 8B). Neither strain expressed mesoderm markers, or they expressed them at very low levels.

[0171] To accurately characterize the axial stem cell lines transcriptionally, we performed single-cell sequencing of axial stem cells derived from H9, HUES6, and HMGU1 (Figure 9A). Axial precursor markers were detected as heterologously expressed in the CFS lines, except for the H9-derived line (Figure 9B). In the CFS_HMGU line, SOX2 expression overlaps with CDX2 expression. However, in the CFS_HUES6 line, both CDX2- and CDX2+ cells express SOX2. The detection of low TBXT expression may be related to technical limitations, as its expression is detected by qPCR in the sequenced samples. Neither TBXT nor CDX2 were expressed in any of the CS lines, confirming previous results and confirming that SOX2 overlaps with PAX6. Next, the inventors analyzed the expression of pluripotency markers, neuronal mesoderm (body axis precursor) markers, and lineage-specific markers (Figure 9D) and found that the CFS strain substantially expresses neuronal mesoderm genes, while the CS strain expresses neuroectoderm genes.

[0172] In addition to the results from RNA sequencing (Figure 14B), the inventors analyzed HOX gene expression at the single-cell level and noted that the CFS strain exhibited broad expression of HOX genes from anterior to posterior, while the CS strain was delimited by anterior HOX genes such as HOX1-4 (Figure 9D). The inventors investigated the signaling pathways that are key to axial elongation in all strains (Figures 9E-J). Although the expression of WNT genes and WNT receptor genes differed among cell lines, CTNNB1 (β-catenin), a downstream gene of the WNT signaling pathway, was highly expressed in all strains (Figure 9E). The CFS strain was detected as mainly expressing FGF17 and FGFR1, while the CS strain also had low expression of FGF13 and FGFR1 (Figure 9F). The inventors noted that while members of the TGFb (Figure 9G) and NOTCH (Figure 9H) signaling pathways are activated in a similar manner in all strains, with the exception of NOTCH ligand (Figure 9H), which was found to be more highly activated in the CS strain, retinoic acid (Figure 9I) and BMP (Figure 9J) signaling may be more important for the CFS strain.

[0173] Next, the inventors analyzed clusters of both CFS and CS strains (Figures 10 and 11) to evaluate whether heterogeneity in SOX2, CDX2, and PAX6 was a result of differentiation of axial stem cells into lineage-committed cells. Of the eight CS clusters, CS, 4 (Figure 10A), which had relatively low SOX2 expression (Figures 9 and 10B), highly expressed DCX, an immature neuron marker, and may be an indicator of differentiation into a neural lineage. In the CFS cluster (Figure 11A), the inventors identified one cluster as SOX2+CDX2-(CFS, 5), in which some intermediate mesoderm markers were slightly upregulated. Except for CFS, 9, in which neural crest markers were upregulated, the inventors did not detect any clear pattern of lineage-specific markers between the SOX2+CDX2+ cluster and the SOX2-CDX2- cluster (Figure 11B).

[0174] Example 5: Axial stem cells are hierarchical and differentiate into peripheral neurons, sclerotioles, and cutaneous muscularis. The inventors sought to investigate the ability of axial stem cells to generate peripheral neurons, and therefore, based on the literature, they performed motor neuron differentiation using a culture medium containing cytokines to mimic spinal cord development and spinal cord neuron identification (Figure 12A). Based on cell morphology during differentiation, the inventors found that the two states of axial stem cells exhibited different rates of neuronal morphogenesis, with CS cells developing at 2 days and CFS cells at least at 7 days (Figure 12B). The inventors focused on the cellular heterogeneity in CFS differentiation from day 16 onward. Based on gene expression analysis, peripherin (a peripheral neuron marker), ISL1, and CHAT (a mature neuron marker) were upregulated in all experiments, but OLIG2 (a motor neuron precursor marker) was not detected in any of them (Figures 12C-D). Surprisingly, CFS and CS differentiation showed different patterns of expression for the motor neuron marker and the sensory neuron marker MNX1 and POU4F1, respectively. Both transcription factors were detected in 28-day differentiated cells derived from CFS inducers (Figure 12C-E). CS-derived cells expressed MNX1 at day 14 (Figure 12F), but, with the exception of CS-1 inducer-derived differentiated cells (Figure 12D) which showed expression of both transcription factors similar to CFS differentiated cells, they expressed either MNX1 or POU4F1 at a later time point (day 28).

[0175] The inventors investigated cutaneous myoblast progeny of axial stem cells by inducing skeletal muscle differentiation. They modified the protocol of Choi et al., 2019, applying four differentiation modes (Figure 13A) and comparing their efficiency. CFS-derived cells were collected at day 40 (Figure 13B), while CS-derived cells exhibited a distinct neural morphology (Figure 13C) and could not be stably maintained until day 8. For the analysis of differentiated progeny, the inventors used literature-published stage-specific markers. These markers are expressed during the generation of skeletal muscle cells derived from paraxial mesoderm. TBXT is expressed in the early mesoderm precursor, and its downregulation is followed by upregulation of TBX6 and MSGN1, indicating presomitic mesoderm formation. Subsequently, PAX3 indicates the appearance of the cutaneous myoblast precursor, followed by MYOD. The latter is expressed in both myoblast precursors and myoblasts. PAX7 expression helps distinguish between myoblast and satellite-like cell states. Co-expression of PAX7 and MYOD is characteristic of myoblasts, while PAX7 alone is expressed in satellite-like cells. MYOG is used as an indicator of myocytes, while MYH3 and TTN are expressed in mature / fused muscle fibers. CDH15 is expressed in myoblasts, myocytes, and mature muscle fibers. Based on gene expression analysis (Figure 13D-G) and immunostaining results (Figure 13H-J), high upregulation of MYOD and MYOG transcription factors, as well as muscle-specific MyHC and M-cadherin cytoskeletal proteins, was detected, indicating that CFS cells can generate myoblasts and myocyte-like cells.

[0176] The inventors further analyzed the skeletal muscle offspring of the CFS strain by generating organoids. They applied a similar protocol to 2D differentiation to 3D cultures (Figure 14A) and analyzed the organoids on day 40 (Figure 14B). Skeletal muscle offspring were identified by immunostaining for MyHC and ACTA1 (muscle-specific actin) (Figure 14D). The inventors also checked for neuronal offspring by immunostaining for MNX1, ISL1, and OLIG2. They detected their expression (Figure 14F), and therefore named the above organoids neuromuscular organoids.

[0177] Finally, the inventors investigated the contribution of CFS cells to the neural tube and somites, which later form the cutaneous muscularis and sclerotioles, by injecting GFP (green fluorescent protein)-tagged CFS cells into the notochord-neural tube caudal junction of HH17 chicken embryos (Figure 15A). Embryonic development was arrested at HH23-24 (Figure 15B). GFP staining showed that CFS cells were located in the neural tube and somites (Figure 15C).

[0178] Discussion of Examples 4-5 SOX2 is known as a major self-renewal master regulator not only in pluripotent stem cells (Avilion et al., 2003; Boyer et al., 2005) but also in lineage-specific stem cells (Graham et al., 2003; Favaro et al., 2009). T expression is a prominent feature of early mesoderm precursors (Showell et al., 2004; Tosic et al., 2019). Co-expression of these two important transcription factors has been used to identify neural mesoderm precursors (NMPs). NMPs have been identified in mouse, chicken, and human embryos. Current scientific understanding of early development makes it possible to transiently generate NMPs in vitro by manipulating the WNT and FGF signaling pathways. To date, no studies have demonstrated long-term in vitro maintenance of NMPs. The commonly described NMP populations (Henrique et al., 2015; Wymeersch et al., 2019) are transient and heterogeneous, which poses challenges to the use of these developmental precursors for disease modeling or the production of cell therapy products.

[0179] The inventors herein introduce a novel type of local stem cell, namely axial stem cells (AxSCs), that can be induced from hESCs or hiPSCs by inhibition of the TGFb signaling pathway, with or without activation of Wnt / β-catenin and FGF signaling. Based on activation of the FGF signaling pathway, the inventors induced two AxSC types that represent two developmental states and could be identified by the expression of SOX2 / T or SOX2 / PAX6. The inventors named SOX2 / T-expressing cells CFS and SOX2 / PAX6-expressing cells CS. PAX6 expression has been shown to be an important determinant of neuroectoderm lineage formation as one of the earliest identifiable markers (Zhang et al., 2010). By single-cell sequencing analysis, the inventors detected high PAX6 expression in CS cells, in addition to SOX1, which is an important transcription factor for marking neuroectoderm cells (Zhang et al., 2010), but no NMP markers were detected except for SOX2. As a result, the inventors can conclude that the transcriptional profile of CS cells exhibits a neural bias. Furthermore, DCX expression in the CS cell population indicated that spontaneous differentiation within this population could be identified as immature neurons. On the other hand, CFS cells, with the exception of SOX2+CDX2- cells, showed no involvement (determination) in any lineage. This subgroup of CFS cells showed clear upregulation of intermediate mesoderm markers and downregulation of neuromesoderm markers, indicating spontaneous differentiation in this subgroup. As a result, the inventors can conclude that CDX2 expression is essential for maintaining a less-primed state in CFS cells. In particular, the downregulation of CDX2 occurred simultaneously with the downregulation of SALL4, independently of SOX2 expression, suggesting that SALL4 may play a role in AxSC self-renewal. Literature has shown that SALL4 is an essential gene for the self-renewal of human pluripotent stem cells (Yilmaz et al., 2018). The majority of CFS cells were clustered as SOX2+CDX2+ cells, which, since no lineage-specific markers were detected, represents a state of non-involvement in CFS cells.Based on these results, we can conclude that CFS cells represent a more heterogeneous and unbiased state of AxSC. Therefore, based on their respective transcriptional profiles, we can describe CS cells as a primed AxSC state and CFS cells as the ground state of AxSC. We investigated the developmental potential of AxSC for the nervous and cutaneous muscular lineages. First, we began by investigating the nervous lineage by performing motor neuron differentiation from AxSC. Based on the literature, we modulated pathways involved in spinal cord development and associated motor neuron identification (Stifani, 2014). Surprisingly, neural morphology was observed faster in CS cells than in CFS cells. The rapid morphological changes support our hypothesis that a strong neural bias exists in CS cells. While CFS cells can produce a mixture of sensory and motor neurons, CS cells have a higher tendency to produce homogeneous differentiated cultures with either a sensory neuron bias or a motor neuron bias; therefore, heterogeneity in the differentiated culture indicated a greater developmental tendency of CFS cells with respect to neuronal progeny. In addition, we demonstrated that AxSCs can differentiate into mature neurons much faster than human pluripotent stem cells, which makes AxSCs a significant advance for cell therapy-based treatments. To confirm the cutaneous myoblast progeny of CFS cells, we successfully differentiated AxSCs into skeletal muscle cells. Regardless of the differentiation protocol we used, there were no apparent differences in the generation of myoblast precursors or myoblasts; however, based on myocyte-like morphology, we concluded that cAMP and vitamin C promote myoblast maturation. When we applied the same experimental conditions to CS cells, CS cells exhibited distinct neuronal morphology and did not produce stable cultures.

[0180] In conclusion, the inventors demonstrated the ability of the CFS strain to generate both neural and cutaneous muscularis progeny in vitro, as well as its potential contribution to the neural tube and somites in vivo. The inventors confirmed that CS cells are restricted to the neural lineage with respect to progeny and cannot produce any cutaneous muscularis progeny. Thus, based on the above conclusions, the assumed AxSC hierarchy of basal / priming states of AxSCs is demonstrated not only based on their transcriptional states but also based on the progeny obtained from each AxSC population. Based on the inventors' developmental potential of AxSCs, this study is the first of its kind to demonstrate the in vitro isolation of a stem cell population representative of in vivo NMPs. The inventors believe that AxSCs may serve as a promising tool for the research and manufacture of cell therapy products with potential for stem cell replacement therapy for peripheral nervous system degenerative diseases such as spinal muscular atrophy and amyotrophic lateral sclerosis.

[0181] Example 6: Axial stem cells (AxSCs) are not neural mesoderm precursors (NMPs). The axial stem cells (AxSCs) of this invention are not neural mesoderm precursors (NMPs). This is primarily because NMPs are transient, meaning they cannot proliferate, whereas AxSCs are not transient cells, can proliferate, and can replicate indefinitely.

[0182] However, to further address the differences between the AxSC of the present invention and known NMPs, the inventors investigated “stem cell” genes that are not expressed by NMPs but are expressed by AxSCs. Self-replicating stem cells (e.g., those found in embryos) tend to express certain genes, some of which are so-called “Yamanaka factors.” Therefore, to address the differences between AxSCs and NMPs at the gene expression level, the inventors analyzed genes essential for induced pluripotent stem (iPS) cells, embryonic stem cells (ESCs), and collectively, pluripotent stem cells (PSCs). Our data show that three of the Yamanaka genes (which are essential for hPSCs), namely LIN28B (e.g., the protein lin-28 homolog B having UniProtKB-Q6ZN17 or SEQ ID NO: 31), MYCN (e.g., the N-myc proto-oncogene protein having UniProtKB-P04198 or SEQ ID NO: 32), and SOX2 (e.g., the transcription factor SOX-2 having UniProtKB-P48431 or SEQ ID NO: 21), are expressed together by AxSCs. Notably, LIN28 and MYC have not been previously mentioned in the context of NMPs in vivo. Typically, Yamanaka genes include LIN28A (e.g., protein lin-28 homolog A having UniProtKB-Q9H9Z2) and c-MYC (e.g., Myc proto-oncogene protein having UniProtKB-P01106), whereas we found expression of LIN28B and MYCN in AxSC, which are functionally very similar to LIN28A and c-MYC. Therefore, this finding strongly supports the idea that the AxSC of the present invention is very different from known NMPs (Figure 16, A-B).

[0183] The inventors further investigated genes that uniquely define AxSC by comparing their RNA-seq data with mouse NMP in vivo. As can be seen from Figure 16, the inventors identified a panel of genes that are significantly expressed by AxSC but not expressed by human NMP derived from human ES cells (Verrier et al., 2018 Development) or mouse NMP derived from embryos (Gouti et al., Dev Cell. 2017), namely, MYCN (e.g., N-myc proto-oncogene protein with UniProtKB-P04198 or SEQ ID NO: 32), LIN28B (e.g., protein lin-28 homolog B with UniProtKB-Q6ZN17 or SEQ ID NO: 31), IRX3 (e.g., Iroquois class homeodomain protein IRX-3 with UniProtKB-P78415 or SEQ ID NO: 34), and SOX1 (e.g., UniProtKB-O00570 or SEQ ID NO: We identified the transcription factors SOX-1 (with 35), ZIC2 (e.g., the zinc finger protein ZIC2 with UniProtKB-O95409 or SEQ ID NO: 33), and SOX11 (e.g., the transcription factor SOX-11 with UniProtKB-P35716 or SEQ ID NO: 36) (Figure 16. Ground state AxSC (CFS on the right) mainly expresses MYCN, LIN28B, ZIC2, and SOX11, while priming state AxSC (CS on the left) mainly expresses MYCN, LIN28B, IRX3, SOX1, ZIC2, and SOX11).

[0184] Finally, the inventors have shown that the AxSC of the present invention can also be generated from iPSCs, and therefore does not involve a method of destroying human embryos. This further confirms the inventors' initial filing regarding the human iPSC strain HMGU#1.

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Claims

1. A method for generating axial stem cells (AxSCs), a) A step of providing pluripotent stem cells, embryonic stem cells, or induced pluripotent stem cells, wherein, prior to the generation, the pluripotent stem cells are maintained in a suitable pluripotent cell medium, The step is to replace the appropriate pluripotent cell medium with RPMI1640 medium supplemented with a vitamin A-containing or vitamin A-free vitamin B27 supplement for production, b) A step of activating the Wnt / β-catenin signaling pathway in the pluripotent stem cells, embryonic stem cells, or induced pluripotent stem cells, wherein the activation is carried out by using an inhibitor of the GSK3b protein. The inhibitor is CHIR99021, and the CHIR99021 inhibitor is used at a concentration of 5 μM for 24 hours. c) Passaging the cells derived from step (b) under conditions of continuous activation of the Wnt / β-catenin signaling pathway in the cells during passaging, wherein the passaging is performed at least 3 to 9 times, the passaging is continuous passaging, the passaging includes reseeding the cells derived from step (b) in fresh serum-free medium at a lower density, the continuous activation of the Wnt / β-catenin signaling pathway is performed by using an inhibitor of the Wnt / β-catenin signaling pathway, the inhibitor is CHIR99021, the CHIR99021 inhibitor is used at a concentration of 5 μM or 7.5 μM, and the cells derived from step (c) endogenously express the transcription factor SOX-2. Includes, A method for generating axial stem cells in which the AxSC is not pluripotent and does not express the OCT4 transcription factor and / or the homeobox protein NANOG.

2. A method for generating axial stem cells according to claim 1, further comprising the step of subculturing the cells derived from step (c).

3. Further including step (d), The sequential activation of the Wnt / β-catenin signaling pathway from step (c) is carried out in the presence of fibroblast growth factor 2 and / or a TGF-β inhibitor. d1) The sequential activation of the Wnt / β-catenin signaling pathway from step (c) is carried out using a 5 μM concentration of CHIR99021 inhibitor in the presence of fibroblast growth factor 2 and a TGF-β inhibitor. The TGF-β inhibitor is SB-431542, the SB-431542 inhibitor is used at a concentration of 10 μM, the fibroblast growth factor 2 is used at a concentration of 20-100 ng / ml, and the cells induced from step (d1) endogenously express the transcription factor SOX-2, the T-box transcription factor T, and the homeobox protein MIXL1, but do not endogenously express the paired box protein Pax-6, or d2) The continuous activation of the Wnt / β-catenin signaling pathway from step (c) is carried out in the presence of a TGF-β inhibitor using a 5 μM concentration of CHIR99021 inhibitor, wherein the TGF-β inhibitor is SB-431542, and the SB-431542 inhibitor is used at a concentration of 10 μM. The cells derived from step (d2) endogenously express the transcription factor SOX-2 and the paired-box protein Pax-6, but do not endogenously express the T-box transcription factor T, the homeobox protein MIXL1, and the homeobox protein CDX-2, or d3) The sequential activation of the Wnt / β-catenin signaling pathway from step (c) is carried out in the presence of a TGF-β inhibitor using a 7.5 μM concentration of CHIR99021 inhibitor, the TGF-β inhibitor being SB-431542, the SB-431542 inhibitor being used at a concentration of 10 μM, and the cells induced from step (d3) endogenously express the transcription factor SOX-2, the T-box transcription factor T, the homeobox protein MIXL1, and the paired-box protein Pax-6. A method for generating axial stem cells according to claim 1 or claim 2.

4. The aforementioned axial stem cells have the following characteristics: i) Endogenously expressing the homeobox protein CDX-2, ii) Expressing the transcription factor SOX-2 having UniProtKB-P48431 or Sequence ID No. 21, iii) Not expressing an OCT4 transcription factor having UniProtKB-Q01860 or Sequence ID No. 22, iv) Not expressing the homeobox protein NANOG having UniProtKB-Q9H9S0 or SEQ ID NO: 23, v) Region-specific differentiated pluripotent stem cells, vi) Can be obtained from pluripotent stem cells, embryonic stem cells, or induced pluripotent stem cells. vii) Not all cells in the embryo can differentiate into all tissue types. viiii) Cell types that emerge from the central axis region during embryonic development, capable of differentiating only into sclerotomy neurons, cutaneous muscularis neurons, and peripheral neurons. ix) Unable to form malformed species, The x-axis region can mimic the properties of precursors that give rise to motor neurons, peripheral neurons, peripheral nervous system neurons, sensory neurons, bone, cartilage, tendons, ligaments, and / or skeletal muscle cells. xi) Not a transient cell, xi) It can differentiate into motor neurons, peripheral neurons, muscle, cartilage, or bone precursors. xiiii) Stem cells that can replicate indefinitely, xiv) Can be reproduced as a clone. xv) Not a neural mesoderm precursor (NMp), and / or xvi) Not artificial neural stem cells (iNSCs) A method for generating axial stem cells according to any one of claims 1 to 3, having one or more of the above.

5. The axial stem cells are not neural mesoderm precursors (NMp), and the axial stem cells are the following proteins, i) N-myc proto-oncoprotein (MYCN) having UniProtKB-P04198 or Sequence ID No. 32, ii) Protein lin-28 homolog B (LIN28B) having UniProtKB-Q6Zn17 or SEQ ID NO: 31, iii) Iroquois class homeodomain protein IRX-3 (IRX3) having UniProtKB-P78415 or Sequence ID No. 34, iv) Transcription factor SOX-1 (SOX1) having UniProtKB-O00570 or SEQ ID NO: 35, v) Zinc finger protein ZIC2 (ZIC2) having UniProtKB-O95409 or SEQ ID NO: 33, vi) Transcription factor SOX-11 (SOX11) having UniProtKB-P35716 or SEQ ID NO: 36, A method for generating axial stem cells according to any one of claims 1 to 4, wherein one or more of the following are expressed.

6. A method for generating axial stem cells according to any one of claims 1 to 5, wherein the axial stem cells can be replicated and differentiated indefinitely into i) basal axial stem cells or ii) priming state axial stem cells. i) Basal axial stem cells, wherein the basal axial stem cells are basal axial stem cells that replicate indefinitely, and the basal axial stem cells are a) Transcription factor SOX-2 having UniProtKB-P48431 or SEQ ID NO: 21, b) T-box transcription factor T having UniProtKB-O15178 or SEQ ID NO: 24, c) Homeobox protein CDX-2 having UniProtKB-Q99626 or Sequence ID No. 25, and d) Basal axial stem cells expressing the homeobox protein MIXL1 having UniProtKB-Q9H2W2 or SEQ ID NO: 26, or ii) A primed axial stem cell, wherein the primed axial stem cell is a primed axial stem cell that replicates indefinitely, and the primed axial stem cell is e) Transcription factor SOX-2 having UniProtKB-P48431 or Sequence ID No. 21, and f) The priming state axial stem cells expressing the paired box protein PAX-6 having UniProtKB-P26367 or SEQ ID NO:

27.

7. A method for generating axial stem cells according to any one of claims 1 to 6, wherein the axial stem cells are human axial stem cells.

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