Two steps to functional mesenchymal stromal cells for clinical application

BACKGROUND: Ex vivo expansion of multipotent mesenchymal stromal cells (MSCs) is a prerequisite for evaluating their therapeutic potential in ongoing clinical trials. Even large volumes of starting material and extended culture periods, however, do not necessarily produce 2 x 106 MSCs per kg per adult patient. A new two-step procedure has been devised to propagate more than 1 x 101 MSCs from small marrow volumes within fewer than 4 weeks. STUDY DESIGN AND METHODS: The influence of log fold decreased MSC seeding (2500, 250, 25, 2.5/cm(2)) on clinical-scale expansion, MSC phenotype, and immunomodulatory, function combined with multiplex cytokine display was analyzed. Maintenance of MSC characteristics was tested in fibroblast colony-forming unit and differentiation assays. RESULTS: Reduced seeding density boosted MSC propagation. Low-density expanded MSCs were CD29+, CD73+, CD90+, CD105+, CD14-, CD34-, CD45-, HLA-DR-; retained their differentiation potential; and inhibited lymphocyte proliferation. This was accompanied by deregulated cytokine production. Seeding 0.7 x 10(6) to 1 x 10(6) MSCs derived from a 10-to 13-day primary culture at a low density of 28 to 40 per cm(2) permitted propagation of 1.5 x 10(8) to 3.7 x 10(8) functional MSCs within a 13- to 15-day secondary expansion step. CONCLUSION: Primary seeding of only 10-mL marrow aspirates on approximately 0.2-m(2) culture area (Step 1) followed by expansion on 2.5 m(2) (Step 2) is sufficient to consistently generate at least 1.5 x 10(8) MSCs in fetal bovine serum-supplemented medium within less than 4 weeks. The efficiency of this two-step procedure for clinical-scale MSC propagation may facilitate rational clinical testing of MSC-based therapies.