Original Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Feb 14, 2012; 18(6): 507-516
Published online Feb 14, 2012. doi: 10.3748/wjg.v18.i6.507
Dynamic tracking of stem cells in an acute liver failure model
Tarek Ezzat, Dipok Kumar Dhar, Massimo Malago, Steven WM Olde Damink
Tarek Ezzat, Dipok Kumar Dhar, Massimo Malago, Steven WM Olde Damink, HPB and Liver Transplantation Surgery, Royal Free Hospital, University College London, London NW3 2PF, United Kingdom
Tarek Ezzat, Department of Surgery, University of Alexandria, Alexandria, PO Box 21131, Egypt
Steven WM Olde Damink, Department of Surgery, Maastricht University Medical Centre, and Nutrition and Toxicology Research Institute, Maastricht University, Maastricht, PO Box 5800, The Netherlands
Author contributions: Ezzat T participated in the study design, performed the majority of the experiment, analyzed and interpreted the data, and wrote the first draft of the article; Dhar DK participated in the study design, analyzed and interpreted the data, performed the experiment, and revised the draft; Malago M edited the manuscript and provided financial support; Olde Damink SWM participated in the study design, interpreted the data, edited the manuscript, and provided financial support.
Supported by Citadel Capital Scholarship Foundation, Egypt; and Dr. Leslie Borthwick/Ms. Anita Holme, Charitable Research Fund East and North Herts NHS TrustHertfordshire, United Kingdom
Correspondence to: Dipok Kumar Dhar, Senior Research Fellow, HPB and Liver transplantation surgery, Royal Free Hospital, University College London, 9th floor, London NW3 2PF, United Kingdom. d.dhar@ucl.ac.uk
Telephone: +44-207-7940500 Fax: +44-207-7940500
Received: June 1, 2011
Revised: September 2, 2011
Accepted: October 28, 2011
Published online: February 14, 2012
Abstract

AIM: To investigate a dual labeling technique, which would enable real-time monitoring of transplanted embryonic stem cell (ESC) kinetics, as well as long-term tracking.

METHODS: Liver damage was induced in C57/BL6 male mice (n = 40) by acetaminophen (APAP) 300 mg/kg administered intraperitoneally. Green fluorescence protein (GFP) positive C57/BL6 mouse ESCs were stained with the near-infrared fluorescent lipophilic tracer 1,1-dioctadecyl-3,3,3,3-tetramethylindotricarbocyanine iodide (DiR) immediately before transplantation into the spleen. Each of the animals in the cell therapy group (n = 20) received 5 × 106 ESCs 4 h following treatment with APAP. The control group (n = 20) received the vehicle only. The distribution and dynamics of the cells were monitored in real-time with the IVIS Lumina-2 at 30 min post transplantation, then at 3, 12, 24, 48 and 72 h, and after one and 2 wk. Immunohistochemical examination of liver tissue was used to identify expression of GFP and albumin. Plasma alanine aminotransferase (ALT) was measured as an indication of liver damage.

RESULTS: DiR-stained ESCs were easily tracked with the IVIS using the indocyanine green filter due to its high background passband with minimal background autofluorescence. The transplanted cells were confined inside the spleen at 30 min post-transplantation, gradually moved into the splenic vein, and were detectable in parts of the liver at the 3 h time-point. Within 24 h of transplantation, homing of almost 90% of cells was confirmed in the liver. On day three, however, the DiR signal started to fade out, and ex vivo IVIS imaging of different organs allowed signal detection at time-points when the signal could not be detected by in vivo imaging, and confirmed that the highest photon emission was in the liver (P < 0.0001). At 2 wk, the DiRsignal was no longer detectable in vivo; however, immunohistochemistry analysis of constitutively-expressed GFP was used to provide an insight into the distribution of the cells. GFP +ve cells were detected in tissue sections resembling hepatocytes and were dispersed throughout the hepatic parenchyma, with the presence of a larger number of GFP +ve cells incorporated within the sinusoidal endothelial lining. Very faint albumin expression was detected in the transplanted GFP +ve cells at 72 h; however at 2 wk, few cells that were positive for GFP were also strongly positive for albumin. There was a significant improvement in serum levels of ALT, albumin and bilirubin in both groups at 2 wk when compared with the 72 h time-point. In the cell therapy group, serum ALT was significantly (P = 0.016) lower and albumin (P = 0.009) was significantly higher when compared with the control group at the 2 wk time-point; however there was no difference in mortality between the two groups.

CONCLUSION: Dual labeling is an easy to use and cheap method for longitudinal monitoring of distribution, survival and engraftment of transplanted cells, and could be used for cell therapy models.

Keywords: Cell transplantation, Cell tracking, Embryonic stem cells, Acute liver failure, Liver regeneration