title: Autocrine production of IGF-I increases stem cell-mediated neuroprotection.
abstract: Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disorder resulting in motor neuron (MN) loss. There are currently no effective therapies; however, cellular therapies using neural progenitor cells protect MNs and attenuate disease progression in G93A-SOD1 ALS rats. Recently, we completed a phase I clinical trial examining intraspinal human spinal stem cell (HSSC) transplantation in ALS patients which demonstrated our approach was safe and feasible, supporting the phase II trial currently in progress. In parallel, efforts focused on understanding the mechanisms underlying the preclinical benefit of HSSCs in vitro and in animal models of ALS led us to investigate how insulin-like growth factor-I (IGF-I) production contributes to cellular therapy neuroprotection. IGF-I is a potent growth factor with proven efficacy in preclinical ALS studies, and we contend that autocrine IGF-I production may enhance the salutary effects of HSSCs. By comparing the biological properties of HSSCs to HSSCs expressing sixfold higher levels of IGF-I, we demonstrate that IGF-I production augments the production of glial-derived neurotrophic factor and accelerates neurite outgrowth without adversely affecting HSSC proliferation or terminal differentiation. Furthermore, we demonstrate that increased IGF-I induces more potent MN protection from excitotoxicity via both indirect and direct mechanisms, as demonstrated using hanging inserts with primary MNs or by culturing with organotypic spinal cord slices, respectively. These findings support our theory that combining autocrine growth factor production with HSSC transplantation may offer a novel means to achieve additive neuroprotection in ALS.
authors.affiliation: Department of Neurology.
authors.forename: J Simon
authors.initials: JS
authors.lastname: Lunn
authors.forename: Stacey A
authors.initials: SA
authors.lastname: Sakowski
authors.forename: Lisa M
authors.initials: LM
authors.lastname: McGinley
authors.forename: Crystal
authors.initials: C
authors.lastname: Pacut
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Hazel
authors.forename: Karl
authors.initials: K
authors.lastname: Johe
authors.forename: Eva L
authors.initials: EL
authors.lastname: Feldman
mesh_terms: D000818:Animals; D019898:Autocrine Communication; D002454:Cell Differentiation; D002465:Cell Movement; D049109:Cell Proliferation; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D058953:Neural Stem Cells / Q000378:metabolism*; D000066829:Neuroprotection; D018696:Neuroprotective Agents / Q000378:metabolism; D051381:Rats; D060888:Real-Time Polymerase Chain Reaction; D017526:Receptor, IGF Type 1 / Q000378:metabolism; D013116:Spinal Cord / Q000166:cytology
chemical_list: D018696:Neuroprotective Agents; D007334:Insulin-Like Growth Factor I; D017526:Receptor, IGF Type 1
keywords: Amyotrophic lateral sclerosis; Cellular therapy; Growth factor; Human spinal stem cell; Key Words. Insulin-like growth factor-I; Neuroprotection; Stem cell