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to investigate further the mechanism of the protective vascular endothelial and perivascular epithelial restoration on ipsc-derived msc-treated allografts, we examined the levels of tissue oxygenation and blood perfusion in d4 and d14 untreated control allografts, which had not been treated with ipsc-derived mscs and served as untreated allograft controls. our data showed that untreated control allografts received no significant improvement in tissue hypoxia or blood perfusion at d4 or d14 post transplantation (fig. 4 a, b), suggesting that the mechanism of protection must be working in the very early period after transplantation, and beyond this, it may be too late to reverse the tissue hypoxic and ischemic state and restore graft tissue hypoxia and blood perfusion. on the other hand, the findings showed that the untreated allografts were significantly in a phase of graft hypoxia and ischemia by d4 and d14 post transplantation, and this was consistent with earlier graft rejection.

in summary, we found that the cymerus ipsc-derived mscs migrated to the grafts of the recipients and accelerated recovery of tissue oxygenation and improved blood perfusion of syngrafts and the control allografts. the ipsc-derived mscs were able to reduce ischemic tissue injury and inflammatory immune responses and normalized the immune homeostasis between t regulatory cells and the effector t cells in the allografts. the effects of the ipsc-derived mscs were greater than those of the syngrafts, suggesting that the mscs have extended the limit of reviving the grafts during rejection. our findings might represent a significant step toward future clinical application of cymerus ipsc-derived mscs in treating alloimmune rejection in allotransplantation.




these results are further supported by studies performed in murine tumor models, where it has been observed that ipsc-derived mscs inhibit tumorigenic growth via a reduction of the number of tregs, an immunosuppressive cell population of cd4+ t cells, and this effect could be reversed with anti-cd25 antibodies and a complete depletion of tregs (10). moreover, studies performed by kodama and colleagues (11) have indicated that ipsc-derived mscs suppress b-cell proliferation via inhibition of b-cell–specific transcription factors and mitogen-activated protein kinases, and the inhibition could be reversed in part by t-cell–derived ifn-γ, suggesting that ipsc-derived mscs demonstrate an immunomodulatory activity beyond a general decrease in the number of activated splenocytes. to determine whether a similar activity is present in our study, we assessed the effects of ipsc-derived mscs on antigen-specific cd4+ t-cell proliferation and found that splenocytes treated with ipsc-derived mscs, but not control mscs, inhibited the proliferation of ova-specific cd4+ t cells, with a stronger effect in the ipsc-derived msc-treated group compared with untreated controls (fig. 5 b, c). collectively, our study strongly suggested that ipsc-derived mscs can alleviate acute graft rejection by inhibiting the proliferation and activation of alloimmune cells, including t cells and, in particular, b cells. skin behaves like a window and responds to uv radiation in the same way as any other tissue. a specialized group of skin-exposed langerhans cells is present in the epidermis and langerin (cd207) is the sole marker that identifies langerhans cells. an immunohistochemical stain for lycopersicum esculentum lectin (lel) was utilized to identify langerhans cells in human skin and compared to the number and location of cd207+ langerhans cells. skin biopsies were obtained from the top of the arm with a 3 mm punch biopsy needle. the samples were fixed in cold acetone for 30 min. and then washed with phosphate buffered saline (pbs) for 3×10 min. the samples were then placed in a humid chamber, the room temperature incubator was set to 37°c overnight. the next day, the samples were washed with pbs 3×10 min and then placed in an incubator set at 37°c for 30 min. to air dry. the samples were then boiled for 2 min in citrate buffer (10mm; ph 6), cooled at room temperature, rinsed twice with pbs and then blocked in 5% horse serum and 10% goat serum for 1 hr. the samples were incubated with primary antibody against cd207 (hlant11, 1:50 dilution) at 4°c overnight and then washed with pbs 3×10 min. the samples were then incubated with secondary antibody (alexa fluor 488 goat anti-mouse igg1, 1:200 dilution) for 1 hr. at room temperature in the dark. after washing with pbs 3×10 min, samples were incubated with dapi for 2 min and then rinsed with pbs and mounted in fluorescent mounting medium (dako, denmark). fluorescence images were captured on an olympus bx40 microscope, equipped with a dp72 digital camera (olympus). the samples were mounted on glass microscope slides, and were all examined under the same light and objective. to score the level of langerhans cells, ten randomly selected fields were captured at 1000× magnification. cell fluorescence and fluorescence intensity were quantified using imagej software. langerhans cell density is expressed as the number of positive cells per mm^2^. only a single section of each graft was evaluated and positive cells were counted in the tissue and accepted positive cells were distinguishable by their unique morphology. 5ec8ef588b


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