Surgery (St Vincent's) - Theses
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ItemNovel mitochondrial Drp1 inhibitors for cardioprotection( 2023)Mitochondria are dynamic organelles, constantly undergoing fusion and fission in a balanced manner to maintain cellular health. In the setting of myocardial ischaemia-reperfusion injury, mitochondrial morphology shifts towards excessive fission, which is associated with cardiomyocyte death and heart dysfunction. Inhibiting the mitochondrial fission protein dynamin-related protein 1 (Drp1) has been shown to reduce excessive mitochondrial fission and attenuate the pathological consequences of myocardial ischaemia-reperfusion injury. However, the most widely used inhibitor, Mdivi-1, is an unreliable inhibitor of Drp1 because of its off-target effects and inconsistent cytoprotection in different cell types, including mammalian cells. Mdivi-1 was originally developed to inhibit the GTPase enzymatic activity of Dnm1, a yeast homologue of human Drp1 protein, which has less than 50% similarity compared to human Drp1. These lines of evidence indicate that Mdivi-1 may not be a specific inhibitor of human Drp1. The overall aim of this thesis is to identify potential inhibitors of Drp1 that directly bind to, and inhibit the GTPase activity of human Drp1, and impart protection against in vitro and in vivo models of acute myocardial ischaemia-reperfusion injury. In Chapter 3, I investigated the interaction between Mdivi-1, yeast Dnm1 and human Drp1 using molecular modelling. Molecular docking analysis predicted that Mdivi-1 is docked more consistently in an open binding site conformation of both species with greater number of molecular interactions between the compound and yeast Dnm1 compared to human Drp1. Biological analysis of Mdivi-1 to human Drp1 was inconclusive due to differing results in direct binding assays, GTPase activity assay and mitochondrial morphology assays in Drp1 wildtype and knockout mouse embryonic fibroblasts. These results are likely confounded by the formation of Mdivi-1 aggregates at concentrations above 18.5 uM. These findings suggest that studies employing Mdivi-1 as an inhibitor of Drp1 warrant cautious interpretation as its effect may not be entirely Drp1-specific. In Chapter 4, further study was then conducted to identify a novel potential inhibitor of human Drp1. The drug discovery campaign for this project had already begun prior to my PhD study and three hit compounds, DRP1i1, DRP1i2 and DRP1i3 were previously identified. The three hit compounds represent three compound classes with distinct scaffolds, namely the diazabicyclic scaffold, tryptophan-like scaffold and the diazaspirocyclic scaffold. Direct binding assays, GTPase activity assays and mitochondrial morphology assays using Drp1 wildtype and knockout mouse embryonic fibroblasts indicate that DRP1i1, DRP1i2 and DRP3 directly bind to human Drp1, can inhibit its GTPase activity and supress Drp1-mediated mitochondrial fission. The most potent hit compound, DRP1i1 (KD value 3.23 uM), was selected for further investigation in in vitro and in vivo models of acute ischaemia-reperfusion injury in Chapter 5. In Chapter 5, DRP1i1 reduced cell death of HL1 cells and human cardiomyocytes derived from induced pluripotent stem cells subjected to hydrogen peroxide-induced oxidative stress and simulated ischaemia-reperfusion injury. In general, this protection was accompanied by reduced mitochondrial fragmentation, decreased mitochondrial superoxide production and improved mitochondrial membrane potential. The protective effect of DRP1i1 was also demonstrated in an in vivo mouse model of acute myocardial ischaemia-reperfusion injury, where I observed a reduction of infarct size accompanied by reduced phosphorylation of Drp1 at Ser616 and reduced circularity of myocardial interfibrillar mitochondria. Collectively, these results suggest that direct inhibition of the Drp1 protein with DRP1i1 possess a cytoprotective effect in in vitro and in vivo models of myocardial ischaemia-reperfusion injury. Due to the moderate affinity of the three hit compounds (within micromolar range; 3.23 uM for DRP1i1, 352 uM for DRP1i2 and 215 uM for DRP1i3), our lab had previously searched for structural analogues of each compound class in a two-dimensional analogue search based on the Tanimoto similarity index of 0.8. A total of 26 structural analogues of DRP1i1, 7 of DRP1i2 and 30 of DRP1i3 were identified. 10 additional analogues of DRP1i2 were also designed by our collaborator, giving us a total of 17 structural analogues for DRP1i2. In Chapter 6, I assessed these analogues for direct binding to human Drp1 and conducted molecular docking studies against human Drp1 to elucidate their structure activity relationship. Molecular docking analysis showed that DRP1i2 and its active analogues displayed the most consistently docked binding mode to the open conformation of human Drp1, whereas analogues of DRP1i1 and DRP1i3 did not show a clear consistency in binding mode. Regardless, hydrogen bond interactions between active compounds and amino acids Lys38 and Ser39 could be important for compound activity in all compound class and the effect of stereochemistry on binding affinity to human Drp1 protein was clearly demonstrated. Among all compound classes, only structural analogues of DRP1i2 and DRP1i3 that could potentially be more potent than their parent compounds. Collectively, the information on the structure activity relationship of these structural analogues will provide the essential fundamental knowledge to design better and more potent inhibitors of human Drp1 in future studies.
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ItemBio-engineering vascularised liver organoids( 2022)Liver organoids are bioengineered constructs that recapitulate native liver tissue, and are used to study liver development, test drugs, and as replacement tissue that can be transplanted to treat liver disease. This thesis focusses on the specific application of liver organoids for use as a cell-based treatment for liver disease via organoid transplantation. It places a particular emphasis on the addition of vascularisation to liver organoids to enhance structure and function, and improve engraftment during in vivo transplantation. Initially, the effect of the addition of endothelial cells to create vascularised liver organoids was assessed using mouse cells. The addition of mouse liver sinusoidal endothelial cells (LSECs) to mouse liver progenitor cells (LPCs) resulted in a striking change in organoid morphology, with the development of hepatobiliary ductular structures and clusters of polygonal hepatocyte-like cells which did not appear when LPCs were cultured alone as organoids. Furthermore, in vitro hepatobiliary gene expression, hepatic synthetic functions (albumin and apolipoprotein E production) and organoid viability was significantly increased by the addition of LSECs. Upon transplantation into vascularised chambers established in Fah-/- Rag2-/- Il2rg-/- (FRG knockout) mice, LPC only organoids had almost zero survival at 2 weeks, whereas LPC/LSEC organoids developed robust hepatobiliary ductular structures with a 115-fold increase in HNF4a+ cells and 42-fold increase in Sox9+ cells. To translate the mouse findings into a humanised platform, human LPCs and LSECs and their human induced pluripotent stem cell (hiPSC)-derived counterparts were characterised. The hepatic differentiation of human primary adult LPCs and hiPSC derived LPCs into hepatocyte-like cells was confirmed based on cell morphology, marker expression, and function (albumin production), and transcriptomic profiling using bulk and single cell RNA sequencing. Concurrently, human primary adult LSECs were compared to hiPSC-derived endothelial cells(iECs). Although in vitro iECs had a generic endothelial phenotype very different to LSECs, when iECs were transplanted into mouse liver they underwent tissue specification to approximate LSECs, highlighting the importance of the liver microenvironment in this process. Subsequently, three types of vascularised human liver organoids were explored using primary human and hiPSC-derived cells. First, primary LPCs, LSECs and adipose-derived mesenchymal stem cells were combined in a human liver-derived extracellular matrix (ECM) hydrogel and seeded into bioabsorbable porous polyurethane scaffolds. Second, iECs were aggregated with hiPSC-derived hepatocyte (iHep) organoids to coat the surface of the iHep organoids. Third, single cell-type organoids were integrated to form a combination organoid created from hepatocyte, cholangiocyte, and vascular organoids. Of the three models, combining organoids of different cell types to create a combination organoid was deemed the best approach to derive complex liver organoids containing well-organised tissue structures such as polarised hepatocytes with bile canaliculi, bile ducts, and blood vessel networks. An overarching theme is that vascularisation is pivotal in the development of transplantable liver organoids. Adding endothelial cells promotes hepatobiliary differentiation, and pre-formed vasculature can significantly enhance the survival of transplanted liver organoids by hastening connection to the host’s blood supply. However, this is not easy to achieve and remains a challenge in the liver organoid field, and the production of well-vascularised liver organoids with sustained development of blood vessels over time in culture remains elusive. Nevertheless, the limitations and challenges identified in this thesis point towards future directions in addressing the issue of vascularisation. For clinical translation of liver organoid transplantation, hiPSC-derived cells are a more reliable source of personalised cells, and the ECM additive should be bio-synthetic and chemically-defined, rather than Matrigel. Ultimately, the results in this thesis support the exciting prospect of stem-cell derived liver organoids being used as a regenerative treatment for liver disease.
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ItemOsteochondral repair using structured biological scaffold and stem cell technologies( 2015)Introduction: Articular cartilage damage can result in pain and loss of function for many patients. The traditional management of moderate to severe defects has been difficult due to the lack of intrinsic capacity for cartilage to regenerate. Current methods of cartilage repair include microfracture, osteochondral grafting and autologous chondrocyte implantation. Whilst some individual studies comparing these techniques have shown improvements in long-term clinical outcomes in some patient groups compared to microfracture, major randomised control trials have failed to show consistent long-term differences in clinical outcomes between microfracture, osteochondral grafting, and autologous chondrocyte implantation. Hence, there is a clinical need to explore novel methods of cartilage repair and regeneration using biological techniques such as tissue engineering, stem cells, biomaterials, and growth/differentiation factors to improve cartilage regeneration. The aim of this project was to develop a technique using human infrapatellar fat pad adipose stem cells (IPFP-ASCs) in 3D cultures for chondrogenesis; this required extensive characterisation of the cartilage formed in the 3D cultures/scaffolds (3D pellet culture, chitosan and acellular dermal matrix) for in vitro chondrogenesis. In vivo testing and characterisation of osteochondral defect repair was achieved using a small animal rabbit model for preliminary testing of the ADM-engineered structures. This preliminary testing in the small animal model may then lead to pre-clinical trials in larger animals and human pilot studies in the future. Materials and methods: In vitro IPFPs were harvested from total knee replacements and digested to release adipose stem cells (IPFP-ASCs) which were expanded in vitro. Pellet cultures were developed using TGF-β3 and BMP-6 for chondrogenesis. IPFP-ASCs were seeded onto 3D printed chitosan scaffolds and acellular dermal matrix (ADM) material under the same chondrogenic conditions as the pellet cultures. Four-week cultures were analysed using histology, immunohistochemistry, and gene expression analysis using qPCR. In vivo Osteochondral defects were drilled into distal femoral condyles of adult New Zealand White rabbits. The defects were repaired using either (1) ADM alone (2) autologous IPFP-ASC (3) ADM with autologous IPFP-ASC) or (4) left empty as control. The animals were euthanised at 12 weeks. Repairs were analysed using histology and immunohistochemistry for collagen Type II and Type I. The modified O’Driscoll score was for histological scoring. Further image analysis was conducted to assess quality and quantity of repair. Results: IPFP-ASCs were capable of undergoing chondrogenesis in vitro using pellet cultures and when cultured directly on 3D chitosan and ADM scaffolds using the growth factor combination of TGF-β3 and BMP-6. The method of chondrogenesis was robust and was replicated across both human and rabbit IPFP-ASCs. A one-step single site surgical process was developed for the in vivo modelling of osteochondral defect repair and autologous IPFP-ASC implantation. In rabbits, the rabbit ADM only group achieved the highest ratio of collagen Type II to Type I (77.3%) on image analysis using area measures based from protein expression by immunohistochemistry. This indicated a higher quality of cartilage repair resembling hyaline or hyaline-like cartilage (p<0.05). Conclusion: IPFP-ASCs exhibited robust chondrogenesis under in vitro conditions used in this study; the combination of TGF-β3 and BMP-6 for generation of hyaline cartilage has demonstrated the potential for improving cartilage repair in vitro. ADM, as a support matrix, promoted ASC ingrowth in vitro and proved to be an excellent substrate to promote formation of hyaline-like cartilage in vitro. In the small animal in vivo experiments, it was clear that ADM exhibited positive outcomes when used as a substrate for osteochondral defect repair. These experiments need to be performed in a larger animal model to consolidate these findings prior to consideration of translational to pre-clinical studies.