Unconjugated
Mesenchymal stem/stromal cells (MSC) are adult stem cells which have been shown to improve survival, enhance bacterial clearance and alleviate inflammation in pre-clinical models of acute respiratory distress syndrome (ARDS) and sepsis. These diseases are characterised by uncontrolled inflammation often underpinned by bacterial infection. The mechanisms of MSC immunomodulatory effects are not fully understood yet. We sought to investigate MSC cell contact-dependent communication with alveolar macrophages (AM), professional phagocytes which play an important role in the lung inflammatory responses and anti-bacterial defence. With the use of a basic direct co-culture system, confocal microscopy and flow cytometry we visualised and effectively quantified MSC mitochondrial transfer to AM through tunnelling nanotubes (TNT). To model the human AM, primary monocytes were isolated from human donor blood and differentiated into macrophages (monocyte derived macrophages, MDM) in the presence of granulocyte macrophage colony-stimulating factor (GM-CSF), thus allowing adaptation of an AM-like phenotype (de Almeida et al., 2000; Guilliams et al., 2013). Human bone-marrow derived MSC, were labelled with mitochondria-specific fluorescent stain, washed extensively, seeded into the tissue culture plate with MDMs at the ratio of 1:20 (MSC/MDM) and co-cultured for 24 h. TNT formation and mitochondrial transfer were visualised by confocal microscopy and semi-quantified by flow cytometry. By using the method we described here we established that MSC use TNTs as the means to transfer mitochondria to macrophages. Further studies demonstrated that mitochondrial transfer enhances macrophage oxidative phosphorylation and phagocytosis. When TNT formation was blocked by cytochalasin B, MSC effect on macrophage phagocytosis was completely abrogated. This is the first study to demonstrate TNT-mediated mitochondrial transfer from MSC to innate immune cells.
Adenotonsillar regrowth in children after adenotonsillectomy (T&A) for obstructive sleep apnea (OSA) is often seen in clinical treatment, however, the relationship between allergic disease and adenotonsillar regrowth remains unclear. In this retrospective study, children were assigned to either the recurrence or control group, and subdivided by age at operation. Among children over 36 months, those in the recurrence group had more allergic disease and higher IgE, IL-4, and IL-5 levels than the same-aged children in control group. The Paediatric Allergic Disease Quality of Life Questionnaire (PADQLQ) scores for nasal symptoms and activity were higher in children older than 36 months in recurrence group. The results of immunohistochemistry and immunofluorescence showed that FoxP3+ cells (Tregs) were less, while GATA3+ cells (Th2 cells) were more in recurrence group for all ages. Allergic status and low levels of FoxP3 were proved as independent risk factors for adenotonsillar regrowth by multivariate logistic regression. These results indicate that allergic disease is a risk factor for adenotonsillar regrowth in children following T&A for OSA, and this risk increases with age. The decreased level of Tregs and subsequent changes in immune function play an important role in the pathogenesis of adenotonsillar regrowth.