AU2012227326B2 - Progenitor cells from wharton's jelly of human umbilical cord - Google Patents

Abstract

Human progenitor cells are extracted from Wharton's jelly that lies within a perivasculature zone of human umbilical cord. The progenitor cell population proliferates rapidly, and harbours both osteoprogenitor cells and MHC-/- cells, and is useful to grow and repair human tissues including bone. S0 ., b a tn n i ot I Zone ''r I -* 4 -. 8 Figure

Description

AUSTRALIA Patents Act 1990 ORIGINAL COMPLETE SPECIFICATION INVENTION TITLE: PROGENITOR CELLS FROM WHARTON'S JELLY OF HUMAN UMBILICAL CORD The following statement is a full description of this invention, including the best method of performing it known to us:- - 1 PROGENITOR CELLS FROM WHARTON'S JELLY OF HUMAN UMBILICAL CORD FIELD OF INVENTION 5 This invention focuses on the harvesting of a population of rapidly proliferating human cells from the connective tissue of the umbilical cord (UC); the culture of such cells in osteogenic, or bone-forming conditions; the demonstration of a high percentage of cells within these populations that are immunologically incompetent, as shown by their lack of cell surface histocompatibility antigens; and the ability of 10 these cells to be used as a source of cells for various cell-based therapies. The present application is a divisional application of Patent Application No. 2008261123, which is itself a divisional application of Patent Application No. 2004210891, the disclosures of both Applications of which are herein incorporated by reference. 15 BACKGROUND OF THE INVENTION The UC is one of the first structures to form following gastrulation (formation of the three embryonic germ layers). As folding is initiated, the embryonic disc becomes connected, by the primitive midgut (embryonic origin) to the primitive yolk sac (extra-embryonic origin) via the vitelline and allantoic vessels which in turn develop 20 to form the umbilical vessels {Pereda, 2002}{Tuchmann-Duplessis, 1972}{Tuchmann-Duplessis, 1972}{Haynesworth, 1998}. These vessels are supported in, and surrounded by, what is generally considered a primitive mesenchymal tissue of primarily extra-embryonic derivation called Wharton's Jely (WJ) {Weiss, 1983}. From this early stage, the UC grows, during gestation, to 25 become the 30-50cm cord seen at birth. It can be expected therefore, that WJ contains not only the fibroblast-like, or myo-fibroblast-like cells which have been described in the literature (see below), but also populations of progenitor cells which can give rise to the cells of the expanding volume of WJ necessary to support the growth of the cord during embryonic and fetal development. 30 WJ was first described by Thomas Wharton, who published his treatise Adenographia in 1956. It has subsequently been defined as a gelatinous, loose mucous connective tissue composed of cells dispersed in an amorphous ground - la substance composed of proteoglycans, including hyaluronic acid {Schoenberg, 1960}, and different types of collagens (Nanaev et al., 1997). The cells dispersed in the matrix have been described as "fibroblast-like" that are stellate in shape in collapsed cord and elongate in distended cord (Parry, 1970). Smooth muscle cells were initially observed within the matrix (Chacko and Reynolds, 1954), although this was disputed by Parry (1970) who described them as somewhat "unusual fibroblasts" which superficially resemble smooth muscle cells. Thereafter, little work had been done on characterizing these 5 cells until 1993 when Takechi et al. (1993) performed immunohistochemical investigations on these cells. They described the cells as "fibroblast-like" that were "fusiform or stellate in shape with long cytoplasmic processes and a wavy network of collagen fibres in an amorphous ground substance" (Takechi et al., 1993). For the immunohistochemical staining, they used primary antibodies against actin and myosin 10 (cytoplasmic contractile proteins), vimentin (characteristic of fibroblasts of embryonic mesenchyme origin) and desmin (specific to cells of myogenic origin) in order to determine which types of myosin are associated with the WJ fibroblasts. They observed high levels of chemically extractable actomyosin; and although fibroblasts contain cytoplasmic actomyosin, they do not stain for actin or myosin, whereas the 15 WJ fibroblasts stained positively for both. Additionally, positive stains for both vimentin and desmin were observed leading to the conclusion that these modified fibroblasts in WJ were derived from primitive mesenchymal tissue (Takechi et al., 1993). A subsequent, more recent study by Nanaev et al. (1997) demonstrated five steps of differentiation of proliferating mesenchymal progenitor cells in pre-term 20 cords. Their findings supported the suggestion that myofibroblasts exist within the WJ matrix. The immunohistochemical characterization of the cells of WJ, shows remarkable similarities to that of pericytes which are known to be a major source of osteogenic cells in bone morphogenesis and can also form bone nodules referred to as colony forming unit-osteoblasts (CFU-0)(Aubin, 1998) in culture (Canfield et al., 25 2000). Recent publications have reported methods to harvest cells from UC, rather than UC blood. Mitchell et al. (Mitchell et al., 2003) describe a method in which they first remove and discard the umbilical vessels to harvest the remaining tissue. The latter, which will include both the remaining WJ (some of which will have been discarded 30 with the vessels, since the umbilical vessels are entirely enveloped in WJ) and the amniotic epithelium, is then diced to produce small tissue fragments that are transferred to tissue culture plates. These tissue fragments are then used as primary explants from which cells migrate onto the culture substratum. 2 -3 In another publication, Romanov et al. (Romanov et al., 2003) indicate they were successful in isolating mesenchymal stem cell-like cells from cord vasculature, although they also indicate their cultures do not contain cells from WJ. Specifically, they employ a single, 15min, collagenase digestion from within the umbilical vein, 5 which yields a mixed population of vascular endothelial and sub-endothelial cells. Romanov et al. show that sparse numbers of fibroblast-like cells appear from this cell harvest after 7 days. Also, US patent 5,919,702 describes a method of isolating "pre-chondrocytes" from 10 the WJ of human UC, and their use to produce cartilage. Particularly, the method comprises slicing open a one inch section of cord longitudinally, dissecting away the blood vessels and 'casing', which are then discarded, and collecting the WJ into a sterile container where it was cut into 2-3mm 3 sections for culturing. In a preferred 3 method, cells are isolated by placing a 2-3mm section of the WJ on a glass slide on 15 the bottom of a Petri dish, covering it with another slide, and culturing it for 10-12 days in order to allow the 'pre-chondrocytes' to migrate out to the culture dish surface. SUMMARY OF THE INVENTION 20 Accordingly, in one aspect the present invention provides a method of obtaining a population of progenitor cells, comprising the step of extracting said population from Wharton's jelly that lies in the perivascular zone of an umbilical cord blood vessel. In another aspect, the present invention provides an extract comprising progenitor 25 cells obtained by extraction from Wharton's jelly that lies in the perivascular zone of a human umbilical cord blood vessel. 16/10/15,ck20275speci.docx,3 - 3a Preferably, the extraction step is performed on a Wharton's jelly-bearing blood vessel that has been excised from a human umbilical cord. Preferably, the extract is in a cryopreserved state. Preferably, the progenitor cell population is in a cryopreserved state. 5 There has now been devised a procedure for extracting cells from Wharton's jelly of human umbilical cord, which yields a unique cell population characterized by rapid proliferation, the presence of osteoprogenitor and other human progenitor cells, including immune-incompetent cells which display neither of the major histocompatibility markers (human leukocyte antigen (HLA) double negative). The 16/10/15,ck20275speci.docx,a -4 cell population is a useful source of progenitor cells from which to grow bone and other connective tissues, and for autogenic and allogeneic transfer of progenitor cells to patients, for therapeutic purposes. There is a Wharton's jelly extract, wherein the extract comprises human progenitor 5 cells and is obtained by enzymatic digestion of the Wharton's jelly proximal to the vasculature of human umbilical cord, in a region usefully termed the perivascular zone. The extraction procedure suitably results in an extract that is essentially free from cells of umbilical cord blood, epithelial cells or endothelial cells of the UC and cells derived from the vascular structure of the cord, where vascular structure is 10 defined as the tunicae intima, media and adventia of arteriolar or venous vessels. A method for obtaining a human progenitor cell, comprising the step of isolating the cell from the Wharton's extract obtained. Preferably, a cell population obtained by culturing of the cells present in the Wharton's jelly extract. In preferred embodiments, there is provided a population of I5 osteoprogenitor cells and provided a population of immune-incompetent progenitor cells. Preferably, there is a population of committed osteoprogenitor cells characterized by the property of differentiating into bone cells when cultured in the absence of supplements otherwise required for such differentiation. 20 Preferably, there is a method for producing connective tissue and especially bone tissue and especially bone tissue, which comprises the step of subjecting cells obtained from the Wharton's jelly extract to conditions conducive to differentiation of those cells into the desired connective tissue phenotype. Preferably, for the use of such cells in cell-based therapies including cell transplantation-mediated treatment of 25 medical conditions, diseases and disorders. These and other preferred aspects of the invention will now be described in greater detail with reference being had to the accompanying drawings, in which: DESCRIPTION OF THE FIGURES Figure 1 is a light micrograph representing the three distinct zones of tissue 30 represented in the human UC; Figure 2 is a representative illustration of the looped vessel in the collagenase solution; 02/02/12,va 17695 p3-5 speci.4 -5 Figure 3 is a light micrograph of the cells isolated from the WJ that have attached to the polystyrene tissue culture surface; Figure 4 is a light micrograph illustrating the initial formation of CFU-0; Figure 5 is a light micrograph illustrating a mature CFU-0; 5 Figure 6 demonstrates tetracycline-labeled CFU-O's under UV fluorescence on a 35mm polystyrene tissue culture dish; Figure 7 illustrates side by side a phase-contrast light micrograph and a fluorescence micrograph of the same tetracycline-labeled CFU-0; Figure 8 is a scanning electron micrograph of a mature CFU-0 on the tissue culture 10 polystyrene surface; Figure 9 is a scanning electron micrograph of a cross-section of CFU-O exposing the underlying matrix; Figure 10 is a scanning electron micrograph of the lightly mineralized collagen fibres located on the advancing edge of the CRU-0; 15 Figure 11 is a scanning electron micrograph of the non-collagenous matrix (seen as globules) laid down on the polystyrene interface by differentiating osteogenic cells; Figure 12 is a scanning electron micrograph of heavily mineralized collagen that comprises the centre of a mature CFU-0; 0 2

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02 /12,va 17695 p3-5 speci.5 Figure 13 illustrates the flow cytometry data demonstrating that WJ-derived cells are 77.4% MHC I and MHC II negative; Figure 14 is a black and white reproduction of a Masson's trichome-stained transverse section of bone nodule showing the distribution of collagen within which cells have 5 become entrapped (osteocytes), and multilayering of peripheral cells some of which are becoming surrounded by the elaborated extracellular matrix; Figure 15 shows the potential expansion of the adherent perivascular WJ population in relation to the expansion of the committed osteoprogenitor subpopulation and total osteoprogenitor subpopulation; 10 Figure 16 shows proliferation of the perivascular WJ cells from 0-144 hours illustrating a normal growth curve with a lag phase from 0-24 hrs, log phase from 24 72 hours, and plateau phase from 72-120 hours. The doubling time during the entire culture period is 24 hours, while during log phase it is 16 hours; and Figure 17 shows major histocompatibility complex (MHC) expression of the WJ cells 15 shown over 5 passages, the change in their expression due to free-thawing, and subsequent expression due to reculture. DETAILED DESCRIPTION OF THE INVENTION The present invention provides an extract of Wharton's jelly (WJ), as a source of a rapidly proliferating cell population comprising human progenitor cells including 20 osteoprogenitor cells, as well as immuno-incompetent cells. As used herein, the term "progenitor cells" refers to cells that will differentiate under controlled and/or defined conditions into cells of a given phenotype. Thus, an osteoprogenitor cell is a progenitor cell that will commit to the osteoblast lineage, and ultimately form bone tissue when cultured under conditions established for such 25 commitment and differentiation. A progenitor cell that is "immuno-incompetent" is a cell having a phenotype that is negative for surface antigens associated with class I and class II major histocompatibility complexes (MHC). Such as progenitor cell is also referred to herein as an HLA double negative.

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The cell population extracted from WJ is also characterized by "rapid proliferation", which refers to the rate at which the extracted cells will grow relative to other known progenitor cell populations, under conditions that are standard for progenitor cell expansion. As will be appreciated from the experimental results presented herein, and 5 as shown in Figure 16, the present progenitor cell population can double within at least about 25 hours and as quickly as 15 hours, and thus expands far more rapidly than other known osteoprogenitor cell populations and other progenitor cell populations extracted from WJ. The cells and cell populations of the present invention can be obtained by extraction 10 from WJ of human umbilical cord. Unlike the prior art, and in accordance with the present invention, such cells are extracted from the WJ that is associated with, i.e., proximal to, the exterior wall of the umbilical vasculature. The Wharton's jelly that is associated with or very near to the external surface of the cord vasculature lies within a region termed the perivascular zone, and typically remains associated with the 15 vasculature when the vessels are excised from the cord, as is done for instance either to extract Wharton's jelly from the cord, or to extract the vessels from the cord and associated Wharton's jelly. It has remarkably been found that the Wharton's jelly within this perivascular zone, and which has typically been discarded in prior art practice, is a rich source of progenitor cells having the characteristics herein 20 described. Accordingly, the present invention exploits the Wharton's jelly from this perivascular zone as a source for useful human progenitor cells. To extract such Wharton's jelly from human umbilical cord, in a preferred embodiment, care is taking during the extraction process to avoid extracting cells of the umbilical cord blood, epithelial cells or endothelial cells of the UC, and cells 25 derived from the vascular structure of the cord, where vascular structure is defined as the tunicae intima, media and adventia of arterial or venous vessels. Obtaining an extract that is essentially free of these unwanted cells can be achieved by careful flushing and washing of the umbilical cord prior to dissection, followed by careful dissection of the vessels from within the cord. The vessels can also be carefully pulled 30 away from the surrounding cord tissue in which case the perivascular Wharton's jelly is removed with the vessels. It will be appreciated that, with care being taken to avoid extracting these unwanted cells, they may still be present to a small extent in the 7 resulting extract. This is acceptable provided they occur at a frequency too low to interfere with the observed results presented herein, i.e., observation of cell colonies derived from mesenchymal and specifically mesodermal origin, frequency and rapidity of formation of CFU-0, and characterization of HLA phenotypes observed in 5 the cultured population. The WJ that lies within the perivascular zone is-the Wharton's jelly proximal to the external wall of the umbilical vasculature, and lies typically within a zone extending to about 3mm from the external wall of the vessels. Suitably, the target extraction zone can lie within about 2mm, e.g., about Imm from the external wall of any one of 10 the three vessels. The extraction of WJ from this region can be readily achieved using the technique described in the examples. In this technique the vessels are used as a carrier for the WJ, and the jelly-bearing vessels per se are used as the substrate from which the progenitor cells are extracted. Thus, in embodiments of the invention, cord vessels bearing a thin coating of WJ are excised either surgically or manually from 15 fresh umbilical cord that has been washed thoroughly to remove essentially all cord blood contaminants. The vessels bearing the proximal Wharton's jelly, or sections thereof, are then incubated at about 37C in an extraction medium such as phosphate buffered saline (PBS) containing an enzyme suitable for digesting the collagen matrix of the WJ in which the desired cells reside. For this purpose, digestion with a 20 collagenase is suitable, at a concentration within the range from about 0.1 mg/mL to 1.Omg/mL or more, e.g., 0.5mg/mL. During the extraction, the ends of the vessels are tied, or clipped, off and can be suspended above the extraction medium to avoid contamination by agents contained within the vessel. It will thus be appreciated that the present Wharton's jelly extract is essentially free from cord blood cells and vessel 25 endothelial cells. After about 24 hours in the extraction medium, e.g., 12-36 hours, such as 18-24 hours, the vessels are removed, leaving a Wharton's jelly extract that contains human progenitor cells. These cells are expanded under conditions standard for expansion of progenitor cells. The cells can, for instance, be selected on polystyrene to select for 30 adherent cells, such as in polystyrene dishes or flasks and then maintained in a suitable culturing medium. In an embodiment of the invention, the extracted cells are cultured for expansion, with or without prior selection for adherent cells, under

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conditions of stirred suspension, as described for instance by Baksh et al in W002/086104, the disclosure of which is incorporated herein by reference. The cells present in the extract can, either directly or after their expansion, be sorted using established techniques to provide expandable subpopulations enriched for cells 5 of a given phenotype. Thus, the present invention further provides WJ extracted cell populations that are enriched for osteoprogenitor cells, cell populations that are enriched for immuno-incompetent progenitor cells, and cell populations that are enriched for osteoprogenitor cells that are immuno-incompetent. As is revealed in Figure 17, it has been found that the distribution of MHC markers 10 within the progenitor cell population is altered by freeze-thawing. Upon passaging of fresh cells, the frequency of MHC double negative cells is relatively constant/marginally increased. However, it has been found, as noted in the examples herein, that the frequency of MHC double negative cells in the progenitor population is increased significantly in cells plated following freezing. Thus, in the present 15 progenitor cell population, cells of the MHC double negative phenotype are further characterized by the propensity to increase in frequency following freezing. Such freezing is performed in the usual manner, by first preparing a cell aliquot, and then storing the cell preparation for the desired period.. It will be appreciated that such cells can be stored for many years if desired. 20 In an embodiment, the present invention thus further provides a method for producing MHC double negative progenitor cells, by obtaining a Wharton's jelly extract as herein described, or an MHC double negative-enriched fraction thereof, subjecting the extract or fraction thereof to freezing, and then culturing the frozen cells. The resulting cells as noted are potentially useful to induce tissue formation or repair in 25 human subjects. The cell populations obtained from the extract or from a suitably enriched fraction thereof, are useful either directly or following their expansion to provide differentiated cell populations. All of the procedures suitable for their fractionation and enrichment, and for their expansion are established in the prior art, and are 30 exemplified herein. Expansion can proceed, for instance, in the presence of factors such as IL-3 and Stem Cell Factor, and similar agents known in the art. In one 9 embodiment, the present cell population, and particularly the osteoprogenitor cells therein, are subjected to differentiation using conditions established for the growth of bone tissue therefrom. Remarkably, a subpopulation of osteoprogenitor cells that arise from the culturing of the present progenitor cell population, referred to as 5 committed osteoprogenitors, have shown the ability to differentiate in the absence of osteogenic supplements. Alternatively, the osteoprogenitor cells are cultured in a medium supplemented with one or more agents that stimulate osteogenesis, such as dexamethasone. In addition, the progenitor cells can also be cultured with supplements suitable for stimulating differentiation into other mesenchymally-derived 10 connective tissues (Caplan, 1991), including cartilage, muscle, tendon, adipose etc., all in accordance with standard practice in the art. As a practical alternative to in vitro culturing of cells in the present cell population, it will be appreciated that the cells can be transplanted in vivo to induce the formation of a desired tissue directly within a patient. By this route, the in situ formation of bone 15 is provided by implanting osteoprogenitor, for the benefit of patients suffering from various bone conditions, diseases and disorders, particularly including bone fracture and osteoporosis. The immuno-incompetent progenitor cells present in the cell population are particularly valuable in this respect, given the substantially reduced rejection response that can be expected following their implantation. 20 Embodiments of the invention are described in the following examples. Harvest of Progenitor Cells from Human Wharton's Jelly The UCs were collected from full-term caesarian section infants immediately upon delivery at Sunnybrook & Women's College Hospital, Toronto, Canada. The UC was transferred by the surgeon into a sterile vessel containing medium (75% a-MEM, 25 15% Fetal Bovine Serum (FBS), 10% antibiotics), and immediately transported to our laboratories at the Institute of Biomaterials & Biomedical Engineering, University of Toronto. All procedures from this point on were performed aseptically in a biological safety cabinet. The UC was washed in Phosphate Buffered Saline (PBS) (-Mg'+, -Ca 2 ) 30 three times to remove as much of the UC blood as possible, and transferred back into a container with medium. A length of approximately 6 cm of cord was cut with 10 sterile scissors and placed onto a sterile cork dissection board. The remaining cord (30-45 cm) was returned to the medium-filled container and placed into an incubator at 37*C. The 6 cm section of cord was 'twisted' against its helix, and pinned at both ends to reveal a smooth and straight surface of the UC epithelium. Using fine 5 scissors, the UC was cut approximately 1-2 mm deep along its length to reveal the WJ. Starting with each 'flap' of cut epithelium, the WJ was teased from its inner surface using the blunt edge of a scalpel, and the teased away epithelium (approximately 0.5mm thick) was pinned down. This procedure resulted in the WJ being exposed, and with its three vessels embedded in it running straight from end to 10 end rather than helically along its longitudinal axis. Care was taken to constantly bathe the section with 37*C PBS. Isolating one of the ends of a vessel with tweezers, it was teased away from the WJ along its length until it was free of the bulk of the WJ matrix. Alternatively, the middle of the vessel could be dissected from the matrix, held with tweezers, and teased from the matrix in each direction toward its ends. 15 Once freed by either method, the vessel was surrounded with approximately 1-2mm of the cell-bearing WJ matrix. The dissected vessel was then clipped at both ends with either a surgical clamp, mosquito clip or sutured to create a 'loop,' blocking the passage of fluid either into or out of the vessel. The 'loop' was immediately placed along with the scissors into a 15ml tube containing a 0.5mg/ml collagenase solution 20 with PBS (-Mg'+, -Ca 2 ), and placed into an incubator at 37 0 C. The remaining two vessels were dissected in a similar fashion, looped, and also placed in the collagenase solution in the incubator. Subsequent to the removal of the vessels, strips of WJ could easily be dissected off the epithelium and placed into 15 ml tubes with the collagenase solution. The remaining epithelial layer was then disposed of in a biohazard waste 25 container. The same protocol was used with the remaining 30-45 cm of UC, producing 15 to 25 tubes with either 'loops' or WJ strips. Initiation of Wharton's Jelly Progenitor Cell Cultures After 18-24 hours, the 'loops' were removed with the aid of their attached suspension clamp or suture and a pipette, and the remaining suspensions were plated directly onto 30 T-75 cm 2 tissue culture polystyrene dishes, and allowed to sit for 72 hours in order to allow the cells to attach to the polystyrene surface. The medium was then changed every two days. 11 The attached cells were passaged using 1% trypsin solution after 7 days, at which point they exhibited 80-90% confluency, as observed by light microscopy, and there was evidence of 'mineralized' aggregate formation, as revealed under phase microscopy and indicated by expected changes in optical properties. Upon passage, 5 cells were plated either in 35mm tissue culture polystyrene dishes or 6 well plates at x 104 cells/cm 2 in 75% t-MEM, 15% FBS, 10% antibiotics and treated with 10- 8 M Dex, 5mM p-GP and 50 pg/ml ascorbic acid to test the osteogenic capacity of these cells. These plates were observed on days 2, 3, 4 and 5 of culture for CFU-O otherwise referred to as 'bone nodule' formation. 10 Another useful approach to obtaining the Wharton's jelly progenitor cell cultures has been adopted, using the following protocol: 1. Obtain sterile umbilical cord (UC) from caesarian-section patient and transport to biological safety cabinet in media (80% a-MEM, 20% antibiotics) 2. Wash the UC 2x in sterile 37*C phosphate buffered saline (PBS) 15 3. Cut the UC into approximately 1-2 inch sections with a sharp pair of scissors 4. Wash each section of UC 2x in sterile 37*C PBS to remove as much residual umbilical cord blood (UCB) as possible. 5. Isolate one of the UC sections on a dry sterile dish 6. Using two sets of forceps, grasp the epithelium approximately 2mm apart, and 20 pull away from each other, tearing the epithelium. 7. Grasping the epithelium along the length of the UC section, continue to tear the epithelium away, exposing the WJ underneath 8. Similarly to step 6, continue tearing the epithelium away in 'strips' until approximately half of the epithelium has been torn away. 25 9. The umbilical vessels should be clearly visible through the WJ, and the ends loose on the cut edges of the UC section. 1'") 10. By grasping a remaining part of the epithelium with one set of forceps, and the end of a vessel with the other, the vessel can be 'pulled' from the bulk WJ with its surrounding PVWJ. 11. This process is repeated with each vessel, until all three are free of the 5 underlying WJ matrix. 12. Once released, each vessel is placed into 37*C PBS. 13. Steps 5-12 are repeated with each section of UC until all the vessels have been isolated in a sterile 37 0 C PBS-filled beaker. 14. Then, by placing each vessel individually on a clean, sterile surface, the ends 10 can be ligated together with a suture using a double knot into a 'loop' 15. Once all of the vessels have been ligated into loops, the loops are placed into a lmg/ml collagenase solution in a sterile 50ml tube 16. The 50ml tube is placed into a rotator in a 37*C, 5%CO 2 incubator overnight. 17. The following day, the collagenase is inactivated with I ml fetal bovine serum 15 (FBS), and the loops removed from the suspension. 18. The remaining suspension is diluted with PBS, centrifuged at 1150rpm for 5 minutes, and the supernatant removed. 19. The cells remaining in the pellet are resuspended in supplemented media (SM) (75% a-MEM, 15% FBS, 20% antibiotics), and aliquot is counted on a 20 hemocytometer. 20. The cell suspension is then plated onto a T-25 tissue-culture polystyrene flask, and allowed to proliferate. 21. The SM is changed every 2 days until the cells reach sub-confluence (1-2 weeks), at which point they are sub-cultured (passaged).

PROGENITOR ASSAYS Cell Proliferation Assay During the weekly passage procedure (occurring every 6 days), aliquots of 2 x 105 cells were plated into 20 T-25 cm 2 tissue culture polystyrene flasks. On days 2, 4, 6, 5 10 and 12 of culture, four of the T-25 flasks were passaged and the cells were counted. The exponential expansion of these cells was plotted, and the mean doubling time for the cells in these cultures was calculated. Results are shown in Figure 16. It will be noted that the doubling time for the PVWJ cell culture is about 24 hours across the entire culturing period. During the log phase, the doubling time is 10 a remarkable 16 hours. This compares with literature reported doubling times of about 33 hours for bone marrow mesenchymal cells ((Conget,P, J J Minguell, 1999, Phenotypical and functional properties of human bone marrow mesenchymal progenitor cells: Journal of Cell Physiology, v. 181, p. 67-73.), and about 3.2 days for mesenchymal stem cells derived from adipose tissue (Sen,A, J.Cell Biochem., v. 81, 15 p. 3 12-319.) As show in Figure 15, the perivascular Wharton's Jelly (PVWJ)-derived progenitors comprise different sub-populations of progenitor cells. Within this population, there are the so-called "committed" osteoprogenitor cells characterized by an ability to form bone nodules, as shown herein, in the absence of the culturing supplements 20 normally required to induce such differentiation, such as culturing in the presence of dexamethasone. These committed osteoprogenitors thus differentiate spontaneously to form bone nodules. Also within the PVWJ progenitor population are osteoprogenitor cells that can be induced to form bone nodules, when cultured in the presence of the required factors, such as dexamethasone, p-glycerophosphate and 25 ascorbic acid. Thus, is the "total osteoprotenitor" sub population graphed in Figure 15 includes the "committed osteoprogenitor" population, as well as the "uncommitted osteoprogenitor" population, and reveals the total number of cells that can be induced to differentiate down the osteogenic lineage. The actual ratio between the "committed" and "uncommitted" population is approximately 1:1, and so the ratio 30 between the "total osteoprogenitor" population and the "committed osteoprogenitor" population is about 2:1. Analysis of the bone forming properties of the progenitors was performed as noted below. 14 CFU-O Assay During the weekly passage procedure, aliquots of test cell populations were directly plated on tissue-culture polystyrene in bone forming medium containing 75% a MEM, 15% FBS (StemCell Batch #: S13E40), 10% antibiotic stock solution 5 containing penicillin G (167 units/ml), gentamicin (50 g/ml) and amphotericin B (0.3p.ig/ml), and Dex (10- 8 M), p-glycerophosphate (5mM) and L-ascorbic acid (50ug/ml), at a cell seeding density of I x 10' cells/cm 2 . Cultures were re-fed every two days for a period of 12 days. The cultures were maintained until mineralized nodular areas, detected as bone nodules, were observed (usually 3 days) at which 10 point the cultures were re-fed with tetracycline containing medium at the last culture re-feed, then fixed in Karnovsky's fixative and prepared for analysis. A Leitz Aristoplan microscope (Esselte Leitz GmbH & Co KG, Stuttgart, Germany) was used to visualize the tetracycline labelled cultures under phase contrast as well as UV fluorescence and a Hitachi S-2000 scanning electron microscope at an accelerating 15 voltage of 15 kV was used to generate images to demonstrate the presence of morphologically identifiable bone matrix. DATA ANALYSIS Tetracycline Stain Tetracycline (9 pg/ml) was added to the cultures prior to termination. At termination, 20 the cells were fixed in Kamovsky's fixative overnight and then viewed by UV-excited fluorescence imaging for tetracycline labeling of the mineral component of the nodular areas. Scanning Electron Microscopy (SEM) Representative samples of CFU-O cultures were prepared for SEM by first placing 25 them in 70%, 80%, 90% and 95% ethanol for 1 hour, followed by immersion in 100% ethanol for 3 hours. They were then critical point dried. A layer of gold approximately 3 nm layer was sputter coated with a Polaron SC515 SEM Coating System onto the specimens, which were then examined at various magnifications in a Hitachi S-2000 scanning electron microscope at an accelerating voltage of 15 kV. The images 30 generated are used to demonstrate the presence of morphologically identifiable bone matrix.

Flow cytometry for HLA-typing Test cell populations of>1 x 105 cells were washed in PBS containing 2% FBS (StemCell Batch #: Si 3E40) and re-suspended in PBS + 2% FBS with saturating concentrations (1:100 dilution) of the following conjugated mouse IgG I HLA-A,B,C 5 PE and HLA-DR,DP,DQ-FITC for 30 minutes at 4*C. The cell suspension was washed twice with PBS + 2% FBS, stained with 1p g/ml 7-AAD (BD Biosciences) and re-suspended in PBS + 2% FBS for analysis on a flow cytometer (XL, Beckman Coulter, Miami, FL) using the ExpoADCXL4 software (Beckman-Coulter). Positive staining was defined as the emission of a fluorescence signal that exceeded levels 10 obtained by >99% of cells from the control population stained with matched isotype antibodies (FITC- and PE-conjugated mouse IgG 1,K monoclonal isotype standards, BD Biosciences). For each sample, at least 10,000 list mode events were collected. All plots were generated in EXPO 32 ADC Analysis software. RESULTS 15 Light micrographs of bone nodule Colonies Figures 3, 4 and 5 illustrate CFU-O's that were present in the cultures on day 3 and day 5. They demonstrated the confluent layer of "fibroblastic-like" cells surrounding a nodular area represented by an 'aggregation' of polygonal cells that were producing the bone-matrix. These CFU-O's were observed in both the Dex (+) and Dex (-) 20 cultures, and displayed similar morphology over successive passages. Tetracycline Labeling of CFU-O Cultures Tetracycline labeling of cultures was used for labeling newly formed calcium phosphate associated with the biological mineral phase of bone. The tetracycline labeling of the cultures coincide with the mineralized nodular areas, which is 25 visualized by exposing the cultures to UV light. Figures 6 and 7 depict tetracycline labeled CFU-O cultures of Day 3 and Day 5 cultures of WJ progenitor cells. These images were generated by UV-excited fluorescence imaging, and photographed. Scanning Electron Microscopy The CFU-O's were observed under SEM for formation of mineralized collagen matrix 30 which demonstrates the formation of the CFU-O's from the initial stages of collagen formation through to the densely mineralized matrix in the mature CFU-0. Figures 8, 9, 10, 11, 12 and 14 represent scanning electron micrographs of the CFUOs.

Flow Cytometry & HLA-typing The flow cytometry, identifying cell-surface antigens representing both Major Histocompatibility Complexes (MHCs) demonstrated 77.4% of the population of isolated cells as MHC ~'~. Figure 13 illustrates the flow cytometry results in relation to 5 the negative control. Figure 17 shows the impact of freeze-thawing on the frequency of MHC -/- cells in the progenitor population. The effect of freeze-thawing was studied as follows: Test cell populations of >1 x 105 cells were washed in PBS containing 2% FBS and re-suspended in PBS + 2% FBS with saturating concentrations (1:100 dilution) of the 10 following conjugated mouse IgGI HLA-A,B,C-PE (BD Biosciences #555553 , Lot M076246) (MHC I), HLA-DR,DP,DQ-FITC (BD Biosciences #555558 , Lot M074842) (MHC II) and CD45-Cy-Cychrome (BD Biosciences # 555484, Lot 0000035746) for 30 minutes at 4'C. The cell suspension was washed twice with PBS + 2% FBS and re-suspended in PBS + 2% FBS for analysis on a flow cytometer (XL, 15 Beckman-Coulter, Miami, FL) using the ExpoADCXL4 software (Beckman-Coulter). Positive staining was defined as the emission of a fluorescence signal that exceeded levels obtained by >99% of cells from the control population stained with matched isotype antibodies (FITC-, PE-, and Cy-cychrome-conjugated mouse IgG1,K monoclonal isotype standards, BD Biosciences), which was confirmed by positive 20 fluorescence of human BM samples. For each sample, at least 10,000 list mode events were collected. All plots were generated in EXPO 32 ADC Analysis software. Sub-culture & cell seeding The attached cells were sub-cultured (passaged) using 0.1% trypsin solution after 7 days, at which point they exhibited 80-90% confluency as observed by light 25 microscopy. Upon passage, the PVWJ (perivasculature zone Wharton's jelly) cells were observed by flow cytometry for expression of MHC-A,B,C, MHC-DR,DP,DQ, and CD45. They were then plated in T-75 tissue culture polystyrene flasks at 4x10 3 cells/cm2 in SM, and treated with 10- 8 M Dex, 5mM P-GP and 50 pg/ml ascorbic acid to test the osteogenic capacity of these cells. These flasks were observed on days 2, 3, 30 4, 5 and 6 of culture for CFU-O or bone nodule, formation. Any residual cells from the passaging procedure also were cryopreserved for future use. 17 Cryopreservation of cells Aliquots of Ix106 PVWJ cells were prepared in I ml total volume consisting of 90% FBS, 10% dimethyl sulphoxide (DMSO) (Sigma D-2650, Lot# 11K2320), and pipetted into Iml polypropylene cryo-vials. The vials were placed into a -70*C 5 freezer overnight, and transferred the following day to a -1 50*C freezer for long-term storage. After one week of cryo-preservation, the PVWJ cells were thawed and observed by flow cytometry for expression of MHC-A,B,C, MHC-DR,DP,DQ, and CD45. A second protocol was used in which the PVWJ cells were thawed after one week of cryopreservation, recultured for one week, sub-cultured then reanalyzed by 10 flow cytometry for expression of MHC-A,B,C, MHC-DR,DP,DQ, and CD45. The results are presented in Figure 17. It will be noted that the frequency of MHC-/ within the fresh cell population is maintained through several passages. When fresh cells are frozen after passaging, at -1 50C for one week and then immediately analyzed for MHC phenotype, this analyzed population displays a remarkably enhanced 15 frequency of cells of the MHC -/- phenotype. Thus, and according to an embodiment of the present invention, cells of the MHC -/- phenotype can usefully be enriched from a population of PVWJ cells by freezing. Still further enrichment is realized upon passaging the cultures of the previously frozen cells. The frozen PVWJ cells per se are potentially very useful in human therapy, given their immuno-incompetence. 20 As noted, the PVWJ progenitor cell population may also be exploited to give rise to mesenchymal cells and tissues other than bone, by culturing under conditions appropriate for such differentiation. To generate adipocytes, for instance, the progenitors are prepared at a concentration of 104 cells/cm 2 and plated in 35 mm tissue culture dishes. The cells are maintained in Preadipocyte Medium (PM) 25 (DMEM/Ham's F- 10 (1:1, vol/vol), 10% fetal calf serum, 15 mM HEPES, 100 U/ml penicillin, 100 pig/ml streptomycin, 0.25 ig/ml amphotericin B) for 3 days. After 3 days, the PM is removed, and the cells are fed with Adipogenic medium (DMEM/ Ham's F- 10 nutrient broth, 1:1, v/v; HEPES buffer (15 mM); Fetal Bovine Serum (3%); Biotin (33 P-M), Pantothenate (17 ILM), human insulin (100 nM), 30 dexamethasone (0.5 P-M), PPARY agonist (1 P-M) and antibiotics), and cultured for 3 days. After the 3 day induction, the Adipogenic medium is removed, and the cultures are maintained in Adipocyte Medium (AM) (DMEM/Ham's F- 10 (1:1, vol/vol), 3% 1o fetal calf serum, 1 pM dexamethasone, 100 nM human insulin, 33 pM D-biotin, 17 pM Na-pantothenate, 15 mM HEPES, 100 U/ml penicillin, 100 pg/ml streptomycin, 0.25 pg/ml amphotericin B), with regular feeding every 3 days, ensuring to only remove half the medium, replenishing with an equal volume of AM since adipocytes 5 will float if all the media is removed. After four feedings (12 days), cells appear rounded with lipid droplets. Positive identification of differentiated mesenchymal cells into adipocytes can be confirmed by staining with Oil Red 0 and Nile Red. Similarly, chondrocytes may be generated using cell suspensions prepared at a concentration of 104 cells/cm 2 and plated in 35 mm tissue culture dishes. To promote 10 chondrogenic cells are cultured without serum and with transforming growth factor p3. The cell pellets develop a multilayered matrix-rich morphology and histologically show an increased proteoglycan-rich extracellular matrix during culture. To generate myoblasts, cell suspensions are prepared at a concentration of 104 cells/cm2 and plated in 35 mm tissue culture dishes. The cells are maintained in 15 MCDB 120 medium completed with 15% fetal bovine serum (FBS) for I week (myoblast proliferation medium, MPM). At I week, the serum level in the basal medium (MPM) is dropped to 2% (myoblast differentiation medium, MDM) and the cultures are terminated after 7 days. The cultures are re-fed 3-times a week with appropriate culture medium. 20 It will thus be appreciated that the present invention provides human progenitor cells having properties useful in the production of various connective tissues including bone, and further provides progenitor cells that are immune incompetent and ideal for transplantation into human patients to treat connective tissue conditions including bone diseases and disorders. The human progenitor cells are generated from extracts 25 of a particular zone of human umbilical cord Wharton's jelly, termed the perivascular zone, extending proximally from the external wall of the cord vessels. The cell population extracted from this zone displays remarkable properties, including rapid proliferation, changes in cell morphology, as witnessed by the formation of cell colonies occurring before day 7 in all subcultured flasks (approximately 7-10 30 doublings) and the appearance of bone nodule formation without the addition of osteogenic supplements to the culture medium, as well as relatively high frequency of 10 MHC double negative cells, the frequency of which is increased upon culturing of cells that have been frozen. The following references are incorporated herein by reference: Aubin,JE, 1998, Bone stem cells: J Cell Biochem Suppl, v. 30-31, p. 73-82. 5 Beckstead,JH, D F Bainton, 1980, Enzyme histochemistry on bone marrow biopsies: reactions useful in the differential diagnosis of leukemia and lymphoma applied to 2 micron plastic sections: Blood, v. 55, p. 386-394. Beckstead,JH, P S Halverson, C A Ries, D F Bainton, 1981, Enzyme histochemistry and immunohistochemistry on biopsy specimens of pathologic human bone marrow: 10 Blood, v. 57, p. 1088-1098. Canfield,AE, M J Doherty, B A Ashton, 2000, Osteogenic potential of vascular pericytes, in JE Davies (ed), Bone Engineering: Toronto, EM Squared, Inc., p. 143 151. Caplan,AI, 1991, Mesenchymal stem cells: J Orthop.Res, v. 9, p. 641-650. 15 Chacko,AW, S R M Reynolds, 1954, Architecture of distended and nondistended human umbilical cord tissues, with special reference to the arteries and veins.: Carnegie Institution of Washington, Contributions to Embryology, v. 35, p. 135-150. Friedenstein,AJ, J F Gorskaja, N N Kulagina, 1976, Fibroblast precursors in normal and irradiated mouse hematopoietic organs: Exp Hematol, v. 4, p. 267-274. 20 Mitchell,KE, M L Weiss, B M Mitchell, P Martin, D Davis, L Morales, B Helwig, M Beerenstrauch, K Abou-Easa, T Hildreth, D Troyer, 2003, Matrix Cells from Wharton's Jelly Form Neurons and Glia: Stem Cells, v. 21, p. 50-60. Nanaev,AK, G Kohnen, A P Milovanov, S P Domogatsky, P Kaufmann, 1997, Stromal Differentiation and Architecture of the Human Umbilical Cord: Placenta, v. 25 18, p. 53-64. Parry,EW, 1970, Some electron microscope observations on the mesenchymal structures of full-term umbilical cord: Journal of Anatomy, v. 107, p. 505-518.

-21 Pereda,J, P M Motta, 2002, New advances in human embryology: morphofunctional relationship between the embryo and the yolk sac: Medical Electron Microscopy, v. 32, p. 67-78. Romanov, YA V A Svintsitskaya, V N Smirnov, 2003, Searching for Alternative 5 Sources of Postnatal Human Mesenchymal Stem Cells: Candidate MSC-Like Cells from Umbilical Cord: Stem Cells, v. 21, p. 105-110. Schoenberg,MD, A Hinman, R D Moore, 1960, Studies on connective tissue V, Feber formation in wharton's Jelly.: Laboratory Investigation, v. 9, p. 350-355. Takechi,K, Y Kuwabara, M Mizuno, 1993, Ultrastructural and Immunohistochemical 10 Studies of Wharton's Jelly Umbilical Cord Cells: Placenta, v. 14, p. 235-245. Tuchmann-Duplessis,H, G David, P Hawgel, 1972, Illustrated Human Embryology, New York, Springer-Verlag, p. 54-61. Weiss,L, 1983, Histology: cell and tissue biology, New York, Elseiver Biomedical, p. 997-998. 15 Throughout this specification and the claims which follow, unless the context requires otherwise, the word "comprise", and variations such as "comprises" and "comprising", will be understood to imply the inclusion of a stated integer or step or group of integers or steps but not the exclusion of any other integer or step or group of integers or steps. 20 The reference to any prior art in this specification is not, and should not be taken as, an acknowledgement or any form of suggestion that the prior art forms part of the common general knowledge in Australia.

Claims (13)

1. A method of obtaining a population of progenitor cells, comprising the step of extracting said population from Wharton's jelly that lies in the perivascular 5 zone of an umbilical cord blood vessel.

2. The method according to claim 1, wherein the extraction step is performed on a Wharton's jelly-bearing blood vessel that has been excised from a human umbilical cord. 10

3. The method according to claim 1 or claim 2, wherein the population of progenitor cells is essentially free from cells derived from the vascular structure of the umbilical cord. 15 4. A method of producing a cell population comprising progenitor cells, comprising the step of culturing cells obtained by the method according to any one of claim 1 to claim 3.

5. The method according to any one of claim 1 to claim 4, comprising the 20 further step of treating said population to enrich for osteoprogenitor cells.

6. The method according to any one of claim 1 to claim 4, comprising the further step of treating said population to enrich for progenitor cells having an MHC double negative phenotype. 25

7. The method according to claim 6, wherein said population is subjected to a freeze/thaw step to enrich for progenitor cells having the MHC double negative phenotype. 30 8. An extract comprising progenitor cells obtained by extraction from Wharton's jelly that lies in the perivascular zone of a human umbilical cord blood vessel. 16/10/15,ck2O275clains.docx,22 -23 9. An extract according to claim 8, in a cryopreserved state.

10. A progenitor cell population, whenever obtained by the method according to 5 any one of claim 1 to claim 7.

11. A progenitor cell population according to claim 10, in a cryopreserved state.

12. A pharmaceutical composition comprising a pharmaceutically acceptable 10 vehicle and a progenitor cell population according to claim 10.

14. A composition according to claim 12, for use in human tissue engineering.

15. The use of a cell population according to claim 10 or claim 11 in the 15 preparation of a medicament for the treatment of a medical condition, disease or disorder.

16. A method of obtaining a population of progenitor cells according to claim 1, substantially as hereinbefore described with reference to any one of the 20 accompanying drawings.

17. An extract according to claim 8, substantially as hereinbefore described with reference to any one of the accompanying drawings. 25 16/10/15,ck2O275clains.docx,23