Culture systems of primary cells

shown by Sato et al. (2011) for the intestine and later by several groups for other organs.

Due to the important role of EGFR in the regulation of cell proliferation, differentiation, survival, and motility it implies that EGFR signaling components are prone to be involved in cancer progression and tumor development. Indeed mutations in EGFR (effect mainly trafficking of the receptor) or overexpression of EGFR and ligands, leading to permanent activation of the EGFR signaling pathway are found in several cancers like non-small cell lung cancer (NSCLC), head and neck cancer, glioblastoma, colorectal cancer or breast cancer (reviewed in Normanno et al. (2006)).

1.4. Culture systems of primary cells

1.4.1. 2D cell culture systems

Different in vitro culture models have been established in the last decades to analyze and understand biological processes of different organs under homeostatic and pathologic conditions in the human body including the gastrointestinal tract. Aim of all these models is to mimic the in vivo situation as close as possible, giving an alternative to in vivo animal models. Every model has advantages and disadvantages which need to be evaluated before their application to test a hypothesis. The simplest approach is the cultivation of cells in two dimensions (2D) using either cell lines or primary cells. Most of the established cell lines originate from tumors and can be cultivated over a long period of time on plastic or glass surface. Moreover, they are robust, cost-effective, and easy to handle and manipulate genetically. However, these cell lines comprise all the mutations and defects in their genome similar to the primary tumor they are derived from and therefore represent already a diseased state. Thus, the biological response of cell lines to certain stimuli or behavior under homeostatic conditions might be different from the in vivo situation due to altered metabolism and defects in certain signaling pathways (up- or downregulation). Nevertheless, cancer cell lines are still a valuable tool for cancer drug screenings and research on potential therapeutic targets. The

1.4 Culture systems of primary cells

cultivation of primary cells from non-cancerous material in vitro instead is challenging as they show a very limited lifespan and undergo replicative senescence after a few passages due to telomere shortening (Campisi 1997; Cristofalo et al. 2004). Primary cells can be immortalized to overcome the limited lifespan. Commonly used methods are the transduction with viral compounds like the oncoprotein SV 40 large T antigen from polyomavirus SV40 or the E6/E7 protein from human papilloma virus (Münger et al. 1989; Steinberg and Defendi 1983; Jha et al. 1998; Daya-Grosjean et al. 1984;

Hawley-Nelson et al. 1989; Hudson et al. 1990; Willey et al. 1991). However, these immortalization strategies influence p53 and retinoblastoma (Rb) tumor suppressor pathways. Another approach uses the overexpression of the human telomerase reverse transcriptase protein (hTERT) in primary cells, but some cell types especially epithelial cells fail to be immortalized by hTERT and rather undergo apoptosis (Lee, Choi, and Ouellette 2004). The conditional reprogramming of cells (CRC) is a further method to achieve indefinite growth in primary cells. Therefore, primary epithelial cells are cultivated on irradiated fibroblast feeder cells and treated with a Rho kinase inhibitor leading to prolonged lifespan without affecting the genome (Chapman et al. 2010; Liu et al. 2012). The CRC method is a 2D cultivation strategy which is limited to reflect the in vivo state because the complexity of the tissue, the anatomy and physiology get lost in the planar 2D culture. Cells cultivated in 2D show an unnatural polarization, loss of differentiated phenotype, altered response to pharmaceutical agents and oversaturation with nutrients due to the extended cell surface (Caliari and Burdick 2016).

1.4.2. 3D cell culture systems

In vivo epithelial cells are embedded in a complex three-dimensional (3D) architecture with defined and intricate cell-cell and cell-extracellular matrix contacts and are surrounded by a defined microenvironment which is lacking in all 2D culture models.

Thus, 3D culture systems are an improvement as they mimic the in vivo conditions more accurately. First attempts of 3D tissue cultures used explanted organ slices which were placed on a porous membrane or in a collagen bed and cultivated under air-liquid interface conditions. This organotypic culture preserves the cytoarchitecture and the different cell types of the original tissue and is mainly applied to studies on brain physiology (Pampaloni, Reynaud, and Stelzer 2007).

1.4 Culture systems of primary cells In the last decades, different 3D cell culture systems were developed to resemble the in vivo situation in vitro, which can be broadly classified into free or scaffold-dependent culture systems. Scaffold-free systems rely on the natural tendency of cells to form multicellular aggregates so-called spheroids. The scaffold of scaffold-based systems represents the complex network built by the ECM in vivo and is of synthetic or biological material in these systems (Pampaloni, Reynaud, and Stelzer 2007; Knight and Przyborski 2015). Although the spheroid models of the scaffold-free systems might be appropriate for tumor research as they reflect the heterogeneity of the tumor mass, they still do not fully recapitulate the polarized architecture of in vivo tissue structures like in the gastrointestinal tract or other organs. Especially epithelial cells depend on a scaffold and need the structural support by the ECM as it provides the spatial orientation for apical-basal polarization which ensures a proper function of the epithelial cells (Watt and Huck 2013). The ECM is a complex network composed of collagens, proteoglycans, hyaluronic acid, laminin, and fibronectin. This complexity is difficult to reproduce in vitro but commercially available products are nowadays able to mimic the ECM or elements of it (Justice, Badr, and Felder 2009). Matrigel is an extract from Engelbreth–Holm–Swarm (EHS) mouse sarcoma tumors that resembles the composition of the basement membrane. It is composed primarily of laminin, type IV collagen, and entactin, with various other constituents including proteoglycans and growth factors (Kleinman and Martin 2005).

The development of the organoid cultivation model by the Clever’s group (Sato et al.

2009) was a breakthrough in terms of culturing primary epithelial cells nearly indefinitely and simultaneously mimicking tissue architecture, cell-type composition and self-renewal dynamics in vitro. Organoids are mini-organs grown from either pluripotent stem cells (induced pluripotent stem cells (iPSC) or embryonic stem cells (ESC)) or organ-specific adult stem cells and consist of organ-specific cell-types which self-organize in a 3D structure and thereby reflecting the epithelial organization in vitro (Kretzschmar and Clevers 2016). In the murine small intestine Lgr5 expressing stem cells are located in the crypt base and are responsible for steady self-renewal and repopulation of the crypt (Barker et al. 2007). Sato et al. (2009) isolated single crypts containing adult stem cells or sorted single Lgr5+ stem cells from mice and seeded them in the ECM substitute Matrigel. The basic cultivation medium was supplemented with

1.4 Culture systems of primary cells

mitogens and growth factors supporting the stem cell niche like WNT3A, the Wnt pathway agonist R-spondin (RSPO) 1, EGF and the BMP antagonist Noggin. With this approach, the authors achieved the formation of spheroids/organoids due to stem cell proliferation, consisting of a polarized epithelial monolayer with an apical side facing the lumen and the basal side aligned with Matrigel and the culture medium. The crypt-like structures were composed of all cell types present in the small intestinal crypt in vivo. Further progress was made when Spence et al. (2011) showed the generation of intestinal organoids from iPSC demonstrating the same developmental fate as in vivo during organogenesis. Besides murine organoids also human organoids were established for the intestine from PSC’s (McCracken et al. 2011) as well as isolated crypts (Sato et al. 2011). Since then organoid cultures for a wide range of organs including stomach (Barker et al. 2010; McCracken et al. 2014; Schlaermann et al. 2014; Bartfeld et al.

2015), kidney (Xia et al. 2014; Morizane et al. 2015; Takasato et al. 2015), liver (Huch, Dorrell, et al. 2013; Huch et al. 2015), pancreas (Huch, Bonfanti, et al. 2013), brain (Lancaster et al. 2013), esophagus (DeWard, Cramer, and Lagasse 2014), fallopian tube (Kessler et al. 2015) and lung (Rock et al. 2009), among others were established.

Human stomach organoids (gastric organoids) can be generated either from isolated glands harboring adult stem cells (Schlaermann et al. 2014; Bartfeld et al. 2015) or by differentiation from PSC’s (McCracken et al. 2014). Likewise intestinal organoids, gastric organoids depend on permanent WNT supply to maintain stem cell activity (Barker et al. 2010). The cultivation medium was further defined to improve the lifespan of the organoid cultures. The medium of gastric organoids is supplemented with WNT3A, RSPO1, EGF and Noggin, FGF10, B27, N2, nicotinamide (NIC), gastrin, TGFβ inhibitor A-83-01 which inhibits Alk4/5/7, and rho-associated coiled-coil forming protein serine/threonine kinase (ROCK) Y-27632. This cultivation medium supports the gastric organoid culture and extended the lifespan from several months up to more than one year (Schlaermann et al. 2014; Bartfeld et al. 2015). Gastric organoids consist of a polarized epithelial monolayer with the apical side facing the lumen and the basal side aligning with the environment. Both, antral and corpus organoids show the same morphology and both can be differentiated into MUC5AC positive foveolar lineage by the withdrawal of WNT3A and RSPO1 from the cultivation medium. While undifferentiated MUC6 dominated organoids have a perfect round shape, differentiated organoids show a folded morphology with budding structures. Although antral

1.4 Culture systems of primary cells organoids are composed of all cell types present in the gland in vivo, corpus organoids lack important cell types like parietal cells or show a much lower abundance of chief cells than present in vivo. Thus, corpus organoids are not a perfect representation of the in vivo situation (Schlaermann et al. 2014).

Besides their application to answer fundamental questions of organ development, stem cell biology, and tissue regeneration, organoids are used to model diseases like cancer, chronic diseases, and study pathophysiologic conditions like infections with viruses, bacteria or parasites (Dutta and Clevers 2017). Due to the apical-basal polarization with the apical side inside, extracellular pathogens like Helicobacter pylori need to be injected into the lumen to mimic the in vivo route of infection (Bartfeld et al. 2015). For infections with intracellular pathogens, for instance, with Salmonella or Chlamydia, another method is used in which the organoids are segregated into fragments or single cells and then incubated with the infectious agent (Kessler et al. 2019; Forbester et al.

2015). However, especially the injection technique e.g. for H. pylori is low-throughput due to the time-consuming procedures.

Although organoids are a valuable 3D culture system recapitulating the in vivo situation of the organ of origin, a major drawback of this model is the lack of complexity. In vivo epithelial cells are in close contact and communicate with other cell types like immune cells, endothelial cells, and stromal cells especially under physiologic and pathophysiologic conditions. Organoids are rather primitive as they are only composed of epithelial cells. Thus, an effort is made to further improve and engineer the organoid system using for instance co-culture or transplantation into immunocompromised mice.

Nevertheless, organoid cultures are heterogeneous and show high variability. Hence, it is attempted to standardize and better control organoid cultures with the aim to reduce variability e.g. by using chemically defined 3D hydrogels (Holloway, Capeling, and Spence 2019). Regardless of the total lifespan of an organoid culture that can last more than one year, the lifespan of one passage is rather short spanning from seven to ten days. Thus, the organoid model is not applicable for long-term in vitro studies.

The Kuo laboratory (Ootani et al. 2009) developed another 3D culture method to generate murine intestinal organoids. The authors applied a combination of an air-liquid interface (ALI) culture and a 3D culture matrix and recapitulated the cellular

1.4 Culture systems of primary cells

myofibroblast architecture and the stem cell niche dependencies on Wnt and Notch pathway activation. They used a transwell filter system filled with two layers of collagen and seeded minced tissue pieces only in the upper collagen layer. The tissue fragments were exposed to air and the outer dish was filled with Ham’s F12 / 20 % FCS medium to create an air-liquid interface. These culture conditions induced the formation of 3D structured organoids composed of a polarized epithelial monolayer with apical-basal orientation. Besides the proliferative activity, all cell lineages were detected in this model, thus recapitulating the in vivo situation accurately. Nevertheless, the authors stated that the long-term culture is only achieved by taking neonatal tissue as starting material. This 3D culture method was also applied to and established for the glandular stomach of mice using again only neonatal tissue (Katano et al. 2013) and a detailed protocol applicable for the whole gastrointestinal tract was published a few years ago (Li, Ootani, and Kuo 2016). Recently, Katano et al. (2015) extended the air-liquid interface gastric organoid culture and included mesenchymal myofibroblasts in the collagen layers of the set-up. They observed that the fibroblasts supported the formation of organoids and sustained proliferation and differentiation of the epithelial cells concluding that fibroblasts have a positive impact on the stem cell niche.

However, the ALI culture method was applied by the Kuo laboratory in other studies before; in this work, Ootani et al. (2000) demonstrated that gastric surface mucus cells GSM06 induce and preserve the mature differentiated phenotype when they are cultured on a collagen layer on a trans-well filter under air-liquid interface conditions. Control cultures without ALI condition resembled pre-pit cells and showed an immature phenotype. In a follow-up study, Ootani et al. (2003) performed the ALI culture with murine primary gastric epithelial cells seeded on a fibroblast-containing collagen gel layer. ALI condition resulted in a highly polarized epithelium and the fibroblastic support induced differentiation of the epithelial cells towards mature gastric surface mucus cells expressing MUC5AC. However, the model was only used for mouse primary cells and the applicability to human primary cells remains open. Moreover, the conducted studies using ALI did not give insights about the longevity of the culture.

Finally, the mechanism inducing the foveolar differentiation in this model is not explored.