FORM 2
THE PATENTS ACT, 1970
(39 OF 1970)
&
THE PATENTS RULES, 2003
COMPLETE SPECIFICATION
(See Section 10; Rule 13)
TITLE
METHODS FOR REPROGRAMMING CELLS AND USES THEREOF
APPLICANT
NEW WORLD LABORATORIES INC.
NATIONALITY: CANADA
OF 500 CARTIER BLVD WEST, LAVAL, QUEBEC H7V
5B7
CANADA
The following specification particularly describes the nature of the invention and the manner in which it is to be performed.

METHODS FOR REPROGRAMMING CELLS AND USES THEREOF Related application
This application claims priority to US provisional application No. 61/256,967 filed on October 31, 2009 which is incorporated herein by reference in its entirety.
Field of the Invention
The present invention relates to the field of eukaryotic ceil reprogramming, and particularly to cell dedifferentiation. The invention is also concerned with methods of generating stable Neural Stem-Like Cells (NSLCs) from human somatic cells (and other cells) and the use of the cells so generated in human therapy.
Background of the Invention
Cell reprogramming
There is a desire in the medical, scientific, and diagnostic fields to reprogram an easily obtainable cell into a cell that is generally harder to obtain, or to reprogram a cell to have new or different functionalities, without fusing or exchanging material with an oocyte or another stem cell.
According to a first mechanism, a stem cell can naturally divide or differentiate into another stem cell, progenitor, precursor, or somatic cell. According to a second mechanism, somatic cell can sometimes transiently change its phenotype or express certain markers when placed in certain conditions, and then revert back when placed back into the original conditions. According to a second mechanism, the phenotype of many cells can be changed through forced expression of certain genes (for example, stably transfecting the c-myc gene into fibroblasts turns them into immortal cells having neuroprogenitor characteristics), however once this forced gene expression is removed, the cells slowly revert back to their original state. Therefore, none of the three above mechanisms should be considered true reprogramming: the first is considered natural differentiation which is part of a cell program that is already in place (going from a more undifferentiated to a more differentiated state), the second is a transient phenotypical change, and the third is a constantly forced cell type. A true stem ceil: (i) self-renews almost 'indefinitely' (for significantly longer than a somatic cell), (ii) is not a cancerous cell, (iii) is not artificially maintained by forced gene expression or similar means (must also be able to be maintained in standard stem cell media), (iv) can differentiate to progenitor, precursor, somatic or other more differentiated cell type (of the same lineage), and (v) has all the characteristics of a stem cell and not just certain markers or gene expression or morphological appearance.

Despite the numerous scientific and patent publications claiming successful reprogramming or dedifferentiation, generally into a stem cell, almost all of these publications do not disclose true reprogramming because they fall under one of the mechanisms mentioned above. For instance, Bhasin (WO2010/088735), Cifarelii et al. (US2010/0003223), Kremer et al. (US2004/0009595), and Winnier et al. (US2010/0047908) all refer to reprogramming, dedifferentiation, and/or obtained stem ceils (or progenitors) as phenotypical cell changes based only on a change in cell surface markers after culture in different media with supplements, with no evidence of true reprogramming or an actual stem cell (non-cancerous self-renewal with stem cells markers and no differentiation markers). The same is true for Benneti (WO2009/079007) who used increased expression of Oct4 and Sox2. Others, such as Akamatsu et al. (WO2010/052904) and You et al. (WO2007/097494, US2009/0246870), refer to having made stem cells, but these came about through constant artificial gene induction delivered by retrovirus (similar to cMyc) with no evidence of true stem cells that are not immortal/ tumorigenic, and stable instead of transient. Others, such as Chen et al. (US2005/0176707) and You et al. (US2009/0227023), have made "muitipotent cells", but not stem cells. In addition these alledged multipotent ceils were not stable (in the case of You et al. the cells could not even proliferate) and both used constant media supplements and conditions to force the phenotypical change. Yet others, such as Oliveri et al. (WO2009/018832) and Zahner et al. (US2002/0136709), have claimed the making of pluripotent, totipotent, multipotent, and/or unipotent cells automatically through genome-wide DNA demethylation and histone acetylation, but with no evidence of a stable, non-cancerous, true ceil line.
True reprogramming appears to have been achieved with induced pluripotent stem cells (iPS ceils) created independently by Yamanaka's group (Takahashi et al., 2007) and Thomson's group (Yu et al., 2007), and potentially by others before them, and although many of these cells were later found to be cancerous, some of them were not. These cells can be induced by true reprogramming since it was later shown that they can also be induced by non-gene integrating transient transfection (Soldner et al., 2009; Woltjen et al., 2009; Yu et al., 2009) as well as by RNA (Warren et al., 2010) or protein (Kim et a!., 2009; Zhou et al., 2009) alone or by small molecules (Lyssiotis et al., 2009), and by similar methods. However, these cells are essentially identical to embryonic stem cells and have the same problems of uncontrolled growth, teratoma formation, and potential tumor formation. .
A more desirable option is to have multipotent stem cells or pluripotenf-like cells whose lineage and differentiation potential is more restricted so that they do not readily form teratomas and uncontrolled growth. There is thus a need for methods of creating multipotent stem cells, multipotent stem-like cells, and stem-like cells and method of reprogramming or transforming

easily obtainable cells to highly desirable multipotent stem cells, multipotent stem-like cells, and stem-like cells.
Neural stem-like cells (NSLC)
Repairing the central nervous system (CNS) is one of the frontiers that medical science has yet to conquer. Conditions such as Alzheimer's disease, Parkinson's disease, and stroke can have devastating consequences for those who are afflicted. A central hope for these conditions is to develop cell populations that can reconstitute the neural network, and bring the functions of the nervous system back in line. For this reason, there is a great deal of evolving interest in neural stem and progenitor cells. Up until the present time, it was generally thought that multipotent neural progenitor cells commit early in the differentiation pathway to either neural restricted cells or glia restricted cells.
Neural stem cells have promise for tissue regeneration from disease or injury; however, such therapies will require precise control over cell function to create the necessary cell types. There is not yet a complete understanding of the mechanisms that regulate cell proliferation and differentiation, and it is thus difficult to fully explore the plasticity of neural stem cell population derived from any given region of the brain or developing fetus.
The CNS, traditionally believed to have (imited regenerative capabilities, retains a limited number of neural stem cells in adulthood, particularly in the dentate gyrus of the hippocampus and the subventricular zone that replenishes olfactory bulb neurons (Singec I et a/., 2007; Zielton R, 2008). The availability of precursor cells is a key prerequisite for a transplant-based repair of defects in the mature nervous system. Thus, donor cells for neural transplants are largely derived from the fetal brain. This creates enormous ethical problems, in addition to immuno-rejection, and it is questionable whether such an approach can be used for the treatment of a large number of patients since neural stem cells can lose some of their potency with each cell division.
Neural stem cells provide promising therapeutic potential for cell-replacement therapies in neurodegenerative disease (Mimeault et a/., 2007). To date, numerous therapeutic transplantations have been performed exploiting various types of human fetal tissue as the source of donor material. However, ethical and practical considerations and their inaccessibility limit the availability as a cell source for transplantation therapies (Ninomiy M et a/., 2006).
To overcome barriers and limitations to the derivation of patient specific cells, one approach has been to use skin cells and inducing the trans-differentiation to neural stem cells and/or to neurons (Levesque et al., 2000). Transdifferentiation has been receiving increasing attention during the past years , and trans-differentiation of mammalian cells has been achieved in co-

culture or by manipulation of ceil culture conditions. Alteration of cell fate can be induced artificially in vitro by treatment of cell cultures with microfilament inhibitors (Shea et al., 1990), hormones (Yeomans et al, 1976), and Calcium-ionophores (Shea, 1990; Sato et al, 1991). Mammalian epithelial cells can be induced to acquire muscle-like shape and function (Paterson and Rudland, 1985), pancreatic exocrine duct cells can acquire an insulin-secreting.endocrine phenotype (Bouwens, 1998a, b), and bone marrow stem cells can be differentiated into liver cells (Theise et al, 2000) and into neuronal cells (Woodbury et al., 2000). Other such as Page et al. (US 2003/0059939) have transdifferentiated somatic cells to neuronal ceils by cuituring somatic cells in the presence of cytoskeletal, acetylation, and methylation inhibitors, but after withdrawal of the priming agent, neuron morphology and established synapses last for not much than a few weeks in vitro, and complete conversion to a fully functional and stable type of neuron has never been demonstrated. These are thus transient cell phenotypes. Complete conversion to a fully functional and stable type of neuroprogenitor or neural stem cell has also never been demonstrated. Acquisition of a stable phenotype following transdifferentiation has been one of the major challenges facing the field.
Thus, there is a need in the biomedical field for stable, potent, and preferably autologouos neural stem cells, neural progenitor cells, as well as neurons and glial cells for use in the treatment of various neurological disorders and diseases. The same is true for many other types of cells. Recently, evidence have been obtained that genes of the basic Helix-Loop-Helix (bHLH) class are important regulators of several steps in neural lineage development, and over-expression of several neurogenic bHLH factors results in conversion of non-determined ectoderm into neuronal tissue. Proneural bHLH proteins control the differentiation into progenitor cells and their progression through the neurogenic program throughout the nervous system (Bertrand et al, 2002). MASH1, NeuroD, NeuroD2, MATH1-3, and Neurogenin 1-3 are bHLH transcription factors expressed during mammalian neuronal determination and differentiation (Johnson et al, 1990; Takebyashi et al, 1997; McCormick et al., 1996; Akazawa et al, 1995). Targeted disruptions of MASH1, Ngn1, Ngn2 or NeuroD in mice lead to the loss of specific subsets of neurons (Guillemot et al, 1993; Fode et al, 1998; Miyata et al, 1999).
U.S. patent No. 6,087,168 (Levesque et al.,) describes a method for converting, or transdifferentiating epidermal basal cells into viable neurons. In one example, this method comprises the transfection of the epidermal cells with one or more expression vector(s) containing at least one cDNA encoding for a neurogenic transcription factor responsible for neural differentiation. Suitable cDNAs include: basic-helix-loop-helix activators, such as NeuroDI, NeuroD2, ASH1, and zinc-finger type activators, such as Zic3, and MyT1. The transfection step was followed by adding at least one antisense oligonucleotide known to suppress neuronal differentiation to the growth medium, such as the human MSX1 gene and/or the human HES1 gene (or non-human, homologous counterparts). Finally, the transfected cells

were grown in the presence of a retinoid and a least one neurotrophin or cytokine, such as brain derived neurotrophic factor (BDNF), nerve growth factor (NGF), neurotrophin 3 (NT-3), or neurotrophin 4 (NT-4). This technology yields 26% of neuronal cells; however, neither ' functionality nor stability of these cells was established, in addition, neural stem cells or neuroprogenitor cells are not produced according to this method.
A later process (Levesque et a/., 2005; U.S. patent No. 6949380) mentions the conversion of the epidermal basal cell into a neural progenitor, neuronal, or glial cell by exposing the epidermal basal cell to an antagonist of bone morphogenetic protein (BMP) and growing the cell in the presence of at least one antisense oligonucleotide comprising a segment of a MSX 1 gene and/or HES1 gene. However, there is no evidence or examples that any neural progenitors or glial cells were produced according to this method, let alone any details or evidence that morphological, physiological or immunological features of neuronal cells was achieved. In addition, since there is also no information on functionality, stability, expansion, and yield about the cells which may or may not have been produced, it is possible that these cells actually are skin-derived precursor cells (Fernandes et al., 2004) that have been differentiated into neuronal cells.
In view of the above, there is thus a need for stable, potent, and preferably autologouos neural stem cells, neural progenitor cells, neurons and glial cells, as well as other types of cells, stem cells and progenitor cells. There is also a need for methods that could result in true cell dedifferentiate and cell reprogramming.
The present invention addresses these needs and provides various types of stem-like and progenitor-like cells and cells derived or differentiated from these stem-like or progenitor-like cells, as well as methods that can result in true cell dedifferentiation and cell reprogramming.
Additional features of the invention will be apparent from a review of the disclosure, figures and description of the invention herein.
Summary of the Invention
The present invention relates to stem-like and progenitor-like cells and cells derived or differentiated from these stem-like or progenitor-like cells. The invention further relates to methods for cell dedifferentiation and cell reprogramming. The invention further features compositions and methods that are useful for reprogramming cells and related therapeutic compositions and methods.
One particular aspect relates to the development of a technology to reprogram a somatic cell or non-neuronal cell to a cell having one or more morphological physiological, and/or immunological features of a neural stem cell and which possess the capacity to differentiate

along neuronal and glial lineages. According to some embodiments, the invention is more particularly concerned with methods of generating stable Neural Stem-Like Cells (NSLCs) from • . human somatic cells, human progenitor cells and/or of human stem cells, as'well as cells, cell lines and tissues obtained by using such methods.
The invention further relates to compositions and methods to induce de-differentiation of human somatic cells into Neural Stem-Like Cells that express neural stem cell specific markers. According to the present invention it is possible to effect the conversion of cells to various types of differentiated neuronal cells that can be created from a single cell type taken from an individual donor and then reprogrammed and transplanted into the same individual. Upon induction cells according to the invention express neural stem-cell specific markers and become Neural Stem-Like ceils.
According to one particular aspect, the invention relates to a method of transforming a cell of a first type to a desired cell of a different type. The comprises i) obtaining a cell of a first type; ii) transiently increasing in the cell of a first type intracellular levels of at least one reprogramming agent, whereby the transient increase induces direct or indirect endogenous expression of at least one gene regulator; iii) placing the cell in conditions for supporting the growth and/or the transformation of the desired ceil and maintaining intracellular levels of the at least one reprogramming agent for a sufficient period of time to allow stable expression of the at least one gene regulator in absence of the reprogramming agent; and iv) maintaining the cell in culture conditions supporting the growth and/or the transformation of the desired cell. Such conditions are maintained for a sufficient period of time to allow a stable expression of a plurality of secondary genes. According to the invention the expression of one or more of the secondary genes is characteristic of phenotypical and functional properties of the desired cell while being not characteristic of phenotypical and functional properties of an embryonic stem cell. Therefore, at the end of the period of time, the desired cell of a different type is obtained.
According to another particular aspect, the invention relates to a method of transforming a ceil of a first type to a cell of a second different type. The method comprises contacting the cell of a first type with one or more agents capable of increasing within said cell levels of at least one reprogramming agent and directly or indirectly remodeling the chromatin and/or DNA of the cell. The at least one reprogramming agent is selected for inducing directly or indirectly the expression of morphological and functional characteristics of a desired cell of a different type or different cell lineage.
According to another aspect, the invention relates to a method of transforming a cell of a first type to a cell of a second different type. The method comprises contacting the chromatin and/or DNA of a cell of a first type with an agent capable of remodeling chromatin and/or DNA of said cell; and increasing intracellular levels of at least one reprogramming agent. The at least one

reprogramming agent is selected for inducing directly or indirectly the expression of morphological and functional characteristics of a desired cell of a different type or cell lineage.
A further aspect of the invention relates to a method of transforming a cell of a first type to a cell of a desired cell of a different type, comprising increasing intracellular levels of at least one reprogramming agent, wherein the at least one reprogramming agent is selected for inducing directly or indirectly the expression of morphological and functional characteristics of a desired second cell type; and maintaining the cell of a first type in culture conditions for supporting the transformation of the desired cell for a sufficient period of time to allow stable expression of a plurality of secondary genes whose expression is characteristic of phenotypical and functional properties of the desired cell, wherein at least one of the secondary genes is not characteristic of phenotypical and functional properties of an embryonic stem cell. At the end of the period of time the desired cell of a different type is obtained and the obtained cell is further characterized by a stable repression of a plurality of genes expressed in the.first cell type.
A further aspect of the invention concerns a process wherein a cell of a first type is reprogrammed to a desired cell of a different type, the process comprising:
- a transient increase of intracellular levels of at least one reprogramming agent, wherein the at least one reprogramming agent induces a direct or indirect endogenous expression of at least one gene regulator, and wherein the endogenous expression of the said at least one gene regulator is necessary for the existence of the desired cell of a different type;
- a stable expression of said at least one gene regulator;
- stable expression of a plurality of secondary genes, wherein the stable expression of the secondary genes is the result of the stable expression of the at least one gene regulator, and wherein: (i) stable expression of the plurality of secondary genes is characteristic of phenotypical and/or functional properties of the desired cell, (ii) stable expression of at least one of said secondary genes is not characteristic of phenotypical and functional properties of an embryonic stem cell, and wherein (i) and (ii) are indicative of successful reprogramming of the cell of the first type to the desired cell of the different type.
In particular embodiments, the at least one reprogramming agent in the process is a Msi1 polypeptide, or a Ngn2 polypeptide together with a MDB2 polypeptide. In particular embodiments, the at least one gene regulator is Sox2 Msi1, or both. In additional embodiments the at least one gene regulator may is one or more of the genes listed in Table A for Neural Stem-Like Cells.
According to another aspect, the invention relates to a method of obtaining a Stem-Like Cell (SLC), comprising:
i) providing a cell of a first type;

ii) transiently increasing in the cell intracellular levels of at least one reprogramming agent, whereby the transient increase induces direct or indirect endogenous ' expression of at least one gene regulator;
iii) placing the cell in conditions for supporting the transformation into the stem-like cell and maintaining intracellular levels of the at least one reprogramming agent for a sufficient period of time to allow stable expression of the at least one gene regulator in absence of the reprogramming agent;
iv) maintaining the cell in culture conditions for supporting the transformation into the stem-like cell, for a sufficient period of time to allow stable expression of a plurality of secondary genes whose expression is characteristic of phenotypical and/or functional properties of the stem-like cell, wherein at least one of the secondary genes is not characteristic of phenotypical and functional properties of an embryonic stem cell. At the end of said period of time a stem-like cell is obtained.
According to another aspect, the invention relates to a method of obtaining a Stem-Like Cell. The method comprises increasing intracellular, levels of at least one polypeptide specific to the desired stem cell type that is able to drive directly or indirectly transformation of the cell of the first type into the Stem-Like Cell. For increasing the yield or type of Stem-Like Cell, the method may further comprises contacting chromatin and/or DNA of a cell of a first type with a histone acetylator, an inhibitor of histone deacetylation, a DNA demethylator, and/or an inhibitor of DNA methylation; and/or increasing intracellular levels of at least one other polypeptide specific to the desired stem cell type that is able to drive directly or indirectly transformation of the cell of the first type into a Stem-Like Cell.
According to another aspect, the invention relates to a method of obtaining a Neural Stem-Like Cell (NSLC). The method comprises increasing intracellular levels of at least one neural stem cell specific polypeptide that is able to drive directly or indirectly transformation of the cell of the first type into a NSLC. For increasing the yield or type of NSLC, the method further comprises.contacting chromatin and/or DNA of a cell of a first type with a histone acetylator, an inhibitor of histone deacetylation, a DNA demethylator, and/or an inhibitor of DNA methylation; and/or increasing intracellular levels of at least one other neural stem cell specific polypeptide that is able to drive directly or indirectly transformation of the cell of the first type into a NSLC.
Another aspect of the invention concerns a method of obtaining a Neural Stem-Like Cell (NSLC). In one embodiment the method comprises transfecting a skin cell with a polynucleotide encoding MusashM, MusashM and Neurogenin 2, MusashM and Methyl-CpG Binding Domain Protein 2 (MBD2), or Neurogenin 2 and Methyl-CpG Binding Domain Protein 2, thereby reprogramming the skin cell into a NSLC. In another embodiment the method comprises exposing a skin cell to: (i) an inhibitor of histone deacetylation, (ii) an inhibitor of DNA

rrtethylation, (iii) a histone acetylator, and/or (iv) a, DNA demethyiator such as a MBD2 polypeptide and/or transfecting with a polynucleotide encoding a MBD2 polypeptide; and further transfecting the' cell (either simultaneously, before, or afterwards) with a polynucleotide encoding MUSASHI1 and/or with a polynucleotide encoding NGN2, thereby reprogramming the skin cell into a NSLC. Some other cells, such as keratinocytes and CD34+ cells, can also be used and reprogrammed.
In one particular embodiment, the method of obtaining a Neural Stem-Like Cell (NSLC), comprises:
- providing a cell of a first type;
- introducing into the cell one or more polynucleotide capable of transient expression of one or more the following polypeptides: Musashil (Msi1); a Musashil (Msi1) and a Neurogenin 2 (Ngn2); a Musashil (Msi1) and methyl-CpG binding domain protein 2 (MBD2); and Neurogenin 2 (Ngn2) and methyi-CpG binding domain protein 2 (MBD2); and
- placing the cell in culture conditions supporting the transformation into a NSLC for a sufficient period of time to allow a stable expression of a plurality of genes whose expression is characteristic of phenotypical and functional properties of a NSLC.
At the end of the period of time a NSLC is obtained and the obtained NSLC is further characterized by a stable repression of a plurality of genes expressed in the first cell type.
According to another embodiment, the method of obtaining a Neural Stem-Like Cell (NSLC), comprises:
- providing a cell of a first type which is not a NSLC;
- increasing intracellular levels of at least one neural stem cell specific polypeptide, wherein the polypeptide is capable of driving directly or indirectly transformation of the ceil of the first type into a NSLC; and
- contacting the chromatin and/or DNA of the cell of a first type with a histone acetylator, an inhibitor of histone deacetylation, a DNA demethyiator, and/or a chemical inhibitor of DNA methylation.

According to another embodiment, the method of obtaining a Neural Stem-Like Cell (NSLC), comprises:
-obtaining a non-NSLC;
-co-transfecting the non-NSLC with a first polynucleotide encoding a MBD2
polypeptide and with at least one second polynucleotide encoding a MUSASHI1
polypeptide and/or encoding a NGN2 polypeptide;
- placing the co-transfected cell in culture conditions for supporting the
transformation of NSLC until said NSLC is obtained.
Certain aspects of the invention concerns isolated ceils, cell lines, compositions, 3D assembly of cells, and tissues comprising ceils obtained using the methods described herein. Additional aspects concerns the use of such isolated cells, cell lines, compositions, 3D assembly of cells, and tissues of medical treatment and methods of regenerating a mammalian tissue or organ.
Yet, a further aspect concerns a method for repairing or regenerating a tissue in a subject. In one embodiment the method comprises the administration of a reprogrammed cell as defined herein to a subject in need thereof, wherein the administration provides a dose of reprogrammed cells sufficient to increase or support a biological function of a given tissue or organ, thereby ameliorating the subject's condition.
The benefits of the present invention are significant and include lower cost of cell therapy by eliminating the need of immuno-suppressive agents, no need for embryos or fetal tissue, thus eliminating ethical and time constraints, lower cost of production, and no health risks due to possible transmission of viruses or other disease. In addition, since the cells are created fresh, they tend to be more potent than cells that have been passaged multiple times.
Additional aspects, advantages and features of the present invention will become more apparent upon reading of the following non-restrictive description of preferred embodiments which are exemplary and should not be interpreted as limiting the scope of the invention.
Brief Description of the Figures
Figure 1 is a panel of light micrograph (10X) presenting cell morphology changes of untransfected and transfected cells with Msi1 and MBD2 at various time points.
Figure 2 is a panel of photomicrographs obtained using Cellomics™ (10x) and revealing NCAM positive cells in transfected cells with Msil or Ngn2 in the presence of MBD2. HFFs were pre-treated with cytochalasin B (10µg/ml) and transfected with pCMV6-XL5-Msi1 and pCMV6-XL5-MBD2 or pCMV6-XL4-Ngn2 and pCMV6-XL5-MBD2. After 24h following transfection, the medium was changed and cells were cultured in proliferation medium (NPBM, Lonza) supplemented with EGF (20ng/ml) and bFGF (20ng/ml) for one week. Differentiation was

induced by changing the medium to NbActive (BrainBits™) supplemented with NGF (20ng/ml), bFGF (20 ng/ml), ATRA (5jiM) and Forskolin (10µM). Cells were incubated at 37°C, 5%C02, 5%O2 for 20 days.
Figure 3 is a panel of photomicrographs obtained using Cellomics™ (10x) and revealing MAP2b positive cells in transfected ceils with Msi1 or Ngn2 in the presence of MBD2. MAP2b positive cells were undetectable in untransfected cells and cells transfected with Pax6/MBD2. HFFs were pre-treated with cytochalasin B (10µg/ml) and transfected with pCMV6-XL5-Msi1, pCMV6-XL4-Ngn2 or pCMV6-XL5-Pax6, and pCMV6-XL5-MBD2. After 24h following' transfection, the medium was changed and cells were cultured in proliferation medium (NPBIvl, Lonza) supplemented with EGF (20ng/ml. Peprotech) and bFGF (20ng/ml, Peprotech) for one week. Differentiation was induced by changing the medium to NbActive (BrainBits™) supplemented with NT-3 (20ng/ml), bFGF (20 ng/ml), ATRA (5µM) and Forskolin (10µM). Cells were incubated at 37°C, 5%CO2, 5%02 for 2 weeks.
Figure 4A is a panel of photographs showing that neurospheres formed by NSLCs from Example V were completely dissociated into single cell suspensions using Accutase and one single cell was monitored over time to reveal neurosphere formation capacity (A, Light microscope observation). Neurospheres stained positive for Sox2.
Figure 4B is a panel of photographs from immunohistochemistry results obtained using Cellomics™. Immunohistochemistry was performed, on day 20, to detect makers for neurospheres and compared to expression levels in neurospheres formed by normal human neuroprogenitor cells (hNPC, Lonza). In addition to Sox2, cells stained positive for the neural stem cells markers Musashi, CD133, Nestin, and GFAP. Cells also stained positive for BllI-tubulin (a marker for neurons), 04 (a marker for oligodendrocytes), and GFAP (a marker for astrocytes), indicating the tri-potent differentiation potential of both sets of cells (NSLC and hNPC), and negative for NGFrec and NeuN (markers for differentiated neurons) indicating that the cells were hot terminally differentiated.
Figure 5 is a panel photomicrographs from immunohistochemistry results obtained using Cellomics™. Immunohistochemistry was performed on HFFs, NSLCs, and hNPCs to detect expression of markers for fibroblasts as well as neural stem cells (Sox2, Nestin, GFAP) in adherent cultures (that prevented cells from floating and forming neurospheres). Nuclei were stained with Hoechst (upper level pictures). HFFs expressed fibroblasts markers while NSLCs created from these HFFs did not. In comparison, the NSLCs expressed neural stem cell markers similarly to hNPCs while the HFFs did not express any of these markers.
Figure 6 is a panel photomicrographs showing Human NSLCs. Human NSLCs were induced to differentiate into neuronal lineages in the presence of NS-A differentiation medium (StemCell

Technologies) in the presence of BDNF (20ng/ml, Peprotech) and bFGF (40ng/ml, Peprotech) for three weeks. At different time point of differentiation, immunostaining using Cellomics™ (10x) revealed differentiation of the cells as shown by the decrease of Sox2 positive cells'and increase in the number and intensity of staining of p75, pill -tubulin and GABA positive ceils, as well as differentiated morphology, while the total number of cells increased as shown by Hoechst staining.
Figure 7 is another panel of photomicrographs. HFF, Keratinocytes, and CD34+ were . transfected with pCMV6-Msi1-Ngn2 and pCMV6-XL5~MBD2. After 24h following transfection, the medium was changed to proliferation medium (StemCell Technologies) supplemented with EGF (20ng/ml. Peprotech) and bFGF (20ng/mi, Peprotech) for two week and then analyzed. Photomicrographs using Cellomics™ (10x) show that NSLCs created from ail three types of cells are positive for Nestin, Sox2 and GFAP (markers for neural stem cells), while the original HFFs are not.
Figure 8 is panel of photomicrographs showing the effect of CDM medium on the trans-differentiation of HFF towards neurons. HFF were pre-treated with cytochalasin B (10µg/ml) and histone deacetylation inhibitor (VPA, 4 mM) and DNA meihylation inhibitor (5-Aza, 5µM and cultured in CDM medium containing 3:1 ratio of Dulbecco's modified Eagle medium (DMEM, high glucose (4.5g/L) with L-glutamine and sodium pyruvate) and Ham's F-12 medium supplemented with the following components: EGF (4.2x10-10M), bFGF (2.8x10"10M), ITS (8.6x10"5M), dexamethasone (1.0x10'-7M), L-ascorbic acid phosphate magnesium salt n-hydrate (3.2x10-4M), L-3,3',54riiodothyronine (2.0x10'10M), ethanolamine (10^M), GlutaMAX™ (4x10" 3M), glutathione (3.3x1 O^M). After 24h the culture medium was replaced with 75% of CDM medium and 25% of Neuronal Proliferation medium (Lonza, Cat#CC-3210); during the following 3 days, the ratio of the medias were changed to 50%:50%, 25%:75%, and then 100% Neuronal Proliferation medium by the third day. Photomicrographs were taken by Cellomics™ (10X) after immunostaining the cells with (3lll-tubulin (neuronal marker) and Hoechst (to stain nuclei) at different time-points. Cells started trans-differentiating within a few days and the trans-differentiatied cells were pIll-tubulin positive; however after one week a spontaneous reversion to fibroblastic shape and loss of plll-tubulin expression was observed.
Figure 9 is panel of photomicrographs showing characterization of reprogrammed ceils within
CDM at different time points following the transfection with Msi1 and Ngn2. The transfected cells
were treated with Cytochalasin B (10 fig/ml), VPA (4mM) and 5-AZA (5µM) resulting in a
disruption of the microfilaments and rounding up of the cells and loosening of the chromatin.
Immunohistochemistry on the 3-Dimensional CDM was performed after one and two weeks
using Cellomics™ (10X). The cells were positive for neuronal mature marker, such as MAP2b,
- but were-absent in the untransfected control CDM.

Figure 10 is another panel of photomicrographs. Cells within Day 4 CDM were lipotransfected with the two vectors pCMV6-XL5-Msi1 and pCMV6-XL4-Ngn2 individually or together in combination with pCMV-XL5-MBD2 for a period of 6 hours. In parallel, transfection was ' performed on fresh HFFs after the 6 hours using Nucleofection, and these fresh HFFs were placed on top of the CDM at the same time as the lipofectamine media was changed to fresh CDM medium after 6 hours. After 24 hours the medium was changed to Neural proliferation medium (NPBM, Lonza) with the presence of Noggin (50ng/m!, Peprotech), recombinant hFGF (20ng/mi, Peprotech), and recombinant hEGF (20ng/ml, Peprotech) for one week. Differentiation was induced at day 7, by adding NS-A differentiation medium (StemCell Technologies) for 24 days. Immunohistochemistry was performed at various time points using Cellomics™ (10X). The CDM was stained with a specific antibody against Nestin (a marker for neural stem cells), and cells within the CDM expressed Nestin at all timepoints tested (Day 8, 15, and 21) following transfection. Cells within the untransfected control CDM did not express any Nestin.
Figure 11 is a panel showing a picture of a polyacryiamide gel electrophoresis. NSLCs grown as adherent cultures or suspension cultures (as neurospheres) both express telomerase (which is expresses in all stem cells, but not in normal differentiated somatic cells). Both early (p5) and late (p27) passage NSLCs express telomerase. (The original HFFs from which the NSLCs were created did not express telomerase.) The samples (NSLCs) were spun down and protein concentration of the supernatant was determined using the BCA Assay. 900ng of protein from each ceil extract was added directly to the TRAP reaction mixture containing TRAP reaction buffer, dNTPs, template substrate (TS) primer, TRAP primer mix and Taq polymerase. The reaction mixtures were incubated at 30°C for 30 minutes for template synthesis, followed by a PCR procedure (95°C/15 min for initial denaturation, 94°C/30 sec, 59°C/30 sec, 72°C/1 min for 32 cycles) for amplification of the extended telomerase products. To detect telomerase activity, polyacryiamide gel electrophoresis (PAGE) was performed for the reaction products on a 10% non-denaturing TBE gel. After electrophoresis, the gel was stained with SYBR® Green I Nucleic Acid Gel Stain for 30 minutes, followed by image capture using the Gel-Documentation System (Alpha Innotech). All 4 samples were telomerase positive (as indicated by the TRAP product ladder).
Figure 12 is a panel showing a picture showing Southern blot analysis of two different NSLC samples analyzed for Msi1 and Ngn2 gene integration two weeks after transient transfection. The Dig-labeled PCR probe revealed distinct signals in the positive control samples where the Msi1/Ngn2 plasmid DNA was spiked into HFF genomic DNA for the equivalence of 1, 10 or 100 integrations per genome. There were a few weak and identical bands that appeared in the restriction enzyme digested genomic DNA from untransfected HFF and NSLC samples #1 and #2, suggesting that there was no plasmid DNA integration into the-genomic DNA-of NSLCs.

These faint bands may represent the endogenous Ngn2 gene since the 1.2 kb Dig-labeled PCR probe contains a small part of the Ngn2 gene. There were positive signals in the lane of the DNA kb ladder as the- bands belong to a number of plasmids digested to completion with appropriate restriction enzymes (NEB). This data shows that no, or only a tiny number of, NSLCs had plasmid integration into the host genome after transient transfection, and that the transiently transfected genes were only present in the cells for a short period of time (less than two weeks).
Figure 13 is a panel whith a line graph and a bar graph showing improvement and significantly better clinical scores in EAE mice treated with NSLCs. Female 8 weeks old C57BL/6 mice were immunized with MOG35-55 (Sheldon Biotechnology Centre McGill University) in CFA containing 5 mg/ml of desiccated (killed and dried) Mycobacterium tuberculosis H37Ra (Difco, inc) at two sites on the back, and injected with 200 ng of pertussis toxin (List Biological Laboratories, Inc) in PBS intraperitoneally on days 0 and 2. Once the mice started showing symptoms of EAE (on Day 13 post-immunization), they were intravenously injected with 200ul of NSLC (1 million cells), hNPC (1 million cells), saline, or saline with cyclosporine. All mice except the saline control group received daily injections of cyclosporine. Mice were scored daily for clinical disease; data represent average daily scores. Mice that received a single injection of NSLCs had a significantly lower disease severity than mice that received hNPCs or cyclosporine alone.
Figure 14 is a line graph showing the results of rotarod assessments according to Example XVII part 2. Rats were trained on the rotarod prior to the start of the experiment. Rats were placed on a stationary and rotating rotarod (rotating at 20 rpm) and the amount of time spent by the rats walking on the rotarod before falling off was monitored. Measurements were taken before (pre-surgery) and after (post-surgery) surgical left brain hemisphere ablation and treatment. The data points represent the mean number of falls by each animal during each 60 second testing session carried out at a constant speed of 20 rpm. Each group consisted of eight rats.
Figure 15 is a line graph showing the results of the walking beam assessments according to Example XVII part 2. Rats were measured on their ability to cross a 100 cm long beam after surgical left brain hemisphere ablation and treatment. Two days after surgery, all groups fail to pass the test, and the animals are not able to stay in balance on the beam. One week after the surgery, all the animals show an improvement on their walking capacity, but no significant difference was noticeable between the different treated groups. From week 4 until week 26, the animals treated with NSLCs show significant improvement in their walking capacity compared to the other groups.
Figure 16 is a panel showing photographs of ADSCs transiently transfected with various pluripotent vectors using nucleofector as described in Example XIX. Following the transfection -cells were cultured-in--6-well plates in suspension with-a 50:50 mixture of ADSC-complete-

medium (StemPro™-43) and embryonic stem cells medium (mTeSRI™, StemCel! Technologies). After two days in culture, cells were re-transfected with the same plasmids and plated in 96 well-plates coated with Matrigel™ (BD Biosciences) in the presence of mTeSRI™ complete medium supplemeneted with, thiazovivin (0.5u.M), an ALK-5 inhibitor (SB341542, Stemgent, 2µM), and an inhibitor of MEK (PD0325901, Stemgent, 0.5µM). Medium was changed every day and cells were cultured for 22 days at 37°C, 5% C02, 5% 02, followed by AP staining and imrnunohistochemistry to analyse the expression of pluripotency markers. Cells formed colonies and were found to express both pluripotency markers Oct4 and AP after transfecting cells with pEF-Rex1-EF-Oct4-2A-Klf4-2A-RFP.
Figure 17 is a panel showing photographs of ADSCs transiently transfected with pCMV6-XL5-Rex1/pCMV6-XL5-Klf4 and pCMV6-XL5-Rex1/pCMV6-XL4-Oct4. After the second transfection, ADSCs were cultured in 96-well plates coated with Matrigel™ for 24 days in the presence of mTeSRI™ medium supplemented with SB341542 and PD0325901 at 37°C, 5%C02l 5%02. In order to characterize subpopulations of cells after transfection, live staining, imrnunohistochemistry and AP staining were used. 1-5% of total ceils transfected with Rex1/Oct4 or Rex1/Klf4 showed a SSEA-4* and TRA-1-81+ phenotype (early pluripotency markers). The observation over time showed that the phenotype of these colonies moves from an early SSEA-4+ phenotype to a late Oct47Sox2/Nanog+ phenotype starting at Day 22, which was closer to the final reprogrammed state and a pluripotent-like cell.
Figure 18 is a panel showing photographs of ADSCs transiently transfected with various pluripotent vectors. Following transfection the cells were plated in StemPro™ MSC SFM medium on Matrigel™ (BD Biosciences) coated 24 well plates and incubated at 37°C, 5% C021 5%02. On day 1, media was changed to a mix of 75% StemPro™ MSC and 25% hES cell medium; the percentage of StemPro™ MSC SFM medium was decreased every day over four days to have 100% hES cell medium by day 4. Then medium was changed every two days. The hES cell medium consisted in Dulbecco's Modified Eagle's Medium (DMEM, Invitrogen) supplemented with 20% Knockout™ Serum Replacement (KSR, Invitrogen), 1 mM GlutaMAX™, 100 uM Non-essential Amino acids, 100 uM p-mercaptoethanol and 10 ng/ml Fgf-2. In order to characterize subpopulations of cells after transfection, live staining, imrnunohistochemistry and AP staining were used. Transfected cells transfected with Oct4/UTF1/MBD2, Oct4/Dppa4/MBD2, FoxD3/Dppa4/MBD2, Oct4/FoxD3/Dppa4, and Sox2/FoxD3/UTF1 were positive for SSEA-4+, TRA1-60, and TRA-1-81* phenotype (early pluripotency markers) at day 14.
Figure 19 is a panel showing photographs of transiently transfected HFFs. HFFs were transiently transfected using the Nucleofector® II Device (Lonza) following the procedure described in Example II with the exception that 1 ug of each of the following 3 DNA plasmids

was used: pCMV-Oct4nuc-IRES2-Sox2nuc, pCMV-Klf4nuc-IRES2-Cmycnuc and pCMV-Nanognuc~IRES2-Lin28. The ceils were pre-treated with or without VPA and 5-Aza. Following transfection the cells were plated in the fibroblast medium, supplemented with or without VPA (2mM) and 5-AZA (2.5µM) on Matrigel™ (BD Biosciences) coated 6-weIi plates and incubated at 37°C, 5% CO2. On Day 1 and 2, media was changed to 100% mTeSRI™ medium (StemCell Technologies) supplemented with or without VPA and 5-AZA. On Day 3 and 6, cells were re-transfected as above and plated on Matrigel™ coated plates in mTeSRI™ medium supplemented with or without VPA and 5-AZA. Media was changed daily as above. Medium was supplemented with Y27632 (Stemgent, 10 µM) from Day 7 to Day 14 to promote viability and clonal expansion of potential reprogrammed cells. Cells were analysed at day 20 using the Alkaline Phosphatase Detection Kit (Millipore) and by immunohistochemistry analysis. Some cells stained positive for the pluripotency markers AP, SSEA-4 and TRA-1-81 (similar to Mel2 human embryonic stem cell line (positive control)). These clones were obtained only in the condition that did not contain inhibitors (i.e.: VPA and 5-AZA). No clones were observed for the condition treated with these inhibitors.
Figure 20 is a panel showing photographs of transfected NSLCs and BG-01. NSLCs and BG-01 NS were transfected as previously described in Example II by two episoma! vectors, pEF-Oct4nuc-IRES2-MBD2 (NC1) or pCMV-FoxD3-2A-Oct4-2A-Klf4 (F72). Following transfection cells were collected and plated onto uncoated petri-dishes in the presence of Proliferation medium and mTeSRI™ medium (50:50) into proliferation conditions at 37°C, 5%C02. After 48 hours, cells were re-transfected by the same plasmid and plated in 96-welt plates coated with Matrigel™ and cultured in the presence of mTeSRI™ medium supplemented by the small molecules BIX01294 (Stemgent, 2µM) and BayK8644 (Stemgent, 2µM) at 37°C, 5%02 for 22 days, after which live staining and immunohistochemistry were performed to characterize subpopulations of cells for pluripotency markers. Cells formed colonies positive for both TRA-1-81 and SSEA-4 indicative of pluripotent-like cells.
Figure 21 is a pane! showing bright field pictures at day 17 of fibroblasts transfected with Msi1/Ngn2 and pCMV6-XL5-MBD2 placed in different media conditions and showing different morphologies and degree of differentiation, (a) Cells in neural proliferation medium from day 1 to day 12, and then in neural differentiation medium with cytokines from day 12 to 17. (b) Cells in neural proliferation medium from day 1 to day 12, and then in NbActive4 medium with cytokines from day 12 to 17. (c) Cells in neural differentiation medium with cytokines plus Fgf-2 from day 1 to day 12, and then in the same medium but without Fgf-2 from day 12 to 17. (d) Cells in NbActive4 medium with cytokines plus Fgf-2 from day 1 to day 12, and in then the same medium but without Fgf-2 from day 12 to 17. (e) Cells in CDM ll medium with cytokines plus Fgf-2 from day 1 to day 12, and in then the same medium but without Fgf-2 from day 12 to 17.

Figure 22 is a panel showing pictures of immunochemistry results at day 17 of fibroblasts transfected with Msi1/Ngn2 and pCMV6-XL5-MBD2 in Figure 21. Fig. 22A and 22B: Cells were in NS-A Proliferation Medium from day 1 to day 12, and then in NS-A Differentiation Medium (A) or NBActive4 medium (B) with cytokines from day 12 to 17. There were more cells in B, but Differentiation from day 12-17 was too short to induce expression of Blll-tubuiin in both cases. Figs. 22C-E: Cells were in NS-A Differentiation Medium (C) or NbActive4 medium (D) from day 1-17 (with FGF-2 supplementation from day 1-12), or CDM II medium from day 1-12 and then NS-A Differentiation Medium from day 12-17 (E). There were a large number of cells in C and a much smaller number of cells in D and E. Cells were immunopositive for both GFAP and pill-tubulin in all cases and placing the cells in differentiation or non-proliferation media from day 1 onwards appears to have induced a more direct transformation into neurons and glia, with more intense BIll-tubulin than GFAP positive cells in E.
Figure 23 is a panel showing two heat maps providing a global overview of the gene expression comparison between either NSLC vs. HFF (Set 1), or NSLC vs. hNPC (Set 2). NSLC has a distinct gene expression profile when compared to either HFF or hNPC. Based on the intensity (the higher the intensity, the higher the relative change in expression), NSLC is much more similar to hNPC than to HFF.
Figure 24 is a panel showing pictures of NSLCs. NSLCs were tested to determine if they are a population of Skin-Derived Precursors Cells (SKPs). SKPs capable of proliferating in response to EGF and bFGF, express nestin and fibronectin, and can differentiate into both neuronal and mesodermal progeny including into adipocytes. For this purpose a standard protocol for turning SKPs into adipocytes was performed, in which adipocyte-derived stem cells (ADSCs) and NSLCs were cultured in StemPro™ proliferation medium and differentiation towards adipocytes were induced by culturing these cells in differentiation medium consisting in DMEM/F12 (50:50), ITS (1: 100), HEPES (1:100), GlutaMAX™ (1:100), T3 (0.2 nM), Rosiglitasone (0.5 µg/ml), IBMX (100µM) and Dexamethasone (1 µM). Three days later, IBMX and Dexamethasone were withdrawn from the medium. At day 10, cells were fixed with a 4% formaldehyde solution for 10 min and stained with Oil Red O (Invitrogen) staining solution. Adipose cells appeared red with lipid droplets (bright white spots in left picture) specifically stained with Oil Red O; however NSLCs stained negative and had no presence of lipid droplet in the cells, but instead adopted neuronal cell morphology. These results conform that NSLCs are not a population of Skin-Derived Precursors Cells (SKPs).
Detailed Description of the Invention
The present invention relates to methods for cell dedifferentiation and cell reprogramming. A significant aspect of the present invention is that it permits the use of a patient's own cells to devetop-different types of cells that can be transplanted after steps of in vitro dedifferentiation

and in vitro reprogramming. Thus, this technology eliminates the problems associated with transplantation of non-host cells, such as, immunological rejection and the risk of transmitting disease. In addition, since the cells are "newly created", they have the potential to be more potent than alternative sources of natural cells that have already divided multiple times.
Definitions
As used herein and in the appended claims, the singular forms "a," "an", and "the", include plural referents unless the context clearly indicates otherwise. Thus, for example, reference to "a cell" includes one or more of such cells or a cell line derived from such a cell, reference to "an agent" includes one or more of such agent, and reference to "the method" includes reference to equivalent steps and methods known to those of ordinary skill in the art that could be modified or substituted for the methods described herein.
As used herein, the term "polynucleotide" refers to any DNA or RNA sequence or molecule, comprising encoding nucleotide sequences. The term is intended to encompass all polynucleotides whether occurring naturally or non-naturafly in a particular cell, tissue or organism. This includes DNA and fragments thereof, RNA and fragments thereof, cDNAs and fragments thereof, expressed sequence tags, artificial sequences including randomized artificial sequences.
As used herein, the term "polypeptide" refers to any amino acid sequence having a desired functional biological activity (e.g. DNA demethylation). The term is intended to encompass complete proteins, fragments thereof, fusion proteins and the like, including carbohydrate or lipid chains or compositions.
"Trans-differentiation" refers to a direct switch of an already differentiated cell to another type of differentiated cell.
"De-differentiation" refers to the loss of phenotypic characteristics of a differentiated cell by activating or deactivating genes or metabolic pathways.
"Marker" refers to a gene, polypeptide, or biological function that is characteristic of a particular cell type or cellular phenotype.
"Genetically-engineered DNA sequence" is meant a DNA sequence wherein the component sequence elements of DNA sequence are organized within the DNA sequence in a manner not found in nature.
"Signal sequence" refers to a nucleic acid sequence which, when incorporated into a nucleic acid sequence encoding a polypeptide, directs secretion of the translated polypeptide from cells which express said polypeptide; or-allows the polypeptide -to~readily cross the cell membrane

into a cell. The signal sequence is preferably located at the 5' end of the nucleic acid sequence encoding the polypeptide, such that the polypeptide sequence encoded by the signal sequence is located at the N-terminus of the translated polypeptide. By "signal peptide" is meant the peptide sequence resulting from translation of a signal sequence.
"Ubiquitous promoter" refers to a promoter that drives expression of a polypeptide or peptides encoded by nucleic acid sequences to which promoter is operably linked. Preferred ubiquitous promoters include human cytomegalovirus immediate early (CMV); simian virus 40 early promter (SV40); Rous sarcoma virus (RSV); or adenovirus major late promoter.
"Gene expression profiling" means an assay that measures the activity of multiple genes at once, creating a global picture of cellular function. For example, these profiles can distinguish between human neural stem cells and somatic cells that are actively dividing or differentiating.
"Transfection" refers to a method of gene delivery that introduces a foreign nucleotide sequences (e.g. DNA molecules) into a cell preferably by a non-viral method, in preferred embodiments according to the present invention foreign DNA is introduced to a cell by transient transfection of an expression vector encoding a polypeptide of interest, whereby the foreign DNA is introduced but eliminated over time by the cell and during mitosis. By "transient transfection" is meant a method where the introduced expression vectors and the polypeptide encoded by the vector, are not permanently integrated into the genome of the host cell, or anywhere in the cell, and therefore may be eliminated from the host cell or its progeny over time. Proteins, polypeptides, or other compounds can also be delivered into a cell using transfection methods.
"Neuroprogenitor Cell" refers to an immature cell of the nervous system, which can differentiate into neurons and glia (oligodendrocytes and astrocytes). "Neural Stem Cell" is an ectoderm germ layer derived multipotent stem cell having, as a physiological feature, a capacity to form neuroprogenitor cells and under physiological conditions that favor differentiation to form neurons and glia. "Neural Stem-Like Cell" or "NSLC" refers to any cell-derived multipotent stem cell having, as a physiological feature, a capacity to form other neural stem-like cells and neuroprogenitor-like cells and under physiojogical conditions that favor differentiation to form neuron-like cells and glial-Nke cells.
"Neurosphere" refers to a cellular aggregate of neural stem cells and neuroprogenitor cells that form a floating sphere formed as a result of proliferation of the neural stem cells and neuroprogenitor cells in appropriate proliferation conditions. NSLCs also form neurospheres consisting of aggregates of NSLCs and neuroprogenitor-like cells.

"Reprogrammed cell" refers to a cell that has undergone stable trans-differentiation, de-differentiation, or transformation. Some reprogrammed cells can be subsequently induced to re-differentiate. The reprogrammed cell stably expresses a cell-specific marker or set of markers, morphology, and/or biological function that was not characteristic of the original ceil. "Reprogrammed somatic cell" refers to a process that alters or reverses the differentiation status of a somatic cell, which can be either complete or partial conversion of the differentiated state to an either less differentiated state or a new differentiated state.
"Regeneration" refers to the capability of contributing to the repair or de novo construction of a cell, tissue or organ.
"Differentiation" refers to the developmental process of lineage commitment of a cell. Differentiation can be assayed by measuring an increase in one or more cell-differentiation specific markers relative to the expression of the undifferentiated cell markers.
"Lineage" refers to a pathway of cellular development, in which a more undifferentiated cell undergoes progressive physiological changes to become a more differentiated cell type having a characteristic function (e.g., neurons and glia are of a neuroprogenitor linage, which is of an ectoderm lineage which formed from blastocysts and embryonic stem (ES) cells).
"Tissue" refers to an ensemble of cells (identical or not) and an extracelfular matrix (ECM) that together carry out a specific function or set of functions.
"CDM" is meant a living tissue equivalent or matrix, a living scaffold, or cell-derived matrix.
Cell transformation
Some aspects of the invention concerns methods and cells to transform or reprogram a given somatic cell into a pluripotent, multipotent and/or unipotent cell. Some aspects of the invention relates to methods for conditioning a somatic cell to reprogramming into a pluripotent, multipotent or unipotent cell.
The terms "transform" or "reprogram" are used interchangeably to refer to the phenomenon in which a cell is dedifferentiated or transdifferentiated to become pluripotent, multipotent and/or unipotent. The dedifferentiated cell could subsequently be redifferentiated into a different type of cell. Cells can be reprogrammed or converted to varying degrees. For example, it is possible that only a small portion of cells are converted or that an individual cell is reprogrammed to be multipotent but not necessarily pluripotent. Thus, the terms "transforming" or "reprogramming" methods can refer to methods wherein it is possible to reprogram a cell such that the "new" cell shows morphological and functional characteristics of a new or different specific ceil lineage (e.g. the transformation of fibroblast cells into neuronal cells).

As used herein, the term "somatic cell" refers to any differentiated cell forming the body of an organism, apart from stem ceils, progenitor cells, and germiine cells (i.e. ovogonies and spermatogones) and the cells derived therefrom (e.g. oocyte, spermatozoa). For instance, internal organs, skin, bones, blood, and connective tissue are all made up of somatic cells. Somatic cells according to the invention can be differentiated ceils isolated from adult or can be fetal somatic cells. Somatic cells are obtained from animals, preferably human subjects, and~ cultured according to standard cell culture protocols available to those of ordinary skill in the art.
As used herein, "Stem cell" refers to those cells which retain the ability to renew themselves through mitotic cell division and which can differentiate into a diverse range of specialized cell types. It includes both embryonic stem cells that are found in blastocysts, and adult stem cells that are found in adult tissues. "Totipotent ceils" refers to cells that have the ability to develop into cells derived from all three embryonic germ layers (mesoderm, endoderm and ectoderm) and an entire organism (e.g., human being if placed in a woman's uterus in the case of humans). Totipotent cells may give rise to an embryo, the extra embryonic membranes and all post-embryonic tissues and organs. The term "piuripotent" as used herein is intended to mean the ability of a cell to give rise to differentiated cells of all three embryonic germ layers. "Multipotent cells" refers to cells that can produce only cells of a closely related family of cells (e.g. hematopoietic stem cells differentiate into red blood cells, white blood cells, platelets, etc.). "Unipotent cells" refers to cells that have the capacity to develop/differentiate into only one type of tissue/cell type (e.g. skin cells).
The present invention allows the reprogramming of any cell to a different type of cell. Although the present application focuses primarily on the preparation of Stem-Like cells, especially, Neural Stem-Like Cells (NSLCs), the invention is not so restricted because many different types of cells can be generated according to the principles described herein. Similarly, while the Examples section describes embodiments where fibroblasts, keratinocytes, CD34+ cells, adipose-derived stem cells (ADSCs), neural stem cells (including NSLCs), and cells within a Cell-Derived Matrix (CDM) are reprogrammed, the invention is not limited such cells. The invention may be employed for the reprogramming of virtually any cell of interest.
Accordingly, a general aspect of the invention relates to a method of transforming a cell of a first type to a cell of a second different type. As used herein, examples of cells of a first type include, but are not limited to germ cells, embryonic stem cells and derivations thereof, adult stem cells and derivations thereof, progenitor cells and derivations thereof, cells derived from mesoderm, endoderm or ectoderm, and a cell of mesoderm, endoderm or ectoderm lineage such as an adipose-derived stem cell (ADSC), mesenchymal stem cell, hematopoietic stem cell (CD34+ cell), skin derived precursor cell, hair follicle cell, fibroblast, keratinocyte, epidermal cell, endothelial cell, epithelial cell, granulosa epithelial ceil, melanocyte, adipocyte, chondrocyte,

hepatocyte, lymphocyte (B and T lymphocyte), granulocyte, macrophage, monocyte, mononuclear cell, pancreatic islet cell, Sertoli cell, neuron, glial cell, cardiac muscle ceil, and - other muscle ceil.
As used herein, examples of cells of a second type include, but are not limited to germ cells, embryonic stem cells and derivations thereof, adult stem cells and derivations thereof, progenitor cells and derivations thereof, cells derived from mesoderm, endoderm or ectoderm, and a cell of mesoderm, endoderm or ectoderm lineage such as an adipose-derived stem cell, mesenchymal stem cell, hematopoietic stem celt, skin derived precursor cell, hair follicle cell, fibroblast, keratinocyte, epidermal cell, endothelial cell, epithelial cell, granulosa epithelial cell, melanocyte, adipocyte, chondrocyte, hepatocyte, lymphocyte (B and T lymphocyte), granulocyte, macrophage, monocyte, mononuclear cell, pancreatic islet cell, Sertoli cell, neuron, glial cell, cardiac muscle cell, and other muscle cell. In addition, each of the above "-like" cell (a cell that has similar but not completely identical characteristics of the known natural type of the ceil) is also included in the examples of cells of a second type.
According to one particular, aspect, the method of transforming a cell of a first type into a cell of
a second different type comprises the steps of: i) providing a cell of a first type;
ii) transiently increasing in the cell of a first type intracellular levels of at least one reprogramming agent, whereby the transient increase induces direct or indirect endogenous expression of at least one gene regulator;
iii) placing the cell in conditions for supporting the transformation of the desired cell and . maintaining intracellular levels of the at least one reprogramming agent for a sufficient period of time to allow stable expression of the at least one gene regulator in absence of the reprogramming agent; and
iv) maintaining the cell in culture conditions supporting the transformation of the desired cell for a sufficient period of time to allow a stable expression of a plurality of secondary genes whose expression is characteristic of phenotypical and functional properties of the desired cell. At least one of the stably expressed secondary genes is not characteristic of phenotypical and functional properties of an embryonic stem cell. At the end of said period of time the cell of the first type has been transformed into the desired cell of a different type. Preferably, the cell of a different type obtained after the transformation is further . characterized by a stable repression of a plurality of genes expressed in the first cell type.
According to various embodiments, step iii) may be carried out consecutively to step ii), simultaneously with step ii), or before step ii).
According to a related aspect, the invention relates to a process wherein a cell of a first type is
" reprogrammed to "adesired cell of a different type, the process comprising:

- a transient increase of intracellular levels of at least one reprogramming agent, wherein
the at least one reprogramming agent induces a direct or indirect endogenous
' expression of at least one gene regulator, wherein the endogenous expression"of the at least one gene regulator is necessary for the existence of the desired cell of a different type;
- a stable expression of said at least one gene regulator;
- stable expression of a plurality of secondary genes, wherein the stable expression of the plurality of secondary genes is the result of the stable expression of the at least one gene regulator, and wherein: (i) stable expression of the plurality of secondary genes is characteristic of phenotypical and/or functional properties of the desired cell, (ii) stable expression of at least one of the secondary genes is not characteristic of phenotypical and functional properties of an embryonic stem cell, and wherein (i) and (ii) are indicative of successful reprogramming of the cell of the first type to the desired cell of the different type.
As used herein, "transiently increasing" refers to an increase that is not necessarily permanent and therefore, which may decrease or disappear over time. For instance, when referring to transiently increasing intracellular levels of at least one reprogramming agent in a cell, it means that the increase in present for a sufficient period of time for causing particular cellular events to occur (e.g. inducing stable endogenous expression of a gene regulator). Typically a transient increase is not permanent and is not associated for instance to genome integration of an expression vector.
As used herein the term "reprogramming.agent" refers to a compound that is capable of inducing directly or indirectly the expression of morphological and/or functional characteristics of the desired cell of a different type. Preferred compounds include those capable of driving directly or indirectly transformation oi the cell of the first type into the desired cell of a different type. In prefererred embodiment, the reprogramming agent is selected for inducing a direct or indirect endogenous expression of at least one gene regulator as defined herein. There are many compounds that may be helpful in reprogramming a cell according to the invention and these compounds can be used alone or in combinations. In various embodiments, the reprogramming agent is a polynucleotide or polypeptide selected according to TABLE A:

TABLE A:

Reprogramming agent
i Examples of l Desired Cell Type Name RefSeq/ GenBank™ (NGBI) Access, No. UniProt™ /Swiss-Prot Access. No. UniGene™ Accession No. Markers
Pluripotent-like cells AGR2 NM_006408.3 095994 Hs.530009 OCT4

AGR3 NM_176813.3 Q8TD06 Hs.100686 Nanog

BRIX1 NM_018321.3 Q8TDN6 Hs.718510 SSEA-4

CRABP2 NM_001878.2 P29373 Hs.405662 TRA1-60

DNMT3B, isoform 1 NM_006892.3 Q9UBC3 Hs.713611 TRA1-80

DNMT3B, isoform 2 NM_175848.1 Q9UBC3 Hs.713611 AP

DNMT3B, isoform 3 NM_175849.1 Q9UBC3 Hs.713611

DNMT3B, isoform 6 NM_175850.1 Q9UBC3 Hs.713611

DPPA2 NM_138815.3 Q7Z7J5 Hs.351113

DPPA3 (STELLA) NM_199286.2 G6W0C5 Hs.131358

DPPA4 NM_018189.3 Q7L190 Hs.317659

DPPA5 (ESG1) NM_001025290.1 A6NC42 Hs.125331

FOXD3 NM_012183.2 Q9UJU5 Hs.546573

FOXH1 NM_003923.2 075593 Hs.708365

GABRB3, isoform 1 NM_000814.5 P28472 Hs.302352

GABRB3, isoform 2 NM_021912.4 P28472 Hs.302352

GABRB3,
, isoform 3 NM_001191320.1 P28472 Hs.302352

GABRB3, isoform 4 NM_001191321.1 P28472 Hs.302352
GBX2 NM_001485.2 P52951 Hs.184945
GDF3 NM_020634.1 Q9NR23 Hs.86232
GJA1 (CX43) NM_000165.3 P17302 Hs.74471
GRB7 NM_005310.2 NM_001030002.1 G14451 Q14451 Hs.86859 Hs.86859
HESRG NR_027122.1 Q1W209 Hs.720658
IFITM1 NM_003641.3 P13164 Hs.458414

IFITM2 NMJJ06435.2 Q01629 Hs.709321
KLF2 NM_016270.2 Q9Y5W3 Hs.726356

KLF4 NM_004235.4 ■ 043474 Hs.376206

LEFTY1 NM_020997.2 075610 Hs.656214

LEFTY2 (EBAF), isoform 1 NM_003240.3 000292 Hs.520187

LEFTY2
(EBAF), isoform 2 NM_001172425.1 B4E332 (TrEMBL) • Hs.520187

LIN28A NM_024674.4 Q9H922 Hs.86154

MYBL2 NMJJ02466.2 P10244 Hs. 179718

NANOG NM_024865.2 Q9H9S0 Hs.635882

NODAL NM_018055.4 Q96S42 Hs.370414

NOG NM_05450.4 Q13253 Hs.248201

NR0B1 (DAX1) NM_000475.4 P51843 Hs.268490

NR5A2, isoform 1 NM_205860.1 000482 Hs.33446

NR5A2, isoform 2 NM_003822.3 000482 Hs.33446

NR6A1, isoform 1 NM_033334.2 Q15406 Hs.586460

NR6A1, isoform 2 NM_001489.3 Q15406 Hs.586460

PHG1 NM_004426.2 P78364 Hs.305985

PITX2, isoform a NM_153427.1 Q99697 Hs.643588

PITX2, ■ isoform b NM_153426.1 Q99697 Hs.643588
PITX2, isoform c NM_000325.5 Q99697 Hs.643588
PODXL, isoform 1 NM_001018111.2 000592 Hs.726449
PODXL, isoform 2 NM_005397.3 000592 Hs.726449
POU5F1 (OCT4), isoform 1* NM_002701.4 Q01860 Hs.249184

POU5F1 (OCT4), isoform 2 NM_203289.4 NM_001173531.1 N/A Hs.249184

PTEN . NM_000314.4 P60484 Hs.500466

REST NM_005612.4 NM_001193508.1 Q13127 Q13127 Hs.307836 Hs.307836

REX1 NM_020695.3 Q8N1G1 Hs. 192477 '

SALL4 NM_020436.3 Q9UJQ4 Hs.517113

SEMA3A NM_006080.2 Q14563 Hs.252451

SFRP2 NM_003013.2 Q96HF1 Hs.481022

SOX2 NM_003106.2 P48431 Hs.518438

TDGF1, isoform 1 NM_003212.3 P13385 Hs.385870

TDGF1, isoform 2 NM_001174136.1 P13385 Hs.385870

TERT, isoform 1 NM_198253.2 014746 Hs.492203

TERT, isoform 2 NM_001193376.1 014746 Hs.492203

TPT1 NM_003295.2 P13693 Hs.374596
UTF1 NM_003577.2 Q5T230 Hs.458406
ZFP42 NM_174900.3 Q96MM3 Hs.335787
Ectoderm-like cells ASCL1
(MASH1) NM_004316.3 P50553 Hs.703025 FoxJ3
CDX1 NM_001804.2 P47902 Hs.1545 Otx2
DLX3 NM_005220.2 060479 Hs.134194 E-cadherin
DLX5 NM 005221.5 P56178 Hs.99348 TP73L
FOXD3 NM_012183.2 Q9UJU5 Hs.546573
MS11 NM_002442.2 043347 Hs.158311
NANOG NM_024865.2 Q9H9S0 Hs.635882
POU5F1 (OCT4), isoform 1* NM_002701.4 Q01860 Hs.249184
POU5F1 (OCT4), isoform 2 NM_203289.4 NM_001173531.1 N/A Hs.249184
SOX1 NM_005986.2 000570 Hs.202526
SOX2 NM_003106.2 P48431 Hs.518438
SP8, isoform 1 NM_182700.4 Q81X23 Hs. 195922

SP8, isoform 2 NM_198956.2 N/A Hs.195922

ZIC1 ■NM__003412.3 Q15915 Hs.647962 •
Mesendoderm-like cells EOMES NM_005442.2 095936 Hs.591663 Mixll .

FOXA2, isoform 1* NM_021784.4 Q9Y261 Hs.155651 Mespl

FOXA2, isoform 2 NM_153675.2 Q9Y261 Hs.155651 Bry

FOXD3 NM_012183.2 Q9UJU5 Hs.546573 Flk1

GATA4 NM_002052.3 P43694 Hs.243987 Pax2

GATA6 NM_005257.3 Q92908 Hs.514746 Six1

MIXL1 NM_031944.1 Q9H2W2 Hs.282079

POU5F1 (OCT4), isoform 1* NM_002701.4 Q01860 Hs.249184

POU5F1 (OCT4), isoform 2 NM_203289.4 NM_001173531.1 N/A Hs.249184

SOX 17 NM_022454.3 Q9H6I2 Hs.98367

T (Brachyury) NM_003181.2 015178 Hs.389457
Desired second "cell' type ■■■;' ■■':■ ;V; . *'. ■- ■: .•.;.
Neural stem- CALB1 NM_004929.2 P05937 Hs.65425 Sox2
like cells DLL1 NM_005618.3 000548 Hs.379912 Nestin
DLX1, isoform 1 NM_178120.4 P56177 Hs.407015 GFAP
DLX1, isoform 2 NM_001038493.1 P56177 Hs.407015 Msi1
DLX2 NM_004405.3 Q07687 Hs.419 Sox1
FOXD3 NM_012183.2 Q9UJU5 Hs.546573 CD133
GJD2 (CX36) NM_020660.1 Q9UKL4 Hs.283816
HES1 NM_005524.2 Q14469 Hs.250666
HES3 NM_001024598.3 Q5TGS1 Hs.532677
HES5 NM_001010926.3 Q5TA89 Hs.57971
HOXB1 NM_002144.3 P14653 Hs.99992
MNIX1 (HB9), isoform 1 NM_005515.3 P50219 Hs.37035
MNX1 (HB9), isoform 2 NM_001165255.1 N/A Hs.37035
MSI1 NM__002442.2 043347 Hs.158311

NANOG NM_024865.2 Q9H9S0 Hs.635882

NEUROD1 NM_002500.2 Q13562 Hs.709709

NEUROG1 - NM_006161.2 Q92886 Hs.248149

NEUROG2 NM_024019.2 Q9H2A3 Hs.567563 .

NKX6.1 NM_006168.2 P78426 Hs.546270

PAX6, isoform a* NM_000280.3 P26367 Hs.270303

PAX6, isoform a NM_001127612.1 P26367 Hs.270303

PAX6, isoform b NM_001604.4 P26367 Hs.270303

SFRP2 NM_003013.2 Q96HF1 Hs.481022

SIX3 NM_005413.3 095343 Hs.567336

SOX1 NM_005986.2 000570 Hs.202526
SOX2 NM_003106.2 P48431 Hs.518438
Cardiac
progenitor-like
cells BAF60C (SMARCD3), isoform 1 NM_001003802.1 Q6STE5 Hs.647067 MLc2a
BAF60C (SMARCD3), isoform 1 NM_003078.3 Q6STE5 Hs.647067 Nkx2.5
BAF60C (SMARCD3), isoform 2* NM_001003801.1 Q6STE5 Hs.647067 lsl+
FOXD3 NM_012183.2 Q9UJU5 Hs.546573 Bry
GATA4 NM_002052.3 P43694 Hs.243987
GATA6 NM_005257.3 Q92908 Hs.514746
HAND1 NM_004821.2 096004 Hs.152531
HAND2 NM_021973.2 P61296 Hs.388245
ISL1 NM_002202.2 P61371 Hs.505
KDR NM_002253.2 P35968 Hs.479756
MESP1 NM_018670.3 Q9BRJ9 Hs.447531
MYOCD, isoform 1 NM_001146312.1 Q6N065 (TrEMBL) Hs.567641
MYOCD, isoform 2 NM_153604.2 Q8IZQ8 Hs.567641
MYOCD, isoform 3 NM_001146313.1 Q8IZQ8 - Hs.567641
NKX2.5, isoform 1* NM_004387.3 P52952 Hs.54473

NKX2.5, Isoform 2* NM_001166175.1 P52952 Hs.54473

NKX2.5, isoform 3* NM_001166176.1 P52952 Hs.54473 -

T (Brachyury) NM_003181.2 015178 Hs.389457

TBX5, isoform
1* NM__000192.3 Q99593 Hs.381715

TBX5, isoform 1 NM_181486.1 Q99593 Hs.381715

TBX5, isoform 2 NM_080718.1 Q99593 Hs.381715

TBX5, isoform 3 NM_080717.2 Q99593 Hs.381715
SOX 17 NM_022454.3 Q9H6I2 Hs.98367
Pancreatic progenitor-like FOXA2, isoform 1* NM_021784.4 Q9Y261 Hs.155651 PDX1
cells FOXA2, isoform 2 NM_153675.2 Q9Y261 Hs.155651 Sox 17
FOXD3 NM_012183.2 Q9UJU5 Hs.546573 FoxA2
MAFA NM_201589.2 Q8NHW3 Hs.670866 Ngn3
MIXL1 NM_D31944.1 Q9H2W2 Hs.282079 Isl1
NEUROG3 NM_020999.3 Q9Y4Z2 Hs.532682
NKX6.1 NM_006168.2 P78426 Hs.546270
PAX4 NM_006193.2 043316 Hs.129706
PDX1 NM_000209.3 P52945 Hs.32938
SOX17 NM_022454.3 Q9H612 Hs.98367
Myogenic FOXC1 NM_001453.2 Q12948 Hs.348883 SMa actin
progenitor-like FOXC2 NM_005251.2 Q99958 Hs.436448 Calponin
ceils MEF2C, isoform 1 NM_002397.4 NM_001193350.1 Q06413 Q06413 Hs.649965 MyoD
MEF2C, isoform 2 NM_001131005.2 Q06413 Hs.649965 MEF2C
MEF2C, isoform 3 NM_001193347.1 Q06413 Hs.649965 Pax3
MEF2C, isoform 4 NM_001193348.1 Q06413 Hs.649965 Pax7
MEF2C, isoform 5 NM_001193349.1 Q06413 Hs.649965
Pax3, isoform Pax3 NM_181457.3' P23760 Hs.42146

Pax3, isoform Pax3a NM_000438.5 P23760 Hs.42146

Pax3, isoform NM_013942.4 P23760 Hs.42t46
Pax3b

Pax3, isoform NM_181458.3 Q494Z3, Q494Z4 Hs.42146
Pax3d (TrEMBL)

Pax3, isoform NM_1 81459.3 Q494Z3, Q494Z4 Hs.42146
Pax3e (TrEMBL)

Pax3, isoform NM_181461.3 Q494Z3, Q494Z4 Hs.42146
Pax3g (TrEMBL)
Pax3, isoform Pax3h NM_181460.3 Q494Z3, Q494Z4 (TrEMBL) Hs.42146
Pax3, isoform Pax3i NM_001127366.2 Q494Z4 (TrEMBL) Hs.42146
PAX7, isoform 1 NM_002584.2 P23759 Hs.113253

PAX7, NM_013945.2 P23759 Hs. 113253
isoform 2

PAX7, NM_001135254.1 P23759 Hs: 113253
isoform 3
In some embodiments, the reprogramming agent is a polypeptide which shares at least 75%, 80%, 85%, 90%, 95%, 97%, 99% or more of the functionality or sequence identity of any one of the reprogramming agents in the table hereinbefore.
Identifying the "sufficient period of time" to allow stable expression of the at least one gene regulator in absence of the reprogramming agent and the "sufficient period of time" in which the cell is to be maintained in culture conditions supporting the transformation of the desired cell is within the skill of those in the art. The sufficient or proper time period will vary according to various factors, including but not limited to, the particular type and epigenetic status of ceils (e.g. the cell of the first type and the desired ceil), the amount of starting materiaf (e.g. the number of cells to be transformed), the amount and type of reprogramming agent(s), the gene regulator(s), the culture conditions, presence of compounds that speed up reprogramming (ex, compounds that increase cell cycle turnover, modify the epigenetic status, and/or enhance ceil viability), etc. In various embodiments the sufficient period of time to allow a stable expression of the at least one gene regulator in absence of the reprogramming agent is about 1 day, about 2-4 days, about 4-7 days, about 1-2 weeks, about 2-3 weeks or about 3-4 weeks. In various embodiments the sufficient period of time in which the cells are to be maintained in culture conditions supporting the transformation of the desired cell and allow a stable expression of a plurality of secondary genes is about 1 day, about 2-4 days, about 4-7 days or about "t-2 -

weeks, about 2-3 weeks, about 3-4 weeks, about 4-6 weeks or about.6-8 weeks. In preferred embodiments, at the end of the transformation period, the number of transformed desired cells is substantially equivalent or even higher than an amount of cells a first type provided at the beginning.
The present invention encompasses various types of compounds that are suitable for increasing in a cell of a first type the intracellular levels of at least one reprogramming agent. Preferably, the compound should also be able to directly or indirectly remodel the chromatin and/or DNA of the cell, thus resulting directly or indirectly in the expression of morphological and functional characteristics of the desired cell of a different type. Preferred compounds are reprogramming agents as defined herein or any other compound having a similar activity and having the ability to activate or enhance the expression of the endogenous version of genes listed in the table of reprogramming agents hereinbefore and which are capable of driving directly or indirectly transformation of the cell of the first type into the desired cell of a different type.
As will be explained hereinafter, the increase in intracellular levels of the at least one reprogramming agent can be achieved by different means. In preferred embodiments the reprogramming agent is a polypeptide and increasing intracellular levels of such polypeptide include transfection (or co-transferction) of an expression vector having a polynucleotide (ex. DNA or RNA) encoding the polypeptide(s), or by an intracellular delivery of polypeptide(s). According to the invention, transient expression is generally preferable. Additional suitable compounds may include compounds capable of increasing the expression of the endogenous version of genes listed in the table of reprogramming agents and gene regulators including, but not limited to, reprogramming factors listed in Table B.
TABLE B:

Desijed cell of different.type 'Reprogramming Factor , •
Pturipotent-iike cells Nodal, ActivinA, Fgf-2, Wnt3a, L-Ascorbic Acid, BIO,
CHIR99021, PD0325901, Thiazovivin, SB431542, Cyclic
Pifithrin-a, Tranylcypromine hydrochloride, Kenpaulione, 5-
Azacytidine, Valproic Acid, BIX01294, R(+)BayK8644,
RG108, Theanine, Sodium butyrate
Ectoderm like cells: a retinoid compound, L-Ascorbic acid, SHH, Wnt 3a, a
1- Neural stem-like cells neurotrophic factor, bFGF, EGF, Transforming growth factor
alpha, neuropeptide Y, Estrogen, Noggin, Forskolin, 5-
Azacytidine, Valproic Acid, BIX01294, R(+)BayK8644,
RG108, Sodium butyrate, Lithium

Mesoendoderm like celts;
BMP4, Epidermal growth factor-Cripto/FRL-l/Cryptic
(EGF-CFC) and the TGFps, Activin, Nodal, SHH,
Vg1/GDF1 (growth and differentiation factor-1)
1- Cardiac progenitor-like 1- BMP4, bFGF, Activin A, VEGF, DKK1 (dickkopf
ceils homologue 1), Insulin-like growth factor 1 (IGF-1) and
hepatocyte growth factor (HGF), 5-Azacytidine,
Valproic Acid, BIX01294, R(+)BayK8644, RG108,
Cardiogenol C hydrochloride, Sodium butyrate
2- Pancreatic progenitor- 2- Activin A, GLP-1, bFGF, Reg1, nicotinamide,
like cells Betacellulin, SHH, (-)-lndolactam V, a retinoid
compound, Cyclopamine, IDE-1 and 2, 5-Azacytidine,
Valproic Acid, BIX01294, R(+)BayK8644, RG108,
Sodium butyrate
3- Myogenic progenitor- 3- retinoic acid, HGF, FGF, IGF, transforming growth
like cells factor-beta, Wnt3a, 5-Azacytidine, Valproic Acid,
BIX01294, R(+)BayK8644, RG108, Sodium butyrate
According to the principles of the invention, increasing intracellular levels of at least one reprogramming agent should induce a direct or indirect endogenous expression of at least one gene regulator. As used herein, "gene regulator" refers to a polynucleotide or polypeptide whose expression is associated with a series of intracellular events leading to the transformation of a given cell of a first type into a pluripotent, multipoint and/or unipotent cell. Typically expression of a gene regulator direcly or indirectly activates genes necessary for the phenotypical and functional characteristic of pluripotent, multipotent and/or unipotent cells, while repressing genes of the cell of a first type. The gene regulator may be the same or be different than the reprogramming agent. Examples of gene regulators according to the invention include, but are not limited to, the polynucleotides and polypeptides listed herein before in TABLE A.
In some embodiments, the gene regulator is a polypeptide which shares at least 75%, 80%, 85%, 90%, 95%, 97%, 99% or more of the functionality or sequence identity of any one of the gene regulators provided in the Table A hereinbefore.
As used herein, "condrtions supporting growth" or "conditions supporting the
transformation" when referring to a desired cell refers to various suitable culture conditions (temperature, pH, 02 tension, cell media, factors, compounds, growth substrate (ex. iaminin, collagen, fibronectin, Matrigel™, low-bind surface, nanostructured or charged surface, etc.), 3D environment, etc.) favdrising"growth of the desired cell type and/or favorising transformation

towards such desired cell type. Those skilled in the art known that growth or transformation of particular cell types is stimulated under specific conditions, while inhibited by others, and it is within their skill to select suitable conditions (e.g. culture conditions) favorising growth or transformation of desired cell types.
The terms "phenotypical and functional properties", when referring to a desired cell or to an embryonic stem cell, means the biological, biochemical, physiological and visual characteristics of a cell, including expression of certain genes and cell surface markers, which can be measured or assessed for confirming its identity or function(s).
An example of a suitable reprogramming agent according to. preferered embodiments of the invention is MUSASHI1. In some embodiments this polypeptide is preferred for driving a first ceil, such as a fibroblast, into a Neural Stem-Like Cell (NSLC). In other embodiments, the at least one reprogramming agent which said intracellular levels is increased is(are) either Musashil (Msi1) alone; Musashil (Msi1) and Neurogenin 2 (Ngn2); MusashM (Msi1) and methyl-CpG binding domain protein 2 (MBD2); or Neurogenin 2 (Ngn2) and methyl-CpG binding domain protein 2 (MBD2). Adequate intracellular levels of these polypeptides are preferred since they tend to be expressed throughout an entire cell lineage, from as early as embryonic stem cells (or even earlier) to pre-somatic cells (or even later).
MBD2 is a member of a family of methyl-CpG-binding proteins that has been reported to be both a transcriptional repressor and a DNA demethylase (dMTase). As used herein, the term "MBD2" generally refers to the human methyl-CpG binding domain protein 2. The GeneBank™ (NCBI) accession number of human MBD2 is NM_003927.3/AF072242, the UniProt™ accession number is NP-003918/Q9UBB5 and the UniGene™ accession number is Hs.25674.
As used herein, the term "Msi1" generally refers to the human musashi homolog 1. The GeneBank™ (NCBI) accession number of human Msi1 is NM_002442.2fAB0"t2851, the UniProt™ accession number is NP-002433/O43347 and the UniGene™ accession number is Hs.158311.
As used herein, the term "Ngn2" generally refers to the human neurogenin 2. The GeneBank™ (NCBI) accession number of human Ngn2 is NM_024019.2/BC036847, the UniProt™ accession number is NP-076924/Q9H2A3 and the UniGene™ accession number is Hs.567563.
According to additional aspects, the method of transforming a celt of a first type to a desired cell
of a different different type comprises the steps of either:
1) contacting the cell of a first type with one or more compounds capable of increasing intracellular levels of at least one reprogramming agent within the cell and directly or indirectly remodeling the chromatin and/or DNA of the cell; or

2) contacting the chromatin and/or DNA of a cell of a first type with an agent capable of
remodeling the chromatin and/or DNA of the cell; and increasing intracellular levels of at
least one reprogramming agent. ' -.
According to various embodiments, step 2) may be carried out consecutively to step 1), simultaneously with step 1), or before step 1).
According to a particular aspect, the invention relates to a method for obtaining a Neural Stem-Like Cell (NSLC), comprising:
- providing a cell of a first type which is not a NSLC;
- increasing intracellular levels of at least one neural stem cell specific polypeptide, wherein the polypeptide is capable of driving directly or indirectly transformation of the cell of the first type into a NSLC; and
- contacting chromatin and/or DNA of a cell of a first type with a histone acetylator, an inhibitor of histone deacetylatbn, a DNA demethylator, and/or a chemical inhibitor of DNA methylation.
With respect to the second step, the term "remodelling the chromatin and/or DNA" refers to dynamic structural changes to the chromatin. These changes can range from local changes necessary for transcriptional regulation, to global changes necessary for opening up the chromatin structure or chromosome segregation to allow transcription of the new set of genes characteristic of the desired cell of a different type, to closing up of the chromatin structure or chromosome segregation to prevent transcription of certain genes that are not characteristic of the desired cell of a different type. In some embodiments, opening up of the chromatin structure refers more specifically to acetylation of histones, and demethylation of DNA, whiie closing up of the chromatin structure refers more specifically to deacetylation of histones, and methylation of DNA.
As used herein, "compound" refers to a compound capable of effecting a desired biological function. The term includes, but is not limited to, DNA, RNA, protein, polypeptides, and other compounds including growth factors, cytokines, hormones or small molecules. As used herein, compounds capable of remodeling chromatin and/or DNA include, but are not limited to, histone acetylators, inhibitors of histone deacetylation, DNA demethylators, inhibitors of DNA methylation and combination thereof.
"Inhibitor of DNA methylation" refers to an agent that can inhibit DNA methylation. DNA methylation inhibitors have demonstrated the ability to restore suppressed gene expression. Suitable agents for inhibiting DNA methylation include, but are not limited to 5-azacytidine, 5-aza-2-deoxycytidine, 1 -β-D-arabinofuranosil-5-azacytosine, and dihydrc~5-azacytidine, and zebularine (ZEB), BIX (histone lysine methytransferase inhibitor), and RG108.

"Inhibitor of histone deacetylation" refers to an agent that prevents the removal of the acetyl groups from the lysine residues of histories that would otherwise lead to the formation of a condensed and transcriptionally silenced chromatin. Histone deacetylase inhibitors fall into several groups, incuding: (1) hydroxamic acids such as trichostatin (A), (2) cyclic tetrapeptides, (3) benzamides, (4) electrophilic ketones, and (5) aliphatic acid group of compounds such as phenylbutyrate and valporic acid. Suitable agents to inhibit histone deacetylation include, but are not limited to, valporic acid (VPA), phenylbutyrate Trichostatin A (TSA), Na-butyrate, and benzamides. VPA promotes neuronal fate and inhibits glial fate simultaneously through the induction of neurogenic transcription factors including NeuroD.
"Histone Acetylator" refers to an agent that inserts acetyl groups to the lysine residues of histones that opens up the chromatin and turns it into a transcriptionally active state. Suitable Histone Acetylator agents include, but are not limited to, Polyamine, CREB (cAMP element binding protein), and BniP3.
"DNA demethylator" refers to an agent that removes the methyl groups from DNA and possesses the ability to inhibit hypermethylation and restore suppressed gene expression. A demethylase is expected to activate genes by removing the repressive methyl residues. Suitable DNA demethylators include, but are not limited to, MBD2 and Gadd45b.
In some embodiments, the reprogramming agent has one or more of the following functions: it decrease the expression of one or more markers of ceils of the first type (ex. see Table C), and/or increase the expression of one or more markers of the desired ceil of the different type (ex. see Table A). Cells that exhibit a selectable marker for the desired cell of a different type are then selected and assessed for characteristics of the desired cell of a different type.
According to the invention, transformation into the desired cell results in stable expression of a plurality of secondary genes whose expression is characteristic of phenotypical and/or functional properties of the desired cell. Genes whose expression is characteristic of phenotypical and/or functional properties of the desired cell include, but is not limited to, those listed in Tabie A.

In some embodiments, expression of secondary genes whose expression is characteristic of phenotypicai and functional properties of the desired cell results in the expression of markers defined according to the following table:

Desired cell type Markers
Neural stem-like cells Nestin, Sox2, GFAP, Msi1
Neural-like cells Blll-tubulin, Map2b, Synapsin, ACHE
Ectoderm-like cells Sox2, Sox1r Zic1, Nestin, Notch 1, FoxJ3, Otx2, Criptol, Vimentin
Mesendoderm-like cells Sox17, FoxA2, CXCR4, GATA4, Mixll, Eomesodermin
Pluripotent-like cells Oct4, SSEA4, TRA-1-60, TRA-1-81, AP
In some embodiments, transformation of a cell of a first type into the desired cell results in a stable repression of a plurality of genes typically expressed in the cell of the first type. Examples of such suppressed genes include, but are not limited to, those defined in Table C:
Table C: Examples of suppressed genes

cell-type specific genes typically repressed during :
■* • - ■ - - -t - Reprogramrnirig

Cell Type Name RefSeq/ UniProt™ -UniGene™:. Markers . .
GenBank™ . /Swis's-Prot Accession--
(NDBI)-Accession Accesstpn,No.. No.
No..
Keratinocytes TP63, isoform 1 NM_0303722.4 Q9H3D4 Hs. 137569 Keratin 14

TP63, NM_001114978.1 Q9H3D4 Hs.137569 Basonuciin
isoform 2

TP63, NM_001114979.1 Q9H3D4 Hs. 137569 P63
isoform 3

TP63, NM_001114980.1 Q9H3D4 Hs.137569
isoform 4
TP63, isoform 5 NM_001114981.1 Q9H3D4 Hs.137569
TP63, isoform 6 NM_001114982.1 Q9H3D4 Hs.137569
BNC1 NM_001717.3 Q01954 Hs.459153
BCN2 NM_017637.5 Q6ZN30 Hs.656581
KRT14 NM_000526.4 P02533 Hs.654380
Involucrin NM_005547.2 P07476 Hs.516439
Fibroblasts THY1 NM_006288.3 P04216 Hs.724411 Col5A2

FBN2 NM_001999.3 P35556 Hs.519294 Fibronectin

COL5A2 NM_000393.3 P05997 Hs.445827

DNMT1, isoform a NM_001130823.1 P26358 Hs.202672

DNMT1, isoform b NM_001379.2 P26358 Hs.202672
CD34+ Isl1 NM_002202.2 P61371 Hs.505 VEGFR

HOXA9 NM_152739.3 P31269 Hs.659350 Cytokeratin

HOXB4 NM_024015.4 P17483 Hs.664706

Klk-1 NM_002257.2 P06870 Hs.123107 CD34

Bry NM_003181.2 015178 Hs.389457
Adipose-derived stem cells (ADSC) ALCAM NM_001627.2 Q13740 Hs.591293 ALBO

VCAM-1 NM_001078.2 P19320 Hs. 109225 Adiponectin

VCAM-1, isoform b NM_080682.1 P19320 Hs. 109225

PROM1, isoform 1 NM_006017.2 043490 Hs.614734 Leptin
PROM1, isoform 2 NM_001145847.1 NM_001145848.1 043490 Hs.614734
PROM1, isoform 4 NM_001145852.1 043490 Hs.614734
PROM1, isoform 5 NM_001145851.1 043490 Hs.614734
PROM1, isoform 6 NM_001145850.1 043490 Hs.614734
PROM1, isoform 7 NM_001145849.1 043490 Hs.614734
FUT4 NM_002033.3 P22083 Hs. 390420
In preferred embodiments, stable repression of any one or more of the genes listed in Table C being expressed in the first celt type is also characterized by a disappearance of the corresponding markers (see Table C).
Those skilled in the art will understand that there exist many alterative steps for facilitating cell reprogramming. Those include destabilizing the cell's cytoskeletal structure (for example, by exposing the cell to cytochalasin B), loosening the chromatin structure of the cell (for example, by using agents such as 5 azacytidine (5-Aza) and Valproic acid (VPA) or DNA demethylator

agents such as MBD2), transfecting the cell with one or more expression vector(s) containing at least one cDNA encoding a neurogenic transcription factor (for example, Msi1 or Ngn2), using an appropriate medium for the desired cell of a different type and an appropriate differentiation medium to induce differentiation commitment of the desired cell of a different type, inhibiting repressive pathways that negatively affects induction into commitment the desired cell of a different type, growing the cells on an appropriate substrate for the desired cell of a different type (for example, iaminin for NSLCs or a low-bind surface for culturing floating neurospheres), and growing the cells in an environment that the desired cell of a different type (or "-like" cell) would be normally exposed to in vivo such as the proper temperature, pH and low oxygen environment (for example about 2-5% 02). In various embodiments, the invention encompasses these and other related methods and techniques for facilitating cell reprogramming.
Accordingly, the method of transforming a cell of a first type into a cell of a second different type may comprise additional facultative steps. In one embodiment, the method of transforming a ceil further comprises the step of pretreating the cell of a first type with a cytoskeleton disruptor. As used herein "cytoskeleton" refers to the filamentous network of F-actin, Myosin light and heavy chain, microtubules, and intermediate filaments (IFs) composed of one of three chemically distinct subunits, actin, tubulin, or one of several classes of IF protein. Accordingly, the term "cytoskeleton disruptor" refers to any molecules that can inhibit the cell cytoskeleton to destabilize the cell and consequently remove the feedback mechanisms between the cell's shape and cellular and nuclear function. Suitable cytoskeleton disruptor according to the invention include, but are not limited to, the cytochaiasin family of actin cytoskeleton inhibitors, such as Cytochaiasin B or D, and myosin inhibitors such as 2,3-butanedione monoxime. Such pretreatment may boost reprogramming. In a preferred embodiment, the cell is cultured in the presence of at least one cytoskeleton inhibitor one day before, during, or after introducing a neurogenic transcription factor(s).
Placing the cell in conditions in conditions for supporting the transformation of the desired cell, and/or maintaining the cell in culture conditions supporting the transformation of the desired cell may comprises culturing the cell in a media comprising one or more factors appropriate for inducing the expression of the morphological and functional characteristics of the desired desired cell of a different type. In some embodiments the one or more factors are reprogramming factors helpful in reprogramming a cell and these reprogramming factors can be used alone or in combinations.
In other embodiments, the step of culturing the cell in a media comprising one or more factors appropriate for inducing the expression of the morphological and functional characteristics of the desired desired cell of a different type is carried out subsequently or simultaneously to steps iii) or iv), or subsequently or simultaneously to steps 1) or 2), as defined hereinbefore.

Those skilled in the art know many different types of media and many reprogramming factors that may be helpful in reprogramming a cell and these reprogramming factors can be used alone or in combinations.' In various embodiments,- the reprogramming factor is selected according to TABLE B.
In some embodiments, reprogramming factors have one or more of the following functions: decrease the expression of one or more markers of the first type of cell and/or increase the expression of one or more markers of the desired cell. Cells that exhibit a selectable marker for the desired cell are then selected and assessed for unipotency, multipotency, pluripotency, or similar characteristics (as appropriate).
In particular embodiments, the cells are cultured in serum-free medium before, during or after any one of steps i) to iv) as defined hereinbefore, or during or after steps 1) or 2), as defined hereinbefore.
Obtaining Neural Stem-Like Cells (NSLCs)
According to preferred embodiments for creating Neural Stem-Like Cells (NSLCs), the methods of the invention are carried out such that cells are treated with selected agents, compounds and factors to promote the reprogramming and/or dedifferentiation towards Stem-Like Cells (SLCs). Such reprogrammed somatic cells can then be further treated with agents and/or cultured under conditions suitable for promoting reprogramming towards Neural Stem-Like Cells (NSLCs), and expansion of the NSLCs for the long-term. NSLCs according to the invention have the potential to differentiate to neuronai-like and/or glial-like cells, as well as neuronal and/or glial cells, for potential treatment of neurological diseases and injuries such as Parkinson's disease and spinal cord injury. The methods described herein are also useful for producing histocompatible cells for cell therapy.
Accordingly, some aspects of the present invention relates to generating neurons from an individual patient, thus making autologous transplantations possible as a treatment modality for many neurological conditions including neurotrauma, stroke, neurodegenerative diseases such as Multiple Sclerosis, Parkinson's disease, Huntington disease, Alzheimer's diseases. Thus, the invention provides for neurological therapies to treat the disease or trauma of interest.
Therefore, another aspect of the invention concerns a method of obtaining a Neural Stem-Like Cell (NSLC), comprising either:
1) contacting the cell of a first type with one or more neural stem cell regulating polypeptide capable of increasing intracellular levels of neural stem cell specific polypeptides within said ceil and directly or indirectly remodeling the chromatin and/or DNA of the cell and driving directly or indirectly transformation of the cell of the first type into a NSLC; or

2) contacting the chromatin and/or DNA of a cell of a first type with a histone acetylator, an inhibitor of histone deacetylation, a DNA demethylator, and/or an inhibitor of DNA methylation; and increasing intracellular levels of at least one neural stem cell specific ' polypeptide driving directly or indirectly transformation of the cell of the first type into a NSLC.
In preferred embodiments, the step 1) comprises increasing intracellular levels of a MUSASHI1 polypeptide. As it will be explained hereinafter this can be achieved by different means including, but not limited to, transient expression of the MUSASHM polypeptide, preferably by transfecting an expression vector encoding the polypeptide.
In preferred embodiments, the step 2) comprises increasing intracellular levels of a MBD2 polypeptide or treating the cells with VPA and 5-AZA. As it will be explained hereinafter this can be achieved by different means including, but not limited to, transient expression of the MBD2 polypeptide, preferably by transfecting an expression vector encoding the polypeptide(s), and/or pre-treating and/or treating the cells with VPA and 5-AZA.
In one particular embodiment, reprogramming a cell of a first type to another type of cell that exhibits at least two selectable markers for neural stem cells requires transfecting the cell of a first type with one vector containing a cDNA encoding for a neurogenic transcription factor and one DNA demethylator. To enhance the de-differentiation the cells are exposed or pre-exposed to an agent(s) that inhibits DNA methylation, inhibits histone deacetylation, and/or disrupts the cell cytoskeleton. For example, the dedifferentiation can be enhanced by pre-treating the cells with an agent that disrupts the cell cytoskeleton followed by transfecting the cells with one or more vector(s) containing two neurogenic transcription factors in the presence of a DNA demethylator and/or inhibitor of DNA methylation and histone deacetylation. The histone deacetylator, inhibitor of histone deacetylation, DNA demethylator, and/or an inhibitor of DNA methylation are as defined previously.
As defined previously, the method may further comprise a preliminary step of pre-treating the cell of a first type with a cytoskeleton disruptor, as defined previously, and/or culturing the ceil in a media comprising one or more reprogramming factors appropriate for appearance and maintenance of the morphological and functional characteristics of NSLCs as defined previously (e.g. a retinoid compound^ a neurotrophic factor, bFGF, EGF, SHH, Wnt 3a,, neuropeptide Y, Estrogen). In some embodiment the method further comprises inhibiting cellular BMP signaling pathways (e.g. by NOGGiN, fetuin, or follistatin).
In preferred embodiments, generation of a NSLC from a first cell comprises the use of one or more reprogramming agents. Suitable agents include, but are not limited to, Musashi-1 (Msi1) and Neurogenin 2 (Ngn2). Other potential agents are listed in Table A and B.

The present invention is also directed to the use of DNA expression vectors encoding a protein or transcript which upregulates the expression of neurogenesis. The genetically-engineered DNA sequence, encoding a defined reprogramming agent such as Msi1 and Ngn2, can be . introduced into cells by using a mono-, bi~, or poly-cistronic vectors. The expression of an endogenous multipotency gene indicates that the cDNA.encodes a protein whose expression in the cell result directly or indirectly in the de-differentiation of the cell. The newly de-differentiated mammalian cells are capable of re-differentiating to neuronal lineages to regenerate said mammalian cells, tissues, and organs.
The present invention is further directed to a method for generating NSLCs by introducing a genetically-engineered DNA sequence into human somatic cells via transient transfection. Since the DNA introduced in the transfection process is not inserted into the nuclear genome, the foreign DNA decreases over time and when the cells undergo mitosis. Nonviral vectors remain in a non-replicative form, have low immunogenicity, and are easy and safe to prepare and to use. Furthermore, plasmids may accommodate large fragments of DNA.
In one particular embodiment, the method starts with obtaining cells from the individual, and reprogramming the cells in vitro to generate NSLCs. The significant aspect of the present invention is the stable reprogramming of a somatic cell or non-neuronal cell into a NSLC that can give rise to different types of.neuronal or glial cells (including neuronal-like or glial-like cells). These can then be implanted back into the same patient from which the cells were obtained, thus making an autologous treatment modality for many neurological conditions including neurotrauma, stroke, and neurodegenerative disease possible. These can also be implanted into a different individual from which the cells were obtained. Accordingly, the cells and methods of the present invention may be helpful to treat, prevent, or to stabilize a neurological disease such as Alzheimer's disease, Parkinson's disease, multiple sclerosis, or spinal cord injury. This technology provides an ample source of neural stem cells, neuro-progenitor cells, neurons and glia for clinical treatment, which can be performed by implantation of NSLCs in vivo or inducing the differentiation in vitro and implantation of neuro-progenitor cells or specific neurons or glia in vivo.
In another embodiment, the method comprises isolating somatic or non-neuronal ceils and exposing the cells to one or more agents that alter cell morphology and chromatin structure, and transfecting the ceils with one or more genes containing at least one cDNA encoding for a neurogenic transcription factor. The gene transfection step may be replaced with alternative agents that induce the expression of the neurogenic transcription factor(s) in the cell, inducing epigenetic modifications to DNA and histones (especially DNA demethylation and an open chromatic structure) facilitate true reprogramming of the cells. In another embodiment, the cells

are incubated in a low oxygen environment, for example 5% 02, thereby helping in reprogrammmg the cells.
This methodology allows the reprogramming of a cell into a NSLC. The further course of development and the expansion of the reprogrammed cell depend on the in situ environment cues to which it is exposed. The embodiments of the invention further include growing the reprogrammed cell in an appropriate proliferation medium to expand the generated NSLC, for example Neural Progenitor proliferation Medium (StemCell Technologies) with the presence of epidermal growth factor (EGF) and basic fibroblast growth factor (bFGF), to promote the neural stem cell to proliferate.
The NSLCs obtained according to the invention can be differentiated into neuronal, astrocyte, and/or oligodendrocyte lineages in appropriate differentiation medium, for example NS-A differentiation medium (StemCell, Technologies) or NbActive medium (BrainBits™) including a retinoid compound, such as all-trans-retinoic acid or vitamin A, and BDNF, to induce the differentiation of NSLCs towards neuronal and/or glial cells. Neuronal cells include cells that display one or more neural-specific morphological, physiological, functional and/or immunological features associated with a neuronal cell type. Useful criteria features includes: morphological features (e.g., long processes or neurites), physiological and/or immunological features such as expression of a set of neuronal-specific markers or antigens, synthesis of neurotransmitters) such as dopamine or gamma aminobutyric acid (GABA), and functional features such as ion channels or action potentials characteristic of neurons.
In accordance with the method, reprogrammed cells can be selected based on differential adherence properties as compared to untransfected cells; for example, reprogrammed cells can form floating neurospheres or grow well on laminin while untransfected fibroblasts attach and grow well on regular cell culture treated plates. Reprogrammed cells include ceils that exhibit one or more neural stem specific markers and morphology and the loss of some or all of the specific markers related to the original cells. Furthermore, some of the functionality of the neural-like cells (NLCs) can be assessed at different time points by, for example, patch-clamping, immunostaining for synaptophysin and MAP2b, and by immunochemical means such as by enzyme-linked immunosorbent assay (ELISA).
In certain embodiments, the present invention provides NSLCs that are able to initiate and direct central nervous system regeneration at a site of tissue damage and can be customized for individual patients using their own cells as the donor or starting cell. The present invention can be used to generate cells from an individual patient, thus making autologous transplantations possible as a treatment modality for many neurological conditions. Thus, this technology eliminates the problems associated with transplantations of non-host cells, such as, immunological rejection and the risk of transmitted disease. The great advantage of the present

invention is that it provides an essentially limitless supply for autologous grafts suitable for transplantation. Therefore, it will obviate some significant problems associated with current source of materials and methods of transplantation.
Delivery of Polynucleotides
In certain embodiments, the invention concerns the use of polynucleotides, e.g. a polynucleotide encoding a MBD2 polypeptide, a MUSASHI1 polypeptide and/or a Ngn2 polypeptide. Means for introducing polynucleotides into a cell are well known in the art. Transfection methods of a cell such as nucleofection and/or lipofection, or other types of transfection methods may be used. For instance a polynucleotide encoding a desired polypeptide can be cloned into intermediate vectors for transfection in eukaryotic cells for replication and/or expression. Intermediate vectors for storage or manipulation of the nucleic acid or production of protein can be prokaryotic vectors, (e.g., plasmids), shuttle vectors, insect vectors, or viral vectors for example. A desired polypeptide can also be encoded by a fusion nucleic acid.
To obtain expression of a cloned nucleic acid, it is typically subcloned into an expression vector that contains a promoter to direct transcription. Suitable bacterial and eukaryotic promoters are well known in the art and described, e.g., in Sambrook and Russell (Molecular Cloning: a laboratory manual, Cold Spring Harbor Laboratory Press). The promoter used to direct expression of a nucleic acid of choice depends on the particular application. For example, a strong constitutive promoter is typically used for expression and purification. In contrast, when a dedifferentiation protein or compound is to be used in vivo, either a constitutive or an inducible promoter or compound is used, depending on the particular use of the protein. In addition, a weak promoter can be used, such as HSV TK or a promoter having similar activity. The promoter typically can also include elements that are responsive to transactivation, e.g., hypoxia response elements, Ga14 response elements, lac repressor response element, and small molecule control systems such as tet-regulated systems and the RU-486 system.
In addition to a promoter, an expression vector typically contains a transcription unit or expression cassette that contains additional elements required for the expression of the nucleic acid in host cells, either prokaryotic or eukaryotic. A typical expression cassette thus contains a promoter operably linked, e.g., to the nucleic acid sequence, and signals required, e.g., for efficient polyadenylation of the transcript, transcriptional termination, ribosome binding, and/or translation termination. Additional elements of the cassette may include, e.g., enhancers, and heterologous spliced intronic signals.
Expression vectors containing regulatory elements from eukaryotic viruses are often used in eukaryotic expression vectors, e.g., SV40 vectors, papilloma virus vectors, and vectors derived from Epstein-Barr virus. Other exemplary eukaryotic vectors include pMSG, pAV009/A+,

pMTO10/A+, pMAMneo-5, baculovirus pDSVE, and any other vector allowing expression of proteins under the direction of the SV40 early promoter, SV40 late promoter, metailothionein promoter, murine mammary tumor virus promoter, Rous sarcoma virus promoter, polyhedrin promoter, or other promoters shown effective for expression in eukaryotic cells.
Standard transfection methods can be used to produce bacterial, mammalian, yeast, insect, or other cell lines that express large quantities of dedifferentiation proteins, which can be purified, if desired, using standard techniques. Transformation of eukaryotic and prokaryotic cells is performed according to standard techniques.
Any procedure for introducing foreign nucleotide sequences into host ceils can be used. These include, but are not limited to, the use of calcium phosphate transfection, DEAE-dextran-mediated transfection, polybrene, protoplast fusion, electroporation, iipid-mediated delivery (e.g., liposomes), microinjection, particle bombardment, introduction of naked DNA, piasmid vectors, viral vectors (both episomal and integrative) and any of the other well known methods for introducing cloned genomic DNA, cDNA, synthetic DNA or other foreign genetic material into a host cell (see, e.g., Sambrook et al., supra). It is only necessary that the particular genetic engineering procedure used be capable of successfully introducing at least one gene into the host cell capable of expressing the protein of choice.
Conventional viral and non-viral based gene transfer methods can be used to introduce nucleic acids into mammalian cells or target tissues. Such methods can be used to administer nucleic acids encoding reprogramming polypeptides to cells in vitro. Preferably, nucleic acids are administered for in vivo or ex vivo gene therapy uses. Non-viral vector delivery systems include DNA plasmids, naked nucleic acid, and nucleic acid complexed with a delivery vehicle such as a iiposome. Virai vector delivery systems inciude DNA and RNA viruses, which have either episomal or integrated genomes after delivery to the cell.
Methods of non-viral delivery of nucleic acids include lipofection, microinjection, ballistics, virosomes, liposomes, immunoliposomes, polycation or iipid-nucleic acid conjugates, naked DNA, artificial virions, and agent-enhanced uptake of DNA. Lipofection reagents are sold commercially (e.g., Transfectam™ and Lipofectin™). Cationic and neutral lipids suitable for efficient receptor-recognition lipofection of polynucleotides are known. Nucleic acid can be delivered to cells (ex vivo administration) or to target tissues (in vivo administration). The preparation of lipid:nucleic acid complexes, including targeted liposomes such as immunolipid complexes, is well known to those of skill in the art.
The use of RNA or DNA virus-based systems for the delivery of nucleic acids take advantage of highly evolved processes for targeting a virus to specific cells in the body and trafficking the viral payload to the nucleus. Viral vectors can be administered directly to patients (in vivo) or they

can be used to treat cells in vitro, wherein the modified cells are administered to patients (ex vivo). Conventional viral based systems for the delivery include retroviral, lentiviral, poxviral, adenoviral, adeno-associated viral, vesicular stomatitis viral and herpesviral' vectors, althoughntegration in the host genome is possible with certain viral vectors, including the retrovirus, lentivirus, and adeno-associated virus gene transfer methods, often resulting in long term expression of the inserted transgene. Additionally, high transduction efficiencies have been observed in many different cell types and target tissues.
pLASN and MFG-S are examples of retroviral vectors that have been used in clinical trials. In applications for which transient expression is preferred, adenoviral-based systems are useful. Adenoviral based vectors are capable of very high transduction efficiency in many cell types and are capable of infecting, and hence delivering nucleic acid to, both dividing and non-dividing cells. With such vectors, high titers and levels of expression have been obtained. Adenovirus vectors can be produced in large quantities in a relatively simple system.
Gene therapy vectors can be delivered in vivo by administration to an individual patient, typically by systemic administration (e.g., intravenous, intraperitoneal, intramuscular, subdermal, or intracranial infusion) or topical application. Alternatively, vectors can be delivered to cells ex vivo, such as cells explanted from an individual patient (e.g., lymphocytes, bone marrow aspirates, tissue biopsy) or universal donor hematopoietic stem cells, followed by reimplantation of the cells into a patient, usually after selection for cells which have been reprogrammed.
Ex vivo cell transfection for diagnostics, research, or for gene therapy (e.g., via re-infusion of the transfected cells into the host organism) is well known to those of skill in the art. In a preferred embodiment, cells are isolated from the subject organism, transfected with a nucleic acid (gene or cDNA), and re-infused back into the subject organism (e.g., patient). Various cell types suitable for ex vivo transfection are well known to those of skill in the art.
Vectors (e.g., retroviruses, adenoviruses, liposomes, etc.) containing therapeutic nucleic acids can be also administered directly to the organism for transfection of cells in vivo. Alternatively, naked DNA can be administered. Administration is by any of the routes normally used for introducing a molecule into ultimate contact with blood or tissue cells. Suitable methods of administering such nucleic acids are available and well known to those of skill in the art, and, although more than one route can be used to administer a particular composition, a particular route can often provide a more immediate and more effective reaction than another route.
Pharmaceutically acceptable carriers are determined in part by the particular composition being administered, as well as by the particular method used to administer the composition. Accordingly, there is a wide variety of suitable formulations of pharmaceutical compositions of the present invention.

Delivery of Polypeptides
In most, if not all the methods described herein, an alternative possibility consists of bypassing the use of a polynucleotide and contacting a cell of a first type cell directly with a compound (e.g. a polypeptide) for which an increased intracellular level is desired. In other embodiments, for example in certain in vitro situations, the cells are cultured in a medium containing one or more functional polypeptides.
An important factor in the administration of polypeptides is ensuring that the polypeptide has the ability to traverse the plasma membrane of a cell, or the membrane of an intra-cellular compartment such as the nucleus. Cellular membranes are composed of lipid-protein bilayers that are freely permeable to small, nonionic lipophilic compounds and are inherently impermeable to polar compounds, macromolecuies, and therapeutic or diagnostic agents. However, proteins, lipids and other compounds, which have the ability to translocate polypeptides across a cell membrane, have been described. For example, "membrane translocation polypeptides" have amphophilic or hydrophobic amino acid subsequences that have the ability to act as membrane-translocating carriers. Polypeptides for which an increased intracellular level is desired according to the invention can be linked to suitable peptide sequences for facilitating their uptake into cells. Other suitable chemical moieties that provide enhanced cellular uptake can also be linked, either covalently or non-covalently, to the polypeptides. Other suitable carriers having the ability to transport polypeptides across cell membranes may also be used.
A desired polypeptide can also be introduced into an animal cell, preferably a mammalian cell, via liposomes and liposome derivatives such as immunoliposomes. The term "liposome" refers to vesicles comprised of one or more concentrically ordered lipid bilayers, which encapsulate an aqueous phase. The aqueous phase typically contains the compound to be delivered to the cell. In certain embodiments, it may be desirable to target a liposome using targeting moieties that are specific to a particular cell type, tissue, and the like. Targeting of liposomes using a variety of targeting moieties (e.g., ligands, receptors, and monoclonal antibodies) has been previously described.
Cells and Cell Lines
The invention encompasses the cells, cell lines, stem cells and purified cell preparations derived from any of the methods described herein. In some embodiments, the ceils, cells lines, stem cells and purified cells preparations of the invention are of mammalian origins, including but not limited to human, primates, rodent, dog, cat, horse, cow, or sheep. In preferred embodiments, they originate from a human.

Accordingly, another aspect of the invention relates to modified cells, eel! lines, pluripotent, multipotent or unipotent cells and purified cell preparations, wherein any of these cells comprise . an exogenous polynucleotide encoding Musashil (Msi1); Msi1 and Ngn2; Msi1 and MBD2; and Ngn2 and MBD2; Msi1, Ngn2 and MBD2; Msi1, Ngn2, Nestin and MBD2; and other potential combinations from Table A preferably including Msi1 and Ngn2 and MBD2. In preferred embodiments the cell according to the invention is a stern-like cell, more preferably a Neural Stem-Like Cell (NSLC), the cell possessing one or more of the following characteristics:
- expression of one or more neural stem cell marker selected from the group consisting of
Sox2, Nestin, GFAP, Msi1, and Ngn2;
- decreased expression of one or more genes specific to the cell that the NSLC was
obtained from (e.g. see Table C);
- forms neurospheres in the neurosphere colony formation assay;
- capable of being cultured in suspension or as an adherent culture;
- capable of proliferating without the presence of an exogenous reprogramming agent for
over 1 month, preferably over 2 months, over 3 monthths, over 5 months and even for more than a year;
- capable of dividing every 36 hours at low passage;
- positive for telomerase activity;
- capable of differentiation into a neuronal-like cell, astrocyte-like cell, oligodendrocyte-like
cell and combinations thereof;
- decreased expression of telomerase and one or more neural stem cell markers after
differentiation;
- having one or more morphological neurite-like processes (axons and/or dendrites) greater
than one ceil diameter in length after differentiation into a neuronai-like cell;
- expression of at least one neural-specific antigen selected from the group consisting of
neural-specific tubulin, microtubule associated protein 2, NCAM, and marker for a neurotransmitter after differentiation into a neuronal-like cell;
- expression of one or more functional neural markers (e.g. synapsin) after differentiation
into a neuronal-like cell;
- capable of releasing one or more neurotrophic factors (e.g. BDNF) after differentiation into
a neuronal-like cell;
- negative in a tumor colony forming assay;
- negative for tumor growth in SCID mice;
- negative for teratoma growth in SCID mice;
- capable of significantly improving one or more functional measures after placement of an
adequate number of NSLCs into the void in a brain ablation model;
- capable of significantly improving or maintaining one or more functional measures after
injecting an adequate number of NSLCs into an EAE model; and

- capable of improving one or more functional measures more significantly than hNPCs in CNS injury or neurodegenerative models. Examples of all of the above items can be found in the Examples section of this application.
In preferred embodiments, a NSLC according to the inventions possesses all of the following characteristics:
- ability to self-renew for significantly longer than a somatic cell;
- is not a cancerous cell;
- is stable and not artificially maintained by forced gene expression or by similar means and may be maintained in standard neural stem cell media;
- can differentiate to a progenitor, precursor, somatic cell or to another more
differentiated cell type of the same lineage;
- has the characteristics of a stem cell and not just certain markers or gene expression or morphological appearance; and
- does not exhibit uncontrolled growth, teratoma formation, and tumor formation in vivo.
In one particular embodiment, the reprogrammed cells (NSLCs) according to the invention are capable of proliferating for several months without losing their neural stem cell markers and their ability to differentiate towards neuron-like, astrocyte-like, and oligodendrocyte-like cells. The generation of the neural lineages is characterized based on morphology, phenotypic changes and functionality.
in some embodiments, the cells of the invention may have one or more of the following characteristics and properties: self-renewal, multilineage differentiation in vitro and in vivo, clonogenicity, a normal karyotype, extensive proliferation in vitro under welf defined culture conditions, and the ability to be frozen and thawed, as well as any of the commoniy known and/or desired properties or characteristics typical of stem cells. The cells of the invention may further express molecular markers of multipotent or pluripotent cells (i.e. gene and surface markers as defined previously).
Another aspect of the invention relates to the production of tissue specific autologous (self) stem and/or progenitor cells. These stem and/or progenitor cells may be used in cell therapy applications to treat diseases of cellular degeneration. Diseases of cellular degeneration include, for example, neurodegenerative diseases such as stroke, Alzheimer's disease, Parkinson's disease, multiple sclerosis, Amyotrophic lateral sclerosis, macular degeneration, osteolytic diseases such as osteoporosis, osteoarthritis, bone fractures, bone breaks,-diabetes, liver injury, degenerative diseases, myocardial infarct, burns and cancer. It is envisioned that cells according to the invention may be implanted or transplanted into a host. An advantage of the invention is that large numbers of autologous stem cells can be produced for implantation without the risk of immune system mediated rejection. Those cells can lead to productiorr of

tissue suitable for transplant into the individual. Since the tissue is derived from the transplant recipient, it should not stimulate an immune response, as would tissue from an unrelated donor. Such transplants can constitute tissues (e.g. vein, artery, skin, muscle), solid organ transplants (e.g., heart, liver, kidney), neuronal cell transplants, or bone marrow transplants such as are used in the treatment of various malignancies such as, for example, leukemias and lymphomas. Neural stem cell, neuroprogenitor, or neuronal cell (as well as NSLCs and derivations thereof) transplants can also be used in the treatment of, for example, neurological disorders, stroke, spinal cord injury, Parkinson's disease, and the like, as well as potentially some non-neurological disorders such as a cardiac infarct.
Another aspect of the invention relates to a method to produce ex vivo engineered tissues for subsequent implantation or transplantation into a host, wherein the cellular components of those engineered tissues comprise cells according to the invention, or cells derived therefrom. For example, expanded cultures of the cells of the invention may be differentiated by in vitro treatment with growth factors and/or morphogens. Populations of differentiated cells are then implanted into the recipient host near the site of injury or damage, or cultured in vitro to generate engineered tissues, as described.
The methods and cells of the invention described herein can be used to immortalize cells, for example to generate a cell line. Using the methods disclosed herein, a somatic cell can be transformed into one possessing a dedifferentiated phenotype, thereby facilitating the generation of cell lines from a variety of tissues. Therefore, the invention encompasses such immortalized cells.
In addition, the methods of deriving the cells according to the invention, may be helpful in scientific and therapeutic applications including, but not limited to, (a) scientific discovery and research involving cellular development and genetic research (e.g. uses in lieu of human stem cells as a model cell line to study the differentiation, dedifferentiation, or reprogramming of human cells), (b) drug development and discovery (e.g., screening for efficacy and toxicity of certain drug candidates and chemicals, screening for prospective drugs or agents which mediate the differentiation, dedifferentiation, or reprogramming of cells), (c) gene therapy (e.g., as a delivery device for gene therapy), and (d) treatment of injuries, trauma, diseases and disorders including, but not limited to, Parkinson's, Alzehimer's, Huntington's, Tay-Sachs, Gauchers, spinal cord injury, stoke, burns and other skin damage, heart disease, diabetes, Lupus, osteoarthritis, liver diseases, hormone disorders, kidney disease, leukemia, lymphoma, multiple sclerosis, rheumatoid arthritis, Duchenne's Musclar Dystrophy, Ontogenesis Imperfecto, birth defects, infertility, pregnancy loss, and other cancers, degenerative and other diseases and disorders.

Additional aspects concern therapeutic methods, methods of treatment and methods of regenerating a tissue or organ in a mammal (e.g. a human subject). One particular method • concerns a method of regenerating a mammalian tissue or organ which comprises contacting the tissue or organ to be regenerated with a SLC, NSLC, or other desired ceil or artificial tissue construct as defined herein. The SLC, NSLC, desired cell or artificial tissue construct may be placed in proximity to the tissue or organ to be regenerated by administering to the subject using any suitable route (e.g. injecting the cell intrathecally, directy into the tissue or organ, or into the blood stream).
Another method for repairing or regenerating a tissue or organ in a subject in need thereof comprises administering to the subject a compound inducing a direct or indirect endogenous expression of at least one gene regulator in cells of the tissue or organ and/or a compound inducing a direct or indirect endogenous expression of at least one gene regulator in cells capable of transformation or dedifferentiation in vivo in the subject. Accordingly, the expression of the at least one gene regulator reprograms the cells into desired cells of a different type (e.g. neural stem-like cells), and these cells of a different type are effective in repairing or regenerating said tissue or organ.
Another method comprises obtaining cells or tissue from a patient (e.g. hematopoietic stem cells, fibroblasts, or keratinocytes), reprogramming a plurality of such cells or the tissue, and reintroducing the reprogrammed cells or tissue into the patient. A related aspect concerns pharmaceutical compositions comprising a plurality of a desired cell, SLC and/or Neural Stem-Like Cell (NSLC) or reprogrammed tissue as defined herein.
The therapeutic methods of the invention may be applicable to the regeneration or repair of various tissues and organs including, but not limited to, the brain, the spine cord, the heart, the eye, the retina, the cochlea, the skin, muscles, intestines, pancreas (including beta cells), kidney, liver, lungs, bone, bone marrow, cartilage, cartilage discs, hair follicles, teeth, blood vessels, glands (including endocrine and exocrine glands), ovaries, reproductive organs, mammary and breast tissue.
A related aspect concerns pharmaceutical compositions comprising a plurality of desired cell, SLC and/or Neural Stem-Like Cell (NSLC) as defined herein.
Tissues
Another aspect of the invention relates to a tissue containing reprogrammed cells as defined herein that can be implanted into a subject in need thereof.

In some embodiments the present invention provides for the reprogramming of cells within a tissue, for example an in vitro produced 3D tissue construct comprising cells and extracellular matrix produced by these cells. In addition, transfected cells can be seeded on top of these 3D tissue constructs that can be made completely autologously, thus preventing host rejection, making it completely immunocompatible and as carrier for reprogrammed cells to be transplanted in vivo. Advantageously, these newly created cells can be used in their undifferentiated and/or differentiated state within these tissues for in vitro diagnostic purposes or transplanted into a patient in need of such a construct in cell therapy / tissue replacement approaches.
The invention further encompasses 3D Neuronal-Like multilayer tissue. Cells within CDM reprogrammed to Neural Stem-Like Cells according to the invention readily differentiate into neuronal-like cells, astrocyte-iike cells, and oiigodendrocyte-like cells within the CDM. It is thus possible to use CDM and reprogramming methods of the invention to reprogram the cells within the CDM to form 3D Neuronal-Like multilayer tissue (up to >30 cell layers). Such 3D tissue comprises neurons {or specifically, neuron-like ceils), astrocytes (or specifically, astrocyte-like cells), and oligodendrocytes (or specifically, oligodendrocyte-like cells) and it can be made completely autologously, can be manually handled and implanted with relative ease, or can used as an in vitro CNS tissue model.
One particular aspect concerns an artificial tissue construct which comprises a 3D assembly of in vitro cultured cells and extracellular matrix produced by these cells. The cells may be desired cells, SLC and/or a plurality of Neural Stem-Like Cell (NSLC) obtained using any one of the methods described herein.
Screening methods
Another aspect of the invention relates to methods for identifying new compounds (e.g. small molecules, drugs, etc) capable of transforming a cell of a first type to a desired cell of a different type. These new compounds may be useful! for research purposes or as medicaments for use in reparing or regenerating tissues in a subject.
The Examples section provides principles, methods and techniques useful for screening and identifying such desirable active compounds. For instance, those skilled in the art will understand that it is conceivable to screen for compounds that will induce transformation of a cell of a first type to a NSLC by replacing the "induction" or "biological activity" provided by the transient increase of Musashl1, NGN2 or MBD2 in the cell by a candidate compound to be tested (e.g. a library of small molecules or compounds) and measuring activity or efficacy of the candidate compound in generating the NSLC. Individual or mixture of active compounds would be selected if they have the same activity and/or if they can provide the same or similar effects

as these polypeptides (e.g. cell transformation and/or appearance of any desirable markers or desirable characteristics as defined hereinbefore): For example, a compound or mixture of compounds capable of transforming a fibroblast into a NSLC could be identified by: -
(i) Setting up, culturing and transforming the fibroblasts into NSLC as in Example 1; (ii) Screening a library of compounds by replacing Msi1, Ngn2 and/or MBD2 with each
candidate compound in a different well; (iii) Identffy a compound 'hit' when the candidate compound is able to transform the
fibroblasts into NSLCs approximately as well as the replaced Msi1, Ngn2 and/or
MBD2; (iv) If compound from part (iii) did not replace all of Msi1, Ngn2 and MBD2, and is not
able to transform the fibroblasts into NSLCs by itself, then by including the
compound from (iii) in each well, screening a library of compounds by replacing the
Msi1, Ngn2 and/or MBD2 that was not removed in part (ii) with each candidate
compound in a different well; (v) Identify a compound 'hit' when the candidate compound is able to transform, along
with the compound from part (iii), the fibroblasts into NSLCs approximately as well as
the replaced Msi1, Ngn2 and/or MBD2; (vi) If compound from part (V) did not replace all of Msi1, Ngn2 and/or MBD2, and is not
able to transform the fibroblasts into NSLCs together with the compound from part
(iii), then by including the compound from (iii) and (v) in each well, screening a library
of compounds by replacing the Msi1, Ngn2 or MBD2 that was not removed in part (ii)
and (iv) with each candidate compound in a different well; (vii) Identify a compound 'hit' when the candidate compound is able to transform, along
with the compound from part (iii) and (v), the fibroblasts into NSLCs approximately
as well as the replaced Msi1, Ngn2 or MBD2; (viii) A combination of the compounds from part (iii), (v) and (vii) will be able to transform
the fibroblasts into NSLC; modifications to these compounds can be made and
further screened to identify more effective or safe versions of these compounds.
The same principles are applicable for other desired types of stem-like cells including pluripotent-like cells, mesendoderm-like cells, pancreatic progenitor-1 ike cells, etc. Tables A and B, and the Examples section provides, for each of these types of cells, a list of potential genes and/or compounds to be considered in such screening methods.
Accordingly, the present invention encompasses these and any equivalent screening methods where candidate compounds are tested for their efficacy in transforming a cell of a first type to a desired cell of a different type when compared to the efficacy of the reprogramming factor and/or gene regulator as defined herein.

Delivery of neurotrophic factors
Local delivery of neurotrophic factors has been suggested as a method to treat several neurological conditions. Strategies using neurotrophic molecules focus on preventing the progressive loss of neurons, maintaining neuronal connections and function (neuroprotection), and inducing additional regenerative responses in neurons such as increased neurotransmitter turnover and/or axonal sprouting (neuroregeneration). Up to date, several therapeutic strategies to deliver neurotrophic-factors in animal models have been explored, but so far testing of the effects of growth factors on the brain and nervous system have been limited to direct peripheral injection of large doses of these factors, which carries a significant risk of side effects. Accordingly, a related aspect of the invention relates to overcoming these problems by using NSLC cells and cell fines according to the invention which can stably express and secrete growth factors of potential interest after transplantation.
To summarize, the present invention provides a plentiful source of Neural Stem-Like Cells, Neuron-Like Cells, Astrocyte-Like Cells or Oligodendrocyte-Like Cells for potential clinical treatments which require transplantation of neural stem cells, neurons, astrocytes or oligodendrocytes 1) to compensate for a loss of host cells (ex. neurons) or 2) as vehicles to deliver genetically-based drugs. Further, the invention provides a novel neurological tool for use in basic research and drug screening.
Those skilled in the art will recognize, or be able to ascertain using no more than routine experimentation, numerous equivalents to the specific procedures, embodiments, claims, and examples described herein. Such equivalents are considered to be within the scope of this invention and covered by the claims appended hereto. The invention is further illustrated by the following examples, which should not be construed as further limiting.
Examples
The examples set forth herein below provide exemplary methods for obtaining Reprogrammed and Dedifferentiated cells, including Neural Stem-Like 'Cells (NSLCs). Also provided are exemplary protocols, molecular tools, probes, primers and techniques.
EXAMPLE! Preparation of Human Fibroblast Cells
Human Foreskin fibroblast (HFF) cells were purchased from American Type Culture Collection (ATCC, Manassas, Va) and expanded in ceil culture flasks with Dulbecco's Modified Eagle's Medium (DMEM, Invitrogen), supplemented with 10% heat-inactivated fetal calf serum (FCS, Hyclone Laboratories), 0.1 mM non-essential amino acids, and 1.0 mM sodium pyruvate (Invitrogen) at 37°C, 5% C02.The medium was changed twice per week. Cells were trypsinized using Trypsin 0.25% for 4 minutes at 37°C, followed by adding trypsin inhibitor solution, ......

pelleting the cells by centrifugation, washing the cells once with PBS, and plating the cells at a ratio of 1:2 onto tissue culture flasks until a suitable number of cells was reached.
Cells were then trypsinized and plated (8x104cells/well) in cell'culture plates pre-coated ' with Laminin (10ug/ml, Sigma) in two different composition of CDM medium: CDM I Medium consisting of a 3:1 ratio of Dulbecco's modified Eagle medium (DMEM, high glucose (4.5g/L) with L-glutamine and sodium pyruvate) and Ham's F-12 medium supplemented with the following components: EGF (4.2x10~10M), bFGF (2.8x10~10M), ITS (8.6x10"5M), dexamethasone (1.0x10'7M), L-3,3',5-triiodothyronine (2.0xKr1oM), ethanolamine (KT'M), GlutaMAX™ <4x10_ 3M), and glutathione (3.3x1 Q^M), but without the presence of L-ascorbic acid.
CDM II Medium consisting of a.3:1 ratio of Dulbecco's modified Eagle medium (DMEM, high glucose (4.5g/L) with L-glutamine and sodium pyruvate) and Ham's F-12 medium supplemented with the following components: EGF (2.5 ng/ml), bFGF (10ng/ml), ethanolamine (2.03mg/ml), insulin (10 mg/ml), Selenious acid (2.5 ng/ml), dexamethasone (19.7 µg/ml), L-3,3',5-triiodothyronine (675 ng/ml), GlutaMAX™ (4x10"3M), and glutathione (3.3x10"SM).
Transient Transfection of HFF by Lipofectamine using Constructed Vectors
After two days in culture, cells were transfected with pCMV6-XL5-MBD2 (2µg) (a DNA demethylator) using lipofectamine reagent (Invitrogen) as per the manufacturer's protocol. The DNA-lipid complex was added to cells and incubated for 24 h at 37°C, 5% C02. After 24 hours of transfection with the DNA demethylator, the medium was changed and ceils were transfected by pCMV6-XL5-Musashi1 (2\ig, Origene) or pCMV6-XL4-Ngn2 (2µg, Origene) for 24 h. After 24 hours, the medium was changed to Neural Progenitor Basal Medium (NPBM, Lonza) supplemented with Noggin (20 ng/ml, Peprotech), EGF (20ng/ml, Peprotech), and bFGF (20ng/ml, Peprotech) and cultured in this Proliferation Medium. Cells were retransfected after three days and incubated at 37°C, 5% C02 and 5% 02. After 7 days in proliferation conditions, 50% of the Proliferation Medium was changed to Differentiation Medium (NbActive, BrainBits™) supplemented with Forskolin (10uM, Tocris), a//-trans-Retinoic Acid (ATRA, 5uM, Spectrum), bFGF (20ng/ml, Peprotech), NGF (20ng/ml, Peprotech), and BDNF (20ng/ml, Peprotech); medium was changed every day by increasing the percentage of Differentiation Medium over Proliferation Medium, and the cells were cultured for 20 days.
Visual observation of reprogrammed cells was performed by light microscopic observation every day following transfection using bright field at 10X magnification. Samples were collected at different time points (6, 12, and 20 days) to analyze neuronal gene expression and protein levels by gene array and immunohistochemistry. Following transfection, reprogramming cells displayed a rapid change in celiular morphology within 3 days post-transfection (Figure 1). The cells were more rounded and the cell's cytoplasm retracted towards the nucleus forming contracted cell bodies with extended cytoplasmic extensions and exhibiting

neuronal perikaryal appearance at day 6 and 12, which was maintained until day 20. However, this morphology was not observed in untransfected cells at day 6 and 12.
Gene Array Analysis
Characterization of the newly engineering cells after transfection was performed using a neuronal gene-array containing 48 partial cDNAs coding for these genes and controls.
RNA was isolated from samples using QfAshredder™ (Qiagen) and RNeasy™ Pfus mini Kit (Qiagen) as per manufacturer's instructions. DNase I treatment was performed on the RNeasy™ Column to further remove the transfected plasmid DNA using Rnase-Free DNase Set (Qiagen). RNA was eluted in 35 pi of RNase-free water. Before cDNA synthesis, all RNA samples were quantified using the NanoDrop 1000™ (ThermoScientific). cDNA was prepared using the High Capacity cDNA archive kit (Applied Biosystems) as per the manufacturer's instructions. 400 ng of RNA was used in each 50ul RT reaction. The resulting cDNA samples were used immediately for TLDA analysis. For each card of the Taqman™ low-density array (TLDA), there are eight separate loading ports that feed into 48 separate wells for a total of 384 wells per card. Each 2 µL well contains specific, user-defined primers and probes, capable of detecting a single gene. In this study, a customized Neuronal Markers 2 TLDA was configured into eight identical 48-gene sets, i.e. 1 loading port for each 48-gene set. Genes were chosen based on literature. Each set of 48 genes also contains three housekeeping genes: ACTIN, GAPDH, and PPIA.
A sample-specific master mix was made for each sample by mixing cDNA (160 ng for each loading port), 2X Taqman™ Gene Expression Master Mix (Applied Biosystems) and nuclease-free water (USB) for a total of 100 pi per loading port. After gentle mixing and centrifugation, the mixture was then transferred into a loading port on a TLDA card. The array was centrifuged twice for 1 minute each at 1200 rpm to distribute the samples from the loading port into each well. The card was then sealed and PCR amplification was performed using Applied Biosystems 7900HT™ Fast Real-time PCR system. Thermal cycler conditions were as follows: 2 minutes at SO'C, 10 minutes at 94.5°C, and 30 seconds at 97°C, 1 minute at 59.7°C for 40 cycles. 1 TLDA's was prepared for 8 samples.
Relative Expression values were calculated using the Comparative CT method. Briefly, this technique uses the formula 2-∆∆CT to calculate the expression of target genes normalized to a calibrator. The threshold cycle (CT) indicates the cycle number at which the amount of amplified target reaches a fixed threshold. CT values range from 0 to 40 (the latter representing the default upper limit PCR cycle number that defines failure to detect a signal). ACT values [ACT = CT (target gene) - CT (Average of 3 Housekeeping genes)] were calculated for HFF Ctrl, and subsequently used as the calibrator for the respective samples. All gene expression values were assigned a relative value of 1.00 for the calibrator, which is used to determine comparative

gene expression such that AACT = ACT (Treated) - ACT (HFF Ctrl). Relative Expression is calculated using the formula 2~∆∆CT.
Quantitative comparison of astrocyte, neuron, and oligodendrocyte gene expression allowed identification of the majority of the genes that are differentially expressed in reprogrammed cells. Data in Table 1 were analyzed by using a significance analysis algorithm to identify genes that were reproducibly found to be enriched in reprogrammed cells compared to untransfected cells. After the transfection with Msi1 or Ngn2 in the presence of MBD2, the expression of oligodendrocytes progenitors such as NKx2.2, olig2, and MAG and two markers for astrocytes (GFAP and AQP4) were highly increased. Also, several markers of early neuronal cells were enhanced after the transfection of HFF. TDLA data revealed a remarkable increase in specific markers for intemeurons, such as somatostatin and calbindinl. The induction of Doublecortin (DCX), which is expressed by migrating immature cells during development, and acetylcholine (ACHE) mRNA, an early marker of neuronal cells, were highly expressed in the reprogrammed cells (Table 1). Transfection increased the expression of dihydropyrimidinase-like 3 (DPYSL3), an early marker of newborn neurons, to fivefold with Msi1 and seven fold with Ngn2. Expression of Microtubule-Associated Protein 2 (MAP2), an essential marker for development and maintenance of early neuronal morphology and neuronal cell adhesion molecule, were highly expressed with Msi1 and Ngn2 (Table 1). The expression of enolase-2, a marker of mature neurons, was 20-fold enhanced by Msi1 and Ngn2. Member of the NeuroD family NeuroDI was highly expressed after transfection with Msi1 to 84 fold and to 34 by Ngn2.
Gene expression of growth factors such as IGF-t, IGF2, NPY and CSF-3 was also enhanced in reprogrammed cells. The expression of VEGF and GDNF genes were up-regulated to almost five fold and seven fold by Msi1 and Ngn2, respectively. However, the expression of BDNF, EGF, and bFGF were not activated and even down-reg dated as compared to untransfected cells. The expression of growth associated protein (GAP-43), a growth- and regeneration-associated marker of neurons, and expression of netrin, implicated in neuronal development and guidance, were highly enriched in reprogrammed cells. Expression of receptors for growth and neurotrophin factors was increased, such as type III receptor tyrosine kinase, neurotrophic tyrosine kinase, and neurotrophic tyrosine kinase receptor. Vimentin and fibronectin, markers for fibroblasts, were down-regulated in reprogrammed cells compared to the untransfected control fibroblast cultures.

Table 1: Gene array of transfected human fibroblast cells by Msi1/MBD2 and Ngn2/MBD2. Gene array was performed on samples after two weeks of differentiation. Expression values are given relative to untransfected fibroblasts.

Symbol Common nime and description Company Relative Relative
Gene ID expression expression
j to Msil to Ngn2
Astrocytes and
oligodendrocytes
markers
-NKx2-2 -Markers for oligodendrocyte NM 002509.2 very high very high
-OLIG2 progenitors NM 005806.2 47.511 8.38
-MAG -Oligodendrocyte lineage transcription factor 2 NM-080600.1 212.61 4.51
-GFAP -Myelin-associated glycoprotein NM 002055.4 very high very high
-AQP4 -Glial fibrillary acidic protein -Aquaporin 4 NM_001650.4 83.77 56.86
NC markers
-SST -Somatostatin, specific marker for NM 0010483 32.73 35.34
-CALB1 interneurons NM_004929.2 18.21 13.22
-Tubulin] A -Calbindin 1, interneuron marker NM_006009.2 7.45 9.32
-NES -Are necessary for axonal growth NM 006617.1 1.61 1.54
-DCX -Precursor neurons (neslin) NMJ78151.1 very high very high
-ACHE -An early neuronal marker (Doublecortin) NM_015831.2 9.02 13.22
-EN02 -Acetylcholinesterase, marker of early NM 301975.2 22.62 20.68
-NEUROD1 neuronal development
-A marker for neurons cells, enolase
-Neural marker; expression gradually NM_002500.2 84.22 34.27
-DPYSU increased from neura! precursor to fully differentiated neuron NM_001387.2 5.33 7.02
-MAP2 -Dihydropyrimidinase-like3, marker of immature neurons -Microtubule-associated protein 2, NM_002374.3 86.38 89.67
-NCAM essential for development of early neuronal morphology and maintenance of adult neuronal NMJ8135.3 very high very high
-CENDI morphology
-Neural cell adhesion molecule 1
-Cell cycle exit & neuronal differentiation, early marker of proliferating precursor cells that will differentiate to neurons NM_016564.3 4.80 5.57

Ncuroregeneration

and survival genes
-FGF2 -Fibroblast growth factor-Epidermal NM 002006.4 0.06 0.11
-EGF growth factor, Hs00l53181_ml . 0.99 0.56
-IGF-1 -Insulin growth factor-1, NM 000618.2 58.92 21.21
-IGF-2 -Insulin growth factor-2 NM 0000612.3 very high very high
-CSF3 -Granulocyte colony-stimulating NM 2219.1 very high 42.60
-BDNF factor- Brain derived growth factor, NM-199231.1 0.05 0.03
-GDNF neurogenesis NM-000614.2 4.77 6.89
-CNTF -Glial derived neurotrophic factor NM 001025366. 1.86 1.09
-VEGF -Ciliary neurotrophic factor 1 6.67 7.32
-BMP-4 -Vascular endothelial growth factor NM 130850.1 5.96 8.57
-KDR -Bone morphogenetic protein 4 NM 002253.1 31.78 6.83
-NTRK2 -Type III receptor tyrosine kinase) NM 006180.3 10.31 13.37
-NPY "-Neurotrophic tyrosine kinase receptor (TrkB) NM_00905.2 very high very high
-PIK3CG -Neuropeptide factors very high very high
-STAT3 NM 002649.2 2.14 3.65
-Gap43 -phosphoinositide-3-kinase, NM 213662.1 very high very high
-NTN1 -Signal transduction transcription 3 -Growth associated protein 43 NM 002045.2 NM__006180.3 26.84 23.98
-NTRk2 -Netrin 3, implicated in neuronal 10.31 13.37
-Slit development and guidance NM 024003.1
-Vimcntin -Neurotrophic tyrosine kinase, very high very high
-Fibronectin receptor, type 2 NM 003061.1 0.11 0.13
-Axonal guidance molecules -Radial glia and fibroblast marker -fibronectin is a marker for fibroblasts HsOOl85584
NM 212474.1 0.15 0.23
Immunohistochemical Analysis
Ceiis were fixed with a 4% formaldehyde /PBS solution for 10min at room temperature and subsequently permeabilized for 5min with 0.1% Triton X-100™ in 4% formaldehyde/PBS. After two brief washes with PBS, unspecific antibody binding was blocked by a 30min incubation with 5% normal goat serum in PBS. Then primary antibodies were added in 5% normal goat serum / PBS as follows: Mouse anti-Nestin (1:100, BD) as an intermediate microfilament present in neural stem cells and mouse anti-NCAM (1:100, Neuromics) as neuronal adhesion ■ molecule. After a 2h incubation the cells were washed 4 times for 5min each with 0.1% Tween™ /PBS. Appropriate fluorescence-tagged secondary antibody was used for visualization; Goat anti-mouse 546 (1:200, invitrogen) prepared in 5% norma! goat serum / PBS was used. After incubation for one hour, cells were washed in 0.1% Tween™ / PBS three times for 5min each. The DNA stain Hoechst33342 (Invitrogen) was used as a marker of nuclei (dilution 1:5000 in PBS, 10min incubation). Fluorescence images were taken with a Cellomics™ ArrayScan HCS Reader microscopy system. To determine an estimate of the percentage of cells adopting neuronal or glial phenotypes, random fields were selected and for each field the total number of cells (as determined by counting Hoechst stained nuclei) and the total number of cells positive for neuronal or glial markers were determined.
To confirm that these cells exhibited markers of neuronal lineages, cells were immunostained for nestin and NCAM. This analysis revealed that reprogrammed cells

expressed both proteins. As shown in Figure 2, NCAM was present in cells during the 6 days post-transfection and increase at day 12 and 20 following differentiation, while the inverse pattern was observed for the nestin staining.
This study showed the ability to reprogram HFF cells using one neurogenic transcription factor with the presence of a DNA demethylator towards cells that expressed neuronal genes and proteins specific to neural stem cells and neuronal cells. These reprogrammed cells were stable in culture for at least 2 weeks:
EXAMPLE II Comparison of Reprogramming Efficiency of Three Different Neurogenic Genes
HFF cells were cultured as described in Example I and plated in CDM f medium. Cells were transfected using the Amaxa Nucleofector™™ Device (Lonza). The HFFs were harvested with TrypLE™ (Gibco), resuspended in CDM Medium and centrifuged for 10 min at 90xg (1x106 cells / tube). The supernatant was discarded and gently resuspended in 100ul of Basic Nucleofector™ Solution (basic Nucleofector™ kit for primary mammalian fibroblasts, Lonza). Each 100 µ! of cell suspension was combined with a different mix of plasmid DNA (for example, sample 1 was mixed with 2 µg of pCMV6-XL5-Pax6 and 2ug pCMV6-XL5-M8D2). Cell suspension was transferred into an Amaxa certified cuvette and transfected with the appropriate program (U023). The sample was transferred without any further resuspension into a coated culture plate with LAS-Lysine/Alanine (BrainBits™, 50|ig/ml) and the cells were incubated at 37°C, 5% C02- These steps were repeated for each sample that was transfected. After 24 hours, the medium was changed to Proliferation Medium. After two days, cells were retransfected using lipofectamine as described in Example f and incubated at 37°C, 5% C02and 5% 02. After 6 days, differentiation was induced with Differentiation Medium that gradually replaced the Proliferation Medium over several days. Cells were collected at day 14 for RT-PCR and imunohistochemistry analysis.
Gene Expression Analysis
RNA isolation and quantification was performed as previously described in Example I. cDNA was prepared using the High Capacity cDNA RT kit (Applied Biosystems) as per the manufacturer's instructions with a final cDNA concentration of 2ng/µl. Real-time PCR was then performed for each gene of interest using the FAST PCR master mix (Applied Biosystems) and the Taqman™® Gene Expression Assays (Applied Biosystems) listed below:

Gene Name Assay ID ]
ACHE Hs00241307 ml
NES Hs00707120 s1
TUBB3 Hs00964962 g1
GFAP Hs00157674 ml
PAX6 Hs00240871 ml

MSI1 Hs01045894 ml
NGN2 Hs00702774 s1
MAP2 Hs00258900 ml
GAPDH (housekeeping gene) Hs99999905 ml
PPIA (housekeeping gene) Hs99999904 ml
The FAST 96-weil reaction was performed with 8ng cDNA per well in a 10µl reaction with 40 cycles. Thermal cycler conditions were as follows: 20 seconds at 95°C, and 1 second at 95°C, 20 seconds at 60°C for 40 cycles.
Relative Expression values were calculated as previously described in Example I, except the Average of 2 Housekeeping genes (GAPDH & PPIA) was used for normalization instead of the Average of 3 Housekeeping genes. Identification of neuronal lineage genes was investigated following the transfection with three independent vectors containing Msi1, Ngn2, and Pax6.
As shown in Table 2, after 14 days following transfection, relative expression of mRNA of neuronal lineage was undetectable in untransfecfed cells (HFF), while the cells transfected with Msi1 or Ngn2 in the presence of MBD2 expressed neural stem cell markers (Nestin and Sox2), however the expression of Sox2 was much more highly expressed than nestin following transfection with Ngn2 or Msi1. Neuronal and astrocyte specific genes (BIII-Tubulin, MAP2b, GFAP, and ACHE) was increased as well. mRNAs level of the tripotent-associated genes plll-tubulin, MAP2b, acetycholine, and GFAP were undetectable in Pax6 transfected cells, indicating that Pax6 alone was not implicated in the reprogmmming process toward neuronal lineage.

Immunohistochemical Analysis
Fluorescent imunohistochemical staining was performed as previously described in Example I. In agreement with the RT-PCR data, immunohistochemical analysis of these ' cultures revealed that reprogrammed cells (with Msi1 or Ngn2) generated morphologically complex neurons that were positive for MAP2b, indicating the differentiation of NSLCs to neuron-like cells (NLCs) {Figure 3): However, the positive staining for these markers was undetectable after transfection with Pax6/MBD2. Moreover, the newly formed neurons expressed the markers for and developed long neurttes with growth cones at their ends, expressed neural specific genes, and ceased to proliferate when they were exposed to differentiation conditions.
EXAMPLE III Transfection of HFF by various combinations of vectors and disruption of cell cytoskeleton
Various combinations of neurogenic regulators and cytokines for epigenetic modifications were tested to ascertain their effect on reprogramming efficiency. Starting one day before transfection, cells were treated with or without cytochalasin B (Calbiochem), with the concentration decreased every day over five days during media changes (starting with 10ug/ml Cytochalasin B on day 1 to 7.5ug/mf, 5ug/ml, 2.5µg/ml, and Oug/ml over the subsequent four days) in order to investigate the effect of disrupting the cell cytoskeleton on the process of reprogramming. Cells were transiently transfected as described in Example IE with one or two vectors containing one neurogenic transcription factors by nucleofection. Cells were co-transfected with either of two DNA demethylators, MBD2 or GAdd45B, (e.g. 2x106 cells were transfected with pCMV6-XL5Msi1 {2µg} and pCMV6-XL5-MBD2 (2pg)). After 24 hours, the medium was changed to Neural Proliferation Medium (NeuroCuft™ proliferation Kit, StemCell Technologies) consisting of DMEM/F12 (1:1), glucose (0.6%), sodium bicarbonate (0.1%), glutamine (20 mM), HEPES (5mM), insulin (230 µg/ml), transferrin (100 jig/ml), progesterone (200nM), putresctne (90 fig/ml), and sodium selenite (300nM) and supplemented with Noggin (20 ng/ml, Peprotech), recombinant hFGF (20ng/ml, Peprotech), and recombinant hEGF (20ng/ml, Peprotech) and cells were cultured for two weeks at 37°C, 5% C02 and 5% 02. Cells were then analyzed for neural stem cell markers.
Gene Expression Analysis
Gene expression analysis was performed for neural stem-specific markers (Sox2, Nestin, GFAP) and a fibroblast-specific marker (Col5A2) by RT-PCR as previously described in Example I. RT-PCR analysis showed that the relative expression of Sox2, nestin and GFAP was enhanced after transfecting the cells with the neurogenic transcription factors. As shown in Table 3, transfecting the cells with one transcription factor Msi1 in the presence of Gadd45b-

was associated with up-regulation of relative expression of Sox2 (22.3+5.26) and GFAP (10.14±0.15) and the expression of the these genes was highly increase when transfecting the cells with Ngn2 by 20 fold and 10 fold respectively! Combining the two neurogenic fators (Msi1 and Ngn2) with Gadd45b enhanced further the expression of Sox2 and GFAP. Transfecting the cells with one transcription factor (Msi1 or Ngn2) in the presence of MBD2 was associated with up-regulation of relative expression of Sox2, Nestin, and GFAP and down-regulation of Col5A2, while co-tranfection with Gadd45b did not increased the expression of nestin and the expression of Col5A2 was not regulated. The enhancement of neural stem cells relative expression was observed when transfecting the ceils with two neurogenic genes in combination with MBD2; a small increase in the expression was noticed in the presence of cytochalasin B under certain conditions. An increase in the relative expression of the neural stem-specific markers (Sox2, Nestin, GFAP) and a decrease in the fibroblast-specific gene (COL5A2) was observed after transfection with Msi1/Ngn2/MBD2, Msi1/Ngn2/Gadd45b, Msi1/MBD2 or Ngn2/MBD2 (Table 3). This study demonstrated that MBD2 increased more reprogramming efficiency then GDA45b and showed that cytochalasin B had no effect of its own in the control cultures.

Immunohistochemical Analysis
Fluorescent imunohistochemical staining was performed as previously described in Example I. Table 4 shows the percentage of Nestin and Sox2 in each condition, with the highest percentage of Sox2 (38.18 ±1.75%) and nestin (28.18 ±2.77%) positive cells observed after transfecting the cells simultaneously with both neurogenic transcription factors and in the presence of a DNA demethylator and cytochalasin B. A slight increase of Sox2 positive cells (10.42 ±10.27%) and nestin positive cells {4.85 ±1.10%) was detected following transfection with one transcription factor Msi1 and MBD2. Same tendency of nestin and Sox2 positive cells was observed following transfection wirhNgn2 and MBD2. Disrupting the cell cytoskeleton with Cytochalasin B significantly enhanced reprogramming, but had no reprogramming effect on its own (Table 4).
Table 4: Percentage of positive cells for Sox2 and nestin after transfection of fibroblast cells with different expression vectors with or without the presence of cytochalasin B. After transfection the cells were cultured in proliferation medium (StemCell Technologies) supplemented by EGF (20ng/ml, Peprotech) and FGF (20ng/ml, Peprotech) for two weeks at 37°C/5%C02/5%02. The percentage of immunopositive cells was determined by Ceflomics™ and represented as mean±SD (n = 3-5).

% of 80x2 positive cells % of Nestin positive cells
+CytoB -Cyto B +CytoB -CytoB
Untransfected cells 0.02+0.01 0.01+0.00 0.14±0.04 0.11+0.09
Ngn2 0.35±0.36 0.15±0.05 2.34±0.99 1.04+0.21
Msi1 0.23±0.15 0.12±0.09 1.95+0.11 1.11+0.18
Gadd45b 0.30+0.17 0.29+O.11 4.94±0.25 2.33+0.42
MBD2 0.22±0.13 0.22±0.11 2.8±0.11 1.53+0.6
Msi1/Ngn2 0.19±0.13 0.32+0.05 1.91±0.56 2.59+1.28
Msi1/MBD2 10.42±10.27 8.84+11.63 4.85+1.10 2.06+0.08
Ivlsi1/Gadd45b 0.06±0.01 0.14±0.17 0.55±0.06 0.24+0.11
Ngn2/MBD2 11.17±0.08 9.07±11.31 5.7+0.10 2.18+0.23
Ngn2/GAdd45b 0.29±0.11 0.95±0.17 1.17±0.54 0.98+0.25
Msi1/Ngn2/MBD2 38.18+1.75 22.03+1.90 28.18+2.77 14.54±0.45
Msi1/Ngn2/Gadd45b 22.65±5.03 18.54±9.40 18.72±6.26 8.70+4.51
Various DNA demethylators were tested as well for their effect on reprogramming , efficiency. Cells were co-transfected with one vector (MSI1/NGN2) containing two neurogenic pCMV6-Msi1-Ngn2 factors with various DNA demethylators. Simultaneously another neurogenic factor was tested for its effect on cells de-differentiation towards NSCs, pCMV-XL-Nestin individually or in combination with pCMV-Msi1-Ngn2, pCMV-XL5-Msi1, or pCMV-XL4-Ngn2 in the presence of MBD2 as previously described in Example ll.
. Cells were co-transfected pCMV-Msi1-Ngn2 with different DNA demethylators (MBD1, MBD2, MBD3, MBD4, MeCP2, AICDA). Another assay was performed to assess the effect of nestin on the reprogramming efficiency; therefore cells were transfected with nestin individually

or in combination with one vector containing one neurogenic factor (Msi1 or Ngn2) or both neurogenic factors in the presence of MBD2. Cells were cultured following transfection in the presence of proliferation medium supplemented' with EGF (20ng/ml), FGF (20ng/ml), and Noggin (20ng/ml) with and without VPA (1mM) treatment for 12 days at 37oC, 5% C02 and 5%02.
Gene expression analysis and immunohitochemistry was performed to analyse neural specific gene and protein expression (BIII-tubulin, GFAP, Sox2, Nestin) as described in Example II. Transfecting cells with Msi1 and Ngn2 in the presence of various DNA demethyfators revealed and confirm previous data showing that the among various DNA demethylators used in this study, MBD2 promotes the expression of neural stem genes {Sox2, GFAP, Nestin) as shown.in Table 5. Furthermore, transfecting cells with nestin with and without the presence of one neurogenic factor had no effect on the reprogramming efficiency into neural stem-like cells. However co-transfection with nestin and Msi1/Ngn2/MBD2 enhanced the expression of neural stem cells genes and this increase was more pronounced in the presence of VPA.
Table 5: RT-PCR analysis of relative expression of neuronal precursor cell markers such as
nestin, Sox2, Blll-tubulin, and GFAP after transfection of fibroblast cells with various
combinations of pCMV-Msi1-Ngn2 (MSI1/NGN2), pCMV-XL5-Msi1, pCMV-XL4-Ngn2, pCMV-
XL-Nestin with different combinations of DNA demethylators, with and without the co-treatment
with VPA.
TUBB3 - GFAP SOX2 --- NES

Rel Exp Std -Dev Rel
Exp -Steps
~*Dev * Rel Exp Std
Dev "Rel Expl Std ,Dev
Day 12, Untransfected (-VPA) 1.00 0.11 1.00 0.05 1.01 0.16 1.00 0.13
Day 12, Untransfected (+VPA) 1.00 0.03 1.00 0.06 1.00 0.00 1.00 0.02
Day 12, MSI1/NGN2/MBD1 (-VPA) 0.96 0.06 2.69 0.13 1.15 0.49 0.46 0.02
Day 12, MSI-WNGN2/MBD1 (+VPA) 1.10 0.06 2.22 0.06 0.80 0.01 0.84 0.02
Day 12 MSJ1/NGN2/MBD2 <~VEA) 323 52 006-
■"36 1638 53 99 86 61467 291 1487 21 3177 0 17
Day 12 MSI1/NGN2/MBD2 (+VPA) 232O0 1889 30 -72022 15" .— E -* t

42.39
"i7894 41 42 69 0f4
Day 12,
MSI1/NGN2/MBD3(-VPA) 0.92 0.07 3.98 0.59 28.05 4.67 0.56 0.01
Day 12, MSI1/NGN2/MBD3 (+VPA) 1.23 0.05 1.66 0.18 11.31 2.35 0.87 0.02
Day 12, MSJ1/NGN2/MBD4 (-VPA) 0.85 0.01 4.80 0.23 5.42 5.20 0.62 0.00
Day 12, MSI1/NGN2/MBD4 (+VPA) 0.95 0.01 1.57 0.16 2.27 0.04 0.79 0.03
Day 12,
MSI1/NGN2/MeCP2(-
VPA) 1.11 0.06 3.80 0.38 6.54 6.45 0.69 0.01
Day 12,
MSI1/NGN2/MeCP2
(+VPA) 1.37 0.09 1.63 0.45 10.53 10.49 1.07 0.01
Day 12, MSI1/NGN2/AtCDA (-VPA) 1.07 0.04 4.59 0.02 0.65 0.01 0.74 0.02

Day 12,
MSI1/NGN2/AICDA (+VPA) 1.10 0.01 2.37 0.29 1.21 0.16 0.91 0.04
Day 12, Msi1/MBD2 (-VPA) .1.31 0.17 3.78 0.49 0.70 0.02 0.78 0.00
Day 12, Msi1/MBD2 (+VPA) 1.36 0.07 1.75 0.31 1.26 0.03 1.15 0,03
Day 12, Ngn2/MBD2(-
VPA) 0.85 0.06 2.93 0.51 0.79 0.05 0.58 0.02
Day 12, Ngn2/MBD2 (+VPA) 1.41 0.05 1.60 0.11 2.30 0.06 1:03 0.03
Day 12, Nes/Msi1 (-VPA) 0.84 0.03 3.21 0.72 0.76 0.01 0.51 0.01
Day 12, Nes/MsM (+VPA) 0.86 0.09 1.82 0.30 2.14 1.02 0.94 0.01
Day 12, Nes/Ngn2 (-VPA) 0.69 0.05 2.88 0.32 0.99 0.10 0.57 0.02
Day 12, Nes/Ngn2 (+VPA) 0.88 0.01 1.53 0.19 2.71 0.02 0.83 0,03
"Day 12, - Nss/MS!1/NGN2/MBD2 111,58 423.56~ -82.87 -72069 27 "624 .51 51.52
Bay"12 Nes/MSy/NGN2/MBD2^ ~ (+VRA) 321.00 0.04 2600 14-' 434.90 "88932 00 708 72 82.74 -0 18
Day 12, Nes/MSt1/NGN2 (-VPA) 0.74 0.11 2.60 0.28 1.98 0.97 0.55 0.01
Day 12, Nes/MSH/NGN2 (+VPA) 0.86 0.00 1.70 0.49 1.70 0.04 0.88 0.05
Day 12, Nes/MBD2 (-VPA) 0.76 0.12 3.15 0.17 0.87 0.03 0.44 0.00
Day 12, Nes/MBD2 (+VPA) 0.87 0.03 2.05 0.07 2.66 1.64 0.91 0.00
Day 12, Nes/Msi1/MBD2<-VPA) 0.81 0.05 3.41 0.66 1.11 0.01 0.58 0.01
Day 12, Nes/Msi1/MBD2 (+VPA) 1.01 0.13 2.43 0.07 3.27 0.26 0.93 0.02
Day 12, Nes/Ngn2/MBD2 (-VPA) 1.19 0.07 5.71 1.30 4.11 0.07 0.91 0.04
Day 12, Nes/Ngn2/MBD2 (+VPA) 1.29 0.03 2.98 0.66 21.20 0.42 1.65 0.02
Immunohistochemistry analysis performed in parallel with RT-PCR data, indicated that positive Sox2 cells were undetectable when transfecting the cells with Msi1/Ngn2 in the presence of MBD1, MBD3, MBD4, MeCP1, or AICADA (Table 6) and that among the different types of DNA demethylator genes tested only MBD2 plays a significant positive role in the reprogramming efficiency of HFF towards NSLCs when using the above neurogenic genes. Immunohsitochemistry analysis revealed a small increase of immunopositive Sox2 cells (89.49±3.18) after co-transfecting the cells with nestin and Msi1/Ngn2 in the presence of MBD2 (Table 6).

Table 6: Percentage of positive cells for Sox2 after transfection of fibroblast cells with different
expression vectors with or without the presence of various DNA demethylators. After
transfection the cells were cultured in proliferation medium (StemCell Technologies)
supplemented by EGF (20ng/mi, Peprotech) and FGF (20ng/ml, Peprotech) for two weeks at
370C/5%CO2/5%O2. The percentage of immunopositive cells was determined by Celiomics™
and represented as mean±SD (n = 3-5).

HFF untransfected 0.13+0,12
Msi-Ngn2 +MBD1 0.92 ±0.13
Msi-Ngn2 + MBD2 79.44 + 9.86
Msi-Ngn2 +MBD3 1.22+0.82
Msi-Ngn2 +MBD4 0.59 +0.03
Msi-Ngn2 +MeCP2 1.10 ±0.25
Msi-Ngn2+AICDA 0.69 ±0.28
Msi+MBD2 0.79 ±0.28
Ngn2+MBD2 1.74 ±1.01
Nestin+Msi 0.91 ±0.01
Nestin+Ngn2 2.16 ±1.44
Nestin+MSI1/NGN2+MBD2 89.49 + 3.18
Nestin+MSI1/NGN2 10.20 ±0.21
Nestin+MBD2 0.00+0.00
Nestin+Msi+MBD2 8.45 ±0.08
Nestin+Ngn2+MBD2 5.71 ±0.66
Another study was designed to test the effect of various neurogenic genes on the reprogramming efficiency towards neural stem-like cells. HFF cells were cultured as described in Example I, and transfected using the Nucleofector™® 96-well Shuttle® Device (Lonza) following procedure described in Example IV, except for the untreated HFF control and the untransfected HFF control (for determining the effect of the complete media & compound treatments on the cells). The cells that had been pre-treated with VPA and 5-Aza and the untreated cells were transfected with the mixes of DNA as described in Table 7. The cells were plated on Laminin-coated plates and incubated at 37°C, 5% C02. Media was changed daily according to Table 7. Cells were analysed at day 3, 7, 12 by immunohistochemistry analysis and at Day 9 by gene array for multipotent and pluripotent gene expression.
Gene Array Analysis
An additional batch of cells treated according to 0a and 1a in Table 7 was analyzed at Day 9, along with HFFs, hNPCs, and passage 5 NSLCs (frozen from previous experiments from Example III) by the Pluripotency Gene Array (ABI) (Tables 8a and b) and a set of genes (Table 8c) to determine the gene expression profile of select pluripotency, ectoderm, endoderm, mesoderm, and neural lineage genes in passage 1 and passage 5 NSLCs compared to HFFs (from which they were created) and normal human n euro progenitor cells (hNPCs). The results in Table 8 indicate that all the genes related to neural stem cells (some of the significantly expressed pluripotency markers and mesendoderm markers are also expressed in neural stem cells) and the neural lineage were significantly expressed in NSLCs as opposed to-HFFs; and

the expression pattern was a bit different from hNPCs indicating that NSLCs are similar to, but not identical, to the hNPCs tested. Passage 5 NSLCs 5 had a higher expression of sternness genes than Passage 1 NSLCs. hNPCs had a higher expression of neuronally committed genes than NSLCs, indicting their neuroprogenitor status versus the greater sternness status of NSLCs.

In another part of the experiment, another batch of cells that were transfected with Msi1/Ngn2 + pCMV6-XL'5-MBD2 were plated on Poly-Ornithine (30 min at RT)'and Laminin (1h at RT) coated plates in CDM II medium in 5 different wells. On day 1, medium in two of the weiis was switched to the same medium as in condition 1a (Table 7) until day 12. Medium was changed daily until day 12, at which point it was switched to either NS-A Differentiation Medium (StemCell Technologies) or NbActive4 (BrainBits™) medium that were both supplemented with BDNF (20 ng/ml), NT-3 (20 ng/ml), NGF (20 ng/ml), Retinoic acid (5 uM), Noggin (20 ng/ml) and Forskolin (10 jJvl). These ceils showed a typical neural stem-like cell morphology by day 7, and proliferated until day 12. During the exposure to either of the two differentiation media, these NSLC changed to a more neuronal and glial phenotype as shown in the bright field pictures (Figure 21), but only expressed GFAP by Day 17 (Figure 22).
For the other three wells, on day 1 medium was switched to either NS-A Differentiation Medium (StemCell Technologies), NbActive4 (BrainBits), or CDM II medium; these first two were supplemented with the same cytokines as previously described but with the addition of Fgf-2 (20 ng/ml). On day 12, Fgf-2 was removed from the first two differentiation media while cells in the CDM II medium were switched to the NS-A Differentiation Medium (StemCell Technologies) supplemented with cytokines without Fgf-2. Between day 12 and day 17, media was changed every two to three days. During the first 12 days of culture, cells in all 3 media developed into a mix of more spindle shaped cells compared to untransfected fibroblasts and some into cells with a NSLC morphology; upon removal of Fgf-2 cell morphology turned into a very pronounced neuronal shape as well as glial cells with a network established between cells as shown in the bright field pictures (Figure 21) that expressed GFAP and (Jlll-tubulin by Day 17 (Figure 22).
An additional study was designed to assess the effect of Msi1, Ngn2 and MBD2 on their
endogenous proteins levels in reprogrammed cells. Cells were transfected with the MSI1/NGN2
vector and MBD2 as previously described and cultured in proliferation condition at 37°C, 5%
C02 and 5%02. Samples were collected at various time points from Day 2-10 and analyzed by
RT-PCR to investigate the expression of endogenous genes and the expression of neural stem
cell and neuronal genes at different time points. RT-PCR revealed a gradual loss of total Msi1,
Ngn2 and MBD2 gene expression starting from Day 2 to Day 10, with the increase in MBD2
expression relative to control having been almost completely lost by Day 5. This decrease was
associated with a significant activation of endogenous Msi1 and Ngn2 on Day 5, with another
jump in endogenous gene expression at Day 9 (Table 9). A significant increase in Sox2
expression was detected at Day 4, and the expression of this ectoderm / neural stem cell /
neuronal gene continued to increase with each subsequent timepoint (Table 10). GFAP (a
neural stem cell and astrocyte marker) was slightly elevated already from Day 2 onwards, but
significantly-inereased on-Day 5 with a large jump in gene-expression at Day—7.analysis- -

timepoint and stayed at this expression level for the rest of the study period. Expression of the neural stem cell marker Nestin also started to slowly increase from Day 5 onwards. Expression of the neuronal genes Blll-tubulin (TUBB3) and Map2b were slightly efevated already from Day 2 onwards, but significantly increased on Day 5 onwards. Expression of a marker for acetylcholine receptors (found in neurons), acetylcholine esterase (ACHE), was also slightly elevated from Day 2 onwards, but did not significantly increased until Day 7 onwards, ft should be noted that among the neural stem cell markers that were analyzed, the relative expression of Sox2 was highly and early expressed which could then be directly or indirectly interact with the exogenous Msi/Ngn2 and/or other genes in the activation of Nestin, GFAP, and endogenous Msi1 and Ngn2 and other genes that promote the reprogramming and cell fate change, as well as the activation of neuronal genes like plll-tubulin (TUBB3), Map2b, and ACHE.

EXAMPLE IV Comparison of the Nucleofector™® fl Device and the Nucleofector™® 96-well Shuttle® Device in the reprogramming of HFF into NSLC in adherent and floating conditions.
HFF cells were cultured as described in Example I, and transfected using the Nucleofector™® II Device (Lonza) as previously described in Example II or the Nucleofector™® 96-wel! Shuttle® Device (Lonza). The HFFs were harvested with TrypLE™ (Gibco), and 1x106 cells / transfection with the Nucleofector™® II Device for 10 min at 90g and 6x105 cells / transfection with the Nucleofector™® 96-well Shuttle® Device for 5 min at 80xg. After centrifugation, the cell pellet was gently resuspended in either 100u1 of Basic Nucleofector™ Solution for the Nucleofector™® II or 20ul of SE Solution (Cell line kit SE, Lonza) for the Nucleofector™® 96-well Shuttle® For the Nucleofector™® li Device, each 100 pi of cell suspension was combined with 2 different mixes of plasmid DNA (sample 1 was mixed with 2 ug of pCMV6-XL5-Msi1 and 2ug pCMV6-XL5-MBD2, and sample 2 with 2 ug of Msi1/Ngn2 and 2ug pCMV6-XL5-MBD2). Each cell suspension was transferred into an Amaxa certified cuvette and transfected with the appropriate program (U-023). Right after transfection, 900 µl of warm CDM1 medium was added to each cuvette and the sample was transferred into a culture plate coated with Laminin (Stemgent, 10 ug/ml) at a cell density of 1x105 to 1.5x105 cells per cm2 or into non-cell culture treated Petri dishes for neurosphere formation. The cells were incubated at 37°C, 5% C02 overnight.. However for the Nucleofector™® 96-well Shuttle® Device, the steps described before were similar with the following exceptions: the cell suspension was mixed with 0.6 ug of each DNA of the same 2 DNA mixes, the cell suspension was transferred to a well of a 96-well Nucleoplate™ (Lonza) and transfected with the program FF-130™. After transfection, 80 ul of warm CDM1 medium was added to each well and the samples were left for 10 min in the incubator prior to being transferred into a laminin coated plate or non-cell culture treated Petri dishes at the same cell density as previously mentioned. For both devices, these steps were repeated for each sample that was transfected. Prior to transfection cells were cultured in CDM1 as described in Example I. After 24 hours, the medium was switched to a mix of 75% CDM medium and 25% Proliferation Medium which was supplemented with EGF (20 ng/ml), FGF-2 (20 ng/ml), Noggin (20 ng/ml) and Cytochalasin & (10 µg/ml) and the cells were incubated at 37°C, 5% C02 and 5% 02. The medium was changed daily with an increased proportion of Neural proliferation medium up to 100% by Day 4 and a decreased proportion of Cytochalasin B that was completely omitted by Day 5. Forskolin (10 uM) was added to the medium from Day 4 onwards. The cells in floating conditions were pelleted by centrifugation and their medium changed daily as described for the adherent condition. Cells were collected at Day 3, 7, and 12 for imunohistochemistry analysis.
Fluorescence images were taken with a Cellomics™ ArrayScan HCS Reader™ microscopy system to determine an estimate of the percentage of cells positive for Sox2, a neural stem cell marker. This analysis revealed that in untranslected controls and at 3 days after

transfection, no nuclear Sox2 staining was detectable. However, at Day 7 and Day 12 the percentage of Sox2 positive cells increased progressively under ail transfection conditions except the pCMV6-XL5-Musashi and pCMV6-XL5-MBD2 Nucleofector™® II condition. The highest percentage at Day 12 was obtained with Msi1/Ngn2 and pCMV6-XL5-MBD2 transfected with the Nucleofector™® 96-well Shuttle® Device (-80%). The same combination transfected with the Nucleofector™® II yielded only -35% positive cells. The pCMV6-XL5-Musashi and pCMV6-XL5-MBD2 with the Shuttle® produced -20% positive cells, while generally none were observed with the Nucleofector™® II. The percentage of positive ceils varied strongly between wells. The staining indicated that the cell population was not homogenous, since fields of densely arranged Sox2 positive cells and complete fields with only negative cells could be found in a!! cases. In general the Shuttle® was initially more toxic to cells than the Nucleofector™® II, however at least in the case of Msi1/Ngn2 and pCMV6-XL5-MBD2 shuttle, the Sox2 positive population rapidly expanded from Day 7 to Day 12 to have twice as many Sox2 positive cells as compared to the Nucleofector™® II. The cells in floating conditions did not form spheres during the 12 day experiment in any of the conditions, suggesting that the formation of neurospheres requires either the generation of neural stem-like cells in adherent conditions first or more time.
Table 11 shows the percentage of Sox2 positive cells with a typical neural stem cell morphology using both the Nucleofector™® II Device and the Nucleofector™® 96-well Shuttle® Device. The latter had the advantages of requiring a smaller starting material (less cells and Jess DNA required) and in addition gave rise to a higher number of Sox2 positive cells. Moreover a very small population of Sox2 positive cells was observed with the Shuttle® Device only upon transfection with only one neurogenic transcription factor (Msi) in the presence of the DNA demethylator MBD2.
Table 11: Percentage of positive cells for Sox2 after transfection of fibroblast cells with different expression vectors. After transfection the cells were cultured in proliferation medium (StemCell Technologies) supplemented by EGF (20ng/ml, Peprotech) and FGF (20ng/ml, Peprotech) for two weeks at 37DC/5%C02/5%02. The percentage of immunopositive cells was determined by Cellomics™ and represented as mean±SD (n = 3-5).

%Sox2 positive cells i

Day3 Day7 Day12

Sox2 Total
Cell
count Sox2 Total
Cell
count Sox2 Total
Cell
count
Shuttle MSM/NGN2+MBD2 1.34
±0.10 6430 +566 31 ±20 ±8.03 10683
±1112 78.17 ±3.10 29341 ±2527
Msi+MBD2 1.08 ±0.61 8253 ±399 3.19 ±3.57 8953 ±672 19.05 ±17.88 11082
±2999
Nucleofector™ MSI1/NGN2+MBD2 0.87 ±0.30 21870 ±4476 14.30 ±1.83 37321 ±6877 35.93
±7.10 33009 ±1567
Msi+MBD2 0.64 -±0.07 46793 ±8808 0.35 ±0.16 34854 ±2186 0.51 ±0.25 32095 ±3236
EXAMPLEV

Neurosphere formation assay and Cell Differentiation Analysis
Based on previous studies showing that greater proportional reprogramming is achieved by transfecting two neurogenic genes, this study was designed to evaluate the number of reprogramming cells by using the vector Msi1/Ngn2, containing two neurogenic transcription factors {Msi1 and Ngn2) and the role of DNA demethylator or DNA methylation inhibitor (5-azacytidine) and histone deacefylation inhibitor (VPA) in the reprogramming process.
HFFs were cultured and treated with cytochalasin B as described in Example III, and treated simultaneously with VPA (1mM) and 5-Azacytidine (0.5µM). After two days of treatment, cells were transfected by Nucleofection as described in Example II with the constructed vector Msi1/Ngn2. After preparing the cells, they were mixed with 2 ug of total DNA (Msi1/Ngn2) and cells that had not been treated with chemical inhibitors (VPA and 5-Aza) were co-transfect with MBD2 (2(µg), using the appropriate program (U023). The samples were transferred into a coated culture plate with Laminin (10 ug/ml, Sigma) and incubated in a humidified 37°C/5%02/5%C02 incubator. The medium was changed to the proliferation basal media, Neural Proliferation Medium (NeuroCult™ proliferation Kit, StemCell Technologies), with the presence of Noggin (20 ng/ml, Peprotech), recombinant hFGF (20ng/mi, Peprotech), and recombinant hEGF (20ng/ml, Peprotech). Following 6 days of transfection, cells were harvested using Accutase™ (Millipore), centrifuged (300xg, 5 min, RT) and plated in uncoated cell culture dishes in NeuroCult™ NSC Proliferation medium to investigate the capacity to grow cells in suspension as neurospheres or on Laminin coated-plates for adherent culture. To prevent loss of floating spheres during media changes, cells were sedimented by centrifugation at 150 x g for 3 min at room temperature (RT). The pellet was then resuspended in fresh medium and plated into new uncoated, low-bind cell culture dishes. Cultures were incubated at 37°C, 5%C02, 5%02 and were fed daily for at least two months.
To investigate whether a single cell from human neural precursor cells (hNPCs) and human NSLCs was able to generate a neurosphere (a standard test for proving that a cell is a neural stem cell), neurospheres were dissociated into single cells and these single cells were isolated and cultured in proliferation medium in suspension, and neurosphere formation was monitored by taking bright field images using light microscope (Nikon, 10X) and by Cellomics™. These cells started to proliferate and grew as spheres starting day 6 to day 10 (Figure 4A). Immunohistochemistry analysis of these spheres (Table 12 and Figure 4) on Day 20, revealed immunopositive staining for the neural stem cells markers Sox2, Musashi, CD133, Nestin, and GFAP. Cells also stained positive for Blll-tubulin (a marker for neurons), 04 (a marker for oligodendrocytes), and GFAP (a marker for astrocytes), indicating the tri-potent differentiation potential of both sets of cells (NSLC and hNPC), and negative for NGFrec and NeuN (markers for differentiated neurons) indicating that the cells were not terminally differentiated.

Table 12: Percentage of positive cells for neural stem cells, and neuronal, astrocyte and oligodendrocyte lineage markers in neurospheres formed from single NSLCs and hNPCs cultured in proliferation medium (StemCell Technologies) supplemented by EGF (20ng/ml, Peprotech) and FGF (20ng/ml, Peprotech) for 20 days at-37°C / 5% C02 / 5% 02. The

% of positive cells NSECs hNPCs
Musashi 91.8+6.8 88.6+7.9
Nestin 78.6+5.7 75.4+12.0
GFAP 69.2+7.4 78.6+8.4
BIll-tubulin 85.6±6.4 76.6+8.4
P75 0 0
NeuN 0 0
04 65.4+6.6 71.4+7.5
CD133 0 0
HFF cells were cultured as described in Example I, and transfected using the Nucleofector™ II device (Lonza) as described in Example II. Cells were co-transfected with pCMV6-XL5-Msi/pCMV6-XL4-Ngn2, pCMV-Msi1-Ngn2 with MBD2 or pre-treated with VPA/5aza. Cells were cultured in proliferation medium as suspension or adherent cultures. Gene expression analysis on 8 samples was performed as previously described in Example I with the customized Neuronal Markers 2 TLDA (Table 13) which profiled the expression of 48 genes (including three housekeeping genes: ACTIN, GAPDH and PPIA) in four major categories; 1) fibroblast specific genes; 2) neuronal lineage specific genes; 3) Neural stem cell marker specific genes; and 4) Genes for growth factors and their receptors.

As shown in Table 14, fibroblast-specific genes (Col3A1, Lox, S100A4) were down-regulated in reprogrammed cells, indicating the loss of fibroblast-specific genes following transfection (note that not all cells got transfected and reprogrammed, so the presence of fibroblast-specific gene expression in the cultures is mostly from the un-programmed fibroblasts left in the culture). The expression of these genes is observed to increase when HFFs were transfected in the absence of DNA demethylator or the DNA methylation inhibitor, indicating that down-regulation of differentiated markers of fibroblast cells requires DNA demethylation. The expression of ectoderm genes such as Msi1, Sox2, and Nestin was remarkably increased following transfection in conjunction with DNA demethylation. The expression of neuronal markers, such as synaptogaminl (a synaptic vesicle protein) and NeuroDI was up-regulated in transfected cells with Msi1/Ngn2/MBD2, and slightly increased in transfected cells with Msi1/Ngn2/VPA and 5-AZA. The selected three markers of oligodendrocytes were detected in the transfected cells with a strong increase of Olig2. Two markers for astrocytes, GFAP and ALDH1L1, were enhanced following transfection. The results support the idea that neurospheres are composed of heterogeneous progenitor subtypes.
Among the neurotrophic factors, expression of CNTF was slightly increased in the reprogrammed cells. The expression of GAP-43 and neuropeptide Y (NPY) were the most annotated genes. GAP-43 has long been acknowledged to play a pivotal role in axonal plasticity and is used as a marker of regenerating neurite outgrowth and synaptogenesis, both in embryonic development and in neuronal regeneration in injured brain and spinal cord. Expression of receptors for growth and neurotrophic factors was increased, such as neurotrophic receptor tyrosine kinase expression.

Further analysis and quantification of the adherent population of NSLCs showed that cells were positively stained for Sox2 (93.43 ±1.9%), nestin (60.76 ±57%), and GABA (37.48 ±4.9), while these markers were undetectable' in untransfected cells (Figure 5, Table 15). Furthermore, these cells stained positive for p75NTR (31.15 ±1.6), BIll-tubulin (37.55 ±0.6%) and GFAP (16.47 ±0.9). However, untransfected HFFs only stained positive for HFF markers (Figure 5), such as fibronectin and fibroblast protein marker, while these markers were undetectable in reprogrammed cells, demonstrating that the reprogrammed cells lost markers of the original cells and adopted morphology and markers of neural stem cells and a neuronal lineage.
Table 15: The percentage of cells stained positive for neural stem cell markers and fibroblast markers in untransfected cells and transfected cells with pMsi1/Ngn2/MBD2. Transfected cells (NSLCs) possess a high percentage of neural stem markers but a very low percentage of fibroblast markers as compared to untransfected cells. The percentage of immunopositive cells was determined by Cellomics™ and represented as mean±SD (n = 5).

Marker protein Transfected fibroblast cells
{% of average positive ceils ± stdv) Untransfected fibroblast cells
(% of average positive celts + stdv)
Sox2 93.43. ± 1.9 1.90 ±0.5
' Nestin . 60.76 ± 5.7 0.84 ±0.2
p75NTR 31.15 ± 1.6 3.95 ±1.7
. NCAM 26.84 ± 3.8 0.87 ± 0.2
S100 41.80 ±0.6 1.60 ±0.3
GFAP 16.47 ±0.9 3.84 + 0.9
pill-Tubulin 37.55 + 0.6 1.90 ±0.9
GABA 37.48 ±4.9 2.54 ± 0.5
Fibronectin 1.05 ±0.7 94.19 ±0.9
Fibroblast marker protein 4.81 ±1.0 50.30 ± 7.8
This study showed as well that NSLCs have the capacity to proliferate in culture and exhibit stable morphology, gene and protein expression that were maintained for the entire study period, which was for over five month in culture (Table 16).

Table 16. Doubling time of NSLCs over serial passages. NSLCs were maintained in proliferation conditions for 35 passages in a 37°C, 5%C02 and 5%02 incubator. The time required for the cell population to double (g) was calculated for each passage, and was defined as g = (In2)/k, where k was the number of generations that occured per unit time (t) defined as, k = (In Nr In N0)/t, where Nf was the final cell number and N0 the initial seeded cell number. The average generation time was 25.4h over 35 passages.

Passage number Time (h) LN N0 LN Nf k (h-1) g(h)
2 168 11.513 15.577 0.024 38.655
3 216 11.513 16.195 0.022 31.977
4 192 11.513 18.258 0.035 39.730
5 144 11.513 16.258 0.033 21.036
6 144 11.513 16.258 0.033 21.036
7 144 11.513 15.702 0.029 33.824
8 168 11.513 15.870 0.026 26.729
9 120 11.513 16.811 0.031 32.548
10 144 11.513 15.415 0.027 35.580 J
11 120 13.122 15.895 0.023 30
12 120 11.513 15.747 0.035 19.645
13 168 11.513 15.870 0.026 26.729
14 168 12.429 15.870 0.020 23.847
15 168 11.513 15.520 0.024. . 29.059
16 192 11.513 16.167 0.024 28.596
17 144 11.513 15.239 0.026 36.791
18 168 11.513 15.790 0.025 37.229
19 120 13.122 15.870 0.023 30.276
20 144 13.122 16.249 0.022 31.922
21 96 13.122 15.761 0.027 25.214
22 120 13.122 15.870 0.023 30.276
23 120 13.122 15.761 0.022 31.518
24 96 13.122 15.687 0.027 25.943
25 96 13.122 16.013 0.030 23.022
26 96 13.122 16.067 0.031 22.599
27 ' 96 13.122 16.300 0.033 , 20.938
28 120 13.122 16.482 0.028 24.752
29 96 13.122 16.380 0.034 20.424
30 96 13.122 16.300 0.033 19.938
31 120 13.122 16.483 0.028 22.752
32 96 13.122 16.062 0.031 20.640
33 96 13.122 16.300 0.033 20.938
34 96 13.122 16.077 0.031 15.519
35 96 13.122 16.077 0.031 15.519
Gene Expression Mic roar ray
■ Microarray expression analysis was performed to get a global overview to compare the
gene expression profile of passage 7 NSLC to both HFF (the cells that the NSLC were created
from) and hNPCs. NSLC (n=3), HFF (n=2), and hNPC (n=3) were resuspended in RNAIater™
(Qiagen) and shipped to Genotypics (India) where the samples were processed and the Gene
Expression Microarray was performed.
In brief, Genotypics extracted RNA from the samples and performed Quality Control
using an Agilent Bioanalyzer™; Labelling "was done using Agilent's Quick Amp™ kit (cDNA

synthesis and in vitro transcription), followed by Labelling QC. Hybridization was then performed using the 8 x 60K array, and scanning was done using high throughput Agilent scanner with SureScdn™ technology. The Agilent Feature Extraction software was used for automated feature extraction, followed by Raw Data QC and Image QC. Advanced Data Analysis was then performed, including Pathway and Gene Ontology analyisis using Agilent's GeneSpring GX™ v10.0 and Genotypic's Biointerpreter Software. The NSLC samples were compared to the HFF samples (Set 1) and hNPC samples {Set 2) The NSLC samples had a global gene expression pattern that was much closer to the hNPCs than the HFFs from which the NSLCs were created (Figure 23). Pearson correlation analysis revealed that NSLCs are closely related to hNPCs, including in terms of neuronal lineage markers, regenerative genes and migration genes. These data confirm that NSLCs are similar, but not identical, to hNPCs.
Microarray analysis revealed an up-regulation of neural precursor genes in the NSLC samples as compared to the HFF samples. ACTL6A and PHF10, which both belong to the neural progenitors-specific chromatin remodelling complex (npbaf complex) and are required for the proliferation of neural progenitors, were up-regulated by 2.9-fold and 2.3 fold respectively. MSI2, which plays a role in the proliferation and maintenance of stem cells in the central nervous system, was up-regulated by 6-fold (Table X1). Glia genes were up-regulated in the NSLC samples as compared to the HFF samples. GFAP, is a neural stem cell- and astrocyte-specific marker that, during the development of the central nervous system, distinguishes astrocytes from other glial cells, is highly up-regulated in the NSLC sample as compared to HFF (690-fold). OLIG1, which promotes formation and maturation of oligodendrocytes, especially within the brain, is also highly up-regulated in NSLC sample as compared to HFF (370-fold) (Table X2).
Table X3 lists a subset of regenerative genes that are up-regulated in the NSLC samples as compared to the HFF samples. SOX2, a gene critical for early embryogenesis and for embryonic stem cell pluripotency as well as neural stem cells, is highly up-regulated in the NSLC samples as compared to the HFF samples (5000-fold). CCND2, which is essential for the control of the cell cycle at the G1/S (start) transition, is also up-regulated in NSLC samples (70-fold as compared to HFF samples). As shown in Table X4, numerous fibroblast genes were down-regulated in the NSLC samples as compared to the HFF samples. This shows that the NSLC lose the expression of numerous fibroblast genes as it gets reprogrammed from HFF to . NSLC.
Table X5 show that neural precursor genes were also up-regulated in the NSLC samples as compared to the hNPC samples. BDNF, which promotes the survival and differentiation of selected neuronal populations of the peripheral and central nervous systems during development, is even more highly expressed in NSLC samples than in hNPC samples (34-fold up-regulation). Table X6 shows that a subset of Glia genes are also up-regulated in the NSLC samples as compared to the hNPC samples. GFAP, a neural stem cell- and astrocyte-

specific marker that, during the development of the central nervous system, distinguishes astrocytes from other glial cells, is more highly expressed in NSLC samples than hNPC samples (13-fold). PLP1, the major myelin protein of the central nervous' system which plays an ' important role in the formation or maintenance of the multilamellar structure of myelin, is also more highly expressed in NSLC samples than in hNPC samples (20-fold).
Regenerative genes were also up-regulated in the NSLC samples as compared to the hNPC samples (Table X7). BMP2, a neural crest marker, but which induces growth especially of cartilage and bone formation and BMP4, which in turn induces cartilage and bone formation and acts in mesoderm induction, tooth development, limb formation and fracture repair, but also in neural stem cells, were both more highly expressed in NSLC samples than in hNPC samples (18-fold and 20-fold respectively). GAP43, which is a major component of the motile growth cones that form the tips of elongating axons was more highly expressed in NSLC samples than hNPC samples (4-fold). This suggests the regenerative potential of NSLC. HOXB4, a transcription factor that is involved in development and also in the expansion of neural stem ceils as well as hematopoietic stem and progenitor cells in vivo and in vitro making it a potential candidate for therapeutic stem cell expansion, was also more highly expressed in NSLCs than in hNPCs. This data indicates that NSLCs are more 'stem-like' or have more 'sternness' than hNPCs.

Table X1: Up-regulated Neural Precursor genes (NSLC vs. HFF)

GeneSymbol Accession Number Fold change of NSLC compared to HFF1 ■ p-value
ACTL6A NM 178042 2.90 0.000
ADAM9 NM 001005845 2.64 0.004
AIFM1 NM 004208 2.45 0.000
BCAT1 NM 005504 3.23 0.000
BMP2 NM 001200 17.49' 0.000
DLL1 NM 005618 40.32 0.000
EDNRB NM 003991 933.03 0.000
ERBB4 NM 005235 53.22 0.006
GMNN NM 015895 4.42 0.000
HES5 BC087840 102.33 0.000
KIF1B NM 015074 9.45 0.002
LIMK1 NM 002314 2.44 0.002
MAPK8IP1 NM 005456 5.88 0.001
MCHR1 NM 005297 68.19 0.001
MEF2C NM 002397 2.91 0.000
MSI2 NM 170721 6.76 0.000
NMB _j NM 021077 3.65 0.000
NOS2A NM 000625 279.45 0.000
NOTCH 1 NM 017617 6.75 0.000
NPAS3 NM 022123 187.85 0.000
PHF10 NM 018288 2.28 0.001
PHLPP NM 194449 8.84 0.000
SMAD1 NM 005900 4.74 0.000
SNTG1 AL161971 34.05 0.000
SP8 NM 198956 1392.67 0.000
STAU2 AK002152 3.35 0.000
STIL NM 003035 494 0.003
Fold change represents the up-regulation of the gene in the NSLC samples as compared to the HFF samples. (n=2 for HFF samples, n=3 for NSLC samples).

Table X2: Up-regulated Glia genes (NSLC vs. HFF)

GeneSymbol Accession Number Fold change of
NSLC compared to
HFF1 p-value
ASTN1 NM 004319 51.44 0.000
ATP1B2 NM 001678 186.64 0.000
B3GAT1 NM 018644 1784.49 0.000
BCL2 NM 000633 2.65 0.002
BMP7 NM 001719 41.35 0.000
CA14 NM 012113 . 43.44 0.000
CLCN2 NM 004366 4.18 0.000
CNDP1 NM 032649 4.39 0.010
CP NM 000096. 93.08 0.002
CXCR4 NM 001008540 4124.29 0.000
ERBB4 NM 005235 53.22 0.006
FABP7 NM 001446 18702.36 0.000
GAB1 NM 207123 2.44 0.001
GFAP NM 002055 696.51 0.000
GJB2 NM 004004 13.89 0.001
ITGB8 NM 002214 8.48 0.005
KCNJ10 NM 002241 263.42 0.000
LM03 NM 018640 194.32 0.000
MAP6D1 NM 024871 3.99 0.000
MAPT NM 016835 2.38 0.001
NDE1 NM 017668 2.21 0.002
NEFL NM 006158 10.30 0.001
NKX6-2 NM 177400 10.83 0.026
NOVA2 NM 002516 7.51 0.000
NTN1 NM 004822 5.29 0.015
NTRK3 NM 001012338 15.32 0.000
OL!G1 NM 138983 372.11 0.000
OLIG2 NM 005806 163.20 0.000
PARD6A NM 016948 4.12 0.001
PASK NM 015148 3.89 0.001
PAX6 NM 001604 28.53 0.001
PDCD11 ENST00000369797 2.23 0.001
PDE6B NM 000283 5.55 0.001
PER1 NM 002616 2.43 0.001
PLP1 M54927 351.09 0.000
PTK2 NM 153831 4.22 0.000
QK! NM 206855 8.75 . 0.003
S100B NM 006272 456.00 0.000
SLC1A3 NM 004172 49.49 0.000
SORL1 NM 003105 27.61 0.000
SOX9 NM 000346 27.82 0.000
SPRY2 NM 005842 15.83 0.000
TARDBP NM 007375 2.69 0.005
TSPAN12 NM 012338 259.78 0.000

Table X3: Up-regulated Regenerative genes (NSLC vs. HFF)
GeneSymbol Accession Number Fold change of NSLC compared to HFF1 p-value
BMP2 • NM 001200 • 17.49 0.000
CCND2 NM 001759 72.79 0.000
DLL1 NM 005618 40.32 0.000
EGR1 NM 001964 2.19 0.000
GAL NM 015973 25.93 0.000
GAP43 NM 002045 1297.42 0.000
HOXB4 NM 024015 102.34 0:000
NFE2L2 AF323119 2.80 0.004
NOTCH1 NM 017617 6.75 0.000
PRPH NM 006262 6.44 0.000
SEMA3A NM 006080 3.03 0.004
SEMA6A NM 020796 23.58 0.000
SOX2 NM 003106 5165.92 0.000
Table X4: Down-regulated Fibroblast genes (NSLC vs. HFF)

GeneSymbol Accession Number Fold change of NSLC compared to HFF1 p-value
ACOT2 NM 006821 0.30 0.000
AEBP1 NM 001129 0.16 0.001
AGA NM 000027 0.35 0.000
ANXA2 NM 001002857 0.26 0.029
AP4E1 NM 007347 0.30 0.008
APOE NM 000041 0.08 0.000
ARHGDIB NM 001175 0.24 0.009
ASAH1 NM 004315 0.31 o.ooo
BDKRB1 NM 000710 0.00 0.001
BDKRB2 NM 000623 0.00 0.000
BDNF NM 170735 0.12 0.000
BMP4 NM 001202 0.28 0.001
C3 . NM 000064 0.25 0.001
C5orf13 NM 004772 0.18 0.000
CACNA1C NM 000719 0.03 0.000
CASP4 NM 033306 0.00 0.000
CASP5 NM 004347 0.00 0.001
CCL2 NM 002982 0.20 0.000
CD36 NM 001001547 0.07 0.023
CDC42EP2 NM- 006779 0.06 0.000
CDC42EP3 NM 006449 0.41 0.000
CDC42EP5 NM 145057 0.41 0.040
CDH11 NM 001797 0.00 0.000
CEMP1 AL833099 0.30 0.001
CFH NM 001014975 0.01 0.010
CITED2 NM 006079 0.14 0.000
COL12A1 NM 004370 0.00 0.001
COL1A1 NM 000088 0.01 0.000
COL1A2 . NM 000089 0.00 0.001
COL3A1 NM 000090 0.00 0.001
COL5A1 NM 000093 0.00 0.000
CPT1A NM 001876 0.16 0.002
CROT NM 021151 0.27 0.002
CTSA NM 000308 0.10 0.000
CTSB NM 147780 0.11 0.001
CXCL1 NM 001511 0.01 0.003

CXCL12
NM 000609 0.00 0.001
CYP27A1 NM 000784 0.28 0.011
CYR61 NM 001554 0.10 0.000
DCHS1 NM 003737 0:29 0.000
DMPK NM 004409' 0.36 0.000
DPT NM 001937 0.05 0.006
EFEMP1 NM 004105 0.00 0.000
ELN NM 000501 0.13 0.001
EMX2 NM 004098 0.00 0.001
EPS8 NM 004447 0.18 0.000
ETS1 NM 005238 0.15. 0.003
FAH NM 000137 0.17 0.000
FAM14A NM 032036 0.22 0.001
FAP NM 004460 0.00 0.000
FBLN2 NM 001004019 0.18 0.000
FBN1 NM 000138 0.01 0.002
FGF1 NM 000800 0.20 0.004
FGF13 NM 004114 0.04 0.006
FGF2 . . NM 002006 0.06 0.000
FGF5 NM 004464 0.01 0.003
FGF7 NM 002009 0.04 0.001
FGF9 NM 002010 0.01 0.000
FGFR1 NM 023110 0.34 0.026
FHL2 NM 201555 0.11 0.000
FN1 NM 212482 0.00 0.001
FSTL1 * NM 007085 0.09 0.000
GADD45B NM 015675 0.09 0.001
GALNT6 NM 007210 0.13 0.001
GAS6 NM 000820 0.02 0.000
GBA NM 001005749 0.22 0.002
GBAP NR 002188 0.19 0.000
GCH1 NM 000161 0.22 0.001
GGTA1 NR 003191 0.28 0.013
GIT2 NM 057169 0.37 0.003
GJA1 NM 000165 0.46 0.001
GLIS1 NM 147193 0.02 0.000
GM2A AK127910 0.25 0.010
GNS NM 002076 0.29 0.000
GPC3 NM 004484 0.22 0.038
GREM1 NM 013372 o.oo 0.011
GSTM1 NM 146421 0.27 0.001
HAAO NM 012205 0.43 0.001
HERPUD1 NM 014685 0.19 0.000
HEXA NM 000520 0.24 0.000
HEXB NM 000521 0.36 0.000
HGF NM 001010932 0.09 0.028
HGS NM 004712 0.26 0.029
HIF1A NM 181054 0.36 0.005
HLA-A NM 002116 0.31 0.002
HLA-H NR 001434 0.19- 0.001
HOXB13 NM 006361 0.03 0.004
HR NM 005144 0.18 0.002
HSPG2 NM 005529 0.19 0.004
IDUA NM 000203 0.16 0.000
IGF1 NM 000618 0.10 0.004
IGFBP7 NM 001553 0.28 0.040
IKBKG NM 003639 0.42 0.001
IRF1 NM 002198 0.28 0.002
ITGA1 NM 181501 0.00 0.001
ITGB3 - NM 000212 0.05 0.000

KLF4
NM 004235 0.05 0.002
LEP NM 000230 0.07 0.001
LEPRE1 NM 022356 0.24 0.000
LMNA NM 005572 0.42 0.000
LOX NM 002317 0.01 0.000
LOXL4 NM 032211 0.10 0.003
LRRC8C NM 032270 0.15 0.013
MAGEL2 AJ243531 0.31 0.002
MAN2B1 NM 000528 0.45 0.006
MAP3K8 NM 005204 0.27 0.001
MEIS2 NM 170677 O.OO 0.001
MKNK1 NM 003684 0.37 0.005
MMP1 NM 002421 0.00 0.000
MMP14 NM 004995 0.07 0.001
MMP2 NM 004530 0.04 0.000
MMP3 NM 002422 0.00 0.001
MOXD1 NM 015529 0.24 0.000
MRAS NM 012219 0.15 0.001
MSX2 NM 002449 0.15 0.031
MTHFR NM 005957 0.27 0.014
MYC NM 002467 0.05 0.000
MYL6 NM 079423 0.33 0.001
MYL9 NM 181526 0.01 0.000
NAGLU NM 000263 0.23 0.000
NBL1 NM 182744 0.11 0.000
NEK9 NM 033116 0.41 0.001
NF2 NM 181831 0.46 0.000
NPC1 NM 000271 0.34 0.000
OPTN NM 001008211 0.04 0.000
P4HB NM 000918 0.37 0.001
PALLD NM 016081 0.29 0.001
PAPPA NM 002581 0.05 0.000
PCDHGB4 NM 032098 0.28 0.001
PCK2 NM 004563 0.04 0.000
PCOLCE NM 002593 0.00 0.000
PDGFRA NM 006206 0.02 0.010
PEX14 BC017848 0.48 0.000
PFKL NM 001002021 0.35 0.004
PPARG NM 138711 0.01 0.000
PPFIBP2 NM 003621 0.08 0.000
PRR5 NM 015366 0.23 0.022
PSEN2 NM 012486 0.34 0.002
PTGS1 NM 000962 0.29 0.000
PXDN AF200348 0.12 0.000
PYCARD NM 013258 0.03 0.000
QSOX1 NM 002826 0.09 0.000
RASSF1 NM 170713 0.30 0.001
RBMS1 NM 002897 0.14 0.001
RECK NM 021111 0.07 0.000
RET NM 020975 0.35 0.015
RFPL1S NR 002727 0.22 0.039
ROD1 NM 005156 0.37 0.001
RSU1 NM 012425 0.41 0.002
S10DA4 NM 002961 0.03 0.000
SAMD9 NM 017654 0.07 0.007
SCARB2 NM 005506 0.42 0.001
SDC2 NM 002998 0.38 0.000
SDPR NM 004657 0.03 0.005
SENP2 AF151697 0.44 0.006
-SEPP1 NM 001-035486 o.oo --0.-005

SFRP1
NM 003012 0.37 0.000
SH0C2 NM 007373 0.39 0.000
SIGIRR NM 021805 0.47 0.000
SLC17A5 NM 012434 0.14 0.001
SLC22A5 NM 003060 0.21 0.001
SLC9A3R2 NM 004785 0.29 0.000
SMPD1 NM 000543 0.17 0.000
STAT1 NM 139266 0.19 0.000
STAT6 NM 003153 0.00 0.000
STS NM 000351 0.10 0.007
STYK1 NM 018423 0.05 0.013
SUMF1 NM 182760 0.28 0.000
TAGLN NM 001001522 0.01 0.000
TFAP2A NM 003220 0.03 0.005
THBS2 NM 003247 0.02 0.000
THRA NM 199334 0.31 0.000
THRB NM 000461 0.10 0.014
TNXB NM 019105 0.26 0.043
TPM2 NM 213674 0.12 0.000
TRIOBP NM 007032 0.15 0.003
TRIP11 NM 004239 0.45 0.001
TSC22D3 NM 004089 0.14 0.000
TWIST 1 NM 000474 0.01 0.003
VCAN NM 004385 0.04 0.000
VCL NM 014000 0.28 0.000
VLDLR NM 003383 0.15 0.000
WISP1 NM 003882 0.05 0.013
WNT5A NM 003392 0.01 0.000
YAP1 NM 006106 0.41 0.007
ZBTB7B NM 015872 0.44 0.000

Table X5: Up-regulated Neural Precursor genes (NSLC vs. hNPC)

GeneSymbol Accession Number Fold change of
NSLC compared to
hNPC2 p-value
ACTL6A NM 178042 2.33 0.000
BCAT1 NM 005504 9.92 0.000
BDNF NM 170735 33.90 0.000
BMP2 NM 001200 17.71 0.000
CDKN2A NM 058197 5.57 0.000
COL18A1 NM 030582 7.22 0.001
DiAPHI NM 005219 2.33 0.001
EDNRB NM 003991 2.78 0.000
IDE NM 004969 2.74 0.000
LIMK1 NM 002314 3.61 0.000
MAPK8IP1 NM 005456 2.77 0.000
MCHR1 NM 005297 4.02 0.000
MYLIP NM 013262 4.22 0.000
NEDD4 NM 006154 2.23 0.000
NOS2A NM 000625 267.58 0.000
PCSK9 NM 174936 9.65 0.000
PSEN2 NM 000447 2.07 0.000
SMAD1 NM 005900 3.09 0.000
TBX1 NM 080647 3.65 0.028
TGFB1 NM 000660 6.66 0.000
Fold change represents the up-regulation of the gene in the NSLC samples as compared to the hNPC samples. (n=3 for hNPC samples, n=3 for NSLC samples).
Table X6: Up-regulated Glia genes (NSLC vs. hNPC)
GeneSymbol Accession Number Fold change of NSLC compared to hNPC1 p-value
ACSL4 NM 004458 2.10 0.000
BDNF NM 170735 33.90 0.000
BMP4 NM 001202 20.55 0.001
CP NM 000096 159.46 0.000
CSPG4 NM 001897 4.94 0.000
FOXC1 NM 001453 5.12 0.000
GFAP NM 002055 13.67 0.000
GJB2 NM 004004 7.25 0.000
GLIPR1 NM 006851 5.58 0.000
ITGA3 NM 002204 24.64 0.000
LM03 NM 018640 129.25 0.000
NEFL NM 006158 7.14 o.ooo
NKX6-2 NM 177400 11.50 0.000
NRTN NM 004558 3.39 0.001
PDCD11 NM 014976 2.48 0.000
PLP1 NM 000533 20.64 0.000
TGFB1 NM 000660 6.66 0.000
TSPAN12 NM- 012338 2.58 0.006

Table X7: Up-regulated Regenerative genes (NSLC vs. hNPC)
GeneSymbol Accession Number Fold change of NSLC compared to hNPC1 p-value
ATR' NM 001184- 2.57 0.000
BMP2 NM 001200 17.71 0.000
BMP4 NM 001202 20.55 0.001
CAV3 NM 001234 26.23 0.000
CCND1 NM 053056 10.34 0.000
CDKN2A NM 058197 5.57 0.000
CEBPB NM 005194 2.58 0.000
GAL NM 015973 12.21 0.000
GAP43 NM 002045 4.27 0.000
HOXB4 NM 024015 133.37 0.000
SMAD3 NM 005902 2.27 0.000
In order to investigate the differentiation potential of NSLCs to neuronal lineages (Neurons, astrocytes, and oligodendocytes), neurospheres were dissociated and plated in iaminin/poly-D-Lysine (10ug/ml; Sigma) in differentiation medium for two weeks. The differentiation towards neuronal lineage was performed using two different mediums: NbActive medium (BrainBits™) supplemented with Brain Derived Neurotrophin Factor (BDNF, 20ng/mi, Peprotech), a//-frans-retinoic acid {ATRA, 5µM, Spectrum), and bFGF (40ng/ml, Peprotech) or NeuroCult™ differentiation medium (NeuroCult™ Differentiation kit, StemCell Technologies), supplemented with BDNF (20 ng/mi, Peprotech) and bFGF (40ng/ml, Peprotech). After two weeks in culture, the cells were stained with the neuronal marker plll-tubulin, astrocyte markers GFAP and S100p, andoligodendrocyte marker CNPase. The cells were fixed with 4% formaldehyde and the primary antibodies were added in 5% normal goat serum / PBS as follows: Mouse antibody plll-tubulin (1:200, Abeam), rabbit antibody S100p (1:100, Abeam), and Chicken antibody CNPase (1:50, Abeam). Secondary antibodies are added in 5% normal goat serum/ PBS as follows: Goat anti mouse Alexa546™ (1:200, Invitrogen), Goat anti rabbit Alexa488™ (1:200, Invitrogen), and Goat anti-chicken cy5 (1:100, Jackson ImmunoResearch Labs).
Immunohistochemistry analysis showed that NbActive medium promoted the differentiation equally to neuronal (48.66 ±14.07%, plll-tubulin) and potential early oligodendrocyte lineages (50.01 ±4.04%, CNPase) and to a lower percentage of astrocyte cells (2.68 ±1.13%, S100p), while NS-A differentiation medium induced the differentiation mainly to neurons (64.89 ±4.11%, BIll-tubulin) and astrocytes (35.94 ±4.04%, S100beta), and a low percentage of potential early oligodendrocytes cells (8.68 ±2.71%, CNPase) . The NSC-A medium was selected over NbActive for further differentiation studies. Differentiation of cells in NS-A differentiation medium promote the differentiation of hNPC and NSLC similarly as shown in Table 17 by the decrease of the percentage of sox2, musashi and nestin positive cells. NSLCs were differentiated to neuronal (74.3±0.1, GABA), astrocyte lineage (65.6±0.0,

SlOObeta) and to a lower percentage of oligodendrocyte cells {5.2±0.6, CNPase). The same pattern of tripotent lineage differentiation was observed with hNPCs (Table 17).
Table 17: The percentage of cells stained positive for neural stem cell and neuronal lineage
markers in transfected and untransfected cells. NSLCs and hNPCs were cultured in NS-A-
differentiation medium supplemented with BDNF (20ng/ml) and FGF (40 ng/ml), cultures were
incubated at 37°C, 5% C02, 5%02for three weeks. The percentage of immunopositive cells was
determined by Cellomics™ and represented as mean±SD (n = 5).
Sox2 Nestin Musashi S100 04 GABA
Tripotent medium hNPC 73.8 ±0.5 46.1 ±5.2 22.1 ±7.0 20.8 ±1.3 6.4 ±2.9 68.5 ±1.6
NSLC 68.6 ±3.9 41.0 ±5.4 26.7 ±5.0 J 65.6 ±0.0 8.2
■ ±0.6 74.3 ±0.1
Several additional antibodies to neuronal antigens were used to characterize, in more detail, the nature of differentiated cells. Antibodies against microtubule-associated protein (MAP2b), NCAM, and synaptophysin were used as recommended by the antibody manufacturer. After three weeks in differentiation medium, there was a differentiation-induced reduction in markers of precursors cells and an increase in mature neuronal markers. The percentage of neural precursor markers such as Sox2 were decreased during differentiation, while p75NTR, plli-tubulin and GABA were increased with lengthening differentiation time (Figure 6); however, 04 positive cells were very low after 3 weeks of differentiation of hNPCs (6.4±2.9) and NSLCs (8.2±0.6). Synaptophysin, an antibody used to identify functional neuronal ceils, was increased following 2 and 3 weeks of differentiation, indicating maturity of the neuronal cells. GABA and acetycholine markers were increased following 2 weeks of differentiation and decreased at week 3.
The morphological changes and expression of a number of neuronal antigens and genes show that the above method results in normal and viable neuronal ceils. Additionally, the newfy formed neuronal cells have the morphological criteria of neurons. In addition to the above markers, the differentiated cells were evaluated by characterizing morphological markers of neurite differentiation. Neuron type ceils (cells strongly expressing plll-tubulin) showed neurite formation after differentiation,, including an increase in the average number of neurites per neuron (from e.g. 1.38 ±0.1} The same pattern was observed in plll-tubulin positive cells. Accordingly, the average neurite length (118.3+3.5 urn) and the number of branch points (3.28+0.3) per neuron also increased. The differentiated neuron-like cells developed long neurites that were greater than three cell diameters in length with a growth cone at the. end, expressed neuron-specific genes, and stopped proliferating after the induction of differentiation.
Further differentiation was performed using an optimised medium that promoted the differentiation towards oligodendrocyte lineage. NSLCs and hNPCs were cultured in NS-A differentiation medium as described previously supplemented with FGF-2 (10ng/m!, Peprotech) and sonic hedgehog (SHH, 100ng/ml, Peprotech) for 4 days. After 4 days medium was

changed to NS-A differentiation medium supplemented by T3 (60 ng/ml, Peprotech), IGF1 (10ng/ml, Peprotech), NT-3 (10ng/ml, Peprotech), and PDGF (10ng/ml, Peprotech). Cells were cultured for 20 days at 37°C; 5% C02.
Table 18: The percentage .of cells stained positive for neural stem cell and neuronal lineage markers in transfected and untransfected cells. NSLCs and hNPCs were cultured in differentiation medium supplemented with SHH {100ng/ml, Peprotech ), T3 (60 ng/ml, Peprotech), IGF1 (10ng/ml, Peprotech), NT-3 (10ng/ml, Peprotech), and PDGF (I0ng/ml, Peprotech) to induce differentiation towards oligodendrocytes. The percentage of immunopositive cells was determined by Cellomics™ and represented as mean+SD (n = 5).
% of positive cells Sox2 Nestin Musashi S100 04 GABA
hNPC 84.3 ±3.7 26.9
±4.4 51.8 ±2.9 - 33.4 ±1.9 40.1 ±6.4 89.6
±0.8
NSLC 69.3 ±4.4 24.3 ±2.5 45.1 ±11.1 51.6 ±9.5 8.5 ±0.6 76.9 ±1.4
Quantification of the differentiation of hNPCs and NSLCs revealed a population of cells that were positively stained for 04. As shown in Table 18, the percentage of 04 positive cells was more pronounced in differentiated hNPC (40.1 ±6.4%) as compared to differentiated NSLCs (8.5 ±0.6%) when using the above differentiation protocol.
This study showed that transfecting the cells with one or two neurogenic transcription factors in the presence of a DNA demethylator or small molecules for epigenetic modification achieves stable reprogrammed cells (NSLCs). Like a DNA demethylator, epigenetic modification (inhibition of acetylation and methylation) are sometimes useful in boosting the reprogramrning process. These cells possess and retain neural stem cell properties as determined by: (1) the expression of neural stem cell genes and proteins, (2) the capacity to generate and grow as neurospheres starting from a single cell, and (3) to differentiate to neuronal lineages in differentiation conditions. When differentiated to neurons, cells display one or more neural-specific morphological, physiological and/or immunological features associated with a neuronal cell type. Useful criteria include morphological features (long processes or neurites), physiological, and/or immunological features such as expression of a set of neuronal-specific markers or antigens. Furthermore, NSLCs readily turn into a tripotent-like precursor cell with differentiation potential to a high percentage of neuronal, astrocytes and lower percentage of oligodendrocyte populations.
EXAMPLE VI Implication of BMP signaling pathway in the Reprogramrning of HFFs
This study was designed to evaluate the role of Noggin in the process of de-differentiation of HFFs towards NSLCs. HFFs were cultured and treated with cytochalasin B as described in Example III. After two days of treatment, cells were transfected by Nucleofection as described in Example II with the constructed vector Msi1/Ngn2.Briefly, after preparing the

cells, they were mixed with 2 pg of total DNA (Msi1/Ngn2) and were co-transfect with MBD2 {2µg), by the Amaxa's Nucleofector™ according to the manufacturer's protocol. The samples were then transferred into a Laminiri (10 ug/ml, Sigma) coated culture plate and cultured in the presence of Neural Proliferation Medium (NeuroCult™ proliferation Kit, StemCell Technologies)with recombinant hFGF (20ng/ml, Peprotech), recombinant hEGF {20ng/ml, Peprotech), and with or without the presence of Noggin (20 ng/ml, Peprotech). Samples were collected at different time points (1, 3, 4, 6, and 8 days) to analyze neuronal gene expression by RT-PCR and protein expression levels by immunohistochemistry.
Fluorescent imunohistochemica! staining was performed on samples after 4 days of transfection as previously described in Example I. Transfected cells were stained and analyzed for expression of Sox2, the percentage of Sox2 was 33.3 ±1.00% in the presence of Noggin compared to 27.5 ±0.50% without the presence of noggin at day 4. RT-PCR analysis of relative expression of neuronal precursor cell markers such as nestin and Sox2 after transfection of HFFs with pCMV-Msi1-2A-Ngn2 and pCMV6-XL5-MBD2 with or without the presence of Noggin (20ng/ml) was associated with an increase in nestin and Sox2 starting at day 3 and maintained until day 8 (Table 19). No difference in the expression was noticed in the absence of Noggin. Inhibiting the BMP signaling pathway by Noggin thus enhanced reprogramming, but had no reprogramming effect on its own.

Table 19: RT-PCR analysis of relative expression of neuronal precursor celt markers such as
nestin and Sox2 after transfection of HFF with pCMV-Msi1-2A-Ngn2 and pCMV6-XL5-MBD2
with or without Noggin (20ng/ml). Relative expression of Sox2, and nestin was increased after
transfection with and without Noggin. ' '
ACHE GFAP NES SOX2 TUBB3

Rel. Exp. Std. Dev. Rel. Exp. Std. Dev. Rel. Exp. Std. Dev. Rel. Exp. Std.
Dev. Rel. Exp. Std. Dev.
#1 Msi1/Ngn2 + MBD2/+Noggin Day1 7.08 1.70 2.97 0.42 1.33 0.10 0.93 0.91 1.37 0.10
#2 Msi1/Ngn2 + MBD2/ +Noggin Day2 7.34 1.03 2.01 . 0.08 1.28 0.18 0.60 0.10 0.98 0.05
#3Msi1/Ngn2 + MBD2/ +Noggin Day3 9.67 2.41 • 15.13 1.66 1.98 0.20 6333.63 277.87 0.95 0.07
#4Msi1/Ngn2 +
MBD2/+Noggin Day4 11.68 2.65 194.07 25.22 4:19 0.52 20231.33 1034.29 1.90 0.45
#5 Msi1/Ngn2 + MBD2/ +Noggin Day6 3.58 0.66 227.99 16.83 168 0.09 6298.51 289.84 0.96 0.17
#6 Msi1/Ngn2 + MBD2/+Noggin Day8 10.89 0.57 650.34 22.92 4.42 0.03 18134.90 63.93 1.81 0.06
#7 Ctrl Untransfected
+Noggin Day1 1.01 0.19 1.00 0.05 1.00 0.02 1.12 0.70 1.00 0.09
-#8 Msi1/Ngn2 + MBD2/ -Noggin Day1 2.79 0.83 1.62 0.19 0.99 0.08 1.28 0.25 0.75 0.01
#9 Msi1/Ngn2 + MBD2/ -Noggin Day2 3.79 0.91 1.47 0.08 1.23 0.08 1.36 0.08 0.72 0.07
#10Msi1/Ngn2 + MBD2/ -Noggin Day3 6:18 0.59 14.60 1.85 2.62 0.30 10949.28 448.28 0.90 0.01
#11 Msi1/Ngn2 + .
MBD2/
-Noggin Day4 5,63 0.74 74.56 16.56 2.97 0.21 19623.99 3109.69 0.75 0.11
#12Msi1/Ngn2 + MBD2/ -Noggin Day6 3.21 0.96 232.42 5.47 1.47 0.07 15311.64 1909.23 0.86 0.03
#13Msi1/Ngn2 + MBD2/ . -Noggin Day8 3.82 0.52 496.99 75.81 3.32 0.32 26892.31 1817.05 2.05 0.10
#14 Ctrl Untransfected -Noggin Day! 1,08 0.57 1.01 0.14 1.00 0.04 1.15 0.81 1.00 0.00
EXAMPLE VI! NSLCs created from HFF cells are not Skin-Derived Precursors (SKPs)
It's known that cells termed skin-derived precursors (SKPs) may reside in adult human
skin (Fernandes et al., 2004). These cells are capable of proliferating in response to EGF and
bFGF and express nestin, versican and fibronectin, and can differentiate into both neuronal and
mesodermal progeny. In order to verify that NSLCs are distinct from SKPs, differentiation
" 1oWards~adipocyte cells"was performed: Adipose derived stem cells (ADSC)'were maintained in """

StemPro™ MSC serum free medium (Invitrogen) on flasks coated with CellStart™ (Invitrogen). CellStart™ was diluted 1:100 in dPBS/Ca2VMg2+ and the flask incubated for 2 hours at 37°C. Cetfs are passaged every 3 to 4 days using Accutase™ and medium was changed every 2 days. Three to four days before initiating differentiation, ADSCs and NSLCs were seeded in 6-wellplates in CellStart™ (1:100 in dPBS/Ca2+/Mg2+/ 2 hours at 37°C) coated tissue culture plates. When cells reached confluence (after 3 to 4 days), proliferation media were replaced by differentiation medium consisting in DMEM/F12 (50:50), ITS (1:100), HEPES (1:100), GlutaMAX™ (1:100), T3 (0.2 nM), Rosiglitasone {0.5 jag/ml), IBMX (100^iM) and Dexamethasone (1 |iM). Three days after, IBMX and dexamethasone were withdrawn from the differentiation medium. At day 10, cells were fixed with a 4% formaldehyde solution for 10 min and stained with Oil Red O (Invitrogen) staining solution for 15 min. Staining was removed and cells washed twice with PBS. Adipose cells appeared red with lipid droplets specifically stained with Oil Red O, however NSLCs were stained negative, with no presence of lipid droplets in the cells, and the cells adopted neuronal cell morphology.
Immunohistochemistry analysis confirmed that NSLCs are distinct from SKPs (Figure 24): NSLCs stained positive for p75NTR and negative for fibronectin and versican, while SKPs express fibronectin and versican and do not express p75NTR (Fernandes et at., 2004). This study indicates that NSLCs represent a tripotent-like precursor cell and they are not a subpopulation of SKPs.
EXAMPLE VIII BDNF release from Neural-Like Cells (NLCs)
Neural Stem-Like Cells (NSLCs) differentiated into neuronal and glial cells were kept in culture for 55 days, and BDNF released in the conditioned medium was measured by antigen-capture ELISA at different time points and compared to the release in mature neurons (ScienCell), undifferentiated Neural Human Normal Precursor cells (NHNP, Lonza) as well as to undifferentiated NSLCs and untransfected cells (HFF). Conditioned medium from each group was collected, centrifuged, and then stored at -80°C until assaying. BDNF concentrations were measured by ELISA kits (BDNF Emax Immunoassay System, Promega Corporation, USA), according to the manufacturer's instructions. Briefly, 96-well ELISA immunoplates were coated with Anti-BDNF (CatNb#G700B) diluted 1/1000 in carbonate buffer (pH 9.7) and incubated at 4°C overnight. The following day, all wells were washed with TBS-Tween™ 0.5% before incubation with Block/Sample buffer 1X at room temperature for one hour without shaking. After blocking, standards and samples were added to the plates and incubated and shaken (450±100rpm) for 2 h at room temperature. Subsequently, after washing with TBS-Tween™ wash buffer, plates were incubated for 2h with Anti-Human BDNF pAb (1:500 dilution in Block & Sample 1X Buffer) at 4°C. After incubation, plates were washed five times with TBS-Tween™

0.5% wash buffer and 100ul of diluted Anti-lgYHRP Conjugate was added to each weil (1:200 dilution in Block & Sample 1X Buffer) and incubated for 1 hour at room temperature with shaking (450 ± 100rpm). Then, plates were washed five times with TBS-Tween™ 0.5% wash buffer and 1OOul of TMB One Solution was added to each well. Following 10 minutes incubation at room temperature with shaking (450 ± 10Orpm) for the BDNF plate, a blue color formed in the wells. After stopping the reaction by adding 100ul of 1N hydrochloric acid, the absorbance was read at 450nm on a microplate reader (Synergy 4™) within 30 minutes of stopping the reactions. Concentration of released BDNF in the supernatants was determined according to the standard curves.
ELISA results revealed that BDNF was released at the same concentration from differentiated Neuron-Like Cells (NLCs differentiated from NSLCs) and normal Human neuron cells starting at day 11 and remained until day 55 (Table 20), while no BDNF (except for tiny amounts in the untransfected HFF group) was released in the other groups.
Table 20: Quantification of BDNF release by Neural-Like Cells (NLCs) that had been differentiated for 55 days from Neural Stem-Like Cells (NSLCs) that had been created from transfected HFFs. BDNF release from NLCs into the medium, at different time points, was measured by antigen-capture ELISA and compared to BDNP release of normal mature human neurons (ScienCell).

Control medium Neurons NLC
day 0
day 11 1.55 30.25 22.99
day 18 0.33 29.49 25.15
day 24 0.33 22.01 26.39
day 34 0.23 25.53 32.21
day 41 0.27 19.02 22.43
day 55 0.02 20.73 30.01
In addition to adopting neuronal morphology criteria, the NLCs were functional and possessed the capacity to release neurotrophic factor (BDNF). Generating reprogrammed neuronal-like cell lines that can locally deliver these neurotrophic factors could be used as a method to treat several neurological conditions and may offer crucial benefits in regeneration and functional recovery from brain and other injuries.
EXAMPLE IX Reprogramming of different cell types towards NSLCs: This study was performed to
investigate the capacity of keratinocytes (Invitrogen), human Adipocytes Derived Stem Cells
(ADSCs, Invitrogen) and human hematopoietic stem cells (CD34+, Invitrogen) cells into neural
stem-like cells.
Preparation of Human CD34* Cells, human ADSC and human Keratinocytes:
Human mobilized peripheral blood CD34+ cells were purchased from StemCell Technologies
and expanded as a floating culture in Petri Dishes in complete StemPro™®-34 Serum-free
Medium (Invitrogen) supplemented with Stem Cell Factor (SCF, 15G-- g/ml,- Peprotech),

Granulocyte Colony-Stimulating Factor (GM-CSF, 37.5 ng/ml, Peprotech) and IL-3 (75 ng/ml, Peprotech). Medium supplemented with cytokines was changed everyday 2-3 days after centrifugation of the cell suspension at 300xg for 10 min. Every other day the cytokines were added directly to the culture without changing the media. Cells were incubated at 37oC, 5% C02. For their passaging, cells were centrifugated, resuspended in the above medium plus cytokines and placed into the adequate number of Petri dishes.
Human Adipose-Derived Stem Cells (ADSC) were purchased from Invitrogen and expanded in complete StemPro™ MSC Serum-free medium (Invitrogen) on CellStart™™ (Invitrogen) coated flasks (diluted 1:100 in PBS containing Ca2+/ Mg2+) at a cell density of 1x104 cells/cm2. Medium was replaced every two days with fresh pre-warmed complete StemPro™ MSC SFM. Cells were incubated at 37°C, 5% C02. Cells were sub-passaged when 80% confluent by incubation for 3-5 min in pre-warmed TrypLE™™ (Invitrogen) and then collected in StemPro™ MSC medium. After centrifugation at 1500 rpm for 5 min, cells were seeded on CellStart™™ coated flasks as described above.
Primary human keratinocytes were purchased from Invitrogen and expanded in Defined Keratinocyte Serum-free medium on Coating matrix (Invitrogen) coated flasks (Invitrogen) at a cell density of 5x103 cells/ cm2. The cells were incubated at 37°C, 5% C02. Media was replaced with fresh, complete growth media every two to three days until subculture. Once the cells had reached 70-80 % confluency, media was removed and the cells were incubated in Versene™ (Invitrogen) for 3-5 min at room temperature. Versene™ was removed, and pre-warmed 0.05% trypsin-EDTA (Invitrogen) was added to the flasks. After 5-10 min incubation, growth medium containing Soybean Trypsin inhibitor (Invitrogen) was added to the flasks and the cells gently triturated. After centrifugation at 100xg for 10 min, cells were resuspended in the desired volume of pre-warmed, complete growth medium on coated flasks as described above.
Prior to transfection, cells were trypsinized and transiently co-transfected with pCMV-Msi1-Ngn2 and pCMV6-XL5-MBD2 as previously described in Example IV using the Shuttle and plated into a culture plate coated with laminin (Sigma, 10µg/ml). Starting one day after transfection, cells were treated with VPA (1mM) for 4 days and the medium was changed gradually to proliferation medium supplemented with FGF (20ng/ml) and EGF (20ng/ml) and were cultured for 18 days at 37°C, 5% C02 and 5% 02. Cells were then analyzed for neural stem cell markers by RT-PCR and Immunohistochemistry.
Further analysis and quantification of the reprogrammed cells revealed a population of NSLCs engendered from keratinocyte and CD34+ cells. RT-PCR Analysis revealed an increase of relative expression of neural stem ceil markers such as Sox2, nestin, GFAP, and BIll-tubulin after transfecting Keratinocyte and CD34+ by Msi1 and Ngn2. Relative expression of nestin and GFAP was enhanced in NSLCs created from keratinocytes and CD34* ceils as compared to NSLCs from HFFs; however, the reverse was true for Sox2 and ACHE expression, plll-tubulin _._(T]JBB3) and Map2b expression was highest |n NSLCs created_from CD34+ cells, follwed by

NSLCs created from HFF (Table 21). This data shows that different types of NSLCs with different gene expression profiles (and characteristics) can be created from different types of starting / source cells (and the same has been observed for creating some other types of stemlike cells discussed in this application). The data is also intriguing since it was not expected that keratinocytes (which are derived from the ectoderm just as endogenous neural stem ceils) would have a lower expression than HFFs for all the genes analyzed except for Nestin (it was expected that keratfnocvtes woufd be the easiest to reprogram into NSLCs since they are derived from the ectoderm).

Immunohistochemistry revealed positive staining for GFAP, Sox2, and nestin as shown in Figure 7. NSLCs developed from HFF yield a higher percentage of positive staining for Sox2 and GFAP (55.8±3.8 and 78.1±2.4) as compared to CD34* cells (42.8+2.7 and 24.2+4.4), and keratinocytes (47.1+2.1 and 43.4+8.9). The percentage of nestin positive cells was high in Keratinocytes (77.6+10.7) and HFF (68.45+12.9) and lower in CD34+ cells (15.5+2.7) (Table 22). Sox2 and Nestin positive staining was undetectable in ADSCs.
Table 22: The percentage of Sox2 and nestin positive cells for neural stem cell markers after
transfecting fibroblast, keratinocyte, and CD34+ cells with pCMV-Msi1-Ngn2 in the presence of
MBD2 and VPA. Cells were cultured on coated culture plates in proliferation medium (StemCell
Technologies) supplemented with EGF (20ng/m!) and FGF (20ng/ml) for 18 days. Untransfected
cells were considered as negative control. The percentage of immunopositive cells was
determined by Ce lomics™ and represented as meaniSD (n = 5).
% ppsitive cells Untransfected
cells Fibroblasts Keratinpcytes- CD34+

Sox2 1.511.7 55.8±3.8 47.1±2.1 42.812.7
GFAP 0.04+/-0.2 78.1+2.4 43.4±8.9 24.214.4
Nestin 0.3+/-0.3 68.45±12.9 77.6110.7 15.512.7
NSLCs generated from keratinocytes and CD34+ cells were tested for tripotent capacity. Further differentiation studies were performed to induce differentiation of these NSLCs towards neuronal lineage, using NeuroCult™ differentiation medium (NeuroCult™ differentiation Kit, StemCell Technologies) supplemented with BDNF (20ng/ml, Peprotech) and bFGF (40ng/ml, Peprotech) as described in Example V. NSLCs generated from HFFs and hNPCs were used as controls, cultures were incubated at 37°C, 5% C02, 5%02 for three weeks. Samples were collected or fixed at Day 14 and 28 following differentiation for further analysis. RT-PCR analysis revealed decrease of undifferentiated genes (Nestin and Sox2) and increased of differentiated genes (Map2, BIII-tubuiin, CNPase, and GFAP) as shown in Tables 23A, 23B, 23C and 23D.

Fluorescent immunohistochemical staining was performed on samples after 14 days and 28 days of differentiation. The expression of Sox2 and Nestin was decreased time dependently in differentiated cells '(HFF, keratinocyte, and CD34+). This decrease was associated with an increase of differentiated markers at day 28 such as GFAP (68.51 ±11.87 for HFF-NC, 59.55 ±9.12 for Keratinocyte NC, and 61.70 ±1.48 for CD34+-NC). A high percentage for pill-tubulin positive ceJIs was generated from differentiated NSLCs generated from HFF (57.83+4.49) as compared to plll-tubulin positive cells generated from Keratinocytes (23.27+2.91) and CD34* cells (39.15±7.99) (Table 24)
Table 24: The percentage of cells stained positive for neural stem cell markers and neuronal lineage markers in hNPCs (Lonza) and transfected keratinocytes, HFF, and CD34+ celis with pMsi1/Ngn2/MBD2. Transfected cells (NSLCs) were cultured in Proliferation medium or differentiation medium for 28 days at 37°C, 5%C02, 5%02. The percentage of immunopositive cells (Sox2, Nestin, GFAP, S100beta, and BIll-tubulin) was determined by Cellomics™ and represented as mean±SD {n = 5).

%positive cells Proliferation conditions 14 days differentiation 28 days differentiation
hNPC Sox2 96.23 ±0.51 59.05 ±3.01 41.43 ±6.05
Nestin 41.47 ±0.23 10.77 ±4.78 16.14 ±7.41
S100p 37.3817.85 49.51 ±2.39 n.d.
plll-tubulin 2.34 ±0.43 11.54 ±4.03 23.34 ±4.77
GFAP 1.16 ±0.14 23.42 ±2.51 48.04 ±8.30
HFF-NC Sox2 93.28 +0.53 79.48 ±0.54 52.06 ±9.07
Nestin 29.29 ±4.72 1.15 ±0.46 2.18 ±1.96
S1003 13.51 ±0.28 80.75 ±3.50 79.38 ±10.62
plll-tubulin 3.91 ±0.33 42.16 ±15.07 57.83 ±4.49
GFAP 8.41 +0.73 59.66 ±11.48 68.51 ±11.87
Keratinocyte-NC Sox2 96.55 ±1.01 76.93 ±5.13 63.11 ±8.54
Nestin 40.10 ±8.41 2.67 ±1.61 3.57 ±0.48
s100p 13.58+4.97 76.6 ±9.72 74.75 ±11.21
plll-tubulin 6.42 ±2.94 20.58 ±8.34 23.27 ±2.91
GFAP 9.36 ±0.34 43.43 ±2.44 59.55 ±9.12
CD34+-NC Sox2 95.49 ±2.6 81.18 ±1.24 63.46 ±5.14
Nestin 51.68 ±14.27 12.64 ±1.27 8.46 ±4.6
s100p 30.1 ±1.03 72.40 ±4.5 79.57 ±8.52
plll-tubulin 5.82 +2.08 25.04 ±19.95 39.15 ±7.99
GFAP 13.99 ±5.48 51.79 ±13.68 61.70 ±1.48
n.d.= not determined; ± = standard deviation
CD34*-NC: neuronal cells generated after differentiation of NSLCs generated from CD34+ cells. Each
data point represents the analysis of at least 1000 cells from at least 8 images.
The % of Sox2 positive cells decreased faster, the % of Nestin positive cells generally decreased slower, and the % of cells expressing one of the differentiation markers (S100p, pill-tubulin, GFAP) generally increased slower in hNPCs than in the NSLCs during differentiation. Out of the three types of created NSLC lines, the % of cells expressing one of the differentiation markers (S100p, plll-tubulin, GFAP) generally increased slowest in NSLCs created from keratinocytes and fastest in NSLCs created from HFFs.

This study indicates that NSLCs can be created from keratinocytes and CD34+ blood cells, and these cells share morphology and markers similarly to NSLCs generated from HFF. Similarly to hNPCs, NSLCs created from from'keratinocytes, CD34+ cells, and HFFs had a tendency to differentiate more towards an astrocyte lineage than a neuronal lineage (except NSLCs created from HFFs had an almost similar number of BIll-tubulin positive and GFAP positive cells) as shown by the high percentage of GFAP positive cells during differentiation, which was confirmed by S100beta staining. However, the proportion of astrocyte and neuronal cells generated from hNPCs .was lower in same culture conditions, indicating that NSLCs generated from HFF, Keratinocytes, and CD34* cells can give rise to a higher number of neuronal and astrocyte cells as compared to hNPCs. NSLCs, whether created from HFFs, Keratinocytes or CD34+ cells (or potentially even some other, cell), are tripotent cells and possess the capacity to differentiate to neurons, astrocytes, and oligodendrocytes similarly to hNPCs. However, RT-PCR and immunohistochemistry analysis, of transfected ADSCs did not reveal any significant expression of neural stem cell genes, indicating a need to optimize conditions for turning ADSCs to NSLCs or to investigate the effect of others neurogenic factors that could turn these into NSLCs.
EXAMPLE X
Fabrication 3D extracellular matrix (CDM)
Fibroblast cells were cultured in DMEM medium in the presence of 10% FCS as described in Example I, followed by seeding onto 12-well plates pre-coated with laminin {10jig/ml) at a concentration of 2x106 ceils/ml in defined CDM Medium consisting of a 3:1 ratio of Dulbecco's modified Eagle medium (DMEM, high glucose (4.5g/L) with L-glutamine and sodium pyruvate) and Ham's F-12 medium supplemented with the following components: EGF (4.2x10"10M), bFGF (2.8x10/10M), ITS (8.6x10"5M), dexamethasone (1.0x10"7M), L-ascorbic acid phosphate magnesium salt n-hydrate (3.2x10"4M), L-3,3',5-triiodothyronine (2.0x10"10M), ethanolamine (lO^MJ.GIutaMAX™ (4x10"3M), glutathione (3.3x10*M), and 1% penicillin/streptomycin/amphotericin B. By culturing the fibroblast cells at hyperconfluent density in this completely chemically defined medium causes them to enter a high synthetic phase with a slow-down in proliferation, leading to the production of a living tissue equivalent (LTE) consisting of multiple layers of fibroblasts within de novo 3D extracellular matrix (CDM) that is completely synthesized by the fibroblasts themselves.
Trans-differentiation and Reprogramming of cells within CDM
Day 14 CDM samples were treated with cytochalsin B (10ug/ml, Calbiochem), with the concentration of cytochalsin B reduced from 10µg/mt to Oµg/ml (none) over 5 days while at the same time switching the medium from CDM Medium to NbActive medium. Samples were cultured for another 12 days at 37°C, 5% C02, and the medium was changed~every day. "

Samples were fixed to perform immunohistochemistry as described previously to detect Neuronal markers. The following antibodies were used: mouse anti-nestin 647 {1:100, BD) and anti-pfll-tubulin (1:200, Neuromics). No clear morphology change of the cells was observed within the CDM and the immunohistochemical analysis failed to detect plll-tubulin positive cells. Thus, inducing the trans-differentiation of cells using only cytochalasin B and chemically-defined neural medium was not sufficient to reprogram the cells.
Next, Day 6 CDM samples grown in LAS pre-coated plates at 37°C and 5% C02, were exposed simultaneously to cytocahlasin B (10µg/ml) over 5 days, histone deacetylation inhibitor (VPA, 4mM, Calbiochem) and inhibitor of DNA methylation (5-Azacytidine, 5µM, Sigma). Four days later, the medium was changed to differentiation medium consisting of a 3:1 ratio of CDM medium without the presence of EGFand NbActive medium (BrainBits™) supplemented with NT-3 {20ng/ml, Peprotech) and BDNF (20ng/ml, Peprotech). The ratio of the differentiation medium was increased gradually day after day until reaching 100% of complete differentiation medium. After two weeks of treatment, cells were fixed for immunohistochemical analysis to investigate the identity of the cells. Figure 18 shows immunostained cells with plll-tubulin at day 7, indicating the de-differentiation of fibroblast cells to neurons. However, one week later, these trans-differentiated cells reverted back to fibroblast cells and plll-tubulin expression was lost (Figure 8). The loss of morphology and plll-tubulin expression after withdrawal of the priming agents indicate that complete conversion to functional and stable reprogrammed cells did not occur.
Next CDM was treated with VPA (4mM), 5-Aza (5µM) and cytochalasin B (10µg/ml) as above. After 2 days of chemical treatment, fibroblast cells within the CDM were transfected with DNA using Lipofectamine reagent (Invitrogen) as per the manufacturer's protocol. 15 µg of the eukaryotic DNA expression vectors pCMV6-XL5-Pax6, pCMV6-XL5-Msi1 and pCMV6-XL4-Ngn2 (Origene) were used to transfect the cells. 24 hours later, the media was changed to Neural Progenitor Basal Medium (Lonza) supplemented with Noggin (50 ng/ml), EGF (20ng/ml), and bFGF (20ng/ml), and the cells were cultured at 37°C, 5% C02and 5% 02, and the medium was changed every day. At day 6, differentiation was initiated by adding gradually NBActive medium (BrainBits™) supplemented with NT-3 (20ng/ml, Peprotech), a//-trans-retinoic acid (ATRA, 5uM, Spectrum), BDNF (20ng/ml, Peprotech), and bFGF (40ng/ml, Peprotech). To characterize the reprogrammed cells, immunohistochemical analysis and RT-PCR was performed at various time points according to the methods described in Example II using primers for nestin, plll-tubulin, GFAP, MAP2b, and ACHE. In agreement wfth previous studies, un-transfected cells and cells transfected with.Pax6 did not expressed genes specific for neuronal lineages (Table 25). On the other hand, following transfection with Msi1, leveis of nestin and ACHE were increased to 4-fold and 8-fold, respectively, and this expression was maintained over the 12-day period. Also levels of GFAP mRNA was enhanced time dependently by approximately 14 times. Likewise, the same pattern was observed in Ngn2 transfected cells.

Whife expression of BIII-tubulin and MAP2b were modestly increased following transfection with one neurogenic transcription factors the regulation of gene expression after transfecting the cells with two neurogenic factors, Msi1 or Ngn2 with Pax6, did not further increase the expression of neuronal genes. Figure 19 shows that expression of these genes was enhanced when the cells were transfected with Msi1 and Ngn2, with BIIII-tubu!in enhanced to almost 6-fold at day 12.

Same pattern of gene expression was observed when transfecting the cells with three transcription factors (Msi1, Ngn2, and Pax6), but the expression was less pronounced than in cells transfecting with just Msi1 and Ngn2. In terms of immunohistochemical analysis after the 12 days of the transfection, cells displayed neuronal markers after transfection with Msi1 or Ngn2, as indicated by the expression of nestin and MAP2b (Figure 9). Cells transfected with pCMV-XL-PAx6 did not stain for Nestin and MAP2b.
This study shows that transfecting cells within CDM with only one neurogenic factor (Msi1 or Ngn2) induces morphological changes and expression of one or more markers of neural stem cells and neuronal cells. Since the reprogrammed cells expressed a key neurogenic factor, a neuronal precursor marker, and a mature neuronal marker at low percentage (10%), this suggests that cells within the CDM were transformed to NSLCs and then started to differentiated through the various phases of the neuronal determination and differentiation program induced in neural stem cells.
EXAMPLE XI Gene Expression Analysis of Reprogrammed cells within CDM
This study was designed to test the effect of transfecting cells with Msi1 and Ngn2 in the presence of MBD2 in the reprogramming process. Cells were transfected after two days of pre-treatment with cytocahlasin B with the DNA expression vectors using Lipofectamine reagent as described in Example X. 15 µg of eukaryotic DNA expression vectors pCMV6-XL5-Musashi or pCMV6-XL4-Ngn2, and pCMV6-XL5-MBD2 (Origene), were used to co-transfect cells. After 24 hours, the media was changed to CDM.Neural Progenitor Maintenance Medium (1:1)supplemented with Noggin (50 ng/ml), EGF {20ng/ml), and bFGF (20ng/ml). Medium was changed every day by increasing the percentage of NPBM and decreasing CDM medium. Cells were cultured for 6 days at 37°C, 5% C02and 5% 02. After one week, differentiation was initiated by gradually supplementing the NPBM Medium with NT-3 (20ng/ml, Peprotech), a/A trans-retinoic acid (ATRA, 5µM, Spectrum), BDNF (20ng/ml, Peprotech), and bFGF (40ng/ml, Peprotech). Samples were collected at the end of the study (day 14) and data were analyzed by gene array to identify genes that were reproducibly found to be specific for neuronal lineages.
Gene Expression Analysis
Gene expression analysis on 8 samples was performed as previously described in Example I with the customized Neuronal Markers 2 TLDA In order to identify the expression of genes related to neural stem cells, neuronal cells and glial cells, and growth factors expressed by the cells after transfection. The expression of oligodendrocyte genes, such as NKx2.2, olig2, and MAG was increased by Msi1 and Ngn2; however, the increased was more pronounced by

Msi1 as compared to Ngn2 (Table 26). Two markers for astrocytes (GFAP and AQP4) were highly expressed after transfection with Msi1 and Ngn2 in the presence of the DNA dernethylator MBD2. Interestingly, several markers of early neuronal cells were enhanced; 12 days after transfection, TDLA data revealed increases in specific markers for interneurons, such as somatostatin and calbindinl. Doublecortin (DCX), which is expressed by migrating immature cells during development, and acetylcholine (ACHE), an early marker of neuronal cells, were highly expressed in reprogrammed cells (Table 26). Transfection with Msi1 or Ngn2 increased the expression of dihydropyrimidinase-like 3 (DPYSL3), an early marker of newborn neurons to five-fold with Msi1 and seven-fold with Ngn2. Expression of microtubuie-associated protein 2 (MAP2), an essential marker for development and maintenance of early neuronal morphology, and neuronal cell adhesion molecule (NCAM) were highly expressed with Msi1 and Ngn2. The expression of enolase-2, a marker of mature neurons, was 20-fold enhanced by Msi1 and Ngn2. Member of the NeuroD family NeuroDI was highly expressed after transfection with Msi1 to 84.22 fold and to 34.27 by Ngn2. Gene expression of growth factors such as IGF-1, IGF-2, NPY and CSF-3 was enhanced following transfection with Msi1 or Ngn2. The expression of VEGF and GDNF genes were increased to almost five-fold and seven-fold by Msi1 and Ngn2, respectively. However in transfected cells, the expression of BDNF, EGF, and bFGF were not activated and even down-regulated as compared to untransfected cells. The expression of growth associated protein (GAP-43), a growth- and regeneration-associated marker of neurite extension, and expression of netrin, implicated in neuronal development and guidance, were highly expressed in transfected cells (Table 26). Expression of receptors for growth and neurotrophic factors was increased, such as type III receptor tyrosine kinase, Neurotrophic tyrosine kinase receptor, and neurotrophic tyrosine kinase. The fibroblast-specific markers vimentin and fibronecttn were down-regulated in the reprogrmmed cells.
Transfection of HFF with only Msi1 and Ngn2 in the presence of MBD2 increased the expression of glial cells and neuronal cells markers.

Table 26: Gene array of CDM transfected with pMsil and pNgn2 following the pre-treatment with cytochalasin B (10µg/ml), VPA (4mM) and 5-Azacytidine (5jiM). Transfected cells were cultured in differentiation medium (NbActive, BrainBits™) supplemented by ATRA (5µM), bFGF (40ng/ml) and BDNF (20ng/ml).

Sjrnbol Common oamtMiti description Company Gene ID ^ £ jRetatne Relative
t- i - erprasjion expression
** <■ - r* C" "Msi1 " Ngn2 _
Astrocytes and
oligodendrocytes
■ markers
-NKx2-2 -Markers for oligodendrocyte progenitors NM 002509.2 1.72 10.19
■OLIG2 -Oligodendrocyte lineage transcription factor 2 NM 005806.2 1.72 1.52
-MBP -Myelin-basic protein NrvMH) 1025090.1 1.72 1.52
GFAP -Glial fibrillary acidic protein NM_002055.4 6.04 2.41
-AQP4 -Aquaporin 4 NM~001650.4 1.72 1.52
-D102 -Deiodinase iodothyronine type II NM_0 13989.3 8.29 10.61
NC markers
-SST -Somatostatin, specific marker for interneurons NM 001048.3 very high very high
-CALB1 -Calbindin I, intemeuron marker NM_004929.2 1.72 1.52
-TubulinlA -Are necessary for axonal growth NM 006009.2 0.63 0.76
-NES -Precursor neurons (nestin) NM 006417.1 2.42 2.86
-DCX -An early neuronal marker (Doublecortin) NM 178151.1 1.72 1.52
-ACHE -Acetylcholinesterase, marker of early neuronal development NM_015831.2 10.68 20.37
-EN02 -A marker for neurons cells, enolase NM 001975.2 0.55 0.54
-NEUROD1 -Neural marker, expression gradually increased from neural precursor to fully differentiated neuron NM_002500.2 1.72 1.50
-DPYSU -Dihydropyrimidinase-like 3, marker of immature neurons NM_001387.2 0.62 0.71
-MAP2 -Microtubulc-associaled protein 2, essential for development of early neuronal morphology and
maintenance of adult neuronal morphology NM_002374.3 1.99 1.70
-NCAM -Neural cell adhesion molecule ] NM_18135.3 3.3 i 5.72
-CEND1 Cell cycle exit & neuronal differentiation, early marker of proliferating precursor cells that will differentiate to neurons NM_016564.3 6.68 8.28
Neuro reg en era tio n
and survival genes
-FCF2 -Fibroblast growth factor NM 002006.4 1.19 1.26
-EGF -Epidermal growth factor, Hs00153181 ml 28.37 52.13
-IGF-1 - Insulin growth factor-1, NM 000618.2 0.82 1.03
-1GF-2 -Insulin growth factor-2 NM 0000612.3 0.99 1.21
-CSF3 -Granulocyte colony-stimulating factor NM.2219J very high very high
-BDNF - Brain derived growth factor, neurogenesis NM-199231.1 8.54 7.84
-GDNF - Glial derived neurotrophic factor NM-000614.2 0.63 0.91
-CNTF - Ciliary neurotrophic factor NM 001025366.1 3.80 14.92
-VEGF -Vascular endothelial growth factor NM 130850.1 6.28 7.22
-BMP-4 -Bone morphogeoetic protein 4 NMJD02253.1 1.17 1.34
-KDR -Type []1 receptor tyrosine kinase) NM 006180.3 113.85 43.87
-NTRK2 -Neurotrophic tyrosine kinase recepto (TrkB) NM 000905.2 0.02 0.02
-NPY -Neuropeptide Y NM 009905.2 33.39 1.52
-NTF-5 -Neurotrophin 5 NM 006179.3 4.43 5.93
-PIK3CG -phosp hoinositi d e-3 - kinase. NM_002649-2 1.70 1.50
-STAT3 -Signal transduction transcription 3 NM 213662-1 3.15 2.24
-Gap43 -Growth associated protein 43 NM 002045-2 1.82 2.98
-NTN1 -Netrinl, implicated in neuronal development and guidance NM_004822.2 0.50 0.29
-NTRU - Neurotrophic tyrosine kinase, receptor, type 2 NM_006180.3 0.02 0.02
-LI CAM -LI cell adhesion molecule, associated with regenerating axons NM_024003.1 0.08 0.11
-LIMK1 - LIM domain kinase 1 NM 002314.2 2.88 2.96
-Vfmentin -Radial gjia and fibroblast marker NM-0033S0.2 0.2] 0.20
-Flbronectin -fibronectin is a marker for fibroblasts NM 212474.1 0.15 0.14
55

EXAMPLE XII
Reprogramming of cells within CDM by Lipofectamine and nucleofection
This study was designed to improve transfection of CDM by combining lipofectamine and nucleofection and using two vectors pCMV6-XL5-Msi1 and pCMV6-XL4-Ngn2 individually or in combination together with pCMV-XL5-MBD2. Cells within Day 4 CDM were iipotransfected for 6 hours with Msi1/MBD2, Ngn2/MBD2 or Msi/Ngn2/MBD2 after 2 days of pre-treatment with or without cytochalasin B. In parallel, transfection was performed on fresh HFFs after the 6 hours using Nucleofection as described in Example II, and transferred on top of the CDM when the lipofectamine media was changed to fresh CDM medium. After 24 hours, the medium was changed to Neural Progenitor Basal Medium (NPBM, Lonza) with the presence of Noggin (50 ng/ml, Peprotech}, recombinant hFGF (20ng/ml, Peprotech), and recombinant hEGF (20ng/ml, Peprotech). Differentiation was induced at day 7, by adding NSA-A differentiation medium {StemCell Technologies) for 21 days.
Gene Expression Analysis
Samples were collected at 8, 15, and 21 days to evaluate the nature of newly formed cells by analyzing the expression of several neuronal marker genes using RT-PCR according to the methods previously described in Example I. As shown in Table 27, ceils transfected with one neurogenic transcription factor (Msi1 or Ngn2) express high levels of nestin and Blll-tubulin at day 8. The same pattern of expression was observed at day 15 and 21, while the expression was slightly decreased in the absence of cytochalasin B in cells transfected with Ngn2. The expression of all genes, except the mature neuronal marker MAP2b, were remarkably increased in cells transfected with both neurogenic transcription factors. The upregulation of these genes was slightly reduced in the absence of cytochalasin B, indicating its role in enhancing reprogramming.

Imunohistochemical Analysis
Samples were collected at 4, 8, 14, and 21 days to evaluate the nature of any reprogrammed cells by analyzing the expression of several neuronal markers using immunohistochemical analysis according to the methods previously described in Example I. The immunhistochemical analysis at various time points revealed that within the first 8 days the expression of nestin was induced in a large proportion of cells and decreased time-dependently after inducing the differentiation (Figure 10).
This study indicates that upon transfecting the cells with one or two neurogenic genes in the presence of cytochalasin B and MBD2, reprogrammed cells were stable in culture, responded to environmental changes (proliferation vs differentiation), and expressed neuronal markers for at least 24 days in culture.
EXAMPLE XIII
Telomerase Activity of NSLCs
Telomerase is active in neural precursor cells and suggest that its regulation is an important parameter for cellular proliferation to occur in the mammalian brain (Caporaso GL et, 2003). This study was performed to evaluate telomerase activity in cell extracts of adherent NSLCs (NSLCs cultured on laminin-coated plates) as well as NSLCs in floating neurospheres (NSLCs cultured in plates with a low-bind surface) at early (P7) and late passage (P27). The telomerase activity of the 4 samples was measured by the PCR-based telomere repeat amplification protocol (TRAP) using the TRAPeze® Telomerase Detection Kit (Chemicon). Briefly, the cells were grown in 24-well plates, washed in PBS, and homogenized for 30 min on ice in buffer containing 10mM Tris-HCI, pH 7.5, 1mM MgCI2, 1mM EGTA, 0.1mM Benzamidine, 5mM p-mercaptoethanol, 0.5% CHAPS and 10% Glycerol (1X CHAPS Lysis Buffer, provided in kit) and RNase Inhibitor. The samples were spun down and the protein concentration of the supernatant was determined using the BCA Assay. 900ng of protein from each cell extract was added directly to the TRAP reaction mixture containing TRAP reaction buffer, dNTPs, template substrate (TS) primer, TRAP primer mix and Taq polymerase. The reaction mixtures were incubated at 30°C for 30 minutes for template synthesis, followed by a PCR procedure (95°C/15 min for initial denaturation, 94°C/30 sec, 59°C/30 sec, 72°C/1 min for 32 cycles) for amplification of the extended telomerase products. To detect telomerase activity, polyacrylamide gel electrophoresis (PAGE) was performed for the reaction products on a 10% non-denaturing TBE gel. After electrophoresis, the gel was stained with SYBR® Green I Nucleic Acid Gel Stain for 30 minutes, followed by image capture using a Gel-Documentation System (Alpha Innotech).
All 4 samples were telomerase positive (as indicated by the TRAP product ladder) as shown in Figure 11. As expected, the Heat-treated control (AH) showed no Telomerase activity (Negative Control). A 36bp internal control band (S-IC) is used to monitor PCR amplification (to distinguish felse-negative results). This S-iC band was observed for all samples except for the

test samples. This may have been due to the excessively high telomerase activity in the test samples; amplification of the TRAP products and the S-IC control band are semi-competitive. All . controls gave expected results (No TRAP products for CHAPS ctri, and TRAP ladder of products for the positive control cells and the TSR8 control).
EXAMPLE XIV
Tumor Formation Assay
Malignantly transformed cells show reduced requirements for extracellular growth promoting factors, are not restricted by cell-cell contact, and are often immortal. Anchorage-independent growth and proliferation is one of the hallmarks of malignant transformation, which is considered the most accurate and stringent in vitro assay for detecting malignant transformation of cells.
Adherent and neurosphere NSLCs at early and late passage (P7 and P25), as well as normal human neuroprogenitor cells (hNPCs), were investigated for the anchorage-independent growth. HFFs were used as a negative control and cervical carcinoma HeLa cells were used as a positive control. Cells were sedimented by centrifugation at 150 x g for 3 min at room temperature (RT). The assay was performed using the CytoSelect ™ 96-well cell transformation assay (CellBiolabs). The base agar layer (1.2%) was dissolved in 2X DMEM / 20% PBS solution and 50 jJ of the agar solution was added to the plate and incubated for 30 min at 4°C to solidify. Prior to adding the cell agar layer, the plate was allowed to warm up for 15 minutes at 37°C. The cells were resuspended at different density (20.000 and 5000 cells/well), except the hNPCs were resuspended only at 5000 cells/well due to a lack of enough cells. The cells were mixed with the 1.2% agar solution, 2X DMEM/ 20%PBS, and cell suspension (1:1:1), and 75µl of the mixture was transferred to wells already containing the solidified base agar layer, and was then placed in 4°C for 15 minutes to allow the cell agar layer to solidify. 100 µl of proliferation medium {StemCell Technologies) was added and the plate was incubated for 8 days at 37°C and 5% C02 before being soiubilized, lysed and detected by the CyQuant™ GR dye in a fluorescence plate reader. The fluorescence measurement was performed using the Flexstatton™ (Molecular Devices) with a 485/538 nm filter.
Table 28 : Fluorescence measurement (Relative Fluorescence Unit, RFU) indicate that under
the same conditions only carcinoma HeLa cells grow as an anchorage-independent colony,
while both hNPCs and NSLCs (adherent and floating neurospheres) were negative for tumor
growth in the standard agar plate tumor formation assay (CytoSelect™ cell transformation kit,
Cell Biolabs Inc. .
Cell
density/Cell types Hela HFF NSLCs HNPCs
20.000 60.05±8.70 14.82±1.57 19.22±1.85 19.00±2.71
10.000 39.03i3.97 13.73±1.05 14.99±1.12 21.61±9.95
5000 24.70±3.89 11.65±0.57 12.29+079 12.45±0.73

As shown in Table 28, fluorescence measurement indicated that under the same conditions only carcinoma HeLa cells significantly grew and proliferated as anchorage-independent colonies, while both hNPCs and NSLCs (adherent and floating neurospheres) were negative for tumor growth (same value as HFFs (negative control) for 5,000 and 10,000 cells) in the standard agar plate tumor formation assay by visual observation of cells by iight microscopic observation using bright field at 10X confirm Fluorescence measurement. Thus the transient transfection method and genes used allows the reprogramming of cells without the neoplastic transformation that generally occurs with stable transfection or certain genes via a series of genetic and epigenetic alterations that yield a cell population that is capable of proliferating independently of both external and internal signals that normally restrain growth.
EXAMPLE XVI No genomic integration of plasmid DNA in NSLCs from transient transfection
The DNA plasmid Msi1/Ngn2 (designed and constructed in house) was used in transient transfection for generation of NSLCs along with MBD2 (for sample 1), or 5~Aza and VPA (for sample 2). Two weeks after transfection, Southern blot was performed to test for possible genomic integration of the plasmid DNA. 3 ug of genomic DNA extracted from the NSLC samples, as well as from HFF (a human fibroblast cell line) used as a negative control, was digested with several restriction enzymes including Bglll, Pstl and Stul, subjected to electrophoresis on a 1 % agarose gel and transferred to a positively charged nylon membrane (Roche). The membrane was hybridized in the DIG Easy Hyb™ buffer (Roche) at 42°C overnight with a 1.2 kb Dig-labeled PCR probe amplified from the plasmid DNA using a set of primers. The membrane was washed twice at room temperature with 2 * SSC, 0.1 % SDS for 5 min per wash, twice with 0.5 * SSC, 0.1 % SDS at 65°C for 15 min per wash. Hybridization signals of the membrane were detected using the CDP-Star™ substrate (Roche). The membrane was exposed to an X-ray film for analysis. The signals were stripped from the membrane using stripping buffer (0.2 M NaOH, 0.1 % SDS). The membrane was re-hybridized with a 0.9 kb Dig-labeled PCR probe amplified from the plasmid DNA using a set of primers.
The Southern blot analysis (Figure 12) with the 1.2 kb Dig-labeled PCR probe revealed distinct signals in the positive control samples where the Msi1/Ngn2 plasmid DNA was spiked into HFF genomic DNA for the equivalence of 1, 10 or 100 integrations per genome. There were a few weak and identical bands that appeared in the restriction enzyme digested genomic DNA from HFF, NSLC samples #1 and #2, suggesting that there is no plasmid DNA integration in the genomic DNA of NSLCs. These bands may represent the endogenous Ngn2 gene since the 1.2 kbi3ig-!abeled PCR probe contains a small part of the-Ngn2-gene. This-data shews-that-no, or

only a tiny number of, NSLCs had plasmid integration into the host genome after transient transfection, and that the transfected genes are only present in the cell for a short period of time (less than two weeks).
EXAMPLE XVfl Neuroprotective effect of transplanted hNSLCs in: 1) Animal model of Multiple sclerosis.
Multiple Sclerosis (MS) is an incurable inflammatory demyelinating disease of the central nervous system (CNS) (Frohman EM et al 2006). Therapies for MS rely on manipulation of the immune system, but with often modest effectiveness on reducing clinical episodes or permanent neurological disability, requiring frequent injections, and with sometimes-significant side effects (Langer-Gould A et al 2004). Experimental Allergic Encephalomyelitis (EAE) is an animal model of MS commonly used for studying disease mechanisms and testing potential therapies. EAE can be induced in a variety of species and strains of animals [mice, Rat, marmoset monkey, rhesus macaques] using various CNS antigens [Myelin Oligodendrocyte Glycoprotein (MOG), proteoiipid protein (PLP) and myelin basic protein (MBP)]. After obtaining all appropriate animal approvals for the experiements, Female 7 to 8 weeks old C57BL/6 mice were purchased from Charles Rivers, and housed at MISPRO animal facility for one week before experimentation for adaption to the new environment. C57BL/6 mice were injected s.c. with 100 µg MOG 35-55 in CFA (Sheldon Biotechnology, McGill University) containing 5 mg/ml Mycobacterium tuberculosis H37Ra (Difco, inc), at 2 sites on the back. All mice received 200 ng pertussis toxin (List Biological Laboratories, Inc) i.p. on day 0 and 2, while clinical scores were calculated blindly daily during a 43 day period, according to the 0-5 scale as follows: 1, limp tail or waddling gait with tail tonicity; 2, waddling gait with limp tail (ataxia); 2.5, ataxia with partial limb paralysis; 3, full paralysis of 1 limb; 3.5, full paralysis of 1 limb with partial paralysis of second limb; 4, full paralysis of 2 limbs; 4.5, moribund; and 5, death.
Treatment of EAE animal model with and without the ceils:
hNSLC and hNPCs (1.5 x106 cells in 200 µl PBS/each mouse) were given by single injection i.v. via the tail vein when the animals started to show symptoms of EAE (day 13 i.v). Both animals groups received cyclosporine (10mg/kg/day) one day before the injection of ceils and daily from the day of transplantation to avoid any rejection of the human cells. Sham-treated age-, sex-, and strain-matched mice, injected i.p. with PBS alone, were used as controls. All groups of animals were observed for 43 days. Animals were sacrificed at 43 days p.t., brains and spinal cord were harvested in 30% sucrose in PBS. Statistical analysis of the clinical scores revealed that the clinical signs of EAE were significantly attenuated in NSLC-injected animals as compared to control and hNPCs-injected animals. Cumulative scores was

significantly reduced in the NSLC transplanted animals (Figure 13) and the treatment has no effect on body weight.
2) Hemiplegic animal model (unilateral ablation of the left sensorimotor cortex in adult rats).
After obtaining ail appropriate animal approvals for the experiements, 8 rats per group (Sprague-Dawley, 25Q-300g, Charles River) were anaesthetized using ketamine (Bimeda-MTC) / xyiazine (50/10 mg/kg, Novopharm) and placed onto a stereotaxic frame. A midline cranial incision was performed with a sterile surgical scalpel blade, the cranial vault exposed and the bregma identified. The skull above the sensorimotor cortex was opened and the sensorimotor cortex area [0.5 - 4.0 mm caudal to bregma and 1.8 -.3.8 mm lateral to the midline (Paxinos and Watson 1986)] was carefully aspirated. After ablation, the treatments (Alginate , Alginate + hNPC, Alginate + NSLCs, RMX + NSLCs, RMX Only, Fibrin Gel, or Saline) were applied directly on the brain after ablation. The opening in the skull was then filled with Bone Wax. In case of a bleeding, small pieces of sterile homeostatic tissue were inserted into the lesion in order to stop the bleeding. The sutures were performed, using Ethicon™ monofilament suture 1/2 circle needle shape. Surgeries were performed in sterile clean rooms, and topical antibiotics (Cicatrin®, GlaxoSmithKiine) were applied to the exposed skull and scalp to limit local infection. Rats were immunosuppressed by daily injection i.p. of cyclosporine A (10 mg/kg/day) starting the day before the surgery until the end of the study period. The purpose of the cyclosporine'A injection was to reduce the rat's immune reaction to the treatment. The immune-suppression was sustained until the end of the study to ensure that any potential failure of regeneration (if taken place) was not due to the immune reaction against the treatment. Functional scores were performed weekly, in all groups, sensorimotor impairment was evaluated based on the behavioural tests as described below.
Rotarod Test: The rotarod speed was manually calibrated for the 10 and 20 RPM speed before all procedures. Animals were required to perch on the stationary rod for 30 sec to acclimate themselves to the environment. During this time, if any animal fell, it was placed back on the rod until it had achieved stationary capabilities for a period of 30 seconds. The animals were allowed 3 trials. The animals that were comfortable staying on the stationary rod for 30 sec were allowed to run with a constant speed of 10 and 20 RPM for 60 sec, and the number of falls were electronically recorded.
Seam walking: Beam walking measures hindlimb coordination by means of distance travelled across 100 cm beam (2.3 cm in diameter, 48 cm off the floor). Rats were systematically trained to walk along the elevated beam from start to finish with the aim of completing the task. A safe location, i.e, a flat box, is placed at the end of the beam so that the rat is motivated to complete-the task.

Scale used for evaluation of beam-walking performance

Scale Performance characteristic
1 Animals fail to traverse the beam and do not place the hindlimb on the horizontal surface of the beam
2 Animals fail to traverse the beam, but place the hindlimb on the horizontal surface of the beam and maintain balance
3 Animafs traverse the beam while dragging the hindlimb
4 Animals traverse the beam and place the hindlimb at least once during the traverse
5 Animals traverse the beam using the hindlimb to aid less than 50% of its steps on the beam
6 Animals traverse the beam using the left hindlimb to aid more than 50% of its steps on the beam
7 Animals traverse the beam with no more than two foot slips
8 Normal animals
Before the surgery, all the animals fell at least once from the rotarod, not because they had a walking or coordination problem, but because the speed was high. After the surgery (2 days), all the animals showed signs of significant walking and coordination problems leading to an increase in the number of falls from the rotarod. Three weeks after the surgery, the number of fafls was dearly reduced for the animals receiving NSLCs as treatment compared to controls (Figure 14).
Animals passed the beam-walking test before the surgery without any difficulty. The rats crossed the 100 cm beam and got to the safe spot without falling off the beam. Two days after surgery, all groups completely failed to pass the test, and the animals were not able to stay in balance on the beam. One week after the surgery, all the animals showed some improvement in their walking capacity, but no significant difference was noticeable between the different treated groups. From week 4 until week 26, the animals treated with NSLCs as well as RMX showed significant improvements in their walking capacity compared to the controls (Figure 15).
EXAMPLE XVIII Transfection of HFF by various combinations of genes using the Shuttle® Device and treatment with different small molecules for reprogramming to Mesendoderm-like cells
HFF cells were cultured as described in CDM II medium as described in Example I with only modifying EGF (5ng/ml) and FGF (10ng/ml), and transfecting using the Nucleofector™® 96-well Shuttle® Device (Lonza) following the procedure described in Example IV. The cells were transfected with various combinations of cDNA clones as described in Table 29. After transfection, the ceils were plated on 0.1% Gelatin-coated plates and incubated at 37°C, 5% C02, 5% 02. Medium was changed every other day according to Table 30. Cells were analyzed at Day 4 by Quantitative Real-time PCR.

Table 29: Various combinations of plasmids with potential to transfect the cells towards mesendoderm lineage.

Day -2 to Day 0 Plasm ids transfected at Day 01
1
2
3 4
5 6 7 8 9 10 Untreated Oct4, FoxD3, MBD2

Oct4,T, MBD2

Oct4.Mixl1.MBD2

Oct4, Sox17, MBD2

FoxD3, T. MBD2

FoxD3. Mixll, MBD2

FoxD3, Sox17, MBD2

T.Mixl1,MBD2

T, Sox17. MBD2

Mixl1,Sox17, MBD2
13 14 15 16 P re-treated with VPA & 5-Aza Oct4, FoxD3

FoxD3, T

FoxD3, MixM

FoxD3, Sox17
17
Oct4, FoxD3, T
18
MixM, Sox17, FoxA2
19
Oct4, FoxD3, T
20
MixI1,Sox17, FoxA2
where Oct4=pCMV6-XL4-Oct4, FoxD3=pCMV6-XL5-FoxD3, MBD2=pCMV6-AC-MBD2, T=pCMV6-XL5-T, Mixl1=pCMV6-XL5-MIXL1, Sox17=pCMV6-XL4-SOX17, FoxA2= pCMV6-XL5-FOXA2. Ail clones were purchased from Origene and prepared using the EndoFree Plasmid Maxi Kit (Qiagen).
Table 30: Medium composition from Day -2 to Day 10

Media Composition2
Day 0 Day 1 Day 2 to Day 3 Day 4 to Day 7 Day 8 to Day 10
CDM 11(3:1 of CDM II (50%) IMDM/F12 + IMDM/F12 + IMDM/F12 + NEAA
DMEM:F12; + IMDM/F12 NEAA + ITS + NEAA + ITS + + ITS + HSA +
GlutaMAX™ 100x, (50%) + NEAA HSA + bFGF + HSA + bFGF + bFGF + EGF +
Dexthamesone, + ITS + HSA + EGF + VPA + EGF + Activin BMP4
19.7ug/ml, bFGF + EGF + Activin A + A + CHIR99021
Glutathione (500 VPA + Activin CHIR99021 + + BIV1P4
µg/ml, L-Ascorbic A + BMP4
75mg/mlt Selenious CHIR99021
acid 2.5µg/ml.
Insulin solution
lOmg/ml, T3
675ng/ml,
ethanolamine
500X, bFGF
2.5ug/ml, and Egf
(1.25µg/ml)+
Activin A + HSA
Supplements added to media at the following concentrations: Activin A (Peprotech, 30ng/ml), HSA (Baxter, 0.5%), NEAA (Gibco, 1X), ITS (Gibco, 1X), EGF (Peprotech, 5ng/ml), bFGF (Peprotech, 10ng/ml), CHIR99021 (Stemgent, 2uM), VPA (Stemgent, 1mM), 5-Aza (Sigma, 0.5uM), BMP4 (Peprotech, 10ng/ml)
Cells were collected on Day 4 by detaching with TrypLE™, followed by centrifugation at 80xg for 5 minutes. Supernatant was aspirated and the cell pellet was frozen at -86°C until ready for RNA Isolation. RNA isolation and quantification was performed as previously. - -

described in Example I. cDNA was prepared and quantitative real-time PCR was performed as previously described in Example II, except the following Taqman™® Gene Expression Assays (Applied Biosystems) were used:

Gene Taqman™ ® Assay ID
GAPDH (housekeeper) Hs99999905_m1
PPIA (housekeeper) Hs99999904_m1
FOXA2 Hs00232764_m1
SOX 17 Hs00751752_Sl
Endogenous T Hs00610073_g1
GSC Hs00418279_m1
CXCR4 Hs00607978_s1
GATA4 Hs00171403_m1
CER1 Hs00193796_m1
CDH1 (E-cadherin) Hs01023894_m1
p63 Hs00978340_m1
SOX2 SOX2_1078-ANY
Table 31 : Relative Expression FoxA2, Sox17, and Cxcr4 after transfecting HFFs once with
various gene combinations with potential to reprogram cells into mesoendoderm-like cells . The
exact values are not significantly accurate due to low RNA yield, however a trend of increasing
gene expression was detected for FoxA2, Sox17, and CXCR4.
FOXA2 SOX17 CXCR4

Rel. Exp. Std.
Dev. Rel. Exp. Std. Dev. Rel. Exp. Std. Dev.
Untreated HFF 1.00 0.04 1.00 0.04 1.00 0.04
Day4 HFF untransf. (+G.F), 1.01 0.06 1.01 0.06 4.77 2.51
Day4 HFF untransf. (-G.F), 1.38 0.11 1.38 0:11 1.38 0.11
Day4 HFF Untransf. (+G.F.J, 0.98 0.02 0.98 0.02 3.32 3.31
Day4 HFF Untransf. {-G.F.), 4.12 4.07 1.28 0.06 1.28 0.06
Day4 Oct4/FoxD3/MBD2 4.67 4.60 3.19 2.78 76.43 .7.91
Day4 0ct4/T/MBD2 "3.91 3.55 4.33 2.36 15.18" 2:52
Day4 Oct4/Mixl1/MBD2 2.66 1.77 10.33 0.:43 7.31 3.21
Day4 Oct4/Sox17/MBD2 14.19 4.85 4135331.31- .127089:6 56,0.4 0.7.1
Day4 FoxD3/T/MBD2 38.62 38.00 3.12 1.32 42-41 .5.23"..
Day4 FoxD3/Mixl1/MBD2 7.76 5.29 2.41 ' 0.30 137,17 27.74
Day4 FoxD3/Sox17/MBD2 26:02 1.95 50904.45- 1523.33; 131.03' 17:53
Day4 T/MixI1/MBD2 3.67 3.26 5.64 4.15 14.04 2.89

Day4T/Sox17/MBD2
9.76 9.70 209797 21 24533 81 11135 1640
Day4Mixl1/Sox17/MBD2 3.60 3.10 23731010- 57448 60 3676 107
Day4 Oct4/FoxD3 13.87 0.16 13.87 0.16 35.44 14.57
Day4 FoxD3/T 60.93 60.18 19.45 1.51 . 19.45 1.51
Day4 FoxD3/Mixl1 21.20 2.31 28.96 8.66 62.31 55.82
Day4FoxD3/Sox17 96.88 360 54177.20; 3313,15" 44.57 41.51
Day4 Oct4/FoxD3/T 25.99 18.15 12.27 1.26 21.17 11.33
Day4Mixl1/Sox17/FoxA2 1850864.68 98259.84 112641.65 : 15923 2'1 23.18 23.10
Day4 Oct4/FoxD3H*
.(IMDM/F12) 9.52 5.61 1.52 0.02 35 74 4 36
Day4 Mixl1/Sox17/FoxA2
(IMDM/F12) 486705 82 19101 53 57060:09 1262 81 13 44 2 36
Table 32: Expression of GATA4, CDH1 (E-cadherin), p63, and SOX2 relative to untreated HFF control 4 days after transfecting HFF cells with various gene combinations with potential to reproqram cells into mesoendoderm-like cells.
GATA4 CDH1 {E-cadherin) p63 SOX2

Rel. Exp. Std.
Dev. Rel. Exp. Std. Dev. Rel. Exp. Std. Dev. Rel. Exp. Std. Dev.
Untreated HFF 1.00 0.04 1.00 0.04 1.00 0.04 1.00 0.04
Day4 HFF untransf.
(+G.F), 12.13 0.70 1.01 0.06 3.09 1.45 1.11 0.21
Day4 HFF untransf. (-G.F), 4.48 0.85 1.38 0.11 3.11 2.54 1.38 0.11
Day4 HFF Untransf.
(+G.F.)f 2.37 2.00 0.98 0.02 4.41 4.40 1.94 1.34
Day4 HFF Untransf. (-G.F.), 6.12 3.33 1.28 0.06 13.23 7.43 1.28 0.06
Day4 Oct4/FoxD3/MBD2 95 23 27 4? f 98.90- 21.58 1.81 0.86 12.72 1:53'
Day4 Oct4/T/MBD2 33 66 - 10 30 1.42 0.02 2.05 0.87 2.62 1.67
Day4 Oct4/Mixl1/MBD2 10'6 33 . 5 70 1.43 0.03 8.68 0.99 25.68 2.18
Day4 Oct4/Sox17/MBD2 23 50 - 5 39 4.65 4.43 95:23-- 13.86 18.77 6.94
Day4 FoxD3/T/MBD2 12136 J168 26.85;: o.d2 2.22 0.04 16.99 4.74
Day4
FoxD3/MixJ1/MBD2 130 21 21 04 • 69:19 . '22.84; 4.05 3.56 1.52 0.01
Day4 FoxD3/Sox17/MBD2 99 49 30 30 6.89 3.69 1.78 0.01 15.19 9.08
Day4T/Mixl1/MBD2 110 30 3.55 1.36 0.00 1.36 0.00 6.64 2.25
Day4 T/Sox17/MBD2 5319 4 02 2.69 1.86 18.01 0.54 14.21 5.21
Day4 Mixl1/Sox17/MBD2 16.53 16.50 2.91 2.13 . 13.44
6.68 10.55 3.27
Day4 Oct4/FoxD3 66.45 26.34 47.31 47.30 13.87 0.16 23.87 14.31
Day4 FoxD3/T 68.25 68.00 39.08 29.27 19.45 1.51 19.45 1.51
Day4 FoxD3/Mixl1 78.18 78.00 21.20 2.31 21.20" 2.31 25/10 3.20

Day4 FoxD3/Sox17
176.45 93.54 15.64 0.60 15.64 0.60 26.78 16.35
Day4 Oct4/FoxD3/T 12.27 1.26 12 27 1.26 '12.27 1.26 12.27 1.26
Day4 Mixl1/Sox17/FoxA2 85.89 64.52 20.06 20.00 3.67 -0.13 13.66 0.66
Day4 Oct4/FoxD3/T ;:;.-.89.05-"' ""50.00' 10.40 8.14 1.52 0.02 1.52 0.02
Day4 Mixl1/Sox17/FoxA2 6.16 6.10 1.23 0.04 1.23 0.04 1.23 0.04
Identification of gene combinations that may induce the formation of Mesendoderm-like cells was investigated by transfection with combinations of Oct4, Sox17, FoxD3, T, MixH, FoxA2, and MBD2. As shown in Table 25 and 26, the Relative Expression of CXCR4 and GATA4, both Mesendoderm/Endoderm/Mesoderm markers, appear to be up-regulated in various combinations, most noticeably in FoxD3/Mi'xl1/MBD2 and FoxD3/Sox17/MBD2. Similarly, FOXA2, a marker for Endoderm and Mesoderm, was up-regulated FoxD3/Sox17-transfected sample, although the expression is still very low. Four days following transfection, SOX17 is still highly expressed in the SOX17-transfected samples (50,000 to 400,000-fold as compared to the untreated HFF sample). The SOX17 gene expression represents leftover plasmid DNA (exogenous SOX17) that still remains 4 days post-transfection, and any endogenous SOX17 expression that may have been induced. Ectoderm markers CDH1, p63 and Sox2 were also up-regulated in some samples (e.g. Oct4/FoxD3/MBD2, Oct4/Sox17/MBD2).
Reprogramming HFFs into Pancreatic Progenitor-Like Cells: HFF cells were cultured as described in Example I, and transfected using the Nucleofector™® 96-well Shuttle® Device (Lonza) following the procedure described in Example IV. The cells were transfected with various combinations of cDNA clones as described in Table 27. After transfection, the cells were plated on Fibronectin-coated collagen gels and incubated at 37°C, 5% C02, 5% 02. Fibronectin-coated Collagen gel plates were prepared prior to transfection. Rat Tail Collagen I (Gibco) was diluted to 1.125mg/mJ using 10X PBS and distilled water, where 125[±\ was added to each welt of a 24-well plate and incubated in 37°C for 40 minutes. After rinsing with 1X PBS, Fibronectin (BD Biosciences) was added on top of the gel at a concentration of 1.9ug/well. Media was changed every other day according to Table 33. Cells were analyzed at Day 7 by Quantitative Real-time PCR.

Table 33: Piasmids and media composition from Day 0 to Day 14

Media Composition'
Piasmids transfected
at Day 01 ' Day O Day 1 to Day 3 Day 4 to Day 14
1 FoxD3,Sox17,Pdx1,
MBD2 CDM II + Activin A + HSA DMEM/F12 + NEAA + ITS + HSA + B27 + EGF + bFGF + Activin A + CHIR99021 + Na Butyrate DMEM/F12 + NEAA + ITS + HSA + B27 +EGF + bFGF + Retinoic Acid + FGF10 + Cyclopamine + Noggin
2 FoxD3, Sox17, Ngn3,
MBD2

3 FoxD3, Mixl1,Pdx1.
MBD2

4 FoxD3, Mixll, Ngn3,
MBD2

5 Sox17,Mixl1, Pdx1,
MBD2

6 Sox17, Mixll, Ngn3,
MBD2

7 FoxD3, Soxl7, Mixll, Pdx1
DMEM/F12 + NEAA + ITS + HSA + B27 + EGF + bFGF + Activin A + CHIR99021 + Na Butyrate + VPA + 5-Aza

8 FoxD3,Sox17,Mixl1, Ngn3

9 FoxD3, Sox17, Pdx1,
Ngn3

10 FoxD3, Mixll, Pdx1, Ngn3

11 Sox17.Mixi1.Pdx1,
Ngn3

'where FoxD3=pCMV6-XL5-FoxD3, Sox17=pCMV6-XL4-SOX17, Mixll =pCMV6-XL5-MIXL1, Pdx1=pCMV6-XL5-Pdx1, and Ngn3=pCMV6-XL5-Ngn3. All clones were purchased from Origene and prepared using the EndoFree Piasmid Maxi Kit (Qiagen).
Supplements added to media at the following concentrations: Activin A (Peprotech, 30ng/ml), HSA (Baxter, 0.5%), NEAA (Gibco, 1X), ITS (Gibco, 1X), B27 (Gibco, 1%), EGF (Peprotech, 5ng/ml), bFGF (Peprotech, 10ng/ml), CHIR99021 (Stemgent, 2µM), Na Butyrate (Stemgent, 1mM), VPA (Stemgent, 1mM), 5-Aza (Sigma, 0.5uM), Retinoic Acid (Sigma, 2uM), FGF10 (Peprotech, 50ng/ml), Cyclopamine (Stemgent, 2.5uM), Noggin (Peprotech, 50ng/ml)
Cells were collected on Day 7 and RNA isolation and quantification was performed as previously described in Example !. cDNA was prepared and quantitative real-time PCR was performed as previously described in Example II, except the following Taqman™® Gene Expression Assays (Applied Biosystems) were used:

Gene Taqman ™ ® Assay ID
GAPDH (housekeeper) Hs99999905_m1
PPIA (housekeeper) Hs99999904_m1
FOXA2 Hs00232764_m1
SOX17 Hs00751752_s1
GATA4 Hs00171403_m1
EndoPDXI PDX1J201
SOX9 Hs00165814_m1
NGN3 Hs01875204_s1
NKX2-2 Hs001596l6_m1
PAX4 Hs00173D14_m1
INS Hs02741908_m1

CXCR4 Hs00607978_sl
(dentification of gene combinations that may induce the format/on of Pancreatic Progenitor-like cells was investigated by transfection with combinations of FoxD3, Sox17, Pdx1, Ngn3, Mbd1, and MBD2. FoxA2, a marker for Endoderm and Mesoderm, was slightly up-regulated for the FoxD3/Sox17/Ngn3/MBD2-transfected sample as compared to the GFP mock-transfected control sample. Similarly, CXCR4, also a marker for both endoderm and mesoderm, was slightly up-regulated (3-fold compared to GFP-ctrl) for the FoxD3/Mixf1/Ngn3/MBD2-transfected sample. 7 days following transfection, SOX17 can still be detected for the samples transfected with SOX17 at varying levels (4 to 570-fold up-regulation as compared to the GFP-ctrl). The highest SOX17 expression up-regulation is detected for the sample transfected with Sox17/Mixl1/Pdx1/Ngn3 (570-fold as compared to GFP-ctrl), which may suggest that this gene combination may increase the amount of SOX17 RNA in cells.
EXAMPLE XIX
Reprogramming human Adipocytes Derived Stem cells (ADSC) to pluripotent-like Stem ceils (PLSC): ADSCs (Invitrogen Corporation) were cultured in cell culture flasks with complete StemPro™ -43 medium (Invitrogen) at 37°C, 5%C02 and the medium was changed 3 times per week. After 3 days in culture cells (passage 5) were trypsinized and counted to be transfected. Cells were transiently transfected with one plasmid: pCMV6-Oct4-2A-Klf4-2A-Nanog, pCMV-Sall4-2A-Oct4-2A-Klf4-2A-Nanog, pCMV-Dax1-2A-Oct4-2A-klf4, pCMV-FoxD3-2A-Oct4-2A-klf4, pCMV-Oct4-2A-Klf4-2A-Sa!l4, pCMV-MBD2-2A-Oct4-2A-Klf4-2A, pCMV-AGR2-2A-Oct4-2A-Klf4-2A, or Rex1-EF-Oct4-2A-Klf4 (2µg); or by two plasmids: pEF-Oct4nuc-IRES2-MBD2 with pCMV-Sox2nuc-IREC-Lin28 or pCMV-Klf4nuc-IRES2-Tpt1nuc or pEF-Steila-IRES2-NPM2, using NucJeofector™ as described in Example II. Following the transfection cells were cultured in 6-well plates in suspension with 50:50 ratio of adipocytes complete medium (StemPro™-43) and embryonic stem cells medium (mTeSRI). After two days in culture, cells were re-transfected with the same plasmids listed above and cells were plated in 96 well-plates coated with Matrigel™ (BD Biosciences) in the presence of mTesR complete medium supplemeneted with thiazovivin (0.5µM), an ALK-5 inhibitor (SB 341542, Stemgent, 2µM), and inhibitor of MEK (PD0325901, Stemgent, 0.5µM). Medium was changed every day and cells were cultured for 22 days at 37°C, 5% C02, 5% 02. Alkaline Phosphatase Detection Kit (AP, Millipore) and immunohistochemistry were performed to analyse the expression of piuripotency markers. ALP staining was performed using AP detection kit (Millipore) according to manufacturer's instructions.
Visual observation of reprogrammed cells was performed by Cellomics™ using a live
staining for SSEA-4647 (BD Biosciences) and TRA-1-81555 (BD Biosciences) starting on Day 6
after transfection-and- every 5 days thereafter. Reprogrammed colonies of PLSCs, positively- -

stained with SSEA-4 and TRA1-81, was observed only with Plasmid pCMV-Sall4-2A-Oct4-2A-Klf4-2A-Nanog, pEF-Rex1-EF-Oct4-2A-Klf4-2A-RFP, pEF-Oct4nuc-IRES1-MBD2 with pCMV-Sox2nuc-IRES1-Lin28, and pEF-Oct4nuc-IRES1-MBD2 with pCMV-Klf4nuc-IRES2-Tpt1nuc. These colonies emerged around Day 6 and maintained in culture up to the end of the study period (Day 22) with a stable morphology. Among the plasmids cited above, pCMV-Sall4-2A-Oct4-2A-Klf4-Nanog and pEF-Rex1-EF-Oct4-2A-Kif4-2A-RFP gave the highest number of colonies. Live staining showed that these colonies express typical pluripotency markers, including SSEA-4 and TRA1-81, and further analysis of these colonies showed that the colonies also expressed other ESC markers such as alkaline phosphatase and Oct4 (Figure 16). When the cultures were treated with PD0325901 and SB431542 for up to 22 days, a 4-fold improvement in efficiency over the conventional method was obtained following the transfection of ADSCs with pCMV-Sall4-2A-Oct4-2A-K!f4-Nanog and pEF-Rex1-EF-Oct4-2A-Klf4-2A-RFP.
Based on the previous study, the highest reprogramming efficiency was observed using pEF-Rex1-EF-Oct4-2A-Klf4-2A-RFP and pCMV-Sall4-2A-Oct4-2A-Klf4-2A-Nanog. Another study was designed to ascertain the effect of pEF-Rex1-EF-Oct4-2A-Klf4-2A-RFP on the reprogramming efficiency and to investigate the effect of individual pluripotent genes Rex1, Oct4, and Klf4 in different combinations. ADSCs were transfected as above with pEF-Rex1-EF-Oct4-2A-Klf4-2A-RFP, pCMV6-XL5-Rex1, pCMV6-XL4-OCt4/pCMV6-XL5-Klf4, pCMV6-XL5-Rex1/pCMV6-XL4-Oct4, or pCMV6-XL5-Rex1/pCMV6-XL5-Klf4. After the second transfection, ADSC were cultured in 96-well plates coated with Matrigel™ for 24 days in the presence of mTeSRI medium supplemented with SB341542 and PD 0.325901 at 37oC, 5% C02, 5%02. In order to characterize subpopulations of cells after transfection, live staining, immunohistochemistry, and AP staining was used to follow the change in pluripotent markers. 1-5% of total cells transfected with Rex1/Oct4 or Rex1/Klf4 showed a SSEA4+ and TRA-1-81* phenotype, and this pattern was stable until the end of the study period (Day 22). The observation over time showed that the phenotype of these colonies moved from an early SSEA-4+ phenotype to a late Oct4"7Sox2/Nanog* phenotype by Day 22, which is closer to the final reprogrammed state of a pluripotent-like stem cell (Figure 17).
Various genes were tested for their effect on reprogramming efficiency towards pluripotent-like cells. ADSC cells were cultured as described in Example IX with 2 days VPA and 5-AZA pre-treatment (1 mM and 0.5 uM respectively) in StemPro™ MSC SFM medium. Cells were transfected using the Nucieofector™® 96-well Shuttle® Device (Lonza) following procedure described in Example IV and using the transfection program EW-104 with the DNA mixes described in Table 34. Following transfection the cells were plated in StemPro™ MSC SFM medium described in example A on Matrigel™ (BD Biosciences) coated 24 well plates and incubated at 37°C, 5% COz, 5%02. On Day 1, media was changed to a mix of 75% StemPro™ MSC and 25% hES cell medium; the percentage of StemPro™ MSC was decreased every day over four days-to have 100% hES cell medium by Day 4. From-thenonwards the-medium was

changed every two days. The hES cell medium consisted in Dulbecco's Modified Eagle's Medium (DMEM, Invitrogen) supplemented with 20 % Knockout™ Serum Replacement (KSR, Invitrogen), 1 mM GlutaMAX™, 100 pM Non-essential Amino acids, 100 pM p-mercaptoethanol and 10 ng/ml Fgf-2. Different inhibitors and growth factors were added through the course of the experiment; these are listed in Table 34. Cells were analysed at Day 7 and Day 14 by immunohistochemistry analysis and at Day 7 by RT-PCR.
Table 34: Plasmids and media composition from Day 1 to Day 14.

From day Plasmids From day 1 to From day 3 to From
-2 transfected at day 3 day 7 day 7 to
to day 0 day 0 day 14
1 VPA + 5- PCMV6-XL4- StemPro™/ hES StemPro™/ hES hES medium
Aza pre- Oct4+ medium* ActivinA medium* ActivinA
treated PCMV6-XL5- {30 ng/ml)+ (30 ng/ml)+
Sox2+ CHIR99021 (3 CHIR99021 (3
pCMV6-XL5-MBD2 µm) MM)
2 VPA + 5- pCMV6-XL4- StemPro™/ hES StemPro™/ hES hES
Aza pre- Oct4+ medium* ActivinA medium* ActivinA medium
treated PCMV6-XL5- (30 ng/ml)+ (30 ng/ml)+
FoxD3 + CHIR99021 (3 CHIR99021 (3
PCMV6-XL5-MBD2 µM) MM)
3 VPA + 5- PCMV6-XL4- StemPro™/ hES StemPro™/ hES hES medium
Aza p re- Oct4+ medium+ ActivinA medium* ActivinA
treated pCMV6-XL5-UTF1 (30 ng/ml)+ (30 ng/ml)+
+ CHIR99021 (3 CHIR99021 (3
PCMV6-XL5-MBD2 MM) MM)
4 VPA + 5- PCMV6-XL4- StemPro™/ hES StemPro™/ hES hES medium
Aza pre- Oct4+ medium+ ActivinA medium* ActivinA
treated PCMV6-XL4- (30 ng/ml)+ (30 ng/ml)+
DPPA4+ CHIR99021 (3 CHIR99021 (3
PCMV6-XL5-MBD2 MM) MM)
5 VPA + 5- PCMV6-XL5- StemPro™/ hES StemPro™/ hES hES medium
Aza pre- Sox2+ medium+ ActivinA medium* ActivinA
treated PCMV6-XL5- (30 ng/m!)+ (30 ng/ml)+
FoxD3+ CHIR99021 (3 CHIR99021 (3
PCMV6-XL5-MBD2 MM) MM)
6 VPA + 5- PCIV1V6-XL5- StemPro™/ hES StemPro™/ hES hES medium
Aza pre- Sox2+ medium* ActivinA medium* ActivinA
treated PCMV6-XL5- (30 ng/mf)+ (30 ng/m!)+
UTF1 + CHIR99021 (3 CH1R99021 (3
PCMV6-XL5-MBD2 µm uM)
7 VPA + 5- PCMV6-XL5- StemPro™/ hES StemPro™/ hES hES medium
Aza pre- Sox2+ medium* ActivinA medium* ActivinA
treated PCMV6-XL4- (30 ng/ml)+ (30 ng/ml)+
DPPA4+ CHIR99021 (3 CHIR99021 (3
PCMV6-XL5-MBD2 µM) MM)

8
VPA + 5- pCMV6-XL5- StemPro™/ hES StemPro™/ hES hES medium
Aza pre- FoxD3+ medium* ActivinA medium* ActivinA
treated pCMV6-XL5- (30 ng/ml)+ (30 ng/ml)+
UTF1 + CHIR99021 (3 CHIR99021 (3
pCMV6-XL5-MBD2 µM). µM)
9 VPA + 5- pCMV6-XL5- StemPro™/ hES StemPro™/ hES hES medium
Aza p re- FoxD3+ medium+ ActivinA medium* ActivinA
treated pCMV6-XL4- (30 ng/ml)+ (30 ng/ml)+
DPPA4+ CH1R99021 (3 CHIR99021 (3
pCMV6-XL5-MBD2 µM) µM)
10 VPA . + 5- pCMV6-XL5- StemPro™/ hES StemPro™/ hES hES medium
Aza pre- UTF1+ medium* ActivinA medium* ActivinA
treated pCMV6-XL4- (30 ng/ml)+ (30 ng/ml)+
DPPA4+ CH1R99021 (3 CHIR99021 (3
pCMV6-XL5-MBD2 µM) µM)
11 VPA + 5- pCMV6-XL4- StemPro™/ hES StemPro™/ hES hES medium
Aza p re- Oct4+ medium+ ActivinA medium* ActivinA
treated pCMV6-XL5- (30 ng/ml)+ (30 ng/ml)+
Sox2+ CHIR99021 (3 CH1R99021 (3
pCMV6-XL5-FoxD3 µM)* VPA + 5-Aza µM)
12 VPA + 5- pCMV6-XL4- StemPro™/ hES StemPro™/ hES hES medium
Aza p re- Oct4+ medium+ ActivinA medium* ActivinA
treated pCMV6-XL5- (30 ng/ml)+ (30 ng/ml)+
Sox2* CHIR99021 (3 CHIR99021 (3
PCMV6-XL5-UTF1 µM)+ VPA + 5-Aza µm
13 VPA + 5- pCMV6-XL4- StemPro™/ hES StemPro™/ hES hES medium
Aza p re- Oct4+ medium* ActivinA medium* ActivinA
treated pCMV6-XL5- (30 ng/ml)+ {30 ng/ml)+
Sox2+ CHIR99021 (3 CH/R99021 (3
pCMV6-XL4-DPPA4 µM)+ VPA + 5-Aza µM)
14 VPA + 5- pCMV6-XL4- StemPro™/ hES StemPro™/ hES hES medium
Aza pre- Oct4+ medium+ ActivinA medium* ActivinA
dated pCMV6-XL5- (30 ng/ml)+ (30 ng/ml)+
FoxD3+ CHIR99021 (3 CHIR99021 (3
PCMV6-XL5-UTF1 µM)+ VPA + 5-Aza µM)
15 VPA + 5- pCMV6-XL4- StemPro™/ hES StemPro™/ hES hES medium
Aza pre- Oct4+ medium* ActivinA medium* ActivinA
treated pCMV6-XL5- (30 ng/ml)+ (30 ng/mJ)+
FoxD3+ CHIR99021 (3 CH1R99021 (3
pCMV6-XL4-DPPA4 uM)+ VPA + 5-Aza µM)
16 VPA + 5- pCMV6-XL4- StemPro™/ hES StemPro™/ hES hES medium
Aza pre- Oct4+ medium* ActivinA medium* ActivinA
treated pCMV6-XL5- (30 ng/ml)+ (30 ng/ml)+
UTF1+ CHIR99021 (3 CHIR99021 (3
pCMV6-XL4-DPPA4 µM)+ VPA + 5-Aza µM)
17 VPA + 5- pCMV6-XL5- StemPro™/ hES StemPro™/ hES hES medium
Aza pre- Sox2+ medium* ActivinA medium* ActivinA
treated pCMV6-XL5- (30 ng/ml)+ (30 ng/ml)+
FoxD3+ CHIR99021 (3 CHIR99021 (3
PCMV6-XL5-UTF1 µM)+ VPA + 5- µm
Aza

18
VPA + 5- pCMV6-XL5- StemPro™/ hES StemPro™/ hES hES medium
Aza pre- Sox2+ medium+ ActivinA medium+ ActivinA
treated pCMV6-XL5- {30 ng/ml)+ (30 ng/ml}+
1 FoxD3+ CHIR99021 (3 CHIR99021 (3
pCMV6-XL4-DPPA4 µM)+ VPA + 5-Aza µM)
19 VPA + 5- pCMV6-XL5- StemPro™/ hES StemPro™/ hES hES medium.
Aza pre- Sox2+ medium+ ActivinA medium* ActivinA
treated pCMV6-XL5- (30 ng/ml)+ (30 ng/ml)+
UTF1+ CHIR99021 (3 CHIR99021 (3
pCMV6-XL4-DPPA4 µM)+ VPA + 5-
Aza µM)
20 VPA + 5- pCMV6-XL5- StemPro™/ hES StemPro™/ hES hES medium
Aza pre- FoxD3+ medium + ActivinA medium+ ActivinA
treated pCMV6-XL5- (30 ng/mi)+ (30 ng/ml)+
UTF1 + CHIR99021 (3 CHIR99021 (3
pCMV6-XL4-DPPA4 µM)+ VPA + 5-Aza µM)
21 VPA + 5- GFP StemPro™/ hES StemPro™/ hES hES medium
Aza pre- medium+ ActivinA medium+ ActivinA
treated (30 ng/mi)+ CHIR99021 (3
µm)
+/or- VPA + 5-Aza (30 ng/mi)+ CHIR99021 (3 µM)
In order to characterize subpopulations of cells after transfection, live staining, immunohistochemistry, and AP staining was performed to follow the change in pluripotent markers. Celts transfected with either Oct4/UTF1/MBD2, Oct4/Dppa4/MBD2, FoxD3/Dppa4/MBD2, Oct4/FoxD3/Dppa4, or Sox2/FoxD3/UTFl showed positive colonies for TRA1-60, TRA1-81, and SSEA4. This observation indicated that MBD2 generally had no effect by itself on re prog ramming towards pluripotent-iike cells, except in the case of Ocf.4/FoxD3/MBD2 transfection. Colonies started to form on Day 7 and continued to form until Day 14 (Figure 18) (the end of the study period). These colonies were positive for AP as welt.
These results were confirmed by RT-PCR analysis showing up-regulation of Oct4 expression as shown in Table 35. Relative expression for SOX2 was also slightly up-regulation in Day 7 after transfecting cells with Oct4/Foxd3/MBD2. There is also a trend of Sox2 up-regulation following transfection with Oct4/Sox2/Foxd3 and Oct4/Foxd3/Utf1.

Table 35: Relative expression of Pluripotent genes after transfecting ADSCs with various combinations of vectors as described in Table 34.

OCT4 Endogenous SOX2

Rel. Exp. Std. Dev. Rel. Exp. Std. Dev.
#1 Day 7, Oct4/Sox2/MBD2 25.20 1089 3.89 2.06
#2 Day 7, Oct4/Foxd3/MBD2 11.28 0.13

#3 Day 7, Oct4/Utf1/MBD2 2.01 0.20 2.93 1.73
#4 Day 7, Oct4/Dppa4/MBD2 9.68 1.36 1.18 0.15
#5 Day 7, Sox2/Foxd3/MBD2 1.06 0.55 2.68 .2.90
#6 Day 7, Sox2/Utf1/MBD2 0.56 , 0.10 3.36 -. 0.68
#7 Day 7, Sox2/Dppa4/MBD2 0.74 0.00 5.03 4.73
#8 Day 7, Foxd3/UtM/MBD2 1.31 0.61 4.15 2.92
#9 Day 7, Foxd3/Dppa4/MBD2 0.63 0.02 3.90 2.17
#10 Day 7, Utf1/Dppa4/MBD2 0.96 0.64 4.97 1.92
#11 Day 7, Oct4/Sox2/Foxd3 48.17 1.89 7.68 1.79
#12 Day 7, Oct4/Sox2/Utf1 48.97 6.93 3.71 0.39
#13 Day 7, Oct4/Sox2/Dppa4 32.40 2.74 4.61 2.37
#14 Day 7, Oct4/Foxd30Itf1 430 0.91 9.83 3.03
#15 Day 7, Oct4/Foxd3/Dppa4 4.21 0.11 4.57 0.85
#16 Day 7, Oct4/Utf1/Dppa4 10.29 3.70 3.53 1.63
#17 Day 7, Sox2/Foxd3/Utf1 1.42 0.83 3.32 2.12
#18 Day 7, Sox2/Foxd3/Dppa4 1.19 0.14 3.37 1.23
#19 Day 7, Sox2/Utf1/Dppa4 0.34 0.09 2.33 2.91
#20 Day 7, Foxd3/Utf1/Dppa4 1.72 0.07 2.45 0.27
#21 Day 7, GFP {-VPA/-5aza) 1.02 10.29 1.01 0.17
#22 Day 7, Untransf. ADSC (-VPA/-5aza) 1.25 N/A 0.30 N/A
#23 Day 7, GFP (+VPA/+5aza) 1.01 0.20 1.87 2.23
#24 Day 7, Untransf. ADSC (+VPA/+5aza) 1.45 N/A 0.27 N/A
Reprogramming Efficiency of defined pluripotency factors on HFF after triple transfection (one transfection every 3 days)
HFF cells were cultured as described in Example I with the exception of the concentrations of VPA and 5-AZA that were respectively 2 mM and 2.5 µM. Cells were transfected using the Nucleofector™® II Device (Lonza) following procedure described in Example II with the exception of the DNA quantity: 1 pg of each of the 3 plasmids DNA was used. The cells that had been pre-treated with VPA and 5-Aza and the untreated cells were both transfected with a mix of pCMV-Oct4nuc-IRES2-Sox2nuc, pCMV-Klf4nuc-IRES2-Cmycnuc or pCMV-Nanognuc-IRES2-l_in28. Following transfection the cells were plated in the fibroblasts medium described in Example i, supplemented with or without VPA and 5-AZA on Matrigel™ (BDBiosciences) coated on 6-well plates and incubated at 37°C, 5% C02. On Day 1 and 2, media was changed to 100% mTeSRI medium (StemCell Technologies) supplemented with or without VPA and 5-AZA. On Day 3 and Day 6, cells from each condition were detached by incubation in TrypLE™ for 5 min, counted and centrifuged. Cells were retransfected as above and plated on Matrigel™ coated plates in mTeSRI medium supplemented with or without VPA and 5-AZA. Media was changed daily as described for day .1 and 2. Medium was supplemented in Y27632 (Stemgent, 10 uM) from day 7 to day 14 to promote viability and clonal expansion of

potential reprogrammed cells. Cells were analysed at Day 20 using the Alkaline Phosphatase Detection Kit (Millipore) and by immunohistochemistry analysis.
' This analysis revealed that after three transfections, three clones were found to be positive for alkaline phosphatase activity and showed a rounded cell/colony morphology. Staining with antibodies against the embryonic stem (ES) cell markers SSEA-4 and TRA-1-81 confirmed that these clones were pluripotenMike (Figure 19). Surrounding HFF cells were negative for these markers. These clones were obtained only in the condition that did not contain inhibitors (i.e.: VPA and 5-AZA). Unexpectedly, no clones were observed for the condition treated with these inhibitors.
Reprogramming of NSLCs into pluripotency
NSLC and neuronal stem cells derived from BG-01, a human ES cell line that expresses markers that are characteristic of ES cells including SSEA-3, SSEA-4, TRA-1-60, TRA-1-81, and OCT-3/4, were reprogrammed into pluripotency. BG-01 cells had previously been cultured in conditions to induce the differentiation towards neural stem cells as described by Chambers SM et al., 2009. NSLCs and BG-01-NSC were cultured in proliferation medium supplemented with FGF (20ng/ml) and EGF (20ng/ml). NSLCs and BG-01-NSCs were transfected as previously described in Example II by two episoma! vectors, pEF-Oct4nuc-IRES2-MBD2 (NC1) or pCMV-FoxD3-2A-Oct4-2A-Klf4 (F72). Following transfection cells were collected and plated onto uncoated petri-dishes in the presence of Proliferation medium and mTeSRI medium (50:50) in proliferation conditions at 37°C, 5%C02. After 48 hours, cells were re-transfected by the same plasmid and plated in 96-well plates coated with Matrigel™ and cultured in the presence of mTeSRI medium supplemented by the small molecules BIX01294 (Stemgent, 2µM) and BayK8644 (Stemgent, 2µM) at 37°C, 5 %02 for 22 days. Live staining and immunohistochemistry were performed to characterize subpopulations of cells for pluripotency markers.
NSLCs and BG-01-NSCs were positively stained with SSEA-4 staging on Day 7 and maintained until 22 days in culture (the end of the study) (Figure 20). Within ten days, cells that were morphologically similar to ESCs were observed and they expressed a wide panel of pluripotency markers, including SSEA-4, TRA1-81, Nanog and Oct4 (Figure 20). This study identified another way to get pluripotenMike cells from somatic cells via Neural Stem-Like Cells (NSLCs). The utility of NSLCs could offer multiple advantages for reprogramming towards pluripotent-like cells. For example, obviating the requirement for tumorigenic genes like c-Myc reduces the risk of inducing cancerous cells. For neuroregenerative and neurodegenerative applications these cells could represent an invaluable source of cells to investigate furthermore human pluripotent cell induction, and also represent a potential source of cells for deriving . patient-specific muttipotent and pluripotent stem cells for modeling human disease.

EXAMPLE XX Teratoma Formation Assay in SCID mice
Transplantation of human pluripotent stem cells (SC) into "severly compromised immuno-deficient" (SCID) mice leads to the formation of differentiated tumors comprising all three germ layers for pluripotent stem cells, resembling spontaneous human teratomas, and specialized tissue for multipotent stem ceils. These assays are considered the standards in the literature for demonstrating differentiation potential of pluripotent stem ceils and hold promise as a standard for assessing safety among SC-derived cell populations intended for therapeutic applications
After al) appropriate animal approvals for the experiment has been obtained, 24 mice were purchased from Charles Rivers, and housed at M1SPRO animal facility for one week without any experimentation for adaption to the new environment. One million human NSLCs, normal human neuroprogenitor cells (hNPCs), or human embryonic stem (ES) cells in 100 pi Phosphate buffered saline, calcium- and magnesium-free (CMF-PBS) were injected with a 21-G needle Intramuscularly into the right hind limb of the 4-week-old male SCID-beige mice under anesthesia with Ketamine/xylazine (8 mice per group). Following injection, the syringe was aspirated up and down a couple of times in a culture dish containing medium to verify that the cells were injected and not stuck inside the syringe.
The mice were maintained for 12 weeks and monitored for clinical signs and any tumor growth regularly. Any specialized tissue or teratoma growth was monitored by externaf examination and an increase in the size of the muscle relative to the same muscle on the left hind limb. When a specialized tissue or teratoma was identified, the location and size of the growth was measured (using measuring calipers) and recorded. The specialized tissue or teratoma is usually first identified as a small growth of the muscle size compared to the left control muscle. Animals were monitored weekly until onset of any tumor growth, and daily after tumors appeared. After 12 weeks, the mice were sacrificed by C02 euthanasia. Each entire animal was observed for any tumor growth anywhere on the animal, and the injected muscle and the comparable left muscle control were measured {with measuring calipers)(see results table below) and then removed and stored in 4% paraformaldehyde solution for histological analysis. The sizes of the muscles were as follows:

Treatment Left leg (control) Right leg (treated)
Dorso-ventral width Lateral width Dorso-ventral
width Lateral width
Human Embryonic Stem Cells 6.44 ±0.11 5.03 ±0.17 6.91 ±0.15 5.3 ±0.14
Human Neuroprogenitor Cells 6.60 ±0.17 5.43 + 0.15 7.01 ± 0.23 5.58 + 0.13
Human NSLC 6.85 ±0.2 5.32 ±0.14 6.86 ±0.21 5.33 ±0.11
Values represent the Average of 8 mice ± the standard error

Measurement of the size of the muscles revealed that all the human embryonic stem cell injected muscles were bigger than the comparable left muscle controls, indicating teratoma growth in the ES cell injected muscles. About' half of all the human neuroprogenitor cell injected muscles were bigger than the comparable left muscle controls, while the mice injected with NSLC did not show any difference between the muscles (treated with the cells or not). The mice injected with NSLC did not show any evidence of tumor or teratoma growth.
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* »*
Headings are included herein for reference and to aid in locating certain sections These headings are not intended to limit the scope of the concepts described therein under, and these concepts may have applicability in other sections throughout the entire specification Thus, the

present invention is not intended to be limited to the embodiments shown herein but is to be accorded the widest scope consistent with the principles and novel features disclosed herein.
It is understood that the examples and embodiments described herein are for illustrative purposes only and that various modifications or changes in light thereof will be suggested to persons skilled in the art and are to be included within the present invention and scope of the appended claims.

CLAIMS:
1. A method of transforming a cell of a first type to a desired cell of a different type,
comprising:
i) providing a cell of a first type;
ii) transiently increasing in said cell of a first type intracellular levels of at least one
re prog ramming agent, whereby said transient increase induces direct or indirect
endogenous expression of at least one gene regulator;
iii) placing the cell in conditions for supporting the transformation of the desired cell
and maintaining intracellular levels of said at least one reprogramming agent for a
sufficient period of time to allow stable expression of said at least one gene regulator
in absence of the reprogramming agent; and
iv) maintaining the cell in culture conditions supporting the transformation of the
desired cell for a sufficient period of time to allow a stable expression of a plurality of
secondary genes whose expression is characteristic of phenotypical and/or
functional properties of the desired cell, wherein at least one of said secondary
genes is not characteristic of phenotypical and functional properties of an embryonic
stem cell, whereby at the end of said period of time the cell of the first type has been
transformed into the desired cell of a different type.
2. The method of claim 1, wherein the desired cell of a different type obtained is characterized by a stable repression of a plurality of genes expressed in the first cell type.
3. The method of claim 1 or 2, wherein said at least one reprogramming agent is a polynucleotide, a polypeptide, a compound or a small molecule.
4. The method of any one of claims 1 to 3, wherein said at least one reprogramming agent is a polynucleotide or a polypeptide, and wherein said polynucleotide or polypeptide comprises a sequence selected from the group of GenBank™, UniProt™ /Swiss-Prot™ or UniGene™ sequences whose accession numbers is listed in TABLE A.
5. The method of claim 4, wherein said at least one reprogramming agent is selected from the group consisting of the following: Musashil (Msi1); Msi1 and Neurogenin 2 (Ngn2); Msi1 and methyl-CpG binding domain protein 2 (MBD2); Ngn2 and MBD2, and Msi1, Ngn2 and MBD2.
6. The method of any one of claims 1 to 3, wherein said at least one reprogramming agent is a polypeptide, and wherein increasing intracellular levels of said at least one reprogramming agent comprises delivering said polypeptide intracellularly.

7. The method of claim 6, wherein said polypeptide delivering is delivered intracellularly by transfection.
8. The method of any one of claims 1 to 7, wherein said at least one gene regulator is a polynucleotide or a polypeptide, and wherein said polynucleotide or polypeptide comprises a sequence selected from the group of GenBank™, UniProt™ /Swiss-Prot™ or UniGerre™ sequences whose accession numbers is listed in TABLE A.
9. The method of any one of claims 1 to 8, wherein said plurality of secondary genes are selected from the group of genes comprising a polynucleotide or encoding a polypeptide for which polynucleotide or polypeptides sequences whose accession numbers is listed in GenBank™, UniProt™ /Swiss-Prot™ or UniGene™ accession number.provided in TABLE A.
10. The method of any one of claims 1 to 9, wherein expression of secondary genes characteristic of phenotypical and/or functional properties of the desired cell is characterized by the expression of one or more markers defined according to the following table:

Desired cell type Markers
Neural stem-like cells Nestin, Sox2, GFAP, Msi1
Neural-like cells BIII-tubulin, Map2b, Synapsin, ACHE
Ectoderm-like cells Sox2, Sox1, Zic1, Nestin, Notch 1, FoxJ3, Otx2,Cripto1, Vimentin
Mesendo derm-like cells Sox17, FoxA2, CXCR4, GATA4, Mixll, Eomesodermin
Pluripotent-like cells Oct4, SSEA4, TRA-1-60, TRA-1-81, AP
11. The method of claim 2, wherein said plurality of genes whose expression is stably repressed are selected according to the genes listed in TABLE C.
12. The method of claim 2, wherein a stable repression of a plurality of genes expressed in the first cell type is characterized by disappearance of corresponding cell markers as defined in Table C.
13. The method of any one of claims 1 to 12, wherein step ii) is carried out consecutivefy to step iii) or simuftaneously with step iii).
14. The method of any one of claims 1 to 13, further comprising contacting the. chromatin and/or DNA of the cell of the first type with an agent capable of remodeling chromatin and/or DNA of said cell.
15. The method of claim 14, wherein the agent capable of remodeling chromatin and/or DNA is selected from the group consisting of histone acetylators, inhibitors of histone deacetylation, DNA demethylators, inhibitors of DNA methylation and combination thereof.

16. The method of claim 15, wherein the inhibitor of DNA methylation is selected from the group consisting of 5-azacytidine, 5-aza-2-deoxycytidine, 1-p-D-arabinofuranosil-5-azacytosineT dihydro-5-azacytidine, zebularine, and RG108; wherein the inhibitor of histone deacetylation is selected from the group consisting of valproic acid, phenylbutyrate, Trichostatin A, Na-butyrate, benzamides, and cyclic tetrapeptides, and wherein the DNA demethylator is MBD2.
17. The method of any one of claims 1 to 16, further comprising treating the cell of a first type with a cytoskeleton disruptor.
18. The method of any one of claims 1 to 17, wherein the celf of a first type is selected from the group consisting of: germ ceils, embryonic stem cells and derivations thereof, adult stem cells and derivations thereof, progenitor cells and derivations thereof, cells derived from mesoderm, endoderm or ectoderm, and a cell of mesoderm, endoderm or ectoderm lineage.
19. The method of claims 1 to 17, wherein the cell of a first type is selected from the group consisting of: adipose-derived stem cell, mesenchymal stem cell, hematopoietic stem cell, skin derived precursor cell, hair follicle cell, fibroblast, keratinocyte, epidermal cell, endothelial cell, epithelial cell, granulosa epithelial cell, melanocyte, adipocyte, chondrocyte, hepatocyte, B lymphocyte, T lymphocyte, granulocyte, macrophage, monocyte, mononuclear cell, pancreatic islet cell, Sertoli cell, neuron, glial cell, cardiac muscle cell, and other muscle cell.
20. The method of any one of claims 1 to 17, wherein the cell of a second different type is selected from the group consisting of: germ cells, embryonic stem cells and derivations thereof, adult stem cells and derivations thereof, progenitor cells and derivations thereof, cells derived from mesoderm, endoderm or ectoderm, and a cell of mesoderm, endoderm or ectoderm
lineage.
21. The method of any one of claims 1 to 17, wherein the cell of a second different type is selected from the group consisting of: adipose-derived stem cell, mesenchymal stem cell, hematopoietic stem cell, skin derived precursor cell, hair follicle cell, fibroblast, keratinocyte, epidermal ceil, endothelial cell, epithelial cell, granulosa epithelial cell, melanocyte, adipocyte, chondrocyte, hepatocyte, B lymphocyte, T lymphocyte, granulocyte, macrophage, monocyte, mononuclear cell, pancreatic islet cell, Sertoli cell, neuron, glial cell, cardiac muscle cell, and other muscle cell.
22. The method of any one of claims 1 to 17, wherein the desired cell is a Neural Stem-Like Cell (NSLC) and wherein placing the cell in culture conditions for supporting the transformation of NSLC comprises contacting the cell with a culture media comprising one or more of factors selected from the group consisting of: a retinoid compound; a neurotrophic factor, bFGF, EGF,

SHH, Wnt3a, transforming growth factor alpha, neuropeptide Y, Estrogen, Lithium and L-Ascorbic acid.
23. The method of claim 22, wherein- the cell of a first type is. selected from the group consisting of: adipose-derived stem cell, hematopoietic stem cell, fibroblast, and keratinocyte.
24. A method of transforming a cell of a first type to a cell of a desired cell of a different type, comprising:
- increasing intracellular levels of at least one reprogramming agent, wherein said at
least one reprogramming agent is selected for inducing directly or indirectly the
expression of morphological and/or functional characteristics of a desired second cell
type;
- maintaining the cell of a first type in culture conditions for supporting the
transformation of the desired cell for a sufficient period of time to allow stable
expression of a plurality of secondary genes whose expression is characteristic of
phenotypical and/or functional properties of the desired cell, wherein at least one of
said secondary genes is not characteristic of phenotypical and/or functional
properties of an embryonic stem cell,
whereby at the end of said period of time the desired cell of a different type is obtained and wherein said obtained cell is further characterized by a stable repression of a plurality of genes expressed in the first cell type.
25. A method of obtaining a Stem-Like Cell (SLC), comprising:
i) providing a cell of a first type;
ii) transiently increasing in said cell intracellular levels of at least one reprogramming
agent, whereby said transient increase induces direct or indirect endogenous
expression of at least one gene regulator;
iii) placing the cell in conditions for supporting the transformation of stem-like cell and
maintaining intracellular levels of said at least one reprogramming agent for a
sufficient period of time to allow stable expression of said at least one gene regulator
in absence of the reprogramming agent;
iv) maintaining the cell in culture conditions for supporting the transformation of said
stem-like cell for a sufficient period of time to allow stable expression of a plurality of
secondary genes whose expression is characteristic of phenotypical and/or
functional properties of said stem-like ceil, wherein at least one of said secondary
genes is not characteristic of phenotypical and functional properties of an embryonic
stem celt, whereby at the end of said period of time of a stem-like cell is obtained.

26. The method of claim 25, wherein the stem-like cell is a Neural Stem-Like Cell (NSLC), wherein said at least one reprogramming agent Is selected from the group consisting of: Musashil (Msi1); Msi1 and Neurogenin 2 (Ngn2); Msi1 and methyl-CpG binding domain protein 2 (MBD2); Ngn2 and MBD2; and Msi1, Ngn2 and MBD2, and wherein said at least one gene regulator is selected from the group consisting of Sox2, Nestin, and Msi1
27. A method of obtaining a Neural Stem-Like Cell (NSLC), comprising:

- providing a cell of a first type;
- introducing into said cell one or more polynucleotide capable of transient expression of one or more the following polypeptides: a Musashil (Msi1) polypeptide; a Musashil (Msi1) and a Neurogenin 2 (Ngn2) polypeptide; a Musashil (Msi1) and methyl-CpG binding domain protein 2 (MBD2) polypeptide; Neurogenin 2 (Ngn2) and methyl-CpG binding domain protein 2 (MBD2); a Musashil (Msi1), Neurogenin 2 (Ngn2) polypeptide, and methyl-CpG binding domain protein 2 (MBD2) polypeptide; and
- placing the cell in culture conditions supporting the transformation into a NSLC for a
sufficient period of time to allow a stable expression of a plurality of genes whose
expression is characteristic of phenotypical and/or functional properties of a NSLC;
whereby at the end of said period of time a NSLC is obtained and wherein said obtained NSLC is further characterized by a stable repression of a plurality of genes expressed in the first cell type.
28. The method of claim 27, wherein placing the cell in culture conditions for supporting the transformation of NSLC comprises contacting the cell with a culture media comprising one or more of factors selected from the group consisting of: a retinoid compound, a neurotrophic factor, bFGF, EGF, SHH, Wnt3a, transforming growth factor alpha, neuropeptide Y, Estrogen, Lithium and L-Ascorbic acid.
29. A method of obtaining a Neural Stem-Like Cell (NSLC), comprising;

- providing a celi of a first type which is not a NSLC;
- increasing intracellular levels of at least one neural stem cell specific polypeptide, wherein said polypeptide is capable of driving directly or indirectly transformation of the cell of the first type into a NSLC; and
- contacting chromatin and/or DNA of the cell of a first type with a histone acetylator, an inhibitor of histone deacetylation, a DNA demethylator, and/or a chemical inhibitor of DNA methylation
whereby a NSLC is obtained.

30. The method of claim 29, further comprising treating the cell of a first type with a cytoskeleton disruptor.
31. The method of claim 29 or 30, wherein increasing, intracellular levels of at least one neural stem cell specific polypeptide comprises transiently transfecting the cell of a first type with an expression vector allowing expression of a Musashil (Msi1) polypeptide; a Musashi1 (Msil) and a Neurogenin 2 (Ngn2) polypeptide; a Musashil (Msi1) and methyl-CpG binding domain protein 2 (MBD2) polypeptide; a Neurogenin 2 (Ngn2) and methyl-CpG binding domain protein 2 (MBD2) polypeptide; or a Musashil (Msi1), Neurogenin 2 (Ngn2) polypeptide, and methyl-CpG binding domain protein 2 (MBD2) polypeptide.
32. The method of any one of claims 29 to 31 wherein the inhibitor of DNA methylation is selected from the group consisting of 5-azacytidine, 5-aza-2-deoxycytidine, 1-p-D-arabinofuranosil-5-azacytosine, dihydro-5-azacytidine, zebularine, and RG108; wherein the inhibitor of histone deacetylation is selected from the group consisting of valproic acid, phenylbutyrate, Trichostatin A, Na-butyrate, benzamides, and cyclic tetrapeptides and wherein the DNA demethylator is MBD2.
33. The method of any one of claims 29 to 32, further comprising culturing the cell in a media comprising one or more factors appropriate for maintaining, supporting and/or inducing the morphological and functional characteristics of a NSLC.
34. The method of claim 33, wherein said one or more factor is selected from the group consisting of: a retinoid compound, a neurotrophic factor, bFGF, EGF, SHH, Wnt 3a, Transforming growth factor alpha, neuropeptide Y, Estrogen, Lithium and L-Ascorbic acid.
35. The method of any one of claims 29 to 34, wherein the NSLC so obtained possesses one or more of the following characteristics:

- expression of one or more neural stem cell marker selected from the group consisting of Sox2, Nestin, GFAP, Msi1, and Ngn2;
- decreased expression of one or more genes specific of the cell of the fist type;
- forms neurospheres in the neurosphere colony formation assay;
- capable of being cultured in suspension or as an adherent culture;
- capable of proliferating without the presence of an exogenous reprogramming agent for
over 1 month;
- capable of dividing every 36 hours at low passage;
- positive for telomerase activity;
- capable of differentiation into a neuronal-like cell, astrocyte-iike cell, oligodendrocyte-like
cell and combinations thereof;
- decreased expression of telomerase and one or more neural stem cell markers; - - - - - — .. .

- having one or more morphological neurite-like processes (axons and/or dendrites) greater
than one cell diameter in length;
- expression of at least one neural-specific antigen selected from the group consisting of
neural-specific tubulin, microtubule associated protein 2, NCAM, and marker for a neurotransmitter;
- expression of one or more functional neural markers;
- capable of releasing one or more neurotrophic factors;
- negative in a tumor colony forming assay;
- negative for tumor growth in SCID mice;
- negative for teratoma growth in SCID mice;
- capable of significantly improving one or more functional measures after placement of an
adequate number of NSLCs into the void in a brain ablation model;
- capable of significantly improving or maintaining one or more functional measures after
injecting an adequate number of NSLCs into an EAE model; and
- capable of improving one or more functional measures more significantly than hNPCs in
CNS injury or neurodegenerative models.
36. The method of any one of claims 29 to 34, wherein the NSLC so obtained possesses all
of the following characteristics:
- ability to self-renew for significantly longer than a somatic cell;
- is not a cancerous cell;
- is stable and not artificially maintained by forced gene expression or by similar means and may be maintained in standard neural stem cell media;
- can differentiate to a progenitor, precursor, somatic cell or to another more
differentiated cell type of the same lineage;
- has the characteristics of a stem cell and not just certain markers or gene expression or morphological appearance; and
- does not exhibit uncontrolled growth, teratoma formation, and tumor formation in vivo.
37. The method of any one of claims 29 to 35, wherein a plurality of NSLCs are obtained
and wherein said plurality of NSLCs are organized within a three-dimensional structure.

38. A method for obtaining a Neural Stem-Like Cell (NSLC), from a non-NSLC, comprising:
-obtaining a non-NSLC;
-co-transfecting the non-NSLC with a first polynucleotide encoding a MBD2
polypeptide and with at least one second polynucleotide encoding a MUSASHI1
polypeptide and/or encoding a NGN2 polypeptide;
- placing the co-transfected cell in culture conditions for supporting the
transformation into a NSLC until said NSLC is obtained.
39. The method of claim 38, wherein said non-NSLC is selected from a keratinocyte, a Adipocyte Derived Stem Cell (ADSCs) and a human hematopoietic stem cells.
40. A cell line obtained using any one of the methods of claims 1 to 38.
41. A stem-like cell possessing all of the following characteristics:

- ability to self-renew for significantly longer than a somatic cell;
- is not a cancerous ceil;
- is stable and not artificially maintained by forced gene expression or by similar means and may be maintained in standard neural stem cell media;
- can differentiate to a progenitor, precursor, somatic cell or to another more
differentiated cell type of the same lineage;
- has the characteristics of a stem cell and not just certain markers or gene expression or morphological appearance; and
- does not exhibit uncontrolled growth, teratoma formation, and tumor formation in vivo.
42. A Neural Stem-Like Cell (NSLC) possessing one or more of the following characteristics:
- expression of one or more neural stem cell marker selected from the group
consisting of Sox2, Nestin, GFAP, Msi1, and Ngn2;
- decreased expression of one or more genes specific of the cell of the fist type;
- forms neurospheres in the neurosphere colony formation assay;
- capable of being cultured in suspension or as an adherent culture;
- capable of proliferating without the presence of an exogenous reprogramming agent
for over 1 month;
- capable of dividing every 36 hours at low passage;
- positive for telomerase activity;
- capable of differentiation into a neuronal-like cell, astrocyte-like cell, oligodendrocyte-
like cell and combinations thereof,
- decreased expression of telomerase and one or more neural stem cell markers;
- having one or more morphological neurite-like processes (axons and/or dendrites)
greater than one cell diameter in length;

- expression of at least one neural-specific antigen selected from the group consisting
of neural-specific tubulin, microtubule associated protein 2, NCAM, and marker for a neurotransmitter;
- expression of one or more functional neural markers;
- capable of releasing one or more neurotrophic factors;
- negative in a tumor colony forming assay;
- negative for tumor growth in SCID mice;
- negative for teratoma growth in SCID mice;
- capable of significantly improving one or more functional measures after placement
of an adequate number of NSLCs into the void in a brain ablation model;
- capable of significantly improving or maintaining one or more functional measures
after injecting an adequate number of NSLCs into an EAE model; and
- capable of improving one or more functional measures more significantly than
hNPCs in CNS injury or neurodegenerative models.
43. The neural stem-like cell of claim 42, wherein the NSLC so obtained possesses all of
the following characteristics:
- ability to self-renew for significantly longer than a somatic cell;
- is not a cancerous cell;
- is stable and not artificially maintained by forced gene expression or by similar means and may be maintained in standard neural stem cell media;
- can differentiate to a progenitor, precursor, somatic cell or to another more
differentiated cell type of the same lineage;
- has the characteristics of a stem cell and not just certain markers or gene expression or morphological appearance; and
- does not exhibit uncontrolled growth, teratoma formation, and tumor formation in vivo.

44. The NSLC of claim 42 or 43, wherein said NSLC is derived from the dedifferentiate, transformation or reprogramming of a somatic cell, a progenitor cell or of a stem cell.
45. An artificial tissue construct, comprising a 3D assembly of in vitro cultured cells, wherein said 3D assembly comprises: a plurality of desired cells obtained using any one of the methods of claims 1 to 24, a plurality of SLC obtained using any one of the methods of claims 25 or 26, a plurality of Neural Stem-Like Cell (NSLC) obtained using any one of the methods of claims 27 to 39, a plurality of SLC as defined in claim 41, and/or a plurality of NSLC as defined in any one of claims 42 to 44: and an extracellular matrix produced by these cells.
46. A method of regenerating a mammalian tissue or organ, comprising: providing a plurality of desired cells obtained using any one of the methods of claims 1 to 24, a plurality of SLC

obtained using any one of the methods of claims 25 or 26, a plurality of Neural Stem-Like Cell (NSLC) obtained using any one of the methods of claims 27 to 39, a plurality of SLC as defined in claim 41, and/or a plurality of NSLC as defined in any one of claims 42 to 44; and contacting the tissue or organ to be regenerated with said plurality of desired cells, SLC, and/or NSLC.
47. The method of claim 46, wherein said desired cells, SLC, and/or NSLC are placed in proximity to the tissue or organ to be regenerated.
48. A method for repairing or regenerating a tissue or organ in a subject in need thereof, the method comprising contacting said tissue or organ with a plurality of desired cells obtained using any one of the methods of claims 1 to 24, a plurality of SLCs obtained using any one of the methods of claims 25 or 26, a plurality of Neural Stem-Like Cells (NSLCs) obtained using any one of the methods of claims 27 to 39, a plurality of SLCs as defined in claim 41, a plurality of NSLCs as defined in any one of claims 42 to 44; and/or an artificial tissue construct as defined in claim 45.
49. A method for repairing or regenerating a tissue or organ in a subject in need thereof, the method comprising administering to the subject a compound inducing a direct or indirect endogenous expression of at least one gene regulator in cells of said tissue or organ and/or a compound inducing a direct or indirect endogenous expression of at least one gene regulator in cells capable of transformation, dedifferentiation or being reprogrammed in vivo in said subject, wherein expression of said at least one gene regulator reprograms said cells into desired cells of a different type, and wherein said cells of a different type are effective in repairing or regenerating said tissue or organ.
50. The method of claim 49, wherein said desired cells of a different type are stem-like cells.
51. The method of claim 49 or 50, wherein said tissue or organ is selected from the group consisting of the brain, the spine cord, the heart, the eye, the retina, the cochlea, the skin, muscles, intestines, pancreas, kidney, liver, lungs, bone, bone marrow, cartilage, cartilage discs, hair follicles, teeth, blood vessels, endocrine glands, exocrine glands, ovaries, reproductive organs, mammary tissue and breast tissue.
52. A process wherein a cell of a first type is reprogrammed to a desired cell of a different type, comprising;
- a transient increase of intracellular levels of at least one reprogramming agent, wherein said at least one reprogramming agent induces a direct or indirect endogenous expression of at least one gene regulator, wherein said endogenous expression of the least one gene regulator is necessary for the existence of the desired cell of a different type;

- a stable expression of said at least one gene regulator;
- stable expression of a plurality of secondary genes, wherein the stable expression of said plurality of secondary genes is the result of the stable expression of the at least one gene regulator, and wherein: (i) stable expression of s plurality of secondary genes is characteristic of phenotypical and/or functional properties of the desired cell, (ii) stable expression of at least one of said secondary genes is not characteristic of phenotypical and functional properties of an embryonic stem cell, and wherein (i) and (ii) are indicative of successful reprogramming of the cell of the first type to the desired cell of the different type.
53. The process of claim 52, wherein the at least one reprogramming agent is a polypeptide
selected from the group consisting a Msi1 polypeptide, or a Ngn2 polypeptide and a MDB2
polypeptide.
54. The process of claim 52 or 53, wherein the at least one gene regulator is a polypeptide selected from the group consisting Sox2, Msi1 and combinations thereof.
55. The process of claim any one of claims 52 to 54, wherein the desired cell is a Neura! Stem-Like Cell (NSLC) and wherein the cell of the first type is a cell selected from keratinocyte, Adipocytes Derived Stem Cell (ADSCs) and human hematopoietic stem cel!.