Patent Application
20200222596
The present invention is directed to compositions and methods for the capture and support of immature endothelial cells. More particularly, the invention is directed to endothelialization of a substrate, including medical devices and implants. The capture and support of immature endothelial cells relies on the presence of two or more peptides or proteins, as described herein, grafted to the surface of the substrate.
Endothelial progenitor cells (EPCs) and pluripotent stem cell-derived endothelial cells have the potential to become a reliable source of autologous cells for endothelialization of intravascular devices and vascularization of tissue engineered constructs. In order to design biomaterials that can employ EPCs to enhance endothelialization, however, a better understanding of their dynamic adhesion to material surfaces under physiological shear is needed.
Endothelial colony forming cells (ECFCs) are one type of EPCs; ECFCs are highly proliferative and are capable of forming mature and functional endothelial cells for vessel repair and postnatal angiogenesis. EPCs are a subpopulation of monocytes that are derived from myeloid cells, which are one type of leukocyte. EPCs that have been isolated from blood and expanded in vitro are frequently called late outgrowth or endothelial colony forming cells (ECFCs). Expression of surface receptors on these cells differs from other types of monocytes, “early outgrowth” EPCs, and mature endothelial cells. Advantages of ECFCs for tissue engineering applications include the relative ease and lack of comorbidity in obtaining autologous cells, the highly proliferative nature of ECFCs, and the ability of ECFCs to yield mature endothelial cells. To exploit their potential, however, it is necessary to first understand whether ECFCs behave similarly to ECs in their abilities to interact with engineered biomimetic materials and which cell surface receptors mediate these interactions.
As a precursor for endothelial cells (ECs), EPCs show an endothelial-like phenotype with high proliferative capability (especially late EPCs), and can be differentiated into mature endothelial cells that form the endothelium. Hence, potential clinical applications of EPCs include vessel repair, neovascularization of ischemic organs, and coating of vascular grafts. Previous work has shown that β2 integrins are important in EPC homing to sites of ischemia and neovascularization. Integrins also play an important role in EPC capture on EC or ECM proteins in vitro. Although the types and distribution of integrin receptors are not well identified on EPCs, prior work has estimated the number of α5β1 and αvβ3 integrin receptors present on umbilical cord-blood derived EPC using flow cytometry. Besides flow cytometry, investigation of EPC migration has shown that blocking α5β1 decreases EPC migration. However, understanding of the constitution and function of integrins present on the membrane surface of EPCs is still very limited and needs to be further explored. Importantly, although it was known that ECFCs express α5β1 and αvβ3 integrins, ECFCs were not known to express an integrin that would bind REDV (SEQ ID NO:2) (discussed below).
Cardiovascular disease is one of many conditions that may be treated by the insertion of stents and/or vascular grafts. However, incomplete endothelialization can reduce the effectiveness of this type of treatment. Therefore, the incorporation of endothelium specific factors, for example, tailoring biomaterials for cardiovascular implant coatings, will provide enhanced clinical treatment alternatives. One such coating includes a nanofibrous matrix that may be applied to the medical implant as a self-assembled coating. Other such materials include biomimetic materials and polymer coatings for implants and medical devices.
Previous work has attempted to identify and characterize peptides, including REDV (SEQ ID NO:2), RGDS (SEQ ID NO:3), and YIGSRG (SEQ ID NO:4), grafted on PEG hydrogels have been shown to support EPC rolling under shear. Despite the fact that REDV (SEQ ID NO:2)-grafted hydrogels reduced EPC rolling velocity the most, however, it does not support firm adhesion even at low shear rate. Thus, there is a continuing need for peptides that are capable of slowing and capturing EPCs. Notably, REDV (SEQ ID NO:2) (which binds α4β1), does not bind either α5β1 and αvβ3 integrin, which are expressed on EPCs and pluripotent stem cell-derived endothelial cells.
The peptide CRRETAWAC (SEQ ID NO:1) has a high binding affinity and selectivity for integrin α5β1. Prior work involved constructing a heptapeptide library by ligating a synthetic oligonucleotide into fUSE 5 vector. The oligonucleotide has a core sequence of TGT(NNK)7TGT (SEQ ID NO:6) where N represents an equal molar mixture of A, C, G, T while K represents G or T. TGT was coded for cysteine and NNK was coded for all amino acid. The cysteines on each side of the peptide were designed to form disulfide bond and to form cyclic peptides. Thus, the oligonucleotide produces a library of cyclic peptides with seven random amino acids. When the peptide library was screened with α5β1 coated wells to identify the peptide with high binding affinity with α5β1, among the non-RGD containing peptides, CRRETAWAC (SEQ ID NO:1) showed the highest affinity to α5β1.
Other previous works has investigated CRRETAWAC (SEQ ID NO:1) in endothelialization of expanded polytetrafluoroethylene (ePTFE) surfaces by incorporating GSSSCRRETAWAC (SEQ ID NO:7) (
Despite the fact that PRb contained the ubiquitous RGD peptide and the synergistic PHSRN (SEQ ID NO:9) peptide, this peptide is chosen to test for the capability on EPC rolling due to the its superior design in accurately mimicking FN's binding affinity for α5β1. This peptide has been shown to mimic FN through HUVEC adhesion, spreading, and extracellular FN production (Mardilovich et al., 2006). In native FN, the distance between PHSRN (SEQ ID NO:9) and RGD is 30-40 Å which is a critical factor for PHSRN (SEQ ID NO:9) to perform its synergistic role in adhesion. With the length for each amino acid being 3.7 Å, the Kokkoli Lab used SGSGSGSGSG (SEQ ID NO:10), which is a total of 10 amino acids to give a linker distance of 37 Å, to match the distance between PHSRN (SEQ ID NO:9) and RGD. In addition, it has been shown that the ratio of hydrophilic to hydrophobic residues in between PHSRN (SEQ ID NO:9) and RGD in FN is almost 1:1 (Mardilovich & Kokkoli, 2004). The repeating SG sequence was chosen to mimic this ratio. Therefore, PRb was able to mimic the adhesion property of FN for α5β1.
P11 was discovered by screening through PS-SPCL using protein-protein competitive inhibition assay. The PS-SPCL that was studied was comprised of 114 types of hexapeptide mixture and this library was divided into 6 groups with each group has various amino acids residues at each position. The PS-SPCL together with fluorescently labeled vitronectin (VN) were added onto αvβ3-coated surface and allowed to compete for the αvβ3 integrin. As shown in
V2 is a peptide representing the 116-135 residues of the cysteine-rich heparin binding protein (CCN1). The functions of CCN1 include regulating cell adhesion, migration, proliferation, survival and differentiation in mesenchymal cells. Studies have shown that CCN1 binds directly to αvβ3 and mediates pro-angiogenic activities. Previous studies have evaluated peptides of different portion of CCN1 and reported that V2 was responsible portion for HUVEC adhesion specifically through αvβ3. Previous work has also shown that when the D residue was altered into A, the altered V2 peptide lost the capability to bind HUVEC through αvβ3 integrin. Furthermore, shorter versions of V2 have also shown similar results meaning V2 is the exact peptide required to bind αvβ3. Therefore, V2 is a potential peptide to capture EPCs due to its specific binding to αvβ3.
The present invention relates to previously unknown peptides and combinations of peptides that significantly increase the capture rate of endothelial cells, including endothelial colony forming cells (ECFCs) under flow conditions with physiological shear rates. The endothelial cell capturing peptides may include CRRETAWAC (SEQ ID NO:1) and PRb (SEQ ID NO: 8). The combination may further involve an endothelial cell slowing peptide REDV (SEQ ID NO:2) and an endothelial cell capturing peptide CRRETAWAC (SEQ ID NO:1). REDV (SEQ ID NO:2) has shown to significantly decrease ECFC rolling velocity compared to other bioactive peptides, including RGDS (SEQ ID NO:3), YIGSRG (SEQ ID NO:4), P11 (SEQ ID NO: 11), PRb (SEQ ID NO: 8), and CRRETAWAC (SEQ ID NO:1). Despite the fact that REDV (SEQ ID NO:2)-grafted hydrogels had the greatest reduction in EPC rolling velocity, REDV (SEQ ID NO:2) does not support capture even at low shear rates. Surprisingly, however, cell capture events were consistently observed on CRRETAWAC (SEQ ID NO:1)-grafted hydrogels and on PRb (SEQ ID NO: 8), grafted hydgrogels at 20 s−1. In our analysis, 3.74%±1.0% of ECFCs were captured on CRRETAWAC (SEQ ID NO:1)-grafted hydrogels and 1.14%±0.2% of ECFCs were captured on PRb grafted hydrogels. To further evaluate the potential use of CRRETAWAC (SEQ ID NO:1) in the ECFC capture for endothelialization, ECFC rolling on hydrogels that were grafted with combinations of CRRETAWAC (SEQ ID NO:1) with REDV (SEQ ID NO:2), which has a high affinity for the integren α4β1, were assessed. Hydrogels grafted with REDV (SEQ ID NO:2)/CRRETAWAC (SEQ ID NO:1) combination (0.35 μmol/μL of REDV (SEQ ID NO:2)/0.35 pmol/ml of CRRETAWAC (SEQ ID NO:1)) had significantly increased ECFC capture of 13.4%±2.3% as compared to CRRETAWAC (SEQ ID NO:1) alone. Thus, we have discovered the peptides CRRETAWAC (SEQ ID NO:1) and PRb and the combination of CRRETAWC (SEQ ID NO:1)/REDV (SEQ ID NO:2) for capturing ECFCs under shear including potential use in establishing or recovering the vascular endothelium.
The following drawings form part of the specification and are included to further demonstrate certain embodiments or various aspects of the invention. In some instances, embodiments of the invention can be best understood by referring to the accompanying drawings in combination with the detailed description presented herein. The description and accompanying drawings may highlight a certain specific example, or a certain aspect of the invention. However, one skilled in the art will understand that portions of the example or aspect may be used in combination with other examples or aspects of the invention.
Various embodiments of the present invention will be described in detail with reference to the drawings, wherein like reference numerals represent like parts throughout the several views. Reference to various embodiments does not limit the scope of the invention. Figures represented herein are not limitations to the various embodiments according to the invention and are presented for exemplary illustration of the invention.
The following definitions and introductory matters are provided to facilitate an understanding of the present invention.
Numeric ranges recited within the specification, including ranges of “greater than,” “at least,” or “less than” a numeric value, are inclusive of the numbers defining the range and include each integer within the defined range.
The singular terms “a”, “an”, and “the” include plural referents unless context clearly indicates otherwise. Similarly, the word “or” is intended to include “and” unless the context clearly indicate otherwise. The word “or” means any one member of a particular list and also includes any combination of members of that list.
“Biomimetic materials” refers to materials which act to emulate properties from a natural biological environment. Such materials may be selected based on one or more characteristics, including, for example, ability to maintain the mechanical and electrical properties of the native tissue, direct cell and tissue orientation, deliver particular drugs and growth factors, and degrade in response to enzymes secreted by cells. Furthermore, these materials can be selected based on ability to promote cell adhesion, mechanical stretch and electrical conduction. Overall, biomimetic materials can be engineered or selected to produce functional tissue with highly controlled, defined properties. Examples of biomimetic materials include natural materials and synthetic materials. Natural materials include, but are not limited to, materials derived from proteins, polysaccharides, and other derivatives of these substances, such as, for example, collagen, gelatin, glycosaminoglycans (e.g. hyaluronic acid), elastin, fibronectin, laminin, fibrin, and alginates. Synthetic materials include temporally-changing or externally-modifiable materials that can be engineered to provide biomimetic properties that facilitate cardiac regeneration. Materials that fall into this category are unique in their ability to change structure based on changes in input (temperature, pH, photoactive, mechanical/electrical stress hydrogels, environmentally-responsive polymers, and conductive materials.
The term “crosslink” refers to a bond or chain of atoms attached between and linking two different polymer chains.
“Endothelialized” and “endotheliazation” refer to formation of a coating layer of endothelial cells. Endotheliazation may include protecting underlying materials or large vessels that have sustained damage, such as from blood flow, and may also include prevention of restenosis by inhibiting overgrowth of other cell types, particularly in the case of stents and other implants.
“Enriching,” as the term is used herein, refers to the process by which the concentration, number, or activity of something is increased from a prior state. For example, a population of 100 ECFCs is considered to be “enriched” in ECFCs if the population previously contained only 50 ECFCs. Similarly, a population of 100 ECFCs is also considered to be “enriched” in ECFCs if the population previously contained 99 ECFCs. Likewise, a population of 100 ECFCs is also considered to be “enriched” in ECFCs even if the population previously contained zero ECFCs.
The terms “graft” and “grafting” generally refer to the attachment or conjugation of two or more materials. With respect to the present invention, grafting refers to any process or method by which a protein or peptide can be attached to a polymer, substrate, matrix or material.
The term “hydrogel” refers to a water-swellable polymeric matrix, consisting of a three-dimensional network of macromolecules held together by covalent crosslinks that can absorb a substantial amount of water to form an elastic gel.
As the term is used herein, “isolated” refers to a polynucleotide, polypeptide, protein, molecule, compound, material or cell of genomic or synthetic origin or some combination thereof which is not associated with all or a portion of the polynucleotides, polypeptides, proteins, molecules, compounds, materials or cells with which the isolated polynucleotide, polypeptide, protein, molecule, compound, material or cell is found in nature, or is linked to a polynucleotide, polypeptide, protein, molecule, compound, material or cell to which it is not linked in nature.
“Maintenance” of a cell or a population of cells refers to the condition in which a living cell or living cell population is neither increasing nor decreasing in total number of cells in a culture. Alternatively, “proliferation” of a cell or population of cells, as the term is used herein, refers to the condition in which the number of living cells increases as a function of time with respect to the original number of cells in the culture.
The term “operably linked” as used herein refers to the joining, coupling, or linking of a peptide to a surface through a wide range of chemistries into an equally large number of different materials. A peptide can be operably linked to a surface, for example, by grafting, bonding, coating, linking, crosslinking, polymerizing, co-polymerizing, or integrating. For example, one or more peptides may be incorporated into a substrate material as the substrate material is being formed, such as incorporation into a nanofibrous matrix or a multilayer vascular graft.
The term “PEG” as used herein refers to poly(ethylene glycol).
The phrase “pluripotent stem cells” (PSCs) refers to stem cells that have the potential to differentiate into any of the three germ layers: endoderm (interior stomach lining, gastrointestinal tract, the lungs), mesoderm (muscle, bone, blood, urogenital), or ectoderm (epidermal tissues and nervous system). PSCs of the present invention include embryonic PSCs and induced PSCs, which are derived from a non-pluripotent cell, typically an adult somatic cell, generated by any method known in the art, including, for example, through introduction or activation of specific transcription factors and/or genes.
As the term is used herein, “population” refers to two or more cells.
The term “physiological shear” refers to the frictional force tangential to the direction of a flowing fluid, the force of which is directly related to the fluid's viscosity shear stress. In blood vessels, shear stress acts on endothelium and is the mechanical force responsible for the acute changes in luminal diameter.
A “somatic cell” is understood to be a biological cell ordinarily found in a multicellular organism that is not a gamete, germ cell, gametocyte, or undifferentiated stem cell. Somatic cells include cells of the endoderm (interior stomach lining, gastrointestinal tract, the lungs), mesoderm (muscle, bone, blood, urogenital), and ectoderm (epidermal tissues and nervous system).
“Substantially homogeneous,” as the term is used herein, refers to a population of a substance that is comprised primarily of that substance, and one in which impurities have been minimized.
“Vascularization” is the process of new blood vessel formation, including vessel formation to support wound healing, perfusion of engineered tissues.
In one aspect, the present invention involves compositions for inducing rolling and stopping of immature endothelial cells. In a further aspect, the compositions are effective for cellularization, specifically endothelialization and vascularization. In one aspect, the compositions comprise a substrate to which is grafted two or more peptides or proteins that mediate rolling, capture, and support of immature endothelial cells under physiological shear.
Peptides and proteins suitable for the compositions and methods of the present invention are generally adhesion ligand peptides and peptides capable of binding integrins. In a further aspect, the proteins and peptides are capable of binding to α5β1, α4β1, or αvβ3 cell surface integrin. In one embodiment, the proteins or peptides comprise one or more proteins or peptides capable of binding to α5β1 or αvβ3 cell surface integrin, and one or more proteins or peptides capable of binding α4β1. In another embodiment, the proteins or peptides are selected from the group consisting of CRRETAWAC (SEQ ID NO:1), YIGSRG (SEQ ID NO:4), REDV (SEQ ID NO:2), RGDS (SEQ ID NO:3), P11 (SEQ ID NO: 11), and PRb (SEQ ID NO: 8). In an even more preferred embodiment, the compositions and methods of the present invention involve two or more peptides, most preferably comprising CRRETAWAC (SEQ ID NO:1) and REDV (SEQ ID NO:2) or PRb (SEQ ID NO: 8), and REDV (SEQ ID NO:2). In a further aspect, proteins and peptides of the invention include proteins and peptides that incorporate any of CRRETAWAC (SEQ ID NO:1), YIGSRG (SEQ ID NO:4), REDV (SEQ ID NO:2), RGDS (SEQ ID NO:3), P11 (SEQ ID NO: 11), and PRb (SEQ ID NO: 8).
According to one aspect of the invention, the compositions and methods include a substrate (i.e. a surface, matrix or material) operably linked to one or more of the peptides described herein. In one further aspect, the substrate can be a polymer compatible with cellular vascularization. In another aspect, the substrate is a biomimetic matrix or material, including materials suitable for use in medical devices or implants, including but not limited to vascular grafts.
In one aspect, the substrate can be a synthetic polymer-based material, such as expanded poly(tetrafluoroethylene) and poly-(ethylene terephthalate) (Dacron). In another aspect, biomimetic materials for use in the present invention include biomaterials that can be engineered or selected to produce functional tissue with highly controlled, defined properties. Examples of biomimetic materials include natural materials and synthetic materials, or a combination of natural materials and synthetic materials. Examples of biomaterials can be found in U.S. Pat. No. 8,691,276, titled “Extracellular matrix-derived gels and related methods” which is incorporated herein in its entirety. Natural materials include, but are not limited to, materials derived from proteins, polysaccharides, and other derivatives of these substances, such as, for example, collagen, gelatin, glycosaminoglycans (e.g. hyaluronic acid), elastin, fibronectin, laminin, fibrin, and alginates. Synthetic materials include temporally-changing or externally-modifiable materials that can be engineered to provide biomimetic properties that facilitate cardiac regeneration. Examples of biomimetic materials include, but are not limited to, polycaprolactone (PCL), poly(glycolic acid) (PGA), poly-4-hydroxybutyrate (P4HB), poly (lactic acid) (PLA) and poly(lactic-co-glycolic acid) (PLGA), poly(glycerol-sebacate) (PGS), poly(trimethylene carbonate-co-lactide), polyester urethane urea (PEUU) 129, Pluronic F127/GelMA, HA/N-cadherin mimetic peptides, MaHA/MMP-degradable crosslinker/BMP-2, fibrin/PDGF-BB/BMP-2, PEGDMA, expanded polytetrafluoroethylene (ePTFE), poly(ethylene terephthalate) (PET) and polyurethanes (PU), biodegradable polymers such as poly(lactide-co-glycolide), poly(ethylene glycol)-b-poly(L-lactide-coe-caprolactone) and polydepsipeptides, polyurethane and combinations thereof; and copolymers of natural and synthetic materials. Materials that fall into this category are unique in their ability to change structure based on changes in input (temperature, pH, photoactive, mechanical/electrical stress hydrogels, environmentally-responsive polymers, and conductive materials). Other artificial extracellular matrix proteins that can be used for, or compose part of, substrates of the present invention include recombinant cellulose-binding domain (CBD)-RGD fusion protein, GFOGER.
In another aspect, the substrate comprises natural polymers and biomimetic materials. Natural polymers include ECM-derived collagen, fibronectin, laminin, hyaluronic acid, and vitronectin. An exemplary natural or synthetic biomimetic material includes hydrogels. Hydrogels are insoluble, cross-linked polymer network structures composed of hydrophilic homo- or hetero-co-polymers, which have the ability to absorb significant amounts of water. Consequently, this is an essential property to achieve an immunotolerant surface and matrix (i.e., with respect to protein adsorption or cell adhesion). Due to their significant water content, hydrogels also possess a degree of flexibility very similar to natural tissue, which minimizes potential irritation to surrounding membranes and tissues. In general, hydrogels are strong hydrophiles, capable of supporting nutrient transport and controlled degradation to allow for cell proliferation, generally composed of self-assembling materials, namely peptide amphiphiles. Hydrogels are highly absorbent (they can contain over 90% water) natural or synthetic polymeric networks. Hydrogels also possess a degree of flexibility very similar to natural tissue, due to their significant water content. Hydrogels for use in the present invention include both entangled hydrogels and covalently linkable hydrogels. In a further aspect, covalently-linkable hydrogels are used as the biomimetic material based on advantageous characteristic, including, for example, the ability to reproducibly form three-dimensional structures using molds or deposition techniques. Covalently-linkable hydrogels include all aqueous-based covalently-linkable hydrogels, including all hydrogels formed from natural polymers and hydrogels formed from synthetic polymers. Covalently linkable hydrogels also include PEG-based (polyethylene glycol) and non-PEG-based polymers; non-PEG-based hydrogels include both natural and synthetic hydrogels. In a most particular aspect, hydrogels of the present invention can be composed of PEGylated fibrinogen, where the naturally occurring component fibrinogen is directly coupled to acrylated PEG to form PEG-fibrinogen. In another aspect, the biomimetic material of the present invention can be an acrylated gelatin.
In certain aspects, the substrate may comprise decellularized extracellular matrix (dECM), such as decellularized ovine pulmonary heart valve cusps (dPVCs) and decellularized rat aortic grafts (dAoGs).
In one aspect, the methods of the present invention can include modulation of the mechanical properties of a hydrogel for different types of cells and/or tissues. In addition, the methods can use state-of-the-art soluble factors and/or media formulations to drive formation of a variety of somatic cells and tissues. In one aspect, the methods can be used to generate cardiac cells or tissues. In another aspect, for example, the methods can be used to generate neural tissue formation, using similar PEG-fibrinogen crosslinking density and/or mechanical properties as those used for production of cardiac cells and tissues, but different soluble factors and media formulation. The density and crosslinking properties of PEG-fibrinogencan be varied by one or more of the following: crosslinking time/light intensity, concentration of PEG-fibrinogen, inclusion of a porogen (e.g. gelatin beads), or addition of 1% or 2% PEG-diacrylate (with or without a matrix metalloproteinase degradable peptide segment, such as acryl-PEG-degradable_peptide-PEG-acryl).
The compositions of the present invention may comprise additional elements that can aid in cell capture, cell support, and/or cell maintenance. Additional components include additional cell adhesion peptides, such as RGDS (SEQ ID NO:3) and YIGSRG (SEQ ID NO:4), heparin, fibrinogen/fibrin, fibronectin, collagen/gelatin, albumin, laminin, the tripeptide Arg-Gly-Asp (RGD), stem cell factor (SCF; c-kit ligand), and CXCR2 ligand. The compositions may also include additional peptides for binding outgrowth endothelial cells, as described in U.S. Pat. No. 8,426,367.
In a further aspect of the invention, the peptides described herein are operably linked to the surface of the substrate. In one embodiment, the peptides can be operably linked to the substrate by incorporation into the substrate material. In another aspect, the peptides can be operably linked to the substrate through grafting, including by any method known in the art, such as various physical, chemical, and biofunctionalization techniques, which can also be combined. For example, the grafting can be passive adsorption or covalent grafting. Physical and chemical modification can be used to influence protein and peptide adsorption. Proteins and peptides can also be grafted to the substrate surface using biofunctionality, including passive coating, covalent linking, and presenting peptide linkers to sequence specific peptides from the environment. Chemical modifications that may be used for coupling proteins or peptides to substrates are summarized in Table 1.
In another aspect, the present invention involves methods for capture of immature endothelial cells and support of endothelial cells under physiological shear. In one aspect, a source of endothelial cells is exposed to a substrate that comprises one or more integrin-binding peptides. The peptides can be operably linked to the substrate, for example by grafting to the surface of the substrate, coupling to the substrate, or incorporation into the substrate. Sources of endothelial cells include, immature endothelial cells, endothelial progenitor cells embryonic stem cell-derived endothelial cells, pluripotent stem cell-derived endothelial cells, induced pluripotent stem cell-derived endothelial cells and adult stem cell sources, such as adipose derived stem cells, mesenchymal stem cells, and bone marrow derived stem cells. In a further aspect, sources of immature endothelial cells may include a homogenous population or fraction of cells, or may include a heterologous population of more than one cell type or fraction of cells. The sources of immature endothelial cells may primary endothelial cells, such as primary coronary artery cells, primary aortic endothelial cells, primary pulmonary artery endothelial cells, primary umbilical vein endothelial cells, and primary dermal microvascular endothelial cells, or cell lines such as SK-HEP-1 cells, HUVEC cells, TeloHAEC cells, EA.hy926 cells, TIME cells, NFκB-TIME cells, HMEC-1 cells, HULEC-5a cells. Endothelial cells can be identified or characterized by gene and protein expression (including, for example, CD31, CD105, CD144, ZO-1, and von Willebrand Factor) and endothelial cell functions (including, for example, tubular network formation, acetylated LDL uptake, barrier function, and wound healing).
Sources of immature endothelial cells used in the present invention can also include cells present in or isolated from a subject. Samples that can be obtained from a subject for use in the present invention include blood or blood parts (i.e. cell pellet or cell fractions obtained by density gradient centrifugation), tissue homogenates, or ex vivo expanded cell populations derived from a sample. The samples can be enriched for immature endothelial cells, for example, by fractionation, density gradient centrifugation, flow cytometry, cell sorting, and the like.
In a further aspect, the methods involve capture of immature endothelial cells by the peptides or proteins grafted to the substrate. Capture is carried out by exposing the cells to the substrate bearing the peptides under conditions that will permit cell attachment to the substrate. In one embodiment, immature endothelial cells are seeded directly onto the substrate. The cells can be seeded at 1,000-100,000 cells/cm2, depending on the source of endothelial cells. For example, a cell fraction obtained from blood may require a higher seeding density, while a population of cells obtained by primary cell culture may require a lower seeding density, due to the relative numbers of immature endothelial cells present in each source. In another aspect, the exposure may occur under fluid flow conditions. In one embodiment, the cells and substrate may be subjected to physiological shear.
In another aspect, the present methods can be used to capture immature endothelial cells in vivo. Thus, the source of immature endothelial cells may be the blood of the subject in vivo.
In another aspect, the present invention involves methods for producing substrates or materials that selectively bind endothelial progenitor cells. In a particular aspect, the methods comprise providing a substrate. The substrate or material can be composed of any substance that will support cell capture and maintenance, including polymers, hydrogels, and other biomimetic matrices and materials, as discussed herein. In one embodiment, the substrate is a material suitable for a medical device or implant, such as a biomimetic material. In another embodiment, the substrate is a polymer for coating for an implant or medical device.
The methods further comprise operably linking one or more peptides to the surface of the substrate. In one aspect of the methods, the proteins and peptides of the present invention are grafted to the surface of a substrate. Grafting of the proteins of peptides can be accomplished through any process or method known in the art, including, for example, incorporating the peptides into the substrate material, or crosslinking, photocrosslinking, bioconjugation, and polymerization. In an exemplary embodiment, proteins or peptides may be grafted to the surface of a PEG hydrogel by conjugation of the protein or peptide to acryloyl-PEG-SVA to produced PEG-peptides, which may then be incorporated into the surface of the PEG hydrogel through polymerization of the PEG. In another embodiment, the proteins or peptides are incorporated into the substrate material, such as by incorporation into a nanofibrous matrix or multilayer vascular graft. In another embodiment, the proteins or peptides are incorporated into a coating that is placed onto a substrate, for example an implant or medical device.
Substrates that can be used for methods of the present invention include polymers as described herein, as well as matrices and materials, and especially biomimetic materials that form medical devices or implants. In one aspect, the substrate can be a coating on a material or matrix, for example a PEG hydrogel coating on the surface of a polymer. In another aspect, the substrate can be a biomimetic material, such that no coating is required for grafting of the proteins or peptides.
In a further aspect, substrates can include surfaces and channels for in vitro testing devices, such as microfluidic chips, and materials that support vascularization such as for use in engineered tissues.
In yet another aspect, the compositions of the present invention may be applied to medical implants or devices. Medical implants according to the present invention are preferably vascular grafts, including stents, shunts, and valves. In one aspect, a polymer compatible with cellular vascularization is applied to or coupled to a surface of a medical implant or device that is comprised of a matrix or material. The application of a polymer to the matrix or material forming the medical implant or device can be, for example, through incorporation of the peptides into the polymer material. Preferred applications include the augmentation of existing systems and/or polymers for medical device and implant coatings, which are in long-standing commercial use. These existing systems and polymers fail frequently, due in many cases to large extent as a results of lack of endotheliazation. Additional long-term applications include use in tissue engineered products. The application of a polymer to the matrix or material forming the implant or medical device can also be, for example, through interfacial photopolymerization with the matrix or material. Matrices or materials for medical devices or implants can include those intended for tissue engineering, including biomimetic materials. Specific applications include vascular grafts, vascularization of synthetic biomaterial, and next generation stenting.
To support vasularization and vascular re-endothelialization and vascular re-endotheliazation, the compositions may comprise materials currently used for intravascular materials. Materials used in vivo to support vascularization and re-endotheliazation include biomimetic materials that are able to maintain adherent cells on their surfaces under physiological shear stress, support migration and proliferation of mature endothelial cells from the ends of the lesion, and provide appropriate ligands for the rolling and eventual firm adhesion of endothelial colony forming cells (ECFCs). In a further aspect, therefore, the medical implants of the present invention may further comprise two or more peptides and combinations of peptides as described herein. Inclusion of the peptides significantly increase the capture rate of ECFCs under shear. The combination of peptides includes an ECFC slowing peptide and an ECFC capturing peptide. The peptides may be one or more of CRRETAWAC (SEQ ID NO:1), REDV (SEQ ID NO:2), RGDS (SEQ ID NO:3), YlGSRG, P11 (SEQ ID NO: 11), and/or PRb (SEQ ID NO: 8). In a preferred embodiment, the peptides are directly incorporated into a polymer, which is in turn applied to or coupled to the matrix or material forming the medical device or implant. Alternatively, the peptides can be grafted to the matrix or material forming the medical device or implant.
In one aspect, the matrix or material used for the medical device or implant comprises a nanofibrous matrix comprising two different peptide amphipiles (PAs), which can include one or more of the peptide described herein, such as REDV (SEQ ID NO:2). PBr (SEQ ID NO: 8), and/or CRRETAWAC (SEQ ID NO:1). In an alternative embodiment, a multilayer vascular graft may include a one or more of the described peptides conjugated into a poly(ethylene glycol) (PEG) hydrogel to generate bioactive hydrogels that bind to endothelial cells (ECs). The peptide-incorporating hydrogel may be reinforced with an electrospun polyurethane mesh to achieve suitable biomechanical properties. A functional small-caliber vascular graft must have suture retention strength sufficient for immediate implantation as well as requisite long-term burst strength. In addition, graft compliance is not only important in matching the physical and bulk mechanical characteristics of native arteries; it has a large effect on preventing reocclusion of grafts. As mesh thickness is increased, the maximum force that can be sustained, or suture retention strength in this case, increases. Mesh thickness has a similar effect on burst pressure of vascular grafts.
In a preferred embodiment, electrospinning may be utilized for fabricating the segmented polyurethane mesh sleeve because this process produces fibrous, porous scaffolds with mechanical properties which can be broadly tailored via modification of electrospinning parameters. The ability to tune the biomechanical properties of electrospun segmented polyurethanes to improve matching to those of native vasculature is important in preventing intimal hyperplasia and thrombosis-induced failure in small diameter grafts.
In another aspect, the present invention involves vascularization of engineered tissues and biomimetic materials. The compositions of the present invention can be applied to implants and medical devices, which are then exposed to endothelial cells. The implants and or medical devices are then incubated with the endothelial cells under conditions that permit blood vessel formation. Such conditions may occur in vitro, through cell and tissue culture, or in vivo, through implantation.
In a further aspect the invention involves in vitro applications of the described compositions and methods. In one aspect, the described peptides can be integrated onto microfluidic chips, which can be used for drug testing devices. Incorporation of the peptides onto such microfluidic chips can be performed as described elsewhere for other substrates. In addition, it is contemplated that the integration can be through processes such as protein “printing” and 3D printing. In a further aspect, the chips can the undergo endotheliazation, to produce chips operably linked to endothelial cells to allow the devices to test drug response.
In another aspect the compositions and methods of the invention can be used for cell capture and diagnosis techniques. In one aspect, the proteins and peptides and be used for targeted delivery to ECFCs, for example for delivery of cancer therapeutics. The proteins or peptides can be operably linked to a drug-delivery system, such as a particle, nanosphere, or liposome, allowing for specific targeting of endothelial cells, including ECFCs. In another aspect, the compositions can be applied to methods of sorting or separating endothelial cells from a mixed population of cells, for example through magnetic affinity cell sorting (MACS). The proteins or peptides can be operably linked to magnetic nanoparticles to preferentially attach to the endothelial cells expressing the molecule to which the proteins or peptides bind. In another aspect, the described compositions can be used for diagnostics, for example through identification of specific cells that bind the proteins or peptides as described. The proteins or peptides can be conjucated to a marker or indicator, such as streptavidin or a fluorophore, which allows for specific detection. Cells to which the conjugated proteins or peptides bind can then be readily detected using known techniques.
In this study, late outgrowth endothelial colony forming cells (ECFCs), a type of EPCs, were investigated based on their advantages for use in endothelialization; ECFCs can be isolated from adult blood, they proliferate rapidly, and they can become mature ECs. Poly(ethylene glycol) diacrylate (PEG-DA) was chosen as the base material to test ECFC dynamic adhesion; PEG-DA is able to resist protein adsorption and therefore served as a “blank slate” for testing adhesion ligands. Peptides, including RGDS (SEQ ID NO:3), REDV (SEQ ID NO:2), YIGSRG (SEQ ID NO:4), CRRETAWAC (SEQ ID NO:1), P11 (SEQ ID NO: 11), PR_b (SEQ ID NO: 8), and RGES (SEQ ID NO:5), were grafted on the surface of the PEG-DA hydrogels. Interactions between ECFCs and the peptides were assessed in two ways: dynamic adhesion and maintenance of adhesion under shear. Through observation and quantification of ECFC rolling and retention on peptide grafted hydrogels under shear, dynamic and static adhesion between ECFCs and peptides was evaluated.
Umbilical cord blood ECFCs were used in this study. To create the peptide-grafted PEG surfaces, PEG-DA was first photopolymerized to form a hydrogel base. Peptides were conjugated to acryloyl-PEG-SVA to produced the PEG-peptides, and 0.7 μmol/mL of each PEG-peptide was grafted onto the surface of the PEG hydrogel base. Shear experiments were performed to examine ECFC rolling and adhesion on the hydrogel surfaces. Using a Glycotech parallel plate flow chamber, the ECFC cell suspension was sheared over the hydrogels at shear rates of 20 s−1, 40 s−1, 80 s−1, and 120 s−1. Cell rolling events were recorded at 70 fps using a high speed camera. Cell tracking was performed using ImageJ and Matlab to determine rolling velocities. Finally ECFC retention on the RGDSQ ID NO:3)-grafted PEG hydrogels was quantified under superphysiological shear stress.
Peptides, either synthesized or purchased (American Peptide), were first conjugated to acryloyl-PEG-succinimidyl valerate (acryloyl-PEG-SVA, 3400Da; Laysan Bio) and then grafted onto PEGDA hydrogels. Peptides, including RGDS (SEQ ID NO:3), RGES (SEQ ID NO:5), RGDSHHHHHHG (SEQ ID NO:14), YIGSRG (SEQ ID NO:4), and REDV (SEQ ID NO:2), were first dissolved in sodium bicarbonate buffer (0.04 mg/μL, pH 8.5). Acryloyl-PEG-SVA was then dissolved in 1 mL of 50 mm sodium bicarbonate buffer (pH 8.5) for every 10 mg of peptide to be reacted. The final peptide:acryloyl-PEG-SVA molar ratio was 1.2:1. The peptide solution was immediately added dropwise to the acryloyl-PEG-SVA solution with mild vortexing. The mixture was allowed to react for 4 hrs at room temperature in the dark with constant mixing. The resulting acryloyl-PEG-peptide was then dialyzed (molecular weight cutoff 500-1,000, Spectrum Labs) and lyophilized for storage under argon at −80° C. in a brown glass vial.
Peptide synthesis was confirmed by mass spectrometry. A small amount of peptide (<1 mg) was dissolved in 10% acetonitrile and 0.1% formic acid injection solution. Result mass was obtained using Q-TOF Premier (Waters, Milford, Mass.) and shown in Appendix A.
To form the PEG-peptide grafting solution, the acryloyl-PEG-peptide was first dissolved in sterile PBS at the desired concentration (ranging from 0.7 mM to 5.6 mM) and the photoinitiator was added as described above. After each PEGDA hydrogel was photocrosslinked, the top plate of the mold was removed. The hydrogels were rinsed with sterile PBS and briefly dried with a stream of nitrogen to remove excess PBS on the surface of the hydrogel. The mold's 0.5 mm PDMS spacers were replaced with 0.7 mm PDMS spacers and a clean glass slide was placed on top. Then the PEG-peptide grafting solution was injected between the hydrogel and the new piece of glass and photocrosslinked to the top of the PEGDA hydrogel under the UV lamp for 7 mM. PEG-peptide grafted hydrogels were then rinsed and swollen in sterile PBS for experiments.
ECFCs were able to form monolayer and maintain cobble stone morphology on RGDS (SEQ ID NO:3), CRRETAWAC (SEQ ID NO:1) and PR_b (SEQ ID NO: 8), grafted hydrogels, but not on REDV (SEQ ID NO:2), YIGSRG (SEQ ID NO:4), and P11 (SEQ ID NO: 11). Rolling velocity of ECFCs was shown to relate to shear rates and adhesion material surface. ECFC rolling velocities increased as shear rates increased up to 120 s−1 (
All tested bioactive peptides supported ECFC rolling, whereas PEG-DA alone and RGES (SEQ ID NO:5) did not. PEG-DA was shown to be a viable “blank slate” base material for testing the ability of grafted ligands, including PEG-peptides, to interact with rolling ECFCs. Results demonstrated the ability of α4β1 integrin-specific peptide REDV (SEQ ID NO:2) to significantly reduce ECFC rolling velocity as compared to other tested peptide sequences. Capture on CRRETAWAC (SEQ ID NO:1) and PRb (SEQ ID NO: 8), suggests that α5β1, rather than αvβ3, is the major integrin that is responsible for ECFC capture under shear. CRRETAWAC (SEQ ID NO:1) was found to be superior in capturing rolling ECFCs under shear, and this effect was enhanced by the combination of REDV (SEQ ID NO:2). Results of this study could be applied in the design of biomaterials for stent coating and vascular grafts to enhance endothelialization and improve EPC strength of adhesion under shear.
Pepbank is a useful text mining tool that was developed to identify peptide sequences in MEDLINE abstracts and two public sources ASPD and UniProt. With this searching tool, peptides that are relevant to target integrins can be researched. When both integrins α5β1 and αvβ3 are blocked, EPC adhesion was significantly reduced. Therefore, it is important to identify peptides that bind to these integrins. Initially, 47 and 88 hits were obtained for α5β1 and αvβ3, respectively. Almost all RGD- and PHSRN (SEQ ID NO:9)-containing peptides were excluded from the results since RGD is a ubiquitous peptide while PHSRN (SEQ ID NO:9) is a well-known synergistic peptide that works together with RGD. For peptides that bind α5β1, VILVLF (A5-1; SEQ ID NO:21), and -(C16)2-Glu-C2-KSSPHSRNSGSGSGSGSGRGDSP (SEQ ID NO:8) (PR_b) were selected for further testing. HSDVHK (SEQ ID NO:11) (P11) and NCKHQCTCIDGAVGCIPLCP (SEQ ID NO:12) (V2) were selected for αvβ3 testing.
VILVLFG (SEQ ID NO:15) was synthesized using standard procedures. Mass spectrometry was used to confirm the synthesis.
Some alterations in the sequence of the peptide and extra reactions were involved in the testing of CRRETAWAC (SEQ ID NO:1), compared to work previously conducted. In prior studies, the peptide sequence GSSS (SEQ ID NO:16) was added at the N-terminus of CRRETAWAC (SEQ ID NO:1) to extend the peptide further away from the substrate interface. In this project, all peptides were coupled to the acryloyl-PEG that serves as the spacer arm, so GSSS may not be necessary. Therefore, the original peptide CRRETAWAC (SEQ ID NO:1) was synthesized for testing in the present work, instead of GSSSCRRETAWAC (SEQ ID NO:7). In order to create the disulfide bridge to form the cyclic CRRETAWAC (SEQ ID NO:1) peptide, Fmoc-Sacetaminomethyl-L-cysteine (Fmoc-Cys(Acm)) was used during the peptide synthesis because the Acm protection group is stable during TFA cleavage. The disulfide bridge can be formed subsequent to cleavage with iodine oxidation as suggested by aapptec. The peptide was dissolved in 2 mg/mL of 50% acetic acid. Then the peptide solution was added into 50 mL of 0.1 M iodine solution in acetic acid. The mixture was then stirred until the yellow color persists. Aqueous ascorbic acid was added drop-wise to quench the excess iodine until the mixture is colorless. The mixture was placed in rotavap to concentrate by evaporation to approximately one third of the original volume. Mass spectrometry was used to confirm the production of the peptide and the cyclic CRRETAWACG (SEQ ID NO:17) should have a molecular weight of 1150 g/mol. However, the cyclized CRRETAWACG (SEQ ID NO:17) (1150 g/mol) was only the minor product whereas the major products were shown to be 1221 g/mol and 1292 g/mol which correspond to the peptide with a single and double Acm protection groups present. After extra iodine oxidation procedures were followed, similar results were obtained. Therefore, the peptide CRRETAWAC (SEQ ID NO:1) (instead of CRRETAWACG (SEQ ID NO:17)) was purchased from American Peptide with >95% purity. Formation of disulfide bonds between the cysteine residues was completed by manufacturer as requested.
Regarding to the original PRb peptide, the C16 hydrophobic tail, glutamic acid tail connector, and the -C2-tail spacer will be discarded to reduce peptide synthesis complexity. As a result, PHSRNSGSGSGSGSGRGDSG (SEQ ID NO:18) (PRb) was synthesized under standard procedures. Mass spectrometry was used to confirm the synthesis.
HSDVHKG (SEQ ID NO:19) was synthesized under standard procedures. Mass spectrometry was used to confirm the synthesis.
NCKHQCTCIDGAVGCIPLCPG (SEQ ID NO:20) (V2) was synthesized under standard procedures, which in this sequence identifier includes the G residue from which the peptide was built. Mass spectrometry was used to confirm the synthesis. However, the peptide was not readily to be dissolved in aqueous injection solution for mass spectrometry analysis. Furthermore, many unexpected by-products were present. Therefore, the V2 peptide was excluded in this study due to the inability to accurately synthesize the peptide.
CRRETAWAC (SEQ ID NO:1), PRb (SEQ ID NO:18), and HSDVHKG (SEQ ID NO:19) were conjugated to PEG as described in Example 1. Mass spectrometry was used to confirm the conjugation. While attempting with the PEG-peptide conjugation under organic solvents as suggested by the existing art, A5-1 peptide precipitated immediately after the addition of DIPEA, which acts as a base catalyst. Therefore, A5-1 was excluded in this study due to the inability to conjugate to acryloyl-PEG for grafting.
Adhesion of ECFCs on CRRETAWAC (SEQ ID NO:1)-, PRb (SEQ ID NO:18)-, P11 (SEQ ID NO: 11)-grafted hydrogels was first accessed. Both CRRETAWAC (SEQ ID NO:1) and PRb supported ECFC adhesion and spreading. ECFCs were also able to form a monolayer and maintain their cobble stone morphology (as shown in
ECFC rolling was performed on novel peptide-grafted hydrogels and the results were compared to RGDS (SEQ ID NO:3), REDV (SEQ ID NO:2), and YIGSRG (SEQ ID NO:4)-grafted hydrogels (
Cell capture events were consistently observed on CRRETAWAC (SEQ ID NO:1)- and PRb (SEQ ID NO:18)-grafted hydrogels at 20 s−1. Number of captured cells were counted and normalized to the total number of cells interacted with each hydrogel surface. During each of the 2 min recordings, 3.74%±1.0% of ECFCs were captured on CRRETAWAC (SEQ ID NO:1)-grafted hydrogels and 1.14%±0.2% of ECFCs were captured on PRb-grafted hydrogels
To further evaluate the potential use of CRRETAWAC (SEQ ID NO:1) and PRb in the ECFC capture for endothelialization, ECFC rolling on hydrogels that were grafted with combinations of CRRETAWAC (SEQ ID NO:1) or PRb (SEQ ID NO:18) with REDV (SEQ ID NO:2) was assessed. In order to maintain consistent grafting of peptides, a final concentrations of 0.7 μmol/mL of equal molar mixtures of acryloyl-PEG-peptides precursors were grafted onto the surface of PEG hydrogels. Hydrogels grafted with REDV (SEQ ID NO:2)/CRRETAWAC (SEQ ID NO:1) combination (0.35 μmol/mL of REDV (SEQ ID NO:2)/0.35 μmol/mL of CRRETAWAC (SEQ ID NO:1)) had significantly increased ECFC capture of 13.4%±2.3% as compared to CRRETAWAC (SEQ ID NO:1) alone (
As REDV (SEQ ID NO:2) has a significantly positive effect on enhancing the ability of CRRETAWAC (SEQ ID NO:1) to support ECFC capture, it has a negative effect on PRb's (SEQ ID NO:18) ability to support ECFC capture (
Novel peptides were selected to evaluate their capability in slowing and capturing EPCs. Pepbank was used to identify peptides that have high affinity and/or selectivity for the integrins α5β1 and αvβ3. Although these peptides have shown great promise in cell adhesion, their performance in cell rolling and capture under shear is yet to be evaluated. Although five peptides were identified, three were assessed due to the success in synthesis and conjugation to acryloyl-PEG. Assessment of CRRETAWAC (SEQ ID NO:1) and PRb (SEQ ID NO: 8 or 18) showed that α5β1 is the major integrin that is responsible for ECFC capture under shear. CRRETAWAC (SEQ ID NO:1) was found to be superior in capturing rolling ECFCs under shear, and this effect was enhanced by the implementation of REDV (SEQ ID NO:2). PRb also has potential in capturing ECFCs, although its capturing ability was not observed when implementing REDV (SEQ ID NO:2). This illustrates the importance of the peptide length in biomaterial design.
To identify whether a cell is rolling, the upper velocity cutoff was determined by flowing ECFCs across the surface of control PEG hydrogels at different shear rates. Using video recordings, ECFC rotation on the focal plane of PEG hydrogels was observed. As shown in
ECFC rolling on RGDS (SEQ ID NO:3)-grafted hydrogels was performed and compared to both PEG hydrogels and RGES (SEQ ID NO:5)-grafted hydrogels. RGDS (SEQ ID NO:3) is a ubiquitous cell adhesion peptide, whereas RGES (SEQ ID NO:5) does not support cell adhesion and served as a control peptide. Velocities of ECFCs on RGES (SEQ ID NO:5) showed no significant difference as compared to control PEGDA hydrogels. On the other hand, velocities of ECFCs on RGDS (SEQ ID NO:3)-grafted hydrogels were significantly decreased as compared to ECFC velocities on RGES (SEQ ID NO:5)-grafted hydrogels at all shear rates. As shown in
In addition to PEG-RGDS (SEQ ID NO:3), PEG-YIGSRG (SEQ ID NO:4) and PEG-REDV (SEQ ID NO:2) grafted hydrogels also supported ECFC rolling. YIGSRG (SEQ ID NO:4) and REDV (SEQ ID NO:2) are peptides known to preferentially interact with ECs. Rolling velocities on YIGSRG (SEQ ID NO:4) were similar to rolling velocities on RGDS (SEQ ID NO:3); specifically, the ECFC rolling velocities on PEG-YIGSRG (SEQ ID NO:4) grafted hydrogels were 102±9 μm s−1, 223±22 μm s−1, 484±12 μm s−1, and 740±10 μm s−1 at 20 s−1, 40 s−1, 80 s−1, and 120 s−1, respectively. Surprisingly, PEG-REDV (SEQ ID NO:2) grafted hydrogels reduced ECFC rolling velocities substantially more than either RGDS (SEQ ID NO:3)- or YIGSRG (SEQ ID NO:4)-grafted hydrogels (
The above specification provides a description of various methods of generating three-dimensional cell cultures or tissues, compositions of the same, methods of use, treatment and diagnosing. Since many embodiments can be made without departing from the spirit and scope of the invention, the invention resides in the claims.
This application is a continuation of U.S. application Ser. No. 15/099,582, filed Apr. 14, 2016, which claims priority under 35 U.S.C. § 119 to provisional application Ser. No. 62/147,215 filed Apr. 14, 2015, each are incorporated by reference in their entireties.
This invention was made with government support under NSF-CBET-1150854 awarded by National Science Foundation, and 14SDG18610002 awarded by the American Heart Association. The government has certain rights in the invention.
| Number | Date | Country | |
|---|---|---|---|
| 62147215 | Apr 2015 | US |
| Number | Date | Country | |
|---|---|---|---|
| Parent | 15099582 | Apr 2016 | US |
| Child | 16743574 | US |
