Human erythropoiesis is a complex multistep process that involves the differentiation of early erythroid progenitors to mature erythrocytes. globin chain specific immunofluorescent analysis showed that this cells increased expression of -globin (from 0% to > 16%) after in vitro culture. Importantly, the cells underwent multiple maturation events, including a progressive decrease in size, increase in glycophorin A expression, and chromatin and nuclear condensation. This process resulted in extrusion of the pycnotic nuclei in up to more than 60% of the cells generating red blood cells with a diameter of approximately 6 to 8 8 m. The results show that it is feasible to differentiate and mature hESCs into functional oxygen-carrying 149709-62-6 manufacture erythrocytes on a large scale. Introduction Human embryonic stem cells (hESCs) can be propagated and expanded in vitro indefinitely, providing a potentially inexhaustible and donorless source of cells for human therapy. Hematopoietic differentiation of hESCs has been extensively investigated in vitro, and hematopoietic precursors as well as differentiated progeny representing erythroid, myeloid, macrophage, megakaryocytic, and lymphoid lineages have been identified in differentiating hESC cultures.1C8 Previous studies also generated primitive erythroid cells from hESCs by embryoid body formation and coculturing with stromal cells.8C10 However, the efficient and controlled differentiation of hESCs into homogeneous red blood cell (RBC) populations with oxygen-carrying capacity has not been previously achieved. Mammalian erythropoiesis is a complex process that involves many actions, including the differentiation of early erythroid progenitors (burst-forming units-erythroid, BFU-E) via late erythroid progenitors (colony-forming units-erythroid, CFU-E), 149709-62-6 manufacture and finally morphologically recognizable erythroid precursors.11 Nuclear condensation is a key event in the late stages of erythropoiesis, and enucleation is the final step in the development of mature erythrocytes, although the molecular and cellular mechanisms involved in these processes are poorly understood. Here we describe an efficient method to generate functional erythroid cells from hESCs under conditions suitable for scale-up. The cells possess oxygen-transporting capacity comparable with normal RBCs and respond to changes in pH and 2,3-diphosphoglycerate. We also show that they undergo a progressive decrease in size, chromatin condensation, and extrusion of the pycnotic nucleus to form enucleated erythrocytes with a diameter similar to normal RBCs. -Globin chain specific antibody analysis showed that more than 16% of the cells after 28 days of culture express the adult 149709-62-6 manufacture -globin chain. Methods Generation and expansion of erythroid cells from hESCs via hemangioblasts Four human ESC lines were used in the current study: H1 (National Institutes of HealthCregistered as WA01), MA01 and MA99 (derived at Advanced Cell Technology), and HuES-3 (established by Cowan et al12 and obtained from the Harvard Stem Cell Institute). hESCs were grown on mitomycin CCtreated mouse embryonic fibroblast (MEF) in total hESC media until they reached 80% confluence. The detailed method for the generation of hemangioblasts (BCs) from hESCs has been described previously.13 A 4-step procedure was used for the generation and expansion of erythroid cells from hESCs. Step 1 1. EB formation and hemangioblast precursor induction (day ?3.5 to 0). To induce hemangioblast precursor (mesoderm) formation, EBs were formed by plating 1 well of hESCs per EB culture well (ultra-low 6-well plates; Corning, Corning, NY) in 3 to 4 4 mL serum-free Stemline media (Sigma-Aldrich, St Louis, MO) with BMP-4, VEGF165 (50 ng/mL each; R&D Systems, Minneapolis, MN), and basic fibroblast growth factor (bFGF, 20 ng/mL; Invitrogen, Carlsbad, CA). Half of the media was refreshed 48 hours later with the addition of stem cell factor (SCF), thrombopoietin, and FLT3 ligand (20 ng/mL each; R&D Systems). Step 2 2. Hemangioblast expansion (days 0-10). After 3.5 days, EBs were collected and dissociated with trypsin. A single cell suspension was obtained by passing the cells through 149709-62-6 manufacture a G21 needle 3 times and filtering through a 40-m filter. After resuspending in Stemline II medium, the cells were mixed with blast-colony growth media (BGM; 5 105 cells/mL) and plated in 100-mm ultra low dishes (10 mL/dish). The cultures were expanded for 9 to 10 149709-62-6 manufacture days in BGM. The addition of 20 ng/mL bFGF and 2 g/mL recombinant tPTD-HoxB4 fusion protein to BGM was found to significantly enhance hematopoietic cell proliferation. HoxB4 protein has been shown to promote hematopoietic development in both mouse and human ESC differentiation systems.14C19 The grape-like blast colonies were usually visible by microscopy after 4 to 6 6 days and expanded rapidly outward. Additional BGM was added to keep the density of blast cells at 1 to 2 2 106 cells/mL. Step 3 3. Erythroid cell differentiation and expansion (days 11-20). At the end of step 2 2, the cell density was often very high ( 2 106/mL). The same volumes of BGM, containing 3 models/mL erythropoietin (Epo; total Epo is usually 6 PTGS2 models/mL) without HoxB4, were added to supplement the existing BGM. The blast cells were further expanded and differentiated into erythroid.