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Lineageconversionofmousefibroblaststopancreaticα-TianjinLiu*1,LiangliangSun2,BeigeJiang3,JinCen1,XiaotaoChen1,ZhaoyunZhang4,QinghuaWang5,XinCheng1,LijianHui*11.InstituteofBiochemistryandCellBiology,InstituteofHealthSciences,ShanghaiInstitutesforBiologicalSciences(SIBS),ChineseAcademyofSciences(CAS)(200031)2.DepartmentofEndocrinologyandMetabolism,ChangzhengHospital,SecondMilitaryMedicalUniversity,Shanghai,PRChina.(200003)3.DepartmentofHepaticSurgery,EasternHepatobiliarySurgeryHospital,SecondMilitaryMedicalUniversity,Shanghai,PRChina.(200438)4.DepartmentofEndocrinologyandMetabolism,HuashanHospital,Shanghai,5.DivisionofEndocrinologyandMetabolism,theKeenanResearchCentreintheLiKaShingKnowledgeInstitute,St.Michael’sHospital,Toronto,Canada.AbbreviatedTitle:InvitroreprogrammingoffibroblasttoendocrineKeyterms:αWordcount:Numberoffiguresandtables:TheseauthorscontributeequallytothisCorrespondingauthorand towhomreprintrequestsshouldbeaddressed:TianjinLiu,PhDInstituteofBiochemistryandCellBiology,InstituteofHealthSciences,ShanghaiforBiologicalSciences(SIBS),ChineseAcademyofSciencesNo.320,RoadYueyang,Shanghai,PRChina,200031ThelaboratoryofL.H.isfundedbyNationalKeyBasicResearchandDevelopmentProgramofChina(2013CB967103),strategicPriorityResearchProgramoftheChineseAcademyofSciences(XDA ),theHundredTalentsProgram( NaturalScienceFoundationofChina( )andNaturalScienceFoundationofShanghaiMunicipality,PRChina(13ZR α-cellsareresponsibleforsynthesizingandsecretingthepeptidehormoneglucagontoelevatetheglucoselevelintheblood.Hence,thedysfunctionofα-cellswillresulttoseverehypoglycemiaandshock.Furthermore,α-cellsarerequiredforislettransplantationtherapyfordiabetes.Recentlystudiesshowα-cellssupportβ-cellssurvivalandareevenabletotrans-differentiatetoβ- caseofdiabetes.However, theunderstanding ofα-cells pathologicalandclinicalapplicationsremainselusiveduetounavailableofmatureα-cells.Herewepresentanewtechniquetogeneratefunctionalα-cells-likecells(iAlphacells).iAlphacellswereconvertedfrommousefibroblastsbytransductionoftranscriptionfactors(TFs)includingHhex,Foxa3,Gata4,Pdx1andPax4,whichcanspecificallyexpressα-cellspecificgenesandsecreteglucagoninresponsetoKclandArgstimulation.iAlphacellspresenttheα-cellsfunctionsinvitroandareabletodisturbthebloodglucoselevelinvivo. TransplantationofiAlphacellsledthenudemicetoinsulin-andincreaseβ-cellsproliferation.Ourstudydemonstratesanovelnewstrategytogeneratefunctionalα-likecellsforthepurposeofdiseasemodelingandregenerativemedicine.Currenttherapiesforthetreatmentoftype1diabetesincludedailyadministrationofexogenousinsulinand,lessfrequently,whole-pancreasorislettransplantation.However,insulininjectionsoftenresultininaccurateinsulindoses,andexposingthepatienttohypoand/orhyperglycemicepisodesthatleadtolong-termcomplications.Transplantationofisolatedisletsorentirepancreasestorecoverdysfunctionofpatient’sislethasyieldedsomepromisingresults(1,2).Withinislets,β-cellssecreteinsulin,whileα-cellssecreteglucagon,andbloodglucosebalancecontrolledbythemisessentialformaintainingenergyhomeostasis.However,limitedavailabilityofhigh-qualityisletdonorshasrestrictedclinicalapplicationsofisletstransplantation(3,4).Therefore,theformationofmature,singlehormone-expressingendocrinecellsincultureremainsamajorhurdle(5).Alternativesourcesofisletshaveattractedgreatattentions(6).Inducedendocrinecellsdifferentiationinvitrohasbeenachievedpreviouslyusingembryonicstemcellsandinducedmulti-potentialstemcells(7-10).However,thesecellsweremalfunctionedandco-expressedmixedpancreatichormonesinvitro.Inaddition,theclinicalusageofpartiallydifferentiatedcellsfromESandiPSmaypresentanunacceptableriskoftumorformation.Thus,theprotocolsofendocrinecellsre-differentiationarerequiredfurtherDynamicchromatinremodelingduringES/iPSdifferentiationwasprovedasarepressorimpairingendocrinecellmaturation(5).Ontheotherhand,reprogramminginducedbytranscriptionfactorsmayfacilitatethefullyconversionofendocrinecellsbyregulatechromatinremodeling.Ithasshownthatforcedexpressionoflineage-specifictranscriptionfactorsdirectlyconvertterminallydifferentiatedcellsintosomeothercell-typelineages(11).Recently,studieshaveshownthatcardiomyocytes,neurons,andhepatocytescanbeinducedfrommousefibroblastsbyover-expressionofdefinedtranscriptionfactors(12-14).Wepreviouslyhavereportedthatover-expressionofHnf1a,gata4andFoxa3canconvertmousefibroblastsintofunctionalhepatocyte-likecells(iHepcells)(12).Also,ithasbeenreportedthatreprogrammingpancreaticexocrinecellstoβ-likecellsbyexpressionofPdx1,Ngn3andMafainvivo(15,16).Therefore,wesupposethatreprogrammingterminaldifferentiatedcellsinvitrocangenerateendocrinecells.Thegenerationoffullydifferentiatedendocrinecells,especiallyα-cells,thatexhibitgenepatternandareabletophysiologicallyregulatehormonesecretioninvitrohasnotyetbeenachieved.Itlargelyimpairsyzingα-cells’roleinpathologicalandclinicalapplications.Inthisstudy,wesetupaprotocolofinvitroconversionofmousefibroblaststofunctional,terminallydifferentiatedendocrinecells.WefoundforcedHhex,Foxa3,Gata4,Pdx1andPax4over-expressioncaninducefibroblastsexpressα-cellspecificgenesandacquiredα-cellsfunctioninvitro,suchcellswerenamediAlphacells.Furthermore,iAlphacellsinthekidneyofnudemiceinduceinsulin-andpromoteβ-cellsproliferation.Basedonthisstudy,iAlphacellscanprovideatoolfordrugdiscovery,diabetesdiseasemodelingandregenerativemedicine.InductionofGcg–producingcellsfrommouseinducedhepatocytes(iHep)andtailtipfibroblasts(TTFs).Ithasbeenreportedthatcellreprogrammingcouldbemoresuccessfulifthestartingcelltypesharesacommondevelopmentalhistorywiththedesiredcelltype(17).Hepatocytesandpancreaticendocrinecellsshareacommonprogenitorcellduringembryonicdevelopment(18).Markedly,hepatocyteshavebeenreprogrammedtoinsulin-positivecellsbyforcedexpressionofPdx1invivo(19).However,itremainsunclearwhetherhepatocytescouldbeconvertedintospecificendocrinecellsinvitro.Fortheproliferationinhibitionofprimaryhepatocytes,weuseiHepcells,whichshowanexpressionprofileandhepaticfunctionclosetothoseofmaturehepatocytes,andiHepcellswereinducedfrommouseTTFbyover-expressionofGata4,Hnf1aandFoxa3andtheinactivationofp19Arf-/-(12).WefirstyzedthepossibilityofendocrinecellsreprogrammingfromiHepcellsinvitro.Wedesignedascreenfortranscriptionfactorscriticalforendocrineinductionusing11pancreatictranscriptionfactors(Fig.Table1).(原圖未提供,請(qǐng)見(jiàn)下表)Table1TranccriptioniHepcellswereinfectedbylentescarryingoneofthecandidatetranscriptionfactors.TheexpressionofendocrinegenesIns2andGcgweremeasuredatday7tomonitortheconversiontopancreaticα-cellsorβ-cells.Notably,themRNAlevelsofGcg(α-cellsspecific)butnotIns2(β-cellswerelargelyinducedinPdx1,HhexandPax4transducedcells(Fig.1b),圖,即原圖中FigindicatingthatiHepcellscanbeconvertedtoglucagon-producingcells.Next,iHepcellsweretransducedwiththecombinationofPdx1,HhexandPax4toenhancesuchconversion.ExpressionsofGcgweresignificantlyincreasedupontransductionofPdx1,HhexandPax4.Moreover,anotherα-cell-markergene,Arxwasalsoincreased(Fig1c).見(jiàn)下圖,即原圖中FigMorphologically,iHepcellsalsotransferedfromtypicalepithelial-likemesenchymal-likewithPdx1,HhexandPax4over-expression(Fig.1d).圖,即原圖中FigSinceiHepcellswerederiveddirectlyfromTTFs,wedeterminedwhetherGcg-producingcellscouldbeacquireddirectlyfromTTFs.Wetransducedp19Arf-/-TTFswithiHepinductionfactors,Gata4,Hnf1aandFoxa3,andPdx1,Hhex,Pax4(collectivelyreferredas6TF),whichcouldformclones14later(Fig1e).見(jiàn)下圖,即原圖中FigGcgmRNAexpressionweredetectedafter6TFsinfection(Fig1f).Fig1g.Wenextremovedindividualfactorsfromthecombination6TF.GcgexpressionincreaseduponremovingofHnf1afrom6TF(Fig.1f).下圖,即原圖中FigHence,wetransducedTTFsbythecombinationtoGata4,Pdx1,Hhex,andFoxa3(collectivelyreferredtoas5TF).Removinganyfactorfrom5TFreducetheexpressionofGcg(Fig.1g,Supplementaryfigure1a).原圖中FigMarkedly,GcgexpressionwasnotinduceduponwithdrawalofHhexFoxA3,Incontrast,over-expressionofHhexandFoxa3weresufficienttoinduceGcgexpression(SupplementaryfigureHowever,mRNAlevelsofGcgandArxin,HhexandFoxa3inducedcellssignificantlylowerthanthatin5TFtransducedcells(Supplementaryfigure見(jiàn)下圖,即原圖中supplementaryFigProteinlevelsofglucagonwerealsoexpressedatalowlevelinHhexFoxa3inducedcellscomparewithiAlphacells(SupplementaryfigurePreviousstudieshaveshownthatcultureconditioniscriticalfordifferentiationofendocrinecellsinvitro(20).WenextimprovedGcginductionbyoptimizingtheculturemedium.Wefoundoneconditionalmedium,whichcontainedneuralbasalmedium,N-2supplement,B-27supplement,nicotianamineandbFGF,wasmorepotentininducingGcgexpressionthanDMEM,orDMEM-F12media(Fig.1h).見(jiàn)下圖,即原圖FigTheexpressionofGcgincreasedgraduallyduringtheinduction,thattheconversionisaprogressiveprocess(Fig.1i見(jiàn)下圖,即原圖FigTakentogether,weconcludedthatTTFareconvertedintoGcg-producingcellswith5TFoverexpressionandneural-basalmedium-basedmedium(Fig.1jTodeterminetheindividualfunctionof5TFininduction,wemonitoredtheexpressionsoflineagespecificmarkersafterremovingindividualfactorsfrom5TF,includingendodermmarker(Emoes,Wnt3a,Gata6),pancreaticprogenitormarker(Sox9),liverspecificmarker(Alb),βcellspecificmarker(Mafa),δcellspecificmarker(sst)andexocrinecellspecificmarkerwithdrawalanyfactorfrom5TFswillinducetheup-regulationof的(Supplementary的(Supplementaryfigure2).Fig2blineagemarkers做修改.Overall,5TFinfectioninwildtypeTTFandpancreatictriggeredGcgandArxexpression(SupplementaryFigure3a,b)supplementaryFig2b,5TFs組Gcg和Arx表達(dá)明顯升高,indicatingthepossibilitytoinduceα-cellfromfibroblastinvivo.p19Arf-/-TTFswereconvertedintoαcell-likeWecomparedtheglobalexpressionprofilesamongiAlphacells,TTFs,andislet.MicroarraydatarevealedthatnumerousisletfunctionalgenesupregulatediniAlphacellscomparedtoTTFs(Fig.2a,supplementary4a,b).原圖未提供,看能不能查閱些文獻(xiàn),文獻(xiàn)中的結(jié)果。1079and3942outof43400annotatedgeneswerefoundtobe5-doubllingup-regulatediniAlphacellsandislet,separay,andabout694genesintheseup-regulatedgenewereoverlap.TocharacterizetheseGcg-producingcells,weyzedexpressionofα-cellspecifictranscriptionfactors,includingArx,Dpp4,Pcsk2andIrx2.ThesemarkergeneswereallinducedinGcg-producingcells.Notably,markergenesforotherpancreaticcells,suchasIns2,Nkx6.1andGlp1R(forβ-cells),Sst(forδ-cells),andAmy2a(forexocrinecells)undetectableorexpressedatalowlevel(Fig.2b).見(jiàn)下圖,即原圖Fig2d,并未檢測(cè)Amy2aTheculturedisletsandiAlphacellsshowsimilarpatternofglucagon(Fig2c).見(jiàn)下圖,即原圖Fig2cThedatasuggestedthatTTFswereconvertedintoα-cellslikecells(iAlphacells),butnototherpancreaticlineagecells.Toassaythestabilityofconversion,wedetecteddynamicchangesofTF (SupplementaryFigure5a-e見(jiàn)下圖,即原圖Fig3a-e.ThemarkersGata6andWnt3awereup-regulatedatday5(Supplementary5f,g)見(jiàn)下圖,即原圖Fig3f,g,whileα-cellspecificmarkerIrx2maintainexpressionduringthecourse(SupplementaryFigure5h)見(jiàn)下圖,即原圖Figh.Hence,α-cellconversionmayundertakeaprocessofreversiontoCharacterizationofiAlphacellsThereceptorsofglucose,insulinandglucagoninα-cellarecriticalforglucagonsenseandsecreting(21).Therefore,wedetectedandfoundthesereceptorswereup-regulatediniAlphacells(Fig.3a),見(jiàn)下圖,即原圖Fig4aGlucagoncontentiniAlphacellswere50percentofthatinislets(Fig.andinsulinproteincouldnotbedetectediniAlphacells(Fig3cBiologicallyactiveglucagonsecretionwasdetectediniAlphacells,iAlphacellsexhibitedsimilarglucagonsecretionpropertyinresponsetoKclandArgstimulationasislets,suggestingthatglucagonbutnotinsulinsecretioncanbephysiologicallyregulatedinthesecells(Fig3d,e)見(jiàn)下圖,即原圖Fig4b-Notably,iAlphacellsestablishedα-cellfunctionsinToverifythephysiologicfunctionofiAlphacells,sensitivitytostimuluswastested.Nudemiceweretransplantedwith1*106iAlphacellsorTTFsinkidneycapsule.Bodyweights,insulintolerancetest(ITT)andglucosetolerancetest(GTT)weremeasuredat2,4and8weeksaftertransplantation.At1-2weeks,therewasnosignificantdifferencebetweenbodyweightsofnudetransplantedwithTTFsandiAlphacells(Fig.4a,SupplementaryFigure6a).原圖Fig5a.iAlphacellrecipientsexhibitedsimilarresponseforITTandatfirstweek(SupplementaryFigure6b,c)即原圖Fig5b-c.While,at2wefoundadelayedbloodglucoselevelsreduction(Fig.4b)即原圖Fig5b recipients(supplementarymovie1),Movie1未提供indicatingthatiAlphacellsmayaffectinsulinrelatedmetabolicfunctioninvivo.GTTresultsshowthattherewasnosignificantdifferencebetweennudemicetransplantedwithTTFsoriAlphacellsat2weeks(Fig.4c)即原圖Fig5c.At4weeks,thebodyweightsofiAlphacellstransplantednudemicesignificantlydecreasedcomparedTTFstransplantedones(Fig.4d)Fig5d.Therewassignificantdifferenceofbloodglucoseinfastandnormalstatecomparedwiththatoftransplantedanimals(Fig.4e,f)即原圖Fig5e-f.ITTresultsshowthathavesignificantdifferenceiniAlphaandTTFtransplantedmice(Fig.4e)圖Fig5e.At8weeksaftertransplantation,bodyweightsofiAlphatransplantedmicerecovered(Fig.4g)即原圖Fig5g,however,therewassignificantdifferenceofITTandGTTcomparedwithcontrolanimals即原圖Fig5h-i.Therefore,iAlphacellspresenttheα-cellsfunctionsinareabletodisturbthebloodglucoseregulationinvivo.這一段就是在講FigiAlphacellsinducetheregenerationofisletcellsinThefunctionofiAlphacellsweredecreasedat8weeksaftertransplantation,sowedetectthesurvivalofiAlphacellsintherecipients,andfoundgraftcanbeseeninthecapsuleofrecipient’skidney(Fig.6a),andthesewereglucagon-positivebutnotinsulin-positive(Fig.6b,Supplementary7c).這里是指Fig6a-b,需 Confusingly,at8weeks,survivediAlphacellsdon’ttakeimportantrolesregulatingglucose.Wedetectedthesecretionofinsulinandglucagonplasmaofrecipients,andfoundthatbothglucagonandinsulininrecipientswerehigherthanthoseinTTFsrecipientsat8weeks(Fig6c,d).ThesedatadeterminethatiAlphacellstransplantationdisturbthefunctionofislet.ThenwedetecttheisletchangesagainsttokidneytransplantediAlphacells.Interestingly,ProportionofKi67positivecellsintheisletofiAlphacellsrecipients,aswellasβ-cells,werehigherthanthatinTTFrecipients,proportionofα-cellsinisletweredecreased(Fig6d見(jiàn)下圖,即原圖FigTheseresultsdemonstrateiAlphacellsdecreasetheratioofα/βcellsinrecipients’islet.Thesemaybecausedbytheαtoβcellstrans-differentiationinislet.Remarkably,iAlphacellsdonotformtumors8weeksafterxeno-innudemice,while,α-TC,aαtumorcellline,formtumors(supplement7a)見(jiàn)下圖,應(yīng)該為supplementfigureMoreover,iAlphacellsingraftisPCNAnegative(supplementfigure6b),datasuggestediAlphacellsarenottumor-prone.此段內(nèi)容見(jiàn)下圖,即原圖supplementfigureTherehasbeenreportthatα-cellscanserveasprogenitorsofβ-cells,Basedontheabovedata,wefoundtheenhancedproliferationofislets’cellsandincreasedβ-cellsiniAlphacellsrecipients’islet,whichenhancedratioofβ/αwewhichmaybecausedbydedifferentiationofαcells,ifso,thisnewroleofα-cellstogeneratenewβ-cellsmightbetheirmostimportantone.Thedefectinα-cellsthatoccursintypeIIdiabetescausesimpairedglucosesensing.Abnormalglucagonsecretionisinvolvedinbothhypoglycemiaandhyperglycemiaindiabetes.Glucagonsecretionisregulatedbyavarietyofnutrient,neuralandhormonalfactors(22).Followinganovernightfast,plasmaglucagonrisesonceglucosefallsbelowathreshold(23)anddecreasesprogressivelyuntilplasmaglucoserisesabovethenormalrange(24).Duetothelimitedaccessibilityandtyofα-cellspopulations,thefunctionsofα-cellsinthepancreaticisletsremainasanenigma.Exceptmaintainingplasmaglucoselevels,α-cellshavealsobeensupposedtoprotectandtogeneratenewβ-cells.However,thepossibilityandmechanismhasremainedcontroversialfortheabsenceofinvitroevidence,asitisnoteasytopurifyα-cellsinvitro.Inthisstudy,weexperimentallydemonstratetheprotocoltogeneratedα-cellslikecells.Byoverexpression5transcriptionfactors(TFs),mousetail-tipfibroblasts(TTFs)canbeconverteddirectlytomaturepancreaticcells(iAlpha)inconditionalculture.Inducedcellsexpresstheα-cellsmarkersGcgandArx.TransplantediAlphacellsinthekidneycapsuledisturbthemetabolismofrecipient,i.e.inducinginsulin promotingβ-cellproliferation.iAlphacellsshowthecharacteristicofprimaryα-Formanyyears,thedogmawasupheldthatterminallydifferentiatedcellswerecommittedtoaspecificfunctionandcouldnolongerchangetheiridentity.Incontrast,progenitor/stemcellsareexpectedtoretainsomemultipotencycapacities,andthereforecanbemoresuitableforreplacementstrategies.However,theES/iPSderivedendocrinecellsusuallyshowbi-function(coexpressinsulinandglucagon)andimpaireglucosesensing.LimitedavailabilityoftheisletsandES/iPSderivedendocrinecellsrestrictthedevelopmentofcellreplacementtherapyfordiabetes.Thus,findinganewresourceofisletcellswhichincludingα-andβ-cellsisdemanded.Reprogramingofisletcellsfromsomaticcellsmaybeanalternativeway.Nowadays,moreandmoreexamplesofefficient“transdifferentiation”havebeenreportedintheabsenceofapluripotentstate.However,reprogrammedendocrinecellscannotbegeneratedinvitropreviously.Here,wesuccessfullyconvertfibroblastsintoendocrinecellsbyoverexpressionofendocrinelineage-specifictranscriptionfactors.Suchconversionavoidsanintermediatepluripotentstateandessentiallyremovestheriskofteratomaformation.α-cellsspecificmarkerGcgexpressionwasdrasticallyinducedinTFstransducedcells.Thefunctionofα-cellsinthepancreaticisletsiswellknowntoproduceglucagoninthepost-absorptivestatetomaintainplasmaglucoselevelsbystimulatinghepaticglucoseproduction.Furthermore,generatedcellsexhibitmatureα-cellsphenotyperesemblingthatofprimarycells.Moreover,thesecellsacquireafullyfunctionalandmatureprofileafterengraftmentintothehosttissue.Oneinterestingfindingisthatgraftdisturbstheinsulin/glucagonequilibriumandaffectsthestabilityofbloodglucoselevels.Glucagonandinsulinmayconstituteafeedbacksystemthatstabilizing/maintainingbloodglucoselevel.thehigherglucagoniniAlphacellsrecipientsenhancedtheplasmainsulinlevels,whichmaybecausedbytheproliferationofβ-cellsorenhancedsecretionofinsulin.Andwefoundtheproliferationofβ-cellsintheiAlphacellsDuringembryogenesis,Gcgexpressioncanbedetectedatearlieststageintheendocrinecells(25).Basedonrecentstudies,α-cellshavebeenassignedanewroleintheisletsasdirectprogenitorsofβ-cells(26).Lineage-tracingstudiesshowedthatα-cellscanserveasprogenitorsofβ-cellsandpresentedahypotheticalmodelthatinjuredβ-cellsmightactivateα-cellsinadultisletstopromoteβ-cellregeneration(27,28).Inlightofthesefindings,β-cellsmaybegeneratedfromiAlphacellsbydirectconversion.Suchtechniquemayprovideanewplatformformoleculescreeningonβ-cellsconversion.Moreover,micetransplantedwithiAlphacellscanbeservicedasadiseasemodelofinsulintoidentifydrugsforthetreatmentofFinally,thesestudiesshowthatreplacementofendocrinetissuebytransplantationofinsulin-producingcellsthatderivedfromembryonicstemcellsisnottheonlyfeasibleapproachtoapermanenttreatmentfordiabetes.Tothecontrary,itisnowpossibletocompletetreatmentapproachesthatconvertα-cellstomakenewβ-cells.Therefore,Ourstudydemonstratesanovelnewstrategytogeneratefunctionalα-likecells.iAlphacellspresenttheα-cellsfunctionsinvitroandareabletodisturbthebloodglucoselevelinvivo,whichcanledtoinsulin-andincreasesβ-cellsproliferationinrecipents.AndiAlphacellsmaytakeimportantrolesindiabetesdiseasemodelingandregenerativeShapiro,A.M.,Lakey,J.R.,Ryan,E.A.,Korbutt,G.S.,Toth,E.,Warnock,G.L.,Kneteman,N.M.,andRajotte,R.V.(2000)TheNewEnglandjournalofmedicine343,230-238Turgeon,N.A.,Avila,J.G.,Cano,J.A.,Hutchinson,J.J.,Badell,I.R.,Page,J.,Adams,A.B.,Sears,M.H.,Bowen,P.H.,Kirk,A.D.,Pearson,T.C.,andLarsen,C.P.(2010)Americanjournaloftransplantation:officialjournaloftheAmericanSocietyofTransplantationandtheAmericanSocietyofTransplantSurgeons10,2082-2091Ryan,E.A.,Paty,B.W.,Senior,P.A.,Bigam,D.,Alfadhli,E.,Kneteman,N.M.,Lakey,J.R.,andShapiro,A.M.(2005)Diabetes54,2060-2069Ashcroft,F.M.,andRorsman,P.(2012)Cell148,1160-Xie,R.,Everett,L.J.,Lim,H.W., ,N.A.,Schug,J.,Kroon,E.,Kelly,O.Wang,A.,D'Amour,K.A.,Robins,A.J.,Won,K.J.,Kaestner,K.H.,andSander,M.(2013)Cellstemcell12,224-237Wang,X.,Metzger,D.L.,Meloche,M.,Hao,J.,Ao,Z.,andWarnock,G.L.(2012)Internationaljournalofendocrinology2012,414812D'Amour,K.A.,Bang,A.G.,Eliazer,S.,Kelly,O.G.,Agulnick,A.D.,Smart,N.G.,Moorman,M.A.,Kroon,E.,Carpenter,M.K.,andBaetge,E.E.(2006)Naturebiotechnology24,1392-1401Kroon,E.,Martinson,L.A.,Kadoya,K.,Bang,A.G.,Kelly,O.G.,Eliazer,S.,Young,H.,Richardson,M.,Smart,N.G.,Cunningham,J.,Agulnick,A.D.,D'Amour,K.A.,Carpenter,M.K.,andBaetge,E.E.(2008)Naturebiotechnology26,443-452Rezania,A.,Riedel,M.J.,Wideman,R.D.,Karanu,F.,Ao,Z.,Warnock,G.L.,andKieffer,T.J.(2011)Diabetes60,239-247Chen,S.,Borowiak,M.,Fox,J.L.,Maehr,R.,Osafune,K.,Davidow,L.,Lam,K.,Peng,L.F.,Schreiber,S.L.,Rubin,L.L.,andMelton,D.(2009)Naturechemicalbiology5,258-265Soda,Y.,Marumoto,T.,Friedmann-Morvinski,D.,Soda,M.,Liu,F.,Michiue,H.,Pastorino,S.,Yang,M.,Hoffman,R.M.,Kesari,S.,andVerma,I.M.(2011)ProceedingsoftheNationalAcademyofSciencesoftheUnitedStatesofAmerica108,4274-4280Huang,P.,He,Z.,Ji,S.,Sun,H.,Xiang,D.,Liu,C.,Hu,Y.,Wang,X.,andHui,L.(2011)Nature475,386-389Ieda,M.,Fu,J.D.,Delgado-Olguin,P.,Vedantham,V.,Hayashi,Y.,B.G.,andSrivastava,D.(2010)Cell142,375-Vierbuchen,T.,Ostermeier,A.,Pang,Z.P.,Kokubu,Y.,Sudhof,T.C.,andWernig,M.(2010)Nature463,1035-1041Zhou,Q.,Brown,J.,Kanarek,A.,Rajagopal,J.,andMelton,D.A.Nature455,627-Banga,A.,Akinci,E.,Greder,L.V.,Dutton,J.R.,andSlack,J.M.(2012)ProceedingsoftheNationalAcademyofSciencesoftheUnitedStatesofAmerica109,15336-15341Pagliuca,F.W.,andMelton,D.A.(2013)Development140,2472-Yang,L.,Li,S.,Hatch,H.,Ahrens,K.,Cornelius,J.G.,Petersen,B.E.,andPeck,A.B.(2002)ProceedingsoftheNationalAcademyofSciencesoftheUnitedStatesofAmerica99,8078-8083Sapir,T.,Shternhall,K.,Meivar-Levy,I.,Blumenfeld,T.,Cohen,H.,Skusky,E.,Eventov-Friedman,S.,Barshack,I.,Goldberg,I.,Pri-Chen,S.,Ben-Dor,L.,Polak-Charcon,S.,Karasik,A.,Shimon,I.,Mor,E.,andFerber,S.(2005)ProceedingsoftheNationalAcademyofSciencesoftheUnitedStatesofAmerica102,7964-7969Andersson,A.(1978)Diabetologia14,397-Gaisano,H.Y.,andLeung,Y.M.(2008)Cellmetabolism7,474-Gerich,J.E.,Charles,M.A.,andGrodsky,G.M.(1974)TheJournalofclinicalinvestigation54,833-841Mitrakou,A.,Ryan,C.,Veneman,T.,Mokan,M.,Jenssen,T.,Kiss,I.,Durrant,J.,Cryer,P.,andGerich,J.(1991)TheAmericanjournalofphysiology260,Chang,A.M.,Jakobsen,G.,Sturis,J.,Smith,M.J.,Bloem,C.J.,An,B.,Galecki,A.,andHalter,J.B.(2003)Diabetes52,1786-1791Herrera,P.L.(2000)Development127,2317-Collombat,P.,Xu,X.,Ravassard,P.,Sosa-Pineda,B.,Dussaud,S.,Billestrup,N.,Madsen,O.D.,Serup,P.,Heimberg,H.,andMansouri,A.(2009)Cell138,Habener,J.F.,andStanojevic,V.(2012)Islets4,188-Sangan,C.B.,andTosh,D.(2010)BioEssays:newsandreviewsinmolecular,cellularanddevelopmentalbiology32,881-884FigureFigure1Transcriptionfactorsinduceα-cell-likeconversionofiHEP(inducedhepatocytes)andtail-tipfibroblasts.a,ExperimentaldesignofiAlphacellinduction.Fibroblastswereinfectedwithlentiesexpressinghepatictranscriptionfactors,andiHEPwereinfectedwithlentiesexpressingendocrinetranscriptionfactors.CultureswerechangedtoDMEMmedium2daysafterinfection.b,,ExpressionofIns2andGcgweremeasuredbyRT–PCRafter7daysinductionofiHEPcells.Expressioninisletcellswasusedaspositivecontrolc,ExpressionofGcgandArxweremonitoredupto9daysbyRT–PCRinPdx1,HhexandPax4transducediHEPcells.Expressioninisletcellswasusedaspositivecontrol(Control=1).d,Leftimage,iHEPsshowepithelialmorphology.Right,Pdx1,HhexandPax4infectediHEPsshowthemesenchymal-likemorphology.Scalebars,100e,Morphologyof6TFs-inducediAlphacells.Scalebars:100f,Effectsofindividualfactorwithdrawalfrom6TFonGcgexpression.Expressioninisletcellswasusedaspositivecontrol(Control=1).Alldataarepresentedasmean+s.d.g,Effectsofindividualfactorwithdrawalfrom5TFonGcgexpression.Alldataarepresentedasmean+s.d.h,ExpressionsofGcgincellsculturedindifferentmediumwereyzedbyRT-PCR.Expressioninisletcellswasusedaspositivecontrol(Control=1).Dataarepresentedasmean+s.d.i,ExpressionofGcgwasmonitoredupto28daysbyRT-PCRduringtheinductionofiAlphacells.Expressioninisletcellwasusedaspositivecontrol(Control=1).Dataarepresentedasmean+s.d.j,ExperimentaldesignofiAlphacellinductionfromTTFswith5transcriptionfactors(Gata4,Foxa3,Pdx1,Pax4,Hhex). iAlphacells transducedby 5TFstablyexpressαcellsfunctionalgenesandαcellspecifictranscriptionfactors.a,OverlapofisletandTTF-iaenrichedgenes,selectedlevelwereislet/TTF>5andTTF-ia/TTF>5.Therewassignificantoverla
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