Biomanufacturing of Therapeutic Cells: State of the Art, Current Challenges, and Future Perspectives.

Stem cells and other functionally defined therapeutic cells (e.g., T cells) are promising to bring hope of a permanent cure for diseases and disorders that currently cannot be cured by conventional drugs or biological molecules. This paradigm shift in modern medicine of using cells as novel therapeutics can be realized only if suitable manufacturing technologies for large-scale, cost-effective, reproducible production of high-quality cells can be developed. Here we review the state of the art in therapeutic cell manufacturing, including cell purification and isolation, activation and differentiation, genetic modification, expansion, packaging, and preservation. We identify current challenges and discuss opportunities to overcome them such that cell therapies become highly effective, safe, and predictively reproducible while at the same time becoming affordable and widely available.

[1]  Carl-Fredrik Mandenius,et al.  Design of large-scale manufacturing of induced pluripotent stem cell derived cardiomyocytes , 2014 .

[2]  P Windrum,et al.  Severe neurotoxicity because of dimethyl sulphoxide following peripheral blood stem cell transplantation , 2003, Bone Marrow Transplantation.

[3]  N E Timmins,et al.  Closed system isolation and scalable expansion of human placental mesenchymal stem cells , 2012, Biotechnology and bioengineering.

[4]  K. Takakuwa,et al.  Vitrification of hematopoietic progenitor cells obtained from human cord blood. , 1994, Bone marrow transplantation.

[5]  P. Murray,et al.  Sterility testing of cell therapy products: parallel comparison of automated methods with a CFR‐compliant method , 2006, Transfusion.

[6]  Karin Tarte,et al.  Immunoregulatory properties of clinical grade mesenchymal stromal cells: evidence, uncertainties, and clinical application , 2013, Stem Cell Research & Therapy.

[7]  Bo Kara,et al.  The translation of cell-based therapies: clinical landscape and manufacturing challenges. , 2015, Regenerative medicine.

[8]  S. Rosenberg,et al.  Culture of human tumor infiltrating lymphocytes in hollow fiber bioreactors. , 1990, Journal of immunological methods.

[9]  Luigi Naldini,et al.  A foundation for universal T-cell based immunotherapy: T cells engineered to express a CD19-specific chimeric-antigen-receptor and eliminate expression of endogenous TCR. , 2012, Blood.

[10]  W. Burns,et al.  Human effector CD8+ T cells derived from naive rather than memory subsets possess superior traits for adoptive immunotherapy. , 2011, Blood.

[11]  Nikolay Bazhanov,et al.  Aggregation of human mesenchymal stromal cells (MSCs) into 3D spheroids enhances their antiinflammatory properties , 2010, Proceedings of the National Academy of Sciences.

[12]  Martyn Hill,et al.  Application of an acoustofluidic perfusion bioreactor for cartilage tissue engineering , 2014, Lab on a chip.

[13]  J. Cigudosa,et al.  Spontaneous human adult stem cell transformation. , 2005, Cancer research.

[14]  Stéphanie Boué,et al.  Methods for making induced pluripotent stem cells: reprogramming à la carte , 2011, Nature Reviews Genetics.

[15]  F. Marincola,et al.  A human memory T-cell subset with stem cell-like properties , 2011, Nature Medicine.

[16]  Kris Thielemans,et al.  Generation of large numbers of dendritic cells in a closed system using Cell Factories. , 2002, Journal of immunological methods.

[17]  F Meuwly,et al.  Packed-bed bioreactors for mammalian cell culture: bioprocess and biomedical applications. , 2007, Biotechnology advances.

[18]  H. Okayama,et al.  High-efficiency transformation of mammalian cells by plasmid DNA. , 1987, Molecular and cellular biology.

[19]  Kevin Eggan,et al.  Progress toward the clinical application of patient-specific pluripotent stem cells. , 2010, The Journal of clinical investigation.

[20]  Martin Scheer,et al.  Cryopreservation of Osteoblast-Like Cells: Viability and Differentiation with Replacement of Fetal Bovine Serum in vitro , 2006, Cells Tissues Organs.

[21]  David J Williams,et al.  Concise Review: Mind the Gap: Challenges in Characterizing and Quantifying Cell- and Tissue-Based Therapies for Clinical Translation , 2010, Stem cells.

[22]  Karin Tarte,et al.  Good manufacturing practices production of mesenchymal stem/stromal cells. , 2011, Human gene therapy.

[23]  Qing He,et al.  CD19-Targeted T Cells Rapidly Induce Molecular Remissions in Adults with Chemotherapy-Refractory Acute Lymphoblastic Leukemia , 2013, Science Translational Medicine.

[24]  Wei Wang,et al.  piggyBac transposition reprograms fibroblasts to induced pluripotent stem cells , 2009, Nature.

[25]  Qing-Jun Zhang,et al.  Therapeutic Potentials of Mesenchymal Stem Cells Derived from Human Umbilical Cord , 2011, Stem Cell Reviews and Reports.

[26]  A. Brivanlou,et al.  An efficient and reversible transposable system for gene delivery and lineage-specific differentiation in human embryonic stem cells. , 2009, Cell stem cell.

[27]  Hélène Rouard,et al.  Clinical-grade production of human mesenchymal stromal cells: occurrence of aneuploidy without transformation. , 2010, Blood.

[28]  Didier Hocquet,et al.  Validation of an automated blood culture system for sterility testing of cell therapy products. , 2014, Cytotherapy.

[29]  Gloria D. Elliott,et al.  Synergistic Development of Biochips and Cell Preservation Methodologies: a Tale of Converging Technologies , 2017, Current Stem Cell Reports.

[30]  Wei-Shou Hu,et al.  Characterization of a hollow fiber bioartificial liver device. , 2005, Artificial organs.

[31]  J. Gimble,et al.  Toward a clinical-grade expansion of mesenchymal stem cells from human sources: a microcarrier-based culture system under xeno-free conditions. , 2011, Tissue engineering. Part C, Methods.

[32]  Bernhard O. Palsson,et al.  Expansion of Human Bone Marrow Progenitor Cells in a High Cell Density Continuous Perfusion System , 1993, Bio/Technology.

[33]  David T. Curiel,et al.  Engineering targeted viral vectors for gene therapy , 2007, Nature Reviews Genetics.

[34]  Michael Butler,et al.  Animal cell cultures: recent achievements and perspectives in the production of biopharmaceuticals , 2005, Applied Microbiology and Biotechnology.

[35]  A. Ignatius,et al.  GMP-Compliant Isolation and Large-Scale Expansion of Bone Marrow-Derived MSC , 2012, PloS one.

[36]  Byung-Soo Kim,et al.  Suspension Culture of Mammalian Cells Using Thermosensitive Microcarrier that Allows Cell Detachment without Proteolytic Enzyme Treatment , 2010, Cell transplantation.

[37]  X. Wang,et al.  Manufacture of tumor- and virus-specific T lymphocytes for adoptive cell therapies , 2015, Cancer Gene Therapy.

[38]  M. Hervy,et al.  Long Term Expansion of Bone Marrow-Derived hMSCs on Novel Synthetic Microcarriers in Xeno-Free, Defined Conditions , 2014, PloS one.

[39]  N. Benvenisty,et al.  The tumorigenicity of human embryonic and induced pluripotent stem cells , 2011, Nature Reviews Cancer.

[40]  Erik J Woods,et al.  Clinical grade adult stem cell banking , 2009, Organogenesis.

[41]  J. Toguchida,et al.  Expression of the p16INK4A Gene Is Associated Closely with Senescence of Human Mesenchymal Stem Cells and Is Potentially Silenced by DNA Methylation During In Vitro Expansion , 2007, Stem cells.

[42]  Boon Chin Heng,et al.  Translating human embryonic stem cells from 2-dimensional to 3-dimensional cultures in a defined medium on laminin- and vitronectin-coated surfaces. , 2012, Stem cells and development.

[43]  G. Ehninger,et al.  Thawing of cryopreserved mobilized peripheral blood--comparison between waterbath and dry warming device. , 2002, Cytotherapy.

[44]  K. Ito,et al.  Directing bone marrow-derived stromal cell function with mechanics. , 2010, Journal of biomechanics.

[45]  P. Andrade,et al.  Maximizing the ex vivo expansion of human mesenchymal stem cells using a microcarrier-based stirred culture system. , 2010, Journal of biotechnology.

[46]  B. Spencer‐Dene,et al.  Murine but Not Human Mesenchymal Stem Cells Generate Osteosarcoma‐Like Lesions in the Lung , 2007, Stem cells.

[47]  R. Lindblad,et al.  A multicenter comparison study between the Endosafe PTS rapid-release testing system and traditional methods for detecting endotoxin in cell-therapy products. , 2008, Cytotherapy.

[48]  Greg Finak,et al.  Critical assessment of automated flow cytometry data analysis techniques , 2013, Nature Methods.

[49]  S. Riddell,et al.  The use of anti-CD3 and anti-CD28 monoclonal antibodies to clone and expand human antigen-specific T cells. , 1990, Journal of immunological methods.

[50]  Malcolm K. Brenner,et al.  Activity of Broad-Spectrum T Cells as Treatment for AdV, EBV, CMV, BKV, and HHV6 Infections after HSCT , 2014, Science Translational Medicine.

[51]  Abhinav A Shukla,et al.  Recent advances in large-scale production of monoclonal antibodies and related proteins. , 2010, Trends in biotechnology.

[52]  Andre Choo,et al.  Scalable platform for human embryonic stem cell differentiation to cardiomyocytes in suspended microcarrier cultures. , 2010, Tissue engineering. Part C, Methods.

[53]  S. Olivares,et al.  Manufacture of Clinical-Grade CD19-Specific T Cells Stably Expressing Chimeric Antigen Receptor Using Sleeping Beauty System and Artificial Antigen Presenting Cells , 2013, PloS one.

[54]  Renate Kunert,et al.  Process parameter shifting: Part I. Effect of DOT, pH, and temperature on the performance of Epo‐Fc expressing CHO cells cultivated in controlled batch bioreactors , 2006, Biotechnology and bioengineering.

[55]  Charles J. Hunt,et al.  Cryopreservation of Human Stem Cells for Clinical Application: A Review , 2011, Transfusion Medicine and Hemotherapy.

[56]  H. Schreiber,et al.  Innate and adaptive immune cells in the tumor microenvironment , 2013, Nature Immunology.

[57]  Antonios G Mikos,et al.  Design of a flow perfusion bioreactor system for bone tissue-engineering applications. , 2003, Tissue engineering.

[58]  W. Wagner,et al.  Tracking of replicative senescence in mesenchymal stem cells by colony-forming unit frequency. , 2013, Methods in molecular biology.

[59]  Yoav Mayshar,et al.  Identification and classification of chromosomal aberrations in human induced pluripotent stem cells. , 2010, Cell stem cell.

[60]  Min Zhu,et al.  Comparison of Multi-Lineage Cells from Human Adipose Tissue and Bone Marrow , 2003, Cells Tissues Organs.

[61]  R. Surendran,et al.  Isolation, expansion and characterisation of mesenchymal stem cells from human bone marrow, adipose tissue, umbilical cord blood and matrix: a comparative study , 2015, Cytotechnology.

[62]  Robert J. Thomas,et al.  Expansion of human mesenchymal stem cells on microcarriers , 2011, Biotechnology Letters.

[63]  C. Whitley,et al.  Closed hollow‐fiber bioreactor: a new approach to retroviral vector production , 1999, The journal of gene medicine.

[64]  G. Haas,et al.  Expansion of Activated Lymphocytes Obtained from Renal Cell Carcinoma in an Automated Hollow Fiber Bioreactor , 1994, Cell transplantation.

[65]  M. Debenedette,et al.  Potency of Mature CD40L RNA Electroporated Dendritic Cells Correlates With IL-12 Secretion by Tracking Multifunctional CD8+/CD28+ Cytotoxic T-cell Responses In Vitro , 2011, Journal of immunotherapy.

[66]  J. Karp,et al.  Mesenchymal stem cell therapy: Two steps forward, one step back. , 2010, Trends in molecular medicine.

[67]  C. Barbas,et al.  ZFN, TALEN, and CRISPR/Cas-based methods for genome engineering. , 2013, Trends in biotechnology.

[68]  Steven A. Rosenberg,et al.  Generation of Tumor-Infiltrating Lymphocyte Cultures for Use in Adoptive Transfer Therapy for Melanoma Patients , 2003, Journal of immunotherapy.

[69]  R. Orentas,et al.  Towards a commercial process for the manufacture of genetically modified T cells for therapy , 2015, Cancer Gene Therapy.

[70]  P. Andrews,et al.  Adaptation to culture of human embryonic stem cells and oncogenesis in vivo , 2007, Nature Biotechnology.

[71]  Ludwika Kreja,et al.  GMP-Compliant Isolation and Expansion of Bone Marrow-Derived MSCs in the Closed, Automated Device Quantum Cell Expansion System , 2013, Cell transplantation.

[72]  Jiehong Liao,et al.  Bioactive polymer/extracellular matrix scaffolds fabricated with a flow perfusion bioreactor for cartilage tissue engineering. , 2010, Biomaterials.

[73]  S. Reuveny,et al.  Long-term microcarrier suspension cultures of human embryonic stem cells. , 2009, Stem cell research.

[74]  Asher Mullard,et al.  Novartis secures first CRISPR pharma collaborations , 2015, Nature Reviews Drug Discovery.

[75]  Lei Zhang,et al.  Editing T cell specificity towards leukemia by zinc finger nucleases and lentiviral gene transfer , 2012, Nature Medicine.

[76]  Michel Sadelain,et al.  Safety and persistence of adoptively transferred autologous CD19-targeted T cells in patients with relapsed or chemotherapy refractory B-cell leukemias. , 2011, Blood.

[77]  Janos Vörös,et al.  pH-controlled recovery of placenta-derived mesenchymal stem cell sheets. , 2011, Biomaterials.

[78]  Vijay P. Singh,et al.  Disposable bioreactor for cell culture using wave-induced agitation , 1999, Cytotechnology.

[79]  W D Lyman,et al.  An Efficient Method for the Cryopreservation of Fetal Human Liver Hematopoeitic Progenitor Cells , 2001, Stem cells.

[80]  G. M. Fahy,et al.  Ice-free cryopreservation of mouse embryos at −196 °C by vitrification , 1985, Nature.

[81]  F. Alt,et al.  Excision of Reprogramming Transgenes Improves the Differentiation Potential of iPS Cells Generated with a Single Excisable Vector , 2009, Stem cells.

[82]  J. Dennis,et al.  Clinical‐Scale Expansion of a Mixed Population of Bone Marrow‐Derived Stem and Progenitor Cells for Potential Use in Bone Tissue Regeneration , 2007, Stem cells.

[83]  Hossein Baharvand,et al.  Long-term maintenance of undifferentiated human embryonic and induced pluripotent stem cells in suspension. , 2011, Stem cells and development.

[84]  Yang Sun,et al.  Proteomic profiling of human bone marrow mesenchymal stem cells under shear stress , 2010, Molecular and Cellular Biochemistry.

[85]  S. Rosenberg,et al.  Expansion of human tumor infiltrating lymphocytes for use in immunotherapy trials. , 1987, Journal of immunological methods.

[86]  S. Reuveny,et al.  Agitation can induce differentiation of human pluripotent stem cells in microcarrier cultures. , 2011, Tissue engineering. Part C, Methods.

[87]  Wei Li,et al.  Manufacturing mesenchymal stromal cells for phase I clinical trials. , 2013, Cytotherapy.

[88]  S. Reuveny,et al.  Application of human mesenchymal and pluripotent stem cell microcarrier cultures in cellular therapy: achievements and future direction. , 2013, Biotechnology advances.

[89]  A. Lloyd,et al.  Human mesenchymal stem cell transformation is associated with a mesenchymal-epithelial transition. , 2008, Experimental cell research.

[90]  Sébastien Sart,et al.  Controlled expansion and differentiation of mesenchymal stem cells in a microcarrier based stirred bioreactor , 2011, BMC proceedings.

[91]  K. Götze,et al.  Increased number of regulatory T cells (T-regs) in the peripheral blood of patients with Her-2/neu-positive early breast cancer , 2012, Journal of Cancer Research and Clinical Oncology.

[92]  R. Dillman,et al.  Characterization of human tumor-infiltrating lymphocytes expanded in hollow-fiber bioreactors for immunotherapy of cancer. , 2001, Cancer biotherapy & radiopharmaceuticals.

[93]  Michel Sadelain,et al.  Manufacturing Validation of Biologically Functional T Cells Targeted to CD19 Antigen for Autologous Adoptive Cell Therapy , 2009, Journal of immunotherapy.

[94]  Luigi Naldini,et al.  Gene editing in human stem cells using zinc finger nucleases and integrase-defective lentiviral vector delivery , 2007, Nature Biotechnology.

[95]  A. Cometa,et al.  Human bone marrow-derived mesenchymal stem cells do not undergo transformation after long-term in vitro culture and do not exhibit telomere maintenance mechanisms , 2010 .

[96]  J. Itskovitz‐Eldor,et al.  Dynamic suspension culture for scalable expansion of undifferentiated human pluripotent stem cells , 2011, Nature Protocols.

[97]  Byung Hyune Choi,et al.  Low-intensity ultrasound increased colony forming unit-fibroblasts of mesenchymal stem cells during primary culture. , 2011, Tissue engineering. Part C, Methods.

[98]  Donna Niedzwiecki,et al.  Immunological and clinical responses in metastatic renal cancer patients vaccinated with tumor RNA-transfected dendritic cells. , 2003, Cancer research.

[99]  Ø. Bruserud,et al.  The viability of cryopreserved PBPC depends on the DMSO concentration and the concentration of nucleated cells in the graft. , 2005, Cytotherapy.

[100]  Stefan Miltenyi,et al.  Integrated Clinical Scale Manufacturing System for Cellular Products Derived by Magnetic Cell Separation, Centrifugation and Cell Culture , 2013 .

[101]  J. Northrop,et al.  Lipofection: a highly efficient, lipid-mediated DNA-transfection procedure. , 1987, Proceedings of the National Academy of Sciences of the United States of America.

[102]  Hermann Eichler,et al.  Comparative Analysis of Mesenchymal Stem Cells from Bone Marrow, Umbilical Cord Blood, or Adipose Tissue , 2006, Stem cells.

[103]  Wolfgang Wagner,et al.  Standardization of Good Manufacturing Practice-compliant production of bone marrow-derived human mesenchymal stromal cells for immunotherapeutic applications. , 2015, Cytotherapy.

[104]  John McMannis,et al.  Current practices and prospects for standardization of the hematopoietic colony-forming unit assay: a report by the cellular therapy team of the Biomedical Excellence for Safer Transfusion (BEST) Collaborative. , 2013, Cytotherapy.

[105]  M. Rao,et al.  Developing safe therapies from human pluripotent stem cells , 2009, Nature Biotechnology.

[106]  W W Minuth,et al.  Engineering of cartilage tissue using bioresorbable polymer carriers in perfusion culture. , 1994, Biomaterials.

[107]  L. Young,et al.  Viral gene therapy strategies: from basic science to clinical application , 2006, The Journal of pathology.

[108]  R. Stuart,et al.  Beyond CD34+ cell dose: impact of method of peripheral blood hematopoietic stem cell mobilization (granulocyte–colony‐stimulating factor [G‐CSF], G‐CSF plus plerixafor, or cyclophosphamide G‐CSF/granulocyte‐macrophage [GM]‐CSF) on number of colony‐forming unit–GM, engraftment, and Day +100 hematopoi , 2011, Transfusion.

[109]  Chang Suk Suh,et al.  Successful vitrification of human amnion-derived mesenchymal stem cells. , 2008, Human reproduction.

[110]  Udo Reichl,et al.  Harvesting and concentration of human influenza A virus produced in serum‐free mammalian cell culture for the production of vaccines , 2007, Biotechnology and bioengineering.

[111]  Øystein Bruserud,et al.  Cryopreserving human peripheral blood progenitor cells with 5‐percent rather than 10‐percent DMSO results in less apoptosis and necrosis in CD34+ cells , 2002, Transfusion.

[112]  Qing He,et al.  Efficacy and Toxicity Management of 19-28z CAR T Cell Therapy in B Cell Acute Lymphoblastic Leukemia , 2014, Science Translational Medicine.

[113]  Scott R Burger,et al.  Developing assays to address identity, potency, purity and safety: cell characterization in cell therapy process development. , 2012, Regenerative medicine.

[114]  R. M. Childs,et al.  Catastrophic failures of freezing bags for cellular therapy products: description, cause, and consequences. , 2002, Cytotherapy.

[115]  L Giorno,et al.  Diffusive and convective transport through hollow fiber membranes for liver cell culture. , 2005, Journal of biotechnology.

[116]  B. Palsson,et al.  Cell growth and differentiation on feeder layers is predicted to be influenced by bioreactor geometry , 2000, Biotechnology and bioengineering.

[117]  Farhaan Vahidy,et al.  Efficient manufacturing of therapeutic mesenchymal stromal cells with the use of the Quantum Cell Expansion System. , 2014, Cytotherapy.

[118]  Dusko Ilic,et al.  Safety paradigm: genetic evaluation of therapeutic grade human embryonic stem cells , 2010, Journal of The Royal Society Interface.

[119]  Ping Li,et al.  Novel pH responsive hydrogels for controlled cell adhesion and triggered surface detachment , 2012 .

[120]  Robert Zweigerdt,et al.  Scalable expansion of human pluripotent stem cells in suspension culture , 2011, Nature Protocols.

[121]  G Bellone,et al.  Tumor-associated transforming growth factor-beta and interleukin-10 contribute to a systemic Th2 immune phenotype in pancreatic carcinoma patients. , 1999, The American journal of pathology.

[122]  Christine E Brown,et al.  Phenotypic and Functional Attributes of Lentivirus-modified CD19-specific Human CD8+ Central Memory T Cells Manufactured at Clinical Scale , 2012, Journal of immunotherapy.

[123]  S. Reuveny,et al.  Critical microcarrier properties affecting the expansion of undifferentiated human embryonic stem cells. , 2011, Stem cell research.

[124]  A. Nienow Reactor Engineering in Large Scale Animal Cell Culture , 2006, Cytotechnology.

[125]  C. Klebanoff,et al.  Sorting Through Subsets: Which T-Cell Populations Mediate Highly Effective Adoptive Immunotherapy? , 2012, Journal of immunotherapy.

[126]  Sanjin Zvonic,et al.  Effect of Various Freezing Parameters on the Immediate Post‐Thaw Membrane Integrity of Adipose Tissue Derived Adult Stem Cells , 2005, Biotechnology progress.

[127]  R. Crystal,et al.  Dendritic cells genetically modified to express CD40 ligand and pulsed with antigen can initiate antigen-specific humoral immunity independent of CD4+ T cells , 2000, Nature Medicine.

[128]  Mike Gough,et al.  Adoptive transfer of effector CD8+ T cells derived from central memory cells establishes persistent T cell memory in primates. , 2008, The Journal of clinical investigation.

[129]  Jens Kurth,et al.  Assessing the safety of stem cell therapeutics. , 2011, Cell stem cell.

[130]  R. Bjerkvig,et al.  Spontaneous malignant transformation of human mesenchymal stem cells reflects cross-contamination: putting the research field on track - letter. , 2010, Cancer research.

[131]  Shinsuke Yuasa,et al.  Generation of induced pluripotent stem cells from human terminally differentiated circulating T cells. , 2010, Cell stem cell.

[132]  M. S. Kallos,et al.  Improved expansion of human bone marrow‐derived mesenchymal stem cells in microcarrier‐based suspension culture , 2014, Journal of tissue engineering and regenerative medicine.

[133]  J. Glowacki,et al.  Perfusion enhances functions of bone marrow stromal cells in three-dimensional culture. , 1998, Cell transplantation.

[134]  Matthias Kraume,et al.  Microcarrier-based Expansion Process for hMSCs with High Vitality and Undifferentiated Characteristics , 2012, The International journal of artificial organs.

[135]  Beth Schachter,et al.  Therapies of the state , 2014, Nature Biotechnology.

[136]  Susana Castro-Obregon,et al.  New non-viral method for gene transfer into primary cells. , 2004, Methods.

[137]  E. Jones,et al.  Age-related changes in human bone marrow-derived mesenchymal stem cells: Consequences for cell therapies , 2008, Mechanisms of Ageing and Development.

[138]  Bernhard O. Palsson,et al.  Large-scale Expansion of Human Stem and Progenitor Cells From Bone Marrow Mononuclear Cells in Continuous Perfusion Cultures , 1993 .

[139]  J. Cigudosa,et al.  Retraction: Spontaneous human adult stem cell transformation. , 2010, Cancer research.