Prematurity negatively affects regenerative properties of human amniotic epithelial cells in the context of lung repair

Dandan Zhu, Gina D. Kusuma, Renate Schwab, Siow Teng Chan, Jean Tan, Mohamed I. Saad, Kristen T. Leeman, Carla Kim, Euan M. Wallace, Rebecca Lim

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There is a growing appreciation of the role of lung stem/progenitor cells in the development and perpetuation of chronic lung disease including idiopathic pulmonary fibrosis. Human amniotic epithelial cells (hAECs) were previously shown to improve lung architecture in bleomycin-induced lung injury, with the further suggestion that hAECs obtained from term pregnancies possessed superior anti-fibrotic properties compared with their preterm counterparts. In the present study, we aimed to elucidate the differential effects of hAECs from term and preterm pregnancies on lung stem/progenitor cells involved in the repair. Here we showed that term hAECs were better able to activate bronchioalveolar stem cells (BASCs) and type 2 alveolar epithelial cells (AT2s) compared with preterm hAECs following bleomycin challenge. Further, we observed that term hAECs restored TGIF1 and TGFβ2 expression levels, while increasing c-MYC expression despite an absence of significant changes to Wnt/β-catenin signaling. In vitro, term hAECs increased the average size and numbers of BASC and AT2 colonies. The gene expression levels of Wnt ligands were higher in term hAECs, and the expression levels of BMP4, CCND1 and CDC42 were only increased in the BASC and AT2 organoids co-cultured with hAECs from term pregnancies but not preterm pregnancies. In conclusion, term hAECs were more efficient at activating the BASC niche compared with preterm hAECs. The impact of gestational age and/or complications leading to preterm delivery should be considered when applying hAECs and other gestational tissue-derived stem and stem-like cells therapeutically.

Original languageEnglish
Pages (from-to)2665-2679
Number of pages15
JournalClinical Science
Issue number20
Publication statusPublished - 30 Oct 2020


  • bronchioalveolar stem cells
  • human amnion epithelial cells
  • lung stem/progenitor cells
  • term and preterm
  • type II alveolar cells

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