Machine Learning for Health: Algorithm Auditing & Quality Control.

Developers proposing new machine learning for health (ML4H) tools often pledge to match or even surpass the performance of existing tools, yet the reality is usually more complicated. Reliable deployment of ML4H to the real world is challenging as examples from diabetic retinopathy or Covid-19 screening show. We envision an integrated framework of algorithm auditing and quality control that provides a path towards the effective and reliable application of ML systems in healthcare. In this editorial, we give a summary of ongoing work towards that vision and announce a call for participation to the special issue  Machine Learning for Health: Algorithm Auditing & Quality Control in this journal to advance the practice of ML4H auditing.

Mouse model of CADASIL reveals novel insights into Notch3 function in adult hippocampal neurogenesis.

Could impaired adult hippocampal neurogenesis be a relevant mechanism underlying CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy)? Memory symptoms in CADASIL, the most common hereditary form of vascular dementia, are usually thought to be primarily due to vascular degeneration and white matter lacunes. Since adult hippocampal neurogenesis, a process essential for the integration of new spatial memory occurs in a highly vascularized niche, we considered dysregulation of adult neurogenesis as a potential mechanism for the manifestation of dementia in CADASIL. Analysis in aged mice overexpressing Notch3 with a CADASIL mutation, revealed vascular deficits in arteries of the hippocampal fissure but not in the niche of the dentate gyrus. At 12 months of age, cell proliferation and survival of newborn neurons were reduced not only in CADASIL mice but also in transgenic controls overexpressing wild type Notch3. At 6 months, hippocampal neurogenesis was altered in CADASIL mice independent of overt vascular abnormalities in the fissure. Further, we identified Notch3 expression in hippocampal precursor cells and maturing neurons in vivo as well as in cultured hippocampal precursor cells. Overexpression and knockdown experiments showed that Notch3 signaling negatively regulated precursor cell proliferation. Notch3 overexpression also led to deficits in KCl-induced precursor cell activation. This suggests a cell-autonomous effect of Notch3 signaling in the regulation of precursor proliferation and activation and a loss-of-function effect in CADASIL. Consequently, besides vascular damage, aberrant precursor cell proliferation and differentiation due to Notch3 dysfunction might be an additional independent mechanism for the development of hippocampal dysfunction in CADASIL.

Author Correction: Defined Geldrop Cultures Maintain Neural Precursor Cells.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Long-term in vivo imaging reveals tumor-specific dissemination and captures host tumor interaction in zebrafish xenografts.

Understanding mechanisms mediating tumor metastasis is crucial for diagnostic and therapeutic targeting. Here, we take advantage of a transparent embryonic zebrafish xenograft model (eZXM) to visualize and track metastatic cells in real time using selective plane illumination microscopy (SPIM) for up to 30 h. Injected human leukemic and breast cancer cells exhibited cell-type specific patterns of intravascular distribution with leukemic cells moving faster than breast cancer cells. Tracking of tumor cells from high-resolution images revealed acute differences in intravascular speed and distance covered by cells. While the majority of injected breast cancer cells predominantly adhered to nearby vasculature, about 30% invaded the non-vascularized tissue, reminiscent of their metastatic phenotype. Survival of the injected tumor cells appeared to be partially inhibited and time-lapse imaging showed a possible role for host macrophages of the recipient embryos. Leukemic cell dissemination could be effectively blocked by pharmacological ROCK1 inhibition using Fasudil. These observations, and the ability to image several embryos simultaneously, support the use of eZXM and SPIM imaging as a functional screening platform to identify compounds that suppress cancer cell spread and invasion.

Multiphasic microgel-in-gel materials to recapitulate cellular mesoenvironments in vitro.

Multiphasic in vitro models with cross-scale heterogeneity in matrix properties and/or cellular composition can reflect the structural and compositional complexity of living tissues more faithfully, thereby creating new options for pathobiology and drug development studies. Herein, a new class of tunable microgel-in-gel materials is reported that build on a versatile platform of multifunctional poly(ethylene glycol)-heparin gel types and integrates monodisperse, cell-laden microgels within cell-laden bulk hydrogel matrices. A novel microfluidic approach was developed to enable the high-throughput fabrication of microgels of in situ adjustable diameters, stiffness, degradability and biomolecular functionalization. By choosing structure and composition of the microgel and the bulk gel compartments independently, our microgel-in-gel arrangements provide cross-scale control over tissue-mimetic features and pave the way for culture systems with designed mesoenvironmental characteristics. The potentialities of the introduced approach are exemplarily shown by creating a reductionistic in vitro model of vascularized prostate cancer tissue.

Defined Geldrop Cultures Maintain Neural Precursor Cells.

Distinct micro-environmental properties have been reported to be essential for maintenance of neural precursor cells (NPCs) within the adult brain. Due to high complexity and technical limitations, the natural niche can barely be studied systematically in vivo. By reconstituting selected environmental properties (adhesiveness, proteolytic degradability, and elasticity) in geldrop cultures, we show that NPCs can be maintained stably at high density over an extended period of time (up to 8 days). In both conventional systems, neurospheres and monolayer cultures, they would expand and (in the case of neurospheres) differentiate rapidly. Further, we report a critical dualism between matrix adhesiveness and degradability. Only if both features are functional NPCs stay proliferative. Lastly, Rho-associated protein kinase was identified as part of a pivotal intracellular signaling cascade controlling cell morphology in response to environmental cues inside geldrop cultures. Our findings demonstrate that simple manipulations of the microenvironment in vitro result in an important preservation of stemness features in the cultured precursor cells.

Lysophosphatidic Acid Receptor Is a Functional Marker of Adult Hippocampal Precursor Cells.

Here, we show that the lysophosphatidic acid receptor 1 (LPA1) is expressed by a defined population of type 1 stem cells and type 2a precursor cells in the adult mouse dentate gyrus. LPA1, in contrast to Nestin, also marks the quiescent stem cell population. Combining LPA1-GFP with EGFR and prominin-1 expression, we have enabled the prospective separation of both proliferative and non-proliferative precursor cell populations. Transcriptional profiling of the isolated proliferative precursor cells suggested immune mechanisms and cytokine signaling as molecular regulators of adult hippocampal precursor cell proliferation. In addition to LPA1 being a marker of this important stem cell population, we also show that the corresponding ligand LPA is directly involved in the regulation of adult hippocampal precursor cell proliferation and neurogenesis, an effect that can be attributed to LPA signaling via the AKT and MAPK pathways.

A co-culture model of the hippocampal neurogenic niche reveals differential effects of astrocytes, endothelial cells and pericytes on proliferation and differentiation of adult murine precursor cells.

The niche concept of stem cell biology proposes a functional unit between the precursor cells and their local microenvironment, to which several cell types might contribute by cell-cell contacts, extracellular matrix, and humoral factors. We here established three co-culture models (with cell types separated by membrane) for both adherent monolayers and neurospheres to address the potential influence of different niche cell types in the neurogenic zone of the adult hippocampus of mice. Astrocytes and endothelial cells enhanced precursor cell proliferation and neurosphere formation. Endothelial factors also led to a prolonged increase in proliferation after growth factor withdrawal, which otherwise induces differentiation. All niche cell types enhanced cell survival in monolayer cultures, endothelial cells also stimulated neuronal differentiation. A parallel trend elicited by astrocytes did not reach conventional statistical significance. Pericytes had variable effects here. We did not observe changes in differentiation in neurosphere co-cultures. In summary, our data indicate that in precursor cell culture protocols survival could be improved by adding as yet unknown factors physiologically contributed by astrocytes and endothelial cells. Our findings also underscore the complexity of the niche and the differential impact of factors from the different sources on distinct aspects of neuronal development. With the help of the models presented here, identification of these factors and their specific biological activity can now be initiated.

Thermoswitching microgel carriers improve neuronal cell growth and cell release for cell transplantation.

Successful cell replacement therapy in the central nervous system (CNS) depends on both the transplanted cell type and the cell delivery method. It was established that differentiated neurons are the most desirable cell source; however, they are highly sensitive to dissociation shear; removing them from the growth surface inflicts serious damage, rendering them less viable for transplantation. Pilot experiments using glass colloids as injectable cell carriers for cell transplantation in the adult rat hippocampus have greatly improved neuron survival and long-term neuron integration. However, these early studies have highlighted glass particle shortcomings. They are uncompressible, and, thus, only a small number of beads can be injected, limiting the transplanted cell number. Moreover, they remain permanently in the brain. To improve colloidal carriers properties for cell transplantation and establish a basis for the next generation of cell delivery supports, we have designed a broadly applicable engineering strategy to enable neuronal cell growth on and release from hydrogel particles before transplantation. Here, we describe poly(N-isopropylacrylamide) (pNIPAM) particle preparation, and we demonstrate that these hydrogel particles both facilitate manipulation of neurons and enable the increase in the number of viable transplanted cells in the young adult rat hippocampus. The absence of long-term cell association to beads suggested that pNIPAM thermoswitching properties enable the separation of cells from the beads during injection, which minimizes the number of injected carriers. Contrary to observations with glass carriers, no particle clumping was observed at the injection site, which indicates minimal risk of long-term inflammatory responses. Taken together, the properties of hydrogel particles make them a promising micro-carrier to improve neuronal cell transplantation.

Extracellular matrix deposition of bone marrow stroma enhanced by macromolecular crowding.

Decellularized extracellular matrices (ECM) from in vitro cell cultures can serve as in vivo-like matrix scaffolds for modulating cell-ECM interactions. Macromolecular crowding (MMC), the supplementation of synthetic or naturally occurring molecules resulting in excluded volume effects (EVE), has been demonstrated to provide valuable options for recapitulating the physiological environment of cells during matrix secretion. Human mesenchymal stem cell (MSC)-derived ECM was produced upon supplementation of standard culture medium with three different macromolecules of various size (10-500 kDa). Matrix secretion, ECM morphology and composition were compared for matrices obtained from crowded and non-crowded MSC cultures. In the context of generating functional stem cell niches, the MSC-derived bone marrow mimetic ECM scaffolds were tested for their supportive effect to maintain and expand human hematopoietic stem and progenitor cells (HSPC) in vitro. MMC in combination with metabolic stimulation of MSC was found to result in tissue-specific, highly organized ECM capable of retaining glycosaminoglycans and growth factors to effectively build in vitro microenvironments that support HSPC expansion.

Cryogel micromechanics unraveled by atomic force microscopy-based nanoindentation.

Cell-instructive physical characteristics of macroporous scaffolds, developed for tissue engineering applications, often remain difficult to assess. Here, an atomic force microscopy-based nanoindentation approach is adapted to quantify the local mechanical properties of biohybrid glycosaminoglycan-poly(ethylene glycol) cryogels. Resulting from cryoconcentration effects upon gel formation, cryogel struts are observed to feature a higher stiffness compared to the corresponding bulk hydrogel materials. Local Young's moduli, porosity, and integral moduli of the cryogel scaffolds are compared in dependence on gel formation parameters. The results provide valuable insights into the cryogelation process and a base for adjusting physical characteristics of the obtained cryogel scaffolds, which can critically influence the cellular response.