AU2012207281A1 - Somatic cells with innate potential for pluripotency - Google Patents

Description

SOMATIC CELLS WITH INNATE POTENTIAL FOR PLURIPOTENCY

CROSS-REFERENCE

This application claims the benefit of U.S. Provisional Patent Application No.

61/434,264, filed January 19, 2011, which application is incorporated herein by reference in its entirety.

GOVERNMENT RIGHTS

This invention was made with government support under grant R01 CA097214 awarded by the National Institute of Health (NCI). The government has certain rights in this invention.

INTRODUCTION

Understanding stem cell biology is important for several aspects of biomedical research. In regenerative medicine, stem cells hold the promise of repairing or replacing defective tissues. In disease states such as cancer, stem cell properties have been implicated in critical steps of malignant transformation.

Currently, regenerative medicine is putting the majority of effort into working with embryonic stem cells or induced pluripotent stem cells. Each has its drawbacks. Embryonic stem cells raise ethical concerns and are difficult to obtain. Induced pluripotent stem cells are generated at a very low frequency by a process that introduces foreign genes into human cells. This approach is very difficult and, as is, cannot be used with FDA approval.

Finding new sources of stem cells that are relatively plentiful, can be expanded, and can be obtained without the same ethical concerns associated with embryonic stem cells is an important goal for advancing the field of regenerative medicine.

SUMMARY

Aspects of the present invention are drawn to compositions of Somatic Cells with Innate Potential for Pluripotency (SCIPPs; also referred to herein as single endogenous Pluripotent Somatic (ePS) cells), that have the potential to differentiate into functional derivatives of each of the major germ layers (i.e., ectodermal, endodermal and mesodermal). Also provided are methods and kits for identifying and isolating the somatic stem cells from a subject as well as methods for their genetic modification and use in tissue regeneration. BRIEF DESCRIPTION OF THE DRAWINGS

Fig. 1, Panels A-C: Isolation and assessment of cell properties. (A) Representative scatter plot of R1-R4 subpopulations from a disease-free reduction mammoplasty. Inset: average values for each subpopulation from ten samples. See Fig. 33 for individual values. (B)

Experimental design for assessing self-renewal and differentiation potentials of sorted R1-R4 subpopulations. (C) R1-R4 subpopulations expressed as average percentages + SEM of the total epithelial population. Mammospheres formed from 1 cell or 1,000 cells of the R1-R4 subpopulations, expressed as averaged % + SEM (n=10).

Fig. 2, Panels A-D: Rl subset enriches for ALD+ cells and has in vitro self -renewal and mammary lineage differentiation capacity for multiple passages. (A) Mammosphere forming ability ( mammospheres) for R1-R4 subsets, and for ALDEFLUOR-positive (ALD+) or ALDEFLUOR- negative (ALD-) total population and sorted Rl, R2 and R3 subsets.

Mammosphere initiating capacity was assessed using 10,000 plated live cells for the first passage and 1000 plated live cells in subsequent passages. Data expressed as Mean + SEM

(n=5) are presented in the legend of Fig. 9, Panel A. (B) FACS analysis of cells dissociated from three passages of R1-R3 ALD+ mammospheres and grown in differentiating conditions. Cells were stained for lineage-specific markers a-6-integrin/CD49f (myoepithelial) and MUC-1 (luminal). (C) Representative images of first passage R1-ALD+ mammospheres dissociated and grown in differentiating conditions for 14 days and immuno-stained for a -6-integrin/CD49f and MUC-1. R1-ALD+ mammosphere-derived cells generate monolineage myoepithelial colonies immunostained for a -6-integrin, monolineage luminal epithelial colonies immunostained for MUC-1 and bipotent colonies with cells immunostained for both α-6-integrin and MUC-1. (D) Western blot analysis for anti-human β-casein in R1-R3 ALD+ and R1-R3 ALD- mammosphere-derived cells. Loading control: actin. Positive control: BT-20 cell line.

Fig. 3, Panels A-F: Characterization of the ductal outgrowths generated from the Rl- ALD+ epithelial subset in humanized NOD/SCID mouse cleared fat pads. (A-B) Positive staining with human specific anti- CK8/18 and anti-aSMA antibodies documenting the human origin of acinar and ductal-acinar structures formed in mouse fat pads. Ducts consist of a luminal layer expressing CK8/18 and a myoepithelial layer expressing aSMA. (C and E)

Specific staining for human CK8/18 showing human origin of the acinar and ducts. (D and F) Specific staining for human β-casein milk protein detected in secretory epithelial cells and alveoli lumen. Fig. 4, Panels A-F: Rl epithelial cells can differentiate into dopaminergic neurons (DA- neurons) along the ectoderm lineage. DIC and corresponding immunofluorescence image of a single Rl-ALD+-derived DA-neuron (A) and a single hESC-derived DA-neuron (B) used for electrophysiology. DAPI (blue); tyrosine hydroxylase (TH, red); vesicular monoamine transporter 2 (VMAT2, green); merge (yellow). (C) Voltage responses in Rl-ALD+-derived DA-neuron shown in panel A and (D) hESC-derived DA-neurons in panel B. Insets: Peak amplitudes of voltage deflections as a function of current injection. (E) Table summarizing Rl- ALD+-derived and hESC-derived DA-neurons membrane properties. No parameter showed significant difference between the two groups (p>0.05 with unpaired t-test, n=5 respectively). (F) Tetrodotoxin (TTX)-mediated blockage of single transient action potentials in Rl-derived DA-neurons.

Fig. 5, Panels A-E: Rl epithelial cells are multipotent and can differentiate into definitive endoderm and mesoderm lineages. Immunofluorescence analysis of R1-ALD+ and Rl-ALD- cells for (A-B) Soxl7, Foxa2 and Brachyury after 3 days of differentiation towards definitive endoderm and (C-D) GATA4, MEF- 2, Nkx2.5 and Troponin I after 6 days of cardiomyogenic differentiation. (E) Schematic representation of the differentiation potential of Rl cells towards the three germ layers, ectoderm, endoderm and mesoderm. SCIPP: human Somatic Cells with an Innate Potential for Pluripotency corresponding to the Rl multipotent epithelial subset.

Fig. 6, Panels A-C: Individual Rl cells generate colonies that express pluripotency markers; Rl cells exhibit phenotypic fluidity. (A) Top and middle panels: phase contrast and immunofluorescence images of representative H7 and Rl-derived colonies on irradiated fibroblast feeders showing expression of pluripotency markers Oct3/4 and Nanog. Bottom panels: phase contrast and immunofluorescence images of R4 cells on irradiated fibroblast feeders documenting lack of expression of Nanog and Oct3/4 but expression of the epithelial marker EpCAM. Sox2 protein is uniformly expressed in H7 cells and Rl-derived colonies but not in R4 cells (data not shown). (B) Top panels: post-sort analysis of Rl and R4 epithelial cell subsets isolated from breast tissue (95.6% and 95.5% pure, respectively). Bottom panels:

dynamic redistribution of Rl into all four epithelial subsets R1-R4 (Rl=55%, R2=26%, R3=15% and R4=4%) after 4 weeks in culture allowing expansion of cells in an undifferentiated state. The R4 subset, even after 8 weeks of extended culture, is mostly limited to its initial distribution (Rl=0.14%, R2=1.99%, R3=10.70% and R4=88.07%). (C) Quantitative real time PCR analysis for pluripotent, reprogramming and stress associated markers in H7 hESCs, Rl- ALD+ and Rl-ALD- epithelial subsets, using endogenous transcriptspecific primers. Transcript expression levels, normalized to GAPDH expression, are relative to H9 human ES cells. Error bars indicate standard deviations (n=4).

Fig. 7, Panels A-B: Isolation and fractionation of human mammary epithelial subpopulations using cell surface marker-based FACS sorting. (A) FACS analysis of lineage cell surface markers CD2, CD3, CD16, CD31, CD45, CD64 and CD140b expression in human mammary tissue on single-cell gated populations. Cells negative or positive for the above markers were defined as the Lineage-negative (Lin-) and the Lineage-positive (Lin+) population. (B) Representative FACS analysis of Lin- unstained single cells to establish the gates for CD73 and CD90 (R1-R4).

Fig. 8, Panels A-B: Experimental Design for FACS distribution of R1-R4 subsets with and without ALDEFLUOR expression. (A) Outline of FACS-based isolation of R1-R4 subsets and their corresponding ALDEFLUOR expressing counterparts. Representative FACS analysis of Lin- cells using the ALDEFLUOR assay. Cells incubated with ALDEFLUOR substrate (BAAA) and the specific ALDH inhibitor, DEAB, were used to establish the baseline fluorescence of these cells (R5) and to define the ALDEFLUOR-positive region (R6).

Incubation of cells with ALDEFLUOR substrate in the absence of DEAB identifies a cell subpopulation that undergoes a shift in BAAA fluorescence and which corresponds to the ALD+ population. Distribution of R1-R4 in the absence of DEAB within the ALD- (R5) and ALD+ (R6) region. (B) Representative FACS analyses of baseline fluorescence (R5) and ALD+ region (R6) in the Lin- Rl, R2, R3 and R4 populations in the presence and absence of DEAB. Data are representative of ten reduction mammoplasties.

Fig. 9, Panels A-B: Self-renewal capacity and ability to recapitulate human mammary ductal- alveolar structures in vitro for R1-R4 human mammary epithelial subsets. (A)

Representative images of mammosphere forming ability for: R1-R4 subsets (a-d); R1-R3 ALD+ subsets (e-g); and R1-R3 ALDsubsets (h-j) that failed to grow in suspension. Mammosphere frequency was: 3.86+0.13, 3.44+0.16, 3.54+0.14 and 3.46+0.19, for Rl at passages 1-4;

0.47+0.01, 0.56+0.05 and 0.54+0.05 for R2 at passages 1-3; 0.58+0.01 and 0.48+0.04 for R3 at passages 1-2; 5.56+0.07, 6.3+0.26, 6.12+0.24 and 5.9+0.18 for R1-ALD+ at passages 1-4;

0.64+0.02, 0.74+0.09 and 0.58+0.07 for R2-ALD+ at passages 1- 3; 0.56+0.03 and 0.58+0.04 for R3-ALD+ at passages 1-2; 0.35+0.02, 0.44+0.05, 0.38+0.04 and 0.4+0.05 for unsorted cells at passages 1-4. Data are expressed as Mean + SEM (n=5). (B) Ductal-acinar and acinar structures generated from R1-ALD+ and R2-ALD+ mammosphere derived cells in colonogenic 3D Matrigel culture. R3-ALD+ and R1-R3 ALD- fail to generate ductal-acinar or acinar structures in these conditions. Fig. 10, Panels A-M: In vivo outgrowth potential of human mammary epithelial subsets transplanted into cleared and humanized mouse mammary fat pads. Hematoxylin and eosin staining of ducts generated by Rl ALD+/ALD- and R3 ALD+/ALD- subsets. The number of cells injected for each subset were as follows: Rl : 15,000; R1-ALD+: 5,000; R1-ALD-: 30,000; R3: 300,000; R3-ALD+: 30,000; and R3-ALD-: 200,000. R2 and R4 subsets did not generate any outgrowth when transplanted into mouse mammary fat pads (data not shown). Data are representative of experiments performed on R1-R4, and Rl and R3 ALD+/ALD- subsets isolated from three reduction mammoplasties.

Fig. 11, Panels A-D: Neural differentiation potential of Rl and R2 subsets.

Immunofluorescence analysis of Rl- ALD+ (A) and R2-ALD+ (B) cells for nestin, GFAP and TUJl/ -III-tubulin after neural differentiation. (C) Immunofluorescence analysis of hESC, H7 cells stained for GFAP and TUJl/p-III-tubulin after neural differentiation. (D) Representative images of DIC showing R1-ALD+ (top panel) and hESC, H7 (bottom panel) differentiation into dopaminergic (DA) neurons. Corresponding immunofluorescence images are shown: DAPI (blue); tyrosine hydroxylase (TH, red); vesicular monoamine transporter 2 (VMAT2, green); merge (yellow).

Fig. 12: Full lineage potential of subclones derived from a single Rl cell.

Immunoflurescence analysis for (A) ectodermal lineage: nestin, Pax6, TUJl/P-III-tubulin, TH and NCAM afler neural differentiation; (B) endodermal lineage: Foxa2, Soxl7 and Brachyury afler definitive endodermal differentiation and (C) mesodermal lineage: GATA4, MEF2 and Nkx2.5 after cardiomyocyte differentiation.

Fig. 13: Table showing distribution of R1-R4 subsets expressing or not ALDEFLUOR in the mammary epithelium. Summary of the average distribution of total Lin- population in R1-R4 subsets; average distribution of R1-R4 subsets in total ALD+ population and average distribution of ALD+ population in Rl- R4 subsets. Data are represented as percentages (means + SEM) from 10 individual samples.

Fig. 14: Short Tandem Repeat (STR) analysis. Genomic DNA was extracted from parental mammary cells dissociated from reduction mammoplasty organoids and beating cardiomyogenic cultures derived from the corresponding parental CD73⁺CD90^" (Rl) cell population. Analysis was conducted for two individual tissue samples (samples 1 and 2) with sample 2 being analyzed from two different independent differentiation experiments. DNA samples from H7 ESCs at passage 56 and K562 cells were included as internal controls for the genotyping reaction. Loci, including D5S818, D13S317, D7S820, D16S539, vWA, TH01, TPOX, CSF1P0 and the sex-chromosome marker amelogenin, were analyzed using the PowerPlex 1.2 or CelllD genotyping kits (Promega). Allelic assignment of all 9 loci analyzed was identical between each parental breast cell population and its corresponding mesodermally- differentiated (cardiomyogenic) Rl derivative in all cases but differed between donors and from that of H7 and K562 at several loci.

Fig. 15: Fold regulation of genes analyzed between R1-ALD+, Rl-ALD- and R4 epithelial subsets, H7and H9, human ESCs. All gene expression changes were normalized to H9, hESCs. Analysis was performed with soflware provided by RT² Profiler PCR Array (Qiagen, Maryland, U.S.A.) support online.

Fig. 16, Panels A-D: Rl cells have self-renewal and mammary multilineage capacity. (A) Mammosphere initiating capacity for R1-R4 subpopulations was assessed using 10,000 cells (first passage) and 1,000 cells (subsequent passages). See Fig. 23, Panel A for % mammospheres expressed as average + SEM (n=5). (B) FACS analysis of cells dissociated from successive passages of mammospheres and stained for a-6-integrin/CD49f (myoepithelial) and MUC-1 (luminal) markers. P=passage. (C) Western blot analysis for anti-human β-casein in R1-R3 mammosphere-derived cells. Loading control: actin. Positive control: BT-20 cell line. (D) Ducts consisting of a luminal layer expressing CK8/18 (green) and a myoepithelial layer expressing aSMA (red) stained with human specific antibodies documenting the human origin of structures formed in mouse fat pads. Scale=100μm.

Fig. 17, Panels A-D: Rl epithelial cells differentiate into mesoendodermal lineages. Immunostaining of Rl cells for (A) PDXl, SOX17 and NKX6.1 after 12 days of pancreatic differentiation and (B) GATA4, NKX2.5, MEF2 and Troponin I after 6 days of cardiomyogenic differentiation. Scale=100μm. (C) Oil Red O staining of Rl and human MSC after 9 days of adipogenic differentiation. (D) Transcript levels of fatty acid binding protein 4 (FABP4), LEPTIN and PPARy (normalized to Glucuronidase B (GUSB)) in directly sorted Rl, Rl in expansion medium (Rl-ctrl), Rl in adipogenic differentiation medium (Rl-diff), MSC in expansion medium (MSC-ctrl), MSC in adipogenic differentiation medium (MSC-diff) and R4.

Fig. 18, Panels A-B: Rl cells form teratomas. Rl cells directly isolated from reduction mammoplasty (A) or Rl clones expanded from single cells in culture (B) were grafted under the renal capsule of SCID/BEIGE mice. Teratomas, harvested 16 weeks after injection, were paraffin-embedded, sectioned and stained for the pan-human-specific marker lamin A/C to document the human origin of these structures (upper panels) and for lineage-specific markers (lower panels): glial (ectodermal) marker, GFAP (250x); pancreatic (endodermal) marker, PDXl (150x); or cartilage (mesodermal) marker, HAPLN1 (250x). Insets: 500x views of GFAP- positive cells. Fig. 19, Panels A-D: Single cell-derived Rl colonies express pluripotency markers. (A- C) Quantitative real-time PCR analysis for pluripotent, stress and reprogramming markers in H7 hESCs, freshly sorted Rl epithelial subpopulations, individual Rl single cell-derived colony on feeder layer, Rl subclone in expansion medium and human MSCs. Transcript levels, normalized to GAPDH expression, relative to H9 hESCs. Error bars indicate standard deviations (n=3). (D) Schematic representation of the differentiation potential of ePS cells, human endogenous Pluripotent Somatic cells, towards ectoderm, endoderm and mesoderm.

Fig. 20, Panels A-E: Rl -derived clones are mortal. (A) Rl cells expanded in culture from a single cell enter senescence. Black arrows: PDs (43, 50 and 56) at which karyotypes were confirmed to be diploid 46,XX (normal); (B) Karyotypic analysis at PD 50. (C) Flow cytometry of early (PD 51) and late (PD 58) passage cells (red circles) showing DNA content after Propidium Iodide (PI) staining and demonstrating Gl arrest at late passage. (D-E) Expression of hTERT normalized to GUSB and telomerase activity evaluated using the TRAPeze XL

Telomerase Detection Kit in the indicated cell lines. TPG: total products generated.

Fig. 21, Panels A-B: Repression of pl6^mK4a and modulation of expression of cell surface markers CD73 and CD90. (A) Transcript levels of pl6^mK4a (CDKN2A) in Mock (primary mammary epithelial cells), plKO-pG13 (cells transduced with control vector) and plKO-shpie^⁴³ (cells transduced with short hairpin to pl6^mK4a) normalized to the

housekeeping gene Glucuronidase B (GusB). (B) Graph of the average percentage of

CD73⁺CD90^" (Rl) cells in the populations measured by FACS analysis in (A) from three independent transductions. Error bars indicate standard deviations (n=3).

Fig. 22: Karyotypic Analysis of reduction mammoplasty samples. Representative karyotypic analyses of six individual reduction mammoplasty samples used in this study exhibit consistent diploid 46,XX (normal) status.

Fig. 23, Panels A-C: Self-renewal capacity and ability to recapitulate luminal, myoepithelial and ductal-alveolar structures in vitro for R1-R4 human mammary epithelial subpopulations. (A) Representative images of mammosphere forming ability for R1-R4 subpopulations (a-d). Mammosphere frequency was: 3.86+0.13, 3.44+0.16, 3.54+0.14 and 3.46+0.19, for Rl at passages 1-4; 0.47+0.01, 0.56+0.05 and 0.54+0.05 for R2 at passages 1-3; 0.58+0.01 and 0.48+0.04 for R3 at passages 1-2; 0.35+0.02, 0.44+0.05, 0.38+0.04 and 0.4+0.05 for unsorted cells at passages 1-4. Data are expressed as average + SEM from five tissue samples (n=5). (B) Representative images of first passage dissociated Rl-mammospheres grown in differentiating conditions for 14 days and immuno- stained for a-6-integrin/CD49f and MUC- 1. Rl-mammosphere-derived cells generated monolineage myoepithelial colonies immunostained for α-6-integrin, monolineage luminal colonies immunostained for MUC-1 and bipotent colonies immunostained for both α-6-integrin and MUC- 1. (C) Ductal-acinar and acinar structures generated from Rl and R2 mammosphere derived cells in colonogenic 3D Matrigel culture. R3 failed to generate ductal-acinar or acinar structures under these conditions.

Scale=10(Vm.

Fig. 24, Panels A-F: In vivo outgrowth potential of human mammary epithelial subpopulations transplanted into cleared and humanized mouse mammary fat pads. (A)

Hematoxylin and eosin staining of ducts generated after injection of 5,000 and 300,000 cells from the Rl and R3 subpopulations, respectively. R2 and R4 subpopulations did not generate any outgrowth when transplanted into mouse mammary fat pads (data not shown). (B)

Immunofluorescence staining of luminal layers with human-specific anti-CK8/18 and myoepithelial layers with anti-aSMA antibodies documenting the human origin of acinar and ductal-acinar structures formed in mouse fat pads. (C and D) Specific staining for human CK8/18 showing human origin of the acini and ducts. (E and F) Specific staining for human β- casein milk protein detected in secretory epithelial cells and alveolar lumen. Data are representative of experiments performed on R1-R4 subpopulations isolated from three reduction mammoplasties.

Fig. 25, Panels A-D: Neural differentiation potential of Rl cells. (A): Phase contrast images of Rl (CD73⁺CD90^~)- or H7- derived neurospheres in culture; (B): immunofluorescence analysis of Rl cells stained for nestin, GFAP and TUJl/β-ΙΙΙ- tubulin after neural differentiation; (C): Immunofluorescence analysis of H7 hESCs stained for GFAP and TUJl/p-III-tubulin after neural differentiation; (D): Immunofluorescence analysis of Rl and H7 hESC stained for tyrosine hydroxylase (TH, red) and vesicular monoamine transporter 2 (VMAT2, green) after differentiation into putative dopaminergic (DA) neurons. DAPI (blue); merge (yellow).

Fig. 26, Panels A-C: Mesoendodermal differentiation potential of Rl cells.

Immunoflurescence analysis of Rl cells for (A) endodermal lineage: FOXA2, SOX17 and Brachyury expression after 3 days of differentiation towards definitive endoderm and (B) mesodermal (adipogenic) lineage: FABP4 expression after 19 days of adipogenic differentiation. Human MSCs were used as a positive control. Scale=100μm. (C) Cord formation capacity evaluated after 24h in endothelial Matrigel differentiation assay by phase-contrast microscopy for (a) Rl, (b) HUVEC, (c) primary human mammary epithelial cells or after 24h in basal growth medium for (d) primary mammary epithelial cells as a negative control.

Fig. 27, Panels A-D: Formation of teratomas from directly sorted Rl cell populations or from a single cell-derived Rl subclone. Rl cells directly isolated from reduction mammoplasty tissues (A-B) or a single cell-derived Rl subclone (C-D) were grafted under the renal capsule of SCID/BEIGE mice. Teratomas were harvested 16 weeks after injection. Serial sections from the paraffin-embedded teratomas were stained for the pan-human-specific marker lamin A/C to document the human origin of these structures (A-C, left panel) and for the lineage- specific marker HAPLN1 (A-C, right panel). Representative 40x views of whole teratoma are shown. (B-D) Additional 80x views of structures expressing the endodermal markers AFP and TFF3 and corresponding staining for human lamin A/C. Cells expressing TFF3 document the generation of intestinal goblet cells.

Fig. 28, Panels A-B: Formation of H7 ESCs-derived teratomas and MDA-MB231 mammary tumors. (A) H7 ESCs or (B) MDA-MB231 breast cancer cells were grafted under the renal capsule of SCID/BEIGE mice. H7 ESCs-derived teratomas and MDA-MB231 mammary tumors were harvested 8 weeks after injection. Serial sections from the paraffin-embedded H7 ESCs-derived teratomas or MDA-MB231 mammary tumors were stained for the pan-human- specific marker lamin A/C to document the human origin of these structures (upper panels) and for lineage-specific markers (lower panels). These markers included the glial (ectodermal) marker GFAP, the pancreatic (endodermal) marker PDX1 or the cartilage (mesodermal) marker HAPLN1. (A) 80x views of representative fields of H7 ESCs-derived teratomas (B) 3x views (left column) and 120x views (right column) of representative fields of a MDA-MB231 mammary tumor.

Fig. 29, Panels A-D: In vitro differentiation potential of single cell-derived Rl subclones towards ectodermal, endodermal and mesodermal lineages. Single cells were expanded in culture and assayed for differentiation potential. Immunofluorescence analysis for (A-B) ectodermal lineage: (A) α-6-integrin (myoepithelial) and MUC-1 (luminal) expression after mammary differentiation. Arrows indicate cells expressing only one marker in contrast to the majority of cells which express both markers (bi-potent progenitors); (B) NCAM, Nestin, PAX6, TH and TUJl/β-ΙΙΙ- tubulin expression after neural differentiation; (C) endodermal lineage: FOXA2, SOX17, PDX1 expression after pancreatic differentiation (note the lack of expression of Brachyury documenting a full commitment towards the endoderm lineage) and (D) mesodermal lineage: GATA4, MEF2 and NKX2.5 expression after cardiomyocyte differentiation. Scale=100μm.

Fig. 30, Panels A-B: Expression of pluripotency markers OCT3/4, SOX2 and NANOG in single cell-derived Rl -colonies. Lin-negative, EPCAM-positive epithelial cells were evaluated for expression of OCT3/4, SOX2 and NANOG. (A) Expression of pluripotency markers OCT3/4 and NANOG in individual cells assessed by flow cytometry after 14 days of culture on feeder layers. Left panel: isotype control, middle panel: Rl-derived colonies; right panel: H7 hESCs. SOX-2 data are not shown. 96% of the Rl population stained positive for all three markers. (B) Western Blot analysis of pluripotency markers OCT3/4, SOX2 and NANOG in single cell-derived Rl-colonies on feeders after 14 days. H7 (positive control), RMF

(reduction mammary fibroblasts) and R4 cells (negative controls). Loading control: γ-tubulin.

Fig. 31, Panels A-D: Specificity of antibodies used to stain ectodermal and endodermal derivatives. Antibodies selected for immunofluorescence staining of ectodermal derivatives (A- B) and endodermal derivatives (C-D) were tested on H7-derived neuronal and definitive endoderm derivatives (A-D, top rows) used as biological positive controls. Human primary fibroblasts (A-D, rows) were used as biological negative controls. Scale=100μm.

Fig. 32: Specificity of antibodies used to stain lineage derivatives within teratomas. Antibodies selected for teratoma analysis were tested on various human tissues used as antibody-specific positive controls (testis for anti-LAMIN A/C, brain for anti-GFAP, pancreas for anti-PDXl, cartilage for anti-HAPLNl, colon for anti-TFF3 and liver tumor for anti-AFP). Teratoma sections were stained in the absence (-Ab; upper row) or in the presence (+Ab; middle row) of the primary antibody as described in the Examples section. Antibodies were also tested on mouse kidney sections (lower row) to demonstrate that the antibodies failed to demonstrate a lack of cross-reactivity with murine tissues. Only the anti-TFF3 antibody showed minimal reactivity with mouse kidney but the human origin of TFF3 -expressing structures in Rl-derived and H7-derived teratomas was documented with the highly human-specific anti lamin A/C antibody (Fig. 27, Panel B). Magnification: 120x.

Fig. 33: Table showing CD73 and CD90 distribution profiles for 10 disease-free women. Percentages of lineage negative cells expressing CD73 and CD90 in various combinations from 10 reduction mammoplasty samples. Age and ethnicity of tissue donors are provided.

Fig. 34: Relative expression of pluripotency, stress response and reprogramming genes in R1-R4 subpopulations, H7 and H9 hESCs and human MSCs. Custom qPCR-array (Qiagen) was performed on H7 hESCs (n=l), H9 hESCs (n=l), human MSCs (n=l), R1-R4 cells isolated from four tissue donors (n=4), single cell-derived Rl colonies grown on feeder layers (n=3), single cell-derived Rl clones grown under expansion conditions (n=3). Each sample was probed as technical duplicates in two different experiments. Analysis was performed with the RT² Profiler PCR Array online software (Qiagen, Maryland, U.S.A.). Averaged gene expression levels relative to those in H9 hESCs with p-values are provided.

Fig. 35, Panels A-B: (A) Unstained single cell isolates from human pancreas showing gate set up according to cell surface markers CD73 and CD90. Stained single cell isolates from human pancreas showing distribution of R1-R4 cell populations in Lineage negative fraction. (B) In vitro mammary lineage differentiation of Rl cells from Panel A. α-6-integrin

=Myoepithelial cell marker; MUCl=luminal cell marker. Scale = ΙΟΟμιη.

DETAILED DESCRIPTION OF THE INVENTION

A substantially enriched mammalian Somatic Cells with an Innate Potential for

Pluripotency (SCIPP) is provided. The SCIPPs are useful in generating differentiated cells of ectodermal, endodermal and mesodermal lineages, either in vitro or in vivo. The SCIPPs are useful in transplantation, for experimental evaluation, and as a source of lineage and cell specific products.

In some embodiments, the cells are defined as being lineage marker negative (Lin ), CD73⁺, and CD90^". The determination of Lin- cells can be done in any convenient manner, including employing lineage marker-specific agents (e.g., antibodies) that bind to and thus identify cells as belonging to a specific cell lineage (e.g., blood cell lineage, e.g., macrophage, lymphocyte, etc.). In certain embodiments, the lineage panel may include binding agents for CD2, CD3, CD16, CD31, CD45, CD64 and/or CD140b. Other lineage markers can also be used in determining Lin- cells.

As detailed below, SCIPP can develop into functional differentiated cell types, including neurons and cardiomyocytes, and thus may be used to treat a variety of injury, trauma or disease states where tissue regeneration or replacement would provide a benefit (e.g., Parkinsons, Alzheimers, diabetes, osteoarthritis, wound repair, recovery after chemotherapy, aging, and the like).

Since stem cell functions are also important in several disease states (such as cancer) these cells also have the potential to be used for therapeutic screens and development of agents and biomarkers for prevention and intervention into several disease processes.

SCIPP also find use as a model for studying malignant transformation as well as stochastic switching of cells, e.g., from a stable phenotypic state to a plastic state.

Systems and kits for isolating SCIPP from a subject are also provided. In addition, aspects of the invention are drawn to services for isolating and providing SCIPP for research and therapeutic purposes to an end user. Before the present invention is described in greater detail, it is to be understood that this invention is not limited to particular embodiments described, as such may, of course, vary. It is also to be understood that the terminology used herein is for the purpose of describing particular embodiments only, and is not intended to be limiting, since the scope of the present invention will be limited only by the appended claims.

Where a range of values is provided, it is understood that each intervening value, to the tenth of the unit of the lower limit unless the context clearly dictates otherwise, between the upper and lower limit of that range and any other stated or intervening value in that stated range, is encompassed within the invention. The upper and lower limits of these smaller ranges may independently be included in the smaller ranges and are also encompassed within the invention, subject to any specifically excluded limit in the stated range. Where the stated range includes one or both of the limits, ranges excluding either or both of those included limits are also included in the invention.

Certain ranges are presented herein with numerical values being preceded by the term "about." The term "about" is used herein to provide literal support for the exact number that it precedes, as well as a number that is near to or approximately the number that the term precedes. In determining whether a number is near to or approximately a specifically recited number, the near or approximating unrecited number may be a number which, in the context in which it is presented, provides the substantial equivalent of the specifically recited number.

Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. Although any methods and materials similar or equivalent to those described herein can also be used in the practice or testing of the present invention, representative illustrative methods and materials are now described.

All publications and patents cited in this specification are herein incorporated by reference as if each individual publication or patent were specifically and individually indicated to be incorporated by reference and are incorporated herein by reference to disclose and describe the methods and/or materials in connection with which the publications are cited. The citation of any publication is for its disclosure prior to the filing date and should not be construed as an admission that the present invention is not entitled to antedate such publication by virtue of prior invention. Further, the dates of publication provided may be different from the actual publication dates which may need to be independently confirmed.

It is noted that, as used herein and in the appended claims, the singular forms "a", "an", and "the" include plural referents unless the context clearly dictates otherwise. It is further noted that the claims may be drafted to exclude any optional element. As such, this statement is intended to serve as antecedent basis for use of such exclusive terminology as "solely," "only" and the like in connection with the recitation of claim elements, or use of a "negative" limitation.

As will be apparent to those of skill in the art upon reading this disclosure, each of the individual embodiments described and illustrated herein has discrete components and features which may be readily separated from or combined with the features of any of the other several embodiments without departing from the scope or spirit of the present invention. Any recited method can be carried out in the order of events recited or in any other order which is logically possible.

DEFINITIONS

The terms "individual," "subject," "host," and "patient," used interchangeably herein and refer to any mammalian subject that is either the source of tissue for isolating or identifying cells as described herein and/or for whom diagnosis, treatment, or therapy is desired, particularly humans.

A "gene product" is a biopolymeric product that is expressed or produced by a gene, such as a peptide or protein. A gene product may be, for example, an unspliced RNA, an mRNA, a splice variant mRNA, a polypeptide, a post-translationally modified polypeptide, a splice variant polypeptide etc. Also encompassed by this term are biopolymeric products that are made using an RNA gene product as a template (i.e., cDNA of the RNA). A gene product may be made enzymatically, recombinantly, chemically, or within a cell to which the gene is native. In many embodiments, if the gene product is proteinaceous, it exhibits a biological activity. In many embodiments, if the gene product is a nucleic acid, it can be translated into a proteinaceous gene product that exhibits a biological activity.

The terms "polypeptide" and "protein," used interchangeably herein, refer to a polymeric form of amino acids of any length, which can include coded and non-coded amino acids, chemically or biochemically modified or derivatized amino acids, and polypeptides having modified peptide backbones. The term includes fusion proteins, including, but not limited to, fusion proteins with a heterologous amino acid sequence, fusions with heterologous and homologous leader sequences, with or without N-terminal methionine residues;

immunologically tagged proteins; and the like.

The term "polynucleotide" refers to polymeric forms of nucleotides of any length, either ribonucleotides or deoxyribonucleotides, including, but not limited to: single-, double-, or multi- stranded DNA or RNA, genomic DNA, cDNA, DNA-RNA hybrids, or a polymer comprising purine and pyrimidine bases or other natural, chemically or biochemically modified, non-natural, or derivatized nucleotide bases. A polynucleotide may comprise modified nucleotides, such as methylated nucleotides and nucleotide analogs as well as one or more non-nucleotide components. The term "polynucleotide" also encompasses peptidic nucleic acids (PNAs; Pooga et al Curr Cancer Drug Targets. (2001) 1:231-9).

The term "specific binding" refers to the ability of an affinity reagent to preferentially bind to a particular target molecule that is present in a homogeneous mixture of different target molecules (e.g., a specific protein present on the surface of a cell).

Specific binding agents (also referred to as "affinity reagents") include, e.g., antibodies, antigen-binding fragments of an antibody; an epitope-binding fragment of an antibody; or other protein that bind specifically to an epitope on a target molecule, e.g., a polypeptide. Specific binding agents also include non- antibody reagents that exhibit specific binding to a target molecule.

The term "antibody", "antibody protein", "antibody reagent" and the like is used herein to refer to an affinity reagent that has at least an epitope binding domain of an antibody. These terms are well understood by those in the field, and refer to a protein containing one or more polypeptides that specifically binds an antigen. Types of antibodies include, but are not limited to: antibody isotypes, monoclonal antibodies and antigen-binding fragments thereof (e.g., Fab, Fv, scFv, and Fd fragments, chimeric antibodies, humanized antibodies, single-chain antibodies, etc.), artificial antibodies (e.g., antibodies and antibody fragments produced and selected in vitro). In some embodiments, an antibody reagent is immobilized on an insoluble, or solid, support (e.g., plate, bead, membrane, etc.). In some embodiments, a panel of antibodies is provided, where a panel of antibodies is two or more different antibodies, each specific for a different polypeptide that comprises an SCIPP signature. The antibody reagents bind specifically to a selected target polypeptide or collection of selected target polypeptides.

In some embodiments, an antibody reagent is directly or indirectly detectably labeled. Direct labels include radioisotopes; enzymes having detectable products (e.g., lucif erase, β- galactosidase, etc.); fluorescent labels (e.g., fluorescein isothiocyanate, rhodamine,

phycoerythrin, etc.); fluorescence emitting metals; chemiluminescent compounds, e.g., luminol, isoluminol, acridinium salts, etc; bioluminescent compounds, e.g., luciferin, fluorescent proteins (e.g., green fluorescent protein), etc. Other suitable detectable labels include fluorescent dyes, e.g., Fluorescein, Rhodamine, Texas Red, Cy2, Cy3, Cy5, Lucifer Yellow, Alexa dye family, BOD1PY, boron dipyrromethene difluoride, Oregon Green, Phycoerythrin, Phycobiliproteins, etc. Indirect labels include second antibodies specific for an antibody reagent, wherein the second antibody is labeled as described above; and members of specific binding pairs, e.g., biotin-avidin, and the like.

The term "binds specifically," in the context of a specific binding reagent, e.g., in the context of antibody binding, refers to high avidity and/or high affinity binding to a specific polypeptide i.e., epitope of a polypeptide, e.g., a cell surface expressed polypeptide (e.g., CD73,

CD90, etc.). For example, antibody binding to an epitope on a specific a target protein (or fragment thereof) is stronger than binding of the same antibody to any other epitope, particularly those which may be present in the same sample. Specific binding reagents, e.g., antibodies, that bind specifically to a polypeptide may be capable of binding other polypeptides at a weak, yet detectable, level (e.g., 10% or less of the binding shown to the polypeptide of interest). Such weak binding, or background binding, is readily discernible from the specific antibody binding to a target polypeptide, e.g. by use of appropriate controls.

A composition (e.g. a polynucleotide, polypeptide, antibody, or cell composition) that is

"isolated" or "in substantially isolated form" (sometimes referred to as an "enriched" or "purified" sample) refers to a composition that is in an environment different from that in which the composition naturally occurs or in which it developed. For example, a cell that is in substantially isolated form is outside of, or removed from, the site in the host in which the cell naturally developed. A composition which is in substantially isolated form is usually

substantially purified or enriched.

As used herein, "subject," "host," "patient," and "individual" are used interchangeably to refer to a mammal, e.g., a human, a non-human primate, ungulates, canines, felines, equines, and the like.

The term "assessing" includes any form of measurement, and includes determining if an element is present or not. The terms "determining", "measuring", "evaluating", "assessing" and "assaying" are used interchangeably and include quantitative and qualitative determinations. Assessing may be relative or absolute. "Assessing the presence of includes determining the amount of something present, and/or determining whether it is present or absent. As used herein, the terms "determining," "measuring," "assessing," and "assaying" are used interchangeably and include both quantitative and qualitative determinations.

CD73 (also referred to as ecto 5 '-nucleotidase) is a membrane -bound enzyme that catalyzes the conversion of AMP to bioactive adenosine at neutral pH; and also has functions independent of its enzyme activity. CD73 is expressed on various cells include endothelial cells, pericytes, follicular dendritic cells, and subsets of T cells as well as others. Amino acid sequences of human CD73 are known, and are presented in, e.g., GenBank Accession Nos. AAH65937, NP_002517, and AI40168.

CD90, also known as Thy-1, is a 25-37 kD, glycosylphosphatidylinositol-anchored, cell surface glycoprotein found on many cell types. Amino acid sequences of human CD90 are known, and are presented in, e.g., GenBank Accession Nos. P04216, AAG13904, AAH65559, and NP_006279. See also, Seki et al. (1985) Proc. Natl. Acad. ScL U.S.A. 82:6657-6661.

It will be understood by those of skill in the art that the expression levels for cell surface markers (e.g., CD antigens) as described herein reflect detectable amounts of the marker protein on the cell surface. Thus, a cell that is "negative" for staining (e.g., the level of binding of a marker- specific antibody is not detectably different from an isotype matched control) may still express minor amounts of the marker. And while it is commonplace in the art to refer to cells as "positive" or "negative" for a particular marker, actual expression levels is a quantitative trait. The number of molecules on the cell surface can vary by several logs, yet still be characterized as "positive".

In some embodiments, the marker- specific staining intensity of cells can be monitored by flow cytometry, e.g., using fluorescently labeled antibodies as is known in the art. In flow cytometry, lasers are employed to detect the quantitative levels of a fluorochrome (e.g., attached to a marker- specific antibody) is associated with a single cell. The detected level of

fluorochrome is proportional to the amount of cell surface marker bound by the specific reagent (e.g. labeled antibodies). Flow cytometry can be used to simultaneously detect the levels of multiple different fluorochromes, and thus can detect the level of binding of multiple differentially labeled marker- specific reagents associated (or bound to) a single cell (e.g., 2, 3, 4, 5, 6, 7, 8, 9, or 10 or more different fluorochromes/markers). Flow cytometry, or FACS, can also be used to separate cell populations based on the intensity of binding to a specific reagent, as well as other parameters such as cell size and light scatter. Although the absolute level of staining may differ with a particular fluorochrome and reagent preparation, the data can be normalized to a control.

In order to normalize the distribution to a control, each cell is recorded as a data point having a particular intensity of staining for each desired parameter (e.g., fluorochrome, light scatted, etc.). These data points may be displayed according to a log scale, where the unit of measure is arbitrary staining intensity. In one example, the brightest stained cells in a sample can be as much as 4 logs more intense than unstained cells. When displayed in this manner, it is clear that the cells falling in the highest log of staining intensity are bright, while those in the lowest intensity are negative. The "low" positively stained cells have a level of staining above the brightness of an isotype matched control, but not as intense as the most brightly staining cells normally found in the population. An alternative control may utilize a substrate having a defined density of marker on its surface, for example a fabricated bead or cell line, which provides the positive control for intensity.

The gene expression level of certain genes is disclosed herein (see, e.g., Figure 15,

Figure 34). The identity of the genes may be found by searching the Entrez PubMed database [www(dot)ncbi(dot)nlm(dot)nih(dot)gov /sites/entrez?cmd=Pager&db=pubmed] using the "Gene" search. Certain representative GenelDs as obtained from PubMed are provided below (all are for human):

KLF4 (Kruppel-like factor 4) : GenelD 9314

cMYC (v-myc myelocytomatosis viral oncogene homolog (avian)): GenelD 4609

OCT4 (POU5F1): GenelD 5460

NANOG (Nanog homeobox): GenelD 79923

CD24: GenelD 100133941

EPCAM (epithelial cell adhesion molecule): GenelD 4072

CECR1 (cat eye syndrome chromosome region, candidate 1): GenelD 51816

DNMT3B (DNA (cytosine-5-)-methyltransferase 3 beta): GenelD 1789

PTGS2 (prostaglandin-endoperoxide synthase 2): GenelD 5743. MARKERS OF SOMATIC CELLS WITH AN INNATE POTENTIAL FOR PLURIPOTENCY

(SCIPP)

Somatic Cells with an Innate Potential for Pluripotency are provided, herein termed SCIPP. SCIPPs may also be referred to herein as endogenous Pluripotent Somatic (ePS) cells. The terms "Somatic Cells with an Innate Potential for Pluripotency," "SCIPP", "endogenous Pluripotent Somatic cell," and "ePS" may be used interchangeably herein. The SCIPP population is useful in any of a variety of research and therapeutic purposes, e.g.,

transplantation, tissue regeneration (e.g., for the replacement or repair of damaged cells/tissues of a subject), in vitro development assays, drug screening, experimental models of cellular differentiation and interaction; screening in vitro assays to define growth and differentiation factors, and to characterize genes involved in development of particular lineages, and the like. The native cells may be used for these purposes, or they may be genetically modified to provide altered capabilities.

In some embodiments, SCIPPs can be enriched from a complex mixture of cells by using reagents that specifically recognize markers present on the cell surface. The SCIPP express detectable levels of, or are "positive for", the marker CD73, and are selected for a lack of expression of, or are "negative" for, Thy-1 (CD90). The SCIPP cells further have the phenotype of lacking expression of lineage specific markers. For staining purposes a cocktail of binding reagents, herein designated "Lin", may be used. The Lin panel will comprise binding reagents, e.g. antibodies and functional binding fragments thereof, ligands, peptidomimetics, etc., that recognize two or more lineage markers. Markers suitable for use in a Lin panel are typically expressed on mature cells, but are not present on multiple lineages, or on stem and progenitor cells. Lineage panel markers include, but are not limited to: CD2, CD3, CD16, CD31, CD45, CD64, CD 140b, and any combination thereof.

SCIPPs may be further characterized based on their pattern of gene expression. Figures 15 and 34 show fold regulation of certain genes analyzed in an SCIPP cell populations (R1-ALD+ and Rl-ALD- in Figure 15; Rl in Figure 34) and other non-SCIPP subsets (R3-ALD+, R3-ALD-, human MSC, and human ES cell line H7). Gene expression in human ES cell line H9 is used as the control for determining whether a gene demonstrates increased/decreased expression in each cell population in Figures 15 and 34. SCIPPs may have a gene expression pattern that is similar to the expression any 1 or more genes, 2 or more genes, 3 or more genes, 5 or more genes, 10 or more genes, 20 or more genes, or up to all of the genes as shown in Figure 15 or 34. Applicants stress that the gene expression pattern of SCIPPs according to aspects of the invention, which are, for brevity, described in Figures 15 or 34, include all gene expression combinations described in the tables and thus are disclosed just as if each and every gene expression combination was individually and explicitly disclosed.

For example, SCIPPs as described herein may express genes that are involved in maintaining pluripotency and/or employed for reprogramming differentiated cells to pluripotency (for exemplary descriptions of pluripotency and reprogramming factors, see US patent application publications: US20090068742 (Yamanaka et al.); US20090191159 (Sakurada et al.); US20080233610 (Thomson et al.); and US20080280362 (Jaenish et al.); each of which is incorporated herein by reference in their entirety). Genes in this category that are expressed in SCIPPs include: KLF4, MYC, OCT4, NANOG, CD24 and any combination thereof. SCIPPs may express certain epigenetic plasticity markers (e.g., CECR1, DNMT3B, or both), stress markers (e.g., PTGS2/COX2), cell adhesion molecules (e.g., EPCAM), or any combination thereof. As shown in Figure 15 and Figure 34, the expression levels of each of the genes KLF4, MYC, and PTGS2 is increased in SCIPPs (R1-ALD+ and R1-ALD-) as compared to the gene expression levels observed in either ESCs or MSCs. The expression levels of each of the genes POU5Fl(OCT3/4), NANOG, CD24 and EPCAM in SCIPPs is increased as compared to MSCs and at a level similar to that detected in ESCs. The expression levels of each of the genes CECRl and DNMT3B in SCIPPs is decreased as compared to ESCs and at a level similar to that detected in MSCs.

Thus, in certain embodiments, SCIPPs express increased levels of any one or more of the genes KLF4, MYC, and PTGS2 as compared to either ESCs or MSCs. In certain embodiments, SCIPPs express any one or more of the genes POU5F1/OCT3/4, NANOG, CD24 and EPCAM at increased levels as compared to MSCs and at levels similar to that detected in ESCs. In certain embodiments, SCIPPs express any one or both of the genes CECRl and DNMT3B at decreased levels as compared to ESCs and at levels similar to that detected in MSCs.

In certain embodiments, a population of SCIPPs contains both ALD+ and ALD- cells.

When present in a subject, SCIPP express epithelial markers and are not readily discemable from other cells in the steady state. Under certain conditions, however, SCIPP begin to express increased levels of certain pluripotency genes, e.g., OCT4, NANOG, SOX and the like. Such conditions include tissue damage (e.g., under wound healing conditions) presence of activin A and when dsDNA breaks occur.

While SCIPP may be expanded in culture, they are not immortal, i.e., they have a limited growth potential. This feature, which is in contrast to other stem cells, e.g., ES cells, provide for an advantage when employing the cells or derivatives thereof as therapeutic agents for tissue regeneration or repair. Specifically, SCIPP have reduced potential for unregulated growth in a subject.

SCIPPs may be further characterized based on their ability to grow on certain substrates or in certain media formulations. SCIPP display unique growth characteristics in in vitro culture. For example, SCIPP can be expanded on placental fibroblast feeder cells as well as in AT ALA media (see Examples section below). This unique growth property allows for SCIPP to be selectively propagated from somatic tissue, thus allowing for a robust method for producing highly enriched cultures of SCIPP, even without the use of pre-culture sorting based on the expression of CD73, CD90 and/or lineage markers.

Based on initial studies with human breast tissue, approximately 5% of ductal epithelial cells (Rl as designated below and in the Figures) typically fall within the CD73+/CD90- subset of cells. Of this 5% of CD73+/CD90- subset of ductal epithelial cells, approximately 3% represent SCIPP cells in a typical disease-free individual. This is based on an analysis of the growth and developmental characteristics of the CD73+/CD90- subset. For example, approximately 3% of the CD73+/CD90- cells will (1) form mammospheres or neurospheres in culture and (2) grow colonies that are pluripotent (e.g, on placental feeders or in ATALA culture conditions).

METHODS OF ISOLATION/ENRICHMENT OF SCIPP

Methods of isolation/enrichment of SCIPP are provided. An isolated/enriched SCIPP sample may include a single cell of the SCIPP phenotype or may comprise a population of cells, where the population of cells contain 1% or more SCIPPs of the selected phenotype, including 2% or more, 3% or more, 4% or more, 5% or more, 6% or more, 7% or more, 8% or more, 9% or more, 10% or more, 15% or more, 20% or more, 25% or more, 30% or more, 35% or more, 40% or more, 45% or more, 50% or more, 55% or more, 60% or more, 65% or more, 70% or more, 75% or more, 80% or more, 85% or more, 90% or more, 95% or more, up to and including 100% of the cells, and can be, for example, a population of cells that contain from 1% to 100%, 5% to 100%, 8% to 100%, 10% to 100%, 15% to 100%, SCIPPs of the selected phenotype.

As noted above, SCIPP can be separated from other cells in a cell sample from a subject on the basis of either specific markers, which are identified with affinity reagents, e.g.

monoclonal antibodies, and/or by differential culturing techniques, e.g., by culturing a cell sample from a subject on placental fibroblast feeder cells or in ATALA media. Thus, as detailed below, an isolation method may include enriching a population of subject-derived cells for CD73+/CD90-/Lin- cells followed by culturing the cells under SCIPP growth promoting conditions. In other embodiments, a subject derived cell sample may be subjected to SCIPP growth promoting conditions without first enriching for CD73+/CD90-/Lin- cells. It is noted that any combination of enrichment/differential growth may be employed to obtain the SCIPP as detailed herein. Moreover, enrichment for only one of CD73+, CD90-, or Lin- cells may be used (as opposed to all three).

Ex vivo and in vitro cell populations useful as a source of SCIPP cells may include freshly harvested or frozen cells from any of a variety of somatic tissues, e.g., mammary tissue, pancreatic tissue, etc., where in certain embodiments the tissues are "normal" (i.e., not neoplastic, not containing tumor cells, etc.) or "disease-free." By "disease free" is meant that the tissue is asymptomatic or substantially asymptomatic for cancer, or the subject from whom the tissue was obtained is asymptomatic for cancer or in clinical remission. By "remission" or "clinical remission," which may be used synonymously, it is meant that the clinical signs, radiological signs, and symptoms of cancer have been significantly diminished or have disappeared entirely based on clinical diagnostics, although cancerous cells can still exist in the body. Thus, it is contemplated that remission encompasses partial and complete remission. The terms "normal" and "disease-free" may be used interchangeably herein. In certain

embodiments, the source of SCIPP is disease-free or normal breast tissue, e.g., as obtained from reduction mammoplasty. The progenitor cells may be obtained from any mammalian species, e.g. human, equine, bovine, porcine, canine, feline, rodent, e.g. mice, rats, hamster, primate, etc. The tissue may be obtained by biopsy from a live donor, or obtained from a dead or dying donor within about 96 hours of death, or freshly frozen tissue, tissue frozen within up to 72 hours of death and maintained at below about -20°C, usually at about liquid nitrogen temperature (- 180°C) indefinitely.

The subject cells are separated from a complex mixture of cells by techniques that enrich for cells that express certain cell surface markers, while lacking certain cell specific markers. For example, methods for producing a sample enriched for SCIPP include the contacting a cell sample (e.g., a somatic cell sample) with an affinity reagent specific for CD73 and an affinity reagent specific for CD90, and then selecting for cells that are CD73 positive and CD90 negative. In some embodiments, the cell sample is also selected for cells that are lineage marker (Lin) negative (as described above; e.g., contacting the sample with affinity reagents specific for the Lin markers, and selecting for cells that are Lin negative; the cells may concurrently or subsequently be selected for cells that are CD73⁺ CD90^"). As such, selection may be made for all markers simultaneously, or for any suitable sequential process, e.g. performing a negative selection, e.g., for one or more of Lin markers and/or CD90, followed by a positive selection for CD73.

The subject cells may further be isolated based on the expression level of one or more genes as described above (and shown in Figures 15 and 34).

For isolation of cells from tissue, appropriate mechanical and/or enzymatic processing steps may be used and the cells placed in a suitable solution for dispersion or suspension. Such solution will generally be a balanced salt solution, e.g. normal saline, PBS, Hank's balanced salt solution, etc., conveniently supplemented with fetal calf serum or other naturally occurring factors, in conjunction with an acceptable buffer at low concentration, generally from 5-25 mM. Convenient buffers include HEPES, phosphate buffers, lactate buffers, etc. Enzymes for cell isolation may include any one or more of collagenase, hyaluronidase, trypsin, dispase-DNAse I, and the like. Exemplary tissue processing steps are described in the Examples section below.

Separation of the subject cell populations may employ affinity separation to provide a substantially enriched population. Techniques for affinity separation may include magnetic separation, using antibody-coated magnetic beads, affinity chromatography, cytotoxic agents joined to a monoclonal antibody or used in conjunction with a monoclonal antibody, e.g.

complement and cytotoxins, and "panning" with antibody attached to a solid matrix, e.g. plate, or other convenient technique. Techniques providing accurate separation include fluorescence activated cell sorters, which can have varying degrees of sophistication, such as multiple color channels, low angle and obtuse light scattering detecting channels, impedance channels, etc. The cells may be selected against dead cells by employing dyes associated with dead cells (e.g. propidium iodide). Any technique may be employed which is not unduly detrimental to the viability of the selected cells.

In certain embodiments, affinity reagents employed may be specific receptors or ligands for the cell surface molecules indicated above. In addition to antibody reagents, peptide-MHC antigen and T cell receptor pairs may be used; peptide ligands and receptor; effector and receptor molecules, phage display fragments and the like. Antibodies and T cell receptors may be monoclonal or polyclonal, and may be produced by transgenic animals, immunized animals, immortalized human or animal B-cells, cells transfected with DNA vectors encoding the antibody or T cell receptor, etc. The details of the preparation of antibodies and their suitability for use as specific binding members are well-known to those skilled in the art.

Of particular interest is the use of antibodies as affinity reagents. Conveniently, these antibodies are conjugated with a label for use in separation. Labels include magnetic beads, which allow for direct separation, biotin, which can be removed with avidin or streptavidin bound to a support, fluorochromes, which can be used with a fluorescence activated cell sorter, or the like, to allow for ease of separation of the particular cell type. Any convenient fluorochrome may be employed, and include those mentioned above and in the Examples section below, e.g., phycobiliproteins, e.g. phycoerythrin and allophycocyanins, fluorescein and Texas red. Frequently each different marker- specific antibody is labeled with a different, differentially detexctable fluorochrome to permit independent sorting for each marker.

However, where multiple different markers are to be used as negative selection markers, each different marker-specific antibody may be labeled with the same fluorochrome (e.g., all lineage marker- specific antibodies may be labeled with the same fluorochrome).

The antibodies are added to a suspension of cells, and incubated for a period of time sufficient to bind the available cell surface antigens (e.g., from 5 minutes to 1 hour; although this time can be variable and will depend on the desires of the user and the antibodies employed). It is generally desirable to have a sufficient concentration of antibodies in the reaction mixture such that the efficiency of the separation is not limited by lack of antibody. The appropriate concentration can be determined by titration. If the cells are to be cultured, grown, amplified or transplanted in subsequent steps (i.e., after the enrichment process), the medium in which the cells are separated will be any medium that maintains the viability of the cells. Various media are commercially available and may be used according to the nature of the cells, including Dulbecco's Modified Eagle Medium (dMEM), Hank's Basic Salt Solution (HBSS), Dulbecco's phosphate buffered saline (dPBS), RPMI, Iscove's medium, PBS with 5 mM EDTA, etc., frequently supplemented with fetal calf serum, BSA, HSA, etc. However, if the enriched SCIPP are to be employed in assays that do not require culture and growth (e.g., to be used immediately in gene expression analyses, e.g., microarray assays), the cells may be placed in media that does not necessarily maintain viability.

In certain embodiments, the separated cells may be collected in any appropriate medium that maintains the viability and pluripotency of the cells. Various media are commercially available and may be used according to the nature of the cells, including dMEM, HBSS, dPBS, RPMI, Iscove's medium, etc., frequently supplemented with fetal calf serum.

As noted above, cells from a subject may be cultured (either with or without cell surface marker enrichment) under SCIPP selection conditions, where the SCIPP culture conditions maintains the pluripotency of the SCIPP present in the sample while expanding the cells without significant differentiation into lineage -restricted cells.

Compositions enriched for SCIPP are achieved in this manner. The SCIPP-enriched cell population can contain anywhere from 1% or more SCIPP cells, including populations of cells containing 2%, 3%, 4%, 5%, 6%, 7%, 8%, 9%, 10%, 15%, 20%, 25%, 30%, 35%, 40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95% or more SCIPP cells (as noted above), and in some embodiments be 95% or more of the cell composition. As note above, SCIPP are identified by their surface phenotype as well as by their ability to maintain pluripotency while expanding under specific culture conditions. In addition, SCIPP develop, under appropriate in vitro or in vivo conditions, to ectodermal, endodermal and mesodermal lineages. The enriched cell population may be used immediately, or may be frozen at liquid nitrogen temperatures and stored for long periods of time, being thawed and capable of being reused. For example, the cells may be stored in 10% DMSO, 50% FCS, 40% RPMI 1640 medium. IN VITRO CULTURE AND GENETIC MANIPULATION

The enriched cell population may be grown in vitro under various culture conditions. Culture medium may be liquid or semi-solid, e.g. containing agar, methylcellulose, etc. The cell population may be conveniently suspended in an appropriate nutrient medium, such as Iscove's modified DMEM or RPMI 1640, normally supplemented with fetal calf serum (about 5-10%), L-glutamine, a thiol, particularly 2-mercaptoethanol, and antibiotics, e.g. penicillin and streptomycin.

The culture may contain growth factors to which the cells are responsive. Growth factors, as defined herein, are molecules capable of promoting survival, growth and/or differentiation of cells, either in culture or in the intact tissue, e.g., through specific effects on a transmembrane receptor. Growth factors include polypeptides and non polypeptide factors. In addition to, or instead of growth factors, the subject cells may be grown in a co-culture with stromal or feeder layer cells.

The subject cultured cells may be used in a wide variety of ways. For example, the nutrient medium, which is a conditioned medium, may be isolated at various stages and the components analyzed. Separation can be achieved with HPLC, reversed phase HPLC, gel electrophoresis, isoelectric focusing, dialysis, or other non-degradative techniques, which allow for separation by molecular weight, molecular volume, charge, combinations thereof, or the like. One or more of these techniques may be combined to enrich further for specific fractions.

The SCIPP may be genetically altered or modified. For example, genes may be introduced into the SCIPP cells or genes may be deleted/inactivated for a variety of purposes, e.g., to replace genes having a loss of function mutation, to block the expression of deleterious genes, or to express genes for use as markers or reporter genes, etc. Thus, any suitable vector may be introduced into the SCIPP, including gene expression vectors; gene targeting vectors (e.g., those used in homologous recombination-based methods in ES cells, e.g., as employed in generating gene knockout cell lines and animals); vectors that express antisense mRNA, small interfering RNAs (siRNAs), ribozymes, or the like, thereby blocking expression of a gene; etc. Other methods of gene therapy are the introduction of drug resistance genes to enable normal progenitor cells to have an advantage and be subject to selective pressure, for example the multiple drug resistance gene (MDR), or anti-apoptosis genes, such as bcl-2. Various techniques known in the art may be used to transfect the target cells, e.g. electroporation, calcium precipitated DNA, fusion, transfection, lipofection, microinjection and the like. The particular manner in which the DNA is introduced is not critical to the practice of the invention.

Many vectors useful for transferring exogenous genes into target mammalian cells are available. The vectors may be episomal, e.g. plasmids, virus derived vectors such

cytomegalovirus, adenovirus, etc., or may be integrated into the target cell genome, through homologous recombination or random integration, e.g. retrovirus derived vectors such MMLV, HIV-1, ALV, etc. Commonly used retroviral vectors are "defective", i.e. unable to produce viral proteins required for productive infection, and thus replication of the vector requires growth in a packaging cell line. Lentiviral vectors such as those based on HIV or FIV gag sequences can be used to transfect non-dividing cells.

The vectors used to genetically alter an SCIPP or cell/tissue derived therefrom may include genes that must later be removed, e.g. using a recombinase system such as Cre/Lox, or the cells that express them destroyed, e.g. by including genes that allow selective toxicity such as herpesvirus TK, bcl-xs, etc.

Vectors employed to express genes in SCIPP will include suitable promoters operably linked to the genes of interest in the vectors, where by "suitable promoter" is meant that the promoter is activated as desired by the user, e.g., in a in a desired target cell type and/or at a desired time, either in the transfected cell (the SCIPP), or progeny thereof. Promoters may be constitutively active, conditionally active, inducible or repressible as known in the art.

To prove that one has genetically modified progenitor cells, various techniques may be employed. The genome of the cells may be restricted and used with or without amplification. The polymerase chain reaction; gel electrophoresis; restriction analysis; Southern, Northern, and Western blots; sequencing; or the like, may all be employed. The cells may be grown under various conditions to ensure that the cells are capable of maturation to a desired cell lineages while expressing the introduced DNA as desired by the user.

USE OF SCIPP IN TREATMENTS AND THERAPIES SCIPP cells, including cells or tissues derived therefrom, alone or in combination with proliferation factors, lineage-commitment factors, or genes, RNAs or proteins of interest, may be used in a number of treatment modalities for subjects having cell/tissue damage. Exemplary treatments/therapies include cell or tissue transplants, congenital malformations, elective surgeries, diseases, and genetic disorders. The SCIPP, or cells/tissues derived therefrom, employed in treatments may be autologous (from the subject) or allogeneic (from a donor).

The SCIPP cells or cells/tissues derived therefrom may be administered in any physiologically acceptable medium to a site in the subject in need of tissue/cell regeneration. The cells may be introduced by any convenient method, including injection, surgical means, or the like. The SCIPP or cells/tissues derived therefrom may be frozen at liquid nitrogen temperatures and stored for long periods of time, being capable of use on thawing. Once thawed, the cells may be used directly or expanded by use of growth factors and/or stromal cells appropriate for proliferation and/or differentiation as desired.

Treatment methods include providing SCIPPs directly for transplantation whereupon the tissue can be regenerated in vivo, recreate the missing tissue in vitro from SCIPP and then transplanting the tissue, or providing sufficient numbers of SCIPP suitable for transfection or transformation for ex vivo or in vivo gene therapy. Thus, the present invention includes a number of therapeutic methods, including: transplantation of SCIPPs of the present invention; transplantation of lineage-committed populations of cells derived from SCIPPs; transplantation of tissues and organs derived from SCIPPs; etc. Such methods can be employed for treatment or alleviation of conditions, diseases, disorders, cellular debilitations or deficiencies which would benefit from such therapy.

The SCIPP cells used in such treatment modalities may be propagated continuously in culture, using culture conditions that promote proliferation without promoting differentiation, using methods known in the art as useful for promoting proliferation without promoting differentiation of hESC and/or induced pluripotent stem cells (iPSCs). SCIPP cells may be used in such treatment modalities after such cells have been differentiated. SCIPP cells may be differentiated using methods known in the art as useful for differentiating stem cells (e.g hESCs and/or iPSCs) in a growth environment that enriches for cells with the desired lineage, and the guidance provided herein.

As described herein, SCIPP of the present invention have the capacity to differentiate into cells of any of the ectodermal, mesodermal, and endodermal lineage. Thus, the SCIPP of the present invention may be utilized in transplantation, cell replacement therapy, tissue

regeneration, gene therapy, organ tissue replacement or regeneration and cell therapies wherein cells, tissues, organs of mesodermal, ectodermal and/or endodermal origin are derived in vivo, ex vivo or in vitro. Exemplary endoderm cell lineages include epithelial linings of the respiratory passages and gastrointestinal tract, the pharynx, esophagus, stomach, intestine and many associated glands, including salivary glands, liver, pancreas and lungs. Exemplary mesoderm cell lineages include smooth muscular coats, connective tissues, and vessels associated with tissues and organs and for replacement/therapy of the cardiovascular system, heart, cardiac muscle, cardiac vessels, other vessels, blood cells, bone marrow, the skeleton, striated muscles, and the reproductive and excretory organs. Exemplary ectoderm cell lineages include epidermis (epidermal layer of the skin), the sense organs, and the entire nervous system, including brain, spinal cord, and all the outlying components of the nervous system. A significant benefit of the SCIPP of the present invention is their potential for self -regeneration prior to commitment to any particular tissue lineage (ectodermal, endodermal or mesodermal) and then further proliferation once committed. These proliferative and differentiative attributes are very important and useful when limited amounts of appropriate cells and tissue are available for transplantation. SCIPP possess qualities that make these cells useful in therapies that maintain or increase the functional capacity and/or longevity of lost, damaged, or diseased tissues. These qualities include, but are not limited to: the potential to be isolated and sorted, significant proliferation capabilities while retaining pluripotentcy, and ability to be manipulated to commit to multiple separate tissue lineages.

In certain embodiments, the SCIPP used for therapy, e.g., transplantation into a host, contains an exogenous gene (as described above). For example, by transfecting the pluripotent embryonic-like stem cells of the present invention with a vector comprising DNA or RNA which expresses a protein or gene of interest.

In certain embodiments, a therapeutic method referred to herein could include administration of SCIPPs and/or cells, tissues or organs derived therefrom in pharmaceutical compositions that comprise proliferation factors, lineage-commitment/differentiation factors, drugs or other therapeutic compounds, and the like.

In certain embodiments, the cells, tissues, or organs derived from SCIPP cells may have the same genome as the SCIPP cells from which they are derived. This means that over and above any karyotype changes, the chromosomal DNA will be at least 90% identical between the SCIPP cell and the cells or tissues derived therefrom. Cells or tissues that have been treated by recombinant methods to introduce a transgene or knock out an endogenous gene are still considered to have the same genome as the SCIPP cells from which they are derived, since all non-manipulated genetic elements are preserved. SCIPP cells and cells or tissues derived therefrom can be identified as having the same genome by standard genetic fingerprinting techniques. Possession of the same genome can also be inferred if the cells or tissues are obtained from the undifferentiated SCIPP cells through the course of normal mitotic division.

SCREENING METHODS

The subject cells are useful for in vitro assays and screening to detect factors that promote differentiation or development of cells to particular lineages or differentiated cell lineages or types, e.g., neuronal cells, cardiomycoytes, mammary gland cells, etc. A wide variety of assays may be used for this purpose, including immunoassays for protein binding; determination of cell growth, differentiation and functional activity (both in vivo and in vitro); assessment of cellular morphology; and the like.

In exemplary embodiments, screening methods include combining a candidate differentiation factor with a population of Somatic Cells with an Innate Potential for Pluripotency (SCIPP) (e.g., a population containing at least 50% CD73+/CD90-/Lin-; as detailed above) and monitoring the effect of the candidate differentiation factor on the formation of differentiated cells from the SCIPP. The monitoring step can include any convenient assay or combination of assays, many of which are known in the art, including gene expression assays (either protein or nucleic acid expression), in vitro and in vivo developmental assays, functional cellular assays, etc. Monitoring may also include performing comparisons with control cell populations upon which the candidate factor(s) employed have known activities (either positive or negative controls, as are commonly used in the art). Thus, no limitation with regard to the screening assays is intended.

For nucleic acid based gene expression assays, any suitable qualitative or quantitative methods known in the art for detecting specific mRNAs can be used. mRNA can be detected by, for example, hybridization to a microarray, in situ hybridization in tissue sections, by reverse transcriptase-PCR, or in Northern blots containing poly A+ mRNA. One of skill in the art can readily use these methods to determine differences in the size or amount of mRNA transcripts between two samples. For example, the level of particular mRNAs in SCIPP is compared with the expression of the mRNAs in a reference sample, e.g. and MSC, an ES, a differentiated cell type, and/or a neoplastic or cancer cell (e.g., a breast tumor cell).

In certain embodiments, gene expression can be assayed for by detecting the level of a protein or polypeptide in the cell or secreted therefrom. For example, detection can utilize staining of cells with labeled antibodies, performed in accordance with conventional methods. Cells can be permeabilized to stain cytoplasmic proteins. In general, antibodies that specifically bind a differentially expressed polypeptide of the invention are added to a sample, and incubated for a period of time sufficient to allow binding to the epitope. The antibody can be detectably labeled for direct detection (e.g., using radioisotopes, enzymes, fluorescers, chemiluminescers, and the like), or can be used in conjunction with a second stage antibody or reagent to detect binding (e.g., biotin with horseradish peroxidase-conjugated avidin, a secondary antibody conjugated to a fluorescent compound, e.g. fluorescein, rhodamine, Texas red, etc.) The absence or presence of antibody binding can be determined by various methods, including flow cytometry of dissociated cells, microscopy, radiography, scintillation counting, etc. Any suitable alternative methods for qualitative or quantitative detection of levels or amounts of differentially expressed polypeptide can be used, for example ELISA, western blot,

immunoprecipitation, radioimmunoassay, etc.

Functional assays for monitoring the effect of a candidate differentiation factor may also include employing animal models (e.g., rodents, felines, canines, primates, etc.). Such animal models, including those in which the animal host is immuno-compromised or impaired (e.g., NOD/SCID mice) have proven valuable systems for determining developmental potential of cells, including for determining the effect of a potential differentiating factor on cells (either applied in vitro or in vivo). Exemplary assays that find us in screening assays are also described in the Examples section below.

KITS, SYSTEMS AND SERVICES

Also provided by the subject invention are kits and systems for practicing the subject methods, as described above. For example, kits containing reagents and components configured to isolate SCIPP from a subject (or a tissue/cell sample obtained from a subject), e.g., a human subject, are provided. The various components of the kits may be present in separate containers or certain compatible components may be precombined into a single container, as desired. The reagents may include one or more, solvents, tissue/sample harvesting and preparation reagents, buffers, enzymatic reagents, specific binding agents, standards or control reagents, e.g., isotype control antibodies, culture media, etc. As such, the kits may include one or more containers such as vials or bottles, with each container containing a separate component for carrying out a sample processing or preparing step and/or for carrying out one or more steps for isolating SCIPP from a subject.

In addition to above-mentioned components, the subject kits typically further include instructions for using the components of the kit to practice the subject methods, e.g., to isolate SCIPP from a subject (or a tissue/cell sample obtained from a subject). The instructions for practicing the subject methods are generally recorded on a suitable recording medium. For example, the instructions may be printed on a substrate, such as paper or plastic, etc. As such, the instructions may be present in the kits as a package insert, in the labeling of the container of the kit or components thereof (i.e., associated with the packaging or sub-packaging) etc. In other embodiments, the instructions are present as an electronic storage data file present on a suitable computer readable storage medium, e.g. CD-ROM, diskette, etc. In yet other embodiments, the actual instructions are not present in the kit, but means for obtaining the instructions from a remote source, e.g. via the internet, are provided. An example of this embodiment is a kit that includes a web address where the instructions can be viewed and/or from which the instructions can be downloaded. As with the instructions, this means for obtaining the instructions is recorded on a suitable substrate.

As noted above, kits may be provided where the kit will include staining reagents that are sufficient to differentially identify/isolate the SCIPP cells described herein. A combination of interest may include one or more reagents specific for a marker or combination of markers of the present invention, and may further include antibodies specific for a lineage panel (as described above, e.g., CD2, CD3, CD16, CD31, CD45, CD64 and CD140b), CD73, and CD90. In certain embodiments, the staining reagents are antibodies, where in some kits the antibodies are detectably labeled (e.g., differentially labeled with fluorescent labels, as described above).

In some embodiments, a subject kit includes reagents for use in detecting a

polynucleotide gene expression product, e.g., an mRNA, present in an SCIPP. For example, a kit may include PCR primer pairs, one or more nucleic acid probes, or both, where the primer pairs and probes are specific for a gene expressed in SCIPP (see, e.g., the genes listed in Figure 15 and described above). For example, PCR primer pairs for any one or more of the genes KLF4, MYC, PTGS2, OCT4, NANOG, CD24, EPCAM, CECR1, and DNMT3B (or any combination thereof) may be included in a subject kit. The nucleic acids will in some embodiments be present in a suitable storage medium, e.g., buffered solution, typically in a suitable container. The kit includes the primers and/or probes, and may further include a buffer; reagents (e.g., for polymerase chain reaction (e.g., deoxynucleotide triphosphates (dATP, dTTP, dCTP, and dGTP), a thermostable DNA polymerase, a buffer suitable for polymerase chain reaction, a solution containing Mg2+ ions (e.g., MgCl₂), and other components well known to those skilled in the art for carrying out a polymerase chain reaction)). The kit may further include reagents necessary for extraction of DNA (or mRNA) from a biological sample. The kit may further include reagents necessary for reverse transcription of an mRNA, to make a cDNA copy of the mRNA. A kit will in some embodiments provide a standard for normalization of a level of a target polynucleotide to a standard, e.g., a level of a glucose-6-phosphate

dehydrogenase polynucleotide (e.g, a G6PDH mRNA or cDNA copy of a G6PDH mRNA).

In certain embodiments, a kit may include isolated, viable SCIPP to a user for research or therapeutic purposes. In some of these embodiments, services for isolating SCIPP from a subject (either of the user's choosing or the service provider' choosing) are provided, where the isolated SCIPP are delivered to the user, e.g., for research or therapeutic purposes. Such services can include quality control assessment, e.g., cell purity, cell typing (e.g., HLA typing, genetic typing, etc.), pathogen assessment, and the like. The SCIPP provided may be freshly isolate or expanded in culture. Cells or tissues derived from the SCIPP, e.g., differentiated cells, lineage-specific progenitors, etc., may also be provided.

EXAMPLES The following examples are put forth so as to provide those of ordinary skill in the art with a complete disclosure and description of how to make and use the present invention, and are not intended to limit the scope of what the inventors regard as their invention nor are they intended to represent that the experiments below are all or the only experiments performed. Efforts have been made to ensure accuracy with respect to numbers used (e.g. amounts, temperature, etc.) but some experimental errors and deviations should be accounted for. Unless indicated otherwise, parts are parts by weight, molecular weight is weight average molecular weight, temperature is in degrees Centigrade, and pressure is at or near atmospheric. MATERIALS AND METHODS

The following are general materials and protocols used in Examples below.

Dissociation of breast epithelium

Breast tissues were obtained from disease-free women undergoing reduction

mammoplasty in accordance with an institutionally approved IRB protocol. Tissue was dissociated mechanically and enzymatically, as previously described by S. R. Romanov et ah , Nature 409, 633 (2001); the disclosure of which is incorporated herein by reference. Briefly, tissue was minced and dissociated in RPMI 1640 with L-glutamine and 25mm HEPES (Fisher, Cat # MT10041CV) supplemented with 10% fetal bovine serum (JR Scientific, Inc, Cat # 43603), 100 units/ml penicillin, 100μg/ml streptomycin S04, 0.25μg/ml fungizone, gentamycin (Lonza, Cat # CC4081G), 0.88 mg/ml collagenase (Worthington, Cat # CLS-2) and 0.40 mg/ml hyaluronidase (Sigma, Cat # H3506-SG) at 37°C for 16h. The cell suspension was centrifuged at 1400rpm for lOmin followed by a wash with RPMI 1640/10% FBS. Clusters enriched in epithelial cells (referred to as organoids) were recovered after serial filtration through a 150-μιη nylon mesh (Fisher, Cat # NC9445658), and a 40-μιη nylon mesh (Fisher, Cat # NC9860187). The final filtrate contained the mammary stromal cells, consisting primarily of fibroblasts and endothelial cells. Following centrifugation at 1200rpm for 5min, the epithelial organoids and filtrate were frozen for long-term storage. To generate single cell suspension, epithelial organoids were further digested for 5min in 0.5g/L trypsin- 0.2g/L EDTA-0.58g/L NaHCC>3 and lmin in dispase-DNAse I (StemCell technologies, Cat # 7913 and Cat # 7900 respectively) then filtered through a 40-μιη cell strainer (Fisher, Cat # 087711).

The following pertains to materials and protocols used in Examples 9-14 below.

Mycoplasma testing was performed by PCR analysis at Bionique Testing Laboratories Inc. (Saranac Lake, NY). Karyotyping of cells obtained from the filtrate fraction or from Rl cell cultures was performed on metaphase spreads at Molecular Diagnostic Services Inc. (San Diego, CA). All samples analyzed yielded a diploid 46,XX karyotype (see Fig. 22 and Fig. 20, Panels A-E). Flow Cytometry staining and ALDEFLUOR Assay for Cell Sorting

The following describes materials and protocols used in Examples 1-8 below.

The single cell suspension obtained as described above was stained for cell sorting with two human-specific primary antibodies, anti-CD73 labeled with PE (BD Biosciences, Cat # 550257) and anti-CD90 labeled with APC (BD Biosciences, Cat # 559869), and biotinylated antibodies for lineage markers, anti- CD2, CD3, CD16, CD64 (BD Biosciences, Cat #s 555325, 555338, 555405 and 555526), CD31 (Invitrogen, Cat # MHCD3115), CD45, CD140b

(BioLegend, Cat #s 304003 and 323604) to specifically remove hematopoietic, endothelial and leukocyte lineage cells (Lin-i- cells). Sequential incubation with primary antibodies was performed for 20min at room temperature in PBS with 1% bovine serum albumin (BSA), followed by washing in PBS with 1% BSA. Biotinylated primary antibodies were revealed with an antihuman secondary antibody labeled with streptavidin-Pacific Blue conjugate (Invitrogen, Cat # SI 1222).

After incubation, cells were washed once in PBS with 1% BSA and processed using the ALDEFLUOR kit (StemCell Technologies, Cat # 1700) in order to isolate the subpopulation with a high ALDH enzymatic activity. Cells obtained above were suspended in ALDEFLUOR assay buffer containing ALDH substrate (BAAA, Ιμιηοΐ/l per 1 x 106 cells) and incubated for 30min at 37°C. An aliquot treated with 50mmol/l diethylaminobenzaldehyde (DEAB), a specific ALDH inhibitor, was used as negative control. Cell sorting was performed using a FACSAria II cell sorter (BD Biosciences).

Flow Cytometry Staining and Cell Sorting

The following describes materials and protocols used in Examples 9-14 below.

The single cell suspension obtained as described above was stained for cell sorting with two human-specific primary antibodies, anti-CD73 labeled with PE (BD Biosciences) and anti- CD90 labeled with APC (BD Biosciences) and biotinylated antibodies for lineage markers, anti- CD3, CD16, CD64 (BD Biosciences), CD31 (Invitrogen), CD45, CD140b (BioLegend) to specifically remove hematopoietic, endothelial and leukocyte lineage cells. Sequential incubation with primary antibodies was performed for 20 min at room temperature in PBS with 1% bovine serum albumin (BSA), followed by washing in PBS with 1% BSA. Biotinylated primary antibodies were revealed with an anti-human secondary antibody labeled with streptavidin-Pacific Blue conjugate (Invitrogen). After incubation, cells were washed once in PBS with 1% BSA and cell sorting was performed using a FACSAria II cell sorter (BD

Biosciences).

Mammosphere culture

Mammosphere culture was performed as previously described by G. Dontu et al. , Genes Dev 17, 1253 (2003); the disclosure of which is incorporated herein by reference. Single cells were plated in ultra-low attachment plates (Corning) at a density of 10,000 viable cells/ml in primary culture and 1000 cells/ml in subsequent passages. For mammosphere culture, cells were grown in a serum-free mammary epithelial basal medium (MEBM) (Lonza), supplemented with B27 (Invitrogen, Cat # 17504044), 20ng/ml EGF (Lonza), 20ng/ml bFGF (Sigma, Cat # F0291- 25UG), and 4μg/ml heparin (Sigma, Cat # H1027). Mammospheres were collected by gentle centrifugation (700 rpm) after 7-10 days and dissociated enzymatically for 5-10min in 0.5g/L trypsin-0.2g/L EDTA-0.58g/L NaHCC>3. Dissociated cells were passed through a 40-μιη sieve, stained with 0.4% Trypan Blue solution (Sigma, Cat # T8154) to assess cell viability and analyzed microscopically to confirm complete cell dissociation.

Differentiation culture conditions

Single cell suspensions obtained from dissociated mammospheres as described above were plated on collagen-coated glass coverslips or cell culture plates at a density of 2000 viable cells/ 10cm diameter dish. Cells were grown in Ham's F-12 medium with 5% FBS, 5μg/ml insulin (Lonza), ^g/ml hydrocortisone (Lonza), 10μg/ml cholera toxin (Sigma, Cat # C8052- 2MG), lOng/ml EGF (Lonza), and gentamycin (Lonza, Cat # CC4081G). After 5 days, a layer of Matrigel (BD Biosciences, Cat # 356230) was added along with ^g/ml prolactin (Sigma, Cat # L4021-50UG) in the case of assays for alveolar differentiation. Cells were fixed and collected for immunostaining after 12 days. 3D cultures were performed as previously described by J. Debnath, et al. , Methods 30, 256 (2003); the disclosure of which is incorporated herein by reference. Briefly, single cells resuspended in the above growth medium were seeded at colonogenic density on a l-2mm thick solidified layer of growth factor reduced Matrigel (BD Biosciences, Cat # 356230). Acinar and branched-acinar structures forming in Matrigel were photographed and Western blot analysis performed after 14 days. Immunostaining and Immunoblotting

In order to assess the lineage composition of the colonies, cells grown on coverslips were fixed for 20 min at room temperature in PBS + 2% paraformaldehyde (PFA) then stained with primary anti-CD49f coupled to FITC (BD Biosciences, Cat # 555735) and anti-MUC-1

(Millipore, Cat # 05-652) used as myoepithelial and luminal epithelial markers respectively. A secondary antibody labeled with Alexa- Fluor 568 (Invitrogen, Cat # A- 11031) was used to detect binding of anti-MUC-1. Nuclei were counterstained and mounted with DAPI/antifade (Invitrogen, Cat # P36935). Coverslips were examined with a fluorescent microscope (Zeiss LSM 510 NLO) with a 20x objective. Lineage composition was also assayed after cell trypsinization from coverslips and fixation for 20min at room temperature in 2% PFA solution in PBS. Samples were stained with the anti-CD49f-FITC and MUC-1 primary antibodies described above for 20min at room temperature in PBS with 1% BSA followed by an incubation with a secondary goat-anti-mouse-IgGl antibody labeled with Tricolor (Invitrogen, Cat # M32006). After incubation, cells were washed once with PBS with 1% BSA. Flow cytometry analysis, using a BD LSRII flow cytometer (BD Biosciences), enabled the distribution of different mammary epithelial cell types ( ) to be determined from mammosphere-derived cells in subsequent passages: R1-ALD+ (passages 1-3): myoepithelial (MUC-1 -/CD49f+):

11.43+0.48, 1.02+0.18 and 1.42+0.19; luminal (MUC-1 +/CD49f-): 60.22+1.57, 62.57+1 and 23.62+0.91; bipotent (MUC-l+/CD49f+): 20.32+0.63, 31.81+0.76 and 65.54+1.08; R2-ALD+ (passages 1-2): myoepithelial: 15.45+0.94 and 20.34+0.94; luminal: 81.23+0.49 and 75.99+0.57; bipotent: 0.26+0.07 and 0.11+0.07; R3-ALD+ (passages 1-2): myoepithelial: 0.07+0.02 and 0.04+0.07; luminal: 94.92+0.57 and 96.6+0.69; bipotent : 4.01+0.69 and 2.32 + 0.18. The R1-R3 ALD- sorted cells yielded only luminal cells: R1-ALD-: 96.4+0.57, R2-ALD-: 96.8+0.94 and R3-ALD-: 97.77+0.49). Data are expressed as Mean + SEM (n=5). Differentiation towards the alveolar lineage was assessed in ly sates of cells that had been layered with Matrigel and prolactin. Briefly, cells were pelleted at 1500 rpm for 3min at 4°C and washed once in icecold wash buffer (25mM Tris, pH 7.5, 250mM sucrose, 2.5mM MgC12, lOmM benzamidine, lOmM NAF, ImM sodium vanadate, 10μg/ml leupeptin, 10μg/ml aprotinin, ^g/ml pepstatin and ImM PMSF). Pellet was resuspunded in lysis buffer (20mM HEPES-KOH, pH 7.5, lOmM KC1, 1.5mM MgC12, ImM EDTA, ImM EGTA, 250mM sucrose, ImM sodium vanadate, ImM DTT, 25μg/ml leupeptin, 25μg/ml aprotinin, 2^g/ml pepstatin, ImM PMSF, lOmM

benzamidine and 20mM NaF), Protein concentration of Dounce homogenized cell extracts was determined with bicinchoninic acid (Pierce Biotechnology, Rockford, IL) using BSA as a standard (Sigma). Cell extracts were heat denatured in loading buffer containing 5% β- mercaptoethanol and separated by gradient (4-20%) polyacrylamide gel electrophoresis (Cambrex).

Proteins were transferred onto Hybond-P memebranes (GE Healthcare Bio, Piscataway, NJ). Membranes were probed with mouse monoclonal antibodies against human β-casein (Santa Cruz Biotechnology, Cat # SC-53189), or mouse anti- -actin (Sigma, Cat # AC-15), followed by a horseradish peroxidase- conjugated goat anti-mouse antibody (Biomeda Corp., Foster City, CA). β-actin was used as a normalization loading control. Staining was developed with the SuperSignal West Pico chemiluminescence detection kit (Pierce). Animal Model

NOD/SCID mice were used to assess the in vivo stem cell properties of sorted R1-R4 epithelial subpopulations from three disease-free breast tissue samples. The animal model used for xenotransplantation of normal mammary epithelial cells has been previously described by D. A. Proia, et al., Nat Protoc 1, 206 (2006); the disclosure of which is incorporated herein by reference. The fat pads were cleared pre-puberty and humanized by injecting 35ul of a 1: 1 mixture of irradiated (4Gy) and nonirradiated immortalized primary human mammary fibroblasts (500,000 cells total/fat pad). Fibroblasts, immortalized with human telomere and GFP (RMF/EG), were a generous gift from Dr. Charlotte Kuperwasser (Tufts University School of Medicine, Boston, MA). Sorted epithelial cells were mixed with 500,000 RMF/EG fibroblasts in 35ul of a 1:3 mixture of Matrigel-Collagen I (BD Biosciences) and implanted in the fat pads 2-4 weeks after clearing and humanization. Ductal outgrowths were analyzed in euthanized animals 12 weeks after cell injection. Human-beta casein production was monitored in animals injected with sorted cells, mated and euthanized at day 18 of pregnancy. Fat pads were fixed in formalin and embedded in paraffin for histological analysis. Evaluation of the outgrowth potential of each cell population was analyzed by H&E staining. The animal studies were conducted in accordance with an institutionally approved animal protocol.

Immunohistochemistry and Immunofluorescence

Immunohistochemistry was performed on formalin-fixed paraffin-embedded tissues. Five micron thick sections were deparaffinized, rehydrated through graded alcohols, and subjected to antigen retrieval for Immunohistochemistry. Sections were incubated with mouse monoclonal antibodies against anti -human smooth muscle actin (a-SMA) diluted 1 :80 (Dako, Cat # M0851) and anti-human CK8/18 (Leica Microsystems, Cat # RTU-5D3), and a rabbit polyclonal antibody against anti-human β casein (a generous gift from Dr. Charles Streuli, University of Manchester, Manchester, U.K.). Immunocomplexes were visualized by the ABC peroxidase method and sections were counterstained with hematoxylin. For fluorescent double staining, samples were incubated for 2h at room temperature with Alexa Fluor 594 (Invitrogen, Cat # A11020) and Alexa Fluor 488 (Invitrogen, Cat # A21121) labeled secondary antibodies diluted 1/500. Nuclei were counterstained with Vectashield-DAPI and coverslipped. Sections were examined with a fluorescent microscope (Zeiss LSM 510 NLO).

Ectodermal Lineage Differentiation: Neurogenic:

The following describes materials and protocols used in Examples 1-8 below.

Sorted R1-R4 subsets and their respective ALDEFLUOR-positive and ALDEFLUOR- negative subpopulations were cultured in suspension at a density of 20,000 cells/well in a 24- well low-attachment plate (Corning) for three weeks in neural precursor medium (NPM) containing 20ng/ml bFGF (R&D Systems, Cat # 233-FB-025/CF) and 500ng/ml noggin (R&D Systems, Cat # 3344-NG-050). After 3 weeks of culture, the media were changed to NPM supplemented with 20ng/ml bFGF and cultured for another week. Phenotypic analysis of the resulting differentiated neurallineage cells (neurospheres) was performed after seeding of neurospheres resuspended in NPM (without mitogens) on poly-D-lysine (Sigma, Cat # P7886) and laminin (Sigma, Cat # L2020) -coated coverslips for either 24h (to immunostain for Nestin expression) or for 21 days (to allow complete differentiation). Immunofluorescence analysis was performed with primary antibodies including a rabbit anti -human nestin antibody (Millipore, Cat # AB5922), a mouse anti-human β -III-tubulin antibody coupled to Alexa Fluor 555 (BD Biosciences, Cat # 560339) and a mouse anti-human GFAP antibody coupled to Alexa Fluor 488 (BD Biosciences, Cat # 560297). A secondary anti-rabbit antibody coupled to Alexa Fluor 546 (Invitrogen, Cat # A10040) was used to label the primary anti-nestin antibody. In order to trigger a two-stage induction leading to differentiation into dopaminergic cells, the Rl- ALDEFLUOR-positive cells were first cultured as neurospheres in neural basal medium consisting of DMEM/F12 supplemented with N2 and B27 additives, lOng/ml bFGF and Penicillin/Streptomycin for 8 days. Fresh bFGF was added every other day. After 8 days, the neurospheres were transferred to glass coverslips coated with poly-D-lysine (lOOug/ml, Sigma) and laminin (20ug/ml, Sigma) and cultured in the neural basal medium in the presence of SDF-1 (lOOng/ml), PTN (lOOng/ml), IGF-II (lOOng/ml) and EFNBl (200ng/ml) (R&D Systems, Cat #s 350-NS/CF, 252-PL, 292-G2 and 473-EB respectively) to induce specific differentiation towards dopaminergic neurons (27). Half of the medium was replaced with fresh medium containing growth factors on day 4 and every 2-3 days afterwards up to 21 days of differentiation. Immunofluorescence analysis was performed with mouse anti-tyrosine hydroxylase (TH) (Sigma, Cat # T1299) and rabbit anti-vesicular monoamine transporter 2 (VMAT2) (Millipore, Cat # AB1598P) primary antibodies followed by goat-anti rabbit coupled to Alexa Fluor 488 (Invitrogen, Cat # Al 1008) and goat anti-mouse coupled to Alexa Fluor 555 (Invitrogen, Cat # A21127) secondary antibodies to ascertain differentiation into dopaminergic neurons.

Whole-cell current-clamp recordings were obtained using a Multiclamp 700B amplifier (Molecular Devices, Sunnyvale, CA). Signals were filtered at 1 kHz and sampled at 10 kHz using a digidata 1440A analog-to-digital converter (Molecular Devices). The liquid junction potential was measured with 3M KC1 and adjusted. Cells grown on coverslips were placed in a bath solution containing 135mM NaCl, 5mM KC1, 2mM CaC12, 1.2mM MgC12, lOmM HEPES and lOmM Glucose at ~ 300 mOsm (pH 7.4), and visualized at 40x magnification using an Olympus ΓΧ71 microscope with differential interface contrast optics (Olympus, Tokyo, Japan). Patch electrodes (3-4 ΜΩ) contained 115mM K-gluconate, 20mM KC1, lOmM Na2phosphate, lOmM HEPES, 2mM Mg3ATP, 0.3mM Na2GTP at ~ 290 mOsm (pH 7.4). Currents were manually injected to hold the membrane potential around -70 mV to record voltage responses. Tetrodotoxin (TTX) was obtained from Tocis (Missouri, MO) and applied through a gravity-fed perfusion system. All data were recorded and analyzed with the pClamp 10 software (Molecular Devices).

In vitro ectodermal lineage differentiation for neurogenic derivatives

The following describes materials and protocols used in Examples 9-14 below.

Sorted R1-R4 subpopulations and H7 hESCs were cultured in suspension at a density of 20,000 cells/well in a 24-well low- attachment plate (Corning) for three weeks in neural precursor medium (NPM) containing 20ng/ml bFGF (R&D Systems, Cat # 233-FB-025/CF) and 500ng/ml noggin (R&D Systems, Cat # 3344-NG-050). After 3 weeks of culture, media were changed to NPM supplemented with 20ng/ml bFGF and cultured for another week. Phenotypic analysis of the resulting differentiated neural-lineage cells (neurospheres) was performed after seeding of neurospheres resuspended in NPM (without mitogens) on poly-D-lysine (Sigma, Cat # P7886) and laminin (Sigma, Cat # L2020) -coated coverslips for either 24h (to immunostain for Nestin expression) or for 21 days (to allow for further differentiation). Immunofluorescence analysis was performed with primary antibodies including a rabbit anti-human nestin antibody (Millipore, Cat # AB5922), a mouse anti-human TUJl/p-III-tubulin antibody coupled to Alexa Fluor 555 (BD Biosciences, Cat # 560339) and a mouse anti-human GFAP antibody coupled to Alexa Fluor 488 (BD Biosciences, Cat # 560297). A secondary anti-rabbit antibody coupled to Alexa Fluor 546 (Invitrogen, Cat # A10040) was used to label the primary anti-nestin antibody. Staining controls are shown in Fig. 31, Panels A-D (top rows). Endodermal Lineage Differentiation: Definitive Endoderm:

The following describes materials and protocols used in Examples 1-8 below.

Sorted R1-R4 subsets, and their respective ALDEFLUOR-positive and ALDEFLUOR- negative subpopulations were cultured under conditions previously reported to induce differentiation towards definitive endoderm (E. Kroon et al , Nat Biotechnol 26, 443 (2008); the disclosure of which is incorporated herein by reference). Briefly, sorted cells seeded on coverslips were subjected to 3 days of differentiation as follows: Day 1: culture in RPMI supplemented with glucose, Glutamax Penicillin/Streptomycin, lOOng/ml Activin A and 25ng/ml Wnt3a (R&D Systems, Cat #s 338-AC-025 and 5036-WN-010/CF respectively); Day 2 and Day3: culture in the same medium except Wnt3a was replaced by 0.2% FBS.

Immunofluorescence analysis was performed with rabbit-anti human Soxl7 (Santa Cruz Biotechnology, Cat # SC-20099), goat-anti human HNF-3 /Foxa2 (R&D Systems, Cat # AF2400) and goat-anti human Brachyury (R&D Systems, Cat # AF2085) primary antibodies followed by donkey anti-rabbit coupled to Alexa Fluor 546 (Invitrogen, Cat # A 10040) and donkey anti-goat coupled to Alexa Fluor 488 (Invitrogen, Cat # A11055) secondary antibodies to ascertain differentiation towards definitive endoderm.

In vitro endodermal lineage differentiation for definitive endoderm and pancreatic derivatives

The following describes materials and protocols used in Examples 9-14 below.

Sorted R1-R4 subpopulations were cultured under conditions previously reported by

Kroon et al. to induce pancreatic lineage in human ESCs (E. Kroon et al. , Nat Biotechnol 26, 443 (2008)). Sorted cells seeded on coverslips or feeder layer were subjected to either 3 days (definitive endoderm) or 12 days (pancreatic lineage) of differentiation. Immunofluorescence analysis was performed with rabbit-anti human SOX17 (Santa Cruz Biotechnology, Cat # SC- 20099), goat-anti human HNF-3p/FOXA2 (R&D Systems, Cat # AF2400), goat-anti human

Brachyury (R&D Systems, Cat # AF2085), goat-anti human PDXl (Santa Cruz Biotechnology, Cat # SC14662) and goat-anti human NKX6.1 (Santa Cruz Biotechnology, Cat # SC15030) primary antibodies followed by donkey anti-rabbit coupled to Alexa Fluor 546 (Invitrogen, Cat # A10040) and donkey anti-goat coupled to Alexa Fluor 488 (Invitrogen, Cat # Al 1055) secondary antibodies to ascertain differentiation towards endodermal lineage. Staining controls are shown in Figure 31, Panels A-D (top rows).

Mesodermal Lineage Differentiation: Cardiomyogenic:

The following describes materials and protocols used in Examples 1-8 below.

Sorted R1-R4 subsets, and their respective ALDEFLUOR-positive and ALDEFLUOR- negative subpopulations were cultured under conditions previously described to induce cardiomyogenic differentiation by J. Bartunek et ah, Am J Physiol Heart Circ Physiol 292, H1095 (2007); the disclosure of which is incorporated herein by reference. Sorted cells (12,000 cells/population) were expanded for 3 weeks in DMEM supplemented with 20% FBS, ΙΟΟμΜ L-ascorbic acid (Sigma, Cat # A5960) and 20nM dexamethasone (Sigma, Cat # D4902). Cells were then plated onto collagen-coated four well chamber slides and cultured in cardiac differentiation medium containing 2% FBS, 50ng/ml bFGF, 25ng/ml BMP-2 (R&D Systems, Cat # 355-BM-010) and 2ng/ml insulin-like growth factor 1 (IGF-I) (R&D Systems, Cat # 291- Gl-050) for 6days. Differentiated cells were fixed in ice-cold methanol and analyzed by immunofluorescence with primary antibodies obtained from Santa Cruz Biotechnologies Inc. including mouse monoclonal IgG2a anti-human GATA-4 (Cat # SC-25310) diluted 1/200, goat polyclonal anti-human MEF-2 (Cat # SC- 13917) diluted 1/200, rabbit polyclonal anti-human Nkx2.5 (Cat # SC- 14033) diluted 1/100 and goat polyclonal anti-human Troponin I (Cat # SC- 8118) diluted 1/100. Staining was completed with secondary antibodies including goat-anti mouse IgG2a coupled to Alexa Fluor 488 (Invitrogen, Cat # A21131), donkey anti-goat IgG coupled to Alexa Fluor 488 (Invitrogen, Cat # A11055) and goat anti-rabbit IgG coupled to Alexa Fluor 488 (Invitrogen, Cat # Al 1008).

In order to differentiate the sorted Rl subset into spontaneously beating cardiomyocytes, sorted cells were first grown on human placental fibroblast feeders (a generous gift from Dr. Susan Fisher, University of California San Francisco, CA) in serum free mammary basal medium as described above. After 14 days, colonies appearing on the placental feeders were manually dissected and allowed to form embroid bodies (EB) in suspension in cardiac differentiation medium containing Knockout DMEM (Invitrogen), 20% FBS, non-essential amino acids, Glutamine and β -mercaptoethanol. After 4 days in suspension, EBs were plated on gelatin-coated 24 well plates and fed fresh medium every day. Monitoring of beating EBs was carried out using time-lapse video microscopy in an environmental chamber controlled by Improvision's Open lab software in real time. 5-10% of EBs began beating after 12-14 days of culture. In vitro mesodermal lineage differentiation for cardiomyocyte, adipocyte and endothelial cell derivatives

The following describes materials and protocols used in Examples 9-14 below.

Sorted R1-R4 subpopulations were cultured under conditions previously described to induce cardiomyogenic differentiation by J. Bartunek et al. , Am J Physiol Heart Circ Physiol 292, H1095 (2007); the disclosure of which is incorporated herein by reference. Sorted cells (12,000 cells/population) were expanded for 3 weeks in DMEM supplemented with 20% FBS, ΙΟΟμΜ L-ascorbic acid (Sigma, Cat # A5960) and 20nM dexamethasone (Sigma, Cat # D4902). Cells were then plated onto collagen-coated four well chamber slides and cultured in cardiac differentiation medium containing 2% FBS, 50ng/ml bFGF, 25ng/ml BMP-2 (R&D Systems, Cat # 355-BM-010) and 2ng/ml insulin-like growth factor 1 (IGF-I) (R&D Systems, Cat # 291- Gl-050) for 6 days. Differentiated cells were fixed in ice-cold methanol and analyzed by immunofluorescence with primary antibodies obtained from Santa Cruz Biotechnologies Inc. including mouse monoclonal IgG2a anti-human GATA-4 (Cat # SC-25310), goat polyclonal anti-human MEF-2 (Cat # SC-13917), rabbit polyclonal anti-human Nkx2.5 (Cat # SC- 14033) and goat polyclonal anti-human Troponin I (Cat # SC-8118). Staining was completed with secondary antibodies including goat-anti mouse IgG2a coupled to Alexa Fluor 488 (Invitrogen, Cat # A21131), donkey anti-goat IgG coupled to Alexa Fluor 488 (Invitrogen, Cat # Al 1055) and goat anti -rabbit IgG coupled to Alexa Fluor 488 (Invitrogen, Cat # Al 1008).

In order to differentiate the sorted Rl subpopulation into spontaneously beating cardiomyocytes, sorted cells were first grown on human placental fibroblast feeders (a generous gift from Dr. Susan Fisher, UCSF) in serum free mammary basal medium (as described above). After 14 days, colonies appearing on the feeder layer were manually dissected and allowed to form embryoid bodies (EB) in suspension in cardiac differentiation medium containing

Knockout DMEM (Invitrogen), 20% FBS, non-essential amino acids, glutamine and β- mercaptoethanol. After 4 days in suspension, EBs were plated onto gelatin-coated 24 well plates and fed fresh media every day. Monitoring of beating EB-derived cells was carried out using time-lapse video microscopy in an environmental chamber controlled with the Improvision' s Open lab software in real time. 5-10% of EB-derived cells began beating after 12-14 days of culture.

Adipocyte differentiation: sorted cells were expanded for 2 weeks in a-MEM medium with glutamine supplemented with 15% ES-FBS (Omega Scientific Inc., Cat # FB-05), 18% Chang B and 2% Chang C (Irvine Scientific, Cat #s C-100 and C-106, respectively) and lx penicillin/streptomycin. Cells were then seeded into 24-well chamber slides and placed under growth conditions (expansion medium) or differentiation conditions (Gibco StemPro

Adipogenesis Differentiation Kit, Cat # A10070-01) for 9 days (for Oil Red O staining, quantitative Real Time PCR analysis) or 18 days (for immunofluorescence analysis of FABP4). Media was changed every 3-4 days. Cells were fixed with 2% PFA prior to staining.

Immunofluorescence analysis was performed with rabbit-anti human FABP4 primary antibody (Cayman Chemical, Cat # 10004944) followed by goat anti-rabbit IgG coupled to Alexa Fluor 488 (Invitrogen, Cat # Al 1008). Human MSCs were used as differentiation control.

Quantitative Real Time PCR was performed using standard methods. Primer probe sets for FABP4 (Hs01086177_ml), Leptin (Hs00174877_ml) and PPARy(Hs01115511_ml) were obtained from ABI. Glucuronidase B (GusB; IDT) expression was used to normalize for variances in input cDNA.

Sorted R1-R4 subpopulations were cultured under conditions previously described by Levenberg, et al. to induce endothelial cell differentiation (S. Levenberg, J. S. Golub, M. Amit, J. Itskovitz-Eldor, R. Langer, Endothelial cells derived from human embryonic stem cells. Proceedings of the National Academy of Sciences of the United States of America 99, 4391 (2002); the disclosure of which is incorporated herein by reference). Briefly, cells were cultured in endothelial medium as previously described and analyzed for expression of the

CD31/PECAM1 cell surface marker by flow cytometry after 2 weeks. Rl cells yielded 2% CD31/PECAM1⁺ cells when cultured under these conditions. The CD 31/PECAM1+ cells were isolated by flow cytometry and seeded at 50,000 cells per 500μ1 of culture medium in a Matrigel differentiation assay. Cord formation was evaluated by phase-contrast microscopy 24h after cell seeding. HUVECs and primary mammary epithelial cells were used as positive and negative differentiation controls, respectively.

Human embryonic stem cell (hESC) culture

H7 and H9 hESCs, routinely maintained in culture with replacement of frozen stocks every 10 passages (a generous gift from Dr. Susan Fisher, UCSF), were expanded on mouse embryonic fibroblasts (MEFs; Millipore, cat PMEF-CFL) used as a feeder layer. MEFs were grown in DMEM, M199 (Invitrogen, Cat # 11150-059) and 10% FBS. Feeders were gamma irradiated at 5,100 rads and frozen for long-term storage. Prior to use, feeders were thawed at 37°C, washed and plated on gelatin-coated 6-well tissue culture plates. H7 and H9 cells were thawed, washed and plated onto confluent feeder cells and grown for up to a week before sub- culturing. The hESC culture medium consisted of Knockout DMEM, 20% Knockout Serum Replacement (Gibco, Cat # 10828-028), lOng/ml bFGF non-essential amino acids, Glutamine, β-mercaptoethanol and Penicillin/Streptomycin. Cultures were monitored daily to confirm that clusters of hESCs were adhering to the feeders and forming typical hESC colonies. When colonies reached an average size of 300-400 cells, colonies were manually dissected and passaged.

Teratoma formation assay

Six to seven week old female SCID/BEIGE mice (Charles Rivers) were used to test teratoma forming capability of directly sorted Rl cells, culture expanded Rl subclones and H7 human ESCs under institutionally approved animal protocol AN079997/AN086757. Briefly, cells were grafted under the renal capsule according to a published protocol of T. A. Prokhorova et ah, Stem cells and development 18, 47 (2009); the disclosure of which is incorporated herein by reference. Mice were euthanized 8 weeks (H7 cells) or 12 weeks (Rl cells) after injection. Teratomas were surgically removed, fixed in formalin, embedded in paraffin and processed for immunohistochemistry as described below.

Histochemistry and Immunohistochemistry for teratoma analysis

Tissues included teratomas, mammary tumors, various human tissues used as positive controls or mouse kidney used as a negative control. Paraffin-embedded tissues were cut into 4μιη serial sections, deparaffinized and rehydrated using standard procedures. All steps were carried out at room temperature except when noted. Following antigen retrieval by microwaving in citrate buffer, pH 6.0, for lOmin, sections were incubated with primary antibodies against human lamin A/C (Epitomics Inc., cat#2966-l, clone EPR4100), GFAP (Dako Inc., cat#M0761), HAPLN1 (Sigma-Aldrich Inc., cat#HPA019105), PDX1 (Epitomics Inc., cat#3470-l, clone EPR3358), AFP (Dako Inc., cat#IR500) and TFF3 (Epitomics Inc., cat#3178- 1, clone EPR3973) for lh. Staining was visualized after incubation with HRP polymer kit (Ultravision LP kit, Thermo Scientific Inc.) for 15 minutes and with diaminobenzidine substrate (Genemed, cat#520017) for 5 minutes. For mouse kidney sections stained with the mouse monoclonal anti-GFAP antibody, an additional peroxidase blocking step (3% H202 for lOmin) was added prior to antigen retrieval and the Mouse on Mouse kit (Vector Laboratories Inc., cat#BMK2202) was used instead of the Ultravision LP kit. Stained sections were scanned at 20x on a digital slide scanner (Aperio Inc.). Image acquisition and processing were carried out using the Imagescope software (Aperio Inc.). Staining controls are shown in Fig. 32. Single cell-derived Rl clone cell culture conditions

Single Rl cells and H7 hESCs were expanded on human placental fibroblasts used as a feeder layer (a generous gift from Dr. Susan Fisher, UCSF). Fibroblasts from human placenta (at week 6.4 of gestation) were grown in media containing DMEM, M199 (Invitrogen, Cat # 11150- 059) and 10% FBS, gamma irradiated at 5,100 rads and frozen for long-term storage. Prior to use, feeders were thawed at 37°C, washed and plated on gelatin-coated 24-well tissue culture plates. Single Rl cells and H7 cells were plated on feeders 24-48h after feeder seeding and cultured for up to 14 days for Rl cells or 7 days for H7 cells. The hESC culture medium contained Knockout DMEM, 20% Knockout Serum Replacement (Gibco, Cat # 10828-028), lOng/ml bFGF, non-essential amino acids, glutamine, β-mercaptoethanol and

penicillin/streptomycin. The Rl cell culture medium contained serum-free mammary epithelial basal medium (MEBM) (Lonza), supplemented with B27 (Invitrogen, Cat # 17504044), 20ng/ml EOF (Lonza), 20ng/ml bFGF (Sigma, Cat # F0291-25UG), and 4μg/ml heparin (Sigma, Cat # H1027). Cultures were monitored daily to confirm that colonies came from a single Rl cell and that clusters of hESCs were adhering to the feeders and spreading out into typical hESC colonies and to determine passaging. Single colonies and H7 cells were probed for pluripotency markers by PCR (see section below) flow cytometry analysis, immunofluorescence and Western blot analysis using anti-human OCT3/4 (Santa Cruz Biotech., Cat# SC-9081), anti-human NANOG (R&D Systems, Cat# AF1997), anti-human SOX2 (R&D Systems, Cat# MAB2018), anti- epithelial cell surface marker EPCAM (Stem Cell Technologies, Cat # 10109) and anti-gamma- tubulin (Sigma, Cat# T6557) primary antibodies and respective secondary antibodies according to the manufacturer's instructions. Corresponding single colonies obtained from individual Rl cells were manually dissociated, trypsinized and split into three parts to probe for the differentiation potential of the sub-clones towards each lineage according to the procedures mentioned above.

Quantitative Real Time PCR for pluripotency associated genes

Total RNA was extracted from sorted R1-R4 subpopulations, Rl colonies grown on feeder layers, Rl colonies grown in expansion media, undifferentiated H7 and H9 hESCs, or human MSCs using the PicoPure RNA Isolation Kit (Molecular Devices, Cat # KIT0204). RNA purity and concentration was determined using a 2100 Bioanalyzer (Agilent Technologies). Quantitative real time PCR was performed using 7ng input RNA on a Custom Human RT² Profiler PCR Array (Qiagen, Maryland. USA) following the manufacturer's instructions, p values were generated using student's t-test with the software provided by RT² Profiler PCR Array (Qiagen) online support.

Human Mesenchymal Stem Cell Culture Conditions

Human mesenchymal stem cells (Lonza; cat # PT-2501) were seeded at a recommended density of 5,000-6,000 cells per cm² and fed 3-4 days after seeding with MSCGM medium (Lonza, Cat # PT-3001) and sub-cultured according to the manufacturer's instructions.

Plasmids and retroviral gene transfer

Lenti viral suspensions for short hairpin pl6^mK4a and non-targeting control were collected from transfected 293T cells as previously published by J. Zhang, C. R. Pickering, C. R. Hoist, M. L. Gauthier, T. D. Tlsty, pl6INK4a modulates p53 in primary human mammary epithelial cells. Cancer Res 66, 10325 (2006); the disclosure of which is incorporated herein by reference. Mammary cells were transduced by exposing them to lentiviral suspensions in the presence of 4 μg/mL Polybrene (Sigma-Aldrich, Milwaukee, WI) for 5 hours. This step was repeated 24h later to increase transduction efficiency. Cells were maintained in the appropriate medium for 72 hours after initial transduction, then selected in the presence of 2μg/mL puromycin (Sigma). Cells were expanded in primary mammary epithelial medium for an additional 72 hours, trypsinized and both total RNA and cell pellet were isolated for q-PCR and flow cytometry analysis, respectively. q-PCR was performed using a primer probe set for pl6^mK4a (custom probe ID: 4331348) obtained from ABI. Glucuronidase B (GusB; IDT) expression was used to normalize for variances in input cDNA. The cell pellet was analyzed for expression of CD73 and CD90 cell surface markers by flow cytometry using antibodies as described above. Expansion of a single cell-derived Rl clone and cell cycle analysis

Rl sorted cells were expanded for 2 weeks in a-MEM medium with glutamine supplemented with 15% ES-FBS (Omega Scientific Inc., Cat # FB-05), 18% Chang B and 2% Chang C (Irvine Scientific, Cat #s C-100 and C-106, respectively) and lx

penicillin/streptomycin. Cells were then trypsinized and plated at limiting dilution to generate single cell-derived subclones. Single cell-derived colonies obtained after 2 weeks in culture were trypsinized using cloning rings and expanded to generate a growth curve (Fig. 20, Panel A). Population doublings were calculated using the equation: PD = log (A/B) I log 2, where A is the number of cells collected and B is the number of cells plated initially. Cells were metabolically labeled with 10 mmol/L bromodeoxyuridine (BrdU) for 4 hours before harvest. Cells were isolated by standard trypsinization, resuspended in PBS, and fixed by addition of ice-cold 70% ethanol. Nuclei were isolated and stained with propidium iodide and FITC-conjugated anti-BrdU antibodies (BD Biosciences). Flow cytometry was carried out on a LSRII cytometer (BD Biosciences) and analyzed using the Flow Jo software. All analyzed events were gated to remove debris and aggregates. A minimum of 20,000 events were collected for each analysis.

Telomerase reverse transcriptase expression measurement and Telomerase activity assay Human telomerase reverse transcriptase (hTERT) expression levels were assessed by q-

PCR using a primer probe set for hTERT (Hs00162669_ml) obtained from ABI. Glucuronidase B (GusB; IDT) expression was used to normalize for variances in input cDNA. Telomerase activity was assayed using a highly sensitive and non-isotopic version of the Telomeric Repeat Amplification Protocol (TRAP) assay, i.e. the fluorescence-based TRAPeze XL Telomerase detection kit (Millipore). Lysates (1000 cell-equivalents) from 184A1 (human mammary cell line), Wi-38 (human fibroblast line), Hela, H7 hESCs and single cell-derived Rl subclones from PDs 44.5 and 55.2 were mixed with TRAPeze XL reaction mix containing Amplifuor primers and incubated at 30°C for 30 minutes. Amplified fluorescently-labeled telomerase products were quantitated with a fluorescence plate reader. Telomerase activity, expressed as TPG units (total products generated), was calculated by comparing the ratio of telomerase products to an internal standard for each lysate, as described by the manufacturer.

DNA fingerprinting

DNA fingerprinting (STR analysis) was carried out at Molecular Diagnostic Services Inc. (San Diego, CA). Three nanograms of genomic DNA isolated from each cell population was amplified using the PowerPlex 1.2 or CelllD short tandem repeat genotyping system (Promega) according to the manufacturer's instructions. DNA amplification was performed on an Applied Biosystems 2720 thermocycler. Following amplification, reactions were denatured with Hi-Di formamide and resulting fragments were separated and detected on an ABI Prism 3130 capillary electrophoresis platform with POP7 polymer (Applied Biosystems). Analysis and allelic assignment of the respective loci was performed using the GeneScan and Genotyper (Applied Biosystems) and the PowerTyper 12 macro (Promega) software packages. Karyotypic analysis

Karyotyping was carried out at Molecular Diagnostic Services Inc. (San Diego, CA). Briefly, primary breast cells were allowed to grow to 80% confluency. Mitotic division was arrested by treating cells with 75 ng/mL Colcemid for 18.5 hours. Following treatment, cells were harvested with Trypsin- EDTA, treated with a hypotonic solution, and fixed in

methanol/acetic acid. Metaphase spreads were prepared from fixed cells and stained to observe chromosomal G bands. For each tissue sample, 20 metaphase spreads were counted, 5 of which were analyzed and karyotyped. A representative karyotypic analysis is shown for several breast tissue samples.

Quantitative Real Time PCR

The following describes materials and protocols used in Examples 1-8 below.

Total RNA was extracted from sorted R1-R4 subsets and the corresponding Rl and R3 ALDEFLUOR-positive and ALDEFLUOR-negative subpopulations, undifferentiated H7 and H9 human ESCs, or human mesenchymal stem cells using the PicoPure RNA Isolation Kit

(Molecular Devices, Cat # KIT0204). RNA purity and concentration was determined using the 2100 Bioanalyzer (Agilent Technologies). Quantitative real time PCR was performed using 7ng input RNA on a Custom Human RT² Profiler PCR Array (Qiagen, Maryland, U.S.A.) following the manufacturer's instructions. P value was generated using student's t-test with software provided by RT² Profiler PCR Array (Qiagen, Maryland, U.S.A.) support online.

EXAMPLE 1: IDENTIFICATION AND CHARACTERIZATION OF HUMAN EPITHELIAL CELLS THAT BYPASS NEGATIVE GROWTH SIGNALS

An important phenotype of somatic stem cells is the ability to bypass negative growth signals and participate in wound healing. Based on this premise, a small subpopulation of cells within the human mammary gland was identified that continues to proliferate when the majority of cells arrest in culture. Using comparative gene expression profiling, a dramatic differential expression of genes in cells that bypassed the proliferation barrier was identified, the most prominent being an over-expression and a downregulation of the cell surface markers

CD73/NT5E and CD90/THY1, respectively. Using this CD73/CD90 combination of cell surface markers, FACS was used to isolate epithelial sub-populations from freshly isolated single cell suspensions derived from reduction mammoplasties after depletion of lineage-positive (Lin+) cells, removing hematopoietic, endothelial and leukocyte lineage cells (Fig. 7, Panel A). The resultant lineage-negative (Lin-) population was fractionated (Fig. 7, Panel A) into four distinct subpopulations, CD73+CD90- (Rl), CD73+CD90+ (R2), CD73-CD90- (R3) and CD73-CD90+ (R4) (Figs. 7, Panel B and 1, Panel A), which accounted for 5.3%, 1.9%, 84.6% and 8.2% of the total Lin- population, respectively (Fig. l, Panels A, C).

To validate the generality of these findings, these sub-populations were analyzed from ten disease-free women who underwent reduction mammoplasty. All values with standard errors from mean are provided in figure legends. The tissue donors were 24 to 49 years of age and of either Caucasian or African- American descent. All cell populations exhibited a normal (46XX) karyotype.

Since aldehyde dehydrogenase (ALDH1) is a marker of normal human mammary stem cells, the ALDEFLUOR assay was used to assess the presence and size of a population with ALDH enzymatic activity in the above four epithelial subsets. ALDEFLUOR-positive (ALD+) cells were rare, accounting for only 4% of total mammary epithelial cells (Fig. 13 and Fig. 8, Panel A). No ALD+ cells were detected in R4. The large pool of ALD+ cells in Rl (40%) represents 31% of the Rl compartment. In contrast, while R3 accounts for about half of all ALD+ cells (52%), this ALD+ pool represents a very small fraction of the total R3 cell population (2.4%). Finally, the small pool of ALD+ cells in R2 (8%) accounts for 16% of the R2 compartment (Fig. 13 and Fig. 8, Panel B).

Hence, ALD+ cells are most highly enriched in the Rl and R2 sub-populations but, as will be documented below, Rl contains all of the stem cell activities.

EXAMPLE 2: Rl ALDEFLUOR- POSITIVE CELLS EXHIBIT SUSTAINED MAMMOSPHERE SELF- RENEWAL CAPACITY

To test whether the R1-R4 mammary epithelial subsets with or without ALD expression had mammosphere-forming abilities, previously established in vitro assays were used. Cell self- renewal capacity was assessed by evaluating the sphere initiation efficiency of single cells cultured as mammospheres and subjected to serial passages (Fig. 1, Panel B). Consistent with the lack of ALD+ cells in the R4 population, this subset failed to generate mammospheres in suspension (Figs. 2, Panel A; and 9, Panel A, d). In contrast, the R1-R3 populations were capable of doing so (1st passage) even when plated at 1 cell/well in 96- well plates. Rl exhibited the maximum frequency of mammosphere formation (3.9%), while R2 and R3 exhibited frequencies of 0.47% and 0.58%, respectively (Figs. 2, Panel A; 9, Panel A, a-c). Similar results were obtained when cells were cultured at 1000 cells/ml for up to three passages.

Consistent with previous mammary cell studies, in vitro self-renewal capacity was restricted to ALD+ cells in R1-R3 (Figs. 2, Panel A; 9, Panel A, e-g versus h-j). Robust and sustained mammosphere generation was observed for R1-ALD+ (5-6% over 4 passages), this phenotype being minimal for R2-ALD+ and R3- ALD+ (Fig. 2, Panel A). Hence, the in vitro self-renewal capacity was fully defined by the CD73/CD90 expression profiles, where Rl was enriched 10-fold (4% vs. 0.4%) in colony forming ability in suspension assays compared to unsorted cells (Fig. 2, Panel A).

EXAMPLE 3: Rl ALDEFLUOR- POSITIVE CELLS ARE CAPABLE OF IN VITRO

DIFFERENTIATION ALONG ALL THREE MAMMARY LINEAGES

The ability to differentiate into multiple lineages is a functional hallmark of stem cells. To test which cells had stem or progenitor cell properties, mammosphere-derived cells from Rl- R3 ALD+, were assessed using three in vitro mammary lineage assays (MLA a-c; Fig. 1, Panel B) and an in vivo mammary gland regeneration assay (Fig. 1, Panel B).

To assess in vitro lineage differentiation potential, parallel assays were conducted on serial passages of cells. Mammospheres derived from R1-R3 ALD+ were dissociated to single cells and plated on collagen-coated coverslips at colonogenic densities (MLA a; Fig. 1, Panel B) and an aliquot was placed in suspension culture to test for self -renewal capacity (Fig. 1, Panel B). Differentiation potential of each R1-R3 ALD+ (and ALD-) serial populations was assessed by flow cytometry and colony morphology analysis.

Expression of lineage- specific markers was monitored in the progeny of cells generated after colonogenic culture conditions that promote differentiation. The commitment to luminal epithelial or myoepithelial lineage was determined by immunostaining for the two mammary epithelium lineage- specific markers MUC-1 and CD49f (α-6-integrin), respectively. As expected, R1-R3 ALD- failed to exhibit multi-lineage potential (Fig. 2, Panel B) and were highly enriched (96-97%) in luminal epithelial cells (MUC-l+/CD49f-).

The only ALD+ population to exhibit multi-lineage potential was Rl. In the first passage, all three lineages were generated. With subsequent passages, the bipotent progenitors were enriched at the expense of the differentiated progeny (Fig. 2, Panel B). Indeed, the percentage of R1-ALD+ cells with bipotent (MUC-1 +/CD49f+) differentiation potential increased over passages 1-3: 20%, 32% and 66%, respectively (Fig. 2, Panel B). In contrast, R2- ALD+ and R3-ALD+ contained a negligible fraction of bipotent progenitors: 0.3-0.1% and 4- 2% in passages 1 and 2, respectively (Fig. 2, Panel B). In addition, whereas R2 generated both luminal and myoepithelial cells, R3 was predominantly restricted to luminal cells.

In the morphologic colonogenic assay that assesses the lineage differentiation potential of single cells, R1-ALD+ mammosphere-derived cells differentiated into three types of colonies: colonies containing exclusively myoepithelial cells (Fig. 2, Panel C, top panel), or exclusively luminal epithelial cells (Fig. 2, Panel C, middle panel) or cells of both lineages as well as bipotent cells with co-expression of both lineage markers (Fig. 2, Panel C, bottom panel). This differentiation potential was maintained in subsequent passages (data not shown). As expected from the flow cytometry results above, R2-ALD+ mammosphere-derived cells differentiated only into myoepithelial and luminal epithelial colonies, whereas R3-ALD+ mammosphere- derived cells differentiated predominantly into luminal epithelial colonies (data not shown). Of particular note, the luminal epithelial colonies generated from R3-ALD+ mammosphere derived cells were morphologically different (bigger) from those derived from R1-ALD+, even though both expressed MUC-1 (data not shown).

To test the potential to differentiate along the alveolar epithelial cell lineage (MLA b), cells derived from R1-R3 ALD+ mammospheres were allowed to differentiate on a collagen substratum for 7 days then overlaid with reconstituted basement membrane gel devoid of growth factors (Matrigel) supplemented with prolactin and further cultured for 7 days. Acquisition of alveolar differentiation was assessed by cellular production of β-casein (Fig. 2, Panel D). Under these conditions, R1-ALD+ mammosphere-derived cells were the only ones able to differentiate along the luminal, myoepithelial and alveolar lineage, representing therefore the only truly multipotent population.

Finally, in vitro differentiation potential was assessed by comparing the ability of R1-R3 ALD+ mammospheres-derived cells to form functional ductal-alveolar structures using a previously described 3D Matrigel cell culture system (MLA c) (Fig. 1, Panel B). This system tests the ability to recapitulate in vitro the spatial orientation and the complex architecture of the mammary tree observed in vivo. Primary human mammary epithelial cells organize in two types of multi-cellular structures: small acinus-like structures of luminal epithelial origin and solid spherical colonies of myoepithelial origin. To test the ability of R1-R3 ALD+ mammospheres- derived cells to develop branched, ductal-acinar structures and functional alveolar cells, single cells from dissociated mammospheres were plated at colonogenic densities in 3D Matrigel culture and cultivated for 3 weeks. Their growth was monitored daily to ensure that each structure was generated from a single cell and that individual structures did not merge. Rl- ALD+ mammosphere-derived cells generated colonies with two morphologically distinct structures: 26% with branched, ductal-acinar structures, with the remaining ones forming acinuslike structures (Fig. 9, Panel B). In contrast, R2-ALD+ mammosphere-derived cells generated only acinus-like structures (Fig. 9, Panel B). R3-ALD+ mammosphere-derived cells as well as ALD- cells failed to generate any structure (Fig. 9, Panel B). When prolactin was added to the differentiation medium, R1-ALD+ but not R2- ALD+ mammosphere-derived cell cultures produced β-casein which was secreted in the central lumen of the acinar structures (data not shown). These data demonstrate once again that the R1-ALD+ population had true multi-lineage differentiation potential in vitro, whereas the R2-ALD+ and R3-ALD+ populations were significantly restricted in their differentiation potential.

EXAMPLE 4: Rl ALDEFLUOR- POSITIVE CELLS ARE CAPABLE OF IN VIVO

DIFFERENTIATION ALONG ALL THREE MAMMARY LINEAGES

To assess in vivo differentiation potential, the mouse model described by Kuperwasser et al. was utilized to evaluate the ability of R1-R4 to enrich for mammary gland regenerating activity in vivo. R1-R4 were transplanted into humanized cleared mammary fat pads of

NOD/SCID mice (Fig. 10, Panels A-M). Only Rl had outgrowth potential, as shown by duct formation upon implantation of 15,000 cells (Fig. 10, Panels A-B). Importantly, this potential resided within its ALD+ fraction and was exhibited by transplanting as few as 5,000 cells (Fig. 10, Panels E-F). The Rl-ALD- fraction was unable to generate any ducts even after

transplanting 30,000 cells (Fig. 10, Panels J-K). R3, which also has ALDEFLUOR activity, failed to repopulate the mammary gland even after transplanting 300,000 cells (Fig. 10, Panels C-D). Thus, ALDEFLUOR activity alone does not dictate outgrowth potential.

The human origins of the epithelial outgrowths were validated by immunostaining with human-specific antibodies for CK8/18 (luminal epithelial cells) and a -smooth muscle actin (a- SMA) (myoepithelial cells). As is the case in the human mammary tree, two kinds of ductal structures were generated in the animal host: acini and elaborate ductal-lobular outgrowths. Both were composed of a luminal epithelial layer, and an outer myoepithelial cell layer (Fig.3, Panels A-B). To test whether the ductal structures from the transplantation had undergone complete functional differentiation, mice bearing the transplanted cells were mated and allowed to develop until day 18 of pregnancy. Human β -casein expression was observed within the luminal cells lining the acini and secretion in the lumina of the human ductal structures only in Rl- ALD+ outgrowths (Fig. 3, Panels D and F). These observations further demonstrate the multipotent capacity of the Rl ALD+ cells both in vitro and in vivo.

EXAMPLE 5: Rl ALDEFLUOR- POSITIVE MULTIPOTENT CELLS ARE CAPABLE OF IN VITRO DIFFERENTIATION INTO ADDITIONAL ECTODERMAL LINEAGES

Since CD73 and CD90 are expressed on other stem cell populations, the capacity of Rl- R4 subsets to differentiate into ectodermal lineages other than that of the mammary lineage, i.e. neural lineage, was determined. Neurosphere formation was restricted to Rl and R2 ALD+ fractions and maintained up to 3 passages. The phenotype of the spontaneously differentiated neural-lineage cells from the neurospheres was analyzed as described above. Although cells from both R1-ALD+ and R2-ALD+ neurospheres stained positive for the neural -specific marker, Nestin, they differed significantly in their potential to give rise to mature neurons (β-ΙΙΙ- tubulin/TUJ-1 -positive cells) or glial cells (GFAP-positive cells). R2-ALD+ neurosphere- derived cells differentiated only into the glial lineages, particularly astrocytes. In contrast, Rl- ALD+ neurosphere-derived cells differentiated into both neurons and astrocytes, the percentage of differentiated neurons being much higher than astrocytes (89% vs. 11%, respectively) (Fig. 11, Panels A-B). This was also the case for human H7, ESCs (Fig. 11, Panel C).

The ability of R1-ALD+ cells to differentiate into functional dopaminergic (DA) neurons was further assessed. After 21 days of differentiation, 80% of Rl ALD+ cells assumed a distinct pyramidal morphology with positive staining for the DA-specific markers tyrosine hydroxylase (TH) and vesicular monoamine transporter 2 (VMAT2) (Fig. 11, Panel D, top panel). It was then investigated whether these cells exhibited electrical membrane properties characteristic of neurons, including negative resting membrane potential (RMP) and action potential firing. To test this, whole-cell patch clamp recordings in Rl-ALD+-derived and hESC-derived DA- neurons were performed (Fig. 4, Panels A-B). Both neuron populations showed similar negative RMPs (-37 and -36mV, respectively), the values being comparable to those previously reported in immature hESC-derived neurons but higher than the ones typically observed in vivo (-58 mV). This reflects the expression of bona fide neuronal ion channels and the efficient regulation of ionic gradients across the cellular membrane.

To test whether Rl-ALD+-derived and hESC-derived DA neurons could fire action potentials, both groups of cells were depolarized by injecting a series of depolarizing current steps. As expected, at depolarized membrane potentials, all five hESC-derived DA-neurons tested fired action potentials after a threshold membrane potential was reached in an all-or- none fashion (Fig. 4, Panel D). Similar all-or-none voltage deflections were observed in R1-ALD+- derived DA-neurons upon depolarization (Fig. 4, Panel C). The threshold at which action potentials were fired was similar in both cases, 52 + 12 pA and 84 + 27.9 pA, respectively. Importantly, unlike mature neurons that display spontaneous repetitive firing of action potentials, only one action potential was fired during each current step above threshold in both hESC- and Rl ALD+-derived DA-neurons, the latency becoming shorter at higher potentials. This observation once again supports the immature state of these DA-neurons, as indicated by their high input resistance, 1.6 and 1.1 ΟΩ, respectively (Fig. 4, Panel E). Importantly, the voltage deflection could be ablated by tetrodotoxin (TTX; Fig. 4, Panel F), indicating that this voltage deflection was mediated by Na+ channels, as expected for neurons. These results provide physiological evidence that hESCs and Rl ALD+ cells can differentiate into functional neurons that share very similar properties.

EXAMPLE 6: Rl MULTIPOTENT CELLS ARE CAPABLE OF IN VITRO DIFFERENTIATION ALONG THE ENDODERM AND MESODERM LINEAGES INDEPENDENT OF ALDEFLUOR EXPRESSION

Having established that R1-ALD+ could differentiate into various cell types along the ectoderm lineage, the differentiation potential of Rl along other somatic lineages, including endoderm and mesoderm, was investigated.

To determine the potential for endodermal differentiation, R1-R4 were cultured under conditions that allow human ESCs to differentiate into definitive endoderm. After 3 days of differentiation, markers indicative of definitive endoderm (transcription factors SOX17 and FOXA2) were assessed by immunostaining. R3 and R4 failed to survive under these differentiation conditions. R2 survived but failed to proliferate, and showed very weak expression of SOX17 in the cytoplasm but did not express FOXA2 (data not shown). The only population that underwent differentiation towards definitive endoderm was Rl, 40% of Rl cells expressing both SOX17 and FOXA2 in their nucleus (Fig. 5, Panels A-B). No cells expressed the mesoendoderm marker Brachyury, demonstrating a complete differentiation towards the definitive endoderm without contributions from a contaminating mesoendoderm lineage.

Surprisingly, the differentiation potential was independent of ALDEFLUOR expression, both R1-ALD+ and Rl-ALD- cells generating definitive endoderm (Fig. 5, Panels A-B).

To determine the potential for mesodermal differentiation, R1-R4 were exposed to growth factors previously reported to induce adult mesenchymal stem cells (MSCs) towards a cardiomyogenic cell lineage. Under these conditions, Rl and R2, irrespective of their

ALDEFLUOR activity, survived, whereas R3 and R4 died. After differentiation, markers indicative of cardiomyogenic differentiation (transcription factors GATA4, MEF-2 and Nkx2.5, and Troponin I) were assessed by immunostaining. Rl-ALD- cells uniformly expressed all the cardiomyogenic markers (Fig. 5, Panel D). R1-ALD+ cells exhibited expression of three out of the four markers: GATA 4, Nkx2.5 and Troponin I, but not MEF-2 (Fig. 5, Panel C).

Differentiation potential of R2 was even further reduced, R2 cells expressing only Nkx2.5 (data not shown). As expected from previous reports, under these conditions, contraction of cardiomyocytes was not observed. Importantly, when Rl cells, with or without ALDEFLUOR activity, were cultured on human placental fibroblast feeders and grown in conditions that promote hESCs differentiation into cardiomyocytes (17), spontaneous beating was observed (data not shown).

CD73+CD90- (Rl) cells exhibit multipotency, functional differentiation into epithelial and mesenchymal lineages and thus are human Somatic Cells with an Innate Potential for Pluripotency (hSCIPP).

EXAMPLE 7: INDIVIDUAL Rl CELLS EXPRESS CERTAIN PHENOTYPES CHARACTERISTIC OF EMBRYONIC STEM CELLS

A single Rl cell, when isolated from primary tissue and placed in conditions that allow expansion of pluripotent human ES cells (23), forms a colony that, by 14 days, robustly expresses pluripotency genes previously documented in ES cells, Nanog, Oct3/4 and Sox2 (Fig.6, Panel A). This is not observed for R2-R4. Progeny of these single cell-derived subclones were divided into three parts, placed in differentiation conditions described above and shown to generate neurons, cardiomyocytes and definitive endoderm (Fig.12). Short Tandem Repeat analysis was used to confirm the origin and individual identity of the parental breast cell population and its mesodermally-differentiated Rl derivative (Figure 14). Thus, these Somatic Cells display an Innate Potential for Pluripotency (SCIPP) when placed in the proper conditions.

Current studies have demonstrated that a general feature of a stem cell phenotype includes the generation of robust dynamic heterogeneity. This phenotypic fluidity can be measured using flow cytometry and monitoring the distribution of a myriad of expression changes. In ES cells this is exhibited by fluctuations in Nanog expression which correlate with a distribution of probabilities of differentiation. In haematopoietic progenitors, Seal expression serves this function. Expression of the cell surface markers CD73 and CD90 were used to document the dramatic plasticity of the Rl population (Fig.6, Panel B). Indeed, the Rl population exhibits a dynamic redistribution towards the four initial states of R1-R4. Associated with the redistribution of the original Rl population is the acquisition in restrictions in differentiation potential (data not shown).

EXAMPLE 8: HSCIPP DISPLAY A GENE EXPRESSION SIGNATURE THAT DISTINGUISHES THEM FROM HESCS

Since hSClPPs can exhibit pluripotency phenotypes along the three germ lineages, the molecular commonalities and distinctions between this newly characterized hSCIPP population and a well-characterized hESC population were assessed. To this end, transcript expression levels of 43 genes were measured, including key pluripotency marker genes and known reprogramming factors, in Rl and R4 populations sorted from four reduction mammoplasties using quantitative RT-PCR (qRT-PCR). This analysis revealed that RI-ALD+ and Rl-ALD- exhibited a similar expression profile and that this profile, although sharing some commonalities with hESCs, also clearly distinguishes them from hESCs. One shared characteristic between hSClPPs and hESCs is the high expression of pluripotency genes, such as Oct3/4 and Nanog, compared to differentiated cells (Fig. 6, Panels A-C and Fig. 15). Unlike hESCs, hSCIPP express much reduced levels of certain epigenetic plasticity markers, such as Dnmt3b, while robustly expressing the critical reprogramming factors, Klf4 and Myc, and the stress marker Ptgs21Cox2 (Fig. 6, Panels A-C and Fig. 15). Thus, hSClPPs exhibit a unique expression profile that supports their potential for pluripotency and clearly distinguishes them from hESCs.

EXAMPLE 9: CELL SURFACE MARKERS CONTROLLED BY P!6^{INK A}

Repression of pl6^mK4a is a key stem cell phenotype. Mice engineered for knock-out of BMI-1, a polycomb repressor protein that inhibits pl6^mK4a transcription and activity, fail to generate hematopoietic and neural stem cells. Functionally, repression of pl6^mK4a in stem cells not only inactivates cell cycle arrest in response to stress but, additionally, enables epigenetic plasticity for differentiation. Repression of pl6^mK4a might also modulate expression of cell surface markers that could be used for the prospective isolation of cells with stem cell properties. Comparative gene expression profiling of human mammary epithelial cells with or without naturally repressed pl6^mK4a identified a dramatic co-incident over-expression and down- regulation of CD73 and CD90, respectively. To confirm the causal role of pl6^mK4a in modulating these proteins, human mammary epithelial cells with shpl6 were assayed for expression of CD73 and CD90 using flow activated cell sorting (FACS). A 61-77% reduction in basal pl6^mK4a protein expression was accompanied by a dramatic shift from the CD73^"CD90⁺ to the CD73⁺CD90^" fraction, resulting, on average, in > 100-fold increase in CD73⁺CD90^" cells (Fig. 21).

Having identified CD73⁺CD90^" as a potential signature for mammary stem cells, nineteen disease-free human breast tissues (reduction mammoplasties) were analyzed for the presence of CD73⁺CD90^" cells. All tissues were devoid of visible disease, bacterial, fungal or viral contamination and exhibited a normal diploid 46, XX karyotype (Examples, and Fig. 22). Freshly isolated single cells were first depleted of the lineage-positive (Lin⁺) fraction

(hematopoietic, endothelial and leukocytic cells) (Fig.7, Panel A). The resultant lineage-negative (Lin ) population, which expresses the epithelial cell surface marker EPCAM, was fractionated into four subpopulations, CD73⁺CD90^" (Rl)(5.3%), CD73⁺CD90⁺ (R2)(1.9%), CD73 CD90^" (R3)(84.6%) and CD73^"CD90⁺ (R4)(8.2%) (Figs. 1, Panels A and C, and Fig. 33), using the gating shown in Fig.7, Panel B. Fractions R1-R4 were subsequently tested in standard assays for mammary stem cell self -renewal and multi-lineage potential as described below. EXAMPLE 10: RARE CELLS EXHIBIT BREAST MULTIPOTENCY

Self-renewal capacity was assessed by evaluating sphere initiation efficiency of single cells, cultured as mammospheres and subjected to serial passages (Fig. l, Panel B). While many cell populations could produce initial mammospheres, even when plated at 1 cell/well in 96-well plates, only cells that demonstrated serial mammosphere formation possessed stem cell properties. Robust and sustained mammosphere generation was observed only for cells within Rl and extended to 8 passages (Fig. l, Panel C; Fig 16, Panel A; and Fig. 23, Panel A).

Importantly, as expected for a rare stem cell population, only a small fraction (-3%) of

CD73⁺CD90^~ cells (Rl cells), accounting for only 0.16% of total epithelial cells, exhibited this complete and sustained clonogenic mammary self-renewal capacity in vitro.

To test further which mammary cells had stem or progenitor cell properties,

mammosphere-derived cells from R1-R3 were assessed using three in vitro Mammary Lineage Assays (MLA a-c; Fig. 1, Panel B) and one in vivo mammary gland regeneration assay (Fig. 1, Panel B).

In the first assay, in vitro lineage differentiation potential was assessed on serial passages of mammosphere-derived cells by flow cytometry and colony morphology analysis.

Mammospheres derived from R1-R3 were dissociated into single cells, cultured in suspension to test for self-renewal capacity and multi-lineage potential and an aliquot was plated on collagen- coated coverslips at colony-producing densities (MLA a; Fig. l, Panel B). Differentiation was monitored by staining cells for expression of mammary luminal and myoepithelial markers, MUC-1 and CD49f (α-6-integrin), respectively (Fig. 23, Panel B). Flow cytometry identified Rl as the only population with multi-lineage potential. The first mammosphere passage generated all three lineages. With subsequent passages, the bipotent progenitors (MUC-1 ⁺/CD49f⁺) increased over passages 1-3: 20%, 32% and 66%, respectively (Fig. 16, Panel B) at the expense of the differentiated progeny. Using the complementary morphologic colony-producing assay, Rl mammosphere-derived (single) cells differentiated into three types of colonies: colonies containing exclusively myoepithelial cells (Figs. 16, Panel B and Fig. 23, Panel B: top), exclusively luminal epithelial cells (Fig. 16, Panel B; and Fig. 23, Panel B: middle) or cells of both lineages as well as bipotent cells with co-expression of both lineage markers (Figs. 16, Panel B and Fig. 18, Panel B; bottom). This differentiation potential was maintained in subsequent passages (data not shown). In contrast, both flow cytometry (Fig. 16, Panel B) and morphological analysis (data not shown) demonstrated that R2 and R3 mammosphere-derived cells differentiated predominantly into myoepithelial and luminal colonies, or only into luminal colonies, respectively

Acquisition of functional alveolar differentiation was assessed by cellular production of β-casein in the second assay (MLA b; Fig. 1, Panel B and Fig. 16, Panel C). Cells derived from R1-R3 mammospheres were allowed to differentiate on a collagen substratum, overlaid with reconstituted basement membrane gel devoid of growth factors (Matrigel), supplemented with prolactin and further cultured. Under these conditions, only Rl mammosphere-derived cells produced β-casein, consistent with alveolar differentiation. R2-R3 produced luminal cells that failed to differentiate in the presence of prolactin. These cells may be like the mature luminal cells reported by Lim et. al. that fail to respond to lactogenic cues, as well as fail to form ducts/lobules in 3D Matrigel culture.

The third in vitro differentiation assay (MLA c; Fig. 1, Panel B) compared the ability of R1-R3 mammosphere-derived cells to organize into two types of multi-cellular structures observed in vivo: small acinus-like structures of luminal origin and solid spherical colonies of myoepithelial origin. Single cells from dissociated mammospheres (R1-R3) were cultured at colony-producing densities in 3D Matrigel. Only Rl mammosphere-derived cells generated both structures: 26% branched, ductal-acinar structures and 74% acinus-like structures (Fig. 23, Panel C). When prolactin was added to the differentiation medium, Rl but not R2 mammosphere- derived cell cultures produced β-casein (data not shown). Thus, the Rl population exhibited true multi-lineage differentiation potential in vitro, whereas the R2 and R3 populations were significantly restricted in potential.

Finally, the ability of R1-R4 to enrich for mammary gland regenerating potential in vivo was evaluated as described above. R1-R4 were sorted and directly transplanted into cleared, humanized mammary fat pads of NOD/SCID mice. Only Rl had outgrowth potential, as shown by duct formation upon implantation of as few as 5,000 cells (Fig. 24, Panels A-B). R2, R3 (Fig. 24, Panel A) and R4 failed to repopulate the mammary gland even after transplantation of up to 300,000 cells. As observed in the human mammary tree, the acini and ductal-lobular outgrowths generated in the host were composed of a luminal layer and an outer myoepithelial cell layer (Fig. 16, Panel D). The human origin of these epithelial outgrowths was validated with human- specific antibodies for CK8/18 (luminal cells) and a-smooth muscle actin (a-SMA)

(myoepithelial cells). To test whether these human ductal structures had undergone complete functional differentiation, mice were mated and mammary glands were harvested at day 18 of pregnancy. Human β-casein was expressed within luminal cells lining the acini and secreted into the lumina of human ductal structures only in Rl outgrowths (Fig. 24, Panels C-F). These results established the mammary gland multipotent capacity of the Rl cells both in vitro and in vivo. EXAMPLE 11: DIFFERENTIATION INTO ADDITIONAL LINEAGES

Analysis of the R1-R4 subpopulations by qPCR array revealed distinctive expression of genes in the Rl population that confer multi- and pluripotency (Fig. 19, Panel A). Thus, the capacity of R1-R4 subpopulations to differentiate into other ectodermal and mesoendodermal lineages was examined.

Sustained neurosphere self-renewal capacity was assessed using previously established in vitro assays ²². Neurosphere formation was restricted to Rl (up to 7 serial passages; Fig. 25, Panels A-D) and R2 fractions (up to 2 serial passages) and exhibited a frequency similar to that for mammosphere formation (-4% of Rl or -0.2% of the total Lin- population). Expression of the neural progenitor marker nestin was confirmed in the spontaneously differentiated neural lineage cells from Rl and R2 neurospheres. However, whereas 89% and 11% of Rl

neurosphere-derived cells expressed neuronal (β-ΙΙΙ-tubulin/TUJ-l) and glial (GFAP) differentiation markers, respectively (Fig. 25, Panels A-D), R2 neurosphere-derived cells expressed only GFAP.

To examine the capacity of R1-R4 subpopulations to differentiate into endodermal lineages, R1-R4 were cultured under conditions that allow human ESCs (hESCs) to differentiate into definitive endoderm and assessed by immunostaining for expression of transcription factors SOX 17 and FOXA2. R3 and R4 failed to survive under these conditions. R2 survived but failed to proliferate, and showed very weak cytoplasmic expression of SOX17 and no expression of FOXA2 (data not shown). Only Rl cells displayed definitive endoderm phenotypes, 40% of cells exhibiting SOX17 and FOXA2 nuclear expression (Fig. 26, Panel A). No cells expressed the mesoendodermal marker Brachyury, demonstrating a complete commitment towards definitive endoderm without contribution from a mesoendoderm lineage (Fig. 26, Panel A). Under proper conditions, Rl cells, could further differentiate towards the pancreatic lineage, as demonstrated by the expression of the pancreatic differentiation markers PDX1 and NKX6.1 (Fig. 17, Panel A).

To determine mesodermal potential, R1-R4 were exposed to differentiation media previously reported to induce adult human mesenchymal stem cells (MSCs) and hESCs towards adipocyte, endothelial or cardiomyocyte cell lineages. Under adipogenic conditions, only Rl cells attached and grew. Under endotheliogenic and cardiomyogenic conditions, Rl and R2 survived, whereas R3 and R4 died. Only Rl cells uniformly co-expressed cell type-specific markers such as leptin, PPARy and FABP4 for adipocytes, CD31 and CD34 for endothelial cells and GATA4, MEF-2, NKX2.5, and Troponin I for cardiomyocytes (Figs. 17, and 25, Panels A- D). R2 cells expressed only NKX2.5 (data not shown). Functional assays demonstrated the production of lipid-filled adipocytes and tubule-forming endothelial cells from Rl (Figs. 17, Panel C and 25, Panels A-D). As expected from previous reports, spontaneous beating of cardiomyocytes was only observed when Rl cells were cultured on human placental fibroblast feeders and grown under conditions that promote hESC differentiation into cardiomyocytes. Thus, a small fraction (3%) of CD73⁺CD90^~ cells from a human somatic cell population exhibits functional expression of markers and phenotypes of ectodermal, endodermal and mesodermal lineages.

EXAMPLE 12: FORMATION OF TERATOMAS

To test the potential for teratoma formation, R1-R4 cells were grafted under the renal capsule of immuno-compromised mice. Both the Rl population sorted directly from mammary tissue (Figs. 18, Panel A and 27, Panels A-C) and the positive control hESC H7 (Fig. 28, Panel A) generated teratomas with representation of all three germ layers. Populations of R2-R4, as well as pre-malignant mammary cells (184A1), failed to form any cell mass while injection of metastatic mammary cells (MDA-MB-231) formed a malignant tumor with no differentiated structures (Fig. 28, Panel B). Together these data demonstrate that a fraction of the Rl population can generate derivatives of all three developmental lineages and that it is not malignant.

EXAMPLE 13: CLONAL EVIDENCE OF PLURIPOTENCY

The power of assessing uncultured Rl cells, isolated directly from human tissue, for differentiation potential in a teratoma assay is that the differentiation potential cannot be attributed to cell expansion in culture. However, with this approach, one cannot ascertain that the Rl subfraction consists of single cells each of which has the ability to generate all three germ lineages, i.e. pluripotent cells. Indeed, this Rl population could, alternatively, represent a collection of cells, each with restricted potency for a single germ lineage.

To distinguish between these two possibilities, progeny of Rl single cell-derived subclones, propagated under conditions that allow expansion of pluripotent human ES cells, were manually divided into three parts, placed in each of the in vitro and in vivo differentiation assays described above, and assessed for potency. These single-cell derived Rl subclones generated all previously described lineage derivatives (Fig. 29, Panels A-D). They also formed teratomas with contributions to all three germ lineages (Figs. 18, Panel B and 27, Panels C-D). Thus, directly sorted Rl cells and single-cell derived Rl subclones are equally potent in generating all three germline derivatives in vitro and in vivo and demonstrating pluripotency.

The pluripotent potential of rare Rl cells isolated from primary tissue became evident when they were placed under conditions known to allow expansion of hESCs. Approximately 3% of the Rl population formed single cell-derived colonies by day 14 (Fig. 19, Panels A-B). The acquisition of a stem cell state could be explained by the robust induction of the canonical pluripotency genes, NANOG, OCT3/4 and SOX2 in these colonies as assayed by four methods. Flow cytometric analysis demonstrated that >95 of cells within each colony co-expressed the three pluripotency genes coincident with the epithelial cell surface marker, EPCAM (Fig. 30, Panel A). Immunocytochemical staining of the colonies provided not only expression levels but also subcellular localization and distribution within the population (Fig. 6, Panel B). Expression of the pluripotency markers was confirmed at the transcript and protein level using qPCR (Fig. 19, Panel A) and Western blot analysis (Fig. 30, Panel B), respectively. The expression of pluripotency markers was not observed within the R2-R4 sub-populations.

To confirm the origin and individual identity of Rl cells, Short Tandem Repeat (STR) was as a forensic analysis to compare markers in FACS isolated cells and a mesodermally- differentiated Rl derivative (beating cardiomyocytes) derived from two breast tissues. Each pair of parental and differentiated samples exhibited identical genetic markers for a given donor, each being distinct from markers from a representative control hESC population or a K562 control cell line (Fig. 14). Collectively, these data demonstrate that a single endogenous Pluripotent Somatic Cell (ePS cell) can exhibit pluripotent functions and generate all three germ lineages when exposed to proper conditions (Fig. 19, Panel D).

EXAMPLE 14: EPS CELLS ARE DISTINCT FROM HESC AND MSC

The molecular commonalities and distinctions between the newly characterized pluripotent ePS cell population and well-characterized hESC populations was assessed.

Additionally, since CD73 is a cell surface marker in MSCs, MSCs were also included in the comparison. To this end, transcript levels of 43 genes were measured in Rl populations sorted from four reduction mammoplasties using quantitative RT-PCR (qRT-PCR) and compared them with profiles from two hESC and a MSC (Fig. 34). These genes included pluripotency, stress and reprogramming genes. Analysis revealed that Rl, although sharing some commonalities with hESCs (Fig. 19, Panel A), exhibited distinct other commonalities with MSCs (Fig. 19, Panel B). One shared characteristic between ePS cells and hESCs, that distinguished them from differentiated cells or MSCs, was the high expression of pluripotency genes OCT3/4, SOX2 and NANOG (Fig. 19, Panel A and Fig. 34). Unlike hESCs, and similar to MSCs, ePS cells expressed much reduced levels of the epigenetic plasticity marker DNMT3b (Fig. 19, Panel B and Fig. 34). Furthermore, Rl cells clearly displayed reduced expression of CD90, this latter phenotype distinguishing them from both hESCs and MSCs (Fig. 19, Panel C). Similar results were obtained using either single cell-derived clonal populations or directly sorted uncultured populations (Fig. 19, Panels A-C and Fig. 34). Thus, ePS cells exhibited a unique expression profile that supported their pluripotent potential and clearly distinguished them from hESCs and MSCs. Finally, also in distinction to immortal hESCs, ePS cells were mortal, grew for up to 58 population doublings and maintained a diploid karyotype before arresting in Gl (Fig. 20, Panels A-C). The ePS population exhibited very low levels of telomerase reverse transcriptase (TERT) and telomerase activity, comparable to those observed in differentiated cells and much lower than those observed in hESCs or malignant cells (Fig. 20, Panels D-E).

EXAMPLE 15: EPS CELLS OBTAINED FROM PANCREAS AND FORESKIN

Pancreas: a CD73+CD90- population was isolated from ductal fraction of pancreas. Cells were harvested as single cell isolates, stained with lineage specific markers and CD73 and CD90. Lineage negative cells yield 1% Rl cells (Fig. 35, Panel A). When these cells were sorted fresh and seeded for mammosphere forming assay, Rl cells from pancreas gave rise to mammospheres that were passaged till three passages and differentiated towards myoepithelial and luminal colonies. No beta-casein production was seen in the in vitro conditions.

Mammosphere assay using CD49f and MUC-1 staining showed the presence of two types of colonies from Rl cells in pancreas (Fig. 35, Panel B). Samples used: 2

Foreskin: isolation of Rl same as above. The foreskin was divided into epidermis and dermis. Rl from dermis gave rise to mammary-duct like structures in a humanized fat pad experiment. 3 foreskin samples were used for this assay. Rl from epideremis and dermis was used. Rl from dermis gave mammary glands in vivo in the humanized model. The fraction of Rl in both epidermis and dermis was approximately 1%.

DISCUSSION

A unique population of somatic cells isolated from disease-free human breast tissue that exhibits remarkable phenotypic plasticity has been described herein. These cells met benchmarks of pluripotency: (a) demonstration of pluripotency without cell culture, (b) clonal evidence of pluripotency, (c) demonstration of cell type-specific gene expression, (d) functionality of all three lineage derivatives (ectodermal: secretion of human milk in

transplanted mice, mesodermal: lipid- accumulating adipocytes, tubule-forming endothelial cells and beating cardiomyocytes, and endodermal: intestinal goblet cells) and finally, (e) exclusion of cell-cell fusion or contamination events (through STR analysis and karyotyping of multiple cell populations before and after differentiation).

As detailed above, ALDEFLUOR positivity of cells was not universally associated with the cells having a full differentiation potential (or a "stem cell phenotype"). For example, ALDEFLUOR-positive cells lacking CD73 did not possess full pluripotent differentiation potential. In contrast, cells expressing CD73 did show full differentiation potential,

ALDEFLUOR positivity conferring only a differentiation advantage towards the ectoderm lineage. Cells expressing CD73, regardless of their ALDEFLUOR status, differentiate equally well towards definitive endoderm and mesoderm.

Gene expression data support the conclusion that, although these ePS cells share some commonalities with hESCs and hMSCs, they display unique properties.

Isolation of this unique human somatic cell population is based on the differential expression of two glycosyl-phosphatidylinositol (GPI)-anchored cell surface proteins, the ecto 5 '-nucleotidase NT5E/CD73, an extracellular, raft-associated enzyme responsible for conversion of extracellular ATP into adenosine, and the cell adhesion molecule CD90/THY-1. CD73 and CD90 have been used previously as cell surface markers for MSCs. However, lack of EPCAM expression and robust expression of CD90 in MSCs easily distinguishes them from ePS. CD73 can affect cell fate through enzymatic and non-enzymatic mechanisms that result in alterations of the micro-environment and regulation of cell-stroma interactions. CD90 expression has been linked to myofibroblast and tumor-associated fibroblast phenotypes.

The non-malignant state of the ePS cells from multiple individuals was demonstrated. The ePS cells, either directly isolated from human tissue or expanded in culture, exhibit normal diploid 46,XX karyotypes, low telomerase expression and activity and ultimately enter replicative senescence, distinguishing them from immortal, genomically unstable tumor cells. Furthermore, while pre-malignant cells do not form growths, metastatic cells generate robust malignant growths but without the expression of differentiated derivatives seen with ePS cells.

Although the foregoing invention has been described in some detail by way of illustration and example for purposes of clarity of understanding, it is readily apparent to those of ordinary skill in the art in light of the teachings of this invention that certain changes and modifications may be made thereto without departing from the spirit or scope of the appended claims.

Accordingly, the preceding merely illustrates the principles of the invention. It will be appreciated that those skilled in the art will be able to devise various arrangements which, although not explicitly described or shown herein, embody the principles of the invention and are included within its spirit and scope. Furthermore, all examples and conditional language recited herein are principally intended to aid the reader in understanding the principles of the invention and the concepts contributed by the inventors to furthering the art, and are to be construed as being without limitation to such specifically recited examples and conditions. Moreover, all statements herein reciting principles, aspects, and embodiments of the invention as well as specific examples thereof, are intended to encompass both structural and functional equivalents thereof.

Additionally, it is intended that such equivalents include both currently known equivalents and equivalents developed in the future, i.e., any elements developed that perform the same function, regardless of structure. The scope of the present invention, therefore, is not intended to be limited to the exemplary embodiments shown and described herein. Rather, the scope and spirit of present invention is embodied by the appended claims.

Claims (23)

WHAT IS CLAIMED IS :

1. An isolated population of cells wherein at least 8% of the cells are Somatic Cells with an Innate Potential for Pluripotency (SCIPP).

2. The isolated population of claim 1, wherein the isolated population comprises cells enriched for CD73⁺/CD907Lineage marker negative (Lin ) cells.

3. The isolated population of any of claims 1-2, wherein the Lineage marker comprises markers specific for one or more of: T cells, thymocytes, NK cells, neutrophils, B cells, myeloid cells, macrophages, monocytes, platelets, granulocytes, B cells, granulocytes, and dendritic cells.

4. The isolated population of any of claims 1-3, wherein the Lineage markers comprise any combination of: CD2, CD3, CD16, CD31, CD45, CD64 and CD140b.

5. The isolated population of any of claims 1-4, wherein the SCIPP express increased levels of KLF4, MYC, PTGS2, or any combination thereof, as compared to embryonic stem cells (ESCs) and adult mesenchymal cells (MSCs).

6. The isolated population of any of claims 1-5, wherein the SCIPP express POU5Fl(OCT3/4), NANOG, CD24, EPCAM, or any combination thereof, at increased levels as compared to MSCs and at levels similar to ESCs.

7. The isolated population of any of claims 1-6, wherein the SCIPP express CECR1,

DNMT3B or both at decreased levels as compared to ESCs and at levels similar to MSCs.

8. The isolated population of any of claims 1-7, wherein the SCIPP are derived from disease-free mammary tissue.

9. The isolated population of any of claims 1-8, wherein the SCIPP are human

SCIPP.

10. The isolated population of any of claims 1-9, wherein at least 50% of the cells in the isolated population are SCIPP.

11. The isolated population of any of claims 1-10, wherein the SCIPP are genetically modified.

12. A method for producing a sample enriched for Somatic Cells with an Innate Potential for Pluripotency (SCIPP), the method comprising:

culturing a cell sample from a subject under conditions that promote the differential maintenance and growth of SCIPP.

13. The method of claim 12, wherein the method further comprises selecting the cell sample from the subject for cells that are CD73 positive, CD90 negative, and Lineage marker negative prior to the culturing step.

14. The method of any of claims 12-13, wherein the Lineage marker comprise markers specific for one or more of: T cells, thymocytes, NK cells, neutrophils, B cells, myeloid cells, macrophages, monocytes, platelets, granulocytes, B cells, granulocytes, and dendritic cells.

15. The method of claim any of claims 12-14, wherein the Lineage markers comprise any combination of: CD2, CD3, CD16, CD31, CD45, CD64 and CD140b.

16. The method of claim any of claims 12-15, wherein the cell sample from the subject comprises mammary cells.

17. The method of any of claims 12-16, wherein the cell sample is derived from a human subject.

18. The method of any of claims 12-17, wherein the sample enriched for SCIPP comprises at least at least 50% SCIPP.

19. The method of any of claims 12-18, wherein the sample enriched for SCIPP comprises SCIPP that express increased levels of KLF4, MYC, PTGS2, or any combination thereof, as compared to embryonic stem cells (ESCs) and adult mesenchymal cells (MSCs).

20. The method of any of claims 12-19, wherein the conditions that promote the differential maintenance and growth of SCIPP is selected from: growth on placental fibroblast feeder cells and AT ALA media.

21. A method of screening for factors that affect cell differentiation, the method comprising:

combining a candidate differentiation factor with a population of cells comprising at least 1% Somatic Cells with an Innate Potential for Pluripotency (SCIPP); and

monitoring the effect of the candidate differentiation factor on the formation of differentiated cells from the SCIPP.

22. The method of claim 21, wherein the SCIPP express increased levels of KLF4, MYC, PTGS2, or any combination thereof, as compared to embryonic stem cells (ESCs) and adult mesenchymal cells (MSCs).

23. The method of claim 21 or 22, wherein the monitoring step comprises performing: a gene expression assay; an in vitro developmental assay; an in vivo developmental assay; a functional cellular assay; or any combination thereof.