IntroductionRed blood cells (RBCs) are part of nonimmune blood-lineage cells derived from hematopoietic stem cells. Anemia continues to exert tremendous burdens to human health. [1][2][3][4] Thus, a considerable effort has been made to develop new therapies for the treatment of anemia. Although the focus in the treatment of anemia has been on growth factors (eg, erythropoietin [EPO]), derivation of hematopoietic cells from human embryonic stem cells and induced pluripotent stem cells are considered a worthwhile endeavor in the areas of transfusion therapies. 5 It has been reported that enucleated RBCs can be differentiated from human embryonic stem cells with functional oxygen-carrying ability on large scale. 6 However, these studies have been limited to in vitro assays because of the lack of a suitable animal model. Immunodeficient mice provide a very useful in vivo model for the study of human lymphohematopoietic cell function. Human hematopoietic stem cell engraftment and differentiation can now be reproducibly established in NOD/SCID mice or their derivatives. 7 However, it remains unclear whether immunodeficient mice are suitable for the study of human RBC differentiation and function. Although a previous report showed detectable human RBCs in NOD/SCID/IL2r null (NSG) mice receiving human cord blood CD34 ϩ cell transplantation via the facial vein at the newborn stage, 8 the ability of immunodeficient mice to support human erythropoiesis and/or survival of human RBCs has not been confirmed by other studies. 9 Recently, hydrodynamic injection of pcDNA-encoding EPO and IL-3 was found to improve human RBC reconstitution in NSG mice receiving CD34 ϩ cells, but the levels of human RBCs in these mice were extremely low compared with the levels of human PBMCs. 10 We have previously developed a humanized mouse model, in which cotransplantation of human fetal thymic tissue (under renal capsule) and CD34 ϩ fetal liver cells (FLCs; intravenously) resulted in sustained repopulation with multilineages of human lymphohematopoietic cells, including T, B, and dendritic cells, and the formation of secondary lymphoid organs in NOD/SCID mice. [11][12][13] In this study, we assessed human RBC reconstitution in these humanized mice. We observed that human RBCs were undetectable in blood circulation, despite that large numbers of human normoblasts were detected in the bone marrow. Furthermore, the lack of human RBCs in blood circulation was largely accounted for by the extremely high susceptibility of human RBCs to rejection by recipient mouse macrophages.
Methods
Animals and human tissues and cellsNOD.CB17-Prkdc scid /J (NOD/SCID), NOD.Cg-Prkdc scid Il2rg tm1Wjl /SzJ (NOD/SCID/␥c Ϫ/Ϫ or NSG), and B6.129-Itgp tm1Fpl (CD47 KO B6) mice were purchased from The Jackson Laboratory and were housed in a specific pathogen-free microisolator environment and used in experiments at 6 to 10 weeks of age. GFP-transgenic CD47 KO mice were generated by Submitted November 24, 2010; accepted September 5, 2011. Prepublished online as Blood First E...