The protocol proposed here describes how to generate three-dimensional clusters of contractile myofibers (myospheres) directly from hESCs. The strategy proposed has the unprecedented and extraordinary potential to produce mini muscles in suspension that can be suitable as a "disease in a dish" model for both screening assays and developmental studies. Moreover, the method to generate myospheres from hESCs is straightforward and does not require any FACS-sorting step during the differentiation, which typically has a negative impact on the yield of cells recovered. Besides, a sorting procedure during the differentiation would interfere with the aggregation since it implies a dissociation of the EB into single cells.
The method proposed is based on the epigenetic reprograming of hESCs with specific factors, MyoD and BaAF60C, which are not expressed in pluripotent embryonic stem cells. MyoD and BAF60C provide the "core" protein complex that marks the genomic loci from which transcription proceeds to activate the skeletal myogenic program. The two factors are delivered to the cells by means of lentiviral infections and it is therefore critical to obtain a high efficiency of infection of both factors in all cells. This can be achieved by using high titer viruses or viruses endowed with selection markers. Culture conditions also play an important role in optimizing the extent of the myogenic differentiation. We propose a serum-based differentiation protocol for the differentiation of MyoD/BAF60C expressing hESCs into clusters of myogenic precursors, followed by incubation in serum-free defined medium (containing insulin transferrin - ITS) to achieve conversion of myogenic precursors into skeletal myotubes. However, it is possible that other defined media can achieve an equal or better myogenic differentiation. One current limitation of the protocol is that it relies on the use of fetal bovine serum, which, besides containing many animal proteins and substances, shows lot-to-lot variations. This may result in lower efficiency or heterogeneity of myogenic conversion within myospheres. Of note, not all the EB-like structures derived from BAF60/MyoD-expressing hESCs are myospheres; namely, some are EB-like aggregates fully composed of myofibers. The number of myospheres normally derived from hESCs expressing BAF60C and MyoD can vary from 30 to 60% as estimated by immunostaining on EB sections performed at the end of the protocol (see Results). A potential approach to enrich a culture dish for only myospheres would be to use a myogenic reporter. This would facilitate discarding the partially or not differentiated EB-like clusters and selecting only the myospheres.
Lastly, a better understanding of the mechanisms underlying the temporal requirements of the factors introduced would be useful to improve the method of delivery. For example, if BAF60C and MyoD are required only for short time to "kick" the cells in the right direction, methods based on modified mRNA delivery might be applied. By contrast, if the factors are required for a longer time before the cells exploit their endogenous proteins, an episomal approach would be recommended to eliminate variability and uncontrolled effects due to integration in the genome. Finally, we note that it is mandatory to express BAF60C prior to or at the same time as MyoD (never after) in order to achieve hESC conversion into skeletal muscles. The requirement for prior expression of BAF60C presumably relies on its role in pre-setting the epigenetic landscape for proper MyoD chromatin distribution through the genome6,15. As such, future protocols might be improved by compounds or other manipulations that promote BAF60C expression in hESCs.