Direct conversion of human fibroblasts to pancreatic epithelial cells through transient progenitor states is controlled by temporal activation of defined factors

Cell fate can be reprogrammed by ectopic expression of lineage-specific transcription factors (TF). For example, few specialized cell types like neurons, hepatocytes and cardiomyocytes have been generated from fibroblasts by defined factors (Wang et al, 2021). However, the exact cell state transitions and their control mechanisms during cell fate conversion are still poorly understood. Moreover, the defined TFs for generating vast majority of the human cell types are still elusive. Here, we report a novel protocol for reprogramming human fibroblasts to pancreatic exocrine cells with phenotypic and functional characteristics of ductal epithelial cells using a minimal set of six TFs. We mapped the molecular determinants of lineage dynamics at single-cell resolution using a novel factor-indexing method based on single-nuclei multiome sequencing (FI-snMultiome-seq) that enables dissecting the role of each individual TF and pool of TFs in cell fate conversion. We show that transdifferentiation - although being considered a direct cell fate conversion method - occurs through transient progenitor states orchestrated by stepwise activation of distinct TFs. Specifically, transition from mesenchymal fibroblast identity to epithelial pancreatic exocrine fate involves two deterministic steps: first, an endodermal progenitor state defined by activation of HHEX concurrently with FOXA2 and SOX17, and second, temporal GATA4 activation essential for maintenance of pancreatic cell fate program. Collectively, our data provide a high-resolution temporal map of the epigenome and transcriptome remodeling events that facilitate cell fate conversion, suggesting that direct transdifferentiation process occurs through transient dedifferentiation to progenitor cell states controlled by defined TFs.