Stem Cell Stories that Caught Your Eye: The Most Popular Stem Cellar Stories of 2014

2014 marked an extraordinary year for regenerative medicine and for CIRM. We welcomed a new president, several of our research programs have moved into clinical trials—and our goal of accelerating treatments for patients in need is within our grasp.

As we look back we’d like to revisit The Stem Cellar’s ten most popular stories of 2014. We hope you enjoyed reading them as much as we did reporting them. And from all of us here at the Stem Cell Agency we wish you a Happy Holidays and New Year.

10. UCSD Team Launches CIRM-Funded Trial to Test Safety of New Leukemia Drug

9. Creating a Genetic Model for Autism, with a Little Help from the Tooth Fairy

8. A Tumor’s Trojan Horse: CIRM Researchers Build Nanoparticles to Infiltrate Hard-to-Reach Tumors

7. CIRM funded therapy for type 1 diabetes gets FDA approval for clinical trial

6. New Videos: Living with Crohn’s Disease and Working Towards a Stem Cell Therapy

5. Creativity Program Students Reach New Heights with Stem Cell-Themed Rendition of “Let it Go”

4. Scientists Reach Yet Another Milestone towards Treating Type 1 Diabetes

3. Meet the Stem Cell Agency President C. Randal Mills

2. Truth or Consequences: how to spot a liar and what to do once you catch them

1. UCLA team cures infants of often-fatal “bubble baby” disease by inserting gene in their stem cells; sickle cell disease is next target

Stem cell stories that caught our eye: two new approaches to treating diabetes and a video on why this work excites

Here are some stem cell stories that caught our eye this past week. Some are groundbreaking science, others are of personal interest to us, and still others are just fun.

Insulin producing cells avoid immune rejection. The phrase, there is more than one way to skin a cat often applies to the science of trying to develop therapies. A CIRM-funded team at the company Viacyte is working to cure diabetes and has developed a cell line that is a middleman, or precursor cell, part way between a stem cell and a fully mature insulin-producing cell. When transplanted into animal patients it has been shown to mature into the needed cells and correct the faulty sugar levels caused by the disease.

But, the company could not just transplant those cells into patients whose own insulin-producing cells had been destroyed by their immune system without protecting them from that immune attack. In a human trial we are funding that began in September the Viacyte team protects the cells inside a small porous pouch placed under the skin.

Insulin-producing cells shown in green surviving after transplant because of the new procedure.

Insulin-producing cells shown in green surviving after transplant because of the new procedure.

Now they have reported in Cell Stem Cell work done with researchers at the University of California, San Francisco that shows that a drug-like pretreatment can alter the animal’s immune response and let the new cells survive without the protective pouch. Those cells, called PEC-01, were protected by agents that blocked a very specific part of the immune system that causes immune rejection—a much gentler treatment than the immune suppression used for organ transplants.

The San Diego Union Tribune did a nice job of putting the two approaches into perspective, and Reuters picked up the company’s press release that quotes the senior UCSF researcher Jeffrey Bluestone:

“The demonstration that these new immunotherapies block specific pathways and immune cells that are responsible for attacking pancreatic islet cells and prevent the rejection of implanted PEC-01 cells is an exciting finding that could lead to advances in the way we treat diabetes and other diseases.”

Stem cell work a runner up for discovery of the year. Each year the journal Science names a discovery of the year and nine runners up. This year the Mars rover took top honors but a Harvard team scored a runner up slot for its work creating mature insulin producing cells from stem cells in the lab. Many labs had failed to accomplish this feat over the past several years.

I agree this is a big deal, but many researchers in the field believe that the best place to mature stem cells into the desired tissue is in the patient where they can take cues from the body that are much more complex than what we can recreate in the lab. The Viacyte team cited above uses the in-the-body approach and is already testing the therapy in patients.

Toward the end of the original Harvard press release and at the end of the notice in Science, the authors note that before the work can be used in patients they need to overcome the patient’s immune reaction—something the most recent Viacyte discovery might be able to help achieve.

Clue found for how stem cells make decisions.
Many a researcher has used the Bizarro cartoon labeled “Stem Cell Parental Advice” with the thought balloon “You are a stem cell you can become anything you want when you grow up.” Researchers have found that ability to be a double-edged sword. Since stem cells can become anything it is often hard to direct them efficiently down a particular desired path.

Now a Danish team from the University of Copenhagen has documented in Cell Reports a way to block all the various maturation paths and keep the stem cells in a stem cell state. This could be a first step to being able to consistently direct them down one preferred path. Science Codex picked up the university’s press release, which quoted a member of the research team, Joshua Brickman on why this could be valuable:

“If you block all the choices they can make, they stay in the stem cell state. If you only allow them one door to exit from the stem cell state, you should be able to make particular cell types more efficiently. So if you only leave one door open then it’s the path of least resistance and when you give them a push they really go.”

Video captures the excitement of stem cell researchers. Stanford’s research blog Scope produced a fun end-of-the-year piece that includes a video of researcher Margaret Fuller describing why she is so excited to work in this field. One example she cites came from a recent report about using stem cells to help repair lost muscle in wounded soldiers returning from Afghanistan. I’ll let you watch the video to see why she said “It gives me chills just thinking about it.”

10 Years/10 Therapies: 10 Years after its Founding CIRM will have 10 Therapies Approved for Clinical Trials

In 2004, when 59 percent of California voters approved the creation of CIRM, our state embarked on an unprecedented experiment: providing concentrated funding to a new, promising area of research. The goal: accelerate the process of getting therapies to patients, especially those with unmet medical needs.

Having 10 potential treatments expected to be approved for clinical trials by the end of this year is no small feat. Indeed, it is viewed by many in the industry as a clear acceleration of the normal pace of discovery. Here are our first 10 treatments to be approved for testing in patients.

HIV/AIDS. The company Calimmune is genetically modifying patients’ own blood-forming stem cells so that they can produce immune cells—the ones normally destroyed by the virus—that cannot be infected by the virus. It is hoped this will allow the patients to clear their systems of the virus, effectively curing the disease.

Spinal cord injury patient advocate Katie Sharify is optimistic about the latest clinical trial led by Asterias Biotherapeutics.

Spinal cord injury patient advocate Katie Sharify is optimistic about the clinical trial led by Asterias Biotherapeutics.

Spinal Cord Injury. The company Asterias Biotherapeutics uses cells derived from embryonic stem cells to heal the spinal cord at the site of injury. They mature the stem cells into cells called oligodendrocyte precursor cells that are injected at the site of injury where it is hoped they can repair the insulating layer, called myelin, that normally protects the nerves in the spinal cord.

Heart Disease. The company Capricor is using donor cells derived from heart stem cells to treat patients developing heart failure after a heart attack. In early studies the cells appear to reduce scar tissue, promote blood vessel growth and improve heart function.

Solid Tumors. A team at the University of California, Los Angeles, has developed a drug that seeks out and destroys cancer stem cells, which are considered by many to be the reason cancers resist treatment and recur. It is believed that eliminating the cancer stem cells may lead to long-term cures.

Leukemia. A team at the University of California, San Diego, is using a protein called an antibody to target cancer stem cells. The antibody senses and attaches to a protein on the surface of cancer stem cells. That disables the protein, which slows the growth of the leukemia and makes it more vulnerable to other anti-cancer drugs.

Sickle Cell Anemia. A team at the University of California, Los Angeles, is genetically modifying a patient’s own blood stem cells so they will produce a correct version of hemoglobin, the oxygen carrying protein that is mutated in these patients, which causes an abnormal sickle-like shape to the red blood cells. These misshapen cells lead to dangerous blood clots and debilitating pain The genetically modified stem cells will be given back to the patient to create a new sickle cell-free blood supply.

Solid Tumors. A team at Stanford University is using a molecule known as an antibody to target cancer stem cells. This antibody can recognize a protein the cancer stem cells carry on their cell surface. The cancer cells use that protein to evade the component of our immune system that routinely destroys tumors. By disabling this protein the team hopes to empower the body’s own immune system to attack and destroy the cancer stem cells.

Diabetes. The company Viacyte is growing cells in a permeable pouch that when implanted under the skin can sense blood sugar and produce the levels of insulin needed to eliminate the symptoms of diabetes. They start with embryonic stem cells, mature them part way to becoming pancreas tissues and insert them into the permeable pouch. When transplanted in the patient, the cells fully develop into the cells needed for proper metabolism of sugar and restore it to a healthy level.

HIV/AIDS. A team at The City of Hope is genetically modifying patients’ own blood-forming stem cells so that they can produce immune cells—the ones normally destroyed by the virus—that cannot be infected by the virus. It is hoped this will allow the patients to clear their systems of the virus, effectively curing the disease

Blindness. A team at the University of Southern California is using cells derived from embryonic stem cell and a scaffold to replace cells damaged in Age-related Macular Degeneration (AMD), the leading cause of blindness in the elderly. The therapy starts with embryonic stem cells that have been matured into a type of cell lost in AMD and places them on a single layer synthetic scaffold. This sheet of cells is inserted surgically into the back of the eye to replace the damaged cells that are needed to maintain healthy photoreceptors in the retina.

What everybody needs to know about CIRM: where has the money gone

It’s been almost ten years since the voters of California created the Stem Cell Agency when they overwhelmingly approved Proposition 71, providing us $3 billion to help fund stem cell research.

In the last ten years we have made great progress – we will have ten projects that we are funding in or approved to begin clinical trials by the end of this year, a really quite remarkable achievement – but clearly we still have a long way to go. However, it’s appropriate as we approach our tenth anniversary to take a look at how we have spent the money, and how much we have left.

Of the $3 billion Prop 71 generates around $2.75 billion was set aside to be awarded to research, build laboratories etc. The rest was earmarked for things such as staff and administration to help oversee the funding and awards.

Of the research pool here’s how the numbers break down so far:

  • $1.9B awarded
  • $1.4B spent
  • $873M not awarded

So what’s the difference between awarded and spent? Well, unlike some funding agencies when we make an award we don’t hand the researcher all the cash at once and say “let us know what you find.” Instead we set a series of targets or milestones that they have to reach and they only get the next installment of the award as they meet each milestone. The idea is to fund research that is on track to meet its goals. If it stops meetings its goals, we stop funding it.

Right now our Board has awarded $1.9B to different institutions, companies and researchers but only $1.4B of that has gone out. And of the remainder we estimate that we will get around $100M back either from cost savings as the projects progress or from programs that are cancelled because they failed to meet their goals.

So we have approximately $1B for our Board to award to new research, which means at our current rate of spending we’ll have enough money to be able to continue funding new projects until around 2020. Because these are multi-year projects we will continue funding them till around 2023 when those projects end and, theoretically at least, we run out of money.

But we are already working hard to try and ensure that the well doesn’t run dry, and that we are able to develop other sources of funding so we can continue to support this work. Without us many of these projects are at risk of dying. Having worked so hard to get these projects to the point where they are ready to move out of the laboratory and into clinical trials in people we don’t want to see them fall by the wayside for lack of support.

Of the $1.9B we have awarded, that has gone to 668 awards spread out over five different categories:

CIRM spending Oct 2014

Increasingly our focus is on moving projects out of the lab and into people, and in those categories – called ‘translational’ and ‘clinical’ – we have awarded almost $630M in funding for more than 80 active programs.

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Under our new CIRM 2.0 plan we hope to speed up the number of projects moving into clinical trials. You can read more about how we plan on doing there in this blog.

It took Jonas Salk almost 15 years to develop a vaccine for polio but those years of hard work ended up saving millions of lives. We are working hard to try and achieve similar results on dozens of different fronts, with dozens of different diseases. That’s why, in the words of our President & CEO Randy Mills, we come to work every day as if lives depend on us, because lives depend on us.

Moving one step closer to a therapy for type 1 diabetes

When I was a medical journalist one word I always shied away from was “breakthrough”. There are few true breakthroughs in medicine. Usually any advance is the result of years and years of work. That’s why good science takes time; it takes hundreds of small steps to make a giant leap forward.

Today we took one of those steps. ViaCyte, a company we have supported for many years, just announced that the first patient has been successfully implanted with a device designed to help treat type 1 diabetes.

It’s an important milestone for the company, for us, and of course for people with type 1 diabetes. As Dr. Paul Laikind, the President and CEO of ViaCyte, said in a news release, this is an exciting moment:

“To our knowledge, this is the first time that an embryonic stem cell-derived cell replacement therapy for diabetes has been studied in human subjects, and it represents the culmination of a decade of effort by the ViaCyte team, our collaborators, and our supporters at the California Institute for Regenerative Medicine and at JDRF.”

The VC-01 device is being tested in a clinical trial at the University of California, San Diego Health System. There are two goals; first to see if it is safe; and secondly to see if it helps patients who have type 1 diabetes. When the device is implanted under the skin the cells inside are able to sense when blood sugar is high and, in response, secrete insulin to restore it to a healthy level.

The beauty of the VC-01 is that while it lets cells secrete insulin out, it prevents the body’s own immune system from getting in and attacking the cells.

The device is about the length and thickness of a credit card but only half as wide which makes it easy to implant under the skin.

Today’s news, that this is now truly out of the lab and being tested in patients is an important step in a long road to showing that it works in patients. The people at ViaCyte, who have been working hard on this project for many years, know that they still have a long way to go but for today at least, this step probably feels a little bit more like a skip for joy.

Scientists Reach Yet Another Milestone towards Treating Type 1 Diabetes

There was a time when having type 1 diabetes was equivalent to a death sentence. Now, thanks to advances in science and medicine, the disease has shifted from deadly to chronic.

But this shift, doctors argue, is not good enough. The disease still poses significant health risks, such as blindness and loss of limbs, as the patients get older. There has been a renewed effort, therefore, to develop superior therapies—and those based on stem cell technology have shown significant promise.

Human stem cell-derived beta cells that have formed islet like clusters in a mouse. Cells were transplanted to the kidney capsule and photo was taken two weeks later by which time the beta cells are making insulin and have cured the mouse's diabetes. [Credit: Douglas Melton]

Human stem cell-derived beta cells that have formed islet like clusters in a mouse. Cells were transplanted to the kidney capsule and photo was taken two weeks later by which time the beta cells are making insulin and have cured the mouse’s diabetes. [Credit: Douglas Melton]

Indeed, CIRM-funded scientists at San Diego-based Viacyte, Inc. recently received FDA clearance to begin clinical trials of their VC-01 product candidate that delivers insulin via healthy beta cells contained in a permeable, credit card-sized pouch.

And now, scientists at Harvard University have announced a technique for producing mass quantities of mature beta cells from embryonic stem cells in the lab. The findings, published today in the journal Cell, offer additional hope for the millions of patients and their families looking for a better way to treat their condition.

The team’s ability to generate billions of healthy beta cells—cells within the pancreas that produce insulin in order to maintain normal glucose levels—has a particular significance to the study’s senior author and co-scientific director of the Harvard Stem Cell Institute, Dr. Doug Melton. 23 years ago, his infant son Sam was diagnosed with type 1 diabetes and since that time Melton has dedicated his career to finding better therapies for his son and the millions like him. Melton’s daughter, Emma, has also been diagnosed with the disease.

Type 1 diabetes is an autoimmune disorder in which the body’s immune system systematically targets and destroys the pancreas’ insulin-producing beta cells.

In this study, the team took human embryonic stem cells and transformed them into healthy beta cells. They then transplanted them into mice that had been modified to mimic the signs of diabetes. After closely monitoring the mice for several weeks, they found that their diabetes was essentially ‘cured.’ Said Melton:

“You never know for sure that something like this is going to work until you’ve tested it numerous ways. We’ve given these cells three separate challenges with glucose in mice and they’ve responded appropriately; that was really exciting.”

The researchers are undergoing additional pre-clinical studies in animal models, including non-human primates, with the hopes that the 150 million cells required for transplantation are also protected from the body’s immune system, and not destroyed.

Melton’s team is collaborating with Medical Engineer Dr. Daniel G. Anderson at MIT to develop a protective implantation device for transplantation. Said Anderson of Melton’s work:

“There is no question that the ability to generate glucose-responsive, human beta cells through controlled differentiation of stem cells will accelerate the development of new therapeutics. In particular, this advance opens the doors to an essentially limitless supply of tissue for diabetic patients awaiting cell therapy.”

Stories of Hope: Diabetes

This week on The Stem Cellar we feature some of our most inspiring patients and patient advocates as they share, in their own words, their Stories of Hope.

The last thing Maria Torres expected was to be diagnosed with type 2 diabetes. She exercised, ate well and kept her weight under control. There had to be some mistake. Maria asked her doctor to repeat the tests, but the results were the same. At 43, for reasons no one could fully explain, she had diabetes, and her life was going to change dramatically.

Maria Torres' diabetes diagnoses was frightening—but she is hopeful that stem cell therapies could one day change how doctors treat this devastating condition.

Maria Torres’ diabetes diagnoses was frightening—but she is hopeful that stem cell therapies could one day change how doctors treat this devastating condition.

“It really scared me,” says Maria. “I thought I was going to die soon.”

That Maria doubted her diagnosis is no surprise. Type 2 diabetes is often associated with obesity, and she didn’t fit the profile. Most likely, some undiscovered genetic component had made her susceptible to the disease.

Regardless, she now had to rework her life to manage the diabetes. Her cells had developed a condition called insulin resistance. Though her pancreas was producing insulin, which tells cells to take in blood sugar, the cells were not cooperating. As a result, glucose was accumulating in her blood, putting her at risk for heart disease, nerve damage, eye issues and a host of other problems.

To help her cells absorb glucose, she needs regular insulin injections. Maria injects the hormone five times a day and must often measure her blood sugar levels even more frequently.

Faithfully following this regimen has kept her alive for 20 years, but insulin is not a cure. Even with the regular injections, she faces dramatic mood swings and more serious complications as glucose levels rise and fall.

Working for a Cure
One of the most promising strategies to cure diabetes is to transplant beta cells, which sense blood sugar levels and produce insulin to reduce them. Patients with type 1 diabetes would benefit because new beta cells would replace the ones they’d lost to disease. Type 2 patients, like Maria, could increase their body’s ability to produce insulin, lowering blood sugar levels and alleviating the need for injections.

With almost $40 million in funding from CIRM, a San Diego-based company named ViaCyte is working on this solution. They have spent years developing new methods to turn human embryonic stem cells into insulin-producing beta cells. It hasn’t been easy. Stem cells are promising because they can form any tissue. However, to make a specific type of cell, researchers must replicate the exact signals that transform a stem cell into a beta cell, rather than a neuron or muscle cell.

In 2008, the company succeeded, but with a clever twist. They created progenitor cells, one step shy of mature beta cells, and allowed them to finish developing in the body. In animal studies, the hardier progenitor cells survived the transplant process and, once mature, began producing insulin. The project has another innovation up its sleeve: these progenitor cells are first placed in a porous capsule, about the size of a credit card, before transplantation under the skin. This device allows transfer of blood sugar, insulin, oxygen, and other molecules but keeps cells out, thus avoiding the possible attack and rejection by the patient’s own immune system.

ViaCyte’s goal is to start clinical trials for type 1 diabetes by the end of 2014. But the company eventually hopes to also help those with type 2. Maria Torres is eager for them to succeed, both for herself and her family.

“I have three kids, and I know they could have the same thing I have,” says Maria. “If they find a cure, for me, that’s peace of mind.”

For more information about CIRM-funded diabetes research, visit our Diabetes Fact Sheet. You can read more about Maria’s Story of Hope on our website.

World’s largest pharmaceutical company signs deal with ViaCyte supporting stem cell therapy for type 1 diabetes

It’s been a good week for ViaCyte, a good week for us here at the stem cell agency and potentially a great week for people with type 1 diabetes.

Earlier this week ViaCyte announced they have been given approval to start a clinical trial for their new approach to treating type 1 diabetes. Then today they announced that they have signed an agreement with Janssen Research & Development LLC and its affiliated investment fund, Johnson & Johnson Development Corporation (JJDC).

ViaCyte's President & CEO, Paul Laikind

ViaCyte’s President & CEO, Paul Laikind

Under this new agreement Janssen and JJDC will provide ViaCyte with $20 million with a future right to consider a longer-term transaction related to the product candidate that ViaCyte is developing for type 1 diabetes.

The agreement is a big deal because Janssen is a division of Johnson & Johnson, which just happens to be the largest pharmaceutical company in the world (they were also ranked the world’s most respected company by Barron’s Magazine in 2008, not a bad reputation to have). Companies like this have traditionally been shy about jumping into the stem cell arena, as they wanted to be sure that they had a good chance to see a return on any investment they made. Not surprising really. You don’t get to be as successful as they are by throwing your money away.

The fact that they have decided that ViaCyte is a good investment reflects on the quality of the company, the years of hard work the people at ViaCyte have put in developing their therapy, and the impressive pre-clinical evidence that it works. It also reflects the fact that we helped fund the project, investing almost $40 million in the program, and get it to this point

In a news release we issued about the announcement our President and CEO, C. Randal Mills, said:

“This is excellent news as it demonstrates that pharmaceutical companies are recognizing stem cell therapies hold tremendous promise and need to be part of their development portfolio,” says C. Randal Mills, Ph.D., President and CEO of the stem cell agency. “This kind of serious financial commitment from industry is vital in helping get promising therapies like this through all the phases of clinical trials and, most importantly, to the patients in need.”

What’s nice is that this is not just a one-off deal. This is the third time this year that a large company has stepped in to make a deal with a company that we are funding.

In January Capricor Therapeutics signed a deal with Janssen Biotech that could ultimately be worth almost $340 million for its work using stem cells to treat people who have had a heart attack. The same month Sangamo, who we are funding to develop a treatment for beta-thalassemia, signed a potential $320 million agreement with Biogen Idec.

As Randy Mills said:

“Our goal at CIRM is to do everything we can to accelerate the development of successful therapies for people in need,” says Mills. “These kinds of agreements and investments help us do that, not only by adding an extra layer of funding for development, but also by validating the scientific and commercial potential of regenerative medicine.”

It’s great news for ViaCyte. It’s confirmation for us that we have been investing our money well in a promising therapy. But most of all it’s encouraging for anyone with type 1 diabetes, giving them a sense of hope that a new treatment could be on the horizon.

Stem Cell Agency Funded Treatment for Type 1 Diabetes Takes a Big Step towards Clinical Trials

Even the best ideas can fail without a lot of support. One of the things we pride ourselves on at the Stem Cell Agency is nurturing really promising ideas for new therapies through sustained funding, giving them the support they need to turn that promise into reality. So it’s very gratifying today to hear that one project we have supported for many years, ViaCyte’s VC-01™ implantable device for treating type 1 diabetes, just took a big step towards being tested in patients.

ViaCyte has submitted what’s called an Investigational New Drug application (“IND”) with the Food and Drug Administration (FDA) asking permission to start a phase 1/2 clinical trial in patients. If the FDA says yes then ViaCyte hopes to start testing their device in patients before the end of the year.

We have invested almost $40 million in nurturing the project through the early, most basic research to see if this approach could be made to work, and then through more rigorous advanced research and testing in animals to make sure it’s safe and that it is effective.

As our Chairman, Jonathan Thomas, says in a press release we sent out announcing the news:

“We have been strong supporters of Viacyte for many years and it’s great to see that they are well on the way to starting a First-in-Human trial, hopefully in the next few months. This therapy’s growth from an idea to a potential treatment highlights CIRM’s commitment to following promising science at all stages of development.”

The device is really quite ingenious. It is a thin plastic pouch that contains an immature form of pancreatic cells. When the device is implanted under the skin these cells become the different kinds of cells needed to regulate blood glucose levels. They are able to sense when blood glucose is high, and then secrete insulin to restore it to a healthy level. The truly impressive part is that the device has holes large enough to allow insulin to be pushed out, but too small to allow the body’s own immune system to get in and attack the device.

The goal of the first phase of this clinical trial, as with all phase 1 trials, is simply to show that the VC-01™ is safe. The second phase will also look at safety but also test it to see if it is helping patients, reducing their dependence on injected insulin. If the results from both those phases are encouraging, the next step is to test it in much larger numbers of patients to see just how effective it is.

But this first step, submitting an application to the FDA, is the starting point for all that. As our President and CEO C. Randal Mills said in our news release, getting to the starting line is often half the battle:

“This is good news for ViaCyte and is an encouraging sign of the progress they are making. Filing for an IND is a crucial step along the path to making a therapy available to patients and we’ll be working with them and supporting them every step of the way to try and make this happen as quickly, and as safely, as possible.”

You can read more about ViaCyte and our support for them on our website.