Month: August 2016

Clearing the first hurdle: spinal cord injury trial passes safety review

/ Kevin McCormack / 9 Comments
Jake 2

Jake Javier, participant in Asterias clinica trial

Starting a clinical trial is like taking a step into the unknown. It’s moving a potential therapy out of the lab and testing it in people. To reach this point the researchers have done a lot of work trying to ensure the therapy is safe. But that work was done in the lab, and on mice or other animals. Now it’s time to see what happens when you try it in the real world.

It can be quite nerve wracking for everyone involved: both the researchers, because years of hard work are at stake, and the patients, because they’re getting something that has never been tested in humans before; something that could, potentially, change their lives.

Today we got some good news about one clinical trial we are funding, the Asterias Biotherapeutics spinal cord injury trial. Asterias announced that its Data Monitoring Committee (DMC) has reviewed the safety data from the first two groups of patients treated and found no problems or bad side effects.

That’s an important first step in any clinical trial because it shows that, at the very least, the therapy is not going to make the patient’s condition any worse.

The big question now, is will it make their condition better? That’s something we’ll come back to at a later date when we have a better idea how the people treated in the trial are doing. But for now let’s take a deeper dive into the safety data.

Asterias – by the numbers

This current trial is a Phase 1/2a trial. The people enrolled have all experienced injuries in the C5-C7 vertebrae – that’s high up in the neck – and have essentially lost all feeling and movement below the injury site. All are treated between two weeks and one month after the injury was sustained.

The therapy involves transplants of Asterias’ AST-OPC1 cells which were made from human embryonic stem cells. The AST-OPC1 cells have been turned into oligodendrocyte progenitors, which are capable of becoming the kind of cells which help protect nerve cells in the central nervous system, the area damaged in spinal cord injury.

The first group of three patients in the Asterias trial was given 2 million cells. The second group of five patients received 10 million cells. The DMC said the safety data from those patients looked fine, that there were no signs of problems.

As Dr. Edward Wirth, the Chief Medical Officer at Asterias, said in a news release, this means the company can plan for its next phase:

“The positive safety data in the previous phase 1 study and in the ongoing phase 1/2a study gives us the confidence to now proceed to administration of 20 million cells, which based on our significant pre-clinical research is likely well within the dosing range where we would expect to see clinically meaningful improvement in these patients.”

Asterias is now looking to enroll 5-8 patients for this 20 million cell phase.

jake and family

For people like Jake Javier this news is not about numbers or data, it’s personal. Earlier this summer Jake broke his neck at a pool party, celebrating graduating from high school. It left him paralyzed from the chest down with extremely limited use of his arms and hands. On July 7th Jake was enrolled in the Asterias trial, and had ten million cells transplanted into his neck.

It could be months, even as much as one year, before we know if those cells are having any beneficial effect on Jake. But at least for now we know they don’t seem to be having any negative effects.

“First do no harm” is the cardinal rule that all budding physicians are taught. This trial seems to be meeting that benchmark. Our hope now is that it will do a lot more, and truly make a difference in the lives of people like Jake.

As Randy Mills, CIRM’s President and CEO, said in a news release:

“I recently met with Jake and heard first-hand what he and his family are going through in the aftermath of his injury. But I also saw a young man with remarkable courage and determination. It is because of Jake, and the others who volunteer to take part in clinical trials, that progress is possible. They are true heroes.”

* On a side note, Roman Reed, a great champion of stem cell research and a patient advocate extraordinaire, helped make much of this story happen. He helped Jake enroll in the Asterias trial ,and the research that led to this therapy was pioneered by Dr. Hans Keirstead who was funded by the Roman Reed Spinal Cord Injury Research Act.

 

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Beige isn’t bland when it comes to solving the obesity epidemic

/ Todd Dubnicoff / Leave a comment

Americans spend over $60 billion a year to lose weight and yet two-thirds (that’s more than 200 million) are considered overweight or obese. Losing weight should be easy: just eat less and exercise more, right? But our body’s metabolism is a very complex thing and appears to fight against our best efforts to shed pounds. A recent analysis of clinical trial data and mathematical modeling suggests that over the long haul, none of the various diet strategies lead to meaningful weight loss. Even the contribution of exercise to weight loss has been called into question.

energy-balance

Lose weight by simply eating less calories than you burn. Easier said than done! (Image credit)

All is not lost. In fact, the fat we carry in our bodies may hold the key to overcoming our obesity woes. A recent CIRM-funded UC Francisco study published in Cell Metabolism finds that harnessing a calorie burning form of fat cells may help guard against the development of obesity.

The Many Hues of Fat
Humans, like other mammals, have two very different types of fat tissue. The more abundant white fat acts to store fat and provides a form of energy to help our body function. An excess of white fat tissue is associated with metabolic diseases including diabetes and obesity. Brown fat tissue, on the other hand, generates heat and is associated with slimness. It was thought that only babies have brown fat which protects them against cold temperatures – they lack the muscle strength for the shivering response – but research in 2009 identified this fat tissue in adults as well.

The UCSF team, led by professor Shingo Kajimura, showed last year that adults actually have so-called beige fat cells that are able to switch from white to brown fat in the presence of colder temperatures and vice versa. This discovery presents the tantalizing potential of promoting weight loss in people by pushing white fat cells toward energy burning brown fat. In that earlier work, the team identified a protein that when inhibited with drugs caused the white fat cells to burn energy like the beige and brown fat. But this effect was short lived and these cells reverted back to the typical features of white fat cells. Kajimura reflected on these previous studies in a university press release:

“Our focus has been on learning to convert white fat into beige fat. Now we’re realizing we also have to think about how to keep it there for longer time.”

In the new study, the team focused on the fact that as beige cells revert back to white cells, their mitochondria – a cell’s energy producing factories – begin to disappear. First author Svetlana Altshuler-Keylin wanted to understand why:

“We knew that the color of brown and beige fat comes from the amount of pigmented mitochondria they contain, so we wondered whether something was going on with the mitochondria when beige fat turns white.”

Stopping cells from eating up too much mitochondria
Examining gene activity as cells went from beige to white implicated a process called autophagy was at play. This house cleaning function of a cell involves the breakdown of its own internal structures that are not functioning properly or aren’t needed. So perhaps stopping the autophagy process from occurring would prevent the energy burning beige cells from eating up their own mitochondria and reverting them back to the energy hoarding white cells.

To test this idea, the team relied on mice lacking genes that play important roles in autophagy. They beefed up their beige fat by subjecting the mice to cold temperatures. But when returned to a normal environment, the mice kept their beige fat and it didn’t convert back to white cells. This change impacted the mice overall health: when place on a fatty diet for two months these mice with the defective autophagy gained less weight. These mice were also able to better regulate blood sugar levels, an indication they there were protected from type 2 diabetes symptoms.

While these results represent very early stage research, Kajimura and his team now have a solid path to travel toward trying to help obese individual burn more calories, especially as they age:

“With age you tend to naturally lose your beige fat, which we think is one of the main drivers of age-related obesity. Your calorie intake stays the same, but you’re not burning as much. Maybe by understanding this process we can help people keep more beige fat, and therefore stay healthier.”

Seeing is believing: how some scientists – including two funded by CIRM – are working to help the blind see

/ Kevin McCormack / Leave a comment
retinitis pigmentosas_1

How retinitis pigmentosa destroys vision – new stem cell research may help reverse that

“A pale hue”. For most of us that is a simple description, an observation about color. For Kristin Macdonald it’s a glimpse of the future. In some ways it’s a miracle. Kristin lost her sight to retinitis pigmentosa (RP). For many years she was virtually blind. But now, thanks to a clinical trial funded by CIRM she is starting to see again.

Kristin’s story is one of several examples of restoring sight in an article entitled “Why There’s New Hope About Ending Blindness” in the latest issue of National Geographic.  The article explores different approaches to treating people who were either born without vision or lost their vision due to disease or injury.

Two of those stories feature research that CIRM has funded. One is the work that is helping Kristin. Retinitis pigmentosa is a relatively rare condition that destroys the photoreceptors at the back of the eye, the cells that actually allow us to sense light. The National Geographic piece highlights how a research team at the University of California, Irvine, led by Dr. Henry Klassen, has been working on a way to use stem cells to replace and repair the cells damaged by RP.

“Klassen has spent 30 years studying how to coax progenitor cells—former stem cells that have begun to move toward being specific cell types—into replacing or rehabilitating failed retinal cells. Having successfully used retinal progenitor cells to improve vision in mice, rats, cats, dogs, and pigs, he’s testing a similar treatment in people with advanced retinitis pigmentosa.”

We recently blogged about this work and the fact that this team just passed it’s first major milestone – – showing that in the first nine patients treated none experienced any serious side effects. A Phase 1 clinical trial like this is designed to test for safety, so it usually involves the use of relatively small numbers of cells. The fact that some of those treated, like Kristin, are showing signs of improvement in their vision is quite encouraging. We will be following this work very closely and reporting new results as soon as they are available.

The other CIRM-supported research featured in the article is led by what the writer calls “an eyeball dream team” featuring University of Southern California’s Dr. Mark Humayun, described as “a courteous, efficient, impeccably besuited man.” And it’s true, he is.

The team is developing a stem cell device to help treat age-related macular degeneration, the leading cause of vision loss in the US.

“He and his fellow principal investigator, University of California, Santa Barbara stem cell biologist Dennis Clegg, call it simply a patch. That patch’s chassis, made of the same stuff used to coat wiring for pacemakers and neural implants, is wafer thin, bottle shaped, and the size of a fat grain of rice. Onto this speck Clegg distributes 120,000 cells derived from embryonic stem cells.”

Humayun and Clegg have just started their clinical trial with this work so it is likely going to be some time before we have any results.

These are just two of the many different approaches, using several different methods, to address vision loss. The article is a fascinating read, giving you a sense of how science is transforming people’s lives. It’s also wonderfully written by David Dobbs, including observations like this:

“Neuroscientists love the eye because “it’s the only place you see the brain without drilling a hole,” as one put it to me.”

For a vision of the future, a future that could mean restoring vision to those who have lost it, it’s a terrific read.

 

Stem cell stories that caught our eye: Salamander limb regrowth, mass producing cells for kidneys and halting cancer stem cells

/ Don Gibbons / Leave a comment

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.

Fun with axolotls.  Axolotls, the albino aquatic critters that look like they have feathers growing out of the backs of their heads, have long been a favorite model for studying how they and their salamander cousins regrow limbs. But only recently, with refined methods for turning specific genes on and off, have we begun to really understand this amazing feat.

b115a-axolotl

Carl Zimmer, national correspondent for the online publication STAT, interviewed Jessica Whited of Harvard-affiliated Brigham and Women’s Hospital about her work trying to understand the genetics of limb regrowth and posted both a four-minute video and a short story about the research. Part of the video series Zimmer calls “Science Happens,” the interview lets Whited explain that when a limb is cut off, the animal summons cells called blastemas to the stump. Those cells have properties like stem cells in that they can make different tissues like the bone, skin and muscle needed to grow a limb, but they seem to do this by selectively turning genes on and off.

With a mix of cartoon drawings and real lab images, the video provides an easy to follow explanation of how the researchers turn off individual genes and then look for the effect. And I have to say I agree with Zimmer when talking about the axolotls he declares “I think they’re creepy.”

 

Advance for kidney disease.  Often in stem cell research you don’t want the starting stem cell and you don’t want the end desired tissue, you want the middleman called a progenitor that has already decided it wants to become the end tissue, but can still mass produce itself. Instead of being handed a roll of 10 dollar bills, you have a printing press with Hamilton’s face already set on the printing plate.

kidney progenitors Salk

Progenitor cells (bright red) growing in a kidney

In CIRM-funded research published this week in Cell Stem Cell a team at the Salk Institute has found a way to configure that printing press for nephron progenitor cells, the cells that yield the vital nephrons that allow your kidneys to cleanse your blood. While many have tried to mass produce these vital cells to repair damaged kidneys, they have not had much luck. These cells do not like to stay in the progenitor state. Once they are on the path toward the end tissue they like to keep on moving in that direction.

The Salk team, led by Juan Carlos Izpisua Belmonte, got around this by changing the progenitor cells’ environment. Instead of a flat lab dish, they grew them in 3D cultures and gave them a new mix of signaling molecules.

“We provide a proof-of-principle for how to make and maintain unlimited numbers of precursor kidney cells,” said Izpisua Belmonte in an institute press release posted by HealthMedicineNet. “Having a supply of these cells could be a starting point to grow functional organs in the laboratory as well as a way to begin applying cell therapy to kidneys with malfunctioning genes.”

Their system worked first in mouse cells and then in human cells. They predicted that the methods could be used to grow progenitor cells for many other tissues.

 

Halting cancer stem cells. The bad guys of the stem cell world, cancer stem cells (CSCs), are turning out to have a number of vulnerabilities, and many companies around the world have staked their fortunes on attacking one of those weak spots. While we have known for some time that CSCs require proteins in the Wnt family to grow, we haven’t had a good way of blocking that path. Now researchers at the Riken Center and National Cancer Center in Japan claim they have a candidate drug, at least for colon cancer.

They screened a library of compounds likely to inhibit the Wnt pathway and tested them in mice that had received transplants of human colon cancer. They found one, NCB-0846 that can be administered orally, that was able to suppress the cancer grafts.

 “We’re very encouraged by our promising preclinical data for NCB-0846, especially considering the difficulty in targeting this pathway to date, and shortly we hope to conduct a clinical trial at the NCC hospitals” said Dr. Tesshi Yamada of the National Cancer Center in a Riken release posted by ScienceCodex.

CIRM funds several team trying to halt CSCs, each team targeting a different vulnerability on the CSCs, including teams at Stanford, and at University of California campuses in San Diego and Los Angeles.

How many stem cell trials will it take to get a cure?

/ Karen Ring / Leave a comment

When I think about how many clinical trials it will take before a stem cell therapy is available to patients, I’m reminded of the decades old Tootsie Pop commercial where a kid asks a series of talking animals, “How many licks does it take to get to the Tootsie Roll center of a Tootsie Pop?”

While Mr. Cow, Mr. Fox, and Mr. Turtle are all stumped, Mr. Owl tackles the question like a true scientist:

“A good question. Let’s find out. [Takes Tootsie pop and starts licking]. A One…A Two-hoo…A Three-hee. [Insert loud crunching sounds] A Three!”

The commercial ends with the narrator concluding that the world may never know how many licks it takes to get to the center (because Mr. Owl failed to complete his experiment…not a true scientist after all).

What do Tootsie Pops have to do with stem cell therapies?

I’m not saying that the Tootsie Pop question holds the same level of importance as the question of when scientists will develop a stem cell therapy that cures a disease, but I find it representative of the confusion and uncertainty that the general public has about when the “promise of stem cell research” will become a reality.

Let me explain…

Mr. Owl claims that it only takes three licks to get to the center of a Tootsie Pop, but three licks obviously aren’t enough to get through the hard candy exterior to the chewy tootsie center. According to the Tootsie “Scientific Endeavors” page, “at least three detailed scientific studies” determined that it takes between 144-411 licks to get to the center. My intuition is to go with the scientists, but depending on how the experiment was conducted or maybe the size of the tongue used, the final answer could vary.

Embryonic stem cells

Embryonic stem cells

For stem cell clinical trials, the situation is similar. The first clinical trial approved in the U.S. using human embryonic stem cells was in 2009. Since then, hundreds of clinical trials have been conducted globally using pluripotent – either embryonic or induced pluripotent stem cells (iPSCs) – or adult stem cells. But so far, none have made their way routinely to patients outside of a clinical trial setting in the U.S., (although a few stem cell-based products have been approved in other countries), and it’s unclear how many more trials it will take to get to this point.

Part of this murkiness is because we’re still in the early days of stem cell research: human embryonic stem cells were first isolated by James Thomson in 1998, and iPSCs weren’t discovered by Shinya Yamanaka until 2006. Scientists need more time to conduct preclinical research to understand how these stem cells can be best used to treat certain diseases and what stem cells will do when transplanted into patients.

Another other issue is that the U.S. Food and Drug Administration (FDA) has only approved one stem cell therapy – cord blood stem cell transplantation – for commercial use in 2011 and none since then. A big debate is currently ongoing about whether the regulatory landscape needs to change so that stem cell treatments that show promise in trials can get to patients who desperately need them.

Hopefully soon, the FDA will adopt a more efficient strategy for approving stem cell therapies that still keeps patient safety at the forefront. Otherwise it could take a lot longer for newer stem cell technologies like iPSCs to make their way to the clinic (although we’ve seen some encouraging preliminary results using iPSC-based therapy in clinical trials for blindness).

Trial, trial, trial again

So how many clinical trials will it take for a stem cell therapy to succeed sufficiently to gain approval and when will that happen?

Unfortunately, we don’t know the answers to these questions, but we do know that scientists need to continue to develop and test new stem cell treatments in human trials if we want to see any progress.

At CIRM, we are currently funding 16 clinical trials involving stem cell therapies for cancer, heart failure, diabetes, spinal cord injury and other diseases. But we need to fund more trials to increase the odds that some will make it through the gauntlet and prove both safe and effective at treating patients. Our goal now is to fund 50 clinical trials in the next five years. It’s an aggressive plan, but one we feel will hopefully take stem cell therapies from promise to reality.

We also know that CIRM is a soldier in a large army of funding agencies, universities, companies, and scientists around the world battling against time to develop stem cell therapies that could help patients in their lifetimes. And with this stem cell army, we believe we’re getting closer to the chewy center of the Tootsie pop, or in this case, an approved stem cell therapy for patients desperate for a cure.

This blog was written as part of the CCRM Signals iPSC anniversary blog carnival. Please click here to read what other bloggers have to say about the future of stem cells and regenerative medicine.

Sleep inducing hormone puts breast cancer cells to rest  

/ Todd Dubnicoff / Leave a comment

It’s pretty easy to connect the dots between a lack of sleep and an increased risk of a deadly car crash. But what about an increased risk of cancer? A 2012 study of 101 women newly diagnosed with breast cancer found that those with inadequate sleep were more likely to have more aggressive tumors. Though the results of this survey were statistically significant, the biological connection between sleep and breast cancer is not well understood.

melatonin

Melatonin, the sleep hormone, may help fight cancer. Image Credit

Now, a report in Genes and Cancer by a Michigan State University research team shows that the interplay between melatonin, a hormone involved in sleep-wake cycles, and breast cancer stem cells may provide an explanation. And, more importantly, the study points to melatonin’s potential use as a cancer therapeutic.

Mammospheres: cancer in a more natural environment
To carry out their lab experiments, the researchers grew breast cancer cells into three-dimensional aggregates, called mammospheres, that resemble the tumor cell composition seen in an actual tumor in the body. This cell mix includes breast cancer stem cells which are thought to drive the uncontrolled tumor growth and reccurrence. David Arnosti, a MSU professor and co-author on the study, used a helpful analogy in a university press release to explain the importance of using the mammosphere technique:

“You can watch bears in the zoo, but you only understand bear behavior by seeing them in the wild. Similarly, understanding the expression of genes in their natural environment reveals how they interact in disease settings. That’s what is so special about this work.”

 

Melatonin fighting cancer cells via their stem cell-like properties
The cancer cells used in this study are also categorized as so-called estrogen receptor (ER) -positive cells. This classification means that the cancer growth is largely stimulated by the hormone estrogen.  The first round of experiments analyzed melatonin’s effects on estrogen’s ability to increase the growth and size of the mammospheres. The team also tested Bisphenol A (BPA), a chemical used in the plastics industry that mimics estrogen’s effects. While estrogen or BPA alone caused a large increase in mammosphere size and number, addition of melatonin stunted these effects.

Next, the team went deeper and looked at melatonin’s impact from a genes and proteins perspective. Estrogen is a steroid hormone that acts by passing through the cell wall and binding to the estrogen receptor inside the cell. Once bound by estrogen, the receptor travels to a cell’s nucleus and binds particular regions of DNA which can activate genes. One of those activated genes is responsible for producing OCT4, a protein that plays a critical role in a stem cell’s ability to indefinitely makes copies of itself and to maintain its unspecialized, stem cell state. This cellular pathway is how estrogen helps drives the growth of ER-positive breast cancer cells. The researchers showed that estrogen- and BPA-stimulated binding of the estrogen receptor to the OCT4 gene in the mammospheres was inhibited when melatonin was added to the cells.

Melatonin: putting cancer stems to bed?
Putting these observations together, melatonin appears to suppress breast tumor growth by directing inhibiting genes responsible for driving the stem cell-like properties of the breast cancer stem cells within the mammosphere. Melatonin is produced by the brain’s pineal gland which is only active at night. Once released, melatonin helps induce sleep. So a disrupted sleep pattern, like insomnia, would reduce melatonin levels and as a consequence the block on estrogen driven cancer growth is removed. ­

James Trosko, whose MSU lab perfected the mammosphere technique, sees these breast cancer results in a larger perspective:

“This work establishes the principal by which cancer stem cell growth may be regulated by natural hormones, and provides an important new technique to screen chemicals for cancer-promoting effects, as well as identify potential new drugs for use in the clinic.”

 

Keep in mind that these are very preliminary studies and more work is needed before a potential clinical application sees the light of day. In the meantime, have a good day and get a good night’s sleep.

 

 

New approach could help turn back the clock and reverse damage for stroke patients

/ Kevin McCormack / 4 Comments
stroke

Stroke: courtesy WebMD

Stroke is the leading cause of serious, long-term disability in the US. Every year almost 800,000 people suffer from a stroke. The impact on their lives, and the lives of those around them can be devastating.

Right now the only treatment approved by the US Food and Drug Administration (FDA) is tissue plasminogen activator or tPA. This helps dissolve the blood clot causing most strokes and restores blood flow to the brain. However, to be fully effective this has to be administered within about 3-4 hours after the stroke. Many people are unable to get to the hospital in time and as a result suffer long-term damage, damage that for most people has been permanent.

But now a new study in Nature Medicine shows that might not be the case, and that this damage could even be reversible.

The research, done by a team at the University of Southern California (USC) uses a one-two punch combination of stem cells and a protein that helps those cells turn into neurons, the cells in the brain damaged by a stroke.

First, the researchers induced a stroke in mice and then transplanted human neural stem cells alongside the damaged brain tissue. They then added in a dose of the protein 3K3A-APC or a placebo.

hey found that mice treated with 3K3A-APC had 16 times more human stem-cell derived neurons than the mice treated with the placebo. Those neurons weren’t just sitting around doing nothing. USC’s Berislav Zlokovic, senior author of the paper, says they were actively repairing the stroke-induced damage.

“We showed that 3K3A-APC helps the grafted stem cells convert into neurons and make structural and functional connections with the host’s nervous system. No one in the stroke field has ever shown this, so I believe this is going to be the gold standard for future studies. Functional deficits after five weeks of stroke were minimized, and the mice were almost back to normal in terms of motor and sensorimotor functions. Synapses formed between transplanted cells and host cells, so there is functional activation and cooperation of transplanted cells in the host circuitry.”

The researchers wanted to make sure the transplanted cell-3K3A-ACP combination was really the cause of the improvement in the mice so they then used what’s called an “assassin toxin” to kill the neurons they had created. That reversed the improvements in the treated mice, leaving them comparable to the untreated mice. All this suggests the neurons had become an integral part of the mouse’s brain.

So how might this benefit people? You may remember that earlier this summer Stanford researchers produced a paper showing they had helped some 18 stroke patients, by injecting stem cells from donor bone marrow into their brain. The improvements were significant, including in at least one case regaining the ability to walk. We blogged about that work here

In that study, however, the cells did not become neurons nor did they seem to remain in the brain for an extended period. It’s hoped this new work can build on that by giving researchers an additional tool, the 3K3A-ACP protein, to help the transplanted cells convert to neurons and become integrated into the brain.

One of the other advantages of using this protein is that it has already been approved by the FDA for use in people who have experienced an ischemic stroke, which accounts for about 87 percent of all strokes.

The USC team now hope to get approval from the FDA to see if they can replicate their experiences in mice in people, through a Phase 2 clinical trial.

 

 

 

 

 

 

 

Stem cell stories that caught our eye: Zika virus and adult brains, a step toward precision medicine and source of blood stem cells

/ Don Gibbons / Leave a comment

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.

Zika virus and the adult brain.  While almost all the press attention for the Zika virus has centered on pregnant women and the devastating impact the virus can have on their developing babies, a few stories have noted that while most adults don’t know they have been infected, a few do. The one significant impact seen is a relatively rare incidence of Guillain-Barre Syndrome, which can cause temporary partial paralysis. That has triggered a few researchers to look for other impacts in adults infected with the mosquito-borne virus.

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Researchers trying to understand why the virus leads to the underdeveloped brains known as microcephaly, in infants have shown the virus does its nasty work at the level of the nerve stem cell. Although adults have far fewer nerve stem cells than a developing fetus, they do have some. So a team at Rockefeller University in New York and the La Jolla Institute for Allergy and Immunology decided to look for any effects of infection on adult nerve stem cells in mice.  They published the work this week in the journal Cell Stem Cell and report a dramatic reduction in adult nerve stem cells in infected mice.

“Adult neurogenesis is implicated in learning and memory,” said the La Jolla Institute’s Sujan Shresta in a press release from the journal. “We don’t know what this would mean in terms of human diseases, or if cognitive behaviors of an individual could be impacted after infection.”

Mice are normally resistant to Zika infection, so the researchers first had to genetically engineer mice to be susceptible to infection. That means several layer of caveats and more research are needed before any assertions about adult impact of Zika infection in humans.

This work captured considerable press attention including in Buzzfeed, NBC and USNews and World Report.

 

Heart felt precision medicine.  With the boost of a special initiative launched by the Obama administration, precision medicine is becoming all the rage, at least as a goal. While a few cancer therapies currently use this concept of matching therapies to a specific patient’s genetic makeup, few doctors outside of oncology can turn to similarly precise therapies.

Cardio cells image

Heart muscle cells

Work from a CIRM-funded team at Stanford has moved other doctors a bit closer to this goal for heart disease. But this research will not lead to treating it, rather it could allow doctors to prevent therapies used for other diseases from causing heart disease. Joseph Wu and his team have made two discoveries that help validate the use of the iPS reprogramming technique to make patient-specific stem cells and then mature them into heart muscle cells and see how those cells react to specific drugs.

“Thirty percent of drugs in clinical trials are eventually withdrawn due to safety concerns, which often involve adverse cardiac effects,” said Wu in a press release picked up by ScienceNewsLine. “This study shows that these cells serve as a functional readout to predict how a patient’s heart might respond to particular drug treatments and identify those who should avoid certain treatments.”

 

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Joseph Wu

There has always been some concern that the genetic manipulation used to create iPS cells changes the genetics of any adult tissue you make from the cells. So, with samples from three patients who were undergoing heart biopsy or transplant, which allowed harvesting mature heart muscle, the team compared the genetic signature of the adult heart muscle and that of heart muscle created from iPS cells.  They found no significant differences.

With skin samples from another seven subjects they created iPS cells and then heart muscle and compared their genetic signatures. The found some slight difference in all seven, but dramatic differences in one. That difference was in a genetic pathway involved in the inner workings of heart muscle. When they treated those cells with a diabetes drug that had been linked to heart problems, the cells reacted quite differently from the cells of the other six subjects treated with the same drug. With this knowledge a doctor could avoid ever choosing to put that particular patient on that diabetes drug.

 

Source of blood stem cells matters.  For years, bone marrow transplant—the one currently routine stem cell therapy—required digging into someone bone to harvest the stem cells. Over the decades that the procedure has been saving thousands of lives doctors have found less invasive methods to get the stem cells using drugs to “mobilize” the marrow stem cells and get them to move into the blood stream where they can be harvested.

While stem cell donors often find the new procedure a vast improvement, no one had done a thorough review of the outcomes for patients who receive stem cells gathered by the different procedures until a paper this week from the Fred Hutchison Cancer Research Center in Seattle. While they did not find any differences in overall life expectancy, they found vastly different outcomes in quality of life including psychological wellbeing and ability to return to work.

The Hutchison team attributed most of this difference to a lower rate of Graft Versus Host Disease (GVHD), possibly the most dangerous side effect of the procedure, which occurs when the stem cell transplant also contains adult immune system cells from the donor and those “graft” cells attack the “host,” the patient. It makes sense that when you harvest cells from the blood stream you would be more likely to also capture mature immune cells than when you harvest cells from marrow. And GVHD can be extremely painful, debilitating, and often deadly.

Stephanie Lee Hutchison

Stephanie Lee

“When both your disease and the recommended treatment are life-threatening, I don’t think people are necessarily asking ‘which treatment is going to give me better quality of life years from now?'” said Stephanie Lee the lead author in a press release from the cancer center. “Yet, if you’re going to make it through, as many patients do, you want to do it with good quality of life. That’s the whole point of having the transplant.”

Better, Faster Quality Control for Stem Cell-Based Therapies

/ Todd Dubnicoff / 1 Comment

“Based”.

It’s a pretty boring word but I make sure to include it when writing about the development of stem cell therapies, as in: “Asterias Biotherapeutics is testing an embryonic stem cell-based treatment for spinal cord injury”. It’s a key word here because no legitimate clinic would transplant embryonic stem cells (ESCs) or induced pluripotent stem cells (iPSCs) directly into a patient. The ability of these cells to make unlimited copies of themselves is great for growing them in the lab; but in the body, that same property presents a very real risk of tumor formation. Instead, ESCs and iPSCs are merely the base material from which specialized cells are matured from for the many promising therapies being developed for clinical trials.

To ensure safety to patients, minimizing the number of these potentially cancer-causing pluripotent stem cells still lingering in a cell therapy product is one of the main safety concerns of the Food and Drug Administration (FDA), the U.S. federal agency that approves therapies for clinical trials. So during therapy development, researchers run assays, or tests, to detect how many ESCs or iPSCs remain in their cell product and if they can form tumors.

In a paper published yesterday in Biomaterials, an Emory University research team reported on the development of a new technique that is several thousand-fold (!!!) higher in sensitivity than current assays and could be a game-changer for the quality control of stem cell-based therapies (also see an Emory U. blog about the study).

Surface-enhanced Raman Scattering Assay: it’s one in a million

SERS-schematic

Illustrated overview of the SERS assay workflow (Image: Biomaterials)

In the technique, called a surface-enhanced Raman scattering (SERS) assay, gold nanoparticles are attached to proteins, called antibodies, that specifically bind to the surface of stem cells. These antibody-nanoparticles are mixed with a preparation of the cell product. A laser is then directed at the cells and a device, called a spectrometer, measures the resulting light scatter which ultimately can be converted into the number of stem cells in the cell mix.

Incredibly, this assay can detect one stem cell out of one million specialized cells making it well suited for testing clinical grade cell therapy products. In comparison, the current flow cytometry technique which uses fluorescently tagged antibodies, can spot 1 stem cell in about 1000 cells.

Another current way to detect stem cells in a cell product is through the so-called teratoma assay. In this test, a mouse is injected with the cell therapy and observed for about three months to see if any teratomas, or tumors, form from residual stem cells. While this technique is a more direct safety test, it’s very costly, time-consuming, and impractical for testing very large doses of cell therapies. As the authors mention in the publication, the SERS technique could help overcome the limitations of both the teratoma and flow cytometry assays:

“Because of their remarkable sensitivity, these SERS assays may facilitate safety assessment of cell preparations for transplantations that require a large quantity of cells, which is unachievable using flow cytometry or the teratoma assay in mice. In addition, these assays are cost-effective, easy to use, and can be done within an hour, which is much faster than the traditional teratoma assay.”

“Faster”. Now that’s a pretty exciting word I always like to include when writing about the development of stem cell therapies.

 

A look back at the last year – but with our eyes firmly on the future

/ Kevin McCormack / 3 Comments
Randy

CIRM President & CEO Randy Mills doesn’t want “good”, he wants “better”

Better.

With that single word Randy Mills, our President and CEO, starts and ends his letter in our 2015 Annual Report and lays out the simple principle that guides the way we work at CIRM.

Better.

But better what?

“Better infrastructure to translate early stage ideas into groundbreaking clinical trials. Better regulatory practices to advance promising stem cell treatments more efficiently. Better treatments for patients in need.”

“Better” is also the standard everyone at CIRM holds themselves to. Getting better at what we do so we can fulfill our mission of accelerating stem cell treatments to patients with unmet medical needs.

The 2015 Annual Report highlights the achievements of the last year, detailing how we invested $135 million in 47 different projects at all levels of research. How our Board unanimously passed our new Strategic Plan, laying out an ambitious series of goals for the next five years from funding 50 new clinical trials, to creating a new regulatory process for stem cell therapies.

Snapshot of CIRM's 2015 Funding

The report offers a snapshot of where our money has gone this year, and how much we have left. It breaks down what percentage of our funding has gone to different diseases and how much we have spent on administration.

Jonathan Thomas, the Chair of our Board, takes a look back at where we started, 10 years ago, comparing what we did then (16 awards for a total of $12.5 million) to what we are doing today. His conclusion; we’re doing better.

But we still have a long way to go. And we are determined to get even better.

P.S. By the way we are changing the way we do our Annual Report. Our next one will come out on January 1, 2017. We figured it just made sense to take a look back at the last year as soon as the new year begins. It gives you a better (that word again) sense of what we did and where we  are heading. So look out for that, coming sooner than you think.