CIRM Board Approves Two Discovery Research Projects for COVID-19

Dr. Steven Dowdy (left), Dr. Evan Snyder (center), and Dr. John Zaia (right)

This past Friday the governing Board of the California Institute for Regenerative Medicine (CIRM) approved two additional discovery research projects as part of the $5 million in emergency funding for COVID-19 related projects.  This brings the number of COVID-19 projects CIRM is supporting to 15, including three clinical trials.

The Board awarded $249,999 to Dr. Evan Snyder at the Sanford Burnham Prebys Medical Discovery Institute.  The study will use induced pluripotent stem cells (iPSCs), a type of stem cell that can be created by reprogramming skin or blood cells, to create lung organoids.  These lung organoids will then be infected with the novel coronavirus in order to test two drug candidates for treatment of the virus. The iPSCs and the subsequent lung organoids created will reflect diversity by including male and female patients from the Caucasian, African-American, and Latinx population.

This award is part of CIRM’s Quest Awards Program (DISC2), which promotes promising new technologies that could be translated to enable broad use and improve patient care.

The Board also awarded $150,000 to Dr. Steven Dowdy at UC San Diego for development of another potential treatment for COVID-19.  

Dr. Dowdy and his team are working on developing a new, and hopefully more effective, way of delivering a genetic medicine, called siRNA, into the lungs of infected patients. In the past trying to do this proved problematic as the siRNA did not reach the appropriate compartment in the cell to become effective. However, the team will use an iPSC lung model to help them identify ways past this barrier so the siRNA can attack the virus and stop it replicating and spreading throughout the lungs.

This award is part of CIRM’s Inception Awards Program (DISC1), which supports transformational ideas that require the generation of additional data.

A supplemental award of $250,000 was approved for Dr. John Zaia at City of Hope to continue support of a CIRM funded clinical study that is using convalescent plasma to treat COVID-19 patients.  The team recently launched a website to enroll patients, recruit plasma donors, and help physicians enroll their patients.

“The use of induced pluripotent stem cells has expanded the potential for personalized medicine,” says Dr. Maria T. Millan, the President & CEO of CIRM. “Using patient derived cells has enabled researchers to develop lung organoids and lung specific cells to test numerous COVID-19 therapies.”

Stem cells used to look at how COVID-19 attacks heart muscle

Human induced pluripotent stem cell-derived cardiomyocytes (heart cells) shown in green and blue, are infected by the novel coronavirus SARS-CoV-2 (red). Image provided by Cedars-Sinai Board of Governors Regenerative Medicine Institute.

There is still a lot that we don’t understand about SARS-CoV-2 (COVID-19), the new coronavirus that has caused a worldwide pandemic. Some patients that contract the virus experiences heart problems, but the reasons are not entirely clear. Pre-existing heart conditions or inflammation and oxygen deprivation that result from COVID-19 have all been implicated but more evidence needs to be collected.

To evaluate this, a joint study between Cedars-Sinai Board of Governors Regenerative Medicine Institute and the UCLA Broad Stem Cell Research Center used human induced pluripotent stem cells (iPSCs), a kind of stem cell that can become any kind of cell in the body and is usually made from skin cells. The iPSCS were converted into heart cells and infected with COVID-19 in order to study the effects of the virus.

The results of this study showed that the iPSC-derived heart cells are susceptible to COVID-19 infection and that the virus can quickly divide inside the heart cells. Furthermore, the infected heart cells showed changes in their ability to beat 72 hours after infection.

In a press release, Dr. Clive Svendsen, senior and co-corresponding author of the study and director of the Cedars-Sinai Board of Governors Regenerative Medicine Institute, elaborated on the results.

“This viral pandemic is predominately defined by respiratory symptoms, but there are also cardiac complications, including arrhythmias, heart failure and viral myocarditis. While this could be the result of massive inflammation in response to the virus, our data suggest that the heart could also be directly affected by the virus in COVID-19.”

Although this study does not perfectly replicate the conditions inside the human body, the iPSC heart cells may also help identify and screen new potential drugs that could alleviate viral infection of the heart.

The research team has already found that treatment with an antibody called ACE2 was able to decrease viral replication on the iPSC heart cells.

In the same press release Dr. Arun Sharma, first author and another co-corresponding author of the study and a research fellow at the Cedars-Sinai Board of Governors Regenerative Medicine Institute, had this to say about the ACE2 antibody.

“By blocking the ACE2 protein with an antibody, the virus is not as easily able to bind to the ACE2 protein, and thus cannot easily enter the cell. This not only helps us understand the mechanisms of how this virus functions, but also suggests therapeutic approaches that could be used as a potential treatment for SARS-CoV-2 infection.”

The study’s third co-corresponding author was Dr. Vaithilingaraja Arumugaswami, an associate professor of molecular and medical pharmacology at the David Geffen School of Medicine at UCLA and member of the Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research.

The full results of this study were published in Cell Reports Medicine.

CIRM Highlights Industrial Alliance Program (IAP)

In the addition to the innovative scientists and clinicians who conceive and develop novel experimental therapies, it takes a village to drive a promising experimental therapy through phases of clinical trials, regulatory marketing approval, and commercialization before it becomes broadly accessible to patients with unmet medical needs. In this case, the village is the broader industry including institutional investors and biopharma companies that have the capital, resources and expertise to carry the development programs past the finish line. 

A big part of what CIRM does revolves around nurturing projects at the very early stages. By providing funding and guidance through our collaborative team of experts, CIRM de-risks its therapy development programs through pre-clinical and clinical stages, thereby readying them for industry partnerships to support them through the last mile. CIRM funding to California academic institutions has enabled the launch of more than 40 spinout companies, one of which we will highlight below.

On April 7th, 2020, Forty Seven, Inc. was acquired by Gilead Sciences for $4.9 billion. CIRM funded the preclinical and early clinical development of an anti-CD47 antibody candidate for cancer at Stanford and subsequently funded two Forty Seven clinical trials. Now, Gilead will leverage all of its resources to accelerate the development of this promising cancer immunotherapy.

Dr. Mark Chao, Co-Founder, Forty Seven, Inc. had this to say about CIRM.

“CIRM’s support has been instrumental to our early successes and our ability to rapidly progress Forty Seven’s CD47 antibody targeting approach with magrolimab. CIRM was an early collaborator in our clinical programs and it’s support was instrumental in helping us reach a point where we could become a part of Gilead and move forward with our research.”

To proactively enable more partnering successes such as Forty Seven, CIRM has established the Industry Alliance Program (IAP) as a direct opportunity for the industry to partner with CIRM grantees in accelerating the most promising stem cell, gene and regenerative medicine therapy programs to commercialization. Through the IAP, CIRM is a dedicated and proactive partner to industry and CIRM grantees.

We recently launched a website for those interested in knowing more about these partnerships. It describes the IAP program in more detail can be accessed by clicking here.

If you are a potential industry partner wishing to learn more about CIRM’s IAP, please contact:

CIRM Board Approves Third Clinical Trial for COVID-19

Dr. Xiaokui Zhang (left), Dr. Albert Wong (center), and Dr. Preet Chaudhary (right)

Today the governing Board of the California Institute for Regenerative Medicine (CIRM) awarded $750,000 to Dr. Xiaokui Zhang at Celularity to conduct a clinical trial for the treatment of COVID-19.  This brings the total number of CIRM clinical trials to 64, including three targeting the coronavirus.

This trial will use blood stem cells obtained from the placenta to generate natural killer (NK) cells, a type of white blood cell that is a vital part of the immune system, and administer them to patients with COVID-19.  NK cells play an important role in defense against cancer and in fighting off viral infections.  The goal is to administer these cells to locate the active sites of COVID-19 infection and destroy the virus-infected cells.  These NK cells have been used in two other clinical trials for acute myeloid leukemia and multiple myeloma.

The Board also approved two additional awards for Discovery Stage Research (DISC2), which promote promising new technologies that could be translated to enable broad use and improve patient care.

One award for $100,000 was given to Dr. Albert Wong at Stanford.  Dr. Wong has recently received an award from CIRM to develop a vaccine that produces a CD8+ T cell response to boost the body’s immune response to remove COVID-19 infected cells.  The current award will enable him to expand on the initial approach to increase its potential to impact the Latinx and African American populations, two ethnicities that are disproportionately impacted by the virus in California.

The other award was for $249,996 and was given to Dr. Preet Chaudhary at the University of Southern California.  Dr. Chaudary will use induced pluripotent stem cells (iPSCs) to generate natural killer cells (NK). These NK cells will express a chimeric antigen receptor (CAR), a synthetic receptor that will directly target the immune cells to kill cells infected with the virus.  The ultimate goal is for these iPSC-NK-CAR cells to be used as a treatment for COVID-19. 

“These programs address the role of the body’s immune T and NK cells in combatting viral infection and CIRM is fortunate enough to be able to assist these investigators in applying experience and knowledge gained elsewhere to find targeted treatments for COVID-19” says Dr. Maria T. Millan, the President & CEO of CIRM. “This type of critical thinking reflects the resourcefulness of researchers when evaluating their scientific tool kits.  Projects like these align with CIRM’s track record of supporting research at different stages and for different diseases than the original target.”

The CIRM Board voted to endorse a new initiative to refund the agency and provide it with $5.5 billion to continue its work. The ‘California Stem Cell Research, Treatments and Cures Initiative of 2020 will appear on the November ballot. 

The Board also approved a resolution honoring Ken Burtis, PhD., for his long service on the Board. Dr. Burtis was honored for his almost four decades of service at UC Davis as a student, professor and administrator and for his 11 years on the CIRM Board as both a member and alternate member. In the resolution marking his retirement the Board praised him, saying “his experience, commitment, knowledge, and leadership, contributed greatly to the momentum of discovery and the future therapies which will be the ultimate outcome of the dedicated work of the researchers receiving CIRM funding.”

Jonathan Thomas, the Chair of the Board, said “Ken has been invaluable and I’ve always found him to have tremendous insight. He has served as a great source of advice and inspiration to me and to the ICOC in dealing with all the topics we have had to face.” 

Lauren Miller Rogen thanked Dr. Burtis, saying “I sat next to you at my first meeting and was feeling so extraordinarily overwhelmed and you went out of your way to explain all these big science words to me. You were always a source of help and support, and you explained things to me in a way that I always appreciated with my normal brain.”

Dr. Burtis said it has been a real honor and privilege to be on the Board. “I’ve been amazed and astounded at the passion and dedication that the Board and CIRM staff have brought to this work. Every meeting over the years there has been a moment of drama and then resolution and this Board always manages to reach agreement and serve the people of California.”

Stem cells used to promote quick and precise bone healing

A close-up view of the intricate microarchitecture of the pluripotent stem-cell-derived extracellular matrix. Image Credit: Carl Gregory/Texas A&M

Although some broken bones can be mended with the help of a cast, others require more complex treatments. Bone grafts, which can come from the patient’s own body or a donor, are used to transplant bone tissue to the injury site. However, these procedures can have setbacks such as increased recovery time and chronic pain. Each year approximately 600,000 people in the United States alone experience complications from bone healing.

Researchers at Texas A&M University found a way to use induced pluripotent stem cells (iPSCs), a type of stem cell that can turn into any cell type and can be derived from adults cells (e.g. skin cells), to create superior bone grafts. The team of researchers said these grafts could potentially be used to promote swift and precise bone healing, enabling patients to optimally benefit from surgical intervention.

The Texas A&M team used iPSCS to make mesenchymal stem cells (MSCs), which make the extracellular matrix needed for bone grafts. MSCs can be obtained from bone marrow, but they have a relatively shorter life span and are not as biologically active when compared to MSCs generated from iPSCs.

To test the effectiveness of their iPSC generated bone grafts, they implanted the extracellular matrix at a site of bone defects. After a few weeks, they found that their iPSC generated matrix was five to sixfold more effective than the best FDA-approved graft stimulator.

In a news release from Texas A&M, Dr. Roland Kaunas discusses the potential benefits of using iPSC generated bone grafts.

“Our material is very promising because the pluripotent stem cells can ideally generate many batches of the extracellular matrix from just a single donor which will greatly simplify the large-scale manufacturing of these bone grafts.”

Additionally, the Texas A&M team said this approach has the potential to be incorporated into numerous engineered implants, such as 3D-printed implants or metal screws, so that these parts integrate better with the surrounding bone.

The full results of this study were published in Nature Communications.

A brief video on bone grafts from Texas A&M is available below.

Magnetized stem cells used to treat lung disease in mice

Magnetic targeting technique has emerged as a new strategy to aid delivery, increase retention, and enhance the effects of mesenchymal stromal cells (MSCs) but, so far, has not been performed in lung diseases. With the aid of magnets, magnetized MSCs remained longer in the lungs, and this was associated with increased beneficial effects for the treatment of silicosis in mice. Image Credit: AlphaMed Press

Certain jobs, such as construction work and sand blasting, are quite labor intensive but can also lead to some unexpected health complications down the road. One of these is called silicosis, a serious lung disease that affects millions of workers worldwide. It is the result of years of breathing in silica, a type of dust particle most commonly found in sand. The particles can cause inflammation and scarring of the lung tissue, which can lead to trouble breathing and death in the most severe cases. There is currently no cure for this condition and once the damage is done it cannot be reversed.

However, Dr. Patricia Rocco and Dr. Fernanda Cruz from the Laboratory of Pulmonary Investigation at Universidade Federal do Rio de Janeiro, Brazil have found a promising approach to treat silicosis that involves the use of stem cells and magnetization.

In this study, mesenchymal stromal cells (MSCs), a type of stem cell that has anti-inflammatory properties, were magnetized using specialized nanoparticles. The effects of the newly magnetized MSCs were then studied in mice in which silicosis was induced to see if magnetization could aid in delivery to the lungs. One group of mice was injected with saline (as a control study) while another group was injected with the magnetized MSCs. A third group of mice was injected with magnetized MSCs with a pair of magnets attached to their chest for 2 days. The results showed that using the magnetized MSCs alongside the magnets proved to be most effective in migrating the cells towards the lungs.

In a news release, Dr. Cruz elaborated on their findings for this portion of the study.

“Upon removal of the magnets, we examined all the animals in all the groups and found that those implanted with magnets had a significantly larger amount of magnetized MSCs in their lungs.”

For the next portion of the study, the team compared treatments in mice using magnetized MSCs with magnets vs non-magnetized MSCs. After 7 days, the magnets were removed from the mice with magnetized MSCs and their lungs were evaluated. It was found that those treated with magnetized MSCs and magnets showed significant signs of lung improvement while the other mice did not.

In the same news release, Dr. Rocco discusses the implications that these results have in terms of developing a potential treatment.

“This tells us that magnetic targeting may be a promising strategy for enhancing the beneficial effects of MSC-based cell therapies for silicosis and other chronic lung diseases.”

The full results of this study were published in Stem Cells Translational Medicine (SCTM).

CIRM has recently funded a clinical trial that uses MSCs to treat patients with acute respiratory distress syndrome (ARDS), a life-threatening lung injury that occurs when fluid leaks into the lungs, in both COVID-19 positive and COVID-19 negative patients.

CIRM Board Approves Two Additional COVID-19 Projects

Dr. Vaithilingaraja Arumugaswami (left) and Dr. Song Li (right), UCLA

Today the governing Board of the California Institute for Regenerative Medicine (CIRM) approved two additional projects as part of the $5 million in emergency funding for COVID-19 related projects. This brings the number of projects CIRM is supporting to 11, including two clinical trials.

The Board awarded $349,999 to Dr. Vaithilingaraja Arumugaswami at UCLA.  The focus of this project will be to study Berzosertib, a therapy targeting viral replication and damage in lung stem cells.  The ultimate goal would be to use this agent as a therapy to prevent COVID-19 viral replication in the lungs, thereby reducing lung injury, inflammation, and subsequent lung disease caused by the virus.  

This award is part of CIRM’s Translational Stage Research Program (TRAN1), which promotes the activities necessary for advancement to clinical study of a potential therapy.

The Board also awarded $149,916 to Dr. Song Li at UCLA.  This project will focus on developing an injectable biomaterial that can induce the formation of T memory stem cells (TMSCs), an important type of stem cell that plays a critical role in generating an immune response to combat viruses. In vaccine development, there is a major challenge that the elderly may not be able to mount a strong enough immunity.  This innovative approach seeks to address this challenge by increasing TMSCs in order to boost the immune response to vaccines against COVID-19.

This award is under CIRM’s Discovery Stage Research Program (DISC2), which promotes promising new technologies that could be translated to enable broad use and improve patient care.

“CIRM continues to support novel COVID-19 projects that build on previous knowledge acquired,” says Dr. Maria T. Millan, the President & CEO of CIRM. “These two projects represent the much-needed multi-pronged approach to the COVID-19 crisis, one addressing the need for effective vaccines to prevent disease and the other to treat the severe illness resulting from infection.”

The growth of virtual clinical trials during COVID-19

A participant in a virtual study run by the California firm Science 37 receives materials at home. Credit: Christian Alexander

In the midst of the coronavirus pandemic, there has been a desire to continue to conduct ongoing clinical trials while maintaining social distancing as much as possible. Clinical trial participants have been hesitant to attend routine check-ups and monitoring due to the risk of exposure and health-care workers are stretched beyond their capacity treating COVID-19 patients. As a result of this, many clinical trials have been put on hold.

Since the coronavirus began to spread, Science 37, a company that supports virtual clinical trials conducted mostly online, began to receive hundreds of inquiries every week from pharmaceutical companies, medical centers, and individual investigators. These inquiries revolve around how best to transition to a virtual clinical trial structure, where consultations are performed online and paperwork and data are collected remotely as much as possible.

In an article published in the journal Nature, Jonathan Cotliar, chief medical officer of Science 37, discusses the impact that COVID-19 has had on the company.

“It’s exponentially accelerated the adoption curve of what we were already doing. That’s been a bit surreal.”

One example of a virtual clinical trial was conducted at the University of Minnesota in Minneapolis by Dr. David Boulware and his colleagues. They conducted a randomized, controlled, virtual trial of the malaria drug hydroxychloroquine to find out if it was effective at protecting people from COVID-19 (the results found that it was not). The trial included more than 800 participants and sent them medicine by FedEx delivery while monitoring their health via virtual appointments.

It is anticipated that even as the coronavirus pandemic and social distancing measures come to an end, virtual clinical trials will continue to be used in the future. Patient advocates have long pushed for these kinds of trials to ease the burden of clinical trial participation, which tends to be more challenging for underrepresented and underserved communities. As a result of the increase in virtual trials, the FDA has released guidelines for conducting virtual trials in order to streamline the process. It is possible that virtual trials might speed up enrollment of participants, which could help speed up the drug-development process while still maintaining rigorous standards.

Researchers grow hairy skin from human stem cells

 Dr. Jiyoon Lee (left) and Dr. Karl Koehler (right), Indiana University School of Medicine

For years the idea of being able to regrow hair has been the domain of cheesy, middle-of-the-night TV infomercials. Now two researchers may have found a way to actually make it happen, and their work could have implications far more important than helping bald men.

Building on years of research, Dr. Jiyoon Lee and Dr. Karl Koehler from the Indiana University School of Medicine were able to use human stem cells to grow hair on skin. The complex skin model was developed by using pluripotent stem cells, a kind of stem cell that can become virtually any kind of cell in the body.

To do this, Dr. Lee, Dr. Koehler, and a team of researchers incubated the human stem cells for 150 days. During this time, the cells formed a ball shaped cluster of cells called a skin organoid. The interior of the organoid is similar to the top layer of skin, known as the epidermis, and the outside is similar to the bottom layer, known as the dermis.

In a press release, Dr. Koehler describes the skin organoid and the process in more detail.

“We’ve developed a new cooking recipe for generating human skin that produces hair follicles after about 70 days in culture. When the hair follicles grow, the roots extend outward radially. It’s a bizarre-looking structure, appearing almost like a deep-sea creature with tentacles coming out from it.”

After the skin organoid was formed, the researchers tested if it could be integrated onto the skin of nude mice by performing skin grafts. The results were remarkable as more than half of the organoids that the scientists engrafted on the mice grew human hair follicles. The skin organoid developed is similar to fetal facial skin and hair.

This skin organoid model has great potential in terms of helping with drug or gene therapies for skin disorders or recreating the earliest stages of skin cancer formation.

In the same press release, Dr. Lee discusses the potential their findings have for reconstructive purposes.

“This could be a huge innovation, providing a potentially unlimited source of soft tissue and hair follicles for reconstructive surgeries.”

The full results of this study were published in Nature.

“Mini” human liver made of stem cells successfully transplanted in rats

Miniature liver made from human skin cells turned stem cells turned specialized liver cells Photo Credit: University of Pittsburgh School of Medicine

According to the American Liver Foundation website, almost 14,000 patients are on the waiting list for a liver transplant. But what if there was a way to generate a liver using your own cells so that you didn’t have to wait? Researchers at the University of Pittsburgh School of Medicine have gotten one step closer towards that goal.

Using human skin cells from volunteers, Dr. Alejandro Soto-Gutierrez and his team of researchers were able to create “mini” livers which were successfully transplanted into rats. In this proof of concept experiment, the “mini” livers survived inside the rats for four days. Additionally, they secreted bile acids and urea and produced proteins similar to a normal liver. Normally, liver maturation takes up to two years in a natural environment, but Dr. Soto-Gutierrez and his team were able to do this in under a month.

The researchers were able to do this by taking human skin cells and reprogramming them into induced pluripotent stem cells (iPSCs), a type of stem cell that has the ability to turn into virtually any other kind of cell. These newly formed iPSCs were then made into liver cells which were then seeded into a rat liver with all of its own cells removed. These newly formed “mini” livers were then transplanted into the rats.

In a press release, Dr. Soto-Gutierrez discusses what it was like observing the newly created “mini” livers.

“Seeing that little human organ there inside the animal – brown, looking like a liver – that was pretty cool. This thing that looks like a liver and functions like a liver came from somebody’s skin cells.”

Although these results were promising, there are still challenges that need to be addressed in future studies such as long-term survival and safety issues.

Even so, Dr. Soto-Gutierrez says his research could one-day benefit patients who are running out of options.

“The long-term goal is to create organs that can replace organ donation, but in the near future, I see this as a bridge to transplant. For instance, in acute liver failure, you might just need hepatic boost for a while instead of a whole new liver”.

The full results to this study were published in Cell Reports.