Building Bridges to a Brighter Future – Celebrating 11 Years of Workforce Development

By: Dr. Kelly Shepard, Associate Director, Discovery and Translation, CIRM

CIRM 2020 Bridges Conference via Zoom

Every July, CIRM is thrilled to announce the arrival a new generation of stem cell scientists who are ready to hit the ground running as laboratory technicians, educators, communicators, or future leaders of their chosen profession. These diverse and remarkable individuals are the latest graduates of the CIRM Bridges Program, which provides students the opportunity to take coursework at California state schools and community colleges and conduct stem cell research at top universities and industry labs. The culmination of this experience is an annual conference where students are able to network with their peers and share their research outcomes with one another.

While the Bridges program has been operating in full force for 11 years now, 2020 brought some new challenges to everyone in the form of a global pandemic. Shelter in place orders- cancellation of in person classes- travel restrictions…. these are only a few of the factors that have touched our lives in recent months. But sometimes challenges bring opportunities and a new way of doing things. Through the collective efforts of program directors, institutional officials, mentors and students, the 2020 Bridges alumni were able to complete their training requirements at their institutions and present their research at the Annual Bridges Conference, which was conducted virtually this year. While visiting students posters via Zoom, we at CIRM were thrilled to learn that many of them already had jobs waiting for them or had been accepted into PhD or MD programs, similar to alumni from previous years, which now number over 1400.

While we cannot predict all of the twists and turns that life may bring us, we can be confident that scientific research and discovery will remain essential to creating a brighter future, and that Bridges alumni will be there to help us navigate it.

Scientists at UC Davis discover a way to help stem cells repair heart tissue

Researchers Phung Thai (left) and Padmini Sirish were part of a research team seeking stem cell solutions to heart failure care.  Image Credit: UC Davis

Repairing the permanent damage associated with a heart attack or long-term heart disease has been a challenge that scientists have been trying to tackle for a long time. Heart failure affects approximately 5.7 million people in the U.S and it is estimated that this number will increase to 9 million by the year 2030. At a biological level, the biggest challenge to overcome is cell death and thickening of muscles around the heart.

Recently, using stem cells to treat heart disease has shown some promise. However, little progress has been made in this area because the inflammation associated with heart disease decreases the chances of stem cell survival. Fortunately, Dr. Nipavan Chiamvimonvat and her team of researchers at UC Davis have found an enzyme inhibitor that may help stem cells repair damaged heart tissue.

Dr. Nipavan Chiamvimonvat
 Image Credit: UC Davis

The enzyme the team is looking at, known as soluble epoxide hydrolase (or sEH for short), is a known factor in joint and lung disease and is associated with inflammation. The inhibitor Dr. Chiamvimonvat and her team are studying closely is called TPPU and it is meant to block sEH.

In their study, the UC Davis team used human-induced pluripotent stem cells (hiPSCs), a kind of stem cell made by reprogramming skin or blood cells that then has the ability to form all cell types. In this case, the hiPSCs were turned into heart muscle cells.

To evaluate the effectiveness of TPPU, the team then induced heart attacks in six groups of mice. A group of these mice was treated with a combination of TPPU and the newly created heart muscle cells.  The team found that the mice treated with this combination approach had the best outcomes in terms of increased engraftment and survival of transplanted stem cells. Additionally, this group also had less heart muscle thickening and improved heart function. 

The next step for Dr. Chiamvimonvat and her team is to conduct more animal testing in order to obtain the data necessary to test this therapy in clinical trials.

In a press release, Dr. Chiamvimonvat discusses the importance of research and its impact on patients.

““It is my dream as a clinician and scientist to take the problems I see in the clinic to the lab for solutions that benefit our patients.”

The full study was published in Stem Cells Translational Medicine.

 

Therapy developed with CIRM award used in new clinical trial for COVID-19

Dr. Joshua Rhein, Assistant Professor of Medicine in the University of Minnesota Medical School’s Division of Infectious Diseases and International Medicine
Image Credit: University of Minnesota

While doctors are still trying to better understand how to treat some of the most severe cases of COVID-19, researchers are looking at their current scientific “toolkit” to see if any potential therapies for other diseases could also help treat patients with COVID-19. One example of this is a treatment developed by Fate Therapeutics called FT516, which received support in its early stages from a Late Stage Preclinical grant awarded by CIRM.

FT516 uses induced pluripotent stem cells (iPSCs), which are a kind of stem cell made from reprogrammed skin or blood cells. These newly made stem cells have the potential to become any kind of cell in the body. For FT516, iPSCs are transformed into natural killer (NK) cells, which are a type of white blood cell that are a vital part of the immune system and play a role in fighting off viral infections.

Prior to the coronavirus pandemic, FT516 was used in a clinical trial to treat patients with acute myeloid leukemia (AML) and B-cell lymphoma, which are two different kinds of blood cancer.

Due to the natural ability of NK cells to fight off viruses, it is believed that FT516 may also help play a role in diminishing viral replication of the novel coronavirus in COVID-19 patients. In fact, Fate Therapeutics, in partnership with the University of Minnesota, has treated their first COVID-19 patient with FT516 in a new clinical trial.

In a news release, Dr. Joshua Rhein, Physician at the University of Minnesota running the trial site, elaborates on how FT516 could help COVID-19 patients.

“The medical research community has been mobilized to meet the unique challenges that COVID-19 presents. There are limited treatment options for COVID-19, and we have been inundated daily with reports of varying quality describing the potential of numerous therapies. We know that NK cells play an important role in responding to SARS-CoV-2, the virus responsible for COVID-19, and that these cells often become depleted in infected patients. Our intent is to replenish NK cells in order to restore a functional immune system and directly target the virus.”

In its own response to the coronavirus pandemic, CIRM has funded three clinical trials as part of $5 million in emergency funding for COVID-19 related projects. They include the following: a convalescent plasma study conducted by Dr. John Zaia at City of Hope, a treatment for acute respiratory distress syndrome (a serious and lethal consequence of COVID-19) conducted by Dr. Michael Matthay at UCSF, and a study that also uses NK cells to treat COVID-19 patients conducted by Dr. Xiaokui Zhang at Celularity Inc.  Visit our dashboard page to learn more about these clinical projects.

CIRM progression award to support research towards immunodeficiency

Dr. Caroline Kuo, a member of the Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research at UCLA

In 2017, CIRM funded a discovery or early stage research project for Dr. Caroline Kuo at UCLA for a hereditary immune disorder known as X-Linked Hyper IgM Syndrome. The work has gone so well that Dr. Kuo and her team are now preparing the pre-clinical work needed to launch a clinical trial.

Thanks to the success of her discovery stage project (these are intended to promote promising new technologies that could be translated to enable broad use and improve patient care), Dr. Kuo received a CIRM progression award to launch a new project for DOCK8 deficiency, a different type of Hyper IgE Syndrome. This new project will compare two gene therapy techniques as potential treatments for DOCK8 deficiency.

Hyper IgM Syndrome is a genetic disorder that occurs when there are abnormal levels of different types of antibodies (Ig) in the body.  Antibodies combat infections by attaching to germs and other foreign substances, marking them for destruction.  In infants with Hyper IgM Syndrome , there are normal or high levels of antibody IgM but low levels of antibodies IgG, IgA, and IgE.  The low level of these antibodies make it difficult to fight off infection, resulting in frequent pneumonia, sinus infections, ear infections, and parasitic infections.  Additionally, these infants have an increased risk of cancerous growths.

While X-Linked Hyper IgM Syndrome is caused by a mutation in the X gene, DOCK8 deficiency is caused by a mutation in the DOCK8 gene. More than 95% of patients with DOCK8 deficiency die by age 40.

To determine the best approach to treat DOCK8 deficiency, Dr. Kuo will compare a traditional gene therapy method with another gene therapy approach that uses CRISPR-Cas9, which work like scissors and can be directed to cut DNA at specific sites to disable, repair, or make other alterations to genes.

In a press release from UCLA, Dr. Kuo describes what inspired her to pursue this research.

“I wanted to research new treatment options for DOCK8 deficiency because I see how debilitating it can be for my patients. It’s already bad enough that my patients feel sick but then add to that visible skin infections on their hands and face that are difficult to treat, I think that’s the hardest part for a lot of the children I see. The prospect of developing a curative therapy for patients definitely brings a lot more meaning to the work.”

Unproven “stem cell” therapy injuries are more common than we realized

Jaime Imitola, senior author of the paper and director of the Comprehensive Multiple Sclerosis Center at UConn Health

Here at CIRM we only fund clinical trials that meet the rigorous standards outlined by the Food and Drug Administration (FDA). These requirements are not only necessary to properly evaluate how effective a potential treatment may be, but they are also important in fulfilling the Hippocratic Oath to “first, do no harm”.

The journey from the bench to the bedside for a potential treatment is one that is long, arduous, and often filled with setbacks. Unfortunately, there are those affected with various diseases that do not have the luxury of time. People who have suffered brain or spinal cord damage, or have been diagnosed with neurological disease, are often frustrated by the lack of treatments available to help them. That frustration can make them susceptible to the false promises made by predatory clinics, which operate outside of FDA oversight and offer “stem cell” treatments that are unproven and cost upwards of $50,000. In the midst of a global pandemic, some of these predatory clinics are even promoting false cures for COVID-19.

In an effort to better understand how often people gravitate to these predatory clinics, a phenomenon known as stem cell tourism, Dr. Jaime Imitola and a team of researchers at UConn Health conducted a nationwide survey of academic neurologists’ experiences in stem cell tourism complications. The study also evaluated the level of physician preparation to counsel and educate patients. These neurologists will typically have patients come to them asking for permission, a kind of “clearance” in their eyes, to get these unapproved stem cell treatments.

The results of the survey were very revealing. Of the neurologists who responded to the survey, one in four had a patient with complications related to stem cell therapy, which includes infections, strokes, spinal tumors, seizures, and even death. Additionally, 73% of neurologists responding to the survey said they felt that having more educational tools to discuss the issue with patients would be helpful.

In a press release, Dr. Imitola elaborated on the importance of this study.

“It is really shocking that only 28% of board-certified neurologists feel completely prepared to discuss this important issue with their patients…The ultimate goal of this research is to be able to determine the extent of the complications and the readiness of neurologists to counsel patients. All of us are interested in bringing real stem cells to the clinic, but this process is arduous and requires a great level of rigor and reproducibility.”

Dr. Imitola and his team also plan on starting a national patient registry, where physicians can report complications from stem cell tourism procedures. This would not only provide a better sense of the problem at hand, it would gather data that physicians could use to better educate patients.

The full results to this study were published in Annals of Neurology.

CIRM has produced a short video and other easy to digest information on questions people should ask before signing up for any clinical trial. You can find those resources here.

CIRM has also published findings in Stem Cells Translational Medicine that discuss the three R’s–regulated, reliable, and reputable–and how these can help protect patients with uniform standards for stem cell treatments .

CIRM Board Approves Two New Discovery Research Projects for COVID-19

Dr. Karen Christman (left) and Dr. Lili Yang (right)

This past Friday the governing Board of the California Institute for Regenerative Medicine (CIRM) approved two new discovery research project 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 17, including three clinical trials.

$249,974 was awarded to Dr. Karen Christman at UC San Diego to develop a treatment for Acute Respiratory Distress Syndrome (ARDS), a life-threatening lung injury that occurs when fluid leaks into the lungs and is prevalent in COVID-19 patients.  Dr. Christman and her team will develop extracellular matrix (ECM) hydrogels, a kind of structure that provides support to surrounding cells.  The goal is to develop a treatment that can be delivered directly to site of injury, where the ECM would recruit stem cells, treat lung inflammation, and promote lung healing.

$250,000 was awarded to Dr. Lili Yang at UCLA to develop a treatment for COVID-19.  Dr. Yang and her team will use blood stem cells to create invariant natural killer T (iNKT) cells, a powerful kind of immune cell with the potential to clear virus infection and mitigate harmful inflammation.  The goal is to develop these iNKT cells as an off the shelf therapy to treat patients with COVID-19.

These awards are 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 harmful lung inflammation caused by COVID-19 can be dangerous and life threatening,” says Maria T. Millan, M.D., the President and CEO of CIRM. “Early stage discovery projects like the ones approved today are vital in developing treatments for patients severely affected by the novel coronavirus.”

Earlier in the week the Board also approved changes to both DISC2 and clinical trial stage projects (CLIN2). These were in recognition of the Agency’s remaining budget and operational timeline and the need to launch the awards as quickly as possible.

For DISC2 awards the changes include:

  • Award limit of $250,000
  • Maximum award duration of 12 months
  • Initiate projects within 30 days of approval
  • All proposals must provide a statement describing how their overall study plan and design has considered the influence of race, ethnicity, sex and gender diversity.
  • All proposals should discuss the limitations, advantages, and/or challenges in developing a product or tools that addresses the unmet medical needs of California’s diverse population, including underserved communities.

Under the CLIN2 awards, to help projects carry out a clinical trial, the changes include:

  • Adjust award limit to the following:
Applicant typePhase 1, Phase 1/2, Feasability Award CapPhase 2 Award CapPhase 3 Award Cap
Non-profit$9M$11.25M$7.5M
For-profit$6M$11.25M$7.5M
  • Adjust the award duration to not exceed 3 years with award completion no later than November 2023
  • Initiate projects within 30 days of approval
  • All proposals must include a written plan in the application for outreach and study participation by underserved and disproportionately affected populations. Priority will be given to projects with the highest quality plans in this regard.

The changes outlined above for CLIN2 awards do not apply to sickle cell disease projects expected to be funded under the CIRM/NHLBI Cure Sickle Cell Disease joint Initiative.

Researchers 3D print a heart pump using stem cells

This image used on the cover of the American Heart Association’s Circulation Research journal is a 3D rendering of the printed heart pump developed at the University of Minnesota. The discovery could have major implications for studying heart disease. 
Credit: Kupfer, Lin, et al., University of Minnesota

According to the Centers for Disease Control and Prevention (CDC), heart disease is the leading cause of death for men, women, and people of most racial and ethnic groups in the United States. About 647,000 Americans die from heart disease each year, which is roughly one out of every four deaths total in the US.

In order to better study heart disease, Dr. Brenda Ogle and her team at the University of Minnesota have successfully 3D printed a functioning centimeter-scale human heart pump.

Previously, researchers have attempted to 3D print heart muscle cells within a 3D structure called an extracellular matrix. The heart muscle cells were made from induced pluripotent stem cells (iPSCs), a type of stem cell that can turn into virtually any kind of cell. Unfortunately, the cell density needed for the heart cells to function was never reached.

In this study. Dr. Ogle and her team made some slight changes to the process that had failed previously. First, they optimized a specialized ink made from extracellular matrix proteins. They then mixed the newly created ink with human iPSCs and used this new mixture to 3D print the chambered structure. The iPSCS were expanded to high cell densities in the structure first, and then were differentiated into heart muscle cells. The heart muscle model is about 1.5 centimeters long and was specifically designed to fit into the abdominal cavity of a mouse for future studies.

A video of this process can be seen below:

The team of researchers found that for the first time ever they could achieve the goal of high cell density to allow the cells to beat together, just like a human heart. Furthermore, this study shows how heart muscle cells can organize and work together. The iPSCs differentiating into heart muscle cells right next to each other is comparable to how stem cells grow in the body and then undergo specification to heart muscle cells.

A video of the heart pump contractions can be seen below as well:

In a press release from the University of Minnesota, Dr. Ogle elaborates on the implications of this study.

“We now have a model to track and trace what is happening at the cell and molecular level in pump structure that begins to approximate the human heart. We can introduce disease and damage into the model and then study the effects of medicines and other therapeutics.”

The full results of this study were published in Circulation Research.

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: