Stories that caught our eye: Spinal cord injury trial milestone, iPS for early cancer diagnosis, and storing videos in DNA

Spinal cord injury clinical trial hits another milestone (Kevin McCormack)
We began the week with good news about our CIRM-funded clinical trial with Asterias for spinal cord injury, and so it’s nice to end the week with more good news from that same trial. On Wednesday, Asterias announced it had completed enrolling and dosing patients in their AIS-B 10 million cell group.

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People with AIS-B spinal cord injuries have some level of sensation and feeling but very little, if any, movement below the site of injury site. So for example, spinal cord injuries at the neck, would lead to very limited movement in their arms and hands. As a result, they face a challenging life and may be dependent on help in performing most daily functions, from getting out of bed to eating.astopc1

In another branch of the Asterias trial, people with even more serious AIS-A injuries – in which no feeling or movement remains below the site of spinal cord injury – experienced improvements after being treated with Asterias’ AST-OPC1 stem cell therapy. In some cases the improvements were quite dramatic. We blogged about those here.

In a news release Dr. Ed Wirth, Asterias’ Chief Medical Officer, said they hope that the five people treated in the AIS-B portion of the trial will experience similar improvements as the AIS-A group.

“Completing enrollment and dosing of the first cohort of AIS-B patients marks another important milestone for our AST-OPC1 program. We have already reported meaningful improvements in arm, hand and finger function for AIS-A patients dosed with 10 million AST-OPC1 cells and we are looking forward to reporting initial efficacy and safety data for this cohort early in 2018.”

Asterias is already treating some AIS-A patients with 20 million cells and hopes to start enrolling AIS-B patients for the 20 million cell therapy later this summer.

Earlier diagnosis of pancreatic cancer using induced pluripotent stem cells Reprogramming adult cells to an embryonic stem cell-like state is as common in research laboratories as hammers and nails are on a construction site. But a research article in this week’s edition of Science Translational Medicine used this induced pluripotent stem cell (iPSC) toolbox in a way I had never read about before. And the results of the study may lead to earlier detection of pancreatic cancer, the fourth leading cause of cancer death in the U.S.

Zaret STM pancreatic cancer tissue July 17

A pancreatic ductal adenocarcinoma
Credit: The lab of Ken Zaret, Perelman School of Medicine, University of Pennsylvania

We’ve summarized countless iPSCs studies over the years. For example, skin or blood samples from people with Parkinson’s disease can be converted to iPSCs and then specialized into brain cells to provide a means to examine the disease in a lab dish. The starting material – the skin or blood sample – typically has no connection to the disease so for all intents and purposes, it’s a healthy cell. It’s only after specializing it into a nerve cell that the disease reveals itself.

But the current study by researchers at the University of Pennsylvania used late stage pancreatic cancer cells as their iPSC cell source. One of the reasons pancreatic cancer is thought to be so deadly is because it’s usually diagnosed very late when standard treatments are less effective. So, this team aimed to reprogram the cancer cells back into an earlier stage of the cancer to hopefully find proteins or molecules that could act as early warning signals, or biomarkers, of pancreatic cancer.

Their “early-stage-cancer-in-a-dish” model strategy was a success. The team identified a protein called thrombospodin-2 (THBS2) as a new candidate biomarker. As team lead, Dr. Ken Zaret, described in a press release, measuring blood levels of THBS2 along with a late-stage cancer biomarker called CA19-9 beat out current detection tests:

“Positive results for THBS2 or CA19-9 concentrations in the blood consistently and correctly identified all stages of the cancer. Notably, THBS2 concentrations combined with CA19-9 identified early stages better than any other known method.”

DNA: the ultimate film archive device?
This last story for the week isn’t directly related to stem cells but is too cool to ignore. For the first time ever, researchers at Harvard report in Nature that they have converted a video into a DNA sequence which was then inserted into bacteria. As Gina Kolata states in her New York Times article about the research, the study represents the ultimate data archive system which can “be retrieved at will and multiplied indefinitely as the host [bacteria] divides and grows.”

A video file is nothing but a collection of “1s” and “0s” of binary code which describe the makeup of each pixel in each frame of a movie. The researchers used the genetic code within DNA to describe each pixel in a short clip of one of the world’s first motion pictures: a galloping horse captured by Eadward Muybridge in 1878.

Horse_1080.gif

The resulting DNA sequence was then inserted into the chromosome of E.Coli., a common bacteria that lives in your intestines, using the CRISPR gene editing method. The video code was still retrievable after the bacteria was allowed to multiply.

The Harvard team envisions applications well beyond a mere biological hard drive. Dr. Seth Shipman, an author of the study, told Paul Rincon of BBC news that he thinks this cell system could be placed in various parts of the body to analyze cell function and “encode information about what’s going on in the cell and what’s going on in the cell environment by writing that information into their own genome”.

Perhaps then it could be used to monitor the real-time activity of stem cell therapies inside the body. For now, I’ll wait to hear about that in some upcoming science fiction film.

CIRM-funded stem cell clinical trial for spinal cord injury expands patient recruitment

asterias

It’s always great to start the week off with some good news. Today we learned that the Food and Drug Administration (FDA) has given Asterias Biotherapeutics approval to expand the number and type of people with spinal cord injuries that it treats in their CIRM-funded clinical trial.

Up till now, Asterias has been treating people who have injuries at the C5-C7 level, those are the lowest levels of the cervical spine, near the base of the neck. Now they will be able to treat people with injuries at the C4 level, that’s not only higher up the neck but it’s also the second most common form of spinal cord injury.

In a news release Dr. Ed Wirth, Asterias’ Chief Medical Officer, says this is a vote of confidence from the FDA in the company’s AST-OPC1 stem cell therapy:

“FDA’s decision to allow the company to enroll qualified patients with C-4 level injuries is the result of the data supporting the safety of both AST-OPC1 and the procedure to inject the cells and means that the second most common cervical spinal cord injury population can now be eligible to receive AST-OPC1. The overall changes to the study protocol will enhance our ability to enroll qualified patient candidates for our current SCiStar study and we also expect the changes to help enrollment rates in a future, larger clinical study.”

C4 image

Photo courtesy Shepherd Center, Atlanta

People who are injured at the C4 level are typically paralyzed from the neck down and need constant help, while people with C5-C7 injuries typically have some use of their hands and arms. Caring for someone with a C4 injury is expensive, with lifetime costs estimated around $5 million. Anything that could help people recover some movement would not only reduce those costs but would, more importantly, also increase the quality of life for people.

Asterias is not only expanding the patient population they are working with, they are also expanding the window for treating the injury. Currently patients have to be enrolled from 14 to 30 days post injury. In this new C4 group that window has been extended to 21 to 42 days post injury.

The reason for that change is that because C4 is higher up in the neck, newly injured people often need to be placed on a ventilator to help stabilize them. These patients take a little more time to recover from the initial trauma before they are ready to be treated.

We have blogged several times (here, here and here) about the encouraging news from the Asterias trial and how it appears to be helping people with injuries at the C5-C7 level recover some movement in their arms and hands. In some cases, such as with Kris Boesen for example, the improvement has been quite dramatic. Now the hope is that this new patient population will see similar benefits.

kris-boesen

Kris Boesen, CIRM spinal cord injury clinical trial patient.

The study is being conducted at six centers in the U.S., including some here in California,  and the company plans to increase this to up to 12 sites to accommodate the expanded patient enrollment.

Stories that caught our eye: An antibody that could make stem cell research safer; scientists prepare for clinical trial for Parkinson’s disease; and the stem cell scientist running for Congress

Antibody to make stem cells safer:

There is an old Chinese proverb that states: ‘What seems like a blessing could be a curse’. In some ways that proverb could apply to stem cells. For example, pluripotent stem cells have the extraordinary ability to turn into many other kinds of cells, giving researchers a tool to repair damaged organs and tissues. But that same ability to turn into other kinds of cells means that a pluripotent stem cell could also turn into a cancerous one, endangering someone’s life.

A*STAR

Researchers at the A*STAR Bioprocessing Technology Institute: Photo courtesy A*STAR

Now researchers at the Agency for Science, Technology and Research (A*STAR) in Singapore may have found a way to stop that happening.

When you change, or differentiate, stem cells into other kinds of cells there will always be some of the original material that didn’t make the transformation. Those cells could turn into tumors called teratomas. Scientists have long sought for a way to identify pluripotent cells that haven’t differentiated, without harming the ones that have.

The team at A*STAR injected mice with embryonic stem cells to generate antibodies. They then tested the ability of the different antibodies to destroy pluripotent stem cells. They found one, they called A1, that did just that; killing pluripotent cells but leaving other cells unharmed.

Further study showed that A1 worked by attaching itself to specific molecules that are only found on the surface of pluripotent cells.

In an article on Phys.Org Andre Choo, the leader of the team, says this gives them a tool to get rid of the undifferentiated cells that could potentially cause problems:

“That was quite exciting because it now gives us a view of the mechanism that is responsible for the cell-killing effect.”

Reviving hope for Parkinson’s patients:

In the 1980’s and 1990’s scientists transplanted fetal tissue into the brains of people with Parkinson’s disease. They hoped the cells in the tissue would replace the dopamine-producing cells destroyed by Parkinson’s, and stop the progression of the disease.

For some patients the transplants worked well. For some they produced unwanted side effects. But for most they had little discernible effect. The disappointing results pretty much brought the field to a halt for more than a decade.

But now researchers are getting ready to try again, and a news story on NPR explained why they think things could turn out differently this time.

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Viviane Tabar, MD; Photo courtesy Memorial Sloan Kettering Cancer Center

Viviane Tabar, a stem cell researcher at Memorial Sloan Kettering Cancer Center in New York, says in the past the transplanted tissue contained a mixture of cells:

“What you were placing in the patient was just a soup of brain. It did not have only the dopamine neurons, which exist in the tissue, but also several different types of cells.”

This time Tabar and her husband, Lorenz Studer, are using only cells that have been turned into the kind of cell destroyed by the disease. She says that will, hopefully, make all the difference:

“So you are confident that everything you are putting in the patient’s brain will consist of  the right type of cell.”

Tabar and Studer are now ready to apply to the Food and Drug Administration (FDA) for permission to try their approach out in a clinical trial. They hope that could start as early as next year.

Hans runs for Congress:

Keirstead

Hans Keirstead: Photo courtesy Orange County Register

Hans Keirstead is a name familiar to many in the stem cell field. Now it could become familiar to a lot of people in the political arena too, because Keirstead has announced he’s planning to run for Congress.

Keirstead is considered by some to be a pioneer in stem cell research. A CIRM grant helped him develop a treatment for spinal cord injury.  That work is now in a clinical trial being run by Asterias. We reported on encouraging results from that trial earlier this week.

Over the years the companies he has founded – focused on ovarian, skin and brain cancer – have made him millions of dollars.

Now he says it’s time to turn his sights to a different stage, Congress. Keirstead has announced he is going to challenge 18-term Orange County Republican Dana Rohrabacher.

In an article in the Los Angeles Times, Keirstead says his science and business acumen will prove important assets in his bid for the seat:

“I’ve come to realize more acutely than ever before the deficits in Congress and how my profile can actually benefit Congress. I’d like to do what I’m doing but on a larger stage — and I think Congress provides that, provides a forum for doing the greater good.”

Nine months in, stem cell-based therapy for spinal cord injury continues to improve paralyzed patients’ lives

If you’ve been following the Stem Cellar blog this year, then you must be as encouraged as we are with Asterias Biotherapeutics’ CIRM-funded clinical trial, which is testing an embryonic stem cell-based therapy for spinal cord injury.

astopc1Over many months, we’ve covered the company’s string of positive announcements that their cell therapy product – called AST-OPC1 – appears safe, is doing what is it’s supposed to after injection into the damaged spinal cord, and shows signs of restoring upper body function at 3 and 6 months after treatment. We’ve also written about first-hand accounts from some of the clinical trial participants who describe their remarkable recoveries.

That streak of good news continues today with Asterias’ early morning press release. The announcement summarizes 9-month results for a group of six patients who received an injection of 10 million AST-OPC1 cells 2 to 4 weeks after their injury (this particular trial is not testing the therapy on those with less recent injuries). In a nut shell, their improvements in arm, hand and finger movement seen at the earlier time points have persisted and even gotten better at 9 months.

Two motors levels = a higher quality of life
These participants sustained severe spinal cord injuries in the neck, leading to a loss of feeling and movement in their body from the neck down. To quantify the results of the cell therapy, researchers refer to “motor levels” of improvement. These levels correspond to an increasing number of motor, or movement, abilities. For a spinal cord injury victim paralyzed from the neck down, recovering two motor levels of function can mean the difference between needing 24-hour a day home care versus dressing, feeding and bathing themselves. The impact of this level of improvement cannot be overstated. As mentioned in the press release, regaining these abilities, “can result in lower healthcare costs, significant improvements in quality of life, increased ability to engage in activities of daily living, and increased independence.”

asterias9mo_results

9-month follow-up results of Asterias’ spinal cord injury trial. Patients treated with stem cell-based therapy (green line) have greater movement recovery compared to historical data from 62 untreated patients (Blue dotted line). Image: Asterias Biotherapeutics.

With the new 9-month follow-up data, the clinical researchers have confirmed that 3 out of the 6 (50%) patients show two motor levels of improvement. This result is up from 2 of 6 patients at the earlier time points. And all six patients have at least one motor level of improvement up through 9 months post-treatment. Now, make no mistake, spontaneous recovery from spinal cord injuries does occur. But historical data collected from 62 untreated patients show that only 29% reached two motor levels of improvement after 12-months.

As you can imagine, the Asterias team is optimistic about these latest results. Here’s what Chief Medical Officer, Dr. Edward Wirth had to say:

Edward-Wirth

Edward Wirth
Photo: Asterias

“The new efficacy results show that previously reported meaningful improvements in arm, hand and finger function in the 10 million cell cohort treated with AST-OPC1 cells have been maintained and in some patients have been further enhanced even 9 months following dosing. We are increasingly encouraged by these continued positive results, which are remarkable compared with spontaneous recovery rates observed in a closely matched untreated patient population.”

Equally encouraging is the therapy’s steady safety profile with no serious adverse events reported through the 9-month follow up.

Looking ahead
Dr. Jane Lebkowski, Asterias’ President of R&D and Chief Scientific Officer, will be presenting these data today during the International Society for Stem Cell Research (ISSCR) 2017 Annual Meeting held in Boston. Asterias expects to share more results later this fall after all six patients complete their 12-month follow-up visit.

The clinical trial is also treating another group of patients with a maximum dose of 20 million cells. The hope is that this cohort will show even more effectiveness.

For the sake of the more than 17,000 people who are incapacitated by a severe spinal cord injury each year, let’s hope the streak of good news continues.

“A limitless future”: young crash victim regains hand, finger movement after CIRM-funded trial

Back in March, we reported on Asterias Biotherapeutics’ exciting press release stating that its CIRM-funded stem cell-based therapy for spinal cord injury had shown improvement in six out of the six clinical trial patients receiving a ten million cell dose. What’s even more exciting is hearing stories about the positive impact of that data on specific people’s lives. People like Lucas Lindner of Eden, Wisconsin.

Lucas Lindner was left paralyzed below the chin after a truck accident last May. Photo: Fox6Now, Milwaukee

Just over a year ago, Lucas headed out in his truck on a Sunday morning to pick up some doughnuts for his grandmother. Along the way, he suddenly saw a deer in the road and, in swerving to avoid hitting the animal, Lucas’ truck flipped over. He was thrown through the window and suffered a severe spinal cord injury leaving him without the use of his arms and legs.

Linder was the 2nd person to receive a 10 million dose of Asterias’ CIRM-funded stem cell-based therapy for spinal cord injury. Video still: Fox6Now, Milwaukee

Earlier this month, Lucas was featured in a local Milwaukee TV news report that highlights his incredible recovery since participating in the Asterias trial shortly after his accident. Surgeons at Medical College of Wisconsin – one of the clinical trial sites – injected 10 million AST-OPC1 cells into the site of the spinal cord injury a few inches below his skull. The AST-OPC1 product contains oligodendrocyte progenitor cells, which when fully matured are thought to help restore nerve signaling in the frayed spinal cord nerve cells.

Lucas was just the second person nationally to receive the 10 million cell dose, and since that time, he’s regained movement in his arms, hands and fingers. This improvement may seem moderate to an outside observer, but for Lucas, it’s life changing because it gives him the independence to pursue his dreams of working in the IT and electronics fields:

“Now that I have near 100% full range on all of my fingers, that pretty much brings everything I ever wanted to do back. It lets you contribute to society. Words can’t express how amazing it feels…The future really is limitless,” he said during the TV new segment.

While regaining movement spontaneously without a stem cell treatment is not unheard of, the fact that all six of the trial participants receiving 10 million cells had improvements suggests the stem cell-based therapy is having a positive impact. We’re hopeful for further good news later this year when Asterias expects to provide more safety and efficacy data on participants given the 10 million cell dose as well as others who received the maximum 20 million cell dose.

Positively good news from Asterias for CIRM-funded stem cell clinical trial for spinal cord injury

AsteriasWhenever I give a talk on stem cells one of the questions I invariably get asked is “how do you know the cells are going where you want them to and doing what you want them to?”

The answer is pretty simple: you look. That’s what Asterias Biotherapeutics did in their clinical trial to treat people with spinal cord injuries. They used magnetic resonance imaging (MRI) scans to see what was happening at the injury site; and what they saw was very encouraging.

Asterias is transplanting what they call AST-OPC1 cells into patients who have suffered recent injuries that have left them paralyzed from the neck down.  AST-OPC1 are oligodendrocyte progenitor cells, which develop into cells that support and protect nerve cells in the central nervous system, the area damaged in spinal cord injury. It’s hoped the treatment will restore connections at the injury site, allowing patients to regain some movement and feeling.

Taking a closer look

Early results suggest the therapy is doing just that, and now follow-up studies, using MRIs, are adding weight to those findings.

The MRIs – taken six months after treatment – show that the five patients given a dose of 10 million AST-OPC1 cells had no evidence of lesion cavities in their spines. That’s important because often, after a spinal cord injury, the injury site expands and forms a cavity, caused by the death of nerve and support cells in the spine, that results in permanent loss of movement and function below the site, and additional neurological damage to the patient.

Another group of patients, treated in an earlier phase of the clinical trial, showed no signs of lesion cavities 12 months after their treatment.

Positively encouraging

In a news release, Dr. Edward Wirth, the Chief Medical Officer at Asterias, says this is very positive:

“These new follow-up results based on MRI scans are very encouraging, and strongly suggest that AST-OPC1 cells have engrafted in these patients post-implantation and have the potential to prevent lesion cavity formation, possibly reducing long-term spinal cord tissue deterioration after spinal cord injury.”

Because the safety data is also encouraging Asterias is now doubling the dose of cells that will be transplanted into patients to 20 million, in a separate arm of the trial. They are hopeful this dose will be even more effective in helping restore movement and function in patients.

We can’t wait to see what they find.

Scientists make stem cell-derived nerve cells damaged in spinal cord injury

The human spinal cord is an information highway that relays movement-related instructions from the brain to the rest of the body and sensory information from the body back to the brain. What keeps this highway flowing is a long tube of nerve cells and support cells bundled together within the spine.

When the spinal cord is injured, the nerve cells are damaged and can die – cutting off the flow of information to and from the brain. As a result, patients experience partial or complete paralysis and loss of sensation depending on the extent of their injury.

Unlike lizards which can grow back lost tails, the spinal cord cannot robustly regenerate damaged nerve cells and recreate lost connections. Because of this, scientists are looking to stem cells for potential solutions that can rebuild injured spines.

Making spinal nerve cells from stem cells

Yesterday, scientists from the Gladstone Institutes reported that they used human pluripotent stem cells to create a type of nerve cell that’s damaged in spinal cord injury. Their findings offer a new potential stem cell-based strategy for restoring movement in patients with spinal cord injury. The study was led by Gladstone Senior Investigator Dr. Todd McDevitt, a CIRM Research Leadership awardee, and was published in the journal Proceedings of the National Academy of Sciences.

The type of nerve cell they generated is called a spinal interneuron. These are specialized nerve cells in the spinal cord that act as middlemen – transporting signals between sensory neurons that connect to the brain to the movement-related, or motor, neurons that connect to muscles. Different types of interneurons exist in the brain and spinal cord, but the Gladstone team specifically created V2a interneurons, which are important for controlling movement.

V2a interneurons extend long distances in the spinal cord. Injuries to the spine can damage these important cells, severing the connection between the brain and the body. In a Gladstone news release, Todd McDevitt explained why his lab is particularly interested in making these cells to treat spinal cord injury.

Todd McDevitt, Gladstone Institutes

“Interneurons can reroute after spinal cord injuries, which makes them a promising therapeutic target. Our goal is to rewire the impaired circuitry by replacing damaged interneurons to create new pathways for signal transmission around the site of the injury.”

 

Transplanting nerve cells into the spines of mice

After creating V2a interneurons from human stem cells using a cocktail of chemicals in the lab, the team tested whether these interneurons could be successfully transplanted into the spinal cords of normal mice. Not only did the interneurons survive, they also set up shop by making connections with other nerve cells in the spinal cord. The mice that received the transplanted cells didn’t show differences in their movement suggesting that the transplanted cells don’t cause abnormalities in motor function.

Co-author on the paper, Dylan McCreedy, described how the transplanted stem cell-derived cells behaved like developing V2a interneurons in the spine.

“We were very encouraged to see that the transplanted cells sprouted long distances in both directions—a key characteristic of V2a interneurons—and that they started to connect with the relevant host neurons.”

Todd McDevitt (right), Jessica Butts (center) and Dylan McCreedy (left) created a special type of neuron from human stem cells that could potentially repair spinal cord injuries. (Photo: Chris Goodfellow, Gladstone)

A new clinical strategy?

Looking forward, the Gladstone team plans to test whether these V2a interneurons can improve movement in mice with spinal cord injury. If results look promising in mice, this strategy of transplanting V2a interneurons could be translated into human clinic trials although much more time and research are needed to get there.

Trials testing stem cell-based treatments for spinal cord injury are already ongoing. Many of them involve transplanting progenitor cells that develop into the different types of cells in the spine, including nerve and support cells. These progenitor cells are also thought to secrete important growth factors that help regenerate damaged tissue in the spine.

CIRM is funding one such clinical trial sponsored by Asterias Biotherapeutics. The company is transplanting oligodendrocyte progenitor cells (which make nerve support cells called oligodendrocytes) into patients with severe spinal cord injuries in their neck. The trial has reported encouraging preliminary results in all six patients that received a dose of 10 million cells. You can read more about this trial here.

What the Gladstone study offers is a different stem cell-based strategy for treating spinal cord injury – one that produces a specific type of spinal nerve cell that can reestablish important connections in the spinal cord essential for movement.

For more on this study, watch the Gladstone’s video abstract “Discovery Offers New Hope to Repair Spinal Cord.


Related Links:

Stem cell stories that caught our eye: spinal cord injury trial update, blood stem cells in lungs, and using parsley for stem cell therapies

More good news on a CIRM-funded trial for spinal cord injury. The results are now in for Asterias Biotherapeutics’ Phase 1/2a clinical trial testing a stem cell-based therapy for patients with spinal cord injury. They reported earlier this week that six out of six patients treated with 10 million AST-OPC1 cells, which are a type of brain cell called oligodendrocyte progenitor cells, showed improvements in their motor function. Previously, they had announced that five of the six patients had shown improvement with the jury still out on the sixth because that patient was treated later in the trial.

 In a news release, Dr. Edward Wirth, the Chief Medical officer at Asterias, highlighted these new and exciting results:

 “We are excited to see the sixth and final patient in the AIS-A 10 million cell cohort show upper extremity motor function improvement at 3 months and further improvement at 6 months, especially because this particular patient’s hand and arm function had actually been deteriorating prior to receiving treatment with AST-OPC1. We are very encouraged by the meaningful improvements in the use of arms and hands seen in the SciStar study to date since such gains can increase a patient’s ability to function independently following complete cervical spinal cord injuries.”

Overall, the trial suggests that AST-OPC1 treatment has the potential to improve motor function in patients with severe spinal cord injury. So far, the therapy has proven to be safe and likely effective in improving some motor function in patients although control studies will be needed to confirm that the cells are responsible for this improvement. Asterias plans to test a higher dose of 20 million cells in AIS-A patients later this year and test the 10 million cell dose in AIS-B patients that a less severe form of spinal cord injury.

 Steve Cartt, CEO of Asterias commented on their future plans:

 “These results are quite encouraging, and suggest that there are meaningful improvements in the recovery of functional ability in patients treated with the 10 million cell dose of AST-OPC1 versus spontaneous recovery rates observed in a closely matched untreated patient population. We look forward to reporting additional efficacy and safety data for this cohort, as well as for the currently-enrolling AIS-A 20 million cell and AIS-B 10 million cell cohorts, later this year.”

Lungs aren’t just for respiration. Biology textbooks may be in need of some serious rewrites based on a UCSF study published this week in Nature. The research suggests that the lungs are a major source of blood stem cells and platelet production. The long prevailing view has been that the bone marrow was primarily responsible for those functions.

The new discovery was made possible by using special microscopy that allowed the scientists to view the activity of individual cells within the blood vessels of a living mouse lung (watch the fascinating UCSF video below). The mice used in the experiments were genetically engineered so that their platelet-producing cells glowed green under the microscope. Platelets – cell fragments that clump up and stop bleeding – were known to be produced to some extent by the lungs but the UCSF team was shocked by their observations: the lungs accounted for half of all platelet production in these mice.

Follow up experiments examined the movement of blood cells between the lung and bone marrow. In one experiment, the researchers transplanted healthy lungs from the green-glowing mice into a mouse strain that lacked adequate blood stem cell production in the bone marrow. After the transplant, microscopy showed that the green fluorescent cells from the donor lung traveled to the host’s bone marrow and gave rise to platelets and several other cells of the immune system. Senior author Mark Looney talked about the novelty of these results in a university press release:

Mark Looney, MD

“To our knowledge this is the first description of blood progenitors resident in the lung, and it raises a lot of questions with clinical relevance for the millions of people who suffer from thrombocytopenia [low platelet count].”

If this newfound role of the lung is shown to exist in humans, it may provide new therapeutic approaches to restoring platelet and blood stem cell production seen in various diseases. And it will give lung transplants surgeons pause to consider what effects immune cells inside the donor lung might have on organ rejection.

Add a little vanilla to this stem cell therapy. Typically, the only connection between plants and stem cell clinical trials are the flowers that are given to the patient by friends and family. But research published this week in the Advanced Healthcare Materials journal aims to use plant husks as part of the cell therapy itself.

Though we tend to focus on the poking and prodding of stem cells when discussing the development of new therapies, an equally important consideration is the use of three-dimensional scaffolds. Stem cells tend to grow better and stay healthier when grown on these structures compared to the flat two-dimensional surface of a petri dish. Various methods of building scaffolds are under development such as 3D printing and designing molds using materials that aren’t harmful to human tissue.

Human fibroblast cells growing on decellularized parsley.
Image: Gianluca Fontana/UW-Madison

But in the current study, scientists at the University of Wisconsin-Madison took a creative approach to building scaffolds: they used the husks of parsley, vanilla and orchid plants. The researchers figured that millions of years of evolution almost always leads to form and function that is much more stable and efficient than anything humans can create. Lead author Gianluca Fontana explained in a university press release how the characteristics of plants lend themselves well to this type of bioengineering:

Gianluca Fontana, PhD

“Nature provides us with a tremendous reservoir of structures in plants. You can pick the structure you want.”

The technique relies on removing all the cells of the plant, leaving behind its outer layer which is mostly made of cellulose, long chains of sugars that make up plant cell walls. The resulting hollow, tubular husks have similar shapes to those found in human intestines, lungs and the bladder.

The researchers showed that human stem cells not only attach and grow onto the plant scaffolds but also organize themselves in alignment with the structures’ patterns. The function of human tissues rely on an organized arrangement of cells so it’s possible these plant scaffolds could be part of a tissue replacement cell product. Senior author William Murphy also points out that the scaffolds are easily altered:

William Murphy, PhD

“They are quite pliable. They can be easily cut, fashioned, rolled or stacked to form a range of different sizes and shapes.”

And the fact these scaffolds are natural products that are cheap to manufacture makes this a project well worth watching.

Stem cell heroes: patients who had life-saving, life-changing treatments inspire CIRM Board

 

It’s not an easy thing to bring an entire Board of Directors to tears, but four extraordinary people and their families managed to do just that at the last CIRM Board meeting of 2016.

The four are patients who have undergone life-saving or life-changing stem cell therapies that were funded by our agency. The patients and their families shared their stories with the Board as part of CIRM President & CEO Randy Mill’s preview of our Annual Report, a look back at our achievements over the last year.

The four included:

jake_javier_stories_of_hope

Jake Javier, whose life changed in a heartbeat the day before he graduated high school, when he dove into a swimming pool and suffered a spinal cord injury that left him paralyzed from the chest down. A stem cell transplant is giving him hope he may regain the use of his arms and hands.

 

 

karl

Karl Trede who had just recovered from one life-threatening disease when he was diagnosed with lung cancer, and became the first person ever treated with a new anti-tumor therapy that helped hold the disease at bay.

 

brenden_stories_of_hopeBrenden Whittaker, born with a rare immune disorder that left his body unable to fight off bacterial or fungal infections. Repeated infections cost Brenden part of his lung and liver and almost killed him. A stem cell treatment that gave him a healthy immune system cured him.

 

 

evangelinaEvangelina Padilla Vaccaro was born with severe combined immunodeficiency (SCID), also known as “bubbly baby” disease, which left her unable to fight off infections. Her future looked grim until she got a stem cell transplant that gave her a new blood system and a healthy immune system. Today, she is cured.

 

 

Normally CIRM Board meetings are filled with important, albeit often dry, matters such as approving new intellectual property regulations or a new research concept plan. But it’s one thing to vote to approve a clinical trial, and a very different thing to see the people whose lives you have helped change by funding that trial.

You cannot help but be deeply moved when you hear a mother share her biggest fear that her daughter would never live long enough to go to kindergarten and is now delighted to see her lead a normal life; or hear a young man who wondered if he would make it to his 24th birthday now planning to go to college to be a doctor

When you know you played a role in making these dreams happen, it’s impossible not to be inspired, and doubly determined to do everything possible to ensure many others like them have a similar chance at life.

You can read more about these four patients in our new Stories of Hope: The CIRM Stem Cell Four feature on the CIRM website. Additionally, here is a video of those four extraordinary people and their families telling their stories:

We will have more extraordinary stories to share with you when we publish our Annual Report on January 1st. 2016 was a big year for CIRM. We are determined to make 2017 even bigger.

First spinal cord injury trial patient gets maximum stem cell dose

kris-boesen

Kris Boesen, CIRM spinal cord injury clinical trial patient.

There comes a pivotal point in every experiment where you say “ok, now we are going to see if this really works.” We may be at that point in the clinical trial we are funding to see if stem cells can help people with spinal cord injuries.

Today Asterias Biotherapeutics announced they have given the first patient in the clinical trial the highest dose of 20 million cells. The therapy was administered at Santa Clara Valley Medical Center (SCVMC) in San Jose, California where Jake Javier – a young man who was treated at an earlier stage of the trial – was treated. You can read Jake’s story here.

The goal of the trial is to test the safety of transplanting three escalating doses of AST-OPC1 cells. These are a form of cell called oligodendrocyte progenitors, which are capable of becoming several different kinds of nerve cells, some of which play a supporting role and help protect nerve cells in the central nervous system – the area damaged in spinal cord injury.

In a news release, Dr. Edward Wirth, Asterias’ Chief Medical Officer, says this could be a crucial phase in the trial:

“We have been very encouraged by the early clinical efficacy and safety data for AST-OPC1, and we now look forward to evaluating the 20 million cell dose in complete cervical spinal cord injury patients. Based on extensive pre-clinical research, this is in the dosing range where we would expect to see optimal clinical improvement in these patients.”

To be eligible, individuals have to have experienced a severe neck injury in the last 30 days, one that has left them with no sensation or movement below the level of their injury, and that means they have typically lost all lower limb function and most hand and arm function.

In the first phase individuals were given 2 million cells. This was primarily to make sure that this approach was safe and wouldn’t cause any problems for the patients. The second phase boosted that dose to ten million cells. That was thought to be about half the therapeutic dose but it seemed to help all those enrolled. By 90 days after the transplant all five patients treated with ten million cells had shown some level of recovery of at least one motor level, meaning they had regained some use of their arms and/or hands on at least one side of their body. Two of the patients experienced an improvement of two motor levels. Perhaps the most impressive was Kris Boesen, who regained movement and strength in both his arms and hands. He says he is even experiencing some movement in his legs.

All this is, of course, tremendously encouraging, but we also have to sound a note of caution. Sometimes individuals experience spontaneous recovery after an accident like this. The fact that all five patients in the 10 million cell group did well suggests that this may be more than just a coincidence. That’s why this next group, the 20 million cell cohort, is so important.

As Steve McKenna, Chief of the Trauma Center at SCVMC, says; if we are truly going to see an improvement in people’s condition because of the stem cell transplant, this is when we would expect to see it:

“The early efficacy results presented in September from the 10 million cell AIS-A cohort were quite encouraging, and we’re looking forward to seeing if those meaningful functional improvements are maintained through six months and beyond. We are also looking forward to seeing the results in patients from the higher 20 million cell AST-OPC1 dose, as well as results in the first AIS-B patients.”

For more information about the Asterias clinical trial, including locations and eligibility requirements, go here: www.clinicaltrials.gov, using Identifier NCT02302157, and at the SCiStar Study Website (www.SCiStar-study.com).

We can never talk about this clinical trial without paying tribute to a tremendous patient advocate and a great champion of stem cell research, Roman Reed. He’s the driving force behind the Roman Reed Spinal Cord Injury Research Act  which helped fund the pioneering research of Dr. Hans Keirstead that laid the groundwork for this clinical trial.