Curing the Incurable through Definitive Medicine

“Curing the Incurable”. That was the theme for the first annual Center for Definitive and Curative Medicine (CDCM) Symposium held last week at Stanford University, in Palo Alto, California.

The CDCM is a joint initiative amongst Stanford Healthcare, Stanford Children’s Health and the Stanford School of Medicine. Its mission is to foster an environment that accelerates the development and translation of cell and gene therapies into clinical trials.

The research symposium focused on “the exciting first-in-human cell and gene therapies currently under development at Stanford in bone marrow, skin, cardiac, neural, pancreatic and neoplastic diseases.” These talks were organized into four different sessions: cell therapies for neurological disorders, stem cell-derived tissue replacement therapies, genome-edited cell therapies and anti-cancer cell-based therapies.

A few of the symposium speakers are CIRM-funded grantees, and we’ll briefly touch on their talks below.

Targeting cancer

The keynote speaker was Irv Weissman, who talked about hematopoietic or blood-forming stem cells and their value as a cell therapy for patients with blood disorders and cancer. One of the projects he discussed is a molecule called CD47 that is found on the surface of cancer cells. He explained that CD47 appears on all types of cancer cells more abundantly than on normal cells and is a promising therapeutic target for cancer.

Irv Weissman

Irv Weissman

“CD47 is the first gene whose overexpression is common to all cancer. We know it’s molecular mechanism from which we can develop targeted therapies. This would be impossible without collaborations between clinicians and scientists.”

 

At the end of his talk, Weissman acknowledged the importance of CIRM’s funding for advancing an antibody therapeutic targeting CD47 into a clinical trial for solid cancer tumors. He said CIRM’s existence is essential because it “funds [stem cell-based] research through the [financial] valley of death.” He further explained that CIRM is the only funding entity that takes basic stem cell research all the way through the clinical pipeline into a therapy.

Improving bone marrow transplants

judith shizuru

Judith Shizuru

Next, we heard a talk from Judith Shizuru on ways to improve current bone-marrow transplantation techniques. She explained how this form of stem cell transplant is “the most powerful form of cell therapy out there, for cancers or deficiencies in blood formation.” Inducing immune system tolerance, improving organ transplant outcomes in patients, and treating autoimmune diseases are all applications of bone marrow transplants. But this technique also carries with it toxic and potentially deadly side effects, including weakening of the immune system and graft vs host disease.

Shizuru talked about her team’s goal of improving the engraftment, or survival and integration, of bone marrow stem cells after transplantation. They are using an antibody against a molecule called CD117 which sits on the surface of blood stem cells and acts as an elimination signal. By blocking CD117 with an antibody, they improved the engraftment of bone marrow stem cells in mice and also removed the need for chemotherapy treatment, which is used to kill off bone marrow stem cells in the host. Shizuru is now testing her antibody therapy in a CIRM-funded clinical trial in humans and mentioned that this therapy has the potential to treat a wide variety of diseases such as sickle cell anemia, leukemias, and multiple sclerosis.

Tackling stroke and heart disease

img_1327We also heard from two CIRM-funded professors working on cell-based therapies for stroke and heart disease. Gary Steinberg’s team is using human neural progenitor cells, which develop into cells of the brain and spinal cord, to treat patients who’ve suffered from stroke. A stroke cuts off the blood supply to the brain, causing the death of brain cells and consequently the loss of function of different parts of the body.  He showed emotional videos of stroke patients whose function and speech dramatically improved following the stem cell transplant. One of these patients was Sonia Olea, a young woman in her 30’s who lost the ability to use most of her right side following her stroke. You can read about her inspiring recover post stem cell transplant in our Stories of Hope.

Dr. Joe Wu. (Image Source: Sean Culligan/OZY)

Dr. Joe Wu. (Image Source: Sean Culligan/OZY)

Joe Wu followed with a talk on adult stem cell therapies for heart disease. His work, which is funded by a CIRM disease team grant, involves making heart cells called cardiomyocytes from human embryonic stem cells and transplanting these cells into patient with end stage heart failure to improve heart function. His team’s work has advanced to the point where Wu said they are planning to file for an investigational new drug (IND) application with the US Food and Drug Administration (FDA) in six months. This is the crucial next step before a treatment can be tested in clinical trials. Joe ended his talk by making an important statement about expectations on how long it will take before stem cell treatments are available to patients.

He said, “Time changes everything. It [stem cell research] takes time. There is a lot of promise for the future of stem cell therapy.”

Avalanches of exciting new stem cell research at the Keystone Symposia near Lake Tahoe

From January 8th to 13th, nearly 300 scientists and trainees from around the world ascended the mountains near Lake Tahoe to attend the joint Keystone Symposia on Neurogenesis and Stem Cells at the Resort at Squaw Creek. With record-high snowfall in the area (almost five feet!), attendees had to stay inside to stay warm and dry, and even when we lost power on the third day on the mountain there was no shortage of great science to keep us entertained.

Boy did it snow at the Keystone Conference in Tahoe!

Boy did it snow at the Keystone Conference in Tahoe!

One of the great sessions at the meeting was a workshop chaired by CIRM’s Senior Science Officer, Dr. Kent Fitzgerald, called, “Bridging and Understanding of Basic Science to Enable/Predict Clinical Outcome.” This workshop featured updates from the scientists in charge of three labs currently conducting clinical trials funded and supported by CIRM.

Regenerating injured connections in the spinal cord with neural stem cells

Mark Tuszynski, UCSD

Mark Tuszynski, UCSD

The first was a stunning talk by Dr. Mark from UCSD who is investigating how neural stem cells can help outcomes for those with spinal cord injury. The spinal cord contains nerves that connect your brain to the rest of your body so you can sense and move around in your environment, but in cases of severe injury, these connections are cut and the signal is lost. The most severe of these injuries is a complete transection, which is when all connections have been cut at a given spot, meaning no signal can pass through, just like how no cars could get through if a section of the Golden Gate Bridge was missing. His lab works in animal models of complete spinal cord transections since it is the most challenging to repair.

As Dr. Tuszynski put it, “the adult central nervous system does not spontaneously regenerate [after injury], which is surprising given that it does have its own set of stem cells present throughout.” Their approach to tackle this problem is to put in new stem cells with special growth factors and supportive components to let this process occur.

Just as most patients wouldn’t be able to come in for treatment right away after injury, they don’t start their tests until two weeks after the injury. After that, they inject neural stem cells from either the mouse, rat, or human spinal cord at the injury site and then wait a bit to see if any new connections form. Their group has shown very dramatic increases in both the number of new connections that regenerate from the injury site and extend much further than previous efforts have shown. These connections conduct electrochemical messages as normal neurons do, and over a year later they see no functional decline or tumors forming, which is often a concern when transplanting stem cells that normally like to divide a lot.

While very exciting, he cautions, “this research shows a major opportunity in neural repair that deserves proper study and the best clinical chance to succeed”. He says it requires thorough testing in multiple animal models before going into humans to avoid a case where “a clinical trial fails, not because the biology is wrong, but because the methods need tweaking.”

Everyone needs support – even dying cells

The second great talk was by Dr. Clive Svendsen of Cedars-Sinai Regenerative Medicine Institute on how stem cells might help provide healthy support cells to rescue dying neurons in the brains of patients with neurodegenerative diseases like Amyotrophic Lateral Sclerosis (ALS) and Parkinson’s. Some ALS cases are hereditary and would be candidates for a treatment using gene editing techniques. However, around 90 percent of ALS cases are “sporadic” meaning there is no known genetic cause. Dr. Svendsen explained how in these cases, a stem cell-based approach to at least fix the cellular cause of the disease, would be the best option.

While neurons often capture all the attention in the brain, since they are the cells that actually send messages that underlie our thoughts and behaviors, the Svendsen lab spends a great deal of time thinking about another type of cell that they think will be a powerhouse in the clinic: astrocytes. Astrocytes are often labeled as the support cells of the brain as they are crucial for maintaining a balance of chemicals to keep neurons healthy and functioning. So Dr. Svendsen reasoned that perhaps astrocytes might unlock a new route to treating neurodegenerative diseases where neurons are unhealthy and losing function.

ALS is a devastating disease that starts with early muscle twitches and leads to complete paralysis and death usually within four years, due to the rapid degeneration of motor neurons that are important for movement all over the body. Svendsen’s team found that by getting astrocytes to secrete a special growth factor, called “GDNF”, they could improve the survival of the neurons that normally die in their model of ALS by five to six times.

After testing this out in several animal models, the first FDA-approved trial to test whether astrocytes from fetal tissue can slow spinal motor neuron loss will begin next month! They will be injecting the precursor cells that can make these GDNF-releasing astrocytes into one leg of ALS patients. That way they can compare leg function and track whether the cells and GDNF are enough to slow the disease progression.

Dr. Svendsen shared with us how long it takes to create and test a treatment that is committed to safety and success for its patients. He says,

Clive Svendsen has been on a 15-year quest to develop an ALS therapy

Clive Svendsen 

“We filed in March 2016, submitted the improvements Oct 2016, and we’re starting our first patient in Feb 2017. [One document is over] 4500 pages… to go to the clinic is a lot of work. Without CIRM’s funding and support we wouldn’t have been able to do this. This isn’t easy. But it is doable!”

 

Improving outcomes in long-term stroke patients in unknown ways

Gary Steinberg

Gary Steinberg

The last speaker for the workshop, Dr. Gary Steinberg, a neurosurgeon at Stanford who is looking to change the lives of patients with severe limitations after having a stroke. The deficits seen after a stroke are thought to be caused by the death of neurons around the area where the stroke occurred, such that whatever functions they were involved with is now impaired. Outcomes can vary for stroke patients depending on how long it takes for them to get to the emergency department, and some people think that there might be a sweet spot for when to start rehabilitative treatments — too late and you might never see dramatic recovery.

But Dr. Steinberg has some evidence that might make those people change their mind. He thinks, “these circuits are not irreversibly damaged. We thought they were but they aren’t… we just need to continue figuring out how to resurrect them.”

He showed stunning videos from his Phase 1/2a clinical trial of several patients who had suffered from a stroke years before walking into his clinic. He tested patients before treatment and showed us videos of their difficulty to perform very basic movements like touching their nose or raising their legs. After carefully injecting into the brain some stem cells taken from donors and then modified to boost their ability to repair damage, he saw a dramatic recovery in some patients as quickly as one day later. A patient who couldn’t lift her leg was holding it up for five whole seconds. She could also touch her arm to her nose, whereas before all she could do was wiggle her thumb. One year later she is even walking, albeit slowly.

He shared another case of a 39 year-old patient who suffered a stroke didn’t want to get married because she felt she’d be embarrassed walking down the aisle, not to mention she couldn’t move her arm. After Dr. Steinberg’s trial, she was able to raise her arm above her head and walk more smoothly, and now, four years later, she is married and recently gave birth to a boy.

But while these studies are incredibly promising, especially for any stroke victims, Dr. Steinberg himself still is not sure exactly how this stem cell treatment works, and the dramatic improvements are not always consistent. He will be continuing his clinical trial to try to better understand what is going on in the injured and recovering brain so he can deliver better care to more patients in the future.

The road to safe and effective therapies using stem cells is long but promising

These were just three of many excellent presentations at the conference, and while these talks involved moving science into human patients for clinical trials, the work described truly stands on the shoulders of all the other research shared at conferences, both present and past. In fact, the reason why scientists gather at conferences is to give one another feedback and to learn from each other to better their own work.

Some of the other exciting talks that are surely laying down the framework for future clinical trials involved research on modeling mini-brains in a dish (so-called cerebral organoids). Researchers like Jürgen Knoblich at the Institute of Molecular Biotechnology in Austria talked about the new ways we can engineer these mini-brains to be more consistent and representative of the real brain. We also heard from really fundamental biology studies trying to understand how one type of cell becomes one vs. another type using the model organism C. elegans (a microscopic, transparent worm) by Dr. Oliver Hobert of Columbia University. Dr. Austin Smith, from the University of Cambridge in the UK, shared the latest about the biology of pluripotent cells that can make any cell type, and Stanford’s Dr. Marius Wernig, one of the meeting’s organizers, told us more of what he’s learned about the road to reprogramming an ordinary skin cell directly into a neuron.

Stay up to date with the latest research on stem cells by continuing to follow this blog and if you’re reading this because you’re considering a stem cell treatment, make sure you find out what’s possible and learn about what to ask by checking out closerlookatstemcells.org.


Samantha Yammine

Samantha Yammine

Samantha Yammine is a science communicator and a PhD candidate in Dr. Derek van der Kooy’s lab at the University of Toronto. You can learn more about Sam and her research on her website.

Stem cell and gene therapy research gets a good report card from industry leader

arm

Panel discussion at ARM State of the industry briefing: left to Right Robert Preti, Chair ARM; Jeff Walsh, bluebird bio; Manfred Rudiger, Kiadis Pharma; Barbara Sasu, Pfizer;  Thomas Farrell, Bellicum Pharmaceuticals. Photo courtesy ARM.

The state of the regenerative medicine field is strong and getting stronger. That was the bottom line verdict at the 2017 Cell and Gene Therapies State of the Industry briefing in San Francisco.

The briefing, an annual update on the field presented by the Alliance for Regenerative Medicine (ARM), gave a “by the numbers” look at the field and apart from one negative spot everything is moving in the right direction.

Robert Preti, Chair of ARM’s Board, said worldwide there are more than 750 regenerative companies working in the stem cell and gene therapy space. And those companies are increasingly moving the research out of the lab and into clinical trials in people.

For example, at the end of 2016 there were 802 clinical trials underway. That is a 21 percent growth over 2015. Those breakdown as follows:

Phase 1 – 271 (compared to 192 in 2015)

Phase 2 – 465 (compared to 376 in 2015)

Phase 3 – 66 (compared to 63 in 2015)

The bulk of these clinical trials, 45 percent, are focused on cancer. The second largest target, 11 percent, is on heart disease. The number of trials for neurological disorders and rare diseases are also growing in number.

Preti says the industry is at an important inflection point right now and that this growth is presenting new problems:

“The pipeline of products is robust and the technologies supporting that pipeline is even more robust. The technologies that are fueling the growth in clinical activity have accelerated so fast that we on the manufacturing side are playing catchup. We are at a point where we have to get serious about large scale commercial production.”

Preti also talked about “harmonization” of the regulatory process and the need to have a system that makes it easier for products approved for clinical trials in one country, to get approval for clinical trials in other countries.

Michael Werner, the executive director of ARM, said the organization has played a key role in helping promote the field and cited the recently passed 21st Century Cures Act as “a major win and a powerful statement of ARM’s leadership in this sector.”

But there was one area where the news wasn’t all positive, the ability of companies to raise capital. In 2015 companies raised $11 billion for research. In 2016 it was less than half of that, $5.3 billion.

With that somber note in mind it was appropriate that the panel discussion that followed the briefing was focused on the near-term and long-term challenges facing the field if it was to be commercially successful.

One of the big challenges was the issue of regulatory approval, and here the panel seemed to be more optimistic than in previous years.

Manfred Rüdiger of Kiadis Pharma said he was pleasantly surprised at how easy it was to work with different regulatory agencies in the US, Canada and Europe.

“We used them as a kind of free consultancy service, listening to their advice and making the changes they suggested so that we were able to use the same manufacturing process in Europe and Canada and the US.”

Jeff Walsh of bluebird bio, said the key to having a good working relationship with regulatory agencies like the Food and Drug Administration (FDA) is simple:

“Trust and transparency between you and the regulatory agencies is essential, it’s a critical factor in advancing your work. The agencies respond well when you have that trust. One thing we can’t be is afraid to ask. The agencies will tell you where their line is, but don’t be afraid to ask or to push the boundaries. This is new for everyone, companies and regulators, so if you are pushing it helps create the environment that allows you to work together to develop safe therapies that benefit patients.”

Another big issue was scalability in manufacturing; that it’s one thing to produce enough of a product to carry out a clinical trial but completely different if you are hoping to use that same product to treat millions of people spread out all over the US or the world.

And of course cost is always something that is front and center in people’s minds. How do you develop therapies that are not just safe and effective, but also affordable? How do companies ensure they will get reimbursed by health insurers for the treatments? No one had any simple answer to what are clearly very complex problems. But all recognized the need to start thinking about these now, long before the treatments themselves are even ready.

Walsh ended by saying:

“This is not just about what can you charge but what should you charge. We have a responsibility to engage with the agencies and ultimately the payers that make these decisions, in the same way we engage with regulatory agencies; with a sense of openness, trust and transparency. Too often companies wait too long, too late before turning to the payers and trying to decide what is appropriate to charge.”

 

 

Your Guide to Awesome Stem Cell Conferences in 2017

Welcome to 2017, a year that will likely be full of change and new surprises. I’m hoping that some of these surprises will be in regenerative medicine with new stem cell therapies showing promise or effectiveness in clinical trials.

A great way to stay on top of new advances in stem cell research is to attend scientific conferences and meetings. Some of them are well known and highly attended like the International Society for Stem Cell Research (ISSCR) conference, which this year will be in Boston in June. There are also a few smaller, more intimate conferences focusing on specific topics from discovery research to clinical therapies.

There are loads of stem cell meetings this year, but a few that I would like to highlight. Here’s my abbreviated stem cell research conference and meeting guide for 2017. Some are heavy duty research-focused events and probably not suitable for someone without a science background; they’re also expensive to sign up for. I’ve marked those with an * asterix.


January 8-12th, Keystone Symposium (Fee to register)*

Keystone will be hosting two concurrent stem cell meetings in Tahoe next week, which are geared for researchers in the field. One will be on neurogenesis during development and in the adult brain and the other will be on transcriptional and epigenetic control in stem cells. CIRM is one of the co-funders of this meeting and will be hosting a panel focused on translating basic research into clinical trials. Keystone symposiums are small, intimate meetings rich with scientific content and great for networking. Be on the look out for blog coverage about this meeting in the coming weeks.


February 3rd, Stanford Center for Definitive and Curative Medicine Symposium (Free to the public)

This free symposium at Stanford University in Palo Alto, CA will present first-in-human cell and gene therapies for a number of disorders including bone marrow, skin, cardiac, neural, uterine, pancreatic and neoplastic disorders. Speakers include scientists, translational biologists and clinicians. Irv Weissman, a Stanford professor and CIRM grantee focused on translational cancer research, will be the keynote speaker. Space is limited so sign up ASAP!


March 23rd, CIRM Alpha Stem Cell Clinics Symposium (Free to the public)

This free one-day meeting will bring together scientists, clinicians, patient advocates, and other partners to describe how the CIRM Alpha Stem Cell Clinics Network is making stem cell therapies a reality for patients. The City of Hope Alpha Clinic is part of a statewide effort funded by CIRM to develop a network of “Alpha Clinics” that has one unifying goal: to accelerate the development and delivery of stem cell treatments to patients.

City of Hope Medical Center and Alpha Stem Cell Clinic

City of Hope Medical Center and Alpha Stem Cell Clinic


June 14-17th, International Society for Stem Cell Research (Fee to register)*

The Annual ISSCR stem cell research conference will be hosted in Boston this year. This is an international conference focusing on new developments in stem cell science and technology. CIRM was one of the funders of the conference last year when ISSCR was in San Francisco. It’s one of my favorite research events to attend full of interesting scientific presentations and great for meeting future collaborators.


For a more comprehensive 2017 stem cell conference and meeting guide, check out Paul Knoepfler’s Niche blog.

Why Goldilocks could provide the answer to changing the way FDA regulates stem cells

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Panel on FDA regulation at World Stem Cell Summit

One of the hottest topics of the past year in regenerative medicine has been the discussion about the need for regulatory reform at the Food and Drug Administration (FDA) so it’s no surprise that topic was the subject of the first main panel discussion at the 2016 World Stem Cell Summit in West Palm Beach, Florida.

The panel, titled ‘FDA Oversight in Regenerative Medicine: What are the Options to Accelerating Translation’, kicked off with Celia Witten, Deputy Director of the Center for Biologics Evaluation and Research at the FDA. She laid out all the new steps that the agency is implementing to try and be more responsive to the needs of researchers and patients.

Perils facing pioneers

Martin McGlynn, the former CEO of StemCells Inc. was up next and he wasted little time listing the companies that had once been considered pioneers in the field only to fail for a variety of reasons. He said one of the big problems is that translational efforts, moving from a good idea to a clinical trial, take too long, saying 15 – 20 years is not unusual and that Big Pharma and strategic investors won’t invest until they see strong Phase 2 study results.

“We need to do great science and design and conduct great clinical trials to advance this field but we also have to come up with a sustainable business model to make this happen.”

A good start

He called the 21st Century Cures Act, which the US Senate approved yesterday, a good start but says many of the challenges won’t be helped by some of the new provisions:

“Many sponsors and companies don’t make it out of open label early studies, so the existence of an accelerated pathway or some of the other enabling tools included in the act will come too late for these groups.”

McGlynn warned that if we don’t take further steps, we risk falling behind the rest of the world where companies are buying up struggling US ventures:

“Many non-USA companies in Japan and China and Australia are quicker to recognize the value of many of the products and approaches that struggle here in the US.”

Too much, too little, just right

Marc Scheineson was the final speaker. He heads the food and drug law practice at Washington, DC law firm Alston & Bird and is a former Associate Commissioner for Legislative Affairs at the FDA. He began his presentation with what he said are the scariest words in the English language: “I‘m a lawyer from Washington D.C. and I’m here to help you.”

Scheineson says part of the problem is that the FDA was created long before cell therapy was possible and so it is struggling to fit its more traditional drug approval framework around stem cell therapies. As a result, this has led to completely separate regulatory processes for the transplantation of human organs and blood vessels, or for the use of whole blood or blood components.

He says it’s like the fable of Goldilocks and the Three Bears. Some of the regulation is too hard- resulting in a lengthy regulatory process that takes years to complete and costs billions of dollars – and some of the regulation is too soft allowing clinics to open up around the US offering unproven therapies. He says we need a Goldilocks approach that blends the two into regulations that are just right.

Time to take a second step

Scheineson agreed with McGlynn that the 21st Century Cures Act is a good start but it’s not enough.  He says it still relies heavily on the use of traditional criteria to regulate stem cells, and also leaves much of the interpretation of the Act to the discretion of the FDA.

“It’s a first step, an experiment to see if we can break the logjam and see if we can move things to an affordable BLA (The Biologics License Application is needed to be able to market a product once it’s approved by the FDA). But make no mistake, a cell therapy revolution is underway and I believe the FDA should seize the opportunity to promote innovation and not defensively protect the “status quo”.

 

 

Three stories give us a glimpse of the real possibilities for stem cell therapies

Today we’re featuring a guest blog by Lisa Willemse about the Till and McCulloch Stem Cell Meeting in Canada. Enjoy!

Stem cell treatments should be incredibly easy. Or rather, that’s what some clinics or products would have you believe. Because, on the surface, a one-stop-shop for injectable cells to cure just about any condition or topical creams to peel away the scourge of time are very easy.

Attend one stem cell research conference and you’ll be convinced that it’s much more complicated. It’s a sea of reagents and transcription factors and unknown cause-and-effect. Many researchers will spend their entire career working on just one unknown and their caution and concern when it comes to the notion of a cure is justifiable.

Whistler (Courtesy of Lisa Willemse)

Whistler (Courtesy of Lisa Willemse)

Which makes it all the more impactful when you attend a research conference and hear three talks, back-to-back, that demonstrate that we’re ticking off some of those unknowns and getting much closer to real – not sham – therapies. Therapies with a sound scientific basis that are well planned and done with patient safety (not sales) in mind. Last week’s Till and McCulloch Meetings, held in Whistler, British Columbia gave us a sense of what is possible for three conditions: macular degeneration (vision), septic shock and a rare neurologic disease (Stiff Person Syndrome). Other blogs have covered  different aspects of this meeting here and here.

Vision Repair – Age-related Macular Degeneration (AMD)

As the world’s first clinical trial to use induced pluripotent stem cells launched amid sweeping regulatory changes in Japan, Dr. Masayo Takahashi’s treatment protocol for AMD has received no small amount of scrutiny. After a brief hiatus, the trial was back on track earlier this year and Takahashi’s presentation at this meeting was highly anticipated.

Dr. Masayo Takahashi

Dr. Masayo Takahashi

It did not disappoint. Takahashi spent the better part of her time outlining the steps taken to reach the point where the clinical trial was possible, including multiple studies in mice and further refinement of the treatment to ensure it would be stable in humans even with genetic changes over time. Given that one of the reasons the trial was put on hold was due to genetic mutations found in the cells prepared for the second potential human transplant, Takahashi’s careful work in ensuring the product was safe bodes well for the future of this trial.

The first patient was treated in 2014, a 78-year-old woman with wet AMD in the right eye, and although only minimal visual improvement was documented, the patient anonymously told the Japan Times, “I’m glad I received the treatment. I feel my eyesight has brightened and widened.”

Takahashi also alluded to some of the other challenges she’d had to overcome to make this trial a reality, including would-be critics who told her that the nervous system and the retina were too complicated to regenerate. Takahashi’s response? “You don’t know stem cells [and] you don’t understand the needs of the patient.”

While it was unclear when the next patient will receive treatment, Takahashi did say that three new applications for clinical trials using her refined protocols have been submitted for approval.

Septic shock  

Septic shock is not a condition that gets a lot of attention, most likely because it’s not a primary illness, but a secondary one; a drastic and often fatal immune response that severely reduces blood pressure and cell metabolism. It accounts for 20% of all intensive care unit (ICU) admissions and is the most common cause of non-coronary mortality in the ICU. For those who survive septic shock, there are significant and long-term health consequences.

Over 100 clinical trials have attempted to improve outcomes for patients with septic shock, but not one has been successfully translated into the clinical setting. Supportive care remains the mainstay of therapy.

Dr. Lauralyn McIntyre

Dr. Lauralyn McIntyre

This was the sober backdrop painted by critical care physician, Dr. Lauralyn McIntyre as she began her talk on the world’s first stem cell clinical trial for septic shock she is co-leading in Ottawa with Dr. Duncan Stewart.

Like Takahashi, McIntyre spent a good deal of time explaining the rationale and research that underpin the trial, which takes advantage of the immune-modulating properties of mesenchymal stromal cells (also called mesenchymal stem cells or MSCs) to suppress and reverse the effects of septic shock. This work includes reviews of more than 50 studies that looked at the effects of MSCs in both human trials and animal studies.

McIntyre also discussed research she did with mice in 2010 as a proof-of-concept, where the MSC therapy was delayed for six days. This delay is important as it better simulates the time frame in which most patients arrive in the hospital. As McIntryre pointed out, if the therapy only worked when given within hours of disease development, what good would it be for patients who come in on day six?

Fortunately, the therapy worked in the mice, even after a delayed timeframe, providing a green light for safety testing in humans. The small first human trial is currently underway for nine patients (with a control arm of 21) with results not yet published – although one of the patients shared his experience earlier this year. McIntyre relayed that the early data is very encouraging – enough that the team is moving ahead with a Phase 2 randomized trial in 10 centres across Canada in 2017.

Stiff Person Syndrome

Tina Ceroni’s story is much more personal. She is only the second person in the world to have received an experimental stem cell treatment for Stiff Person Syndrome, a rare neurologic condition that causes uncontrolled and sustained contractions of the arm, leg or other muscles. Often misdiagnosed initially as Multiple Sclerosis or anxiety/depression, SPS is also an autoimmune disease for which the cause is unknown.

Tina Ceroni

Tina Ceroni (The Ottawa Hospital)

I’ve written about Tina’s story before – about how she was hospitalized 47 times in one year and how a chance meeting with another SPS patient propelled Ceroni on a journey that included an intensive stem cell therapy under the guidance of Dr. Harry Atkins at the Ottawa Hospital, in which her blood stem cells were harvested from her bone marrow and used to repopulate her system after her immune system was wiped clean with chemotherapy.

Now a stem cell advocate, Ceroni’s story keeps getting better – not merely in how powerfully and passionately she tells it, but in the continued good health she enjoys after her treatment and in her efforts to share it more broadly.

Most importantly, she drives home a key message:

“My story underscores the importance of clinical trials…. My experience will help to change the future for others. I am living proof that a clinical trial for stem cell therapy can have a life-changing outcome.”

“Often hope is the only medicine we have.”

It’s important that patients like Ceroni continue share their story, not just with the research community to give a human face to the work they do, but to show that solid research is making an impact, one that can be measured in lives saved.


Lisa Willemse

Lisa Willemse

This article is published simultaneously, with permission by the author, Lisa Willemse, on the Ontario Institute for Regenerative Medicine (OIRM) Expression blog.

Trash talking and creating a stem cell community

imilce2

Imilce Rodriguez-Fernandez likes to talk trash. No, really, she does. In her case it’s cellular trash, the kind that builds up in our cells and has to be removed to ensure the cells don’t become sick.

Imilce was one of several stem cell researchers who took part in a couple of public events over the weekend, on either side of San Francisco Bay, that served to span both a geographical and generational divide and create a common sense of community.

The first event was at the Buck Institute for Research on Aging in Marin County, near San Francisco. It was titled “Stem Cell Celebration” and that’s pretty much what it was. It featured some extraordinary young scientists from the Buck talking about the work they are doing in uncovering some of the connections between aging and chronic diseases, and coming up with solutions to stop or even reverse some of those changes.

One of those scientists was Imilce. She explained that just as it is important for people to get rid of their trash so they can have a clean, healthy home, so it is important for our cells to do the same. Cells that fail to get rid of their protein trash become sick, unhealthy and ultimately stop working.

Imilce is exploring the cellular janitorial services our bodies have developed to deal with trash, and trying to find ways to enhance them so they are more effective, particularly as we age and those janitorial services aren’t as efficient as they were in our youth.

Unlocking the secrets of premature aging

Chris Wiley, another postdoctoral researcher at the Buck, showed that some medications that are used to treat HIV may be life-saving on one level, preventing the onset of full-blown AIDS, but that those benefits come with a cost, namely premature aging. Chris said the impact of aging doesn’t just affect one cell or one part of the body, but ripples out affecting other cells and other parts of the body. By studying the impact those medications have on our bodies he’s hoping to find ways to maintain the benefits of those drugs, but get rid of the downside.

Creating a Community

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Across the Bay, the U.C. Berkeley Student Society for Stem Cell Research held it’s 4th annual conference and the theme was “Culturing a Stem Cell Community.”

The list of speakers was a Who’s Who of CIRM-funded scientists from U.C. Davis’ Jan Nolta and Paul Knoepfler, to U.C. Irvine’s Henry Klassen and U.C. Berkeley’s David Schaffer. The talks ranged from progress in fighting blindness, to how advances in stem cell gene editing are cause for celebration, and concern.

What struck me most about both meetings was the age divide. At the Buck those presenting were young scientists, millennials; the audience was considerably older, baby boomers. At UC Berkeley it was the reverse; the presenters were experienced scientists of the baby boom generation, and the audience were keen young students representing the next generation of scientists.

Bridging the divide

But regardless of the age differences there was a shared sense of involvement, a feeling that regardless of which side of the audience we are on we all have something in common, we are all part of the stem cell community.

All communities have a story, something that helps bind them together and gives them a sense of common purpose. For the stem cell community there is not one single story, there are many. But while those stories all start from a different place, they end up with a common theme; inspiration, determination and hope.

 

Stem Cell Experts Discuss the Ethical Implications of Translating iPSCs to the Clinic

Part of The Stem Cellar blog series on 10 years of iPSCs.

This year, scientists are celebrating the 10-year anniversary of Shinya Yamanaka’s Nobel Prize winning discovery of induced pluripotent stem cells (iPSCs). These are cells that are very similar biologically to embryonic stem cells and can develop into any cell in the body. iPSCs are very useful in scientific research for disease modeling, drug screening, and for potential cell therapy applications.

However, with any therapy that involves testing in human patients, there are ethical questions that scientists, companies, and policy makers must consider. Yesterday, a panel of stem cell and bioethics experts at the Cell Symposium 10 Years of iPSCs conference in Berkeley discussed the ethical issues surrounding the translation of iPSC research from the lab bench to clinical trials in patients.

The panel included Shinya Yamanaka (Gladstone Institutes), George Daley (Harvard University), Christine Mummery (Leiden University Medical Centre), Lorenz Studer (Memorial Sloan Kettering Cancer Center), Deepak Srivastava (Gladstone Institutes), and Bioethicist Hank Greely (Stanford University).

iPSC Ethics Panel

iPSC Ethics Panel at the 10 Years of iPSCs Conference

Below is a summary of what these experts had to say about questions ranging from the ethics of patient and donor consent, genetic modification of iPSCs, designer organs, and whether patients should pay to participate in clinical trials.

How should we address patient or donor consent regarding iPSC banking?

Multiple institutes including CIRM are developing iPSC banks that store thousands of patient-derived iPSC lines, which scientists can use to study disease and develop new therapies. These important cell lines wouldn’t exist without patients who consent to donate their cells or tissue. The first question posed to the panel was how to regulate the consent process.

Christine Mummery began by emphasizing that it’s essential that companies are able to license patient-derived iPSC lines so they don’t have to go back to the patient and inconvenience them by asking for additional samples to make new cell lines.

George Daley and Hank Greely discussed different options for improving the informed consent process. Daley mentioned that the International Society for Stem Cell Research (ISSCR) recently updated their informed consent guidelines and now provide adaptable informed consent templates that can be used for obtaining many type of materials for human stem cell research.  Daley also mentioned the move towards standardizing the informed consent process through a single video shared by multiple institutions.

Greely agreed that video could be a powerful way to connect with patients by using talented “explainers” to educate patients. But both Daley and Greely cautioned that it’s essential to make sure that patients understand what they are getting involved in when they donate their tissue.

Greely rounded up the conversation by reminding the audience that patients are giving the research field invaluable information so we should consider giving back in return. While we can’t and shouldn’t promise a cure, we can give back in other ways like recognizing the contributions of specific patients or disease communities.

Greely mentioned the resolution with Henrietta Lack’s family as a good example. For more than 60 years, scientists have used a cancer cell line called HeLa cells that were derived from the cervical cancer cells of a woman named Henrietta Lacks. Henrietta never gave consent for her cells to be used and her family had no clue that pieces of Henrietta were being studied around the world until years later.

In 2013, the NIH finally rectified this issue by requiring that researchers ask for permission to access Henrietta’s genomic data and to include the Lacks family in their publication acknowledgements.

Hank Greely, Stanford University

Hank Greely, Stanford University

“The Lacks family are quite proud and pleased that their mother, grandmother and great grandmother is being remembered, that they are consulted on various things,” said Hank Greely. “They aren’t making any direct money out of it but they are taking a great deal of pride in the recognition that their family is getting. I think that returning something to patients is a nice thing, and a human thing.”

What are the ethical issues surrounding genome editing of iPSCs?

The conversation quickly focused on the ongoing CRISPR patent battle between the Broad Institute, MIT and UC Berkeley. For those unfamiliar with the technique, CRISPR is a gene editing technology that allows you to cut and paste DNA at precise locations in the genome. CRISPR has many uses in research, but in the context of iPSCs, scientists are using CRISPR to remove disease-causing mutations in patient iPSCs.

George Daley expressed his worry about a potential fallout if the CRISPR battle goes a certain way. He commented, “It’s deeply concerning when such a fundamentally enabling platform technology could be restricted for future gene editing applications.”

The CRISPR patent battle began in 2012 and millions of dollars in legal fees have been spent since then. Hank Greely said that he can’t understand why the Institutes haven’t settled this case already as the costs will only continue to rise, but that it might not matter how the case turns out in the end:

“My guess is that this isn’t ultimately going to be important because people will quickly figure out ways to invent around the CRISPR/Cas9 technology. People have already done it around the Cas9 part and there will probably be ways to do the same thing for the CRISPR part.”

 Christine Mummery finished off with a final point about the potential risk of trying to correct disease causing mutations in patient iPSCs using CRISPR technology. She noted that it’s possible the correction may not lead to an improvement because of other disease-causing genetic mutations in the cells that the patient and their family are unaware of.

 Should patients or donors be paid for their cells and tissue?

Lorenz Studer said he would support patients being paid for donating samples as long as the payment is reasonable, the consent form is clear, and patients aren’t trying to make money off of the process.

Hank Greely said the big issue is with inducement and whether you are paying enough money to convince people to do something they shouldn’t or wouldn’t want to do. He said this issue comes up mainly around reproductive egg donation but not with obtaining simpler tissue samples like skin biopsies. Egg donors are given money because it’s an invasive procedure, but also because a political decision was made to compensate egg donors. Greely predicts the same thing is unlikely to happen with other cell and tissue types.

Christine Mummery’s opinion was that if a patient’s iPSCs are used by a drug company to produce new successful drugs, the patient should receive some form of compensation. But she said it’s hard to know how much to pay patients, and this question was left unanswered by the panel.

Should patients pay to participate in clinical trials?

George Daley said it’s hard to justify charging patients to participate in a Phase 1 clinical trial where the focus is on testing the safety of a therapy without any guarantee that there will be beneficial outcome to the patient. In this case, charging a patient money could raise their expectations and mislead them into thinking they will benefit from the treatment. It would also be unfair because only patients who can afford to pay would have access to trials. Ultimately, he concluded that making patients pay for an early stage trial would corrupt the informed consent process. However, he did say that there are certain, rare contexts that would be highly regulated where patients could pay to participate in trials in an ethical way.

Lorenz Studer said the issue is very challenging. He knows of patients who want to pay to be in trials for treatments they hope will work, but he also doesn’t think that patients should have to pay to be in early stage trials where their participation helps the progress of the therapy. He said the focus should be on enrolling the right patient groups in clinical trials and making sure patients are properly educated about the trial they are participating.

Thoughts on the ethics behind making designer organs from iPSCs?

Deepak Srivastava said that he thinks about this question all the time in reference to the heart:

Deepak Srivastava, Gladstone Institutes

Deepak Srivastava, Gladstone Institutes

“The heart is basically a pump. When we traditionally thought about whether we could make a human heart, we asked if we could make the same thing with the same shape and design. But in fact, that’s not necessarily the best design – it’s what evolution gave us. What we really need is a pump that’s electrically active. I think going forward, we should remove the constraint of the current design and just think about what would be the best functional structure to do it. But it is definitely messing with nature and what evolution has given us.”

Deepak also said that because every organ is different, different strategies should be used. In the case of the heart, it might be beneficial to convert existing heart tissue into beating heart cells using drugs rather than transplant iPSC-derived heart cells or tissue. For other organs like the pancreas, it is beneficial to transplant stem cell-derived cells. For diabetes, scientists have shown that injecting insulin secreting cells in multiple areas of the body is beneficial to Diabetes patients.

Hank Greely concluded that the big ethical issue of creating stem cell-derived organs is safety. “Biology isn’t the same as design,” Greely said. “It’s really, really complicated. When you put something into a biological organism, the chances that something odd will happen are extremely high. We have to be very careful to avoid making matters worse.”

For more on the 10 years of iPSCs conference, check out the #CSStemCell16 hashtag on twitter.

Sneak Peak of our New Blog Series and the 10 Years of iPSCs Cell Symposium

New Blog Series

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Shinya Yamanaka

A decade has passed since Dr. Shinya Yamanaka and his colleagues discovered the Nobel Prize-winning technology called induced pluripotent stem cells (iPSCs). These stem cells can be derived from adult tissue and can develop into any cell type in the body. They are an extremely useful tool to model disease in a dish, screen for new drug therapeutics, and have the potential to replace lost or damaged tissue in humans.

In honor of this amazing scientific discovery, we’re launching a new blog series about iPSCs and their impact on CIRM since we started funding stem cell research in 2007. It will be a four-part series over the course of September ending with a blog highlighting the 10 Years of iPSCs Cell Symposium that will be hosted in Berkeley, CA in late September.

Here are the topics:

  • CIRM jumps on the iPSC bandwagon before it had wheels.
  • Expanding the CIRM iPSC bank, how individuals are making a difference.
  • Spotlight on CIRM-funded iPSC research, interviews with CIRM-funded scientists.
  • What the experts have to say, recap of the 10 Years of iPSCs Cell Symposium.

A Conference Dedicated to 10 Years of iPSCs

slide-2Cell Press is hosting a Symposium on September 25th dedicated to the 10th anniversary of Yamanaka’s iPSC discovery. The symposium is featuring famous scientists in biology, medicine, and industry and is sure to be one of the best stem cell conferences this year. The speakers will cover topics from discovery research to technology development and clinical applications of iPSCs.

More details about the Symposium can be found here.

Here are a few of the talks and events we’re excited about:

  • Keynote by Gladstone’s Shinya Yamanaka: Recent progress in iPSC research and application
  • Panel on ethical considerations for clinical translation of iPSC research
  • Organized run with Shinya Yamanaka (I can finally say that I’ve run with a Nobel Prize winner!)
  • Advances in modeling ALS with iPSCs by Kevin Eggan, Harvard University
  • Cellular reprogramming approaches for cardiovascular disease by Deepak Srivastava, Director of the Roddenberry (named after Star Trek’s Gene Roddenberry) Stem Cell Center at the Gladstone Institutes in San Francisco
  • Keynote by MIT’s Rudolf Jaenisch: Stem cells, iPSCs and the study of human development and disease

CIRM will be attending and covering the conference through our blog and on Twitter (@CIRMnews).

Young Minds Shine Bright at the CIRM SPARK Conference

SPARK students take a group photo with CIRM SPARK director Karen Ring.

SPARK students take a group photo with CIRM SPARK director Karen Ring.

Yesterday was one of the most exciting and inspiring days I’ve had at CIRM since I joined the agency one year ago. We hosted the CIRM SPARK conference which brought together fifty-five high school students from across California to present their stem cell research from their summer internships.

The day was a celebration of their accomplishments. But it was also a chance for the students to hear from scientists, patient advocates, and clinicians about the big picture of stem cell research: to develop stem cell treatments and cures for patients with unmet medical needs.

Since taking on the role of the CIRM SPARK director, I’ve been blown away by the passion, dedication, and intelligence that our SPARK interns have shown during their short time in the lab. They’ve mastered techniques and concepts that I only became familiar with during my PhD and postdoctoral research. And even more impressive, they eloquently communicated their research through poster presentations and talks at the level of professional scientists.

During their internships, SPARK students were tasked with documenting their research experiences through blogs and social media. They embraced this challenge with gusto, and we held an awards ceremony to recognize the students who went above and beyond with these challenges.

I’d like to share the winning blogs with our readers. I hope you find them as inspiring and motivating as I do. These students are our future, and I look forward to the day when one of them develops a stem cell treatment that changes the lives of patients. 

Andrew Choi

Andrew Choi

Andrew Choi, Cedars-Sinai SPARK student

Am I crying or is my face uncontrollably sweating right now? I think I am doing both as I write about my unforgettable experiences over the course of the past 6 weeks and finalize my poster.

As I think back, I am very grateful for the takeaways of the research field, acquiring them through scientific journals, lab experiments with my mentor, and both formal and informal discourses. It seems impossible to describe all the episodes and occurrences during the program in this one blog post, but all I can say is that they were all unique and phenomenal in their own respective ways.

Gaining new perspectives and insights and being acquainted with many of the techniques, such as stereology, immunocytochemistry and immunohistochemistry my peers have utilized throughout their careers, proved to me the great impact this program can make on many individuals of the younger generation.

CIRM SPARK not only taught me the goings on behind the bench-to-bedside translational research process, but also morals, work ethics, and effective collaboration with my peers and mentors. My mentor, Gen, reiterated the importance of general ethics. In the process of making my own poster for the program, her words resonate even greater in me. Research, education, and other career paths are driven by proper ethics and will never continue to progress if not made the basic standard.

I am thankful for such amazing institutions: California Institute of Regenerative Medicine (CIRM) and Cedars-Sinai Medical Center for enabling me to venture out into the research career field and network. Working alongside with my fellow seven very brilliant friends, motivated me and made this journey very enjoyable. I am especially thankful my mentor, Gen, for taking the time to provide me with the best possible resources, even with her busy ongoing projects. She encouraged me to be the best that I am.

I believe, actually, I should say, I KNOW Cedars-Sinai’s CIRM SPARK program does a SUPERB and astounding job of cultivating life-long learners and setting exceptional models for the younger generation. I am hoping that many others will partake in this remarkable educational program.

I am overall very blessed to be part of a successful summer program. The end of this program does not mark the end of my passions, but sparks them to even greater heights.

Jamey Guzman

Jamey Guzman

Jamey Guzman, UC Davis SPARK student

When I found out about this opportunity, all I knew was that I had a fiery passion for learning, for that simple rush that comes when the lightbulb sputters on after an unending moment of confusion. I did not know if this passion would translate into the work setting; I sometimes wondered if passion alone would be enough to allow me to understand the advanced concepts at play here. I started at the lab nervous, tentative – was this the place for someone so unsure exactly what she wanted to be ‘when she grew up,’ a date now all too close on the horizon? Was I going to fit in at this lab, with these people who were so smart, so busy, people fighting for their careers and who had no reason to let a 16-year-old anywhere near experiments worth thousands of dollars in cost and time spent?

I could talk for hours about the experiments that I worked to master; about the rush of success upon realizing that the tasks now completed with confidence were ones that I had once thought only to belong to the lofty position of Scientist. I could fill pages and pages with the knowledge I gained, a deep and personal connection to stem cells and cell biology that I will always remember, even if the roads of Fate pull me elsewhere on my journey to a career.

The interns called the experience #CIRMSparkLab in our social media posts, and I find this hashtag so fitting to describe these last few months. While there was, of course, the lab, where we donned our coats and sleeves and gloves and went to work with pipets and flasks…There was also the Lab. #CIRMSparkLab is so much more than an internship; #CIRMSparkLab is an invitation into the worldwide community of learned people, a community that I found to be caring and vibrant, creative and funny – one which for the first time I can fully imagine myself joining “when I grow up.”

#CIRMSparkLab is having mentors who taught me cell culture with unerring patience and kindness. It is our team’s lighthearted banter across the biosafety cabinet; it is the stories shared of career paths, of goals for the present and the future. It is having mentors in the best sense of the word, trusting me, striving to teach and not just explain, giving up hours and hours of time to draw up diagrams that ensured that the concepts made so much sense to me.

#CIRMSparkLab is the sweetest ‘good-morning’ from scientists not even on your team, but who care enough about you to say hi, to ask about your projects, to share a smile. It is the spontaneity and freedom with which knowledge is dispensed: learning random tidbits about the living patterns of beta fish from our lab manager, getting an impromptu lecture about Time and the Planck Constant from our beloved professor as he passes us at lunch. It is getting into a passionate, fully evidence-backed argument about the merits of pouring milk before cereal that pitted our Stem Cell team against our Exosome team: #CIRMSparkLab is finding a community of people with whom my “nerdy” passion for learning does not leave me an oddball, but instead causes me to connect instantly and deeply with people at all ages and walks of life. And it is a community that, following the lead of our magnificent lab director, welcomed ten interns into their lab with open arms at the beginning of this summer, fully cognizant of the fact that we will break beakers, overfill pipet guns, drop gels, bubble up protein concentration assays, and all the while never stop asking, “Why? Why? Why? Is this right? Like this? WHY?”

I cannot make some sweeping statement that I now know at age 16 exactly what I want to do when I grow up. Conversely, to say I learned so much – or I am so grateful – or you have changed my life is simply not enough; words cannot do justice to those sentiments which I hope that all of you know already. But I can say this: I will never forget how I felt when I was at the lab, in the community of scientists. I will take everything I learned here with me as I explore the world of knowledge yet to be obtained, and I will hold in my heart everyone who has helped me this summer. I am truly a better person for having known all of you.

Thank you, #CIRMSparkLab. 

Adriana Millan

Adriana Millan

Adriana Millan, CalTech SPARK student

As children, we all grew up with the companionship of our favorite television shows. We enjoyed sitcoms and other animations throughout our childhood and even as adults, there’s no shame. The goofy and spontaneous skits we enjoyed a laugh over, yet we did not pay much attention to the lessons they attempted to teach us. As a child, these shows play crucial roles in our educational endeavors. We are immediately hooked and tune in for every episode. They spark curiosity, as they allow our imaginations to run wild. For me, that is exactly where my curiosity stemmed and grew for science over the years. A delusional young girl, who had no idea what the reality of science was like.

You expect to enter a lab and run a full day of experimentations. Accidentally mix the wrong chemicals and discover the cure for cancer. Okay, maybe not mix the incorrect chemicals together, I learned that in my safety training class. The reality is that working in a lab was far from what I expected — eye opening. Working alongside my mentor Sarah Frail was one of the best ways I have spent a summer. It was not my ideal summer of sleeping in until noon, but it was worthwhile.

My experience is something that is a part of me now. I talk about it every chance I get, “Mom, can you believe I passaged cells today!” It changed the way I viewed the principles of science. Science is one of the most valuable concepts on this planet, it’s responsible for everything and that’s what I have taken and construed from my mentor. She shared her passion for science with me and that completed my experience. Before when I looked at cells, I did not know exactly what I was supposed to observe. What am I looking at? What is that pink stuff you are adding to the plate?

However, now I feel accomplished. It was a bit of a roller coaster ride, with complications along the way, but I can say that I’m leaving this experience with a new passion. I am not just saying this to please the audience, but to express my gratitude. I would have never even looked into Huntington’s Disease. When I first arrived I was discombobulated. Huntington’s Disease? Now I can proudly say I have a grasp on the complexity of the disease and not embarrass my mentor my calling human cells bacteria – quite embarrassing in fact.  I’m a professional pipette handler, I work well in the hood, I can operate a microscope – not so impressive, I have made possibly hundreds of gels, I have run PCRs, and my cells love me, what else can I ask for.

If you are questioning what career path you are to take and even if it is the slightest chance it may be a course in science, I suggest volunteering in a lab. You will leave with your questioned answered. Is science for me? This is what I am leaving my experience with. Science is for me.

Other SPARK 2016 Awards

Student Speakers: Jingyi (Shelly) Deng (CHORI), Thomas Thach (Stanford)

Poster Presentations: Jerusalem Nerayo (Stanford), Jared Pollard (City of Hope), Alina Shahin (City of Hope), Shuling Zhang (UCSF)

Instagram Photos: Roxanne Ohayon (Stanford), Anna Victoria Serbin (CHORI), Diana Ly (UC Davis)

If you want to see more photos from the CIRM SPARK conference, check out our Instagram page @CIRM_Stemcells or follow the hashtag #CIRMSPARKLab on Instagram and Twitter.