Heads or tails? Stem cells help guide the decision

Two cell embryo

There are many unknown elements for what triggers the cells in an embryo to start dividing and multiplying and becoming every single cell in the body. Now researchers at the Gladstone Institutes in San Francisco have uncovered one of those elements, how embryos determine which cells become the head and which the tail.

In this CIRM-funded study the Gladstone team, led by Dr. Todd McDevitt, discovered almost by chance how the cells align in a heads-to-tail arrangement.

Todd McDevitt

They had created an organoid made from brain cells when they noticed that some of the cells were beginning to gather in an elongated fashion, in the same way that spinal cords do in a developing fetus.

In a news article, Nick Elder, a graduate student at Gladstone and the co-author of the study, published in the journal Development, says this was not what they had anticipated would happen: “Organoids don’t typically have head-tail directionality, and we didn’t originally set out to create an elongating organoid, so the fact that we saw this at all was very surprising.”

Further study enabled the team to identify which molecules were involved in signaling specific genes to switch on and off. These were similar to the process previously identified in developing mouse embryos.

“This is such a critical point in the early development of any organism, so having a new model to observe it and study it in the lab is very exciting,” says McDevitt.

This is not just of academic interest either, it could have real world implications in helping understand what causes miscarriages or birth defects.

“We can use this organoid to get at unresolved human developmental questions in a way that doesn’t involve human embryos,” says Dr. Ashley Libby, another member of the team. “For instance, you could add chemicals or toxins that a pregnant woman might be exposed to, and see how they affect the development of the spinal cord.”

Welcoming back old friends and some new ones

When Proposition 14 was approved by voters in November we were given a chance to carry on the work we have been doing for more than 16 years. What we hadn’t anticipated was that we would also get a chance to do that with some of the team that helped us make CIRM what it is, but who had since moved on to other jobs.

We are delighted to say that as we build up our team again we are welcoming back a couple of dear friends, and welcoming in some new ones too. They’re a talented bunch and, if they don’t mind me saying so, a darned good looking group too.

Rosa Canet-Aviles, PhD., has been named as the new Vice President Scientific Programs. Rosa is a familiar face at the agency, serving as a Science Officer with CIRM from 2008 to 2014. During that time she helped oversee the development of our Translational program, managed a broad portfolio of projects and organized workshops on Parkinson’s and autism.

After leaving CIRM she joined the Foundation for the National Institutes of Health (FINH) where she served as the Director of Neuroscience Research Partnerships. In that role she led the successful development and management of 5 new large partnerships including the Biomarkers Consortium Neuroscience Steering Committee, the Accelerating Medicines Partnership (AMP) for Alzheimer’s disease 1.0 and 2.0, AMP Parkinson’s disease and AMP Schizophrenia.

Rosa has more than 15 years of experience working in industry, academia and government and her experience in developing and managing neuroscience programs will be invaluable as CIRM looks to invest some $1.5 billion in neuroscience under Proposition 14.

“I am very excited to be back,” says Rosa. ”It is a dream come true being able to translate all the skills, learning and networks gathered over the past 7 years towards the development and implementation of CIRM’s new phase and accelerate stem cell therapies for patients in need.” 

“We are thrilled to announce the timely return of Rosa to CIRM as we build our new strategic plan under Prop 14,” says Dr. Maria T. Millan, CIRM’s President & CEO. “Rosa has demonstrated time and again the unique ability to bring together often seemingly disparate stakeholders to successfully drive toward a common goal of advancing the science on behalf of patients with diseases of the brain and neuropsychiatric disorders. At CIRM, she assembled key international leaders who went on to form an international Parkinson’s Disease consortium. At the Foundation for NIH (FNIH), she directed the development of five prominent public-private partnerships. A neuroscientist by training, she is held in high regard and has been called a “quick study” in her ability to lead in new areas such as in genomics and data science, key components of her role at FNIH and at Eisai’s Center for Genetics Guided Dementia Discovery.“

In addition, CIRM is pleased to announce the following new team members:

Uta Grieshammer, PhD. is also returning to CIRM as the Senior Science Officer for our Discovery program. Uta was at CIRM from 2007 to 2015 and led the programs that created both our Genomics Initiative and our iPSC bank. She also organized several scientific conferences and workshops involving hundreds of CIRM-funded researchers.

After leaving CIRM she became the Scientific Director of the California Initiative to Advance Precision Medicine at the University of California San Francisco where she created and managed the application and peer review process. Most recently she was the Program Officer at the University of California Office of the President’s (UCOP) Tobacco Related Disease Research Program where she focused on the neuroscience of nicotine addiction. She also helped develop a scholarship program to attract students from diverse backgrounds to pursue a career in science. 

Michael Bunch joins CIRM as a Business Service Officer. Michael is a decorated veteran who has been working as the Chief Business Officer at the Veterans Home in Yountville, California. In that role he implemented new contract and reviewing processes and oversaw the income and insurance tracking for some 1,000 residents. With his extensive background in acquisition management, contingency contracting, and his deep knowledge of state regulations and guidelines Michael was able to increase funding, streamline processes and assist Veterans and their families to obtain the benefits and services that they qualified for.

Michael spent 25 years in the US Army including serving as part of the NATO peacekeeping force in Kosovo. During that deployment he was awarded the Joint Service Commendation Medal (JSCM) for managing the fuel needs of 4 Multinational Task Forces and 33 Nations, an essential element in helping the mission succeed.

A Senior Drill Sergeant, Infantry Instructor and Financial and Resource Manager Michael has been awarded the Army Commendation Medal with 4 Oak Leaves, Army Achievement Medal with 4 Oak Leaves, Global War on Terrorism Service Medal, KOSOVO Campaign Medal, Military Outstanding Volunteer Service Medal, NATO Medal, Expert Infantryman Badge, Honorary Kentucky Colonel and Honorary Kentucky Admiral.

Nellie Almazan joins CIRM as a Grants Management Specialist. Nellie comes to us from the California Department of Transportation (Caltrans) where she has worked for 16 years, most recently as the Associate Transportation Planner with the Low Carbon Transit Operations program. Nellie managed more than 150 projects, reviewing grants to help reduce greenhouse gas emissions in the state and overseeing programs that had an emphasis on serving Disadvantaged Communities.

She is currently enrolled at Sacramento City College where her focus is on Sociology and Deaf Culture.

Alexandra Caraballo joins CIRM as a Grants Management Specialist. Alex has more than 15 years of grant administration experience with a focus on incorporating equity, diversity, and inclusion into grantmaking practices and decision-making. She comes to CIRM from the Kaiser Foundation Health Plan where she was the National Manager of Philanthropy. There she was responsible for the administration of approximately 200 grants in the national community health portfolio. Before Kaiser she was the Program Assistant and Associate Program Officer at the East Bay Community Foundation, where she partnered with donors and community-based organizations to advance racial equity and transform political, social and economic outcomes for East Bay Communities.

Alex currently serves on the Board of Directors for the Lindsay Wildlife Experience and was a former Advisory Board member for Oakland Head Start.

Physicians and patient advocates on the front lines of the fight for a more equitable health system

Over the last year there has been increasing awareness of the inequalities in the American healthcare system. At every level there is evidence of bias, discrimination and unequal access to the best care. Sometimes unequal access to any care. That is, hopefully, changing but only if the new awareness is matched with action.

At the recent World Stem Cell Summit CIRM helped pull together a panel of physicians and patient advocates who have been leading the charge for change for years. The panel was called ‘Addressing Disparities, Promoting Equity and Inclusion in Clinical Research.’

The panelists include:

This image has an empty alt attribute; its file name is ysabel-duron.jpeg
Ysabel Duron – Founder of The Latino Cancer Institute & CIRM Board member
Adrienne Shapiro – sickle cell disease patient advocate, Founder of Axis Advocacy – Sickle Cell Disease support and advocacy group
Dr. Leah Ke‘ala‘aumoe Dowsett – Clinical geneticist, serves on hospital DEI committee, Board member Association of Native Hawaiian Physicians
Dr. Nathan Chomilo – Co-Founder, Minnesota Doctors for Health Equity and head of the Minnesota COVID Vaccine Equity Program

The conversation they had was informative, illuminating and fascinating. But it didn’t sugar coat where we are, and the hard work ahead of us to get to where we need to be.

Enjoy the event, with apologies for the inept cameo appearance by me at the beginning of the video. Technology clearly isn’t my forte.

How stem cells play “follow the leader”

Todd McDevitt, PhD., Photo: courtesy Gladstone Institutes

It’s hard enough trying to follow the movements of individuals in a crowd of people but imagine how much harder it is to follow the movements of stem cells, crowded into a tiny petri dish. Well, researchers at the Gladstone Institutes in San Francisco have done just that.

In a CIRM-funded study ($5.85M) Dr. Todd McDevitt and his team created a super smart artificial intelligence way of tracking the movements of hundreds of stem cells growing together in a colony, and even identify “leaders” in the pack.

In our bodies groups of stem cells are able to move in specific ways to form different organs and tissues when exposed to the right environment. Unfortunately, we are still trying to learn what “the right environment” is for different organs.

In a news release, McDevitt, the senior author of the paper published in the journal Stem Cell Reports, says this method of observing cells may help us better understand that.

“If I wanted to make a new human heart right now, I know what types of cells are needed, and I know how to grow them independently in dishes. But we really don’t know how to get those cells to come together to form something as complex as a heart. To accomplish that, we need more insights into how cells work cooperatively to arrange themselves.”

Normally scientists watch cells by tagging them with a fluorescent marker so they can see them under a microscope. But this is slow, painstaking work and not particularly accurate. This new method used a series of what are called “neural networks”, which are artificial intelligence (AI) programs that can detect patterns in the movements of the cells. When combined together the networks proved to be able to track the movement of 95 percent of the cells. Humans by comparison can only manage up to 90 percent. But the nets were not only sharper, they were also faster, much faster, some 500 times faster.

This enhanced ability to watch the cells showed that instead of being static most of the time, as had previously been thought, they were actually on the move a lot of the time. They would move around for 15 minutes and then take a breather for ten minutes (time for the stem cell equivalent of a cup of tea perhaps).  

Some cells moved around a lot in one direction, while others just seemed to shuffle around in the same area. Some cells even seemed to act as “leaders” while other cells appeared to be “followers” and shuffle along behind them.

None of this would have been visible without the power of the AI networks and McDevitt says being able to tap into this could help researchers better understand how to use these complex movements.

“This technique gives us a much more comprehensive view of how cells behave, how they work cooperatively, and how they come together in physical space to form complex organs.

Follow the Leader is not just a kids’ game anymore. Now it’s a scientific undertaking.

Hitting our goals: Making good progress

Way, way back in 2015 – seems like a lifetime ago doesn’t it – the team at CIRM sat down and planned out our Big 6 goals for the next five years. The end result was a Strategic Plan that was bold, ambitious and set us on course to do great things or kill ourselves trying. Well, looking back we can take some pride in saying we did a really fine job, hitting almost every goal and exceeding them in some cases. So, as we plan our next five-year Strategic Plan we thought it worthwhile to look back at where we started and what we achieved. Goal #5 was Advance.

A dictionary definition of progression is “The act of moving forward or proceeding in a course.” That’s precisely what we set out to do when we set one of the goals in our 2015 Strategic Plan. We wanted to do all that we could to make sure the work we were funding could advance to the next stage. The goal we set was:

Advance: Increase projects advancing to the next stage of development by 50%.

The first question we faced was what did we mean by progression and how were we going to measure it? The answer basically boiled down to this: when a CIRM award completes one stage of research and gets CIRM funding to move on to the next stage or to develop a second generation of the same device or therapy.

In the pre-2016 days we’d had some success, on average getting around nine progression events every year. But if we were going to increase that by 50 percent we knew we had to step up our game and offer some incentives so that the team behind a successful project had a reason, other than just scientific curiosity, to try and move their research to the next level.

So, we created a series of linkages between the different stages of research, so the product of each successful investment was the prerequisite for the next stage of development for the research or technology.

We changed the way we funded projects, going from offering awards on an irregular basis to having them happen according to a pre-defined schedule with each program type offered multiple times a year. This meant potential applicants knew when the next opportunity to apply would come, enabling them to prepare and file at the time that was best for them and not just because we said so. We also timed these schedules so that programs could progress from one stage to the next without interruption.

But that’s not all. We recognized that some people may be great scientists at one level but didn’t have the experience or expertise to carry their project forward. So, we created both an Accelerating Center and Translating Center to help them do that. The Translating Center helped projects do the work necessary to get ready to apply to the US Food and Drug Administration (FDA) for permission to start a clinical trial. The Accelerating Center helped the team prepare that application for the trial and then plan how that trial would be carried out.

Creating these two centers had an additional benefit; it meant the work that did progress did so faster and was of a higher quality than it might otherwise have been.

Putting all those new building blocks in place meant a lot of work for the CIRM team, on top of their normal duties. But, as always, the team rose to the challenge. By the end of December 2020, a total of 74 projects had advanced or progressed to the next level, an increase of 100 percent on our pre-2016 days.

When we were laying out the goals we said that “The full implementation of these programs will create the chassis of a machine that provides a continuous, predictable, and timely pathway for the discovery and development of promising stem cell treatments.” Thanks to the voter approved Proposition 14 we now have the fund to help those treatments realize that promise.

Hitting our Goals: Let’s start at the beginning shall we

Way, way back in 2015 – seems like a lifetime ago doesn’t it – the team at CIRM sat down and planned out our Big 6 goals for the next five years. The end result was a Strategic Plan that was bold, ambitious and set us on course to do great things or kill ourselves trying. Well, looking back we can take some pride in saying we did a really fine job, hitting almost every goal and exceeding them in some cases. So, as we plan our next five-year Strategic Plan we thought it worthwhile to look back at where we started and what we achieved. Goal #3 was Discover.

When journalists write about science a lot of the attention is often focused on clinical trials. It’s not too surprising, that’s the stage where you see if treatments really work in people and not just in the lab. But long before you get to the clinical trial stage there’s a huge amount of work that has to be done. The starting point for that work is in the Discovery stage, if it works there it moves to the Translational stage, and only after that, assuming it’s still looking promising, does it start thinking about moving into the clinic.

The Discovery, or basic, stage of research is where ideas are tested to see if they have any promise and have the potential to lead to the development of a therapy or device that could ultimately help patients. In many ways the goal of Discovery research is to gain a better understanding of how, in our case, stem cells work, and how to harness that power to treat particular diseases or disorders.

Without a rigorous Discovery research program you can’t begin to create a pipeline of promising projects that you can advance towards patients. And of course having a strong Discovery program is not much use if you don’t have somewhere for those projects to advance to, namely Translational and ultimately clinical.

So, when we were laying out our Strategic Plan goals back in 2015 we wanted to create a pipeline for all three programs, moving the most promising ones forward. So we set an ambitious goal.

Introduce 50 new therapeutic or device candidates into development.

Now this doesn’t mean just fund 50 projects hoping to develop a new therapy or device. A lot of studies that are funded, particularly at the earliest stages, have a good idea that just doesn’t pan out. In fact one quite common definition of early research – in this case from Translational Medicine Communications – is “the earliest stage of research, conducted for the advancement of knowledge, often without any concern for its practical applications.

That’s not what we wanted. We aren’t in this to do research just for its own sake. We fund research because we want it to lead somewhere, we want it to have a practical application. We want to fund projects that actually ended up with something much more promising, a candidate that might actually work and was ready to move into the next level of research to test it further.

And we almost, almost made it to the 50-candidate goal. We got to 46 and almost certainly would have made it to 50 if we hadn’t run out of money. Even so, that’s pretty impressive. There are now 46 projects ready to move on, or are already moving on, to the next level of research.

Of course, there’s no guarantee that these will ultimately end up as an FDA-approved therapy or device. But if you don’t set goals, you’ll never score. And now, thanks to the passage of Proposition 14, we have a chance to support those projects as they move forward.

A Match Made in Heaven, if heaven were in Oakland!

The Matchmaker – by Gerrit van Honthorst

Throughout history, matchmakers have played an important role in bringing together couples for arranged marriages. Fast forward to today and CIRM is now playing a similar role. We’re not looking to get anyone hitched, what we are trying to do is create partnerships between people we are funding and companies looking for the next hot thing.

So far, I’d say we are doing a pretty decent job. Over the years we have leveraged our funding to bring in some $13 billion in additional investments in stem cell research. But there’s still a lot of untapped potential out there. That’s why tomorrow, March 9th, we’re joining with BIOCOM to host a Partner Day.

The idea is to highlight some of the most promising programs we are funding and see if we can find partners for them, partners who want to help advance the research and ultimately – we hope – bring those therapies to patients.

The webinar and panel discussion will feature a presentation from the CIRM Business Development team about our portfolio. That’s a pretty extensive list because it covers all stages of research from Discovery or basic, through Translational and all the way to Clinical. We’ll show how our early investment in these programs has helped de-risk them and given them the chance to get the data needed to demonstrate their promise and potential.

So, who are we interested in having join us? Pretty nearly everyone involved in the field:

  • Academic institutions
  • Research organizations
  • Entrepreneurs
  • Venture capital firms
  • Companies

And the areas of interest are equally broad:

  • Stem or progenitor cell-based therapy
  • Cell Therapy
  • Gene therapy
  • Biologic
  • Small molecule
  • Medical Device
  • Diagnostic
  • Tools/Tech
  • Other

And for those who are really interested and don’t want to waste any time, there’s an opportunity to set up one-on-one meetings right away. After all, if you have found the perfect match, why wait!

But here’s the catch. Space is limited so you need to register ahead. Here’s where you go to find out all the details and sign up for the event.

A word from our Chair, several in fact

In 2005, the New Oxford American Dictionary named “podcast” its word of the year. At the time a podcast was something many had heard of but not that many actually tuned in to. My how times have changed. Now there are some two million podcasts to chose from, at least according to the New York Times, and who am I to question them.

Yesterday, in the same New York Times, TV writer Margaret Lyons, wrote about how the pandemic helped turn her from TV to podcasts: “Much in the way I grew to prefer an old-fashioned phone call to a video chat, podcasts, not television, became my go-to medium in quarantine. With their shorter lead times and intimate production values, they felt more immediate and more relevant than ever before.”

I mention this because an old colleague of ours at CIRM, Neil Littman, has just launched his own podcast and the first guest on it was Jonathan Thomas, Chair of the CIRM Board. Their conversation ranged from CIRM’s past to the future of the regenerative field as a whole, with a few interesting diversions along the way. It’s fun listening. And as Margaret Lyons said it might be more immediate and more relevant than ever before.

Scientists look at how the lung and brain respond differently to SARS-CoV-2 infection

UC San Diego School of Medicine researchers found approximately 10-fold higher SARS-CoV-2 infection (green) in lung organoids (left), compared to brain organoids (right). Image courtesy of UCSD Health

Since the start of the coronavirus pandemic early last year, scientists all over the world are still trying to better understand SARS-CoV-2, the virus that causes COVID-19. Although the more commonly known symptoms involve respiratory issues, there have been other long term problems observed in recovered patients. These consist of heart issues, fatigue, and neurological issues such as loss of taste and smell and “brain fog”.

To better understand this, Dr. Tariq Rana and a team of researchers at the UC San Diego School of Medicine are using stem cells to create lung and brain organoids to better understand how the virus interacts with the various organ systems and to better develop therapies that block infection. Organoids are 3D models made of cells that can be used to analyze certain features of the human organ being modeled. Although they are far from perfect replicas, they can be used to study physical structure and other characteristics. 

The team’s lung and brain organoids produced molecules ACE2 and TMPRSS2, which sit like doorknobs on the outer surfaces of cells. SARS-CoV-2 is able to use these doorknobs to enter cells and establish infection.

Dr. Rana and his team then developed a pseudovirus, a noninfectious version of SARS-CoV-2, and attached a fluorescent label, allowing them to measure how effectively the virus binds in human lung and brain organoids as well as to evaluate the cells’ response. The team was surprised to see an approximately 10-fold higher SARS-CoV-2 infection in lung organoids compared to brain organoids. Additionally, treatment with TMPRSS2 inhibitors reduced infection levels in both organoids.

Besides differences in infection levels, the lung and brain organoids also differed in their responses to the virus. Infected lung organoids pumped out molecules intended to summon help from the immune system while infected brain organoids upped their production of molecules that plays a fundamental role in pathogen recognition and activation of the body’s own immune defenses.

In a news release from UC San Diego Health, Dr. Rana elaborates on the results of his study.

“We’re finding that SARS-CoV-2 doesn’t infect the entire body in the same way. In different cell types, the virus triggers the expression of different genes, and we see different outcomes.”

The next steps for Rana and his team is to develop SARS-CoV-2 inhibitors and test out how well they work in organoid models derived from people of a variety of racial and ethnic backgrounds that represent California’s diverse population. To carry out this research, CIRM awarded Dr. Rana a grant of $250,000, which is part of the $5 million in emergency funding for COVID-19 research that CIRM authorized at the beginning of the pandemic.

The full results of this study can be found in Stem Cell Reports.

Charting a course for the future

A new home for stem cell research?

Have you ever been at a party where someone says “hey, I’ve got a good idea” and then before you know it everyone in the room is adding to it with ideas and suggestions of their own and suddenly you find yourself with 27 pages of notes, all of them really great ideas. No, me neither. At least, not until yesterday when we held the first meeting of our Scientific Strategy Advisory Panel.

This is a group that was set up as part of Proposition 14, the ballot initiative that refunded CIRM last November (thanks again everyone who voted for that). The idea was to create a panel of world class scientists and regulatory experts to help guide and advise our Board on how to advance our mission. It’s a pretty impressive group too. You can see who is on the SSAP here.  

The meeting involved some CIRM grantees talking a little about their work but mostly highlighting problems or obstacles they considered key issues for the future of the field as a whole. And that’s where the ideas and suggestions really started flowing hard and fast.

It started out innocently enough with Dr. Amander Clark of UCLA talking about some of the needs for Discovery or basic research. She advocated for a consortium approach (this quickly became a theme for many other experts) with researchers collaborating and sharing data and findings to help move the field along.

She also called for greater diversity in research, including collecting diverse cell samples at the basic research level, so that if a program advanced to later stages the findings would be relevant to a wide cross section of society rather than just a narrow group.

Dr. Clark also said that as well as supporting research into neurodegenerative diseases, such as Alzheimer’s and Parkinson’s, there needed to be a greater emphasis on neurological conditions such as autism, bipolar disorder and other mental health problems.

(CIRM is already committed to both increasing diversity at all levels of research and expanding mental health research so this was welcome confirmation we are on the right track).

Dr. Mike McCun called for CIRM to take a leadership role in funding fetal tissue research, things the federal government can’t or won’t support, saying this could really help in developing an understanding of prenatal diseases.

Dr. Christine Mummery, President of ISSCR, advocated for support for early embryo research to deepen our understanding of early human development and also help with issues of infertility.

Then the ideas started coming really fast:

  • There’s a need for knowledge networks to share information in real-time not months later after results are published.
  • We need standardization across the field to make it easier to compare study results.
  • We need automation to reduce inconsistency in things like feeding and growing cells, manufacturing cells etc.
  • Equitable access to CRISPR gene-editing treatments, particularly for underserved communities and for rare diseases where big pharmaceutical companies are less likely to invest the money needed to develop a treatment.
  • Do a better job of developing combination therapies – involving stem cells and more traditional medications.

One idea that seemed to generate a lot of enthusiasm – perhaps as much due to the name that Patrik Brundin of the Van Andel Institute gave it – was the creation of a CIRM Hotel California, a place where researchers could go to learn new techniques, to share ideas, to collaborate and maybe take a nice cold drink by the pool (OK, I just made that last bit up to see if you were paying attention).

The meeting was remarkable not just for the flood of ideas, but also for its sense of collegiality.  Peter Marks, the director of the Food and Drug Administration’s Center for Biologics Evaluation and Research (FDA-CBER) captured that sense perfectly when he said the point of everyone working together, collaborating, sharing information and data, is to get these projects over the finish line. The more we work together, the more we will succeed.