Can stem cells help people recovering from a stroke? You asked, and the experts answered

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We recently held our first ever Facebook Live event. It was focused on the use of stem cells and recovery from a stroke and featured three great guests: Dr. Gary Steinberg, chief of Neurosurgery at Stanford, Sonia Coontz, a patient of Dr. Steinberg’s, and CIRM’s own Science Officer Dr. Lila Collins.

We had an amazing response from people during the event and in the days since then with some 6,750 people watching the video and almost 1,000 people reacting by posting a comment or sharing it with friends. It was one of the most successful things we have ever done on Facebook so it’s not surprising that we plan on doing many more Facebook Live ‘Ask the Expert’ events in the future. We will post more details of that as we finalize them.

We tried to cover as many topics as possible during the hour but there were simply too many questions for us to get to all of them. So here is a recap of the key issues we covered, and a few we didn’t have a chance to answer.

Let’s start with Dr. Steinberg’s explanation of the research that led to his current clinical trial:

Dr. Steinberg: “I got interested in this about 18 years ago when I took human cells and transplanted them into rodent models of stroke. What we found was that when we transplanted those cells into the stroke region, the core of the stroke, they didn’t survive very well but when we moved them a few millimeters away from the stroke they not only survived but they migrated to the stroke.

The reason they migrate is that the stem cells have receptors on them that interact with chemicals given off by the stroke environment and that’s why they migrate to the stroke site. And when they get to the site they can turn into different kinds of cells. Very importantly we found these mice and rats that had behavioral problems – walking, moving – as a result of the stroke, we found we could improve their neurological outcomes with the stem cells.

With the help of CIRM, which has been very generous, we were fortunate enough to receive about $24 million in funding over the last 8 years, from 2010, to move this therapy into the clinic to understand the basic mechanisms of the recovery and to start clinical trials

One of the surprising things was that our initial notion was that the cells we transplanted into the brains would initially turn into the cells in the brain affected by the stroke and reconstitute those circuits. We were shocked to find that that was not what was happening, that only a few of the transplanted cells turned into neurons. The way they were recovering function was by secreting very powerful growth factors and molecules and proteins that enhanced native recovery or the ability of the normal brain to recover itself. Some of these processes included outgrowth of neurons, new connections, new synapses, not from the stem cells but from the native cells already in the brain.

This is not cell replacement but enhancing native recovery and, in a simple sense, what the cells are doing, we believe, is to change the adult brain, which has a hard time recovering from a stroke, into an infant brain and infants recover very well after a stroke.”

All this work was focused on ischemic strokes, where a blockage cuts off blood flow to the brain. But people like Cheryl Ward wanted to know: “Will this work for hemorrhagic stroke?” That’s where a blood vessel in the brain leaks or ruptures.

Dr. Steinberg: “I suspect we will be generalizing this therapy into hemorrhagic patients very, very soon and there’s no reason why it shouldn’t work there. The reason we didn’t start there is that 85% of strokes are ischemic and only 15% are hemorrhagic so it’s a smaller population but a very, very important population because when patients have a hemorrhage from a stroke they are often more seriously disabled than from ischemic.”

Dr. Lila Collins: “I would like to highlight one trial for hemorrhagic stroke with the Mayo Clinic and that’s using mesenchymal stem cells (normally found in bone marrow or blood). It’s an early stage, Phase 1 safety study in patients with recent cerebral hemorrhage.  They are looking at improvements in neurological function and patients have to be treated within 72 hours after the stroke.”

Dr. Steinberg explained that because it’s more difficult to enroll patients within 72 hours of a stroke that we may end up offering a combination of therapies spread out over months or even years.

Dr. Steinberg: “It may be that and we may figure this out in the next 5 to 10 years, that you might want to treat patients acutely (right away) with an intravenous therapy in the first 72 hours and then you might want to come in again sub-acutely within a few months, injecting the cells into the brain near the stroke, and then maybe come in chronically a few years later if there are still problems and place the cells directly in the brain. So, lots of ways to think about how to use this in the future.”

James Russell suffered a stroke in 2014 and wrote:

“My left side was affected. My vision was also impacted. Are any stroke patients being given stem cells seeing possible improvement in visual neglect?”

Dr. Steinberg: “We don’t know the answer to that yet, it’s quite possible. It’s true these vision circuits are not dead and could be resurrected. We have not targeted visual pathways in our work, we have targeted motor functions, but I would also be optimistic that we could target patients who have vision problems from stroke. It’s a very important area.

A number of people wondered if stem cells can help people recovering from a stroke can they also help people with other neurological conditions.

Hanifa Gaphoor asked “What about Parkinson’s disease?” and Ginnievive Patch wondered “Do you feel hopeful for neurological illnesses like Huntington’s disease and ALS? Dr. Steinberg was cautiously optimistic.

Dr. Steinberg: “We’ve extended this kind of treatment not just for ischemic stroke but into traumatic brain injury (TBI) and we just completed a trial for patients with chronic TBI or who have suffered a trauma to the brain. Many other indications may be possible. In fact, now that we know these circuits are not dead or irreversibly injured, we believe we could even extend this to neurodegenerative diseases like ALS, Parkinson’s, maybe even to Alzheimer’s disease in the future. So, lots of hope but we don’t want to oversell this, and we want to make sure this is done in a rigorous fashion.”

Several people had questions about using their own adipose, or fat stem cells, in therapies being offered at clinics around the US and in other countries. Cheri Hicks asked: “I’m curious if adipose stem cell being used at clinics at various places is helpful or beneficial?”

Dr. Steinberg: “I get emails or calls from patients every week saying should I go to Russia, India or Mexico and get stem cell transplants which are done not as part of a rigorous trial and I discourage patients from getting stem cells that are not being given in a controlled fashion. For one thing, patients have been getting hurt by these treatments in these clinics; they have developed tumors and infections and other problems. In many cases we don’t even know what the cells are, there’s not published information and the patients pay cash for this, of course.”

At CIRM we also worry about people going to clinics, in the US and in other countries, where they are getting therapies that have not been approved by the US Food and Drug Administration (FDA) or other appropriate regulatory bodies. That’s why we have created this page on our website to help people who want a stem cell therapy but don’t know what to look for in a clinical trial or what questions to ask to make sure it’s a legitimate trial, one that’s been given the go-ahead by the FDA.

Bret Ryan asked: “What becomes of the implanted cells?”

Dr. Steinberg: We found after transplanting the cells, one week after the transplant, we see a new abnormality in the premotor cortex, the area of the brain that controls motor function. We saw a new abnormality there or a new signal that disappears after a month and never comes back. But the size of that temporary abnormality after one week correlates very closely with the degree of recovery after six months, one year and two years.

One of the interesting things is that it doesn’t seem to be necessary for the cells to survive long term to have beneficial effects. The cells we used in the SanBio trial don’t survive more than a month and yet they seem to aid recovery function in our pilot studies which is sustained for years.”

And of course, many people, such as Karen Smart, wanted to know how they could get the therapy. Right now, the clinical trial is fully enrolled but Stanford is putting together a waiting list for future trials. If you are interested and would like more information, please email: stemcellstudy@stanford.edu.

Sonia Coontz, the patient who was also a key part of the Facebook Live event, has an amazing story to tell. She was left devastated, physically and emotionally, after having a stroke. But then she heard about Dr. Steinberg’s clinical trial and it changed her life. Here’s her story.

We were thrilled to receive all of your comments and questions during our first Facebook Live event. It’s this kind of dialogue between scientists, patients and the public that will be critical for the continued support of our mission to accelerate stem cell treatments to patients with unmet medical needs.

Due to the response, we plan to regularly schedule these “Ask the Expert” events. What disease area would you like us to focus on next time? Leave us a comment or email info@cirm.ca.gov

 

Friday Stem Cell Roundup: Making Nerves from Blood; New Clues to Treating Parkinson’s

Stanford lab develops method to make nerve cells from blood.

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Induced neuronal (iN) cells derived from adult human blood cells. Credit: Marius Wernig, Stanford University.

Back in 2010, Stanford Professor Marius Wernig and his team devised a method to directly convert skin cells into neurons, a nerve cell. This so-called transdifferentiation technique leapfrogs over the need to first reprogram the skin cells into induced pluripotent stem cells. This breakthrough provided a more efficient path to studying how genetics plays a role in various mental disorders, like autism or schizophrenia, using patient-derived cells. But these types of genetic analyses require data from many patients and obtaining patient skin samples hampered progress because it’s not only an invasive, somewhat painful procedure but it also takes time and money to prepare the tissue sample for the transdifferentiation method.

This week, the Wernig lab reported on a solution to this bottleneck in the journal, PNAS. The study, funded in part by CIRM, describes a variation on their transdifferentiation method which converts T cells from the immune system, instead of skin cells, into neurons. The huge advantage with T cells is that they can be isolated from readily available blood samples, both fresh or frozen. In a press release, Wernig explains this unexpected but very welcomed result:

“It’s kind of shocking how simple it is to convert T cells into functional neurons in just a few days. T cells are very specialized immune cells with a simple round shape, so the rapid transformation is somewhat mind-boggling. We now have a way to directly study the neuronal function of, in principle, hundreds of people with schizophrenia and autism. For decades we’ve had very few clues about the origins of these disorders or how to treat them. Now we can start to answer so many questions.”

Two studies targeting Parkinson’s offer new clues to treating the disease (Kevin McCormack)
Despite decades of study, Parkinson’s disease remains something of a mystery. We know many of the symptoms – trembling hands and legs, stiff muscles – are triggered by the loss of dopamine producing cells in the brain, but we are not sure what causes those cells to die. Despite that lack of certainty researchers in Germany may have found a way to treat the disease.

Mitochondria

Simple diagram of a mitochondria.

They took skin cells from people with Parkinson’s and turned them into the kinds of nerve cell destroyed by the disease. They found the cells had defective mitochondria, which help produce energy for the cells. Then they added a form of vitamin B3, called nicotinamide, which helped create new, healthy mitochondria.

In an article in Science & Technology Research News Dr. Michela Deleidi, the lead researcher on the team, said this could offer new pathways to treat Parkinson’s:

“This substance stimulates the faulty energy metabolism in the affected nerve cells and protects them from dying off. Our results suggest that the loss of mitochondria does indeed play a significant role in the genesis of Parkinson’s disease. Administering nicotinamide riboside may be a new starting-point for treatment.”

The study is published in the journal Cell Reports.

While movement disorders are a well-recognized feature of Parkinson’s another problem people with the condition suffer is sleep disturbances. Many people with Parkinson’s have trouble falling asleep or remaining asleep resulting in insomnia and daytime sleepiness. Now researchers in Belgium may have uncovered the cause.

Working with fruit flies that had been genetically modified to have Parkinson’s symptoms, the researchers discovered problems with neuropeptidergic neurons, the type of brain cell that helps regulate sleep patterns. Those cells seemed to lack a lipid, a fat-like substance, called phosphatidylserine.

In a news release Jorge Valadas, one of the lead researchers, said replacing the missing lipid produced promising results:

“When we model Parkinson’s disease in fruit flies, we find that they have fragmented sleep patterns and difficulties in knowing when to go to sleep or when to wake up. But when we feed them phosphatidylserine–the lipid that is depleted in the neuropeptidergic neurons–we see an improvement in a matter of days.”

Next, the team wants to see if the same lipids are low in people with Parkinson’s and if they are, look into phosphatidylserine – which is already approved in supplement form – as a means to help ease sleep problems.

Can stem cells help people recover from a stroke? Join us for a Facebook Live event this Thursday, May 31 for the answers

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Stroke is one of the leading causes of death in the US and the leading cause of serious, long-term disability. But could stem cell therapies change that and help people who’ve had a brain attack?  Could stem cells help repair the damage caused by a stroke and restore a person’s ability to speak normally, to be able to walk without a limp or regain strength in their hands and arms?

To find out the answers to these and other questions joins us for “Ask the Expert”, a special Facebook Live event this Thursday, May 31, from noon till 1pm PDT

 The event will feature Dr. Gary Steinberg, the Chair of Neurosurgery at Stanford University. Dr. Steinberg is currently running a CIRM-funded clinical trial targeting stroke.

We will also be joined by CIRM Senior Science Officer Lila Collins, PhD who can talk about the broad range of other projects using stem cells to help people recover from a stroke.

We are also delighted to welcome Sonia Coontz, who suffered a devastating stroke several years ago and made a remarkable recovery after getting a stem cell therapy.

To join us for the event, all you have to do is go to our Facebook page on Thursday at noon (PDT) and you should see a video playing, which you can watch on mobile or desktop. Click the video to enter viewing mode.

Also, make sure to “like” our page before the event to receive a notification that we’ve gone live.

And we want to hear from you, so you will be able to post questions for the experts to answer or, you can email them directly to us at info@cirm.ca.gov

We look forward to seeing you there.

 

CIRM invests in stem cell clinical trial targeting lung cancer and promising research into osteoporosis and incontinence

Lung cancer

Lung cancer: Photo courtesy Verywell

The five-year survival rate for people diagnosed with the most advanced stage of non-small cell lung cancer (NSCLC) is pretty grim, only between one and 10 percent. To address this devastating condition, the Board of the California Institute for Regenerative Medicine (CIRM) today voted to invest almost $12 million in a team from UCLA that is pioneering a combination therapy for NSCLC.

The team is using the patient’s own immune system where their dendritic cells – key cells in our immune system – are genetically modified to boost their ability to stimulate their native T cells – a type of white blood cell – to destroy cancer cells.  The investigators will combine this cell therapy with the FDA-approved therapy pembrolizumab (better known as Keytruda) a therapeutic that renders cancer cells more susceptible to clearance by the immune system.

“Lung cancer is a leading cause of cancer death for men and women, leading to 150,000 deaths each year and there is clearly a need for new and more effective treatments,” says Maria T. Millan, M.D., the President and CEO of CIRM. “We are pleased to support this program that is exploring a combination immunotherapy with gene modified cell and antibody for one of the most extreme forms of lung cancer.”

Translation Awards

The CIRM Board also approved investing $14.15 million in four projects under its Translation Research Program. The goal of these awards is to support promising stem cell research and help it move out of the laboratory and into clinical trials in people.

Researchers at Stanford were awarded almost $6 million to help develop a treatment for urinary incontinence (UI). Despite being one of the most common indications for surgery in women, one third of elderly women continue to suffer from debilitating urinary incontinence because they are not candidates for surgery or because surgery fails to address their condition.

The Stanford team is developing an approach using the patient’s own cells to create smooth muscle cells that can replace those lost in UI. If this approach is successful, it provides a proof of concept for replacement of smooth muscle cells that could potentially address other conditions in the urinary tract and in the digestive tract.

Max BioPharma Inc. was awarded almost $1.7 million to test a therapy that targets stem cells in the skeleton, creating new bone forming cells and blocking the destruction of bone cells caused by osteoporosis.

In its application the company stressed the benefit this could have for California’s diverse population stating: “Our program has the potential to have a significant positive impact on the lives of patients with osteoporosis, especially in California where its unique demographics make it particularly vulnerable. Latinos are 31% more likely to have osteoporosis than Caucasians, and California has the largest Latino population in the US, accounting for 39% of its population.”

Application Title Institution CIRM funding
TRAN1-10958 Autologous iPSC-derived smooth muscle cell therapy for treatment of urinary incontinence

 

 

Stanford University

 

$5,977,155

 

TRAN2-10990 Development of a noninvasive prenatal test for beta-hemoglobinopathies for earlier stem cell therapeutic interventions

 

 

Children’s Hospital Oakland Research Institute

 

$1,721,606

 

TRAN1-10937 Therapeutic development of an oxysterol with bone anabolic and anti-resorptive properties for intervention in osteoporosis  

MAX BioPharma Inc.

 

$1,689,855

 

TRAN1-10995 Morphological and functional integration of stem cell derived retina organoid sheets into degenerating retina models

 

 

UC Irvine

 

$4,769,039

 

‘Ask The Expert’ on Facebook Live about the power of stem cells to reverse damage caused by a stroke.

facebook-live-brand-awarenessIt’s not often you get a chance to ask a world class stem cell expert a question about their work, and how it might help you or someone you love. But on Thursday, May 31 you can do just that.

CIRM is hosting a special ‘Ask the Expert’ event on Facebook Live. The topic is Strokes and Stem Cells. Just head over to our Facebook Page on May 31st from noon till 1pm PST to experience it live. You can also re-watch the event any time after the broadcast has ended from our Facebook videos page.

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We will be joined by Dr. Gary Steinberg, chair of neurosurgery at Stanford University, who will talk to us about his work in helping reverse the damage caused by a stroke, even for people who experienced a brain attack several years ago.

CIRM Senior Science Officer, Dr. Lila Collins, will talk about other stem cell research targeting stroke, its promise and some of the problems that still need to be overcome.

You will have a chance to ask questions of both our experts, either live on the day or by sending us questions in advance at info@cirm.ca.gov.

We’ll post reminders on Facebook so make sure to follow us. But for now, mark the date and time on your diary and please feel free to share this information with anyone you think might be interested.

It promises to be a fascinating event.

 

 

Therapies Targeting Cancer, Deadly Immune Disorder and Life-Threatening Blood Condition Get Almost $32 Million Boost from CIRM Board

An innovative therapy that uses a patient’s own immune system to attack cancer stem cells is one of three new clinical trials approved for funding by CIRM’s Governing Board.

Researchers at the Stanford University School of Medicine were awarded $11.9 million to test their Chimeric Antigen Receptor (CAR) T Cell Therapy in patients with B cell leukemias who have relapsed or are not responding after standard treatments, such as chemotherapy.CDR774647-750Researchers take a patient’s own T cells (a type of immune cell) and genetically re-engineer them to recognize two target proteins on the surface of cancer cells, triggering their destruction. In addition, some of the T cells will form memory stem cells that will survive for years and continue to survey the body, killing any new or surviving cancer cells.

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Maria T. Millan

“When a patient is told that their cancer has returned it can be devastating news,” says Maria T. Millan, MD, President & CEO of CIRM. “CAR T cell therapy is an exciting and promising new approach that offers us a way to help patients fight back against a relapse, using their own cells to target and destroy the cancer.”

 

 

Sangamo-logoThe CIRM Board also approved $8 million for Sangamo Therapeutics, Inc. to test a new therapy for beta-thalassemia, a severe form of anemia (lack of healthy red blood cells) caused by mutations in the beta hemoglobin gene. Patients with this genetic disorder require frequent blood transfusions for survival and have a life expectancy of only 30-50 years. The Sangamo team will take a patient’s own blood stem cells and, using a gene-editing technology called zinc finger nuclease (ZFN), turn on a different hemoglobin gene (gamma hemoglobin) that can functionally substitute for the mutant gene. The modified blood stem cells will be given back to the patient, where they will give rise to functional red blood cells, and potentially eliminate the need for chronic transfusions and its associated complications.

UCSFvs1_bl_a_master_brand@2xThe third clinical trial approved is a $12 million grant to UC San Francisco for a treatment to restore the defective immune system of children born with severe combined immunodeficiency (SCID), a genetic blood disorder in which even a mild infection can be fatal. This condition is also called “bubble baby disease” because in the past children were kept inside sterile plastic bubbles to protect them from infection. This trial will focus on SCID patients who have mutations in a gene called Artemis, the most difficult form of SCID to treat using a standard bone marrow transplant from a healthy donor. The team will genetically modify the patient’s own blood stem cells with a functional copy of Artemis, with the goal of creating a functional immune system.

CIRM has funded two other clinical trials targeting different approaches to different forms of SCID. In one, carried out by UCLA and Orchard Therapeutics, 50 children have been treated and all 50 are considered functionally cured.

This brings the number of clinical trials funded by CIRM to 48, 42 of which are active. There are 11 other projects in the clinical trial stage where CIRM funded the early stage research.

Celebrating Exciting CIRM-Funded Discovery Research on World Parkinson’s Day

April 11th is World Parkinson’s Disease Awareness Day. To mark the occasion, we’re featuring the work of CIRM-funded researchers who are pursuing new, promising ideas to treat patients with this debilitating neurodegenerative disease.


Birgitt Schuele, Parkinson’s Institute

CIRM Grant: Quest Award – Discovery Stage Research

Research: Birgitt and her team at the Parkinson’s Institute in Sunnyvale, California, are using CRISPR gene editing technology to reduce the levels of a toxic protein called alpha synuclein, which builds up in the dopaminergic brain cells affected by Parkinson’s disease.

Birgitt Schuele

“My hope is that I can contribute to stopping disease progression in Parkinson’s. If we can develop a drug that can get rid of accumulated protein in someone’s brain that should stop the cells from dying. If someone has early onset PD and a slight tremor and minor walking problems, stopping the disease and having a low dose of dopamine therapy to control symptoms is almost a cure.”

Parkinson’s disease in a dish. Dopaminergic neurons made from Parkinson’s patient induced pluripotent stem cells. (Image credit: Birgitt Schuele)


Jeanne Loring, Scripps Research Institute

CIRM Grant: Quest Award – Discovery Stage Research

Research: Jeanne Loring and her team at the Scripps Research Institute in La Jolla, California, are deriving dopaminergic neurons from the iPSCs of Parkinson’s patients. Their goal is to develop a personalized, stem cell-based therapy for PD.

Jeanne Loring

“We are working toward a patient-specific neuron replacement therapy for Parkinson’s disease.  By the time PD is diagnosed, people have lost more than half of their dopamine neurons in a specific part of the brain, and loss continues over time.  No drug can stop the loss or restore the neurons’ function, so the best possible option for long term relief of symptoms is to replace the dopamine neurons that have died.  We do this by making induced pluripotent stem cells from individual PD patients and turning them into the exact type of dopamine neuron that has been lost.  By transplanting a patient’s own cells, we will not need to use potentially dangerous immunosuppressive drugs.  We plan to begin treating patients in a year to two years, after we are granted FDA approval for the clinical therapy.”

Skin cells from a Parkinson’s patient (left) were reprogrammed into induced pluripotent stem cells (center) that were matured into dopaminergic neurons (right) to model Parkinson’s disease. (Image credit: Jeanne Loring)


Justin Cooper-White, Scaled BioLabs Inc.

CIRM Grant: Quest Award – Discovery Stage Research

Research: Justin Cooper-White and his team at Scaled Biolabs in San Francisco are developing a tool that will make clinical-grade dopaminergic neurons from the iPSCs of PD patients in a rapid and cost-effective manner.

Justin Cooper-White

“Treating Parkinson’s disease with iPSC-derived dopaminergic neuron transplantation has a strong scientific and clinical rationale. Even the best protocols are long and complex and generally have highly variable quality and yield of dopaminergic neurons. Scaled Biolabs has developed a technology platform based on high throughput microfluidics, automation, and deep data which can optimize and simplify the road from iPSC to dopaminergic neuron, making it more efficient and allowing a rapid transition to GMP-grade derivation of these cells.  In our first 6 months of CIRM-funded work, we believe we have already accelerated and simplified the production of a key intermediate progenitor population, increasing the purity from the currently reported 40-60% to more than 90%. The ultimate goal of this work is to get dopaminergic neurons to the clinic in a robust and economical manner and accelerate treatment for Parkinson’s patients.”

High throughput differentiation of dopaminergic neuron progenitors in  microbioreactor chambers in Scaled Biolabs’ cell optimization platform. Different chambers receive different differentiation factors, so that optimal treatments for conversion to dual-positive cells can be determined (blue: nuclei, red: FOXA2, green: LMX1A).


Xinnan Wang, Stanford University

CIRM Grant: Basic Biology V

Research: Xinnan Wang and her team at Stanford University are studying the role of mitochondrial dysfunction in the brain cells affected in Parkinson’s disease.

Xinnan Wang

“Mitochondria are a cell’s power plants that provide almost all the energy a cell needs. When these cellular power plants are damaged by stressful factors present in aging neurons, they release toxins (reactive oxygen species) to the rest of the neuron that can cause neuronal cell death (neurodegeneration).  We hypothesized that in Parkinson’s mutant neurons, mitochondrial quality control is impaired thereby leading to neurodegeneration. We aimed to test this hypothesis using neurons directly derived from Parkinson’s patients (induced pluripotent stem cell-derived neurons).”

Dopaminergic neurons derived from human iPSCs shown in green, yellow and red. (Image credit: Atossa Shaltouki, Stanford)


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Stem Cell Round: Improving memory, building up “good” fat, nanomedicine

Stem Cell Photo of the Week

roundup03618In honor of brain awareness week, our featured stem cell photo is of the brain! Scientists at the Massachusetts General Hospital and Harvard Stem Cell Institute identified a genetic switch that could potentially improve memory during aging and symptoms of PTSD. Shown in this picture are dentate gyrus cells (DGC) (green) and CA3 interneurons (red) located in the memory-forming area of the brain known as the hippocampus. By reducing the levels of a protein called abLIM3 in the DGCs of older mice, the researchers were able to boost the connections between DGCs and CA3 cells, which resulted in an improvement in the memories of the mice. The team believes that targeting this protein in aging adults could be a potential strategy for improving memory and treating patients with post-traumatic stress disorder (PTSD). You can read more about this study in The Harvard Gazette.

New target for obesity.
Fat cells typically get a bad rap, but there’s actually a type of fat cell that is considered “healthier” than others. Unlike white fat cells that store calories in the form of energy, brown fat cells are packed with mitochondria that burn energy and produce heat. Babies have brown fat, so they can regulate their body temperature to stay warm. Adults also have some brown fat, but as we get older, our stores are slowly depleted.

In the fight against obesity, scientists are looking for ways to increase the amount of brown fat and decrease the amount of white fat in the body. This week, CIRM-funded researchers from the Salk Institute identified a molecule called ERRg that gives brown fat its ability to burn energy. Their findings, published in Cell Reports, offer a new target for obesity and obesity-related diseases like diabetes and fatty liver disease.

The team discovered that brown fat cells produce the ERRg molecule while white fat cells do not. Additionally, mice that couldn’t make the ERRg weren’t able to regulate their body temperature in cold environments. The team concluded in a news release that ERRg is “involved in protection against the cold and underpins brown fat identity.” In future studies, the researchers plan to activate ERRg in white fat cells to see if this will shift their identity to be more similar to brown fat cells.

brownfat_mice

Mice that lack ERR aren’t able to regulate their body temperature and are much colder (right) than normal mice (left). (Image credit Salk Institute)

Tale of two nanomedicine stories: making gene therapies more efficient with a bit of caution (Todd Dubnicoff).
This week, the worlds of gene therapy, stem cells and nanomedicine converged for not one, but two published reports in the journal American Chemistry Society NANO.

The first paper described the development of so-called nanospears – tiny splinter-like magnetized structures with a diameter 5000 times smaller than a strand of human hair – that could make gene therapy more efficient and less costly. Gene therapy is an exciting treatment strategy because it tackles genetic diseases at their source by repairing or replacing faulty DNA sequences in cells. In fact, several CIRM-funded clinical trials apply this method in stem cells to treat immune disorders, like severe combined immunodeficiency and sickle cell anemia.

This technique requires getting DNA into diseased cells to make the genetic fix. Current methods have low efficiency and can be very damaging to the cells. The UCLA research team behind the study tested the nanospear-delivery of DNA encoding a gene that causes cells to glow green. They showed that 80 percent of treated cells did indeed glow green, a much higher efficiency than standard methods. And probably due to their miniscule size, the nanospears were gentle with 90 percent of the green glowing cells surviving the procedure.

As Steve Jonas, one of the team leads on the project mentions in a press release, this new method could bode well for future recipients of gene therapies:

“The biggest barrier right now to getting either a gene therapy or an immunotherapy to patients is the processing time. New methods to generate these therapies more quickly, effectively and safely are going to accelerate innovation in this research area and bring these therapies to patients sooner, and that’s the goal we all have.”

While the study above describes an innovative nanomedicine technology, the next paper inserts a note of caution about how experiments in this field should be set up and analyzed. A collaborative team from Brigham and Women’s Hospital, Stanford University, UC Berkeley and McGill University wanted to get to the bottom of why the many advances in nanomedicine had not ultimately led to many new clinical trials. They set out looking for elements within experiments that could affect the uptake of nanoparticles into cells, something that would muck up the interpretation of results.

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imaging of female human amniotic stem cells incubated with nanoparticles demonstrated a significant increase in uptake compared to male cells. (Green dots: nanoparticles; red: cell staining; blue: nuclei) Credit: Morteza Mahmoudi, Brigham and Women’s Hospital.

In this study, they report that the sex of cells has a surprising, noticeable impact on nanoparticle uptake. Nanoparticles were incubated with human amniotic stem cells derived from either males or females. The team showed that the female cells took up the nanoparticles much more readily than the male cells.  Morteza Mahmoudi, PhD, one of the authors on the paper, explained the implications of these results in a press release:

“These differences could have a critical impact on the administration of nanoparticles. If nanoparticles are carrying a drug to deliver [including gene therapies], different uptake could mean different therapeutic efficacy and other important differences, such as safety, in clinical data.”

 

It’s World Kidney Day: Highlighting CIRM’s Investments in Treating Kidney Failure

WKD-Logo-HiToday is World Kidney Day. Hundreds of events across the globe are taking place “to raise awareness of the importance of our kidneys to our overall health and to reduce the frequency and impact of kidney disease and its associated health problems worldwide.” (Side note: in recognition that today is also International Women’s Day, World Kidney Day’s theme this year is “Kidney’s & Women: Include, Value, Empower.)

To honor this day, we’re highlighting how CIRM is playing its part in that mission. The infographic below provides big picture summaries of the four CIRM-funded clinical trials that are currently testing stem cell-based therapies for kidney failure, a condition that affects well over 600,000 Americans.

When a person’s kidneys fail, their body can no longer filter out waste products and extra fluid from the blood which leads to life-threatening complications. About 30% of those affected in the U.S. have organ transplants. Due to the limited availability of donor organs, the other 70% need dialysis, a blood filtration therapy, that requires several trips a week to a special clinic.

Both treatment options have serious limitations. Organ recipients have to take drugs that prevent organ rejections for the rest of their lives. Over time, these drugs are toxic and can increase a patient’s risk of infection, heart disease, cancer and diabetes. In the case of dialysis treatment, the current procedure uses a plastic tube called a shunt to connect to a patient’s vein. These shunts are far from ideal and can lead to infection, blood clots and can be rejected by the patient’s immune system. These complications probably play a role in the average life expectancy of 5-10 years for dialysis patients.

Four CIRM-funded clinical trials aim to circumvent these drawbacks. Humacyte has received over $24 million from the Agency to support two clinical trials that are testing an alternative to the plastic shunt used in dialysis treatment. The company has developed a bioengineered vessel that is implanted in the patient’s arm and over time is populated with the patient’s own stem cells which develop into a natural blood vessel. The trials will determine if the bioengineered vessel is superior to the shunt in remaining open for longer periods of time and with lower incidence of interventions due to blood clots and infections.

The other two CIRM-funded trials, one headed by Stanford University and the other by Medeor Therapeutics, aims to eliminate the need for long-life, anti-rejection medicine after kidney transplant. Both trials use a similar strategy: blood stem cells and immune cells from the organ donor are infused into the patient receiving the organ. If all goes as planned, those donor cells will engraft into and mix with the recipient’s immune system, making organ rejection less likely and ending the need for immune-system suppressing drugs.

For more details visit our Clinical Trial Dashboard.

MonthofCIRM_Kidney3b

Friday Roundup: A better kind of blood stem cell transplant; Encouraging news from spinal cord injury trial; Finding an “elusive” cell that could help diabetics

Cool Instagram image of the week:

Pancreatic Progenitors

Diabetes Research Institute scientists have confirmed that the unique stem cells reside within large ducts of the human pancreas. Two such ducts (green) surrounded by three islets (white) are shown. [Diabetes Research Institute Foundation]

Chemo- and radiation-free blood stem cell transplant showing promise

Bubble baby disease, also known as severe combined immunodeficiency (SCID), is an inherited disorder that leaves newborns without an effective immune system. Currently, the only approved treatment for SCID is a blood stem cell transplant, in which the patient’s defective immune system cells are eliminated by chemotherapy or radiation to clear out space for cells from a healthy, matched donor. Even though the disease can be fatal, physicians loathe to perform a stem cell transplant on bubble baby patients:

Shizuru“Physicians often choose not to give chemotherapy or radiation to young children with SCID because there are lifelong effects: neurological impairment, growth delays, infertility, risk of cancer, etc.,” says Judith Shizuru, MD, PhD, professor of medicine at Stanford University.

To avoid these complications, Dr. Shizuru is currently running a CIRM-funded clinical trial testing a gentler approach to prepare patients for blood stem cell transplants. She presented promising, preliminary results of the trial on Tuesday at the annual meeting of Stanford’s Center for Definitive and Curative Medicine.

Trial participants are receiving a protein antibody called CD117 before their stem cell transplant. Previous studies in animals showed that this antibody binds to the surface of blood stem cells and blocks the action of a factor which is required for stem cell survival. This property of CD117 provides a means to get rid of blood stem cells without radiation or chemotherapy.

Early results in two participants indicate that, 6 and 9 months after receiving the CD117 blood stem cell transplants, the donor cells have successfully established themselves in the patients and begun making immune cells.

Spinal cord injury trial reports more promising results:

AsteriasRegular readers of our blog will already know about our funding for the clinical trial being run by Asterias Biotherapeutics to treat spinal cord injuries. The latest news from the company is very encouraging, in terms of both the safety and effectiveness of the treatment.

Asterias is transplanting stem cells into patients who have suffered recent injuries that have left them paralyzed from the neck down. It’s hoped the treatment will restore connections at the injury site, allowing patients to regain some movement and feeling in their hands and arms.

This week the company announced that of the 25 patients they have treated there have been no serious side effects. In addition:

  • Magnetic Resonance Imaging (MRI) scans show that in more than 90 percent of the patients the cells appear to show signs of engraftment
  • At least 75 percent of those treated have recovered at least one motor level, and almost 20 percent have recovered two levels

In a news release, Michael Mulroy, Asterias’ President and CEO, said:

“The positive safety profile to date, the evidence supporting engraftment of the cells post-implantation, and the improvements we are seeing in upper extremity motor function highlight the promising findings coming from this Phase 1/2a clinical trial, which will guide us as we work to design future studies.”

There you are! Finding the “elusive” human pancreatic progenitor cells – the story behind our cool Instagram image of the week.

Don’t you hate it when you lose something and can’t find it? Well imagine the frustration of scientists who were looking for a group of cells they were sure existed but for decades they couldn’t locate them. Particularly as those cells might help in developing new treatments for diabetes.

Diabetes-Research-Institute_University-of-Miami-Miller-School-of-MedicineWell, rest easy, because scientists at the Diabetes Research Institute at the University of Miami finally found them.

In a study, published in Genetic Engineering and Biotechnology News, the researchers show how they found these progenitor cells in the human pancreas, tucked away in the glands and ducts of the organ.

In type 1 diabetes, the insulin-producing cells in the pancreas are destroyed. Finding these progenitor cells, which have the ability to turn into the kinds of cells that produce insulin, means researchers could develop new ways to regenerate the pancreas’ ability to function normally.

That’s a long way away but this discovery could be an important first step along that path.