Partnering with the best to help find cures for rare diseases

As a state agency we focus most of our efforts and nearly all our money on California. That’s what we were set up to do. But that doesn’t mean we don’t also look outside the borders of California to try and find the best research, and the most promising therapies, to help people in need.

Today’s meeting of the CIRM Board was the first time we have had a chance to partner with one of the leading research facilities in the country focusing on children and rare diseases; St. Jude Children’s Researech Hospital in Memphis, Tennessee.

a4da990e3de7a2112ee875fc784deeafSt. Jude is getting $11.9 million to run a Phase I/II clinical trial for x-linked severe combined immunodeficiency disorder (SCID), a catastrophic condition where children are born without a functioning immune system. Because they are unable to fight off infections, many children born with SCID die in the first few years of life.

St. Jude is teaming up with researchers at the University of California, San Francisco (UCSF) to genetically modify the patient’s own blood stem cells, hopefully creating a new blood system and repairing the damaged immune system. St. Jude came up with the method of doing this, UCSF will treat the patients. Having that California component to the clinical trial is what makes it possible for us to fund this work.

This is the first time CIRM has funded work with St. Jude and reflects our commitment to moving the most promising research into clinical trials in people, regardless of whether that work originates inside or outside California.

The Board also voted to fund researchers at Cedars-Sinai to run a clinical trial on ALS or Lou Gehrig’s disease. Like SCID, ALS is a rare disease. As Randy Mills, our President and CEO, said in a news release:

CIRM CEO and President, Randy Mills.

CIRM CEO and President, Randy Mills.

“While making a funding decision at CIRM we don’t just look at how many people are affected by a disease, we also look at the severity of the disease on the individual and the potential for impacting other diseases. While the number of patients afflicted by these two diseases may be small, their need is great. Additionally, the potential to use these approaches in treating other disease is very real. The underlying technology used in treating SCID, for example, has potential application in other areas such as sickle cell disease and HIV/AIDS.”

We have written several blogs about the research that cured children with SCID.

The Board also approved funding for a clinical trial to develop a treatment for type 1 diabetes (T1D). This is an autoimmune disease that affects around 1.25 million Americans, and millions more around the globe.

T1D is where the body’s own immune system attacks the cells that produce insulin, which is needed to control blood sugar levels. If left untreated it can result in serious, even life-threatening, complications such as vision loss, kidney damage and heart attacks.

Researchers at Caladrius Biosciences will take cells, called regulatory T cells (Tregs), from the patient’s own immune system, expand the number of those cells in the lab and enhance them to make them more effective at preventing the autoimmune attack on the insulin-producing cells.

The focus is on newly-diagnosed adolescents because studies show that at the time of diagnosis T1D patients usually have around 20 percent of their insulin-producing cells still intact. It’s hoped by intervening early the therapy can protect those cells and reduce the need for patients to rely on insulin injections.

David J. Mazzo, Ph.D., CEO of Caladrius Biosciences, says this is hopeful news for people with type 1 diabetes:

David Mazzo

David Mazzo

“We firmly believe that this therapy has the potential to improve the lives of people with T1D and this grant helps us advance our Phase 2 clinical study with the goal of determining the potential for CLBS03 to be an effective therapy in this important indication.”

 


Related Links:

Listen Up: A stem cell-based solution for hearing loss

Can you hear me now?

If you’re old enough, you probably recognize this phrase from an early 2000’s Verizon Wireless commercial where the company claims to be “the nation’s largest, most reliable wireless network”. However, no matter how hard wireless companies like Verizon try, there are still dead zones where cell phone reception is zilch and you can’t in fact hear me now.

This cell phone coverage is a good analogy for the 5% of the world population, or 360 million people, that suffer from hearing loss. There are many causes for hearing loss including genetic predispositions, birth defects, constant exposure to loud noises, infectious diseases, certain drugs, ear infections and aging. There is no cure that fully restores hearing, but patients can benefit from hearing aids, cochlear implants and other hearing devices.

But listen to this. A new stem cell-based technique developed by the Massachusetts Eye and Ear Infirmary may restore hearing in patients with hearing loss. The team discovered that stem cells in the inner ear can be manipulated in a culture dish to expand and develop into large quantities of cochlear hair cells, which make it possible for your brain to detect sound. Their work was published this week in the journal Cell Reports.

In a previous study, the Boston team found that stem cells in the inner ears of mice could be directly converted into cochlear hair cells, but they weren’t able to generate enough hair cells to fully restore hearing in these mice. Building on this work, the team isolated these stem cells, which express a protein called LGR5, and developed an augmentation technique consisting of drugs and growth factors to expand these stem cells and then specialize them into larger populations of hair cells.

A new technique converts stems cells into hair cells. Image credit Will McLean, Albert Edge, Massachusetts Eye and Ear

A new technique converts stems cells into hair cells. Image credit Will McLean, Albert Edge, Massachusetts Eye and Ear.

From a single mouse cochlea, they made more than 11,500 hair cells using their new augmentation method, which is more than 50 times the number of hair cells they made using a more basic method.

In a news release, senior author on the study, Dr. Albert Edge, explained the importance of their findings for patients with hearing loss:

Albert Edge

Albert Edge

“We have shown that we can expand Lgr5-expressing cells to differentiate into hair cells in high yield, which opens the door for drug discovery for hearing. We hope that by stimulating these cells to divide and differentiate that we will improve on our previous results in restoring hearing. With this knowledge, we can make better shots on goal, which is critical for repairing damaged ears. We have identified the cells of interest and have identified the pathways and drugs to target to improve on previous results. These clues may lead us closer to finding drugs that could treat hearing loss in adults.”

Rare diseases are not so rare

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Brenden Whittaker – cured in a CIRM-funded clinical trial focusing on his rare disease

It seems like a contradiction in terms to say that there are nearly 7,000 diseases, affecting 30 million people, that are considered rare in the US. But the definition of a rare disease is one that affects fewer than 200,000 people and the National Institutes of Health’s (NIH) Genetic and Rare Diseases Information Center (GARD) has a database that lists every one of them.

Those range from relatively well known conditions such as sickle cell disease and cerebral palsy, to lesser known ones such as attenuated familial adenomatous polyposis (AFAP) – an inherited condition that increases your risk of colon cancer.

Because disease like these are so rare, in the past many individuals with them felt isolated and alone. Thanks to the internet, people are now able to find online support groups where they can get advice on coping strategies, ideas on potential therapies and, just as important, can create a sense of community.

One of the biggest problems facing the rare disease community is a lack of funding for research to develop treatments or cures. Because these diseases affect fewer than 200,000 people most pharmaceutical companies don’t invest large sums of money developing treatments; they simply wouldn’t be able to get a big enough return on their investment. This is not a value judgement. It’s just a business reality.

And that’s where CIRM comes in. We were created, in part, to help those who can’t get help from other sources. This week alone, for example, our governing Board is meeting to vote on funding clinical trials for two rare and deadly diseases – ALS or Lou Gehrig’s disease, and Severe Combined Immunodeficiency or SCID. This kind of funding can mean the difference between life and death.

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For proof, you need look no further than Evie Vaccaro, the young girl we feature on the front of our 2016 Annual Report. Evie was born with SCID and faced a bleak future. But UCLA researcher Don Kohn, with some help from CIRM, developed a therapy that cured Evie. This latest clinical trial could help make a similar therapy available to other children with SCID.

But with almost 7,000 rare diseases it’s clear we can’t help everyone. In fact, there are only around 450 FDA-approved therapies for all these conditions. That’s why the National Organization for Rare Disorders (NORD) and groups like them are organizing events around the US on February 28th, which has been designated as Rare Disease Day. The goal is to raise awareness about rare diseases, and to advocate for action to help this community. Here’s a link to Advocacy Events in different states around the US.

Alone, each of these groups is small and easily overlooked. Combined they have a powerful voice, 30 million strong, that demands to be heard.

 

 

Stem cell stories that caught our eye: drug safety for heart cells, worms hijack plant stem cells & battling esophageal cancer

Devising a drug safety measuring stick in stem cell-derived heart muscle cells
One of the mantras in the drug development business is “fail early”. That’s because most of the costs of getting a therapy to market occur at the later stages when an experimental treatment is tested in clinical trials in people. So, it’s best for a company’s bottom line and, more importantly, for patient safety to figure out sooner rather than later if a therapy has dangerous toxic side effects.

Researchers at Stanford reported this week in Science Translational Medicine on a method they devised that could help weed out cancer drugs with toxic effects on the heart before the treatment is tested in people.

In the lab, the team grew beating heart muscle cells, or cardiomyocytes, from induced pluripotent stem cells derived from both healthy volunteers and kidney cancer patients. A set of cancer drugs called tyrosine kinase inhibitors which are known to have a range of serious side effects on the heart, were added to the cells. The effect of the drugs on the heart cell function were measured with several different tests which the scientists combined into a single “safety index”.

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A single human induced pluripotent stem cell-derived cardiomyocyte. Cells such as these were used to assess tyrosine kinase inhibitors for cardiotoxicity in a high-throughput fashion. Credit: Dr. Arun Sharma at Dr. Joseph Wu’s laboratory at Stanford University

They found that the drugs previously shown to have toxic effects on patients’ hearts had the worst safety index values in the current study. And because these cells were in a lab dish and not in a person’s heart, the team was able to carefully examine cell activity and discovered that the toxic effects of three drugs could be alleviated by also adding insulin to the cells.

As lead author Joseph Wu, director of the Stanford Cardiovascular Institute, mentions in a press release, the development of this drug safety index could provide a powerful means to streamline the drug development process and make the drugs safer:

“This type of study represents a critical step forward from the usual process running from initial drug discovery and clinical trials in human patients. It will help pharmaceutical companies better focus their efforts on developing safer drugs, and it will provide patients more effective drugs with fewer side effects”

Worm feeds off of plants by taking control of their stem cells
In what sounds like a bizarre mashup of a vampire movie with a gardening show, a study reported this week pinpoints how worms infiltrate plants by commandeering the plants’ own stem cells. Cyst nematodes are microscopic roundworms that invade and kill soybean plants by sucking out their nutrients. This problem isn’t a trivial matter since nematodes wreak billions of dollars of damage to the world’s soybean crops each year. So, it’s not surprising that researchers want to understand how exactly these critters attack the plants.

nematode-feeding-site

A nematode, the oblong object on the left, activates the vascular stem cell pathway in the developing nematode feeding site on a plant root. Credit: Xiaoli Guo, University of Missouri

Previous studies by Melissa Goellner Mitchum, a professor at the University of Missouri, had shown that the nematodes release protein fragments, called peptides, near a plant’s roots that help divert the flow of plant nutrients to the worm.

“These parasites damage root systems by creating a unique feeding cell within the roots of their hosts and leeching nutrients out of the soybean plant. This can lead to stunting, wilting and yield loss for the plant,” Mitchum explained in a press release.

In the current PLOS Pathogens study, Mitchum’s team identified another peptide produced by the nematode that is identical to a plant peptide that instructs stem cells to form the plant equivalent of blood vessels. This devious mimicking of the plant peptides is what allows the nematode to trick the plant stem cells into building vessels that reroute the plants’ nutrients directly to the worm.

Mitchum described the big picture implications of this fascinating discovery:

“Understanding how plant-parasitic nematodes modulate host plants to their own benefit is a crucial step in helping to create pest-resistant plants. If we can block those peptides and the pathways nematodes use to overtake the soybean plant, then we can enhance resistance for this very valuable global food source.”

Finding vulnerabilities in treatment-resistant esophageal cancer stem cells

diagram_showing_internal_radiotherapy_for_cancer_of_the_oesophagus_cruk_162-svg

Illustration of radiation therapy for esophageal cancer.
Credit: Cancer Research UK

The incidence of esophageal cancer has increased more than any other disease over the past 30 years. And while some patients respond well to chemotherapy and radiation treatment, most do not because the cancer becomes resistant to these treatments.

Focusing on cancer stem cells, researchers at Trinity College Dublin have identified an approach that may overcome treatment resistance.

Within tumors are thought to lie cancer stem cells that, just like stem cells, have the ability to multiply indefinitely. Even though they make up a small portion of a tumor, in some patients the cancer stem cells evade the initial rounds of treatment and are responsible for the return of the cancer which is often more aggressive. Currently, there’s no effective way to figure out how well a patient with esophageal cancer will response to treatment.

In the current study published in Oncotarget, the researchers found that a genetic molecule called miR-17 was much less abundant in the esophageal cancer stem cells. In fact, the cancer stem cells with the lowest levels of miR-17, were the most resistant to radiation therapy. The researchers went on to show that adding back miR-17 to the highly resistant cells made them sensitive again to the radiation. Niamh Lynam-Lennon, the study’s first author, explained in a press release that these results could have direct clinical applications:

“Going forward, we could use synthetic miR-17 as an addition to radiotherapy to enhance its effectiveness in patients. This is a real possibility as a number of other synthetic miR-molecules are currently in clinical trials for treating other diseases.”

TV’s Dr. Oz takes on clinics offering dubious stem cell treatments

foyt

A. J. Foyt: Photo courtesy Indycar.com

oz

At first glance motor car racing legend A. J. Foyt and TV celebrity heart surgeon Dr. Mehmet Oz would seem to have little in common. But this week they both made news for being at opposite ends of an all too familiar story: for-profit medical clinics offering unproven stem cell therapies.

Foyt, who is now 82 years old, made history by becoming the only driver to win the Indianapolis 500 (4 times), the Daytona 500, the 24 Hours of Daytona, and the 24 Hours of Le Mans. But along the way he crashed several times leading to a broken back, broken feet and legs and numerous other injuries. Now, in a story in USA Today he announced he is going to Mexico to get a stem cell treatment to help repair his battered body.

In the article he is quoted talking about the procedure to IndyCar.com:

“They have to cut away some of the tissue from my stomach and it takes 8-10 weeks for it to grow back to produce the stem cells. I’ll probably have it done soon so that we can begin the treatment within the next two to three months.”

He then plans on having those stem cells, taken from fat in his stomach, injected into his ankles, shoulders and blood.

Now, that doesn’t sound like any stem cell therapy I have ever heard of and ordinarily we’d blog about the risks involved in going to a clinic like this for a “treatment” like this. But this week we don’t have to, because Dr. Oz did it for us.

This week the Dr. Oz TV show ran a special investigative story that looked at for-profit stem cell clinics that offer ”treatments” for everything from arthritis to Alzheimer’s, using the same cells and the same approach.

In an accompanying blog called ‘Crucial Tips to Avoid Stem Cell Scammers’ Elizabeth Leamy – who took part in undercover visits to several clinics – says there are more than 570 clinics around the US offering unproven and unapproved treatments:

“What I learned is that revenue has eclipsed research. Hundreds of for-profit stem cell clinics already exist across the country because desperate patients will pay big money —$5,000 to $20,000 a pop— for stem cell treatments. Surely it’s no coincidence that the patients these clinics target are those with diseases for which there is no known cure.”

The blog does a terrific job of exposing the tricks that clinics use to get patients to sign up for these “treatments” and highlights key red flags for people to watch out for:

  • Be wary of clinics that offer treatments with stem cells that originate from a part of the body that is different from the part being treated.
  • Watch out for clinics where treatments are offered for a wide variety of conditions but rely on a single cell type.
  • Be wary of clinics that measure or advertise their results primarily through patient testimonials.
  • Be wary of claims that stem cells will somehow just know where to go and what to do to treat a specific condition.

She concludes by warning that “just because stem cells came from your body doesn’t mean they are safe,” then listing the complications, even deaths, that have occurred among patients going to clinics like this, both inside and outside the US, saying:

“Yes, what we heard in our undercover visits was troubling. But worst yet, the premature stem cell treatments of today could undermine trust in the promising stem cell treatments of tomorrow.”

Perhaps someone should tell A. J. Foyt.

 

Rhythmic brain circuits built from stem cells

The TV commercial is nearly 20 years old but I remember it vividly: a couple is driving down a street when they suddenly realize the music on their tape deck is in sync with the repetitive activity on the street. From the guy casually dribbling a basketball to people walking along the sidewalk to the delivery people passing packages out of their truck, everything and everyone is moving rhythmically to the beat.

The ending tag line was, “Sometimes things just come together,” which is quite true. Many of our basic daily activities like breathing and walking just come together as a result of repetitive movement. It’s easy to take them for granted but those rhythmic patterns ultimately rely on very intricate, interconnected signals between nerve cells, also called neurons, in the brain and spinal cord.

Circuitoids: a neural network in a lab dish

A CIRM-funded study published yesterday in eLife by Salk Institute scientists reports on a method to mimic these repetitive signals in a lab dish using neurons grown from embryonic stem cells. This novel cell circuitry system gives the researchers a tool for gaining new insights into neurodegenerative diseases, like Parkinson’s and ALS, and may even provide a means to fix neurons damaged by injury or disease.

The researchers changed or specialized mouse embryonic stem cells into neurons that either stimulate nerve signals, called excitatory neurons, or neurons that block nerve signals, called inhibitory neurons. Growing these groups of cells together led to spontaneous rhythmic nerve signals. These clumps of cells containing about 50,000 neurons each were dubbed circuitoids by the team.

pfaff-circutoid-cropped

Confocal microscope immunofluorescent image of a spinal cord neural circuit made entirely from stem cells and termed a “circuitoid.” Credit: Salk Institute.

Making neural networks dance to a different beat

A video produced by the Salk Institute (see below), shows some fascinating microscopy visualizations of these circuitoids’ repetitive signals. In the video, team leader Samuel Pfaff explains that changing the ratio of excitatory vs inhibitory neurons had noticeable effects on the rhythm of the nerve impulses:

“What we were able to do is combine different ratios of cell types and study properties of the rhythmicity of the circuitoid. And that rhythmicity could be very tightly control depending on the cellular composition of the neural networks that we were forming. So we could regulate the speed [of the rhythmicity] which is kind of equivalent to how fast you’re walking.”

It’s possible that the actual neural networks in our brains have the flexibility to vary the ratio of the active excitatory to inhibitory neurons as a way to allow adjustments in the body’s repetitive movements. But the complexity of those networks in the human brain are staggering which is why these circuitoids could help:

Samuel Pfaff. (Salk Institute)

Samuel Pfaff. (Salk Institute)

“It’s still very difficult to contemplate how large groups of neurons with literally billions if not trillions of connections take information and process it,” says Pfaff in a press release. “But we think that developing this kind of simple circuitry in a dish will allow us to extract some of the principles of how real brain circuits operate. With that basic information maybe we can begin to understand how things go awry in disease.”

Wishing You and Your Stem Cells a Happy Valentine’s Day!

cirm-valentines-day

Roses are Red, 

Violets are Blue,

 Let’s thank pluripotent stem cells,

For making humans like me and you

Happy Valentine’s Day from me and everyone at CIRM! Today, we are celebrating this day of love by sending our warmest wishes to you our readers. We’re grateful for your interest in learning more about stem cells and your steadfast support for the advancement of stem cell research.

We also want to wish a Happy Valentine’s Day to your stem cells, yes that’s right the stem cells you have in your body. Without pluripotent stem cells, which are embryonic cells that generate all the cells in your body, humans wouldn’t exist. And without adult stem cells, which live in your tissues and organs, we wouldn’t have healthy, functioning bodies.

So, as you’re wishing your loved ones, friends, and colleagues a Happy Valentine’s Day, take a moment to thank your body and the stem cells living in it for keeping you alive.

I’ll leave you with a few Valentine’s Day themed stem cell blogs for you to enjoy. Have a wonderful day!


Valentine’s Day Themed Blogs:

1) Toronto Scientists Have an Affair with the Heart by OIRMexpression

Ventricular heart muscle cells. Image courtesy of Dr. Michael Laflamme

Ventricular heart muscle cells. Image courtesy of Dr. Michael Laflamme

2) A Cardiac Love Triangle: How Transcription Factors Interact to Make a Heart by the Stem Cellar

© Gladstone Institutes photo credit: Kim Cordes / Gladstone Institute Lay Description: In this image, human embryonic stem cells have been differentiated into cardiomyocytes, or heart muscle cells, and stained to show the expression of cardiac Troponin T (red), a protein that helps cardiomyocytes to contract, and cell nuclei (blue). Scientific Description: Cultured human iPSCs reprogrammed into CMs. Stain for cTnT (red), and DAPI (blue). Original caption: cardiomyocytes.tif

Heart cells made from human induced pluripotent stem cells. © Gladstone Institutes
photo credit: Kim Cordes / Gladstone Institute

3) Stem Cells on Valentine’s Day: Update on Cardiac Regenerative Medicine by Paul Knoepfler on the Niche Blog

4) Hope For Broken Hearts this Valentine’s Day – a Clinical Trial to Repair the Damage by the Stem Cellar


Special thanks to Samantha Yammine for letting us her her “Icy Astrocytes” photo in our Valentine’s Day graphic.

The power of the patient’s voice: how advocates shape clinical trials and give hope to those battling deadly diseases

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The Stack family: L to R Alex, Natalie, Nancy & Jeff

Tennis great Martina Navratilova was once being interviewed about what made her such a great competitor and she said it was all down to commitment. When pressed she said “the difference between involvement and commitment is like ham and eggs; the chicken is involved but the pig is committed.”

That’s how I feel about the important role that patients and patient advocates play in the work that we do at CIRM. Those of us who work here are involved. The patients and patient advocates are committed. This isn’t just their life’s work;  it’s their life.

I was reminded of that last week when I had the privilege of talking with Nancy Stack, the Patient Representative on a Clinical Advisory Panel (CAP) we have created for a program to treat cystinosis. She has an amazing story to tell. But before we get to that I have to do a little explaining.

Cystinosis is a rare disease, affecting maybe only 2,000 people worldwide, that usually strikes children before they are two years old and can lead to end stage kidney failure before their tenth birthday. Current treatments are limited, which is why the average life expectancy for someone with this is only around 27 years.

When we fund a project that is already in, or hoping to be in, a clinical trial we create a CAP to help assist the team behind the research. The CAP consists of a CIRM Science Officer, an independent scientific expert in this case for cystinosis, and a Patient Representative.

The patient’s voice

The Patient Representative’s role is vital because they can help the researchers understand the needs of the patient and take those needs into account when designing the trial. In the past, many researchers had little contact with patients and so designed the trial around their own needs. The patients had to fit into that model. We think it should be the other way around; that the model should fit the patients. The Patient Representatives help us make that happen.

Nancy Stack did just that. At the first meeting of the CAP she showed up with a list of 38 questions that she and other families with cystinosis had come up with for the researchers. They went from the blunt – “Will I die from the treatment” – to the practical –  “How will children/teens keep up with school during the process?” – and included a series of questions from a 12-year old girl with the disease – “Will I lose my hair because I’ve been growing it out for a long time? Will I feel sick? Will it hurt?”

Nancy says the questions are not meant to challenge the researcher, in this case U.C. San Diego’s Stephanie Cherqui, but to ensure that if the trial is given the go-ahead by the US Food and Drug Administration (FDA) that every patient who signs up for it knows exactly what they are getting into. That’s particularly important because many of those could be children or teenagers.

Fully informed

“As parents we know the science is great and is advancing, but we have real people who are going to go through this treatment so we have a responsibility to know what will it mean to them. Patients know they could die of the disease and so this research has real world implications for them.”

“I think without this, without allowing the patients voice to be heard, you would have a hard time recruiting patients for this kind of clinical trial.”

Nancy says not only was Dr. Cherqui not surprised by the questions, she welcomed them. Dr. Cherqui has been supported and funded by the Cystinosis Research Foundation for years and Nancy says she regards the patients and patient advocates as partners in this journey:

“She knows we are not challenging her, we’re supporting her and helping her cover every aspect of the research to help make it work.”

Nancy became committed to finding a cure for cystinosis when her daughter, Natalie, was diagnosed with the condition when she was just 7 months old. The family were handed a pamphlet titled “What to do when your child has a terminal disease” and told there was no cure.

Birthday wish

In 2003, on the eve of her 12th birthday, Nancy asked Natalie what her wish was for her birthday. She wrote on a napkin “to have my disease go away forever.” The average life expectancy for people with cystinosis at that point was 18. Nancy told her husband “We have to do something.”

They launched the Cystinosis Research Foundation and a few weeks later they held their first fundraiser. That first year they raised $427,000, an impressive amount for such a rare disease. Last year they raised $4.94 million. Every penny of that $4.94 million goes towards research, making them the largest funders of cystinosis research in the world.

“We learned that for there to be hope there has to be research, and to do research we needed to raise funds. Without that we knew our children would not survive this disease.”

Natalie is now 26, a graduate of Georgetown and USC, and about to embark on a career in social work. Nancy knows many others are not so fortunate:

“Every year we lose some of our adults, even some of our teens, and that is unbelievably hard. Those other children, wherever they may live, they are my children too. We are all connected to each other and that’s what motivates me every day. Having a child with this disease means that time is running out and there must be a commitment to work hard every day to find a cure, and never giving up until you do.”

That passion for the cause, that compassion for others and determination to help others makes the Patient Representative on the CAP so important. They are a reminder that we all need to work as hard as we can, as fast as we can, and do everything we can to help these trials succeed.

And we are committed to doing that.


Related Links:

Stem Cell Stories That Caught our Eye: Making blood and muscle from stem cells and helping students realize their “pluripotential”

Stem cells offer new drug for blood diseases. A new treatment for blood disorders might be in the works thanks to a stem cell-based study out of Harvard Medical School and Boston Children’s hospital. Their study was published in the journal Science Translational Medicine.

The teams made induced pluripotent stem cells (iPSCs) from the skin of patients with a rare blood disorder called Diamond-Blackfan anemia (DBA) – a bone marrow disease that prevents new blood cells from forming. iPSCs from DBA patients were then specialized into blood progenitor cells, the precursors to blood cells. However, these precursor cells were incapable of forming red blood cells in a dish like normal precursors do.

Red blood cells were successfully made via induced pluripotent stem cells from a Diamond-Blackfan anemia patient. Image: Daley lab, Boston Children’s

Red blood cells were successfully made via induced pluripotent stem cells from a Diamond-Blackfan anemia patient. Image: Daley lab, Boston Children’s

The blood progenitor cells from DBA patients were then used to screen a library of compounds to identify drugs that could get the DBA progenitor cells to develop into red blood cells. They found a compound called SMER28 that had this very effect on progenitor cells in a dish. When the compound was tested in zebrafish and mouse models of DBA, the researchers observed an increase in red blood cell production and a reduction of anemia symptoms.

Getting pluripotent stem cells like iPSCs to turn into blood progenitor cells and expand these cells into a population large enough for drug screening has not been an easy task for stem cell researchers.

Co-first author on the study, Sergei Doulatov, explained in a press release, “iPS cells have been hard to instruct when it comes to making blood. This is the first time iPS cells have been used to identify a drug to treat a blood disorder.”

In the future, the researchers will pursue the questions of why and how SMER28 boosts red blood cell generation. Further work will be done to determine whether this drug will be a useful treatment for DBA patients and other blood disorders.

 

Students realize their “pluripotential”. In last week’s stem cell stories, I gave a preview about an exciting stem cell “Day of Discovery” hosted by USC Stem Cell in southern California. The event happened this past Saturday. Over 500 local middle and high school students attended the event and participated in lab tours, poster sessions, and a career resource fair. Throughout the day, they were engaged by scientists and educators about stem cell science through interactive games, including the stem cell edition of Family Feud and a stem cell smartphone videogame developed by USC graduate students.

In a USC press release, Rohit Varma, dean of the Keck School of Medicine of USC, emphasized the importance of exposing young students to research and scientific careers.

“It was a true joy to welcome the middle and high school students from our neighboring communities in Boyle Heights, El Sereno, Lincoln Heights, the San Gabriel Valley and throughout Los Angeles. This bright young generation brings tremendous potential to their future pursuits in biotechnology and beyond.”

Maria Elena Kennedy, a consultant to the Bassett Unified School District, added, “The exposure to the Keck School of Medicine of USC is invaluable for the students. Our students come from a Title I School District, and they don’t often have the opportunity to come to a campus like the Keck School of Medicine.”

The day was a huge success with students posting photos of their experiences on social media and enthusiastically writing messages like “stem cells are our future” and “USC is my goal”. One high school student acknowledged the opportunity that this day offers to students, “California currently has biotechnology as the biggest growing sector. Right now, it’s really important that students are visiting labs and learning more about the industry, so they can potentially see where they’re going with their lives and careers.”

You can read more about USC’s Stem Cell Day of Discovery here. Below are a few pictures from the event courtesy of David Sprague and USC.

Students have fun with robots representing osteoblast and osteoclast cells at the Stem Cell Day of Discovery event held at the USC Health Sciences Campus in Los Angeles, CA. February 4th, 2017. The event encourages students to learn more about STEM opportunities, including stem cell study and biotech, and helps demystify the fields and encourage student engagement. Photo by David Sprague

Students have fun with robots representing osteoblast and osteoclast cells at the USC Stem Cell Day of Discovery. Photo by David Sprague

Dr. Francesca Mariana shows off a mouse skeleton that has been dyed to show bones and cartilage at the Stem Cell Day of Discovery event held at the USC Health Sciences Campus in Los Angeles, CA. February 4th, 2017. The event encourages students to learn more about STEM opportunities, including stem cell study and biotech, and helps demystify the fields and encourage student engagement. Photo by David Sprague

Dr. Francesca Mariana shows off a mouse skeleton that has been dyed to show bones and cartilage. Photo by David Sprague

USC masters student Shantae Thornton shows students how cells are held in long term cold storage tanks at -195 celsius at the Stem Cell Day of Discovery event held at the USC Health Sciences Campus in Los Angeles, CA. February 4th, 2017. The event encourages students to learn more about STEM opportunities, including stem cell study and biotech, and helps demystify the fields and encourage student engagement. Photo by David Sprague

USC masters student Shantae Thornton shows students how cells are held in long term cold storage tanks at -195 celsius. Photo by David Sprague

Genesis Archila, left, and Jasmine Archila get their picture taken at the Stem Cell Day of Discovery event held at the USC Health Sciences Campus in Los Angeles, CA. February 4th, 2017. The event encourages students to learn more about STEM opportunities, including stem cell study and biotech, and helps demystify the fields and encourage student engagement. Photo by David Sprague

Genesis Archila, left, and Jasmine Archila get their picture taken at the USC Stem Cell Day of Discovery. Photo by David Sprague

New stem cell recipes for making muscle: new inroads to study muscular dystrophy (Todd Dubnicoff)

Embryonic stem cells are amazing because scientists can change or specialize them into virtually any cell type. But it’s a lot easier said than done. Researchers essentially need to mimic the process of embryo development in a petri dish by adding the right combination of factors to the stem cells in just the right order at just the right time to obtain a desired type of cell.

Making human muscle tissue from embryonic stem cells has proven to be a challenge. The development of muscle, as well as cartilage and bone, are well characterized and known to form from an embryonic structure called a somite. Researches have even been successful working out the conditions for making somites from animal stem cells. But those recipes didn’t work well with human stem cells.

Now, a team of researchers at the Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research at UCLA has overcome this roadblock by carrying out a systematic approach using human tissue. As described in Cell Reports, the scientists isolated somites from early human embryos and studied their gene activity. By comparing somites that were just beginning to emerge with fully formed somites, the researchers pinpointed differences in gene activity patterns. With this data in hand, the team added factors to the cells that were known to affect the activity of those genes. Through some trial and error, they produced a recipe – different than those used in animal cells – that could convert 90 percent of the human stem cells into somites in only four days. Those somites could then readily transform into muscle or bone or cartilage.

This new method for making human muscle will be critical for the lab’s goal to develop therapies for Duchenne muscular dystrophy, an incurable muscle wasting disease that strikes young boys and is usually fatal by their 20’s.

The new protocol turned 90 percent of human pluripotent stem cells into somite cells in just four days; those somite cells then generated (left to right) cartilage, bone and muscle cells.  Image: April Pyle Lab/UCLA

The new protocol turned 90 percent of human pluripotent stem cells into somite cells in just four days; those somite cells then generated (left to right) cartilage, bone and muscle cells. Image: April Pyle Lab/UCLA

“Apples to Apples” analysis: induced pluripotent stem cell (iPSC) method doesn’t increase mutations

It’s full steam ahead for the development of induced pluripotent stem cell (iPSC)-derived clinical trials. That’s according to a group at the National Human Genome Research Institute in Bethesda, Maryland who report this week in PNAS that the process of reprogramming a skin cell into the embryonic stem cell-like state of an iPSC does not itself cause an increased number of genetic mutations.

logo_nhgriEver since the technique was first devised ten years ago, there has been a lot of excitement about applying IPSCs to cell therapies for patients with unmet medical needs. Unlike human embryonic stem cells (hESCs) which are generated through the destruction of a fertilized embryo, iPSCs avoid ethical concerns because they’re obtained using adult cells like blood or skin. And the fact they’re patient specific carries the additional advantage of delivering iPSC-derived therapies back to the same patient with less concerns of rejection by the immune system.

Still, the use of iPSC-derived therapies has certainly not been worry-free and their translation into human clinical trials has been slow. One big concern is that the process of reprogramming inherently causes cell stress leading to an increased rate of genetic mutations in the cells. An abnormal number of mutations is bad news for cell therapies because they could carry an increased risk of becoming cancerous after being injected into a patient – an event that would end up causing more harm than good. Previous DNA sequencing studies comparing iPSCs with their cell source (skin, blood, etc.) identified many new sequence mutations in the iPSCs. But other studies suggested that many of those mutations already existed in the source cells and so they were essentially inherited during the iPSC process.

The team in this study sought out a definitive answer by tackling this mutation question using an “apples to apples” approach. To explain their approach, let’s first understand a technical detail about the iPSC method. When the iPSC reprogramming factors are added to the adult skin cells, the process is not efficient and only a few become iPSCs. Single iPSCs are then isolated and allowed to divide and make clones of themselves. This population of cells is called a cell “line” and takes several rounds of cell division to multiply into enough numbers to analyze their DNA sequence.

dnasequencing

Credit: Darryl Leja and Ernesto Del Aguila III, NHGRI

So the researchers decided to also go through the process of making cell lines from the original skin cells but in this set they did not add the iPSC reprogramming factors. Now, they could compare the fate of DNA sequences in skin cell lines with and without the iPSC reprogramming method. The sequencing results showed that mutations occurred at the same rate in both the skin cell lines and the iPSC cell lines. This direct comparison suggests that iPSCs aren’t any less stable than non-reprogrammed cells. This finding bodes well for moving ahead with iPS-derived clinical trials. That’s certainly the perspective Erika Mijin Kwon, a co-author on the publication:

“Based on this data, we plan to start using iPSCs to gain a deeper understanding of how diseases start and progress,” said Kwon, in a press release. “We eventually hope to develop new therapies to treat patients with leukemia using their own iPSCs. We encourage other researchers to embrace the use of iPSCs.”