cord blood

How stem cells may help children battling birth injuries

/ Kevin McCormack / Leave a comment

From time to time we invite patients or patient advocates to post a guest blog on the Stem Cellar. Today we are featuring Brigitta Burguess, a mother and writer from Michigan, who focuses on pregnancy, parenting, and children with disabilities. Brigitta writes for the HIE Help Center, a website that offers information and supportive resources for families of children with disabilities.

HIE-Early-Intervention

Because stem cells are the building blocks of the immune system, they possess the ability to develop into other types of cells. You can use stem cells to help repair tissues, organs, and blood vessels, and even treat a host of different diseases. This is done through stem cell harvesting and stem cell therapy. In stem cell therapy, stem cells are injected into injured tissues in the hopes of replacing damaged tissue and preserving existing tissues.

Cord Blood

Every part of the human body contains stem cells. However, many areas of the body do not contain enough stem cells to make harvesting them worthwhile. Cord blood, the leftover blood collected from a baby’s umbilical cord or a mother’s placenta after birth, is especially beneficial because:

  • It provides a rich source of stem cells that can be changed into other types of cells and help to maintain and repair tissues
  • Its stem cells are immature and have not developed the ability to attack foreign cells, which makes them perfect for transplant
  • Its stem cells differ from embryonic stem cells in that they are considered adult stem cells and do not require the destruction of an embryo to harvest
  • It can be used to treat blood disorders, immune deficiencies, and certain cancers
  • Storing cord blood can help family and community members receive gene therapy treatment for the aforementioned conditions and diseases

The Applications of Stem Cell Therapy for Kids

Today, over 2,000 total cord blood stem cell transplants are performed annually, with the total number of cord blood banks worldwide reaching over 150. The innovations in stem cell therapy have made waves over the past four decades. Today, more than 80 difference diseases are being treated with cord blood stem cells.

In 2012, many clinical trials revealed that cord blood transplants were an effective treatment for cerebral palsy. Researchers also believe that cord blood stem cells have great potential in treating the neonatal brain injuries such as hypoxic-ischemic encephalopathy (HIE). As of right now, there is no indication that stem cell therapy can cure these conditions, but there is some evidence that it can lessen the severity of symptoms.

It is important to note that there is thus far no cure for hypoxic-ischemic encephalopathy (HIE) and resulting motor, cognitive, and/or intellectual disorders. Stem cell therapy seeks to limit the damage caused by HIE and reduce the severity of disabilities caused by HIE, but it is not a cure.

Because stem cell therapy is still in clinical trials, parents should think twice before going down this untested path, as no formal guidelines about administration protocol, dosages, safety, or treatment timeline have yet been established. Clinical trials are important for ensuring that treatments are safe and effective – unregulated treatments bear significant risk.

To learn more about stem cell therapy trials for hypoxic-ischemic encephalopathy, please visit the National Institute of Health’s (NIH) Clinical Trial Recruitment Center.

 

Confusing cancer to kill it

/ Kevin McCormack / Leave a comment
Kipps

Thomas Kipps, MD, PhD: Photo courtesy UC San Diego

Confusion is not a state of mind that we usually seek out. Being bewildered is bad enough when it happens naturally, so why would anyone actively pursue it? But now some researchers are doing just that, using confusion to not just block a deadly blood cancer, but to kill it.

Today the CIRM Board approved an investment of $18.29 million to Dr. Thomas Kipps and his team at UC San Diego to use a one-two combination approach that we hope will kill Chronic Lymphocytic Leukemia (CLL).

This approach combines two therapies, cirmtuzumab (a monoclonal antibody developed with CIRM funding, hence the name) and Ibrutinib, a drug that has already been approved by the US Food and Drug Administration (FDA) for patients with CLL.

As Dr. Maria Millan, our interim President and CEO, said in a news release, the need for a new treatment is great.

“Every year around 20,000 Americans are diagnosed with CLL. For those who have run out of treatment options, the only alternative is a bone marrow transplant. Since CLL afflicts individuals in their 70’s who often have additional medical problems, bone marrow transplantation carries a higher risk of life threatening complications. The combination approach of  cirmtuzumab and Ibrutinib seeks to offer a less invasive and more effective alternative for these patients.”

Ibrutinib blocks signaling pathways that leukemia cells need to survive. Disrupting these pathways confuses the leukemia cell, leading to its death. But even with this approach there are cancer stem cells that are able to evade Ibrutinib. These lie dormant during the therapy but come to life later, creating more leukemia cells and causing the cancer to spread and the patient to relapse. That’s where cirmtuzumab comes in. It works by blocking a protein on the surface of the cancer stem cells that the cancer needs to spread.

It’s hoped this one-two punch combination will kill all the cancer cells, increasing the number of patients who go into complete remission and improve their long-term cancer control.

In an interview with OncLive, a website focused on cancer professionals, Tom Kipps said Ibrutinib has another advantage for patients:

“The patients are responding well to treatment. It doesn’t seem like you have to worry about stopping therapy, because you’re not accumulating a lot of toxicity as you would with chemotherapy. If you administered chemotherapy on and on for months and months and years and years, chances are the patient wouldn’t tolerate that very well.”

The CIRM Board also approved $5 million for Angiocrine Bioscience Inc. to carry out a Phase 1 clinical trial testing a new way of using cord blood to help people battling deadly blood disorders.

The standard approach for this kind of problem is a bone marrow transplant from a matched donor, usually a family member. But many patients don’t have a potential donor and so they often have to rely on a cord blood transplant as an alternative, to help rebuild and repair their blood and immune systems. However, too often a single cord blood donation does not have enough cells to treat an adult patient.

Angiocrine has developed a product that could help get around that problem. AB-110 is made up of cord blood-derived hematopoietic stem cells (these give rise to all the other types of blood cell) and genetically engineered endothelial cells – the kind of cell that lines the insides of blood vessels.

This combination enables the researchers to take cord blood cells and greatly expand them in number. Expanding the number of cells could also expand the number of patients who could get these potentially life-saving cord blood transplants.

These two new projects now bring the number of clinical trials funded by CIRM to 35. You can read about the other 33 here.

 

 

 

Novel diabetes therapy uses stem cell “teachers” to calm immune cells

/ Todd Dubnicoff / Leave a comment

Type 1 diabetes is marked by a loss of insulin-producing beta cells in the pancreas. Without insulin, blood sugar can’t shuttle into the body’s energy-hungry organs and tissues. As a result, sugar accumulates in the blood which, over time, causes many serious complications such as kidney disease, heart disease and stroke.  An over-reactive immune system is to blame which mistakes the beta cells for foreign invaders and attacks them.

Much of the focus on diabetes therapy development is turning stem cells into beta cells in order to replace the lost cells.  But a recent Stem Cell Translational Medicine publication describes a different approach that uses umbilical cord blood stem cells to tame the immune system and preserve the beta cells that are still intact.

Stem+Cell+Educator+Therapy+Process

Schematic diagram of the Stem Cell Educator therapy procedure.
Image: Tianhe Stem Cell Biotechnologies

The research team, composed of scientists from the U.S., China and Spain, devised a technology they call Stem Cell Educator (SCE) therapy that draws blood from a diabetic patient then separates out the lymphocytes – the white blood cells of the immune system – which trickle through a series of stacked petri dishes that contains cord blood stem cells. Because the stem cells are attached to the surface of the device, only the lymphocytes are recovered and returned to the patient’s blood.  The idea is that through this forced interaction with the cord blood stem cells – which have been shown to blunt immune cell activity – the patient’s own lymphocytes “learn” to quiet their damaging response to beta cells.

In a series of clinical trials in China and Spain from 2010 to 2014, the researchers showed that a single treatment of the SCE therapy restored beta cell function and blood sugar control in patients. Though the treatment appeared safe and effective after one year, how exactly it worked remained unclear. So, in this current study, the team aimed to better understand cord blood stem cell function and to perform a 4-year follow up on the patients.

Shortly after the SCE therapy, the researchers had observed elevated levels of platelets in the blood. They examined these cells more closely to see if they contained any factors that would dampen the immune response. Sure enough, the platelets carried a protein called autoimmune regulator (AIRE) which plays a role in inhibiting immune cells that react against the body.

Now, platelets do not contain a nucleus or nuclear DNA but they do have mitochondria – a cell’s energy producers – which contain their own DNA and genetic code. An analysis of the mitochondrial DNA revealed that it encoded proteins associated with the regeneration and growth of pancreatic beta cells. In an unusual finding in the lab, the researchers showed that the platelets release their mitochondria, which can be taken up by pancreatic beta cells where these beta cell associated proteins can exert their effects.

HealthDay reporter Serena Gordon interviewed Julia Greenstein, vice president of discovery research at JDRF, to get her take on these results:

“The platelets seem to be having a direct effect on the beta cells. This research is intriguing, but it needs to be reproduced.”

For the four-year follow up study, nine of the type 1 diabetes patients from the original trial in China were examined. Two patients who were treated less than a year after being diagnosed with diabetes still had normal levels of insulin in their blood and were still free of needing insulin injections. In the other seven patients, the single treatment had gradually lost its effectiveness. Team leader Dr. Yong Zhao of the University of Hackensack in New Jersey, felt that a single treatment possibly isn’t enough in those patients:

“Because this was a first trial, patients just got one treatment. Now we know it’s very safe so patients can receive two or three treatments.”

I imagine Dr. Zhao will be testing out multiple treatments in a clinical trial that is now in the works here in the states at Hackensack Medical Center. Stay tuned.

Stem cell stories that caught our eye: young blood, cord blood, and blood cancers

/ cirmweb / Leave a comment

Here are some stem cell stories that caught our eye this past week. Some are groundbreaking science, others are of personal interest to us, and still others are just fun.

Pinning down young blood’s rejuvenating power. A trio of studies in the past week provided more evidence that giving older mice the blood of younger mice can rejuvenate some aspect of their function to a younger state. This has been shown for some years with various tissues, such as CIRM grantee Irina Conboy’s work at UC Berkeley looking at revitalizing older muscle. The recent studies all showed improvement in various aspects of brain function. Most important, the studies started to uncover some reasons for why the young blood could be beneficial when introduced into older animals. Conboy has suggested that one thing it does is provide an environment that lets muscle stem cells do a better job. The three current teams’ work suggests there are probably many factors at play in the young blood. The Boston Globe focused on the work of the Harvard team but puts all three projects in perspective. The San Francisco Business Times focused on the Stanford work and includes an extensive Q&A with the lead researcher.

Expanding cord blood could expand uses. The blood-forming stem cells found in umbilical cord blood have proven extremely valuable as a part of therapy for certain blood cancers. The problem with them is there just are not enough of them in a single cord to treat anyone large than a nine or 10-year-old child. That means when an adult needing a blood stem cell transplant can’t find a matching adult donor and has to resort to cord blood, they receive cells from two cords doubling the chance for severe side effect. Now, a team at Mount Sinai School of Medicine in New York has found a way to get cord blood stem cells to proliferate in the lab in greater numbers than anyone has in the past. They accomplished the trick by resetting the genetic switches that turn genes on and off. Genetic Engineering and Biotechnology News ran a description of the work.

Deciding on banking cord blood. I handle many desperate patient calls here at CIRM, and occasionally get a call from a parent wanting advice about banking their soon-to-be-born child’s cord blood. While I never offer specific advice, I do try to talk through a few factual issues for them to consider, such as the limitation on the number of cells in the cord discussed above. In this Huffington Post blog a mom walks through her family’s decision process for two different pregnancies that came to different, though pretty logical, conclusions for each. She raises many important considerations. However, note that toward the end when she talks about research “advancing” for several diseases, for all those diseases many more years of research will be needed before cord blood therapies become a reality if they ever do.

Blood cancers vs. blood stem cells. One of the difficulties of treating blood cancers is you often end up killing off the vital blood forming stem cells at the same time you destroy the cancer cells. A team at Dartmouth has developed a method to make it easier to distinguish between the stem cells and the cancer cells. Knowing this difference should help researchers find more specific cancer therapies that can destroy the cancer without harming the needed stem cells. Science Codex posted the press release from the medical school. You can read about projects CIRM funds in the field on our leukemia fact sheet.

Don Gibbons

Read more stem cell research news from the California Institute for Regenerative Medicine by visiting our blog at cirmresearch.blogspot.com.