Using reengineered human skin cells to treat COVID-19

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Investigators at Cedars-Sinai have identified a potential new therapy for COVID-19: a biologic substance created by reengineered human skin cells.   

In the study—co-funded by the California Institute for Regenerative Medicine (CIRM)—scientists found the substance stopped SARS-CoV-2, the virus that causes COVID-19, from reproducing itself. The substance also protected infected cells when tested in human lung cells.  

Although still in the early stages, the findings open the possibility of having a new therapy for COVID-19 patients, of which there are few. Current COVID-19 treatments primarily focus on preventing the virus from replicating. This new potential treatment inhibits replication but also protects or repairs tissue, which is important because COVID-19 can cause symptoms that affect patients long after the viral infection has been cleared. 

The potential therapy investigated in this study was created by scientists using skin cells called dermal fibroblasts. The investigators engineered the cells to produce therapeutic extracellular vesicles (EVs), which are nanoparticles that serve as a communication system between cells and tissue. Engineering these fibroblasts allowed them to secrete EVs—which the investigators dubbed “ASTEX”—with the ability to repair tissue. 

The study tested ASTEX by applying it to human lung epithelial cells, cells that line the pulmonary tract and are the targets of SARS-CoV-2 infection. They discovered that ASTEX prevented cells from launching an inflammatory process that could lead to cell death. Cells treated with ASTEX also made fewer of a type of protein called ACE that SARS-CoV-2 may use to infect cells. 

The team compared the new potential treatment with remdesivir, a drug currently used to treat COVID-19, and found that remdesivir did not inhibit production of ACE. Instead, remdesivir stops the virus from latching on to a protein called ACE2. ASTEX, therefore, may present another way to prevent the virus from entering cells. 

“We were surprised to find this potential therapy shuts down a novel pathway for viral replication and also protects infected cells,” said Ahmed G. Ibrahim, PhD, MPH, assistant professor in the Smidt Heart Institute at Cedars-Sinai and first author of the study. 

Investigators at Cedars-Sinai are planning future studies.  

The details of the potential therapy are published in the journal Biomaterials and Biosystems. Read the source article here

Could a common herb help in the fight against COVID-19 and other inflammatory diseases?

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The culinary herb rosemary is commonly used in our kitchens to season an array of dishes, and is also considered a good source for vitamins and minerals.  

Rosemary is also valued for its medicinal properties, and has traditionally been used to help alleviate muscle pain, boost the immune and circulatory system, as well as many other health benefits. 

Now, scientists at Scripps Research have found evidence that a compound contained in rosemary could be a two-pronged weapon against the SARS-CoV-2 coronavirus that causes COVID-19.  

The research was partly funded by the California Institute for Regenerative Medicine (CIRM). 

Published in the journal Antioxidants, the study found that the compound, carnosic acid, can block the interaction between the SARS-CoV-2 outer “spike” protein and the receptor protein, ACE2, which the virus uses to gain entry to cells. 

“We think that carnosic acid, or some optimized derivative, is worth investigating as a potentially cheap, safe, and effective treatment for COVID-19 and some other inflammation-related disorders,” says study senior author Dr. Stuart Lipton of Scripps Research. 

The team also reviewed prior studies and presented new evidence that carnosic acid could inhibit a powerful inflammatory pathway that is active in severe COVID-19, as well as in other diseases including Alzheimer’s.   

They also proposed that this effect could be beneficial in treating the post-COVID syndrome known as “long COVID” whose reported symptoms include cognitive difficulties often described as “brain fog.” 

While the research is preliminary, the researchers propose that carnosic acid has this antiviral effect because it is converted to its active form by the inflammation and oxidation found at sites of infection. In that active form, they suggest, the compound modifies the ACE2 receptor for SARS-CoV-2—making the receptor impregnable to the virus and thereby blocking infection. 

Lipton and his colleagues are now working with Scripps Research chemists to synthesize and test more potent derivatives of carnosic acid with improved drug characteristics for potential use in inflammation-related disorders. 

The full study was co-authored by Takumi Satoh of the Tokyo University of Technology; and by Dorit Trudler, Chang-ki Oh and Stuart Lipton of Scripps Research. Read the source news release here

Disclaimer: This research is still in its early phase and there is no suggestion that sprinkling rosemary on everything you eat could help prevent or fight COVID-19. For the latest guidance on COVID-19, see the official CDC website. 

CIRM Board gives thumbs up to training and treatment programs

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CIRM Bridges student discusses her poster presentation

At CIRM, the bread and butter of what we do is funding research and hopefully advancing therapies to patients. But the jam, that’s our education programs. Helping train the next generation of stem cell and gene therapy scientists is really inspiring. Watching these young students – and some are just high school juniors – come in and grasp the science and quickly become fluent in talking about it and creating their own experiments shows the future is in good hands.

Right now we fund several programs, such as our SPARK and Bridges internships, but they can’t cover everything, so last week the CIRM Board approved a new training program called COMPASS (Creating Opportunities through Mentorship and Partnership Across Stem Cell Science). The program will fill a critical need for skilled research practitioners who understand and contribute at all levels in the translation of science to medicine, from bench to bedside.

The objective of the COMPASS Training Program is to prepare a diverse group of undergraduate students for careers in regenerative medicine through the creation of novel recruitment and support mechanisms that identify and foster untapped talent within populations that are historically under-represented in the biomedical sciences. It will combine hands-on research with mentorship experiences to enhance transition of students to successful careers. A parallel objective is to foster greater awareness and appreciation of diversity, equity and inclusion in trainees, mentors, and other program participants

The CIRM Board approved investing $58.22 million for up to 20 applications for a five-year duration.

“This new program highlights our growing commitment to creating a diverse workforce, one that taps into communities that have been historically under-represented in the biomedical sciences,” says Dr. Maria T. Millan, President and CEO of CIRM. “The COVID19 pandemic made it clear that the benefits of scientific discovery are not always accessible to communities that most need them. CIRM is committed to tackling these challenges by creating a diverse and dedicated workforce that can meet the technical demands of taking novel treatment ideas and making them a reality.”

The Board also approved a new $80 million concept plan to expand the CIRM Alpha Stem Cell Clinic Network. The Network clinics are all in top California medical centers that have the experience and the expertise to deliver high-quality FDA-authorized stem cell clinical trials to patients.

There are currently five Alpha Clinics – UC San Diego; UCLA/UC Irvine; City of Hope; UCSF; UC Davis – and since 2015 they have hosted more than 105 clinical trials, enrolled more than 750 patients in these trials, and generated more than $95 million in industry contracts. 

Each award will provide up to $8 million in funding over a five-year period. The clinics will have to include:

  • A demonstrated ability to offer stem cell and gene therapies to patients as part of a clinical trial.
  • Programs to help support the career development of doctors, nurses, researchers or other medical professionals essential for regenerative medicine clinical trials.
  • A commitment to data sharing and meeting CIRM’s requirements addressing issues of diversity, equity and inclusion and meeting the needs of California’s diverse patient population.

Creating a New Model for Diversity in Scientific and Medical Research

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Nature Cell Biology cover

The global pandemic has highlighted many of the inequities in our health care system, with the virus hitting communities of color the hardest. That has led to calls for greater diversity, equity and inclusion at every level of scientific research and, ultimately, of medical care. A recently released article in the journal Nature Cell Biology, calls for “new models for basic and disease research that reflect diverse ancestral backgrounds and sex and ensure that diverse populations are included among donors and research participants.”

The authors of the article are Dr. Maria T. Millan, CIRM’s President & CEO; Rick Horwitz Senior Advisor and Executive Director, Emeritus, Allen Institute for Cell Science; Dr. Ekemini Riley, President, Coalition for Aligning Science; and Dr. Ruwanthi N. Gunawardane, Executive Director of the Allen Institute for Cell Science.

Dr. Maria Millan, CIRM’s President & CEO, says we need to make these issues a part of everything we do. “At CIRM we have incorporated the principles of promoting diversity, equity and inclusion in our research funding programs, education programs and future programs. We believe this is essential to ensure that the therapies our support helps advance will reach all patients in need and in particular communities that are disproportionately affected and/or under-served.”

The article highlights how, in addition to cultural, environmental, and socioeconomic factors, genetic factors also appear to play a role in the way disease affects different people. For example, 50 percent of people in South Asia have genetic traits that increases their risk for severe COVID-19, in contrast only 16 percent of Europeans have those traits.

But while some studies have shown how African American men are at greater risk for prostate cancer than white men, most of the research in this and other areas has been done on white populations of European ancestry. Efforts are already underway to change these disparities. For example, the National Institutes of Health (NIH) has sponsored the All of Us Research Program, which is inviting one million people across the U.S. to help build one of the most diverse health databases in history.

The article in Nature Cell Biology stresses the need to account for diversity at the individual molecular, cellular and tissue level. The authors make the point that diversity in those taking part in clinical trials is essential, but equally essential is that diverse biology is accounted for in the scientific work that leads to the development of potential therapies in order to increase the likelihood of success.

That’s why the authors of the article say: “If we are to truly understand human biology, address health disparities, and personalize our treatments, we need to go beyond our important, ongoing efforts in addressing diversity and inclusion in the workforce and the delivery of healthcare. We need to improve the data we generate by including diverse populations among donors and research participants. This will require new models and tools for basic and disease research that more closely reflect the diversity of human tissues, across diverse donor backgrounds.”

“Greater diversity in biological studies is not only the right thing to do, it is crucial to helping researchers make new discoveries that benefit everyone,” said Ru Gunawardane, Executive Director of the Allen Institute for Cell Science.

To do this they propose creating “a suite” of research cells, such as human induced pluripotent stem cell (hiPSC) lines from a diverse group of individuals to reflect the racial, ethnic and gender composition of the population. Human iPSCs are cells taken from any tissue (usually skin or blood) from a child or adult that have been genetically modified to behave like an embryonic stem cell. As the name implies, these cells are pluripotent, which means that they can become any type of adult cell.

CIRM has already created one version of what this suite would look like, through its iPSC Repository, a collection of more than 2,600 hiPSCs from individuals of diverse ancestries, including African, Hispanic, Native American, East and South Asian, and European. The Allen Institute for Cell Science also has a collection that could serve as a model for this kind of repository. Its collection of over 50 hiPSC

lines have been thoroughly analyzed on both a genomic and biological level and could also be broken down to include diversity in donor ethnicity and sex.

Currently researchers use cells from different lines and often follow very different procedures in using them, making it hard to compare results from one study to another. Having a diverse and well defined collection of research cells and cell models that are created by standardized procedures, could make it easier to compare results from different studies and share knowledge within the scientific community. By incorporating diversity in the very early stages of scientific research, the scientists and therapy developers gain a more complete picture of the biology disease and potential treatments.  

Bridges Scholar Spotlight: Samira Alwahabi

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For more than a decade, CIRM has funded a number of educational and research training programs to give students the opportunity to explore stem cell science. One such project, the Bridges to Stem Cell Research program, helps train future generation of scientists by preparing undergraduate and master’s students from several California universities for careers in stem cell research.

Last summer, the Pacific Division of AAAS organized a ‘Moving on from COVID-19’ virtual forum specifically focused on students of science presenting their future career and research plans through 3-5 minute descriptive videos. 

Samira Alwahabi, a Bridges scholar and undergraduate student majoring in Biological Sciences at California State University, Fullerton was one of the many participants who submitted a video detailing their current work and future aspirations. Alwahabi is a CIRM intern conducting research in the Kuo lab at the Stanford University School of Medicine where she focuses on the identification and characterization of human distal lung stem cells as well as the effects of the novel SARS-CoV-2 virus on the human distal lung through the use of organoids. Her video, which you can watch below, was recognized for “Best Video Submission by an Undergraduate Student.” 

We reached out to Samira to congratulate her and she shared a few words with us about her experience with the Bridges program:

I am very grateful to the CSUF Bridges to Stem Cell Research program for giving me the opportunity to pursue research in the Kuo Lab at Stanford University. The past 11 months have been nothing less than exceptional! I have learned more than I could have even imagined and have been able to really solidify my future career goals through hands-on practice and interactions with professionals at all levels in the field of medical research. The CIRM Bridges program has allowed me to better understand how medical advancements are made and helped to further strengthen my interest in medicine. My future career goals include a career in medicine as a physician, where I will be able to use my research experience to better understand medical innovations that translate into improved quality of care for my patients. 

Congratulations Samira!

Sweating bullets and other stories from the front line

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When the COVID-19 pandemic hit and the 2020 election became one of the most contentious in living history it suddenly made trying to get a proposition on the ballot in California a lot harder. That meant the fate of Proposition 14, a ballot initiative refunding CIRM, California’s Stem Cell Agency, was in doubt. And if the agency went down, then a vital source of future funding for scientific research that could change and even save lives would also disappear.

It was a pretty nerve-racking time for all of us involved. We waited day after day after day after day before the election was finally called. Happily, it was in our favor. But only just!

In this podcast we talk to two of the key figures in this saga. Melissa King and Maria Bonneville. Melissa was part of the team that helped secure the votes needed to pass Proposition 14, and Maria helped keep CIRM on track to cope with whatever the outcome of the election was. 

I hope you enjoy this latest episode of our podcast ‘Talking ‘Bout (re)Generation.’

COVID is a real pain in the ear

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The more you learn about COVID-19 the more there is to dislike about it. The global death toll from the virus is now more than five million and for those who survive there can be long-term health consequences. We know COVID can attack the lungs, heart and brain. Now we are learning it can also mess up your ears causing hearing problems, ringing in the ear (tinnitus) and leave you dizzy.

Viral infections are a known cause of hearing loss and other kinds of infection. That’s why, before the pandemic started, Dr. Konstantina Stantovic at Massachusetts Eye and Ear and Dr. Lee Gherke at MIT had been studying how and why things like measles, mumps and hepatitis affected people’s hearing. After COVID hit they heard reports of patients experiencing sudden hearing loss and other problems, so they decided to take a closer look.

They took cells from ten patients who had all experienced some hearing or ear-related problems after testing positive for COVID and, using the iPSC method, turned those cells into the kind found in the inner ear including hair cells, supporting cells, nerve fibers, and Schwann cells.  

They then compared those to cells from patients who had similar hearing issues but who had not been infected with COVID. They found that the hair and Schwann cells both had proteins the virus can use to infect cells. That’s important because hair cells help with balance and the Schwann cells play a protective role for neuronal axons, which help different nerve cells in the brain communicate with each other.

In contrast, some of the other cells in the inner ear didn’t have those proteins and so were protected from COVID.

In a news release Dr. Stankovic says it’s not known how many people infected with COVID experienced hearing issues. “Initially this was because routine testing was not readily available for patients who were diagnosed with COVID, and also, when patients were having more life-threatening complications, they weren’t paying much attention to whether their hearing was reduced or whether they had tinnitus. We still don’t know what the incidence is, but our findings really call for increased attention to audio vestibular symptoms in people with Covid exposure.”

The doctors are not sure how the virus gets into the inner ear but speculate that it may enter through the Eustachian tube, that’s a small passageway that connects your throat to your middle ear. When you sneeze, swallow, or yawn, your Eustachian tubes open, preventing air pressure and fluid from building up inside your ear. They think that might allow particles from the nose to spread to the ear.

The study is published in the journal Communications Medicine.

CIRM has funded 17 different projects targeting COVID-19, several of which are still active.

Beware of misleading headlines and claims

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Coronavirus particles, illustration.

When the COVID pandemic broke out researchers all over the world scrambled to find new approaches to tackling the virus. Some of these, such as the vaccines, proved remarkably effective. Others, such as the anti-parasite medication ivermectin or the anti-malaria drug chloroquine, were not only not helpful, they were sometimes harmful.

Part of the problem was the understandable desire to find something, anything that would protect people from the virus. But another part of the problem was that even with research that was based on solid science, the reporting of that research in the media sometimes tilted towards hype rather than hard evidence.

A new study in the journal Stem Cell Reports takes a look at the explosion of research targeting COVID. They highlighted the lack of rigor that sometimes accompanied that research, and the lack of regulation that allowed some predatory clinics to offer stem cell “therapies” that had never been tested in people let alone shown to be either safe or effective.

Dr. Leigh Turner, from the University of California Irvine and a co-author of the study, warned against studies that were cutting ethical and scientific corners. “Scientists, regulators, and policymakers must guard against the proliferation of poorly designed, underpowered, and duplicative studies that are launched with undue haste because of the pandemic, but are unlikely to provide convincing, clinically meaningful safety and efficacy data.”

The researchers cited an earlier study (by UC Davis’ Dr. Paul Knoepfler and Dr. Mina Kim) that looked at 70 clinical trials involving cell-based treatments for COVID-19. Drs. Knoepfler and Kim found that most were small, involving around 50 patients, and only 22.8% were randomized, double-blinded, and controlled experiments. They say even if these produced promising results they would have to be tested in much larger numbers to be of real benefit.

Another issue that Turner and his team highlighted was the hype that sometimes accompanied this work, citing news releases that over-hyped findings and failed to mention study limitations to gain more media coverage.

In a news release Dr. Laertis Ikonomou, of the University at Buffalo and a co-author of the study, said over-hyping treatments is nothing new but that it seemed to become even more common during COVID.

“Therefore, it is even more important to communicate promising developments in COVID-19-related science and clinical management [responsibly]. Key features of good communication are an accurate understanding of new findings, including study limitations and avoidance of sensationalist language.”

“Realistic time frames for clinical translation are equally important as is the realization that promising interventions at preliminary stages may not always translate to proven treatments following rigorous testing.”

They also warned about clinics advertising “stem cell therapies” that were unproven and unlicensed and often involved injecting the patients’ own cells back into them. The researchers say it’s time that the FDA and other authorities cracked down on companies taking advantage of patients in this way.

“If companies and affiliated clinicians are not fined, forced to return to patients whatever profits they have made, confronted with criminal charges, subject to revocation of medical licensure, or otherwise subject to serious legal and financial consequences, it is possible that more businesses will be drawn to this space because of the profits that can be generated from selling unlicensed and unproven cell-based products in the midst of a pandemic.”

At a time when so many were dying or suffering long-term health problems as a result of COVID, it’s unconscionable that others were happy to cash in on the fear and pain to make a quick buck.

When the pandemic broke out the CIRM Board voted to approved $5 million in emergency funding to help develop new therapies to combat the virus. Altogether we funded 17 different projects including three clinical trials.

Study shows that COVID-19 vaccine is safe and effective in people with cancer

As we have seen in the US and all around the world, SARS-CoV-2, the virus that causes COVID-19, can cause severe complications and even death in many patients. In the early days of the pandemic, CIRM authorized $5 million in emergency funding for projects targeting the virus. To date CIRM has funded 20 projects related to COVID-19 research, including three clinical studies.

Luckily there have been several vaccines developed that are extremely effective at protecting individuals from the virus. These vaccines work by priming the body’s immune system to produce antibodies that are able to recognize and destroy SARS-CoV-2.

However, one question that remains is if patients with a weakened immune system, such as those receiving active cancer treatment, would be able to produce the antibodies after vaccination. Fortunately, a review of 200 patients with a wide spectrum of cancer diagnoses conducted by researchers at Montefiore Health System and Albert Einstein College of Medicine in the Bronx, NY, found that the COVID-19 vaccine is safe and effective in people with cancer.

The study looked at the rate of seroconversion, which indicates the presence of SARS-CoV-2 antibodies, in patients with solid tumors and blood cancers. The higher the rate of seroconversion, the more protection from COVID the patient has. The results showed that overall 94 percent of patients demonstrated seroconversion. Patients with solid tumors had a higher seroconversion rate compared to patients with blood cancers. Among patients with solid tumors 98 percent showed seroconversion while those with blood cancers showed a seroconversion rate of 85 percent.

The seroconversion rate also varied between those that received different cancer treatments. Those that received therapies for blood cancers that work by killing B cells (such as rituximab or CAR-T therapies) showed seroconversion rates of 70 percent. For those who had recently had bone marrow or stem cell transplants, the success rate was 74 percent. But the researchers stated that those rates were still much higher than expected.

In a news release, Amit Verma, M.B.B.S., senior co-author on the study, stresses the importance of cancer patients getting vaccinated.

“Vaccination among these populations have been lower, even though these groups were hardest hit by the pandemic. It’s important to stress how well these patient populations did with the vaccines.”

The full results of the study were published in Cancer Cell.

CIRM funding helps identify potential COVID-19 treatment

The steps of the virus growth cycle that can be targeted with therapies: The virus enters a host cell (1), the virus’s genetic instructions are released, taking over cellular machinery (2), the virus is replicated within the cell (3) and copies of the virus exit the cell in search of new host cells to infect (4). Drugs like berzosertib might disrupt steps 2 and 3.  Image credit: Marc Roseboro/California NanoSytems Institute at UCLA

During the global pandemic, many researchers have responded to the needs of patients severely afflicted with COVID-19 by repurposing existing therapies being developed to treat patients.  CIRM responded immediately to the pandemic and to researchers wanting to help by providing $5 million in emergency funding for COVID-19 related projects. 

One of these grants ($349,999), awarded to Dr. Vaithilingaraja Arumugaswami at UCLA, has aided a study that has singled out a compound that shows promise for treating SARS-CoV-2, the virus that causes COVID-19.

In the spirit of banding together to help patients severely affected by COVID-19, the project was a collaboration among scientists from UCLA and other universities in California, Delaware and Germany, as well as a German pharmaceutical company.

The compound is named berzosertib and is licensed by the company Merck KGaA in Darmstadt, Germany.  Prior to the pandemic, it was developed for potential use, in combination with chemotherapy, as a possible treatment for small-cell lung cancer, ovarian cancer, and other types of solid tumors.

The team screened 430 drugs from among the approximately 200,000 compounds in CNSI’s Molecular Screening Shared Resource libraries before zeroing in on berzosertib as the most promising candidate.  They limited their search to compounds that either had been approved, or are already in the process of being evaluated, for safety in humans.

In a press release from UCLA, Dr. Arumugawami explains the rationale behind screening a potential drug candidate.

“That way, the compounds have cleared the first regulatory hurdle and could be deployed for further clinical trials on COVID-19 faster than drugs that have not been tested in humans.”

The researchers, led by Dr. Arumugaswami and Dr. Robert Damoiseaux from UCLA, conducted a series of experiments using different cell types in lab dishes to look at how effective the compound was at blocking SARS-CoV-2 from replicating.  Unlike other approaches which attack the virus directly, targeting replication could help better address the ability of the virus to mutate. 

For this study, the team used cells from the kidney, heart and lungs, all of which are organs that the virus is known to attack. The researchers pretreated cells with berzosertib, exposed the cells to SARS-CoV-2, allowed 48 hours for infection to set in, and then evaluated the results.

The team found that the compound consistently stalled SARS-CoV-2 replication without damaging the cells. The scientists also tested the drug against SARS and MERS, both of which are other types of coronaviruses that triggered deadly outbreaks earlier in the 2000s. They found that it was effective in stopping the replication of those viruses as well.

In the same press release from UCLA, Dr. Damoiseaux expressed optimism for what these findings could mean as a potential treatment.

“This is a chance to actually find a drug that might be broader in spectrum, which could also help fight coronaviruses that are yet to come.”

The next steps for this research would be to explore the mechanism through which the compound blocks coronavirus replication.  Understanding this and conducting preclinical studies are both necessary before the compound could be tested in clinical trials for COVID-19.

The full results of this study were published in Cell Reports.

The study’s co-corresponding author is Ulrich Betz of Merck KGaA, Darmstadt, Germany; the company also provided partial funding and clinical-grade berzosertib for the research. Other co-authors are from UCLA, Cedars-Sinai Medical Center, UC Irvine, University of Delaware, the Leibniz Institute for Experimental Virology in Germany, Heidelberg University in Germany and Scripps Research Institute.

In addition to CIRM, the study was also funded by CNSI, the Broad Stem Cell Research Center, the David Geffen School of Medicine at UCLA, the National Eye Institute, and the Bill and Melinda Gates Foundation.