genetic mutation

Promising start to CIRM-funded trial for life-threatening blood disorder

/ Kevin McCormack / 1 Comment
Aristotle

At CIRM we are always happy to highlight success stories, particularly when they involve research we are funding. But we are also mindful of the need not to overstate a finding. To quote the Greek philosopher Aristotle (who doesn’t often make an appearance on this blog), “one swallow does not a summer make”. In other words, one good result doesn’t mean you have proven something works.  But it might mean that you are on the right track. And that’s why we are welcoming the news about a clinical trial we are funding with Sangamo Therapeutics.  

The trial is for the treatment of beta-thalassemia, (beta-thal) a severe form of anemia caused by a genetic mutation. People with beta-thal require life-long blood transfusions because they have low levels of hemoglobin, a protein needed to help the blood carry oxygen around the body. Those low levels of oxygen can cause anemia, fatigue, weakness and, in severe cases, can lead to organ damage and even death. The life expectancy for people with the more severe forms of the condition is only 30-50 years.

In this clinical trial the Sangamo team takes a patient’s own blood stem cells and, using a gene-editing technology called zinc finger nuclease (ZFN), inserts a working copy of the defective hemoglobin gene. These modified cells are given back to the patient, hopefully generating a new, healthy, blood supply which potentially will eliminate the need for chronic blood transfusions.

Yesterday, Sangamo announced that the first patient treated in this clinical trial seems to be doing rather well.

The therapy, called ST-400, was given to a patient who has the most severe form of beta-thal. In the two years before this treatment the patient was getting a blood transfusion every other week. While the treatment initially caused an allergic reaction, the patient quickly rebounded and in the seven weeks afterwards:

  • Demonstrated evidence of being able to produce new blood cells including platelets and white blood cells
  • Showed that the genetic edits made by ST-400 were found in new blood cells
  • Hemoglobin levels – the amount of oxygen carried in the blood – improved.

In the first few weeks after the therapy the patient needed some blood transfusions but in the next five weeks didn’t need any.

Obviously, this is encouraging. But it’s also just one patient. We don’t yet know if this will continue to help this individual let alone help any others. A point Dr. Angela Smith, one of the lead researchers on the project, made in a news release:

“While these data are very early and will require confirmation in additional patients as well as longer follow-up to draw any clinical conclusion, they are promising. The detection of indels in peripheral blood with increasing fetal hemoglobin at seven weeks is suggestive of successful gene editing in this transfusion-dependent beta thalassemia patient. These initial results are especially encouraging given the patient’s β0/ β0 genotype, a patient population which has proved to be difficult-to-treat and where there is high unmet medical need.” It’s a first step. But a promising one. And that’s always a great way to start.

Stanford scientists devise an algorithm that identifies gene pairs associated with cancer

/ Karen Ring / Leave a comment

Using data from human tumor samples, Stanford scientists have developed a new computer algorithm to identify pairs of genes that cause cancer. Their research aims to identify alternative ways to target cancer-causing mutations that have thus far evaded effective clinical treatment.

The study, which was published this week in Nature Communications, was led by senior authors Dr. Ravi Majeti and Dr. David Dill and included two CIRM Bridges interns Damoun Torabi and David Cruz Hernandez.

Identifying Partners in Crime

Cancer cells are notorious for acquiring genetic mutations due to the instability of their genomes and errors in the machinery that repairs DNA. Sometimes these errors create what are called synthetic lethal genes. These are pairs of genes that can cause a cell to die if both genes are defective due to acquired mutations, but a defect in only one of the genes allows a cell to live.

Cancer cells rely on pairs of genes with similar functions for their survival. If one gene is mutated, then the cancer cell depends on the other functional gene, aka its “partner in crime”, to keep it doing its mischief. Scientist are interested in targeting this second partner gene in synthetic lethal pairs in the hopes of developing less toxic cancer therapies that only kill cancer cells instead of healthy ones too.

The Stanford team went on the hunt for synthetic lethal partner genes in data from 12 different human cancers using an algorithm they developed called Mining Synthetic Lethals (MiSL). David Dill explained their strategy in a Stanford Medicine news release:

“We were looking for situations in which, if gene A is mutated, gene Y is amplified to compensate for the loss of function of gene A. Conversely, gene Y is only ever deleted in cells in which gene A is not mutated.”

David Dill. (Credit: L.A. Cicero/Stanford News Service)

They identified a total of 3,120 cancer-causing mutations and over 145,000 potential synthetic lethal partner genes associated with these mutations. Some of these partnerships were identified in other studies, validating MiSL as an effective tool for their purposes, while other partnerships were novel.

Targeting Partners in Crime

One of the new partnerships they discovered was between a mutation in the IDH1 gene, which is associated with acute myeloid leukemia, and a gene called ACACA. The team validated this pair with experiments in the lab proving that defects in both IDH1 and ACACA blocked leukemia cell growth. MiSL identified 89 potential synthetic lethal partners for the leukemia-causing IDH1 mutation, 17 of which they believe could be targeted by existing cancer drugs.

The authors concluded that using computer algorithms to sift through mountains of biological data is a powerful strategy for identifying genetic relationships leveraged by tumors and could advance drug development for different types of cancers.

Ravi Majeti concluded,

“We’re entering a new era of precision health. Using data from real human tumors gives us important, fundamental advantages over using cancer cell lines that often don’t display the same mutation profiles. We’ve found that, although many known cancer-associated mutations are difficult to target clinically, their synthetic lethal partners may be much more druggable.”

Ravi Majeti (Credit: Steve Fisch)

New study says stem cells derived from older people may have more problems than we thought.

/ Kevin McCormack / Leave a comment

heart muscle from iPS

iPS-generated heart muscle cells

Ever since 2006 when Japanese researcher Shinya Yamanaka showed that you could take an adult cell, such as those in your skin, and reprogram it to act like an embryonic stem cell, the scientific world has looked at these induced pluripotent stem (iPS) cells as a potential game changer. They had the ability to convert a person’s own cells into any other kind of cell in the body, potentially offering a way of creating personalized treatments for a wide variety of diseases.

Fears that this reprogramming method might create some cancer-causing genetic mutations seemed to have been eased when two recent studies suggested this approach is relatively safe and unlikely to lead to any tumors in patients. We funded one of those studies and blogged about it.

Reason for caution

But now a new study in the journal Cell Stem Cell  says “not so fast”. The study says the older the person is, the greater the chance that any iPS cells derived from their tissue could contain potentially harmful mutations, but not in the places you would normally think.

A team at Oregon Health and Science University, led by renowned scientist Shoukhrat Mitalipov, took skin and blood samples from a 72-year-old man. The scientists examined the DNA from those samples, then reprogrammed those cells into iPS cells, and examined the DNA from the new stem cells.

Mitalipov-2

Shoukhrat Mitalipov: photo courtesy Oregon Health and Science University

When they looked at the cells collectively the levels of mutations in the new iPS cells appeared to be quite low. But when they looked at individual cells, they noticed a wide variety of mutations in the mitochondria in those cells.

Now, mitochondria play an important role in the life of a cell. They act as a kind of battery, providing the power a cell needs to perform a variety of functions such as signaling and cell growth. But while they are part of the cell, mitochondria have their own genomes. It was here that the researchers found the mutations that raised questions.

Older cells have more problems

Next they repeated the experiment but this time took skin and blood samples from 14 people between the ages of 24 and 72. They found that  older people had more genetic mutations in their mitochondrial DNA that were then transferred to the iPS cells derived from those people. In some cases up to 80 percent of the iPS cell lines generated showed mitochondrial mutations. That’s really important because the greater the amount of mutated mitochondrial DNA in a cell, the more its ability to function is compromised.

In a news release, Mitalipov says this should cause people to pause before using iPS cells derived from an older person for therapeutic purposes:

“Pathogenic mutations in our mitochondrial DNA have long been thought to be a driving force in aging and age-related diseases, though clear evidence was missing. Now with that evidence at hand, we know that we must screen stem cells for mutations or collect them at younger age to ensure their mitochondrial genes are healthy. This foundational knowledge of how cells are damaged in the natural process of aging may help to illuminate the role of mutated mitochondria in degenerative disease.”

To be clear, the researchers are not saying these iPS cells from older people should never be used, only that they need to be carefully screened to ensure they are not seriously damaged before being transplanted into a patient.

A possible solution

Mitalipov suggests a simple way around the problem would be to identify the iPS cell with the best mitochondria, and then use that as the basis for a new cell line that could then be used to create a new therapy.

Taosheng Huang, a researcher at the Mitochondrial Disorders Program at Cincinnati Children’s Hospital Medical Center, is quoted in the news release saying the lesson is clear:

“If you want to use iPS cells in a human, you must check for mutations in the mitochondrial genome. Every single cell can be different. Two cells next to each other could have different mutations or different percentages of mutations.”

Unlocking the brain’s secrets: scientists find over 100 unique mutations in brain cells

/ Karen Ring / Leave a comment

Your brain is made up of approximately 100 billion neurons. These are the cells that process information and pass along electrical and chemical signals to their other neuron buddies throughout the body to coordinate thoughts, movement, and many other functions. It’s no small task to create the intricate neuronal network that is the backbone of the central nervous system. If any of these neurons or a group of neurons acquire genetic mutations that alter their function, a lot can go wrong.

The genetic makeup of neurons is particularly interesting because it appears that each neuron has its own unique genome. That means 100 billion different genomes in a single cell type in the brain. Scientists suggest that this “individuality” could explain why monozygotic, or identical, twins have different personalities and susceptibilities to neurological disorders or mental illnesses and why humans develop brain diseases or cancer over time.

To understand what a genome of a cell looks like, you need to sequence its genetic material, or the DNA, that’s housed in a cell’s nucleus. Sequencing the genome of an individual cell is hard to do accurately with our current technology, so scientists have developed clever alternatives to get a front-row view into the workings of neuronal genomes.

Cloning mouse neurons reveals 100+ unique genetic mutations

One such method was published recently in the journal Neuron by a CIRM-funded team from The Scripps Research Institute (TSRI). Led by senior author and Associate Professor at TSRI, Kristen Baldwin, the team took on the challenge of cloning individual mouse neurons to unlock the secrets of neuronal genomes. (For those who aren’t familiar with the term, cloning is a process that produces new cells or organisms that harbor identical genetic information from the originating cell.)

What they found from their cloning experiment was surprising: each neuron they sequenced had an average of more than 100 unique genetic mutations, and these mutations tended to appear in genes that were heavily used by neurons, something that is uncommon in cell types of other organs that tend to protect their frequently used genes. Their findings could help unravel the mystery behind some of the causes for diseases like Alzheimer’s and autism.

In a TSRI news release, Kristen Baldwin explained:

Kristen Baldwin

Kristen Baldwin

“Neuronal genomes have remained a mystery for a long time. The findings in this study and the extensive validation of genome sequencing-based mutation discovery that this method permits, open the door to additional studies of brain mutations in aging and disease, which may help us understand or treat cognitive decline in aging, neurodegeneration and neurodevelopmental diseases such as autism.”

Making mice with neuronal genomes

To clone individual neurons, the team took the nucleus of a single neuron and transplanted it into a mouse egg cell that lacked its own nucleus. The egg developed and matured all while copying and passing on the genetic information of the original mouse neuron. The team generated cloned embryonic stem cell lines from these eggs and were able to expand the stem cell lines to generate millions of stem cells that contained the same genetic material.

TSRI Research Assistant Alberto Rodriguez uses a tiny straw-like micropipette to pick up red fluorescent neurons and transfer their genomes into an egg.

TSRI scientists extract the nuclei of neurons and transfer their genomes into an egg. (Image courtesy of TSRI)

They made several different cloned stem cell lines representing different neuronal genomes and sequenced these lines to identify unique genetic mutations. They also were able to generate cloned stem cell lines from the neurons of older mice, and thus were able to track the accumulation of genetic mutations over time. Even more impressive, they made living mice that contained the cloned genomes of individual neurons in all of their cells, proving that neuronal genomes are compatible with development.

The team did report that not all neurons could be developed into cloned stem cell lines for reasons that they couldn’t fully explain, but they decided to focus on studying the cloned stem cell lines that were successful.

What does this mean for humans?

Baldwin explained that what was most surprising about their study was “that every neuron we looked at was unique – carrying more than 100 DNA changes or mutations that were not present in other cells.”

The next steps for their research are to explore why this diversity among neuronal genomes exists and how this could contribute to neurological disease in humans.

Co-first authors Jennifer Hazen and Gregory Faust.

Co-first authors Jennifer Hazen and Gregory Faust.

Co-first author Jennifer Hazen explains, “We need to know more about mutations in the brain and how they might impact cell function.”

Also mentioned in the news release, the team plans “to study neuronal genomes of very old mice and those with neurological diseases. They hope this work will lead to new insights and therapeutic strategies for treating brain aging and neurologic diseases caused by neuronal mutations.”

Related Links:

CIRM-funded study suggests methods to make pluripotent stem cells are safe

/ Karen Ring / 1 Comment

We live in an era where stem cell treatments are already being tested in human clinical trials for eye disease, spinal cord injury, and type 1 diabetes. The hope is that transplanting stem cells or their cell derivatives will replace diseased tissue, restore function, and cure patients – all while being safe and without causing negative side effects.

Safety will be the key to the future success of stem cell replacement therapies. We’ve learned our lesson from early failed gene therapy experiments where genetically altered stem cells that were supposed to help patients actually caused them to get cancer. Science has since developed methods of gene therapy that appear safe, but new concerns have cropped up around the safety of the methods used to generate pluripotent stem cells, which are considered a potential starting material for cell replacement therapies.

Stem cell reprogramming can cause problems

Induced pluripotent stem cells (iPS cells) cultured in a dish.

Induced pluripotent stem cells (iPS cells) cultured in a dish.

Induced pluripotent stem cells, or iPS cells, are a potential source of pluripotent stem cells for cell therapy. These cells are equivalent to embryonic stem cells but can be generated from adult tissue (such as skin or even blood) by reprogramming cells back to a pluripotent state. During cellular reprogramming, one set of genes is turned off and another set is turned on through a process called epigenetic remodeling. We don’t have time to explain epigenetics in this blog, but to be brief, it involves chromatin remodeling (chromatin is the complex of DNA and protein that make up chromosomes) and is essential for controlling gene expression.

To make healthy iPS cells, the intricate steps involved in cellular reprogramming and epigenetic remodeling have to be coordinated perfectly. Scientists worry that these processes aren’t always perfect and that cancer-causing mutations could be introduced that could cause tumors when transplanted into patients.

A CIRM-funded study published Friday in Nature Communications offers some relief to this potential roadblock to using reprogrammed iPS cells for cell therapy. Scientists from The Scripps Research Institute (TSRI) and the J. Craig Venter Institute (JCVI) collaborated on a study that assessed the safety of three common methods for generating iPS cells. Their findings suggest that these reprogramming methods are relatively safe and unlikely to give cancer-causing mutations to patients.

Comparing three reprogramming methods

In case you didn’t know, iPS cells are typically made by turning on expression of four genes – OCT4, SOX2, KLF4, and c-MYC – that maintain stem cells in a pluripotent state. Scientists can force an adult cell to express these genes by delivering extra copies into the cell. In this study, the scientists conducted a comparative genomic analysis of three commonly used iPS cell reprogramming methods (integrating retroviral vectors, non-integrating Sendai virus, and synthetic mRNAs) to search for potential cancer-causing mutations in the DNA of the iPS cells.

Unlike previous studies that focused on finding a single type of genetic mutation in reprogrammed iPS cells, the group looked at multiple types of genetic mutations – from single nucleotide changes in DNA to large structural variations – by comparing whole-genome sequencing data of the starting parental cells (skin cells) to iPS cells.

They concluded that the three reprogramming methods generally do not cause serious problems and hypothesized that cancer-causing mutations likely happen at a later step after the iPS cells are already made, an issue the team is addressing in ongoing work.

They explained in their publication:

“We detected subtle differences in the numbers of [genetic] variants depending on the method, but rarely found mutations in genes that have any known association with increased cancer risk. We conclude that mutations that have been reported in iPS cell cultures are unlikely to be caused by their reprogramming, but instead are probably due to the well-known selective pressures that occur when hPSCs [human pluripotent stem cells] are expanded in culture.”

The safety of patients comes first

Senior authors on the study, Dr. Jeanne Loring from TSRI and Dr. Nicholas Schork from JCVI, explained in a TSRI News Release that the goal of this study was to make sure that the reprogramming methods used to make iPS cells were safe for patients.

4fb4e-jeanne_loring_headshot_web

Jeanne Loring

“We wanted to know whether reprogramming cells would make the cells prone to mutations,” said Jeanne Loring, “The answer is ‘no.’ The methods we’re using to make pluripotent stem cells are safe.”

 

Nicholas Schork added:

Nicholas Schork

Nicholas Schork

“The safety of patients comes first, and our study is one of the first to address the safety concerns about iPSC-based cell replacement strategies and hopefully will spark further interest.”

 

 

Moving from bench to clinic

It’s good news that reprogramming methods are relatively safe, but the fact that maintaining and expanding iPS cells in culture causes cancerous mutations is still a major issue that scientists need to address.

Jeanne Loring recognizes this important issue and says that the next steps are to use similar genomic analyses to assess the safety of reprogrammed iPS cells before they are used in patients.

“We need to move on to developing these cells for clinical applications,” said Loring. “The quality control we’re recommending is to use genomic methods to thoroughly characterize the cells before you put them into people.”

Stem cells could offer hope for deadly childhood muscle wasting disease

/ Kevin McCormack / 1 Comment

Duchenne muscular dystrophy (DMD) is a particularly nasty rare and fatal disease. It predominantly affects boys, slowly robbing them of their ability to control their muscles. By 10 years of age, boys with DMD start to lose the ability to walk; by 12, most need a wheelchair to get around. Eventually they become paralyzed, and need round-the-clock care.

There are no effective long-term treatments and the average life expectancy is just 25.

Crucial discovery

Duchenne MD team

DMD Research team: Photo courtesy Ottawa Hospital Research Inst.

But now researchers in Canada have made a discovery that could pave the way to new approaches to treating DMD. In a study published in the journal Nature Medicine, they show that DMD is caused by defective muscle stem cells.

In a news release Dr. Michael Rudnicki, senior author of the study, says this discovery is completely changing the way they think about the condition:

“For nearly 20 years, we’ve thought that the muscle weakness observed in patients with Duchenne muscular dystrophy is primarily due to problems in their muscle fibers, but our research shows that it is also due to intrinsic defects in the function of their muscle stem cells. This completely changes our understanding of Duchenne muscular dystrophy and could eventually lead to far more effective treatments.”

Loss and confused

DMD is caused by a genetic mutation that results in the loss of a protein called dystrophin. Rudnicki and his team found that without dystrophin muscle stem cells – which are responsible for repairing damage after injury – produce far fewer functional muscle fibers. The cells are also confused about where they are:

“Muscle stem cells that lack dystrophin cannot tell which way is up and which way is down. This is crucial because muscle stem cells need to sense their environment to decide whether to produce more stem cells or to form new muscle fibers. Without this information, muscle stem cells cannot divide properly and cannot properly repair damaged muscle.”

While the work was done in mice the researchers are confident it will also apply to humans, as the missing protein is almost identical in all animals.

Next steps

The researchers are already looking for ways they can use this discovery to develop new treatments for DMD, hopefully one day turning it from a fatal condition, to a chronic one.

Dr. Ronald Worton, the co-discoverer of the DMD gene in 1987, says this discovery has been a long-time coming but is both welcome and exciting:

“When we discovered the gene for Duchenne muscular dystrophy, there was great hope that we would be able to develop a new treatment fairly quickly. This has been much more difficult than we initially thought, but Dr. Rudnicki’s research is a major breakthrough that should renew hope for researchers, patients and families.”

In this video CIRM grantee, Dr. Helen Blau from Stanford University, talks about a new mouse model created by her lab that more accurately mimics the Duchenne symptoms observed in people. This opens up opportunities to better understand the disease and to develop new therapies.