Rare Disease Day, a chance to raise awareness and hope.

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Battling a deadly disease like cancer or Alzheimer’s is difficult; but battling a rare and deadly disease is doubly so. At least with common diseases there is a lot of research seeking to develop new treatments. With rare diseases there is often very little research, and so there are fewer options for treatment. Even just getting a diagnosis can be hard because most doctors may never have heard about, let alone seen, a case of a disease that only affects a few thousand individuals.

That’s why the last day of February, every year, has been designated Rare Disease Day.  It’s a time to raise awareness amongst the public, researchers, health  professionals and policy makers about the impact these diseases have on the lives of those affected by them. This means not just the individual with the problem, but their family and friends too.

There are nearly 7,000 diseases in the U.S. that are considered rare, meaning they affect fewer than 200,000 people at any given time.

No numbers no money

The reason why so many of these diseases have so few treatment options is obvious. With diseases that affect large numbers of people a new treatment or cure stands to make the company behind it a lot of money. With diseases that affect very small numbers of people the chances of seeing any return on investment are equally small.

Fortunately at CIRM we don’t have to worry about making a profit, all we are concerned with is accelerating stem cell treatments to patients with unmet medical needs. And in the case of people with rare diseases, those needs are almost invariably unmet.

That’s why over the years we have invested heavily in diseases that are often overlooked because they affect relatively small numbers of people. In fact right now we are funding clinical trials in several of these including sickle cell anemia, retinitis pigmentosa and chronic granulomatous disease. We are also funding work in conditions like Huntington’s disease, ALS or Lou Gehrig’s disease, and SCID or “bubble baby” disease.

Focus on the people

As in everything we do our involvement is not just about funding research – important as that is – it’s also about engaging with the people most affected by these diseases, the patient advocate community. Patient advocates help us in several ways:

  • Collaborating with us and other key stakeholders to try and change the way the Food and Drug Administration (FDA) works. Our goal is to create an easier and faster, but no less safe, method of approving the most promising stem cell therapies for clinical trial. With so few available treatments for rare diseases having a smoother route to a clinical trial will benefit these communities.
  • Spreading the word to researchers and companies about CIRM 2.0, our new, faster and more streamlined funding opportunities to help us move the most promising therapies along as fast as possible. The good news is that this means anyone, anywhere can apply for funding. We don’t care how many people are affected by a disease, we only care about the quality of the proposed research project that could help them.
  • Recruiting Patient Advocates to our Clinical Advisory Panels (CAPs), teams that we assign to each project in a clinical trial to help guide and inform the researchers at every stage of their work. This not only gives each project the best possible chance of succeeding but it also helps the team stay focused on the mission, of saving, and changing, people’s lives.
  • Helping us recruit patients for clinical trials. The inability to recruit and retain enough patients to meet a project’s enrollment requirements is one of the biggest reasons many clinical trials fail. This is particularly problematic for rare diseases. By using Patient Advocates to increase our ability to enroll and retain patients we will increase the likelihood a clinical trial is able to succeed.

Organizing to fight back

There are some great organizations supporting and advocating on behalf of families affected by rare diseases, such as the EveryLife Foundation  and the National Organization for Rare Diseases (NORD).  They are working hard to raise awareness about these diseases, to get funding to do research, and to clear away some of the regulatory hurdles researchers face in being able to move the most promising therapies out of the lab and into clinical trials where they can be tested on people.

For the individuals and families affected by conditions like beta thalassemia and muscular dystrophy – potentially fatal genetic disorders – every day is Rare Disease Day. They live with the reality of these problems every single day. That’s why we are committed to working hard every single day, to find a treatment that can help them and their loved ones.

The Critical Role of Patient Advocates in Accelerating Stem Cell Cures

At CIRM, our goal is to bring stem cell therapies to patients with unmet medical needs, and we do that by funding the most promising and innovative research in regenerative medicine. A critical component of this goal is to support our patient advocates and make sure that their voices are heard.

At this year’s World Stem Cell Summit, patient advocates from around the world, representing a breadth of diseases and disorders, came together to share their stories, goals, and needs with the larger scientific community.

One session that particularly stood out, was “Accelerating Cures: The Critical Role of Patient Advocates” on Day 3 of the conference. This panel featured key leaders in patient advocacy:

  • Don Reed, the “Grandfather of Stem Cell Research Advocacy”, Vice President of Public Policy at the Americans for Cures Foundation
  • Frances Saldaña, an advocate for Huntington’s disease (HD) and founder of HD-Care at UC Irvine, which is a support group to advance HD research and clinical care
  • Tory Williams, the Executive Director of the Alabama Institute of Medicine (AIM) which raises funds and awareness for stem cell treatments and cures of disease and injury and the author of “Inevitable Collision

The panel was moderated by our fearless leader and head of communications, Kevin McCormack. Each speaker shared their story about how they became a patient advocate and what they are currently doing to push the pace of stem cell research.

Don Reed, Kevin McCormack, Frances Saldana, Tory Williams.

Don Reed, Kevin McCormack, Frances Saldana, Tory Williams.

Don Reed described the heartbreaking story of his son Roman Reed, who suffered a severe spinal cord injury while playing football. Through Don and Roman’s relentless efforts, “Roman’s Law” was passed in 1999, which raised $17 million in California state funding for spinal cord injury research. Don was also a key instigator for the passage of Proposition 71, which gave $3 billion dollars to our agency to fund stem cell research. He continues to be a passionate advocate for stem cell research and spinal cord injury patients, and recently published a book called “Stem Cell Battles: Proposition 71 and Beyond” which you can read more about in our recent blog.

Next, Frances Saldana told a compelling story of raising a family of three beautiful children with a husband who had Huntington’s disease. Unaware of his condition when they were together, Frances’ world took a devastating turn when he died of HD, leaving her to question whether her children would face the same fate. Sadly, all three of Frances’s kids carried the HD mutation. Having to deal with the passing of her two daughters, and a son who is battling the end stages of this disease, Frances decided to share her experience with others and to create a support organization called HD-Care so that others wouldn’t have to face similar experiences alone. HD-Care is conducting an aggressive campaign to bring visibility to HD and supports cutting-edge research in the field including the work done by CIRM-grantee Dr. Leslie Thompson at UC Irvine.

Frances told the audience that her happiest moment since this all began was when her daughter Margie, already suffering from symptoms of HD, spoke at CIRM in 2007. She saw the Board and the scientists and thought, “somebody cares, and somebody will find a cure.” It was a new chapter for her, she explained, and she knew something good was going to happen.

Lastly, Tory Williams, introduced the Alabama Institute of Medicine, which is a non-profit organization that supports the stem cell community with education and public dialogue. She started the institute following both personal and family experiences with cancer and after TJ Atchinson, a close family friend, suffered a severe spinal cord injury. Along the way, she forged a close relationship with Roman Reed who helped her pass TJ’s law in 2013, which is an Alabama state law that promotes spinal cord injury research.

“The goal [of AIM],” said Williams, “is to make a difference in people’s lives affected by disease and injury by helping to advance medicine to eradicate these debilitating issues.”

Laurel Barchas, Student Society for Stem Cell Research

Laurel Barchas, Student Society for Stem Cell Research

When the session was opened up to questions, the atmosphere in the room turned electric. Patients and scientists stood up to tell their stories and asked hard questions. One question came from Laurel Barchas, one of the founders of the Student Society for Stem Cell Research, who asked how we as a society can advocate for mental illness and similar diseases where the symptoms are not visible and where patients are either embarrassed or hesitant to make their disease public. Another question was how emerging countries like Mexico who don’t have the same benefits and infrastructure as the US can promote and support patient advocacy.

The mood of the advocates was positive but measured. They know that new treatments and cures take time but they also pointed out that many people don’t have much time so we have to work as hard as we can to help them.

The panel ended with the consensus that the voices of patient advocates are invaluable, and that they will be the key to accelerating stem cell therapies into cures. Frances Saldaña urged other patient advocates that the key to progress is to be aggressive, and be unafraid to be out there. Don Reed concluded on a similar note with quote from Shakespeare’s Hamlet:

“Whether ’tis Nobler in the mind to suffer

The Slings and Arrows of outrageous Fortune,

Or to take Arms against a Sea of troubles,

And by opposing end them.”


Related links:

CIRM Scholar Spotlight: Berkeley’s Maroof Adil on stem cell transplants for Parkinson’s disease

Maroof Adil, CIRM Scholar

Maroof Adil, CIRM Scholar

Stem cell therapy has a lot of potential for Parkinson’s patients and the scientists that study it. One of our very own CIRM scholars, Maroof Adil, is making it his mission to develop stem cell based therapies to treat brain degenerating diseases like Parkinson’s.

Maroof got his undergraduate degrees from MIT in both Chemical Engineering and Biology, and a PhD in Chemical Engineering from the University of Minnesota. As a graduate student, he dived into the world of cancer research and explored ways of delivering cancer-killing genes specifically to cancer cells in the body while leaving healthy tissues in the body unharmed.

While he enjoyed his time spent on cancer research, he realized his main interest was to apply his skills in chemical engineering and materials science to understand biological problems. This brought him to his current position as a postdoc at UC Berkeley in the Schaffer lab.

Maroof is doing some pretty cutting edge research to develop 3D biomaterials that will vastly improve the transplantation and survival of stem cell derived neurons (nerve cells) in the brain. Check out our exclusive interview with this talented scientist below!


Q: What are you working on and why?

MA: I have always been excited about finding engineering solutions to medically relevant problems. I decided to do a postdoc at UC Berkeley in David Schaffer’s lab because I wanted to combine chemical and materials engineering skills from my graduate research with stem cell technologies to solve biological problems. One of the exciting parts of Dave’s lab, and a reason why I joined, is that he is working on translational stem cell-based regenerative therapies for central nervous system diseases such as Parkinson’s and Huntington’s.

My current research is motivated by the need to find better therapies for these neurodegenerative diseases. While stem cell-based regenerative medicine is an up-and-coming field, there are still a lot of challenges that need to be addressed before stem cells can be successfully used in the clinic. There are three main challenges that are most relevant to my research. First, we need to improve the efficiency of stem cell differentiation, i.e. how well we can convert these stem cells to the mature, functional neurons that we need to treat neurodegenerative diseases. Second, after implanting these cells into the body, we need to increase their survival efficiency. This is because one of the main issues with stem cell-based transplants right now is that after implantation, most of these cells die. Given these first two challenges, we need to generate a lot of cells in order to effectively treat degenerative diseases. The third challenge is to make good quality, functional, transplantable cells in a large-scale fashion.

So given my chemical and materials engineering background, I wanted to see if we could use biologically inspired materials (biomaterials) to address some of these issues with stem cell differentiation and transplantation. In brief, we are developing functionalized biomaterials, differentiating stem cells within these biomaterials into neurons, characterizing the quality of these neurons, and testing the function of these stem cell-derived neurons in animal models of disease.

A major focus of our lab is to develop 3D biomaterials to increase the efficiency of large-scale production of clinical-grade stem cells [and the mature cells that are derived from them]. Our preliminary results suggest that we can get higher numbers of better quality neurons when we differentiate and grow them in 3D biomaterials compared to when they are traditionally grown on a flat, 2D tissue culture surface. Presently, I’m trying to verify that our 3D method works in the lab. If it does, this technology could help us save a lot of time and resources in generating the type of cells we need for effective cell replacement therapies.

Stem cells growing as clusters in 3D[1]Neurons generated in 3D platforms 1[1]

Stem cell derived neurons grown in 3D cultures (left) and generated on 3D biomaterials (right). Images courtesy of Maroof Adil.

Q: Your research sounds fascinating but complicated. How are you doing it?

MA: It’s certainly a multidisciplinary project, and constantly requires us to draw ideas from diverse fields including polymer chemistry, developmental biology and chemical engineering. I am very grateful to be part of a resourceful lab, to my mentors, and to have amazing, motivated people working with me. UC Berkeley provides a highly collaborative work environment. So for some of the follow-up work that further characterizes the quality of these stem cells and their mature cell derivatives, we are collaborating with other labs at UC Berkeley and at UCSF.

Q: Are you interested in applying this work to other brain diseases?

MA: Certainly. Although we are primarily working on generating stem cell-derived dopaminergic neurons, which are the major cell type that die in Parkinson’s patients, I’m also interested in applying similar biomaterials to derive other types of neurons, for instance medium spiny neurons for Huntington’s disease.

The advantage of some of the materials we are working with is their modular nature. That is, we can tune their properties so that they are useful for other applications.

Q: In your opinion what is the future of stem cells in your field? Will they bring cures?

MA: I am very hopeful given what I’m seeing right now in the scientific literature, and in clinical trials for stem cell-based therapies in general. Right now, there are several trials that are testing the benefit and safety of stem cell-based transplants in different diseases. However, right now there are no clinical trials applying stem cell-derived neurons to treat brain diseases. But I think there’s certainly a lot of promise. There are challenges that we need to address in this field, and some of these I outlined earlier. Researchers are working on finding solutions to these problems, and I think that if we find them, the chances of successfully finding cures will be higher.

Q: Tell us about your experience as a CIRM Scholar.

MA: I started as a CIRM scholar in 2014. It was really great to have a source of funding that lined up with what I was interested in, which was doing translational work in regenerative medicine.

I first began working with stem cells when I started my postdoc career, but I didn’t really have a background in this area. So being new to the stem cell field, I felt that CIRM provided the support structure that I needed. And I’m not just referring to funding. CIRM brings scientists with different scientific backgrounds together in one place, where we can learn from one another, and initiate fruitful collaborations. Being a CIRM scholar makes me feel like I’m part of a bigger community, with other scientists conducting very different, but related stem cell research.

Also, I am a big fan of the CIRM blog. I am able to learn about patients and about other researcher’s backgrounds. It helps you realize that patients and researchers are part of the same field. And I like that concept of bringing the field closer: patients towards researchers and researchers towards patients. I think that is useful to boost motivation for researchers, and to give patients a better idea of what we do.

Through CIRM, we’ve had a chance to go out into the local community and present some of our research. For example, the past two years I’ve talked to local high school students during Stem Cell Awareness Week, and that was a really great experience.  I’ve presented to other professionals before, but never to those as young as high school students.  To me, it was quite exciting to realize that these kids are very much interested in the type of work we are doing, and to feel like I was able to influence them to potentially pursue science as a career.

Q: What are your career goals?

MA: I definitely want to stay in science and solve medically relevant problems. It could be nice to be faculty at a research university and in a position to pursue my own independent ideas at the interface of biomaterials and stem cell based therapies. An industry position working towards regenerative medicine or other biologically relevant applications is also an exciting possibility. At this point, being in science is my priority.

Q: What’s your favorite thing about being a scientist?

MA: The excitement you get when your experiments work out, and the joy of making new discoveries. I also like the thrill of designing experiments that may advance the field, and the feeling that what you’re doing day-to-day is contributing to a body of knowledge that others may find useful. I find it especially rewarding to be a scientist in the medical field, working on translational projects closely related to finding cures for diseases.

Stem cell stories that caught our eye: Parkinson’s in a dish, synthetic blood, tracking Huntington’s and cloning

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.

3D nerve model for Parkinson’s. The wave of successes in making more complex tissues in three dimensional lab cultures continues this week with a team in Luxembourg creating nerves from stem cells derived from Parkinson’s patients that assembled into complex connections in the lab.

Nerve cells made from skin cells. Credit: Luxembourg Centre for Systems Biomedicine (LCSB), 2015

Nerve cells made from skin cells. Credit: Luxembourg Centre for Systems Biomedicine (LCSB), 2015

The name of the journal where the group published their results, Lab on a Chip, says a lot about where the field is going. While many have grown the dopamine-producing nerves lost in Parkinson’s disease in two dimensional cultures, the new technique better replicates the disease state and does it about 10-fold cheaper because the 3D bioreactors used can be automated and use less of the reagents needed to grow the cells and to tell them to become the right nerves.

They started with skin samples from patients and reprogrammed them into iPS-type stem cells. After those cells are placed in the vessel, they are matured into 90 percent pure dopamine-nerves. At that point they are ideal for testing potential drugs for any impact on the disease. The senior researcher, Ronan Fleming, explained the benefit in a press release from the University of Luxembourg, picked up by ScienceDaily:

“In drug development, dozens of chemical substances can therefore be tested for possible therapeutic effects in a single step. Because we use far smaller amounts of substances than in conventional cell culture systems, the costs drop to about one tenth the usual.”

Synthetic blood from stem cells. Making synthetic blood, particularly for people with rare blood types for which there are few donors, has long been a goal of science. Now, the British National Health Service (NHS) says it expects to begin giving patients at least one component of lab-made blood—red cells—by 2017.

Starting with adult stem cells grown in just the right solution they hope to produce large quantities of red blood cells. Initially they plan to give only small quantities to healthy individuals with rare blood types to compare them to donor blood.

“These trials will compare manufactured cells with donated blood,” said Nick Warkins of the NHS. “The intention is not to replace blood donation but provide specialist treatment for specific patient groups.”

The story got wide pick up in the British press including in the Daily Mail and in several web portals including Rocket News.

Tracking Huntington’s spread in the brain. A CIRM-funded team at the University of California, Irvine, has developed a way to track the spread of the mutant protein responsible for progression of Huntington’s disease. They were able to accurately detect the mutant protein in cerebrospinal fluid and distinguish between people who carried the mutation but were pre-symptomatic from those that had advanced disease.

The protein appears to be released by diseased cells and migrates to other cells, seeding additional damage there. Measuring levels of the protein should allow physicians to monitor progression of the disease ahead of symptoms.

“Determining if a treatment modifies the course of a neurodegenerative disease like Huntington’s or Alzheimer’s may take years of clinical observation,” said study leader Dr. Steven Potkin. “This assay that reflects a pathological process can play a key role in more rapidly developing an effective treatment. Blocking the cell-to-cell seeding process itself may turn out to be an effective treatment strategy.”

Medical News Today wrote up the research that the team published in the journal Molecular Psychiatry.

Good overview of cloning. Writing for Medical Daily, Dana Dovey has produced a good overview of the history of cloning, and more important, the reasons why reproductive cloning of human is not likely to happen any time soon.

She describes the important role a number of variations on cloning play in scientific research, and the potential to create personalized cells for patients through a process known as therapeutic cloning. But she also describes the many problems with reproductive cloning as it is practiced in animals. It is very inefficient with dozens of eggs failing to mature and often results in animals that have flaws. She quotes Robert Lanza of Advanced Cell Technologies (now Ocata Therapeutics):

“It’s like sending your baby up in a rocket knowing there’s a 50-50 chance it’s going to blow up. It’s grossly unethical.”