December 8, 2011 by

Adult Stem Cell Clinical Trials Showing Success

A Number of Clinical Trials Using Adult Stem Cells Are Showing Early Success

Dozens of adult stem cell treatments are moving through clinical trials and showing early success, raising hopes that some could reach the market within five years. ‘It will only take a few successes to really change the field,’ said Gil Van Bokkelen, chief executive of Athersys and chairman of the Alliance for Regenerative Medicine. ‘As you see things getting closer and closer to that tipping point, you’re going to see a frenzy of activity take place.’ Many of the trials focus on heart disease and inflammatory conditions, some of the biggest markets in medicine. The cells used are derived from adult tissue such as fat, or bone marrow, thereby circumventing the ethical concerns raised by the use of cells derived from embryos.

Data for the most part remains early, but as more results emerge, pharmaceutical companies are beginning to take note. ‘A lot of big companies are looking to place bets on some Phase II products once that data has been confirmed,’ said Paul Schmitt, managing partner at Novitas Capital. ‘Even now they’re attending all the medical meetings and talking to all the stem cell companies.’ Steven Martin, from Aspire Capital Partners LLC said they were willing to be patients as the benefits from treatment could be enormous. ‘My philosophy in the stem cell space is that it’s very difficult at this point to pick the winners and losers,’ he said. ‘We believe that over time there will be some very significant clinical progress, and valuations will improve, but we’re still a long way from an approved therapy.’

Aastrom Biosciences recently presented promising results from a mid-stage trial of its treatment for patients with critical limb ischemia, a disease in which blood flow to the extremities is restricted, at the American Heart Association’s annual meeting. A mid-stage trial from Australia’s Mesoblast Ltd showed its stem cell product reduced the rate of heart attacks and the need for artery clearing procedures by 78 per cent. ‘We’re actually developing products now,’ said Timothy Mayleben, chief executive of Aastrom, which is using cells derived from a patient’s own bone marrow to develop treatments for cardiovascular disease. ‘For the first time you are starting to see data being presented at major medical meetings.’ Pfizer Inc, Johnson & Johnson and Roche Holding AG are members of the Alliance for Regenerative Medicine, a nonprofit group that promotes awareness of the field. Pfizer has a regenerative medicine unit and a partnership with Athersys. But their projects are small as they want to wait to see data in hundreds of patients. The promise of stem cells, which have been used for 40 years in bone marrow transplants, lies in their ability to repair tissue, reduce inflammation, regulate the immune system, and respond to calls for help from multiple places inside the body. Stem cells are the body’s master cells – blank slates that renew themselves and mature into specific cell types in the heart, muscle and other organs.

Embryonic stem cells are uniquely capable of differentiating into every type of mature cell in the body, and were long viewed as the most promising for regenerating tissue. But harvesting stem cells from embryos requires the destruction of the embryo itself, a process opposed by conservative Christian groups. Moreover, their endless capacity to divide can lead to the formation of teratomas, or stem cell cancers. Recently, Geron Corp, the world’s leading embryonic stem cell company, said it could no longer fund its stem cell work and would focus on developing cancer drugs. It closed its trial for spinal cord injury. Unlike embryonic stem cells, adult stem cells have a more limited capacity to differentiate, but appear able to reduce inflammation and promote blood vessel formation. Furthermore, they can respond to damage in the body in a flexible and dynamic way, offering advantages over traditional drugs.
‘They seem to be preprogrammed to act some way in tissue repair, not to form an organ or a tissue,’ said Douglas Losordo, head of stem cell research at Baxter International Inc, which is developing cell therapies for heart disease. ‘The cells that we use are very effective at stimulating the formation of new blood vessels, but if I wanted to make a brain cell out of those cells they would not be very good at it.’ These are the type of stem cell treatments, delivered by infusion, injection or catheter, that are being developed today.
‘We wanted to create a product that everyone could receive and not have to match every donor to every recipient,’ said Robert Hariri, chief executive of Celgene’s Cellular Therapeutics unit.

Different types of stem cell are being used for different diseases. Cytori Therapeutics is developing a heart disease product derived from fat cells, for example, while Celgene is using placental cells for Crohn’s disease and rheumatoid arthritis therapies. Fetal cells are also being explored. Neuralstem Inc, for example, is developing treatments for neurological disorders from an aborted fetus. As cell therapies move further through clinical trials, companies will need more money, and funding is scarce.
Yet even if companies remain afloat long enough to bring a product through late-stage clinical trials, it is unclear what regulators like the Food and Drug Administration will require in order to approve them Some believe the regulatory hurdles for treatments derived from a patient’s own cells will be lower than those where the cells come from donors, since there is less risk of cell rejection. However, no clear pathway has yet been established. ‘We need a clear, consistent and rigorous regulatory framework,’ said Athersys’s Van Bokkelen. ‘The FDA is actually willing to provide lots of guidance and assistance to sponsors, if you just ask them.’

Filed Under: Adult Stem Cells, News, Stem Cell Research Tagged With: , , , , , ,
December 6, 2011 by

Stem Cell Treatments for Pemphygoid: Jane Wrede

“With such strong signs of remission and impatience with side effects, I took it upon myself to taper prednisone from 20 to 7.5mg/day and after 3 weeks at 7.5, I see no change in my healthy oral condition. All sores healed and no new blisters. I count this as successful!”

My name is Jane Wrede I have an autoimmune disease called Pemphygoid. Pemphygoid symptoms in my mouth and throat gradually improved after stem cell treatment so that my gums are firm, I feel no pain and can eat all but hot and spicy food! My eyes continue to be dry and I use sterile drops when they feel tired and sore. This is less severe than before and not until late in the day and sometimes at night. With such strong signs of remission and impatience with side effects, I took it upon myself to taper prednisone from 20 to 7.5mg/day and after 3 weeks at 7.5, I see no change in my healthy oral condition. All sores healed and not new blisters. I count this as successful!

Jane Wrede

Filed Under: Autoimmune Diseases, Patient Stories, Pemphygoid Tagged With: , , , , , ,
December 6, 2011 by

Stem cell therapy for juvenile dermatomyositis: Nathan Byrd

“Nathan, my son, is only on Prednisone at 3 mg q d now. Absolutely no problems at all. No weakness. No pain. No stiffness. Rash is gone. The calcinosis is less based on a recent x-ray. Flow cytometry was normal.

“(Nathan has) Absolutely no problems at all. No weakness. No pain. No stiffness. Rash is gone.”

How can I ever express my gratitude to all of you?”

– Richard W Byrd MD

Filed Under: Autoimmune Diseases, juvenile dermatomyositis, Patient Stories Tagged With: , , , ,
December 6, 2011 by

Healing juices’ of stem cells could help treat asthma

Research suggests future use of cells in kidney, heart disease
BY BRENT WITTMEIER, EDMONTON JOURNAL DECEMBER 2, 2011

University of Alberta pediatric asthma researcher says that the medical benefits of stem cells may lie in their by-product “healing juices”.

Dr. Bernard Thébaud believes the by-products of mesenchymal stem cells – found in umbilical cord tissue and with known anti-inflammatory characteristics – could possibly heal lungs inflamed by chronic and acute asthma.

The findings, published in the American Journal of Respiratory Cell and Molecular Biology, look at the effects of what Thébaud called “healing juices” on refractory asthma, a form of the disease that is particularly difficult to treat with inhalers.

Thébaud, a neonatal pediatrician and professor of pediatrics at the University of Alberta Faculty of Medicine and Dentistry, said the cells and their juices are easily isolated and cultivated in the lab.

“We cultured the cells in the petri dish, and instead of taking the cells, we just took what the cells produced, the juice they were basically swimming in,” Thébaud said. “We compared that to control cells cultured the same way, but didn’t have that same effect.”

Thébaud’s team created asthma in lab mice, then injected the juices through their noses. The by-products opened airways, restored breathing and reduced inflammation in their lungs.

Thébaud began researching pediatric lung disease in 2002, adding the “exciting” discipline of stem-cell research two years later. The new study builds on some of Thébaud’s previous research into how stem cells work.

“Initially we thought you have to give the cells (to the patient) because they replace dead cells,” he said. “That’s not actually the case.”

Thébaud initially used the mesenchymal stem cells in a study of newborn lung injury, discovering “tremendous benefits” for the health of the lungs. But when his research team tried to see where those stem cells were, they couldn’t find them.

“Maybe they don’t replace dead cells. Maybe they sit there and produce juices, then vanish,” he said.

Although the research is still at an early stage, Thébaud said his hope is for a “super-inhaler” five to 10 years from now that would heal inflammation, boost healthy cells and aid in breathing. He hopes to live the researcher’s dream and drive the discovery from his lab into the clinic.

His goal “would be to have a puffer with stem cell by-products that would prevent those symptoms of asthma,” he said.

Thébaud is convinced it could work. But exactly which compounds or factors are doing the “healing” is hardly academic, and will likely form the next stage in the research.

“It is the question,” said Thébaud. “First, we have to know should we not give the cells, or can we just deliver the juices. Do we have to know what’s in there?”

That question could also delay clinical research by an additional five years, the time he estimates it would take to synthesize the factor pharmaceutically. He will be discussing the study with Health Canada to determine barriers to clinical research using just undifferentiated by-products.

Thébaud also believes the approach demonstrates “many therapeutic avenues” beyond asthma, which affects an estimated 300 million people worldwide. The potential of stem-cell research isn’t yet known.

“It’s up to us now to harness the healing powers of these cells,” he said.

“We know it works in a variety of lung diseases. By extension, we know it will work in kidney, or heart or brain disease as well.”

Filed Under: Adult Stem Cells, Asthma, News, Stem Cell Research Tagged With: , , , , ,
April 30, 2011 by

Where Cord Matrix Stem Cells Go After Injection

Maurya et al. World J Stem Cells. 2011 Apr 26;3(4):34-42.

Stem cell migration is a very relevant issue when discussing the systemic administration of stem cells as therapeutics. There is a widely held belief that intravenous administration of stem cells results in accumulation into the lungs and liver. While studies have demonstrated that stem cells home to area of injury, in part through the SDF-1 protein produced by injured tissue, relatively little work has been performed in terms of analyzing where stem cells home in healthy, or non-diseased situations. A recent study (Maurya et al. Non-random tissue distribution of human naïve umbilical cord matrix stem cells. World J Stem Cells. 2011 Apr 26;3(4):34-42) attempted to address this.
The scientists used human cord matrix mesenchymal stem cells. These cells are similar to the ones used by Osiris, except that some believe that they are more potent due to their relatively more immature origin. As a model system, the cells were injected into mice that lack an immune system due to a genetic mutation that causes lack of T cells and B cells (SCID). In order to track the human cord matrix stem cells, the cells were labeled with the radioactive tracer compound tritiated thymidine. This compound integrates into replicating DNA and is imaged using beta radiation detection.
The investigators assessed injected animals at days 1, 3, 7 and 14 for radioactivity. To confirm results they also used an immunofluorescence detection technique was employed in which anti-human mitochondrial antibody was used to identify human cells in mouse tissues. Additionally, standard microscopy and histology staining was performed.
The injected cord matrix mesenchymal cells preferentially accumulated in the lung 24 hours after injection. With time, the stem cells migrated to other tissues. Specifically, on day three, the spleen, stomach, and small and large intestines were the major accumulation sites. On day seven, a relatively large amount of radioactivity was detected in the adrenal gland, uterus, spleen, lung, and digestive tract. In addition, labeled cells had crossed the blood brain barrier by day 1.
The fact that injected stem cells enter various tissues in a healthy animal suggests the possibility that stem cells are involved in the natural renewal process. It would be interesting to see the same experiment was performed in the animal model of progeria if more stem cells would be integrated. Additionally, experiments should use allogeneic T cell reconstituted animals to see if allogeneic human cord matrix cells survive.

Filed Under: News, Stem Cell Research Tagged With: , , , ,
April 27, 2011 by

Forcing Stem Cells into Circulation Results in Protection from Liver Failure in Animals

Zhang et al. Toxicol Lett.
While previous studies showed that administration of bone marrow cells are capable of repairing livers in animal and human studies, relatively little work has been performed to augment existing means by which the body uses its own stem cells to heal the liver. Specifically, it has been demonstrated that in liver failure bone marrow stem cells exit the bone marrow and home to the damaged liver. While conventional approaches include performing a bone marrow aspiration and mechanically placing the bone marrow into the liver, usually vial the hepatic artery, an alternative would be administration of a chemical that “instructs” the bone marrow stem cells to exit the bone marrow and go into systemic circulation. The other approach would be to augment the chemical signals that the injured liver produces to attract stem cells. This approach is currently pursued in other indications by the company Juventas. Stromal Derived Factor (SDF)-1 is produced by injured tissues and induces migration of bone marrow stem cells. The genetic administration of SDF-1 into already injured tissues causes an increase in stem cell trafficking and has been demonstrated to augment existing regenerative mechanisms.
A recent study (Zhang et al. Granulocyte colony-stimulating factor treatment ameliorates liver injury and improves survival in rats with d-galactosamine-induced acute liver failure. Toxicol Lett. 2011 Apr 27) from the First Affiliated Hospital, School of Medicine, of the Xi’an Jiaotong University demonstrated that administration of the stem cell mobilizer G-CSF into rats with chemically induced liver failure results in prolonged survival and the appearance of liver regeneration.
The investigators administered a single dose of d-galactosamine (d-GalN, 1.4g/kg) to induce ALF. After 2h, the rats were randomized to receive G-CSF (50μg/kg/day), or saline vehicle injection for 5 days. In the liver failure model, 5-day survival after d-GalN injection was 33.3% (10/30), while G-CSF administration following d-GalN resulted in 53.3% (16/30) survival (p=0.027). G-CSF treated rats had lower ALT level and less hepatic injury compared with saline vehicle rats. The increases of CD34+ cells in bone marrow and liver tissue and Ki-67+ cells in liver tissue in G-CSF treated rats were higher than those in saline rats.
These data suggest the possibility that stem cell therapy using chemicals that mobilize endogenous stem cells may be useful in the treatment of liver failure. It remains to be seen whether other chemicals associated with mobilization may cause improved outcome. For example, in addition to G-CSF, agents such as M-CSF, GM-CSF, parathyroid hormone, and the CXCR4 antagonist Mozibile are all capable of inducing mobilization of different types of stem cells.

Filed Under: Adult Stem Cells, Liver, News, Stem Cell Research Tagged With: , , , ,
February 23, 2011 by

Stem Cell Technique Could Help Those With Fast-aging Disease

Washington Examiner

February 23, 2011

Hutchinson-Gilfod progeria syndrome is a fast-aging disease that is rare, has no cure, and is fatal. Children with this disease undergo rapid aging and generally do not live to their teens. It is caused by a single mutation of the LMNA gene, which results in a defect in the production of lamin A, a protein which is required to build the membranous shell around genetic material. The majority of children with Hutchinson-Gilford progeria die from complications pertaining to hardening of their blood vessels. Fortunately, this disease is very rare, as only 64 children in the world are known to have it, however due to the small number of patients suffering from this disease, there are very few opportunities to study it and thus form any type of treatment.

New technology has introduced a new possibility in the treatment of this progeria. In the past five years, scientists have begun using targeted retroviruses that selectively alter DNA in order to cause a regression of cells from the muscle or skin into their stem cell form, pluripotent stem cells. Pluripotent stem cells have the potential to form various different types of cells in the body, depending on where they are transplanted to.

The cells that were taken from the patients were regressed back to their pluripotent stem cell stage by a research team led by Juan Carlos Izpisua Belmonte and Guanghui Liu at the Salk Institute in La Jolla, California. The researchers found that after this regression, the cells from the patients no longer contained the information that corresponded to diseased cells. However, despite the absence of the mutation in the stem cell state, these cells would not necessarily be rid of the defect which sets the fate for the disease. The resetting of the cells does allow for the scientists to study the progression of the disease its beginning.

Liu’s lab is working on a technique that will fix the genetic mutation responsible for the progeria in hopes of developing a treatment or even a cure for the disease. “Hopefully our efforts will be useful to generate … [non-symptomatic] progeria cells and help those progeria patients in the near future,” he said.

Filed Under: Adult Stem Cells, News, Stem Cell Research Tagged With: , , , ,
February 22, 2011 by

PRECISE: Adipose-derived stem cells show utility as therapy

Cardiology Today

PRECISE is The Randomized Clinical Trial of Adipose-Derived Stem Cells in Treatment of Non Revascularizable Ischemic Myocardium, a double blind, placebo-controlled trial involving 27 patients with chronic ischemic heart disease with HF, angina or both, who were not eligible for percutaneous or surgical revascularization. The patients in the study underwent a liposuction to remove adipose tissue from their abdomen, the stem cells were separated and then reinjected directly into the heart. Placebo patients received the same treatment however were injected with placebo in place of stem cells. “These patients were not even able to be transplanted. So these were very high-risk, no-option patients,” said Francisco Fernández-Avilés, MD, with the department of cardiology, Hospital General Universitario Gregorio Marañón, Madrid, and PRECISE investigator.

The patients who were treated with stem cells had improved infarct size at 6 months and peak oxygen consumption compared to the placebo patients. “In my opinion, the results of the PRECISE trial are good enough to reconsider the possibility to start a larger scale randomized trial comparing cells to placebo in terms of left ventricular function, mainly clinical outcomes [like] mortality, HF and ischemia,” Fernández-Avilés said. For the years ahead, Fernández-Avilés said in patients with chronic HF and viability, the answer for stem cell therapy is adipose tissue, “and for patients with no viability, in my opinion, we need more basic investigation to find more effective cells.”

Filed Under: Adult Stem Cells, Heart Disease, News, Stem Cell Research, Stem Cell Therapy Tagged With: , , , , , ,
February 1, 2011 by

Scientists look to stem cells to mend broken hearts

Cardiac medicine has traditionally been associated with innovative procedures that sometimes where considered heretical to the present day dogma. For example, the first heart transplant, the use of the balloon catheter, the introduction of thrombolytics, all met substantial resistance from the “establishment” in their time. It appears that the next revolution in cardiac medicine is the use of stem cells. Aside from the obvious ethical and moral dilemmas surrounding embryonic tissues, the major controversy has been the belief that heart tissue does not repair itself after it has been lost. However, slowly but surely it appears that support behind the use of stem cells for heart conditions is gaining momentum.

One sign of this is the recent announcement that Britain’s leading heart charity, the British Heart Foundation (BHF), launched a 50 million pound ($80 million) research project into the potential of stem cells to regenerate heart tissue and “mend broken hearts”.

“Scientifically, mending human hearts is an achievable goal and we really could make recovering from a heart attack as simple as getting over a broken leg,” said Professor Peter Weissberg, medical director at the BHF.

One example of research in this area being performed in England is the work of Professor Paul Riley of the Institute of Child Health at University College London (UCL) who has identified a natural protein, called thymosin beta 4, that plays a role in developing heart tissue. He said his researchers had already had some success in using this protein to “wake up” cells known as epicardial cells in mice with damaged hearts. “We hope to find similar molecules or drug-like compounds that might be able to stimulate these cells further,” he told reporters at the briefing.

Currently the most advanced type of stem cell therapy for the heart involves administration of the patient’s own bone marrow cells into the area of heart damage after a heart attack. This work, which was performed in England and internationally, seems to suggest that cardiac muscle may be preserved when cells from the bone marrow produce various growth factors that stimulate stem cells that are already existing in the heart.

Other methods of administering stem cells into the heart include direct injection into the heart muscle during bypass surgery. This is performed experimentally in patients with severe angina on the hope that the injected stem cells will provide support for formation of new blood vessels, called collaterals, which are anticipated to increase the blood flow to the heart and thereby reduce angina.

Currently embryonic or fetal derived stem cells have not been used for treatment of heart conditions in humans. Therefore, at least for now, ethical issues do not seem to be a major obstacle to advancement of stem cell medicine for hearts.

Filed Under: Adult Stem Cells, Bone Marrow, Heart Disease, News, Stem Cell Research Tagged With: , , , , ,
December 27, 2010 by

Time to end stem cell institute CIRM

Wesley J. Smith , San Francisco Chronicle

The California Institute for Regenerative Medicine (CIRM) was created in 2004 as a result of the California Proposition 71, which called for a new bond issue to generate 3 billion dollars in order to support stem cell research in the State. In part, the institute was created as a response to President George W. Bush’s order restricting federal funding of embryonic stem cell research. The hope behind this enormous influx of cash to stem cell research was based on the popular belief that the State would have reduced medical costs, as well as treatments for many of the debilitating diseases that could benefit from stem cell therapy.

According to the author of the article, who is a senior fellow at the Discovery Institute’s Center on Human Exceptionalism and a consultant to the Center for Bioethics and Culture. “The CIRM hasn’t come close to fulfilling those promises. Here’s why California voters should reject the bond issue and shut the agency down in 2014…”

His rationale is that a) CIRM was created primarily to fund human cloning for research and embryonic stem cell research. So far, cloning has failed and embryonic stem cell cures, if they ever come, are a very long way off; b) Questionable uses of taxpayer’s funds. Specifically, $300 million went to help pay for plush research facilities, particularly those associated with board members of CIRM; c) Members of CIRM are paid exorbitant salaries. For example, the head of CIRM makes just under $500,000 a year, Art Torres, a board member and former chairman of the California Democratic Party, works four days a week – for a whopping $225,000 a year.

It is our opinion that basic research is critical for development of new therapies and for advancement of medicine. Therefore, conceptually, there is nothing wrong with supporting the use of taxpayer’s dollars for stem cell research. The issue that we have revolves around what research gets funded and how those projects are in line with the goals for which the funds were donated.

In the “drug development cycle” the first step is basic research and discovery of a biological mechanism of action associated with the disease. The second step is understanding how to manipulate the interaction. The third step is developing an intervention that may theoretically be useful and testing it in animal models of diseases. The fourth step, which is considerably more difficult, is to test the putative therapy in humans either at a low dose in healthy volunteers, or in terminal patients. This usually involves 10-40 patients and is formally called a Phase I clinical trial. Phase II clinical trials are the fifth step of developing a therapeutic. This involves 30-100 patients and assesses efficacy of the therapy in patients with disease. The last step of developing a drug involves conducting Phase III clinical trials, whose aim is to see whether the putative therapy induces therapeutic effects in a double blind, placebo controlled manner.

The majority of research funded by CIRM covers projects that are at the first to third steps, that is, from identifying new biological pathways, to trying to treat mice. Very few CIRM funded projects supported adult stem cell companies that are using their cells to treat patients. We anticipate that with more articles such as the one published by Wesley Smith, CIRM will become more cognizant of the reason why taxpayers supported the Institute: to develop cures faster. Indeed, one can see this increasing support in CIRM for adult stem cell companies in that in October of this year only 5 of 19 grants were for embryonic stem cell research.

Filed Under: News, Stem Cell Research Tagged With: , , , , , ,
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