Trading on hope: A look at what motivates stem cell tourists and what happens when it goes wrong

In recent years, the research community has been quite outspoken in its condemnation of rogue stem cell clinics operating in many countries across the globe. Indeed, through announcements made by health and related ministries in China, India and the US, it appears the message is beginning to be heard.  

On the heels of a recent 60 Minutes newscast in the US, a similar exposé aired on January 14 here in Canada. In it, Stem Cell Network Scientific Director Michael Rudnicki spoke with Global TV’s Carolyn Jarvis, condemning stem cell tourism and the agencies that offer them as “despicable” (view the entire Global TV 16x9 segment here). His interview was just a small part of the broadcast, in which the news team looked at the unproven and unapproved therapies offered by a clinic operating in Mexico and a Canadian-based travel operator that offers packages to help people access the services.

Along with Rudnicki, the program profiles several patients, one of whom was successfully treated in an FDA-approved clinical trial for MS, another who was unsuccessfully treated in a Mexican clinic, and a set of parents raising funds to seek treatment in China for their five-year-old son. Each of the struggle to balance the pain of dealing with their ailments, the hope that stem cells could help them, and the risks involved in these experimental therapies.

Exercising caution over unproven therapies: India holds public consultation meetings to update stem cell guidelines

by David Kent

Last fall, I wrote on the Eurostemcell documentary film entitled Stem Cell Revolutions: A Vision of the Future, which featured some experimental stem cell treatments in India, and since that time, I have tried to keep my finger on the pulse of what has been happening in India with respect to stem cell therapy.

Last month a pair of interesting statements were made in the India Times:

“As of today there is no approved indication for stem cell therapy as part of routine medical practice, other than bone marrow transplantation.”

This was followed by:

Sifting through all that monkey business

by David Kent

 

Yesterday, a landmark paper emerged from Cell which reported two major findings to the scientific community:

1. Primate embryonic stem cells cannot generate chimeras, and 
2. Aggregation and injection of multiple early-stage four-cell primate embryos (not embryonic stem cells) can form chimeras. 

Together these findings underscore a fundamental difference between rodent and primate embryonic stem cell lines and show that generating primate chimeras is possible.

As you might expect, this article was heavily publicized (e.g.: The Guardian, The National Post, and the BBC) but it seems that all of the reports focus on the generation of a monkey chimera and not on the more challenging question for scientists that results from not being able to do this from embryonic stem cells. Much of our understanding about embryonic stem cells comes from studies in lower order animal models (frog, mouse, sheep, etc.) and scientists sometimes tacitly assume that this process operates similarly in humans. This not only has major implications for our understanding of early development, but also substantially impacts the struggle to bring stem cell derived therapies and treatments into the clinic.   

The apple of a bioengineer’s eye: mature photoreceptors

by Angela C.H. McDonald

Last spring, I wrote about the remarkable generation of self-organizing retinal tissue created from mouse embryonic stem cells. The study successfully created all major retinal components including photoreceptors, albeit at a low abundance. However, while multi-layered optic tissue did form, the alignment and organization of mature retinal cell types differed from that of the mouse eye in vivo.

The missing ingredient in this experiment was a physical, instructive cue to direct retinal cells into the complex structural pattern of the eye. 

A recent paper published in Biomaterials by another group of researchers described a biomaterials-based approach for creating organized photoreceptor cells from human embryonic stem cells.

Human embryonic stem cells were differentiated into retinal cells and seeded onto a specially designed scaffold positioned on top of a retinal pigment epithelial cell layer. This resulted in the organization of cells into a complex retinal architecture.

Unsolved mysteries in the intestinal crypt

by Angela C.H. McDonald

The intestine is an amazing organ. In fact, when I am not reading research related to my thesis, I read about the stem cell population that maintains our gut, the intestinal stem cells (ISCs). And sometimes, the reading reveals most unusual mysteries. 

ISCs have their work cut out for them. They must renew the lining of our intestines every few days throughout our lives. ISCs reside in a niche located somewhere within the glands that line our gut tissue (also known as intestinal crypts) however; much speculation and controversy has surrounded the exact identity and location of the ISCs. 

Early data promising for first clinical trial using human cardiac stem cells

by Ben Paylor

A week of highs and lows for the global stem cell community brought with it a healthy dose of optimism for cardiac stem cell researchers. Pilot data from Dr. Roberto Bolli and colleagues’ landmark SCIPIO (Stem Cell Infusion in Patients with Ischemic CardiOmyopathy) clinical trial, published in The Lancet last week, provides much needed new momentum for the therapeutic potential of cardiac stem cells (CSCs).

Finances halt first-ever FDA approved human embryonic stem cell clinical trial

by Angela C.H. McDonald

The stem cell community was shocked to hear Geron Corporation’s announcement on Monday that the company will immediately discontinue its stem cell programs including its much-publicized Phase I clinical trial for the treatment of spinal cord injury. 

Following a strategic review of costs and regulatory hurdles involved with their stem cell program, Geron has decided to instead focus its efforts on ongoing cancer trials. Dr. John Scarlett, CEO of Geron Corporation announced yesterday that “by narrowing our focus to the oncology therapeutic area, we anticipate having sufficient financial resources to reach these important near-term value inflection points for shareholders without the necessity of raising additional capital. This would not be possible if we continue to fund the stem cell programs at the current levels.”  

It should be noted that Dr. Scarlett assumed the role of CEO in September of this year. Scarlett is a cancer specialist, which has spurred questions whether this has influenced the decision to terminate Geron’s stem cell program.

It has been a long road for Geron to reach the Phase I clinical trail stage of their human embryonic stem cell trial. Years were spent in preclinical trials, where Geron successfully treated injured rats by injecting oligodendrocyte progenitor cells derived from human embryonic stem cells into spinal cord lesions, improving locomotion.   

In 2008, Geron initiated a Phase I trail but it was put on hold when in animal studies, microscopic cysts where found at injection sites. Additional preclinical studies resolved concerns around these cysts and Geron again initiated Phase I of this trial in October 2010.

Just a few weeks ago, Geron presented a clinical update for the Phase I trial at the Pre-Conference Symposia of the joint 2011 American Congress of Rehabilitation Medicine and American Society of Neuro-Radiology Annual Meeting in Atlanta. At this time, the cells had been administered to four thoracic spinal cord injury patients. Clinical data showed no indication of complications related to the surgical procedure or injected cells.However, Geron representatives did report a few minor problems related to immunosuppressive drugs.

Phase I clinical trials are meant to address safety of an experimental treatment and not meant to measure effectiveness.

Although the decision to end this trial appears to be a strategic move for Geron based on finances, many stem cell researchers are questioning whether Geron is throwing in the towel too soon for the wrong reasons. Reports late yesterday indicated the company's stocks were at an all time low following the announcement. Chatter in the stem cell field suggests that the four patients treated to date have shown no signs of efficacy. Could this be the real reason Geron is ending the trial? Many scientists favour this hypothesis (have a look at recent posts on the Knoepfler blog to see reaction and good further discussion on this topic). 

The premature end to the first FDA-approved human embryonic stem cell clinical trial comes as sad and surprising news to the stem cell community. The field is now left questioning what will happen to the future of embryonic stem cell research?  Will this event slow the translation of this research into the clinic?  Has Geron now set a precedent that human embryonic stem cell clinical trials are not worth the money? Not worth the risk? If Geron can’t afford to fund a human embryonic stem cell clinical trial, who can?

 

New York loves stem cells

by Lisa Willemse

Art shows are not exactly routine activities for those who work in research, let alone in the field of stem cells. So when an art exhibit that examines our perceptions of biotechnology and stem cell research opens in New York, it's something of an occasion. Even more so if New York embraces the show right back, which certainly appeared to be the case of the crowd in attendance, as well as some of the other activities planned around the exhibit.

We've blogged about the Perceptions of Promise exhibit before - the inaugurual exhibit in Calgary early in 2011 garnered a fair bit of attention from critics and the popular press, but the show's presence at the Chelsea Art Museum (running until November 19) somehow underscores the importance of this endeavour. 

Maybe it's because having a show in a trendy New York gallery is a proud achievment for any artist. Maybe it's that all-too-Canadian need to be recognized outside our own country. I'd like to think it has more to do with the importance of the topic itself, which we have so often seen can be polarized and clouded with hype as well as legal, political, economic and religious overtones.

Personally -- and I'm not alone in this sentiment -- I think there needs to be more thoughtful and informed discsussion about biotechnology in atypical locations -- not in labs, but in coffee joints, at dinner parties, on the street, in schools. And if shows such as this one help achieve this, by asking people to think about what it means to them and to stimulate interest and greater understanding, so much the better.

Read full news release. 

Images all from Perceptions of Promise at the Chelsea Art Museum, NY. Top artwork by Sean Caulfield, centre by Royden Mills, bottom by Liz Ingram and Bernd Hildebrandt

Cancer stem cells revealing their many secrets

by Lisa Willemse

Last week, Statistics Canada released a report with figures detailing the cause of death in which it noted that, for the first time, cancer had eclipsed heart disease as the leading cause of death in every province and territory in the country. According to the report, cancer accounted for 30% of all deaths in Canada in 2008. Worldwide, cancer can be attributed to 13% of all deaths.

It seems a fitting time to review some of the latest findings on stem cells and cancer.

Better, faster biomaterials design with high throughput technology

by Angela C.H. McDonald

In the body, cells receive instructive signals from their niche, but how do researchers direct stem cells to perform a specific function? Researchers supply cues to cells in the form of growth factors, small molecules, cell culture density, culture surface and biomaterial design. Cells respond to these cues by altering cellular processes such as cytoskeletal organization, proliferation, adhesion, migration, secretory behaviour and differentiation.

Of particular interest to materials scientists is the cell's response to surfaces it sits on. A growing body of research is focused on enhancing biomaterial function by manipulating a number of material design parameters including the surface or topography of the materials themselves (reviewed here).

In regenerative medicine, biomaterials can function as support for cells and tissue transplanted into the body, templates for tissue regeneration and substrates for delivery and release of biological substances such as growth factors or cells into the body. The intended function of a biomaterial will inform biomaterial design strategies to elicit a specific cellular response.