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Novozymes and Chr. Hansen announce name of future combined company; Novonesis

Novozymes and Chr. Hansen have announced that the name of the future combined company will be ‘Novonesis’. Novonesis means ‘A new beginning’ and derives from the Greek word ‘genesis’. The name reflects a new era of biosolutions where innovation in biological sciences and technology will offer solutions to solve some of the biggest challenges facing humanity.

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Novozymes and Chr. Hansen announce name of future combined company; Novonesis

Mayo Clinic researchers say stem cell therapy improves quality of life for patients with advanced heart failure – WXOW.com

ROCHESTER, Minn. A multinational clinical trial involving Mayo Clinic researchers has found stem cell-based therapy improved quality of life for patients with advanced heart failure.

In the study, patients reported their daily hardship lessened when stem cells optimized for heart repair supplemented the standard of care, and the study further documented lower death and hospitalization rates among those treated with cell therapy.

"In this era of global aging, people live longer, yet are at risk of chronic disease imposing a poor quality of life. Heart failure is an emerging epidemic in need of new healing options," says Andre Terzic, M.D., Ph.D., a Mayo Clinic cardiovascular researcher and lead author of the paper. "The stem cell-based approach in the present study demonstrates sustained benefit on physical and emotional health in response to biotherapy."

Dr. Terzic is the Marriott Family Director, Comprehensive Cardiac Regenerative Medicine for the Center for Regenerative Biotherapeutics.

Approximately 800,000 people in the U.S. suffer heart attacks every year.

The study team recruited 315 patients from 39 hospitals in 10 countries who had advanced heart failure despite receiving standard of care. Mayo Clinic says patients were randomly divided into groups that would receive stem cell therapy versus those who would not. Patients assigned to cell treatment underwent cardiac catheterization. Then, stem cells taken from their own bone marrow and programmed to heal damaged heart tissue were delivered to the heart. Patients assigned not to receive stem cells had cardiac catheterization without cell delivery known as the sham treatment.

"Data from one of the largest cardiovascular cell therapy trials, testing a regenerative technology discovered at Mayo Clinic, indicate benefit in both quantity and quality of life in advanced heart disease," saysSatsuki Yamada, M.D., Ph.D., a Mayo Clinic cardiovascular researcher, and first author on the study. "The benefit of regenerative care has been typically evaluated on the basis of clinician-reported outcomes. What's unique in this study is that it was designed to listen to the patient's experience."

This research is published in Stem Cells Translational Medicine.

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Mayo Clinic researchers say stem cell therapy improves quality of life for patients with advanced heart failure - WXOW.com

Stem Cell Therapy Market Worth $615 Million | MarketsandMarkets – PR Newswire

CHICAGO, Dec. 12, 2023 /PRNewswire/ --Stem Cell Therapy Marketin terms of revenue was estimated to be worth $286 million in 2023 and is poised to reach $615 million by 2028, growing at a CAGR of 16.5% from 2023 to 2028 according to a new report by MarketsandMarkets. The global stem cell therapy market is expected to grow at a CAGR of 16.8% during the forecast period. The major factors driving the growth of the market are expanding number of clinical trials of stem cell therapies, rise in stem cell research funding and growing number of GMP-certified cell therapy production facilities. However, high costs associated with the development of stem cell therapy and treatment is anticipated to hamper the market growth in coming years.

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Browse in-depth TOC on "Stem Cell Therapy Market"

157 - Tables

40 - Figures

203 - Pages

Stem Cell Therapy Market Scope:

Report Coverage

Details

Market Revenue in 2023

$286 million

Estimated Value by 2028

$615 million

Growth Rate

Poised to grow at a CAGR of 16.5%

Market Size Available for

2021-2028

Forecast Period

2023-2028

Forecast Units

Value (USD Million)

Report Coverage

Revenue Forecast, Competitive Landscape, Growth Factors, and Trends

Segments Covered

Cell Source, Type, Therapeutic Application and Region

Geographies Covered

North America, Europe, Asia Pacific, Latin America, the Middle East and Africa.

Report Highlights

Updated financial information / product portfolio of players

Key Market Opportunities

The emergence of iPSCs as an alternative to ESCs

Key Market Drivers

Increased funding for stem cell research

The adipose tissue derived MSCs segment dominated the stem cell therapy market in 2022.

The global stem cell therapy market is segmented into adipose tissue-derivedMSCs, bone marrow-derived MSCs, placenta/umbilical cord-derived MSCs, and other cell sources. Prominent factors such as easy availability of adipose-derived stem cell tissues and its diversified properties properties similar to other mesenchymal stem cells/tissues is likely to uplift the demand for adipose tissue derived MCs.

In 2022, the musculoskeletal disorders led the stem cell therapy market.

Based on therapeutic application, the global stem cell therapy market is segmented intomusculoskeletal disorders, wounds & surgeries, cardiovascular diseases, surgeries, inflammatory & autoimmune diseases, neurological disorders, and other therapeutic applications. The large share of this segment can be attributed increasing prevalence of musculoskeletal diseases. Increasing investment in stem cell therapy for neurological diseases is likely to skyrocket the segment in coming years.

The Asia Pacific region is likely to grow at faster pace during the forecast period.

The Asia Pacific is estimated to be the fastest-growing segment of the market. The growth of the stem cell therapy markets in the region is driven by a rising emphasis on strategic initiatives such as partnerships, collaborations & expansion and increased adoption of stem cell therapies among the patient population. The rising prevalence of cancer and increased investment in research & development of the launch of novel stem cell therapies in the region are some of the major factors anticipated to upsurge the market growth.

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Stem Cell Therapy MarketDynamics:

Drivers:

1. Increased funding for stem cell research

Restraints:

1. Ethical concerns related to embryonic stem cells

Opportunities:

1. The emergence of iPSCs as an alternative to ESCs

Challenge:

1. Technical limitations

Key Market Players ofStem Cell Therapy Industry:

The stem cell therapy market is competitive, with a small number of players competing for market shares. Smith+Nephew (UK),MEDIPOST Co., Ltd. (South Korea), Anterogen Co., Ltd. (South Korea), CORESTEM (South Korea), Pharmicell Co., Ltd. (South Korea), NuVasive, Inc. (US), RTI Surgical (US), AlloSource (US), JCR Pharmaceuticals Co., Ltd. (Japan), Takeda Pharmaceutical Company Limited (Japan), Holostem Terapie Avanzate Srl (Italy), Orthofix (US), Regrow Biosciences Pvt Ltd. (India), and STEMPEUTICS RESEARCH PVT LTD. (India) among others are some of the leading players in this market. Most companies in the market focus on organic and inorganic growth strategies, such as product launches, expansions, acquisitions, partnerships, agreements, and collaborations, to increase their product offerings, cater to the unmet needs of customers, increase their profitability, and expand their presence in the global market.

The primary interviews conducted for this report can be categorized as follows:

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Stem Cell Therapy Market Recent Developments:

Stem Cell Therapy Market - Key Benefits of Buying the Report:

The report will help market leaders/new entrants by providing them with the closest approximations of the revenue numbers for the overall stem cell therapy market and itssubsegments. It will also help stakeholders better understand the competitive landscape and gain more insights to better position their business and make suitable go-to-market strategies. This report will enable stakeholders to understand the market's pulse and provide them with information on the key market drivers, restraints, opportunities, and challenges.

The report provides insights on the following pointers:

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MarketsandMarkets has been recognized as one of America's best management consulting firms by Forbes, as per their recent report.

MarketsandMarkets is a blue ocean alternative in growth consulting and program management, leveraging a man-machine offering to drive supernormal growth for progressive organizations in the B2B space. We have the widest lens on emerging technologies, making us proficient in co-creating supernormal growth for clients.

Earlier this year, we made a formal transformation into one of America's best management consulting firms as per a survey conducted by Forbes.

The B2B economy is witnessing the emergence of $25 trillion of new revenue streams that are substituting existing revenue streams in this decade alone. We work with clients on growth programs, helping themmonetize this $25 trillion opportunity through our service lines - TAM Expansion, Go-to-Market (GTM) Strategy to Execution, Market Share Gain, Account Enablement, and Thought Leadership Marketing.

Built on the 'GIVE Growth' principle, we work with several Forbes Global 2000 B2B companies - helping them stay relevant in a disruptive ecosystem. Our insights and strategies are molded by our industry experts, cutting-edge AI-powered Market Intelligence Cloud, and years of research. TheKnowledgeStore (our Market Intelligence Cloud) integrates our research, facilitates an analysis of interconnections through a set of applications, helping clients look at the entire ecosystem and understand the revenue shifts happening in their industry.

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Stem Cell Therapy Market Worth $615 Million | MarketsandMarkets - PR Newswire

Lab-made stem cell model will offer new way to study Parkinson’s – Parkinson’s News Today

Researchers have developed a wayto generate a family of nerve cells implicated in Parkinsons disease in the lab using human stem cells, according to newly published research.

These cells, found in a brain region called the locus coeruleus (LC), produce a signaling chemical called norepinephrine, or NE. While these cells are known to degenerate early in Parkinsons and other neurological diseases, it is not known exactly why.

The scientists discovered a protein important for the cells growth, which enabled them to be generated in the lab. The team now plans to use the stem cell model to more closely study neurodegenerative disease mechanisms and to test possible therapeutic candidates.

Importantly, according to Yunlong Tao, PhD, the studys first author, we have some new understanding about locus coeruleusdevelopment.

Thats the major finding in this paper, and based on that finding, we are able to generate locus coeruleus norepinephrine neurons, Tao said in a press release from the University of Wisconsin (UW)-Madison, where the study was conducted. Tao, an investigator at Nanjing University, in China, was working as a UW-Madison researcher at the time of the study.

Titled Generation of locus coeruleus norepinephrine neurons from human pluripotent stem cells, the study was published in Nature Biotechnology.

A tiny cluster of nerve cells (neurons) deep in the brain, the locus coeruleus plays a critical role in brain function. The cells there are the main producers of norepinephrine, a signaling chemical best known for its role in mediating so-called fight or flight reactions that occur during stressful situations.

Nerve cells originating in the locus coeruleus extend throughout the brain and spinal cord via an extensive branching system, where they release norepinephrine to regulate heartbeat, blood pressure, arousal, memory, and attention.

The norepinephrine neurons in the locus coeruleus are essential for our life, said Su-Chun Zhang, MD, PhD, a neuroscience and neurology professor at UW-Madison and the studys senior author.

We call it the life center, Zhang said, adding that without these nerve cells, we would probably be extinct from Earth.

Dysfunction of this brain region, therefore, can have severe consequences for brain health. Indeed, locus coeruleus-norepinephrine (LC-NE) cells have been implicated in a range of neurodegenerative diseases, including Parkinsons and Alzheimers disease.

In Parkinsons, the locus coeruleus is one of the first brain regions to start degenerating. This has been associated with a range of the diseases nonmotor symptoms.

People have noticed this for a long time, but they dont know what the function of the locus coeruleus is in this process, Tao said, adding thats also partly because we dont have a good model to mimic the human LC-NE neurons.

Stem cells, which have the capacity to become virtually any other cell type under the right conditions, give rise to basically all mature cells in the body. Scientists can leverage this to generate nerve cells of human origin in the lab. When treated with specific chemicals, stem cells can be prompted to turn into almost any cell type the researchers want to study.

However, this has proven difficult in the past with LC-NE neurons, and several attempts had failed.

In their new study, the team identified that a growth factor protein called ACTIVIN-A is necessary for regulating the development of these cells. Without it, the gene activity needed for precursor cells to become LC-NE neurons cant occur.

By adding in ACTIVIN-A during the process, the scientists could thus develop LC-NE neurons from stem cells. The cells they produced had the expected structural and functional characteristics of LC-NE neurons, including the release of NE and other functions related to their role in breathing and heart rate.

Ultimately, the researchers believe the LC-NE cells can be used to further study how and why these cells seem to die off so early in diseases like Parkinsons.

If this is somewhat causative, then we could potentially do something to prevent or delay the neurodegeneration process, Zhang said.

The availability of functional human LC-NE neurons enables investigation of their roles in psychiatric and neurodegenerative diseases and provides a tool for therapeutics development.

Stem cell-derived neurons will have the genetic and cellular characteristics of the person from whom the stem cells were taken. As such, scientists could generate LC-NE neurons from Parkinsons patients to learn more about how the cells behave and how they respond to therapeutic candidates.

The availability of functional human LC-NE neurons enables investigation of their roles in psychiatric and neurodegenerative diseases and provides a tool for therapeutics development, the researchers wrote.

The team also developed a line of the cells with a fluorescent sensor for detecting norepinephrine levels, which the scientists believe, may be useful to find novel drugs that regulate NE [norepinephrine] release and/or uptake.

As a next step, the scientists plan to look more closely at how ACTIVIN-A regulates LC-NE cell development. In addition, the team will use the stem cell model for experiments aimed at modeling human disease and testing therapeutics.

The application of these cells is quite broad in its significance, Zhang noted.

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Lab-made stem cell model will offer new way to study Parkinson's - Parkinson's News Today

Improvements in Stem Cell Transplants for AML With CRISPR – Targeted Oncology

Guenther Koehne, MD, PhD, deputy director and chief of blood and marrow Transplant, hematologic oncology and benign hematology, Baptist Health Medical Group, discusses a phase 1/2 study (NCT04849910) where he served as the principal investigator. The abstract is being presented at this year's American Society of Hematology 2023 Annual Meeting.

The study is a first-in-human phase 1/2 open-label multicenter trial to establish the safety of trem-cel, a CRISPR/Cas9 gene-edited allograft lacking CD33, as a donor allograft for CD33-positive patients with acute myeloid leukemia at high risk of relapse.

Transcription:

Some patients with high-risk acute myeloid leukemia relapse earlier. And that is also, I think, a big step forward that we now don't consider a acute myeloid leukemia all the same. They are risk-stratified from the beginning : FLT3-positive AMLs, TD53-mutated AML, and some others we know are very high risk of relapse, so they will relapse despite of allogeneic transplants. So what's happening there is now we can certainly come in with post-transplantation maintenance treatments, as we do in multiple myeloma. But that's a little complicated, more complicated, because the markers that are expressed on the leukemia cell that can be targeted are also expressed on the normal healthy hematopoietic stem cell, and therefore, you would eliminate the healthy stem cells at the same time as you're trying to knock off the leukemia cell population. But now, I'm proud to say I'm a principal investigator of a clinical trial that uses CRISPR technology. That is gene editing of downregulating the expression of CD33 on the normal hematopoietic stem cells prior to the transplant. And with that, now we have a CD33 that is highly overexpressed on leukemia cell populations. So if we now have a CD33-negative stem cell product from the donor, and infuse this into the patient, then the patients have a normal reconstitution normal blood production, normal recovery of this white cells, platelets, but the cells are all CD33-negative. And now we can go in with treatments that target CD33.

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Improvements in Stem Cell Transplants for AML With CRISPR - Targeted Oncology

The Risks of Stem Cell and Exosome Treatments for Long COVID: A Call for Stricter Regulations – Medriva

In a recent study led by Leigh Turner, PhD, it was revealed that stem cell and exosome treatments are being marketed to patients suffering from long COVID by 36 businesses. These treatments, boasting claims of symptomatic relief, immune boosting, acute COVID infection treatment, and prevention of COVID, have an average cost of $11,322. However, despite their prevalence, these treatments lack extensive scientific evidence and pose potential risks, including serious injury and financial scams. This raises the need for stricter regulation by the Food and Drug Administration (FDA) and the Federal Trade Commission (FTC).

According to the study, the majority of these businesses offering stem cell and exosome treatments for long COVID are based in the U.S. and Mexico. The cost of these therapies ranges from $2,950 to $25,000. Despite the FDA and FTC issuing warning letters to such companies, the marketplace remains vast and largely unregulated. It is noteworthy that long COVID patients, in their desperation for relief, can easily fall prey to entities making appealing therapeutic claims without solid scientific evidence.

While the use of stem cell and exosome treatments for long COVID remains controversial, research has highlighted the potential of Mesenchymal stem cell-derived exosomes (MSC-Exos) in the treatment of lung diseases. They are considered a more stable and safer option than traditional cell therapies. MSC-Exos deliver non-coding RNAs (ncRNAs) to communicate with target cells, inhibiting inflammatory factors, reducing oxidative stress, promoting normal lung cell proliferation, and reducing apoptosis. Some researchers are exploring the detailed mechanisms of MSC-Exos in the clinical treatment of lung disease by developing standardized culture, isolation, purification, and administration strategies.

Its important to note that the link between stem cell treatments and COVID-19 isnt entirely new. A study conducted during the recent COVID-19 outbreak in China revealed that pediatric patients who had received hematopoietic stem cell transplants were more susceptible to COVID-19 infection. This vulnerability was particularly high in recipients over 100 days post-transplant. This study, while not directly connected to the stem cell and exosome treatments for long COVID, does provide some insight into the interaction between stem cell treatments and COVID-19.

While there are ongoing clinical trials and research exploring the use of stem cell and exosome treatments for long COVID, the current lack of substantial scientific evidence calls for caution. Potential benefits for managing long-term symptoms of COVID-19 are promising, but more rigorous scientific studies are needed to confirm these benefits and to understand the risks involved.

Given the potentially serious risks and the high cost of these treatments, there is an urgent need for stricter regulations to prevent financial scams and to ensure patient safety. It is crucial that the FDA and FTC take more robust actions to regulate this marketplace. Until then, patients and healthcare professionals should approach such treatments with caution, critically evaluating claims and seeking treatments that are backed by solid scientific evidence.

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The Risks of Stem Cell and Exosome Treatments for Long COVID: A Call for Stricter Regulations - Medriva

FDA approves CRISPRCas9 therapy for sickle cell disease – ASBMB Today

Officials at the U.S. Food and Drug Administration todayannouncedapproval ofthe first CRISPRCas9 therapeutic to treat sickle cell disease. The cell therapy is the only cure to date for patients who are not eligible for stem cell transplants. The FDA approved the therapy for patients age 12 to 35.

Casgevy uses CRISPRCas9 technology to edit a patients own hematopoietic stem cells to produce high levels of fetal hemoglobin, which is not normally expressed at adulthood and drowns out the damaging effects of sickle hemoglobin.

The therapeutic, exagamglogene autotemcel, sold as Casgevy, from CRISPR Therapeutics and Vertex Pharmaceuticals, uses CRISPRCas9 technology to edit a patients own hematopoietic stem cells to produce high levels of fetal hemoglobin, which is not normally expressed in adulthood and drowns out the damaging effects of their sickle hemoglobin. The therapy was approved in the United Kingdom in November.

Sickle cell disease is a debilitating, genetic disorder that causes abnormal red blood cell development. It affects approximately 7.74 million individuals worldwide. Red blood cells are normally disk-shaped and move easily throughout the blood, carrying oxygen to vital organs. In a patient with sickle cell disease, red blood cells are warped, or sickle-shaped, which can lead to impaired blood flow and cause stroke, infection, eye issues, severe pain crises and premature death.

The therapeutic specifically targets BCL11A, a repressor of the fetal hemoglobin gene, using a guide RNA. The precise target site is a residue within the BCL11A enhancer region, which, once modified by the Cas9 nuclease, takes the brakes off the fetal hemoglobin gene, leaving transcription and later translation free to occur.

Victoria Gray, a mother of four from Mississippi, was the first sickle cell patient to receive Casgevy in a 2019 clinical trial. Prior to the treatment, Gray said she had to rush to the emergency room at least once a month and often stay in the hospital for weeks at a time due to her painful crises. Since receiving Casgevy, she has had no emergency room visits, hospital stays or crises, she said.

I feel cured, Gray said. My life has changed dramatically with just a leap of faith.

Emmanuelle Charpentier is a biochemist, microbiologist and geneticist, recognized as an expert in regulatory mechanisms underlying processes of infection and immunity in bacterial pathogens.

Emmanuelle Charpentier is a cofounder of CRISPR Therapeutics and the director of and a scientific member at the Max Planck Unit for the Science of Pathogens. Charpentier shared the 2020 Nobel Prize in chemistry for the development of CRISPRCas9 with Jennifer Doudna, an RNA biochemist at the University of California, Berkeley.

Peter Marks, director of the FDAs Center for Biologics Evaluation and Research, commented on today's action.These approvals represent an important medical advance with the use of innovative cell-based gene therapies to target potentially devastating diseases and improve public health, Marks said. Todays actions follow rigorous evaluations of the scientific and clinical data needed to support approval, reflecting the FDAs commitment to facilitating development of safe and effective treatments for conditions with severe impacts on human health.

The FDA approved Casgevy based on three studies showing that the drug is a safe and effective treatment for sickle cell disease. In the most recent safety and efficacy clinical trial, patients like Gray who received the therapeutic sustained long-term high levels of total hemoglobin, similar to what is seen in healthy adults, and most were blood transfusionindependent and free of painful crises for at least one year after treatment.

Benjamin Oakes, CEO and cofounder of Scribe Therapeutics, said The approval is just the tip of the iceberg. It's a really beautiful proof of concept for what CRISPR genome editing can do. The real vision and mission for the whole CRISPR field should be to create safer, more effective therapies that can be brought more broadly to patients.

Benjamin Oakes is cofounder and CEOof Scribe Therapeutics.

Oakes said he and his colleagues are developing the next generation of CRISPR gene therapies using an engineered CasX protein that cuts DNA more precisely than Cas9.

According to the Institute for Clinical and Economic Review, Casgevy could be priced at up to $1.93 million to be cost-effective, a measure that estimates how much it costs to gain a unit of a health outcome, such as a life year gained or a death prevented. With this price tag, ICER estimated that 15% of eligible patients could be treated over a five-year period.

In 2022, patients with sickle cell disease incurred out-of-pocket medical costs totaling up to $44,000, with insurers covering approximately $1.7 million per patient. Economists predict that gene therapies like Casgevy could cost a single state Medicare program more than$30 million per year.

The FDA will evaluate a second gene therapy for sickle cell disease, bluebird bios lovo-cel, later this month. Unlike Casgevy, lovo-cel uses a lentiviral vector to introduce a modified beta globin gene into patient stem cells. This modified gene produces an antisickling hemoglobin protein, which is designed to inhibit the polymerization of mutant sickle hemoglobin, making it less likely to form blockages in the circulation.

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FDA approves CRISPRCas9 therapy for sickle cell disease - ASBMB Today

FDA Approves A CRISPR-Based Therapy for Sickle Cell Disease – geneonline

FDA Approves A CRISPR-Based Therapy for Sickle Cell Disease

After CASGEVY (exagamglogene autotemcel) passed the U.S. Food and Drug Administrations (FDA) Biologics License Application (BLA) in June this year (2023), Vertex Pharmaceuticals and CRISPR Therapeutics announced its FDA approval on December 8. CASGEVY is the first FDA-approved treatment utilizing the novel genome-editing technology CRISPR, marking an innovative advance in gene therapy and offering a glimmer of hope for patients with severe sickle cell disease (SCD). Approximately 16,000 patients aged 12 years and older with recurrent Vaso-Occlusive Crisis (VOC) are now eligible to receive this innovative one-time treatment.

Related article: Vertex and CRISPR Collaborate Again with $330 Million Diabetes Gene Editing Deal

The administration of CASGEVY requires specialized knowledge in stem cell transplantation. Vertex is actively collaborating with proficient hospitals to establish Authorized Treatment Centers (ATCs) throughout the United States. Notable institutions involved in this initiative include Boston Medical Center, Childrens National Hospital, and City of Hope Childrens Cancer Center, among others. These ATCs are set to play a pivotal role in facilitating the delivery of CASGEVY to eligible patients. The companies have outlined plans to introduce additional ATCs in the forthcoming weeks, expanding accessibility for patients in need.

CASGEVY, a genome-editing cell therapy, leverages CRISPR/Cas9 technology to edit autologous CD34+ hematopoietic stem cells. This targeted approach aims to diminish BCL11A expression, leading to an increased production of fetal hemoglobin (HbF). Through the reduction or elimination of vaso-occlusive crises, CASGEVY holds the promise of significantly enhancing the quality of life for individuals affected by sickle cell disease (SCD). The therapy has obtained conditional marketing authorization in the United Kingdom and Bahrain. Regulatory agencies in Europe and Saudi Arabia are actively reviewing CASGEVY, with ongoing assessments for its investigational use in treating transfusion-dependent thalassemia (TDT).

The approval marks a significant milestone, not just in the landscape of sickle cell disease (SCD) treatments but also in advancing the frontier of CRISPR-based therapies. The success of CASGEVY represents a noteworthy leap forward in the realm of genetic medicine, offering hope and potential therapeutic avenues for those who require them.

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FDA Approves A CRISPR-Based Therapy for Sickle Cell Disease - geneonline

Modified Stem Cell Transplant Procedure Shows Favorable Results in Adults Living with Severe Sickle Cell Disease – InvestorsObserver

Less Toxic Approach to Haploidentical Bone Marrow Transplantation in Adults Living with Severe Sickle Cell Disease Offers Promise

LBA-4 : Reduced Intensity Haploidentical Bone Marrow Transplantation in Adults with Severe Sickle Cell Disease: BMT CTN

SAN DIEGO , Dec. 12, 2023 /PRNewswire/ --Stem cell transplantation is a potentially curative treatment for sickle cell disease (SCD), but it is not feasible for most people, often due to a lack of suitable donors or the inability to tolerate the intensive chemotherapy required as part of the treatment. In a new study, presented during the 65th American Society of Hematology (ASH) Annual Meeting and Exposition, adults living with severe SCD saw good outcomes from a modified transplantation procedure that broadens the potential donor pool and includes a gentler conditioning regimen, suggesting a less toxic approach could allow a much broader array of people to benefit from the treatment.

"This is a pragmatic approach for adults with SCD, and the results are fantastic," said Adetola A. Kassim , MBBS, MS , professor of medicine at Vanderbilt University Medical Center, the study's lead author. "It actually beat our expectations. This study has clearly shown that you can take selected adult patients with significant comorbidities to transplant, and hopefully change the trajectory of their disease."

The trial is the largest multi-center study to date to test the modified approach in adults with SCD.

SCD is an inherited blood disorder in which red blood cells become misshapen, diminishing their ability to carry oxygen. It causes episodes of severe pain, called vaso-occlusive crises, as well as damage to tissues and organs that accrue over time and can lead to early death. A stem cell transplant can cure the disease by removing the stem cells that produce misshapen blood cells and replacing them with stem cells from a donor that will make healthy blood cells.

The standard transplantation procedure for SCD requires that the donor be a sibling with a high degree of genetic similarity and that the recipient be healthy enough to tolerate a high-intensity chemotherapy regimen as part of the procedure. In the modified procedure used for the study, called related, reduced intensity haploidentical bone marrow transplantation, the donor only needs to be "half-matched" genetically to the recipient, broadening the pool of potential donors to include not only siblings but parents, children, cousins, aunts, and uncles.

While fewer than one-quarter of people with SCD have a matched sibling who could potentially serve as a donor, about 90% have a relative who could serve as a half-matched donor. In addition, because it uses a lower intensity conditioning regimen, the modified approach is more easily tolerated by people with health problems such as organ damage, a complication of SCD that becomes more common with age.

As a result of these modifications, a much broader group of people living with SCD could be eligible for reduced intensity haploidentical bone marrow transplantation than for conventional matched-donor transplantation, including older individuals, those with more comorbidities, and those without a matched sibling donor.

For the study, researchers enrolled 54 individuals living with SCD with a history of stroke or reduced heart functioning, pain episodes, or frequent blood transfusions. Forty-two participants ultimately underwent the modified stem cell transplantation procedure. At two years, the overall rate of survival following the transplant was 95% and the estimated rate of event-free survival (defined as survival without graft failure or a second infusion of stem cells) was 88%.

At 100 days following the transplant, 4.8% of patients experienced a primary graft failure and 4.8% experienced adverse events of grade three or higher. Infections were common; 78.6% of patients experienced at least one hospital admission following their transplant, most due to infections. Two participants died within the first year after the transplant, one from organ failure and one from fluid buildup in the lungs associated with COVID-19 infection.

Most participants experienced significant improvements in markers of healthy blood functioning, a reduction in pain episodes and fatigue, and improved heart and lung functioning. Overall, researchers said that the results suggest the modified procedure can achieve results that are comparable to conventional stem cell transplantation and is tolerable even for people with health conditions that would make them ineligible for a conventional transplant.

In future studies, the researchers plan to focus on opportunities to reduce rates of infection, enhance supportive care, and preserve fertility among people undergoing the procedure. They also plan to continue to follow trial participants to track long-term outcomes.

"Some of these patients are really thriving and now getting back into the community," said Dr. Kassim. "Our hope is that long-term follow-up will be able to quantify the added value of curing patients of SCD." Dr. Kassim added that most patients were off immunosuppression therapy at both the one and two-year post-transplant timepoints with no significant chronic graft-versus-host disease, providing evidence that the study's cyclophosphamide-based post-transplant regimen helped to reduce the risk of this serious complication.

Researchers noted that for many people, the feasibility of this treatment will depend not only on the availability of family donors, but on costs and insurance coverage, the ability to take time off work and even temporarily relocate to undergo the procedure, and the availability of family and caregiver support.

This study was funded by the National Heart, Lung and Blood Institute and the National Cancer Institute.

Adetola Kassim , MBBS, MS, of Vanderbilt University , will discuss this study in the Late-Breaking Abstracts Session on Tuesday, Dec. 12, 2023 , at 9:00 a.m. Pacific time in Hall A ( San Diego Convention Center).

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The American Society of Hematology (ASH) ( hematology.org ) is the world's largest professional society of hematologists dedicated to furthering the understanding, diagnosis, treatment, and prevention of disorders affecting the blood. For more than 60 years, the Society has led the development of hematology as a discipline by promoting research, patient care, education, training, and advocacy in hematology.

ASH's flagship journal, Blood ( bloodjournal.org ) is the most cited peer-reviewed publication in the field, and Blood Advances ( bloodadvances.org ) is an open-access, online journal that publishes more peer-reviewed hematology research than any other academic journal worldwide. Two new journals will be joining the Blood Journals portfolio in 2024, Blood Neoplasia ( bloodneoplasia.org ) and Blood Vessels, Thrombosis & Hemostasis ( bloodvth.org ).

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Stem cell study reveals how infantile cystinosis causes kidney failure and how to cure it – EurekAlert

image:

This image, produced by a fluorescence microscope,shows a normal renal proximal tubule, the specific nephron segment in the kidney that is impaired in the rare disease infantile cystinosis. The red, green and yellow regions indicate the presence of different proteins in the tubule and the blue indicates the presence of nuclei. The UB researchers generated the tubule in the image from stem cells derived from an individual who does not have the disease.

Credit: Alexandra Kojac

BUFFALO, N.Y. University at Buffalo research has identified how a misstep in the genesis of a key component of the kidney causes infantile cystinosis, a rare disease that significantly shortens the lifespan of patients. Published Nov. 30 in theInternational Journal of Molecular Sciences, the work reveals that the mechanisms that cause the disease could be addressed and potentially cured through the genome-editing technique CRISPR. That could make kidney transplants, the most effective treatment currently available for these patients, unnecessary.

Infantile cystinosis, the most common and most severe type of cystinosis, occurs as the result of an accumulation in the bodys cells of cystine, an amino acid. The buildup damages cells throughout the body, especially the kidneys and the eyes. Treatment consists of medications that work to lower the level of cystine in the body, as well as therapies that address the impaired growth of these children due to the inability to properly absorb nutrients. Some children require feeding tubes. Eventually, patients with infantile cystinosis, also called nephropathic cystinosis, will require dialysis and a kidney transplant.

Promise of stem cells

Human-induced pluripotent stem cells (hiPSCs) are stem cells that can differentiate into many different cell types. They hold tremendous potential for studying genetic diseases; the drawback has been that differentiation into certain cell types has been problematic. Such is the case with many cell types found in the kidney.

But a new protocol developed by this research team was successful.

When our normal human-induced pluripotent stem cells were subjected to the differentiation protocol we developed, we were able to demonstrate extensive expression of physiologically important markers of the renal proximal tubule, the specific nephron segment that is altered in this disease, saysMary L. Taub, PhD, senior author on the paper and professor of biochemistry in the Jacobs School of Medicine and Biomedical Sciences at UB.

Ramkumar Thiyagarajan, PhD, assistant professor of geriatric studies at the University of Kansas and formerly a postdoctoral fellow at UB, is first author on the paper.

The protocol involved extracting stem cells from a healthy individual and an individual with infantile cystinosis. The researchers developed a culture medium to grow stem cells that included a small number of defined components present in blood, including insulin, specific proteins, growth factors and others. Conducting the differentiation protocol under these conditions occurred in a timely manner, says Taub, we didnt have to wait for weeks on end, and it occurred in a reproducible manner.

The researchers were able to efficiently differentiate the hiPSCs into the kidney proximal tubule, the type of nephron in the kidney that is impaired in infantile cystinosis, as well as in other kidney diseases.

Unlike in other studies, we were able to retain a number of markers in the tubule that are physiologically important in the kidneys reabsorptive functions, says Taub. Although these markers were expressed in both the normal and the cystinosis-derived hiPSCs, the genesis of the tubule was impaired in the cystinosis-derived cells, mimicking what happens in infantile cystinosis.

A potential cure

That finding means that the CRISPR genome-editing technique could be used to repair the defective genome and potentially cure the disease. The normal gene can be introduced in the genome of cystinotic hiPSCs, which can then be injected in the kidney to replace the defective proximal tubules of individuals with infantile cystinosis, Taub says.

In cystinotic individuals, it is the renal proximal tubule that degenerates, presumably due to programmed cell death, explains Taub, so the entire kidney would not need to be replaced. The defective renal proximal tubules of individuals with this disease can be replaced with normal tubules following the introduction of the normal gene into cystinotic hiPSCs obtained from the patient. And because these tubules are from cells derived from the patient, there should be no problem with tissue rejection.

The findings are applicable to other kidney diseases where the renal proximal tubule is damaged, including acute kidney injury that can lead to chronic kidney disease and renal failure, and can be fatal.

Initial studies will need to be conducted with animal models as well as with in vitro tissue culture cells.

The research was funded byUBs WNYSTEM and The Cystinosis Research Foundation.

International Journal of Molecular Sciences

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