No Extra Mutations in Modified Stem Cells, Study Finds

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Newswise LA JOLLA-The ability to switch out one gene for another in a line of living stem cells has only crossed from science fiction to reality within this decade. As with any new technology, it brings with it both promise--the hope of fixing disease-causing genes in humans, for example--as well as questions and safety concerns. Now, Salk scientists have put one of those concerns to rest: using gene-editing techniques on stem cells doesn't increase the overall occurrence of mutations in the cells. The new results were published July 3 in the journal Cell Stem Cell.

"The ability to precisely modify the DNA of stem cells has greatly accelerated research on human diseases and cell therapy," says senior author Juan Carlos Izpisua Belmonte, professor in Salk's Gene Expression Laboratory. "To successfully translate this technology into the clinic, we first need to scrutinize the safety of these modified stem cells, such as their genome stability and mutational load."

When scientists want to change the sequence of a stretch of DNA inside cells--either for research purposes or to fix a genetic mutation for therapeutic purposes--they have their choice of two methods. They can use an engineered virus to deliver the new gene to a cell; the cell then integrates the new DNA sequence in place of the old one. Or scientists can use what's known as custom targeted nucleases, such as TALEN proteins, which cut DNA at any desired location. Researchers can use the proteins to cut a gene they want to replace, then add a new gene to the mix. The cell's natural repair mechanisms will paste the new gene in place.

Previously, Belmonte's lab had pioneered the use of modified viruses, called helper-dependent adenoviral vectors (HDAdVs) to correct the gene mutation that causes sickle cell disease, one of the most severe blood diseases in the world. He and his collaborators used HDAdVs to replace the mutated gene in a line of stem cells with a mutant-free version, creating stem cells that could theoretically be infused into patients' bone marrow so that their bodies create healthy blood cells.

Before such technologies are applied to humans, though, researchers like Belmonte wanted to know whether there were risks of editing the genes in stem cells. Even though both common gene-editing techniques have been shown to be accurate at altering the right stretch of DNA, scientists worried that the process could make the cells more unstable and prone to mutations in unrelated genes--such as those that could cause cancer.

"As cells are being reprogrammed into stem cells, they tend to accumulate many mutations," says Mo Li, a postdoctoral fellow in Belmonte's lab and an author of the new paper. "So people naturally worry that any process you perform with these cells in vitro--including gene editing--might generate even more mutations."

To find out whether this was the case, Belmonte's group, in collaboration with BGI and the Institute of Biophysics, Chinese Academy of Sciences in China, turned to a line of stem cells containing the mutated gene that causes sickle cell disease. They edited the genes of some cells using one of two HDAdV designs, edited others using one of two TALEN proteins, and kept the rest of the cells in culture without editing them. Then, they fully sequenced the entire genome of each cell from the four edits and control experiment.

While all of the cells gained a low level of random gene mutations during the experiments, the cells that had undergone gene-editing--whether through HDAdV- or TALEN-based approaches--had no more mutations than the cells kept in culture.

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No Extra Mutations in Modified Stem Cells, Study Finds

Keck Medicine pushing into O.C. with oncology network acquisition

Keck Medicine of USC has acquired a small oncology network, Orange Coast Oncology Hematology, to expand its growing presence in Orange County.

Keck intends to change the name of the newly acquired network to USC Oncology/Hematology, which will operate out of offices in Newport Beach and Irvine.

Orange County cancer patients will now have access to university-based treatment, including clinical trials and genetic stem cell research, without having to drive to Los Angeles, said Thomas Jackiewicz, chief of Keck Medicine of USC.

The acquisition is part of Keck Medicines ongoing expansion into Orange County, Jackiewicz said. Keck Medicine has previously affiliated with Hoag Memorial Hospital Presbyterian in Newport Beach as part of its Orange County outreach.

We realized a lot of people were leaving Orange County for their cancer care, Jackiewicz said. We really wanted to make it about the patient and try to bring cancer care closer to home.

Under the acquisition, which was announced Wednesday, physicians with the former Orange Coast Oncology Hematology will become faculty at Keck School of Medicine. The physicians joining Keck include Greg Richard Angstreich, Minh D. Nguyen, George B. Semeniuk III, Dilruba Haque and Louis VanderMolen.

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Keck Medicine pushing into O.C. with oncology network acquisition

Stem cell patient has NOSE grows on her back after 8 years

Unnamed woman had tissue from her nose implanted in her spine in the hope the cells would help repair nerve damage causing paralysis Treatment failed and woman complained of increasing pain in the area Eight years later, a 3cm growth made of nasal tissue and bones appeared

By Emily Payne

Published: 07:58 EST, 9 July 2014 | Updated: 12:55 EST, 9 July 2014

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Nose-like: A 3cm growth formed from nasal tissue, bone and nerve branches was discovered

A woman has developed a nose-like growth eight years after a stem cell treatment to cure her paralysis failed.

At the Hospital de Egas Moniz in Lisbon, Portugal, the unnamed woman, a U.S. citizen, had tissue from her nose implanted in her spine.

Doctors hoped the cells would develop into neural cells and help repair the nerve damage to the woman's spine.

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Stem cell patient has NOSE grows on her back after 8 years

Stem cell boss joins board he funded

Alan Trounson, then president of the California Institute for Regenerative Medicine, poses for a portrait at his offices in San Francisco, Monday, March 9, 2009. (AP Photo/Eric Risberg)

The former head of California's stem cell agency, which is handing out $3 billion of voter-approved funds for research, has joined the board of a major grant recipient one week after leaving his post.

Alan Trounson, the former president of the California Institute for Regenerative Medicine, has joined the board of StemCells Inc., the recipient of $19.4 million from the agency.

The agency has been grappling with potential conflicts of interest, some of which are built into its governance under Proposition 71, approved by voters in 2004. CIRM paid $700,000 for a report last year making recommendations on how to mitigate conflicts.

Trounson's move has reignited debate over the issue.

"The announcement raises serious and obvious concerns on a number of fronts," Chairman Jonathan Thomas wrote to his colleagues on the CIRM board. "Under state law, however, it is permissible for Dr. Trounson to accept employment with a CIRM-funded company. Nonetheless, state law does impose some restrictions on Dr. Trounsons post-CIRM employment activities.

Board members will be forbidden to discuss the company with Trounson for one year after his departure, Thomas wrote.

Randy Mills, Trounson's successor as agency president, said in a statement Wednesday that "in the interests of transparency and good governance we will be conducting a full review of all CIRM activities relating to StemCells Inc.

"We take even the appearance of conflicts of interest very seriously," Mills said in the statement.

Not only board members, but CIRM employees are being reminded of the conflict of interest rules.

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Stem cell boss joins board he funded

NOSE grows on woman's BACK after failed stem cell treatment

A woman found a nose-like growth on her back eight years after stem cell treatment[GETTY]

The unnamed woman had tissue from her nose implanted in her spine to help cure her paralysis but the procedure failed.

Eight years later the woman complained of increasing pain in the area and doctors found a three-centimetre long growth made of nasal tissue.

It was discovered last year and was also made of bits of bone and nerve branches but it had not connected with her spinal nerves.

Surgeons at the University of Iowa Hospitals removed the growth from the US citizen, then aged 28, which they said was not cancerous.

The unnamed woman had tissue from her nose implanted in her spine [GETTY / PIC POSED BY MODEL]

Doctors discovered a nose-like growth on a woman's back eight years after stem cell treatment

However, it was secreting a "thick copious mucus-like material" which likely caused the pain on the woman's spine.

The results of the surgery were published in New Scientist today.

George Daley, a stem cell researcher at Harvard Medical School, said: "It is sobering.

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NOSE grows on woman's BACK after failed stem cell treatment

TESTS ADVANCE FOR CARDIOCELL MEDICINE

CardioCell, a stem cell company in San Diego, has started a Phase 2a clinical trial of its treatment for chronic heart failure.

The companys special stem cells are injected into patients with heart failure not caused by a heart attack. Nearly 2 million Americans have that kind of heart failure.

Separately, CardioCell is testing these stem cells on heart attack patients.

The cells are licensed from Stemedica, the parent company of CardioCell.

Taken from bone marrow, the stem cells produce chemicals intended to heal malfunctioning heart cells. They are grown under low-oxygen conditions, or hypoxia. CardioCell said hypoxia reflects the conditions under which natural stem cells exist.

Also in San Diego, the company Histogen is developing its own type of low-oxygen stem cells.

Growing stem cells with abundant oxygen reduces their stemness, and they become prone to differentiation turning into other types of cells, said Sergey Sikora, CardioCells president and chief executive.

More than 20 patients are being sought for the Phase 2a trial, which is taking place at Emory University in Atlanta, Northwestern University near Chicago and the University of Pennsylvania in Philadelphia.

Patients receive injections of the stem cells, while a control group receives a saline injection. After 90 days, the groups treatment will be reversed.

The stem cells live for about a month, Sikora said.

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TESTS ADVANCE FOR CARDIOCELL MEDICINE

Woman Reportedly Grows A 'Nose' On Her Back

Eight years after doctors implanted stem cell tissues from her nose into her spine, an American woman experienced a nose-like growth on her back.

The woman received the treatment for paralysis at Hospital de Egas Moniz in Portugal with the hope that stem cells would help cure the nerve damage she experienced in her spine. While she did not have the symptoms initially, she started feeling the growth in her back about a year ago, according to the Daily Mail.

She started experiencing pain in her back and told doctors, who found a nose-like growth that was three centimeters long.

Doctors said that the tissue growing from her back was mostly nasal tissue, but it included small bone particles and had nerves in it, which had latched to the spinal cord.

Mucus-like fluids were also coming out of the growth, said neurosurgeon Brian Dlouhy, who removed the growth surgically.

Though the womans case is unfortunate, some researchers say that it is rare.

Most people who receive the treatment and are rehabilitated correctly saw improvement in their conditions, said Jean Peduzzi-Nelson, a Wayne State University stem cell researcher.

I am saddened to learn of this adverse event, however, the incidence of this problem is less than 1 percent, she told the New Scientist. Many patients receiving this treatment have had remarkable recovery.

Source: Daily Mail

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Woman Reportedly Grows A 'Nose' On Her Back

Stem cell therapy caused nasal tumour on paraplegic's back

A young paraplegic woman who underwent spinal stem cell therapy developed a growth in her back made up of nasal cells eight years later.

The team from the University of Iowa Hospitals and Clinics that removed and investigated the growth has reported the anomaly in a paper published in the Journal of Neurosurgery: Spine. Although the case is a rare occurrence (the first of its kind, that we know of) the authors admit this may simply be because patients that undergo therapy are not monitored long enough, and either way it provides ample evidence attesting to our lack of understanding around programming and controlling stem cell proliferation and differentiation post-transplant.

Human trials for this type of therapy are still at the very early stages, but animal trials have had some promising results. Several different types of cells have been experimented with for implantation including schwann cells (these surround nerves and sometimes grow on the spinal cord post-injury), foetal neural cells (with successes in rat studies) andnasal olfactory ensheathing cells (these are extracted from the lining of the nose and were the ones used in this particular case study).

The patient in question was just 18 years old when she suffered an injury during a car accident. She had been paraplegic for three years when she opted to undergo surgery, implanting olfactory mucosal cells into the injury site. These cells originate in the roof of the nasal cavity and have the ability to take on the characteristics of other cells in the body because they are partially made up of progenitor cells (adult stem cells). They also contain olfactory ensheathing cells, often used in spinal cord therapy trials. This is all despite, as the authors note, the fact that: "the ability of these cell types to differentiate into organised neural tissue in humans or support new neural growth in humans in the setting of spinal cord injury is unclear."

The location of the transplantation was not divulged in the Spine paper, but the New Scientist reports that it was carried out as part of an early stage trial in the Hospital de Egas Moniz in Lisbon, Portugal. In a paper, the Lisbon team revealed that out of 20 candidates, 11 regained some sensation and one person's paralysis actually worsened.

The woman's therapy did not flag up any issues at the time of implantation, but eight years down the line she complained of worsening back pain that had already been ongoing for a year. Scans at the University of Iowa Hospitals and Clinics revealed a mass, thick like mucus and surrounded by fibrous walls, on the spinal cord, at the site of the cell implantation. The investigators explain that the mass was made up "mostly of cysts lined by respiratory epithelium, submucosal glands with goblet cells, and intervening nerve twigs". Nasal elements were growing.

The mass was pressing against the spinal cord, causing the patient discomfort and threatening her spine. When it was extracted, the team could confirm it came from the neural stem-like cells implanted eight years earlier, because the cysts contained a network of non-functioning nerves that were separate from the spine (suggesting they were new) and bone.

"The presence of these nerves within the mass indicates the capacity of olfactory mucosa to support nerve fibre regeneration or new nerve formation," write the team.

In total, the mass was made up of two major parts, measuring 1.4 x 0.8 x 0.7 cm and 1.6 x 1.3 x 0.7 cm. When they were removed, the patient's pain immediately subsided.

These kinds of trials have been ongoing for years, but the fears have been that stem cells -- which have the ability to turn into any cell in the body if programmed to -- could just as easily mutate into something that is not intended, and create tumours in the long term.

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Stem cell therapy caused nasal tumour on paraplegic's back

New York Stem Cell | Regenerative Disk Therapy for Spine NY

Dr. Spivak is a board-certified Neurosurgeon who specializes in minimally invasive spine surgery and stem cell therapies. He has dedicated himself to helping heal your back!

Back pain is a major source of pain and suffering throughout America. Almost everyone suffers from back pain at least at least once in his or her lifetime. Back pain can cause depression and cause problems with work and family. There is no reason to prolong your suffering, as many different treatments are available to provide you with back pain relief. The most common cause of back pain is caused by injury to the lower back. Damage to the disks is called Degenerative Disk Disease. Damaged disks can herniate and pinch spinal nerves. This can cause the searing pain in the legs known as sciatica. Sometimes chiropractic treatment or physical therapy will help relieve back pain, but sometimes interventional surgical procedures must be undertaken when a person does not recover after less intensive treatment. There are many types of invasive treatments, some of which can be quite effective but none of them actually repair the damaged disk. Much progress has been made in experimental stem cell treatments that can actually heal the damage that has been done to the disk, restoring it to like new condition. This procedure is called Disk Regeneration; it produces new disk cells inside the disk itself, so that it can rebuild itself. The Disk Regeneration procedure is short and minimally invasive. Bone marrow is extracted from the patients hip bone and stem cells are separated out using a centrifuge. The stem cells are then injected into the disk using the guidance of an x-ray. The patient is then free to go home and recover.

Dr. Spivak is known for his innovative minimally invasive approach to spine repair, as well as his focus on research and developing cutting edge endoscopic techniques.

Dr. Spivak began his study of medicine at theUniversity of Winnipeg and completed his residency in Neurological Surgery at theUniversity of Saskatchewan. He has also completed several fellowships at prestigious medical schools throughout the United States, where he further refined his surgical techniques.

He has also held several faculty positions at esteemed universities, including Stanford Medical School and Columbia Medical School, and has contributed to several clinical journals, such as the Journal of Neurosurgery.

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New York Stem Cell | Regenerative Disk Therapy for Spine NY