Voters asked to approve $5.5 billion for stem cell research – Lebanon Express

We built something good, but I think the field has expanded and there's plenty of money going into research in California now, said Jeff Sheehy, who sits on the governing board of the California Institute for Regenerative Medicine but says the state can't afford to borrow more bond money to support it.

When voters approved the initial $3 billion in 2004, President George W. Bush's administration had banned the use of federal funds for research using newly created human embryonic stem cell lines. The Obama administration lifted that ban in 2009.

Since then, opponents say, the National Institutes of Health has provided $1.5 billion a year in stem cell research money, while private investment in companies doing stem cell research has flowed in.

Supporters say that federal money could stop at any time, noting more than 90 members of Congress recently signed a letter demanding the Trump administration put an end to funding stem cell research.

More than a third of the initial $3 billion was spent to create stem cell research facilities at Stanford, the University of California, Berkeley, and other prestigious California institutions. Much of the rest has gone toward research.

With only about $30 million left, the California Institute for Regenerative Medicine has reduced its staff and stopped funding new studies.

If the proposition keeps its lead and passes, at least $1.5 billion would be earmarked for developing treatments for Alzheimer's, Parkinson's and other brain-related diseases. Some funds would be used to train California university and college students, and no more 7.5% could be used for administrative costs.

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Voters asked to approve $5.5 billion for stem cell research - Lebanon Express

Cell Therapy Manufacturing Market to be Worth USD 8 billion by 2030, predicts Roots Analysis – PRnews Leader

Roots Analysis has announced the addition of Cell Therapy Manufacturing Market (2nd Edition), 2018-2030 report to its list of offerings.

Natasha Thakur, the principal analyst, stated, The growing number of cell therapy candidates continues to create an increasing demand for facilities that offer manufacturing services for these complex pharmacological interventions. Presently, over 145 companies / organizations are actively offering manufacturing services for such products. The installed global manufacturing capacity is estimated to be over 1 billion sq ft, with the maximum capacity available in North America

The report presents opinions on several key aspects of the market. Among other elements, it includes:

The report features inputs from a number of eminent industry stakeholders. Thakur remarked, Most of the experts we spoke to confirmed that the manufacturing of cell therapies is largely being outsourced due to exorbitant costs associated with setting-up such facilities. The report features detailed transcripts of discussions held with the following experts:

The research also includes detailed profiles of the following players:

For additional details, please visithttps://www.rootsanalysis.com/reports/view_document/cell-therapy-manufacturing-market-2nd-edition-2018-2030/209.hl or email [emailprotected]

Contact:

Gaurav Chaudhary

+1-604-595-4954

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Cell Therapy Manufacturing Market to be Worth USD 8 billion by 2030, predicts Roots Analysis - PRnews Leader

Transcriptional priming as a conserved mechanism of lineage diversification in the developing mouse and human neocortex – Science Advances

INTRODUCTION

The cerebral cortex is the seat of higher-order cognition, motor control, and social behavior. It emerges early during embryonic development from a simple epithelial sheet in the prosencephalon and expands into a complex six-layered amalgam of neural cells and circuits, with cell identity, morphology, and function consolidated both by laminar position and regional localization. At least 55 excitatory and 60 inhibitory transcriptomically defined neuron cell types (ExN and InN, respectively) have recently been reported in two regions of the adult mouse neocortex (1), and it is probable that even more cell types exist in other cortical areas and in other mammalian species. This repertoire of neurons is produced during neurogenesis from germinal zone stem and progenitor cells and is essential for the normal development of cognitive, sensory, and motor functions. Alterations in neurogenesis are known to lead to numerous neurodevelopmental and neuropsychiatric disorders (2). Crucially, although the importance of neuron diversity in the neocortex is well recognized, the fundamental mechanisms underlying production of this neuronal variety from the comparatively homogeneous stem and progenitor cells is not currently understood.

All excitatory neocortical neurons are born from two broad classes of neural stem and progenitor cells that reside in the dorsal ventricular and subventricular zones during embryonic development. Apical or ventricular radial glial cells (aRGCs or vRGCs) have been identified as the neural stem cells of the neocortex, because they alone exhibit multipotency and the ability to undergo self-renewing asymmetric cell divisions. Daughter cells born from aRGCs are fated to either become neurons (direct neurogenesis) or to generate the second class of precursors, the intermediate progenitor cells (IPCs), which in turn undergo limited rounds of cell division to amplify neuronal output (indirect neurogenesis) (3, 4). In recent years, subgroups of IPCs have been characterized on the basis of marker gene expression, morphology, cell cycle (CC) dynamics, and the location of their mitosis. These include at least three known IPC types: apical IPCs (aIPCs) (58), basal IPCs (bIPCs) (9, 10), and basal or outer radial glial cells (bRGCs or oRGCs) (1113). Despite the identification of these major apical and basal precursor groups, major deficiencies remain in our understanding of these cells and their roles in generating the extensive neuronal variation that arises during brain development. For example, our recent data indicate that different precursor types can contemporaneously produce excitatory neurons with distinct properties (14, 15). Thus, if aRGCs, aIPCs, bIPCs, and bRGCs are each comprised by distinct subtypes of cells, it could provide a mechanism for generating a wide number of neuron types with specific functions and roles in the cortical circuitry.

Using single-cell droplet capture, we conducted a high-throughput gene expression analysis of neocortical cells in mouse and identified many groups of stem and progenitor cells with distinct transcriptional profiles. Comparison of these results to published human single-cell RNA-sequencing (scRNA-seq) datasets not only (2, 1618) revealed remarkable similarities across species but also highlighted an increase in bRGC diversity in human neocortex. We observed multiple cell types with mixed identity transcriptional profiles, that is, coexpression of genes typically thought to define separate types of stem and progenitor cells. In vivo intersectional fate mapping and in situ gene expression experiments revealing the identity of these cells in both mouse and human brain indicate that transcriptional priming in aRGC subgroups is a primary mechanism used to generate progenitor heterogeneity during neurogenesis. Last, state-of-the-art bioinformatics approaches indicate that, as a population, the neural precursor lineages simultaneously produce multiple streams of cortical neurons. These data, describing the shared and divergent features between rodents and primates, provide a new picture of how neural precursor heterogeneity is leveraged to influence cortical size and neuronal diversity in a species-specific manner.

We used the ddSEQ Single-Cell Isolator (Bio-Rad and Illumina) to capture cells from the developing wall of the cerebral neocortex at embryonic day (E) 15.5, when excitatory neurons destined for the upper layers are generated (Fig. 1A). After applying stringent quality control measures, 5777 cells from multiple litters (N = 8) and two technical replicates were subject to downstream analyses (fig. S1A). Principal components analysis (PCA) of highly variable genes (HVGs) and subsequent gene ontology analysis revealed that the first two principal components (PCs) were related to CC/cell division and neuron differentiation (fig. S1B). To minimize the effect of CC on cell type classification, we next regressed out the variance related to CC (fig. S1, C and D). Using the first 33 PCs (fig. S1E), we then performed t-stochastic neighbor embedding (t-SNE) analysis (19) and Louvain-Jaccard clustering. Cells from the two replicates mixed well, indicating negligible technical variation (fig. S1F). The clustering analysis resulted in the identification of 25 clusters of cells with distinct transcriptional profiles. On the basis of the expression of canonical marker genes, two types of dorsal telencephalic mouse radial glial cells (mRGCs), five types of mouse IPCs (mIPCs), eight types of mouse excitatory neurons (mExN), and six types of mouse inhibitory interneurons (mInN) were identified (Fig. 1B). In addition, we also identified one group of ventral radial glial cells (mRGC3; inadvertently included due to microdissection procedures), ventral progenitor cells (VPs), Cajal-Retzius cells (CRs), and cells from the choroid plexus (CPs). In general, these clusters expressed cell type selective markers including Pax6, Hes1, and Sox2 (RGCs); Dlx1 and Sp9 (VPs); Reln (CRs); and Ttr (CPs), as well as layer-specific neuronal markers including Satb2 (layers 2 to 4) and Sox5 and Fezf2 (layers 5 and 6) (Fig. 1, C and D; figs. S1G and S2; and table S1). Further confirming the putative identities of many of these clusters, weighted gene coexpression network analysis (WGCNA) (20) indicated the concerted expression of numerous gene modules likely to play key functional and cell typespecific roles (Fig. 1E and fig. S3). For example, genes in module 1 (M1), such as Nes, Pax6, Gli3, Hes1, Notch1, Notch2, and Fgfr3, have been associated with apical progenitor populations, and the expression of M1 genes was enriched in mRGC1/2/3 and mIPC1/2 (Fig. 1F). In contrast, genes in M8 were enriched in mIPCs and included the canonical IPC marker gene Tbr2/Eomes and several genes, such as Neurog1 and Neurog2, which have been associated with IPCs (Fig. 1F). This module also included Mfng and Mfap4, genes encoding extracellular matrix proteins involved in cell adhesion or intercellular interactions whose role in IPCs has not been extensively characterized. WGCNA also identified core gene expression networks expressed in mExN subtypes (M10, M11, and M12) and in mInN subtypes (M12, M13, and M14). These core gene networks likely play fundamental roles in establishing and maintaining the identity and function of the corresponding cell types.

(A) Schematics of experimental design. Dissociated neocortical cells from embryonic day 15.5 (E15.5) mouse brain were captured by ddSEQ method. (B) t-SNE plot of single cells from E15.5 mouse cortex. Colors represent cell types. VP, ventral progenitor; CR, Cajal-Retzius cell; CP, choroid plexus. (C) Feature plots of canonical marker gene expression. Heatmap represents normalized level of gene expression. The number of cells in each cell type is indicated in parentheses (D) Heatmap of differentially expressed (DEX) genes between cell types. Colors represent cell types as in (B). Two of the DEX genes from each cell type are listed on the right. (E) Weighted gene correlation networks of all mouse cell types found in the current dataset. Seventeen coexpression modules are identified. Size of the dots indicates level of correlation between network and cell type, whereas colors represent level of significance (Bonferroni-corrected P value). (F) Genes in module 1 (M1: RGC) and module 8 (M8: IPC) are shown.

Although the WGCNA and marker gene expression were sufficient to discriminate and provisionally uncover the cellular identity within the dataset, several cell types were found to be simultaneously associated with mixed molecular signatures. For example, both mRGC2 and mIPC1 expressed apical progenitor markers, including Sox2, Hes1, and Fabp7, as well as basal progenitor markers such as Eomes. Although these mixed character cells may represent transitional phases between apical and basal progenitor types, we were struck by the remarkably high proportion of such cells within their corresponding cell types (fig. S4, A to C). Similarly, some clusters were highly correlated for the expression of genes in WGCNA modules, indicative of alternate cell identities. For example, although M8 included several genes known to be associated with mIPCs, mRGC2 was also enriched for the expression of genes in M8 (Fig. 1E). These results raised the possibility that such mixed signatures may be distinct cellular states contributing to differentiation or lineage diversification.

To distinguish whether mixed character progenitors represent transient and transitional or stable and distinctive cell states, we first assessed the diversity of cells within each cluster by intracluster distance (fig. S4D). We found that mRGC cell types generally showed higher transcriptome complexity, demonstrated by a high level of intracluster distance, compared with other cell types; mRGC2, which contained cells exhibiting a mixed RGC/IPC expression profile, was the most diverse. This observation prompted us to investigate the substructure within each progenitor cell type using pseudotime analysis (21), which identified multiple states within mRGC1 and mRGC2. We identified three states in mRGC1 that were related to CC progression (Fig. 2A and fig. S4E), demonstrated by gene expression patterns of CC-related genes along pseudotime (fig. S4F). However, in mRGC2, we found four states that appeared to reflect distinctive lineage commitments, as evidenced by the expression of lineage-selective marker genes (Fig. 2B). In particular, state II in mRGC2 was enriched for Eomes expression as compared with all other states in both mRGC1 and mRGC2 (Fig. 2C). Differential expression (DEX) analysis between the four mRGC2 states confirmed that state II was enriched with bIPC genes, including Eomes and Mfng (fig. S4G). Notably, although mRGC2 state II exhibited higher Eomes expression relative to other mRGCs, its expression of Eomes and other IPC markers was significantly lower than found in mIPC cell types.

(A and B) Pseudotime trajectory of mRGC1 (A) and mRGC2 (B). Color indicates pseudotime progression. Cell states are indicated with circled Roman numerals. Genes showing strong association with pseudotime, and cell states are shown at the bottom of each panel. (C) Boxplot of Eomes expression levels in each cell state (circled Roman numerals) of mRGC cell types. Asterisks indicate statistical significance (Fishers exact test) compared with any other cell state. (D) Eomes-Cre IUE-based fate mapping demonstrates multiple cell morphotypes including aRGCs, bIPCs, and bRGCs. (E) IUE of Eomes-Cre with dual-color StopLight reporter using PH3 to isolate mitotic cells. A subpopulation of Eomes-Creexpressing cells divides at the VZ surface while nonTbr2-Creexpressing cells primarily divide at the VZ surface. (F) Location of PH3+ divisions by Eomes-Cre fate map lineage. (G) Proportion of precursors dividing at the surface of the lateral ventricle or subapically differs by lineage; 36.7% of mitotic cells expressing Eomes-Cre divide at the ventricular surface. Mann-Whitney U test, n = 3, P < 0.001. (H to J) Cells with aRGC morphology expressing Eomes-Cre plasmid do not express EOMES protein. (K and L) Precursors expressing Eomes-Cre plasmid express Eomes mRNA. Scale bars, 20 mm.

To determine whether some aRGCs in the mouse neocortex may express Eomes and to test whether this expression reflects lineage identity, we used in utero electroporation (IUE) to label precursors at E11.5 and E14.5 with plasmids expressing mCherry under the control of the Eomes promoter along with a plasmid expressing Lyngreen fluorescent protein (GFP) from the constitutive EF1 promoter. After classifying precursor types based on morphological properties, these experiments showed that 16% of bipolar apical precursors (presumed aRGCs) and 32% of the unipolar apical precursors express the pEomes construct at E12.5 (fig. S5, A to C). The percentages of bipolar and unipolar apical precursors increased to 35 and 72% at E14.5, respectively (fig. S5, D to F). To also assess this question with fate mapping constructs, we performed IUE with a plasmid expressing membrane-tagged Lyn-GFP governed by Cre recombination driven by the Eomes promoter into the E14.5 developing neocortical wall. Twenty-four hours later, this labeling method elucidated multiple classes of progenitors expressing the Eomes promoter construct, identified by morphological and anatomical properties as aRGCs, aIPCs, bIPCs, and bRGCs (Fig. 2D) (22). To confirm expression of Eomes by aRGCs, we next electroporated E13.5 brains with pEomes-Cre and a conditional dual-color StopLight plasmid that expresses mCherry after Cre-mediated recombination (Fig. 2E), followed 24 hours later by immunohistochemical labeling for phosphorylated histone H3, a marker for mitotic cells. Consistent with the prominence and rapid cycling of aRGCs, the majority of pEomes-Crenegative cells (ZsGreen-positive) were located at apical positions near the ventricle. In contrast, and in agreement with the canonical view of Eomes expression by basal progenitors, most (63.3%) pEomes-Cre (mCherry)expressing cells divided at basal positions away from the ventricle (Fig. 2, F and G). However, we also observed that approximately 36.7% of the cells expressing mCherry following Eomes-Cremediated recombination were found dividing at the ventricular zone (VZ) surface, the preferential location for aRGC mitoses, most likely representing cells of the mRGC2 cluster. To confirm that the pEomes-Cre plasmid faithfully reports endogenous Eomes expression, we used single molecular fluorescent RNA in situ hybridization and detected Eomes mRNA in cells transfected with pEomes-Cre and a Cre-conditional enhanced GFP (eGFP) reporter plasmid (Fig. 2, H and I). However, immunolabeling using an antibody against the EOMES protein failed to detect expression of EOMES in the eGFP-expressing aRGCs (Fig. 2, J to L). Thus, using morphological and gene expression tools, we revealed a pEomes-Cre+ apical precursor cell population that expresses Eomes mRNA but not the EOMES protein.

The detection of Eomes mRNA but not EOMES protein in certain mRGCs based on in silico and in vivo data, suggests that transcriptional priming, a phenomenon whereby mRNA for proteins that will be expressed in progeny is present but not translated in the parent cell (23), may contribute to key features of the developing mouse brain. To assess whether this phenomenon is widespread among progenitor cell populations in the developing mouse brain, we correlated mRNA and protein expression in several cell types and states exhibiting mixed character gene expression signatures similar to those we observed in mRGC2. To identify candidate genes/proteins potentially subject to transcriptional priming, we focused on the genes in the IPC module (M8) from the WGCNA analysis (Fig. 1F). Because genes from M8 are likely important for the establishment of IPC identity, it is reasonable that other genes from the module, in addition to Eomes, exhibit transcriptional priming in RGCs. We observed multiple M8 genes expressed in one or multiple states in RGCs (fig. S5G). In particular, Igsf8 was expressed by all states, except state IV, in mRGC2, whereas Mfap4 was only expressed by state III in mRGC2. Using immunohistochemistry, we found that IGSF8 and MFAP4 are widely expressed at the protein level in the mouse ventricular zone and are therefore not candidates for transcriptional priming (not shown). Applying this same approach to mIPC1, mIPC2, mIPC3, and mIPC5 also identified multiple states in each of these mIPC cell types characterized by expression of Eomes and many other genes previously attributed to bIPCs, although Eomes expression in these IPC groups was at least 10-fold greater than that found in mRGC2 (fig. S6).

Because the pEomes-Cre fate mapping approach labeled multiple morphotypes (Fig. 2D), we hypothesized that an in vivo approach restricting labeling to cells that coexpress both Eomes and apical marker genes such as Hes1, Fabp7, or Slc1a3 could specifically highlight the cells with mixed identity, including those within the mRGC2 and mIPC1 profiles. To this end, we designed an intersectional approach combining FLP recombinase (Flpe) driven by the Eomes promoter, an Flpe conditional plasmid expressing Cre under the control of one of the apical marker genes (e.g., Hes1, Slc1a3, or Fabp7), and a Cre-conditional eGFP reporter (Fig. 3A). Fifteen hours following IUE with these intersectional fate mapping plasmids at E14.5, most of the labeled cells resembled aRGCs and expressed SOX2 protein (Fig. 3, B and B2), demonstrating the presence of a subpopulation of aRGCs expressing the Eomes transcript as predicted by the expression profile of the mRGC2 cluster. In addition, a few cells with bRGC morphology were also present among the GFP-labeled cohort, and these bRGCs expressed EOMES protein (Fig. 3B1) as well as SOX2 (Fig. 3, D and E). By 24 hours elapsed time, the SOX2+/EOMES aRGCs in the VZ were joined by a much larger SOX2+/EOMES+ bRGC population in the subventricular zone (SVZ) (Fig. 3, C, C1, C2, and C3), consistent with the contemporaneous expression of aRGC and IPC genes (including Eomes) in mIPC1 (fig. S6A). Many of the cells with bRGC morphology were located adjacent to a second eGFP+ cell, suggestive of a recent cell division and the generation of a daughter cell within the 24-hour period Fig. 3 (D and E). Immunostaining for PH3 and SOX2 confirmed the proliferative status of eGFP+ bRGCs and indicated that they express SOX2 as in primate and carnivore brain (fig. S7A). The bRGCs as well as their daughter cells expressed the SOX2 protein (fig. S7, B and B), suggesting that they produce daughter cells that retain molecular aspects of apical progenitor identity despite their distinctive morphology and localization within deeper regions of the neocortical wall. Together, these results indicate that a subgroup of aRGCs expresses translationally blocked Eomes mRNA transcripts and that this lineage of aRGCs generates proliferative bRGCs.

(A) Intersectional (dual switch) genetic fate mapping strategy for in vivo labeling of cell types. The Flpe-conditional Cre construct used either Fapb7, or Slc1a3, or Hes1 promoters. (B) IUE to label cells coexpressing Eomes and Fabp7 at E14.5 with 15-hour survival. Proportion of each morphological cell type represented in pie chart. Eomes+ bRGCs (1) and Sox2+ aRGCs (2) were present. (C) IUE to label cells coexpressing Eomes and Fabp7 at E14.5 with 24-hour survival. Proportion of each morphological cell type represented in the pie chart. Transfectants include Eomes+ bRGCs (1 and 2) and Sox2+/Eomes aRGCs (3). (D) IUE to label cells coexpressing Eomes and Hes1 at E14.5 with 24-hour survival, demonstrating that bRGCs and their daughter cells express SOX2. (E) IUE to label cells coexpressing Eomes and Hes1 at E14.5 with 24-hour survival, demonstrating expression of SOX2 in aRGC and bRGC (white arrowheads) but not bIPCs (white arrows). (F to I) Pseudotime trajectories of mIPC1 (F), mIPC2 (G), mIPC3 (H), and mIPC5 (I). Color indicates pseudotime progression. Cell states are indicated with circled Roman numerals. Genes showing strong association with pseudotime and cell states are shown at the bottom of each panel. (J) Violin plot of canonical marker genes for RGCs and IPCs expressed by mIPCs. Colors represent different genes. Vertical axis shows normalized gene expression levels. Scale bars, 20 mm.

In addition to mIPC1, our bioinformatics analysis also revealed other IPC groups with mixed apical and basal gene expression (Fig. 3, F to I). Specifically, mIPC3 strongly expressed both Eomes and apical markers like Fabp7, but was further defined by the expression of NeuroD4 (Fig. 3J). A previous single-cell study bioinformatically identified a subset of cells that coexpress FABP7 and NEUROD4 as bRGCs in human and ferret neocortex, but a cognate population was absent in the mouse (24). To determine whether these NeuroD4+ mouse progenitors align with the bRGC morphotype, we fate mapped cells in the neocortical wall at E14.5 using pEomes and pNeuroD4 plasmids driving mRFP and GFP reporters, respectively (Fig. 4A). Cotransfection of these four constructs highlighted the overall Eomes-expressing cell population with RFP and identified that a subset of these cells (30%) also expressed NeuroD4 (GFP+). The NeuroD4+ subset was comprised entirely by cells with bIPC and bRGC morphology, the latter of which were often found closely opposed to a presumed daughter cell (Fig. 4, B and C, and fig. S7, C and D). Immunostaining showed that the NeuroD4 lineage bIPCs are EOMES+/SOX2, whereas the NeuroD4-expressing bRGCs are EOMES+/SOX2+ (Fig. 4D). To determine whether the NeuroD4+ bRGCs are the same population of bRGCs found in the Eomes/VZ gene intersectional cohort in Fig. 3, we quantified the proportion of pNeuroD4-creexpressing bRGCs in the total bRGC population. Using the dual-color StopLight reporter driven by the ubiquitous chicken beta-actin promoter, we identified the total bRGC population with morphological criteria and found that only 40% of the Eomes-expressing bRGCs also expressed NeuroD4 (Fig. 4, E to I). We then used fluorescence mRNA labeling along with intersectional fate mapping to confirm the presence of Eomes+/NeuroD4+ and Eomes+/NeuroD4 bRGCs in the mouse neocortical wall (fig. S7E to H). These are the first data to indicate multiple different classes of bRGCs in the mouse neocortex.

(A) Fate mapping constructs used to elucidate identity of cells expressing both Eomes and NeuroD4 via IUE in E14.5 mouse neocortex. (B) Quantification and morphologies of Eomes+/NeuroD4 and Eomes+/NeuroD4+ cells 24 hours after IUE. (C, B, B) Eomes+/NeuroD4+ cells exhibit bIPC and bRGC morphology. Cell colors as in (A). White arrows indicate radial processes, and yellow arrows indicate cell bodies. (D) NeuroD4-expressing cells in mouse neocortical wall 24 hours after IUE. Insets show numbered cells and their expression of Eomes and Sox2. White dashed lines show location of cell bodies. (E to G) NeuroD4 StopLight fate mapping with IUE on E14.5 followed by 24-hour survival demonstrates that NeuroD4+ bRGCs are Sox2+. White arrows indicate radial processes, and yellow arrows indicate cell bodies. (H and I) Quantification of bRGCs 24 hours after IUE with NeuroD4 fate mapping approach. NeuroD4+ bRGCs represent 38% of entire bRGC population. Scale bars, 50 mm.

Our published work demonstrates that neurons born from distinct precursor groups can express specific electrophysiological and morphological properties, even when they are generated on the same day and migrate to the same neocortical layer (14,15). We therefore sought to determine how the precursor diversity found in this single-cell study correlates with the multiple subgroups of excitatory neurons found after cell capture and analysis (e.g., mEx-1 through mEx-8). To do this, we focused on the mouse single-cell data and used novel trajectory reconstruction methods to resolve the pseudodevelopmental process from progenitors to highly differentiated excitatory neurons. Through this process, we were able to establish four well-separated streams emanating from the precursor cell types (fig. S8, A and B). The excitatory neurons in these streams expressed genes identifying them as either superficial (streams 1, 2, and 3) or deep (stream 4) excitatory neurons (fig. S8C). Stream 1 also displayed characteristics of immature neurons as shown by the expression of Neurod1. We then plotted the ExN groups onto these streams and found that mExN cell types exhibited highly specific locations within these streams (fig. S8D). Some mExN groups were primarily restricted to one stream (e.g., mExN1, mExN3, and mExN6), while other groups (mExN2, mExN4, and mExN7) were present in two streams, and cells from the mExN5 cluster were present in all four streams. These computational results support previous studies indicating that excitatory neuron identity is varied, as measured by gene expression profiling, and that excitatory neuron types potentially resolve into different lineage streams produced by neocortical precursors.

To determine whether specific precursor cell types may be lineally correlated with the streams and the ExN contained therein, we quantified the percentage of each precursor cell state (i.e., mRGC and mIPC cell types) in the four streams (fig. S8E). In general, multiple precursor types are found along any given stream trajectory, but the contributions of each precursor cell state to the streams are distinctive. For example, a majority of cells from state III in mRGC2 and mIPC4 contribute to stream 1, the stream that showed immature neuron characteristics. A high percentage of cells from mRGC1-II and mIPC5-III contribute significantly to stream 2 (superficial excitatory neurons). All states from mRGC1 and mIPC3 contribute predominantly to stream 3 (deep excitatory neuron). State I of mRGC2 as well as mIPC1 states I, II, and III contribute almost exclusively to stream 4 (superficial excitatory neurons). These analyses suggest that multiple different precursor types and states may underlie each stream of excitatory neurons and that particular admixtures of precursor cell types cooperate to produce specific lineage streams during neocortical neurogenesis. These data, coupled with our recent publications demonstrating that different precursor lineages produce ExN with specific properties (14, 15), suggest that the precursor heterogeneity identified in the current study, while subtle and dynamic, may be an important driving factor for excitatory neuron diversity and circuit complexity.

The morphology of bRGCs has been previously shown to be quite variable (25), and we noticed this as well. To quantify bRGC morphology, we conducted three-dimensional (3D) image analysis to determine whether bRGC shape differed between subtypes or across labeling procedures. We scored cells as belonging to one of three categories (fig. S8, F to H): type A, characterizing cells having many small filopodial projections along with short apical or basally directed main processes; type B, unipolar bRGCs with one relatively unbranched basally directed process that terminates before reaching the pia; and type C, unipolar bRGCs that project to the pial surface. We found that all dual switch labeling strategies yielded bRGCs with all three types of morphology, suggesting that these variations in shape may be a general property of bRGCs, perhaps relating to transitory phases of their maturation or proliferation state. We did find differences in proportions of bRGC type, though, suggesting that bRGC diversity may be correlated with signaling from the basal lamina and with cytoskeletal complexity during cell production. For example, the pEomes-Flpe + pFabp7-FNF-Cre population had a higher proportion of pia-touching type C bRGC, whereas the pEomes-Flpe + pSlc1a3-FNF-Cre population was overrepresented by short bRGCs of type A morphology (fig. S8, I to L). Together, these results confirmed the separation of cell types elucidated by the bioinformatics approaches and that Eomes-expressing bRGCs consist of multiple subgroups. We next sought to determine how similar these newly elucidated mouse cell types are to those found during human neocortical development, especially because primate bRGCs have not been previously described as part of the EOMES lineage.

To compare transcriptomic features of mouse and human neocortical stem and progenitor cells, we created a human cell database by combining multiple published human scRNA-seq datasets (2, 1618) of 12 to 20 postconceptional week (PCW) neocortex into one containing cell number comparable to our mouse dataset. We confirmed that the combined human data also contained all major cell types in the developing human neocortex (fig. S9, A to C) and then used several methods to conduct a cross-species comparison. First, we correlated the WGCNA modules identified from the mouse single-cell analysis to human single cells and found a similar correlation pattern, suggesting that core transcriptomic networks are shared by the same cell types across species (fig. S9D). This approach also identified a human IPC cell type with mixed character gene expression. Specifically, hIPC1 was highly correlated with both RGC (M1) and IPC (M8) modules (fig. S9D). Marker gene expression profiling confirmed the coexpression of RGC markers (i.e., SLC1A3, FABP7, and HES1) and IPC markers (i.e., EOMES) in hIPC1 (fig. S9E). Next, we used an established method (17) to integrate the human single-cell dataset with our mouse dataset and showed that all major cell types were well integrated between the two species (Fig. 5A and fig. S9, F to H). Focusing on RGCs and IPCs, we observed that certain human and mouse cell types overlap in UMAP (uniform manifold approximation and projection) space (Fig. 5, B and C). Using MetaNeighbor analysis (26), we identified pairs of human and mouse neural precursor cell types that were highly similar to each other after integration (Fig. 5D). DEX analysis was then performed separately for the human or mouse precursor types, and the intersection between the human and mouse results was used to identify common genes by cell type using stringent criteria (Materials and Methods; table S1). These genes were then used to conduct enrichment analysis for the shared human and mouse precursor cell types in the context of human developmental and neurodegenerative disorders (Fig. 5F). We found that some pairs of human and mouse cell types were enriched for genes associated with neurodevelopmental or neurodegenerative diseases. For example, genes specific to and shared by hIPC2 and mIPC3 were significantly enriched for low IQ and schizophrenia.

(A) UMAP plot of integrated human (4, 2224) and mouse datasets (open and gray circles, respectively). Colors represent different major cell types. (B and C) UMAP plots of integrated human (h) and mouse (m) RGC (B) and IPC (C) single-cell data. Human single cells are represented by circles, whereas mouse single cells by square. Colors represent cell types. (D) Heatmap plot of MetaNeighbor analysis. Colors represent AUROC score. (E) Enrichment analysis for genes associated with human neurodevelopmental and neurodegenerative disorders in human and mouse progenitor cell types. Clustering based on MetaNeighbor analysis is shown on top (colors represent clusters). Dashed line indicates clustering threshold. Heatmap color represents unadjusted P value. Significant enrichment at unadjusted P < 0.05 is indicated by box, and adjusted P value (Padj) < 0.05 by x. N.S., not significant. (F) Violin plot of common DEX genes in both human and mouse progenitors. Colors are the same as in (B), (C), and (E). Horizontal axis indicates scaled expression level (Scaled exp.).

In general, a continual transcriptomic profile shift emerged, with apical RGCs (i.e., mRGC1, hRGC2, and mRGC2) at one end and more differentiated IPCs (i.e., hIPC3, mIPC4, and mIPC5) at the other end, with combinations of canonical marker genes clearly demarcating the two ends of this range (Fig. 5F). Specifically, RGCs expressed HES1, ID4, CYR61, FOS, and TUBA1B at high levels consistently, whereas IPCs expressed EOMES, NEUROD1, ELAVL2, and ELAVL4. We observed similar mixed signatures in hRGC3, mIPC1, hIPC1, mIPC2, and hIPC2. For example, hRGC3, which is likely a human bRGC cell type based on HOPX expression (fig. S9E), also expressed IPC genes such as NEUROD6 and ELAVL4 at relatively high levels compared with other RGCs. Clusters mIPC1 and hIPC1, on the other hand, showed an undoubtable IPC identity with high levels of EOMES, but also expressed a panel of canonical RGC genes including ID4, FABP7, and CKB. We also observed that hIPC1 and hIPC3 expressed NEUROD4, perhaps highlighting a common bRGC precursor identity with mIPC3.

These gene expression results indicate that the human neocortex also contains multiple subtypes of bRGCs (i.e., expressing EOMES/NEUROD4 and EOMES/SOX2). To confirm this in vivo, we used multiplex fluorescence in situ hybridization to localize cells expressing NEUROD4, EOMES and SOX2 in sections of the human neocortex at 12 weeks of gestation. Because of fixation and RNA degradation artifacts in two of the three samples in our archive, we were only able to obtain results from one brain. Nevertheless, the mRNA localization we report for EOMES and SOX2 below matches the Allen Developing Human Brain Atlas and other previous publications. We found that EOMES and NEUROD4 are largely coexpressed in cells of the inner SVZ (iSVZ), although a substantial number of cells express only EOMES or NEUROD4 in this zone (Fig. 6, A to C). In contrast, the number of positively stained cells fell to 9.1% of the overall population in the outer SVZ (oSVZ) (Fig. 6, D and E). Whereas most of these labeled cells in the oSVZ expressed EOMES only (56%), 27.7% also expressed NEUROD4, while fewer cells (16.3%) expressed NEUROD4 alone (Fig. 6E). We noted that a substantial proportion (45.4%) of cells expressed NEUROD4 or EOMES mRNA in the human VZ as well (Fig. 6, F and G).

(A and B) Single-molecule multiplex mRNA hybridization (RNAScope) for NEUROD4 (green) and EOMES (red) in human 12wg neocortical wall. Boxed inset (B) shows larger magnification. Arrows indicate NEUROD4+/EOMES+ cells. (C) Quantification of EOMES+ (red), NEUROD4+ (green), and EOMES+/NEUROD4+ (blue) cells from the top of the ventricular zone (VZ) to the top of the OSVZ. (D and F) Quantification of all unlabeled (gray), EOMES+ (red), NEUROD4+ (green), and EOMES+/NEUROD4+ (blue) cells in OSVZ (D) and VZ (E). (E and G) Distribution of RNAScope+ cells expressing EOMES, NEUROD4, or both markers in OSVZ (E) and VZ (G); colors as in (C). (H and I) RNAScope for SOX2 (green) and EOMES (red) in human 12wg neocortical wall. Boxed inset (i) shows larger magnification. Arrows indicate SOX2+/EOMES+ cells. (J) Quantification of EOMES+ (red), SOX2+ (green), and EOMES+/SOX2+ (purple) cells from the top of the VZ to the top of the OSVZ. (K and M) Quantification of all unlabeled (gray), EOMES+ (red), SOX2+ (green), and EOMES+/SOX2 (purple) cells in OSVZ (K) and VZ (M). (L and N) Distribution of EOMES+, SOX2+, or EOMES+/SOX2+ cells in OSVZ (L) and VZ (N); colors as in (J).

Mapping of EOMES and SOX2 led to similar results. A significant number of iSVZ and oSVZ cells coexpressed EOMES and SOX2, and the SOX2+/EOMES+ population was greater in the iSVZ than in the oSVZ, where it comprised 9.6% of the labeled cells (Fig. 6, H to K). We also identified a large population of SOX2+/EOMES cells in the oSVZ that represented the largest population (73.1%) of labeled cells in this zone (Fig. 6L). As expected, the VZ contained a high number of SOX2+ cells and a very small number of EOMES-only cells. Unexpectedly, though, we found that 36% of the human VZ cells coexpressed SOX2 and EOMES, a finding that further supports the single-cell gene expression evidence for aRGC heterogeneity and identifying the presence of aRGC cell types with expression features, indicating transcriptional priming (Fig. 6, M and N). Together, these in vivo human data indicate substantial similarities with the mouse bRGC results, showing that NEUROD4/EOMES and SOX2/EOMES double-positive bRGCs exist in both species and that their parent cell types are present in the VZ. Furthermore, adding to this cell diversity, our RNA labeling studies indicate that the largest human oSVZ population is a SOX2-only population of oRG (Fig. 6, K and L) that has been previously identified (2729). This SOX2-only oRG cell type is not observed in the mouse neocortical SVZ.

Cellular imaging studies indicate that neocortical aRGCs can divide to generate neurons directly and can also produce other precursor types; how one group of cells accomplishes these varied tasks is unknown. Our bioinformatics and in vivo findings demonstrate a much larger variety of neural precursor cell types than previously recognized, indicating multiple types of specialized aRGCs and IPCs during neurogenesis. We showed that the dynamic transcriptomic states of specific aRGCs may be indicativeperhaps even instructiveto the route of differentiation that an individual RGC may undertake. In addition, in vivo validation experiments demonstrate that bRGC cells and their precursors share novel transcriptional profiles in the mouse and human neocortex, as well as species-specific profiles, that contribute to separate lineages in the developing brain. Here, we describe two subtypes of dorsal neocortical aRGCs in mouse and three aRGC subtypes in human. Two of these RGC types in each species (mRGC1, mRGC2, hRGC1, and hRGC2) exhibit remarkably shared properties, and one (hRGC3) is likely the SOX2-only bRGC precursor present in human but not mouse. We also identify three similar IPC subtypes in human and mouse as well as two mouse IPC types that do not appear to have human counterparts.

Crucially, the novel cellular diversity we describe is not represented exclusively by morphological or anatomical characteristics but rather by newfound mixed transcriptional profiles. Although previous scRNA-seq studies have categorized cell populations based on morphological type (i.e., aRGC versus bIPC versus bRGC) and the expression of cardinal transcription factor genes (24, 27), we found several clusters of cells that coexpressed gene sets previously regarded as exclusive for distinct progenitor populations. Moreover, our in vivo fate mapping and RNAScope analyses revealed that these mixed marker clusters are comprised by cells with multiple morphotypes, including subsets of aRGCs, bIPCs, and bRGCs. This suggests that transcriptional profiles may reflect discrete lineages of progenitors more accurately than morphological classes. It is noteworthy that the differences we found between states within any precursor cell type are subtle, both in terms of the number of DEX genes and the magnitude of differences in expression levels. Therefore, we suspect that the states are dynamic or cyclic in nature. However, the identification of developmental streams and the differential involvement of precursor cells, at the level of their cell states, suggest that the differences we observed may be instructive for neuronal differentiation and the establishment of neuronal diversity. While still preliminary, this observation sheds new light on the complexity of neuronal precursor populations and invites further investigation.

Transcriptional priming may underlie some aspects of the diversification of cell types and the complexity of precursor dynamics both within and between species. Regulatory mechanisms driving precursor diversity have long been known to include temporal maturation and epigenetic modification (23, 30, 31). Recently, transcriptional priming, or the accumulation of untranslated mRNAs preceding the staged expression of protein, has been linked to specification of neuronal subtypes of daughter cells (23). Here, we show that transcriptional priming of the transcription factor Eomes may be a driver of precursor and lineage diversity, consistent with another report describing changes in neuronal identity and localization in response to deletion of the Eomes gene (32). We observed, in particular, that subgroups of apical precursors within mouse and human VZ express Eomes mRNA but not protein. Fate mapping with the Eomes regulatory sequence supported this conclusion as we observed multiple precursor morphotypes, including aRGCs, which lacked immunoreactivity for the Eomes protein. This suggests that the Eomes transcript itself contains regulatory motifs that are not found in the mRNAs encoding our fluorescent reporters and that these properties allow for repression of Eomes translation in these precursors. miRNA-92b has been shown to bind to and regulate Eomes mRNA (33); its activity may be important in regulating apical-to-basal precursor transition within this lineage. Together, these results suggest that transcriptional profile diversity is seeded in the broader population of aRGC stem cells and is then further amplified by the progression of individual neuron-producing lineages. This may be comparable to, and potentially allows inferences to be drawn from, similar mechanisms underlying lineage diversification in the development of organ systems other than the brain (34).

While several studies have noted small numbers of cells in the mouse neocortex that resemble bRGCs (12, 13, 28, 35), they are thought to have lower proliferative capacity and unique gene expression profiles compared with those found in species with convoluted or gyrencephalic brains, such as ferret and human. These findings have prompted the theory that bRGCs have enabled the large expansion in cortical surface area during carnivore and primate evolution (11). However, here, we have identified and developed specific labeling tools for multiple mouse bRGCs as well as the aRGC group that precedes them. The presence of these subtypes of bRGCs in both the mouse and human neocortex provides a new facet to the theory that bRGC underlie gyrencephalization and cortical expansion. The bRGC subtypes we identified express similar gene and protein expression patterns in both species, clearly indicating their conservation during mammalian evolution. These cell types found in both human and mouse should be called bRGCs and not oRGs because the mouse neocortex does not contain an oSVZ and because most of these cells are found in the human iSVZ. However, our study also confirms the presence of a human-specific type of bRGC (SOX2-only, hRGC3) that is present in the oSVZ and has been previously named the oRG cell (11, 27). The presence of this oRG cell type in the human brain may lead to the expansion of the human neocortex.

The demonstration of multiple progenitor cell types and states supports a model whereby progenitor diversity yields neuronal diversity. In general, while a brain with more progenitor cells has a larger growth capacity, a brain with greater progenitor diversity may have important additional qualities. Formation of the neocortex by multiple groups of dividing progenitors provides a varied landscape from which individual neuron properties can be germinated; our scRNA-seq and in vivo fate mapping studies now confirm that such a varied landscape is present in both mouse and human neocortex. Our data indicate the existence of coherent molecular signatures that constitute a thread tying cells within the same lineage together, even though individual cells within the lineage express various levels of such threading genes along the path of differentiation and may be found in various morphological states. This lineage diversity is likely to be integral to cortical complexity. For example, several reports have indicated that the morphology and action potential firing properties of the eventually produced neurons can vary, even in the same cortical layer (i.e., neurons born at the same developmental time) (5, 36). These differences appear to correlate with the properties of the neurons parent cell type; we recently showed in mouse brain that progenitor lineage directly contributes to the intralaminar diversity of neurons both in the somatosensory and the frontal cortex (14, 15).

Overall, the bioinformatics results presented here identify unique expression profiles of progenitor diversity. These profiles then served as guides for in vivo fate mapping experiments that, in turn, reinforced and clarified the bioinformatics findings. The confirmed molecular properties can now be used to track the developmental roles of the multiple progenitor types undergoing neurogenesis in the fetal brain. Building information from fate maps of particular precursor lineages into a system-level analysis of neocortical circuitry and function will greatly elucidate how the neocortex is generated and how it is altered in neurodevelopmental disorders.

Cohorts of timed pregnant CD-1 IGS mice (#022) were obtained from Charles River at E9.5 or E10.5 stage and were maintained at the Boston University Laboratory Animal Science Center with a 12-hour light/dark cycle in conventional housing cages until surgery.

The ddSEQ Single-Cell Isolator (Bio-Rad and Illumina) was used for single-cell capture. Briefly, freshly dissected mouse brain tissue was transferred into a tube with 37C prewarmed trypsin solution. The mix was pipetted with a wide-bore pipette tip for 10 times, and then the tube was incubated in a 37C water bath for 30 min. The mix was gently pipetted 10 to 20 times every 10 min during incubation. After incubation, the cell suspension was repipetted again until homogenized. Last, the well-dissociated cell suspension was centrifuged at 300g for 3 min, washed, and resuspended in Dulbeccos phosphate-buffered saline (DPBS) to about 1000 cells/l. The cells were loaded onto the four wells of the ddSEQ Single-Cell Isolator following the manufacturers protocol to generate cDNA and sequencing libraries. The capture experiment was conducted in two separate technical replicates.

cDNA and sequencing library concentration was quantified with Quant-iT PicoGreen (Invitrogen, P7589). All sequencing libraries were assessed for quality by Agilent Bioanalyzer using high-sensitivity double stranded DNA (dsDNA) assay. Library was sequenced on an Illumina NextSeq 500 platform with the pair-end mode following the manufacturers instructions.

About 305 million (M) were generated, and FastQC was used to assess the quality of reads. Reads with average quality less than 30 were removed. We used SureCell RNA Single-Cell v1.1.0 (Illumina) to align all the reads in FastQC files to the mouse genome reference (mm10). Over 270M reads (89.58%) were aligned, with 260M that had valid barcode (85.6%). Among the aligned reads, 56.15% mapped to unique genes, whereas only 0.17% mapped to mitochondrial chromosome. We then assessed the distribution of unique molecular identifiers (UMI) in each cell as knee plot (fig. S1A) and removed barcodes with low UMI counts, with 16,681 barcodes remaining. We further removed low-quality barcodes with less than 200 total UMI counts, and 5777 cells passed quality control. UMI counts were normalized by NormalizeData function with log transformation using natural log as base.

The removal of CC effect was performed similarly as described before (20). Briefly, to minimize the effect of CC in the identification of progenitor cell types, we sought to remove CC from our data through regression. Briefly, we used a published list of CC genes (37) and calculated G1/S and G2/M phase scores for each cell using function CellCycleScoring from R package Seurat (38). Then, we calculated the difference between G1/S phase score and G2/M phase score. This result was used to perform regression on all cells in our dataset with Seurat. Using this approach, CC differences among dividing cells were regressed out, while signals segregating cycling and noncycling cells were maintained.

To define HVGs, we calculated the mean of logged expression values using Seurat function FindVariableGenes and plotted it against variance to mean expression level ratio (VMR) for each gene. Genes with log-transformed mean expression level between 1 and 8.5 and VMR above were considered as HVGs.

We used PCA and t-distributed SNE (19) as our main dimension reduction approaches. PCA was performed with RunPCA function (Seurat) using HVGs. Following PCA, we conducted JACKSTRAW analysis with 100 iterations to identify statistically significant (P < 0.01) PCs that were driving systematic variation. We used t-SNE to present data in 2D coordinates, generated by RunTSNE function in Seurat. Significant PCs identified by JACKSTRAW analysis were used as input. Perplexity was set to 30. t-SNE plots were generated using R package ggplot2 (39). Clustering was done with the Luvain-Jaccard algorithm using t-SNE coordinates by FindClusters function from Seurat with default setting.

WGCNA (20) was performed using R package WGCNA. The UMI counts from all cells were used to generate correlation matrix with bicorrelation algorithm. Next, pickSoftThreshold function was used to analyze the network topology with 3 as soft-threshold power. Minimum size of modules was set to 10 genes. Module was identified using the tree method with deepSplit. For each module, WGCNA generated an eigengene to represent modular features. Network edge and node information of each module were exported using exportNetworkToCytoscape function and was visualized with Cytoscape software.

The human authologs of the mouse genes from each module were selected. The expression of the selected genes was used in PCA, and the first PC was used as the module eigengenes.

We used R package Monocle3 alpha to reconstruct pseudotime on each of the analyzed progenitor cell type separately (40), following standard procedure with customized parameters. Briefly, we first calculated the dispersion of each gene and calculated an estimated dispersion by the mean-variance model using dispersionTable function. Only genes with dispersion greater than the estimated value and mean UMI greater than 0.1 were kept for further analysis. Then, preprocessing was conducted where the expression levels were log normalized with a residual model using number of UMI as the independent variable, followed by PCA (number of dimensions set to 30). UMAP was used to reduce dimensions further to two, with Minkowski metric. The number of neighbors was determined empirically based on the number of single cells in each cell type (ranging between 5 and 20). To identify states within each cell type, Louvain-Jaccard clustering was conducted. Ridge plots as in Figs. 2C and 3B were generated with ggridges package. Plot_pseudotime_heatmap function was used to visualize gene expression levels across pseudotime as in fig. S5 (C and D) and fig. S6 (A to D), with number of clusters set to 3 and a natural spline function with degree of freedom equal to 2.

The integration of human and mouse datasets was conducted following recommended steps (41). We used the top 2000 most variable features from each of the mouse and human single-cell datasets to find integration anchors. UMAP analysis was conducted with Minkowski metric. MetaNeighbor analysis was then conducted on the integrated data, using average expression levels of cell types from either species. Enrichment analysis for genes associated with human developmental and neurodegenerative disorders in human and mouse progenitor cell types was performed as previously described using genes specific to each human and mouse precursor cell type pairs (20). To identify genes specific to each pair of precursor cell types between human and mouse, we first conducted DEX analysis between cell types within same species to find genes specific to each human or mouse cell type. Then, we intersected the lists of DEX genes from mouse and human cell types of the same pair and regarded the intersected list as genes specific to the pair.

To identify neuronal differentiation lineages, we applied STREAM (v0.4.0) analysis pipeline (42) to a subset of our single-cell transcriptome dataset containing mRGCs, mIPCs, and mExNs. Briefly, the top 20 PCs from the selected cells were used to create a diffusion map with diffusion scale parameter of the Gaussian kernel (Sigma-Aldrich) set to 1 and number of nearest neighbors set to square root of the number of cells (43). The first three eigenvectors of the diffusion map were passed to STREAM pipeline, and differentiation lineages were identified by seed_elastic_principal_graph function (with number of initial nodes set to 10) followed by elastic_principal_graph function. To present the lineages, we used R package URD following recommended steps with minor adjustments based on the structure of the dataset (44). Briefly, mRGC1 was set as the root, and the diffusion map was flooded 1000 times to establish the pseudodevelopment axis. Tips of the diffusion map were identified from the final stage of pseudodevelopment. Biased random walks were then performed from each tip. Last, a tree graph was built using buildTree with cells per bin set to 25 and bins per window set to 8. A 2D representation of the resulted 3D graph from buildTree function was produced using R package rgl with a manually selected view point.

t-SNE plots were generated using TSNEPlot function from R package Seurat. Unless otherwise noted, all heatmaps were generated with R function heatmap.3. All other plots were generated using ggplot2.

IUE was performed as described previously (14) on E11.5, E13.5, and E14.5 timed pregnancies. Briefly, dams were anesthetized with ketamine/xylazine cocktail, and the uterine horns were exposed by a midline laparotomy. One to two microliters of plasmid, or plasmid combination, mixed with 0.1% fast green dye (Sigma-Aldrich) in phosphate buffer was injected into the lateral ventricles using a pulled glass micropipette and a picoinjector (PLI-100, Harvard Apparatus). Final plasmid or plasmid mixture concentration was between 3 and 6 g/l. The anode of a tweezertrode (1-mm diameter for E11.5, 3-mm diameter for E13.5, and 5 mm diameter for E14.5, Harvard Apparatus) was placed over the dorsal telencephalon above the uterine muscle, and four pulses (50 V for E11.5, 35 V for E13.5, and E14.5, 50-ms duration separated by 950-ms intervals) were applied with a BTX ECM830 square pulse generator (Harvard Apparatus). Following electroporation, the uterine horns were replaced into the abdomen, and the cavity was filled with warm 0.9% saline before suturing the abdominal muscle and skin separately. Dams were then placed into a clean cage for recovery and monitoring. These procedures were reviewed and approved by the Institutional Animal Care and Use Committee at Boston University School of Medicine.

For embryonic studies, the heads of electroporated embryos were harvested 24 hours after IUE, fixed overnight in 4% paraformaldehyde (PFA), and cryoprotected in 30% sucrose for 24 to 48 hours, or the brains were removed and cut into 60-m vibratome sections for morphometric analysis. Cryoprotected tissue was frozen in OCT compound in tissue molds with an ethanol/dry ice bath. Frozen tissue was cut into 20 m sections using an HM560 Cryostar cryostat and mounted and dried on to superfrost slides (Thermo Fisher Scientific). For all IUE studies, we used n = 4 brains. Before immunostaining, antigen retrieval was performed by microwaving sections in sodium citrate buffer [10 mM (pH 6)] at 800 W for 1 min followed by 80 W for 10 min. Sections were then blocked in diluent [5% goat serum, 0.3% Triton X-100, 1 phosphate-buffered saline (PBS)] for 1 hour at room temperature. Incubation with primary antibodies, anti-Sox2 (1:200; Santa Cruz), or anti-Tbr2 (1:250; Abcam), or anti-PH3 (1:300; Millipore) was performed overnight at 4C. Following three 5-min washes in PBS, sections were incubated for 2 hours at room temperature in diluent containing the appropriate secondary antibodies (1:250 for all). Sections were washed an additional three times for 5 min and mounted with Vectashield mounting medium containing 4,6-diamidino-2-phenylindole (DAPI). Then, 40 Z-stack images (15 m for cryosections, 20 m for vibratome sections) were acquired using an upright Zeiss LSM 710 microscope at a minimum of 1024 1024 resolution, and positive cells were identified and counted using LSM image browser software. Counts for each experiment were then averaged.

In situ hybridization for mRNA expression in the fixed-frozen mouse and human tissues was performed using RNAscope Multiplex Fluorescent Reagent Kit V2 (catalog no. 323100, Advanced Cell Diagnostics Inc., Hayward, CA) according to the manufacturers instructions. The commercially available human and mouse RNA probes were as follows: Hs-Eomes-C2 (429691-C2), Hs-Sox2 (400871), Mm-NeuroD4-O1-C2 (564191-C2), and Mm-Eomes-C2 (19078C), all from Advanced Cell Diagnostics Inc. The human probe Hs-NeuroD4-No-XMmRn (584701) was custom designed based on the NM_021191.3 cDNA sequence, targeting the region of 3180 to 3927 base pairs (bp) that does not overlap with other NeuroD genes.

Briefly, after pretreating of the section with hydrogen peroxide, followed by antigen retrieval (solution of 1 target retrieval, at 800 W for 1 min followed by 80 W for 10 min) and protease 3 pretreatment, the probes were incubated with the brain slices and the fluorescent dye for each detection channel was assigned as recommended. The signal was amplified using the multiplex reagents following the instructions.

The integrity of the RNA was confirmed in each tissue section using the RNAscope 3-plex Positive Control Probe for housekeeping gene expression (catalog no. 320861 for human tissue and catalog no. 320881 for mouse tissue). To confirm signal specificity, RNAscope 3-plex Negative Control Probe (catalog no. 320871 for human and mouse tissues) was used. After the final amplification, the slides were treated with Hoechst 33342 (catalog no. H3570, Invitrogen, Carlsbad, CA) for 10 min and sealed with coverslips using ProLong Gold Antifade Reagent (catalog no. P36930, Invitrogen, Carlsbad, CA).

Z-stack 20 images (16 m) were captured using a Zeiss LSM 710 microscope. Positive cells were identified and counted (four to five sections; N = 1 human brain) by two independent investigators using the LSM image browser software. The percentage of Eomes-, NeuroD4-, and Sox2-positive/double positive cells was assessed by normalizing the number to the total number of cells as marked by Hoechst nuclei staining. The laminar distribution analysis was performed using LSM image browser and Volocity software, and the results were plotted graphically using Sigma-Aldrich plot.

DEX analysis was conducted using Seurat function FindAllMarkers. Briefly, we took one group of cells and compared it with the rest of the cells using a Wilcoxon rank sum test. For any given comparison, we only considered genes that were expressed by at least 25% of cells in either population. Genes that exhibit Bonferroni-corrected P values under 0.01 were considered statistically significant.

To identify state-specific genes in mRGCs or mIPCs, we conducted principal graph test with nearest neighbor (k) parameter set to 10 (40). Genes expressed by more than 10% of cells in the state of interest and Morans I greater than 0.1 were considered as state specific. To generate gene expression heatmap over pseudotime, we used the plot_pseudotime_heatmap function from Monocle 3 Alpha with top 10 state-specific genes as input. A natural spline model was used to describe gene expression as a function of pseudotime, with degree of freedom set to 2.

Acknowledgments: We thank the Boston University Microarray and Sequencing Core Facility for help with the scRNA sequencing. Funding: This work was supported by the following PHS grants: R01 NS095654 (T.F.H. and N.S.), R21 NS089340 (T.F.H.), and P50 MH106934, RO1 MH110926, and UO1 MH116488 (N.S.). M.O. was supported by the Japan Society for the Promotion of Science (JSPS) Postdoctoral Fellowship for Research Abroad and the Kanae Foundation. G.S.B. was supported by the la Caixa Foundation (ID 100010434). Fellowship code was LCF/BQ/PI19/11690010. Author contributions: Z.L. contributed to the conceptualization, data curation, formal analysis, methodology, development of manuscript figures, writing of the original draft, and writing and editing of the manuscript. W.A.T. contributed to the conceptualization, data curation, formal analysis, methodology, development of manuscript figures, writing of the original draft, and writing and editing of the manuscript. E.Z. contributed to the data curation, formal analysis, development of manuscript figures, and editing of the manuscript. G.S.B. contributed to the formal analysis and data curation. M.O. contributed to the data curation, formal analysis, methodology, and development of manuscript figures and editing of the manuscript. T.G. and M.L. contributed to the formal analysis and data curation. N.S. contributed to the funding acquisition, project administration, supervision of Z.L., G.S.B., T.G., and M.L., and review and editing of the manuscript. T.F.H. contributed to the conceptualization, formal analysis, investigation, methodology, project administration, supervision of W.A.T., E.Z., and M.O., validation, visualization, writing of the original draft, and manuscript review and editing. Competing interests: The authors declare that they have no competing interests. Data and materials availability: All data needed to evaluate the conclusions in the paper are present in the paper and/or the Supplementary Materials. Sequences have been deposited to NCBI GEO GSE143949. Additional data related to this paper may be requested from the authors.

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Transcriptional priming as a conserved mechanism of lineage diversification in the developing mouse and human neocortex - Science Advances

City of Hope Doctors Present New Research on Bone Marrow Transplants, Immunotherapy and Other Blood Cancer Treatments – Business Wire

DUARTE, Calif.--(BUSINESS WIRE)--City of Hope announced today that it will present data on new findings on bone marrow transplants, immunotherapies and other blood cancer treatments at ASH 62nd Annual Meeting and Exposition on Dec. 5 to 8, a virtual event.

City of Hope is addressing some of the hardest-to-treat cancers by accelerating innovative clinical research approaches. The comprehensive cancer center was a pioneer in bone marrow and stem cell transplants and the transplantation program is now one of the largest and most successful programs of its kind in the U.S. For the 15th year in a row, the Center for International Blood & Marrow Transplant Research has ranked City of Hope as providing exceptional care and strong clinical outcomes for patients who received bone or stem cell transplants; it is the only cancer center to hold this distinction.

During the ASH virtual conference, City of Hope researchers will make presentations on the following and other data:

Title: Efficacy of Post-Transplant Cyclophosphamide as Graft-Versus-Host Disease Prophylaxis After Peripheral Blood Stem Cell HLA-Mismatched Unrelated Donor Hematopoietic Cell Transplantation; A Prospective Pilot Trial

Publication Number: 298

Type: Oral

Session Name: 732. Clinical Allogeneic Transplantation Results III

Session Date and Time: Saturday, Dec. 5, 2020, 2 to 3:30 p.m. ET

Presentation Time: 2:30 p.m.

Presenter: Monzr M. Al Malki, M.D., City of Hope Director of Unrelated Donor BMT Program and Haploidentical Transplant Program, Assistant Clinical Professor, Department of Hematology & Hematopoietic Cell Transplantation

Title: Consolidation With Nivolumab and Brentuximab Vedotin After Autologous Hematopoietic Cell Transplantation in Patients With High-Risk Hodgkin Lymphoma

Publication Number: 472

Type: Oral

Session Name: 624. Hodgkin Lymphoma and T/NK Cell LymphomaClinical Studies: Clinical Studies in Hodgkin Lymphoma Session Date and Time: Sunday, Dec. 6, 2020, 2 to 3:30 p.m. ET

Presentation Time: 2:30 p.m.

Presenter: Alex Herrera, M.D., City of Hope Assistant Professor, Department of Hematology & Hematopoietic Cell Transplantation

Title: Total Marrow and Lymphoid Irradiation (TMLI) at a Dose of 2000cGy in Combination With Post-Transplant Cyclophosphamide (PTCy)-Based Graft Versus Host Disease (GvHD) Prophylaxis Is Safe and Associated With Favorable GvHD-Free/Relapse-Free Survival at 1 Year in Patients With Acute Myeloid Leukemia (AML)

Publication Number: 192

Type: Oral

Session Name: 721. Clinical Allogeneic Transplantation: Conditioning Regimens, Engraftment and Acute Transplant Toxicities

Session Date and Time: Saturday, Dec. 5, 2020, Noon to 1:30 p.m. ET

Presentation Time: 12:45 p.m.

Presenter: Anthony S. Stein, M.D., City of Hope Associate Director, Gehr Family Center for Leukemia Research; Clinical Professor, Department of Hematology & Hematopoietic Cell Transplantation

Title: A Multi-Center Biologic Assignment Trial Comparing Reduced Intensity Allogeneic Hematopoietic Cell Transplantation to Hypomethylating Therapy or Best Supportive Care in Patients Aged 50-75 with Advanced Myelodysplastic Syndrome: Blood and Marrow Transplant Clinical Trials Network Study 1102

Publication Number: 75

Type: Oral

Session Name: 732. Clinical Allogeneic Transplantation: Results I

Session Date and Time: Saturday, Dec. 5, 2020, 7:30 to 9 a.m. ET

Presentation Time: 7:30 a.m.

Study Co-chair: Ryotaro Nakamura, M.D., City of Hope Director, Center for Stem Cell Transplantation; Professor, Department of Hematology & Hematopoietic Cell Transplantation

About City of Hope

City of Hope is an independent biomedical research and treatment center for cancer, diabetes and other life-threatening diseases. Founded in 1913, City of Hope is a leader in bone marrow transplantation and immunotherapy such as CAR T cell therapy. City of Hopes translational research and personalized treatment protocols advance care throughout the world. Human synthetic insulin and numerous breakthrough cancer drugs are based on technology developed at the institution. A National Cancer Institute-designated comprehensive cancer center and a founding member of the National Comprehensive Cancer Network, City of Hope has been ranked among the nations Best Hospitals in cancer by U.S. News & World Report for 14 consecutive years. Its main campus is located near Los Angeles, with additional locations throughout Southern California. For more information about City of Hope, follow us on Facebook, Twitter, YouTube or Instagram.

Original post:
City of Hope Doctors Present New Research on Bone Marrow Transplants, Immunotherapy and Other Blood Cancer Treatments - Business Wire

Critically ill Indonesian woman thanks Taiwan for saving life – Taiwan News

Indonesian caregiver thanks Taiwan for life-saving stem cell transplant

By Central News Agency

2020/11/06 10:40

Nina Herlina (right) and her 5-year-old younger sister. Nina Herlina (right) and her 5-year-old younger sister. (CNA photo)

Taipei, Nov. 5 (CNA) An Indonesian migrant worker who received a stem cell transplant in Taiwan in June thanked the nation on Thursday for expediting her treatment by lifting travel restrictions for her family amid COVID-19 thereby facilitating the operation that saved her life.

At a press conference that day to celebrate being discharged from the hospital, 23-year-old Nina Herlina thanked Taiwan for giving her a new lease of life and said her treatment was a testament to Taiwan's healthcare capabilities. In November last year, Nina began suffering from bouts of menorrhagia that lasted for about 20 days and came with symptoms that included dizziness, tiredness, and fever.

In February, she turned to the Taiwan International Workers' Association (TIWA), a local NGO that promotes migrant workers' rights when she was fired, shortly after a doctor diagnosed her as suffering from aplastic anemia, an autoimmune disease in which the bone marrow stops making new blood cells. With the help of the TIWA, the young woman was allowed to remain in Taiwan, where she had worked as a caregiver since October 2018.

In March, she was confirmed as having severe aplastic anemia, requiring an allogeneic stem cell transplant to treat the disease, according to the TIWA. However, at that time the COVID-19 pandemic was worsening and Nina's family were in rural Indonesia and local medical institutions lacked the technology and techniques to identify a donor in time for a bone marrow transplant.

At that time she was being kept alive in Taiwan by weekly blood transfusions. However, frequent blood transfusions can have a detrimental effect on the success of a transplant.

In addition, she also had leukopenia, a condition when a person has a reduced number of white blood cells, which increases the risk of infection. As a result, doctors at Taipei Veterans General Hospital (TVGH) determined the patient was in urgent need of a transplant, according to TIWA.

With the assistance of TIWA, a TVGH medical team explained the condition to Herlina and her family members in Indonesia via video calls. Doctors said the healthy cells for the transplant should ideally come from a family member, making her two younger sisters, aged 5 and 14, the best candidates for the operation, TIWA said.

Based on humanitarian considerations, the Central Epidemic Command Center decided in June to lift travel restrictions for her mother and sisters to visit Taiwan.

After undergoing special blood tests arranged by TVGH, the 5-year-old sister was identified as a suitable donor for a transplant. The operation was carried out after the three family members completed their 21-day quarantine in Taiwan and provided two consecutive negative COVID-19 test results.

After having received medical treatment in Taiwan for nine months, Nina was discharged from the hospital Thursday, after doctors confirmed she had recovered from the life-threatening illness.

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Critically ill Indonesian woman thanks Taiwan for saving life - Taiwan News

Daily Edition for Wednesday, November 4, 2020 – California Healthline

Latest From California Healthline:

A Biden Win and Republican Senate Might Lead to Gridlock on Health Issues

If Democrat Joe Biden is successful in his bid for the presidency but the Senate remains in GOP control, Democrats plans for major changes in health care may be curbed. The federal role in those policies is at stake as is Californias ambitious health care agenda. (Julie Rovner, 11/3)

Los Angeles Times: Prop. 23, Which Would Have Imposed New Regulations On Dialysis Industry, Fails A $100-million effort to impose new regulations on the dialysis industry was defeated Tuesday. Proposition 23 would have required dialysis clinics to employ at least one doctor who would be on site whenever patients are receiving treatment. Supporters of the measure, including the Service Employees International Union-United Healthcare Workers West, said dialysis clinics were putting profits over patient care by not having a doctor available in the event of complications or an emergency. (Gutierrez, 11/3)

San Francisco Chronicle: Prop. 23: California Measure To Stiffen Regulations At Dialysis Clinics Fails California voters have rejected Proposition 23, a ballot initiative that would have created new safety regulations for kidney dialysis clinics that serve 80,000 patients. The initiative sought to require that clinics always have a doctor on site during treatments, which patients with kidney failure must receive routinely to stay alive. Prop. 23 was behind by a wide margin in unofficial returns, with a simple majority needed for passage. (Gardiner, 11/3)

Los Angeles Times: Prop. 14 Leading In Early Results On Stem Cell Bond A ballot measure to authorize $5.5 billion in new funding for stem cell research was leading in early returns Tuesday. Proposition 14 asked voters to approve an infusion of cash for the California Institute for Regenerative Medicine, known as CIRM, for stem cell studies and trials. California voters created CIRM in 2004 after approving a bond measure that year for $3 billion. CIRM used that bond money for research grants, new laboratories and training programs, but unallocated funds ran out last year, prompting supporters of the agency to return to taxpayers for additional money. (Gutierrez, 11/3)

Los Angeles Times: A Close Race On Proposition 15 To Loosen Californias Business Property Tax Rules The fate of Proposition 15, an effort to remove high-value business properties from the low-tax protections enacted by California voters more than four decades ago, was unclear in early election returns Tuesday, after an expensive and fierce campaign over how much to spend on government services and the economic effects of raising taxes. The ballot measure was opposed by a razor-thin majority with more than 9.5 million ballots counted, a shortfall that was far from certain with millions of votes left to count. (Myers, 11/3)

Los Angeles Times: California Voters Approve Prop. 22, Allowing Uber And Lyft Drivers To Remain Independent Contractors Californians sided with the $200-million Proposition 22 campaign led by Uber and Lyft, voting to pass the measure and grant ride-hail and delivery companies an exemption from California employment law to continue treating workers as independent contractors. The fight was one of the most closely watched ballot measure contests in the country and the costliest in state history. A win for the app-based companies has the potential to create a new campaign paradigm, with companies sidestepping government and spending large sums of money to sway voters with traditional advertisements and more unconventional direct marketing to customers. The measures passage also deals a blow to Californias powerful labor unions, underdogs in the race with far fewer financial resources than their foes. (Luna, 11/3)

Los Angeles Times: Californians Once Again Reject Bid To Expand Rent Control In The State The failure of Proposition 21 means that, once again, landlord groups have convinced voters that stricter limits on rent hikes are not a solution to Californias housing affordability problems. A statewide ban on most new forms of rent control will remain in effect. Yet again, California voters clearly understood the negative impacts Prop. 21 would have had on the availability of affordable housing in our state by clearly rejecting this radical ballot measure, said Tom Bannon, chief executive of the California Apartment Assn., in a statement. It is now time to move from ballot-box battles and enact policies through the Legislature that allow the state to build more affordable housing that will once again make California an affordable place to live for our families. (Dillon, 11/3)

Santa Rosa Press Democrat: Measure O: Sonoma County Voters Backing Tax Measure For Mental Health, Homeless Services Voters early Wednesday were supporting a ballot measure that would raise sales taxes in Sonoma County to boost local spending on mental health and homelessness services by $25 million annually. (Silvy, 11/4)

AP VoteCast: California Voters Sour On State Of Nation Voters in California made their pick for president while holding negative views about the countrys direction, according to an expansive AP survey of the American electorate. The race between President Donald Trump and Democratic rival Joe Biden concluded Tuesday as the nation remains in the throes of a global public health crisis and mired in the economic downturn it brought on. AP VoteCast found that almost three-fourths of California voters said the U.S. is headed in the wrong direction and about a quarter of voters said it is on the right track. (Keller, 11/4)

AP: California Chooses Biden, State GOP Hoping For US House Wins California delivered a strong rebuke to Donald Trumps presidency on Tuesday as Democrat Joe Biden ran up the score in the liberal state with a victory of 4 million votes in an election upended by the coronavirus pandemic. Bidens supersized victory didnt derail the state GOPs hopes of clawing back some of the seven U.S. House seats he party lost two years ago. Republican candidates had narrow leads over two Democratic incumbents in Orange County while another GOP incumbent clung to a small lead in the Central Valley. (Beam, 11/4)

AP: Some California Legislative Incumbents Fighting To Survive California Democrats were hoping to expand their supermajorities in the state Legislature as votes were tallied Tuesday. Several Republican incumbents in the 80-member Assembly and 40-member Senate were in danger of defeat. And with Californias top-two balloting, voters in some cases set up contests within the same political party by advancing the two highest vote-getters from the March primary election. Several in Orange County, the greater Los Angeles area and in the San Francisco Bay Area face challengers and have drawn high spending from interest groups. (Thompson, 11/4)

Bay Area News Group: Californias COVID-19 Cases Continue To Rise COVID-19 cases are continuing to climb, furthering a pattern thats trending in the wrong direction following two months where the numbers were stagnant. The seven-day average for the state increased for the second straight day, from about 4,162 cases per day through Sunday to 4,306 on Monday. It had decreased for four straight days following an eight-day stretch in which the number went up each day. The seven-day average no longer reflects the artificial increase of 6,300 backlogged tests in Los Angeles that were added in late October. (Hurd, 11/3)

Modesto Bee: Announcement Delayed For States Coronavirus Tier System. Stanislaus Cutting It Close Citing Tuesdays national election, California health officials postponed an update on coronavirus tier assignments until Wednesday. The weekly updates assigning counties to different levels of COVID-19 restrictions are usually released on Tuesdays. Dr. Julie Vaishampayan, health officer for Stanislaus County, told the Board of Supervisors the countys daily case rate was right at the key metric of 7 per 100,000 population. The county needs to stay below that limit to meet criteria for the red tier, which places lighter restrictions on restaurants, retail shopping areas, fitness centers and worship services. (Carlson, 11/3)

Sacramento Bee: 11 Dead Of COVID-19 At Woodland Skilled Nursing Home A skilled nursing facility in Northern California has been ravaged by two separate coronavirus outbreaks, with at least 11 residents dead and dozens still sick. Nearly 100 combined residents and staff at Alderson Convalescent Hospital in Woodland have tested positive for COVID-19 in two waves of infection occurring three months apart, according to Yolo County health officials. In early July, 17 residents and 10 staff members at the 140-bed facility contracted the respiratory disease, and three of the residents died, Yolo officials said. (McGough, 11/3)

Fresno Bee: If Fresno-Area COVID-19 Cases Spike Again, These Local Schools Could Still Reopen Classrooms Fresno County has remained in the red-tier according to Californias color-coded Blueprint for a Safer Economy, meaning schools can start to re-open. Many schools continue to apply for re-opening waivers as a safety measure if the area falls back into the most restrictive purple tier. A 14-day rolling average shows the county continues to report an average of at least 100 new coronavirus cases per day. Health professionals are also concerned with rising COVID-19 cases as winter approaches in lockstep with cold and flu season. (Dieppa, 11/3)

The Bakersfield Californian: Housing Project For Homeless Women, Children Slated For Panorama Bluffs Draws Opposition From Neighbors Plans to convert a single-family home overlooking the bluffs of northeast Bakersfield into a transitional residence for homeless women and children has drawn opposition from neighbors but received an endorsement from the city's planning department last week to proceed.(Shepard, 11/2)

The Bakersfield Californian: Please Don't Burn Wood At Home, Air Officials Beseech Residents In 'Worst Wildfire Season' "To protect the health of their families and their neighbors, we encourage residents to not burn wood this winter and instead choose to upgrade to natural gas devices through our grant program," he said. (Mayer, 11/3)

San Francisco Chronicle: One Bay Area Hospital Is Prepping For A Rise In Heart Attacks Caused By Election Stress Regional Medical Center in San Jose put extra staff on call Tuesday to handle what doctors believe could be a 15% increase in patients experiencing an array of cardiac issues caused by the stress of election day. These kind of stresses cause a well-documented increase in cardiovascular events, said Dr. Paul Silka, director of the emergency room at Regional Medical Center of San Jose. The 45-bed emergency room usually sees 185 patients a day. Because of the election, Silka expects that to go up to 210 patients or so. (Rubenstein, 11/3)

Becker's: California Health System To Lay Off 31 Workers NorthBay Healthcarewill lay off31 full-time workers as part of its pandemic recovery plan, the system said Nov. 2.The Fairfield, Calif.-based nonprofit health system said it needs to adjust operations to fit a new healthcare reality brought by the COVID-19 pandemic.(11/3)

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Daily Edition for Wednesday, November 4, 2020 - California Healthline

‘We’re truly blood brothers’ – Stanford coach David Shaw and his recent fight to save his brother, Eric – ESPN

David Shaw walks into the hospital room and takes a seat next to the bed. He does this nearly every day, right around lunchtime.

He looks at his younger brother, Eric, tubes snaking across his arms, machines beeping and whirring. Eric does not look like Eric anymore, his skin darkened, scars deepened, features altered. They both know this but never mention it.

They talk about movies, or random memories from their childhood when they were often inseparable, riding bikes, playing video games and challenging each other to one-on-one basketball. They avoid talking about why David comes as often as he does to visit, though they know the reason.

Eric is dying, a rare, aggressive skin cancer rampaging through his body with such ferocity that his doctors are nearly out of options. Radiation failed. Chemotherapy failed. Two bone marrow transplants failed.

As Stanford's head football coach, David Shaw is relied on to always know what to say, how to say it and when to say it; but he cannot find the words now that he and his brother are staring down what seems to be an inevitable fate.

"What do you say, where you think you've pulled at the last thread and there are no more threads?" David said. "All I could tell him was that I loved him and that I was there for him. The rest of it was really just ... I thought it was only a matter of time before he passed away."

Two years later, what happened between David and Eric remains real, present and raw -- changing their entire relationship, redefining what it means to be a brother. The words are still difficult to say, so they tip-toe around the crushing physical and mental toll Eric's cancer took on them.

David and Eric are sure to think about it all this weekend, when Stanford opens its season at Oregon on Saturday. Because the last time the Cardinal visited Eugene, neither one knew whether Eric would live or die.

After Stanford came from behind to win that game 38-31 in overtime, David delivered a message at the end of his postgame television interview, looking at the camera and saying, "To my brother Eric: I love you." He tapped the lime green pin on his black Stanford sweatshirt before he left the screen.

When Shaw became head coach at Stanford in 2011, it was the culmination of a family journey. His father was a longtime coach there; David played receiver for the Cardinal and eventually returned as an assistant under Jim Harbaugh. The entire Shaw family -- parents Willie and Gay, along with David, Eric and their sister, Tawnya -- all call the Bay Area home.

To this day, David says the day he was introduced as coach was "one of the better days in all our lives."

Yet something started to happen to Eric that no one could quite figure out. That same year, Eric found strange looking spots on his torso. His wife, Crystal, noticed the first one under his arm. Maybe it was eczema, they thought. Then the spots started to spread. He went to the doctor. They prescribed an ointment, but the spots kept popping up, until they covered his entire body. Eventually, tumors started to grow. It looked as if someone had pushed marbles under his skin. Doctors remained confounded. Eric itched uncontrollably, insatiably. His skin itched so badly, it became difficult to put on clothes, shower, sleep and go to work. He eventually needed sleep medication so he could get uninterrupted rest.

Even then, he itched subconsciously, only realizing what happened when he woke up in the morning to find his arms and sheets covered in blood. Some nights, he tried to sleep on his forearms so his body wouldn't touch the sheets, because his skin grew too sensitive to any touch. At one point, he had more than 30 open wounds on his body.

"It's something that's so pervasive and so destructive that a lot of people have mental problems -- you can't do anything without extreme pain," Eric said. "You bleed a lot through the tumors, through the lesions, through the scratching. A lot of people don't survive, really, because of the mental stress that comes with it."

Doctors had a hard time diagnosing his disease because it is often confused with psoriasis, eczema or other skin conditions. Eventually, they determined he had a rare form of skin cancer called mycosis fungoides, a type of T-cell lymphoma that affects one in 6 million people in the United States and Europe. At the time, Eric Shaw was 38.

In 2013, he and Crystal pushed for a referral to Stanford Cancer Center, which has leading experts in the disease. Mycosis fungoides is so rare, it accounts for only 4% of all non-Hodgkin lymphoma cases; among those who suffer from it, only 20% have the type of itching Eric experienced. Rarer still is to find it in people under the age of 40, and African American men often end up with the worst prognosis. All the odds were firmly against him.

"When you first hear skin cancer, your mind doesn't go too far," David said. "So initially I was like, 'There are creams and other minor surgeries. I think it'll be OK.' And then Eric said, 'No, this is not the typical skin cancer. This is inside my body. This is inside the layers of my skin, and it's not one spot. It's everywhere.'

"I didn't really get it for weeks after that because, rectifying something that I didn't think was so serious to [then thinking] ... 'Oh my gosh. So this is really cancer. This is really scary now.' It took a long time for that to sink in."

David turned it over in his mind. He was the big brother, the protector, the one who always made sure Eric would be OK. They were supposed to raise their kids together, grow old together, and reminisce about the randomness of a life spent together.

He kept coming back to one thought: You're not supposed to lose your little brother.

David and Eric Shaw grew particularly close as children as they moved from place to place when their father, Willie, took new coaching jobs. Tawnya, their older sister, fit in anywhere socially. But David and Eric, who is two years younger, stuck together.

"Like a pair," David said.

They loved riding their bikes and, when they moved to Arizona, they took advantage of the wide-open spaces in the new development where they lived. They rode for miles and miles, setting up their own ramps and doing tricks and wheelies, visiting friends along the way before returning home after dark. They played sports, too, and though David loved football as much as their dad, the basketball court is where the brothers had their epic battles.

"I was always kind of a little bit stronger and I'll never forget the last time we played one-on-one basketball," David said. "He just got better than me, and he won, and once I got over the anger and disappointment, I was proud because my younger brother had grown and was gaining confidence."

Said Eric: "I wanted nothing more than to beat him, and he wanted nothing more than to keep beating me. But, during those times, it was just us, it was me and him. He was my best friend."

David went on to play at Stanford and eventually got into coaching, against his mother's best wishes. Eric did not pursue a career in athletics. He went to San Diego State and got into a career in marketing at a financial services company, where his gregarious nature, big smile and easy laugh made him a perfect fit. Though their personalities are different -- David is stoic and introspective, Eric makes anyone feel as if they have been friends forever -- they are grounded in the same values they learned at a young age: family and faith above everything else.

Those principles only grew stronger after they found themselves in the Bay Area as adults.

After David was hired by Stanford, the entire Shaw family made it clear it would always be around to support him. Family members all have a standing invitation to come for dinner on Tuesdays. And they always attend home football games, waving and hugging David during the team's pregame walk, cheering from the stands, and then waiting for some time together once the game ends.

Even as Eric grew sick, he made it a point to go cheer for his big brother. "It's not just the football game. Our family comes together," he said. "We celebrate, we come to watch the game and cheer the team on and support David. And then afterwards, win or lose, we all wait for him to come out. It's a family day. It's been wonderful to share that experience with David."

Stanford eventually drew them even closer, and it had nothing to do with football.

Eric did not understand the gravity of his situation until his first meeting in 2013 with the doctors at Stanford Cancer Center. They put it bluntly: He had such an aggressive form of the disease that he needed immediate treatment. They would start with total skin radiation, preparing Eric to lose his hair, eyebrows, eyelashes, fingernails and toenails.

If that did not work, they would try chemotherapy next.

"All these thoughts are running through your mind," Crystal said. "'Is he going to make it? Is it going to work? What's going to happen?' At the time, our youngest daughter was 3 months old, so it was pretty overwhelming. We were just putting our lives together and then boom: you're in the middle of this cancer war."

The next week, Eric took a leave of absence from work and began four-times-a-week trips from their home east of Palo Alto, California, to Stanford Hospital, often driving as many as three hours one way in traffic. When he arrived, he went into a box and his whole body was exposed to the radiation light for about an hour. Then, he would make the drive back home to see Crystal and their four kids -- Caleb Michael, Jared Spann-Shaw, Madison Shaw and Olivia Shaw.

The radiation charred his skin. He lost weight. When he looked in the mirror, Eric no longer recognized the man looking back at him.

"Nothing prepares you for something like this," he said. "Knowing that other people were looking at me and knowing that something was very wrong, that was a daily grind to get myself up out of bed and get ready for the day, knowing that that was going to be my life."

He did this for three straight months, all to keep the disease from growing to a point where it would kill him. It worked for a short time, but the disease came back more aggressively six months later. Doctors moved on to chemotherapy treatments, some of them experimental, but also began discussing the last-resort option: a bone marrow transplant.

David and Tawnya immediately volunteered to become donors, and underwent testing. In most cases, siblings are the best chance at a donor match. Unfortunately, in their case, neither was close. On a 10-point match scale, Tawnya registered a 3, David a 5. Neither qualified to donate.

"I wanted to jump to the front of the line and say, 'Whatever I have to do, whatever you have to take out of me, however you have to do it, just do it,'" David said. "For them to come back and say that you're not a strong enough match was disheartening. It hurt me. The fact that we had to put our trust and faith in people that we didn't know, and that we're going to have to go out to registries and try to find someone who was a better match than I was, that uncertainty, and that doubt, it's hard to keep it at bay at that point. It starts to creep in."

In late 2017, the disease came back so strong, doctors determined Eric needed the long-discussed bone marrow transplant. Finding a suitable match was exceedingly difficult: Only 4% of donors on the bone marrow registry are African American, resulting in only a 16% chance to find a match.

Doctors eventually found two donors whom they believed could work, but they were not perfect matches. In early 2018, Eric and his family moved into a two-bedroom apartment near Stanford Hospital to prepare for the transplant. For three months, he went through radiation, then chemotherapy to prepare his body to accept the donor cells.

He underwent the transplant in April, feeling confident and inspired it would work. After a month, doctors did an initial check to see how many of the donor cells had survived the transplant.

None survived.

"It was like I never even had the transplant," Eric said. "That was so devastating. We just knew it was going to work. I mean, we're people of faith, and we knew everybody was praying for us, and that we were praying that this six-year journey was going to finally be over. And it wasn't over. It was crushing for them to say, 'It didn't work. We're going to have to try again.'"

The second attempt happened in September. Crystal bought lime green pins for the family to wear for lymphoma awareness. Without telling Eric or Crystal, David decided he would wear his on his shirt for the 2018 football season. In addition to that, he had lime green and yellow ribbons placed on the back of Stanford helmets as a way to show support for both cancer patients and cancer survivors.

He told his team that his brother was fighting cancer, and briefly mentioned the helmet ribbons publicly during an early-season news conference. But beyond that, David kept the severity of what was happening to his brother to himself, masking his growing nervousness, fear and anxiety as the clock ticked toward the next transplant. He had a hard time processing what was happening. He did not want to put that at the feet of his players, or his staff.

The doctors used the same donor cells that failed the first time for the second transplant on Sept. 11, 2018, because that was the only option available. But this time, doctors used even stronger drugs to prepare Eric's body to receive the donor cells -- hoping that would do enough to stop his immune system from attacking them.

When Stanford played Oregon on Sept. 22, no one in the Shaw family knew whether the transplant had worked. But the situation was more dire than the first transplant. The stronger chemotherapy caused major complications, and Eric became severely ill.

David coached the game with this in the back of his mind. Stanford rallied from a 21-7 deficit to win an overtime thriller, moving to 4-0 on the season, with a top-10 matchup against Notre Dame the following week. Back in Palo Alto, Eric watched the entire game alone in an apartment he rented near the hospital, the comeback buoying his spirits.

He had no idea his brother would speak to him through the television until he heard the words, "To my brother Eric ..."

"In that moment, I didn't feel any sickness at all," Eric said. "I can't really describe what I felt, just how proud I am of him and how awesome it made me feel that he would do that for me."

Said David: "If that transplant didn't work, I didn't know how many more games he was going to be able to see. That was an opportunity for me on national TV to speak to him, to say to my brother that against the odds, we came back and throughout the entire game, I was thinking about him."

Eric soon returned to Stanford Hospital. The chemotherapy destroyed his blood system, so he needed daily blood transfusions to stay alive. It came as no surprise when doctors told him the second transplant had failed. They had no plan now, no other donor options. David came by to visit as often as he could, but he had a hard time finding the words to say to his dying brother.

"I thought about Crystal. I thought about their kids," Shaw said. "I thought about, 'How can we help?' And then I kept going, 'We just can't get there. There has to be something else.' And we all prayed and we all comforted each other and trusted the doctors and prayed for the doctors. And just kept saying, 'Just tell us whatever options there are. Just tell us what to do and we'll do it.'"

During the day, Eric had his mother, Crystal, David, or David's wife, Kori, at his side, helping to keep his mind off what was happening to him. But in the evenings, when he was alone in his hospital room, he couldn't help but think about the dwindling medical options and his own death, slowly accepting what he believed would inevitably come.

Over seven years, everything the doctors tried had failed, and the disease always came back more aggressively. He felt exhausted in every possible way, desperate to feel better. He didn't want to die. All he wanted to do was get better, and see his kids again, hug his wife and go home. But that possibility seemed as far off as the stars.

"The doctors couldn't help us," Eric said. "They had lost all hope. There was nothing left, but we were in the deepest part of the valley, and there was nobody there but God. I said, 'You're going to take me off this Earth.' And he told me, 'Eric, you're not going to die.' That was the point at which my faith really took over, and I really had true peace."

His team of doctors huddled together again and came up with a plan many of their colleagues questioned, simply because they had never attempted it. In mid-October of 2018, they told Eric they wanted to try a third transplant.

Only this time, they wanted David to be the donor and they had only weeks to make it happen.

Eric thought, "Are they trying to kill me?"

When David was initially rejected, doctors had worked for 25 years to find a way to do half-match transplants but had virtually no success. By 2018, doctors explained that a different way to do the transplant had emerged, opening up the potential to try it with Eric. These transplants, called haploidentical transplants, typically use donor cells from a family member.

Dr. Wen-Kai Weng, Eric's bone marrow transplant physician, explained, "It was relatively new at this time. We decided to go ahead, because we knew if we didn't do it, the disease would really come back with a vengeance."

No one had ever done a third transplant with donor cells at Stanford.

"If he didn't go for this risk, he wouldn't be here," said Dr. Youn Kim, who treated Eric and heads Stanford's multidisciplinary Cutaneous Lymphoma Clinic/Program. "He wouldn't be living."

Doctors told Shaw there was a 15% chance he would not survive the transplant itself. If he did survive it, there was only about a 30% to 40% chance the donor cells would work. Compared to much steeper survival odds with no transplant at all, the decision -- filled with multiple layers of danger -- did not feel risky at all.

They had to try.

"They might have told us what the odds were, and I honestly just pushed it out of my brain," David said. "If this is the Hail Mary, hey, we're going to drop back and throw it as far as we can and send prayers along with it and hope that it works."

Without hesitation, David said to his brother, "Tell me what I need to do."

Stanford gathered in its team hotel early on Oct. 27 to begin final preparations before hosting Washington State later that day. David checked in for a 9 a.m. meeting and when it finished, he checked out of the hotel without saying a word. He walked toward the back exit, careful to make sure no one saw him, and snuck out the door to a waiting car.

Shaw sat in the passenger seat, headed toward campus and Stanford Hospital, praying all the while that what he was about to do would work.

He arrived at the hospital and was hooked up to an IV for the first dose of medication. This would not be the more traditional bone marrow transplant, where cells are extracted with a needle through the hips. Rather, the medication flowing through the IV would stimulate his body to overproduce the stem cells needed for the transplant, flooding his blood with them. The cells would then be extracted from his blood, and transplanted into Eric.

Doctors told him to expect to start feeling joint pain and tiredness within 24 hours. Those symptoms would grow only stronger over the coming days, when he came in for more medication. They told him he should stay off his feet, rest and remain hydrated.

That would be nice, David thought. But he had a game to coach. Only two people inside the program knew he had gone that morning: assistant athletic director for football operations Callie Dale, who drove him to the hospital, and defensive coordinator Lance Anderson.

"The way that I do my job, I work really hard not to make it about me," David said. "Although I wanted my team to know what my family was going through, college football is about the student-athletes. I wanted them to focus on what they needed to do. I didn't want to pull from that. I didn't want to, all of a sudden, now make it about me and my family."

A few hours later, he returned to the team hotel and acted as if he had been there the entire day, speaking nothing about his trip to the hospital. Shaw put on his lime green pin and made his way toward the bus. The short ride to the stadium felt long that day. His mind wandered before returning to the flip card in front of him.

As he exited the bus and finished the walk to the stadium, his two young nieces ran up to him. They squeezed him, holding on longer than usual, as if they knew their Uncle David was their only option, too.

David started to feel pain in his knees and legs during the game, a heartbreaking 41-38 loss to the Cougars. That pain only intensified in the coming days as he continued to go in for daily treatments, driving himself on a golf cart from the football facility to the hospital without anyone knowing. It felt as if he had a 50-pound backpack strapped on at all times. He normally jogs from place to place during practice but found it difficult to walk because his legs, hips and shoulders hurt so badly.

He worried players would notice him moving around so slowly. If they did, no one said a word. Shaw kept pushing the pain aside, shoving his emotions down deep, saying prayers every chance he got.

On Wednesday, Shaw woke up and was so lethargic, he felt as if he was moving like a sloth. He went to the hospital for the final procedure: extracting the cells from his blood. Shaw wore comfortable clothes, arranged his pillows and settled in for a long day ahead. Doctors hooked him up to a machine that would do the work through two IVs: One took his blood so the needed donor cells could be siphoned out; the other IV would put the blood back in his body.

Eric rested on another floor in the same hospital.

David worked on his game plan, watched a few movies and occasionally stared at his own blood in the IVs, willing it to save his brother. He kept saying to himself over and over again, "God, I hope this works."

After eight hours, he was finished. Shaw then went out to practice.

"I remember walking up to him and just asking him, 'How are you doing, how are you feeling?'" Anderson said. "I could see it in him that he wasn't his normal self. He paused for a little bit and then he's like, 'I'm OK. A little bit tired, but I'm OK.' You know, just trying to put the most positive light that he could on it."

The next day, Nov. 1, 2018, Shaw went back to the hospital. It was transplant day, and he had to be with Eric to witness what they hoped would be a miracle. David and Crystal watched as Eric received a transfusion of David's stem cells, a shimmering light pink fluid flowing into his body. They sang and prayed. Already, they had received one small bit of good news: Doctors extracted 28 million cells from David's blood, about 20 million more than what they had hoped to get.

Stanford traveled the following day to Seattle, for a game against Washington. David felt guilty for leaving, but he knew there was nothing else he could do. Eric struggled in the hospital, not only from the transplant, but from the heavy chemo and radiation doctors used to prepare his body for the new cells.

Eric ran a fever of 105 degrees and vomited for days. The pain grew so intense he was put on a morphine drip and was in and out of consciousness. In Seattle, Shaw remembers being locked into the game, "except for those little moments where my heart was with my brother."

Stanford lost another heartbreaker, 27-23.

"I know us losing had nothing to do with everything David was going through," Dale said. "But just piling that on with everything else he was dealing with, it was a lot for him. He brought that up many times, about how Eric would tell him the biggest excitement for him every week was watching us play and watching us win. I know David had a lot of pressure on himself, amongst the pressure he already has as a head coach, to win for Eric. And I know that every time he did, he really felt like it was for him. And when we came up short, I know he was probably even harder on himself than he normally would have been."

Back at Stanford, David visited Eric when he could. But the waiting game took an increasing mental toll. David prides himself on his ability to compartmentalize, to focus on the only thing in front of him. He never spaces out, and he rarely gets emotional. But Shaw was falling apart on the inside.

He often found himself staring at cut-ups of red zone plays, not realizing the film had been paused for 20 minutes while his mind drifted off. Whenever that happened, he would stop and call someone, either his brother, his wife, his mother or Crystal just to see how they were doing.

"There were times where I thought life was slow motion, but it was actually moving and I was the one who was in slow motion," David said. "I found myself sometimes saying, 'Is this real? Is this really happening? This shouldn't happen.'"

In the middle of every single meeting, in the middle of every single film session, he silently prayed, "God help my brother. Just please let this one work."

"I look back now and I know more of everything that was going on and the situation," Anderson said. "I realized how much he was dealing with and how much he had to bear that week. And it's amazing that he was able to go through that week without really letting any of us really know exactly what he was going through and what a big deal this really was."

Within a few weeks, Eric started to turn a corner. Though they did not know whether the transplant had worked just yet, he showed enough improvement to leave the hospital after 52 days. David arrived for the big day, and Eric slowly put on a protective mask before shuffling to a waiting wheelchair. Doctors, nurses and support staff lined the hallway, clapping and cheering.

David cries when recalling that moment, his pent-up emotions flooding out as he describes it publicly for the first time.

"This is my little brother, after years of cancer, getting to leave the hospital," Shaw said, his voice quavering. He pauses to wipe tears from his eyes. "The nurses were crying. The doctors were crying. Because a few months earlier, they were preparing us for him to die. And he got to go home."

Three days later, doctors met with Eric and Crystal to deliver the results from the transplant. After only 27 days, Eric had none of his own blood coursing through his body.

It was all David's.

Eric picked up the phone.

"Dave," Eric said. "You have a twin. We're truly blood brothers."

See the article here:
'We're truly blood brothers' - Stanford coach David Shaw and his recent fight to save his brother, Eric - ESPN

‘We’re really blood brothers’ – Stanford coach David Shaw and his current battle to save lots of his brother, Eric – The Shepherd of the Hills Gazette

David Shaw walks into the hospital room and takes a seat next to the bed. He does this nearly every day, right around lunchtime.

He looks at his younger brother, Eric, tubes snaking across his arms, machines beeping and whirring. Eric does not look like Eric anymore, his skin darkened, scars deepened, features altered. They both know this but never mention it.

They talk about movies, or random memories from their childhood when they were often inseparable, riding bikes, playing video games and challenging each other to one-on-one basketball. They avoid talking about why David comes as often as he does to visit, though they know the reason.

Eric is dying, a rare, aggressive skin cancer rampaging through his body with such ferocity that his doctors are nearly out of options. Radiation failed. Chemotherapy failed. Two bone marrow transplants failed.

As Stanfords head football coach, David Shaw is relied on to always know what to say, how to say it and when to say it; but he cannot find the words now that he and his brother are staring down what seems to be an inevitable fate.

David Shaw and the Stanford Cardinal open their pandemic-delayed season Saturday, when they travel to face Pac-12 rival Oregon.John Todd/isiphotos.com

What do you say, where you think youve pulled at the last thread and there are no more threads? David said. All I could tell him was that I loved him and that I was there for him. The rest of it was really just I thought it was only a matter of time before he passed away.

Two years later, what happened between David and Eric remains real, present and raw changing their entire relationship, redefining what it means to be a brother. The words are still difficult to say, so they tip-toe around the crushing physical and mental toll Erics cancer took on them.

David and Eric are sure to think about it all this weekend, when Stanford opens its season at Oregon on Saturday. Because the last time the Cardinal visited Eugene, neither one knew whether Eric would live or die.

After Stanford came from behind to win that game 38-31 in overtime, David delivered a message at the end of his postgame television interview, looking at the camera and saying, To my brother Eric: I love you. He tapped the lime green pin on his black Stanford sweatshirt before he left the screen.

When Shaw became head coach at Stanford in 2011, it was the culmination of a family journey. His father was a longtime coach there; David played receiver for the Cardinal and eventually returned as an assistant under Jim Harbaugh. The entire Shaw family parents Willie and Gay, along with David, Eric and their sister, Tawnya all call the Bay Area home.

To this day, David says the day he was introduced as coach was one of the better days in all our lives.

Yet something started to happen to Eric that no one could quite figure out. That same year, Eric found strange looking spots on his torso. His wife, Crystal, noticed the first one under his arm. Maybe it was eczema, they thought. Then the spots started to spread. He went to the doctor. They prescribed an ointment, but the spots kept popping up, until they covered his entire body. Eventually, tumors started to grow. It looked as if someone had pushed marbles under his skin. Doctors remained confounded. Eric itched uncontrollably, insatiably. His skin itched so badly, it became difficult to put on clothes, shower, sleep and go to work. He eventually needed sleep medication so he could get uninterrupted rest.

It took several years before Eric Shaws illness was properly diagnosed as a rare form of skin cancer called mycosis fungoides. Early signs were spots all over his body, similar to psoriasis, before tumors began to form underneath his skin.Courtesy Shaw Family

Even then, he itched subconsciously, only realizing what happened when he woke up in the morning to find his arms and sheets covered in blood. Some nights, he tried to sleep on his forearms so his body wouldnt touch the sheets, because his skin grew too sensitive to any touch. At one point, he had more than 30 open wounds on his body.

Its something thats so pervasive and so destructive that a lot of people have mental problems you cant do anything without extreme pain, Eric said. You bleed a lot through the tumors, through the lesions, through the scratching. A lot of people dont survive, really, because of the mental stress that comes with it.

Doctors had a hard time diagnosing his disease because it is often confused with psoriasis, eczema or other skin conditions. Eventually, they determined he had a rare form of skin cancer called mycosis fungoides, a type of T-cell lymphoma that affects one in 6 million people in the United States and Europe. At the time, Eric Shaw was 38.

In 2013, he and Crystal pushed for a referral to Stanford Cancer Center, which has leading experts in the disease. Mycosis fungoides is so rare, it accounts for only 4% of all non-Hodgkin lymphoma cases; among those who suffer from it, only 20% have the type of itching Eric experienced. Rarer still is to find it in people under the age of 40, and African American men often end up with the worst prognosis. All the odds were firmly against him.

When you first hear skin cancer, your mind doesnt go too far, David said. So initially I was like, There are creams and other minor surgeries. I think itll be OK. And then Eric said, No, this is not the typical skin cancer. This is inside my body. This is inside the layers of my skin, and its not one spot. Its everywhere.

I didnt really get it for weeks after that because, rectifying something that I didnt think was so serious to [then thinking] Oh my gosh. So this is really cancer. This is really scary now. It took a long time for that to sink in.

David turned it over in his mind. He was the big brother, the protector, the one who always made sure Eric would be OK. They were supposed to raise their kids together, grow old together, and reminisce about the randomness of a life spent together.

He kept coming back to one thought: Youre not supposed to lose your little brother.

David and Eric Shaw grew particularly close as children as they moved from place to place when their father, Willie, took new coaching jobs. Tawnya, their older sister, fit in anywhere socially. But David and Eric, who is two years younger, stuck together.

Like a pair, David said.

They loved riding their bikes and, when they moved to Arizona, they took advantage of the wide-open spaces in the new development where they lived. They rode for miles and miles, setting up their own ramps and doing tricks and wheelies, visiting friends along the way before returning home after dark. They played sports, too, and though David loved football as much as their dad, the basketball court is where the brothers had their epic battles.

I was always kind of a little bit stronger and Ill never forget the last time we played one-on-one basketball, David said. He just got better than me, and he won, and once I got over the anger and disappointment, I was proud because my younger brother had grown and was gaining confidence.

Although they have different personalities, brothers David, left, and Eric Shaw formed a strong bond as children. They were like a pair, David said.Courtesy Shaw Family

Said Eric: I wanted nothing more than to beat him, and he wanted nothing more than to keep beating me. But, during those times, it was just us, it was me and him. He was my best friend.

David went on to play at Stanford and eventually got into coaching, against his mothers best wishes. Eric did not pursue a career in athletics. He went to San Diego State and got into a career in marketing at a financial services company, where his gregarious nature, big smile and easy laugh made him a perfect fit. Though their personalities are different David is stoic and introspective, Eric makes anyone feel as if they have been friends forever they are grounded in the same values they learned at a young age: family and faith above everything else.

Those principles only grew stronger after they found themselves in the Bay Area as adults.

After David was hired by Stanford, the entire Shaw family made it clear it would always be around to support him. Family members all have a standing invitation to come for dinner on Tuesdays. And they always attend home football games, waving and hugging David during the teams pregame walk, cheering from the stands, and then waiting for some time together once the game ends.

Even as Eric grew sick, he made it a point to go cheer for his big brother. Its not just the football game. Our family comes together, he said. We celebrate, we come to watch the game and cheer the team on and support David. And then afterwards, win or lose, we all wait for him to come out. Its a family day. Its been wonderful to share that experience with David.

Stanford eventually drew them even closer, and it had nothing to do with football.

Eric did not understand the gravity of his situation until his first meeting in 2013 with the doctors at Stanford Cancer Center. They put it bluntly: He had such an aggressive form of the disease that he needed immediate treatment. They would start with total skin radiation, preparing Eric to lose his hair, eyebrows, eyelashes, fingernails and toenails.

If that did not work, they would try chemotherapy next.

All these thoughts are running through your mind, Crystal said. Is he going to make it? Is it going to work? Whats going to happen? At the time, our youngest daughter was 3 months old, so it was pretty overwhelming. We were just putting our lives together and then boom: youre in the middle of this cancer war.

David, left, and Eric Shaw back in 2014, roughly around the time Eric started undergoing treatments for a rare, aggressive skin cancer.Courtesy Shaw Family

The next week, Eric took a leave of absence from work and began four-times-a-week trips from their home east of Palo Alto, California, to Stanford Hospital, often driving as many as three hours one way in traffic. When he arrived, he went into a box and his whole body was exposed to the radiation light for about an hour. Then, he would make the drive back home to see Crystal and their four kids Caleb Michael, Jared Spann-Shaw, Madison Shaw and Olivia Shaw.

The radiation charred his skin. He lost weight. When he looked in the mirror, Eric no longer recognized the man looking back at him.

Nothing prepares you for something like this, he said. Knowing that other people were looking at me and knowing that something was very wrong, that was a daily grind to get myself up out of bed and get ready for the day, knowing that that was going to be my life.

He did this for three straight months, all to keep the disease from growing to a point where it would kill him. It worked for a short time, but the disease came back more aggressively six months later. Doctors moved on to chemotherapy treatments, some of them experimental, but also began discussing the last-resort option: a bone marrow transplant.

David and Tawnya immediately volunteered to become donors, and underwent testing. In most cases, siblings are the best chance at a donor match. Unfortunately, in their case, neither was close. On a 10-point match scale, Tawnya registered a 3, David a 5. Neither qualified to donate.

I wanted to jump to the front of the line and say, Whatever I have to do, whatever you have to take out of me, however you have to do it, just do it,' David said. For them to come back and say that youre not a strong enough match was disheartening. It hurt me. The fact that we had to put our trust and faith in people that we didnt know, and that were going to have to go out to registries and try to find someone who was a better match than I was, that uncertainty, and that doubt, its hard to keep it at bay at that point. It starts to creep in.

[The doctors] had lost all hope. There was nothing left, but we were in the deepest part of the valley, and there was nobody there but God. I said, Youre going to take me off this Earth. And he told me, Eric, youre not going to die. That was the point at which my faith really took over, and I really had true peace.

Eric Shaw, on the point when he thought he ran out of options to treat his cancer

In late 2017, the disease came back so strong, doctors determined Eric needed the long-discussed bone marrow transplant. Finding a suitable match was exceedingly difficult: Only 4% of donors on the bone marrow registry are African American, resulting in only a 16% chance to find a match.

Doctors eventually found two donors whom they believed could work, but they were not perfect matches. In early 2018, Eric and his family moved into a two-bedroom apartment near Stanford Hospital to prepare for the transplant. For three months, he went through radiation, then chemotherapy to prepare his body to accept the donor cells.

He underwent the transplant in April, feeling confident and inspired it would work. After a month, doctors did an initial check to see how many of the donor cells had survived the transplant.

None survived.

It was like I never even had the transplant, Eric said. That was so devastating. We just knew it was going to work. I mean, were people of faith, and we knew everybody was praying for us, and that we were praying that this six-year journey was going to finally be over. And it wasnt over. It was crushing for them to say, It didnt work. Were going to have to try again.'

The second attempt happened in September. Crystal bought lime green pins for the family to wear for lymphoma awareness. Without telling Eric or Crystal, David decided he would wear his on his shirt for the 2018 football season. In addition to that, he had lime green and yellow ribbons placed on the back of Stanford helmets as a way to show support for both cancer patients and cancer survivors.

During the 2018 football season, coach David Shaw and players donned green ribbons to raise awareness for lymphoma.David Bernal/isiphotos.com

He told his team that his brother was fighting cancer, and briefly mentioned the helmet ribbons publicly during an early-season news conference. But beyond that, David kept the severity of what was happening to his brother to himself, masking his growing nervousness, fear and anxiety as the clock ticked toward the next transplant. He had a hard time processing what was happening. He did not want to put that at the feet of his players, or his staff.

The doctors used the same donor cells that failed the first time for the second transplant on Sept. 11, 2018, because that was the only option available. But this time, doctors used even stronger drugs to prepare Erics body to receive the donor cells hoping that would do enough to stop his immune system from attacking them.

When Stanford played Oregon on Sept. 22, no one in the Shaw family knew whether the transplant had worked. But the situation was more dire than the first transplant. The stronger chemotherapy caused major complications, and Eric became severely ill.

David coached the game with this in the back of his mind. Stanford rallied from a 21-7 deficit to win an overtime thriller, moving to 4-0 on the season, with a top-10 matchup against Notre Dame the following week. Back in Palo Alto, Eric watched the entire game alone in an apartment he rented near the hospital, the comeback buoying his spirits.

He had no idea his brother would speak to him through the television until he heard the words, To my brother Eric

In that moment, I didnt feel any sickness at all, Eric said. I cant really describe what I felt, just how proud I am of him and how awesome it made me feel that he would do that for me.

Said David: If that transplant didnt work, I didnt know how many more games he was going to be able to see. That was an opportunity for me on national TV to speak to him, to say to my brother that against the odds, we came back and throughout the entire game, I was thinking about him.

Eric soon returned to Stanford Hospital. The chemotherapy destroyed his blood system, so he needed daily blood transfusions to stay alive. It came as no surprise when doctors told him the second transplant had failed. They had no plan now, no other donor options. David came by to visit as often as he could, but he had a hard time finding the words to say to his dying brother.

I thought about Crystal. I thought about their kids, Shaw said. I thought about, How can we help? And then I kept going, We just cant get there. There has to be something else. And we all prayed and we all comforted each other and trusted the doctors and prayed for the doctors. And just kept saying, Just tell us whatever options there are. Just tell us what to do and well do it.'

During the day, Eric had his mother, Crystal, David, or Davids wife, Kori, at his side, helping to keep his mind off what was happening to him. But in the evenings, when he was alone in his hospital room, he couldnt help but think about the dwindling medical options and his own death, slowly accepting what he believed would inevitably come.

They might have told us what the odds were, and I honestly just pushed it out of my brain. If this is the Hail Mary, hey, were going to drop back and throw it as far as we can and send prayers along with it and hope it works.

David Shaw on when doctors revisited the idea of him being a donor for his brother

Over seven years, everything the doctors tried had failed, and the disease always came back more aggressively. He felt exhausted in every possible way, desperate to feel better. He didnt want to die. All he wanted to do was get better, and see his kids again, hug his wife and go home. But that possibility seemed as far off as the stars.

The doctors couldnt help us, Eric said. They had lost all hope. There was nothing left, but we were in the deepest part of the valley, and there was nobody there but God. I said, Youre going to take me off this Earth. And he told me, Eric, youre not going to die. That was the point at which my faith really took over, and I really had true peace.

His team of doctors huddled together again and came up with a plan many of their colleagues questioned, simply because they had never attempted it. In mid-October of 2018, they told Eric they wanted to try a third transplant.

Only this time, they wanted David to be the donor and they had only weeks to make it happen.

Eric thought, Are they trying to kill me?

When David was initially rejected, doctors had worked for 25 years to find a way to do half-match transplants but had virtually no success. By 2018, doctors explained that a different way to do the transplant had emerged, opening up the potential to try it with Eric. These transplants, called haploidentical transplants, typically use donor cells from a family member.

Dr. Wen-Kai Weng, Erics bone marrow transplant physician, explained, It was relatively new at this time. We decided to go ahead, because we knew if we didnt do it, the disease would really come back with a vengeance.

No one had ever done a third transplant with donor cells at Stanford.

If he didnt go for this risk, he wouldnt be here, said Dr. Youn Kim, who treated Eric and heads Stanfords multidisciplinary Cutaneous Lymphoma Clinic/Program. He wouldnt be living.

Doctors told Shaw there was a 15% chance he would not survive the transplant itself. If he did survive it, there was only about a 30% to 40% chance the donor cells would work. Compared to much steeper survival odds with no transplant at all, the decision filled with multiple layers of danger did not feel risky at all.

They had to try.

They might have told us what the odds were, and I honestly just pushed it out of my brain, David said. If this is the Hail Mary, hey, were going to drop back and throw it as far as we can and send prayers along with it and hope that it works.

Without hesitation, David said to his brother, Tell me what I need to do.

David Shaw went through an unusual bone marrow transplant procedure to help his brother, Eric. Instead of stem cells being extracted from his hips, he was given medication that stimulated his body to overproduce the cells needed for the transplant.Courtesy Shaw Family

Stanford gathered in its team hotel early on Oct. 27 to begin final preparations before hosting Washington State later that day. David checked in for a 9 a.m. meeting and when it finished, he checked out of the hotel without saying a word. He walked toward the back exit, careful to make sure no one saw him, and snuck out the door to a waiting car.

Shaw sat in the passenger seat, headed toward campus and Stanford Hospital, praying all the while that what he was about to do would work.

He arrived at the hospital and was hooked up to an IV for the first dose of medication. This would not be the more traditional bone marrow transplant, where cells are extracted with a needle through the hips. Rather, the medication flowing through the IV would stimulate his body to overproduce the stem cells needed for the transplant, flooding his blood with them. The cells would then be extracted from his blood, and transplanted into Eric.

Doctors told him to expect to start feeling joint pain and tiredness within 24 hours. Those symptoms would grow only stronger over the coming days, when he came in for more medication. They told him he should stay off his feet, rest and remain hydrated.

That would be nice, David thought. But he had a game to coach. Only two people inside the program knew he had gone that morning: assistant athletic director for football operations Callie Dale, who drove him to the hospital, and defensive coordinator Lance Anderson.

On the same day he underwent a bone marrow transplant for his brother, David Shaw received a surprise pregame hug from his two young nieces, Olivia and Madison.John P. Lozano/isiphotos.com

The way that I do my job, I work really hard not to make it about me, David said. Although I wanted my team to know what my family was going through, college football is about the student-athletes. I wanted them to focus on what they needed to do. I didnt want to pull from that. I didnt want to, all of a sudden, now make it about me and my family.

A few hours later, he returned to the team hotel and acted as if he had been there the entire day, speaking nothing about his trip to the hospital. Shaw put on his lime green pin and made his way toward the bus. The short ride to the stadium felt long that day. His mind wandered before returning to the flip card in front of him.

As he exited the bus and finished the walk to the stadium, his two young nieces ran up to him. They squeezed him, holding on longer than usual, as if they knew their Uncle David was their only option, too.

David started to feel pain in his knees and legs during the game, a heartbreaking 41-38 loss to the Cougars. That pain only intensified in the coming days as he continued to go in for daily treatments, driving himself on a golf cart from the football facility to the hospital without anyone knowing. It felt as if he had a 50-pound backpack strapped on at all times. He normally jogs from place to place during practice but found it difficult to walk because his legs, hips and shoulders hurt so badly.

He worried players would notice him moving around so slowly. If they did, no one said a word. Shaw kept pushing the pain aside, shoving his emotions down deep, saying prayers every chance he got.

On Wednesday, Shaw woke up and was so lethargic, he felt as if he was moving like a sloth. He went to the hospital for the final procedure: extracting the cells from his blood. Shaw wore comfortable clothes, arranged his pillows and settled in for a long day ahead. Doctors hooked him up to a machine that would do the work through two IVs: One took his blood so the needed donor cells could be siphoned out; the other IV would put the blood back in his body.

Eric rested on another floor in the same hospital.

David worked on his game plan, watched a few movies and occasionally stared at his own blood in the IVs, willing it to save his brother. He kept saying to himself over and over again, God, I hope this works.

After eight hours, he was finished. Shaw then went out to practice.

I remember walking up to him and just asking him, How are you doing, how are you feeling?' Anderson said. I could see it in him that he wasnt his normal self. He paused for a little bit and then hes like, Im OK. A little bit tired, but Im OK. You know, just trying to put the most positive light that he could on it.

The next day, Nov. 1, 2018, Shaw went back to the hospital. It was transplant day, and he had to be with Eric to witness what they hoped would be a miracle. David and Crystal watched as Eric received a transfusion of Davids stem cells, a shimmering light pink fluid flowing into his body. They sang and prayed. Already, they had received one small bit of good news: Doctors extracted 28 million cells from Davids blood, about 20 million more than what they had hoped to get.

Stanford traveled the following day to Seattle, for a game against Washington. David felt guilty for leaving, but he knew there was nothing else he could do. Eric struggled in the hospital, not only from the transplant, but from the heavy chemo and radiation doctors used to prepare his body for the new cells.

Eric Shaw endured a dangerously high fever, pain and vomiting in the initial days after his third transplant attempt, using his brother Davids cells. A few weeks later, Eric started to turn a corner for the better.Courtesy Shaw Family

Eric ran a fever of 105 degrees and vomited for days. The pain grew so intense he was put on a morphine drip and was in and out of consciousness. In Seattle, Shaw remembers being locked into the game, except for those little moments where my heart was with my brother.

Stanford lost another heartbreaker, 27-23.

I know us losing had nothing to do with everything David was going through, Dale said. But just piling that on with everything else he was dealing with, it was a lot for him. He brought that up many times, about how Eric would tell him the biggest excitement for him every week was watching us play and watching us win. I know David had a lot of pressure on himself, amongst the pressure he already has as a head coach, to win for Eric. And I know that every time he did, he really felt like it was for him. And when we came up short, I know he was probably even harder on himself than he normally would have been.

Read the original:
'We're really blood brothers' - Stanford coach David Shaw and his current battle to save lots of his brother, Eric - The Shepherd of the Hills Gazette

Mark Drought: Are we on the brink of another civil war? – The Advocate

Illustration for election 2020 column

Illustration for election 2020 column

Photo: M. Ryder / M. Ryder

Illustration for election 2020 column

Illustration for election 2020 column

Mark Drought: Are we on the brink of another civil war?

This was written during the run-up to Election Day. Its possible we will have chosen a president by the time you read it, but it could remain unsettled well into December. Some are calling this the most important election in American history. That might be hyperbole; however, it is likely to be the most critical vote since Lincolns reelection in 1864.

Coming at the end of a year in which governmental incompetence may contribute to a quarter-million deaths, this election is more tense than usual. Many of us are voting angrily this time, because of whats been taken from us during the past four years, and what could be lost during the next four. For some, belief in their country has rapidly eroded, as events have transpired that they had never imagined possible.

It started when the GOP toyed with the idea of a game show host as its standard bearer. A majority of the Americans who consider themselves righteous and on the Right decided Trump had the right stuff to lead the free world. This possibility seemed far-fetched, until it began happening. I never thought the Republicans would nominate the worst human being since George Wallace to run for the White House, nor did I think the most vulgar, dishonest, unqualified and unfit candidate in recent memory would receive a minority of votes sufficiently large to put him in the Oval Office.

Four years later, the country has changed in ways wed never have predicted. Candidate Trump promised to drain the swamp, which now smells worse than ever, and would have been a sewer into the prison system, had the Justice Department not joined the executive branch in this cesspool. Yet they tell us not to trust the deep state the functioning part of the government (e.g., the CIA, FBI and NSC) that actually gets things done because it doesnt slavishly parrot the policies and fiats of the Dear Leader enough.

This has also been extended to his handpicked lackeys, such as former Attorney General Jeff Sessions, who was fired for being insufficiently ruthless in running the Justice Dept. as Trumps own personal law firm. His intensely obsequious replacement, Bill Barr, has been enough of a boot-licker to keep the boss happy, thus keeping his job.

In the Trump orbit, sycophants are considered both necessary and virtuous. Ted Cruz whose wife Trump called ugly and whose father Trump called complicit in the Kennedy assassination has failed to defend his familys honor; instead, hes become one of The Donalds more craven lapdogs. The GOPs labeling of liberals as snowflakes seems ironic at a time when the spineless Cruz and gelatinous Lindsey Graham typify Trump Republicans. GOP mavericks such as John McCain are as extinct as the Stegosaurus.

Speaking of snowflakes, did you ever imagine youd see the day a U.S. president would moan that the questions Leslie Stahl asked during a 60 Minutes interview were tougher than those asked of his opponent? Trump looked like he was ready to cry after he fled this unfair interrogation, but we now live in a time when a tough guy who cant face tough questions and calls a free press the enemy of the American people prefers to simply run from both. Its what youd expect from a whiny, fact-averse, habitual liar.

And who would imagine that, in the midst of a 21st century pandemic, Trump Republicans would reject science? We already knew their attitudes toward evolution, stem cell research and climate science, but the scary Trumpian warning that, if elected, Biden would, listen to the scientists, seems as weird as his bizarre accusation that, Doctors get more money if someone dies from COVID.

The Trump era has become a time when you can literally claim anything from birtherism to Obamagate to COVID is a hoax for which hydroxychloroquine is the cure just by saying it. More ominously, Trumpists are undermining our system of governance by claiming the election is rigged and rife with voter fraud, with no evidence whatsoever, just in case they lose.

Meanwhile, they work to restrict peoples ability to vote by sabotaging the postal system and by encouraging armed, thuggish poll watchers to suppress the vote. By the time this election is over, the Orange Mans militias will have diminished Americas faith in free elections, which were once a hallmark of democracy.

The Right threatens a civil war if the election is closely contested. I suspect many of them believe the wrong side won the previous civil war and take exception to the self-evident statement that Black lives matter. Obviously, everyones life should matter, so why do Trump cultists consider Blacks who want to protect their own lives to be anti-American radicals? Could it be because American exceptionalism has become largely about white supremacy, and reflects the views of Klansmen and neo-Nazis, whom our president refers to as some good people?

Walmart has reportedly removed guns and ammo from its shelves due to fears of potential violence brought on by a close election, and some businesses have increased insurance coverage in the face of possible looting. This situation is worsened by the presidents refusal to accept a peaceful transfer of power should he lose. Hes stated that he could lose only if the Democrats cheated, and no prominent GOP leaders oppose his unwillingness to respect the decision of the American people in a free election.

Many Americans have lost respect for their country and their countrymen. Even if Trump loses, nearly half the nation will have voted for a buffoonish bigot responsible for thousands of deaths, whos no friend of democracy or the U.S. electoral system. And should he be reelected, it will be as hard to get his first Trump-Biden debate performance out of my head as it will be to unsee the image of him dancing to the Village Peoples YMCA at his campaign rallies.

Greenwich native Mark Drought (markdrought4@gmail.com) is an editor at a Stamford IT firm and was an adjunct English professor at the University of Connecticut-Stamford.

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Mark Drought: Are we on the brink of another civil war? - The Advocate

Brain Development and Disorder Research Receives $1.5 Million NSF Boost – USC Viterbi School of Engineering

Megan McCain, Giorgia Quadrato and Leonardo Morsut have been awarded a four year National Science Foundation grant to develop better organoids, to help us understand human brain development and disease.

A 15-day-old brain organoid: Department of Biomedical Engineering researchers are partnering with Keck School of Medicine of USC to improve the creation of these materials, which can help us better understand brain development and disorders.Image/ Giorgia Quadrato

The human brain is an incredibly complex organ to study in its living tissue form. Researchers cannot experiment on human tissue directly, and animal models are often too different to human physiology to be effective.

For this reason, in the last decade, neurological research has been increasingly turning to brain-on-a-chip organoid models to give researchers living examples to demonstrate brain development, and how to effectively treat brain diseases and disorders. Organoids are grown out of stem cells into new cell clusters that mimic the structure of and features of a whole organ, such as the brain.

Co-principal investigator Megan McCain from the USC Viterbi Department of Biomedical Engineering will partner with fellow co-principal investigators Giorgia Quadrato and Leonardo Morsut in the Department of Stem Cell Biology and Regenerative Medicine at the Keck School of Medicine of USC on a four year, $1.5m NSF-funded project to vastly improve the process of developing brain organoids. The project aims to make the end products more consistent and reliable as tools for brain researchers.

McCain is the Chonette Early Career Chair and assistant professor of biomedical engineering at USC Viterbi. She said that one of the biggest hurdles in the current process of organoid creation was their lack of uniformity.

Researchers start with a small group of human stem cells, and then give them some chemical cues to direct their development into brain tissue, but ultimately, the cells are mostly left to their own devices, so they often grow very randomly, McCain said. They divide and differentiate into other cell types in a somewhat haphazard process. So if you make ten organoids, all ten of them will look slightly different.

A brain organoid in a fluidic device from the labs of Megan McCain and Giorgia Quadrato.

McCain said it was this issue that could be detrimental to the accuracy of using organoids in certain types of research, such as the testing of therapeutics and how the brain responds to these drugs, and that organoids needed to be more uniform and reproducible in order to be more effective tools.

Drug testing with organoids today is very challenging because it is hard to separate the effect of the drug from the inherent variability of the organoids themselves, McCain said.

Morsut said that his part of the project involves developing synthetic molecular tools to simplify the analysis of what happens during the formation of brain organoids in a laboratory setting.

The normal molecules that are used by the cells to self-organize, as well as to make decisions, are linked in very complex networks, and we need artificial tools to tease apart the contributions of these different components, Morsut said. The challengeand the exciting partis to use these tools to explain the remarkable phenomenon of self-organization.

McCain said her lab will focus on the device sidethe organ-on-chipand make microfluidic components for growing and studying organoids under more defined conditions.

This will likely improve reproducibility and possibly organoid maturity, which is another major bottleneck, McCain said.

In order to do this, McCains lab will be repurposing a microfluidic device that they previously used to help explanted zebrafish hearts to remain alive longer and regenerate, while also live-imaging the process.

The device, when applied to brain organoids, will constrain the cells in chambers where the team can run experiments through them in a more controlled way, to see if this improves the consistency of the end product.

And we will also be able to image and monitor their reproducibility by putting them in this little device where theyre all growing in the same configuration, McCain said.

Quadrato, an expert in brain organoids, said she was excited about the collaboration, because a multidisciplinary approach was needed to improve the relevance of current organoids.

One way to improve brain organoid-to-organoid reproducibility is to expose them to small molecules to direct differentiation of the stem cells, Quadrato said.

She said that these small molecules unfortunately sometimes have problematic side effects, such as impairing the survival of other non-neural cell types, or skewing tests of potential treatments for brain diseases and disorders.

In our proposal, we suggest an alternative strategy to increase brain organoid reproducibility that does not cause these side effects, and therefore can be used to create organoids to accurately model disease, Quadrato said.

Further information about the project is available from the National Science Foundation.

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Brain Development and Disorder Research Receives $1.5 Million NSF Boost - USC Viterbi School of Engineering