Major Sickle Cell Surge: Feds and California Collaborate on Cell Therapies for the Disease

In August, the stem cell agency staged a live event on Facebook dealing  with 

the current state of sickle cell research. It has since received  more than 2,200

 page views. Here is a link to the event, which featured  Don Kohn of  UCLA  and 

Mark Walters of UCSF Benioff Children’s Hospital. 

California's stem cell agency has embarked on what it calls a "remarkable" collaboration with the federal government aimed at developing cell-based and gene-based therapies for sickle cell disease, which affects 100,000 persons nationwide.

The partnership marks the first time that the state agency has partnered directly with the National Institutes of Health(NIH), which spend $100 million a year on sickle cell research. 

The NIH has committed an additional $7 million to jump start its new effort, dubbed "The Cure Sickle Cell Initiative."   The California stem cell agency has already pumped nearly $39 million into sickle cell research. 

The affliction is caused by a genetic defect that deprives the body of oxygen, "wreaks havoc on the body, damaging organs, causing severe pain, and potentially leading to premature death," says the NIH. 

In the agreement (see below) with California's $3 billion stem cell agency, the NIH said that the agency is "a recognized leader in the development and funding of clinical trials focused on cell-based therapies and is now working to accelerate support for clinical stage candidate treatments that demonstrate scientific excellence."

Millan told directors in in June that the arrangement amounted to a "quite remarkable" recognition of CIRM's capabilities. She said the NIH "made a decision that they needed to partner with us in order to have the best shot at accomplishing what they want to do with this 'cure sickle cell initiative.'"

On Thursday, directors of the California Institute for Regenerative Medicine (CIRM), as the agency is formally known, will receive a more complete briefing about the full range of CIRM's involvement.

CIRM will handle the funding processes for the applications for the late stage research program, making funding decisions in as little as 85 days. The agency's work will include scientific peer review, contracting and post-award management, according to CIRM documents. (The documents are part of the presentation that can be found here.)

Millan said that the NIH has recognized the agency's value in terms of accelerating development therapies, building late development research and translating basic research into clinical use. 

The agency said it will provide funding on approved awards for work done in California, according to CIRM rules. It will have the ability, in consultation with the NIH,  to suspend or terminate research if milestones are missed, including taking back unused funds. Kevin McCormack, a spokesman for the agency, said that it will be compensated by the NIH for additional work that it has to perform but that details are yet to be worked out.. 

Last month, the NIH said in a news release:

"Currently, the only cure for sickle cell disease is a bone marrow transplant, a procedure in which a sick patient receives bone marrow from a healthy, genetically-compatible sibling donor. However, transplants are too risky for many adults, and only about 18 percent of children with sickle cell disease have a healthy, matched sibling donor.

"The Cure Sickle Cell Initiative seeks to develop cures for a far broader group of individuals with the disease, and it is initially focusing on gene therapies that modify the patient’s own hematopoietic stem cells (HSCs), which make red and other blood cells. These modified HSCs can then be given back to the patient via a bone marrow transplant, making a cure available to more patients who lack a matched donor."

Below is a CIRM video on sickle cell disease and a copy of the agreement between the stem cell agency and the NIH. 

(Editor's note: An earlier version of this item incorrectly reported that the agency had committed more than $200 million to sickle cell research, based on inaccurate figures on the CIRM web site. The correct amount is $38,8 million. CIRM said the error was created by a computer glitch and that it has corrected the figures on its site.)

Sickle Cell Cirm-nhlbi Mou ... by on Scribd

The Final $144 Million and the California Stem Cell Agency's Future

The Golden State's stem cell research program is down to its last $144 million after nearly 14 years of financing searches for therapies for everything ranging from diabetes to bubble baby syndrome. 

Funded with $3 billion in November 2004, California's stem cell agency has yet to back a therapy that is widely available to the public. Its directors are scheduled to meet on Wednesday to approve plans for what could be the last year for new awards. 

Known formally as the California Institute for Regenerative Medicine (CIRM), the agency was created by voters through a ballot initiative. The measure provided $3 billion in bond support but no additional cash beyond that. 

The agency is pinning its hopes for survival on a yet-to-be-written $5 billion bond measure for the November 2020. It is attempting privately to raise $200 million to bridge the gap between the end of 2019 and the election. 

On Thursday, CIRM's 2019 research award budget is slated to come before the Science Committee of its board of directors. The public can participate in the meeting via the Internet and at a number of locations throughout the state. More information about access can be found on the agenda. 

The agency's staff has proposed $123 million in awards for clinical trials during 2019 with another $20 million going for translational research, which is an effort to take basic research and translate it into a clinical application. An additional $600,000 is slated for "educational" awards. 

CIRM documents said there were "insufficient" funds to finance additional basic research. The agency also aims to limit its clinical/translational awards to research that has been previously backed by the agency.

By the end of this year, CIRM expects to have made $2.6 billion in awards. The remainder of the $3 billion has gone or will have gone for administrative expenses, which will continue for a few years as multi-year awards wind down. 

The agency may recover an estimated $30 million in 2019 from research that does not pan out, making those possible funds available for awards in 2020. 

Currently, CIRM is backing 49 clinical trials, the last stage before a therapy is certified for widespread use. But there is no guarantee that any of those trials will generate a treatment prior to the November 2020 election. 

State of Stem Cells: Three-day Conference Opens Today, Includes Japanese Research, Affordability and More

A three-day session to kick around business and scientific developments involving genes and stem cells begins today in La Jolla with live Internet video casts of many of the presentations and panels.

The state of Japanese research, therapies for stroke, commercialization pathways, affordability and much, much more are available. Some samples and times for today for the Cell and Gene Meeting on The Mesa:

7:15am – 8:45am -- Learning Theater, Readiness strategies for cell therapy commercial manufacturing workshop

7:20am – 8:00am -- Ballroom 2, Panel, Session 1: U.S.-based Clinical Programs

7:50am – 8:05am -- Magnolia Room, Development of an “off the shelf” cell therapy for ischemic stroke and other indications under the regenerative medicine regulatory framework in Japan
Speaker: Gil Van Bokkelen, Ph.D., Chairman and CEO, Athersys

1:15pm – 2:15pm -- Ballroom 1, Panel, Navigating acceptance, uptake and affordability across the life cycle 

The full agenda can be found here. The webcasts are available here.  Webcasts can be found by room location. 

Possible Federal Restrictions on Stem Cell Research and the Multi-Billion Dollar California Angle

The recent federal crackdown on the use of fetal tissue in scientific research could well be a harbinger of an effort to revive restrictions on the use of human embryonic stem cells, placing a roadblock in the way of creation of therapies to treat often deadly afflictions that affect millions of Americans.

And it could have an impact on the fate of California's $3 billion stem cell program, which expects to run out of money for new awards by the end of next year.

A leader of the pro-life movement signalled today that anti-abortion groups' next target is likely to be the National Institutes of Health(NIH), which provide billions of dollars in research funding, including use of embryonic stem cells (hESC).

Writing on The Hill web site, Tom McClusky, president of March for Life Action, denounced current federal research practices. His opinion piece was headlined.

"Trump's move on unethical fetal tissue experimentation isn't enough"

McClusky wrote,

"The head of NIH, Frances Collins, has been a long-time supporter of unethical research and has a reputation of disinterest for the countless lives lost as long as it produces results.
"His track record not only includes support for fetal tissue research but also human-embryonic stem cell experimentation, human-animal chimeras and even human cloning. Of the many great nominations made by President Trump, Frances Collins sticks out as a counter to his stated pro-life agenda."

This is a bit of deja vu for the California stem cell agency, whose $3 billion program was approved by voters in 2004. The impetus for creation of the agency, known formally as the California Institute for Regenerative Medicine (CIRM), was generated by then President Bush's restrictions on federal funding for hESC research. State cash, however, was not similarly restricted.

Trump has not yet revived Bush's restrictions, but the issue seems to be increasing in importance for Trump's evangelical political base and at least 102 congressmen. The opposition is based on the belief that using human embryonic stem cells for research is tantamount to murder.

The stem cell agency is hoping that California voters will extend its life in November 2020 by approving $5 billion more for the research. However, the agency has not delivered on 2004 expectations that stem therapies were right around the corner. The agency has yet to finance a therapy that is widely available.

Overcoming voter disenchantment could be difficult. But a Trump crackdown could energize stem cell supporters much as Bush's did in 2004. Scientists, patient advocate groups, venture capitalists and others banded together to win approval of the ballot initiative that created the state stem cell program, using Bush as a handy villain in the argument for more stem cell research.

Ironically, the article by the pro-life group came almost exactly one year after the then president of the International Society for Stem Cell Research,  Hans Clever, wrote on the Stat website that fetal tissue is absolutely necessary to produce cures and therapies. He said,

"The development of vaccines against polio, rubella, measles, chickenpox, adenovirus, rabies, and treatments for debilitating diseases such as rheumatoid arthritis, cystic fibrosis, and hemophilia all involved fetal tissue."

"Fetal tissue has been essential in research used to develop therapies that have saved millions of lives, and it continues to be necessary for the future of medicine."

The Reality of Stem Cell Research vs. Results: A Scientist/Blogger Speaks Out on California's Efforts

A researcher writing on the web site of Science Translational Medicine weighed in last week on California's $3 billion stem cell agency, raising questions about its progress, hype and the fate of the nearly 14-year-old effort. 

In an item Sept. 28 on the blog "In The Pipeline," Derek Lowe said, 

"It’s not like the CIRM money has all been wasted, of course. There’s been a lot of basic research done, and there certainly has been a lot that needed to be done. The amount of brush to be cleared in human developmental cell biology is just monumental. A quick thought the way that all of your body, all the bodies of every human being, comes each from their own single cell will make that clear. If you want stem cell therapies to regenerate organs – as who doesn’t – then you’re asking for a thorough understanding of that process. You may well be asking to do even more than it can tell us how to do."

CIRM is the California Institute for Regenerative Medicine, as the agency is formally known. Lowe's brief bio on the the site says he has worked for "several major pharmaceutical companies since 1989 on drug discovery projects."

The occasion for his remarks was the recent lengthy look at the agency by the San Francisco Chronicle at CIRM and its performance. Lowe wrote, 

"What’s happened? What you’d have expected, if you knew the field at all (or were familiar with basic research in general). None of the bigger promises made during the campaign to fund the CIRM have come true. No approved therapies have come out of the work yet – and that’s one of the class of promises that were most egregious, in California and elsewhere. Just imagine the time it takes from discovery to approval for something like this, and then factor in that the needed discovery hadn’t even been made yet. But if you don’t know anything much about stem cells, or regulatory approvals, or medicine in general, the idea of get-out-of-that-wheelchair cures being just around the corner becomes more plausible."

Lowe also noted that voters may be asked in 2020 to provide more billions for the agency. He said, 

"If you measure it (the agency's work) against what was known and what had been accomplished then versus what’s been done since, you can make a case, for sure. If you measure it against the promises made at the time, though, things look bad. And that informs how you’re going to campaign for renewal: do you point at what’s been done and make the argument that it’s been a success, or do you promise them miracle cures again, because now they just have to be around the corner after all this work, eh?"

Lowe's article received comments from nine readers, who appear also to be researchers. One, who was identified as Miguel Sanchez, wrote, 

"Just at my small CA research institute, the amount of poor science that has been funded by CIRM is staggering. I would say that roughly half the CIRM money we have received has gone to research programs that are prima facie bad science but the PIs are well connected so hey shut up. I don’t think any outright fraud has been published, but the taxpayers of CA are for damn sure not getting their moneys worth on these investments here."

Sanchez did not further identify his employer. The agency's list of grantees did not contain Sanchez's name.