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Reasons for ibrutinib therapy discontinuation in CLL

Posted: February 28, 2015 at 5:47 am

About 10 percent of patients with chronic lymphocytic leukemia (CLL) discontinued therapy with the Bruton tyrosine kinase (BTK) inhibitor drug ibrutinib because of disease progression during clinical trials, according to a study published online in JAMA Oncology.

CLL is the most prevalent leukemia in adults and it is not considered curable without an allogeneic (donor) stem cell transplant. However, advances in therapy have been made, notably the emergence of kinase inhibitors for patients whose disease relapsed, according to the study background.

The drug ibrutinib (marketed as Imbruvica) is the first drug designed to target Bruton's tyrosine kinase (BTK), a protein essential for CLL-cell survival and proliferation. The drug is approved by U.S. Food and Drug Administration in chronic lymphocytic leukemia and mantle cell lymphoma. Much of the clinical and basic-science research that led to the approval of ibrutinib for CLL was performed by scientists at The Ohio State University Comprehensive Cancer Center -- Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC -- James).

Hematologists Kami Maddocks, MD, Jennifer Woyach, MD, and colleagues have now described the characteristics of patients who discontinued ibrutinib therapy and their outcomes in a group of 308 patients participating in four trials at The OSUCCC -- James.

The study results show that with a median (midpoint) follow-up of 20 months, 232 patients (75 percent) remained on therapy, 31 (10 percent) discontinued because of disease progression and 45 discontinued for other reasons (including 28 because of infection, eight for other adverse events and nine due to other medical events).

Disease progression included Richter's transformation (when the cancer becomes an aggressive lymphoma) or progressive CLL. Richter's transformation appeared to occur early and CLL progression later. Median survival after Richter's transformation was 3.5 months and 17.6 months following CLL progression, the results indicate.

"These data enhance our understanding of how patients do on ibrutinib long-term and who is likely to relapse. We know that many patients will have very durable remissions with ibrutinib, and understanding which patients are at higher risk helps us select who might benefit from clinical trials investigating other new agents and combination therapies rather than starting ibrutinib treatment by itself," says Woyach, senior author of the study. "We have confirmed that specific gene mutations are seen in patients who relapse, which gives us an idea of other drugs that might be effective in these circumstances."

OSUCCC -- James researchers conclude that this data confirms ibrutinib as an effective therapy and identifies, for the first time, baseline factors associated with ibrutinib therapy discontinuation.

"Outcomes data show poor prognosis after discontinuation, especially for those patients with Richter's transformation. Patients with either progressive CLL or Richter's tend to require therapy quickly after ibrutinib is stopped, so having a plan in place for alternative therapy is necessary. This sub-segment of patients who relapse on ibrutinib remains a high research priority to identify new targets and new therapies, and we have multiple studies ongoing at the James to try to help these patients," adds Maddocks.

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Study affirms role of specialized protein in assuring normal cell development

Posted: February 27, 2015 at 10:56 pm

Study led by NYU Langone Medical Center adds to groundwork for cell-based treatment of disease

New York, NY -- Scientists at NYU Langone Medical Center and New York University have demonstrated that a specialized DNA-binding protein called CTCF is essential for the precise expression of genes that control the body plan of a developing embryo.

The findings, to publish online February 27 in Science, focus on mouse brain cells that work to manage an animal's movements. The results add important details to how so-called Hox genes help cells keep their positions straight and in the right positions back to front.

Hox genes are arranged in particular clusters on an animal genome and only a subset of Hox genes are active in a given cell. Maintaining a precise "memory" from mother cell to daughter cell of active and inactive Hox genes is fundamental to establishing a normal body plan, the researchers report, and failure of that system produces a body part in the wrong anatomical position.

"Previous research has shown that CTCF acts as a key insulating barrier to prevent mistakes in cells as they multiply and differentiate," says Varun Narendra, the study's lead author, and a fifth-year graduate PhD student in developmental biology at NYU Langone and the Howard Hughes Medical Institute. "Now we have shown that correct positioning also depends on CTCF."

"The findings provide new insight into how cells faithfully transmit this organizational information as embryos develop, and into what goes wrong when cellular development goes awry, thereby giving rise to abnormal cell development and diseases such as cancer," says senior study investigator Danny Reinberg, PhD, professor of biochemistry and molecular pharmacology at NYU Langone and a Howard Hughes Medical Institute investigator. "Information from this study could help lay the groundwork for therapies that address developmental missteps tied to Hox genes and their regulators."

CTCF is a so-called DNA-binding protein, which marks regions of DNA in animal genomes that serve as "insulators" or partitioning boundaries as cells package their DNA. What the researchers discovered is that CTCF binding ensures that segments of the genome that are packaged to be active do not interfere with neighboring segments that should not be active in the daughter cells they generate.

Using mouse embryonic stem cells that generate motor neurons as a model, the researchers found that CTCF isolates Hox genes from harmful activation. "We found that the activity of CTCF is to divide the Hox cluster into segments, allowing the cluster to fold into strict domains that are either active or inactive on either side of CTCF," Narendra adds.

To demonstrate that CTCF binding is necessary for correct Hox gene activation, the researchers removed the sites on the genome where CTCF would normally bind and showed that without that CTCF binding, the Hox cluster would not fold properly. As a result, motor neurons activated the wrong set of Hox genes.

"By altering the folding pattern of the Hox cluster, we altered the motor neurons' understanding of their anatomical position," says Esteban Mazzoni, PhD, a study co-investigator and assistant professor of biology and New York University. "In doing so, we also altered their ability to send nerve signals to the appropriate muscle targets."

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Health and beauty news

Posted: February 27, 2015 at 10:55 pm

The units of umbilical cord blood are stored in liquid nitrogen at minus 196 degrees :: SUR

The umbilical cord blood bank of Andaluca, which is situated at the Hospital Civil in Malaga, is the most powerful in Europe and the third best in the world after those in the American cities of New York and Durham. It holds this impressive position thanks to the large number of umbilical cord stem cell units which are stored there, ready to be used in bone marrow transplants for patients, children and adults, who suffer from leukemia or lymphoproliferative disorders.

At present, the bank at the Hospital Civil contains 24,565 units. Since this centre began operating in 1995, 435 bone marrow transplants have been carried out, 79 of which were in 2013. Each year, the centre incorporates more than 1,300 samples of umbilical cord and this is something which has made it an international benchmark in this field.

The stem cells of the umbilical cord are highly effective in a complete regeneration of bone marrow. The banks which store these units are a crucial part of this type of transplant. Quality umbilical cord blood has been part of the success of many bone marrow transplant cases. There is one patient compatible with every 200 units of cord which are stored in the banks.

Encouraging women who give birth to donate their babys umbilical cord is a vital part of the service provided by hospital gynaeology and obstetrics departments and the midwives who prepare the pregnant women for the birth, explains the director of the umbilical cord bank of Andaluca, Isidro Prat.

The samples of cord blood are preserved in tanks of liquid nitrogen at a temperature of minus 196 degrees. One of the advantages for the patients is that the stem cells of the cord are very young and this enables bone marrow transplants to be carried out even if the receiver is not 100 per cent compatible, says Dr Prat.

Patients all over the world

Units from the bank in Malaga have been transplanted into patients from all over the world, including the USA, Australia, France, Germany, Sweden, Jordan, Israel and Spain, among others. When a patient needs a bone marrow transplant you look internationally to find the highest level of compatability, says Isidro Prat. The samples are transported by plane and are preserved in nitrogen.

The umbilical cord bank of Andaluca recently received international accreditation from the Foundation For The Accreditations of Cellular Therapy (FATC NetCord), which is based at the University of Nebraska, in the USA. Since 2010 the Andalusian bank has been one of the elite medical centres which have successfully met the demanding standards which are necessary to be awarded this distincion. Only 21 institutions related with the transplant of stem cells from umbilical cords in the world have been granted this FATC accreditation.

The samples of umbilical cord which are processed and stored at the bank come from the maternity departments of different state-run and private hospitals. The technician who is responisble for the umbilical cord blood bank of Andaluca, Carmen Hernndez, has confimred that at present 24,565 units are being stored there ready for transplants. In 2013, there were 4,751 donations.

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Cleveland BioLabs Reports Fourth Quarter and Fiscal 2014 Financial Results and Development Progress

Posted: February 27, 2015 at 10:54 pm

Cleveland BioLabs reported a net income for the fourth quarter of 2014 of $11.3 million, or $3.95 per share, compared to a net loss of $0.4 million, or $0.16 per share, for the same period in 2013.Net income for fiscal 2014 was $1.6 million, or $0.60 per share, compared to a net loss of $17.3 million, or $7.67 per share, for the same period in 2013.The increase in net income was primarily attributable to a $14.2 million gain on the deconsolidation of the Company's joint venture, Incuron LLC.Excluding the gain on the deconsolidation of Incuron, net loss per share for the fourth quarter of 2014 was $1.02 and net loss per share for fiscal 2014 was $4.66.

At December 31, 2014, the Company had cash, cash equivalents and short-term investments of $3.1 million, $0.5 million of which was restricted for the use of subsidiaries Panacela Labs, Inc. and BioLab 612, LLC.In addition, on February 6, 2015, the Company closed an equity transaction pursuant to which it received net proceeds of approximately $3.7 million.

Yakov Kogan, Ph.D., MBA, Chief Executive Officer, stated, "We have made significant progress with all of our development programs over the past few months and believe that 2015 will be an important year for CBLI, as we near potential commercialization for entolimod's biodefense indication and release clinical data bringing validation to our first-in-class oncology assets.The pre-Emergency Use Authorization (pre-EUA) submission for entolimod is on schedule to be filed within the first half of 2015.We are actively engaged with several U.S. government agencies to solicit their input to our pre-EUA dossier, as well as potential funding and procurement support.We recently announced that we received notice that our proposal to support further development of entolimod as a medical radiation countermeasure has been recommended for funding by the Department of Defense office of Congressionally Directed Medical Research Programs.This potential funding is subject to negotiations and availability of funds and relates to our proposal to conduct several pivotal animal efficacy studies required by the U.S. Food and Drug Administration(FDA) for submission of a Biological Licensure Application (BLA)."

"In addition, our oncology drug candidates continue to advance through clinical studies," continued Dr. Kogan."The Phase 1 study of entolimod in advanced cancer patients at Roswell Park Cancer Institute has been completed and the findings have been submitted for presentation at the annual meeting of the American Society of Clinical Oncology (ASCO), which will be held from May 29 - June 2 in Chicago, Illinois.Preliminary evaluations of the study indicate that the tolerability profile in patients with advanced cancer was similar to that observed in two previously conducted studies in 150 healthy volunteers and initial assessments of immunological response were consistent with activation of toll-like receptor 5 (TLR5), the drug's target.Early analyses also indicate that stable disease was observed in several patients with heavily pretreated cancers.These observations confirm our preclinical findings and support the hypothesis that entolimod has potential as an immunotherapeutic agent.We have initiated a follow-on study in Moscow, Russia intended to extend the clinical observations from the higher entolimod dose levels evaluated in the Roswell Park trial.This follow-on study is supported by a matching-funds development contract from the Ministry of Industry and Trade of the Russian Federation (MPT)."

"Incuron's two ongoing clinical studies evaluating oral and intravenous administrations of Curaxin CBL0137 in patients with advanced solid tumors are recruiting patients to the ninth and seventh dose-escalation cohorts, respectively.In January, we disclosed that a formal interim analysis of the 19 patients enrolled in the first six cohorts of the ongoing oral administration study indicated that the study medication was well tolerated at all investigated dose levels.The observation of drug exposure in plasma documented high oral bioavailability (typically estimated to be greater than or equal to 50%).To date, no dose-limiting toxicities have been observed with either oral or intravenous administration through the highest CBL0137 dose levels tested.Heavily pretreated patients with advanced cancers of the esophagus, colon, breast, cervix, and prostate have had stable disease for periods ranging from 4 to 6 months.Peripheral blood mononuclear cells (PBMC) from evaluable blood samples have shown pharmacodynamic effects consistent with the expected mechanism of action of CBL0137.These initial results are encouraging, and Incuron plans to initiate a multicenter study of CBL0137 in patients with hematological malignancies in 2015."

"Finally, the Phase 1 healthy subject study of CBLB612, a drug candidate in development for the induction and mobilization of hematopoietic stem cells (HSCs) continues.In addition to evaluating safety, tolerability and pharmacology of a single administration of CBLB612, this study has been designed to characterize the type, quantity and timing of HSC mobilization in these subjects.We look forward to sharing continued progress with our drug candidates as more clinical data becomes available."

Further Financial Highlights

Revenue for the fourth quarter of 2014 decreased to $1.4 million compared to $3.9 million for the fourth quarter of 2013.Revenue for fiscal 2014 decreased to $3.7 million compared to $8.5 million for the same period in 2013.These decreases were primarily the result of the completion of contracts with the Department of Defense for entolimod's biodefense indication and variances in the levels of development activity under other contracts with MPT.

Research and development costs for the fourth quarter of 2014 decreased to $2.8 million compared to $4.6 million for the same period in 2013.Research and development costs for fiscal 2014 decreased to $9.7 million compared to $19.5 million for the same period in fiscal 2013.These decreases were primarily due to completion of third-party service contracts for several compounds in-line with and largely in support of the contracted development work discussed above, as well as reduced compensation costs in-line with our reduced workforce.

General and administrative costs for the fourth quarter of 2014 decreased to $2.0 million compared to $2.3 million for the same period in 2013.General and administrative costs for fiscal 2014 decreased to $8.5 million compared to $12.0 million for the same period in 2013.For the year, $2.2 million of these decreases were due to reduction in personnel and consultants.

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Human evolution questioned: 'Big brain gene found humans, not chimps'

Posted: February 27, 2015 at 10:51 pm

Human evolution questioned: 'Big brain gene found humans, not chimps'

A single gene may have paved the way for the rise of human intelligence by dramatically increasing the number of brain cells found in a key brain region.

This gene seems to be uniquely human: It is found in modern-day humans, Neanderthals and another branch of extinct humans called Denisovans, but not in chimpanzees.

By allowing the brain region called the neocortex to contain many more neurons, the tiny snippet of DNA may have laid the foundation for the human brain's massive expansion.

"It is so cool that one tiny gene alone may suffice to affect the phenotype of the stem cells, which contributed the most to the expansion of the neocortex," said study lead author Marta Florio, a doctoral candidate in molecular and cellular biology and genetics at the Max Planck Institute of Molecular Cell Biology and Genetics in Dresden, Germany.

Still, it's likely this gene is just one of many genetic changes that make human cognition special, Florio said.

An expanding brain

The evolution from primitive apes to humans with complex language and culture has taken millions of years.

Some 3.8 million ago, Australopithecus afarensis, the species typified by the iconic early human ancestor fossil Lucy, had a brain that was less than 30 cubic inches (500 cubic centimeters) in volume, or about a third the size of the modern human brain.

By about 1.8 million years ago, Homo erectus was equipped with a brain that was roughly twice as big as that of Australopithecus.

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UW Stem Cell Researchers Building a 'Retinal Patch' to …

Posted: February 27, 2015 at 10:51 pm

Madison, Wisconsin A team led by a University of Wisconsin School of Medicine and Public Health stem-cell scientist and ophthalmologist is beginning work on a patch made of induced pluripotent stem cells (iPSCs) to help restore vision to people whose retinas have been damaged by conditions such as retinitis pigmentosa and age-related macular degeneration.

Dr. David Gamm, director of the McPherson Eye Research Institute and associate professor of ophthalmology and visual sciences at the UW School of Medicine and Public Health, and collaborators will begin developing the stem-cell therapy, thanks to a $900,000 grant from the Foundation Fighting Blindness.

Gamm, a pioneer in retinal stem-cell research, says that a two-layered patch of cells to replace damaged retinal tissue could be the best strategy for reconstructing the outer retina when multiple cell types have succumbed to disease. Gamms lab has succeeded in using stem-cell technology to turn skin and blood cells into retinal cells.

The continuing challenge has been to get the transplanted cells to survive the hostile conditions of the diseased retina, arrange themselves appropriately, and make the necessary connections to restore vision, says Gamm. I believe we have a plan that will make progress toward that goal.

Video: Learn more about how David Gamm is using stem cells to treat retinal diseases.

Gamms collaborators include Dr. James Thomson of the Morgridge Institute for Research, Dr. Derek Hei of the UW-Madison Waisman Center and Dr. Dennis Clegg of the University of California-Santa Barbara.

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Stem cell therapy a boon to Parkinson's patients

Posted: February 27, 2015 at 10:44 pm

Bengaluru:Feb 27, 2015, DHNS

Two courses of stem cell therapy have helped Ashok Kumar, 59, who suffered from tremors and rigidity due to Parkinsons disease, recover completely, much to the joy of his family. The man was brought inside my cabin in a wheelchair. He was unable to even sit on the chair without support. Today, he walks independently. Stem cell therapy has made it possible for him, said Dr Naseem Sadiq, Director, Plexus Neuro and Stem Cell Research Centre, who began treating Kumar in October, last year.

Previously, medication and surgical procedure were the only treatment option for Parkinsons disease. Medication in the long-term often lacks effectiveness and may cause side effects, while surgery is not always feasible. Lately, stem cell therapy has turned out to be a boon for patients with Parkinsons, Dr Sadiq said.

Kumar is among the few who have benefited from stem cell therapy. However, though the State has been reporting an increase in the number of registered stem cell donors, it is far behind sufficient as the genetic match between donor and recipient could be anywhere between one in 10,000 and one in two million, according to experts.

Speaking to Deccan Herald, Raghu Rajgopal, co-founder, Datri, a registry for stem cell donation, said, The response we get from Karnataka when we conduct stem cell camps is great. We see a lot of people and registering with us.

As many as 6,000 people have registered from the State under the Datri registry. A total of 72,000 people have registered across the country. In Kerala, 11,000 have signed up, the highest so far, he said.

Among the common myths are that by donating stem cells one turns infertile and weak, have increased chances of cancer and also that there would be excess loss of blood, he said.

According to studies, over one lakh people are diagnosed with Leukemia (blood cancer) and other blood disorders every year in India. The Indian Council of Medical Research has predicted that by the end of 2015, Leukemia cases will reach an estimated 1,17,649 and 1,32,574 by 2020. Stem cell therapy is a widely used treatment mechanism for Leukemia.

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Graphene derivative interferes with seemingly invincible cancer stem cells

Posted: February 27, 2015 at 1:48 am

While well known for its unique electromechanical properties, graphene may also prove key in preventing cancer tumor recurrence. A drawback of traditional cancer treatment with radiation and chemotherapy is that the primary developmental source of future tumors is not eradicated. Cancer stem cells, or CSCs, can survive treatment and give rise to recurring tumors, metatasis, and drug resistance after repeated treatments. Researchers from the University of Manchester and the University of Calabria have discovered that graphene oxides targets and neutralize CSCs in a manner that is not yet fully understood.

One CSC can develop into a ball of new CSCs called a tumor-sphere, or into new tumor cells, such as what happens in metastasis. They're immortal, divide rapidly, and resist stress. A potential solution? Graphene oxide, GO, which is an oxidized form of its well-known carbon cousin and soluble in many solvents.

For a complete look at the efficacy of GO across cancers, researchers used CSCs from six types of cancer: breast, pancreatic, lung, brain, ovarian and prostate. They also used normal skin cells to confirm that GO would not be toxic to the body.

After cells were treated for 48 hours with a GO solution, the researchers found that not only did GO interrupt the ability of CSCs in all cancer types to proliferate by forming spheres, but that GO was safe to the skin cells.

Dr Aravind Vijayaraghavan of the National Graphene Institute at the University of Manchester says that GO seems to force the cancer stem cells to differentiate into non-cancer stem cells. In this way, GO effectively takes the CSC out of commission for creating future tumors. Currently the theory is that GO interferes with the signalling pathways in the cell membranes, curbing the proliferation mechanism.

Interestingly, this graphene derivative had already been researched for as a targeted delivery vehicle in tumors, but has now been found to have an important effect itself on the tumor.

While the researchers acknowledge that the mechanisms at play need to be researched more before the material can be used to treat cancers, the ability to destroy cancer stem cells is an an important component of a cancer treatment protocol that kills existing tumors as well as shuts down future metatasis.

Vijayaraghavan and the Graphene Institute have previously made headlines as a recipient of research money from the Bill and Melinda Gates Foundation towards the development of a better condom. Their proposal, of course, used graphene.

The team's research was originally published in Oncotarget on February 24, 2015.

Source: University of Manchester

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Moffitt researchers identify protein pathway involved in brain tumor stem cell growth

Posted: February 27, 2015 at 1:48 am

H. Lee Moffitt Cancer Center & Research Institute

TAMPA, Fla. - Glioblastomas are a highly aggressive type of brain tumor, with few effective treatment options. Moffitt Cancer Center researchers are one step closer to understanding glioblastoma development following the identification of a key protein signaling pathway involved in brain tumor stem cell growth and survival. Brain tumor stem cells are believed to play an important role in glioblastoma development and may be possible therapeutic targets.

The neurotrophin protein pathway controls nerve growth, survival and specialization. In an article published in the Feb. 6 issue of The Journal of Biological Chemistry, Moffitt researchers reported that the neurotrophin pathway is also involved in the survival and growth of brain tumor stem cells. The stem cells have high levels of neurotrophin receptors called TrkB and TrkC. Cellular signals from normal brain cells can activate TrkB and TrkC on the stem cells and stimulate cell growth. And when scientists inhibited TrkB and TrkC, they found decreased stem cell survival. This suggests that TrkB and TrkC may be possible drug targets for stem cells in gliomas and glioblastomas.

"This work might be a first step in developing new treatment approaches targeting brain tumor stem cells. It may also partly explain why brain tumors can grow so quickly since proteins from the surrounding normal brain might be used by the tumor to grow even faster," said Peter A. Forsyth, M.D., chair of the Department of Neuro-Oncology at Moffitt.

Researchers also reported a potential reason why several clinical trials targeting a protein called EGFR in glioblastoma patients have failed to live up to expectations. EGFR is frequently activated in glioblastoma, but results from trials using EGFR inhibitors showed little or no patient improvement. Moffitt scientists discovered that TrkB and TrkC maintain brain stem cell survival and growth even when EGFR inhibitors are used. These observations suggest that one reason why EGFR inhibitors may be ineffective in glioblastoma is that TrkB and TrkC are active, thereby bypassing EGFR inhibition and allowing stem cells to continue to grow.

This is the first time that scientists have shown that TrkB and TrkC are involved in brain tumor stem cell growth. Currently, no drugs that target TrkB and TrkC have been used as brain cancer treatments. Researchers hope that these results might encourage the development of drugs that target both the stem cell compartment and the more differentiated parts of the brain tumor and result in more effective therapies.

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The study was supported by funds The V Foundation for Cancer Research and the Moffitt Cancer Center Foundation.

About Moffitt Cancer Center:

Located in Tampa, Moffitt is one of only 41 National Cancer Institute-designated Comprehensive Cancer Centers, a distinction that recognizes Moffitt's excellence in research, its contributions to clinical trials, prevention and cancer control. Moffitt is the top-ranked cancer hospital in the Southeast and has been listed in U.S. News & World Report's "Best Hospitals" for cancer care since 1999. With more than 4,500 employees, Moffitt has an economic impact in Florida of nearly $1.6 billion. For more information, visit MOFFITT.org, and follow the Moffitt momentum on Facebook, Twitter and YouTube.

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Small molecule helps get stem cells to sites of disease, damage

Posted: February 27, 2015 at 1:48 am

Bioengineers from Brigham and Women's Hospital (BWH) with collaborators at the pharmaceutical company Sanofi have identified small molecules that can be used to program stem cells to home in on sites of damage, disease and inflammation. The techniques used to find and test these small molecules may represent important tools in advancing cell-based therapy, offering a new strategy for delivering cells to the right locations in the body. The results of their work appear online this week in Cell Reports.

Through a collaborative research project, the research team tested more than 9,000 compounds, and used a multi-step approach -- including a sophisticated microfluidics set up and novel imaging technique -- to narrow in on and test the most promising compounds.

"There are all kinds of techniques and tools that can be used to manipulate cells outside of the body and get them to do almost anything we want, but once we transplant cells we lose complete control over them," said co-senior author Jeff Karp, PhD, an associate professor at BWH, Harvard Medical School, and principal faculty at the Harvard Stem Cell Institute. "Through this collaboration, we've been able to identify small molecules that can be used to treat cells outside of the body, programming them to target blood vessels in diseased or damaged tissue."

Small molecules offered the team several advantages including the ability to use a safe and relatively simple procedure to pre-treat the cells before injecting them intravenously.

"There's a great need to develop strategies that improve the clinical impact of cell-based therapies," said co-first author Oren Levy, PhD, an instructor in medicine at BWH. "If you can create an engineering strategy that is safe, cost effective and simple to apply, that's exactly what we need to achieve the promise of cell-based therapy."

Karp's team at the Brigham had previously found that it is possible to use bioengineering techniques to chemically attach molecules to the surface of a cell that act as a GPS, guiding the cell to the site of inflammation. These findings indicated that targeted delivery of cells was possible, but a scalable approach would be needed to impact patients.

"At BWH, we had laid the groundwork. Our collaborators at Sanofi have complementary expertise in screening for small molecules, deep understanding of the biology and unmet needs, and an exceptional ability to bring new therapeutics to the clinic," said Karp. "Defined goals and both teams working seamlessly together created perfect synergy. We learned so much from each other."

The Sanofi team screened thousands of compounds, looking for ones that activated telltale molecules on the surface of the MSCs, as well as verified that the active compounds did not alter mesenchymal stromal cell viability or the profile of secreted immunomodulatory protein factors.

There are currently more than 450 clinical trials ongoing or completed using mesenchymal stem cells (MSCs) to treat a range of diseases including heart attacks, Crohn's disease, lupus, multiple sclerosis and more, but many trials fail to meet clinical endpoints. One of the key challenges has been getting MSCs to arrive at -- and stay at -- sites of damage.

Researchers found six promising molecules, including one known as Ro-31-8425, the most potent of the group. Karp's lab then tested these compounds further by pre-treating cells with them, and then flowed the cells onto a microfluidic device -- a glass slide with tiny channels only big enough to allow small groups of cells to flow through at a time. The channels were coated with an Intracellular Adhesion Molecule (ICAM-1), which is also found on the surface of blood vessels at inflamed tissue within the body. Cells pre-treated with Ro-31-8425 stuck -- a sign that they might be able to home in on sites of inflammation.

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