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RL1-00662-1: Derivation and analysis of pluripotent stem cell lines with inherited TGF-b mediated disorders from donated IVF embryos and reprogrammed adult skin fibroblasts
Recommendation: Recommended for funding
Scientific Score: 79
First Year Funds Requested: $474,804
Total Funds Requested: $1,424,412
Public Abstract (provided by applicant)
The field of regenerative medicine revolves around the capacity of a subset of cells, called stem cells, to become the mature tissues of the adult human body. By studying stem cells, we hope to develop methods and reagents for treating disease. For instance, we hope to develop methods for making stem cells become cardiovascular cells in the lab which could then be used to rapidly screen large numbers drugs that may be used to treat cardiovascular disease. In another example, if we are able to create bone in the lab from stem cells, we may be able to help treat people with catastrophic skeletal injuries such as wounded soldiers. Until recently, the most flexible type of stem cell known was the embryonic stem cell. Embryonic stem cells are pluripotent, meaning they can give rise to all of the adult tissues. In contrast, stem cells found in the adult are considered only multipotent, in that they can only become a limited number of mature cells. For example, bone marrow stem cells can give rise to all of the components of the blood, but cannot make nerves for a spinal chord. Breakthroughs in the past couple of months have indicated that it is possible to "reprogram" adult skin cells and make them become pluripotent, like stem cells from an embryo. These new kind of cells ares called "induced pluripotent cells" or iPS cells for short. This has lead to great excitement within the scientific community because it raises the possibility that we may use this technology to rapidly create pluripotent stem cells from a large host of human diseases using skin from affected individuals. However, whether the new iPS cells made from skin cells and embryonic stem cells are functionally the same in all applications remains to be seen. Our lab is in the unique position to test this hypothesis. We have derived several normal embryonic stem cell lines and are in the process of deriving iPS cells from normal skin. Furthermore, we are fortunate enough to have begun deriving a new embryonic stem cell line harboring an inherited mutation that results in severe cardiovascular and bone disease that affects more than 7,500 Californians. What's more, one of our collaborators has over the past ten years assembled a cell bank of more that 50 unique adult skin cell lines with the same inherited disease. Therefore, for our proposal, we will make new normal and disease specific iPS and embryonic stem cell lines. We will use these new stem cell lines to test whether the iPS and embryonic stem cells are truly functionally the same, by comparing them after we make them become cardiovascular and bone cells. This work will allow us to advance the field of regenerative medicine on two fronts. 1. We will perform an important comparison of iPS and embryonic stem cell lines. 2. We will compare the disease specific cells with normal cells which will help us better understand cardiovascular and bone disease and pave the way for the development of new therapies.
Statement of Benefit to California (provided by applicant)
Our proposal compares normal and disease specific pluripotent stem cells derived from embryonic and adult skin sources. This proposal will benefit the state of California and its citizens in several specific ways. First, the specific inherited disease we are studying affects approximately one in every 5,000 people worldwide. That translates into over 7,500 Californians and over 60,000 men, women and children of every race and ethnic group in the United States. By examining the characteristics of the disease specific lines, we hope to better understand the mechanisms of the disease and create assays for screening new drugs that can be used to treat people with the disease. Second, this disease is one of a broad class of cardiovascular disease, called thoracic aortic disease. An estimated 3,700 Californians are treated for thoracic aortic disease every year. Our findings may provide insight into the mechanisms underlying these diseases and other cardiovascular diseases. Third, this disease also results in skeletal defects. By studying the mechanisms of the skeletal defects, we will better understand the mechanisms of bone development, which will lead to improved applications of stem cell therapies for individuals with bone injury and disease. Finally, by providing detailed comparisons of iPS and embryonic stem cells, our work will have important ramifications for the future direction of the entire field of stem cell research and regenerative medicine.
Review
This proposal aims at deriving pluripotent stem cell lines carrying mutations that cause Marfan Syndrome (MFS) and a related disease, Loeys-Dietz Syndrome (LDS). MFS patients suffer from connective tissue defects in the skeletal, ocular, and cardiovascular compartments. The applicant will derive disease-specific pluripotent cell lines, both induced pluripotent stem cell (iPSC) lines and human embryonic stem cell (hESC) lines, and intends to test whether they are similar in their capacities for prolonged undifferentiated euploid growth and differentiation potential. The focus is on differentiation of cardiovascular and osteogenic cell types from the pluripotent stem cells.
The proposed iPSC and hESC lines may provide new approaches to study the disease progression and pathology of MFS and LDS, and to develop drug screens relevant to thoracic aortic disease, a clinical manifestation of MFS and an important clinical target. The PI thus provides an excellent rationale for the project, which was considered to be of high significance. During the discussion, reviewers considered whether the generation of iPSC and hESC lines was necessary to study the mesenchymal derivatives as proposed in this application, rather than studying patient-derived fibroblasts directly. However, it is important to note (as one reviewer did) that the disease phenotypes may be initiated early during differentiation, so that only pluripotent cells could provide insight into early defects that may be responsible for the ultimate disease phenotype.
This is a very well written, focused proposal that provides the right balance of experimental detail, so that reviewers had reasonable expectations for success. The principal investigator (PI) has a very good, relevant track record of peer-reviewed publications, and the assembled team seems ideally suited to carry out these derivations. Although some of the proposed cell line characterization studies are technically challenging, the approach is well described and the PI has access to appropriate and outstanding resources. Although not essential, it is hoped that hESC can be generated from donor embryos, and iPSC from the same donor couple, such that the same mutation could be studied in both contexts (yielding extra information about differences between iPSC and primary hESC). The direct comparison between iPSC and hESC was considered a major strength of this proposal. Overall, the proposed work has a high likelihood of success in generating novel human pluripotent stem cell lines carrying clinically-relevant disease genes.
Reviewer synopsis
This is a project to derive iPSC and hESC lines representing Marfan Syndrome (MFS) or the related Loeys-Dietz Syndrome (LDS).
The following Working Group members had a conflict of interest with this application and were therefore recused from participating in review of, discussion of, and voting on the application:- None

