Neurological Disorders

Coding Dimension ID: 
303
Coding Dimension path name: 
Neurological Disorders
Funding Type: 
Tools and Technologies II
Grant Number: 
RT2-02018
Investigator: 
Name: 
Institution: 
Type: 
PI
ICOC Funds Committed: 
$1 930 608
Disease Focus: 
Stroke
Neurological Disorders
Stem Cell Use: 
Adult Stem Cell
oldStatus: 
Active
Public Abstract: 

Clinical application of cell transplantation therapy requires a means of non-invasively monitoring these cells in the patient. Several imaging modalities, including MRI, bioluminescence imaging, and positron emission tomography have been used to track stem cells in vivo. For MR imaging, cells are pre-loaded with molecules or particles that substantially alter the image brightness; the most common such labelling strategy employs iron oxide particles. Several studies have shown the ability of MRI to longitudinally track transplanted iron-labeled cells in different animal models, including stroke and cancer. But there are drawbacks to this kind of labeling. Division of cells will result in the dilution of particles and loss of signal. False signal can be detected from dying cells or if the cells of interest are ingested by other cells.

To overcome these roadblocks in the drive toward clinical implementation of stem cell tracking, it is now believed that a genetic labeling approach will be necessary, whereby specific protein expression causes the formation of suitable contrast agents. Such endogenous and persistent generation of cellular contrast would be particularly valuable to the field of stem cell therapy, where the homing ability of transplanted stem cells, long-term viability, and capacity for differentiation are all known to strongly influence therapeutic outcomes. However, genetic labeling or "gene reporter" strategies that permit sensitive detection of rare cells, non-invasively and deep in tissue, have not yet been developed. This is therefore the translational bottleneck that we propose to address in this grant, through the development and validation of a novel high-sensitivity MRI gene reporter technology.

There have been recent reports of gene-mediated cellular production of magnetic iron-oxide nanoparticles of the same composition as the synthetic iron oxide particles used widely in exogenous labeling studies. It is an extension of this strategy, combined with our own strengths in developing high-sensitivity MRI technology, that we propose to apply to the task of single cell tracking of metastatic cancer cells and neural stem cells.

If we are successful with the proposed studies, we will have substantially advanced the field of in vivo cellular imaging, by providing a stable cell tracking technology that could be used to study events occurring at arbitrary depth in tissue (unlike optical methods) and over unlimited time duration and arbitrary number of cell divisions (unlike conventional cellular MRI).
With the ability to track not only the fate (migration, homing and proliferation) but also the viability and function of very small numbers of stem cells will come new knowledge of the behavior of these cells in a far more relevant micro-environment compared with current in vitro models, and yet with far better visualization and cell detection sensitivity compared with other in vivo imaging methods.

Statement of Benefit to California: 

Stem cell therapy has enormous promise to become a viable therapy for a range of illnesses, including stroke, other cardiovascular diseases, and neurological diseases. Progress in the development of these therapies depends on the ability to monitor cell delivery, migration and therapeutic action at the disease site, using imaging and other non-invasive technologies. If breakthroughs could be made along these lines, it would not only be of enormous benefit to the citizens of the state of California, but would also greatly reduce healthcare costs.

From a broader research perspective, the state of California is the front-runner in stem cell research, having gathered not only private investments, as demonstrated by the numerous biotechnology companies that are developing innovative tools, but also extensive public funds that allows the state, through CIRM, to sponsor stem cell research in public and private institutions. In order to preserve the leadership position and encourage research on stem cells, CIRM is calling for research proposals to develop innovative tools and technologies that will overcome current roadblocks in translational stem cell research. This proposal will benefit the state by providing important new technology that will be valuable for both basic and translational stem cell research.

A key bottleneck to the further development and translation of new stem cell therapies is the inability to track stem cells through a human body. It is possible to image stem cells using embedded optical fluorescence labels, but optical imaging does not permit tracking of cells deep in tissue. Other imaging modalities and their associated cellular labels (for example positron emission tomography) have also been used to track cells but do not have the sensitivity to detect rare or single cells. Finally, MRI has been used to track cells deep in tissue, down to the single cell level, but only by pre-loading cells with a non-renewable supply of iron oxide nanoparticles, which prevents long-term tracking and assessment of cell viability and function. We propose here to develop MRI technology and a new form of genetically-encoded, long-term cell labeling technology, to a much more advanced state than available at present. This will make it possible to use MRI to detect and follow cancer and stem cells as they migrate to and proliferate at the site of interest, even starting from the single cell stage. This will provide a technology that will help stem cell researchers, first and foremost in California, to understand stem cell behavior in a realistic in vivo environment. This technology will be translatable to future human stem cell research studies.

Progress Report: 
  • We have made good progress in the first year. This project involves four separate scientific teams, brought together for the first time, representing diverse backgrounds ranging from magnetic resonance imaging (MRI) physics and cell tracking (Dr. Rutt), microbiology (Dr. Matin), nano and magnetic characterization (Dr. Moler) and stem cell imaging in stroke models (Dr. Guzman). Substantial progress has been made by all four teams, and we are starting to see important interactions between the teams. An overall summary of progress is that we have evaluated three different bacterial genes (magA, mms6, mamB) in one mammalian cell line (MDA-MB-231BR) and have shown significant iron accumulation in vitro with two of these genes, which is a very positive result implying that these genes may have the required characteristics to act as "reporter genes" for MRI-based tracking of cells labeled with these genes. MR imaging of mouse brain specimens has yielded promising results and in vivo imaging experiments are underway at medium MRI field strength (3 Tesla). At the same time, we are ramping up our higher field, higher sensitivity MR imaging methods and will be ready to evaluate the different variations of our MR reporter gene at 7 Tesla (the highest magnetic field widely available for human MRI) in the near future. Finally, methods to perform quantitative characterization of our reporter cells are being developed, with the goal of being able to characterize magnetic properties down to the single cell level, and also to be able to assess iron loading levels down to the single level in brain tissue slices.
  • We have made good progress in the second year. This project involves four separate scientific teams, brought together for the first time for this project, representing diverse backgrounds ranging from magnetic resonance imaging (MRI) physics and cell tracking (Dr. Rutt), microbiology (Dr. Matin), nano and magnetic characterization (Dr. Moler) and imaging reporter development and testing in small animal models of disease (Dr. Contag). Substantial progress has been made by all four teams, and we are starting to see important interactions between the teams.
  • An overall summary of progress is that we have been evaluating three different bacterial genes (magA, mms6, mamB) in two mammalian cell lines (MDA-MB-231BR and DAOY). In year I we had shown significant iron accumulation in vitro with two of these genes, which was a very positive result implying that these genes may have the required characteristics to act as "reporter genes" for MRI-based tracking of cells labeled with these genes. In year 2, we diversified and intensified the efforts to achieve expression of one or more of the bacterial genes in different cell lines, using different genetic constructs. We began a concerted effort to achieve optical labeling such that we could visualize the gene expression and to identify sub-cellular localization of the report gene products.
  • We obtained promising results from MR imaging of mouse brain. In vivo imaging experiments were accomplished at medium MRI field strength (3 Tesla). At the same time, we ramped up our higher field, higher sensitivity MR imaging methods and began to evaluate the sensitivity gains enabled at the higher magnetic field strength of 7 Tesla (the highest magnetic field widely available for human MRI
  • Finally, methods to perform quantitative characterization of our reporter cells were developed, with the goal of being able to characterize magnetic properties down to the single cell level, and also to be able to assess iron loading levels down to the single level in brain tissue slices.
  • We have made good progress in the third year. This project involves four separate scientific teams, brought together for the first time for this project, representing diverse backgrounds ranging from magnetic resonance imaging (MRI) physics and cell tracking (Dr. Rutt), microbiology (Dr. Matin), nano and magnetic characterization (Dr. Moler) and imaging reporter development and testing in small animal models of disease (Dr. Contag). Substantial progress has been made by all four teams, and we have benefited from important interactions between all teams in this third year.
  • An overall summary of progress is that we evaluated several iron-binding bacterial genes (magA, mamB, mms6, mms13), both singly and doubly, in two mammalian cell lines (MDA-MB-231BR and DAOY). In year 2, we diversified and intensified the efforts to achieve expression of one or more of the bacterial genes in different cell lines, using different genetic constructs. We completed an effort to achieve optical labeling such that we could visualize the gene expression and to identify sub-cellular localization of the report gene products. In year 3, while continuing to face challenges with single gene constructs, we succeeded in finding substantial iron uptake in cells containing unique double gene expression, notably magA and mms13.
  • We completed much of the development of our higher field, higher sensitivity MR imaging methods and evaluated the sensitivity gains enabled at the higher magnetic field strength of 7 Tesla (the highest magnetic field widely available for human MRI).
  • Finally, we demonstrated novel nanomagnetic methods to characterize our reporter cells, able to characterize magnetic properties down to the single cell level.
  • We have made good progress during this 6-month extension period. This project involves four separate scientific teams, brought together for the first time for this project, representing diverse backgrounds ranging from magnetic resonance imaging (MRI) physics and cell tracking (Dr. Rutt), microbiology (Dr. Matin), nano and magnetic characterization (Dr. Moler) and imaging reporter development and testing in small animal models of disease (Dr. Contag). Substantial progress has been made by all four teams, and we have benefited from important interactions between all teams in this third year.
  • An overall summary of progress is that we evaluated several iron-binding bacterial genes (magA, mamB, mms6, mms13), singly, doubly and triply, in several mammalian cell lines (MDA-MB-231BR, DAOY, COS1, 293FT). In year 3 as well as through the extension period, we succeeded in finding substantial iron uptake in cells containing certain expressed genes, notably mms13 by itself, as well as combinations of mms13 with mms6 and mamB.
  • We completed the development of our higher field, higher sensitivity MR imaging methods and evaluated the sensitivity gains enabled at the higher magnetic field strength of 7 Tesla (the highest magnetic field widely available for human MRI).
  • Finally, we demonstrated novel nanomagnetic methods to characterize our reporter cells, able to characterize magnetic properties down to the single cell level.
Funding Type: 
Tools and Technologies II
Grant Number: 
RT2-01927
Investigator: 
ICOC Funds Committed: 
$1 816 157
Disease Focus: 
Alzheimer's Disease
Neurological Disorders
Stem Cell Use: 
iPS Cell
Cell Line Generation: 
iPS Cell
oldStatus: 
Active
Public Abstract: 

Elucidating how genetic variation contributes to disease susceptibility and drug response requires human Induced Pluripotent Stem Cell (hIPSC) lines from many human patients. Yet, current methods of hIPSC generation are labor-intensive and expensive. Thus, a cost-effective, non-labor intensive set of methods for hIPSC generation and characterization is essential to bring the translational potential of hIPSC to disease modeling, drug discovery, genomic analysis, etc.

Our project combines technology development and scaling methods to increase throughput and reduce cost of hiPSC generation at least 10-fold, enabling the demonstration, and criterion for success, that we can generate 300 useful hiPSC lines (6 independent lines each for 50 individuals) by the end of this project. Thus, we propose to develop an efficient, cost effective, and minimally labor-intensive pipeline of methods for hIPSC identification and characterization that will enable routine generation of tens to hundreds of independent hIPSC lines from human patients. We will achieve this goal by adapting two simple and high throughput methods to enable analysis of many candidate hIPSC lines in large pools. These methods are already working in our labs and are called "fluorescence cell barcoding" (FCB) and expression cell barcoding (ECB).

To reach a goal of generating 6 high quality hIPSC lines from one patient, as many as 60 candidate hIPSC colonies must be expanded and evaluated individually using labor and cost intensive methods. By improving culturing protocols, and implementing suitable pooled analysis strategies, we propose to increase throughput at least 10-fold with a substantial drop in cost. In outline, the pipeline we propose to develop will begin with the generation of 60 candidate hIPSC lines per patient directly in 96 well plates. All 60 will be analyzed for diagnostic hIPSC markers by FCB in 1 pooled sample. The 10 best candidates per patient will then be picked for expression and multilineage differentiation analyses with the goal of finding the best 6 from each patient for digital karyotype analyses. Success at 10-fold scaleup as proposed here may be the first step towards further scaleup once these methods are fully developed.

Aim 1: To develop a cost-effective and minimally labor-intensive set of methods/pipeline for the generation and characterization high quality hIPSC lines from large numbers of human patients. We will test suitability/develop a set of methods that allow inexpensive and rapid characterization of 60 candidate hIPSC lines per patient at a time.

Aim 2: To demonstrate/test/evaluate the success and cost-effectiveness of our pipeline by generating 6 high quality hIPSC lines from each of 50 human patients from [REDACTED]. We will obtain skin biopsies and expand fibroblasts from 50 patients, and generate and analyze a total of 6 independent hIPSC lines from each using the methods developed in Aim 1.

Statement of Benefit to California: 

Many Californians suffer from diseases whose origin is poorly understood, and which are not treatable in an effective or economically advantageous manner. Part of solving this problem relies upon elucidating how genetic variation contributes to disease susceptibility and drug response and better understanding disease mechanism. Achieving these goals can be accelerated through the use of human Induced Pluripotent Stem Cell (hIPSC) lines from many human patients. Yet, current methods of hIPSC generation are labor-intensive and expensive. Thus, a cost-effective, non-labor intensive set of methods for hIPSC generation and characterization is essential to bring the translational potential of hIPSC to disease modeling, drug discovery, genomic analysis, etc.

If successful, our project will lead to breakthroughs in understanding of disease, development of better therapies, and economic development in California as businesses that use our methods are launched. In addition, new therapies will bring cost-savings in healthcare to Californians, stimulate employment since Californians will be employed in businesses that develop and sell these therapies, and relieve much suffering from the burdens of chronic disease.

Progress Report: 
  • An important problem in stem cell and regenerative medicine research has been the ability to quickly and cheaply generate and characterize reprogrammed stem cells from defined human patients. The primary goal of our project is to address this need by developing new technologies that allow stem cell lines to be characterized in large mixed pools as opposed to one by one. Our new methods use flow cytometry and highly sensitive methods for detecting the activity of genes in the cell lines. We made excellent progress in the first year and reduced flow cytometry methods to practice taking advantage of a method called fluorescence cell barcoding. Methods for analyzing activity of genes and chromosome number are in progress and being tested. Our ultimate goal is to reduce cost tenfold and increase speed by about tenfold and our methods development is on track to accomplish this aim.
  • A key bottleneck in reprogramming technology to make induced pluripotent stem (IPS) cell lines is the ability to make large numbers of lines from large numbers of patients in a way that is cost effective and minimizes labor. Our project has focused primarily on dropping the cost of characterization of candidate lines. We have made a number of discoveries about the behavior of candidate reprogrammed lines that allow us to drop cost and labor needed for candidate reprogrammed line characterization. We measured the frequency of candidate lines that were well-behaved in a large retroviral reprogramming experiment, which allows us to rigorously estimate how many candidate lines must be picked and analyzed if 4-6 high-quality lines are to be generated for every patient fibroblast sample subjected to typical retroviral reprogramming technology. We then continued our work on developing a combination of different array and microfluidic chip technologies to measure the chromosome number in each candidate line and the ability of each line to be pluripotent, i.e., to be able to generate many different type of cells similar to embryonic stem cells. We are optimistic that our work will simplify and drop the cost of the characterization process so that it costs far less than before our work was initiated.
  • Reprogrammed stem cell lines, i.e., induced pluripotent stem cell lines, have the potential to revolutionize research into causes of disease and genetic contributions to the causes of disease. One key limitation, however, is the ability to generate large numbers of different stem cell lines from different people to sample the range of genetic variation in the human population as it relates to disease development. A key bottleneck is the speed and cost with which reprogrammed stem cell lines can be generated and validated for usefulness. We have succeeded in developing a streamlined workflow for characterization of reprogrammed stem cell lines that drops the cost for characterization from several thousand dollars to a few hundred dollars and increases the speed and number of lines that can be handled substantially. We take advantage of novel genetic characterization methods to analyze genetic stability and the pattern of gene expression as it reveals the capabilities of the stem cell lines. We are finishing up the loose ends on this project now and should have a high quality publication prepared for submission shortly that describes this simple and inexpensive workflow that we have developed with modern gene characterization methods.
Funding Type: 
Tools and Technologies II
Grant Number: 
RT2-01920
Investigator: 
ICOC Funds Committed: 
$1 833 054
Disease Focus: 
Neurological Disorders
Pediatrics
Stem Cell Use: 
iPS Cell
Cell Line Generation: 
iPS Cell
oldStatus: 
Active
Public Abstract: 

This study will use Ataxia-Telangiectasia (A-T), an early-onset inherited neurodegenerative disease of children, as a model to study the mechanisms leading to cerebellar neurodegeneration and to develop a drug that can slow or halt neurodegeneration. We will start with skin cells that were originally grown from biopsies of patients with A-T who specifically carry “nonsense” type of mutations in the ATM gene. We will convert these skin cells to stem cells capable of forming neural cells that are lacking in the brain (cerebellum) of A-T patients; presumably these neural cells need ATM protein to develop normally. We will then test the effects of our most promising new “readthrough compounds” (RTCs) on the newly-developed neural cells. Our lab has been developing the drugs over the past six years. At present, there is no other disease model (animal or in a test tube) for evaluating the effects of RTCs on the nervous system and its development. Nor is there any effective treatment for the children with A-T or other progressively-deteriorating ataxias. Success in this project would open up at least three new areas for understanding and treating neurodegenerative diseases: 1) the laboratory availability of human neural cells with specific disease-causing mutations; 2) a new approach to learning how the human brain develops and 3) a new class of drugs (RTCs) that correct nonsense mutations, even in the brain, and may correct neurodegeneration.

Statement of Benefit to California: 

This project seeks to merge the expertise of two major research cultures: one with long-standing experience in developing a treatment for a progressive childhood-onset disease called Ataxia-telangiectasia and another with recent success in converting skin cells into cells of the nervous system. California citizens will benefit by finding new ways to treat neurodegenerative diseases, like A-T, Parkinson and Alzheimer, and expanding the many possible applications of stem cell technology to medicine. More specifically, we will construct a new “disease in a dish” model for neurodegeneration, and this will enable our scientists to test the positive and negative effects of a new class of drugs for correcting inherited diseases/mutations directly on brain cells. These advances will drastically decrease drug development costs and will stimulate new biotech opportunities and increase tax revenues for California, while also training the next generation of young scientists to deliver these new medical products to physicians and patients within the next five years.

Progress Report: 
  • No effective treatments are available for most neurodegenerative diseases. This study uses Ataxia-Telangiectasia (A-T), an early-onset inherited neurodegenerative disease of children, as a model to study the mechanisms leading to cerebellar neurodegeneration and to develop a drug that can slow or halt neurodegeneration. Aim1 proposed to use “Yamanaka factors” to reprogram A-T patient-derived skin fibroblasts, which carry nonsense mutations that we have shown can be induced by RTCs to express full-length and functional ATM protein, into iPSCs. We have successfully reprogrammed A-T fibroblasts to hiPSCs and teratoma formation shows their pluripotency. Aim2 will use these established iPSCs to model neurodegeneration, focusing on differentiation to cerebellar cells, such as Purkinje cells and granule cells. We have generated the Purkinje cell promoter –driven GFP reporter system and will use this system to examine the differentiation capacity of A-T iPSCs to Purkinje cells. Aim3 will utilize the newly-developed neural cells carrying disease-causing ATM nonsense mutations as targets for evaluating the potential therapeutic effects of leading RTCs. We have already started to test the efficacy and toxicity of our lead RTC compounds on A-T iPSC-derived neural progenitor cells. The continuation of this study will help us to pick up one promising RTC compound for IND application. This project is on the right track towards its objective for the development of disease models with hiPSCs and the test of our lead small molecule compounds for the treatment of A-T or other neurodegenerative diseases.
  • No effective treatments are available for most neurodegenerative diseases. This study uses Ataxia-Telangiectasia (A-T), an early-onset inherited neurodegenerative disease of children, as a model to study the mechanisms leading to cerebellar neurodegeneration and to develop a drug that can slow or halt neurodegeneration. Aim1 proposed to use “Yamanaka factors” to reprogram A-T patient-derived skin fibroblasts, which carry nonsense mutations that we have shown can be induced by RTCs to express full-length and functional ATM protein, into iPSCs. Aim2 will use these established iPSCs to model neurodegeneration, focusing on differentiation to cerebellar cells, such as Purkinje cells and granule cells. Aim3 will utilize the newly-developed neural cells carrying disease-causing ATM nonsense mutations as targets for evaluating the potential therapeutic effects of leading RTCs.
  • During the past two years of this project, we established Ataxia-telangiectasia (A-T) patient-derived iPSC lines from two patients which contain nonsense mutations and splicing mutations. These two lines are currently used for testing the mutation-targeted therapies with small molecule readthrough (SMRT) compounds and antisense morpholino oligonucleotides (AMOs). Manuscript describing this work was recently accepted, showing that SMRT compounds can abrogate phenotypes of A-T iPSC-derived neural cells
  • This is the third year (last year) progress report. During the first two years of this project, we have already established two Ataxia-telangiectasia (A-T) patient-derived iPSC lines which contain nonsense mutations and splicing mutations, respectively. These two lines are currently used for testing the mutation-targeted therapies with small molecule readthrough (SMRT) compounds and antisense morpholino oligonucleotides (AMOs). In the third year, we have formally published our results from the first two years’ research work in Nature Communications (Lee et al., 2013). In the last year, we continue to make progresses in the characterization of A-T iPSCs and their derived neuronal cells as well as developing the mutation-targeted therapies for neurodegeneration diseases
Funding Type: 
Tools and Technologies II
Grant Number: 
RT2-01906
Investigator: 
Institution: 
Type: 
PI
ICOC Funds Committed: 
$1 884 808
Disease Focus: 
Autism
Neurological Disorders
Pediatrics
Stem Cell Use: 
iPS Cell
Cell Line Generation: 
iPS Cell
oldStatus: 
Active
Public Abstract: 

Autism Spectrum Disorders (ASDs) are a heritable group of neuro-developmental disorders characterized by language impairments, difficulties in social integrations, and the presence of stereotyped and repetitive behaviors. There are no treatments for ASDs, and very few targets for drug development. Recent evidence suggests that some types of ASDs are caused by defects in calcium signaling during development of the nervous system. We have identified cellular defects in neurons derived from induced pluripotent stem cells (iPSCs) from patients with Timothy Syndrome (TS), caused by a rare mutation in a calcium channel that leads to autism. We propose to use cells carrying this mutant calcium channel to identify drugs that act on calcium signaling pathways that are involved in ASDs.

Our research project has three aims. First, we will determine whether known channel modulators reverse the cellular defects we observe in cells from TS patients. It is possible that we will find that existing drugs already approved for use in humans might be effective for treating this rare but devastating disorder.

Our second aim is to determine whether screens using neuronal cells derived from ASD patients can be used to identify calcium signaling modulators. A bottleneck to therapy development for ASDs has been the lack of appropriate in vitro models for these disorders, and we would like to determine whether our studies could serve as the basis for a new type of screen in human neurons.

Our third aim is to identify signaling molecules that might be affected in patients with ASDs, which could be targets for future drug discovery. There is increasing evidence that several types of ASDs are caused by defects in neuronal activity and calcium signaling. More specifically, the CaV1.2 calcium channel that we are studying has been implicated in syndromic and non-syndromic forms of autism, and also in schizophrenia and bipolar disorder. One of the more exciting aspects of our screen of neurons with a mutation in CaV1.2 is that it gives us a tool to explore calcium-mediated signaling pathways that are defective in ASDs. We will try to modify calcium signaling in neurons from ASD patients by changing the expression of proteins that are known to affect calcium signaling in other contexts. These experiments will identify targets that are active in human neurons and that affect cellular phenotypes that are defective in ASD.

In summary, the work described in this proposal constitutes a critical step to fulfilling the promise that reprogramming of patient-specific cells offers for the treatment of neuropsychiatric disorders such as autism. Our studies will identify lead compounds that could be tested in the clinic for a rare form of autism, and novel molecular targets for therapeutic development in the future. Importantly, these studies will provide a proof of principle that iPSC-derived cells are valuable for drug discovery for neuropsychiatric disorders.

Statement of Benefit to California: 

Autism Spectrum Disorders (ASDs) affect approximately 1 in 110 children in California. In addition to the devastating effects that ASDs have on the families of affected individuals, treating and educating people with ASDs imposes a heavy economic burden on the state. In 2007, almost 35,000 individuals with autism were receiving services from the California Regional Centers, and the number was expected to rise to 50,000 by last year. Recent estimates suggest that the lifetime cost of caring for an individual with an ASD can exceed $3 million.

In spite of their impact on our society, there are currently no effective therapies for ASDs. Our lack of cellular and molecular tools to study these disorders means that there are no good targets for drug screening, so there are very limited prospects for developing effective pharmacological treatments in the near future. New drug discovery paradigms are needed to help develop therapies for these neuropsychiatric conditions.

The research described in this proposal could have a dramatic impact on drug discovery methods for ASDs. First, we hope to identify drugs that are effective in treating Timothy Syndrome, a rare form of autism caused by an electrophysiological defect in a calcium channel. Second, we aim to develop new tools to explore calcium-mediated signaling pathways that are defective in ASDs. If successful, our research will identify a family of molecular targets that will be useful for developing therapies for ASDs in the future.

Progress Report: 
  • Autism Spectrum Disorders (ASDs) are a heritable group of neuro-developmental disorders characterized by language impairments, difficulties in social integrations, and the presence of stereotyped and repetitive behaviors. There are no treatments for ASDs, and very few targets for drug development. The goal of this CIRM project is to develop a series of in vitro screens for drugs that might affect the underlying cellular defects in ASDs.
  • Since ASDs are uniquely human, we proposed to design, optimize and conduct high-throughput chemical screens using human neurons derived from induced pluripotent stem cells (iPSCs). Our lab identified cellular defects in neurons derived from patients with Timothy Syndrome (TS), a syndromic disorder often presenting with autism that is caused by a rare mutation in a calcium channel. In our project, we proposed to develop in vitro screening assays for ASDs based on these TS phenotypes, and to screen these assays to identify drugs that might affect behavioral symptoms of autism. In the first year of this award, we conducted preliminary screens and found that certain calcium channel modulators reverse some of the differentiation defects that we observe in these cells. We also extended observations that we had made in mice and showed that TS neurons have defects in the structure and length of their dendrites, measurable features that we can use as the basis for additional drug screens. We have therefore progressed within the aims of the original award.
  • For the remainder of the grant, however, we are proposing to broaden the scope of this project to include iPSC-based screens using neurons from patients with more prevalent forms of ASDs. In other research in our lab, we have characterized phenotypes in neurons derived from patients with two other diseases that are more prevalent than TS: DiGeorge Syndrome (DGS) and Phelan-McDermid Syndrome (PMDS), two neurodevelopmental disorders resulting from deletions within chromosome 22 and patients present symptoms that often include autism. We have shown that these cells have defects in the length of their dendrites, in the structure and function of their synapses, and in their ability to transmit electrical impulses. We propose to broaden the scope of our work to develop screens for TS, DGS, and PMDS. These screens will serve as a basis for identifying drugs that lessen or reverse cellular defects in these disorders, and thus may lead to more generalized treatments for ASDs.
  • We believe that this research not only fulfills critical steps in the development of a novel test for potential ASD treatments, but demonstrates the power of iPSC technology for understanding the underlying mechanisms of neurological disorders. Expanding the scope of our original project will help us increase the impact of our studies on therapeutic development and on the understanding of the neurobiology of ASDs.
  • Autism Spectrum Disorders (ASDs) are a heritable group of neurodevelopmental disorders that affect the verbal, social, and behavioral abilities of affected individuals. There are no pharmacological treatments for ASDs, in part because of a lack of validated cellular and animal models for use in drug screens. The goal of this project is to develop and validate a cell-based high throughput screening method that we will use to identify therapies for ASDs.
  • Our laboratory has established methods for collecting skin samples from patients and reprogramming these cells into induced pluripotent stem (iPS) cells, which we then differentiate into neurons. We have characterized neurons from patients with ASDs, and identified cellular phenotypes that are amenable to high-throughput methods to identify drug targets. Our efforts in Year 2 of our CIRM funding have focused on Phelan-McDermid Syndrome (PMDS), an inherited progressive neurodevelopmental disorder characterized by developmental delay, absent or severely impaired speech, and an increased risk of autism. We have discovered that neurons from PMDS patients who have autism have defects in excitatory synaptic transmission caused by the loss of one copy of the gene Shank3. Shank3 lies in the region of Chromosome 22 that is deleted in PMDS, and is important for the development of synapses. Based on our studies, PMDS neurons can be distinguished from their wildtype counterparts by low expression levels of Shank3 measured by quantitative PCR, decreased number of excitatory synapses labeled by immunocytochemistry and imaged with a microscope, and reduced excitatory cellular currents measured electrophysiologically. Each of these phenotypes is amenable to high throughput screening of therapeutic compounds. We tested several candidate therapeutics and found that prolonged treatment with the growth factor IGF-1 partially reverses the defects we have discovered in PMDS neurons. While IGF-1 is highly bioactive and therefore not an ideal drug candidate, it can be used to validate our screening method.
  • We are currently running trials to select the best phenotype and assay for larger-scale screening. In parallel, we have developed protocols to culture large numbers of iPSC-derived neurons for high throughput screens, and we are growing and banking working stocks of PMDS and control neurons. These experiments will help us identify drug candidates for PMDS, and will represent a significant advance in HTS approaches for the testing of ASD therapies using iPSC-based systems.
  • Autism Spectrum Disorders (ASDs) are a heritable group of neurodevelopmental disorders that affect the verbal, social, and behavioral ability of affected in individual. There are no treatments for ASD, in part because the biological basis for the disorders are not know. In addition, there are no methods for screening drugs that may be therapeutic. The goal of this project was to develop screening assays based on stem cells that were derived from individuals with autism.
  • Using skin samples from affected individuals, our laboratory was able to generate induced pluripotent stem cells (iPSC) and use these stem cells to generate neurons. With CIRM support, we have now generated iPSC from many individuals, some of whom carry genetic alterations that cause autism. Work under this award focused on two genetic disorders, Timothy Syndrome (TS) and Phelan-McDermid Syndrome (PMDS). Both are inherited syndromes that affect several body systems and also greatly increase the risk of autism. In each case, we found that neurons from affected individuals displayed changes in the way neurons connect and communicate. The effects were pronounced in PMDS neurons, in part due to the loss of the Shank3 gene that is involved in the function of the excitatory synapse. Work in year 3 has focused on identifying a robust alteration in neuron function that can be used for drug screening.
  • One such phenotype was discovered and involves a change in the way calcium is utilized when neurons communicate by generating an electrical current. Using chemicals that detect calcium, fluorescent assays were developed that show a robust difference in calcium response in PMDS neurons relative to neurons from unaffected individuals. Adapting the fluorescent calcium reporter assay to a high-throughput format also required the invention of new stem cell culture methods for generating neurons that were more efficient and less costly. Ultimately, a novel strategy was developed that now permits the production of very large numbers of neurons that can be assayed in high throughput screens. A limited screen using candidate drugs has confirmed the utility of the assay and future work will utilize these assays in large scale screens for drugs that normalize or augment the synaptic defects.
Funding Type: 
Early Translational II
Grant Number: 
TR2-01856
Investigator: 
Type: 
PI
Institution: 
Type: 
Co-PI
ICOC Funds Committed: 
$6 016 624
Disease Focus: 
Parkinson's Disease
Neurological Disorders
Collaborative Funder: 
Maryland
Stem Cell Use: 
Embryonic Stem Cell
oldStatus: 
Active
Public Abstract: 

Parkinson's disease (PD) is a devastating movement disorder caused by the death of dopaminergic neurons (a type of nerve cells in the central nervous system) present in the midbrain. These neurons secrete dopamine (a signaling molecule) and are a critical component of the motor circuit that ensures movements are smooth and coordinated.

All current treatments attempt to overcome the loss of these neurons by either replacing the lost dopamine, or modulating other parts of the circuit to balance this loss or attempting to halt or delay the loss of dopaminergic neurons. Cell replacement therapy (that is, transplantation of dopaminergic neurons into the brain to replace lost cells and restore function) as proposed in this application attempts to use cells as small pumps of dopamine that will be secreted locally and in a regulated way, and will therefore avoid the complications of other modes of treatment. Indeed, cell therapy using fetal tissue-derived cells have been shown to be successful in multiple transplant studies. Work in the field has been limited however, partially due to the limited availability of cells for transplantation (e.g., 6-10 fetuses of 6-10 weeks post-conception are required for a single patient).

We believe that human embryonic stem cells (hESCs) may offer a potentially unlimited source of the right kind of cell required for cell replacement therapy. Work in our laboratories and in others has allowed us to develop a process of directing hESC differentiation into dopaminergic neurons. To move forward stem cell-based therapy development it is important to develop scale-up GMP-compatible process of generating therapeutically relevant cells (dopaminergic neurons in this case).

The overall goal of this proposal is to develop a hESC-based therapeutic candidate (dopaminergic neurons) by developing enabling reagents/tools/processes that will allow us to translate our efforts into clinical use. We have used PD as a model but throughout the application have focused on generalized enabling tools. The tools, reagents and processes we will develop in this project will allow us to move towards translational therapy and establish processes that could be applied to future IND-enabling projects. In addition, the processes we will develop would be of benefit to the CIRM community.

Statement of Benefit to California: 

Parkinson’s disease affects more than a million patients United States with a large fraction being present in California. California, which is the home of the Parkinson’s Institute and several Parkinson’s related foundations and patient advocacy groups, has been at the forefront of this research and a large number of California based scientists supported by these foundations and CIRM have contributed to significant breakthroughs in this field.

In this application we and our collaborators in California aim propose to develop a hESC-based therapeutic candidate (dopaminergic neurons) that will allow us to move towards translational therapy and establish processes that could be applied to future IND-enabling projects for this currently non-curable disorder. We believe that this proposal includes the basic elements that are required for the translation of basic research to clinical research. We believe these experiments not only provide a blueprint for moving Parkinson’s disease towards the clinic for people suffering with the disorder but also a generalized blueprint for the development of stem cell therapy for multiple neurological disorders including motor neuron diseases and spinal cord injury. The tools and reagents that we develop will be made widely available to Californian researchers. We expect that the money expended on this research will benefit the Californian research community and the tools and reagents we develop will help accelerate the research of our colleagues in both California and worldwide.

Progress Report: 
  • Parkinson's disease (PD) is a devastating movement disorder caused by the death of dopaminergic neurons (a type of nerve cells in the central nervous system) present in the midbrain. These neurons secrete dopamine (a signaling molecule) and are a critical component of the motor circuit that ensures movements are smooth and coordinated.
  • All current treatments attempt to overcome the loss of these neurons by either replacing the lost dopamine, or modulating other parts of the circuit to balance this loss or attempting to halt or delay the loss of dopaminergic neurons. Cell replacement therapy (that is, transplantation of dopaminergic neurons into the brain to replace lost cells and restore function) as proposed in this application attempts to use cells as small pumps of dopamine that will be secreted locally and in a regulated way, and will therefore avoid the complications of other modes of treatment. Indeed, cell therapy using fetal tissue-derived cells have been shown to be successful in multiple transplant studies. Work in the field has been limited however, partially due to the limited availability of cells for transplantation (e.g., 6-10 fetuses of 6-10 weeks post-conception are required for a single patient).
  • We believe that human embryonic stem cells (hESCs) may offer a potentially unlimited source of the right kind of cell required for cell replacement therapy. Work in our laboratories and in others has allowed us to develop a process of directing hESC differentiation into dopaminergic neurons. To move forward stem cell-based therapy development it is important to develop scale-up GMP-compatible process of generating therapeutically relevant cells (dopaminergic neurons in this case).
  • The overall goal of this proposal is to develop a hESC-based therapeutic candidate (dopaminergic neurons) by developing enabling reagents/tools/processes that will allow us to translate our efforts into clinical use. We have used PD as a model but throughout the application have focused on generalized enabling tools. The tools, reagents and processes we will develop in this project will allow us to move towards translational therapy and establish processes that could be applied to future IND-enabling projects. In addition, the processes we will develop would be of benefit to the CIRM community.
  • Parkinson's disease (PD) is a devastating movement disorder caused by the death of dopaminergic neurons (a type of nerve cells in the central nervous system) present in the midbrain. These neurons secrete dopamine (a signaling molecule) and are a critical component of the motor circuit that ensures movements are smooth and coordinated.
  • All current treatments attempt to overcome the loss of these neurons by either replacing the lost dopamine, or modulating other parts of the circuit to balance this loss or attempting to halt or delay the loss of dopaminergic neurons. Cell replacement therapy (that is, transplantation of dopaminergic neurons into the brain to replace lost cells and restore function) as proposed in this application attempts to use cells as small pumps of dopamine that will be secreted locally and in a regulated way, and will therefore avoid the complications of other modes of treatment. Indeed, cell therapy using fetal tissue-derived cells have been shown to be successful in multiple transplant studies. Work in the field has been limited however, partially due to the limited availability of cells for transplantation (e.g., 6-10 fetuses of 6-10 weeks post-conception are required for a single patient).
  • We believe that human pluripotent stem cells (PSC) may offer a potentially unlimited source of the right kind of cell required for cell replacement therapy. Work in our laboratories and in others has allowed us to develop a process of directing PSC differentiation into dopaminergic neurons. To move forward stem cell-based therapy development it is important to develop scale-up GMP-compatible process of generating therapeutically relevant cells (dopaminergic neurons in this case).
  • During this grant, we have optimized a step-wise scalable process for generating authentic dopaminergic neurons in defined media from human PSC, and have determined the time point at which dopaminergic neurons can be frozen, shipped, thawed and transplanted without compromising their ability to mature and provide therapeutic benefit in animal models. Our process has been successfully transferred to a GMP facility and we have manufactured multiple lots of GMP-equivalent cells using this process. Importantly, we have shown functional equivalency of the manufactured cells in appropriate models. The tools, reagents and processes we have developed in this project allow us to move towards translational therapy and establish processes that could be applied to future IND-enabling projects. In addition, the processes we have developed would be of benefit to the CIRM community.
  • CIRM Progress Report Part A: Scientific Progress
  • I. Project Overview
  • During the past three years (36 months) we have successfully completed the milestones defined in the NGA for this grant. In brief, we have selected 1 clinically compliant ESC line H14 (and a back-up line H9), which have shown reproducible, efficient differentiation to dopaminergic neurons at lab scale. We have performed in vitro and in vivo characterization as defined in the NGA and guided by our discussion with our program officer at CIRM. We have determined the time point at which dopaminergic precursors (14 days after the NSC stage) can be frozen, shipped, thawed and transplanted without compromising their ability to mature and provide therapeutic benefit in animal models. Importantly, we have evaluated efficacy of cryopreserved dopaminergic precursors manufactured by the GMP-compatible process in a rodent PD model and shown functional recovery up to 6 months post transplantation as well as survival of dopaminergic neurons.
  • In the meanwhile we have successfully transferred the process of generating transplant ready dopaminergic neurons to the manufacture facilities at City of Hope (COH). They have adapted and optimized our protocols and have established GMP-compatible protocols for the culture of ESC-NSC and for differentiating NSC to Stage 3, Day 14 DA precursors for transplantation. During this reporting period (36 month), we have tested the equivalency of these lots and confirmed that lots manufactured at COH are consistent and similar to cells produced in the laboratory.
  • Our effort resulted in two important manuscripts in Cytotherapy:
  • 1. Liu, Q., Pedersen, OZ., Peng, J., Couture, LA., Rao, MS., and Zeng, X. Optimizing dopaminergic differentiation of pluripotent stem cells for the manufacture of dopaminergic neurons for transplantation. Cytotherapy. 2013 Aug;15(8):999-1010.
  • 2. Peng, J., Liu, Q., Rao, MS., and Zeng, X. Survival and engraftment of dopaminergic neurons manufactured by a GMP-compatible process. Cytotherapy. 2014 Sep;16(9):1305-12.
Funding Type: 
Early Translational II
Grant Number: 
TR2-01844
Investigator: 
Name: 
Institution: 
Type: 
PI
ICOC Funds Committed: 
$5 665 887
Disease Focus: 
Spinal Muscular Atrophy
Neurological Disorders
Pediatrics
Stem Cell Use: 
iPS Cell
oldStatus: 
Closed
Public Abstract: 

Spinal muscular atrophy (SMA) is the leading genetic cause of infant death in the U.S. This devastating disease affects 1 child in every 6,000-10,000 live births, with a North American prevalence of approximately 14,000 individuals. The disease is characterized by the death of spinal cord cells called motor neurons that connect the brain to muscle. Death of these cells causes muscle weakness and atrophy, which progresses to paralysis, respiratory failure and frequently death. The three different types of SMA differ in severity and prognosis, with Type I being the most severe. SMA is caused by a genetic defect that leads to reduced levels of a single protein called SMN.

There are currently no approved therapies for the disease. The existing treatments for SMA consist of supportive care for the respiratory and nutritional deficits, for example ventilation and feeding tubes. Previous attempts to develop drugs using conventional technologies, such as cultured cancer cells or cells derived from animals have been unsuccessful. These failures are likely due the fact that previous attempts used cell types that don’t reflect the disease or aren’t affected by low levels of the SMN protein.

Our approach uses patient-derived motor neurons, the specific cell type that dies. We will conduct drug discovery experiments using these motor neurons to find potential therapeutics that increase the levels of the SMN protein in these diseased cells. Induced pluripotent stem cell (iPSC) technology allows us to take skin cells from patients with SMA, grow them in a dish, and turn them into motor neurons. We are conducting high-throughput screens of potential drugs with these cells to identify drug candidates that increase SMN protein levels in motor neurons derived from SMA patients. An added advantage to our approach is that we can test our drug candidates in motor neurons from many different patients, with different disease subtypes and from different ethnic backgrounds. We have generated iPSCs from many patients with SMA and we will test compounds for effectiveness against this cohort. These studies will give us an indication of the effectiveness of our compounds across patients before moving into costly and lengthy clinical trials.

If our drug candidate is successful, it could be the first effective therapeutic available for SMA. It will increase the amount of SMN protein and prevent motor neuron death. Halting the death of spinal cord motor neurons prevents the progressive weakness and muscle atrophy. We anticipate that this would prevent disability in Type III patients. For Type I and II patients, we believe such a therapy would mitigate respiratory and feeding challenges and allow lifespan increase.

The sponsoring institution has integrated iPSC-based drug discovery capabilities, ranging from stem cell line production, high throughput drug screening and medicinal chemistry. Accordingly, this institution is uniquely positioned to achieve the aims of this grant.

Statement of Benefit to California: 

Spinal muscular atrophy (SMA) is the second-most common autosomal-recessive disorder and leading genetic cause of death of infants in the U.S. We estimate that there are up to 1,500 SMA patients currently living in California, with 100 new cases diagnosed in California every year. The CIRM Early Translational II Awards is intended to fund studies that will propel drug discovery forward for many devastating diseases. In keeping with this mission, we propose to leverage iPSC technology to generate disease-relevant cell types from patients themselves for a high throughput drug screen. A successful therapy for SMA would lead to significant cost savings to California’s health care system, and would provide relief to families of patients with this devastating disorder.

Given that there are not many successful drugs in the making for neurological diseases such as ALS, SMA, Parkinson’s disease or Alzheimer’s disease, our project should significantly impact drug discovery in this area by introducing iPSC technologies as a valid drug discovery and development platform. The application of iPSC-based disease modeling and drug discovery to SMA is highly innovative and represents the opportunity to establish worldwide leadership for California in this emerging field.

Furthermore, the sponsoring institution will fund over 70% of the direct costs during the timeframe of this award. Accordingly, the 3:1 leverage provides great opportunity to magnify the effect of a CIRM award. Our research program will also create new, high-paying jobs in California, and will stimulate California’s economy by creating new research and clinical tools. These activities will continue to strengthen California’s leadership position at the forefront of the stem cell and regenerative medical revolution of the 21st century.

Progress Report: 
  • Spinal muscular atrophy (SMA) is the leading genetic cause of infant death in the U.S. This devastating disease affects 1 child in every 6,000-10,000 live births, with a North American prevalence of approximately 14,000 individuals. The disease is characterized by the death of spinal cord cells called motor neurons that connect the brain to muscle. Death of these cells causes muscle weakness and atrophy, which progresses to paralysis, respiratory failure and frequently death. The three different types of SMA differ in severity and prognosis, with Type I being the most severe. SMA is caused by a genetic defect that leads to reduced levels of a single protein called SMN. There are currently no approved therapies for the disease.
  • Existing treatments for SMA consist of supportive care for the respiratory and nutritional deficits, for example ventilation and feeding tubes. Previous attempts to develop drugs using conventional technologies, such as cultured cancer cells or cells derived from animals have been unsuccessful. These failures are likely due to the fact that previous attempts used cell types that do not reflect the disease or are not affected by low levels of the SMN protein. Our approach uses patient-derived motor neurons, the specific cell type that dies in SMA.
  • An added advantage to our approach is that we can test our drug candidates in motor neurons from many different patients and different disease subtypes. We have generated iPSCs from many patients with SMA and we will test compounds for effectiveness against this cohort. These studies will give us an indication of the effectiveness of our compounds across patients before moving into costly and lengthy clinical trials. It will increase the amount of SMN protein and prevent motor neuron death. Halting the death of spinal cord motor neurons prevents the progressive weakness and muscle atrophy. We anticipate that this would prevent disability in Type III patients. For Type I and II patients, we believe such a therapy would mitigate respiratory and feeding challenges and allow an increase in lifespan.
  • In the past year, we conducted drug discovery experiments using these motor neurons to find potential therapeutics that increase the levels of the SMN protein in these diseased cells. Induced pluripotent stem cell (iPSC) technology allows us to take skin cells from patients with SMA, grow them in a dish, and turn them into SMA motor neurons. We conducted high-throughput screens of potential drugs with these cells to identify drug candidates that increase SMN protein levels in motor neurons derived from SMA patients. Despite the high quality of these screens, no suitable drug candidate was identified. We have modified our strategy and developed a method to identify, in parallel, all targets in the “druggable” genome that regulate SMN protein levels. An exhaustive screen currently is being performed to identify such a target and will be completed by end April 2012. Once a target is identified, it will be developed into a lead and validated in animals.
Funding Type: 
Early Translational II
Grant Number: 
TR2-01841
Investigator: 
Type: 
PI
ICOC Funds Committed: 
$4 045 253
Disease Focus: 
Huntington's Disease
Neurological Disorders
Stem Cell Use: 
Embryonic Stem Cell
Cell Line Generation: 
Embryonic Stem Cell
oldStatus: 
Active
Public Abstract: 

Huntington’s disease (HD) is a devastating degenerative brain disease with a 1 in 10,000 prevalence that inevitably leads to death. These numbers do not fully reflect the large societal and familial cost of HD, which requires extensive caregiving. HD has no effective treatment or cure and symptoms unstoppably progress for 15-20 years, with onset typically striking in midlife. Because HD is genetically dominant, the disease has a 50% chance of being inherited by the children of patients. Symptoms of the disease include uncontrolled movements, difficulties in carrying out daily tasks or continuing employment, and severe psychiatric manifestations including depression. Current treatments only address some symptoms and do not change the course of the disease, therefore a completely unmet medical need exists. Human embryonic stem cells (hESCs) offer a possible long-term treatment approach that could relieve the tremendous suffering experienced by patients and their families. HD is the 3rd most prevalent neurodegenerative disease, but because it is entirely genetic and the mutation known, a diagnosis can be made with certainty and clinical applications of hESCs may provide insights into treating brain diseases that are not caused by a single, known mutation. Trials in mice where protective factors were directly delivered to the brains of HD mice have been effective, suggesting that delivery of these factors by hESCs may help patients. Transplantation of fetal brain tissue in HD patients suggests that replacing neurons that are lost may also be effective. The ability to differentiate hESCs into neuronal populations offers a powerful and sustainable alternative for cell replacement. Further, hESCs offer an opportunity to create cell models in which to identify earlier markers of disease onset and progression and for drug development.

We have assembled a multidisciplinary team of investigators and consultants who will integrate basic and translational research with the goal of generating a lead developmental candidate having disease modifying activity with sufficient promise to initiate IND-enabling activities for HD clinical trials. The collaborative research team is comprised of investigators from multiple California institutions and has been assembled to maximize leverage of existing resources and expertise within the HD and stem cell fields.

Statement of Benefit to California: 

The disability and loss of earning power and personal freedom resulting from Huntington's disease (HD) is devastating and creates a financial burden for California. Individuals are struck in the prime of life, at a point when they are their most productive and have their highest earning potential. As the disease progresses, individuals require institutional care at great financial cost. Therapies using human embryonic stem cells (hESCs) have the potential to change the lives of hundreds of individuals and their families, which brings the human cost into the thousands. For the potential of hESCs in HD to be realized, a very forward-thinking team effort will allow highly experienced investigators in HD, stem cell research and clinical trials to come together and identify a lead development candidate for treatment of HD. This early translation grant will allow for a comprehensive and systematic evaluation of hESC-derived cell lines to identify a candidate and develop a candidate line into a viable treatment option. HD is the 3rd most prevalent neurodegenerative disease, but because it is entirely genetic and the mutation known, a diagnosis can be made with certainty and clinical applications of hESCs may provide insights into treating brain diseases that are not caused by a single, known mutation.

We have assembled a strong team of California-based investigators to carry out the proposed studies. Anticipated benefits to the citizens of California include: 1) development of new human stem cell-based treatments for HD with application to other neurodegenerative diseases such as Alzheimer's and Parkinson's diseases that affect thousands of individuals in California; 2) improved methods for following the course of the disease in order to treat HD as early as possible before symptoms are manifest; 3) transfer of new technologies and intellectual property to the public realm with resulting IP revenues coming into the state with possible creation of new biotechnology spin-off companies; and 4) reductions in extensive care-giving and medical costs. It is anticipated that the return to the State in terms of revenue, health benefits for its Citizens and job creation will be significant.

Progress Report: 
  • Huntington’s disease (HD) is a devastating degenerative brain disease with a 1 in 10,000 prevalence that inevitably leads to death. Because HD is genetically dominant, the disease has a 50% chance of being inherited by the children of patients. Symptoms of the disease include uncontrolled movements, difficulties in carrying out daily tasks or continuing employment, and severe psychiatric manifestations including depression. Current treatments only address some symptoms and do not change the course of the disease, therefore a completely unmet medical need exists. Human embryonic stem cells (hESCs) offer a possible long-term treatment approach that could relieve the tremendous suffering experienced by patients and their families. Because HD is entirely genetic and the mutation known, a diagnosis can be made with certainty and clinical applications of hESCs may provide insights into treating brain diseases that are not caused by a single, known mutation. The ability to differentiate hESCs into neuronal populations offers a powerful and sustainable treatment opportunity. We have established the multidisciplinary team of investigators and consultants to integrate basic and translational research with the goal of generating a lead developmental candidate having disease modifying activity with sufficient promise to initiate IND-enabling activities for HD clinical trials.
  • In preliminary experiments, the transplantation of mouse neural stem cells, which survived in the brain for the four week period of the trial, provided protective effects in delaying disease progression in an HD mouse model and increased production of protective molecules in the brains of these mice. In the first year, the team has developed and established methods to differentiate hESCs into neural, neuronal and astrocyte precursors to be used for transplantation and has determined the correct cells to use that can be developed for future clinical development of these cells. In initial studies during this year, transplantation of neural stem cells (NSCs) provided both neurological and behavioral benefit to a HD mouse model. In addition, neuroprotective molecules were increased. Three immunosuppression regimens were tested to optimize methods for next stage preclinical trials. Finally, breeding of the three different HD mouse models has been initiated. Taken as a whole, progress supports the feasibility of the CIRM-funded studies to transplant differentiated hESCs into HD mice for preclinical development with the ultimate goal of initiating IND-enabling activities for HD clinical trials.
  • Huntington’s disease (HD) is a devastating degenerative brain disease with a 1 in 10,000 prevalence that inevitably leads to death. Because HD is genetically dominant, the disease has a 50% chance of being inherited by the children of patients. Symptoms of the disease include uncontrolled movements, difficulties in carrying out daily tasks or continuing employment, and severe psychiatric manifestations including depression. Current treatments only address some symptoms and do not change the course of the disease, therefore a completely unmet medical need exists. Human embryonic stem cells (hESCs) offer a possible long-term treatment approach that could relieve the tremendous suffering experienced by patients and their families. Because HD is entirely genetic and the mutation known, a diagnosis can be made with certainty and clinical applications of hESCs may provide insights into treating brain diseases that are not caused by a single, known mutation. The ability to differentiate hESCs into neuronal populations offers a powerful and sustainable treatment opportunity. We have established the multidisciplinary team of investigators and consultants to integrate basic and translational research with the goal of generating a lead developmental candidate having disease modifying activity with sufficient promise to initiate IND-enabling activities for HD clinical trials.
  • We previously performed transplantation of human neural stem cells into an HD mouse model and found that a subset of cells survived in the brain for the four week period of the trial, providing protective effects in delaying disease progression. In the past year, we have increased production and characterization of human neural stem cells (hNSCs) into neuronal (hNPC) and astrocyte (hAPC) precursors to be used for transplantation and optimized methods for shipping and implantation. Immunosuppression regimens were improved to optimize cell survival of implanted cells in HD mice. Transplantation of both human NSCs and NPCs are neuroprotective to HD mice and transplantation of hAPCs is in progress. Once completed, the cell giving the greatest protective benefit will be transplanted into mice that display slower progression over a longer time frame to validate and optimize approach for subsequent human application. All three HD mouse models have been bred and are ready for stem cell transplants. Taken as a whole, progress supports the feasibility of the CIRM-funded studies to transplant differentiated hESC-derived cell types into HD mice for preclinical development with the ultimate goal of identifying a lead candidate cell type and initiating IND-enabling activities for HD clinical trials.
  • Huntington’s disease (HD) is a devastating degenerative brain disease with a 1 in 10,000 prevalence that inevitably leads to death. Because HD is genetically dominant, the disease has a 50% chance of being inherited by the children of patients. Symptoms of the disease include uncontrolled movements, difficulties in carrying out daily tasks or continuing employment, and severe psychiatric manifestations including depression. Current treatments only address some symptoms and do not change the course of the disease, therefore a completely unmet medical need exists. Human embryonic stem cells (hESCs) offer a possible long-term treatment approach that could relieve the tremendous suffering experienced by patients and their families. Because HD is entirely genetic and the mutation known, a diagnosis can be made with certainty and clinical applications of hESCs may provide insights into treating brain diseases that are not caused by a single, known mutation. The ability to differentiate hESCs into neuronal populations offers a powerful and sustainable treatment opportunity. We have established the multidisciplinary team of investigators and consultants to integrate basic and translational research with the goal of generating a lead developmental candidate having disease modifying activity with sufficient promise to initiate Investigational New Drug (IND) enabling activities for HD clinical trials.
  • We have completed several rounds of transplantation of human neural stem cells into an HD mouse model and found that the cells survived in the brain for the four-week period of the trial, provided protective effects in delaying disease progression and increased production of protective molecules in the brains of these mice. In the last year the team differentiated hESCs into neural, neuronal and astrocyte precursors and performed transplantation studies to determine the best cell candidate to use and develop for future clinical work. We determined that the human neural stem cells produce the most robust effect. We have now selected a GMP grade hNSC line that will be carried forward for further testing in both rapidly progressing and slower progressing HD mice, as well as in mouse preclinical dosing studies. Taken as a whole, progress supports the feasibility of the CIRM-funded studies to transplant differentiated hESCs into HD mice for preclinical development with the ultimate goal on initiating IND-enabling activities for HD clinical trials.
Funding Type: 
Early Translational II
Grant Number: 
TR2-01814
Investigator: 
ICOC Funds Committed: 
$1 491 471
Disease Focus: 
Autism
Neurological Disorders
Pediatrics
Stem Cell Use: 
iPS Cell
Cell Line Generation: 
iPS Cell
oldStatus: 
Active
Public Abstract: 

Autism and autism spectrum disorders (ASD) are complex neurodevelopmental diseases that affect 1 in 150 children in the United States. Such diseases are mainly characterized by deficits in verbal communication, impaired social interaction, and limited and repetitive interests and behavior. Because autism is a complex spectrum of disorders, a different combination of genetic mutations is likely to play a role in each individual. One of the major impediments to ASD research is the lack of relevant human disease models. ASD animal models are limited and cannot reproduce the important language and social behavior impairment of ASD patients. Moreover, mouse models do not represent the vast human genetic variation. Reprogramming of somatic cells to a pluripotent state (induced pluripotent stem cells, iPSCs) has been accomplished using human cells. Isogenic pluripotent cells are attractive from the prospective to understanding complex diseases, such as ASD. Our preliminary data provide evidence for an unexplored developmental window in ASD wherein potential therapies could be successfully employed. The model recapitulates early stages of ASD and represents a promising cellular tool for drug screening, diagnosis and personalized treatment. By testing whether drugs have differential effects in iPSC-derived neurons from different ASD backgrounds, we can begin to unravel how genetic variation in ASD dictates responses to different drugs or modulation of different pathways. If we succeed, we may find new molecular mechanisms in ASD and new compounds that may interfere and rescue these pathways. The impact of this approach is significant, since it will help better design and anticipate results for translational medicine. Moreover, the collection and molecular/cellular characterization of these iPSCs will be an extremely valuable tool to understand the fundamental mechanism behind ASD. The current proposal uses human somatic cells converted into iPSC-derived neurons. The proposed experiments bring our analyses to real human cell models for the first time. We anticipate gaining insights into the causal molecular mechanisms of ASD and to discover potential biomarkers and specific therapeutic targets for ASD.

Statement of Benefit to California: 

Autism spectrum disorders, including Rett syndrome, Angelman syndrome, Timothy syndrome, Fragile X syndrome, Tuberous sclerosis, Asperger syndrome or childhood disintegrative disorder, affect many Californian children. In the absence of a functionally effective cure or early diagnostic tool, the cost of caring for patients with such pediatric diseases is high, in addition to a major personal and family impact since childhood. The strikingly high prevalence of ASD, dramatically increasing over the past years, has led to the emotional view that ASD can be traced to a single source, such as vaccine, preservatives or other environmental factors. Such perspective has a negative impact on science and society in general. Our major goal is to develop a drug-screening platform to rescue deficiencies showed from neurons derived from induced pluripotent stem cells generated from patients with ASD. If successful, our model will bring novel insights on the dentification of potential diagnostics for early detection of ASD risk, or ability to predict severity of particular symptoms. In addition, the development of this type of pharmacological therapeutic approach in California will serve as an important proof of principle and stimulate the formation of businesses that seek to develop these types of therapies (providing banks of inducible pluripotent stem cells) in California with consequent economic benefit.

Progress Report: 
  • During the first year of the project, we focused on creating a cell bank of reprogrammed fibroblasts derived from several autistic patients. These pluripotent stem cells were then induced to differentiate into neurons and gene expression analyses will be done at different time points along the process. We also used some of the syndromic and non-syndromic patients for neuronal phenotypic assays and found that a subset of idiopathic autism cases displayed a molecular overlap with Rett syndrome. Our plan is to use these data to test the ability of candidate drugs on reverting some of the neuronal defects observed in patient neurons.
  • The goal of this CIRM translational award is to generate a hiPSC-based drug-screening platform to identify potential therapies or biomarkers for autism spectrum disorders. In this second year we have made significant progress toward this goal by working on validating several neuronal phenotypes derived from iPSCs from idiopathic and syndromic autistic patients. We also made significant progress in order to optimize a synaptic readout for the screening platform. This step was important to speed up drug discovery. Using Rett syndrome iPSC-derived neurons as a prototype, we showed that we could rescue defect in synaptogenesis using a collection of FDA-approved drugs. Finally, we have initiated our analyses on global gene expression, from several neurons and progenitor cells derived from controls and autistic patients. We expect to find pathways that are altered in subgroups of patients, defined by specific clinical phenotypes.
  • The goal of this CIRM translational award is to generate a hiPSC-based drug-screening platform to identify potential therapies or biomarkers for ASDs. We have made significant progress toward this goal by working on validating several neuronal phenotypes derived from iPSC from Rett syndrome (RTT) and idiopathic autistic patients. We also made significant progress to optimize the readout for our screening platform. This was important to speed up drug discovery. Using RTT iPSC as a prototype, we showed that we could rescue defect in synaptogenesis using a collection of FDA-approved drugs. Finally, we initiate our analyses on gene expression, collected from several neurons and progenitor cells derived from controls and autistic patients. We expect to find pathways that are altered in subgroups of patients, defined by specific clinical phenotypes. Here, we describe the results of our drug screening, using FDA-approved drugs in a repurposing strategy. We also show for the first time that iPSC-derived human neurons are able to generate synchronized neuronal networks. RTT neurons behave differently from controls. Our focus now is on the completion of our gene expression analyses and to validate positive drugs using a battery of secondary cellular assays.
  • The goal of this CIRM translational award is to generate a hiPSC-based drug-screening platform to identify potential therapies or biomarkers for ASDs. We have made significant progress toward this goal by working on validating several neuronal phenotypes derived from iPSC from Rett syndrome (RTT) and idiopathic autistic patients. We also made significant progress to optimize the synaptogenesis readout for our screening platform. This was important to speed up drug discovery. Using RTT iPSC as a prototype, we showed that we could rescue defect in synaptogenesis using a collection of FDA-approved drugs. We also show for the first time that iPSC-derived human neurons are able to generate synchronized neuronal networks using a multi-electrode array approach. We showed that RTT and ASD neurons behave differently from controls and defects in synchronization can be rescued with candidate drugs. Finally, we concluded our analyses on gene expression, collected from several neurons and progenitor cells derived from controls and autistic patients. We revealed and validated pathways that are altered in ASD patients, defined by specific clinical phenotypes (macrencephaly).
Funding Type: 
Early Translational II
Grant Number: 
TR2-01785-A
Investigator: 
Type: 
PI
ICOC Funds Committed: 
$1 614 441
Disease Focus: 
Spinal Cord Injury
Neurological Disorders
Stem Cell Use: 
Embryonic Stem Cell
oldStatus: 
Active
Public Abstract: 

Injuries to the spinal cord commonly result from motor vehicle accidents, traumatic falls, diving, surfing, skiing, and snowboarding accidents, other forms of sports injuries, as well as from gunshot injuries in victims of violent crimes. Injuries to the anatomically lowest part of the spinal cord, the lumbosacral portion and its associated nerve roots commonly cause paralysis, loss of sensation, severe pain, as well as loss of bladder, bowel, and sexual function. Lumbosacral injuries represent approximately one-fifth of all traumatic lesions to the human spinal cord.

As a result of the direct injury to the lumbosacral portion of the spinal cord, there is degeneration and death of spinal cord nerve cells, which control muscles in the legs as well as bladder, bowel, and sexual function. No treatments are presently available in clinical practice to reverse the effects of these devastating injuries.

In order to reverse the loss of function after lumbosacral spinal cord injury, replacement of the lost nerve cells is required. Recent research studies have identified some properties that are shared by spinal cord neurons responsible for muscle and bladder control. Human embryonic stem cells can now be prepared in research laboratories to develop properties that are shared between nerve cells controlling muscle and bladder function. Such nerve cells are particularly at risk of degeneration and death as a result of injuries to the lumbosacral spinal cord. Human embryonic stem cells, which have undergone treatment to obtain properties of muscle and bladder controlling nerve cells, are now very attractive development candidates for new cell replacement therapies after lumbosacral spinal cord injuries. The proposed feasibility studies will study the properties of such cells in a clinically relevant rat model for lumbosacral spinal cord injuries.

In Specific Aim 1, we will determine whether ACUTE transplantation of human embryonic stem cells, which have been treated to develop properties of specific lumbosacral spinal cord neurons, may replace lost nerve cells and result in a return of bladder function in a rat model of lumbosacral spinal cord injury and repair.

In Specific Aim 2, we will determine whether DELAYED transplantation of human embryonic stem cells, which have been treated to develop properties of specific lumbosacral spinal cord neurons, may replace lost nerve cells and result in a return of bladder function in a rat model of lumbosacral spinal cord injury and repair.

A variety of functional studies will determine the effect of the cell transplantation on bladder function, walking, and pain. We will also use detailed anatomical studies to determine in microscopes whether the transplanted cells have grown processes to connect with pelvic target tissues, including the lower urinary tract. If successful, the proposed experiments may lead to a new treatment strategy for patients with lumbosacral spinal cord injuries.

Statement of Benefit to California: 

There are presently about 250,000 patients living with neurological impairments from spinal cord injuries (SCIs) in the United States, and approximately 11,000 new cases present every year. SCIs typically result in paralysis, loss of sensation, pain as well as bladder, bowel, and sexual dysfunction. No successful treatments are available to reverse the neurological deficits that result from SCI. Common causes for SCIs include car and motorcycle accidents, skiing, diving, surfing, and snow boarding injuries, traumatic falls, sports injuries, and acts of violence. California medical centers encounter a large proportion of the overall cases in the U.S. because of our large population, extensive network of freeways, and an active life style with recreational activities taking place both along the Californian coastline and in the mountains.

The proposed development candidate feasibility project will capitalize on recent progress in human stem cell science and surgical repair of conus medullaris/cauda equina (CM/CE) forms of SCI. Human embryonic stem cell-derived neurons and neuronal progenitors, which express the transcription factor Hb9, will be transplanted into the conus medullaris in attempts to replace lost motor and autonomic neurons after a lumbosacral ventral root avulsion injury in rats. Surgical replantation of avulsed lumbosacral ventral roots into the spinal cord will also be performed in this clinically relevant model for CM/CE injury and repair.

If successful, our development candidate may reinnervate muscles and pelvic organs, including the lower urinary tract after CM/CE forms of SCI. Return of functional bladder control represents one of the absolute top priorities among the spinal cord injured population (Anderson, J Neurotrauma, 2004; 21, 1371-83). Successful recovery of bladder function after SCI is expected to have very significant impact on the quality of life of spinal cord injured subjects and markedly reduce health care costs.

Recovery of bladder function in spinal cord injured subjects would markedly reduce or eliminate the need for intermittent bladder catheterizations and indwelling bladder catheters. The number of visits in physicians’ offices and already over-crowded California emergency rooms for bladder infections and other complications would be markedly reduced, thereby significantly reducing health care costs for both patients and our state. Improved neurological function among the SCI population is also expected to reduce care giver needs, thereby further reducing health care costs. The increased independence that will result from improved bladder control and concomitant possible recovery of other neurological functions, for instance in transfers and locomotion, will promote return to and participation in the work force for many individuals with SCI. These effects are also expected to bring a very positive effect to the California economy and increased quality of life for those living with an SCI.

Progress Report: 
  • Injuries to the lowest portion of the spine and the spinal cord commonly results in paralysis and impairment of bladder , bowel, and sexual functions. These injuries are usually referred to as conus medullaris and cauda equina forms of spinal cord injuries. Presently, no treatments are available to reverse the neurological deficits that result from these injuries.
  • In this project, we aim to reverse neurological deficits, including bladder function, in a rat model of spinal cord injury, which affects the lowermost portion of the spinal cord. This part of the spinal cord and the associated nerve roots are called the conus medullaris and cauda equina. In our experimental model, nerve roots carrying fibers that control muscle function and pelvic organs, such as the bladder and bowel, are injured at the surface of the spinal cord. This injury mimics many of the neurological deficits encountered in human cases.
  • For treatment purposes, we transplant human derived embryonic stem cells, which have been prepared to acquire properties of motor neurons, into the lowermost portion of the rat spinal cord after injury and surgical repair of nerve roots carrying motor fibers. The studies will evaluate both acute and delayed transplantation of human embryonoic
  • During the first year of the studies, we have developed improved protocols to increase our ability to produce large number of motor neurons from human embryonic stem cells. We have also developed improved methods to detect motor neurons during the neuron production process by using fluorescent reporters inside of the cells. The latter development is of great help when sorting and preparing cells with desired properties for transplantation studies. In addition, we have refined our surgical methods to make it less invasive, using a one-sided injury model instead of lesions on both sides of the spinal cord in rats. Specifically, bladder dysfunction can be assess after a one sided injury of nerve roots and be evaluated using a combination of bladder pressure recorings and electrical recordings referred to as electromyography (EMG) from muscles along the urethra. The revised procedure is well tolerated by the rats and is a suitable approach for studies of chronic injury and cell-based long-term treatments. A research manuscript describing this improved experimental method and refinement has been submitted to a scientific journal and reviewed, and the manuscript is currently undergoing our revisions before being considered for publication. The experimental refinement will greatly assist with our long-term studies on the effects of transplanted motor neurons derived from human embryonic stem cells. We have also begun experiments using our refined model and cells, which now can be produced in high numbers and be identifiable during both the cell culture steps and during the animal studies. Initial tissues have been harvested and are being processed for morphological analyses.
  • Injuries to the lowest portion of the spine and the spinal cord commonly results in paralysis and impairment of bladder , bowel, and sexual functions. These injuries are usually referred to as conus medullaris and cauda equina forms of spinal cord injuries. Presently, no treatments are available to reverse the neurological deficits that result from these injuries.
  • In this project, we aim to reverse neurological deficits, including bladder function, in a rat model of spinal cord injury, which affects the lowermost portion of the spinal cord. This part of the spinal cord and the associated nerve roots are called the conus medullaris and cauda equina. In our experimental model, nerve roots carrying fibers that control muscle function and pelvic organs, such as the bladder and bowel, are injured at the surface of the spinal cord. This injury mimics many of the neurological deficits encountered in human cases.
  • For treatment purposes, we transplant human derived embryonic stem cells, which have been prepared to acquire properties of motor neurons, into the lowermost portion of the rat spinal cord after injury and surgical repair of nerve roots carrying motor fibers. The studies will evaluate both acute and delayed transplantation of human embryonic stem cells, which have acquired properties of motor neurons.
  • During the second year of the studies, we have developed improved protocols to increase our ability to produce large number of motor neurons from human embryonic stem cells. We have also developed improved methods to detect motor neurons during the neuron production process by using fluorescent reporters inside of the cells. The latter development is of great help when sorting and preparing cells with desired properties for transplantation studies. In addition, we have refined our surgical methods to make it less invasive, using a one-sided injury model instead of lesions on both sides of the spinal cord in rats. Specifically, bladder dysfunction can be assessed after a one sided injury of nerve roots and be evaluated using a combination of bladder pressure recordings and electrical recordings referred to as electromyography (EMG) from muscles along the urethra. The revised procedure is well tolerated by the rats and is a suitable approach for studies of chronic injury and cell-based long-term treatments. A research manuscript describing this improved experimental method and refinement has been published. The experimental refinement will greatly assist with our long-term studies on the effects of transplanted motor neurons derived from human embryonic stem cells. We have also performed transplantations of embryonic human stem cell derived motor neurons into the rat spinal cord and demonstrated surgical feasibility as well as survival of large numbers of neurons in the rat spinal cord. Some of the transplanted cells also demonstrate anatomical markers for motor neurons after transplantation.
  • During the reporting period, we have contined to demonstrate that human embryonic stem cell derived motor neurons and motor neuron progenitors can be produced in vitro. These motor neurons and motor neuron progenitors are transplanted into the rat spinal cord after a lumbosacral ventral root avulsion injury and repair of injured roots in the form of surgical re-attachment of the roots to the spinal cord surface. The lumbosacral ventral root avulsion injury mimics cauda equina and conus medullaris forms of spinal cord injury, an underserved patient population with paralysis of the legs and loss of bladder and bowel funcion. In this clinically relevant injury and repair model in rats, we have during the past several months demonstrated that transplanted human embryonic stem cell-derived motor neurons and motor neuron progenitors are able to survive in the spinal cord of rats over extended periods of time with large numbers of neurons being detectable in the spinal cord grey matter at 1, 2, and 10 weeks after the injury, surgical root repair, and transplantation of the cells. The long term viability of translanted cells suggests integration of the transplanted cells in the host tissues. Some of the cells show expression of motor neuron markers, such as the transcription factor Hb9, as demonstrated by immunohistochemistry and light microscopy.
  • Additional studies have been performed during this reporting period to address whether the transplanted cells may extend axons into the replanted lumbosacral ventral roots. Interestingly, many human axons were detected in the replanted ventral roots using immunohistochemitry and light microscopy for the detection of human processes. Additional immunohistochemistry demonstrated that these processes contained neurofilaments, which are characteristic for axons. In control experiments, we showed that avulsed roots, which had not been replanted into the spinal cord, did not exhibit any human axons. As expected, surgical reconnection of lesioned ventral roots to the spinal cord is needed in order for the axons of the transplanted human embryonic stem cell derived motor neurons and motor neuron progenitors to be extended into avulsed ventral roots. Furthermore, in a series of sham operated animals without ventral root lesions, human motor neurons and motor neuron progenitors were also transplanted into the rat spinal cord. Interestingly, the transplanted human motor neurons and motor neuron progenitors were here also able to extend axons into ventral roots, even though the ventral roots had never been lesions. We conclude that transplanted human embryonic stem cell derived motor neurons are capable of extending axons into both intact ventrl roots and into ventral roots, which had been avulsed and surgically reattached to the spinal cord using a replantation procedure.
  • In functional studies, we have performed urodynamic studies and voiding behavioral studies in rats after the transplantation of human embryonic stem cell derived motor neurons and motor neuron progenitors. These studies are still ongoing with additional experiments being performed. However, preliminary studies suggest that the combination of acute repair of avulsed ventral roots and cell transplantation results in a gradual improvement of voiding reflexes. Ongoing studies are addressing the relative contribution that may be provided by the replantation of avulsed ventral roots and by the transplantation of human motor neurons and motor neuron progenitors into the rat spinal cord.
Funding Type: 
Early Translational II
Grant Number: 
TR2-01778
Investigator: 
Name: 
Type: 
PI
Type: 
Partner-PI
ICOC Funds Committed: 
$2 472 839
Disease Focus: 
Parkinson's Disease
Neurological Disorders
Collaborative Funder: 
Germany
Stem Cell Use: 
iPS Cell
Cell Line Generation: 
iPS Cell
oldStatus: 
Active
Public Abstract: 

Parkinson’s Disease (PD) is the most common neurodegenerative movement disorder. It is characterized by motor impairment such as slowness of movements, shaking and gait disturbances. Age is the most consistent risk factor for PD, and as we have an aging population, it is of upmost importance that we find therapies to limit the social, economic and emotional burden of this disease. Most of the studies to find better drugs for PD have been done in rodents. However, many of these drugs failed when tested in PD patients. One problem is that we can only investigate the diseased neurons of the brain after the PD patients have died. We propose to use skin cells from PD patients and reprogram these into neurons and other surrounding cells in the brain called glia. This is a model to study the disease while the patient is still alive. We will investigate how the glial surrounding cells affect the survival of neurons. We will also test drugs that are protective for glial cells and neurons. Overall, this approach is advantageous because it allows for the study of pathological development of PD in a human system. The goal of this project is to identify key molecular events involved at early stages in PD and exploit these as potential points of therapeutic intervention.

Statement of Benefit to California: 

The goal of this proposal is to create human cell-based models for neurodegenerative disease using transgenic human embryonic stem cells and induced pluripotent stem cells reprogrammed from skin samples of highly clinically characterized Parkinson’s Disease (PD) patients and age-matched controls. Given that age is the most consistent risk factor for PD, and we have an aging population, it is of utmost importance that we unravel the cellular, molecular, and genetic causes of the highly specific cell death characteristic of PD. New drugs can be developed out of these studies that will also benefit the citizens of the State of California. In addition, if our strategy can go into preclinical development, this approach would most likely be performed in a pharmaceutical company based in California.

Progress Report: 
  • In the first year of our CIRM Early Translational II Award we have largely accomplished the first two aims put forth in our proposal “Crosstalk: Inflammation in Parkinson’s disease (PD) in a humanized in vitro model.” Dr. Juergen Winkler, in Erlangen, Germany, has enrolled 10 patients and 6 controls in this project, most of which have had a biopsy of their skin cells sent to The Salk Institute in La Jolla. In Dr. Gage’s lab at The Salk Institute these patient fibroblasts are being reprogrammed into induced pluripotent stem cells (iPSCs), and initial attempts at differentiation into dopaminergic neurons are underway. Additionally, patient blood cells have been sent from Dr. Winkler’s clinic to the lab of Dr. Glass at UC San Diego, where their gene expression profile is being determined. In this initial reporting period we are successfully building the cellular tools necessary to investigate the role of nuclear receptors and inflammation in Parkinson’s Disease.
  • In the second year of our CIRM Early Translational II Award we are making substantial progress towards completing all three aims put forth in our proposal. Dr. Juergen Winkler, our German collaborator, has completed the patient recruitment phase of this project, and skin cells from all 16 subjects (10 with PD and six controls) have been reprogrammed into induced pluripotent stem cells (iPSCs) at the Salk Institute in La Jolla. The patient-specific iPSCs have been differentiated into well-characterized neural stem cells, which the Gage lab is further differentiating into both dopaminergic neurons and astrocytes. In addition to collecting patient skin cells, Dr. Winkler’s group has collected blood cells which are currently being analyzed for gene expression differences by Dr. Glass’ lab at UCSD using state-of-the-art RNA sequencing technology. We have identified a compound that is anti-inflammatory in human cells that we will test on the patient-specific cells once we finish building the cellular tools required to investigate the role of nuclear receptors and inflammation in Parkinson’s Disease.
  • In the final year of our CIRM Early Translational II Award we made considerable progress towards completing all three aims put forth in our proposal. Dr. Juergen Winkler, our German collaborator, has completed the patient recruitment phase of this project, and skin cells from all 16 subjects (10 with PD and six controls) have been reprogrammed into induced pluripotent stem cells (iPSCs) at the Salk Institute in La Jolla. The patient-specific iPSCs have been differentiated into well-characterized neural stem cells, which the Gage lab is further differentiating into both dopaminergic neurons and astrocytes. In addition to collecting patient skin cells, Dr. Winkler’s group has collected blood cells which are currently being analyzed for gene expression differences by Dr. Glass’ lab at UCSD using state-of-the-art RNA sequencing technology. We have identified a compound that is anti-inflammatory in human cells that can reduce inflammation in patient-specific cells, and we are beginning to look at its effects on neuronal survival. This award has allowed us to build the cellular tools required to investigate the role of nuclear receptors and inflammation in Parkinson’s disease, which is a model with endless potential.

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