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Moll G, Ankrum JA, Olson SD, Nolta JA. OUP accepted manuscript. Stem Cells Transl Med 2022; 11:2-13. [PMID: 35641163 PMCID: PMC8895495 DOI: 10.1093/stcltm/szab005] [Citation(s) in RCA: 68] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 09/27/2021] [Indexed: 11/22/2022] Open
Abstract
The number of mesenchymal stromal/stem cell (MSC) therapeutics and types of clinical applications have greatly diversified during the past decade, including rapid growth of poorly regulated “Stem Cell Clinics” offering diverse “Unproven Stem Cell Interventions.” This product diversification necessitates a critical evaluation of the reliance on the 2006 MSC minimal criteria to not only define MSC identity but characterize MSC suitability for intravascular administration. While high-quality MSC therapeutics have been safely administered intravascularly in well-controlled clinical trials, repeated case reports of mild-to-more-severe adverse events have been reported. These are most commonly related to thromboembolic complications upon infusion of highly procoagulant tissue factor (TF/CD142)-expressing MSC products. As TF/CD142 expression varies widely depending on the source and manufacturing process of the MSC product, additional clinical cell product characterization and guidelines are needed to ensure the safe use of MSC products. To minimize risk to patients receiving MSC therapy, we here propose to supplement the minimal criteria used for characterization of MSCs, to include criteria that assess the suitability of MSC products for intravascular use. If cell products are intended for intravascular delivery, which is true for half of all clinical applications involving MSCs, the effects of MSC on coagulation and hemocompatibility should be assessed and expression of TF/CD142 should be included as a phenotypic safety marker. This adjunct criterion will ensure both the identity of the MSCs as well as the safety of the MSCs has been vetted prior to intravascular delivery of MSC products.
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Affiliation(s)
- Guido Moll
- BIH Center for Regenerative Therapies (BCRT) and Berlin Brandenburg School of Regenerative Therapies (BSRT), Berlin Institute of Health (BIH) at the Charité—Universitätsmedizin Berlin, corporate member of Freie Universität zu Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Corresponding author: Guido Moll, PhD, BIH Center for Regenerative Therapies (BCRT), Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, D-13353 Berlin, Germany.
| | - James A Ankrum
- Roy J. Carver Department of Biomedical Engineering and Fraternal Order of Eagles Diabetes Research Center, Pappajohn Biomedical Institute, University of Iowa, Iowa City, IA, USA
| | - Scott D Olson
- Department of Pediatric Surgery, McGovern Medical School, University of Texas Health Sciences Center at Houston, Houston, TX, USA
| | - Jan A Nolta
- Director of the Stem Cell Program, University of California Davis School of Medicine, Sacramento, CA, USA
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2
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van Geffen C, Deißler A, Quante M, Renz H, Hartl D, Kolahian S. Regulatory Immune Cells in Idiopathic Pulmonary Fibrosis: Friends or Foes? Front Immunol 2021; 12:663203. [PMID: 33995390 PMCID: PMC8120991 DOI: 10.3389/fimmu.2021.663203] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 03/22/2021] [Indexed: 12/20/2022] Open
Abstract
The immune system is receiving increasing attention for interstitial lung diseases, as knowledge on its role in fibrosis development and response to therapies is expanding. Uncontrolled immune responses and unbalanced injury-inflammation-repair processes drive the initiation and progression of idiopathic pulmonary fibrosis. The regulatory immune system plays important roles in controlling pathogenic immune responses, regulating inflammation and modulating the transition of inflammation to fibrosis. This review aims to summarize and critically discuss the current knowledge on the potential role of regulatory immune cells, including mesenchymal stromal/stem cells, regulatory T cells, regulatory B cells, macrophages, dendritic cells and myeloid-derived suppressor cells in idiopathic pulmonary fibrosis. Furthermore, we review the emerging role of regulatory immune cells in anti-fibrotic therapy and lung transplantation. A comprehensive understanding of immune regulation could pave the way towards new therapeutic or preventive approaches in idiopathic pulmonary fibrosis.
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Affiliation(s)
- Chiel van Geffen
- Department of Experimental and Clinical Pharmacology and Pharmacogenomics, University Hospital Tübingen, Tübingen, Germany
| | - Astrid Deißler
- Department of Experimental and Clinical Pharmacology and Pharmacogenomics, University Hospital Tübingen, Tübingen, Germany.,Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany
| | - Markus Quante
- Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany
| | - Harald Renz
- Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Philipps University of Marburg, Marburg, Germany.,Universities of Giessen and Marburg Lung Center, German Center for Lung Research (DZL), Marburg, Germany
| | - Dominik Hartl
- Department of Pediatrics I, Eberhard Karls University of Tübingen, Tübingen, Germany.,Dominik Hartl, Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Saeed Kolahian
- Department of Experimental and Clinical Pharmacology and Pharmacogenomics, University Hospital Tübingen, Tübingen, Germany.,Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Philipps University of Marburg, Marburg, Germany.,Universities of Giessen and Marburg Lung Center, German Center for Lung Research (DZL), Marburg, Germany
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3
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Multipotent Mesenchymal Stromal Cells and Lung Disease: Not Ready for Prime Time. Ann Am Thorac Soc 2020; 16:669-671. [PMID: 30786224 DOI: 10.1513/annalsats.201811-843ps] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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4
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Mah N, Seltmann S, Aran B, Steeg R, Dewender J, Bultjer N, Veiga A, Stacey GN, Kurtz A. Access to stem cell data and registration of pluripotent cell lines: The Human Pluripotent Stem Cell Registry (hPSCreg). Stem Cell Res 2020; 47:101887. [PMID: 32707486 DOI: 10.1016/j.scr.2020.101887] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 06/19/2020] [Indexed: 01/15/2023] Open
Abstract
The value of human pluripotent stem cells (hPSC) in regenerative medicine has yet to reach its full potential. The road from basic research tool to clinically validated PSC-derived cell therapy products is a long and winding one, leading researchers, clinicians, industry and regulators alike into undiscovered territory. All stakeholders must work together to ensure the development of safe and effective cell therapies. Similarly, utilization of hPSC in meaningful and controlled disease modeling and drug screening applications requires information on the quality and suitability of the applied cell lines. Central to these common goals is the complete documentation of hPSC data, including the ethical provenance of the source material, the hPSC line derivation, culture conditions and genetic constitution of the lines. Data surrounding hPSC is scattered amongst diverse sources, including publications, supplemental data, researcher lab books, accredited lab reports, certificates of analyses and public data repositories. Not all of these data sources are publicly accessible nor associated with metadata nor stored in a standard manner, such that data can be easily found and retrieved. The Human Pluripotent Stem Cell Registry (hPSCreg; https://hpscreg.eu/) was started in 2007 to impart provenance and transparency towards hPSC research by registering and collecting standard properties of hPSC lines. In this chapter, we present a short primer on the history of stem cell-based products, summarize the ethical and regulatory issues introduced in the course of working with hPSC-derived products and their associated data, and finally present the Human Pluripotent Stem Cell Registry as a valuable resource for all stakeholders in therapies and disease modeling based on hPSC-derived cells.
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Affiliation(s)
- Nancy Mah
- Berlin-Brandenburger Centrum für Regenerative Therapien (BCRT), Charité - Universitätsmedizin Berlin, Berlin, Germany.
| | - Stefanie Seltmann
- Berlin-Brandenburger Centrum für Regenerative Therapien (BCRT), Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Begoña Aran
- Stem Cell Bank, Regenerative Medicine Program, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
| | - Rachel Steeg
- Fraunhofer UK Research Ltd, Technology and Innovation Centre, Glasgow, UK
| | - Johannes Dewender
- Berlin-Brandenburger Centrum für Regenerative Therapien (BCRT), Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Nils Bultjer
- Berlin-Brandenburger Centrum für Regenerative Therapien (BCRT), Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Anna Veiga
- Stem Cell Bank, Regenerative Medicine Program, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
| | - Glyn N Stacey
- ISCBI, Barley, UKSSCBio Ltd, Barley, UK; National Stem Cell Resource Centre, Institute of Zoology, Chinese Academy of Sciences, Beijing 100190, China; Innovation Academy for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, China
| | - Andreas Kurtz
- Berlin-Brandenburger Centrum für Regenerative Therapien (BCRT), Charité - Universitätsmedizin Berlin, Berlin, Germany
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5
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Abstract
Cell therapies hold significant promise for the treatment of injured or diseased musculoskeletal tissues. However, despite advances in research, there is growing concern about the increasing number of clinical centres around the world that are making unwarranted claims or are performing risky biological procedures. Such providers have been known to recommend, prescribe, or deliver so called ‘stem cell’ preparations without sufficient data to support their true content and efficacy. In this annotation, we outline the current environment of stem cell-based treatments and the strategies of marketing directly to consumers. We also outline the difficulties in the regulation of these clinics and make recommendations for best practice and the identification and reporting of illegitimate providers. Cite this article: Bone Joint J 2020;102-B(2):148–154
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Affiliation(s)
- Iain R Murray
- Department of Orthopaedic Surgery, University of Edinburgh, Edinburgh, UK
| | - Jorge Chahla
- Rush University Medical Center, Chicago, Illinois, USA
| | - Rachel M Frank
- University of Colorado School of Medicine, Aurora, Colorado, USA
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6
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Skrepnik N. Therapies for osteoarthritis today and tomorrow: Review. SCRIPTA MEDICA 2020. [DOI: 10.5937/scriptamed51-28263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Osteoarthritis is a common human disease with well understood pathophysiology, signs and symptoms, prevalence, risk factors, pain, and suffering with great understanding of personal, economic and social effects around the world. There are no drugs or treatments considered "disease modifying", with symptomatic control aiming to stave off the final solution of total joint replacement. Regenerative medicine and use of mesenchymal stem cells (MSC) promised hope to change that but have so far fallen short. This review focuses on current knowledge and use of MSC in clinic, completed research, and future directions for development of this once so promising biological treatment. Powerful treatment for pain in form of monoclonal antibodies against Nerve Growth Factor (NGF) are getting close to FDA approval in the US. Wnt signaling pathway modulators that decrease inflammation, increase function and potential to regenerate cartilage should be presented to the FDA early next year.
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7
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Yoon AR, Hong J, Li Y, Shin HC, Lee H, Kim HS, Yun CO. Mesenchymal Stem Cell-Mediated Delivery of an Oncolytic Adenovirus Enhances Antitumor Efficacy in Hepatocellular Carcinoma. Cancer Res 2019; 79:4503-4514. [PMID: 31289131 DOI: 10.1158/0008-5472.can-18-3900] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 05/01/2019] [Accepted: 07/02/2019] [Indexed: 12/27/2022]
Abstract
Oncolytic virotherapy is a promising alternative to conventional treatment, yet systemic delivery of these viruses to tumors remains a major challenge. In this regard, mesenchymal stem cells (MSC) with well-established tumor-homing property could serve as a promising systemic delivery tool. We showed that MSCs could be effectively infected by hepatocellular carcinoma (HCC)-targeted oncolytic adenovirus (HCC-oAd) through modification of the virus' fiber domain and that the virus replicated efficiently in the cell carrier. HCC-targeting oAd loaded in MSCs (HCC-oAd/MSC) effectively lysed HCC cells in vitro under both normoxic and hypoxic conditions as a result of the hypoxia responsiveness of HCC-oAd. Importantly, systemically administered HCC-oAd/MSC, which were initially infected with a low viral dose, homed to HCC tumors and resulted in a high level of virion accumulation in the tumors, ultimately leading to potent tumor growth inhibition. Furthermore, viral dose reduction and tumor localization of HCC-oAd/MSC prevented the induction of hepatotoxicity by attenuating HCC-oAd hepatic accumulation. Taken together, these results demonstrate that MSC-mediated systemic delivery of oAd is a promising strategy for achieving synergistic antitumor efficacy with improved safety profiles. SIGNIFICANCE: Mesenchymal stem cells enable delivery of an oncolytic adenovirus specifically to the tumor without posing any risk associated with systemic administration of naked virions to the host.
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Affiliation(s)
- A-Rum Yoon
- Department of Bioengineering, College of Engineering, Hanyang University, Seoul, Republic of Korea (South).,Institute of Nano Science and Technology (INST), Hanyang University, Seoul, Republic of Korea (South)
| | - JinWoo Hong
- Department of Bioengineering, College of Engineering, Hanyang University, Seoul, Republic of Korea (South).,GeneMedicine CO., Ltd., Seoul, Republic of Korea (South)
| | - Yan Li
- Department of Bioengineering, College of Engineering, Hanyang University, Seoul, Republic of Korea (South)
| | - Ha Chul Shin
- Pharmicell Co., Ltd., Gangnam-gu, Seoul, Republic of Korea (South)
| | - Hyunah Lee
- Pharmicell Co., Ltd., Gangnam-gu, Seoul, Republic of Korea (South)
| | - Hyun Soo Kim
- Pharmicell Co., Ltd., Gangnam-gu, Seoul, Republic of Korea (South)
| | - Chae-Ok Yun
- Department of Bioengineering, College of Engineering, Hanyang University, Seoul, Republic of Korea (South). .,Institute of Nano Science and Technology (INST), Hanyang University, Seoul, Republic of Korea (South).,GeneMedicine CO., Ltd., Seoul, Republic of Korea (South)
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8
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Valimahomed AK, Haffey PR, Urman RD, Kaye AD, Yong RJ. Regenerative Techniques for Neuraxial Back Pain: a Systematic Review. Curr Pain Headache Rep 2019; 23:20. [DOI: 10.1007/s11916-019-0758-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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9
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Purdon S, Patete CL, Glassberg MK. Multipotent Mesenchymal Stromal Cells for Pulmonary Fibrosis? Am J Med Sci 2019; 357:390-393. [PMID: 31010466 DOI: 10.1016/j.amjms.2019.02.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 02/04/2019] [Accepted: 02/10/2019] [Indexed: 01/31/2023]
Abstract
With the combination of ideologic beliefs and the will to survive, fraught patients and determined clinicians seek alternative therapies for treatment of terminal conditions, such as idiopathic pulmonary fibrosis. Unfortunately, the need for treatment has supported the growth of unapproved stem cell therapy over the years spanning across many countries. The reality, however, is that the science behind this therapy is lagging. While there have been promising results from phase I trials, there remain multiple reasons that "stem cells" are not ready for clinical application, starting from a gap in understanding at the bench research level, all the way to optimal clinical application in order to provide effective therapy.
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Affiliation(s)
- Stefanie Purdon
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida
| | - Carissa L Patete
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida
| | - Marilyn K Glassberg
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida.
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10
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Wyles SP, Hayden RE, Meyer FB, Terzic A. Regenerative medicine curriculum for next-generation physicians. NPJ Regen Med 2019; 4:3. [PMID: 30774984 PMCID: PMC6367326 DOI: 10.1038/s41536-019-0065-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 01/07/2019] [Indexed: 12/17/2022] Open
Abstract
Regenerative sciences are poised to transform clinical practice. The quest for regenerative solutions has, however, exposed a major gap in current healthcare education. A call for evidence-based adoption has underscored the necessity to establish rigorous regenerative medicine educational programs early in training. Here, we present a patient-centric regenerative medicine curriculum embedded into medical school core learning. Launched as a dedicated portal of new knowledge, learner proficiency was instilled by means of a discovery–translation–application blueprint. Using the “from the patient to the patient” paradigm, student experience recognized unmet patient needs, evolving regenerative technologies, and ensuing patient management solutions. Targeted on the deployment of a regenerative model of care, complementary subject matter included ethics, regulatory affairs, quality control, supply chain, and biobusiness. Completion of learning objectives was monitored by online tests, group teaching, simulated clinical examinations along with longitudinal continuity across medical school training and residency. Success was documented by increased awareness and proficiency in domain-relevant content, as well as specialty identification through practice exposure, research engagement, clinical acumen, and education-driven practice advancement. Early incorporation into mainstream medical education offers a tool to train next-generation healthcare providers equipped to adopt and deliver validated regenerative medicine solutions.
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Affiliation(s)
- Saranya P Wyles
- Department of Dermatology, Rochester, MN USA.,2Mayo Clinic Center for Regenerative Medicine, Rochester, MN USA
| | - Richard E Hayden
- 2Mayo Clinic Center for Regenerative Medicine, Rochester, MN USA.,Department of Otolaryngology, Phoenix, AZ USA
| | - Fredric B Meyer
- 4Mayo Clinic Alix School of Medicine, Rochester, MN USA.,Department of Neurologic Surgery, Rochester, MN USA
| | - Andre Terzic
- 2Mayo Clinic Center for Regenerative Medicine, Rochester, MN USA.,Department of Cardiovascular Medicine, Rochester, MN USA.,Department of Molecular Pharmacology and Experimental Therapeutics, Rochester, MN USA.,8Department of Clinical Genomics, Mayo Clinic, Rochester, MN USA
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11
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Wu DB, Chen EQ, Tang H. Stem cell transplantation for the treatment of end-stage liver disease. World J Hepatol 2018; 10:907-910. [PMID: 30631395 PMCID: PMC6323519 DOI: 10.4254/wjh.v10.i12.907] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 08/14/2018] [Accepted: 10/09/2018] [Indexed: 02/06/2023] Open
Abstract
The past two decades have witnessed an explosion of research and clinical application of stem cells, transforming the field of regenerative medicine. Stem cell transplantation has already been performed to treat patients with cancer, liver diseases, and various types of chronic diseases. Indeed, stem cell-based therapies are effective in many diseases, and provide novel insights into the treatment of end-stage liver disease. Several clinical trials have indicated the efficacy profiles of stem cell transplantation in patients with end-stage liver disease, including liver cirrhosis, liver failure, and liver tumors. Animal models of acute liver failure have also provided important insights into the safety, mechanisms, and efficacy of stem cell therapies. Nevertheless, excitement due to this promising field must be tempered with careful and calculated research. In particular, studies on the quality, safety, and efficacy of stem cell transplantation are needed to ensure that qualified products are tested in well-designed clinical trials and approved by governments. Therefore, further investigations are required to effectively balance the safety with the innovation of stem cell transplantation research toward the effective treatment of end-stage liver disease.
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Affiliation(s)
- Dong-Bo Wu
- Center of Infectious Diseases, West China Hospital of Sichuan University, Sichuan 610041, Chengdu Province, China
| | - En-Qiang Chen
- Center of Infectious Diseases, West China Hospital of Sichuan University, Sichuan 610041, Chengdu Province, China
| | - Hong Tang
- Center of Infectious Diseases, West China Hospital of Sichuan University, Sichuan 610041, Chengdu Province, China
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12
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Kleiderman E, Boily A, Hasilo C, Knoppers BM. Overcoming barriers to facilitate the regulation of multi-centre regenerative medicine clinical trials. Stem Cell Res Ther 2018; 9:307. [PMID: 30409192 PMCID: PMC6225696 DOI: 10.1186/s13287-018-1055-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
In the context of regenerative medicine and cellular therapies, the treatment under study often targets a less common disease or condition for which recruitment of a large number of research participants at any given site is challenging, if not impossible. One way to overcome this challenge is with a multi-centre clinical trial. This manuscript first aims to briefly outline the existing ethical, legal and social implications as well as the regulatory frameworks associated with multi-centre regenerative medicine clinical trials. Second, it considers the regulatory limitations and barriers surrounding the initiation of such trials in Canada, the USA and Europe. Third, it concludes with a set of recommendations for facilitating multi-centre clinical trials, at both national and international levels.
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Affiliation(s)
- Erika Kleiderman
- Centre of Genomics and Policy, Department of Human Genetics, McGill University, Montreal, QC, H3A 0G1, Canada.
| | - Audrey Boily
- Centre of Genomics and Policy, Department of Human Genetics, McGill University, Montreal, QC, H3A 0G1, Canada
| | - Craig Hasilo
- CellCAN, Pavillon Rachel-Tourigny RT2101, Montreal, QC, H1T 2M4, Canada
| | - Bartha Maria Knoppers
- Centre of Genomics and Policy, Department of Human Genetics, McGill University, Montreal, QC, H3A 0G1, Canada
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13
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14
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Tzouvelekis A, Toonkel R, Karampitsakos T, Medapalli K, Ninou I, Aidinis V, Bouros D, Glassberg MK. Mesenchymal Stem Cells for the Treatment of Idiopathic Pulmonary Fibrosis. Front Med (Lausanne) 2018; 5:142. [PMID: 29868594 PMCID: PMC5962715 DOI: 10.3389/fmed.2018.00142] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 04/25/2018] [Indexed: 12/24/2022] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is an inexorably progressive lung disease of unknown origin. Prognosis is poor, with limited treatment options available, and the median survival remains just 3-5 years. Despite the use of pirfenidone and nintedanib for the treatment of IPF, curative therapies remain elusive and mortality remains high. Regenerative medicine and the use of cell-based therapies has recently emerged as a potential option for various diseases. Promising results of preclinical studies using mesenchymal stem cells (MSCs) suggest that they may represent a potential therapeutic option for the treatment of chronic lung diseases including IPF. Encouraging results of Phase 1 studies of MSCs various have reduced safety concerns. Nonetheless, there is still a pressing need for exploratory biomarkers and interval end-points in the context of MSCs investigation. This review intends to summarize the current state of knowledge for stem cells in the experimental and clinical setting of IPF, present important safety and efficacy issues, highlight future challenges and address the need for large, multicenter clinical trials coupled with realistic end-points, including biomarkers, to assess treatment efficacy.
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Affiliation(s)
- Argyrios Tzouvelekis
- First Academic Respiratory Department, Sotiria General Hospital for Thoracic Diseases, University of Athens, Athens, Greece.,Division of Immunology, Alexander Fleming Biomedical Sciences Research Center, Athens, Greece
| | - Rebecca Toonkel
- Department of Medicine, Florida International University Herbert Wertheim College of Medicine, Miami, FL, United States
| | - Theodoros Karampitsakos
- First Academic Respiratory Department, Sotiria General Hospital for Thoracic Diseases, University of Athens, Athens, Greece
| | - Kantha Medapalli
- Department of Medicine, Florida International University Herbert Wertheim College of Medicine, Miami, FL, United States.,Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Ioanna Ninou
- Division of Immunology, Alexander Fleming Biomedical Sciences Research Center, Athens, Greece
| | - Vasilis Aidinis
- Division of Immunology, Alexander Fleming Biomedical Sciences Research Center, Athens, Greece.,Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Demosthenes Bouros
- First Academic Respiratory Department, Sotiria General Hospital for Thoracic Diseases, University of Athens, Athens, Greece
| | - Marilyn K Glassberg
- Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, United States.,Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, United States
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15
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Price J. Pharmacovigilance in Crisis: Drug Safety at a Crossroads. Clin Ther 2018; 40:790-797. [DOI: 10.1016/j.clinthera.2018.02.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 02/27/2018] [Accepted: 02/28/2018] [Indexed: 11/28/2022]
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