Analytics, Big Data and the Cloud E2. Personalized Medicine – Diagnostics & Therapy
Engineered Cells and Tissues Locksley McGann, PhD Professor Department of Laboratory Medicine and Pathology University of Alberta 24 April, 2012 Image: http://www.jamesphillips.org/wp-content/uploads/2011/07/Engineered-Neural-Tissue-300x261.jpg
This talk is a little bit about … • • • •
Cellular therapies Tissue transplantation Current and emerging applications Role of analytics in future developments
Image: http://njcprinting.files.wordpress.com/2012/01/publicspeaking.jpg
Cell Therapies and Stem Cells • Cell therapies do not necessarily use stem cells • Example: – Blood transfusion • Donor blood is typed for ABO and Rh, processed, banked, and transfused into patients with the same blood type • The most successful and widely-used cellular therapy
Graphic: http://blood.ca
Cell Therapies and Stem Cells • Cell therapies do not necessarily use stem cells • Examples: – Blood transfusions – Islets of Langerhans Islets are isolated from the pancreas of a donor and transplanted into a patient to treat diabetes (Edmonton is an international leader in this area)
Image: http://www.keyvive.com/wp-content/userimages/1280326032Islet_Cell_Transplantation.jpg
Stem Cells There are 3 general categories of stem cells: 1. Embryonic • • • •
Derived from human embryos Controversial Ethical challenges Active research area, not in common use
Image: http://www.westhavennow.org/wp-content/uploads/2012/01/What-are-Embryonic-Stem-Cells.jpg
Stem Cells There are 3 general categories of stem cells: 1. Embryonic 2. Non-embryonic (“adult”) • Cells from a living person – e.g. hematopoietic stem cells in bone marrow transplants
• Cells from umbilical cord blood • Active research area • In common clinical use Image: http://www.kumc.edu/images/stemcell/maturemarrow.jpg
Stem Cells There are 3 general categories of stem cells: 1. Embryonic 2. Non-embryonic (“adult”) 3. Induced pluripotent stem cells (IPS cells) • Differentiated cells modified to express characteristics of stem cells • Active research area • Emerging applications Image: http://upload.wikimedia.org/wikipedia/commons/thumb/0/09/Induction_of_iPS_cells.svg/350px-Induction_of_iPS_cells.svg.png
Adult stem cell examples - 1 Hematopoietic stem cells (bone marrow)
Image: http://www.fareastgizmos.com/entry_images/0210/08/Hematopoietic_Stem_Cells-thumb-450x244.jpg
Adult stem cell examples - 1 Hematopoietic stem cells (bone marrow)
Bone marrow transplantation is used to treat certain cancers of the blood or bone marrow, such as multiple myeloma or leukemia.
Image: http://www.fareastgizmos.com/entry_images/0210/08/Hematopoietic_Stem_Cells-thumb-450x244.jpg
Adult stem cell examples - 1
Hematopoietic stem cells (bone marrow) • Treatment summary:
– Patient is typed for specific characteristics related to immunological rejection – An international search is conducted to find a living donor with a good match • Using shared national registries of typed volunteer donors
– Cells are collected from the donor and shipped – The patient undergoes a specific treatment regimen, then receives the transplant Image: http://www.fareastgizmos.com/entry_images/0210/08/Hematopoietic_Stem_Cells-thumb-450x244.jpg
Adult stem cell examples - 1 Bone marrow (allogeneic hematopoietic stem cells)
• Registries
– Most countries have national registries to manage donors. – The Canadian Blood Services’ OneMatch registry manages most Canadian donors and patients. – Hema Quebec manages donors and patients in Quebec.
Adult stem cell examples - 2 Autologous hematopoietic stem cells
Image: http://www.kancer.co.uk/images/autoglass.gif
Adult stem cell examples - 3 Umbilical cord blood • After a baby is born and the umbilical cord is cut, there remains in the cord and the placenta, some of the baby’s blood. • This blood, which is normally discarded with the placenta, contains a significant number of hematopoietic stem cells. • These hematopoietic stem cells can be cryopreserved for storage, and later used for transplantation. Image: http://jama.ama-assn.org/content/292/20/2453/embed/graphic-1.jpg
Umbilical cord blood – Public and Private Banking • Public banking
– Mothers donate the umbilical cord blood after birth – The cord blood is recovered, typed and cryopreserved – Cell characteristics are listed on international registries
• Private banking
– The mother pays to recover and cryopreserve the cord blood for future use – Cell characteristics are not typed or listed on registries – There are about 12 private banks in Canada
Adult stem cell examples - 3 Umbilical cord blood
• In March, 2011, the provincial and territorial ministries of health (except Quebec) provided funding for the Canadian Blood Services to create a national umbilical cord blood bank • There will be several collection sites across the country • There will be 2 processing/storage/distribution sites – one in Ottawa (2013) – the other in Edmonton (2014)
Tissues • General process: – – – –
Cadaveric donors Tissues recovered in an operating room Processed and stored (mostly frozen) Distributed to hospitals
– – – – –
Bone for repair Corneas to restore vision Skin for severe burns Heart valves, blood vessels Some engineered tissues approaching routine use
• Donor tissues commonly transplanted include:
Image: http://www.cbcp.info/images/pic-pillar-tissuebank.png
Tissues • A proposal is before the provincial and territorial governments to create a national system for tissue banking (except Quebec) • This would improve access to tissues for Canadians requiring transplants • This would also reduce the cost of importing tissues from the USA Image: http://www.cbcp.info/images/pic-pillar-tissuebank.png
Looking ahead • Therapies utilizing living cells and tissues are increasingly begin used in treating patients • Analytics will play an increasingly important role to:
– define specific requirements for each patient – design and develop the appropriate biological modalities – monitor the patient to track the performance of the grafted cells/tissues, and to improve procedures
• These developments require development of partnerships between the disciplines