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Q&A: The future of stem cell research

Scientists derive stem cells from adult, fetal and embryonic tissue.

Vasiliy Koval

Already in clinical use through therapies such as bone-marrow transplants and cartilage repair, regenerative medicine has only started to realize its potential. Although scientists may eventually use stem cells and biomaterials to cure everything from heart disease to neurodegenerative illnesses, developing and commercializing these technologies will take time.

"What we all hope is that there will be new curative treatments for debilitating diseases," says Peter Zandstra, a professor at the University of Toronto's Institute of Biomaterials and Biomedical Engineering and a Canada Research Chair in Stem Cell Bioengineering. "It's not clear right now if our approaches will be successful, but I think there's a lot of hope and promise."

Among other regenerative medicine projects, U of T's Dr. Zandstra is utilizing new technologies, such as tissue engineering. "We generate cells such as cardiac cells [and]we're interested in formulating these cells into micro-tissues that mimic adult heart tissue," he says. "Then we can use those for drug screening."

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Dr. Zandstra, who works closely with Toronto's McEwen Centre for Regenerative Medicine, stresses the importance of collaboration with fellow researchers here and abroad. He also wants to see innovative technology reach the marketplace. In addition to his research duties, Dr. Zandstra is chief scientific officer of the new Centre for the Commercialization of Regenerative Medicine (CCRM).

The Toronto-based centre takes early-stage technologies from Ontario institutions and adds value to help commercialize them, he explains. "One of the problems that we face in regenerative medicine – and there are many – is that numerous technologies that come out are too early for real commercialization, and we need this extra step of turning them into products."

So what's the future for stem cell medicine, and how long will it take these new therapies to move from the lab to the market? Dr. Zandstra joined us for a live discussion.

11:48

Niamh O'Doherty - Hi everyone, my name is Niamh O'Doherty and I'll be moderating this live chat on the future of stem cell research. Please feel free to send in your questions now.

12:00

[Comment From pzandstra ]

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Hi - Peter Zandstra here ...

12:00

Niamh O'Doherty - Hi Peter. Readers, allow me to welcome Peter Zandstra, a professor at the University of Toronto's Institute of Biomaterials and Biomedical Engineering and a Canada Research Chair in Stem Cell Bioengineering.

12:01

Niamh O'Doherty - Peter, perhaps you could explain to us a little bit about your work in regenerative medicine.

12:02

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[Comment From Guest]

Sure - thanks for your intrest Niamh. My lab works of the development of technologies that can help control stem cell fate. We hope that by having bete technologies we will help accelerate the progress of stem cell towards the clinic.

12:03

[Comment From Peter Zandstra]

Sorry - that last comment was from me.

12:03

Niamh O'Doherty - Thanks Peter. Now, on to our readers' questions...

12:03

[Comment From Elizabeth ]

You hear a lot of stories in the news about how stem cells can treat different diseases. Can you get any of these treatments in Canada?

12:04

[Comment From Peter Zandstra]

Right now the only stem cell therapies availible in canada are bone marrow transplantations.

12:05

[Comment From Peter Zandstra]

Importantly, many new therapis moving towards clinical trials. In canada there are more than 40 of these at the moment.

12:07

Niamh O'Doherty - Peter, could you tell us a little more about these clinical trials? What kind of therapies are we talking about?

12:09

[Comment From Peter Zandstra]

Most of the therapies currently being contemplated are using adult stem cells. Examles are the use of mesenchymal cells to regenrate bone and other connective tissue, or to transplant these cells and use them as "factories" for the prodcution of proeins that may change healing rates or outcomes

12:09

[Comment From Carol ]

How many researchers are there in Canada working on stem cell therapies...and how are we positioned compared to other countries?

12:11

[Comment From Peter Zandstra]

Canada has a very strong foundation in stem cell reseach. The propertis and principles of stem cells were first defind in Canada by Till and McCulloch, and we now have, with the Canadain Stem Cell Network and other organizations a world class research endeavor.

12:12

[Comment From Peter Zandstra]

Ontiario itself is a great leader in stem cell research, investing in both basic and tranlational programms.

12:13

Niamh O'Doherty - Can you see the area growing in the future Peter?

12:15

[Comment From Peter Zandstra]

Yes - the area of regenrative medicine is receiving much attention - world wide. Strategies that use stem cells - eaither as sources of cells for transplantation, or as tools for drug development are anticipatd to have a great impact.

12:15

[Comment From Tim ]

With all the exciting research and clinical trials occurring, what do you foresee as the next big breakthrough, or therapy becoming commercialized?

12:18

[Comment From Peter Zandstra]

In my mind we are in a period of consolidation. Only 6 years ago i was found that we could turn adul cells into cells that are similar to embryonic stem cells. Similarly, many of the findings with adult cells are worthing their way into clinics. I think that these will start to have impact in the near future.

12:18

[Comment From Elizabeth ]

How long will it take for treatments to become available? Why does the process take a long time?

12:19

[Comment From Peter Zandstra]

Typically the process from discovery to therapy takes more than 10 years. One thing we are hoping is that the use of stem cells to model disease better, this process will be accelerated.

12:21

Niamh O'Doherty - Thanks Peter. In the comments section for this article, some readers spoke about stem cell research in China, which seems to be have been going on for a lot longer than its Canadian equivalent. Is this accurate?

12:24

[Comment From Peter Zandstra]

No - not really. Certainly China and many countries arrounf the world are investing signifcnatly in stem cell research. What is improant to realize is that it takes time to identfy safe and effective approches to difficult diseases. It is important thatnew therpies move forward in a well defined reguatory environment.

12:26

Niamh O'Doherty - Thanks. Peter, in your article you mentioned that many new therapies that come out aren't yet ready for commercializing - can you tell us why that is?

12:29

[Comment From Peter Zandstra]

Basically it is becasue these discoveries have not been turned into products. To deliver new thrapies the discoveries have to be very robust, have to be cost effective and have to find their place in our clincial enviroment. This takes a different type of effort. One that is the focus of translational reseach endeavors line CCRM.

12:29

[Comment From Susie ]

I am thinking of banking my unborn baby's cord blood, how useful do you think it could be in the future?

12:31

[Comment From Peter Zandstra]

Cord blood is a growing source of blood stem cells for the treatment of blood disease, especilly in the US. The chances that any one individual will need their cord blood is small, thus public banking of cord blood is an attractive option for some.

12:32

[Comment From Elizabeth ]

Are these treatments expensive because they are new? Like when new drugs come out, they tend to cost more - is it the same thing?

12:34

[Comment From Peter Zandstra]

Currently the cost of new therapies incorperate the cost of development of the therapy and the cost of manufacturing the product. It is hoped that as these therapies become more main stream both these costs will be reduced.

12:35

Niamh O'Doherty - How long will it take for these therapies to become popular, Peter?

12:39

Niamh O'Doherty - And another question from Susie:

12:39

[Comment From Susie ]

For those ones that missed the chance of banking their cord blood, are there any alternative ways to get stem cells during their adulthood?

12:39

[Comment From Peter Zandstra]

It will depend on their clinical impact. Some types of cell products (skin replacement for example) currenly have treated more than 100,000 patients. There are many diseases that we are currnely very bad at treating. If we can develop new strategies to help people with these diseases, and if the impact on the cost of treating these diseases (which are often chronic) is low enought, they will have a great uptake.

12:41

[Comment From Peter Zandstra]

As I alluded to earlier, public cord blood and bone marow banking programs have been and are being establishd with the hope of ensuring that one day we will all have access to new therapies using these cells.

12:42

[Comment From Martha ]

Are we at a stage where there is a need to educate/train more physicians about the use of potential regenerative medicine products... seem that awareness may be a barrier to implementation.

12:43

[Comment From Peter Zandstra]

Good question Martha. Certainly engaging physicians in the pocess of developing regenerative medicine therapies is critical.

12:44

[Comment From Peter Zandstra]

These are some new programs in Canada to do this, but certainly more can be done. One example is cord blood transplantation which is much more prevalent in the US than in Canada.

12:46

Niamh O'Doherty - Peter, can you tell us a little about what you're working on right now? Are you still engineering cardiac cells for drug screening?

12:49

[Comment From Peter Zandstra]

We are working on a number of things. Wih Milica Radisic's lab we are woking on developing a drug screeing platform for cadiac cells, we are working on technologis to grow blood stem cells and we are developing "bioreactors" to grow cells in larger numbers, for example.

12:49

[Comment From Matt ]

Why is north america working from scratch with Stem Cells, when you can get so much 1st hand knowledge from the Chinese who have been working on Stem Cells for 20 years?

12:51

[Comment From Peter Zandstra]

Stem cell research is very strong in Canada and the US.

12:51

[Comment From Peter Zandstra]

The important thing is to move this reseach into the clinic in a way that is safe and effective. This takes time.

12:52

Niamh O'Doherty - Thanks Peter. Any final thoughts before we wrap up this discussion?

12:52

[Comment From Peter Zandstra]

More information on stem cell theriapies internationally can be found on the ISSCR web site called "a closer look at stem cells".

12:54

[Comment From Peter Zandstra]

I think we are at a very exciting time in stem cell and regnerative medicine reseach and technology development. I hopethat over the next 5 years we will see the results of this signifciant effort impact Canadains and people world wide.

12:54

Niamh O'Doherty - Thanks very much for your time Peter. Readers, feel free to continue the discussion in the comments section - looks like it's a pretty popular topic!

12:55

Niamh O'Doherty - Thanks for tuning in, everyone.





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