1. Engineered Cells and Tissues Locksley McGann, PhD Professor Department of Laboratory Medicine and Pathology University of Alberta 24 April, 2012 Analytics, Big Data and the Cloud E2. Personalized Medicine – Diagnostics & Therapy Image: http://www.jamesphillips.org/wp-content/uploads/2011/07/Engineered-Neural-Tissue-300x261.jpg

2. This talk is a little bit about … Cellular therapies Cellular therapies Tissue transplantation Tissue transplantation Current and emerging applications Current and emerging applications Role of analytics in future developments Role of analytics in future developments Image: http://njcprinting.files.wordpress.com/2012/01/publicspeaking.jpg

3. Cell Therapies and Stem Cells Cell therapies do not necessarily use stem cells Cell therapies do not necessarily use stem cells Example: Example: – Blood transfusion Donor blood is typed for ABO and Rh, processed, banked, and transfused into patients with the same blood type 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 The most successful and widely-used cellular therapy Graphic: http://blood.ca

4. Cell Therapies and Stem Cells Cell therapies do not necessarily use stem cells Cell therapies do not necessarily use stem cells Examples: 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

5. Stem Cells There are 3 general categories of stem cells: 1.Embryonic Derived from human embryos Derived from human embryos Controversial Controversial Ethical challenges Ethical challenges Active research area, not in common use Active research area, not in common use Image: http://www.westhavennow.org/wp-content/uploads/2012/01/What-are-Embryonic-Stem-Cells.jpg

6. Stem Cells There are 3 general categories of stem cells: 1.Embryonic 2.Non-embryonic (“adult”) Cells from a living person Cells from a living person – e.g. hematopoietic stem cells in bone marrow transplants Cells from umbilical cord blood Cells from umbilical cord blood Active research area Active research area In common clinical use In common clinical use Image: http://www.kumc.edu/images/stemcell/maturemarrow.jpg

7. 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 Differentiated cells modified to express characteristics of stem cells Active research area Active research area Emerging applications Emerging applications Image: http://upload.wikimedia.org/wikipedia/commons/thumb/0/09/Induction_of_iPS_cells.svg/350px-Induction_of_iPS_cells.svg.png

8. 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

9. Adult stem cell examples - 1 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 Hematopoietic stem cells (bone marrow)

10. Adult stem cell examples - 1 Treatment summary: 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 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 Hematopoietic stem cells (bone marrow)

11. Adult stem cell examples - 1 Registries 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. Bone marrow (allogeneic hematopoietic stem cells)

12. Adult stem cell examples - 2 Autologous hematopoietic stem cells Image: http://www.kancer.co.uk/images/autoglass.gif

13. Adult stem cell examples - 3 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. 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. 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. These hematopoietic stem cells can be cryopreserved for storage, and later used for transplantation. Umbilical cord blood Image: http://jama.ama-assn.org/content/292/20/2453/embed/graphic-1.jpg

14. Umbilical cord blood – Public and Private Banking Public 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 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

15. Adult stem cell examples - 3 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 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 several collection sites across the country There will be 2 processing/storage/distribution sites There will be 2 processing/storage/distribution sites – one in Ottawa (2013) – the other in Edmonton (2014) Umbilical cord blood

16. Tissues General process: General process: – Cadaveric donors – Tissues recovered in an operating room – Processed and stored (mostly frozen) – Distributed to hospitals Donor tissues commonly transplanted include: Donor tissues commonly transplanted include: – Bone for repair – Corneas to restore vision – Skin for severe burns – Heart valves, blood vessels – Some engineered tissues approaching routine use Image: http://www.cbcp.info/images/pic-pillar-tissuebank.png

17. Tissues A proposal is before the provincial and territorial governments to create a national system for tissue banking (except Quebec) 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 improve access to tissues for Canadians requiring transplants This would also reduce the cost of importing tissues from the USA This would also reduce the cost of importing tissues from the USA Image: http://www.cbcp.info/images/pic-pillar-tissuebank.png

18. Looking ahead Therapies utilizing living cells and tissues are increasingly begin used in treating patients Therapies utilizing living cells and tissues are increasingly begin used in treating patients Analytics will play an increasingly important role to: 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 These developments require development of partnerships between the disciplines Image: http://futureday.org/wp-content/uploads/2011/10/The_Eye_of_future.jpg