BIOINF/BIOTECH-TED Talks-Susan Solomon: The Promise of Research with Stem Cells

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Transcript:
So, embryonic stem cellsare really incredible cells.They are our body's own repair kits,and they're pluripotent, which means they can morph intoall of the cells in our bodies.Soon, we actually will be able to use stem cellsto replace cells that are damaged or diseased.

But that's not what I want to talk to you about,because right now there are some reallyextraordinary things that we are doing with stem cellsthat are completely changingthe way we look and model disease,our ability to understand why we get sick,and even develop drugs.I truly believe that stem cell research is going to allowour children to look at Alzheimer's and diabetesand other major diseases the way we view polio today,which is as a preventable disease.

So here we have this incredible field, which hasenormous hope for humanity,but much like IVF over 35 years ago,until the birth of a healthy baby, Louise,this field has been under siege politically and financially.Critical research is being challenged instead of supported,and we saw that it was really essential to haveprivate safe haven laboratories where this workcould be advanced without interference.And so, in 2005,we started the New York Stem Cell Foundation Laboratoryso that we would have a small organization that coulddo this work and support it.

What we saw very quickly is the world of both medicalresearch, but also developing drugs and treatments,is dominated by, as you would expect, large organizations,but in a new field, sometimes large organizationsreally have trouble getting out of their own way,and sometimes they can't ask the right questions,and there is an enormous gap that's just gotten largerbetween academic research on the one handand pharmaceutical companies and biotechsthat are responsible for delivering all of our drugsand many of our treatments, and so we knew thatto really accelerate cures and therapies, we were goingto have to address this with two things:new technologies and also a new research model.Because if you don't close that gap, you really areexactly where we are today.And that's what I want to focus on.We've spent the last couple of years pondering this,making a list of the different things that we had to do,and so we developed a new technology,It's software and hardware,that actually can generate thousands and thousands ofgenetically diverse stem cell lines to createa global array, essentially avatars of ourselves.And we did this because we think that it's actually goingto allow us to realize the potential, the promise,of all of the sequencing of the human genome,but it's going to allow us, in doing that,to actually do clinical trials in a dish with human cells,not animal cells, to generate drugs and treatmentsthat are much more effective, much safer,much faster, and at a much lower cost.

So let me put that in perspective for youand give you some context.This is an extremely new field.In 1998, human embryonic stem cellswere first identified, and just nine years later,a group of scientists in Japan were able to take skin cellsand reprogram them with very powerful virusesto create a kind of pluripotent stem cellcalled an induced pluripotent stem cell,or what we refer to as an IPS cell.This was really an extraordinary advance, becausealthough these cells are not human embryonic stem cells,which still remain the gold standard,they are terrific to use for modeling diseaseand potentially for drug discovery.

So a few months later, in 2008, one of our scientistsbuilt on that research. He took skin biopsies,this time from people who had a disease,ALS, or as you call it in the U.K., motor neuron disease.He turned them into the IPS cellsthat I've just told you about, and then he turned thoseIPS cells into the motor neurons that actuallywere dying in the disease.So basically what he did was to take a healthy celland turn it into a sick cell,and he recapitulated the disease over and over againin the dish, and this was extraordinary,because it was the first time that we had a modelof a disease from a living patient in living human cells.And as he watched the disease unfold, he was ableto discover that actually the motor neurons were dyingin the disease in a different way than the fieldhad previously thought. There was another kind of cellthat actually was sending out a toxinand contributing to the death of these motor neurons,and you simply couldn't see ituntil you had the human model.

So you could really say thatresearchers trying to understand the cause of diseasewithout being able to have human stem cell modelswere much like investigators trying to figure outwhat had gone terribly wrong in a plane crashwithout having a black box, or a flight recorder.They could hypothesize about what had gone wrong,but they really had no way of knowing what ledto the terrible events.And stem cells really have given us the black boxfor diseases, and it's an unprecedented window.It really is extraordinary, because you can recapitulatemany, many diseases in a dish, you can seewhat begins to go wrong in the cellular conversationwell before you would ever seesymptoms appear in a patient.And this opens up the ability,which hopefully will become something thatis routine in the near term,of using human cells to test for drugs.

Right now, the way we test for drugs is pretty problematic.To bring a successful drug to market, it takes, on average,13 years — that's one drug —with a sunk cost of 4 billion dollars,and only one percent of the drugs that start down that roadare actually going to get there.You can't imagine other businessesthat you would think of going intothat have these kind of numbers.It's a terrible business model.But it is really a worse social model because ofwhat's involved and the cost to all of us.So the way we develop drugs nowis by testing promising compounds on --We didn't have disease modeling with human cells,so we'd been testing them on cells of miceor other creatures or cells that we engineer,but they don't have the characteristics of the diseasesthat we're actually trying to cure.You know, we're not mice, and you can't go intoa living person with an illnessand just pull out a few brain cells or cardiac cellsand then start fooling around in a lab to testfor, you know, a promising drug.But what you can do with human stem cells, now,is actually create avatars, and you can create the cells,whether it's the live motor neuronsor the beating cardiac cells or liver cellsor other kinds of cells, and you can test for drugs,promising compounds, on the actual cellsthat you're trying to affect, and this is now,and it's absolutely extraordinary,and you're going to know at the beginning,the very early stages of doing your assay developmentand your testing, you're not going to have to wait 13 yearsuntil you've brought a drug to market, only to find outthat actually it doesn't work, or even worse, harms people.

But it isn't really enough just to look atthe cells from a few people or a small group of people,because we have to step back.We've got to look at the big picture.Look around this room. We are all different,and a disease that I might have,if I had Alzheimer's disease or Parkinson's disease,it probably would affect me differently than ifone of you had that disease,and if we both had Parkinson's disease,and we took the same medication,but we had different genetic makeup,we probably would have a different result,and it could well be that a drug that worked wonderfullyfor me was actually ineffective for you,and similarly, it could be that a drug that is harmful for youis safe for me, and, you know, this seems totally obvious,but unfortunately it is not the waythat the pharmaceutical industry has been developing drugsbecause, until now, it hasn't had the tools.

And so we need to move awayfrom this one-size-fits-all model.The way we've been developing drugs is essentiallylike going into a shoe store,no one asks you what size you are, orif you're going dancing or hiking.They just say, "Well, you have feet, here are your shoes."It doesn't work with shoes, and our bodies aremany times more complicated than just our feet.So we really have to change this.

There was a very sad example of this in the last decade.There's a wonderful drug, and a class of drugs actually,but the particular drug was Vioxx, andfor people who were suffering from severe arthritis pain,the drug was an absolute lifesaver,but unfortunately, for another subset of those people,they suffered pretty severe heart side effects,and for a subset of those people, the side effects wereso severe, the cardiac side effects, that they were fatal.But imagine a different scenario,where we could have had an array, a genetically diverse array,of cardiac cells, and we could have actually testedthat drug, Vioxx, in petri dishes, and figured out,well, okay, people with this genetic type are going to havecardiac side effects, people with these genetic subgroupsor genetic shoes sizes, about 25,000 of them,are not going to have any problems.The people for whom it was a lifesavercould have still taken their medicine.The people for whom it was a disaster, or fatal,would never have been given it, andyou can imagine a very different outcome for the company,who had to withdraw the drug.

So that is terrific,and we thought, all right,as we're trying to solve this problem,clearly we have to think about genetics,we have to think about human testing,but there's a fundamental problem,because right now, stem cell lines,as extraordinary as they are,and lines are just groups of cells,they are made by hand, one at a time,and it takes a couple of months.This is not scalable, and also when you do things by hand,even in the best laboratories,you have variations in techniques,and you need to know, if you're making a drug,that the Aspirin you're going to take out of the bottleon Monday is the same as the Aspirinthat's going to come out of the bottle on Wednesday.So we looked at this, and we thought, okay,artisanal is wonderful in, you know, your clothingand your bread and crafts, butartisanal really isn't going to work in stem cells,so we have to deal with this.

But even with that, there still was another big hurdle,and that actually brings us back tothe mapping of the human genome, becausewe're all different.We know from the sequencing of the human genomethat it's shown us all of the A's, C's, G's and T'sthat make up our genetic code,but that code, by itself, our DNA,is like looking at the ones and zeroes of the computer codewithout having a computer that can read it.It's like having an app without having a smartphone.We needed to have a way of bringing the biologyto that incredible data,and the way to do that was to finda stand-in, a biological stand-in,that could contain all of the genetic information,but have it be arrayed in such a wayas it could be read togetherand actually create this incredible avatar.We need to have stem cells from all the genetic sub-typesthat represent who we are.

So this is what we've built.It's an automated robotic technology.It has the capacity to produce thousands and thousandsof stem cell lines. It's genetically arrayed.It has massively parallel processing capability,and it's going to change the way drugs are discovered,we hope, and I think eventually what's going to happenis that we're going to want to re-screen drugs,on arrays like this, that already exist,all of the drugs that currently exist,and in the future, you're going to be taking drugsand treatments that have been tested for side effectson all of the relevant cells,on brain cells and heart cells and liver cells.

It really has brought us to the thresholdof personalized medicine.It's here now, and in our family,my son has type 1 diabetes,which is still an incurable disease,and I lost my parents to heart disease and cancer,but I think that my story probably sounds familiar to you,because probably a version of it is your story.At some point in our lives, all of us,or people we care about, become patients,and that's why I think that stem cell researchis incredibly important for all of us.Thank you. (Applause)(Applause)