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We work at the UK stem cell bank with poor potent stem cells. There's a very specific time that's used, but it means that they have the potential to form all the cell types of the body, the embryonic stem cells that we have, we can would still be considered the gold standard for treating disease. But I think it could be game-changing for patients.
This is the National Health Executive Podcast, bringing new views, insight and conversation from leaders across the health sector, presented by Louis Morris.
Today, I'm delighted to be joined by Lee Carpenter, who is the head of the UK Stem Cell Bank, so Lee stem cells are quite a popular term. It's a phrase that everyone I guess knows but, I guess not everyone will be. That's really what stem cells actually are. So could you give us a rundown on what stem cells are and how they help the NHS?
Yeah, sure. There's different types of stem cells. There's more mature stem cells that exist in in adults, say blood stem cells that can help to repopulate blood through adult life. But they have limited expansion potential. And they can only contribute to blood, blood lineages such as red cells, T cells, B cells and so on. We work at the UK stem cell Bank with pro potent stem cells. There's a very specific term that's used, but it means that they have the potential to form all the cell types of the body. So that makes very special for many, many different applications in disease and regenerative therapies. And the other aspects of pluripotent stem cell. Is that they can divide essentially in immortal fashion. They can divide for long periods and retain their stability and their qualities, so they can be expanded and manufactured. And even Gene edited so we get the desired effects from cell types that we want to manufacture and produce.
You mentioned the UK stem cell banner and you are the head of the UK stem cell bank. Would you mind explaining what the UK stem cell bank is? And what it is you guys do?
Well, I'm fairly. New on the as I understand it, the third director head of the UK stem Cell Bank, my role is to provide scientific leadership and strategic leadership. As you're aware from from the. There's median coverage that we've had. The bank has been in existence for 20 years now and celebrated that recently it came as a result of a House of Lords Steering Committee on the use of embryonic stem cells or pure potent stem cells as we refer to them as to ensure our guardianship. High quality and standards and safe and ethical use. So that's the reason that the bank is is it was set up again to offer the guardianship and safe use and ensure quality, but we also conduct. Research. So we've got programmes and research around better banking practises, automation. We've just had a collaboration with the A Japanese consortium called Symphonia that was very successful and we offer advice and guidance to the stem cell community. And there are. Regulations that exist for the stem cell manufacturing.
As you mentioned the partnership, the Japanese company there and automation of some stuff in the media by that as well, how big the future will automation play in the stem cells?
I think it's going to be fairly critical. We can see that the manufacturing of stem cells. Is usually labour intensive. It's fairly expensive too. So when we think about scale up and and manufacturing, we can bring the cost down. If we do that, we automation and then bring down the cost makes it more accessible to healthcare organisations and ultimately to the patients, but also as a side to that we can ensure. The highest quality standards when when automation is involved in manufacturing stem cells. The expectation is that they will remove any unexpected human errors and ensure the quality and safety of the stem cells remain.
And for your perspective, what are the main opportunities for stem cell research? Because I was doing a little bit of research. Health, and it seems like they can help with everything from blood cancer to blindness. That's quite a huge range. Where do you think that's the next big step is? Where do you think, I guess research should focus or could focus?
I mean, as you mentioned, there's lots of disease areas that stem cells can be used to treat. We've heard that our 20 celebrations, a phase one clinical trial for macular degeneration, that that was run by Moorfields Eye Hospital and University College London, presented by Peter Coffey. And that was very successful. It is phase one is primarily a safety study, but it also demonstrates that you you could restore vision in those. Patients and those patients were over 80 years old and they were essentially classed as blind. They had their drivers licence taken away and even after treatment that the the licence was restored. So that was a very good outcome for those patients. We also see it in the treatment of type one diabetes with pharmaceutical company in the USA. Now publishing data to to show that type 1 diabetics have been very successfully treated with stem cell therapies so they can maintain their glycemic levels in a very healthy. State we can see it with the trials that were started some time ago for treatment with Parkinson's and spinal cord. That's ongoing. Well, I think the next revolution in treatment of the use of stem cells and treatment cancer. So this is where you can derive immune cells from stem cells, the, the, the blood compartments. Talked about earlier. You can you. Can direct them to counselling patients and that will then target either leukemias or or solid tumours. Hopefully one day. But there's some very good readouts, more from from 2 suitables in the US around leukemias, and so that that's looking very promising.
He also wants to earn CHS for. Quite a while. On human induced pluripotent stem cells, which you've mentioned there and you'd like them to embryonic stem cells as. More running a male term would you say?
Well, originally they were termed embryonic like there are so much similar that that they could be considered group of stem cell for sure. Lots of work to demonstrate that they are very, very similar to embryonic stem cells, but they don't have that same origin they've been derived from skin cells and reprogrammed. It's a term we call when you introduced. Genetic factors, and it takes them all the way back to the embryonic state. So skin cells are no longer the epithelial like cells that you would expect to see in skin. Even fibreglass cells. They become embryonic, like, and they express all the factors associated with proponent stem cells, and they retain that pure potency that we talk about so they can differentiate into all the cell types you could considered for advanced therapies in the different disease areas that you mentioned. So very promising and and the the the thing that was very exciting. About that work, it's groundbreaking back in 2006, which first demonstrated in mice 2007 in human cells. Is that it does take some away. Some of the ethical concerns they they're easy to work with. It's not such a highly regulated environment. It does mean of course, I mean more applicable for research, but there are thousands of solar now that that now are research grade induced pluripotent stem cells or artificial. Themselves, it's not many that are considered clinical grade. So again that do we have a quite a vast repository of human embryonic stem cells in the bank, over 180 lines, research and development, but 30 which can be used for human application. So of clinical grade, it's the largest repository in the world of its kind. And in the sense they also represent the gold standard in the field. So we took that artificially induced pluripotent stem cells. But the human Beric stem cells that we have would still be considered the gold standard for treating disease.
I mean, it really is a fascinating subject area. How do you get into stem cell research in the first place?
Yeah, that's a good question. I have had quite a a varied career and I started my first postdoc in Australia in Sydney. Are actually investigating enzymes. Proteins were involved in type One, type 2 diabetes only manipulated proteins and cells to understand their role in type one, type 2 diabetes. Those cells started growing as if they were stem cells, and that really excited me and thought immediately the cell replacement here an option for treatment of type one and type 2 diabetes. This came back to the UK and continued my postdoctoral fellowship career at the University of Cambridge, where we looked at the role of genes in stem cells and cancer. So I continued trying to investigate mechanisms of power potency, what constitutes a stem cell that maintains pluripotent? Features of stem cell for clinical application and then I moved to NHS building transplant where I spent the best part of 10 years trying to understand. And the potential for proponent stem cells. It was really focused on, as I mentioned, induced pluripotent stem cells. They're a little bit easier to work with in terms of regulatory aspects and and just being able to obtain the tissue and at that time there's a lot of controversy in the literature around the potential for any pluripotent stem cell. For application in in disease and degenerative medicine, because the dogma was that they couldn't contribute to adult tissues, and if you want to prove. Adult cures you want say, such as having more sites you want that to be an adult, cardiomyocyte or heart cell that can integrate properly into the adult heart and not induce potentially induce arrhythmias. And that's one aspect of the concern in the field around treating heart disease. But in blood, we were concerned that. Or say applications in transfusion medicine or replacement of blood in transfusions, the red cells that we were making using proper stem cells, the the worry was that they were only embryonic thoughts at the time that they couldn't differentiate into adult red cells and that could be a problem for them. It's and it became a focus of my work to demonstrate that regardless of the source, whether it's proponent stem cells, we took core blood 2, which is considered adult stem cells and showed that they're essentially identical when you differentiate them. When you make red cells from them. And we made these cells and we subsequently made T cells and biotech. And they have very similar characteristics to their adult counts. But so they could be considered as a safe option for therapies.
How prominent a role do you think stem cell research can play in the health services overall future strategy?
Yeah, I think it could be game changing for patients, providing material that can replace or restore disease, tissue or aged tissue and it's not something that you tend to associate with drugs and small molecules and even RNA strategies now. So it's advanced cellular therapies is going to be a game changer for treatment of patients in the future. I think it would be great if NHS fund transplant could adopt some of these options sooner or at least investigate potential for for uptake. The other aspect of. Setting the therapist is considered a living. Drug so it's. Usually considered a one off treatment, get one infusion differentiated. Cells that then persist with the patient if it's cardiomyocyte or heart cells, you expect them to integrate with heart and and persist with the patient and continue to provide improvement in heart function. And if it's T cells, treatment in cancer therapy that lives with the patients or with once in the mission and they stay in the mission. The hope is that. And the T cells link with the patient and if the tumour grows back then the T cells are reactivated and can target the cancer again. So so eventually that will bring down the cost of treatments. So it's not gonna be daily regimes of injections or pills. It will be a one off treatment of a living drug that persists with the patient. So yeah, this this can be really, uh, game changing at exciting times.
And as you mentioned, that really does seem like the possibilities are almost endless, but moving back onto the UK stem cell bank in particular, what do you think the next two 5-10 years has in store for them or for you?
Yeah, we want to continue to release more lines and we have to mention 30 considered clinical grade. We want to keep on releasing those to the scientific community, make more available that's of major importance. We want to continue our research activities around better banking practises. Automation is going to be. Key we also want to move into new areas of banking, so other progenitors we we do want to bank some artificial juice blood. And stem cells, we want to ease the manufacturing paths for customers so that if they get progenitors that are really committed to the tissues, that would be suitable for treating. These then that, that's a big advantage for them.
In fact, ask you one thing. That you want. To happen in the next 10 years, one thing just one thing. What would it be? In terms of stem cells, obviously.
All that's tricky. Obviously automation is really important. But that I. Think will progress with with the farmaceutico companies and and us working with them with our projects. Our research projects that we we've had and will continue to investigate those options allow automation but I think. A major area that I would like. To focus on to be treatment of cancer obviously affects millions. Wide and there's some very good readouts in in clinical trials now that we're seeing particularly in the US with the US of the NK and T cells, which are part of the immune system targeting cancer. Particularly leukemias and very good readouts there. So I think it's the future for for treatment of cancer, but for a long time, we've been stuck with the usual chemotherapy regimes, radiation. Combination strategies and this is the start of a new era, I think in cell therapy for cancer.
That's been the national home for Executive podcast. Thank you for listening, and we'll catch you.
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