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Bench-to-Bedside Development of MSC Therapies: A Multidisciplinary Approach

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Mesenchymal Stromal Cells

Abstract

There is a worldwide interest in developing mesenchymal stromal/stem cells (MSCs) for a broad and steadily expanding range of potential clinical applications. Whether developed by academia or industry, successful transition from the research bench to the clinic requires a systematic, coordinated, and multidisciplinary approach to execute the many simultaneous, interrelated activities aimed at demonstrating the product’s safety and efficacy. Like conventional drug development, MSC product development requires attention to basic and translational science, ­preclinical safety and efficacy studies in animal models, manufacturing process development, good manufacturing practice, development and validation of analytical methods to characterize the product, quality control and quality assurance, regulatory affairs, and design and execution of clinical trials. Broad expertise is needed to accomplish these activities and includes molecular and cell biologists; scientists and technicians to develop and perform laboratory assays, manufacturing, and imaging; physicians with expertise in the disease application and clinical trials; pathologists; clinical imaging experts; nurses and clinical trials staff; veterinarians; quality officers; regulatory affairs experts, technology transfer officers and patent counsels; and institutional ethics committees. An integrated project management approach can be adapted by both academia and industry to successfully negotiate the complex product development pathway. In this chapter, we review the preclinical, manufacturing, clinical, quality, and regulatory requirements to move MSC products from bench to bedside and highlight the resources needed for success in this endeavor.

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References

  1. Bach FH, Albertini RJ, Joo P et al (1968) Bone-marrow transplantation in a patient with the Wiskott-Aldrich syndrome. Lancet 2:1364–1366

    Article  PubMed  CAS  Google Scholar 

  2. De Koning J, Van Bekkum DW, Dicke KA et al (1969) Transplantation of bone-marrow cells and fetal thymus in an infant with lymphopenic immunological deficiency. Lancet 1:1223–1227

    Article  PubMed  Google Scholar 

  3. Gatti RA, Meuwissen HJ, Allen HD et al (1968) Immunological reconstitution of sex-linked lymphopenic immunological deficiency. Lancet 2:1366–1369

    Article  PubMed  CAS  Google Scholar 

  4. http://www.clinicaltrials.gov

  5. DiMasi JA, Hansen RW, Grabowski HG (2003) The price of innovation: new estimates of drug development costs. J Health Econ 22:151–185

    Article  PubMed  Google Scholar 

  6. Adams CP, Brantner VV (2006) Estimating the cost of new drug development: is it really 802 million dollars? Health Aff (Millwood) 25:420–428

    Article  Google Scholar 

  7. Branscomb LM, Auerswald PE (2003) Valleys of death and Darwinian seas: financing the invention to innovation transition in the United States. J Technol Trans 28:3–4

    Google Scholar 

  8. Reed W, Noga SJ, Gee AP et al (2009) Production Assistance for Cellular Therapies (PACT): four-year experience from the United States National Heart, Lung, and Blood Institute (NHLBI) contract research program in cell and tissue therapies. Transfusion 49:786–796

    Article  PubMed  Google Scholar 

  9. Trounson A, Baum E, Gibbons D et al (2010) Developing a case study model for successful translation of stem cell therapies. Cell Stem Cell 6:513–516

    Article  PubMed  CAS  Google Scholar 

  10. (1938) Federal food, drug and cosmetic act (21USC351)

    Google Scholar 

  11. (1987) Code of federal regulations title 21, in 21 food and drugs

    Google Scholar 

  12. http://www.fda.gov/BiologicsBloodVaccines/NewsEvents/ucm232821.htm

  13. FDA (2009) Guidance for industry formal meetings between the FDA and the sponsors or applicants

    Google Scholar 

  14. ICH (1997) Preclinical safety evaluation of biotechnology-derived pharmaceuticals (S6), in safety guidelines

    Google Scholar 

  15. ICH (2009) Addendum to ICH S6: preclinical safety evaluation of biotechnology-derived pharmaceuticals (S6R1), in safety guidelines

    Google Scholar 

  16. Federal Register (2010). p 76011–76015

    Google Scholar 

  17. Adolph EF (1949) Quantitative relations in the physiological constitutions of mammals. Science 109:579–585

    Article  PubMed  CAS  Google Scholar 

  18. McMahon TAB, Bonner JT (1983) On size and life. Scientific American Books, Inc, New York

    Google Scholar 

  19. Prockop DJ, Brenner M, Fibbe WE et al (2010) Defining the risks of mesenchymal stromal cell therapy. Cytotherapy 12:576–578

    Article  PubMed  Google Scholar 

  20. ICH (2000) Detection of toxicity to reproduction for medicinal products & toxicity to male fertility S5(R2), in safety guidelines

    Google Scholar 

  21. ICH (2008) Guidance on genotoxicity testing and data interpretation for pharmaceuticals intended for human use S2(R1), in safety guidelines

    Google Scholar 

  22. ICH (1995) Need for carcinogenicity studies of pharmaceuticals S1A, in safety guidelines

    Google Scholar 

  23. Code of federal regulations, title 21, in 21 part 58 good laboratory practice for nonclinical laboratory studies

    Google Scholar 

  24. FDA (1998) Guidance for industry: guidance for human somatic cell therapy and gene therapy

    Google Scholar 

  25. FDA (2008) Guidance for FDA reviewers and sponsors: content and review of chemistry, manufacturing, and control information for human somatic cell therapy investigational new drug applications (INDs)

    Google Scholar 

  26. FDA (2008) Guidance for FDA reviewers and sponsors: content and review of chemistry, manufacturing, and control information for human gene therapy investigational new drug applications (INDs)

    Google Scholar 

  27. Code of federal regulations title 21, in 21 part 1271, subpart C donor elgibility rule

    Google Scholar 

  28. FDA (2009) Draft guidance for industry: use of serological tests to reduce the risk of transmission of trypanosoma cruzi infection in whole blood and blood components for transfusion and human cells, tissues, and cellular and tissue-based products

    Google Scholar 

  29. FDA (2007) Guidance for industry: eligibility determination for donors of human cells, tissues, and cellular and tissue-based products (HCT/Ps)

    Google Scholar 

  30. FDA (2008) Draft guidance for industry: use of nucleic acid tests to reduce the risk of transmission of West Nile virus from donors of whole blood and blood components intended for transfusion and donors of human cells, tissues, and cellular and tissue-based products (HCT/Ps)

    Google Scholar 

  31. Gee A (ed) (1991) Bone marrow processing and purging: a practical guide. In: Thomas J (ed) Bone marrow harvesting and reinfusion. CRC Press, Boca Raton, p 31–38

    Google Scholar 

  32. Schepers KG, Davis JM, Rowley SD (1992) Incidence of bacterial contamination of bone marrow grafts. Prog Clin Biol Res 377:379–384

    PubMed  CAS  Google Scholar 

  33. Le Blanc K, Frassoni F, Ball L et al (2008) Mesenchymal stem cells for treatment of ­steroid-resistant, severe, acute graft-versus-host disease: a phase II study. Lancet 371:1579–1586

    Article  PubMed  Google Scholar 

  34. Zuk PA, Zhu M, Ashjian P et al (2002) Human adipose tissue is a source of multipotent stem cells. Mol Biol Cell 13:4279–4295

    Article  PubMed  CAS  Google Scholar 

  35. Hung SC, Chen NJ, Hsieh SL et al (2002) Isolation and characterization of size-sieved stem cells from human bone marrow. Stem Cells 20:249–258

    Article  PubMed  Google Scholar 

  36. Haack-Sorensen M, Friis T, Bindslev L et al (2008) Comparison of different culture conditions for human mesenchymal stromal cells for clinical stem cell therapy. Scand J Clin Lab Invest 68:192–203

    Article  PubMed  CAS  Google Scholar 

  37. Goedecke A, Wobus M, Krech M et al (2011) Differential effect of platelet-rich plasma and fetal calf serum on bone marrow-derived human mesenchymal stromal cells expanded in vitro. J Tissue Eng Regen Med

    Google Scholar 

  38. Antweiler D, Peters R, Windmiller D, Jones M, Vang B, Brecheisen M (2009) Quantum cell expansion system: a novel hollow-fiber bioreactor for GMP production of mesenchymal stem cells. In: World conference on regenerative medicine

    Google Scholar 

  39. FDA (1993) Points to consider in the characterization of cell lines used to produce biologicals

    Google Scholar 

  40. ICH (1997) Derivation and characterisation of cell substrates used for production of biotechnological/biological products (Q5D), in quality guidelines

    Google Scholar 

  41. Pharmacopeia US, <1043> Ancillary materials for cell, gene and tissue engineered products

    Google Scholar 

  42. Selvaggi TA, Walker RE, Fleisher TA (1997) Development of antibodies to fetal calf serum with arthus-like reactions in human immunodeficiency virus-infected patients given syngeneic lymphocyte infusions. Blood 89:776–779

    PubMed  CAS  Google Scholar 

  43. Pharmacopeia US, <1024> Bovine serum

    Google Scholar 

  44. Pharmacopeia US, <90> Fetal bovine serum quality attributes and functionality tests

    Google Scholar 

  45. Rowley SD, Feng Z, Yadock D et al (1999) Post-thaw removal of DMSO does not completely abrogate infusional toxicity or the need for pre-infusion histamine blockade. Cytotherapy 1:439–446

    Article  PubMed  CAS  Google Scholar 

  46. Davis JM, Rowley SD, Braine HG et al (1990) Clinical toxicity of cryopreserved bone marrow graft infusion. Blood 75:781–786

    PubMed  CAS  Google Scholar 

  47. Junior AM, Arrais CA, Saboya R et al (2008) Neurotoxicity associated with dimethylsulfoxide-preserved hematopoietic progenitor cell infusion. Bone Marrow Transplant 41:95–96

    Article  PubMed  CAS  Google Scholar 

  48. Mueller LP, Theurich S, Christopeit M et al (2007) Neurotoxicity upon infusion of dimethylsulfoxide-cryopreserved peripheral blood stem cells in patients with and without pre-existing cerebral disease. Eur J Haematol 78:527–531

    Article  PubMed  CAS  Google Scholar 

  49. Bauwens D, Hantson P, Laterre PF et al (2005) Recurrent seizure and sustained encephalopathy associated with dimethylsulfoxide-preserved stem cell infusion. Leuk Lymphoma 46:1671–1674

    Article  PubMed  CAS  Google Scholar 

  50. Carpenter JF, Dawson PE (1991) Quantitation of dimethyl sulfoxide in solutions and tissues by high-performance liquid chromatography. Cryobiology 28:210–215

    Article  PubMed  CAS  Google Scholar 

  51. AABB (2009) Circular of information for the use of cellular therapy products

    Google Scholar 

  52. Pharmacopeia US, <1046> Cell and gene therapy products

    Google Scholar 

  53. ICH (1994) Validation of analytical procedures: text and methodology Q2(R1), in quality guidelines

    Google Scholar 

  54. Pharmacopeia US <1225> Validation of compendial methods

    Google Scholar 

  55. Dominici M, Le Blanc K, Mueller I et al (2006) Minimal criteria for defining multipotent mesenchymal stromal cells. The International Society for Cellular Therapy position statement. Cytotherapy 8:315–317

    Article  PubMed  CAS  Google Scholar 

  56. FDA (2011) Guidance for industry – potency tests for cellular and gene therapy products

    Google Scholar 

  57. Pharmacopeia US (2009), <71> Sterility tests

    Google Scholar 

  58. ICH (2011) Impurities: guidelines for residual solvents Q3C(R5), in quality guidelines

    Google Scholar 

  59. (2005) Code of federal regulations, title 45 in 21 part 45 public welfare

    Google Scholar 

  60. Code of federal regulations, title 21, in 21 part 50 protection of human subjects

    Google Scholar 

  61. Code of federal regulations, title 21, in 21 part 56 institutional review board

    Google Scholar 

  62. Hare JM, Traverse JH, Henry TD et al (2009) A randomized, double-blind, placebo-controlled, dose-escalation study of intravenous adult human mesenchymal stem cells (prochymal) after acute myocardial infarction. J Am Coll Cardiol 54:2277–2286

    Article  PubMed  CAS  Google Scholar 

  63. NCI (2009) Common terminology criteria for adverse events (CTCAE). Health NIo (editor)

    Google Scholar 

  64. FDA (2007) Draft guidance for industry: preparation of IDEs and INDs for products intended to repair or replace knee cartilage

    Google Scholar 

  65. FDA (2009) Guidance for industry: considerations for allogeneic pancreatic islet cell products

    Google Scholar 

  66. FDA (2009) Draft guidance for industry: clinical considerations for therapeutic cancer vaccines

    Google Scholar 

  67. FDA (2009) Guidance for industry: minimally manipulated, unrelated allogeneic placental/umbilical cord blood intended for hematopoietic reconstitution for specified indications

    Google Scholar 

  68. FDA (2010) Guidance for industry: cellular therapy for cardiac disease

    Google Scholar 

  69. Code of federal regulations, title 21, in 21 part 210 current good manufacturing practice in manufacturing, processing, packing or holding of drugs: general

    Google Scholar 

  70. ICH (1996) Good clinical practice E6(R1), in efficacy guidelines

    Google Scholar 

  71. (1938) Federal food, drug and cosmetics act (21 USC 351)

    Google Scholar 

  72. (1997) Code of federal regulations, title 21, in 21 part 211 current good manufacturing practice for finished pharmaceuticals

    Google Scholar 

  73. Code of federal regulations, title 21, in 21 part 1271 human cells, tissues, and cellular and tissue-based products

    Google Scholar 

  74. FDA (2008) Guidance for industry: CGMP for phase 1 investigational drugs

    Google Scholar 

  75. FDA (2004) Guidance for industry: sterile drug products produced by aseptic processing: current good manufacturing practices

    Google Scholar 

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Correspondence to Sowmya Viswanathan Ph.D. .

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Viswanathan, S., Read, E.J. (2013). Bench-to-Bedside Development of MSC Therapies: A Multidisciplinary Approach. In: Hematti, P., Keating, A. (eds) Mesenchymal Stromal Cells. Stem Cell Biology and Regenerative Medicine. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4614-5711-4_15

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