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ALS Stem Cell Breakthrough
 Featured Article
Main Category: Stem Cell Research
Also Included In: Muscular Dystrophy / ALS
Article Date: 01 Aug 2008 - 10:00 PDT

Scientists in the US have converted skin cells from an 82-year-old woman 
with amyotrophic lateral sclerosis (ALS) into stem cells that formed motor 
neurons with the same genetic make up as the patient. The breakthrough opens 
the possibility of modelling a patient's specific disease outside of the 
patient, to improve investigation and drug screening, and perhaps even to 
develop new neurons to replace the damaged ones in the patient.

The breakthrough is written up as a study in the 31st July online issue of 
Science, and was the work of Dr Kevin Eggan, a biologist at the Harvard Stem 
Cell Institute, and other colleagues from Harvard University in Cambridge, 
Massachusetts, and Columbia University, New York.

ALS, also known as Lou Gehrig's disease, is a progressive degenerative 
disease that attacks the motor neurons in the spinal cord, leading to 
paralysis of limbs and respiration.

Eggan told a press conference that by generating a population of motor 
neurons from the skin cells of a patient, he and his colleagues effectively 
moved the study of ALS "out of the patient and into the petri dish", 
according to a report in ScienceNOW Daily News.

Eggan and colleagues generated induced pluripotent stem cells (iPS cells) 
from fibroblasts taken from the skin of an 82-year-old woman with a familial 
form of ALS. The patient-specific iPS cells behaved like embryonic stem 
cells and differentiated successfully into motor neurons, the type of cell 
that ALS destroys.

The patient had a familial form of ALS that occurs in 2 per cent of cases. 
It is caused by a mutation in a gene called superoxide dismutase 1, or SOD1. 
95 per cent of ALS cases however, are sporadic and there is no known 
inherited mutation, possibly because the genetic change occurs during the 
person's lifetime through interaction with the environment.

But Eggan was not despondent about this, "I think this approach has 
incredible promise for studying other forms of ALS," he said, explaining 
that the symptoms of familial and sporadic ALS are similar and probably 
share enough common mechanisms to make it worth trying this method with 
other forms of ALS.

Recent studies have shown it is possible to reprogram human fibroblasts (a 
type of skin cell that acts like scaffolding and holds other skin cells 
together) and return them to a "pluripotent state", where they become stem 
cells that can be coaxed into producing a range of other cells. But this is 
the first study to show it is possible to do this with the skin cells of an 
elderly patient with chronic disease.

There are many illnesses that scientists would like to study "outside of the 
patient", and they hope one day even to be able to grow healthy versions of 
diseased cells and put them back in the patient. Until recently, it was 
thought the only way to do this was using the controversial technique of 
therapeutic cloning, where the DNA of an egg would be replaced with the DNA 
of the patient, and then the early stage embryo would be harvested for 
embryonic stem cells that had the same DNA as the patient. The method is yet 
to be proved in humans though.

However, using induced pluripotent stem (iPS) cells overcomes the ethical 
problems of using embryos. They are adult cells that are reprogrammed to 
behave very much like embryonic stem cells. Two years ago, scientists 
inserted four genes into the skin cells of mice and rats to create iPS 
cells, and then last year, this was done with human skin cells. And now, 
with this latest study, it would seem that researchers have taken the method 
a step further, by showing you can make iPS cells from a chronically sick 
person's skin cells and turn them into healthy versions of the cells that 
are being killed by the disease.

For this study, Eggan and colleagues put the same four genes into about 
30,000 skin cells taken from the patient. Although hundreds of colonies were 
cultured, only a handful had the correct markers for pluripotency. These 
were then coaxed into nerve cells by using molecules that are known to guide 
mammalian stem cells into nerve cells. Tests showed that a significant 
proportion of them had markers characteristic of motor neurons, but the 
final confirmation awaits further tests where the cells are injected into 
mouse or chick embryos to see if they form the connections characteristic of 
neurons.

Jeffrey Rothstein of Johns Hopkins University in Baltimore, Maryland, a stem 
cell researcher who is also studying ALS, told ScienceNOW Daily News that: 
"It is exciting that they have generated human cells from the patient 
material."

But he suggested that there is still a long way to go, because the cells are 
only useful if they are exactly the same as the ones causing the disease in 
the patient, partial replicates would be of little use, and it is important 
to bear in mind that iPS generated cells are quite different to cells 
buffeted by a lifetime of drugs and other environmental and metabolic 
influences.

"Induced Pluripotent Stem Cells Generated from Patients with ALS Can Be 
Differentiated into Motor Neurons."
John T. Dimos, Kit T. Rodolfa, Kathy K. Niakan, Laurin M. Weisenthal, 
Hiroshi Mitsumoto, Wendy Chung, Gist F. Croft, Genevieve Saphier, Rudy 
Leibel, Robin Goland, Hynek Wichterle, Christopher E. Henderson, and Kevin 
Eggan.
Science, Published Online July 31, 2008
DOI: 10.1126/science.1158799

Sources: ScienceNOW Daily News, journal abstract.

Written by: Catharine Paddock, PhD
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Rayilyn Brown
Director AZNPF
Arizona Chapter National Parkinson Foundation
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