3 CIRM challenges: search for new prez, funding, & clinical POW!

The idea of CIRM as a dedicated state stem cell agency was one of the things that got me excited about starting my time as a professor doing research on stem cells in California way back in 2005-2006 on the job hunt. Fast forwarding to today now 11 years later, CIRM is still on the cutting edge, but some major things have changed for California’s stem cell agency and as it looks to its future, the questions and challenges are different too.CIRM 2.0

By analogy, the original CIRM was at first like a stem cell itself navigating its differentiation branches as it went. The new CIRM of 2017, what some call CIRM 2.0, is in contrast more like a developing tissue. It has matured and has a history to build upon as it continues. Today CIRM and its staff aren’t newbies. They were newbies by necessity when I came to California in 2006 because they were literally inventing themselves with no past example to use as a model. Now they are stem cell veterans and CIRM is trying to sort out its fresh path ahead relative to its current path rather than strike a path from scratch.

Three key areas need tackling to navigate the new path for maximum positive impact.

Funding. Does CIRM 2.0 and its backers go for a “Prop 71 2.0” to get another round of California state funding? If so, how much and how to approach the voters? If not (or if “yes”, but the effort isn’t successful), where does CIRM get its funding to continue? Of course, in theory a third option is that CIRM simply ends when its current funding runs out, but to me that’s not a real option. CIRM cannot end because it has so much more to do and it is in some ways just getting to the most exciting part: the bedside part of the bench-to-bedside path. Update: over at California Stem Cell Report, David Jensen has the scoop on an industry-centric stem cell bond proposal idea.

New Prez. CIRM 2.0 President and CEO Randy Mills announced the surprising news recently that he’s moving on from CIRM after a relatively short, but impactful tenure. Who will be the new CIRM President? It’s anybody’s guess at this point, but I’d say that CIRM needs to achieve two things at once here: move very quickly to get a new leader and make that leader be a fantastic choice for CIRM. What exactly do I mean by the latter? The new CIRM President ideally should have impeccable stem cell credentials and also big picture clinical vision as well as strong leadership skills. I asked CIRM where things stand on the President search today and CIRM Sr. Director Public Communications & Patient Advocate Outreach, Kevin McCormack, provided this quote:

“the Presidential Search subcommittee is going to be meeting on July 17th to evaluate the options regarding appointing a permanent President and CEO to replace Randy. They’ll then make their recommendations to the full Board.”

I’m planning a future post to throw some names out on the table for discussion of people who might be considered for the position by CIRM.

Clinical POW! CIRM’s mission is focused on having transformative clinical impact so the agency needs some snap, crackle, and POW! on that front moving forward. It already has provided key support for a number of ongoing clinical trials and the goal moving forward is final approved products that are proven safe and effective. I would call that some stem cell POW! Not everything is going to be a success, but I predict that some will.

I believe that CIRM has the potential to achieve all this. That doesn’t mean it’ll be easy, but what great things have ever been easy?

Top 10 stem cell websites

top ten listIf you are a true stem cell aficionado, what are the top 10 websites for you to bookmark and follow on a daily or weekly basis? I wanted to generate a list.

So what are my criteria for top 10 stem cell/regenerative medicine websites?

It’s got to be regularly updated. It has to be influential. It has to have broad impact including ideally both science and policy. It has to go beyond facts to include opinions and ideas.

As important as they may be, relatively static websites like the stem cells pages on Mayo Clinic and the NIH don’t have the timeliness and dynamic nature that I want.

So here are the websites in my top 10 in alphabetical order.

*I included this blog in there so hopefully that wasn’t an over the top thing to do.

Other recommended stem cell sites (also check out blog roll in the right tool bar of this website)

  • The Node is great even if it is not entirely stem cell specific.
  • The NYSCF website is very useful and cool.
  • Although it didn’t make my Top 10 since its content is only changed relatively infrequently (which may change), I recommend checking out the new version of ISSCR’s A Closer Look at Stem Cells.
  • A newer site is the blog by msemporda.
  • The Cell Culture Dish is not stem cell specific, but has a lot of good content.

What are your favorite stem cell websites? What would be your top 10? Did I miss any deserving ones?

Super Science Weekend Reading

Here’s some thought-provoking weekend reading.

ALEXEY. CLINICAL CELL PROCESSING NEWS – PART 1, 2015

BIOPOLITICAL TIMES. MITOCHONDRIAL MISSION CREEP AND THE CLONING CONNECTION

CALIFORNIA STEM CELL REPORT. CALIFORNIA’S BOB KLEIN PROPOSES $100 BILLION, INTERNATIONAL STEM CELL/GENOMICS VENTURE

CARL ZIMMER. A NEW THEORY ON HOW NEANDERTHAL DNA SPREAD IN ASIA

DN LEE. YOU SHOULD KNOW: MICHELLE HUNTER AND EXPLORING NEUROSCIENCE THROUGH ART

DRUGMONKEY BLOG. NIH CLUMSILY TRIES TO .. [SOMETHING] … FOR GRANT REVIEWERS

ED YONG. FAST-EVOLVING HUMAN DNA LEADS TO BIGGER-BRAINED MICE

GORSKI. BLOWING THE ANTIVACCINE DOG WHISTLE AGAIN

KELLY HILLS. PRIMUM NON NOCERE AND THE HIPPOCRATIC OATH

MARYN MCKENNA. A FACTORY FARMER STRIKES BACK AT THE COMPANY HE FARMS FOR

MICHELLE GOLDBERG. FEMINIST WRITERS ARE SO BESIEGED BY ONLINE ABUSE THAT SOME HAVE BEGUN TO RETIRE

VIRGINIA HUGHES. VITAMIX BLENDERS SPIN OFF SHARDS OF TEFLON — BUT IT’S PROBABLY OK

Recommended reading for innovative, evidence-based medicine

evidence-based medicineOne of my goals is promoting evidence-based medicine and science-based medicine that is in the best interest of the community including patients.

Below is a list of recommended reading for you including mostly blogs, but also other resources that should be on your regular must-read list.

Some are stem cell-focused, while most are broader.

Caplan Article on Bogus Stem Cell Research: Some Different Views

When bioethicist Arthur Caplan talks about stem cells, people pay close attention and for good reason.

Art Caplan

Caplan has provided important perspectives on the stem cell field over the years. For example, you can see a guest post on this blog here about human cloning.

However, in my post today I respectfully discuss how I disagree with several parts of this week’s piece by Caplan on why there are allegedly so many ethical problems in the stem cell research field.

Caplan’s article (see screenshot from video at right) is focused on a question articulated by the title:

Why so much Fake, Unduplicable Stem Cell Research?

One might start off the bat by challenging the article’s title and intrinsic question above, since in reality that the vast majority of stem cell research is quite real and replicable.

David Jensen over at California Stem Cell Report, writing about Caplan’s article, pointed out that serious research issues are not unique to the stem cell field as, for example, there have been disastrous issues in the cancer field too:

There is no doubt some spectacular fraud has surfaced in stem cell research. But the problem of replication within stem cell research may not be entirely out of line with problems elsewhere in science. Los Angeles Times columnist Michael Hiltzik wrote last fall about a study by Amgen that examined 53 “landmark papers” in cancer research and blood biology. Only five could be proved valid, a shocking result, according to Amgen. Similar results were turned up byBayer in Germany, Hiltzik said.

On the other hand, there have been some truly terrible stem cell research fiascos of late so let’s focus on Caplan’s reasoning for why the stem cell field has had these problematic events.

Caplan begins by talking about the STAP cell fiasco in Japan involving allegedly faked research reported in Nature that powerful stem cells could be made by simple stressors such as low pH.

Caplan writes that the researcher in question, Haruko Obokata, “confessed that she had made it up.” In fact, quite the opposite is true. Dr. Obokata says that her study is correct overall and that she did not make it up. To my knowledge, she only admitted to careless errors arising innocently from lack of experience that she says do not affect the conclusions of her papers.

Getting back to the central question of why stem cell research sometimes runs into ethical problems Caplan argues that lack of funding is one reason for the problems. I wish there was indeed more stem cell research funding, but I do not believe this is a clear reason for ethical problems in the field. I don’t see this playing a significant role and funding woes certainly aren’t specific to the stem cell field.

A second reason given for trouble is what one might call the “stem cell hero temptation” effect. In other words, breakthroughs in stem cells might gain a researcher the world’s attention  (“being a hero to the world” is how Caplan describes the attraction ) so there may be perceived incentive to fudge or outright fake stuff. From some of the cases we’ve seen in recent years, this reason seems accurate.

An additional Caplan assertion for explaining the ethical issues facing the stem cell field can be boiled down to a lack of people to provide oversight. Caplan writes:

Another major problem in the stem cell field is that the number of people doing research in this area has shrunk…That may mean that there are fewer people to watch one another.

I’d be interested to see if he has any data to back up this claim. In fact, my sense is the opposite about the size of the stem cell field. If anything the number of people working on stem cells seems to continue to grow overall. I do not believe that the stem cell field lacks sufficient people power to adequately review itself.

So if I disagree with two out of three of Caplan’s reasons, why then do I think that there are sometimes ethical challenges in the stem cell field such as the STAP cell problem?

First, let me say again that he’s right about a few unwise research folks chasing international fame at any cost.

However, another issue here is that a heck of a lot more people around the globe are paying attention to the stem cell field. As a result, ethical problems that are also present in other fields of science (e.g. image manipulation, non-reproducible papers, etc) get noticed far more if they are in stem cell papers. To sum it up, there are more eyes on stem cell papers looking for troubles after publication.

As I blogged before, I also believe that in the specific STAP case, the reviewers and probably editors too were unduly positively biased by the addition of some stem cell big wigs to the authors list on the STAP Nature papers. This points to another contributing problem to broader problems in the field: a small number of stem cell bigwigs have way too much power as reviewers. In other words, journal editors rely on too few eyes to review the highest profile manuscripts. Big journals and their editors need to diversify their stem cell reviewer lists and the review process needs to be more about data and less about names.

In the end the stem cell field is likely to continue to run into a few bumps and even land mines as it proceeds. Addressing recurring problems in an open, expeditious manner would be wise. Training in ethics for researchers seems to be in need of a boost. The journal review process also is a logical place to focus. Is it naive to hope that Nature might take the lead on reform of the review process?