2014 MFDS Global Biopharmaceutical Forum: "Clinical and Preclinical Researches in Human Pluripotent Stem Cells"
Human ES Cell Product – RPE Program for Blindness
(CHA & ACT-Ocata)
2014 MFDS Meeting - 2014. 7. 9~10.
Hyung Min Chung
Konkuk University, College of Medicine, Seoul, Korea
2014 MFDS Global Biopharmaceutical Forum: "Clinical and Preclinical Researches in Human Pluripotent Stem Cells"
Human ES Cell Product – RPE Program for Blindness
(CHA & ACT-Ocata)
2014 MFDS Meeting - 2014. 7. 9~10.
Hyung Min Chung
Konkuk University, College of Medicine, Seoul, Korea
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
2. This presentation is intended to present a summary of ACT’s (“ACT”, or “Advanced Cell
Technology Inc”, or “the Company”) salient business characteristics.
The information herein contains “forward-looking statements” as defined under the federal
securities laws. Actual results could vary materially. Factors that could cause actual results
to vary materially are described in our filings with the Securities and Exchange Commission.
You should pay particular attention to the “risk factors” contained in documents we file from
time to time with the Securities and Exchange Commission. The risks identified therein, as
well as others not identified by the Company, could cause the Company’s actual results to
differ materially from those expressed in any forward-looking statements. Ropes Gray
Cautionary Statement Concerning Forward-Looking Statements
2
3. ACT is a publicly-traded biotechnology company
• Develop cellular therapies for the treatment of diseases and conditions
that impact hundreds of millions of people worldwide
• Premier scientific and research development team
• Cell therapies are traditionally derided for being high cost, high touch
and having lack of scalability. Not our approach at all
>> Centralized, Scalable, Cost Effective Cell Therapy Products <<
About ACT:
– Ticker – ACTC
– Market Capitalization: $190 million
– Principal lab and GMP facility: Marlborough, MA
– Corporate HQ: Santa Monica, CA
– Only hESC-derived tissue trials ongoing worldwide
3
Company Overview
4. Multiple Pluripotent Cell Platforms
Single Blastomere-derived
Embryonic Stem Cell Lines
Generating hESC lines
WITHOUT DESTRUCTION OF EMBRYO
Utilizes a
SINGLE CELL BIOPSY
ACT never needs to make another hESC line again
4
Final Product Definition: hESC-derived
products will be manufactured using
a cell line made in 2005 from single
cell isolated without the destruction
of any embryos
5. Multiple Pluripotent Cell Platforms
Induced Pluripotency
Stem Cells (iPS cells)
Generating pluripotent cell lines
FROM ADULT TISSUE
….potential for patient specific stem cell lines
• Early Innovator in Pluripotency (before iPS was even a term!)
• Controlling Patent Filings (earliest priority date) to use of OCT4 for
inducing pluripotency
5
7. 7
Life Support to Photoreceptors
Provides nutrients and growth factors
• photoreceptors see no blood
Recycles Vitamin A
• maintains photoreceptor excitability
Detoxifies photoreceptor layer
Maintains Bruch’s Membrane
• natural antiangiogenic barrier
• immune privilege of retina
Absorbs stray light / protects from UV
RPE Layer has
multiple
critical roles
in the
health and
function
of photoreceptors and
the retina as a whole.
8. 8
Life Support to Photoreceptors
Loss of RPE cells
Build up of toxic waste
Loss of photoreceptors
Dry AMD
Bruch’s Mem. dehiscence
Choroidal neovascularization
Wet AMD
9. 9
RPE Therapy- Rationale
Dry AMD
represents more than
90%
of all cases of AMD
North America & Europe
alone have more than 30 million dry AMD patients
who should be eligible for our RPE cell therapy
What if we could
replace
missing RPE cells?
10. RPE cell therapy may impact
over 200 retinal diseases
10
RPE Therapy- Rationale
• Massive unmet medical need
• Unique measuring and observation environment
• Easy to identify – aids manufacturing
• Small dosage size – less than 200K cells
• Immune-privileged site - minimal/no immunosuppression
• Ease of administration - no separate device approval
11. GMP process for differentiation and purification of RPE
– Virtually unlimited supply from stem cell source
– Optimized for manufacturing
Ideal Cell Therapy Product
– Centralized Manufacturing
– Small Doses
– Easily Frozen and Shipped
– Simple Handling by Doctor
GMP Manufacturing
11
Product Cold Chain is Easily Scaled for Global Sales
ACT Cleanroom Suite
12. Preclinical Models
12
Injected human RPE cells
repair monolayer
structure in eye
Transplanted cells
engraft and form
correct anatomical
structure
Mouse model for macular degeneration
14. Phase I - Clinical Trial Design
14
SMD and dry AMD Trials approved in U.S., SMD Trial approved in U.K.
12 Patients / trial plus 4 in new cohort 2a – better vision
ascending dosages of 50K, 100K, 150K and 200K cells.
Regular Monitoring - including high definition imaging of retina
50K Cells 100K Cells 150K Cells 200K Cells
Patient 1 Patients 2/3
DSMB Review DSMB Review
15. Participating Retinal Surgeons
15
Steven D. Schwartz, MD
Chief, Retina Division
Ahmanson Professor of Ophthalmology
Director, Diabetic Eye Disease and Retinal Vascular Center
Director, Ophthalmic Photography Clinical Laboratory
Jules Stein Eye Institute
Wills Eye Institute
Carl D. Regillo, MD
Director, Retina Service
Professor of Ophthalmology, Jefferson Medical College
Byron L. Lam, MD
Director, Clinical Visual Physiology
Professor of Ophthalmology
Bascom Palmer Eye Institute
16. Participating Retinal Surgeons
16
Dean Eliott, MD
Associate Director, Retina Service
Professor, Harvard Medical School
Massachusetts Eye and Ear Infirmary
Moorfields Eye Hospital
James Bainbridge, MA MB BChir PhD FRCOphth
Professor of Retinal Studies, UCL Institute of Ophthalmology
Philip J. Rosenfeld, MD PhD
Professor of Ophthalmology
Bascom Palmer Eye Institute
Edinburgh Royal Infirmary
Baljean Dhillon BMed Sci, BM BS, FRCS
Surgeon, Edinburgh Royal Infirmary
Surgeon, Lothian University Hospitals NHS Trust
Professor of Ophthalmology, University of Edinburgh
Professor of Visual Impairment Studies, Heriot Watt University
17. Surgical Overview
17
Procedure:
• 25 Gauge Pars Plana
Vitrectomy
• Posterior Vitreous Separation
(PVD Induction)
• Subretinal hESC-derived RPE
cells injection
• Bleb Confirmation
• Air Fluid Exchange
18. Preliminary Results
18
No Adverse Events
No signs of hyperproliferation,
abnormal growth, rejection or retinal
detachment.
Persistence of cells
Anatomical evidence of hESC-RPE
survival and engraftment.
Increased pigmentation within the bed
of the transplant.
Impact on Acuity
Recorded functional visual
improvements in both patients.
19. 19
Engraftment and Survival: SD-OCT image collected at month 3
show survival and engraftment of RPE
SMD US01
3mo post-op
Preliminary Results – Structural
22. Current Safety Profile
22
12 SMD Patients Treated
6 patients (50K cells cohort) treated – US&UK Trials > Cohort Complete
6 patient (100K cells cohort) treated – US&UK Trials > Cohort Complete
6 dry AMD Patients Treated
3 patients (50K cells cohort) treated > Cohort Complete
3 patient (100K cells cohort) treated > Cohort Complete
No reports of any adverse events or complications due to cells
• No evidence of inflammation or infiltration
• No evidence of ectopic tissue formation
• No evidence of retinal detachment
23. Expanding Clinical Programs
23
Myopia creates a higher risk of permanent vision loss due
to Myopic Macular Degeneration (MMD)
• Severe near-sightedness causes elongation of the eyeball --
which can causes fissures in RPE layer.
• MMD can occur at ages as young as 30 years old.
FDA Approved IND – MMD Phase I/II study
Jules Stein Eye Institute (UCLA) and ACT
• Will use ACT’s RPE cells to treat MMD
• Primary focus will be to evaluate the safety
• Dr. Stephen Schwartz is the investigator
24. RPE Program Milestone Objectives
24
Key upcoming milestones
• Continue to treat and review patient data
FDA has recently approved vision as good as
20/100 in treated eye for patient inclusion criteria
• Define efficacy endpoints and targeted patient visual
criteria
• Treat earlier stage disease to determine curative
power of dissociated cell injections
• Simplify shipping and cell-prep to enhance scaled
distribution platform
25. Intellectual Property – RPE Program
Treatment Dominant Patent Position for Treating Retinal
Degeneration
Manufacturing Broad Coverage for Manufacturing RPE Cells from hESC
Preparations Claims directed to pharmaceutical preparations of RPE
Cells from hESC, including both cell suspensions and
scaffolded RPE layers.
Sources Issued patents cover RPE Cells derived from other
pluripotent stem cells (including iPS cells)
Vigilance Regularly Filing on Improvements
• Extend patent life cycle, with significance to commercialization
• Include composition-of-matter claims (cell preparations,
pharmaceutical preparations, etc.)
25
26. RPE Program - Investment Thesis
26
• Immense unmet medical need
• Small Doses
• Immunoprivileged – permits central (allogeneic) source of cells
• Noninvasive monitoring of retina
Market potential: More than 50 million patients in major markets.
1% market penetration
may represent $5-10B market opportunity.
Orphan indications are meaningful: Estimating a 10% market penetration with
reoccurring treatments every 3-5 years, Stargardt’s disease can be a $100+
million/year product.
30. Mesenchymal Stem Cells in Therapy
30
Mesenchymal stem cells (MSCs) regulate immune responses
promising therapeutic potential for treating autoimmune
and inflammatory diseases.
• Allogeneic - without HLA matching.
• Track Record - Adult-derived MSCs already in 200+ clinical trials.
Derived from Bone Marrow and Adipose Tissue
However, allogeneic adult-derived MSC’s are limited
by replicative capacity
and as it turns out, a
relative lack of potency
31. A differentiated MSC
31
Unlimited Supply of Donor-less MSCs
• Immense replicative capacity
• hESC & iPS - inexhaustible sources of starting material
Advantages for Manufacturing
• Use Single Master Cell Bank
• Simplifies FDA/regulatory process
• No need for continually finding and qualifying donors
• Less labor-intensive
32. A differentiated MSC
32
Our mesenchymal stem cells are
substantially more potent
than both bone marrow and
adipose derived MSC
36. Generation of Blood Products
36
Hemangioblasts RBCsHemangioblasts Enucleated
RBC’s
Process generates large
quantities of functional
red blood cells
and
megakaryocytes &
platelets
37. The Case for Platelets
37
Platelets are key elements of
hemostasis and thrombosis as well as
tissue regeneration after injury or surgery.
• Maintain vascular integrity and play vital roles in wound repair
• Thrombocytopenia is a major cause of morbidity in sepsis,
cancer and preeclampsia
• Used regularly in soft- and hard-tissue applications in most fields
of surgery.
.
Beyond Donor Supply: Estimate
demand for additional 1-2M units/year
38. The Case for Platelets
38
Platelets are the blood product most difficult to
maintain without unnecessary wastage.
Platelets do not tolerate refrigeration.
Storage at room temperature is limited to 5–7 days
Need for new strategies
to generate platelets
for infusion therapy.
39. Platelets 2.0
39
Ability to control platelet manufacturing provides
opportunities to improve storage, fine tune
platelets for use in wound healing applications, as well
as to engineer new roles for platelets beyond
traditional involvement in wound healing.
• Improve cryopreservation of platelets
• Make lyophilization of platelets tractable solution
• Utilize platelets for drug delivery
• Utilize platelets in imaging (load with contrast agents)
CONFIDENTIAL - BUSINESS PROPRIETARY
40. Achieving Function and Scale
40
• Ultrastructural and morphological features of SC-derived
platelets are indistinguishable from normal blood
platelets.
• SC-derived platelets respond to thrombin stimulation, form
microaggregates, and facilitate clot formation and
retraction.
• SC-derived platelets contribute to developing thrombi at sites of
laser-induced vascular injury in mice - first evidence for in vivo
functionality of SC-derived platelets.
41. Clinical Program Status
41
• Animal model studies show
proper in vivo function
• Achieved clinical dose
scale manufacturing
• Completely feeder-free process
(bioreactor capable!)
• Pre-IND meeting requested
with FDA
42. Sample 10 year plan
42
Achieve 100 plt/mk Achieve 500 plt/mk
Achieve
1011 scale
Achieve
1012 scale
Achieve
1014 scale
Phase 0 Study
Prepare and
File IND Phase I/II Study Phase II
File
Exploratory
IND
EOP I
meeting
Achieve
1 Million Dose Scale
1yr 2yr 3yr 4yr 5yr 10yr
Achieve
2000-5000 plt/mk
44. Financial Update – Strong Balance Sheet
44
• Company ended 2012 Q3 with $42 million in
cash or availability of cash through financing
commitments
• $16 million annual cash-burn rate
(funded through early 2015)
• Settled nearly all litigation hangover from
previous management
45. ACT Management Team
Highly Experienced and Tightly Integrated Management Team
Gary Rabin – Chairman & CEO
Dr. Robert Lanza, M.D. – Chief Scientific Officer
Edmund Mickunas – Vice President of Regulatory Affairs
Dr. Irina Klimanskaya, Ph.D. – Director of Stem Cell Biology
Dr. Shi-Jiang (John) Lu, Ph.D. – Senior Director of Research
Dr. Roger Gay, Ph.D. - Senior Director of Manufacturing
Kathy Singh - Controller
Rita Parker – Director of Operations
Dr. Matthew Vincent, Ph.D. – Director of Business Development
Bill Douglass – Dir. of Corporate Communications & Social Media
45
46. Dr. Ronald M. Green: Chairman
Dr. Judith Bernstein
Dr. Jeremy B.A. Green
Dr. Robert Kauffman
Dr. Carol A. Tauer
ACT Leadership
Gary Rabin: Chairman & CEO
Dr. Robert S. Langer, ScD: Prolific medical inventor; Chair – ACT SAB
Gregory S. Perry: EVP – Immunogen
Michael Heffernan: CEO – Collegium Pharma
Zohar Loshitzer: CEO Presbia; Founder LifeAlert Medical
Dr. Alan C. Shapiro: Renowned business school professor
46
World Class Board of Directors
Highly-regarded Ethics Advisory Board