‘It’s really getting real’: payoffs in the effort to treat Huntington’s disease

The path to treating Huntington’s disease – a potential major breakthrough in the history of science and medicine – is becoming clearer.

That was the takeaway message from the Ninth Annual HD Therapeutics Conference, organized by the CHDI Foundation, Inc. and held February 24-27 at the Parker hotel in Palm Springs, CA. Spending tens of millions of dollars annually, CHDI is a non-profit, virtual biotech founded solely to discover HD treatments. Some 300 participants from academia, the pharmaceutical industry, and biotech firms took part, as well as a number of patient advocates, including Olympic rowing medalist Sarah Winckless, who delivered the keynote address.

“The tagline would have to be ‘it’s really getting real,’” said Robert Pacifici, Ph.D., the chief scientific officer for CHDI Management, Inc., in an interview with me at the conference. “What I’m seeing at this conference already is the culmination of very large, very long-term efforts – things that have taken years and thousands of person hours, patients’, caregivers’, researchers’, and physicians’ – finally coming together in ways that are really conclusive and really helpful.”

All that work has involved numerous questions about the disease and potential ways to treat it, Dr. Pacifici explained.

“All of those things sadly have an incredibly high attrition rate,” he observed. “The fact that we’re getting answers is the thing that makes me the most excited. Sadly, sometimes we don’t like the answer. Sometimes the answer is: ‘That doesn’t work.’ But that’s still very useful for researchers.”

Winnowing out the useless approaches allows researchers to “refocus our resources on something that we feel has a better chance of bearing fruit,” Dr. Pacifici said.

Sitting one evening with a group of CHDI researchers, I expressed the natural concern of the HD community – a concern sometimes tinged with impatience and frustration: could the rapidly expanding knowledge about HD result in an endless search for treatments fueled by questions that simply produce new questions rather than treatments?

They answered with an emphatic no. Echoing Dr. Pacifici, they said that real solutions were in the works.

The conference did seem more coherent in comparison with the previous three I had attended. Indeed, as one senior CHDI advisor observed in response to my observation, Huntington’s researchers now have an understandable “story to tell” about the disease and the research.

You can watch my interview with Dr. Pacifici in the video below. Just below the Pacifici interview, Portuguese speakers can watch my interview about the conference with Dr. Mônica Haddad of Brazil.

'It's Really Getting Real': Payoffs in the Effort to Treat Huntington's Disease from Gene Veritas on Vimeo.

A esperança de tratar a doença de Huntington: Dra. Mônica Haddad fala sobre a conferência da CHDI from Gene Veritas on Vimeo.

Confirming the shots on goal

Just three days before the conference, CHDI and Genzyme Corporation announced an agreement to jointly develop a “novel gene-silencing therapeutic for Huntington’s disease” using an adeno-associated virus, which does not cause disease, as a delivery system.

The venture expands CHDI and other research projects’ portfolio of potential treatments for HD, several of which are in the early stages of clinical trials or aim to begin trials soon.

In Dr. Pacifici’s words, the growing number of drug targets means there are more “shots on goal” in the quest for treatments.

CHDI is concentrating on “validating” (confirming) the targets to assure that as many potential remedies as possible have a chance of becoming effective, safe treatments, Dr. Pacifici explained.

“It’s important for any drug discovery organization, because when you select a target, that’s what underpins the rest of the (drug discovery) activity,” he said.

No organization has yet discovered how to validate targets “exactly,” he said. However, CHDI is especially working hard to insure that a “particular target is really tethered” to the HD disease process and not some other disease or process, he added.

“While nobody has the magic bullet there, it was really impressive to see the variety of approaches that were taken,” Dr. Pacifici said of the talks on target validation.

These included X. William Yang’s report on his latest research with transgenic HD mice, Ernest Fraenkel’s study of the impact of the mutant huntingtin gene at the molecular level, and CHDI scientist Jim Rosinski’s efforts to unify and interpret the totality of biological data on HD by employing a systems biology approach.

You can watch an excerpt from Dr. Fraenkel’s presentation, Dr. Rosinski’s full presentation, and most of the other talks by viewing my 2014 CHDI video album.

Finding a modifier gene, delaying onset

Jim Gusella, Ph.D., one of the lead discoverers of the HD gene in 1993, described the work of a large international team to find a so-called modifier gene, which might act as a trigger for the disease and affect the rate of progression.

Such a gene could also become the target of a treatment, Dr. Pacifici explained.

“Imagine coming up with a drug that can delay your age of onset by 30 years,” he said, referring to the wide variability in age of onset for people with the same degree of mutation. “That would be fabulous.”

The Gusella team’s search for the modifier gene points to “a couple of specific sites on human chromosomes,” Dr. Pacifici said. In contrast with the numerous studies done in mice and other organisms, this project “was generated with human data. So we don’t have to worry about the predictive value of those studies.”

Dr. Pacifici described the 20-year quest for the modifier gene as “a great example of how the community pulls together and the generosity of the families affects the progress of research. Without your blood, without your DNA sequences, without your permission, there’s no way these types of studies could be done.”

The team analyzed DNA from more than 4,000 HD gene carriers and affected individuals. The study also required the ongoing commitment of participants to allow researchers to track their symptoms.

“We need to make the correlation as to when the motoric age of onset (the start of involuntary movements) occurred,” Dr. Pacifici explained. “That’s invaluable and incredibly appreciated. Hopefully now people can understand why participation in trials like this leads to such exciting discoveries.”

New potential therapies

A session on “novel therapeutic approaches” focused on potential remedies different from the traditional concept of oral medication.

Jan Vesper, M.D., presented the promising results of his pilot trial using deep brain stimulation, which involves the placement in the brain of metal capsules covered with electrodes. Long-time HD specialist Gill Bates, Ph.D., discussed her new research on the muscle deterioration involved in HD mice and the potential use of a myostatin inhibitor to remedy the problem as well as perhaps ameliorate the involuntary movements typically suffered by patients.  Beth Stevens, Ph.D., explained the importance of restoring proper function of microglia (cells performing as the immune system of the nervous system) in pruning synapses, the connections between brain cells.

‘A horrible, lifelong case of jet lag’

Changes in people’s behavior could provide another way to ameliorate HD, Dr. Pacifici noted.

Along those lines, Christopher Colwell, Ph.D., presented critical new research on the circadian rhythm – our sleep clocks – and how its disrupted function in HD might worsen symptoms.

“Think of Huntington’s almost as a horrible, lifelong case of jet lag,” Dr. Pacifici said in describing the implications of Colwell’s and others’ work in this area. “By entraining (synchronizing) the clocks in your mind and the clocks in your various organs to stay in sync with each other – by using things like when you eat, when you go to sleep, when you exercise, what kind of light you’re exposed to – you could compensate for some of the mechanisms that go awry in Huntington’s disease. That type of regimen could be a therapy, or an add-on to a therapy, rather than something as traditional as a pill.”

Dr. Colwell’s engaging talk provided a wealth of ideas about the circadian rhythm and keeping it healthy. You can watch his presentation in the video below.

Circadian disruptions in Huntington's disease: mechanisms and possible treatment options from Gene Veritas on Vimeo.

Alpar Lazar, Ph.D., Stephen Morairty, Ph.D., and Tom Warner, Ph.D., provided additional evidence about the importance of the sleep cycle.

Assuring the drug does its job

In the session on “huntingtin lowering biomarkers,” several presenters described cutting-edge techniques for measuring the efficacy of potential therapies designed to attack HD at its genetic roots and reduce the effects of the mutant huntingtin protein. Those projects include the above-mentioned CHDI-Genzyme venture and the Isis-Roche-CHDI partnership.

“What you’d like to do is make sure that after you administer one of those drugs, that the drug has done its job,” Dr. Pacifici explained. “We don’t want to wait for five years to measure hundreds of people only to find out that the drug never did its primary job, which was to lower huntingtin levels.”

Along with an expert task force, CHDI has developed a series of ways to determine huntingtin-lowering efficacy in humans within a period of weeks, he said.

“Because we want to know what’s going on in the human brain, and we can’t go in there and take a little chunk of brain out every couple of weeks, we have to figure out a way of non-invasively making those measurements,” Dr. Pacifici continued.

The techniques include quantitative EEG (a kind of brain mapping), magnetic resonances pectroscopy, assessment of dysfunction in the mitochondria (the powerhouses of the cell), and measurement of huntingtin in bodily fluids such as cerebral spinal fluid.

Scientists are developing ways to measure other types of potential HD remedies such as phosphodiesterase inhibitors (aka “Viagra for the brain”).

As the HD field moves towards clinical trials, CHDI has increasingly emphasized the need for the exchange of information between scientists in the lab and physicians and others focused on patients and clinical trials, Dr. Pacifici commented. Such teamwork will enhance the possibility of finding treatments, he said.

Supporting Enroll-HD

The conference also featured several activities promoting Enroll-HD.

First announced in 2010 and officially launched in 2012, the CHDI-sponsored Enroll-HD is building a worldwide registry of HD patients, HD gene carriers, untested at-risk individuals, family members, and volunteers. It aims to facilitate scientific understanding of HD, identify potential participants in clinical trials, and therefore speed the process of finding therapies.

In a pre-conference meeting of Enroll-HD physicians and administrators on February 23, participants focused on ways to use the project to improve patient care. On February 24, Enroll-HD’s international steering committee met to discuss administrative matters.

On February 25, the CHDI conference featured a practical lunchtime session that provided an update on program details like the number of participants.

A ‘matchmaker’ facilitating clinical trials

In order to deepen understanding of Huntington’s, Enroll-HD looks at individual and family histories of HD “over a long period of time,” Joe Giuliano, CHDI’s director of clinical operations and the chief Enroll-HD administrator, said in an interview on February 24.

“The vision for Enroll-HD is to provide a clinical research platform that can be used by the community of HD researchers around the world to do clinical studies, and it can be used by pharmaceutical sponsors to do clinical trials,” Giuliano explained. “It’s an enabling tool to help answer important questions about Huntington’s disease using clinical research.”

Giuliano described the program’s three levels: the international administration, the wide range of sites based in local communities (run by physicians and other health workers), and the HD families.

“It starts with families,” Giuliano said. “Enroll-HD is really a study for all the family to participate in.

“Enroll-HD is a great opportunity for us to come together as a global research community. The clinical trials that are going to lead ultimately to new therapies for Huntington’s disease are going to be conducted in global clinical trials…. The more people we can get in Enroll-HD, the more powerful the study can become, for example, for recruiting for clinical trials. Enroll-HD can help identify participants … who are eligible for clinical trials.”

This potential makes Enroll-HD “very attractive” for pharmaceutical companies to collaborate with the program, Giuliano said.

Enroll-HD is a “matchmaker” putting together researchers, patients, drug companies, and others, he continued.

Anybody in the HD community can participate, including unaffected relatives of HD people. “By joining Enroll-HD, you’re being very proactive in a lot of different ways,” he said. “You’re providing the possibility that you may be eligible for a future clinical trial.”

The larger the pool of potential participants, the faster trials can take place, he concluded.

You can watch my interview with Giuliano in the video below.

For other coverage of the conference, visit www.HDBuzz.net.

Coming soon: a detailed report and more videos on Enroll-HD.

What is Enroll-HD? An interview with Joe Giuliano from Gene Veritas on Vimeo.

Accentuating the positive: Olympic medalist Sarah Winckless’s strategy against Huntington’s disease

As a bronze medalist in rowing in the 2004 Summer Olympics in Athens and chair of the highly successful British athletes’ commission in the 2012 London games, Sarah Winckless pursued her goals based on strenuous training, teamwork, and effective thinking.

However, Sarah faces a challenge far more daunting than most Olympians could imagine.

Since 1997, when she learned at just 22 that she carries the gene for Huntington’s disease, Sarah has faced the difficult reality of knowing that she will likely follow in the footsteps of her HD-afflicted mother Val, who requires full-time care.

Sarah has kept upbeat by focusing on athletics and her major leadership roles in the British sports and HD communities.

Huntington’s is always a family story. Sarah was the first of four siblings to undergo genetic testing. When Sarah began to feel isolated from her two brothers and sister after all three tested negative for HD, she turned once again to the “thinking challenge” she had learned in sports.

“Suddenly my siblings didn’t know what is was like to open the door of your genetic counselor and know that you’ve got a bad result,” Sarah told an audience of several hundred scientists, drug company representatives, and Huntington’s disease advocates the evening of February 24 in her keynote address at the Ninth Annual HD Therapeutics Conference, sponsored by the CHDI Foundation, Inc., in Palm Springs, CA. “And I didn’t want them to know that. But it made me different. It separated me.”

Sarah said that she “hated” herself for “thinking and feeling that way.”

“I had to choose a thought that brought me back in, that made me part of my family – they’re so important to me,” she continued. “And I did what I always do when I need to think.”

Sarah went out for a long session of rowing, which helped bring clarity to the issue at hand. She had in mind the fact that every child of a parent with HD has a 50-50 chance of inheriting the genetic mutation.

“I came up with a thought: three out of four, we’ve beaten the odds,” she said. “And for the next two weeks, every time I caught myself thinking in a negative way, I ran that thought into my brain. And people would come and go, ‘We’ve heard the news about John (the last to be tested). How do you feel?’ And I’d go: ‘three out of four, we’ve beaten the odds!’

“And it helped, because suddenly I was part of it, and I was with them.”

Sarah struck a similarly optimistic, sometimes even jovial chord throughout her speech. (You can watch an excerpt in the video below.)

 

At dinner, Sarah regaled a group of conference attendees with other stories from her athletic career as well as her mother’s spirited fight against HD. Though HD patients rarely live two decades beyond onset, Val has now lived with the disease for about 25 years.

I felt infected by Sarah’s optimism.

“In all of my years of dealing with HD, you are the most positive individual I have ever met,” I told Sarah as I prepared to retire for the evening.

I hugged her and gave her a brotherly kiss on the forehead. “You are not going to get HD,” I declared. She smiled broadly as she thanked me.

As an HD gene carrier, I live with the stark knowledge of the disease’s inevitability. However, scientists believe that personal enrichment and staying active and positive might very well help delay onset. And there is the very real hope of an effective treatment for Sarah, me, and the entire HD community.

Sarah Winckless and Gene Veritas (photo by Simon Noble, CHDI)

That night and into the next day, I thought of how I need to maintain my own positive attitude – not just to bolster myself in the fight against HD, but to become a better husband, father, coworker, and citizen.

As the HD therapeutics conference proceeded, Sarah’s spirit lived on as the participants presented new research demonstrating a deeper understanding of HD and continued progress in the quest for treatments.

We all need to become infected with Sarah’s optimism.

Like the Winckless family, we must all bond together in this fight.

As difficult and terrible as it may feel, we are never alone.

“Three out of four, we’ve beaten the odds” – despite her own adversity, Sarah found joy in her siblings’ good fortune.

She has reminded us of a key lesson: no matter how difficult our situation, our lives mean so much more than the fight against HD.

Next time: a report on the therapeutics conference.

To take, or not to take, unproven supplements in the fight against Huntington’s disease

Should people facing Huntington’s disease take creatine and other supplements to relieve or prevent symptoms?

I do.

I saw HD inexorably destroy my mother’s ability to walk, talk, and care for herself. She died eight years ago this month. I tested positive for HD in 1999 and since then have worried daily about when it will strike.

There is no treatment to slow HD’s devastation of the brain. So I’ve been open to taking supplements that might help.

In early 1996, just shortly after learning of my mother’s diagnosis, I started taking coenzyme Q-10 (Co-Q), a vitamin-like substance found throughout our bodies and seen by researchers as a possible way to help remedy the energy deficits suffered in HD.

In 2004, when Dr. LaVonne Goodman introduced a “treatment now” regimen and clinical trial of safe supplements that had shown promising results in animal testing, I jumped at the chance to participate. I was the only presymptomatic individual in the small, three-year study, run under the auspices of Dr. Goodman’s Huntington’s Disease Drug Works (HDDW).

Starting in 2005, I introduced the supplements into my diet in steps. I worked up to a daily routine in which I took 75 grams of trehalose, a sugar that seems to help the brain clear cellular debris; 600 mg of medical-grade Co-Q; two g of omega-3 oil; two g of blueberry extract; and ten g of medical-grade creatine. The trial paid for and delivered the supplements.

The trial did not show significant improvement for any of the symptomatic participants. “The only thing that appeared to be helpful was trehalose,” Dr. Goodman said in a February 9 phone interview. Today, almost a decade later, the supplements remain medically unproven to affect HD.

Nevertheless, scientists still think that trehalose, Co-Q, and creatine might still provide help in treating HD. Since the end of the HDDW, I have continued to take all of the supplements, spending about $2,000 per year. In fact, several years ago, relying on medical advice, I roughly doubled my daily intake of creatine to about 20 g.

I get semi-annual blood tests to monitor potential kidney damage, which creatine can cause. I also drink plenty of water throughout the day to prevent dehydration, which can occur at doses higher than 10 g. Creatine also can cause weight gain.

Am I wasting money and endangering my health?

I don’t think so. A few years ago, one of the doctors at the local Huntington’s disease clinic told me to stay on the supplements, observing that the combination of substances might be helping to delay my HD onset. I inherited the same degree of mutation as my mother, but, at 54, have passed the age of her onset.

The yin-yang of supplements

Whether others in the HD community should take creatine and other supplements is an individual choice ideally made in consultation with a doctor.

During our interview, the Seattle-based Dr. Goodman reviewed the pros and cons of taking creatine.

She cautioned against taking high doses of the substance, because more serious side effects occur at higher dosage, and urged people to consult a physician before starting any supplement.

She stressed that people need to understand the “yin-yang” involved in the decision to take supplements.

“Yes, you want to take care of yourself,” Dr. Goodman said. If they do nothing else, supplements can at least furnish a “very important” placebo effect and the prospect of hope, she said.

Dr. LaVonne Goodman (photo by Gene Veritas)

The placebo effect is a “real” phenomenon, she observed. “If you could bottle it, it would be great.”

However, taking supplements also reminds asymptomatic gene carriers of their risk, she added.

More importantly, people’s use of supplements could also obstruct the path to other, potentially far more promising treatments, she said.

The benefits of supplements “need to be counterbalanced with the need to test promising new drugs, or we will never have better treatments for Huntington’s,” she explained.

Interfering with clinical trials?

“There are so many competing interests here,” Dr. Goodman continued. “We all want to believe that (creatine) is helpful, because it’s available, and we can take it, so why not do it, we say. This is what I said with HDDW trials. Well, yes, but it needs to be measured. Otherwise, we’re going to know nothing more than we did.”

“It is important for people to know that if they take these things, they can’t be in clinical trials at the same time. We deplete our clinical trial participant base, which is going to impede progress for finding better treatments. There’s the yin-yang. And people need to hear both.”

However, Dr. Goodman noted that individuals could do both: to become eligible for a clinical trial, individuals could clear the supplements out of their system so that they don’t interfere with the measurement of the tested drug’s effects, then resume the supplements after completing the trial.

I would stop taking my supplements in order to qualify for a trial, although until the most recent creatine trial (see below), practically every trial has targeted only symptomatic individuals.

Dr. Goodman underscored the need to treat creatine and all other supplements as “medicines.” Supplements should meet USP (U.S. Pharmacopeial Convention) standards, she added. The HDDW website contains information on supplement safety. Further information on supplements is available at Huntington’s Disease Lighthouse Families.

(I buy my creatine from my local GNC outlet but plan to search for a better grade of the product.)

All drugs, including FDA-approved ones, produce side effects and can affect individuals differently, Dr. Goodman noted.

Regarding creatine, she concluded: “If it’s not watched closely, it may cause more harm than good.”

A historic trial

People in the HD community became excited about creatine as a potential treatment after Harvard University’s online news service on February 7 published an article titled “Nutritional supplement slows onset of Huntington’s.”

According to the article, a team of researchers based at the Harvard-affiliated Massachusetts General Hospital had finished a historic Phase II clinical trial that produced MRI scans showing evidence of the slowing of brain atrophy (shrinkage) in HD gene carriers who have yet to manifest the classic symptoms of the disorder. Sixty-four people took part.

Participants took up to 30 g of creatine per day.

According to Steven Hersch, M.D., Ph.D., the trial, called PRECREST (Creatine Safety and Tolerability in Premanifest HD), was a “huge step” for three reasons – including its impact on a separate creatine trial for symptomatic patients called CREST-E (Creatine Safety, Tolerability, and Efficacy in Huntington’s Disease)

“One, it’s the first therapeutic trial that has tried doing prevention,” Dr. Hersch, the study’s senior author and a long-time HD researcher, said in a February 11 phone interview. “Two, because we created a design that let anybody participate who’s at 50% risk, as well as those who have tested positive. And three, the imaging finding increases the probability that CREST-E will show a clinical benefit.”

Dr. Steven Hersch (photo from HDSA website)

Currently in progress and still recruiting participants, CREST-E is a phase III trial – the final step before drug approval (click here to learn how to enroll).

The PRECREST administrators recruited untested at-risk individuals who were then tested for the purposes of the trial as well as individuals who already knew that they have the HD mutation. However, those who entered the study untested did not receive their results, which were only known to the statistician. Thus, they avoided the potentially traumatic psychological aftermath and remained protected from genetic discrimination.

“The ethical challenges for those recruiting and conducting trials include how to accommodate nontested at-risk individuals while preserving a noncoercive choice regarding genetic testing,” states an editorial about PRECREST in the March 2014 issue of the prestigious journal Neurology, adding that “unequivocal changes” occur in the brain of presymptomatic individuals “15 to 20 years before conventional clinic-based diagnosis.” An article on PRECREST by Dr. Hersch, lead author Herminia D. Rosas, M.D., and nine other collaborators appears in the same issue.

For these and other reasons, 90 percent of at-risk individuals choose not to test, Dr. Hersch explained.

The MRI changes and other data from PRECREST will eventually be assessed in CREST-E, Dr. Hersch explained. CREST-E is also doing MRI imaging. With nearly 600 participants so far, it will be large enough to show whether the benefits shown in PRECREST images correspond to a significant slowing of HD.

Avoiding false hopes

As with many news articles about clinical trials and other scientific experiments, the Harvard report’s headline, which claimed the supplement slowed the onset of HD, inaccurately reflected the researchers’ results as reported in the actual scientific article.

“While slowed atrophy suggests that creatine could slow preclinical progression, the potential clinical impact of these findings on delaying the onset of HD is unknown and must be defined by an efficacy study designed to measure it,” the Neurology article states.

Nor can the public buy the high-quality creatine used in the study, as it’s prepared specially for clinical trials.

“I don’t want people to take from this study that they ought to go running out and take a bunch of creatine or take it at these doses,” said Dr. Hersch. “Even though the imaging benefit is very exciting, we don’t know what it means clinically. It doesn’t provide the evidence that would lead me to recommend that people take it. The high doses that we used should also not be used without medical supervision.”

As noted in the Neurology article, some PRECREST participants suffered stomach upset and diarrhea caused by the creatine. About a dozen people had to drop out of the study.

Regarding the study’s clinical significance, Dr. Goodman offered an assessment similar to that of Dr. Hersch.

The widely read HD research website HDBuzz.net also weighed in.

“How much hope and how my hype?” an HDBuzz article asked. While recognizing the importance of the study, it pointed out that the causes and effects of the slowed shrinkage in the brains of the PRECREST participants need further study.

“It’s possible that creatine causes HD brain cells to bulge or swell without making them healthier,” it states. “Swelling like that could produce false optimism and might even be harmful. That’s not something this trial can tell us either way, because the patients weren’t followed long enough to see whether creatine treatment delayed the onset of symptoms.”

“The participants in PRECREST who took creatine but did not have the HD mutation did not experience any brain swelling, so this is an unlikely explanation for our findings,” said Dr. Hersch. “Including and treating these subjects was very unusual. However, we did so to allow us to answer questions like this.”

Awaiting the Holy Grail

“HD researchers face a major challenge in finding a treatment for the pre-manifest,” I wrote in 2011. “It’s really the Holy Grail not only for HD, but also for other neurological diseases such as Alzheimer’s in which brain damage occurs many years before symptoms appear. Ideally, researchers want to design medications that will completely prevent these diseases.”

The Neurology editorial used the term “Holy Grail,” too, in noting how the PRESCREST study “investigates a potentially neuroprotective agent designed to delay disease onset.”

The word “potentially” is key.

As Dr. Hersch explained, the PRECREST findings about slower shrinkage “suggest” that creatine provides a benefit, but they don’t permit researchers to say anything about delayed onset of symptoms in presymptomatic individuals or a longer lifespan for patients.

It remains for the CREST-E Phase III trial to produce similar brain scan results – and an actual effect on symptoms.

“If CREST-E shows efficacy in slowing down the disease in people who are symptomatic, I would think that most people would think that you may be slowing down the disease in people who aren’t symptomatic yet as well,” he said.

Until treatments become available, presymptomatic gene carriers like me will continue to face the extremely difficult decision about whether to take supplements.

I’m grasping at creatine and other supplements in the hopes of delaying onset until researchers succeed. 

Proof of heaven? My ongoing search for the meaning of Huntington’s disease in life and death

The knowledge that I carry the Huntington’s disease genetic mutation and will inevitably develop devastating, ultimately deadly symptoms has led me to intensify my search for the meaning of life, especially after the death of my mother from HD eight years ago this month.

As a historian tracking neuroscience developments and the quest for an HD treatment, I am also deeply interested in the nature of the mind and consciousness. This growing field of inquiry is full of new insights and challenges.

In 2010, I wrote an article titled “God, Huntington’s disease, and the meaning of life,” in which I explored human evolution as the cause of the HD mutation but also the impetus towards greater consciousness of our species, a vast network of thinking beings.

HD may serve “a purpose as of yet undiscovered,” I wrote. “HD people have a huge cross to carry, but they should see their lives as part of the evolutionary surge towards a better life for all.”

I saw that thought partially confirmed in Brazil last September at the sixth World Congress on Huntington’s Disease, where renowned HD researcher Dr. Elena Cattaneo noted that the normal huntingtin gene, present in all humans and many other species, has a “social function, because it brings cells together…. Huntingtin is a good gene.”

Dr. Cattaneo offered an insight from a study of 300 normal brains: the greater the expansion of the huntingtin gene’s DNA (HD happens when the expansion is too great), the greater the amount of gray matter, or neurons, and therefore the larger and potentially more complex the circuitry of those brains. (Click here to watch Dr. Cattaneo’s presentation.)

Thus, because brain enlargement has played a key role in human evolution, the huntingtin gene might have had a part in the creation of human intelligence.

In my 2010 article, I also explored the oft-denied nexus between faith and science and the centrality of consciousness in the human experience by analyzing the life and writings of the so-called Catholic Darwin, the Jesuit paleontologist-priest Pierre Teilhard de Chardin.

In other articles, I have described how faith has given me the courage to confront the many challenges posed by HD.

An intriguing title

A large part of my focus on spirituality involves its effectiveness as a coping mechanism.

Last year, I augmented my morning meditation with a reading from Living Faith: Daily Catholic Devotions. Based on Biblical passages, the practical spiritual advice offered in this booklet helps me focus on meeting life’s challenges and becoming a better person.

Like many believers, however, I haven’t thought much about heaven and the afterlife – until last month a book title flashed across my TV screen and intrigued me with its seemingly incongruous combination of two words: “heaven” and “neurosurgeon.”

I felt moved to almost immediately download onto my Kindle Dr. Eben Alexander III’s account of his near-death experience (NDE) and purported encounter with God, the bestseller Proof of Heaven: A Neurosurgeon’s Journey into the Afterlife.

I knew almost nothing about NDEs other than what I glimpsed on TV programs about them over the years, but now that a neurosurgeon had experienced one and written about it, I felt the need to take the matter more seriously.

Because of my HD advocacy, I have delved into the world of neuroscience research, where scientists seek to explain phenomena such as NDEs purely in terms of the brain. Many scientists reject the supernatural, although notable exceptions do exist such as Dr. Francis Collins, the head of the National Institutes of Health and one of the individuals responsible for the discovery of the huntingtin gene.

Quite frankly, thanks in part to the intellectual rigor of both believing and non-believing scientists as well as my own experience as an academic and historian, I have also learned to keep an open mind with regard to practically any question or mystery.

As an HD advocate, I was also anxious to learn what Dr. Alexander might have to say about the brain and disease.

I had another, very important reason to read Proof of Heaven. Seeing a title that hinted at the existence of scientific proof for heaven fulfilled a growing desire for hope stirred in me by the approach of old age and especially the inevitable onset of HD.

Discovering the soul

According to Dr. Alexander, he had lain in a coma for a week, his brain under a severe attack from an untreatable, unique form of meningitis. He should have died, but, in the words of one of the attending physicians cited in the book, staged a miraculous recovery.

Dr. Alexander claims that, during his time in coma, he was transported to another realm, where he encountered a kind of guardian angel and learned truths about the universe and the overwhelming power of love. He explains that he found many of those truths extremely difficult to describe in the language of earthly existence.

Once a typical, scientifically oriented skeptic about the spiritual dimension, Alexander became a man of deep faith committed to revealing the significance of NDEs.

Dr. Eben Alexander III (photo from author's website)

“Science – the science to which I’ve devoted so much of my life – doesn’t contradict what I learned up there,” Dr. Alexander writes. “But far, far too many people believe it does, because certain members of the scientific community, who are pledged to the materialist worldview, have insisted again and again that science and spirituality cannot coexist. They are mistaken….

“In fact, I feel confident in saying that, while I didn’t even know the term at the time, while in the Gateway and in the Core (heaven), I was actually ‘doing science.’ Science that relied on the truest and most sophisticated tool for scientific research that we possess: Consciousness itself.”

According to Dr. Alexander, during his NDE he had discovered the existence of his own soul – a form of consciousness outside of the body and the brain-generated mind.

He summed up the message from heaven: “Love is, without a doubt, the basis of everything. Not some abstract, hard-to-fathom kind of love but the day-to-day kind that everyone knows—the kind of love we feel when we look at our spouse and our children, or even our animals. In its purest and most powerful form, this love is not jealous or selfish, but unconditional.”

A convincing yet disappointing story

As I read Dr. Alexander’s account and gained hope for the future, I became ecstatic. Finally, I thought, I can truly look forward to the afterlife! I will continue to fight for the cure of HD, but I don’t have to worry about dying! Finally, someone has nailed down proof of heaven!

As I read the book, however, I also felt disappointed at how little Dr. Alexander could say about God and heaven, because of the admitted human limitations in describing the experience.

At about 200 pages, the book also struck me as very short for a topic of the utmost importance.

In addition, his description of the cosmos seemed to echo scientific hypotheses put forth on earth. Of course, in reality scientific ideas and divine revelation about the cosmos should coincide. However, I wondered whether his perception was a true insight from God or simply a projection of his professed love for physics and cosmology.

Despite these criticisms, I found the book highly convincing.

A hallucination?

But then I thought some more and dug more deeply.

Jesus was the son of a carpenter. Eben Alexander III is a neurosurgeon who taught many years at Harvard University.

Here on earth, Dr. Alexander’s status validates the idea of the NDE. People crave such validation when considering an idea – or buying a book – even though the idea could stand on its own when carefully considered.

Wanting to see what others thought of Dr. Alexander’s book, I discovered the expected response from some in the scientific community. An article in Scientific American, for instance, concluded that Dr. Alexander’s experience was “proof of hallucination, not heaven.”

Esquire magazine contributing editor Luke Dittrich wrote a long, unflattering expose of Dr. Alexander’s departure from Harvard, his status as a defendant in a series of malpractice lawsuits, the suspension of his operating privileges, publisher Simon & Schuster’s manipulation of and shortening of the original manuscript, and inaccuracies in Proof of Heaven. Dittrich describes Dr. Alexander as a self-proclaimed “prophet,” a man in reality seeking in the time-honored American tradition to remake himself in the wake of legal and professional difficulties.

Dr. Alexander’s website contains a rebuttal to the piece by Esquire, which it accuses of “journalistic malpractice.”

In Proof of Heaven, Dr. Alexander states that material success became unimportant to him after his glimpse of the afterlife. Aside from some bracelets for sale with half the proceeds intended for charity, I could find nothing about the destination of the presumably millions of dollars in royalties Dr. Alexander has earned from sales estimated in mid-2013 at nearly two million copies.

For me, the jury is still out on Dr. Alexander’s story.

The larger context

Ultimately, only God would know exactly what happened to Dr. Alexander during his near-death experience.

For me, the book is important because it contributes to the effort to create a synthesis of faith and science.

Proof of Heaven also rekindled my interest in the afterlife and introduced me to the seriousness and breadth of NDEs. Whether one believes in the soul or not, NDEs can and should be studied in the larger context of understanding how the brain and consciousness work.

A seemingly infinite number of mysteries about our existence remain to be solved.

Seeing patients as persons

While I can’t judge the veracity of Dr. Alexander’s NDE, reading his book made me reflect on my mother’s final days in January and February 2006. Proof of Heaven has also helped me come to a fuller and more compassionate understanding of Huntington’s disease patients.

My mother struggled with HD for nearly two decades.

In the HD community, because we need to build awareness, we are so used to emphasizing the devastation of the disease. The devastation is real. But there is more to the person. Some readers of this blog have reminded me that I have not recognized this.

I regret not having the emotional strength and presence of mind to have seen my mother more as a person, with a consciousness and perhaps even a soul, and less as a mind and body racked by the symptoms of Huntingon’s. Because I had tested positive for the mutation, “my fear of HD kept me from sitting down with her and attempting to converse,” I wrote in a blog entry titled “Saying good-bye to Mom.”

My mother’s astonishing gesture

Only near the end of her life did I really perceive that a powerful life force continued in my mother.

The first evidence of this came in a phone call from my California home to my mom’s nursing home in suburban Cleveland. I wrote: “The nurse bluntly revealed an emotional bombshell: Mom had said that she was ‘not afraid to die.’”

I was struck by that revelation, because for years she had not spoken in any intelligent manner.

Looking back on our good-bye, I now see more clearly the increased presence of her consciousness and the degree of her “cogency” (Dr. Alexander’s word to describe another situation) as she prepared to die. Demented elderly people on their deathbed sometimes achieve an “astonishing clarity of mind” known as “terminal lucidity,” he notes.

I wrote: We then wheeled Mom to a reception room with more comfortable furniture. There we took some pictures.

Then I asked my sister and father to leave the room briefly so that I could say my final farewell to Mom.

I told Mom that I was saying goodbye and that I might not see her again. I told her what an excellent mother she had been, and I apologized for all the times that I had not been the best of sons.

I looked her in the eyes.

I hugged and kissed her.

I put her hand on top of mine on top of the tray that was part of her special chair.

I told her I loved her. She said she loved me too.

In the past couple days Mom had not moved her hands at all. When we asked her to point out things, she had been unresponsive. But then, inexplicably, Mom started to move her left hand upwards. Slowly it moved until it touched my face.

I took her hand and pressed it against my face.

Miraculously we had touched each other’s hearts.

I felt a warm glow of love and relief.

A wonderful gift

Wanting to know a Huntington’s disease specialist’s assessment of my mother’s cogency, I asked Dr. Martha Nance, a neurologist and the director of the Huntington’s Disease Society of America Center of Excellence at Hennepin County Medical Center in Minneapolis, to comment via e-mail.

“I don’t know what to say about consciousness independent of mind and body,” Dr. Nance responded. “My work and personal worlds do not operate on that plane, if there is such a plane of existence.”

However, Dr. Nance has heard extraordinary stories about and from patients suffering from neurological disorders, like the woman dying from progressive supranuclear palsy who on her last day had a vodka martini with her husband and their best friend from college days.

Dr. Martha Nance (photo from HDSA website)

As Dr. Nance told it, the patient “raised her hand that hadn’t moved in a week, and took her own glass.  She then raised the glass up in the air – a toast to life – and put it to her lips. She died quietly that night.”

What causes these moments of lucidity? Science hasn’t yet found the answer, Dr. Nance replied.

“If you play your cards right, this kind of thing can and does happen,” Dr. Nance wrote. “The point is, if you acknowledge the coming of death, perhaps even embrace it, that it can be at least peaceful, and sometimes beautiful. And strange moments of lucidity or awareness shortly before the final moment do seem to happen (sometimes, not always) – and are a wonderful gift to the family when they do.”

Riding the advocacy revolution: stem cell activists, the future of CIRM, and public awareness

If the promise of stem cells to treat a myriad of diseases – a potential outlined in my first of two reports on the sixth World Stem Cell Summit – is to be fulfilled, advocates and patient organizations must exercise effort and expertise in helping steer the research.

Starting with AIDS-related patient advocacy, a “revolution” has occurred over the past two decades in how patients have related to their doctors and the pharmaceutical industry, said Kevin McCormack, the senior director of Public Communications and Patient Advocate Outreach for the California Institute for Regenerative Medicine (CIRM). CIRM was one of the leading co-sponsors of the summit, held last month in San Diego.

“This is a really exciting time and really interesting time in medicine,” McCormack said, introducing a panel on patient advocacy and stem cell research on December 5. “There’s a lot of change going on. Part of it is due to all the advances that have been taking place, all the progress that is being made in many different fields, but obviously in stem cells in particular. That’s why we’re here.

“There’s also a change in the way we’re engaged. In the past it was a very paternalistic system, for want of a better word, where you went to the doctor, and the doctor said, ‘This is what you have,’ and then the doctor said, ‘This is how we’re going to treat you.’”

Now, said McCormack, that has changed. “Patients and patient advocates are really demanding more of a role, more of a voice, beginning with HIV-AIDS, where people just didn’t want to wait around ... to get the therapies,” he said. “And so they pushed and advocated and demanded in every part of the decision-making process.”

Beyond the key issue of Huntington’s disease advocacy, this article also addresses the future of the world-leading, public-bond-supported CIRM and the need for greater public education about the stem cell field, including safety concerns.

Show up, get involved

Judy Roberson, RN, one of California’s leading HD activists, led off the above-mentioned panel with a simple but crucial tenet of advocacy: “Show up for things. Show up for meetings like this. Join support groups and national organizations…. When you get involved, opportunities come your way.”

Such opportunities become available because major “decision-makers” usually attend scientific meetings such as the Huntington’s Study Group conference she keynoted in 2009, Roberson pointed out.

As a result, Roberson, then the president of the Northern California Chapter of the Huntington’s Disease Society of America (HDSA) and head of the Joseph P. Roberson Foundation (founded by and named for her HD-stricken brother-in-law), was invited by the Food and Drug Administration (FDA) to become an FDA HD advocate. The FDA oversees clinical trials for drugs and approves treatments. Roberson’s husband Tim died of HD at the age of 51.

“You’ll never get anything unless you ask for it,” Roberson continued, recounting how in the early 1990s she approached her neighbor, California State Senator Mike Thompson, to seek support for Huntington’s programs. Thompson, who headed the legislature’s powerful budget committee, helped allocate $1 million for HD programs over a period of five years. Thompson now serves in the U.S. Congress.

More recently, Roberson and other California HD advocates worked to help Drs. Vicki Wheelock and Jan Nolta of the University of California, Davis, secure a $19 million grant to conduct research towards a stem cell trial for HD, as mentioned in my previous article on the summit and detailed in a 2012 article.

You can watch the Stem Cell Summit advocacy panel, including Roberson’s speech, in the video below.

How Patients and Patient Organizations Are Impacting Advances in Stem Cell Research and Regenerative Medicine from Gene Veritas on Vimeo.

An eye-opening experience

For Katie Jackson, also of Sacramento and the vice president for Help4HD-International, a newly emerging patient and family support organization, the summit opened up a new world. Jackson’s husband was diagnosed with HD in 2006. The couple has two untested children with a 50-50 chance of inheriting the HD mutation.

“This summit has been so eye-opening and so amazing,” Jackson told me in an interview on December 5. “I thank the California Institute for Regenerative Medicine for sending me here….  From the second you wake up in the morning till the second you go to bed, you’re amongst these innovator-researchers that are just changing the world.”

Jackson said she was excited to be “part of the medicine that’s today, and that is regenerative medicine…. People are starting to understand that this is important stuff.”

The Stem Cell Summit left Jackson with a feeling of great hope, she said.

“There are a lot of people that are working hard to find therapies and possibly the cure,” she said. “Hopefully this is the last generation of Huntington’s disease.”

You can watch the entirety of our interview in the video below.

Huntington' Disease Advocate Katie Jackson at the World Stem Cell Summit: An Interview with Gene Veritas from Gene Veritas on Vimeo.

The center of the stem cell universe

As stated by outgoing CIRM President Dr. Alan Trounson in his keynote speech on December 4, numerous CIRM-supported projects are putting the drive towards stem cell treatments into “high gear.”

According to Jonathan Thomas, the chair of the Independent Citizens’ Oversight Committee (ICOC), CIRM’s governing board, the agency is currently funding research regarding 40 incurable diseases and conditions. That research is part of projects funded at 70 different California universities, research institutions, and biotech companies.

Critically, these efforts aim to get potential therapies into human clinical trials, the final, crucial step before the FDA can approve a drug.

CIRM, approved in a 2004 statewide vote on Proposition 71, has so far spent $1.85 billion of its mandated $3 billion budget, funded by state-issued bonds.

California was already “loaded” with research talent, Thomas observed in a CIRM public forum on December 3, “but the fact that CIRM is here has enabled the state to attract senior stem cell scientists from all over the world just to have the opportunity to get funded for their work.”

Thanks to CIRM, California has become “the center of the stem cell universe” and the “envy of the rest of the world because of what the voters have enabled us to do,” Thomas continued.

“No other state has been able to duplicate this,” he said. “There are smaller efforts that are funded either by annual appropriations by state legislatures or largely funded through philanthropic gifts or whatever. No place has the bonding authority we do.”

Keeping the research pipeline open

CIRM will fund its final round of projects by 2017. Actual administration of the grants will extend to about 2021, McCormack said.

“But obviously the key question here is: what about funding the research that’s already in the pipeline, about the kind of exciting progress that we’ve made that we don’t want to see wither and die, because if we go away, who’s going to fund it?” he said.

McCormack explained that continued support for the early and middle stages of a project enables the researchers to avoid the so-called “valley of death” – a lack of funds preventing the scientists from approaching large drug companies to promote the idea of the large, expensive, and sometimes lengthy Phase III clinical trials, the final stage before FDA approval.

“We’re looking at a number of different ways of getting new money – private funding, philanthropy, a number of different choices that we’ll be exploring,” McCormack said. “We’re not ready to go public yet with some of the things we’re looking at, but hopefully we’ll be able to find some way of continuing this research.”

“I hope with all my heart that we can go for a part 2 of Proposition 71,” said panel member Don Reed, a leader in the 2004 effort, who became active in the cause because of his son Roman’s paralysis resulting from a college football accident in 1994. “It’s going to be the greatest stem cell battle in the history of the world, and if we win, there’s just going to be unbelievable stuff that will happen…. Support it. Send letters to the editor. Fight every we you can.”

Roberson noted that Prop 71 originator Bob Klein’s comments at the Stem Cell Summit included plans for an “advocate boot camp” in support of CIRM. Klein served as the first chair of the ICOC from 2004-2011.

Panel member Alex Richmond, an advocate for treatment of children’s neurological disorders and the executive director of Children’s Neurobiological Solutions, observed that, as a public agency, CIRM cannot advocate for its own existence. “So it puts more pressure on organizations like ours and individuals like you, individual scientists that are out there, to be really as good an advocate as they can,” he said.

Public education critical

Researchers speaking at the CIRM public forum and presenting projects at the Stem Cell Summit both emphasized the need for greater public understanding of stem cell science.

In addition to reports on specific diseases such as Parkinson’s, AIDS, and cancer, the public forum provided easily understandable introductions to stem cell basics, focusing on such themes as adult stem cells, pluripotent stem cells (which can become any kind of cell type), and cell replacement therapy.

You can watch videos of all the public forum presentations, as well as a number of other panels and presentations of the summit, by visiting my 2013 World Stem Cell Summit video album, to which I've just added twelve more presentations.

To promote stem cell education, two researchers presented a poster titled “Developing an Easy-to-Understand Booklet for the General Public to Discuss Issues in Stem Cell Research.” Authored by Keiko Sato, Ph.D., and researcher Mie Samura of Kyoto University, Japan, the project seeks to correct misinformation and misunderstanding about the field.

“Misleading information released by the media is a routine problem for stem cell research stakeholders,” they stated on their poster, which refers to Japan but can be applied to the U.S. and other cultures. They cited the examples of embryonic stem cells, reported in some media outlets as being “created by destroying fertilized eggs intended to become babies.”

The book will appear in Japanese and also online in English.

Dr. Keiko Sato (right) and researcher Mie Samura at their poster about stem cell education (photo by Gene Veritas)

Their poster also warned about the “hype” surrounding unproven stem cell treatments, sometimes leading to “unexpected side effects” in patients who try them.

“Thus, the current situation has the potential to undermine the relations of mutual trust between researchers and the general public about stem cell research,” the authors wrote.

The poster “Stem Cell Clinics and the Internet,” by Dr. Ruairi Connolly and two collaborators from the National University of Ireland, further underscored the dangers of unproven treatments offered by online clinics.

“Despite a lack of appropriate accreditation, (such) clinics report major clinical improvements and the curative potential of treatment,” they wrote. “The provision of stem cell therapies in such an unregulated online environment is jeopardising the development of this nascent branch of medicine and offers a substantial risk to both the health of patients availing of these treatments and to the credibility of long term research in this domain.”

Dr. Ruairi Connolly with poster about unaccredited, online stem cell clinics (photo by Gene Veritas)

(Disclaimer: I received a stem cell summit scholarship from CIRM, which covered the cost of registration. CIRM officials did not in any way influence or control what I have written here.)

Game-changers in the fight against disease: a report from the World Stem Cell Summit

With a growing array of possibilities, stem cell treatments for diseases and other medical conditions hold the potential for a new era in human health.

That upbeat message – including a report on Huntington’s disease research – dominated the 2013 World Stem Summit, held in my home city of San Diego last December 4-6. I attended the sixth annual summit as an advocate for the Huntington’s Disease Society of America (HDSA).

“Over the next 20 years we need the brightest young minds using all the platforms of technology to drive creativity for solutions to defeat the problems of disease using stem cells,” said Alan Trounson, Ph.D., the outgoing president of the California Institute for Regenerative Medicine (CIRM), during his keynote address. “If we do that, I’m sure we’re going to be successful.” CIRM, a state-run research funding agency, is spending a voter-approved $3 billion by 2017 to explore stem-cell treatments for various diseases.

“All of us nationally and internationally involved in stem cell research firmly believe that some of these things will work out,” Jonathan Thomas, Ph.D., J.D., the chair of the CIRM oversight board, said at a CIRM public forum. “The great thing about this field is everything’s a game changer. So whatever any of these terrific scientists are able to get through to fruition will literally change the world when it comes to that particular disease or condition. Therein lies the promise of stem cell research.”

You can watch the Trounson and Thomas speeches, as well as other presentations, in my stem cell summit album by clicking here.

‘Cell sheets’ for eyes and hearts

From AIDS to cancer to urinary incontinence, researchers presented exciting advances in stem cell research and the efforts to improve people’s health.

In one of the most striking presentations, Teruo Okano, Ph.D., of Tokyo Women’s Medical University, demonstrated his “cell harvesting” technique to create “cell sheets” of particular kinds of tissue. He has transplanted these sheets onto diseased eyes, cancerous esophageal tissue, and damaged heart muscle.

The small number of patients receiving these experimental treatments has shown dramatic improvement.

Dr. Okano’s team is seeking to employ cell sheets in the treatment of conditions affecting the gums, lungs, liver, pancreas, cartilage, and the middle ear. They are currently seeking to develop a cell sheet-based tissue and organ factory to automate and standardize cell sheet production, aiming to minimize human error and expand the availability of these treatments.

You can watch Dr. Okano’s presentation in the video below.

A Cell Harvesting Method: A Presentation by Dr. Teruo Okano at the 2013 World Stem Cell Summit from Gene Veritas on Vimeo.

Safe cells for an HD trial

On the same panel, Jan Nolta, Ph.D., the director of the Stem Cell Program and Institute for Regenerative Cures at the University of California, Davis, provided an overview of her lab’s work with mesenchymal stem cells (MSCs), which scientists primarily derive from the bone marrow.

“I’ve been working with these cells and have a love affair with them for over 25 years,” Dr. Nolta said. “What we do with them is to genetically engineer them…. They are in clinical trials. They are safe. And they have some really cool properties.”

The MSCs' abilities include restoring blood flow, preventing cell death, reducing inflammation, and keeping the immune system at bay during tissue remodeling (natural repair of tissue), Dr. Nolta explained. MSCs have been used with “statistically significant success” in clinical trials involving heart disease, orthopedics and spine fusion, cartilage repair, autoimmune diseases, Crohn’s disease, stroke, and arthritis, she added.

Dr. Nolta also provided an update on her lab’s projected clinical trial of MSCs to combat Huntington’s disease by using the cells to deliver a key growth factor, BDNF (brain-derived neurotrophic factor), to brain cells. In July 2012, CIRM granted her lab $19 million to support the project. (Click here to read more.

“We’ve just started the lead-in clinical trial,” Dr. Nolta told the summit audience. “We’ll observe patients for a year, before they would get the cell therapy. We’re recruiting patients at that trial now.”

You can watch Dr. Nolta’s presentation in the video below.

Mesenchymal Stem/Stromal Cell Therapies: A Presentation by Dr. Jan Nolta at the 2013 World Stem Cell Summit from Gene Veritas on Vimeo.

Becoming part of the fabric

Further confirmation of advances in the stem cell field came in the release of a report, Stem Cell Research: Trends and Perspectives on the Evolving International Landscape, which revealed that stem cell research is growing at more than twice the world average for research in general (7% versus 2.9%). The report further noted that about half of stem cell papers refer to “drug development” or “regenerative medicine,” further evidence of the field’s promise for developing treatments.

In the summit’s exhibit hall, scores of scientific posters demonstrated progress on numerous fronts, and displays by stem cell related companies, flanked by expert salespersons, showed how much stem cells are becoming part of the fabric of business.

At the booth for BioSpherix, sales representative Ray Gould explained to me how his company’s product Xvivo System, a small, modular GMP (good manufacturing practices) setup, provides an alternative (for a fraction of the cost) to the large, multi-million-dollar facilities put up by organizations for stem cell and other kinds of research.

Ray Gould of BioSpherix explains the use of the company's modular GMP system (photo by Gene Veritas).

Fulfilling the promise, understanding the odds

For me, even though I carry the deadly HD gene, the glow of hope from the summit has not worn off.

After the conference, as requested, I started receiving e-mails from the Genetics Policy Institute, which, along with CIRM, was one of the event’s six major sponsors. The messages update the latest developments in stem cell research.

Of the many items, two in particular struck me: a project by the Mayo Clinic to grow stem cells at the International Space Station as a pathway to treatments for stroke and the use of inkjet printing technology to print eye cells to potentially treat retinal disease and help cure blindness.

Although a number of news reports echoed the optimism of the summit (click here for one example), at least one carried the reminder that many attempts at developing stem cell treatments have failed.

Such failures are not surprising. In general, 90 percent of all clinical trials fail to produce a treatment. By their very nature, science and drug discover involve a long process of trial and error.

Stem cells capture our imagination because they come from our bodies. In this respect they differ from typical pharmaceutical agents such as vaccines and medicines, which involve introducing non-human agents into the body (such as dead viruses or chemicals). In addition, as the work of Dr. Nolta and others has demonstrated, stem cell research gives us a greater understanding of the function of the human body.

Stem cells comprise just one part of the toolkit for treating diseases. Despite the likelihood of a high failure rate in clinical trials, having them in the kit along with gene therapy and numerous other approaches increases the overall chances of discovering effective treatments, including Huntington's disease and other currently untreatable neurological disorders.

Next time: the stem cell summit, advocacy, and the future of CIRM.

(Disclaimer: I received a stem cell summit scholarship from CIRM, which covered the cost of registration. CIRM officials did not in any way influence or control what I have written here.)