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A BI-WEEKLY PUBLICATION FROM THE CEDARS-SINAI CHIEF OF STAFF March 9, 2018 | Archived Issues

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Cedars-Sinai, Emulate Advance Precision Medicine

Microengineered Organ-Chip, made out of a flexible polymer, features tiny channels that can be lined with thousands of living human cells.

Scientists at Cedars-Sinai and Emulate Inc. are pioneering a Patient-on-a-Chip program to help predict which disease treatments would be most effective based on a patient's genetic makeup and disease variant—a new approach to precision medicine for improving patient care and health.

The collaboration leverages innovative stem cell science from the Cedars-Sinai Board of Governors Regenerative Medicine Institute and Emulate's Human Emulation System, which uses Organs-on-Chips technology to re-create true-to-life biology outside the body.

This technology creates an environment where the cells exhibit an unprecedented level of biological function, and provides control of complex human biology and disease mechanisms not possible with existing techniques.

Initial scientific findings, recently published in Cellular and Molecular Gastroenterology and Hepatology, a journal of the American Gastroenterology Association, mark a milestone in the Patient-on-a-Chip program.

Investigators from Cedars-Sinai and Emulate demonstrated how cells of a human intestinal lining created outside an individual's body mirror living tissue when placed inside Emulate's Intestine-Chips, opening the door to personalized testing of drug treatments.

The research points to a host of practical clinical applications that can benefit patients. By placing a patient's cells in Organ-Chips and exposing those cells to a drug or series of drugs, clinicians could gain more accurate information about how that individual would respond to treatment, avoiding the risk of administering a drug that may cause harm or is ineffective and costly.

"The medical potential of a Patient-on-a-Chip is extraordinary," said Clive Svendsen, PhD, director of the Board of Governors Regenerative Medicine Institute and professor of Biomedical Sciences and Medicine. "As examples, scientists could use Organs-on-Chips to create a living model of a patient with Parkinson's disease, amyotrophic lateral sclerosis or Crohn's syndrome, a debilitating inflammatory bowel disorder linked to several gene mutations. By flowing drugs through Organ-Chips containing the patient's own cells and tissue, we could predict which treatment is most beneficial for that patient."

Cedars-Sinai and Emulate each have contributed integral components to the Patient-on-a-Chip program.

Cedars-Sinai scientists can harvest cells from the blood or skin of an individual and reprogram them into induced pluripotent stem cells, which can be made into any organ cell (such as those from the lung, liver or intestine), each bearing the unique genetic fingerprint and characteristics of the person.

Emulate's Human Emulation System—made up of Organs-on-Chips, instrumentation and software apps—re-creates the natural physiology cells experience within the body. Each chip, which is approximately the size of an AA battery, features tiny channels lined with tens of thousands of living human cells, re-creating the smallest functional unit of an organ.

Air and fluid, such as blood, can be passed through the chips, creating a microengineered environment that is a "home-away-from-home" for cells, where they behave just as they do in the body.

"By creating a personalized Patient-on-a-Chip, we can really begin to understand how diseases, medicines, chemicals and foods affect an individual's health," said Geraldine A. Hamilton, PhD, president and chief scientific officer of Emulate. "The goal of Emulate working with Cedars-Sinai is to advance and qualify the system for new clinical applications and ultimately democratize the technology so that it can have broad impact on patient healthcare."

In the future, a Patient-on-a-Chip also could be used to predict how a disease progresses in an individual, allowing for the design of personalized regimens to promote wellness and prevent disease, said Robert Barrett, PhD, an assistant professor of Medicine at Cedars-Sinai and senior author of the study in Cellular and Molecular Gastroenterology and Hepatology. Other applications include designing clinical trials to identify at-risk populations for adverse drug reactions.

"Cedars-Sinai's world-class stem cell expertise and discovery, combined with Emulate's pioneering Human Emulation System, is poised to reshape the future of medical care," said Shlomo Melmed, MB, ChB, executive vice president of Academic Affairs and dean of the medical faculty at Cedars-Sinai. "This project is an important initiative of Cedars-Sinai Precision Health, whose goal is to drive the development of the newest technology and best research, coupled with the finest clinical practice, to rapidly enable a new era of personalized health."

Cells of a human intestinal lining, after being placed in an Intestine-Chip, form intestinal folds as they do in the human body.

Disclosure: Cedars-Sinai owns a minority stock interest in Emulate, Inc. An officer of Cedars-Sinai also serves on Emulate's board of directors. Emulate provides no financial support for this research.

Funding: Research reported in this news release was supported by the National Center for Advancing Translational Sciences (award number 1-UG3-NS-105703-01) and the National Institute of Diabetes and Digestive and Kidney Diseases (award number R56DK106202-01) of the National Institutes of Health: the Cedars-Sinai Board of Governors Regenerative Medicine Institute; the F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute; and the Joseph Drown Foundation.

Related story:
Scientists Re-Create Living Gut Lining on Chip


Image Credits
Top: Photo from Emulate Inc.
Bottom: Image from Cedars-Sinai Board of Governors Regenerative Medicine Institute