Center for Cell Engineering, Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA.
Ocular and Stem Cell Translational Research Section, Ophthalmic Genetics and Visual Function Branch, National Eye Institute, National Institutes of Health, Bethesda, Maryland, USA.
Stem Cells Transl Med. 2021 Feb;10(2):198-208. doi: 10.1002/sctm.20-0242. Epub 2020 Sep 18.
Induced pluripotent stem cells (iPSC)-based therapies have been hailed as the future of regenerative medicine because of their potential to provide treatment options for most degenerative diseases. A key promise of iPSC-based therapies is the possibility of an autologous transplant that may engraft better in the longer-term due to its compatibility with the patient's immune system. Despite over a decade of research, clinical translation of autologous iPSC-based therapies has been slow-partly due to a lacking pre-defined regulatory path. Here, we outline regulatory considerations for developing an autologous iPSC-based product and challenges associated with the clinical manufacturing of autologous iPSCs and their derivatives. These challenges include donor tissue source, reprogramming methods, heterogeneity of differentiated cells, controls for the manufacturing process, and preclinical considerations. A robust manufacturing process with appropriate quality controls and well-informed, prospectively designed preclinical studies provide a path toward successful approval of autologous iPSC-based therapies.
基于诱导多能干细胞(iPSC)的疗法被誉为再生医学的未来,因为它们有可能为大多数退行性疾病提供治疗选择。基于 iPSC 的疗法的一个关键承诺是自体移植的可能性,由于其与患者免疫系统的兼容性,可能会在更长时间内更好地植入。尽管经过了十多年的研究,但自体 iPSC 为基础的疗法的临床转化一直很缓慢——部分原因是缺乏预先定义的监管途径。在这里,我们概述了开发自体 iPSC 为基础的产品的监管考虑因素,以及与自体 iPSC 及其衍生物的临床制造相关的挑战。这些挑战包括供体组织来源、重编程方法、分化细胞的异质性、制造过程的控制以及临床前考虑因素。一个具有适当质量控制和知情、前瞻性设计的临床前研究的强大制造过程为自体 iPSC 为基础的疗法的成功批准提供了一条途径。