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Professor Timothy O’Brien MD, PhD, FRCPI, FRCP,
FACP
Professor of Medicine, NUI Galway
Consultant Endocrinologist, West Northwest Hospital Group
Director of REMEDI and CCMI,
Dean of the College of Medicine, Nursing and Health Sciences, NUI Galway
Research, Clinical Practice and Service Delivery
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Conflicts
• Founder, Director and Equity holder in Orbsen Therapeutics
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Theme 1
• Ireland working as a single entity can have global impact in clinical translation in defined areas
• Medical Device Technology and Regenerative Medicine
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Theme 2
• The needs of the patient always come first
• State of the art clinical care
• Educate health care providers
• Create the clinical care of the future
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Theme 3
• Irish healthcare system must contribute to economic recovery through
• Innovation
• Job creation
• Industry engagement
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innovation research
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Business
Clinic
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Innovation
• Definition: something new or different introduced
• From a clinical perspective one might add that it is necessary for the invention to be useful and to represent an advance in clinical practice
• Additionally for the innovation to have impact it must be affordable
• Who should innovate? – all healthcare workers
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Innovation will create conflict of interest
• Hospital groups need to have systems to engage with industry
• IP policy – full time hospital staff versus academic clinicians
• COI policy – disclosure and management
• Inventors and innovators should be rewarded
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Benefits that academic medicine bring to health service (BMA)
• Critical appraisal
• Financial gains and economic growth
• New ideas, evidence and products
• Better patient care and decreased costs
• Direct benefits to patients treated
• Contribution to high quality clinical services
• Contribution to international health care
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Principals underlying academic health science centres (UK Government)
• Excellence in biomedical, clinical, and applied health research
• International standing and critical mass
• Excellence in patient care
• Excellence in education
• Partnerships for delivery benefits in patient care
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Expertise - Access to clinical specialists and networks
- Clinical trial management
- Research nursing support
- Biostatistical and methodological support on study design and analysis
- Data management and IT support
Clinical Research Facility
CRFG provides the infrastructure, physical space, facilities, expertise and culture needed to optimally support patient-focused research studies and clinical studies
The CRFG has a very experienced leadership team with extensive international pre-clinical, translational, and clinical research experience allied to global regulatory and reimbursement achievements.
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NUI Galway infrastructure
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Major priority for enhancing clinical research in Ireland
• Ireland needs to present itself as a single entity for clinical research
• CRFs linked to health care facilities
• Single point of entry for industry
• Distributive model
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Distributive Model
• All centres capable of performing high quality clinical research
• Biobanking
• Biometrics
• Education and Competence
• Study management and quality
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Regenerative Medicine
• Aims to augment, repair, replace or regenerate organs and tissues that have been damaged by disease, injury or natural aging
• It represents a new paradigm in human health with the potential to resolve unmet medical needs by addressing the underlying causes of disease Alliance for Regenerative Medicine Annual Report 2012-13
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New paradigm
• Most therapies today focus on the delay of disease progression and prevention of associated complications
• Regenerative medicine is an interdisciplinary field translating basic science into regenerative technologies
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Healthcare Challenges
• Increasing cost ($3 trillion to $6 trillion in the USA over the next 20 years)
• Increasing cost is not only due to technology but is also due to demographics and the aging population
• Increase in chronic disease burden
• Many conditions of unmet medical need
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Healthcare Spending
• 75% on chronic diseases
• WHO have defined chronic disease as the priority of the century
• 60% occurs in the last year of life
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Aging
• Aging is associated with many degenerative diseases
• Regenerative Medicine has the potential to restore the patient with chronic disease to health
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Regenerative Medicine Needs• Advances in fundamental science – multidisciplinary and may
be on the borders of traditional disciplines
• Clinical trials – demonstrate a major clinically meaningful benefit
• Industrialization of product manufacture
• Innovative regulatory strategies
• Innovative business models and re-imbursement strategies
• Demonstrate cost saving through robust health economic analysis
• Investment
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Expertise - Cell therapies for vascular and arthritic diseases
- Cell manufacturing and bioprocessing - Medical devices
- Basic stem cell biology - Flow cytometry
- Biomaterials - Immunology
- Translational research - Gene therapy
Infrastructure - Fully Equipped Pre-Clinical Facility
- Centre for Cell Manufacturing Ireland (GMP-compliant cell manufacturing)
- Flow Cytometry Core (Facs Canto and Aria, Guava etc)
- Histology Core
- Microscopy Core (TEM, confocal, etc)
- Tissue Culture Core
- Gene Vector Core
- Clinical Research Facility
Key Research - Patented technologies including novel therapeutics for vascular disease, antibodies for stem cell isolation and devices for stem cell delivery
- Established Orbsen Therapeutics to commercialise REMEDI technology
- Five EU FP7-funded projects
- >550 publications and 25,000 citations since 2004.
The Regenerative Medicine Institute (REMEDI)
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Expertise - Adult stem cells, mesenchymal stem cells (MSCs) in particular
- Induced pluripotent stem cells
- Serum-free culture media - Developmental biology
- Regulation and commitment - Stem cell host interactions
Stem Cell Biology
MSC –stimulated cardiac repair
Use of iPSCs in human disease modelling e.g. schizophrenia
Differing osteogenic potential of sorted clones from one cell line
MSCs cultivated in different media. a) 2% FCS media supplemented with EGF and PDGF (b) 10% FCS media supplemented with FGF-2
www.purstem.eu
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Expertise - Preclinical models, small and large animal
- Cardiovascular and peripheral vascular disease
- Patented angiogenic molecules
- Patented “next generation” stem cells
- Stem cell homing and tracking
Cell Therapy for Vascular Disease
MSCs increase blood flow in ischemic limbs of diabetic mice
Blood flow restoration
Therapeutic Approach:
MSCs
Porcine acute myocardial infarct
Acute Infarct Region
Diabetic mouse (left) Normal mouse (right)
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Expertise - Good manufacturing practice
- Cell processing including isolation, expansion, characterisation
- Clinical trials
- Media formulation
- Cleanrooms
Cell Manufacturing (CCMI)
The CCMI is a versatile cleanroom with standout features including two parallel production suites. Each of the two suites is capable of clinical grade manufacturing of cellular therapy products and small molecules for therapeutic applications.
CCMI are very interested in discussing opportunities with clients interested in procuring human GMP-grade mesenchymal stem cells or a custom manufacturing service
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REMEDI – International Academic Network
Mayo Clinic
Arizona
Cleveland
Georgia Tech
Barcelona
Gustafe-Roussy
LeedsNewcastleEdinburgh Genoa
Toronto
Singapore
Xian
Shanghai
Rotterdam
Israel
Lithuania
published with authors from 197 other institutions worldwidepublished with over 895 authors nationally and internationallypublished with authors from 20 different countries worldwide
REMEDI Investigators have:
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“Delivercell”
“Osteocoat”
“Cell Enhance”
“Chondroscaff”
“Angiocell”
“Angiocap”
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Orbsen Therapeutics1. Human ORB1+MSC: best-in-class stromal cell purification for therapeutic use – two patents generating over €1M in private equity
• 2. Leveraged private equity to generate €20M in R&D funding from non-exchequer (FP7) sources
• Orbsen - €2.7M from EU FP7 awards; NUI Galway – €2.5 in funding from Orbsen collabtorations Orbsen. Ireland – Over €6.1M to Irish FP7 Partners. EU and USA – Over €20M for all FP7 partners
• 3. Top 15 Irish companies in the EU FP7 : 55% success rate
• 4. Employment for highly-skilled Irish Graduates :Company has grown from 1 FTE to 16 FTE in 18 months. Hired 9 Irish Graduates on 3 year contracts
• 5. The Irish Times InterTradeIreland Innovation Awards 2014 : Short-listed to Top 18 Innovations in Ireland
• 6. Three FP7-funded Clinical trials testing CD362+MSC : 2015 – Phase 1b trial - REDDSTAR FP7; 2016 – Phase 2a trial - MERLIN FP7; 2017 – Phase 1b trial - VISICORT FP7
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CURAM
• National Centre for Medical Device Research
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Team
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IndustryPartners
26 SMEs
3 Start-Ups
13 MNC’s
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Research Programme
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Trainingand Education
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Key Performance Indicators
KPIs
Academic Outputs
Human Capital
CommercialisationNew TreatmentsFunding
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Conclusion• Affordable innovation is crucial to contain the
future costs of healthcare
• The focus should be on the development of more effective treatments of chronic and burdensome diseases
• Progress will involve partnership between hospital, academia and industry.
• Ireland should function as a single entity in translational medicine
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