December 8, 2009

Dr. Cherie Stabler, Ph.D. of DRI

by



Cherie Stabler, Ph.D., is an Assistant Professor of Biomedical Engineering at the University of Miami School of Medicine and Director of the Tissue Engineering Laboratory at the Diabetes Research Institute.

Her research interests are concentrated in the areas of tissue engineering, biomaterials, and noninvasive monitoring.

Specifically, Dr. Stabler’s research focuses on the design and development of various islet encapsulation techniques and evaluating how these barriers can protect the islets against the vigorous immunological and inflammatory responses of the host.

In addition, she is investigating the application of conjugation techniques to tether agents to polymer layers in order to generate implants capable of β€œactively” modulating the interaction between the host and implanted cells.

Dr. Stabler is studying the use of NMR imaging and spectroscopy for noninvasive monitoring and assessment of tissue engineered implants, such as insulin-producing cells.

Noninvasive monitoring of islets after they are transplanted is significant for understanding their function and remodeling over time. It is also important in determining the link between implantation and the endpoint physiologic effects.

Dr. Stabler has a background in both chemical and biomedical engineering. She received her doctoral degree from the Georgia Institute of Technology/Emory University Department of Biomedical Engineering.

Following her doctoral studies, she continued her research in tissue engineering and diabetes at the Department of Surgery at Emory University School of Medicine where she was supported by a Juvenile Diabetes Research Foundation Postdoctoral Fellowship.



Jon says to (17:01):
Thanks everybody for coming

Jon says to (17:02):
I have fixed the problem with the moderated chats

Jon says (17:02):
Allison will be moderating

John2795 says to (17:02):
It’s working now?

Lloyd says to (17:02):
cool, thanks

Anthill says to (17:02):
hello πŸ™‚

AllisonBlass says to (17:02):
Yay! I’m a moderator again!

AllisonBlass says to (17:02):
Whew.

Jon says (17:03):
take it away allison

PowerPumper says to (17:03):
u there Peter?

Anthill says to (17:03):
yes

sstrumello says to AllisonBlass (17:03):
Yay … Allison is a moderator again!

allysmomma says to froglady (17:03):
its hard having a teenager with diabetes hr numbers all over the place

allysmomma says to (17:04):
she was in hospital this weekend

Lady_Poet says to (17:04):
hi

Florian says to Dr. Cherie Stabler (17:04):
Is Dr Stabler in the room?

AllisonBlass says to (17:04):
I’d like to welcome everyone to our chat with Dr. Cherie Stabler. Dr. Stabler is the Director of the Tissue Engineering Laboratory for the Diabetes Research Institute.

Dr. Cherie Stabler says to (17:04):
Hey everyone! Sorry if I am late – I had to kiss my daughter goodnight.

Florian says to Dr. Cherie Stabler (17:04):
Hello Dr Stabler. Are you familiar with the company Living Cell Technologies and their work with encapsulated pig islet cells that are being used in a small clincial study in Russia?

Anthill says to (17:04):
is this new disovery will go to human triles

AllisonBlass says to (17:05):
No problem, Dr. Stabler. Family comes first!

Dr. Cherie Stabler says to (17:05):
πŸ™‚

Lady_Poet says to (17:05):
Dr. Stabler how much closer are we to a cure for type 1 diabetics?

Dr. Cherie Stabler says to (17:05):
Yes, I am familiar with the LCT trials. Their partnership in CA seems to be very promising.

AllisonBlass says to (17:05):
Rules of the road: Please pay attention to how many questions are being asked and give Dr. Stabler a few minutes to asking previous questions before posting your own.

Lady_Poet says to (17:05):
great news

AllisonBlass says to (17:05):
Also, stay ON TOPIC. Questions about other issues with diabetes can be answered after the chat at 10 p.m.

AllisonBlass says to (17:06):
Dr. Stabler, why don’t you give us some background on what you are currently work on?

sstrumello says to (17:06):
LCT just announced they received some generous venture capital financing!

Dr. Cherie Stabler says to (17:06):
Allison – sure.

Florian says to Dr. Cherie Stabler (17:07):
Are you close to having encapsulated islets ready for testing in humans?

Dr. Cherie Stabler says to (17:07):
My research focuses on two main areas: one is the development of nanoencapsulated coatings for islets and the other is the development of an islet-loaded device

Florian says to Dr. Cherie Stabler (17:08):
Can you explain more

Dr. Cherie Stabler says to (17:08):
The nanoencapsulation work is focused on reducing the size of standard microcapsules (such as those used by LCT) to the nanoscale.

Dr. Cherie Stabler says to (17:08):
It may not seem like much – but it is like decreasing the size of a capsule from a football field to the size of a blade of grasss.

Lloyd says to (17:08):
cool

Florian says to Dr. Cherie Stabler (17:09):
Good analogy

Dr. Cherie Stabler says to (17:09):
The importance of decreasing the capsule size is that islets are very metabolically active cells. They need lots of oxygen to survive.

Dr. Cherie Stabler says to (17:09):
When you put them in a large micocapsule, you may protect them from immune attack, but you also can kill a large portion of them because they are dying from lack of nutrients.

Anthill says to (17:09):
is the procedure easy to do?

sstrumello says to Dr. Cherie Stabler (17:10):
What, if anything, will happen to your nanoencapsulation findings … will you license it to a private company?

Dr. Cherie Stabler says to (17:10):
We are trying to decrease the size so we still have all the benefits of encapsulation (reduce the need for immunsuppression) but lose the disadvantages.

PowerPumper says to (17:10):
balance

Florian says to Dr. Cherie Stabler (17:10):
What about the material that the capsules are made of?

Dr. Cherie Stabler says to (17:11):
SStrumello – we are already in collaboration with a company that is funded by an angel fund whose primary donor has a daughter with diabetes. I cannot speak too much about it, but our primary goal is to create a cute in the fastest and safest way possible

Dr. Cherie Stabler says to (17:11):
Ha – i meant “cure” instead of “cute” of course

sstrumello says to (17:12):
Thanks!

PowerPumper says to (17:12):
Curious. Are there many such angel funds in the world of research?

Dr. Cherie Stabler says to (17:12):
The capsules are made of different biomaterials. All the materials have already been approved for clinical use, we are just tweaking them a litte to get them to do what we want.

Lady_Poet says to (17:13):
but how long a time are we speaking of Dr.? I am 45 years old and been diabetic since birth.

Dr. Cherie Stabler says to (17:13):
PP – No, not in my experience. I think that the Diabetes Research Institute has the advantage of promoting (and showing) that we are focused on a cure for diabetes. So people that want to find a cure for themselves or their children typically look to the

Dr. Cherie Stabler says to (17:13):
DIR

froglady says to Dr. Cherie Stabler (17:13):
Will your cure be universal or will it only work in certain situations?

Dr. Cherie Stabler says to (17:13):
DRI grr.

kat9rina says to (17:14):
i understand you are also looking to create an non-evasive monitoring system? How is that going?

Dr. Cherie Stabler says to (17:14):
Lady_poet – I honestly do not know. I would like to say tomorrow, but I cannot promise that. All I know is that we have everything in place that needs to be in place (the clinicians, the protocols, the support), we just need to move it forward as quickly

Dr. Cherie Stabler says to (17:14):
and safely as possible.

Lady_Poet says to (17:15):
I see

Dr. Cherie Stabler says to (17:15):
The nanoencapsulation is developed to be applicable for anyone receiving an islet transplant.

PowerPumper says to (17:15):
LP: a widely held sentiment. We’ve been hearing about cures for years. Peter & the wolf syndrome. Dr. we’re cheering for you πŸ˜‰

ves says to (17:15):
thanks

Dr. Cherie Stabler says to (17:16):
The non-invasive monitoring work has been a little slower. We have been more focused on trying to develop a treatment – then we will focus more on the monitoring aspects.

Lady_Poet says to (17:16):
yes we are

Florian says to Dr. Cherie Stabler (17:16):
Would this really be a cure or perhaps another form of treatment?

Tiger Lily says to (17:16):
where do you place the islet cell transplant?

Tiger Lily says to (17:16):
the liver? the pancreas?

PowerPumper says to (17:17):
and would it need continued follow-up treatment?

Dr. Cherie Stabler says to (17:17):
Florian – we are striving for a cure, not a treatment. This is the main reason why we are using cells. We want to completely replace the damaged beta cells – not just supplement with an alternative.

sstrumello says to Dr. Cherie Stabler (17:17):
What are your thoughts about using nanotechnology for improved treatments? For example, Beverly, Massachusetts-based company known as SmartCells is encapsulating the insulin molecule in glucose sensitive polymers.

Dr. Cherie Stabler says to (17:17):
The nanocapsules can be placed in the liver if necessary, because they add virtually no volume to the islet size.

Dr. Cherie Stabler says to (17:18):
However, the liver site is non-ideal, so we are looking into alternative transplant sites and the development of devices to hold these cells.

sstrumello says to Dr. Cherie Stabler (17:18):
Skip that, you just answered my question

Dr. Cherie Stabler says to (17:19):
This is a big initiative at the DRI. It is called the Biohybrid Device and you can read a little more about it on the website.

Dr. Cherie Stabler says to (17:19):
Oh and sstrumello – we have actually used this same glucose sensitive polymer in the past. It has wonderful properties, but can also be very toxic, so we stopped most of this work.

sstrumello says to Dr. Cherie Stabler (17:20):
very interesting

sstrumello says to Dr. Cherie Stabler (17:20):
what were the adverse effects?

PowerPumper says to (17:21):
Are there any ethical issues you may be struggling with? There seems to be a lot of bio-engineering going on.

Dr. Cherie Stabler says to (17:21):
The material can release the glucose sensitive agent, ConA, which can be very toxic to cells. We are focused more on the use of biomaterials that are easily translated to the clinic, so these materials are not on the short list right now.

Dr. Cherie Stabler says to (17:22):
PP – That is an interesting question. Honestly, the main ethical issue I struggle with is trying to focus my work on developing a cure.

Lady_Poet says to (17:22):
this will be implanted how?

sstrumello says to Dr. Cherie Stabler (17:22):
Gotcha … it might work for insulin, but not in cell transplants

Anthill says to (17:22):
What would be the first thing that the pasient to do before the transplant takes place?

Lady_Poet says to (17:22):
via surgery?

Lady_Poet says to (17:22):
or shot

Dr. Cherie Stabler says to (17:22):
Lady_Poet – do you mean the biohybrid device?

Lady_Poet says to (17:23):
yes

Dr. Cherie Stabler says to (17:23):
The biohybrid device (BHD for short) is just a small cage that can be easily inserted subcutaneously (or in another location). It would be a small incision.

Lady_Poet says to (17:23):
are transplants a good idea?

Lady_Poet says to (17:23):
of the pancreas

Lady_Poet says to (17:24):
I’ve heard ppl talk

Dr. Cherie Stabler says to (17:24):
The cage is pre-vascularized for a period of time to create a nice bed of blood vessel to supply nutrients to the islets, and then the islets are implanted.

Lady_Poet says to (17:24):
implanted how

Dr. Cherie Stabler says to (17:25):
A small incision is made at the side of the device, the inner lumen of the device is removed and the islets are loaded within the inner chamber of the device.

PowerPumper says to (17:25):
man, you’d think a diabetic’s organs would be pre-vascularized already πŸ˜‰ *bad eye joke*

Dr. Cherie Stabler says to (17:25):
πŸ™‚

Lady_Poet says to (17:25):
lol

Dr. Cherie Stabler says to (17:26):
The advantage of developing a BHD is that you can localize immunosuppression treatment to the actual site of the implant.

Dr. Cherie Stabler says to (17:26):
This is one of the major problems with current islet transplantation – the use of
immunsuppressive drugs that supress your entire body.

Lady_Poet says to (17:27):
ok surpress the entire body?

Lady_Poet says to (17:27):
not good right?

Dr. Cherie Stabler says to (17:27):
If we localize the drugs to just the site of the islet implantation, which is where it is needed, then you can use 100th dose or even 1000th of the standard dose.

sstrumello says to Dr. Cherie Stabler (17:28):
Tougher question: given your expertise, do you have any thoughts or feelings about the debate on transplantation vs. islet regeneration?

Dr. Cherie Stabler says to (17:28):
This greatly minimizes side effects and can actually improve the efficacy of islet protection.

Dr. Cherie Stabler says to (17:28):
SStrumello – that is a difficult question. My main thought has always been that you use what works best.

Lady_Poet says to (17:29):
what works best is always a shot of some sort and I am tired of those.

Dr. Cherie Stabler says to (17:29):
However, if you can isolate islets, coat them with biomaterials that mask the immune response and put them in a small device that can be easily implanted within your body in a 10min surgery. I would guess that islet transplantation would be far superior.

Lady_Poet says to (17:29):
my skin is tough from so many injections and tests for so many years.

Lady_Poet says to (17:30):
yeah

Lady_Poet says to (17:30):
thats what Im

Lady_Poet says to (17:30):
talking about

PowerPumper says to (17:30):
So for the non-scientific accountant types like me: in summary you are protecting cells with engineered tissue that lets in the good nutrients but keeps out the bad immuno-sppressive antibodies?

DiabeticDiva says to Dr. Cherie Stabler (17:30):
Any thoughts on Faustman’s latest study with the BCG vaccine?

Dacarsha says to (17:31):
how long before islet transplants are available for the little guy – not just the rich folks

Dr. Cherie Stabler says to (17:31):
PP – basically yes. You allow transport of nutrients and insulin, but you mask all of the surface antigens that basically scream at the immune system “Hey I am not you – attack me”.

Dacarsha says to (17:31):
years or decades?

Dr. Cherie Stabler says to (17:32):
DD – I think the Faustman study is a very interesting approach and I will be watching to see the further studies.

froglady says to Dr. Cherie Stabler (17:33):
Earlier you sounded like you have all the pieces in place to start clinical trials – is that right?

Dr. Cherie Stabler says to (17:33):
Dacarsha – To my knowledge, the development of clinical trial candidates is independent of income. However, if you mean broader applicability, we hope to have that.

Dr. Cherie Stabler says to (17:33):
Our goal is to develop a technology that is not just focused on islets, but could also be applied to other cell types, whether they are stem cells, genetically engineered cells, or cells from other animal sources.

PowerPumper says to (17:34):
do the islets first please! 8-|

Dr. Cherie Stabler says to (17:34):
Froglady – What I meant is that we have all the tools in place to start a clinical trial the minute that we have promising results in larger animals. At this stage, we do not have
that data, but we have the line in place to push it forward.

Dr. Cherie Stabler says to (17:34):
PP πŸ™‚

Dacarsha says to (17:36):
Type 1s first, right?

froglady says to Dr. Cherie Stabler (17:36):
Do you have an estimate of the time frame before you will be ready for clinical trials?

Dr. Cherie Stabler says to (17:36):
That is the unique thing about the DRI – we have an entire institute that is focused on developing a cure. We also have the tools, people, and procedures in place to translate anything promising on the benchtop, to the mouse/rat, to large animals,

Dr. Cherie Stabler says to (17:36):
…and then to the clinic

Dr. Cherie Stabler says to (17:36):
Type 1 is the top priority of the DRI

Dr. Cherie Stabler says to (17:36):
Froglady – I wish I did. The problem with doing something no one has done before is that you have no idea how long it will take.

Dr. Cherie Stabler says to (17:37):
Steps that I predicted would take months have taken days, but steps that I thought would take days have taken weeks.

Florian says to (17:37):
Dr Stabler, do you know what the encapsulation material is that is being used by LCT?

Dr. Cherie Stabler says to (17:37):
Yes. They have published on it.

froglady says to Dr. Cherie Stabler (17:38):
It’s wonderful that you are getting somewhere. We are all praying that you move forward fast!

Carolina says to (17:38):
Sorry I’m late. Are you also encapsulating porcine islets?

Florian says to (17:38):
It seems to be protecting the pig islets

Anthill says to (17:39):
are anti rejecting drugs are used?

Dr. Cherie Stabler says to (17:39):
Yes. I does seem promising. It is based on the standard technique of alginate and a polycation polymer.

Dr. Cherie Stabler says to (17:40):
Anthill – for what study.

Anthill says to (17:40):
transplant

Dr. Cherie Stabler says to (17:40):
Carolina – porcine islets are not our focus at this time. We are focused on human islets,
but porcine islets are a possibility.

Dr. Cherie Stabler says to (17:40):
We will always be faced with the organ shortage problems, so looking for alternative sources of beta cells is critical

Lady_Poet says to (17:41):
eww

Lady_Poet says to (17:41):
lol u mean they might use porky on us?

Carolina says to (17:41):
You think it’s worthwhile pursuing human cadaver islets when there will never be enough for all the people with diabetes?

Dr. Cherie Stabler says to (17:42):
Carolina – Yes in the respect that xenotransplantation (the implantation of cells from different species like pig to human) has tremendous risks.

sstrumello says to Dr. Cherie Stabler (17:42):
You mentioned that your technology that is not just focused on islets, but could also be applied to other cell types. Do you see this as having applicability beyond diabetes, and are your results published so others will have access to the work?

Anthill says to (17:42):
the pork purifed insulin like Protaphane

Dr. Cherie Stabler says to (17:42):
LCT has sought to combat these risks by using very “clean” pigs, but the risk is still there.

froglady says to Dr. Cherie Stabler (17:42):
I am on the DRI website. I want to contribute to your research. The choices for use of the donaton are islet transplantation, Stem Cell, Eliminating Immunosuppression,
Emerging Technologies

Carolina says to (17:42):
Has there been any transmission of PERV from pig to human?

froglady says to Dr. Cherie Stabler (17:43):
Which one is you? Emerging Technologies?

Dr. Cherie Stabler says to (17:43):
SS (I hope you dont mind the shortening). Yes, there is applications to other areas. In the past, I have used the same technology for blood vessel substitutes. We will publish our results soon.

Dr. Cherie Stabler says to (17:43):
Emerging technologies

Florian says to (17:44):
It’s going to take a lot of work, a lot of success, by a lot of researchers to make this all work and available to all the people who need it.

Dr. Cherie Stabler says to (17:44):
Carolina – not to my knowledge. However, the implantation of live porcine cells into humans is extremely limited.

Dr. Cherie Stabler says to (17:45):
The use of porcine proteins (like insulin) or dead tissue (like heart valves) do not carry the same risks of PERV transmission.

Carolina says to (17:45):
I really value your work. I am just particularly afraid of the long term results of immunosuppression

Dr. Cherie Stabler says to (17:45):
Carolina – that is a big focus on our work.

Dr. Cherie Stabler says to (17:46):
We know that the use of high levels of immunosuppressive drugs is not going to be feasible to treat all diabetics.

Carolina says to (17:46):
And it doesn’t look like there are going to be a lot of human islets anytime soon

Dr. Cherie Stabler says to (17:46):
This is why we are focused on developing alternatives: such as nanoencapsulation and localized immunosuppression.

Lady_Poet says to (17:47):
(@)

Dr. Cherie Stabler says to (17:47):
?

Lady_Poet says to (17:48):
sorry meant πŸ™

Lady_Poet says to (17:48):
kind of feeling that no cure in time for me.

Lady_Poet says to (17:48):
Im not getting any younger

Dr. Cherie Stabler says to (17:49):
Carolina – I believe when it is demonstrated that we have a feasible means to cure diabetes using islets cells, the source will increase.

Carolina says to (17:49):
How will the source suddenly increase?

Dr. Cherie Stabler says to (17:49):
Right now, we are not capitalizing on the organs we have, because the technique of islet transplantation is so new.

Dr. Cherie Stabler says to (17:49):
Most pancreas donations are not used because of the lack of places that can perform islet isolation.

sstrumello says to Dr. Cherie Stabler (17:50):
Isn’t the only way to know if PERV is a risk is to do trials?

Dr. Cherie Stabler says to (17:51):
When a viable cure is developed, you can bet that there will be a lot more places that perform islet isolations. I mean, Miami is the only place in the whole state of Florida that
isolates islets.

PowerPumper says to (17:51):
I have to run soon, so tyvm Dr. It’s really encouraging communicating with a front line researcher.

Carolina says to (17:51):
Respectfully, I don’t believe there will ever be enough cadaver pancreas tissue to provide iselts to everyone who has type 1 diabetes in the world

Dr. Cherie Stabler says to (17:51):
PP – thanks for joining in πŸ™‚

Dr. Cherie Stabler says to (17:51):
Carolina – I completely agree with you.

Dr. Cherie Stabler says to (17:51):
That is why we have many researchers working on finding alternative sources for beta cells.

Carolina says to (17:52):
What other sources look promising at the moment?

Dr. Cherie Stabler says to (17:52):
We have researchers working on created beta cells from embryonic stem cells, amniotic fluid, cord blood, etc. or creating beta cells from liver cells.

Dr. Cherie Stabler says to (17:53):
I meant “creating”

froglady says to Dr. Cherie Stabler (17:53):
Everyone, it is really easy to donate to Dr. Stabler’s research:Β https://www.diabetesresearch.org/Donate.aspxΒ pick Emerging Technologies

sstrumello says to (17:53):
Dr. Stabler has done a great job typing and keeping up with everyone, I have to say I’m really impressed!

Carolina says to (17:53):
Are any of them glucose responsive yet? BTW, I’m a long time supporter of the DRIF

Lady_Poet says to (17:53):
well doc time for another shot gotta go ty for your answers.

Dr. Cherie Stabler says to (17:54):
The embryonic stem cell work is very promising. We have two researchers that are taking alternative approachs and both have really made a lto of progress recently.

Dr. Cherie Stabler says to (17:54):
Thanks Carolina πŸ™‚ I know they have some promising cells, but they probably could answer more clearly than I can.

AllisonBlass says to (17:55):
I just want to point out to everyone that it’s coming up on the hour and the official chat is going to end then, so if you have any last minute questions, please get them in now.

Dr. Cherie Stabler says to (17:55):
We are also in collaboration with other researchers, like Dr. Atlala in Wake Forest, who has some promising research using amniotic cells (take from the amniotic fluid of
pregnant woman). We are working to scale-up his promising results and test these…

Dr. Cherie Stabler says to (17:55):
cells in rodents.

kat9rina says to (17:56):
there was a doc from the U of Toronto talking about stem cells. seems like there is one that creates a new neuron. Would a neuron be a good choice as it already has a brain?

Anthill says to (17:56):
are anti rejection drugs are usd in the transplant recpieant

Dr. Cherie Stabler says to (17:57):
πŸ™‚ I am not sure kar9rina. Usually it is easier to get a stem cell to become a neuron than a beta cell, so that is why the research in that areas have been a little more efficient.

kat9rina says to (17:57):
for the stem cells to work best they would have to be connected to the neurological system of the recipient

Dr. Cherie Stabler says to (17:58):
Anthill – we hope to not use anti-rejection drugs when a patient receives an islet transplanta.

sstrumello says to (17:58):
Thank you so much for chatting with us this evening, Dr. Stabler … you did really well in the chatroom and answered so many questions!

Anthill says to (17:58):
WOW!!! πŸ˜€

Carolina says to (17:58):
I wish you continued success with your research.

Dr. Cherie Stabler says to (17:58):
It may be that we will have to use a small dosage at the initial time of transplant – but hopefullly wean off after that.

Dr. Cherie Stabler says to (17:58):
SS and Carolina thank you. It is wonderful to chat with you all.

kat9rina says to (17:58):
Thank you Dr. Stabler, enjoyed learning more about your research

Jeffrey says to (17:58):
thank you for being here tonight Dr. keep up your good work πŸ™‚

Carolina says to (17:58):
Are you still using the edmonton protocol in recipients?

Dr. Cherie Stabler says to (18:00):
Carolina – we are using a modified Edmonton Protocol that has shown a longer patency
in patients. Dr. Alejandro has some wonderful results that should be published very soon.

AllisonBlass says to (18:00):
It’s now 10pm, so I think we should all thank Dr. Stabler for her time and let her get off to bed. It’s getting late here on the East Coast. Dr. Stabler, do you have contact information if anyone has any more questions?

Florian says to (18:00):
Thanks Dr Stabler. Now go back to the lab and please find us a cure.

Anthill says to (18:00):
Yes indeed

sstrumello says to (18:00):
Good night, and thinks again!

Dr. Cherie Stabler says to (18:01):
Thanks. The DRI gives a lot of tours, so come by anytime.

Carolina says to (18:01):
THANKS DTF

Dr. Cherie Stabler says to (18:01):
Thanks Allison. Anyone can contact me via the DRI. They also give tours of the facility, so come by anytime.

Dr. Cherie Stabler says to (18:02):
Florian – can I take the night off πŸ˜‰

Jeffrey says to (18:02):
lol

AllisonBlass says to (18:03):
The chatroom is open for anyone who wants to stay.

Jeffrey says to (18:03):
yes Dr. take the night off, you’ve earned it πŸ™‚

Dr. Cherie Stabler says to (18:03):
Well I better head out. Thanks you guys. It has been fun.