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Chronic kidney disease (CKD) is a progressive fibrosis or hardening of this important organ that can lead to renal failure and death. It currently affects 8 % of Europeans, and 10 % of Australian adults show signs of CKD, such as reduced kidney function and/or albumin in the urine.
More patients than ever rely heavily on kidney dialysis, which can cost up to 80 000 euro a year. While transplantation is more cost-effective, the increasing age and number of people with end-stage renal failure, and shortage of available organs, means dialysis remains vital.
With alternatives limited and costs mounting on healthcare systems, even a small improvement in therapies could make a big difference, as outlined in a cost model study performed by the EU-funded STELLAR project. An international cooperation between high-level academic institutions in Europe and Australia, STELLAR focused attention on an alternative to renal replacement therapy that harnesses the innate repairing abilities of a newly-discovered cell type, called kidney perivascular stromal cells (kPSCs).
Pieces of the puzzle
“STELLAR and the Australian-European collaboration created a number of unique scientific breakthroughs and fascinating economic opportunities which would not have been possible without the input of our Australian partners,” says team leader Ton Rabelink, professor at Leiden University Medical Center in the Netherlands.
By injecting kPSC into the affected kidneys of animal models, the goal was to tackle kidney fibrosis, kick-start tissue repair and, ultimately, restore normal kidney function. And a major piece of the puzzle fell into place with the September 2016 publication in Stem Cells, Translational Medicine of findings describing a clinical grade method to isolate human kidney-derived perivascular stromal cells (hkPSC), the subject of a European Patent (EP151685005).
Progress was also made by Miltneyi Biotec, an SME partner, in developing a medium to culture the cells for clinical application, and a technology for closed-system cell separation. Another SME partner, Scinus Cell Expansion, refined their bioreactor technology for large-scale isolation of kPSC. Altogether, these are promising steps in the quest to find therapeutic candidates for treating CKD that could have great market potential.
Fruitful collaboration pays off
A major strength of the project all along was its 16-partner consortium of heavy hitters combining experts in the field of kidney development, regenerative medicine and kidney pathogenesis from academia, technology SMEs and patient organisations like Kidney Health Australia. The collaboration has had a huge impact on the basic understanding of how kidney fibrosis develops, and provided insight into potential new renal repair therapies – advances that would not have been possible without this international collaboration.
The fruitful ties built in STELLAR have also fostered follow-up international research focused on kidney regeneration, according to Melissa Little, who leads labs at the University of Queensland in Australia and Murdoch Children’s Research Institute. “Indeed, my group has ongoing research activities with Prof. Rabelink in Leiden and strong collaborative links with other STELLAR groups across Europe.”
One such collaboration is a Dutch-Australian initiative, funded by the Dutch Kidney Foundation (RECORDKID), using a scaffold to rebuild a functioning new kidney using a patient’s own primitive cells cultured in a lab. Related work is being carried out in the RegMed cross-border platform, a European regional private-public initiative involving multiple universities in the Netherlands and Belgium.
The partners have also cleverly promoted the project and the important societal impact of the topic though evening debates with kidney patients, TV broadcasts and active Facebook exchanges. A video explaining the new kPSC isolation procedure was produced and published in the journal Visualised Experiments.
“We even got a STELLAR song, called Regenerate, which was composed by Andrea Pittini, a patient with kidney disease, to create awareness of the work performed within the consortium,” says Rabelink.