Moving Forward: Advantages and Challenges of Closed-Loop Control for Cell-Based Therapies

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Moving Forward: Advantages and Challenges of Closed-Loop Control for Cell-Based Therapies Guy-Bart Stan Control Engineering Synthetic Biology Group Centre for Synthetic Biology and Innovation Department of Bioengineering Imperial College London g.stan@imperial.ac.uk Funded by EPSRC projects EP/K020781/1 and EP/K020617/1 In vivo integral feedback control for robust synthetic biology

Synthetic Biology = (Control) Engineering Biology Society & Industry Research in my group: Control Engineering Synthetic Biology Systems & Control Engineering control engineering synthetic biology G K Academic Research Synthetic Biology

Improving the Robust Performance of Engineered Cells Goal: Engineer cells that autonomously and reliably perform useful tasks, with applications to biotechnology and cell-based medicine Problem: Depending on the target application, engineered cells must operate in changing and uncertain conditions/contexts Solution: Design of biomolecular feedback control mechanisms that enable robust performance of engineered cells

Examples of Man-Made Systems with Robust Performance Fly-by-wire planes Advanced autonomous robots How is this achieved? Autonomous trains Self-driving cars

Performance Despite Uncertainties and Perturbations reference - measured temp compu-ng actua-ng reference temperature sensing

The Feedback (Closed-Loop) Control Paradigm control error = reference - measured output reference Controller Actuator System output Sensor Feedback Control Paradigm

The Feedback (Closed-Loop) Control Paradigm Cell reference Controller Actuator Extracellular Environment concentra-on Sensor Feedback Control Paradigm

Closed-Loop Control by Engineered Cells Cells that Maintain Homeostasis actuation molecule (drug, vitamin, nutrient) environmental (control) variable response sensing Cell Engineered Control System Goal: Engineer (populations of) cells that autonomously, reliably and safely: Monitor the status of their surrounding environment (diagnosis) Produce, locally and on-demand, specific molecules (treatment) Continuously check and adjust the performance of their action (closed-loop) (automatic correction of error between desired and actual values)

Closed-Loop Control by Engineered Cells Examples TtgR P hcmv +1 Lipid-sensing receptor TtgR TtgR-PPARα pa PPARα LBD O TtgR P hcmvmin Transgene (e.g.pramlintide)pa PPARα P TtgR1 Co-repressor complex LBD Pramlintide Absence of fatty acids HT-1080 Appetite Suppression & Weight Loss Cell microencapsulation Presence of fatty acids TtgR PPARα LBD Co-activator complex Pramlintide Processing Integration Coordination Pramlintide Intraperitoneal injection Implant Fatty acid Obese ob/ob mice Blood Fat Sensor Hyperlipidemia ( ) Input High-fat Diet Cell Therapy to Maintain Uric Acid Homeostasis Cell Therapy for Graves Disease Cell Therapies for Obesity Control Cell Therapy for Psoriasis (Martin Fussenegger, ETH Zurich) Goal: Engineer (populations of) cells that autonomously, reliably and safely: Monitor the status of their surrounding environment (diagnosis) Produce, locally and on-demand, specific molecules (treatment) Continuously check and adjust the performance of their action (closed-loop) (automatic correction of error between desired and actual values)

Closed-Loop Cell-Based Therapies: the Cells Will See You Now Questions: How useful might bacterial cell-based therapies that involve feedback regulation be? For what purposes? How could they be translated into commercially viable medical products that deliver real benefits to patients?

Closed-Loop Cell-based Therapies: Suggested Questions for Discussion 1. How useful might bacterial cell-based therapies that involve feedback regulation be? For what purposes? What are the advantages? What are the disadvantages? Which medical/health conditions might they be most useful for? Why? How does this therapeutic approach compare to other existing or potential approaches? Who should decide and on what basis? 2. How could they be translated into commercially viable medical products that deliver real benefits to patients? Consider: Technical aspects; Regulatory aspects; and Social & economic aspects (including Health Technology Assessments) In each case: What is the current status? What are the hurdles? How could they be addressed? By whom? What is the timescale from prototyping in the lab, to clinical trials, to access to therapies for people who need them?

Closed-Loop Cell-based Therapies: Questions for Clinical Use What are the best indications for the first clinical applications, balancing risk / benefit? How to do preclinical modelling of closed-loop therapies in vitro and animals? How to characterise the pharmacodynamics / pharmacokinetics of closed-loop therapies? How to quality-control the manufacturing of closed-loop therapies? How to monitor the in vivo performance of closed-loop therapies when introduced into patients? How to measure the long-term durability of closed-loop therapies? How to incorporate safeguards or external control over closed-loop therapies? How does this fit into existing regulatory frameworks? Do these make sense? When in the process does environmental risk assessment come into play? How are fecal transplants regulated?