Launch HN: Forever Labs (YC S17) – Stem-Cell Banking

Not something we provide! :)

The decline in functionality begins to be detectable between 20-40, and accelerates with age. This study has a number of measures regarding bone mesenchymal stem cells (which are included in what we collect and store):

https://www.ncbi.nlm.nih.gov/pubmed/18248663

Ideally, we all store at 18. However, my mother just stored at 70. Her mother lived to 93, and two of her aunts over 100. She decided that in 10 years, she might be glad she did. My own cells are 40. I am 42.

Thanks! Here's a small collection of research:

https://foreverlabs.com/blogs/research

Also, here are some recent clinical trials using autologous bone marrow for treatment of heart disease or stroke:

https://clinicaltrials.gov/ct2/show/NCT01716481 https://clinicaltrials.gov/ct2/show/NCT02438306 https://clinicaltrials.gov/ct2/show/NCT01569178 https://clinicaltrials.gov/ct2/show/NCT01652209

Also, searching https://clinicaltrials.gov for 'autologous mesenchymal' will produce many results to peruse.

We currently have enough clients that the annual storage fees paid in more than cover the costs of our repository. We are actively pursuing two options to address this possibility: 1) The cell banking service is a separate entity, and all of us who have banked continue to pay into that entity keeping it funded, even if Forever Labs were to dissolve, and 2) An insurance policy covers long-term storage if Forever Labs dissolves.

All of our cells are banked, as are my wife's and family members. We are addressing this.

That said, your cells remain your own. At any time, we will ship them to another biorepository for $300.

Currently, we only perform collections in the US. We do have clients from other countries that have banked with us. Our biorepository is in MA. Once you've banked with us, we can arrange to have your cells sent anywhere, however.

There are mesenchymal stem cells (MSCs) in dental pulp. I have not studied them myself; however, they are reportedly similar to bone marrow MSCs. We bank all the nucleated cells in the bone marrow for two reasons: 1) there are high numbers of MSCs and hematopoietic stem cells (which build blood and immune cells), as well as endothelial progenitor cells (which build vasculature) and others such as marrow stromal cells, pericytes, etc, and 2) most trials employ bone marrow-derived MSCs. The significantly higher numbers are an advantage from an expansion standpoint, and the diversity of cells for applications. Still, having your young biology from your teeth (as long as the cryopreservation is done properly) is an asset, IMO.

As mentioned above:

>The cell populations are actually quite similar; there are both mesenchymal and hematopoietic stem cells in cord blood and bone marrow. In many ways, our service is 'cord blood banking for adults'. However, unlike a cord blood bank, we are developing potential rejuvenative therapies using these cells.

>A comparison could help others decide and migrate over once their kids are 18.

We have considered this possibility.

One possibility is that you will have your young stem cells for the treatment of age-related disease later in life.

Stroke: https://clinicaltrials.gov/ct2/show/NCT01716481 Congestive heart failure: https://clinicaltrials.gov/ct2/show/NCT00644410

We are interested in using the cells to rejuvenate the decline in the bone marrow itself.

https://www.ncbi.nlm.nih.gov/pubmed/22355586

This is something that we are working on.

The cell populations are actually quite similar; there are both mesenchymal and hematopoietic stem cells in cord blood and bone marrow. In many ways, our service is 'cord blood banking for adults'. However, unlike a cord blood bank, we are developing potential rejuvenative therapies using these cells.

1. There may be few pluripotent cells in what we collect, but the majority of stem cells collected are multipotent (mesenchymal and hematopoietic lineages).

2. We haven't been cryopreserving stem cells for 60 years, so that is impossible to know. However, there is evidence that bone mesenchymal stem cells can be stored for more than 20 years: https://www.ncbi.nlm.nih.gov/pubmed/22280954 In my own experience, I have used cell lines that were stored more than 30 years, and primary cells stored more than a decade. Evidence suggests that the freezing and thawing process have the greatest impact, and that time in liquid nitrogen does not.

3. Once collected, you have a dashboard where you can log in and see/request your cells. We are working on rejuvenation therapies that employ these cells, so such a roadmap might develop should we have success.

4. I would not venture a guess.

It is legal to store them. If you want to expand (grow them to greater numbers) AND use them therapeutically, then you must be part of a clinical trial in the US. Many clinical trials using these cells expand them. I have grown some of my own, but have not used them to any purpose.

I found it to be quite painful for about 10 minutes (the length of the aspiration procedure). Once the procedure is over, I would describe the sensation as "annoying, not particularly painful" for about 48 hours.

A bone marrow biopsy is much more painful than an aspiration, which is what our physicians do. There is variability, but my own experience was a fleeting cramp (3 out of 10), that lasted about 15 seconds. I have been many of our collections, and that's typical. A local anesthetic is used, and mostly what you feel is pressure. You don't see anything, because the draw is on your lower back. Our physicians often prescribe an oral pain killer, and sometimes something to relax you. However, a surprising number of our clients decline both, typically because they want to drive home. The procedure takes about 15 minutes from laying down on your side, to standing up again. You are usually in and out within 1 hour.

The speed of extraction helps determine the intensity. If it's very slow it's a mild sharp pain - difficult to describe otherwise. If it's extracted too quickly that mild sharpness becomes super intense. It's an interesting experience.

I've had an aspiration done. It was mostly just uncomfortable 3/10, with a few moments of pretty sharp pain more like a 6/10. However, those moments were brief and it was totally fine afterwards.

I also turned down some more potent painkillers beforehand, so if I had taken those instead of just the local anesthetic, it likely would have been less unpleasant.

Mild discomfort followed for a few days and within a week or so I had forgotten about it.

We collect 60mL. There are normally about 10-15M nucleated cells recovered per mL of bone marrow. Stem cell counts are typically 0.01% of this (MSCs are about 1000/mL). We bank the cells in multiple chambers (3 larger ones, 5-6 smaller ones) so that you can draw them up multiple times. As they can be greatly expanded, it is our intent that the cells be grown to large numbers and then those portions cryopreserved. As an experiment, I have done this with my mesenchymal stem cells, and now have more outside of me than inside of me. If properly managed, a vast pool of cells could be created to draw upon. It's worth noting that we have gotten much better at expanding these cells over the last decade (decreasing negative effects of expansion). I expect that trend to continue.

I don't know about smoking, but there have been studies showing the positive impact of exercise on stem cell health.

Per our client agreement, they are disposed of unless an arrangement has been made. In some instances, your cells could be useful to someone else (such as an HLA match for bone marrow donation), however for tissue replacement, you are your own best donor due to immune rejection/clearing of allogenic donor cells.

As mentioned elsewhere here:

>>The cell populations are actually quite similar; there are both mesenchymal and hematopoietic stem cells in cord blood and bone marrow. In many ways, our service is 'cord blood banking for adults'. However, unlike a cord blood bank, we are developing potential rejuvenative therapies using these cells.

The use of cord blood stem cells has been dramatically low. I believe that around 1 in 14000 are used. That said, cord blood has long intended to be only used for rare blood cancers.

We see the landscape changing, using such cells for age-related disease, but also for rejuvenation. Given the low historical use, it's little wonder why storage isn't seen as high-priority. Personally, I see the young biology in cord blood as an asset that will grow in value. However, it should be noted that cord blood storage has been found to be of variable quality, it's worth going with a reputable service.

Cost can vary between markets, but it's generally around $2,500 for collection, plus $250/year for cryo-storage. If you don't want to pay for yearly storage, there is a lifetime storage plan for $7,000 which includes collection, and as the name suggests, lifetime storage as well.

Optimal age is addressed here: https://news.ycombinator.com/item?id=15386117

In some cases, that may be possible. We have not explored registry/donation at this time.

Currently, iPS has a high risk of teratoma or malignancy. We haven't yet been able to induce pluripotency in a safe manner. I do believe that it is likely that one day we will overcome this obstacle, however having youthful multipotent cells will remain an advantage then. Age-damage to cells increases the risk of malignancy when inducing stemness.

Edward with FL here.

To answer your question, no. Because our stem cell niche degrades over time, we perceive a strong value of banking to come from the delta between when you banked, and when you employ your younger biology in future applications. The current regulatory environment doesn't change that calculus.

Also, we wouldn't want to expand/grow your sample before freezing anyway. The particulars of the expansion itself could change depending on the application, so we want to preserve them in a state that will afford the broadest range of future use.

Regarding the second half, I'll let Mark jump in when he comes back if he wishes. In the lab, he's had over a decade and half to muse about the regulatory environment. I can tell you that as we see it, we're near the cusp of where cellular therapies begin to transition from the clinic to the marketplace.

The benefits are not hypothetical, but are in the clinical trial phase. Numerous are phase 3, however. That said, this is not a 'save for next week' service. The idea is that your young biology will likely be advantageous, as the decline in your stem cell health is certain.

>Can I fix my knees from my banked wisdom tooth stem cells?

That might be possible, but isn't currently. Most trials for osteoarthritis use mesenchymal stem cells isolated from bone marrow or adipose tissue. It remains to be seen if the FDA approves cells by type or source-specific. Typically, all variables that can be controlled for are, so source-specific cells will probably be the initial requirement.

Thanks!

We do perform QA on samples post-freeze process.

We are working on some uses of these cells for rejuvenation purposes. We will be sharing specifics on that in the coming months. Here are a couple of posts that I made about one experiment:

https://foreverlabs.com/blogs/news/health-maintenance-we-can... https://foreverlabs.com/blogs/news/donating-youth-to-yoursel...

That's an interesting question that is difficult to answer in brief. I believe I covered it a bit in a Google Talk I gave that was posted a couple of days ago:

https://www.youtube.com/watch?v=aSRqd1JfoaI

In short, I see storing your youthful multipotent biology giving you an early onramp on pluripotent stem cell induction, however I am not as optimistic as some. Biology is complex and there are blind spots to intervention. We still struggle with male-pattern baldness.

I can say that we are working on what I would like to see come to fruition. That is, take our younger cells, and rejuvenate the bone marrow niche, using our young bone marrow as bone marrow. In addition to that simple 'heterochronic transplantation', I intend to determine how we can improve upon it. Some realistic avenues are 1) removal of resident senescent cells and 2) rejuvenation of the cells ex vivo prior to reintroduction.