“An awesome responsibility”: A conversation with CIRM board member Kim Barrett

Written by Holly Alyssa MacCormick

It's not every day that you get to contribute to something that could help save a life, but when Kim Barrett joined the board of the California Institute for Regenerative Medicine (CIRM), that's exactly what happened.

Barrett is a research physiologist. For 36 years she studied the cells of the human gut, specializing in digestive disorders as Distinguished Professor of Medicine at the University of California, San Diego (UCSD).

2021 was an especially busy time, Barrett said. She was completing her second year as rotating director of the Division of Graduate Education in the Education and Human Resources Directorate at the National Science Foundation while maintaining her faculty appointment and research lab at UCSD. Then, out of the blue, she was contacted by Allison Brashear, the (then) dean of the School of Medicine at the University of California at Davis (UCD) and the representative for UCD on CIRM's board.

Brashear offered Barrett the role as Vice Dean for Research for their School of Medicine, and when Brashear left UCD shortly thereafter to accept a promotion, Barrett was asked to take Brashear's place on the board. Barrett said she was familiar with CIRM from her time at UCSD, which has a strong tradition of stem cell education and research.

"One of the big triumphs for UCSD was partnering with other San Diego institutions to create a stem cell building that was financed in part with CIRM support," Barrett said.

CIRM was the first taxpayer-funded agency in the U.S. dedicated to accelerating regenerative medicine research, specifically with the goal of developing new therapies. As part of its mission, CIRM funds research, education, and training programs to foster future regenerative medicine therapies, and it prioritizes access to those therapies for all people living in California. CIRM was founded by Proposition 71 in 2004-a time when stem cell research was not supported at the federal level-and augmented by Proposition 14 in 2020.

"For a state agency to step in when the federal government was not supporting that sort of research was extraordinary, and it's one of the amazing things about California," Barrett said.

Barrett began serving as a board member for CIRM in December 2021. She quickly learned the ropes and got to know the California-based patient advocates, research and biotechnology industry leaders, nurses, and university and institution representatives on the board. "I was very honored to have that opportunity, not only to represent the University of California at Davis, but to get involved with CIRM's board," said Barrett. "It's really an awesome responsibility to have the opportunity to guide strategy for research spending."

Walking, healthy toddlers

One of the studies that CIRM helped fund in 2021 was a first-of-its-kind trial of a stem cell therapy for babies with spina bifida. The project, called the CuRe Trial, is led by Diana Farmer, surgeon-in-chief at the children's hospital at UCD and chief of pediatric surgery at Shriners Children's Northern California-the university Barrett represents as a CIRM board member.

"Of course I'm pleased that this work is ongoing at UCD. I've also been really impressed with the care and attention that is paid to avoiding conflicts of interest at CIRM," Barrett said. "A significant portion of the board are people representing the institutions that can benefit from funding, so the foundational work that was done to ensure that conflicts of interest would not enter the decision-making process was really time well spent."

Spina bifida is a birth defect that affects spinal cord development and closure during development. In severe forms, a portion of spinal cord or nearby nerves may bulge out through an opening in the spine. This is linked to changes in brain structure, leg weakness, and bladder and bowel dysfunction.

"The first trial with six babies was just to establish safety, but those babies are now walking, healthy toddlers. They could have been severely disabled for their entire life if they had not been treated and likely would have had shortened lifespans," Barrett said.

Since then, CIRM has funded additional phases of the CuRe Trial to help accelerate development of this therapy and fully establish its effectiveness.

"One thing the public doesn't realize is just how long it takes to bring a successful treatment to the market," Barrett explained. "I sometimes hear comments that no cures have emerged from CIRM-funded work. That simply isn't true, not only are cures on the way some are already here in the form of clinical trials."

Building the scientific pipeline

Many scientific studies that don't immediately result in a new therapy or cure are actually essential because they pave the way for breakthroughs down the line. For example, the CuRe Trial was made possible by previous research that tested the proposed therapy for humans on spina bifida birth defects that occur naturally in English bulldogs, Barrett said.

"Those dogs benefited from this treatment, and the larger trial is also showing great successes," Barret said. "I firmly believe that without a robust basic science pipeline, those discoveries that could get translated into cures can't happen, and we ignore that at our peril. I've seen international funding agencies that now only fund late-stage translational work and clinical work. And they lose their seed corn, they lose the possibility for things that we can't predict as potential cures right now."

Avoiding pitfalls like this is one of the challenges that face CIRM board members.

"Being a CIRM board member is a big responsibility, but the decision-making process doesn't happen in isolation," Barrett said. "It rests on an incredibly robust peer review system with the best experts that the agency can find, giving their recommendations on what's the best science to fund."

Bringing together a diverse group of people, like CIRM's board, can yield more effective and creative solutions to problems than a group of people from shared backgrounds with similar experiences, Barrett said. "We need that diversity to bring the best solutions for the most pressing problems."

For Barrett, being able to bring her unique skills and expertise to the CIRM board is particularly meaningful.

"We have an amazing board with a wonderful variety of backgrounds and experiences," Barrett said. "They are smart, dedicated people who give their time for this organization. It is so inspiring to feel that I am part of an institute that is making this wonderful contribution."