Sunday 6 December 2015

Scientists debate risks, ethics of editing human DNA




A hot new tool to edit the human genetic code has a big wow factor: the promise of long-sought cures for intractable diseases. But depending on how it's used, that same tool could alter human heredity.

The debate has brought hundreds of scientists and ethicists from 20 countries to a highly unusual, three-day meeting in Washington on the ethics of human gene editing.

"We could be on the cusp of a new era in human history," Nobel laureate David Baltimore of the California Institute of Technology said Tuesday in opening the international summit to examine what he called "deep and disturbing questions."

"The overriding question is when, if ever, would we want to use gene editing to change human inheritance?" he said.

That question gained urgency after Chinese researchers made the first attempt at altering genes in human embryos, a laboratory experiment that didn't work well but did raise the prospect of one day modifying genes in a way that goes far beyond helping one sick person — it also could pass those alterations on to future generations.

"That really does raise the issue of, how do we use this technology in a responsible fashion," said molecular biologist Jennifer Doudna of the University of California, Berkeley, who helped pioneer the most-used gene-editing tool. Her calls for debate on its implications and boundaries led to this week's gathering, a step that could eventually lead to research recommendations.

At issue are tools to precisely edit genes inside living cells, finding specific sections of DNA to slice and repair or replace much like a biological version of cut-and-paste software. There are a few methods but one with the wonky name CRISPR-Cas9 is so fast, cheap and simple for biologists to use that research is booming.

The potential is huge: Scientists are engineering animals with humanlike disorders to unravel the gene defects that fuel them. They're developing treatments for muscular dystrophy, sickle cell disease, cancer and HIV. They're trying to grow transplantable human organs inside pigs. They're even hatching mutant mosquitoes designed to be incapable of spreading malaria, and exploring ways to wipe out invasive species.

One hurdle is safety. While the CRISPR tool is pretty precise, it sometimes cuts the wrong section of DNA. Tuesday, CRISPR pioneer Feng Zhang of the Broad Institute at MIT and Harvard reported Tuesday tweaking the tool's molecular scissors to significantly lower chances of off-target editing errors — an improvement that could have implications both for developing therapies and for germline research.

"The reality is, it will be years until this is turned into some kind of a therapy," Doudna cautioned reporters.

Yet many scientists said it's not too early to consider the biggest ethical quandary, that performing what's called germline editing, manipulating reproductive cells — sperm, eggs or embryos — could spread gene changes to future generations.

In the U.S., germline editing for clinical use — meaning for pregnancy — "is a line that should not be crossed at this time," John Holdren of the White House Office of Science and Technology Policy said Tuesday.

Last spring's experiment in China highlighted that ethics aside, embryo editing wasn't anywhere near ready for real-world use, because those off-target edits risked fixing one problem only to create another.

But there's controversy over whether and how to continue laboratory experiments to see if it eventually could work. And just as fraudulent stem cell clinics already lure desperate patients, there's worry about misuse of gene-editing techniques before they're proven.

Around the world, laws and guidelines vary widely about what germline, or hereditary, research is allowed. Some ban any research; some allow only lab research but not pregnancies; some have no policies. In the U.S., the National Institutes of Health won't fund germline research but private funding is allowed.

What one country attempts "will have consequences in others," the White House's Holdren noted.

It's not just about editing embryos. At the University of Pittsburgh, Dr. Kyle Orwig is exploring treatments for male infertility that could alter sperm-producing cells that don't do their job.

Critics note there are other ways to halt transmission of inherited disease. Already, couples undergo in vitro fertilization and have the resulting embryos tested for the family's problem gene before deciding which to have implanted, noted Marcy Darnovsky of the Center for Genetics and Society advocacy group.

Allowing gene editing for medical reasons would open the door to designer babies with cosmetic changes, too, she added.

"It would alter future human societies, perhaps profoundly so," Darnovsky said Tuesday.

Pre-testing of embryos doesn't solve the problem for all families with devastating rare diseases, said Dr. George Daley of Boston Children's Hospital, recounting families that have dozens of embryos created through IVF to come up with one or two usable ones.

"Is it more ethical to edit embryos, or to screen a lot of embryos and throw them away? I don't know the answer," Doudna said.

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Scientists debate risks, ethics of editing human DNA
Published December 02, 2015
Associated Press

Rapid onset of motor deficits in a mouse model of spinocerebellar ataxia type 6 precedes late cerebellar degeneration



Spinocerebellar ataxia type 6 (SCA6) is an autosomal dominant cerebellar ataxia that has been associated with loss of cerebellar Purkinje cells.

Disease onset is typically midlife, although it can vary widely from late teens to old age in SCA6 patients. 

Our study focused on an SCA6 knock-in mouse model with a hyper-expanded (84X) CAG repeat expansion that displays midlife-onset motor deficits at ∼7 months old, reminiscent of mid-life onset symptoms in SCA6 patients, although a detailed phenotypic analysis of these mice has not yet been reported. Here, we characterize the onset of motor deficits in SCA684Q mice using a battery of behavioral assays to test for impairments in motor coordination, balance, and gait. We found that these mice performed normally on these assays up to and including at 6 months, but motor impairment was detected at 7 months with all motor coordination assays used, suggesting that motor deficits emerge rapidly during a narrow age window in SCA684Q mice. In contrast to what is seen in SCA6 patients, the decrease in motor coordination was observed without alterations in gait. 

No loss of cerebellar Purkinje cells or striatal neurons were observed at 7 months, the age at which motor deficits were first detected, but significant Purkinje cell loss was observed in 2-year-old SCA684Q mice, arguing that Purkinje cell death does not significantly contribute to the early stages of SCA6.

Significance Statement: 


We confirm that disease onset in an 84Q-hyperexpanded polyglutamine mouse model of spinocerebellar ataxia type 6 (SCA6) occurs at 7 months of age, in agreement with a previous study by Watase and colleagues (2008). We characterize disease onset more precisely using a barrage of behavioral tests at multiple ages, and identify that motor coordination abnormalities emerge in a narrow time window between 6 and 7 months, in contrast to the variable age of onset observed in human patients. 

We find that Purkinje cell degeneration occurs in this SCA6 mouse model at 2 years, nearly 1.5 years after the onset of motor deficits, demonstrating that Purkinje cell loss is not necessary for early SCA6 disease symptoms.



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Rapid onset of motor deficits in a mouse model of spinocerebellar ataxia type 6 precedes late cerebellar degeneration, Sriram Jayabal, Lovisa Ljungberg, Thomas Erwes, Alexander Cormier, Sabrina Quilez, Sara El Jaouhari, Alanna J. Watt, eneuro Dec 2015, DOI: 10.1523/ENEURO.0094-15.2015







Wednesday 4 November 2015

Positive interim results from clinical study of Cabaletta in OPMD


On October 27, 2015 BioBlast Pharma Ltd. announced positive interim results from a Phase 2 open label clinical study of Cabaletta®, in 25 patients with oculopharyngeal muscular dystrophy (OPMD).


OPMD



OPMD is a rare progressive muscle-wasting disease characterized by severe swallowing difficulties leading to malnutrition, dehydration, and aspiration of food into the lungs, as well as more generalized, progressive muscle weakness. Aspiration pneumonia and severe emaciation are frequently the cause of death.

Study



The study was designed as a proof-of-concept open-label clinical study in 74 patients for 24 weeks, following which all patients would be randomized into a treatment arm or non-treatment control group, and followed for an additional 12 months in a continuation study. The primary objective was to assess the safety and tolerability of Cabaletta. Secondary endpoints were to determine if Cabaletta improves or prevents worsening of OPMD disease markers.

As previously reported, based on the positive signals seen in the first 25 patients enrolled in Canada and Israel, further recruitment has been terminated, with the aim of beginning a Phase 3 study.

Although unplanned, an analysis was done on clinical data accumulated as of September 1, 2015 on these 25 patients.
  • Cabaletta was observed to be safe and well-tolerated with no drug-related serious adverse events. 
  • Statistically significant improvement or numerical improvement versus baseline, was observed on multiple efficacy endpoints related to dysphagia.
  • Patients showed a statistically significant improvement in their lower extremities muscle strength versus baseline, and showed numerical improvement in other muscle strength and function tests.

"The detailed analysis of the interim results of the Phase 2 Cabaletta therapy trial for OPMD are very encouraging," stated Bernard Brais, MD, M.Phil., PhD, FRCP(C), Professor, Department of Neurology and Neurosurgery and Human Genetics, Faculty of Medicine, McGill University, Co-director Rare Neurological Diseases Group at the Montreal Neurological Institute, and Principal Investigator in the study. "Since OPMD is a chronically progressive muscular dystrophy, we felt it was optimistic to expect more than a stabilization of symptoms. In fact, the data suggest that most participants improved across multiple clinical endpoints with significant swallowing improvements, suggesting that the drug may lead to early benefits. These results are quite promising and I look forward to the confirmation of the results in the planned placebo controlled Phase 3 study which could, for the first time, show rapid and chronic improvement in a late-onset muscular dystrophy."

Cabaletta and SCA3


"The interim results for OPMD, specifically with respect to dysphagia and muscle strength and function, give us insight into the potential of Cabaletta for use in other protein aggregation-related diseases, such as spinocerebellar ataxia type 3 (SCA3 or Machado Joseph disease), another devastating hereditary disease in which we are planning a pivotal Phase 3 study in the U.S. and E.U.," Mr. Foster continued.   

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 Press release BioBlast.       

Tuesday 27 October 2015

What happens if you try to park in a disabled parking space?


More than 30% of the drivers in Russia take disabled parking spaces without caring about the signs on the ground.

Dislife, a Russian non-profit organisation, came up with a powerful campaign to stop this inconsiderate behaviour. They installed projections of a real disabled person that popped up every time a non-disabled driver tried to park in their space. Special cameras verified the presence of the disabled sticker on their windshields and if no sticker was detected, the hologram would appear to confront the driver.

Watch the stunt in action below.




Friday 23 October 2015

Funding for European Spinocerebellar Ataxia Type 3 Disease Initiative (ESMI)


Twenty one research projects have won a total of €35 million (£25.7 million) in a transnational scheme to boost research into neurodegenerative diseases, according to an announcement made by the EU Joint Programme – Neurodegenerative Disease Research (JPND) today. The winning projects will help researchers to better understand, treat and eventually prevent a wide range of debilitating neurodegenerative diseases. Neurodegenerative diseases are one of the toughest medical and economic challenges facing our global community.

The initiative aims to increase coordination of European research efforts in this area and 30 countries currently participate.



European Spinocerebellar Ataxia Type 3 / Machado-Joseph Disease (ESMI)


Coordinator: 


Thomas Klockgether, Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Bonn, Germany.

Partners:


Paola Giunti, University College London (UCL), United Kingdom
Manuela Lima, University of the Azores Ponta Delgada, Portugal
Luis Pereira de Almeida, University of Coimbra, Portugal
Olaf Rieß, University of Tübingen, Germany
Bart P.C. van de Warrenburg, Radboud University Medical Center Nijmegen, Netherlands


Research proposal 



Spinocerebellar ataxia type 3/Machado-Joseph disease (SCA3) is worldwide the most common autosomal dominantly inherited ataxia disorder. Currently, there is no treatment for SCA3. However, as there is an advanced understanding of the molecular mechanisms underlying SCA3, new therapeutic approaches are being developed, and the SCA3 field is entering a phase of intense trial activity. 

To enable interventional trials, availability of large cohorts that consist of preclinical mutation carriers and mildly affected patients is mandatory. For this purpose, the European Spinocerebellar Ataxia Type 3/Machado-Joseph Disease Initiative (ESMI) will set up a trial ready cohort by bringing together 7 European cohorts and 1 US cohort which together comprise approximately 900 subjects. 

The group will integrate the existing data in a common database and apply standardized and quality-controlled clinical assessment, MRI and biobanking protocols. A major part of the initiative will be the development and validation of innovative assessment instruments and disease markers, including a new highly sensitive motor test battery, diffusion-tensor imaging (DTI), automated MRI volumetric evaluation and blood as well as CSF markers based on transcript profiling and disease protein (ataxin-3) measurement. In addition, the impact of lifestyle on disease evolution will be assessed by measuring physical activity with ambulatory sensor-based activity recording and appropriate questionnaires. 

By exploiting the data obtained in this cohort,  a revised model of SCA3 disease evolution will be developed  that conceives the preclinical (pre-ataxia) stage and the ataxia stage as the graded manifestation of one disease process, and that will take lifestyle factors into account. 

The research directly impacts not only on feasibility and design of interventional trials, but also on routine health care because the new instruments, such as automated activity measurement and MRI analysis, can be used in diagnosis and routine management of ataxia patients. The European and national ataxia patient organizations are directly involved in planning and management of this project.  







Monday 19 October 2015

100 Trains. The global charity event of 2016




A series of charity walks, and rolls (for wheelchair users), along the route of a 50,000 km train journey will be organised.

The trains that are included in this journey, are some of the highest, longest and most iconic trains on Earth; passing through some of the most beautiful and wild landscapes on the planet.

The entire, 50,000 km, journey will restart in 2016 - to raise vital funds for Ataxia UK and as a vehicle to raise global awareness of ataxia and to serve as a vehicle to unite ataxia sufferers, supporters and charities worldwide.






How you can be part of this journey


Organizer: "The journey will start on the 23rd of January next year, with a Walk'n'Roll through Hyde Park in London (my 50th birthday & I can't think of a better way of marking the occasion). Everyone, whether a London resident or visitor, ataxia sufferer or not, is invited to join me for a gentle stroll through London's finest park."

The continuation of the journey is being funded, in no small part, by the Friends of 100 Trains - a group of well-wishers (many complete strangers) who wish to be part of this journey (even if simply watching, as the journey unfolds, from the comfort of their very own armchair). ANYONE can become a "Friend" of the journey.

And as a way of thanking "Friends" for their vital support, their websites, Twitter and Facebook pages are listed. Additionally, their Twitter accounts are listed on a dedicated Twitter list at: Friends of 100 Trains.


A bit of history


The original journey, from Scotland to Siberia, was undertaken, and ultimately abandoned in Siberia, in 2013. Over 21,000 km from Glasgow in Scotland, through central and northern Europe, western Russia to Novosibirsk (Siberia).

On reaching Novosibirsk, it became obvious that a previously minor "balance" condition was progressively worsening, and that seeking medical attention might be a wise idea.

So the journey was very reluctantly abandoned, and the initiator returned to Scotland for what would turn out to be 2 years of medical tests.

"On returning to Scotland, it took a never-ending stream of doctors and neurologists almost 2 years to identify the cause of my deteriorating health. And it wasn't good news: I am suffering from a form of ataxia. Late onset Spinocerebellar Ataxia in my case."

"Ataxia? Never heard of it? Neither had I. And we're not alone. Around 91% of the UK population have never heard of it either (one of my aims for this journey, is to put a huge dent in that 91% figure!)."

"So now I will attempt the entire 50,000 km journey again. Only this time, the journey will be done in a number of smaller stages (due to the nature of my ataxia). Plus, I'll be taking part in fundraising walks in many of the cities I pass through - raising vital research funds for ataxia research, and uniting ataxia sufferers and supporters worldwide. "









Investigating a new treatment in SCA14


This study will expand on the previous preliminary results which found a reduction of glutathione
in the cerebellum of people with SCA14. 

Glutathione is an antioxidant that ordinarily protects cells from damage by oxidative stress, thus a reduction in glutathione could be linked to cerebellar degeneration. Oxidative stress occurs when the production of reactive oxygen is greater than the body's ability to detoxify the reactive intermediates. This imbalance leads to oxidative damage to proteins, molecules, and genes within the body. Since the body is incapable of keeping up with the detoxification of the free radicals, the damage continues to spread.
 

Ball-and-stick model of the glutathione molecule


Research


The researchers plan to use a non-invasive technique called MR Spectroscopy to detect changes in the level of the anti-oxidant glutathione in the brain in 12 people with SCA14.

The team at The Charité - University Medicine Berlin want to find a new, more reliable way of specifically measuring the level of glutathione reduction. This could potentially pave the way for a new therapy in the future which targets glutathione reduction. It could also potentially be used to detect for any glutathione reductions in other ataxias in the future. 

For example, a small preliminary study found that the drug N-Acetylcystein could be used to increase glutathione levels in a certain part of the brain in people with Parkinson’s disease. 

Although SCA14 is a rare form of ataxia it might be under-diagnosed as it is not routinely tested for in all hospitals. However, if a treatment were found the need for diagnosis would be even more important.


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The study will be jointly funded by Ataxia UK and the German ataxia charity DHAG.

Dr Sarah Doss and Dr Jan Rinnenthal, The Charité - University Medicine Berlin

Article Ataxia UK