Posts (24)

Fri, Jun 12 11:40am · Who should get COVID-19 testing?

a medical illustration of orange coronavirus with a dark blue background

Dr. Bobbi Pritt, a clinical microbiologist at Mayo Clinic, acknowledges that there seems to be a lot of confusion with the general public when it comes to COVID-19 testing. Terms like viral, molecular, serology and antibodies, and convalescent plasma have sprung up in everyday language when talking about COVID-19 — but do you really need to know all of these terms or is it just causing more confusion? Let’s break it down to what you need to know and why it’s important for you.

Two COVID-19 tests 

Swab test (diagnostic test) — Do you have it?

If you’re experiencing signs and symptoms of COVID-19, like fevers, chills, body aches, trouble breathing, and so on, this test may be recommended to you by your health care provider. It detects the virus responsible for COVID-19. If you test positive for COVID-19 from the swab test, you will be asked to self-isolate to stop the spread of infection. Health officials may also conduct contact tracing to determine whether you may have exposed others to the virus. If so, those who came into contact with you may need to self-isolate. Most people will recover from home safely and will not require hospitalization. However, if you are experiencing troublesome symptoms such as difficulty breathing, call your health care provider.

For those who have tested positive and recovered from COVID-19 a blood test for antibodies is not recommended for everyone at this time.

Blood test (antibodies test or serology test) — Did you have it?

The blood test for antibodies is used to determine how many people in a population have been infected with COVID-19. This test identifies whether you had COVID-19 and have developed some degree of immunity against the virus that could prevent re-infection.  

Another important reason for this test is to identify people who have recovered from COVID-19 and may want to donate plasma to be used to treat other patients with severe COVID-19.

According to Dr. Pritt whether you have COVID-19 or had it, there is no magic test or easy answer when it comes to testing. 

“We don’t know how protective these antibodies are at this time, and how long they last,” says Dr. Pritt. “Therefore, a positive test doesn’t guarantee protection against re-infection with the COVID-19 virus.”

With the stay-at-home order in many communities across the U.S. being lifted, understanding testing and taking preventive measures are more important than ever for you and your community.

What preventive measures should you take to protect yourself and others from COVID-19?

  • Wash your hands often
  • Get tested when you’re sick
  • Maintain social distance
  • Wear a mask
  • Stay home when able
  • Follow state, local, and employer guidelines

Dr. Pritt also emphasizes the importance of following up on your results if you were tested. 

“If you were tested and have not received your results, please reach out to your health care provider by phone or email,” says Dr. Pritt. “Whether your results are positive or negative, it’s important that you know so you can take the right steps in stopping the spread of the virus.”

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Fri, Jun 12 11:37am · Mayo Clinic launches neutralizing antibody test to advance COVID-19 therapies

By Ginger Plumbo

A new COVID-19 antibody test developed by researchers in Mayo Clinic Center for Individualized Medicine and Advanced Diagnostic Laboratory explores whether people gain immunity after being infected, and can fight off the novel virus if it comes back. 

The new SARS-CoV-2 neutralizing antibody test supports the national Expanded Access Program for Convalescent Plasma and other critical research efforts to establish effective therapies and vaccines for COVID-19. The test will be available through Mayo Clinic Laboratories to select labs, blood banks, and biopharma clients in late June.

The new test measures the level of neutralizing antibodies against SARS-CoV-2, the virus that causes COVID-19. Neutralizing antibodies are a subset of antibodies able to independently inactivate viruses, and are associated with protective immunity against re-infection for many infectious pathogens.

“This clinical test for SARS-CoV-2 neutralizing antibodies represents an exciting step that may help us better understand how we respond to infection with the virus that causes COVID-19,” says Richard Weinshilboum, M.D., interim Director-Center for Individualized Medicine. “We are delighted that the partnership between the Mayo Clinic Center for Individualized Medicine and DLMP has helped to support this important step forward in our understanding of the pandemic that we all are facing.”

Related: Who should get COVID-19 testing?

“The neutralizing antibody test is a critical addition to our COVID-19 testing, expanding on the capabilities of the molecular tests used to diagnose active infection and the serology test, which indicates previous infection by identifying antibodies for the SARS-CoV-2 virus,” says William Morice, II, M.D., Ph.D., president of Mayo Clinic Laboratories. “This new test provides us with incredibly important information about how effective a person’s antibodies are at neutralizing the virus. This will help us identify optimal convalescent plasma donors and ultimately help assess the efficacy of anti-SARS-CoV-2 vaccines.”

The neutralizing antibody test provides semi-quantitative detection of total neutralizing antibodies against the SARS-CoV-2 spike glycoprotein in human serum. The surface of the SARS-CoV-2 virus is coated with the spike glycoprotein, which binds to receptor proteins on the surface of healthy cells, leading to viral entry and infection throughout the body. Following infection, most individuals will develop an immune response to the virus, including the production of neutralizing antibodies against the SARS-CoV-2 spike glycoprotein. These antibodies can prevent future infection by blocking the binding activity of the spike glycoprotein. At this time, it is unknown for how long neutralizing antibodies persist following infection and what level of neutralizing antibodies are necessary to confer protective immunity.

The SARS-CoV-2 neutralizing antibody test should not be used to diagnose SARS-CoV-2 infection. The test should only be ordered upon confirmation of prior infection by molecular and/or serological studies using clinically validated assays with high clinical specificity.

“It is important to note that the neutralizing antibody test is not a replacement for the existing serology testing for COVID-19, which detects antibodies that recognize the virus and serves as an indicator of current or prior infection,” says John Mills, Ph.D., co-director of the Mayo Clinic Neuroimmunology Laboratory. “However, the existing serology tests do not directly assess the virus-neutralizing capacity of those antibodies. The neutralizing antibody test adds that next level of detail for researchers and clinicians by providing an accurate estimate of SARS-CoV-2 neutralizing activity.”

This new test was developed and clinically-validated at Mayo Clinic with support of Vyriad, Inc.Regeneron, and Imanis Life Sciences. This was made possible through a significant COVID-19 innovation initiative of the Mayo Clinic Department of Laboratory Medicine and Pathology and the Mayo Clinic Center for Individualized Medicine.

“The co-development of this neutralizing antibody assay in record time (two months!) is really a testament to the dedication and teamwork of countless individuals at Mayo Clinic, Vyriad,  Regeneron, and Imanis Life Sciences,” says Elitza Theel, Ph.D., director of Mayo Clinic’s Infectious Diseases Serology Laboratory. “These teams have been devoted to advancing the science and expanding our available laboratory testing capabilities, which will ultimately lead to a better understanding of our immune response to this virus.”

The test was made possible by a multi-organization collaboration, each bringing unique expertise and technology to the effort. The basis of the new test is the IMMUNO-COV™ neutralizing antibody test developed by Vyriad. A license was granted from Regeneron.

“The development of this scalable neutralizing antibody assay was the result of an extraordinary and highly integrated collaborative effort between scientific teams at four companies: Imanis Life Sciences, Vyriad, Mayo Clinic, and Regeneron,” said Stephen Russell, M.D., Ph.D., chief executive officer of Vyriad. “We believe that the launching of the test at Mayo Clinic Laboratories fills a critical gap in the serology testing landscape and represents a significant milestone in the fight against COVID-19.”

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Fri, Feb 28 9:00am · Rare diseases are not rare

By Sara Tiner

Across the world, an estimated 300 million people live with one or more of over 7,000 identified rare diseases. For them, their family, friends and team of caregivers, Rare Disease Day, on this rarest day of the year, is a time to bring awareness to this community.

Due to the broad diversity of disorders and relatively common symptoms, which can hide underlying rare diseases, many patients with rare disorders are initially misdiagnosed. In addition, symptoms differ not only from disease to disease, but also from patient to patient suffering from the same rare disorder.

Mayo Clinic was the first in the U.S. to establish a multidisciplinary, individualized medicine clinic to treat patients with rare and undiagnosed diseases and advanced cancers.  Many patients who have a genetic based disorder and unexplained conditions search an average of 8-10 years for answers. At Mayo Clinic, specialists in individualized medicine have been able to make a diagnosis in 30% of the cases. The rest are reviewed through DNA test results and compared with similar cases worldwide.

“Rare is not rare to us. Mayo Clinic has over 3,800 researchers who relentlessly pursue discoveries that will deliver hope and better health to people today and for generations to come,” says Konstantinos Lazaridis, M.D., Mayo consultant, Department of Gastroenterology and Hepatology and Medical Genetics.

Dr. Konstantinos Lazaridis

The following stories cover the broad diversity of disorders and symptoms that vary from patient to patient, and the common challenges faced by people managing a disease few others have experienced.

Diagnosed with multiple sclerosis (MS), Maureen Jessen, always wondered why the disease affected her so differently than it did others. Doctor after doctor told her that MS was likely causing her symptoms, so she believed them. Mayo Clinic specialists, however, gave Maureen new insight into her illness — one that had nothing to do with MS. Maureen actually has a rare, genetic metabolic disorder. Read her story at Sharing Mayo Clinic.

After three generations in one family suffered from a rare bleeding disorder, a genetic test solved the mystery leading to a correct diagnosis and a treatment plan. This case spurred the launch of the first of its kind Mayo Clinic Premyeloid and Bone Marrow Failure Disorder Clinic, meeting the needs of patients with blood disorders. Read the rest of the story on the Center for Individualized Medicine blog.

One of the basic building blocks of understanding disease is epidemiologic research. In this science, researchers seek to understand how often a condition occurs in a particular population, and to identify successful ways to treat or prevent disease. In a study published in 20-19, a team of Mayo Clinic researchers led by rheumatologist Ali Duarte-Garcia, M.D., described the epidemiology of antiphospholipid syndrome. This is the first ever publication characterizing this disease – the newest building block in understanding this rare disease. Read the full story on Advancing the Science.

Nick Saleum felt a painless lump in his left forearm. One doctor misdiagnosed the lump as a ganglion cyst or lipoma, but Nick noticed the lump growing and went to see another doctor. A biopsy revealed a rare, cancerous tumor: epithelioid sarcoma. Read Nick’s story at Sharing Mayo Clinic blog.

A Mayo researcher used her detective skills to collaborate with other researchers worldwide to find answers for a young boy suffering from an extremely rare disorder that was causing rapid loss of liver function. Read about the mystery on the CIM blog.

Discovery researchers at Mayo are investigating how a cellular “antenna,” or cilium, determines what stem cells differentiate into: muscle, connective tissue, or bones. The knowledge will help understand many degeneration diseases that currently have no treatment or cure. Read more about recently funded discovery science efforts on the Advancing the Science blog.

Morgan Cook was an active and healthy 27-year-old until she started experiencing symptoms of decreased energy levels, low blood counts, and hyperextensible joints (capacity to be stretched to a greater than normal degree). She thought it was all in her head until a Mayo physician dug deeper to uncover the cause of her premature aging syndrome. With a correct diagnosis of short telomeres syndrome, Cook is relieved to have a diagnosis. With patience, monitoring, and hope, she’s on the right path to manager her condition. Read the full story on the CIM blog.

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Tue, Jan 21 6:00am · Patient's premature aging symptoms tied to shorter DNA strands

At only 27-years-old, Morgan Cook recalls the days when she had an abundant amount of energy.

“I would lift weights. I would do cardio. I would – you name it, I would do it. I was a lot more active,” says Cook. “I felt like I was able to do more things with friends. I was able to keep up with anything and everything that was thrown at me, and I didn’t really have an issue with energy.”

Today, Cook is in the midst of accepting her new normal after being diagnosed with short telomeres syndrome.

According to her Mayo Clinic physician, Mrinal Patniak, M.B.B.S., short telomeres are regions present at the end of the DNA that help protect the DNA from premature shortening.

“Every time our cells divide, there is a potential for the DNA to shorten, and premature shortening could lead to cell death or defective repair,” says Dr. Patnaik. “This is most applicable to stem cells in the body. If they don’t have the telomerase apparatus, you’ll find that there is a premature shortening, cell death, and essentially, it leads to a premature aging symptoms.”

In Cook’s case, she had all of the classic symptoms of short telomeres ailments—decreased energy levels,  low blood counts, and hyperextensible joints (capacity to be stretched to a greater than normal degree).

Cook’s health journey started with a visit to her primary physician in Iowa who ran some tests and noticed her white blood cell counts were really low, even though Cook was feeling fine at the time. Her physician referred Cook to Mayo Clinic’s hematology department to uncover the cause of the low blood counts.

Dr. Patnaik, a specialist in blood disorders, invited Cook to participate in a study to examine several potential causes for her condition and to see multiple areas where it could be causing issues with her low blood count. As part of the study Cook underwent genetic testing, which revealed that she had short telomeres syndrome.

Diagnosis provides relief, plan for the future

Mrinal Patnaik, M.B.B.S.

“Once Mayo figured out the diagnosis it was a huge relief. It made me feel like this is real. It’s not just in my head,” says Cook. “It may take a while to explain it because it’s pretty rare, but it’s something tangible.”

Today she takes weekly shots that help build up her white blood cell counts so she doesn’t get as sick as easily. “Every day is kind of different. I don’t have a great predicting tool to see how I’m going to do. Sometimes my energy’s fantastic and other times I hit a low point,” says Cook.

With the diagnosis in hand Cook took a realistic look at her life and what she is able to do. Although physically she doesn’t have the energy to work full time she is able to continue her passion for physical fitness by coaching others with their fitness goals.  

Another area of concern with this diagnosis was family planning. Dr. Patnaik referred Cook to a fertility specialist who discovered that the genetic mutation that causes short telomeres syndrome is dominant, meaning her child would have a 50% chance of having short telomeres syndrome too. According to Cook having this information is critical for her and her husband as they plan for the future and decide whether or not to have children.

Patience, monitoring, and hope

Cook admits it’s
still a hard game of patience as Dr. Patnaik continues to monitor her symptoms.

“It’s hard on the
psyche. It’s hard to know what may happen in a year or two years or three
years, but having the comfort and the knowledge from Mayo Clinic and knowing
I’m taken care of at all times is very awesome,” says Cook.

According to Dr. Patnaik the ultimate fix for Cook’s immune system would be a bone marrow transplant. Dr. Patnaik acknowledges that Cook still has a lot to endure as she looks at her future in managing this disease— from the timing of a bone marrow transplant to finding the optimal donor. 

Hope sprung up quickly for Cook when her sister was tested for the same gene mutation. Her sister tested negative for the gene mutation and turned out to be a good match as a bone marrow donor.

“We are extremely blessed in that aspect and it gives us a ton of hope because my sister’s healthy. She’s here. She is willing,” says Cook. “So we kid around that after the transplant, I’m going to owe her because she gave me some pretty good bone marrow, but it’s just an inside joke with the family. She’d do it in a heartbeat because she cares.”

Dr. Patnaik is also optimistic about exciting clinical trials underway and drugs that may come up for short telomeres syndromes. “We hope to provide them to hundreds of people like her who are yearning for this kind of multidisciplinary care,” says Dr. Patnaik.

Dr. Patnaik also connected Cook with a nonprofit support group for others who have short telomeres syndrome.  “It’s amazing now that I can ask questions when I need to through that group as well.  And without that, I think it would be really hard,” says Cook.

Cook looks forward to a day when she will be much stronger, more active and able to get back to her former self. “I feel like I’m on that right path and then as the years go by, we’ll know how to handle each new thing that arises,” says Cook.

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Thu, Jan 9 8:20am · Mayo Clinic to sequence 100K participants to build genomic database for improved care and research in collaboration with Helix

Mayo Clinic is creating a library of genomic sequencing data on 100,000 consented Mayo Clinic participants to advance research and patient care.

“We believe that whole exome sequencing has the potential to reveal predispositions to health problems and enable earlier use of preventive measures throughout a person’s lifespan,” says  Keith Stewart, M.B., Ch.B., Carlson and Nelson Endowed director, Mayo Clinic Center for Individualized Medicine.

Mayo is collaborating with Helix, a population genomics company. Helix’s clinical Exome+ä sequencing is a technology that reads all 20,000 genes that code for proteins, plus hundreds of thousands of regions outside the protein-coding regions that are known to be informative, and thus have the most impact on an individual’s health. This comprehensive DNA test uses Next Generation Sequencing technology to screen the exome for genetic variants that can significantly increase the risk for disease.

Dr. Keith Stewart

Participants’ DNA will undergo Exome+ sequencing with results returned over time to the participant, as well as their Mayo Clinic provider. This will allow Mayo to evaluate the benefits of Exome+ sequencing and the short- and long-term impact on health-related outcomes, health care utilization and physician acceptance.

For the initial part of the study, known as Tapestry, participants will receive results of screening for three highly actionable hereditary conditions that often go unrecognized, including familial hypercholesterolemia (FH), hereditary breast and ovarian cancer (BRCA1 and BRCA2), and Lynch syndrome, a form of hereditary colorectal cancer.

“Many individuals affected by these conditions are not aware they are at risk, but genetic screening can lead to diagnoses for individuals and their families,” says Konstantinos Lazaridis, M.D., associate director, Mayo Clinic Center for Individualized Medicine and principal investigator of the Tapestry study.

“We agree that Exome+ sequencing has the potential to impact health-related outcomes for many individuals. We look forward to working with Mayo to accelerate the integration of genomics into standard patient care and drive novel genetic discovery,” says Marc Stapley, Helix CEO.

Disclosure: Mayo Clinic has a financial interest in Helix.

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Dec 16, 2019 · Mayo Clinic researchers look at post menopause as key factor in endometrial cancer

Mayo Clinic researchers have identified a microbiome signature associated with endometrial cancer, which is in part promoted by post menopause. In a study, supported by Mayo Clinic Center for Individualized Medicine and published in Scientific Reports, researchers sought to understand how endometrial cancer risk factors alter the reproductive tract microbiome and endometrial cancer risk.

“If the microbiome does play a role in endometrial cancer, beyond being a marker for it, this could have important implications for endometrial cancer prevention,” says Marina Walther-Antonio, Ph.D., lead author of the Mayo Clinic study.

Endometrial cancer is the most common gynecological malignancy in the U.S. and the fourth most common cancer among women. In addition, endometrial cancer incidence rates are on the rise in the western world, suggesting that alterations in environmental factors such as diet, lifestyle, and the vaginal microbiome may be important drivers in its cause.

Read more…

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Oct 21, 2019 · What men need to know about breast cancer risk

Male breast cancer is a rare disease, comprising 1% of all breast cancers, but the number of men diagnosed is on the rise.

“And there is an increasing appreciation of differences in the tumor biology of female breast cancer versus male breast cancer,” says Siddhartha Yadav, M.D., co-author of a Mayo Clinic study published in the journal Cancer.

“In this study, we looked at how male breast cancer has been treated in the 21st century, as there is limited understanding of treatment patterns and prognostic factors,” Dr. Yadav explains. “There is a need for studies focused on this unique population.”

According to Dr. Yadav, in many ways, male breast cancer resembles female breast cancer, but there are important differences:

  • Male breast cancer tends to present at an older age, with more frequent lymph node metastases and a higher percentage of estrogen receptor–positive (ER+) tumors compared with female breast cancer.
  • Inherited risk factors for male breast cancer also are slightly different. In contrast to female breast cancer, male breast cancer is more likely to occur within the setting of a BRCA2 mutation rather than BRCA1 mutation.
  • In addition, lower levels of male sex hormones, particularly testosterone) is a known risk factor for male breast cancer

In the last 20 years, there has been significant progress in the local and systemic management of female breast cancer, but it is unclear whether these advances have been applied to the management of male breast cancer.

“In this study, we looked at how male breast cancer has been treated in the 21st century, as there is limited understanding of treatment patterns and prognostic factors. There is a need for studies focused on this unique population.”

Siddhartha Yadav, M.D.

Researchers identified several factors associated with better overall survival in male breast cancer including, residing in a higher income area, having progesterone receptor–positive tumors, and receiving chemotherapy, radiotherapy, and endocrine therapy. In addition, they demonstrated that the treatment of male breast cancer has evolved over the past decade, with increases in the rates of total mastectomy, radiotherapy after breast conserving surgery, ordering of Oncotype DX testing to estimate the likelihood of disease recurrence, and the use of hormonal therapy.

“The results of the current study highlight unique practice patterns and factors associated with prognosis in patients with male breast cancer, furthering understanding of the treatment and prognosis of male breast cancer and identifying unanswered questions for future research,” says Dr. Yadav.

What men need to know about hereditary breast cancer risk

Genetic testing can play an important role in the care of men with breast cancer. A recent study suggested that up to 18% of men with breast cancer have an inherited gene mutation. The National Comprehensive Cancer Network recommends offering genetic testing to all men with a personal history of breast cancer.

Inherited or hereditary cancer risk is caused by a gene mutation that is passed down from parents to children. A mutation is a change in a gene that causes the gene to not work correctly. Two genes commonly linked with an increased risk for male breast cancer are BRCA1 and BRCA2. Different cancers, affecting both men and women, are also linked to mutations in these genes, including breast, ovarian, and prostate cancer. These mutations may be passed down to children. Other family members, including parents, siblings, and more distant relatives may also be at risk.

“If a man has a family or personal history of male breast cancer, a family history of breast or ovarian cancer, especially at younger ages, is of Ashkenazi or Jewish descent, or has a known family history of BRCA1 or BRCA 2 mutation, we would encourage him to talk to a provider or a genetic counselor to see if genetic testing is right for him,” says Sarah Kroc, a Mayo Clinic genetic counselor, in the Department of Clinical Genomics.

“As more high-risk men undergo genetic testing, more will be learned about inherited cancers in men. Knowing this information may help improve decision making about cancer prevention, detection and treatment options, both for patients and their families.”

Sarah Kroc

Kroc acknowledges that estimating a person’s cancer risk is complex.

“As more high-risk men undergo genetic testing, more will be learned about inherited cancers in men,” says Kroc. “Knowing this information may help improve decision making about cancer prevention, detection and treatment options, both for patients and their families.”

Learn more about BRCA mutations and hereditary cancers in men at: Mayoclinic.org and National Cancer Institute – cancer.gov.

Inherited genetic mutations can play a major role in some cancers. Watch this Video Q&A About Cancer & Genomics  featuring Jewel Samadder, M.D., oncology nurse Kelli Fee-Schroeder and genetic counselor Maggie Klint from Mayo Clinic.

Watch this Mayo Clinic Minute on male breast cancer.

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Oct 15, 2019 · Mayo researcher secures NIH grant to advance care of rare disease

Eva Morava-Kozicz, M.D., Ph.D. received a $5 million grant from the National Institutes of Health to study frontiers in congenital disorders of glycosylation (CDG). These disorders often cause serious, sometimes fatal, malfunction of several different organ systems in affected infants.

“This grant will allow us to leverage cross-disciplinary, team-based clinical science to address decades of unresolved questions, increase clinical trial readiness, advance and share knowledge, develop treatment, and meet unmet patient needs,” says Dr. Morava-Kozicz.

Dr. Morava-Kozicz conducts translational research in congenital disorders of glycosylation and mitochondrial disorders and is actively involved in developing dietary therapies in genetic disorders. In addition to her roles as a pediatrician, geneticist and metabolic specialist, she has decades of experience in the diagnostics, follow-up and treatment in inborn errors of metabolism, especially congenital disorders of glycosylation and in mitochondrial disorders.

As principal investigator of the multicenter study on the natural history of congenital disorders of glycosylation, Dr. Morava-Kozicz knows first-hand what gaps need to be addressed.

In response to this need Dr. Morava-Kozicz established a nation-wide network of 10 regional centers to:  

  • Define the natural history, validate patient reported outcomes and share CDG knowledge
  • Develop and validate new biochemical diagnostic techniques and therapeutic biomarkers to increase clinical trial readiness
  • Evaluate whether dietary treatments restore appropriate glycosylation to improve clinical symptoms and quality of life

The grant supports the new Frontiers in Congenital Disorders of Glycosylation consortia, through the Rare Diseases Clinical Research Network (RDCRN), aimed at fostering collaborative research among scientists to better understand how rare diseases progress and to develop improved approaches for diagnosis and treatment.

Congenital disorders of glycosylation are a group of over 150 inherited metabolic disorders affecting several steps of the pathway involved in the glycosylation of proteins. They typically present as multi-systemic disorders with a broad clinical spectrum including, but not limited to, developmental delay, an abnormally low level of muscle tone, abnormal magnetic resonance imaging findings, skin manifestations, and hemorrhaging or clotting disorders. Neurological abnormalities may also be present. There is considerable variation in the severity of this group of diseases ranging from a mild presentation in adults to severe multi-organ dysfunctions causing infantile death.

An important focus of the award is on clinical trial readiness. In order to be prepared to conduct clinical trials the consortia needs to have strong natural history studies that show how the disease progresses. This will lead to ways to measure outcomes of treatments and biomarker studies that provide indicators of how a drug is working in patients.

Collaboration is key. The consortium includes numerous partner research teams from different sites, along with rare disease patients and advocacy groups as research partners. Scientists from different institutions will come together to share patients, data, experience and resources.

Investigator partners include Children Hospital of Philadelphia, Seattle Children’s and Sanford Burnham Prebys Medical Discovery Institute.

Co-investigators include Baylor College of Medicine; Boston Children’s Hospital; Children’s Hospital of Colorado; Children’s Hospital of Pittsburgh at the University of Pittsburgh Medical Center; National Human Genome Institute; Seattle Children’s Hospital; Tulane University Medical School; University of Alabama; University of Colorado, University of Minnesota Masonic Children’s Hospital; and University of Utah.

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