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Wednesday, July 25, 2012

Recap of MPS symposium, Netherlands. By: Raquel

 
The 12th International Symposium of Mucopolysaccharidoses and Related Diseases took place between June 28th and July 1st 2012 in the Netherlands. By: Raquel Marques of Portugal

The conference was intense and productive. We used our free time to have private meetings and informal conversations with some researchers: Graciana Diez-Roux/Andrea Ballabio (Italy), John Hopwood / Kim Hemsley (Astralia), Gregourz Wegryzn (Poland), Brian Bigger (UK), Alexey Pshezhetsky (Canada), Jerome Ausseil (France) and make an update on research. 

To the researchers was also very important to meet us as well as our children. They feel how important are they to us. They stop seeing cell lines only, and start to see people too. John Hopwood, during our private meeting, finally got his own camera and took a picture of our group of Sanfilippo parents!

We devoured information. Our heads were spinning! Strong emotions, as always. I laughed and cried!
Seeing all the families around us , with some severe affected children, always give me a bitter / sweet feeling. Beautiful love stories , that sometimes carry me to an unknown future…

For MPSIII, was very encouraging to see how science is changing and how many progresses were made in genetic disorders. In the last couple of years, three types of treatments for MPS disorders were arisen and so many others are close. Seeing so many routes on research for MPS III and so many people around the subject, made me motivated. To go on!

Here are a few of my notes, most related to Sanfilippo:
- Brian Bigger
Everything is ready for a clinical trial with pure synthetic genistein in Manchester, UK. If they could get funded now, they could start tomorrow. The problem is that there are still 580.000 pounds missing and it is becoming really difficult to get this funding. As parents, we promoted several approaches amongst the Polish, the British and the Dutch to try to get an understanding and collaboration and finding a solution for the funding that is missing.
The principal investigator of the trial will be Simon Jones (Manchester).

B. Bigger also explained his project on pre-clinical studies of lentiviral haematopoietic stem cells transplant in MPSIIIA mice and the success on the results. Before proceeding to clinical trial, further studies are needed regarding toxicity. Brian Bigger will test the same therapeutic approach for type B.

- Alexey Pshezhetsky/ Brian Bigger – gene therapy (type C)
A new post doc was hired to work on the project, starting next September in Manchester. The rats were characterized in Canada, are considered good models and traveled to the United Kingdom.
At the moment, the type C colony C is prepared in Manchester. They already have the vectors that are going to be used. Within six months (starting from September), so by March, the plan is to inject the mice with the gene. Fingers crossed it will work!
Moreover Alexey Pshezhetsky has shown in its presentation that type C is slower to progress, compared to A and B, due to less accumulation of heparan sulfate.

- Graciana Diez-Roux / Andrea Ballabio
As in Geneva, Graciana came and spoke with our group, this time with Andrea Ballabio.
Ballabio explained the work that is being developed with the TFEB. He found that there is a 'master' gene that controls all functions of the lysosome, once it’s activated, promotes cellular clearance. This has been demonstrated both in vitro and in vivo, in animal models of various lysosomal diseases, including MPS IIIA mice.
He said this approach is a very promising therapy, but still in early stages, because they have to figure out the next phase, where does the eliminated material goes? To the bloodstream, urine? They have to find out ...
Moreover, in TIGEM’s lab, they were sponsored by BioMarin that bought a huge 'screening' machine, to find molecules that can activate the TFEB. At this time, they have screened 1500 molecules and had 150 hits. This is the first step, because from this 150, some can be used and some cannot. For example, if a molecule enables TFEB, but if kills cells around, it doesn’t fit. So the hits that they’re getting, are being subjected to various tests: activation, toxicity, etc ...
Ballabio used to work as a pediatrician, is a very sensitive person and passionated with his job. He chose investigating LSD’s because he wanted to help somehow families with affected children, that he was following as a doctor, some years ago.

- John Hopwood / Kim Hemsley –Australia group
They were very kind and made us an update on the project that TeamSanfilippo / StopSanfilippo started funding in February. They are studying pathology in Sanfilippo, what happens in the brain, can damage be reversible, what is the percentage on the production of new cells, are new cells healthy, etc ...
The project is moving fast. They concluded cells staining and are now studying cells movements. Marioko (the Phd student) took pictures of each stage of the project, showing all the specialized equipment used to cut parts of the brain slices (like salami), how it is weighted, etc..

Tracking cells will allow to know: how many cells are produced, what path they take, how they divide, if the new generation of cells are healthy, what kind of cells are created....

Now that they have stained cells, will try to get answers to all questions. The stained cells are growing in cultures. Let's wait...

- L. Calogera Simonaro – Monte Sinai school Medicine USA
With her presentation "Activation of the TLR4 pathway in the MPS: potentials for therapy"
Dr Simonaro demonstrated that the use of a molecule that is both FDA and EMA approved, polysulfat pentosan (PPS), had excellent results in MPS VI rats (bones and muscles) - the before and after videos had huge differences!  PPS reduces the inflammation in the cells, reducing the severity of physical symptoms. MPS VI does not have neurological involvement like MPSIII.
We spoke with her, and she told us she was open to test the compound in MPS III mice, to see if the PPS can cross the BBB.

- F. Wijburg, G. Ruijter – AMC Amsterdam
His presentation 'Heparan sulfate in plasma and GAGs in urine correlate with disease severity in Sanfilippo disease', proved that there is a correlation between the plasma gags level and severity of the disease.
Lower HS levels in plasma and urine - more attenuated - less severe

On the posters section, one of them had the first results of Barbara Burton’s study 'High Dose Synthetic Genistein Treatment in MPS Patients with Neurological Involvement' . They used pure synthetic genistein at high doses (150 mg / kg / day ) in MPS II and MPS III patients. No side effects were observed and the product was well tolerated.

On another note, there was also Wegrzyn’s poster with his discovery that genistein enhances expression of TFEB, a regulator of lysossomal biogenesis.

-Regarding Lysogene’s gene therapy clinical trial, taking place in France for MPS IIIA, there was no presentation. Although, all four patients have been enrolled. However regarding the efficacy ,results will come out next year.

Below is a very useful link, were some videos and presentations from the conference are available:
http://www.mps2012.eu/Basis.aspx?Lid=4&Lit=VIEW&rw=0&QUERY=ccu_articles.menu=42
Thanks to all of you, whom have supported our cause, science goes forward. Thanks to your help and contributions, every day researchers make progresses. THANK YOU!- Raquel

Raquel... I would be at a complete loss without her.  Over the course of two years I have gotten to know her very well.  We skype at least once a week.  We have met each other in 7 different countries, stayed in each others homes and shared hotel rooms. Giggled like old school mates and cried like desperate Mom's. 

Raquel is Portuguese she speaks perfect English; her French and Spanish is getting there. She's a beautiful soul and I'm so very thankful to have her in my boat.  Raquel has 2 daughters, Joana is 8 now and her little sister Sophia will be celebrating her 4th Birthday on the same day as Jonah (July 30th.)  How time flies.  For Jonah and Joana the clock is ticking.  Joana was born on leap year, so she's really only 2. :) So we like to tell ourselves. -Jill p.s. I don't know why the white box is there, it is a glitch.

Thursday, July 19, 2012

The perfect storm

The Perfect Storm

Dishwasher broke, IPad broke, House Keeper went on vacation and Jeremy flat on his back for two weeks; after having a handful of kidney stones surgically removed.  The saying holds true, "you don’t know what you got until it’s gone."

Jeremy is healed now and back to work after four months of no full time job and we’re broke.  IPad is at the repair shop still no cleaning lady and dishwasher still broken.  It might sound like I’m a princess, in my defense I did close out Jonah’s college fund, cancelled my subscription to the Y and we turned off the cable.  These are the things and people that help me get my job done.  My support staff.

Jonah on the other hand is doing great, the sinus infections have magically cleared up. He’s loving school and his friends.  He begs for road trips to go see his cousins (5 hours away.)  Can’t wait to take him to Oregon in a few weeks.  Jonah is an awesome traveler.  He easily adjusts to where ever we go.  We’re planning his 4th Birthday, I’m actually ok with it, I haven’t been able to throw him a party for two years. I let grandma take care of it.  But Jonah is doing so well academically, emotionally and physically.  That I’m not so panicked about his age.  So despite the household system failure, we’re doing pretty well.

The Netherlands was bitter sweet as usual.  Good to see my friends and talk to our scientists, everyone is very optimistic.  I’m happy with how much science is happening for us now.  It’s just hard to accept that we’re years out from any trial. Our group of parents are doing everything we can to drive all the science we can.  Raquel is going to give us the recap on what we learned from the Netherlands conference.

My European families have been feeling the recession.  Sanfilippo Sud’s 2nd annual concert fundraiser was a big disappointment.  Last year they raised 20K this year they raised 4k.  So I’m a bit nervous about our wine tasting event.  JJB has a big chunk of change to make up by our September 1st payment.  On that note if you got one of our dozen invites for Salut, Prost, Cheers To A Cure.  The wine tasting event and silent auction is taking place on the 12th of August.  This is an open event so please pass along your invites to friends.  Despite the fact that it’s for a great cause it’s an awesome deal. Twelve wineries that are spread out through the Willamette Valley all in one place.  Plus Fire Mountain Brewery and awesome band.  Not to mention Cafe Uncorked will be catering the small bites. We’re still taking silent auction donations and there are a few more tables up for sponsorship.  A great opportunity to show the community your support and to network.  BTW I did work in sales for 20 years, the pitch comes naturally to me. ha

I have some huge news.... we launched Phoenix Nest on Monday!  It actually feels a bit anticlimactic, I should be thrilled that I created a new company a freaking virtual biotech no-less!  I’m a CEO of a biotech, doesn’t that get you some sort of honors at your HS reunion or something?  Under any other circumstances I would be giddy with pride and probably a little nervous.  But I’m neither it just feels like the next logical step.

So what’s a virtual biotech?  We’re a “dry” lab meaning that all the work is sourced out. Phoenix Nest is here to ultimately facilitate a clinical trial.  While we wait for the science to catch up.  We will continue to write small business loan grants to help continue funding of our research and to gain Intellectual property.  In the mean time I’m seeking angel investors to pay for the management teams salaries and lawyer fees.

The name Phoenix Nest comes from the mythological bird that made its nest
from frankincense, myrrh and spices. In essence, the bird’s nest is a pharmacy; and the virtual
biotech, Phoenix Nest, wants to provide a place where
parents can find treatments for their sick children.

To leave you in good thoughts:  My neighbor had a stoop sale for JJB (a stoop sale is the brooklyn version of a garage sale.)  They had a stroller priced at $50.00 a customer stopped by and said: “50.00 bucks and this is for charity?”  Reply: “yes”  Customer: “would you take $100 for it?”

That brought tears to my eyes. Customer... who ever you are thank you!

p.s. We’re taking donations for the silent auction if you want to donate contact Janet at pjanetwood@gmail.com

p.s.s Wineries Pouring: Stoller, Anderson Family Vineyards, Antica Terra, August Cellars, Brooks Wines @brookswinery, DePonte Cellars, Daedalus Cellars, Hyland Estate, J. Wrigley, Twelve, Walnut City Wineworks and White Rose.

p.s.s. Thanks to our sponsors:
Want to add your companies name to our sponsorship? Check out the benefits on our event pg.
D Sands Motel & Bend Riverside Inn and Suites
Mailey's Mercantile and Cakery
Chiropractic Physicians Clinic
Andrew Physical Therapy
Navarra Gardens
Oregon Wine Services and Storage
Wood Mark Homes
Barrett Town & Country LLC

Tuesday, July 3, 2012

We stormed the Castle

Nicole Bioce or the RARE project, me and Julia of RDLA.
We stormed the castle. 

I wanted to get this blog out before I went to the Netherlands,  which didn’t happen.  Consider this installment #1 of 3.

Two week’s ago I attended a ginormous bitotech conference in Boston.  The conference offered 100’s of sessions on how to become a biotech it was like Bio 101- just what I needed.  There were so many classes going on at the same time, it was hard to choose.

Attending the Biotech conference was much different then attending a scientific conference.  I imagined that I’d feel out of place.  I thought- where do I get off being the CEO of a virtual biotech?  But it wasn’t like that, I ran into a handful of biotech friends and I realized I was surrounded by people who admired me for what I was doing and were more then happy to lend me a hand. I accomplished what I set out to do and I took a lot out of the conference.

The first night of my trip to Boston I met up with my friends from RDLA Julia Jenkins and Jen Bernstein,  Jen is a lobbiest she works for companies like RDLA and Ammicus.   Stephanie Fischer, the director of communications with BIO was there along with a couple of other patient advocates like me. My new best friend Nicole Bioce of the RARE project, graced us with her presence.   We all had a lovely dinner at a beautiful restaurant and who should be sitting at the table across from us... The mayor of Boston!  So of course we had to bend his ear and get a photo opp.


So there we all were when Julia received confirmation via Iphone email that indeed our accelerated approval language from the ULTRA & TREAT acts actually made it into PDUFA V intact.  I can't get over the timing of the announcement and the coincidence that I was with the people that wrote the legislation and lobbied for it.  I don't believe in coincidences anymore.

While my lobbyist's friends celebrated their personal victories.  I was overcome with emotion, this legislation is literally half our battle and I can't believe it fell into my lap.  Again coincidence?   Many other rare diseases have gone up against the FDA and lost... Thousands of children have died while waiting;  gathering the time consuming data for the FDA when lifesaving treatments were ready for trial.

I reminded my friends why they did this, it's not about concurring the FDA or proving our op posers wrong.  It's about the families, families like mine.  This legislation just doubled our chances for saving our kids, saving Jonah.  They just opened the FDA's doors wide open for us.

Thanks to all of my friends and family and to the many other disease groups that sent in a record breaking amount of calls and letters to their legislators.  The grassroots effort of the rare disease community won and we won big!  Thanks for being a part of the movement, we couldn't have done this without the constituents support.  Here are the specific's.

‘‘SEC. 506. EXPEDITED APPROVAL OF DRUGS FOR SERIOUS OR LIFETHREATENING
DISEASES OR CONDITIONS.
 
Page 92:
‘‘(B) EVIDENCE.—The evidence to support that an endpoint
is reasonably likely to predict clinical benefit under
subparagraph (A) may include epidemiological,
pathophysiological, therapeutic, pharmacologic, or other
evidence developed using biomarkers, for example, or other
scientific methods or tools.
 
Page 94:
(3) CONSIDERATION.—In developing the guidance under
paragraphs (1) and (2)(A) and the amendments under paragraph
(2)(B), the Secretary shall consider how to incorporate
novel approaches to the review of surrogate endpoints based
on pathophysiologic and pharmacologic evidence in such guidance,
especially in instances where the low prevalence of a
disease renders the existence or collection of other types of
data unlikely or impractical.

The conference was electrified due to the timing of the PDUFA V finalization.  I was sitting in a session where John Crowley of Amicus Pharmaceuticals spoke (John’s life was made into the movie Extraordinary Measures with Brendon Fraiser and Harrison Ford.)  The rest of the panel included Anne Pariser the associate director for Rare Diseases @ the FDA.  The session was moderated by Wayne Pines the president of regulatory services and Healthcare. Pines asked the panel of Pharma CEO’s:  "What was the most important piece of language added to PDUFA?
The three pharma peeps unanimously agreed that our accelerated approval language was the most important piece of legislation.

Anne from the FDA just scowled, you could cut the tension with a knife.  Then our fair feathered friend Tim Cote, the x director of the Orphan Drug Dept @ the FDA,  stood up and asked the panel: “So what now... does this mean the rare disease community should flock to the FDA?”

Someone in the audience replied: “Yes!  It’s time that the groups with treatments put pen to paper.”  (Meaning it’s time for us to start writing our IND’s.)  Tim Cote is the man that was in the GMA interview with me at the time he supported my stance.  I was naive then I didn’t realize that he was just placating me.  Tim wasn’t asked back to the FDA when his contract was up....

Several of the sessions went on like this.  The Super Session facilitated by Margaret Anderson the director of Partnering for Cures (the conference that I met Sean at.) The panel included the Medical Dean of Harvord, Sanofi and Lilly Pharmaceutical bigwigs, Francis Collins the director of the NIH and Janet Woodcock the director of the FDA. 

The conference started out on a contentious note.  Francis told us how broke the NIH is, that there is less and less funding for them.

Janet Woodcock told the audience:  “The FDA approves 80% of the drugs that are approved for clinical trial.”  “So clearly we’re not the problem.”  (She was accusing the FDA for not supporting them more.)

I guess that means that it’s the problem of the families suffering with an Ultra Rare disease.  Since we’re funding research for an ultra rare disease that doesn’t have the clinical data needed for a clinical trial and never will because our kids don’t live long enough to get the data.  I guess we’re all just SOL.  Not anymore, thanks to the new language in PDUFA V.  Look out Janet here we come!


RDLA Poster, never mind the random beer. Jonah is on the upper left corner. I'm standing with my representative Nydia Valesquez.
All in all the conference was awesome!  I ran into so many people and made several new  connections. The RDLA had a booth, their poster featured pictures of my family lobbying on Capitol Hill.

To top the week off I took the bus out to Cape Cod from Boston where Jeremy and Jonah met up with me at the Burke's rented cottage.  I had the most blissful weekend.  No internet access, a forced vacation.  Jonah had a the time of his life hanging out with the Burke girls.  Kelsey was at Jonah’s beck and call.  They adored each other. We all swan in the ocean, relaxed and convalesced.  Being with the girls helped me adjust to the disease. 

For better or worse: "We're all in."
The girls are all in different stages, regardless of the progression the young ladies are all beautiful, even without communication you can hear their souls talking to you.  You know that behind the disease they’re all dynamic women and would have excelled at everything they set their minds too.  I greatly admired them, I looked passed the disease and felt with my senses. I could see the person that they were supposed to be. 

Life has dealt the Burkes an unbearable deck, but they hold their heads high and get up everyday, for the unconditional love of their girls.  I have nothing but the utmost admiration for Paul and Nancy.  They work together like a precision clock, they never sat down. Moving from one girl to the next constantly picking things up and preparing for the next activity.  They didn’t skip a beat. I wouldn’t say that they have accepted their fate, they keep the hope alive.  But the happy moments are few and far between. 

Lindsey doesn't talk much now, since her illness last year.  She woke up before Jonah did and came to me.  She looked at me intently and carefully posed her question: "Where is the little boy?"  It brought tears to my eyes. 
My new goal is to make the Burkes filthy rich with the biotech, so that they can buy a beautiful home on the beach. Where Jillian can feel the extremes of the weather, the wind in her hair and rain on her cheek.  Where Lindsey can collect rocks and shells to her hearts content. A place where Kelsey rarely gets bored.  The Burkes are the strongest people I have ever met, they are my inspiration.