Professor Laurent Servais appointed to MDUK Oxford Neuromuscular Centre

Professor Laurent Servais has recently been appointed Professor of Paediatric Neuromuscular Diseases at the MDUK Oxford Neuromuscular Centre. Not only does Professor Servais have great general experience of neuromuscular disease, he is also in charge of the natural history study for x-linked myotubular myopathy and dynamin 2.

Professor Laurent Servais

The Oxford Neuromuscular Centre is a partnership between Muscular Dystrophy UK (MDUK) and the University of Oxford, which aims to drive research into potential treatments from the lab into the clinic. The aim of the centre will be to boost capacity for clinical trials while working alongside the major centres in Newcastle and London.

Professor Servais will join the MDUK Oxford Neuromuscular Centre with a wealth of experience within the neuromuscular field, having overseen numerous clinical trials to test treatments for duchenne muscular dystrophy and spinal muscular atrophy (SMA). He is also the leader of the newborn screening program for SMA in southern Belgium.

Currently Head of the Institute I-Motion, in Paris and Head of the Neuromuscular Centre in Liège, Belgium, Professor Servais is also a Professor of Child Neurology at Liège University. He will cease his activity in Paris, but will keep an affiliation in his hometown hospital and university as an invited Professor.

Professor Servais will start his tenure with the MDUK Oxford Neuromuscular Centre in September 2019 and will relocate to Oxford from Belgium.

Further information

Dr Alfred J Spiro, 1930 – 2019

Dr Alfred J Spiro, a distinguished neurologist, died 17 April. He was 88. Born in New York City in 1930 and educated at NYU and the University of Bern Faculty of Medicine, Dr. Spiro was trained in paediatrics and then in neurology at the Children’s Hospital of the University of Pennsylvania.  In 1966 Dr Spiro published the first paper on myotubular myopathy in the Archives of Neurology.

Persistence of fetal muscle in adolescent boy.

The same year Dr Spiro joined the faculty of the Albert Einstein College of Medicine, where he stayed his entire academic career and where he worked as a professor of neurology and paediatrics and director of the Division of Paediatric Neurology, until his retirement in 2017.

Dr Spiro was internationally known for his work in muscle disorders, directed the MDA Muscle Disease Clinic and published many scientific papers. He was recognised with several teaching awards and in 2018 received the Lifetime Achievement Award from the Child Neurology Society.

Research into centronuclear and myotubular myopathy has come a long way since 1966  and we are grateful to Dr Spiro for his contributions to the science of muscle diseases and taking the first steps that led us to where we find ourselves today.

219th ENMC workshop: Titinopathies – International database of TTN mutations and phenotypes

This article about the 219th ENMC workshop on myotubular/centronuclear myopathies first appeared in the Information Point newsletter Our World in 2016.

Titin infographic

The purpose of the workshop was to establish an international database of mutations, variations and their clinical presentations, to be able to determine if particular genetic variants of the gene are the cause of disease. The workshop brought together worldwide leaders in the Titin myopathy field, Titin family advocates, as well as representatives from other successfully developed groups.

219th ENMC workshop

 

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214th ENMC workshop: establishing an international consortium for gene discovery and clinical research for congenital muscle diseases

This article about the 214th ENMC workshop first appeared in the Information Point newsletter Our World in 2016.

214th ENMC workshop

The 214th ENMC workshop entitled ‘establishing an international consortium for gene discovery and clinical research for congenital muscle diseases’ took place from between 16 – 18 October 2015 in Heemskerk, Netherlands.

26 participants took part in this workshop, including 22 clinical and researchers from France, the UK, Japan, Canada, Brazil, China, Turkey, Italy, the Netherlands, Australia and the USA, together with patient representatives from the Myotubular Trust, RYR1 Foundation and CureCMD.

Individually congenital muscle diseases are very rare but collectively, the diseases which include centronuclear and myotubular myopathy, represent a major subset of neuromuscular diseases, so the aim of the workshop was to address current barriers with the primary goal being to establish a consortium for the study of the genetics of congenital muscle diseases and deciding what the initial projects of the group should be.

 

 

198th ENMC international workshop on myotubular/centronuclear myopathies (MTM/CNM)

This article about the 198th ENMC international workshop on myotubular/centronuclear myopathies first appeared in the Information Point newsletter Our World in 2013.

198th ENMC workshop

At the beginning of June 2013, the European Neuromuscular Centre (ENMC) (an international organisation facilitating communication amongst scientists and clinicians working in the area of neuromuscular disease) sponsored a conference on myotubular and centronuclear myopathy, the first for our condition since 2009. Leading researchers from all over Europe and the US presented and and we were really delighted to be there to see the collaboration and the sharing of ideas and information between them all.

It was incredibly reassuring to see how closely they are all trying to work together. None of us can be unmoved by the following line from the conference lay summary: “Since the most recent ENMC workshop on MTM/CNM in 2009, the field has seen an exponential increase in knowledge concerning these conditions, with therapy development becoming an increasingly realistic prospect”.

Sessions included a workshop focused on already known forms of MTM/CNM, in particular those due to mutations in the MTM1, DNM2, BIN1 and RYR1 genes and more recently recognised disorders identified through systematic application of powerful novel genetic techniques.

Further sessions concentrated on the current understanding of disease mechanisms, as studied in cells and animal models including zebrafish, mouse and dog, which have been shown to faithfully replicate many aspects of MTM/CNM in humans. The results of experimental therapeutic approaches in animal models of MTM/CNM were presented, with a particular view to their potential applicability in humans affected by these disorders and the final session summarised the current state of the tools needed, including patient registries and studies of the natural history of the disorders, to translate recent insights derived from animal studies into therapy development of direct benefit for patients.

Lastly, the importance of joint international efforts for the study of rare conditions such as MTM/CNM was emphasized, and plans for further collaborations and meetings were drafted.

 

ENMC workshops

The Information Point newsletter Our World has written about ENMC workshops on several occasions. You can read the reports below and view the full reports on the ENMC website.

 

 

 

 

 

The importance of genetic testing

This article first appeared in The Information Point newsletter Our World in 2012 when Sarah Foye with contributions by Dr. Alan Beggs and Lindsay Swanson, MS, CGC told us about the importance of genetic testing.

The centronuclear myopathies (CNMs) are a group of rare inherited muscle disorders that are caused by genetic changes in any one of several different genes. CNMs are considered to be an inherited group of disorders, meaning that the genetic change can be passed from parent to child. However, there are rare cases where neither parent is found to share the genetic change, meaning that the child has a new or ‘sporadic’ mutation.

In any case of muscle disorder, families are often left wondering, where did this come from, what caused this problem, what are the risks for other family members? For many families the answers to these questions can be found by testing the affected individual for the genetic mutations known to cause CNM.

Diagnosing a muscle disorder like CNM is usually made by reviewing a person’s symptoms and their family medical history and by having a physical examination by a doctor who is often a specialist. Once a doctor suspects a muscle disorder, they will often do further testing like a blood test, a nerve test, or a muscle biopsy.

During a muscle biopsy, a small portion of muscle is removed and examined closely. Different muscle disorders often have a unique appearance under a microscope. Examining the features of the muscle helps doctors to diagnose a specific muscle disorder. The muscle biopsy is considered the gold standard method of diagnosing CNM today. However, there are limitations to this method. Unfortunately, there are many problems with diagnosing CNM by muscle biopsy. Certain features of a muscle biopsy may be ambiguous or misleading because these findings may be present in many different forms of muscle disease. For example, centrally located nuclei can be present in myotubular myopathy but also with muscular dystrophy, myotonic dystrophy and many other muscle disorders.

Although there are difficulties with muscle biopsies, the discovery of new genes and the invention of new gene-testing technologies have opened new doors for diagnosing CNM and other related muscle disorders. Testing for genetic mutations known to cause CNM is one way of answering families’ questions as well as confirming a diagnosis. The genes known to be associated with CNM include the following: MTM1, DNM2, BIN1 and RYR1. Once a doctor suspects that a person has CNM, they can send a sample of DNA to test for one of these known genes.

Genetic testing can be arranged by a pediatrician, primary doctor, or a doctor specializing in genetics (geneticist). Because genetic testing for CNM can be complex, families with CNM may want to consider seeing a geneticist along with a genetic counselor when pursing a genetic diagnosis. Further information on how to arrange genetic testing can be found on the genetic testing pages of the Information Point website.

Why bother with genetic testing?

There are many benefits to pursing a genetic diagnosis. We already touched on how genetic testing can confirm a specific diagnosis. Some other benefits include:

Family planning

Knowing the genetic diagnosis can help people to understand how the disorder is passed within a family. It can also inform people about the risks of having an affected child. This information can help people make decisions about having children and can provide health risks for family members.

Medical problems

Identifying the specific gene can help to predict medical problems that may be associated with the gene. For example, liver problems can be associated with mutations in the MTM1 gene and malignant hypothermia can be associated with RYR1 mutations. By knowing that there are risks for certain medical problems, patients and their doctors can decide together what type of monitoring, treatments, or preventative actions they may need.

Research

As clinical trials get underway for CNM, researchers will want to enroll people in research based on their genetic diagnosis. Thus, genetic confirmation may be a condition to participate in future research.

Treatment

Knowing the specific gene mutation can help doctors and scientists to understand the specific cause of the disorder in the body. By identifying the specific mechanism which is causing the deficit, it can help to target potential treatments.

Please keep in mind that genetic test results can sometimes be surprising, upsetting, and lead to more questions. Please work with your healthcare professionals and genetic counselors to guide you through this process. If you might be interested in learning more about whole exome sequencing for your rare or unknown condition, please contact the Manton Center for Orphan Disease Research at Boston Children’s Hospital or contact Meghan Connolly by email or by telephone one 617-919-4287.

Rare Disease Day 2013

This article first appeared in The Information Point newsletter Our World in 2013. This year marked the sixth Rare Disease Day with 71 countries from around the world helping to raise public and political awareness of the issues faced by the rare disease community and to. The Ward and Whiston families wrote about what they did to mark Rare Disease Day 2013.

The Ward family: Erin, Mark and Will

Rare Disease Day this year took place on 28 February which also happened to be Will’s 12th birthday. Wanting to raise funds for the 2013 US MTM-CNM Family Conference, we approached Will’s sixth grade teachers, along with school administration, about hosting an ‘I Wear Jeans For Rare Jeans Day’.

Often schools will host ‘jeans days’ as a day when school staff are allowed to wear jeans if they give a donation for a certain cause they are raising funds for in a given month and Will’s amazing school team happily agreed to our request.

Along with asking Will’s school staff to participate, we also invited family and friends to join in as well. Altogether, we were able to raise $752.00 on Rare Disease Day and in honor of Will’s 12th Birthday for the 2013 US MTM-CNM Family Conference and we would like to thank everyone who participated in making our ‘I Wear Jeans for Rare Genes’ a success.

For further information about hosting a ‘Wear Jeans for Genes’ fundraiser at your school or workplace for the US Family Conference contact Mark and Erin. If you would like to make a direct donation visit the conference Firstgiving donations page.

The Whiston family: Melanie, Daniel, Will and Juliet

Our foundation for myotublar myopathy, Where There’s A Will There’s A Cure, held its first annual awareness event ‘Blue for the Cure – Rare Disease Day 2013’. We asked our friends, family and supporters to wear blue and post pictures on our facebook event page to help raise awareness for Rare Disease Day and myotubular myopathy.

The event was a huge success and it tuned out to be a really fun day. We are thrilled with the support we received and are excited about Blue for the Cure – Rare Disease Day 2014.

Rare Disease Day 2016

This article first appeared in The Information Point newsletter Our World in 2016. This was the ninth Rare Disease Day and it took place on the rarest of days, 29 February 2016.

The Rare Disease Day 2016 theme was ‘Patient Voice’ and recognised the crucial role that patients play in voicing their needs and in instigating change that improves their lives and the lives of their families and carers.

Patients and patient advocates use their voice to bring about change that ensures that politicians continuously and increasingly acknowledge rare diseases as a public health policy priority at both national and international levels; increases and improves rare disease research and orphan drug development; achieves equal access to quality treatment and care at local, national and European levels, as well as earlier and better diagnosis of rare diseases; supports the development and implementation of national plans and policies for rare diseases and helps to reduce isolation sometimes felt by people living with a rare disease and their families.

This year the US charity Where There’s a Will There’s a Cure once again held their Blue for the Cure Facebook event to mark Rare Disease Day and raise awareness of centronuclear and myotubular myopathy by asking people to wear the colour blue and post a photo on Facebook. Melanie Whiston told The Information Point: ‘Each year it is overwhelming to see how many people support the CNM-MTM community. We want to thank everyone for showing the families and community that we are not alone in this journey’.

Neil who works as a volunteer at his local Multiple Sclerosis centre in the UK went to work in blue and his colleague Amanda wore blue to support him. Twins Lilly and Cooper, aged six from Ohio wore blue for Cooper who has x-linked myotubular myopathy (Lilly wore some pink too) and Jackie, also from Ohio wore blue to raise awareness of centronuclear myopathy, the condition with which she is diagnosed.

Rebekah from Oklahoma wore blue for sons Lane and Christian. Sharon wore blue to support her grandson Kmoney, while Marie from New York went for a run in blue with her husband across the Bronx river. Lori and her family from New Jersey wore blue to support Beau who has MTM, as did many of their friends and family. Anne and Mel from the Myotubular Trust in the UK also wore blue.