Snapshot: What is Omaveloxolone?

A new therapeutic compound shows promise to treat Friedrich’s ataxia.

What is Friedrich’s ataxia (FA)?

Friedrich’s ataxia is a genetic neurodegenerative disease that affects many organs, most notably nerves, muscles, and heart. FA is a recessive ataxia. Symptoms typically present in childhood and result in significant physical disability. Cognition (thinking, memory) remains intact.

Some of the symptoms a person with FA may experience include ataxia (loss of movement coordination), fatigue, muscle weakness, cardiomyopathy (heart issues), scoliosis (curvature of the spine) and sensory impairments (vision, hearing). Life expectancy is reduced as a result of the disease.

The genetic change that is present in FA affects the production of a protein called frataxin. Frataxin deficiency leads to abnormal iron accumulation in mitochondria.  As mitochondria are critical for energy metabolism and other important functions in cells, their dysfunction causes faulty energy production and undesirable toxicity in the form of reactive oxygen species.

There is currently no treatment available to patients with FA.

white medical pills in the shape of a question mark
What is Omaveloxolone? How could it help people with Friedrich’s Ataxia? Photo by Anna Shvets on Pexels.com

How does Omaveloxolone work?

Omevaloxolone is a synthetic compound. It works by counteracting deficits seen in disease at the cellular level. Omevaloxolone promotes Nrf2, which works to activate a series of defence mechanisms that help cells handle oxidative stress (mentioned above). Nrf2 is also important for improving the energy production machinery mitochondria require to function efficiently. Thus, by activating Nrf2, Omevaloxolone is thought to mitigate oxidative damage, improve energy production, and promote neuroprotection. Additionally, Omevaloxolone and similar compounds exhibit anti-inflammatory action.

What exactly has been validated?

In the MOXIe clinical trial, study participants with FA from several countries were randomized to either daily omaveloxolone (drug) or placebo (control). Their neurological function, activities of daily living, and ataxia were assessed at baseline (at the beginning) and after 48 months of receiving treatment. At the end of this period, the data showed statistically significant improvement in each of these measures. Participants who received omaveloxolone fared better than those who did not (placebo). Additionally, participants who received omaveloxolone saw improvements after treatment compared to their own baseline at the beginning of the study.

What is happening next?

The next step in testing omaveloxolone is to have a long-term study to examine its safety (and any side effects) over the course of a few years. Instead of having a control group in this type of study, called an open-label extension, now everyone enrolled received the same amount of omaveloxolone. This study is already underway and is expected to be completed by 2022. There have been some modifications to the long-term safety study in response to COVID-19, but Reata doesn’t expect there to be a significant delay in their timelines.

If you would like to learn more about omaveloxolone, take a look at these resources by the Reata Pharmaceuticals and ClinicalTrials.gov. To learn more about Friedrich’s Ataxia, visit the Friedrich’s Ataxia Research Alliance website.

Snapshot written by Dr. Judit M. Pérez Ortiz and edited by Larissa Nitschke.

Snapshot: What does dominant ataxia mean?

Ataxias can occur due to a multitude of reasons. One way a patient might acquire ataxia is from an accident or an injury – not as a result of genetics. On the other hand, a patient could also inherit a specific mutation (a genetic defect, in other words) from one or both of their parents. In this case, the ataxia is called “hereditary.” Hereditary ataxias can be further classified as either “dominant” or “recessive.”

What is a dominantly-inherited disorder?

Most genes in our body have two copies: one that we inherit from our mother, and one that we inherit from our father. Dominantly-inherited disorders are diseases in which a mutation in just one copy of a gene is enough to cause disease. When both copies of a gene need to be mutated to cause symptoms, the disorder is known as “recessive” (learn more in the Snapshot on recessive ataxias). For a patient with a dominantly-inherited ataxia, this means that there is a 1-in-2 chance that their children will inherit the disease-causing mutation (assuming that their spouse is unaffected). If both spouses are affected by the same dominantly-inherited disease, this chance increases to 3-in-4. In cases where the child inherits both mutant copies of the gene, the symptoms are often more severe than when a single copy is inherited.

Visual depiction of paragraph above
How dominant disorders are inherited. Illustration by Larissa Nitschke, created with BioRender.

Which ataxias are dominantly-inherited?

The most well-known ataxias with dominant inheritance patterns are the Spinocerebellar Ataxias (SCAs), such as SCA1, SCA2, SCA3, SCA6, and SCA7. Each disease is caused by defects in a different gene. Due to the high similarity in symptoms among all ataxias, genetic testing is often required to determine the exact gene mutation and type of ataxia a patient has.

How can a patient prevent passing on a dominantly-inherited disorder to their children?

There are multiple options to prevent passing on the disease to your child if you are affected by a hereditary ataxia. One potential option is to perform in vitro fertilization (IVF), a technology that is used the conceive embryos outside the human body. The embryos can be screened for genetic mutations, allowing only the healthy embryos to be implanted into the uterus.

If you are affected by a hereditary ataxia and want to prevent having a child with ataxia, it is recommended to talk to your physician and genetic counselor regarding reproductive options.

If you would like to learn more about in vitro fertilization and embryo screening, please take a look at these resources by the University of Pennsylvania. If you want to learn more about dominant ataxia, take a look at these resources by the National Organization for Rare Disorders and Ataxia Canada.

Snapshot written by Larissa Nitschke and edited by Dr. Marija Cvetanovic.

Saiba mais: O que são os modelos de Caenorhabditis elegans?

O que é C. elegans?

Se você leu o título deste artigo e não fazia ideia do que é Caenorhabditis elegans, você não está sozinho! Caenorhabditis elegans, mais comumente conhecido como C. elegans, são vermes microscópicos que normalmente crescem até 1 mm de comprimento. C. elegans são naturalmente encontrados em todo o mundo em solos onde há vegetação podre. Se você estiver se sentindo corajoso, tente localizá-los no adubo caseiro da sua casa! Embora esses vermes sejam menos familiares ao público em geral, C. elegans são bem conhecidos pelos cientistas, pois o estudo desses pequenos vermes nos ensinou muito sobre doenças humanas.

Por que C. elegans é usado como modelo?

elegans foi isolado pela primeira vez em 1900 e, desde o final da década de 1960, tem sido usado para “modelar” doenças humanas. Isso ocorre porque C. elegans e humanos compartilham algumas características fisiológicas comuns e têm uma sobreposição significativa em seus códigos genéticos. O SCAsource publicou anteriormente um Saiba Mais em modelos de camundongos, amplamente utilizados na pesquisa de ataxia. Embora C. elegans não seja amplamente utilizado na pesquisa de ataxia, há muitas vantagens em usar C. elegans como modelo:

  • C. elegans é de manutenção barata, permitindo a triagem de milhares de medicamentos a um custo relativamente baixo. Uma vez administrados, os cientistas podem estudar os efeitos das drogas no movimento, desenvolvimento e função do sistema nervoso de C. elegans.
  • C. elegans é fácil de cultivar em laboratório.
  • C. elegans são hermafroditas auto-fertilizantes, o que significa que eles podem se reproduzir sem um parceiro sexual. Um único hermafrodita pode produzir de 300 a 350 filhotes por um período de três dias, permitindo que os cientistas estudem facilmente um grande número de vermes que possuem as mesmas características genéticas.
  • Os cientistas podem manipular facilmente o genoma de C. elegans para estudar muitas doenças humanas.
  • Como C. elegans é transparente, seus órgãos internos, incluindo o sistema nervoso, podem ser visualizados sem dissecção.

Como C. elegans pode ser usado para estudar a neurodegeneração?

O sistema nervoso de um C. elegans é composto de algumas centenas de neurônios, o que é relativamente simples comparado ao cérebro humano (que contém cerca de 86 bilhões de neurônios). Devido a essa simplicidade, os cientistas usaram C. elegans para desenvolver modelos para várias doenças neurodegenerativas, incluindo Alzheimer, Parkinson, ataxia de Friedreich e, mais recentemente, ataxia espinocerebelar do tipo III (SCA3). O modelo SCA3 C. elegans foi desenvolvido por um grupo de pesquisa em Portugal liderado pela Dra. Patrícia Maciel, e é o primeiro do gênero no campo da ataxia espinocerebelar. Esses vermes expressam a proteína humana que causa SCA3 em todos os seus neurônios, resultando em disfunção motora de início adulto que se assemelha ao que vemos em pacientes com SCA3.

uma imagem microscópica de neurônios em dois c. vermes elegans. Um é um neurônio suave e saudável. Um deles tem um neurônio danificado que tem uma ruptura nele.
Uma imagem de microscopia dos neurônios de C. elegans colorida em verde. Imagem cortesia de Kim Pho.

A neurodegeneração (dano / morte de neurônios) em C. elegans é monitorada marcando os neurônios com um marcador que brilha em verde sob um tipo específico de luz. A saúde dos neurônios é então avaliada, possibilitando determinar se a neurodegeneração ocorreu. A imagem acima mostra um neurônio saudável de C. elegans à esquerda, que parece intacto, comparado a um neurônio danificado de C. elegans, à direita, com uma ruptura (seta branca). Ser capaz de distinguir entre neurônios saudáveis ​​e danificados em C. elegans é muito útil, pois os cientistas podem usar essa ferramenta para testar diferentes maneiras de reparar ou proteger os neurônios. Se os cientistas forem capazes de retardar ou impedir a neurodegeneração em C. elegans, existe o potencial de que essa descoberta possa eventualmente ajudar a tratar a neurodegeneração humana também.

Espero que este breve resumo tenha lhe mostrado que existe um enorme potencial científico nesses minúsculos vermes! Compreender a biologia de C. elegans fornece informações sobre a biologia humana, como como ocorre a neurodegeneração e o que podemos fazer para impedi-la.

Se você quiser saber mais sobre os sistemas modelo da C. elegans, dê uma olhada no WormBook, Wormbase e WormAtlas.

Obrigado a Kim Pho, do laboratório do Dr. Lesley MacNeil da Universidade McMaster, por fornecer as imagens fluorescentes dos neurônios da C. elegans.

Saiba mais escrito por Katie Graham, editado pelo Dr. Lesley MacNeil, e traduzido para Português por Guilherme Santos, publicado inicialmente em: 03 de abril de 2020.

Snapshot: What are Preprints?

Scientific research takes a long time: experiments are performed, clinical trials are run, and the data that’s generated has to be analysed and understood before it can be published. Together, this process does not happen quickly. Though people may not realise it, one step that takes a lot of time between generating data and publishing a paper is the publishing process itself.

Publishing a scientific paper can take anywhere from a few months to years. If we look at statistics from 2018 for the journal PLOS ONE, for instance, we see that the median time it took a paper to go through the publication process was 6 months. That means that half of the papers took less than 6 months to process, while the other half took longer. In addition, it often takes multiple submissions to different journals before a paper is accepted, and researcher teams can only submit a paper to one journal at a time. Considering all this, it is no surprise that the process of publishing a scientific article can take a substantial amount of time.

Illustration of a scientist working at a laptop computer, sharing ideas with colleagues
A scientist working on writing a scientific paper. Image courtesy of Piqsels.

However, there are many important things that happen during this process: manuscripts are screened by a journal editor, appropriate experts in the field are asked to perform peer review, and reviews are submitted to the editor. This editor then makes a decision on how to move forward (usually asking the authors to update their work to meet the reviewers’ requests). Papers can be rejected at any of these stages, and this process may occur two or three times at any one journal before a final decision to accept or reject is made.

Due to the time this process takes, there is a delay in getting the results of a study to fellow scientists – information that could drastically influence the experiments being conducted in research laboratories right now. Thankfully, this is where preprints come in.

Preprints are final drafts of papers that research teams share on public servers before/as they start the publication process. This means that other researchers can see the draft manuscripts long before the “official” paper is published. One of the most popular sites for unpublished preprints in the life sciences is bioRxiv (pronounced “bio-archive”), which, as of March 2020, has had over 77,000 preprint papers uploaded to its servers.

What are the benefits of preprint papers?

One of the main benefits of preprints is the rapid spread of information. Instead of the months- or years-long delay to share papers, the scientific community can read preprints to learn about some of the latest findings in the field.

The authors also benefit from uploading a preprint because it acts as a time stamp for when they revealed their results. Establishing a priority of research findings can be important to authors because of the competitive nature of science. Likewise, because of the collaborative nature of science, multiple different research groups may choose to upload preprints on similar results at the same time to ensure priority is not assigned to one study while the other studies are held up in the publishing process.

It is also much easier for researchers to share information on “negative data” through preprints, as well as replication studies. Negative data are the results you get when an experiment reveals that your initial prediction – known as your “hypothesis” – is likely incorrect. Replication studies are repeats of experiments that have previously been published by other groups, and they serve to double-check that the work of those groups was done correctly. Although replication studies and negative data are very important to the scientific process, it can be hard to publish these studies, as some journals do not view such studies as new or interesting. Preprints are an alternative to share this information.

Do we still need traditional publishing?

Despite the extensive time it takes, traditional publishing will always have one advantage over preprints: peer review. Peer review can catch little mistakes and improve the overall quality of papers in many ways, including suggesting additional experiments and/or alterations to the writing style. In rare cases where fraud or plagiarism occurs, peer review can also prevent the publication of such studies.

This difference between preprints and published papers has recently been highlighted by bioRxiv. During the COVID-19 pandemic, bioRxiv published the following statement:

“bioRxiv is receiving many new papers on coronavirus 2019-nCoV. A reminder: these are preliminary reports that have not been peer-reviewed. They should not be regarded as conclusive, guide clinical practice/health-related behavior, or be reported in news media as established information”

This statement is a response to some media outlets not completely understanding the difference between preprints and published papers. As bioRxiv says, they are different and should not be treated the same.

This does not mean, though, that we cannot trust the information we find in preprint papers – it just means that we need to critically analyse the information in preprints. When reading preprints, it is important to understand that they are a preview of a work in progress, not the final product.

If you would like to learn more about preprints, take a look at this article by Science Magazine, this video by iBiology, or this definition by bioRxiv.

Snapshot written by Celeste Suart and edited by Dr. Hannah Shorrock.

Snapshot: What are Caenorhabditis elegans models?

What are C. elegans?

If you read the title of this article and had no idea what Caenorhabditis elegans are, you are not alone! Caenorhabditis elegans, more commonly known as C. elegans, are microscopic worms that typically grow up to 1 mm in length. C. elegans are naturally found worldwide in soil where there is rotting vegetation. If you are feeling brave, you can try to locate them in your household compost! Although these worms are less familiar to the general public, C. elegans are well known to scientists, since studying these tiny worms has taught us a lot about human disease.

Why are C. elegans used as a model system?

C. elegans were first isolated in 1900 and, since the late 1960s, have been used to “model” human disease. This is because C. elegans and humans share some common physiological features and have a significant overlap in their genetic codes. SCAsource previously published a Snapshot on mouse models, which are widely used in ataxia research,. Although C. elegans are not used as widely in ataxia research, there are many advantages to using C. elegans as a model system:

  • C. elegans are inexpensive to maintain, allowing for the screening of thousands of drugs at a relatively low cost. Once administered, scientists can study the drugs’ effects on C. elegans movement, development, and nervous system function.
  • C. elegans are easy to grow in the laboratory.
  • C. elegans are self-fertilizing hermaphrodites, meaning that they can reproduce without a sexual partner. A single hermaphrodite can produce 300-350 offspring over a 3-day period, allowing scientists to easily study a large number of worms that have the same genetic characteristics.
  • Scientists can easily manipulate the genome of C. elegans to study many human diseases.
  • Because C. elegans are transparent, their internal organs, including the nervous system, can be imaged without dissection.

How can C. elegans be used to study neurodegeneration?

The nervous system of a C. elegans is made up of a few hundred neurons, which is relatively simple compared to the human brain (which contains about 86 billion neurons). Because of this simplicity, scientists have used C. elegans to develop models for several neurodegenerative diseases, including Alzheimer’s, Parkinson’s, Friedreich’s ataxia and, more recently, spinocerebellar ataxia type III (SCA3). The SCA3 C. elegans model was developed by a research group in Portugal led by Dr. Patrícia Maciel, and it is the first of its kind in the spinocerebellar ataxia field. These worms express the human SCA3-causing protein in all their neurons, resulting in adult-onset motor dysfunction that resembles what we see in SCA3 patients.

a microscope image of neurons in two c. elegans worms. One is a smooth, healthy neuron. One has a damaged neuron that has a break in it.
A microscopy image of C. elegans neurons coloured green. Image courtesy of Kim Pho.

Neurodegeneration (damage/death of neurons) in C. elegans is monitored by tagging neurons with a marker that shines green under a specific type of light. The health of neurons is then assessed, making it possible to determine if neurodegeneration has occurred. The image above shows a healthy C. elegans neuron on the left, which appears intact, compared to a damaged C. elegans neuron on the right, which has a break (white arrowhead). Being able to distinguish between healthy and damaged neurons in C. elegans is very useful, as scientists can use this tool to test different ways of repairing or protecting neurons. If scientists are able to slow or prevent neurodegeneration in C. elegans, there is potential that such a discovery could eventually help treat human neurodegeneration, as well.

I hope this short summary has shown you that there is a massive amount of scientific potential in these tiny worms! Understanding the biology of C. elegans provides insight into human biology, like how neurodegeneration occurs and what we can do to stop it.

If you would like to learn more about C. elegans model systems, take a look at WormBook, Wormbase, and WormAtlas.

Thank you to Kim Pho from Dr. Lesley MacNeil’s lab at McMaster University for providing the fluorescent images of C. elegans neurons.

Snapshot written by Katie Graham and edited by Dr. Lesley MacNeil.