National ALS Advocacy Day

  • Tuesday May 16, 2017 is National ALS Advocacy Day
  • Mark Your Calendar and Get Involved!
  • Read on to Find Out Why Involvement Matters

Lou Gehrig (1903-1941). Taken from Wikipedia.org

Amyotrophic lateral sclerosis (ALS) is more commonly referred to in North America as “Lou Gehrig disease.” Henry Louis “Lou” Gehrig was a record-setting baseball All-Star for the New York Yankees from 1923 through 1939, when he voluntarily took himself out of the lineup to stunned fans after his play was hampered by ALS. Sadly, Mr. Gehrig died only two years later, which indicates the rapidity of ALS disease progression.

ALS was first found in 1869 by French neurologist Jean-Martin Charcot, but it wasn’t until Lou Gehrig’s affliction that national and international attention was brought to the disease. ALS is now known to be a group of neurological diseases that mainly involve the degeneration of nerve cells (neurons) responsible for controlling voluntary muscle movement, like chewing, walking, breathing and talking. Motor neurons are nerve cells that extend from the brain to the spinal cord and to muscles throughout the body.

Taken from irelandms.com

The disease is relentlessly progressive, meaning the symptoms get continuously worse over time. Both the upper motor neurons in the brain and the lower motor neurons in the spine degenerate or die, and stop sending messages to the muscles. Unable to function, the muscles gradually weaken, start to twitch, and waste away (atrophy). Eventually, the brain loses its ability to initiate and control voluntary movements.

Currently, there is no cure for ALS and no effective treatment to halt, or reverse, the progression of the disease. Most people with ALS die from respiratory failure, usually within 3 to 5 years from when the symptoms first appear. However, about 10 percent of people with ALS survive for 10 or more years.

It is generally estimated there are over 30,000 people living with ALS in the United States at any given time, and that the number worldwide is around 450,000. Someone is diagnosed with ALS every 90 minutes. The life-time incident rate for an average person is often estimated at between 1-in-400 to 1-in-600 people—an incidence rate comparable to that for multiple sclerosis.

Who Gets ALS and Why?

Following are some reliable facts that I selected from an authoritative NIH website for ALS:

  • ALS affects people of all races and ethnic backgrounds.
  • Caucasians and non-Hispanics are most likely to develop the disease.
  • Although the disease can strike at any age, symptoms most commonly develop between the ages of 55 and 75.
  • Men are slightly more likely than women to develop ALS. However, the difference between men and women disappears with aging.
  • Military veterans are about 1.5 to 2 times more likely to develop ALS, and is recognized as a service-connected disease by the U.S. Department of Veterans Affairs.
  • 90% of ALS cases are considered sporadic, i.e. the disease seems to occur at random.
  • 10% of ALS cases are familial, i.e. an individual inherits the disease from his or her parents.
  • Mutations in more than a dozen genes have been found to cause familial ALS

How is ALS treated?

Riluzole. Taken from healthtap.com

No cure has yet been found for ALS. However, there are treatments available that can help control symptoms, prevent unnecessary complications, and make living with the disease easier. In 1995, the FDA approved riluzole (Rilutek), the only disease-modifying drug to date for ALS. Riluzole has multiple neural mechanisms of action, and is believed to reduce damage to motor neurons by decreasing levels of glutamate, which transports messages between nerve cells and motor neurons. Unfortunately, clinical trials in people with ALS showed that riluzole prolongs survival by only a few months.

BrainStorm Cell Therapeutics & NurOwn®

In researching clinical trials for hopefully much more effective therapies for ALS, I came across a company in Israel named BrainStorm Cell Therapeutics Inc. (BCTI) that offers a form of stem cell therapy for ALS that appears to be quite promising. Following is a short synopsis of what I found.

Space-filling model of BDNF. Taken from Wikipedia.org

BCLI has developed a patented stem cell-based technology that delivers a growth factor that can help neurons live longer at or near the site of injury or damage. More specifically, a mesenchymal stem cell isolated from an ALS patient is grown in a cell culture under certain conditions to produce a differentiated phenotype that secretes brain-derived neurotrophic factor (BDNF) at a level at least five-times greater than normal. The term “factor” is generic in biomedical parlance, and in the case of BDNF refers to a protein pictured to the right.

After these “super secreting” cells are obtained ex vivo, they are reintroduced (aka implanted) into the same ALS patient (i.e. an autologous transplant; see schematic diagram) wherein BDNF acts on neurons of the central nervous system and the peripheral nervous system, helping to support the survival of existing neurons, and encourage the growth and differentiation of new neurons and synapses.

Taken from Byrne JA. Overcoming clinical hurdles for autologous pluripotent stem cell-based therapies. OA Stem Cells 2013 Sep 01;1(1):3.

Details for this cell-harvesting, ex vivo differentiation, selection, and implantation can be read in this 2014 article by BCTI in Clinical Translation Medicine. BCTI has registered these differentiated BDNF-secreting cells as NurOwn®, which I assume is intended to sound bit like “your own”—to reflect the autologous nature of the transplant—and be a linguistic blend of neuron and own. In any case, the important point is that safety and efficacy have been reported in a recently published Phase 1/2 and 2a open-label, proof-of-concept studies of patients with ALS at the Hadassah Medical Center in Jerusalem, Israel.

In the Phase 1/2 part of the trial, 6 patients with early-stage ALS were injected intramuscularly (IM) and 6 patients with more advanced disease were transplanted intrathecally (IT), i.e. via the spinal cord. In the Phase 2a dose-escalating study, 14 patients with early-stage ALS received a combined IM and IT transplantation of autologous BDNF-secreting cells. Interested readers can consult this publication for details, but the bottom line, if you will, was that the possible clinical benefits would be hopefully confirmed in an upcoming clinical trial.

My further research on this led to a February 2017 press release by BCTI announcing that City of Hope’s Center for Biomedicine and Genetics (CBG) in Duarte, California will produce clinical supplies of NurOwn® adult stem cells for the BCTI’s planned randomized, double-blind, multi-dose Phase 3 clinical study in patients with ALS. It added that CBG is expected to support all U.S. medical centers that will be participating in the Phase 3 trial.

A second February 2017 press release by BCTI announced an agreement with Centre for Commercialization of Regenerative Medicine (CCRM) in Toronto, Canada to support the market authorization request for NurOwn® and explore the opportunity to access Health Canada’s early access pathway for treatment of patients with ALS as early as 2018.

Other ALS Clinical Studies

My “go to” authoritative source of reliable information about clinical trials is NIH’s ClinicalTrials.gov website that has an updated database that can be searched and filtered in many ways. When I searched for ALS clinical trials that were recruiting patients, I was heartened to find over 180 studies that can be perused via this link. For each study, there is information about purpose, study design and measures, eligibility, contacts and locations.

Incidentally, as regular readers of my blog will know, modified mRNA (mod mRNA) therapeutics is a relatively new and very promising modality for treating diseases that respond to providing or supplementing proteins. Given that DNA vectors encoding BDNF mRNA are readily available, I’m hoping that a mod mRNA for BDNF will soon be investigated as yet another avenue of treatment for ALS.

Advocate for ALS!

Taken from alsa.org

The ALS Association (ALSA) has the stated mission “to discover treatments and a cure for ALS, and to serve, advocate for, and empower people affected by ALS to live their lives to the fullest.” ALSA’s website offers various ways for any individual to become an advocate for ALS, such as becoming informed and donating much needed money or time, participating in the Walk to Defeat ALS® that draws people of all ages and athletic abilities together (see picture) to honor the courageous souls who are affected by ALS, to remember those who have passed, and to show support for the cause.

One of my long-time friends has recently been diagnosed with ALS, which in part led me to research this blog to help inform him, and led me to find a Walk to Defeat ALS® in which to participate. I encourage you to do advocate for ALS in whatever way you wish and are able.

As usual, your comments are welcomed.

RNA and DNA Examples of ‘Seek, and Ye Shall Find’

  • New RNA Modification Found in the Epitranscriptomic Library for Mammals
  • Ditto for a DNA Modification in Mammalian Epigenetics
  • What Will ‘Ye’ Find Next with Improved RNA and DNA Analytical Methods?

‘Seek, and ye shall find’ is a biblical quote (Matthew 7:7) that many might say is a self-evident statement indicating that to find something you need to look for it. In any case, I used it as a segue for us scientists to remember that our collective understanding of RNA and DNA is limited, in part, by the analytical tools we use for these nucleic acid molecules. To me this predicament is akin to a person under the lamp post at night being limited to find whatever is illuminated, and miss what is not. The old cartoon below conveys a humorous variant of this. But I digress…

Taken from quoteinvestigator.com

Taken from quoteinvestigator.com

In previous postings here, I’ve commented on new illuminations—pun intended—for RNA modifications, such as pseudouridine, about which understanding of function is just emerging. And likewise for congeners of the 5-methyl group of cytidine in DNA, such as 5-hydroxymethyl or 5’-formyl moieties.

To continue this metaphor—but to get to the point—the lamp post’s light-field has been recently expanded to allow researchers to now find previously unseen modified bases in mammalian RNA and DNA, namely, N1-methyladenosine and N6-methyl-2’-deoxyadenosine, respectively. Briefly, here’s what’s been reported.

Expanding Epitranscriptomics

Just like modification of bases in DNA after its replication leads to what’s called epigenetics—which I’ll get to in the next section—modification of bases in RNA after its transcription leads to epitranscriptomics. This somewhat of a tongue-twister term was first introduced in 2013 by Sibbritt et al. in reference to increasing amounts of data for methylated bases in mRNA in the form of N6-methyladenosine (m6A) and 5-methylcytosine (m5C).

Both m6A and m5C have long been known to exist in both prokaryotic and eukaryotic organisms, but only more recently have a flurry of publications shed light—pun intended—on the precise locations, as well as enzymatic introduction and removal of m6A and m5C. This dynamic “writing” and “erasing” has been expertly reviewed by He and coworkers, who have also contributed to these discoveries.

m1A; taken from genengnews.com

m1A; taken from genengnews.com

He and collaborators at the University of Chicago, together with researchers in Israel, have recently reported in venerable Nature magazine a new mRNA modification, namely N1-methyladenosine (m1A), which occurs on thousands of different gene transcripts in eukaryotic cells spanning genetically simple yeast to much more complex mammals.

Taking advantage of newly developed sequencing approaches—i.e. brighter lamp posts in my metaphor—they showed that m1A is enriched around the start codon upstream of the first splice site. More specifically, they observed that m1A “preferentially decorates more structured regions around canonical and alternative translation initiation sites, is dynamic in response to physiological conditions, and correlates positively with protein production.”

They conclude by noting that “these unique features are highly conserved in mouse and human cells, strongly indicating a functional role for m1A in promoting translation of methylated mRNA.” So, as I said at the beginning of this blog, seek and ye shall find, and He did—capital H and pun intended.

Incidentally, those of you who are chemists will recognize that the ionic structure for m1A pictured above can undergo deprotonation to form a formally neutral counterpart having an H-N=C-N-CH3 moiety, as shown in TriLink’s catalog for the triphosphate derivative of m1A. Which one, or the proportion of these two structures for m1A exists in an mRNA of interest will depend on sequence context, local pH, etc. In this regard, scientists will need to somehow seek, in order to find, those answers in epitranscriptomics.

Expanding Epigenetics

m1A; taken from genengnews.com

m1A; taken from genengnews.com

Until recently, mammalian epigenetics had been solely focused on 5-methyl-2’-deoxycytidine and sequentially oxidized versions thereof, i.e. having hydroxyl, formyl, and carboxyl moieties, all of which are offered by TriLink as various products as either 5’-triphosphates or oligonucleotides. In less complex, prokaryotic organisms such as bacteria, N6-methyl-2’-deoxyadenosine (m6dA) is prevalent, but whether it is found in mammals has remained unclear until now.

A multi-university collaboration with the single-molecule-sequencing company Pacific Biosciences now report (Wu et al. 2016) the existence of m6dA in mouse stem cells. This landmark discovery was even more exciting because of the identification of an enzyme that removes methyl groups from m6dA, and by finding that m6dA is enriched in certain regulatory DNA sequences. Together these data provide clues to the possible function of m6dA in mammalian genomes.

Akin to my introductory light-from-the-lamp-post metaphor, detection and location of m6dA was enabled by more powerful analytical methods compared to those available in the past. Using state-of-the-art liquid chromatography-tandem mass spectrometry (LC-MS/MS), Wu et al. found that m6dA represented only 6–7 bases per million (!) adenines genome-wide. m6dA was enriched ~4-fold in genomic regions associated with a rare histone protein, H2AX, although the reasons for this association remain unclear.

The authors next determined specific locations of m6dA in sequences of DNA bound to H2AX by using Pacific Biosystems single-molecule real-time (SMRT) sequencing, which detects different kinetics with which a polymerase enzyme replicates modified bases compared with standard ones. Readers interested in this clever—dare I say “SMaRT”—method can check out my previous blog on SMRT.

In my opinion, the most challenging aspect of investigating epigenetics and epitranscriptomics is deciphering the dynamics and functional impact of “writing” and “erasing” methyl groups on bases in DNA and RNA, respectively. Erasure, i.e. removal of methyl groups is carried out by so-called demethylase enzymes. Several demethylases of the AlkB protein family have been shown to remove methyl groups from m6A in RNA as a means of regulating mRNA function. In mammals, this protein family has nine members, among which AlkBH1-deficiency was found by Wu et al. in mouse embryonic stem cells (ESCs) to lead to accumulation of m6dA in the genome, and that AlkBH1 could remove methyl groups from m6dA in DNA in vitro.

Intriguingly, Wu et al. further discovered that AlkBH1 worked most effectively on single-stranded DNA in vitro, thus raising the question of whether the enzyme preferentially operates during transcription or DNA replication in vivo, when DNA is transiently single stranded.

It’s also worth noting that enzymes that “write” (i.e. add) methyl groups to the N6-position of dA in mammalian DNA remain to be defined, as do the “reader” proteins that detect genomic m6dA.

In conclusion, I hope that this brief synopsis of new findings in “epi-marking” RNA and DNA has been illuminating—pun intended—with regard to molecular biology and the need for applying ever more powerful analytical methods to find more of what we are looking for: the molecular basis for living organisms.

On second thought, it seems to me that scientific discovery is perhaps more like moving forward from one lighted area to the next…

As usual, I welcome your comments.

Highlights of 2015 Publications Using TriLink BioTechnologies Products

  • Publications Citing TriLink Products Exceed 6,000
  • TriLink Products Showed up at a Rate of One Publication per Work Day
  • Among These Customer Publications, Modified mRNA is Trending
Taken from thetrymovement.com

Taken from thetrymovement.com

From my college classes decades ago, I can still clearly recall—thankfully—many “ah ha” moments. Most importantly is when I crystalized to purity and then confirmed structure by NMR the first compound I synthesized in Organic Chemistry Lab. Another ah ha moment—but on a completely different level—was during a philosophy class when the professor partially paraphrased a quote by Aristotle as “we are what we do.” The full quote given above is even more thought provoking because it ties in the notion of excellence, which I took to heart then, and have attempted to live by ever since.

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Longing for Longevity

  • Craig Venter’s HGI is Slow Moving Compared to Google’s Calico
  • 90 is the New 40: Palo Alto Longevity Prize
  • A 1,000 Year-old Human has Already Been Born, Says Aubrey de Grey
  • Dosing with Modified mRNA for Telomerase Turns Back the Clock—Sort Of

I suspect that thinking about immortality—if not living longer—was something humans mused about ever since they comprehended the notion of death. Why we die and—more importantly—seeking ways to avoid death inevitably followed. Among ancient legends about immortality, I’m fond of alchemists searching for the Philosopher’s Stone (aka elixir of life), although that is predated by several millennia of other mythical attempts by ancient Egyptians, Chinese and Greeks to live forever. Forever is a long time, you may be thinking, and perhaps overreaching even conceptually (although that’s been debated), so how about the likelihood of living a lot longer? If you’re skeptical about living longer and—here’s the catch—enjoying it—here are some scientifically notable folks who think this isn’t too far from reality.

"The Alchymist [sic] in Search of the Philosopher's Stone" painted by Joseph Wright in 1771. Taken from ultraculture.org.

“The Alchymist [sic] in Search of the Philosopher’s Stone” painted by Joseph Wright in 1771. Taken from ultraculture.org.

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