Variants to Diagnosis & Treatment

Variants to Diagnosis & Treatment2023-07-19T16:02:38-04:00

Use of understanding gained in the genomic medicine cycle to refine treatment, diagnosis, or promote new therapeutics for rare or common human disease.

News | Variants to Diagnosis & Treatment

Long-term effects of l-serine supplementation upon a mouse model of diabetic neuropathy

Deoxysphingolipids (1-deoxySLs) are neurotoxic sphingolipids associated with obesity and diabetic neuropathy (DN) and have been linked to severity of functional peripheral neuropathies. L-serine supplementation can reduce 1-deoxySL accumulation and improve insulin sensitivity and sensory nerve velocity, but long-term outcomes have not yet been examined. In this work published by CGM investigator Florian Eichler and colleagues, a preclinical model of diabetic neuropathy was treated oral l-serine and longitudinally quantified the extent of functional neuropathy progression. Functional neuropathy and sensory modalities were significantly improved in the treatment group well into advanced stages of disease, however, structural assessments revealed prominent axonal degeneration, apoptosis and Schwann cell pathology, suggesting that neuropathy was ongoing. Thus, despite significant functional improvements, L-serine does not prevent chronic degenerative changes specifically at the structural level, pointing to other processes such as oxidative damage and hyperglycemia that may have additional pathological effects in DN.

June 21, 2023

Publication

CGM Primary Investigator

June 21, 2023|

Proteasomal pathway inhibition as a potential therapy for NF2-associated meningioma and schwannoma

Neurofibromatosis 2 (NF2) is an inherited disorder caused by bi-allelic inactivation of the NF2 tumor suppressor gene. NF2-associated tumors, including schwannoma and meningioma, are resistant to chemotherapy, often recurring despite surgery and/or radiation, and have generally shown cytostatic response to signal transduction pathway inhibitors, highlighting the need for improved cytotoxic therapies. In this manuscript by CGM investigator Vijaya Ramesh and colleagues, data from previous high-throughput drug screening in NF2 preclinical models was leveraged to identify a class of compounds targeting the ubiquitin-proteasome pathway (UPP) that may have utility in NF2. Through a series of elaborate investigation of these UPP targeting agents in vitro and in vivo, the group found that treatment delayed tumor growth, suggesting a therapeutic potential. This important work in preclinical models lays the groundwork for use of these drugs as a promising novel treatment strategy for NF2 patients.

Read more in Neuro-Oncology

June 21, 2023

Publication

CGM Primary Investigator

June 21, 2023|

CHIPping away at cardiovascular disease

Clonal hematopoiesis of indeterminate potential (CHIP), a condition defined by a set of aging-related genetic mutations in blood cells, is associated with an increased risk of several conditions. A team led by CGM PI Pradeep Natarajan and colleagues from Centro Nacional de Investigaciones Cardiovasculares, Stanford University, and Vanderbilt University explored the relationship between CHIP and atherosclerosis in the peripheral arteries. Individuals with mutations in DNA damage repair genes had an increased risk, and mouse data indicated that such mutations may drive increased aortic plaque size and accumulation of macrophages within plaques.

June 21, 2023

Publication

CGM Primary Investigator

June 21, 2023|

Cardiometabolic profiles in children and adults with overweight and obesity and down syndrome

Being obese is associated with an increased cardiometabolic risk in the general population. While individuals with Down syndrome are at increased risk for being overweight and obese, the associated cardiometabolic risk in this population is not clear. This new study helps clarify this risk. Dr. Skotko and his colleagues performed a cross-sectional anthropometric and clinical laboratory data were collected on 240 patients between the ages of 3 and 63 years across 7 international sites. Distributive percentiles were calculated for common cardiometabolic biomarkers, with adjusted models testing for adiposity as a predictor of cardiometabolic risk. Most cardiometabolic biomarker profiles showed distributive values within normal ranges in both children and adults. The data suggest that in contrast to the general population, in individuals with Down syndrome, being overweight and obese does not appear to confer a significantly increased risk for cardiometabolic disease by biomarker profile. Individuals with DS who are overweight/obese appear to have unique cardiometabolic profiles unrelated to adiposity, notable for increased hs-CRP and normal HA1c levels.

June 21, 2023

Publication

CGM Primary Investigator

June 21, 2023|

Precise DNA cleavage using CRISPR-SpRYgests

The ability to precisely cleave DNA at specifiable bases is critical for many applications in life science research, including for molecular biology and cloning, genome editing, DNA sequencing, protein engineering, and a wide variety of other methods. Until now, no enzyme or method existed that permitted efficient cleavage of any position of a DNA substrate. Current workflows typically rely on restriction enzymes (REs) that are beholden to constraining 6-8 bp binding motifs, and yet despite a diverse catalog of REs, collectively they can only target a small fraction of all DNA sequences. To solve this key challenge, CGM Investigator Ben Kleinstiver and colleagues optimized our recently engineered RNA-programmed PAMless Cas9 enzyme, named SpRY, as a highly precise DNA cleavage tool. The use of SpRY for DNA digests (SpRYgests) enables precise manipulation of nucleic acids in ways not possible with REs or other nucleases. The applications of SpRYgests are vast and hold promise to expedite and improve a range of biomedical research endeavors.

Read more in a Tweetorial here, and read the preprint on BioRxiv here.

June 21, 2023

Publication

CGM Primary Investigator

June 21, 2023|

A Genomic Risk Score Identifies Individuals at High Risk for Intracerebral Hemorrhage

Intracerebral hemorrhage (ICH) is the most devastating type of stroke, being responsible for almost 50% of stroke-related morbidity and mortality. Given its severity, primary and secondary prevention is of critical importance. In this study, the authors, led by CGM Investigators Chris Anderson and Jonathan Rosand, developed and validated an ICH meta-genomic risk score (metaGRS) of 2.6 million variants, combining GWAS data from 21 ICH risk factors and related traits and tested its ability to predict ICH risk in relation to traditional clinical ICH predictors. ICH metaGRS was associated with 31% higher odds of ICH per standard deviation, and identified individuals with almost 5-fold higher odds of ICH in the top score percentile. In models incorporating both the metaGRS as well as a collection of traditional clinical predictors, the metaGRS showed comparable predictive performance to the most potent clinical predictor, hypertension, and, importantly, it improved the predictive performance on top of established risk factors. In an external validation in the UK Biobank, the metaGRS was associated with higher risk of incident ICH both in a relatively high-risk population of antithrombotic medications users, as well as among a relatively low-risk population with a good control of vascular risk factors and no use of anticoagulants. Overall, the results demonstrate that the incorporation of genomic information in clinical prediction models for ICH could enhance predictive performance and lay the groundwork for future analyses in larger genetic datasets for ICH to optimally combine genomic information to maximize predictive benefit.

Read more in Stroke

June 21, 2023

Publication

CGM Primary Investigators

Chris Anderson

Jonathan Rosand

June 21, 2023|

Faculty | Variants to Diagnosis & Treatment

Phil H. Lee, PhD

Categories: Variants to Diagnosis, Variants to Disease & Traits, Variants to Function & Mechanism
Harvard Medical School: Assistant Professor of Psychiatry
Massachusetts General Hospital: Assistant in Research
Assistant in Research, Massachusetts General Hospital
Assistant Professor, Harvard Medical School

We use computational and statistical approaches to understand the genetic bases of complex neuropsychiatric traits and mental disorders. Multivariate pathway analysis forms the backbone of our research on identifying disease risk genes and mechanisms. We also apply multi-modal data analysis integrating genomic and neuroimaging data.

Phil H. Lee, PhD

Assistant Professor of Psychiatry, Harvard Medical School

Marcy E. MacDonald, PhD

Categories: Populations to Variants, Variants to Diagnosis, Variants to Disease & Traits, Variants to Function & Mechanism
Harvard Medical School: Professor of Neurology
Massachusetts General Hospital: Research (Non-Clinical) Staff
Research (Non-Clinical) Staff, Massachusetts General Hospital
Professor of Neurology, Harvard Medical School

Our research, evolving from the discovery of the genetic causes of inherited brain disorders (hereditary spastic paraparesis, neurofibromatosis, neuronal ceroid lipofuscinosis, Huntington’s disease), is now largely focused on the DNA variants that modify the effects of the unstable expanded CAG repeat that causes Huntington’s disease. We do molecular genetic studies with disease and population cohorts and genetically precise model systems. Our goal is to enable timely intervention, diagnosis and disease-management.

Marcy E. MacDonald, PhD

Professor of Neurology, Harvard Medical School

Alicia Martin, PhD

Categories: Populations to Variants, Training Program Faculty, Variants to Diagnosis, Variants to Disease & Traits
Harvard Medical School: Assistant Professor of Medicine
Massachusetts General Hospital: Assistant Investigator
Assistant Investigator, Massachusetts General Hospital
Assistant Professor, Harvard Medical School

As a population and statistical genetics lab, our research examines the role of human history in shaping global genetic and phenotypic diversity. Given vast Eurocentric study biases, we investigate the generalizability of knowledge gained from large-scale genetic studies across globally diverse populations. We are focused on ensuring that the translation of genetic technologies particularly via polygenic risk does not exacerbate health disparities induced by these study biases. Towards this end, we are developing statistical methods, community resources for genomics, and research capacity for multi-ancestry studies especially in underrepresented populations.

Alicia Martin, PhD

Assistant Professor, Harvard Medical School

Heidi L. Rehm, PhD

Categories: Populations to Variants, Training Program Faculty, Variants to Diagnosis, Variants to Disease & Traits
Harvard Medical School: Professor of Pathology
Massachusetts General Hospital: Chief Genomics Officer
Chief Genomics Officer, Massachusetts General Hospital
Professor of Pathology, Harvard Medical School

The Translational Genomics Group (TGG) has a mission to support the discovery of the genetic basis of rare disease and translate our work into medical practice by focusing on community-centered projects that promote collaboration, data sharing and open science. Heidi Rehm leads the TGG, with co-leadership by Anne O’Donnell-Luria for the rare disease group and Mark Daly for the gnomAD project. TGG is composed of a multidisciplinary team of researchers, clinicians, computational biologists, and software engineers. We are located at Massachusetts General Hospital and the Broad Institute of MIT and Harvard.

Heidi L. Rehm, PhD

Professor of Pathology, Harvard Medical School

Jeremiah M. Scharf, MD, PhD

Categories: Populations to Variants, Training Program Faculty, Variants to Diagnosis, Variants to Disease & Traits, Variants to Function & Mechanism
Harvard Medical School: Assistant Professor of Neurology
Massachusetts General Hospital: Physician-Scientist
Physician-Scientist, Massachusetts General Hospital
Assistant Professor of Neurology, Harvard Medical School

The Scharf lab investigates the genetic and neurobiological mechanisms of Tourette Syndrome (TS) and related developmental neuropsychiatric disorders that lie at the interface between traditional concepts of neurologic and psychiatric disease, including obsessive compulsive spectrum disorders (OCD/OCSD) and attention-deficit hyperactivity disorder (ADHD). We conduct genetic and clinical research to identify both genetic and non-genetic risk factors that contribute to the predisposition of TS, ADHD, and OCD in patients and families. We hope to identify novel targets for treatment, to understand the course of TS and related conditions at a patient-specific level, and to better predict treatment response.

Jeremiah M. Scharf, MD, PhD

Assistant Professor of Neurology, Harvard Medical School

Jordan W. Smoller, MD, ScD

Categories: Training Program Faculty, Variants to Diagnosis, Variants to Disease & Traits, Variants to Function & Mechanism
Harvard Medical School: Professor of Psychiatry
Massachusetts General Hospital: MGH Trustees Endowed Chair in Psychiatric Neuroscience
Massachusetts General Hospital: MGH Trustees Endowed Chair in Psychiatric Neuroscience
MGH Trustees Endowed Chair in Psychiatric Neuroscience, Massachusetts General Hospital
MGH Trustees Endowed Chair in Psychiatric Neuroscience, Massachusetts General Hospital
Professor of Psychiatry, Harvard Medical School

The focus of Dr. Smoller’s research interests has been:

  • Understanding the genetic and environmental determinants of psychiatric disorders across the lifespan.
  • Integrating genomics and neuroscience to unravel how genes affect brain structure and function.
  • Using “big data”, including electronic health records and genomics, to advance precision medicine.

Jordan W. Smoller, MD, ScD

Professor of Psychiatry, Harvard Medical School

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