Stories about: Therapeutics

Could a simple injection fix spina bifida before birth?

Mesenchymal stem cells derived from amniotic fluid (FAUZA LAB / BOSTON CHILDREN’S HOSPITAL)

Ed. note: This is an update of a post that originally appeared in 2014.

The neural tube is supposed to close during the first month of prenatal development, forming the spinal cord and the brain. In children with spina bifida, it doesn’t close completely, leaving the nerves of the spinal cord exposed and subject to damage. The most common and serious form of spina bifida, myelomeningocele, sets a child up for lifelong disability, causing complications such as hydrocephalus, leg paralysis, and loss of bladder and bowel control.

A growing body of research from Boston Children’s Hospital, though still in animal models, suggests that spina bifida could be repaired at least partially early in pregnancy, through intrauterine injections of a baby’s own cells.

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Study sounds another warning about proton pump inhibitors

child crying while feeding oropharyngeal dysphagia
Toddlers with oropharyngeal dysphagia who were treated with a PPI had a nearly doubled hospitalization rate. (IMAGE: ADOBE STOCK)

A new study adds to growing concerns about a class of drugs frequently prescribed to suppress stomach acid in patients with gastroesophageal reflux disease (GERD). Previous research has linked the use of proton pump inhibitors (PPIs) to an increased risk of various pulmonary and gastrointestinal infections in both adults and children. Patients treated with PPIs are also at higher risk for upper respiratory infections, pneumonia and sepsis.

A new study, published last week in JAMA Otolaryngologysuggests that use of PPIs may also raise the risk of hospitalization of infants and children with oropharyngeal dysphagia, a common swallowing disorder. The study was led by Rachel Rosen, MD, MPH and Daniel Duncan, MD at Boston Children’s Hospital’s Aerodigestive Center.

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Earlier treatment may help reverse autism-like behavior in tuberous sclerosis

research in Purkinje cells may help complete the puzzle of autism
(IMAGE: PETER TSAI)

New research on autism has found, in a mouse model, that drug treatment at a young age can reverse social impairments. But the same intervention was not effective at an older age.

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Getting closer to cracking HIV’s envelope protein

missing segment of HIV envelope could be target for HIV vaccine
(IMAGE: ADOBE STOCK)

For 30 years, researchers have tried to develop an HIV vaccine that would stop the virus from gaining a foothold in the body — before it attaches to T cells and slowly weakens the immune system.

“It has been extremely challenging to induce effective antibody responses against HIV-1,” says Bing Chen, PhD, who researches HIV’s molecular mechanisms at Boston Children’s Hospital.

HIV offers just one target for a vaccine to mimic to trigger protective antibodies: the envelope protein on its surface. Scientists have been struggling to capture the complex protein’s precise structure — and specifically, its structure before the virus fuses with the T-cell membrane.

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In zebrafish, a way to find new cancer therapies, targeting tumor promoters

A new study suggests the power of zebrafish as tools for cancer drug discovery (PHOTO: KATHERINE C. COHEN)

The lab of Leonard Zon, MD, has long been interested in making blood stem cells in quantity for therapeutic purposes. To test for their presence in zebrafish, their go-to research model, they turned to the MYB gene, a marker of blood stem cells. To spot the cells, Joseph Mandelbaum, a PhD candidate in the lab, attached a fluorescent green tag to MYB that made it easily visible in transparent zebrafish embryos.

“It was a real workhorse line for us,” says Zon, who directs the Stem Cell Research Program at Boston Children’s Hospital.

In addition to being a marker of blood stem cells, MYB is an oncogene. About five years ago, Zon was having lunch at a cancer meeting and, serendipitously, sat next to Jeff Kaufman, who was also interested in MYB. Kaufman was excited to hear about Zon’s fluorescing MYB zebrafish, which can be studied at scale and are surprisingly similar to humans genetically.

“Have you ever heard of adenoid cystic carcinoma?” he asked Zon.

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Super suppressor: Boosting a gene that stifles tumor growth

Researchers have packaged a tumor suppressor into a therapeutic nanoparticle.
Researchers have packaged a tumor suppressor into a therapeutic nanoparticle. IMAGE: ISLAM, ET AL.

Most of the time, cancer cells do a combination of two things: they overexpress genes that drive tumor growth and they lose normal genes that typically suppress tumors. No two tumors are exactly alike, but some combination of these two effects is usually what results in cancer. Now, for the first time, researchers have shown that it’s possible to treat cancer by delivering a gene that naturally suppresses tumors.

Researchers from Boston Children’s Hospital, Brigham and Women’s Hospital and Memorial Sloan Kettering Cancer Center combined their cancer biology and nanomaterials expertise and developed a therapeutic capable of delivering a tumor suppressor gene known as PTEN, the loss of which can allow tumors to grow unchecked.

In several preclinical models, their PTENboosting therapeutic was able to inhibit tumor growth. Their findings were published yesterday in Nature Biomedical Engineering.

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Neurons from the brain amplify touch sensation. Could they be targeted to treat neuropathic pain?

neuropathic pain amplification circuit
CREDIT: ALBAN LATREMOLIERE/BOSTON CHILDREN’S HOSPITAL/JOHNS HOPKINS

Neuropathic pain is a hard-to-treat chronic pain condition caused by nervous system damage. For people affected, the lightest touch can be intensely painful. A study in today’s Nature may open up a new angle on treatment — and could help explain why mind-body techniques can sometimes help people manage their pain.

“We know that mental activities of the higher brain — cognition, memory, fear, anxiety — can cause you to feel more or less pain,” notes Clifford Woolf, MB, BCh, PhD, director of the F.M. Kirby Neurobiology Center at Boston Children’s Hospital. “Now we’ve confirmed a physiological pathway that may be responsible for the extent of the pain. We have identified a volume control in the brain for pain — now we need to learn how to switch it off.”

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Typing medulloblastoma: From RNA to proteomics and phospho-proteomics

medulloblastoma proteomics study
Medulloblastoma (CREDIT: ARMED FORCES INSTITUTE OF PATHOLOGY/WIKIMEDIA)

Medulloblastoma is one of the most common pediatric brain tumors, accounting for nearly 10 percent of cases. It occurs in the cerebellum, a complex part of the brain that controls balance, coordination and motor function and regulates verbal expression and emotional modulation. While overall survival rates are high, current therapies can be toxic and cause secondary cancers. Developing alternative therapeutics is a priority for the field.

As early as the 1990s, the lab of Scott Pomeroy, MD, PhD, neurologist-in-chief at Boston Children’s Hospital, discovered molecules in medulloblastoma tumors that could predict response to therapies. In 2010, Pomeroy and colleagues uncovered four distinct molecular subtypes of medulloblastoma.

The World Health Organization updated the brain tumor classification scheme in 2016 to include these molecular and genetic features. In the new scheme, tumor subtypes with a good molecular prognosis receive less radiation and chemotherapy. But the creation of targeted therapeutics has remained a challenge, since some of the genetic pathways implicated in these subtypes are found in non-cancerous cells.

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Blood filtration device could provide personalized care for sepsis

Artistic image of cytokines
Could cell-signaling proteins called cytokines be modulated to tame inflammation? IMAGE: ADOBE STOCK

Cytokines are small proteins produced by the body’s cells that have a big impact on our immune system. Researchers at Boston Children’s Hospital believe that modulating their presence in our bodies could be the key to improving outcomes in life-threatening cases of trauma, hemorrhage and many other conditions including sepsis, which alone impacts nearly one million Americans each year.

The reason? Cells essentially use cytokines to talk to one another. In response to their surroundings, cells release different types of cytokines that encourage inflammatory or anti-inflammatory effects on the body. Infection or trauma causes cells to pump out more cytokines that produce inflammation. Altogether, an escalating chorus of cytokines can sometimes tip a person’s body into overwhelming inflammation that can turn fatal, which is what happens during sepsis.

But what if scientists could remove the problematic cytokines to bring the choir into perfect tune, allowing the immune system to respond with just the right amount of inflammation for healing?

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Finally in the game: Patient in drug trial for PTEN mutation seems to benefit

The first patient to receive everolimus for PTEN hamartoma tumor syndrome
Preston Hall is the first Boston Children’s Hospital patient with PTEN hamartoma tumor syndrome to be treated with everolimus. At left, Siddharth Srivastava, MD. (PHOTO: SEBASTIAN STANKIEWICZ/BOSTON CHILDREN’S HOSPITAL)

From the time of Preston Hall’s birth at 30 weeks, his parents navigated multiple diagnoses, surgeries and sometimes life-threatening medical issues. At 11 months, Preston underwent skull revision surgery for trigonocephaly (a fusion of the skull bones causing a triangular-shaped forehead). After surgery, his doctors discovered serious airway and gastrointestinal issues that led to his failure to thrive. Preston eventually bounced back, but the underlying cause of his complex medical problems remained a mystery. All the while, his fraternal twin Luke overcame more typical preemie issues by age 3.

“At one point Preston had 20 different diagnoses,” his mother, Jennifer Hall, says. “It wasn’t until he was about 4 years old that we started to think his delays were not due to prematurity alone.”

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