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FSH Society Annual International Research Consortium


 

Annually since 1994, the FSH Society has held the FSHD International Research Consortium Workshop for researchers and clinicians involved with FSHD. This meeting is one day in length and is held as a satellite meeting to the annual American Society of Human Genetics (ASHG) meeting or as an annual meeting of the DHHS NIH NICHD BBRI Sen. Paul D. Wellstone Muscular Dystrophy Cooperative Research Center for FSHD, in Watertown, Massachusetts. This meeting is the primary annual platform for clinicians, medical researchers and basic scientists to present and discuss new developments in FSHD research, reinforce collaborative efforts and facilitate new initiatives.

The meeting has three goals:

1) To discuss the genetic and biological mechanisms and patho-physiological causes of FSHD;
2) To improve diagnostic techniques and criteria for FSHD; and
3) To consider and evaluate new and existing therapies.

The workshop has an open admission for active research professionals with usually now 90 to 100 attendees from the U.S., Europe, Australia, Asia, Africa and South America, including clinicians, scientists and representatives of funding organizations. The workshop has been co-chaired by distinguished scientists and patient advocates including Drs. Silvère van der Maarel and Rune Frants (both at Leiden University, the Netherlands), Dr. Kathryn Wagner (Kennedy Krieger Institute & Johns Hopkins School of Medicine), Dr. Sara Winokur (University of California, Irvine), Dr. Rabi Tawil (University of Rochester), Dr. Robert H. Brown, Jr,, M.D., D.Phil. (University of Massachusetts Medical School UMASSMemorial, Worcester, Massachusetts and Mr. Daniel Paul Perez (President & CEO of the FSH Society).

The workshop includes platform and poster presentations. Attendees are requested to submit abstracts in advance. Abstracts are scored on priority and allocated to platform or poster presentations. An abstract booklet is made available at the meeting and is sent to the attendees a week in advance.

The 2011 International Research Consortium & Research Planning Meetings Were a Huge Success!

Scientists, patients, advocates, biotech and pharmaceutical companies, and clinicians from throughout the world gathered at Boston Biomedical Research Institute (BBRI) on November 7-8, 2011, to attend the FSH Society 2011 International Research Consortium and Research Planning Meetings for facioscapulohumeral muscular dystrophy (FSHD).

The FSH Society, co-organized the meetings that focused on collaborating to find new treatments and cures for FSHD, which is the most common adult form of muscular dystrophy affecting 1 in 14,000. Dr. Charles Emerson, Jr., distinguished scientist and Director of the Boston Biomedical Research Institute, and Co-Director, along with Dr. Louis Kunkel of Harvard Medical School and Children’s Hospital, of the NIH Eunice Shriver Kennedy NICHD BBRI Sen. Paul D. Wellstone Muscular Dystrophy Cooperative Research Center for FSHD, hosted the meeting at BBRI in Watertown, Massachusetts.  Daniel Perez, President & CEO of the FSH Society, Watertown, Massachusetts served as the organizational chair. Silvère van der Maarel, Ph.D. (Leiden University Medical Center, Leiden, the Netherlands), was the European research co-Chair. Dr. Robert H. Brown, Jr, M.D., D.Phil. (University of Massachusetts Medical School UMASSMemorial, Worcester, Massachusetts was the American clinical co-Chair. 

Also joining the meetings were several muscular dystrophy program directors from the NIH: John Porter, Ph.D., program director for the NIH NINDS and Glen Nuckolls, NIH NIAMS.  Other research directors attending the meeting were Dr. Paul Muhlrad of MDAUSA, Tucson, Arizona, Dr. Glen Pilkington of FSHD Global Research of Australia, Gillian Butler Browne, AFM, Paris, France, and Dr. Dan Miller of Friends of FSH Research, Seattle, Washington.  All volunteer agencies working on FSHD were invited by the FSH Society and encouraged to attend.

Over 95 researchers and clinicians from institutions, industry and funding agencies gathered from across the United States and around the world. It was a very successful workshop. And once again was better than the year before and really was "the place to be" for FSHD research. The atmosphere was very positive and constructive and all in attendance felt that it was one of the most productive meetings to date. Also was excellent to see that the interaction between all research groups and funding agencies, evidenced by several announcements and agreements to work jointly and corroboratively on projects. Also, excellent to see most all FSHD organizations working extremely well together side by side in the common front to solve and treat FSHD.

Sponsors for the event included: Association Française Contre les Myopathies (AFM), FSH Society, FSHD Global Research Foundation, NIH Eunice Kennedy Shriver NICHD Boston Biomedical Research Institute Sen. Wellstone MDCRC, Muscular Dystrophy Association United States (MDAUSA) and Quest Diagnostics Athena Diagnostics. 

Click here to view the 2011 Meeting Program, Scientific Abstracts, Organizers/Moderators, Hosts, and Sponsors

Together we reviewed last year’s research priorities and reprioritize them in light of recent developments. We also expanded on the format of the meeting. A series of topical discussions (working sessions) were each led by a pair of distinguished scientists whose role was to provide a stimulating overview of the topic and facilitate discussion. The meeting was a working meeting with experts, developing future plans in the context of what we know now. In the interest of time, we emphasized new data and ideas and to avoid restating data that has already been published.

Click here to view the Suggested Topics for FSH Society FSHD Working Groups

The goal of this meeting was to explore and verify the complex genetic mechanism and various features of FSHD, to allow us to move quickly to the development of potential treatments for FSHD. 2011 brought quite a significant increase in interest from government, non‐profit, and private agencies and a need for much more funding for FSHD. It has also ushered in an international collaboration of volunteer health agencies and FSHD patients working side‐by‐side with research and clinical communities. It is essential to keep going in this direction, and for the entire community to work together at every level to communicate clearly on programs, developments and needs.

This year’s workshop participants included clinicians, scientists, biotechnology companies, pharmaceutical companies, government and non‐profit funding agencies, and patients – committed to solving, treating and curing FSHD at this workshop. Over the course of the two days the FSHD community presented the latest findings/data and had various breakout discussion groups and whole group discussions which culminated in discussions to identify areas in need of development and funding in FSHD. During the Planning components of the meeting all attendees collectively developed a list of future plans in the context of what we know now. In the interest of time, we emphasized new data and ideas and to avoid restating data that has already been published.

Click here to view the Sponsors for the 2011 International Research Consortium & Research Planning Meetings


The Summary and Recommendations 2011

The summary and recommendations of the group stated that given the recent developments in our definition of FSHD and the potential that within one to two (1-2) years, evidence-based intervention strategies, therapeutics, and trials being planned and conducted. Our immediate priorities should be to confirm the DUX4 hypothesis, if valid then understand normal DUX4 function, and finally, understanding the naturally occurring variability should allow us to manipulate the disease in our favor. The group stated that we need to be prepared for this new era in the science of FSHD, by accelerating efforts in the following four areas:

Click here to view the full IRC Workshop 2011 Working Consensus of Tactical and Strategic Research Priorities for FSHD

Priorities as Stated by FSHD Research Community For FSHD Research: 2012 and Beyond

The international FSHD clinical and research community recently came together at the DHHS NIH NICHD Boston Biomedical Research Institute Senator Paul D. Wellstone MD CRC for FSHD. Almost 90 scientists working on FSHD globally met at the 2011 FSH Society FSHD International Research Consortium, held November 7-8, 2011.

The summary and recommendations of the group state that given the recent developments in our definition of FSHD and the potential that within one to two (1-2) years, evidence-based intervention strategies, therapeutics, and trials being planned and conducted. Our immediate priorities should be to confirm the DUX4 hypothesis, if valid then understand normal DUX4 function, and finally, understanding the naturally occurring variability should allow us to manipulate the disease in our favor. We need to be prepared for this new era in the science of FSHD, by accelerating efforts in the following four areas:

1. Genetics / epigenetics
It is now broadly accepted that disregulation of the expression of D4Z4 / DUX4 is at the heart of FSHD1 and FSHD2. Additional FSHD (modifier) loci are likely to exist.

FSHD molecular networks. The relaxation of the chromatin structure on permissive #4 haplotypes leads to activation of downstream molecular networks. Importantly, the upstream processes – triggering of activation – are equally important.
Detailed studies on these processes are crucial for insight in the molecular mechanisms of FSHD pathogenesis and may contribute to explaining the large intra- and interfamily clinical variability. Importantly such work may lead to intervention (possibly also prevention) targets.

Additional FSHD genes. FSHD2 is characterized by hypomethylation of D4Z4 on #4 as well as #10. This also leads to bursts of DUX4 expression. Identification of the responsible factor (gene) and molecular mechanisms is of utmost importance. This work will be facilitated by the recruitment of additional families. Also other genes need to be considered that may give rise to FSHD-like phenotypes. These include, but are not limited to, CAPN3 and the FAT1 gene that was recently suggested to be involved in FSHD.

2. Clinical trial readiness
It is now broadly accepted that disregulation of the expression of D4Z4 / DUX4 is at the heart of FSHD1 and FSHD2. This finding opens perspectives for intervention along different avenues.

Clinical Trial Readiness. Intervention trials are envisaged within the next several years. The FSHD field needs to be prepared for this crucial step. To design and coordinate this important translational process, it was envisaged to install an international task force Clinical Trial Readiness (FSHD-CTR), with Dr Rabi Tawil as leader. The FSHD-CTR needs to be a multidisciplinary group, including members with expertise, not only in FSHD but also, in trial design and execution, statistics, (non-invasive) biomarkers etc. Important issues are:
Natural history
Homogeneous clinical criteria
Biobanks, biomarkers etc.
Reliable outcome measures
Patient registries

Biomarkers. Sensitive biomarkers are needed to monitor intervention: they might also improve diagnosis. Important to consider biomarkers established from easily accessible sources like blood. Non-invasive methods like imaging needs further attention.
Quantitative muscle function methods are instrumental as are patient-reported indicators.

3. Model systems
There are a plethora of cellular and models, based on different pathogenic (candidate gene) hypotheses. Moreover, the phenotypes are very diverse and often difficult to compare with the human FSHD phenotype.

FSHD Model Data Base. The importance of a systematic database was recognized. This DB should contain detailed information on the molecular characteristics of the model (design and phenotype). Particular emphasis should be paid to the muscle pathology. Non-muscle phenotypes – described also in FSHD patients deserves attention.

Human pathology and bio-banking. Importantly, this DB should also contain well-documented muscle pathology data of patients – astonishingly difficult to find in the literature.

Human cellular resources continuously deserve attention. Recent progress in ES-cell technology, including iPS lines, allows for inter-group distribution and dedicated molecular (epi)genetic studies.

4. Sharing
Timely sharing of information and resources remains a critical contributor to the progress in the field. There are several initiatives that create large repositories of data and resources, e.g. Wellstone and Fields Center. Their websites should be used for sharing of information (e.g. protocols, guide to FSHD muscle pathology (images), model systems, contact information), reagents, and resources.

We thank you for your financial support of the FSH Society, Inc. and its research programs to make such significant progress possible.

Current and previous year's program and abstract booklets can be obtained here:

2011 Watertown, Massachusetts
2010 Watertown, Massachusetts
2009 Watertown, Massachusetts

2008 Philadelphia, Pennsylvania

2007 San Diego, California
2006 New Orleans, Louisiana
2005 Salt lake City, Utah
2004 Toronto, Ontario, Canada
2003 Los Angeles, California


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The Summary and Recommendations 2010

The summary and recommendations of the group stated that given the recent developments in our definition of FSHD and the potential that within one to two (1-2) years, evidence-based intervention strategies, therapeutics, and trials being planned and conducted. Our immediate priorities should be to confirm the DUX4 hypothesis, if valid then understand normal DUX4 function, and finally, understanding the naturally occurring variability should allow us to manipulate the disease in our favor. The group stated that we need to be prepared for this new era in the science of FSHD, by accelerating efforts in the following ten areas:

1. Shareable Protocols. There is a need for access to FSHD research protocols and experimental methods by FSHD researchers internationally. Needed are available, clear and well defined research protocols to allow verification, standardization and corroboration of research findings and publications.

2. Common and shareable materials and data by whole community. There is a need for global and international biomaterials and data management. Needed are schemas to identify source and context of biomaterials and data, meaningful data identifiers, and easily accessible bio-repositories and data sources.

3. Corroborate and verify DUX4 finding. This line of work will be instrumental to pinpoint the real identity of FSHD1A (chromosome-4-D4Z4-contraction-linked cases) and FSHD1B (chromosome-4-non-D4Z4-contraction-linked cases & non-chromosome-4-linked cases). This information will form the basis for evidence-based intervention. There is a need to verify and reproduce the DUX4 finding using multiple sites and patient materials.

4. FSHD alleles in context of population genetics need to be defined. There is a need to understand the normal function of the short DUX4 transcript in every human being and the abnormal function of toxic long-form of the DUX4 transcript.

5. Biomarkers. There is obvious need for monitoring intervention. There is the need to define biomarkers for clinical trials endpoints, to understand the FSH disease at multiple omics levels and to understand pathways and signaling of FSHD through “omics” analysis

6. FSHD clinical evaluation scales/systems need be defined under one agreed standard. There is an important need to have a comprehensive and single clinical evaluation standard to allow a list of clinical identifiers and parameters to be assembled into a thorough and robust dataset. This can be applied to subsequent systems biology and –omics areas.

7. Working Groups / Mouse model working group consortium. There is a need for models and methods to interpret the current mechanistic paradigm of FSHD and fidelity of current data. What is needed is an assessment of various modeling approaches. Short and near-term we need consensus on the limits and capabilities of current modeling approaches.

8. Model systems for mechanistic, intervention work and advancement to clinical trials. We need to be able to understand the limits of the both data and models. There is the need to address the complexity of FSHD in the context of mammalian systems. It becomes even more important to have a solid model and dataset to test.

9. Epigenetics / Genetics. There is the need to further evaluate FSHD1, FSHD2 and phenocopies using the genetic approach. Resolve and establish genes involved in the pathophysiology of FSHD (DUX4, FRG1, FRG2 and other 4q35 loci, PitX1, Pax3, Pax7 and other impacted distributed loci, related cascades and pathways, etc.)

10. Clinical trials readiness. There is a need to revisit we know about the pathological progression

Click here to view the full IRC Workshop 2010 Working Consensus of Tactical and Strategic Research Priorities for FSHD

We thank you for your financial support of the FSH Society, Inc. and its research programs to make such significant progress possible.

N.B.

During the 2010 meeting Ljubisa Vitkovic, Ph.D., program director for the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) gave a seminar on “NIH Grants Workshop For Beginners (the art of writing, targeting and revising applications, and developing a relationship with NIH).” This was especially targeted for junior investigators who are applying for their first NIH grants or have limited experience with the NIH.

To view an excellent set of selected sites of interest for NIH information on the World Wide Web click here.

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