how can we help families with mitochondrial disease? this ...€¦ · elamipretide =bendavia effect...

19
Research Update Prof Jo Poulton

Upload: others

Post on 11-Aug-2020

4 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: How can we help families with mitochondrial disease? This ...€¦ · Elamipretide =Bendavia Effect on Mitochondrial Bioenergetics Healthy Disease Elamipretide X80,000 Eirin et al

Research Update

Prof Jo Poulton

Page 2: How can we help families with mitochondrial disease? This ...€¦ · Elamipretide =Bendavia Effect on Mitochondrial Bioenergetics Healthy Disease Elamipretide X80,000 Eirin et al

For further strides we need YOU!

Page 3: How can we help families with mitochondrial disease? This ...€¦ · Elamipretide =Bendavia Effect on Mitochondrial Bioenergetics Healthy Disease Elamipretide X80,000 Eirin et al

Different views on what is important

Page 4: How can we help families with mitochondrial disease? This ...€¦ · Elamipretide =Bendavia Effect on Mitochondrial Bioenergetics Healthy Disease Elamipretide X80,000 Eirin et al

Advances relevant to…

• Families with young children

– Genetic advances offer reproductive

options

• Older people with established disease

– A new drug to be trialled

Page 5: How can we help families with mitochondrial disease? This ...€¦ · Elamipretide =Bendavia Effect on Mitochondrial Bioenergetics Healthy Disease Elamipretide X80,000 Eirin et al

Genetic advances offer

reproductive options

Page 6: How can we help families with mitochondrial disease? This ...€¦ · Elamipretide =Bendavia Effect on Mitochondrial Bioenergetics Healthy Disease Elamipretide X80,000 Eirin et al

Predicting recurrence is DIFFICULT

Page 7: How can we help families with mitochondrial disease? This ...€¦ · Elamipretide =Bendavia Effect on Mitochondrial Bioenergetics Healthy Disease Elamipretide X80,000 Eirin et al

Child’s severity reflects mtDNA

composition in embryos and oocytes

Page 8: How can we help families with mitochondrial disease? This ...€¦ · Elamipretide =Bendavia Effect on Mitochondrial Bioenergetics Healthy Disease Elamipretide X80,000 Eirin et al

And in human“control”

MtDNA flags show that eggs are already decided

Marchington et al AJHG 1997;60:408

Sampling earlystages is accurate

? CVSSampling laterstages varies

Page 9: How can we help families with mitochondrial disease? This ...€¦ · Elamipretide =Bendavia Effect on Mitochondrial Bioenergetics Healthy Disease Elamipretide X80,000 Eirin et al
Page 10: How can we help families with mitochondrial disease? This ...€¦ · Elamipretide =Bendavia Effect on Mitochondrial Bioenergetics Healthy Disease Elamipretide X80,000 Eirin et al

Reproductive options now available

Page 11: How can we help families with mitochondrial disease? This ...€¦ · Elamipretide =Bendavia Effect on Mitochondrial Bioenergetics Healthy Disease Elamipretide X80,000 Eirin et al

Reproductive options now available

2006

Page 13: How can we help families with mitochondrial disease? This ...€¦ · Elamipretide =Bendavia Effect on Mitochondrial Bioenergetics Healthy Disease Elamipretide X80,000 Eirin et al

25% m.8993T>G WT (0%)

…or was mutant low?

Page 14: How can we help families with mitochondrial disease? This ...€¦ · Elamipretide =Bendavia Effect on Mitochondrial Bioenergetics Healthy Disease Elamipretide X80,000 Eirin et al

Advances relevant to…

• Families with young children

– Genetic advances offer reproductive

options

• Older people with established disease

– A new drug to be trialled

Page 15: How can we help families with mitochondrial disease? This ...€¦ · Elamipretide =Bendavia Effect on Mitochondrial Bioenergetics Healthy Disease Elamipretide X80,000 Eirin et al

Elamipretide =BendaviaEffect on Mitochondrial Bioenergetics

Healthy Disease Elamipretide

X80,000

Eirin et al. Cardio. Research 2013

KID

NEY

Op

hth

alm

ic

Alam et al. ADA 2012 Rabinovitch et al. Circulation 2013

Car

dia

c

Page 16: How can we help families with mitochondrial disease? This ...€¦ · Elamipretide =Bendavia Effect on Mitochondrial Bioenergetics Healthy Disease Elamipretide X80,000 Eirin et al

Cardiolipin is an important building block for

keeping the production line connected

Page 17: How can we help families with mitochondrial disease? This ...€¦ · Elamipretide =Bendavia Effect on Mitochondrial Bioenergetics Healthy Disease Elamipretide X80,000 Eirin et al

ROS damage cardiolipin and hence the

mitochondrial production line for energy

Bendavia protectscardiolipin

Page 18: How can we help families with mitochondrial disease? This ...€¦ · Elamipretide =Bendavia Effect on Mitochondrial Bioenergetics Healthy Disease Elamipretide X80,000 Eirin et al

BUT: it needs to be injected

Studies to start soon but entry criteria will be strict

Page 19: How can we help families with mitochondrial disease? This ...€¦ · Elamipretide =Bendavia Effect on Mitochondrial Bioenergetics Healthy Disease Elamipretide X80,000 Eirin et al

Jo Poulton

http://www.obs-gyn.ox.ac.uk/research/jo-poulton

RARE MITOCHONDRIAL

DISORDERS

SERVICE FOR ADULTS AND

CHILDREN