Research Studies

The purpose of this natural history study is to perform a long-term follow-up of a large group of people with osteogenesis imperfecta (OI). OI is a rare disorder that causes bones to break easily. People with OI may have broken bones with little or no trauma, curvature of the spine, dentinogenesis imperfecta (DI), and, in adult years, hearing loss. It is seen in both genders and all races. OI can range from very severe to very mild. This study will observe the progression of the disease from participants of all ages, races, and genders. We will see how often people with type I OI have vertebral compression fractures of the spine. We will follow people with all forms of OI to see how often they develop scoliosis (curvature of the spine) and how it affects lung function, ability to walk and quality of life. We will look at dental health in people with OI and how that impacts a person’s quality of life. The genetic cause of the brittle bone disease will be compared with things like severity, various features and response to treatments. The overall goal is to improve the health and quality of life of people with OI.

The purpose of this study is to determine if it is safe to use clear aligners in correcting the misalignment of teeth in people with Osteogenesis imperfecta (OI). OI can affect the shape of the face, mouth and overall quality of life. Misalignment of teeth may interfere with oral hygiene, gum health, jaw function, opening of the jaw, chewing, breathing, and speech. There is very little information on the appropriate treatment for teeth misalignment in OI. Clear aligners are transparent plastic trays that are designed to fit over the teeth. With each new tray, teeth are moved a little at a time until they reach the desired position.

To quantify the factors that contribute to restrictive physiology (cardiopulmonary insufficiency) in the OI population

The overall purpose of this study is to understand the mental health concerns, psychosocial functioning, and priority treatment needs of
individuals with OI.

To classify and describe rates of cesarean section, hemorrhage(bleeding), and fracture in
women with Osteogenesis Imperfecta (OI) in pregnancy.

The purpose of the Clinical Procedures to Support Research in ALS (CAPTURE-ALS) study is to utilize information collected in the medical record to learn more about a disease called amyotrophic lateral sclerosis (ALS) and related disorders.

The purpose of this study is to learn more about amyotrophic lateral sclerosis (ALS) and other related neurodegenerative diseases, including frontotemporal dementia (FTD), primary lateral sclerosis (PLS), hereditary spastic paraplegia (HSP), progressive muscular atrophy (PMA) and multisystem proteinopathy (MSP). More precisely, the investigator wants to identify the links that exist between the disease phenotype (phenotype refers to observable signs and symptoms) and the disease genotype (genotype refers to your genetic information). The investigator also wants to identify biomarkers of ALS and related diseases.

The purpose of this study is to get a better understanding of what causes neonatal viral sepsis and to assess the impact of the infection on the babies' health over time. Enterovirus (EV) or human parechovirus (HPeV) are very common viruses that can cause neonatal viral sepsis. Information gained from this study may guide diagnosis and treatment of babies with neonatal viral sepsis in the future. This study will observe babies with neonatal EV or HPeV sepsis to assess and characterize the complications affecting them. The study will also identify key clinical measurements and tests that help predict the health outcomes of children with neonatal EV and HPeV sepsis. Further, although EV and HPeV are common causes of neonatal viral sepsis, this study seeks to identify other unknown viruses linked to neonatal viral sepsis. The information generated by this study will lay the foundation for clinical trial studies of antiviral drugs to treat neonatal viral sepsis.

The purpose of this study is to evaluate at-risk babies to determine the appropriate dose of oral valacyclovir comparable to the intravenous (IV) acyclovir doses typically used to treat babies with neonatal Herpes Simplex Virus (HSV) disease. IV acyclovir is best for the treatment of babies who already have HSV disease, but it is not ideal to prevent HSV disease because there are risks associated with IV use in babies. Valacyclovir is metabolized to become acyclovir, and although it has been studied in babies as young as one month old, there are no dosing recommendations for those less than three months old. This study focuses on at-risk babies whose mothers have a history of genital HSV infection and have been taking oral acyclovir or valacyclovir for several weeks before delivery. By studying the blood concentration, metabolism, clearance and safety profile of valacyclovir in infants less than one month old, we will determine the best dose of valacyclovir to prevent HSV infection when babies are exposed to it at birth. We will also inform larger studies using valacyclovir to treat neonatal HSV disease.

Congenital cytomegalovirus (CMV) infection is common and the leading viral cause of sensorineural hearing loss (SNHL) and mental retardation in infants. Despite current treatment options, babies with symptomatic congenital CMV disease are still at risk for hearing loss and neurologic deficits. Letermovir is the first new antiviral treatment of CMV to be licensed in over two decades. Two groups will be enrolled, and letermovir will be administered for 14 days in subjects in both groups. All subjects also will receive valganciclovir as standard of care. Group 1 (n=4) will be given a single dose based on their weight of letermovir on Study Day 0, with a full PK profile obtained over the next 24 hours to verify that the selected dose does not exceed the targeted exposure. Blood specimens will be shipped within approximately 24 hours to the UAB Pharmacokinetic Lab and processed in real time in order to get results back to the study site within an anticipated 7 days. If the drug levels are acceptable, the subject begin a 14-day course of once daily oral letermovir. If the dose is not acceptable, the dose will be adjusted down in 2.5mg increments. Once 4 subjects have been enrolled in group 1, the data and safety monitoring board will review all safety and drug level data. If no concerns are identified, then 8 additional subjects will be enrolled in group 2. The group 2 subject will start the 14 day course of study medication. The dose for group will be based on the data reviewed by the safety committee for the group 1 subjects.

Congenital cytomegalovirus (CMV) infection is the leading non-genetic cause of sensorineural hearing loss (SNHL) and the most frequent viral cause of mental retardation. Approximately 10% of infants born with CMV infection are symptomatic at birth, and of these, one-third will develop SNHL and two-thirds will experience developmental delays. A previous clinical trial run by the Collaborative Antiviral Study Group (CASG study 112) studied babies with congenital CMV infection who received either 6 weeks or 6 months of oral valganciclovir therapy. The results from this study suggested that 6 months of oral valganciclovir improved measures of neurodevelopment and hearing compared to 6 weeks of the treatment. The purpose of the current study is to assess participants from previous CASG studies and patients treated clinically for cCMV. The goal is to determine if there are long-term benefits of antiviral therapy on hearing and neurodevelopmental outcomes. Further, the current study will examine the long-term safety profile of valganciclovir when administered during infancy by assessing reports of cancer diagnoses and signs of puberty.

CEGIR is conducting this study because they want to learn more about Eosinophilic Gastrointestinal Diseases (EGIDs). As part of that goal, one area of study will compare how well a patient feels – their symptoms – with what the tissue samples look like under a microscope. The study aims to answer a series of questions, including the following: - What if the tissue looks good, but you are still experiencing symptoms? - What if the symptoms have subsided, but the eosinophil counts haven’t changed?

This is a phase 2, open-label trial testing the efficacy and safety of Zemaira in EoE. Qualifying participants will receive weekly intravenous infusions of 120 mg/kg body weight (BW) dose/week for 8 weeks for a total of 8 infusions. All participants will be followed for an additional 12 weeks after the last dose of study drug.

The study is a cross-sectional observational study designed to determine if eosinophilic gastritis (EoG) results in gastric mobility impairment.

This research includes four related projects each having different but overlapping goals. The first three projects, Natural History, Objective Measures, and Biobank, go together because they are related. The Patient-Centered Outcomes project is optional and depends on the type of dystonia you have and its treatment. 1. Natural History Project: The aim of this observational project is to better characterize the heterogeneity of clinical manifestations among subjects with dystonia, how these manifestations evolve over time, and how they relate to other family members. 2. Objective Measures Project: The aim of this project is to exploit technological advances for the development of objective tools to measure the severity of dystonia. 3. Biobank Project: The aim of this project is to develop a resource that expands the existing dystonia DNA biorepository to include other biomaterials. To date, no large multi-center open-access biorepository exists for any type of dystonia. 4. Patient-Centered Outcomes Project: The aim of this project is to delineate both between-subject and within-subject variations over time in response to the standard of care treatment with Botulinum toxin (BoNT) injections.

The investigators are conducting a natural history study of patients with congenital disorders of glycosylation (CDG). The study will look into the progression of the disease amongst the participants and also look at the clinical symptoms and how they vary amongst different diseased population groups. The participants will be asked to fill out questionnaires either on their own or with a provider that will grade the severity of disease and document symptoms and diet. Participants will have an opportunity to submit blood, urine, and stool samples that will be tested for biomarkers for CDG. Participants will also complete dietary food records, physical exams, CDG scores, and the PROMIS questionnaires to assess disease progression and severity.

A collaboration between pulmonologists and immunologists across the consortium, the project will systematically characterize the clinical phenotype and laboratory profile of patients with chronic suppurative respiratory diseases that are typically referred to pediatric and adult pulmonologists. A primary goal of this project is to identify the genetic basis of suppurative respiratory disease, including those with primary ciliary dyskinesia, primary immunodeficiencies, and other genetic disorders that interfere with airway defenses in patients without a confirmed genetic cause for their disease. This one-visit study includes a comprehensive medical history, physical exam, spirometry, nasal nitric oxide measurements, laboratory testing for genetics and immunologic evaluation, and a chest CT.

This longitudinal study will examine respiratory tract exacerbations in primary ciliary dyskinesia. Given their negative impact on the lives of people with primary ciliary dyskinesia, respiratory tract exacerbations are obvious targets for interventional trials designed to establish evidence-based guidelines for their prevention and treatment. This longitudinal, multicenter study will define clinical features that characterize exacerbations, and examine innovative mobile health monitoring tools, including home spirometry, validated disease-specific quality of life instruments, and novel bedside digital cough monitoring over a one-year period.

A collaboration between pulmonologists, immunologists, and otolaryngologists at four sites, this project is designed to comprehensively define and compare the clinical manifestations and morbidity of upper airway involvement in primary ciliary dyskinesia and primary immunodeficiencies. The main objective of this project is to collect critical data to inform the design of future clinical trials that treat upper airway disease in these conditions. This one-visit study will include a comprehensive medical history, targeted ENT physical, nasal endoscopy, mucus sample collection, nasal nitric oxide, smell identification testing, audiology assessment and a sinus CT.

The purpose of this study is to: (a) define novel homogeneous groups of patients with leukodystrophies and work toward finding the cause of these disorders; (b) assess the validity and utility of next-generation sequencing in the diagnosis of leukodystrophies; (c) establish disease mechanisms in selected known leukodystrophies; (d) track current care and natural history of these patients to define the longitudinal course and determinants of outcomes in these disorders; and (e) contacting subjects with specific diagnoses (or lack thereof) with information about other research studies or clinical programs that may be beneficial.

This study seeks to query the Electronic Health Record (EHR) at participating institutions in an automated fashion in order to development a large-scale library of clinically pertinent natural history data for individuals with a confirmed diagnosis of leukodystrophy. Automated data extraction techniques will be supplemented by traditional/manual chart abstraction approaches to ensure data integrity. Data collection and analysis methodologies will undergo face validation, inter-rater reliability, reproducibility, longitudinal stability, internal validation and construct validity under the careful oversight of the GLIA-CTN Data Integration Core (DIC) based at the Children's Hospital of Philadelphia.

The goal of this clinical project is to create a portfolio of disease-specific outcome assessments to facilitate design and execution of future therapeutic trials for adults with AMN. Specifically, investigators will determine the ability of a novel AMN rating scale to measure function, including a comparison of the trajectory between this rating scale and the Patient Reported Outcome (PRO) data obtained via RDCRN Protocol No. 8501. Finally, investigators will assess the rate of change in quantitative ataxia measures using force plate technology, and then compare this to wearable devices in enrolled individuals.

The primary objective of this research study is to identify and validate novel biomarkers in CSF, and to establish their correlation to clinical features and outcomes in specific leukodystrophies; for example, we propose to explore known protein biomarkers in AGS and AxD, including GFAP, NFL, and IP10, as well as candidate biomarkers such as inflammatory proteins including cytokines and chemokines, structural proteins, cell surface proteins, and markers of myelination and neuronal function. The study also seeks to characterize the stability of known and novel biomarkers under different shipping and storage conditions, which will allow investigators to explore the feasibility of multi-center biomarker collection procedures, with centralized processing and storage, in preparation for similar approaches in the context of future clinical trials for various leukodystrophies. Assay validity will be investigated using both intra- and inter-assay measurements.

A lack of high quality natural history data, based on a uniform, quantitative evaluation of patients continues to hinder the efforts to perform clinical trials for most forms of CMT. This study aims to determine the natural history of CMT1B, CMT2A, CMT4A, CMT4C, and other types of CMT in order to refine the overall picture of disease for use in future clinical trials.

Despite great success of gene identification in CMT, there is still much more genetic heterogeneity to uncover. In addition, modifying factors are an important aspect of CMT, but have been rarely studied in a systematic fashion. This study will apply innovative study designs and the latest technology to tackle some of the most pressing genetic issues in CMT, ultimately paving the way for new therapeutic approaches. This study aims to determine if gene modifiers exist for CMT1A, and to find new genetic causes of CMT.

It is likely that progression also varies during different pediatric age groups for different forms of CMT. However, there are no large-scale epidemiological data available for the genetic distribution or natural history of inherited neuropathies in the pediatric age group. This study aims to develop and test the CMT Peds scale (CMTPedS) in children with CMT in order to refine the scoring for future natural history and therapeutic trials. This study involves designing a pediatric scale(s) to measure impairment in children with CMT and to test the scale’s ability to measure disease progression in patients.

No CMT-specific clinical outcome measure currently exists to measure disease severity or progression in children from birth to 3 years of age. This is an important omission since future clinical interventions may be most effective in slowing disease progression if given early in life.The purpose of this study is to develop and validate a clinical outcome measure to evaluate disability and disease progression of children ≤3 years of age (infants and toddlers) with various types of Charcot-Marie-Tooth disease (CMT).

This proposal aims to study the natural history and ERT effect on cardiac and vascular tissue in Fabry disease using unbiased quantitative validated morphometric approaches with functional and imaging correlations. These studies will substantially improve our understanding of the pathophysiology of cardiovascular and renal complications in Fabry and can introduce new approaches to quantify treatment response in cardiomyocytes and arteriol smooth muscle cells, with potential application in clinical trials and at the bedside. In addition to these histomorphometric studies, we propose to study autonomic dysfunction, a common complication in FD patients that is not well characterized, and the effect of ERT on this complication. The novel nature of this study lies in the analysis of tissues samples in a heretofore unused method that correlates tissue analysis with medical data to make determinations of kidney, cardiac, and skin tissue damage in Fabry disease.

Study personnel will perform broad outreach via social media, patient advocacy groups, academic institutions to identify subjects with MUSK myasthenia who will be willing to provide verification of laboratory diagnosis, medical and family history, and a saliva sample. Subjects will be able to contact the study personnel by website, email, phone, and mail. Once inclusion criteria are met, saliva collection kit will be mailed with a return mailer. Samples will be stored in the GW biorepository until the study is complete. Saliva will then be shipped to NIH after an appropriate material transfer agreement is approved. 

NEPTUNE is a study network to improve the identification and management of patients with Nephrotic Syndrome (NS) from Minimal Change Disease (MCD), Focal and Segmental Glomerulosclerosis (FSGS), and Membranous Nephropathy (MN). NEPTUNE includes study sites located at universities and medical facilities across North America and brings together patients, patient advocates, doctors and scientists working together to find better treatments for NS. The network allows experts from many areas to share research information to fast-track results that lead to new discoveries.

Continue the longitudinal natural history study of phenotypic and genetic features of PDC deficiencies by integration with the NAMDC Patient Data Registry and Biorepository, recruitment of a broad group of subjects, and detailed longitudinal follow-up, to identify and objective measurable clinically relevant outcomes, biomarkers, and responses to treatments.

Establish the maximum tolerable dose of L-citrulline in patients with MELAS.

Evaluate PRISM and CFN interventions in adults with primary mitochondrial disease (PMD). Develop basic statistical pilot information to develop a first efficacy study.

The porphyrias are a group of rare metabolic diseases that may present in childhood or adult life and are due to deficiencies of enzymes in the heme biosynthetic pathway. Porphyrias have various symptoms depending on the type, but these can range from neurological symptoms to sun sensitivity. See the descriptions of each type to get more information. The natural history of these disorders is not well described and it is not known why some patients are more severe than others. Therefore, the purpose of this long-term follow-up study is to collect a large group of patients with the different types of porphyria and to provide a better understanding of the natural history of these disorders. The hope is that this information will help in developing new forms of treatment. The research aims are: 1. To study the prevalence of specific indicators of disease severity. To study the effects on quality of life and health of various porphyrias. 2. To determine the relationships between disease severity and various biological characteristics, genetic information, and environmental factors.

The purpose of this study is to collect information on acute porphyria attacks that may have been caused by a medication. Individuals who have tested positive for an acute porphyria, or have been told by a doctor that they may have the disease may join this study. We are particularly interested in the following: (1) Attacks that appeared to be due to a specific medication; (2) Use of a medication that is considered risky in porphyria but caused no problems; and (3) Use of medications for which the safety profile in porphyria is unknown.

Erythropoietic protoporphyria (EPP) and X-linked protoporphyria (XLP) result from genetic defects of heme biosynthesis that cause life-long, painful cutaneous sensitivity to light. The objective of this study is to determine the efficacy and safety of oral cimetidine administration for treatment of the protoporphyrias. Efficacy will be based on protoporphyrin levels, photosensitivity, and quality of life questionnaires.

AIP is rare a genetic disorder caused by mutations in the hydroxymethylbilane synthase gene (HMBS) that reduce the function of an enzyme (a type of protein) in the body that is necessary for the production of heme. Heme is important for your body to use oxygen and for your liver to work properly. When a person does not produce enough of this enzyme, substances called ALA and PBG can accumulate, and this can cause symptoms of AIP. These symptoms may include abdominal pain; pain in the arms, legs and back; muscle weakness; nausea and vomiting; and confusion, hallucinations, and seizures. A small portion of AIP patients have recurrent attacks, while many others who have a mutation in the HMBS gene never develop symptoms. The purpose of this research study is to learn more about genetic factors (specific patterns in a gene) that predispose or protect an individual with a change (or mutation) in the gene that causes Acute Intermittent Porphyria (AIP) to develop symptoms.

This study focuses on the natural history of patients with PIRD to help collect data on ideal therapies for these patients. There are two groups that are being studied. The first group enrolls patients who have clinical symptoms commonly seen in PIRD. These patients can have a known or unknown genetic defect. We will collect retrospective data from the medical chart and follow these patients over time prospectively. This study will help characterize the clinical symptoms and responses to treatments both medications and bone marrow transplant. The study will collect data yearly from the clinical record. There will also be research samples at the start of enrollment and one year later. If the patient receives a bone marrow transplant, research samples will be collected one month prior to transplant and a year later. The second group is focused on family members of PIRD patients enrolled in the first group with a known genetic mutation. These family members will have the same genetic change but do not have clinical symptoms of PIRD. These participates will answer yearly questionnaires to monitor of symptoms.

Individuals with a possible diagnosis of severe combined immune deficiency (including infants who were identified by newborn screening) may be eligible to be enrolled on the PIDTC research study 6907. Speak to your doctor to determine if you / your child may be eligible.  Protocol 6907 follows all patients with SCID, meaning the 6907 study enrolls participants regardless of whether they have already received a blood and marrow transplant (BMT), enzyme replacement therapy (ERT), or gene therapy (GT). Patients are then followed after diagnosis and treatment according to standard of care recommendations, which typically align with a schedule set out by the study protocol. The times the study requests follow up will be the same as when your doctor would want to be seeing you / your child as part of their regular ongoing medical care. Patients with “leaky SCID” (a form of SCID with T cell numbers less severely compromised) and Omenn syndrome are also eligible to participate in 6907. The 6907 research study does NOT dictate how your / your child’s doctors should treat you / your child, as the PIDTC recognizes that there are many complex factors that go into this decision.  The decision about how you / your child with SCID will be treated is made by your doctor.  The 6907 study simply follows how you / your child do over time.  There are no experimental therapies on this study.

Chronic Granulomatous Disease (CGD) is an inherited condition characterized by a defect of specific white blood cells called neutrophils. Neutrophils are important for the killing of bacterial and fungal infections. In CGD, the neutrophils are unable to make the hydrogen peroxide needed to kill bacteria and fungi. Patient with CGD are, therefore, highly susceptible to infections from certain bacterial and fungal organisms. Patients with CGD have normal immunity to other microbes, including viruses. As a result, patients with CGD have normal immunity against common infections like the common cold or stomach flu (the majority of which are caused by viruses). Children with CGD are usually healthy at birth; however, they typically develop serious bacterial and fungal infections in early childhood that are difficult to treat. Patients may have severe or frequent infections.

Long-term observation of the impact of UCDs on physical and neurological functioning, the relationship between health indicators and disease severity and the efficiency of UCD therapies.

A post-marketing surveillance of carglumic acid (Carbaglu) to obtain long-term clinical safety information. Carglumic acid was approved by the United States Food and Drug Administration (FDA) for treatment of acute hyperammonemia due to N-acetylglutamate synthase (NAGS) deficiency.

Study of how UCDs affect thinking, body chemistry and brain structure using magnetic resonance imaging (MRI) and behavioral testing.

The purpose of this research is to determine if silent seizures (electrographic seizures) occur during a hyperammonemic (HA) episode in patients with urea cycle disorders (UCD). Urea cycle disorders lead to accumulation increased ammonia due to problems breaking down protein. The symptoms of UCD may present at birth, childhood or adulthood (milder deficiencies) and are associated with cognitive deficits, changes in behavior, brain swelling and seizures. Sometime the seizures are not clinically obvious, but can be picked up if a video recording and concurrent EEG (video EEG is used, cVEEG). cVEEG is used in many intensive care units across the country to pick up seizures. We want to determine if having seizures due to HA leads to any adverse cognitive outcomes, and want to use the EEG to identify any changes that may be associated with that.

The purpose of this study is to measure liver stiffness and chemicals in the blood that test liver injury and function in four urea cycle disorders. Sometimes the seizures are not clinically obvious, but can be picked up if a video recording and concurrent EEG (video EEG is used, cVEEG). cVEEG is used in many intensive care units across the country to pick up seizures. We want to determine if having seizures due to HA leads to any adverse cognitive outcomes, and want to use the EEG to identify any changes that may be associated with that.

We are doing this study to see how the results of two sets of tools used to measure developmental progress relate to one another and how acceptable completing each of these measures is to children and families of children with Urea Cycle Disorders. We are anxious to make longitudinal assessment (repeated observations over time) of cognition easier, quicker and more accessible for families of children with urea cycle disorders. In order to do so we want to understand the relationship between the 2 sets of measures.

The purpose of this research study is to test a new method to measure food intake using smart phone photos of your food before and after meals. We will compare the smart phone food photos to a 3-day diet record and we will measure how many calories you burn.