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FRAXA's mission is to find effective treatments and a cure for all children and adults with Fragile X, by directly funding the most promising research.

Click here to view a list of Principal Investigators with FRAXA funding; click on a name to view an abstract. Or, read below about our research strategy.


Our Strategy
What is the Most Promising Research?
Development of the mGluR Theory
Goals for 2010

Our Strategy

As the pace of Fragile X research accelerates, the prospects of finding effective treatments and a cure for Fragile X continue to improve. FRAXA-funded researchers at universities around the world are leading the way.

FRAXA's current research portfolio spans the full spectrum of basic science, pre-clinical, and clinical research -- all coordinated to make the most of each research dollar. We maintain a diversified approach, developing several treatment strategies in parallel, since success is never certain in developing a single drug. We continue to fund research to define the precise defect in the Fragile X brain, because these basic studies may yield additional important therapeutic targets. FRAXA also organizes and sponsors conferences where Fragile X researchers share their results and plan collaborations, and where new researchers are recruited.



Where are we now?

In the words of FRAXA Scientific Advisor Dr. Justin Fallon, "Fragile X is poised to become a triumph for translational research and the design of rational therapeutics for brain disease."



What is the Most Promising Research?

We are often asked "What is the research most likely to lead to better treatments for Fragile X in the near future?" While no one can foresee the future, we are optimistic that the mGluR Theory of Fragile X will lead to treatments for Fragile X and for autism.

The first step towards a cure is to fully understand the cause of Fragile X. In the words of Nobel Laureate James D. Watson, the 1991 discovery of the Fragile X gene "was the first major human triumph of the Human Genome Project." Researchers now know that this gene shuts down in people with Fragile X, and the result is that brain cells don't communicate normally. In fact, there is actually too much of a certain kind of learning; in scientific jargon this is termed mGluR-LTD. Researchers have found that excessive mGluR-LTD may be common to many forms of autism spectrum disorders.

The really exciting part of this discovery is that it is possible to intervene in this hyperactive brain mechanism. Compounds exist which dampen the mGluR pathway, and some of these drugs are being developed by major pharmaceutical companies for other indications, like anxiety disorders. This discovery has led us to the threshold of treatment for Fragile X, and possibly for autism as well.

FRAXA-funded scientists are currently testing several drug strategies for toning down this excessive activity. Animal studies are in progress, several human Fragile X trials of new compounds are being planned, and a clinical trial of one drug which acts on mGluR pathways - lithium -- is underway.



Development of the mGluR Theory
  • May 1997 FRAXA investigator and scientific advisor Dr. William Greenough reports that FMRP, the fragile X protein, is synthesized in dendrites in response to synaptic activity and stimulation of metabotropic glutamate receptors (mGluRs).

  • Nov. 2000 In a FRAXA-funded research project started at Brown University, Drs. Mark Bear and Kim Huber make the important discovery that one mechanism of communication between neurons is defective in mice which have been bred to model Fragile X. This mechanism, called long-term depression (LTD), is a form of synaptic plasticity, the molecular basis of learning and memory. The team studied one specific form of LTD which occurs only if and when mGluRs are stimulated. They found that mGluR-LTD is excessive in the Fragile X knockout mouse.

    This discovery has enormous implications for our understanding of Fragile X and related autism spectrum disorders. It and follow-up experiments have led to the "mGluR Theory" of Fragile X: that exaggerated signaling in mGluR pathways underlies many cognitive, behavioral, and neurological symptoms of Fragile X (and probably autism, too.)

  • May 2001 With FRAXA funding, Dr. Robert Bauchwitz of Columbia University tests the mGluR Theory by treating Fragile X mice with MPEP, a compound which blocks one kind of metabotropic glutamate receptor (mGluR5). According to the theory, this should reverse the major symptoms of Fragile X. In mice, the simplest symptoms to test are hyperactivity and sound-induced seizures. MPEP is found to reverse these symptoms with a single low dose in Fragile X mice.

  • April 2002 The mGluR Theory is introduced at FRAXA's Banbury Conference on Fragile X at Cold Spring Harbor Laboratory, spurring other researchers to follow up on this discovery. Fragile X is now becoming accepted as the first known disease of "synaptic plasticity." Yearly Banbury meetings have since recruited some of the world's top neuroscientists to the study of Fragile X.

  • 2003 A team led by Dr. Tom Jongens of the University of Pennsylvania demonstrate that fruit flies with a mutated Fragile X gene have learning deficits and that MPEP can rescue these abnormalities, even when given to adult flies. The team subsequently shows that the Fragile X flies have abnormal brain anatomy, which can also be corrected by treatment with MPEP during development. Further studies demonstrate that an available drug, lithium, which inhibits mGluR signaling pathways, also rescues Fragile X fly anatomy and cognition. FRAXA then commissions further studies at the Bauchwitz lab at Columbia, which confirm that lithium can treat seizures and hyperactivity in the Fragile X mouse model.

  • 2004 FRAXA-funded researcher Dr. Robert Wong at SUNY Downstate demonstrates that isolated slices of Fragile X knockout mouse brain have more seizure activity than normal mouse brain. He shows that this seizure activity occurs only if mGluR5s are stimulated and shows also that MPEP blocks it.

  • February 2005 Dr. Peter Vanderklish of Scripps Institute, a FRAXA-funded investigator, shows a distinct pattern of abnormal protein synthesis in Fragile X neurons. This pattern immediately normalizes with brief MPEP treatment.

  • July 2005 FRAXA funds a clinical trial of lithium in Fragile X patients, run by Dr. Elizabeth Berry-Kravis at RUSH University, Chicago.

  • July 2005 Researchers at Hoffman LaRoche report that fenobam, a compound used in Phase II/III human trials from 1978-82, is a selective mGluR5 antagonist. In these trials, fenobam showed efficacy for treatment of anxiety disorders, but it was never tested in patients with Fragile X. Its patent has now expired, so it can be tested at will.

  • December 2005 FRAXA contracts with Scynexis to synthesize fenobam for experimental basic research and makes test batches available to qualified researchers free of charge.

  • December 2007 Dr. Mark Bear, Dr. Gul Dolan, and colleagues publish a definitive validation of the mGluR Theory in Neuron (Correction of Fragile X Syndrome in Mice). They generated Fmr1 mutant mice with reduced mGluR5 expression and studied a range of phenotypes with relevance to the human disorder. They were able to correct 4 out of 5 features of the disorder.

    They note: "a simple way to conceptualize the constellation of findings is that fragile X is a disorder of excess — excessive sensitivity to environmental change, synaptic connectivity, protein synthesis, memory extinction, body growth, and excitability — and these excesses can be corrected by reducing mGluR5. ... These findings have major therapeutic implications for FXS and autism."

  • June 2010 FRAXA is now actively collaborating with several of the largest pharmaceutical companies in the world and several of the smallest startup companies to bring treatments for Fragile X into clinical trials. FRAXA is developing clinical trial sites, as well as improved biomarkers and outcome measures, which will make future trials more effective. We will continue to develop the capacity necessary to advance potential therapies through clinical trials and into routine use.

    For current clinical trials and breaking news, see News Releases and sign up for email updates below.


FRAXA's Top 2010 Goals
  1. In 2008, our goal was to initiate human trials of experimental drugs that target mGluR5 (mGluR5 antagonists) in people with Fragile X. In 2009, we aimed to begin the next phase: long term (1 month or more) trials in people with Fragile X.

    These have been done: Novartis conducted a trial in Europe, and Roche is now in the middle of a trial in the U.S.

  2. Over the past two years, we aimed to initiate clinical trials of available drugs which FRAXA-funded research showed to to be promising, including lithium, baclofen, and minocycline. This too has been done:
    1. lithium trial was completed and results published
    2. baclofen trial has been completed by Seaside Therapeutics and results will be analyzed and announced this year
    3. minocycline trial has completed its first phase in Canada. Results are being analyzed now.

    In 2010, our top goals are:

    1. to report results of the baclofen and minocycline trials and
    2. to move forward with the studies needed to bring mGluR5 antagonist drugs to the clinic. This is a complex process dependent on FDA rules and regulations.
    3. to identify additional available drugs that show promise in treating or curing Fragile X.


    Thanks to a dedicated and growing team of talented scientists and generous donors, We have every hope of bringing effective treatments to fragile X patients and their families!

    by Katie Clapp and Michael Tranfaglia MD

 
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Editor/writers: Katie Clapp, MS, and Michael Tranfaglia, MD. Updated 5/23/10. All rights reserved. Disclaimer Created by Dave Fullam and Icovia