ICF: Epigenomics Rare Diseases Node
Lead Research Organisation:
UNIVERSITY OF EXETER
Department Name: Clinical and Biomedical Sciences
Abstract
Epigenomics and epigenetics are the studies on how the activity of genes are controlled. The EpiGenRare node will coordinate research in epigenomics of rare diseases. This is important because >100 rare epigenetic diseases are known, and collectively they represent a large number of patients with rare dieases. Epigenetic diseases remain challenging to discover, diagnose, understand and treat. Furthermore, epigenomic studies that have the ability to study changes across all of the DNA in patients are important even for those rare diseases that are not traditionally seen as epigenetic diseases.
This multi-disciplinary node team (investigators, partners and collaborators) includes experts in relevant disciplines, industry, and patient support groups and encompasses institutions across the UK and investigators at different career stages. Our team builds on substantial existing infrastructure, funding and track records that will enable us to tackle the challenges in the area.
In our networking activities we will undertake a scoping survey to generate a list of individuals and institutions relevant for this field, and invite them to be members of EpiGenRare. Between years two and five, we will host two multi-disciplinary EpiGenRare conferences. Over the course of five years, we will arrange at least four EpiRare meetups on the side-lines of other scientific conferences. We will organise research or educational sessions at other conferences where epigenomics is relevant, but traditionally has not been a focus for those meetings. We will prioritise networking with other nodes in the Rare Disease Platform through brainstorming sessions.
For co-ordination we will organise a virtual EpiGenRare (for investigators and partners) kick-off meeting followed by an Introductory EpiGenRare meeting (for all members). Thereafter, we will hold EpiGenRare Operational meetings every 4 months. Individual research project team meetings will be organised at appropriate frequencies, minimum once a month. We will also form the EpiGenRare Advisory Board (including scientific and clinical leaders, industry and patient and public representatives) that will meet annually.
We propose three enabling projects: (1) To generate a resource linking patients' genomic and epigenomic data which can be used by other researchers. (2) To perform preliminary studies in animal models to test if similar treatment approach could be used for multiple epigenetic diseases that share clinical features and biological mechanisms. (3) Generate a resource of well studied human cell models for large scale drug testing in epigenetic diseases. Additionally, we have put in place ideas for future projects with our collaborators and several other nodes in the UK Rare Disease Platform.
As part of our patient and public involvement (PPI) program we will build upon our existing relationships with various relevant patient-family support groups. Patient support groups will be part of the advisory board and will participate in driving the networking activities and the research and collaboration agenda. We will bring together several patient support groups at different stages of development. With patient support groups we will co-develop patient information resources, organise family education days and work together to develop evidence-based management guidelines for epigenetic disorders.
In conclusion, the EpiGenRare node is timely and addresses several unmet needs and will help to enhance the performance of the UK Rare Disease Platform. Our networking activities and PPI program will lead to establishing a national collaborative multi-disciplinary network for epigenomics of rare diseases that would be an international reference on research in rare epigenetic disorders for clinicians, researchers, patient support groups and policy-leaders. Our current and future research projects will allow us to accelarate diagnosis and treatments for epigenetic disorders.
This multi-disciplinary node team (investigators, partners and collaborators) includes experts in relevant disciplines, industry, and patient support groups and encompasses institutions across the UK and investigators at different career stages. Our team builds on substantial existing infrastructure, funding and track records that will enable us to tackle the challenges in the area.
In our networking activities we will undertake a scoping survey to generate a list of individuals and institutions relevant for this field, and invite them to be members of EpiGenRare. Between years two and five, we will host two multi-disciplinary EpiGenRare conferences. Over the course of five years, we will arrange at least four EpiRare meetups on the side-lines of other scientific conferences. We will organise research or educational sessions at other conferences where epigenomics is relevant, but traditionally has not been a focus for those meetings. We will prioritise networking with other nodes in the Rare Disease Platform through brainstorming sessions.
For co-ordination we will organise a virtual EpiGenRare (for investigators and partners) kick-off meeting followed by an Introductory EpiGenRare meeting (for all members). Thereafter, we will hold EpiGenRare Operational meetings every 4 months. Individual research project team meetings will be organised at appropriate frequencies, minimum once a month. We will also form the EpiGenRare Advisory Board (including scientific and clinical leaders, industry and patient and public representatives) that will meet annually.
We propose three enabling projects: (1) To generate a resource linking patients' genomic and epigenomic data which can be used by other researchers. (2) To perform preliminary studies in animal models to test if similar treatment approach could be used for multiple epigenetic diseases that share clinical features and biological mechanisms. (3) Generate a resource of well studied human cell models for large scale drug testing in epigenetic diseases. Additionally, we have put in place ideas for future projects with our collaborators and several other nodes in the UK Rare Disease Platform.
As part of our patient and public involvement (PPI) program we will build upon our existing relationships with various relevant patient-family support groups. Patient support groups will be part of the advisory board and will participate in driving the networking activities and the research and collaboration agenda. We will bring together several patient support groups at different stages of development. With patient support groups we will co-develop patient information resources, organise family education days and work together to develop evidence-based management guidelines for epigenetic disorders.
In conclusion, the EpiGenRare node is timely and addresses several unmet needs and will help to enhance the performance of the UK Rare Disease Platform. Our networking activities and PPI program will lead to establishing a national collaborative multi-disciplinary network for epigenomics of rare diseases that would be an international reference on research in rare epigenetic disorders for clinicians, researchers, patient support groups and policy-leaders. Our current and future research projects will allow us to accelarate diagnosis and treatments for epigenetic disorders.
Technical Summary
The EpiGenRare node will coordinate research in the domain of epigenomics of rare diseases. Our multi-disciplinary team has expertise in epigenomics, epigenetic mechanisms, human genetics, animal and human pluripotent cell models. We will establish a national collaborative multi-disciplinary network that would be an international reference on research in rare epigenetic disorders for clinicians, researchers, patient support groups and policy-leaders. We will provide training opportunities for early career researchers and deliver networking opportunities by hosting EpiGenRare conferences to bring together fundamental and clinician scientists, clinicians, technical and methodological experts, and patient groups, members of other nodes and international experts.
Our initial research focus will be on rare diseases with mutations in genes encoding chromatin modifiers and multi-locus imprinting disorders (MLID). Collectively, this group of epigenetic disorders are relatively common with major unmet clinical need due to their mechanistic basis being poorly understood, and progress in their management being hampered by the lack of known biomarkers and therapies. To address these challenges, we will (1) create a linked resource of patient samples to decipher the genome-epigenome relationships in imprinting disorders; (2) explore the possibility of therapeutic convergence in chromatinopathies using mouse models of biologically and clinically overlapping diseases, and (3) lay the ground for large-scale high throughput drug screening for therapies using human stem cell models for chromatinopathies.
These projects will enable technology evaluation and complete data integration for the development of diagnostic, prognostic and therapeutic biomarkers from patient samples, provide evidence for convergent mechanisms and preliminary data for translational and pre-clinical projects and generate sharable resources (mouse and human models, technological approaches and data).
Our initial research focus will be on rare diseases with mutations in genes encoding chromatin modifiers and multi-locus imprinting disorders (MLID). Collectively, this group of epigenetic disorders are relatively common with major unmet clinical need due to their mechanistic basis being poorly understood, and progress in their management being hampered by the lack of known biomarkers and therapies. To address these challenges, we will (1) create a linked resource of patient samples to decipher the genome-epigenome relationships in imprinting disorders; (2) explore the possibility of therapeutic convergence in chromatinopathies using mouse models of biologically and clinically overlapping diseases, and (3) lay the ground for large-scale high throughput drug screening for therapies using human stem cell models for chromatinopathies.
These projects will enable technology evaluation and complete data integration for the development of diagnostic, prognostic and therapeutic biomarkers from patient samples, provide evidence for convergent mechanisms and preliminary data for translational and pre-clinical projects and generate sharable resources (mouse and human models, technological approaches and data).
Organisations
- UNIVERSITY OF EXETER (Lead Research Organisation, Project Partner)
- National Inst. Health & Care Research (Co-funder)
- ORYZON Genomics SA (Project Partner)
- Great Ormond Street Hospital (Project Partner)
- CARDIFF UNIVERSITY (Project Partner)
- University of Oxford (Project Partner)
- University of Southampton (Project Partner)
- University of Edinburgh (Project Partner)
- University of Manchester (Project Partner)
- Genomics England (Project Partner)
- Unique (Rare Chromosome Disorder SG) (Project Partner)
- Babraham Institute (Project Partner)
Publications
Rots D
(2024)
Comprehensive EHMT1 variants analysis broadens genotype-phenotype associations and molecular mechanisms in Kleefstra syndrome.
in American journal of human genetics
Lessel I
(2025)
DNA-binding affinity and specificity determine the phenotypic diversity in BCL11B-related disorders.
in American journal of human genetics
Basson M
(2024)
Neurodevelopmental functions of CHD8: new insights and questions
in Biochemical Society Transactions
Rots D
(2024)
Pathogenic variants in KMT2C result in a neurodevelopmental disorder distinct from Kleefstra and Kabuki syndromes.
in American journal of human genetics
Ciuca A
(2024)
Patient-reported outcomes and measures are under-utilised in advanced therapy medicinal products trials for orphan conditions.
in Journal of clinical epidemiology
| Description | Functional Genomics of Human Brain Development Cluster |
| Amount | £4,194,985 (GBP) |
| Funding ID | MR/Y031016/1 |
| Organisation | Medical Research Council (MRC) |
| Sector | Public |
| Country | United Kingdom |
| Start | 04/2024 |
| End | 05/2028 |
| Description | SINEUP for CHARGE |
| Amount | $50,000 (USD) |
| Organisation | CHARGE Syndrome Foundation |
| Sector | Charity/Non Profit |
| Country | United States |
| Start | 09/2024 |
| End | 09/2025 |
| Title | A Double-Blind, Randomized, Placebo-Controlled, Safety and Efficacy Study of ANAVEX2-73 in Patients with Rett Syndrome (ANAVEX2-73-RS-002, adult patients) |
| Description | A double-blind, placebo-controlled study to assess the safety and efficacy of ANAVEX2-73 in patients with Rett (RTT) Syndrome. RTT is a progressive neurodevelopmental disorder occurring predominantly in females. RTT patients develop normally until 6 to 18 months and then regress in physical, cognitive, and neurological functions. Patients lose expressive language skills, motor skills and develop stereotypic hand movements. Multiple issues develop, including microcephaly, seizures, anxiety, ataxia, hyperventilation and gastrointestinal dysfunction. ANAVEX2-73 is an oral sigma-1 receptor agonist that restores cellular homeostasis by targeting protein misfolding, oxidative stress, mitochondrial dysfunction, inflammation and cellular stress. It is an effective neuroprotective, anticonvulsive and anti-depressive agent. Assessments of cognition, behaviour, motor function, seizures, respiratory and other autonomic dysfunction will be used to measure the safety, tolerability and efficacy of ANAVEX2-73 over a 7 week period (followed by a 48 week voluntary extension) in female RTT patients aged 18 or over. Therapeutic benefit will be measured as improvement in behavioral and physiological activity. Study sites include a Neuroscience site and a Genomic Medicine site in the UK and a Hospital Neurology Department in Ireland. Anavex Life Sciences Corp will fund the research and exploratory efficacy endpoints will be measured as: RSBQ Emotional Factor-Adult Anxiety, Depression, and Mood Scale (ADAMS) Children's Sleep Habits Questionnaire (CSHQ) Visual Analog Scale (VAS) of the top three concerns a family has for their daughter Rett syndrome Caregiver Inventory Assessment (RTT CIA) Child Health Questionnaire-Parent Form 50 (CHQ-PF50) Seizure Frequency via seizure diary. A Clinical Global Impression Scale will be used to assess severity improvement of the Rett condition. Siddharth Banka's team in Manchester was activated as a site by the sponsor (Anavex Life Sciences Corp.) on 27th November 2020. The first patient was recruited in June 2021. Recruitment has since closed (5 patients recruited) and the trial is currently in follow-up with data cleaning taking place. |
| Type | Therapeutic Intervention - Cellular and gene therapies |
| Year Development Stage Completed | 2020 |
| Development Status | Under active development/distribution |
| Impact | TBC |
| URL | https://www.hra.nhs.uk/planning-and-improving-research/application-summaries/research-summaries/the-... |
| Title | A Novel, Regulated Gene Therapy (NGN-401) Study for Female Children With Rett Syndrome |
| Description | A Phase 1/2, Open-Label Clinical Study to Evaluate Safety, Tolerability, and Efficacy of NGN-401 in Pediatric Subjects with Rett Syndrome This first-in-human study will test an experimental gene therapy study treatment, NGN-401. NGN-401 is an adeno-associated viral vector serotype 9 (AAV9), using Neurogene's proprietary transgene regulation technology. NGN-401 contains a full-length human MECP2 gene which is designed to express therapeutic levels of the MECP2 protein while avoiding overexpression. The purpose of this research study is to test whether NGN-401 is safe, tolerable and effective in female children who are 4 to 10 years old with a diagnosis of typical Rett syndrome and who have a documented disease-causing mutation in the MECP2 gene. The study treatment will be administered under general anesthesia via intracerebroventricular (ICV) delivery. Each participant will be followed for safety and preliminary efficacy for 5 years after treatment and is expected to enroll in a long-term follow-up study for 10 years. Siddharth Banka's team in Manchester was activated as a site by the sponsor (Neurogene Inc.) on 30th Aug 2024. |
| Type | Therapeutic Intervention - Cellular and gene therapies |
| Year Development Stage Completed | 2024 |
| Development Status | Under active development/distribution |
| Impact | N/A |
| URL | https://www.hra.nhs.uk/planning-and-improving-research/application-summaries/research-summaries/a-no... |
| Title | Double-Blind, Randomized, Placebo-Controlled, Safety and Efficacy Study of ANAVEX2-73 in Patients with Rett Syndrome (ANAVEX2-73-RS-003, paediatric patients) |
| Description | This Phase 2/3 efficacy study is designed as a double-blind, randomized, placebo-controlled study. This is a 12-week placebo-controlled study of ANAVEX2-73 oral solution for the treatment of patients with RTT 5-17 years of age. A voluntary option will be offered for all patients who meet the exposure criteria for ANAVEX2-73 to continue a 48-week open label extension. Siddharth Banka's team in Manchester was activated as a site by the sponsor (Anavex Life Sciences Corp.) on 1st June 2022. Recruitment has since closed (6 patients recruited) and the trial is currently in follow-up with data cleaning taking place. |
| Type | Therapeutic Intervention - Cellular and gene therapies |
| Current Stage Of Development | Early clinical assessment |
| Year Development Stage Completed | 2022 |
| Development Status | Closed |
| Impact | N/A |
| URL | https://clinicaltrials.gov/study/NCT04304482 |
| Description | Hosted the 1st EpiGenRare Meeting |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | Siddharth Banka and Albert Basson hosted the 1st EpiGenRare Meet-up virtually on October 30, 2024, bringing together members of the EpiGenRare network, SAB members, and other collaborators. The event highlighted fascinating research on epigenetic rare conditions within this Node and also featured talks from patient advocates and an international plenary speaker. |
| Year(s) Of Engagement Activity | 2024 |
| URL | https://rd-research.org.uk/uncategorized/event-epigenrare-virtual-meet-up/ |
| Description | Presented Poster at the Manchester Rare Conditions Centre Annual Celebration Event (Manchester) |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Professional Practitioners |
| Results and Impact | Henry Frost and Gabrielle Parkinson presented an EpiGenRare poster at the Manchester Rare Conditions Centre Annual Celebration Event (Manchester) on the 17th July 2024. |
| Year(s) Of Engagement Activity | 2024 |
| URL | https://www.mrcc.org.uk/events/rare-manchester-17th-july-2024/ |
| Description | Presented Talk at mTOR symposium |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Professional Practitioners |
| Results and Impact | Albert Basson presented a talk on neurodevelopmental disorders at the mTOR Symposium on 23rd April 2024. |
| Year(s) Of Engagement Activity | 2024 |
| URL | https://rd-research.org.uk/uncategorized/mtor-pathway-diseases-node-2024-symposium-2/ |
| Description | Presented at 13th International Conference on Rare and Undiagnosed Diseases (Seoul, South Korea) |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | Siddharth Banka presented a talk at the 13th International Conference on Rare and Undiagnosed Diseases (Seoul, South Korea) on the 5th Sept 2024. Title: "Clinically-Directed Panel-Agnostic Family-customised Deep Reanalysis Of Genomic Data Leads To Discovery Of Novel Ultra-Rare Genetic Skin Disorders". |
| Year(s) Of Engagement Activity | 2024 |
| URL | https://udni2024seoul.org/program/detail.php |
| Description | Presented at the Kabuki UK Family Information Day (Manchester) |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Patients, carers and/or patient groups |
| Results and Impact | Siddharth Banka and his team at the Manchester Rare Conditions Centre provided an enlightening update on ongoing research initiatives, making significant strides towards understanding Kabuki Syndrome at the Kabuki UK Family Day on the 16th March 2024. |
| Year(s) Of Engagement Activity | 2024 |
| URL | https://www.mrcc.org.uk/events/patient-information-days/2024-kabuki-syndrome-information-day/ |
| Description | Presented talk at The Festical of Genomics and Biodata (London) |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | Siddharth Banka presented at The Festival of Genomics & Biodata (London). Talk Title: "DNA methylation based testing to improve diagnosis of rare conditions". |
| Year(s) Of Engagement Activity | 2025 |
| URL | https://www.genomicseducation.hee.nhs.uk/events/the-festival-of-genomics-biodata-2025/ |
| Description | Presented talk at the Epigenetics in Rare Diseases Symposium (Izmir, Turkey) |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | Siddharth Banka presented a talk at the Epigenetics in Rare Diseases Symposium (Izmir, Turkey), 3rd - 7th February 2025, exploring the epigenetic mechanisms observed in rare diseases and how these insights could be transformed into potential diagnostic and therapeutic opportunities for patients. |
| Year(s) Of Engagement Activity | 2025 |
| URL | https://www.ibg.edu.tr/news/details/latest-insights-at-the-epigenetics-in-rare-diseases-symposium/ |
| Description | Talk at the British Association of Dermatology (BAD) Meeting (Manchester) |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | Siddharth Banka presented talk at the British Association of Dermatology (BAD) Meeting, Title: "Novel insights about genetic and mechanistic basis of dermatogenetic and ectodermal disorders" |
| Year(s) Of Engagement Activity | 2024 |
| URL | https://badannualmeeting.co.uk/wp-content/uploads/2024/06/BAD-Final-Programme-2024-v3.pdf |
