Research at Johns’ Hopkins Offers Hope for EDS

Posted on July 1, 2010. Filed under: Awareness, Ehlers-danlos syndrome, Related Disorders, Research Information, Treatment | Tags: , , , , , , , , |

Update – 2/4/2011:  The information contained in this article is published with the permission of EDS Network C.A.R.E.S., for whom this letter was originally written by Dr. Dietz.  It’s through the relentless pursuit and dedication of this group that this project is happening at all.  They are a fabulous group of patients, families, and friends who work tirelessly for research that will save the lives of all those affected by Ehlers-Danlos Syndrome.  I am proud to call them my friends.

 

This is a copy of a letter written by Dr. Hal Dietz of Johns’ Hopkins University regarding a study aimed at developing a way to medically manage the vascular complications such as aneurysms and arterial rupture that can go along with Ehlers-Danlos Syndrome.  For patients with these serious issues, surgical intervention can be every bit as life-threatening as the problem itself.  Finding a non-surgical way to treat such deadly complications can radically change the outcome for patients with this diagnosis.  If successful, this treatment could mean a virtually normal life-expectancy for my son’s generation of VEDS patients.

Dr. Hal Dietz

Vascular Ehlers-Danlos syndrome (or vascular EDS) is a disorder of the body’s connective tissue – the material between the cells that give the tissues form and strength. In vascular EDS the body lacks sufficient type III collagen, a molecule that contributes to the strength of the skin, intestines, uterus, and most importantly, the blood vessels. People with vascular EDS live with the knowledge that they will die from this condition at an age ranging from childhood to young adulthood.  They are also told that there are no effective treatments. There are no medications that are known to strengthen the tissues or delay blood vessel rupture. Attempts at surgical repair are often delayed unless there is confidence that the patient will die within hours if nothing is tried. This is because the tissues are so weak that they often simply fall apart during surgery – akin to trying to sew together wet tissue paper. Of all the conditions that I care for, I hate this one the most. It not only drastically shortens the length of life, but also robs people of any meaningful sense of hope and quality of life – always anticipating that the shoe will drop at any moment.

Indeed, all too often children with vascular EDS lose any sense of ambition and purpose despite truly remarkable talents and potential. To their mind, “Why bother“.

Fortunately, there is now strong reason for hope. During the study of related connective tissue disorders, specifically conditions called Marfan syndrome and Loeys-Dietz syndrome, we learned that many issues, including blood vessel enlargement and rupture, do not simply reflect an inherent weakness of the tissues due to a deficiency of the body’s glue. Instead, the deficiency of a connective tissue protein, as in vascular Ehlers-Danlos syndrome, triggers an increase in a specific cellular signaling pathway, causing the cells to behave abnormally and to release enzymes that break down the tissues. We have early evidence that the same process is at work in vascular EDS. In mouse models of Marfan syndrome we have shown that a medication that is widely used for other purposes can blunt abnormal cellular behaviors and prevent blood vessel enlargement and rupture, leading to a fully normal lifespan. This medication is now in clinical trial in children with Marfan syndrome. It is now our goal and intention to make mouse models of vascular EDS in order to learn more about the condition and to test this and other therapies.

If someone had suggested 5 years ago that a pill might be able to treat a connective tissue disorder, I would have considered them crazy. Given recent breakthroughs and sufficient resources for further research, I will be shocked if a revolutionary new treatment for vascular EDS is not in general use within 5 years.

I have already begun to share this sense of optimism with children with vascular EDS. Our job is to bring this goal to fruition. Their job is to begin dreaming big.

While ambitious, the proposed work directly parallels our prior initiatives for Marfan syndrome and Loeys-Dietz syndrome. Realistically, the work could start with an investment of $100,000. This would cover initial costs for the development of a mouse model and the recruitment of a research scientist fully committed to this work. Expansion of the mouse colony and completion of both mechanistic and treatment studies would require about $200,000 per year for three to four years.

How You Can Help

When I lost my first husband almost 13 years ago, this sort of treatment was unimaginable.  I’ve spent most of the time raising my son with the fear Dr. Dietz describes so accurately in his letter; knowing that the “shoe could drop” at any time and there would be little anyone could do about it.  Reading this letter for the first time brought tears to my eyes and left me shaking; almost afraid to believe the possibility was real.

Now, with that reality well-rooted in my mind and in my hopes, I and other families facing this disorder have set about the urgent business of securing the funding needed to see this thing through to the end.  We’ve successfully carried on the backs of an all-volunteer army the difficult task of raising enough money to cover the intial investment required to begin the project.

Thanks to an online voting competition on Facebook, you have an opportunity to help us keep this research going.  The Chase Community Giving Challenge is a contest where different charities compete for votes with the top vote-getters receiving the largest grants.  First place will receive a grant for $250,000; second through fifth places will each receive $100,000 and the remaining charities in the top 200 will get a grant for $25,000.

When the contest started on June 15th we shot to first place and held on for five days, but now have fallen to fifth place and are fighting hard to stay in the top five and secure one of the $100,000 grants.   You can help us do that – and maybe make it back to #1 – by voting for EDS Today and then getting as many of your friends and family to do the same.

Rarely do  people get such a genuine opportunity to make the sort of difference they can right now by helping us secure this funding.  Voting will end on July 12th, with winners announced on the 13th.  With YOUR help, we can change the future for my son and thousands of children just like him – all it takes is the decision to do so.  Click on the picture below to get involved and help make this happen!!

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The Council of Mothers (and a few devoted dads)

Posted on June 27, 2010. Filed under: Awareness, Ehlers-danlos syndrome, Life's Lessons | Tags: , , , , , , , , , , |

The Council of Mothers (and a few devoted dads) convenes as necessary in the wee hours of the morning, the midday afternoon on holidays, the Tuesdays after checkups and at all other times deemed necessary by its members. Together we share one another’s questions, worries, and our greatest common fear – the loss of our children. 

Some of its wisest members are the mothers and fathers who’ve already crossed that chasm once and who, instead of turning their backs and continuing their lives in the opposite direction, fix their eyes on those of us still walking this treacherous road and on our children; pouring their hearts, their souls, their experience and all the love they had for their own children into ours.  

Such wisdom only comes from life’s hardest lessons learned, and theirs – regrettably – are lessons they can now apply only to the children of others.  It is their hindsight, their regrets, their “If I had it to do overs” that serve as the only road map available for this journey of ours.

Many in our group serve as surrogates, knowing they’ll have no children of their own because they’ve chosen not to risk passing on the disease that brings us all together. With all their strength and determination, they walk along with us, loving our children as their own – loving us as though we are family. 

There are also several others who, like me, do not carry this disease but who loved someone who did; someone whose grave we stood beside and to whom we said “goodbye” far too soon.  And now, like living in a land where we do not speak the language, we are raising our children as best we can, hoping to choose wisely, and wishing that we bore the pain in the place of our sons and daughters.  

The collective wisdom and experience this Council brings to bear serves as our reference when any of us, as I did recently, face a new experience with our children and have nowhere else to turn.  As is the case with virtually all rare diseases, there are precious few in the field of medicine who, though they may have the best intentions and sincerity of effort, can offer any actual valid guidance. 

At even the most prestigious well-respected hospitals and institutions, very few doctors or surgeons will have seen a child or adult with a body like theirs.  While some may have a vague memory from medical school about Ehlers-Danlos Syndrome, almost none will have diagnosed it themselves — not through any lack in their qualifications as a doctor, but simply as a result of the rarity of the disease.

Sounding the Alarm 

On a Tuesday night a few short weeks ago around 10:00 p.m. I was the one sounding the alarm, posting on our internet support group a message about my son.  For our children, and for the adults living with Vascular EDS, virtually all sports and activities are off-limits.  Because of the high-risk of injury, aneurysm, organ and arterial rupture that follows them their entire lives, very few athletic options are available.   But, in hopes of finding a way around that difficult reality, I’d signed him up for a community swim team that a few of his life-long buddies are on.  He’s always loved swimming and being able to do something he loved in a team environment was definitely a chance worth taking. 

After the first night’s practice he was understandably tired, but he was also excited and quick to tell me how much fun he’d had.  The coaches had already moved him up to the intermediate group where most of his friends were placed and I could hardly wait to share the good news with my friends online. 

But before I’d had a chance to share my excitement, the moment was gone. After the second night of practice, reality crept back in and like the stupor following a night of drunkenness, I felt sickened by the dizzying truth of what his body can actually handle. My son was in pain; his jaw was hurting and difficult to open.  His shoulder, which has become increasingly loose-jointed over the last year, was in more pain than he’d had so far.  He came to me quietly when no one was around and this normally very active boy, who just one night before was bursting with joy and anticipation at the possibility of a team sport he could enjoy with his friends, told me with tear-filled eyes he didn’t want to go back – he couldn’t go back – because the pain was too much. 

By the time he finished telling me about it, I learned it was more than just his jaw and shoulder; it was his knees, his ankles – all of which are dependent on the one ingredient his body cannot give him — collagen.  Aside from his vascular system, his joints will pay the highest price for this deficiency; possibly bringing on arthritis as early as adolescence – as early as now. 

Once the kids were in bed, I grabbed my laptop and retreated to my bedroom – ignoring all other responsibilities for the night.  I sat alone on my bed and went looking for what has now become my lifeline; a close-knit group of people formed over time with others just like me – desperate for guidance and understanding. 

I typed at a furious pace; ignoring the tears of anger running down my cheeks. “How dare this damn disease take something else from him!” was running across the screen of my mind like one of those annoying crawls on T.V.  How was I supposed to handle this?  Should I take him to the doctor?  Did he need to go to the dentist?  Or, was this just “normal” muscle pain from a new activity?  Would taking him to a doctor or dentist even do any good?  What were the odds they would even be able to give me good advice?  What experience could they possibly draw from to help me sort this out?  The stream of words became a flood of anger, confusion, and pure, raw emotion – and without worrying how any of it may have “sounded”, my rational mind was no match for my mother’s heart that was breaking – again – for the losses my son has endured, and will endure, throughout his life.   

Having thoroughly emptied myself into this cry for help, I sat back on my pillows and took a long, deep breath.  Still utterly confused, and now emotionally drained, I could relax just a little knowing I’d sent up my flare; knowing someone would see it, and knowing help would soon come.  

Within the hour I received my first response from a mother in Canada who’d lost her son seven years ago at the age of 13.  He had experienced chronic jaw pain off and on in the weeks before he died from a thoracic aortic aneurysm.  As has been the case in many such messages, regret was the tone of her voice; telling me now what she had intended to do but never got the chance.  She had been concerned about his jaw; she’d planned to take him to the doctor, but then one night it was over.  At home in his bedroom with her son in her arms, she held him as he closed his eyes and slipped away from her.  Her pain was as evident now as it surely must have been that night when the unthinkable settled in on her and her family in the most merciless way. 

She was quick to remind me it didn’t mean that’s what my son was dealing with, and didn’t want to frighten me; but she also felt compelled to let me know the possibility was out there and until I’d gotten her email, I’d never known that jaw pain might be a symptom of something serious.

By the next afternoon and throughout the week, I had more replies than I could keep up with.  Mothers and fathers, husbands and wives, and people who are living with VEDS offered their words of encouragement, caution, and something to lean on while I struggled to find my way through this.

In spite of the distances that separate us, it was as though this Council had convened on a moment’s notice someone’s living room or around a dining room table to figure out this problem as a team.  As the week wore on, my anxieties began to ease with each new message I received.  I read each word gratefully– keenly aware of the price at which their experience had come. Bought with the pain in their own lives and the lives of those they love, paid for with grief and regret, theirs are the words I cannot ignore.  Theirs are the words I must not ignore.

With all the frustrations and disappointments that go along with raising a child with a rare disease, having this group has meant the difference in my level of sanity more times than I can remember.  Whether or not I ever lay eyes on them or find out what their voices sound like, I know without question they are with me.  In the doctor’s office, the emergency room, or in my own home facing another night racked with insomnia–at any hour of the day or night–I can ask for help and someone will be there.   I know I am no longer alone – and next to a cure . . . that’s the most imporant thing.

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Great Opportunity!!

EDS Today is competing in the Chase Community Giving Challenge on FB to win up to $250,000 for research. 

We WERE in first place for the first five days, but have been bumped down to 5th – and could use your help moving back up. 

The first place charity at the end of the voting gets $250k; the groups in 2nd, 3rd, 4th, and 5th will each get $100k. Goups ranked below 5th place will get $25k. 

You can help us out and cast your vote by clicking on the picture.  You’ll get 20 votes to use in the competition, so look for others you’d like to help out.  After you’ve used the first five votes, you’ll get a “gift vote” and can use it to vote a 2nd time for EDS Today. 

Please share the link and information with as many people as you can.  The competition lasts until July 12th – winners will be announced on July 13th.  We need as much help as we can get generating some buzz and getting those votes coming in! 

Many thanks!

Debbie Vaughan

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Survey Results: Vascular Type

Posted on May 7, 2010. Filed under: Awareness, Ehlers-danlos syndrome, Research Information, Symptoms of Ehlers-Danlos syndrome | Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |

What Vascular EDS Patients are Saying:

The symtoms and percentages listed below are from the informal online survey I’ve had posted for a few weeks now.  These results are only for the patients who identified themselves or their loved ones as having the Vascular type of Ehlers-Danlos Syndrome. 

Also, these results are changing every day as more and more people are signing on and taking the survey – what a great problem to have!  So far, a total of 270 people have filled one out. 

If you’ve already completed one, THANK YOU!!  If you haven’t had a chance yet, please do so as soon as you’re able.  The more we know and understand about ourselves, the better equipped we will be to advocate for each other and work to get the care we so desperately need. 

You can also keep up with results as they come in through Facebook; Ehlers-Danlos Network C.A.R.E.S. will be posting tidbits as part of the May Awareness campaign. 

And YES – I am going to post the list of symptoms for the other types including those who haven’t been able to have their type identified. 

Symptoms Percentage #
Family history of EDS 50.00% 30
Premature birth 41.70% 25
Clubbed foot 11.70%   7
Hyperelastic (stretchy) skin 18.30% 11
Thin, translucent skin 75.00% 45
Large or prominent round eyes 60.00% 36
Lobeless ears 53.30% 32
Sleep with eyes half-opened 58.30% 35
Flat footed 55.00% 33
Visible veins (part of translucent skin) 75.00% 45
Easy bruising 85.00% 51
Atrophic scarring 31.70% 19
Hip dysplasia 3.30%   2
Scoliosis 21.70% 13
Positive Beighton scale 16.70% 10
Hypermobility of large joints 30.00% 18
Hypermobility of small joints 48.30% 29
Arthritis 35.00% 21
Inguinal hernias 15.00%   9
Umbilical hernias 10.00%   6
Frequent nosebleeds 20.00% 12
Reynauds syndrome 30.00% 18
Numbness/tingling in extremities 33.30% 20
Migraines 45.00% 27
Chronic constipation 26.70% 16
Aneurysm or arterial complication 63.30% 38
Bowel perforation 23.30% 14

 

Important Note!!

It’s super critical to remember that just because you may share a symptom on this list does not mean you have Vascular Ehlers-Danlos Syndrome.  The official diagnostic criteria – as defined by the National Institutes of Health – is listed below:

Major:

  • Arterial rupture
  • Intestinal rupture
  • Uterine rupture during pregnancy
  • Family history of the vascular type of EDS

Minor:

  • Thin, translucent skin (especially notable on the chest/abdomen)
  • Easy bruising
  • Characteristic facial appearance (thin lips and philthrum, small chin, thin nose, large eyes)
  • Acrogeria (an aged appearance to the extremities, particularly the hands)
  • Hypermobility of small joints
  • Tendon/muscle rupture
  • Early-onset varicose veins
  • Arteriovenous carotid-cavernous sinus fistula
  • Pneumothorax/pneumohemothorax
  • Chronic joint subluxations/dislocations
  • Congenital dislocation of the hips
  • Clubfoot
  • Gingival recession
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