Awarded Grants

Bacterial resistance to current antibiotics is becoming an increasing problem resulting in more morbidity and mortality. In individuals with Cystic Fibrosis (CF), Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA), is frequently observed and causes infections in the noses that subsequently seed the lungs. In this project, the utility of phage lysins to control MRSA infections will be investigated. Lysins represent an alternative to antibiotics as they use a completely distinct mechanism from antibiotics in order to kill bacteria. For alternative bacterial species, resistance to lysins has not been observed. In addition, lysins can be delivered both systemically and via aerosol. Thus, MRSA-specific lysins may have advantages over conventional antimicrobial approaches, prevent chronic infections, and increase quality of life for people living with CF.

Cystic Fibrosis (CF) is caused by mutations that limit the functionality in the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) gene, which can lead to respiratory failure. The W1282X nonsense mutation leads to the production of a shorter CFTR gene that is present in low levels, making it partially functional, due to a cellular quality-control mechanism called nonsense-mediated mRNA decay (NMD). This project utilizes a novel approach that includes targeting pre-mRNA splicing to remove exon 23—the region of the CFTR gene that contains the W1282X mutation—to increase the CFTR gene function in individuals with a W1282X mutation of CF. Thus, this project investigates this strategy by developing synthetic Antisense Oligonucleotides (ASOs) that can induce the skipping of exon 23 of the pre-MRNA sequence in order to achieve increased functionality in the mutated CFTR gene.  

People living with CF continue to be susceptible to bacterial infections and typically require extensive antibiotic regimens to maintain clear airways. Infections with methicillin-resistant Staphylococcus aureus (MRSA) are a lifelong challenge and new strategies are needed for control. This application will investigate two novel strategies to fight MRSA. The first approach aims to develop a vaccine for MRSA. Conventional vaccines employ protein fragments from a pathogen to produce an immune response. In contrast, this project will use synthetic DNA and rely on the human body to generate the protein fragment – an approach that has many advantages including activation of antibody and cell based immunity, and easier drug production and storage. The second approach will develop engineered antibodies against MRSA with enhanced antimicrobial activity relative to endogenous anti-MRSA antibodies. As in the first Aim, this study will use DNA to deliver the genetic information to encode these therapeutic antibodies, a strategy that enables sustained delivery and reduces drug costs. These approaches will initially be developed using a clinical isolate derived from a CF subject. It is anticipated that this personalized approach could be applied for other antimicrobial resistant bacterial pathogens that impact CF.

Individuals with Cystic Fibrosis (CF) are at great risk to develop recurrent lung infections. These infections are often caused by antibiotic-resistant bacteria like MRSA. This project aims to develop a panel of phage targeting MRSA that work collectively towards eliminating or reducing MRSA in the lungs of those with CF. By developing a well-characterized MRSA phage bank, this project will advance rational development of MRSA phage cocktails for use in the management of CF and make this collection widely available to physicians and researchers across the globe to facilitate life-saving phage therapy.

Models that enable testing of new therapies to treat CFTR nonsense mutation are needed. Craig Hodges and colleagues at Case Western Reserve University are creating new mouse models that contain the W1282X mutation in the CFTR gene. Several CF mouse models exist, including models that contain the F508del, G551D or G542X mutations. The objective of this proposal is to generate well characterized models that can be distributed to laboratories (academic or industry) focused on developing or testing of therapeutic strategies specifically for the W1282X mutation, or for CF nonsense mutations in general. 

S. aureus is a multi-drug resistant (MDR) bacteria that causes pulmonary infections in individuals with CF starting at a young  age. Infections caused by MDR bacteria directly contribute to morbidity and mortality as physicians are forced to rely on a diminishing arsenal of antibiotics. In those persistently infected with S. aureus, reduction in the bacterial burden could have significant positive impact on lung function, pulmonary exacerbations, and quality of life. Phage therapy harnesses bacteriophages (bacteria-specific viruses) that target and kill bacteria. When used therapeutically, these phages are able to kill bacteria expressing specific virulence factors that enable them to cause infection. Funding from EE will enable further development efforts of phage-based therapeutics in treating CF-associated infections.

Delivery of nucleic acids to the lungs, including tRNAs, is a promising alternative approach for CF therapy. However, targeting nucleic acids to the appropriate cells in the lung remains a major challenge.  Using state-of-art approaches, the Dahlman lab aims to evolve optimized lung-specific delivery agents called nanoparticles to facilitate nucleic acid delivery. The overall goal of this project is to accelerate the rate at which nanoparticles can be used to treat CF.

The stimulus funding from Emily’s Entourage will be used to purchase a specialized piece of equipment, called Ussing chambers, which are the gold-standard way to measure CFTR activity in airway epithelial cells and determine the effectiveness of developmental CF therapeutics. Specifically, Ussing chambers will be used to test the effectiveness of nonsense suppressing ACE-tRNAs, developed through a previous research grant from Emily’s Entourage.

The goal of this project is to investigate if current or investigational CFTR modulators are effective in organoids derived from CF subjects with the W1282X mutation. 

Prior studies supported by Emily’s Entourage revealed that KALYDECO provides therapeutic benefit in some CF subjects with the W1282X mutation. These provocative studies will be extended in further n-of-1 clinical trials to assess whether clinical benefits can be further enhanced by an approved corrector-potentiator therapy.

Combining expertise in cell culture, CFTR functional assessment, therapeutic development, and clinical practice, this project will assess whether available therapeutic approaches modulate key properties, including ion transport and mucociliary clearance, in airway epithelial cells derived from CF subjects with the W1282X mutation.

CF is caused by loss of function of the CFTR ion channel. Development of alternative ways to restore missing channel function independently of CFTR is an urgent unmet medical need. Based on compelling studies in cell culture models and in CF animal models, this project will test a novel therapeutic strategy to directly address this need. This approach uses a drug approved for an alternative indication and could eventually lead to development of a novel therapeutic approach for CF.

Using innovative biochemical techniques, the major aim of this project is to identify new targets to improve trafficking of CFTR1281, the truncated protein product that results from the W1282X mutation.

The absence of validated cell models has been a major barrier to the development of therapies for CFTR nonsense mutations. Scott H Randell, PhD, in collaboration with Finn Hawkins, MBBCh (Boston University) will develop W1282X homozygous airway epithelial cell models that should expedite therapeutic developments.

This project employs pioneering high throughput screening approaches to identify drug-like molecules that target W1282X-CFTR, and other rare CF mutations. In studies previously funded by Emily’s Entourage, Dr. Verkman established the concept that combined “correctors” and “potentiators” –  as used to treat the most common CF mutation, F508del– could also be used to treat the W1282X mutation. These new studies aim to progress this area.

A key characteristic of CF is thick, dehydrated mucus that accumulates in the lungs causing chronic bacterial infections. In patients with CF, an overactive protein called ENaC contributes to airway surface dehydration to drive this process. This project will investigate a novel therapeutic approach to rehydrate the airways using a preclinical candidate that inhibits ENaC.

This project uses an innovative genetic approach to correct the W1282X-CFTR mutation. Engineered transfer-RNA molecules will be used to direct delivery of an appropriate tryptophan (W) to the W1282X mutation during protein synthesis to promotes production of the full length CFTR protein.

Through a unique partnership with the University of Iowa and Militia Hill Ventures, Emily’s Entourage provided seed funding to launch Spirovant Sciences (formerly Talee Bio), a biotech company focused exclusively on gene therapy to cure all mutations of CF. In a race against the clock, this venture philanthropy model can expedite advances by harnessing the power of venture capital.

Using synthetic chemistry in conjunction with biochemical approaches, the aim of this project is to identify the site of action of Ataluren, a drug that promotes premature stop codon readthrough, and to develop improved chemical analogs of this drug candidate.

This project considered two distinct areas to advance W1282X-CFTR targeted therapeutic development. The first objective was to develop assays of CFTR function in patient-derived cell samples to test efficacy of existing and new CF therapies. The second considered a novel genetic approach to overcome the W1282X mutation.

The objective of this project was to assess current therapeutic options for the W1282X-CFTR mutation in a patient-specific manner. The major outcome of this study, reported in the Journal of Cystic Fibrosis, indicated that the potentiator Ivacaftor elicited CFTR-dependent current in a W1282X-CFTR subject.

This project aimed to establish a novel paradigm for therapy for the W1228X-CFTR mutation. Studies developed initial small molecule discovery platforms and provided the first evidence that a combined “correctors” and “potentiators” — as used to treat the most common CF mutation, F508del — could also be used to treat the W1282X mutation.