Genetic Health - Bruce LeFroy Centre
Health, wellbeing, access and equity for children and adults living with genetic diseases
The Genetic Health group at the Bruce Lefroy Centre (BLC) is dedicated to improving the lives of children and adults living with genetic conditions.
Our research focus
Our group has a long-standing clinical and research focus on neurogenetic diseases, such as Friedreich ataxia, and other ataxias such as spinocerebellar ataxias, and dentatorubral-pallidoluysian atrophy (DRPLA).
We aim to accelerate diagnosis, improve treatment options, and enhance support for individuals and families affected by these complex conditions.
Challenges
The challenge for our researchers is identifying a treatment that can, at the very least, slow the progression of rare diseases in children and adults.
While the search for treatment continues, people with rare neurogenetic diseases require access to specialist multi-disciplinary care based on long-term, evidence-based management.
Our research priorities
We are committed to:
- Understanding disease mechanisms: Investigating how genetic mutations cause neurodegenerative diseases.
- Improving diagnostics: Developing faster, more accurate genetic testing methods.
- Enhancing clinical care: Informing best practices for managing symptoms and improving quality of life.
- Promoting equity in healthcare: Ensuring all communities have access to genetic services and support.
Key projects and collaborations
Our team leads and contributes to several national and international research initiatives, including:
- Friedreich Ataxia Clinical Research Program: A long-standing program focused on understanding disease progression and testing new therapies.
- Community genetics initiatives: Working with diverse communities to improve access to genetic information and services.
- Collaborative studies: Partnering with universities, hospitals, and research institutes to share knowledge and drive innovation.
Clinical trials and genetic screening
The Bruce Lefroy Centre (BLC) addresses two critical needs in neurogenetic healthcare: advancing treatment and improving clinical care. We conduct clinical trials for therapies designed to slow the progression of neurogenetic diseases and generate the evidence base needed for effective, translational clinical care.
BLC was the trial site for the Friedreich ataxia omaveloxolone drug trial — the first pharmaceutical treatment for this condition to be approved in the United States and Europe.
In addition to treatment research, our Genetic Health group conducts research into genetic screening. This includes:
- Reproductive carrier screening for conditions such as Cystic fibrosis, Tay Sachs disease and Thalassaemia.
- Health screening for conditions that may affect an individual's wellbeing, including Haemochromatosis.
We also led Mackenzie’s Mission, a $20 million initiative funded by the Medical Research Future Fund (MRFF), aimed at exploring the national implementation of reproductive genetic screening in Australia.
Leadership and collaboration
The Centre is co-directed by Professor Martin Delatycki and Professor Paul Lockhart, both internationally recognised leaders in clinical genetics and molecular research.
We work closely with clinicians, scientists and community groups to ensure our research translates into real-world benefits.
Funding of BLC
The Bruce Lefroy Centre, made possible through the generosity of the Lefroy family and friends, recognises that families affected by rare neurodegenerative diseases cannot afford to wait.
While long-term pharmacological solutions are in development, there is an urgent need for interventions that can slow and ideally reverse the effects of these relentless conditions.
Contact us
Professor Paul Lockhart, Group Leader / Co-Director BLC
Email:
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Professor Martin Delatycki, Group Leader / Co-Director BLC
Email: [email protected]
Theme Director
Team Leaders
Our projects
Australian Friedreich Ataxia Stem Cell and Gene Therapy Consortium
The Consortium’s vision is to facilitate and undertake Friedreich ataxia cell and gene therapy clinical trials leading to successful outcomes for patients as soon as possible. The Consortium is a strategic alliance of pre-eminent experts in Friedreich Ataxia, Stem Cells, Gene Therapy, Policy, Advocacy and Regulation. Please support the Australian Friedreich Ataxia Stem Cell and Gene Therapy Consortium.
Read more...Friedreich Ataxia Global Clinical Consortium UNIFIED Natural History Study (UNIFAI)
The Friedreich Ataxia Global Clinical Consortium UNIFIED Natural History Study is a multicentre, prospective, observational study conducted across approximately 50 international sites. The Bruce Lefroy Centre (BLC) serves as the Australian site for this important initiative.
The study aims to:
- Unify the global Friedreich ataxia (FRDA) community, including clinician-researchers and patients
- Contribute to understanding of the disease’s natural history
- Track health issues and symptom progression over time
- Evaluate change in natural history as new disease specific therapies are approved
- Establish a sustainable data platform to support future clinical studies and therapy development
Validating the Ataxia Instrumented Measures in Friedreich ataxia
Friedreich ataxia (FA) impacts mobility, balance, speech and limb movement. This project uses movement analysis technology, specifically the Ataxia Instrumented Measures (AIMs) to evaluate upper limb movement and balance in children and adults with FRDA enrolled in the Friedreich Ataxia Global Clinical Consortium UNIFIED Natural History Study (UNIFAI).
The AIMs devices have been developed for use in FA by Associate Professor Louise Corben (MCRI), Professor Pubudu Pathirana (Deakin University) and Professor Malcolm Horne (the University of Melbourne).
The objective of this study is to validate the AIMs devices as objective and ecologically valid measures of severity of FA in clinical trials.
For more information visit BioKin.
Investigating the use of the Ataxia Instrumented Measure – Spoon (AIM-S) in measuring upper limb function in Dentatorubral-pallidoluysian atrophy (DRPLA)
Dentatorubral-pallidoluysian atrophy (DRPLA) is a rare neurodegenerative disorder caused by an expanded CAG repeat in the ATN1 gene, resulting in a mutant atrophin-1 protein with a polyglutamine expanded tract.
Due to the ultra-rare nature of DRPLA, little is known about its natural history. This study uses the Ataxia Instrumented Measure – Spoon (AIM-S) to objectively assess upper limb motor control in participants. The project is part of a broader international effort to collect longitudinal data and investigate a comprehensive set of biomarkers for DRPLA.
Measuring ataxia in children with Friedreich ataxia
The concurrent development of the cerebellum—peaking around age 12—can complicate the use of traditional clinical rating scales in children with Friedreich ataxia (FRDA). To address this, we developed a developmentally appropriate, objective measure of ataxia using the Ataxia Instrumented Measure (AIM).
The AIM system includes a data logger with inertial sensors and machine learning (ML) algorithms that analyse kinetic and kinematic features. This technology generates a personalised ataxia severity score that accounts for typical variability in motor coordination during childhood. The AIM score is designed to support both clinical care and clinical trials involving children with FRDA.
Natural History Study to TRACK Brain and Spinal Cord Changes in Individuals with Friedreich Ataxia (TRACK-FA)
TRACK-FA is the most comprehensive international, longitudinal, multi-centre neuroimaging study focused on Friedreich ataxia (FRDA). This study aims to:
- Deepen understanding of FRDA’s natural history, particularly changes in the brain and spinal cord
- Validate neuroimaging biomarkers for use in clinical trials
- Build a global, shared database to support ongoing research and therapeutic development
The study is a collaboration between six leading international research sites:
- Monash University / Murdoch Children’s Research Institute (Australia)
- University of Minnesota (USA)
- Aachen University (Germany)
- University of Campinas (Brazil)
- University of Florida (USA)
- Children’s Hospital of Philadelphia (USA)
The project is supported by the Friedreich’s Ataxia Research Alliance (FARA) and several industry partners, who contribute to study design, endpoint selection, and monitoring.
Trial identifier: NCT04349514
- TRACK-FA - Monash University
- TRACK-FA: A Natural History Study to TRACK Brain and Spinal Cord Changes in Individuals with Friedreich’s ataxia
The efficacy of rehabilitation for hereditary ataxias – a randomised controlled trial
Rehabilitation is currently one of the few available treatments for individuals with hereditary cerebellar ataxia (HCA). This multi-site, randomised, single-blind, superiority trial evaluated the effectiveness of a structured rehabilitation program compared to standard care in 76 adults and adolescents with HCA.
Participants in the intervention group completed a 30-week rehabilitation program, which included:
- 6 weeks of outpatient physiotherapy, followed by
- 24 weeks of physiotherapy-supported home exercises
Those in the control group continued with their usual care.
The primary outcome was improvement in the motor domain of the Functional Independence Measure (FIM). A range of secondary outcomes assessed ataxia severity, balance, and quality of life. These were measured at baseline, 7 weeks, 18 weeks, and 30 weeks.
Trial registration: ACTRN12618000908235
Mackenzie’s Mission research study
The Australian Reproductive Genetic Carrier Screening study Mackenzie’s Mission is a research project offering reproductive genetic carrier screening to thousands of Australian couples who are either planning to have children or are in early pregnancy.
The screening provies information about the couple’s chance of having a child with a severe genetic condition, covering approximately 750 serious autosomal and X-linked recessive conditions.
The primary goal of Mackenzie’s Mission is to determine how best to deliver reproductive genetic carrier screening at scale in Australia—making it freely available to all couples who choose to access it.
The data collection phase of the project is now complete, and the research team is preparing the findings for publication. The next step is to provide evidence and recommendations to government, with the aim of achieving publicly funded access to reproductive carrier screening for all Australians.
Novel SMART AAV vectors for gene therapy for Friedreich’s Ataxia
Friedreich ataxia (FRDA) is a genetic disorder caused by mutations in the FXN gene, resulting in significantly reduced levels of the frataxin protein in the body. Reduced frataxin levels leads to cell degeneration, particularly within heart tissue and the nervous system.
Gene therapy is emerging as a potential approach to successfully treat FRDA by restoring frataxin levels. The primary goal is to use human stem cells as a platform to significantly advance current technologies in gene therapy to treat FRDA.
This project, led by Dr Mirella Dottori from the University of Wollongong, is supported by a Medical Research Future Fund (MRFF) Stem Cell Therapies Mission Grant.
Repurposing Clinical Grade Medications for Treatment of Friedreich Ataxia Heart Disease
This project, led by Dr Shiang Lim at St Vincent's Institute of Medical Research, focuses on developing a novel blood test to monitor the onset, progression, and severity of heart disease in individuals with Friedreich ataxia (FRDA).
The test is designed to play a critical role in clinical trials, helping to evaluate the benefits of drugs or therapies on heart function. By providing a reliable and accessible biomarker, this research will enhance our understanding of FRDA-related heart disease and support the development of targeted treatments.
The findings from this study will contribute to identifying effective measures forassessing the effect of drugs or therapies on heart function during FRDA clinical trials.
A randomised placebo-controlled crossover trial of micronised resveratrol as a treatment for Friedreich ataxia
This study, involving 20 participants, aimed to evaluate the safety and efficacy of micronised resveratrol as a potential treatment for Friedreich ataxia (FRDA).
Participants received 2 grams per day of micronised resveratrol or a placebo over a 24-week period. The primary outcome was the change in the modified Friedreich Ataxia Rating Scale (mFARS) from baseline to week 24.
Long-Term Open-Label Study to Assess the Safety and Efficacy of Vatiquinone in Patients with Friedreich Ataxia
This study, sponsored by PTC Therapeutics Inc, is a follow-on to the MOVE-FA placebo-controlled trial evaluating vatiquinone in individuals with Friedreich ataxia (FRDA).
The long-term, open-label extension study is assessing the safety and efficacy of vatiquinone in participants who previously took part in the original trial. While the initial study did not meet statistical significance on the primary endpoint (change in mFARS score), it revealed clinically meaningful findings, including:
- Improvement in fatigue
- Positive changes in the upright stability sub-section of the mFARS scale
PTC Therapeutics is currently in discussions with the US Food and Drug Administration (FDA) to explore potential regulatory pathways for approval based on these results.
Phase 2a open-label, single dose study to evaluate the safety, tolerability, pharmacokinetics, and pharmacodynamics of MIB-626 (β-nicotinamide mononucleotide), a dietary supplement, in adult patients with Friedreich ataxia
β-nicotinamide mononucleotide (NMN) is a naturally occurring compound related to Vitamin B3, commonly used as a dietary supplement. NMN is believed to offer several health benefits, including neuroprotection, making it a potential therapeutic option for individuals with Friedreich ataxia (FRDA).
MIB-626, a proprietary form of NMN developed by Metro International Biotech, is being evaluated in this Phase 2a study. The trial aims to assess the safety, tolerability, pharmacokinetics, and pharmacodynamics of MIB-626 compared to placebo, administered over 28 consecutive days in adults with FRDA.
Phase 2 study of the safety, efficacy, and pharmacodynamics of RTA 408 in the treatment of Friedreich ataxia
RTA 408, also known as omaveloxolone (marketed as Skyclarys), was developed by Reata Pharmaceuticals (now part of Biogen) and is the first approved treatment for Friedreich ataxia (FRDA). It is currently available in the United States and Europe only.
Omaveloxolone works by activating the Nrf2 transcription factor, by increasing Nrf2, reducing oxidative stress and improves mitochondrial function — beneficial in FRDA.
The open-label extension of the original trial is ongoing at Murdoch Children’s Research Institute (MCRI), continuing to evaluate the long-term safety and efficacy of the treatment. Efforts are now underway to seek regulatory approval for omaveloxolone in Australia.
Funding
Thank you to our supporters,
- National Health and Medical Research Council (NHMRC
- Medical Research Future Fund (MRFF)
- Biomedical Translation Bridge Program
- Friedreich Ataxia Research Alliance (USA)
- Friedreich Ataxia Research Association (Australia)
- Ataxia UK
- Cure DRPLA
- L’Association Francaise de l’Ataxie de Friedreich (AFAF)
- Rebecca L Cooper
Collaborations
We partner with leading institutions worldwide, including:
- Ataxia UK
- Friedreich’s Ataxia Research Alliance (USA)
- University of South Florida (USA)
- IRCCS Medea – Associazione La Nostra Famiglia Institute (Conegliano, Italy)
- Turner Institute for Brain and Mental Health (Melbourne, Australia)
- Department of Physiotherapy, Monash University (Melbourne, Australia)
- Monash Heart, Monash Medical Centre (Melbourne, Australia)
- Department of Engineering, Deakin University (Melbourne, Australia)
- Monash Biomedical Imaging (Melbourne, Australia)
- Royal Brisbane and Women’s Hospital (Brisbane, Australia)
- Children’s Hospital of Philadelphia (USA)
- Machado Joseph Disease (MJD) Foundation (Northern Territory, Australia)
- University of Sydney
- University of Wollongong
- St Vincent's Institute of Medical Research (Melbourne, Australia)
Featured publications
Corben LA, Collins V, Milne S, Farmer J, Musheno A, Lynch D, Subramony S, Pandolfo M, Schulz JB, Lin K, Delatycki MB. Clinical Management Guidelines for Friedreich ataxia: best practice in rare diseases. Orphanet J Rare Dis. 2022 Nov 12;17(1):415.
Archibald AD, McClaren BJ, Caruana J, Tutty E, King EA, Halliday JL, Best S, Kanga-Parabia A, Bennetts BH, Cliffe CC, et al. The Australian Reproductive Genetic Carrier Screening Project (Mackenzie’s Mission): Design and Implementation. Journal of Personalized Medicine. 2022; 12(11):1781. doi: 10.3390/jpm12111781
Lieschke K, Scott V, Delatycki MB, Lewis S, Munsie M, Tanner C, Corben LA. How Great a Risk Do You Take? A Qualitative Study Exploring Attitudes of Individuals with Friedreich Ataxia Toward Gene Therapy. Hum Gene Ther. 2023 Oct;34(19-20):1041-1048. doi: 10.1089/hum.2023.088. PMID: 37624740.
Milne SC, Corben LA, Roberts M, Szmulewicz D, Burns J, Grobler AC, Williams S, Chua J, Liang C, Lamont PJ, Grootendorst AC, Massey L, Sue C, Dalziel K, LaGrappe D, Willis L, Freijah A, Gerken P, Delatycki MB. The Rehabilitation for Ataxia Study: Protocol for a randomised controlled trial of an outpatient and supported home-based physiotherapy program for people with hereditary cerebellar ataxia. BMJ Open 2020 Dec 17;10(12):e040230.
Corben LA, Nguyen, KD, Pathirana, PN, Horne, MK, Szmulewicz DJ, Roberts M, Delatycki MB. Developing an instrumented measure of upper limb function in Friedreich Ataxia. Cerebellum. 2021 Jun;20(3):430-438.