Thanks to a UNC research project, she can walk again

When she was six, a mysterious ailment caused Elizabeth Davis to walk on her toes. Kids began making fun of her. Doctors couldn’t figure out why she walked like this. Then her condition got worse. She began using crutches. Eventually, she didn’t want to leave the house and would rely on a wheel chair.

She went on a diagnostic odyssey for decades and her condition never improved despite various treatments and even surgeries until she came to Jane Fan, MD, a neurologist at UNC who thought Elizabeth’s condition had an underlying genetic component that typical diagnostics couldn’t find. Fan thought Elizabeth might benefit from enrolling in NCGENES—North Carolina Clinical Genomic Evaluation by NextGen Exome Sequencing.

This was a four-year $6.4-million NIH-funded initiative led by Jim Evans, MD, PhD, the Bryson Distinguished Professor of Genetics and Medicine. Researchers sequenced the genomes of hundreds of people to develop best practices for diagnostic tools, some of which clinical geneticists now use to help guide health care for North Carolinians and people around the world.

Fan wanted Evans to weigh in and referred Elizabeth to the NCGENES study. As Evans and colleagues studied Elizabeth’s genome, something jumped out at them—a variant in a gene that was well known to be associated with a condition called dopa-responsive dystonia. Evans thought, could Elizabeth’s particular genetic variant actually be the cause of her condition? Would she respond well to the common drug L-Dopa?

Watch the accompanying video for Elizabeth’s incredible story.

Today, the NIH announced the next wave Clinical Sequencing Evidence-Generating Research Consortium. At UNC, it’s simply called NCGENES 2, this time led by Jonathan Berg, MD, PhD, associate professor of genetics at the UNC School of Medicine, who has worked with Evans for many years.

NCGENES 2 is a four-year, $9,777,556 project. Co-principal investigators are Bradford Powell, MD, PhD, clinical assistant professor in the genetics department, and Christine Rini, PhD, formerly of UNC and now at the Hackensack University Medical Center in New Jersey.

“The more we learn about the human genome and how our genes influence rare and common diseases, the more opportunities we’ll have to help patients and achieve the kind of outcome we saw with Elizabeth,” said Berg, who like Evans is a member of the UNC Lineberger Comprehensive Cancer Center.

And if we want to help more people, then this is the kind of research we need to make it happen.

The first NCGENES grant explored how best to incorporate new DNA sequencing technology into clinical practice. NCGENES 2 will focus on generating evidence to support the routine use of genomic sequencing as a first-line diagnostic test in patients like Elizabeth.

“We can’t expect stories like Elizabeth’s to happen every day,” Berg said. “But all of us doctors who see patients every week understand there is so much more we can learn about human genetics in relation to human health. And if we want to help more people, then this is the kind of research we need to make it happen.”

Read more about the history of genetics research, NC GENES, and Elizabeth’s story at Endeavors, UNC’s online research magazine.

The national CSER2 consortium is specifically funded by the National Human Genome Research Institute, the National Cancer Institute, and the National Institute on Minority Health and Health Disparities.