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© 1991-2009
Deb Lee Gould & FODSupport.org

Research Study - Treatment Protocol for Inherited Disorders of Fat Oxidation

Charles R Roe, MD
- is NOT taking any new patients for the c7 Study at this time (May 2009) and no clinical treatment is being done at Baylor as well, at least as far as FOD Families are concerned. There is no longer an FOD clinical expert on staff. Although Dr Roe is officially 'retired' from Baylor he will continue to assist with Families in his c7 Oil study. For now, however, he has listed some other Physicians willing to help Families with the c7 protocol - please see our upcoming July 2009 newsletter for that listing.

Inherited defects of mitochondrial beta-oxidation are autosomal recessive disorders. These defects prevent adequate energy production from long-chain fatty acids. During illness or fasting, toxic fatty acids, or their intermediates from partial oxidation, accumulate in most organs. Attempts to treat the long-chain fat oxidation disorders with dietary medium chain triglycerides (MCT) have not been generally successful.

Commercially available MCT oil, in the US, contains fatty acids that require Carnitine palmitoyltransferases I & II, Translocase, VLCAD, LCHAD, and Trifunctional protein activity for complete oxidation. Current research in our Institute has identified a fatty acid that does not require these enzymes for further oxidation and therefore appears to be very effective for the treatment of these mitochondrial disorders. Unfortunately, this novel fatty acid is contraindicated for the treatment of MCAD deficiency since MCAD is required for its oxidation. Please note: SCAD is no longer being studied as part of this specific study.

The treatment protocol includes infants, children and adults (including pregnant women) who have documented deficiencies of mitochondrial fat oxidation. These disorders include all clinical phenotypes of Carnitine-Acylcarnitine Translocase (CATR), Carnitine Palmitoyltransferase I and II (CPT I, CPT II), Very Long Chain Acyl-CoA Dehydrogenase (VLCAD), L-3-Hydroxy-Acyl-CoA Dehydrogenase (LCHAD),and Mitochondrial Trifunctional Protein (TFP). A diagnosis must be established and well documented before a patient can qualify for the protocol. In addition, each patient's cultured skin cells must be completely investigated by the Institute of Metabolic Disease at Baylor (Dallas) to determine if the proposed intervention is potentially applicable.

Each patient is admitted for up to 5 days for the initial treatment protocol. Chemical and metabolic monitoring as well as serial exercise and muscle strength testing and NMR spectroscopy, as indicated, will be utilized in the evaluation. The Institute will provide the dietary components for a period of 18 months (length of the protocol). During this interval, follow-up visits to Dallas are required at two, six, twelve, and 18 months.

 

••• It has come to our attention that there are questions about the Institute of Metabolic Disease clinical study of C7 (triheptanoin) for treatment of fatty acid oxidation disorders (see more detailed info in yellow box on right sidebar). These studies with human subjects, and appropriate Informed Consent, were approved by the Institutional Review Board (IRB) of the Baylor Research Institute at Baylor University Medical Center in December 1999 and annual reports of the study progress have been reviewed by the IRB. The study was submitted to the Food and Drug Administration (FDA) and an Investigative New Drug (IND) was approved in December 1999.

 


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Treatment of Cardiomyopathy and Rhabdomyolysis
in Long-Chain Fat Oxidation Disorders Using an Anaplerotic Odd-Chain Triglyceride (PDF*)
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