A faint hope that a family clings to
Laura and Josh Ledbetter know they have only a few years left, at the most, until their five-year-old son, Grayson, dies.
A year ago, Grayson was diagnosed with Alexander disease, an extremely rare type of leukodystrophy that destroys the white matter that protects the nerve fibres in the brain, resulting in debilitating mental and physical delays, and in most cases, death by age 10.
It’s a disease so rare that only about 500 cases have been reported since 1949.
The Ledbetters, who live in Ooltewah — a suburb of Chattanooga, Tenn. — had never heard of Alexander disease before Grayson was born. Now they are part of a small community of families trying to figure out what they can do for their children who have no hope of a cure.
As a baby, Grayson had trouble feeding, then learning to walk, then speaking. Doctors couldn’t figure out what was behind these symptoms. At age 4, he had his first seizure, triggered by a high fever. Emergency room doctors ran a CT scan and found an abnormality. Two days later Grayson had an MRI. The results puzzled doctors, who didn’t know what to tell the parents. “They wouldn’t give us results because radiologists were calling each other across the Southeast,” Laura says.
A search for specialists eventually took the family to the Leukodystrophy Center at the Children’s Hospital of Philadelphia (CHOP). Grayson, they were told, had Alexander disease. The MRI had shown deterioration of the white matter in his brain.
“I felt utterly hopeless,” says Josh.
Gradually, Josh, an account executive for a software company, and Laura, an administrator for a cardiothoracic surgery practice, began to come to terms with the diagnosis. They enrolled Grayson in a study of Alexander disease, they created a nonprofit organization to raise money for research, and they try to enjoy every day they have together.
“I mean, Grayson, he lights up a room,” Laura says. “I don’t know that there’s anybody who wakes up happier than Grayson. He’s just the happiest little guy and always full of joy. And he’s working all day. He doesn’t necessarily know it, but he’s working and being evaluated and measured all day long . ... I don’t know a 5-year-old that works harder than him.”
Grayson is part of an Alexander disease study led by Amy Waldman, a pediatric neurologist and director of the Leukodystrophy Center at CHOP. The study monitors how the disease affects patients, gathering information in an effort to develop treatment.
Other research is underway at the University of Wisconsin at Madison, where Albee Messing, a professor emeritus of comparative biosciences, has been studying Alexander disease for more than 20 years.
“I was spending most of my time with mouse genetics and basically engineering mice, to study cell biology and development in the nervous system,” Messing says. “At some point in the mid-1990s, we created a mouse, which to our surprise, had lesions in its brain, that I recognized as reminiscent of Alexander disease. And I knew about Alexander disease from my neuropathology training ... Even though it’s an extremely rare disease, it’s so distinctive. And so I realized that this mouse provided a clue into a potential genetic basis for the disease.”
Messing and his team have connected Alexander disease to a protein called GFAP — glial fibrillary acidic protein. For more than a decade, they have been working on ways to reduce levels of GFAPs in mice.
About four years ago, working with scientists from Ionis Pharmaceuticals, they began using oligonucleotides, called oligos. After injecting the oligos into mouse brains, levels of GFAP dropped almost completely, offering hope that the technique could someday be used in humans.
The Ledbetters started the nonprofit Grayson’s Ladder to raise funds for Waldman’s study and for further research. They recently had their first fundraising event at their home, attended by four other families who have children with the disease.
So far, Grayson’s Ladder has raised nearly $100,000.
While working toward a cure the Ledbetters, who also have a 9-year-old son named Cooper, are trying to keep Grayson healthy.
Weekdays he receives physical, speech and occupational therapy, part of his school schedule. Outside of school, he goes to gymnastics to help with his flexibility, and does hippotherapy — a type of neuromuscular therapy that uses horseback riding to help improve posture and co-ordination.