Archive for the ‘Blog’ Category

At Global, we were shocked about the suggestions to cut the already scarce funding for students with special needs (12% of our students BTW!) and to completely defund Special Olympics. This past week, we saw our congressional heroes fiercely support maintaining funding, including leadership from both sides of the aisle – Congresswoman Rosa DeLauro (D-CT) and Senator Roy Blunt (R-MO) (both Global’s Q-Award Winners). THANK YOU!

We are pleased that Congress and President Trump heard the concerns of those who are differently-abled and that the government will continue to support the incredible Special Olympics program. PLEASE make sure you also safeguard funding for our students with special need in public school who deserve a chance to learn and reach their potential!

From Down Syndrome World Issue 4 2018

People with Down syndrome are highly protected from most solid tumor cancers, and yet they are highly predisposed to certain blood cancers. Studying people with Down syndrome may lead to new cancer treatments that could benefit everyone.

ACCORDING TO THE AMERICAN CANCER SOCIETY, an estimated 1,762,450 new cases of cancer will be diagnosed in 2019. There are hundreds of types of cancers and different ways to categorize them. One way to categorize cancer is into two types — solid tumor cancers and blood, or hematological, cancers.

People with Down syndrome are highly protected from most solid tumor cancers, such as breast, uterine, and prostate cancers. However, people with Down syndrome are much more likely to develop certain leukemias, one of the key blood cancers found predominantly in children.

IN SEARCH OF ANSWERS

World-renowned cancer researcher Joaquín Espinosa, Ph.D., Executive Director of the Linda Crnic Institute for Down Syndrome, has studied cancer biology for years. He was an early career scientist of the Howard Hughes Medical Institute before a grant from the Global Down Syndrome Foundation opened his eyes to the broad implications of investigating the connection between cancer and Down syndrome.

“My mentor, Tom Blumenthal, was the director of the Crnic Institute and insisted I apply for a grant,” says Dr. Espinosa. “I had no idea that the science would be so fascinating and that I would come to feel that people with Down syndrome are like my extended family.”

Three years later, Dr. Espinosa and his team discovered that the extra copy of chromosome 21 in people with Down syndrome triggers an immune system process called the interferon response, which may have a significant bearing on cancer risk.

“From birth, the immune system of people with Down syndrome is very dysregulated,” Dr. Espinosa says. “It’s out of balance, so aspects of it are hyperactive and others are weakened. The hyperactivity may explain why solid tumor cancers are not allowed to grow and, therefore, why it is rare for people with Down syndrome to get most solid tumor cancers. Conversely, it may also explain why autoimmune disorders are so prevalent.”

Other researchers hypothesize that chromosome 21 contains one or more tumor-suppressing genes, which may explain why having an extra copy of the chromosome protects against solid tumors, and that the chromosome also contains genes that spur the development of leukemias.

This article was published in the award-winning Down Syndrome World™ magazine. Become a member to read all the articles and get future issues delivered to your door!

LUKEMIA: AN EARLY CHILDHOOD RISK

Children with Down syndrome are particularly susceptible to two types of leukemia: acute megakaryoblastic leukemia (AMKL) and B-cell acute lymphoblastic leukemia (B ALL), the most common subtype of acute lymphoblastic leukemia (ALL).

They are also uniquely susceptible to one bone marrow disorder that results in a higher risk of AMKL called transient myeloproliferative disorder (TMD). TMD, also called transient leukemia, is found only in newborns with Down syndrome. As many as 30 percent of babies with Down syndrome are born with TMD, and although it can cause severe or life-threatening problems, the overwhelming majority of cases resolve naturally by the third month of life.

However, infants with TMD are at increased risk of developing acute myeloid leukemia (AML), which can strike children all the way through the teenage years. In particular, children with Down syndrome between ages 1 and 5 are 150 times more likely than typical children to develop AMKL, a rare type of AML. AMKL is a life threatening leukemia in which malignant megakaryoblasts proliferate abnormally and injure various tissues.

While the risk for AMKL is consider ably higher, many studies report better outcomes for patients with Down syndrome compared with their typical counterparts. Children with Down syndrome who develop AMKL have a roughly 80 percent five year event-free survival rate, which is substantially better than that seen in typical children with this leukemia, according toJohn Crispino, Ph.D., Robert I. Lurie, M.D. and Lora S. Lurie Professor of Medicine at Northwestern University.

“Nevertheless, not all children with Down syndrome survive the disease, and survival rates for those who relapse even after a bone marrow transplant are abysmal,” Dr. Crispino says.

Dr. Crispino’s lab has several areas of focus including acute leukemias and myeloproliferative neoplasms, and he is considered one of the leading authorities regarding leukemia in patients with Down syndrome.

According to Dr. Crispino, there is a 20-fold increased risk of B-ALL in children and young adults with Down syndrome primarily from ages 5 to 20. B-ALL is an aggressive type of leukemia in which too many B-cell lymphoblasts are found in the bone marrow and blood.

Unlike AMKL, reports and studies show that patients with Down syndrome with B-ALL fair worse than their typical counterparts — they have a higher relapse rate, may suffer severe side effects from chemotherapy, and have higher treatment-related mortality.

According to Dr. Crispino, part of the problem could be attributed to the attending physicians’ lack of adherence to the different chemotherapy protocols for pediatric patients with Down syndrome. Patients with Down syndrome often react poorly to standard chemotherapy for B-ALL, and their “toxicity profile” means more side effects that can result in extreme loss of red and white blood cells and platelets, inflammation in the digestive tract, and even heart failure.

“These patients need modified treatment protocols and universal supportive care guidelines that are optimal,” says Dr. Crispino. “Including patients with Down syndrome in studies of novel agents, such as immunotherapy and JAK inhibitors, could also help address this problem.”

Global’s lobbying and advocacy effor ts, resulting in a $24 million increase in Down syndrome research at the National Institutes of Health (NIH) in 2018, certainly led to an increase in cancer research in this special population, but there is still a long w ay to go. Dr. Crispino believes we desperately need less toxic and more effective therapies, especially to prevent relapse and treatment related mortality in patients with Down syndrome. He advocates for research at the NIH that would determine why Down syndrome leads to the increased incidence of leukemia and identify novel drug targets that will lead to development of safer treatments, and for leveraging new technologies that will identify specific genes on chromosome 21 linked to leukemia.

While leukemia does not always cause symptoms, Karen Rabin, M.D., Ph.D., Associate Professor of Pediatric Hematology/Oncology and Director of the Leukemia Program at Texas Children’s Cancer Center and Baylor College of Medicine, says parents should look out for bone pain, difficult y walking, easy bruising or bleeding, pallor, prolonged and unexplained fevers, and swollen glands in the neck and elsewhere.

A complete blood count can detect leukemia in some cases but is not recommended unless symptoms are present, according to Dr. Rabin. Chemotherapy is the standard treatment for most acute leukemia. But immunotherapy — a class of therapies that train the immune system to target cancer — is an emerging option.

“Immunotherapy is not generally used for newly diagnosed ALL at this time, but it is a very effective treatment in cases of relapse,” Dr. Rabin explains. “I particularly recommend early consideration of immunotherapy for relapsed ALL in children with Down syndrome because they are at high risk of serious complications when treated with standard relapse chemotherapy regimens.”

RESEARCH THAT BENEFITS EVERYONE
Of the 1.7 million new cancer cases estimated to be diagnosed in the United States in 2019, it is impossible to know how many of those cancers will occur in people with Down syndrome, according to Dr. Espinosa. Regardless, studying cancer in this population benefits anyone who develops the disease. Dr. Rabin agrees.

“We first discovered a major class of genetic alterations in ALL by studying ALL samples from children with Down syndrome, where the alterations are much more common than in other ALL cases,” she says. “This has led to a clinical trial of ruxolitinib, an inhibitor targeting this pathway, as a new treatment for ALL.”

Dr. Espinosa and his team at the Crnic Institute, with financial support from Global’s Mary Miller & Charlotte Fonfara-LaRose Down Syndrome & Leukemia Research Fund, are testing the effectiveness of drugs that inhibit two genetic mutations that cause runaway cellular growth linked to leukemia. Dr. Crispino and his team have conducted preclinical studies of inhibitors of a particular gene on chromosome 21 that may be active both in individuals with Down syndrome who have B-ALL and in some typical individuals with that type of leukemia.

“With respect to solid tumors, research into why people with Down syndrome develop cancer at low rates has enormous potential to shed light on chemoprevention strategies,” Dr. Crispino states. “If we can discover the genes on chromosome 21 that protect against solid tumors, we may be able to leverage these insights to develop drugs to halt cancer initiation or progression in all people.”

Like this article? Join Global Down Syndrome Foundation’s Membership program today to receive 4 issues of the quarterly award-winning publication, plus access to 4 seasonal educational Webinar Series, and eligibility to apply for Global’s Employment and Educational Grants.
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From Down Syndrome World Issue 3 2018

ZACHARY “ZACK” GOTTSAGEN, an accomplished stage performer and film actor who happens to have Down syndrome, was working on set for a movie in Los Angeles courtesy of the amazing nonprofit, Zeno Mountain Farm, when he met directors Tyler Nilson and Michael Schwartz. They were so taken with Zack’s intelligence, humor, enthusiasm, and joy for life that they decided to write a film for him to star in. The result, The Peanut Butter Falcon, incorporates Zack’s infectious personality and his love for wrestling into their lead character, also named Zak. The two relatively new directors gained the support of big-name actors including Shia LaBeouf, Dakota Johnson, and Thomas Haden Church.

Nilson and Schwartz hope The Peanut Butter Falcon, their first feature-length movie, gives people who are differently-abled a taste of the freedom they can enjoy when they follow their dreams.

A modern-day spin on Huckleberry Finn, The Peanut Butter Falcon follows Zak, a 22-year-old man with Down syndrome, who escapes the nursing home where he lives to pursue his ambition of professional wrestling. The budding wrestler hopes to meet retired wrestling legend “The Salt Water Redneck,” played by Thomas Haden Church, who lives in rural North Carolina. On his journey, Zak meets a crab fisherman and small-time outlaw named Tyler (played by LaBeouf), who becomes Zak’s ally.

Lucky Treehouse, one of the film’s production companies, describes the pair’s adventure: “Together they wind through deltas, elude capture, drink whiskey, find God, [and] catch fish.” Tyler and Zak are eventually joined by Eleanor (played by Johnson), an employee from Zak’s nursing home who is searching for him as well as answers of her own.

“Many people struggle to maintain a regular life, not because of their disabilities, but because of others’ disbelief in their talents … I am making [this film] for the people who believe it is OK to dismiss them,” Nilson writes on Lucky Treehouse’s production website.

AN A-LIST CAST Gottsagen was excited to work alongside the Hollywood A-list actors. LaBeouf is known for roles in movies such as Transformers, Holes, and Borg vs McEnroe. Johnson is known for films including How to be Single and for starring in the Fifty Shades of Grey franchise. Church has acted in TV shows and movies since 1980 and most recently played the lead in the HBO series Divorce.

Bruce Dern, a two-time Oscar nominee, plays Carl, Zak’s roommate at the nursing home. Producers for the movie include Ron Yerxa and Albert Berger, the talent behind Cold Mountain and Little Miss Sunshine. T Bone Burnett, the creative genius behind numerous award-winning film scores, produced the soundtrack.

In addition to Lucky Treehouse, the film was produced by Armory Films, Nut Bucket Films, and Tvacom Film and TV.

This article was published in the award-winning Down Syndrome World™ magazine. Become a member to read all the articles and get future issues delivered to your door!

THE MAKING OF A FALCON Despite its impressive cast and crew, The Peanut Butter Falcon’s true star is Gottsagen, 33, who credits his first acting role as the star of a natural childbirth instructional video on April 22, 1985. He was the first student to be fully included in a Palm Beach County public school, and in 2004, he earned a theater degree from the A.W. Dreyfoos School of the Arts in West Palm Beach. Currently, Gottsagen lives independently in Boynton Beach, Florida, and works at a local movie theater.

For more than 10 years, Gottsagen worked with Zeno Mountain Farm, a nonprofit that hosts camps for people of all abilities in Vermont, California, and Florida. He worked with the nonprofit’s Film Camp and appeared in movies such as Burning Like a Fire and Life of a Dollar Bill. While filming a western called Bulletproof, he got involved with a documentary titled Becoming Bulletproof, which followed the movie’s actors and probed the question of why more actors who are differently-abled don’t appear in films. The movie was nominated at numerous film festivals and won the Best Film, Audience Choice, Festival Prize, Grand Jury, and Best Documentary awards at the Cleveland International Film Festival, Heartland Film Festival, Massachusetts International Film Festival, New Hampshire Film Festival, and the Vail Film Festival respectively. It was screened at the Smithsonian Museum’s 25th anniversary of the Americans with Disabilities Act in July 2015 — Gottsagen was the keynote speaker at the event.

But it gets even better. In a March 2018 Esquire cover story interview, LaBeouf gave Gottsagen some serious credit for sobering up. In the cover story, LeBeouf not only alludes to Gottsagen’s acting chops, he states, “That mother#>@%&* is magical.”

For Gottsagen, he is centered knowing he has an extended family of actors and film crews. He appreciates the opportunity to live out his dream of being an actor and has already started on two additional productions.

“I hope that thousands of fans see [The Peanut Butter Falcon],” Gottsagen told the Palm Beach Post. “I hope that they will love it, and the cast, a lot, including myself.”

In May, the Global Down Syndrome Foundation hosted a special screening of The Peanut Butter Falcon at the Sie FilmCenter in Denver. It was attended by a focus group of local self-advocates and families, as well as Gottsagen and his mother, Shelley, who flew in from Florida.

Shelley is an extremely articulate but quiet woman who clearly has a remarkable relationship with her son. While she is awed by how outgoing her son is, she is not surprised at his career choice.

“Zack told me when he was 3 years old, and every year after that, he was going to be an actor,” she told the audience. “I am definitely proud at what he has accomplished.”

Gottsagen, music and film producer Berger, and director Schwartz did a Q&A after the screening, and the audience left inspired and thoroughly entertained. The film is currently in post-production and will be released later this year.

Gottsagen’s talent and his many accomplishments have earned him Global’s 2018 Quincy Jones Exceptional Advocacy Award along with award-winning Irish actor, Colin Farrell. The award will be presented at Global’s 10th Anniversary Be Beautiful Be Yourself Fashion Show, scheduled for Saturday, Oct. 20, in Denver.

Like this article? Join Global Down Syndrome Foundation’s Membership program today to receive 4 issues of the quarterly award-winning publication, plus access to 4 seasonal educational Webinar Series, and eligibility to apply for Global’s Employment and Educational Grants.
Register today at downsyndromeworld.org!

From Down Syndrome World Issue 3 2018

As one of the lead authors of the Medical Care Guidelines for Adults with Down Syndrome, George T. Capone, M.D., is continuing his life’s work of improving evidence-based medical care for people with Down syndrome.

FOR THE PAST 30 YEARS, George T. Capone, M.D., has specialized in providing quality care for patients with Down syndrome, always pushing for better evidence-based treatment and interventions. As a research scientist, Director of the Kennedy Krieger Institute’s Down Syndrome Clinic and Research Center (DSCRC), and Associate Professor of Pediatrics at the Johns Hopkins University School of Medicine, he has seen more than 2,500 patients, ranging in age from infants to seniors. Dr. Capone has contributed to improved care since the 1980s, and he continues to be concerned about health care for adults with Down syndrome.

Dr. Capone’s extensive knowledge, experience, and passion to improve care are the primary reasons he was tapped to join a team of physicians and researchers updating the Medical Care Guidelines for Adults with Down Syndrome, a project funded by the Global Down Syndrome Foundation.

AN EARLY SUPPORTER OF TRANSLATIONAL RESEARCH

Dr. Capone’s career treating people with Down syndrome took root in 1988, when he began a neurobiology fellowship at Johns Hopkins University School of Medicine. At the time, researchers at Johns Hopkins, including his mentor Joseph T. Coyle, M.D., were conducting groundbreaking genetic research on the link between Down syndrome and Alzheimer’s disease. Among the many projects he saw occurring in Dr. Coyle’s lab was research that used TS16 mouse models to investigate the impact that three copies of chromosome 21 — the defining characteristic of Down syndrome — has on early-onset Alzheimer’s disease. It was some of the earliest research on the subject.

This article was published in the award-winning Down Syndrome World™ magazine. Become a member to read all the articles and get future issues delivered to your door!

The time spent in Dr. Coyle’s lab helped lay the foundation for Dr. Capone’s interest in how that research could be directly applied to the health and well-being of patients. In the early 1990s, Dr. Capone joined the Kennedy Krieger Institute. There, he recognized that the DSCRC provided ample opportunity to develop hypotheses and research questions on the neurobiological and neurobehavioral basis of cognitive impairment associated with Down syndrome. The clinic’s diverse patient population allowed for “person-centered clinical research focusing on the medical and mental health conditions we see on a daily basis.” Such research, he knew, would benefit not only people with Down syndrome but also patients with its co-occurring conditions, such as Alzheimer’s disease, sleep apnea, and heart conditions.

Under Dr. Capone’s leadership, the DSCRC has conducted studies on a range of conditions, including autism-spectrum disorders and attention-deficit/hyperactivity disorder. His research has led to the characterization of autism in children with Down syndrome, uncommon neurobehavioral and developmental profiles of children and teenagers with Down syndrome, and developmental regression in people of all ages with the condition.

He has also designed and conducted several clinical pharmacology trials for drugs intended to improve memory and cognition in both children and adults, including risperidone, guanfacine, and rivastigmine.

“The science is fascinating, and the associated medical conditions are complex and perplexing,” Dr. Capone said. “The families I work with are the best, and the children and adults I interact with always amaze me.”

FORGING NEW PATHS FOR ADULT MEDICAL CARE

Dr. Capone agrees that the increased knowledge and advocacy among parents and healthcare professionals, the establishment of specialized clinics such as the DSCRC, and advancements in medical-surgical care for children have all progressed health for people with Down syndrome. Yet, despite contributions to the field of care for people with Down syndrome, more research is necessary to improve lives.

“We need to better understand the etiology-pathogenesis and risk factors associated with certain medical conditions, as well as what treatment approaches and prevention strategies are most beneficial to our patients,” Dr. Capone explained. “We also need a more organized approach to managing data sets to improve clinical decision-making, patient and caretaker outcomes, and quality of life.”

The Medical Care Guidelines for Adults with Down Syndrome will go a long way toward improving clinical decision-making and health outcomes. The current guidelines available for adults with Down syndrome were last updated in 2001 and do not adequately reflect the more than doubling of life span for people with Down syndrome since the 1980s. As adults with Down syndrome are living longer, they require care specific to their unique aging experience and risk factors.

“Many physicians in adult medicine do not have adequate training to care for people with genetic and neurodevelopmental conditions,” Dr. Capone said. “The medical conditions experienced by adults with Down syndrome can appear overwhelming and beyond the reach of many physicians, but with sufficient resources and training, we can teach primary care and other adult healthcare providers how to provide this care with confidence.

“Coming up with medical care guidelines will expose how little we really know about ‘best practices’ when caring for aging adults with Down syndrome and chronic medical conditions,” he added. “I hope it will stimulate further interest and investigation into this often neglected aspect of clinical research.”

To learn more about the Medical Care Guidelines for Adults with Down Syndrome, please visit globaldownsyndrome.org/medical-care-guidelines.   

ADVICE FOR FAMILIES AND SELF-ADVOCATES

George T. Capone, M.D., Director of the Down Syndrome Clinic and Research Center at Kennedy Krieger Institute and Associate Professor of Pediatrics at the Johns Hopkins University School of Medicine, has some advice, learned over a 30-year career, to pass along to people with Down syndrome and their families.

Don’t get caught up in comparisons.

“If your child seems different compared to other children you know with Down syndrome, don’t despair,” Dr. Capone said. “All our children are unique, and we should rejoice in these differences.”

Exercise body and mind.

“Stay physically and mentally active once you leave high school or post-secondary school,” he said. “Find your own means of self-expression through the performing arts, fitness, hobbies, and fun social activities.”

Connect.

“Stay informed and connected to the larger Down syndrome community of families and selfadvocates,” he advised.

Like this article? Join Global Down Syndrome Foundation’s Membership program today to receive 4 issues of the quarterly award-winning publication, plus access to 4 seasonal educational Webinar Series, and eligibility to apply for Global’s Employment and Educational Grants.
Register today at downsyndromeworld.org!

From Down Syndrome World Issue 3 2018

How does an extra copy of chromosome 21 drive the developmental and clinical features of Down syndrome? This question has been the subject of many investigations since 1958, when Jérôme Lejeune reported the Presence of trisomy 21 in cells of people with Down syndrome. The answer has remained elusive.

NOW, RESEARCH FROM the Linda Crnic Institute for Down Syndrome points to dysregulation of the immune system as a mechanism by which the extra chromosome would cause this multiorgan, multi-system condition. The implications of these results are profound, because they not only provide a new conceptual framework for future research, but also illuminate avenues for the development of novel diagnostic and therapeutic opportunities to improve health outcomes in Down syndrome. Of the more than 20,000 genes encoded in the human genome, chromosome 21 carries fewer than 300, the lowest number of genes on any human chromosome. While consensus among scientists is that Down syndrome is a “polygenic condition,” a condition caused by increased activity of more than one gene, it is also agreed that not all genes on chromosome 21 would contribute equally to the condition. If one were to select a random group of 300 genes, it is recognized that only a few genes would be master regulators of cellular and organismal function. What then are the master regulator genes on chromosome 21 with the greatest impact on human biology? To address this question, scientists at the Crnic Institute employed an approach known as functional genomics, which involves measurements of the activity of thousands of genes across the entire genome, to identify the gene networks most impacted by trisomy 21.

OVERACTIVE IMMUNE SYSTEMS?

The first set of results from the analysis of cells of people with Down syndrome (Sullivan et al., 2016) revealed that trisomy 21 causes constitutive activation of the gene network known as the Interferon response, a key branch of the immune system responsible for fighting off viral infections. In cells from typical people, the Interferon response was dormant, but cells from people with Down syndrome seemed to be fighting off a viral infection that just wasn’t there. These results immediately drove attention to four genes on chromosome 21 known as the Interferon receptors, which are required for cells and tissues to respond to a viral infection and whose triplication could potentially trigger constant activation of this arm of the immune system.

The second set of results from the analysis of blood samples (Sullivan et al., 2017) revealed signs of chronic autoinflammation in people with Down syndrome. Measurements of approximately 4,000 different proteins in the blood identified about 300 that are differentially abundant between people with and without Down syndrome, with about half of those 300 proteins being involved in the immune system. Importantly, this study revealed signs of both constant activation and exhaustion of different aspects of the immune system, with obvious ties to the Interferon response. It is well established that the Interferon response enhances anti-viral defenses, but too much Interferon activity eventually weakens antibacterial defenses. Indeed, the results of the blood analysis were consistent with a type of immune dysregulation caused by lifelong hyperactivation of the Interferon response.

Noteworthy, both studies revealed, among people with Down syndrome, strong inter-individual variation in the degree of activation of the Interferon response and autoinflammation, which could potentially be linked to the obvious clinical diversity in this population.

This article was published in the award-winning Down Syndrome World™ magazine. Become a member to read all the articles and get future issues delivered to your door!

GREATER INSIGHTS AND POTENTIAL TREATMENTS

These results have triggered a flurry of activity at the Crnic Institute to answer key follow-up questions: Which of the symptoms of Down syndrome could be explained by the observed immune dysregulation? To what degree is the immune dysregulation caused by triplication of the four Interferon receptors versus other genes on chromosome 21? What would be the diagnostic value of measuring immune dysregulation to predict the risk of the same person developing certain co-occurring diseases or conditions? What would be the therapeutic value of medications that inhibit the Interferon response and accompanying inflammatory process?

Several key facts are generating much enthusiasm in the pursuit of these answers. First, it is well established that a hyperactive Interferon response has negative effects on human development, as illustrated by type I Interferonopathies, a newly recognized class of genetic conditions caused by gene mutations that lead to activation of the Interferon response and share many symptoms with Down syndrome. Second, the pharmaceutical industry has developed many medications that inhibit the Interferon response, some of which are approved for the treatment of autoinflammatory conditions, such as rheumatoid arthritis, and are currently being tested for the treatment of autoimmune conditions more prevalent in Down syndrome, such as alopecia areata and vitiligo. Third, pioneer studies in mouse models of Down syndrome completed by Lenny Maroun, Ph.D., currently at the Crnic Institute, demonstrated that reducing the Interferon response improves the development of these mice (Maroun et al., 2000).

Altogether, this body of research justifies a strong investment in the study of the immune system in Down syndrome, with the obvious potential to develop diagnostic and therapeutic strategies to improve the well-being of those living with trisomy 21.

To learn more about research at the Crnic Institute, visit globaldownsyndrome.org/our-story/linda-crnic-institute.

References:

Maroun, L.E., Heffernan, T.N., and Hallam, D.M. Partial IFN-alpha/ beta and IFN-gamma receptor knockout trisomy 16 mouse fetuses show improved growth and cultured neuron viability. Journal of Interferon & Cytokine Research: the Official Journal of the International Society for Interferon and Cytokine Research. 2000; 20, 197–203.

Sullivan, K.D., Evans, D., Pandey, A., Hraha, T.H., Smith, K.P., Markham, N., Rachubinski, A.L., Wolter-Warmerdam, K., Hickey, F., Espinosa, J.M., et al. Trisomy 21 causes changes in the circulating proteome indicative of chronic autoinflammation. Scientific Reports. 2017; 7, 14,818.

Sullivan, K.D., Lewis, H.C., Hill, A.A., Pandey, A., Jackson, L.P., Cabral, J.M., Smith, K.P., Liggett, L.A., Gomez, E.B., Galbraith, M.D., et al. Trisomy 21 consistently activates the interferon response. 2016; eLife. 5.

Like this article? Join Global Down Syndrome Foundation’s Membership program today to receive 4 issues of the quarterly award-winning publication, plus access to 4 seasonal educational Webinar Series, and eligibility to apply for Global’s Employment and Educational Grants.
Register today at downsyndromeworld.org!

From Down Syndrome World Issue 3 2018

The Salah family and the Salah Foundation are giving countless people hope, life-changing support, and a brighter future. For the Global Down Syndrome Foundation, the Salah Foundation is making its dream come true — the opening of a state-of-the-art education center for the differently-abled.

THE SALAH FAMILY is originally from Lebanon, a country of great maritime and cultural history, where even in the second millennium BC, people living in the area cultivated land in a sophisticated society. The ancient Lebanese were creators of the oldest known 24-letter alphabet, and eventually, their alphabet would influence Hebrew, Aramaic, and other languages throughout the Mediterranean region. More recent history has been tumultuous for Lebanon, including during World War I (1914–1918), after which the country was put under the direct control of France. It was during this difficult time, in 1919, that Joseph and Nora Salah courageously left their Maronite Christian hometown and emigrated from Lebanon to the United States in pursuit of a better life.
With little money and unable to speak English, the Salahs worked hard to make a life for themselves and their three children: Isabel, James, and George. James “Jim” Salah was a natural and brilliant entrepreneur. He started his own construction business in Boston, handling some of the city’s largest utility projects, and then branched out into real estate and heavy equipment leasing, and his companies prospered. Upon his death in 2009, The Salah Foundation was founded and now serves as a living tribute to his lifelong success and generosity. Today, Jim’s commitment to philanthropy lives on through his niece, Noreen Salah Burpee, who serves as Executive Director of the foundation.

A FORMIDABLE FORCE FOR GOOD
Under the direction of Burpee, The Salah Foundation has become a formidable force for good. “We have a special interest in self-sufficiency programs,” Burpee explains. “We seek to improve the lives of the under educated, undernourished, and medically needy to become productive and responsible citizens.” The foundation has an emphasis on the economically disadvantaged, young, elderly, and disabled. “The need for responsible philanthropy is almost overwhelming,” Burpee said. “Our greatest inspiration is when we witness someone breaking the cycle of poverty, or ignorance, or homelessness.” Burpee has tapped her own three children — Fred Churbuck, Megan Fearnow, and George J. Taylor — to share the responsibility of philanthropy. “It is a privilege to work together as a family ,” Burpee explains. “Each board member brings their own personal passions to the table. We are a brave family and not afraid to fund the underserved.” Some important organizations that are close to their hearts include The Salah Foundation’s Children’s Hospital at Broward Health and The Noreen Salah Burpee Adult Infusion Center, an inpatient cancer center, both in Fort Lauderdale, Florida, and most recently, The Salah Foundation Learning Zone at the future Global Down Syndrome Foundation Education Center of Excellence. The Salah Foundation connected with Global’s dedication to research, medical care, education, and advocacy for people with
Down syndrome. When the family learned about the lack of research funding and medical care and the discrimination against people with Down syndrome, Burpee says she was “very moved by each child with Down syndrome and their supporting families. The very thought that their needs and the needs of children like them were
not being met made us very sad.” “Research is the key,” she continues. “People must be educated on the difficulties and lives of these children so they can live productive, meaningful lives, and Global is doing just that.”

This article was published in the award-winning Down Syndrome World™ magazine. Become a member to read all the articles and get future issues delivered to your door!

TWO GENERATIONS OF IMPACT GIVING
Burpee’s son, Fred Churbuck, was the first to experience Global at one of our annual Be Beautiful Be Yourself Fashion Show fundraisers. Churbuck admits that at first he didn’t want to attend. “I thought I would feel uncomfortable,” he says. “I had never met a person with Down syndrome.” Then something magical happened. The keynote speaker, Tim Harris, came out, and his speech touched Churbuck. “He was so energetic and articulate, and then he turns to the audience and says, ‘I’m living my dream. You ask yourself, are you living yours? Are you the best you can be?” Churbuck retells the moment. “For the next few weeks, I had all my marketing team watch Tim on video, and we were all inspired.” Over the next two years, The Salah Foundation generously funded Global’s important adult life skills classes and a post – secondary research study that spelled out, for the first time , how adults with Down syndrome best learn life skills and improve their cognitive abilities. “The support that Salah provided to our class and research helped us to make adults more self-sufficient while being able to create and share best practices,” says Bryn Gelaro, LSW (licensed social worker), Global’s Director of Adult Initiatives and Special Projects. Then in 2017, four years to the date of Churbuck at tending Global’s annual fundraiser, the Salah family at tended with a game-changing surprise announcement. Burpee got on stage and announced a new pledge to help under write Global’s future Education Center of Excellence with the lar gest single donation Global has received — $1 million. “We are out of our minds grateful!” says Michelle Sie Whitten, President and CEO of Global. “The Salah Foundation was amazingly generous, and it was so hard to keep it a secret — literally even our board didn’t know. We were so intent on making it a surprise. There were 1,400 people in attendance, we were sold out, and then the lovely, articulate Noreen gets up there and just makes the announcement. Even Quincy Jones, John C. McGinley, Jamie Foxx, and Eva Longoria were high-fiving each other!” Burpee recalls, “When I made that pledge and hear d the gasps and then the applause, I looked to my family’s table and saw them standing and wildly applauding. It took my breath away.” The 2017 Be Beautiful Be Yourself Fashion Show was the largest grossing Global fundraiser to date.

INCLUSION, INSPIRATION, AND ACHIEVEMENT
Global’s future Education Center will open in 2019. The Education Center will house The Salah Foundation Learning Zone where transformative educational programs for adults and children with Down syndrome will be held. To better understand the needs of the local community, Global organized an informal listening campaign and survey resulting in 26 disability organizations identifying programs and classes that could take place in The Salah Foundation Learning Zone. Examples of programs already being planned are cooking classes, computer classes, and summer center-based learning classes so children with Down syndrome can be better prepared for the school year. The Education Center is nestled between the Cherry Creek neighborhood of over 1,000 residents and the vibrant Cherry Creek North shopping district with over 600 businesses and 8 ,000 employees. A key focus of the center will be vocational training with the long-term goal of having 30 to 40 people who are differently abled working in Cherry Creek North. “We are not just a check-writing foundation but a partner in philanthropy,” Burpee says. The partnership with The Salah Foundation and the Salah family will surely empower the dreams of those with Down syndrome and the differently-abled for years to come.

The Salah Foundation is a private foundation that makes investments in nonprofits by invitation only.

Draft rendering of The Salah Foundation Learning Zone at Global Down Syndrome Foundation Courtesy of OfficeScapes and ArtHouse Design

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From Down Syndrome World Winter 2017

Since its inception in 2010, The Anna and John J. Sie Center for Down Syndrome at Children’s Hospital Colorado has championed healthy starts and bright futures by caring for the unique medical needs of young people with down syndrome.

WHEN HER DAUGHTER, Sophia, was born with Down syndrome 13 years ago, Michelle Sie Whitten, President and CEO of the Global Down Syndrome Foundation, traveled more than 1,000 miles from her home in Denver to the Thomas Center for Down Syndrome Services at Cincinnati Children’s Hospital Medical Center to find the specialized medical care Sophia needed. After talking with other local families making the same trek, Whitten began exploring what it would take to bring a similar center to Colorado.

“The initial thinking was, ‘Why should we have to travel?’” Whitten said. “Why shouldn’t Colorado have a fabulous, world-class pediatric medical center for kids with Down syndrome?”

From Whitten’s due diligence and efforts, and funding from Sophia’s grandparents, Anna and John J. Sie, came the Sie Center, a medical center that opened in 2010 at Children’s Hospital Colorado as part of the Linda Crnic Institute for Down Syndrome.

PUTTING POTENTIAL WITHIN REACH

“There’s a lot of talk about people with Down syndrome reaching their full potential,” Whitten said. “At Global, we feel very strongly that without good health, you’ll never reach your full potential.”

Helping children and young adults up to age 21, the Sie Center’s team of medical professionals provides the expert care and resources needed to manage a wide range of physical and behavioral health issues associated with Down syndrome. These specialists work closely with primary care providers at Children’s Hospital Colorado to coordinate care and deliver services through seven clinics.

At the Medical Clinic, a developmental pediatrician, nurse, and physical therapist evaluate children’s medical issues and physical growth to develop a comprehensive care plan. During visits, kids may also see an occupational therapist as needed.

This article was published in the award-winning Down Syndrome World™ magazine. Become a member to read all the articles and get future issues delivered to your door!

The Sie Center’s Feeding Clinic offers families an opportunity to visit with a feeding and swallowing specialist, developmental pediatrician or nurse practitioner, physical therapist, and social worker. These providers help parents address muscle weakness and other issues with eating and drinking that can interfere with a child’s ability to breast-feed, chew, and/or swallow and therefore raise his or her risk of silent aspiration.

The ENT Clinic helps manage diseases of the ear, nose, and throat, including chronic ear infections, airway obstructions, and hearing loss. Approximately 70 to 75 percent of kids with Down syndrome deal with hearing loss, according to the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

The Sie Center is the first center of its kind to have a full-time School-Age Clinic. The clinic’s educational specialist and psychologist help families develop individualized education programs and identify medical problems that may contribute to difficulties with behavior and learning. For example, a child who is acting out in gym class may do so because his feet hurt — not because he doesn’t want to participate in the activity.

“These specialists are like medical detectives,” Whitten said. “They work very closely to understand what’s happening at school and what modifications, support, and resources may be helpful.”

Through the Infant Clinic, babies receive a complete evaluation of their physical health to identify medical needs at a very early age.

At the Sleep Clinic, physicians evaluate children for sleep disorders and help parents troubleshoot solutions for common challenges, such as using a continuous positive airway pressure machine.

Currently, the Telemedicine Clinic connects Sie Center specialists with providers in Durango, Colorado, who treat children with Down syndrome, but Whitten said the goal is to expand the service to benefit the maximum possible number of patients.

In addition to these clinics, the Sie Center recently instituted a mental wellness program. Often, young people experiencing regression or warning signs of depression and anxiety are told that these symptoms are complications related to Down syndrome. However, these issues may be treatable mental illnesses, just as they would be for typical young adults.

A GLOBAL IMPACT

The clinic’s specialists are actively involved in clinical research projects that will help doctors around the world improve care for children with Down syndrome.

Arwen Jackson, MA, CCC-SLP; Jennifer Maybee, OTR, MA, CCC-SLP; Maura K. Moran; Kristine Wolter-Warmerdam; and Francis Hickey, M.D., FAAP, all with the Sie Center or Children’s Hospital Colorado, published their latest study on aspir ation in the international journal Dysphagia.

“Doctors at Children’s Hospital Colorado are also joint appointees at the University of Colorado School of Medicine, so we’re able to get a lot of medical students who are required to do a fellowship or some kind of rotation,” Whitten said. “Working with the Sie Center gives them an in-depth look at the best way to provide medical care to patients with Down syndrome, and that carries over to the care they give in the future.

“The services the Sie Center provides are nothing short of life-changing, if not lifesaving,” Whitten added. “I’ve spoken with parents who’ve told me, ‘I was always afraid, but now that I’m at the Sie Center, I understand what’s going on. I know what I’m supposed to be doing for my child’s health.’”

CARE COUNTS

The Anna and John J. Sie Center for Down Syndrome at Children’s Hospital Colorado is one of the largest centers of its kind in the world. Here’s a snapshot of the clinic’s impact:

• More than 1,500 visits take place at the Sie Center each year.
• The Sie Center serves approximately 1,300 patients annually.
• The pediatricians, specialists, and therapists at the Sie Center have more than 80 years collective experience caring for children with Down syndrome.
• Families representing 26 states, seven countries, and Puerto Rico seek care at the Sie Center.

Global provides continued financial support for the Sie Center. Visit The Sie Center web page to learn how you can help efforts to provide medical care for children and young adults with Down syndrome. 

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From Down Syndrome World 2018 Issue 2 of 4

When people first meet 15-year-old Brett Logan, they see a charismatic young man full of joy, laughter, and love. What they don’t see at first glance are the many struggles he has overcome to get to where he is.
From the time Brett was just an infant, he faced severe, life-threatening medical challenges. Doctors questioned if he would live into his adolescent years. Defying the odds, Brett prevailed. But in addition to being a medically fragile child with Down syndrome, Brett developed complex behavioral and social difficulties as a result of the neglect and abuse he endured during his upbringing. One evening when Brett was 8 years old, the local Department of Human Services found him wandering the streets of Greeley, Colorado, by himself in filthy clothes and no shoes. He was sent from foster home to foster home, never truly getting a chance to reach his potential.

A ROUGH START
Born with two heart defects, Brett was diagnosed with failure to thrive. At 20 months old, he had both croup and the flu, which caused his heart to stop and required weeks in the intensive care unit at Children’s Hospital Colorado. During that time, he became addicted to sedation medication and had to be treated with methadone.
When Brett began school, he w as delayed in all areas of development, ranging from nutrition to verbal language. At age 8, Brett was transferred from a different school district into then 22-year-old Jennifer Nelson’s class.
“He was very tiny — about the size of a 3 y ear old at age 8,” Jennifer recalled of the young Brett. “But through all that, I knew there was something really special about him. He had me wrapped around his finger from day one, and we developed a really close student-teacher bond.”
As the school year went on, Jennifer fell in love with Brett’s infectious personality. “He is really loving, empathetic, and funny,” Jennifer said. “He can always make me laugh, and he truly loves others like nobody I’ve ever met.”
After a year of being Brett’s teacher and getting to know him, the 23-year-old, barely out of college, took a life -changing gamble and adopted Brett. At the start of their journey, “they told us he was too old and if he hadn’t learned yet, he wasn’t going to,” Jennifer recalled.
“They were so wrong!”
Brett is now a sophomore in high school, more active and happier than ever before.

BECOMING A FAMILY
After a court hearing where it was clear that Brett would not be returning to his last home, Jennifer stepped up.
“I had decided pretty early on that I wanted to adopt him,” she said. “So many people had given up on him in his life, and I knew he deserved more. Somehow destiny brought us together.”
In 2015, Jennifer and Brett officially became a family. For the first time in his life, Brett had a real home.
“I was happy!” Brett said of learning Jennifer would be his adoptive mother. “My favorite thing about being adopted is that I get to sleep in my bed every night.”
“I will admit, it was very challenging at the beginning,” Jennifer said. “I became a parent of a 9-year-old overnight, when I was just barely out of college myself. I knew he was capable of learning. He just needed someone to teach him.”

THE POWER OF POSITIVITY
With the proper nutrition and medical care, Brett has grown in everyway imaginable, Jennifer said. He is physically larger, very verbal and talkative, and learns new things everyday.
Now a student at Legend High School in Parker, Colorado, Brett has a full calendar with show choir and varsity cheerleading. Off campus, Brett is involved in a number of extracurricular activities as a multi-sport Special Olympics athlete, Junior Denver Broncos Cheerleader, and active participant in Global Down Syndrome Foundation’s Dare to Cheer Camps. In fact, this will be his fourth year attending Dare to Cheer.
His newest interest, modeling, got him on the runway with Sam Cronin, a midfielder for the Minnesota United Major League Soccer team, at Global’s 2017 Be Beautiful Be Yourself Fashion Show.
“I loved everything about the fashion show,” Brett said. “I hope I get to be in it again someday. I loved dancing on the runway with all the cameras on me and the whole crowd cheering! My buddy Sam was awesome. He even gave me a piggyback ride after the show and waited with me until my mom got back.”
Brett still deals with medical challenges, including epilepsy, sleep apnea, and hypothyroidism, all of which have a higher prevalence in people with Down syndrome. But he takes them in stride and continues to prevail. In 2015, he was named an ambassador for Children’s Hospital Colorado for his perseverance through all his treatments.
“I love my doctors at Children’s Hospital, so it was great to be involved,” Brett said. “I got to meet other kids who also battle health issues, and it was great to just be me!”
Brett and his mother don’t know what the future holds, but are excited for all the possibilities that lie ahead.
“Don’t let anyone tell you that something is impossible,” Brett said. “I am proof that challenges can be over come and that you can do anything you put your mind to.”

BRETT LOGAN, IN HIS OWN WORDS
Favorite subject at school: “Guitar, because my teacher lets me have the stage and put on performances for my class.”

Favorite way to make people laugh: “By showing off my muscles or my dance moves!”

Best part of Dare to Cheer Camp: “I love hanging out with my friends and cheering for the audience.”

On being a Junior Denver Broncos Cheerleader: “I love my coaches Jozie and McKenna! They are my favorite part of cheer. I also love performing at the Bronco games. One time Demaryius Thomas threw a football to me on the sidelines!”

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From Down Syndrome World 2018 Issue 2 of 4

In February 2018, a little boy with Down syndrome took the world by storm with his contagious smile, bright blue eyes and charming personality. His name is Lucas Warren, and he’s the first-ever Gerber Spokesbaby with Down syndrome.

The nearly century-old Gerber Products Company is an iconic brand that sells baby food and baby products. Often recognized by its trademark logo, a drawing of the first Gerber Baby, Ann Turner Cook, the company selects a new Gerber Spokesbaby each year. The 1-year-old from Dalton, Georgia, was chosen from 140,000 other contestants to be the Gerber Spokesbaby for the entire year. The Gerber brand personifies the healthy, happy, perfect baby. Choosing Lucas as the 2018 Gerber Spokesbaby challenges negative stereotypes about people with Down syndrome and makes an important statement about inclusion and diversity of those who are differently-abled. Global was able to share the excitement of this historical moment during an exclusive interview with Lucas’ parents, Cortney and Jason Warren.

DOWN SYNDROME WORLD™: TELL US ABOUT THE MOMENT YOU LEARNED LUCAS WON THE GERBER CONTEST.
Cortney and Jason: Our first reaction was shock and doubt, followed by extreme excitement for Lucas! We weren’t able to tell our families and friends until after it was announced.

WHAT AN EXCITING TIME SINCE LUCAS WON! HE HAS MILLIONS OF FANS ON SOCIAL MEDIA, AND EVEN INTERVIEWS ON THE TODAY SHOW. WHAT IS IT LIKE TO BE FAMOUS?
It is a proud moment for us as par ents knowing that Lucas has a platform to spread joy, not only to people he comes in contact with daily but to people all over the U .S. We are so happy that he will have this moment to look back on in the futur e and feel proud.

WHAT ARE LUCAS’ RESPONSIBILITIES AS THE 2018 GERBER SPOKESBABY?
Lucas will represent Gerber in advertisements, social media, and more throughout the year, representing joy and love. In addition, he receives $50,000 for his Spokesbaby title, which we plan to use toward his education.

WHAT HAS SURPRISED YOU ABOUT LUCAS?
What has surprised us the most about Lucas is Lucas himself. Being our first child, and having Down syndrome on top of that, everything is new to us. Seeing him pick up on milestones faster than what doctors and therapists say he should makes us feel so proud of him. He continues to show his doctors, therapists, friends, and family that there are no limits for him.

WHAT DO YOU HOPE HAVING LUCAS AS THE GERBER SPOKESBABY WILL DO FOR THE DOWN SYNDROME COMMUNITY AND SOCIETY IN GENERAL?
We hope this announcement will impact ever yone and shed light on the special needs community. We hope Lucas as the Gerber Spokesbaby will help educate more people that individuals with special needs should be accepted, not limited, and therefore have the potential to change the world.

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