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Mississippi’s heartbeat: A mother, her son, and their family’s battle with Barth syndrome



Christopher Pena
Christopher (Photo courtesy of Kristi Pena)
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Amidst Mississippi’s soulful blues and majestic magnolias is a testament to the enduring spirit of its people. In Rankin County, the life of 15-year-old Christopher paints a poignant narrative of hope, challenge, and resilience as he and his family confront Barth syndrome.

Decoding Barth Syndrome: More Than Just a Diagnosis

To many, Barth syndrome might appear as a mere term in the vast sea of medical jargon. However, for families affected by it, Barth syndrome becomes a daily reality, intricately woven into their life tapestry. This condition exhibits a unique blend of symptoms—from cardiac anomalies to skeletal muscle weakness. But beyond the clinical definitions, it’s the real-life stories of those affected that offer a window into its true impact.

“Mississippi is where our story begins and, regardless of our challenges, it’s home,” Kristi Pena, Christopher’s mother, began.

Kristi harbored dreams like many mothers—of family love, daily life’s comforting rhythm, and the sheer joy in her child’s laughter. Yet, fate had other plans.

Christopher Pena

Christopher’s birth was both a moment of joy and a moment of uncertainty. (Photo courtesy of Kristi Pena)

With Christopher’s birth came profound joy, but the path soon took an unexpected turn. Medical check-ups, which should have been routine, unraveled into an intricate web of investigations.

Kristi, with a heavy heart, shared, “When Christopher was born we didn’t know there was going to be anything wrong, and initially the only thing that we knew when he was born was, we were surprised to find out that he was in severe heart failure.”

When Barth syndrome was finally pinpointed as the cause, the diagnosis illuminated the genetic patterns and health challenges other family members had faced, bringing them out of the shadows of mystery.

“When Christopher was diagnosed, it was like stepping into a world we never knew existed,” Kristi explained.

Christopher: The Heart of the Story

Christopher Pena

Christopher (Photo courtesy of Kristi Pena)

Central to this tale is Christopher—a boy embodying resilience in every heartbeat. Barth syndrome might delineate his medical chart, but it’s his dreams, aspirations and tiny victories that define his essence.

Reenie McCarthy, CEO of Stealth BioTherapeutics, describes the genetic basis of Barth syndrome and its association with mitochondrial dysfunction.

“In Barth syndrome, patients carry a genetic defect affecting a protein crucial for the formation of cardiolipin, a building block of the mitochondria,” McCarthy clarified.

Mitochondria, our cells’ powerhouses, generate most of the energy we need. They’re pivotal for organs like the heart, muscles, and eyes. For Christopher, this means that every joyful jump, every excited step, demands more from him than it would from most.

“Every mother has dreams for her child. My dream was simply for a happy, healthy life for Christopher,” Kristi shared. “Every hurdle Christopher faces, he tackles with such spirit. It’s heartbreaking and inspiring at the same time.”

Navigating the Daily Challenges

Christopher’s journey with Barth Syndrome is an emblematic testament to the struggles, the perseverance, and the depths of a family’s love and hope. Now 15, Christopher’s life has been markedly different from that of his peers.

Reflecting on this journey, Kristi poignantly shared, “Since we have been on this journey, Christopher has been in heart failure three times, he has suffered a stroke, he has suffered seizures, he’s been under hospice, he has been through a lot.”

Although his father plays an active role in his life, he tends to keep their challenges private, reflecting the common notion that fathers often internalize their pain. Kristi remarked, “Fathers are often quieter about these matters than mothers. It’s not that they’re unaffected by seeing their sons suffer; they just express it differently.”

While both parents have distinct ways of coping, Kristi emphasized that they both share a heartfelt desire for “quality of life over quantity of life.”

Christopher’s father operates a prominent game recovery service during hunting season. It’s a physically demanding business that Christopher hasn’t been able to participate in due to the physical constraints of his condition.

Christopher Pena

Christopher (Photo courtesy of Kristi Pena)

While they have previously taken a proactive approach, championing Christopher’s condition and being ambassadors for the children’s hospital and children’s miracle network hospitals, the intensity of their journey has had its toll. “I don’t like the spotlight anymore the way we used to… We just got burned out over time with it all,” Kristi admitted. Yet, the urgency of their current challenges pushes her forward. “However, I’m stepping out of my comfort zone because… me being vocal about what’s at stake is required. One of those things you do what you have to for your children, type of things.”

These challenges spill over into Christopher’s social life. “Christopher has never been to school in a school setting. He does have friends outside of school; however, they want to play football, they want to play soccer and Christopher can’t and they don’t understand because he looks okay,” Kristi explained. It’s the unseen challenges, the invisible barriers, that make their journey even harder. “He’s dealt with a lot of cruelty from some of his peers and even from adults that don’t understand,” she added.

The emotional burden of their journey reverberates through Kristi’s words, “It’s emotional, when from the first day that he’s born we have to imagine but at the same time try not to think about this disease claiming his life, because from an infant we were told there was nothing we could do, that he was going to die.”

It’s these little everyday moments, activities taken for granted by many, that highlight the depths of their challenges. “Access to Elamipretide would allow Christopher the chance to participate in so many things he’s excluded from today,” Kristi added, indicating the potential doors it could open for him.

A beacon in the Night: Elamipretide

In the ever-advancing realm of medicine, Elamipretide emerges as a beacon of hope. Elamipretide, developed by Stealth BioTheraputics, as of 2017, obtained an orphan designation in the United States for use in mitochondrial myopathy. This potential therapeutic agent, specifically designed to address the mitochondrial dysfunction seen in Barth syndrome, has kindled hope in numerous hearts.

“When I first heard of Elamipretide, it felt like a beacon in the night,” stated Kristi.

McCarthy spotlighted the potential therapeutic response in the form of Elamipretide, “The way our drug works,” began McCarthy. “…it actually targets cardiolipin in the inner mitochondrial membrane. So in a lot of diseases, you’re going to have damage to cardiolipin. Its mitochondria come into play in a couple of big areas. One is like rare genetic diseases like Barth syndrome. The other is diseases like aging that unfortunately affect us all. So Cardiolipin damage definitely happens with mitochondrial dysfunction. It’s just that in Barth syndrome, that’s actually the genetic defect.”

Navigating the Regulatory Labyrinth: Elamipretide’s Journey

In the multifaceted realm of medical research, Elamipretide emerges as a glimmer of hope for those combatting Barth syndrome. Tracing back to an innovative discovery at Weill Cornell, Elamipretide targets cardiolipin in the inner mitochondrial membrane, a pivotal element for those wrestling with the intricacies of Barth syndrome.

The path from the research lab to patients’ hands is replete with hurdles. McCarthy provides an insider’s perspective on the regulatory challenges faced, particularly in the U.S. She notes, “…in the US, the regulatory framework for the FDA is that Congress has given the FDA regulatory flexibility to look at, again, novel trial designs and novel ways, particularly for rare and ultra-rare diseases. So that leaves it to FDA discretion, and that’s very inconsistently applied.” McCarthy emphasizes the differences across the Atlantic, stating, “Europe, on the other hand, has specific approval pathways that are designed for cases like this. We’ve been talking to the FDA since 2019… We just haven’t gotten any clear guidance on what type of additional data the FDA might accept.”

The FDA’s recent cautionary stance on Elamipretide trials has been met with mostly confusion, as the data seems to show a 40% cardiac improvement with Elamipretide. Yet, despite the pleas from the Barth syndrome community, the use of the drug as a treatment remains at a standstill.

“…there’s no approved therapies for Barth syndrome, and it is a disease where life expectancy is reduced and to my knowledge there are no other therapies in clinical development,” stated McCarthy. “This is the only thing that there is in clinical development. We’ve been talking to the FDA since 2019 about this data. We’ve done the natural history comparison since then.”

McCarthy continued, “We’re pretty stuck. We’ve been moved through four different FDA review divisions. The FDA at one point said they would look at a new drug application and then they changed their mind. And we’re back in that same position again right now. So it’s just been very challenging.”

McCarthy’s insights underline a dynamic and, at times, challenging landscape for innovative treatments. Yet, amidst these challenges, the unwavering resilience of advocacy, the strength of collaborations like that of Stealth and the Barth syndrome Foundation, and the relentless pursuit of solutions for conditions like Barth syndrome stand as testament to the dedication of those involved.

“Basically, the whole population of Barth Syndrome is depending on this treatment, but it all originates here, in the United States,” explained Kristi.

Stand with Christopher: Make Your Voice Heard

The journey of children like Christopher, affected by Barth syndrome, underscores the urgency to bridge the gap between medical advancements and regulatory approvals. Right now, there’s an actionable step you can take to make a difference: sign the petition urging the FDA to review Elamipretide, a potential life-changing treatment.

Join Kristi, Christopher, and countless others who believe in a brighter, healthier future for those with Barth syndrome. Your voice can amplify theirs, drawing attention to the need for prompt action.

Sign the Petition Here

Mississippi’s Heartbeat: The Continuing Tapestry of Hope and Resilience

In the historical tapestry of Rankin County, Mississippi, lies the story of Kristi and Christopher—a narrative that embodies not just a fight against Barth syndrome but also the resilience of a community.

“The support from our community has been our rock,” Kristi passionately conveyed. “Our story is Mississippi’s story. Filled with challenges but also rich in love and hope.”

Their journey, unique in its challenges, represents many families navigating the intricate maze of rare diseases in the United States. “It’s not just our fight. So many families are going through similar battles, seeking answers,” Kristi reflected. This shared narrative signals an urgent plea for the healthcare system to evolve, ensuring that the challenges of rare diseases receive the focus they warrant.

Each day, as the narrative of those touched by Barth syndrome unfolds, it becomes clear that their journey is far from over. Amid regulatory challenges, the alliance between Stealth and the Barth syndrome Foundation strengthens, embodying the essence of community support and collaboration.

McCarthy emphasized, “Our partnership has been nothing short of extraordinary,” reflecting the steadfast dedication of both her organization and the broader community they serve.

And as Christopher faces each day, his experiences—whether it’s the simple joy of a new video game or the stories spun at bedtime—serve as a mirror to the lives of countless children confronting rare diseases. Through these moments, both mundane and momentous, he weaves a tale of hope, and with the undying support from the wider community and their relentless spirit, they light the way for many.

But as Kristi encapsulated, “Our journey is far from over, but every day is a new chance, a new hope.”

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