Characterizing Friedreich’s ataxia cardiomyopathy with serial cardiac magnetic resonance imagings

Cripe, L. H., Alvarado, C., Hayes, E. A., Krishnamurthy, R., Gunsaulus, M. E., Waldrop, M. A., & Nandi, D. (2026). Characterizing Friedreich’s ataxia cardiomyopathy with serial cardiac magnetic resonance imagings. Annals of Pediatric Cardiology, 19(4), 364–373. doi:10.4103/apc.apc_22_26 

In this exploratory study, CMR demonstrated patterns of septal hypertrophy, lateral wall fibrosis, and trends toward declining ventricular function. Findings were largely nonsignificant and should be considered hypothesis-generating. Larger, multicenter studies are needed to clarify the role of CMR in disease progression and clinical management.

Effects of Friedeich Ataxia on the Interrelations Between Left Ventricular Length and Long-Axis Systolic and Diastolic Excursions

R. Peverill, Effects of Friedeich Ataxia on the Interrelations Between Left Ventricular Length and Long-Axis Systolic and Diastolic Excursions, Heart, Lung and Circulation, Volume 35, Supplement 3, 2026, Page S142, doi:10.1016/j.hlc.2026.07.126. 

 Features of long-axis dysfunction in FRDA include: (i) a smaller contraction amplitude, which is partly attributable to a smaller LVEDL, and therefore has both structural and functional elements, (ii) smaller early diastolic excursion which is fully accounted for by smaller long-axis contraction, and (iii) lack of any compensatory increase in LA contraction, which is consistent with the presence of a concomitant LA myopathy.

Cardiomyocyte Dysfunction is Modulated by PCDHGA10 in Friedreich Ataxia,

J. Lees, H. Zhang, L. Jiao, A. Kong, R. Phang, L. Li, N. Su, A. Mukhtar, S. Bass-Stringer, A. Pébay, M. Dottori, L. Corben, M. Delatycki, R. Peverill, S. Wilcox, J. Choi, J. Pullin, D. McCarthy, J. Napierala, M. Napierala, S. Lim, Cardiomyocyte Dysfunction is Modulated by PCDHGA10 in Friedreich Ataxia, Heart, Lung and Circulation, Volume 35, Supplement 3, 2026, Pages S709-S710, doi:10.1016/j.hlc.2026.07.1148. 

Our human iPSC model captures early, clinically relevant features of FRDA cardiomyopathy and identifies PCDHGA10 as a disease-associated target within the γ-protocadherin family of calcium-dependent adhesion molecules. siRNA-mediated PCDHGA10 knockdown rescued cell survival, diastolic dysfunction, and mitochondrial ROS levels, implicating Ca2+-coupled and redox-linked phenotypes in cardiomyocyte dysfunction. These findings support further mechanistic study and therapeutic exploration of PCDHGA10

Design Therapeutics Provides RESTORE-FA Clinical Development Update and Reports Second Quarter 2026 Financial Results

CARLSBAD, Calif., Aug. 03, 2026 (GLOBE NEWSWIRE) -- Design Therapeutics, Inc..Positive 

RESTORE-FA Four-Week Data Support Advancement of DT-216P2. As reported in May 2026, DT-216P2 was generally well-tolerated and demonstrated dose-dependent increases in endogenous frataxin mRNA and protein levels, together with improvements across multiple clinical measures following four weeks of intravenous dosing in patients with Friedreich ataxia. 

Modifications to RESTORE-FA. Based on the four-week data, Design is modifying the ongoing cohorts in the RESTORE-FA trial to support the next stage of clinical development. The study will continue to evaluate 1 mpk as the planned go-forward dose, with the intention of enrolling 10 patients in the 12-week cohort. In addition, modifications include specifying endogenous blood FXN protein percent change from baseline as the primary efficacy endpoint and exploring a dose level above 1 mpk. 

Next Steps and Expected Milestones: Design expects to provide an update on its registrational plans in the fourth quarter of 2026, with data following 12 weeks of treatment expected in the first quarter of 2027.

Towards routine genetic testing of repeat expansions in neurogenetic diseases using multiplex CRISPR-Cas9-targeted long read sequencing

Fergelot, P., Boury, C., Penaud, B. et al. Towards routine genetic testing of repeat expansions in neurogenetic diseases using multiplex CRISPR-Cas9-targeted long read sequencing. Sci Rep (2026). doi:10.1038/s41598-026-64095-6 

 We simultaneously targeted nine loci involved in 10 repeat expansion disorders in a single capture panel, including FMR1, HTT, DMPK, CNBP/ZNF9, ATXN2, JPH3, FXN, C9ORF72 and RFC1, covering a broad range of repeat types, sizes and diagnostic needs. Results were compared with standard routine testing methods.

Clinical Challenges in Managing Diabetes Mellitus in Friedreich’s Ataxia

Aarya Naik, MBBS, Hooman Oktaei, MD, Clinical Challenges in Managing Diabetes Mellitus in Friedreich’s Ataxia, Endocrine Practice , 32, S66-S67. doi:10.1016/j.eprac.2026.01.168 

Friedreich’s ataxia (FRDA) is a multisystem disease, with ataxia being the most overt clinical feature. It can be complicated by diabetes mellitus. FRDA-related diabetes has been reported in 5% to 40% of children and adults. Despite the clinical relevance of FRDA-related diabetes mellitus, no evidence-based clinical practice guidelines for screening or management have been set.

CRISPR-Cas9-based therapies for Huntington's disease and Friedreich's ataxia: mechanisms, advances, and future perspectives

Mundada AR, Badikol AR, Mangu K. CRISPR-Cas9-based therapies for Huntington's disease and Friedreich's ataxia: mechanisms, advances, and future perspectives. Neurogenetics. 2026 Jul 13;27(1):49. doi: 10.1007/s10048-026-00921-3. PMID: 42439976. 

 This review examines current CRISPR therapeutic strategies for HD and FRDA, including allele-specific editing, transcriptional suppression, repeat excision, epigenetic reactivation, and emerging precision editing approaches such as base editing and prime editing. We compare the molecular rationale, preclinical outcomes, and translational limitations associated with each approach while highlighting how disease architecture influences therapeutic design. Although preclinical studies demonstrate promising restoration of cellular phenotypes and functional improvement, significant barriers remain. Efficient delivery to the central nervous system and cardiac tissue, control of editing duration, immune responses, off-target activity, and emerging concerns regarding on-target genomic instability continue to limit clinical translation. Recent advances in delivery engineering, non-viral systems, and programmable editing platforms suggest that future therapeutic success will depend on integrating disease-specific biology with increasingly precise and controllable genome engineering technologies. Ethical and regulatory concerns remain substantial, particularly regarding informed consent in the context of cognitive decline and the irreversibility of genomic modification.

Microglia from Friedreich Ataxia patients are intrinsically primed for neuroinflammation

La microglía de Friedreich Ataxia de los pacientes está intrínsecamente preparada para la neuroinflamación Ye Man Tang, Rita Lo, Louise Thiry, Michael Fiorini, Sali Farhan, Massimo Pandolfo, Stefano Stifani bioRxiv 2026.07.16.738960; doi:10.64898/2026.07.16.738960

Aquí, mostramos que la microglía generada a partir de iPSC derivadas de pacientes FRDA exhibe un fenotipo proinflamatorio autónomo de células en ausencia de estímulos inflamatorios exógenos. Este fenotipo se caracteriza por la activación coordinada de programas transcripcionales inmunes, la secreción desregulada de proteínas neuroinflamatorias, la función autofagia-lisosomal deteriorada y la activación de las vías de los inflamasomas que involucran NLRP2 y NLRP3. Estos hallazgos demuestran que la deficiencia de FXN es suficiente para inducir la activación microglial intrínseca e identificar vías moleculares que pueden representar objetivos atractivos para futuras terapias con FRDA.

Unlocking Sulforaphane's Potential in Friedreich Ataxia: Further Evidence from Preclinical Investigations Using Induced Pluripotent Stem Cell-Derived Sensory Neurons

Yang W, Thompson B, Miellet S, Maddock M, Napierala M, Dottori M, Kwa FAA. Unlocking Sulforaphane's Potential in Friedreich Ataxia: Further Evidence from Preclinical Investigations Using Induced Pluripotent Stem Cell-Derived Sensory Neurons. Antioxid Redox Signal. 2026 Jul 20:15230864261470377. doi: 10.1177/15230864261470377. Epub ahead of print. PMID: 42473835.

In FA1, SF treatment improved cell viability and reduced oxidative stress and inflammation. In FA3, SF increased cell viability, FXN protein levels, and gene and protein expression of redox markers, while targeting dysregulated epigenetic mechanisms and inflammation. All three lines showed SF's consistent anti-oxidant and anti-inflammatory effects. Responses to Omav and DMF varied across the FA lines with less pronounced effects than when treated with SF. Overall, SF was more effective than Omav and DMF in improving cell viability and regulating FXN expression and epigenetic, redox, and inflammatory pathways.

Cellares and Papillon Therapeutics Partner to Automate Manufacturing of PPL-001 for Patients With Friedreich’s Ataxia

SOUTH SAN FRANCISCO, Calif. & SAN DIEGO, Jul 21, 2026. Cellares, the first Integrated Development and Manufacturing Organization (IDMO), and Papillon Therapeutics Inc., a clinical-stage biotechnology company advancing a pipeline of multi-systemic genetic medicines directed at the underlying causes of inherited disease, today announced a collaboration to automate manufacturing of PPL-001, Papillon’s investigational gene-corrected hematopoietic stem and progenitor cell (HSPC) therapy targeting Friedreich’s ataxia.