History of AxD

1898

1898

German pathologist Werner Rosenthal first describes Rosenthal fibers.
1898
1949

1949

In September of 1949, researcher W. Stewart Alexander reports his findings on the brain of a 15-month-old boy who passed away two years prior at London Hospital in the United Kingdom. Alexander noted specific irregularities within astrocytes, mainly within the white matter and blood vessels of the brain and spinal cord. These irregularities were determined to be Rosenthal fibers.
1949
1952-1962

1952-1962

Reports of similar neurological symptoms and deposits in the cellular bodies of astrocytes within white matter are found throughout medical literature over the course of a decade.

1952-1962
1964

1964

A sixth case is reported by Reinhard Friede, which is determined to be the same condition as those previously recorded. This condition is named after W. Stewart Alexander and is now known as Alexander disease.

1964
1968

1968

A 32-year-old patient is reported to have partial paralysis in one arm, followed by years of deterioration. This is the first reported case of adult-onset Alexander disease.

1968
1976

1976

A classification is proposed that separates the disease into three types based on age of onset. This system is still commonly used today, although updates have been made since its creation.

1976
1989

1989

Messing and Brenner work together to research GFAP in mice. GFAP is identified as a positive gene for Alexander disease.

1989
1998

1998

The first mouse model of Alexander disease is established.

1998
2000

2000

A neonatal form of Alexander disease is introduced, classified as onset within the first month, and noted to be rapidly progressive.

2000
2001

2001

Mutations in the GFAP gene are identified, making Alexander disease the first genetic disorder of primary astrocytes to be identified.

Potential diagnostic criteria through MRI imaging are created after a notable study of patients officially diagnosed through autopsies.

2001
2001-2005

2001-2005

There is a boom in genetic research, with numerous variants being discovered and published.

2001-2005
2005

2005

Research shows that changes within GFAP account for all forms of the disease in over 90% of patients.

2005
2008

2008

The first meeting dedicated to Alexander disease is held in DeKalb, Illinois, 59 years after the first case was reported in 1949.

2008
2011

2011

New studies propose alternative classification systems based on statistical analysis, leaning away from typing by age of onset. These systems consist of a range in the number of classifications, with some having only two types and others having up to nine.

The first fly model of Alexander disease isbestablished.

2011
2016

2016

Induced pluripotent stem cell (iPSC) models are introduced to determine disease phenotypes of astrocytes in Alexander disease.

2016
2018

2018

A demonstration of antisense suppression GFAP as a potential treatment for Alexander disease is run using rodent models.

Ten years following the first Alexander disease conference, a second meeting is held in Madison, Wisconsin.

2018
2021

2021

The first rat model of Alexander disease is established.

Ionis Pharmecuticals, Inc. launches the first human clinical trial for Alexander disease.

2021
2024

2024

An AxD Summit is held in Philadelphia, Pennsylvania, hosted by Elise’s Corner at the Children’s Hospital of Philadelphia.

2024

Rosenthal Fibers:

Protein aggregates that are sometimes found in lesions of the central nervous system. These structures are a hallmark of Alexander disease.

Astrocytes:

Specialized cells that make up the majority of cells in the central nervous system.

GFAP:

Glial fibrillary acidic protein.