INSTRUCTION: Read the following text to answer the questions.

In the mid‑1980s, a family with a mysterious problem lived in a small town in Italy. For many years, members of this family had trouble sleeping, but no one knew why. One day, a family member named Silvano decided to find out what was causing this strange problem. Silvano traveled to the city of Bologna to meet with the best sleep doctors. He told them all about his family’s mystery.

The doctors were intrigued by Silvano’s story and immediately began to study his case. After much research, the doctors discovered something never seen before: a tiny change in a special gene passed down from generation to generation in Silvano’s family, which stopped them from sleeping. They called this disease fatal familial insomnia (FFI).

Fatal familial insomnia is an extremely rare disease. Like many other rare diseases, FFI is passed on through the DNA from parents to their children. The symptoms of FFI start slowly and get worse over time. People with FFI start to have difficulty falling and / or staying asleep, and then, as it gets worse, they may suddenly fall asleep without warning. People with FFI also tend to develop other problems like a fast heartbeat; high blood pressure; hormonal, mood and behavior swings; anxiety; excessive sweating; and trouble thinking clearly and moving their bodies. The symptoms usually start between the ages of 51 and 60, although rarely they can start as early as 18 – 20 years old. FFI affects both men and women equally. To date, more than 70 families around the world have been found to have FFI.

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Although there is still no cure for FFI, research is happening all over the world. Researchers are working to find new pieces to help them solve the complex puzzle of FFI and to develop treatments that can improve the lives of those affected. Ongoing research aims to understand the underlying mechanisms of FFI, especially how genetic mutations change healthy prion proteins into abnormal ones and how the buildup of abnormal prions in the brain causes FFI symptoms. This understanding is essential for developing effective therapies.

Additionally, researchers are searching for biomarkers of FFI. Biomarkers are things that can be measured through blood tests or brain scans, for example, that indicate the presence of a disease or the risk of developing it. Biomarkers could help doctors to diagnose FFI earlier and to track how it changes over time.

In terms of developing therapies for FFI, gene therapy is a promising approach that aims to fix or replace defective genes. Gene therapy could eventually improve patients’ quality of life. Researchers are also studying drugs that might stop or slow down the buildup of PrPSc in the brain. New drugs are first tested on animals to see if they work and are safe, and drugs that pass these initial tests are then tested on people. With effective new medicines, it might be possible to slow down or even stop FFI.