We first started researching XLHED in the late 1980s. Since that time, we have led an ongoing effort to find a potential treatment. We are excited to have one going to clinical trial. In preliminary studies, three babies who received the therapy before birth developed normal sweat glands and an increased number of teeth. They had other positive outcomes as well. The clinical trial aims to confirm these findings. If approved, the treatment would go to market!


The gene that causes x-linked hypohidrotic ectodermal dysplasia (XLHED), EDA, was discovered in 1996 by an international team of researchers. In the early 2000s, a synthetic protein called ER-004 (formerly called EDI200 and APO200), was developed to replace the nonfunctioning protein in the EDA gene. Researchers administered the protein to mice and dogs with XLHED and had promising results. Since that time, there have been a series of human studies indicating the treatment is safe.

EspeRare and Pierre Fabre Launch Clinical Trial

EspeRare and Pierre Fabre are developing the in utero protein replacement therapy for XLHED. They began a clinical trial called EDELIFE in November of 2021. The study’s goal is to confirm the findings of Dr. Holm Schneider’s Trial to Cure (which you can read about below). If this treatment is found to be successful and it is approved, it could be the first treatment of its kind to correct a genetic condition before birth.

Learn About EDELIFE Clinical Trial

EspeRare announced on July 6, 2020 that the FDA had granted ER-004 Breakthrough Therapy Designation which will expedite the process

Read About FDA Designation

EspeRare and the Pierre Fabre group announced on December 14, 2020 that they entered an agreement to develop ER-004 as a treatment for XLHED and commercialize it.

Read Partnership Announcement

Testing a Non-Invasive Way to Diagnose XLHED in Utero

Prof. Angus Clarke at Cardiff University and his research team are investigating a way to diagnose XLHED in a baby prenatally in a way that is less invasive to the mother than current methods. If successful, this method will help facilitate EspeRare’s upcoming clinical trial. Mothers will be able to simply give a blood sample to learn if their baby is affected by XLHED. The NFED has awarded $25,000 to help underwrite this important research.

Learn more about the Prof. Clarke’s study

Past Studies

Beth, Steve and Liam participated in the Newborn XLHED Clinical Trial
Beth, Steve and Liam participated in the Newborn XLHED Clinical Trial

Newborn XLHED Clinical Trial 

In the Newborn XLHED Clinical Trial, 2013-2016, Edimer Pharmaceuticals evaluated whether the recombinant protein, then called EDI200, had any impact on the symptoms of children affected by XLHED, including the early development of teeth, sweat glands, hair follicles and more. Ten babies participated.

Unfortunately, the clinical trial did not achieve its expected outcomes. There were some modest signs of improvement in the development and function of various body parts that XLHED affects. However, they didn’t see significant changes in sweat gland function and other early markers of biologic activity. That trial closed and Edimer shut its doors.

These twins participated in the Trial to a Cure.

Trial to Cure

Dr. Holm Schneider from Erlangen, Germany was one of the initial primary investigators in the Newborn XLHED Clinical Trial. He and other investigators believe that dosing after birth is too late to impact the development of sweat glands and other key markers. They believe the dosing needs to occur by injecting the recombinant protein into the mother’s amniotic fluid, prior to birth.

In 2016, Dr. Schneider engaged in a “Trial to Cure” which is a legal possibility under the German law to dose. He administered the recombinant protein to three babies in utero who were affected by XLHED. He and his team of German researchers published their amazing findings in the New England Journal of Medicine in April of 2018.


XLHED Natural History Study

Dr. Holm Schneider completed the first part of the Natural History Study launched by Edimer Pharmaceuticals in 2014. Twenty-five children were examined up to age five. They can now compare this data of how XLHED develops naturally with the data from babies treated with the recombinant protein in the prenatal trial to determine if it works. We are proud to have helped fund this project.


Learn more about the history of XLHED research that the NFED has initiated and families have advanced. Also, Dr. Magi Casal continues to research treating the respiratory issues in dogs with XLHED.

Shape Our Futures With Research

Ectodermal dysplasia can cause a lifetime of challenges. By supporting research, you expand early diagnostics, treatments, pathways toward cures… and hope!

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Research Articles

Following are links to XLHED research articles.