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Kim S, Whitley CB, Jarnes JR. Chitotriosidase as a biomarker for gangliosidoses. Mol Genet Metab Rep 2021; 29:100803. [PMID: 34646735 PMCID: PMC8498089 DOI: 10.1016/j.ymgmr.2021.100803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 11/02/2022] Open
Abstract
Elevated serum chitotriosidase (CHITO) is an indication of macrophage activation, and its capacity have been explored as a marker of inflammation in a number of disease states. For over a decade, CHITO plasma levels have been used by clinicians as a biomarker of inflammation in the lysosomal disease, Gaucher disease, including monitoring response to therapies in patients with Gaucher disease type I. Although it is becoming increasingly recognized that inflammation is a prominent component of many lysosomal diseases, the relation of CHITO levels to disease burden has not been well-characterized in the large majority of lysosomal diseases. Moreover, the role of CHITO in lysosomal diseases that affect the central nervous system (CNS) has not been systematically studied. In this study, one hundred and thirty-four specimens of CSF and serum were collected from 34 patients with lysosomal diseases affecting the CNS. This study included patients with GM1-gangliosidosis, GM2-gangliosidosis, mucopolysaccharidoses (MPS), multiple sulfatase deficiency and Gaucher disease. CHITO levels in the CSF were significantly higher in patients with more rapidly progressing severe neurological impairment: GM1-gangliosidosis vs MPS (p < 0.0001); GM2-gangliosidosis vs MPS (p < 0.0001). CHITO levels were higher in patients with the more severe phenotypes compared to milder phenotypes in GM1-gangliosidosis and GM2-gangliosidosis (serum CHITO in GM1-gangliosidosis infantile vs juvenile p = 0.025; CSF CHITO in Tay-Sachs infantile vs Tay-Sachs late-onset p < 0.0001). Moreover, higher CHITO levels in the CSF were significantly associated with lower cognitive test scores in patients with GM1-gangliosidosis, GM2-gangliosidosis, and MPS (p = 1.12*10-5, R2 = 0.72). Patients with infantile GM1-gangliosidosis showed increasing CSF CHITO over time, suggesting that CSF CHITO reflects disease progression and a possible surrogate endpoint for future clinical trials with infantile GM1-gangliosidosis. In summary, these results support the use of CSF CHITO to diagnose between different disease phenotypes and as a valuable tool for monitoring disease progression in patients. These results necessitate the inclusion of CHITO as an exploratory biomarker for clinical trials.
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Affiliation(s)
- Sarah Kim
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, 7-115 Weaver-Densford Hall, 308 Harvard St. S.E., Minneapolis, MN 55455, USA.,Gene Therapy and Diagnostics Laboratory, Department of Pediatrics, University of Minnesota, 420 Delaware St SE, MMC 391, Minneapolis, MN 55455, USA
| | - Chester B Whitley
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, 7-115 Weaver-Densford Hall, 308 Harvard St. S.E., Minneapolis, MN 55455, USA.,Gene Therapy and Diagnostics Laboratory, Department of Pediatrics, University of Minnesota, 420 Delaware St SE, MMC 391, Minneapolis, MN 55455, USA.,Advanced Therapies Program, University of Minnesota-Fairview, 420 Delaware St SE, MMC 391, Minneapolis, MN 55455, USA
| | - Jeanine R Jarnes
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, 7-115 Weaver-Densford Hall, 308 Harvard St. S.E., Minneapolis, MN 55455, USA.,Gene Therapy and Diagnostics Laboratory, Department of Pediatrics, University of Minnesota, 420 Delaware St SE, MMC 391, Minneapolis, MN 55455, USA
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Muñoz G, García-Seisdedos D, Ciubotariu C, Piris-Villaespesa M, Gandía M, Martín-Moro F, Gutiérrez-Solana LG, Morado M, López-Jiménez J, Sánchez-Herranz A, Villarrubia J, Del Castillo FJ. Early detection of lysosomal diseases by screening of cases of idiopathic splenomegaly and/or thrombocytopenia with a next-generation sequencing gene panel. JIMD Rep 2019; 51:53-61. [PMID: 32071839 PMCID: PMC7012743 DOI: 10.1002/jmd2.12078] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 09/06/2019] [Accepted: 09/12/2019] [Indexed: 02/02/2023] Open
Abstract
Lysosomal diseases (LD) are a group of about 70 rare hereditary disorders (combined incidence 1:5000) in which diverse lysosomal functions are impaired, impacting multiple organs and systems. The first clinical signs and symptoms are usually unspecific and shared by hundreds of other disorders. Diagnosis of LD traditionally relies on performing specific enzymatic assays, if available, upon clinical suspicion of the disorder. However, the combination of the insidious onset of LD and the lack of awareness on these rare diseases among medical personnel results in undesirable diagnostic delays, with unchecked disease progression, appearance of complications and a worsened prognosis. We tested the usefulness of a next‐generation sequencing‐based gene panel for quick, early detection of LD among cases of idiopathic splenomegaly and/or thrombocytopenia, two of the earliest clinical signs observed in most LD. Our 73‐gene panel interrogated 28 genes for LD, 1 biomarker and 44 genes underlying non‐LD differential diagnoses. Among 38 unrelated patients, we elucidated eight cases (21%), five with LD (GM1 gangliosidosis, Sanfilippo disease A and B, Niemann‐Pick disease B, Gaucher disease) and three with non‐LD conditions. Interestingly, we identified three LD patients harboring pathogenic mutations in two LD genes each, which may result in unusual disease presentations and impact treatment. Turnaround time for panel screening and genetic validation was 1 month. Our results underline the usefulness of resequencing gene panels for quick and cost‐effective screening of LDs and disorders sharing with them early clinical signs.
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Affiliation(s)
- Gloria Muñoz
- UCA de Genómica Traslacional Hospital Universitario Ramón y Cajal, IRYCIS Madrid Spain
| | | | - Crina Ciubotariu
- UCA de Genómica Traslacional Hospital Universitario Ramón y Cajal, IRYCIS Madrid Spain
| | | | - Marta Gandía
- UCA de Genómica Traslacional Hospital Universitario Ramón y Cajal, IRYCIS Madrid Spain
| | - Fernando Martín-Moro
- Servicio de Hematología Hospital Universitario Ramón y Cajal, IRYCIS Madrid Spain
| | - Luis G Gutiérrez-Solana
- Consulta de Neurodegenerativas, Servicio de Neurología Pediátrica Hospital Infantil Universitario Niño Jesús Madrid Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) Madrid Spain
| | - Marta Morado
- Servicio de Hematología Hospital Universitario La Paz Madrid Spain
| | - Javier López-Jiménez
- Servicio de Hematología Hospital Universitario Ramón y Cajal, IRYCIS Madrid Spain
| | | | - Jesús Villarrubia
- UCA de Genómica Traslacional Hospital Universitario Ramón y Cajal, IRYCIS Madrid Spain.,Servicio de Hematología Hospital Universitario Ramón y Cajal, IRYCIS Madrid Spain
| | - Francisco J Del Castillo
- UCA de Genómica Traslacional Hospital Universitario Ramón y Cajal, IRYCIS Madrid Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) Madrid Spain.,Servicio de Genética Hospital Universitario Ramón y Cajal, IRYCIS Madrid Spain
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Degtyareva AV, Proshlyakova TY, Gautier MS, Degtyarev DN, Kamenets EA, Baydakova GV, Rebrikov DV, Zakharova EY. Oxysterol/chitotriosidase based selective screening for Niemann-Pick type C in infantile cholestasis syndrome patients. BMC MEDICAL GENETICS 2019; 20:123. [PMID: 31296176 PMCID: PMC6625024 DOI: 10.1186/s12881-019-0857-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Accepted: 07/02/2019] [Indexed: 01/11/2023]
Abstract
Background Niemann-Pick disease type C (NP-C) is an inherited neurodegenerative disease (1 per 100 000 newborns) caused by NPC proteins impairment that leads to unesterified cholesterol accumulation in late endosomal/lysosomal compartments. To date the NP-C diagnostics is usually based on cholesterol detection in fibroblasts using an invasive and time-consuming Filipin staining and we need more arguments to widely introduce oxysterols as a biomarkers in NP-C. Methods Insofar as NP-C represents about 8% of all infant cholestases, in this prospective observational study we tried to re-assess the specificity plasma oxysterol and chitotriosidase as a biochemical screening markers of NP-C in children with cholestasis syndrome of unknown origin. For 108 patients (aged from 2 weeks to 7 years) the levels of cholestane-3β,5α,6β-triol (C-triol) and chitotriosidase (ChT) were measured. For patients with elevated C-triol and/or ChT the NPC1 and NPC2 genes were Sanger-sequenced and 47 additional genes (from the custom liver damage panel) were NGS-sequenced. Results Increased C-triol level (> 50 ng/ml) was detected in 4 (of 108) infants with cholestasis syndrome of unknown origin, with following molecular genetic NP-C diagnosis for one patient. Plasma cholesterol significantly correlates with C-triol (p < 0.05). NGS of high C-triol infants identified three patients with mutations in JAG1 (Alagille syndrome) and ABCB11 (Byler disease) genes. Increased ChT activity was detected in 8 (of 108) patients with various aetiologies, including NP-C, Byler disease and biliary atresia. Conclusion Combined analysis of ChT activity and C-triol levels is an effective method for identifying NP-C.
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Affiliation(s)
- Anna V Degtyareva
- Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russia.,Sechenov First Moscow State Medical University, Moscow, Russia
| | | | - Marina S Gautier
- Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russia
| | - Dmitry N Degtyarev
- Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russia.,Sechenov First Moscow State Medical University, Moscow, Russia
| | | | | | - Denis V Rebrikov
- Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russia. .,Pirogov Russian National Research Medical University, Moscow, Russia.
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Cebolla JJ, Irún P, Mozas P, Giraldo P. Evaluation of two approaches to lysosomal acid lipase deficiency patient identification: An observational retrospective study. Atherosclerosis 2019; 285:49-54. [PMID: 31004967 DOI: 10.1016/j.atherosclerosis.2019.03.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 03/06/2019] [Accepted: 03/14/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIMS Lysosomal acid lipase deficiency (LALD) leads to the accumulation of cholesteryl esters and/or triglycerides (TG) in lysosomes due to the lack of the enzyme codified by the LIPA gene. The most common symptoms are dyslipidaemia and hypertransaminasemia, together with manifestations common to other lysosomal storage disorders (LSDs), including visceromegalies and elevated plasma biomarkers. Alteration of the lipid-liver profile (LLP) has been widely applied as a criterion for LALD screening, but the usefulness of biomarkers has not yet been explored. Our purpose was to explore the utility of plasma chitotriosidase activity (ChT) and CCL18/PARC concentration in addition to LLP to identify LALD patients in an observational retrospective study of two different sample collections. METHODS Biological samples refining: Collection 1 (primary hypercholesterolemia suspected) included unrelated individuals with hyperlipidaemia and without LDLR, APOB and PCSK9 gene mutations (Set 1), and Collection 2 (LSD suspected) included individuals without definitive LSD diagnosis (Set 2). We assessed plasma LLP (total cholesterol and its fractions, TG concentration and transaminases activities), as well as plasma ChT and CCL18/PARC. All subjects with anomalous LLP and/or biomarker levels were LIPA sequenced. RESULTS Twenty-four subjects showed altered LLP and/or biomarkers. We identified two LALD patients (one homozygous and one compound heterozygous) and one carrier of a novel LIPA variant. CONCLUSIONS The measurement of plasma ChT and CCL18/PARC combined with LLP will be a useful approach to identifying LALD patients in retrospective LALD patient studies.
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Affiliation(s)
- Jorge J Cebolla
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), GIIS-012, Zaragoza, 50009, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), CB/06/07/1036, Instituto de Salud Carlos III (ISCIII), Hospital Universitario Miguel Servet, Zaragoza, 50009, Spain; Fundación Española para el Estudio y Terapéutica de la Enfermedad de Gaucher y Otras Lisosomales (FEETEG), Zaragoza, 50008, Spain; Departamento de Bioquímica, Biología Molecular y Celular, Facultad de Ciencias, Universidad de Zaragoza, Zaragoza, 50009, Spain.
| | - Pilar Irún
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), CB/06/07/1036, Instituto de Salud Carlos III (ISCIII), Hospital Universitario Miguel Servet, Zaragoza, 50009, Spain
| | - Pilar Mozas
- Departamento de Bioquímica, Biología Molecular y Celular, Facultad de Ciencias, Universidad de Zaragoza, Zaragoza, 50009, Spain
| | - Pilar Giraldo
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), GIIS-012, Zaragoza, 50009, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), CB/06/07/1036, Instituto de Salud Carlos III (ISCIII), Hospital Universitario Miguel Servet, Zaragoza, 50009, Spain; Fundación Española para el Estudio y Terapéutica de la Enfermedad de Gaucher y Otras Lisosomales (FEETEG), Zaragoza, 50008, Spain
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Kadali S, Kolusu A, Sunkara S, Gummadi MR, Undamatla J. Clinical evaluation of chitotriosidase enzyme activity in Gaucher and Niemann Pick A/B diseases: A retrospective study from India. Clin Chim Acta 2016; 457:8-11. [DOI: 10.1016/j.cca.2016.03.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 03/09/2016] [Accepted: 03/10/2016] [Indexed: 11/29/2022]
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Kurt I, Sertoglu E, Okur I, Tapan S, Uyanık M, Kayadıbı H, Ezgu FS, Aydın HI, Hasanoglu A. Serum dipeptidyl peptidase-IV: a better screening test for early detection of mucopolysaccharidosis? Clin Chim Acta 2014; 431:250-4. [PMID: 24582858 DOI: 10.1016/j.cca.2014.02.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2013] [Revised: 02/15/2014] [Accepted: 02/17/2014] [Indexed: 02/07/2023]
Abstract
We aimed to investigate the diagnostic utility of serum DPP-IV enzyme activity, urinary GAG/Cre ratio, chitotriosidase activity, total adenosine deaminase (ADA) and ADA-1 isoenzyme activity in the diagnosis of MPS. 31 MPS patients which were previously diagnosed by clinical and enzymatic analysis and 31 healthy controls matched with age and gender were included in this study. Serum DPP-IV enzyme activity, urinary GAG/Cre ratio, total ADA and ADA-1 isoenzyme activity were significantly higher in patients than in controls (p<0.001, p<0.001, p=0.038 and p=0.006, respectively). There were significant correlations between serum DPP-IV enzyme activity and urinary GAG/Cre ratios, ADA-1 activity, ADA-1/total ADA (r=0.498, p<0.001; r=0.348, p=0.006; r=0.270, p=0.034, respectively). Area under ROC curve for DPP-IV enzyme activity was 0.988, p<0.001 and for urinary GAG/Cre ratio was 0.986, p<0.001. DPP-IV enzyme activity and urinary GAG/Cre ratio were the most significant parameters according to the univariate logistic regression analysis (p=0.001 and p<0.001, respectively). The measurement of serum DPP-IV enzyme activity can be used complementary to the urinary GAG/Cre ratio for first-line MPS screening, since it is more less prone to age and hydration related interferences.
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Affiliation(s)
- Ismail Kurt
- Gülhane School of Medicine, Department of Medical Biochemistry, Ankara, Turkey
| | - Erdim Sertoglu
- Ankara Mevki Military Hospital, Anittepe Dispensary, Biochemistry Laboratory, Ankara, Turkey.
| | - Ilyas Okur
- Gazi University Faculty of Medicine, Department of Pediatric Metabolism and Nutrition, Ankara, Turkey
| | - Serkan Tapan
- Gülhane School of Medicine, Department of Medical Biochemistry, Ankara, Turkey
| | - Metin Uyanık
- Gülhane School of Medicine, Department of Medical Biochemistry, Ankara, Turkey
| | - Huseyin Kayadıbı
- Adana Military Hospital, Department of Medical Biochemistry, Adana, Turkey
| | - Fatih Suheyl Ezgu
- Gazi University Faculty of Medicine, Department of Pediatric Metabolism and Nutrition, Ankara, Turkey
| | | | - Alev Hasanoglu
- Gazi University Faculty of Medicine, Department of Pediatric Metabolism and Nutrition, Ankara, Turkey
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Elmonem MA, Ramadan DI, Issac MS, Selim LA, Elkateb SM. Blood spot versus plasma chitotriosidase: A systematic clinical comparison. Clin Biochem 2014; 47:38-43. [DOI: 10.1016/j.clinbiochem.2013.10.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2013] [Revised: 09/18/2013] [Accepted: 10/20/2013] [Indexed: 11/25/2022]
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Ramanathan R, Kohli A, Ingaramo MC, Jain A, Leng SX, Punjabi NM, Walston JD, Fedarko NS. Serum chitotriosidase, a putative marker of chronically activated macrophages, increases with normal aging. J Gerontol A Biol Sci Med Sci 2013; 68:1303-9. [PMID: 23525479 DOI: 10.1093/gerona/glt022] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Chitotriosidase (ChT) is secreted by chronically activated macrophages in Gaucher's disease. We hypothesize that circulating levels of ChT are altered with normal aging, reflecting age-related chronic macrophage activation. Potential sources that might contribute to altered levels were assessed by measuring systemic levels of ChT are α-naphthyl acetate esterase, a macrophage lysosomal enzyme; granulocyte-macrophage colony-stimulating factor (GM-CSF), which stimulates neutrophilic granule release of ChT; interleukin-6 (IL-6); and neopterin, a macrophage activation marker. METHODS Serum was obtained from 315 healthy participants whose age ranged from 18 to 92 years. Anthropometric measures included percent body fat and body mass index. ChT and α-naphthyl acetate esterase levels were measured by enzyme activity assays. GM-CSF, IL-6, and neopterin concentrations were measured by commercial enzyme-linked immunosorbent assays. Serum marker values were statistically analyzed using nonparametric tests. RESULTS Six percent of the participants had undetectable ChT levels. A positive association with age was observed for ChT and IL-6, whereas a negative correlation with age was seen for α-naphthyl acetate esterase and GM-CSF. ChT values were not associated with α-naphthyl acetate esterase or GM-CSF levels. ChT was independently associated with IL-6 and neopterin levels, but statistical significance was attenuated when controlled for age. CONCLUSIONS The data are consistent with increased serum ChT activity not arising from altered macrophage lysosomal enzyme trafficking or GM-CSF-stimulated release of neutrophil granule stores. The association of ChT with age remains significant after controlling for neopterin and IL-6 changes with age, suggesting that ChT levels reflect a macrophage state distinct from acute macrophage activation or inflammatory state.
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Affiliation(s)
- Rohit Ramanathan
- Room 1A12 JHAAC, 5501 Hopkins Byview Circle, Baltimore, MD 21224.
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Serum chitotriosidase activity and Wegener's granulomatosis. Clin Biochem 2009; 43:512-4. [PMID: 19958755 DOI: 10.1016/j.clinbiochem.2009.11.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2009] [Revised: 11/12/2009] [Accepted: 11/22/2009] [Indexed: 11/23/2022]
Abstract
OBJECTIVE We evaluated serum chitotriosidase activity in patients with Wegener's granulomatosis (WG) and compared the values to controls. DESIGN AND METHODS We used a standard fluorometric assay to measure chitotriosidase enzyme activity. RESULTS Serum chitotriosidase enzyme activity levels were higher in WG patients. We found no association between clinical disease activity and chitotriosidase enzyme activity. CONCLUSIONS Serum chitotriosidase enzyme activity has limited utility as a biomarker in WG patients.
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Xaidara A, Karavitakis EM, Kosma K, Emma F, Dimitriou E, Michelakakis H. Chitotriosidase plasma activity in nephropathic cystinosis. J Inherit Metab Dis 2009; 32 Suppl 1:S157-9. [PMID: 19455402 DOI: 10.1007/s10545-009-1118-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2008] [Revised: 03/27/2009] [Accepted: 04/06/2009] [Indexed: 11/29/2022]
Abstract
Chitotriosidase is a fully active chitinase produced and secreted by activated phagocytes. Plasma chitotriosidase activity is a well-established marker of total disease burden in Gaucher disease that has proved useful in monitoring the response to both enzyme replacement and substrate reduction therapies in patients with Gaucher disease. Increased chitotriosidase plasma activity has also been observed in several other lysosomal and non lysosomal disorders. Cystinosis, a rare multisystemic lysosomal storage disease, is characterized by the intralysosomal accumulation of free cystine in many cell types including phagocytes. We here report on plasma chitotriosidase activity in a child with nephropathic cystinosis. Increased plasma chitotriosidase activity (481 nmol/h per ml; normal range 0-150 units) was found on diagnosis and prior to the initiation of oral cysteamine (Cystagon) treatment. Serial estimations of plasma chitotriosidase activity showed that it correlated with leukocyte cystine content and decreased to 100 nmol/h per ml following 14 months' treatment. This novel observation suggests that cystinosis should be included in the differential diagnosis of disorders associated with increased plasma chitotriosidase activity. Furthermore, it suggests that serial estimations of plasma chitotriosidase activity could be of value in monitoring the response to oral cysteamine treatment in cystinosis.
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Affiliation(s)
- A Xaidara
- First Department Pediatrics, Athens University, Athens, Greece
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Caciotti A, Di Rocco M, Filocamo M, Grossi S, Traverso F, d'Azzo A, Cavicchi C, Messeri A, Guerrini R, Zammarchi E, Donati MA, Morrone A. Type II sialidosis: review of the clinical spectrum and identification of a new splicing defect with chitotriosidase assessment in two patients. J Neurol 2009; 256:1911-5. [PMID: 19568825 DOI: 10.1007/s00415-009-5213-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2009] [Accepted: 06/08/2009] [Indexed: 11/30/2022]
Abstract
Sialidosis is a lysosomal storage disease caused by the deficiency of alpha-N-acetyl neuraminidase-1 (NEU1). Sialidosis is classified into two main clinical variants: Type I, the milder form of the disease, and Type II, which can in turn be subdivided into three forms: congenital, infantile and juvenile. We report herein the clinical, biochemical and molecular characterisation of two patients with Type II sialidosis exhibiting the congenital (P1) and infantile forms (P2). We also review clinical data on the rare Type II forms of sialidosis in the hope of improving understanding of the disorder and facilitating its diagnosis. The genetic characterization of the two patients showed one known [c. 679G > A (p.G227R)] NEU1 missense mutation (detected in P2), and the new c.807 + 1G > A splicing defect (detected in P1), a genetic lesion that is extremely rare in this disease. Interestingly, P2 presented an extremely elevated level of chitotriosidase in plasma. This is the first pathological detection of chitotriosidase in sialidosis patients.
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