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Sato Y, Okuyama T. Novel Enzyme Replacement Therapies for Neuropathic Mucopolysaccharidoses. Int J Mol Sci 2020; 21:ijms21020400. [PMID: 31936354 PMCID: PMC7014430 DOI: 10.3390/ijms21020400] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 12/26/2019] [Accepted: 01/07/2020] [Indexed: 12/14/2022] Open
Abstract
Although the advent of enzyme replacement therapy (ERT) for mucopolysaccharidoses (MPS) has paved the way for the treatment for these hereditary disorders, the blood brain barrier (BBB) has prevented patients with MPS involving the central nervous system (CNS) from benefitting from ERT. Therefore, finding ways to increase drug delivery into the brain across the BBB remains a crucial challenge for researchers and clinicians in the field. Attempts have been made to boost brain uptake of enzymes by targeting various receptors (e.g., insulin and transferrin), and several other administration routes have also been tested. This review summarizes the available information on clinical trials (completed, ongoing, and planned) of novel therapeutic agents with efficacy against CNS symptoms in neuropathic MPS and also discusses the common associated challenges and pitfalls, some of which may help elucidate the pathogenesis of the neurodegeneration leading to the manifold CNS symptoms. A summary of current knowledge pertaining to the neuropathological progression and resultant neuropsychiatric manifestations is also provided, because it should be useful to ERT researchers looking for better approaches to treating CNS lesions in MPS.
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Affiliation(s)
- Yuji Sato
- Research and Development, JCR Pharmaceuticals, Hyogo 659-0021, Japan
- Correspondence:
| | - Torayuki Okuyama
- Centre for Lysosomal Storage Diseases, National Centre for Child Health and Development, Tokyo 157-8535, Japan;
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Martins C, Hůlková H, Dridi L, Dormoy-Raclet V, Grigoryeva L, Choi Y, Langford-Smith A, Wilkinson FL, Ohmi K, DiCristo G, Hamel E, Ausseil J, Cheillan D, Moreau A, Svobodová E, Hájková Z, Tesařová M, Hansíková H, Bigger BW, Hrebícek M, Pshezhetsky AV. Neuroinflammation, mitochondrial defects and neurodegeneration in mucopolysaccharidosis III type C mouse model. ACTA ACUST UNITED AC 2015; 138:336-55. [PMID: 25567323 DOI: 10.1093/brain/awu355] [Citation(s) in RCA: 100] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Severe progressive neurological paediatric disease mucopolysaccharidosis III type C is caused by mutations in the HGSNAT gene leading to deficiency of acetyl-CoA: α-glucosaminide N-acetyltransferase involved in the lysosomal catabolism of heparan sulphate. To understand the pathophysiology of the disease we generated a mouse model of mucopolysaccharidosis III type C by germline inactivation of the Hgsnat gene. At 6-8 months mice showed hyperactivity, and reduced anxiety. Cognitive memory decline was detected at 10 months and at 12-13 months mice showed signs of unbalanced hesitant walk and urinary retention. Lysosomal accumulation of heparan sulphate was observed in hepatocytes, splenic sinus endothelium, cerebral microglia, liver Kupffer cells, fibroblasts and pericytes. Starting from 5 months, brain neurons showed enlarged, structurally abnormal mitochondria, impaired mitochondrial energy metabolism, and storage of densely packed autofluorescent material, gangliosides, lysozyme, phosphorylated tau, and amyloid-β. Taken together, our data demonstrate for the first time that deficiency of acetyl-CoA: α-glucosaminide N-acetyltransferase causes lysosomal accumulation of heparan sulphate in microglial cells followed by their activation and cytokine release. They also show mitochondrial dysfunction in the neurons and neuronal loss explaining why mucopolysaccharidosis III type C manifests primarily as a neurodegenerative disease.
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Affiliation(s)
- Carla Martins
- 1 CHU Ste-Justine, University of Montreal, Montreal, QC, Canada
| | - Helena Hůlková
- 2 Institute of Inherited Metabolic Disorders, First Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - Larbi Dridi
- 1 CHU Ste-Justine, University of Montreal, Montreal, QC, Canada
| | | | | | - Yoo Choi
- 1 CHU Ste-Justine, University of Montreal, Montreal, QC, Canada
| | | | - Fiona L Wilkinson
- 3 Stem Cell and Neurotherapies, University of Manchester, Manchester, UK
| | - Kazuhiro Ohmi
- 4 Department of Biological Chemistry, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | | | - Edith Hamel
- 5 Montreal Neurological Institute, McGill University, Montréal, QC, Canada
| | - Jerôme Ausseil
- 6 CHU Amiens, and Unité INSERM U1088, UFR de Médecine, Université de Picardie-Jules Verne, Amiens, France
| | - David Cheillan
- 7 Service des Maladies Héréditaires du Métabolisme et Dépistage Néonatal - Centre de Biologie Est, Hospices Civils de Lyon, Bron, France
| | - Alain Moreau
- 1 CHU Ste-Justine, University of Montreal, Montreal, QC, Canada
| | - Eva Svobodová
- 2 Institute of Inherited Metabolic Disorders, First Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - Zuzana Hájková
- 8 Department of Paediatrics, First Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - Markéta Tesařová
- 8 Department of Paediatrics, First Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - Hana Hansíková
- 8 Department of Paediatrics, First Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - Brian W Bigger
- 3 Stem Cell and Neurotherapies, University of Manchester, Manchester, UK
| | - Martin Hrebícek
- 2 Institute of Inherited Metabolic Disorders, First Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic
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Meijer OLM, van Vlies N, Wijburg FA. Treatment of mucopolysaccharidosis type III (Sanfilippo syndrome). Expert Opin Orphan Drugs 2013. [DOI: 10.1517/21678707.2013.830069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Olga LM Meijer
- University of Amsterdam, Academic Medical Centre, Department of Pediatrics and Amsterdam Lysosome Centre ‘Sphinx', Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands ;
| | - Naomi van Vlies
- University of Amsterdam, Academic Medical Centre, Department of Pediatrics and Amsterdam Lysosome Centre ‘Sphinx', Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands ;
- University of Amsterdam, Academic Medical Centre, Department of Clinical Chemistry and Pediatrics, Lab Genetic Metabolic Diseases, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Frits A Wijburg
- University of Amsterdam, Academic Medical Centre, Department of Pediatrics and Amsterdam Lysosome Centre ‘Sphinx', Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands ;
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