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Vernet Machado Bressan Wilke M, Iop GD, Faqueti L, Lemos da Silva LA, Kubaski F, Poswar FO, Michelin-Tirelli K, Randon D, Borelli WV, Giugliani R, Schwartz IVD. A Brazilian Rare-Disease Center's Experience with Glucosylsphingosine (lyso-Gb1) in Patients with Gaucher Disease: Exploring a Novel Correlation with IgG Levels in Plasma and a Biomarker Measurement in CSF. Int J Mol Sci 2024; 25:2870. [PMID: 38474117 PMCID: PMC10931658 DOI: 10.3390/ijms25052870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 02/21/2024] [Accepted: 02/23/2024] [Indexed: 03/14/2024] Open
Abstract
Gaucher disease (GD, OMIM 230800) is one of the most common lysosomal disorders, being caused by the deficient activity of the enzyme acid β-glucocerebrosidase (Gcase). Three clinical forms of Gaucher's disease (GD) are classified based on neurological involvement. Type 1 (GD1) is non-neuronopathic, while types 2 (GD2) and 3 (GD3) are neuronopathic forms. Gcase catalyzes the conversion of glucosylceramide (GlcCer) into ceramide and glucose. As GlcCer accumulates in lysosomal macrophages, it undergoes deacylation to become glycosylsphingosine (lyso-Gb1), which has shown to be a useful and reliable biomarker for the diagnosis and monitoring of treated and untreated patients with GD. Multiple myeloma (MM) is one of the leading causes of cancer-related death among patients with GD and monoclonal gammopathy of undetermined significance (MGUS) is a non-neoplastic condition that can be a telltale sign of a B clonal proliferation caused by the chronic activation of B cells. This study aimed to quantify Lyso-Gb1 levels in dried blood spots (DBS) and cerebrospinal fluid (CSF) as biomarkers for Gaucher disease (GD) and discuss the association of this biomarker with other clinical parameters. This is a mixed-methods study incorporating both cross-sectional and longitudinal elements within a cohort design with a convenience-sampling strategy. Data collection took place from January 2012 to March 2023. Lyso-Gb1 extraction from DBS involved the use of a methanol-acetonitrile-water mixture, followed by incubation and centrifugation. Analysis was performed using UPLC-MS/MS with MassLynx software version 4.2 and the control group for the DBS measurements included general newborns. CSF Lyso-Gb1 was extracted using ethyl acetate, analyzed by UPLC-MS/MS with a calibration curve, and expressed in pmol/L. Lysosomal activity in CSF was assessed by measuring chitotriosidase (Cht), and other lysosomal enzyme activities were assessed as previously described in the literature. Patients with metachromatic leukodystrophy (MLD) were used as controls. Thirty-two treated patients (twenty-nine GD1 and three GD3, all on ERT except for one GD type on SRT with eliglustat) and three untreated patients (one GD1, one GD2, and one GD3) were included. When analyzing only the treated GD1 group, a significant correlation was found between lyso-Gb1 and age (rho = -0.447, p = 0.001), ChT, and IgG levels (rho = 0.73, p < 0.001; and rho = 0.36, p = 0.03, respectively). Five GD1 patients (three females, mean age 40 years) also had their CSF collected and analyzed. The average measurement of lyso-Gb1 in CSF was 94 pmol/L (range: 57.1-157.9 pmol/L) versus <6.2 pmol/L in the control group (MLD). This is the first time, to the best of our knowledge, that lyso-Gb1 has been associated with IgG levels. While this finding reflects a risk for MGUS or MM and not only chronic plasma B-cell activation, it still requires further studies. Moreover, the analysis of CSF lyso-Gb1 levels in GD1 patients was demonstrated to be significantly higher than the control group. This raises the hypothesis that CSF lyso-Gb1 may serve as a valuable indicator for neurological involvement in GD, providing insights into the potential implications for neurological manifestations in GD, including GD1. The correlation between lyso-Gb1 and ChT levels in treated GD1 patients further underscores the interconnectedness of lysosomal markers and their relevance in monitoring.
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Affiliation(s)
| | - Gabrielle Dineck Iop
- Biodiscovery Laboratory, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035903, Brazil; (G.D.I.); (L.F.); (L.A.L.d.S.)
| | - Larissa Faqueti
- Biodiscovery Laboratory, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035903, Brazil; (G.D.I.); (L.F.); (L.A.L.d.S.)
| | - Layzon Antonio Lemos da Silva
- Biodiscovery Laboratory, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035903, Brazil; (G.D.I.); (L.F.); (L.A.L.d.S.)
| | - Francyne Kubaski
- Biochemical Genetics Laboratory, Greenwood Genetics Center, Greenwood, SC 29646, USA;
| | - Fabiano O. Poswar
- Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035003, Brazil;
- Postgraduate Program in Genetics and Molecular Biology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90035003, Brazil
| | - Kristiane Michelin-Tirelli
- LEIM-Biochemical Genetics Laboratory, Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035003, Brazil;
| | - Dévora Randon
- BRAIN Laboratory, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035003, Brazil
| | | | - Roberto Giugliani
- Postgraduate Program in Medical Sciences, Universidade Federal do Rio Grande do Sul, UFRGS, Porto Alegre 90035003, Brazil; (M.V.M.B.W.); (R.G.)
- Biodiscovery Laboratory, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035903, Brazil; (G.D.I.); (L.F.); (L.A.L.d.S.)
- Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035003, Brazil;
- Postgraduate Program in Genetics and Molecular Biology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90035003, Brazil
- Department of Genetics, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90035003, Brazil
- Dasa Genômica, São Paulo 04078013, Brazil
- Casa dos Raros, Porto Alegre 90035003, Brazil
| | - Ida Vanessa D. Schwartz
- Postgraduate Program in Medical Sciences, Universidade Federal do Rio Grande do Sul, UFRGS, Porto Alegre 90035003, Brazil; (M.V.M.B.W.); (R.G.)
- Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035003, Brazil;
- BRAIN Laboratory, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035003, Brazil
- Department of Genetics, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90035003, Brazil
- Instituto Nacional de Doenças Raras—InRaras, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035003, Brazil
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Van Baelen A, Roosens L, Devos S, Verhulst S, Eyskens F. A new multiplex analysis of glucosylsphingosine and globotriaosylsphingosine in dried blood spots by tandem mass spectrometry. Mol Genet Metab Rep 2023; 37:100993. [PMID: 37649874 PMCID: PMC10462886 DOI: 10.1016/j.ymgmr.2023.100993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 09/01/2023] Open
Abstract
Background Gaucher's and Fabry's disease are two of the most common treatable lysosomal storage diseases, and have a wide spectrum of clinical symptoms. Early detection is important, because timely initiation of treatments can improve the disease status and prevent complications. However disease manifestations develop in childhood, diagnosis is delayed until adulthood partly due to the limitations of the currently used diagnostic pathway. The aim of this research is to develop and validate a multiplex assay and defining reference ranges, which do not exist at this moment, to improve and facilitate the entire diagnostic work up and enable treatment in an earlier stage of disease. Methods and findings Biomarkers glucosylsphingosine (GlcSph) and globotriaosylsphingosine (Lyso-Gb3) were detected and quantified using LC-MS/MS on dried blood spots. We developed an improved and new extraction method that allowed to measure GlcSph and Lyso-Gb3 in a multiplex analytical platform. After validation of the method, samples of 1480 individuals with normal enzymatic activity were collected to determine age and gender-related reference ranges.Our combination method showed a good linearity, precision, accuracy and limit of quantification with lack of carry-over following the specific international CLSI guidelines. The suggested protocol is robust, efficient, sensitive, specific, comprehensive and relatively cheap in order to accelerate the diagnostic process for both lysosomal storage diseases. The samples, with normal enzymatic activity, defined statistical relevant and clinical correct reference ranges for each specific age group by gender. Conclusion We report a multiplex LC-MS/MS method and relevant reference ranges that are appropriate for the targeted screening, diagnosis and follow-up of Fabry and Gaucher disease.
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Affiliation(s)
- Amber Van Baelen
- Center of Inherited Metabolic Diseases, UZA, Antwerp, Belgium
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Belgium
- Pediatric Department, UZA, Antwerp, Belgium
| | | | | | - Stijn Verhulst
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Belgium
- Pediatric Department, UZA, Antwerp, Belgium
| | - François Eyskens
- Center of Inherited Metabolic Diseases, UZA, Antwerp, Belgium
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Belgium
- Pediatric Department, UZA, Antwerp, Belgium
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Malinová V, Poupětová H, Řeboun M, Dvořáková L, Reichmannová S, Švandová I, Murgašová L, Kasper DC, Magner M. Long-Term Evaluation of Biomarkers in the Czech Cohort of Gaucher Patients. Int J Mol Sci 2023; 24:14440. [PMID: 37833892 PMCID: PMC10572410 DOI: 10.3390/ijms241914440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 09/18/2023] [Accepted: 09/19/2023] [Indexed: 10/15/2023] Open
Abstract
A personalized treatment decision for Gaucher disease (GD) patients should be based on relevant markers that are specific to GD, play a direct role in GD pathophysiology, exhibit low genetic variation, reflect the therapy, and can be used for all patients. Thirty-four GD patients treated with enzyme replacement therapy (ERT) or substrate reduction therapy (SRT) were analyzed for platelet count, chitotriosidase, and tartrate-resistant acid phosphatase activity in plasma samples, and quantitative measurement of Lyso-Gb1 was performed in dried blood spots. In our ERT and SRT study cohorts, plasma lyso-GL1 correlated significantly with chito-triosidase (ERT: r = 0.55, p < 0.001; SRT: r = 0.83, p < 0.001) and TRAP (ERT: r = 0.34, p < 0.001; SRT: r = 0.88, p < 0.001), irrespective of treatment method. A platelet count increase was associated with a Lyso-Gb1 decrease in both treatment groups (ERT: p = 0.021; SRT: p = 0.028). The association of Lyso-Gb1 with evaluated markers was stronger in the SRT cohort. Our results indicate that ERT and SRT in combination or in a switch manner could offer the potential of individual drug effectiveness for particular GD symptoms. Combination of the key biomarker of GD, Lyso-Gb1, with other biomarkers can offer improved response assessment to long-term therapy.
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Affiliation(s)
- Věra Malinová
- Department of Pediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital, 128 08 Prague, Czech Republic (H.P.); (M.Ř.); (L.D.); (S.R.); (I.Š.); (L.M.)
| | - Helena Poupětová
- Department of Pediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital, 128 08 Prague, Czech Republic (H.P.); (M.Ř.); (L.D.); (S.R.); (I.Š.); (L.M.)
| | - Martin Řeboun
- Department of Pediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital, 128 08 Prague, Czech Republic (H.P.); (M.Ř.); (L.D.); (S.R.); (I.Š.); (L.M.)
| | - Lenka Dvořáková
- Department of Pediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital, 128 08 Prague, Czech Republic (H.P.); (M.Ř.); (L.D.); (S.R.); (I.Š.); (L.M.)
| | - Stella Reichmannová
- Department of Pediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital, 128 08 Prague, Czech Republic (H.P.); (M.Ř.); (L.D.); (S.R.); (I.Š.); (L.M.)
| | - Ivana Švandová
- Department of Pediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital, 128 08 Prague, Czech Republic (H.P.); (M.Ř.); (L.D.); (S.R.); (I.Š.); (L.M.)
| | - Lenka Murgašová
- Department of Pediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital, 128 08 Prague, Czech Republic (H.P.); (M.Ř.); (L.D.); (S.R.); (I.Š.); (L.M.)
| | | | - Martin Magner
- Department of Pediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital, 128 08 Prague, Czech Republic (H.P.); (M.Ř.); (L.D.); (S.R.); (I.Š.); (L.M.)
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Giuffrida G, Markovic U, Condorelli A, Calafiore V, Nicolosi D, Calagna M, Grasso S, Ragusa MTV, Gentile J, Napolitano M. Glucosylsphingosine (Lyso-Gb1) as a reliable biomarker in Gaucher disease: a narrative review. Orphanet J Rare Dis 2023; 18:27. [PMID: 36782327 PMCID: PMC9926807 DOI: 10.1186/s13023-023-02623-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 01/23/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Gaucher disease (GD) is a rare, inherited, autosomal recessive disorder caused by a deficiency of the lysosomal enzyme, acid β-glucosidase. Its diagnosis is achieved via measurements of acid β-glucosidase activity in either fresh peripheral blood leukocytes or dried blood spots, and confirmed by identifying characteristic mutations in the GBA1 gene. Currently, several biomarkers are available for disease monitoring. Chitotriosidase has been used over the last 20 years to assess the severity of GD, but lacks specificity in GD patients. Conversely, the deacylated form of glucosylceramide, glucosylsphingosine (also known as lyso-Gb1), represents a more reliable biomarker characterized by its high sensitivity and specificity in GD. MAIN TEXT Herein, we review the current literature on lyso-Gb1 and describe evidence supporting its usefulness as a biomarker for diagnosing and evaluating disease severity in GD and monitoring treatment efficacy. CONCLUSION Lyso-Gb1 is the most promising biomarker of GD, as demonstrated by its reliability in reflecting disease burden and monitoring treatment response. Furthermore, lyso-Gb1 may play an important role in the onset of monoclonal gammopathy of uncertain significance, multiple myeloma, and Parkinson's disease in GD patients.
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Affiliation(s)
- Gaetano Giuffrida
- Division of Haematology, A.O.U. Policlinico Vittorio Emanuele, Catania, Italy.
| | - Uros Markovic
- grid.412844.f0000 0004 1766 6239Division of Haematology, A.O.U. Policlinico Vittorio Emanuele, Catania, Italy ,Oncohematology and BMT Unit, Mediterranean Institute of Oncology, Viagrande, Italy ,grid.10438.3e0000 0001 2178 8421Department of Biomedical, Dental, Morphological and Functional Imaging Sciences, University of Messina, 98122 Messina, Italy
| | - Annalisa Condorelli
- grid.412844.f0000 0004 1766 6239Division of Haematology, A.O.U. Policlinico Vittorio Emanuele, Catania, Italy ,grid.8158.40000 0004 1757 1969Postgraduate School of Hematology, University of Catania, Catania, Italy
| | - Valeria Calafiore
- grid.412844.f0000 0004 1766 6239Division of Haematology, A.O.U. Policlinico Vittorio Emanuele, Catania, Italy
| | - Daniela Nicolosi
- grid.412844.f0000 0004 1766 6239Division of Haematology, A.O.U. Policlinico Vittorio Emanuele, Catania, Italy
| | - Marianna Calagna
- grid.412844.f0000 0004 1766 6239Division of Haematology, A.O.U. Policlinico Vittorio Emanuele, Catania, Italy ,grid.8158.40000 0004 1757 1969Postgraduate School of Hematology, University of Catania, Catania, Italy
| | - Stephanie Grasso
- grid.412844.f0000 0004 1766 6239Division of Haematology, A.O.U. Policlinico Vittorio Emanuele, Catania, Italy
| | | | | | - Mariasanta Napolitano
- grid.10776.370000 0004 1762 5517Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
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Arévalo NB, Lamaizon CM, Cavieres VA, Burgos PV, Álvarez AR, Yañez MJ, Zanlungo S. Neuronopathic Gaucher disease: Beyond lysosomal dysfunction. Front Mol Neurosci 2022; 15:934820. [PMID: 35992201 PMCID: PMC9381931 DOI: 10.3389/fnmol.2022.934820] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 06/27/2022] [Indexed: 11/21/2022] Open
Abstract
Gaucher disease (GD) is an inherited disorder caused by recessive mutations in the GBA1 gene that encodes the lysosomal enzyme β-glucocerebrosidase (β-GC). β-GC hydrolyzes glucosylceramide (GluCer) into glucose and ceramide in the lysosome, and the loss of its activity leads to GluCer accumulation in different tissues. In severe cases, enzymatic deficiency triggers inflammation, organomegaly, bone disease, and neurodegeneration. Neuronopathic Gaucher disease (nGD) encompasses two different forms of the disease, characterized by chronic or acute damage to the central nervous system (CNS). The cellular and molecular studies that uncover the pathological mechanisms of nGD mainly focus on lysosomal dysfunction since the lysosome is the key organelle affected in GD. However, new studies show alterations in other organelles that contribute to nGD pathology. For instance, abnormal accumulation of GluCer in lysosomes due to the loss of β-GC activity leads to excessive calcium release from the endoplasmic reticulum (ER), activating the ER-associated degradation pathway and the unfolded protein response. Recent evidence indicates mitophagy is altered in nGD, resulting in the accumulation of dysfunctional mitochondria, a critical factor in disease progression. Additionally, nGD patients present alterations in mitochondrial morphology, membrane potential, ATP production, and increased reactive oxygen species (ROS) levels. Little is known about potential dysfunction in other organelles of the secretory pathway, such as the Golgi apparatus and exosomes. This review focuses on collecting evidence regarding organelle dysfunction beyond lysosomes in nGD. We briefly describe cellular and animal models and signaling pathways relevant to uncovering the pathological mechanisms and new therapeutic targets in GD.
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Affiliation(s)
- Nohela B. Arévalo
- Department of Gastroenterology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Department of Cell and Molecular Biology, Biological Sciences Faculty, Pontificia Universidad Católica de Chile, Santiago, Chile
- Departamento de Biología Celular y Molecular, Facultad de Ciencias Biológicas, Millennium Institute on Immunology and Immunotherapy, Pontificia Universidad Católica, Santiago, Chile
| | - Cristian M. Lamaizon
- Department of Cell and Molecular Biology, Biological Sciences Faculty, Pontificia Universidad Católica de Chile, Santiago, Chile
- Departamento de Biología Celular y Molecular, Facultad de Ciencias Biológicas, Millennium Institute on Immunology and Immunotherapy, Pontificia Universidad Católica, Santiago, Chile
| | - Viviana A. Cavieres
- Facultad de Medicina y Ciencia, Centro de Biología Celular y Biomedicina (CEBICEM), Universidad San Sebastián, Santiago, Chile
- Facultad de Ciencias Biológicas, Centro de Envejecimiento y Regeneración (CARE-UC), Pontificia Universidad Católica, Santiago, Chile
| | - Patricia V. Burgos
- Facultad de Medicina y Ciencia, Centro de Biología Celular y Biomedicina (CEBICEM), Universidad San Sebastián, Santiago, Chile
- Facultad de Ciencias Biológicas, Centro de Envejecimiento y Regeneración (CARE-UC), Pontificia Universidad Católica, Santiago, Chile
- Centro Ciencia & Vida, Fundación Ciencia & Vida, Santiago, Chile
| | - Alejandra R. Álvarez
- Department of Cell and Molecular Biology, Biological Sciences Faculty, Pontificia Universidad Católica de Chile, Santiago, Chile
- Departamento de Biología Celular y Molecular, Facultad de Ciencias Biológicas, Millennium Institute on Immunology and Immunotherapy, Pontificia Universidad Católica, Santiago, Chile
- Facultad de Ciencias Biológicas, Centro de Envejecimiento y Regeneración (CARE-UC), Pontificia Universidad Católica, Santiago, Chile
| | - María J. Yañez
- Faculty of Medicine and Science, School of Medical Technology, Universidad San Sebastian, Concepción, Chile
- *Correspondence: María J. Yañez
| | - Silvana Zanlungo
- Department of Gastroenterology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Silvana Zanlungo
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