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Tahara M, Higurashi N, Narita A, Ida H. Long-term efficacy of low-dose perampanel for progressive myoclonus epilepsy in a patient with Gaucher disease type 3. Brain Dev 2022; 44:308-312. [PMID: 34991910 DOI: 10.1016/j.braindev.2021.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 12/02/2021] [Accepted: 12/09/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE We report the case of a patient with progressive myoclonus epilepsy due to Gaucher disease type 3 whose seizures and ability to perform activities of daily living were significantly improved after starting low-dose perampanel therapy. CASE Our patient's generalized tonic-clonic seizures and myoclonus did not improve despite the administration of multiple antiseizure medications and enzyme replacement therapy. The myoclonus reduced following pharmacological chaperone therapy, but this effect was temporary, and the generalized tonic-clonic seizures continued to occur. However, the generalized tonic-clonic seizures disappeared following treatment with 2 mg/day of perampanel. In addition, the decrease in myoclonus dramatically improved motor function such as talking, eating, and walking and stabilized the patient's mental status. These effects have been sustained for more than 4 years. CONCLUSION Perampanel is expected to be effective in the treatment of progressive myoclonus epilepsy associated with Gaucher disease type 3 and should be considered the drug of choice for this condition.
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Affiliation(s)
- Mayu Tahara
- Department of Pediatrics, The Jikei University School of Medicine, Japan.
| | | | - Aya Narita
- Division of Child Neurology, Tottori University Hospital, Japan
| | - Hiroyuki Ida
- Department of Pediatrics, The Jikei University School of Medicine, Japan
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2
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Daykin EC, Ryan E, Sidransky E. Diagnosing neuronopathic Gaucher disease: New considerations and challenges in assigning Gaucher phenotypes. Mol Genet Metab 2021; 132:49-58. [PMID: 33483255 PMCID: PMC7884077 DOI: 10.1016/j.ymgme.2021.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/04/2021] [Accepted: 01/05/2021] [Indexed: 12/13/2022]
Abstract
Gaucher disease (GD), resulting from biallelic mutations in the gene GBA1, is a monogenic recessively inherited Mendelian disorder with a wide range of phenotypic presentations. The more severe forms of the disease, acute neuronopathic GD (GD2) and chronic neuronopathic GD (GD3), also have a continuum of disease severity with an overlap in manifestations and limited genotype-phenotype correlation. In very young patients, assigning a definitive diagnosis can sometimes be challenging. Several recent studies highlight specific features of neuronopathic GD that may provide diagnostic clues. Distinguishing between the different GD types has important therapeutic implications. Currently there are limited treatment options specifically for neuronopathic GD due to the difficulty in delivering therapies across the blood-brain barrier. In this work, we present both classic and newly appreciated aspects of the Gaucher phenotype that can aid in discriminating between acute and chronic neuronopathic GD, and highlight the continuing therapeutic challenges.
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Affiliation(s)
- Emily C Daykin
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, USA
| | - Emory Ryan
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, USA
| | - Ellen Sidransky
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, USA.
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3
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Ciana G, Dardis A, Pavan E, Da Riol RM, Biasizzo J, Ferino D, Zanatta M, Boni A, Antonini L, Crichiutti G, Bembi B. In vitro and in vivo effects of Ambroxol chaperone therapy in two Italian patients affected by neuronopathic Gaucher disease and epilepsy. Mol Genet Metab Rep 2020; 25:100678. [PMID: 33294373 PMCID: PMC7691604 DOI: 10.1016/j.ymgmr.2020.100678] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 01/08/2023] Open
Abstract
Gaucher disease (GD) is an autosomal recessive lysosomal storage disorder caused by mutations in the acid β-glucosidase encoding gene (GBA1), resulting in the deficient activity of acid β-glucosidase (GCase). To date, there is no approved treatment for the neurological manifestations of the disease. The role of Ambroxol as a chaperone for mutant GCase has been extensively demonstrated in vitro. Furthermore, different authors have reported beneficial effects of high doses of Ambroxol on neurological manifestations in patients affected by GD. In this report, we describe the in vitro and in vivo effects of Ambroxol in two patients (P1 and P2) affected by the neurological form of GD and epilepsy, carrying mutations already reported as responsive to the chaperone. Indeed, P1 presented the N188S mutation in compound heterozygous with a null allele (IVS2 + 1G > A) and P2 was homozygous for the L444P mutation. As expected, a beneficial effect of Ambroxol was observed in cultured fibroblasts as well as in vivo, both on epilepsy and on biomarkers of GD, in P1. However, Ambroxol was completely undefective in P2, suggesting that other factors besides the GBA1 mutation itself would be involved in the response therapy which would be difficult to predict based on the patient genotype. The present report expands the experience of Ambroxol treatment in neurological GD patients and highlights the need to in vitro test the individual response to Ambroxol even in patients carrying mutations already classified as responsive to the chaperone.
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Affiliation(s)
- Giovanni Ciana
- Pediatric Department, Hospital of Merano, Merano, Italy.,Regional Coordinator Centre for Rare Diseases, University Hospital of Udine, Udine, Italy
| | - Andrea Dardis
- Regional Coordinator Centre for Rare Diseases, University Hospital of Udine, Udine, Italy
| | - Eleonora Pavan
- Regional Coordinator Centre for Rare Diseases, University Hospital of Udine, Udine, Italy
| | - Rosalia Maria Da Riol
- Regional Coordinator Centre for Rare Diseases, University Hospital of Udine, Udine, Italy
| | - Jessica Biasizzo
- Institute of Clinical Pathology, University Hospital of Udine, ASUFC, Udine, Italy
| | - Dania Ferino
- Institute of Clinical Pathology, University Hospital of Udine, ASUFC, Udine, Italy
| | - Manuela Zanatta
- Regional Coordinator Centre for Rare Diseases, University Hospital of Udine, Udine, Italy
| | - Antonella Boni
- U.O. di Neuropsichiatria Infantile, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Luisa Antonini
- UO di Neurofisiopatologia, Spedali Civili di Brescia, Brescia, Italy
| | | | - Bruno Bembi
- Regional Coordinator Centre for Rare Diseases, University Hospital of Udine, Udine, Italy
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4
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Oguri M, Saito Y, Okanishi T, Matuura Y, Akiyama S, Ikeguchi T, Narita A, Hirooka Y, Maegaki Y. High-frequency component in flash visual evoked potentials in type 3 Gaucher disease. Brain Dev 2020; 42:19-27. [PMID: 31561936 DOI: 10.1016/j.braindev.2019.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 07/23/2019] [Accepted: 08/20/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To characterize the visual evoked potentials (VEP) in patients with type 3 Gaucher disease (GD) with or without progressive myoclonus epilepsy. METHODS Three young adults with progressive myoclonus epilepsy (type 3a GD) and two children without progressive myoclonus epilepsy (type 3b GD) were enrolled. Flash visual and somatosensory evoked potentials (F-VEP and SEP, respectively) were retrospectively reviewed in all patients under enzyme replacement therapy. Pattern reversal visual evoked potentials (PR-VEP) were recorded in the type 3a group. RESULT High-frequency components were provoked at early latencies on averaged F-VEP in all patients with type 3a and one patient with type 3b GD. Conversely, no activities were recorded in PR-VEP. The onset latency of the components began at 15.3-19.8 ms after flash stimulation. Four-five of the F-VEP examination the activities' duration overrode the N75 waveforms and were prolonged toward the P100 peak latency. The F-VEP amplitude did not differ between the type 3a and type 3b groups, while the SEP amplitude was higher in the type 3a than in the type 3b group. SIGNIFICANCE High-frequency components on F-VEP using bandpass filter at 10-200 Hz may help assess augmented excitability in the visual cortex of type 3 GD patients.
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Affiliation(s)
- Masayoshi Oguri
- Department of Pathobiological Science and Technology, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Yoshiaki Saito
- Division of Child Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago, Japan; Yokohama Medical and Welfare Centre, Konan, Yokohama, Japan
| | - Tohru Okanishi
- Department of Child Neurology, Seirei-Hamamatsu General Hospital, Hamamatsu, Japan
| | - Yuka Matuura
- Department of Pathobiological Science and Technology, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Shota Akiyama
- Department of Pathobiological Science and Technology, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Takuya Ikeguchi
- Department of Pathobiological Science and Technology, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Aya Narita
- Division of Child Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Yasuaki Hirooka
- Department of Pathobiological Science and Technology, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Yoshihiro Maegaki
- Division of Child Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago, Japan.
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5
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Li SJ, Zheng WW, Sun MY, Qi JY, Jiang B. [Clinical features and genetic manifestations of two families with Gaucher's disease]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2019; 40:774-776. [PMID: 31648483 PMCID: PMC7342435 DOI: 10.3760/cma.j.issn.0253-2727.2019.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Indexed: 11/05/2022]
Affiliation(s)
- S J Li
- Department of Hematology, Tianjin Fourth Central Hospital, Tianjin 300140, China
| | - W W Zheng
- GCP Center, Institute of Hematology & Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China
| | - M Y Sun
- GCP Center, Institute of Hematology & Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China
| | - J Y Qi
- GCP Center, Institute of Hematology & Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China
| | - B Jiang
- GCP Center, Institute of Hematology & Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China
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Hertz E, Thörnqvist M, Holmberg B, Machaczka M, Sidransky E, Svenningsson P. First Clinicogenetic Description of Parkinson's Disease Related to GBA Mutation S107L. Mov Disord Clin Pract 2019; 6:254-258. [PMID: 30949558 DOI: 10.1002/mdc3.12743] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Revised: 01/28/2019] [Accepted: 02/12/2019] [Indexed: 12/24/2022] Open
Abstract
Background Mutations in the glucocerebrosidase gene (GBA) are a common genetic risk factor for Parkinson's disease (PD). Mutations in the N-terminus part of GBA are less commonly found in association with PD than those in the C-terminus. Phenotypic characterization of GBA-related PD has been challenging, in part attributed to differential impact of distinct GBA mutations. Aim To provide a phenotypic description of two patients with PD heterozygous for the GBA mutation S107L. The S107L mutation is located in the catalytic domain of glucocerebrosidase and has not previously been reported in patients with PD. Methods Motor and nonmotor symptoms (NMS) of PD were evaluated using established rating scales and questionnaires. The genotype was determined by Sanger sequencing. Results Two half-brothers, both heterozygous carriers of S107L, exhibited an early PD onset with several NMS. Conclusions In these patients, heterozygosity for S107L was associated with an early onset of PD with NMS.
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Affiliation(s)
- Ellen Hertz
- Section of Neurology, Department of Clinical Neuroscience Karolinska Institute Stockholm Sweden
| | | | - Björn Holmberg
- Department of Clinical Neuroscience and Rehabilitation The Sahlgrenska Academy at University of Gothenburg Gothenburg Sweden
| | - Maciej Machaczka
- Hematology Center Karolinska and Department of Medicine Huddinge Karolinska Institutet, Karolinska University Hospital Huddinge Stockholm Sweden.,Medical Faculty University of Rzeszow Rzeszow Poland
| | - Ellen Sidransky
- Medical Genetics Branch National Human Genome Research Institute, National Institutes of Health Bethesda Maryland USA
| | - Per Svenningsson
- Section of Neurology, Department of Clinical Neuroscience Karolinska Institute Stockholm Sweden
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7
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Progressive myoclonus epilepsy in Gaucher Disease due to a new Gly-Gly mutation causing loss of an Exonic Splicing Enhancer. J Neurol 2018; 266:92-101. [PMID: 30382391 PMCID: PMC6342868 DOI: 10.1007/s00415-018-9084-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 10/02/2018] [Accepted: 10/03/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND Patients with Gaucher Disease (GD) exhibit three phenotypes, including type 1 (non-neuronopathic), type 2 (acute neuronopathic), and type 3 (subacute neuronopathic). AIM Identifying which GBA changes represent benign polymorphisms and which may result in disease-causing mutations is essential for diagnosis and genotype/phenotype correlations but is often challenging. RESULTS Here, we describe a patient with type 3 GD, presenting with drug-resistant epilepsy, who bears a set of GBA polymorphic variants including the novel c.363A > G (Gly82Gly) synonymous mutation. In silico predictions, mRNA and functional studies revealed that the new Gly82Gly mutation causes skipping of GBA exon 4, leading to a severe reduction of the wild type GBA mRNA. This is the first report of a synonymous change causing GD through loss of an exonic splicing enhancer sequence. The synonymous mutation is in trans with the Asn188Ser missense mutation, thus making the Asn188Ser responsible for the patient's phenotype and strengthening the association of Asn188Ser with the particular neurological phenotype of type 3 GD. CONCLUSION We strengthen the association of Asn188Ser with the type 3 GD phenotype and progressive myoclonus epilepsy. Our data confirm that in silico predictions and mRNA analysis are mandatory in discriminating pathological mutations from the background of harmless polymorphisms, especially synonymous changes.
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8
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Sechi A, Deroma L, Dardis A, Ciana G, Bertin N, Concolino D, Linari S, Perria C, Bembi B. Long term effects of enzyme replacement therapy in an Italian cohort of type 3 Gaucher patients. Mol Genet Metab 2014; 113:213-8. [PMID: 25127542 DOI: 10.1016/j.ymgme.2014.07.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 07/28/2014] [Accepted: 07/28/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND The chronic neuropathic form of Gaucher disease (GD3) is characterised by hepatosplenomegaly, anaemia, thrombocytopenia, bone alterations and central neurological involvement. Enzyme replacement therapy (ERT) has been demonstrated to be effective in non neuropathic Gaucher disease, but long term results in patients with GD3 are still limited and contrasting. A possible role of genotype in determining the response to ERT has been hypothesised. PATIENTS AND METHODS All patients affected by GD3, treated with ERT, and followed-up in 4 different Italian centres (Udine, Catanzaro, Sassari and Florence) were included. Data on clinical conditions, laboratory values, neurological and neuropsychological examinations, radiological and electrophysiological features were collected retrospectively from clinical records. RESULTS Ten patients (6 females, 4 males) with four different genotypes (L444P/L444P, L444P/F231I, P159T/unknown, C.115+1G>A/N188S) were identified. They received ERT infusions from 3 to 21years. Haematological parameters and organomegaly improved/normalised in all patients. Three patients showed severe progressive skeletal deformities. 6/10 patients were neurologically asymptomatic when they started ERT for systemic symptoms. During the follow-up, 2/6 developed an important central nervous system disease; 2/6 developed mild central symptoms; and 2/6 did not show any neurological symptom after 5, and 20years of treatment respectively, despite the presence of epileptiform abnormalities at the electroencephalogram. Overall, neurological involvement worsened over time in 6/10 patients, 3 of whom developed progressive myoclonic encephalopathy and died. CONCLUSIONS ERT improved the systemic manifestations in patients with GD3, but was not able to counteract the progression of neurological symptoms in the long term.
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Affiliation(s)
- Annalisa Sechi
- Regional Coordinator Centre for Rare Diseases, University Hospital of Udine, Udine, Italy.
| | - Laura Deroma
- Regional Coordinator Centre for Rare Diseases, University Hospital of Udine, Udine, Italy
| | - Andrea Dardis
- Regional Coordinator Centre for Rare Diseases, University Hospital of Udine, Udine, Italy
| | - Giovanni Ciana
- Regional Coordinator Centre for Rare Diseases, University Hospital of Udine, Udine, Italy
| | - Nicole Bertin
- Regional Coordinator Centre for Rare Diseases, University Hospital of Udine, Udine, Italy
| | - Daniela Concolino
- Department of Paediatrics, University Magna Graecia, Catanzaro, Italy
| | - Silvia Linari
- Regional Reference Centre for Inherited Bleeding Disorders, University Hospital of Florence, Florence, Italy
| | - Chiara Perria
- Section of Childhood and Adolescence Neuropsychiatry, Department Experimental and Clinical Medicine, University of Sassari, Sassari, Italy
| | - Bruno Bembi
- Regional Coordinator Centre for Rare Diseases, University Hospital of Udine, Udine, Italy
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9
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Malini E, Grossi S, Deganuto M, Rosano C, Parini R, Dominisini S, Cariati R, Zampieri S, Bembi B, Filocamo M, Dardis A. Functional analysis of 11 novel GBA alleles. Eur J Hum Genet 2013; 22:511-6. [PMID: 24022302 DOI: 10.1038/ejhg.2013.182] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Revised: 07/01/2013] [Accepted: 07/11/2013] [Indexed: 12/26/2022] Open
Abstract
Gaucher disease is the most frequent lysosomal storage disorder due to the deficiency of the acid β-glucosidase, encoded by the GBA gene. In this study, we report the structural and functional characterization of 11 novel GBA alleles. Seven single missense alleles, P159S, N188I, E235K, P245T, W312S, S366R and W381C, and two alleles carrying in cis mutations, (N188S; G265R) and (E326K; D380N), were studied for enzyme activity in transiently transfected cells. All mutants were inactive except the P159S, which retained 15% of wild-type activity. To further characterize the alleles carrying two in cis mutations, we expressed constructs bearing singly each mutation. The presence of G265R or D380N mutations completely abolished enzyme activity, while N188S and E326K mutants retained 25 and 54% of wild-type activity, respectively. Two mutations, affecting the acceptor splice site of introns 5 (c.589-1G>A) and 9 (c.1389-1G>A), led to the synthesis of aberrant mRNA. Unpredictably, family studies showed that two alleles resulted from germline or 'de novo' mutations. These results strengthen the importance of performing a complete and accurate molecular analysis of the GBA gene in order to avoid misleading conclusions and provide a comprehensive functional analysis of new GBA mutations.
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Affiliation(s)
- Erika Malini
- Regional Coordinator Centre for Rare Diseases, University Hospital Santa Maria della Misericordia, Udine, Italy
| | - Serena Grossi
- U.O.S.D. Centro di Diagnostica Genetica e Biochimica delle Malattie Metaboliche, Istituto G. Gaslini, Genova, Italy
| | - Marta Deganuto
- Regional Coordinator Centre for Rare Diseases, University Hospital Santa Maria della Misericordia, Udine, Italy
| | - Camillo Rosano
- Patologia Molecolare Integrata - A.O.U. IRCSS San Martino - IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - Rossella Parini
- Rare Metabolic Diseases Unit, Pediatric Clinic, San Gerardo Hospital, Monza, Italy
| | - Silvia Dominisini
- Regional Coordinator Centre for Rare Diseases, University Hospital Santa Maria della Misericordia, Udine, Italy
| | - Roberta Cariati
- Regional Coordinator Centre for Rare Diseases, University Hospital Santa Maria della Misericordia, Udine, Italy
| | - Stefania Zampieri
- Regional Coordinator Centre for Rare Diseases, University Hospital Santa Maria della Misericordia, Udine, Italy
| | - Bruno Bembi
- Regional Coordinator Centre for Rare Diseases, University Hospital Santa Maria della Misericordia, Udine, Italy
| | - Mirella Filocamo
- U.O.S.D. Centro di Diagnostica Genetica e Biochimica delle Malattie Metaboliche, Istituto G. Gaslini, Genova, Italy
| | - Andrea Dardis
- Regional Coordinator Centre for Rare Diseases, University Hospital Santa Maria della Misericordia, Udine, Italy
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Girard JM, Turnbull J, Ramachandran N, Minassian BA. Progressive myoclonus epilepsy. HANDBOOK OF CLINICAL NEUROLOGY 2013; 113:1731-6. [PMID: 23622396 DOI: 10.1016/b978-0-444-59565-2.00043-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The progressive myoclonus epilepsies (PMEs) consist of a group of diseases with myoclonic seizures and progressive neurodegeneration, with onset in childhood and/or adolescence. Lafora disease is a neuronal glycogenosis in which normal glycogen is transformed into starch-like polyglucosans that accumulate in the neuronal somatodendritic compartment. It is caused by defects of two genes of yet unknown function, one encoding a glycogen phosphatase (laforin) and the other an ubiquitin E3 ligase (malin). Early cognitive deterioration, visual seizures affecting over half, and slowing down of EEG basic activity are three major diagnostic clues. Unverricht-Lundborg disease is presently thought to be due to damage to neurons by lysosomal cathepsins and reactive oxygen species due to absence of cystatin B, a small protein that inactivates cathepsins and, by ways yet unknown, quenches damaging redox compounds. Preserved cognition and background EEG activity, action myoclonus early morning and vertex spikes in REM sleep are the diagnostic clues. Sialidosis, with cherry-red spot, neuronopathic Gaucher disease, with paralysis of verticality, and ataxia-PME, with ataxia at onset in the middle of the first decade, are also lysosomal diseases. How the lysosomal defect culminates in myoclonus and epilepsy in these conditions remains unknown.
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Affiliation(s)
- Jean-Marie Girard
- Division of Neurology, Department of Paediatrics, Hospital for Sick Children and University of Toronto, Toronto, Canada
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11
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Aureli M, Bassi R, Loberto N, Regis S, Prinetti A, Chigorno V, Aerts JM, Boot RG, Filocamo M, Sonnino S. Cell surface associated glycohydrolases in normal and Gaucher disease fibroblasts. J Inherit Metab Dis 2012; 35:1081-91. [PMID: 22526844 DOI: 10.1007/s10545-012-9478-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2011] [Revised: 03/05/2012] [Accepted: 03/07/2012] [Indexed: 12/15/2022]
Abstract
Gaucher disease (GD) is the most common lysosomal disorder and is caused by an inherited autosomal recessive deficiency in β-glucocerebrosidase. This enzyme, like other glycohydrolases involved in glycosphingolipid (GSL) metabolism, is present in both plasma membrane (PM) and intracellular fractions. We analyzed the activities of CBE-sensitive β-glucosidase (GBA1) and AMP-DNM-sensitive β-glucosidase (GBA2) in total cell lysates and PM of human fibroblast cell lines from control (normal) subjects and from patients with GD clinical types 1, 2, and 3. GBA1 activities in both total lysate and PM of GD fibroblasts were low, and their relative percentages were similar to those of control cells. In contrast, GBA2 activities were higher in GD cells than in control cells, and the degree of increase differed among the three GD types. The increase of GBA2 enzyme activity was correlated with increased expression of GBA2 protein as evaluated by QRT-PCR. Activities of β-galactosidase and β-hexosaminidase in PM were significantly higher for GD cells than for control cells and also showed significant differences among the three GD types, suggesting the occurrence of cross-talk among the enzymes involved in GSL metabolism. Our findings indicate that the profiles of glycohydrolase activities in PM may provide a valuable tool to refine the classification of GD into distinct clinical types.
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Affiliation(s)
- Massimo Aureli
- Department of Medical Chemistry, Biochemistry and Biotechnology, University of Milan, 20090, Segrate, Italy
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12
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Zampieri S, Cattarossi S, Oller Ramirez AM, Rosano C, Lourenco CM, Passon N, Moroni I, Uziel G, Pettinari A, Stanzial F, de Kremer RD, Azar NB, Hazan F, Filocamo M, Bembi B, Dardis A. Sequence and copy number analyses of HEXB gene in patients affected by Sandhoff disease: functional characterization of 9 novel sequence variants. PLoS One 2012; 7:e41516. [PMID: 22848519 PMCID: PMC3407239 DOI: 10.1371/journal.pone.0041516] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Accepted: 06/21/2012] [Indexed: 11/18/2022] Open
Abstract
Sandhoff disease (SD) is a lysosomal disorder caused by mutations in the HEXB gene. To date, 43 mutations of HEXB have been described, including 3 large deletions. Here, we have characterized 14 unrelated SD patients and developed a Multiplex Ligation-dependent Probe Amplification (MLPA) assay to investigate the presence of large HEXB deletions. Overall, we identified 16 alleles, 9 of which were novel, including 4 sequence variation leading to aminoacid changes [c.626C>T (p.T209I), c.634C>A (p.H212N), c.926G>T (p.C309F), c.1451G>A (p.G484E)] 3 intronic mutations (c.1082+5G>A, c.1242+1G>A, c.1169+5G>A), 1 nonsense mutation c.146C>A (p.S49X) and 1 small in-frame deletion c.1260_1265delAGTTGA (p.V421_E422del). Using the new MLPA assay, 2 previously described deletions were identified. In vitro expression studies showed that proteins bearing aminoacid changes p.T209I and p.G484E presented a very low or absent activity, while proteins bearing the p.H212N and p.C309F changes retained a significant residual activity. The detrimental effect of the 3 novel intronic mutations on the HEXB mRNA processing was demonstrated using a minigene assay. Unprecedentedly, minigene studies revealed the presence of a novel alternative spliced HEXB mRNA variant also present in normal cells. In conclusion, we provided new insights into the molecular basis of SD and validated an MLPA assay for detecting large HEXB deletions.
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Affiliation(s)
- Stefania Zampieri
- Regional Coordinator Center for Rare Diseases, University Hospital Santa Maria della Misericordia, Udine, Italy
| | - Silvia Cattarossi
- Regional Coordinator Center for Rare Diseases, University Hospital Santa Maria della Misericordia, Udine, Italy
| | - Ana Maria Oller Ramirez
- Centro de Estudio de las Metabolopatias Congénitas, CEMECO, University of Córdoba, Córdoba, Argentine
| | - Camillo Rosano
- Patologia Molecolare Integrata – A.O.U. IRCSS San Martino – IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - Charles Marques Lourenco
- Medical Genetics Service, Clinics Hospital of Ribeirao Preto, University of Sao Paulo, Sao Paulo, Brazil
| | - Nadia Passon
- Dipartimento di Scienze Mediche e Biologiche, Università di Udine, Udine, Italy
| | - Isabella Moroni
- Department of Child Neurology, Fondazione Istituto Neurologico Besta, Milan, Italy
| | - Graziella Uziel
- Department of Child Neurology, Fondazione Istituto Neurologico Besta, Milan, Italy
| | - Antonella Pettinari
- Laboratorio di Genetica Medica, Clinica Pediatrica, Ospedali Riuniti Ancona, Ancona, Italy
| | - Franco Stanzial
- Servizio di Consulenza Genetica, Centro Provinciale di Coordinamento della Rete delle Malattie Rare, Azienda Sanitaria dell’Alto-Adige, Bolzano, Italy
| | - Raquel Dodelson de Kremer
- Centro de Estudio de las Metabolopatias Congénitas, CEMECO, University of Córdoba, Córdoba, Argentine
| | - Nydia Beatriz Azar
- Centro de Estudio de las Metabolopatias Congénitas, CEMECO, University of Córdoba, Córdoba, Argentine
| | - Filiz Hazan
- Medical Faculty, Genetic Department, Izmir, Turkey
| | - Mirella Filocamo
- U.O.S.D. Laboratorio Diagnosi Pre-Postnatale Malattie Metaboliche, Istituto G. Gaslini, Genova, Italy
| | - Bruno Bembi
- Regional Coordinator Center for Rare Diseases, University Hospital Santa Maria della Misericordia, Udine, Italy
| | - Andrea Dardis
- Regional Coordinator Center for Rare Diseases, University Hospital Santa Maria della Misericordia, Udine, Italy
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Kraoua I, Sedel F, Caillaud C, Froissart R, Stirnemann J, Chaurand G, Flodrops H, Tari S, Gourfinkel-An I, Mathieu S, Belmatoug N, Billette de Villemeur T, Mignot C. A French experience of type 3 Gaucher disease: Phenotypic diversity and neurological outcome of 10 patients. Brain Dev 2011; 33:131-9. [PMID: 20307947 DOI: 10.1016/j.braindev.2010.02.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2009] [Revised: 02/10/2010] [Accepted: 02/16/2010] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To describe the clinical presentation of 10 patients with type 3 Gaucher disease and the clinical evolution of nine of them following specific therapy regimes. METHODS The follow-up of these 10 patients was between 2 and 15 years. The clinical history was provided by each patient's general practitioner and a final clinical evaluation was made by two different physicians including a neurologist. One patient received no treatment, eight received enzyme replacement therapy (ERT) and one received ERT combined with substrate reduction therapy (SRT, miglustat). RESULTS The clinical presentations were heterogeneous and most phenotypes reported for type 3 Gaucher disease were represented. The neurological involvement stabilized or improved in six patients under ERT with a follow-up of 2-15 years. Four of them showed isolated oculomotor signs only that improved or remained unchanged during the follow-up. Of two patients with progressive myoclonic epilepsy, the outcome was clearly unfavorable in one receiving ERT and disputable for the other receiving ERT+SRT. An unfavorable neurological outcome was observed in another patient in whom the ERT dose had been reduced before clinical decline. CONCLUSION The stabilization of the clinical course in most patients is noteworthy. Though further evidence is needed from a larger series in order to draw any definite conclusions, our data suggest that ERT may be effective in preventing the evolution of neurological disturbances associated with type 3 Gaucher disease in some patients. However, the clinical course of the two patients with progressive myoclonic epilepsy was not influenced by ERT, as previously reported. In accordance with that reported in the literature, data from our series suggest that the outcome of patients undergoing ERT depends on the type of clinical involvement, treatment onset and dose. Genotype may also be an important factor, with p.L444P/p.L444P possibly indicating a better outcome.
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Affiliation(s)
- Ichraf Kraoua
- Reference Center for Lysosomal Diseases, Hôpital de la Salpêtrière, Paris, France
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14
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Tajima A, Ohashi T, Hamano SI, Higurashi N, Ida H. Gaucher disease patient with myoclonus epilepsy and a novel mutation. Pediatr Neurol 2010; 42:65-8. [PMID: 20004867 DOI: 10.1016/j.pediatrneurol.2009.08.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2009] [Revised: 05/26/2009] [Accepted: 08/12/2009] [Indexed: 11/25/2022]
Abstract
The N188S mutation in Gaucher disease is associated with myoclonus epilepsy. We performed genetic analysis on a patient with progressive myoclonus epilepsy, who had received antiepileptic drugs for over 10 years. We detected N188S/G199D on the gene encoding glucocerebrosidase. Mutant proteins carrying each mutation were expressed in COS-1 cells (a commonly used cell line which derives from kidney cells of the African green monkey). Measurements of enzymatic activity and Western blotting analysis were performed. When residual activities were measured, glucocerebrosidase with the N188S mutation exhibited 50% activity of the wild type, and with G199D, 7.4%. Neither mutation influenced the stability of the enzyme protein. These data suggested a diagnosis of Gaucher disease for this patient, and indicated that G199D is a novel mutation.
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Affiliation(s)
- Asako Tajima
- Department of Pediatrics, Jikei University School of Medicine, Tokyo 105-8461, Japan.
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15
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Ramachandran N, Girard JM, Turnbull J, Minassian BA. The autosomal recessively inherited progressive myoclonus epilepsies and their genes. Epilepsia 2009; 50 Suppl 5:29-36. [DOI: 10.1111/j.1528-1167.2009.02117.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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16
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Erdos M, Hodanova K, Taskó S, Palicz A, Stolnaja L, Dvorakova L, Hrebicek M, Maródi L. Genetic and clinical features of patients with Gaucher disease in Hungary. Blood Cells Mol Dis 2007; 39:119-23. [PMID: 17395504 DOI: 10.1016/j.bcmd.2007.02.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2007] [Revised: 02/15/2007] [Accepted: 02/15/2007] [Indexed: 11/29/2022]
Abstract
The aim of this study was to identify mutations in the gene encoding for lysosomal beta-glucocerebrosidase (GBA; gene symbol, GBA) in Hungarian patients with Gaucher disease (GD), and to study genotype-phenotype relationships. Genotypes and allele variations in 27 patients with type I GD of 25 unrelated families were studied. Of the 54 mutant alleles, we detected 38 frequent (N370S, 22/54; RecNciI, 8/54; L444P, 8/54) and 9 rare (N188S, R257Q, R285C, G377S, R120W, T323I, 84GG, 1263-1317del and 1263-1317del/RecTL) mutations. In addition, we identified two novel mutations. The N370S/RecNciI genotype found in 8 patients and the N370S/L444P genotype found in 5 patients were the most frequent genotypes in this cohort. In 22 patients the mutations occurred in heterozygosity with the N370S sequence variant, and one patient was homozygous for the L444P mutation. These data suggest that N370S, RecNciI, and L444P are the most prevalent mutations in Hungarian patients with GD. This mutation profile is characteristic for a Caucasian (non-Jewish) population. The c.260G>A and c.999G>A missense mutations are described here for the first time in GD patients contributing to the panel of reported GBA mutations.
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Affiliation(s)
- Melinda Erdos
- Department of Infectious and Pediatric Immunology, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
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Kowarz L, Goker-Alpan O, Banerjee-Basu S, LaMarca ME, Kinlaw L, Schiffmann R, Baxevanis AD, Sidransky E. Gaucher mutation N188S is associated with myoclonic epilepsy. Hum Mutat 2005; 26:271-3; author reply 274-5. [PMID: 16086325 DOI: 10.1002/humu.20217] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The recent article by Montfort et al. [2004] reported a functional analysis of 13 glucocerebrosidase alleles, including mutation N188S, which they considered to be a "very mild mutation" or "modifier variant." Our clinical experience with patients carrying this mutation and preliminary protein modeling data lead us to dispute this conclusion.
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Montfort M, Chabás A, Vilageliu L, Grinberg D. A response to Kowarz et al.: Gaucher mutation c.680A>G (p.N227S) is associated with myoclonic epilepsy. Hum Mutat 2005. [DOI: 10.1002/humu.20218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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