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Martín-Jiménez P, Bermejo-Guerrero L, Hernandez-Voth A, Arteche-López A, Hernández-Lain A, Rabasa M, Domínguez-González C. Adult Pompe disease: Analysis of 13 patients. Med Clin (Barc) 2024:S0025-7753(24)00399-3. [PMID: 39155212 DOI: 10.1016/j.medcli.2024.05.022] [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: 03/25/2024] [Revised: 05/16/2024] [Accepted: 05/16/2024] [Indexed: 08/20/2024]
Abstract
INTRODUCTION Pompe Disease (PD) is a lysosomal disorder caused by a deficiency of the enzyme acid alpha-glucosidase (GAA), primarily manifesting as a progressive myopathy with early respiratory involvement. Enzyme replacement therapy (ERT) is available since 2006. MATERIALS AND METHODS We describe 13 patients with partial GAA deficiency, followed at Hospital 12 de Octubre, 8 of whom were receiving treatment. RESULTS 8 patients exhibit symptoms, all with late onset. They display axial and proximal weakness predominantly in the lower limbs but maintain autonomous gait. Five patients require non-invasive mechanical ventilation due to respiratory insufficiency. All symptomatic patients receive ERT, and in 7/8 (87.5%), there is a decline in motor and pulmonary function after an average of 8.25 years of treatment (baseline and post-treatment FVC and 6MWT mean 86.6% vs 70.8% and 498 vs 430 meters, respectively). CONCLUSION Not all patients with partial GAA deficiency experience symptoms of PD, and symptomatic patients, despite ERT with recombinant alpha-glucosidase, mostly experience a gradual decline in motor and respiratory function.
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Affiliation(s)
- Paloma Martín-Jiménez
- Unidad de Enfermedades Neuromusculares, Servicio de Neurología, Hospital Universitario 12 de Octubre, Madrid, España
| | - Laura Bermejo-Guerrero
- Unidad de Enfermedades Neuromusculares, Servicio de Neurología, Hospital Universitario 12 de Octubre, Madrid, España; Grupo de Investigación de Enfermedades metabólicas, mitocondriales y neuromusculares, Instituto de Investigación imas12, Hospital 12 de Octubre, Madrid, España
| | - Ana Hernandez-Voth
- Servicio de Neumología, Hospital Universitario 12 de Octubre, Madrid, España
| | - Ana Arteche-López
- Grupo de Investigación de Enfermedades metabólicas, mitocondriales y neuromusculares, Instituto de Investigación imas12, Hospital 12 de Octubre, Madrid, España; Servicio de Genética, Hospital Universitario 12 de Octubre, Madrid, España
| | - Aurelio Hernández-Lain
- Servicio de Anatomía Patológica, Sección de Neuropatología, Hospital Universitario 12 de Octubre, Madrid, España
| | - María Rabasa
- Servicio de Neurología, Hospital de Fuenlabrada, Fuenlabrada, Madrid, España
| | - Cristina Domínguez-González
- Unidad de Enfermedades Neuromusculares, Servicio de Neurología, Hospital Universitario 12 de Octubre, Madrid, España; Grupo de Investigación de Enfermedades metabólicas, mitocondriales y neuromusculares, Instituto de Investigación imas12, Hospital 12 de Octubre, Madrid, España; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, España.
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Martinez-Marin RJ, Reyes-Leiva D, Nascimento A, Muelas N, Dominguez-González C, Paradas C, Olivé M, García-Romero M, Pascual-Pascual SI, Grau JM, Barba-Romero MA, Gomez-Caravaca MT, de Las Heras J, Casquero P, Mendoza MD, de León JC, Gutierrez A, Morís G, Blanco-Lago R, Ramos-Fransi A, Pintós G, García-Antelo MJ, Rabasa M, Morgado Y, Usón M, Miralles FJ, Bárcena-Llona JE, Gómez-Belda AB, Pedraza-Hueso MI, Hortelano M, Colomé A, Garcia-Martin G, Lopez de Munain A, Jericó I, Galán-Dávila L, Pardo J, Salgueiro-Origlia G, Alonso-Pérez J, Pla-Junca F, Schiava M, Segovia-Simón S, Díaz-Manera J. Description of clinical and genetic features of 122 patients included in the Spanish Pompe registry. Neuromuscul Disord 2024; 34:1-8. [PMID: 38087756 DOI: 10.1016/j.nmd.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 10/06/2023] [Accepted: 10/08/2023] [Indexed: 12/26/2023]
Abstract
Pompe disease is a rare genetic disorder with an estimated prevalence of 1:60.000. The two main phenotypes are Infantile Onset Pompe Disease (IOPD) and Late Onset Pompe Disease (LOPD). There is no published data from Spain regarding the existing number of cases, regional distribution, clinical features or, access and response to the treatment. We created a registry to collect all these data from patients with Pompe in Spain. Here, we report the data of the 122 patients registered including nine IOPD and 113 LOPD patients. There was a high variability in how the diagnosis was obtained and how the follow-up was performed among different centres. Seven IOPD patients were still alive being all treated with enzymatic replacement therapy (ERT) at last visit. Ninety four of the 113 LOPD patients had muscle weakness of which 81 were receiving ERT. We observed a progressive decline in the results of muscle function tests during follow-up. Overall, the Spanish Pompe Registry is a valuable resource for understanding the demographics, patient's journey and clinical characteristics of patients in Spain. Our data supports the development of agreed guidelines to ensure that the care provided to the patients is standardized across the country.
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Affiliation(s)
- Rafael Jenaro Martinez-Marin
- NeuService, Hospital La Paz Institute for Health Research - IdiPAZ (La Paz University Hospital - Universidad Autónoma de Madrid, Madrid, Spain
| | - David Reyes-Leiva
- Institut de Recerca Biomedica Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; CIBERER, Spain
| | - Andrés Nascimento
- Servicio de Neuropediatría, CIBERER, ERN-NMD, Hospital Sant Joan de Deu, Esplugues de Llobregat, Barcelona, Spain
| | - Nuria Muelas
- CIBERER, Spain; Neurology Service, Hospital La Fe de Valencia, Valencia, Spain
| | - C Dominguez-González
- CIBERER, Spain; Neurology Service, Hospital 12 de Octubre, imas12 Research Institute, ERN-NMD, Madrid, Spain
| | - Carmen Paradas
- Neurology Service, Hospital Virgen del Rocío, Sevilla, Spain
| | - Montse Olivé
- Institut de Recerca Biomedica Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; CIBERER, Spain; Neuromuscular Diseases Unit, Neurology Service, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Mar García-Romero
- Neuropaediatrics Service, Hospital Universitario La Paz, Madrid, Spain
| | | | - Josep Maria Grau
- Internal Medicine Service, Hospital Clínic de Barcelona, Barcelona, Spain
| | | | | | - Javier de Las Heras
- Division of Pediatric Metabolism at Cruces University Hospital, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), European Reference Network for Hereditary Metabolic Disorders (MetabERN), Biocruces-Bizkaia Health Research Institute and University of the Basque Country (UPV/EHU), Barakaldo, Spain
| | - Pilar Casquero
- Neurology Service, Hospital Mateu Orfila, Menorca, Spain
| | | | - Juan Carlos de León
- Neurology Service, Hospital Universitario Nuestra Señora de la Candelaria, Tenerife, Spain
| | | | - Germán Morís
- Neurology Service, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Raquel Blanco-Lago
- Paediatrics Service, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Alba Ramos-Fransi
- Neurology Service, Hospital Universitario Germans Trias i Pujol, Badalona, Spain
| | - Guillem Pintós
- Internal Medicine Service, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | | | - Maria Rabasa
- Neurology Service, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | - Mercedes Usón
- Neurology Service, Hospital Universitario Son Llatzer, Palma de Mallorca, Spain
| | | | | | | | | | - Miryam Hortelano
- Paediatric Service, Hospital Universitario de Segovia, Segovia Spain
| | - Antoni Colomé
- Internal Medicine Service, Hospital de Terrassa, Barcelona, Spain
| | | | - Adolfo Lopez de Munain
- Neurology Service, Instituto Biodonostia-CIBERNED-EHU-UPV, Hospital Universitario Donostia-OSAKIDETZA, Spain
| | - Ivonne Jericó
- Neurology Service, Complejo Hospitalario de Navarra, Spain
| | - Lucía Galán-Dávila
- Neurology Service, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Julio Pardo
- Neurology Service, Hospital Universitario de Santiago de Compostela, Santiago de Compostela. Spain
| | - Giorgina Salgueiro-Origlia
- Internal Medicine Service, Hospital La Paz Institute for Health Research - IdiPAZ (La Paz University Hospital, Universidad Autónoma de Madrid, Spain
| | - Jorge Alonso-Pérez
- Institut de Recerca Biomedica Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; CIBERER, Spain
| | - Francesc Pla-Junca
- Institut de Recerca Biomedica Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; CIBERER, Spain
| | - Marianela Schiava
- John Walton Muscular Distrophy Research Center, Newcastle University, UK
| | - Sonia Segovia-Simón
- Institut de Recerca Biomedica Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; CIBERER, Spain
| | - Jordi Díaz-Manera
- Institut de Recerca Biomedica Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; CIBERER, Spain; John Walton Muscular Distrophy Research Center, Newcastle University, UK.
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Gómez-Cebrián N, Gras-Colomer E, Poveda Andrés JL, Pineda-Lucena A, Puchades-Carrasco L. Omics-Based Approaches for the Characterization of Pompe Disease Metabolic Phenotypes. BIOLOGY 2023; 12:1159. [PMID: 37759559 PMCID: PMC10525434 DOI: 10.3390/biology12091159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/17/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023]
Abstract
Lysosomal storage disorders (LSDs) constitute a large group of rare, multisystemic, inherited disorders of metabolism, characterized by defects in lysosomal enzymes, accessory proteins, membrane transporters or trafficking proteins. Pompe disease (PD) is produced by mutations in the acid alpha-glucosidase (GAA) lysosomal enzyme. This enzymatic deficiency leads to the aberrant accumulation of glycogen in the lysosome. The onset of symptoms, including a variety of neurological and multiple-organ pathologies, can range from birth to adulthood, and disease severity can vary between individuals. Although very significant advances related to the development of new treatments, and also to the improvement of newborn screening programs and tools for a more accurate diagnosis and follow-up of patients, have occurred over recent years, there exists an unmet need for further understanding the molecular mechanisms underlying the progression of the disease. Also, the reason why currently available treatments lose effectiveness over time in some patients is not completely understood. In this scenario, characterization of the metabolic phenotype is a valuable approach to gain insights into the global impact of lysosomal dysfunction, and its potential correlation with clinical progression and response to therapies. These approaches represent a discovery tool for investigating disease-induced modifications in the complete metabolic profile, including large numbers of metabolites that are simultaneously analyzed, enabling the identification of novel potential biomarkers associated with these conditions. This review aims to highlight the most relevant findings of recently published omics-based studies with a particular focus on describing the clinical potential of the specific metabolic phenotypes associated to different subgroups of PD patients.
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Affiliation(s)
- Nuria Gómez-Cebrián
- Drug Discovery Unit, Instituto de Investigación Sanitaria La Fe, 46026 Valencia, Spain
| | - Elena Gras-Colomer
- Pharmacy Department, Hospital Manises of Valencia, 46940 Valencia, Spain
| | | | - Antonio Pineda-Lucena
- Molecular Therapeutics Program, Centro de Investigación Médica Aplicada, 31008 Pamplona, Spain
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