1
|
Hung CL, Wu YW, Kuo L, Sung KT, Lin HH, Chang WT, Chang CH, Lai CH, Huang CY, Wang CL, Lin CC, Juang JMJ, Chen PS, Wang CY, Chang HC, Chu CY, Wang WH, Tseng H, Kao YT, Wang TD, Yu WC, Chen WJ. 2024 Update of the TSOC Expert Consensus of Fabry Disease. ACTA CARDIOLOGICA SINICA 2024; 40:544-568. [PMID: 39308653 PMCID: PMC11413953 DOI: 10.6515/acs.202409_40(5).20240731a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/14/2024] [Accepted: 07/31/2024] [Indexed: 09/25/2024]
Abstract
As an X-linked inherited lysosomal storage disease that is caused by α-galactosidase A gene variants resulting in progressive accumulation of pathogenic glycosphingolipid (Gb3) accumulation in multiple tissues and organs, Fabry disease (FD) can be classified into classic or late-onset phenotypes. In classic phenotype patients, α-galactosidase A activity is absent or severely reduced, resulting in a more progressive disease course with multi-systemic involvement. Conversely, late-onset phenotype, often with missense variants (e.g., IVS4+919G>A) in Taiwan, may present with a more chronic clinical course with predominant cardiac involvement (cardiac subtype), as they tend to have residual enzyme activity, remaining asymptomatic or clinically silent during childhood and adolescence. In either form, cardiac hypertrophy remains the most common feature of cardiac involvement, potentially leading to myocardial fibrosis, arrhythmias, and heart failure. Diagnosis is established through α-galactosidase enzyme activity assessment or biomarker analyisis (globotriaosylsphingosine, Lyso-Gb3), advanced imaging modalities (echocardiography and cardiac magnetic resonance imaging), and genotyping to differentiate FD from other cardiomyopathy. Successful therapeutic response relies on early recognition and by disease awareness from typical features in classic phenotype and cardiac red flags in cardiac variants for timely therapeutic interventions. Recent advances in pharmacological approach including enzyme replacement therapy (agalsidase alfa or beta), oral chaperone therapy (migalastat), and substrate reduction therapy (venglustat) aim to prevent from irreversible organ damage. Genotype- and gender-based monitoring of treatment effects through biomarker (Lyso-Gb3), renal assessment, and cardiac responses using advanced imaging modalities are key steps to optimizing patient care in FD.
Collapse
Affiliation(s)
- Chung-Lieh Hung
- Institute of Biomedical Sciences, MacKay Medical College, New Taipei City
- Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei
| | - Yen-Wen Wu
- Division of Cardiology, Cardiovascular Medical Center, and Department of Nuclear Medicine, Far Eastern Memorial Hospital, New Taipei City
- Department of Internal Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei
- Graduate Institute of Medicine, Yuan Ze University, Taoyuan
| | - Ling Kuo
- Department of Internal Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei
- Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei
| | - Kuo-Tzu Sung
- Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei
- Department of Medicine, MacKay Medical College
| | - Heng-Hsu Lin
- Division of Cardiology, Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City
| | - Wei-Ting Chang
- School of Medicine and Doctoral Program of Clinical and Experimental Medicine, College of Medicine and Center of Excellence for Metabolic Associated Fatty Liver Disease, National Sun Yat-sen University, Kaohsiung
- Division of Cardiology, Department of Internal Medicine, Chi Mei Medical Center, Tainan
| | - Chia-Hsiu Chang
- Division of Cardiology, Cardiovascular Center, Cathay General Hospital, Taipei
| | - Chih-Hung Lai
- Cardiovascular Center, Taichung Veterans General Hospital, Taichung
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University
| | - Chun-Yao Huang
- Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University
- Division of Cardiology, Department of Internal Medicine and Cardiovascular Research Center, Taipei Medical University Hospital
- Taipei Heart institute, Taipei Medical University, Taipei
| | - Chun-Li Wang
- Division of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan
| | - Chih-Chan Lin
- Division of Cardiology, Department of Internal Medicine, An Nan Hospital, China Medical University, Tainan
| | - Jyh-Ming Jimmy Juang
- Heart Failure Center and Division of Cardiology, Department of Internal Medicine, Center of Genetic Heart Diseases, National Taiwan University Hospital
- Department of Medicine, National Taiwan University College of Medicine, Taipei
| | - Po-Sheng Chen
- Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan
| | - Chao-Yung Wang
- Division of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan
- Institute of Cellular and System Medicine, National Health Research Institutes, Miaoli
- Department of Medical Science, National Tsing Hua University, Hsinchu
| | - Hao-Chih Chang
- Department of Internal Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei
- Department of Medicine, Taipei Veterans General Hospital Taoyuan Branch, Taoyuan
| | - Chun-Yuan Chu
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital
| | - Wen-Hwa Wang
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung
| | - Hsinyu Tseng
- Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu
| | - Yung-Ta Kao
- Division of Cardiology, Department of Internal Medicine and Cardiovascular Research Center, Taipei Medical University Hospital
- Taipei Heart institute, Taipei Medical University, Taipei
| | - Tzung-Dau Wang
- Department of Medicine, National Taiwan University College of Medicine, Taipei
- Division of Cardiology, Department of Internal Medicine, Min-Sheng General Hospital, Taoyuan
| | - Wen-Chung Yu
- Department of Internal Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Wen-Jone Chen
- Division of Cardiology, Department of Internal Medicine, Min-Sheng General Hospital, Taoyuan
| |
Collapse
|
2
|
Kugadas A, Artoni P, Ruangsiriluk W, Zhao M, Boukharov N, Islam R, Volfson D, Derakhchan K. Cardiac manifestations of Fabry disease in G3Stg/GlaKO and GlaKO mouse models-Translation to Fabry disease patients. PLoS One 2024; 19:e0304415. [PMID: 38820517 PMCID: PMC11142664 DOI: 10.1371/journal.pone.0304415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 05/11/2024] [Indexed: 06/02/2024] Open
Abstract
Fabry disease (FD) is an X-linked disorder of glycosphingolipid metabolism caused by mutations in the GLA gene encoding alpha-galactosidase A (α-Gal). Loss of α-Gal activity leads to progressive lysosomal accumulation of α-Gal substrate, predominately globotriaosylceramide (Gb3) and its deacylated derivative globotriaosylsphingosine (lyso-Gb3). FD manifestations include early onset neuropathic pain, gastrointestinal symptoms, and later onset life-threatening renal, cardiovascular and cerebrovascular disorders. Current treatments can preserve kidney function but are not very effective in preventing progression of cardiovascular pathology which remains the most common cause of premature death in FD patients. There is a significant need for a translational model that could be used for testing cardiac efficacy of new drugs. Two mouse models of FD have been developed. The α-Gal A-knockout (GlaKO) model is characterized by progressive tissue accumulation of Gb3 and lyso-Gb3 but does not develop any Fabry pathology besides mild peripheral neuropathy. Reports of minor cardiac function abnormalities in GlaKO model are inconsistent between different studies. Recently, G3Stg/GlaKO was generated by crossbreeding GlaKO with transgenic mice expressing human Gb3 synthase. G3Stg/GlaKO demonstrate higher tissue substrate accumulation and develop cellular and tissue pathologies. Functional renal pathology analogous to that found in early stages of FD has also been described in this model. The objective of this study is to characterize cardiac phenotype in GlaKO and G3Stg/GlaKO mice using echocardiography. Longitudinal assessments of cardiac wall thickness, mass and function were performed in GlaKO and wild-type (WT) littermate controls from 5-13 months of age. G3Stg/GlaKO and WT mice were assessed between 27-28 weeks of age due to their shortened lifespan. Several cardiomyopathy characteristics of early Fabry pathology were found in GlaKO mice, including mild cardiomegaly [up-to-25% increase in left ventricular (LV mass)] with no significant LV wall thickening. The LV internal diameter was significantly wider (up-to-24% increase at 9-months), when compared to the age-matched WT. In addition, there were significant increases in the end-systolic, end-diastolic volumes and stroke volume, suggesting volume overload. Significant reduction in Global longitudinal strain (GLS) measuring local myofiber contractility of the LV was also detected at 13-months. Similar GLS reduction was also reported in FD patients. Parameters such as ejection fraction, fractional shortening and cardiac output were either only slightly affected or were not different from controls. On the other hand, some of the cardiac findings in G3Stg/GlaKO mice were inconsistent with Fabry cardiomyopathy seen in FD patients. This could be potentially an artifact of the Gb3 synthase overexpression under a strong ubiquitous promoter. In conclusion, GlaKO mouse model presents mild cardiomegaly, mild cardiac dysfunction, but significant cardiac volume overload and functional changes in GLS that can be used as translational biomarkers to determine cardiac efficacy of novel treatment modalities. The level of tissue Gb3 accumulation in G3Stg/GlaKO mouse more closely recapitulates the level of substrate accumulation in FD patients and may provide better translatability of the efficacy of new therapeutics in clearing pathological substrates from cardiac tissues. But interpretation of the effect of treatment on cardiac structure and function in this model should be approached with caution.
Collapse
Affiliation(s)
- Abirami Kugadas
- Rare Diseases Drug Discovery Unit, Takeda Development Center Americas Inc., Cambridge, Massachusetts, United States of America
- Oncology and Immunology Unit, WuXi AppTec, Natick, Massachusetts, United States of America
| | - Pietro Artoni
- Statistical and Quantitative Sciences, Takeda Development Center Americas Inc., Cambridge, Massachusetts, United States of America
| | - Wanida Ruangsiriluk
- Rare Diseases Drug Discovery Unit, Takeda Development Center Americas Inc., Cambridge, Massachusetts, United States of America
- Crosswalk Therapeutics, Cambridge, Massachusetts, United States of America
| | - Meng Zhao
- Statistical and Quantitative Sciences, Takeda Development Center Americas Inc., Cambridge, Massachusetts, United States of America
| | - Natalia Boukharov
- Rare Diseases Drug Discovery Unit, Takeda Development Center Americas Inc., Cambridge, Massachusetts, United States of America
- Crosswalk Therapeutics, Cambridge, Massachusetts, United States of America
| | - Rizwana Islam
- Rare Diseases Drug Discovery Unit, Takeda Development Center Americas Inc., Cambridge, Massachusetts, United States of America
- Crosswalk Therapeutics, Cambridge, Massachusetts, United States of America
| | - Dmitri Volfson
- Statistical and Quantitative Sciences, Takeda Development Center Americas Inc., Cambridge, Massachusetts, United States of America
| | - Katayoun Derakhchan
- Rare Diseases Drug Discovery Unit, Takeda Development Center Americas Inc., Cambridge, Massachusetts, United States of America
- Pioneering Medicines at Flagship Pioneering, Cambridge, Massachusetts, United States of America
| |
Collapse
|
3
|
Miller JJ, Kanack AJ, Dahms NM. Progress in the understanding and treatment of Fabry disease. Biochim Biophys Acta Gen Subj 2019; 1864:129437. [PMID: 31526868 DOI: 10.1016/j.bbagen.2019.129437] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 09/10/2019] [Accepted: 09/12/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Fabry disease is caused by α-galactosidase A deficiency. Substrates of this lysosomal enzyme accumulate, resulting in cellular dysfunction. Patients experience neuropathic pain, kidney failure, heart disease, and strokes. SCOPE OF REVIEW The clinical picture and molecular features of Fabry disease are described, along with updates on disease mechanisms, animal models, and therapies. MAJOR CONCLUSIONS How the accumulation of α-galactosidase A substrates, mainly glycosphingolipids, leads to organ damage is incompletely understood. Enzyme replacement and chaperone therapies are clinically available to patients, while substrate reduction, mRNA-based, and gene therapies are on the horizon. Animal models exist to optimize these therapies and elucidate disease mechanisms for novel treatments. GENERAL SIGNIFICANCE Recent newborn screening studies demonstrate that Fabry disease is the most common lysosomal storage disease. As many countries now include Fabry disease in their screening panels, the number of identified patients is expected to increase significantly. Better knowledge of disease pathogenesis is needed to improve treatment options.
Collapse
Affiliation(s)
- James J Miller
- Department of Biochemistry, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Adam J Kanack
- Department of Biochemistry, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Nancy M Dahms
- Department of Biochemistry, Medical College of Wisconsin, Milwaukee, WI, United States of America.
| |
Collapse
|
4
|
Miller JJ, Aoki K, Mascari CA, Beltrame AK, Sokumbi O, North PE, Tiemeyer M, Kriegel AJ, Dahms NM. α-Galactosidase A-deficient rats accumulate glycosphingolipids and develop cardiorenal phenotypes of Fabry disease. FASEB J 2018; 33:418-429. [PMID: 29979634 DOI: 10.1096/fj.201800771r] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Fabry disease is an X-linked lysosomal storage disease caused by α-galactosidase A (α-Gal A) deficiency. Kidney and heart failure are frequent complications in adulthood and greatly contribute to patient morbidity and mortality. Because α-Gal A-deficient mouse models do not recapitulate cardiorenal findings observed in patients, a nonmouse model may be beneficial to our understanding of disease pathogenesis. In this study, we evaluated disease processes in a recently generated Fabry rat model. We found that male Fabry rats weighed significantly less than wild-type (WT) males, whereas female Fabry rats weighed significantly more than WT females. Whereas no difference in female survival was detected, we observed that male Fabry rats had a decreased lifespan. Skin histology revealed that inflammation and lipoatrophy may be chief disease mediators in patients. With respect to the kidney and heart, we found that both organs accumulate α-Gal A substrates, including the established biomarkers, globotriaosylceramide and globotriaosylsphingosine. Longitudinal serum and urine chemistry panels demonstrated pronounced renal tubule dysfunction, which was confirmed histologically. Mitral valve thickening was observed in Fabry rats using echocardiography. We conclude that Fabry rats recapitulate important kidney and heart phenotypes experienced by patients and can be further used to study disease mechanisms and test therapies.-Miller, J. J., Aoki, K., Mascari, C. A., Beltrame, A. K., Sokumbi, O., North, P. E., Tiemeyer, M., Kriegel, A. J., Dahms, N. M., α-Galactosidase A-deficient rats accumulate glycosphingolipids and develop cardiorenal phenotypes of Fabry disease.
Collapse
Affiliation(s)
- James J Miller
- Department of Biochemistry, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Kazuhiro Aoki
- Complex Carbohydrate Research Center, University of Georgia, Athens, Georgia, USA
| | - Carly A Mascari
- Department of Biochemistry, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Angela K Beltrame
- Department of Biochemistry, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Olayemi Sokumbi
- Department of Dermatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Paula E North
- Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA; and
| | - Michael Tiemeyer
- Complex Carbohydrate Research Center, University of Georgia, Athens, Georgia, USA
| | - Alison J Kriegel
- Department of Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Nancy M Dahms
- Department of Biochemistry, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| |
Collapse
|
5
|
Shen JS, Arning E, West ML, Day TS, Chen S, Meng XL, Forni S, McNeill N, Goker-Alpan O, Wang X, Ashcraft P, Moore DF, Cheng SH, Schiffmann R, Bottiglieri T. Tetrahydrobiopterin deficiency in the pathogenesis of Fabry disease. Hum Mol Genet 2017; 26:1182-1192. [PMID: 28158561 DOI: 10.1093/hmg/ddx032] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 01/19/2017] [Indexed: 02/07/2023] Open
Abstract
Fabry disease is caused by deficient activity of α-galactosidase A and subsequent accumulation of glycosphingolipids (mainly globotriaosylceramide, Gb3), leading to multisystem organ dysfunction. Oxidative stress and nitric oxide synthase (NOS) uncoupling are thought to contribute to Fabry cardiovascular diseases. We hypothesized that decreased tetrahydrobiopterin (BH4) plays a role in the pathogenesis of Fabry disease. We found that BH4 was decreased in the heart and kidney but not in the liver and aorta of Fabry mice. BH4 was also decreased in the plasma of female Fabry patients, which was not corrected by enzyme replacement therapy (ERT). Gb3 levels were inversely correlated with BH4 levels in animal tissues and cultured patient cells. To investigate the role of BH4 deficiency in disease phenotypes, 12-month-old Fabry mice were treated with gene transfer-mediated ERT or substrate reduction therapy (SRT) for 6 months. In the Fabry mice receiving SRT but not ERT, BH4 deficiency was restored, concomitant with ameliorated cardiac and renal hypertrophy. Additionally, glutathione levels were decreased in Fabry mouse tissues in a sex-dependent manner. Renal BH4 levels were closely correlated with glutathione levels and inversely correlated with cardiac and kidney weight. In conclusion, this study showed that BH4 deficiency occurs in Fabry disease and may contribute to the pathogenesis of the disease through oxidative stress associated with a reduced antioxidant capacity of cells and NOS uncoupling. This study also suggested dissimilar efficacy of ERT and SRT in correcting pre-existing pathologies in Fabry disease.
Collapse
Affiliation(s)
- Jin-Song Shen
- Institute of Metabolic Disease, Baylor Research Institute, Dallas, TX 75226, USA
| | - Erland Arning
- Institute of Metabolic Disease, Baylor Research Institute, Dallas, TX 75226, USA
| | - Michael L West
- Division of Nephrology, Department of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Taniqua S Day
- Institute of Metabolic Disease, Baylor Research Institute, Dallas, TX 75226, USA
| | | | - Xing-Li Meng
- Institute of Metabolic Disease, Baylor Research Institute, Dallas, TX 75226, USA
| | - Sabrina Forni
- Institute of Metabolic Disease, Baylor Research Institute, Dallas, TX 75226, USA
| | - Nathan McNeill
- Institute of Metabolic Disease, Baylor Research Institute, Dallas, TX 75226, USA
| | - Ozlem Goker-Alpan
- Lysosomal and Rare Disorders Research and Treatment Center, Fairfax, VA, USA
| | - Xuan Wang
- Baylor Research Institute, Dallas, TX, USA
| | - Paula Ashcraft
- Institute of Metabolic Disease, Baylor Research Institute, Dallas, TX 75226, USA
| | - David F Moore
- Sanford Health and University of North Dakota, Fargo, ND, USA
| | | | - Raphael Schiffmann
- Institute of Metabolic Disease, Baylor Research Institute, Dallas, TX 75226, USA
| | - Teodoro Bottiglieri
- Institute of Metabolic Disease, Baylor Research Institute, Dallas, TX 75226, USA
| |
Collapse
|
6
|
Relative distribution of Gb3 isoforms/analogs in NOD/SCID/Fabry mice tissues determined by tandem mass spectrometry. Bioanalysis 2016; 8:1793-807. [PMID: 27523577 DOI: 10.4155/bio-2016-0116] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
AIM Fabry disease is a lysosomal storage disorder leading to glycosphingolipid accumulation in different organs, tissues and biological fluids. The development of a Fabry disease gene therapy trial is underway in Canada. A tool to determine the distribution of Gb3 biomarkers in tissues of Fabry mice might be applicable to monitor the effect of gene therapy. Results & methodology: An ultra-performance LC-MS/MS (UPLC-MS/MS) method for the analysis of 22 Gb3 isoform/analogs in various Fabry mice tissues was developed and validated. Marked variation in biomarker organ distribution was found with higher levels in the spleen, followed by the small intestine, kidneys, lungs, heart, liver and brain. CONCLUSION The devised method is sensitive and useful for the evaluation of biomarker profiles in Fabry mice.
Collapse
|
7
|
Sanagawa A, Iwaki S, Asai M, Sakakibara D, Norimoto H, Sobel BE, Fujii S. Sphingosine 1‑phosphate induced by hypoxia increases the expression of PAI‑1 in HepG2 cells via HIF‑1α. Mol Med Rep 2016; 14:1841-8. [PMID: 27357063 DOI: 10.3892/mmr.2016.5451] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 05/23/2016] [Indexed: 11/06/2022] Open
Abstract
Our group has recently reported that in the immortal human HepG2 liver cell line, sphingosine 1‑phosphate (S1P) increases transcription of plasminogen activator inhibitor type‑1 (PAI‑1), the major physiological inhibitor of fibrinolysis, within 4 h. The present study aimed to elucidate the molecular mechanisms underlying this effect. PAI‑1 expression was measured by reverse transcription‑quantitative polymerase chain reaction and immunoblotting. It was demonstrated that S1P increased PAI‑1 promoter activity but did not increase the activity of promoters lacking the hypoxia responsive element (HRE) 2. In addition, S1P transiently increased the concentration of hypoxia inducible factor (HIF)‑1α, a transcription factor capable of binding to HRE. When HIF‑1α was knocked down, the induction of transcription of PAI‑1 by S1P was no longer observed. Sphingosine kinase (SPHK) activity is increased by hypoxia. It was demonstrated that increases in the concentration of the HIF‑1α protein induced by hypoxia were prevented by treatment with SPHK inhibitor or S1P receptor antagonists. Thus, modification of the induction of HIF‑1α by S1P, leading to increased transcription of PAI‑1, may be an attractive therapeutic target for thrombosis and consequent inhibition of fibrinolysis associated with hypoxia.
Collapse
Affiliation(s)
- Akimasa Sanagawa
- Department of Molecular and Cellular Pathobiology and Therapeutics, Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya, Aichi 467‑8603, Japan
| | - Soichiro Iwaki
- Department of Molecular and Cellular Pathobiology and Therapeutics, Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya, Aichi 467‑8603, Japan
| | - Moyoko Asai
- Department of Molecular and Cellular Pathobiology and Therapeutics, Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya, Aichi 467‑8603, Japan
| | - Daisuke Sakakibara
- Department of Molecular and Cellular Pathobiology and Therapeutics, Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya, Aichi 467‑8603, Japan
| | - Hiroaki Norimoto
- Department of Molecular and Cellular Pathobiology and Therapeutics, Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya, Aichi 467‑8603, Japan
| | - Burton E Sobel
- Cardiovascular Research Institute, University of Vermont, Colchester, VT 05446, USA
| | - Satoshi Fujii
- Department of Molecular and Cellular Pathobiology and Therapeutics, Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya, Aichi 467‑8603, Japan
| |
Collapse
|
8
|
|
9
|
Zigdon H, Meshcheriakova A, Futerman AH. From sheep to mice to cells: Tools for the study of the sphingolipidoses. Biochim Biophys Acta Mol Cell Biol Lipids 2014; 1841:1189-99. [DOI: 10.1016/j.bbalip.2014.02.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Revised: 02/24/2014] [Accepted: 02/25/2014] [Indexed: 12/12/2022]
|
10
|
Porubsky S, Jennemann R, Lehmann L, Gröne HJ. Depletion of globosides and isoglobosides fully reverts the morphologic phenotype of Fabry disease. Cell Tissue Res 2014; 358:217-27. [PMID: 24992926 PMCID: PMC4186980 DOI: 10.1007/s00441-014-1922-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 05/15/2014] [Indexed: 12/02/2022]
Abstract
Fabry disease is a monogenic X-linked lysosomal storage disease caused by α-galactosidase A (αGalA) deficiency. Enzyme replacement therapy through administration of the missing αGalA is currently the only accepted therapeutic option. However, this treatment is connected to high costs, has ill-defined indication criteria and its efficacy is controversially discussed. Our aim was to explore the possibility of a novel targeted substrate reduction therapy for Fabry disease. Owing to the fact that αGalA-deficient humans and mice accumulate the same glycosphingolipids (i.e. globosides, galabiosylceramide and isoglobosides), αGalA-deficient mice were crossed with mice deficient in enzymes synthesizing these classes of glycosphingolipids (i.e. globotrihexosylceramide and isoglobotrihexosylceramide synthase, respectively). Functional heart and kidney tests were performed together with an extensive biochemical analysis of urine and serum in aged mice. Lysosomal storage was assessed by thin layer chromatography and electron microscopy. We showed that depletion of globosides was sufficient to fully abolish the storage of glycosphingolipids in heart, kidney and liver and was paralleled by a complete restoration of lysosomal morphology in these organs. In contrast, in dorsal root ganglia, a depletion of both globosides and isoglobosides was necessary to fully counteract the lysosomal storage. The deficiency in globosides and/or isoglobosides did not cause any adverse effects. We conclude that substrate reduction therapy through inhibition of the synthesis of globosides and isoglobosides represents a valuable therapeutic option for Fabry disease, all the more as globosides and isoglobosides seem to be dispensable.
Collapse
Affiliation(s)
- Stefan Porubsky
- Department of Cellular and Molecular Pathology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany,
| | | | | | | |
Collapse
|
11
|
Madonna R, Cevik C, Cocco N. Multimodality imaging for pre-clinical assessment of Fabry's cardiomyopathy. Eur Heart J Cardiovasc Imaging 2014; 15:1094-100. [PMID: 24904036 DOI: 10.1093/ehjci/jeu080] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Anderson Fabry's disease (AFD) is a rare but underdiagnosed intracellular lipid disorder which can cause left ventricular hypertrophy (LVH). Pre-clinical diagnosis of Fabry's disease is important as it permits early stratification for enzyme replacement therapy, improving the patient's long-term prognosis, avoiding progression to irreversible fibrosis, and preventing cardiovascular complications. Combinations of imaging modalities that integrate the strengths of each modality and at the same time eliminate weaknesses of an individual modality can offer improved diagnostics, therapeutic monitoring, and pre-clinical assessment of Fabry's disease. This review discusses the advantages and challenges in developing multimodality imaging systems of Fabry's cardiomyopathy, highlights some successful combinations that are now routinely used in the clinic and in research, and discusses recent advances in multimodality instrumentation that may offer new opportunities for pre-clinical assessment of this disease.
Collapse
Affiliation(s)
- Rosalinda Madonna
- Texas Heart Institute and St Luke's Episcopal Hospital, Houston, TX, USA Institute of Cardiology, 'G. D'Annunzio' University, Chieti, C/o Ospedale SS. Annunziata, Via dei Vestini, 66013 Chieti, Italy
| | - Cihan Cevik
- Texas Heart Institute and St Luke's Episcopal Hospital, Houston, TX, USA
| | - Nino Cocco
- Department Cuore e Grossi Vasi Attilio Reale, Sapienza University in Rome, Policlinico Umberto I, Rome, Italy
| |
Collapse
|
12
|
Pastores GM, Torres PA, Zeng BJ. Animal models for lysosomal storage disorders. BIOCHEMISTRY (MOSCOW) 2014; 78:721-5. [PMID: 24010835 DOI: 10.1134/s0006297913070043] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The lysosomal storage disorders (LSD) represent a heterogeneous group of inherited diseases characterized by the accumulation of non-metabolized macromolecules (by-products of cellular turnover) in different tissues and organs. LSDs primarily develop as a consequence of a deficiency in a lysosomal hydrolase or its co-factor. The majority of these enzymes are glycosidases and sulfatases, which in normal conditions participate in degradation of glycoconjugates: glycoproteins, glycosaminoproteoglycans, and glycolipids. Significant insights have been gained from studies of animal models, both in understanding mechanisms of disease and in establishing proof of therapeutic concept. These studies have led to the introduction of therapy for certain LSD subtypes, primarily by enzyme replacement or substrate reduction therapy. Animal models have been useful in elucidating molecular changes, particularly prior to onset of symptoms. On the other hand, it should be noted certain animal (mouse) models may have the underlying biochemical defect, but not show the course of disease observed in human patients. There is interest in examining therapeutic options in the larger spontaneous animal models that may more closely mimic the brain size and pathology of humans. This review will highlight lessons learned from studies of animal models of disease, drawing primarily from publications in 2011-2012.
Collapse
Affiliation(s)
- G M Pastores
- Neurogenetics, Department of Neurology, New York University School of Medicine, New York, NY 10016, USA.
| | | | | |
Collapse
|
13
|
Nelson MP, Tse TE, O’Quinn DB, Percival SM, Jaimes EA, Warnock DG, Shacka JJ. Autophagy-lysosome pathway associated neuropathology and axonal degeneration in the brains of alpha-galactosidase A-deficient mice. Acta Neuropathol Commun 2014; 2:20. [PMID: 24529306 PMCID: PMC3933238 DOI: 10.1186/2051-5960-2-20] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Accepted: 02/01/2014] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Mutations in the gene for alpha-galactosidase A result in Fabry disease, a rare, X-linked lysosomal storage disorder characterized by a loss of alpha-galactosidase A enzymatic activity. The resultant accumulation of glycosphingolipids throughout the body leads to widespread vasculopathy with particular detriment to the kidneys, heart and nervous system. Disruption in the autophagy-lysosome pathway has been documented previously in Fabry disease but its relative contribution to nervous system pathology in Fabry disease is unknown. Using an experimental mouse model of Fabry disease, alpha-galactosidase A deficiency, we examined brain pathology in 20-24 month old mice with particular emphasis on the autophagy-lysosome pathway. RESULTS Alpha-galactosidase A-deficient mouse brains exhibited enhanced punctate perinuclear immunoreactivity for the autophagy marker microtubule-associated protein light-chain 3 (LC3) in the parenchyma of several brain regions, as well as enhanced parenchymal and vascular immunoreactivity for lysosome-associated membrane protein-1 (LAMP-1). Ultrastructural analysis revealed endothelial cell inclusions with electron densities and a pronounced accumulation of electron-dense lipopigment. The pons of alpha-galactosidase A-deficient mice in particular exhibited a striking neuropathological phenotype, including the presence of large, swollen axonal spheroids indicating axonal degeneration, in addition to large interstitial aggregates positive for phosphorylated alpha-synuclein that co-localized with the axonal spheroids. Double-label immunofluorescence revealed co-localization of phosphorylated alpha-synuclein aggregates with ubiquitin and LC3. CONCLUSION Together these findings indicate widespread neuropathology and focused axonal neurodegeneration in alpha-galactosidase A-deficient mouse brain in association with disruption of the autophagy-lysosome pathway, and provide the basis for future mechanistic assessment of the contribution of the autophagy-lysosome pathway to this histologic phenotype.
Collapse
Affiliation(s)
- Michael P Nelson
- />Department Pathology, Neuropathology Division, University of Alabama at Birmingham, Birmingham, AL USA
| | - Tonia E Tse
- />Department Pathology, Neuropathology Division, University of Alabama at Birmingham, Birmingham, AL USA
- />Birmingham VA Medical Center, Birmingham, AL USA
| | - Darrel B O’Quinn
- />Department Pathology, Anatomic Pathology Division, University of Alabama at Birmingham, Birmingham, AL USA
| | - Stefanie M Percival
- />Department Pharmacology and Toxicology, University of Alabama at Birmingham, Birmingham, AL USA
| | - Edgar A Jaimes
- />Birmingham VA Medical Center, Birmingham, AL USA
- />Department Medicine, Nephrology Division, University of Alabama at Birmingham, Birmingham, AL USA
| | - David G Warnock
- />Department Medicine, Nephrology Division, University of Alabama at Birmingham, Birmingham, AL USA
| | - John J Shacka
- />Department Pathology, Neuropathology Division, University of Alabama at Birmingham, Birmingham, AL USA
- />Birmingham VA Medical Center, Birmingham, AL USA
| |
Collapse
|
14
|
Coats CJ, Parisi V, Ramos M, Janagarajan K, O'Mahony C, Dawnay A, Lachmann RH, Murphy E, Mehta A, Hughes D, Elliott PM. Role of serum N-terminal pro-brain natriuretic peptide measurement in diagnosis of cardiac involvement in patients with anderson-fabry disease. Am J Cardiol 2013; 111:111-7. [PMID: 23040658 DOI: 10.1016/j.amjcard.2012.08.055] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Revised: 08/20/2012] [Accepted: 08/20/2012] [Indexed: 10/27/2022]
Abstract
Enzyme replacement therapy has the potential to delay or reverse adverse cardiac remodeling in Anderson-Fabry disease (AFD); however, the current indications for enzyme replacement therapy rely on detecting relatively advanced features of the disease. We aimed to determine the relation between the serum N-terminal pro-brain natriuretic peptide (NT-proBNP) concentration and cardiac abnormalities in patients with AFD. We hypothesized that it might help to detect early disease. NT-proBNP was measured under at rest conditions in 117 patients with AFD (age 48 ± 15 years, 46.2% men). All patients underwent clinical evaluation with electrocardiography and echocardiography. The median NT-proBNP concentration was 24 pmol/L (range <5 to 6,059). Of the 117 patients, 67 (57%) had elevated, age-corrected, NT-proBNP levels. In the 56 patients (48%) with normal echocardiographic findings, the NT-proBNP levels were greater than the age-predicted cutoffs in 10 of 25 patients with abnormal electrocardiographic findings and 3 of 31 patients with normal electrocardiographic findings (p <0.05). On multiple regression analysis, age, creatinine, left atrial volume index, E/Ea, and the presence of abnormal electrocardiographic findings were independently associated with log NT-proBNP (R(2) = 0.67, p <0.05). In conclusion, NT-proBNP concentrations were elevated in patients with AFD and early cardiac involvement, suggesting its measurement could assist in decisions regarding the timing of enzyme replacement therapy.
Collapse
|