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Doerr A, Farooq M, Faulkner C, Gould R, Perry K, Pulikottil-Jacob R, Rajasekhar P. Diagnostic odyssey for patients with acid sphingomyelinase deficiency (ASMD): Exploring the potential indicators of diagnosis using quantitative and qualitative data. Mol Genet Metab Rep 2024; 38:101052. [PMID: 38469089 PMCID: PMC10926222 DOI: 10.1016/j.ymgmr.2024.101052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 01/08/2024] [Indexed: 03/13/2024] Open
Abstract
Acid sphingomyelinase deficiency (ASMD) is a rare, progressive, and potentially fatal lysosomal storage disease. This two-part international study aimed to understand physician, patient, and caregivers' experiences during the ASMD diagnostic journey. Qualitative interviews were conducted with patients with ASMD type B or A/B, caregivers (for patients <18 years), and physicians (January 2018-May 2019). A quantitative patient chart review was then performed by physicians (1-3 charts per physician) (April to May 2020). Overall, 12 physicians and 27 patients (self-reported, n = 11; caregiver-reported, n = 16) completed qualitative interviews. Symptoms first presented at approximately 2 years, with physician visits 2 months-1 year later. On average, diagnosis took 3 years and average age at diagnosis was 5 years. During childhood, all patients reported abdominal enlargement and 67% had respiratory issues. Adult patients frequently reported fatigue (64%) and heart problems (36%). In the quantitative study, 86 physicians reviewed 193 ASMD patient charts. At initial presentation, most patients reported abdominal enlargement (pediatric, 55%; adolescents/adults, 39%). Time to diagnosis ranged 0-10 years for patients with ASMD type A/B or type B, and most patients (85%) received an incorrect initial diagnosis. Diagnosis of ASMD can be challenging, and is often delayed due to disease heterogeneity and misdiagnoses.
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Affiliation(s)
- Andrew Doerr
- Fulcrum Research Group, Waltham, MA, United States
| | | | | | | | - Krista Perry
- Trinity Life Sciences, Waltham, MA, United States
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Pulikottil-Jacob R, Dehipawala S, Smith B, Athavale A, Gusto G, Chandak A, Khachatryan A, Banon T, Fournier M, Guillonneau S, Pollissard L, Munoz-Rojas MV. Survival of patients with chronic acid sphingomyelinase deficiency (ASMD) in the United States: A retrospective chart review study. Mol Genet Metab Rep 2024; 38:101040. [PMID: 38188692 PMCID: PMC10767269 DOI: 10.1016/j.ymgmr.2023.101040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 01/09/2024] Open
Abstract
Background Acid sphingomyelinase deficiency (ASMD), historically known as Niemann-Pick disease type A, A/B, and B, is a rare lysosomal storage pathology with multisystemic clinical manifestations. The aims of this study were to estimate the survival probability in patients in the United States with chronic ASMD (ASMD types B and A/B), and to describe the disease characteristics of these patients. Methods This observational retrospective study included medical chart records of patients with chronic ASMD with retrievable data abstracted by 69 participating physicians from 25 medical centers in the United States. Included patients had a date of ASMD diagnosis or first presentation to a physician for ASMD symptoms (whichever occurred first) between January 01, 1990, and February 28, 2021. Medical chart records were excluded if patients were diagnosed with ASMD type A. Eligible medical chart records were abstracted to collect demographic, medical and developmental history, and mortality data. Survival outcomes were analyzed using Kaplan-Meier survival analyses from birth until death. Results The overall study population (N = 110) included 69 patients with ASMD type B, nine with type A/B, and 32 with ASMD "non-type A" (ASMD subtype was unknown, but patients were confirmed as not having ASMD type A). The majority of patients were male with a median age at diagnosis of 3.8 years. Thirty-eight patients died during the study observation period, at a median age of 6.8 years. The median (95% confidence interval) survival age from birth was 21.3 (10.2; 60.4) years. At diagnosis or first presentation, 42.7% patients had ≥1 ASMD-related complication; splenic (30.0%) and hepatobiliary (20.9%) being the most common, and 40.9% required ≥1 medical visit due to complications. Conclusion Patients with chronic ASMD in the United States have poor survival and significant burden of illness.
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Hammoud M, Rodrigues AMS, Assiri I, Sabir E, Lafhal K, Najeh S, Jakani M, Imad N, Bourrahouat A, Ait Sab I, Elqadiry R, Nassih H, Outzourit A, Elamiri M, Maoulainine F, Slitine Elidrissi N, Bennaoui F, Bourous M, Mrhar S, Essaadouni L, Stien D, Rada N, Bouskraoui M, Houël E, Fdil N. Sphingolipidoses in Morocco: Chemical profiling for an affordable and rapid diagnosis strategy. Prostaglandins Other Lipid Mediat 2023; 168:106751. [PMID: 37295489 DOI: 10.1016/j.prostaglandins.2023.106751] [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: 02/27/2023] [Revised: 05/28/2023] [Accepted: 06/03/2023] [Indexed: 06/12/2023]
Abstract
Sphingolipidoses are a group of metabolic diseases in which lysosomal hydrolases dysfunction disrupt normal sphingolipids' metabolism, leading to excess accumulation in cellular compartments and excretion in urine. These pathologies represent a significant burden among Moroccan population, for which an easy access to enzymatic assays and genetic tests is not guaranteed. Parallel analytical methods thus have to be developed for preliminary screening. In this study, 107 patients were addressed to the metabolic platform of the Marrakesh Faculty of Medicine for diagnosis confirmation. Thin-Layer Chromatography was used as a first step to perform chemical profiling of the patients' urinary lipids, allowing 36% of the patients to be efficiently oriented towards the adequate enzymatic assay. UPLC-MS/MS analyses of urinary sulfatides excreted in urines patient had been used to control the reliability of TLC analysis and to obtain more accurate information related to the sulfatides isoforms. This analytical process combining TLC with UPLC-MS/MS has enabled rapid and appropriate patient management in a reduced time and with reduced resources.
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Affiliation(s)
- M Hammoud
- Metabolic platform, Biochemistry Laboratory, Team for Childhood, Health and Development, Faculty of Medicine, Cadi Ayyad University, B.P. 7010, Marrakesh, Morocco; Moroccan Association for Inherited Metabolic Diseases, Morocco
| | - A M S Rodrigues
- Sorbonne Université, CNRS, Laboratoire de Biodiversité et Biotechnologies Microbiennes, USR3579, LBBM, Observatoire Océanologique, Banyuls-sur-Mer 66650, France
| | - I Assiri
- Metabolic platform, Biochemistry Laboratory, Team for Childhood, Health and Development, Faculty of Medicine, Cadi Ayyad University, B.P. 7010, Marrakesh, Morocco; Moroccan Association for Inherited Metabolic Diseases, Morocco
| | - Es Sabir
- Metabolic platform, Biochemistry Laboratory, Team for Childhood, Health and Development, Faculty of Medicine, Cadi Ayyad University, B.P. 7010, Marrakesh, Morocco; Moroccan Association for Inherited Metabolic Diseases, Morocco
| | - K Lafhal
- Metabolic platform, Biochemistry Laboratory, Team for Childhood, Health and Development, Faculty of Medicine, Cadi Ayyad University, B.P. 7010, Marrakesh, Morocco; Moroccan Association for Inherited Metabolic Diseases, Morocco
| | - S Najeh
- Metabolic platform, Biochemistry Laboratory, Team for Childhood, Health and Development, Faculty of Medicine, Cadi Ayyad University, B.P. 7010, Marrakesh, Morocco; Moroccan Association for Inherited Metabolic Diseases, Morocco
| | - M Jakani
- Metabolic platform, Biochemistry Laboratory, Team for Childhood, Health and Development, Faculty of Medicine, Cadi Ayyad University, B.P. 7010, Marrakesh, Morocco; Moroccan Association for Inherited Metabolic Diseases, Morocco
| | - N Imad
- Paediatrics' Department, Mohammed VI Hospital University, Marrakesh, Morocco
| | - A Bourrahouat
- Paediatrics' Department, Mohammed VI Hospital University, Marrakesh, Morocco
| | - I Ait Sab
- Paediatrics' Department, Mohammed VI Hospital University, Marrakesh, Morocco
| | - R Elqadiry
- Paediatrics' Department, Mohammed VI Hospital University, Marrakesh, Morocco
| | - H Nassih
- Paediatrics' Department, Mohammed VI Hospital University, Marrakesh, Morocco
| | - A Outzourit
- Internal Medicine Department, Mohammed VI Hospital University, Marrakesh, Morocco
| | - M Elamiri
- Metabolic platform, Biochemistry Laboratory, Team for Childhood, Health and Development, Faculty of Medicine, Cadi Ayyad University, B.P. 7010, Marrakesh, Morocco
| | - F Maoulainine
- Paediatrics' Department, Mohammed VI Hospital University, Marrakesh, Morocco
| | - N Slitine Elidrissi
- Paediatrics' Department, Mohammed VI Hospital University, Marrakesh, Morocco
| | - F Bennaoui
- Paediatrics' Department, Mohammed VI Hospital University, Marrakesh, Morocco
| | - M Bourous
- Paediatrics' Department, Mohammed VI Hospital University, Marrakesh, Morocco
| | - S Mrhar
- Paediatrics' Department, Mohammed VI Hospital University, Marrakesh, Morocco
| | - L Essaadouni
- Internal Medicine Department, Mohammed VI Hospital University, Marrakesh, Morocco
| | - D Stien
- Sorbonne Université, CNRS, Laboratoire de Biodiversité et Biotechnologies Microbiennes, USR3579, LBBM, Observatoire Océanologique, Banyuls-sur-Mer 66650, France
| | - N Rada
- Paediatrics' Department, Mohammed VI Hospital University, Marrakesh, Morocco
| | - M Bouskraoui
- Paediatrics' Department, Mohammed VI Hospital University, Marrakesh, Morocco
| | - E Houël
- Sorbonne Université, CNRS, Laboratoire de Biodiversité et Biotechnologies Microbiennes, USR3579, LBBM, Observatoire Océanologique, Banyuls-sur-Mer 66650, France.
| | - N Fdil
- Metabolic platform, Biochemistry Laboratory, Team for Childhood, Health and Development, Faculty of Medicine, Cadi Ayyad University, B.P. 7010, Marrakesh, Morocco; Moroccan Association for Inherited Metabolic Diseases, Morocco.
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Hughes MP, Nelvagal HR, Coombe-Tennant O, Smith D, Smith C, Massaro G, Poupon-Bejuit L, Platt FM, Rahim AA. A Novel Small NPC1 Promoter Enhances AAV-Mediated Gene Therapy in Mouse Models of Niemann-Pick Type C1 Disease. Cells 2023; 12:1619. [PMID: 37371089 PMCID: PMC10296851 DOI: 10.3390/cells12121619] [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: 03/20/2023] [Revised: 05/22/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023] Open
Abstract
Niemann-Pick disease type C1 (NP-C) is a prematurely lethal genetic lysosomal storage disorder with neurological and visceral pathology resulting from mutations in the NPC1 gene encoding the lysosomal transmembrane protein NPC1. There is currently no cure for NP-C, and the only disease modifying treatment, miglustat, slows disease progression but does not significantly attenuate neurological symptoms. AAV-mediated gene therapy is an attractive option for NP-C, but due to the large size of the human NPC1 gene, there may be packaging and truncation issues during vector manufacturing. One option is to reduce the size of DNA regulatory elements that are essential for gene expression, such as the promoter sequence. Here, we describe a novel small truncated endogenous NPC1 promoter that leads to high gene expression both in vitro and in vivo and compare its efficacy to other commonly used promoters. Following neonatal intracerebroventricular (ICV) injection into the CNS, this novel promoter provided optimal therapeutic efficacy compared to all other promoters including increased survival, improved behavioural phenotypes, and attenuated neuropathology in mouse models of NP-C. Taken together, we propose that this novel promoter can be extremely efficient in designing an optimised AAV9 vector for gene therapy for NP-C.
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Affiliation(s)
- Michael Paul Hughes
- UCL School of Pharmacy, University College London, London WC1N 1AX, UK (H.R.N.); (O.C.-T.); (G.M.)
| | - Hemanth Ramesh Nelvagal
- UCL School of Pharmacy, University College London, London WC1N 1AX, UK (H.R.N.); (O.C.-T.); (G.M.)
| | - Oliver Coombe-Tennant
- UCL School of Pharmacy, University College London, London WC1N 1AX, UK (H.R.N.); (O.C.-T.); (G.M.)
| | - Dave Smith
- Department of Pharmacology, University of Oxford, Oxford OX1 3QT, UK; (D.S.); (C.S.); (F.M.P.)
| | - Claire Smith
- Department of Pharmacology, University of Oxford, Oxford OX1 3QT, UK; (D.S.); (C.S.); (F.M.P.)
| | - Giulia Massaro
- UCL School of Pharmacy, University College London, London WC1N 1AX, UK (H.R.N.); (O.C.-T.); (G.M.)
| | - Laura Poupon-Bejuit
- UCL School of Pharmacy, University College London, London WC1N 1AX, UK (H.R.N.); (O.C.-T.); (G.M.)
| | - Frances Mary Platt
- Department of Pharmacology, University of Oxford, Oxford OX1 3QT, UK; (D.S.); (C.S.); (F.M.P.)
| | - Ahad Abdul Rahim
- UCL School of Pharmacy, University College London, London WC1N 1AX, UK (H.R.N.); (O.C.-T.); (G.M.)
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Pulikottil-Jacob R, Ganz ML, Fournier M, Petruski-Ivleva N. Healthcare Service Use Patterns Among Patients with Acid Sphingomyelinase Deficiency Type B: A Retrospective US Claims Analysis. Adv Ther 2023; 40:2234-2248. [PMID: 36897522 PMCID: PMC10129952 DOI: 10.1007/s12325-023-02453-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 02/06/2023] [Indexed: 03/11/2023]
Abstract
INTRODUCTION Acid sphingomyelinase deficiency (ASMD) is a rare lysosomal storage disease. Patients with ASMD type B experience multiple morbidities, potentially leading to early mortality. Before the 2022 approval of olipudase alfa for non-neuronopathic ASMD manifestations, only symptom management was offered. Data on healthcare services used by patients with ASMD type B are limited. This analysis used medical claims data to evaluate real-world healthcare service use by patients with ASMD type B in the United States of America (USA). METHODS The IQVIA Open Claims patient-level database (2010-2019) was cross-examined. Two patient cohorts were identified: the primary analysis cohort, which included patients with at least two claims associated with ASMD type B (ICD-10 code E75.241) and more total claims with ASMD type B than any other ASMD types, and the sensitivity analysis cohort, which included patients with a high probability of having ASMD type B identified using a validated machine-learning algorithm. Claims for ASMD-associated healthcare services were recorded, including outpatient visits, emergency department (ED) visits, and inpatient hospitalizations. RESULTS The primary analysis cohort included 47 patients; a further 59 patients made up the sensitivity analysis cohort. Patient characteristics and healthcare service use were similar in both cohorts and were consistent with established characteristics of ASMD type B. Overall, 70% of the primary analysis cohort from this study were aged < 18 years, and the liver, spleen, and lungs were the most frequently affected organs. Cognitive, developmental, and/or emotional problems and respiratory/lung disorders caused most outpatient visits; respiratory/lung disorders accounted for most ED visits and hospitalizations. CONCLUSION This retrospective analysis of medical claims data identified patients with ASMD type B who had characteristics typical of this condition. A machine-learning algorithm detected further cases with a high probability of having ASMD type B. High use of ASMD-related healthcare services and medications was observed in both cohorts.
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Affiliation(s)
- Ruth Pulikottil-Jacob
- Health Economics and Value Assessment Business Partner-Rare Diseases, Sanofi, Thames Valley Park, Reading, UK.
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Geberhiwot T, Wasserstein M, Wanninayake S, Bolton SC, Dardis A, Lehman A, Lidove O, Dawson C, Giugliani R, Imrie J, Hopkin J, Green J, de Vicente Corbeira D, Madathil S, Mengel E, Ezgü F, Pettazzoni M, Sjouke B, Hollak C, Vanier MT, McGovern M, Schuchman E. Consensus clinical management guidelines for acid sphingomyelinase deficiency (Niemann-Pick disease types A, B and A/B). Orphanet J Rare Dis 2023; 18:85. [PMID: 37069638 PMCID: PMC10108815 DOI: 10.1186/s13023-023-02686-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 04/02/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND Acid Sphingomyelinase Deficiency (ASMD) is a rare autosomal recessive disorder caused by mutations in the SMPD1 gene. This rarity contributes to misdiagnosis, delayed diagnosis and barriers to good care. There are no published national or international consensus guidelines for the diagnosis and management of patients with ASMD. For these reasons, we have developed clinical guidelines that defines standard of care for ASMD patients. METHODS The information contained in these guidelines was obtained through a systematic literature review and the experiences of the authors in their care of patients with ASMD. We adopted the Appraisal of Guidelines for Research and Evaluation (AGREE II) system as method of choice for the guideline development process. RESULTS The clinical spectrum of ASMD, although a continuum, varies substantially with subtypes ranging from a fatal infantile neurovisceral disorder to an adult-onset chronic visceral disease. We produced 39 conclusive statements and scored them according to level of evidence, strengths of recommendations and expert opinions. In addition, these guidelines have identified knowledge gaps that must be filled by future research. CONCLUSION These guidelines can inform care providers, care funders, patients and their carers about best clinical practice and leads to a step change in the quality of care for patients with ASMD with or without enzyme replacement therapy (ERT).
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Affiliation(s)
- Tarekegn Geberhiwot
- University Hospital Birmingham NHS Foundation Trust, Birmingham, UK.
- Institute of Metabolism and System Research, University of Birmingham, Birmingham, UK.
| | - Melissa Wasserstein
- Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY, USA
| | | | | | - Andrea Dardis
- Regional Coordinator Centre for Rare Disease, AMC Hospital of Udine, Udine, Italy
| | - Anna Lehman
- Department of Medical Genetics, University of British Columbia, Vancouver, BC, V6T 1Z2, Canada
| | - Olivier Lidove
- Department of Internal Medicine, Hôpital de La Croix Saint Simon, Paris, France
| | - Charlotte Dawson
- University Hospital Birmingham NHS Foundation Trust, Birmingham, UK
| | - Roberto Giugliani
- BioDiscovery and DR BRASIL Research Group, HCPA, Department of Genetics and PPGBM, UFRGS, INAGEMP, DASA, and Casa Dos Raros, Porto Alegre, Brazil
| | - Jackie Imrie
- International Niemann-Pick Disease Registry, Newcastle, UK
| | - Justin Hopkin
- National Niemann-Pick Disease Foundation, Fort Atkinson, WI, USA
| | - James Green
- International Niemann-Pick Disease Registry, Newcastle, UK
| | | | - Shyam Madathil
- Department of Respiratory Medicine, University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK
| | - Eugen Mengel
- Institute of Clinical Science in LSD, SphinCS, Hochheim, Germany
| | - Fatih Ezgü
- Division of Pediatric Metabolism and Division of Pediatric Genetics, Department of Pediatrics, Gazi University Faculty of Medicine, 06560, Ankara, Turkey
| | - Magali Pettazzoni
- Biochemistry and Molecular Biology and Reference Center for Inherited Metabolic Disorders, Hospices Civils de Lyon, 59 Boulevard Pinel, 69677, Bron Cedex, France
| | - Barbara Sjouke
- Department of Endocrinology and Metabolism, Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, F5-169, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands
| | - Carla Hollak
- Department of Endocrinology and Metabolism, Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, F5-169, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands
| | | | | | - Edward Schuchman
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, Room 14-20A, New York, NY, 10029, USA
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Mauhin W, Brassier A, London J, Subran B, Zeggane A, Besset Q, Jammal C, Montardi C, Mellot C, Strauss C, Borie R, Lidove O. Manifestations pulmonaires des maladies héréditaires du métabolisme. Rev Mal Respir 2022; 39:758-777. [DOI: 10.1016/j.rmr.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/11/2022] [Indexed: 11/05/2022]
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Leal AF, Suarez DA, Echeverri-Peña OY, Albarracín SL, Alméciga-Díaz CJ, Espejo-Mojica ÁJ. Sphingolipids and their role in health and disease in the central nervous system. Adv Biol Regul 2022; 85:100900. [PMID: 35870382 DOI: 10.1016/j.jbior.2022.100900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/21/2022] [Accepted: 07/11/2022] [Indexed: 12/22/2022]
Abstract
Sphingolipids (SLs) are lipids derived from sphingosine, and their metabolism involves a broad and complex network of reactions. Although SLs are widely distributed in the body, it is well known that they are present in high concentrations within the central nervous system (CNS). Under physiological conditions, their abundance and distribution in the CNS depend on brain development and cell type. Consequently, SLs metabolism impairment may have a significant impact on the normal CNS function, and has been associated with several disorders, including sphingolipidoses, Parkinson's, and Alzheimer's. This review summarizes the main SLs characteristics and current knowledge about synthesis, catabolism, regulatory pathways, and their role in physiological and pathological scenarios in the CNS.
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Affiliation(s)
- Andrés Felipe Leal
- Institute for the Study of Inborn Errors of Metabolism, Faculty of Science, Pontificia Universidad Javeriana, Bogotá D.C, Colombia
| | - Diego A Suarez
- Institute for the Study of Inborn Errors of Metabolism, Faculty of Science, Pontificia Universidad Javeriana, Bogotá D.C, Colombia
| | - Olga Yaneth Echeverri-Peña
- Institute for the Study of Inborn Errors of Metabolism, Faculty of Science, Pontificia Universidad Javeriana, Bogotá D.C, Colombia
| | - Sonia Luz Albarracín
- Nutrition and Biochemistry Department, Faculty of Science, Pontificia Universidad Javeriana, Bogotá D.C, Colombia
| | - Carlos Javier Alméciga-Díaz
- Institute for the Study of Inborn Errors of Metabolism, Faculty of Science, Pontificia Universidad Javeriana, Bogotá D.C, Colombia.
| | - Ángela Johana Espejo-Mojica
- Institute for the Study of Inborn Errors of Metabolism, Faculty of Science, Pontificia Universidad Javeriana, Bogotá D.C, Colombia.
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Mauhin W, Belmatoug N, Berger M, Besset Q, Boitiaux J, Brassier A, Douillard C, Gousseff M, Lavigne C, Martis N, Mellot C, Nguyen A, Subran B, Klein E, Strauss C, Guillot E, Lidove O. Accès compassionnel à l’enzymothérapie chez les patients adultes avec déficit en sphingomyélinase acide (Niemann-Pick B) en France : expérience multicentrique. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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