1
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Yan S, Fu F, Zhou H, Huang R, Wang Y, Liao C. Functional analysis of a novel splice site variant in the ASAH1 gene. Mol Genet Genomic Med 2024; 12:e2317. [PMID: 37962265 PMCID: PMC10767590 DOI: 10.1002/mgg3.2317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 10/11/2023] [Accepted: 10/22/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Acid ceramidase (ACDase) deficiency is an ultrarare autosomal recessive lysosomal disorder caused by pathogenic N-acylsphingosine amidohydrolase (ASAH1) variants. It presents with either Farber disease (FD) or spinal muscular atrophy with progressive myoclonic epilepsy (SMA-PME). OBJECTIVE The study aims to identify a novel splice site variant in a hydrops fetus that causes ASAH1-related disorder, aid genetic counseling, and accurate prenatal diagnosis. METHODS We report a case of hydrops fetalis with a novel homozygous mutation in ASAH1 inherited from non-consanguineous parents. We performed copy number variation sequencing (CNV-Seq) and whole exome sequencing (WES) on the fetus and family, respectively. Minigene splicing analyses were conducted to confirm the pathogenic variants. RESULTS WES data revealed a splice site variant of the ASAH1 (c.458-2A>T), which was predicted to affect RNA splicing. Minigene splicing analyses found that the c.458-2A>T variant abolished the canonical splicing of intron 6, thereby activating two cryptic splicing products (c.456_458ins56bp and c.458_503del). CONCLUSIONS Overall, we identified a novel splice site variant in the mutational spectrum of ASAH1 and its aberrant effect on splicing. These findings highlight the importance of ultrasonic manifestation and family history of fetal hydrops during ASAH1-related disorders and could also aid genetic counseling and accurate prenatal diagnosis. To the best of our knowledge, this is the shortest-lived account of ASAH1-related disorders in utero with severe hydrops fetalis.
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Affiliation(s)
- Shujuan Yan
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical CenterGuangzhou Medical UniversityGuangzhouGuangdongChina
| | - Fang Fu
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical CenterGuangzhou Medical UniversityGuangzhouGuangdongChina
| | - Hang Zhou
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical CenterGuangzhou Medical UniversityGuangzhouGuangdongChina
| | - Ruibin Huang
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical CenterGuangzhou Medical UniversityGuangzhouGuangdongChina
| | - You Wang
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical CenterGuangzhou Medical UniversityGuangzhouGuangdongChina
| | - Can Liao
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical CenterGuangzhou Medical UniversityGuangzhouGuangdongChina
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2
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He X, Schuchman EH. Identification of a Novel Acid Sphingomyelinase Activity Associated with Recombinant Human Acid Ceramidase. Biomolecules 2023; 13:1623. [PMID: 38002305 PMCID: PMC10669851 DOI: 10.3390/biom13111623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 11/26/2023] Open
Abstract
Acid ceramidase (AC) is a lysosomal enzyme required to hydrolyze ceramide to sphingosine by the removal of the fatty acid moiety. An inherited deficiency in this activity results in two disorders, Farber Lipogranulomatosis and spinal muscular atrophy with myoclonic epilepsy, leading to the accumulation of ceramides and other sphingolipids in various cells and tissues. In addition to ceramide hydrolysis, several other activities have been attributed to AC, including a reverse reaction that synthesizes ceramide from free fatty acids and sphingosine, and a deacylase activity that removes fatty acids from complex lipids such as sphingomyelin and glycosphingolipids. A close association of AC with another important enzyme of sphingolipid metabolism, acid sphingomyelinase (ASM), has also been observed. Herein, we used a highly purified recombinant human AC (rhAC) and novel UPLC-based assay methods to investigate the recently described deacylase activity of rhAC against three sphingolipid substrates, sphingomyelin, galactosyl- and glucosylceramide. No deacylase activities were detected using this method, although we did unexpectedly identify a significant ASM activity using natural (C-18) and artificial (Bodipy-C12) sphingomyelin substrates as well as the ASM-specific fluorogenic substrate, hexadecanoylamino-4-methylumbelliferyl phosphorylcholine (HMU-PC). We showed that this ASM activity was not due to contaminating, hamster-derived ASM in the rhAC preparation, and that the treatment of ASM-knockout mice with rhAC significantly reduced sphingomyelin storage in the liver. However, unlike the treatment with rhASM, this did not lead to elevated ceramide or sphingosine levels.
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Affiliation(s)
| | - Edward H. Schuchman
- Department of Genetics & Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
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3
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Kleynerman A, Rybova J, Faber ML, McKillop WM, Levade T, Medin JA. Acid Ceramidase Deficiency: Bridging Gaps between Clinical Presentation, Mouse Models, and Future Therapeutic Interventions. Biomolecules 2023; 13:biom13020274. [PMID: 36830643 PMCID: PMC9953133 DOI: 10.3390/biom13020274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 01/25/2023] [Accepted: 01/27/2023] [Indexed: 02/04/2023] Open
Abstract
Farber disease (FD) and spinal muscular atrophy with progressive myoclonic epilepsy (SMA-PME) are ultra-rare, autosomal-recessive, acid ceramidase (ACDase) deficiency disorders caused by ASAH1 gene mutations. Currently, 73 different mutations in the ASAH1 gene have been described in humans. These mutations lead to reduced ACDase activity and ceramide (Cer) accumulation in many tissues. Presenting as divergent clinical phenotypes, the symptoms of FD vary depending on central nervous system (CNS) involvement and severity. Classic signs of FD include, but are not limited to, a hoarse voice, distended joints, and lipogranulomas found subcutaneously and in other tissues. Patients with SMA-PME lack the most prominent clinical signs seen in FD. Instead, they demonstrate muscle weakness, tremors, and myoclonic epilepsy. Several ACDase-deficient mouse models have been developed to help elucidate the complex consequences of Cer accumulation. In this review, we compare clinical reports on FD patients and experimental descriptions of ACDase-deficient mouse models. We also discuss clinical presentations, potential therapeutic strategies, and future directions for the study of FD and SMA-PME.
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Affiliation(s)
- Annie Kleynerman
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Jitka Rybova
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Mary L. Faber
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - William M. McKillop
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Thierry Levade
- Laboratoire de Biochimie Métabolique, CHU Toulouse, and INSERM U1037, Centre de Recherches en Cancérologie de Toulouse, Université Paul Sabatier, 31062 Toulouse, France
| | - Jeffrey A. Medin
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Department of Biochemistry, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Correspondence: ; Tel.: +1-414-955-4118
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4
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Rybova J, Kuchar L, Sikora J, McKillop WM, Medin JA. Skin inflammation and impaired adipogenesis in a mouse model of acid ceramidase deficiency. J Inherit Metab Dis 2022; 45:1175-1190. [PMID: 36083604 PMCID: PMC9826362 DOI: 10.1002/jimd.12552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 08/29/2022] [Accepted: 09/06/2022] [Indexed: 01/11/2023]
Abstract
Acid ceramidase catalyzes the degradation of ceramide into sphingosine and a free fatty acid. Acid ceramidase deficiency results in lipid accumulation in many tissues and leads to the development of Farber disease (FD). Typical manifestations of classical FD include formation of subcutaneous nodules and joint contractures as well as the development of a hoarse voice. Healthy skin depends on a unique lipid profile to form a barrier that confers protection from pathogens, prevents excessive water loss, and mediates cell-cell communication. Ceramides comprise ~50% of total epidermis lipids and regulate cutaneous homeostasis and inflammation. Abnormal skin development including visual skin lesions has been reported in FD patients, but a detailed study of FD skin has not been performed. We conducted a pathophysiological study of the skin in our mouse model of FD. We observed altered lipid composition in FD skin dominated by accumulation of all studied ceramide species and buildup of abnormal storage structures affecting mainly the dermis. A deficiency of acid ceramidase activity also led to the activation of inflammatory IL-6/JAK/signal transducer and activator of transcription 3 and noncanonical NF-κB signaling pathways. Last, we report reduced proliferation of FD mouse fibroblasts and adipose-derived stem/stromal cells (ASC) along with impaired differentiation of ASCs into mature adipocytes.
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Affiliation(s)
- Jitka Rybova
- Departments of Pediatrics and BiochemistryMedical College of WisconsinMilwaukeeWisconsinUSA
| | - Ladislav Kuchar
- Rare Diseases Research Unit, Department of Pediatrics and Inherited Metabolic DisordersCharles University, 1st Faculty of Medicine and General University HospitalPragueCzech Republic
| | - Jakub Sikora
- Rare Diseases Research Unit, Department of Pediatrics and Inherited Metabolic DisordersCharles University, 1st Faculty of Medicine and General University HospitalPragueCzech Republic
- Institute of PathologyCharles University, 1st Faculty of Medicine and General University HospitalPragueCzech Republic
| | - William M. McKillop
- Departments of Pediatrics and BiochemistryMedical College of WisconsinMilwaukeeWisconsinUSA
| | - Jeffrey A. Medin
- Departments of Pediatrics and BiochemistryMedical College of WisconsinMilwaukeeWisconsinUSA
- Department of BiochemistryMedical College of WisconsinMilwaukeeWisconsinUSA
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5
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Rabionet M, Bernard P, Pichery M, Marsching C, Bayerle A, Dworski S, Kamani MA, Chitraju C, Gluchowski NL, Gabriel KR, Asadi A, Ebel P, Hoekstra M, Dumas S, Ntambi JM, Jacobsson A, Willecke K, Medin JA, Jonca N, Sandhoff R. Epidermal 1-O-acylceramides appear with the establishment of the water permeability barrier in mice and are produced by maturating keratinocytes. Lipids 2022; 57:183-195. [PMID: 35318678 DOI: 10.1002/lipd.12342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/11/2022] [Accepted: 03/11/2022] [Indexed: 12/17/2022]
Abstract
1-O-Acylceramides (1-OACs) have a fatty acid esterified to the 1-hydroxyl of the sphingosine head group of the ceramide, and recently we identified these lipids as natural components of human and mouse epidermis. Here we show epidermal 1-OACs arise shortly before birth during the establishment of the water permeability barrier in mice. Fractionation of human epidermis indicates 1-OACs concentrate in the stratum corneum. During in vitro maturation into reconstructed human epidermis, human keratinocytes dramatically increase 1-OAC levels indicating they are one source of epidermal 1-OACs. In search of potential enzymes responsible for 1-OAC synthesis in vivo, we analyzed mutant mice with deficiencies of ceramide synthases (Cers2, Cers3, or Cers4), diacylglycerol acyltransferases (Dgat1 or Dgat2), elongase of very long fatty acids 3 (Elovl3), lecithin cholesterol acyltransferase (Lcat), stearoyl-CoA desaturase 1 (Scd1), or acidic ceramidase (Asah1). Overall levels of 1-OACs did not decrease in any mouse model. In Cers3 and Dgat2-deficient epidermis they even increased in correlation with deficient skin barrier function. Dagt2 deficiency reshapes 1-OAC synthesis with an increase in 1-OACs with N-linked non-hydroxylated fatty acids and a 60% decrease compared to control in levels of 1-OACs with N-linked hydroxylated palmitate. As none of the single enzyme deficiencies we examined resulted in a lack of 1-OACs, we conclude that either there is functional redundancy in forming 1-OAC and more than one enzyme is involved, and/or an unknown acyltransferase of the epidermis performs the final step of 1-OAC synthesis, the implications of which are discussed.
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Affiliation(s)
- Mariona Rabionet
- Lipid Pathobiochemistry Group, German Cancer Research Center, Heidelberg, Germany
| | - Pauline Bernard
- Infinity, Université Toulouse, CNRS, Inserm, UPS, Toulouse, France
| | - Melanie Pichery
- Infinity, Université Toulouse, CNRS, Inserm, UPS, Toulouse, France
| | - Christian Marsching
- Lipid Pathobiochemistry Group, German Cancer Research Center, Heidelberg, Germany.,Center for Applied Research in Biomedical Mass Spectrometry (ABIMAS), Mannheim, Germany.,Center for Mass Spectrometry and Optical Spectroscopy (CeMOS), Mannheim University of Applied Sciences, Mannheim, Germany.,Instrumental Analytics and Bioanalytics, Mannheim University of Applied Sciences, Mannheim, Germany
| | - Aline Bayerle
- Lipid Pathobiochemistry Group, German Cancer Research Center, Heidelberg, Germany
| | - Shaalee Dworski
- Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
| | | | - Chandramohan Chitraju
- Department of Genetics and Complex Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.,Department of Cell Biology, Harvard Medical School, Boston, Massachusetts, USA
| | - Nina L Gluchowski
- Department of Genetics and Complex Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.,Department of Cell Biology, Harvard Medical School, Boston, Massachusetts, USA.,Division of Gastroenterology and Nutrition, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Katlyn R Gabriel
- Department of Genetics and Complex Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.,Department of Cell Biology, Harvard Medical School, Boston, Massachusetts, USA.,Howard Hughes Medical Institute, Boston, Massachusetts, USA
| | - Abolfazl Asadi
- Department of Molecular Biosciences, The Wenner-Gren Institute, The Arrhenius Laboratories, Stockholm University, Stockholm, Sweden
| | - Philipp Ebel
- Molecular Genetics, Life and Medical Sciences Institute (LIMES), University of Bonn, Bonn, Germany
| | - Menno Hoekstra
- Leiden Academic Centre for Drug Research, Division of BioTherapeutics, Leiden University, Leiden, Netherlands
| | - Sabrina Dumas
- Department of Nutritional sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - James M Ntambi
- Department of Nutritional sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Biochemistry, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Anders Jacobsson
- Department of Molecular Biosciences, The Wenner-Gren Institute, The Arrhenius Laboratories, Stockholm University, Stockholm, Sweden
| | - Klaus Willecke
- Molecular Genetics, Life and Medical Sciences Institute (LIMES), University of Bonn, Bonn, Germany
| | - Jeffrey A Medin
- Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada.,University Health Network, Toronto, Ontario, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.,Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Nathalie Jonca
- Infinity, Université Toulouse, CNRS, Inserm, UPS, Toulouse, France.,CHU Toulouse, Hôpital Purpan, Laboratoire de Biologie Cellulaire et Cytologie, Institut Fédératif de Biologie, Toulouse, France
| | - Roger Sandhoff
- Lipid Pathobiochemistry Group, German Cancer Research Center, Heidelberg, Germany.,Center for Applied Research in Biomedical Mass Spectrometry (ABIMAS), Mannheim, Germany
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6
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Mahmoud IG, Elmonem MA, Zaki MS, Ramadan A, Al-Menabawy NM, El-Gamal A, Mansour L, Issa MY, Abdel-Hamid MS, Abdel-Hady S, Khalifa I, Ibrahim A, Solyom A, Rolfs A, Selim L. ASAH1-related disorders: Description of 15 novel pediatric patients and expansion of the clinical phenotype. Clin Genet 2020; 98:598-605. [PMID: 32875576 DOI: 10.1111/cge.13834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/10/2020] [Accepted: 08/15/2020] [Indexed: 11/27/2022]
Abstract
Acid ceramidase deficiency is an orphan lysosomal disorder caused by ASAH1 pathogenic variants and presenting with either Farber disease or spinal muscle atrophy with progressive myoclonic epilepsy (SMA-PME). Phenotypic and genotypic features are rarely explored beyond the scope of case reports. Furthermore, the new biomarker C26-Ceramide requires validation in a clinical setting. We evaluated the clinical, biomarker and genetic spectrum of 15 Egyptian children from 14 unrelated families with biallelic pathogenic variants in ASAH1 (12 Farber and 3 SMA-PME). Recruited children were nine females/six males ranging in age at diagnosis from 13 to 118 months. We detected ASAH1 pathogenic variants in all 30 alleles including three novel variants (c.1126A>G (p.Thr376Ala), c.1205G>A (p.Arg402Gln), exon-5-deletion). Both total C26-Ceramide and its trans- isomer showed 100% sensitivity for the detection of ASAH1-related disorders in tested patients. A 10-year-old girl with the novel variant c.1205G>A (p.Arg402Gln) presented with a new peculiar phenotype of PME without muscle atrophy. We expanded the phenotypic spectrum of ASAH1-related disorders and validated the biomarker C26-Ceramide for supporting diagnosis in symptomatic patients.
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Affiliation(s)
- Iman G Mahmoud
- Pediatrics Department, Neurology and Metabolic division, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed A Elmonem
- Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Maha S Zaki
- Clinical Genetics Department, Human Genetics and Genome Research Division, National Research Centre, Giza, Egypt
| | - Areef Ramadan
- Pediatrics Department, Neurology and Metabolic division, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nihal M Al-Menabawy
- Pediatrics Department, Neurology and Metabolic division, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Aya El-Gamal
- Pediatrics Department, Neurology and Metabolic division, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Lobna Mansour
- Pediatrics Department, Neurology and Metabolic division, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mahmoud Y Issa
- Clinical Genetics Department, Human Genetics and Genome Research Division, National Research Centre, Giza, Egypt
| | - Mohamed S Abdel-Hamid
- Medical Molecular Genetics, Human Genetics and Genome Research Division, National Research Centre, Giza, Egypt
| | - Sawsan Abdel-Hady
- Pediatrics Department, Neurology and Metabolic division, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Iman Khalifa
- Pediatrics Department, Helwan University, Cairo, Egypt
| | - Ahmed Ibrahim
- Pediatrics Department, Suez Canal University, Ismailia, Egypt
| | | | - Arndt Rolfs
- Albrecht-Kossel-Institute for Neurodegeneration, Rostock University Medical-Centre and Centogene AG, Rostock, Germany
| | - Laila Selim
- Pediatrics Department, Neurology and Metabolic division, Faculty of Medicine, Cairo University, Cairo, Egypt
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7
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Bao X, Ma M, Zhang Z, Xu Y, Qiu Z. Farber disease in a patient from China. Am J Med Genet A 2020; 182:2184-2186. [PMID: 32706452 DOI: 10.1002/ajmg.a.61752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 05/28/2020] [Accepted: 05/30/2020] [Indexed: 11/08/2022]
Abstract
Farber disease (FD) is a rare lysosomal storage disorder caused by mutation of the ASAH1 gene. Classic symptoms of FD include subcutaneous nodules, joint pain and hoarseness. Most patients die during childhood. Here we report a 25-year-old female FD patient with rare osteolytic changes of bilateral hands and toes. Genetic analysis revealed novel compound heterozygous mutations in the ASAH1 gene (c.427T>G and c.358G>C). Further research is needed to elucidate the pathophysiological course.
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Affiliation(s)
- Xudong Bao
- Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China
| | - Mingsheng Ma
- Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Zhenjie Zhang
- Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Yiwen Xu
- Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Zhengqing Qiu
- Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
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8
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Bayerle A, Marsching C, Rabionet M, Dworski S, Kamani MA, Chitraju C, Gluchowski NL, Gabriel KR, Herzer S, Jennemann R, Levade T, Medin JA, Sandhoff R. Endogenous levels of 1-O-acylceramides increase upon acidic ceramidase deficiency and decrease due to loss of Dgat1 in a tissue-dependent manner. Biochim Biophys Acta Mol Cell Biol Lipids 2020; 1865:158741. [PMID: 32474112 DOI: 10.1016/j.bbalip.2020.158741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 04/19/2020] [Accepted: 05/15/2020] [Indexed: 02/03/2023]
Abstract
Except for epidermis and liver, little is known about endogenous expression of 1-O-acylceramides (1-OACs) in mammalian tissue. Therefore, we screened several organs (brain, lung, liver, spleen, lymph nodes, heart, kidney, thymus, small intestine, and colon) from mice for the presence of 1-OACs by LC-MS2. In most organs, low levels of about 0.25-1.3 pmol 1-OACs/mg wet weight were recorded. Higher levels were detected in liver, small and large intestines, with about 4-13 pmol 1-OACs/mg wet weight. 1-OACs were esterified mainly with palmitic, stearic, or oleic acids. Esterification with saturated very long-chain fatty acids, as in epidermis, was not observed. Western-type diet induced 3-fold increased 1-OAC levels in mice livers while ceramides were unaltered. In a mouse model of Farber disease with a decrease of acid ceramidase activity, we observed a strong, up to 50-fold increase of 1-OACs in lung, thymus, and spleen. In contrast, 1-OAC levels were reduced 0.54-fold in liver. Only in lung 1-OAC levels correlated to changes in ceramide levels - indicating tissue-specific mechanisms of regulation. Glucosylceramide synthase deficiency in liver did not cause changes in 1-OAC or ceramide levels, whereas increased ceramide levels in glucosylceramide synthase-deficient small intestine caused an increase in 1-OAC levels. Deficiency of Dgat1 in mice resulted in a reduction of 1-OACs to 30% in colon, but not in small intestine and liver, going along with constant free ceramides levels. From these data, we conclude that Dgat1 as well as lysosomal lipid metabolism contribute in vivo to homeostatic 1-OAC levels in an organ-specific manner.
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Affiliation(s)
- Aline Bayerle
- Lipid Pathobiochemistry Group, German Cancer Research Center, Heidelberg, Germany
| | - Christian Marsching
- Lipid Pathobiochemistry Group, German Cancer Research Center, Heidelberg, Germany; Center for Applied Research in Biomedical Mass Spectrometry (ABIMAS), Mannheim, Germany; Instrumental Analytics and Bioanalytics, Mannheim University of Applied Sciences, Mannheim, Germany; Center for Mass Spectrometry and Optical Spectroscopy (CeMOS), Mannheim University of Applied Sciences, Mannheim, Germany
| | - Mariona Rabionet
- Lipid Pathobiochemistry Group, German Cancer Research Center, Heidelberg, Germany
| | - Shaalee Dworski
- Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
| | | | - Chandramohan Chitraju
- Department of Genetics and Complex Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Cell Biology, Harvard Medical School, Boston, MA, USA
| | - Nina L Gluchowski
- Department of Genetics and Complex Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Cell Biology, Harvard Medical School, Boston, MA, USA; Division of Gastroenterology and Nutrition, Boston Children's Hospital, Boston, MA, USA
| | - Katlyn R Gabriel
- Department of Genetics and Complex Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Cell Biology, Harvard Medical School, Boston, MA, USA; Howard Hughes Medical Institute, Boston, MA, USA
| | - Silke Herzer
- Lipid Pathobiochemistry Group, German Cancer Research Center, Heidelberg, Germany
| | - Richard Jennemann
- Lipid Pathobiochemistry Group, German Cancer Research Center, Heidelberg, Germany
| | - Thierry Levade
- Laboratoire de Biochimie Métabolique, Institut Fédératif de Biologie, CHU Purpan, INSERM UMR1037 CRCT, Toulouse, France
| | - Jeffrey A Medin
- Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada; University Health Network, Toronto, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada; Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Roger Sandhoff
- Lipid Pathobiochemistry Group, German Cancer Research Center, Heidelberg, Germany; Center for Applied Research in Biomedical Mass Spectrometry (ABIMAS), Mannheim, Germany.
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9
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Elsea SH, Solyom A, Martin K, Harmatz P, Mitchell J, Lampe C, Grant C, Selim L, Mungan NO, Guelbert N, Magnusson B, Sundberg E, Puri R, Kapoor S, Arslan N, DiRocco M, Zaki M, Ozen S, Mahmoud IG, Ehlert K, Hahn A, Gokcay G, Torcoletti M, Ferreira CR. ASAH1 pathogenic variants associated with acid ceramidase deficiency: Farber disease and spinal muscular atrophy with progressive myoclonic epilepsy. Hum Mutat 2020; 41:1469-1487. [PMID: 32449975 DOI: 10.1002/humu.24056] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 04/28/2020] [Accepted: 05/16/2020] [Indexed: 11/12/2022]
Abstract
Farber disease and spinal muscular atrophy with progressive myoclonic epilepsy are a spectrum of rare lysosomal storage disorders characterized by acid ceramidase deficiency (ACD), resulting from pathogenic variants in N-acylsphingosine amidohydrolase 1 (ASAH1). Other than simple listings provided in literature reviews, a curated, comprehensive list of ASAH1 mutations associated with ACD clinical phenotypes has not yet been published. This publication includes mutations in ASAH1 collected through the Observational and Cross-Sectional Cohort Study of the Natural History and Phenotypic Spectrum of Farber Disease (NHS), ClinicalTrials.gov identifier NCT03233841, in combination with an up-to-date curated list of published mutations. The NHS is the first to collect retrospective and prospective data on living and deceased patients with ACD presenting as Farber disease, who had or had not undergone hematopoietic stem cell transplantation. Forty-five patients representing the known clinical spectrum of Farber disease (living patients aged 1-28 years) were enrolled. The curation of known ASAH1 pathogenic variants using a single reference transcript includes 10 previously unpublished from the NHS and 63 that were previously reported. The publication of ASAH1 variants will be greatly beneficial to patients undergoing genetic testing in the future by providing a significantly expanded reference list of disease-causing variants.
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Affiliation(s)
- Sarah H Elsea
- Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | | | - Kirt Martin
- Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Paul Harmatz
- Pediatric Gastroenterolgy and Nutrition, UCSF Benioff Children's Hospital Oakland, Oakland, California
| | | | | | | | - Laila Selim
- Cairo University Children's Hospital, Cairo, Egypt
| | | | | | - Bo Magnusson
- Karolinska University Hospital, Stockholm, Sweden
| | | | - Ratna Puri
- Sir Ganga Ram Hospital, New Delhi, India
| | - Seema Kapoor
- Lok Nayak Hospital and Maulana Azad Medical College, New Delhi, India
| | - Nur Arslan
- Dokuz Eylul University Hospital, Izmir, Turkey
| | - Maja DiRocco
- Metabolic Diseases, Istituto Giannina Gaslini, Genoa, Italy
| | - Maha Zaki
- Clinical Genetics Department, National Research Center, Cairo, Egypt
| | - Seza Ozen
- Pediatric Rheumatology, Hacettepe University Hospital, Ankara, Turkey
| | | | | | - Andreas Hahn
- UKGM Universitätsklinikum Giessen, Giessen, Germany
| | | | | | - Carlos R Ferreira
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
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10
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Beckmann N, Becker KA, Kadow S, Schumacher F, Kramer M, Kühn C, Schulz-Schaeffer WJ, Edwards MJ, Kleuser B, Gulbins E, Carpinteiro A. Acid Sphingomyelinase Deficiency Ameliorates Farber Disease. Int J Mol Sci 2019; 20:ijms20246253. [PMID: 31835809 PMCID: PMC6941101 DOI: 10.3390/ijms20246253] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 12/03/2019] [Accepted: 12/07/2019] [Indexed: 12/20/2022] Open
Abstract
Farber disease is a rare lysosomal storage disorder resulting from acid ceramidase deficiency and subsequent ceramide accumulation. No treatments for Farber disease are clinically available, and affected patients have a severely shortened lifespan. We have recently reported a novel acid ceramidase deficiency model that mirrors the human disease closely. Acid sphingomyelinase is the enzyme that generates ceramide upstream of acid ceramidase in the lysosomes. Using our acid ceramidase deficiency model, we tested if acid sphingomyelinase could be a potential novel therapeutic target for the treatment of Farber disease. A number of functional acid sphingomyelinase inhibitors are clinically available and have been used for decades to treat major depression. Using these as a therapeutic for Farber disease, thus, has the potential to improve central nervous symptoms of the disease as well, something all other treatment options for Farber disease can’t achieve so far. As a proof-of-concept study, we first cross-bred acid ceramidase deficient mice with acid sphingomyelinase deficient mice in order to prevent ceramide accumulation. Double-deficient mice had reduced ceramide accumulation, fewer disease manifestations, and prolonged survival. We next targeted acid sphingomyelinase pharmacologically, to test if these findings would translate to a setting with clinical applicability. Surprisingly, the treatment of acid ceramidase deficient mice with the acid sphingomyelinase inhibitor amitriptyline was toxic to acid ceramidase deficient mice and killed them within a few days of treatment. In conclusion, our study provides the first proof-of-concept that acid sphingomyelinase could be a potential new therapeutic target for Farber disease to reduce disease manifestations and prolong survival. However, we also identified previously unknown toxicity of the functional acid sphingomyelinase inhibitor amitriptyline in the context of Farber disease, strongly cautioning against the use of this substance class for Farber disease patients.
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Affiliation(s)
- Nadine Beckmann
- Department of Molecular Biology, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany; (N.B.); (K.A.B.); (S.K.); (F.S.); (M.K.); (C.K.); (E.G.)
| | - Katrin Anne Becker
- Department of Molecular Biology, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany; (N.B.); (K.A.B.); (S.K.); (F.S.); (M.K.); (C.K.); (E.G.)
| | - Stephanie Kadow
- Department of Molecular Biology, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany; (N.B.); (K.A.B.); (S.K.); (F.S.); (M.K.); (C.K.); (E.G.)
| | - Fabian Schumacher
- Department of Molecular Biology, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany; (N.B.); (K.A.B.); (S.K.); (F.S.); (M.K.); (C.K.); (E.G.)
- Department of Toxicology, Institute of Nutritional Science, University of Potsdam, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany;
| | - Melanie Kramer
- Department of Molecular Biology, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany; (N.B.); (K.A.B.); (S.K.); (F.S.); (M.K.); (C.K.); (E.G.)
| | - Claudine Kühn
- Department of Molecular Biology, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany; (N.B.); (K.A.B.); (S.K.); (F.S.); (M.K.); (C.K.); (E.G.)
| | | | - Michael J. Edwards
- Department of Surgery, University of Cincinnati, 231 Albert Sabin Way, ML 0558, Cincinnati, OH 45229, USA;
| | - Burkhard Kleuser
- Department of Toxicology, Institute of Nutritional Science, University of Potsdam, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany;
| | - Erich Gulbins
- Department of Molecular Biology, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany; (N.B.); (K.A.B.); (S.K.); (F.S.); (M.K.); (C.K.); (E.G.)
- Department of Surgery, University of Cincinnati, 231 Albert Sabin Way, ML 0558, Cincinnati, OH 45229, USA;
| | - Alexander Carpinteiro
- Department of Molecular Biology, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany; (N.B.); (K.A.B.); (S.K.); (F.S.); (M.K.); (C.K.); (E.G.)
- Department of Hematology, University Hospital Essen, Hufelandstraße 55, 45147 Essen, Germany
- Correspondence: ; Tel.: +49-201-723-84579; Fax: +49-201-723-5974
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11
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Cozma C, Hovakimyan M, Iurașcu MI, Makhseed N, Selim LA, Alhashem AM, Ben-Omran T, Mahmoud IG, Al Menabawy NM, Al-Mureikhi M, Martin M, Demuth L, Yüksel Z, Beetz C, Bauer P, Rolfs A. Genetic, clinical and biochemical characterization of a large cohort of patients with hyaline fibromatosis syndrome. Orphanet J Rare Dis 2019; 14:209. [PMID: 31455396 PMCID: PMC6712857 DOI: 10.1186/s13023-019-1183-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 08/16/2019] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Hyaline fibromatosis syndrome (HFS) is a rare clinical condition in which bi-allelic variants in ANTXR2 are associated with extracellular hyaline deposits. It manifests as multiple skin nodules, patchy hyperpigmentation, joint contractures and severe pain with movement. HFS shows some clinical overlap to Farber disease (FD), a recessive lysosomal storage disorder. RESULTS We here present the largest cohort of independent, genetically confirmed HFS cases reported to date: in 19 unrelated index patients, we identified ten distinct homozygous ANTXR2 mutations, three of which are novel frame-shift variants. The associated clinical data are consistent with the previous hypothesis of non-truncating variants in the terminal exons 13-17 to confer rather mild phenotypes. The novel observation of gender-dependent disease manifestation in our cohort received support from a meta-analysis of all previously published cases. Untargeted blood-based metabolomics revealed patient samples to be biochemically distinct from control samples. Numerous potential HFS biomarker metabolites could thus be identified. We also found metabolomics profiles of HFS patients to highly overlap with those from FD patients. CONCLUSIONS Our study extends the mutational spectrum for HFS, suggests gender-dependency of manifestation, and provides pilot metabolomics data for biomarker identification and a better pathomechanistic understanding of the disorder.
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Affiliation(s)
| | | | | | - Nawal Makhseed
- Department of Pediatrics, Jahra Hospital, Ministry of Health, Jahra City, Kuwait
| | - Laila A. Selim
- Division of Neurology and Metabolism, Kasr Al Ainy School of Medicine, Cairo University Children Hospital, Cairo, Egypt
| | - Amal M. Alhashem
- Prince Sultan Military Medical City, Pediatrics, Riyadh, Saudi Arabia
- Alfaisal University, Riyadh, Saudi Arabia
| | - Tawfeg Ben-Omran
- Division of Clinical and Metabolic Genetics, Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar
| | - Iman G. Mahmoud
- Division of Neurology and Metabolism, Kasr Al Ainy School of Medicine, Cairo University Children Hospital, Cairo, Egypt
| | - Nihal M. Al Menabawy
- Division of Neurology and Metabolism, Kasr Al Ainy School of Medicine, Cairo University Children Hospital, Cairo, Egypt
| | - Mariam Al-Mureikhi
- Division of Clinical and Metabolic Genetics, Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar
| | - Magi Martin
- Division of Clinical and Metabolic Genetics, Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar
| | - Laura Demuth
- Centogene AG, Am Strande 7, 18057 Rostock, Germany
| | - Zafer Yüksel
- Centogene AG, Am Strande 7, 18057 Rostock, Germany
| | | | - Peter Bauer
- Centogene AG, Am Strande 7, 18057 Rostock, Germany
| | - Arndt Rolfs
- Centogene AG, Am Strande 7, 18057 Rostock, Germany
- Rostock Medical University, Rostock, Germany
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12
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Beckmann N, Kadow S, Schumacher F, Göthert JR, Kesper S, Draeger A, Schulz-Schaeffer WJ, Wang J, Becker JU, Kramer M, Kühn C, Kleuser B, Becker KA, Gulbins E, Carpinteiro A. Pathological manifestations of Farber disease in a new mouse model. Biol Chem 2019; 399:1183-1202. [PMID: 29908121 DOI: 10.1515/hsz-2018-0170] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 05/07/2018] [Indexed: 11/15/2022]
Abstract
Farber disease (FD) is a rare lysosomal storage disorder resulting from acid ceramidase deficiency and subsequent ceramide accumulation. No treatments are clinically available and affected patients have a severely shortened lifespan. Due to the low incidence, the pathogenesis of FD is still poorly understood. Here, we report a novel acid ceramidase mutant mouse model that enables the study of pathogenic mechanisms of FD and ceramide accumulation. Asah1tmEx1 mice were generated by deletion of the acid ceramidase signal peptide sequence. The effects on lysosomal targeting and activity of the enzyme were assessed. Ceramide and sphingomyelin levels were quantified by liquid chromatography tandem-mass spectrometry (LC-MS/MS) and disease manifestations in several organ systems were analyzed by histology and biochemistry. We show that deletion of the signal peptide sequence disrupts lysosomal targeting and enzyme activity, resulting in ceramide and sphingomyelin accumulation. The affected mice fail to thrive and die early. Histiocytic infiltrations were observed in many tissues, as well as lung inflammation, liver fibrosis, muscular disease manifestations and mild kidney injury. Our new mouse model mirrors human FD and thus offers further insights into the pathogenesis of this disease. In the future, it may also facilitate the development of urgently needed therapies.
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Affiliation(s)
- Nadine Beckmann
- Department of Molecular Biology, University of Duisburg-Essen, Hufelandstraße 55, D-45147 Essen, Germany
| | - Stephanie Kadow
- Department of Molecular Biology, University of Duisburg-Essen, Hufelandstraße 55, D-45147 Essen, Germany
| | - Fabian Schumacher
- Department of Molecular Biology, University of Duisburg-Essen, Hufelandstraße 55, D-45147 Essen, Germany.,Department of Toxicology, Institute of Nutritional Science, University of Potsdam, Arthur-Scheunert-Allee 114-116, D-14558 Nuthetal, Germany
| | - Joachim R Göthert
- Department of Hematology, University Hospital Essen, Hufelandstraße 55, D-45147 Essen, Germany
| | - Stefanie Kesper
- Department of Hematology, University Hospital Essen, Hufelandstraße 55, D-45147 Essen, Germany
| | - Annette Draeger
- Institute of Anatomy, University of Bern, Baltzerstr. 2, CH-3012 Bern, Switzerland
| | - Walter J Schulz-Schaeffer
- Insitute of Neuropathology, University of the Saarland, Kirrberger Str. 100, D-66421 Homburg, Germany
| | - Jiang Wang
- Department of Pathology and Laboratory Medicine, UC Health University Hospital, 234 Goodman Street, Cincinnati, OH 45219, USA
| | - Jan U Becker
- Institute of Pathology, University Hospital Cologne, Kerpener Straße 62, D-50937 Cologne, Germany
| | - Melanie Kramer
- Department of Molecular Biology, University of Duisburg-Essen, Hufelandstraße 55, D-45147 Essen, Germany
| | - Claudine Kühn
- Department of Molecular Biology, University of Duisburg-Essen, Hufelandstraße 55, D-45147 Essen, Germany
| | - Burkhard Kleuser
- Department of Toxicology, Institute of Nutritional Science, University of Potsdam, Arthur-Scheunert-Allee 114-116, D-14558 Nuthetal, Germany
| | - Katrin Anne Becker
- Department of Molecular Biology, University of Duisburg-Essen, Hufelandstraße 55, D-45147 Essen, Germany
| | - Erich Gulbins
- Department of Molecular Biology, University of Duisburg-Essen, Hufelandstraße 55, D-45147 Essen, Germany.,Department of Surgery, University of Cincinnati, 231 Albert Sabin Way, ML 0558, Cincinnati, OH 45229, USA
| | - Alexander Carpinteiro
- Department of Molecular Biology, University of Duisburg-Essen, Hufelandstraße 55, D-45147 Essen, Germany.,Department of Hematology, University Hospital Essen, Hufelandstraße 55, D-45147 Essen, Germany
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13
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Goudie C, Alayoubi AM, Tibout P, Duval M, Maranda B, Mitchell D, Mitchell JJ. Hematopoietic stem cell transplant does not prevent neurological deterioration in infants with Farber disease: Case report and literature review. JIMD Rep 2019; 46:46-51. [PMID: 31240154 PMCID: PMC6498832 DOI: 10.1002/jmd2.12008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 12/20/2018] [Indexed: 11/23/2022] Open
Abstract
Farber disease (FD) is an inherited autosomal recessive disorder of lipid metabolism. The hallmark of the disease is systemic accumulation of ceramide due to lysosomal acid ceramidase deficiency. The involvement of the central nervous system is critical in this disorder leading to rapid deterioration and death within a few years after birth. Efforts to treat patients by hematopoietic stem cell transplant (HSCT) have resulted in favorable results in the absence of neurological manifestations. We report the outcomes of HSCT in two patients with FD who received early HSCT and had neurological deterioration posttransplant. We also present a new understanding of the limitations of HSCT in FD management based on our observations of the clinical course of the two patients after therapy.
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Affiliation(s)
- Catherine Goudie
- Division of Hematology‐Oncology, Department of PediatricsMcGill University Health CenterMontrealQuebecCanada
| | - Abdulfatah M. Alayoubi
- Division of Medical Genetics, Department of Human GeneticsMcGill UniversityMontrealQuebecCanada
- Department of Biochemistry and Molecular Medicine, College of Medicine, Taibah UniversityMadinahSaudi Arabia
| | - Pauline Tibout
- Department of PediatricsCHU de Québec—Université LavalQuebecQuébecCanada
| | - Michel Duval
- Division of Hematology‐Oncology, Department of PediatricsCHU Sainte‐Justine, University of MontrealMontrealQuebecCanada
| | - Bruno Maranda
- Division of Genetics, Department of PediatricsUniversité de SherbrookeSherbrookeQuebecCanada
| | - David Mitchell
- Division of Hematology‐Oncology, Department of PediatricsMcGill University Health CenterMontrealQuebecCanada
| | - John J. Mitchell
- Division of Medical Genetics, Department of Human GeneticsMcGill UniversityMontrealQuebecCanada
- Department of PediatricsMcGill UniversityMontrealQuebecCanada
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14
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Yildiz EP, Yesil G, Bektas G, Caliskan M, Tatlı B, Aydinli N, Ozmen M. Spinal muscular atrophy with progressive myoclonic epilepsy linked to mutations in ASAH1. Clin Neurol Neurosurg 2017; 164:47-49. [PMID: 29169047 DOI: 10.1016/j.clineuro.2017.11.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Revised: 11/08/2017] [Accepted: 11/13/2017] [Indexed: 11/26/2022]
Abstract
Spinal muscular atrophy with progressive myoclonic epilepsy (SMA-PME), a rare disorder caused by mutation in the ASAH1 gene, is characterized by progressive muscle weakness and intractable epilepsy. The literature about SMA-PME is very rare and most of the time limited to case reports. Mutation in the ASAH1 gene is also found in another rare syndrome which is Farber disease. We report a case of a 13.5-year-old girl with SMA-PME associated with ASAH1 gene mutation. She presented with progressive muscle weakness, tremor, seizure, and cognitive impairment. Clinical features and electrophysiological investigations revealed a motor neuron disease and generalized epilepsy. The marked difference in disease manifestations may explain why Farber and SMA-PME diseases were not suspected of being allelic conditions. SMA-PME cases with ASAH1 mutation could be treated using therapeutic studies regarding Farber disease. In patients with undefined PME or lower motor neuron disease cases, ASAH1 mutation scans should be studied.
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Affiliation(s)
- Edibe Pembegül Yildiz
- Division of Pediatric Neurology, Department of Pediatrics, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey.
| | - Gözde Yesil
- Department of Medical Genetics, Bezmi Alem Vakif University Faculty of Medicine, Istanbul, Turkey
| | - Gonca Bektas
- Division of Pediatric Neurology, Department of Pediatrics, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Mine Caliskan
- Division of Pediatric Neurology, Department of Pediatrics, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Burak Tatlı
- Division of Pediatric Neurology, Department of Pediatrics, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Nur Aydinli
- Division of Pediatric Neurology, Department of Pediatrics, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Meral Ozmen
- Division of Pediatric Neurology, Department of Pediatrics, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
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15
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Abstract
Lysosomes are cytoplasmic organelles that contain a variety of different hydrolases. A genetic deficiency in the enzymatic activity of one of these hydrolases will lead to the accumulation of the material meant for lysosomal degradation. Examples include glycogen in the case of Pompe disease, glycosaminoglycans in the case of the mucopolysaccharidoses, glycoproteins in the cases of the oligosaccharidoses, and sphingolipids in the cases of Niemann-Pick disease types A and B, Gaucher disease, Tay-Sachs disease, Krabbe disease, and metachromatic leukodystrophy. Sometimes, the lysosomal storage can be caused not by the enzymatic deficiency of one of the hydrolases, but by the deficiency of an activator protein, as occurs in the AB variant of GM2 gangliosidosis. Still other times, the accumulated lysosomal material results from failed egress of a small molecule as a consequence of a deficient transporter, as in cystinosis or Salla disease. In the last couple of decades, enzyme replacement therapy has become available for a number of lysosomal storage diseases. Examples include imiglucerase, taliglucerase and velaglucerase for Gaucher disease, laronidase for Hurler disease, idursulfase for Hunter disease, elosulfase for Morquio disease, galsulfase for Maroteaux-Lamy disease, alglucosidase alfa for Pompe disease, and agalsidase alfa and beta for Fabry disease. In addition, substrate reduction therapy has been approved for certain disorders, such as eliglustat for Gaucher disease. The advent of treatment options for some of these disorders has led to newborn screening pilot studies, and ultimately to the addition of Pompe disease and Hurler disease to the Recommended Uniform Screening Panel (RUSP) in 2015 and 2016, respectively.
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Affiliation(s)
- Carlos R. Ferreira
- Division of Genetics and Metabolism, Children’s National Health System, Washington, DC, USA
- George Washington University School of Medicine & Health Sciences, Washington, DC, USA
- Human Biochemical Genetics Section, Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - William A. Gahl
- Human Biochemical Genetics Section, Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
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16
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Abstract
A rare syndrome characterized by lower motor neuron disease associated with progressive myoclonic epilepsy, referred to as "spinal muscular atrophy associated with progressive myoclonic epilepsy" (SMA-PME), has been described in childhood and is inherited as an autosomal recessive trait. SMA-PME is caused by mutation in the ASAH1 gene encoding acid ceramidase. Ceramide and the metabolites participate in various cellular events as lipid mediators. The catabolism of ceramide in mammals occurs in lysosomes through the activity of ceramidase. Three different ceramidases (acid, neutral and alkaline) have been identified and appear to play distinct roles in sphingolipid metabolism. The enzymatic activity of acid ceramidase is deficient in two rare inherited disorders; Farber disease and SMA-PME. Farber disease is a very rare and severe autosomal recessive condition with a distinct clinical phenotype. The marked difference in disease manifestations may explain why Farber and SMA-PME diseases were not previously suspected to be allelic conditions. The precise molecular mechanism underlying the phenotypic differences remains to be clarified. Recently, a condition with mutation in CERS1, the gene encoding ceramide synthase 1, has been identified as a novel form of PME. This finding underlies the essential role of enzymes regulating either the synthesis (CERS1) or degradation (ASAH1) of ceramide, and the link between defects in ceramide metabolism and PME.
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17
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Dworski S, Berger A, Furlonger C, Moreau JM, Yoshimitsu M, Trentadue J, Au BCY, Paige CJ, Medin JA. Markedly perturbed hematopoiesis in acid ceramidase deficient mice. Haematologica 2015; 100:e162-5. [PMID: 25682603 DOI: 10.3324/haematol.2014.108530] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Affiliation(s)
| | | | | | | | - Makoto Yoshimitsu
- Division of Hematology and Immunology, Center for Chronic Viral Diseases, Graduate School of Medical and Dental Sciences, Kagoshima University, Japan
| | | | | | - Christopher J Paige
- University Health Network, Toronto, Canada Department of Immunology, University of Toronto, Canada Department of Medical Biophysics, University of Toronto, Canada
| | - Jeffrey A Medin
- Institute of Medical Science, University of Toronto, Canada University Health Network, Toronto, Canada Department of Medical Biophysics, University of Toronto, Canada
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