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Prencipe F, Barzan C, Savian C, Spalluto G, Carosati E, De Amici M, Mosconi G, Gianferrara T, Federico S, Da Ros T. Gaucher Disease: A Glance from a Medicinal Chemistry Perspective. ChemMedChem 2024:e202300641. [PMID: 38329692 DOI: 10.1002/cmdc.202300641] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/19/2024] [Accepted: 02/07/2024] [Indexed: 02/09/2024]
Abstract
Rare diseases are particular pathological conditions affecting a limited number of people and few drugs are known to be effective as therapeutic treatment. Gaucher disease, caused by a deficiency of the lysosomal enzyme glucocerebrosidase, belongs to this class of disorders, and it is considered the most common among the Lysosomal Storage Diseases. The two main therapeutic approaches are the Enzyme Replacement Therapy (ERT) and the Substrate Reduction Therapy (SRT). ERT, consisting in replacing the defective enzyme by administering a recombinant enzyme, is effective in alleviating the visceral symptoms, hallmarks of the most common subtype of the disease whereas it has no effects when symptoms involve CNS, since the recombinant protein is unable to significantly cross the Blood Brain Barrier. The SRT strategy involves inhibiting glucosylceramide synthase (GCS), the enzyme responsible for the production of the associated storage molecule. The rational design of new inhibitors of GCS has been hampered by the lack of either the crystal structure of the enzyme or an in-silico model of the active site which could provide important information regarding the interactions of potential inhibitors with the target, but, despite this, interesting results have been obtained and are herein reviewed.
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Affiliation(s)
- Filippo Prencipe
- Department of Chemical and Pharmaceutical Sciences, University of Trieste, Via Licio Giorgieri 1, 34127, Trieste, Italy
| | - Chiara Barzan
- Department of Chemical and Pharmaceutical Sciences, University of Trieste, Via Licio Giorgieri 1, 34127, Trieste, Italy
- Molecular Genetics Institute, CNR Via Abbiategrasso 207, 27100, Pavia, Italy
| | - Chiara Savian
- Department of Chemical and Pharmaceutical Sciences, University of Trieste, Via Licio Giorgieri 1, 34127, Trieste, Italy
| | - Giampiero Spalluto
- Department of Chemical and Pharmaceutical Sciences, University of Trieste, Via Licio Giorgieri 1, 34127, Trieste, Italy
| | - Emanuele Carosati
- Department of Chemical and Pharmaceutical Sciences, University of Trieste, Via Licio Giorgieri 1, 34127, Trieste, Italy
| | - Marco De Amici
- Department of Pharmaceutical Sciences, University of Milano Via Luigi Mangiagalli 25, 20133, Milano, Italy
| | - Giorgio Mosconi
- Fidia Farmaceutici Via Ponte della Fabbrica 3/A, 35021, Abano Terme, Italy
| | - Teresa Gianferrara
- Department of Chemical and Pharmaceutical Sciences, University of Trieste, Via Licio Giorgieri 1, 34127, Trieste, Italy
| | - Stephanie Federico
- Department of Chemical and Pharmaceutical Sciences, University of Trieste, Via Licio Giorgieri 1, 34127, Trieste, Italy
| | - Tatiana Da Ros
- Department of Chemical and Pharmaceutical Sciences, University of Trieste, Via Licio Giorgieri 1, 34127, Trieste, Italy
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Ahani AR, Irawan C, Harahap AS, Yuliarti K, Ham MF, Izzaty FN, Sjarif DR. Gaucher Disease: A First Reported Adult Case in Indonesia. Acta Med Indones 2024; 56:69-75. [PMID: 38561877] [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] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
A 44-year-old female presented with a distended abdomen and fatigue. On physical examination, prominent splenomegaly was found. The laboratory investigations revealed pancytopenia and decreased albumin-globulin ratio. The abdominal ultrasonography revealed splenomegaly, cholelithiasis, and cystitis, and the bone survey showed osteopenia. Differential diagnoses included leukemia, multiple myeloma, and myelofibrosis therefore bone marrow puncture was performed. However, histopathologic examination found Gaucher-like cells in the bone marrow aspiration. The finding of CD68 positivity in Gaucher-like cells by using the immunohistochemistry staining supporting Gaucher disease. To confirm the diagnosis, an examination of glucocerebroside substrate from the patient's blood plasma was performed. Glucosylsphingosine, a deacylated form of glucosylceramide, was markedly elevated. Therefore, the diagnosis of Gaucher disease was confirmed. This is the first reported adult Gaucher case diagnosed in Indonesia.
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Affiliation(s)
- Ardhi Rahman Ahani
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
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Stylianou C, Deftereos S. The Erlenmeyer Flask Deformity on Computed Tomography. Acta Med Acad 2023; 52:146-147. [PMID: 37933512 DOI: 10.5644/ama2006-124.415] [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: 03/22/2023] [Accepted: 06/09/2023] [Indexed: 11/08/2023] Open
Abstract
No abstract available.
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Affiliation(s)
| | - Savas Deftereos
- Radiology Department, University General Hospital of Alexandroupolis
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Di Rocco M, Vici CD, Burlina A, Venturelli F, Fiumara A, Fecarotta S, Donati MA, Spada M, Concolino D, Pession A. Screening for lysosomal diseases in a selected pediatric population: the case of Gaucher disease and acid sphingomyelinase deficiency. Orphanet J Rare Dis 2023; 18:197. [PMID: 37480063 PMCID: PMC10362631 DOI: 10.1186/s13023-023-02797-0] [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: 10/04/2022] [Accepted: 07/05/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND GD and ASMD are lysosomal storage disorders that enter into differential diagnosis due to the possible overlap in their clinical manifestations. The availability of safe and effective enzymatic therapies has recently led many investigators to develop and validate new screening tools, such as algorithms, for the diagnosis of LSDs where the lack of disease awareness or failure to implement newborn screening results in a delayed diagnosis. RESULTS the proposed algorithm allows for the clinical and biochemical differentiation between GD and ASMD. It is based on enzyme activity assessed on dried blood spots by multiplexed tandem mass spectrometry (MS/MS) coupled to specific biomarkers as second-tier analysis. CONCLUSIONS we believe that this method will provide a simple, convenient and sensitive tool for the screening of a selected population that can be used by pediatricians and other specialists (such as pediatric hematologists and pediatric hepatologists) often engaged in diagnosing these disorders.
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Affiliation(s)
- Maja Di Rocco
- Department of Pediatrics, Unit of Rare Diseases IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | | | - Alberto Burlina
- Division of Inherited Metabolic Diseases, Department of Diagnostic Services, University Hospital, Padua, Italy
| | - Francesco Venturelli
- Pediatric Unit, Istituti di Ricovero e Cura a Carattere Scientifico Azienda Ospedaliero- Universitaria di Bologna, University of Bologna, Bologna, Italy.
| | - Agata Fiumara
- Referral Center for Inherited Metabolic Disorders, Pediatric Clinical, University-Hospital "Gaspare Rodolico - San Marco", Catania, Italy
- Clinical and Experimental Medicine Department, University of Catania, Catania, Italy
| | | | | | - Marco Spada
- Department of Pediatrics, University of Torino, Torino, Italy
| | - Daniela Concolino
- Department of Science of Health, Pediatric Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Andrea Pession
- Pediatric Unit, Istituti di Ricovero e Cura a Carattere Scientifico Azienda Ospedaliero- Universitaria di Bologna, University of Bologna, Bologna, Italy
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Starosta RT, Siebert M, Vairo FPE, Costa BLDL, Ponzoni CT, Schwartz IVD, Cerski CTS. Histomorphometric analysis of liver biopsies of treated patients with Gaucher disease type 1. Autops Case Rep 2021; 11:e2021306. [PMID: 34458174 PMCID: PMC8387085 DOI: 10.4322/acr.2021.306] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 06/15/2021] [Indexed: 01/12/2023] Open
Abstract
Gaucher disease (GD) is an autosomal recessive lysosomal disorder caused by a disturbance in the metabolism of glucocerebroside in the macrophages. Most of its manifestations – hepatosplenomegaly, anemia, thrombocytopenia, and bone pain – are amenable to a macrophage-target therapy such as enzyme replacement. However, there is increasing evidence that abnormalities of the liver persist despite the specific GD treatment. In this work, we adapted histomorphometry techniques to the study of hepatocytes in GD using liver tissue of treated patients, developing the first morphometrical method for canalicular quantification in immunohistochemistry-stained liver biopsies, and exploring histomorphometric characteristics of GD. This is the first histomorphometric technique developed for canalicular analysis on histological liver biopsy samples.
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Affiliation(s)
- Rodrigo Tzovenos Starosta
- Universidade Federal do Rio Grande do Sul, Graduate Program in Genetics and Molecular Biology, Porto Alegre, RS, Brasil.,Washington University, Department of Pediatrics, Saint Louis, MO, USA
| | - Marina Siebert
- Hospital de Clínicas de Porto Alegre, Laboratorial Research Unit, Experimental Research Center, Porto Alegre, RS, Brasil.,Universidade Federal do Rio Grande do Sul, Graduate Program in Science in Gastroenterology and Hepatology, Porto Alegre, RS, Brasil
| | - Filippo Pinto E Vairo
- Mayo Clinic, Center for Individualized Medicine, Rochester, MN, USA.,Mayo Clinic, Department of Clinical Genomics, Rochester, MN, USA
| | | | | | - Ida Vanessa Doederlein Schwartz
- Universidade Federal do Rio Grande do Sul, Graduate Program in Genetics and Molecular Biology, Porto Alegre, RS, Brasil.,Universidade Federal do Rio Grande do Sul, Department of Genetics, Porto Alegre, RS, Brasil.,Hospital de Clínicas de Porto Alegre, Medical Genetics Service, Porto Alegre, RS, Brasil
| | - Carlos Thadeu Schmidt Cerski
- Universidade Federal do Rio Grande do Sul, Graduate Program in Science in Gastroenterology and Hepatology, Porto Alegre, RS, Brasil.,Hospital de Clínicas de Porto Alegre, Department of Surgical Pathology, Porto Alegre, RS, Brasil
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Srikanth MP, Feldman RA. Elevated Dkk1 Mediates Downregulation of the Canonical Wnt Pathway and Lysosomal Loss in an iPSC Model of Neuronopathic Gaucher Disease. Biomolecules 2020; 10:biom10121630. [PMID: 33287247 PMCID: PMC7761665 DOI: 10.3390/biom10121630] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 11/29/2020] [Accepted: 11/30/2020] [Indexed: 12/11/2022] Open
Abstract
Gaucher Disease (GD), which is the most common lysosomal storage disorder, is caused by bi-allelic mutations in GBA1—a gene that encodes the lysosomal hydrolase β-glucocerebrosidase (GCase). The neuronopathic forms of GD (nGD) are characterized by severe neurological abnormalities that arise during gestation or early in infancy. Using GD-induced pluripotent stem cell (iPSC)-derived neuronal progenitor cells (NPCs), we have previously reported that neuronal cells have neurodevelopmental defects associated with the downregulation of canonical Wnt signaling. In this study, we report that GD NPCs display elevated levels of Dkk1, which is a secreted Wnt antagonist that prevents receptor activation. Dkk1 upregulation in mutant NPCs resulted in an increased degradation of β-catenin, and there was a concomitant reduction in lysosomal numbers. Consistent with these results, incubation of the mutant NPCs with recombinant Wnt3a (rWnt3a) was able to outcompete the excess Dkk1, increasing β-catenin levels and rescuing lysosomal numbers. Furthermore, the incubation of WT NPCs with recombinant Dkk1 (rDkk1) phenocopied the mutant phenotype, recapitulating the decrease in β-catenin levels and lysosomal depletion seen in nGD NPCs. This study provides evidence that downregulation of the Wnt/β-catenin pathway in nGD neuronal cells involves the upregulation of Dkk1. As Dkk1 is an extracellular Wnt antagonist, our results suggest that the deleterious effects of Wnt/β-catenin downregulation in nGD may be ameliorated by the prevention of Dkk1 binding to the Wnt co-receptor LRP6, pointing to Dkk1 as a potential therapeutic target for GBA1-associated neurodegeneration.
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Belarbi K, Cuvelier E, Bonte MA, Desplanque M, Gressier B, Devos D, Chartier-Harlin MC. Glycosphingolipids and neuroinflammation in Parkinson's disease. Mol Neurodegener 2020; 15:59. [PMID: 33069254 PMCID: PMC7568394 DOI: 10.1186/s13024-020-00408-1] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [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] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 10/01/2020] [Indexed: 12/15/2022] Open
Abstract
Parkinson's disease is a progressive neurodegenerative disease characterized by the loss of dopaminergic neurons of the nigrostriatal pathway and the formation of neuronal inclusions known as Lewy bodies. Chronic neuroinflammation, another hallmark of the disease, is thought to play an important role in the neurodegenerative process. Glycosphingolipids are a well-defined subclass of lipids that regulate crucial aspects of the brain function and recently emerged as potent regulators of the inflammatory process. Deregulation in glycosphingolipid metabolism has been reported in Parkinson's disease. However, the interrelationship between glycosphingolipids and neuroinflammation in Parkinson's disease is not well known. This review provides a thorough overview of the links between glycosphingolipid metabolism and immune-mediated mechanisms involved in neuroinflammation in Parkinson's disease. After a brief presentation of the metabolism and function of glycosphingolipids in the brain, it summarizes the evidences supporting that glycosphingolipids (i.e. glucosylceramides or specific gangliosides) are deregulated in Parkinson's disease. Then, the implications of these deregulations for neuroinflammation, based on data from human inherited lysosomal glycosphingolipid storage disorders and gene-engineered animal studies are outlined. Finally, the key molecular mechanisms by which glycosphingolipids could control neuroinflammation in Parkinson's disease are highlighted. These include inflammasome activation and secretion of pro-inflammatory cytokines, altered calcium homeostasis, changes in the blood-brain barrier permeability, recruitment of peripheral immune cells or production of autoantibodies.
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Affiliation(s)
- Karim Belarbi
- Univ. Lille, Inserm, CHU-Lille, Lille Neuroscience & Cognition, 1 Place de Verdun, 59006 Lille, France
- Département de Pharmacologie de la Faculté de Pharmacie, Univ. Lille, Lille, France
| | - Elodie Cuvelier
- Univ. Lille, Inserm, CHU-Lille, Lille Neuroscience & Cognition, 1 Place de Verdun, 59006 Lille, France
- Département de Pharmacologie de la Faculté de Pharmacie, Univ. Lille, Lille, France
| | - Marie-Amandine Bonte
- Univ. Lille, Inserm, CHU-Lille, Lille Neuroscience & Cognition, 1 Place de Verdun, 59006 Lille, France
| | - Mazarine Desplanque
- Univ. Lille, Inserm, CHU-Lille, Lille Neuroscience & Cognition, 1 Place de Verdun, 59006 Lille, France
- Département de Pharmacologie de la Faculté de Pharmacie, Univ. Lille, Lille, France
| | - Bernard Gressier
- Univ. Lille, Inserm, CHU-Lille, Lille Neuroscience & Cognition, 1 Place de Verdun, 59006 Lille, France
- Département de Pharmacologie de la Faculté de Pharmacie, Univ. Lille, Lille, France
| | - David Devos
- Univ. Lille, Inserm, CHU-Lille, Lille Neuroscience & Cognition, 1 Place de Verdun, 59006 Lille, France
- Département de Pharmacologie Médicale, I-SITE ULNE, LiCEND, Lille, France
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Andrade-Campos M, Escuder-Azuara B, de Frutos LL, Serrano-Gonzalo I, Giraldo P. Direct and indirect effects of the SARS-CoV-2 pandemic on Gaucher Disease patients in Spain: Time to reconsider home-based therapies? Blood Cells Mol Dis 2020; 85:102478. [PMID: 32688219 PMCID: PMC7358160 DOI: 10.1016/j.bcmd.2020.102478] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/08/2020] [Accepted: 07/10/2020] [Indexed: 01/05/2023]
Abstract
Objective An analysis of the SARS-CoV-2 pandemic impact in the Spanish Gaucher Disease (GD) community is presented here. Patients & methods The Spanish GD foundation (FEETEF) surveyed 113 GD patients from March 30 to April 27; all patients provided a verbal consent. Results 110 surveys were analyzed. The median age was 47 years old (y.o.), 31 patients were ≥ 60 y.o.; and 34% of patients reported comorbidities. 46% (51/110) of patients were treated by enzyme replacement therapy (ERT), 48 of them at hospitals; 45.1% (45/110) were on substrate reduction therapy (SRT) and 9% (10/110) receive no therapy. 25% (11/48) of ERT-hospital-based patients reported therapy interruptions, while SRT-patients did not report missing doses. No bone crises were reported. However, 50% (55/110) of patients reported being worried about their predisposition to a severe SARS-COV-2 infection and 29% (16/55) of them took anxiolytics or antidepressants for this. While 6 patients reported to have contact with an infected person, another two confirmed SARS-CoV-2 infections were reported in splenectomyzed patients, one of them (a 79-year-old diabetic) died. Conclusions One quarter of the patients treated at hospitals reported dose interruptions. Home-based therapy may need to be considered in order to minimize the impact of the COVID-19 pandemic.
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Affiliation(s)
- Marcio Andrade-Campos
- Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.; Fundación Española para el Estudio y Terapéutica de la Enfermedad de Gaucher y otras lisosomales (FEETEG), Zaragoza, Spain; Grupo de Estudio en Enfermedades de Depósito Lisosomal, Sociedad Española de Hematología y Hemoterapia, Zaragoza, Spain
| | - Beatriz Escuder-Azuara
- Fundación Española para el Estudio y Terapéutica de la Enfermedad de Gaucher y otras lisosomales (FEETEG), Zaragoza, Spain
| | - Laura López de Frutos
- Fundación Española para el Estudio y Terapéutica de la Enfermedad de Gaucher y otras lisosomales (FEETEG), Zaragoza, Spain; Grupo de Estudio en Enfermedades de Depósito Lisosomal, Sociedad Española de Hematología y Hemoterapia, Zaragoza, Spain; Grupo de Investigación en enfermedades Metabólicas y Hematológicas raras (GIIS-012), Fundación Instituto de Investigación Sanitaria Aragón (IIS-Aragón), Zaragoza, Spain
| | - Irene Serrano-Gonzalo
- Fundación Española para el Estudio y Terapéutica de la Enfermedad de Gaucher y otras lisosomales (FEETEG), Zaragoza, Spain; Grupo de Investigación en enfermedades Metabólicas y Hematológicas raras (GIIS-012), Fundación Instituto de Investigación Sanitaria Aragón (IIS-Aragón), Zaragoza, Spain
| | - Pilar Giraldo
- Fundación Española para el Estudio y Terapéutica de la Enfermedad de Gaucher y otras lisosomales (FEETEG), Zaragoza, Spain; Grupo de Estudio en Enfermedades de Depósito Lisosomal, Sociedad Española de Hematología y Hemoterapia, Zaragoza, Spain.
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Tonin R, Catarzi S, Caciotti A, Procopio E, Marini C, Guerrini R, Morrone A. Progressive myoclonus epilepsy in Gaucher Disease due to a new Gly-Gly mutation causing loss of an Exonic Splicing Enhancer. J Neurol 2019; 266:92-101. [PMID: 30382391 DOI: 10.1007/s00415-018-9084-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 10/02/2018] [Accepted: 10/03/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND Patients with Gaucher Disease (GD) exhibit three phenotypes, including type 1 (non-neuronopathic), type 2 (acute neuronopathic), and type 3 (subacute neuronopathic). AIM Identifying which GBA changes represent benign polymorphisms and which may result in disease-causing mutations is essential for diagnosis and genotype/phenotype correlations but is often challenging. RESULTS Here, we describe a patient with type 3 GD, presenting with drug-resistant epilepsy, who bears a set of GBA polymorphic variants including the novel c.363A > G (Gly82Gly) synonymous mutation. In silico predictions, mRNA and functional studies revealed that the new Gly82Gly mutation causes skipping of GBA exon 4, leading to a severe reduction of the wild type GBA mRNA. This is the first report of a synonymous change causing GD through loss of an exonic splicing enhancer sequence. The synonymous mutation is in trans with the Asn188Ser missense mutation, thus making the Asn188Ser responsible for the patient's phenotype and strengthening the association of Asn188Ser with the particular neurological phenotype of type 3 GD. CONCLUSION We strengthen the association of Asn188Ser with the type 3 GD phenotype and progressive myoclonus epilepsy. Our data confirm that in silico predictions and mRNA analysis are mandatory in discriminating pathological mutations from the background of harmless polymorphisms, especially synonymous changes.
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Omrani F, Ansari-Damavandi S, Zamani B, Omrani Z, Mohammadzade N, Rohani S, Rohani M. Transcranial sonography in carriers of Gaucher disease. Iran J Neurol 2018; 17:145-148. [PMID: 30886682 PMCID: PMC6420695] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background: Glucocerebrosidase (GBA) mutation is the most common genetic risk factor in Parkinson's disease (PD). Transcranial sonography (TCS) shows increased substantia nigra (SN) echogenicity in both idiopathic and genetic forms of PD. The goal of this study was to compare maximal area of SN hyperechogenicity (aSNmax) and diameter of third ventricle (DTV) between GBA mutation carriers and healthy controls. Methods: Twenty-six carriers of GBA mutation and twenty-six healthy controls underwent TCS. The aSNmax and the DTV were measured. Mini-mental status examination (MMSE) and demographic data of the subjects were recorded, too. Results: Mean aSNmax in GBA mutation carriers was significantly higher (0.31 ± 0.06 cm2) than controls (0.16 ± 0.04 cm2). Moreover, DTV was significantly higher in GBA mutation carriers group (3.98 ± 0.90 vs 3.29 ± 0.56 cm). Conclusion: Increased SN echogenicity and increased third ventricle diameter in GBA mutation carriers may be caused by alterations in iron metabolism with reference to their genetic status.
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Affiliation(s)
- Fatemeh Omrani
- Department of Neurology, Hazrat-e-Rasool Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Shahla Ansari-Damavandi
- Department of Pediatric Hematology, Ali Asghar Children's Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Babak Zamani
- Department of Neurology, Firouzgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Omrani
- Department of Neurology, Hazrat-e-Rasool Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Nahid Mohammadzade
- Department of Neurology, Hazrat-e-Rasool Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Sadra Rohani
- Department of Neurology, Hazrat-e-Rasool Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Rohani
- Department of Neurology, Hazrat-e-Rasool Hospital, Iran University of Medical Sciences, Tehran, Iran
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Mazher W, Ali J, Abubakar S, Basar S, Murtaza G. Improvement In Symptoms Of Gaucher's Disease By Enzyme Replacement Therapy. J Ayub Med Coll Abbottabad 2018; 30:479-481. [PMID: 30465391] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Gaucher's disease is the most common lysosomal storage disease which occurs due to a deficiency of the enzyme glucocerebrosidase. This enzyme deficiency leads to accumulation of glucocerebrosidase in the cells of macrophage-monocyte system. It is inherited as an autosomal recessive mutation and has three clinical subtypes. The disease presents with anaemia, hepatosplenomegaly, skeletal disorders and organ dysfunction. We present the case of an 18- month old male child who had presented to Civil Hospital, Karachi with fever, progressive pallor, abdominal distention for 6 months and was diagnosed as a case of type 1 Gaucher's disease on the basis of low leukocyte glucocerebrosidase activity, raised plasma chitotriosidase and the presence of Gaucher cells on bone marrow biopsy. The disease was treated with Intravenous replacement of the enzyme Imiglucerase (cerezyme) and the patient was followed. An informed Consent of the parents was taken prior to the writing of the manuscript.
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Affiliation(s)
| | - Jamshed Ali
- Dow university of Health Sciences, Karachi, Pakistan
| | | | - Saqib Basar
- Dow university of Health Sciences, Karachi, Pakistan
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Collins LM, Williams-Gray CH, Morris E, Deegan P, Cox TM, Barker RA. The motor and cognitive features of Parkinson's disease in patients with concurrent Gaucher disease over 2 years: a case series. J Neurol 2018; 265:1789-94. [PMID: 29845374 DOI: 10.1007/s00415-018-8908-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 05/12/2018] [Accepted: 05/16/2018] [Indexed: 01/01/2023]
Abstract
We report the cognitive features and progression of Parkinson’s disease (PD) in five patients with concurrent Gaucher disease. The patients presented at an earlier age than patients with sporadic PD, as previously noted by others; but in contrast to many previous reports, our patients followed a variable clinical course. While two patients developed early cognitive deficits and dementia, three others remained cognitively intact over the follow-up period. Thus, in this small case series, PD in the context of GD more closely resembles idiopathic PD in terms of its clinical heterogeneity in contrast to PD associated with GBA heterozygote mutations.
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Lei K, Zhao Y, Sun L, Liang H, Luo R, Sun X, Tao Y, Chen L, Zhang L, Li A, Li F, Ding H. A pilot screening of high-risk Gaucher disease children using dried blood spot methods in Shandong province of China. Orphanet J Rare Dis 2018; 13:48. [PMID: 29625627 PMCID: PMC5889577 DOI: 10.1186/s13023-018-0782-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 03/09/2018] [Indexed: 11/25/2022] Open
Abstract
Background The study aim was to verify the feasibility of a diagnostic algorithm with the evaluation of beta glucocerebrosidase (GBA) activity on dried blood spots (DBS) in screening high-risk Gaucher disease (GD) children in China, and to investigate the GD prevalence in this selected population. Methods Children were recruited from 20 departments of pediatrics or children’s hospitals in Shandong Province, China, due to splenomegaly and/or thrombocytopenia associated with one or more of the following creteria: anemia, history of bone pain, monoclonal gammopathy of unknown significance (MGUS), polyclonal gammopathy and splenectomy. GBA activity on DBS was tested, and patients with DBS GBA activity under 30 nmol/h.ml were recalled to assess enzyme assay with gold standard and molecular GBA gene analysis on leukocytes. Results A total of 73 children (47 boys and 26 girls) were enrolled in this study. GBA activity DBS < 30 nmol/h.ml was found in 18 (23.7%) children among which four (three boys and one girl) were diagnosed as GD with a median age 1.5 years, and the prevalence in this pediatric population was 5.5% (1.5%~ 13.4%). Three new mutations of GBA found in the four GD patients, L264I, A100Cfs*7 and D399E, have not been reported before. Conclusions With evaluation of GBA activity on DBS as a preliminary screening method, the diagnostic algorithm used in this study is appropriate to make early diagnosis for GD patients with mild symptoms or atypical symptoms and avoid diagnosis delay. Trial registration Not applicable.
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Affiliation(s)
- Ke Lei
- Pediatric Center, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yanxia Zhao
- Pediatric Center, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lirong Sun
- Pediatric Center, Affiliated Hospital of Qingdao University, Qingdao, China.
| | - Hui Liang
- Department of Pediatric Hematology, Qingdao Children's Hospital, Qingdao, China
| | - Ronghua Luo
- Department of Pediatrics, Taian City Central Hospital, Taian, China
| | - Xiaojing Sun
- Department of Pediatrics, Liaocheng People's Hospital, Liaocheng, China
| | - Yanling Tao
- Department of Pediatrics, Affiliated Hospital of Jining Medical College, Jining, China
| | - Lijun Chen
- Department of Pediatric Endocrinology and Hematology, Shandong Provincial Hospital, Jinan, China
| | - Lingling Zhang
- Department of Pediatrics, Linyi People's Hospital, Linyi, China
| | - Aimin Li
- Department of Pediatrics, Yantai Yuhuangding Hospital, Yantai, China
| | - Fu Li
- Department of Pediatric Hematology, Jinan Children's Hospital, Jinan, China
| | - Hongfang Ding
- Department of Pediatrics, Shengli Oilfield Central Hospital, Dongying, China
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14
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Demirci U, Çizmecioglu A, Aydogdu I. Actual reason for bone fractures in the case of a patient followed-up with the osteogenesis imperfecta: Gaucher's Disease. ACTA ACUST UNITED AC 2018; 14:336-339. [PMID: 29354164 DOI: 10.11138/ccmbm/2017.14.3.336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Gaucher's disease (GD) is a rare disease characterized by a β-glucocerebroside accumulation in the reticulo-endothelial system. Patients may refer to the clinic with complaints of bone pain, hepatosplenomegaly, anemia, thrombocytopenia, growth retardation, interstitial pulmonary disease, pulmonary hypertension, and skeletal disorders. Skeletal system involvement is observed commonly in Gaucher patients and a significant cause of morbidity. Our patient was followed for several years as a glass child - osteogenesis imperfecta and he had joint deformities due to skeletal fractures. We wanted to present this case to raise awareness of GD's skeletal involvement and effects of late diagnosis.
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Affiliation(s)
| | - Ahmet Çizmecioglu
- Department of Internal Medicine, Private Konya Anit Hospital, Konya, Turkey
| | - Ismet Aydogdu
- Department of Hematology, Celal Bayar University Faculty of Medicine, Manisa, Turkey
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15
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Dasari SK, Schejter E, Bialik S, Shkedy A, Levin-Salomon V, Levin-Zaidman S, Kimchi A. Death by over-eating: The Gaucher disease associated gene GBA1, identified in a screen for mediators of autophagic cell death, is necessary for developmental cell death in Drosophila midgut. Cell Cycle 2017; 16:2003-2010. [PMID: 28933588 PMCID: PMC5731414 DOI: 10.1080/15384101.2017.1380134] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Autophagy is critical for homeostasis and cell survival during stress, but can also lead to cell death, a little understood process that has been shown to contribute to developmental cell death in lower model organisms, and to human cancer cell death. We recently reported 1 on our thorough molecular and morphologic characterization of an autophagic cell death system involving resveratrol treatment of lung carcinoma cells. To gain mechanistic insight into this death program, we performed a signalome-wide RNAi screen for genes whose functions are necessary for resveratrol-induced death. The screen identified GBA1, the gene encoding the lysosomal enzyme glucocerebrosidase, as an important mediator of autophagic cell death. Here we further show the physiological relevance of GBA1 to developmental cell death in midgut regression during Drosophila metamorphosis. We observed a delay in midgut cell death in two independent Gba1a RNAi lines, indicating the critical importance of Gba1a for midgut development. Interestingly, loss-of-function GBA1 mutations lead to Gaucher Disease and are a significant risk factor for Parkinson Disease, which have been associated with defective autophagy. Thus GBA1 is a conserved element critical for maintaining proper levels of autophagy, with high levels leading to autophagic cell death.
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Affiliation(s)
- Santosh K Dasari
- a Department of Molecular Genetics , Weizmann Institute of Science , Rehovot , Israel
| | - Eyal Schejter
- a Department of Molecular Genetics , Weizmann Institute of Science , Rehovot , Israel
| | - Shani Bialik
- a Department of Molecular Genetics , Weizmann Institute of Science , Rehovot , Israel
| | - Aya Shkedy
- a Department of Molecular Genetics , Weizmann Institute of Science , Rehovot , Israel
| | - Vered Levin-Salomon
- a Department of Molecular Genetics , Weizmann Institute of Science , Rehovot , Israel
| | - Smadar Levin-Zaidman
- b Department of Chemical Research Support , Weizmann Institute of Science , Rehovot , Israel
| | - Adi Kimchi
- a Department of Molecular Genetics , Weizmann Institute of Science , Rehovot , Israel
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16
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Andrade-Campos M, Alfonso P, Irun P, Armstrong J, Calvo C, Dalmau J, Domingo MR, Barbera JL, Cano H, Fernandez-Galán MA, Franco R, Gracia I, Gracia-Antequera M, Ibañez A, Lendinez F, Madruga M, Martin-Hernández E, O’Callaghan MDM, del Soto AP, del Prado YR, Sancho-Val I, Sanjurjo P, Pocovi M, Giraldo P. Diagnosis features of pediatric Gaucher disease patients in the era of enzymatic therapy, a national-base study from the Spanish Registry of Gaucher Disease. Orphanet J Rare Dis 2017; 12:84. [PMID: 28468677 PMCID: PMC5415726 DOI: 10.1186/s13023-017-0627-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [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] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 04/07/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The enzymatic replacement therapy (ERT) availability for Gaucher disease (GD) has changed the landscape of the disease, several countries have screening programs. These actions have promoted the early diagnosis and avoided many complications in pediatric patients. In Spain ERT has been available since 1993 and 386 patients have been included in the Spanish Registry of Gaucher Disease (SpRGD). The aim of this study is to analyze the impact of ERT on the characteristics at time of diagnosis and initial complications in pediatric Gaucher disease patients. AIM To analyze the impact of ERT on the characteristics at time of diagnosis and initial complications in pediatric Gaucher disease patients. METHODS A review of data in SpRGD from patients' diagnosed before 18 years old was performed. The cohort was split according the year of diagnosis (≤1994, cohort A; ≥1995, cohort B). RESULTS A total of 98 pediatric patients were included, GD1: 80, GD3: 18; mean age: 7.2 (0.17-16.5) years, 58 (59.2%) males and 40 (40.8%) females. Forty-five were diagnosed ≤ 1994 and 53 ≥ 1995. Genotype: N370S/N370S: 2 (2.0%), N370S/L444P: 27 (27.5%), N370S/other: 47 (48%), L444P/L444P: 7 (7.1%), L444P/D409H: 2 (2.0%), L444P/other: 3 (6.2%), other/other: 10 (10.2%). The mean age at diagnosis was earlier in patients diagnosed after 1995 (p < 0.001) and different between the subtypes, GD1: 8.2 (0.2-16.5) years and GD3: 2.8 (0.17-10.2) years (p < 0.001). There were more severe patients in the group diagnosed before 1994 (p = 0.045) carrying L444P (2), D409H (2), G377S (1), G195W (1) or the recombinant mutation. The patients' diagnosed ≤1994 showed worse cytopenias, higher chance of bone vascular complications at diagnosis and previous spleen removal. The patients started ERT at a median time after diagnosis of 5.2 years [cohort A] and 1.6 years [cohort B] (p < 0.001). CONCLUSIONS The early diagnosis of Gaucher disease in the era of ERT availability has permitted to reduce the incidence of severe and irreversible initial complication in pediatric patients, and this has permitted better development of these patients. This is the largest pediatric cohort from a national registry.
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Affiliation(s)
- Marcio Andrade-Campos
- Haematology Department, Miguel Servet University Hospital, Zaragoza, Spain
- CIBER de Enfermedades Raras (CIBERER), Instituto Salud Carlos III, Zaragoza, Spain
- Traslational Research Unit, Aragon Institute of Health Research (IISAragon), Zaragoza, Spain
| | - Pilar Alfonso
- CIBER de Enfermedades Raras (CIBERER), Instituto Salud Carlos III, Zaragoza, Spain
- Traslational Research Unit, Aragon Institute of Health Research (IISAragon), Zaragoza, Spain
| | - Pilar Irun
- CIBER de Enfermedades Raras (CIBERER), Instituto Salud Carlos III, Zaragoza, Spain
- Traslational Research Unit, Aragon Institute of Health Research (IISAragon), Zaragoza, Spain
| | | | - Carmen Calvo
- Pediatric Department, San Jorge Hospital, Huesca, Spain
| | - Jaime Dalmau
- Pediatric Department, La Fe University Hospital, Valencia, Spain
| | | | | | - Horacio Cano
- Haematology Department, Los Arcos del Mar Menor University Hospital, Murcia, Spain
| | | | - Rafael Franco
- Haematology Department, Punta Europa Hospital, Cádiz, Spain
| | - Inmaculada Gracia
- Pediatric Department, Miguel Servet University Hospital, Zaragoza, Spain
| | | | - Angela Ibañez
- Haematology Department, Complejo Hospitalario Albacete, Albacete, Spain
| | | | - Marcos Madruga
- Neurology Department, Hospital Universitario Virgen del Rocio, Sevilla, Spain
| | | | | | | | | | | | - Pablo Sanjurjo
- Pediatric Department, Cruces University Hospital, Bilbao, Spain
| | - Miguel Pocovi
- Biochemistry and Molecular and Cellular Biology Department, Zaragoza University, Zaragoza, Spain
| | - Pilar Giraldo
- Haematology Department, Miguel Servet University Hospital, Zaragoza, Spain
- CIBER de Enfermedades Raras (CIBERER), Instituto Salud Carlos III, Zaragoza, Spain
- Traslational Research Unit, Aragon Institute of Health Research (IISAragon), Zaragoza, Spain
- Spanish Foundation for the Study and Therapy of Gaucher Disease (FEETEG), Zaragoza, Spain
- Unidad de Investigacion Traslacional, Pta Baja, Hospital Universitario Miguel Servet, Paseo Isabel La Catolica 1-3, Zaragoza, 50009 Spain
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17
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Amico G, Grossi S, Vijzelaar R, Lanza F, Mazzotti R, Corsolini F, Ketema M, Filocamo M. MLPA-based approach for initial and simultaneous detection of GBA deletions and recombinant alleles in patients affected by Gaucher Disease. Mol Genet Metab 2016; 119:329-337. [PMID: 27802905 DOI: 10.1016/j.ymgme.2016.10.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 10/24/2016] [Accepted: 10/24/2016] [Indexed: 11/23/2022]
Abstract
The chromosomal region, in which the GBA gene is located, is structurally subject to misalignments, reciprocal and nonreciprocal homologous recombination events, leading to structural defects such as deletions, duplications and gene-pseudogene complex rearrangements causing Gaucher Disease (GD). Interestingly deletions and duplications, belonging to the heterogeneous group of structural defects collectively termed Copy Number Variations (CNVs), together with gene-pseudogene complex rearrangements represent the main cause of pitfalls in GD mutational analysis. In the present study, we set up and validate a Multiplex Ligation-dependent Probe Amplification (MLPA)-based approach to simultaneously investigate the potential occurrence of CNVs and complex rearrangements in 8 unrelated GD patients who had still not-well-characterized or uncharacterized alleles. The findings allowed us to complete the mutational analysis in 4 patients, identifying a rare deletion (g.-3100_+834del3934) and 2 novel recombinant alleles (g.4356_7031conJ03060.1:g.2544_4568; g.1942_7319conJ03060.1:g.1092_4856). These results demonstrate the diagnostic usefulness of MLPA in the detection of GBA deletions and recombinations. In addition, MLPA findings have also served as a basis for developing molecular approaches to precisely pinpoint the breakpoints and characterize the underlying mechanism of copy number variations.
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Affiliation(s)
- Giulia Amico
- Centro di Diagnostica Genetica e Biochimica delle Malattie Metaboliche, Istituto G. Gaslini, Via Gaslini 5, 16147 Genova, Italy.
| | - Serena Grossi
- Centro di Diagnostica Genetica e Biochimica delle Malattie Metaboliche, Istituto G. Gaslini, Via Gaslini 5, 16147 Genova, Italy.
| | - Raymon Vijzelaar
- MRC-Holland, Willem Schoutenstraat 1, 1057 DL Amsterdam, The Netherlands.
| | - Federica Lanza
- Centro di Diagnostica Genetica e Biochimica delle Malattie Metaboliche, Istituto G. Gaslini, Via Gaslini 5, 16147 Genova, Italy.
| | - Raffaella Mazzotti
- Centro di Diagnostica Genetica e Biochimica delle Malattie Metaboliche, Istituto G. Gaslini, Via Gaslini 5, 16147 Genova, Italy.
| | - Fabio Corsolini
- Centro di Diagnostica Genetica e Biochimica delle Malattie Metaboliche, Istituto G. Gaslini, Via Gaslini 5, 16147 Genova, Italy.
| | - Mirjam Ketema
- MRC-Holland, Willem Schoutenstraat 1, 1057 DL Amsterdam, The Netherlands.
| | - Mirella Filocamo
- Centro di Diagnostica Genetica e Biochimica delle Malattie Metaboliche, Istituto G. Gaslini, Via Gaslini 5, 16147 Genova, Italy.
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MOZAFARI H, TAGHIKHANI M, KHATAMI S, ALAEI MR, VAISI-RAYGANI A, RAHIMI Z. Chitotriosidase Activity and Gene Polymorphism in Iranian Patients with Gaucher Disease and Sibling Carriers. Iran J Child Neurol 2016; 10:62-70. [PMID: 27843468 PMCID: PMC5100039] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Chitotriosidase (CT) activity is a useful biomarker for diagnosis and monitoring of Gaucher disease (GD). Its application is limited by some variants in the CT gene. Two main polymorphisms are 24 bp duplication and G102S led to reduce CT activity. The aim of this study was to determine these variants influencing on plasma CT activity. MATERIALS & METHODS Blood samples were collected from 33 patients with GD, 15 sibling carriers and 105 healthy individuals serving as controls. CT activity was measured using 4-methylumbelliferyl-β-D-N,N',N″triacetylchitotrioside substrate in plasma samples. The CT genotypes of 24 bp duplication and G102S variants were determined using PCR and PCR-RFLP. RESULTS Untreated GD patients had a significantly higher CT activity compared to treated patients (P = 0.021). In addition, chitotriosidase activity in carriers was higher rather than controls. Allele frequencies of 24 bp duplication in GD patients, sibling carriers and controls were 0.21, 0.266 and 0.29 and for G102S were 0.318, 0.366 and 0.219, respectively. Different G102S genotypes had not significant effect on CT activity. Chitotriosidase activity has a positive correlation with age in normal group, carriers, and negative correlation with hemoglobin in GD patients. Using cut-off level of 80.75 nmol/ml/h, sensitivity and specificity of CT activity were 93.9% and 100%, respectively. CONCLUSION Chitotriosidase activity is a suitable biomarker for diagnosis and monitoring of GD. Determination of 24 bp duplication is helpful for more accurate monitoring the GD patient's therapy. However, it seems that, specifying of the G102S polymorphism is not required for Iranian GD patients.
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Affiliation(s)
- Hadi MOZAFARI
- Department of Clinical Biochemistry, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mohammad TAGHIKHANI
- Department of Clinical Biochemistry, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Shohreh KHATAMI
- Department of Biochemistry, Pasteur Institute of Iran, Tehran, Iran
| | - Mohammad Reza ALAEI
- Department of Pediatric, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Asad VAISI-RAYGANI
- Department of Clinical Biochemistry, Medical School, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Zohreh RAHIMI
- Department of Clinical Biochemistry, Medical School, Kermanshah University of Medical Sciences, Kermanshah, Iran
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19
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Choi JH, Lee BH, Ko JM, Sohn YB, Lee JS, Kim GH, Heo SH, Park JY, Kim YM, Kim JH, Yoo HW. A phase 2 multi-center, open-label, switch-over trial to evaluate the safety and efficacy of Abcertin® in patients with type 1 Gaucher disease. J Korean Med Sci 2015; 30:378-84. [PMID: 25829804 PMCID: PMC4366957 DOI: 10.3346/jkms.2015.30.4.378] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 12/03/2014] [Indexed: 11/23/2022] Open
Abstract
Gaucher disease is a lysosomal storage disease for which enzyme replacement therapy has proven to be effective. A switch-over clinical trial was performed to evaluate the efficacy and safety of Abcertin® (ISU Abxis, Seoul, Korea) in subjects with type 1 Gaucher disease who were previously treated with imiglucerase. Five Korean patients with type 1 Gaucher disease were enrolled. Previous doses of imiglucerase ranged from 30 to 55 U/kg every other week. The same dose of Abcertin® was administered to all patients for 24 weeks. Primary efficacy endpoints were changes in hemoglobin levels and platelet counts, and the secondary efficacy endpoints included changes in liver and spleen volumes, serum biomarkers, skeletal status and bone mineral density (BMD). During the study period, no statistically significant changes were observed in all parameters including hemoglobin levels and platelet counts, liver and spleen volumes, skeletal status and BMD. Abcertin® administration was continued in three patients for another 24 weeks as an extension of the study. Hemoglobin levels and platelet counts were maintained in all three patients. In conclusion, the efficacy and safety of Abcertin® are similar to those of imiglucerase, and Abcertin® is an effective therapeutic agent for patients with type 1 Gaucher disease (Clinical Trial Registry No. NCT02053896 at www.clinicaltrials.gov).
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Affiliation(s)
- Jin-Ho Choi
- Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea
| | - Beom Hee Lee
- Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea
| | - Jung Min Ko
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Young Bae Sohn
- Department of Medical Genetics, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea
| | - Jin-Sung Lee
- Department of Clinical Genetics, Yonsei University College of Medicine, Seoul, Korea
| | - Gu-Hwan Kim
- Medical Genetics Center, Asan Medical Center Children's Hospital, Seoul, Korea
| | - Sun Hee Heo
- Medical Genetics Center, Asan Medical Center Children's Hospital, Seoul, Korea
| | | | - Yoo-Mi Kim
- Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea
| | - Ja-Hye Kim
- Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea
| | - Han-Wook Yoo
- Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea
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20
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Essabar L, Meskini T, Lamalmi N, Ettair S, Erreimi N, Mouane N. Gaucher's disease: report of 11 cases with review of literature. Pan Afr Med J 2015; 20:18. [PMID: 25995815 PMCID: PMC4431408 DOI: 10.11604/pamj.2015.20.18.4112] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Accepted: 10/09/2014] [Indexed: 12/16/2022] Open
Abstract
Gaucher's disease (GD) is a lysosomal storage disorder due to glucocerebrosidase deficiency; it's one of the rare genetic diseases for which therapy is now available. The purpose of this work is to study the epidemiological features of the disease and to highlight the diagnostic difficulties. We performed an 11-year retrospective study of 11 patients with GD followed-up in the department of paediatric hepatology gastroenterology and nutrition of Rabat children's Hospital. We observed 11 patients with GD: 6 males and 5 females. Age at onset ranged from 3 months to 10 years with an average of 3.41 years. Mean age at diagnosis was 4 years (range 3months-14years). Parental consanguinity was noted in 85% cases. According to the clinical presentation, we classified our patients into: 9 cases of type 1 (81%) and two cases of type 2 (19%), none of the patients presented GD type 3. GD type 1: The age at diagnosis ranged from 2 years to 14 year with an average of 6 years. Main symptoms were: splenomegaly, hepatomegaly, pallor, haemorrhagic appearance (40%), bone pain (40%). The diagnosis was based on histology showing the Gaucher's cells in various tissues (100%). Enzymatic activity dosage confirmed the diagnosis of GD for 4 patients (44.5%). The treatment was always symptomatic (analgesics, transfusion). A splenectomy was performed in one case presenting with multiple splenic abscesses and high transfusion requirements. None of the patients received a specific treatment (substitutive enzymotherapy). The follow-up period ranged from 3 months to 6 years with an average follow-up of 4 years. We noticed stability in 4 cases, 2 worsening cases with bone and spleen complications. Three patients were lost to follow-up. GD type 2: we observed two cases of GD type 2 diagnosed at 3 and 18 months. The visceral symptoms were serious and the neurological features included seizures, hypertony, squint, physical developmental milestones delay. Both of them died. Gaucher's disease is not exceptional in Morocco. Type 1 is the most common type. We noted through this study some diagnostic difficulties as the diagnosis was delayed and the enzymatic dosage was performed in only 42% of the cases as well as therapeutic difficulty with no prescription of the specific treatment given the high cost of the enzyme.
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Affiliation(s)
- Laila Essabar
- FMPR, University Mohammed V Souissi, Department of Pediatric Hepatology Gastroenterology and Nutrition - P III, Rabat Children's Hospital, Morocco
| | - Toufik Meskini
- FMPR, University Mohammed V Souissi, Department of Pediatric Hepatology Gastroenterology and Nutrition - P III, Rabat Children's Hospital, Morocco
| | - Najat Lamalmi
- FMPR, University Mohammed V Souissi, Department of Anatomo-Pathology, Rabat Children's Hospital
| | - Said Ettair
- FMPR, University Mohammed V Souissi, Department of Pediatric Hepatology Gastroenterology and Nutrition - P III, Rabat Children's Hospital, Morocco
| | - Naima Erreimi
- FMPR, University Mohammed V Souissi, Department of Pediatric Hepatology Gastroenterology and Nutrition - P III, Rabat Children's Hospital, Morocco
| | - Nezha Mouane
- FMPR, University Mohammed V Souissi, Department of Pediatric Hepatology Gastroenterology and Nutrition - P III, Rabat Children's Hospital, Morocco
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21
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Yap TL, Jiang Z, Heinrich F, Gruschus JM, Pfefferkorn CM, Barros M, Curtis JE, Sidransky E, Lee JC. Structural features of membrane-bound glucocerebrosidase and α-synuclein probed by neutron reflectometry and fluorescence spectroscopy. J Biol Chem 2014; 290:744-54. [PMID: 25429104 DOI: 10.1074/jbc.m114.610584] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Mutations in glucocerebrosidase (GCase), the enzyme deficient in Gaucher disease, are a common genetic risk factor for the development of Parkinson disease and related disorders, implicating the role of this lysosomal hydrolase in the disease etiology. A specific physical interaction exists between the Parkinson disease-related protein α-synuclein (α-syn) and GCase both in solution and on the lipid membrane, resulting in efficient enzyme inhibition. Here, neutron reflectometry was employed as a first direct structural characterization of GCase and α-syn·GCase complex on a sparsely-tethered lipid bilayer, revealing the orientation of the membrane-bound GCase. GCase binds to and partially inserts into the bilayer with its active site most likely lying just above the membrane-water interface. The interaction was further characterized by intrinsic Trp fluorescence, circular dichroism, and surface plasmon resonance spectroscopy. Both Trp fluorescence and neutron reflectometry results suggest a rearrangement of loops surrounding the catalytic site, where they extend into the hydrocarbon chain region of the outer leaflet. Taking advantage of contrasting neutron scattering length densities, the use of deuterated α-syn versus protiated GCase showed a large change in the membrane-bound structure of α-syn in the complex. We propose a model of α-syn·GCase on the membrane, providing structural insights into inhibition of GCase by α-syn. The interaction displaces GCase away from the membrane, possibly impeding substrate access and perturbing the active site. GCase greatly alters membrane-bound α-syn, moving helical residues away from the bilayer, which could impact the degradation of α-syn in the lysosome where these two proteins interact.
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Affiliation(s)
| | - Zhiping Jiang
- From the Laboratory of Molecular Biophysics, NHLBI, and
| | - Frank Heinrich
- the Department of Physics, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, and the Center for Neutron Research, National Institute of Standards and Technology (NIST), Gaithersburg, Maryland 20899
| | | | | | - Marilia Barros
- the Department of Physics, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, and
| | - Joseph E Curtis
- the Center for Neutron Research, National Institute of Standards and Technology (NIST), Gaithersburg, Maryland 20899
| | - Ellen Sidransky
- the Medical Genetics Branch, NHGRI, National Institutes of Health, Bethesda, Maryland 20892
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Kallemeijn WW, Witte MD, Voorn-Brouwer TM, Walvoort MTC, Li KY, Codée JDC, van der Marel GA, Boot RG, Overkleeft HS, Aerts JMFG. A sensitive gel-based method combining distinct cyclophellitol-based probes for the identification of acid/base residues in human retaining β-glucosidases. J Biol Chem 2014; 289:35351-62. [PMID: 25344605 DOI: 10.1074/jbc.m114.593376] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Retaining β-exoglucosidases operate by a mechanism in which the key amino acids driving the glycosidic bond hydrolysis act as catalytic acid/base and nucleophile. Recently we designed two distinct classes of fluorescent cyclophellitol-type activity-based probes (ABPs) that exploit this mechanism to covalently modify the nucleophile of retaining β-glucosidases. Whereas β-epoxide ABPs require a protonated acid/base for irreversible inhibition of retaining β-glucosidases, β-aziridine ABPs do not. Here we describe a novel sensitive method to identify both catalytic residues of retaining β-glucosidases by the combined use of cyclophellitol β-epoxide- and β-aziridine ABPs. In this approach putative catalytic residues are first substituted to noncarboxylic amino acids such as glycine or glutamine through site-directed mutagenesis. Next, the acid/base and nucleophile can be identified via classical sodium azide-mediated rescue of mutants thereof. Selective labeling with fluorescent β-aziridine but not β-epoxide ABPs identifies the acid/base residue in mutagenized enzyme, as only the β-aziridine ABP can bind in its absence. The Absence of the nucleophile abolishes any ABP labeling. We validated the method by using the retaining β-glucosidase GBA (CAZy glycosylhydrolase family GH30) and then applied it to non-homologous (putative) retaining β-glucosidases categorized in GH1 and GH116: GBA2, GBA3, and LPH. The described method is highly sensitive, requiring only femtomoles (nanograms) of ABP-labeled enzymes.
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Affiliation(s)
- Wouter W Kallemeijn
- From the Department of Medical Biochemistry, Academic Medical Center, University of Amsterdam, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands and
| | - Martin D Witte
- Bioorganic Synthesis, Leiden Institute of Chemistry, P. O. box 9502, 2300 RA Leiden, The Netherlands
| | - Tineke M Voorn-Brouwer
- From the Department of Medical Biochemistry, Academic Medical Center, University of Amsterdam, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands and
| | - Marthe T C Walvoort
- Bioorganic Synthesis, Leiden Institute of Chemistry, P. O. box 9502, 2300 RA Leiden, The Netherlands
| | - Kah-Yee Li
- Bioorganic Synthesis, Leiden Institute of Chemistry, P. O. box 9502, 2300 RA Leiden, The Netherlands
| | - Jeroen D C Codée
- Bioorganic Synthesis, Leiden Institute of Chemistry, P. O. box 9502, 2300 RA Leiden, The Netherlands
| | - Gijsbert A van der Marel
- Bioorganic Synthesis, Leiden Institute of Chemistry, P. O. box 9502, 2300 RA Leiden, The Netherlands
| | - Rolf G Boot
- From the Department of Medical Biochemistry, Academic Medical Center, University of Amsterdam, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands and
| | - Herman S Overkleeft
- Bioorganic Synthesis, Leiden Institute of Chemistry, P. O. box 9502, 2300 RA Leiden, The Netherlands
| | - Johannes M F G Aerts
- From the Department of Medical Biochemistry, Academic Medical Center, University of Amsterdam, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands and
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23
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Galea GL, Meakin LB, Williams CM, Hulin-Curtis SL, Lanyon LE, Poole AW, Price JS. Protein kinase Cα (PKCα) regulates bone architecture and osteoblast activity. J Biol Chem 2014; 289:25509-22. [PMID: 25070889 PMCID: PMC4162157 DOI: 10.1074/jbc.m114.580365] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Bones' strength is achieved and maintained through adaptation to load bearing. The role of the protein kinase PKCα in this process has not been previously reported. However, we observed a phenotype in the long bones of Prkca−/− female but not male mice, in which bone tissue progressively invades the medullary cavity in the mid-diaphysis. This bone deposition progresses with age and is prevented by disuse but unaffected by ovariectomy. Castration of male Prkca−/− but not WT mice results in the formation of small amounts of intramedullary bone. Osteoblast differentiation markers and Wnt target gene expression were up-regulated in osteoblast-like cells derived from cortical bone of female Prkca−/− mice compared with WT. Additionally, although osteoblastic cells derived from WT proliferate following exposure to estradiol or mechanical strain, those from Prkca−/− mice do not. Female Prkca−/− mice develop splenomegaly and reduced marrow GBA1 expression reminiscent of Gaucher disease, in which PKC involvement has been suggested previously. From these data, we infer that in female mice, PKCα normally serves to prevent endosteal bone formation stimulated by load bearing. This phenotype appears to be suppressed by testicular hormones in male Prkca−/− mice. Within osteoblastic cells, PKCα enhances proliferation and suppresses differentiation, and this regulation involves the Wnt pathway. These findings implicate PKCα as a target gene for therapeutic approaches in low bone mass conditions.
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Affiliation(s)
- Gabriel L Galea
- From the School of Veterinary Sciences, University of Bristol, Bristol BS2 8EJ, United Kingdom and
| | - Lee B Meakin
- From the School of Veterinary Sciences, University of Bristol, Bristol BS2 8EJ, United Kingdom and
| | - Christopher M Williams
- the School of Physiology and Pharmacology, University of Bristol, Bristol BS8 1TD, United Kingdom
| | - Sarah L Hulin-Curtis
- From the School of Veterinary Sciences, University of Bristol, Bristol BS2 8EJ, United Kingdom and
| | - Lance E Lanyon
- From the School of Veterinary Sciences, University of Bristol, Bristol BS2 8EJ, United Kingdom and
| | - Alastair W Poole
- the School of Physiology and Pharmacology, University of Bristol, Bristol BS8 1TD, United Kingdom
| | - Joanna S Price
- From the School of Veterinary Sciences, University of Bristol, Bristol BS2 8EJ, United Kingdom and
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24
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Abstract
Gaucher Disease (GD) is a progressive lysosomal storage disorder caused by deficiency of glucocerebrosidase (GBA). The clinical phenotype follows a spectrum ranging from severe early-onset to milder late-onset disease. The absence of neurological involvement defines GD type I, whereas neuronopathic features define GD type II and III. Early diagnosis may be important for timely initiation of enzyme replacement therapy to prevent disease complications, although the enzyme does not cross the blood brain barrier. Diagnosis of GD can be readily achieved by analysis of GBA in leukocytes, fibroblasts, and/or dried blood spots using fluorometric, microfluidic or mass spectrometry-based assays. Low GBA activities are typically confirmed through molecular analysis of the GBA gene. GBA analysis in dried blood spots may be attractive for high-throughput screening of at-risk individuals and/or newborn infants. The method detailed in this unit is based on GBA analysis by tandem mass spectrometry following incubation of dried blood spots with the GBA-specific substrate D-glucosyl-β1-1'-N-dodecanoyl-D-erythro-sphingosine [C12-glucocerebroside (C36H69NO8)] and internal standard N-myristoyl-D-erythro-sphingosine [C14-ceramide (C32H63NO3)]. GBA activities in more than 2,000 newborn infants showed a mean of 22.0 ± 13.8 μmol/hr/liter (median: 19.9 μmol/hr/liter; 95% CI: 21.41-22.59 μmol/hr/liter). GBA activities in an adult population (n >1,200) showed generally lower enzyme activities than newborns, with a mean of 9.87 ± 9.35 μmol/hr/liter (median: 8.06 μmol/hr/liter). GBA activities in ten adult patients with confirmed GD were less than 4.2 μmol/hr/liter and in seven infants and children with GD less than 1.24 μmol/hr/liter. This method is robust, sensitive, and suitable for high-throughput analysis of hundreds of samples.
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Affiliation(s)
- Britt A Johnson
- Division of Clinical and Translational Genetics, Dr. John T. MacDonald Foundation Department of Human Genetics, University of Miami, Miller School of Medicine, Miami, Florida
| | - Angela Dajnoki
- Division of Clinical and Translational Genetics, Dr. John T. MacDonald Foundation Department of Human Genetics, University of Miami, Miller School of Medicine, Miami, Florida
| | - Olaf Bodamer
- Division of Clinical and Translational Genetics, Dr. John T. MacDonald Foundation Department of Human Genetics, University of Miami, Miller School of Medicine, Miami, Florida
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25
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Siebert M, Westbroek W, Chen YC, Moaven N, Li Y, Velayati A, Saraiva-Pereira ML, Martin SE, Sidransky E. Identification of miRNAs that modulate glucocerebrosidase activity in Gaucher disease cells. RNA Biol 2014; 11:1291-300. [PMID: 25584808 PMCID: PMC4615671 DOI: 10.1080/15476286.2014.996085] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [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: 06/06/2014] [Accepted: 10/02/2014] [Indexed: 12/21/2022] Open
Abstract
Gaucher disease is an autosomal recessive disorder caused by deficiency of the enzyme glucocerebrosidase. Although it is a monogenic disease, there is vast phenotypic heterogeneity, even among patients with the same genotype. MicroRNAs (miRNAs) are small non-coding RNAs involved in many biological processes and diseases. To determine whether miRNAs can affect glucocerebrosidase activity, we performed a screen of 875 different miRNA mimics. The screen was performed using Gaucher fibroblasts, and glucocerebrosidase activity was used as the initial outcome parameter. We found several miRNAs that either up- or down-regulated glucocerebrosidase activity. In follow-up assays, we confirmed that one specific miRNA (miR-127-5p) down-regulated both glucocerebrosidase activity and protein levels by down-regulation of LIMP-2, the receptor involved in proper trafficking of glucocerebrosidase from the endoplasmic reticulum to the lysosome. A conditioned media assay demonstrated that cells treated with this miRNA secreted glucocerebrosidase into the extracellular environment, supporting impaired LIMP-2 function. Two other miRNAs, miR-16-5p and miR-195-5p, were found to up-regulate glucocerebrosidase activity by greater than 40% and to enhance expression and protein levels of the enzyme. In conclusion, we show that miRNAs can alter glucocerebrosidase activity in patient cells, indicating that miRNAs can potentially act as modifiers in Gaucher disease.
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Affiliation(s)
- Marina Siebert
- Section on Molecular Neurogenetics; Medical Genetics Branch; National Human Genome Research Institute; National Institutes of Health; Bethesda, MD USA
- Postgraduate Program in Cellular and Molecular Biology; Universidade Federal do Rio Grande do Sul; Porto Alegre, RS Brazil
- Laboratory of Genetic Identification and Medical Genetics Service; Hospital de Clínicas de Porto Alegre; Porto Alegre, RS Brazil
| | - Wendy Westbroek
- Section on Molecular Neurogenetics; Medical Genetics Branch; National Human Genome Research Institute; National Institutes of Health; Bethesda, MD USA
| | - Yu-Chi Chen
- RNAi Screening Facility; National Center for Advancing Translational Sciences; National Institutes of Health; Rockville, MD USA
| | - Nima Moaven
- Section on Molecular Neurogenetics; Medical Genetics Branch; National Human Genome Research Institute; National Institutes of Health; Bethesda, MD USA
| | - Yan Li
- Protein/Peptide Sequencing Facility; National Institute of Neurological Disorders and Stroke; National Institutes of Health; Bethesda, MD USA
| | - Arash Velayati
- Section on Molecular Neurogenetics; Medical Genetics Branch; National Human Genome Research Institute; National Institutes of Health; Bethesda, MD USA
| | - Maria Luiza Saraiva-Pereira
- Postgraduate Program in Cellular and Molecular Biology; Universidade Federal do Rio Grande do Sul; Porto Alegre, RS Brazil
- Laboratory of Genetic Identification and Medical Genetics Service; Hospital de Clínicas de Porto Alegre; Porto Alegre, RS Brazil
- Department of Biochemistry; Universidade Federal do Rio Grande do Sul; Porto Alegre, RS Brazil
| | - Scott E Martin
- RNAi Screening Facility; National Center for Advancing Translational Sciences; National Institutes of Health; Rockville, MD USA
| | - Ellen Sidransky
- Section on Molecular Neurogenetics; Medical Genetics Branch; National Human Genome Research Institute; National Institutes of Health; Bethesda, MD USA
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26
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Binesh F, Yousefi A, Ordooei M, Bagherinasab MA. Gaucher's Disease, an Unusual Cause of Massive Splenomegaly, a Case Report. Iran J Ped Hematol Oncol 2013; 3:173-5. [PMID: 24575292 PMCID: PMC3915458] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Accepted: 09/29/2013] [Indexed: 12/04/2022]
Abstract
BACKGROUND Gaucher's Disease (G.D.) is an autosomal recessive disorder resulting from the accumulation of glucocerebrosidase in the cells of macrophage-monocyte system as a result of a deficiency in lysosomal glucocerebrosidase. This enzyme is encoded by a gene on chromosome-1. Here we report a case of Gaucher's Disease .G.D is rare in Yazd. CASE REPORTS We reported a patient that presented with weakness, pallor and gradually increasing abdominal girth. Clinical examination and history pointed to be a lipid storage disease. Final diagnosis of G.D. was reported after examining the bone marrow smears. Confirmation of diagnosis on Gaucher's disease was performed by measurement of glucocerebrosidase level. CONCLUSION We report a case of G.D. to emphasize the importance of early recognition by clinical manifestation and histological findings. G.D. should be considered in the differential diagnosis of children with unexplained splenomegaly.
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Affiliation(s)
- F Binesh
- Associate Professor Of Pathology,Shahid Sadoughi University Of Medical Sciences,Yazd,Iran
| | - A Yousefi
- Assistant Professor Of Pediateric Disease, Shahid Sadoughi University Of Medical Sciences,Yazd,Iran
| | - M Ordooei
- Assistant Professor Of Pediateric Disease, Shahid Sadoughi University Of Medical Sciences,Yazd,Iran
| | - MA Bagherinasab
- General practitioner, Shahid Sadoughi University Of Medical Sciences,Yazd,Iran
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27
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Shehi B, Boçari G, Vyshka G, Xhepa R, Alushani D. Gaucher's Disease in Albanian Children: Casuistics and Treatment. Iran J Pediatr 2011; 21:1-7. [PMID: 23056756 PMCID: PMC3446102] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/01/2010] [Revised: 08/10/2010] [Accepted: 09/20/2010] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Gaucher's disease is a rare genetic disorder that results in the accumulation of cerebrosides in the liver, spleen, kidneys, lungs, brain and bone marrow. The deficiency of the specific lysosomal enzyme glucocerebrosidase is considered as causative factor. The first effective treatment for the disease, the drug Ceredase, approved in 1995, was replaced in 2001 by the drug Cerezyme®. METHODS During the period 2004-2009 in our service 11 children were hospitalized and treated for Gaucher's disease: 9 children with type 1, and 2 children with type 3 of the disease. The enzymatic examinations of the biomarker chitotriosidase were performed in Sahlgren's University Hospital, Mölndal Sweden; the DNA analysis was performed in the Children's Hospital & Regional Medical Center, Seattle, USA. FINDINGS We are presenting the biological and genetic molecular data of the children. In our case series, one year after the treatment started, the hemoglobin level was normalized; the platelet count was normalized in 7 patients after one year of treatment, and in 9 patients after two years of treatment. The hemorrhagic syndrome stopped after 6 months of treatment. Chitotriosidase values decreased 10-20 times the initial value, after one year of treatment and in one case the value reached the normal range. The treatment with Cerezyme® has also improved the visceral and biological signs. Anomalies of the oculomotricity were less sensitive to the treatment. CONCLUSION According to our experience, Chitotriosidase is a sensitive and specific marker in diagnosing and monitoring Gaucher's disease. The enzyme replacement therapy through Cerezyme® is an effective and safe treatment of Gaucher's disease. Blood signs (anemia, platelet count); visceral signs (splenomegaly, hepatomegaly) as well as bone involvement showed decisive improvement under the therapy.
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Affiliation(s)
- Behar Shehi
- Department of Pediatrics, University Hospital Center “Mother Theresa”, Tirana, Albania
| | - Gëzim Boçari
- Department of Biomedical and Experimental, University Hospital Center “Mother Theresa”, Tirana, Albania
| | - Gentian Vyshka
- Department of Physiology, University Hospital Center “Mother Theresa”, Tirana, Albania
| | - Rezar Xhepa
- Department of Pediatrics, University Hospital Center “Mother Theresa”, Tirana, Albania
| | - Dritan Alushani
- Department of Pediatric Surgery, University Hospital Center “Mother Theresa”, Tirana, Albania
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28
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Kzhyshkowska J, Gratchev A, Goerdt S. Human chitinases and chitinase-like proteins as indicators for inflammation and cancer. Biomark Insights 2007; 2:128-46. [PMID: 19662198 PMCID: PMC2717817] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Human Glyco_18 domain-containing proteins constitute a family of chitinases and chitinase-like proteins. Chitotriosidase and AMCase are true enzymes which hydrolyse chitin and have a C-terminal chitin-binding domain. YKL-40, YKL-39, SI-CLP and murine YM1/2 proteins possess solely Glyco_18 domain and do not have the hydrolytic activity. The major sources of Glyco_18 containing proteins are macrophages, neutrophils, epithelial cells, chondrocytes, synovial cells, and cancer cells. Both macrophages and neutrophils use the regulated secretory mechanism for the release of Glyco_18 containing proteins. Glyco_18 containing proteins are established biomarkers for human diseases. Chitotriosidase is overproduced by lipid-laden macrophages and is a major marker for the inherited lysosomal storage Gaucher disease. AMCase and murine lectin YM1 are upregulated in Th2-environment, and enzymatic activity of AMCase contributes to asthma pathogenesis. YKL proteins act as soluble mediators for the cell proliferation and migration, and are also involved in rheumatoid arthritis, inflammatory bowel disease, hepatic fibrosis and cirrhosis. Chitotriosidase and YKL-40 reflect the macrophage activation in atherosclerotic plaques. Serum level of YKL-40 is a diagnostic and prognostic marker for numerous types of solid tumors. YKL-39 is a marker for the activation of chondrocytes and the progression of the osteoarthritis in human. Recently identified SI-CLP is upregulated by Th2 cytokine IL-4 as well as by glucocorticoids. This unique feature of SI-CLP makes it an attractive candidate for the examination of individual sensitivity of patients to glucocorticoid treatment and prediction of side effects of glucocorticoid therapy. Human chitinases and chitinase-like proteins are found in tissues and circulation, and can be detected by non-invasive technologies.
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Affiliation(s)
- Julia Kzhyshkowska
- Correspondence: Julia Kzhyshkowska, Tel: +49 621 383 2440; Fax: +49 621 383 3815 julia.kzhyshkowska @haut.ma.uni-heidelberg.de,
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